1
|
Beomonte Zobel L, Dhimolea S, Billeci F, Sbraccia P, Sica GS. Laparoscopic Sleeve Gastrectomy with Staple-Line Oversewing in a Patient with Factor XI Deficiency: A Case Report. Am J Case Rep 2024; 25:e942824. [PMID: 38654503 DOI: 10.12659/ajcr.942824] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/26/2024]
Abstract
BACKGROUND Bariatric surgery (BS) has a lower percentage of complications than other abdominal surgeries. Hemorrhage in one of the most common complications and can be life-threatening. Hereditary factor XI (FXI) deficiency is a coagulation disorder that can result in excessive bleeding requiring intervention to restore hemostasis. Risks over benefits in patients with morbid obesity with BS indication, as well as those with FXI deficiency, should be carefully evaluated. This article reports the case of an obese woman with FXI deficiency -undergoing SG. CASE REPORT A 49-year-old woman with a BMI of 51 kg/m² was diagnosed as having severe FXI deficiency during preoperative exams prior to bariatric surgery. Virus-inactivated homo-group plasma 10 ml/kg infusion was administrated 1 h before surgery, during the entire procedure, and continuing until postoperative day (POD) 4. A very low-calorie ketogenic diet (VLCKD) was proposed to the patient 4 weeks before surgery. Laparoscopic sleeve gastrectomy was performed with staple-line reinforcement by oversewing the seromuscular layer using continuous suture. Subcutaneous enoxaparin 4000 U.I. was administered from POD 1 until POD 25 to prevent any thromboembolic event. The patient was discharged on POD 5 in good clinical condition. CONCLUSIONS Risks of bleeding andor thromboembolic events before or after BS are increased in patient with FXI deficiency. Bariatric surgery in these patients is safe in experienced BS centers, and the risks associated with the obesity seem to exceed those of the coagulopathy and surgery. Careful preoperative counseling, extensive hematological checks, and meticulous surgery are essential to reduce BS risks. Sleeve gastrectomy oversewing the stapler line seems a reasonable choice.
Collapse
Affiliation(s)
- Lorenza Beomonte Zobel
- Minimally Invasive Unit, Department of Surgical Science, University and Policlinico Tor Vergata, Rome, Italy
| | - Sirvjo Dhimolea
- Minimally Invasive Unit, Department of Surgical Science, University and Policlinico Tor Vergata, Rome, Italy
| | - Federica Billeci
- Minimally Invasive Unit, Department of Surgical Science, University and Policlinico Tor Vergata, Rome, Italy
| | - Paolo Sbraccia
- Internal Medicine Unit and Obesity Center, Department of Systems Medicine, University and Policlinico Tor Vergata, Rome, Italy
| | - Giuseppe S Sica
- Minimally Invasive Unit, Department of Surgical Science, University and Policlinico Tor Vergata, Rome, Italy
| |
Collapse
|
2
|
Degiuli M, Aguilar AHR, Solej M, Azzolina D, Marchiori G, Corcione F, Bracale U, Peltrini R, Di Nuzzo MM, Baldazzi G, Cassini D, Sica GS, Pirozzi B, Muratore A, Calabrò M, Jovine E, Lombardi R, Anania G, Chiozza M, Petz W, Pizzini P, Persiani R, Biondi A, Reddavid R. A Randomized Phase III Trial of Complete Mesocolic Excision Compared with Conventional Surgery for Right Colon Cancer: Interim Analysis of a Nationwide Multicenter Study of the Italian Society of Surgical Oncology Colorectal Cancer Network (CoME-in trial). Ann Surg Oncol 2024; 31:1671-1680. [PMID: 38087139 PMCID: PMC10838239 DOI: 10.1245/s10434-023-14664-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2023] [Accepted: 11/12/2023] [Indexed: 02/06/2024]
Abstract
BACKGROUND Although complete mesocolic excision (CME) is supposed to be associated with a higher lymph node (LN) yield, decreased local recurrence, and survival improvement, its implementation currently is debated because the evidence level of these data is rather low and still not supported by randomized controlled trials. METHOD This is a multicenter, randomized, superiority trial (NCT04871399). The 3-year disease-free survival (DFS) was the primary end point of the study. The secondary end points were safety (duration of operation, perioperative complications, hospital length of stay), oncologic outcomes (number of LNs retrieved, 3- and 5-year overall survival, 5-year DFS), and surgery quality (specimen length, area and integrity rate of mesentery, length of ileocolic and middle-colic vessels). The trial design required the LN yield to be higher in the CME group at interim analysis. RESULTS Interim data analysis is presented in this report. The study enrolled 258 patients in nine referral centers. The number of LNs retrieved was significantly higher after CME (25 vs. 20; p = 0.012). No differences were observed with respect to intra- or post-operative complications, postoperative mortality, or duration of surgery. The hospital stay was even shorter after CME (p = 0.039). Quality of surgery indicators were higher in the CME arm of the study. Survival data still were not available. CONCLUSIONS Interim data show that CME for right colon cancer in referral centers is safe and feasible and does not increase perioperative complications. The study documented with evidence that quality of surgery and LN yield are higher after CME, and this is essential for continuation of patient recruitment and implementation of an optimal comparison. Trial registration The trial was registered at ClinicalTrials.gov with the code NCT04871399 and with the acronym CoME-In trial.
Collapse
Affiliation(s)
- Maurizio Degiuli
- Division of Surgical Oncology and Digestive Surgery, Department of Oncology, San Luigi University Hospital, University of Turin, Orbassano (Turin), Italy
| | - Aridai H Resendiz Aguilar
- Division of Surgical Oncology and Digestive Surgery, Department of Oncology, San Luigi University Hospital, University of Turin, Orbassano (Turin), Italy
| | - Mario Solej
- Division of Surgical Oncology and Digestive Surgery, Department of Oncology, San Luigi University Hospital, University of Turin, Orbassano (Turin), Italy
| | - Danila Azzolina
- Department of Environmental and Preventive Sciences, University of Ferrara, Via Fossato di Mortara, Ferrara, Italy
| | - Giulia Marchiori
- Department of Surgical Sciences, University of Turin, Turin, Italy
| | - Francesco Corcione
- Chirurgia Oncologica e Miniinvasiva Clinica Mediterranea Napoli, University of Naples Federico II, Naples, Italy
| | - Umberto Bracale
- Minimally Invasive, General and Oncologic Surgery Unit, University Federico II of Naples, Naples, Italy
| | - Roberto Peltrini
- Minimally Invasive, General and Oncologic Surgery Unit, University Federico II of Naples, Naples, Italy
| | - Maria M Di Nuzzo
- Minimally Invasive, General and Oncologic Surgery Unit, University Federico II of Naples, Naples, Italy
| | | | - Diletta Cassini
- ASST Ovest Milanese, P.O. Nuovo Ospedale di Legnano, Legnano, Italy
| | - Giuseppe S Sica
- Minimally Invasive and Gastrointestinal Surgery Unit, Università e Policlinico Tor Vergata, Rome, Italy
| | - Brunella Pirozzi
- Minimally Invasive and Gastrointestinal Surgery Unit, Università e Policlinico Tor Vergata, Rome, Italy
| | - Andrea Muratore
- Surgical Department, Edoardo Agnelli Hospital, Pinerolo, Italy
| | | | - Elio Jovine
- IRCCS AOU of Bologna, University of Bologna, Bologna, Italy
| | | | - Gabriele Anania
- Dipartimento Scienze Mediche, Università di Ferrara, Ferrara, Italy
| | - Matteo Chiozza
- Dipartimento Scienze Mediche, Università di Ferrara, Ferrara, Italy
| | - Wanda Petz
- Digestive Surgery, European Institute of Oncology-IRCCS, Milan, Italy
| | - Paolo Pizzini
- Digestive Surgery, European Institute of Oncology-IRCCS, Milan, Italy
| | - Roberto Persiani
- Fondazione Policlinico Universitario A. Gemelli IRCCS, Università Cattolica del Sacro Cuore, Rome, Italy
| | - Alberto Biondi
- Fondazione Policlinico Universitario A. Gemelli IRCCS, Università Cattolica del Sacro Cuore, Rome, Italy
| | - Rossella Reddavid
- Division of Surgical Oncology and Digestive Surgery, Department of Oncology, San Luigi University Hospital, University of Turin, Orbassano (Turin), Italy.
