[The biocompatibility of suture materials used in colon surgery. An experimental study in the rat]. / Biocompatibilità dei materiali di sutura in uso nella chirurgia del colon. Studio sperimentale nel ratto.

BACKGROUND: The aim of this experimental study was to compare the tissue behavior of biofragmentable anastomotic ring (BAR) with other synthetic materials used in colonic surgery. METHODS: Thirty-three rats were divided into four groups: group 1, sham-operated control animals without material implanted; group 2, with fragments of polypropylene monofilament implanted extraperitoneally in abdominal wound, between musculature and peritoneum; group 3, with metal clips implanted extraperitoneally in abdominal wound, between musculature and peritoneum and group 4, with fragments of biofragmentable anastomotic ring implanted extraperitoneally in abdominal wound, between musculature and peritoneum. Animals were sacrificed 30 days after the operation. Macroscopic and histological criteria were used to characterize the resistance of the wound and the tolerance of the host to the foreign material. RESULTS: The inflammatory cell reaction of host tissue was significantly greater in group 4 compared with other groups (p < 0.05). In three cases, in group 4, we observed the adhesion of implanted fragment to epiploa. The enumeration of giant cells and the degree of fibrotic reaction was similar in all groups with material implanted, but no significant difference between the groups was observed. Our findings showed the greater biocompatibility of polypropylene and metallic clips, compared to the biofragmentable ring anastomosis. The strong inflammatory reaction in the host tissue caused by biofragmentable anastomotic ring may explain partially clinical postoperative complications (anastomotic wound infection and/or dehiscence and/or stricture). CONCLUSIONS: In conclusion, the choice of suture materials should be based not only on the mechanical properties, but also on their biological interactions between host and suture materials and on the evaluation of their effective cost/benefit.

[The impact of conventional proctocolectomy on sexual function]. / Impatto della proctocolectomia convenzionale sulla funzione sessuale.

Seventy-one women who had a proctocolectomy for ulcerative colitis (n. 41) or Crohn's disease (n. 30) were interviewed in the follow-up clinic for gynaecological problems and fertility. Forty-nine per cent (35/71) of the women had a distressing vaginal discharge after proctocolectomy, compared with 9% before surgery. At the gynaecological examination 45% (32/71) had a heavy vaginal secretion without any signs of an acute vaginal infection. In 68% (30/44) fluid retention in the vagina was associated with a caudally firmly-fixed and dilated posterior vaginal fornix. Twelve per cent (8/66) of the women reported dyspareunia before surgery. After surgery, 27% (18/66) complained of this symptom. Fertility was significantly reduced after surgery since only 37% (10/27) of the women who attempted to become pregnant succeeded within five years follow-up. The corresponding figure before surgery was 72% (39/54). Those who conceived went through pregnancy and parturition without any incident, 6 of 24 delivered by cesarean section. Fifty-seven men who had a proctocolectomy for ulcerative colitis (n.41) or Crohn's disease (n. 30) were interviewed in the follow-up clinic for the presence of sexual disturbances and their incidence was studied. Fifty-seven per cent of elderly patients (above 40 years old) complained of reduced libido and sexual satisfaction. In younger patients (below 40 years old) 33% complained of an impaired quality of sexual life and 22% complained of an impaired sexual satisfaction. However, despite some sexual dysfunction, 56% reported improved sexual life and 67% improved sexual satisfaction. This may be explained by improved general health and increased libido after removal of diseased bowel.(ABSTRACT TRUNCATED AT 250 WORDS)

[Experimental porto-systemic diversion in the rat: a comparative analysis of technics and results]. / Le derivazioni porto sistemiche sperimentali nel ratto: analisi comparativa di tecniche e risultati.

A number of techniques for performing portacaval end-to-side and side-to-side pancreaticoduodenal and mesenterico-caval shunts in rats are described. These shunts, transposition and arterialization are valuable objects for training in microvascular surgery. Effects of shunts, liver function, hemodynamics, metabolic and neurological changes related to portal flow, liver metabolism, and portal pressure are compared.

[Diagnosis and therapy of splenic injuries]. / Diagnosi e terapia dei traumi splenici.

The purpose of this work is a critical revision of spleen traumatism treatment. We have examined 46 patients which we treated by total splenectomy. We examined the recent literature on spleen functions and we tried to punctualize the newest methods for conservative treatment of the spleen.

[Surgical therapy of recurrent varicocele]. / Terapia chirurgica del varicocele recidivo.

In the surgical treatment of recidivous varicocele, has been adopted in eight patients a personal technique that varies in some points from the Ivanissevich's one. Large dissection and resection of the spermatic vein in peritoneum back zone for 6-8 cm. length, prier ligature of all possible collaterals. In four cases has been applied the microsurgical technique, anastomosing the veins of the spermatic plexus to the saphena vein. Checks performed at distance of time haven't shown any relapsing case. The microsurgical technique should give the more immediate normalization of spermatogenesis.

[Esophagogastroplasty in upper esophageal lesions. Apropos of 4 cases]. / L'esofagogastroplastica nelle lesioni esofagee alte. A proposito di 4 casi.

Oesophagogastroplasty has been performed in 4 patients in the Turin Department of Emergency Surgery. Three of them presented high neoplastic lesion of the oesophagus, while the fourth was suffering from mediastinic compression due to sclerosing mediastinitis. The technique and results are reported in detail. Indications for surgery for both malignant and benign lesions are presented. The real advantages of the operation with respect to stomach to chest transposition and oesophagocolonplasty which have in the personal series created considerable inconvenience, are discussed. The reasons making it necessary to carry out the operation in two stages, with different modalities, are also discussed. Complications are indicated and postoperative treatment discussed. This plays a notable part in the success of the operation, as does correct technique.

[Radiological changes after mitral valvuloplasty]. / Modificazioni radiologiche dopo valvuloplastica mitralica.

The results of a radiological study carried out on a limited number of patients undergoing mitral valvuloplasty are reported. The good results achieved with this technique are confirmed objectively.