The use of stereotaxic cytology in the diagnosis of non-palpable breast lesions. Personal experience

Background and aims. The increasingly frequent use of mammography for the early diagnosis of breast cancer and the consequent identification of mammary lesions at a preclinical stage raises the fundamental problem of the differential diagnosis between non-suspected non-palpable lesions (NPL) which can therefore be monitored over time and suspected NPL or definite carcinoma requiring histological confirmation and surgical biopsy. The diagnostic accuracy of mammography alone is not sufficiently high to differentiate benign lesions from malignant or strongly suspected ones. The use of surgical biopsy in the event of suspected NPL could be significantly reduced by the use of stereotaxic cytolog…

Affezioni benigne della tiroide: indicazioni al trattamento chirurgico ed attuale ruolo della tiroidectomia totale

Total thyroidectomy is the most popular surgical option in a wide range of indications for the treatment of benign disease of the thyroid. The preference for the procedure derives from a long period of observation and clinical experience dating as far back as the early 'seventies and confirms its safety and efficiency. Nevertheless, many doubts still exist as to the indications in the context of benign thyroid disease, as well as the incidence and seriousness of the complications which, though not frequent, are often invalidating. On the basis of the experience gained over the period from January 1994 to November 2002 in 697 patients undergoing surgery for benign disease of the thyroid, the…

La bilicultura un'utile guida per la terapia antibiotica nella chirurgia delle vie biliari

La terapia chirurgica del morbo di Basedow. Tiroidectomia totale o subtotale a confronto

The surgical treatment of Basedow's disease is the most rapid and effective therapeutic approach to obtain the long-term remission of disease. Controversy persists regarding the choice of total or subtotal thyroidectomy. The authors report their experience in 38 cases of Basedow's disease undergoing surgery, of which 20 were treated with total thyroidectomy and 18 with subtotal thyroidectomy. No hemorrhages, wound infections, recurrent lesions, or definitive hypoparathyroidism were observed in the two groups of patients. Those patients undergoing subtotal thyroidectomy reported a 44.5% incidence of hypothyroidism. In particular, hypothyroidism was clinically manifest in 16.7% of cases and s…

Prognostic significance of DNA ploidy, S-phase fraction, and tissue levels of aspartic, cysteine, and serine proteases in operable gastric carcinoma

A consecutive series of 63 untreated patients undergoing surgical resection for stage I-IV gastric adenocarcinomas (GCs) has been prospectively studied. Our purpose was to analyze the predictive relevance of DNA ploidy, S-phase fraction (SPF), and tissue levels of lysosomal proteinases cathepsin D (CD), cathepsin B (CB), cathepsin L (CL), and urokinase-type plasminogen activator (uPA) and that of the intracellular cysteine proteinase inhibitor stefin A on clinical outcome. All of the patients taking part in this study were followed up for a median of 73 months. DNA aneuploidy was present in 71% of the cases (45/63), whereas 9% of these (4/45) showed multiclonality. Both DNA ploidy and SPF w…

The role of the left choleic artery in the rectum anterious resection with colo-anal anastomosis: technique and considerations of anastomosis oxigenation through nitric oxide valutation.

La coagulazione elettrotermica bipolare (ligasure bipolar vessel sealing system) in chirurgia della tiroide

Over the past few years different methods of achieving haemostasis in surgery have been developed. Among these methods, bipolar electrothermal coagulation carried out with the "LigaSure Bipolar Vessel Sealing System" has found numerous applications in some types of abdominal and pelvic surgery, especially when performed laparoscopically, where traditional methods of haemostasis sometimes prove more difficult to perform and are often unsafe. The authors also experimented with the use of electrothermal cautery in thyroid surgery, evaluating its efficacy in achieving haemostasis, as well as in reducing a number of complications such as hypoparathyroidism and recurrent palsy, which can be obtai…

LES TUMEURS PHYLLODES DU SEIN

The authors report on their experience with six patients suffering from carcinoma phylloides of the breast and discuss the clinical and diagnostic characteristics of this rare neoplasm and its treatment. Clinical examination is the most important procedure in the diagnosis of this tumour of the breast. In most cases, ultrasonography, mammography and cytology are not helpful in establishing the correct diagnosis. Indeed is very difficult to identify valid criteria of differential diagnosis between this tumour and other breast neoplasms especially fibroadenoma. Limited surgery, consisting in a wide excision of the tumour, is the treatment of choice although a higher incidence of local recurre…