BackgroundExternal hemorrhoidal thrombosis (EHT) is a common complication of hemorrhoidal disease. This condition causes extreme pain, likely resulting from internal anal sphincter hypertonicity, which traps the hemorrhoids below the dentate line thus leading to congestion and swelling. The choice of treatment remains controversial and both conservative and surgical options have been proposed in the last decades.MethodsThis mini-review focuses on the most relevant studies found in literature evaluating conservative and surgical management of EHT. Special conditions such as pregnancy and EHT in elderly patients have been considered.ResultsTraditionally, symptoms duration represents the discriminant in the choice between medical and surgical treatment. Several Coloproctological Societies considered conservative treatment as the first-line approach to EHT and a variety of options have been proposed: wait and see, mixture of flavonoids, mix of lidocaine and nifedipine, botulinum toxin injection and topical application of 0.2% glyceryl trinitrate. Meanwhile, different surgical treatments are recommended when EHT fails to respond to conservative management or when symptoms onset falls within the last 48–72 h: drainage with radial incision, conventional excision, excision under local anesthesia and stapled technique.ConclusionThe management and treatment of EHT is still controversial since no specific guidelines have been published. Both medical and surgical treatment have been proven effective but randomized clinical trials and structured consensus-based guidelines are warranted.

In this paper, a new protocol is described, based on solid phase microextraction (SPME) coupled with gas chromatography–mass spectrometry (GC-MS), to monitor ex vivo changes in endogenous volatile organic compounds (VOCs) released by surgically resected colonic tissues (normal colonic mucosa and adenomatous polyps) from seven patients undergoing operative colonoscopy to identify their molecular pattern. The exhalated volatile organic molecules from these patients were sampled by the ReCIVA® breath sampler, shortly before surgery, and analyzed by GC-MS. Comparing VOC patterns identified in the tissues and in the breath of the same patients, a possible correlation can be found between the levels of methylbenzene and benzaldehyde exhaled and the presence of colonic adenomatous polypoid lesions.

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The incidence of courtesy authorship in research over time has probably increased due to the enormous pressure to publish to increase the bibliometric indexes necessary to achieve an academic role. The aim of this survey was to quantify and characterize this research malpractice among a very selected group of surgeons from different surgical specialties belonging to the European Association of Surgery (ESA). E-mail addresses for the invitation to take part to the survey were collected by the Twenty-eighth Annual Meeting final program. Five-item were designed and developed by the authors using an online platform. Eighty-six members from 21 countries completed the survey (female/male ratio: 0.09). In the last 10 years, almost half of the responders (41, 47.7%, 37 academics) have included colleagues for courtesy authorship. The most common reason of courtesy authorships was to support the academic career of another researcher (62.5%). Other reasons were fear of retaliation (12.5%), reciprocal authorship (12.5%) or support for a partner (10%). This survey showed that undeserved authorship is sadly confirmed to be a common research misconduct across any countries and medical specialties, even among a very selected group of surgeons with international reputation irrespective of the academic position.