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Farinazzo E, Ponis G, Zelin E, Errichetti E, Stinco G, Pinzani C, Gambelli A, De Manzini N, Toffoli L, Moret A, Agozzino M, Conforti C, Di Meo N, Schincariol P, Zalaudek I. Cutaneous adverse reactions after m-RNA COVID-19 vaccine: early reports from Northeast Italy. J Eur Acad Dermatol Venereol 2021; 35:e548-e551. [PMID: 34021625 PMCID: PMC8242497 DOI: 10.1111/jdv.17343] [Citation(s) in RCA: 45] [Impact Index Per Article: 15.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/24/2023]
Affiliation(s)
- E Farinazzo
- Dermatology Clinic, Maggiore Hospital, University of Trieste, Trieste, Italy
| | - G Ponis
- Hospital Pharmacy Unit, Cattinara Hospital, Trieste, Italy
| | - E Zelin
- Dermatology Clinic, Maggiore Hospital, University of Trieste, Trieste, Italy
| | - E Errichetti
- Department of Medical Area, Institute of Dermatology, University of Udine, Udine, Italy
| | - G Stinco
- Department of Medical Area, Institute of Dermatology, University of Udine, Udine, Italy
| | - C Pinzani
- Dermatology and Venereology, Private Practice, Udine, Italy
| | - A Gambelli
- Division of Molecular Oncology, Centro di Riferimento Oncologico di Aviano (CRO) IRCCS, National Cancer Institute, Aviano, Italy
| | - N De Manzini
- UCO Chirurgia Generale, Cattinara Hospital, University of Trieste, Trieste, Italy
| | - L Toffoli
- Dermatology Clinic, Maggiore Hospital, University of Trieste, Trieste, Italy
| | - A Moret
- Dermatology Clinic, Maggiore Hospital, University of Trieste, Trieste, Italy
| | - M Agozzino
- Dermatology Clinic, Maggiore Hospital, University of Trieste, Trieste, Italy
| | - C Conforti
- Dermatology Clinic, Maggiore Hospital, University of Trieste, Trieste, Italy
| | - N Di Meo
- Dermatology Clinic, Maggiore Hospital, University of Trieste, Trieste, Italy
| | - P Schincariol
- Hospital Pharmacy Unit, Cattinara Hospital, Trieste, Italy
| | - I Zalaudek
- Dermatology Clinic, Maggiore Hospital, University of Trieste, Trieste, Italy
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Campisciano G, Palmisano S, Cason C, Giuricin M, Silvestri M, Guerra M, Macor D, De Manzini N, Crocé LS, Comar M. Gut microbiota characterisation in obese patients before and after bariatric surgery. Benef Microbes 2018; 9:367-373. [PMID: 29482339 DOI: 10.3920/bm2017.0152] [Citation(s) in RCA: 29] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Abstract
Intestinal microbiota analysis of obese patients after bariatric surgery showed that Proteobacteria decreased after laparoscopic sleeve gastrectomy (SG), while it increased after laparoscopic gastric bypass (LGB). Comparing to normal weight (NW) patients, obese patients that were selected for SG showed an almost equal amount of Firmicutes and Bacteroidetes and the ratio was not affected by the surgery. Obese patients before LGB showed a predominance of Bacteroidetes, whose amount regained a relative abundance similar to NW patients after surgery. Obese patients before LGB showed the predominance of Bacteroides, which decreased after surgery in favour of Prevotella, a bacterium associated with a healthy diet. The bacteria detected at the highest percentages belonged to biofilm forming species. In conclusion, in this study, we found that the characterization of the gut microbial communities and the modality of mucosal colonisation have a central role as markers for the clinical management of obesity and promote the maintenance of good health and the weight loss.
