Evaluating the efficacy of current treatments for reducing postoperative ileus: a randomized clinical trial in a single center.

AIM: Postoperative ileus has been considered an inevitable consequence of abdominal surgery. The aim of the study was to investigate the efficacy of same treatments in resolving postoperative ileus in various surgical approaches. METHODS: A total of 360 patients underwent abdominal surgery, and was divided into four groups: videolaparoscopic cholecystectomy, laparotomic colo-rectal surgery, laparotomic Hartmann procedure, laparotomic gastric surgery. In each group, patients received different postoperative treatments: chewing gum, olive oil, both, and water. Each group was compared with a control group. RESULTS: In patients who underwent videolaparoscopic cholecystectomy, median postoperati…

A 3D totally absorbable synthetic mesh in antireflux surgery: Gore Bio-A tissue reinforcement for hiatal hernia repairing

Introduction Hiatal hernia, defined as “transitory or stable dislocation of a part of the stomach in mediastinum through the diaphragmatic crura delimiting esophageal hiatus”. Its appearance presupposes anatomic anomalies or weakening of structures and mechanisms able to maintain esophago-gastric junction and stomach in the abdominal cavity [1]. Classically hiatal hernia was classified in four types using Hill’s classification: Type 1 hiatal hernia is associated with GERD in 50-90% of cases, in facts its presence gradually compromises esophago-gastric junction’s continence favouriting the backwater of acid secretion and its reflux in contact with esophageal mucosa during transient relaxatio…

Recurrent cystic lymphangioma of the neck. Case report.

TRANSCRANIAL DIRECT STIMULATION (TDCS) CAN MODULATE ESOPHAGEAL MOTILITY IN GASTROESOPHAGEAL REFLUX DISEASE (GERD) PATIENTS

Autologous adipose-derived stromal vascular fraction and platelet concentrates for the treatment of complex perianal fistulas

Abstract Background Complex perianal fistulas are a major challenge for modern surgery since 10–35% of patients have functional problems after treatment. Sphincter-saving techniques have a wide range of efficacy (10–80%). We hypothesised that autologous adipose-derived stromal vascular fraction in combination with platelet rich plasma is a new therapeutic strategy with enhanced cure and function preservation rates. Methods Adult patients with complex cryptoglandular perianal fistulas were treated with injection of autologous adipose-derived stromal vascular fraction in combination with platelet rich plasma around and inside the fistulous tract between May 2018 and April 2019 at the General …

Can the balloon expulsion test be used to exclude the diagnosis of'"dyssynergic defecation"?

BACKGROUND: Fimctional constipation (FC) is a common disorder, particularly frequent m women. The aim of our study was to compare the results of balloon expulsion test with the manometry and defecography findings to exclude dyssynergic defecation (DD) in patients with chronic constipation. METHODS: From January 2005 to December 2011, 127 patients with the diagnosis of functional constipation were recruited retrospectively. They were divided into three groups: 24 with DD, 54 with descending perineum syndrome (PDS), 49 without DD/PDS. Diagnosis of DD was established by manometnc and defecographic fmdmgs according to Rome EH criteria. RESULTS: The balloon expulsion test was abnormal m 11 out o…

OSSERVAZIONi A PROPOSITO DI UN CASO DI CISTI GIGANTE DELLA MILZA

The Authors, on the basis of a case of giant spleen cyst with positive tumoral markers, analyse some epidemiological and clinical aspects related to splenic non parasitic cysts. They affirm the priority of the conservative surgery, whenever possible, followed by an appropriate follow-up, although in this case their therapeutic choice was radical, due to the lack of residual parenchyma. In accordance with the data of several publications, as well as on the basis of the results obtained, the conservative approaches have been reevaluated, above all in view of the modern findings related to the function of the spleen. The conservative approach cannot be carried out in the following cases: neopl…

The use of haemostatic agents in thyroid surgery: efficacy and further advantages. Collagen-Fibrinogen-Thrombin Patch (CFTP) versus Cellulose Gauze.

Abstract Aim: To assess the efficacy of two widely used topical haemostatic agents: oxidised regenerated cellulose gauze and Collagen-Fibrinogen-Thrombin Patch in patients undergoing total thyroidectomy. Material of study: This was a prospective, comparative, non-randomised study in which consecutive patients undergoing total thyroidectomy for benign disease received standard treatment with no haemostatic agent, cellulose gauze, or CFTP. Main outcome measures were drainage volume 24 hours after surgical procedure and the occurrence of post-operative complications (haematoma, seroma, surgical-site infection). Results: Two hundred seventy-one (271) patients undergoing total thyroidectomy for …