Doppler-Guided Transanal Hemorrhoidal Dearterialization (DG-THD) Versus Stapled Hemorrhoidopexy (SH) in the Treatment of Third-Degree Hemorrhoids: Clinical Results at Short and Long-Term Follow-Up.

Introduction: The stapled hemorrhoidopexy (SH) and the Doppler-guided transanal hemorrhoidal dearterialization (DG-THD) are minimally invasive procedures for the surgical treatment of hemorrhoids. This study aims to verify the efficacy of the DG-THD versus the SH in the treatment of third-degree hemorrhoids.

Method: One hundred consecutive patients were causally allocated to either procedure, obtaining two groups of 50 pts.

Intestinal Intussusception by Monophasic Synovial Sarcoma: Case Report and Literature Review.

Introduction: Synovial sarcomas are rare malignant tumors of soft tissues, arising mainly from periarticular structures. Gastrointestinal localizations are unusual presentation of these rare sarcomas.

Methods: We present the case of a 56- years old man with monophasic synovial sarcoma, arising primarily from the ileum, and causing intussusception.

Reconstruction of Scrotal Sac and Penis with Biological Prosthesis and Vacuum Therapy.

Fournier's gangrene is a rapidly progressing necrotizing fasciitis, involving perineal, perianal, or genital regions, and it constitutes a true surgical emergency. Surgical excision of all necrotic tissue is required, and multiple debridements may be necessary to remove all nonviable tissue. After surgical intervention for debridement, reconstruction may be necessary.

Quality of life after treatment of rectal intussusception or rectocele by means of STARR.

Aim: Stapled Transanal Rectal Resection (STARR) has been proposed for surgical treatment of rectal intussusception and rectocele. This study aims at evaluating the effect of the STARR on symptoms of obstructed defecation and associated faecal incontinence regarding the impact on the quality of life of patients with rectal intussusception and rectocele.

Materials And Methods: Twenty-nine patients with rectal intussusception and 22 with rectocele, who underwent to STARR in the General Surgery of the University of L'Aquila-Italy, are the subjects of the study.

Laparoscopic floppy Nissen fundoplication: 11-year follow-up.

Background: There are few published reports on the outcomes of ≥ 10 years after a laparoscopic floppy Nissen fundoplication (LFNF).

Materials And Methods: From April 1994 to January 2012, 567 patients underwent LFNF and the outcomes of 211 cases were determined (from April 1994 to October 2000).

Results: Outcomes at ≥ 11 years after surgery was available for 178 patients (84.

Systemic inflammation and immune response after laparotomy vs laparoscopy in patients with acute cholecystitis, complicated by peritonitis.

Aim: To evaluate acute cholecystitis, complicated by peritonitis, acute phase response and immunological status in patients treated by laparoscopic or open approach.

Methods: From January 2002 to May 2012, we conducted a prospective randomized study on 45 consecutive patients (27 women, 18 men; mean age 58 years). These subjects were taken from a total of 681 patients who were hospitalised presenting similar preoperative findings: acute upper abdominal pain with tenderness, involuntary guarding under the right hypochondrium and/or in the flank; fever higher than 38 °C, leukocytosis greater than 10 × 10(9)/L or both, and ultrasonographic evidence of calculous cholecystitis possibly complicated by peritonitis.

The neutrophils response after laparoscopic and open cholecystectomy.

Aim: This study want to examine (a) whether neutrophils, the neutrophil-elastase, C-reactive protein and the Interleukin- 6 are modified and how, in patients after laparoscopic cholecystectomy open cholecystectomy; (b) whether these findings are indicative of an increased risk to develop infectious complications.

Materials Of Study: Circulating Interleukin-6 level, C-reactive protein and neutrophil-elastase were measured in 71 patients (35 underwent open cholecystectomy and 36 laparoscopic cholecystectomy). The diagnosis was confirmed by ultrasound examination.

Adenocarcinoma of the third duodenal portion: Case report and review of literature.

We focus on the diagnostic and therapeutic problems of duodenal adenocarcinoma, reporting a case and reviewing the literature. A 65-year old man with adenocarcinoma in the third duodenal portion was successfully treated with a segmental resection of the third part of the duodenum, avoiding a duodeno-cephalo-pancreatectomy. This tumor is very rare and frequently affects the III and IV duodenal portion.

Idiopathic intramural hematoma of sigmoid colon. A case report.

Intramural hematoma of the colon is rare. It may be "spontaneous" in patients with anticoagulant therapy or blood dyscrasia or caused by blunt abdominal trauma. An uncertain origin is also reported, so we have also "idiopathic hematoma".

Sigmoid intramural hematoma and hemoperitoneum: an early severe complication after stapled hemorrhoidopexy.

Stapled hemorrhoidopexy is a widely used surgical technique for treating hemorrhoids, although severe complications have been reported. The authors report a rare case of extensive ascending intramural hematoma of the sigmoid colon complicating stapled hemorrhoidopexy, with perforation and hemoperitoneum. Diagnosis was established at CT scan and treatment consisted of drainage, suturing, and diverting colostomy.

Cholecystectomy for gallbladder disease in elderly aged 80 years and over.

Background/aims: Patients aged 80 years and over show greater risk of complicated gallbladder diseases and associated comorbidities. The aim of the study is to evaluate the prognosis after laparoscopic or open cholecystectomy in these patients.

