Papers by Giorgio C Ginesu
International journal of surgery case reports, Jan 21, 2016
Broncho-esophageal fistula is a rare clinical condition which can be manifested with non-specific... more Broncho-esophageal fistula is a rare clinical condition which can be manifested with non-specific signs and symptoms. Here, we report an adult case of a broncho-esophageal fistula in a 43-year-old man referred for chronic cough after fluid food intake and weight loss. Barium swallow, esophagogastroduodenoscopy, bronchoscopy and Computed Tomography of the chest demonstrated a broncho-esophageal fistula between the apical segmental bronchus of the lower right lobe and the middle section of the esophagus. The patient underwent video-assisted thoracoscopic surgery for resection of the fistula. No post-operative complications occurred. Broncho-esophageal fistula in adults is rare and its diagnosis is often delayed due to the frequent lack of specific symptoms. Although there is no standard protocol, the most widely used treatment is thoracotomy with identification and dissection of the fistula tract followed by repair of bronchial and esophageal defects. Video-assisted thoracoscopic surg...
Journal of Pediatric Surgery, Jan 4, 2005
Background/Purpose: In the United States, the treatment of choice for the correction of phimosis ... more Background/Purpose: In the United States, the treatment of choice for the correction of phimosis is circumcision, whereas in European countries, the condition is usually treated by preputial plasty using Duhamel's method or modified versions. We report our experience in correcting phimosis by preputial plasty using transversal widening on the dorsal side with EMLA local anesthetic cream. Methods: Twenty-six patients with phimosis were operated on by preputial plasty, under local anesthesia with EMLA cream. A transversal incision is made on the dorsal side of the ring of prepuce, like 3 contiguous Ts, the middle one inverted with the long arm on the preputial mucosa side. The 2 small mucocutaneous flaps of the prepuce are separated and then sutured with interrupted stitches, thus transforming the incisions from T to V. Results: No postoperative complications were observed. At 1-year follow-up, the cosmetic and functional results were satisfactory. Conclusions: The technique of preputial plasty that the authors present enlarges the stenotic ring of prepuce by a transversal widening on the dorsal side. The ring of prepuce obtained is wide and symmetrical on its dorsal and ventral sides and therefore cosmetically and functionally satisfactory. It is a good alternative to the more radical circumcision technique. D
The Journal of Urology, Jan 10, 2003
Purpose: The most common techniques to reconstruct the urethra for severe hypospadias or epispadi... more Purpose: The most common techniques to reconstruct the urethra for severe hypospadias or epispadias involve use of the genital skin. Buccal mucosa free graft is usually used in a second operation due to a paucity of usable genital tissue. We report our experience using buccal mucosa free graft as primary surgery for hypospadias and epispadias.
Multidisciplinary Respiratory Medicine, 2016
International surgery
We report our experience on 10 patients with primary tumors of the appendix treated at our instit... more We report our experience on 10 patients with primary tumors of the appendix treated at our institution from 1998 to 2005. There were 5 women and 5 men, with a mean age of 59.1 years. Laparotomy was performed in 4 cases; whereas, the other 6 patients underwent laparoscopic exploration: Three operations were completed laparoscopically, and 3 were converted to laparotomy. Six tumors were malignant, and the remaining were benign. Proportions of perioperative and late mortality were both 10%. Two of the four patients with benign tumors died from causes unrelated to the appendiceal neoplasm. The 6 patients with malignant tumors and the other 2 with benign disease were alive and disease free after a mean follow-up of 43 months. Despite the rarity of appendiceal primary tumors, surgeons should be aware of these neoplasms for making correct treatment decisions. We stress the importance of laparoscopic exploration in the management of appendiceal masses.
European journal of gastroenterology & hepatology, 2004
The widespread use of ultrasound in screening programmes for chronic liver disease has led to ear... more The widespread use of ultrasound in screening programmes for chronic liver disease has led to early diagnosis of hepatocellular carcinoma (HCC), and to the observation of some cases of tumour spontaneous regression. This is a rare event whose underlying mechanism is still unclear. We present here a case of spontaneous regression of HCC in a 71-year-old woman with chronic hepatitis and discuss possible aetiologies. None of the causative mechanisms proposed for spontaneous regression of HCC is completely satisfactory, so further studies are necessary to improve understanding of this unusual biological event. Therefore, we stress the importance of accumulating all such cases in the literature, because the clarification of aetio-pathogenic mechanisms may lead to the development of new treatment strategies for HCC.
Journal of Gastrointestinal Surgery, 2010
Introduction Bouveret's syndrome (gastric outlet obstruction due to impaction of a stone) is a ra... more Introduction Bouveret's syndrome (gastric outlet obstruction due to impaction of a stone) is a rare variant of gallstone ileus. A recently observed case led us to review the literature, with the aim to discuss the recent advances in the management of this rare syndrome. Discussion A 69-year-old woman was admitted with symptoms of high intestinal obstruction. Computed tomography scan of the abdomen showed a large gallstone impacted in the duodenum. One-stage surgery, consisting in enterolithotomy, cholecystectomy, and fistula repair, was carried out. Although several surgical and nonoperative procedures have been used, the optimal treatment of Bouveret's syndrome remains controversial. Surgery still maintains a prominent position, even though nonoperative procedures have an increasing role especially in high risk patients with important comorbidities. The decision should be taken on an individual basis, after evaluating patient's general condition and age, stone size, comorbidities influencing the operative risk, and expertise of surgical and endoscopic teams. One-stage surgery may offer definitive management in selected patients.
