Diffuse intestinal diverticulosis: a case report.

We report an asymptomatic case of diffuse intestinal diverticulosis simultaneously affecting duodenum, jejunum and colon. The patient presented signs of progressive systemic sclerosis, which supports the hypothesis in the literature of an aetiological link.

[Lung transplantation. Progress and perspectives]. / Il trapianto di polmone. Progressi e prospettive.

Techniques and indications for lung transplantation evolved significantly in the past few decades, at present there is a resurgence of interest in single- and double-lung transplantation for end-stage disease. The surgical procedure has been recently simplified and complications at the tracheal anastomosis have been significantly decreased. Many problems, common to organ transplantation, remain to be solved including availability of suitable donor organs, the ability to effectively treat organ rejection and improve the immunosuppressive regimens. The authors report a review of the international literature of the last three years, carrying on a critical analysis with the aim of identifying the problems related to this organ transplantation, progress in the research filed, complications and results.

[Retroperitoneal sarcomas: recent advances in nosographic framework, diagnosis and integrated surgical treatment]. / I sarcomi retroperitoneali: recenti acquisizioni in tema di inquadramento nosografico, diagnosi e terapia chirurgica integrata.

In this paper the Authors reviewed the recent literature for a more comprehensive and clear vision of the epidemiological and pathological aspects of retroperitoneal sarcomas. The most effective procedures for a an early and accurate diagnosis were identified. Moreover, the different therapeutic choices were taken into account focusing on those provided of the major potential in terms of oncologically valid treatment.

[Treatment via laser of airway obstructions]. / Il trattamento mediante laser delle ostruzioni delle vie aeree.

The Nd-YAG laser is widely used in endoscopy. Laser therapy either by contact or non-contact method, can be considered the best palliative option for patients affected by airway obstruction due to endoluminal malignant tumours. It aims at the improvement of breathing conditions and symptomatology. In patients affected by benign obstructions, it often allows to obtain curative results avoiding the use of traditional surgery. From 1988 to 1993 at the First Department of Surgery of the University of Rome "La Sapienza", 163 treatments out of 111 clinical cases affected by airway obstruction, caused by malignant tumours considered inoperable or relapsed after operation, or by vegetating benign tumours, or granulomas or fibrous diaphragms were performed. The symptomatological improvement and beneficial changes in functional breathing tests, haemogasanalysis, and X-ray findings were registered 24-48 hours after each treatment. The results showed an improvement in functional breathing values especially after treatment of the main airways such as trachea and main bronchi. The therapy offered an acceptable quality of life. A fairly good number of patients may also return to radio and chemotherapy, if previously interrupted.

[Esophageal achalasia: etiopathogenesis and possibility of treatment. Review of the literature and presentation of a clinical case]. / L'acalasia esofagea: etiopatogenesi e possibilità di trattamento. Revisione della letteratura e presentazione di un caso clinico.

The Authors report a particular case and make a careful international literature regarding etiopathogenesis and surgical treatment of oesophageal achalasia. First they consider the infection mechanisms as the cause of underlying motor disturbances of the oesophagus. Afterwards holding as parameters of reference for the evaluation of effectiveness of the therapy both the relief of dysphagia and the appearance of postoperative RGE, the various surgical options are then examined: pneumatic dilatation as opposed to surgery; the approach to thoracic and abdominal surgery and the possible assembly of a reflux protection mechanism. Finally, they propose the discussion on the challenge that the new technological systems have opened to the international surgical scene: the minimal-access surgery.

[Use of endoprosthesis in the treatment of airway pathology]. / L'impiego di endoprotesi nel trattamento delle patologie delle vie aeree.

In patients affected by benign or malignant inoperable airway obstructions, therapeutical options include endoscopic treatment by Nd-YAG laser therapy, tracheobronchial dilatations with rigid or flexible bronchoscope, and inflating balloon dilators. Metal self-expanding or silicone stents allow to obtain stable results. Our experience is based on the use of 14 stents (10 Dumon and 4 Wallstent) in 13 cases of stenosis either due to vegetating malignant tumours not amenable to surgery or benign stenosis. In the following 24-48 hours both subjective and objective changes of the pulmonary function, blood gas analysis and radiologic aspects were observed. The results showed an improvement in the respiratory parameters and a sensible improvement in the quality of life.