[Conservative surgical treatment in differentiated thyroid carcinoma]. / Trattamento chirurgico conservativo nel carcinoma differenziato della tiroide.

BACKGROUND: Purpose of the present study was to compare survival of patients affected by differentiated thyroid carcinoma after total and partial thyroidectomy. METHODS: The study has been carried in a retrospective way; mean follow-up has been 160 months. Surgical setting has been the Institute of Emergency Surgery at the University of Catania, where about 80 thyroid surgical procedures are performed every year. Patients have been divided into two groups: the first included 65 patients who underwent total thyroidectomy, while the second group included 67 patients who underwent partial thyroidectomy. Ten patients affected by a T3-T4, N0-N1 tumor were ruled out of the study to allow better uniformity of data. Besides early postoperative complications (recurrent nerve lesion, hypoparathyroidism), patients have been followed by periodic clinical and instrumental examinations. RESULTS: Follow-up has shown similar survival between patients treated by total thyroidectomy and those who underwent partial thyroidectomy (respectively 92.3% and 92.5%). Postoperative complications were instead significantly less in group 2. CONCLUSIONS: For patients affected by differentiated thyroid carcinoma at early stages it is suggested to perform a partial thyroidectomy since, compared to total thyroidectomy, a similar survival rate and a lower incidence of postoperative complications are obtained. According to personal opinion, total thyroidectomy should be performed in cases of thyroid carcinoma with vascular involvement and metastases.

[The use of Dacron prostheses in laparoceles]. / L'impiego di protesi in Dacron nei laparoceli.

BACKGROUND: Purpose of the study was to evaluate indications and efficacy of Dacron prostheses in the treatment of incisional hernias. METHODS: The study has been carried out in a retrospective way; mean follow-up has been 20 months. Surgical setting has been the Institute of Emergency Surgery at the University of Catania, where about 500 abdominal operations are performed every year. Thirty patients affected by incisional hernias have been considered (mean age 66.8 years). In 12 patients the Mayo technique was performed, whereas a Dacron prosthesis was placed in 18 patients. Other than early postoperative complications, patients have been followed by periodical clinical exams in order to find out possible recurrences as well as other late complications. RESULTS: Among 18 patients treated with insertion of Dacron prosthesis no infection, recurrence, bowel fistula, haematoma or dislocation have been observed. Only in one case an intestinal occlusion secondary to adhesions between prosthesis and bowel has occurred; in this patient a new operation has been necessary to remove the prosthesis. CONCLUSIONS: Considering that prostheses have been used in large incisional hernias or in patients with a weak abdominal wall, the high successful percentage (94%) obtained suggests the use of Dacron prostheses which guarantee long stability and minimum risk of recurrences.

[Laparoscopic appendectomy]. / L'appendicectomia per via laparoscopica.

The authors report their experience of 6 cases of appendicectomy using a laparoscopic route of which 5 were performed under local anesthesia and 1 under general anesthesia. The results indicate that this new technique is easy to perform and as rapid and safe as the traditional operation. The possibility of using local anesthesia, the lack of complications when operating on obese patients, the lower incidence of wound infections and rapid postoperative mobilisation all argue in favour of this alternative approach to conventional open surgery.

[Synchronous tumors of the colon]. / I tumori sincroni del colon.

Although rare, synchronous tumors of the colon represent an important clinical manifestation of cancer of the colon. The paper reports a study carried out in 437 patients with the aim of evaluating the incidence of synchronous tumours and identifying the most useful diagnostic tools for diagnosis. On the basis of the results obtained the authors conclude that the incidence of synchronous tumours of the colon ranges between 1-3% and that in comparison to other methods pancolonoscopy enables a complete diagnosis for a prophylactic approach to multiple tumours.

[Simultaneous bilateral primary lymphomatous tumors of the testis]. / Tumore primitivo sincrono bilaterale linfomatoso del testicolo.

Among the malignant tumours of the gonads, primary lymphoma of the testis represents a rare pathology. It is even more rare to observe this pathology in a bilateral localisation. After a careful evaluation of the cases described in the literature, the authors report a case or primary synchronous and bilateral lymphoma of the testis in a 68-year-old patient; they examine the clinical data and diagnostic methods and analyse the surgical treatment. In conclusion the authors affirm that primary synchronous bilateral lymphoma of the testis represents a rare form of tumour which is burdened by a high mortality rate.