Annali italiani di chirurgia
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Nowadays, there is no standardization in surgical procedures for treatment of colon cancer. Since its introduction, laparoscopic surgery has gained increasing interest in colorectal surgery and it is now performed worldwide for treatment of colon cancer. Following the concept of total mesocolic excision introduced by Heald in 1988 in order to reduce local recurrence after surgical treatment of mid/low rectal tumors, the idea of complete removal of the mesocolon mesocolic envelope has been developed also for colon cancer, has evolved longtime and complete mesocolic excision has been recently adopted as the optimal approach for colon cancer. However, complete mesocolic excision, whose purpose is to remove all lymphatics and lymph nodes draining the tumor, is still discussed as far as oncologic results are concerned. Moreover, the role of laparoscopic approach for complete removal of mesocolon has to be defined. ⋯ Colorectal-tumor, Complete mesocolic excision, High vascular ligation, Laparoscopic colorectal surgery, Splenic flexure mobilization, Total mesocolic excision.
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The aim of the study was to investigate the effect of neutrophil lymphocyte (NLR) and platelet lymphocyte ratio (PLR) on prognosis in acute ischemic stroke (AIS) patients undergoing mechanical thrombectomy. ⋯ Ischemia, Mechanical thrombectomy, Neutrophil lymphocyte ratio, Platelet lymphocyte ratio, Stroke.
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Comparative Study Observational Study
Does the status of surgical resident compared to that of consultant have an impact on patient's satisfaction over the informed consent process?
The informed consent process is a fundamental element of best practice in the surgical patient's care. The aim of the present study is to investigate the value of informed consent from the patient's perspective in a Teaching Hospital. In particular, the role of the Residents within this process is analyzed to compare their performance with that of Consultants. ⋯ Educational program, Informed consent, Informed consent process, Patient's satisfaction, Resident.
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Neoadjuvant chemotherapy is being used with increasing frequency in the multidisciplinary treatment of patients with operable breast cancer. Although large clinical trials have shown no differences between the same systemic therapy given pre- or post-surgery on diseasefree and overall survival, neoadjuvant therapy may have several advantages. By downstaging of the tumor, chemotherapy can convert patients who are candidates for mastectomy to breast-conserving surgery candidates. ⋯ To optimize the oncological and aesthetic results and minimize local recurrence rates, there are essential procedures to be respected as: - Careful local and systemic staging before chemotherapy (Ultrasonography, Mammography, Magnetic Resonance and PET- TAC); - Use of the technique of breast tattooing as practical method to delimit the initial tumor size and its margins before chemotherapy; - Placement of clips before chemotherapy to mark the primary tumor site and metastatic lymph nodes; - Accurate clinical restaging of the disease performed at the completion of chemotherapy; - Adequate radiological preoperative study with localization of residual tumor and/or calcifications and/or clips especially after a good response to neoadjuvant chemotherapy; - Use of innovative oncoplastic techniques that gives more options to have wide resections without compromising the cosmetic outcome; - Intraoperative radiological and pathological evaluation of the specimen, for the definition of the lesion and the margins of resection; - Accurate pathological management and assessment of the specimen using histological large sections (macrosections). In conclusion, sufficient evidence is now available to suggest that breast conservation after neoadjuvant chemotherapy is safe and effective for selected patients. Though neoadjuvant chemotherapy may increase the complexity of breast conservative treatment, a close collaboration between a multidisciplinary team and use of oncoplastic surgical techiques permit to optimize oncological and cosmetis outcomes.
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Patients with thoracic trauma constitute one third of all the trauma cases, in west Sicily were recorded 941 thoracic trauma during the period between 2006 and 2009. Sicily is one of the Italian regions with the highest rate of obesity: some studies have demonstrated that obesity is an independent risk factor for mortality in high energy blunt traumas. ⋯ BMI, Obesity, Thoracic trauma.