Marco Rovati - Academia.edu (original) (raw)
Papers by Marco Rovati
Annali italiani di chirurgia
The authors, in the period from Jan. 1980 to Dec. 1990, observed 67 patients with tumor located i... more The authors, in the period from Jan. 1980 to Dec. 1990, observed 67 patients with tumor located in the head of pancreas and 27 patient with periampullary tumors. These included 18 tumors originated from the ampulla of Vater and 9 from distal common bile duct. Operability rate ranged from 62.6% pancreatic carcinoma to 94.4% tumors of ampulla, according to the tumor location. Resectability rate ranged from 9.5% for pancreatic adenocarcinoma for 94.1% to ampullary tumors. Considering 23 resections, 18 were pancreatoduodenectomies and 5 local excisions for tumor of ampulla. Mortality was 7.7% after non resectional treatment and two patients (8.7%) died in the immediate postoperative period after radical resection. Multivariate analysis on all patients operated (n. 65) revealed that 5 years survival rate was significantly related to intent of operation (palliative = 0 - curative = 8.6%), histologic type, and site. In fact no patient with pancreatic adenocarcinoma achieved a 5 years survival rate. Two patients with adenocarcinoma of ampulla survived 5 years. Cancer of the head of pancreas is quite malignant because, owing to pancreas position, an early diagnosis is very hard. Most times resective surgical treatment is impossible because of the cancer diffusion.
Giornale italiano di oncologia
Giornale italiano di oncologia
Il Giornale di chirurgia
The authors report their experience in the diagnosis and treatment of primary torsion of the omen... more The authors report their experience in the diagnosis and treatment of primary torsion of the omentum. They emphasize the clinical findings of the cases observed for a better understanding of this uncommon abdominal pathology.
Giornale italiano di oncologia
Giornale italiano di oncologia
Hepato-gastroenterology
Primary mesenteric fibromatosis is a rare, histologically benign, pathology which is characterize... more Primary mesenteric fibromatosis is a rare, histologically benign, pathology which is characterized by fibrous proliferation in the mesentery and made more serious by biological malignancy as it has a high inclination towards involving the visceral abdominal structures in its growth. While the cases reported in the literature describe the attempts to cure and reduce the tumor growth, this report describes the clinical, ultrasonographic and tomographic features during the natural growth rate of a case of inoperable primary mesenteric fibromatosis during a 20 month follow-up.
BMC Cancer
Carcinosarcoma of the colon is a rare histopathological entity with uncertain histogenesis, that ... more Carcinosarcoma of the colon is a rare histopathological entity with uncertain histogenesis, that shows both epithelial and mesenchymal malignant differentiation. Carcinosarcoma rarely affects the gastrointestinal tract and only few cases are reported in the colon. Herein we describe a carcinosarcoma of the ascending colon, with morphological, ultrastructural and molecular analysis. An 81-year-old man was hospitalised for asthenia, weight loss and iron-deficiency anaemia. The patient underwent colonoscopy and adenocarcinoma was diagnosed by endoscopic biopsy. A right hemicolectomy was performed and, during surgical operation, liver metastases were detected. Histological examination of the surgical specimen revealed areas of both carcinomatous and sarcomatous differentiation, completely separated by fibrous septae. The sarcomatous component exhibited areas of smooth muscle and osteoblastic differentiation, with focal osteoid material deposition. Molecular analysis conducted separately...
Transplantation proceedings, 1990
Minerva chirurgica, 1997
HPLC determination of bilirubin conjugates in bile demonstrated a subgroup of patients with chole... more HPLC determination of bilirubin conjugates in bile demonstrated a subgroup of patients with cholesterol gallstones who have more monoconjugated than diconjugated bilirubin in their gallbladder bile. None of the patients had abnormal liver function tests nor hemolysis. It was shown that this is not due to differences in liver secretion of the conjugates. In these patients, the more insoluble monoconjugated bilirubin might have provided the nucleus for the subsequent crystallization of cholesterol leading to the formation of cholesterol gallstones.
