About 1 to 5 percent of patients affected by chronic obstructive venous disease of the lower extremity, are eligible to surgical treatment, by veno-venous bypass, for the relief of unerely invalidating symptoms. Indications to operation include a class II to III chronic venous insufficiency of the deep venous system, failure of medical treatment continued for at least 12 months, good patency of outflow axis, a significant gradient of pressure between discared and outflow axis, a good quality saphenous vein to be utilized for bypass. The case of an aged patient, successfully treated with a femoro-femoral venous bypass, associating an artero venous fistula, is presented and indications to the operation in the older patients, together with indication to and technical details of performing the fistula are discussed.

Aged↗

PubMedDate not supplied

[Carcinoid of the thymus].

Thymic carcinoid is a rare lesion. Two cases are reported and diagnostic as well as therapeutic problems are discussed.

Adult↗

PubMedDate not supplied

[Preparation of the colon for endoscopic examinations. A clinical study].

The paper gives a short critical bibliographic review of colonic preparation for endoscopy, focusing on the out-patient use of gastrointestinal endoscopy. A method of preparation based on dietary restrictions plus cathartics is proposed that allows the number of enemas used to be reduced to a minimum. The results obtained in 265 out-patients undergoing colonoscopy confirm the efficacy, practicality and tolerability of the method.

Adolescent↗

PubMedDate not supplied

[Bilateral retroperitoneal lymphadenectomy in tumors of the testis: anatomo-clinical considerations].

Bilateral retroperitoneal lymphadenectomy is usually indicated for non-seminomatous testis tumour at stage IIA and IIB. For seminoma is generally used radiotherapy, although some Authors prefer the surgical approach. Radical retroperitoneal lymphadenectomy must be bilateral, because metastatic cell can often spread to the contralateral lymph nodes. Lymphadenectomy is used not only for therapy, but also for staging: thus clinical evaluation and other diagnostic techniques are not always correct (30% of understaging). Permanent sexual disfunction can follow radical surgery, due to extensive retroperitoneal dissection and exeresis of lumbar sympathetic nerves; so it is proposed, for stage I tumors, a monolateral or limited retroperitoneal lymphadenectomy. Eight patients with non-seminomatous testicular tumours are reported by the authors; 2 (stage I) were treated with monolateral, 4 (stage IIA and IIB) with bilateral retroperitoneal lymphadenectomy; in 2 patients (stage IIC and IID) chemotherapy was followed by debulking surgery. Relapses were observed between 3 and 19 months. Sexual dysfunctions after surgery were present in 5 patients (69%); in all of these a bilateral retroperitoneal lymphadenectomy was performed.

Adolescent↗