Radiofrequency thermal ablation of renal graft neoplasms: A literature review.

Neoplasms occurring in renal grafts represent a relatively novel and rare condition, whose treatment has not been standardized yet. Radiofrequency thermal ablation (RFA) of renal graft neoplasms is a nephron-sparing treatment, reported to be safe and effective. However, even in the RFA field, there is no procedural standardization.

Endoscopic therapy for confirmed low-grade dysplasia in Barrett's esophagus.

Barrett's esophagus (BE) is a premalignant condition characterized by replacement of the esophageal lining with metastatic columnar epithelium. To date, the management in case of confirmed low-grade dysplasia (LGD) remains controversial. In this article we summarize the available endoscopic options and their results in terms of efficacy and safety in the treatment of confirmed LGD in BE.

Palliative care and end-stage colorectal cancer management: the surgeon meets the oncologist.

Colorectal cancer (CRC) is a common neoplasia in the Western countries, with considerable morbidity and mortality. Every fifth patient with CRC presents with metastatic disease, which is not curable with radical intent in roughly 80% of cases. Traditionally approached surgically, by resection of the primitive tumor or stoma, the management to incurable stage IV CRC patients has significantly changed over the last three decades and is nowadays multidisciplinary, with a pivotal role played by chemotherapy (CHT).

Comparison between thyroidectomy and hemithyroidectomy in treatment of single thyroid nodules identified as indeterminate follicular lesions by fine-needle aspiration cytology.

Aim: The objective of this study is to determine the optimal surgical approach for patients undergoing thyroid operation for indeterminate follicular lesions diagnosed by cytology and to evaluate the long-term outcome of patients treated by hemi or total thyroidectomy for these lesions.

Material Of Study: From January 2000 to January 2010, 98 patients having a solitary thyroid nodule with a cytological diagnosis of "indeterminate follicular lesion" were selected retrospectively.

Results: There were 81 women and 17 men with a mean age of 56 years (range: 28-83).

Impact of palliative chemotherapy and surgery on management of stage IV incurable colorectal cancer.

Background: Recent trials proposed chemotherapy (CHT) as the treatment of choice for patients affected by incurable colorectal cancer (ICRC). Nevertheless, surgery is still commonly offered to these patients. On the other hand, CHT is offered to ICRC patients regardless of the pattern of spread of the disease, local or distant, despite some evidence suggesting that metastatic pattern may influence the response to treatment.

Primary bilateral adrenal non-Hodgkin's Burkitt-like lymphoma: a rare cause of primary adrenal insufficiency. Case report and literature review.

Aims And Background: Primary bilateral adrenal non-Hodgkin's lymphoma is an extremely rare entity. Only 44 cases have been reported in the literature. The most common presenting symptoms are abdominal pain, fever, asthenia, constipation, weight loss or typical symptoms of adrenal insufficiency, hypertension, darkening of skin, orthostatic hypotension or an addisonian crisis.

[Adhesive small bowel occlusion: a clinical and therapeutic study of 163 consecutive patients].

The aim of this retrospective study is to evaluate the immediate and late outcomes of the surgical and conservative treatment of adhesive small bowel obstruction. A series of 163 consecutive patients affected by adhesive occlusion were analysed. 63 patients were submitted to emergency surgery and 100 to conservative treatment; 15 of these ones were operated on because they did not improve or deteriorated.

[Emergencies in colorectal carcinoma: negative prognostic factor?].

The authors analyze a consecutive series of 219 patients affected by complicated colorectal cancer who underwent surgery in emergency. In hospital mortality, 5-year survival and recurrence's incidence in 104 of these patients who underwent curative treatment are calculated and compared with a series of 701 patients who underwent elective surgical treatment. There was no significative statistical difference between emergency and elective group.

[Inflammatory pseudotumour of the liver: case report and review of the literature].

We report a case of inflammatory pseudotumour of the liver in a 53-year-old woman who over the previous month had presented malaise, fever and right-sided hypochondralgia. On physical examination the liver was tender at palpation 2 cm below the right costal margin. Laboratory data were normal.

[Primary aortoenteric fistula. Report of a case].

Primary aortoenteric fistulas (PAEF) are rare entities associated with a high mortality. Although several causes have been reported, their occurrence is usually due to erosion of an abdominal aortic aneurysm into the intestinal tract. The most common sites for the fistula are the third and fourth portions of duodenum.

[Evaluation of surgical risk in elderly patients: a review of 207 cases].

Thorough evaluation of surgical risk represents the sine qua non for a correct therapeutic choice particularly in the elderly who are frequently affected by multiple pathologies. The aim of this study was to evaluate the prognostic value of two of the most common classification systems for predicting surgical risk (ASA and Reiss scores) and of other laboratory parameters. A consecutive series of 207 patients aged 70 or above were analysed retrospectively, considering age, ASA and Reiss scores, elective or emergency surgery, operative time, leucocytes, haemoglobin, creatinine, and albumin levels.

[Colonic diverticulosis complicated with perforation. Analysis of several prognosis variables and criteria for emergency surgery].

The aim of this study was to analyse the clinical course, surgical strategy and results in patients with perforated large bowel diverticulitis. Over a 15-year period ending in January 1997, 25 patients (13 males and 12 females; mean age 64.1 years) underwent operation for perforation of acute diverticulitis.

