Abstract:
BACKGROUND:Spontaneous rupture is a life-threatening complication of HCC, occurring in 4.8-26% of cases. Liver failure is the main cause of death. Debates still remain on the most appropriate treatment in such patients because of the high operative mortality of emergency surgery and the high risk of rebleeding and less satisfying mid- and long-term results of nonoperative procedures like angiographic embolization. Early and long-term results of a surgically oriented treatment, based on prompt evaluation of the functional liver reserve and tumor resectability was retrospectively review-ed. METHODS:From January 1994 to December 2000, 11 patients (7 males and 4 female, mean age 66.2 (11.86 years) were treated for ruptured HCC, in 10 cases involving a cirrhotic liver. Seven patients underwent emergency surgery and 4 patients transcutaneous arterial embolization (TAE). Liver resection was performed in patients with preserved liver function, after ultrasonography and/or CT scan demonstrated hemoperitoneum and a single resectable liver tumour (5 cases). In one patient with cirrhosis, ultrasonography showed only hemoperitoneum. A bleeding nodule was discovered intraoperatively and resected in a liver with a multinodular HCC. Another patient under-went emergency resection after referral at our Unit with a surgical packing. In 4 cases with poor liver function and/or unresectable tumour TAE of the neoplasm was performed, in one case after surgical packing. Mortality, morbidity and patients survival after treatment were analyzed. All patients had at least 1 year follow-up. RESULTS:All patients underwent minor resection; 2 left lobectomies, 1 segmentectomy (VII), 1 bisegmentectomy (VII-VIII), and 3 wedge resections. Postoperative course was complicated by ascites in 5 cases and subphrenic abscess in one case. Four patients died 3, 4, 6 and 62 months after surgery; 3 patients are actually alive 22, 25, and 89 months after surgery. Four patients were submitted to TAE: all patients died within 6 months. CONCLUSIONS:When ruptured HCC is suspected, preserved liver function (Child A-B7) and a resectable hepatic tumour are considered clear indications to surgery. Emergency liver resection achieved good early and long-term results. In cases of advanced liver disease or multinodular HCC a non-operative approach, like TAE, must be attempted. Surgical direct hemostasis or hepatic artery ligation must be reserved for patients with uncontrollable o recurrent bleeding after TAE.
journal_name
Minerva Chirjournal_title
Minerva chirurgicaauthors
Recordare A,Bonariol L,Caratozzolo E,Callegari F,Bruno G,Di Paola F,Bassi Nkeywords:
subject
Has Abstractpub_date
2002-06-01 00:00:00pages
347-56issue
3eissn
0026-4733issn
1827-1626journal_volume
57pub_type
杂志文章abstract::Colonsphinctorometrography (CSMG) is a new, original method for the simultaneous investigation of the motility of the descending colon, sigmoid colon, rectosigmoid junction, rectum, and internal and external anal sphincters. A 60 cm open-ended tip sound with an external diameter of 10 mm is used. Three 3 cm long stimu...
journal_title:Minerva chirurgica
pub_type: 杂志文章
doi:
更新日期:1980-03-15 00:00:00
abstract::Lung cancer is globally the second most common form of cancer in both men and women and the single largest cause of cancer-related mortality in the world. It is a disease with poor prognosis and the survival statistics have scarcely improved since historical times. The advent of targeted therapies has caused an increm...
journal_title:Minerva chirurgica
pub_type: 杂志文章,评审
doi:
更新日期:2009-12-01 00:00:00
abstract::The efficacy of defibrotide in the treatment of acute thrombophlebitis of the legs has been investigated in 140 patients, randomized into two groups. All patients received defibrotide either alone or as an addition to conventional therapies. Two different schemes of administration were selected and carried out in each...
journal_title:Minerva chirurgica
pub_type: 临床试验,杂志文章,随机对照试验
doi:
更新日期:1989-05-15 00:00:00
abstract:BACKGROUND:The conservative surgery is considered currently the treatment of choice for the carcinoma of the breast in the initial stage. METHODS:From 1993 to the 2000, 46 patients (median age 52 years) affected by intraductal carcinoma of the breast, have been submitted to surgical intervention. In 10 cases (21,7%) a...
journal_title:Minerva chirurgica
pub_type: 杂志文章,评审
doi:
更新日期:2003-08-01 00:00:00
abstract::Following and exhaustive review of the literature on this topic, the paper reports the results of the treatment of 16 patients with male breast cancer. From an analysis of findings, it was observed that diagnosis is frequently delayed (mean 1 year), disease is at a locally advanced stage in the majority of patients, a...
