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Total thyroidectomy is the surgical preferred procedure for the treatment of benign and malignant disease. The purpose of this research was to evaluate total thyroidectomy operation by Ligasure in comparison with total thyroidectomy by the traditional technique that uses clamp and tie. We evaluated 256 patients. In 144 patients (56%), we used Ligasure without tie for total thyroidectomy; in the remaining 112 patients (44%), we used clamp and tie. The middle values of the variables examined were inferior (P < 0.0005) in the Ligasure group compared with the clamp and tie group. Only the middle value of operating room costs was higher in the first group than in the second, balanced by a decreased hospital stay of two days. Ligasure can be safely used for total thyroidectomy, because there is a meaningful difference in the distribution of variance between the two groups. There are decreasing risks of parathyroid gland and laryngeal nerve injury in the Ligasure group.

The hepatic hydatid cyst can lead to serious complications as a perforation into the biliary system or into the respiratory tract. The perforation into the peritoneal cavity can become dramatic, characterized by acute abdomen, usually with anaphylaxis. We recently treated a patient with a liver hydatid cyst perforated into the abdominal cavity. Computed tomography was a useful diagnostic tool, and the patient underwent emergency surgery. At laparotomy, 8 liters of hydatid liquid with floating daughter cysts and purulent material was found. The peritoneal cavity was washed with hypertonic solution, the hepatic cyst with daughter cysts. was removed, and a subtotal pericystectomy was performed. The critical clinical picture did not allow a cholecystectomy or a probe of the common hepatic duct to verify a biliary leakage. A biliary fistula appeared after 4 days and was successfully treated by endoscopic sphincterotomy. No anaphylactic phenomena were seen, probably because the great quantity of purulent material caused inactivity of the allergic component.

Non-Hodgkin lymphomas present a wider systemic diffusion than Hodgkin lymphomas. Superficial and internal nodes, the tracheobronchial tree, and the digestive tract are almost always affected. The gastrointestinal tract is affected in 50% of the cases; the stomach is the first organ, followed by the small intestine and large intestine. The colon is affected in only approximately 0.4% of cases. The clinical picture of our patient showed abdominal pain, palpable mass, and anemia. Colonoscopy showed a tumor in the cecum (diameter, approximately 10 cm) and the biopsy indicated lymphoma. Through computed tomography, bone marrow biopsy, and measurement of beta2-microglobulin, complete staging was obtained. Right hemicolectomy was immediately performed because the large tumor could determine intestinal occlusion. Definitive diagnosis was non-Hodgkin lymphoma, type mucosa-associated lymphatic tissue B cells with a low grade of malignancy. After surgery the patient underwent six courses of chemotherapy according to the CHOP scheme (750 mg/m2 cyclophosphamide, 1.4 mg/m2 vincristine, 50 mg/m2 adriamicin, and 80 mg prednisone). Two years after surgery the patient shows no sign of the disease.