检索结果-南通市图书馆

Aggressive behaviour of solid-pseudopapillary tumor of the pancreas in adults:A case report and review of the literature

在线全文

维普期刊数据库

学校读者我要写书评

暂无评论

World Journal of Gastroenterology 2008年第6期14卷 960-965页

作者： cosimo Sperti Mattia Berselli Claudio Pasquali Davide Pastorelli sergio Pedrazzoli Department of Medical and Surgical Sciences Clinica Chirurgica Ⅳ University of Padua Padua 35128 Italy Department of Oncology Istituto Oncologico Veneto Padua Italy

Solid-pseudopapillary tumor (SPT) is a rare neoplasm of the pancreas that usually occurs in young females. It is generally considered a low-grade malignant tumor that can remain asymptomatic for several years. The occurrence of infiltrating varieties of SPT is around 10%-15%. Between 1986 and 2006, 282 cystic tumors of the pancreas were observed. Among them a SPT was diagnosed in 8 patients (2.8%) with only one infiltrating variety. This was diagnosed in a 49-year-old female 13 years after the sonographic evidence of a small pancreatic cystic lesion interpreted as a pseudocyst. The tumor invaded a long segment of the portal- mesenteric vein confluence, and was removed with a total pancreatectomy, resection of the portal vein and reconstruction with the internal jugular vein. Histological examination confirmed the R-0 resection of the primary SPT, although a vascular invasion was demonstrated. The postoperative course was uneventful, but 32 mo after surgery the patient experienced diffuse liver metastases. Chemotherapy with different drugs was started. The patient is alive and symptom-free, with stable disease, 75 mo after surgery. Twenty-five patients with invasion of the portal vein and/or of mesenteric vessels were retrieved from the literature, 16 recent patients with tumor relapse after potentially curative resection were also retrieved. The best treatment remains a radical resection whenever possible, even in locally advanced or metastatic disease. The role of chemotherapy, and/or radiotherapy, is still to be defined.

关键词：胰腺切除术肝位移胰腺肿瘤病理机制

Thermal ablation in colorectal liver metastases: Lack of evidence or lack of capability to prove the evidence?

在线全文

维普期刊数据库

学校读者我要写书评

暂无评论

World Journal of Gastroenterology 2016年第13期22卷 3511-3515页

作者： sergio Sartori Paola Tombesi Francesca di Vece Section of Interventional Ultrasound St Anna Hospital

Many studies suggest that combined multimodality treatments including ablative therapies may achieve better outcomes than systemic chemotherapy alone in patients with colorectal liver metastases. Nevertheless,ablative therapies are not yet considered as effective options because their efficacy has never been proved by randomized controlled trials(RCT). However, there are in literature no trials that failed in demonstrating the effectiveness of ablative treatments: what are lacking, are the trials. All the attempts to organize phase Ⅲ studies on this topic failed as a result of non accrual. Just one prospective RCT comparing radiofrequency ablation combined with systemic chemotherapy vs chemotherapy alone has been published. It was designed as a phase Ⅲ study, but it was closed early because of slow accrual, and was downscaled to phase Ⅱ study, with the consequent limits in drawing definite conclusions on the benefit of combined treatment. However, the combination treatment met the primary end point of the study and obtained a significantly higher 3-year progression-free survival than systemic chemotherapy alone. It is very unlikely that ultimate efficacy of ablation treatments will ever be tested again, and the best available evidence points toward a benefit for the combination strategy using ablative treatments and chemotherapy.

关键词： Liver metastases Colorectal cancer Thermal ablation Radiofrequency ablation Microwave ablation Laser

Parenchyma-sparing pancreatectomies for benign or border-line tumors of the pancreas

在线全文

维普期刊数据库

学校读者我要写书评

暂无评论

World Journal of Gastrointestinal Oncology 2010年第6期2卷 272-281页

作者： cosimo Sperti Valentina Beltrame Anna Caterina Milanetto Margherita Moro sergio Pedrazzoli Department of Medical and Surgical Sciences IV Surgical Clinic University of Padua

