Complete vs Culprit-Only Revascularization in Older Patients With Myocardial Infarction With or Without ST-Segment Elevation.

Background: The effectiveness of complete revascularization is well established in patients with ST-segment elevation myocardial infarction (STEMI), but it is less investigated in those with non-ST-segment elevation myocardial infarction (NSTEMI).

Objectives: This study aimed to assess whether complete revascularization, compared with culprit-only revascularization, was associated with consistent outcomes in older patients with STEMI and NSTEMI.

Methods: In the FIRE (Functional Assessment in Elderly MI Patients with Multivessel Disease) trial, 1,445 older patients with myocardial infarction (MI) were randomized to culprit-only or physiology-guided complete revascularization, stratified by STEMI (n = 256 culprit-only vs n = 253 complete) and NSTEMI (n = 469 culprit-only vs n = 467 complete).

Health-Status Outcomes in Older Patients With Myocardial Infarction: Physiology-Guided Complete Revascularization Versus Culprit-Only Strategy.

Background: The FIRE trial (Functional Assessment in Elderly Myocardial Infarction Patients With Multivessel Disease) enrolled 1445 older (aged ≥75 years) patients with myocardial infarction and multivessel disease in Italy, Spain, and Poland. Patients were randomized to physiology-guided complete revascularization or treatment of the only culprit lesion. Physiology-guided complete revascularization significantly reduced ischemic adverse events at 1 year.

Prospective validation of a lymphocyte infiltration prognostic test in stage III colon cancer patients treated with adjuvant FOLFOX.

Background: The prognostic value of lymphocyte infiltration (LI) of colorectal carcinoma (CC) has been demonstrated by several groups. However, no validated test is currently available for clinical practice. We previously described an automated and reproducible method for testing LI and aimed to validate it for clinical use.

Juxtapapillary duodenal diverticular bezor as an exceptional cause of biliary stent obstruction. Case report.

Introduction: we describe the first case in literature of biliary stent obstruction by bezoar impaction in a iuxtapapillary duodenal diverticulum.

Case Report: this case illustrates an juxtapapillary duodenal diverticulum and bezoar in it causing obstructive jaundice in subject with two biliary stents for cholangiocarcinoma (Klatskin's tumor) in the absence of bile duct stones.

Result: successful treatment with endoscopic stent removal and diverticulum toilette.

Unusual acute onset of pedunculated extragastric leiomyosarcoma. Case report.

Introduction: A case report of 25 yrs-old man with pedunculated exogastric leiomyosarcoma (with acute onset) surgically treated is presented.

Case Report: The patient was operated after clinical, instrumental and blood sample tests. We performed a 5 cm wedge resection of the stomach in continuity with the omentum.

[Bowel preparation before colonoscopy: personal experience and brief literature review].

Introduction: Colonoscopy is the most commonly used technique for inspection of the colonic mucosa. The safety and effectiveness of colonoscopy in identifying important colonic pathology is directly impacted by the operator experience and by the quality of the bowel preparation performed in anticipation of the procedure.

Patients And Methods: From December 2000 to June 2006, we performed 8328 total colonoscopy (M:F ratio =1:1.

[Pull percutaneous endoscopic gastrostomy: personal experience].

Objective: To review the indications, complications, and outcomes of percutaneous endoscopic gastrostomy (PEG), that are placed routinely in patients unable to obtain adequate nutrition from oral feeding for swallowing disorders (neurological diseases, head and neck cancer, oesophageal cancer, psychological disorders).

Design: Retrospective review of patients referred for PEG placement from 2003 to 2005.

Setting: Endoscopic Surgery in Section of General and Thoracic Surgery, Faculty of Medicine and Surgery, Palermo, Italy.

[Severe rectal bleeding after transrectal US-guided prostate biopsy. Case report].

Case: The Authors report their experience about a case of severe rectal bleeding after transrectal ultrasound-guided prostate biopsy.

Intervention: After correct and sure diagnosis, the patient was submitted to resolutive endoscopic haemostatic treatment (failure of haemostatic mechanical manoeuvres, emergency colonscopy, haemostasis with sclerotherapy, heat bipolar probe and Argon Plasma Coagulation).

Results: Complete recovery (immediate stop bleeding).

[Substernal goitre. Personal experience].

Introduction: Aim of the study is to discuss the diagnostic and therapeutic problems of substernal goiter (SG).

Materials And Methods: The Authors retrospectively analyzed 12 patients (3.1%) with substernal goiters among 379 patients undergoing surgical treatment for thyroid diseases from January 2000 to 2005, and evaluated the clinical data, preoperative diagnostic findings, surgical treatments, histopathological results, and postoperative complications.

[Endoscopic palliation of obstructive jaundice caused by inoperable pancreatic cancer: personal experience].