| |
Collapse
|
3
|
Degiuli M, Azzolina D, Corcione F, Bracale U, Peltrini R, Baldazzi G, Sica GS, Muratore A, Jovine E, Anania G, Borin S, Persiani R, Reddavid R. ASO Author Reflections: Complete Mesocolic Excision Versus Conventional Surgery for Right Colon Cancer (CoME-in trial): An Interim Analysis of a Multicenter, Randomized, Controlled Trial. Ann Surg Oncol 2024; 31:1694-1695. [PMID: 38087137 DOI: 10.1245/s10434-023-14771-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/20/2023] [Accepted: 11/25/2023] [Indexed: 02/08/2024]
Affiliation(s)
- M Degiuli
- Department of Oncology, University of Turin, Torino, Italy
- Department of Oncology, San Luigi Gonzaga University Hospital, Orbassano, Italy
| | - D Azzolina
- Department of Environmental and Preventive Sciences, University of Ferrara, Ferrara, Italy
| | - F Corcione
- Department of General and Oncological Minimally Invasive Surgery, University of Naples Federico II, Naples, Italy
| | - U Bracale
- Department of General and Oncological Minimally Invasive Surgery, University of Naples Federico II, Naples, Italy
| | - R Peltrini
- Department of General and Oncological Minimally Invasive Surgery, University of Naples Federico II, Naples, Italy
| | - G Baldazzi
- ASST OVEST MILANESE, P.O. Nuovo Ospedale di Legnano, Legnano, Italy
| | - G S Sica
- Minimally Invasive and Gastrointestinal Surgery Unit, Università e Policlinico Tor Vergata, Rome, Italy
| | - A Muratore
- Edoardo Agnelli Hospital of Pinerolo, Pinerolo, Italy
| | - E Jovine
- University of Bologna, IRCCS AOU of Bologna, Bologna, Italy
| | - G Anania
- Departement of Medical Science, Faculty of Medicine Pharmacy and Prevention, University of Ferrara, Ferrara, Italy
| | - S Borin
- Digestive Surgery European Institute of Oncology - IRCCS, Milan, Italy
| | - R Persiani
- General Surgery Unit, Fondazione Policlinico Universitario Agostino Gemelli, Catholic University, Rome, Italy
| | - R Reddavid
- Department of Oncology, University of Turin, Torino, Italy.
- Department of Oncology, San Luigi Gonzaga University Hospital, Orbassano, Italy.
| |
Collapse
|
4
|
Degiuli M, Aguilar HAR, Solej M, Azzolina D, Marchiori G, Corcione F, Bracale U, Peltrini R, Di Nuzzo MM, Baldazzi G, Cassini D, Sica GS, Pirozzi B, Muratore A, Calabrò M, Jovine E, Lombardi R, Anania G, Chiozza M, Petz W, Pizzini P, Persiani R, Biondi A, Reddavid R. ASO Visual Abstract: A Randomized Phase III Trial of Complete Mesocolic Excision in Comparison with Conventional Surgery for Right Colon Cancer: Interim Analysis of a Nationwide Multicenter Study of the Italian Society of Surgical Oncology Colorectal Cancer Network (CoME-In Trial). Ann Surg Oncol 2024; 31:1700-1701. [PMID: 38198001 DOI: 10.1245/s10434-023-14794-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/11/2024]
Affiliation(s)
- M Degiuli
- Division of Surgical Oncology and Digestive Surgery, Department of Oncology, San Luigi University Hospital, University of Turin, Orbassano, Italy
| | - H A Resendiz Aguilar
- Division of Surgical Oncology and Digestive Surgery, Department of Oncology, San Luigi University Hospital, University of Turin, Orbassano, Italy
| | - M Solej
- Division of Surgical Oncology and Digestive Surgery, Department of Oncology, San Luigi University Hospital, University of Turin, Orbassano, Italy
| | - D Azzolina
- Department of Environmental and Preventive Sciences, University of Ferrara, Ferrara, Italy
| | - G Marchiori
- Department of Surgical Sciences, University of Turin, Turin, Italy
| | - F Corcione
- Minimally Invasive, General and Oncologic Surgery Unit, University Federico II of Naples, Naples, Italy
| | - U Bracale
- Minimally Invasive, General and Oncologic Surgery Unit, University Federico II of Naples, Naples, Italy
| | - R Peltrini
- Minimally Invasive, General and Oncologic Surgery Unit, University Federico II of Naples, Naples, Italy
| | - M M Di Nuzzo
- Minimally Invasive, General and Oncologic Surgery Unit, University Federico II of Naples, Naples, Italy
| | - G Baldazzi
- ASST Ovest Milanese, P.O. Nuovo Ospedale di Legnano, Legnano, Italy
| | - D Cassini
- ASST Ovest Milanese, P.O. Nuovo Ospedale di Legnano, Legnano, Italy
| | - G S Sica
- Minimally Invasive and Gastrointestinal Surgery Unit, Università e Policlinico Tor Vergata, Rome, Italy
| | - B Pirozzi
- Minimally Invasive and Gastrointestinal Surgery Unit, Università e Policlinico Tor Vergata, Rome, Italy
| | - A Muratore
- Surgical Department, Edoardo Agnelli Hospital, Pinerolo, Italy
| | - M Calabrò
- Surgical Department, Edoardo Agnelli Hospital, Pinerolo, Italy
| | - E Jovine
- IRCCS Azienda Ospedaliero Universitaria di Bologna, Bologna, Italy
| | - R Lombardi
- IRCCS Azienda Ospedaliero Universitaria di Bologna, Bologna, Italy
| | - G Anania
- Dipartimento Scienze Mediche, Università di Ferrara, Ferrara, Italy
| | - M Chiozza
- Dipartimento Scienze Mediche, Università di Ferrara, Ferrara, Italy
| | - W Petz
- Digestive Surgery European Institute of Oncology IRCCS, Milan, Italy
| | - P Pizzini
- Digestive Surgery European Institute of Oncology IRCCS, Milan, Italy
| | - R Persiani
- Fondazione Policlinico Universitario A. Gemelli IRCCS, Università Cattolica del Sacro Cuore, Rome, Italy
| | - A Biondi
- Fondazione Policlinico Universitario A. Gemelli IRCCS, Università Cattolica del Sacro Cuore, Rome, Italy
| | - R Reddavid
- Division of Surgical Oncology and Digestive Surgery, Department of Oncology, San Luigi University Hospital, University of Turin, Orbassano, Italy.
| |
Collapse
|
5
|
Chang TP, Ali O, Tsimogiannis K, Sica GS, Khan JS. Robotic Lateral Pelvic Lymph Node Dissection in Rectal Cancer: A Feasibility Study from a European Centre. J Clin Med 2023; 13:90. [PMID: 38202097 PMCID: PMC10779823 DOI: 10.3390/jcm13010090] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/22/2023] [Revised: 12/17/2023] [Accepted: 12/18/2023] [Indexed: 01/12/2024] Open
Abstract
INTRODUCTION The role of robotic lateral pelvic lymph node dissection (LPLND) for lateral pelvic nodal disease (LPND) in rectal cancer has yet to be investigated in the Western hemisphere. This study aims to investigate the safety and feasibility of robotic LPLND by utilising a well-established totally robotic TME protocol. METHODS We conducted a retrospective study on 17 consecutive patients who underwent robotic LPLND for LPND ± TME for rectal cancer between 2015 and 2021. A single docking totally robotic approach from the left hip with full splenic mobilisation was performed using the X/Xi da Vinci platform. All patients underwent a tri-compartmental robotic en bloc excision of LPND with preservation of the obturator nerve and pelvic nerve plexus, leaving a well-skeletonised internal iliac vessel and its branches. RESULTS The median operative time was 280 min, which was 40 min longer than our standard robotic TME. The median BMI was 26, and there were no conversions. The median inpatient stay was 7 days with no Clavien-Dindo > 3 complications. One patient (6%) developed local recurrence and metastatic disease within 5 months. The proportion of histologically confirmed LPND was 41%, of which 94% were well to moderately differentiated adenocarcinoma. Median pre-operative lateral pelvic node size was significantly higher in positive nodes (14 mm vs. 8 mm (p = 0.01)). All patients had clear resection margins on histology. DISCUSSION Robotic LPLND is safe and feasible with good peri-operative and short-term outcomes, with the ergonomic advantages of a robotic TME docking protocol readily transferrable in LPLND.
