A randomised trial comparing submucosal haemorrhoidectomy with radiofrequency bistoury vs. diathermic haemorrhoidectomy.

BACKGROUND: Haemorrhoid disease has become more and more frequent during the past years among western populations. Great attention has been paid in development of surgical procedures, in order to reduce post-operative pain (the main adverse effect of surgical treatment for haemorrhoids) and shorten execution time and hospital stay. This randomised clinical study compares the results obtained using submucosal haemorrhoidectomy with radiofrequency vs. diathermic haemorrhoidectomy. METHODS: Thirty-one patients were randomised to undergo submucosal haemorrhoidectomy with radiofrequency bistoury (16 patients, Group A) or diathermic haemorrhoidectomy (15 patients, Group B). The operating time, amount of pain and postoperative analgesic requirement, intra and post-operative complications and patient satisfaction were documented. RESULTS: The mean values for operative time have been 35.8 min for group A and 23.2 min for group B. According to pain score, patients' mean values for first day postoperative pain were 3.8 (A) and 5.8 (B). Pain at first evacuation 4.7 (A) and 6.5 (B). Pain at 7th postoperative day was 2.3 (A) and 3.7 (B). Patient's postoperative satisfaction rate was 6.0 (A) vs. 5.2 (B) at 3rd day and 6.7 (A) and 5.7 (B) at 6 months. CONCLUSIONS: In spite of relatively difficult execution and longer operating times, submucosal haemorrhoidectomy with radiofrequency bistoury appears to be the most precise and accurate treatment for IV degree haemorrhoids. Performing submucosal haemorrhoidectomy with radiofrequency bistoury allows us to reduce postoperative pain, bleeding and shorten hospital stay.

[Description of a case of giant adrenal myelolipoma and survey of the literature]. / Presentazione di un caso clinico di mielolipoma surrenalico gigante e revisione della letteratura.

Adrenal myelolipoma is a benign tumor affecting the adrenal gland. It is composed by adipose cells and myelopoietic cells present in each normal differentiating stage of the bone marrow. The neoplasia is often asymptomatic, sometimes leading to very large adrenal masses (more than 10 cm in diameter). These are often called "giant myelolipoma". A case is reported and a survey of the literature on this topic is made; the present knowledge of this disease as well as its diagnosis and treatment are discussed also.

[Acute phlegmonous appendicitis due to a villous adenoma in a hernial sac. A case report]. / Appendicite acuta flemmosa da adenoma villoso in sacco erniario. Descrizione di un caso.

The authors report a case of a 93-year-old man with villous adenoma causing acute phlegmonous appendicitis. The appendicular localization, extremely uncommon, is the cause of an acute appendicitis in 50% of cases. Therefore, they analyse the anatomo-pathological, clinical, diagnostic and therapeutic aspects of this pathology with the help of the literature.

[Hemangioma of the masseter: a rare location of a pathology not always accurately diagnosed]. / Emangioma del massetere: una rara localizzazione di una patologia non sempre esattamente diagnosticata.

The hemangiomas of the skeletal muscles are rare. The authors describe a case of masseter muscle hemangioma, dwelling upon the problems of differential diagnosis that are present for the straight rapport that the muscle contract with the parotid gland. Thus, the surgeon is led to confuse the malformation with a neoplasm of the parotid gland.