[So-called "dense-vascularised" peritoneal adhesions: clinical and aetiopathogenetic considerations].

In the daily clinical practice of surgeons operating electively or, more frequently, in the emergency setting, within the abdominal cavity and pelvis, the detection of an intestinal adhesive disorder is frequent and is capable of causing numerous complications and subsequent reintervention. We report three cases of female patients referred to our observation for bowel subocclusion due to adhesive syndrome. After laparotomy, which revealed the presence of singular tenacious fibrovascular adhesions, the patients were subjected to immunohistochemical and receptor analysis yielding a diagnosis of leiomyomatosis peritonealis disseminata.

Aggressive sebaceous carcinoma of the head.

Cutaneous sebaceous carcinoma (SC) is a rare malignancy deriving from the adnexal epithelium of the sebaceous glands. Periorbital SC is approximately three times more common than extraorbital cutaneous SC. Extraocular SC is reported to be less aggressive than orbital sebaceous carcinoma and rarely metastasizes.

[Reconstruction of the inguinal ligament in recurrent inguinal hernia using the "three-sheet" technique].

Destruction of the groin ligament is an unusual occurrence, often of traumatic or surgical origin. In the event of recurrent inguinal hernia with a destroyed inguinal ligament, the reconstruction of the wall with the surgical techniques currently available yields prognostically unfavourable results with frequent recurrence in only a short space of time. The aim of this report was to present a hernioplasty technique using the "three-sheet" implant involving reduction of the hernia sac and the affixing of two reinforcement nets in Prolene in an attempt to reconstruct the destroyed groin ligament.

Sex steroid receptors, secondary bile acids and colorectal cancer. A possible mechanism of interaction.

Aim: The aim of the work was to study in colon-rectum cancer mucosae the binding charateristics, as sex steroid receptors.

Methods: Specific androgen (AR), estrogen (ER) and progesterone (PgR) receptors were measured in the tissue samples of 35 patients (15 males, 20 females) undergoing colectomy or coloproctectomy for adenocarcinoma. The characteristics of androgen receptor (AR, DHT-R: dihydrotestosterone receptor) were also investigated using competitive activity of cyproterone acetate, cortisol, aldosterone and steroid-like substances such as deoxycholic and lithocholic acid, present in the milieu of the considered organ.

[Fistulae in diverticular disease of the colon].

Fistulas in colon diverticular disease are a not uncommon complication, that arise spontaneously in the evolution of a diverticulitis, and also as a complicated dehiscence of surgical anastomosis. The intermediate step of a fistula is a deep abscess that finds through the parietal layers of abdomen or towards other adjacent organs. So the surgeon can be confronted with external and internal and complex fistulas.

[Cholecystectomy by minilaparotomy].

The authors relate their experience of 62 cases of minicholecystectomy. This procedure is compared to "open" conventional and laparoscopic cholecystectomy. Report results and the analysis of the literature shows that the technique of cholecystectomy by minilaparotomy is a valid option to laparoscopic cholecystectomy and represents a clear improvement compared to conventional cholecystectomy.

[Perineal sarcoma. Report of a clinical case].

The authors report a case of perineal leiomyosarcoma treated using a combined surgical and radiotherapy protocol. Exeresis was performed through an incision in the left anterior perineum, beside the vagina. The patient then underwent TCT with excellent results.

[Surgical treatment of alkaline and mixed reflux after surgical interventions on the stomach].

The Authors report their experience in the surgical management of 13 cases of alkaline and/or mixed type gastroesophageal reflux (GER) secondary to gastric surgery. In 5 cases the gastroesophageal "diversion" "technique" proposed by the Authors, was used. Results obtained with this procedure (clinically and instrumentally evaluated) are presented.

Our experience with strictureplasty in the surgical treatment of Crohn's disease.

Strictureplasty is a recent surgical procedure that permits surgical cure of chronic intestinal strictures due to Crohn's disease without the need for bowel resection. The authors report the results of 19 stricture-plasties in eight patients, all of whom were affected by Crohn's disease in the chronic phase and showed subocclusive symptoms due to ileal strictures and fistulas. After surgery all patients improved, and none showed occlusive or subocclusive symptoms or signs of relapse after a mean follow-up of 16.

Lateral high abdominal ovariopexy: an original surgical technique for protection of the ovaries during curative radiotherapy for Hodgkin's disease.

An original surgical method for gonadal protection in young women given pelvic radiation for Hodgkin's disease is presented. Lateral high ovarian transposition (LHAO) consists of the transposition of the ovaries into the paracolic gutter during staging laparotomy, after disconnecting the gonads from the fallopian tubes by dividing the tubo-ovarian vessels. The technique's effectiveness was assessed by a study using clinical investigation, radioimmunoassay (RIA) determination of sex hormones, and dosimetry; of 18 patients treated, 10 participated in the study.

A study of esophageal reflux following total gastrectomy with hepatobiliary sequential scintigraphy using TC-99m DISIDA.

A new technique to study esophageal reflux by means of hepatobiliary photoscintigraphy using TC-99m DISIDA was examined. The study was undertaken on 19 patients undergoing total gastrectomy without esophageal recurrence or hepatic or pulmonary metastases. The results of hepatobiliary photoscintigraphy were compared with the clinical, endoscopic and radiologic data.