Standard pancreatic resections, such as pancreaticoduodenectomy, distal pancreatectomy, or total pancreatectomy, result in an important loss of normal pancreatic parenchyma and may cause impairment of exocrine and endocrine function. Whilst these procedures are mandatory for malignant tumors, they seem to be too extensive for benign or border-line tumors, especially in patients with a long life expectancy. In recent years, there has been a growing interest in parenchyma-sparing pancreatic surgery with the aim of achieving better functional results without compromising oncological radicality in patients with benign, border-line or low-grade malignant tumors. Several limited resections have been introduced for isolated or multiple pancreatic lesions, depending on the location of the tumor: central pancreatectomy, duodenum-preserving pancreatic head resection with or without segmental duodenectomy, inferior head resection, dorsal pancreatectomy, excavation of the pancreatic head, middle-preserving pancreatectomy, and other multiple segmental resections. All these procedures are technically feasible in experienced hands,with very low mortality, although with high morbidity rate when compared to standard procedures. Pancreatic endocrine and exocrine function is better preserved with good quality of life in most of the patients, and tumor recurrence is uncommon. Careful patient selection and expertise in pancreatic surgery are crucial to achieve the best results.

关键词： Middle pancreatectomy Pancreatic head resection Pancreas Pancreatectomy Limited pancreatectomy

In vivo confocal microscopy: qualitative investigation of the conjunctival and corneal surface in open angle glaucomatous patients undergoing the XEN-Gel implant, trabeculectomy or medical therapy

在线全文

维普期刊数据库

学校读者我要写书评

暂无评论

Eye and Vision 2020年第1期7卷 136-149页

作者： Stefano Baiocchi cosimo Mazzotta Arianna Sgheri Alessandro di Maggio Simone Alex Bagaglia Matteo Posarelli Leonardo Ciompi Alessandro Meduri Gian Marco Tosi Department of Medicine Surgery and NeurosciencesOphthalmology UnitPoliclinico Santa Maria alle ScotteUniversity of SienaViale Bracci 8ZIP code 53100 SienaItaly Ophthalmology Unit Department of Biomedical SciencesUniversity of MessinaMessinaItaly

Purpose:Assessing the quality of the ocular surface by in vivo scanning laser confocal microscopy(IVCM)in primary open angle glaucoma(POAG)patients treated by Xen 45 Gel Stent,medical therapy and trabeculectomy.Methods:Retrospective,single-center,single-masked,comparative study including 60 eyes of 30 patients(mean age 61.16±10 years)affected by POAG.Eyes were divided into 3 groups:Group 1 eyes underwent the Xen 45 Gel Stent procedure,Group 2 eyes were under medical therapy,Group 3 eyes were surgically treated by trabeculectomy.All patients underwent HRT II IVCM analysis of cornea,limbus,conjunctiva,sub-tenionian space and sclera.Results:The Xen 45 Gel stent,if properly positioned in the sub-conjunctival space preserves goblet cells and limits ocular surface inflammation.Regular corneal epithelial cells with micro-cysts,and normo-reflective sub-epithelial nerve plexus are documented by IVCM.In sub Tenon’s implants an alternative lamellar intra-scleral filtration is detectable.Combined surgical procedures show a noticeable number of inflammatory cells with rare micro-cysts.Post-trabeculectomy inflammatory reaction is more evident than Xen 45 Gel Stent associated surgical procedures,but less than medical therapy where a conspicuous presence of Langerhans cells,peri-neural infiltrates,marked loss of goblet cells and fibrosis is visible.Conclusion:Ocular surface inflammation was more notable in topical therapy than after trabeculectomy,which itself causes more inflammation than XEN Gel stents.

关键词： Glaucoma Primary open angle glaucoma POAG MIGS Xen 45 gel stent Ocular surface Inflammation Confocal microscopy IVCM

维普期刊数据库

Practical Implementation and Operational Experience of Dynamic Mode Decomposition in Wide-area Monitoring Systems of Italian Power System

在线全文

学校读者我要写书评

暂无评论

Journal of Modern Power Systems and Clean Energy 2023年第3期11卷 793-802页

作者： Andrea Vicario Alberto Berizzi Giorgio Maria Giannuzzi cosimo Pisani Department of Energy at Politecnico di Milano MilanItaly Terna S.p.A. RomeItaly

This study presents the assumptions and strategies for the practical implementation of the dynamic mode decomposition approach in the wide-area monitoring system of the Italian transmission system operator,Terna.The procedure setup aims to detect poorly damped interarea oscillations of power systems.Dynamic mode decomposition is a data-driven technique that has gained increasing attention in different fields;the proposed implementation can both characterize the oscillatory modes and identify the most influenced areas.This study presents the results of its practical implementation and operational experience in power system monitoring.It focuses on the main characteristics and solutions identified to reliably monitor the interarea electromechanical modes of the interconnected European power system.Moreover,conditions to issue an appropriate alarm in case of critical operating conditions are described.The effectiveness of the proposed approach is validated by its application in three case studies:a critical oscillatory event and a short-circuit event that occurred in the Italian power system in the previous years,and a 15-min time interval of normal grid operation recorded in March 2021.

