Search results for "procedures"

How should I treat a DeBakey type I acute aortic dissection four weeks after transcatheter aortic valve implantation in an old, fragile patient?

2015

The improvement of quality of life a indication for elective surgery in elderly patients with minimally symptomatic inguinal hernia.

2014

AIM: Effectiveness of surgery on quality of life in elderly affected by minimally symptomatic inguinal hernia. MATERIAL OF STUDY: Forty male patients aging over 75 years affected by minimally symptomatic inguinal hernia were included. In the first group were allocated 15 patients who refused hernioplasty; in the second were included 25 patients who underwent early elective hernioplasty using an high density polypropylene mesh under local anesthesia. The SF-36 questionnaire was administered to all patients at the time of enrollment and 6 months after. RESULTS: All 8 domains of SF-36 and his related two comprhensive index, Mental Component Summary and Physical Component Summary scores, improv…

Open mini-invasive cholecystectomy in high risk elderly. A review of 121 consecutive procedures.

2011

INTRODUCTION: the report describes the features of a low cost, open mini-invasive procedure for cholecystectomy in a sample of 121 consecutive high risk elderly (ASA score 3 to 5). PATIENTS AND METHODS: the surgery is performed through a 3 - 4 cm right subcostal skin incision. An optimal exposition of the operating field was achieved thanks to an innovative three valve retractor. RESULTS: a mean hospital stay of 3,02 days, low complication rate and 2,4% mortality are the results of the described procedure. CONCLUSIONS: in high risk elderly the results are extremely encouraging, particularly in comparison with both laparoscopic and traditional open cholecystectomy. The open minisurgical chol…

Endovascular treatment of abdominal aortic anastomotic pseudoaneurysm. The experience of two centers.

2012

INTRODUCTION: Abdominal aortic pseudoaneurysms are a rare but serious complication of aortic surgery. Treatment with traditional open surgery is associated with a high rate of perioperative mortality and morbidity. Endovascular treatment is less invasive and guarantees lower mortality and morbidity rates. The aim of this study was to evaluate the role of short-, medium- and long-term endovascular treatment of these pseudoaneurysms. MATERIALS AND METHODS: Over the past 10 years, 14 patients with abdominal aortic aneurysms, which developed after prior aortic surgery, underwent endovascular treatment involving implantation of an endoprosthesis at our institutions. Exclusion criteria were emerg…

Survival after Suicidal Transsection of the Left Common Carotid Artery in Octogenarian

2011

Surgical repair of popliteal artery aneurysms remains a safe treatment option in the endovascular era: a 10-year single-center study

2012

Introduction: Endovascular popliteal artery aneurysm repair has emerged recently as a feasible alternative to standard surgical repair. However the evidence from the literature is still limited, with only case reports, case series and one small randomized trial. Currently these data suggest the use of stent-grafts in patients at very high surgical risk. The purpose of this study is to present our surgical experience in popliteal artery aneurysm repair in an era of endovascular philosophy. Materials and Methods: Data from 36 consecutive patients who were admitted to our hospital from January 2000 to April 2010, were analyzed retrospectively. Twenty-six patients underwent surgical treatment t…

Role of Cachexia and Fragility in the Patient Candidate for Cardiac Surgery

2021

Frailty is the major expression of accelerated aging and describes a decreased resistance to stressors, and consequently an increased vulnerability to additional diseases in elderly people. The vascular aging related to frail phenotype reflects the high susceptibility for cardiovascular diseases and negative postoperative outcomes after cardiac surgery. Sarcopenia can be considered a biological substrate of physical frailty. Malnutrition and physical inactivity play a key role in the pathogenesis of sarcopenia. We searched on Medline (PubMed) and Scopus for relevant literature published over the last 10 years and analyzed the strong correlation between frailty, sarcopenia and cardiovascular…

The place of frailty and vulnerability in the surgical risk assessment: should we move from complexity to simplicity?

2018

Due to aging of the world population, older patients accessing health services are becoming continuously more frequent. This has increased the interest in assessing frailty and vulnerability in all specialties and general medicine. Although the term frailty has been recognized for over 30 years, there is not yet a universally recognized definition, and different care providers assess frailty and vulnerability with dissimilar tools, from very complex to very simple validated scales. Being treated with respect and dignity at the right time and place is the key message, as well as after undergoing a global evaluation both in urgency/emergency and in programmed surgery for all older surgical pa…

Fissurectomy and anoplasty in posterior normotensive chronic anal fissure.

2021

Purpose: Anal Fissure (AF) is the second most frequent proctological disease in Italy. Chronic AF (CAF) most common located at the posterior anal commissure (CAPF). CAPF are thought to be associated with hypertonic internal anal sphincter (IAS) but manometric findings showed that a normotonic IAS is present in the 20-40%. Sphincterotomy is often recommended as treatment of choice for CAF independently from IAS tone; nevertheless, this approach appears less logical for CAF with normotonic IAS, as in those cases there’s a higher risk of post-operative anal incontinence. The aim of this study is to evaluate the results of fissurectomy and anoplasty with V-Y cutaneous advancement flap, as treat…

Preconcentration of aluminium by micellar-enhanced ultrafiltration

1993

Abstract Traces of aluminium were preconcentrated in water samples by forming a complex with lumogallion, and successfully accumulated in the micellar phase obtained from cationic or non-ionic surfactants and filtered through 10 000 molecular weight cut-off ultrafiltration membranes. Studies indicated that, at pH 5.9, with 1 X 10 −3 M lumogallion and 2 X 10 −2 M cetyltrimethylamonium bromide, quantitative retention of aluminium present at μg ml −1 concentration levels was achieved. A micellar-enhanced fluorimetric procedure was employed to analyse the permeate solutions, whereas nitrous oxide-acetylene flame atomic emission spectrometry was used to determine aluminium in the retentate. The …