Surgical excision of developmental retrorectal cysts: results with long-term follow-up from a single institution.

Developmental cysts are very rare lesions occurring in the retrorectal space, and include epidermoid, dermoid, tailgut cysts and teratomas. There is little information on their natural history and biologic behavior, although a recent paper reported a greater incidence of malignant transformation than previously thought. The diagnosis requires high-resolution imaging, and complete surgical excision is the treatment of choice.

Treatment of chronic anal fissures and associated stenosis by autologous adipose tissue transplant: a pilot study.

Purpose: A substantial body of recent evidence suggests that autologous adipose tissue transplant promotes healing in different lesions associated with local ischemia. We report the outcome of lipoaspirate transplant in hard-to-treat chronic anal fissures.

Methods: Eight patients were included in this pilot study, 5 with single and 3 with multiple fissures.

Is sacral nerve stimulation an effective treatment for chronic idiopathic anal pain?

Background: Chronic idiopathic anal pain is a common, benign symptom, the etiology of which remains unclear. Traditional treatments are often ineffective. This study investigated the efficacy of sacral nerve stimulation in treating chronic idiopathic anal pain.

Long-term outcome of sacral nerve stimulation for fecal incontinence.

Purpose: Sacral nerve stimulation is a safe and effective procedure for fecal incontinence. We investigated whether its efficacy is maintained long term.

Patients And Methods: Sixty patients with fecal incontinence underwent permanent sacral nerve stimulation.

Fistula in ano: anatomoclinical aspects, surgical therapy and results in 844 patients.

Background: Several new therapies, including advancement flaps and fibrin glue, have been proposed for fistula in ano, with conflicting results. Most colorectal surgeons continue to use classic methods, e.g.

Submucosal reconstructive hemorrhoidectomy (Parks' operation): a 20-year experience.

Background: Submucosal reconstructive hemorrhoidectomy has never been a popular operation due to its difficulty and duration, the amount of blood loss, and the risk of incontinence. The main indication for hemorrhoidectomy according to Parks is fourth-degree hemorrhoids with prolapse of the dentate line outside the anus and with simultaneous presence of external hemorrhoids. We report our experience in the treatment of hemorrhoids using submucosal reconstructive hemorrhoidectomy according to Parks.

Calibrated lateral internal sphincterotomy for chronic anal fissure.

Unlabelled: Lateral internal sphincterotomy is an effective procedure for the treatment of anal fissure, but may affected anal continence. We describe a procedure aimed at tailoring the division of the sphincter according to the degree of the hypertonia and to the sphincter length in order to offer an effective and safe treatment for chronic anal fissure.

Methods: The internal sphincter was divided on the basis of anal manometry results.

[Anorectal manometry: standardisation of the execution technique].

Anorectal manometry is the basic investigation for the study of anorectal function. The lack of a standard execution technique and of any common definition of the manometric parameters constitutes a major limitation. The aim of the present study is to propose a standard technique for performing manometry.

[When to combine internal sphincterotomy with hemorrhoidectomy].

396 patients, treated with hemorrhoidectomy (278 Parks, 118 Milligan-Morgan) were submitted to preoperative manometry, which, in 158 patients (39.9%), revealed high anal resting pressure (TBS), with or without an associated anal fissure; this group was submitted to a regulated lateral sphincterotomy (SILR) in association with the haemorroidectomy. The manometric follow-up, two mounts after the operations showed similar TBS values in both groups of patients.

[Submucosal reconstructive hemorrhoidectomy (A.G. Parks operation)].

Indications and procedure of submucosal reconstructive hemorrhoidectomy (A.G. Parks hemorrhoidectomy) are described and discussed.

[Anorectal manometry in hemorrhoidal disease].

Manometry is an important approach to anorectal function. In the haemorrhoids the evaluation of the anal resting tone, of the squeeze and of the sphincterial length is very useful to realize the best surgical treatment. Anorectal manometry is neither invasive nor expensive; it can be ready repeated and the results are reproducible.

[Continence in low resections].

