AIM:
To compare the subsequent reproductive outcome after laparoscopic salpingostomy or salpingec... more AIM: To compare the subsequent reproductive outcome after laparoscopic salpingostomy or salpingectomy for tubal ectopic pregnancy (EP).
MATERIAL OF STUDY: A retrospective cohort study was conducted between January 2002 and May 2014 on 132 women admitted to Unit of Gynecology and Obstetrics of the Department of Human Pathology in Adulthood and Childhood "G. Barresi", "Gaetano Martino" Hospital, University of Messina (Italy), with EP and who received surgical treatment, including laparoscopic salpingectomy (n=57) or salpingostomy (n=75). Main outcomes included intrauterine pregnancy (IUP), recurrent EP and persistent trophoblastic disease rates.
RESULTS: The IUP rates up to 24 months after surgery were 56.1% for salpingectomy and 60% for salpingostomy. The 2-year recurrent EP rates were 5.3% for salpingectomy and 18.7% for salpingostomy. The persistent trophoblastic disease rate were 1.8% for salpingectomy and 12% for salpingostomy.
DISCUSSION: Our results show that the reproductive outcomes after laparoscopic salpingectomy are similar to those observed after conservative treatment.
CONCLUSIONS: In the surgical treatment of EP, the clinician should choose the best treatment in accordance with the patient, considering the severity of the disease, the clinical characteristics of the patient and her desire to preserve fertility.
The method of sentinel lymphnode is a new procedure, suitable for the cases of early diagnosed br... more The method of sentinel lymphnode is a new procedure, suitable for the cases of early diagnosed breast cancers: identifying the first lymphatic station of the cancer, it can avoid the axillary lymphadenectomy in those women with primitive invasive and unifocal neoplasis of not more than 1.5 cm in diameter and without lymphnodal invasion. So it is reduced the frequency of postoperative troubles (sensitive and motor diseases, lymphedema). In our study, we have researched and identified, using radioactive isotopes, the sentinel lymphnode in 20 women suffering from subclinic breast cancer. We have obtained a percentage of 5% of false negatives. The optimal level of identification of the sentinel lymphnode and the good level of predictivity about the axillary lymphatic status, that we have obtained, represent a further confirmation of the surety and validity of this method.
Background: During the past three decades, the incidence of hepatocellular carcinoma in the Unite... more Background: During the past three decades, the incidence of hepatocellular carcinoma in the United States has tripled. The neuroendocrine character has been observed in some tumor cells within some hepatocellular carcinoma nodules and elevated serum chromogranin A also been reported in patients with hepatocellular carcinoma. The aim of this work was to investigate the role of serum concentration of chromogranin A in patients with hepatocellular carcinoma at different stages. Methods: The study population consisted of 96 patients (63 males and 33 females age range 52-84) at their first hospital admission for hepatocellular carcinoma. The control group consisted of 35 volunteers (20 males and 15 females age range 50-80). The hepatocellular carcinoma patients were stratified according the Barcelona-Clinic Liver Cancer classification. Venous blood samples were collected before treatment from each patients before surgery, centrifuged to obtain serum samples and stored at -80°C until assayed. Results: The chromogranin A serum levels were elevated (> 100 ng/ml) in 72/96 patients with hepatocellular carcinoma. The serum levels of chromogranin A were significantly correlated (p<0.05) with alpha-fetoprotein. In comparison with controls, the hepatocellular carcinoma patients showed a significant increase (p<0.001) vs controls. The chromogranin A levels in the Barcelona staging of hepatocellular carcinoma was higher in stage D compared to stage C (p<0.01), to stage B (p<0.001), and to stage A (p<0.001). Conclusions: Molecular markers, such as chromogranin A, could be very useful tools for hepatocellular carcinoma diagnosis. However the molecular classification should be incorporated into a staging scheme, which effectively separated patients into groups with homogeneous prognosis and response to treatment, and thus serves to aid in the selection of appropriate therapy.