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Affiliation(s)
- G Campisciano
- 1 Institute for Maternal and Child Health - IRCCS Burlo Garofolo, Via dell'Istria 65/1, 34137 Trieste, Italy
| | - S Palmisano
- 2 Department of Medical, Surgical and Health Sciences, General Surgery Clinic, University Hospital of Trieste, Strada di Fiume 447, 34100 Trieste, Italy.,3 General Surgery Clinic, ASUITS, Strada di Fiume 447, 34149 Trieste, Italy
| | - C Cason
- 2 Department of Medical, Surgical and Health Sciences, General Surgery Clinic, University Hospital of Trieste, Strada di Fiume 447, 34100 Trieste, Italy
| | - M Giuricin
- 3 General Surgery Clinic, ASUITS, Strada di Fiume 447, 34149 Trieste, Italy
| | - M Silvestri
- 3 General Surgery Clinic, ASUITS, Strada di Fiume 447, 34149 Trieste, Italy
| | - M Guerra
- 3 General Surgery Clinic, ASUITS, Strada di Fiume 447, 34149 Trieste, Italy
| | - D Macor
- 2 Department of Medical, Surgical and Health Sciences, General Surgery Clinic, University Hospital of Trieste, Strada di Fiume 447, 34100 Trieste, Italy.,4 Clinica Patologie del Fegato, ASUITS, Strada di Fiume 447, 34149 Trieste, Italy.,5 University of Verona, via S. Francesco 22, 37129 Verona, Italy
| | - N De Manzini
- 2 Department of Medical, Surgical and Health Sciences, General Surgery Clinic, University Hospital of Trieste, Strada di Fiume 447, 34100 Trieste, Italy.,3 General Surgery Clinic, ASUITS, Strada di Fiume 447, 34149 Trieste, Italy
| | - L S Crocé
- 2 Department of Medical, Surgical and Health Sciences, General Surgery Clinic, University Hospital of Trieste, Strada di Fiume 447, 34100 Trieste, Italy.,4 Clinica Patologie del Fegato, ASUITS, Strada di Fiume 447, 34149 Trieste, Italy
| | - M Comar
- 1 Institute for Maternal and Child Health - IRCCS Burlo Garofolo, Via dell'Istria 65/1, 34137 Trieste, Italy.,2 Department of Medical, Surgical and Health Sciences, General Surgery Clinic, University Hospital of Trieste, Strada di Fiume 447, 34100 Trieste, Italy
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Tarchi P, Cosola D, Germani P, Troian M, De Manzini N. Self-adhesive mesh for Lichtenstein inguinal hernia repair. Experience of a single center. MINERVA CHIR 2014; 69:167-176. [PMID: 24736447] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/03/2023]
Abstract
AIM Lichtenstein tension-free mesh repair is the most frequently performed procedure for inguinal hernioplasty. In the past surgery aimed to control recurrences. Nowadays it is important to avoid postoperative chronic pain and thus several studies have examined the potential role of meshes in causing postoperative pain. The purpose of this study was to retrospectively assess the early and long-term results after Lichtenstein tension-free repair using a self-adhesive mesh (Parietex ProgripTM - Covidien, Germany) in a single center. METHODS The study enrolled 211 patients, 199 males (94.3%) and 12 females (5.7%), mean age 62 years (28-90 years), between January 2008 and December 2011. Of these, 206 had primary inguinal hernias while 5 were recurrences following previous tension repair. Ten different general surgeons, including residents, performed Lichtenstein hernia repair using a 12 x 8-cm Parietex ProgripTM mesh. In 88.1% of patients no additional fixation was used, while in 11.9% a single 2-0 polypropylene stitch was placed on the pubic bone. A 1-10 visual analog scale (VAS) was used to assess postoperative pain, evaluating it at 1 week, 1 month and 12, 24 and 36 months. Local paresthesia was assessed at same intervals. Any pain sensation lasting longer than 3 months postoperatively, or requiring injection of analgesics was defined as chronic pain. RESULTS Mean operating time was 64.1 minutes (SD ± 21.14). There were no intraoperative complications. Early postoperative complications included hematoma-seroma (5.7% cases), superficial wound infection (1%), urinary retention (0.5%), and scrotal swelling (1%). The main follow-up period was 3 years, although patients operated between 2009 and 2011 underwent a shorter follow-up. At one-year follow-up, 17 patients reported groin discomfort, but did not require analgesics. Three patients reported moderate pain, requiring occasional use of oral analgesics, and 2 of these described a discontinuous pain mainly during movement. One patient reported severe pain requiring local injection of analgesics. At 2-year follow-up, 3 patients reported groin discomfort. Five of the 17 patients who reported discomfort at 1 year were lost to the 2-year follow-up. One patient kept reporting a high VAS score (6), though slightly reduced from the previously reported at 1-year follow-up. Recurrence was observed in 0.5% at 1 year and in 2.4% at 2 years. At 3 years only half of the patients (102) were still on follow-up. Of these, 1 reported mild discomfort and 3 developed hernia recurrence. Globally a decrease in pain and local discomfort was observed. No cases of seroma, testicular complications or mesh infection were reported at 1-, 2- and 3-year follow-up. CONCLUSION Self-gripping mesh for inguinal hernia repair is a good and safe option, easy to handle and with a low incidence of chronic pain (<3%). A sutureless fixation seems to prevent the development of postoperative chronic pain, without increasing recurrence rates. Using a self-adhesive mesh also slightly reduce operating times, and costs are lower when compared to biological glue used to fix the mesh. In conclusion, our experience with the self-gripping mesh is limited but positive, randomized clinical trials are warranted to confirm our results.
