[Fournier syndrome: report of a clinical case]. / La sindrome di Fournier: descrizione di un caso clinico.

The case of a Fournier's syndrome in a 58 years old patient is reported from the Authors that describe the ethiopathogenetic and therapeutic aspects. They analyse the importance of an early surgical treatment associated with antibiotic therapy and later a riparation of the lesions with a myocutaneous skin flap of TLF.

[Incidental diagnosis of seminoma in male infertility: report of a clinical case]. / Diagnosi incidentale di seminoma nell'infertilità maschile: descrizione di un caso clinico.

The aims of the study were to evaluate the association between male infertility and risk of developing testis cancer and to establish guidelines for the early diagnosis of testis neoplasia in subfertile men. 32-year-old infertile man. The patient underwent random testicular biopsy to establish the exact cause of infertility. An incidental diagnosis of seminoma was made and the patient then underwent right testis excision. Anatomopathologic macroscopic examination revealed two nodules, the sizes of which were 0.8 x 0.4 and 0.3 x 0.2 cm, respectively. Histologic examination confirmed the diagnosis of typical seminoma, pT1, with copious lymphocytic struma infiltration. There appears to be a correlation between male infertility and occurrence of seminoma. Diagnosis of testis cancer is often incidental and sometimes occurs in men undergoing testicular biopsy to investigate infertility. Since the biopsy was not specifically targeted in our case, the diagnosis of seminoma was casual. This suggests the need for a careful follow-up, including testicular ultrasonography as a screening test to achieve an early diagnosis of testis cancer in all infertile men, because of their higher risk of developing testis cancer than the normal population.

[Endolaparoscopic "Rendez-vous" in the treatment of cholecysto-choledochal calculosis]. / Il "Rendez-vous" endolaparoscopico nel trattamento della calcolosi colecisto-coledocica.

Different methods, all of which equally efficacious and safe, can be selected to access the choledochus in patients with cholecysto and choledocholithiasis on the basis of clinical and anatomosurgical parameters. From 1990 we evaluated three groups of patients who underwent surgery at different times and with different methods: sequentially (endoscopic sphincterotomy and laparoscopic cholecystectomy), one step laparoscopy and combined laparo-endoscopy. The results obtained seem to show that the treatment with laparoscopy alone is the most advantageous in terms of cost-benefit, while the endoscopic access of the choledochus during laparoscopic cholecystectomy is the one to prefer in terms of efficacy and safety.

[Gastric resection and subtotal gastrectomy. Principles and updated surgical technique]. / La resezione gastrica e la gastrectomia subtotale. Princìpi ed attualità di tecnica chirurgica.

The Authors describe their last 10 years experience in gastric surgery. They report the results obtained in 12 gastric resections performed for complications following gastric and/or duodenal peptic ulcers, in 33 cases of total gastrectomies (34%), and 48 cases of subtotal gastrectomies (49%) for early and advanced cancer. The results lead to interesting conclusions: first of all achieving a wide jejunojejunostomy between the afferent and the efferent loop the problems related to gastric resection (as postoperative sequelae, dumping syndrome, reflux esophagitis, alkaline gastritis, etc.) are avoided. Problems regarding lymphadenectomy in patients submitted to subtotal gastrectomy (D2-D3) are then reported. After a brief history of gastric reconstruction following gastric resection the evolution in surgical techniques and the results obtained during the last 10 years are described. The good long term results allow to conclude that our strategy in gastric surgery ensures a good quality of life of the patients as well as a radical operation in case of gastric cancer.

[Septic ascites: a rare post-operative complication]. / L'ascite settica: una rara complicanza post-operatoria.

Spontaneous bacterial peritonitis in patients with chronic hepatitis represents a very controversial matter in terms of frequency, pathology and treatment. This unusual complication mainly due to decreased immunological defences and ascitic fluid opsonic activity is not accepted by all the Authors as a rare event. However, there is agreement as far as management is concerned: cultural examination of the ascitic fluid and the relative antibiogram are the best tools in guiding the approach to an adequate antibiotic therapy.

[Anterograde laparoscopic cholecystectomy: when and why]. / La colecistectomia laparoscopica per via anterograda: quando e perché.

Today largely diffused is the concept that laparoscopic cholecystectomy (LC) represents the treatment of choice for symptomatic gallstones. Nonetheless some questions have been raised on the real safety of this new method in terms of procedure-related complications. On the basis of our experience with traditional open cholecystectomy, we have recently performed a prograde LC in those cases with difficulties in identifying the anatomical structures of the so called Calot's triangle. This alternative route can be easily performed laparoscopically and has been useful in reducing the time of the intervention in the most difficult setting and to increase the safety of the procedure. The technical details and the results are compared with those of the laparoscopic retrograde route.