[Smooth-muscle-cell tumors of the gastroenteric tract. A review of cases]. / I tumori a cellule muscolari lisce del tratto gastroenterico. Revisione casistica.

Smooth muscle tumors of the gastrointestinal tract are difficult to evaluate and to stage. Twenty-four patients surgically treated during the last ten years have been evaluated using a TGM staging to identify the more rational criteria for the therapeutic choice. Six gastric leiomyomas, 1 ileal leiomyoma, 4 gastric leiomyosarcomas, 1 esophageal leiomyosarcoma, 4 ileal leiomyosarcomas, 2 rectal leiomyosarcomas and 6 gastric leiomyoblastomas were included. 62.5% of cases presented acute clinical features. Preoperative histological diagnosis was adequate in 29% of cases. We performed 7 excisions, 6 gastric subtotal resections, 3 total gastrectomies, 1 esophageal resection, 5 ileal resections, 2 rectal low anterior resection. Fourteen patients were staged I/II, 8 staged III and 2 staged IV. The overall median survival time was 27.5 months (56, 20 and 5 months concerning stage I/II, III and IV respectively; p < 0.01). In relation to T and G factors overall survival was statistically significant. TGM staging was highly significant to predict long-term survival. Radical surgical procedure was highly effective to guarantee long-term survival. Extended follow up is requested because recurrences after many years seem to be possible also with low histologic grade at first presentation.

[Simultaneous multiregional embolization from a cardiac myxoma. Case report]. / Embolizzazione sincrona pluridistrettuale da mixoma cardiaco. Presentazione di un caso clinico.

Atrial myxoma is the most frequent cardiac tumor. Distal embolization occurs in about one third of the patients with this nosological entity; a simultaneous embolization to three different arterial districts, however, is a rare event. Of particular interest is also, in our opinion, the evolution of the clinical picture and the surgical treatment performed.

[Gastric leiomyoblastoma: report of our case load]. / Il leiomioblastoma gastrico: presentazione della nostra casistica.

Leiomyoblastoma of the stomach is a rare nosological entity (0.3% of all gastric tumors). During the last 13 years, the authors observed 7 of such tumors. In this paper, our cases are presented: these are discussed (together with a revision of the literature), particularly focusing on anatomo-pathological, diagnostic and therapeutic problems.

[The complications of pulmonary resection surgery: the experience of 200 consecutive cases]. / Le complicanze della chirurgia resettiva polmonare: esperienza su 200 casi consecutivi.

Postoperative complications observed in 200 patients after pulmonary resection (66 pneumonectomies--30%, 106 lobectomies--53% and 28 wedge resections--17%) are presented. Surgical operations were carried out in 86% of cases for cancer, in 16% for benign lesions. Major complications were: lobar atelectasis, bronchopneumonia, pulmonary embolism, respiratory insufficiency, bronchial fistula, ventricular tachyarrhythmia, altogether they concerned 21% of the cases. Their incidence was not significantly influenced by the extension of resection (the latter, on the contrary, influenced postoperative mortality as much as 4.5% after pneumonectomy, 2.8% after lobectomy and 0% after wedge resection), age of patients under or over 70 years, functional respiratory reserve, or associated cardiovascular diseases. On the contrary, the advanced stage of disease in neoplastic patients was significant for major complications. An adequate monitoring of minor respiratory and cardiac complications is recommended to reduce the incidence of major ones and their control when present. In authors' experience, in fact, postoperative mortality was overall 3% following such behaviour.

[Staging of lung cancer by computerized tomography: evaluation based on surgical experience]. / La stadiazione del cancro polmonare con tomografia computerizzata: valutazioni emergenti dall'esperienza chirurgica.

One hundred seventy patients with M0 bronchogenic carcinoma were preoperatively evaluated by CT staging whose results were correlated with surgical findings. A number of over and understaging were observed in assessing mediastinal nodes involvement, chest wall invasion, mediastinal pleura and vessels invasion as well as pulmonary vessels involvement. In conclusion, the Authors believe that no patient surgical indication should be excluded on the basis of CT evidence of intrathoracic invasion, in the light of the demonstrated potential for false-positive diagnoses.