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Manceau G, Sabbagh C, Mege D, Lakkis Z, Bege T, Tuech JJ, Benoist S, Lefèvre JH, Karoui M, Bridoux V, Venara A, Beyer‐Berjot L, Codjia T, Dazza M, Gagnat G, Hamel S, Mallet L, Martre P, Philouze G, Roussel E, Tortajada P, Dumaine AS, Heyd B, Paquette B, Brunetti F, Esposito F, Lizzi V, Michot N, Denost Q, Rullier E, Tresallet C, Tetard O, Rivier P, Fayssal E, Collard M, Moszkowicz D, Lupinacci R, Peschaud F, Etienne JC, Loge L, Bege T, Corte H, D’Annunzio E, Humeau M, Issard J, Munoz N, Abba J, Jafar Y, Lacaze L, Sage PY, Susoko L, Trilling B, Arvieux C, Mauvais F, Ulloa‐Severino B, Pitel S, Vauchaussade de Chaumont A, Badic B, Blanc B, Bert M, Rat P, Ortega‐Deballon P, Chau A, Dejeante C, Piessen G, Grégoire E, Alfarai A, Cabau M, David A, Kadoche D, Dufour F, Goin G, Goudard Y, Pauleau G, Sockeel P, Villeon B, Pautrat K, Eveno C, Abdalla S, Couchard AC, Balbo G, Mabrut JY, Bellinger J, Bertrand M, Aumont A, Duchalais E, Messière AS, Tranchart A, Cazauran JB, Pichot‐Delahaye V, Dubuisson V, Maggiori L, Panis Y, Djawad‐Boumediene B, Fuks D, Kahn X, Huart E, Catheline JM, Lailler G, Baraket O, Baque P, Diaz de Cerio JM, Mariol P, Maes B, Fernoux P, Guillem P, Chatelain E, de Saint Roman C, Fixot K, Voron T, Parc Y. Colon sparing resection versus extended colectomy for left-sided obstructing colon cancer with caecal ischaemia or perforation: a nationwide study from the French Surgical Association. Colorectal Dis 2020; 22:1304-1313. [PMID: 32368856 DOI: 10.1111/codi.15111] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/14/2020] [Accepted: 04/02/2020] [Indexed: 02/08/2023]
Abstract
AIM It is not known whether patients with obstructive left colon cancer (OLCC) with caecal ischaemia or diastatic perforation (defined as a blowout of the caecal wall related to colonic overdistension) should undergo a (sub)total colectomy (STC) or an ileo-caecal resection with double-barrelled ileo-colostomy. We aimed to compare the results of these two strategies. METHOD From 2000 to 2015, 1220 patients with OLCC underwent surgery by clinicians who were members of the French Surgical Association. Of these cases, 201 (16%) were found to have caecal ischaemia or diastatic perforation intra-operatively: 174 patients (87%) underwent a STC (extended colectomy group) and 27 (13%) an ileo-caecal resection with double-end stoma (colon-sparing group). Outcomes were compared retrospectively. RESULTS In the extended colectomy group, 95 patients (55%) had primary anastomosis and 79 (45%) had a STC with an end ileostomy. In the colon-sparing group, 10 patients (37%) had simultaneous resection of their primary tumour with segmental colectomy and an anastomosis which was protected by a double-barrelled ileo-colostomy. The demographic data for the two groups were comparable. Median operative time was longer in the STC group (P = 0.0044). There was a decrease in postoperative mortality (7% vs 12%, P = 0.75) and overall morbidity (56% vs 67%, P = 0.37) including surgical (30% vs 40%, P = 0.29) and severe complications (17% vs 27%, P = 0.29) in the colon-sparing group, although these differences did not reach statistical significance. Cumulative morbidity included all surgical stages and the rate of permanent stoma was 66% and 37%, respectively, with no significant difference between the two groups. Overall survival and disease-free survival were similar between the two groups. CONCLUSION The colon-sparing strategy may represent a valid and safe alternative to STC in OLCC patients with caecal ischaemia or diastatic perforation.