Background: Colorectal cancer represents the most common malignancy of the gastrointestinal tract... more Background: Colorectal cancer represents the most common malignancy of the gastrointestinal tract. Owing to differences in dietary habits and lifestyle, this neoplasm is more common in industrialized countries than in developing ones. Evidence from a wide range of sources supports the assumption that the link between diet and colorectal cancer may be due to an imbalance of the intestinal microflora. Discussion: Probiotic bacteria are live microorganisms that, when administered in adequate amounts, confer a healthy benefit on the host, and they have been investigated for their protective anti-tumor effects. In vivo and molecular studies have displayed encouraging findings that support a role of probiotics in colorectal cancer prevention. Summary: Several mechanisms could explain the preventive action of probiotics against colorectal cancer onset. They include: alteration of the intestinal microflora; inactivation of cancerogenic compounds; competition with putrefactive and pathogenic microbiota; improvement of the host's immune response; anti-proliferative effects via regulation of apoptosis and cell differentiation; fermentation of undigested food; inhibition of tyrosine kinase signaling pathways.
The new objective in primary hernia surgery should be the reduction of disabling chronic pain. Th... more The new objective in primary hernia surgery should be the reduction of disabling chronic pain. This article will discuss the safety, efficacy, and reduction of pain of a sutureless glue mesh procedure for primary uncomplicated inguinal hernia repair. We began performing sutureless glue mesh repairs in 2004 for primary uncomplicated inguinal hernias with good results. After reduction of the hernia sac, polypropylene medium-weight preshaped flat mesh is fixed to the posterior inguinal wall with 0.5 mL of fibrin glue on the pubic tubercle; another 1.5 mL is sprayed on the entire mesh surface. The cord is positioned in subcutaneous space. The TI.ME.LI (Tissucol/Tisseel for MEsh fixation in LIchtenstein hernia repair) trial was planned and conducted based on this experience. In two years, we treated more than 600 primary inguinal hernias with fibrin glue mesh fixation repair. At follow-up (2 to 96 months after surgery), no patients presented with severe pain, 2.7% of patients complained of moderate pain. Fibrin sealant for mesh fixation in open repair is well tolerated and it should be considered as a first-line option for mesh fixation in open inguinal hernia repair.
This review describes genetic and molecular changes related to adenocarcinoma of the esophagus an... more This review describes genetic and molecular changes related to adenocarcinoma of the esophagus and gastroesophageal junction (GEJ) with emphasis on prognostic value and possibilities for targeted therapy in clinical setting. The progression of Barrett's esophagus to adenocarcinoma has been the focus of particular scrutiny, and a number of potential tissue and serum-based disease biomarkers have emerged. Tissue biomarkers allowing risk stratification of Barrett's are reviewed as well as strategies currently being used to discover novel biomarkers that will facilitate the early detection of esophageal adenocarcinoma.
The post-thrombotic syndrome (PTS) is a long-term complication of deep venous thrombosis (DVT) th... more The post-thrombotic syndrome (PTS) is a long-term complication of deep venous thrombosis (DVT) that is characterized by chronic, persistent pain, swelling and other signs in the affected limb. PTS is common, burdensome and costly. It is likely to increase in prevalence, since despite widespread use of and improvements in the efficacy of thromboprophylaxis, the incidence of DVT has not decreased over time. Preventing ipsilateral recurrence of DVT, by ensuring an adequate duration and intensity of anticoagulation for the initial DVT and by prescribing situational thromboprophylaxis after discontinuation of oral anticoagulants, is likely to reduce the risk of developing PTS. Pending the results of ongoing studies, stockings are recommended in patients with persistent symptoms or swelling after DVT. Future research should focus on standardizing criteria for PTS diagnosis, identification of DVT patients at high risk for PTS, and rigorously evaluating the effectiveness of stockings, throm...
Hernia is due to abdominal wall weakening. This allows the contents of the abdomen to protrude fr... more Hernia is due to abdominal wall weakening. This allows the contents of the abdomen to protrude from normal boundaries. Hernias are repaired by implanting a sterile surgical mesh to strengthen the weakened abdominal wall. Aim of this study is to compare the results obtained by bard Composix® L/P mesh or Dualmesh Plus Gore® implanting. The mesh has various beneficial characteristics. It is a reinforcing material for the abdominal wall, even when in the direct contact with the intestinal tract does not cause adhsion problems. The use of biocompatible materials is necessary in laparoscopic hernia repair. e-PTFE prosthesis and Dual Mesh® were the first to be used for laparoscopic treatment of the abdominal wall defects. These prosthesis are the result of many improvements, actually they are 1-mm thick and the two surfaces have different characteristics. Compound meshes are composed by e-PTFE and polypropylene with different percentage of the two materials and methods of interactions. The...
