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Il Giornale di Chirurgia

I Karanikas, C Koutserimpas, P Siaperas, A Skarpas, J Karoubalis, G Velimezis
AIM: Two-dimensional transrectal ultrasonography can nowadays be safely used for preoperatively evaluation of perianal fistulas. The aim of this study is to demonstrate its efficacy by comparing the results of this imaging technique with the surgical findings, as well as recurrence rates. PATIENTS AND METHODS: A 4-year retrospective study with a mean follow-up of 4.7 years was performed, including patients treated surgically for a perianal fistula at the surgical department of a tertiary secondary hospital...
July 2018: Il Giornale di Chirurgia
M S Antonelli, G Mallel, A Pecoraro, V Vitale, S Maggi, A Lombardi, G Stanzani, C Amanti
Adenomyoepithelioma are uncommon tumors. The majority of them occur in women in the fifth and sixth decades who usually present with a self-palpated, solitary breast mass or a lesion identified on mammography. We report the case of adenomyoepithelioma of the breast with malignant transformation of both myoepitheliel and epithelial components diagnosed as malignancy during the preoperative stage in a seventy-six year old woman.
July 2018: Il Giornale di Chirurgia
G Bruno, P Trentino, M A Viarengo, A Toma, C Virili, M Centanni, A Picarelli, P Gozzo, F Accarpio, B Porowska
The prevalence of sporadic duodenal polyps is estimated to be 0.3%-4.6% in patients referred for an upper endoscopy. Most of patients are asymptomatic (66-80%) at the time of diagnosis though bleeding, anemia and abdominal pain are the most commonly reported symptoms. These are related to the polyp's size, location and histological characteristics. We describe three cases of big, pedunculated nonampullary sporadic duodenal polyps (tubulovillous low-grade dysplasia adenomas) located in the second part of the duodenum and characterized by different clinical presentations, managed in our Endoscopic Unit within one year (between 2016 and 2017)...
July 2018: Il Giornale di Chirurgia
C Grigoriadis, A Tympa, E Terzakis, K Theodoraki, D Hassiakos
AIM: According to the so far published literature, only one case of endometrial cancer in a patient with unicornuate uterus has been reported. This is a case report study, presenting a rare case of complex atypical endometrial hyperplasia in a woman with unicornuate uterus and multiple genitourinary anomalies. CASE REPORT: A 43-year old G1P1 woman presented with episodes of menometrorrhagia and anemia. She had previous surgical history of laparoscopy due to infertility, in which she was diagnosed with unicornuate uterus with a rudimentary left uterine horn and ipsilateral ectopic ovary in the anatomic place of the left kidney...
July 2018: Il Giornale di Chirurgia
S Izzo, L Izzo, P Di Cello, G Sinaimeri, A De Santis, F Razionale, U Costi, R Gabriele, S Valabrega, F Pugliese, P Izzo
INTRODUCTION: Although the intervention of knee arthroplasty became routine, there is no standard reference on the densitometric characteristics of the patella before and after surgery. Scope of this work is the evaluation of patellar bone density before and after unilateral knee arthroplasty. PATIENTS AND METHODS: BMD was assessed by DEXA examination in 146 individuals, who have been divided into three distinct groups. Group I: 68 subjects with a mean age of 70...
July 2018: Il Giornale di Chirurgia
S Vaccari, A Lauro, M Cervellera, Giuseppina Casella, V D'Andrea, F M Di Matteo, A Santoro, A Panarese, E Gulotta, R Cirocchi, A Ussia, M Brighi, A Romano, V Tonini
BACKGROUND: Discussion regarding the timing of cholecystectomy for acute cholecystitis is still ongoing. This study evaluates the outcomes of patients who underwent surgery for acute cholecystitis after emergency admission at St. Orsola University Hospital of Bologna and Umberto I Hospital La Sapienza University of Rome. PATIENTS AND METHODS: . We performed a retrospective study on 464 patients who underwent cholecystectomy for acute cholecystitis. We divided patients in three groups based on the time elapsed between the onset of symptoms and surgery: within 72 hours (Group A), between 72 hours and 6 weeks (Group B) and after 6 weeks (Group C)...
July 2018: Il Giornale di Chirurgia
R Malagola, S Collini, F Troisi, R Giannotti, L Arrico
PURPOSE: To evaluate the advantage of peribulbar anesthesia in two quadrants (infero-temporal and upper nasal) vs single injection technique (infero-temporal) for scleral rhegmatogenous retinal detachment surgery (RRD). PATIENTS AND METHODS: 57 patients, aged between 33 and 75 years (57.01 ± 8.68), waiting for retinal detachment surgery, were randomized in two groups: a group S (29 patients), with single quadrant injection technique and a group C (28 patients) with two quadrants injection...
