0000000000553823
AUTHOR
N. Falco
Benign multicystic mesothelioma: A case report of recurrent disease in a young adult with familiarity for renal cell carcinoma
Benign multi-cystic peritoneal mesothelioma (BMCM) is a very rare disease (about 150 cases observed). The aetiology is currently little-known, and the data collected, without having achieved conclusive re sults, identify two possible causes: neoplastic and reactive inflammatory. This case report refers to a recidivism of BCMC in a patient whose brother, few months before, underwent a left nephrectomy and right renal Radio Frequency Termo Ablation (RFTA) for bilateral papillary renal cell carcinoma. For the recurring trend, the onset in a male young patient without chronic inflammatory diseases evidence, the presence of a first degree relative with a rare carcinoma we supposed a neoplastic a…
Emergency hernia repair in the elderly: multivariate analysis of morbidity and mortality from an Italian registry
Abstract Purpose The incidence of inguinal hernia is higher in elderly because of aging-related diseases like prostatism, bronchitis, collagen laxity. A conservative management is common in elderly to reduce surgery-related risks, however watchful waiting can expose to obstruction and strangulation. The aim of the present study was to assess the impact of emergency surgery in a large series of elderly with complicated groin hernia and to identify the independent risk factors for postoperative morbidity and mortality. The predictive performance of prognostic risk scores has been also assessed. Methods This is a prospective observational study carried out between January 2017 and June 2018 in…
Outpatient management of proctologic disease. Which techniques for local anesthesia? The experience of a single center
Introduction. Since 1899 outpatient management of surgical patients had been increasing, becoming the best option when possible. In 1988 was described the first experience of outpatient management of proctologic disease. Advances in local anesthesia techniques have improved the outpatient approach to surgical disease, particularly in patients with proctological diseases. Methods. From 2010 to 2016, 1160 patients who needed surgery for proctologic disease have been recruited: 239 hemorrhoidectomies using the variant of Milligan Morgan technique described by Phillips, 45 trans-anal hemorrhoidal DE-arterialization (THD), 315 sphincterotomies, 12 anal polypectomies, 230 loop seton positions, 65…
Complication of endoscopic tattooing: a case report of covered perforation
Aim Laparoscopy is considered a good approach in treatment of colorectal neoplastic diseases; the endoscopic tattooing is then recommended (Evidence Level III and grade of recommendation A) to mark a lesion or a polypectomy site for intraoperative identification. We describe the case of perforation after tattoing treated conservatively. Case report 63 years old woman, underwent colonoscopy for lipoma tattooing with India ink SPOT® solution kit and saline test. Immediately after the procedure the patient has been referred the appearance of colic epi-mesogastric pain and fever; Computed Tomography (CT) without MDC identified an irregular thickening of transverse colon with some microbubbles c…
Frailty and emergency surgery in the elderly: protocol of a prospective, multicenter study in Italy for evaluating perioperative outcome (The FRAILESEL Study)
Improvements in living conditions and progress in medical management have resulted in better quality of life and longer life expectancy. Therefore, the number of older people undergoing surgery is increasing. Frailty is often described as a syndrome in aged patients where there is augmented vulnerability due to progressive loss of functional reserves. Studies suggest that frailty predisposes elderly to worsening outcome after surgery. Since emergency surgery is associated with higher mortality rates, it is paramount to have an accurate stratification of surgical risk in such patients. The aim of our study is to characterize the clinicopathological findings, management, and short-term outcom…
Surgeons' fear of getting infected by COVID19: A global survey
During the last three months, COVID- 19 pandemic had led to a serious backlog of operations globally, and plans for restarting operation are imperative. Recommendations for surgical activities were studied, aiming to protect the surgical staff from being infected. In the meantime, it is also important to give attention to the surgeon’s personal feeling during work. We conducted a survey to investigate global surgi- cal practices during the COVID-19 pandemic, and the surgeon’s personal feeling was also investigated in the sur- vey. In this special letter, we performed multivariate analysis to explore factors that associated with surgeon’s fear of getting infected by COVID-19.
