[Incidental diagnosis of caecum adenocarcinoma due to retention of endoscopic videocapsule: a clinical case].

Capsule endoscopy is a new technique for the study of small intestine particularly in cases of obscure gastro-intestinal bleeding or chronic iron-deficiency anemia. In our study we present a case of 62 years-old man with a chronic iron-deficiency anaemia developed at least six months before and refractory to iron therapy. The patient was submitted to upper gastro-intestinal endoscopy and to partial colonscopy due to abdominal adhesions for previous abdominal surgery.

[Nerve sparing total mesorectal excision for rectal cancer. Technical notes and results].

Objective: To evaluate the quality of life after nerve sparing total mesorectal excision for rectal cancer.

Patients And Methods: Crucial technical aspects of the procedure such as the preservation of genitourinary innervation and the achievement of optimal local control of the disease have been emphasized. It is known that local recurrences, sexual and urinary dysfunctions may have a significant impact on postoperative quality of life of the patients.

Surgical management of substernal goitres. When is sternotomy inevitable?

Purpose: Aim of this retrospective study is to report personal experience in the surgical management of substernal goitres emphasizing the guidelines for preoperative planning of sternotomy in selected cases.

Patients And Methods: Medical records of all patients (n=355) submitted to thyroidectomy for struma in our Operative Unit, between 1993-2003, were analysed. A substernal goitre was defined as a goitre having a significant retrosternal extension (>50%) requiring mediastinal dissection.

Improvement in the fertility rate after placement of microsurgical shunts in men with recurrent varicocele.

Objective: To evaluate the effectiveness of microsurgical shunts for secondary varicocele repair after ligation-like procedures, focusing on long-term functional outcomes.

Design: Long-term survey (mean follow-up, 8.5 years) of infertile men after secondary microsurgical reconstructive varicocelectomy.

[Transfixed stitches for the treatment of haemorrhoids].

Nowadays the proctologist has the opportunity to perform various different surgical techniques for the treatment of hemorrhoids. Circumferential mucosectomy with a stapler, diathermic hemorrhoidectomy with high frequency devices, and the HLA doppler II system have significantly modified the classical indications for the treatment of the disease. There is, however, still no general consensus as to the indications for the use of each of these techniques in clinical practice, giving rise to confusion among specialists and an inappropriate use of health care resources.