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Il Giornale di Chirurgia

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https://www.readbyqxmd.com/read/29549684/lipoma-of-the-transverse-colon-covered-by-tubulovillous-adenoma-a-rare-indication-for-surgical-treatment
#1
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
#2
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
#3
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
#4
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
#5
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
#6
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
#7
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
#8
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
#9
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
#10
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
https://www.readbyqxmd.com/read/29442066/-28%C3%A2-congresso-chirurgia-dell-apparato-digerente-14%C3%A2-corso-per-infermieri-di-sala-operatoria-presidente-prof-giorgio-palazzini-roma-23-24-novembre-2017
#11
https://www.readbyqxmd.com/read/29442065/-steven-d-wexner-james-w-fleshman-chirurgia-del-colon-e-del-retto-operazioni-addominali-piccin-padova-2015-steven-d-wexner-james-w-fleshman-chirurgia-del-colon-e-del-retto-operazioni-anorettali-piccin-padova-2015
#12
https://www.readbyqxmd.com/read/29442064/pilonidal-disease-mimicking-anterior-anal-fistula-and-associated-with-posterior-anal-fistula-a-two-step-surgery-case-report
#13
Chiara Eberspacher, D Mascagni, L Fralleone, G Grimaldi, P Antypas, P Mascagni, A Maturo, F M Di Matteo, S Pontone, D Pironi
AIM: Anal fistula is a common disease originated from abscess according the cryptoglandular theory. A rare etiology is the pilonidal disease. In our case we observed a pilonidal disease mimicking an anterior perianal fistula, associated with another posterior anal fistula. CASE PRESENTATION: A 36-year old man was referred to our department with an anal fistula with an anterior opening. Despite the clinical examination and the endoanal ultrasound, only during the surgery we discovered the origin of the anterior fistula from a misdiagnosed pilonidal sinus...
November 2017: Il Giornale di Chirurgia
https://www.readbyqxmd.com/read/29442063/bowel-perforation-in-crohn-s-disease-correlation-between-cdai-and-clavien-dindo-scores
#14
T Fontana, N Falco, M Torchia, R Tutino, G Gulotta
BACKGROUND: Many studies have elaborated different kind of activity indices for Crohn's Disesase (CD) with the endpoint of univocally measure and evaluate the gravity of its lesions and symptoms. AIM: Purpose of this work is to study and define the correlation that runs between the preoperative score obtained at the Crohn's Disease Activity Index, the occurrence of postoperative complications that will require re-intervention and the severity of the postoperative lesions evaluated using the Clavien-Dindo score...
November 2017: Il Giornale di Chirurgia
https://www.readbyqxmd.com/read/29442062/gallstone-ileus-in-a-ninety-two-years-old-colecistectomized-patient-after-endoscopic-biliary-sphincterotomy-a-case-report
#15
S Fedele, P Lobascio, G Carbotta, G Balducci, R Laforgia, M G Sederino, M Minafra, A Delvecchio, N Palasciano
INTRODUCTION: Gallstone ileus is an uncommon condition of mechanical bowel obstruction caused by the passage of a gallstone into the bowel. It occurs more frequently in female patients older than 65 years and often for a biliary-enteric fistula. The pathognomonic features of gallstone ileus - the Rigler's triad - are pneumobilia, ectopic gallstone and bowel obstruction. Less commonly, a gallstone may enter the intestinal lumen through the common bile duct, after endoscopic retrograde cholangiopancreatography, and very rarely in colecistectomized patient...
November 2017: Il Giornale di Chirurgia
https://www.readbyqxmd.com/read/29442061/unusual-presentation-of-retroperitoneal-schwannoma-case-report
#16
R Latino, Daniela Bosco, M E Frattallone, A Amico, R Lanteri, A Di Cataldo
Schwannoma is a rare tumor that develops from the Schwann cells in the nerve sheath. A 42 years old woman was found incidentally to have a bulky mass in epigastric region. Abdominal ultrasonography CT and MRI have been of aid to know the position and size of the tumor. A massive capsulated retroperitoneal lesion was identified. It moved forward the hepatoduodenal ligament, inferior vena cava laterally and aorta medially. The mass is exte-riorized and detached from adhesions. There were no complications after the operation and the patient was discharged on the fourth post-operative day...
