RESUMEN
Four patients with leiomyoma of the upper or middle third of the oesophagus treated by surgical excision are reported. All operations were performed through a right thoracotomy with simple enucleation of the lesion. Two patients were asymptomatic. In one the tumour had a spiral configuration almost completely surrounding the lumen. No complications occurred. Early surgical treatment is advised although the tumour grows slowly.
Asunto(s)
Neoplasias Esofágicas/cirugía , Leiomioma/cirugía , Adulto , Neoplasias Esofágicas/diagnóstico , Femenino , Humanos , Leiomioma/diagnóstico , Masculino , Persona de Mediana EdadRESUMEN
Two cases of Budd-Chiari's Syndrome are presented. These refer to two women aged 34 and 33 years respectively. The aetiology of the first case is linked to polycythaemia rubra and the use of oral contraceptives; that of the second case to a fibrous perihepatitis involving the outlet of the suprahepatic veins, with a tenacious action of stenosis. The surgical therapy used was a latero-terminal left porto-renal shunt in the first case, and a decapsulation and ligature of the common hepatic artery in the second case. In the discussion the aetiopathogenetic, diagnostic and therapeutic problems inherent in the Syndrome are analysed, also on the basis of the most recent experiences reported in the relevant literature.
Asunto(s)
Síndrome de Budd-Chiari , Adulto , Angiografía , Síndrome de Budd-Chiari/diagnóstico , Síndrome de Budd-Chiari/cirugía , Cateterismo Cardíaco , Femenino , Arteria Hepática/cirugía , Humanos , Hígado/patología , Vena Porta/cirugía , Venas Renales/cirugíaRESUMEN
The long-term fate of patients treated surgically for carcinoma of the lung is not well known. In a careful review of the literature the authors found only nine papers with a postoperative followup of at least 10 years; the mean survival was 16,3% of patients so treated. Factors making for a good long-term prognosis include small initial tumor size, absence of mediastinal lymph node invasion, a favorable histologica type, and the type of surgery performed (partial exeresis). Translated into TNM code, this means that the best candidates for prolonged survival are patients with lung carcinoma of the squamous cell type, stage I, treated by limited lung exeresis.
Asunto(s)
Neoplasias Pulmonares/mortalidad , Estudios de Seguimiento , Humanos , Neoplasias Pulmonares/patología , Neoplasias Pulmonares/cirugía , Estadificación de Neoplasias , Cuidados Paliativos/mortalidad , Neumonectomía/mortalidad , Pronóstico , Factores de TiempoRESUMEN
A study was made at the Padua University Second Surgical Clinic--located in Verona--on four cases of digestive haemorrhage in patients with pancreatic pseudo-cysts. The psysiopatological, diagnostic and therapeutic problems inherent in this pathology are discussed. In particular, attention is drawn to the need for and difficulty of marking a correct diagnosis in good time, and the utility, for such purpose, of endoscopic examinations and selective arteriography of the coeliac tripod and the superior mesenteric artery. Lastly, the various possibilities that surgery offers in the treatment of this disease are mentioned.
Asunto(s)
Hemorragia Gastrointestinal/etiología , Quiste Pancreático/complicaciones , Adulto , Drenaje , Femenino , Hemorragia Gastrointestinal/cirugía , Humanos , Masculino , Persona de Mediana Edad , Pancreatectomía , Quiste Pancreático/diagnóstico , Quiste Pancreático/cirugía , Complicaciones PosoperatoriasRESUMEN
A hepatic localised antiblastic chemotherapic technique combining limited discomfort for patients with appreciable palliative results is illustrated; a short description of the surgical procedure of intubation of the hepatic artery itself and of some auxiliary procedures is given. Lastly the possible complications and the results are illustrated.
Asunto(s)
Antineoplásicos/administración & dosificación , Neoplasias Hepáticas/tratamiento farmacológico , Cuidados Paliativos/métodos , Antineoplásicos/uso terapéutico , Arteria Hepática , Humanos , Inyecciones Intraarteriales , Metástasis de la NeoplasiaRESUMEN
Hepatic arterial vascularisation, as described by Michels in 1954, is outlined; the importance of selective angiography in preparation of the hepatic de-arterialisation operation is then stressed, and its theoretical foundations and the surgical technique are illustrated; other procedures which can usefully be combined are also indicated. Lastly an evaluation of the limits and results of this therapy is given.