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Affiliation(s)
- P Tarchi
- Department of General Surgery University of Trieste, Trieste, Italy -
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Pelizzo MR, Dobrinja C, Casal Ide E, Zane M, Lora O, Toniato A, Mian C, Barollo S, Izuzquiza M, Guerrini J, De Manzini N, Merante Boschin I, Rubello D. The role of BRAF(V600E) mutation as poor prognostic factor for the outcome of patients with intrathyroid papillary thyroid carcinoma. Biomed Pharmacother 2014; 68:413-7. [PMID: 24721322 DOI: 10.1016/j.biopha.2014.03.008] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2014] [Accepted: 03/04/2014] [Indexed: 01/21/2023] Open
Abstract
BACKGROUND BRAF(V600E) mutation, which represents the most frequent genetic mutation in papillary thyroid carcinoma (PTC), is widely considered to have an adverse outcome on PTC outcome, however its real predictive value is not still well stated. The aim of the present study was to evaluate if BRAF(V600E) mutation could be useful to identify within patients with intrathyroid ultrasound-N0 PTC those who require more aggressive treatment, by central neck node dissection (CLND) or subsequent postoperative (131)I treatment. METHODS Among the whole series of 931 consecutive PTC patients operated on at 2nd Clinical Surgery of University of Padova and at General Surgery Department of University of Trieste during a period from January 2007 to December 2012, we selected 226 patients with an intrathyroid tumor and no metastases (preoperative staging T1-T2, N0, M0). BRAF(V600E) mutation was evaluated by PCR-single-strand conformation polymorphism analysis and direct genomic sequencing. We analyzed the correlation between the presence/absence of the BRAF(V600E) mutation in the fine-needle aspiration (FNA) and the clinical-pathological features: age, gender, extension of surgery, node dissection, rate of cervical lymph node involvement, tumor size, TNM stage, variant of histotype, mono/plurifocality, association with lymphocitary chronic thyroiditis, radioactive iodine ablation doses, and outcome. RESULTS The BRAF(V600E) mutation was present in 104 of 226 PTC patients (47.8%). BRAF(V600E) mutation correlated with multifocality, more aggressive variants, infiltration of the tumoral capsule, and greater tumor's diameter. BRAF(V600E) mutation was the only poor prognostic factor in these patients. DISCUSSION In our series, BRAF(V600E) mutation demonstrated to be an adverse prognostic factor indicating aggressiveness of disease and it could be useful in the management of low-risk PTC patients, as supplementary prognostic factor to assess the preoperative risk stratification with the aim to avoid unnecessary central neck node dissection (BRAF pos.) or to perform complementary (131)I-therapy (BFAF neg.).
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Affiliation(s)
- M R Pelizzo
- Surgical Clinic II, Department of Surgical, Oncological and Gastroenterological Sciences, University of Padova, Padova, Italy
| | - C Dobrinja
- Division of General Surgery, Department of Medical and Surgical Sciences, Hospital of Cattinara, University of Trieste, Trieste, Italy
| | - E Casal Ide
- Surgical Clinic II, Department of Surgical, Oncological and Gastroenterological Sciences, University of Padova, Padova, Italy
| | - M Zane
- Surgical Clinic II, Department of Surgical, Oncological and Gastroenterological Sciences, University of Padova, Padova, Italy
| | - O Lora
- Radiotherapy and Nuclear Medicine Unit, Istituto Oncologico Veneto-IRCCS, Padova, Italy
| | - A Toniato
- Surgical Clinic II, Department of Surgical, Oncological and Gastroenterological Sciences, University of Padova, Padova, Italy
| | - C Mian
- Endocrinology Unit, Department of Medicine, University of Padova, Padova, Italy
| | - S Barollo
- Endocrinology Unit, Department of Medicine, University of Padova, Padova, Italy
| | - M Izuzquiza
- Surgical Clinic II, Department of Surgical, Oncological and Gastroenterological Sciences, University of Padova, Padova, Italy
| | - J Guerrini
- Division of General Surgery, Department of Medical and Surgical Sciences, Hospital of Cattinara, University of Trieste, Trieste, Italy
| | - N De Manzini
- Division of General Surgery, Department of Medical and Surgical Sciences, Hospital of Cattinara, University of Trieste, Trieste, Italy
| | - I Merante Boschin
- Surgical Clinic II, Department of Surgical, Oncological and Gastroenterological Sciences, University of Padova, Padova, Italy
| | - D Rubello
- Department of Imaging, Nuclear Medicine, PET/CT Centre, Radiology, Neuroradiology, Medical Physics, Santa Maria della Misericordia Hospital, Rovigo, Italy.
