Clinical and Functional Outcome After Abdominal Wall Incisional Hernia Repair: Evaluation of Quality-of-Life Improvement and Comparison of Assessment…

2019

Background Hernias severely impact patient quality of life (QoL), and 80% of patients need surgical operation. The primary outcome of the study is to assess improvements in balance, posture and deambulation after abdominal hernia repair. Moreover, the study investigated the improvement in the postoperative QoL. Methods Patients operated at the Policlinico “Paolo Giaccone” at Palermo University Hospital between June 2015 and June 2017 were identified in a prospective database. The functional outcome measures and QoL assessment scales used were numeric rating scale for pain, performance-oriented mobility assessment (POMA) scale, Quebec back pain disability scale, center of gravity (barycenter…

Which Role for Hyperbaric Oxygen Therapy in the Treatment of Fournier's Gangrene? A Retrospective Study.

2022

PurposeIn Fournier's gangrene, surgical debridement plus antimicrobial therapy is the mainstay of treatment but can cause a great loss of tissue. The disease needs long hospital stays and, despite all, has a high mortality rate. The aim of our study is to investigate if factors, such as hyperbaric therapy, can offer an improvement in prognosis.MethodsWe retrospectively evaluated data on 23 consecutive patients admitted for Fournier's gangrene at the University Hospital “P. Giaccone” of Palermo from 2011 to 2018. Factors related to length of hospital stay and mortality were examined.ResultsMortality occurred in three patients (13.1%) and was correlated with the delay between admission and su…

Two cases of monomicrobial intraabdominal abscesses due to KPC - 3 Klebsiella pneumoniaeST258 clone

2011

Abstract Background Knowledge of the etiology of pyogenic liver and pancreatic abscesses is an important factor in determining the success of combined surgical and antibiotic treatment. Literature shows geographical variations in the prevalence and distribution of causative organisms, and the spread of Klebsiella pneumoniae carbapenemase-producing bacteria is an emerging cause of abdominal infections. Case presentation We herein describe two cases of intra-abdominal abscesses due to monomicrobial infection by Klebsiella pneumoniae Sequence Type 258 producing K. pneumoniae carbapenemase 3 (KPC-Kp). In case 1, a 50-year-old HIV-negative Italian woman with chronic pancreatitis showed infection…

Quantification of the risk of relapses after thyroid loboisthmusectomy for benign thyroid nodules

2006

AIM OF THE STUDY: To evaluate correlations between pre-operating epidemiological, clinical and diagnostic data and relapses concerning to patients operated on for benign thyroid nodules. MATERIAL AND METHODS: The AA. carried out a new ultrasonographic exam in 155 patients selected at random among 1012 treated by thyroid lobectomy between September 1976 and December 2002; 107 relapses were found (69%). The obtained data are analysed by chi2 test and a significant correlation between recurrence and data preceding first operation was found: non-homogeneous thyroid structure, multiple nodules, presence of peri-lesional halo, anti-thyroid antibodies, and non-adenomatous histological structure. C…

IL NODULO UNICO DELLA TIROIDE: AFFIDABILITA’ DELL’INDAGINE ECOGRAFICA

2004

DIFFERENZE PROGNOSTICHE NEL CARCINOMA COLO-RETTALE TRATTATO IN CONDIZIONI DI ELEZIONE E DI URGENZA

2004

The non-surgical management for hemorrhoidal disease. A systematic review

2017

The non-surgical treatments for hemorrhoids are cost and time-saving techniques usually performed in patients suffering early hemorrhoidal disease. The most used are rubber band ligation (RBL), injection sclerotherapy (IS), and infrared coagulation (IRC). We performed a systematic review in order to evaluate: do these procedures really help to avoid further more aggressive treatments? What are the common harms? What are the rare harms? How many recurrences there are? A total of 21 RCTs were included in this review: 12 on RBL, 4 on IRC and 5 on IS. In RBL bleeding stops in up to 90% and III degree hemorrhoids improves in 78%-83.8%. IV degree prolapse should have a more invasive treatment. Th…

Colonic stenting in acutely obstructed left-sided colon cancer Clinical evaluation and cost analysis.

2015

This retrospective study aims to evaluate clinical and cost effectiveness of colonic stenting as a bridge to surgery and as a palliative treatment in acutely obstructed left-sided colon cancer.Onehundred fortyfour patients were collected between 2006 and 2012, with acute left-sided malignant colonic obstruction with no evidence of peritonitis: 96 patients underwent surgical treatment, 48 underwent decompressive stenting. For the stenting we used self-expandable metallic stent in nitinol.Patients who had successful colonic stenting were 40, 8 underwent elective surgery within 10 days, 32 decompression stenting had only palliative intent. in 8/48 patients subjected to stenting decompression t…

Dolore anale: quando è una urgenza?

2004

Deep seroma after incisional hernia repair. Case reports and review of the literature.

2015

Wound-related complications are common after incisional hernia repair with mesh; seroma formation is the most frequent problem. The formation of a deep seroma has been rarely reported in the literature.In one year, September 2012-2013, 136 patients underwent surgery for incisional hernia repair, both elective and urgent.The following complications were observed: one dislocation of polypropylene prosthesis, a massive relapsed seroma and two deep seromas described in this article. A 63- years-old female underwent open incisional hernia repair with an intraperitoneal PTFE patch. She developed recurrent seroma under the mesh drained percutaneously, and finally the prosthesis was removed. A 72- …

Muscle degeneration in inguinal hernia specimens.

