[Choledochal calculosis due to a suture thread]. / Calcolosi coledocica da filo di sutura.

The authors recently observed a patient suffering from recurrent choledochal, postcholecystectomy calculosis caused by suture thread. Given the relative rarity of this pathology, the difficulty of preoperative diagnosis and the possible confusion with other anatomoclinical syndromes, they take this opportunity to make a number of diagnostic and therapeutic comments in the light of the latest literature on this subject.

[Role of surgery in the treatment of gastroduodenal ulcer]. / Ruolo della chirurgia nel trattamento dell'ulcera gastroduodenale.

Medical approach to gastroduodenal ulcer has dramatically changed with the advent of anti-H2 drugs. There is still a role for surgery, but it has been confined to the treatment of the complications (perforation, stenosis and some cases of haemorrhage). In this paper the Authors collected the data of 43 patients (27 males and 16 females, mean age 45), operated between July 1988 and December 1992; 12 patients were operated for pyloric stenosis, 16 for gastrointestinal bleeding and 15 for perforation. Surgery was accomplished as an emergency procedure in 20 cases, delayed emergency procedure in 4 cases and elective procedure in 19 cases. 39 out of 43 patients were under anti-H2 treatment for a previous diagnosis of peptic ulcer. In conclusion, anti-H2 therapy, even correctly carried on, may not be effective in avoiding possible complications. This goal may be obtained in patients under omeprazole treatment.

[Carcinoma of the rectum. Considerations on diagnosis and therapy]. / Il carcinoma del retto. Considerazioni in tema di diagnosi e terapia.

In this review the authors after an introduction on the risk factors, the symptoms and diagnostic aspects of rectal carcinoma, show the different surgical techniques, used second the literature and personal experience on 37 cases for the upper, middle and lower neoplastic lesions of the rectum.

[Chronic anemia due to Meckel's diverticulum. The diagnostic and therapeutic considerations]. / Anemia cronica da diverticolo di Meckel. Considerazioni diagnostico-terapeutiche.

Meckel's diverticulum is a frequent embryologic residual organ. The importance of considering this diagnosis in the young adult presenting chronic hypochromic [correction of hyperchromic] anemia, despite the difficulties of the same, is emphasized. The condition to be satisfied is the complete excision of Meckel's diverticulum, to avoid leaving ectopic mucosa residuals, so we think it useful to resect an ileal sleeve.

[The surgical treatment of a rare pulmonary infection: mucormycosis]. / Trattamento chirurgico di una rara infezione polmonare: la mucormicosi.

Pulmonary mucormycosis (phycomycosis) is an uncommon infection occurring in immunodepressed or debilitated patients. Mortality is very high. Recovery depends upon underlying disease and upon early diagnosis, although difficult to obtain. Aggressive medical therapy is requested and surgical treatment in some instances is indicated. The following is a report of pulmonary mucormycosis occurring in a man with lymphocytic leukemia under chemotherapy treatment. Surgical treatment was considered as medical treatment had been unsuccessful. No success has been achieved, as also diffuse bone metastases showed up.

[Intrahepatic jejunostomy by trans-scission approach in neoplasms of the superior biliary confluent (SBC)]. / Intraepatico-digiunostomie per via trans-scissurale per neoplasie del confluente biliare superiore (CBS).

The Authors consider the trans-scission approach as a quick and safe alternative approach for doing intrahepatic bilio-intestinal anastomoses for the surgical treatment of well confined cancers of hepatic hilus (type I and II of Bismuth e Corlette). This approach should be recommended particularly when the presence of anatomical variations makes the hilar approach hazardous.

[Pulmonary metastases. Their diagnosis and surgical therapy]. / Le metastasi polmonari. Diagnosi e terapia chirurgica.

The Authors on the basis of their own experience and scientific literature, study the indications to the surgical treatment of pulmonary metastasis. Surgical treatment usually produces a palliative result, bettering the quality of life. For some other Authors, surgical treatment if there are no local recurrences and metastasis, could produce complete healing.

[An analysis of 100 consecutive mediastinoscopies for the diagnosis and/or staging of pulmonary carcinoma]. / Analisi di 100 mediastinoscopie consecutive per diagnosi e/o stadiazione del carcinoma del polmone.

The authors analyze data of 100 consecutive mediastinoscopies, performed for diagnostic and/or staging purposes in suspected or known bronchogenic carcinomas. They confirm once again how mediastinoscopy is, in many cases, the only diagnostic procedure that can give, at the same time, a preoperative histological diagnosis and a quite accurate staging, thus avoiding useless exploratory thoracotomies.

[Soft-tissue sarcomas of the limbs at high risk of malignity. Current role of surgery and conservative treatment]. / Sarcomi ad alto rischio di malignità dei tessuti molli degli arti. Ruolo attuale della chirurgia e trattamento conservativo.

The authors discuss the role of surgical treatment in patients with highly malignant soft tissue sarcomas in the limbs. A careful analysis is made of different therapies on the basis of the results obtained by the authors and those reported in the literature. The anatomic classification of lesions is based on functional anatomic compartments, defined as intra- or extracompartmental. If a lesion was within an intrafascial compartment, all the muscles with intact fascial sheaths have up till now been removed "en bloc" to obtain radical margins. Many authors now think that all manifest disease be removed with a generous soft tissue margin on all sides to ensure adequate local treatment. Amputation has commonly been performed for extracompartmental lesions, but a multinodal treatment programme, including limb-sparing resection and tumour-bed radiation, should now be considered if possible in the management of these tumours.

[Clinical use of ceftriaxone in short-term prophylaxis in general surgery. A case load contribution]. / Impiego clinico del ceftriaxone in corso di profilassi "short-term" in chirurgia generale. Contributo casistico.

The results obtained after short-term surgical prophylaxis with ceftriaxone in 443 patients of whom 361 operated of choice are reported. In all, only 3 failures were encountered. The drug also proved to be well tolerated and there were no noteworthy side-effects in the treated patients. The effectiveness of prophylactic treatment is attributed to the long half-life of the molecule (about 8 hours) guaranteeing efficient antibacterial cover with just one administration for the whole period that is critical for surgical infections, during and after operation.

[Early treatment of acute necrotico-hemorrhagic pancreatitis: percutaneous peritoneal dialysis. Preliminary data]. / Il trattamento precoce della pancreatite acuta necrotico-emorragica: la dialisi peritoneale per via percutanea. Dati preliminari.

Early peritoneal dialysis is proposed for the early treatment of acute necrotic haemorrhagic pancreatitis on the basis of experimental and clinical studies. The results obtained in 53 cases so treated in the past 8 years are reported.

[Indications, value and limits of surgical therapy in the treatment of cancer of the gallbladder]. / Indicazioni, valore e limiti della terapia chirurgica nel trattamento del cancro della colecisti.

The authors analyze different therapeutic modalities for gallbladder can and discuss indications, value and limitations on the basis of the results obtained by their own experience on 13 cases as well as literature data.

[Primary tumors of the biliary hilum. Anatomical and therapeutic aspects]. / Tumori primitivi dell'ilo biliare. Aspetti anatomoclinici e terapeutici.

The validity of a selective surgical attitude towards primary tumours of the hepatic hilus after accurate pre- and intra-operative staging is stressed. Moreover the active management for both radical and palliative purposes is justified by some personal observations of the specific anatomoclinical behaviour of these tumours.