关键词： Power system control power system dynamics wide-area monitoring system(WAMS) dynamic mode decomposition

Laser ablation of liver tumors:An ancillary technique,or an alternative to radiofrequency and microwave?

维普期刊数据库

同方期刊数据库评论

在线全文

学校读者我要写书评

暂无评论

World Journal of Radiology 2017年第3期9卷 91-96页

作者： sergio Sartori Francesca di Vece Francesca Ermili Paola Tombesi Section of Interventional Ultrasound St Anna Hospital44100 FerraraItaly

Radiofrequency ablation(RFA) is currently the most popular and used ablation modality for the treatment ofnon surgical patients with primary and secondary liver tumors, but in the last years microwave ablation(MWA) is being technically improved and widely rediscovered for clinical use. Laser thermal ablation(LTA) is by far less investigated and used than RFA and MWA, but the available data on its effectiveness and safety are quite good and comparable to those of RFA and MWA. All the three hyperthermia-based ablative techniques, when performed by skilled operators, can successfully treat all liver tumors eligible for thermal ablation, and to date in most centers of interventional oncology or interventional radiology the choice of the technique usually depends on the physician's preference and experience, or technical availability. However, RFA, MWA, and LTA have peculiar advantages and limitations that can make each of them more suitable than the other ones to treat patients and tumors with different characteristics. When all the three thermal ablation techniques are available, the choice among RFA, MWA, and LTA should be guided by their advantages and disadvantages, number, size, and location of the liver nodules, and cost-saving considerations, in order to give patients the best treatment option.

关键词： Radiofrequency 脱离肝瘤激光脱离微波脱离 Hepatocellular 癌肝转移

Liver-directed therapies for liver metastases from neuroendocrine neoplasms:Can laser ablation play any role?

在线全文

维普期刊数据库

学校读者我要写书评

暂无评论

World Journal of Gastroenterology 2020年第23期26卷 3118-3125页

作者： sergio Sartori Lara Bianchi Francesca di Vece Paola Tombesi Department of Internal Medicine Section of Interventional UltrasoundSt.Anna HospitalFerrara 44100Italy

Aggressive cytoreduction can prolong survival in patients with unresectable liver metastases(LM)from neuroendocrine neoplasms(NEN),and minimally invasive,liver-directed therapies are gaining increasing interest.Catheter-based treatments are used in disseminated disease,whereas ablation techniques are usually indicated when the number of LM is limited.Although radiofrequency ablation(RFA)is by far the most used ablative technique,the goal of this opinion review is to explore the potential role of laser ablation(LA)in the treatment of LM from NEN.LA uses thinner needles than RFA,and this is an advantage when the tumors are in at-risk locations.Moreover,the multi-fiber technique enables the use of one to four laser fibers at once,and each fiber provides an almost spherical thermal lesion of 12-15 mm in diameter.Such a characteristic enables to tailor the size of each thermal lesion to the size of each tumor,sparing the liver parenchyma more than any other liver-directed therapy,and allowing for repeated treatments with low risk of liver failure.A recent retrospective study reporting the largest series of LM treated with LA documents both safety and effectiveness of LA,that can play a useful role in the multimodality approach to LM from NEN.

