Parathyroid autotransplantation during total thyroidectomy. Results of a retrospective study.

Authors analyze their experience of parathyroid autotransplantation during total thyroidectomy, with the purpose of seeing whether this practice influenced the rate of postoperative hypocalcemia and/or hypoparathyroidism. We identified three groups of patients: group A, consisting of 57 patients, underwent parathyroid autotransplantation during total thyroidectomy; group B consisting of 87 patients not submitted to intraoperative autotransplantation in whom, as an incidental finding, a parathyroid gland was detected in the surgical specimen; group C consisted of 100 patients who did not undergo autotransplantation and whose surgical specimens were not found to contain parathyroid glands. The three groups were compared for sex and age as well as for a series of clinical and laboratory parameters on the first three postoperative days and at six months after surgery. The rate of permanent hypoparathyroidism was 3.5% in Group A, 3.45% in Group B, and 1% in Group C. Multivariate analysis revealed that all three groups showed postoperative recovery of calcium levels, although the rate and extent of this recovery differed between them. The control group showed a more rapid and more complete recovery of serum calcium values compared with Groups A and B. Calcium recovery in Groups A and B was comparable, in terms of both rate and extent. The same pattern of results emerged for the iPTH values. The analysis of the data showed that there were no significant differences in the analyzed parameters between Groups A and B. This suggests that parathyroid autotransplantation does not influence the rate of postoperative hypocalcemia and/or hypoparathyroidism.

Appendiceal abscess in a giant left-sided inguinoscrotal hernia: a rare case of Amyand hernia.

The hernia of Amyand is an inguinal hernia containing the appendix in the sac. It is a rare pathology often diagnosed only intra-operatively. We report a case even more rare of a giant left-sided inguinoscrotal Amyand hernia with appendiceal abscess without clinical findings of incarceration/strangulation, occlusion, perforation, or acute scrotum and with the presence in the sac of the caecum and other anatomical structures (last ileal loops, bladder and omentum). The 68-years-old man patient successfully underwent surgical treatment only through the hernia sac (meshless repair according to Postempski technique).

Laparoscopic cholecystectomy in Steinert's myotonic dystrophy. About two clinical cases.

Myotonic dystrophy type 1, or Steinert's myotonic dystrophy, is a rare RNA-mediated autosomal dominant disease. Here we describe two clinical cases of patients with Steinert's disease who underwent laparoscopic cholecystectomy under general anaesthesia in conjunction with thoracic peridural anaesthesia, without muscle relaxants. Using such an anaesthesiological technique allowed for rapid recovery from anaesthesia, quick and complete recovery of autonomous breathing, and a significant haemodynamic and arterial blood gases stability, as well as an adequate and complete analgesic coverage over the entire perioperative period.