Aim Of The Study: Few patients with pancreatic cancer are eligible for resection. In the remainder, estimation of prognosis is important to optimise various aspects of care, including palliation of biliary obstruction and trial of chemotherapy. The aim is to refer our personal experience about the palliation with endoscopic stenting in patients with unresectable pancreatic cancer.

[Surgical treatment of liver hydatidosis: our experience with diagnostic and therapeutic consideration].

Objective: The Authors report on their experience in diagnosis and treatment of liver hydatidosis (LH).

Materials And Methods: From January 2000 to December 2003, we observed 24 patients (10 male = 42% and 14 female = 58%, male/female ratio 1:1.4, range of age 23 - 80 years, mean age 45.

Heterotopic gastric mucosa in the gallbladder: case report and literature review.

Introduction: we report on a case of heterotopic gastric mucosa in the neck of the gallbladder and we also review 95 other reports of HGM in the gallbladder in the international medical literature from 1977.

Aim: to evaluate the gold standard treatment in heterotopic gastric mucosa of the gallbladder by the analysis of literature, compared with our anecdotal experience.

Patient And Method: a 43-year-old man, who was recently symptomatic, visited our hospital to submit to laparoscopic cholecistectomy for cholelithiasis.

[Prevention of complications in thyroid surgery recurrent laryngeal nerve injury personal experience on 313 cases].

Introduction: Thyroidectomy poses many challenges for the surgeon who undertakes endocrine surgery and iatrogenic injury of inferior laryngeal nerve (ILN) is one of the most serious (0-20%). We report our personal experience of a series of 313 thyroidectomy with intraoperative identification of ILN.

Methods: 313 patients (253 females, 60 males, whose age was between 17 and 86 years, mean 41 years) had undergone thyroidectomy in our Operative Unit from January 2000 to January 2004.

["Rendez-vous" technique for palliation of neoplastic jaundice: personal experience].

Introduction: "Rendez-vous" technique (RV) assume contemporaneous percutaneous transhepatic choledochal drainage (PTCD) and endoscopic (ERCP) approach to make easier biliary cannulation when it fails for anatomic, neoplastic or iatrogenic causes, in subject unresectable at presentation ("not fit for surgery").

Materials And Methods: Over a 3 years period 618 ERCP were performed in the Service of Digestive Endoscopy in Section of General and Thoracic Surgery, 59 of whom (9%) failed for non-visualization of ampulla of Vater (25%), intradiverticular ampulla (54%) or anatomic defects (21%). Were attempted 44 pre-cut: 14 failed (close biliary stricture), and we proceed to RV.

Treatment of complications of hepatic hydatid disease by ERCP: our experience.

Background: The aim of this study was to evaluate the effectiveness of endoscopic sphincterotomy and positioning of naso-biliary drain or biliary endoprosthesis for preoperative and postoperative complications of hepatic hydatid disease (fistuias, compressioni cholestasis, rupture in biliary tree).

Methods: During the period 1994-2003, 22 patients (12 male and 10 female, mean age 55.4 years, range 16-65 yrs) underwent endoscopic treatment for complications of hepatic hydatid disease.

[Prevention of clogging of biliary stents by administration of levofloxacin and ursodeoxycholic acid].

One of the main advances in biliopancreatic endoscopic therapy has been the ability to palliate patients with biliary obstruction by placement of a stent during ERCP, but this is often complicated by clogging of the stent with subsequent jaundice and/or cholangitis. Stent clogging may be caused by microbiological adhesion and biliary stasis. Therefore, the use of antibiotics and choleretic agents such as levofloxacin and ursodeoxycholic acid has been investigated to see whether they prolong stent patency.

[Aberrant pancreas: a rare cause of epigastralgia].

Objective: The Authors report their experience about a case of aberrant pancreas that lead epigastralgia.

Design: Report of 1 case and endoscopic treatment (upper endoscopy + EUS + endoscopic polypectomy + endoscopic biopsy of the base. Surgical effectiveness evaluation.

[Regression of primary low-grade gastric mucosa-associated lymphoma by eradication of Helicobacter pylori infection: case report].

Objective: The Authors report their experience in diagnosis and treatment of one case of primary low-grade gastric lymphoma of mucosa associated lymphoid tissue (MALT); recent international literature review.

Experimental Design: Complete clinical report. Diagnostic, clinical and prognostic indication, evaluation of effectiveness of eradication therapy and short follow-up.

[Gastric antral vascular ectasia (GAVE) or watermelon stomach syndrome: report of 3 cases and clinical and therapeutic indications].

Objective: The authors report their experience in diagnosis, treatment and ambulatorial follow up of 3 cases of obscure upper gastrointestinal bleeding by gastric antral vascular ectasia (GAVE).

Experimental Design: Complete clinical report of 3 cases. Clinical and endoscopic indication, evaluation of effectiveness of endoscopic treatment with bipolar electrocoagulation and follow-up.