[Laparoscopic colostomy, indications and technical notes]. / Colostomia laparoscopica: indicazioni e note di tecnica chirurgica.

The aim of this article was to review the main indications of laparoscopic colostomy. A series of 9 patients is reported, stressing the technical steps of laparoscopic colostomy. The laparoscopic approach in patients with unresectable colorectal cancer permit to avoidance mayor laparotomy. In conclusion this technique appears safe, feasible and effective.

Laryngotracheal reconstruction in glottic-subglottic stenosis associated with DiGeorge syndrome in a four and a half-month-old infant.

Neonatal subglottic stenosis still remains a substantial challenge for paediatric ENT surgeons. Herein, we present a case of a single stage laryngotracheal reconstruction for a glottic-subglottic stenosis in an 18-week-old, 7.2 kg infant with DiGeorge syndrome. Our surgical approach was compared with those reported in the literature. Paediatric airway surgery should be tailored to individual patients according to age, weight, comorbidities and family collaboration, with the ultimate objective to minimise the invasiveness of the procedure.

[Lymphangioma of the spleen. Apropos of 2 cases]. / Il linfangioma della milza. A proposito di due osservazioni.

On the basis of two observed cases and a review of the literature, the extreme rarity of cystic lymphangioma of the spleen is pointed out. The presumed pathogenesis of the condition is described as are its greater frequency among the young, the possibility of dangerous complications and its non-malignity. The superiority of non-invasive instrumental diagnosis (echotomography and CAT) over traditional techniques is reported. Finally splenectomy is identified as the therapy of choice.

[Local regional recurrences after radical mastectomy. Studies of 50 cases]. / Recidive loco-regionali dopo mastectomia radicale. Osservazioni su 50 casi.

Resection of locoregional recurrences was performed after mastectomy in 50 cases in the period 1961-1974. An incidence of 2% to 35% is reported for such recurrences, which are due to a variety of factors. In the present series, attention was directed to age at mastectomy and at recurrence, size of primary tumour, presence of axillary metastases, and details of menarche, menopause and pregnancy. Mean age at mastectomy was 50 yr and at recurrence 53 yr. Tumour diameter ranged from 2 to 5 cm in 73% of cases. Lympho node metastases were present in 42%. In 80%, the recurrence was paracicatricial, in 13% parasternal, and in 7% axillary. Treatment consisted of resection, radiochemotherapy or endocrino-ablative management.

[Primary lymphoma of the breast]. / Il linfoma primitivo della mammella.

Analysis of 5 cases of primary breast lymphoma highlights the marked rarity of the lesion and the extreme difficulty of pre-operative diagnosis. It is also shown that the disease generally runs a rapid course and that prognosis is usually unfavourable. The most effective treatment appears to be a combination of surgery and radiation therapy, while chemotherapy--although widely used--still requires further confirmation.

[Treatment of leg ulcers with fibrin glue]. / Trattamento delle ulcere degli arti inferiori con colla di fibrina.

The work is based on two years studied cases. It consists of 80 patients between 35 and 80 years old with leg ulcers (73.8% women and 26.2% men). In 80% of patients this affection is due to a venous disease. In 10% of cases the cause was an arterial insufficiency of the lower extremity. Lymphatic and extravascular diseases are rarely involved. A group of 54 patients was treated with a traditional method. In the remaining 26 patients we used fibrin glue. Leg ulcers are an evolutive chronic pathology characterized by slow recovery. This means expensive social and therapeutic costs. From this point of view the treatment with fibrin glue, weekly applied, besides reducing pain, has a favourable impact on the outcome, times of re-epithelialization are shortened.

[Inguinal hernioplasty by a modified Shouldice technic. Our experience with 350 treated cases]. / Ernioplastica inguinale secondo la tecnica di Shouldice modificata. La nostra esperienza su 350 casi trattati.

A statistical analysis of 340 patients operated between 1986 and 1991 for inguinal hernia using the Shouldice procedure are reported by the authors. The majority of patients (60%) treated was between 45 and 65 years old. Two-hundred-eighty-one (82%) were controlled with a mean follow-up of 30 months (range 1-6 years) and was executed with physical examination and a medical questionnaire looking for recurring factors of risk. Hundred-twenty-eight patients (45% of controls) were at the high risk, nevertheless hernia recurrences were not noticed. Postoperative course was uncomplicated in 93% of patients. Early or late loco-regional complications had an incidence of 7%. Local infections and edema were reported in 10 of 22 patients. Acute urinary retention, cephalalgia and hypotension correlated with an anesthesiologic method had an incidence of 5% (17 cases). There were no deaths was pulmonary embolisms. A review of literature was performed and compared with our work. From experience in our Division, Shouldice's hospital technique had a high reliability compared to methods utilized in the previous ten years (Bassini, McNealy, Postemskj, Mugnai-Ferrari), in terms of recurrences.

[Methods of treatment of tumors of the soft parts and bones of the limbs and extremities. Analysis of case records]. / Modalità di trattamento dei tumori delle parti molli e delle ossa, degli arti e delle estremità. Analisi di una casistica.

218 patients examined for localized cancer of the extremities (50% benign, 50% malignant) are reported. The incidence is considered by sex and age. Demolition surgery was carried out in 35 patients and 27 locoregional treatment with antiblastics and radioactive isotopes was employed. Conservative surgery was used in 158. Operative mortality was less than 1% (2 cases out of 218) and did not reach 6% if amputations and disarticulations alone are considered. There were no deaths in cases submitted to radiochemotherapy and inguinocrural hymphadenectomy. The series includes a 15-years survival for giant-cell tumour of the femur treated with radioactive microsphores, an 11-years survival for a popliteal melanoma submitted to radiocolloid infiltration, a 9-year survival for femoral osteosarcoma for which hip disarticulation was carried out and a 4-year survival for a recurrent rhabdomyosarcoma of the hip operated by hemipelvectomy.

[Biliary peritonitis without perforation]. / Peritonite biliare senza perforazione.

The extreme rarity of this condition is shown and its anatomopathological and clinical features described. Conclusive diagnosis is impossible to formulate preoperatively and emergency surgery is necessary to avoid complications which are always serious in biliary peritonitis. Finally the observed clinical case is described.

[Minor pancreatitis after a Billroth II gastric resection for gastroduodenal ulcer]. / Pancreatiti minori dopo resezione gastrica secondo Billroth II per ulcera gastroduodenale.

Pancreatic complications arising after 117 Billroth II gastric resections carried out between 1976 and 1980 are evaluated. Changes in blood and urinary amylase were noted in 35% of cases. A distinction is drawn between minor forms (MPOP), and major forms (APOP), with an incidence of 34% and 1% respectively. Lastly, the question of aetiopathogenesis is discussed, with particular reference to the causal factors observed on each occasion.

[Postoperative pneumoperitoneum. Incidence, significance, duration]. / Il pneumoperitoneo post-operatorio. Incidenza, significato, durata.

The phenomenon of post-operative pneumoperitoneum is considered and its formation modalities, incidence, site and duration evaluated. The phenomenon is related to the constitution of the patient and the extent of the operation performed. Differences between post-operative and perforation forms are pointed out.