[The superior vena cava occlusion syndrome. A case of neoplastic thrombosis due to hepatocarcinoma and cirrhosis]. / Sindrome da occlusione della vena cava superiore. Su di un caso di trombosi neoplastica da epatocarcinoma su cirrosi.

The authors report their experience with 11 patients, surgically treated since 1990, affected with superior vena cava syndrome. A peculiar case of neoplastic thrombosis in hepatocarcinoma is stressed. In fact a similar case hadn't been reported in the last ten-year literature, although hepatocarcinoma may spread in different organs. A subject review and a discussion are presented.

[Spinal cord protection in surgery of the thoracic, descending, and thoraco-abdominal aorta. Comparison of methods]. / La protezione midollare nella chirurgia dell'aorta toracica, discendente e toraco-addominale. Metodiche a confronto.

The authors compare the strategus needed for the elimination of paraplegia and for protection of abdominal organs after replacement of descending thoracic or thoraco-abdominal aorta. They analyse single technique considering the advantages and the controindications; furthermore they compare these properties and those of possible variants in the light of the presentation; type of disease and general conditions of the patient. These considerations are in agreement with later literature as well as the attitude of the surgeon.

[Pseudoaneurysms after carotid endarterectomy]. / I pseudoaneurismi postendoarterectomia carotidea.

Pseudoaneurysms after TEA of the internal carotid artery are one of the rarest and most severe complications of this form of surgery. Their etiology appears to depend on 3 causes: a suturing defect due to technical errors made by the surgeon or to the incorrect choice of threads; an infections, and lastly the arterial wall weakened by TEA. The patch increases the risk of false aneurysm approximately four fold. We therefore agree with other authors that, in spite of the undoubted value of the patch in the prevention of restenosis, it must only be used in the presence of an internal carotid of small diameter (less than 4 mm). Contrary to what is reported in the literature we performed both these operations under loco-regional anesthesia and a detailed knowledge of this method allows is to be performed on the carotid axis. Only through a careful follow-up of all the carotids operated can the small dilations which often do not require surgical treatmente identified. The two cases reported here were treated by the removal of the pseudoaneurysms and its replacement with a prosthesis in one case and with the vena saphena in the other. Both were monitored with clinical examination and echo-Doppler and no recidivation has been reported to date.

[A case of retroperitoneal leiomyosarcoma]. / Su di un caso di leiomiosarcoma retroperitoneale.

Leiomyosarcoma is a rare malignant tumour originating from the smooth muscular tissue in any part of the organism, including retroperitoneum where it is particularly aggressive. It is nearly always characterized by a silent development causing diagnostic delay. The results of the primary therapy, which is always surgical, are limited because of the tumoral mass extension and the high local aggressiveness. The Authors present a clinical case which was under their observation and seize the opportunity of making a revision of the literature about it.

[Verrucous carcinoma of the penis. A case report and review of the literature]. / Il carcinoma verrucoso del pene. Descrizione di un caso e revisione della letteratura.

The Authors report a case of a verrucous carcinoma of the penis. Among male malignant epithelial tumors the verrucous carcinoma represents a very rare form, with a typical oesophitic development, of vegetating sometimes ulcerated appearance, with slow evolution that rarely presents metastases. Although a therapeutic preservation approach is possible, a surgical operation is the treatment of choice.

[Carcinoid tumor of the appendix]. / Il tumore carcinoide dell'appendice.

The Authors report a case of tumour carcinoid of the appendix incidentally found at operation for appendicitis in a young patient. Diagnosis was confirmed at histologic analysis of the operating piece. Appendiceal carcinoid is the most frequent carcinoid tumor of the gastrointestinal tract and rarely becomes malignant. The Authors emphasize the importance of the knowledge of this not rare neoplasm.

[Dehiscence of anastomosis in surgery of the colon. Causes and prevention]. / Le deiscenze anastomotiche nella chirurgia del colon. Cause e prevenzione.

150 operations on the large intestine performed in 1976-81 are presented with the percentage of dehiscences following surgery. In considering the problem of fistulas arising on the colonic sutures, the more frequent aetiopathogenetic factors are examined. The percentages reported are compared with those produced by the best medical schools. Curves recommended in recent literature are also reported.

[Protective colostomy in surgery of the left colon]. / La colostomia di protezione nella chirurgia del colon sinistro.

2 groups of patients were given anterior rectal resections, one of the groups also receiving protective colostomy. Results show the usefulness of protective colostomy, not so much because it reduces the incidence of anastomotic dehiscence as because it minimizes the possible consequences of any such dehiscence.