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    3848 results match your criteria Chirurgia italiana[Journal]

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    Voluntary self-amputation of the colon.
    Chir Ital 2009 Sep-Dec;61(5-6):691-3
    Dipartimento di Chirurgia Generale, Clinica Chirurgica, Università di Modena e Reggio Emilia.
    We describe an unusual case of self-amputation of a transanal prolapsed colorectal segment by a 48-year-old mentally impaired woman. The surgical procedure and favourable outcome are reported. Read More

    Duodenal obstruction by self-expanding biliary stents in patients with pancreatic cancer.
    Chir Ital 2009 Sep-Dec;61(5-6):687-90
    Clinica Chirurgica IV, University of Padua.
    Self-expanding biliary drains seem to allow long-term patency and prevent stent migration in peri-ampullary neoplastic lesions. We report two cases of duodenal occlusions due to the stent advancing towards the intestinal lumen in patients with tumours of the pancreatic head. The stents had been percutaneously positioned after an endoscopic papillotomy or palliative choledocho-jejunostomy and were impacted by alimentary debris, blocking the passage of food. Read More

    Surgical treatment of a double splenic artery aneurysm.
    Chir Ital 2009 Sep-Dec;61(5-6):683-5
    Department of Digestive Surgery, CH Toulon-La Seyne, France.
    Splenic artery aneurysms account for the majority of splanchnic artery aneurysms. These constitute a uncommon pathology, but with a mortality rate greater 70%. We report a case of a double symptomatic aneurysm of the splenic artery with a proximal and distal localization. Read More

    Small bowel metastasis from primary neuroendocrine small cell lung carcinoma.
    Chir Ital 2009 Sep-Dec;61(5-6):679-82
    UO Chirurgia Oncologica e dei Sistemi Impiantabili, AOU San Martino, Genova.
    Small bowel metastases from a primary lung carcinoma are rare. We report a case of a 76-year-old male with a primary neuroendocrine small cell carcinoma of the lung, treated by chemotherapy, who developed fever and bowel symptoms (subocclusion and pain). On CT examination, he was found to have a tumour in the small bowel. Read More

    [Echo-guided spleen-preserving resection of the pancreas tail for pancreatic intraductal papillary mucinous neoplasms].
    Chir Ital 2009 Sep-Dec;61(5-6):667-77
    UO di Chirurgia Generale, Dipartimento di Emergenza/Urgenza, Chirurgia Generale e dei Trapianti, Azienda Ospedaliera di Bologna, Policlinico S. Orsola-Malpighi, Università degli Studi di Bologna
    Intraductal papillary mucinous neoplasms (IPMNs) of the pancreas are a distinct entity with malignant potential, which may recur after surgical excision. Limited pancreatectomies have been recently proposed for non-invasive tumours. We report our technique of intraoperative US-guided resection of non-invasive IPMNs located in the tail of the pancreas with spleen and splenic vessel preservation. Read More

    Mesenteric revascularisation in a young patient with antiphospholipid syndrome and fibromuscular dysplasia: report of a case and review of the literature.
    Chir Ital 2009 Sep-Dec;61(5-6):659-65
    First Clinical Division of General Surgery, Vascular Surgery Unit, University of Verona, School of Medicine, Verona.
    Fibromuscular dysplasia or fibromuscular hyperplasia is a rare non-atherosclerotic and non-inflammatory vascular disease that primarily involves medium-size and small arteries, most commonly the renal and carotid arteries, and less frequently the vertebral, iliac, subclavian or visceral arteries (mesenteric, hepatic, splenic). Antiphospholipid syndrome is one of the most commonly acquired hypercoagulable states, defined by the association of laboratory evidence of anti-phospholipid antibodies with arterial or venous thrombosis or recurrent pregnancy losses. The presence of these antibodies is associated with an increased risk of thromboembolic phenomena, including peripheral thrombophlebitis, pulmonary thromboembolism, stroke, retinal artery occlusion, myocardial infarction, placental thrombosis and Budd-Chiari syndrome. Read More