journal_title:Minerva chirurgica
pub_type: 杂志文章
doi:
更新日期:1990-01-01 00:00:00
abstract:BACKGROUND:The incidence of perforative diverticulitis of the left colon is steadily increasing. Today the decision is generally taken to perform two-stage surgery: segmentary resection without (Hartmann's operation) or with anastomosis, but protected by a colostomy ("limited intervention"). This study aimed to examine...
journal_title:Minerva chirurgica
pub_type: 杂志文章
doi:
更新日期:1998-12-01 00:00:00
abstract::The authors discuss the efficacy of the lateral calcaneal artery flap in repairing the calcaneal and malleolar regions. The lateral calcaneal artery flap is a safe flap, with constant vascularization represented by the lateral calcaneal artery and the external saphenous vein; the flap has a sensory nerve (the sural ne...
journal_title:Minerva chirurgica
pub_type: 杂志文章
doi:
更新日期:1995-05-01 00:00:00
abstract::Thirty-four patients who underwent carotid-subclavian bypass (64.7%), aorto-carotid bypass (17.6%), endarterectomy of subclavian artery (5.8%) or endarterectomy of innominate artery for "subclavian" or "innominate steal" syndromes, had a follow-up studies 3-8 years since surgery. All patients demonstrated originally a...
journal_title:Minerva chirurgica
pub_type: 杂志文章
doi:
更新日期:1980-08-15 00:00:00
abstract::The authors report a case of gastric leiomyoblastoma, a rare benign neoplasm that can sometimes undergo a malignant course. The main clinical an pathological issues are reviewed, in order to offer guidance as to the best suited surgical approach. ...
journal_title:Minerva chirurgica
pub_type: 杂志文章,评审
doi:
更新日期:1992-11-01 00:00:00
abstract::The biological and synthetic materials employed over the years for filling breasts after mastectomy or for congenital malformations are reviewed. At the start of the century, breast shape and volume were changed by adipose tissue grafts. In the 50s and 60s dermo-fibro-adipose grafts and later auto-grafts and grafts of...
journal_title:Minerva chirurgica
pub_type: 历史文章,杂志文章
doi:
更新日期:1989-09-30 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::The surgical approach to acute cholecystitis has changed through the years. It was extended to all ages. The authors report their 10-year experience with 562 cases of cholecystitis. The mortality rate was 1.5% the morbidity rate was 7.6% The authors propose early surgery (within 72 hours of diagnosis) in the majority ...
journal_title:Minerva chirurgica
pub_type: 杂志文章
doi:
更新日期:1997-06-01 00:00:00
abstract::Surgical correction of pectus excavatum et carinatum in a series of adult patients is described. The relationship between deformity of the anterior chest wall and cardiac, respiratory and digestive disturbances is assessed. The indications for surgical management are explained. Reference is also made to the satisfacto...
journal_title:Minerva chirurgica
pub_type: 杂志文章
doi:
更新日期:1975-02-15 00:00:00
abstract::The haemodynamic premises for extra-anatomical by-pass in the treatment of stenosis and obstructions of the subclavian and vertebral arteries are discussed with a report on a surgically treated series. ...
journal_title:Minerva chirurgica
pub_type: 杂志文章,评审
doi:
更新日期:1989-03-15 00:00:00
abstract::Microscopic examination of organs from outbred and inbred rats used in 5 groups for experiments in parabiosis with and without crossing of the digestive tubes and pseudoparabiosis showed that skin junctions soon became dehiscent, with boundary furrows tendings to separate the animals, in outbred rats, whereas continui...
journal_title:Minerva chirurgica
pub_type: 杂志文章
doi:
更新日期:1976-02-15 00:00:00
abstract::Thoracic trauma occurs in an estimated 25% of all trauma victims, with approximately 50% of trauma mortalities attributable to these injuries. Only 4% of thoracic traumas involve injuries to thoracic vessels, including the aorta, innominate veins and artery, left carotid artery, internal mammaries, and pulmonary hilar...
journal_title:Minerva chirurgica
pub_type: 杂志文章,评审
doi:
更新日期:2013-06-01 00:00:00
abstract:AIM:The primary objective of the study was to compare the effect of laparoscopic-assisted (LPS) versus open surgery (LPT) for colorectal cancer on postoperative morbidity. The secondary objectives were to evaluate immune response and intestinal wall oxygen perfusion. METHODS:A total of 610 patients with colorectal can...
