Endorectal ultrasound in the diagnosis of rectal cancer: accuracy and criticies.

Introduction: Endorectal ultrasound (ERU) is used for locoregional staging of rectal cancer. Our work compares the data in the literature regarding diagnostic accuracy of the technique and results of routine use of the technique in two centers in Piedmont.

Material And Methods: 77 reports ultrasound with the final diagnosis of rectal cancer from the period 2008-2012 were examined.

Prompt or delayed appendectomy? Influence of timing of surgery for acute appendicitis.

Purpose: The aim of the study was to compare the clinical outcomes and histological findings in prompt and delayed appendectomy for acute appendicitis.

Methods: All patients who underwent appendectomy for histologically confirmed acute appendicitis from 2003 to 2009 were included in this study. Patients were divided into three groups according to the time of surgery after hospital admission: The early appendectomy (EA) group underwent surgery within 12 h, the early-delayed appendectomy (EDA) group between 12 and 24 h and the delayed appendectomy (DA) group more than 24 h.

Giant gastrointestinal stromal tumor of the stomach in an elderly patient.

We report a case of giant gastrointestinal stromal tumor (GIST) of the stomach of 17 cm in diameter detected in an 88-year-old Caucasian female. An en-block resection of the mass requiring gastric and transverse colon resection was carried out. Pathological examination evidenced a smooth multicystic giant gastric GIST measuring 17 x 13 x 9 and weighing 1,630 g.

Unexpected results using rapid intraoperative parathyroid hormone monitoring during parathyroidectomy for primary hyperparathyroidism.

Rapid intraoperative parathyroid hormone (RIOPTH) monitoring predicts complete removal of all hypersecreting tissue by means of a significant parathyroid hormone (PTH) decrease. In this study we have tried to provide an explanation for some unexpected results of RIOPTH monitoring observed during a series of 125 conventional parathyroidectomies for primary hyperthyroidism, discussing the possible consequences on the surgical strategy. Three main groups can be recognized: (1) spikes: a PTH increase 10 minutes after removal of the diseased gland was observed in three patients; (2) false-negative results: six patients showed an inadequate PTH decreases at 10 minutes, three of them resulting in cure at 20 minutes (all six patients were cured at follow-up); (3) false-positive results: five patients with multiglandular disease showed a PTH decrease to a cure level despite excision of one adenoma only (in two of these patients a 20-minute sample showed a PTH increase soon after manipulation of the second adenoma).

Ligation of the inferior mesenteric artery in the surgery of rectal cancer: anatomical considerations.

Background: No agreement has been found in the literature concerning the safest point of ligation of the inferior mesenteric artery (ima) in order to avoid nerve damage during the surgery of rectal cancer.

Study Design: The distance between the origin of the ima and the left paraortic trunk was measured, as was the distance between the left paraortic trunk and the origin of the left colic artery (lca). The measurements were carried out on 20 cadavers and during 22 operations for rectal cancer.