    [A new needle for colon-proctological surgery: personal experience].
    Chir Ital 2009 Sep-Dec;61(5-6):653-8
    Dipartimento di Chirurgia Generale e Trapianti d'Organo, Istituto "Paride Stefanini", Università degli Studi di Roma
    Rectocele and haemorrhoidal prolapse are two pathologies that in all cases entail partial excision of anorectal tissue possibly with less invasive surgical procedures. For these pathologies, the authors have recently improved their treatment procedures, introducing the sequential transfixed stitch technique (STST) for rectocele and the transfixed stitch technique (TST) for haemorrhoidal prolapse, and thereby obtaining a significant technical and clinical improvement in terms of both outcomes (complete correction of rectal prolapse and haemorrhoidal prolapse) and discomfort and quality of life in the postoperative period. Moreover, in the present study the authors propose a subsequent innovation of the technique developed recently for the treatment of rectocele and haemorrhoidal disease using a new curved siliconate needle, thinner than the traditional lanceolate needles, with a longer, more rigid needle-thread junction in order to achieve less invasiveness and mucosal trauma, enabling the surgeon to perform sutures in a simple, easy manner. Read More

    [Eyebrow reconstruction with a scalp island flap based on the superficial temporal artery].
    Chir Ital 2009 Sep-Dec;61(5-6):647-51
    Clinica Chirurgica II, Dipartimento ad Attività Integrata di Chirurgia Generale e Specialità Chirurgiche, Università degli Studi di Modena e Reggio Emilia.
    The Authors describe the reconstruction of an eyebrow, in a case of complete traumatic avulsion, using a scalp island flap based on the superficial temporal artery, in a young person aged 32 years. The lesion represented a serious aesthetic disablement capable of causing disturbed psychic equilibrium and individual relationships, in view of the fact that the eyebrows play a decisive role in the characterisation of the face and expressive gestures. The strategy of using a scalp island flap with a limited amplitude only slightly larger than that of the site in which it was inserted enabled optimal projection of the newly constructed eyebrow to be achieved during suturing. Read More

    [Self-expanding oesophageal stents: comparison of Ultraflex and Choostent].
    Chir Ital 2009 Sep-Dec;61(5-6):641-6
    Cattedra e UO di Chirurgia Generale, Università degli Studi di Milano, IRCCS Policlinico San Donato, Milano.
    Two types of covered self-expanding metal stents were compared in a consecutive series of 57 patients. Stent placement was successful in all patients. No procedure-related deaths were observed. Read More

    Small bowel obstruction by a congenital band. Report of two cases.
    Chir Ital 2009 Sep-Dec;61(5-6):635-9
    Dipartimento di Chirurgia Generale-Clinica Chirurgica II, Università di Modena e Reggio Emilia.
    The authors report two cases of acute small bowel obstruction, the first in an adult patient, and the second in a three-month-old baby due to a congenital fibrous band. The second case was retrospectively detected from a pool of at least 50 cases of secondary fibrous band obstructions over the period from 1970 to 2008. Surgery was performed early, and simple resection of this very rare malformative bundle (usually affecting very young people) was required. Read More

    [So-called "dense-vascularised" peritoneal adhesions: clinical and aetiopathogenetic considerations].
    Chir Ital 2009 Sep-Dec;61(5-6):627-33
    VI Divisione di Chirurgia Generale, Azienda Ospedaliera S. Giovanni Battista, Torino.
    In the daily clinical practice of surgeons operating electively or, more frequently, in the emergency setting, within the abdominal cavity and pelvis, the detection of an intestinal adhesive disorder is frequent and is capable of causing numerous complications and subsequent reintervention. We report three cases of female patients referred to our observation for bowel subocclusion due to adhesive syndrome. After laparotomy, which revealed the presence of singular tenacious fibrovascular adhesions, the patients were subjected to immunohistochemical and receptor analysis yielding a diagnosis of leiomyomatosis peritonealis disseminata. Read More