Collapse
Affiliation(s)
- Tou Pin Chang
- Epsom and St. Helier University Hospitals NHS Trust, Carshalton SM5 1AA, UK;
| | - Oroog Ali
- Gateshead Health NHS Foundation Trust, Gateshead NE9 6SX, UK;
| | - Kostas Tsimogiannis
- Department of Colorectal Surgery, Victory Institute of Minimal Access Surgery, Queen Alexandra Hospital, Portsmouth Hospitals University NHS Trust, Portsmouth PO6 3LY, UK;
| | - Giuseppe S. Sica
- Department of Surgery, Minimally Invasive Unit, Università degli Studi di Roma, Tor Vergata Hospital, Viale Oxford 81, 00133 Rome, Italy;
| | - Jim S. Khan
- Department of Colorectal Surgery, Victory Institute of Minimal Access Surgery, Queen Alexandra Hospital, Portsmouth Hospitals University NHS Trust, Portsmouth PO6 3LY, UK;
| |
Collapse
|
6
|
Sica GS, Sensi B, Siragusa L, Blasi F, Crispino B, Pirozzi B, Angelico R, Biancone L, Khan J. Surgical management of colon cancer in ulcerative colitis patients with orthotopic liver transplant for primary sclerosing cholangitis. A systematic review. Eur J Surg Oncol 2023; 49:106922. [PMID: 37210276 DOI: 10.1016/j.ejso.2023.04.021] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/30/2022] [Revised: 03/13/2023] [Accepted: 04/27/2023] [Indexed: 05/22/2023]
Abstract
INTRODUCTION Colon cancer in ulcerative colitis patients with liver transplant (UCCOLT) due to primary sclerosing cholangitis carries significant treatment challenges. Aim of this literature search is to review management strategies and provide a framework to facilitate the decisional process in this clinical setting. METHODS PRISMA-compliant systematic search was followed by critical expert commentary of the results and development of a surgical management algorithm. Endpoints included surgical management, operative strategies, functional and survival outcomes. Technical and strategics aspects with particular regard to the choice of reconstruction were evaluated to tentatively develop an integrated algorithm. RESULTS Ten studies reporting treatment of 20 UCCOLT patients were identified after screening. Nine patients underwent proctocolectomy and end-ileostomy (PC) and eleven had restorative ileal pouch-anal anastomosis (IPAA). Reported results for perioperative outcomes, oncological outcomes, and graft loss were comparable for both procedures. There were no reports of subtotal colectomies and ileo-rectal anastomosis (IRA). CONCLUSIONS Literature in the field is scarce and decision-making is particularly complex. PC and IPAA have been reported with good results. Nevertheless, IRA may also be considered in UCCOLT patients in selected cases, reducing the risks of sepsis, OLT and pouch failure; furthermore, in young patients, it has the advantage of preserving fertility or sexual function. The proposed treatment algorithm may represent a valuable support in guiding surgical strategy.
Collapse
Affiliation(s)
- G S Sica
- Department of Surgical Science, University of Rome Tor Vergata, Rome, Italy.
| | - B Sensi
- Department of Surgical Science, University of Rome Tor Vergata, Rome, Italy
| | - L Siragusa
- Department of Surgical Science, University of Rome Tor Vergata, Rome, Italy
| | - F Blasi
- Department of Surgical Science, University of Rome Tor Vergata, Rome, Italy
| | - B Crispino
- Department of Surgical Science, University of Rome Tor Vergata, Rome, Italy
| | - B Pirozzi
- Department of Surgical Science, University of Rome Tor Vergata, Rome, Italy
| | - R Angelico
- Department of Surgical Science, University of Rome Tor Vergata, Rome, Italy
| | - L Biancone
- Department of Systems Medicine, University of Rome Tor Vergata, Rome, Italy
| | - J Khan
- Portsmouth Hospitals, NHS Trust, Portsmouth, UK
| |
Collapse
|
7
|
Neri B, Mancone R, Savino L, Schiavone S, Formica V, Pizzi F, Salvatori S, Mossa M, Migliozzi S, Fiorillo M, Morelli C, Moscardelli A, Lolli E, Calabrese E, Sica GS, Monteleone G, Biancone L. Mucinous and Signet-Ring Cell Colonic Adenocarcinoma in Inflammatory Bowel Disease: A Case-Control Study. Cancers (Basel) 2023; 15:3803. [PMID: 37568619 PMCID: PMC10417294 DOI: 10.3390/cancers15153803] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2023] [Revised: 07/18/2023] [Accepted: 07/25/2023] [Indexed: 08/13/2023] Open
Abstract
A higher frequency of mucinous and signet-ring cell colonic adenocarcinoma has been reported in inflammatory bowel disease (IBD). The primary aim was to investigate the frequency of mucinous and signet-ring cell colorectal adenocarcinoma in patients with IBD (Cases) versus age-matched non-IBD Controls. The secondary aims were to compare the characteristics of these two histotypes of colorectal cancer (CRC) in IBD patients vs. Controls and to search for specific risk factors in IBD. In a case-control study, all IBD patients with CRC diagnosed from 2000 to 2022 were enrolled and matched for age (1:2) with non-IBD Controls with CRC. The study population included 120 CRC patients (40 IBD, 80 Controls). In IBD, CRC included standard adenocarcinoma in 23 (57.5%) patients mucinous/signet-ring cell adenocarcinoma in 17 (42.5%) patients. The proportion of mucinous/signet-ring cell adenocarcinoma was higher in IBD than in Controls (17 [42.5%] vs. 18 [22.5%]; p = 0.03). In rectal CRC, the proportion of mucinous/signet-ring cell adenocarcinoma was higher than standard adenocarcinoma in IBD (8 [47.1%] vs. 4 [17.4%]; p = 0.04) but not in Controls (4 [22.2%] vs. 20 [32.2%]; p = 0.59). In rectal CRC, the proportion of these two histotypes was higher in Cases than in Controls (8/12 [66.6%] vs. 4/24 [16.6%]; p = 0.008), with no risk factors identified in IBD. CRC was more frequently represented by mucinous/signet-ring cell adenocarcinoma in IBD than in age-matched non-IBD Controls. In IBD, these two CRC histotypes were more frequent in the rectum.
Collapse
Affiliation(s)
- Benedetto Neri
- Gastroenterology Unit, Department of Systems Medicine, University “Tor Vergata” of Rome, 00133 Roma, Italy; (B.N.); (R.M.); (S.S.); (F.P.); (S.S.); (M.M.); (S.M.); (M.F.); (A.M.); (E.L.); (E.C.); (G.M.)
| | - Roberto Mancone
- Gastroenterology Unit, Department of Systems Medicine, University “Tor Vergata” of Rome, 00133 Roma, Italy; (B.N.); (R.M.); (S.S.); (F.P.); (S.S.); (M.M.); (S.M.); (M.F.); (A.M.); (E.L.); (E.C.); (G.M.)
| | - Luca Savino
- Pathology Unit, Department of Biomedicine and Prevention, University “Tor Vergata” of Rome, 00133 Roma, Italy;
| | - Sara Schiavone
- Gastroenterology Unit, Department of Systems Medicine, University “Tor Vergata” of Rome, 00133 Roma, Italy; (B.N.); (R.M.); (S.S.); (F.P.); (S.S.); (M.M.); (S.M.); (M.F.); (A.M.); (E.L.); (E.C.); (G.M.)
| | - Vincenzo Formica
- Medical Oncology Unit, Department of Systems Medicine, University “Tor Vergata” of Rome, 00133 Roma, Italy; (V.F.); (C.M.)
| | - Francesca Pizzi
- Gastroenterology Unit, Department of Systems Medicine, University “Tor Vergata” of Rome, 00133 Roma, Italy; (B.N.); (R.M.); (S.S.); (F.P.); (S.S.); (M.M.); (S.M.); (M.F.); (A.M.); (E.L.); (E.C.); (G.M.)
| | - Silvia Salvatori
- Gastroenterology Unit, Department of Systems Medicine, University “Tor Vergata” of Rome, 00133 Roma, Italy; (B.N.); (R.M.); (S.S.); (F.P.); (S.S.); (M.M.); (S.M.); (M.F.); (A.M.); (E.L.); (E.C.); (G.M.)
