[Frequency of surgical wound infections in patients treated with a barrier procedure. Multicentric study].

In 3088 patients submitted to various surgical procedures an open clinical trial was carried out to evaluate the rare of surgical wound infections (SWI). All of them were treated, before and after surgery, with a foam emulsion (Bioshield) considered, from a theoretical point of view, to be able decrease the bacterial contamination of the surgical wounds. The SWI rate was really low (congruent to 2.

[Surgical approach in the treatment of recurrent primary hyperparathyroidism].

Recurrent or persistent primary hyperparathyroidism (HPT) is a rare occurrence requiring generally a careful reoperation. From 1980 to 1992 a total of 192 patients underwent bilateral cervical exploration following a diagnosis of primary hyperparathyroidism. Persistent of recurrent HPT was found in 6 (3.

[Primary malignant melanoma of the esophagus. Report of 3 cases and review of the literature].

Primary malignant melanoma of the esophagus is an extremely rare tumour with a fatal prognosis. Only 122 cases have been reported to date in the literature, of which 105 are undoubtedly primary. This study presents three new cases which were surgically treated: two cases underwent subtotal esophageal resection and intrathoracic esophagogastroplasty, and one case underwent total esophageal resection and cervical esophagogastroplasty.

Videoendoscopic thoracic surgery.

Personal experience of 42 videothoracoscopic operations is reported. From September 91 to May 92 we performed 10 major lung resections (1 pneumonectomy, 8 lobectomies, 1 segmentectomy) 9 wedge lung resections, 4 excisions of pulmonary bullae, 12 pleurectomies with or without apicectomy, 6 excisions of mediastinal masses (3 thymomas, 2 mediastinal cysts, 1 thoracic disembryoma), 1 removal of esophageal leiomyoma. No major complications occurred.

[Omeprazole prevention of the recurrence of peptic ulcer: the efficacy of treatment with 20 mg on alternate days].

Omeprazole, 20 mg every second day, in prevention of duodenal ulcer relapse has been tested. 15 patients with peptic ulcer, which was endoscopically proved and then healed, underwent the treatment. No matter of ulcer original seat as well as antacid drug previously employed, recurrences were not seen after a 6 months period, while clinical symptoms and possible adverse reactions appeared to be very slight.

[Adrenal cystic lymphangioma. A case report].

Adrenal cysts are uncommon. A case of left adrenal cystic lymphangioma in 16 year old boy is reported. The adrenal cyst was a chance finding during radiological investigation for abdominal pain.

Androgen profile in patients with pancreatic carcinoma.

Serum testosterone, free testosterone and androstenedione levels were measured in 28 male patients with pancreatic cancer and compared with the values obtained from 28 male patients with chronic pancreatitis, 29 with gastrointestinal malignancies and 41 healthy controls. Mean total testosterone values were significantly lower in the pancreatic cancer group when compared to chronic pancreatitis and healthy controls. Total testosterone concentrations were also significantly lower in patients with gastrointestinal malignancies when compared to healthy controls.

[Clinical use of a totally implantable and programmable pump for the infusion of drugs].

Totally implantable programmable systems allow preordained complex continuous infusion of drugs. Sixteen totally programmable implantable pumps (Medtronic DAD) have been implanted in fifteen advanced colorectal and renal cancer patients for continuous ia and iv sinusoidal Fudr infusion. Median duration of pump function was 125 days (range 46-468), there was observed only one case of malfunction device which required the implant of a new device, and three complications of pump pocket (seroma, hematoma and infection) without interrumption of chemotherapy for clinical causes.

[Continuous sinusoid systemic Fudr infusion in advanced colorectal carcinoma. Preliminary experience].

Sinusoidal circadian continuous infusion with a maximal flow rate in the afternoon (3-9 pm) reduces Fudr toxicity. In order to estimate if the reported lower toxicity is merely due to the quasi-intermittence of the daily dose or to the circadian rhythm of infusion. Ten patients with widespread cancer (9 colorectal and 1 renal) underwent sinusoidal continuous iv Fudr infusion with the peak level in antiphase (ie 68% of the dose from 3 to 9 am) as compared with the Römeling shape.

[Endoscopic laser therapy in the palliative treatment of cancer of the esophagus].

Frequently when dysphagia first becomes manifest, esophageal carcinoma is already unresectable. Endoscopic laser therapy is a recently introduced method which can be used for the palliative treatment of esophageal cancer. By using the method the tumour is destroyed and the esophagus is recanalized, there is low incidence of complications, and the patient can be fed naturally thus improving quality of life.

Effect of castration and testosterone replacement on pancreatic carcinogenesis in Syrian hamsters.

