Short and long term results of the laparoscopic Heller–Dor myotomy. The influence of age and previous conservative therapies

Analisi dei risultati della terapia chirurgica dell'acalasia esofagea con tecnica di Heller-Dor laparoscopica in pazienti anziani con e senza dilatazione pneumatica pregress

Laparoscopic One-Stage vs Endoscopic Plus Laparoscopic Management of Common Bile Duct Stones – A Prospective Randomized Study

Improvements in diagnostic and operative approach to CBD stones associated with cholelithiasis allow the surgeon to treat in a single stage the disease through a laparoscopic approach, The AA report the results of a prospective randomised study comparing this approach to a a double stage endoscopic plus laparoscopic cholecistectomy in 124 patients. techniques and procedures are referred and the results are statistically analysed. the outcome of the two procedures were recorded as success or failure according to the complete clearance of the CB

Assessment of respiratory function in infants and young children wearing face masks during the COVID-19 pandemic

Importance: Face masks have been associated with effective prevention of diffusion of viruses via droplets. However, the use of face masks among children, especially those aged younger than 3 years, is debated, and the US Centers for Disease Control and American Academy of Physicians recommend the use of face mask only among individuals aged 3 years or older.Objective: To examine whether the use of surgical facial masks among children is associated with episodes of oxygen desaturation or respiratory distress.Design, Setting, and Participants: This cohort study was conducted from May through June 2020 in a secondary-level hospital pediatric unit in Italy. Included participants were 47 healthy children divided by age (ie, group A, aged ≤24 months, and group B, aged >24 months to ≤144 months). Data were analyzed from May through June 2020.Interventions: All participants were monitored every 15 minutes for changes in respiratory parameters for the first 30 minutes while not wearing a surgical face mask and for the next 30 minutes while wearing a face mask. Children aged 24 months and older then participated in a walking test for 12 minutes.Main Outcomes and Measures: Changes in respiratory parameters during the use of surgical masks were evaluated.Results: Among 47 children, 22 children (46.8%) were aged 24 months or younger (ie, group A), with 11 boys (50.0%) and median (interquartile range [IQR]) age 12.5 (10.0-17.5) months, and 25 children (53.2%) were aged older than 24 months to 144 months or younger, with 13 boys (52.0%) and median (IQR) age 100.0 (72.0-120.0) months. During the first 60 minutes of evaluation in the 2 groups, there was no significant change in group A in median (IQR) partial pressure of end-tidal carbon dioxide (Petco2; 33.0 [32.0-34.0] mm Hg; P for Kruskal Wallis =.59), oxygen saturation (Sao2; 98.0% [97.0%-99.0%]; P for Kruskal Wallis =.61), pulse rate (PR; 130.0 [115.0-140.0] pulsations/min; P for Kruskal Wallis =.99), or respiratory rate (RR; 30.0 [28.0-33.0] breaths/min; P for Kruskal Wallis =.69) or for group B in median (IQR) Petco2 (36.0 [34.0-38.0] mm Hg; P for Kruskal Wallis =.97), Sao2 (98.0% [97.0%-98.0%]; P for Kruskal Wallis =.52), PR (96.0 [84.0-104.5] pulsations/min; P for Kruskal Wallis test=.48), or RR (22.0 [20.0-25.0] breaths/min; P for Kruskal Wallis =.55). After the group B walking test, compared with before the walking test, there was a significant increase in median (IQR) PR (96.0 [84.0-104.5] pulsations/min vs 105.0 [100.0-115.0] pulsations/min; P<.02) and RR (22.0 [20.0-25.0] breaths/min vs 26.0 [24.0-29.0] breaths/min; P<.05).Conclusions and Relevance: This cohort study among infants and young children in Italy found that the use of facial masks was not associated with significant changes in Sao2 or Petco2, including among children aged 24 months and younger

IL COMPARTIMENTO POSTERIORE DELLA PELVI: anatomia, fisiopatologia e sintomatologia del prolasso rettale.

