San Salvatore Regional Hospital

Italy

San Salvatore Regional Hospital

Italy
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Zoccali C.,Italian National Cancer Institute | Covello R.,Italian National Cancer Institute | Di Francesco A.,San Salvatore Regional Hospital | Zoccali G.,Italian National Cancer Institute
European Journal of Surgical Oncology | Year: 2013

Background: Wide surgery is the main factor influencing survival in muscular skeletal tumor. Sometimes the margin can be very thin and the contamination risk can be very high because of manipulation of the mass. Materials and methods: A patch of cyanoacrylate and a silastic mesh are applied on tumor surface. In order to demonstrate the tumor sealing an histologic exam was performed. Discussion: The application of protective patch can decrease the risk of accidental tumor rupture and neoplastic cells spreading. © 2012 Elsevier Ltd. All rights reserved.


Zoccali C.,Italian National Cancer Institute | Zoccali C.,University of L'Aquila | Marolda G.,Italian National Cancer Institute | Di Francesco A.,San Salvatore Regional Hospital | And 3 more authors.
Revue de Chirurgie Orthopedique et Traumatologique | Year: 2013

Peripheral chondrosarcoma is a rare tumor particularly insidious when arising from the pelvis, becoming symptomatic later in time when surgery may be too difficult and dangerous due to this complex area. In the present case the tumor arose from an exostosis located on the medial surface of the left iliac wing. Its diameter was 25. cm. ×. 20. cm. ×. 15. cm, adhering to the last three vertebrae, involving the left iliac vein and artery, displacing the left ureter. In a similar case, a hindquarter amputation is indicated but, if the patient refuses, a resection remains possible. In this paper, we describe a multistage technique consisting of an extra-anatomic vascular bypass, a lumbar stabilization, a neurovascular bundles anterior isolation and a postero-lateral resection of this mass. After a five-year follow-up, the patient is alive and able to stand and walk with support, after undergoing twice lung metastasis removal. © 2013 Elsevier Masson SAS.


Zoccali C.,Italian National Cancer Institute | Zoccali C.,University of L'Aquila | Marolda G.,San Salvatore Regional Hospital | Di Francesco A.,San Salvatore Regional Hospital | And 3 more authors.
Orthopaedics and Traumatology: Surgery and Research | Year: 2013

Peripheral chondrosarcoma is a rare tumor particularly insidious when arising from the pelvis, becoming symptomatic later in time when surgery may be too difficult and dangerous due to this complex area. In the present case, the tumor arose from an exostosis located on the medial surface of the left iliac wing. Its diameter was 25. cm × 20. cm × 15. cm, adhering to the last three vertebrae, involving the left iliac vein and artery, displacing the left ureter. In a similar case, a hindquarter amputation is indicated but, if the patient refuses, a resection remains possible. In this paper, we describe a multistage technique consisting of an extra-anatomic vascular bypass, a lumbar stabilization, a neurovascular bundles anterior isolation and a postero-lateral resection of this mass. After a five-year follow-up, the patient is alive and able to stand and walk with support, after undergoing twice lung metastasis removal. © 2013 Elsevier Masson SAS.


PubMed | University of Arizona, Italian National Cancer Institute and San Salvatore Regional Hospital
Type: Journal Article | Journal: Computer assisted surgery (Abingdon, England) | Year: 2016

In oncological orthopedics, navigation systems are limited to use in specialized centers, because specific, expensive, software is necessary. To resolve this problem, we present a technique using general spine navigation software to resect tumors located in different segments.This technique requires a primary surgery during which screws are inserted in the segment where the bone tumor is; next, a CT scan of the entire segment is used as a guide in a second surgery where a resection is performed under navigation control. We applied this technique in four selected cases. To evaluate the procedure, we considered resolution obtained, quality of the margin and its control.In all cases, 1mm resolution was obtained; navigation allowed perfect control of the osteotomies, reaching the minimum wide margin when desired. No complications were reported and all patients were free of disease at follow-up (average 25.5 months).This technique allows any bone segment to be recognized by the navigation system thanks to the introduction of screws as landmarks. The minimum number of screws required is four, but the higher the number of screws, the greater the accuracy and resolution. In our experience, five landmarks, placed distant from one another, is a good compromise. Possible disadvantages include the necessity to perform two surgeries and the need of a major surgical exposure; nevertheless, in our opinion, the advantages of better margin control justify the application of this technique in centers where an intraoperative CT scanner, synchronized with a navigation system or a dedicated software for bone tumor removal were not available.

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