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ABSTRACT: A late inflammatory reaction and the formation of fistula after prostetic implant for primitive hernia of the abdominal wall are recent clinical events. The Authors describe a case of inguinal cutaneous fistula verified after 6 years from the execution of an prostetic hernioplasty with polypropylene. The possible etiology and the therapeutic options are discussed.
Annali italiani di chirurgia 77(5):447-50; discussion 450. · 0.23 Impact Factor
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ABSTRACT: Chronic venous insufficiency affects about 10-12% to 35-50% of the population in industrialised countries. We analyse the role of echo-colour Doppler in the diagnostic-therapeutic work-up for this pathology in the light of their own experience. We report the results of the study of 158 legs in 79 patients, classifying the severity of chronic venous insufficiency using the Widmer classification, and private circulations using the Franceschi shunt classification. The mean duration of the examination was about 30 minutes (range: 22-46). A reflux time > 0.5 sec. was considered pathological. The patients with chronic venous insufficiency were divided into three groups on the basis of type of treatment: medical treatment and elastic compression (group 1,12 patients), sclerotherapy and elastic compression (group II, 20 patients), surgical treatment and sclerotherapy (group III, 36 patients). The echo-colour Doppler results were confirmed in the operating theatre in 34 patients. Echo-colour Doppler enabled us to identify patients who needed less invasive treatment than stripping; in group III, echo-colour Doppler allowed precise mapping and identification of communicant veins and collaterals, with 95% accuracy.
Chirurgia italiana 58(3):337-45.
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ABSTRACT: Few studies have addressed the use of ultrasonography in the evaluation of abdominal hernia. In the present study ultrasonography was used to assess tissue modifications after apposition of a polypropylene prosthesis for inguinal hernia. Seventy-two patients submitted to calibrated inguinal hernioplasty (mesh and plugs) in local anaesthesia for inguinal hernia were studied by ultrasonography at 5 days, 1 and 3 months, and 1 year after the surgical intervention. The mesh presented as a small hyperechoic layer. In 50 patients (69.4%) a seroma was present above the mesh. The seroma was < 5 cc in 33 patients, between 5 and 10 cc in 6 patients, and > 10 cc in 11 patients. During the ultrasound examinations no recurrences were found and the mesh was not displaced. The seroma disappeared spontaneously between postoperative days 30 and 90 and was probably related to the size of the hernia and the number of plugs.
Chirurgia italiana 59(6):835-41.
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ABSTRACT: Prosthetic repair of femoral hernias is now standard practice. The aim of the study was to evaluate the results obtained using different types of polypropylene plugs in relation to the different anatomic-surgical aspects of the hernia. Twenty-five femoral hernioplasties were performed, 3 with Gilbert's conical plug, 18 with a dart plug, and 4 with Lichtenstein's cylindrical plug. The functional rehabilitation was rapid, and there were no postoperative complications; over follow-up periods of 3-132 months no recurrences have been reported. The correct choice of plug in femoral hernioplasty makes for efficacy, safety and simplicity. The possibility of choosing among different types of plug in relation to the anatomical characteristics of the hernia provides the surgeon with the right degree of flexibility for achieving the best possible result.
Chirurgia italiana 57(4):449-55.
