A cross-sectional nationwide survey on esophageal atresia and tracheoesophageal fistula.

BACKGROUND: Our study aims at disclosing epidemiology and most relevant clinical features of esophageal atresia (EA) pointing to a model of multicentre collaboration. METHODS: A detailed questionnaire was sent to all Italian Units of pediatric surgery in order to collect data of patients born with EA between January and December 2012. The results were crosschecked by matching date and place of birth of the patients with those of diagnosis-related group provided by the Italian Ministry of Health (MOH). RESULTS: A total of 146 questionnaires were returned plus a further 32 patients reported in the MOH database. Basing on a total of 178 patients with EA born in Italy in 2012, the incidence of EA was calculated in 3.33 per 10,000 live births. Antenatal diagnosis was suspected in 29.5% patients. 55.5% showed associated anomalies. The most common type of EA was Gross type C (89%). Postoperative complications occurred in 37% of type C EA and 100% of type A EA. A 9.5% mortality rate was reported. CONCLUSIONS: This is the first Italian cross-sectional nationwide survey on EA. We can now develop shared guidelines and provide more reliable prognostic expectations for our patients.

[Surgical treatment of perforated duodenal ulcer. Review of 36 cases]. / Il trattamento chirurgico dell'ulcera duodenale perforata. Revisione di 36 casi.

Results obtained in the surgical management of 36 cases of perforated duodenal ulcer treated between January 1976 and November 1979 are presented. A choice was made between three methods (suturing, excision plus pyloroplasty and truncular vagotomy, and Péan-Billroth resection and reconstruction) in the light of the duration of the disease, the extent of the duodenal alterations, and the concomitance of serious disorders. No account was taken of age, the time elapsed between perforation and treatment, or the extent of peritoneal reaction.