Il capitolo esamina le caratteristiche anatomo-funzionali del compartimento posteriore della pelvi in relazione alle alterazioni dell'evacuazione conseguenti al prolasso del retto.Sono analizzati gli elementi clinici peculiari che orientano la diagnosi strumentale e la strategia terapeutic

Sutureless hernioplasty with light-weight mesh and fibrin glue versus Lichtenstein procedure: a comparison of outcomes focusing on chronic postoperative pain

Abstract PURPOSE: Groin hernia is one of the most common disease requiring surgical intervention (8-10% of the male population). Nowadays, the application of prosthetic materials (mesh) is the technique most widely used in hernia repair. Although they are simple and rapid to perform, and lower the risk of recurrence, these techniques may lead to complications. The aim of the present study is to assess the incidence and degree of chronic pain, as well as the impairment in daily life, in two procedures: (1) the "Lichtenstein technique" with polypropylene mesh fixed with non-absorbable suture, and (2) the "sutureless" technique carried out by using a partially absorbable mesh (light-weight mesh) fastened with fibrin glue. METHODS: This was a study conducted over a period of 3 years from July 2006 to July 2009. A total of 148 consecutive male patients suffering from groin hernia were divided randomly into two groups: (1) Group A: patients operated with "sutureless" technique with partially absorbable mesh and plug fastened with 1 ml haemostatic sealant; (2) Group B: patients operated with Lichtenstein technique using non-absorbable mesh and plug anchored with polypropylene suture. Follow-up took place after 7 days, and 1, 6 and 12 months and consisted of examining and questioning patients about chronic pain as well as the amount of time required to return to their normal daily activities. RESULTS: No major complications or mortality were observed in either group. In group A there was a faster return to work and daily life activities. Six patients (7.8%) in group B suffered from chronic pain, whereas no patient in group A demonstrated this feature. CONCLUSIONS: Our experience shows that the combined use of light-weight mesh and fibrin glue gives significantly better results in terms of postoperative pain and return to daily life

Survival and locations of recurrence following abdomino-perineal resection for rectal cancer.Journal Article: Journal of Surgical Oncology (impact factor: 2.5). 05/1986; 31(4):235-9.

Abstract Records of 134 patients treated by abdomino-perineal resection (1971-1979) were reviewed. One hundred and thirteen had curative operations. Mortality was 2.6% and morbidity was 51%. Ninety-three were evaluable and were followed for 5 to 8 years; they were evaluated for survival and pattern of recurrence. Five-year survival for Dukes' A, B, C, and D lesions was 86, 62, 31, and 0%, respectively. Thirty-seven had recurrence: Four pelvic, nine pelvic and distant, and 24 only distant lesions. The overall incidence of failures was 47%, failure rates by stage were 11% for stage A, 27% for B, 48% for C, and 70% for D. Incidence of local recurrence was significantly higher in stage C compared to stage B. Irrespective of stage, after detection of local or distant recurrence, survival did not differ. Furthermore, radiotherapy for local recurrence and chemotherapy for distant lesions did not improve survival time

OESOPHAGEAL ACHALASIA IN ELDERLY PEOPLE: RESULTS OF THE LAPAROSCOPIC HELLER-DOR MYOTOMY

The study has the aim of assessing the influence of age on the outcome of surgical treatment of oesophageal achalasia using the the Gastrointestinal Quality of Life Index to compare laparoscopic surgery with conservative treatment in two groups of 28 patients. The conclusions are that laparoscopic Heller-Dor Miotomy is an effective palliation for achalasia and age does not affect the medim term outcome of surgical treatment

Ernioplasty suturless with light-weight mesh (Ultrapro®) and fibrin glue (Quixil®). Results of a randomised prospective study. HERNIA 14: S13-S46 – OP 70 – ISSN 1265-4906

The aim of the study is to assess the incidence and degree of chronic pain, as well as the impairment in daily life, in two procedures: (1) the "Lichtenstein technique" with polypropylene mesh fixed with non-absorbable suture, and (2) the "sutureless" technique carried out by using a partially absorbable mesh (light-weight mesh) fastened with fibrin glue in 148 consecutive male patients suffering from groin herni

EARLY AND LATE RESULTS OF LAPAROSCOPIC RESECTION FOR COLO- RECTAL CANCER. A 5 YEARS EXPERIENCE

The results of the surgical outcome and of a middle term follow up of a series of 64 consecutive patients undergone laparoscopic colorectal resections are referred preliminarly. showing that the laparoscopic approachis comparable to the open surgery as far as functional and oncologic results are concerned