Intestinal infarction is caused by secondary ischemic damage due to partial or complete obstructi... more Intestinal infarction is caused by secondary ischemic damage due to partial or complete obstruction of blood flow usually of arterial origin. About 50% of acute mesenteric infarctions are due to superior mesenteric artery emboli. Arterial thrombosis are most commonly caused to atherosclerosis, less commonly vasculitis, or hypercoaguable states. Venous thrombosis represents only 5-10% of cases usually associated with an hypercoagulable state, less commonly inflammation, portal hypertension or trauma. Non occlusive ischemia may represent up to 25% of acute mesenteric infarction, and is most commonly associated with shock, cardiac arrhythmia or acute pulmonary edema. From January 2002 to March 2007, 19 patients with intestinal infarction were treated, at the General Surgery and Oncology Department of Catania University. All patients were submitted to RX direct (RX) and computed tomography (CT). In 94.7% of patients RX has demonstrated clear bowel gaseous distension. Preoperative arteri...
Total thyroidectomy vs subtotal thyroidectomy for plurinodular goiter. Analysis 1517 cases. AIM O... more Total thyroidectomy vs subtotal thyroidectomy for plurinodular goiter. Analysis 1517 cases. AIM OF THE STUDY:The surgical treatment of benign thyroid diseases is still controversial, as there is a tendency by some Authors toward a more conservative treatments and wider treatments by others. OBJECTIVE: To claim and demonstrate that total thyroidectomy is the best and effective surgical therapy in benign thy-roid diseases. MATERIALS AND METHODS: Retrospective study based on an analysis of 2136 patients with benign thyroid diseases of the thyroid, observed from January 1985 to July 2008 in the Operative Unit of Surgical Clinic of the Ospedale Vittorio Emanuele of Catania. Patients with certain or suspected diagnosis of thyroid cancer have been drawn out from the study. RESULTS: 71% of the patient (that is 1517) were treated for a goiter, 5.9% with preoperative diagnosis of recurrent goiter; 105 cases of primary and non recurrent goiter (6.9%) were found to have foci of microcarcinoma (...
European review for medical and pharmacological sciences, 2012
Osteoblastoma is a rare benign tumor of bone that accounts for approximately 1% of primary skelet... more Osteoblastoma is a rare benign tumor of bone that accounts for approximately 1% of primary skeletal neoplasms, with around 90% of cases diagnosed in the second and third decades of life. Cervical spine is an usual localization of osteoblastoma. The main clinical manifestation in case of cervical spine location is a progressive and resistant pain, possibly accompanied by stiffness, scoliosis or other ailments, including severe neurological deficits. Owing to a non-specific clinical presentation of osteoblastoma, the delay in diagnosis is common. Osteoblastomas may have an aggressive behavior, tend to enlarge and damage the bone and adjacent structures. The treatment of choice is, therefore, a wide and complete surgical excision of the lesion in order to achieve full recovery and prevent recurrence or, in some cases, malignant transformation. In the case of persistent neck pain, not readily relieved by aspirin and possibly accompanied by stiffness, scoliosis or neurological deficits, ...
Intestinal infarction is caused by secondary ischemic damage due to partial or complete obstructi... more Intestinal infarction is caused by secondary ischemic damage due to partial or complete obstruction of blood flow usually of arterial origin. About 50% of acute mesenteric infarctions are due to superior mesenteric artery emboli. Arterial thrombosis are most commonly caused to atherosclerosis, less commonly vasculitis, or hypercoaguable states. Venous thrombosis represents only 5-10% of cases usually associated with an hypercoagulable state, less commonly inflammation, portal hypertension or trauma. Non occlusive ischemia may represent up to 25% of acute mesenteric infarction, and is most commonly associated with shock, cardiac arrhythmia or acute pulmonary edema. From January 2002 to March 2007, 19 patients with intestinal infarction were treated, at the General Surgery and Oncology Department of Catania University. All patients were submitted to RX direct (RX) and computed tomography (CT). In 94.7% of patients RX has demonstrated clear bowel gaseous distension. Preoperative arteri...
