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Your search keyword '"Gremmo, F."' showing total 40 results
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40 results on '"Gremmo, F."'

3. GASTRECTOMIA SUBTOTALE FULL-ROBOTIC

Author

Morelli, Luca, Pisano, Roberta, Guadagni, Simone, Palmeri, Matteo, Baglioni, M, D'Isidoro, Cristiano, Caprili, G, Gremmo, F, Marciano, E, DI CANDIO, Giulio, and Mosca, Franco

Published
2014

15. Pancreatic metastases from renal carcinoma

Author

Croce, C., Del Chiaro, M., Dinelli, E., Gremmo, F., Signori, S., FABIO VISTOLI, Sgambelluri, A. F., Mosca, I., Balzano, E., Funel, N., DANIELA CAMPANI, UGO BOGGI, and Mosca, F.

Published
2005

25. PANCREAS PROCUREMENT FROM MARGINAL DONORS

Author

UGO BOGGI, FABIO VISTOLI, Del Chiaro, M., Vanadia Bartolo, T., Marciano, E., Moretto, C., Gremmo, F., Pietrabissa, A., FRANCO FILIPPONI, and Mosca, F.

40. Arterial devices for regional hepatic chemotherapy: transaxillary versus laparotomic access

Author

L Aldrighetti, R. Caterini, E. Angeli, Marcella Arru, Monica Ronzoni, G. Ferla, F. Gremmo, Arru, M, Aldrighetti, L, Gremmo, F, Ronzoni, M, Angeli, E, Caterini, R, and Ferla, G

Subjects
medicine.medical_specialty, Percutaneous, Surgical stress, business.industry, medicine.medical_treatment, 030232 urology & nephrology, 030204 cardiovascular system & hematology, medicine.disease, Thrombosis, Colorectal surgery, Surgery, 03 medical and health sciences, Catheter, 0302 clinical medicine, Nephrology, Laparotomy, Anesthesia, Concomitant, medicine, Embolization, business
Abstract

Introduction Intra-Arterial Hepatic Chemotherapy (IAHC) based on floxuridine (FUdR) infusion is an effective treatment for hepatic metastases from colorectal cancer. A percutaneously implanted intra-arterial device may overcome the surgical stress of the laparotomic placement allowing an increase in the number of patients treated by IAHC. The aim of the present study is the comparative analysis of surgical and percutaneous transaxillary approaches to implant the catheter into the hepatic artery (HA) for IAHC. Materials and Methods Between September 1993 and February 1999, 56 patients received an implantable infusion system [SynchroMed® (Medtronic, USA) or Port-a-cath® (Deltec, USA) connected to an external infusion pump (CADD®, Deltec, USA)] for IAHC. Twenty-eight patients (LPT group) underwent laparotomy to implant the catheter into the HA, the other 28 patients (PCT group) received a percutaneous catheter into the HA through a transaxillary percutaneous access. Indications for the laparotomic placement were: 1) synchronous metastases not suitable [technically unresectable or large (>40% of liver parenchyma) or multiple (> 3) metastases] for hepatic resection during colorectal surgery; 2) metachronous metastases treated by radical hepatic resection and subsequent adjuvant IAHC. Indications for percutaneous placement were: 1) metachronous metastases not suitable [see above] for hepatic resection; 2) metachronous metastases suitable for hepatic resection after neoadjuvant IAHC for tumor downstaging. All patients received IAHC based on continuous infusion of FUdR (dose escalation 0.15–0.30 mg/kg/day for 14 days every 28 days) plus dexamethasone 28 mg. For the purpose of the study, the LPT group and the PCT group were comparatively analyzed in terms of age, gender, primary diagnosis, vascular anatomy of HA, ligation/embolization of aberrant HA, previous intestinal or hepatic surgery, contextual systemic chemotherapy, concomitant diseases. Safety and efficacy of surgical and percutaneous transaxillary approaches were then comparatively analyzed in terms of number of IAHC cycles administered, device-related complications causing temporary or definitive suppression of IAHC, biological costs of the procedures (procedure-related complications, postoperative pain and hospitalization). LPT cases without concomitant surgical procedure other than catheter placement (Cath-LPT group - 10 cases) were also compared with the PCT group for the same end points of the study. Results LPT group and PCT group were comparable (p=n.s.) when evaluated for all the above listed variables. As for the end points of the study, mean postoperative hospitalization was 8.2±2.2 days in the LPT group and 1.8±0.7 days in the PCT group (pConclusions Surgically implanted indwelling catheters for IAHC present lower incidence of device-related complications than percutaneous transaxillary implanted catheters. In spite of its irreversibility and significant biological costs, surgical implant is still advised when laparotomy has to be performed for other contextual procedures, such as colorectal or hepatic resection, while percutaneous transaxillary catheter placement is indicated for palliative or neoadjuvant IAHC.

Published
2007

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