No abstract

Because it is still a puzzling debate whether ligation of a unilateral varicose spermatic vein is worth performing by laparoscopy, even with the two-port technique, we conducted a study in which 280 patients with palpable left varicoceles were treated with spermatic vein ligation either by open surgery (120 patients) or by laparoscopy (160 patients). The inclusion criteria were the same for each group, and the two groups were homogeneous in preoperative clinical features and patient characteristics. The clinical outcomes were compared 6 months after surgery, and the costs of each treatment were analyzed. The procedures showed the same effectiveness and intraoperative safety. Open surgery scored a shorter operating time, whereas hospitalization was significantly shorter in the laparoscopic group. Postoperative complications occurred more frequently in the open surgery than in the laparoscopic group (7.5% and 0.6%, respectively). Of the patients treated, 197 were eligible for seminal analysis: 82 and 115 in the open surgery and laparoscopic groups, respectively. Significant improvement in seminal analysis was recorded in both groups, whereas no difference was found between the groups. Laparoscopy costs about 60% more than open surgery. It can thus be concluded that laparoscopy is not a worthy method to treat unilateral varicocele.

Two cases of superior mesenteric artery syndrome are presented. In both, conclusive diagnosis was made noninvasively in the presence of acute symptoms by obtaining details of the duodenum and vessels in a sonographic investigation.

The wide use of caustic compounds is responsible for an increase in gastric lesions, a severe condition with acute mortality and long-term morbidity, secondary to accidental or voluntary ingestion. A careful evaluation of patients with such lesions is mandatory for proper treatment planning. Ultrasonography may play an important role in providing complementary information on the integrity of the gastric wall and the possible presence of pathognomonic signs.

Clinical data are filed to be retrieved whenever they are needed. They must comply with the following requisites: give access to all information regarding the matter of the study, be easy to record, be easy and quick to recover and offer the possibility of correct, easy analysis of the actual data. To identify the clinical data filing methods, it is necessary to identify the purpose for which the data are filed, what must be filed and the media available. The reasons are: to keep a record of patient data for clinical purposes; as a diagnostic and therapeutical reference for the medical examiner, and to recover data for a clinical review for scientific purposes. Depending on the purpose the collection of data should be organised by choosing both the type of data to be filed and exactly what should be filed from a data record. Records may be classified into 4 main types: numerical, logical, imaginal, descriptive: it should be borne in mind that a descriptive and/or statistical analysis is impossible when data filed are not digital or logical records. There are basically two means of filing: on paper and on a magnetic medium. Paperwork requires a copy of data and different filing methods depending on its future use, while direct filing of data on a magnetic medium by computer enables work to be optimised: just one recording/filing of data serves for any future purpose. Filing on a magnetic medium is good training for the work optimization because the collection of data must be organized in advance. This method offers excellent results and certainty, plus saving of time and resources. Filing on a magnetic medium is therefore the ideal method for organizing both clinical and scientific work.