To evaluate feasibility, safety and effectiveness of laparoscopic biopsies in the diagnosis and s... more To evaluate feasibility, safety and effectiveness of laparoscopic biopsies in the diagnosis and stadiation of intraabdominal lymphadenopathy. From January 2005 to December 2006 12 patients (5 males, 7 females, age 31-54, average 43) with intra-abdominal lymphadenopathy were admitted to our institution (V Chirurgia Generale Ospedale Ferrarotto Catania) to perform laparoscopic biopsies. Indication to treatment was primary diagnosis in ten patients and restaging in two cases. Laparoscopic procedure was performed with a three-trocars technique also using an ultrasound laparoscopic probe. All cases were completed laparoscopically (conversion rate nil). Mean operation time: 35 min. All patients were discharged from hospital the day after the procedure. There were no complications. In all cases laparoscopic biopsies provided adequate tissue for correct diagnosis and complete immune-histochemical assessment (11 Lymphoma H, 1 Lymphoma NH). Today surgery has a new important role in the diagno...
Mesenteric cysts (MC) are a rare surgical condition occurring approximately in 1/200.000-350.000.... more Mesenteric cysts (MC) are a rare surgical condition occurring approximately in 1/200.000-350.000. The aetiology is unknown and the rarity of the tumor has led to confusion about their nature and classifi cation. They can be uni- or multi-locular, and are mostly benign. Approximately 830 cases have been reported in the literature and only four of them were found to be malignant. Cysts are usually diagnosed during routine abdominal examinations, they can present with various signs, such as acute abdominal pain, chronic abdominal pain, nausea and vomiting, or change in bowel habit. Although rare, shock due to rupture or bleeding of the cyst, intestinal obstruction secondary to external compression and volvulus or torsion of the cyst have been reported. Defi nitive treatment requires complete surgical resection of the cyst and is indicated when the lesion causes symptoms. We report a case of calcifi ed MC which was completely excised using the laparoscopic approach.
Resection of celiac axis for gastric cancer was first performed by Appleby in 1953. Subsequently,... more Resection of celiac axis for gastric cancer was first performed by Appleby in 1953. Subsequently, Mayumi et al. and Kimura et al. adopted this approach for locally advanced adenocarcinoma of pancreatic body. We are here describing this technique in case of adenocarcinoma of pancreatic body with infiltration of celiac axis achieving also gastric preservation. Our patient presented with diabetes, back pain and weight loss. CT scan showed a 3 cm mass in the body of pancreas infiltrating the origin of celiac axis, causing obstructive atrophy of pancreatic tail. Bilirubin, transaminases, amylase and tumoral markers were in the normal range with the exception of CEA (34 ng/ml) and chromogranin (30 IU/l). Vascular reconstruction imaging indicated the feasibility of the procedure. Under intraoperative ultrasound guidance we clamped the common hepatic artery in order to check the gastric and hepatic blood flow. We then performed a distal pancreasectomy and splenectomy with "en bloc"...
Rectal cancer predominantly affects elderly people, who are however more likely to have concomita... more Rectal cancer predominantly affects elderly people, who are however more likely to have concomitant medical diseases and, therefore, are at higer surgical risk. After a careful selection of the patients, some surgical procedures can be performed safely. We studied a series of 149 patients affected by low rectal cancer; of these, 46 were aged 75 or older and comprise the elderly group; 94 curative resections, 19 palliative surgical treatments, 31 local excisions were performed. This approach demonstrated to be safe and effective among older patients too; therefore we may conclude that it is associated with a good control of surgical risk and of cancer in selected patients.
AIM:
To compare the subsequent reproductive outcome after laparoscopic salpingostomy or salpingec... more AIM: To compare the subsequent reproductive outcome after laparoscopic salpingostomy or salpingectomy for tubal ectopic pregnancy (EP).
MATERIAL OF STUDY: A retrospective cohort study was conducted between January 2002 and May 2014 on 132 women admitted to Unit of Gynecology and Obstetrics of the Department of Human Pathology in Adulthood and Childhood "G. Barresi", "Gaetano Martino" Hospital, University of Messina (Italy), with EP and who received surgical treatment, including laparoscopic salpingectomy (n=57) or salpingostomy (n=75). Main outcomes included intrauterine pregnancy (IUP), recurrent EP and persistent trophoblastic disease rates.
RESULTS: The IUP rates up to 24 months after surgery were 56.1% for salpingectomy and 60% for salpingostomy. The 2-year recurrent EP rates were 5.3% for salpingectomy and 18.7% for salpingostomy. The persistent trophoblastic disease rate were 1.8% for salpingectomy and 12% for salpingostomy.
DISCUSSION: Our results show that the reproductive outcomes after laparoscopic salpingectomy are similar to those observed after conservative treatment.
CONCLUSIONS: In the surgical treatment of EP, the clinician should choose the best treatment in accordance with the patient, considering the severity of the disease, the clinical characteristics of the patient and her desire to preserve fertility.
