First case of bronchiolar-pleural fistula repair with platelet-leukocyte rich gel.

Bronchiolar-pleural fistulas are a frequent complication of thoracic surgery. Current treatment strategies and their invasiveness are quiet different, but often surgeons decide for a new surgical intervention and definitive closure of the breach. We report the case of a bronchiolar-pleural fistula in a 75 years old man with important co-morbidities that we treated with instillation of platelet-leukocyte rich gel (PLR-G). We discuss actual indications for PLR-G as well as its possible role in thoracic surgery.

Stapled hemorrhoidopexy in the treatment of hemorrhoid disease. Our eight-year experience.

AIM: Stapled hemorrohoidopexy using Longo technique (PPH) is accompanied by good postoperative outcomes. The aim of this study was to report the data regarding our experience with stapled hemorrhoidopexy, the results of the operations and the complications rate in comparison with those published in the literature. METHODS: In our Department 127 patients with symptomatic hemorrhoids have been selected between November 2000 and December 2008 for PPH. This retrospective study included patients with a rectal prolapse from second to fourth degree. RESULTS: Two patients had an anal bleeding on the day of surgery. All of them were returned to the operating theatre. A third patient had an anal bleeding that did not require a second surgical intervention. In one case a postoperative stenosis occurred that required a reoperation three days after the dismission from hospital. In one case an urgency occurred, with transitional fecal incontinence, spontaneously regressed two weeks after the intervention. No urinary retention occurred in our caseload. Pain was referred by 37 patients and was controlled by standard analgesia in all cases. No cases of chronic pain were detected. There were no cases of anal stenosis, permanent incontinence or deaths in this series. CONCLUSION: Among the cases examined important complications occurred in five (3.9%), but reintervention was necessary only for three patients (2.4%). This study confirms that PPH, used on patients with a rectal prolapse from second to fourth degree, is feasible and safe.