Abstract：
:Patients with cirrhosis have reduced life expectancy. Surgery is often associated with clinical decompensation in this group of patients. The purpose of this paper is to study the surgical risk in cirrhotic patients undergoing nonderivative operations. Unfortunately, most of the studies in the literature about this problem are retrospective reviews with limitations. The conditions increasing surgical risk in cirrhotic patients are analysed. These include changes in the pharmacokinetics and pharmacodynamics of various drugs, altered hemostasis, poor resistance to infections, water retention, suture line insufficiency, chronic renal failure and congestive heart failure. Assessment of the disease stage in cirrhosis is very important, because the severity of hepatic abnormalities influences the prognosis. The Child-Pugh classification has been used extensively to risk-stratify patients with cirrhosis. However, the disregard for cardiorespiratory, renal, electrolyte balance and acid-base status limits its predictive accuracy. Recently a new scoring system, the Acute Physiology and Chronic Health Evaluation (APACHE III), has been introduced and seems to be superior to Child-Pugh for prognosticating short term survival of cirrhotic patients. In conclusion, surgery can be done safely only in cirrhotic patients with a good hepatic function. On the contrary, in patients with advanced cirrhosis, surgery causes a very high mortality. Finally, the patients with moderate hepatic failure can be operated only after a careful study of the disease and an adequate correction of the reversible risk factors.
journal_name
Minerva Chirjournal_title
Minerva chirurgicaauthors
Pisani Ceretti A,Cordovana A,Pinto A,Spina GPkeywords:
subject
Has Abstractpub_date
2000-11-01 00:00:00pages
771-8issue
11eissn
0026-4733issn
1827-1626journal_volume
55pub_type
杂志文章,评审abstract：:An experience of 1240 patients suffering from varicose veins of the lower limbs and operated from December 1987 to October 1992, is reported. In order to obtain an objective valuation of functional and aesthetic results, a table with subjective symptoms and clinical and instrumental signs was filled in, before the sur...
journal_title：Minerva chirurgica
pub_type： 临床试验,杂志文章
doi：
更新日期：1994-06-01 00:00:00
abstract：:In the orbital region the variety of tumors is so vast that even an expert oculoplastic surgeon may be deceived. The various tumors may be classified as benign, precancerous and malignant. Approximately 5-10% of all skin cancers occur in the eyelids. Incidence studies indicate that basal cell carcinoma is the most fre...
journal_title：Minerva chirurgica
pub_type： 杂志文章,评审
doi：
更新日期：2013-12-01 00:00:00
abstract：:Papillomatosis of the biliary tract is characterised by multicentric papillary lesions of intra and extrahepatic biliary epithelium. It's a rare benign neoplasm of the biliary tract that causes obstructive jaundice with a high rate of malignant transformation. We described a case of papillomatosis of the biliary tract...
journal_title：Minerva chirurgica
pub_type： 杂志文章
doi：
更新日期：2001-10-01 00:00:00
abstract：:A case of acute gangrenous appendicitis in the sac of right inguinal hernia in a 77 year-old man is described. This condition is extremely uncommon; it is very difficult to establish a correct diagnosis preoperatively; a high mortality rate is due to extensive peritoneal contamination; primary hernia repair is indicat...
journal_title：Minerva chirurgica
pub_type： 杂志文章
doi：
更新日期：1997-06-01 00:00:00
abstract：:Obesity is the leading public health concern in the industrialized world with the advent of the very obese or "super obese" increasing exponentially. Bariatric surgery remains the only effective and enduring treatment for morbid obesity and can be safely accomplished in experienced centers. Surgery in the very obese m...
journal_title：Minerva chirurgica
pub_type： 杂志文章
doi：
更新日期：2010-12-01 00:00:00
abstract：:Two cases of Mirizzi's syndrome are reported. The syndrome consists of: external compression of the common bile duct due to a benign lesion (Type I)--presence of a cholecystobiliary fistula with impacted stones and partial or total obstruction of the hepatic duct (Type II). Clinical signs are non-specific and suggest ...
journal_title：Minerva chirurgica
pub_type： 杂志文章,评审
doi：
更新日期：1997-01-01 00:00:00
abstract：:The key concepts regarding nutrition of elderly patients prior to surgery are outlined. The main metabolic changes that occur during surgical stress, paying special attention to the characteristics of elderly patients, are described. Lastly, the caloric-energy intake required by postoperative geriatric patients is eva...
