Abstract: Intraoperative radiofrequency (RF) ablation has recently become a valid procedure in the treatment of liver primary or secondary malignancies in selected cases. This procedure can be used alone or in association with surgery in treating lesions not considered for curative surgery. Heat damage of the main bile ducts represents nowadays a limitation in the use of radiofrequency ablation of hepatic lesions. Up to now, in tumors proximal to a main bile duct or to the biliary bifurcation this procedure has been contraindicated. In order to preserve these structures from heat damage, a new technique consisting of intraductal cooling of the bile ducts has recently been introduced. We report a case of successful experience with this technique.
Abstract: The authors report a series of 111 cases of non-palpable breast tumours. Radiological examinations showed the following mammographic patterns: microcalcification (63%); irregular opacity and/or denseness (26%); opacity and low density microcalcifications (12%), to which 3 progressive risk rates were assigned (high, medium, low). Histological controls of the tumours showed a positive predictive value of 73% for mammographic patterns defined as "high-risk". Localisation using a metal probe proved to be a simple and efficacious method which was well tolerated by patients.
Abstract: The paper reports two rare cases of adrenal myelolipoma which were referred to the authors' attention. This is a functionally inactive benign tumour made up of fatty tissue and foci of hemopoietic cells. It is often diagnosed due to the compression disorders caused to adjacent structures, whereas at other times it is identified by chance during the course of diagnostic tests carried out for other pathologies.
Abstract: Following a brief review of the main method of prosthetic repair used for inguinal hernia: Lichtenstein, Stoppa, Rives, etc, the authors propose an original technique consisting in the placement of a marlex patch below the trasversalis fascia, in a pre-peritoneal site, using a classical inguinal access route. The prosthesis is fitted round the spermatic funicle and fixed with a single stitch to the pubis and with a few others, in resorbable material, to the posterior face of the trasversalis fascia. Above it, plastic surgery is performed to bring the triple stratum closer to the reflexio of the inguinal ligament. The prosthesis is kept in place by positive abdominal pressure. The method outlined here has been used in 71 cases of primary or recurrent inguinal hernia. Follow-up lasted for 1-24 months and showed the low morbidity (4.5%) due to sepsis of the surgical wound, which did not require reoperation, and only 1 case of recurrent hernia which was probably caused by the incorrect positioning of the prosthesis.
Abstract: The paper analyses the authors' initial experience of video laparoscopic cholecystectomy, outing the difficulties and incidence of morbidity in the preliminary group of 38 patients. The details of complications and their pathogenesis are also reported.
Abstract: The paper outlines the indications for the use of Kehr's tube in the surgical management of extra-hepatic biliary lithiasis by reporting the authors' personal experience relating to the period 1988-1992. In line with data reported in the literature the paper emphasizes the value of Kehr's tube not only in those cases where it is necessary to prevent choledochotomy and radiological control, but above all were the postoperative possibility of removing any residual calculi using litholytic, endoscopic or lithotripsic methods, is of prime importance.
Abstract: Sixty patients with stage IIIA and IIIB breast cancer have been treated with a combined modality approach including induction chemotherapy, surgery and adjuvant chemotherapy: 74.5% of patients achieved an objective response after 3 cycles of induction chemotherapy, and 98.3% of patients were rendered disease-free after induction chemotherapy and surgery or radiotherapy; at 4 years, actuarial survival and disease-free survival are 71.5% and 43%, respectively. These results are significantly better than our historical control, and locally advanced breast cancer must now be considered a curable disease when treated with an aggressive multimodal approach.
Abstract: A case of retroperitoneal infectious myositis is described. The symptoms of infectious myositis may be confused with those of other more frequent soft tissue pathologies (haematoma and sarcomata). This infection is more frequent in countries with a tropical climate. The most frequent aetiological agent is Staphylococcus aureus. This paper reports on the diagnostic and therapeutic problems of this disease as recently observed at the Division of Surgical Oncology of the National Cancer Institute in Genoa.
Abstract: Myelolipoma is a rare, benign tumour composed of fat and hematopoietic cells. Abdominal pain is often the only symptom and the result of compression by the tumour of contiguous organs. A personal case is reported after a review of the literature.
Abstract: Estrogen (ER) and progesterone (PgR) receptors were evaluated in the tumor tissue (T) and in the mammary gland far from malignancy (D) in 36 breast cancers. Results were correlated with the pathological grading of the tumor and the axillary nodal status. It is suggested that a lower cancer malignancy with negative nodes and lower values of pathological grading (G1-G2) may be associated with a high level of ER in the mammary parenchyma far from the tumor (D).
Abstract: The authors review the epidemiologic and etiopathogenetic aspects of AIDS, in agreement with data published in december by the Center for Disease Control and by the WHO for the States, Europe and Italy. In their experience twenty-one patients, with clinical clues of AIDS, undergoing lymph node biopsy, have been analysed (18 LAS-ARC and 3 AIDS) and the role of prophylaxis for the surgical approach to the patient with aids or related syndrome has been underlined.
