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1.
Br J Surg ; 98(11): 1635-43, 2011 Nov.
Artículo en Inglés | MEDLINE | ID: mdl-21713758

RESUMEN

BACKGROUND: Of the few studies that have investigated quality-of-life (QoL) outcomes after transanal endoscopic microsurgery (TEM), the majority have reported only short-term follow-up data. This study assessed long-term clinical and instrumental outcomes (QoL, sexual, urinary and sphincter function) after TEM for extraperitoneal rectal cancer. METHODS: Preoperative and postoperative anorectal function was assessed in consecutive patients with benign rectal lesions or early rectal cancer, based on clinical scores and anorectal manometry. RESULTS: Between January 2000 and July 2005, 93 patients undergoing TEM completed the 60-month study protocol. The mean Wexner continence score increased from baseline at 3 months, began to decline within 12 months, and had returned to the preoperative value at 60 months. Urgency was reported by 65·0, 30·0 and 5 per cent of patients at 3, 12 and 60 months respectively (P < 0·050). A significant improvement was noted in various clinical and QoL scores at 12 and 60 months. Postoperative manometry values at 3 months were significantly lower than at baseline (P < 0·050), but had returned to preoperative values at 12 months. Tumour size of 4 cm or above was the only factor that significantly (P = 0·008) affected the rectal sensitivity threshold, the urge to defaecate threshold and the maximum tolerated volume at 3 months after TEM. CONCLUSION: TEM had no long-term effect on anorectal function or QoL. Lower anal resting pressure at early follow-up was not associated with defaecation problems in patients who were continent before surgery.


Asunto(s)
Adenocarcinoma/cirugía , Adenoma/cirugía , Microcirugia/efectos adversos , Calidad de Vida , Neoplasias del Recto/cirugía , Adenocarcinoma/fisiopatología , Adenoma/fisiopatología , Anciano , Anciano de 80 o más Años , Incontinencia Fecal/etiología , Incontinencia Fecal/fisiopatología , Femenino , Humanos , Masculino , Manometría , Microcirugia/métodos , Persona de Mediana Edad , Complicaciones Posoperatorias/etiología , Complicaciones Posoperatorias/fisiopatología , Presión , Proctoscopía/métodos , Estudios Prospectivos , Neoplasias del Recto/fisiopatología
2.
J Visc Surg ; 158(3): 198-203, 2021 Jun.
Artículo en Inglés | MEDLINE | ID: mdl-32446913

RESUMEN

INTRODUCTION: Laparoscopic sleeve gastrectomy (LSG) is the most popular bariatric procedure worldwide. A tremendous recent increase in the number of LSGs has not been driven by an accurate learning process, especially in low volume bariatric centers. The cumulative-sum (CUSUM) method is an effective analysis of the learning process, taking intraoperative and postoperative variables into account. This study was aimed at establishing a CUSUM learning curve for LSG in order to define the number of procedures needed to achieve sufficient surgical skill. METHODS: All LSGs performed by a single general surgeon between September 2014 and November 2017 were considered. We hypothesized that the key t variables related to the LSG learning process (LP) are: operative time (OT), intraoperative complications or difficulties, need for expert assistance, length of hospital stay (LOS), and 3-month postoperative morbidity. All of these parameters are binary variables analyzed with the risk-adjusted CUSUM method. Two groups, learning group (LG) and experienced group (EG), were identified and compared by univariate analysis. Multivariate analysis was performed to identify the variables most closely associated with operative time and surgical success. One-year weight loss outcomes were likewise analyzed. RESULTS: One hundred and ten (110) consecutive LSGs were considered. CUSUM-LSG showed that the mean number of consecutive interventions necessary to reach proficiency in LSG was 58. In multivariate analysis, surgical success was negatively correlated with longer operative time and need for expert assistance. Body mass index was not correlated with surgical success. CONCLUSION: Fifty-eight LSG procedures were required to achieve surgical skill. Operative time and the need for expert assistance were variables most closely associated with surgical success. ACGME COMPETENCY: Practice-based learning and improvement.


