[One-day surgery: results of 3,000 surgical procedures]. / One day-surgery: risultati di 3000 interventi chirurgici.

AIMS: To evaluate the advantages and limits of one day surgery operations performed between January 1990 and December 2000. METHODS: Pre-operative study of out patients with indications to surgical treatment with short-stay hospitalisation and research of criteria of feasibility of day-surgical program: a) morning hospitalisation; b) surgical intervention; c) post-operative control; d) night control; e) careful evaluation of admission 24 hour after operation and instruction for house-therapy; f) program of follow-up (7 and 14 days after operation). RESULTS: Mortality 0%; immediate post-operative complications 1.8%; post-operative sequelae (one year after surgery): 0.5%; high satisfaction gradient of patients one year after treatment: 89%. DISCUSSION: The Day-Surgery seems to be, after ten years of experience, available in high number of patients, with progressive extension of indications to ever more surgical fields and results very satisfactory, in term of cost-effectiveness too, with an high compliance of the patients to surgical program.

[Surgical treatment of acute colonic diverticulitis. Personal experience]. / Il trattamento chirurgico della diverticolite acuta del colon. Esperienza personale.

BACKGROUND: Colonic acute diverticulitis presents in patients that suffered from colonic diverticula in 10-25% of cases higher percentage in the elder patient. Colonic acute diverticulitis mortality leads high rates in over 70 years old patients with a value a upper than 75-80%. Perforation and diffuse peritonitis are the more serious complications. Accurate clinical staging followed by correct surgical option are the base of the therapeutical success. METHODS: Between january 1995 and june 2000 we studied by a retrospective analysis 56 patients (34M/22F), mean age 67, hospitalized cause acute perforate colonic diverticulitis, all patients were recorded in order their clinical conditions APS score and Hinchey staging of the disease. At the time of the recovery all patients underwent at clinical examination, abdominal ultrasound, plane X-ray, and bloody tests. Surgical operations performed were: PRA; PRA and protective colostomy; Hartmann procedure. In the patients with APS score > 6-10 and aged > 70 Hartmann procedure was performed. RESULTS: Overall mortality was 9% (5 pazienti), overall morbility was 40%. On the basis of the I and II Hinchey stage mortality rate was 0%. In the III stage was recorded mortality of 4% and 33% in IV stage. Complication were: 6 anastomotic lekage; 7 infections of the laparotomic wound; 1 incisional hernia; 2 lekeages of the stomoa; 3 stomatitis; 5 proctitis. CONCLUSION: Therapeutical choise treatment has to consider Hinchey stage and APS score. Hartmann procedure is indicated in stage III-IV with score APS > 8-10. For the other patients primary resection anastomosis and if is necessary associated colostomy is the treatment recommended.

[New perspectives in the treatment of liver metastasis from colorectal cancer: radiofrequency thermal ablation]. / Nuove prospettive nel trattamento delle metastasi epatiche da cancro colorettale: la termoablazione mediante radiofrequenza.

Preliminary results of new treatment of metastatic hepatic malignancies from colo-rectal cancer, the radiofrequency ablation (RFA), are reported. The method is limited by few cases treated and short follow-up but it opens new perspectives in metasurgical treatment of these lesions as regards the previous experiences based on wide numbers of patients, recently reported in the literature.

[Abdominal compartment syndrome in video laparoscopic surgery. Etiopathogenetic aspects, physiopathology and personal experience]. / La sindrome addominale compartimentale in chirurgia videolaparoscopica. Considerazioni etiopatogenetiche, fisiopatologia ed esperienza personale.

The abdominal compartment syndrome (ACS) is a very seven pathology, consequence oh abdominal injuries and traumatism, acute pancreatitis, aortic aneurism rupture, acute peritonitis. The etiopatogenesis is the increase of intra-abdominal pressure with systemic consequences for cardiorespiratory and renal failure. The authors after careful physiopathologic consideration, describe, a case report of ACS in the laparoscopic cholecystectomy for acute cholecystitis. To conclusion, we report very important the accurate intraoperative monitoring of vital parameters (PCO2, PO2, Pa, Fc, PVC, Ph, Diuresis) and immediate decision at laparotomic conversion for abdominal decompression.