A multicenter retrospective study on 4480 implanted PICC-ports: A GAVeCeLT project.

Background: PICC-ports may be defined as totally implantable central venous devices inserted in the upper limb using the current state-of-the-art techniques of PICC insertion (ultrasound-guided venipuncture of deep veins of the arm, micro-puncture kits, proper location of the tip preferably by intracavitary ECG), with placement of the reservoir at the middle third of the arm. A previous report on breast cancer patients demonstrated the safety and efficacy of these devices, with a very low failure rate.

Methods: This retrospective multicenter cohort study-developed by GAVeCeLT (the Italian Group of Long-Term Venous Access Devices)-investigated the outcomes of PICC-ports in a large cohort of unselected patients.

PICC-PORT: Valid indication to placement in patient with results of extensive skin burns of the neck and chest in oncology. The first case in the scientific literature.

Introduction: The management of patients with advanced gastric cancer requires a stable venous access required at different stages of disease (treatment phase, palliative phase). Totally implantable central venous access in the arm, named PICC-PORT, is used in a patient with results of extensive skin burns of the neck, chest and right arm and surgical outcomes of multiple skin grafts of chest. The described clinical case is the first event in the scientific literature.

Abdominal compartment syndrome due to a giant multilobulated ovarian serous cystadenoma. Case report and review of the literature.

The Authors report a case of abdominal compartment syndrome due to a giant ovarian serous cystadenoma. Despite of the relief of intra-abdominal hypertension (IAP: 16 mmHg), mild symptomatology (clinostatic dyspnea) lead to defer the emergency surgical treatment; after CT scan of abdomen and pelvis was performed a resection en bloc of the cystic mass, oophorectomy and cholecystectomy. However it seems advisable to perform an emergency laparotomy in patients with abdominal compartment syndrome (ACS) grade II when presenting as an acute abdomen.

[Conservative treatment of chyle fistula of the neck following a reintervention of cervical bilateral lymphectomy for medullary carcinoma of the thyroid. Case report].

Chyle fistula is an uncommon serious complication of neck surgery, occurring in 1-3% of radical neck dissections. An untreated chyle leak is a potentially dangerous condition that may rarely lead to hypovolemia, hyponatremia, hypochloremia, hypoproteinemia and lymphopenia. Anatomic variants of the terminal portion of the thoracic duct and suction drainage in the neck wound play a primary role in causing this kind of lesion.

[Diagnosis, surgical treatment and follow-up of the hyalizing trabecular adenoma of the thyroid].

In the last twenty years, we submitted 853 patients to thyroid surgery. We found only in ten patients a hyalinizing trabecular adenoma at the (histological control), as a confirmation of the rarity of this tumour. The authors report a retrospective analysis of this cases to document the clinical features and the evolution through a long-term follow-up that has showed no recurrent disease.

[Diagnosis, surgical treatment and follow-up of the hyalizing trabecular adenoma of the thyroid].

In the last twenty years, we submitted 853 patients to thyroid surgery. We found only in ten patients a hyalinizing trabecular adenoma at the (histological control), as a confirmation of the rarity of this tumour. The authors report a retrospective analysis of this cases to document the clinical features and the evolution through a long term follow-up that has showed no recurrent disease.

The semiopen first umbilical trocar access technique in laparoscopic surgery: easy and safe.

Background: First access in laparoscopy still causes trouble and a small percentage of visceral and vascular injuries. Residents and surgeons-in-training often have doubts about which technique is safer and "friendlier." Semiopen technique (SO) for the first umbilical trocar access was originally described in 2002.

[Subtotal colectomy in the treatment of neoplastic left colon obstruction].

Introduction: Subtotal colectomy and ileo-sigmoid or ileo-rectal anastomosis is a treatment wort of considering in patients affected by colonic neoplastic obstruction, as it shows low morbidity and mortality, and good results.

Case Report: A case of bowel obstruction due to a stenotizing neoplasm of sigmoid colon is reported. The obstruction causes severe dilation before the stricture), particularly accentuated in the cecum, which showed very reduced wall thickness and initial signs of ischaemia.

[Complications in the treatment of cholangiolithiasis. Personal experience].

Bile ducts lithiasis is a very common disease all over the world. In Italy prevalence is about 5 millions cases: 11% of the population. Choledocholithiasis concurrent with gallbladder stones frequency is estimated from 4 to 20%.

[Evaluation of operative risk in emergency treatment of neoplastic left colon obstruction: personal experience].

Aim Of The Study: To analyse the risk factors in the treatment of intestinal obstruction due to colorectal carcinoma. The treatment of neoplastic obstruction of the right colon until the splenic flexure is well defined: right hemicolectomy, enlarged right hemicolectomy. Otherwise the treatment of the obstruction due to left colon carcinoma beyond left flexure is not standardized.

[Chronic abdominal pain and peritoneal mesothelioma: case report].

Chronic abdominal pain syndrome is becoming increasingly important. The main symptom is persistent abdominal pain, which may vary intensely and be associated with constipation and episodes of vomiting, evolving towards sub- or total occlusion of the bowel. A 65-year old man presented with malignant peritoneal mesothelioma, with environmental asbestos exposure and chronic abdominal pain for more than one year.

Venting direct percutaneous jejunostomy (DPEJ) for drainage of malignant bowel obstruction in patients operated on for gastric cancer.

Malignant chronic bowel obstruction (MCBO) is a syndrome caused by abdomen-pelvic diffusion of neoplastic diseases of any origin. It generally occurs in an advanced disease, affecting 3-15% of patients recently operated, untreated, or submitted to radiotherapy. Patients complain of chronic pain and vomitus.

[Mixed medullary and follicular carcinoma of the thyroid: report of one case].

Introduction: Mixed medullary-follicular carcinoma of the thyroid with pleomorphic pattern is an uncommon malignant epithelial tumor characterized by clinical and immunohistochemical features of both follicular and parafollicular thyroidal C cells.

Material And Methods: We describe a rare case of this type of tumor observed in a 56 year old woman, undergone total thyroidectomy for suspected thyroid carcinoma, without lymph node metastasis. Preoperative basal calcitonin levels were in the limits, while thyroglobulin resulted increased.

Acute onset of non-Hodgkin's lymphoma with serious gastrointestinal haemorrhage: diagnosis and surgical treatment (case report).

The authors report a rare case of acute onset of gastrointestinal non-Hodgkin's lymphoma with acute gastrointestinal haemorrhage. The patient, a man aged 49 years, was admitted to the surgical department for the evaluation of an increased anemia and weakness. Physical examination disclosed mild epigastric tenderness in response to palpation but no palpable mass.

[Reoperation on the femoral arterial bifurcation: technical notes and surgical strategy].

Femoral bifurcation reoperation is a stern test for skilfull surgeons, owing to the presence of thick scar tissue from the previous operations, especially when prosthetic grafts are used. In cases of aorto-femoral graft thrombosis, if thrombectomy of the entire graft is possible, one could isolate the anastomotic tract with all the afferent vessels and construct a new anastomosis downstream in tissue which allows a better run-off. Often in our experience we executed a by-pass, with a vein or short tract of new graft, from the previous prosthetic branch to a distal part of the deep femoral artery.