Asunto(s)
Laparoscopía , Obesidad Mórbida , Estudios de Seguimiento , Gastrectomía , Humanos , Obesidad Mórbida/cirugía , Estudios Retrospectivos , Resultado del Tratamiento
3.
Aliment Pharmacol Ther ; 25(7): 835-40, 2007 Apr 01.
Artículo en Inglés | MEDLINE | ID: mdl-17373922

RESUMEN

BACKGROUND: Argon plasma coagulation seems to be a promising technique for ablation of Barrett's oesophagus, yet few long-term efficacy data are available. AIM: To report on a long-term follow-up and the factors that determine the recurrence of intestinal metaplasia in a cohort of patients with non dysplastic, intestinal type Barrett's oesophagus, after complete ablation of the metaplastic mucosa with argon plasma coagulation. METHODS: Ninety-six patients underwent endoscopic argon plasma coagulation with adequate acid suppression obtained through a continuous omeprazole therapy (50 patients) or through laparoscopic fundoplication (46 patients). Complete ablation was achieved in 94 patients who underwent follow-up. Endoscopic and histological examinations were performed every 12 months. RESULTS: The median follow-up of the patients was 36 months (range 18-98). A recurrence of intestinal metaplasia was found in 17 patients (18%), with an annual recurrence rate of 6.1%. Neither dysplasia, nor adenocarcinoma were found during the follow-up. Through the use of logistic regression analysis, previous laparoscopic fundoplication was associated with a reduced recurrence rate of intestinal metaplasia (odds ratio 0.30, 95% confidence interval 0.10-0.93). CONCLUSIONS: The long-term recurrence of intestinal type Barrett's oesophagus was low after complete ablation with argon plasma coagulation. The control of oesophageal acidity acid exposure with laparoscopic fundoplication seems to reduce the recurrence rate.


Asunto(s)
Esófago de Barrett/cirugía , Esófago/patología , Coagulación con Láser/métodos , Adulto , Anciano , Femenino , Estudios de Seguimiento , Humanos , Masculino , Metaplasia , Persona de Mediana Edad , Prevención Secundaria , Resultado del Tratamiento
4.
Surg Endosc ; 20(7): 1011-6, 2006 Jul.
Artículo en Inglés | MEDLINE | ID: mdl-16763927

RESUMEN

BACKGROUND: The laparoscopic management of large hiatal hernias still is controversial. Recent studies have presented a high recurrence rate. METHODS: In this study, 65 patients underwent elective laparoscopic repair of large hiatal hernia. A short esophagus was diagnosed in 13 cases. A primary closure of the hiatal defect was performed in 14 cases. "Tension-free" repair using a mesh was performed in 37 cases, and 14 patients underwent a Collis-Nissen gastroplasty. For the last 38 patients in the series, an intraoperative endoscopy was performed to identify the esophagogastric junction. RESULTS: There was no mortality, no conversions to open surgery, and no intraoperative complications. A recurrent hernia was present in 23 of the 77 patients (30%). The recurrence rate was 77% when a direct suture was used and 35% when a mesh was used (p < 0.05). No recurrences were observed in the patients treated with the Collis-Nissen technique, but in one case, perforation of the distal esophagus developed 3 weeks after surgery. The multivariate analysis showed that recurrences are statistically correlated with the type of hiatal hernia and surgical technique. CONCLUSIONS: To reduce recurrences after laparoscopic management of large hiatal hernias, it is essential to identify all cases of short esophagus using intraoperative endoscopy and to perform a Collis-Nissen procedure in such cases.