    Visual disorders or "eye stroke"after heart surgery: can we prevent it?
    Chir Ital 2009 Sep-Dec;61(5-6):623-5
    Department of Cardiovascular and Thoracic Surgery, University Hospital of Thessaly, Larissa.
    The aim of the study was to elucidate the problem of visual disorders after heart surgery, focusing on aetiology, modes of prevention and treatment. Information from a literature search and the authors' personal experience are provide clues as to the modes of development and the means of avoidance and therapy of this category of postoperative, neurosensory complications. Multiple morbid situations, such as preoperative augmented ocular pressure, perioperative bleeding and hypotension, are shown to be predisposing and precipitating factors. Read More

    Rare cases of bowel obstruction: internal hernias.
    Chir Ital 2009 Sep-Dec;61(5-6):617-21
    General Surgery Unit, San Massimo Hospital, Penne, Pescara.
    Internal hernias are a rare form of dislocation of the abdominal viscera, usually in the small intestine, in the peritoneal sacs or cavities, resulting from the defective coalescence of the peritoneal flaps due to abnormal rotation of the medium intestine in the second stage of embryogenesis. In this paper the authors describe three cases observed during the last twelve months: two cases were ascribable to left paraduodenal hernia and one to a transepiploic hernia. Special attention needs to be paid to knowledge of the rotation process of the primitive medium intestine and to understanding whether an internal hernia underlies the clinical picture, when occlusive patients have not previously undergone surgery and show no signs of external hernias. Read More

    Laparoscopic cholecystectomy can be performed safely with only three ports in the majority of cases.
    Chir Ital 2009 Sep-Dec;61(5-6):613-6
    Department of Surgery, Santa Corona Hospital, Pietra Ligure, Savona.
    Reducing the number of ports used to perform laparoscopic cholecystectomy (LC) is indicated as means of further minimising postoperative pain, allowing a rapid return to activity and work, and obtaining patient satisfaction and better cosmetic results. It is still debatable whether the three-port technique is comparably safe. Since 2001, 374 consecutive patients underwent laparoscopic cholecystectomy in elective and emergency surgery. Read More

    [Totally trans-umbilical laparoscopic cholecystectomy: our experience].
    Chir Ital 2009 Sep-Dec;61(5-6):607-11
    Policlinico San Marco, Zingonia, Osio Sotto, Bergamo.
    Videoassisted surgery has recently led to a new era, aimed mainly at minimising surgical trauma and improving the cosmetic result. Natural Transluminal Endoscopic Surgery (NOTES) and Single Incision Laparoscopic Surgery (SILS) are emerging as effective techniques whose advantages and possible applications have been widely explored in the most recent literature. Twenty-two consecutive patients, mean age 51. Read More

    Blunt abdominal trauma: current management.
    Chir Ital 2009 Sep-Dec;61(5-6):601-6
    Department of Digestive Surgery, CH Toulon-La Seyne, France.
    Management of blunt abdominal trauma has evolved over the last decade and non-operative management (NOM), initially viewed with scepticism, has now become widely used. The aim of this retrospective study was to examine the results of liberal utilisation of NOM of blunt abdominal trauma. For that purpose we examined the charts of 119 patients admitted to our Department of Surgery from January 1998 to July 2006 for blunt abdominal trauma. Read More

    Carcinoma of the appendix and its natural history in relation to surgical management. A case report.
    Chir Ital 2009 Sep-Dec;61(5-6):597-600
    General and Emergency Surgery Department, Garibaldi Hospital, Azienda Ospedali Garibaldi.
    There are several classifications of appendicular epithelial cancer with a wide variety of nomenclature. Epithelial tumours of the appendix have been classified into four distinct types: carcinoids, mucinous adenocarcinoma (often called mucinous cystadenocarcinoma or malignant mucocele), colonic-type adenocarcinoma, and adenocarcinoids with a dual cell origin. We report a case of a woman who presented to our emergency unit with a history of acute appendicitis and who had undergone an appendectomy. Read More

    Laparoscopic appendectomy for acute appendicitis.
    Chir Ital 2009 Sep-Dec;61(5-6):591-6
    Department of Surgical Sciences, Organ Transplantation and Advanced Technologies, University of Catania.
    The advantages and applications of the videolaparoscopic technique (VL) versus open surgery in the treatment of acute and complicated appendicitis are not well defined. The aim of this study was to identify which of the two procedures is more suitable. The study examined 124 patients, 73 females (57. Read More

