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Article ; Online: Laparoscopic repair of a large rectal injury during colonoscopy: challenging an old-fashioned paradigm - a video vignette.

Tebala, G D / Symons, N

Colorectal disease : the official journal of the Association of Coloproctology of Great Britain and Ireland

2020 Volume 22, Issue 12, Page(s) 2355–2356

MeSH term(s)	Colonic Diseases ; Colonoscopy ; Humans ; Laparoscopy
Language	English
Publishing date	2020-09-30
Publishing country	England
Document type	Letter ; Video-Audio Media
ZDB-ID	1440017-0
ISSN	1463-1318 ; 1462-8910
ISSN (online)	1463-1318
ISSN	1462-8910
DOI	10.1111/codi.15351
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Article ; Online: Gastroesophageal reflux disease. Are we acting in the best interest of our patients?

Tebala, G D

European review for medical and pharmacological sciences

2016 Volume 20, Issue 21, Page(s) 4553–4556

Abstract: Oesophageal adenocarcinoma is strictly related to gastroesophageal reflux and cylindrical metaplasia of the epithelium of the distal esophagus (Barrett's esophagus) due to chronic inflammation. Worldwide incidence of oesophageal adenocarcinoma is rising ... ...

Abstract	Oesophageal adenocarcinoma is strictly related to gastroesophageal reflux and cylindrical metaplasia of the epithelium of the distal esophagus (Barrett's esophagus) due to chronic inflammation. Worldwide incidence of oesophageal adenocarcinoma is rising despite the availability of precise international guidelines for the treatment of gastroesophageal reflux disease and the increasing use of proton-pump inhibitors (PPIs). While PPIs can control GERD symptoms in a significant amount of cases, still a large number of patients progress to Barrett's esophagus and adenocarcinoma. Recent investigations have demonstrated that in one-third of the patients their reflux symptoms are due to non-acid reflux, obviously not affected by PPIs. Robust evidences are available to demonstrate the role of non-acid reflux in the development of Barrett's esophagus and adenocarcinoma. Therefore, PPIs are not effective in preventing the worst complications of GERD. It is mandatory to develop new and more effective guidelines on the treatment of GERD; that would take into account the fact that GERD should be considered a "surgical" disease, as it is due, at least in its late stages, to an anatomical defect of the lower oesophageal sphincter. Medical treatment should be considered in early stage GERD, when reflux is due to transient relaxations of the lower oesophageal sphincter, whereas surgery should be considered in late stages, in the presence of a demonstrated mechanical failure of the sphincter.
MeSH term(s)	Adenocarcinoma/etiology ; Adenocarcinoma/prevention & control ; Barrett Esophagus/complications ; Esophageal Neoplasms/diagnosis ; Esophageal Neoplasms/etiology ; Esophageal Neoplasms/prevention & control ; Esophageal Sphincter, Lower/anatomy & histology ; Esophageal Sphincter, Lower/physiopathology ; Esophageal Sphincter, Lower/surgery ; Gastroesophageal Reflux/complications ; Humans ; Proton Pump Inhibitors/therapeutic use
Chemical Substances	Proton Pump Inhibitors
Language	English
Publishing date	2016-11
Publishing country	Italy
Document type	Journal Article
ZDB-ID	605550-3
ISSN	2284-0729 ; 1128-3602 ; 0392-291X
ISSN (online)	2284-0729
ISSN	1128-3602 ; 0392-291X
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Zs.A 1887: Show issues

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Article ; Online: Appendicovesical fistula presenting as hypokalaemic hyperchloraemic metabolic acidosis: a case report.

Keane, S / Tebala, G D

Annals of the Royal College of Surgeons of England

2019 Volume 101, Issue 6, Page(s) e131–e132

Abstract: A 52-year-old man was admitted with diarrhoea and faecaluria and referred recurrent urinary tract infections for over 20 years. He also reported a two-week hospital admission more than 20 years ago for right iliac fossa pain, which was managed ... ...

