20 results on '"MAFFETTONE, Vincenzo"'
Search Results
2. The short esophagus: Intraoperative assessment of esophageal length
- Author
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Mattioli, Sandro, Lugaresi, Maria Luisa, Costantini, Mario, Del Genio, Alberto, Di Martino, Natale, Fei, Landino, Fumagalli, Uberto, Maffettone, Vincenzo, Monaco, Luigi, Morino, Mario, Rebecchi, Fabrizio, Rosati, Riccardo, Rossi, Mauro, Santi, Stefano, Trapani, Vincenzo, and Zaninotto, Giovanni
- Published
- 2008
3. Evaluation of normal subjects by defecographic technique
- Author
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Selvaggi, Francesco, Pesce, Giuseppe, Di Carlo, Ennio Scotto, Maffettone, Vincenzo, and Canonico, Silvestro
- Published
- 1990
- Full Text
- View/download PDF
4. Intersphincteric surgical access to the rectum for the treatment of villous adenomas
- Author
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Selvaggi, Francesco, di Carlo, Ennio Scotto, Maffettone, Vincenzo, Silvestri, Antonio, and Notaroberto, Alessandro
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- 1992
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5. Surgical treatment of circumferential hemorrhoids
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Selvaggi, Francesco, Scotto di Carlo, Ennio, Silvestri, Antonio, Notaroberto, Alessandro, and Maffettone, Vincenzo
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- 1990
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6. Laparoscopic Nissen-Rossetti Fundoplication with Routine Use of Intraoperative Endoscopy and Manometry: Technical Aspects of a Standardized Technique.
- Author
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Genio, Gianmattia, Rossetti, Gianluca, Brusciano, Luigi, Limongelli, Paolo, Pizza, Francesco, Tolone, Salvatore, Fei, Landino, Maffettone, Vincenzo, Napolitano, Vincenzo, and Genio, Alberto
- Subjects
FUNDOPLICATION ,ESOPHAGEAL surgery ,LAPAROSCOPIC surgery ,OPERATIVE surgery ,DEGLUTITION disorders - Abstract
Several different ways of fashioning a total fundoplication lead to different outcomes. This article addresses the technical details of the antireflux technique we adopted without modifications for all patients with GERD beginning in 1972. In particular it aims to discuss the relation between the mechanism of function of the wrap and the physiology of the esophagus. The study population consisted of 380 patients affected by GERD with a 1-year minimum of follow-up who underwent laparoscopic Nissen-Rossetti fundoplication by a single surgeon. No conversion to open surgery and no mortality occurred. Major complications occurred in 4 patients (1.1%). Follow-up (median 83 months; range: 1–13 years) was achieved in 96% of the patients. Ninety-two percent of the patients were satisfied with the results of the procedure and would undergo the same operation again. Postoperative dysphagia occurred in 3.5% of the patients, and recurrent heartburn was observed in 3.8%. Laparoscopic Nissen-Rossetti fundoplication with the routine use of intraoperative manometry and endoscopy achieved good outcomes and long-term patient satisfaction with few complications and side-effects. Appropriate preoperative investigation and a correct surgical technique are important in securing these results. [ABSTRACT FROM AUTHOR]
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- 2007
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- View/download PDF
7. Orthotopic liver transplantation in primary liver tumors.
- Author
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Moreno-González, Enrique, Loinaz, Carmelo, Gómez, Ramon, Garclá, Ignacio, González-Pinto, Ignacio, Jiménez, Carlos, Maffettone, Vincenzo, Colina, Francesco, Palomo, Juan Carlos, Vorwald, Peter, and Musella, Mario
- Published
- 1993
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8. Laparoscopic treatment of an uncommon abdominal localization of Castleman disease.
