[Merkel cell carcinoma of the skin. Two clinical cases]. / Carcinoma a cellule di Merkel della cute. Considerazioni su due casi clinici.

In this study are described two clinical cases of Merkel cell tumor treated in the first half of 1991. The MCC is a rare primary skin tumor with an aggressive biologic nature. The elective therapy of primary sites is surgical management with lymphadenectomy although this kind of treatment is debated. Local recurrence high incidence requires a frequent and careful follow-up with possibility of second surgical treatment in the cases without metastasis and a radiochemotherapy in the patients affected by systemic recurrences.

[Tracheostomy: indications, techniques, and complications]. / La tracheostomia: indicazioni, tecnica e complicanze.

The authors report their experience relative to 46 tracheostomies performed over a 10-year period. In 6 cases the indication for a tracheostomy was a post-traumatic respiratory failure; in 20 cases a chronic respiratory insufficiency, in 6 cases a malignant neoplasm of the larynx; in 10 cases a postoperative respiratory insufficiency; in 4 cases for tongue and/or neck wounds. The authors stress the importance of a correct indication, the use of large volume-low pressure cuffs and an appropriate surgical technique to prevent complication of tracheostomy.

[Hydatid choleperitoneum: a rare complication of hepatic hydatid disease]. / Idatidocoleperitoneo: rara complicanza della idatidosi epatica.

The authors report their experience relative to hydatid choleperitoneum which is a rare complication of hydatid hepatic disease (one case of 236 operated). They underline how such pathology constitutes a clinic and anatomopathological case, well characterized and different from those offered by other complications of this hepatic disease. They draw attention moreover on how preoperative diagnosis is often difficult and consequently how the surgical therapeutic technique requires a very careful examination of anatomic relations of the lesion and recognize, as a chiefly foundation, a radical treatment of hepatic disease and whenever possible, the removal of the pseudomembrane of encystment.

[Use of the omental mesh graft in protecting intestinal anastomoses. Experimental research]. / L'uso dell'innesto omentale a rete nella protezione delle anastomosi intestinali. Ricerca sperimentale.

The faultless seal of the intestinal anastomosis makes up a very important event of abdominal surgery. This work proposes an original experimental method to reinforce the intestinal anastomosis and to prevent the complications due defective seal of the sutures. The results obtained show that this method reduces remarkably the possibility of peritonitis due to the filtration or dehiscence of reinforced anastomosis as regards a control group not treated with omental mesh graft.

Management of liver trauma.

A ten-year experience with the management of liver trauma is reported. The diagnostic approach is examined, stressing the role of selective arteriography. The management of the 78 observed cases is described. The need for biliary drainage to prevent postoperative leakages, is supported. Overall mortality in this series was 16.6%.