The method of sentinel lymphnode is a new procedure, suitable for the cases of early diagnosed br... more The method of sentinel lymphnode is a new procedure, suitable for the cases of early diagnosed breast cancers: identifying the first lymphatic station of the cancer, it can avoid the axillary lymphadenectomy in those women with primitive invasive and unifocal neoplasis of not more than 1.5 cm in diameter and without lymphnodal invasion. So it is reduced the frequency of postoperative troubles (sensitive and motor diseases, lymphedema). In our study, we have researched and identified, using radioactive isotopes, the sentinel lymphnode in 20 women suffering from subclinic breast cancer. We have obtained a percentage of 5% of false negatives. The optimal level of identification of the sentinel lymphnode and the good level of predictivity about the axillary lymphatic status, that we have obtained, represent a further confirmation of the surety and validity of this method.
Background: During the past three decades, the incidence of hepatocellular carcinoma in the Unite... more Background: During the past three decades, the incidence of hepatocellular carcinoma in the United States has tripled. The neuroendocrine character has been observed in some tumor cells within some hepatocellular carcinoma nodules and elevated serum chromogranin A also been reported in patients with hepatocellular carcinoma. The aim of this work was to investigate the role of serum concentration of chromogranin A in patients with hepatocellular carcinoma at different stages. Methods: The study population consisted of 96 patients (63 males and 33 females age range 52-84) at their first hospital admission for hepatocellular carcinoma. The control group consisted of 35 volunteers (20 males and 15 females age range 50-80). The hepatocellular carcinoma patients were stratified according the Barcelona-Clinic Liver Cancer classification. Venous blood samples were collected before treatment from each patients before surgery, centrifuged to obtain serum samples and stored at -80°C until assayed. Results: The chromogranin A serum levels were elevated (> 100 ng/ml) in 72/96 patients with hepatocellular carcinoma. The serum levels of chromogranin A were significantly correlated (p<0.05) with alpha-fetoprotein. In comparison with controls, the hepatocellular carcinoma patients showed a significant increase (p<0.001) vs controls. The chromogranin A levels in the Barcelona staging of hepatocellular carcinoma was higher in stage D compared to stage C (p<0.01), to stage B (p<0.001), and to stage A (p<0.001). Conclusions: Molecular markers, such as chromogranin A, could be very useful tools for hepatocellular carcinoma diagnosis. However the molecular classification should be incorporated into a staging scheme, which effectively separated patients into groups with homogeneous prognosis and response to treatment, and thus serves to aid in the selection of appropriate therapy.
Background: Colorectal cancer represents the most common malignancy of the gastrointestinal tract... more Background: Colorectal cancer represents the most common malignancy of the gastrointestinal tract. Owing to differences in dietary habits and lifestyle, this neoplasm is more common in industrialized countries than in developing ones. Evidence from a wide range of sources supports the assumption that the link between diet and colorectal cancer may be due to an imbalance of the intestinal microflora. Discussion: Probiotic bacteria are live microorganisms that, when administered in adequate amounts, confer a healthy benefit on the host, and they have been investigated for their protective anti-tumor effects. In vivo and molecular studies have displayed encouraging findings that support a role of probiotics in colorectal cancer prevention. Summary: Several mechanisms could explain the preventive action of probiotics against colorectal cancer onset. They include: alteration of the intestinal microflora; inactivation of cancerogenic compounds; competition with putrefactive and pathogenic microbiota; improvement of the host's immune response; anti-proliferative effects via regulation of apoptosis and cell differentiation; fermentation of undigested food; inhibition of tyrosine kinase signaling pathways.
The new objective in primary hernia surgery should be the reduction of disabling chronic pain. Th... more The new objective in primary hernia surgery should be the reduction of disabling chronic pain. This article will discuss the safety, efficacy, and reduction of pain of a sutureless glue mesh procedure for primary uncomplicated inguinal hernia repair. We began performing sutureless glue mesh repairs in 2004 for primary uncomplicated inguinal hernias with good results. After reduction of the hernia sac, polypropylene medium-weight preshaped flat mesh is fixed to the posterior inguinal wall with 0.5 mL of fibrin glue on the pubic tubercle; another 1.5 mL is sprayed on the entire mesh surface. The cord is positioned in subcutaneous space. The TI.ME.LI (Tissucol/Tisseel for MEsh fixation in LIchtenstein hernia repair) trial was planned and conducted based on this experience. In two years, we treated more than 600 primary inguinal hernias with fibrin glue mesh fixation repair. At follow-up (2 to 96 months after surgery), no patients presented with severe pain, 2.7% of patients complained of moderate pain. Fibrin sealant for mesh fixation in open repair is well tolerated and it should be considered as a first-line option for mesh fixation in open inguinal hernia repair.
