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Your search keyword '"Gianmattia del Genio"' showing total 2 results
Start Over Author "Gianmattia del Genio" Journal annals of surgery
2 results on '"Gianmattia del Genio"'

1. A total fundoplication is not an obstacle to esophageal emptying after heller myotomy for achalasia: results of a long-term follow up

Author

Vincenzo Napolitano, Alberto del Genio, Giuseppe Amato, Gianluca Russo, F. Russo, Gianluca Rossetti, Domenico Izzo, Gianmattia del Genio, V. Maffettone, Luigi Brusciano, Francesco Pizza, Rossetti, G, Brusciano, L, Amato, G, Maffettone, V, Napolitano, Vincenzo, Russo, G, Izzo, D, Russo, F, Pizza, F, DEL GENIO, Gianmattia, and DEL GENIO, A.

Subjects
Myotomy, Adult, Male, medicine.medical_specialty, Adolescent, Manometry, medicine.medical_treatment, Achalasia, Fundoplication, Risk Assessment, Severity of Illness Index, Cohort Studies, Severity of illness, medicine, otorhinolaryngologic diseases, Humans, Minimally Invasive Surgical Procedures, Esophagus, Child, Digestive System Surgical Procedures, Peristalsis, Aged, Retrospective Studies, Heller myotomy, business.industry, Stomach, Recovery of Function, Original Articles, Middle Aged, medicine.disease, Dysphagia, Combined Modality Therapy, Surgery, Esophageal Achalasia, medicine.anatomical_structure, Treatment Outcome, Quality of Life, Female, Esophagoscopy, medicine.symptom, business, Follow-Up Studies
Abstract

OBJECTIVE: The aim of this study was to evaluate the role and efficacy of a total 360 degrees wrap, Nissen-Rossetti fundoplication, after esophagogastromyotomy in the treatment of esophageal achalasia. SUMMARY BACKGROUND DATA: Surgery actually achieves the best results in the treatment of esophageal achalasia; the options vary from a short extramucosal esophagomyotomy to an extended esophagogastromyotomy with an associated partial fundoplication to restore the main antireflux barrier. A total 360 degrees fundoplication is generally regarded as an obstacle to esophageal emptying. MATHERIALS AND METHODS: Since 1992 to November 2003, a total of 195 patients (91 males, 104 females), mean age 45.2 years (range, 12-79 years), underwent laparoscopic treatment of esophageal achalasia. Intervention consisted of Heller myotomy and Nissen-Rossetti fundoplication with intraoperative endoscopy and manometry. RESULTS: In 3 patients (1.5%), a conversion to laparotomy was necessary. Mean operative time was 75 +/- 15 minutes. No mortality was observed. Overall major morbidity rate was 2.1%. Mean postoperative hospital stay was 3.6 +/- 1.1 days (range, 1-12 days). At a mean clinical follow up of 83.2 +/- 7 months (range, 3-141 months) on 182 patients (93.3%), an excellent or good outcome was observed in 167 patients (91.8%) (dysphagia DeMeester score 0-1). No improvement of dysphagia was observed in 4 patients (2.2%). Gastroesophageal pathologic reflux was absent in all the patients. CONCLUSIONS: Laparoscopic Nissen-Rossetti fundoplication after Heller myotomy is a safe and effective treatment of esophageal achalasia with excellent results in terms of dysphagia resolution, providing total protection from the onset of gastroesophageal reflux.

Published
2005

2. Laparoscopic Adjustable Silicone Gastric Banding Versus Vertical Banded Gastroplasty in Morbidly Obese Patients: A Prospective Randomized Controlled Clinical Trial.

Author

Mario Morino, Mauro Toppino, Gisella Bonnet, and Gianmattia del Genio

Subjects
STOMACH, LAPAROSCOPY, OBESITY, HOSPITALS
Abstract

SUMMARY: OBJECTIVE To compare, in a prospective, randomized, single-institution trial laparoscopic adjustable silicone gastric banding (LASGB) with laparoscopic vertical banded gastroplasty (LVBG) in morbidly obese patients.SUMMARY BACKGROUND DATA LASGB is a simple and safe procedure, but some reports have suggested disappointing long-term results. Despite the recent widespread use of LASGB, there are no prospective nor randomized trials comparing LASGB with other laparoscopic procedures.METHODS A total of 100 morbidly obese patients, with body mass index (BMI) 40 to 50 kg/m2, without compulsive eating, were randomized to either LASGB (n = 49) or LVBG (n = 51). Minimum follow-up was 2 years (mean 33.1 months).RESULTS There were no deaths or conversions in either group. Mean operative time was 94.2 minutes in LVBGs and 65.4 in LASGBs (P < 0.05). Early morbidity rate was lower in LASGBs (6.1%) versus LVBGs (9.8%) (P = 0.754). Mean hospital stay was shorter in LASGBs versus LVBGs: 3.7 days versus 6.6 (P < 0.05). Late complications rate in LVBGs was 14% (7 of 50) and in LASGBs 32.7% (16 of 49) (P < 0.05). The most frequent complication was the slippage of the band (18%). Late reoperations rate in LVBGs was 0% (0 of 50) versus 24.5% (12 of 49) in LASGBs (P < 0.001). Excess weight loss in LVBGs was, at 2 years, 63.5% and, at 3 years, 58.9%; in LASGBs, excess weight loss, respectively, was 41.4% and 39%. BMI in LVBGs was, at 2 years, 29.7 kg/m2 and, at 3 years, 30.7 kg/m2; in LASGBs, BMI was 34.8 kg/m2 at 2 years and 35.7 kg/m2 at 3 years. According to Reinhold's classification, a residual excess weight <50% was achieved, at 2 years, in 74% of LVBG and 35% of LASGB (P < 0.001).CONCLUSIONS This study demonstrates that, in patients with BMI 40 to 50 kg/m2, LASGB requires shorter operative time and hospital stay but LVBG is more effective in terms of late complications, reoperations, and weight loss. [ABSTRACT FROM AUTHOR]

Published
2003
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