Complications of videolaparoscopic cholecystectomy: a retrospective analysis of 1037 consecutive cases.

The authors describe some of the complications that appear more frequently with laparoscopic cholecystectomy than open cholecystectomy and the mechanisms underlying the occurrence of bile duct injuries, making reference to 0.58% of bile duct injuries in 1037 consecutive laparoscopic cases and the possibility of treatment.

[Pelvic masses in young women: a case of giant uterine fibroleiomyomatosis].

The authors reported a particular case of giant uterine fibroleiomyomatosis in young women and describe some clinical feature and differential diagnoses.

[Surgical complications of the diverticular disease. A rare case of sigmoid-vaginal fistula].

The Authors report on a rare case of diverticular disease complicated by a sigmoid- vaginal fistula with personal considerations based on a review of literature. A 75 year old patient becomes to our observation suffering the lost of smelly vaginal secretions without fever or abdominalgia. In anamnesis hysterectomy cholecystectomy appendectomy and visceral adhesions lysis.

[Nasogastric tubes: a lot of bother].

The insertion of the nasogastric tube is one of the procedure that produces the most discomfort for the patients and practitioners. The AA, with the make use of their clinical experience and the data of the literature, report some personal reflections about the management of the nasogastric tube. The AA also analyse some variables (choice of the tube, approach to the patient, insertion of the tube, examination of the position, fixation and removal) that can influence on discomfort of the patient.

[Amyand's hernia. Case report].

The authors report a case of Amyand's hernia and describe the pathophysiology, the diagnosis and the therapy in occurrence of this surgical condition.

[A rare case of intestinal carcinoid tumour. Clinical considerations and therapeutic approach].

The AA report on a case of intestinal carcinoid tumour. The characters of these tumours to permit a specific clinical and therapeutic approach.

[Use of Tachosil in splenectomy in patients with clotting and blood composition disorders].

Unlabelled: Splenectomy in patients suffering from onco-haematological conditions presents clotting-related problems which make correct haemostasis more difficult. Using operative haemostasis during splenectomy for onco-haematological conditions as a starting point, the authors report their personal clinical experience of the use of Tachosil, comparing it with other similar products and drawing some personal

Conclusions: To complete their reflexions on clotting problems during splenectomy in the course of onco-haematological diseases, the comparison with its use in oncological pathologies in other parenchymas, such as the kidney and liver, which also present operative haemostatic difficulties of a technical nature, is pointed out and the soundness of the results indicated. The cases of 3 patients suffering from severe clotting disturbances and treated with splenectomy and 1 patient suffering from clear cell renal carcinoma and subjected to nephrectomy in which Tachosil was used as an aid to haemostasis are reported.

[A surgical emergency: iatrogenic lesion of the spleen. Case report and review of the literature].

The spleen is an organ often injured during surgical procedures. Iatrogenic lesions belong frequently to a low grade and can be treated with a conservative therapy. The surgeon may avoid the splenectomy by using new haemostatic agents as the patch of fibrinogen and thrombin in fixed combination.

[Gynaecological pelvic mass. Emergency clinical assessment].

Background: The authors report the gynaecological pathology of surgical interest occurring in an Emergency Department in the first half of 2000 and occasionally found during an operation in women who presented a pelvic mass or abdominal pain.

Methods: Six women, average age of 50 years, reached the Emergency Department: five of them were operated with an emergency procedure.

Results: Of the 6 cases, 1 patient was affected by uterine mass, 1 by uterine-ovarian mass and 3 by ovarian mass; in one patient, affected by ovarian tumour, another intervention was necessary for intestinal metastasis.

[CT pulmonary density mapping: surgical utility].

Background: The present paper considers the technique of CT scan maps of pulmonary isodensity, examining lung density differences as a function of the type of disease and considering their significance for the purposes of refined, useful diagnosis in a surgical context. METHODS. The method is used to examine 3 groups of subjects selected on a clinical/anamnestic basis and a further group already admitted for surgery.

[Hemorrhoids: epidemiology and correlation with chronic constipation].

Following a review of international literature, AA report main results and refer their opinion about the correlation of hemorrhoidal disease with constipation, considering some variants as well as age, sex, breed, social-economic condition and geographic distribution in USA, England and Wales. Epidemiologically ten millions of people, in USA, are affected by hemorrhoidal disease; the incidence rate is 4.4% with an age distribution that shows a prevalence between 45-65 years old subject while constipation has an exponential increase with aging.

