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Having reviewed the literature on this topic, the authors examined the "quality of life" of elderly patients undergoing surgery for gastric carcinoma over the past 5 years. From the results obtained it was seen that the most frequent operation was total gastrectomy (51.1%), followed by gastric resection (48.9%); it was therefore possible to assert that living patients were all well, with a score of 100 on Karnofsky's scale (22.40%), despite the high percentage of deaths during the period examined. The authors therefore concluded that, given that the "quality of life" of those undergoing surgery was satisfactory, it is worthwhile operating whenever possible to give geriatric patients the possibility of leading a normal life.

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Following a brief review of the literature on this topic, the paper analyses a series of geriatric undergoing surgery for cancer of the large intestine and controlled during follow-up over the past years. From the results obtained, the authors assessed the quality of life of these patients according to Masera and Esposito's classification, as a state of well-being, intermediate or illness: it was found that 78.7% were in a state of well-being, 10.3% were unchanged, 12.1% were in a state of illness, and only 6.9% had died. The authors therefore concluded that the quality of life in the majority of elderly patients undergoing surgery is good, thus encouraging surgeons to intervene.

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Following a review of the literature on this topic, the authors examine all patients with thyroid pathologies who were admitted to the 1st Institute of Surgical Pathology of the University of Pavia between 1-1-1974 and 31-12-1990. Only patients aged over 65 were included in the study and were subdivided into two groups, namely those aged between 65-74 (3rd age) and those over 75 (4th age). Particular attention was focused on the type of pathology (benign or malignant), other pathologies associated to the basic pathology, the type of operation performed and, in the case of malignant diseases, the histological type of tumour and any metastasis. The results of this series were then compared to those reported elsewhere. The Authors conclude that thyroid pathologies in geriatric patients are very important since, given that at this age the gland is becoming atrophic, the onset of disease often occurs before the age of 65 and symptoms in these patients are imprecise. In view of the good results obtained, it is always worth operating in order to give the patient a reasonable life expectancy, especially in those cases with collateral disorders (compression) caused by the thyroid mass.

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After reviewing the literature on this topic, the authors examine all patients admitted to the Institute of Surgical Pathology in Pavia with a diagnosis of intestinal occlusion from 1-1-1974 to 31-12-1990. Of these, only those aged over 65 were included in the study and were in turn subdivided into 3rd and 4th age groups. The etiopathogenesis of this disorder is also discussed, stressing that it may be non-neoplastic (Group I) or neoplastic (Group II). The treatment used is also examined (surgical in the majority of cases) together with postoperative complications occurring in these patients. From the results obtained it is concluded that the method used in the pre-, intra- and postoperative stages provided satisfactory results, also in relation to the postoperative mortality rate which relatively low compared to other published reports.

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Acute pathologies of the biliary tract in geriatric patients were examined in this study taking into account the major causes, treatment used and results obtained. All patients aged over 65 who had been hospitalised during the past 17 years for acute pathologies of the biliary tract (564 cases, equivalent to 34.2% of all in-patients suffering from acute biliary pathologies) were included in the study. These patients were then subdivided into 3rd and 4th age groups (65-74 and < 75 years respectively). The results obtained in the 3rd age group (267 patients, 60%) showed the greatest number of cases of inflammatory lithiasic disease of the cholecystus (61.2%) and VBP (17.7%), whereas 45 patients, equivalent to 49.5%, presented tumours with jaundice. Out of a total of 179 cases in patients in the 4th age group, equivalent to 39.3%, 119 (66.5%) were suffering from lithiasic cholecystitis and 16 (8.9%) from calcolosis of the VBP with jaundice. Cancer of the pancreas head was diagnosed in 27 patients (58.7%), whereas 9 (19.6%) had obstruent cancer of the biliary tract. The Authors conclude that both the preoperative preparation, the choice of operation and postoperative treatment give satisfactory results with a very low early mortality (0.8% in non-tumour cases and 6.9% in tumour cases).

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Following a review of the literature on the topic, the Authors examined all patients admitted to the Institute of Surgical Pathology 1st at the University of Pavia between 1-1-1974 and 31-12-1988 for hiatus hernia, paying special attention to those aged over 65. From an analysis of the results, it was possible to evaluate the influence of collateral pathologies and age-dependent biological changes on the basic disease and the outcome of the operation in elderly patients. In conclusion, this pathology, although not strictly confined to old age, affects a large number of elderly patients, particularly females. It rarely causes acute attacks and it is therefore possible to time the operation to coincide with the patient's best conditions. This is the reason for the excellent results achieved, whereas complications are not related to chronological age but above all to the biological age of the patient.