2012

BACKGROUND: There are few articles in the literature reporting the histological changes of groin structures affected by inguinal hernia. A deeper knowledge of this matter could represent an important step forward in the identification of the causes of hernia protrusion. This study aimed to recognise the pathological modifications of muscular structures in autopsy specimens excised from tissues surrounding the hernia orifice. METHODS: Inguinal hernia was identified in 30 autopsied cadavers, which presented different varieties of hernia, including indirect, direct and mixed. Tissue specimens were resected for histological study from structures of the inguinal area surrounding the hernia openi…

Laparoscopic treatment for esophageal achalasia: experience at a single center

2013

Background. Achalasia is a not frequent esophageal disorder cha- racterized by the absence of esophageal peristalsis and incomplete re- laxation of the lower esophageal sphincter (LES). Its cause is unknown. The aim of treatment is to improve the symptoms. We report the results of the treatment of this condition achieved in one center. Patients and methods. We conducted a retrospective study of pa- tients with esophageal achalasia. In the period 2010-2012 we observed 64 patients, of whom 19 were referred for medical treatment. Three of Introduction Achalasia is a not frequent esophageal motor disor- der that affects both the body of the esophagus and the lower esophageal sphincter (LES). It…

VANTAGGI DELL’ACCESSO TRANSGIUGULARE INTERNO CON PREPARAZIONE CHIRURGICA: OTTIMIZZAZIONE DELLA VIA DI IMPIANTO DEI SISTEMI TOTALMENTE IMPIANTABILI

2004

Search for the mutation of B-RAFV600E in FNA of thyroid nodules

2006

Galectin-3 immunodetection for improving the performance of conventional thyroid cytology: preliminay results

2008

Introduction: Most of differentiated thyroid carcinomas should be easily revealed by fine-needle aspiration cytology but sometimes preoperative diagnosis is doubtful. Galactin-3 is a carbohydrate –binding protein with affinity for beta-galactosides that plays a significant role in cell-cell and cell matrix adhesion, growth, neoplastic transformation and metastasis. Moreover, galectin-3 immunodetection is related to follicular thyroid malignancies. Our aim is to test Galectin-3 as potential preoperative marker for follicular and papillary carcinomas. Methods: Expression of galectin -3 was tested by fluorescence staining on 40 fresh cytological thyroid samples obtained preoperatively; the sam…

SURRENALECTOMIA LAPAROSCOPICA DESTRA PER MIELOLIPOMA, CASE REPORT

2005

Rettocele: l'esperienza maturata in un ambulatorio di colonproctologia.

2004

Evidence-Based Strategies to Promote Long-Term Cardiac Implant Site Health: Review of the Literature

2021

Cardiac implantable electronic devices (CIEDs) are commonly used nowadays. The association between CIED placement and infections is responsible for the high mortality and device explantation rate. Since CIED placement has increased in the past decade, CIED-related complications have risen. In order to reduce the CIED-related complications rate, the prevention of device infection represents the main goal. Over time, many different studies have proven the importance of the measures to prevent CIED-related infections. This review aims to collect the actual recommendations for CIED infection prevention, providing an overview of the main evidence-based strategies.

DIAGNOSI PRECOCE ED INTERVENTO D’URGENZA NELLA COLECISTITE ACUTA ALITIASICA

2004

DIAGNOSI PRECOCE ED INTERVENTO D’URGENZA NELLA COLECISTITE ACUTA ALITIASICA.

TRATTAMENTO RIABILITATIVO DELL’INCONTINENZA FECALE: NOSTRA ESPERIENZA

2004

Surgical Emergencies in Crohn’s Disease

2015

Crohn’s disease, as a chronic inflammatory disease of unknown etiology that can affect any part of the alimentary canal from the mouth to the anus, has a highly variable course and a very unpredictable evolution. Even surgery does not cure CD, it has however a relevant role in its treatment in combination to medical therapy during the large course of the disease; indeed almost each patient is submitted to a surgical intervention during his life. Nowadays, surgery is considered the last treatment to use whenever medical therapy is insufficient to control symptoms; this choice involves an intervention on more serious patients with more surgical complications. Surgery finds in the Crohn’s dise…

An unusual case of a partial midgut malrotaion

2009

Diagnostic role of ultrasound-guided fine-needle aspiration biopsy (FNAB) in infracentimetric thyroid nodules.

2008

Nerve degeneration in inguinal hernia specimens

2011

BACKGROUND: The histological study of the herniated inguinal area is rare in the literature. This report is focused on the detection of structural changes of the nerves within tissues bordering the inguinal hernia of cadavers. Their physiopathological consequences are hypothesized. MATERIALS AND METHODS: Primary inguinal hernia was diagnosed in 30 fresh cadavers. Tissue specimens from the inguinal region close to and around the hernia opening were excised for histological examination. A control of the data was achieved through tissue samples excised from equivalent sites of the inguinal region in 15 cadavers without hernia. RESULTS: The detected nerves in the inguinal area demonstrated path…

IL PARAGANGLIOMA: PRESENTAZIONE DI UN CASO CLINICO.

2004

LINFOADENOPATIE PERIFERICHE: QUANDO L’EXERESI A SCOPO BIOPTICO?

2004

Histological findings in direct inguinal hernia

2013

Abstract BACKGROUND: The study is focused on recognizing the histological changes of the structures close to and around the hernia opening in patients having direct inguinal hernia. METHODS: In 15 patients with primary bilateral direct inguinal hernia who underwent a Stoppa open posterior inguinal hernia repair, tissue specimens from the abdominal wall surrounding a direct hernia border were excised for histological examination. These findings in patients with direct inguinal hernia were compared with tissue specimens excised from the fossa inguinalis media of cadavers without hernia. RESULTS: Significant degenerative modifications such as fibrohyaline degeneration and fatty substitution of…

GLI EMATOMI RETROPERITONEALI POST-TRAUMATICI

2004

Rectal bleeding and prolapse… not always benign diseases rather anal cancer. The importance of a correct decision making since primary care

2016

Rectal bleeding is very common in general population with a prevalence of 10-20 %. Primary care physicians have to stratify patients basing on urgency and on the colo-rectal cancer risk and to conduct a decision making for the correct management. We report a case of a 61-years-old woman, complaining rectal bleeding and an anal mass attended to their family doctor who does a visit but without a digital rectal examination and diagnosed a hemorrhoidal prolapse suggesting medical therapy. For the persistence of symptoms she comes to our service from emergency attention. Inspection and digital rectal examination revealed an anal mass. CT scan was performed showing a large anal mass involving hal…

Malattia di Crohn: diagnosi e trattamento in urgenza.