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Brusciano L, Rossetti G, Maffettone V, Napolitano V, Izzo D, Pizza F, Russo G, Russo F, del Genio G, del Genio A, Brusciano, Luigi, Rossetti, Gianluca, Maffettone, Vincenzo, Napolitano, Vincenzo, Izzo, Domenico, Pizza, Francesco, Russo, Gianluca, Russo, Federica, del Genio, Gianmattia, and del Genio, Alberto
- Published
- 2005
- Full Text
- View/download PDF
9. Surgical resection of biliary tract malignancies after intervention al radiology treatment.
- Author
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Moreno-Gonzalez, Enrique, Gomez, Ramon, Loinaz, Carmelo, García, Ignacio, González-Pinto, Ignacio, Maffettone, Vincenzo, de la Calle, Angel, Palomo, Juan Carlos, and Palma, Fermin
- Published
- 1993
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10. Etiopathogenesis and prognosis of centrilobular necrosis in hepatic grafts
- Author
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Gómez, Ramon, Colina, Francisco, Moreno, Enrique, González, Ignacio, Loinaz, Carmelo, Garcia, Ignacio, Musella, Mario, Garcia, Huberto, Lumbreras, Carlos, and Maffettone, Vincenzo
- Published
- 1994
- Full Text
- View/download PDF
11. Laparoscopic reoperation with total fundoplication for failed Heller myotomy: is it a possible option? Personal experience and review of literature.
- Author
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Rossetti G, del Genio G, Maffettone V, Fei L, Brusciano L, Limongelli P, Pizza F, Tolone S, Di Martino M, del Genio F, and del Genio A
- Subjects
- Female, Humans, Length of Stay statistics & numerical data, Male, Reoperation, Treatment Failure, Treatment Outcome, Digestive System Surgical Procedures methods, Esophageal Achalasia surgery, Fundoplication methods, Laparoscopy methods
- Abstract
Laparoscopic Heller myotomy with antireflux procedure seems the procedure of choice in the treatment of patients with esophageal achalasia. Persistent or recurrent symptoms occur in 10% to 20% of patients. Few reports on reoperation after failed Heller myotomy have been published. No author has reported the realization of a total fundoplication in these patient groups. The aim of this study is to evaluate the efficacy of laparoscopic reoperation with the realization of a total fundoplication after failed Heller myotomy for esophageal achalasia. From 1992 to December 2007, 5 out of a series of 242 patients (2.1%), along with 2 patients operated elsewhere, underwent laparoscopic reintervention for failed Heller myotomy. Symptoms leading to reoperation included persistent dysphagia in 3 patients, recurrent dysphagia in another 3, and heartburn in 1 patient. Mean time from the first to the second operation was 49.7 months (range, 4-180 months). Always, the intervention was completed via a laparoscopic approach and a Nissen-Rossetti fundoplication was realized or left in place after a complete Heller myotomy. Mean operative time was 160 minutes (range, 60-245 minutes). Mean postoperative hospital stay was 3.1 +/- 1.5 days. No major morbidity or mortality occurred. At a mean follow-up of 16.1 months, reoperation must be considered successful in 5 out of 7 patients (71.4%). The dysphagia DeMeester score fell from 2.71 +/- 0.22 to 0.91 +/- 0.38 postoperatively. The regurgitation score changed from 2.45 +/- 0.34 to 0.68 +/- 0.23. Laparoscopic reoperation for failed Heller myotomy with the realization of a total fundoplication is safe and is associated with good long-term results if performed by an experienced surgeon in a center with a long tradition of esophageal surgery.
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- 2009
12. [Laparoscopic total fundoplication is not an obstacle to oesophageal emptying after oesophago-gastric myotomy for the surgical treatment of achalasia].