[Rupture of the urinary bladder caused by trivial trauma. Case report].

The urinary bladder occupies the deep pelvic cavity and is well protected from the bacin: this is the reason why it can rarely be traumatized. Anyway it could suffer traumas, which can cause extraperitoneal and intraperitoneal ruptures. A classification of traumas that can injure the urinary bladder and the treatments of these lesions are presented.

Single stage repair of symptomatic type IV thoracoabdominal aortic and iliac aneurysm in Behçet's disease. Case report.

A 50-year-old man with Behçet's disease (BD) diagnosed ten years previously, was submitted to emergency operation of two symptomatic type IV thoracoabdominal aortic and left common iliac aneurysms repair. Despite the rarity of vascular lesions in the course of BD, the uncommon clinical situation of double symptomatic aneurysms was successfully treated with surgical management that appears more difficult because of the inflammatory process associated with obliterative endoarteritis involving all periaortic tissues.

[Combined complex surgical procedures: cardiovascular and general surgery].

Background: Aim of the paper is to evaluate the surgical indication in patients with cardiac and concomitant pathology.

Methods: In this study, are examined ten combined surgical sessions performed from 1992 at 1999, in patients affected by both cardiac and neoplastic disease with surgical indication. Eight men and two women, mean age 59.

Antonio Scarpa and the discovery of the membranous inner ear.

Objective: To give a historical perspective of Antonio Scarpa's contributions to otology, specifically the discovery of the inner ear organs as the foundation for the experimental work that followed.

Background/method: Scarpa's original descriptions of the human inner ear were translated from the Latin text, and his illustrations were analyzed and compared with current knowledge.

Conclusions: Antonio Scarpa's anatomic and clinical studies place him among the great scientists of the eighteenth century.

[Biliary complications during videolaparoscopic cholecystectomy. Remarks on methodology and indications in the training period].

In our study we have considered the activity of a surgeon working in our Surgery Department during his laparoscopic training period. We focus our attention on a date related to the same complications checked in 27 cases of cholelithiasis operated by the same surgeon. We have observed three cases of biliary cholelithiasis fistulas, all of them during the three last operations.

[Hemorrhoid disease. Physiopathology, etiopathology and surgical approach].

The authors report a number of cases of hemorrhoid disease and describe the therapeutic iter followed with particular reference to the surgical approach used. After a description of the physiopathological aspects linked to the disease, bearing in mind the use of electromanometry and electromyography in diagnosis, the authors underline the contemporary presence of varices in the lower limbs and hemorrhoid disease, as well as the frequent finding of hemorrhoids in a syndrome of portal hypertension. They then affirm how it is impossible to establish the causes of this pathology with any certainty and how a single standardised treatment plan is untenable.

[Medullary carcinoma of the thyroid. A clinical case].

A case of medullary thyroid carcinoma is reported. Moreover, the main peculiarity, the correct diagnostic approach and the therapeutic indication of this rare pathology are described.

[Tracheobronchial ruptures in closed thoracic trauma].

Authors refer about their experience on five cases of thoracic trauma. Following a review of international literature, they analyze the clinical, diagnostic and therapeutic aspects of this kind of injuries.

Tumor interstitial fluid: misconsidered component of the internal milieu of a solid tumor.

The tumor interstitial fluid (TIF) is a fluid phase present in the extracellular space of all tumors whose importance in oncology is seldom recognized. In order to stimulate other researchers to give it the due importance, a review of the available data (including our own) is provided. An hypothesis is presented for the genesis, fate and role of the TIF in the processes of invasion, growth and metastatization.

Characterization of the metabolism of perinecrotic cells in solid tumors by enzyme histochemistry.

Hypoxic tumor cells resist most therapies and cause tumor regrowth when their environment improves. Identifying the adaptation strategies to hypoxia would help develop better tailored cancer therapies. Ehrlich carcinomas implanted on mice were analyzed histochemically for the following enzyme activities: lactate, succinate and glucose-6-phosphate dehydrogenases, dihydrofolate reductase, purine nucleoside phosphorylase, xanthine oxidoreductase, and acid phosphatase.

[Traumatic tearing of the mesentery: immediate or deferred emergency surgery].

We have considered a 1 year first-aid survey and focused a 6 checked mesentery vascular traumatic tearing cases. We have valued some hypotheses on pathogenic mechanism assumptions about these vascular injuries in abdomen trauma. Among these, we have focused our attention on the relationship between visceral stretching from alimentary bolus and abdominal vascular trauma.