Asunto(s)
Hernia Hiatal/cirugía , Laparoscopía , Adulto , Anciano , Anciano de 80 o más Años , Femenino , Hernia Hiatal/patología , Humanos , Masculino , Persona de Mediana Edad , Estudios Retrospectivos , Factores de Tiempo , Resultado del Tratamiento
5.
Minerva Chir ; 61(4): 299-306, 2006 Aug.
Artículo en Italiano | MEDLINE | ID: mdl-17122762

RESUMEN

AIM: The advent of laparoscopic surgery produced a new interest in the surgical treatment of many benign and functional gastrointestinal diseases; one of the most commonly treated is the gastroesophageal reflux disease (GERD). In this paper the Authors report their 15 years experience in the laparoscopic surgical management of GERD. METHODS: From October 1991 to June 2005, 581 patients with GERD were treated by a laparoscopic fundoplication with a 360 degrees wrap (524 cases) or with a 270 degrees wrap (29 cases) or with a Collis gastroplasty (28 cases). RESULTS: The absence of intraoperative mortality, a low conversion to open surgery (0.7%) and a low postoperative morbidity (2.4%) with good clinical and instrumental long term results let the Authors to think that GERD represent an ideal indication for laparoscopic surgery. CONCLUSIONS: Good results are possible in the laparoscopic management of GERD with a precise selection of patients and with a good open and laparoscopic surgical experience in the management of functional esophageal diseases.


Asunto(s)
Fundoplicación , Reflujo Gastroesofágico/cirugía , Laparoscopía , Adolescente , Adulto , Anciano , Anciano de 80 o más Años , Femenino , Estudios de Seguimiento , Humanos , Masculino , Persona de Mediana Edad , Estudios Retrospectivos , Resultado del Tratamiento
6.
Eur J Surg Oncol ; 30(3): 303-8, 2004 Apr.
Artículo en Inglés | MEDLINE | ID: mdl-15028313

RESUMEN

BACKGROUND: The disadvantages of D2 gastrectomy have been mostly related to splenopancreatectomy. Unlike two large European trials, we have recently showed the safety of D2 dissection with pancreas preservation in a one-arm phase I-II trial. This new randomised trial was set up to compare post-operative morbidity and mortality and survival after D1 and D2 gastrectomy among the same experienced centres that participated into the previous trial. METHODS: In a prospective multicenter randomised trial, D1 gastrectomy was compared to D2 gastrectomy. Central randomisation was performed following a staging laparotomy in 162 patients with potentially curable gastric cancer. FINDINGS: Of 162 patients randomised, 76 were allocated to D1 and 86 to D2 gastrectomy. The two groups were comparable for age, sex, site, TNM stage of tumours, and type of resection performed. The overall post-operative morbidity rate was 13.6%. Complications developed in 10.5% of patients after D1 and in 16.3% of patients after D2 gastrectomy. This difference was not statistically significant (p<0.29). Reoperation rate was 3.4% after D2 and 2.6% after D1 resection. Post-operative mortality rate was 0.6% (one death); it was 1.3% after D1 and 0% after D2 gastrectomy. INTERPRETATION: Our preliminary data confirm that in very experienced centres morbidity and mortality after extended gastrectomy can be as low as those showed by Japanese authors. They also suggest that D2 gastrectomies with pancreas preservation are not followed by significantly higher morbidity and mortality than D1 resections.


Asunto(s)
Gastrectomía/métodos , Escisión del Ganglio Linfático/métodos , Complicaciones Posoperatorias , Neoplasias Gástricas/cirugía , Adulto , Anciano , Anciano de 80 o más Años , Femenino , Humanos , Masculino , Persona de Mediana Edad , Estadificación de Neoplasias , Estudios Prospectivos , Neoplasias Gástricas/mortalidad , Neoplasias Gástricas/patología , Análisis de Supervivencia
7.
Surg Endosc ; 17(4): 539-42, 2003 Apr.
Artículo en Inglés | MEDLINE | ID: mdl-12582755