- Author
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Pizza F, Rossetti G, Del Genio G, Maffettone V, Napolitano V, Allaria A, Brusciano L, Montesarchio L, Tolone S, Di Martino M, Lucido FS, Barra L, Giugliano S, D'Alessandro A, Del Genio F, Pizza NL, and Del Genio A
- Subjects
- Adolescent, Adult, Aged, Child, Deglutition Disorders etiology, Esophageal Achalasia complications, Esophageal Achalasia diagnosis, Female, Follow-Up Studies, Humans, Laparoscopy, Length of Stay, Male, Manometry, Middle Aged, Time Factors, Treatment Outcome, Esophageal Achalasia surgery, Fundoplication methods, Gastroesophageal Reflux prevention & control
- Abstract
There are different surgical possibilities for the treatment of oesophageal achalasia ranging from a short extramucosal oesophagomyotomy to an extended esophago-gastric myotomy combined with a partial fundoplication to restore the main antireflux barrier. A total 360 degrees fundoplication is generally regarded as an obstacle to oesophageal emptying. The aim of this study was to evaluate the role and efficacy of total 360 degrees laparoscopic Nissen-Rossetti fundoplication after oesophago gastric myotomy in the treatment of oesophageal achalasia. From 1992 to January 2008, a total of 245 patients (112 males, 133 females), mean age 45.1 years (range: 12-79), were submitted to laparoscopic Nissen-Rossetti fundoplication after a Heller myotomy with endoscopic and manometric intraoperative monitoring. In 3 patients (1.2%), conversion to laparotomy was necessary. Mean operative time was 60 +/- 15 minutes. No mortality was observed. The overall morbidity rate was 1.6%. The mean postoperative hospital stay was 3.5 +/- 1.0 days (range: 1-12 days). A mean clinical follow-up of 100.2 +/- 7 months (range: 3-177) was possible for 228 patients (93.1%), and an excellent or good outcome was observed in 209 patients (91.7%) (DeMeester dysphagia score 0-1). No improvement in dysphagia was observed in 5 (2.2%) patients. Pathological gastro-oesophageal reflux was absent in all patients. Laparoscopic Nissen-Rossetti fundoplication after a Heller myotomy is a safe, effective treatment for oesophageal achalasia with excellent results in terms of dysphagia resolution, affording total protection from the onset of gastrooesophageal reflux.
- Published
- 2008
13. Whole stomach transposition without gastric drainage procedure: a good surgical option to restore digestive continuity after esophagectomy.
- Author
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Maffettone V, Rossetti G, Rambaldi P, Russo F, Cuccurullo V, Brusciano L, del Genio G, Russo G, Pizza F, Mansi L, and del Genio A
- Subjects
- Adult, Aged, Anastomosis, Surgical methods, Drainage, Esophageal Neoplasms surgery, Esophageal Stenosis surgery, Female, Follow-Up Studies, Gastric Emptying physiology, Gastrointestinal Contents diagnostic imaging, Gastrointestinal Transit physiology, Humans, Male, Middle Aged, Pylorus, Radionuclide Imaging, Radiopharmaceuticals, Technetium Tc 99m Sulfur Colloid, Time Factors, Esophagectomy methods, Stomach surgery
- Abstract
After esophagectomy, the stomach is usually used to restore digestive continuity. To prevent postoperative delayed gastric emptying, most authors perform a gastric drainage procedure or transpose a tubulized stomach. The aim of our work is to evaluate the emptying of a transposed whole stomach without performing a pyloromyotomy or a pyloroplasty. From 1996 to January 2004, 45 patients underwent total esophagectomy for cancer or for caustic stenosis. Reconstruction of digestive continuity was realized through transposition of the whole stomach without performing a pyloric drainage procedure. At 12 months after the intervention, 35 patients (77.8%; 20 men and 15 women) were submitted to a gastric emptying scintigraphic study by means of ingestion of a mixed meal labeled with 37 MBq 99mTc-sulfur colloid. Mean half-emptying time was 71.4 minutes (range, 15-90 minutes; reference range, 83 +/- 34 minutes): all the patients were in the normal range except one. No patient complained of delayed gastric emptying symptoms. After esophagectomy, the transposition of the whole stomach without a pyloric drainage procedure seems to be an interesting option, and is not associated with delayed gastric emptying.
- Published
- 2007
14. Laparoscopic conversion of an omega in a Roux-en-y reconstruction after mini-invasive total gastrectomy for cancer: a technical report.
