Feasibility and operative outcomes of surgery in the liver area in advanced ovarian cancer.

Objective: The study aimed to characterize intra-and postoperative complications according to a standardized anatomo-surgical classification for ovarian cancer metastases in the liver area.

Methods: Data from all patients with advanced ovarian cancer undergoing primary or secondary surgery with perihepatic liver involvement (May-2016 to May-2022), were retrospectively retrieved and classified according to a standardized anatomo-surgical classification, and clustered into four Classes: Class I "Peritoneal", Class II "Hepatoceliac-lymph-nodes", Class III "Parenchymal" and Class IV Mixed (≥ 2 classes).

Results: Data from 615 patients were collected.

Implementing a Personalized Antimicrobial Stewardship Program for Women with Gynecological Cancers and Healthcare-Associated Infections.

Healthcare-associated infections (HCAIs) represent a major cause of morbidity and mortality in gynecologic cancer patients, requiring personalized cures. A retrospective study on gynecologic patients with HCAIs, managed through an antimicrobial stewardship program, was performed, focusing on rates of clinical cure, breakthrough/relapse of infections, death, and time of hospital stay (THS). In total, 27 patients (median 60 years, mainly suffering from ovarian, cervical, and uterine cancer) were evaluated by a specialist in infectious diseases and were mainly diagnosed with complicated urinary tract (cUTIs, 12 cases, 44.

Nomogram to predict feasibility of minimally invasive interval debulking surgery in advanced ovarian cancer.

Objective: Currently, there is no clear guidance defining the ideal candidate for minimally invasive interval debulking surgery. This study aimed to identify predictive factors for a minimally invasive approach in patients with advanced ovarian cancer who are candidates for interval debulking surgery after neoadjuvant chemotherapy.

Methods: This was a single institution retrospective study conducted between January 2014 and June 2020 Perioperative variables were used to predict the likelihood of minimally invasive interval debulking surgery using multivariable models.

Laparoscopic sacrocolpopexy plus ventral rectopexy as combined treatment for multicompartment pelvic organ prolapse.

Background: Pelvic organ prolapse (POP) is a dynamic disorder that affects the entire pelvic diaphragm. POP may often involve multiple organs. Abdominal sacrocolpopexy is considered the gold standard to treat female anterior and apical prolapse.

Laparoscopic sacral colpopexy for pelvic organ prolapse recurrence after transvaginal mesh surgery.

Objective: Pelvic organ prolapse (POP) recurrence in transvaginal mesh surgery patients has become increasingly common, due to widespread mesh use before the FDA alert. The aim was to assess feasibility, effectiveness and safety of laparoscopic sacral colpopexy (LSCP) in recurrent POP after previous vaginal surgery with polypropylene mesh.

Study Design: Medical records of 20 patients with ≥ stage 2 POP recurrence, who underwent LSCP from January 2015 to July 2018, were retrospectively analyzed in a monocentric observational study.

The role of robotic aortic lymphadenectomy in gynecological cancer: surgical and oncological outcome in a single institution experience.

Background And Objective: This study aims to investigate the surgical outcomes observed in robotic transperitoneal aortic lymphadenectomy (AL) in gynecological cancer patients.

Methods: Retrospective data were collected and analyzed on 71 patients undergoing robotic surgical procedures for gynecological cancers, including transperitoneal AL, between December 2014 and February 2018 at the Catholic University of the Sacred Heart, Rome, Italy.

Results: Median age of the sample population was 50 years (range, 26-76 years).

Laparoscopic supracervical hysterectomy and sacral colpopexy for pelvic organ prolapse with percutaneous surgical system: Results from a pilot study.

Objective: The aim of the study was to report our preliminary experience of supracervical 2 hysterectomy followed by sacral colpopexy performed with the Percuvance ™ PSS in terms of feasibility, effectiveness and safety.

Study Design: Between Jan 2017 and Feb 2017 10 patients affected by POP were enrolled in the present study. All patients undergoing supracervical hysterectomy followed by sacral colpo-cervicopexy with the Percuvance ™ PSS.

