ABSTRACT
The Authors present their experience on the treatment of the varicocele; they performed laparoscopic clamping of the internal spermatic vein in 12 subfertile patients, utilizing only the bipolar coagulation without the use of clips. All patients were available for follow-up, which ranged from 6 to 12 months, including physical examination, Doppler C.W. and study of semen quality. Recurrence of varicocele was not observed, the semen quality demonstrated improvement in semen motility in 9 patients (75%) and normal on 3 patients (25%). The use of bipolar coagulation with smaller ports (phi 5 mm) resulted in less postoperative pain and shorter convalescence than when larger ports were used (phi 10 mm). The Authors conclude that the laparoscopic procedure, used as they do, is safe and costs less than classic ligation with clips as well as radiological occlusion procedures.
Subject(s)
Laparoscopy/methods , Varicocele/surgery , Adolescent , Adult , Humans , MaleABSTRACT
Surgery for the treatment of inguinal and femoral hernias has recent years acquired numerous increasingly modern, innovative techniques. This has been possible thanks modern, innovative techniques. This has been possible thanks to the introduction of prosthetic material which is better tolerated by the tissues and to the utilization of new ways of approach. A new method of hernia classification, no longer based on anatomical criteria but on a broader evaluation which takes multiple aspects into account, is now needed to decide on valid criteria for choice of operation, at the same time expressing themselves in a common language which will allow the results to the verified.
Subject(s)
Hernia, Femoral/classification , Hernia, Inguinal/classification , Adult , Elective Surgical Procedures , Emergencies , Hernia, Femoral/surgery , Hernia, Inguinal/surgery , Humans , RecurrenceABSTRACT
Conservative therapy of hemorrhoids can be curative at stage I and II of disease; further it rappresent a valid preliminary management for a better result of more aggressive treatments, be they surgical or not. Beside local and general drugs other aspects play an important role in conservative therapy of hemorrhoids: adequate local hygiene, correct diet, education to a physiological evacuation and last but not least stool frequency regulation.
Subject(s)
Hemorrhoids/therapy , Constipation , Defecation , Exercise , Hemorrhoids/drug therapy , Hemorrhoids/physiopathology , Humans , Hygiene , Physical Therapy ModalitiesABSTRACT
After a short historical outline, the advantages of, the indication for, and the contraindications for local anaesthesia in hernial surgery are considered. The principal pharmacological characteristics of the most widely-employed local anaesthetics are set out. Preoperative preparation of the patient, intraoperative monitoring and the technique of local anaesthesia employed by the authors are described in detail.
Subject(s)
Anesthesia, Local , Herniorrhaphy , Anesthesia, Local/methods , Anesthetics, Local/adverse effects , Contraindications , Humans , Intraoperative Care , Preanesthetic Medication , Preoperative CareABSTRACT
The Authors present their experience with anal fistulas with recess above the levators. They mainly analyze the diagnostic, clinical, instrumental and therapeutic problems which this type of anal fistula may present.
Subject(s)
Rectal Fistula , Humans , Rectal Fistula/diagnosis , Rectal Fistula/surgeryABSTRACT
Local recurrences of rectal cancer after surgical therapy are a mainly diagnostic and therapeutic problem. The Authors report their experience in local recurrences of rectal cancer. They consider anterior resection versus abdomino-perineal resection, the type of anastomosis and the stage of primary disease. Follow-up is discussed emphasizing early diagnosis for local recurrences.
Subject(s)
Neoplasm Recurrence, Local , Rectal Neoplasms/surgery , Adult , Aged , Aged, 80 and over , Female , Humans , Lymphatic Metastasis , Male , Methods , Middle Aged , Rectal Neoplasms/pathologyABSTRACT
Rectal injuries during barium enema are uncommon but not unusual complications. Radiologists and surgeons must be able to recognize them, as early diagnosis is essential for effective treatment. The Authors discuss various aspects of problems arising from rectal perforation, and report their experience on seven cases.
Subject(s)
Barium Sulfate , Enema/adverse effects , Intestinal Perforation/diagnostic imaging , Rectum/injuries , Aged , Extravasation of Diagnostic and Therapeutic Materials/diagnosis , Female , Gastrointestinal Diseases/diagnostic imaging , Humans , Intestinal Perforation/physiopathology , Intestinal Perforation/surgery , Male , Middle Aged , Prognosis , Radiography , RuptureABSTRACT
Ten patients with peripheral atherosclerotic disease(PAD) treated with 750 mg/d of 5-(2-chlorophenylmethyl)-4,5,6,7-tetrahydrothieno (3,5-c-pyridine) hydrochloride (ticlopidine, Tiklid) were studied for three months. As control was studied a similar group of patients treated with a traditional vasodilator (nicotinate). The aim of our study was to evaluate the effect of ticlopidine both on the clinical evolution of the disease and on rheologic, coagulative and platelet parameters. A progressive increase of maximal walking distance was noted during the three months of therapy with ticlopidine and limited to the first 30 days of treatment with nicotinate. The fibrinogen levels resulted significantly lowered during 90 days of treatment with ticlopidine, while that was not evident in the nicotinate group. There was also a slight improvement of blood viscosity in the ticlopidine group (not evident in the nicotinate group), but it was not statistically significant. No further modifications of investigated data were found in the two groups of patients. The clinical benefit of ticlopidine in PAD without adverse reactions can be confirmed at least at the dosage of 750 mg/d instead of the usual dose of 500 mg/d. A direct or indirect action of ticlopidine on plasma fibrinogen is suggested. This observation may supply new clues for the understanding of the mechanism of action of this drug.