The use of a methylene blue and glyceryl trinitrate-based cream for the treatment of chronic anal fissures: a phase II randomized pilot trial from a referral coloproctological unit.

Background: Chronic anal fissures (CAFs) are the second most common anorectal disease. Non-surgical treatment includes several options with controversial efficacy. The aim of this study was to evaluate the efficacy and safety of a new ointment based on methylene blue in addition to glyceryl trinitrate.

Short-term outcomes of vessel-oriented D2 and D3 lymph node dissection for sigmoid colon cancer.

Background: Level of lymph nodes dissection (LND) and inferior mesenteric artery (IMA) ligation is still matter of debate of radical resection of colorectal cancer. This study aims to compare the short-term outcome of three different surgical techniques to treat sigmoid cancer: low ligation (LL) of the IMA with D3-LND, low IMA ligation with D2-LND, and high ligation (HL) of the IMA with D3-LND.

Methods: Patients affected by sigmoid colon cancer, who underwent radical resection with three different techniques (LL and D3-LND Group A, HL and D3-LND Group B, and LL with D2 LND- Group C), were included.

Suture reinforcement using a modified cyanoacrylate glue to prevent anastomotic leak in colorectal surgery: a prospective multicentre randomized trial : The Rectal Anastomotic seaL (ReAL) trial.

Background: Anastomotic leakage (AL) is the most frequent life-threating complication following colorectal surgery. Several attempts have been made to prevent AL. This prospective, randomized, multicentre trial aimed to evaluate the safety and efficacy of nebulised modified cyanoacrylate in preventing AL after rectal surgery.

Sclerotherapy for hemorrhoidal disease: systematic review and meta-analysis.

Background: This systematic review and meta-analysis aimed to evaluate the safety and efficacy of sclerotherapy methods for hemorrhoidal disease (HD) over the past 40 years.

Methods: The review followed the 2020 Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA) guidelines. A comprehensive literature search was conducted, including studies reporting the use of sclerotherapy in patients with HD.

The management of low trans-sphincteric anal fistula during the COVID-19 pandemic: revisiting the role of the seton.

The management of trans-sphincteric anal fistula (TAF) includes several surgical options; however, during the COVID-19 pandemic, the access to the operating rooms was severely limited, leaving only the choice of minimally invasive procedures. This study aimed to evaluate the safety and effectiveness of the slow cutting seton technique for TAF performed in an outpatient setting during the COVID-19 pandemic.Patients treated for TAF between January 2020 and July 2022 and followed-up for at least 12 months were retrospectively evaluated.

Management and surgical treatment of parathyroid carcinoma: a 6-year experience of a single centre of endocrine surgery unit.

Background: Parathyroid carcinoma (PC) affects 0.1-0.3% of the general population and represents the rarest malignant neoplasms among endocrinological diseases, comprising less than 1%.

Efficacy of Intragastric Balloon versus Liraglutide as Bridge to Surgery in Super-Obese Patients.

Introduction: Bariatric surgery is a safe and effective treatment for obesity, although in super-obese patients (BMI ≥50 kg/m2) it can become challenging for anatomical and anesthesiologic issues. Several bridging therapies have been proposed to increase preoperative weight loss and decrease perioperative morbidity and mortality. The aim of this study was to compare the efficacy and safety of different two-stage approaches in super-obese patients: laparoscopic sleeve gastrectomy (LSG) following preoperative liraglutide therapy versus LSG with preoperative intragastric balloon (IGB) during a 1-year follow-up.

Assessment of coastal vulnerability to land-based sources of pollution and its application in Apulia, Italy.

The present paper deals with the assessment of the coastal vulnerability to pollution sources induced by land-based activities (LBAs). The coastal vulnerability is expressed and evaluated in relation to the land-based activities present in the coastal areas and a new index, namely Coastal Pollution Index from land-based activities (CPI_LBAs), is proposed. The index is calculated considering nine indicators using a transect-based approach.

Safety and efficacy of Levorag emulgel in the treatment of anal fissures using a validated scoring system.

