ABSTRACT
BACKGROUND: In HCV-infected cirrhotic patients with successfully treated early hepatocellular carcinoma (HCC), the time to HCC recurrence and the effects of sustained viral eradication (SVR) by interferon (IFN)-based or IFN-free regimens on HCC recurrence remain unclear. AIM: To perform an indirect comparison of time to recurrence (TTR) in patients with successfully treated early HCC and active HCV infection with those of patients with SVR by IFN-based and by IFN-free regimens. METHODS: We evaluated 443 patients with HCV-related cirrhosis and Barcelona Clinic Liver Cancer Stage A/0 HCC who had a complete radiological response after curative resection or ablation. Active HCV infection was present in 328, selected from the Italian Liver Cancer group cohort; 58 patients had SVR achieved by IFN-free regimens after HCC cure, and 57 patients had SVR achieved by IFN-based regimens after HCC cure. Individual data of patients in the last two groups were extracted from available publications. RESULTS: TTR by Kaplan-Meier curve was significantly lower in patients with active HCV infection compared with those with SVR both by IFN-free (P = 0.02) and by IFN-based (P < 0.001) treatments. TTR was similar in patients with SVR by IFN-free or by IFN-based (P = 0.49) strategies. CONCLUSION: In HCV-infected, successfully treated patients with early HCC, SVR obtained by IFN-based or IFN-free regimens significantly reduce tumour recurrence without differences related to the anti-viral strategy used.
Subject(s)
Carcinoma, Hepatocellular/surgery , Catheter Ablation , Hepatitis C/surgery , Interferons/therapeutic use , Liver Neoplasms/surgery , Neoplasm Recurrence, Local/surgery , Adult , Aged , Aged, 80 and over , Antiviral Agents/therapeutic use , Carcinoma, Hepatocellular/diagnosis , Carcinoma, Hepatocellular/drug therapy , Catheter Ablation/methods , Databases, Factual , Female , Follow-Up Studies , Hepatitis C/diagnosis , Hepatitis C/drug therapy , Humans , Liver Cirrhosis/diagnosis , Liver Cirrhosis/drug therapy , Liver Cirrhosis/surgery , Liver Neoplasms/diagnosis , Liver Neoplasms/drug therapy , Male , Middle Aged , Neoplasm Recurrence, Local/diagnosis , Neoplasm Recurrence, Local/drug therapy , Prospective Studies , Retrospective StudiesABSTRACT
Colonrectal polyps are rare in children. They are an important albeit uncommon cause of rectal bleeding, increase in number of defection with normal consistence of faeces with abundant mucus and sometimes steaks of fresh blood. Colonoscopy promotes both rapid and accurate diagnosis and the opportunity for immediate therapeutic polypectomy. This case concerns a 4 years little female who has complained some episodes of rectal bleeding and mucorrhea for about 3 month without any symptoms.
Subject(s)
Colonic Polyps , Gastrointestinal Hemorrhage/etiology , Child, Preschool , Colonic Polyps/complications , Colonic Polyps/diagnosis , Colonic Polyps/surgery , Colonoscopy , Diagnosis, Differential , Female , Follow-Up Studies , Humans , Mucus/metabolism , Rectum , Time Factors , Treatment OutcomeABSTRACT
The authors deal with huge ventral hernias having a defect of more than 10 cm in diameter. They report 16 cases in three years of experience: 10 treated with Marlex patches and 6 treated with Goretex prosthetic material.
Subject(s)
Hernia, Ventral/surgery , Polyethylenes , Polypropylenes , Polytetrafluoroethylene , Surgical Mesh , Abdominal Muscles/surgery , Female , HumansSubject(s)
Colectomy , Gastrectomy , Parenteral Nutrition, Total , Adult , Aged , Colectomy/methods , Female , Humans , Infusions, Parenteral , Male , Middle Aged , Parenteral Nutrition, Total/methods , Postoperative CareSubject(s)
Diverticulum, Colon/surgery , Abdomen, Acute/diagnosis , Adult , Aged , Diagnosis, Differential , Diverticulitis, Colonic/diagnosis , Diverticulitis, Colonic/surgery , Diverticulum, Colon/complications , Diverticulum, Colon/diagnosis , Emergencies , Endoscopy , Female , Humans , Male , Middle AgedSubject(s)
Hernia, Inguinal/surgery , Adolescent , Adult , Aged , Aged, 80 and over , Anesthesia, Inhalation/economics , Anesthesia, Local/economics , Anesthesia, Spinal/economics , Biocompatible Materials , Child , Child, Preschool , Cost-Benefit Analysis , Humans , Methods , Middle Aged , Polyethylenes/economics , Polypropylenes/economics , Surgical Mesh/economics , Sutures/economicsABSTRACT
Following a review of the literature. The authors present their personal experience in the surgical treatment for groin hernia using the Trabucco method. The work's aim was to describe every steps of this technique. The easy execution using a polypropylene patch and plug with the characteristics tension free-suture less and the rarity of general and local complications renders the validity of this method.