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Barazzoni R, Zanetti M, Giuricin M, Palmisano S, Cattin M, Moretti E, Guarnieri G, De Manzini N. PP219-SUN GASTRIC BY-PASS DIFFERENTIALLY MODULATES CIRCULATING SHORT AND LONG PENTRAXINS – HIGHER PLASMA PENTRAXIN-3 AFTER GASTRIC BY-PASS-INDUCED WEIGHT LOSS. Clin Nutr 2013. [DOI: 10.1016/s0261-5614(13)60264-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
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Pessaux P, Tuech JJ, Laurent B, Regenet N, Lermite E, Simone M, Huten N, De Manzini N, Arnaud JP. Complications après anopexie circulaire pour cure d’hémorroïdes : résultats à long terme d’une série de 140 malades et analyse de la littérature. ACTA ACUST UNITED AC 2004; 129:571-7. [PMID: 15581817 DOI: 10.1016/j.anchir.2004.05.008] [Citation(s) in RCA: 15] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Abstract
AIM The aim of this study was to determine the results and the complications of the treatment of hemorrhoids with circular stapler with a follow-up of 18 months, and to review the complications in the literature. METHODS From April 1998 to August 1999, 140 patients (83 males and 57 females) with an average age of 43.8 years (range: 19-83 years) underwent haemorrhoidectomy using a circular stapler in three university hospital centers. The degree of hemorrhoids has been classified: three cases of degree II, 97 cases of degree III, and 40 cases of degree IV. All the patients were prospectively evaluated at two weeks, two and 18 months after surgery. RESULTS The average length of the operation was 18 minutes (range: 8-60 minutes). Mean hospital stay was 36 hours (range: 8-72 hours). There was no intraoperative complication. There was no mortality. The postoperative complication rate was 7.8% (N = 11): there were five cases of bleeding that two complicated by a submucosal hematoma (one was infected and needed a rectotomy on day 21), two cases of urinary retention, and two cases of external hemorrhoid thrombosis. The bleeding occurred in the 12 hours after surgery except for one patient with antivitamin K whith presented a secondary bleeding on day 16. At 18 months, five patients presented a moderate asymptomatic stricture dilated on digital examination. Two patients complained of persistent skin tags. Neither functional trouble nor incontinence to gas, liquids, or solids was presented. With a mean follow-up of 40 months, 90% (N = 112) of the patients were fully satisfied. CONCLUSIONS Treatment of hemorrhoids with circular stapler appears to be effective with 96% of patients fully satisfied at 18 months. The morbidity rate was low, and no higher than the diathermy excision hemorrhoidectomy. The results are directly dependent on the practice that required a learning, and not on the technique itself.
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Affiliation(s)
- P Pessaux
- Département de chirurgie viscérale, CHU de Angers, 4, rue Larrey, 49033 Angers cedex 01, France
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Arnaud JP, Pessaux P, Huten N, De Manzini N, Tuech JJ, Laurent B, Simone M. Treatment of hemorrhoids with circular stapler, a new alternative to conventional methods: a prospective study of 140 patients. J Am Coll Surg 2001; 193:161-5. [PMID: 11491446 DOI: 10.1016/s1072-7515(01)00973-5] [Citation(s) in RCA: 24] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
Abstract
BACKGROUND Surgical hemorrhoidectomy has a reputation for being a painful procedure. The aim of this study was to determine the efficacy and safety of a new procedure for surgical treatment of hemorrhoid disease. STUDY DESIGN From April 1998 to August 1998, 140 patients (83 men and 57 women) with an average age of 43.8 years (range 19 to 83 years) underwent hemorrhoidectomy using a circular stapler. Operative times, pen- and postoperative complications, mean hospital stay, assessment of the postoperative pain, period of incapacity for work, and functional results were collected. All patients were evaluated at 2 weeks, 2 months, and 18 months after operation. RESULTS The average length of the operation was 18 minutes (range 8 to 60 minutes). There were no perioperative complications. The postoperative complication rate was 6.4% (n = 9). Mean hospital stay was 36 hours (range 8 to 72 hours). Paracetamol was the only analgesic used. Eighty-three patients (59.3%) required analgesic for less than 2 days, 45 patients (32.1%) between 2 and 7 days, and 12 patients (8.6%) more than 7 days. No patients had anal wound care. One hundred four patients had professions. The period of incapacity for work was less than 3 days for 22 patients (21.1%), between 3 and 7 days for 13 patients (12.5%), between 7 and 14 days for 62 patients (59.6%), and more than 14 days for 7 patients (6.8%). At 18 months, 95.7% of patients were fully satisfied with the results, 3.6% were somewhat satisfied (n = 4), and 0.7% were unsatisfied. CONCLUSIONS Treatment of hemorrhoids with a circular stapler appears to be safe, effective, and rapid, causing few postoperative complications and minimal postoperative pain. At 18 months, 95.7% of the patients were fully satisfied with the results.
