[Lung cancer with bronchial stenosis due to foreign body and Entoameba gingivalis infection]. / Carcinoma con stenosi bronchiale da corpo estraneo e infezione da Entoameba gingivalis. Case report.

Oral cavity infection by protozoarian agents may lead to pathologies such as stomatitis and gengivitis. An higher incidence has been reported in immunocompromised patients and in patients with dental disorders. Entoameba gingivalis localizes into oral cavity and in particular into interstitial and interdental spaces. Infection propagation to bronchial or lung parenchyma represents a complication. In this report the Authors, starting from a recently treated case, discuss on the incidence, complications and surgical management of lung infection by Entoameba gingivalis.

[Bilateral and multiple traumatic pulmonary pseudo-cysts: a case report]. / Pneumatocele post-traumatico: a proposito di un caso a localizzazione multipla bilaterale.

Traumatic pulmonary pseudocyst is a very rare consequence of blunt chest trauma characterized by formation of cystic like parenchymal lesions. Generally multiple and bilateral distribution is more rare than a single localization. The computed tomography (CT) scan has an higher diagnostic value compared with conventional chest X-ray. Prognosis of traumatic pseudocysts is generally good with benign clinical course and spontaneous resolution within several months. However initial strictly patient follow-up is necessary to early discover and treat potentially severe complications. Utility of chest magnetic resonance imaging (MRI) to exclude potentially severe infectious complications is described. Any complications required percutaneous drainage or surgical resection.

[Etiology, pathophysiology and management of post-traumatic pneumomediastinum: our experience]. / Pneumomediastino post-traumatico: meccanismi eziopatogenetici e management diagnostico-terapeutico. Nostra esperienza.

The Authors reported the cases of posttraumatic pneumomediastinum came to their observation over the past 8 years. The etiology, pathophysiology, diagnosis, treatment and blunt injures eventually associated are discussed. Conclude that in the absence of associated injuries the treatment and the course of post-traumatic pneumomediastinum are the same that spontaneous pneumomediastinum.

[Thoracic trauma: incidence, social and economic costs, educational opportunities. Experience on the last eight years of Thoracic Surgical Unit of Messina University]. / Il trauma toracico: incidenza, costi socio-economici, ricaduta didattico-formativa. Esperienza della Cattedra di Chirurgia Toracica dell'Università di Messina negli ultimi otto anni.

The Authors, after extensive introduction on the incidence, etiology, classification, pathophysiology, possible complications, diagnosis and treatment of thoracic trauma, relate their experience on the last eight years, stressing the diagnostic and therapeutic strategy in management of trauma simple and complicated and assessing finally serious social impact of these pathologies and the educational opportunities provided.

[Percutaneous radio frequency thermal ablation of non-resectable lung cancer: state of the art]. / Termoablazione percutanea con radiofrequenza dei tumori polmonari inoperabili: stato dell'arte.

BACKGROUND: Unfortunately, as of yet, most lung cancers are not operable as soon as diagnosis is available; in these situations chemo- and radio-therapy still play a key role, albeit palliative, improving survival rate moderately, but are not lacking in toxic effects, especially in case of concurrent pathology, reduced cardio-respiratory functionality or being advanced in years. Therefore thermal ablation mini-invasive techniques, already employed as ancillary treatments of hepatic cancer or in place of surgery, have been performed for these pathologies. AIM: Aim of this work is to define the current state of the art for Radio-Frequency Ablation (RFA) to be performed on non-resectable lung cancer, also by means of a thorough review of international literature, from which to infer purposes, suggestions, methodologies, effectiveness, safety, complications and achievements, also in terms of the possible improvement of life quality and/or survival expectancy. PATIENTS AND METHODS: Patients have been carefully selected. Pulmonary nodules have been treated with TC or echo-guided percutaneous thermal ablation and, afterwards, evaluated by radiological and clinical (sometimes histopathological) follow-up. RESULTS: The size of the RFA-treated nodules is necessary in order to evaluate full or partial necrosis extent and, therefore, average survival rate. CONCLUSIONS: Availability of more extensive and homogeneous case histories, as well as standard follow-up (TC and/or histopathological sampling) methodologies, is required. Nevertheless several authors agree that RFA is a safe and effective technique within the framework of a substitutive or complementary treatment of non-operable lung cancer. The best results can be achieved for cancers less than 3 cm wide; RFA, performed before chemo- and/or radio-therapy, plays a neoadjuvant role for larger cancers, decreasing cancer volume and weakening the symptoms.

