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Aim: The aim of the study was to evaluate expression of CD10 in a series of gastrointestinal tumors (GIST) and to find its relationship with prognosis, biological and clinical behavior. GISTs represent the most frequent gastrointestinal (GI) mesenchymal tumors. Biological behavior of GIST cannot be easily predicted; for this reason many biomolecular factors are being investigated to predict prognosis. Recently the role of the CD10 as prognostic predictor in the carcinogenesis of the gastrointestinal carcinomas has been accurately studied. To our knowledge, no data regarding the role of CD10 in GISTs have been published to date., Methods: CD10 expression was searched by immunohistochemistry in 29 histological specimens of proved GIST surgically treated. Patients' characteristics and all pathologic features of tumors were statistically reviewed and compared to CD10 expression. Survival analysis was also calculated respect to CD10 expression and relevant clinical or pathological features., Results: CD10 was expressed in 24.1% of cases. There was no correlation between CD10 positivity and risk category, morphology, size or mitosis. The CD10 expression status did not prove to be statistically related to worse prognosis, advanced disease (metastasis) or recurrence, however it was significantly correlated to the tumor site., Conclusion: CD10 expression in our series seems to be associated to a small bowel origin of tumor. CD10 expression alone failed to reveal a statistically significant prognostic value. However survival analysis revealed worse prognosis in stomach tumours with mitotic count >10/50 HPF.

Treatment of acute colorectal malignant obstruction, by using self-expandable metallic stents is useful for both palliative and decompressive therapy before the final surgical treatment. In this case, the patient may be benefit from a period of medical optimization prior to undergoing planned surgical resection by a colorectal surgeon. This is a minimally invasive procedure, relatively safe, which obviates the need for colostomy for evacuation relieving physical and psychological burden and contributing the improvement of quality of life. Furthermore, this method also has the advantage of being cost-effective. The previous experience in the benign biliary stenosis allowed the extension of using the metallic stents also for the treatment of benign colorectal diseases (diverticular occlusion, anastomotic strictures, colonic endometriosis). Complications of colon self-expandable metallic stents placement may occur during the procedure and soon after placement (early complications) or, rarely, late after insertion (late complications). These include bleeding, re-obstruction, pain, tenesmus, stent migration, and perforation. The authors report a case of an 81 year-old woman with inoperable rectal carcinoma with liver metastasis who underwent palliative treatment of self-expanding metallic stent endoscopic placement. One month later, the patient presented with acute abdomen at Accidents and Emergencies Department. The diagnosis was a late rectosigmoid junction perforation by stent placement.

The performance of the ileal conduit (Bricker's operation) is a well and minutely known surgical procedure (choice of a particular ileal loop; uretero-ileal anastomosis; uretero-cutaneostomy); however we can still observe several and different details in the operative technique management. The Authors, on the basis of their own experience of 55 cases, and after a complete review of the literature, emphasize the technical controversies of ileal loop urinary diversion; moreover they analyze the technic changes previously pointed out be several Authors, to avoid surgical complications. They conclude that the ileal conduit urinary diversion shall have less complication if: 1) the ileal loop is a short one, but with a very good blood supply; 2) antireflex techniques are not used; 3) Brooke's technique is used in performing uretero-cutaneostomy.

The role played by the surgical route on the immediate post-operative course has been studied on the basis of personal experience of thymectomy for myasthenia gravis (75 operated cases). Time of respiratory assistance, pleuropulmonary complications, operative mortality and recourse to trachetomy were evaluted in two homogenous groups of patients thymectomized cervically (group I: 36 cases) or trans-sternally (group II: 39 cases). It is was found that the average duration of respiratory assistance was significatly less in the first than in the second group (it was often not necessary at all), pleuropulmonary complications were halved, tracheotomy was never indicated and operative mortality was nil. The cervical approach thus offers enormous functional advantages and devers a leading place in surgery of the thymus; it would appear to be contraindicated only in the presence of radiologically evident thymomas and at times in cases where tracheotomy has been performed previously.