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Il Giornale di Chirurgia

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https://www.readbyqxmd.com/read/29694313/paget-s-disease-of-the-male-breast-case-report-and-a-point-of-view-from-actual-literature
#1
M Vergine, A Musella, E Gulotta, F Frusone, Alberto De Luca, F Maceli, A Libia, P Benedetti Panici, M Monti
INTRODUCTION: Paget disease of the nipple in man is a very rare breast cancer, and there are not standard procedures or guidelines. In any cases, a Paget's disease could hide an invasive ductal breast cancer. CASE DESCRIPTION: We report the case of a 77-years old man affected by Alzheimer's disease, who presented to our attention because of an ulcerated palpable mass in the right nipple. A biopsy of the lesion showed "intra-epidermic proliferation of epitelioid cells, associated with linfo-plasmacellular infiltration of superficial dermis, compatible with Paget's disease (pTis)"...
March 2018: Il Giornale di Chirurgia
https://www.readbyqxmd.com/read/29694312/a-case-of-peduncolated-brunner-s-gland-hamartoma
#2
A Tornambè, G Tornambè
AIM: To report a case of Brunner's gland hamartoma (BGH) in patient treated with surgical resection. CASE REPORT: A 73 years old male patient that was admitted with melena. The preoperative investigations suggested a suspected duodenal large polypoidal mass. A local resection was performed. Surgical resection is actually considered the best treatment for this lesion. DISCUSSION: Brunner's glands were first described by Brunner in 1688. Hamartoma designates an excessive focal overgrowth of mature normal cells and tissues, composed of identical cellular elements...
March 2018: Il Giornale di Chirurgia
https://www.readbyqxmd.com/read/29694311/primary-abdominal-wall-endometriosis-presentation-of-rarely-seen-two-cases
#3
M F Ferhatoglu, K Senol
Abdominal wall endometriosis is a pathology which usually develops after preceding surgeries on the surgical incision line and shows clinical manifestation especially during menstrual cycle. However, primary abdominal wall endometriosis is seen very rarely and it is a condition developing without a previous history of surgery. In this paper, we aimed to provide a contribution to the theories of pathogenesis of the disease by presenting two cases of primary abdominal wall endometriosis in two patients without previous history of surgery...
March 2018: Il Giornale di Chirurgia
https://www.readbyqxmd.com/read/29694310/superior-vena-cava-syndrome-due-to-central-port-catheter-thrombosis-a-real-life-threatening-condition
#4
G D Lianos, N Hasemaki, E Tzima, G Vangelis, A Tselios, I Mpailis, E Lekkas
Superior vena cava syndrome (SVCS) represents undoubtedly a rare life-threatening condition. Herein, we present a rare case of a 69-year-old woman, with a history of hepatic flexure tumor and an indwelling central venous port, presenting with acute signs and symptoms of SVCS due to thrombosis of the catheter. The patient was treated with intravenous anticoagulation and fibrinolytic therapy and showed regression of symptoms. It is reported that central venous catheters are routinely used in clinical practice mainly in oncological cases for chemotherapy, parenteral nutrition or dialysis...
March 2018: Il Giornale di Chirurgia
https://www.readbyqxmd.com/read/29694309/malakoplakia-of-the-large-intestine-an-incidental-extremely-rare-finding
#5
C Koutserimpas, A Ioannidis, M Demonakou, P Siaperas, A Skarpas, G Velimezis, I Karanikas
Malakoplakia is a rare inflammatory disease, most commonly found in the urinary tract. It appears be related to a functional deficiency of macrophages, resulting in an inability to destroy digested bacteria and it is associated with various conditions that cause immunodeficiency. A rare case of malakoplakia of the colon in a healthy 68-year old male is presented. The patient underwent emergency surgery with colon resection and an end stoma with closure of the distal bowel (Hartmann's procedure), due to incarcerated ventral hernia and sigmoid-colon rupture...