    [Laparoscopic total mesorectal excision for extraperitoneal rectal cancer. Oncological outcome at 5 years].
    Chir Ital 2009 Sep-Dec;61(5-6):585-9
    U.O.C. Chirurgia Generale e Mininvasiva, Ospedale "San Paolo", ASL-RM/F, Civitavecchia, Roma.
    Total mesorectal excision (TME) is the cornerstone of surgical treatment for extraperitoneal rectal cancer. The aim of the present study was to analyse our five-year experience with laparoscopic TME, evaluating the overall five-year and disease-free survival rates. Twenty-five patients with low-middle rectal cancer were treated with laparoscopic TME. Read More

    [Five-year oncological results of laparoscopic versus open left hemicolectomy].
    Chir Ital 2009 Sep-Dec;61(5-6):579-83
    UOC Chirurgia Generale e Mininvasiva, Ospedale "San Paolo", ASL-RM/F, Civitavecchia, Roma.
    Laparoscopic left hemicolectomy is still uncommon in surgical practice, because of both an unjustified fear of oncological inadequacy and technical difficulties with a steep learning curve. The aim of the present study was to analyse our 5-year experience with laparoscopic left hemicolectomy and its short- and long-term results. Thirty patients with non-metastatic non-infiltrating left colon cancer were treated laparoscopically and retrospectively compared to a group treated laparotomically and well matched for age, comorbidity and stage of disease in respect to the laparoscopic group. Read More

    [Laparoscopic versus open right hemicolectomy: 5-year oncology results].
    Chir Ital 2009 Sep-Dec;61(5-6):573-7
    UOC Chirurgia Generale e Miniinvasiva, Ospedale "San Paolo", ASL-RM/F, Civitavecchia, Roma.
    Laparoscopic right hemicolectomy has developed less markedly than rectosigmoid resection, probably because of the more complicated regional anatomy and greater difficulty in performing an adequate regional lymphectomy. The aim of the present study was to analyse our 5-year experience with laparoscopic right hemicolectomy. Twenty patients were enrolled with non-metastatic, non-infiltrating right colonic cancer, treated laparoscopically and compared to a group well matched for age, sex, comorbidity and stage of disease, treated laparotomically. Read More

    [Emergency colonic surgery: analysis of risk factors predicting morbidity and mortality].
    Chir Ital 2009 Sep-Dec;61(5-6):565-71
    Dipartimento di Chirurgia, II Facoltà di Medicina e Chirurgia, Università Roma Sapienza, Azienda Ospedaliera Sant'Andrea, Roma.
    The aim of the present study was to identify risk factors for morbidity and mortality in patients submitted to emergency colonic surgery. Between 1997 and 2008 157 patients, 106 of whom affected by colon cancer (67.5%) and 51 by benign disease (32. Read More

    Gastrointestinal stromal tumours. Is aggressive surgical treatment reasonable in locally advanced cases?
    Chir Ital 2009 Sep-Dec;61(5-6):559-64
    Porretta and Vergato Department of Surgery, Porretta Terme Hospital, Bologna.
    Gastrointestinal stromal tumours (GISTs) are the most common mesenchymal neoplasms of the gastrointestinal tract and have only recently been described based on their specific immunohistochemistry and the presence of particular kit-related mutations which potentially make them targets for tyrosine kinase inhibition. Most GISTs are respectable, with survival mainly depending upon mitotic count and completeness of resection. Our own and other studies suggest that, in locally advanced cases, complete surgical resection (R0 resection) and adjuvant molecular therapy with imatinib yield good outcomes in terms of survival and disease-free status at 12 and 18 months. Read More

    [Modulation of the extent of lymphadenectomy in early gastric cancer. Review of the literature and role of laparoscopy].
    Chir Ital 2009 Sep-Dec;61(5-6):551-8
    UOC Chirurgia Generale e Mini-invasiva, Ospedale "S. Paolo", Civitavecchia (ASL-RM/F), Roma.
    Early gastric cancer is a gastric carcinoma confined to the mucosa or submucosa of the stomach, regardless of the presence of nodal involvement, which in any event is present only in about 20% of patients. This uncommon nodal involvement is a distinct clinical problem, because standard D2 lymphadenectomy constitutes overtreatment in more than 80% of patients. A review of the literature shows that the present surgical tendency for those patients who do not fulfill the Gotoda criteria (i. Read More