Anorectal function is an important problem after low anterior resection procedure. This paper reports the results from 14 patients undergoing to low resection at Surgical Pathology Institute of the University of Verona. In 12 cases the restoration of the bowel continuity has been obtained by colon-anal anastomosis (Parks Operation) and in 3 cases by colo-rectal anastomosis at the anorectal ring level.

[Anastomotic complications in the surgical treatment of rectal neoplasms].

The authors review the problems relating to the healing of colorectal anastomotic complications following anterior resection. They report on their own experience with 328 anastomoses, 281 of which constructed manually and 47 using a mechanical suturing gun. Following manual anastomosis, the reported incidence of clinical dehiscence was 1%, as against a 10.

[A rare case of colonic invagination due to leiomyosarcoma].

The authors report on a case of leiomyosarcoma with intussusception of the large bowel. They stress the importance of the clinical suspicion in targeting preoperative instrumental instrumental investigations.

[Extended surgical resections of locally diffuse colorectal carcinoma (clinical cases)].

The authors report on a study population of extended operations for locally spread colon-rectum cancer in the Verona Surgical Clinic over the period from 1971 to 1987 (114 surgical demolitions for colon-rectum cancer out of a total of 1294 operations). They report an overall 5-year survival rate of 41% and a 3-year survival rate of 59% with a perioperative mortality rate of 1.75%.

[Our experience with the surgical treatment of the solitary ulcer syndrome of the rectum].

The authors examine the question of the pathogenesis of solitary rectal ulcer syndrome (S.R.U.

[Surgical treatment of malignant colorectal neoplasms in the population over (our experience)].

The Authors examine a series of 95 operations in the Verona Surgical Clinic for colorectal carcinoma in patients aged above 75 and discuss the results obtained. The low mortality rate (2.95% for resections) and the acceptable incidence of morbidity confirm the validity of performing radical surgery for malignancies in very elderly patients, as is stressed in most of the relevant literature.

[Treatment of perineal breach in radical surgery of the rectum: notes on the surgical technic].

The Authors review the various techniques used in closing and draining the pelvic basin after total resection of the rectum due to neoplastic and/or inflammatory disease. The examine their experience with 248 cases of total resection of the rectum and propose closure of the perineal breach as the first step in through closure of the pelvic peritoneum.

[Malignant schwannoma of the ileum: an extremely rare disease entity (presentation of a case and review of the literature)].

The authors examine a case of malignant ileal schwannoma successfully treated in the Verona Surgical Clinic. They compare their experience with the data reported in the literature, confirming the extreme difficulty encountered in diagnosing the disease. Therapy is discussed, and the authors stress that, in the presence of an intestinal haemorrhage the origin of which traditional diagnostic investigations are unable to establish, one should always bear in mind the possibility of schwannoma despite its rarity.

[Synchronous abdomino-perineal amputation (global evaluation of the intervention in our experience)].

In the light of their experience, the Authors examine the validity of synchronous abdomino-perineal resection. Their study population consists of 224 such operations. On the basis of the results achieved, the conclusion is reached that there is still no realistic alternative today to synchronous abdomino-perineal resection for the treatment of malignancies whose lower borders lie at a distance of less than 6.

[Our experience in the surgical treatment of Arbuthnot Lane disease].

In the light of their experience, the authors review the data reported in the literature regarding Arbuthnot Lane Disease. The therapeutic indications are examined, and the results of the various types of surgery proposed are compared.

[Our experience in the surgical treatment of diverticular disease (I: Election)].

The authors review their patient population with regard to the surgical treatment of diverticular disease. This population consists of 76 cases, 30 of which were subjected to elective surgery. They conclude by stating that, in the light of their experience, the most effective elective operation is resection of the tract affected by diverticuli followed by and end-to-end anastomosis with the protection of a decompressive transversostomy.

[Non-specific solitary ulcer of the transverse colon (presentation of a case and review of the literature)].

In the light of findings emerging from a critical review of the literature, the Authors present a case of solitary non-specific ulcer of the transverse colon successfully treated by surgery. The various pathogenetic theories are examined, and the diagnostic work-up to which the patient must be subjected is discussed. The study concludes with a description of the choice of therapy.