Transumbilical laparoscopic-assisted appendectomy versus laparoscopic appendectomy in children: a single center experience.

Laparoscopic Appendectomy (LPSA) is the first choice for appendectomy in pediatric surgery. Trans-Umbilical Laparoscopic Assisted Appendicectomy (TULAA) is another used technique. We compared both these procedures used for the treatment of acute appendicitis.

Dirofilaria repens Testicular Infection in Child, Italy.

Testicular Dirofilaria repens infection was identified and confirmed by sequence analysis in a child in northeastern Italy. Because human dirofilariasis is emerging in southern and eastern Europe, this parasitic infection should be considered in the differential diagnosis of scrotal swelling in disease-endemic countries to avoid unnecessary interventions, such as orchiectomy.

Monitoring environmental and climate goals for European agriculture: User perspectives on the optimization of the Copernicus evolution offer.

A vicious cycle exists between agricultural production and climate change, where agriculture is both a driver and a victim of the changing climate. While new and ambitious environmental and climate change-oriented goals are being introduced in Europe, the monitoring of these objectives is often jeopardized by a lack of technological means and a reliance on heavy administrative procedures. In particular, remote sensing technologies have the potential to significantly improve the monitoring of such goals but the characteristics of such missions should take into consideration the needs of users to guarantee return on investments and effective policy implementation.

Retroperitoneoscopic One-Trocar-Assisted Pyeloplasty in Children: An Age-Related Evaluation.

Introduction: The aim of this study was to evaluate the efficacy of the retroperitoneoscopic one -trocar -assisted pyeloplasty (OTAP) in children of different ages.

Materials And Methods: Clinical data of all children who underwent OTAP for ureteropelvic junction (UPJ) obstruction at our Institution, between 2006 and 2014, were reviewed by focusing on demographics, surgical management, and outcomes. Data were analyzed by dividing patients into three groups according to age at operation: patients younger than 2 years (group 1), between 2 and 6 years (group 2), and older than 6 years (group 3).

A multidisciplinary, minimally invasive approach for complicated deep infiltrating endometriosis.

Objective: To present a case of complicated deep infiltrating endometriosis managed by a multidisciplinary minimally invasive approach.

Design: Case report.

Setting: Tertiary care university hospital.

Infliximab in the treatment of Crohn's disease.

The recent introduction of infliximab, a chimeric monoclonal antibody against tumor necrosis factor-alpha, has greatly modified the treatment of Crohn's disease (CD). Data from the literature show encouraging results after intravenous infusion both for closure of intestinal or perianal fistulas and for induction and maintenance of remission in patients with moderate to severe intestinal disease unresponsive to other treatments. However, some contraindications such as fibrostenosing CD and sepsis have been identified.

Short-term treatment with infliximab in chronic refractory pouchitis and ileitis.

Background: Chronic refractory pouchitis is a long-term complication after ileal pouch-anal anastomosis and it may be associated with ileal inflammation.

Aim: To determine the efficacy of infliximab in treatment of chronic refractory pouchitis complicated by ileitis, using a wireless capsule endoscopy.

Methods: Sixteen patients with chronic refractory pouchitis complicated by ileitis were enrolled.

Surgical outcome and long-term follow up after laparoscopic rectosigmoid resection in women with deep infiltrating endometriosis.

The aim of this study was to assess the long-term outcome of treating severely symptomatic women with deep infiltrating intestinal endometriosis by laparoscopic segmental rectosigmoid resection. Detailed intraoperative and postoperative records and questionnaires (preoperatively, 1 month postoperatively and every 6 months for 3 years) were collected from 22 women. The estimated blood loss during surgery was 290 +/- 162 ml (range 180-600), and average hospital stay was 8 days (range 6-19).

Oral budesonide in the treatment of chronic refractory pouchitis.

Background: Pouchitis is the major long-term complication after ileal-pouch nal anastomosis for ulcerative colitis. Ten to 15% of patients develop a chronic pouchitis, either treatment responsive or treatment refractory.

Aim: To evaluate the efficacy of oral budesonide in inducing remission and improving quality of life in patients with chronic refractory pouchitis.

An international, multicenter, prospective, observational study of the side-to-side isoperistaltic strictureplasty in Crohn's disease.

Purpose: The side-to-side strictureplasty is a bowel-sparing alternative to resection in the treatment of stricturing Crohn's disease. This study was initiated to review the adoption of the side-to-side strictureplasty as a new surgical technique and the relative outcomes a decade after its description.

Methods: A total of 184 unique patients from six centers in the United States, Italy, and Japan served as the basis for this study.

Local injection of Infliximab for the treatment of perianal Crohn's disease.

Purpose: Perianal disease is a serious complication of Crohn's disease and its surgical management is still controversial. It has been suggested that the local injection of infliximab has resulted in some potential benefit. This pilot study analyzed the feasibility and safety of such therapy in selected patients with severe perianal Crohn's disease.

Management of pouch dysfunction or pouchitis with an ileoanal pouch.