    [Recurrent goitre: our experience].
    Chir Ital 2009 Sep-Dec;61(5-6):545-9
    Dipartimento di Chirurgia e Scienze Odontostomatologiche, Università degli Studi di Cagliari
    Recurrence after conservative thyroid surgery ranges from 7 to 40%. Risk factors for recurrence are female sex, multiple nodules in the resected lobe and lack of postoperative LT4 therapy. Indications for reoperation are suspected malignancy, recurrent thyrotoxicosis and recurrent uninodular or multinodulare goitre. Read More

    [Lymphectomy in differentiated thyroid carcinoma].
    Chir Ital 2009 Sep-Dec;61(5-6):539-44
    IV Divisione di Chirurgia Generale e di Endocrinochirurgia, Seconda Università degli Studi di Napoli, Napoli.
    Papillary and follicular thyroid carcinoma are still characterised by unclear biological and clinical behaviour with an autoptic incidence higher than the clinical incidence. Lymph-node involvement represents a prognostic factor that may increase the rate of local relapse, reducing long-term survival only in high risk patients--age > 45 years, M+, T > 3 cm, extra thyroidal extension, follicular histotype. The authors analyse the role of lymph-node cervical dissection. Read More

    [The RET gene and medullary thyroid cancer: from mutations to the planning of therapy].
    Chir Ital 2009 Sep-Dec;61(5-6):531-8
    IV Divisione di Chirurgia Generale e di Endocrinochirurgia, Seconda Università degli Studi di Napoli.
    The RET gene codes for a tyrosine kinase receptor, expressed in neural crest derived cells playing a central role during embryogenesis. The RET proto-oncogene is responsible for medullary thyroid cancer and multiple endocrine neoplasia type 2. To date, more than 50 germline point mutations have been described. Read More

    [Isoperistaltic endoluminal drainage (IED) in the surgical treatment of upper digestive tract dehiscence].
    Chir Ital 2009 Sep-Dec;61(5-6):523-9
    UO Chirurgia Generale Universitaria "C. Righetti", Università degli Studi di Bari, Policlinico di Bari.
    Dehiscence of upper gastrointestinal sutures still remains a severe clinical problem and often requires complex surgical repair. Despite its multifactorial aetiopathogenesis, endoluminal pressure seems to play an important role in the onset and maintenance of this complication. The efficacy of isoperistaltic endoluminal drainage (IED) in the operative treatment or prevention of upper gastrointestinal surgical dehiscence was assessed in a retrospective study. Read More

    [Giant angiomyolipoma of the kidney not associated with tuberous sclerosis: a case report and review of the literature].
    Chir Ital 2009 Jul-Aug;61(4):507-13
    U.O.C. di Chirurgia Generale dell'Istituto Clinico Sant'Ambrogio di Milano, Cattedra di Chirurgia Generale, Università degli Studi di Milano.
    The authors describe a paradigmatic case of a large renal angiomyolipoma not associated with tuberous sclerosis. The lesion was discovered as an incidental finding during abdominal ultrasound for other pathology. Owing to the extent of the lesion and the appreciable risk of spontaneous rupture and bleeding, we opted for surgical treatment. Read More

    Leiomyosarcoma of the inferior vena cava: a case report and review of the literature.
    Chir Ital 2009 Jul-Aug;61(4):503-5
    U. O. Chirurgia Generale, Ospedale di Castelfranco Veneto (Treviso).
    Leiomyosarcoma of the inferior vena cava is a particularly rare tumour, originating from the smooth muscle of the vessel wall. The authors describe the case of a female patient admitted with a picture of anorexia and weight loss, accompanied by epi- and mesogastric pain. Preoperative examinations revealed the presence of a mass of considerable size originating from the inferior vena cava. Read More

