Hernia repair with porcine small-intestinal submucosa.

Purpose: Although at present nonabsorbable meshes are the preferred material for tension-free hernioplasty, some problems with their use have yet to be addressed (i.e., chronic pain and infections).

Hernioplasty with Surgisis Inguinal Hernia Matrix (IHM).

Although at present nonabsorbable meshes are the preferred material for tension-free hernioplasty, some problems with their use are still to be addressed (i.e., chronic pain and infections).

Use of porcine dermal collagen graft (Permacol) for hernia repair in contaminated fields.

Background: Complicated hernias often involve contaminating surgical procedures in which the use of polypropylene meshes can be hazardous. Prostheses made of porcine dermal collagen (PDC) have recently been proposed as a means to offset the disadvantages of polypropylene meshes and have since been used in humans for hernia repairs. The aim of our study was to evaluate the safety and efficacy of incisional hernia repair using PDC as a mesh in complicated cases involving contamination.

Experimental evaluation of Surgisis as scaffold for neointestine regeneration in a rat model.

The aim of the study was to evaluate the use of Surgisis (Cook Biotech Inc.), a porcine derived extracellular matrix already used in tissue engineering, as a scaffold for neointestinal regeneration in a rat model. A 3-cm length of tubular Surgisis graft was interposed with bilateral anastomoses in the middle of an isolated ileal loop of Sprague Dawley rats with an ileostomy.

Skin angiosarcoma arising in an irradiated breast: case-report and literature review.

Background: Angiosarcoma (AS) is a rare, invasive malignancy originating from endothelial cells caused by many different clinical situations. AS following radiotherapy for breast cancer after conservative surgery is a rare but well-known association.

Objective: The aim of this article is to describe a case of AS after breast conserving surgery and to review the literature to date.

Small bowel tumours in emergency surgery: specificity of clinical presentation.

Background: Despite advances in diagnostic modalities, small bowel tumours are notoriously difficult to diagnose and are often advanced at the time of definitive treatment. These malignancies can cause insidious abdominal pain and weight loss, or create surgical emergencies including haemorrhage, obstruction or perforation. The aim of the present study was to describe the clinical presentation, diagnostic work-up, surgical therapy and short-term outcome of 34 patients with primary and secondary small bowel tumours submitted for surgical procedures in an emergency setting and to look for a correlation between clinical presentation and the type of tumours.

[Ruptured aortic aneurysm presenting as acute abdomen: particular case report].

Aim: Ruptured aortic aneurysm can be a cause of acute abdomen. Nowadays using modern diagnostic techniques diagnosis is very easy. We report a particular case of a misdiagnosed ruptured aortic aneurysm.

Postoperative Delirium after elective and emergency surgery: analysis and checking of risk factors. A study protocol.

Background: Delirum is common in hospitalized elderly patients and may be associated with increased morbidity, length of stay and patient care costs. Delirium (acute confusional state) is defined as an acute disorder of attention and cognition. In elderly patients, delirium is often an early indicator of patho-physiological disturbances.

Lichtenstein repair of inguinal hernia with Surgisis inguinal hernia matrix soft-tissue graft in immunodepressed patients.

While polypropylene mesh remains the preferred prosthesis material for hernioplasties, there are some problems with infections, intestinal obstruction and fistulization, and migration particularly in immunodepressed patients. A new degradable and reabsorbable material, the porcine small intestinal submucosa (Surgisis) has been developed for hernia repairs in humans. This prospective study evaluated the safety and efficacy of Lichtenstein hernioplasty using the Surgisis inguinal hernia matrix soft-tissue graft as a mesh in ten immunodepressed subjects.

Emergency surgery for recurrent intraabdominal cancer.

Background: Recurrent abdominal cancer can manifest in many ways but there are certain situations that are a great challenge to clinicians. Emergency presentation is one such situation. Surgeons are faced with a therapeutic dilemma that on the one hand most of these patients have a limited life expectancy, and on the other surgical procedures are unavoidable.

Necrotizing fasciitis: a dramatic surgical emergency.

Objectives: Necrotizing fasciitis is a challenging and potentially lethal disease; early diagnosis is of paramount importance and aggressive multidisciplinary treatment is mandatory. Overall mortality rates of 33-73% have been reported. The aim of this study was to report the experience with necrotizing fasciitis of an emergency surgery department.

Analytical performance and method comparison study of the total homocysteine fluorescence polarization immunoassay (FPIA) on the AxSYM analyzer.

A fluorescence polarization immunoassay (FPIA) has been commercially released for routine large-scale testing of total homocysteine (tHcy) on the AxSYM analyzer. We evaluated the analytical performance of the AxSYM tHcy FPIA and compared it with the well established high-performance liquid chromatography (HPLC) and IMx tHcy FPIA methods. Homocysteine concentrations were measured by AxSYM and IMx tHcy FPIA and by a rapid isocratic HPLC method with fluorescence detection.

