[Anal fistulas: experience on 1 800 operated patients]. / Le fistole anali: esperienza su 1 800 pazienti operati.

AIM: Considering their long experience acquired in 25 years in a specialist Hospital of Proctology and related to the treatment of 1800 patients suffering from anal fistulas, the authors reassess the problem of this affection from an etiopathogenic, classifying, diagnostic and therapeutic point of view. METHODS: Surgical treatment of Arnous's French School was performed; this method foresee a slow sphincteric sectioning by an elastic constriction, eventually with the division of the operative times. RESULTS: Results were excellent, with 99.5% of complete recoveries and very few failures or complications: 0.3% of incomplete recovery, 0.2% of relapses, 2.6% of soiling and 1.4% of gas temporary incontinence. CONCLUSIONS: The best premise to obtain the patient's recovery is to perform a faultless technique and to follow assiduously and minutely the postoperative period of surgical wounds.

[Obstructive jaundice caused by residual and/or recurrent choledochal lithiasis: endoscopic and surgical treatment]. / Ittero ostruttivo da litiasi residua e/o recidiva del coledoco: trattamento endoscopico e chirurgico.

Results of surgical and endoscopic treatment in 79 patients (58 females and 21 males, age 40-89, mean 62), affected with jaundice, due to secondary choledochal lithiasis, are reported. Thirty-four patients (43%) underwent surgical operation: choledochotomy and T-tube 12, choledocho-jejunostomy 4, choledochoduodenostomy 3, papillosphincteroplasty 15. In 45 patients (57%) EST has been performed. Comparison of results has been obtained after 30 days and after 3-105 months (mean 49). Optimal results have been achieved in 94.9% of patients: 100% after surgery and 94.1% after EST. Morbidity and mortality outcomes in patients who underwent EST (11.1% and 0% after 30 days respectively, 8.1% and 8.1% after several months) are better compared to those ones after surgical treatment (17.6% and 5.8% after 30 days, 20% and 16% after several months). We conclude that EST is nowadays the therapy of choice in patients with jaundice due to choledochal lithiasis, either relapsing or residual.

[A case of small-cell carcinoma of the rectum]. / Su un caso di carcinoma a piccole cellule del retto.

A case of oat-cell carcinoma of the rectum prompted the authors to undertake a review of the literature. The main histological aspects allowing an accurate diagnosis are stressed. This is a rare form of highly malignant neoplasm of uncertain origin (probably similar to that of carcinoids) with a very marked tendency to metastasize, even to distant organs; it is characterized by substantial cellular polymorphism with small-sized elements, very little cytoplasm, a large hyperchromic nucleus, barely visible nucleoli and histochemical reactions typical of neuroendocrine cells.

[Indications for internal, medioposterior with anoplasty or lateral sphincterectomy during hemorrhoidectomy. Our experience]. / Le indicazioni alla sfinterotomia interna, mediana posteriore con anoplastica o laterale, in corso di emorroidectomia. Nostra esperienza.

The authors report their experience of internal, medial posterior with anoplasty and left lateral, sphincterotomy during haemorrhoidectomy according to Milligan and Morgan. Internal sphincterotomy represents a valid complement to haemorrhoidectomy assuring a better postoperative period: it removes the pain by hypertone of the internal sphincter and avoids the stenosis. The indications for both sphincterotomy techniques are suggested by anatomo-clinical characteristics of the lesion and by combined pathologies.

[Verneuil's peri-anal suppurative hidrosadenitis. Considerations on 2 clinical cases]. / L'idrosadenite suppurativa peri-anale di Verneuil. Considerazioni su due casi clinici.

Two cases of perianal Verneuil's disease personally observed are described. It is a rare chronic inflammation of the apocrine sweat glands in several skin areas. The exasperating chronicity and the propensity to extend of the disease involve complicated problems of diagnosis and therapy. A squamous cell carcinoma can rarely complicate long lasting hidrosadenitis. The treatment consist in a radical surgical excision of the involved areas. The patient must be controlled for a long time since the evolution of this disease cannot be foreseen.

[The use of DuoDerm in the surgical wound after surgical treatment of pilonidal fistulae using the open method]. / L'impiego del "DuoDerm" nella ferita operatoria dopo trattamento chirurgico delle fistole pilonidali col metodo aperto.

The results of a study on the use of DuoDerm Hydroactive sterile occlusive dressing on the operative wound after simple excision of pilonidal fistula are reported. Two groups of 20 patients were studied: in the first group the wound was treated with traditional medications, in the second group with DuoDerm. Comparing the results obtained from these two groups, the Authors conclude underlining the therapeutic efficacy of the dressing which stimulates granulation and accelerates re-epithelialization with complete healing in 6 weeks on average compared with the 10 needed with traditional medications.