journal_title：Minerva chirurgica
pub_type： 杂志文章,评审
doi：
更新日期：1999-01-01 00:00:00
abstract：BACKGROUND:Soft tissue defects are mostly managed surgically by free microvascular flaps. The progressive development of techniques and the availability and reliability of new different and free flaps encouraged this surgical approach. Thus, there is a constant need of free flap models to reproduce in laboratory. The e...
journal_title：Minerva chirurgica
pub_type： 杂志文章
doi：
更新日期：2002-08-01 00:00:00
abstract：BACKGROUND:Our aim is to propose the Video-Consulting Emergency (VCE) protocol as a tool to improve the decision-making process between an on-site emergency physician and a remote acute care surgeon using a smartphone, the FaceTime application, and the Acute Abdominal Decision Making (AADM®) model proposed by World Soc...
journal_title：Minerva chirurgica
pub_type： 杂志文章
doi：10.23736/S0026-4733.18.07963-4
更新日期：2019-06-01 00:00:00
abstract：:The efficacy of two methods of orthograde lavage preparation in elective colorectal surgery was tested in 133 consecutive patients: the results obtained with whole gut irrigation (50 patients, group A) were compared with the results of oral lavage solution (83 patients, group B). All patients received a parenteral ass...
journal_title：Minerva chirurgica
pub_type： 杂志文章
doi：
更新日期：1992-08-01 00:00:00
abstract：:Uniportal Video-Assisted Thoracic Surgery (uniportal VATS) lobectomy represents the last evolution of minimally invasive techniques for the surgical treatment of lung cancer. Uniportal VATS was developed from two-ports approach, with two main advantages: only one intercostal space is damaged and the direct view to the...
journal_title：Minerva chirurgica
pub_type： 杂志文章,评审
doi：
更新日期：2016-02-01 00:00:00
abstract：AIM:The aim of the present study was to prospectively evaluate the Stretta radiofrequency (RF) treatment for gastroesophageal reflux disease (GERD) -related respiratory symptoms over a 5-years follow-up period. METHODS:A total of 132 patients underwent the Stretta procedure between April 2007 and February 2009; 122 of...
journal_title：Minerva chirurgica
pub_type： 杂志文章
doi：
更新日期：2014-10-01 00:00:00
abstract：:The Authors report a case of benign mucocele which was brought to their attention for emergency treatment. Following a review of the literature, they examine the clinical, anatomopathological, pathogenetic and therapeutic problems related to this rare disease. In conclusion, it is important to assess the benign nature...
journal_title：Minerva chirurgica
pub_type： 杂志文章
doi：
更新日期：1990-10-31 00:00:00
abstract：:A typical case of spontaneous rupture of the oesophagus (Boerhaave's syndrome) successfully operated at the Surgery Division of the Lodi Greater Hospital is presented. An account of the aetiopathogenetic, anatomopathological and clinical problems involved is followed by an examination of the possibilities of diagnosis...
journal_title：Minerva chirurgica
pub_type： 杂志文章
doi：
更新日期：1975-10-15 00:00:00
abstract：:The authors starting from two observed cases of gallstone ileus, describe of these, the pathogenesis, the diagnostic difficulty, and they express their opinion with regard to surgical treatment to execute, related to the data reported by the authors and from their own experience. ...
journal_title：Minerva chirurgica
pub_type： 杂志文章,评审
doi：
更新日期：1996-01-01 00:00:00
abstract：:Two cases of cardiac wounds in association with acute anaemia and acute cardiac tamponade respectively are presented. The statistical and, more particularly, the diagnostic factors involved are discussed. Stress is laid on the measurement of CVP along with pericardiocentesis. Correct interpretation of the data furnish...
journal_title：Minerva chirurgica
pub_type： 杂志文章
doi：
更新日期：1978-11-15 00:00:00
abstract：:The clinical records and pathologic patterns of all the cases of primary small bowel malignancies, treated in the last 15 years, were reviewed. There were 12 patients: 8 men and 4 women ranged from 41 to 86 years old. Carcinoma was the most common (82%) followed by carcinoid and lymphoma (9%). The distribution of the ...
journal_title：Minerva chirurgica
pub_type： 杂志文章
doi：
更新日期：1990-06-15 00:00:00
abstract：:The authors report the own experience about the experimental use of tissue adhesive in the colonic surgery, on 14 rabbits, with quite satisfactory result. Therefore they evince that this tissue adhesive, althought it can't replace the surgical suture, yet it can help the surgeon out of a hard colonic anastomosis. ...