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Affiliation(s)
- J P Arnaud
- Department of Visceral Surgery, CHU Angers, France
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Papillon M, Arnaud JP, Descottes B, Gravie JF, Huten X, De Manzini N. [Treatment of hemorrhoids with the Longo technique. Preliminary results of a prospective study on 94 cases]. Chirurgie 1999; 124:666-9. [PMID: 10676029 DOI: 10.1016/s0001-4001(99)00079-3] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
Abstract
AIM OF STUDY The aim of this multicenter prospective study was to report the early results of Longo procedure for the surgical treatment of hemorrhoids disease. PATIENTS AND METHOD From April 1998 to July 1998, 94 patients (60 men and 34 women with a mean age of 47 years) were treated according to Longo procedure for a mucosal prolapse (12 grade II, 63 grade III, and 19 grade IV). All patients were evaluated at 2 and 6 postoperative months. The technique consisted in the reduction of mucosal and hemorrhoidal prolapses with a circular suturing device. RESULTS Postoperative morbidity rate was 6.3% (n = 6). A rectal bleeding occurred within 12 hours after surgery in five patients. The mean postoperative length of hospital stay was 36 hours (range: 24-72 hours). The only antalgic prescribed was paracetamol. Local care was not necessary in any patient. After 6 months, 89 patients (94.7%) were very satisfied, three patients (3.2%) were satisfied (rectal sub-mucosal abscess in one case, functional troubles in two cases) and two patients (2.1%) were not satisfied (persistence of mucosal prolapse). CONCLUSION These preliminary results are satisfactory but need to be confirmed by a prospective randomized trial, comparing Milligan Morgan procedure and Longo procedure.
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Affiliation(s)
- M Papillon
- Département de chirurgie viscérale, CHU Angers, France
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Meyer C, Rohr S, De Manzini N, Firtion O, Thiry L, Bourtoul C. [Laparoscopic treatment of gastroesophageal reflux using fundoplication. Midterm results]. Ann Chir 1998; 52:598-601. [PMID: 9805795] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/09/2023]
Abstract
UNLABELLED The aim of this study was to see whether the results of surgical treatment of gastroesophageal reflux disease (GERD) by laparoscopic fundoplication were satisfactory and stable over time. PATIENTS AND METHODS From July 1992 to September 1996, 161 patients with medical treatment-dependent GERD were operated. 17 patients were excluded from the study (conversion or immediate laparotomy). The group of 144 patients included consisted of 92 men and 52 women with a mean age of 50 (25-77 years). The preoperative work-up included endoscopy, esophageal manometry and 24-hour pH monitoring. The surgical procedures were complete fundoplication without section of the short vessels (Nissen-Rossetti: 122 cases), with section of the shorts vessels (Nissen: 18 cases), or partial fundoplication of 270 degrees (Toupet: 4 cases). The patients were reviewed clinically 3 months after the operation, with repeat manometry and pH monitoring; yearly survey was performed. RESULTS There was no postoperative mortality. The morbidity consisted of 2 respiratory complications (1.5%) with good recovery. With a follow-up of 3 and 21 months, the dysphagia rate was 24 vs 2% of patients (p < 0.05), the rate of gas bloat syndrome was 18% vs 21% (n.s.), and the GERD recurrence 6% vs 14% (p < 0.05). The mean time to recurrence was 8 months. 2 patients were reoperated: one for incisional hernia and one for slipped-Nissen. CONCLUSION The results of laparoscopic treatment of GERD with fundoplication procedures at 2 years follow-up showed an 86% cure rate of GERD control and 94% satisfaction rate for the patients who were investigated.