2004

Vacuum-Assisted Wound Closure with Mesh-Mediated Fascial Traction Achieves Better Outcomes than Vacuum-Assisted Wound Closure Alone: A Comparative St…

2017

Background Open abdomen (OA) permits the application of damage control surgery principles when abdominal trauma, sepsis, severe acute peritonitis and abdominal compartmental syndrome (ACS) occur. Methods Non-traumatic patients treated with OA between January 2010 and December 2015 were identified in a prospective database, and the data collected were retrospectively reviewed. Patients’ records were collected from charts and the surgical and intensive care unit (ICU) registries. The Acosta ‘‘modified’’ technique was used to achieve fascial closure in vacuum-assisted wound closure and mesh-mediated fascial traction (VAWCM) patients. Sex, age, simplified acute physiology score II (SAPS II), ab…

Retrospective Analysis of 29 Patients with Multiple Pulmonary Metastases from Colorectal Carcinoma Resected by a 1318-nm Laser

2018

NO Abstract

TRATTAMENTO ENDOSCOPICO DEL CARCINOIDE GASTRICO. A PROPOSITO DI UN CASO CLINICO

2005

The abdominal wall hernia in cirrhotic patients: A historical challenge

2018

Abstract Background The incidence rate of abdominal wall hernia is 20–40% in cirrhotic patients. A surgical approach was originally performed only if complication signs and symptoms occurred. Several recent studies have demonstrated the usefulness of elective surgery. During recent decades, the indications for surgical timing have changed. Methods Cirrhotic patients with abdominal hernia who underwent surgical operation for abdominal wall hernia repair at the Policlinico “Paolo Giaccone” at Palermo University Hospital between January 2010 and September 2016 were identified in a prospective database, and the data collected were retrospectively reviewed; patients’ medical and surgical records…

Pathological anatomy of hernia disease

2011

Short stay thyroid surgery: a personal experience

2008

Introduction: In spite of a low incidence of complications during thyroidectomy, there is a widespread tendency to extend hospitalization at least until postoperative second day. The need of a rebalancing between costs and profits had led us to revise the hospitalization’s duration. Methods: We reviewed our early experience (129 patients candidated to total thyroidectomy as ordinary hospitalization from 2001 to 2002) identifying the causes of hospitalization’s delay both preoperatively and in discharge. We excluded from our analysis re-operations, substernal goitre requiring sternotomy, carcinomas needing a systematic lymphadenectomy and some cases of internal medical interest. Between June…

An investigation of bedside laparoscopy in the ICU for cases of non-occlusive mesenteric ischemia

2017

Background: Acute mesenteric ischemia is a rare affection with high related mortality. NOMI presents the most important diagnostic problems and is related with the higher risk of white laparotomy. This study wants to give a contribution for the validation of laparoscopic approach in case of NOMI. Methods: Thirty-two consecutive patients were admitted in last 10 years in ICU of Paolo Giaccone University Hospital of Palermo for AMI. Diagnosis was obtained by multislice CT and selective angiography was done if clinical conditions were permissive. If necrosis was already present or suspected, surgical approach was done. Endovascular or surgical embolectomy was performed when necessary. Twenty N…

Traumatic Isolated Intramural Duodenal Hematoma Causing Intestinal Obstruction

2015

A 21-year-old man was admitted 36 hours after a blunt abdominal trauma occurred during a sporting competition. He complained of colic epigastric abdominal pain, nausea, and vomiting. He was hemodynamically stable; blood counts and metabolic panel were normal. Abdominal CT showed an intestinal obstruction caused by an 8 x 6 x 11 cm hematoma on the right lateral duodenal wall without signs of active bleeding (Figure 1). He underwent gastric decompression and started total parenteral nutrition and intravenous pump inhibitors. Esophagogastroduodenoscopy (EGD) performed 48 hours after the diagnosis showed an extrinsic compression by a bluish obstruction in the first part of the duodenum resembli…

An uusual case of a partial midgut malrotation

2009

Surgical pathology and the diagnosis of invasive visceral yeast infection: two case reports and literature review

2013

Invasive mycoses are life-threatening opportunistic infections that have recently emerged as a cause of morbidity and mortality following general and gastrointestinal surgery. Candida species are the main fungal strains of gut flora. Gastrointestinal tract surgery might lead to mucosal disruption and cause Candida spp. to disseminate in the bloodstream. Here we report and discuss the peculiar clinical and morphological presentation of two cases of gastrointestinal Candida albicans lesions in patients who underwent abdominal surgery. Although in the majority of cases reported in the literature, diagnosis was made on the basis of microbiological criteria, we suggest that morphological feature…

Fixation free prosthetic repair of large umbilical hernia granting a broad defect overlap

2012

lntroduction: Umbilical hernia is a common surgical disease, accounting for l0-147o of all hernias and having many therapeutic options. Pure tissue repair is affected by a recurrence tp to 40Vo. Prosthetic mesh repair is now widely utilized with a decrease of recurrences up to 107o. Nevertheless, if large defect are present, assuring a wide overlap and a fixation-free technique still represent an issue. In this report we describe the outcomes of an umbilical hernia repair technique via a new implant with radiating straps at its boundary. Material and methods: A light weight, large porous polypropylene implant having a central body of 12x15 cm in diameter and eight radiating straps was used …

Open mini-invasive cholecystectomy in high risk elderly. A review of 121 consecutive procedures.

2011

INTRODUCTION: the report describes the features of a low cost, open mini-invasive procedure for cholecystectomy in a sample of 121 consecutive high risk elderly (ASA score 3 to 5). PATIENTS AND METHODS: the surgery is performed through a 3 - 4 cm right subcostal skin incision. An optimal exposition of the operating field was achieved thanks to an innovative three valve retractor. RESULTS: a mean hospital stay of 3,02 days, low complication rate and 2,4% mortality are the results of the described procedure. CONCLUSIONS: in high risk elderly the results are extremely encouraging, particularly in comparison with both laparoscopic and traditional open cholecystectomy. The open minisurgical chol…

Dynamic autostatic implant for inguinal hernia repair. Early results in an explorative cohort of patients

2010

Acknowledging the need to further improve outcomes and reduce complications in inguinal hernia repair, our group has been developing new surgical implants for this condition. Our primary considerations are to reduce complications associated with invasive fixation, and improve the quality of the tissue ingrowth within the implant. We have developed a new type of 3D dynamic, self retaining implant to achieve these effects. This newly designed implant was previously experimentally tested in porcine model, showing excellent outcomes. Above all, the results concerning the quality of tissue ingrowth and the nearby absence of shrinkage in the long term were excellent. In this report we describe th…

