RESUMO
The topic chosen by the Board of the Italian Society of Surgery for the 2013 annual Consensus Conference was gastric cancer. With this purpose, under the direction of 2 chairmen, 36 experts nominated by the Regional Societies of Surgery and by the Italian Research Group for Gastric Cancer (GIRCG) participated in an experts consensus exercise, preceded by a questionnaire and mainly held by telematic vote, in accordance with the rules of the Delphi method. The results of this Consensus Conference, presented to the 115th National Congress of the Italian Society of Surgery, and approved in plenary session, are reported in the present paper.
Assuntos
Neoplasias Gástricas/terapia , Técnica Delphi , Endossonografia , Feminino , Humanos , Itália , Excisão de Linfonodo , Masculino , Estadiamento de Neoplasias , Sociedades Médicas , Neoplasias Gástricas/diagnóstico , Neoplasias Gástricas/patologia , Neoplasias Gástricas/cirurgiaRESUMO
A hernia of Morgagni (also called hernia of Morgagni-Larrey) is a congenital herniation of abdominal contents into the thoracic cavity through a retrosternal diaphragmatic defect. The Morgagni hernia can create uncertainty in its diagnosis and difficulty for subsequent treatment. If after clinical examination and x-ray we suspect the hernia, computed tomography imaging should be the desired imaging method to confirm the diagnosis. Surgery is the only definitive treatment. When a patient presents signs and symptoms of incarceration or strangulation, emergency surgery is required. We report the first life-threatening case of an association between a hernia of Morgagni and a mediastinal lipoma. We present an adult patient with mediastinal lipoma and a right incarcerated hernia of Morgagni with engagement of the stomach, the duodenum and the transverse colon, successfully treated without complications. To our knowledge, this is the first report of an association between those two rare entities in an acute setting. We discuss the differential diagnosis and physiopathology of the condition, referring to published reports.
Assuntos
Hérnias Diafragmáticas Congênitas , Lipoma/complicações , Neoplasias do Mediastino/complicações , Idoso , Feminino , Hérnia Diafragmática/diagnóstico por imagem , Hérnia Diafragmática/cirurgia , Humanos , Obstrução Intestinal/etiologia , Lipoma/diagnóstico por imagem , Lipoma/cirurgia , Neoplasias do Mediastino/diagnóstico por imagem , Neoplasias do Mediastino/cirurgia , Tomografia Computadorizada por Raios X , Resultado do TratamentoRESUMO
In locally advanced rectal cancer, tumour-negative margins often cannot be obtained by surgery alone. Nevertheless only patients with complete tumour resections can be cured. Different surgical options, possibly combined with neoadjuvant therapy, are available for the treatment of rectal cancer. Preoperative staging is essential to plan the correct treatment. Our aim was to assess the efficacy and tolerability of combined therapy in rectal cancer, an important aspect of which is the evaluation of the diagnostic accuracy of computed tomography in the local staging of rectal cancer. The results of the study confirm that combined preoperative therapy is well tolerated in most cases and constitutes the protocol of choice in patients with rectal cancer.