Methodology: 100 patients aged between 80 and 92 years (group 1) and 241 patients aged between 70 and 79 years (group 2), undergoing cholecystectomy for gallbladder disease, are the subject of the study.

Multidisciplinary day surgery unit: seven years' experience.

The autonomous multidisciplinary day surgery unit is the gold standard for day surgery procedures. The Authors report their experience with the Pescina Hospital autonomous multidisciplinary day surgery unit (Avezzano Heath Authority, University of L'Aquila). In total, 4140 patients were enrolled to the day surgery setting from 2001 to 2007.

Randomized clinical trial examining the effect of music therapy in stress response to day surgery.

Background: Music therapy could reduce stress and the stress response. The aim of this study was to investigate the role of music therapy in alleviating stress during day surgery.

Methods: Sixty patients undergoing day surgery were randomized to one of three groups, each containing 20 patients.

Acute ischaemic colitis: outcome in elderly patients.

The Authors report the results of the management of ischaemic colitis in a surgical unit dedicated to elderly patients. Sixty-two elderly patients affected by ischaemic colitis were observed consecutively in the Surgery Unit of the University of L'Aquila from 1986 to 2004. The clinical records of the patients were retrospectively reviewed in order to assess clinical, biohumoral, endoscopic and x-ray findings pre- dictive of the most suitable type of treatment.

Spontaneous hematoma of the mesocolon.

Spontaneous hematoma of the mesocolon is a rare condition, mainly due to the rupture of a colic artery aneurysm. The authors report on two cases of spontaneous hematoma of the mesocolon and examine the relevant literature. The clinical presentation in our patients was, as indicated in the literature, non-specific, with the occurrence of acute abdomen (case 1) or mild abdominal pain (case 2).

[Hyperthyroidism in the elderly].

Unlabelled: Hyperthyroidism in elderly patients is not to be under-evaluated, since it is characterized in such age range by particular clinical and prognostic features. Based upon literature survey and their clinical experience, the authors discuss in the present paper clinical, diagnostic and therapeutic problems of hyperthyroidism in geriatric patients.

Material And Method: In the period between 1978-2003 out of 1804 patients surgically treated for thyroid disease (non neoplastic in 1470 pts.

Is there a place for intraperitoneal onlay mesh repair (IPOM) of inguinal hernia among laparoscopic techniques?

Background/aims: The Authors report their experience on laparoscopic hernioplasty using the intraperitoneal onlay mesh repair in 56 patients.

Methodology: Thirty patients had a monolateral hernia, 9 of which were recurrent and 26 had a bilateral hernia, 6 of which were recurrent. Overall, a total of 90 hernias were treated.

[Recurrent parastomal hernia and middle incisional hernia: surgical treatment through midline incision with wide prosthetic mesh].

Parastomal hernia is a frequent complication of stoma surgery. The results of parastomal hernia repair however are poor, showing an high incidence of postoperative recurrences. In the last years, hernia repair with prosthetic mesh has given better postoperative results.

[Postoperative pain as complication of hernia surgical repair with mesh and plug].

The authors assess the incidence of locoregional chronic pain after inguinal hernia repair. One hundred consecutive patients, with a mean age of 65.4 years, suffering from primary monolateral inguinal hernia, underwent suture-less mesh-plug hernioplasty.

Perianal acquired tufted angioma associated with pregnancy: case report.

Tufted angiomas are rare lesions described as slowly growing/spreading erythematous macules especially located in the upper trunk and neck. Herein we report the case of perianal location of a tufted angioma in a young pregnant woman. She came to our observation complaining of perianal pain accompanied by bleeding at defecation.

[Acute cholecystitis in patients over 70 years old].

Background: Gallstone disease is the most common surgical indication in the elderly. Post-operative prognosis is severe in elderly with acute cholecystitis. Aim of this paper is to investigate the factors responsible for the severe prognosis and to detect how it could be improved.

[The role of melatonin in the immediate postoperative period in elderly patients].

Background: Melatonin induces sleep and modulates immune system. Aim of the paper is to show a possible relation between impaired rhythm of melatonin secretion and the onset of postoperative septic complications and insomnia in old patients undergoing surgery.

Methods: Fifty old patients, aged from 60 to 94 years, have been studied; 39.

[Therapeutic strategy in symptomatic diverticular disease of the colon].

Diverticular disease of the colon has been recorded with increasing frequency and approximately 25-30% of symptomatic patients require surgery for complications. Controversy still surrounds the best operative approach for the management of diverticular disease, particularly when it presents with complications. The three-stage operation has, for the most part, been abandoned because of its unacceptably high morbidity and mortality rates.

[Mesh repair of inguinal and femoral hernia].

The authors describe a 6-year experience with mesh repair of inguinal and femoral hernia in a surgical teaching department. Two hundred and ninety-seven hernioplasties were performed in 256 consecutive patients: 237 Trabucco sutureless and 11 Lichtenstein tension-free hernioplasties for inguinal hernia; 21 tension-free hernioplasties for femoral hernia; 20 Wantz GPRVS and 8 Rutkow tension-free hernioplaties for recurrences. Local anaesthesia was used in 59% of cases.

[An intramural hematoma of the duodenum].

Intramural hematoma of the duodenum is a rare event which is usually associated with trauma. Because of the rarity of this problem, there has been little conformity of opinions as to diagnosis and treatment of this disease. The authors report on a case of intramural hematoma of the duodenum post-traumatically occurred in a young woman.