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Affiliation(s)
- G Manceau
- Department of Digestive Surgery, Assistance Publique-Hôpitaux de Paris, Pitié Salpêtrière University Hospital, Sorbonne Université, Paris, France
| | - C Sabbagh
- Department of Digestive Surgery, Amiens University Hospital, Amiens, France
| | - D Mege
- Department of Digestive Surgery, Assistance Publique-Hôpitaux de Marseille, Timone University Hospital, Marseille, France
| | - Z Lakkis
- Department of Digestive Surgery, Besançon University Hospital, Besançon, France
| | - T Bege
- Department of Digestive Surgery, Assistance Publique Hôpitaux de Marseille, North University Hospital, Marseille, France
| | - J J Tuech
- Department of Digestive Surgery, Charles Nicolle University Hospital, Rouen, France
| | - S Benoist
- Department of Digestive Surgery, Assistance Publique-Hôpitaux de Paris, Bicêtre University Hospital, Université Paris-Sud, Le Kremlin Bicêtre, France
| | - J H Lefèvre
- Department of Digestive Surgery, Assistance Publique-Hôpitaux de Paris, Saint-Antoine University Hospital, Sorbonne Université, Paris, France
| | - M Karoui
- Department of Digestive Surgery, Assistance Publique-Hôpitaux de Paris, Pitié Salpêtrière University Hospital, Sorbonne Université, Paris, France
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Manceau G, Mege D, Bridoux V, Lakkis Z, Venara A, Voron T, De Angelis N, Ouaissi M, Sielezneff I, Karoui M, Dazza M, Gagnat G, Hamel S, Mallet L, Martre P, Philouze G, Roussel E, Tortajada P, Dumaine AS, Heyd B, Paquette B, Brunetti F, Esposito F, Lizzi V, Michot N, Denost Q, Tresallet C, Tetard O, Regimbeau JM, Sabbagh C, Rivier P, Fayssal E, Collard M, Moszkowicz D, Peschaud F, Etienne JC, loge L, Beyer L, Bege T, Corte H, D'Annunzio E, Humeau M, Issard J, Munoz N, Abba J, Jafar Y, Lacaze L, Sage PY, Susoko L, Trilling B, Arvieux C, Mauvais F, Ulloa‐Severino B, Lefevre JH, Pitel S, Vauchaussade de Chaumont A, Badic B, Blanc B, Bert M, Rat P, Ortega‐Deballon P, Chau A, Dejeante C, Piessen G, Grégoire E, Alfarai A, Cabau M, David A, Kadoche D, Dufour F, Goin G, Goudard Y, Pauleau G, Sockeel P, De la Villeon B, Pautrat K, Eveno C, Brouquet A, Couchard AC, Balbo G, Mabrut JY, Bellinger J, Bertrand M, Aumont A, Duchalais E, Messière AS, Tranchart A, Cazauran JB, Pichot‐Delahaye V, Dubuisson V, Maggiori L, Djawad‐Boumediene B, Fuks D, Kahn X, Huart E, Catheline JM, Lailler G, Baraket O, Baque P, Diaz de Cerio JM, Mariol P, Maes B, Fernoux P, Guillem P, Chatelain E, de Saint Roman C, Fixot K. Thirty-day mortality after emergency surgery for obstructing colon cancer: survey and dedicated score from the French Surgical Association. Colorectal Dis 2019; 21:782-790. [PMID: 30884089 DOI: 10.1111/codi.14614] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/09/2018] [Accepted: 02/27/2019] [Indexed: 02/08/2023]
Abstract
AIM The aim was to define risk factors for postoperative mortality in patients undergoing emergency surgery for obstructing colon cancer (OCC) and to propose a dedicated score. METHOD From 2000 to 2015, 2325 patients were treated for OCC in French surgical centres by members of the French National Surgical Association. A multivariate analysis was performed for variables with P value ≤ 0.20 in the univariate analysis for 30-day mortality. Predictive performance was assessed by the area under the receiver operating characteristic curve. RESULTS A total of 1983 patients were included. Thirty-day postoperative mortality was 7%. Multivariate analysis found five significant independent risk factors: age ≥ 75 (P = 0.013), American Society of Anesthesiologists (ASA) score ≥ III (P = 0.027), pulmonary comorbidity (P = 0.0002), right-sided cancer (P = 0.047) and haemodynamic failure (P < 0.0001). The odds ratio for risk of postoperative death was 3.42 with one factor, 5.80 with two factors, 15.73 with three factors, 29.23 with four factors and 77.25 with five factors. The discriminating capacity in predicting 30-day postoperative mortality was 0.80. CONCLUSION Thirty-day postoperative mortality after emergency surgery for OCC is correlated with age, ASA score, pulmonary comorbidity, site of tumour and haemodynamic failure, with a specific score ranging from 0 to 5.