LE COMPLICANZE DELLA CHIRURGIA TIROIDEA IN RELAZIONE ALL’INTERVENTO CHIRURGICO PRATICATO

2004

Minimally Invasive Video-Assisted Thyroidectomy: Analysis of Complications From a Systematic Review

2019

Background. Nowadays, minimally invasive video-assisted thyroidectomy (MIVAT) is considered a safe and effective option. However, its complication rate has not been specifically discussed yet. The aim of this systematic review was enrolling a large number of studies to estimate early and late complications (transient and definitive, uni- and bilateral laryngeal nerve palsy; transient and definitive hypocalcemia; cervical hematoma; hypertrophic or keloid scar) of MIVAT compared with conventional technique. Methods. The review was performed according to PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) criteria in PubMed and Embase. Search terms were “minimally inva…

Physiopathology of hernia disease

2012

The genesis of inguinal hernia still represents a dilemma. Deryite innovation in surgical matenals and techniques, no care has lrccn eler concerning the etiology of hernia. Following a specific Erlnù tissue samples were excised in 30 fresh male cadavers with iÉr.l lsnias, from structures close to the hemia orifice. for histological study. 15 cadavers without hernia served as conffol. The tissue excised demonstrated several histological changes. Among these, fibrohyaline degeneration and fatty dystrophy of the myocytes. Besides limpho-histiocytic and plasmacellular clusters, we found also vein fibrosis and congestion. The arterial structrres showed thicken- ing of the media due to Lyperplade…

Pooled analysis of who surgical safety checklist use and mortality after emergency laparotomy

2019

Background The World Health Organization (WHO) Surgical Safety Checklist has fostered safe practice for 10 years, yet its place in emergency surgery has not been assessed on a global scale. The aim of this study was to evaluate reported checklist use in emergency settings and examine the relationship with perioperative mortality in patients who had emergency laparotomy. Methods In two multinational cohort studies, adults undergoing emergency laparotomy were compared with those having elective gastrointestinal surgery. Relationships between reported checklist use and mortality were determined using multivariable logistic regression and bootstrapped simulation. Results Of 12 296 patients incl…

Surgical site infection after gastrointestinal surgery in high-income, middle-income, and low-income countries: a prospective, international, multice…

2018

Background Surgical site infection (SSI) is one of the most common infections associated with health care, but its importance as a global health priority is not fully understood. We quantified the burden of SSI after gastrointestinal surgery in countries in all parts of the world. Methods This international, prospective, multicentre cohort study included consecutive patients undergoing elective or emergency gastrointestinal resection within 2-week time periods at any health-care facility in any country. Countries with participating centres were stratified into high-income, middle-income, and low-income groups according to the UN's Human Development Index (HDI). Data variables from the Globa…

The abdominal wall incisional hernia repair in cirrhotic patients

2018

BACKGROUND: The incidence of abdominal wall hernia in cirrhotic patients with ascites is between 20 and 40%. Controversies regarding the treatment modality and surgical timing of abdominal wall incisional hernia repair in cirrhotic patients remain. The study proposed wants to analyze the abdominal incisional hernia repair in cirrhotic patients with ascites performed in a single center to determine post-operative morbidity, mortality and complication rate. PATIENTS AND METHODS: Cirrhotic patients with abdominal incisional hernia that underwent surgical operation for abdominal wall hernia repair at the "Policlinico Paolo Giaccone" at Palermo University Hospital between January 2015 and Decemb…

Risk Factors for Anaplastic Thyroid Carcinoma: A Case Series From a Tertiary Referral Center for Thyroid Surgery and Literature Analysis

2022

Anaplastic thyroid carcinoma (ATC) is a very rare and extremely aggressive disease with a very poor prognosis. Several risk factors have been hypothesized, but there is no clear-cut literature data on it. We reviewed the literature concerning risk factors for ATC and analyzed the institutional database from 2005 to 2022. In total, 15 papers were suitable for review, while the retrospective data collection search, conducted on our institutional database, provided 13 results. In our experience, in agreement with literature data, ATC seems to be a neoplasm peculiar to old age (in our database, mean age is 72 years), with a higher prevalence in subjects with a low level of education and a long …

SARS-CoV-2 infection and venous thromboembolism after surgery: an international prospective cohort study

2021

SARS-CoV-2 has been associated with an increased rate of venous thromboembolism in critically ill patients. Since surgical patients are already at higher risk of venous thromboembolism than general populations, this study aimed to determine if patients with peri-operative or prior SARS-CoV-2 were at further increased risk of venous thromboembolism. We conducted a planned sub-study and analysis from an international, multicentre, prospective cohort study of elective and emergency patients undergoing surgery during October 2020. Patients from all surgical specialties were included. The primary outcome measure was venous thromboembolism (pulmonary embolism or deep vein thrombosis) within 30 da…

Chemioterapia di II linea nel carcinoma epiteliale dell'ovaio. Studio di Fase II

2007

Chemioterapia di II linea nel carcinoma epiteliale dell'ovaio. Studio di Fase II.

Laparoscopic, three-port and SILS cholecystectomy: a retrospective study.

2014

Introduction. The aim of this study was to compare the results of classic laparoscopic, three-port and SILS cholecystectomy. Materials and methods. We conducted a retrospective study of da- ta collected between January 2010 and December 2012 pertaining to 159 selected patients with symptomatic gallstones. 57 underwent lapa- roscopic cholecystectomy, 51 three-port cholecystectomy and 48 SILS cholecystectomy. We then compared the groups with respect to mean ope- rating time, intraoperative complications, postoperative pain, duration of hospitalization and final aesthetic result. Introduction The first laparoscopic cholecystectomy was carried out in 1987 in France by Philippe Mouret (1). The p…

Terminal or truncal ligation of the inferior thyroid artery during thyroidectomy? A prospective randomized trial.

