[Radical peritonectomy in 37 patients with stage II and III ovarian cancer]. / Peritonectomia radicale in 37 pazienti affette da neoplasia ovarica II e III stadio.

AIM: Radical peritonectomy followed by intraperitoneal early chemotherapy and systemic chemotherapy is the treatment of choice of stage II C and III ovarian cancer, due to the low 5-years survival rate (20%) of stage III and IV. METHODS: The authors present a 5-years experience in 37 patients affected by stage II C and III ovarian cancer treated by Sugarbaker's radical peritonectomy with some surgical technical differences. Intraperitoneal chemotherapy with adriamycin and cisplatin is started and followed after 25 days by a systemic chemotherapy with taxol and carboplatin. A 6-months second-look is performed. RESULTS: All the patients have been treated with radical peritonectomy with tumoral residual lesser than 2.5 mm; we performed 4 minor hepatectomies, 5 radical cystectomies, 35 resections of rectum and sigmoid colon with hysterectomies, bilateral salpingo-oophorectomies and pelviperitonectomies, 14 right hemicolectomies. We had no postoperative mortality, but we recorded a 40% minor morbidity rate. During the second look we found 7 recurrences (18%), 6 lesser than 6 mm, often located on the mesentery and treated with radical resections. The follow-up range is 2-60 months, 27 patients are still alive. Actually, 22 patients (80% of live patients) are in good health and disease free. CONCLUSION: Radical surgery associated with early postoperative chemotherapy followed by systemic chemotherapy in the treatment of ovarian cancer makes it possible to achieve the best survival results and long periods of disease free.

[Surgical therapy of liver metastases secondary to colorectal neoplasms]. / Considerazioni sulla terapia chirurgica delle metastasi epatiche secondarie a neoplasia colo-rettale.

Of the therapeutic aids currently available for the treatment of liver metastases, surgical treatment, when possible, has acquired an irreplaceable role. The exact criteria needed to establish a correct indication still have to be established. Various factors have been examined so far: number, site, dimensions of the metastases and features of the primary tumour whose prognostic importance does not lend itself to unequivocable interpretation. Personal experience of a series of 11 surgically treated cases seems to confirm that of the parameters analysed, the tumour-host relationship remains the most important prognostic factor.

[Primary malignant neoplasms of the liver. Contribution of echography to the preoperative diagnosis]. / Neoplasie maligne primitive del fegato. Contributo dell'ecografia alla diagnosi preoperatoria.

Primary malignant hepatic tumors are relatively common and the possibility of radical surgical treatment in the initial stages has modified our clinical approach therefore stressing the validity of a correct screening and follow-up of this pathology. The Authors present their clinical experience in the field enriched by the use of ultrasonography and conclude that this represents a highly effective diagnostic technique whereas it is less reliable in the determination of the nature of the lesion.

[Hamartomatous polyps of Brunner's gland. Presentation of 2 cases. Review of the literature]. / I polipi amartomatosi delle ghiandole di Brunner. Presentazione di due casi. Review della letteratura.

Two uncommon cases of Brunner gland hyperplasia are reported. Both presented clinical symptoms simulating gastrointestinal disease caused by hyperacidity. In conjunction with clinical statistics, diagnosis based on aetiology was only formulated after a double-contrast radiological exam of the g-i tract. After treatment with antiacid and antisecretory drugs, remission of the clinical symptoms was obtained, and regression of the hamartomatous polypoid duodenal neoformation, thus confirming the hypothesis which states that hyperacidic gastric secretion is the main cause of Brunner gland hyperplasia.