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Affiliation(s)
- G Manceau
- Department of Digestive Surgery, Assistance Publique Hôpitaux de Paris, Pitié Salpêtrière Hospital, Sorbonne Université, Paris, France
| | - D Mege
- Department of Digestive Surgery, Timone University Hospital, Marseille, France
| | - V Bridoux
- Department of Digestive Surgery, Charles Nicolle University Hospital, Rouen, France
| | - Z Lakkis
- Department of Digestive Surgery, Besançon University Hospital, Besançon, France
| | - A Venara
- Department of Digestive Surgery, Angers University Hospital, Angers, France
| | - T Voron
- Department of Digestive Surgery, Assistance Publique Hôpitaux de Paris, Saint Antoine Hospital, Sorbonne Université, Paris, France
| | - N De Angelis
- Department of Digestive Surgery, Assistance Publique Hôpitaux de Paris, Henri Mondor Hospital, Université Paris-Est (UEP), Créteil, France
| | - M Ouaissi
- Department of Digestive Surgery, Tours University Hospital, Tours, France
| | - I Sielezneff
- Department of Digestive Surgery, Timone University Hospital, Marseille, France
| | - M Karoui
- Department of Digestive Surgery, Assistance Publique Hôpitaux de Paris, Pitié Salpêtrière Hospital, Sorbonne Université, Paris, France
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Cianflocca D, Balbo G, Reddavid R, Mussa B, Sandrucci S. Office-based Denver peritoneovenous shunt for malignant ascites: A feasibility study. Eur J Surg Oncol 2012. [DOI: 10.1016/j.ejso.2012.07.102] [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: 11/17/2022] Open
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Camandona M, Balbo G, Catalano S, Lettini I, Gasparri G. [Reoperations in hyperparathyroidism]. G Chir 2010; 31:310-311. [PMID: 20646379] [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: 05/29/2023]
Abstract
Reoperative parathyroidectomy (PTx) is challenging for the surgeon. Before reintervention it is essential to evaluate the operative notes and pathology reports from the previous operation, the localization exams (sestaMIBI scintigraphy and ultrasound) and IOPTH assay are also essential. The surgeon is supposed to perfectly know the anatomy and embryology of parathyroid glands and experience with parathyroid surgery is still the most important predictor of success in reoperative PTx. Reinterventions in HPT have good results with a resolution of hyperparathyroidism in 85-90% for primary HPT and in 70% for secondary and tertiary HPT. Authors present their experience of 76 reinterventions after HPT I and 85 reinterventions after HPT II and III over a total of 2072 parathyroidectomies, carried out between January 1975 and October 2009.
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Lasagna B, Resegotti A, Garino M, Balbo G. [Repair of large laparoceles]. MINERVA CHIR 1993; 48:1415-9. [PMID: 8177445] [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: 01/29/2023]
Abstract
The authors report a series of 100 incisional hernias operated on and consider general and local problems in repair of wide hernias. They underline some rules in order to obtain a strong reconstruction, with minimal relapse risk and to avoid adverse systemic effects produced by the intervention itself. Now they consider synthetic meshes to be apt for the treatment of the largest hernias, in order to reinforce or to repair the fascial defect, as meshes are strong, easy to use and are well tolerated by tissues and have a good resistance to infection.