Asunto(s)
Arteria Hepática/cirugía , Neoplasias Hepáticas/cirugía , Cuidados Paliativos/métodos , Antineoplásicos/administración & dosificación , Antineoplásicos/uso terapéutico , Estudios de Evaluación como Asunto , Humanos , Inyecciones Intraarteriales , Neoplasias Hepáticas/tratamiento farmacológicoRESUMEN
Thirteen cases of congenital anomalies of the bile passages are described, as observed in the Verona Surgical Clinic during the period 1970-75, out of a total of 908 operations on the biliary passages and hence with a frequency of about 1.6%. They consisted of one case each of agenesis of the gall-bladder, septal gall-bladder, clepsydra gall-bladder, Hartmann's sac, diverticulum of the gall-bladder, outlet of the right hepatic in gall-bladder, outlet of cystic duct in third duodenal portion, accessory cholecystobiliary ducts, three cases of outlet of cystic duct in right hepatic duct, and two cases of common choledocho-wirsunghian canal. After a brief description of the individual types of anomaly, the main data in the relevant literature are considered, with a review of the semeiological and therapeutic aspects of the most frequent anomalies.
Asunto(s)
Sistema Biliar/anomalías , Vesícula Biliar/anomalías , Adulto , Anciano , Procedimientos Quirúrgicos del Sistema Biliar , Colecistectomía , Conducto Colédoco/anomalías , Conducto Cístico/anomalías , Femenino , Conducto Hepático Común/anomalías , Humanos , Masculino , Persona de Mediana EdadRESUMEN
The Authors review the methods of palliative treatment of cardial carcinoma, and particularly report some results obtained through the application of oesophageal endoprostheses (by Celestin and by Haring), following the traction method, in 38 patients. The global mortality amounted to 8 cases (21%). In 12 patients (31%), complications such as stoppage or dislocation of the prosthesis were observed. In two cases the perforation of oesophageal wall occurred, with spontaneous resolution in one of the two patients and serious mediastinitis and exitus in the other. The Authors' present trend is toward the use of push type endoprosthesis, because of the lower mortality reported in literature.
Asunto(s)
Adenocarcinoma/cirugía , Carcinoma de Células Escamosas/cirugía , Esófago , Cuidados Paliativos , Prótesis e Implantes , Neoplasias Gástricas/cirugía , Adenocarcinoma/complicaciones , Anciano , Carcinoma de Células Escamosas/complicaciones , Cardias , Femenino , Humanos , Masculino , Persona de Mediana Edad , Complicaciones Posoperatorias , Neoplasias Gástricas/complicacionesRESUMEN
The authors report a statistical investigation conducted in 95 patients with mammary carcinoma, designed to show the behavior of calcemia in the course of this malignancy. The data were analyzed statistically by the binomial test, the scatter of values (F test of Snedecor), and the t test of Student. The authors confirmed the existence of a statistically significant alteration of calcemia only in the group of patients with metastasis to bone versus control subjects; conversely there was no significant difference of distribution in the various groups in regard to values beyond those given as normal.
Asunto(s)
Neoplasias Óseas/sangre , Neoplasias de la Mama/sangre , Calcio/sangre , Adulto , Anciano , Femenino , Humanos , Persona de Mediana Edad , Metástasis de la NeoplasiaRESUMEN
Taking a case of duodenal schwannoma, that they had observed, as a starting point, on the base of their experience and the data of literature, the authors discuss the epidemiological, of classification and anatomo-pathological aspects of this rare neoplastic form. They particularly outline the clinical aspect, the diagnostic pre-operating iter and the correct and radical surgical behaviour that must be practiced during laparatomy.
