[Appendectomy without inversion of the stump. A valid alternative. Our experience in 690 cases]. / L'appendicectomia senza affondamento del moncone. Una valida alternativa. Nostra esperienza su 690 casi.

The paper reports the Authors' ten year experience on simple ligation in appendicectomy. After having reviewed the various surgical procedures, the Authors report their clinical experience and, considering the good postoperative results with this method, regard this procedure as an alternative to the technique of ligation with inversion of the stump in appendicectomy.

[Surgery of the saphenous-popliteal junction in the treatment of initial insufficiency of the small saphenous vein]. / La crossectomia dell'ostio safeno-popliteo nel trattamento dell'insufficienza iniziale della piccola safena.

Insufficiency of the sapheno-popliteal junction may be the first sign of varicose disease, and represents one of several ways that lower limb-venous insufficiency uses to present itself. Doppler ultrasound is particularly helpful in diagnosing this often subclinical insufficiency. Based on satisfactory results in a series of 18 patients treated between 1985 and 1988 (mean follow-up 1.5 years), the authors suggest treating sapheno-popliteal junction insufficiency by means of crossectomy, under local anesthesia, and on an out-patient basis. When surgical treatment is performed during the first stages of the disease, the consequent irreversible damages to the lesser saphenous vein due to stasis are avoided, and thereby, a true varicose state is avoided.

[Long-term results of prolonged dicoumarol anticoagulant therapy in 327 peipheral arteriopathic subjects]. / Risultati a distanza della terapia anticoagulante dicumarolica protratta su 327 arteriopatici periferici.

327 patients with peripheral arteriopathy were treated solely with protracted dicoumarol anticoagulant therapy. The indication for such therapy was applied not only in patients in whom the high risk and poor run-off contraindicated revascularisation operations, but also in those in good general conditions at the 2nd or 3rd stage with iliac and femoral thromboses. Two-thirds of the arteriopathics observed were given the anticoagulant treatment for more than two years, with a maximum of eight years. Clinical evolution of the disease is discussed in relation to the treated patients' age and stage, while emphasis is given to the very low incidence of complications and contraindications, despite the long period of treatment.

[Revascularization of the aorto-femoral axis by means of a by-pass. Remote results]. / La rivascolarizzazione dell'asse aorto-iliaco-femorale mediante by-pass. Risultati a distanza.

The Authors report their experience in 73 patients wit aorto-iliaco-femoral chronic obliteration, subjected to revascularisation. In 49 cases a bilateral by-pass was performed, in 22 a monolateral by-pass, and in two a thromboendarterioectomy. The results obtained were classified as successes or failures according to the perviousness or otherwise of the substituted or disobliterated arterial segments, and as immediate or longterm according to whether they were evaluated at the time of the patient's discharge or during a period lying betwee six months and seven years from the operation. Immediate successes were obtained in 95.9% of cases with bilateral by-pass, and in 90.9% of the monolateral by-passes. Aggregate mortality was 2.7%. In the long-term chick-ups, the previousness of the bilateral by-passes was 82.9%, that of the monolateral by-passes 72.2%. On the basis of the results obtained the Authors therfore reiterate their preference for by-passes, and for bilateral by-passes in particular (70% of cases). Monolateral bridging were in fact performed only in those cases where the contralateral vascular district was unharmed, in patients with serious ganrenous lesions and those with a high operative risk.

[Traumatic rupture of the diaphragm (twelve cases) (author's transl)]. / Le rotture traumatiche del diaframma (considerazioni su 12 casi)

Twelve cases of male patients with traumatic rupture of the diaphragm are reported. Eleven involved the left hemidiaphragm, and the twelfth the right. The aetiopathogenetic and anatomical-pathological aspects are discussed, and stress is laid on the importance of early diagnosis. In general, the most effective form of reanimation is prompt surgery, reducing the herniated organs in the abdominal cavity, re-expanding the lungs, and treating the frequent concomitant visceral lesions as each case demands. The criteria followed in selecting the route of access to traumatic lesions of the diaphragm are described; in most of the cases reported, the thoracic route was preferred, often associated with laparotomy.