Extraction of a foreign body in the liver using single incision laparoscopic surgery: a new application for minimally invasive surgical procedures.

Ingestion of foreign bodies is a common medical problem frequently observed in children, psychiatric patients and prisoners. Various cases have been found in the medical literature, with different diagnostic and therapeutic approaches. We report a case of a 41-year-old male inmate, hospitalized for right upper quadrant pain of the abdomen due to the ingestion of two syringe needles two weeks previously.

Primary omental torsion: A case report.

A patient presented with an acute abdomen at the Emergency Department. The patient, a 69-year-old man, was admitted and underwent surgery with a provisional diagnosis of acute appendicitis. During surgery, omental torsion was diagnosed and the involved omentum was removed.

Total mesorectal excision with radiofrequency in rectal cancer: open versus laparoscopy approach.

Aim: The aim of this study was to compare the safety, efficacy and oncologic results in the low rectal resection with total mesorectal excision with radiofrequency (Ligasure™, Covidien, Boulder, CO, USA) in laparoscopic surgery.

Methods: From July 2005 to December 2008, 227 patients underwent colorectal resection for cancer at S. Martino Hospital in Genoa.

Factors that influence 12 or more harvested lymph nodes in resective R0 colorectal cancer.

Background/aims: The number of lymph nodes required for accurate staging is a critical component in colorectal cancer (CRC). Current guidelines demand at least 12 lymph nodes to be retrieved. Results of previous studies were contradictory in factors, which influenced the number of harvested lymph nodes.

Gastric Abrikosoff tumor (granular cell tumor): case report.

Granular Cells Tumor (GCT), also called Abrikosoff tumor, is very uncommon lesion of neural derivation. It is characterized by the presence of granular cell; benign and malignamt counterparts are known, even if the second ones are rare. It has a slight predominance in female sex and black race; the age range is wide, with peak between fourth and sixth decades of life.

Colon and rectal surgery for cancer without mechanical bowel preparation: one-center randomized prospective trial.

Background: Mechanical bowel preparation is routinely done before colon and rectal surgery, aimed at reducing the risk of postoperative infectious complications. The aim of the study was to assess whether elective colon and rectal surgery can be safely performed without preoperative mechanical bowel preparation.

Methods: Patients undergoing elective colon and rectal resections with primary anastomosis were prospectively randomized into two groups.

Small bowel metastasis from primary neuroendocrine small cell lung carcinoma.

Small bowel metastases from a primary lung carcinoma are rare. We report a case of a 76-year-old male with a primary neuroendocrine small cell carcinoma of the lung, treated by chemotherapy, who developed fever and bowel symptoms (subocclusion and pain). On CT examination, he was found to have a tumour in the small bowel.

Survival in surgical palliative resection of stage IV colorectal cancer: short term results in a single institution.

Aim: In this study, we analyze clinical parameters, survival and possible advantage of surgery in patients affected by symptomatic Dukes D colorectal cancer.

Methods: From July 2005 to December 2008 at our Oncological Surgery Unit we treated 69 symptomatic stage IV CRC, 46 of them resected at our Oncological Surgical Unit. Clinical variables were tested for their relationship to survival in a univariate prognostic analysis and revealed the interaction of the prognostic factors.

[Leakage of colorectal anastomosis after neoadjuvant therapy with bevacizumab. Case report].

Background: Despite progresses achieved in last decades in treatment of rectal cancer, anastomotic leakage remains the main complication.

Patients And Methods: We report two cases of patients affected by distal rectal cancer. Both patients received neoadjuvant therapy according to ROCHE ML 18522 experimental protocol (Xeloda, Avastin and radiotherapy).

Urachal tumour: case report of a poorly understood carcinoma.

Background: Urachal carcinoma is an uncommon neoplasm associated with poor prognosis.

Case Presentation: A 45-year-old man was admitted with complaints of abdominal pain and pollakisuria. A soft mass was palpable under his navel.

