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Letters to the Editor: Use of human fibrin glue (Tissucol) versus staples for mesh fixation in laparoscopic transabdominal preperitoneal hernioplasty.
No full text
Uretero-neocystostomy in a swine model of kidney transplantation: a new technique
No full textThe comparison between the old techniques and the new one (LG and LP versus Direct) showed a lower incidence of complications among the animals that underwent the new direct technique (P < 0.05). This technique could be applied clinically in selected pediatric cases either of transplantation or reflux
Incidental carcinoma in multinodular goiter: risk factors
No full textThe aim of the study was to analyze the frequency of incidental thyroid carcinoma (unknown
tumor smaller than or equal to 10 mm) in a consecutive series of 462 total thyroidectomies for
multinodular goiter and to investigate the clinical risk factors for this type of malignancy. A
retrospective, single-center study of outcome data collected from patients with preoperative diagnosis
of multinodular goiter who underwent total thyroidectomy at the General Surgery Unit
of Pavia (Italy) between January 2000 and December 2008 was performed. Possible risk factors
for malignancy were: gender, age, time of evolution of goiter, presence of a dominant nodule in
multinodular goiter, hyperthyroidism, history of radiation to the neck, residence in an area of
endemic goiter, prior thyroid surgery, calcifications in the goiter detected by neck ultrasound or
chest X-rays, and a family history of thyroid diseases. In a 9-year period, 462 patients underwent
total thyroidectomy. We found 41 cases of incidental thyroid carcinoma; the most common histopathological
type was papillary. The multivariable analysis demonstrated that the clinical variables
associated with occult carcinoma were a personal history of radiation therapy to the neck,
the presence of calcifications detected by ultrasound or neck X-rays, and a family history of
thyroid diseases; residence in an area of endemic goiter was a protective factor. A personal history
of radiation to the neck, detection of calcifications by ultrasound or by neck X-rays, and a family
history of thyroid diseases should be considered clinical risk factors for malignancy in multinodular
goiter
Chronic intestinal pseudo-obstruction secondary to al amyloidosis associated with severe gastroparesis: case report
No full textLaparoscopic transabdominal preperitoneal (TAPP) hernia repair: surgical phases and complications
No full textA total of 1,973 TAPP procedures were reviewed, and 81% of the patients completed 5 years of follow-up evaluation. The 74 complications (3.7%) reported were categorized as follows: 33 major (1.7%) versus 41 minor (2.0%), 66 hernia-related (3.4%) versus 8 laparoscopy-related (0.5%) complications, and 12 recurrences (0.6%). Risk factors for complications included inguinoscrotal hernia (p <= 0.001), dissection/ reduction of the sac (p = 0.02), and surgeon experience (< 50 TAPP procedures; odds ratio, 7.1; 95% confidence interval, 4.2-11.9).
Conclusions: Accuracy in dissection/reduction of the sac improves the outcome of TAPP hernia repair. This effect is related to the experience of the surgeon. Experience performing more than 75 procedures is required for optimal results
Use of human fibrin glue (Tissucol) versus staples for mesh fixation in laparoscopic transabdominal preperitoneal hernioplasty: a prospective, randomized study.
No full textAssessments took place at 1, 3, 6, and 12 months, with all patients completing each follow-up visit. Mean VAS scores were significantly lower in the Tissucol group versus the staples group (MANOVA, P < 0.05). Higher scores for the modified SF-36 questionnaire at 1 month were demonstrated in the Tissucol group compared with the staples group (23.2 and 22.6, respectively; P < 0.05). The mean recovery time for normal physical activity was significantly shorter in the Tissucol group compared with the staples group (7.9 vs. 9.1 day, respectively; P < 0.001). One recurrence was seen in the fibrin glue group, which was attributable to a technical error in fixation of the mes
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