| | - Michelangela Mossa
- Gastroenterology Unit, Department of Systems Medicine, University “Tor Vergata” of Rome, 00133 Roma, Italy; (B.N.); (R.M.); (S.S.); (F.P.); (S.S.); (M.M.); (S.M.); (M.F.); (A.M.); (E.L.); (E.C.); (G.M.)
| | - Stefano Migliozzi
- Gastroenterology Unit, Department of Systems Medicine, University “Tor Vergata” of Rome, 00133 Roma, Italy; (B.N.); (R.M.); (S.S.); (F.P.); (S.S.); (M.M.); (S.M.); (M.F.); (A.M.); (E.L.); (E.C.); (G.M.)
| | - Mariasofia Fiorillo
- Gastroenterology Unit, Department of Systems Medicine, University “Tor Vergata” of Rome, 00133 Roma, Italy; (B.N.); (R.M.); (S.S.); (F.P.); (S.S.); (M.M.); (S.M.); (M.F.); (A.M.); (E.L.); (E.C.); (G.M.)
| | - Cristina Morelli
- Medical Oncology Unit, Department of Systems Medicine, University “Tor Vergata” of Rome, 00133 Roma, Italy; (V.F.); (C.M.)
| | - Alessandro Moscardelli
- Gastroenterology Unit, Department of Systems Medicine, University “Tor Vergata” of Rome, 00133 Roma, Italy; (B.N.); (R.M.); (S.S.); (F.P.); (S.S.); (M.M.); (S.M.); (M.F.); (A.M.); (E.L.); (E.C.); (G.M.)
| | - Elisabetta Lolli
- Gastroenterology Unit, Department of Systems Medicine, University “Tor Vergata” of Rome, 00133 Roma, Italy; (B.N.); (R.M.); (S.S.); (F.P.); (S.S.); (M.M.); (S.M.); (M.F.); (A.M.); (E.L.); (E.C.); (G.M.)
| | - Emma Calabrese
- Gastroenterology Unit, Department of Systems Medicine, University “Tor Vergata” of Rome, 00133 Roma, Italy; (B.N.); (R.M.); (S.S.); (F.P.); (S.S.); (M.M.); (S.M.); (M.F.); (A.M.); (E.L.); (E.C.); (G.M.)
| | - Giuseppe S. Sica
- Department of Surgery, University “Tor Vergata” of Rome, 00133 Roma, Italy;
| | - Giovanni Monteleone
- Gastroenterology Unit, Department of Systems Medicine, University “Tor Vergata” of Rome, 00133 Roma, Italy; (B.N.); (R.M.); (S.S.); (F.P.); (S.S.); (M.M.); (S.M.); (M.F.); (A.M.); (E.L.); (E.C.); (G.M.)
| | - Livia Biancone
- Gastroenterology Unit, Department of Systems Medicine, University “Tor Vergata” of Rome, 00133 Roma, Italy; (B.N.); (R.M.); (S.S.); (F.P.); (S.S.); (M.M.); (S.M.); (M.F.); (A.M.); (E.L.); (E.C.); (G.M.)
| |
Collapse
|
8
|
Vitale I, Pietrocola F, Guilbaud E, Aaronson SA, Abrams JM, Adam D, Agostini M, Agostinis P, Alnemri ES, Altucci L, Amelio I, Andrews DW, Aqeilan RI, Arama E, Baehrecke EH, Balachandran S, Bano D, Barlev NA, Bartek J, Bazan NG, Becker C, Bernassola F, Bertrand MJM, Bianchi ME, Blagosklonny MV, Blander JM, Blandino G, Blomgren K, Borner C, Bortner CD, Bove P, Boya P, Brenner C, Broz P, Brunner T, Damgaard RB, Calin GA, Campanella M, Candi E, Carbone M, Carmona-Gutierrez D, Cecconi F, Chan FKM, Chen GQ, Chen Q, Chen YH, Cheng EH, Chipuk JE, Cidlowski JA, Ciechanover A, Ciliberto G, Conrad M, Cubillos-Ruiz JR, Czabotar PE, D'Angiolella V, Daugaard M, Dawson TM, Dawson VL, De Maria R, De Strooper B, Debatin KM, Deberardinis RJ, Degterev A, Del Sal G, Deshmukh M, Di Virgilio F, Diederich M, Dixon SJ, Dynlacht BD, El-Deiry WS, Elrod JW, Engeland K, Fimia GM, Galassi C, Ganini C, Garcia-Saez AJ, Garg AD, Garrido C, Gavathiotis E, Gerlic M, Ghosh S, Green DR, Greene LA, Gronemeyer H, Häcker G, Hajnóczky G, Hardwick JM, Haupt Y, He S, Heery DM, Hengartner MO, Hetz C, Hildeman DA, Ichijo H, Inoue S, Jäättelä M, Janic A, Joseph B, Jost PJ, Kanneganti TD, Karin M, Kashkar H, Kaufmann T, Kelly GL, Kepp O, Kimchi A, Kitsis RN, Klionsky DJ, Kluck R, Krysko DV, Kulms D, Kumar S, Lavandero S, Lavrik IN, Lemasters JJ, Liccardi G, Linkermann A, Lipton SA, Lockshin RA, López-Otín C, Luedde T, MacFarlane M, Madeo F, Malorni W, Manic G, Mantovani R, Marchi S, Marine JC, Martin SJ, Martinou JC, Mastroberardino PG, Medema JP, Mehlen P, Meier P, Melino G, Melino S, Miao EA, Moll UM, Muñoz-Pinedo C, Murphy DJ, Niklison-Chirou MV, Novelli F, Núñez G, Oberst A, Ofengeim D, Opferman JT, Oren M, Pagano M, Panaretakis T, Pasparakis M, Penninger JM, Pentimalli F, Pereira DM, Pervaiz S, Peter ME, Pinton P, Porta G, Prehn JHM, Puthalakath H, Rabinovich GA, Rajalingam K, Ravichandran KS, Rehm M, Ricci JE, Rizzuto R, Robinson N, Rodrigues CMP, Rotblat B, Rothlin CV, Rubinsztein DC, Rudel T, Rufini A, Ryan KM, Sarosiek KA, Sawa A, Sayan E, Schroder K, Scorrano L, Sesti F, Shao F, Shi Y, Sica GS, Silke J, Simon HU, Sistigu A, Stephanou A, Stockwell BR, Strapazzon F, Strasser A, Sun L, Sun E, Sun Q, Szabadkai G, Tait SWG, Tang D, Tavernarakis N, Troy CM, Turk B, Urbano N, Vandenabeele P, Vanden Berghe T, Vander Heiden MG, Vanderluit JL, Verkhratsky A, Villunger A, von Karstedt S, Voss AK, Vousden KH, Vucic D, Vuri D, Wagner EF, Walczak H, Wallach D, Wang R, Wang Y, Weber A, Wood W, Yamazaki T, Yang HT, Zakeri Z, Zawacka-Pankau JE, Zhang L, Zhang H, Zhivotovsky B, Zhou W, Piacentini M, Kroemer G, Galluzzi L. Apoptotic cell death in disease-Current understanding of the NCCD 2023. Cell Death Differ 2023; 30:1097-1154. [PMID: 37100955 PMCID: PMC10130819 DOI: 10.1038/s41418-023-01153-w] [Citation(s) in RCA: 61] [Impact Index Per Article: 61.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2023] [Revised: 03/10/2023] [Accepted: 03/17/2023] [Indexed: 04/28/2023] Open
Abstract
Apoptosis is a form of regulated cell death (RCD) that involves proteases of the caspase family. Pharmacological and genetic strategies that experimentally inhibit or delay apoptosis in mammalian systems have elucidated the key contribution of this process not only to (post-)embryonic development and adult tissue homeostasis, but also to the etiology of multiple human disorders. Consistent with this notion, while defects in the molecular machinery for apoptotic cell death impair organismal development and promote oncogenesis, the unwarranted activation of apoptosis promotes cell loss and tissue damage in the context of various neurological, cardiovascular, renal, hepatic, infectious, neoplastic and inflammatory conditions. Here, the Nomenclature Committee on Cell Death (NCCD) gathered to critically summarize an abundant pre-clinical literature mechanistically linking the core apoptotic apparatus to organismal homeostasis in the context of disease.
Collapse
Affiliation(s)
- Ilio Vitale
- IIGM - Italian Institute for Genomic Medicine, c/o IRCSS Candiolo, Torino, Italy.
