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The chapter aims to trace a state-of-the-art development of the corporate social responsibility and sustainability debate and practices in Albania, a post-communist country that, in the last few decades, has made drastic political and economic changes. Rapid urbanisation, higher economic activity and population growth place multiple pressures on environmental and social problems. In the last decade, to create an enabling environment for the promotion of CSR, the Albanian government—with the leadership of the Ministry of Economy, Trade and Energy (METE) and the support of UNDP—has developed a National Action Plan for CSR. Currently, the implementation process of CSR policies by the Albanian government seems to be accelerating due to the EU accession process since CSR is one of the vehicles for putting Albania in a better position concerning European business partners and creating a competitive advantage with a high CSR performance over other Balkan states. Starting from these premises, the first chapter introduces a literature review aimed to point out the institutional factors that influence CSR diffusion and identify the gaps that should be filled in order to improve the knowledge of CSR in Albania. Secondly, the work addresses the practical implementation of CSR, focusing on some cases relative to both large and small-sized enterprises, in order to point out the barriers faced and evaluate the potentials of the top-down and/or bottom-up approaches adopted by Albanian companies.

The chapter aims to trace a state-of-the-art development of the corporate social responsibility and sustainability debate and practices in Albania, a post-communist country that, in the last few decades, has made drastic political and economic changes. Rapid urbanisation, higher economic activity and population growth place multiple pressures on environmental and social problems. In the last decade, to create an enabling environment for the promotion of CSR, the Albanian government—with the leadership of the Ministry of Economy, Trade and Energy (METE) and the support of UNDP—has developed a National Action Plan for CSR. Currently, the implementation process of CSR policies by the Albanian government seems to be accelerating due to the EU accession process, creating a competitive advantage with a high CSR performance over other Balkan states.

Il saggio è frutto del lavoro da un gruppo di docenti costituito in seno alla SIDREA (Società Italiana Docenti di Ragioneria e di Economia Aziendale) con lo scopo di analizzare e valutare le eventuali nuove prospettive di studio della disciplina economico-aziendale.

To the Editor, We thank Hompes et al. for their comments on and for the interesting questions that have been raised about our article [1]. In the literature few topics are as confusing as local excision for the treatment of rectal cancer. In fact, the term ‘‘local excision’’ includes different exeresis techniques with respect to the tumor-free mucosa margins, the depth of excision into the rectal wall, and the extent of perirectal fat removal. In order to avoid performing different treatments, we have standardized the operation, as described in our article. In our opinion, the extent of tissue removal is the main technical factor in improving the results. Therefore, our results cannot be compared with those reported by Stipa and Bach [2, 3] for several reasons. Stipa et al. [2] reported the results of a nonextended resection. The multi-institutional study by Bach et al. [3] has the following biases: (1) Surprisingly, one third of the patients were preoperatively diagnosed as benign; (2) R1 excision occurred in pT1 and pT2 in 9.9 and 21.7%, respectively; (3) a full-thickness excision was performed in only 80% of pT1-2 patients; (4) international criteria for local excision were not observed in more than 70% of cases. Moreover, on average each center enrolled only 23 patients. The first question raised by Hompes et al. is about the 6.6% wound dehiscence rate reported in our study, which is substantially different from the result of Marks et al. [4] of 25.6% in the irradiated group and 0% in the nonirradiated group. Indeed, in that paper the two groups were not comparable in terms of staging. In the nonirradiated group only uT0-1 were included, while the irradiated group included mostly uT2-3 rectal tumors. Consequently, it is reasonable to speculate that patients underwent a different extent of local excision in the series by Marks et al. Again, we are strongly convinced that the favorable results of their series are related to the different surgical technique used. The key point is a wide dissection and mobilization at the level of the perirectal fascia of the cranial margin in order to facilitate tissue approximation and to avoid tension on the suture line. Furthermore, the lower suture line dehiscence rate in our series may be related to a different followup protocol. Marks et al. performed a routine follow-up study 2 and 6 weeks after surgery, including digital rectal examination and endoscopy. Instead, our protocol included follow-up endoscopy in all patients 3 months after surgery. In the early postoperative period only patients with clinical symptoms (i.e., fever, pain) underwent endoscopy. This policy is aimed at avoiding iatrogenic suture line dehiscence possibly induced by scope introduction or excess gas insufflation. Marks et al. describe and treat all wound dehiscence, including the subclinical ones, whereas we describe and cure only patients with clinical symptoms due to a partially leaking suture. If our series underestimates the suture line dehiscence rate, it is also true that not all suture line dehiscence after transanal endoscopic microsurgery (TEM) are clinically relevant and require treatment. In this respect, it is interesting to note that in the Marks et al. series [4] only one patient with suture line dehiscence required a temporary stoma. The second question posed by Hompes et al. focused on the postoperative strategy in case of pathological lymph G. Lezoche (&) Clinica di Chirurgia Generale e Metodologia Chirurgica, Ospedali Riuniti, Universita Politecnica delle Marche, Via Conca 1, Ancona 60121, Italy e-mail: lezoche@me.com