2016

Abstract Introduction Thyroidectomy is a common procedure in general and endocrine surgery. The technique of ligation of inferior thyroid artery (ITA) has been invoked as a possible cause of appearance of postoperative hypocalcemia. Methods We performed a prospective randomized study involving 184 patients undergoing total thyroidectomy to evaluate the differences of truncal ligation versus distal ligation of ITA in terms of postoperative hypocalcemia, vocal fold palsy, voice and swallowing impairment. The patients were divided into group A (trunk ligation of ITA) and group B (terminal branches ligation of ITA). Results We evaluated postoperative PTH and calcemia (immediate, 6 and 12 months…

Comparison of minimally invasive parathyroidectomy under local anaesthesia and minimally invasive video-assisted parathyroidectomy for primary hyperp…

2016

Background: Primary hyperparathyroidism (PHPT) origins from a solitary adenoma in 70-95% of cases. Moreover, the advances in methods for localizing an abnormal parathyroid gland made minimally invasive techniques more prominent. This study presents a micro-cost analysis of two parathyroidectomy techniques. Patients and methods: 72 consecutive patients who underwent minimally invasive parathyroidectomy, video-assisted (MIVAP, group A, 52 patients) or "open" under local anaesthesia (OMIP, group B, 20 patients) for PHPT were reviewed. Operating room, consumable, anaesthesia, maintenance costs, equipment depreciation and surgeons/anaesthesiologists fees were evaluated. The patient's satisfactio…

Outpatient management of proctologic disease. Which techniques for local anesthesia? The experience of a single center

2019

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…

Chirurgia generale Metodologia - Patologia - Clinica Chirurgica

2008

Nell''ambito della patologia chirurgica gli autori hanno realizzato una completa trattazione delle varie patologie chirurgiche sino alla traumatologia.

Outpatient Treatment of Hemorrhoidal Disease: The Alternative Way to Treat Hemorrhoidal Disease in a Simple, Safe and Effective Manner.

2021

Background:: Hemorrhoidal disease is a widespread problem in healthy working patients. The traditional surgical approaches cause a loss of several working days related to the post-- operative course that is often painful. To avoid these problems while offering a symptoms resolution in patients with low degrees hemorrhoids, the non-surgical treatments are nowadays largely proposed in proctological clinics. Methods: We resume the recent literature on the issue to offer a practical and easy to use guide for clinicians. Results: Rubber band ligation, injection sclerotherapy and infrared coagulation are cost effective, safe and effective treatments for patients with II- and III-degree hemorrhoi…

Global economic burden of unmet surgical need for appendicitis

2022

Abstract Background There is a substantial gap in provision of adequate surgical care in many low- and middle-income countries. This study aimed to identify the economic burden of unmet surgical need for the common condition of appendicitis. Methods Data on the incidence of appendicitis from 170 countries and two different approaches were used to estimate numbers of patients who do not receive surgery: as a fixed proportion of the total unmet surgical need per country (approach 1); and based on country income status (approach 2). Indirect costs with current levels of access and local quality, and those if quality were at the standards of high-income countries, were estimated. A human capita…

Studio clinico sulla profilassi antibiotica "Ultra- Short term" in chirurgia tiroidea con amoxicillina-acido clavulanico.

2004

SEARCH OF THE MUTATION OF B-RAFV600E IN FNA OF THYROID NODULES

2006

Recherche de la mutation B-RAF V600E sur materiel preleve par citopontion de nodule thyroidiens: utilitè diagnostique et valeur prognostique

2007

DIFFERENZE PROGNOSTICHE NEL CARCINOMA COLO-RETTALE TRATTATO IN CONDIZIONE DI ELEZIONE E DI URGENZA

2004

Pulmonary Laser Metastasectomy by 1318-nm Neodymium-Doped Yttrium-Aluminum Garnet Laser: A Retrospective Study About Laser Metastasectomy of the Lung

2018

Background. The lungs are among the first organ affected by remote metastases from many primary tumors. The surgical resection of isolated pulmonary metastases represents an important and effective element of therapy. This is a retrospective study about our entire experience with pulmonary resection for metastatic cancer using 1318-nm neodymium-doped yttrium-aluminum garnet laser. Method. In this single-institution study, we retrospectively analyzed a group of 209 patients previously treated for primary malignant solid tumors. We excluded 103 patients. The number and location of lesions in the lungs was determined using chest computed tomography and positron emission tomography-computed tom…

Candida spp. infections after abdominal urgent surgery: comparative analysis of histologic data for which microbiological results were positive for C…

2015

EV0515 ePoster Viewing Diagnostic/laboratory methods other than molecular Candida spp. infections after abdominal urgent surgery: comparative analysis of histologic data for which microbiological results were positive for Candida spp. V. Rodolico1, G. Gulotta1, L. Montana1, G. Salamone1, D.C. Paola1 1Department of Sciences for Health Promotion and Mother Child Care, Palermo, Italy Objectives: Microbiological identification is justified when the yeast is isolated from a sterile site, the potential clinical impact of identified isolates from non sterile sites such as intra- abdominal organs don’t help the clinicians to determine whether the strain isolate represents contamination, colonizatio…

Skip metastases to lateral cervical lymph nodes in differentiated thyroid cancer: a systematic review.

2019

Abstract Papillary thyroid carcinoma is a slow-growing cancer with a generally good prognosis that sometimes have an aggressive behaviour. Metastases to neck lymph nodes is the first step of the diffusion. The central neck compartment is involved most commonly. The ipsilateral lateral neck compartments are usually involved afterwards, and the involvement of the contralateral one is considered a quite rare occurrence. In more rare cases, metastases to lateral neck compartment without central lymph node metastasis (so called “skip metastases”) could be observed. Aim of this literature review study is to analyse the average incidence, pattern and risk factors of this occurrence. This study was…

Large cavernous hemangioma of the adrenal gland: Laparoscopic treatment. Report of a case

2015

Highlights • Identify the preoperative radiologic features of adrenal hemangioma. • We examine the better surgical approach for adrenal tumors and adrenal hemangioma. • Controindication to laparoscopic adrenalectomy.