RESUMEN

BACKGROUND: Barrett's esopagus (BE) is considered a risk factor for the development of esophageal carcinoma. Recently, partial restoration of squamous mucosa after ablation of BE with endoscopic techniques has been described. METHODS: From November 1996 to November 1999, 23 patients with histologically proven BE have been treated by endoscopic argon plasma coagulation (APC) following suppression of gastro-esophageal reflux by laparoscopic fundoplication. Histological follow-up after completed ablation ranged from 16 to 45 months (mean, 31.9 months). RESULTS: Histologically, complete squamous reepithelialization was observed in 20/23 patients, whereas a regrowth of a mixed squamous and gastric type mucosa was observed in 1 patient. Small islands of intestinal metaplasia were observed under the neosquamous epithelium in two patients (9%) during follow-up. CONCLUSION: The success rate of APC ablation following laparoscopic antireflux surgery in our series may be as high as 91%. Nevertheless, small islands of intestinal metaplasia under the new squamous epithelium may persist in some patients. In these circumstances, the authors recommend that endoscopic ablation of BE should be confined to controlled clinical trials.


Asunto(s)
Esófago de Barrett/cirugía , Coagulación con Láser , Adulto , Anciano , Argón , Esófago de Barrett/complicaciones , Esófago de Barrett/patología , Endoscopía , Femenino , Fundoplicación , Reflujo Gastroesofágico/complicaciones , Reflujo Gastroesofágico/cirugía , Humanos , Laparoscopía , Masculino , Persona de Mediana Edad , Resultado del Tratamiento
8.
Surg Endosc ; 18(12): 1742-6, 2004 Dec.
Artículo en Inglés | MEDLINE | ID: mdl-15809781

RESUMEN

BACKGROUND: The aim of this study was to assess the benefits and disadvantages of robot-assisted laparoscopic surgery for disorders of the adrenal gland in terms of feasibility, safety, and length of hospitalization. METHODS: Twenty consecutive patients with benign lesions of adrenal gland were randomized into two groups: Patients in the laparoscopic group underwent traditional laparoscopic adrenalectomy (LAP), whereas those in the robotic group underwent robot-assisted adrenalectomy (ROBOT) using the da Vinci robotic system. RESULTS: There was no significant difference between the groups in terms of age, sex, body mass index, and size or locations of lesions. Operative times were significant longer in the ROBOT group (total operative time, 169.2 min [range, 136-215] vs 115.3 min (range, 95-155) p < 0.001. Skin-to-skin time was 107 m (range, 77-154) vs 82.1 min (range, 55-120) (p < 0.001). There were no conversions to open surgery. However, conversion to standard laparoscopic surgery was necessary in four of 10 ROBOT patients (40%; left, one right). Perioperative morbidity was higher in the ROBOT group (20% vs 0%). There was no difference in length of hospital stay. In the following ROBOT group, hospital stay was 5.7 days (range, 4-9) vs 5.4 days (range, 4-8) in the LAP group (p = NS). The total cost of the ROBOT procedure ($3,467) was significantly higher than that for LAP ($2,737) (p < 0.01). CONCLUSION: Laparoscopic adrenalectomy is superior to robot-assisted adrenalectomy in terms of feasibility, morbidity, and cost.


Asunto(s)
Enfermedades de las Glándulas Suprarrenales/cirugía , Adrenalectomía/métodos , Laparoscopía/métodos , Robótica , Adulto , Anciano , Femenino , Humanos , Masculino , Persona de Mediana Edad , Estudios Prospectivos
9.
Minerva Gastroenterol Dietol ; 40(3): 119-24, 1994 Sep.
Artículo en Italiano | MEDLINE | ID: mdl-7948320

RESUMEN

The authors report their experience relative to 33 patients with hepatic hydatidosis surgically treated during the years 1987 through 1993. Various surgical techniques were employed: subtotal (21 cases) and total (5 cases) cystopericystectomy, partial pericystectomy (12 cases), hepatic resection (2 cases). The postoperative rate complication was 30% (4 cases of cholangitis, 4 biliary fistulas, 1 suppuration of residual cavity and 1 colonic fistula). The postoperative morbidity was higher in patients treated with partial pericystectomy. There was no postoperative mortality.