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Affiliation(s)
- B Lasagna
- Divisione di Chirurgia Generale, Ospedale Maggiore di San Giovanni Battista, e della Città di Torino
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Lasagna B, Resegotti A, De Paolis P, Balbo G. [Extension of thyroidectomy in the treatment of benign nodular thyroid diseases]. MINERVA CHIR 1993; 48:1421-4. [PMID: 8177446] [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: 01/29/2023]
Abstract
A series of 268 benign nodular goitres, operated on in a 10-year period, is presented. Subtotal thyroidectomy was the chosen operation; however, during the first period of our experience, when the goitre was obviously limited to one lobe we performed unilateral lobectomy in some cases. After surgery no patient received hormone therapy without previous evaluation of thyroid function. Thyroid function was evaluated after surgery and alterations were corrected. As recurrent goitre was a rare occurrence and complications of subtotal thyroidectomy are low, we do not support total thyroidectomy for nodular goitre. In order to avoid recurrences hemithyroidectomy no longer must be performed: the surgical treatment of nodular goitre is carried out by subtotal thyroidectomy, leaving little residual thyroid, to spare parathyroids and inferior laryngeal nerves, which is usually enough for adequate hormone production; in the case of TSH raising, thyroxine must be given.
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Affiliation(s)
- B Lasagna
- Divisione di Chirurgia Generale, Ospedale Maggiore di S. Giovanni Battista, e della Città di Torino
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Lasagna B, Garino M, Resegotti A, Balbo G. [Palliative treatment of pancreatic carcinoma. Comparison between 2 successive observation periods]. MINERVA CHIR 1993; 48:1395-8. [PMID: 7513830] [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: 01/25/2023]
Abstract
Explorative laparotomies and palliative surgery for pancreatic carcinoma have been reduced due to improved diagnostic tools, the spread of laparoscopic techniques and the growing use of external biliary drainage and endoprostheses. By comparing two successive observation periods the authors point out that, owing to the good results obtained, mini-invasive surgery is more frequently used in the management of obstructive jaundice than biliodigestive surgical derivations. Of these, hepatico-jejunostomy is preferable to duodenal anastomosis due to the latter's frequent involvement by the primary tumour. The authors also consider it inappropriate to increase operative morbidity through the systematic association of gastroenteric with biliodigestive derivation, except in cases of symptomatic or radiologically or endoscopically ascertained duodenal stenosis and when the objective finding of visceral involvement leads to the supposition of its imminent obliteration. The indications for surgical splannicectomy have also been reduced with the spread of percutaneous alcoholization of the celiac plexy in cases which resist analgesic treatment using a parenteral route.
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Affiliation(s)
- B Lasagna
- Divisione di Chirurgia Generale, Ospedale Maggiore di S. Giovanni Battista e della Città di Torino
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Balbo G, Soldati T, De Paolis P, Garino M, Lasagna B, Resegotti A, Garretti L, Andriulli A. [Endoscopic and intraoperative ultrasonography in staging of stomach neoplasms]. MINERVA CHIR 1992; 47:1455-9. [PMID: 1461517] [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: 12/27/2022]
Abstract
In Japan a better prognosis of gastric cancer has been achieved by early diagnosis and wide, careful lymphectomy. This is not true in western countries. Thus the Authors believe that rational surgical strategy and the careful use of advanced diagnostic tools would produce a better outcome. The Authors report the new diagnostic methods that they adopt in every case of gastric neoplasm: endoscopic ultrasonography, which also proved useful in submucosal tumors, like lymphomas; parenteral nutrition, immune status assessment for a possible use of immune response modulators, single-dose antimicrobial prophylaxis, antithrombotic prophylaxis, autologous blood storage, in order to reduce transfusion-linked risks. Surgical strategy is also reported, which includes wide resection with adequate margins, R2 lymphectomy and intraoperative assessment of disease extension by ultrasonography.
