Retroperitoneal Hemangiopericytoma in a young woman. Case report and literature review.

UNLABELLED: Hemangiopericytoma (HPC) is a primary tumor with mesenchymal vascular origin that represents 1% of all vascular neoplasm. HPC develops from the Zimmerman's pericytes around capillaries venules and it is possible to observe it frequently in the extremities, pelvis, retroperitoneum, head, neck and meninges. The only definitive parameter of malignancy is the development of recurrence or distant metastases. This report describes a case of symptomatic retroperitoneal HPC in a young female patient treated by surgical complete removal of the mass, and literature review. Despite the relatively simple surgical management of retroperitoneal Hemangiopericytoma, its diagnosis still remains difficult and often is incidentally. Patients should undergo a close long-term follow up, by periodic CT scan, due to the high probability of local recurrence or distant metastases that can occur also many years after surgery. KEY WORDS: Hemangiopericytoma (HPC), Retroperitoneum, Surgery.

Recurrent incisional hernia, enterocutaneous fistula and loss of the substance of the abdominal wall: plastic with organic prosthesis, skin graft and VAC therapy. Clinical case.

Surgical wounds dehiscence is a serious post-operatory complication, with an incidence between 0.4% and 3.5%. Mortality is more than 45%. Complex wounds treatment may require a multidisciplinary management. VAC Therapy could be an alternative treatment regarding complex wound. VAC therapy has been recently introduced on skin's graft tissue management reducing skin graft rejection. The use of biological prosthesis has been tested in a contaminated field, better than synthetic meshes, which often need to be removed. The Permacol is more resistant to degradation by proteases due to its cross-links. Surgery is still considered the best treatment for digestive fistula. A 58 years old obese woman come to our attention, she was operated for an abdominal hernia. She had a post-operatory entero-cutaneous fistula. She was submitted to bowel resection, the anastomosis has been tailored and the hernia of the abdominal wall has been repaired with biological mesh for managing such condition. She had a wound dehiscence with loss of substance and the exposure of the biological prosthesis, nearly 20 cm diameter. She was treated first with antibiotic therapy and simple medications. In addiction, antibiotic therapy was necessary late associated to 7 months with advanced medications allowed a small reduction's defect. Because of its, treatment went on for two more months using VAC therapy. Antibiotic's therapy was finally suspended. The VAC therapy allowed the reduction of the gap, between skin and subcutaneous tissue, and the defect's size preparing a suitable ground for the skin graft. The graft, managed with the vac therapy, was necessary to complete the healing process.

Multiorgan female pelvic prolapse: pelvic organ prolapse suspension (P.O.P.S.) stapled transanal rectale resection (S.T.A.R.R.): new surgical tecniques and results.

AIM: To demonstrate the surgical treatment validity and the post-operative complication decrease. MATERIAL OF STUDY: Seventythree women who underwent P.O.P.S. + S.T.A.R.R. treatment, follow-up one year. RESULTS: We observed an important reduction or a completely disappearance about pre-operative signs and symptoms. DISCUSSION: We are aware that the proposed technique, if taken into account by urogynecologists, will raise several arguments and will raise many doubts and perplexities. For this reason we wanted develop a follow-up sufficiently long and many case studies with data to support our claims. CONCLUSIONS: We believe that the procedure proposed by us, given the results, was excellent in patients with multiorgan pelvic prolapse, especially with the vagina walls elongated and that retain a good trophism.