Annali italiani di chirurgia
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A progressive and constant increase of mean life duration in the last century has determined the challenge of the treatment of lung cancer even in the elderly with good functional status. The aim of the present study is to evaluate the results obtained in the elderly, over seventy years old, who underwent pulmonary resection at our Division of Thoracic Surgery of Polyclinic of Bari from 1985 to 1995. ⋯ Diagnostic and therapeutical procedures for lung cancer should be different in the elderly. In our experience, main post-operative complications were cardiovascular, consequent to the entity and duration of surgical operation and intra-operative blood leaks. The elderly require a more careful post-operative monitoring to prevent this kind of complications.
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Review Case Reports
[Penetrating injuries of the neck: review of 16 operated cases].
Cervical lesions from penetrating trauma in the neck are increasing together with other types of trauma especially in big towns. Nevertheless in Italy a Register of Trauma is still lacking and no guidelines are available. Conservative management is also advocated and is still under discussion. Comparison of diagnostic tools and evaluation of different treatments in case of vascular damage is also expected. ⋯ The penetrating trauma in the neck may show various degrees of severity: nevertheless, no cervical penetrating trauma should be underestimated in spite of the minimal width of the lesion. Surgical exploration was invariably the preferred treatment in our experience.
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Randomized Controlled Trial Comparative Study Clinical Trial
[Lymphedema secondary to breast cancer treatment: possibility of diagnostic and therapeutic prevention].
We performed a prospective randomized study upon 50 patients who had undergone a breast cancer treatment, considering particularly the possibility of appearance of arm secondary lymphedema. The patients were divided in two groups of 25 patients each. In the 1st group, we performed only a clinical follow-up, whilst in the 2nd one, we used also lymphoscintigraphy. ⋯ Lymphoscintigraphy allows to pointout alterations of lymphatic drainage before the clinical appearance of edema. Preventive physical and rehabilitative measures allows to reduce the clinical appearance of lymphedema significantly. Microsurgical operation performed precociously, at the early stages of the disease, permits to obtain the complete regression of the pathology thanks to the repair of preferential lymphatic pathways before of fibrosclerotic tissural alterations occur, which cause progressive worsening of clinical conditions, together with recurrent attacks of acute lymphangitis.
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After some preliminary remarks upon pathophysiologic and anatomo-surgical aspects, the main complications of axillary lymph-nodal dissection for breast cancer treatment are reported. The role of surgical technique is particularly underlined and also the importance of proper management of wound and surgical drainage post-operatively are pointed out. Author describes, finally, the necessity of an adequate knowledge of lymphatic drainage not only of mammary region, but also of surrounding area, in order to prevent lesions to lymphatic pathways, particularly to those draining upper arm at the same site of breast cancer.
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Case Reports
[Unusual case of intestinal obstruction at the ileal level: strangulated obturator hernia. A case report].
The authors report their experience about treatment of a rare case of intestinal (ileal) obstruction by strangulated obturator hernia. ⋯ Obturator hernia is a rare pathology, with difficult and delayed diagnosis: all these character make dangerous this hernia, with a risk of high morbidity and mortality (delayed diagnosis and treatment). The only useful treatment is surgery, especially in front of intestinal obstruction, with a wide median laparotomy.