EAES rapid guideline: surgical management of complicated diverticulitis - with ESCP participation.

Background: The surgical management of complicated diverticulitis varies across Europe. EAES members prioritized this topic to be addressed by a clinical practice guideline through an online questionnaire.

Objective: To develop evidence-informed clinical practice recommendations for key stakeholders involved in the treatment of complicated diverticulitis; to improve operative and perioperative outcomes, patient experience and quality of life through a systematic evidence-to-decision approach by a diverse, multidisciplinary panel.

Surgical management of complicated diverticulitis: systematic review and individual patient data network meta-analysis : An EAES/ESCP collaborative project.

Background: We performed a systematic review and network meta-analysis (NMA) of individualized patient data (IPD) to inform the development of evidence-informed clinical practice recommendations.

Methods: We searched MEDLINE, Embase, and Cochrane Central in October 2023 to identify RCTs comparing Hartmann's resection (HR), primary resection and anastomosis (PRA), or laparoscopic peritoneal lavage (LPL) among patients with class Ib-IV Hinchey diverticulitis. Outcomes of interest were prioritized by an international, multidisciplinary panel including two patient partners.

Prospective, randomised, multicentre, open-label trial, designed to evaluate the best timing of closure of the temporary ileostomy (early versus late) in patients who underwent rectal cancer resection and with indication for adjuvant chemotherapy: the STOMAD (STOMa closure before or after ADjuvant therapy) randomised controlled trial.

Introduction: Temporary ileostomy is a valuable aid in reducing the severity of complications related to rectal cancer surgery. However, it is still unclear what is the best timing of its closure in relation to the feasibility of an adjuvant treatment, especially considering patient-reported outcomes and health system costs. The aim of the study is to compare the results of an early versus late closure strategy in patients with indication to adjuvant chemotherapy after resection for rectal cancer.

Collision Tumor Composed of an Inflammatory Myofibroblastic Tumor and Adenocarcinoma of the Colon: a Rare Entity.

This report presents the case of an 83-year old man with a collision tumor consisting of an inflammatory myofibroblastic tumor (IMT) and adenocarcinoma of the left colon. As the clinical and radiologic features of IMT are non-specific, only the accurate histopathological examination from the left hemicolectomy specimen was diagnostic. Although the prognosis of a colorectal IMT seemed more favorable than in other sites, four months after surgery the patient developed a tumor relapse.

An example of lumpectomy for lower inner quadrant breast cancer with 1(st) level oncoplastic reconstruction by glandular splitting.

Oncoplastic techniques extend the scope for breast conserving surgery by combining an extensive local excision with a simultaneous reconstruction of the defect to avoid local deformity. If less than 20% of the breast volume is excised a level I procedure is adequate and can be performed by breast surgeon without specific training in plastic surgery. For breast cancer is possible to fill the defect of the lower inner lumpectomy by splitting the upper inner quadrant.

Use of oxidized and regenerated cellulose polymer in oncoplastic breast surgery.

Aim: The aim of this paper is evaluate the use of oxidized regenerated cellulose in order to control breast symmetry, shape and volume reducing skin retraction after wide excision for the treatment of early breast cancer.

Material Of Study: The Authors describe a new procedure using oxidized regenerated cellulose polymer after 8 resections for breast cancer and 1 total galactophore ducts resection for nipple discharge.

Discussion: Oncoplastic breast surgery allows a more radical local tumour excision achieving an acceptable cosmetic result.

Clinical presentation and risks.

Background: A recurrent episode of diverticulitis is a new distinct episode of acute inflammation after a period of complete remission of symptoms. Outdated literature suggested a high recurrence rate (>40%) and a worse clinical presentation with less chance of conservative treatment. More recent studies showed a more benign course with no need toward an aggressive policy of treatment.

[Haemorrhoidal disease: role of conservative outpatient treatments].

Aim: This study is a critical review of conservative office treatments of haemorrhoidal disease.

Material Of Study: Many are outpatient techniques proposed in current literature; several with small series, anecdotal ones or some ones yet abandoned for excessive morbidity (for example anal divulsion, dilatation and so on); among most used we describe procedure, indications, contraindications, results and limits about rubber band ligation, sclerotherapy, cryotherapy, infrared photocoagulation, bipolar diathermy and direct current therapy.

Results: Each method has its supporters, indications and limits; therefore in literature there are discordant opinions even when randomized studies are compared.

[Diverticular disease of the colon: diagnosis and treatment. Consensus Conference, 5th National Congress of the Italian Society of Academic Surgeons].

Diverticular disease (DD) is one of the most common disorders of the colon with an increased prevalence in Western populations. There are still many unsolved issues about indications, timing of surgery and modality of surgical treatment. These topics were discussed during the Consensus Conference (CC).

Right portal vein thrombosis after splenectomy for trauma.

Portal vein thrombosis may complicate splenectomy in patients with hemolytic anemia and myeloproliferative disease, whereas the frequency of portal vein thrombosis in case of trauma is not defined. A case of right portal vein thrombosis after splenectomy for trauma is reported in this paper. Hematologic workup did not reveal an underlying platelet or coagulation disorder.