Abstract	A 52-year-old man was admitted with diarrhoea and faecaluria and referred recurrent urinary tract infections for over 20 years. He also reported a two-week hospital admission more than 20 years ago for right iliac fossa pain, which was managed conservatively. Computed tomography showed a fistulous tract extending from the bladder with an unclear connection to the bowel. Cystoscopy confirmed the presence of a vesical fistula and biopsy of the tract confirmed colonic mucosa. Flexible sigmoidoscopy was negative. A cystogram was requested as an outpatient procedure and the patient was discharged after antibiotic treatment. A few days after discharge the patient was readmitted as an emergency to critical care for severe hyperchloraemic hypokalaemic acidosis and a Glasgow Coma Score of 6/15. He was intubated and ventilated and his metabolic derangement was treated. As soon as his conditions improved, he underwent emergency laparotomy, which revealed the presence of a fistula between the caecal fundus and the bladder. The fistula was repaired and the patient recovered swiftly and completely and was discharged on postoperative day 5. At 12-month follow up the patient was completely symptoms-free, his bowel habits were normal and he has not had any urinary infection. Appendicovesical fistula is a rare and potentially lethal condition due to its metabolic consequences. Past history of right iliac fossa pain treated conservatively, diarrhoea and recurrent urinary tract infection must raise suspicion.
MeSH term(s)	Acidosis/diagnosis ; Acidosis/etiology ; Appendix/diagnostic imaging ; Chlorides/blood ; Humans ; Hypokalemia/etiology ; Intestinal Fistula/complications ; Intestinal Fistula/diagnosis ; Intestinal Fistula/diagnostic imaging ; Male ; Middle Aged ; Tomography, X-Ray Computed ; Urinary Bladder Fistula/complications ; Urinary Bladder Fistula/diagnosis ; Urinary Bladder Fistula/diagnostic imaging
Chemical Substances	Chlorides
Language	English
Publishing date	2019-06-03
Publishing country	England
Document type	Case Reports ; Journal Article
ZDB-ID	80044-2
ISSN	1478-7083 ; 0035-8843
ISSN (online)	1478-7083
ISSN	0035-8843
DOI	10.1308/rcsann.2019.0047
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Uk I Zs.234: Show issues

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Article ; Online: Laparohernioscopic right colectomy for bowel ischaemia within a strangulated inguinal hernia.

Tebala, G D / Yee, J / Kola-Adejumo, A

Annals of the Royal College of Surgeons of England

2019 Volume 101, Issue 5, Page(s) e125–e127

Abstract: Visual inspection of the content of the hernia sac is a crucial step of the emergency repair of strangulated inguinal hernias, to rule out the presence of bowel ischaemia which would need resection. Occasionally the content of the hernia sac reduces ... ...

Abstract	Visual inspection of the content of the hernia sac is a crucial step of the emergency repair of strangulated inguinal hernias, to rule out the presence of bowel ischaemia which would need resection. Occasionally the content of the hernia sac reduces spontaneously into the abdomen after the induction of general anaesthesia and cannot be assessed. We present a case where hernioscopy t(i.e. laparoscopy through the hernia sac) has been used to confirm the ischaemia of the strangulated bowel and perform a hybrid laparohernioscopic right colectomy with intracorporeal anastomosis without the need for a formal laparotomy. Hernioscopy is an easy and reliable method to assess the viability of the content of the hernia sac in strangulated hernias that have spontaneously reduced before it could be visually inspected. It can also be associated with a laparoscopic access in a hybrid laparohernioscopic technique to perform complex procedures.
MeSH term(s)	Aged ; Colectomy/methods ; Colon/blood supply ; Colon/diagnostic imaging ; Colon/surgery ; Hernia, Inguinal/complications ; Hernia, Inguinal/diagnostic imaging ; Hernia, Inguinal/surgery ; Herniorrhaphy/methods ; Humans ; Ischemia/diagnostic imaging ; Ischemia/etiology ; Ischemia/surgery ; Laparoscopy/methods ; Male
Language	English
Publishing date	2019-07-17
Publishing country	England
Document type	Case Reports ; Journal Article
ZDB-ID	80044-2
ISSN	1478-7083 ; 0035-8843
ISSN (online)	1478-7083
ISSN	0035-8843
DOI	10.1308/rcsann.2019.0043
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Article ; Online: Hernioscopy: a reliable method to explore the abdominal cavity in incarcerated or strangulated inguinal hernias spontaneously reduced after general anaesthesia.

Tebala, G D / Kola-Adejumo, A / Yee, J

Hernia : the journal of hernias and abdominal wall surgery

2019 Volume 23, Issue 2, Page(s) 403–406

Abstract: Purpose: The diagnosis of bowel or omental ischaemia in strangulated inguinal hernias needs visual exploration of the content of the hernia sac. In some cases, the content of the sac retracts spontaneously into the abdomen at the induction of ... ...

