[Veno-venous crossover bypass according to Palma: our experience]. / Il bypass veno-venoso crossover sec. Palma: nostra esperienza.

Four cases of Palma's operation (veno-venous cross-over bypass) performed from 1986 through 1992 for occlusive venous disease are reported together with an extensive follow-up. After a synthetic review of the literature, the authors conclude that this operation should no more be considered an experimental procedure, even if a definite statement of its long-term usefulness (and therefore of the indication) is still lacking.

[Entrapment syndrome of the popliteal vein: results of the surgical treatment]. / La sindrome da intrappolamento della vena poplitea: risultati del trattamento chirurgico.

Entrapment of the popliteal vein has been rarely reported. Purpose of the present study was to evaluate the long-term results of vein decompression in the popliteal vein entrapment syndrome. Between August 1986 and June 1994, 35 patients (49 limbs) were operated on for popliteal vein entrapment syndrome at our Institution. There were 28 female and 7 male (mean age 44.5 +/- 13.5 years). Seven limbs had associated a popliteal artery entrapment syndrome. Twenty-three (49.6%) limbs presented with skin changes ascribed to venous disease. Preoperative diagnosis consisted on Doppler CW, Duplex Scan, venography and ambulatory venous pressure measurements. Surgical management consisted on the division of the anomalous structure causing entrapment. In 35 (71.4%) limbs subfascial ligation of perforating veins was associated. The patients were followed-up (mean 61 +/- 7 months) with venography and AVP. No deaths occurred and morbidity was 14.3%. Doppler CW and Duplex Scan were not accurate to diagnose the entrapment. Ambulatory venous pressure and venography accurately diagnosed the syndrome. Age and preoperative status did not affect long-term results (p = NS). Long-term operative success was negatively influenced by associated procedures for ligation of perforating veins (p < 0.03). Popliteal vein entrapment syndrome should be early diagnosed to prevent incompetence of perforating veins. Surgical treatment of cases not requiring ligation of perforating veins had a better long-term success rate. Treatment at later stages allows symptom amelioration but does not prevent the consequences of a long-standing chronic venous disease.

Benign fibrous mesothelioma: report of a case.

A case of fibrous benign mesothelioma is reported, together with some considerations on the diagnosis and the treatment of this rare tumour. Preoperative diagnosis is often impossible and so surgery is of great value both for treatment and diagnosis.

[Ileal diverticula: apropos of a case]. / I diverticoli ileali: aproposito di un caso.

The authors report a case of abdominal aortic aneurysm surgically treated. At surgical exploration an ileal diverticulum was discovered. A 15 cm ileum tract was hyperemic and oedematous. The abdominal aortic aneurysm was resected and an aorto aortic graft implanted. The retroperitoneal space was carefully closed and then the diverticulum resected and an end-to end intestinal anastomosis performed. An etiological review of this pathology was done identifying two possible causes: true and false diverticula. The true diverticulum is a congenital lesion involving the 3 layers of the intestinal wall. On the contrary the false diverticulum is acquired and generally develops on the mesenteric site due to a pulsion mechanism. The wall involves the mucosa and serosa layers only. Diagnosis is often done during abdominal exploration for other cause (as in our case) or for complicated diverticula. Preoperative radiologic diagnosis is rare and doesn't always require surgical treatment.