[Value of rectosigmoidoscopy in the secondary prevention of carcinoma of the colon and rectum. Results of a study of ours carried out in elderly patients]. / Il valore della rettosigmoidoscopia nella prevenzione secondaria del carcinoma del colon-retto. Risultati di un nostro studio condotto su pazienti anziani.

Secondary prevention is undoubtedly a vital consideration in the early diagnosis of cancer of the large bowel. The examination of asymptomatic subjects considered to be at high risk of colorectal carcinomas will improve the prognosis for this tumour by identifying lesions at an early stage or, even better, pathologies considered precancerous. Rectosigmoidoscopy was therefore employed on a sample of asymptomatic geriatrics, at high risk because of their age. The examination of 245 elderly people revealed various asymptomatic conditions (haemorrhoids, rhagades, polyps, etc.) and, more importantly, 4 cases (1.6%) of rectosigmoid tumours, 2 of them Dukes stage A and 2 polyps in the initial phase of degeneration into malignancy. The paper concludes by emphasising the value of mass screening of the elderly and indeed of other high risk groups using a flexible rectosigmoidoscope, in the hope of identifying early-stage tumours or precancerous lesions with a view to reducing the incidence of colorectal carcinoma and therefore significantly improving the prognosis for that condition.

[Laparoscopic approach to appendiceal emergencies. Our experience. Preliminary results]. / L'approccio laparoscopico alle urgenze appendicolari. Nostra esperienza. Risultati preliminari.

Laparoscopic surgery in acute appendectomy is a very much debated subject also for skilled teams of mini-invasive surgery. The authors review 25 urgent laparoscopic interventions for acute appendicitis, treating some technical aspects of trocar introduction and Endoloops and EndoGia employment in this field. They conclude by emphasizing that the laparoscopic approach for acute appendicitis is the treatment of choice, considering the good results and the future prospects of laparoscopic versus open surgery.

[Intraoperative cholangiography in laparoscopic cholecystectomy. Our experience]. / La colangiografia intraoperatoria nella colecistectomia per via laparoscopica. Nostra esperienza.

Cholangiography during conventional cholecystectomy has always been useful for anatomo-topographic study and for research of the stones of biliary tree. After a natural period of training the authors included the easy technique of cholangiography in laparoscopic cholecystectomy. The study was performed in 13 patients using Olsen's cannula with an internal a normal catheter for cholangiography. The catheterization of the cystic duct was performed in 85% of cases (11 patients), in the other 15% (2 patients) it was not possible to cannulate the cystic duct. Non complication. The mean duration of the study was 14 minutes. The authors describe the technique and conclude, after a brief discussion of the reports in the literature and personal experience, that peroperative cholangiography is an easy and safe procedure without risk and prevents the injuries to the biliary tract whose incidence is about 1.3%.

Myxoma of the maxilla: report of case.

A review of the literature and a report of a case of myxoma of the maxilla in a 1-year-old Negro girl have been presented. This case is interesting because of its rarity at this age and its location. Originally, a Weber-Ferguson approach was considered. However, a transoral approach provided excellent access for complete visualization and removal of the tumor. This reinforces the advantages to the patient that result from the cooperation of different surgical services.

Histological and histochemical changes in the colon mucosa after ureterosigmoidostomy or colonic conduit.

A study was made of 22 patients previously subjected to urinary diversion, 12 with ureterosigmoidostomy and 10 with colon conduit. The histological and histochemical examination of biopsies of intestinal mucosa near to and far from the ureteral orifices showed transformations with considerable inflammatory infiltration, variations in the composition of the acid mucins with a prevalence of sialomucins, lengthening and branching of the glandular crypts, and sometimes dysplasias of the epithelium. These structural modifications are typical of transitional mucosa. Transitional mucosa might reflect an aspecific reaction of the intestinal mucosa or alternatively it might signify a precancerous condition. Its presence in intestinal diversions suggests the advisability of careful follow-up in all patients subjected to this operation.