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…

Predictive factors of mortality in patients with acute mesenteric ischemia: A retrospective study

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

Role of prophylactic central neck dissection in cN0-papillary thyroid carcinoma: Results from a high-prevalence area

BACKGROUND: Prophylactic, compartment-oriented central neck dissection (CND) for cN0 papillary thyroid carcinoma (PTC) is not widely practiced. We examined our results with this surgical approach. METHODS: A cohort of 158 patients operated on for the classical variant of PTC at a follow-up of 1-22 years (mean: 6.6) were enrolled. The patients with a preoperative diagnosis of cN0 PTC (group A, 59 patients) underwent total thyroidectomy (TT) + CND. In the patients with incidental postoperative diagnosis of malignancy (group B, 99 patients) a TT alone was performed. RESULTS: Ninety-six T1, 36 T2, 26 T3/T4 PTC patients were enrolled. The overall biochemical/scintigraphic recurrence rate (15 pat…

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…

Surgical complications in prophylactic central neck dissection: Preliminary findings from a retrospective cohort study

Aim. Papillary thyroid carcinoma (PTC) is the most frequent thyroid malignancy with an overall ten-year survival more than 90%. Total thyroidectomy (TT) is considered the gold standard for PTC, but not all the endocrine surgeons agree on central neck dissection except in case of known metastases. Methods. We enrolled 158 patients, that underwent, between January 1990 and September 2012 total thyroidectomy±prophylactic CND for PTC. 59 Patients (group A) had a preoperative diagnosis of PTC; 99 (group B) had a diagnosis of benign disease. We focused on possible complications. Results. In group A we had 4 patients who blamed a definitive RLN palsy, only 1 patient in group B, with an OR=7.12. De…