[Indications, surgical strategies and evaluation of prognostic factors in the treatment of pulmonary metastases]. / Indicazioni, strategie chirurgiche e studio dei fattori prognostici nel trattamento delle metastasi polmonari.

Pulmonary metastases resection is a method universally accepted in selected patients. Long-term survival reaches good levels after complete resection of lung metastases independently of primary tumour histology. The Authors emphasizes literature data; they report data of their experience no statistically significant but useful for valuation of results. They discuss of advantages vs disadvantages of the surgical procedures. In conclusion they believe metastasectomy is a safe treatment of pulmonary metastases.

[Surgical treatment of celomic cysts]. / Trattamento chirurgico delle cisti celomatiche.

Celomic cysts (pericardiopleural or serous cysts) are rare, as they account for about 30% of all the homoplastic disembryogenetic lesions of the mediastinum. There is not usually a characteristic symptomatology associated with this anomaly, which is, however, easily diagnosed by means of the most common radiologic techniques. The TC together with the MRI provides all the necessary data for an appropriate management of the patient. The Authors report on their five year experience of the surgical treatment of celomic cysts, pointing out that surgery must be aimed at preserving pulmonary function as much as possible. They finally maintain that the first surgical approach should be video-thoracoscopic with the aid of a minithoracotomy, if necessary.

[Evaluation of lung function as a prognostic index before and after surgical resection due to NSCLC]. / Valutazione pre e postoperatoria della funzionalità respiratoria come indice prognostico dopo resezione polmonare per NSCLC.

BACKGROUND: Although there were several studies on survival, death and morbidity rates after lung resection, considering both limited and extended resections, lung exercise capacity has been quite seldom taken into account as an index for prognosis. The aim of this study compare the consequences of three kinds of lung resections (pneumonectomy, lobectomy and wedge resection), to test pre- and post-surgery exercise capacity for patients affected by NSCLC in order to obtain more detailed prognostic indices. METHODS: All the patients were studied by means of thorough lung static function and hemogas analytical tests before and after surgical resection, from 15 days to 12 twelve months' time past surgery. RESULTS: In fact, in relation to lung resection due to neoplasms, several studies pointed out that zone-limited resections show an obvious anatomical benefit in terms of parenchyma spair compared to lobectomy; however, it is underlined that the functional benefits of small resections don't really prevail over post-lobectomy anatomical advantages. Furthermore local relapses are more common after small resections rather than after lobectomy. CONCLUSIONS: Neither limited lung resection nor lobectomy alone, therefore, in accordance with nearly all the recent and still ongoing studies in this huge research field, has a significant effect on exercise capacity. Only pneumonectomy is associated with impaired exercise performance, and, nevertheless, quite below our expectations.

[One-day surgery: results of 3,000 surgical procedures]. / One day-surgery: risultati di 3000 interventi chirurgici.

AIMS: To evaluate the advantages and limits of one day surgery operations performed between January 1990 and December 2000. METHODS: Pre-operative study of out patients with indications to surgical treatment with short-stay hospitalisation and research of criteria of feasibility of day-surgical program: a) morning hospitalisation; b) surgical intervention; c) post-operative control; d) night control; e) careful evaluation of admission 24 hour after operation and instruction for house-therapy; f) program of follow-up (7 and 14 days after operation). RESULTS: Mortality 0%; immediate post-operative complications 1.8%; post-operative sequelae (one year after surgery): 0.5%; high satisfaction gradient of patients one year after treatment: 89%. DISCUSSION: The Day-Surgery seems to be, after ten years of experience, available in high number of patients, with progressive extension of indications to ever more surgical fields and results very satisfactory, in term of cost-effectiveness too, with an high compliance of the patients to surgical program.