Use of the KSVM-based system for the definition, validation and identification of the incisional hernia recurrence risk factors
BACKGROUND: Incisional hernia is one of the most common complications after abdominal surgery with an incidence rate of 11 to 20% post laparotomy. Many different factors can be considered as risk factors of incisional hernia recurrence. The aim of this study is to confirm and to validate the incisional hernia recurrence risk factors and to identify and to validate new ones. METHODS: In the period from July 2007 to July 2017, 154 patients were selected and subjected to incisional hernia repair. The surgical operations were conducted under general anaesthesia. Patients received antibiotic prophylaxis when indicated, according to the hospital prophylaxis scheme. Inclusion criteria of the study…
A primary subcutaneous hydatid cyst in the thigh. A case report
Hydatid disease is a parasitic disease considered endemic in many parts of the world such as South America, Middle East, Africa, Australia and the Mediterranean regions. Liver and lung hydatid disease accounts for 90% of all echinococcal cysts. Primary hydatid disease of subcutaneous sites is rare and the subcutaneous localization of a solitary hydatid cyst accounts for 1.6%. Not enough data exist for this localization, and only many heterogeneous data are described in order to define this rare condition.We present the case of a 68-year-old-woman affected by a mass in upper-medial side of her right thigh with a 12-year-growing history. Anamnestic data were accurately collected. Many differe…
Usefulness of ileostomy defunctioning stoma after anterior resection of rectum on prevention of anastomotic leakage A retrospective analysis
Anastomotic leakage is one of the major complications occurring after anterior resection of rectum. A defunctioning stoma is usually created routinely or on surgeons' discretion. The aim of this study was to investigate the usefulness of temporary ileostomy to prevent anastomotic leakage comparing the postoperative course of patients with and without defunctioning loop ileostomy.Patients that underwent anterior resection of rectum were recruited. 140 patients were enrolled and divided in two groups: patients without and with defunctioning loop ileostomy. Patients' characteristics and other useful data were recorded. A comparison between the two groups was made. The minimum follow-up was 11 …
Solitary metastasis from melanoma causing bowel perforation
Skin melanoma can metastasize to any organ or tissue. The median survival in patient with intestinal metastases is inferior to 7 months compared to other sites metastasis. A wide intestinal resection including the resection of the mesentery with lymph nodes remains the main treatment due to the low morbidity and mortality rate it is also associated with.We took under analysis a recent case of acute abdomen for small bowel perforation from intestinal metastases in a patient with metastatic melanoma who was under treatment with Pemrolizumab. A bowel resection was performed and no other lesions were found in the abdominal examination. However, the chemotherapy was stopped due to the advanced a…
Impact of asymptomatic COVID-19 patients in global surgical practice during the COVID-19 pandemic
The rapid spread of COVID-19 has changed the global surgical care. Patients infected with COVID-19 may present without typical symptoms, and such asymptomatic patients may potentially trigger in-hospital outbreaks by transmitting the disease to health care providers and other hospitalized patients. Further, asymptomatic COVID-19 patients have worse postop- erative outcomes with an unexpectedly high morbidity and mortality, reaching 20⋅5 per cent deaths. However, we do not have objective global data on this issue. In an attempt to clarify the current global surgical practice under the COVID-19 pandemic particularly focusing on the preoperative screening of asymptomatic COVID-19 patients, we …
P-POSSUM score: a prognostic instrument for postoperative complications in Crohn's disease
The purpose of this work is to demonstrate the correlation between the p-POSSUM score and the severity of Crohn's Disease (CD) postoperative complications, evaluated by using the Clavien-Dindo score.We have selected data of 22 patients (11 males, 11 females) that had been recovered in the Operative Unit of General Surgery of the University of Palermo General Hospital and undergone surgery for CD from 2010 to 2017.Patients who underwent surgery for complicated CD was divided in three different group on the base of Clavien Dindo score, C1 (Clavien-Dindo ≤ 1), C2 (Clavien Dindo = 2), and C3 (Clavien Dindo ≥ 3). ANOVA one way statistic analysis was used to investigate the presence of statistic …
Three-port colectomy: reduced port laparoscopy for general surgeons. A single center experience
To evaluate three-port colectomy as an alternative reduced-port laparoscopy technique in colonic surgery.Retrospective study carried out through the analysis of 32 consecutive patients that underwent alternatively to a three ports left colectomy or a conventional laparoscopic colectomy for colonic diseases in order to evaluate the benefits of the reduced-port technique. A multivariate analysis among duration of surgery, hospital stay and conversion rate was performed using the OLS regression and the binary logistic regression.We found a reduced operative time in the three-port colectomy in comparison to the four-port technique (p=0.07). The hospital stay was not found related to the number …
Fibrin sealant agents: clinical application of TachoSil® in abdominal surgery. Six years experience in an emergency surgery department and review of the literature
The success of every surgical procedure depends on an appropriate hemostatis. Topical haemostatic agents, like fibrin sealants, are an option for providing haemostasis and may be particularly useful for complex injuries.