Il Giornale di chirurgia, 1988
Giornale italiano di oncologia
International journal of tissue reactions, 1989
Defibrotide, a polydeoxyribonucleotide obtained from mammalian lungs, has been demonstrated to ex... more Defibrotide, a polydeoxyribonucleotide obtained from mammalian lungs, has been demonstrated to exert profibrinolytic and antithrombotic activity through stimulation of vascular prostacyclin (PGI2) production. We studied the effect of defibrotide administration in protecting liver and heart from ischaemic and postischaemic reperfusion damage. Defibrotide was administered as an i.v. bolus (30 mg/kg) at the beginning of liver ischaemia and at the same dose continuously during 60 min of postischaemic reperfusion. ATP levels were significantly improved in livers of defibrotide-treated rats as compared to those obtained in livers of rats treated with vehicle of the drug. Intrahepatic cytoplasmic and mitochondrial NAD+/NADH ratios were higher in defibrotide-treated than in vehicle-treated animals. The hearts, isolated from rats according to the transplantation procedure, were subjected to different times of warm + cold ischaemia. During ischaemia, the hearts were perfused continuously with...
Background: Carcinosarcoma of the colon is a rare histopathological entity with uncertain histoge... more Background: Carcinosarcoma of the colon is a rare histopathological entity with uncertain histogenesis, that shows both epithelial and mesenchymal malignant differentiation. Carcinosarcoma rarely affects the gastrointestinal tract and only few cases are reported in the colon. Herein we describe a carcinosarcoma of the ascending colon, with morphological, ultrastructural and molecular analysis.
Research in Immunology, 1989
We studied the levels of nucleotides in peripheral blood and in spleen lymphocytes obtained from ... more We studied the levels of nucleotides in peripheral blood and in spleen lymphocytes obtained from allografted rats. Four types of allografts were performed by using ACI rats (RT1a) as donors and Lewis rats (RT1l) as recipients: heart, pancreas, kidney and liver. Ungrafted Lewis rats were used as controls. Rejection time without immunosuppression occurred at 6.7 +/- 0.25 days from transplant in heart-allografted, at 7.3 +/- 0.25 days in pancreas-grafted, at 6.8 +/- 0.24 days in kidney-grafted, and at 20 +/- 3 days in liver-grafted rats. Biochemical assays on lymphocytes were performed on the 7th day after operation by measuring the intracellular content of APT, ADP, AMP, cAMP, NAD+ and NADH. Our results showed that the prolonged survival of allografts in liver-grafted rats correlated with the higher content of cAMP in their lymphocytes than in those of controls. In addition, ATP and ADP levels in lymphocytes from heart-and pancreas-allografted rats were significantly lower than those of lymphocytes from liver-allografted rats.
Annali italiani di chirurgia
In spite of the decreasing incidence of gastric carcinoma, as it is reported in recent reports fr... more In spite of the decreasing incidence of gastric carcinoma, as it is reported in recent reports from the U.S.A., total gastrectomy and its surgical indications results and complications, focus the interest of surgeons. We analize 61 cases of total gastrectomy for carcinoma, treated in the years 1982-1992. Perioperative mortality and long term survival appear highly satisfactory, mainly if one considers that the site and extension of the neoplasms treated would have severely impaired the possibilities of cure or long term survival with surgery of lesser momentum. We believe that nowaday indications for total gastrectomy can be widened in the hope of improving results of gastric cancer surgery with no or little additional risk.
Hepato-gastroenterology
Carcinoma of the head of the pancreas is reported with increasing incidence. The classical Whippl... more Carcinoma of the head of the pancreas is reported with increasing incidence. The classical Whipple procedure, modified by Traverso and Longmire, is a major surgical undertaking and there is question on its indication in the case of lesions which, although technically resectable, are not susceptible to cure. We review 67 cases of carcinoma of the head of the pancreas comparing the results of radical vs. palliative surgery. The results were then compared with 27 additional cases of periampullary carcinomas. Long term survival was obviously higher after resection, due to the more advanced tumor stage in the palliation group. However, perioperative mortality, supposedly high in extensive resective surgery, was 8.7% (vs 11.9% in the palliation group). At present, extensive resective surgery carries unacceptable incidence of perioperative mortality. Therefore we suggest that indication for resection should be widened, as it may offer better chances of cure in resectable periampullary carc...