Asunto(s)
Equinococosis Hepática/cirugía , Adolescente , Adulto , Anciano , Femenino , Hepatectomía , Humanos , Masculino , Persona de Mediana Edad , Complicaciones Posoperatorias
10.
Minerva Gastroenterol Dietol ; 40(3): 155-8, 1994 Sep.
Artículo en Italiano | MEDLINE | ID: mdl-7948325

RESUMEN

The authors report a case of intrabiliary rupture of some recurrent hepatic hydatid cysts. The biliary drainage was performed endoscopically during ERCP. The results of treatment were satisfactory. The value of total cystopericystectomy and external biliary drainage on prevention of cyst-biliary fistulas is underlined.


Asunto(s)
Enfermedades de las Vías Biliares/etiología , Equinococosis Hepática/complicaciones , Anciano , Enfermedades de las Vías Biliares/diagnóstico por imagen , Enfermedades de las Vías Biliares/cirugía , Equinococosis Hepática/diagnóstico por imagen , Equinococosis Hepática/cirugía , Humanos , Masculino , Radiografía , Recurrencia , Rotura Espontánea
11.
Int Surg ; 80(4): 332-5, 1995.
Artículo en Inglés | MEDLINE | ID: mdl-8740679

RESUMEN

Results of an ongoing clinical study treating achalasia patients with laparoscopic Heller myotomy and Dor anterior fundoplication are presented. 18 patients underwent surgery between August 1991 and July 1995. Completeness of myotomies and calibration of fundoplications were measured using intraoperative manometry. Only one intraoperative complication, a perforation of the mucosa sutured laparoscopically, was encountered. There were no surgical mortalities nor postoperative morbidities. Mean hospital stay was 3.4 days. Complete relief of dysphagia and modifications of radiological and manometric patterns were achieved in all patients. All patients remain asymptomatic at 2 to 48 months from surgery. These results compare favourably with those of traditional surgery and of pneumatic dilatation.


Asunto(s)
Acalasia del Esófago/cirugía , Laparoscopía , Manometría , Monitoreo Intraoperatorio , Adolescente , Adulto , Anciano , Cardias/lesiones , Cardias/cirugía , Cateterismo , Niño , Trastornos de Deglución/cirugía , Unión Esofagogástrica/fisiopatología , Femenino , Estudios de Seguimiento , Fundoplicación/métodos , Mucosa Gástrica/lesiones , Reflujo Gastroesofágico/cirugía , Humanos , Complicaciones Intraoperatorias , Laparoscopía/métodos , Tiempo de Internación , Masculino , Persona de Mediana Edad
12.
Minerva Cardioangiol ; 44(9): 461-6, 1996 Sep.
Artículo en Italiano | MEDLINE | ID: mdl-8999371

RESUMEN

Self-transfusion represents a method used for the restoration of haematic losses that, in recent years, has been employed more and more widely in the surgical ambit. The utilisation of this method has become increasingly frequent because of the high diffusion of blood transmitted diseases and of the incidence, not negligible, of complications relative to the transfusions of homologous blood. The techniques that are currently used are: self-donation with predeposit; inter-surgery recovery; hemodilution normal blood volume. The authors report their experience relative to the use of self-transfusion, as self-donation with predeposit and as inter-surgery recovery, employed in the treatment of haemorrhagic complications, from 1990 until now in the Department of I Surgical Clinic of University of Turin, in a series of 48 patients in which were performed infrarenal abdominal aortic repair. In practice this technique did not present any complications.