Asunto(s)
Neoplasias Duodenales/diagnóstico , Neurilemoma/diagnóstico , Neoplasias Duodenales/patología , Neoplasias Duodenales/cirugía , Humanos , Masculino , Persona de Mediana Edad , Neurilemoma/patología , Neurilemoma/cirugíaRESUMEN
Taking as their starting point the observation of a case of primary lymphoma of the breast, the Authors point out that this tumour constitutes a rare disease in the context of non-Hodgkin lymphomas arising in sites other than the lymph nodes. They emphasize the clinical and instrumental diagnostic difficulties which the disease poses, as well as the uselessness of radical surgical therapy and the need for radio-chemotherapeutic management along with periodic follow-up. The Authors go on to explain how difficult it is to formulate a reliable prognosis for this type of tumour in view of the lack of homogeneity and the limited numbers of cases reported in the literature.
Asunto(s)
Neoplasias de la Mama , Linfoma no Hodgkin , Neoplasias de la Mama/patología , Neoplasias de la Mama/cirugía , Neoplasias de la Mama/terapia , Terapia Combinada , Femenino , Humanos , Linfoma no Hodgkin/patología , Linfoma no Hodgkin/cirugía , Linfoma no Hodgkin/terapia , Persona de Mediana EdadRESUMEN
The Authors show a case of a 68 year old woman underwent a successful operation for spontaneous stomach heavage. The linear solution of continuity, 5-6 cms long, was sutured on the small gastric curve. The treatment consisted in suturing the lesion and performing a decompressive gastrostomy.
Asunto(s)
Gastropatías/cirugía , Anciano , Femenino , Humanos , Radiografía , Rotura Espontánea , Gastropatías/diagnóstico por imagenRESUMEN
In eight patients who underwent surgical treatment for diaphragmatic rupture, pulmonary function and differential ventilation of the lungs were evaluated four months-one year after surgery. The results of the study show that diaphragmatic rupture produces only a small reduction in total ventilatory function. Moreover our data indicate that the ventilation estimated to be contributed by the side injured, is decreased in a larger extent in abdominal than in thoracic trauma.
Asunto(s)
Hernia Diafragmática Traumática/fisiopatología , Respiración , Adolescente , Adulto , Urgencias Médicas , Femenino , Estudios de Seguimiento , Hernia Diafragmática Traumática/cirugía , Humanos , Pulmón/fisiopatología , Masculino , Persona de Mediana Edad , Pruebas de Función Respiratoria , RoturaRESUMEN
The authors consider the incidence of arm lymphedema after mastectomy. Considering the temporary results which come from surgical practices, either from excision operations or lymphovenous anastomosis, they stress out the importance of the prevention measures and of the physiotherapeutic treatment. This is essential to keep lasting as long as possible the results of the operation when it is necessary because of serious functional deficit. Two cases of Thompson's operation are shown.
Asunto(s)
Linfedema/terapia , Mastectomía/efectos adversos , Femenino , Humanos , Escisión del Ganglio Linfático/efectos adversos , Linfedema/etiología , Linfedema/prevención & control , MétodosRESUMEN
The frequency of benign mammary disease and the need to differentiate between benign and malignant tumors without the indiscriminate use of instrumental examinations and biopsies have prompted the Cooperative Interdisciplinary Group on Mammary Neoplasms to adopt the diagnostic protocol and propose a number of therapeutic indications. Though involving a progressive reduction in biopsies, the use of the protocol has not led to failure to recognize carcinomas, the number of identified malignancies being maintained within the anticipated limits.
Asunto(s)
Neoplasias de la Mama/diagnóstico , Adenofibroma/patología , Factores de Edad , Biopsia con Aguja , Neoplasias de la Mama/patología , Femenino , Humanos , Mamografía , Tumor Filoide/patología , RiesgoRESUMEN
Ten patients (9 males and 1 female; mean age: 44.8 yrs) with bullous lung disease were treated. Frequent patient-history findings were smoking and spontaneous pneumothorax. Nine cases were treated surgically either by bullectomy or atypical resection. In one case, an attempt at endobullous aspiration failed owing to the patient's very poor general condition. Among the postoperative complications in three cases we observed difficult pulmonary re-expansion and infection of the surgical wound with consequent pleural empyema in another.