关键词： Neuroendocrine neoplasms Liver metastases Liver-directed therapies Ablation techniques Laser ablation Radiofrequency ablation

Protective benefit of minimally invasive liver surgery for hepatocellular carcinoma prior to transplant

在线全文

维普期刊数据库

学校读者我要写书评

暂无评论

Hepatoma Research 2022年第1期8卷 179-187页

作者： Simone Khouzam Duilio Pagano Marco Barbara Vito di Marco Giada Pietrosi Marco Maringhini Marco Canzonieri sergio Calamia Salvatore Gruttadauria Sidney Kimmel Medical College Thomas Jefferson UniversityPhiladelphiaPA 19107USA Department for the Treatment and Study of Abdominal diseases and Abdominal Transplantation IRCCS-ISMETT(Istituto di Ricovero e Cura a Carattere Scientifico-Istituto Mediterraneo per I Trapianti e Terapie ad Alta Specializzazione)UPMC(University of Pittsburgh Medical Center)via E.Tricomi 5Palermo 90127Italy Sezione di Gastroenterologia e Epatologia Dipartimento Biomedico di Medicina Interna e SpecialisticaUniversity of PalermoPalermo 90128Italy Medicina Interna Universitàdi Palermo/ISMETTVia del Vespro 129Palermo 90127Italy Department of Surgery and Medical and Surgical Specialties University of CataniaCatania 95124Italy

Aim:The purpose of this study is to assess the benefit of laparoscopic liver resection(LLR)for hepatocellular carcinoma(HCC)given recurrence and future need for liver transplantation(LT).Methods:Data on liver resections were gathered from the Istituto di Ricovero e Cura a Carattere Scientifico-Istituto Mediterraneo per i Trapianti e Terapie ad alta specializzazione(IRCCS-ISMETT)from 2003-2021.A retrospective analysis of 1408 consecutive adult patients who had a liver resection was performed with categorization based on the underlying disease process.A sub-analysis studied the 291 patients who had an LLR with an intention to transplant approach after LLR.Results:From 2012 to 2020,ISMETT’s mean annual LLR rate was 45%.Data suggests that a laparoscopic approach to iterative surgical treatment for HCC has demonstrated protective benefits.Compared to open surgery or LT,LLR is protective against the risk of de-listing,post-transplant patient death,tumor recurrence,adhesions,and bleeding in a cirrhotic patient.Kaplan Meier’s analysis showed no difference between post-LT survival curves for those with prior open abdominal surgery or LLR(P=0.658).Conclusion:Laparoscopic surgery has important protective advantages over laparotomy surgery for the surgical treatment of HCC,particularly since treatment is not always curative.LLR can be considered a bridge therapy for transplantation,ensuring less crowding of waiting lists,a desirable condition in areas of donor storage.

关键词： Laparoscopic liver resection hepatocellular carcinoma minimally invasive liver surgery

Resection vs thermal ablation of small hepatocellular carcinoma:What's the first choice?

在线全文

维普期刊数据库

学校读者我要写书评

暂无评论

World Journal of Radiology 2013年第1期5卷 1-4页

作者： Paola Tombesi Francesca di Vece sergio Sartori Section of Interventional Ultrasound Department of MedicineSt Anna HospitalI-44100 FerraraItaly

Nowadays,hepatocellular carcinoma(HCC) is frequently diagnosed at an early stage,opening good perspectives to radical treatment by means of liver transplantation,surgical resection,or percutaneous ablation.Liver transplantation is considered the best option,but the lack of liver donors represents a major limitation.Therefore,surgical resection,offering a 5-year-survival rate of over 50%,is considered the first-choice treatment for patients with early stage HCC,whereas percutaneous ablation is usually reserved to patients who are not candidate to surgery.However,in the recent years some trials showed that percutaneous radiofrequency ablation(RFA) can be as effective as surgical resection in terms of overall survival and recurrencefree survival rates in patients with small HCC,and a retrospective comparative study reported 1-,3-,and 5-year overall survival rates and recurrence-free survival rates significantly better in patients with central HCC measuring 2 cm or smaller treated with RFA than in those treated with surgical resection.RFA is less expensive,less invasive,with lower complication rate and shorter hospital stay than surgical resection,and on the basis of the results of these studies it should be considered the first option in the treatment of very early HCC.However,RFA is size-dependent,so at present the need to achieve an adequate safety margin around the tumor limits to about 2 cm the diameter of the nodules that can be ablated with long-term outcomes comparable to or better than surgical resection.The main goal of the next technical developments of the thermal ablation systems should be the achievement of larger ablation areas with a single needle insertion.In this regard,the recent improvements in microwave energy delivery systems seem to open interesting perspectives to percutaneous microwave ablation,which could become the ablation technique of choice in the next future.

关键词： Hepatocellular carcinoma Thermal ablation Radiofrequency thermal ablation Microwave thermal ablation Treatment