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Affiliation(s)
- C Meyer
- Service de Chirurgie Générale et Digestive, CHU Hautepierre, Strasbourg
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Meyer C, Rohr S, Vix J, De Manzini N, Bourtoul C, Thiry LC. [Outcome of surgical treatment of cancer of the stomach. Report of 330 cases]. Chir Ital 1998; 49:27-33. [PMID: 9612649] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
The study concerned 330 cases of gastric adenocarcinoma operated from January 1969 to June 1996. Clinical, histological and therapeutic features were analyzed and compared during 3 periods (Group 1: 1969-79, Group 2: 1979-88, Group 3: 1989-96). The aim was to evaluate changes and results occurred in gastric carcinoma. The median age was 65 +/- 11 year (range 25-90), the sex ratio 2. The most common location was in the lower third of the stomach and the cancer was often far advanced (71 percent of stages III and IV). Subtotal gastrectomy was replaced by total gastrectomy and large lymph node dissection was systematically performed in group 3. Curative resection rate increased from 28 to 60 percent between group 1 and group 3. Despite the more radical surgery, post-operative mortality rates decreased respectively 22%, 9%, 8% for the groups 1, 2, 3 (p < 0.01) and global morbidity remained stable while the rate of intra-abdominal infection have changed in group 3 (4.8% vs 2.7% and 2.1% in respectively groups 1 and 2; p = ns). Two year survival rates were 20% for group 1.25% for group 2 and 35% for group 3 (p < 0.01). This results can be considered as encouraging but have to be confirmed at 5 year survival.
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Affiliation(s)
- C Meyer
- Service de Chirurgie Générale et Digestive, Hôpital de Hautepierre, CHU de Strasbourg
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Rohr S, De Manzini N, Vix J, Tiberio G, Wantz C, Meyer C. [Value of absorbable clips in laparoscopic cholecystectomy. A randomized prospective study]. J Chir (Paris) 1997; 134:180-4. [PMID: 9499947] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
Most surgeons use metal clips in laparoscopic cholecystectomy. The aim of this prospective randomized controlled study was to evaluate the efficacy of absorbable clips in elective laparoscopic cholecystectomy. One hundred consecutive patients with symptomatic gallstones without complications were randomized into groups; group T had two metal clips (titan clip ETHICONR), group R (laproclipR Davis and Geck) had one absorbable clip applied on the cystic duct and cystic artery. The patients were followed for one year. There was no difference between the two groups concerning operative time, hospital stay and postoperative complications. The absorbable clips seem to be as effective as metal clips in providing hemostasis in cystic artery and in cystic duct ligation.
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Affiliation(s)
- S Rohr
- Service de Chirurgie Générale et Digestive Centre de Chirurgie Viscérale et de Transplantation, Strasbourg
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Meyer C, Rohr S, De Manzini N, Thiry CL, Firtion O. [Pancreatico-jejunal anastomosis with invagination on isolated loop after cephalic pancreatoduodenectomy]. Ann Ital Chir 1997; 68:613-5. [PMID: 9577036] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
The most frequent and most dangerous complication of the duodenopancreatectomy is pancreatic fistula due to dehiscence of the pancreatic anastomosis. A technique that uses a separate Roux en Y loop for pancreatic anastomosis, to reduce the fatal risks of the pancreatic fistula, has been initially reported more than 50 years ago. With the development of the pancreaticogastrostomy, it seems interesting to present a procedure using an isolated loop for the pancreas; this technique is derived from those previously published, allowing a good intussuception of the pancreas in the intestinal loop. This method has been performed in 35 duodenopancreatectomy (malignant pancreatic disease: 32 patients, benign pancreatic disease: 3 patients). The mean age of the patients was 64 years (range 34-74). There were four operative deaths unrelated to the pancreaticojejunal anastomosis and two pancreatic fistulas with spontaneous healing. The pancreatico-jejunostomy using a separate Roux en Y loop represented in this short experience a safe procedure to prevent pancreatic fistula.
