Gluten-free diet: a new strategy for management of painful endometriosis related symptoms?

Aim: Pelvic pain affects 4% to 39% of women and accounts for 10-40% of all outpatient gynecologic visits. The etiology of painful endometriosis-related has not been fully delineated. No studies have been published concerning gluten-free diet administered to achieved relief of painful symptoms endometriosis-related.

Radiofrequency versus conventional diathermy Milligan-Morgan hemorrhoidectomy: a prospective, randomized study.

Background: In the past decade, several new surgical tools have revived the hope for an improved technique to treat radically hemorrhoids with less postoperative pain. Among these radiofrequency (RF), excisional surgery seems to be safe, fast, and accompanied by less postoperative pain. The aim of this study was to evaluate and compare RF (ligasure TM) to conventional diathermy Milligan-Morgan hemorrhoidectomy (MMH).

Porcine dermal collagen matrix injection may enhance flap repair surgery for complex anal fistula.

Introduction: The use of biomaterials to treat anal fistula has drawn great interest. More recently, a porcine dermal matrix injection has been proposed as infill biomaterial to treat fistulas.

Methods: We propose a novel approach consisting in non-cutting seton positioning followed by flap repair associated with dermal matrix injection into the fistula tracts after several weeks.

Conservative and surgical treatment of chronic anal fissure: prospective longer term results.

Introduction: The aim of this prospective study was to assess the efficacy of different medical treatments and surgery in the treatment of chronic anal fissure (CAF).

Patients And Methods: From January 2004 to March 2009, 311 patients with typical CAF completed the study. All patients were initially treated with 0.

Modified stapled transanal rectal resection (Starr) for full thickness excision of rectal tumour.

Introduction: Traditionally, adenomatous rectal lesions and unexpected malignant polyps that could not be removed endoscopically are referred to surgery. Local excision is the treatment of choice, and several techniques have been proposed. The choice of the approach requires that the tumour is excised intact, with a low recurrence rate and limited morbidity.

Intragastric balloon followed by biliopancreatic diversion in a liver transplant recipient: a case report.

Liver transplantation is a life-saving procedure for end-stage liver disease. In liver transplant recipients, morbid obesity influences post-operative survival and graft function. In 1996, our patient underwent a successful liver transplantation because of a HCV-related liver failure (body mass index (BMI) 31).

Metachronous splenic metastasis from colonic carcinoma five years after surgery: a case report and literature review.

Metastatic lesions of the spleen are a rare finding and are generally associated with widespread disease. Moreover, solitary metastases of the spleen are exceptional. In this paper, we describe the case of a patient who developed an isolated splenic metastasis from colon carcinoma five years after surgery, and was successfully treated by splenectomy.

Retroperitoneal sepsis with mediastinal and subcutaneous emphysema complicating stapled transanal rectal resection (STARR).

The STARR procedure was introduced a few years ago for the treatment of obstructed defaecation syndrome secondary to internal rectal intussusception and rectocele. We present a case of severe retroperitoneal sepsis with mediastinal and subcutaneous emphysema complicating STARR, treated by transperineal pelvic drainage and a loop sigmoid colostomy.

Surgical treatment of gastric outlet obstruction due to gastroduodenal tuberculosis.

Gastroduodenal tuberculosis is a very rare location of abdominal tuberculosis; it is usually secondary to pulmonary tuberculosis and is often associated with HIV infection. We report a case of a 45-year-old woman with no HIV infection and no evidence of pulmonary tuberculosis, with a history of duodenal ulcer treated for several months, who presented at the emergency department with severe gastric outlet obstruction of recent onset caused by ulcerohypertrophic antroduodenal tuberculosis. The lesion was misdiagnosed at endoscopy as a malignancy, although histological examination of biopsies showed only chronic inflammation.

Early (1 hour) post-operative parathyroid hormone (PTH) measurement predicts hypocalcaemia after thyroidectomy: a prospective case-control single-institution study.

The aim of the study was to evaluate the efficacy of parathyroid hormone 1-hour assay for the early prediction of hypoparathyroidism after thyroidectomy. Candidates for total, subtotal, completion thyroidectomy or lobectomy were entered into the study. Pre- and postoperative calcium and parathyroid hormone (1 hour and postoperative day 1 after thyroidectomy) levels and clinical hypocalcaemia were recorded.

Reinterventions for specific technique-related complications of stapled haemorrhoidopexy (SH): a critical appraisal.

Introduction: Stapled haemorrhoidopexy (SH) is an attractive alternative to conventional haemorrhoidectomy (CH) because of reduced pain and earlier return to normal activities. However, complication rates are as high as 31%. Although some complications are similar to CH, most are specifically technique-related.

Treatment of hemorrhoids in day surgery: stapled hemorrhoidopexy vs Milligan-Morgan hemorrhoidectomy.

Background: Recently, it has been demonstrated that surgical treatment of hemorrhoids in a day-care basis is possible and safe. The aim of this study was to compare the Longo stapled hemorrhoidopexy (SH) and the Milligan-Morgan hemorrhoidectomy (MMH).

Methods: One hundred seventy one patients (95 cases in SH group and 76 cases in MMH group) entered the study: 83 cases were III degree hemorrhoids, 88 IV degree.

Stapled hemorrhoidopexy: a prospective study from pathology to clinical outcome.

Stapled hemorrhoidopexy is widely accepted to treat hemorrhoids, but serious complications have been reported. In this prospective audit, we correlated clinical outcome with pathological findings. From January 2003 to April 2007, 94 patients underwent hemorrhoidopexy.

