[Conservative surgical treatment in differentiated thyroid carcinoma]. / Trattamento chirurgico conservativo nel carcinoma differenziato della tiroide.

BACKGROUND: Purpose of the present study was to compare survival of patients affected by differentiated thyroid carcinoma after total and partial thyroidectomy. METHODS: The study has been carried in a retrospective way; mean follow-up has been 160 months. Surgical setting has been the Institute of Emergency Surgery at the University of Catania, where about 80 thyroid surgical procedures are performed every year. Patients have been divided into two groups: the first included 65 patients who underwent total thyroidectomy, while the second group included 67 patients who underwent partial thyroidectomy. Ten patients affected by a T3-T4, N0-N1 tumor were ruled out of the study to allow better uniformity of data. Besides early postoperative complications (recurrent nerve lesion, hypoparathyroidism), patients have been followed by periodic clinical and instrumental examinations. RESULTS: Follow-up has shown similar survival between patients treated by total thyroidectomy and those who underwent partial thyroidectomy (respectively 92.3% and 92.5%). Postoperative complications were instead significantly less in group 2. CONCLUSIONS: For patients affected by differentiated thyroid carcinoma at early stages it is suggested to perform a partial thyroidectomy since, compared to total thyroidectomy, a similar survival rate and a lower incidence of postoperative complications are obtained. According to personal opinion, total thyroidectomy should be performed in cases of thyroid carcinoma with vascular involvement and metastases.

[The use of Dacron prostheses in laparoceles]. / L'impiego di protesi in Dacron nei laparoceli.

BACKGROUND: Purpose of the study was to evaluate indications and efficacy of Dacron prostheses in the treatment of incisional hernias. METHODS: The study has been carried out in a retrospective way; mean follow-up has been 20 months. Surgical setting has been the Institute of Emergency Surgery at the University of Catania, where about 500 abdominal operations are performed every year. Thirty patients affected by incisional hernias have been considered (mean age 66.8 years). In 12 patients the Mayo technique was performed, whereas a Dacron prosthesis was placed in 18 patients. Other than early postoperative complications, patients have been followed by periodical clinical exams in order to find out possible recurrences as well as other late complications. RESULTS: Among 18 patients treated with insertion of Dacron prosthesis no infection, recurrence, bowel fistula, haematoma or dislocation have been observed. Only in one case an intestinal occlusion secondary to adhesions between prosthesis and bowel has occurred; in this patient a new operation has been necessary to remove the prosthesis. CONCLUSIONS: Considering that prostheses have been used in large incisional hernias or in patients with a weak abdominal wall, the high successful percentage (94%) obtained suggests the use of Dacron prostheses which guarantee long stability and minimum risk of recurrences.

[Acute thyroiditis]. / La tiroidite acuta.

Acute suppurating thyroiditis is now an uncommon pathology which is rarely found, although it was frequent before the introduction of antibiotics. Having observed a case, the Authors were prompted to study the subject in greater depth, in particular to assess whether the disease is easier to diagnose using modern techniques diagnosis, and whether there are changes in the therapy. In conclusion, the paper affirms that in spite of the fact that the diagnostic evolution has thrown further light on the clinical aspects of the disease, biopsy still remains the most reliable instrument of diagnosis, whereas surgery is the most effective form of therapy.

[Intestinal obstruction and incomplete obstruction from mesenteric cyst formation in children (author's transl)]. / Occlusioni e sub-occlusioni dell'eta' infantile da affezioni cistiche del mesentere.

In the light of three cases of their own observation, of children with mesenteric cysts causing complete or incomplete intestinal obstruction, the authors review the existing literature on the subject, discuss the etiology, clinical aspects, and therapeutic methods for the correction of such pathology, and conclude by calling attention to mesenteric cysts as possible causes of intestinal transit disorders in the pediatric age group.