This review describes genetic and molecular changes related to adenocarcinoma of the esophagus an... more This review describes genetic and molecular changes related to adenocarcinoma of the esophagus and gastroesophageal junction (GEJ) with emphasis on prognostic value and possibilities for targeted therapy in clinical setting. The progression of Barrett's esophagus to adenocarcinoma has been the focus of particular scrutiny, and a number of potential tissue and serum-based disease biomarkers have emerged. Tissue biomarkers allowing risk stratification of Barrett's are reviewed as well as strategies currently being used to discover novel biomarkers that will facilitate the early detection of esophageal adenocarcinoma.
The post-thrombotic syndrome (PTS) is a long-term complication of deep venous thrombosis (DVT) th... more The post-thrombotic syndrome (PTS) is a long-term complication of deep venous thrombosis (DVT) that is characterized by chronic, persistent pain, swelling and other signs in the affected limb. PTS is common, burdensome and costly. It is likely to increase in prevalence, since despite widespread use of and improvements in the efficacy of thromboprophylaxis, the incidence of DVT has not decreased over time. Preventing ipsilateral recurrence of DVT, by ensuring an adequate duration and intensity of anticoagulation for the initial DVT and by prescribing situational thromboprophylaxis after discontinuation of oral anticoagulants, is likely to reduce the risk of developing PTS. Pending the results of ongoing studies, stockings are recommended in patients with persistent symptoms or swelling after DVT. Future research should focus on standardizing criteria for PTS diagnosis, identification of DVT patients at high risk for PTS, and rigorously evaluating the effectiveness of stockings, throm...
Hernia is due to abdominal wall weakening. This allows the contents of the abdomen to protrude fr... more Hernia is due to abdominal wall weakening. This allows the contents of the abdomen to protrude from normal boundaries. Hernias are repaired by implanting a sterile surgical mesh to strengthen the weakened abdominal wall. Aim of this study is to compare the results obtained by bard Composix® L/P mesh or Dualmesh Plus Gore® implanting. The mesh has various beneficial characteristics. It is a reinforcing material for the abdominal wall, even when in the direct contact with the intestinal tract does not cause adhsion problems. The use of biocompatible materials is necessary in laparoscopic hernia repair. e-PTFE prosthesis and Dual Mesh® were the first to be used for laparoscopic treatment of the abdominal wall defects. These prosthesis are the result of many improvements, actually they are 1-mm thick and the two surfaces have different characteristics. Compound meshes are composed by e-PTFE and polypropylene with different percentage of the two materials and methods of interactions. The...
Intestinal infarction is caused by secondary ischemic damage due to partial or complete obstructi... more Intestinal infarction is caused by secondary ischemic damage due to partial or complete obstruction of blood flow usually of arterial origin. About 50% of acute mesenteric infarctions are due to superior mesenteric artery emboli. Arterial thrombosis are most commonly caused to atherosclerosis, less commonly vasculitis, or hypercoaguable states. Venous thrombosis represents only 5-10% of cases usually associated with an hypercoagulable state, less commonly inflammation, portal hypertension or trauma. Non occlusive ischemia may represent up to 25% of acute mesenteric infarction, and is most commonly associated with shock, cardiac arrhythmia or acute pulmonary edema. From January 2002 to March 2007, 19 patients with intestinal infarction were treated, at the General Surgery and Oncology Department of Catania University. All patients were submitted to RX direct (RX) and computed tomography (CT). In 94.7% of patients RX has demonstrated clear bowel gaseous distension. Preoperative arteri...
