Feasibility and efficacy of routinary PECs 1 block on perioperative and postoperative pain control in breast surgery: a prospective non-controlled trial in a medium-volume breast unit.

Strategies to reduce the postoperative pain in patients undergoing breast cancer surgery include the use of Interpectoral (PECs) block, first described by Blanco in 2011, but its feasibility and efficacy in everyday clinical practice has been debated. The aim of the study was to evaluate the routine feasibility and effectiveness of PECs block added to general anesthesia to reduce postoperative pain and opioids consumption in the Breast Unit's patients. From June to December 2021 all patients undergoing surgery were included to receive PECs1 block before general anesthesia; clinical and outcome data were prospectively collected.

The COVID - AGICT study: COVID-19 and advanced gastro-intestinal cancer surgical treatment. A multicentric Italian study on the SARS-CoV-2 pandemic impact on gastro-intestinal cancers surgical treatment during the 2020. Analysis of perioperative and short-term oncological outcomes.

Background: This Italian multicentric retrospective study aimed to investigate the possible changes in outcomes of patients undergoing surgery for gastrointestinal cancers during the COVID-19 pandemic.

Method: Our primary endpoint was to determine whether the pandemic scenario increased the rate of patients with colorectal, gastroesophageal, and pancreatic cancers resected at an advanced stage in 2020 compared to 2019. Considering different cancer staging systems, we divided tumors into early stages and advanced stages, using pathological outcomes.

Laparoscopic trans-cystic common bile duct exploration and treatment of choledocholithiasis in a patient with Roux-en-Y reconstruction after gastrectomy: report of an emergency case.

We present the case of choledocholithiasis with purulent cholangitis treated with laparoscopic approach in a patient with Roux-en-Y reconstruction after total gastrectomy. After cholangiography, the common bile duct was explored with trans-cystic choledochoscopy and the retained stone extracted under direct vision.

COVID-19 and psychiatric illness: rectal foreign bodies (30 stylus batteries) in a young male patient affected by Asperger syndrome.

Here we present the case of a 17-year-old male patient, affected by Asperger syndrome, who reached the emergency division of our hospital after anal insertion of some stylus batteries. Transanal extraction of 30 stylus batteries avoided surgical intervention. Lockdown and boredom due to the strict domestic quarantine policies adopted during COVID-19 pandemic might have unmasked in our patient a susceptibility to unhealthy behaviour.

Laparoscopic treatment of idiopathic jejuno-jejunal intussusception in an adult.

Here we present the case of a 29-year-old female patient who underwent to laparoscopic reduction of idhiopatic jejuno-jenunal intussusception, a very rare cause of intestinal obstruction in adults. Laparoscopic exploration represents the best approach in adults. Unfortunately, manoeuvres of laparoscopic reduction are difficult and conversion to laparotomy is often needed.

Saving from unnecessary pancreaticoduodenectomy. Brunner's gland hamartoma: Case report on a rare duodenal lesion and exhaustive literature review.

Introduction: Brunner's gland hamartoma (BGH) is an infrequently encountered, benign, polypoid proliferation of Brunner's glands. Usually these lesions are asymptomatic, just only occasionally presenting with duodenal obstruction or bleeding signs and mimicking a tumoral lesion.

Case Presentation: A 72-year-old male, referred for recurrent vomiting and epigastralgia, was investigated and all preoperative findings were suggestive of a tumour of the duodenum.

Arterial Decellularized Scaffolds Produced Using an Innovative Automatic System.

There is still an unmet clinical need for small-caliber artery substitution. Decellularized scaffolds in tissue engineering represent a promising solution. We have developed an innovative system for the automatic decellularization of blood vessels, used to process pig arteries.

Influence of Surgical Technique, Performance Status, and Peritonitis Exposure on Surgical Site Infection in Acute Complicated Diverticulitis: A Matched Case-Control Study.

Background: Acute generalized peritonitis secondary to complicated diverticulitis is a life-threatening condition; the standard treatment is surgery. Despite advances in peri-operative care, this condition is accompanied by a high peri-operative complication rate (22%-25%). No definitive evidence is available to recommend a preferred surgical technique in patients with Hinchey stage III/IV disease.

Ventriculoperitoneal shunt and the need to remove a gallbladder: Time to definitely overcome the feeling that laparoscopic surgery is contraindicated.

Since Baskin et al. reported the first documented case of failure of a laparoscopically-induced ventriculoperitoneal shunt (VP) in 1998, the cerebrospinal fluid shunt has been generally considered a relative contraindication to laparoscopy. Although the literature is limited there is a small body of evidence indicating that it is safe to perform laparoscopic surgery on these patients with routine anaesthetic monitoring.

Intra and post-operative complications of esophageal achalasia.

Aim: To evaluate and discuss all the potential complications affecting morbidity of patients treated with surgery for primary achalasia.

Material Of Study: A review of the available English literature published to date has been conducted. All articles reporting surgical experience in achalasia were examined and then were selected only those specifically inherent to the topic at issue.

Detergent-enzymatic decellularization of swine blood vessels: insight on mechanical properties for vascular tissue engineering.

