[Retractile mesenteritis: case report]. / Mesenterite retrattile: presentazione di un caso.

The Authors report a case al retractile mesenteritis. The disease is a chronic inflammation of the mesentery with the developement of fibrosis. The mesenteritis is a benign disease and sometimes it is related to urogenital neoplasm. The CT fìndings of mesenteritis are non specific and often is necessary a laparotomic or laparoscopic biopsy. The therapy in uncomplicated cases is steroid treatment.

Global approach to hepatic metastases from colorectal cancer: indication and outcome of intra-arterial chemotherapy and other hepatic-directed treatments.

Liver metastases of colorectal cancer is present in more than 20% of new diagnosed patients and in 40-60% of relapsed patients. It is a life-threatening prognostic aspect. Hepatic resection, when possible, is the best therapeutic modality, although the overall survival rate is still low (30%). Angiography and intraoperative ultrasonography are useful for resection. The number of hepatic metastases and the surgical margin are probably the most significant prognostic factors. Colorectal cancer may spread predominantly to the liver making regional treatment strategies viable options. Subtotal hepatic resections and segmentectomies are potentially curable procedures for single or small numbers of hepatic metastases without other sites of disease. However, there have been no prospective randomized trials comparing patients with unresected liver metastases and resected metastases. Regional chemotherapy with floxuridine seems usefull combined with hepatic resection or as palliative therapy. Gastric ulcer and biliary sclerosis are the main related toxicities. Patients with localized, unresectable hepatic metastases or concomitant bad medical condition may be candidates for radiation, percutaneous ethanol injection, cryosurgery, percutaneous radiofrequency, hypoxic flow-stop perfusions with bioreductive alkylating agents, hepatic arterial ligation, embolization and chemoembolization. These new hepatic-directed modalities of treatment are being investigated and may offer new approaches to providing palliation and prolonging survival. This review will report the possibilities of intra-arterial chemotherapy and other novel hepatic-directed approaches to the treatment of liver metastases from colorectal cancer.

[Liver abscess secondary to ingestion of foreign body. A case report]. / Ascesso epatico secondario ad ingestione di corpo estraneo. Caso clinico.

Hepatic abscess is a serious surgical problem with a high mortality rate. The Authors report a case of a liver abscess following the migration of a toothpick from the stomach into the hepatic left lobe. Percutaneous abscess drainage combined with endoscopical removal of the foreign body were the goal treatment. The Authors stress importance of the laparoscopy-guided drainage with placement of intra-hepatic drains.

[Palliative surgery in nonresectable pancreatic carcinoma]. / Chirurgia palliativa nel carcinoma pancreatico non resecabile.

The authors report 30 cases of adenocarcinoma of the pancreas treated with palliative surgery at the 2nd Department of Surgery of S. Maria delle Croci Hospital in Ravenna, in the period 1985-1991. Biliary bypass or gastroenterostomy were performed because of severe jaundice and duodenal obstruction, and not with prophylactic intent. According to Fortner's classification 60% of the neoplasias were stage 3, 36.7% stage 2, and 3, 3% stage 1 tumors. The hospitalization mean time was 15 days, perioperative mortality was 6.6% and mean survival rate was 6.5 months. The authors conclude that palliative surgical treatment is useful in case of neoplastic biliary and duodenal stenoses, with no liver or lung metastases, and also whenever an histological evaluation of the tumor is necessary to evaluate resection chances.

[Treatment of hepatic trauma. Our experience with 14 surgically treated cases]. / Trattamento del trauma epatico. Nostra esperienza su 14 casi operati.

The authors report their experience of 14 cases of hepatic trauma that underwent surgical treatment. During the period 1987-1990, 42 patients were admitted with diagnosis of hepatic injuries to the surgical department of Ravenna Hospital. 28 of the 42 patients were subjected to repeated abdominal echography and didn't undergo surgical treatment. The authors consider the importance of the abdominal echography whether of the surgical treatment or nonoperative management. Prognosis is always serious, and it is influenced by three factors: the kind of trauma, the concomitant lesions and the general conditions of the patient. The authors, in conclusion, report the per cent of survive and of complications that they have found.

