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Aim: The aim of this retrospective study was to evaluate the impact of some risk factors on mortality in patients with Acute mesenteric ischemia (AMI)., Materials and Methods: From September 2003 to August 2011, 200 patients were operated on for bowel infarction at our unit: 149 were included in the study. For each patient, socio-demographic (gender and age) and clinical data (extent of necrosis, predisposing factors, WBC, LDH, comorbidities) were collected from patients' clinical records., Results: Of the 149 patients who underwent surgery, 57 (38.3%) died. A significantly higher mortality was associated with older age (79.9 versus 74.2 years, p < 0.01), higher LDH serum levels (695 versus 636 UI/L, p < 0.01), higher WBC (25.1 versus 22.5 X 103/mm3; p < 0.01), and extent of necrosis (p< 0.01). Otherwise, there was no correlation between comorbidities and mortality. Finally, multivariate analysis confirmed the significantly higher risk of death in patients with right colon and massive small bowel infarction (adjOR= 3.58; 95% CI=1.36-9.42) and intestinal perforation (adjOR=31.1; 95% CI=2.45-395.7)., Discussion: The results of our study suggest that the contribution of laboratory tests is limited, even if increased indexes of necrosis (such as LDH) associated with neutrophilic leukocytosis and metabolic acidosis, may help in defining diagnosis/ prognosis, though with low accuracy., Conclusions: The extent of necrosis and diagnostic delay seem to be the most important prognostic factors even after adjusting for confounding due to age, presence of comorbidities, and laboratory tests (LDH and WBC)., Key Words: Acute mesenteric ischemia, Mortality, Predictive factors.

Unlabelled: Cystic lymphangioma is a rare benign tumor commonly located in the head or neck. Approximately 100 adult cases have been reported in the literature. The etiopathogenesis is unclear, though trauma has been suggested as one of the possible causes., Case Report: We report a case of recurrent cystic lymphangioma arising in an adult who had been successfully treated in our department, leading us to review the literature for a critical examination of our therapeutic choices and the pathological, clinical and therapeutic aspects. We performed a dissection of the cyst respecting anatomical structures.Three days after the surgery, the patient showed a recurrence under the previous site of the excision, We then decided to place a suction drainage under local anesthesia, The suction drainage was removed 25 days later.The post-operative course of the patient showed no signs of recurrence for twenty-four months., Discussion: Complete surgical excision is the treatment of choice in symptomatic patients. In our experience, postoperative suction drainage improved the outcome. Some authors have come out in favor of experimental, non-surgical methods, such as percutaneous sclerotherapy, which they claim offer the most promising results., Conclusions: In our experience, totally excision of the mass was the treatment of choice but, placing just one suction drainage for weeks for new recurrence resulted in a surprising outcome. In fact, recurrence usually appears within the first nine months in about 10-15% of patients.

Aim: To assess the efficacy of two widely used topical haemostatic agents: oxidised regenerated cellulose gauze and Collagen- Fibrinogen-Thrombin Patch in patients undergoing total thyroidectomy., Material of Study: This was a prospective, comparative, non-randomised study in which consecutive patients undergoing total thyroidectomy for benign disease received standard treatment with no haemostatic agent, cellulose gauze, or CFTP. Main outcome measures were drainage volume 24 hours after surgical procedure and the occurrence of post-operative complications (haematoma, seroma, surgical-site infection)., Results: Two hundred seventy-one (271) patients undergoing total thyroidectomy for benign disease: 65 received standard treatment, 60 received cellulose gauze and 146 received CFTP. Seroma was significantly reduced in the CFTP group compared with both the cellulose gauze group (p=0.006) and the standard treatment group (p=0.017). A significant reduction in drainage volume was also observed with CFTP compared with the other two groups (both p<0.001). Drainage volume was also significantly reduced with cellulose gauze versus standard treatment (p<0.001). No septic events were observed after application of CFTP. One hematoma was observed in the non haemostatic group., Conclusions: Both haemostatic agents reduced the amount of sero-hematic fluid during the first 24 hours post-surgery, with CFTP more effective than oxidized cellulose gauze. The use of haemostatic agents may increase the quality of thyroid surgery, improve patient comfort after surgery, and reduce hospital stay.