Asunto(s)
Quistes/cirugía , Enfisema Pulmonar/cirugía , Adulto , Anciano , Quistes/complicaciones , Quistes/diagnóstico , Femenino , Humanos , Enfermedades Pulmonares/complicaciones , Enfermedades Pulmonares/diagnóstico , Enfermedades Pulmonares/cirugía , Masculino , Persona de Mediana Edad , Enfisema Pulmonar/complicaciones , Enfisema Pulmonar/diagnósticoRESUMEN
The authors report on their experience with 42 cases of squamous carcinoma of the oesophagus subjected to oesophagectomy and oesophagogastroplasty. The patients' mean age was 55.2 years (range: 41-70) with a 13:1 male/female ratio. A positive history of cigarette smoking and of alcohol consumption was found in 87% and 80% of patients respectively. The sites of the neoplasms were as follows: 24 in the mid 3rd of the oesophagus, 9 in the lower 3rd, 6 in the upper 3rd of the thoracic oesophagus and 3 in the cervical oesophagus. In 39 patients the operation was performed in two stages according to Lewis and in 2 cases it was performed in 3 stages according to McKeown, while one patient was treated with a pull-through operation according to Akiyima. Six patients died during the first 30 days postoperatively as a result of circulatory complications or ARDS. Fistulization of the anastomosis as observed in 5 cases, though this was clinically manifest only in two. Mean survival was 5.9 months, 18.6 months and 10.5 months according to the period considered.
Asunto(s)
Carcinoma de Células Escamosas/cirugía , Neoplasias Esofágicas/cirugía , Esofagoplastia , Laringe/cirugía , Estómago/cirugía , Adulto , Anciano , Femenino , Humanos , Masculino , Persona de Mediana Edad , Complicaciones Posoperatorias/etiología , Complicaciones Posoperatorias/mortalidadRESUMEN
The Authors report a case of gastric metastasis from melanoma of the skin, occurring 6 years after removal of the primary neoplasm. The metastasis, which was characterized by conspicuous alimentary tract haemorrhage, called for emergency surgery consisting in a total gastrectomy with oesophago-jejunal anastomosis according to Roux. The Authors then go on to review the literature on the subject, stressing the frequency of gastrointestinal metastases in skin melanomas with an incidence affecting up to 60% of cases in autopsy series. After examining the main clinical aspects, endoscopic appearances and r-ray findings, the Authors deal at some length with prognosis, pointing out that isolated metastases may constitute a surgical indication in view of the cases of fairly good long-term survival reported in the literature.
Asunto(s)
Melanoma/secundario , Neoplasias Gástricas/secundario , Adulto , Urgencias Médicas , Hemorragia Gastrointestinal/etiología , Hemorragia Gastrointestinal/patología , Humanos , Metástasis Linfática , Masculino , Melanoma/complicaciones , Melanoma/patología , Neoplasias Cutáneas/patología , Estómago/patología , Neoplasias Gástricas/complicaciones , Neoplasias Gástricas/patología , Factores de TiempoRESUMEN
The authors consider the behaviour of TBII (TSH receptor binding inhibitory immunoglobulins) in multinodular goiter, in relation to the functional status of the thyroid classified on the basis of T3, FT4, TSH IRMA. The samples were collected from 53 patients with normal T3, FT4 and TSH; 14 patients with T3 and FT4 in normal range and TSH less than 0.15 milli U/l; 8 patients with T3 and/or FT4 above the superior limits of normal range and TSH less than 0.15 milli U/l and from a control group of 10 patients with Grave's disease. TBII was measured by radioreceptor assay and the index resulted less than 15% in all the patients with eufunctioning or hyperfunctioning multinodular goiter. Mean value in biochemically hyperthyroid patients was 6.25% and in euthyroid patients was 5.69%. The difference was statistically not significant. Moreover, significantly elevated levels of TBII were found in 60% of patients with Grave's disease.
Asunto(s)
Bocio Nodular/sangre , Inmunoglobulina G/metabolismo , Enfermedad de Graves/sangre , Humanos , Inmunoglobulinas Estimulantes de la TiroidesRESUMEN
The authors consider their experience in male breast cancer. Making a review of the literature they point out the risk factors and the prognosis of this disease.