Pouchitis, a non-specific inflammation of the ileal reservoir, is the most frequent long-term complication after pouch surgery for ulcerative colitis. Incidence rates vary widely. The etiology is still unknown, but genetic susceptibility and fecal stasis with bacterial overgrowth seem to be important factors.

A new model of strictureplasty for multiple and long stenoses in Crohn's ileitis: side-to-side diseased to disease-free anastomosis.

Conservative surgery has become the treatment of choice for diffuse jejunoileal Crohn's Disease. Previous research described a conservative approach both for multiple strictures located in close proximity to each other and for long stenoses. The side-to-side enteroenteric anastomosis has gained popularity and has lead to nonresectional surgery even for those patients who, until now, were considered suitable only for resection.

Primary paraganglioma strictly confined to the liver and mimicking hepatocellular carcinoma: an immunohistochemical and in situ hybridization study.

We describe a case of primary nonfunctioning paraganglioma that, unlike any other previously reported case, was strictly confined to the liver and must therefore have arisen on liver parenchyma. An asymptomatic 46-year-old man was referred to us for laparotomy and a right hemihepatectomy after a preoperative diagnosis of fibrolamellar hepatocellular carcinoma, based on a fine-needle biopsy. An 8-cm resiliently firm, pale gray nodule with a large central area of fibrosis and a thin fibrous capsule was resected.

A revised consideration on the use of very aged donors for liver transplantation.

The upper age limit for organ donation for liver transplantation has increased over the past few years. A retrospective case control study was carried out to evaluate the outcome of 36 liver transplants (group A) performed with grafts procured from donors over 70 years old in the period 1996 to April 2000, matched with 36 transplants (group B) chronologically performed thereafter with organs procured from donors below the age of 40 yr. The groups were comparable as regards main clinical characteristics.

Review article: indication and type of surgery in Crohn's disease.

The large majority of patients affected by Crohn's disease require surgery during their clinical history. Radical resection originally advocated for Crohn's disease does not decrease the recurrence rate, and repeated resections predispose patients to the development of short-bowel syndrome. Over the last few years, conservative surgery has become accepted by many authors as a safe means of treating obstructive Crohn's disease.

Improved results of liver resection for hepatocellular carcinoma on cirrhosis give the procedure added value.

Objective: To review a single-center experience to update the performance indexes of liver resection (LR).

Summary Background Data: Several therapies have been proposed in the treatment of hepatocellular carcinoma (HCC) on cirrhosis, although LR was the first to be widely applied.

Methods: Of 408 patients with cirrhosis admitted for HCC in the period 1983 to 1998, 264 had a LR.

Isolated resection of segment 8 for liver tumors: a new approach for anatomical segmentectomy.

Hypothesis: Isolated resection of segment 8 (the right anterosuperior liver segment) is one of the most difficult hepatectomies to perform because of the location of segment 8, the relation between section 8 and the main intrahepatic vessels, and the absence of any anatomical landmarks. The few reports that deal with isolated resection of section 8 generally describe the use of a deep wedge transparenchymal transection.

Design: Original surgical technique.

Highly aggressive policy of hepatic resections for neuroendocrine liver metastases.

Background/aims: Neuroendocrine tumors are usually slow growing and carry a prolonged prognosis. The presence of liver metastases significantly impairs long-term survival. The clinical experience with 28 patients admitted since 1981 for liver metastases from neuroendocrine tumors was retrospectively reviewed to analyze the clinical and surgical management and to evaluate their outcome.

The lidocaine (MEGX) test as an index of hepatic function: its clinical usefulness in liver surgery.

Background: The purpose of this study was to evaluate the clinical usefulness of the lidocaine test, as an index of hepatic function, in the different fields of liver surgery.

Methods: The lidocaine (MEGX [monoethylglycinexylidide]) test, which was performed in 200 patients with different liver diseases and in 23 organ donors, was compared with common laboratory tests. The MEGX value was related to postoperative complications in patients who undergo liver resection and to the survival of patients with cirrhosis who are awaiting transplantation.

Continuous versus intermittent portal triad clamping for liver resection: a controlled study.

Objective: The authors compared the intra- and postoperative course of patients undergoing liver resections under continuous pedicular clamping (CPC) or intermittent pedicular clamping (IPC).

Summary Background Data: Reduced blood loss during liver resection is achieved by pedicular clamping. There is controversy about the benefits of IPC over CPC in humans in terms of hepatocellular injury and blood loss control in normal and abnormal liver parenchyma.

An appraisal of percutaneous treatment of liver metastases.

Percutaneous treatments, such as ethanol injection and radiofrequency, have been recently proposed for the treatment of liver metastases. The aim of this study was to evaluate the effects of these treatments in a series of 8 patients who subsequently underwent liver resection. These patients had been treated with percutaneous methods between December 1995 and May 1997.

Hepatic resective surgery in cirrhotic patients. Techniques and results of anatomical segmentectomies.

The paper describes the technique of anatomical liver segmentectomies based on the extraparenchymal clamping, at the hepatic hilum, of the afferent vascular pedicles. The resection is started on the liver surface along the demarcation line caused by the ischemia. During parenchymal transection the technique of hemihepatic vascular occlusion has been undertaken.