Abstract:
BACKGROUND:In gastric cancer surgery, to search for a technique to remove the entire posterior mesogastric region using a standardised operation using well defined methods and anatomic-embryological planes. METHODS:A concise description of the embryological evolution of the posterior mesogastrium allow the formation of the mesogastric fascia (and the supramesocolic fascia of the omentum--which is a continuation) to be documented. It is also clear that the mesogastric fascia is the embryological--anatomical equivalent of Treitz's fascia, pancreatic retro-head, and Toldt's retrocolic fascia, of which it is a structural continuation. Like Treitz's and Toldt's fascias, the mesogastric fascia also represents the surgical plane for the detachment of the region in question and allows maximum safety and radicality. By carrying out primary ligature of the arteries at the origin and the veins at the outlet, the entire posterior mesogastric region, with the relative lymph node stations, can be removed en bloc with maximum radicality and safety, and also in line with the principle of "no touch isolation". We used this technique to operate 61 cases, 17% of all cases of gastric carcinomas between 1973 and 1994. RESULTS:Mesogastrectomy was required in 87% of cases with carcinoma in a high localisation or widespread nature of the linitis plastica type. Only 23 cases (37%) were at pTNM II and III A stages. Thirty-eight cases (63%) were at stages III B and IV. In non-selected cases and those with severe associated pathologies and undergoing emergency surgery, and those cases that were extended beyond mesogastrectomy, morbidity was above all linked to pleural effusion. There were only 2 cases (3%) of operating mortality owing to two technical errors: an esophago-jejunal anastomotic dehiscence (the only case in the series, 1.6%) caused by esophageal cancer nests in the suture and a case of necrosis in the left hepatic region following the section of the left gastric artery at the origin despite the existence of a large hepatic collateral vessel. The results for stages II and III A were excellent: stage II, 100% survival at 5, 10 and 15 years; stage III A 88% survival at 5 years, 70% at 10 years, 55% at 15 years, but only two deaths from neoplasia at 2.7 and 4.6 years. The results for stages III B and IV are comparable to large series undergoing traditional forms of surgery. Postoperative conditions of nutrition and quality of life were good and patients resumed activities with the aid of constant chlorhydric-peptic replacement treatment and the total extraction of gastric mucosa. CONCLUSIONS:We believe that mesogastrectomy represents a real advance in both technical terms and results for stages II and III A; it is debatable for stages III B and IV, although individual cases who survived for more than 10 years were also reported. The case of a stage pT3N0M1 = IV pathology, with a single hepatic metastasis that increased until one year and then spontaneously resolved leaving the patient alive and in good health 20 years and 6 months after the operation is truly amazing.
journal_name
Minerva Chirjournal_title
Minerva chirurgicaauthors
Gullino D,Giordano O,Ghione S,Lijoi C,Masella M,Zavattero Ckeywords:
subject
Has Abstractpub_date
2000-10-01 00:00:00pages
721-32issue
10eissn
0026-4733issn
1827-1626journal_volume
55pub_type
临床试验,杂志文章abstract::The physiopathological premises for various methods of hepatic revascularisation are described and results wiht splenohepatoplasty in 40 rats are presented. This operation involves insertion of the upper pole of decapsulated spleen in the left hepatic lobe to create a new parenchymal supply and regenerate the liver ce...
journal_title:Minerva chirurgica
pub_type: 杂志文章
doi:
更新日期:1975-09-30 00:00:00
abstract::The length of stay (LOS) is one of the major determinants of rising costs in surgical patient care. We studied the timing of the diagnostic procedures performed in 323 surgical patients admitted to 8 surgical departments of a large hospital. Of these: 50 underwent gastrectomy, 28 colectomy, 90 biliary tract (BT) opera...
journal_title:Minerva chirurgica
pub_type: 杂志文章
doi:
更新日期:1992-10-15 00:00:00
abstract:BACKGROUND:Laparoscopic surgery is used with increasing frequency to treat colorectal pathologies and some groups have also attempted to treat the complicated forms of diverticulitis (abscesses and/or fistulas). The results reported in the international literature are still controversial, especially in terms of the dur...
journal_title:Minerva chirurgica
pub_type: 杂志文章
doi:
更新日期:2002-02-01 00:00:00
abstract::Three cases of acute torsion of the greater omentum two unipolar in two 5-yr-old children and one bipolar in a man of 46 are reported. Correct diagnosis was impossible and never suspected in any of the patients and was only made during surgery. The postoperative course was normal in all three cases. ...
journal_title:Minerva chirurgica
pub_type: 杂志文章
doi:
更新日期:1980-02-29 00:00:00
abstract::Two cases of congenital diaphragmatic hernia affecting the central tendon are described. The anatomic, etiologic, pathogenic and clinic characteristics of this uncommon disease are then discussed. Finally some considerations about indications on how to operate on these congenital hernias and different repairing surgic...
