Tumori cardio-pericardici primitivi

capitolo sui tumori cario-pericardici nell'ambito del Trattato di Medicina Interna di Paolo Larizza, opera in 14 volum

Two cases of medullary thyroid carcinoma associated with papillary carcinoma

This manuscript reports two cases of medullary thyroid carcinoma associated with papillary carcinom

Laparoscopic approach for a case of oesophageal achalasia with epiphrenic diverticulum.

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Surgical management of ascending saphenous thrombophlebitis.

Background. Acute saphenous vein ascending thrombophlebitis is recognised to be a dangerous condition due to the reported high incidence of deep vein thrombus involvement and possibly fatal pulmonary embolism. We assessed the accuracy of duplex scanning in determining the extent of thrombosis as well as the effectiveness of surgical treatment. Methods. We retrospectively reviewed 146 patients referred to our Vascular Laboratory for acute superficial thrombophlebitis from 1987 to 1997. Duplex scanning identified 85 cases of superficial thrombophlebitis involving at least a segment of the saphenous vein localised below the knee (58.2%); 37 of thrombophlebitis extending into both the superficial and deep venous systems (25.3%), and 24 of saphenous thrombosis extending to within 5 cm of the saphenofemoral junction (16.4%). The latter group underwent saphenofemoral disconnection. We compared the preoperative duplex with the surgical reports and evaluated the surgical results. Results. We did not observe any complication. Return to work and normal activity occurred within 3-5 days. When varicose vein thrombectomy was performed concurrently, the patients had better postoperative pain control. Conclusions. Duplex scanning showed 100% accuracy both in determining the presence of thrombosis and its extent. Saphenofemoral disconnection for thrombosis involving the saphenofemoral junction is a safe procedure and can be performed on an outpatient basis

When CHIVA treatment could be videoguided.

CHIVA seems to be a more effective varicose vein treatment than high ligation and distal stab avulsion. It also preserves a higher rate of long saphenoius veins, suitable fo r bypass surgery

The ideal length of hospital stay in the surgical treatment of colo-rectal cancer.

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Early oral feeding after colorectal resection: a randomized controlled study.

Background: Nasogastric (NG) intubation is widely used following elective abdominal operations although it is associated with morbidity and discomfort. The present study is a randomised controlled trial on the effect of early oral feeding without NG decompression following elective colorectal resection for cancer. Methods: One hundred patients were randomized to group A (NG catheter and fasting until passage of flatus, followed by liquid diet advanced to soft-solid) or group B (no NG tube, clear liquids the day after surgery, followed by soft-solid food). The endpoints were: (i) morbidity; (ii) resumption of intestinal function; (iii) length of hospital stay; and (iv) patients’ well being evaluated by short-form health survey [36 items] (SF-36). Results: Twelve complications occurred in group A (50 patients) and 13 in group B (50 patients) (P = NS). Seven patients developed vomiting in group A as compared to 16 in group B (P < 0.05). Twenty per cent of patients required NG decompression in group B hence 80% did not need NG tubes. Resumption of intestinal function occurred after 4 days, and length of hospital stay was 7 days in both groups. No significant difference was detected between groups (P = NS) in the SF-36 score change before and after the operation. Conclusion: Patients undergoing elective colorectal resection can be managed without postoperative NG catheters, starting oral feeding on the first postoperative day. Albeit, no reduction in postoperative hospital stay or patients’ well being could be detected, abolition of postoperative NG intubation with early oral feeding was a safe approach, with only 20% of patients requiring NG decompression because of repeated episodes of vomiting

CARCINOMA DEL PANCREAS: NPT, SOMATOSTATINA E DECORSO POST-OPERATORIO

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Trattamento Chirurgico del Cancro Colorettale Complicato. Studio retrospettivo

L'intervento chjirurgico d'urgenza per il cancro colorettale perforato può essere sicuro, avere bassa morbilità e mortalità, garantendo sopravvivenze paragonabili aquello della chirurgia elettiva