[Laparoscopic deroofing of non parasitic posterolateral liver cyst. Technical considerations]. / Fenestrazione laparoscopica di cisti non parassitaria posterolaterale del fegato. Considerazioni tecniche.

Laparoscopic deroofing of the solitary non parasitic cysts of the liver is a safe and effective procedure. This technique allows a wide access for surgical treatment of cysts localized in segments II, III, IVb, V, and VIII of the liver. On the contrary, the posterior segments, VI and VII, and the segment IVa, are difficult to approach laparoscopically. This report describes a laparoscopic technique used in treating 3 cases of symptomatic solitary cysts of the posterior segments of the liver. The patients were placed in the left lateral position. The fenestration treatment was easy and the mobilization of the right hepatic lobe was not required. At one year follow-up, neither postoperative complications nor recurring episodes were observed.

[Splenectomy for hematologic disease. Mini-invasive versus traditional technique]. / La splenectomia per malattie ematologiche. Tecnica mininvasiva e tradizionale.

BACKGROUND: This study aimed to compare the safety, efficacy and clinical benefits of laparoscopic splenectomy (LS) to open splenectomy (OS) in patients with hematologic disorders. EXPERIMENTAL DESIGN: prospective study; SETTING: II Department of Surgery, Santa Maria Nuova Hospital, Reggio Emilia and III Department of Surgery, Santo Spirito Hospital Pescara; PATIENTS: 48 consecutive adult patients underwent splenectomy; 30 patients under-went LS and 18 OS. Perioperative characteristics, outcomes, complications and costs were comparatively analyzed. RESULTS: Mean age was 35.3 years in the LS group, and 40.8 in the OS group. Mean spleen size was 11.7 cm in the LS group and 15.2 cm in the OS group. Accessory spleens were found in 5 patients in the LS group and in 4 patients in the OS group; 4 conversions to laparotomy occurred in the LS group. A total of 4 complications occurred in 3 patients of the LS; 9 complications occurred in 5 patients of OS group. Mean surgical time was 141.5 minutes for LS and 89.7 minutes for OS (p<0.005). Mean postsurgical stay was 5.8 days in the LS group and 8.5 days in the OS group (p<0.005). Response rates were similar in both groups. CONCLUSIONS: LS is comparable to OS in terms of efficacy and safety and it is associated with a shorter hospital stay. LS should become the technique of choice for treatment of intractable benign hematologic disease.

[The defecation balloon proctogram in the study of idiopathic incontinence]. / Il proctogramma defecatorio con pallone nello studio della incontinenza idiopatica.

The authors report their findings in the study of idiopathic rectal incontinence using a defecatory balloon proctogram. The study provides a detailed anatomico-functional analysis of the sphincteric tract and, together with manometric and electromyographic studies, is useful in assessing the need for reconstructive surgery and for monitoring the results of ileoanal and coloanal anastomoses, sphincteric plastic surgery and posterior anal plastic surgery.