- Candiolo Cancer Institute, FPO -IRCCS, Candiolo, Italy.
| | - Federico Pietrocola
- Department of Biosciences and Nutrition, Karolinska Institute, Huddinge, Sweden
| | - Emma Guilbaud
- Department of Radiation Oncology, Weill Cornell Medical College, New York, NY, USA
| | - Stuart A Aaronson
- Department of Oncological Sciences, Icahn School of Medicine at Mount Sinai, New York City, NY, USA
| | - John M Abrams
- Department of Cell Biology, University of Texas Southwestern Medical Center, Dallas, TX, USA
| | - Dieter Adam
- Institut für Immunologie, Kiel University, Kiel, Germany
| | - Massimiliano Agostini
- Department of Experimental Medicine, University of Rome Tor Vergata, TOR, Rome, Italy
| | - Patrizia Agostinis
- Department of Cellular and Molecular Medicine, KU Leuven, Leuven, Belgium
- VIB Center for Cancer Biology, Leuven, Belgium
| | - Emad S Alnemri
- Department of Biochemistry and Molecular Biology, Thomas Jefferson University, Philadelphia, PA, USA
| | - Lucia Altucci
- Department of Precision Medicine, University of Campania Luigi Vanvitelli, Naples, Italy
- BIOGEM, Avellino, Italy
| | - Ivano Amelio
- Division of Systems Toxicology, Department of Biology, University of Konstanz, Konstanz, Germany
| | - David W Andrews
- Sunnybrook Research Institute, Toronto, ON, Canada
- Departments of Biochemistry and Medical Biophysics, University of Toronto, Toronto, ON, Canada
| | - Rami I Aqeilan
- Hebrew University of Jerusalem, Lautenberg Center for Immunology & Cancer Research, Institute for Medical Research Israel-Canada (IMRIC), Faculty of Medicine, Jerusalem, Israel
| | - Eli Arama
- Department of Molecular Genetics, Weizmann Institute of Science, Rehovot, Israel
| | - Eric H Baehrecke
- Department of Molecular, Cell and Cancer Biology, University of Massachusetts Chan Medical School, Worcester, MA, USA
| | - Siddharth Balachandran
- Blood Cell Development and Function Program, Fox Chase Cancer Center, Philadelphia, PA, USA
| | - Daniele Bano
- Deutsches Zentrum für Neurodegenerative Erkrankungen (DZNE), Bonn, Germany
| | - Nickolai A Barlev
- Department of Biomedicine, Nazarbayev University School of Medicine, Astana, Kazakhstan
| | - Jiri Bartek
- Department of Medical Biochemistry and Biophysics, Science for Life Laboratory, Karolinska Institute, Stockholm, Sweden
- Danish Cancer Society Research Center, Copenhagen, Denmark
| | - Nicolas G Bazan
- Neuroscience Center of Excellence, School of Medicine, Louisiana State University Health New Orleans, New Orleans, LA, USA
| | - Christoph Becker
- Department of Medicine 1, Friedrich-Alexander-University Erlangen-Nuremberg, Erlangen, Germany
| | - Francesca Bernassola
- Department of Experimental Medicine, University of Rome Tor Vergata, TOR, Rome, Italy
| | - Mathieu J M Bertrand
- VIB-UGent Center for Inflammation Research, Ghent, Belgium
- Department of Biomedical Molecular Biology, Ghent University, Ghent, Belgium
| | - Marco E Bianchi
- Università Vita-Salute San Raffaele, School of Medicine, Milan, Italy and Ospedale San Raffaele IRCSS, Milan, Italy
| | | | - J Magarian Blander
- Department of Medicine, Jill Roberts Institute for Research in Inflammatory Bowel Disease, Weill Cornell Medicine, New York, NY, USA
- Department of Microbiology and Immunology, Weill Cornell Medicine, New York, NY, USA
- Sandra and Edward Meyer Cancer Center, New York, NY, USA
| | | | - Klas Blomgren
- Department of Women's and Children's Health, Karolinska Institute, Stockholm, Sweden
- Pediatric Hematology and Oncology, Karolinska University Hospital, Stockholm, Sweden
| | - Christoph Borner
- Institute of Molecular Medicine and Cell Research, Medical Faculty, Albert Ludwigs University of Freiburg, Freiburg, Germany
| | - Carl D Bortner
- Signal Transduction Laboratory, National Institute of Environmental Health Sciences, National Institutes of Health, Department of Health and Human Services, Research Triangle Park, Durham, NC, USA
| | - Pierluigi Bove
- Department of Experimental Medicine, University of Rome Tor Vergata, TOR, Rome, Italy
| | - Patricia Boya
- Centro de Investigaciones Biologicas Margarita Salas, CSIC, Madrid, Spain
| | - Catherine Brenner
- Université Paris-Saclay, CNRS, Institut Gustave Roussy, Aspects métaboliques et systémiques de l'oncogénèse pour de nouvelles approches thérapeutiques, Villejuif, France
| | - Petr Broz
- Department of Immunobiology, University of Lausanne, Epalinges, Vaud, Switzerland
| | - Thomas Brunner
- Department of Biology, University of Konstanz, Konstanz, Germany
| | - Rune Busk Damgaard
- Department of Biotechnology and Biomedicine, Technical University of Denmark, Kongens Lyngby, Denmark
| | - George A Calin
- Department of Translational Molecular Pathology, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
- Center for RNA Interference and Non-Coding RNAs, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - Michelangelo Campanella
- Department of Comparative Biomedical Sciences, The Royal Veterinary College, University of London, London, UK
- UCL Consortium for Mitochondrial Research, London, UK
- Department of Biology, University of Rome Tor Vergata, Rome, Italy
| | - Eleonora Candi
- Department of Experimental Medicine, University of Rome Tor Vergata, TOR, Rome, Italy
| | - Michele Carbone
- Thoracic Oncology, University of Hawaii Cancer Center, Honolulu, HI, USA
| | | | - Francesco Cecconi
- Cell Stress and Survival Unit, Center for Autophagy, Recycling and Disease (CARD), Danish Cancer Society Research Center, Copenhagen, Denmark
- Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy
- Università Cattolica del Sacro Cuore, Rome, Italy
| | - Francis K-M Chan
- Department of Immunology, Duke University School of Medicine, Durham, NC, USA
| | - Guo-Qiang Chen
- State Key Lab of Oncogene and its related gene, Ren-Ji Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Quan Chen
- College of Life Sciences, Nankai University, Tianjin, China
| | - Youhai H Chen
- Shenzhen Institute of Advanced Technology (SIAT), Shenzhen, Guangdong, China
| | - Emily H Cheng
- Human Oncology and Pathogenesis Program, Memorial Sloan Kettering Cancer Center, New York, NY, USA
| | - Jerry E Chipuk
- Department of Oncological Sciences, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - John A Cidlowski
- Signal Transduction Laboratory, National Institute of Environmental Health Sciences, National Institutes of Health, Department of Health and Human Services, Research Triangle Park, Durham, NC, USA
| | - Aaron Ciechanover
- The Technion-Integrated Cancer Center, The Rappaport Faculty of Medicine, Technion-Israel Institute of Technology, Haifa, Israel
| | | | - Marcus Conrad
- Helmholtz Munich, Institute of Metabolism and Cell Death, Neuherberg, Germany
| | - Juan R Cubillos-Ruiz
- Department of Obstetrics and Gynecology, Weill Cornell Medical College, New York, NY, USA
| | - Peter E Czabotar
- The Walter and Eliza Hall Institute of Medical Research, Melbourne, Victoria, Australia
- Department of Medical Biology, The University of Melbourne, Melbourne, Victoria, Australia
| | | | - Mads Daugaard
- Department of Urologic Sciences, Vancouver Prostate Centre, Vancouver, BC, Canada
| | - Ted M Dawson
- Institute for Cell Engineering and the Departments of Neurology, Neuroscience and Pharmacology & Molecular Sciences, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Valina L Dawson
- Institute for Cell Engineering and the Departments of Neurology, Neuroscience and Pharmacology & Molecular Sciences, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Ruggero De Maria
- Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy
- Università Cattolica del Sacro Cuore, Rome, Italy
| | - Bart De Strooper