July 2018: Il Giornale di Chirurgia
L Licari, G Salamone, S Campanella, C Sabatino, G Ciolino, Z Parinisi, F Carfì, P De Marco, G Gulotta
INTRODUCTION: The surgical techniques described to approach the incisional hernia repair are various and there is not consensus about which of them to use. The Intra-Peritoneal Onlay Technique (IPOM) with classic mesh positioning is burdened by high post-operative complication rate. The study shows the preliminary results of a novel technique of open IPOM mesh positioning with "percutaneous" approach. PATIENTS AND METHODS: From January 2010 to December 2016 patients with abdominal wall incisional hernia that underwent surgical operation via open mesh technique for abdominal wall hernia repair at the "Policlinico Paolo Giaccone" at Palermo University Hospital were identified and the data collected were retrospectively reviewed; patients' medical and surgical records were collected from charts and the surgical registries...
July 2018: Il Giornale di Chirurgia
E Zumrutdal, T Tolga Sahin, Ö Kulahci, T Bilecik, Ö Temiz, S Cetinkunar, N Turut, K Daglioglu, Y Canbolat, S Akbulut
OBJECTIVE: The aim of this study was to neutralize acidic pH using an alkaline dialysate for continuous ambulatory peritoneal dialysis (CAPD) in mice with peritoneal carcinomatosis (PC) and to investigate the change of the pH level in the acidic fluid along with its effects on liver oxidative stress, liver and kidney histopathology and the lifespan of the body. MATERIALS AND METHODS: A total of 38 mice were randomly divided into 4 groups.PC development was inhibited by intraperitoneal injection of Ehrlich tumor cells in all mice in each group...
July 2018: Il Giornale di Chirurgia
A Toro, G Stella, A Gueli, M Mannino, M Teodoro, E Schembari, F Palermo, I Di Carlo
INTRODUCTION: The Mayo technique is one of the most common techniques used to repair incisional, umbilical, and epigastric hernias. A high percentage of recurrences, together with the use of particular expensive types of meshes, are some of the most relevant problems in this surgical field. PATIENTS AND METHODS: This study is a clinical prospective observational and involves all the patients who underwent procedures using a new modified Mayo technique from 2006 through 2013...
July 2018: Il Giornale di Chirurgia
G Cochetti, M Del Zingaro, A Boni, D Cocca, M Panciarola, Alessandra Tiezzi, G Gaudio, F Balzarini, P Ursi, E Mearini
Colovesical fistula (CVF) is an abnormal communication between bowel and urinary bladder. Main causes are represented by complicated diverticular disease, colonic and bladder cancer and iatrogenic complications. Diagnosis is often based on patognomonic signs: faecaluria, pneumaturia and recurrent urinary tract infections. Treatment of CVF includes non-surgical and surgical strategy. The non-surgical treatment is reserved to selected patients who are unfit for surgery. Surgery of CVFs is determined by the site of the colonic lesion and patient's comorbidity...
July 2018: Il Giornale di Chirurgia
F Tatulli, A Delcuratolo, A Caraglia, A Notarnicola, F P N Carbone, A Caputi
INTRODUCTION: Laparoscopy is perceived as the state-of-the-art technique for a wide variety of operations but is contraindicated by comorbidities such as respiratory diseases. We present the case of a patient affected by asthma who underwent a successful three-trocar low-pressure pneumoperitoneum under spinal anesthesia. CASE REPORT: A 58 year-old male with symptomatic gallstones had partly-controlled asthma and respiratory allergies. Potential bronchospasm was avoided by a less invasive laparoscopic technique...
May 2018: Il Giornale di Chirurgia
M De Monti, L Pacchiarini, G Cestaro, G Peloni, F Fasoli
Intussusception is a rare condition in the adult population: it is responsible for 1% of all bowel obstructions. In most of intussusceptions a malignant tumor is involved; a lot of studies show that approximately 50% of malignant metastases causing small bowel intussusception are metastatic melanomas. In present paper a case of a small bowel intussusception probably due to metastases of an occult melanoma, in a 69-year-old patient, is presented. Surgery resection, careful research of possible primitive neoplasms and an accurate follow-up program has been the treatment of choice...