Asunto(s)
Aneurisma de la Aorta Abdominal/cirugía , Transfusión de Sangre Autóloga , Prótesis Vascular , Adulto , Anciano , Arteriopatías Oclusivas/cirugía , Pruebas de Coagulación Sanguínea , Femenino , Humanos , Masculino , Persona de Mediana Edad , Selección de Paciente
13.
Minerva Cardioangiol ; 42(5): 239-44, 1994 May.
Artículo en Italiano | MEDLINE | ID: mdl-8090296

RESUMEN

The authors report their experience relative to 8 patients who underwent IMA revascularization during infrarenal AAA repair. The Carrel patch technique was employed in all cases operated. With this procedure no ischemic intestinal complication occurred. Two cases of ischemic colitis were observed in a second group of 40 patients operated for AAA in whom the IMA wasn't reimplanted into the aortic graft. The overall incidence of acute intestinal ischemia was 4%.


Asunto(s)
Aneurisma de la Aorta Abdominal/cirugía , Prótesis Vascular , Arterias Mesentéricas/trasplante , Adulto , Anciano , Colitis/etiología , Femenino , Humanos , Isquemia/etiología , Masculino , Persona de Mediana Edad
15.
Minerva Chir ; 51(9): 739-43, 1996 Sep.
Artículo en Italiano | MEDLINE | ID: mdl-9082242

RESUMEN

The authors report two cases of colorectal ischemic necrosis following surgical reconstruction of abdominal aorta. An intestinal resection according to Hartmann was performed in both cases. The value of prevention based on a careful anamnesis, on a precise angiography study of the abdominal aorta and of splanchnic circle in addition to inferior mesenteric artery reimplantation, when advisable, is underlined as the most effective therapeutic instrument against colorectal ischemic necrosis following surgical reconstruction of the abdominal aorta.


Asunto(s)
Aneurisma de la Aorta Abdominal/cirugía , Colitis Isquémica/cirugía , Colon/irrigación sanguínea , Isquemia/cirugía , Complicaciones Posoperatorias/cirugía , Recto/irrigación sanguínea , Anciano , Humanos , Masculino , Necrosis , Complicaciones Posoperatorias/patología
16.
Minerva Chir ; 50(11): 943-8, 1995 Nov.
Artículo en Italiano | MEDLINE | ID: mdl-8710146

RESUMEN

The authors report their experience relative to 12 cases of adrenal "incidentaloma" surgically treated. All masses removed had a main diameter larger than 3 cm. In all patients an anterior median transperitoneal incision was performed. They didn't record postoperative mortality and the postoperative morbidity rate was 15%. In 6 cases a nonfunctioning cortical adenoma was diagnosed. No malignant neoplasm was detected in their series.


Asunto(s)
Neoplasias de las Glándulas Suprarrenales/diagnóstico , Neoplasias de las Glándulas Suprarrenales/cirugía , Adenoma/diagnóstico , Adenoma/terapia , Neoplasias de la Corteza Suprarrenal/diagnóstico , Neoplasias de la Corteza Suprarrenal/terapia , Anciano , Femenino , Humanos , Masculino , Persona de Mediana Edad
17.
Minerva Chir ; 51(9): 675-80, 1996 Sep.
Artículo en Italiano | MEDLINE | ID: mdl-9082232

RESUMEN

During a 5-year period, from 1990 to 1994, 61 patients underwent prosthetic reconstruction of aorto-iliac district for aneurysmal (53 cases) or obstructive (8 cases) disease. There was no postoperative mortality; 3 cases of early perianastomotic thrombosis, 2 cases of left colon necrosis, 4 cases of femoral pseudoaneurysm and 5 cases of sexual disfunction were recorded. If accurately performed, the surgery of this arterial district offers very good early and late results.