November 2017: Il Giornale di Chirurgia
https://www.readbyqxmd.com/read/29442060/thyroid-hemiagenesis-associated-with-multinodular-goiter-and-hashimoto-s-thyroiditis
#17
Daniela Bosco, A Cammarata, R Cannarella, R Latino, R Lanteri, A Di Cataldo, A Calogero
Thyroid hemiagenesis is a rare congenital abnormality in which one of the thyroid lobes is not developed. It can be associated with various thyroid diseases, such as Grave's disease, nodular goiter and thyroid neoplasm, rarely with hyperparathyroidism. We report a case of a 50-year old woman with left thyroid lobe agenesis diagnosed by ultrasonography and scintigraphy. Right thyroidectomy was performed and the histopathological examination showed diffuse hyperplasia, multinodular goiter and Hashimoto's thyroiditis...
November 2017: Il Giornale di Chirurgia
https://www.readbyqxmd.com/read/29442059/modified-transverse-coloplasty-pouch-new-reconstruction-techniques-after-total-mesorectal-excision-our-experience
#18
G Grimaldi, Chiara Eberspacher, A M Romani, D Merletti, A Maturo, S Pontone, D Pironi
AIM: The incidence of rectal cancer continues to rise. The functional results after complete Total Mesorectal Excision (TME) depend on the segment of colon used for reconstruction of colonic continuity and the form, the volume and the functional proprieties of the "neorectum". The aim of our study is evaluate the efficacy of our Modified Transverse Coloplasty Pouch (MTCP) after the treatment of low rectal cancer in terms of functional outcomes and quality of life. PATIENTS AND METHODS: The study included 136 patients, underwent TME from January 2007 to December 2016 with diagnosis of extraperitoneal carcinoma of the rectum...
November 2017: Il Giornale di Chirurgia
https://www.readbyqxmd.com/read/29442058/multiparametric-evaluation-of-risk-factors-associated-to-seroma-formation-in-abdominal-wall-surgery
#19
L Licari, G Salamone, Z Parinisi, S Campanella, C Sabatino, G Ciolino, P De Marco, N Falco, S Boventre, G Gulotta
INTRODUCTION: Incisional hernia is one of the main topics in the general surgery since there is not a unanimous consensus concerning to the best surgical methodology to adopt. It seems that prosthetic surgery is the best technique, even if responsible for the development of periprosthetic seroma. The aim of this study is to assess whether the preoperative abnormalities of the bio-humoral parameters may be considered as risk factors for seroma. PATIENTS AND METHODS: From July 2016 to July 2017 at the "Policlinico Paolo Giaccone", Palermo, Department of Emergency Surgery, 56 patients included in this study, underwent laparotomic mesh repair...
November 2017: Il Giornale di Chirurgia
https://www.readbyqxmd.com/read/29442057/inguinal-hernia-repair-in-day-surgery-the-role-of-mac-monitored-anesthesia-care-with-remifentanil
#20
P Palumbo, S Usai, C Amatucci, B Perotti, L Ruggeri, G Illuminati, G Tellan
BACKGROUND: The extension of indications for procedures in a Day Surgery (DS) setting has led to changes in the anesthetic and surgical treatment of Inguinal Hernias (IH). According to the recommendations of the European Hernia Society, the treatment of IH in DS units should be performed under Monitored Anesthesia Care (MAC). PATIENTS AND METHODS: 960 patients underwent IH repairs over a period of 24 months. The patients were randomly divided into two groups: R (remifentanil) and F (fentanyl); the group F was considered as a control group...
November 2017: Il Giornale di Chirurgia
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