[Hernioplasty compared: Shouldice-Trabucco-Lichtenstein]. / Ernioplastiche a confronto: Shouldice-Trabucco-Lichtenstein.

The authors report their experience with the mostly used technique of hernioplasty. They compare the Shouldice hernioplasty, development of the traditional Bassini, with the Trabucco and Lichtenstein techniques in which synthetic prosthesis are used. The two surgical departments participating to this study present 234 patients who underwent hernioplasty with the above mentioned techniques. The authors consider local and general complications during the postoperative time and after a 6-month follow-up. Results indicate that the surgical techniques used are efficient in terms of low complication rates and reduced hospitalization.

[Cystic lymphangioma of the colon. Report of a case]. / Il linfangioma cistico del colon. Descrizione di un caso.

The authors report a rare case of cystic lymphangioma of the colon. Cystic lymphangioma is a benign neoplasm, that originate from lymphatic structures; it unusually involves the large bowel. This tumor has some original features: big dimension, intracystic sepiments, bad demarcation from surroundings structures. Diagnostic examinations are aspecific, showing only a generic mass, which structure is assessable with abdominal echography or TC. A definite diagnosis is only possible with surgical resection.

[Incidence of neoplasm recurrence after colorectal resection for cancer]. / Incidenza delle recidive neoplastiche dopo resezione rettocolica per cancro.

The Authors report their experience on the incidence of anastomotic recurrence in 122 patients surgically treated with colorectal resection for cancer. The number of local recurrences (3 cases, that is 2.5%) is in the inferior range of what reported in Literature. Parameters that influence the local failure are: depth of tumor invasion, extension to adjacent organs and structures, presence of lymph node metastases (valuable with Dukes' modified staging). Type of operation and histologic grade do not seem to influence local recurrence. The Authors report the therapeutic choices adopted in the cases considered.

[The correlation of bacteriobilia/wound infections in elective biliary surgery]. / Correlazione bactobilia/infezioni della ferita in chirurgia biliare d'elezione.

The authors report their experience concerning the cultural study of bile samples taken during elective biliary surgery. All the operations were carried out after a randomized preoperative antibiotic prophylaxis. Among the 138 cases examined the presence of surgical infections (wound infection) was taken into account. A lack of correlation between the germs present in the bile and those isolated from samples of complicated cases, was registered. However, the Authors emphasize that, although antibiotic prophylaxis gives a reduced percentage of postoperative infections, it is unable to sterilize the bile.

[Aztreonam and clindamycin in short-term antibiotic prophylaxis in colorectal surgery: results of a multicenter studies]. / Aztreonam e clindamicina nella profilassi antibiotica a breve termine in chirurgia colorettale: risultati di uno studio policentrico.

The Authors studied the effects of a short-term prophylaxis (Aztreonam + Clindamycin) administered to 259 patients operated on for colo-rectal diseases. Thirteen wound sepsis (5.15%) and 49 different infections (19.44%) occurred in this group of patients. The study confirms the link between P.N.I. greater than 50 and the incidence of wound infections. The incidence of urogenital sepsis was correlated with the catheterization period (greater than 6 days), operative time (greater than 200 min.), hospitalization (greater than 12 days) and age (greater than 70 years). General tolerance to the antibiotics was good.

[Surgery in aged patients: a study on 476 surgical cases]. / La chirurgia nel paziente anziano: studio su 476 casi operati.

The Authors report their experience from 1984 to 1989 with surgery in the elderly. Patients aged 75 years were considered as geriatric and entered the study. Mortality and morbidity rates were analysed in 476 cases operated. Pre-existent diseases were related to postoperative complications. The Authors conclude underlining the feasibility of geriatric surgery as well as the acceptable risk rate.