journal_title:Minerva chirurgica
pub_type: 杂志文章,随机对照试验
doi:
更新日期:2006-08-01 00:00:00
abstract::We have reported two patients with unilateral adrenal hyperplasia as a rare cause of primary aldosteronism, and discussed the literature on this subject. When diagnosed by NMR-CT imaging and selective sampling from adrenal veins, the treatment of this disorder appears to be surgical. Whether its pathogenesis is relate...
journal_title:Minerva chirurgica
pub_type: 杂志文章,评审
doi:
更新日期:1995-01-01 00:00:00
abstract::The Authors perform a retrospective study on the incidence of postoperative jaundice in a selected group of 2060 patients, who underwent operations of general or vascular surgery. The incidence of jaundice in the postoperative period appears to be quite high in vascular surgery: out of 96 patients became jaundiced, 78...
journal_title:Minerva chirurgica
pub_type: 杂志文章
doi:
更新日期:1980-06-30 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::An increased risk of colorectal cancer has been reported in first-degree relatives of affected patients, and following cholecystectomy or partial gastrectomy for benign peptic ulcer disease. The aim of this study was to examine the incidence of these potential risk factors in 197 patients (127 males, 70 females, mean ...
journal_title:Minerva chirurgica
pub_type: 杂志文章
doi:
更新日期:1996-12-01 00:00:00
abstract::The Authors present a case of bile peritonitis due to a biliary fistula developed after T tube removal from the common bile duct. Highlighting poor clinical manifestations they report an alternative conservative treatment, by drainage of the bile leakage with culdocenthesis and successive endoscopic spincterotomy and ...
journal_title:Minerva chirurgica
pub_type: 杂志文章
doi:
更新日期:1991-03-31 00:00:00
abstract::A case of giant hydatid cyst of the left lung submitted to conservative surgery is reported. The postoperative period was complicated by the appearance of a bronchopleural fistula and a residual cavity. The complication was treated with targeted double lumen drainage which enabled pleuroclysis with saline solution and...
journal_title:Minerva chirurgica
pub_type: 杂志文章
doi:
更新日期:2000-07-01 00:00:00
abstract::Cholecystolithotomy and cholecystojejunostomy has been carried out on 11 patients with severe hypertension from cirrhosis. The indications were frequently recurring attacks of biliary cholic or acute cholecystitis at onset. There was 1 postoperative death from cardiac infarction and only minor in-hospital morbidity. N...
journal_title:Minerva chirurgica
pub_type: 临床试验,杂志文章
doi:
更新日期:1995-03-01 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::Stomitis due to non absorbable sutures is an increasingly common endoscopic finding. Personal experience has shown that this complication is not encountered when catgut sutures are employed in stomach operations. It is therefore recommmended that this or other absorbable material be used in gastric surgery. Stress is ...
journal_title:Minerva chirurgica
pub_type: 杂志文章
doi:
更新日期:1978-10-15 00:00:00
abstract:BACKGROUND:Utility of long term central venous accesses. METHODS:Personal experience in 173 long term central venous accesses (a.v.c.) performed from January 1990 to December 1997 in 172 patients mostly affected by neoplastic disease is reported. The device used was totally implantable in 102 cases (59%): 82 Port (80....
journal_title:Minerva chirurgica
pub_type: 杂志文章
doi:
更新日期:1999-11-01 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:AIM:Severe obesity is a major health problem affecting more than 1,000,000 people in Italy, with a 95% failure rate of nonsurgical treatments. We report our over five-years experience with laparoscopic Roux-en-Y gastric bypass (LRYGBP), evaluating the postoperative course of the patients undergoing 3 different gastro-e...
journal_title:Minerva chirurgica
pub_type: 杂志文章
doi:
更新日期:2007-04-01 00:00:00
abstract::Leiomyosarcoma of rectum is a rather rare malignant tumour. Generally, it manifests late when pain, tenderness, rectal bleeding and obstruction occur or ulceration through the rectal mucose with bleeding or discharge occur. Rectal examination leads to the diagnosis of malignancy. The histological report confirms the t...
journal_title:Minerva chirurgica
pub_type: 杂志文章
doi:
更新日期:1980-11-30 00:00:00