    Cryptogenetic intestinal angiodysplasia and elderly aortic stenosis: Heyde's syndrome? A case report.
    Chir Ital 2009 Jul-Aug;61(4):497-501
    Department of General Surgery LeScotte Hospital, Siena.
    Gastrointestinal haemorrhage is extremely frequent, but in some cases the aetiology may remain unknown. Haemorrhage from the small bowel especially can create important diagnostic problems. We report the case of a patient admitted to hospital with intestinal bleeding in an ileal site in association with aortic stenosis. Read More

    Biliary stent migration into the abdominal wall: a case report.
    Chir Ital 2009 Jul-Aug;61(4):493-6
    Department of Surgical Science, Organ Transplantation and Advanced Technologies, University of Catania.
    Biliary stent migration occurs in about 5% of patients. The most common complications secondary to stent migration are pancreatitis, small bowel perforation and peritonitis. We report the case of a patient presenting with an abdominal wall abscess secondary to migration of a biliary stent. Read More

    [Iatrogenic lesion of the hepatic artery in the course of pancreatic surgery].
    Chir Ital 2009 Jul-Aug;61(4):485-92
    Dipartimento di Scienze Chirurgiche, Università Cattolica del Sacro Cuore, Divisione di Chirurgia Digestiva, Policlinico A. Gemelli, Roma.
    The authors report a case of operative injury of the hepatic artery during a total spleno-pancreasectomy procedure for a mixed-type intraductal papillary mucinous neoplasm. During the preparation of the structures of the hepatic pedicle, a "true" hepatic artery was not identified, but only a small arterial vessel measuring about 2 mm in diameter, just in front of the portal vein, apparently emerging from the parenchyma of the pancreatic head. To obtain complete mobilisation of the duodeno-pancreatic block from the portal vein, it was necessary to cut this small arterial vessel. Read More

    [Rectus sheath haematoma as an early complication of laparoscopic hemicolectomy: a case report and review of the literature].
    Chir Ital 2009 Jul-Aug;61(4):481-3
    U.O.C. Chirurgia Generale ed Endocrina, Azienda Policlinico Umberto I, Università degli Studi La Sapienza, Roma.
    We report a case of rectus sheath haematoma (RSH) in a patient undergoing laparoscopic right hemicolectomy and anticoagulant prophylaxis of a pulmonary thromboembolism (PTE) with low molecular weight heparin. This pathological condition is rare and could be a cause of misdiagnosis in patients with acute abdominal pain. It can be a serious complication in the course of anticoagulant therapy. Read More

    [Usefulness of plug test for the intraoperative staging of rectal mucosal prolapse].
    Chir Ital 2009 Jul-Aug;61(4):475-80
    Dipartimento di Chirurgia Generale e Trapianti d'Organo, Istituto Paride Stefanini, Università degli Studi di Roma.
    Rectal mucosal prolapse is characterised by protrusion of the rectal mucosa alone in the anal lumen. To correctly establish the intraoperative stage of rectal mucosal prolapse the authors performed a test based on the intrarectal introduction of a large-sized hydrophilic plug, to be extracted later from the anal canal. A total of 40 patients with proctological symptoms and with a diagnosis of rectal mucosal prolapse were submitted, in the outpatient setting, to a minimally invasive test with a small plug and later, in the preoperative stage, in patients under anaesthesia, using a plug entirely inserted into the rectal lumen and extracted via the anus. Read More

    [Laparoscopic lavage and drainage in the surgical treatment of diverticular disease complicated by peritonitis].
    Chir Ital 2009 Jul-Aug;61(4):467-74
    S.C. di Chirurgia Generale, Ospedale San Bartolomeo, A.S.L. n. 5 Spezzino, Sarzana (La Spezia).
    The treatment of peritonitis complicating diverticular disease of the colon is yet to be universally regarded as established practice and major differences in management are to be noted in the various surgical institutions. In the emergency setting, the minimally invasive approach is used by few surgeons and the most frequent therapeutic options are sigmoid resection with primary anastomosis (with or without a diverting stoma) and Hartmann's procedure. The Authors report their preliminary experience (13 cases) with laparoscopic lavage and drainage without colonic resection in diverticulitis complicated by peritonitis and describe the technical details of the surgical procedure. Read More