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Affiliation(s)
- G Balbo
- Divisione di Chirurgia generale B, Università degli Studi di Torino, Ospedale Molinette
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Balbo G, Farina EC. Secondary immunodeficiencies in surgical patients. Pharmacol Res 1992; 26 Suppl 2:86-7. [PMID: 1409335 DOI: 10.1016/1043-6618(92)90612-f] [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] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
Affiliation(s)
- G Balbo
- Divisione Chirurgia Generale B, Ospedale Maggiore S. Giovanni Battista, Torino
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Balbo G, Fiora U, Garino M, De Paolis P, Soldati T. [Roux-en-Y loop gastro-jejuno anastomosis]. G Chir 1992; 13:223-4. [PMID: 1637634] [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: 12/28/2022]
Affiliation(s)
- G Balbo
- Chirurgia Generale B, Ospedale Molinette, Torino
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Avila G, Balbo G, Biasiato R, Brighenti FM, Conte R, Donini I, Landi E, Marzocca G, Mazzi U, Morino F. [Ketoprofen in the prevention of postoperative pain in abdominal surgery. A multicenter study]. G Chir 1991; 12:456-8. [PMID: 1751342] [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: 12/28/2022]
Abstract
Two-hundred-forty-eight patients undergoing abdominal surgery were admitted to a multicentric clinical trial. The patients were randomly assigned to a single i.v. dose of ketoprofen or acetylsalicylic acid, 15 minutes after the end of operation. Ketoprofen showed a better analgesic activity with a statistically significant difference at 2 and 4 hours after administration. Two patients treated with ketoprofen reported vomiting and skin rash respectively. The results of this study confirm the efficacy of ketoprofen for the prophylaxis of postoperative pain in abdominal surgery.
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Affiliation(s)
- G Avila
- Divisione Chirurgica 2a, Ospedale Consorziale di Treviglio
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Ottobrelli A, Lagget M, Arrigoni A, Gindro T, Bosio C, Balbo G, Rizzetto M. [Eosinophilic gastroenteritis and ascites. Clinical case]. MINERVA GASTROENTERO 1991; 37:131-4. [PMID: 1742398] [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: 12/28/2022]
Abstract
We report the case of a patient with recurrent subocclusive episodes and diarrhea (no malabsorption) associated with ascites, in the absence or liver, kidney or heart disease. The demonstration of hypereosinophilia in the peripheral blood and in the ascites fluid and the failure to identify parasitic or haematological disorders have led to a through examination of the stomach (Endoscopy, Echoendoscopy), small bowel (X-rays and Computerized Axial Tomography) and colon (colonoscopy) in a search for parietal lesions. The absence of segmental lesions and the observation of CAT images of diffuse, regular thickening of the ileum and of the mesentery, coupled with the monotonous clinical history spanning over three decades, have led to a diagnosis of eosinophilic gastroenteritis with involvement of the serosal layer. Serosal involvement is rare in eosinophilic disease of the gut; in analogy with other cases reported in the literature, steroids have improved clinical symptoms and normalized the hematological picture.
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Affiliation(s)
- A Ottobrelli
- Divisione di Gastroenterologia, Ospedale S. Giovanni Battista, Molinette - Torino
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14
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Lasagna B, Balbo G, De Paolis P, Sacchetti M. [Diagnostic and prognostic value of CEA and GICA in colo-rectal tumors. A caseload contribution]. Minerva Med 1990; 81:769-71. [PMID: 2255411] [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: 12/31/2022]
Abstract
The Authors analyse the clinical usefulness of serum levels' determination of Carcinoembryonic Antigen (CEA) and Gastrointestinal Cancer Antigen (GICA) in 152 patients with colorectal cancer, admitted to their Hospital from November 1982 to March 1989. The sensibility for primary diagnosis of each tumor marker is not very high but there is a relationship between the stage and the histological characters of the disease, especially when the markers are considered at the same time. Preoperative serum level determination of CEA and GICA can be considered a good prognostic index: infarct the increase of the levels is generally due to metastatic tissue or local recurrence. This was confirmed during patients follow-up by further tests which revealed recurrence of the disease.
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Affiliation(s)
- B Lasagna
- Divisione di Chirurgia Generale B, Ospedale Maggiore di San Giovanni Battista e della Città di Torino
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Lasagna B, Resegotti A, Garino M, Balbo G. [Laparocele: a review of the literature and analysis of case histories]. Ann Ital Chir 1990; 61:613-9. [PMID: 2100109] [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: 12/30/2022]
Abstract
We analyze a group of 64 laparoceles from which it emerges a per cent distribution in the different regions and a correlation between the dimensions of the lesion and the relative regions in agreement with the data usually given in the literature. Furthermore we point out a clear dependence on pathogenetic factors of general and local order. Is therefore recognized the necessity of preventing their insurgence and reducing the risk of relapses through appropriate laparotomy incisions, with adoption of a suitable surgical technique and the correction of systemic diseases. The voluminous laparoceles are responsible of cardiac, respiratory, coagulative diseases, that must be scrupulously judged for an appropriate therapeutical approach. The surgical treatment, as well as for the cases of bigger dimensions, has mostly availed itself of an elementary technique (simple approach, apposition "en paletot" splitting of the fasciae). In the necessity of strengthening weak parietal tissues or of replacing vast losses of matter, we have limitedly resorted to autologous grafts, while good results have been observed with the lyophilized dura mater.