March 2018: Il Giornale di Chirurgia
https://www.readbyqxmd.com/read/29694308/severe-neurological-complication-following-adjustable-gastric-banding
#6
G Martines, N Musa, F Aquilino, P Capuano
AIM: In the last years with the increase of bariatric surgery, first of all as a result of new indications, a rise in the incidence of nutrient-related complications has been observed. Currently little is known about the impact of post-bariatric malnutrition and neurological complications. Wernicke's encephalopathy is a severe neurological syndrome which occurs as a result of thiamine deficiency. Wernicke-Korsakoff syndrome must be considered a serious neurological complication of bariatric surgery with significant morbidity and mortality, with rapidly progressing neurological symptoms, and must be treated immediately...
March 2018: Il Giornale di Chirurgia
https://www.readbyqxmd.com/read/29694307/laparoscopic-cholecystectomy-for-acute-cholecystitis-are-intended-operative-approach-timing-and-outcome-affected-by-bmi-a-multicenter-retrospective-study
#7
A Lauro, S Vaccari, M Cervellera, Giuseppina Casella, V D'Andrea, F M Di Matteo, A Panarese, A Santoro, R Cirocchi, V Tonini
BACKGROUND: Laparoscopy is the gold-standard for cholecystectomy after acute cholecystitis, but the issue is controversial in obese subjects. PATIENTS AND METHODS: We reviewed 464 patients operated for acute cholecystitis (59 open and 405 laparoscopic) over the last five years at St Orsola University Hospital-Bologna and Umberto I University Hospital-Rome, comparing retrospectively: 1) BMI < 30 (397 patients) and BMI =/> 30 (67 patients) and moreover 2) BMI < 25 (207 patients) and BMI =/> 25 (257 patients)...
March 2018: Il Giornale di Chirurgia
https://www.readbyqxmd.com/read/29694306/totally-laparoscopic-resection-and-extraction-of-specimens-via-transanal-route-in-synchronous-colon-and-gastric-cancer
#8
F Sumer, S Karakas, E Gundogan, T Sahin, C Kayaalp
INTRODUCTION: Synchronous colon and gastric cancer is a rare clinical entity. In the present case, it is aimed to show that in a patient with synchronous colon and gastric cancer, laparoscopic resection can be safely performed and both specimens can be delivered through a natural orifice. In our knowledge, this is the first example showing the delivery of the gastric resection specimen through the anus in a human being. CASE REPORT: Sixty-six years old male patient with an upper gastrointestinal bleeding and obstruction symptoms was admitted to our department and the evaluation revealed an advanced stage gastric and a synchronous colon cancer...
March 2018: Il Giornale di Chirurgia
https://www.readbyqxmd.com/read/29694305/the-use-of-local-anesthesia-to-perform-lower-limb-revascularization-in-the-fragile-patient-with-critical-limb-ischemia
#9
N Kontopodis, A Papaioannou, E Tavlas, G Papadopoulos, S Lioudaki, K Tzirakis, C V Ioannou
Patients with critical limb ischemia are usually compromised, frequently making administration of general or regional anesthesia problematic. We treated 3 fragile patients presenting contraindications to undertake traditional anesthetic techniques for lower limb revascularization, in whom local anesthesia with conscious sedation was used to complete the operation. An axillo-bifemoral, a unilateral axillo-femoral and a femoro-femoral bypass were performed. Procedure was uneventful in all three cases despite the coexistence of specific surgical challenges (distal anastomosis at the profunda in two cases, redo surgery and scarred groin in the third)...
March 2018: Il Giornale di Chirurgia
https://www.readbyqxmd.com/read/29694304/does-the-internet-provide-patients-or-clinicians-with-useful-information-regarding-faecal-incontinence-an-observational-study
#10
C A Leo, J Murphy, J D Hodgkinson, C J Vaizey, Y Maeda
BACKGROUND: The Internet has become an important platform for information communication. This study aim to investigate the utility of social media and search engines to disseminate faecal incontinence information. METHODS: We looked into Social media platforms and search engines. There was not a direct patient recruitment and any available information from patients was already on public domain at the time of search. A quantitative analysis of types and volumes of information regarding faecal incontinence was made...
