[Total thyroidectomy in recurrent goiters (anatomicosurgical observations with the operating microscope)]. / La tiroidectomia totale nelle recidive di gozzo (osservazioni anatomo-chirurgiche con l'ausilio del microscopio operatorio).

The relapses of the multinodular goitre, often linked with an insufficient surgical treatment of primitive lesions, make serious problems about the operating technique. The current guidance of surgeons is directed towards the complete thyroidectomy which profits, during the operating time, by the use of microscope to identify and to protect the recurrent nerves. This equipment has to be used by those equipped which know how to use it. In our work we report the results obtained with this technique and it's underlined how the complete thyroidectomy for the benign relapsing goitre could be considered curative towards those cases which present hidden microcarcinoma.

[A case of hernia of the liver following a traumatic lesion of the diaphragm]. / Considerazioni su un caso di ernia del fegato conseguente a lesione traumatica del diaframma.

The authors describe a case of liver -hernia ensuing a right diaphragmatic rupture. This is a rare event. However, the difficult diagnosis and possible ways of surgical access are discussed.

[Cystic dilatation of the choledocus]. / Dilatazione cistica del coledoco.

Choledochal cyst is an uncommon congenital lesion of the pancreatobiliary system. The pathologic features are cystic dilatation of the common bile duct, normal liver parenchyma, a normal intrahepatic biliary system and partial obstruction of the terminal common bile duct. More than 1400 cases have been reported in tre literature, 83 per cent of which have been diagnosed in patients below the age of 30. A triad of abdominal pain, jaundice and a palpable abdominal mass in the right hypocondrium has been classically associated with this condition. Ultrasonography and CT scanning are usually successful in demonstrating the mass. Cholangiography by the endoscopic retrograde approach may demonstrate the cystic dilatation of the common bile duct. The precise relation ship of the cyst to the biliary tree should be demonstrated by cholangiography at operation. The common type I fusiform cyst is currently treated either by excision combined with a biliary intestinal anastomosis of by anastomosis of the cyst to the intestinal tract. Treatment of the rare type II diverticulum consist of simple excision, while the rare type III choledococele is treated by transduodenal excision of the cyst wall. The current mortality rate of choledochal cyst treated by surgical decompression is 5 to 10 per cent. A case of choledochal cyst in a 58 years old woman is described. The anatomopathologic, clinic features and therapeutic lines are pointed out.

[Experimental porto-systemic diversion in the rat: a comparative analysis of technics and results]. / Le derivazioni porto sistemiche sperimentali nel ratto: analisi comparativa di tecniche e risultati.

A number of techniques for performing portacaval end-to-side and side-to-side pancreaticoduodenal and mesenterico-caval shunts in rats are described. These shunts, transposition and arterialization are valuable objects for training in microvascular surgery. Effects of shunts, liver function, hemodynamics, metabolic and neurological changes related to portal flow, liver metabolism, and portal pressure are compared.

[Diagnosis and therapy of splenic injuries]. / Diagnosi e terapia dei traumi splenici.

The purpose of this work is a critical revision of spleen traumatism treatment. We have examined 46 patients which we treated by total splenectomy. We examined the recent literature on spleen functions and we tried to punctualize the newest methods for conservative treatment of the spleen.

[Acute pancreatitis: retrospective study on the treatment of 45 cases observed in a general surgery department]. / Pancreatite acuta: indagine retrospettiva sul trattamento di 45 casi osservati in una divisione di chirurgia generale.

The Authors have developed a retrospective study of 45 patients, suffering from acute pancreatitis and hospitalized at a general surgery Departement during a period of two years. The purpose of the study was to evaluate the validity of the classification of acute pancreatitis in three degrees (slight, moderate, serious), suggested by Hollender to prognostic and therapeutic aims.

[Open and closed injuries of the abdomen (review of 107 surgically treated cases)]. / Traumi aperti e chiusi dell'addome (revisione di 107 casi sottoposti ad intervento chirurgico).

The authors relate about 107 cases of multiple injuries observed from 1975 to 1984. The causes of trauma, the different injuries caused by trauma, the association of different injuries intra and extra abdominal are examined; the diagnostic procedure, the results obtained, mortality, complications. The studied patients are divided on the basis of the trauma occurred. These data support the position that, in patients with severe multiple injuries, certain criteria, as rapidly increasing abdominal distension or uncorrectable hypotension and isolated rigidity of abdominal wall, eliminate the need for diagnostic examinations and make these procedures unwise waste of valuable time.

[Liver lesions in abdominal traumatology]. / Le lesioni epatiche nella traumatologia addominale.

Hepatic traumas are one of the most common sequelae of abdominal injuries. The Authors report 24 cases of hepatic traumas about a casuistry of 104 patients, that, in the decade '74-'84, had an abdominal traumatism. The quality of injuries, the therapeutic actions, and results are described.