Medical and surgical treatment of chronic anal fissure: a prospective study.

The aim of this prospective study was to assess the efficacy of different medical treatments and surgery in the treatment of chronic anal fissure (CAF). From 1/04 to 09/06, 156 patients with typical CAF completed the study. All patients were treated with 0.

Laparoscopic suture repair of a perforated gastric ulcer in a severely cirrhotic patient with portal hypertension: first case report.

Background: Open digestive surgery in cirrhotic patients is associated with high morbidity and mortality. Laparoscopy in this setting has the potential to reduce postoperative complications. Laparoscopic treatment of a perforated gastric ulcer in a severely cirrhotic patient with portal hypertension is herein described.

[Role of radioisotopic lymphoscintigraphy in postphlebitic syndrome of the legs].

Post-phlebitis syndrome of the lower limbs is a set of symptoms that follow a state of phlebostasis and phlebolymphostasis with consequent oedema and tissue distress. We submitted 36 patients with post-phlebitis syndrome of the lower limbs to radioisotopic lymphoscintigraphy for the purposes of evaluating the vicariant function of the lymphatic system and the possible role of the lymphatic system in the genesis of dermo-epidermal abnormalities. The average age of the patients was 53.

Percutaneous liver biopsy using an ultrasound-guided subcostal route.

Percutaneous biopsy is considered one of the most important diagnostic tools to evaluate diffuse liver diseases. The introduction and widespread diffusion of ultrasounds in medical practice has improved percutaneous bioptic technique, while reducing postoperative complications. Although ultrasonography has become almost ubiquitous in prebiopsy investigation, only one third of biopsies are performed under ultrasound control.

[Retrospective analysis of the use of prophylactic drainage of the pelvis after anterior resection of the rectum].

Although the use of drains is common in clinical practice, its real role in the prophylaxis and therapy of postoperative complications is still not clear. In the literature we can find both supporters of drains, and many opponents who consider their use unnecessary and sometimes even dangerous. In fact, during new experimental and clinical studies, it was impossible to determine the usefulness of prophylactic abdominal drain, at least in the case of colo-rectal anastomosis, it has been demonstrated that use of drains limits the risks of an anastomotic leakage but, in some cases, the same drains could be the cause of some of the complications that should be avoided.

[Revascularization of the corpora cavernosa in vasculogenic impotence].

The vasculogenic erectile impotence, caused by occlusion and/or stenosis of arteries supplying the penis, is the most common cause of erectile failure in men over 40 years. The vasculogenic impotence is more found by peripheral vasculopathies like diabetes mellitus and nicotine abuse. It is important that the precise site of vascular lesion is established with selective arteriography of the hypogastric-internal pudendal axis.

Delorme's operation and sphincteroplasty for rectal prolapse and fecal incontinence.

Clinical and manometric results of Delorme's operation and sphincteroplasty were assessed retrospectively in patients undergoing this procedure for fecal incontinence and rectal prolapse. A series of 33 patients (11 males, 22 females; aged 18-83 years, mean 59) with external rectal prolapse were treated by Delorme's operation between 1989 and 1996. Mean follow-up was 39 months (range 7-84).

[Clinico-pathological study of microcarcinoma of the thyroid].

We have analysed the results of surgical treatment for microcarcinoma of the thyroid (MCT). In sixteen patient clinical and follow-up data were retrospectively evaluated during a 35.1-month follow-up.

[Radiotherapy of cancer of the uterine cervix and successive appearance of new malignant growth in the irradiated field].

Among the late complications of high-dosage pelvic radiotherapy for cervical cancer, anorectal and bladder malignancies are sporadically reported in the literature. In this study the possible relationships of previous radiotherapy with late appearance of neoplasms are analyzed and in particular post-radiotherapy interval, dosage and type or irradiation to the cervical area. The mechanisms or neoplastic transformation or irradiated tissues are also studied.

Immunohistochemical study of the corpora cavernosa of the human clitoris.

The microarchitecture of the corpora cavernosa of the human clitoris was investigated by immunohistochemistry. The distribution pattern of the nerve network was demonstrated by S-100 and neuron specific enolase immunoreactivity. Vascular and nonvascular muscle cells were identified by desmin and/or vimentin expression, and fibroblasts and endothelial cells by vimentin immunoreactivity.

Use of laparoscopic techniques in oncologic right colectomy in a canine model.

Background: The purpose of this study was to evaluate the feasibility of laparoscopic oncologic righ colectomy (RC) with intraperitoneal ileocolic anastomosis (ICA) in a canine model.

Methods: In 21 dogs a laparoscopic RC with transection of the main right colic artery and removal of adjacent lymph nodes (LN) was carried out using an Nd:YAG contact laser and endoscopic stapler. Two weeks after surgery, all animals were killed.

Use of laparoscopic techniques in colorectal surgery. Preliminary study.

Purpose: This study evaluated the feasibility and safety of laparoscopic bowel surgery performed by colorectal surgeons not previously experienced in laparoscopic biliary or appendiceal surgery.

Methods: Thirty-two patients underwent ileocolic resection/anastomosis (n = 12), loop ileostomy (n = 7), colostomy (n = 4), ileostomy takedown/ileorectal anastomosis (n = 3), subtotal colectomy/ileorectal anastomosis (n = 2), sigmoid resection (n = 2), or other procedures (n = 2). No curative cancer surgery was undertaken.