March 2018: Il Giornale di Chirurgia
https://www.readbyqxmd.com/read/29549684/lipoma-of-the-transverse-colon-covered-by-tubulovillous-adenoma-a-rare-indication-for-surgical-treatment
#11
M Moschetta, R Virelli, F Laricchia, V Alberotanza, M Telegrafo, G Angelelli, A A Stabile Ianora
Lipomas of the digestive tract are rare benign tumours which, in most cases, are totally asymptomatic. Because of their localization within the intestinal wall, endoscopy may be completely negative so contrast-enhanced computed tomography (CT) is very important for detecting and typing these lesions. The case of a 49-year-old man with abdominal pain is presented. Colonoscopy and biopsy of a polypoid lesion on the right colonic flexure concluded for tubulovillous adenoma. The subsequent CT showed a polylobate lesion of 5 cm in diameter with predominant fat density causing luminal sub-stenosis...
January 2018: Il Giornale di Chirurgia
https://www.readbyqxmd.com/read/29549683/retroperitoneal-or-mesenteric-primary-liposarcoma-clinical-and-prognostic-evaluations-on-five-cases
#12
L Rosato, L Panier Suffat, L Bertotti, P Perino, E Comello, G Mondini
BACKGROUND: Retroperitoneal or mesenteric primary liposarcoma is a malignant neoplasia whose prognosis depends on the biological variants, the radical resection surgery and the histological subtypes, as well as on local and remote recurrences. Liposarcoma is the most common variant of this tumour among tumours of soft retroperitoneal tissue. The purpose of this study is to evaluate whether the treatment of this disease, carried out at the Ivrea Hospital for urgent reasons, may be considered in line with the experience of high-volume Centres...
January 2018: Il Giornale di Chirurgia
https://www.readbyqxmd.com/read/29549682/primary-thyroid-leiomyosarcoma-a-case-report-and-review-of-the-literature
#13
G L Canu, J S Bulla, M L Lai, F Medas, G Baghino, E Erdas, S Mariotti, P G Calò
Primary thyroid leiomyosarcoma (LMS) is an extremely rare tumor. We report a case of a 47-year-old male with a rapidly growing neck mass and disfagia. Preoperative investigations were diagnostic of anaplastic carcinoma. Total thyroidectomy with partial esophagectomy and dissection of right infrahyoid muscles was performed. Through histolological and immunohistochemical evaluations a primary thyroid high-grade LMS was diagnosed. At 2 months of follow-up a local recurrence was detected and consequently the patient was submitted to chemotherapy with partial response...
January 2018: Il Giornale di Chirurgia
https://www.readbyqxmd.com/read/29549681/update-on-sutureless-thyroidectomy
#14
R Ruggiero, G Docimo, A Bosco, M Lanza Volpe, G Terracciano, A Gubitosi, L Docimo
INTRODUCTION: The Harmonic scalpel ("Focus" and the new version "Focus+") is one of the first devices for surgical simultaneous cutting and tissue coagulation which allows to obtain dissection and hemostasis by direct application of ultrasound and allows minimally invasive surgical procedures with minimal lateral thermal spread and, thus, minimal adjacent tissue destruction. The aim of the study is to complete the previous study that we made in 2014, based on the TT performed between January 2008 and December 2013, with new data about TT performed in our Surgical Division between January 2014 and December 2016 and compare the outcome using the Ultrasonic scalpel versus the device Ligasure in term of safety, operative time, overall drainage volume, complications, hospital stay...
January 2018: Il Giornale di Chirurgia
https://www.readbyqxmd.com/read/29549680/bowel-wall-thickening-inquire-or-not-inquire-our-guidelines
#15
D Iadicola, P De Marco, S Bonventre, E M Grutta, G Barletta, L Licari, G Gulotta
INTRODUCTION: Bowel wall thickening is not an uncommon finding among patient undergoing abdomen CT scan. It may be caused by neoplastic, inflammatory, infectious or ischaemic conditions but also be a normal variant. Although specific radiologic patterns may direct to a precise diagnosis, occasionally misidentification may occur. Thus, in the absence of guidelines, further and not always needed diagnostic procedures (colonoscopy, esophagogastroduodenoscopy or capsule endoscopy) are performed...