Studio di Fase II nel Carcinoma Gastrico in fase avanzata

2005

An unusual case of partial midgut malrotation

2009

The Synthetic Scaffolds for Ventral Hernia Repair: Perspectives for Regenerative Surgery—Systematic Review

2022

AbstractVentral hernia (VH) frequently affects patients after abdominal surgery. The use of a mesh is often recommended. Different materials are described, from synthetic non-resorbable meshes to biological meshes. New generation meshes, also named scaffolds, aim to combine the advantages of both materials. The aim of this review is to provide an overview of the cytological, histological, biomechanical, and clinical outcomes of the use of the newest resorbable synthetic scaffolds in VH repair, based on experimental studies in a pre-clinical setting. A systematic review was conducted according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines and t…

TAP Block Prior to Open Ventral Hernia Repair Improves Surgical Outcome.

2022

Abstract Background Ventral hernias commonly affect patients after major abdominal surgery. To reduce postoperative pain, the effects of the transversus abdominis plane (TAP) block, epidural analgesia and medication-only protocol have been investigated. The primary outcome was the cumulative dosage of opioids (morphine milligram equivalents MME), of acetaminophen and diclofenac for postoperative pain control on postoperative day (POD) 0, 1, and 2. Secondary outcomes were length of stay (LOS) and the pain scale rating using the numeric rating scale (NRS) on POD 0, 1, and 2. Methods The data were retrospectively extracted from the charts of the patients admitted for a surgical operation for O…

A rare case of abdominal cocoon.

2013

Abdominal cocoon is a rare cause of intestinal obstruction usually diagnosed incidentally at laparotomy. It manifests by forming a membrane that typically encases the small bowel loops, leading to mechanical obstruction. Preoperative diagnosis is difficult. The etiology of this condition is not well understood; however, it is a form of chronic irritation and inflammation.A 33 years old male, from Bangladesh, presented to our emergency department complaining of abdominal pain, nausea, and vomiting. CT abdomen shows a picture of intestinal obstruction at the level of the small intestine. Intraoperative findings showed encapsulation of small bowel by a dense whitish membrane as a cocoon. Histo…

Laparoscopy is an available alternative to open surgery in the treatment of perforated peptic ulcers: A retrospective multicenter study

2018

Abstract Background Perforated peptic ulcers (PPU) remain one of the most frequent causes of death. Their incidence are largely unchanged accounting for 2–4% of peptic ulcers and remain the second most frequent abdominal cause of perforation and of indication for gastric emergency surgery. The minimally invasive approach has been proposed to treat PPU however some concerns on the offered advantages remain. Methods Data on 184 consecutive patients undergoing surgery for PPU were collected. Likewise, perioperative data including shock at admission and interval between admission and surgery to evaluate the Boey’s score. It was recorded the laparoscopic or open treatments, the type of surgical …

Use of the KSVM-based system for the definition, validation and identification of the incisional hernia recurrence risk factors

2019

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…

COLONIC LOCALIZATION OF MYXOID LIPOSARCOMA: CASE REPORT

2008

INTRODUCTION: myxoid liposarcoma approximately constitutes 20% of all mesenchymal malignancies preferably occurring in adults with prevalent localization in arts even if there are rare intra-abdominal locations: only 3 cases reported in the literature. We present a case of myxoid liposarcoma with colic localization outlining a diagnostic and therapeutic procedure through a literature’s review. CASE REPORT: We observed a 37 year-old man in January 2007 because of colic pain in the middle abdomen, dyspepsia and constipation. The CT with contrast agent showed a capsulated solid mass with net margins, lobules and adipose tissue component compressing and displacing small bowel. After incision we…

Efficacy of fibrin sealant in thyroid surgery. Is drainage still necessary?

2019

The routinely use of drains in thyroid surgery is a traditional and well-defined method, even if there is no clear evidence of significant improvement in patients outcomes. Aim of our study is to define the feasibility, safety and cost- effectiveness of fibrin sealant in total thyroidectomy in order to overcome the use of drains.We enrolled 262 patients (45 men and 217 women, mean age 54.7 yrs) undergone total thyroidectomy in University Hospital of Palermo (Italy), between July 2015 and October 2017. We randomized patients into group A (drain) and group B (no drain, fibrin sealant application).We registered statistical difference between the two groups in mean operative time, visual analog…

A primary subcutaneous hydatid cyst in the thigh. A case report

2016

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…

New mesh shape and improved implantation procedure to simplify and standardize open ventral hernia repair: a preliminary report.

2010

Introduction Issues in ventral hernia repair are represented by the need for mesh fixation and how to assure a sufficient mesh overlap of the defect. Aiming to resolve these problems, this study describes a modified technique for ventral and incisional hernia repair based upon a newly developed mesh with a special design. This new type of implant allows broader coverage of the abdominal wall and results in tension- and fixation-free repair. Materials and methods A unique geometrically shaped mesh consisting of a large central body and radiating arms was used to repair ventral or incisional hernia. The mesh was intended not to be point-fixated. The friction of the straps passing through the …

Mannheim Peritonitis Index (MPI) and elderly population: prognostic evaluation in acute secondary peritonitis

2016

Introduction. Acute Secondary Peritonitis due to abdominal visceral perforation is characterized by high mortality and morbidity risk. Risk stratification allows prognosis prediction to adopt the best surgical treatment and clinical care support therapy. In Western countries elderly people represent a significant percentage of population Aim. Evaluation of Mannheim Peritonitis Index (MPI) and consideration upon old people. Patients and methods. Retrospective study on 104 patients admitted and operated for “Acute Secondary Peritonitis due to visceral perforation”. MPI was scored. In our study we want to demonstrate efficacy of MPI and the possibility to consider older age an independent …

De Garengeot Hernia: Case Report and Review of the Literature of a Rare Femoral Hernia

2021

AbstractDe Garengeot hernia is a rare femoral hernia defined as the presence of the appendix within the femoral hernia sac. The incidence of appendicitis in this type of hernia is a rare condition that accounts for 0.08–0.13% of all De Garengeot hernias. We describe the case of a 61-year-old woman that presented at the emergency department with a tender mass (diameter 10 × 8 cm) in the right groin region for 5 days associated with pain in lower right abdomen and accompanied by fever (38 °C). Computed tomography (CT) of the abdomen revealed the presence of a complex fluid collection with small foci of air in the right inguinal region, measuring 9 × 7 × 10 cm in the 3 orthogonal dimensions an…