- VIB Centre for Brain & Disease Research, Leuven, Belgium
- Department of Neurosciences, Leuven Brain Institute, KU Leuven, Leuven, Belgium
- The Francis Crick Institute, London, UK
- UK Dementia Research Institute at UCL, University College London, London, UK
| | - Klaus-Michael Debatin
- Department of Pediatrics and Adolescent Medicine, Ulm University Medical Center, Ulm, Germany
| | - Ralph J Deberardinis
- Howard Hughes Medical Institute and Children's Medical Center Research Institute, University of Texas Southwestern Medical Center, Dallas, TX, USA
| | - Alexei Degterev
- Department of Developmental, Molecular and Chemical Biology, Tufts University School of Medicine, Boston, MA, USA
| | - Giannino Del Sal
- Department of Life Sciences, University of Trieste, Trieste, Italy
- International Centre for Genetic Engineering and Biotechnology (ICGEB), Area Science Park-Padriciano, Trieste, Italy
- IFOM ETS, the AIRC Institute of Molecular Oncology, Milan, Italy
| | - Mohanish Deshmukh
- Department of Cell Biology and Physiology, University of North Carolina, Chapel Hill, NC, USA
| | | | - Marc Diederich
- College of Pharmacy, Seoul National University, Seoul, South Korea
| | - Scott J Dixon
- Department of Biology, Stanford University, Stanford, CA, USA
| | - Brian D Dynlacht
- Department of Pathology, New York University Cancer Institute, New York University School of Medicine, New York, NY, USA
| | - Wafik S El-Deiry
- Division of Hematology/Oncology, Brown University and the Lifespan Cancer Institute, Providence, RI, USA
- Legorreta Cancer Center at Brown University, The Warren Alpert Medical School, Brown University, Providence, RI, USA
- Department of Pathology and Laboratory Medicine, The Warren Alpert Medical School, Brown University, Providence, RI, USA
| | - John W Elrod
- Cardiovascular Research Center, Lewis Katz School of Medicine at Temple University, Philadelphia, PA, USA
| | - Kurt Engeland
- Molecular Oncology, University of Leipzig, Leipzig, Germany
| | - Gian Maria Fimia
- Department of Epidemiology, Preclinical Research and Advanced Diagnostics, National Institute for Infectious Diseases 'L. Spallanzani' IRCCS, Rome, Italy
- Department of Molecular Medicine, Sapienza University of Rome, Rome, Italy
| | - Claudia Galassi
- Department of Radiation Oncology, Weill Cornell Medical College, New York, NY, USA
| | - Carlo Ganini
- Department of Experimental Medicine, University of Rome Tor Vergata, TOR, Rome, Italy
- Biochemistry Laboratory, Dermopatic Institute of Immaculate (IDI) IRCCS, Rome, Italy
| | - Ana J Garcia-Saez
- CECAD, Institute of Genetics, University of Cologne, Cologne, Germany
| | - Abhishek D Garg
- Department of Cellular and Molecular Medicine, KU Leuven, Leuven, Belgium
| | - Carmen Garrido
- INSERM, UMR, 1231, Dijon, France
- Faculty of Medicine, Université de Bourgogne Franche-Comté, Dijon, France
- Anti-cancer Center Georges-François Leclerc, Dijon, France
| | - Evripidis Gavathiotis
- Department of Biochemistry, Albert Einstein College of Medicine, New York, NY, USA
- Department of Medicine, Albert Einstein College of Medicine, New York, NY, USA
- Albert Einstein Cancer Center, Albert Einstein College of Medicine, New York, NY, USA
- Institute for Aging Research, Albert Einstein College of Medicine, New York, NY, USA
- Wilf Family Cardiovascular Research Institute, Albert Einstein College of Medicine, New York, NY, USA
| | - Motti Gerlic
- Department of Clinical Microbiology and Immunology, Sackler school of Medicine, Tel Aviv university, Tel Aviv, Israel
| | - Sourav Ghosh
- Department of Neurology and Department of Pharmacology, Yale School of Medicine, New Haven, CT, USA
| | - Douglas R Green
- Department of Immunology, St Jude Children's Research Hospital, Memphis, TN, USA
| | - Lloyd A Greene
- Department of Pathology and Cell Biology, Columbia University, New York, NY, USA
| | - Hinrich Gronemeyer
- Department of Functional Genomics and Cancer, Institut de Génétique et de Biologie Moléculaire et Cellulaire (IGBMC), Illkirch, France
- Centre National de la Recherche Scientifique, UMR7104, Illkirch, France
- Institut National de la Santé et de la Recherche Médicale, U1258, Illkirch, France
- Université de Strasbourg, Illkirch, France
| | - Georg Häcker
- Faculty of Medicine, Institute of Medical Microbiology and Hygiene, Medical Center, University of Freiburg, Freiburg, Germany
- BIOSS Centre for Biological Signalling Studies, University of Freiburg, Freiburg, Germany
| | - György Hajnóczky
- MitoCare Center, Department of Pathology, Anatomy and Cell Biology, Thomas Jefferson University, Philadelphia, PA, USA
| | - J Marie Hardwick
- Department of Molecular Microbiology and Immunology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
- Departments of Molecular Microbiology and Immunology, Pharmacology, Oncology and Neurology, Johns Hopkins Bloomberg School of Public Health and School of Medicine, Baltimore, MD, USA
| | - Ygal Haupt
- VITTAIL Ltd, Melbourne, VIC, Australia
- Peter MacCallum Cancer Centre, Melbourne, VIC, Australia
| | - Sudan He
- Institute of Systems Medicine, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, China
- Suzhou Institute of Systems Medicine, Suzhou, Jiangsu, China
| | - David M Heery
- School of Pharmacy, University of Nottingham, Nottingham, UK
| | | | - Claudio Hetz
- Biomedical Neuroscience Institute, Faculty of Medicine, University of Chile, Santiago, Chile
- Center for Geroscience, Brain Health and Metabolism, Santiago, Chile
- Center for Molecular Studies of the Cell, Program of Cellular and Molecular Biology, Institute of Biomedical Sciences, University of Chile, Santiago, Chile
- Buck Institute for Research on Aging, Novato, CA, USA
| | - David A Hildeman
- Division of Immunobiology, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, USA
| | - Hidenori Ichijo
- Laboratory of Cell Signaling, The University of Tokyo, Tokyo, Japan
| | - Satoshi Inoue
- National Cancer Center Research Institute, Tokyo, Japan
| | - Marja Jäättelä
- Cell Death and Metabolism, Center for Autophagy, Recycling and Disease, Danish Cancer Society Research Center, Copenhagen, Denmark
- Department of Cellular and Molecular Medicine, University of Copenhagen, Copenhagen, Denmark
| | - Ana Janic
- Department of Medicine and Life Sciences, Pompeu Fabra University, Barcelona, Spain
| | - Bertrand Joseph
- Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden
| | - Philipp J Jost
- Clinical Division of Oncology, Department of Internal Medicine, Medical University of Graz, Graz, Austria
| | | | - Michael Karin
- Departments of Pharmacology and Pathology, School of Medicine, University of California San Diego, San Diego, CA, USA
| | - Hamid Kashkar
- CECAD Research Center, Institute for Molecular Immunology, University of Cologne, Cologne, Germany
| | - Thomas Kaufmann
- Institute of Pharmacology, University of Bern, Bern, Switzerland
| | - Gemma L Kelly
- The Walter and Eliza Hall Institute of Medical Research, Melbourne, Victoria, Australia
- Department of Medical Biology, The University of Melbourne, Melbourne, Victoria, Australia
| | - Oliver Kepp
- Metabolomics and Cell Biology Platforms, Gustave Roussy Cancer Center, Université Paris Saclay, Villejuif, France
- Centre de Recherche des Cordeliers, Equipe labellisée par la Ligue contre le cancer, Université de Paris, Sorbonne Université, Inserm U1138, Institut Universitaire de France, Paris, France
| | - Adi Kimchi
- Department of Molecular Genetics, Weizmann Institute of Science, Rehovot, Israel
| | - Richard N Kitsis
- Department of Biochemistry, Albert Einstein College of Medicine, New York, NY, USA
- Department of Medicine, Albert Einstein College of Medicine, New York, NY, USA
