[Cancer of the anus. Analysis of our surgical experience]. / Il cancro dell'ano. Analisi di un'esperienza chirurgica.

BACKGROUND: The different histological varieties of anal cancer due to the presence of different histogenesis tissue can be anatomically distinguished from anal canal tumours by their growth in a periorificial or marginal site. The first appearance of symptoms are common to usual non-tumoral pathologies, but can be ascertained at an early stage using biopsy. Anal cancer can be treated with surgery, conservative or radical treatment, radiotherapy alone and radiochemotherapy with possible surgery. METHODS: Based on the results obtained by radical surgical exeresis due to the frequent spread of tumours to the pelvis and the possibility of metastases in the cava and portal vein, current therapeutic possibilities were analysed in 101 patients with anal cancer undergoing abdominal-perineal surgery. The priority of radiochemotherapy was underlined, reserving the faculty of surgical treatment for cases of large tumours with insufficient penetration. RESULTS: The choice of therapy should be modulated according to its histology, tumour site, increase and grading. Only surgery can ensure long-term results similar to those obtained using surgical treatment of rectal cancer. CONCLUSIONS: For the best results the authors recommend a therapeutic approach which involves some methods used for an early diagnosis.

[Evaluation of the mechanism determining the painful symptomatology after proctological interventions]. / Valutazione dei meccanismi determinanti la sintomatologia dolorosa dopo interventi proctologici.

In order to evaluate the importance of the contraction of the perineal muscular system in causing the symptomatology following a hemorrhoidal prolapse operation, a drug, dantrolene sodium which has a known myorelaxant action due to a partial inhibition of the release of calcium ions from the sarcoplasmic reticulum in the muscular cell was used. The double-blind study involved 40 patients, of whom 20 were treated with sodium dantrolene in doses of 25 mg, twice a day, for seven days; the remaining 20 with a placebo. Symptoms, consumption of pain-killers and need for catheters, were monitored daily, while hemochemical parameters were checked before the start, and at the end of the study. The results obtained showed a similar post-operative trend in the patients receiving dantrolene and in the controls. This is interpreted as an indirect demonstration that the mechanism of pain is primarily due to the inflammatory factors rather than due to contraction of the perineal muscles.