    [Role of endoanal ultrasonography in reducing anal fistula recurrence].
    Chir Ital 2009 Jul-Aug;61(4):461-5
    Area Funzionale di Chirurgia Generale, Dipartimento di Chirurgia, Ortopedia, Traumatologia ed Emergenze, A.O. Universitaria Federico II, Napoli.
    The aim of surgical treatment of fistula-in-ano is to eradicate the suppurative process permanently without compromising faecal continence. The appearance of a recurrence of fistula-in-ano is often due to non-identification of the internal opening by the surgeon, and to the presence of complex fistulae. We evaluated the clinical course of 214 patients in a randomised. Read More

    [Surgical approach in the management of oesophageal tumours: considerations based on therapeutic results].
    Chir Ital 2009 Jul-Aug;61(4):449-60
    Divisione di Chirurgia Generale, Struttura di Sondrio, AOVV Sondrio.
    Over the last two decades, oesophageal cancers, although considered among the most malignant visceral tumours, have witnessed a gradual increase in survival rates at a distance after surgery. The aims of the study were to present the results of our surgical approach and, on this basis, to discuss a number of considerations regarding the type of intervention to be adopted. In a retrospective study we recruited 105 patients with oesophageal cancer treated with various types of oesophageal resection, with or without thoracotomy, in the Division of General Surgery of the Civic Hospital of Sondrio. Read More

    [Emergency laparoscopic cholecystectomy in the treatment of acute cholecystitis: when and how?].
    Chir Ital 2009 Jul-Aug;61(4):435-47
    Dipartimento di Emergenza Accettazione DEAII, Università degli Studi La Sapienza di Roma, Policlinico Umberto I, Roma.
    Optimal surgical timing and operative technique in the treatment of acute cholecystitis are of major importance and are still debatable issues. We report the results of our study on the timing of surgery in a consecutive series of 163 patients treated in the emergency setting for acute cholecystitis over the period from 1998 to 2008. Early surgery and the partially downwards laparoscopic cholecystectomy technique provide a safe and effective way of treating these patients and preventing major complications. Read More

    [Laparoscopic splenectomy in haematological diseases: short- and medium-term results in thirty initial cases].
    Chir Ital 2009 Jul-Aug;61(4):427-33
    U.O.C. Chirurgia Generale, Ospedale S. Eugenio, Roma.
    In 1991 Delaitre and Maignien described the first laparoscopic splenectomy, since when a rapid spread of this technique has been observed and the procedure has become the gold standard in the surgical management of benign and malignant haematological diseases. In the present study, the results of the first 30 laparoscopic splenectomies performed at the Division of General Surgery of the S. Eugenio Hospital of Rome are reported. Read More

    [Prognostic significance of the Mandard TRG classification after induction therapy in carcinoma of the oesophagus and cardia].
    Chir Ital 2009 Jul-Aug;61(4):419-25
    I Divisione Clinicizzata di Chirurgia, Cattedra di Statistica Medica, Università di Verona.
    Mandard's tumor regression grade (TRG) is widely used to evaluate the pathological response to induction therapy with concurrent chemoradiotherapy in cancer of the oesophagus or gastro-oesophageal junction. The aim of this study was to evaluate the prognostic significance and clinical applicability of TRG. From 2000 to 2007, 108 patients with squamous cell carcinoma of the oesophagus (57 cases) or Siewert type I and II adenocarcinoma of the cardia (51 cases) were treated with induction chemoradiotherapy followed by surgery in the 1st Division of General Surgery of the University of Verona. Read More

    [Anastomotic leak following colorectal surgery: incidence, risk factors and treatment].
    Chir Ital 2009 Jul-Aug;61(4):407-17
    Istituto di Chirurgia Generale I, Dipartimento Chirurgico Materno-Infantile e di Scienze dell'Immagine Università degli Studi di Cagliari, A.O.U. di Cagliari, Ospedale San Giovanni di Dio, Cagliari.
    The aim of this study was to assess the incidence and identify the risk factors associated with colorectal anastomotic leakage. A further objective was to investigate the therapeutic choices. We reviewed the clinical files of 124 patients who underwent mechanical end-to-end anastomosis after colorectal resection during the period 2000-2007. Read More