- Albert Einstein Cancer Center, Albert Einstein College of Medicine, New York, NY, USA
- Institute for Aging Research, Albert Einstein College of Medicine, New York, NY, USA
- Department of Cell Biology, Albert Einstein College of Medicine, New York, NY, USA
- Einstein-Mount Sinai Diabetes Research Center, Albert Einstein College of Medicine, New York, NY, USA
| | | | - Ruth Kluck
- The Walter and Eliza Hall Institute of Medical Research, Melbourne, Victoria, Australia
- Department of Medical Biology, The University of Melbourne, Melbourne, Victoria, Australia
| | - Dmitri V Krysko
- Cell Death Investigation and Therapy Lab, Department of Human Structure and Repair, Ghent University, Ghent, Belgium
- Cancer Research Institute Ghent (CRIG), Ghent, Belgium
| | - Dagmar Kulms
- Department of Dermatology, Experimental Dermatology, TU-Dresden, Dresden, Germany
- National Center for Tumor Diseases Dresden, TU-Dresden, Dresden, Germany
| | - Sharad Kumar
- Centre for Cancer Biology, University of South Australia, Adelaide, SA, Australia
- Faculty of Health and Medical Sciences, The University of Adelaide, Adelaide, SA, Australia
| | - Sergio Lavandero
- Universidad de Chile, Facultad Ciencias Quimicas y Farmaceuticas & Facultad Medicina, Advanced Center for Chronic Diseases (ACCDiS), Santiago, Chile
- Department of Internal Medicine, Cardiology Division, University of Texas Southwestern Medical Center, Dallas, TX, USA
| | - Inna N Lavrik
- Translational Inflammation Research, Medical Faculty, Otto von Guericke University, Magdeburg, Germany
| | - John J Lemasters
- Departments of Drug Discovery & Biomedical Sciences and Biochemistry & Molecular Biology, Medical University of South Carolina, Charleston, SC, USA
| | - Gianmaria Liccardi
- Center for Biochemistry, Medical Faculty, University of Cologne, Cologne, Germany
| | - Andreas Linkermann
- Division of Nephrology, Department of Internal Medicine 3, University Hospital Carl Gustav Carus, Technische Universität Dresden, Dresden, Germany
- Biotechnology Center, Technische Universität Dresden, Dresden, Germany
| | - Stuart A Lipton
- Neurodegeneration New Medicines Center and Department of Molecular Medicine, The Scripps Research Institute, La Jolla, CA, USA
- Department of Neurosciences, University of California, San Diego, School of Medicine, La Jolla, CA, USA
- Department of Neurology, Yale School of Medicine, New Haven, CT, USA
| | - Richard A Lockshin
- Department of Biology, Queens College of the City University of New York, Flushing, NY, USA
- St. John's University, Jamaica, NY, USA
| | - Carlos López-Otín
- Departamento de Bioquímica y Biología Molecular, Facultad de Medicina, Instituto Universitario de Oncología (IUOPA), Universidad de Oviedo, Oviedo, Spain
| | - Tom Luedde
- Department of Gastroenterology, Hepatology and Infectious Diseases, University Hospital Duesseldorf, Heinrich Heine University, Duesseldorf, Germany
| | - Marion MacFarlane
- Medical Research Council Toxicology Unit, University of Cambridge, Cambridge, UK
| | - Frank Madeo
- Institute of Molecular Biosciences, NAWI Graz, University of Graz, Graz, Austria
- BioTechMed Graz, Graz, Austria
- Field of Excellence BioHealth - University of Graz, Graz, Austria
| | - Walter Malorni
- Center for Global Health, Università Cattolica del Sacro Cuore, Rome, Italy
| | - Gwenola Manic
- IIGM - Italian Institute for Genomic Medicine, c/o IRCSS Candiolo, Torino, Italy
- Candiolo Cancer Institute, FPO -IRCCS, Candiolo, Italy
| | - Roberto Mantovani
- Dipartimento di Bioscienze, Università degli Studi di Milano, Milano, Italy
| | - Saverio Marchi
- Department of Clinical and Molecular Sciences, Marche Polytechnic University, Ancona, Italy
| | - Jean-Christophe Marine
- VIB Center for Cancer Biology, Leuven, Belgium
- Department of Oncology, KU Leuven, Leuven, Belgium
| | | | - Jean-Claude Martinou
- Department of Cell Biology, Faculty of Sciences, University of Geneva, Geneva, Switzerland
| | - Pier G Mastroberardino
- Department of Molecular Genetics, Rotterdam, the Netherlands
- IFOM-ETS The AIRC Institute for Molecular Oncology, Milan, Italy
- Department of Life, Health, and Environmental Sciences, University of L'Aquila, L'Aquila, Italy
| | - Jan Paul Medema
- Laboratory for Experimental Oncology and Radiobiology, Center for Experimental and Molecular Medicine, Cancer Center Amsterdam, Amsterdam UMC, University of Amsterdam, Amsterdam, The Netherlands
- Oncode Institute, Amsterdam UMC, University of Amsterdam, Amsterdam, The Netherlands
| | - Patrick Mehlen
- Apoptosis, Cancer, and Development Laboratory, Equipe labellisée 'La Ligue', LabEx DEVweCAN, Centre de Recherche en Cancérologie de Lyon, INSERM U1052-CNRS UMR5286, Centre Léon Bérard, Université de Lyon, Université Claude Bernard Lyon1, Lyon, France
| | - Pascal Meier
- The Breast Cancer Now Toby Robins Research Centre, The Institute of Cancer Research, London, UK
| | - Gerry Melino
- Department of Experimental Medicine, University of Rome Tor Vergata, TOR, Rome, Italy
| | - Sonia Melino
- Department of Chemical Science and Technologies, University of Rome Tor Vergata, Rome, Italy
| | - Edward A Miao
- Department of Immunology, Duke University School of Medicine, Durham, NC, USA
| | - Ute M Moll
- Department of Pathology and Stony Brook Cancer Center, Renaissance School of Medicine, Stony Brook University, Stony Brook, NY, USA
| | - Cristina Muñoz-Pinedo
- Institut d'Investigació Biomèdica de Bellvitge (IDIBELL), L'Hospitalet de Llobregat, Spain
| | - Daniel J Murphy
- School of Cancer Sciences, University of Glasgow, Glasgow, UK
- Cancer Research UK Beatson Institute, Glasgow, UK
| | | | - Flavia Novelli
- Thoracic Oncology, University of Hawaii Cancer Center, Honolulu, HI, USA
| | - Gabriel Núñez
- Department of Pathology and Rogel Cancer Center, The University of Michigan, Ann Arbor, MI, USA
| | - Andrew Oberst
- Department of Immunology, University of Washington, Seattle, WA, USA
| | - Dimitry Ofengeim
- Rare and Neuroscience Therapeutic Area, Sanofi, Cambridge, MA, USA
| | - Joseph T Opferman
- Department of Cell and Molecular Biology, St. Jude Children's Research Hospital, Memphis, TN, USA
| | - Moshe Oren
- Department of Molecular Cell Biology, The Weizmann Institute, Rehovot, Israel
| | - Michele Pagano
- Department of Biochemistry and Molecular Pharmacology, New York University Grossman School of Medicine and Howard Hughes Medical Institute, New York, NY, USA
| | - Theocharis Panaretakis
- Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden
- Department of GU Medical Oncology, MD Anderson Cancer Center, Houston, TX, USA
| | | | - Josef M Penninger
- IMBA, Institute of Molecular Biotechnology of the Austrian Academy of Sciences, Vienna, Austria
- Department of Medical Genetics, Life Sciences Institute, University of British Columbia, Vancouver, Canada
| | | | - David M Pereira
- REQUIMTE/LAQV, Laboratório de Farmacognosia, Departamento de Química, Faculdade de Farmácia, Universidade do Porto, Porto, Portugal
| | - Shazib Pervaiz
- Department of Physiology, YLL School of Medicine, National University of Singapore, Singapore, Singapore
- NUS Centre for Cancer Research (N2CR), National University of Singapore, Singapore, Singapore
- National University Cancer Institute, NUHS, Singapore, Singapore
- ISEP, NUS Graduate School, National University of Singapore, Singapore, Singapore
| | - Marcus E Peter
- Department of Medicine, Division Hematology/Oncology, Northwestern University, Chicago, IL, USA
| | - Paolo Pinton
- Department of Medical Sciences, University of Ferrara, Ferrara, Italy
| | - Giovanni Porta