Intra-abdominal Candida spp infection in acute abdomen in a quality assurance (QA)-certified academic setting

2016

AimsTo evaluate the contribution of light microscopy to detecting Candida spp infection in patients with complicated intra-abdominal infections (IAIs) admitted for acute abdomen to a quality assurance (QA)-certified surgical emergency ward.MethodsWe conducted a retrospective study (2008–2012) of 809 abdominal intraoperative or biopsy tissue specimens obtained from patients admitted with acute abdomen and microbiological samples positive for Candida spp. Demographic data, mortality, comorbidities, specimen type, microscopy results, special histological staining performed, antimicrobial therapy were collected and analysed. Any comments at the multidisciplinary team meeting was recorded in min…

Fixation free open ventral hernia repair using a new mesh with integrated placement straps

2011

Uncommon localizations of hydatid cyst. Review of the literature

2016

Introduction Hydatid disease is an endemic anthropozoonosis with usual localization in liver and lungs. Rarely it localizes in uncommon sites as spleen, skeleton, kidney, brain, cardiac muscle, peritoneum, sub cutis. Complications of uncommon localizations are the same that for usual ones. Material and methods Review of the literature on rare and atypical localization of hydatid cysts in soft tissues. Key-words used on Pub-Med [(echinococ OR hydatid) AND (soft tissue OR subcutaneous OR cutaneous)] without time limit. There were found 282 articles; 242 were excluded because of muscular or bone localizations. 40 were coherent. Results Different variables are taken into account: age, sex, geog…

CHIRURGIA TIROIDEA NEL PAZIENTE GERIATRICO: INDICAZIONI E COMPLICANZE

2004

Usefulness of ileostomy defunctioning stoma after anterior resection of rectum on prevention of anastomotic leakage A retrospective analysis

2016

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 …

LA NOSTRA ESPERIENZA SULLA PREVENZIONE E SUL TRATTAMENTO DELL’IPOCALCEMIA DOPO INTERVENTI DI TIROIDECTOMIA TOTALE

2004

Open versus laparoscopic approach in the treatment of abdominal emergencies in elderly population

2016

AIM: To evaluate the role of laparoscopy in the treatment of surgical emergency in old population. PATIENTS AND METHODS: Over-70 years-old patients submitted to emergency abdominal surgery from January 2013 to December 2014 were collected and grouped according to admission diagnoses. These accounted small bowel obstruction, colonic acute disease, appendicitis, ventral hernia, gastro-duodenal perforation, biliary disease. In each group it was analyzed the operation time (OT), the morbidity rate and the mortality rate comparing open and laparoscopic management using T-test and Chi-square test. RESULTS: 159 over 70-years-old patients underwent emergency surgery in the General and Emergency sur…

Abdominal wall incisional hernia repair improves respiratory function: results after 3 years of follow-up

2020

Abstract Purpose Hernias severely impact patient quality of life (QoL), and 80% of patients require a surgical operation. Moreover, hernias are responsible for respiratory function alterations. This study aims to investigate the postoperative alterations in respiratory function after open ventral hernia repair in patients with incisional hernia. Methods Patients operated on at the Policlinico “Paolo Giaccone” at Palermo University Hospital between January 2015 and December 2016 were identified in a prospective database. Fifty-one patients were enrolled in the study. The respiratory outcome measures used were forced vital capacity (FVC), forced expiratory volume in 1 s (FEV1), FEV1/FVC ratio…

Deep SSI after mesh-mediated groin hernia repair: Management and outcome in an Emergency Surgery Department

2017

Aim. Mesh-mediated groin hernia repair is considered the goldstandard procedure. It has low recurrence rate. Rarely a deep Surgical Site Infection (SSI) is seen when a synthetic prosthesis is used. Case report. We describe a rare case of bilateral deep SSI after mesh- mediated groin hernia repair. Diagnosis was performed through the physical examination and radiological exams. Microbiological samples identified a methicillin-resistant Staphylococcus aureus responsible of the infection. Target therapy was performed and re-operation performed in order to remove the infected prosthesis and to apply a biological one to create the fibrous scaffold. During follow-up time, right side recurrence wa…

Ruolo del linfonodo sentinella nel trattamento chirurgico delle neoplasie colo-rettali

2004

Clinical strategies for the management of intestinal obstruction and pseudo-obstruction. A Delphi Consensus study of SICUT (Società Italiana di Chiru…

2016

Intestinal obstructions/pseudo-obstruction of the small/large bowel are frequent conditions but their management could be challenging. Moreover, a general agreement in this field is currently lacking, thus SICUT Society designed a consensus study aimed to define their optimal workout.The Delphi methodology was used to reach consensus among 47 Italian surgical experts in two study rounds. Consensus was defined as an agreement of 75.0% or greater. Four main topic areas included nosology, diagnosis, management and treatment.A bowel obstruction was defined as an obstacle to the progression of intestinal contents and fluids generally beginning with a sudden onset. The panel identified four major…

Laparoscopic ileocecal resection in acute and chronic presentations of Crohn's disease. A single center experience

2017

Introduction The terminal ileum is the most involved tract in Crohn's disease. The obstruction in this location is the most frequent complication. Acute or chronic presentations can occur. Surgery finds a role in the management of chronic strictures and in acute clinical presentations with complications not improving with conservative therapy. Patients and methods We investigate the outcome of patients with obstruction of the ileo-cecal bowel tract laparoscopically managed. It was analyzed the average operative time (OT), the conversion rate and the occurrence of re-operation due to surgical complications. Results 21 patients underwent an ileocecal resection for complicated Crohn's disease …

Damage to the vascular structures in inguinal hernia specimens.