Subject(s)
Hernia, Inguinal/surgery , Biocompatible Materials , Follow-Up Studies , Humans , Male , Methods , Polyethylenes , Polypropylenes , Surgical Mesh , Suture Techniques , Time FactorsSubject(s)
Colonic Neoplasms/pathology , Lipoma/pathology , Aged , Colectomy , Colon/pathology , Colonic Neoplasms/surgery , Colostomy , Female , Humans , Lipoma/surgery , Male , Middle AgedABSTRACT
Mondor's disease is commonly described as thrombophlebitis of the subcutaneous veins of the chest. It is a relatively uncommon syndrome, generally considered of trivial importance for its poor symptoms: local pain, rarely fever. Recovery is obtained in one or two months with adequate medical treatment. Common causes are traumas, surgery, stress, breast phlogosis; however, some Authors still consider the syndrome as a sinchronous breast cancer "marker".
Subject(s)
Thoracic Diseases , Thrombosis , Adult , Biomarkers , Breast Neoplasms/complications , Breast Neoplasms/diagnosis , Breast Neoplasms/diagnostic imaging , Diagnosis, Differential , Female , Humans , Mammography , Middle Aged , Syndrome , Thoracic Diseases/complications , Thoracic Diseases/diagnosis , Thoracic Diseases/diagnostic imaging , Thrombosis/complications , Thrombosis/diagnosis , Thrombosis/diagnostic imaging , UltrasonographyABSTRACT
The authors describe a case of lung hamartoma recently observed. Diagnosis occurred by chance through routine chest X-rays. A stationary radiological aspect of the hamartoma, regularly followed up, suggested to defer surgery up to the moment of a visible radiologic enlargement of the lesion.
Subject(s)
Hamartoma/diagnostic imaging , Lung Diseases/diagnostic imaging , Humans , Lung/diagnostic imaging , Male , Middle Aged , Tomography, X-Ray ComputedABSTRACT
The authors describe a recent anaesthetic technique: the subarachnoid monolateral superselective anaesthesia. Currently they use it in the surgical operation of "long stripping" saphenectomy. They argue on the utility of codifying this technique for its numberless advantages and discuss on the opportunity to perform day-hospital saphenectomy.
Subject(s)
Anesthesia, Spinal/methods , Saphenous Vein/surgery , Bupivacaine , Humans , Preanesthetic Medication , Subarachnoid Space , Varicose Veins/surgeryABSTRACT
The authors report on a particular affection of the cholecyst wall known as adenomyomatosis. Having observed seven cases in the last three years they analyse the most suitable diagnostic methods and treatment.
Subject(s)
Adenomyoma/pathology , Gallbladder Neoplasms/pathology , Adenomyoma/surgery , Adult , Female , Gallbladder/pathology , Gallbladder Neoplasms/surgery , Humans , Male , Middle AgedABSTRACT
The extra-abdominal fibromatosis is a benign tumour presenting considerable problems in terms of diagnosis and therapy. The Authors report a case recently observed.
Subject(s)
Fibroma , Soft Tissue Neoplasms , Thigh , Fibroma/diagnosis , Fibroma/surgery , Humans , Male , Middle Aged , Soft Tissue Neoplasms/diagnosis , Soft Tissue Neoplasms/surgeryABSTRACT
The results of a clinico-pathologic and immunohistochemical study of an angiomatoid malignant fibrous histiocytoma are reported. This lesion is an uncommon tumor of the superficial soft tissue, of low-grade malignancy, typical of adolescence and early adult life. The patient, a 10-year-old female, presented with a mass of the left popliteal fossa, treated with surgical excision of the tumor and the surrounding cutaneous and subcutaneous tissue. The tumor was a well-circumscribed, firm nodule measuring 2.5 x 1.0 cm. Histologically, it showed aggregates of spindled and rounded cells often lining cystic cavities filled with blood. The immunohistochemical analysis revealed a cytoplasmatic immunoreactivity for KP1 (CD68), which was taken as indicating that the tumoral mesenchymal cells had acquired phagocytic capacities. The patient is well without signs of local recurrence or metastatic disease 4 years after the surgical treatment. The case reported confirms that appropriate local surgery is the elective therapy for this type of soft tissue tumor.
Subject(s)
Histiocytoma, Benign Fibrous/pathology , Knee , Soft Tissue Neoplasms/pathology , Child , Female , Humans , ImmunohistochemistryABSTRACT
Various operations could be used for pilonidal sinus disease. The authors report their experience, discuss the etiopathogenesis (acquired or congenital origin) describe their method of treatment and results and compare them with those of the other reviews.
Subject(s)
Pilonidal Sinus/surgery , Female , Follow-Up Studies , Humans , Male , Recurrence , Sutures , Time FactorsABSTRACT
In a review of the literature, the association nephroblastoma-horseshoe kidneys has been demonstrated in 34 patients. Radiologic signs of horseshoe kidney may be difficult to evaluate when a large mass is present. Treatment of Wilms' tumor in horseshoe kidneys does not differ, on principle, from that of Wilms' tumor occurring in the normally separated kidneys.
Subject(s)
Kidney Neoplasms/diagnosis , Kidney/abnormalities , Wilms Tumor/diagnosis , Child, Preschool , Female , Humans , Kidney/diagnostic imaging , Kidney Neoplasms/surgery , Nephrectomy , Radiography , Ultrasonography , Wilms Tumor/surgeryABSTRACT
The infarction of the greater omentum is an unusual cause of acute abdominal pain. The Authors report their experience in the management of three cases. It is stressed that clinical manifestations are those of an appendicitis or cholecystitis; therefore, the diagnosis is usually intraoperative.