- Author
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Rossetti G, del Genio G, Maffettone V, Napolitano V, Brusciano L, Russo G, Limongelli P, Fiume I, Pizza F, and del Genio A
- Subjects
- Anastomosis, Roux-en-Y, Humans, Male, Middle Aged, Punctures, Esophagitis surgery, Gastrectomy methods, Laparoscopy methods, Stomach Neoplasms surgery
- Abstract
Introduction: Few cases of laparoscopic total gastrectomy have been published. Reconstruction of the digestive tract was generally accomplished with a Roux-en-y esophagojejunal mechanical anastomosis. Here we report the first 2 cases of laparoscopic conversion of an omega in a Roux-en-y reconstruction due to the occurrence of a severe alkaline esophagitis after mini-invasive total gastrectomy for cancer., Materials and Methods: Two male patients presented in 2004. One year prior, at another facility, they had undergone laparoscopic total gastrectomy for cancer, with reconstruction of digestive tract by means of an esophagojejeunostomy with a jejunal loop and Braun's side-to-side enteroanastomosis. They complained of daily symptoms of nausea, regurgitation, heartburn, and early postprandial fullness with reduction of appetite and weight loss of almost 15 kg. Instrumental examination diagnosed alkaline esophagitis. Intervention was performed via laparoscopic approach and the digestive reconstruction was reconfigured in a Roux-en-y type with a proximal limb of almost 60 cm., Results: Operative time was 135 to 180 minutes. No postoperative complications occurred. After 1-year follow-up, symptoms resolution and esophagitis healing have been observed in both patients., Conclusions: Laparoscopic gastrectomy is gaining wide acceptance. In our opinion, a standardization of the technique is necessary: we believe Roux-en-y should be considered the preferred reconstruction route ensuring the best protection of the esophagus from alkaline reflux.
- Published
- 2007
- Full Text
- View/download PDF
15. [Endoscopic ultrasonography-guided management of mesenchymal tumors of the upper digestive tract].
- Author
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Napolitano V, Russo G, Pezzullo A, Maffettone V, Rossetti G, del Genio G, Brusciano L, Pizza F, Sagnelli C, and del Genio A
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- Humans, Immunohistochemistry, Retrospective Studies, Sensitivity and Specificity, Treatment Outcome, Ultrasonography, Interventional methods, Endosonography, Gastrointestinal Stromal Tumors diagnostic imaging, Gastrointestinal Stromal Tumors surgery
- Abstract
Stromal tumours of the gastrointestinal tract can be defined by endoscopic ultrasonography as "hypoechoic intramural tumours" on the basis of their echostructure. Unfortunately, this definition is inadequate for distinguishing between the biological behaviour patterns of different types of stromal tumour. One hundred and twelve hypoechoic intramural tumours observed from 1998 to 2005 were classified in 4 distinct groups (leiomyomas, gastrointestinal stromal tumours, gastrointestinal stromal tumours suspected of malignancy, and malignant stromal tumours) according to more detailed endoscopic ultrasonography criteria in order to better plan the surgical treatment. The endoscopic ultrasonography diagnosis was compared with histology and immunochemistry findings in 33 patients who were operated on. The overall accuracy was 78.6% for the diagnosis of leiomyoma (sensitivity, specificity, positive predictive value, and negative predictive value were 92.3%, 90.0%, 85.7% and 94.7%, respectively). The corresponding data for the diagnosis of malignant stromal tumours were 80.0%, 95.2%, 88.9% and 91.7%. Endoscopic ultrasonography seemed to be less reliable only in relation to the diagnosis of gastrointestinal stromal tumours (specificity 80.9%, positive predictive value 75.0%). The surgical procedures planned on the basis of the endoscopic ultrasonography diagnosis proved adequate in 31 out of 33 cases.
- Published
- 2006
16. [Esophageal perforation: which factors affect the prognosis? Results of a 10-year experience].
