Annali italiani di chirurgia (ANN ITAL CHIR )


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    Annali italiani di chirurgia
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Publications in this journal

  • Annali italiani di chirurgia 12/2014;
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    ABSTRACT: Mycotic endocarditis has an incidence of 6.7% of all the forms of endocarditis and in 33-75% of the cases it complicates with peripheral embolization, more frequently to the lower limbs. Although the prognosis of the mycotic endocarditis is improved in the last years, it remains particularly serious especially when it's associated with arterial peripheral embolization. The authors report their experience in the surgical treatment of one case of occlusion of the iliac artery secondary to mycotic endocarditis, making a review of the Literature on this matter.
    Annali italiani di chirurgia 11/2014; 69(3):379-82; discussion 382-3.
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    ABSTRACT: This study aims evaluate the effectiveness of various surgical techniques in treating diverticular fistulas, and the safety and efficacy of the laparoscopic procedure comparing our results with those of the literature. This was a prospective and uncontrolled study performed at a general surgery units. Between 2005 and 2011, 16 patients (11 men, 5 women) underwent surgery for diverticular fistulas. The mean age was 70.2 (range, 35-87) years. The medical evaluation of these patients was based on symptoms and diagnostic procedures confirming the diagnosis of diverticular fistulas. Our surgical options included one-stage, two-stage, and defunctioning procedures. Out of 16 cases of diverticular fistula 14 were colovesical and 2 colovaginal. One-stage procedure was performed in 12 patients, two-stage procedure in 3 and defunctioning colostomy in 1. The overall complication rate was 31.2%. We recorded 1 colovesical recurrent fistula. The laparoscopic surgery was performed in 4 patients, nobody was converted to open and there were no post-operative complications and recurrence. The data show that one-stage procedure is effective in the majority of cases of diverticular fistulas. However, the surgery of colovesical and colovaginal fistulas is often associated to high complication rates. This is often due to the shoddy clinical conditions and long-term diverticular illness of this group of patients. At present, the laparoscopy in an elective setting is not considered any more a contraindication in the treatment of diverticular fistulas. Diverticular fistulas, Laparoscopic surgery.
    Annali italiani di chirurgia 10/2014; 85.
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    ABSTRACT: Aim of this study is to evaluate the validity of videothoracoscopic staging and treatment in a twenty-year-long series of 286 VATS lobectomies for Clinical Stage I NSCLC.
    Annali italiani di chirurgia 09/2014; 85.
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    ABSTRACT: Faecal incontinence is an important disabling symptom in the affected patients. Classically, we divide faecal incontinence in two main types: traumatic faecal incontinence and neurogenic faecal incontinence. Neurogenic faecal incontinence is characterized by a diffuse weakness of anal sphincter and of the elevator muscles. The aim of the present study was to evaluate the outcome of postanal repair procedure in the management of neurogenic faecal incontinence. To this end we studied 20 patients with neurogenic faecal incontinence who underwent a postanal repair procedure according to the method described by Parks. Mean follow up was up two years and was based mainly both on clinical evaluation and manometric values carried out on a 6 monthly basis. When the outcome was evaluated in terms of faecal incontinence our date were similar to those reported by Parks and Keighley. In the subjects studied we haven't reported any major complications apart from two cases of wound's infection which were efficaciously treated. Our findings supported the view that postanal repair procedure is the surgical approach of choice in the patients with idiopathic neurogenic faecal incontinence.
    Annali italiani di chirurgia 08/2014; 65(4):495-7; discussion 498.
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    ABSTRACT: Analyse the results after 8 years of experience in the laparoscopic treatment of adrenal surgical pathology.
    Annali italiani di chirurgia 07/2014; 85.
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    ABSTRACT: To detect the effectiveness of pneumoreduction (PR) in intussusception, which is one the most common reasons of abdominal pain in infancy and childhood.
    Annali italiani di chirurgia 07/2014; 85.
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    ABSTRACT: To achieve healing of cutaneous deep and complicated ulcers, along with adequate ulcer debridement and microbespecific antibiotics, any fluid and/or exudate stasis should be avoided.
    Annali italiani di chirurgia 07/2014; 85.
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    ABSTRACT: The Achilles' heel of pancreatic surgery is the management of the pancreatic stump. Leakage from pancreatic anastomosis with subsequent fistula, abscess formation, sepsis, or bleeding is one of the most common causes of morbidity and mortality, and it also contributes significantly to prolonged hospitalization and increased hospital expenses. Many surgical methods have been developed aimed at reducing the incidence of post-operative pancreatic fistula. However, the best technique for pancreatico-enteric reconstruction continues to be disputed. Herein, we describe an interim analysis of 35 consecutive pancreatico-duodenectomies, all with the same standardized technique that combines microsurgical technique for duct-to-mucosa pancreatico-jejunostomy with the routine use of fibrin sealant. The rate of leakage of pancreaticojejunostomy was 5,7% (n=2), all of which were grade A fistulas, treated conservatively. The increased precision of magnification instruments and microsurgical technique for duct to mucosa anastomosis, combined with routine sealing of the pancreatic anastomosis are key factors to efficiently manage the pancreatic stump. The good results obtained and especially the minimal rate of fistula suggests that this technical solution is a safe, feasible and reliable approach for pancreatic reconstruction after pancreatico-duodenectomy.