Introduction: Anal fissure is one of the most common anal disease characterized by intense anal pain, and deterioration of patients quality of life. Treatment is mainly based on the topical administration of calcium antagonist or nitric oxide ointments, and in cases refractory to medical treatment patients can undergo surgery. This study aims to assess the efficacy and safety of Levorag emulgel in the treatment of acute and chronic fissures using of a validated scoring system.

Efficacy and safety of Propionibacterium extract gel versus glyceryl trinitrate ointment in the treatment of chronic anal fissure: a randomized controlled trial.

Aim: Chronic anal fissure (CAF) is an extremely frequent finding in clinical practice. Several topical agents have been proposed for its treatment with the common goal of increasing anodermal blood flow to promote healing. The aim of this study was to compare the efficacy and safety of a Propionibacterium extract gel (PeG) and 0.

Improvement of a coastal vulnerability index and its application along the Calabria Coastline, Italy.

The present paper further develops a coastal vulnerability index formulation (CVI) previously proposed by the authors by integrating a new variable and redefining three variables to improve the suitability of the index for low-lying coasts. Eleven variables are divided into three typological groups: geological, hydro-physical process and vegetation. The geological variables are: geomorphology, shoreline erosion/accretion rates, coastal slope, emerged beach width, and dune.

Laparo-endoscopic management of chole-choledocholithiasis: Rendezvous or intraoperative ERCP? A single tertiary care center experience.

Introduction: The management of chole-choledocholithiasis remains a matter of debate to preserve minimal invasive management and different options have been proposed, with single- or two-stage approaches. Two techniques of single-stage approach are intraoperative ERCP and laparoscopic rendezvous, which have the great advantage of reducing the length of hospital stay with increased patient compliance. This retrospective study aims to evaluate and compare the efficacy and safety of intraoperative ERCP and rendezvous technique for more than 15 years.

A New Possible Cut-Off of Cytokeratin 19 mRNA Copy Number by OSNA in the Sentinel Node of Breast Cancer Patients to Avoid Unnecessary Axillary Dissection: A 10-Year Experience in a Tertiary Breast Unit.

(1) Background: The main discriminant in breast cancer prognosis is axillary lymph node status. In a select cohort of patients, axillary lymph node dissection (ALND) may be safely spared. This study aimed to determine a new possible cut-off of cytokeratin (CK) 19 mRNA copy number in the SLN to predict cases at high risk of positive ALND.

Osteoclast-like stromal giant cells in invasive ductal breast cancer: A case series.

Introduction: Breast Cancer with osteoclast-like stromal giant cells (OLGCs) is a rare pattern of invasive non-special type ductal carcinoma. The OLGCs are specific type of macrophage and are likely distinct from true osteoclasts. The aim of this case series was to describe the characteristics of this invasive ductal carcinoma rare histotype.

Gastroesophageal reflux after sleeve gastrectomy. Fact or fiction?

Background: One of the most controversial issues surrounding laparoscopic sleeve gastrectomy is the development of gastroesophageal reflux disease following surgery. The aim of the study was to evaluate the occurrence of gastroesophageal reflux disease after laparoscopic sleeve gastrectomy and to analyze patients' weight loss, comorbidities, and quality of life after surgery.

Methods: The clinical records of 52 patients submitted to laparoscopic sleeve gastrectomy between January and November 2018, with 3 years of follow-up, were retrospectively reviewed.

Management and Treatment of External Hemorrhoidal Thrombosis.

Background: External hemorrhoidal thrombosis (EHT) is a common complication of hemorrhoidal disease. This condition causes extreme pain, likely resulting from internal anal sphincter hypertonicity, which traps the hemorrhoids below the dentate line thus leading to congestion and swelling. The choice of treatment remains controversial and both conservative and surgical options have been proposed in the last decades.

Histopathologic findings on removed stomach after sleeve gastrectomy. Do they influence the outcome?