[Role of the total and prolonged diversion of portal blood on hepatic function in the rat]. / Ruolo della derivazione totale e protratta del sangue portale sulla funzionalita' epatica nel ratto.

In this experience the effect on hepatic parenchyma and function has been analyzed 180 days after total portacaval shunt. The portacaval shunt induces 50% mortality rate at six months. In the survived animals a significant reduction of hepatic mass has been observed. The liver still presents significant elevation of necrosis and cholestasis enzymes. The residual hepatocellular function related to hepatic mass is comparable to sham operated rats, but it is quite insufficient to maintain endogenous clearances.

[Intestinal adaptive response of the rat after bilio-pancreatic and food diversion from the duodenum]. / La risposta adattativa intestinale del ratto dopo diversione bilio-pancreatica ed alimentare dal duodeno.

The object of the research was to evalute, in the rat, the effects brought about on the intestinal trophism by the selective and combined exclusion of the bile, the pancreatic secretion and the food exsert, certainly, a trophic activity on the intestinal mucous membrane where they pass trough, as it has been observed by other authors; but the modifications, observed on last segments of the ileum, do not explain a direct action of these factors to modulate the adaptative intestinal reaction. In the following essay we propose the hypothesis that the privation of biliary and pancreatic secretions and the food from the duodenum may stimulate a hormonal and duodenal reaction which is able to produced observed phenomena.

[Total parenteral nutrition in the treatment of acute pancreatitis]. / La nutrizione parenterale totale nel trattamento della pancreatite acuta.

The authors refer their experience in the treatment of the acute pancreatitis by total parenteral nutrition. The study has been carried on twelve patients selected on the basis of prognostic factors of gravity by Ranson. The total parenteral nutrition proved to be useful as a therapy of support, causing the functional rest of the gland and assuring to the patient a caloric and proteic contribution strict necessary to overcome the serious hypercatabolic state which is determined.

[Presence of dilatations of the aneurysm type in the abdominal aorta after experimental terminoterminal anastomosis in the rat]. / Osservazioni sulla presenza di dilatazioni di tipo aneurismatico nel tratto addominale dell'aorta dopo intervento sperimentale di anastomosi termino terminale nel ratto.

We have examined the aneurysmal dilatations in the wall of abdominal aorta after microsurgical experimental operation of end-to-end anastomosis. We observed this alteration both by macroscopic examination and by optical light microscopy. The wall presents various damages, particularly in the media, that seems thick, disarranged and often necrotic.

[Behavior of the principal blood coagulation parameters in rats with portacaval anastomosis]. / Comportamento dei principali parametri emocoagulativi in ratti sottoposti ad anastomosi porto-cava.

The aim of our research was to evaluate same coagulative parameters in the rat after end-to-side porto-caval shunt, comparing the data with "sham operated" rats. At 180th day in each group the following parameters were controlled: platelet, fibrinogen, prothrombin time, partial thromboplastin time, T.E.G. The results have shown a significant diminution in the following parameters: PLT, PT, fibrinogen, and T.E.G.

[Metabolic changes following termino-lateral portacaval anastomosis in the rat]. / Alterazioni metaboliche conseguenti ad anastomosi porto-cava termino-laterale nel ratto.

The purpose of these present experiences was to evaluate some metabolic parameters, which can show liver damage after end-to-side porto-caval shunt, comparing the data with "sham operated" rats. At 180th day in each group the following parameters were controlled: ALT, AST, Alkaline phosphatase, gamma GT, bilirubin, Cholesterol, albumin and ammonia blood level. The results showed a significant increase of gamma GT, APh, bilirubin and ammonia blood level in porto-caval shunt operated rats.

[Experimental microsurgery operations on the rabbit fallopian tube]. / Modelli sperimentali microchirurgici sulla tuba di coniglio.

The authors show their experience in tubal microsutures in rabbits belonging to the New Zealand type. Three groups of seven rabbits each have been examined and for each group a different type of microsurgical operation has been carried out. Post operational checks where effected immediately afterwards and sometimes after the operation.

[Collagen hemostatic felt for local application in the control of surgical bleeding]. / La falda di collageno come emostatico locale.

The authors have employed the collagen haemostatic felt in the control of capillary bleeding, parenchymatous haemorrhages and oozing wound haemorrhage in several surgicals cases. Collagen haemostatic felt, apart from its excellent haemostatic properties, is pliable, conforms readily to irregular contours, is soft, has excellent absorptive capacity and has good tissue compatibility.

[Total parenteral nutrition in resuscitation. A study of 31 cases]. / Nutrizione parenterale totale in rianimazione. Studio di 31 casi.

The authors analyse the results obtained above study of 31 patients managed with total parenteral nutrition for a period variant from 3 to 18 days. From these dates result importance of caloric and nitrogen administration both qualitatively and quantitatively. The authors analyse the nutritional requirements in the seriously patients, particularly with renal insufficiency.