[Low rectal cancer treatment in frail elderly patients. A personal series]. / Il trattamento del carcinoma del retto basso nel paziente anziano fragile. Contributo casistico.

Rectal cancer predominantly affects elderly people, who are however more likely to have concomitant medical diseases and, therefore, are at higer surgical risk. After a careful selection of the patients, some surgical procedures can be performed safely. We studied a series of 149 patients affected by low rectal cancer; of these, 46 were aged 75 or older and comprise the elderly group; 94 curative resections, 19 palliative surgical treatments, 31 local excisions were performed. This approach demonstrated to be safe and effective among older patients too; therefore we may conclude that it is associated with a good control of surgical risk and of cancer in selected patients.

[Repair of umbilical hernia in postmenopausal women]. / La riparazione dell'ernia ombelicale nella donna in postmenopausa.

The Authors report their personal experience on the employment of the dual-mesh in PTFE for the treatment of the umbilical hernias in postmenopausal women. The prosthetic repair versus the classic Mayo's technique finds justification for the biostructural deficits of the muscolofascial structures of the women in menopause, due to the reduction of the ovarian function and made worse from previous pregnancies. An evaluation of the trofism of the structures of the abdominal wall and the dimensions of the hernias is however indispensable in the choice of the prosthetic surgery. In our casuistry the reported morbidity due to immediate complications is absolutely negligible. Up to the present, although the follow-up is still short, we have not found recurrences.

[Day surgery for breast cancer in the elderly]. / La day-surgery del carcinoma della mammella senile.

Early diagnosis of breast cancer and improvement of new technologies for identification and analysis of sentinel node allow more conservative surgical approaches, which guarantee both excellent local control and a good quality of life, also in elderly patients. We have studied a series of 28 women aged 70 years or older and affected by breast cancer. They underwent breast-preserving surgery either alone or in association with axillary lymphadenectomy and all of them had early discharge from hospital. This approach demonstrated to be safe and effective, so we may conclude that day-surgery treatment of breast cancer in these patients is possible in the majority of cases, is associated with low morbidity and is profitable for clinical, social and economic issues.

Abscess and cecum carcinoma in inguinal hernia: case report.

Cecal adenocarcinoma within an inguinal hernial sac is an uncommon clinical condition. A primary adenocarcinoma of the cecum in a right sided inguinal hernia is presented and discussed. This case represents one of the unexpected findings in a hernia sac and also very rare septic evolution. This particular condition is a main dignostic and therapeutic challenge.

[Fibrin sealant in tension free hernioplasty: our experience]. / La colla di fibrina nelle ernioplastiche tension-free: nostra esperienza.

The aim of this study was to prove that it is possible to fix mesh sutureless with Tissucol in the Lichtenstein procedure. The mesh fixation with Tissucol was done in 28 patients. Respect the traditional Lichtenstein technique, which was done in the remaining 28 patients, the advantages of using Tissucol are: no surgical trauma, total mesh fixation, no pain, reduced morbidity and reduced costs. Furthermore it is a safe and reproducible method. The results are promising, even if the verification goes more carried out with consisting casuistics and longer follow-up.

Pathological evaluation in colorectal polyps endoscopic treatment.

This retrospective study shows that endoscopic polypectomy is the technique of choice to remove the majority of polyps; follow-up and pathologic examinations shed light on the carcinogenesis of colorectal lesions. From January 1990 to December 2001, 1302 adenomatous polyps were removed, 1175 endoscopically, 127 with surgical procedures. The anatomical and morphologic conditions of the colon and some characteristics of the polyps represent limits to the feasibility and to the efficacy of polypectomy, and the most important variables for the correct management of the patients affected by colorectal adenomatous polyps.