[Leiomyosarcoma of the inferior vena cava: a case report].

Leiomyosarcoma (LMS) of the inferior vena cava (IVC) is a rare vascular tumour, with about 200 cases reported since 1871. The Authors report a case of leiomyosarcoma of the suprarenal inferior vena cava preoperatively diagnosed by ultrasonography and computed tomography. A surgical resection and venous wall reconstruction was performed.

[Caecal-rectal antiperistaltic anastomosis without torsion of the vascular pedicle].

Caecorectal anastomosis by Deloyers' procedure has the disadvantage of creating torsion of the vascular pedicle. The technique reported here is a simple mechanical anti-peristaltic anastomosis without inversion of the caecum. This technique was performed successfully in 26 patients after subtotal colectomy for multiple colonic carcinomas or severe constipation.

[Congenital anomalies of the inferior vena cava].

Congenital anomalies of the inferior vena cava are a relatively rare pathology, usually with an asymptomatic iter. They are usually diagnosed by chance during surgery on the aorta or retroperitoneal structures. From bioptic material their incidence is estimated to be 2-3% and the percentage of intraoperative findings varies in different series between 0.

[Current trends in the treatment of rectal carcinoma].

Authors report their personal experience about 336 cases of curative surgery for rectal cancer. They describe technical surgical details universally accepted in Literature such as sharp total mesorectal excision, the extension of lymphadenectomy with high ligature of inferior mesenteritis artery while pelvic lymphadenectomy seems to be unuseful and burdened by high morbidity; finally they underline advantages offered by a colic pouch above all for lower incidence of anastomotic leakages. As adjuvant therapy is concerned, our actual tendency is a preoperative radiochemiotherapy of which we are still evaluating long-term results.

[Videolaparoscopy and carcinoma of the gallbladder].

There have been several reports claiming that there is a risk that laparoscopic cholecystectomy might worsen the prognosis of unexpected gallbladder cancer. The objective of this study was to evaluate which factors influence the prognosis of such cancers. A clinicopathological study was conducted in 25 patients with unexpected gallbladder cancer.

[Umbilical endometriosis: report of a case and review of the literature].

The authors present a clinical of umbilical endometriosis in a young woman. This patient never underwent any operation or diagnostic abdominal procedures. The case is very interesting because of problems concerning differential diagnosis with other umbilical and periumbilical diseases and pathogenetic theories.

[Unusual case of benign neoplasm of the breast mimicking a carcinoma: granular cell tumor. Case report].

Granular cell tumors are rare, usually benign neoplasms of soft tissues which most commonly occur in the tongue, skin and subcutaneous tissue. Although the histogenesis is still object of debate, recent immunohistochemical studies and ultrastructural findings support the origin of this neoplasm from the peripheral nervous tissue, most likely from Schwann's cells. Occurrence of this neoplasm in the breast, although uncommon, warrants special attention, since its clinical, mammographic and pathological appearances on frozen sections "may often closely resemble" hose of breast malignancy.

Local excision for rectal cancer.

Background And Objectives: The aim of this retrospective study is to evaluate the results of local excision (LE) for rectal cancer for curative purposes.

Methods: From 1969 to December 1997, a total of 456 operations were performed for surgical treatment of rectal carcinoma (262 males and 194 females, mean age 66 years). Twenty patients (4.

[Surgical treatment of differentiated carcinoma of the thyroid. Follow-up of 99 cases].

The surgical treatment of differentiated thyroid carcinoma continues to be a matter of considerable debate in terms of defining the appropriate extent of thyroid or lymph node resection to ensure optimal patient survival. Whereas, at organ level, the majority of surgeons are in favor of total thyroidectomy, both the extent and timing of lymphadenectomy remain controversial issues. In the light of this, the Authors have conducted a retrospective study in 99 consecutive patients with differentiated thyroid carcinoma.

[An occult pancreatic insulinoma: radio-guided surgery with 111-In-octreotide. A case report and review of the literature on pre- and intraoperative diagnosis].

Introduction: Pancreatic insulinoma is a small, rare neoplasm; its radical therapy is surgical enucleation or resection. Although clinical diagnosis is simple, instrumental and radiological localization is still difficult (occult insulinoma: 10-20%).

Material And Methods: The authors present the case of a 71-year-old patient suffering from relapsing vertigo syndrome, derangement and transient lypothymia after strong physical activity.

Diverticulitis of the caecum and ascending colon: an unavoidable diagnostic pitfall?

Purpose: The infrequency of right-sided colonic diverticulitis prompted this presentation of our experiences, with emphasis on the diagnostic aspects.

Patients And Methods: Charts and documentation regarding 20 patients who underwent surgery for diverticulitis of the caecum and/or ascending colon over 22 years were reviewed.

Results: Eleven patients underwent pre-operative instrumental examinations: right-sided diverticulitis was recognized in five patients (two by barium enema, two by both ultrasonography and computerized tomography, one by all three examinations) and was suspected in another four.

[Emergency surgery: suppurating urachal cyst producing intestinal occlusion].

Urachal cysts are anomalies related to the persistence of urachal remnants after the birth. They are seldom asymptomatic, but in some cases they mimic acute abdominal disease. We report a case of a 67-year-old man with relapsing episodes of intestinal sub-occlusion caused by the presence of an infected urachal cyst.