Frailty predicts recurrence after laparoscopic Nissen fundoplication with mesh cruroplasty for giant sliding hiatal hernia with severe reflux esophagitis in elderly patients: a multicenter retrospective study.

Purpose: Giant sliding hiatal hernias (HH) are prevalent in the elderly population (EP) and often present with multiple comorbidities and a high surgical risk. Frailty has been increasingly recognized as a predictor of surgical outcomes in the EP. This study assessed the rate of recurrent sliding HH following mesh cruroplasty and laparoscopic Nissen fundoplication (LNF), and evaluated frailty as a potential risk factor of recurrence.

Mucosal advancement flap versus ligation of the inter-sphincteric fistula tract for management of trans-sphincteric perianal fistulas in the elderly: a retrospective study.

Purpose: There is no consensus on the standard approach for trans-sphincteric perianal fistulas (TPAF) in the elderly population. The most commonly used sphincter-saving procedures are ligation of the inter-sphincteric fistula tract (LIFT) and mucosal advancement flap (MAF). We aimed to evaluate the incidence and risk factors for recurrence and incontinence in elderly patients with TPAF using both approaches.

Side-specific factors for intraoperative hemodynamic instability in laparoscopic adrenalectomy for pheochromocytoma: a comparative study.

Background: Adrenalectomy for pheochromocytoma (PHEO) is challenging because of the high risk of intraoperative hemodynamic instability (HDI). This study aimed to compare the incidence and risk factors of intraoperative HDI between laparoscopic left adrenalectomy (LLA) and laparoscopic right adrenalectomy (LRA).

Methods: We retrospectively analyzed two hundred and seventy-one patients aged > 18 years with unilateral benign PHEO of any size who underwent transperitoneal laparoscopic adrenalectomy at our hospitals between September 2016 and September 2023.

A prospective multicentre study evaluating the outcomes of the abdominal wall dehiscence repair using posterior component separation with transversus abdominis muscle release reinforced by a retro-muscular mesh: filling a step.

Background: This study aimed to evaluate the results of posterior component separation (CS) and transversus abdominis muscle release (TAR) with retro-muscular mesh reinforcement in patients with primary abdominal wall dehiscence (AWD). The secondary aims were to detect the incidence of postoperative surgical site occurrence and risk factors of incisional hernia (IH) development following AWD repair with posterior CS with TAR reinforced by retromuscular mesh.

Methods: Between June 2014 and April 2018, 202 patients with grade IA primary AWD (Björck's first classification) following midline laparotomies were treated using posterior CS with TAR release reinforced by a retro-muscular mesh in a prospective multicenter cohort study.

Comparison of Centella with Flavonoids for Treatment of Symptoms in Hemorrhoidal Disease and After Surgical Intervention: A Randomized Clinical Trial.

Phlebotonics' effects were evaluated to reduce time-to-stop bleeding and anal irritation in 130 patients who complained of hemorrhoidal disease (HD); bleeding and pain after hemorrhoidectomy (31 patients) and hemorrhoidal thrombosis (34 patients) in the short time. Sixty patients were randomized to receive the routine treatment (both conservative and surgical) (control Group C). The treated group (both conservative and surgical) was divided into two subgroups: one treated with flavonoids (Group A, n = 73), the other with Centella (Group B, n = 66).

Comparison of Flavonoids and Centella asiatica for the treatment of chronic anal fissure. A randomized clinical trial.

Aims: We aim to test and compare the effects of Flavonoids (Fs) and Centella asiatica (Ca), and the traditional treatment to find out which best deals with healing time, bleeding and pain in the treatment of chronic Anal Fissure (AF). Materials of Study: 98 outpatients were divided randomly into treated (either Fs or Ca) and control group. The control group (Group C, n=32) received the traditional treatment along with the other two subgroups which were treated, additionally, with Fs (Group A, n=30) or Ca (Group B, n=36).

Early rectal cancer: a choice between local excision and transabdominal resection. A review of the literature and current guidelines.

Introduction: Indication for Local Excision (LE) or Trans Abdominal Resections with Total Mesorectal Excision (TAR) in Early Rectal Cancer (ERC) are still controversial.

Material Of Study: We reviewed meta-analyses, scientific societies guidelines, randomized and controlled clinical trials from 1999 to 2016 for a total of 146,231 patients. We included in our analysis the accuracy of different tools of investigation, the reliability of the endoscopic biopsies and compared the results of the various LE and TAR.

Post-operative ileus in hemicolectomy for cancer: open versus laparoscopic approach.

Aim: This study aims to verify if the duration of postoperative ileus (POI), in patients undergoing abdominal surgery, is related to the surgical approach used (open or laparoscopic) or rather to the manipulation of bowel loops.

Materials And Methods: Ninety patients, undergoing elective colon resection for cancer, were randomized in three groups with different surgical approaches: open technique with extensive manipulation of intestinal loops (GROUP A), open technique with minimal manipulation (GROUP B) and laparoscopic technique (GROUP C). Return of bowel functions was investigated by: detection of bowel sounds, passage of flatus and passage of stool.