Total thyroidectomy vs subtotal thyroidectomy for plurinodular goiter. Analysis 1517 cases. AIM O... more Total thyroidectomy vs subtotal thyroidectomy for plurinodular goiter. Analysis 1517 cases. AIM OF THE STUDY:The surgical treatment of benign thyroid diseases is still controversial, as there is a tendency by some Authors toward a more conservative treatments and wider treatments by others. OBJECTIVE: To claim and demonstrate that total thyroidectomy is the best and effective surgical therapy in benign thy-roid diseases. MATERIALS AND METHODS: Retrospective study based on an analysis of 2136 patients with benign thyroid diseases of the thyroid, observed from January 1985 to July 2008 in the Operative Unit of Surgical Clinic of the Ospedale Vittorio Emanuele of Catania. Patients with certain or suspected diagnosis of thyroid cancer have been drawn out from the study. RESULTS: 71% of the patient (that is 1517) were treated for a goiter, 5.9% with preoperative diagnosis of recurrent goiter; 105 cases of primary and non recurrent goiter (6.9%) were found to have foci of microcarcinoma (...
European review for medical and pharmacological sciences, 2012
Osteoblastoma is a rare benign tumor of bone that accounts for approximately 1% of primary skelet... more Osteoblastoma is a rare benign tumor of bone that accounts for approximately 1% of primary skeletal neoplasms, with around 90% of cases diagnosed in the second and third decades of life. Cervical spine is an usual localization of osteoblastoma. The main clinical manifestation in case of cervical spine location is a progressive and resistant pain, possibly accompanied by stiffness, scoliosis or other ailments, including severe neurological deficits. Owing to a non-specific clinical presentation of osteoblastoma, the delay in diagnosis is common. Osteoblastomas may have an aggressive behavior, tend to enlarge and damage the bone and adjacent structures. The treatment of choice is, therefore, a wide and complete surgical excision of the lesion in order to achieve full recovery and prevent recurrence or, in some cases, malignant transformation. In the case of persistent neck pain, not readily relieved by aspirin and possibly accompanied by stiffness, scoliosis or neurological deficits, ...
Intestinal infarction is caused by secondary ischemic damage due to partial or complete obstructi... more Intestinal infarction is caused by secondary ischemic damage due to partial or complete obstruction of blood flow usually of arterial origin. About 50% of acute mesenteric infarctions are due to superior mesenteric artery emboli. Arterial thrombosis are most commonly caused to atherosclerosis, less commonly vasculitis, or hypercoaguable states. Venous thrombosis represents only 5-10% of cases usually associated with an hypercoagulable state, less commonly inflammation, portal hypertension or trauma. Non occlusive ischemia may represent up to 25% of acute mesenteric infarction, and is most commonly associated with shock, cardiac arrhythmia or acute pulmonary edema. From January 2002 to March 2007, 19 patients with intestinal infarction were treated, at the General Surgery and Oncology Department of Catania University. All patients were submitted to RX direct (RX) and computed tomography (CT). In 94.7% of patients RX has demonstrated clear bowel gaseous distension. Preoperative arteri...
To evaluate feasibility, safety and effectiveness of laparoscopic biopsies in the diagnosis and s... more To evaluate feasibility, safety and effectiveness of laparoscopic biopsies in the diagnosis and stadiation of intraabdominal lymphadenopathy. From January 2005 to December 2006 12 patients (5 males, 7 females, age 31-54, average 43) with intra-abdominal lymphadenopathy were admitted to our institution (V Chirurgia Generale Ospedale Ferrarotto Catania) to perform laparoscopic biopsies. Indication to treatment was primary diagnosis in ten patients and restaging in two cases. Laparoscopic procedure was performed with a three-trocars technique also using an ultrasound laparoscopic probe. All cases were completed laparoscopically (conversion rate nil). Mean operation time: 35 min. All patients were discharged from hospital the day after the procedure. There were no complications. In all cases laparoscopic biopsies provided adequate tissue for correct diagnosis and complete immune-histochemical assessment (11 Lymphoma H, 1 Lymphoma NH). Today surgery has a new important role in the diagno...
Mesenteric cysts (MC) are a rare surgical condition occurring approximately in 1/200.000-350.000.... more Mesenteric cysts (MC) are a rare surgical condition occurring approximately in 1/200.000-350.000. The aetiology is unknown and the rarity of the tumor has led to confusion about their nature and classifi cation. They can be uni- or multi-locular, and are mostly benign. Approximately 830 cases have been reported in the literature and only four of them were found to be malignant. Cysts are usually diagnosed during routine abdominal examinations, they can present with various signs, such as acute abdominal pain, chronic abdominal pain, nausea and vomiting, or change in bowel habit. Although rare, shock due to rupture or bleeding of the cyst, intestinal obstruction secondary to external compression and volvulus or torsion of the cyst have been reported. Defi nitive treatment requires complete surgical resection of the cyst and is indicated when the lesion causes symptoms. We report a case of calcifi ed MC which was completely excised using the laparoscopic approach.
