Chirurgia italiana
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Patients with cancer of the upper digestive tract may present with malnutrition, which may cause immunodepression and an increased rate of postoperative complications. In this study we describe the rationale and the feasibility of immediate postoperative enteral nutrition (NEPI) and evaluate its effectiveness for the nutritional support of patients undergoing surgery of the upper digestive tract. We studied 46 patients undergoing the following procedures: total gastrectomy (n = 22); oesophageal resection (n = 12); duodenocephalopancreasectomy (n = 12). ⋯ The surgical procedures caused a transient and reversible acute-phase decrease of nutritional and immunological parameters in the early postoperative period. However the NEPI preserved the nutritional status postoperatively as shown by the lack of significant changes in the nutritional indices at 10-14 days after surgery, as compared with baseline. In summary, we documented that NEPI can be started from postoperative day 0 with good intestinal tolerance, allowing adequate nutritional support, after extensive surgical procedures on the upper digestive tract.
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Comparative Study
[Fine needle aspiration biopsy in the diagnosis of thyroid neoplasms].
The clinical value of fine needle aspiration biopsy cytology is discussed with reference to 4514 histologically verified cases. A good sensitivity and specificity, together with high accuracy, make this technique a method of choice in the preoperative diagnosis of thyroid disease.
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Comparative Study
[Role of video-thoracoscopy in the diagnostic specification of thoraco-pulmonary diseases].
Video-thoracoscopy can be used for diagnostic purposes when the other non-invasive methods are not satisfactory for an accurate histological diagnosis, in lung and pleural pathology. Cases observed in last six months and subject to surgery are discussed.
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The AA. report about a case of hepatic abscess found in a operated patient for perforation of a sigmoid diverticulum. The AA. made some consideration on the rarity of the hepatic abscess as complication of diverticulum perforation.
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The Authors report on their experience with 36 cases of traumatic lesions of the diaphragm. Such lesions should be suspected in all cases of thoraco-abdominal trauma. ⋯ In emergency surgery, lesions of the diaphragm are treated by the laparotomy route, which allows complete exploration of the abdominal cavity. The morbidity and mortality of such lesions depend on the associated lesions, on prompt diagnosis and surgery and on appropriate postoperative treatment.