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Affiliation(s)
- C Meyer
- Service de Chirurgie Générale et Digestive, Centre de Chirurgie Viscérale et de Transplantation, Hôpitaux Universitaires de Strasbourg-Hautepierre, Francia
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13
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Meyer C, Perraud V, Rohr S, De Manzini N, Thiry LC. [Surgical treatment of adenocarcinoma of the stomach: 1969-1994. Apropos of 261 cases]. J Chir (Paris) 1995; 132:423-9. [PMID: 8550705] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/31/2023]
Abstract
The study concerned 261 cases of gastric adenocarcinoma operated on between 1969 and 1994. Clinical, histological and therapeutic features were analyzed and compared during 3 periods (Group 1: 1969-78, Group 2: 1979-88, Group 3: 1989-94). The aim was to evaluate changes and results occurred in gastric carcinoma. The median age was 65 years (rage 25-90 years), the sex ratio, 1.9. The most common location was in the lower third of the stomach and the cancer was often far-advanced (73 percent of stages III and IV). Subtotal gastrectomy was replaced by total gastrectomy; the number of distal gastrectomy was unchanged. Large lymph node dissection was systematically performed in group 3. Curative resection rate increased from 28 to 51 percent between group 1 and group 3. Despite the more radical surgery, morbidity and post operative mortality rates decreased (respectively: 44.5%, 33%, 25.4%, and 22%, 10%, 7.2% for the groups 1, 2, 3, p < 0.01). 2-year survival rates were 20 percent for group 1, 25 percent for group 2 and 32 percent for group 3 (p < 0.01). This rates can be considered as satisfying in view of the high rate of III and IV stages.
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Affiliation(s)
- C Meyer
- Service de Chirurgie Générale et Digestive, Hôpital de Hautepierre, CHU de Strasbourg
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Meyer C, Jobard D, Thiry L, De Manzini N, Rohr S. [Retro-duodenal papillary perforation after endoscopic sphincterotomy. Role of surgical treatment by exclusion of the duodenum. Apropos of 3 cases]. J Chir (Paris) 1995; 132:118-22. [PMID: 7782382] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/27/2023]
Abstract
Among the complications of endoscopic sphincterotomy whose rate is about 10% of cases, the retroduodenal papillary perforation represents about 1% of cases. The diagnosis lies on radiological examination which may show during the sphincterotomy the extravasation of the contrast fluid used for the retrograde cholangiography; it can be suggested by the presence of clinical signs of retroperitoneal sepsis or peritonitis. The treatment depends on the severity or peritonitis. The treatment depends on the severity of the clinical symptomatology; it is generally a medical treatment associating nasogastric aspiration and antibiotherapy, and more rarely a surgical one. There is no consensus concerning surgical modalities. We report 3 cases of retroduodenal papillary perforation treated surgical by a duodenal exclusion aiming to transform a complex fistula in a bilio-pancreatic fistula which can be more easily managed by somatostatine-like drugs.
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Affiliation(s)
- C Meyer
- Service de Chirurgie Générale et Digestive, C.H.U. de Strasbourg-Hautepierre
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15
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Meyer C, Bachellier-Billot C, Rohr S, De Manzini N, Leclercq A. [Surgical treatment of pyloric stenosis of ulcerous origin. Apropos of 68 cases]. J Chir (Paris) 1991; 128:112-5. [PMID: 2055971] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
Abstract
The study turns about 68 cases of post ulcerous pyloric stenosis operated from 1970 to 1990, that means 8.5% of the duodenal ulcers (796 cases) operated during this period. The stenosis was entire or strangled in 27 cases (39.7%) with an important gastric dilatation in 34 cases (50%). The treatment has been composed of a gastroenterostomy (30 cases--44%), most of the time with a troncular vagotomy, of a pyloroplasty with vagotomy in 20 cases (29.5%) and of an inferior polar gastric resection in 18 cases (26.5%). The operative mortality was 2 cases (3%). The at distance-results (average follow-up of 7 years) show that 71% of the re-examined patients (45 cases) are classified Visick 1 or 2 and 9% visick 4. Ones concludes to the value of troncular vagotomy with gastroenterostomy which can be realised in all of the occasions and gives good functional results when the vagotomy with pyloroplasty seems to lie more frequently in state to uncertain functional results.
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Affiliation(s)
- C Meyer
- Service de Chirurgie Générale et Digestive, CHU Hautepierre, Strasbourg
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Hollender LF, De Manzini N. [Realities and prospects of viscero-synthesis]. G Chir 1990; 11:80-1. [PMID: 2223503] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
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Hollender LF, De Manzini N. [State of the art in the treatment of peptic ulcer]. Ann Ital Chir 1990; 61:5-8. [PMID: 2240935] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
Affiliation(s)
- L F Hollender
- Facoltà di Medicina, Università Louis Pasteur, Centre Hospitalier Universitaire, Strasbourg
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Bahnini J, De Manzini N, Meyer C, Hollender LF. [Current concepts of the treatment of cholelithiasis in aged patients]. J Chir (Paris) 1989; 126:611-8. [PMID: 2684999] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/02/2023]
Abstract
Biliary lithiasis in elder patients is characterized by the physical defects usually present--therefore surgery is less mandated than endoscopic procedures or extra corporeal lithotripsy. However, if surgery is undertaken, then it should be carried out as completely as possible. In this paper, the authors emphasize the special aspects of its indications and technics--for more than any where else this surgery required perfection.