Small caliber vessels substitutes still remain an unmet clinical need; few autologous substitutes are available, while synthetic grafts show insufficient patency in the long term. Decellularization is the complete removal of all cellular and nuclear matters from a tissue while leaving a preserved extracellular matrix representing a promising tool for the generation of acellular scaffolds for tissue engineering, already used for various tissues with positive outcomes. The aim of this work is to investigate the effect of a detergent-enzymatic decellularization protocol on swine arteries in terms of cell removal, extracellular matrix preservation, and mechanical properties.

A novel device for the automatic decellularization of biological tissues.

Objectives: Decellularized biological scaffolds represent a promising solution for tissue engineering. They offer a good substrate for cells in terms of biochemical composition, ultrastructure and mechanical properties without generating an immunogenic response. The aim of this study was to design and develop a device for the automatic decellularization of biological tissues to overcome manual operation limits, toward a good manufacturing practice-compliant process.

Incidental carcinoma in multinodular goiter: risk factors.

The aim of the study was to analyze the frequency of incidental thyroid carcinoma (unknown tumor smaller than or equal to 10 mm) in a consecutive series of 462 total thyroidectomies for multinodular goiter and to investigate the clinical risk factors for this type of malignancy. A retrospective, single-center study of outcome data collected from patients with preoperative diagnosis of multinodular goiter who underwent total thyroidectomy at the General Surgery Unit of Pavia (Italy) between January 2000 and December 2008 was performed. Possible risk factors for malignancy were: gender, age, time of evolution of goiter, presence of a dominant nodule in multinodular goiter, hyperthyroidism, history of radiation to the neck, residence in an area of endemic goiter, prior thyroid surgery, calcifications in the goiter detected by neck ultrasound or chest X-rays, and a family history of thyroid diseases.

Laparoscopic treatment of splenomegaly: a case for hand-assisted laparoscopic surgery.

Hypothesis: Hand-assisted laparoscopic surgery (HALS) is a safe therapeutic approach to remove megaspleens of any size. Conventional laparoscopic splenectomy for splenomegaly is difficult because of limited exposure and complex vascular control, with increased risk of intraoperative bleeding and conversion to open surgery. HALS can overcome some of these limitations, reducing the risk of conversion to open surgery and resulting in a postoperative course similar to that of conventional laparoscopy.

Unique vascular tumor primary arising in the liver and exhibiting histopathological features consistent with so-called polymorphous hemangioendothelioma.

Reported herein is an unusual vascular tumor primary arising in the liver and exhibiting unique histopathological features. A 47-year-old woman underwent left hepatectomy because of a large hepatic mass. On histology the tumor had a composite pattern, consisting of angiomatous, retiform and solid areas, formed by oval to cuboidal to spindle cells, that expressed only endothelial markers (CD31 and factor VIII-related antigen).

Low-grade fibromatosis-like spindle cell metaplastic carcinoma: a basal-like tumor with a favorable clinical outcome. Report of two cases.

Fibromatosis-like spindle-cell metaplastic carcinoma (FLSpCC) is an atypical variant of spindle-cell carcinoma with a particular clinical behavior characterized by frequent local recurrence, very low potential for axillary lymph node metastasis, and uncommon distant metastases. Although it presents the typical immunoprofile of basal-like carcinomas, FLSpCC is associated with a favorable clinical outcome and conservative treatment is generally indicated. Because of the lack of specific clinical and radiological characteristics, the criteria for the differential diagnosis from other benign and malignant tumors are based only on histological findings and immunostaining.

Left pneumothorax secondary to colonoscopic perforation of the sigmoid colon: a case report.

We present here the case of a 75-year-old woman who complained of acute abdominal pain after a diagnostic colonoscopy. Abdominal x-rays demonstrated pneumoperitoneum, whereas chest x-rays showed pneumomediastinum and left pneumothorax. A chest drain was placed and subsequently an exploratory laparoscopy was performed, during which air was found in the subserosa of the sigmoid colon and in the mesosigmoid secondary to perforation of a sigmoid diverticulum.

Use of human fibrin glue (Tissucol) versus staples for mesh fixation in laparoscopic transabdominal preperitoneal hernioplasty: a prospective, randomized study.

Objective: The aim of this study was to compare the morbidity of fixation of prosthetic meshes using Tissucol fibrin glue versus staples in laparoscopic transabdominal preperitoneal (TAPP) repair of inguinal and femoral hernias.

Summary Background Data: In patients undergoing laparoscopic hernia repair, fixation of mesh prostheses with staples may affect inguinocrural nerves causing early postoperative neuralgia and chronic neuralgia.

Methods: Between June 2003 and February 2005, 197 patients with inguinal or femoral hernia were enrolled in this prospective, randomized study, to assess morbidity following hernia repair with staples (n = 98) or Tissucol (n = 99).

Uretero-neocystostomy in a swine model of kidney transplantation: a new technique.

Background: Swine constitute a well-characterized large animal model for kidney transplantation (K-Tx) although the uretero-neocystostomy represents a crucial aspect because of the very small caliber of the ureter and the mucosal susceptibility to the edema during surgical management. Besides infectious and occlusive complications limited the employment of a stent and the peculiar anatomy of the species prevents its removal without an operative approach. These features find an equivalent in children (<4 year old) candidates to urological surgery.

Thoracic-abdominal approach in primary pulmonary synovial sarcoma.

We report a case of primary synovial sarcoma of the lung. The patient was a 32-year-old male who presented with a mass in the right hemithorax invading the peritoneal cavity. The neoplasm was resected through a thoracic-abdominal approach.