[Pheochromocytoma. A case report]. / Feocromocitoma. Presentazione di un caso.

The pheochromocytoma is a catecholamine-secreting tumor, localized in the adrenal gland in 90% of the cases and in extra-adrenal site in the remaining 10%. It can be single or associated with other endocrine neoplasms. On the basis of the case presented, the several clinical manifestations, the treatment of the disease and especially the recent development in imaging as MIBG, TAC, RNM are discussed.

[Video-laparoscopic cholecystectomy with suprapubic approach. Technical note]. / Colecistectomia per via videolaparoscopica con approccio sovrapubico. Note di tecnica.

The authors describe a personal variant of the videolaparoscopic technique of cholecystectomy. This is characterised by the use of an open access to the abdominal cavity following the execution of pneumoperitoneum through an incision in a non-umbilical but suprapubic site, and the use of only three incisions and therefore only three operating trocars. Twenty-nine cholecystectomies have been performed using this personal technique of which only 2 had to be converted to open surgery. The reasons were not attributable to the technique and no complications were observed. The authors also performed a total of 99 laparoscopic cholecystectomies between February 1993 and September 1994 with a total of 4 reconversions and 1 complication (choleperitoneum). Concomitant lithiasis of the choledochus was present in 4 cases and treated with operative ERCP prior to laparoscopic cholecystectomy. Throughout this period only 4 cholecystectomies were performed using a laparotomic access roule owing to concomitant choledochal lithiasis and non-cannulatable papilla during ERCP. The reasons that led the authors to prefer the suprapubic access route were both aesthetic and technical owing to the reduced interference of the videocamera with other instruments, whereas the use of only 3 trocars was also based on the need to economise as well as on aesthetic grounds.

[Esophago-jejunal anastomosis after total gastrectomy with circular suturing: using a personal method]. / Anastomosi esofago-digiunale dopo gastrectomia totale con suturatrice circolare: accorgimento tecnico personale.

The authors describe a personal technique of oesophagus-jejunum anastomosis post total gastrectomy for gastric cancer, inspired by the Oesophagel transection technique. This consists of introducing into the oesophagus the detachable head of the circular stapler by gastrotomy before sectioning the oesophagus and removing the stomach and subsequently carrying out anastomosis as usual. The principal advantage of this technique is in respect to the oesophageal margins to be anastomosed which remain immune to ischemic lesions, lacerations and retractions of the mucosa, with a minor incidence of anastomotic leakage.