Immediate definitive prosthetic reconstruction in patients with ptotic breasts.

Immediate reconstruction of medium/large ptotic breasts can be performed by using expanders, definitive implants, or autologous flaps. If a skin-sparing mastectomy is feasible, excellent results can be achieved by planning Wise pattern incisions, using definitive implants. The authors suggest the use of a dermal-adipose flap, harvested from the ptotic part of the breast, rotated laterally, and interposed between the serratus fascia and the pectoralis muscle to close the inferolateral part of the pocket.

Hydroacoustic estimation of fish biomass in the Gulf of Nicoya, Costa Rica.

A stratified sampling design was used for a hydroacoustic survey of the inner parts of the Gulf of Nicoya in 1987 and 1988. The bottom topography of the inner Gulf was modeled by introducing the concept of a topographical basin model, as the basis for the projection of the sample survey estimates to the entire inner gulf. The bottom depth contours and volumes for the basin model were constructed from nautical charts.

Effects of ischemia on sarcoplasmic reticulum and contractile myofilament activity in human myocardium.

The effects of global ischemia on the contractile system and on sarcoplasmic reticulum (SR) function were studied by measuring the isometric tension and the SR Ca2+ release activity of chemically skinned cardiac fiber preparations from seven patients undergoing open-heart surgery. Ten minutes of ischemia caused 1) a decrease in the myofilament sensitivity to Ca2+ (expected Ca2+ concentration giving half-maximal tension; from 0.69 +/- 0.

[Acute rejection: the diagnostic and therapeutic problems].

Acute allograft rejection is still a leading cause of both early and late mortality and morbidity after cardiac transplantation. Besides cell-mediated acute rejection, a "humoral" form exists which is more frequent in younger patients in the early postoperative period, and less likely to respond to the usual therapy. Cyclosporine therapy has deeply affected the clinical, laboratory and histological aspects of acute rejection.

[Controversies in the selection of donors in heart transplants].

The shortage of ideal donor hearts has led to an increasing number of would-be heart transplant recipients who die while on the waiting list: an extension of the classical donor criteria seems necessary to expand the donor pool. In this paper, the major controversies on donor selection are presented, along with the clinical results obtained in cardiac transplantation with donor grafts not complying with standard criteria. The extension of donor age over 35 years is supported by the decreased incidence of coronary artery disease (CAD) in the Western world.

A new, noninvasive method to monitor the aging of bioprosthetic valves in the mitral position.

Bioprosthetic valves undergo a tissue degeneration of unpredictable onset and amount. This process alters the structure and function of the valve and consequently shortens its lifespan. The echocardiographic technique usually used in the follow-up of these patients does not provide accurate information concerning the amount of prosthesis tissue degeneration.

Heart valve replacement with the Sorin tilting-disc prosthesis. A 10-year experience.

From 1978 to 1988, 697 patients with a mean age of 48 +/- 11 years (range 5 to 75 years) received a Sorin tilting-disc prosthesis; 358 had had aortic valve replacement, 247 mitral valve replacement, and 92 mitral and aortic valve replacement. Operative mortality rates were 7.8%, 11.

Contractile properties and Ca2+ release activity of the sarcoplasmic reticulum in dilated cardiomyopathy.

Background: We performed a comparative study on Ca2+ release activity of the sarcoplasmic reticulum and calcium sensitivity of contractile apparatus of chemically skinned myocardial fibers obtained from four nonfailing human hearts and 13 excised hearts from patients with idiopathic dilated cardiomyopathy.

Methods And Results: Ca2+ sensitivity of contractile apparatus was studied by following the isometric tension developed by chemically skinned myocardial fibers challenged with solutions of decreasing pCa. Ca2+ release from sarcoplasmic reticulum was monitored indirectly by measurement of the isometric tension developed by skinned fibers challenged with caffeine.

The risk of reoperation in patients with bioprosthetic valves.