May 2018: Il Giornale di Chirurgia
A Tornambè, P S L Aiello, G Tornambè
Gallbladder cancer is the most frequent neoplasm originating from the extrahepatic biliary tract, with characteristics of late presentation and rapid progression. We report the case of a 58 years old female patient with concomitant small cell carcinoma and adenocarcinoma of the gallbladder, incidentally reported after a cholecystectomy performed for cholelithiasis. According to the stage of the disease, we performed a second surgical procedure with laparotomy, resection of the liver parenchyma IVb and V and regional lymphadenectomy...
May 2018: Il Giornale di Chirurgia
A Ioannidis, I Karanikas, C Koutserimpas, G Velimezis
Littre hernia is defined as the herniation of a Meckel's diverticulum, while Richter's hernia is the herniation of a portion of the bowel wall. An extremely rare case of a combined Littre and Richter's femoral hernia is reported. An 82-year-old male presented at the emergency department with a painful golf ball-like mass at the right inguinofemoral region. With the diagnosis of incarcerated femoral hernia, he was urgently taken to the operating room. Intraoperatively, an incarcerated Littre, as well as a Richter's hernia were revealed...
May 2018: Il Giornale di Chirurgia
R Ruggiero, A Bosco, R Pirozzi, M C Bondanese, G Gualtieri, L Docimo
Papillary thyroid microcarcinoma (PTMC) typically has an indolent behavior with a good prognosis but it is not always completely harmless. Surgical treatment varies from thyroid lobectomy to total thyroidectomy eventually associated with lymph node dissection and radioiodotherapy. The ability to identify patients with aggressive PTMCs from the majority of low risk patients is critical to planning proper clinical management. Several studies don't report any statistically significant differences about recurrence and mortality among patients undergone lobectomy and patients undergone total thyroidectomy...
May 2018: Il Giornale di Chirurgia
N Falco, T Fontana, D Scrivano, R Tutino, L Licari, C Raspanti, G I Melfa, G Cocorullo
AIM: The purpose of this work is to demonstrate the correlation between the p-POSSUM score and the severity of Crohn's Disease (CD) postoperative complications, evaluated by using the Clavien-Dindo score. PATIENTS AND METHODS: We have selected data of 22 patients (11 males, 11 females) that had been recovered in the Operative Unit of General Surgery of the University of Palermo General Hospital and undergone surgery for CD from 2010 to 2017. RESULTS: Patients who underwent surgery for complicated CD was divided in three different group on the base of Clavien Dindo score, C1 (Clavien-Dindo ≤ 1), C2 (Clavien Dindo = 2), and C3 (Clavien Dindo ≥ 3)...
May 2018: Il Giornale di Chirurgia
T Fontana, M Izzo, P Venturelli, V L Lentini, N Falco, L Gulotta, A M Florena, G Cocorullo
OBJECTIVE: This study aims to evaluate the percentage of cyto-histologic correlation in patients with a thyroid disease documented through clinical-instrumental, cytological (FNAB), histological and surgical examinations. The purpose of this study is also to determine the percentage of disease incidence and evaluating any surgical indication in relation to biological behavior (benign, malignant or indeterminate lesions, occult carcinomas), sex, and age. BACKGROUND: Almost all of thyroid neoplasms is manifested through thyroid nodule...
May 2018: Il Giornale di Chirurgia
L Lorenzon, F Bini, M Quatrale, A Biondi, R Persiani, M Di Pietropaolo, F Landolfi, E Iannicelli, F Marinozzi, G Balducci, D D'Ugo
AIM: Recent studies focused on rectal cancer suggested that a 3D imaging segmentation obtained from MRI data could contribute in the definition of the circumferential resection margin (CRM) and in the assessment of the tumor regression following neo-adjuvant treatments. Here, we propose a method for defining and visualizing the circumferential margins using 3D MRI segmentation; this methodology was tested in a clinical study comparing 3D CRM assessment vs standard MRI imaging. PATIENTS AND METHODS: MRI scans performed before neo-adjuvant treatments were selected and reviewed...
May 2018: Il Giornale di Chirurgia
M Assenza, D Rossi, I De Gruttola, C Ballanti
OBJECTIVE: The aim of this work is to evaluate the treatment strategies for a common major surgery complication like the enterocutaneous fistula (ECFs). Since there is not any standard treatment for this common disease and since new therapies, like NPWT and fibrin sealants, have come up a review of all their indications seemed useful. We also present two clinical cases treated in this way. PATIENTS AND METHODS: A research was made in the principle databases such as: "Cochrane", "Pubmed", "Google Scholar" and "Google" using the following Key words "enterocutaneous fistula", "fibrin glue", "VAC", "VAC treatment", "fistula", "conservative treatment", "surgery" and using the MESH Function to search similar key words and expand the research...
May 2018: Il Giornale di Chirurgia
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