journal_title:Minerva chirurgica
pub_type: 杂志文章
doi:
更新日期:1981-06-15 00:00:00
abstract:BACKGROUND:The authors describe the advantages and disadvantages of plastic surgery performed in a day-care public hospital unit. METHODS:A retrospective study was made of the day-surgery activities over 16 months (1998-1999) as part of a centralized system. Data were compared to day-surgery activities undertaken in 1...
journal_title:Minerva chirurgica
pub_type: 杂志文章
doi:
更新日期:2000-09-01 00:00:00
abstract::Although the common bile duct is now accessed using a coelioscopic approach by an increasing number of surgical equipes, the problems related to the diagnostic iter of lithiasis of the common bile duct and the need to obtain a correct preoperative diagnosis, in order to select the most appropriate form of therapy, are...
journal_title:Minerva chirurgica
pub_type: 杂志文章,评审
doi:
更新日期:1995-03-01 00:00:00
abstract:BACKGROUND:The well-known soft tissue healing properties in some rat models as well as the modulating fibroblasts activity of heterologous collagen led us to the hypothesis that it is possible to prevent the peritoneal adhesions in the rat by interposition of the collagen after peritoneal surgery. METHODS:In this stud...
journal_title:Minerva chirurgica
pub_type: 杂志文章,评审
doi:
更新日期:1998-11-01 00:00:00
abstract::In the clinical office, during surgical planning, or in the operating room, neurosurgeons have been surrounded by the digital world either recreating old tools or introducing new ones. Technological refinements, chiefly based on the use of computer systems, have altered the modus operandi for neurosurgery. In the emer...
journal_title:Minerva chirurgica
pub_type: 杂志文章,评审
doi:
更新日期:2010-08-01 00:00:00
abstract::The factors underlying late thrombosis of aortobifemoral by-pass are analysed on the basis of personal experience and reported data. They are considered to be due to progressive degradation of the prosthesic tissue and, particularly, to the lack of an adequate back flow route, apart from any faults in the actual const...
journal_title:Minerva chirurgica
pub_type: 杂志文章
doi:
更新日期:1979-02-28 00:00:00
abstract::Echotomography was used in the diagnosis of abdominal disease in children. The results obtained were compared with those given by conventional methods. The soundness of echotomography in the location and indication of the size and structure of lesions was demonstrated in a series of 20 cases. ...
journal_title:Minerva chirurgica
pub_type: 杂志文章
doi:
更新日期:1978-05-15 00:00:00
abstract::A case of great bleeding cyst formation in the abdominal wall is presented. Some aspects of differential diagnosis are discussed and the technique used to close the resultant hole in the intestinal wall after removing the cyst. The particular technical method they used permitted the reconstruction without using artifi...
journal_title:Minerva chirurgica
pub_type: 杂志文章
doi:
更新日期:1980-03-31 00:00:00
abstract::The Authors report two cases with local recurrence after partial gastrectomy for advanced gastric carcinoma. The Authors suggest that chemo and/or radiotherapy associated with surgical treatment can improve the prognosis in some patients with recurrence. Response to chemotherapy and time elapsing before recurrence app...
journal_title:Minerva chirurgica
pub_type: 杂志文章,评审
doi:
更新日期:1992-06-15 00:00:00
abstract::Ductal carcinoma in situ (DCIS) has been the subject of much controversy since the advent of population based breast screening programs. An increasing number of asymptomatic women are being diagnosed with this condition and there is uncertainty over the best treatment algorithm for this condition if treatment is to be...
journal_title:Minerva chirurgica
pub_type: 杂志文章,评审
doi:10.23736/S0026-4733.18.07729-5
更新日期:2018-06-01 00:00:00
abstract::Non-hypertrophic breast ptosis are common diseases. Various degree of ptosis and different involutions of the breast tissue can condition the surgical treatment. Plastic surgery must provide the best surgical treatment in any case. ...
journal_title:Minerva chirurgica
pub_type: 杂志文章
doi:
更新日期:1994-11-01 00:00:00
abstract::On the basis of a case of rectal Schwannoma and a review of the literature on this rare condition, stress is laid on the clinical features, diagnostic difficulties and indicated surgical therapy approaches. The need for radical operation, because of the tendency of the form to recur locally and because of the real pos...
journal_title:Minerva chirurgica
pub_type: 杂志文章
doi:
更新日期:1981-02-28 00:00:00
abstract::Successful closure of a iatrogenic tracheoesophageal fistula by means of bronchoscopic application of fibrin glue in a 77-year old patient is reported. The fistula was completely obliterated after a single application of the glue, with resolution of the clinical and radiological signs. The procedure may be suggested a...
journal_title:Minerva chirurgica
pub_type: 杂志文章
doi:
更新日期:1993-10-15 00:00:00
abstract::The locoregional treatment of breast cancer has rapidly evolved from disfiguring approaches to nipple-sparing mastectomy (NSM) in selected patients. The goal of the nipple-sparing mastectomy procedure is to remove all glandular breast tissue in order to maximize oncologic therapy, while leaving the nipple-areola compl...