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Affiliation(s)
- B Lasagna
- Divisione Chirurgica B, Ospedale Maggiore di San Giovanni Battista e della Città di Torino
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Lasagna B, Balbo G, Garino M, Botto Micca F. [Actinic lesions of the small intestine requiring surgery. Case reports]. Ann Ital Chir 1990; 61:553-9. [PMID: 2129260] [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: 12/30/2022]
Abstract
Radiation enteropathy is a disease that seldom requires surgical treatment, in the chronic variety. We report the findings of four cases we operated in an attempt to identify the weak points of surgery involving a high percentage and morbidity of mortality. NPT (total parenteral nutrition) can favour a positive evolution with total rest of the bowel and with reinstatement of normal nutrition.
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Affiliation(s)
- B Lasagna
- Divisione di Chirurgia Generale B, Ospedale Maggiore di S. Giovanni Battista e della città di Torino
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Soldati T, Del Noce G, Garino M, Farina EC, De Paolis P, Balbo G. Pancreatic somatostatinoma. Panminerva Med 1990; 32:141-4. [PMID: 2077482] [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: 12/30/2022]
Abstract
The Authors describe a case of somatostatinoma in the pancreatic tail, characterized by the absence of a specific symptomatology, with the exception of a slight hyperglycaemia. The patient underwent a surgical operation of pancreatic resection and splenectomy, and now enjoys very good health. They have examined literature from 1977 to 1988, and overall the 30 cases of pancreatic localization, describing the symptomatology, the pathological anatomy, the therapy, and evaluating the malignity degree. Then the Authors could notice that the prognosis of these neoplasms is often fatal, both for the frequent tumor metastatization, and for the difficulties in making an early diagnosis. The therapy is essentially surgical.
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Affiliation(s)
- T Soldati
- General Surgery Department B, Molinette Hospital, Turin, Italy
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Lasagna B, Soldati T, Balbo G, Del Noce G. [Etiopathogenetic considerations on local recurrence after excision of rectal carcinoma]. MINERVA CHIR 1990; 45:369-72. [PMID: 2190109] [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: 12/30/2022]
Abstract
A series of 77 cases of rectum carcinoma observed in a six year period, is presented. Sixty-one patients underwent radical operation and 57 of them have been regularly followed up. The incidence of local relapses has been 12.28%, with a majority of perianastomotic forms. It turned out to be proportional to the aboral distance and to primitive neoplasm staging, but not to histologic differentiation degree. Staplers were used and therefore the choice between resection or amputation was determined by the degree of loco-regional infiltration of the neoplasm. The frequency of local relapses turned out not to be related to the type of operation, but the impossibility to the exeresis of perirectal tissues involved by neoplastic process.
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Affiliation(s)
- B Lasagna
- Ospedale Maggiore di San Giovanni Battista, Divisione di Chirurgia Generale B, Torino
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Lasagna B, Balbo G, Garino M, Del Noce G. [Analysis of a series of cases of liver metastasis of colorectal carcinoma]. MINERVA CHIR 1989; 44:2315-9. [PMID: 2626196] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/01/2023]
Abstract
The Authors present a six years case-report concerning 135 patients operated on colo-rectal carcinoma (82 of them are still followed up). The incidence of hepatic metastases (synchronous and metachronous) has been 30.37% in all. The preoperative ultrasonography has shown an 11% about margin mistake to visualize secondary lesions of liver. They have acknowledged the intraoperative ultrasonography very useful to visualize occult metastases and to guide an exeresis operation. The resectability of hepatic metastases from colo-rectal cancer has been of 12.19%. Synchronous forms have been rarely operable (5.88%) because they are constituted by multiple and disseminated lesions. They have found an higher incidence of operable forms among the metachronous metastases (42.85%), whose average time of appearance from the primary operation has been about 13 months. The operative mortality and the complications following hepatectomy have been null. The average survival time from operation has been over 22 months. Therefore they recognized the importance of a careful follow-up to find precociously operable lesions.