- Author
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Rossetti G, Maffettone V, Napolitano V, Brusciano L, del Genio G, Russo G, Limongelli P, Pizza F, Di Martino M, Tolone S, and del Genio A
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- Adult, Aged, Esophageal Perforation etiology, Esophageal Perforation mortality, Esophageal Perforation surgery, Evaluation Studies as Topic, Female, Humans, Male, Middle Aged, Prognosis, Retrospective Studies, Risk Factors, Survival Analysis, Esophageal Perforation diagnosis
- Abstract
Oesophageal perforations are a catastrophic event with a 10-40% mortality rate. The decisive prognostic factor is the time from the event to the diagnosis, while there is no agreement as to the therapeutic options. The aim of this study was to present our ten-year experience in the treatment of oesophageal perforations together with an evaluation of the prognostic factors. From January 1995 to January 2005, 18 patients (11 M, 7 F), mean age 49.3 years (range: 22-79), with oesophageal perforations were treated in our department. They were classified according to the cause and localization of the perforation and the time elapsing since the event. The perforation was localised in the cervical oesophagus in 4 patients (22.2%), in the abdominal oesophagus in 4 patients (22.2%) and in the thoracic oesophagus in 10 patients (55.5%). It was spontaneous in 4 patients (22.2%), traumatic in 4 (22.2%) and iatrogenic in the remaining 10 (55.5%). In 7 patients (38.9%), the treatment was started during the first 24 hours from the event, while the remaining 11 (61.1 %) were referred to us more than 24 hours after the perforation occurred. The overall mortality was 27.8% (5 patients). The only decisive prognostic factor was the time of observation: only 1 patient (14.3%) died in the group observed in the first 24 hours, while the remaining 4 who died (36.4%) were in the group treated more than 24 hours after the event (p < 0.05). Our series confirms that the time elapsing from the event to the diagnosis is the only decisive prognostic factor in the treatment of oesophageal perforations. There is no therapeutic option of choice since there is no significant influence of either cause or localisation of the perforation on outcome.
- Published
- 2006
17. Gastroesophageal junction adenocarcinoma: what are the factors influencing long-term survival?
- Author
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del Genio A, Rossetti G, Maffettone V, Napolitano V, Brusciano L, del Genio G, Russo G, Limongelli P, Fiume I, Pizza F, Tolone S, and Di Martino M
- Subjects
- Adenocarcinoma pathology, Adenocarcinoma surgery, Aged, Esophageal Neoplasms pathology, Esophageal Neoplasms surgery, Female, Follow-Up Studies, Humans, Male, Neoplasm Staging, Prognosis, Survival Rate, Adenocarcinoma mortality, Esophageal Neoplasms mortality, Esophagogastric Junction
- Abstract
The incidence of gastroesophageal junction adenocarcinoma is increasing. About 30% of the tumors cannot be completely resected, and 40% of the patients relapse after complete resection. There is much controversy over the role of neoadjuvant therapy, the approach route, lymphadenectomy, and the extent of esophageal resection. The aim of our study was to report our experience in the treatment of gastroesophageal junction adenocarcinoma. From January 1987 until February 2005, 157 patients (125 men, 32 women), mean age 72.1 +/- 3.2 years, came for observation. One hundred sixteen patients underwent curative intervention. Mean operative time was 185 +/- 45 minutes. Mean postoperative hospital stay was 16.4 +/- 6.1 days. Postoperative complications were observed in 25 patients (21.6%); 6 patients (5.2%) died during the postoperative period. Overall survival was 36.2% and 27.6% at 3- and 5-year follow-up, respectively. Five-year survival rate was significantly lesser in R1/R2 versus R0 resections (0% versus 33.7%), N+ versus N- patients (11.3% versus 53.3%), and worsened with progression of pT histological staging (T1, 100%; T2, 24.1%; T3, 15.1%; T4, 0%). Determining prognostic factors are the radicality of resection, lymph nodal invasion, and histological staging.
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- 2006
18. A total fundoplication is not an obstacle to esophageal emptying after heller myotomy for achalasia: results of a long-term follow up.
