Parastomal hernia repair with the use of Parietex composite mesh: a technical note.

Parastomal hernia is an incisional hernia related to an abdominal wall stoma. The incidence ranges from 5 to 50% and only 10% of these require surgical treatment. The authors propose an innovative surgical technique for treatment of parastomal hernia.

Biofeedback therapy for outlet dysfunction: our experience.

Biofeedback is an important therapeutic option in patients with outlet dysfunction. A total of 75 patients referred to our proctological division from March 2004 to June 2008 and complaining of chronic constipation were studied by history, physical examination, anorectal functional tests and a structured questionnaire. Patients were treated with biofeedback plus electrical stimulation or both biofeedback plus electrical stimulation and surgery.

Biofeedback therapy for faecal incontinence: our experience.

Biofeedback combined with electrical stimulation is an appealing conservative therapeutic option in patients with faecal incontinence. A total of 51 patients with faecal incontinence referred to our proctological division from March 2004 to June 2008 were studied. All patients were treated with biofeedback plus electrical stimulation.

Perineal hernia: a case of outlet dysfunction.

This article describes and discusses a successfully treated case of a primary posterior perineal hernia which is a rare cause of outlet dysfunction. A 46-year-old female patient had a 6 cm left para-anal protrusion and a 7-year history of outlet dysfunction. The perineal hernia orifice was closed via an abdominal approach using both a polypropylene mesh and a Parietex Composite Net.

Treatment strategies for chronic constipation: our experience.

Outlet dysfunction is responsible for 25% of all cases of chronic constipation. The aim of this article was to report our outcomes and investigate the efficacy of the different treatments that we have adopted to solve it. One hundred and twenty-six patients were treated with either surgery and/or biofeedback therapy.

Colorectal endometriosis: aggressive surgical management and practical considerations in a patient with advanced disease.

The aim of this study was to evaluate the results of bowel resection in a patient with obstructive colorectal endometriosis. The presentation will acquaint the physician with the signs and symptoms, evaluation, and surgical treatment of colorectal endometriosis. We emphasize that our findings strongly support an aggressive surgical approach with resection for all visible cases of colorectal endometriosis in women with advanced disease.

[Cystic lymphangioma of the pancreas: clinical case and review of the literature].

Cystic lymphangioma is a rare benign tumor that occurs more often in children with different localizations. Abdominal localization and its development may produce symptoms and clinical features of acute abdomen leading to problems in the differential diagnosis. The Authors report a rare case of pancreatic lymphangioma in a nine years old child resolved by surgical treatment.

Brain metastasis: first sign of colorectal carcinoma.

The purpose of this study was to describe the detection of a brain metastasis as the first sign of colorectal carcinoma, without any liver and/or lung involvement. This finding demonstrates primarily the need for regular central nervous system investigation in diagnosing colorectal cancer and secondly that further, more thorough research into the biomolecular events involved in metastases from colorectal cancer is warranted.

[Malignant anorectal melanoma: description of a clinical case and review of the literature].

Malignant ano-rectal melanoma is a rare pathology without characteristic symptoms. It is more frequent in females than in males (ratio 2:1) and represents 3-15% of anal canal tumours. A case of a woman who recently came to us complaining of painful defecation, tenesmus and rectal bleeding induced us to reconsider the diagnostic and therapeutic implications in ano-rectal melanoma.

Which kind of surgery in elderly people for colorectal cancer?

Colo-rectal cancers are of high incidence in elderly patients. Different clinical features and the peculiar behavior of the tumor may influence surgical results and should be considered in the decision making, when the surgeon has to decide whether to perform radical gut resection or less straining palliative procedures. In a retrospective study, 102 large bowel cancer patients are analyzed submitted to surgery in the period 1989-1994.

[Axillofemoral bypass: a potential solution of acute ischemia of the lower limb].

When deobstruction by Fogarty catheter fails, the axillofemoral bypass can be considered as a therapeutic solution of the acute ischaemia of the limb. The authors discuss a case occurred in their experience and focus their attention on the therapeutic potentiality of this kind of revascularization. As a matter of fact it is important to consider that the operation should not only eliminate the acute ischaemia, but also correct the atherosclerotic lesions that led to it.

[Surgery in neoplasms of the low rectum. Analysis of the Knight-Griffen technique].

The major advantage offered by the "double stapling technique" in the treatment of low rectum cancers is sphincter preservation while respecting oncological criteria of radicality. The authors report their experience in surgical treatment of rectal neoplasms, considering a 24 patient group observed between 1989 and 1991, when new staplers were available in Italy. They also present primary results obtained with modified Knight-Griffen technique evaluating a series of 10 patients with rectal cancers placed between 5 and 10 cm from the anal verge.

[Cystic lymphangioma of the retroperitoneum. A case report].

Cystic lymphangioma of the retroperitoneum is a primary mesodermal derived benign neoplasm, arising from retroperitoneal lymphatics. The Authors report a case of cystic lymphangioma of the retroperitoneum recently observed, and a review of the international literature registering 181 cases from 1958 up to nowadays. Retroperitoneal localization, sub-clinic evolution and the impossibility to preoperatively define the histological type of the tumour, in spite of the modern diagnostic techniques, explain the difficulties to reach a correct differential diagnosis.

[Significance of prognostic parameters in acute pancreatitis].

The diagnostic and therapeutic approach to Acute Pancreatitis (A.P.) is directly related to the clinical presentation.

[Somatostatin in the treatment of acute pancreatitis and prevention of postoperative acute pancreatitis. Personal experience].

Authors' personal experience is reported in the use of somatostatin for the treatment of acute pancreatitis and after bilio-pancreatic surgery. The drug has proved to be highly effective in reducing the pain and in controlling the biohumoral balance. The preliminary results appear to confirm the opinion that somatostatin is a major therapeutic tool in the treatment of bilio-pancreatic diseases.

Intestinal perforation caused by non specific idiopathic ulcer of the small intestine. A case report.

A case of non specific idiopathic ulcer of the small intestine in a 79-year-old patient is reported. On admission he presented with acute abdomen and was submitted to wide intestinal resection. The features of this rare disease (only 370 cases described until 1987), which has an undefined etiopathogenesis, severe symptoms, and poses diagnostic problems, are discussed.

Carcinoma of the male breast and ocular metastases.

Breast carcinoma in males associated with ocular metastases is not often observed. A case is reported with review of the literature. Medical management is satisfactory in case of metastases and enucleation is suggested for severe pain.

[Toxic adenoma of the thyroid gland: personal experience].

The Authors analyzed the thyroid diseases series of the Institute of 1a Clinica Chirurgica of the University of Catania which includes 1022 patients over the last 17 years, reviewing clinical and laboratory tests usually used in a register of diagnosis for autonomous adenomas of the thyroid. The Authors discuss pathogenesis, likely etiology and epidemiology of Plummer's adenoma, taking into consideration the therapy and the complications related to the therapy itself. They conclude stating that the adenoma is a pathology where the surgical operation solves the dismetabolic condition in a lasting way.

Leiomyosarcoma of the spermatic cord. Case report and review of the literature.

An additional case of leiomyosarcoma of spermatic cord which brings the total reported number to 49, is described. The case is compared with the others and further data on histogenesis and histological behaviour of the tumor, are given. Surgical treatment and role of radiotherapy and chemotherapy, are discussed.