Abstract	Purpose: The diagnosis of bowel or omental ischaemia in strangulated inguinal hernias needs visual exploration of the content of the hernia sac. In some cases, the content of the sac retracts spontaneously into the abdomen at the induction of anaesthesia, so making sure of its viability can be quite difficult. Hernioscopy can allow direct inspection of the whole abdominal cavity and the performance of surgical procedures such as small bowel, large bowel or omental resection, without the need of a formal laparotomy. Methods: Hernioscopy entails inserting a 10-12-mm trocars in the hernia sac, after its complete mobilization. A 30° camera is then passed into the abdomen through the sac and a thorough examination of the abdominal cavity is performed. If necessary, accessory trocars can be inserted into the hernia sac or through the abdominal wall to perform additional procedures such as bowel resection. After the exploration and the eventual resection, the operation is concluded with a tension-free mesh repair of the hernia. Results: We performed hernioscopy on eight patients. In four of them, no ischaemia was found and the operation was concluded with mesh repair of the hernia. In four patients, a further operative procedure was necessary. No significant postoperative surgical complications were recorded. Conclusions: Hernioscopy is an easy and reliable method to explore the abdominal cavity and make sure of the viability of the bowel in patients with strangulated inguinal hernia and to proceed to minimally invasive resection if needed.
MeSH term(s)	Abdominal Wall/surgery ; Aged ; Aged, 80 and over ; Anesthesia, General ; Hernia, Inguinal/surgery ; Humans ; Intestine, Small/blood supply ; Intestine, Small/surgery ; Ischemia/diagnosis ; Ischemia/surgery ; Laparoscopy/methods ; Male ; Middle Aged ; Omentum/surgery
Language	English
Publishing date	2019-02-05
Publishing country	France
Document type	Journal Article
ZDB-ID	1388125-5
ISSN	1248-9204 ; 1265-4906
ISSN (online)	1248-9204
ISSN	1265-4906
DOI	10.1007/s10029-019-01901-3
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Zs.A 5390: Show issues

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Article: Specimen removal after laparoscopic appendectomy: a cheap trick.

Tebala, G D

European review for medical and pharmacological sciences

2008 Volume 12, Issue 1, Page(s) 55–57

Abstract: Laparoscopic appendectomy (LA) has gained worldwide acceptance as an effective surgical treatment of acute appendicitis. One of its main advantages is the almost total absence of cosmetic sequelae. Obviously, this relates with the use of little sized ... ...

Abstract	Laparoscopic appendectomy (LA) has gained worldwide acceptance as an effective surgical treatment of acute appendicitis. One of its main advantages is the almost total absence of cosmetic sequelae. Obviously, this relates with the use of little sized trocars. Whereas the whole dissection can be performed by means of two 5-mm operative ports, other than the 10-mm laparoscope one, usually the dissected appendix cannot be removed through a 5-mm trocar. As in most cases a 5-mm camera is not available, the surgeon must use a second 10-mm trocar, thus losing the cosmetic advantages. In this technical note a cheap trick to retrieve the specimen after LA is described.
MeSH term(s)	Adult ; Appendectomy/methods ; Appendicitis/surgery ; Female ; Humans ; Laparoscopes ; Laparoscopy/methods ; Male ; Middle Aged ; Surgical Instruments
Language	English
Publishing date	2008-01
Publishing country	Italy
Document type	Journal Article
ZDB-ID	605550-3
ISSN	2284-0729 ; 1128-3602 ; 0392-291X
ISSN (online)	2284-0729
ISSN	1128-3602 ; 0392-291X
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Zs.A 1887: Show issues

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Article: Laparoscopic treatment of a gastric diverticulum.

Tebala, G D / Camperchioli, I / Tognoni, V / Innocenti, P / Gaspari, A L

European review for medical and pharmacological sciences

2010 Volume 14, Issue 2, Page(s) 135–138

Abstract: Gastric diverticula are rare disorders which present usually with vague upper abdominal symptoms. The diagnosis is based on endoscopic and radiologic findings, but it may remain uncertain until the operation. Herein we report the case of a 46-year-old ... ...

Abstract	Gastric diverticula are rare disorders which present usually with vague upper abdominal symptoms. The diagnosis is based on endoscopic and radiologic findings, but it may remain uncertain until the operation. Herein we report the case of a 46-year-old woman with a diverticulum of the posterior aspect of the upper part of the gastric fundus, referred to our attention for epigastric pain. The preoperative work out evidenced a pouch of the gastric fundus which was misinterpreted as a paraesophageal or a diaphragmatic hernia. The operation was performed by laparoscopy with a 4-port technique and the diverticulum was resected by an endoscopic stapler. The patient is well and symptom-free more than two months after the operation.
MeSH term(s)	Aged ; Diverticulum, Stomach/surgery ; Female ; Humans ; Laparoscopy/methods ; Middle Aged
Language	English
Publishing date	2010-02
Publishing country	Italy
Document type	Case Reports ; Journal Article
ZDB-ID	605550-3
ISSN	2284-0729 ; 1128-3602 ; 0392-291X
ISSN (online)	2284-0729
ISSN	1128-3602 ; 0392-291X
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Article: Laparoscopic Management of Cholecystogastric Fistula

Nuzzo, G. / Giultante, F. / Tebala, G. D. / Vellone, M.