- Author
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Rossetti G, Brusciano L, Amato G, Maffettone V, Napolitano V, Russo G, Izzo D, Russo F, Pizza F, Del Genio G, and Del Genio A
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- Adolescent, Adult, Aged, Child, Cohort Studies, Combined Modality Therapy, Digestive System Surgical Procedures adverse effects, Digestive System Surgical Procedures methods, Esophagoscopy adverse effects, Female, Follow-Up Studies, Fundoplication adverse effects, Humans, Male, Manometry, Middle Aged, Minimally Invasive Surgical Procedures, Quality of Life, Recovery of Function, Retrospective Studies, Risk Assessment, Severity of Illness Index, Treatment Outcome, Esophageal Achalasia diagnosis, Esophageal Achalasia surgery, Esophagoscopy methods, Fundoplication methods
- 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., Materials 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
- Full Text
- View/download PDF
19. Giant right post-traumatic diaphragmatic hernia: laparoscopic repair without a mesh.
- Author
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Rossetti G, Brusciano L, Maffettone V, Napolitano V, Sciaudone G, Del Genio G, Russo G, and Del Genio A
- Subjects
- Adult, Hernia, Diaphragmatic etiology, Humans, Male, Surgical Mesh, Diaphragm injuries, Hernia, Diaphragmatic surgery, Laparoscopy
- Abstract
Diaphragmatic ruptures are fairly frequent after thoraco-abdominal traumas (0.8-5%). In 90% of cases, they are left-sided. In the literature, very few cases are treated by laparoscopy. The aim of this study was to evaluate the feasibility and effectiveness of laparoscopic repair of a giant right post-traumatic diaphragmatic hernia without the use of a mesh. We present the case of a 28-year-old male operated by the laparoscopic approach for a giant right post-traumatic diaphragmatic hernia, diagnosed 18 months after the trauma. Surgical repair was carried out by means of 10 non-absorbable interrupted stitches, without the use of a mesh. The duration of the operation was 145 minutes. The patient was discharged 3 days after the surgical procedure, and no complications occurred. After a 40-month follow-up, the patient is asymptomatic and healthy. Laparoscopic repair of post-traumatic diaphragmatic hernias without the use of a mesh is safe and effective and affords an early postoperative recovery.
- Published
- 2005
20. [Personal treatment of a case of gastrointestinal autonomic nerve tumour of the second duodenal segment].
- Author
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Napolitano V, Russo G, Maffettone V, Rossetti G, Brusciano L, Sciaudone G, and del Genio A
- Subjects
- Anastomosis, Surgical methods, Endosonography, Female, Humans, Middle Aged, Pancreaticoduodenectomy, Autonomic Nervous System, Duodenal Neoplasms surgery, Duodenum surgery, Peripheral Nervous System Neoplasms surgery
- Abstract
Gastrointestinal autonomic nerve tumours are an uncommon form of gastrointestinal stromal tumours. Since both gastrointestinal stromal tumours and gastrointestinal autonomic nerve tumours are potentially malignant, radical surgical excision is always required. We report a case of a gastrointestinal nerve tumour measuring about 5 cm in diameter and arising from the medial wall of the second portion of the duodenum about 1.5 cm below the papilla of Vater. Because of this rare location a very invasive procedure (duodenocephalo-pancreatectomy) might have been required for tumour resection. We avoided this operation and implemented an alternative solution. Endoscopic ultrasonography was very helpful for this purpose, revealing that the tumour was confined within the duodenal wall and separated from the papilla. We employed a non-conventional surgical technique consisting in a duodenal resection comprising the tumour and a direct TT anastomosis of the duodenal stumps. Two technical devices were of fundamental importance for carrying out this procedure: (i) Ligasure which made dissection between the pancreatic head and duodenal wall a safe manoeuvre with little bleeding; and (ii) Valtrac, which allowed us to perform a large anastomosis without any tension on the duodenal stumps. Intraoperative endoscopy was also important. No anastomotic leakage occurred. At follow-up at 12 months the patient is in good health and CT scan and endoscopic ultrasonography have shown no recurrence of disease.
- Published
- 2004
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