Asunto(s)
Aorta Abdominal/cirugía , Aneurisma de la Aorta Abdominal/cirugía , Arteriopatías Oclusivas/cirugía , Prótesis Vascular/efectos adversos , Arteria Ilíaca/cirugía , Adulto , Anciano , Femenino , Humanos , Masculino , Persona de Mediana Edad , Complicaciones Posoperatorias/epidemiología
18.
Minerva Chir ; 58(1): 71-6, 2003 Feb.
Artículo en Italiano | MEDLINE | ID: mdl-12692499

RESUMEN

BACKGROUND: The colonic ischemic necrosis is one of the most serious complication in the surgical reconstruction of abdominal aorta aneurysm (AAA) due to surgical inappropriate binding of the inferior mesenteric artery (IMA). METHODS: A retrospective analyzed of a group of 118 infrarenal AAA surgically treated is presented. RESULTS: The most common cause of ischemic colitis (75% of cases) is the surgical binding of an opened IMA or its failed reimplantation. CONCLUSIONS: In this paper according to their personal experience and the literature data, the authors outline a diagnostic behaviour to select the patients needing the reimplantation of IMA; they suggest to complete the pre operative information with an instrumental evaluation during the surgical treatment.


Asunto(s)
Aneurisma de la Aorta Abdominal/cirugía , Colitis Isquémica/prevención & control , Arteria Mesentérica Inferior/cirugía , Complicaciones Posoperatorias/prevención & control , Reimplantación , Anciano , Implantación de Prótesis Vascular , Colitis Isquémica/epidemiología , Colitis Isquémica/etiología , Femenino , Humanos , Incidencia , Masculino , Persona de Mediana Edad , Complicaciones Posoperatorias/epidemiología , Complicaciones Posoperatorias/etiología , Estudios Retrospectivos , Resultado del Tratamiento
19.
Minerva Chir ; 53(7-8): 609-13, 1998.
Artículo en Italiano | MEDLINE | ID: mdl-9793349

RESUMEN

BACKGROUND: Personal experience concerning the treatment of 8 patients with infrarenal aortic aneurysms associated with extravascular non-neoplastic abdominal diseases is presented. METHODS AND RESULTS: In all 7 cases which underwent combined surgical procedures (aneury-smectomy + cholecystectomy in 4 patients and aneurysmectomy + groin hernia repair in 3 patients) early and late postoperative complications were not recorded. CONCLUSIONS: The main therapeutic guidelines concerning the pathologic association of infrarenal aortic aneurysms associated with extravascular non-neoplastic abdominal diseases are discussed on the basis of a literature review and of personal experience.


Asunto(s)
Aneurisma de la Aorta Abdominal/complicaciones , Aneurisma de la Aorta Abdominal/cirugía , Adulto , Anciano , Anciano de 80 o más Años , Aneurisma de la Aorta Abdominal/diagnóstico , Protocolos Clínicos , Femenino , Humanos , Masculino , Persona de Mediana Edad
20.
Minerva Chir ; 56(5): 495-9, 2001 Oct.
Artículo en Italiano | MEDLINE | ID: mdl-11568725

RESUMEN

BACKGROUND: On the basis of a literature review and of personal experience, the authors analyze the main indications and the best strategy for elective surgical repair of infrarenal abdominal aortic aneurysm (AAA). METHODS: Personal experience concerning elective surgical treatment of 110 patients with infrarenal AAA, is presented. RESULTS: No operative deaths have been observed and the postoperative recovery was regular in 108 patients. Two early complications (colon ischemia) and ten late postoperative complications (5 pseudoaneurysms, 5 sexual dysfunctions) occurred. CONCLUSIONS: The main therapeutic guidelines concerning the management of AAA should follow specific indications (aneurysm dimensions and growth rates). Indications for operative repair of aneurysms obviously should be judged in relation to the presence or absence of associated risk factors or concomitant medical conditions. In most cases, aneurysm repair can be performed safely, despite associated medical risks, by careful preoperative evaluation and preparation.


Asunto(s)
Aneurisma de la Aorta Abdominal/cirugía , Adulto , Anciano , Anciano de 80 o más Años , Humanos , Persona de Mediana Edad
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