Annali italiani di chirurgia
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Review
Surgical management of acute diverticulitis. An update based on our experience and literature data.
The treatment of acute diverticulitis is a matter of debate and has undergone significant changes. Currently the main focus of surgical treatment is a more conservative and less invasive management. ⋯ Acute diverticulitis, Laparoscopic surgery, Surgical treatment.
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Comparative Study
Comparison of endocrinological and cytokine response to trauma in laparoscopic and conventional appendectomy in patients with acute appendicitis.
In this study, we compared the endocrine and cytokine reaction of the patients which laparoscopic and conventional appendectomy was done for acute appendicitis. ⋯ ACTH, Appendectomy, Conventional appendectomy, IL-6, CRP, Laparoscopic appendectomy, Perforation.
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Aim of this paper is to allows to analyze a topic of great relevance and media interest such as the role of prophylactic mastectomy in healthy women with BRCA mutation proposing to the surgeons some useful informations for decision-making. Less than 15% of all breast cancers are associated with germline genetic mutations. The majority of hereditary breast tumors are due to mutations in BRCA1 and BRCA2 genes that are responsible for only one third of hereditary cases. ⋯ A personalized multidisciplinary path should guarantee an accurate genetic and clinical counselling, adequate psychological support and detailed information about all alternative risk management strategies. Clinical decision-making about strategies to pursue for breast cancer risk reduction should involve a tradeoff between life expectancy and quality of life. However if the patient and the medical team opt to proceed with prophylactic surgery, the cumulative evidence to date supports nipple sparing mastectomy with immediate reconstruction as an appropriate risk-reducing procedure to optimize the oncological and aesthetic results and improve quality of life.
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There is no doubt that postgraduate education and all "professional development activity" is in crisis, not only in our country but in all of Europe. The crisis is on one hand due to a lack of resources which has been evident for more than a decade, and on the other hand due to factors such as organization, culture, and education. Many of the chief medical disciplines such as internal medicine or general surgery, have been literally crushed and replaced by a myriad of subspecialties that have undermined the original unified character of the main disciplines 1. ⋯ The Italian Society of Emergency Surgery and Trauma (SICUT), after having validated and proposed in Italy the best English-speaking products and having directly imported the DSCT, began its own production of residential events and dedicated education proposals addressed in particular to the young surgeons. The current symposium consists of a series of short presentations of the various training initiatives for the professional development of emergency surgical care staff that the SICUT has organized in the last few years. This is a series of educational and training events of different kinds, many of which are produced in partnership with other organizations, dedicated to surgeons willing to implement or renew their knowledge and technical skills.
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Comment Letter
Intragastric enucleation of stromal tumors through a combined laparoscopic and endoscopic approach.
Dear Editor, We read with great interest the paper entitled "Laparoscopic organ-preserving gastric resection improves the quality of life in stromal tumor patients: an observational study with 23 patients" written by Ozcan et al. in Ann Ital Chir. 2018 Oct 23;7 1. We agree with the Authors that preserving the stomach after excision of stromal tumors is essential to improve the patients' quality of life. We would like, however, to discuss some issues that the paper published by Ozcan et al. might raise. ⋯ The excellent exposure of the site of excision allowed by the endoscopic traction was essential in this step. The specimen was then pulled away from the mouth after its introduction into a small plastic bag and the gastric holes were closed with monofilament non-absorbable sutures. In selected cases of submucosal iuxta-cardial gastric stromal tumors, as well as in every small stromal gastric lesions, the laparoscopic-endoscopic technique should be preferred since it allows a complete safe and oncologic resection of submucosal lesions, reducing risk of complications (e.g., perforation) and lowering morbidity when compared to other open or laparoscopic approaches.