Total colectomy for cancer: analysis of factors linked to patients' age.

Total colectomy (TC) is a valid option for cancer treatment in selected cases. Emergency presentation, association to familial adenomatous polyposis (FAP) or intestinal bowel disease (IBD), hereditary non-polyposis cancer (HNPCC), and synchronous tumors are the common indications to TC for cancer. Despite potential high morbidity and mortality rates for worse general health conditions of the advanced age it has even suggested for elderly patients. We reviewed our experience to analyze the current role of TC comparing different results between young and elderly patients. During the period 1990-2012, 76 patients were operated on TC for cancer. Patients were divided in two groups according to the age [65 years old - group B (elderly)] and were compared their systemic and surgical complication, considering the presence of comorbidities, ASA score, lifestyle habits, elective or emergency presentation. Morbidity rate was 7.7% and 38.8% in young and elderly patients respectively.21 systemic complications (3 in group A and 18 in group B) occurred in 17 patients (22.36%) (with the coexistence of two complications in 4 patients belonging to the group B. There were 6 surgical complications (7.9%) (3 in group A and 3 in group B): anastomotic leakage 3, major wound infections 2, postoperative bleeding 1; no intra-abdominal abscess were observed. In 2 cases (2.6%) (1 anastomotic leak and 1 intra-abdominal postoperative hemorrhage) was needed a reoperation. We observed only 2 deaths in the elderly. High ASA score and emergency were associated with worst results. Systemic complications were more frequent in elderly patients cause of significant comorbidities, while the incidence of surgical complications was similar and according to literature. Besides the classic indications, it is a viable surgical option also in cancer associated with complicated diverticulitis. Our data show that TC is a safe and effective procedure providing good results even in elderly patients, when combined with a careful preoperative evaluation and age is not an absolute controindication to this procedur

Physical activity in elderly kidney transplant patients with multiple renal arteries

Introduction: Kidney transplantation (KT) is the gold standard for treatment of patients with end- stage-renal disease. To expand the donor reserve, it is necessary to use marginal/suboptimal kidneys. Methods: We retrospectively evaluated the short/long-term outcome of 34 KT elderly patients who received allografts with vascular abnormalities (MRA group), in comparison with 34 KT patients who received a kidney with a single renal artery (SRA group) pair-matched by age, length of time on dialysis, comorbidity and donor age. Results: All participants completed the International Physical Activity Questionnaire at KT, and then 4, 8, and 12 weeks after transplantation. Our data indicate that kidney with vascular anatomical variants may be successfully transplanted, since the overall rate of surgical complications was 20.6% in the SRA group and 17.6% in the MRA group and that the 5-year survival rate after KT was 100% in both groups. Conclusions: The data also underline that individualized physical activity programs induced similar excellent results in both groups, improving physical capacities, arterial pressure, lipid metabolism, insulin sensitivity, quality of life and physical and mental status

“ IL CHIRURGO E LA FAMILIARITÀ NEOPLASTICA”.

CONGRESSO 2002 - SOCIETÀ NAPOLETANA DI CHIRURGIA (S.NA.C.).STROMBOLI 13-16GIUGNO 2002

bioinformatics in MPM: prediction of a second tumor site by using decision trees

Assessment of the risk of second tumors with bioinformatic

“Diagnosi molecolare e chirurgia colo-rettale”.

XLVI CONGRESSO DELLA SOCIETÀ SICILIANA DI CHIRURGIA “LA CHIRURGIA TRA ARTE, TECNOLOGIA, ECONOMIA ED ETICA.”CEFALU’, 26-28 SETTEMBRE 2002

RUOLO ED EVOLUZIONE DEI MEMS NELLA DIAGNOSTICA E NEL TRATTAMENTO CHIRURGICO MINI-INVASIVI

Gli avanzamenti nella tecnologia di produzione dei MEMS hanno reso ormai realistico e reale il loro impiego in medicina in generale e in chirurgia in particolare. Si è osservato come i sistemi di sensorizzazione e di attuazione di dimensioni delle decine di micron siano ormai sviluppati, e come la loro integrazione in strumenti intelligenti sia in fase matura. L’impiego di nanotecnologie al posto delle microtecnologie promette sviluppi ancora più vertiginosi. Alcuni problemi restano tuttavia ancora aperti, primo fra tutti quello della biocompatibilità dei materiali innovativi, per la quale si rendono necessarie sperimentazioni mirate. Inoltre, le fonti energetiche rappresentano una risorsa estremamente preziosa per dispositivi che devono muoversi all’interno del corpo umano in maniera autonoma, senza poter attingere energia dall’esterno. Dal punto di vista tecnologico si devono quindi sviluppare microbatterie e sistemi di trasmissione di potenza senza fili. Il tutto va poi integrato in maniera sistemica progettando congiuntamente attuatori, sensori, sistemi di controllo e di supervisione. Ciò richiede la collaborazione di discipline scientifiche tradizionalmente molto distanti fra loro come Medicina, Ingegneria, Fisica, Chimica, Biologia, nonché la disponibilità ad investire su questi argomenti risorse da parte di centri di ricerca pubblici e privati

"IL MESORETTO E LE NUOVE RICOSTRUZIONI".

VII CONFERENZA NAZIONALE AIOM. TAORMINA, 11-14 MAGGIO 2003