Annali italiani di chirurgia
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Comparative Study
Management and outcome of 308 cases of liver trauma in Bologna Trauma Center in 10 years.
Management of Liver Trauma may vary widely from NOM +/- angioembolization to Damage Control Surgery. Multidisciplinary management is essential for achieving better outcomes. ⋯ NOM +/- angioembolization is safe and effective in any grade of liver injury provided hemodynamic stability. DCS is Gold Standard for hemodynamically unstable patients.
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Acute appendicitis is among the most common emergency conditions in surgical practice and appendectomy is the most common treatment. Single-port (SP) laparoscopic transumbilical surgery has emerged in clinical practice. The aim of this study is to describe SP laparoscopic transumbilical surgery procedure performed in three patients undergoing appendectomy. ⋯ SP laparoscopic transumbilical appendectomy is a safe, effective and reliable technique leading potentially scarless abdominal surgery. Even though SP laparoscopic transumbilical surgery cannot substitute laparoscopic appendectomy for the moment, it is assumed that this procedure will become widespread by putting novel instruments into practice.
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Review Case Reports
[Spontaneous rectus sheath hematoma: a rare condition with uneasy diagnosis and multidisciplinary treatment. Report of 5 cases and review of literature].
Spontaneous rectus sheath hematoma is a rare condition. It encompasses a wide spectrum of severity (self-limiting to fatal) depending of its size, etiology, and the development of complications. It enters into the differential diagnosis of abdominal pain but it's frequently difficult to diagnose and often radiologic imaging is required. ⋯ The difficulties in the correct diagnosis frequently lead to delay in treatment or unneeded surgery. CT-scan is the gold-standard investigation. Treatment options are variable and include conservative treatment, intravascular embolization and surgery Frequently an interdisciplinary team approach is needed.
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Review Multicenter Study
Post-operative peritonitis due to anastomotic dehiscence after colonic resection. Multicentric experience, retrospective analysis of risk factors and review of the literature.
Intraperitoneal sepsis due to anastomotic leakage significantly affects the outcomes of intestinal surgery. The aim of this retrospective review is to examine retrospectively general and local factors involved in anastomotic leakage and their prognostic value. ⋯ In our experience, the site of colonic anastomosis represents the risk factor most strictly related to the anastomotic leak rate, while other technical factors seem weakly associated with leakage. A significantly high percentage of patients (65.6%) with anastomotic fistulas have medical comorbidities.