Surgical laparoscopy & endoscopy, 1997
Up to now it has been unclear whether laparoscopic surgery has fewer immunosuppressive effects th... more Up to now it has been unclear whether laparoscopic surgery has fewer immunosuppressive effects than traditional laparotomic procedures. In a series of 38 patients affected by symptomatic gallstone disease and operated on either by laparoscopy (group 1) or by traditional open surgery (group 2), we determined the postoperative changes in lymphocyte subpopulations up to postoperative day (POD) 30. We collected 15 ml of venous blood from all patients in both groups on the day before surgery and on POD 1, 7, 15, and 30. A control group (group 3) comprised 56 healthy volunteers; the control group was used only to ensure that baseline values were totally comparable with a normal population; only one blood sample was obtained from the subjects in group 3. Patients undergoing open cholecystectomy had a significant decrease in total lymphocyte count on POD 1. Basal levels of lymphocyte subpopulations did not differ significantly in the study and control groups. No differences were found in th...
Hepato-gastroenterology
Surgical treatment of primary liver tumors has undergone significant changes in recent years beca... more Surgical treatment of primary liver tumors has undergone significant changes in recent years because of improved surgical and anesthesiological techniques and better pre- and post-operative care. We review our personal series from 1987-1995. Of 31 cases of hepatocellular carcinoma (HCC) observed in the years 1987-1995, 23 underwent curative resective surgery for a total of 24 liver resections: 6 hepatectomies; 10 segmentectomies; 4 atypical subsegmentectomies; 2 extended resections, with excision of neoplastic thrombi within the portal vein; 1 orthotopic liver transplantation in another institution, and 1 limited segmental resection for tumor recurrence. In 7 recent cases, pre-operative transcatheter arterial chemoembolization (TAE) was used. The mean survival of the 13 patients that are known to be deceased is 27 months (range: 7-114 months). Perioperative mortality was nil. Actuarial 5-year survival rate is 27%. Pre-operative TAE was used in 7 patients: 4 out of 7 lesions were sig...
Annali italiani di chirurgia
The authors, in the period from Jan. 1980 to Dec. 1990, observed 67 patients with tumor located i... more The authors, in the period from Jan. 1980 to Dec. 1990, observed 67 patients with tumor located in the head of pancreas and 27 patient with periampullary tumors. These included 18 tumors originated from the ampulla of Vater and 9 from distal common bile duct. Operability rate ranged from 62.6% pancreatic carcinoma to 94.4% tumors of ampulla, according to the tumor location. Resectability rate ranged from 9.5% for pancreatic adenocarcinoma for 94.1% to ampullary tumors. Considering 23 resections, 18 were pancreatoduodenectomies and 5 local excisions for tumor of ampulla. Mortality was 7.7% after non resectional treatment and two patients (8.7%) died in the immediate postoperative period after radical resection. Multivariate analysis on all patients operated (n. 65) revealed that 5 years survival rate was significantly related to intent of operation (palliative = 0 - curative = 8.6%), histologic type, and site. In fact no patient with pancreatic adenocarcinoma achieved a 5 years survival rate. Two patients with adenocarcinoma of ampulla survived 5 years. Cancer of the head of pancreas is quite malignant because, owing to pancreas position, an early diagnosis is very hard. Most times resective surgical treatment is impossible because of the cancer diffusion.
Giornale italiano di oncologia
Giornale italiano di oncologia
Il Giornale di chirurgia
The authors report their experience in the diagnosis and treatment of primary torsion of the omen... more The authors report their experience in the diagnosis and treatment of primary torsion of the omentum. They emphasize the clinical findings of the cases observed for a better understanding of this uncommon abdominal pathology.
Giornale italiano di oncologia
Giornale italiano di oncologia
Hepato-gastroenterology
Primary mesenteric fibromatosis is a rare, histologically benign, pathology which is characterize... more Primary mesenteric fibromatosis is a rare, histologically benign, pathology which is characterized by fibrous proliferation in the mesentery and made more serious by biological malignancy as it has a high inclination towards involving the visceral abdominal structures in its growth. While the cases reported in the literature describe the attempts to cure and reduce the tumor growth, this report describes the clinical, ultrasonographic and tomographic features during the natural growth rate of a case of inoperable primary mesenteric fibromatosis during a 20 month follow-up.