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Affiliation(s)
- J Bahnini
- Service de Chirurgie Générale 1 et de Chirurgie Digestive, Centre Hospitalier Universitaire de Strasbourg
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19
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Liguori G, De Manzini N, Balani A, Leggeri A. [Role of abdominoperineal resection in the surgical treatment of cancer of the rectum]. J Chir (Paris) 1989; 126:374-8. [PMID: 2674172] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/02/2023]
Abstract
The respective indications for abdomino-perineal amputation and colorectal resection are being debated, especially in the treatment of mid-rectal cancer. We report a series of 242 patients operated on for cancer of the rectum, including 200 who underwent tumor resection, which aimed to be curative in 162 cases. In the choice of intervention we took into account the possibility of keeping a distal margin of security of at least 2 cm when carrying out the resection. The size of the tumor, its staging and degree of differentiation did not influence our choice. Operative mortality was 9.8% for amputations and 5.3% for resection; deaths occurring in patients over 65 years and in only two cases for specific reasons. Local recurrence developed in 16.3% of amputations and in 12.5% of resections. For the mid-rectum these percentages were respectively 20 and 10.7%, though this difference may partially be explained by a greater number of patients with Dukes stage C, among the patients undergoing amputation. Five year survival was 56.8% for amputation and 63.2% for resection. We therefore feel that abdomino-perineal amputation does not produce a better tumor clearance than resection, and that it should currently only be proposed in cases where a resection with a satisfactory margin of security cannot be ensured.
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Affiliation(s)
- G Liguori
- Clinique Chirurgicale de l'Université, Trieste, Italie
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Hollender LF, Bahnini J, De Manzini N, Lau WY, Fan ST, Hermansyur K, Benny P, Husni AN, Sutjipto, Lorber RR. A multicentric study of netilmicin once daily versus thrice daily in patients with appendicitis and other intra-abdominal infections. J Antimicrob Chemother 1989; 23:773-83. [PMID: 2668247 DOI: 10.1093/jac/23.5.773] [Citation(s) in RCA: 60] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/02/2023] Open
Abstract
This multicentric, randomized, double-blind trial compared the efficacy and safety of netilmicin, 4.5 mg/kg od and 1.5 mg/kg tid, in patients with intra-abdominal infections. Of 114 patients enrolled, 57 patients (mean age 40.3 years) in the od group and 55 (mean age 36.8 years) in the tid group were evaluated for efficacy; 58 and 56 patients in corresponding groups were evaluated for safety. Among those evaluated for efficacy were 12 od-treated and 11 tid-treated patients with documented septicaemia, and 32 and 30 patients of respective groups with polymicrobial infections. Initially, 86 and 81 netilmicin-susceptible causative microorganisms were isolated in corresponding groups. Of these pathogens, 55% in the od group and 62% in the tid group were Escherichia coli. Daily dosage of netilmicin ranged from 3.70 to 4.71 mg/kg (mean 4.50) for the od group and from 3.06 to 4.76 mg/kg (mean 4.46) for the tid group. Duration of netilmicin therapy ranged from six to 13 days (mean 8.7 days) for od-treated patients and from seven to 16 days (mean 8.8 days) for tid-treated patients. Concomitant metronidazole was administered to 41 patients of the od group and 34 of the tid group; one patient in the tid group received clindamycin. Clinical and bacteriological responses were assessed, and peak and trough serum netilmicin levels were measured periodically, during therapy. Laboratory tests, including determinations of serum creatinine and blood urea nitrogen values, were performed throughout the trial. A clinical cure was achieved in 57/57 od-treated patients and 54/55 tid-treated patients; treatment failed in one tid-treated patient (1/55). In od and tid groups, 86/86 and 80/81 netilmicin-susceptible pathogens initially isolated were considered to be eliminated, respectively; one isolate (Esch. coli) persisted in the tid group. Mean peak serum netilmicin concentration in the od group was approximately two-fold greater than that in the tid group; mean trough serum netilmicin concentrations were similar for the two groups. Adverse reactions were limited to mild pain at the site of netilmicin administration in several patients in each treatment group. Netilmicin od and tid (alone or in combination with metronidazole) were similarly efficacious in the treatment of patients with appendicitis and other intra-abdominal infections caused by netilmicin-susceptible pathogens. Both dosage regimens of netilmicin were safe and well tolerated.
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Affiliation(s)
- L F Hollender
- Department of Abdominal Surgery, University Louis Pasteur, Strasbourg, France
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