European Journal of Gastroenterology & Hepatology, 2004
Digestive Diseases and Sciences, 2005
KEY WORDS: greater omentum; torsion; acute abdomen.
Clinical Radiology, 2002
AIM: To assess the usefulness of self-expandable metal stents in the recanalization of cervical a... more AIM: To assess the usefulness of self-expandable metal stents in the recanalization of cervical and/or hypopharyngeal strictures. MATERIALS AND METHODS: We report our experience in 10 patients with inoperable cervical and/or hypopharyngeal strictures treated by implantation of 11 uncovered self-expandable metal stents inserted perorally under¯uoroscopic guidance. The stent was placed in the hypopharynx and cervical oesophagus in 3 patients and cervical oesophagus alone in 7. There were 8 men and 2 women, mean age 70.2 years, range 45±85 years. All patients but two had malignant stricture caused by squamous cell carcinoma, in one case there was a benign postoperative stenosis secondary to laryngectomy, and in the last patient a local recurrence from thyroid cancer. RESULTS: Eleven stents were placed in 10 patients: technical success was achieved in 9 cases while clinical improvement was obtained in 8 cases. Seven of ten patients had a rapid improvement of dysphagia. One patient had a distal misplacement of the prosthesis, while in the other two cases stent position was very proximal and interfered with swallowing. A mean 9-month follow-up was obtained (range 3±24 months). Four patients with malignant stricture developed proliferation of neoplastic tissue after 2±5 months. The only patient treated for a benign stricture developed inside proliferation of granulation tissue after 4 months. CONCLUSION: Despite several technical diculties and a high rate of late complications, recanalization of cervical oesophageal strictures by self-expandable metal stents allowed good palliation of symptoms. Stents proved to be eective and well tolerated palliative treatment also for hypopharyngeal stenoses.
Neurilemmomas – or schwannomas – are rare soft tissue tumours involving peripheral nerve sheaths,... more Neurilemmomas – or schwannomas – are rare soft tissue tumours involving peripheral nerve sheaths, usually found in the head and neck regions. They can infrequently originate within the tissues of the abdominal wall. Here, we present a case of symptomatic schwannoma of the abdominal wall in a 62-year-old woman referred for abdominal pain in the right iliac fossa. On physical examination, a 5-7 cm oval-shaped area of consolidation with regular borders and elastic consistence was palpable. Ultrasound examination of the abdomen revealed a hypoechogenic mass measuring 80-33-42 mm; subsequently, a CT scan confirmed the presence of a well-circumscribed mass, with small calcifications inside. Radical excision of the lesion under general anaesthesia was performed and the histological examination was consistent with the diagnosis of “ancient” schwannoma.
The patient was discharged on the second postoperative day and, at a clinical check one month post-operation, she reported no recurrence of abdominal pain and had an improved quality of life.
Schwannomas have a good prognosis overall, with malignant degeneration being very rare. Local recurrence is plausible only if non-radical resection of the primitive tumour occurs. This is the second case ever reported, to our knowledge, of symptomatic schwannoma of the abdominal wall. We advocate surgical removal of the tumour when it presents as a cause of abdominal pain, ensuring that a radical excision is performed due to the possibility – though rare – of malignant transformation or recurrence. This offers the possibility of total regression of symptoms through surgical therapy.
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Papers by Giorgio C Ginesu
The patient was discharged on the second postoperative day and, at a clinical check one month post-operation, she reported no recurrence of abdominal pain and had an improved quality of life.
Schwannomas have a good prognosis overall, with malignant degeneration being very rare. Local recurrence is plausible only if non-radical resection of the primitive tumour occurs. This is the second case ever reported, to our knowledge, of symptomatic schwannoma of the abdominal wall. We advocate surgical removal of the tumour when it presents as a cause of abdominal pain, ensuring that a radical excision is performed due to the possibility – though rare – of malignant transformation or recurrence. This offers the possibility of total regression of symptoms through surgical therapy.
The patient was discharged on the second postoperative day and, at a clinical check one month post-operation, she reported no recurrence of abdominal pain and had an improved quality of life.
Schwannomas have a good prognosis overall, with malignant degeneration being very rare. Local recurrence is plausible only if non-radical resection of the primitive tumour occurs. This is the second case ever reported, to our knowledge, of symptomatic schwannoma of the abdominal wall. We advocate surgical removal of the tumour when it presents as a cause of abdominal pain, ensuring that a radical excision is performed due to the possibility – though rare – of malignant transformation or recurrence. This offers the possibility of total regression of symptoms through surgical therapy.