Laparoscopic appendectomy for complicated acute appendicitis.

The role of laparoscopic appendectomy in complicated appendicitis is still not widely accepted. The authors report their retrospective study performed to evaluate the effectiveness of the laparoscopic approach in the management of complicated appendicitis. From January 2003 to October 2008, 552 patients underwent appendectomy in our surgical department. Among these, 358 were not complicated appendicitis while 194 were complicated. Of the 194 cases of complicated appendicitis, 121 patients underwent laparoscopic appendectomy while the remaining 73 cases were treated by conventional open surgery. The average length of hospital stay was 5.7 days, with a range from 4 to 13 days. Post-operative complications were observed in a total 11 patients (9.1%), including 3 cases of intra abdominal abscess (2.5%), 2 cases of umbilical wound infection (1.6%) and 6 cases of prolonged ileus (4.9%). Our experience suggests that the laparoscopic procedure is a valid, safe and feasible option to manage acute complicated appendicitis.

Usefulness of ultrasound-guided fine-needle aspiration cytology in the diagnosis of non-palpable small thyroid nodules: our growing experience.

AIMS AND BACKGROUND: Contradictory approaches have been suggested for the management of non-palpable thyroid nodules. The aim of our study is to evaluate indications and limits of ultrasound-guided fine-needle aspiration cytology (US-FNAC) in the management of non-palpable infracentimetric thyroid nodules. METHODS AND STUDY DESIGN: From September 2003 to June 2007 we studied 1043 patients with non-palpable thyroid nodules. We divided our series into three groups according to the diameter of the lesion in order to verify the effectiveness of US-FNAC for lesions <1 cm. RESULTS: We assessed the cases with satisfactory and unsatisfactory results in the 3 groups into which the sample was divided. Our statistical analysis using the z-test showed there was no significant (p=0.05) difference in the percentage distribution of the unsatisfactory results in the 3 groups. CONCLUSIONS: FNAC appears to be a useful diagnostic tool also for nodules <1 cm because the percentage of unsatisfactory results is not related to the size of the nodule.