January 2018: Il Giornale di Chirurgia
https://www.readbyqxmd.com/read/29549679/trauma-in-elderly-patients-a-study-of-prevalence-comorbidities-and-gender-differences
#16
M Gioffrè-Florio, L M Murabito, C Visalli, F P Pergolizzi, F Famà
AIM: Trauma, in geriatric patients, increases with age, and is a leading cause of disability and institutionalization, resulting in morbidity and mortality. The aim of our study was to analyse the prevalence of trauma, the related risk factors, mortality and sex differences in the prevalence in a geriatric population. PATIENTS AND METHOD: We observed 4,554 patients (≥65 years) with home injuries or car accidents. Patients were evaluated with ISS (Injury Severity Score) and major trauma with ATLS (Advanced Trauma Life Support)...
January 2018: Il Giornale di Chirurgia
https://www.readbyqxmd.com/read/29549678/higher-cost-of-single-incision-laparoscopic-cholecystectomy-due-to-longer-operating-time-a-study-of-opportunity-cost-based-on-meta-analysis
#17
F Fuertes-Guirò, M Girabent-Farrés
BACKGROUND: We aimed to calculate the opportunity cost of the operating time to demonstrate that single incision laparoscopic cholecystectomy (SILC) is more expensive than classic laparoscopic cholecystectomy (CLC). METHODS: We identified studies comparing use of both techniques during the period 2008-2016, and to calculate the opportunity cost, we performed another search in the same period of time with an economic evaluation of classic laparoscopy. We performed a meta-analysis of the items selected in the first review considering the cost of surgery and surgical time, and we analyzed their differences...
January 2018: Il Giornale di Chirurgia
https://www.readbyqxmd.com/read/29549677/the-abdominal-wall-incisional-hernia-repair-in-cirrhotic-patients
#18
L Licari, G Salamone, G Ciolino, S Campanella, Z Parinisi, C Sabatino, F Carfì, S Bonventre, G Gulotta
BACKGROUND: The incidence of abdominal wall hernia in cirrhotic patients with ascites is between 20 and 40%. Controversies regarding the treatment modality and surgical timing of abdominal wall incisional hernia repair in cirrhotic patients remain. The study proposed wants to analyze the abdominal incisional hernia repair in cirrhotic patients with ascites performed in a single center to determine post-operative morbidity, mortality and complication rate. PATIENTS AND METHODS: Cirrhotic patients with abdominal incisional hernia that underwent surgical operation for abdominal wall hernia repair at the "Policlinico Paolo Giaccone" at Palermo University Hospital between January 2015 and December 2016 were identified and the data collected were retrospectively reviewed; patients' medical and surgical records were collected from charts and the surgical and ICU registries...
January 2018: Il Giornale di Chirurgia
https://www.readbyqxmd.com/read/29549676/validation-of-memorial-sloan-kettering-cancer-center-nomogram-to-detect-non-sentinel-lymph-node-metastases-in-a-united-kingdom-cohort
#19
A Syed, S Eleti, V Kumar, A Ahmad, H Thomas
AIM: Axillary lymph node dissection, although associated with long-term morbidity, has been the standard of treatment for all nodepositive breast cancer patients. We assessed the risk prediction ability (validity) of Memorial Sloan Kettering Cancer Center (MSKCC) nomogram for non-sentinel lymph node metastases and analysed the outcome of patients with sentinel node metastases. PATIENTS AND METHODS: All operable early breast cancer patients with sentinel node macro metastases (size > 2mm) who underwent axillary dissection from April 2009 to March 2015 were considered eligible...
January 2018: Il Giornale di Chirurgia
https://www.readbyqxmd.com/read/29549675/surgeon-volume-and-hospital-volume-in-endocrine-neck-surgery-how-many-procedures-are-needed-for-reaching-a-safety-level-and-acceptable-costs-a-systematic-narrative-review
#20
REVIEW
G Melfa, C Porello, G Cocorullo, C Raspanti, G Rotolo, A Attard, R Gullo, S Bonventre, G Gulotta, G Scerrino
The relationship between quality of care and provider's experience is well known in all fields of surgery. Even in thyroidectomies and parathyroidectomies, the emphasis on positive volume-outcome relationships is believed. It led us to an evaluation of volume activity's impact in terms of quality of care. A systematic narrative review was performed. According to the PRISMA criteria, we selected 87 paper and, after the study selection was performed, 22 studies were finally included in this review. All articles included were unanimous in attributing to activity volume of surgeons as well as centers a substantial importance...
January 2018: Il Giornale di Chirurgia
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