Wet adhesion of buckypaper produced from oxidized multiwalled carbon nanotubes on soft animal tissue.

Buckypaper (BP) is the general definition of a macroscopic assembly of entangled carbon nanotubes. In this paper, a new property of a BP film produced from oxidized multiwalled carbon nanotubes was investigated. In particular, BP shows to be able to promptly and strongly adhere to animal internal soft and wet tissues, as evaluated by peeling and shear tests.

Urinary schistosomiasis in asylum seekers in Italy: an emergency currently undervalued.

Despite schistosomiasis is one of the most prevalent tropical diseases in developing countries and and large flows of migrants come from countries where the disease is endemic, imported urinary schistosomiasis is still not easily recognized in non-endemic areas, especially if not subjected to specific investigations. Moreover schistosomiasis is currently not reportable in any European public health system. The data presented in this report were collected were collected between asylum seekers by a simple screening method based on a prior or actual history of a macroscopic hematauria.

Primary omental torsion (POT): a review of literature and case report.

Eitel first described omental torsion in 1899, since then, fewer than 250 cases have been reported. Although omental torsion is rarely diagnosed preoperatively, knowledge of this pathology is important to the surgeon because it mimics the common causes of acute surgical abdomen. For this reason, in the absence of diagnosed preexisting abdominal pathology, including cysts, tumors, foci of intra-abdominal inflammation, postsurgical wounds or scarring, and hernial sacs, omental torsion still can represent a surprise.

Micro-Raman study of the role of sterilization on carbon nanotubes for biomedical applications.

Aim: We investigate the effect of four different types of sterilization procedures on the structural properties and morphological features of single-wall carbon nanotube samples approachable by micro-Raman spectroscopy. Sterilization procedures (treatment in humid heat autoclave or ethylene oxide and irradiation with gamma-rays or UV light) are necessary in view of the use of carbon nanotube sterile samples in in vivo toxicity tests on laboratory rats. Micro-Raman spectroscopy allows us to estimate several details about the morphology of the single-wall carbon nanotube mixture (mainly the presence of disorder and diameter distribution) before and after the sterilization treatment.

Multi-walled carbon nanotubes: Lack of mutagenic activity in the bacterial reverse mutation assay.

The mutagenic effect of multi-walled carbon nanotubes (MWCNTs) characterised by small surface/volume ratio, high diameter and less than 0.1% of metal contaminants was evaluated by the bacterial reverse mutation assay (Ames test) on Salmonella typhimurium TA 98 and TA 100 strains, and on Escherichia coli WP2uvrA strain, in presence and in absence of the metabolic activation system S9. A preliminary cytotoxicity assay was carried out to ensure that cytotoxicity did not interfere with response.

Is there a place for intraperitoneal onlay mesh repair (IPOM) of inguinal hernia among laparoscopic techniques?

Background/aims: The Authors report their experience on laparoscopic hernioplasty using the intraperitoneal onlay mesh repair in 56 patients.

Methodology: Thirty patients had a monolateral hernia, 9 of which were recurrent and 26 had a bilateral hernia, 6 of which were recurrent. Overall, a total of 90 hernias were treated.

[Ergonomic and cosmetic aspects of laparoscopic appendectomy: personal technique].

We analyzed our case series in order to evaluate the evolution of our laparoscopic technique in ergonomic and cosmetic terms, leading to the right compromise between these aspects. We retrospectively analyzed 136 diagnostic laparoscopies for suspected appendicitis, using scheme A in the first 98 cases (one 10/12-mm umbilical trocar for the optics and two 5-mm operative trocars placed above the pubis on the right and left side) and scheme B in the other 38 cases (one 10/12-mm umbilical trocar for the optics and two 5-mm operative trocars, one placed over the pubis and the other one on the right hip, just on the umbilical line). The diagnosis of appendicitis was confirmed in 117 patients, while other diseases were present in 19 patients.

["Low-pressure" laparoscopic cholecystectomy in high risk patients (ASA III and IV): our experience].

The insufflation pressure used for laparoscopic cholecystectomy is usually 12-15 mm Hg, and a pneumoperitoneum with carbon dioxide has a significant effect on both cardiovascular and respiratory function. These effects are transient in young, healthy patients, but may be dangerous in ASA III and IV patients with a poor cardiac reserve. This study was designed to assess the feasibility of performing laparoscopic cholecystectomy at 6.

[Treatment of esophageal perforations. Considerations on a clinical case].

The Authors describe a rare case of esophageal perforation occurred after Transoesophageal echocardiography in 68 years old patient and review the literature relating to the causes and management of this pathology. Transoesophageal echocardiography, which is a semi-invasive investigation increasingly used in cardiology and cardiac surgery and intensive care units, is a rare though extremely dangerous cause of such complications. Perforation of the esophagus continues to present a formidable diagnostic and therapeutic challenge.