BMC Cancer
Carcinosarcoma of the colon is a rare histopathological entity with uncertain histogenesis, that ... more Carcinosarcoma of the colon is a rare histopathological entity with uncertain histogenesis, that shows both epithelial and mesenchymal malignant differentiation. Carcinosarcoma rarely affects the gastrointestinal tract and only few cases are reported in the colon. Herein we describe a carcinosarcoma of the ascending colon, with morphological, ultrastructural and molecular analysis. An 81-year-old man was hospitalised for asthenia, weight loss and iron-deficiency anaemia. The patient underwent colonoscopy and adenocarcinoma was diagnosed by endoscopic biopsy. A right hemicolectomy was performed and, during surgical operation, liver metastases were detected. Histological examination of the surgical specimen revealed areas of both carcinomatous and sarcomatous differentiation, completely separated by fibrous septae. The sarcomatous component exhibited areas of smooth muscle and osteoblastic differentiation, with focal osteoid material deposition. Molecular analysis conducted separately...
Transplantation proceedings, 1990
Minerva chirurgica, 1997
HPLC determination of bilirubin conjugates in bile demonstrated a subgroup of patients with chole... more HPLC determination of bilirubin conjugates in bile demonstrated a subgroup of patients with cholesterol gallstones who have more monoconjugated than diconjugated bilirubin in their gallbladder bile. None of the patients had abnormal liver function tests nor hemolysis. It was shown that this is not due to differences in liver secretion of the conjugates. In these patients, the more insoluble monoconjugated bilirubin might have provided the nucleus for the subsequent crystallization of cholesterol leading to the formation of cholesterol gallstones.
Il Giornale di chirurgia, 1988
Giornale italiano di oncologia
International journal of tissue reactions, 1989
Defibrotide, a polydeoxyribonucleotide obtained from mammalian lungs, has been demonstrated to ex... more Defibrotide, a polydeoxyribonucleotide obtained from mammalian lungs, has been demonstrated to exert profibrinolytic and antithrombotic activity through stimulation of vascular prostacyclin (PGI2) production. We studied the effect of defibrotide administration in protecting liver and heart from ischaemic and postischaemic reperfusion damage. Defibrotide was administered as an i.v. bolus (30 mg/kg) at the beginning of liver ischaemia and at the same dose continuously during 60 min of postischaemic reperfusion. ATP levels were significantly improved in livers of defibrotide-treated rats as compared to those obtained in livers of rats treated with vehicle of the drug. Intrahepatic cytoplasmic and mitochondrial NAD+/NADH ratios were higher in defibrotide-treated than in vehicle-treated animals. The hearts, isolated from rats according to the transplantation procedure, were subjected to different times of warm + cold ischaemia. During ischaemia, the hearts were perfused continuously with...
Background: Carcinosarcoma of the colon is a rare histopathological entity with uncertain histoge... more Background: Carcinosarcoma of the colon is a rare histopathological entity with uncertain histogenesis, that shows both epithelial and mesenchymal malignant differentiation. Carcinosarcoma rarely affects the gastrointestinal tract and only few cases are reported in the colon. Herein we describe a carcinosarcoma of the ascending colon, with morphological, ultrastructural and molecular analysis.
Research in Immunology, 1989
We studied the levels of nucleotides in peripheral blood and in spleen lymphocytes obtained from ... more We studied the levels of nucleotides in peripheral blood and in spleen lymphocytes obtained from allografted rats. Four types of allografts were performed by using ACI rats (RT1a) as donors and Lewis rats (RT1l) as recipients: heart, pancreas, kidney and liver. Ungrafted Lewis rats were used as controls. Rejection time without immunosuppression occurred at 6.7 +/- 0.25 days from transplant in heart-allografted, at 7.3 +/- 0.25 days in pancreas-grafted, at 6.8 +/- 0.24 days in kidney-grafted, and at 20 +/- 3 days in liver-grafted rats. Biochemical assays on lymphocytes were performed on the 7th day after operation by measuring the intracellular content of APT, ADP, AMP, cAMP, NAD+ and NADH. Our results showed that the prolonged survival of allografts in liver-grafted rats correlated with the higher content of cAMP in their lymphocytes than in those of controls. In addition, ATP and ADP levels in lymphocytes from heart-and pancreas-allografted rats were significantly lower than those of lymphocytes from liver-allografted rats.