2012

BACKGROUND: Few scientific reports to date describe the histological modification of structures outlining a hernia opening. This article is focused on the identification of the pathological changes in vascular structures in tissues excised from cadavers with inguinal hernia. A deeper comprehension of this topic could lead to essential improvements in the detection of hernia genesis. MATERIALS AND METHODS: Different kinds of hernia, including indirect, direct and mixed, were identified in 30 autopsied subjects. Tissue samples were resected for histological study from abdominal wall structures close to the hernia opening. Histological examination focused on the detection of structural changes…

LA MASTOPATIA FIBROCISTICA NELLE GIOVANI DONNE, INDAGINI E TERAPIA

2004

Multiparametric evaluation of risk factors associated to seroma formation in abdominal wall surgery

2018

INTRODUCTION: Incisional hernia is one of the main topics in the general surgery since there is not a unanimous consensus concerning to the best surgical methodology to adopt. It seems that prosthetic surgery is the best technique, even if responsible for the development of periprosthetic seroma. The aim of this study is to assess whether the preoperative abnormalities of the bio-humoral parameters may be considered as risk factors for seroma. PATIENTS AND METHODS: From July 2016 to July 2017 at the "Policlinico Paolo Giaccone", Palermo, Department of Emergency Surgery, 56 patients included in this study, underwent laparotomic mesh repair. The inclusion criteria were: age > 18 years, inc…

PRINCIPLES AND PRELIMINARY EXPERIENCE OF A NEW TISSUE SEALING DEVICE IN LAPAROSCOPIC COLONIC SURGERY

2008

La fase ricostruttiva dopo duodenocefalopancreasectomia: l’anastomosi pancreatico-digiunale. Nostra esperienza.

2004

Functional outcome of patients with uncomplicated acute sigmoid diverticulitis after conservative and surgical treatment: risk factors for recurrence.

2012

Three-port colectomy: reduced port laparoscopy for general surgeons. A single center experience

2016

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 …

[Informed consent in thyroid and parathyroid surgery].

2005

The Authors outline the law problems and the practice implications of thyroid and parathyroid surgery from the point of view of the informed consensus of the patient, and expose the criteria they usually adopt in their clinical practice for such procedures. This problem is particularly important because is exceptionally needed in emergency; therefore the preoperative information must be completed as possible, illustrating the risks of the procedure and the possible solutions alternative to surgery.

Non-occlusive mesenteric Ischemia (NOMI) in Parkinson’s disease: Case report

2017

Non-occlusive mesenteric ischemia (NOMI) is a severe pathological condition characterized by signs and symptoms of bowel obstruction, intestinal necrosis resulting from acute and/or chronic inadequate blood perfusion, in the absence of an organic vascular obstruction detectable by imaging techniques. A 64 years old man case with a history of Parkinson’s disease in high-functioning levodopa treatment is presented. Clinical and radiological signs of intestinal obstruction were observed. He underwent surgical operation with total colectomy and terminal ileostomy for generalized secondary peritonitis due to perforation of sigmoid colon. Ischemic pancolitis was first suspected. In third post-o…

Prosthetic strap system for simplified ventral hernia repair. Its results in a porcine experimental model.

2010

Abstract: Introduction Aiming to achieve a simplified ventral hernia repair, a proprietary shaped mesh was experimentally tested in the porcine model. The mesh is structured with a large central body and radiating straps. The friction of the straps passing through the tissues are hypothesized to be adequate to maintain the mesh in place during tissue ingrowth, avoiding classic point fixation while ensuring a wide coverage of the abdomen. Methods The mesh, having 6 radial straps, was placed using a sublay preperitoneal technique in 4 pigs. All straps were passed laterally through the abdominal wall and exteriorized from the skin. The straps were trimmed at the level of the skin, allowing the…

Papillary Thyroid Microcarcinoma: Active Surveillance Against Surgery. Considerations of an Italian Working Group From a Systematic Review

2022

IntroductionActive surveillance is considered a viable option for papillary thyroid microcarcinoma. Since the last decade of the 20th century, this method has spread from Japan to other countries, but has not yet been fully accepted and validated by the major Western Scientific Societies. In 2016, a systematic review on the results of active surveillance was published, based on two articles that showed encouraging results. Other reviews published subsequently, were mainly based on articles from the Far East. The aim of this review is to assess the most recent results published from 2017 to 2020 on this subject.Materials and MethodsA systematic literature search was performed on MEDLINE via …

Use of NPTWi in Fournier's gangrene

2013

Aim: Fournier's gangrene (FG) is defined as a fulminant form of infective necrotizing fascitis of the perineal, genital or perianal regions. Even with appropriate treatment approaches, mortality is high as 4 to 67%. There have been many advances in management of Fournier gangrene including use of vacuum assisted closure and hyperbaric oxygen therapy. Methods: a 72 y.o. male with swelling, redness, pain on palpating and necrosis of the penis, scrotum and perineal area including the perianal area, with diabetes mellitus type II, previous non Hodgkin lymphoma recent surgery for perianal fistula, was admitted in our clinic. Because of the extensive involvement of the anus and its sphincter was …

Su di un caso clinico di stipsi cronica dell’adulto dopo trattamento chirurgico per MAR in età neonatale

2004

Update in laparoscopic approach to acute mesenteric ischemia

2016

AMI is an uncommon but serious disease often associated with a bad prognosis, associated with occlusion of Superior Mesenteric Artery (SMA) for embolism or thrombosis (67.2 %), mesenteric venous thrombosis (15.7 %), and non-occlusive mesenteric ischemia (15.4 %). Clinical markers are often aspecific and symptoms low suggestive. The gold standard for the diagnosis is multidetector CT Angiography (CTA) with sensibility of 93.3 % and specificity of 95.9 %. Abdominal exploration could be useful to confirm cases of AMI without signs of SMA occlusion at CTA. Few reports have been found on the diagnostic role of Exploratory Laparoscopy. To increase the sensibility of laparoscopy in the diagnosis o…

La Ricerca in Chirurgia

2008

Dalla nascita della chirurgia scientifica durante la metà del ‘700, anni in cui J. Hunter ricorreva alla corruzione di un becchino per studiare il caso del gigante Charles Byrne ad oggi, la pratica medico-chirurgica è molto cambiata; si affida, infatti, sempre di più alle evidenze basate sulla costruzione, sull’esecuzione e sull’analisi degli studi clinici sperimentali. Il CD multimediale,rivolto prevalentemente ai giovani (studenti, medici, specializzandi) ha lo scopo di guidarli nell'affascinante mondo della ricerca in ambito chirurgico.