The acceptability of the classic laparoscopic technique in the treatment of acute appendicitis is slow, probably due to the higher costs of this method compared to the cheaper, efficacious, safe and ...rapid discharge associated with traditional surgery.
In order to combine the advantages of the laparoscopic technique with those of traditional surgery, we performed a retrospective study of the safety, efficacy, rapid discharge with return to normal working activities, and the costs in 70 patients referred to our attention with a diagnosis of acute appendicitis and who underwent one trocar appendectomy. This technique consists of positioning a single trocar in an umbilical site and using a 10 mm telecamera with a 5 mm operating canal. Having visualised the appendix and freed it from any synechiae, the distal end is grasped and it is removed through the umbilical trocar. Appendectomy is performed outside using a technique that is similar to traditional surgery. The diagnosis of acute appendicitis was made on the basis of clinical data (pain, leucocytosis, fever, possible resistance in the right iliac fossa).
Two cases intramural pseudodiverticulosis of the oesophagus are presented. The importance of a radiological examination when studying this condition is underlined.
The authors face the problem of accuracy, specificity and sensitivity of double-contrast arthrography in meniscal injury of the knee. They report the results obtained in a clinical-statistic and ...retrospective investigation on 206 patients. The final diagnoses were obtained by arthrotomy (105 cases) by arthroscopy (70 cases) and clinically with a follow-up of 6 months (31 patients). Diagnostic accuracy (94,5%), sensibility (92%), specificity (98,7%) and predictive values on positives (99%) and negatives (87,5%), confirm double-contrast arthrography as a highly accurate examination. A specific diagnosis can be made only when the diagnostic modalities are correctly applied and the arthrographers are qualified.
Plain films and direct magnification radiographs of the hands were performed in 34 patients affected by rheumatoid arthritis, using mammographic x-ray tube, achieved with 0.1 mm microfocus, and 1.85 ...X magnification factor. Direct magnification radiography has provided essential or useful diagnostic data in 44% of cases, particularly in recognizing early skeletal erosions. Nevertheless direct magnification radiography must be used only in those cases in which traditional mammographic techniques do not supply satisfactory results.
The problem of surgical fixing for incisional hernia is still far from a final solution. Over the past few years, prostheses have been used in addition to traditional plastic surgery. The aim of this ...experimental study was to assess the efficacy of traditional techniques in comparison to modern methods using prostheses. For this purpose, two original experimental models were designed to assess parietal resistance. Ninety-six Wistar rats were subdivided into 4 group: 1) control; 2) "waistcoat" plastic surgery; 3) plastic surgery using a vicryl prosthesis. With the exception of rats in group 1, a lozenge-shaped section of abdominal wall was removed from all other rats and, subsequently, the wall was repaired using the above-mentioned methods. Rats were killed after 30-60-120-180 days and the abdominal walls were subjected to traction and pressure using specially designed experimental models. For the first 30 days, the walls with dacron and vicryl prostheses behaved in a similar way, and showed a greater resistance than the other two groups; but after day 120, the resistance of dacron prostheses was considerably greater than that of the other groups studied. In conclusion, plastic surgery based on the use of nonreabsorbable prostheses is now more efficacious than traditional plastic surgery in the surgical treatment of incision hernia.