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Balbo G, Farina EC, Garino M. Mezlocillin and prophylaxis of postoperative infections in biliary surgery. Chemioterapia 1987; 6:592-3. [PMID: 3334636] [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] [Subscribe] [Scholar Register] [Indexed: 01/05/2023]
Affiliation(s)
- G Balbo
- Division of General Surgery B, Molinette Hospital, Torino, Italy
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Resegotti L, Balbo G, De Crescenzo A, Orsucci L, Paolino F, Resegotti A, Soldati T, Tonso A. The preparation for splenectomy of adult patients with chronic idiopathic thrombocytopenic purpura by intravenous administration of monomeric intact immunoglobulin. Haematologica 1987; 72:269-71. [PMID: 3114097] [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: 01/04/2023] Open
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Farina EC, Garino M, Balbo G. Thymostimulin prophylaxis of postoperative infections in anergic patients. Can J Surg 1986; 29:445-6. [PMID: 3536050] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/06/2023] Open
Abstract
The rate of postoperative infections is significantly increased in anergic patients. The authors evaluated prospectively, in a controlled, randomized and stratified study, the efficiency of thymostimulin in reducing postoperative infections in 42 such patients. Excluded were those who were malnourished in whom preoperative alimentation corrected the anergy. The incidence of infections was significantly (p less than 0.05) reduced in thymostimulin-treated patients (4.8% versus 28.6%).
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Farina EC, Garino M, Soldati T, De Paolis P, Balbo G. [Immunosuppression and postoperative infections: a rational approach to the problem]. MINERVA CHIR 1986; 41:709-13. [PMID: 3725106] [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: 01/07/2023]
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Balbo G, Massaioli N, Meda E, Nuti C, Sacchetti M, Morra C. [Measurement of bioimpedance in cryosurgery. Experimental and clinical study]. MINERVA CHIR 1984; 39:303-10. [PMID: 6462488] [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: 01/20/2023]
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Massaioli N, Balbo G, Meda E, Teich-Alasia S, Ambroggio G, Oberto E. [Current trends in reconstruction of the breast after mastectomy for carcinoma]. MINERVA CHIR 1981; 36:231-40. [PMID: 7242985] [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: 01/24/2023]
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Balbo G, Meda E, Barbero C, Castagna B, Massaioli N, Gagna G, Bussolati G, Giove S. [Anatomo-pathological study of the evolution of cryonecrosis in the rat pancreas]. MINERVA CHIR 1980; 35:1725-32. [PMID: 7231733] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/24/2023]
Abstract
The progress of a cryonecrosis site occupying about one-third of the rat pancreas and induced with liquid nitrogen applied via a 10 mm luminal diameter probe applied for 2 min was followed. The lesion was not responsible for irreversible functional and anatomical lesions. Blood sugar remained within normal limits. Blood amylase peaked on the 1st day and was normal by the 14th. The treated area shrank considerably and was replaced by fibrous tissue within 30 days. The histological picture was similar to that encountered pathologically in man. Neither chain-type autolysis nor pseudocysts were observed.
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Balbo G, Meda E, Castagna B, Barbero C, Massaioli N, Gagna G. [Anatomo-pathological study of the development of a focus of cryonecrosis in the rat spleen]. MINERVA CHIR 1980; 35:1669-76. [PMID: 7454066] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/25/2023]
Abstract
A focus of cryonecrosis in the rat spleen, induced with liquid nitrogen (4 mm diameter probe, application time 2') does not cause haemorrhage either during or after treatment. The frozen area, which is of infarctual type with disappearance of spleen cells and preservation of the elastic structures of the follicular arteries, sees its surface reduced considerably and is replaced by connective tissue within 30 days.