    Aggressive sebaceous carcinoma of the head.
    Chir Ital 2009 May-Jun;61(3):401-4
    Department of Clinical Physiopathology, VIth General Surgery Division, Turin University, Turin.
    Cutaneous sebaceous carcinoma (SC) is a rare malignancy deriving from the adnexal epithelium of the sebaceous glands. Periorbital SC is approximately three times more common than extraorbital cutaneous SC. Extraocular SC is reported to be less aggressive than orbital sebaceous carcinoma and rarely metastasizes. Read More

    [Multiple intestinal perforations due to tuberculosis: a case report and review of the literature].
    Chir Ital 2009 May-Jun;61(3):397-9
    S.C. di Chirurgia Generale e Oncologíca, Dipartimento di Sdenze Chirurgiche, Radiologiche, Odontostomatologiche, Università degli Studi di Perugia.
    The incidence of tuberculosis in Italy steadily decreased until two decades ago, but the infection is now frequently diagnosed in common clinical practice. The Authors describe a rare acute abdominal presentation of the disease featuring a double intestinal perforation in a subject affected by pulmonary, renal and gastrointestinal miliary tuberculosis. A review of the literature is also presented. Read More

    Gastric vascular lesion: a case report.
    Chir Ital 2009 May-Jun;61(3):391-5
    Section of General Surgery, University of Turin, School of Medicine, San Luigi Gonzaga Hospital, Orbassano, Turin.
    Arteriovenous malformations of the gastrointestinal tract are a known but rare cause of bleeding. Those of the stomach are the rarest if compared with other causes of gastric bleeding. The aetiology is still unknown, but senile age is considered an important cause, as are the degenerative processes connected with old age. Read More

    Complicated small-bowel diverticulosis: a case report and review of the literature.
    Chir Ital 2009 May-Jun;61(3):387-90
    Department of Oncological Surgery, San Martino Hospital, Genoa.
    Here we report a case of a 60 years old woman who came to the Emergency Department of San Martino Hospital suffering from abdominal pain for about a week with high fever in the last 24 hours. The final histological examination led to the diagnosis of ileal diverticulosis associated with perforation and peritonitis with a fibrotic reaction involving the last ileal loop, the caecum and the appendix. Read More

    Triple synchronous tumours of the urinary system with different histologies: a case report.
    Chir Ital 2009 May-Jun;61(3):381-5
    Department of Surgery, Monterotondo Hospital, Rome.
    We present the case report of a male patient with a diagnosis of synchronous kidney, bladder and prostate tumours with different histologies: renal oncocytoma, urothelial carcinoma of the bladder, and adenocarcinoma of the prostate. This is the first case report described in the literature in which a complete surgical resection of triple tumours has been performed with surgery in a single session. Recent advances in the field of genetics enable the surgeon to hypothesise new strategies in the early treatment of synchronous tumours, particularly when a number of common tumour markers are positive. Read More

    Mucinous cystic neoplasm of the pancreas: a case report.
    Chir Ital 2009 May-Jun;61(3):375-9
    General Surgery and Liver Transplantation, DETO, University of Bari.
    Cystic neoplasms of the pancreas account for only a small percentage of pancreatic tumours. They include mucinous cystic tumours, which have a higher incidence in females in their forties or fifties. Cystic neoplasms of the pancreas can present in a benign, borderline or malignant form. Read More

    Giant nodular pseudoangiomatous stromal hyperplasia (PASH) of the breast presenting as a rapidly growing tumour.
    Chir Ital 2009 May-Jun;61(3):369-73
    General Surgery 1, Azienda Ospedaliera G. Salvini, Ospedale di Rho, Milano.
    Pseudoangiomatous stromal hyperplasia (PASH) is often a microscopic incidental finding in breast biopsies performed for benign or malignant diseases. In rare cases, it presents as a localised breast mass. Since Vuitch et al first described this condition in 1986, only 109 cases of PASH presenting as a palpable or mammographically detectable mass have been documented. Read More

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