[The Hartmann intervention. The current indications and the authors' own experience]. / L'intervento secondo Hartmann. Indicazioni attuali ed esperienza personale.

Seventy years after it was first presented at the 30th Congress of the French Association of Surgery Hartmann's operation still fulfils a necessary albeit limited role in colorectal surgery. It is generally regarded as necessary in emergency surgery when general or local conditions advise against immediate anastomosis or would make it dangerous, or more rarely it is used electively in palliative neoplastic pathologies. The authors report their personal experience over twenty years and the reasons which led them to opt for this technique rather than others. Their personal postoperative mortality rate is similar to that reported in the literature and is not correlated to surgical trauma but rather to the severity of clinical conditions.

[The marginal leakage of amalgam and Vitrebond restorations after an occlusal load test]. / Infiltrazione marginale di restauri in amalgama e Vitrebond dopo test da carico occlusale.

The use of adhesive liners in amalgam fillings and restorations is a recent form of conservative dentistry. The aim of our study was to assess marginal microleakage in amalgam and Vitrebond restorations after occlusal load test. Using extracted teeth, we prepared 16 class II amalgam restorations, (Valiant ICQ, Caulk). Adhesive liner, (Vitrebond, 3M USA), was used in half of these. The samples then had first a cyclic load test, (27 kg per 7,000 cycles), followed by a microleakage test, (sample immersed in 2% erythrosin solution for 24 hours). The results showed that, in samples with adhesive liner, color penetrated to a statistically lesser extent than in the control group without Vitrebond.

[Diverticulosis of the sigmoid colon: when to operate and which surgical treatment to use]. / La diverticolosi del colon sigma: quando intervenire e che trattamento chirurgico eseguire.

Diverticulosis of the colon is an increasing frequent disease: 50% of all subjects over 70 are affected by this pathology. The paper reports a series of cases and a therapeutic approach for simple, symptomatic and complicated diverticulosis. The long-term results are also reported.

[Percutaneous needle aspiration biopsy in intrathoracic lesions]. / Agoaspirato percutaneo nelle diagnosi delle lesioni intratoraciche.

The authors report their experience of transthoracic needle biopsy of the lung based on 68 consecutive cases from 1984 to 1990. In 55 cases significant data has been found: in 44 cases the diagnosis was exact, instead in other 11 cases it was only indicative. The overall complications were 11.7% and in particular were as follow: pneumothorax in 5 cases, hemoptysis in 2 cases and a temporary Horner syndrome in one case. The authors conclude by confirming the utility of transthoracic needle biopsy of intrathoracic tumors in which there is not other way to obtain a diagnosis. This technique is reliable and its complications can be disregarded.

[Treatment of spontaneous pneumothorax]. / Il trattamento del pneumotorace spontaneo.

Following an analysis of current treatment strategies for spontaneous pneumothorax and their surrounding controversies, the paper reports the Authors' personal experience. From 1 January 1984 to 31 December 1989 a total of 76 cases of spontaneous pneumothorax were treated, of which 3 were bilateral. The M:F ratio was 9:1 and the age of patients ranged between 16 and 77 years (mean age 39.2); 22 cases were relapses (27.8%). Conservative therapy was used in 12 cases (15.1%); pleural drainage was introduced in 54 cases (68.3%) for a mean of 7.5 days. Fourteen thoracotomies were performed in 13 patients (10.4%): bullectomy was performed 10 times with stapler, whereas pleurodesis was obtained in 9 cases using pleural abrasion and in 5 cases using apical pleurectomy plus pleural abrasion. Axillary thoracotomy at the 5th space was most commonly used. No major complications were observed during the postoperative period and, in spite of the minimum follow-up of 3 months, no cases of relapse were observed in operated patients.