Search results for "Surgical"
showing 10 items of 2288 documents
Outpatient management of proctologic disease. Which techniques for local anesthesia? The experience of a single center
2019
Introduction. Since 1899 outpatient management of surgical patients had been increasing, becoming the best option when possible. In 1988 was described the first experience of outpatient management of proctologic disease. Advances in local anesthesia techniques have improved the outpatient approach to surgical disease, particularly in patients with proctological diseases. Methods. From 2010 to 2016, 1160 patients who needed surgery for proctologic disease have been recruited: 239 hemorrhoidectomies using the variant of Milligan Morgan technique described by Phillips, 45 trans-anal hemorrhoidal DE-arterialization (THD), 315 sphincterotomies, 12 anal polypectomies, 230 loop seton positions, 65…
Effect of epidural anesthesia on colorectal anastomosis: a tonometric assessment.
1997
PURPOSE: Epidural anesthesia is believed to benefit colorectal anastomotic blood flow because of the sympathetic blockade it produces. Our purpose is to measure with tonometry the effect of epidural anesthesia on colorectal anastomotic oxygenation. PATIENTS AND METHODS: Fifteen patients operated on for rectal cancer (radical anterior resection) were monitored postoperatively using tonometers placed in the stomach (celiac trunk), transverse colon (superior mesenteric artery), and the anastomotic area during the operation. An epidural catheter was placed at L1-2, and on the first postoperative day, 8 ml of bupivacaine (0.25 percent) was administered. The anesthetic effect extended up to T-4. …
Lack of prompt expansion of cytomegalovirus pp65 and IE-1-specific IFNγ CD8+ and CD4+ T cells is associated with rising levels of pp65 antigenemia an…
2009
Rising levels of cytomegalovirus (CMV) DNAemia and/or pp65 antigenemia have been observed during pre-emptive ganciclovir therapy in patients undergoing allogeneic hematopoietic stem cell transplantation (allo-SCT). We assessed the incidence of this event in our series, and investigated whether its occurrence was associated with an impairment in the CMV-specific T-cell response. A total of 36 allo-SCT recipients experienced one or more episodes of active CMV infection (n=68) that were pre-emptively treated with val(ganciclovir). Rising levels of antigenemia and DNAemia, and an isolated increase in antigenemia, were observed in 39.7 and 2.9% of all episodes, respectively. Receipt of corticost…
Increase of CCR7- CD45RA+ CD8 T cells (TEMRA) in Chronic Graft-versus-host Disease
2006
Among the late effects of hematopoietic stem cell transplantation (HSCT), chronic graft-vs-host disease (cGVHD) still remains as the major determinant of long-term outcome and quality of life. The disease typically appears between 3 months to 1.5 years following an allogeneic transplantation and is characterized by symptoms similar to those of autoimmune disease.
Incidence of bisphosphonate-associated osteonecrosis of the jaws in breast cancer patients.
2009
BACKGROUND: Bisphosphonate-associated osteonecrosis of the jaws (BP-ONJ) is a relatively new disease. The aim of this study was to evaluate the prevalence of BP-ONJ in breast cancer patients with osseous metastasis and bisphosphonate therapy. METHODS: A retrospective study was conducted in a EUSOMA accredited breast unit in Germany. All patients treated from January of 2000 to March of 2006 with metastatic breast cancer and bisphosphonate therapy were reviewed. All patients were contacted, and missing data were completed through structured interviews with their dentists and physicians (n = 75). Primary outcome was the development of BP-ONJ and the detection of possible additional trigger fa…
Delayed Coloanal Anastomosis for rectovaginal fistula after colorectal resection for deep endometriosis
2016
The deep infiltrating endometriosis, defined as a subperitoneal infiltration of endometrial implants of ≥ 5 mm involving not only the colorectal tract but also rectovaginal septum, vagina and bladder often requires a challenging surgery. Endometriosis nodes of the rectovaginal septum, if symptomatic, need a resection of the involved colorectal tract with colorectal or coloanal anastomosis. Unfortunately in these cases is not uncommon the possibility of a postoperative rectovaginal fistula (RVF), caused by the weakness of the septum that must be skeletonized to completely remove the endometriosis nodes. Here we present a case of anastomotic leakage with high RVF after colorectal resection an…
Empowering counseling--a case study: nurse-patient encounter in a hospital
2001
This study illustrates practices that a nurse uses in order to empower patients. The emphasis is on speech formulae that encourage patients to discuss their concerns and to solicit information about impending surgery. The study is a part of a larger research project and a single case was selected for presentation in this article because it differed from the rest of the data by manifesting empowering practice. A videotaped nurse-patient health counseling session was conducted in a hospital and transcribed verbatim. The investigator interviewed the nurse and the patient after the conversation, and these interviews were transcribed as well. The encounter that is presented here as a case study …
Extraction of Impacted Maxillary Canines With Simultaneous Implant Placement
2005
When impacted maxillary canines are not amenable to orthodontic traction or reimplantation, extraction is the only option available, followed by implant placement. If apical and ridge crest bone remains after the extraction of the maxillary canines, an immediate implant can be placed. The implant is anchored bicortically with good primary fixation. This article presents a new surgical technique that allows an immediate implant placement after the extraction of the maxillary canines. The full circumference of the implant is left without bone coverage, except for the apical and coronal area. The implant screw threads and the bone defect are covered with the bone shavings collected by the filt…
Giant pseudocyst of the abdominal wall following incisional ventral hernia repair: an extremely rare clinical entity. Report of a case
2021
Il “gold standard” per il trattamento dei laparoceli è l’intervento chirurgico con impiego di protesi, nonostante questo approccio sia gravato da numerose complicanze post-operatorie; tra queste possiamo annoverare le pseudocisti giganti della parete addominale, tale evenienza risulta ancora molto rara e la sua eziopatogenesi riamane non chiara. In questo lavoro descriviamo il caso clinico di una paziente di 36 anni, diabetica ed obesa, precedentemente sottoposta a taglio cesareo e riparazione di laparocele con posizionamento di protesi in sede soprafasciale. La paziente si è presentata presso i nostri ambulatori per la comparsa di un gonfiore asintomatico a livello della fossa iliaca sinis…
Treatment of tumors of the pancreatic head with suspected but unproved malignancy: is a nihilistic approach justified?
1999
The aim of the present prospective observational study was to evaluate the accuracy of preoperative imaging studies and the outcome of patients after pancreaticoduodenectomy for suspected but unproved malignancy. Pancreaticoduodenectomy was performed in 186 patients with a suspected but histologically unproved malignancy of the pancreatic head: 86 with a ductal pancreatic carcinoma, 56 with a periampullary tumor, 18 with a cystadenocarcinoma, 13 with a rare malignant tumor or a metastasis, and 13 with a benign tumor. An accurate differentiation between a ductal pancreatic carcinoma and a nonductal tumor or a benign tumor was neither possible with tumor marker CA 19-9 nor with diagnostic ima…