The role of surgical treatment in colon diverticulitis: indications and results.

Purpose: Colon diverticulitis is a common illness with affects 37-45% of western populations. Indications regarding therapy guidelines, operative timing and which surgical procedure to perform are still controversial.

Material And Method: Between January 1977 and December 1997, 239 patients, diagnosed with diverticulitis, have been admitted, on emergency, to our Department of General Surgery; 135 males (56%) and 104 females (44%), (mean age of 63 years).

Combined modality therapy in low risk (T2N0) rectal cancer.

The authors' experience with local excision (LE) and adjuvant radiotherapy in the treatment of selected cases of rectal cancer, is reported. 41 patients with distal rectal cancer underwent elective LE for cure. Selection criteria were: the site of tumor in the lower rectum, exophytic growth, maximum diameter equal to or lower than 4 cm, tumor "freely" mobile on the rectal wall, clinical staging T1-2 N0M0, histological grading G1-2.

Surgery of rectal cancer (technical observations).

The evolution of the surgical management of rectal cancer is briefly reviewed. Factors which influence the choice of the surgical procedure relatively to the tumor characteristics, are examined. The role played by preoperative staging as the basis of a correct therapeutic approach is underlined.

Concomitant preoperative radiochemotherapy in operable locally advanced rectal cancer.

Purpose: The aim of this study was to examine the effectiveness of a combination of preoperative radiotherapy and chemotherapy for operable locally advanced rectal cancer (Stages II and III).

Methods: Chemotherapy and radiotherapy are started jointly on day one of the therapy. 5-Fluorouracil is given in a dosage of 1000 mg/m2/day as a continuous 24-hour infusion for 4 days.

[The prognostic significance of the vascular invasion of colorectal tumors].

The authors report their experience about the clinical significance of the invasion of veins (BVI) in 68 patients with colorectal carcinoma, submitted to potentially curative surgery in the period 1980-1988. Every patient was screened for BVI. The tumoral spreading was differentiated into endovascular and perivascular permeation.

[Colonic neoplasms: long-term survival after surgical treatment. Our experience].

The surgery is still the only treatment for large bowel tumours. The patients who underwent a radical operation and then were treated with chemo and/or radiotherapy have not shown a longer free-disease survival. Palliative resection should be preferred to by pass operation, since the latter has shown less postoperative morbility and mortality.

[Constipation. New therapeutic trends].

Surgical treatment is warranted only once medical management has proved unsuccessful and should preferably be preceded by psychological evaluation of the patient. So far, surgery has yielded few convincing results in view of the high percentage of failures. After surgery, many patients complain of abdominal pain and diarrhea.

5-Fluorouracil (FU) with folinic acid (FA) and mitomycin C (MMC) in the adjuvant treatment of colorectal carcinoma. Part I. Evaluation of toxicity.

Ninety-six patients with colorectal cancer (stage B2-C) were randomized to the control arm or to receive adjuvant chemotherapy with folinic acid, FU and MMC. Ninety-three patients are evaluable. The median follow up is 12 months.

Mesenteric vein thrombosis in protein S congenital deficiency.

Mesenteric vein thrombosis is considered an uncommon clinical presentation of protein S congenital deficiency. In the two patients with mesenteric vein thrombosis here reported an isolated deficiency of protein S was diagnosed; family investigation recognized protein S deficiency also in five relatives of one of them.

High-dose folinic acid (HDFA) combined with 5-fluorouracil (5-FU) in first line chemotherapy of advanced large bowel cancer.

The therapeutic activity of 5-FU in large bowel cancer is enhanced by increasing the intracellular pool of reduced folates. We treated 45 patients with advanced colon cancer with HDFA and 5-FU for 5 consecutive days. None had been given previous radio- or chemotherapy.

Clinical staging of rectal cancer. Results of a prospective continuing study.

78 patients with rectal adenocarcinoma were studied with a diagnostic protocol in order to obtain a TNM clinical stage in the preoperative period. Each patient underwent digital rectal examination, proctoscopy, double contrast barium enema, pelvic CT scan, liver ultrasound and chest x-ray. The degree of infiltration of the rectal wall by the tumor and the presence or absence of node and liver metastases were evaluated.

[Selective ligation of the hepatic artery in treatment of post-traumatic hemobilia. Case report].

A case of post-traumatic haemobilia in a 15-yr-old boy is presented. The clinical picture is described, together with the treatment adopted (selective ligation of the right hepatic artery). A brief account is given of the reasons underlying the choice of this approach.