The surgical treatment of fecal incontinence with artificial anal sphincter implant. Preliminary clinical report.

Background/aims: Fecal incontinence has a serious impact upon patients' quality of life. Several treatment methods are possible according to the pathophysiology of the disease.

Methodology: Between March 1999 and February 2002 eight artificial anal sphincters (American Medical System - AMS) were implanted in seven patients affected with severe fecal incontinence; in one case the device was positioned in a patient who had previously undergone a Miles' resection.

The management of retrorectal congenital tumors.

Although retrorectal congenital tumors are still rare, the number of the observed ones is destined to increase, as methods by imaging become routinely used in the clinical practice. By presenting three clinical cases the authors describe the surgical technique of the anterior route they performed for the management of such formations. The abdominal approach had no postoperative complications, short hospital stay, no neurological consequences and good long-term results.

[General anesthesia and cervical anesthesia. What changes in carotid surgery].

Carotid surgery must be preventive; therefore cerebral protection procedures have been the centre of interest for a decade. Nowadays local cervical block anaesthesia seems to have changed the terms of the problem allowing achieve the aim of "no risk surgery". Therefore we considered our 16 year experience (352 carotids operated on 290 patients).

Local recurrences and primary surgery in rectal carcinoma.

Background: The authors analyze retrospectively a consecutive series of rectal carcinomas operated on with different surgical strategies at Third Surgical Department of "La Sapienza" University of Rome, between January 1985 and December 1997, by one expert surgeon (GDM), and report the incidence of the local recurrence correlated to the surgical technique development.

Methods: In most recent groups of patients treated for extraperitoneal neoplasm from January 1992 with curative (R0) total mesorectal excision (TME) and nerve sparing technique (NST) (Group C, n = 47) and with curative TME plus lateral pelvic lymphadenectomy (LPL) and NST (Group D, n = 7), sacrificing the pelvic autonomic nervous system only in case of neoplastic infiltration, the local recurrence was 8.5% (4 cases, with mean interval of 30.

Gallstones in elderly patients: impact of laparoscopic cholecystectomy.

The use of laparoscopic cholecystectomy (LC) in elderly patients may pose problems because of their poor general condition, especially of cardiopulmonary function. Moreover, these patients present with acute cholecystitis and associated common bile duct stones more often than their younger counterparts. From 1990 to 1999, the authors performed 943 LCs; 31 (3.