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61.
Pierpaolo Sileri Vito Maria Stolfi Giampiero Palmieri Alessandra Mele Alessandro Falchetti Sara Di Carlo Achille Lucio Gaspari 《Journal of gastrointestinal surgery》2007,11(12):1662-1668
Stapled hemorrhoidopexy is widely accepted to treat hemorrhoids, but serious complications have been reported. In this prospective
audit, we correlated clinical outcome with pathological findings. From January 2003 to April 2007, 94 patients underwent hemorrhoidopexy.
Macroscopic appearance of the specimen (shape, size, and depth) was recorded. Microscopically, the presence of columnar, transitional,
and squamous epithelium, the involvement of circular/longitudinal smooth muscle, and features of mucosal prolapse were assessed.
Clinical outcome was evaluated by a validated questionnaire. Postoperative pain, secretion, and bleeding durations were 12.7 +/− 10.6,
5.6 +/− 9.6, and 6.3 +/− 8.4 days. Patient’s return to work averaged 16.7 +/− 10.7 days. Fissure, skin tags, and anal strictures
were observed in 23.4%. Seven patients experienced pain for a significantly longer period of time. All specimens contained
columnar mucosa, but 29.8% contained columnar and transitional epithelium and 12.8% contained columnar, anal transitional,
and stratified squamous epithelium. Smooth muscle was observed in 62.7%. Pain was significantly increased if transitional
epithelium was present in the specimen. No correlation or differences were observed if smooth muscle was present, although
postoperative bleeding was more frequent. Hemorrhoidopexy is safe and effective. The specimen should always be sent for pathology
examination. Only columnar epithelium should be present and, although the presence of smooth muscle does not influence the
outcome in terms of functional results, its presence may play a role in postoperative bleeding.
Presented as poster at the Digestive Disease Week, May 2007, Washington, USA 相似文献
62.
63.
Isidoro Di Carlo Elia Pulvirenti Adriana Toro Giuseppe Corsale 《World journal of surgery》2009,33(3):520-525
Background Laparoscopic cholecystectomy is now indisputably the gold standard for managing most gallbladder diseases. However, subversion
of the Calot triangle anatomy cannot always be managed by laparoscopy and often requires a laparotomy conversion. This report
discusses our patients treated with our personal technique.
Methods Patients undergoing subtotal cholecystectomy performed by the same surgeon with a personal technique from January 1999 to
December 2007 were considered for the present study. Sex, age, symptoms, co-morbidities, diagnostic modality, time between
hospitalization and surgery, length of postsurgical hospitalization, morbidity and mortality, and follow-up were assessed.
Results Four men and six women, aged 23 to 88 years, were included. Every patient had symptoms of acute cholecystitis. Four patients
had had symptoms for an average of 2.5 days and six for an average of 5.1 h. All patients were studied by ultrasonography,
and seven underwent computed tomography. The operation was performed within 48 h in all patients. The average hospital stay
from surgery to discharge was different for patients who underwent primary open cholecystectomy (10 days, range 5–16 days)
and those having a conversion after a laparoscopic attempt (7.8 days, range 4–16 days). During the postoperative period only
one patient presented a self-limiting biliary leak. No postoperative mortality occurred. At follow-up, any recurrences of
stone in the biliary tract or newly formed pouch were recorded.
Conclusions The results suggest that this new approach can be considered effective in every instance of subversion of the normal anatomy
of Calot’s triangle. 相似文献
64.
65.
Carlo Piccinni Chiara Sacripanti Elisabetta Poluzzi Domenico Motola Lara Magro Ugo Moretti Anita Conforti Nicola Montanaro 《European journal of clinical pharmacology》2010,66(2):199-206
Aim
The aim of the present study was to collect and compare cases of drug-induced PML in order to contribute to the debate about the role of the underlying diseases and/or drug immunosuppression in PML occurrence. 相似文献66.
67.
68.
V. Di Carlo C. Staudacher M. Cristallo G. Ferrari M. Carlucci R. Castoldi A. Secchi E. La Rocca S. Martinenghi R. Caldara et al. 《Diabetologia》1991,34(Z1):S11-S13
Results of 33 simultaneous pancreas and kidney transplantations performed at the San Raffaele Hospital, Milan, Italy are presented. In 26 cases segmental neoprene duct-injected grafts were transplanted and in seven cases, duodenopancreatic bladder-drained grafts. Five-year patient, kidney and pancreas survival were respectively, 89%,72% and 58%. Five-year survival in patients with technically successful pancreas transplants was 73%. Thrombosis occured in 20% of cases. Mortality was 6% and overall morbidity 76%. Surgical complications were present in 51% of cases. 相似文献
69.
70.
Giovanni Battista Grossi Carlo Maiorana Rocco Alberto Garramone Andrea Borgonovo Luca Creminelli Franco Santoro 《Journal of oral and maxillofacial surgery》2007,65(5):901-917
PURPOSE: The purpose of this study was to identify the risk factors for severe discomfort after mandibular third molar surgery and to assess the validity of the Postoperative Symptom Severity (PoSSe) scale. PATIENTS AND METHODS: In a 2-year prospective study, a total of 255 unilateral impacted mandibular third molar teeth were surgically removed under local anesthesia by 3 surgeons. Standardized surgical and analgesic protocols were followed. At the review appointment, 1 week after surgery, all patients returned a completed follow-up questionnaire (PoSSe scale) and were evaluated clinically for postoperative pain (number of painkillers taken) and trismus (differences in mouth opening). Sixteen predictive variables were evaluated using stepwise logistic regression analysis to identify the risk factors associated with severe discomfort. RESULTS: Severe postoperative discomfort was predicted by these independent variables: gender, tobacco use, ramus relationship/space available, and antibiotic prophylaxis. Oral contraceptive use and operation time were not identified as risk factors. The patients' perceptions of the severity of symptoms (PoSSe scale score) was strongly correlated with clinical assessment of trismus (r = 0.54) and pain (r = 0.42). CONCLUSION: The PoSSe scale resulted in a valid and responsive measure of the severity of symptoms after surgical extraction of lower third molars and reflected the clinical severity of the postoperative discomfort. From a patient's perspective, operative factors had little bearing on the quality of life after removal of mandibular third molars. 相似文献