journal_title:Minerva chirurgica
pub_type: 杂志文章,评审
doi:
更新日期:2012-06-01 00:00:00
abstract:BACKGROUND:Peripheral lymphadenopathy can be caused by benign disease, or it could be a manifestation of underlying hematological disease or metastasis of a yet undiagnosed malignant condition. Fine-needle aspiration cytology (FNAC) and image-guided core biopsy usually make up the first line of investigation. There are...
journal_title:Minerva chirurgica
pub_type: 杂志文章
doi:10.23736/S0026-4733.18.07752-0
更新日期:2019-06-01 00:00:00
abstract:AIM:Despite improvement in the operative technique and graft and suture material, femoral anastomotic aneurysms (FAAs) represent a continuing problem for patients undergoing lower extremity revascularization. The present retrospective study investigates the clinical presentation, the infection as a cause of FAAs, the i...
journal_title:Minerva chirurgica
pub_type: 杂志文章
doi:
更新日期:2006-04-01 00:00:00
abstract:AIM:Systematic surveys with advanced non-invasive imaging techniques have revealed that hepatic cysts are quite common in the general population. Therefore, we retrospectively examined our case series and compared it with the literature. METHODS:Between January 1990 and December 2000, 228 patients with non-parasitic l...
journal_title:Minerva chirurgica
pub_type: 杂志文章
doi:
更新日期:2004-08-01 00:00:00
abstract::The early detection of breast cancer is of primary importance, as one method which many reduce the unacceptably high mortality rate associated with this disease. In fact, it is well stated that the most concrete possibility of therapeutic success in the treatment of breast cancer is represented by early treatment, whi...
journal_title:Minerva chirurgica
pub_type: 杂志文章
doi:
更新日期:1994-04-01 00:00:00
abstract::We have analysed the results of surgical treatment for microcarcinoma of the thyroid (MCT). In sixteen patient clinical and follow-up data were retrospectively evaluated during a 35.1-month follow-up. Thyroid hyperfunctional state us was present in two subjects. A single nodule was detected by echotomography in 11 pat...
journal_title:Minerva chirurgica
pub_type: 杂志文章
doi:
更新日期:1997-07-01 00:00:00
abstract:INTRODUCTION:One anastomosis gastric bypass (OAGB) is now a recognized mainstream bariatric procedure being adopted by an increasing number of surgeons. The purpose of this review was to present an evidence-based summary of its key technical aspects and prevention and management of its specific complications. EVIDENCE...
journal_title:Minerva chirurgica
pub_type: 杂志文章,评审
doi:10.23736/S0026-4733.18.07844-6
更新日期:2019-04-01 00:00:00
abstract::Continuing researches on the monitoring of acute phase proteins (A.P.P.) as markers of septic risk in the surgery patient, a series of 50 patients suffering from pathological processes classifiable as follows has been examined: 1) acute biliary pancreatitis 18 cases; 2) acute hepatobiliary pathology without pancreatic...
journal_title:Minerva chirurgica
pub_type: 杂志文章
doi:
更新日期:1990-04-15 00:00:00
abstract:BACKGROUND:There are several therapeutic proposals for idiopathic varicocele treatment, but all of them present a certain number of relapses. The technique proposed consists, through an inguinal approach, in a systematic ligation and section of all veins potentially responsible of a venous reflux. METHODS:During a per...
journal_title:Minerva chirurgica
pub_type: 杂志文章
doi:
更新日期:1999-05-01 00:00:00
abstract::H2 blockers have accelerated the reduction in elective peptic ulcer surgery but appear to have had no equivalent effect on the incidence of perforated ulcer success. A 13 year (1975-1987) review of perforated peptic ulcer is presented. The mean annual number of operations for perforation fell from 8.21% to 4.93% after...
journal_title:Minerva chirurgica
pub_type: 杂志文章
doi:
更新日期:1989-11-15 00:00:00
abstract::The role of some so-called primary and secondary (or oligo-elements) elements in the physiopathology of the cardiocirculatory system has been well known from a number of years and they have been regularly included in the treatment protocols. Some, including K, Ca, Mg and Zn, are extremely well known and widely used in...
journal_title:Minerva chirurgica
pub_type: 杂志文章
doi:
更新日期:1993-02-01 00:00:00
abstract::Barrett's esophagus is the most serious form of gastroesophageal reflux disease. It may develop due to uncontrolled chronic duodenogastroesophageal reflux and represents a premalignant abnormality. The question of the development of Barrett's esophagus and the progression to adenocarcinoma of the esophagus is addresse...
journal_title:Minerva chirurgica
pub_type: 杂志文章,评审
doi:
更新日期:2002-08-01 00:00:00
abstract::Between January 1989 and December 1994 we accomplished 130 CT-guided transthoracic fine needle aspirations (FNA) in 120 patients. Ten patients underwent a second FNA because of the negativity and doubts of the first. Diagnosis was targeted in 114 (95%) patients and 89% showed cytological evidence of malignancy. FNA-CT...
journal_title:Minerva chirurgica
pub_type: 杂志文章
doi:
更新日期:1996-01-01 00:00:00