Endoscopy

2008 Volume 29, Issue 03, Page(s) 226–226

Language	English
Publishing date	2008-03-17
Publishing place	Stuttgart ; New York
Document type	Article
ZDB-ID	80120-3
ISSN	1438-8812 ; 0013-726X
ISSN (online)	1438-8812
ISSN	0013-726X
DOI	10.1055/s-2007-1004173
Database	Thieme publisher's database

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Zs.A 669: Show issues			Location: Je nach Verfügbarkeit (siehe Angabe bei Bestand) bis Jg. 1994: Bestellungen von Artikeln über das Online-Bestellformular Jg. 1995 - 2021: Lesesall (1.OG) ab Jg. 2022: Lesesaal (EG)
Zs.MO 162: Show issues

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Article: Laparoscopic management of cholecystogastric fistula.

Nuzzo, G / Giuliante, F / Tebala, G D / Vellone, M

Endoscopy

1997 Volume 29, Issue 3, Page(s) 226

MeSH term(s)	Biliary Fistula/surgery ; Cholecystectomy, Laparoscopic ; Common Bile Duct Diseases/surgery ; Female ; Gastric Fistula/surgery ; Humans ; Laparoscopy ; Middle Aged
Language	English
Publishing date	1997-03
Publishing country	Germany
Document type	Case Reports ; Journal Article
ZDB-ID	80120-3
ISSN	1438-8812 ; 0013-726X
ISSN (online)	1438-8812
ISSN	0013-726X
DOI	10.1055/s-2007-1004173
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Zs.A 669: Show issues			Location: Je nach Verfügbarkeit (siehe Angabe bei Bestand) bis Jg. 1994: Bestellungen von Artikeln über das Online-Bestellformular Jg. 1995 - 2021: Lesesall (1.OG) ab Jg. 2022: Lesesaal (EG)
Zs.MO 162: Show issues

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Article: Resection of hepatic metastases from colorectal cancer.

Nuzzo, G / Giuliante, F / Giovannini, I / Tebala, G D / Clemente, G / Vellone, M

Hepato-gastroenterology

1997 Volume 44, Issue 15, Page(s) 751–759

Abstract: Background/aims: Long term results of hepatic resection for metastases from colorectal cancer depend upon several factors which are related to both features of primary cancer and of metastases. The aim of this study was to evaluate prognostic factors ... ...

Abstract	Background/aims: Long term results of hepatic resection for metastases from colorectal cancer depend upon several factors which are related to both features of primary cancer and of metastases. The aim of this study was to evaluate prognostic factors that best correlate with long-term results. Materials and methods: Fifty-eight hepatic resections were performed for colorectal cancer metastases. Long-term results were evaluated in relation to age of patients, features of primary tumor, features of metastases, section margin, number of intra-operative blood transfusions and execution of adjuvant chemotherapy. Results: Overall 5-year survival rate was 17%. 5-year survival rate in patients with stage B primary tumor was 63%, in patients with late metachronous metastases it was 28%, in patients with section margin > 1 cm it was 33% and in patients who did not receive intra-operative transfusions it was 45%. Patients with a solitary metastasis or with metastases sized less than 4 cm and those who received adjuvant chemotherapy also showed a better survival than the others. Conclusions: Better results were observed in patients without nodal involvement of the primary tumor. Patients with a small solitary metachronous metastasis that appeared more than one year after the colorectal resection and resected with a section margin of more than 1 cm, also showed good results.
MeSH term(s)	Adult ; Aged ; Colorectal Neoplasms/mortality ; Colorectal Neoplasms/pathology ; Female ; Hepatectomy/mortality ; Humans ; Liver Neoplasms/mortality ; Liver Neoplasms/secondary ; Liver Neoplasms/surgery ; Male ; Middle Aged ; Postoperative Complications ; Survival Rate
Language	English
Publishing date	1997-05
Publishing country	Greece
Document type	Journal Article
ZDB-ID	801013-4
ISSN	0172-6390
ISSN	0172-6390
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