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After examining the various diagnostic methods used for gastric cancer, the paper analyses all geriatric patients affected by this disease and hospitalised in the Institute of Pathological Surgery at the University of Pavia between 1/1/1974 and 31/12/1986. The results obtained confirmed that: the subjective symptoms of the elderly patient affected by gastric cancer differ in a large number of cases from those in adults; in some cases, in fact, the disease is silent for long periods of time, whereas it is only slight in others; tests performed revealed neoplasia and possible metastases. In conclusion, although the symptomatology in elderly patients is not clear, some symptoms (weight loss, anemia, etc.) may give the doctor cause for concern. Diagnosis may be made using a variety of tests, ranging from the more commonplace (X-ray of the digestive tract, echography, gastroscopy with biopsy, etc.) to the most recent techniques (immunoscintigraphy).

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Following a review of the literature on the topic, the authors examined all patients admitted to the Institute of Surgical Pathology 1st at the University of Pavia between 1-1-1974 and 31-12-1988 affected by hernias of the abdominal wall or surgical laparoceles, paying special attention to those patients aged over 65. Attention was focused on concomitant diseases, the acuteness of the basic pathology and possible recurrence. From the results obtained it was concluded that the associated pathology and the acute state of the basic diseases condition the successful outcome of the operation more than age itself. For this reason, it is important that patients affected by these pathologies are operated as soon as possible in order to carry out an elective operation which reduces postoperative complications and reduces the risk of recurrence.

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After a review of the literature on the subject, all IIIrd and IVth age patients admitted for acute abdomen to the Department of Surgical Pathology I of the University of Pavia between 1-1-1974 and 31-12-1988 were studied. The various pathologies encountered in acute abdomen are considered on the basis of the results obtained, stress being laid on the clinical and diagnostic problems observed in these patients in relation to those of adult age. It is concluded that the study method used in the elderly gave good results with a mortality rate lower than that encountered in other studies on the subject.

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After a review of the literature a study was conducted into oesophageal cancers among elderly patients in Pavia University's Institute of Surgical Pathology in 1974-1985. The results led to the following conclusions: this disease occurs most often among the elderly especially those in their sixties; symptoms (dysphagia, weight loss, regurgitation with epigastric and retrosternal pain are initially unclear which makes early diagnosis difficult; most cases require surgery. It is concluded that the appropriate tests should be performed at the first warning signs and that, once the condition is diagnosed, the elderly patient should be prepared for surgery which should be as radical as possible.

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After examining the literature on the subject, all patients aged over 60 and admitted to the Surgical Pathology Department of Pavia University from 1-1-1974 to 31-12-1985, suffering from gastric carcinoma have been considered. From the results obtained it is concluded that stomach cancer is a disease that preferentially affects the IIIrd age, usually occurring with atypical symptomatology that leads the patient to underestimate the seriousness of the disease, and impeding early diagnosis that would be effective for therapeutic purposes. It is therefore essential for the necessary examination to be carried out at the first warning symptoms. Further, the general state of these patients has to be controlled and appropriate treatment sought to treat the various accompanying conditions and so prepare the patient for operation.

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After examining the literature on the subject, all patients of the IIIrd age suffering from non-neoplastic pathology of the pancreas are considered. The results show that this pathology contains more acute pancreatitis and fewer chronic pancreatitis (at times a consequence of the acute) cases. Pancreatic cyst was also noted. The age most affected by this pathology is the 6th decade and the average age encountered in the series was 60, as is also stated by Camatte and Sarles. It is concluded that the above-mentioned conditions that affect the 6th decade and specially the 60th year of life may be held to involve the IIIrd age.

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The Authors, after having reviewed all the literature on this topic, have studied all patients over 60 which were admitted with a diagnosis of peptic ulcer disease at the Institute of Surgical Pathology of the University of Pavia from January 1, 1974 until December 31, 1985. They noted, from their results, that this disease shows a predilection for adults, but is also frequently found in the elderly. In fact, in the latter, during this period of life, the complications which are most frequently observed (especially gastric) are hemorrhage and perforation; according to the Authors the former is due to arteriosclerosis which hinders vascular contraction, while the latter to a reduction of blood flow due to endarteritis, which causes necrosis of the ulcer's base, creating therefore a "locus minoris resistentiae". The Authors conclude that in the elderly, when drug therapy is inefficient, a surgical approach is necessary. In fact, with a well followed pre-operative care program the outcome of surgery is usually satisfactory and complications (mentioned above), which would render surgery and the post-operative period difficult, are prevented.

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A case of small bowel lipoma with few evident symptoms is reported. Radiological diagnosis was confirmed at surgery. The comparative rarity of this type of benign intestinal neoformation is pointed out.

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The Authors after having paid considerable attention on the contemporary existence of numerous carcinoid tumours of the intestine and of other abdominal organs, as well as on the frequent multicentricity exhibited by the very same at the level of the last tract of the ileum, explain this by considering the recent research performed on the APUD cells and on the cells of the diffuse endocrine system (DES) of the intestine. They present a carcinoid case, where it is understood that the product of secretion of the same, still not completely identified in its structure and mode of action, produces an arterial vascular alteration even at considerable distance from the tumour, hence bringing about an intestinal ischemic symptomatology which they hypothesize is the case for all the cells of the intestinal diffuse endocrine system, a type of self-regulatory feed-back hormonal system.

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