The incidence of complications is slightly higher than in major pilot centres but it is comparable, hence RALP also appears feasible in our italian peripheral centre.

No abstract

No abstract

We present our ten years experience of orthotopic substitution of the bladder affected by infiltrating urothelial carcinoma in order to estimate a relatively small number of patients but with a long follow-up and to outline the reasons for our technical choices. Since January 1986 we have performed 70 orthotopic substitutions of the bladder, using the Carney I at the beginning and then passing on to the Carney II “detubularized” neobladder and in the following years the ileo-cecal bladder, the VIP till the “J” neobladder now preferred by the authors. Technically we have identified a series of parameters that we have used to evaluate the different types of neobladder. This examination shows that all the neobladders utilized are valid, but the “J” type corresponds much better to the current concept of ideal neobladder. We have illustrated and explained critically the patient selection principles and the results we obtained.

Background and aims The effect of surgical treatment for spontaneous intracerebral hemorrhage (ICH) remains uncertain. We conducted an observational retrospective cohort study on supra-centimeter spontaneous ICH treated with either neurosurgical or conservative management. The baseline demographics and risk factors were correlated with in-hospital mortality and 3 and 6-month survival rates stratified by management. Methods We included all patients with evidence of spontaneous ICH > 1 cm detected by CT and admitted between august 2020 and march 2021 to the “SMM” Hospital in Perugia. Results Onehundredandtwentytwo patients were included in the study, and 45% (n.55) were surgically treated. The mean age was 71.9 ± 15.3, and 61% (n.75) were males. Intra-hospital mortality ended up being 31% (n.38), 3 months-survival was 63% (n.77) and 6 months-survival was 60% (n.73). From the multivariate analysis of the surgical patients versus medical patient, we observed that the surgical patients were younger (67.5 ± 14.9 vs 75.5 ± 14.7 y; OR 0.87; Cl 95% 0.85–0.94; p 0.001), with greater ICH volume at the onset (61 ± 39.4 cc vs 51 ± 64 cc; OR 1.03; Cl 95% 1.005–1.07; p 0.05), more midline shift (7.61 ± 5.54 mm vs 4.09 ± 5.88 mm; OR 1.37; Cl 95% 1.045–1.79; p 0.023), and a higher ICH score (3 vs 2 mean ICH score; OR 21.12; Cl 95% 2.6–170.6; p 0.004). Intra-hospital mortality in the surgical group and in the conservative treatment group was respectively 33% vs 30%, 3 month-survival was 64% vs 63% and 6 month- survival were 60% in both groups. Conclusions Our patient cohort shows no overall benefit from surgery over conservative treatment, but surgical patients were younger and had larger ICH volume.