Annali italiani di chirurgia
In spite of the decreasing incidence of gastric carcinoma, as it is reported in recent reports fr... more In spite of the decreasing incidence of gastric carcinoma, as it is reported in recent reports from the U.S.A., total gastrectomy and its surgical indications results and complications, focus the interest of surgeons. We analize 61 cases of total gastrectomy for carcinoma, treated in the years 1982-1992. Perioperative mortality and long term survival appear highly satisfactory, mainly if one considers that the site and extension of the neoplasms treated would have severely impaired the possibilities of cure or long term survival with surgery of lesser momentum. We believe that nowaday indications for total gastrectomy can be widened in the hope of improving results of gastric cancer surgery with no or little additional risk.
Hepato-gastroenterology
Carcinoma of the head of the pancreas is reported with increasing incidence. The classical Whippl... more Carcinoma of the head of the pancreas is reported with increasing incidence. The classical Whipple procedure, modified by Traverso and Longmire, is a major surgical undertaking and there is question on its indication in the case of lesions which, although technically resectable, are not susceptible to cure. We review 67 cases of carcinoma of the head of the pancreas comparing the results of radical vs. palliative surgery. The results were then compared with 27 additional cases of periampullary carcinomas. Long term survival was obviously higher after resection, due to the more advanced tumor stage in the palliation group. However, perioperative mortality, supposedly high in extensive resective surgery, was 8.7% (vs 11.9% in the palliation group). At present, extensive resective surgery carries unacceptable incidence of perioperative mortality. Therefore we suggest that indication for resection should be widened, as it may offer better chances of cure in resectable periampullary carc...
Surgical laparoscopy & endoscopy, 1997
Up to now it has been unclear whether laparoscopic surgery has fewer immunosuppressive effects th... more Up to now it has been unclear whether laparoscopic surgery has fewer immunosuppressive effects than traditional laparotomic procedures. In a series of 38 patients affected by symptomatic gallstone disease and operated on either by laparoscopy (group 1) or by traditional open surgery (group 2), we determined the postoperative changes in lymphocyte subpopulations up to postoperative day (POD) 30. We collected 15 ml of venous blood from all patients in both groups on the day before surgery and on POD 1, 7, 15, and 30. A control group (group 3) comprised 56 healthy volunteers; the control group was used only to ensure that baseline values were totally comparable with a normal population; only one blood sample was obtained from the subjects in group 3. Patients undergoing open cholecystectomy had a significant decrease in total lymphocyte count on POD 1. Basal levels of lymphocyte subpopulations did not differ significantly in the study and control groups. No differences were found in th...
Hepato-gastroenterology
Surgical treatment of primary liver tumors has undergone significant changes in recent years beca... more Surgical treatment of primary liver tumors has undergone significant changes in recent years because of improved surgical and anesthesiological techniques and better pre- and post-operative care. We review our personal series from 1987-1995. Of 31 cases of hepatocellular carcinoma (HCC) observed in the years 1987-1995, 23 underwent curative resective surgery for a total of 24 liver resections: 6 hepatectomies; 10 segmentectomies; 4 atypical subsegmentectomies; 2 extended resections, with excision of neoplastic thrombi within the portal vein; 1 orthotopic liver transplantation in another institution, and 1 limited segmental resection for tumor recurrence. In 7 recent cases, pre-operative transcatheter arterial chemoembolization (TAE) was used. The mean survival of the 13 patients that are known to be deceased is 27 months (range: 7-114 months). Perioperative mortality was nil. Actuarial 5-year survival rate is 27%. Pre-operative TAE was used in 7 patients: 4 out of 7 lesions were sig...