Ogilvie's syndrome treatment.

Introduction: Ogilvie's Syndrome (OS) is a rare condition caused by parasympathetic dysfunction of large bowel characterized by acute and massive colon distension without mechanical obstruction. Rarely this disease has to be treated by the surgeon but operations may be indicated in case of medical treatment failure.

Methods: A retrospective analysis was carried out at the Emergency Surgery DPT of St Orsola-Malpighi University Hospital Bologna Italy.

Prospective randomized, double-blind, controlled trial comparing Lichtenstein's repair of inguinal hernia with polypropylene mesh versus Surgisis gold soft tissue graft: preliminary results.

Introduction: Although polypropylene mesh are the preferred prosthesis materials for the tension-free hernioplasties because they handle well and become quickly integrated, having reduced the recurrence rate below 1%, some problems with their use are still to be addressed (postoperative pain, long-term discomfort, infections, intestinal obstruction and fistulization). In order to answer to these disadvantages, a new degradable and reabsorbable material, the porcine small intestinal submucosa (SIS mesh gold, Surgisis), has recently been used in humans for laparoscopic hernia repairs. Aim to our study is to evaluate the safety and efficacy of the Lichtenstein's hernioplasty using the Surgisis gold soft tissue graft, as a mesh, and to compare it with the traditional Lichtenstein procedure performed with polypropylene mesh.

Laparoscopic appendectomy in Italy: an appraisal of 26,863 cases.

Objective: To evaluate the practice of laparoscopic appendectomy (LA) in Italy.

Methods: On behalf of the Italian Society of Young Surgeons (SPIGC), an audit of LA was carried out through a written questionnaire sent to 800 institutions in Italy. The questions concerned the diffusion of laparoscopic surgery and LA over the period 1990 through 2001, surgery-related morbidity and mortality rates, indications for LA, the diagnostic algorithm adopted prior to surgery, and use of LA among young surgeons (<40 years).

Stapled versus hand-sewn anastomoses in emergency intestinal surgery: results of a prospective randomized study.

Purpose: Sutured and stapled intestinal anastomoses are perceived to be equally safe in elective intestinal surgery. However, our search of the literature failed to find any studies comparing hand-sewn and mechanical anastomoses in emergency intestinal surgery. Thus, we compared the short-term outcomes of patients with sutured as opposed to stapled anastomoses in emergency intestinal surgery.

[Treatment of complicated peptic ulcer: personal experience].

Background: The availability of drugs which can effectively inhibit gastric secretion allowed the control of the peptic disease in almost all the patients, but the incidence of complications is substantially unchanged.

Methods: In the present study, we performed a retrospective evaluation of 153 patients treated for complicated peptic ulcer (hemorrhage and perforation) in the last 6 years. Hemor-rhage is a common onset of the peptic disease and it rarely requires a surgical treatment, because medical and endoscopic therapies are successful in a high number of patients.

Untreatable faecal incontinence: colostomy or colostomy and proctectomy?

PURPOSE: To determine the frequency of rectal symptoms and secondary proctectomy in patients undergoing elective permanent end sigmoid colostomy for faecal incontinence and determine risk factors. METHODS: A retrospective chart review of patients undergoing elective end sigmoid colostomy for faecal incontinence at St Mark's Hospital between January 1991 and December 1998. Patients were divided into three groups: A, symptoms leading to subsequent proctectomy; B, symptomatic but avoiding proctectomy; C, asymptomatic.

Emergency surgery for patients with colorectal cancer over 90 years of age.

Background/aims: Colorectal cancer has an extremely poor prognosis in the elderly with high rates of emergency presentation and perioperative mortality. This report examines our experience and results in the emergency treatment of patients older than 90 years with colorectal cancer.

Methodology: From 1995 to 2000, 486 patients with colorectal cancer were operated on in an emergency surgery situation at the Department of Emergency Surgery of Sant'Orsola-Malpighi University Hospital.

[Emergency surgery of colorectal cancer in patients older than 80 years of age].

Aim: In elderly people colorectal cancer has an high incidence of emergency presentation. In this article we report our experience on colorectal emergency surgery for cancers in patients older than 80 yrs.

Methods: From October 1995 to December 2000 323 patients were submitted to emergency surgical procedure for colorectal cancer at the Dpt of Emergency Surgery of University of Bologna.

Use of prosthetic mesh in complicated incisional hernias.

Background: Incisional hernia (IH) repair with conventional techniques is associated with high recurrence rate. Surgical repair using prosthetic biomaterials is becoming increasingly popular. On the basis of the good results an increasing number of surgeons have begun to use this technique.