The risk of operative mortality in patients undergoing a first reoperation for bioprosthetic failure was assessed in a series of patients reoperated upon during the last two decades (1970-1990). A total of 330 such patients underwent replacement of 351 bioprostheses: 88 had aortic; 221 mitral; and 21 mitral and aortic bioprosthetic replacement. Indication for reoperation was in most cases structural valve deterioration (87%), followed by periprosthetic leak (7%) and endocarditis (6%).

Extended follow-up of the standard Hancock porcine bioprosthesis.

We have reviewed 665 patients in whom the standard Hancock porcine bioprosthesis (HPB) was used for aortic (AVR = 173), mitral (MVR = 437), and mitral and aortic (MAVR = 55) valve replacement in the time interval from 1970 to 1983. After AVR, HPB-related deaths occurred in 24 patients (1.7% +/- 0.

Influence of type of prosthesis on late results after combined mitral-aortic valve replacement.

The influence of type of prosthesis on the late outcome of patients with combined mitral-aortic valve replacement was analyzed by comparing, at a 14-year follow-up, patients receiving two biological prostheses (group 1; n = 135), two mechanical prostheses (group 2; n = 221), or a mechanical prosthesis in the aortic position and a bioprosthesis in the mitral position (group 3; n = 97). No difference was found among the three groups in terms of actuarial survival and incidence of and freedom from valve-related deaths, thromboemboli, and hemorrhages. Patients with biological prostheses had a significantly greater incidence of structural valve deterioration, reoperations, and overall complications when compared with patients with only mechanical prostheses.

Failure of Hancock pericardial xenografts: is prophylactic bioprosthetic replacement justified?

The incidence of major valve-related complications was evaluated in a series of patients in whom the Hancock pericardial xenograft was used for aortic (AVR; n = 84), mitral (MVR; n = 17) and mitral-aortic (MAVR; n = 13) valve replacement. At 7 years actuarial survival is 66% +/- 8% after AVR, 64% +/- 13% after MVR, and 41% +/- 15% after MAVR, whereas actuarial freedom from valve-related death is 79% +/- 7% after AVR, 78% +/- 13% after MVR, and 81% +/- 12% after MAVR. Actuarial freedom from thromboemboli and anticoagulant-related hemorrhage at 7 years is 93% +/- 4% and 98% +/- 2% after AVR and 83% +/- 10% and 88% +/- 11% after MVR; no such complications occurred after MAVR.

Is lung biopsy useful for surgical decision making in congenital heart disease?

Sixty patients with congenital heart disease (CHD), age range 3 months-45 years (median 2 years), underwent lung biopsy to exclude pulmonary vascular disease (PVD): 25 had an atrioventricular (AV) septal defect, 14 a ventricular septal defect (VSD), 7 a complete transposition of the great arteries (TGA) + VSD, 3 an atrial septal defect, and 2 a patent ductus arteriosus; 9 had other malformations. Scoring of histological section (0-4) according to a modified Heath-Edwards classification disclosed that 30 patients had severe "irreversible" PVD (greater than or equal to grade 3) (11 AV septal defect, 8 VSD, 6 TGA + VSD and 5 others); 8 patients were younger than 1 year. Pulmonary vascular resistance (PVR) was calculated in 51 patients and exceeded 7 U/m2 in 1 of 2 patients with grade 0, in 9 of 18 with grade 1, in 1 of 4 with grade 2, in 11 of 18 with grade 3, and in 8 of 9 with grade 4.

The pathology of Hancock standard porcine valve prosthesis: a 20-year span of experience.

A spectrum of events leading to tissue failure is responsible for late dysfunction of Hancock porcine valve xenografts: (a) Primary failure: dystrophic calcification, thrombosis, fibrous tissue overgrowth, primary tears, cuspal hematomas, and stent postbending. (b) Secondary failure: endocarditis and paravalvular leak. Dystrophic calcification is the main factor influencing long-term durability and accounts in our experience for 88% of primary failure, through different clinical presentations; particularly, incompetence by cusp tearing and egg-shell fragmentation is by far the most frequent mode of failure.