    Annali italiani di chirurgia 07/2014; 85.
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    ABSTRACT: Breast cancer is acknowledged as an international priority in health care. It is currently the most common cancer in women worldwide, with demographic trends indicating a continuous increase in incidence. In the World, it is estimated that by 2020 there will be approximately 2,000,000 new cases of breast cancer per year. The enormous burden placed by this disease both on the population and on health care systems explains the increasing efforts and resources that have been devoted over the years to the search for a systematic and optimized strategy in breast cancer diagnosis and treatment. Today, the Breast Unit model is identified as the gold-standard to ensure optimized patient-centered and research-based clinical services for breast cancer patients improving survival rates and patients' quality of life by a multidisciplinary approach in breast care. The present work reviews the lines of development of this multidisciplinary model of breast cancer treatment and analyzes the requirements of a high quality Breast Unit, its potential advantages and the many open issues that still require proper definition and implementation.
    Annali italiani di chirurgia 07/2014; 85.
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    ABSTRACT: We have read with great interest the article of Paliogiannis et al 1 regarding the evolution of plantar hyperhidrosis" on patients submitted to Transthoracic Endoscopic Sympathectomy (TES) for the treatment of palmar and axillary hyperhidrosis. The Authors state, based on a case series of 26 patients with palmar or axillary hyperhidrosis associated to plantar hyperhidrosis that, after surgical intervention, three patients (11.5%) displayed complete regression of plantar hyperhidrosis, 11 (42.3%) partially improved and the remaining 12 (46.1%) did not have any change, i.e., neither improved nor worsened. From two studies of evolution the plantar hyperhidrosis after TES in patients with palmar or axillary hyperhidrosis associated to plantar excessive sweating, the first based on self-assessment 2, and the second on an objective evaluation with a sudometer 3, we observed that the improvement of maintenance of the sweating levels in feet were 91.43% and 52.2%, respectively. However we found that unlike the data presented in this study there were cases of worsening in plantar hyperhidrosis , with 6 out of 7o patients (8.57%) in the first (self-assessment) and 38 of 80 (47.5%) in the second measurements with the audiometers) group. We believe it is of utmost importance that surgeons and be patients be aware that ,while there is room for improvement in plantar sweating after surgery, there is a definite risk of worsening in plantar hyperhidrosis after intervention, which cannot be overlooked.
    Annali italiani di chirurgia 07/2014; 85:201.
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    ABSTRACT: Among the regenerative medicine technologies, the tissue engineering has emerged, in recent years, as a prominent tool, particularly given the tremendous developments in the field of synthetic polymer-based scaffolds. Scaffold surface coatings with either extracellular matrix (ECM) proteins or integrin-binding bioactive peptide sequences, such as RDG, proved to be extremely useful to enhance cell adhesion and growth. Nevertheless, about it, excellent effects may be reached by electrospinning-obtained nanofiber-structured synthetic polymer scaffold - such as polyurethane or polyethylene-terephthalate electrospun nanofibers - without resorting to surface- coated adhesion proteins. As for bladder tissue engineering, properly cell-seeded synthetic biomaterial-based scaffolds allow today timely chances to obtain constructs provided with specific bladder native tissue-like both histological-immunohistochemical and functional-dynamic features. Recent bright advances in the tissue engineering research, particularly in the area of materials science - together with increasing availability of suitable bioreactors - and stem cell biology, make foreseeable, in the near future, further technological improvements that might widen the clinical applications of bladder tissue engineering up to whole bladder replacement in radical tumor surgery.
    Annali italiani di chirurgia 06/2014; 85.
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    ABSTRACT: The spontaneous pneumothorax (pnx. s.) is a type of pathology with a high per cent of relapse so its aetiological treatment can't be done only with a pleural drainage. With the resection of the bubble (that is the cause of it) instead, the problem will be resolved without possibilities of relapses. In the past, this was possible only with a thoracotomy, now with the new techniques of video-thoracoscopy, the therapeutical approach to this pathology has been revolutionized. In fact, this methodology resolves definitively the pulmonary lesion, can avoid the relapses, can guarantee a short stay in hospital and a very good restarting of the working and social activity.
    Annali italiani di chirurgia 03/2014; 67(2):225-7; discussion 227-8.
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    ABSTRACT: In the last ten years we assisted to spreading of laparoscopic approach on the correction of median incisional hernia, although for increased interesting toward mini-invasive techniques than for matching results between lap and open approaches. The aim of our study is the critical analysis of the results of lap and open surgery in the approach of ventral hernia, through the meta-analytical revision of the principal checked prospective trials. There were emerged 7 perspective studies to fit to a meta-analysis with the revision of the literature, with 1165 patients in total. Among the perioperative outcomes the briefer surgical time and a reduction of postoperative hospitalization were observed with the significant statistic data in favor of the lap. Laparoscopy can be considered a valid technical alternative to traditional open surgery in the treatment of ventral incisional hernia. The advantages of mini-invasive approach are the reducing of the surgical time and of the total hospital stay. There were not emerged any significant differences regarding the other surgical end-points or the recurrences of hernias after 1 and 5 years.
    Annali italiani di chirurgia 01/2014; 85:358-364.