[The pilonidal sinus: its surgical treatment, our experience and a review of the literature]. / Sinus pilonidalis: trattamento chirurgico, nostra esperienza e revisione della letteratura.

The authors report their experience in the surgical management of pilonidal sinus. During a 3-year period (1989-1991) 106 patients underwent primary closure. Average postoperative stay was 5.5 days, while mean healing time was 14.6 days. During the follow up, 3 patients developed a true recurrence (3.26%). After a critical review of the literature, the authors emphasize the importance of primary closure in the surgical treatment of pilonidal disease.

[Gastric polyps: histogenetic considerations and therapeutic trends]. / I polipi gastrici: considerazioni istogenetiche ed orientamento terapeutico.

The Authors report their series of 86 patients with gastric polyps, observed from 1986 to 1989. Basing on the literature data the lesions were divided in A) inflammatory polyps, B) hyperplastic polyps, C) adenomatous polyps and 27, 49 and 10 lesions, were respectively found for each type. Particular attention was given to the association between intestinal metaplasia and gastric dysplasia for each type of polyp. A significant prognostic value as a precancerous lesion was recognized only to dysplasia. Therapeutic trend for each single polyp, based on the histologic type, is suggested.

Proximal gastric vagotomy without drainage and selective gastric vagotomy with drainage for surgical therapy of duodenal ulcer: a retrospective study.

During a 3-year period proximal gastric vagotomy without drainage and selective gastric vagotomy with drainage were performed in 61 patients with duodenal ulcer. Of these, 57 patients were followed for 3-6 years. 77% were symptom-free (Visick I); 8,3% were improved but still have periods of dyspepsia (Visick II) and 14% were failures because of recurrent ulcer (Visick III). There were seven duodenal recurrences in the bulb, and one prepyloric recurrence. There were no operative deaths or major complications. The side effects, like diarrhoea and dumping, after proximal gastric vagotomy and selective vagotomy were mild and rare. The majority of our patients gained their ideal body weight within the first six months from surgery. Blood chemistry did not show any deficiency in haemoglobin secondary to vagotomy, but plasma basal level of gastrin was constantly higher after surgery. It is concluded that 3-6 years after proximal gastric vagotomy and selective gastric vagotomy for duodenal ulcer there was a 14% recurrence rate, but the absence of mortality, severe complications or significant side effects seems to be at least as important as the high recurrence rate.