[Laparoscopic and thoracoscopic reintervention after mini-invasive surgery in emergencies]. / Reinterventi laparo e toracoscopici dopo chirurgia mini-invasiva in urgenza.

One-hundred-eighty patients underwent emergency minimally invasive procedures (laparo and thoracoscopy) in the last two years. In twelve postoperative drawbacks another surgical procedure was performed. Laparoscopic or thoracoscopic exploration was undertaken in 8 cases while open surgery was done in 4. Complications and surgical overtiming rate was higher after endoscopic than open surgery. This approach allows us to correct very few and selected disease when a skilled surgical team is available especially during reoperations.

[Emergency minimally invasive surgery]. / Chirurgia mini-invasiva in urgenza.

In the last two years 203 patients underwent minimally invasive surgery for thoracic and abdominal emergencies. Thoracic and abdominal surgical exploration was performed for acute disease and blunt traumas except gunshots. Early open surgery was performed to avoid intraoperative problems and to minimize anesthesiological overtime with a minimally invasive/open surgery ratio of 23% (46 patients). Bleeding, adhesions and visceral damage proved the most frequent causes of open surgery conversion. Nine patients underwent laparotomy for postoperative complications while in 4 patients another minimally invasive procedure was performed. Five patients showed spontaneous recovery of postoperative complications. Minimally invasive procedures are useful as diagnostic and therapeutic procedure in many acute diseases with a shorter hospitalization than open surgery.

[Clinical and therapeutic aspects of stab and gunshot wounds]. / Aspetti clinici e terapeutici delle ferite d'arma bianca e da fuoco.

In the last three years (1992-1995) 130 stab (114) and gunshot (16) wounds were observed at and admitted to the Emergency Surgical Department of Fatebenefratelli Hospital of Milan. We observed a high incidence of non-EEC patients (62%). Imaging devices (US and CT scan) and surgical minimally invasive procedures have reduced open surgery rate with a remarkable reduction in drawbacks and mortality.

[Carcinoids in emergency surgery]. / I carcinoidi nell'urgenza chirurgica.

The authors report their experience of three cases of carcinoids of the gastroenteric tract which required emergency surgery. Two patients presented symptoms of acute appendicitis caused by appendicular carcinoid, whereas the third presented an occlusive syndrome due to ileal carcinoid.