Complicated small-bowel diverticulosis: a case report and review of the literature.

Here we report a case of a 60 years old woman who came to the Emergency Department of San Martino Hospital suffering from abdominal pain for about a week with high fever in the last 24 hours. The final histological examination led to the diagnosis of ileal diverticulosis associated with perforation and peritonitis with a fibrotic reaction involving the last ileal loop, the caecum and the appendix.

Factors predicting survival in surgical palliative resection of stage IV colorectal cancer.

Aim: Colorectal cancer (CRC) harbors accumulated genetic alterations with cancer progression, which results in uncontrollable disease. To regulate the most malignant CRC, we have to know the most dismal phenotype of stage IV disease.

Methods: A retrospective review of our Oncological Surgical Unit was performed (from 2005 to 2008) to extract the 52 resected stage IV CRC.

Lymphadenectomy in elective and urgency surgery for resective colorectal cancer.

Aim: The aim of this study was to analyze the factors affecting the number of lymph nodes examined in colorectal cancer specimens after elective or urgent surgery on the current clinical practice in our surgical unit.

Methods: The authors considered 120 patients who had undergone surgery for colorectal carcinoma from July 2005 to December 2007 divided into two groups, 102 elective oncologic resections (group A) and 18 performed in emergency (group B). All patients underwent laparotomic colorectal resection.

Total mesorectal excision with radiofrequency in rectal cancer.

Aim: The aim of this study was to compare the safety, the efficacy and the oncologic results in rectal cancer with total mesorectal excision using Ligasure (LS), a modern bipolar vessel sealing system, with monopolar electrocoagulation or stitches (ME).

Methods: From July 2005 to December 2007 one hundred twenty-nine patients underwent colon resection for cancer at the San Martino Hospital of Genoa (Italy); 43 patients underwent rectal resection. All patients underwent laparotomy rectal resection with total mesorectal excision; 9 (21%, group LS) underwent total mesorectal excision with radiofrequency, 34 (79%, group ME) with monopolar electrocoagulations, vessels ligation or stitches.

[Stomach rupture due to barotrauma (a report of the 13th case since 1969)].

The thirteenth case of rupture of the stomach after a diving accident since 1969 is reported. This rare event was caused by equipment failure and panic reaction, which induced swallowing air during diving and consequential gas expansion in gastric cavity meanwhile the rapid ascent. Peritoneal decompression by paracentesis quickly improved the patient's condition and the following surgical laparotomy revealed a gastric tear along the lesser curvature, which was closed by suturing.

[Emergency surgery in inflammatory bowel disease. Experience in 26 cases].

Background: The emergency surgical treatment of inflammatory chronic bowel diseases is closely related to the classification of patients according to their symptoms and clinical conditions, as well as possible surgical options. In our study, an actual set of criteria is proposed for the classification of the degree of seriousness of symptoms, related to patient conditions, and applicable surgical strategies.

Methods: Retrospectively evaluation of the outcome of the disease has been performed over 26 patients undergoing emergency treatment in our Hospital, and with at least 5 years of follow-up.

[Anesthesia in laparoscopic cholecystectomy. Clinical contribution and review].

The authors compare the problems arising during the course of 280 cases of anesthesia in videolaparoscopic cholecystectomy with 265 cases of laparotomic cholecystectomy. Ventilatory mechanics and intraoperative respiratory function were analysed together with respiratory function and postoperative pain. The authors also examined the possible complications linked to the endoscopic technique and underline the anesthesiological contraindications for videolaparoscopic cholecystectomy.

[Technic of multiple procurement from donor cadavers (observations on 19 cases)].

Several procedures for multiple cadaveric organ procurement have been developed for the recent growth of transplantation of extrarenal organs. These techniques permit removal of the kidneys, liver, pancreas and heart from the same donor without jeopardy to the kidneys above all. At the Department of Surgery - Section Transplantation of the University of Genoa in 1983 and 1984 19 multiple organ harvesting have been carried out.