Hormonal manipulation has been proposed as a possible new approach to the treatment of pancreatic cancer. We studied the effect of orchiectomy and testosterone replacement on early stage pancreatic carcinogenesis induced by diisopropanolnitrosamine (DIPIN) in Syrian golden hamsters. Eighty-five hamsters (mean body weight, 100 g) were divided into the following treatment groups: 1) DIPN (n = 20); 2) DIPN plus orchiectomy (n = 17); 3) DIPN plus orchiectomy plus testosterone (n = 18); 4) orchiectomy (n = 10); 5) sham operation (n = 10); 6) DIPN plus testosterone (n = 10).

Intraductal breast cancer: review of 183 consecutive cases.

The aim was to review a series of 183 intraductal breast cancer to define the diagnostic features and therapeutic outcome. Patients' average age was 54 years. Diagnostic procedures employed were clinical examination, mammography in 173 cases and fine-needle aspiration cytology in 98 cases.

Esophageal carcinoma and achalasia: prevalence, incidence and results of treatment.

Unlabelled: Between 1980 and 1988, we treated 1,521 patients with squamous cell carcinoma of the esophagus and 336 patients with adenocarcinoma of the gastric cardia. Between 1967 and 1988, 244 patients with esophageal achalasia were also observed. Among 1,857 patients with cancer, achalasia was present in 21 cases (1.

[Leiomyosarcomas of the small intestine].

The main clinical and anatomico-pathological aspects of small bowel leiomyosarcomas are stressed. These are rarely observed malignant tumours, which sometimes prove difficult to diagnose and have a poor prognosis. Also characteristic is the substantial difficulty often encountered in defining the malignancy grade histologically.

[Clinical course of diabetes in patients operated upon for chronic pancreatitis].

Diabetes evolution among patients who underwent surgery for chronic pancreatitis has been evaluated (10 had left pancreatectomy, 23 pancreatoduodenectomy, 39 pancreaticojejunostomy, 13 other operations not on the pancreas). On the basis of insulin needs for achieving a normal glycemic status, left pancreatectomy proves to cause or at least to hasten the development of diabetes which appears hardly kept under control and easily followed by complications. The choice of such surgical treatment should be justified, besides the local pathologicoanatomic situation, by a well established endocrine impairment.

Glutaraldehyde-tanned mandril-grown grafts as venous substitutes.

The present study was performed to evaluate the potential of glutaraldehyde-tanned mandril-grown grafts as caval substitutes. Short-term experiments consisted of 30 tubular grafts (35 x 8 mm), either of tanned collagen or polytetrafluoroethylene, that were sutured in the infrarenal inferior vena cava of pigs and removed 1 hour after implantation. There was no significant difference between the extent of the thrombus-lined graft surface in the biologic group and that in the polytetrafluoroethylene group.

[Subcutaneous emphysema. A rare complication of colorectal colonoscopy].

The Authors describe a case of subcutaneous emphysema following rectosigmoidoscopy in a 72 year old woman. Guidelines of preliminary conservative treatment and eventually careful surgical approach are suggested.

[Leiomyoblastoma of the stomach. Another case report].

A further case of gastric leiomyoblastoma in a 53 year old woman is presented. Pathology, diagnosis, and therapy of this rare neoplasm are discussed.

[Endoscopic treatment of postoperative external pancreatic fistula by means of papillotomy and naso-pancreatic drainage].

External pancreatic fistula is a common complication after pancreatic resection. We report a case successfully treated by endoscopic papillotomy and a naso-pancreatic tube.

[Pyloric stenosis caused by gallstone (Bouveret's syndrome). Presentation of a further case].

The Bouveret's syndrome is a rare complication of a bilio-digestive fistula, where a big stone occludes the pyloro-duodenal region. The clinical symptomatology is atypical, symptoms of the disease are acute and only in fifty per cent of cases it is possible to have a positive anamnesis for biliary lithiasis. The evolution of the occlusion is generally rapid.

[Functional evaluation of the intrathoracic stomach after esophagectomy for esophageal cancer].

Sixteen patients underwent evaluation of duodenogastric reflux and gastric function 1 to 7 years after esophagectomy, high intrathoracic anastomosis, and pyloric divulsion for esophageal cancer. Ten patients (62%) had either postoperative digestive symptoms or endoscopic mucosal lesions, cholescintigraphy demonstrated duodenogastric reflux in 11 cases (69%). No gastric motor activity was recorded on manometry.

[The ileocecal valve as a prognostic factor in extensive resection of the small intestine].

The aim of the study was to examine the role of the ileocaecal valve in relation to the nature and extent of symptoms following extensive bowel resection (EBR) in 13 patients with short bowel syndrome (SBS) referred to our department over the period 1962-1988. The results obtained do not allow us to assess the effective role of the ileocaecal valve in determining the severity of SBS. The factors conditioning the extent of the aftermath of EBR and effectively affecting prognosis are, in fact, multiple and act in various interrelated ways, thus making it difficult to define the precise role of any one of them.