Resection of celiac axis for gastric cancer was first performed by Appleby in 1953. Subsequently,... more Resection of celiac axis for gastric cancer was first performed by Appleby in 1953. Subsequently, Mayumi et al. and Kimura et al. adopted this approach for locally advanced adenocarcinoma of pancreatic body. We are here describing this technique in case of adenocarcinoma of pancreatic body with infiltration of celiac axis achieving also gastric preservation. Our patient presented with diabetes, back pain and weight loss. CT scan showed a 3 cm mass in the body of pancreas infiltrating the origin of celiac axis, causing obstructive atrophy of pancreatic tail. Bilirubin, transaminases, amylase and tumoral markers were in the normal range with the exception of CEA (34 ng/ml) and chromogranin (30 IU/l). Vascular reconstruction imaging indicated the feasibility of the procedure. Under intraoperative ultrasound guidance we clamped the common hepatic artery in order to check the gastric and hepatic blood flow. We then performed a distal pancreasectomy and splenectomy with "en bloc"...
Rectal cancer predominantly affects elderly people, who are however more likely to have concomita... more Rectal cancer predominantly affects elderly people, who are however more likely to have concomitant medical diseases and, therefore, are at higer surgical risk. After a careful selection of the patients, some surgical procedures can be performed safely. We studied a series of 149 patients affected by low rectal cancer; of these, 46 were aged 75 or older and comprise the elderly group; 94 curative resections, 19 palliative surgical treatments, 31 local excisions were performed. This approach demonstrated to be safe and effective among older patients too; therefore we may conclude that it is associated with a good control of surgical risk and of cancer in selected patients.
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Papers by Antonio Biondi
To compare the subsequent reproductive outcome after laparoscopic salpingostomy or salpingectomy for tubal ectopic pregnancy (EP).
MATERIAL OF STUDY:
A retrospective cohort study was conducted between January 2002 and May 2014 on 132 women admitted to Unit of Gynecology and Obstetrics of the Department of Human Pathology in Adulthood and Childhood "G. Barresi", "Gaetano Martino" Hospital, University of Messina (Italy), with EP and who received surgical treatment, including laparoscopic salpingectomy (n=57) or salpingostomy (n=75). Main outcomes included intrauterine pregnancy (IUP), recurrent EP and persistent trophoblastic disease rates.
RESULTS:
The IUP rates up to 24 months after surgery were 56.1% for salpingectomy and 60% for salpingostomy. The 2-year recurrent EP rates were 5.3% for salpingectomy and 18.7% for salpingostomy. The persistent trophoblastic disease rate were 1.8% for salpingectomy and 12% for salpingostomy.
DISCUSSION:
Our results show that the reproductive outcomes after laparoscopic salpingectomy are similar to those observed after conservative treatment.
CONCLUSIONS:
In the surgical treatment of EP, the clinician should choose the best treatment in accordance with the patient, considering the severity of the disease, the clinical characteristics of the patient and her desire to preserve fertility.
To compare the subsequent reproductive outcome after laparoscopic salpingostomy or salpingectomy for tubal ectopic pregnancy (EP).
MATERIAL OF STUDY:
A retrospective cohort study was conducted between January 2002 and May 2014 on 132 women admitted to Unit of Gynecology and Obstetrics of the Department of Human Pathology in Adulthood and Childhood "G. Barresi", "Gaetano Martino" Hospital, University of Messina (Italy), with EP and who received surgical treatment, including laparoscopic salpingectomy (n=57) or salpingostomy (n=75). Main outcomes included intrauterine pregnancy (IUP), recurrent EP and persistent trophoblastic disease rates.
RESULTS:
The IUP rates up to 24 months after surgery were 56.1% for salpingectomy and 60% for salpingostomy. The 2-year recurrent EP rates were 5.3% for salpingectomy and 18.7% for salpingostomy. The persistent trophoblastic disease rate were 1.8% for salpingectomy and 12% for salpingostomy.
DISCUSSION:
Our results show that the reproductive outcomes after laparoscopic salpingectomy are similar to those observed after conservative treatment.
CONCLUSIONS:
In the surgical treatment of EP, the clinician should choose the best treatment in accordance with the patient, considering the severity of the disease, the clinical characteristics of the patient and her desire to preserve fertility.