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Massaioli N, Balbo G, Fausone G, Negro D. [Endothyroid (non-chromaffin) branchiomeric paraganglioma. Description of a clinical case]. MINERVA CHIR 1979; 34:867-74. [PMID: 225698] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
A case of endothyroid paraganglioma in a 9-yr-old girl is described. Subtotal lobectomy was performed and the tumour was not recognised until a histological examination has been carried out on a section embedded in paraffin. Only two other cases could be found in the literature. An account is given of the diagnosis of this form, and reference is made to its prognostic aspects since there is a remote possibility that metastasis may occur many years after surgery.
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Balbo G, Massaioli N, Meda E, De Mari S, Villata E. [Anatomo-pathological study of the evolution of cryonecrosis of the liver, stomach, trachea and striated muscle in rats]. Chir Patol Sper 1977; 25:165-78. [PMID: 614936] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 12/23/2022]
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Balbo G, Massaioli N, Meda E, De Mari S, Villata E. [Results of cryotreatment of Walker 256 tumor implanted in the liver, stomach, trachea and striated muscle of the rat]. Chir Patol Sper 1977; 25:122-33. [PMID: 614935] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 12/23/2022]
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Massaioli N, Balbo G, Villata E, Fausone G, Segre D. [Our experience with reparative and derivative operations for non-cancerous lesions in the extrahepatic bile ducts]. MINERVA CHIR 1976; 31:221-29. [PMID: 1004737] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/25/2022]
Abstract
17 reparative operations on the bile ducts, 7 of which were immediate (5 for peroperative lesions and 2 for "spontaneous" lesions) and 10 reoperations to deal with sclero-cicatricial lesions, were studied. 7 reconstructive operations (plastic or end-to-end anastomosis) and 10 derivative operations with a preference for hepato- or choledocho-jejunostomy on defunctionalized loop were carried out. The former were reserved for lesions without or with minimum loss of substance, the latter for extensive lesions. Operative mortality is high and higher still in immediate interventions. Long term results were good in all cases but one.
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Balbo G, Fausone G, Villata E, Massaioli N. [Cryogenic surgery of malignant tumors of the trachea. Experimental research in rats with Walker's carcinoma]. Chir Patol Sper 1976; 24:1-19. [PMID: 964092] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 12/25/2022]
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Balbo G, Masenti E. [Results of the surgical treatment of esophageal carcinoma]. MINERVA CHIR 1971; 26:232-48. [PMID: 4103057] [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: 01/08/2023]
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Martello G, Mattioli D, Balbo G. [On a case of probable Mediterranean eruptive fever]. G Mal Infett Parassit 1970; 22:383. [PMID: 5459590] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/15/2023]
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Monacelli M, Balbo G, D'Amato C. [On 2 cases of acute anterior poliomyelitis in vaccinated subjects, with immunological deficiency syndrome]. G Mal Infett Parassit 1970; 22:363-4. [PMID: 5459581] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/15/2023]
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Masenti E, Balbo G, Trotti-Maina G. [Malabsorption after extensive resections of the ileum]. MINERVA CHIR 1969; 24:345-56. [PMID: 5790463] [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: 01/16/2023]
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Masenti E, Balbo G. [Possibilities and advantages of ileo-colo-esophagoplasty in surgical treatment of subaortic esophageal neoplasms]. Lyon Chir 1968; 64:629-35. [PMID: 5744753] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/16/2023]
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Masenti E, Balbo G, Trotti-Maina G. [Current trends in the diagnostic problem and treatment of acute hematemesis]. Minerva Med 1967; 58:1983-92. [PMID: 6066656] [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: 01/18/2023]
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Masenti E, Balbo G. [Esophageal stenosis caused by caustics. Possibilities and results of surgical treatment]. MINERVA CHIR 1967; 22:246-60. [PMID: 6049057] [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: 01/18/2023]
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Masenti E, Ferrara L, Balbo G. [Current trends in surgical treatment of segmental enteritis]. MINERVA CHIR 1966; 21:737-47. [PMID: 5969395] [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: 01/17/2023]
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Masenti E, Balbo G, Ferrara L. [Possibilities and results in the surgical treatment of carcinoma of the esophagus]. MINERVA CHIR 1966; 21:39-51. [PMID: 5930393] [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: 01/17/2023]
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