journal_title：Minerva chirurgica
pub_type： 杂志文章
doi：
更新日期：1980-05-15 00:00:00
abstract：:The prevalence of obesity has increased three-fold in the past two decades. In Europe, 150.000.000 adults and 15.000.000 children are currently affected and obesity epidemic is responsible for approximately 1,000,000 deaths annually. Bariatric surgery for the severely obese has resulted in an overall of 61% weight red...
journal_title：Minerva chirurgica
pub_type： 杂志文章
doi：
更新日期：2009-06-01 00:00:00
abstract：:Twenty autotransplantations and five allotransplantations were performed in female pigs; exocrine secretion was suppressed by injecting an acrylic glue into the ductal system; pancreatic segment was transplanted extraperitoneally in the iliac fussa. We describe an original technique most suitable to the morfologic car...
journal_title：Minerva chirurgica
pub_type： 杂志文章
doi：
更新日期：1980-05-31 00:00:00
abstract：AIM:Outcome of patients with locally advanced non-small-cell lung cancer (NCSLC) is generally poor, with five-year survival rate of only 23%, when patients are treated with surgery only. The presentation of positive adjuvant therapy trials in NSCLC has changed clinical practice, doubling the number of patients with com...
journal_title：Minerva chirurgica
pub_type： 杂志文章,评审
doi：
更新日期：2013-04-01 00:00:00
abstract：:The authors report a retrospective study of four patients treated for sigmoid volvulus at the Clinica Chirurgica II of IRCCS Policlinico S. Matteo of Pavia between April 1974 and June 1989. They are collected from a series of 74 consecutive operations for colonic obstruction not related to hernias of the inguinal-crur...
journal_title：Minerva chirurgica
pub_type： 杂志文章,评审
doi：
更新日期：1993-05-31 00:00:00
abstract：AIM:Although many studies on laparoscopic surgery of the stomach have been conducted so far, yet they have not provided surgeons with criteria for gradual and safe training with this technique. The results of gastric surgery with 30 patients operated on by laparoscopic approach are hereby described. The aim of this iss...
journal_title：Minerva chirurgica
pub_type： 杂志文章
doi：
更新日期：2005-02-01 00:00:00
abstract：:This study analysed 90 cases of symptomatic cholelithiasis treated with laparoscopic cholecystectomy. 27% of the cases studied suffered from microlithiasis, 44% from multiple calculosis with calculi measuring 1 to 2 cm in diameter, 25% from single calculi measuring up to 4 cm in diameter, and 4% from a benign prolifer...
journal_title：Minerva chirurgica
pub_type： 杂志文章
doi：
更新日期：1993-10-15 00:00:00
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：:Senology is going to be an independent branch, but resistances to the acknowledgement of the senologist as a devoted professional are still under way. Nevertheless, in the last 20 years an irreversible educational training was traced out. The senologist is not only the surgeon who operates on the breast: he is also a ...
journal_title：Minerva chirurgica
pub_type： 杂志文章,评审
doi：
更新日期：2005-12-01 00:00:00
abstract：:Following the exclusion of the ventilation of a lung, perfusion is arrested as a consequence of the Von Euler and Liljestrand vasoconstrictive reflex. However it is as yet unknown how long this phenomenon takes to manifest itself in human beings. In order to verify whether hypoxic pulmonary vasoconstriction follows im...
journal_title：Minerva chirurgica
pub_type： 杂志文章
doi：
更新日期：1993-06-15 00:00:00
abstract：:The authors report a case of associated injuries (thoracoabdominal trauma with multiple rib and sternum fractures, perforation of the small intestine, abdominal cutaneous ecchymosis) caused by a seat belt, and describe the possible seat-belt mechanisms of lesion in road accidents. Some clinical aspects are discussed; ...
journal_title：Minerva chirurgica
pub_type： 杂志文章
doi：
更新日期：1993-05-15 00:00:00
abstract：:Self-transfusion represents a clinical method used for the restoration of haematic losses that, in recent years has been employed more and more widely in the surgical ambit. The utilisation of this method has become increasingly frequent because of the high diffusion of haemotransmitted diseases, and of the incidences...
journal_title：Minerva chirurgica
pub_type： 杂志文章
doi：
更新日期：1993-11-01 00:00:00
abstract：:The authors present their personal experience of three cases of bronchial fistulae post pneumonectomy or lobectomy. Surgical treatment was not done directly on the bronchial stump but by thoracoplasty. This approach to the thoracic chest gets good results on condition that stabilization in reexpansion of residual pare...
journal_title：Minerva chirurgica
pub_type： 杂志文章
doi：
更新日期：1997-04-01 00:00:00