Little is known about the role of chronic gastritis on weight loss after laparoscopic sleeve gastrectomy (LSG). This study aims to investigate the relationship between histopathologic findings of gastric specimens, excess weight loss (% EWL), and excess BMI loss (% EBL) at 6 and 12 months follow up after LSG. We retrospectively reviewed the clinical records of 95 patients who had undergone LSG between January 2017 and December 2019.

Outcome and risk factors for local recurrence after breast conserving surgery in patients affected by ductal carcinoma in situ.

Background: Ductal carcinoma in situ (DCIS) is a tumor with long term survival and low local recurrence rate. Although the progression of these lesions is rare, the current guidelines recommend breast conservating surgery (BCS) with adjuvant radio and/or endocrine therapy, often resulting in an overtreatment for patients. The aim of this single-center study was to evaluate the long-term outcome of the breast conservating surgery of DCIS followed by adjuvant radio and/or endocrine therapy and to identify prognostic factors associated with the risk of recurrence.

Synchronous "skip" facial metastases from colorectal adenocarcinoma: a case report and review of literature.

Background: Skin metastases from colorectal adenocarcinoma are rare conditions that are metachronous in most of cases and may represent the first sign of a recurrence. These lesions are usually located to the abdominal wall on postoperative scars, perineum and chest due to direct spread from the tumor or to the lymphatic and venous dissemination. We describe a rare case of synchronous skin metastases in a patient affected by sigmoid adenocarcinoma with no sign of liver and lung repetitive lesions.

201 cases of foreign body ingestion in a Surgical Emergency Unit A 16-year retrospective study.

Aim: The aim of this study is to analyse clinical characteristics of FB ingestion and predictive factors for complications, in order to reduce mortality and morbidity.

Materials And Methods: A retrospective study of emergency surgical consultation records has been carried out from June 2005 through June 2015 yielded 201 episodes with the diagnosis of ingestion of foreign objects at the Surgical Unit of the University of Bari.

Results: Natural Removal in 44,8% of cases; Endoscopic retrieval in 42,4%, Surgical Procedures 4,4%.

Staple line reinforcement with nebulized cyanoacrylate glue in laparoscopic sleeve gastrectomy: A propensity score-matched study.

Background: A dreaded complication of laparoscopic sleeve gastrectomy (LSG) is suture leak. The study aimed to assess the efficacy of the nebulized comonomer Glubran 2 (-butyl-cyanoacrylate + metacrylosysolfolane) applied to the LSG staple line.

Methods: A propensity-matched comparison analysis was conducted in 125 patients undergoing LSG between 2017 and 2019.

Ageing with sacral nerve modulation for fecal incontinence: how many patients get benefit after more than 10 years?

Sacral nerve modulation (SNM) has represented a major advancement in the minimally invasive management of patients with fecal incontinence (FI). Although the success rate in the short-medium term has widely been demonstrated, the very long-term outcomes are poorly investigated. This study aims to assess the effectiveness of SNM in a cohort of patients with a follow-up longer than 10 years.

Safety and Effectiveness of Tailored Hemorrhoidectomy in Outpatients Setting.

Single or double prolapsed pile instead of full muco-hemorrhoidal prolapse is a common finding in patients with symptomatic III or IV degree hemorrhoids. For this selected group of patients, relief of symptoms could be achieved by managing the single/double prolapsed piles instead of performing traditional hemorrhoidectomy. The aim of this single-center study was to evaluate the safety and medium- and long-term effectiveness of an outpatient tailored Milligan-Morgan hemorrhoidectomy (MMH) performed under local anesthesia (LA).

Direct Scaling of Measure on Vortex Shedding through a Flapping Flag Device in the Open Channel around a Cylinder at ∼10: Taylor's Law Approach.

The problem of vortex shedding, which occurs when an obstacle is placed in a regular flow, is governed by Reynolds and Strouhal numbers, known by dimensional analysis. The present work aims to propose a thin films-based device, consisting of an elastic piezoelectric flapping flag clamped at one end, in order to determine the frequency of vortex shedding downstream an obstacle for a flow field at Reynolds number Re∼103 in the open channel. For these values, Strouhal number obtained in such way is in accordance with the results known in literature.