Outcomes of bilateral mammoplasty for early stage breast cancer.

AIM: Long-term oncological follow-up of oncoplastic breast surgery. METHODS: Sixthy-one (63 cancers) patients affected by breast cancer suitable for breast conservation, were treated with bilateral breast reductions. Tumours located in the inferior pole of the breast were treated by a superior pedicle technique; lesions in the upper pole or in the infero-lateral or infero-medial quadrants of the breast were removed with an inferior pedicle reduction. Small and medium size breast irrespective of tumour location required a periareolar, or comma-shaped approach. RESULTS: Fifty-six patients were alive at a mean follow-up of 68 months. One patient recurred locally and she is currently alive free of disease. CONCLUSION: Results from this study are in accordance with those reported by other similar papers. Oncoplastic breast surgery maximizes cosmetic results and with wider excisions provides effective local control.

[Emergencies in oncologic surgery of the large intestine]. / Le urgenze nella chirurgia oncologica del grosso intestino.

The authors analyse of the large intestine at their Institute over the past 20 years. Four hundred and fifty-two cases out of 842 were performed during the period 1970-1979 and 300 during the subsequent decade. 21% (95 cases) were emergencies during the first decade and 16% (62 cases) during the second. From this study it emerges that patients operated with primary resection during the first decade 1970-1979 had a better survival rate than those operated in various stages. This was particularly true of cases of occlusion, whereas in cases of perforation the percentage remained practically unchanged. The approach adopted for this type of pathology changed during the next decade and it was decided to opt for primary resective surgery. A comparison between emergency surgery performed in a single session and operations performed in a number of stages revealed that both survival and morbidity were improved in primary resective surgery, 20% and 10% respectively, whereas mortality was higher (15%).

[Follow up in carcinoma of the large intestine]. / Il follow-up nel carcinoma del grosso intestino.

A valid program of follow-up has always been a crucial point in the overall therapy of the colon-cancer. In this retrospective study, the authors have used as specimen 74 patients put under observation between the years 1987 and 1992. The patient have been followed throughout the diagnostic period with various methods. It has been the will of the authors, who have presented their protocol of reference, to put under comparison the various controlling methods in order to visualize their reliability, specificity and the indication of each one of them. The CEA is the most sensible haemanalysis for lifting the doubt of recidivation. As for the TAC and ultrasound it has been reserved the job of formulating a correct diagnosis; the results of both diagnostics through imagery have been more or less the same. However, the ultrasound examination have shown more false positives than the TAC. The research of the blood occult in the stool is a rapid and economic detection in the case of intramural recidivations, even if we cannot disregard the share of false positives. A high specificity for the study of intramural recidivations has been offered by the endoscopic scan particularly when associated by a brushing and biopsy.

[Risk factors in laparoscopic cholecystectomy]. / I fattori di rischio nella colecistectomia laparoscopica.

In this report the authors have analysed the various risk factors of the laparoscopy cholecystectomy, proving that those are not different from the ones of standard open cholecystectomy. It has been underlined that laparoscopy cholecystectomy offers significant advantages over open cholecystectomy and moreover the possibility to convert laparoscopy cholecystectomy when it is necessary.

[Foreign bodies and injuries of the rectum]. / Corpi estranei e traumi del retto.

Personal experience of 33 cases of foreign rectal bodies introduced transanally with or without associated lesions is reported. After examining the principles of diagnosis, stress is laid on therapy and personal experience and it is suggested that more energy should be applied to extracting the foreign body transanally even using more or less deep anaesthesia, so avoiding the need for abdominal surgery.