- Center of Genomic Medicine, Department of Medicine and Surgery, University of Insubria, Varese, Italy
| | - Jochen H M Prehn
- Department of Physiology and Medical Physics, Royal College of Surgeons in Ireland (RCSI) University of Medicine and Health Sciences, Dublin 2, Ireland
| | - Hamsa Puthalakath
- Department of Biochemistry and Chemistry, La Trobe Institute for Molecular Science, La Trobe University, Melbourne, VIC, Australia
| | - Gabriel A Rabinovich
- Laboratorio de Glicomedicina. Instituto de Biología y Medicina Experimental (IBYME), Consejo Nacional de Investigaciones Científicas y Técnicas (CONICET), Buenos Aires, Argentina
| | | | - Kodi S Ravichandran
- VIB-UGent Center for Inflammation Research, Ghent, Belgium
- Division of Immunobiology, Department of Pathology and Immunology, Washington University School of Medicine, St. Louis, MO, USA
- Center for Cell Clearance, Department of Microbiology, Immunology, and Cancer Biology, University of Virginia, Charlottesville, VA, USA
| | - Markus Rehm
- Institute of Cell Biology and Immunology, University of Stuttgart, Stuttgart, Germany
| | - Jean-Ehrland Ricci
- Université Côte d'Azur, INSERM, C3M, Equipe labellisée Ligue Contre le Cancer, Nice, France
| | - Rosario Rizzuto
- Department of Biomedical Sciences, University of Padua, Padua, Italy
| | - Nirmal Robinson
- Centre for Cancer Biology, University of South Australia, Adelaide, SA, Australia
| | - Cecilia M P Rodrigues
- Research Institute for Medicines (iMed.ULisboa), Faculty of Pharmacy, Universidade de Lisboa, Lisbon, Portugal
| | - Barak Rotblat
- Department of Life sciences, Ben Gurion University of the Negev, Beer Sheva, Israel
- The NIBN, Beer Sheva, Israel
| | - Carla V Rothlin
- Department of Immunobiology and Department of Pharmacology, Yale School of Medicine, New Haven, CT, USA
| | - David C Rubinsztein
- Department of Medical Genetics, Cambridge Institute for Medical Research, Cambridge, UK
- UK Dementia Research Institute, University of Cambridge, Cambridge Institute for Medical Research, Cambridge, UK
| | - Thomas Rudel
- Microbiology Biocentre, University of Würzburg, Würzburg, Germany
| | - Alessandro Rufini
- Dipartimento di Bioscienze, Università degli Studi di Milano, Milano, Italy
- University of Leicester, Leicester Cancer Research Centre, Leicester, UK
| | - Kevin M Ryan
- School of Cancer Sciences, University of Glasgow, Glasgow, UK
- Cancer Research UK Beatson Institute, Glasgow, UK
| | - Kristopher A Sarosiek
- John B. Little Center for Radiation Sciences, Harvard School of Public Health, Boston, MA, USA
- Department of Systems Biology, Lab of Systems Pharmacology, Harvard Program in Therapeutics Science, Harvard Medical School, Boston, MA, USA
- Department of Environmental Health, Molecular and Integrative Physiological Sciences Program, Harvard School of Public Health, Boston, MA, USA
| | - Akira Sawa
- Johns Hopkins Schizophrenia Center, Johns Hopkins University, Baltimore, MD, USA
| | - Emre Sayan
- Faculty of Medicine, Cancer Sciences Unit, University of Southampton, Southampton, UK
| | - Kate Schroder
- Institute for Molecular Bioscience, The University of Queensland, St Lucia, QLD, Australia
| | - Luca Scorrano
- Department of Biology, University of Padua, Padua, Italy
- Veneto Institute of Molecular Medicine, Padua, Italy
| | - Federico Sesti
- Department of Neuroscience and Cell Biology, Robert Wood Johnson Medical School, Rutgers University, NJ, USA
| | - Feng Shao
- National Institute of Biological Sciences, Beijing, PR China
| | - Yufang Shi
- Department of Experimental Medicine, University of Rome Tor Vergata, TOR, Rome, Italy
- The Third Affiliated Hospital of Soochow University and State Key Laboratory of Radiation Medicine and Protection, Institutes for Translational Medicine, Soochow University, Suzhou, Jiangsu, China
- CAS Key Laboratory of Tissue Microenvironment and Tumor, Shanghai Institute of Nutrition and Health, Chinese Academy of Sciences, Shanghai, China
| | - Giuseppe S Sica
- Department of Surgical Science, University Tor Vergata, Rome, Italy
| | - John Silke
- The Walter and Eliza Hall Institute of Medical Research, Melbourne, Victoria, Australia
- Department of Medical Biology, The University of Melbourne, Melbourne, Victoria, Australia
| | - Hans-Uwe Simon
- Institute of Pharmacology, University of Bern, Bern, Switzerland
- Institute of Biochemistry, Brandenburg Medical School, Neuruppin, Germany
| | - Antonella Sistigu
- Dipartimento di Medicina e Chirurgia Traslazionale, Università Cattolica del Sacro Cuore, Rome, Italy
| | | | - Brent R Stockwell
- Department of Biological Sciences and Department of Chemistry, Columbia University, New York, NY, USA
| | - Flavie Strapazzon
- IRCCS Fondazione Santa Lucia, Rome, Italy
- Univ Lyon, Univ Lyon 1, Physiopathologie et Génétique du Neurone et du Muscle, UMR5261, U1315, Institut NeuroMyogène CNRS, INSERM, Lyon, France
| | - Andreas Strasser
- The Walter and Eliza Hall Institute of Medical Research, Melbourne, Victoria, Australia
- Department of Medical Biology, The University of Melbourne, Melbourne, Victoria, Australia
| | - Liming Sun
- State Key Laboratory of Cell Biology, Shanghai Institute of Biochemistry and Cell Biology, Center for Excellence in Molecular Cell Science, Chinese Academy of Sciences, Shanghai, China
| | - Erwei Sun
- Department of Rheumatology and Immunology, The Third Affiliated Hospital, Southern Medical University, Guangzhou, China
| | - Qiang Sun
- Laboratory of Cell Engineering, Institute of Biotechnology, Beijing, China
- Research Unit of Cell Death Mechanism, 2021RU008, Chinese Academy of Medical Science, Beijing, China
| | - Gyorgy Szabadkai
- Department of Biomedical Sciences, University of Padua, Padua, Italy
- Department of Cell and Developmental Biology, Consortium for Mitochondrial Research, University College London, London, UK
| | - Stephen W G Tait
- School of Cancer Sciences, University of Glasgow, Glasgow, UK
- Cancer Research UK Beatson Institute, Glasgow, UK
| | - Daolin Tang
- Department of Surgery, The University of Texas Southwestern Medical Center, Dallas, TX, 75390, USA
| | - Nektarios Tavernarakis
- Institute of Molecular Biology and Biotechnology, Foundation for Research and Technology-Hellas, Heraklion, Crete, Greece
- Department of Basic Sciences, School of Medicine, University of Crete, Heraklion, Crete, Greece
| | - Carol M Troy
- Departments of Pathology & Cell Biology and Neurology, Taub Institute for Research on Alzheimer's Disease and the Aging Brain, Columbia University Irving Medical Center, New York, NY, USA
| | - Boris Turk
- Department of Biochemistry and Molecular and Structural Biology, J. Stefan Institute, Ljubljana, Slovenia
- Faculty of Chemistry and Chemical Technology, University of Ljubljana, Ljubljana, Slovenia
| | - Nicoletta Urbano
- Department of Oncohaematology, University of Rome Tor Vergata, TOR, Rome, Italy
| | - Peter Vandenabeele
- VIB-UGent Center for Inflammation Research, Ghent, Belgium
- Department of Biomedical Molecular Biology, Ghent University, Ghent, Belgium
- Methusalem Program, Ghent University, Ghent, Belgium
| | - Tom Vanden Berghe
- VIB-UGent Center for Inflammation Research, Ghent, Belgium
- Department of Biomedical Molecular Biology, Ghent University, Ghent, Belgium
- Infla-Med Centre of Excellence, Department of Biomedical Sciences, University of Antwerp, Antwerp, Belgium
| | - Matthew G Vander Heiden
- Koch Institute for Integrative Cancer Research, Massachusetts Institute of Technology, Cambridge, MA, USA
- Department of Biology, Massachusetts Institute of Technology, Cambridge, MA, USA
- Dana-Farber Cancer Institute, Boston, MA, USA
| | | | - Alexei Verkhratsky
- Faculty of Biology, Medicine and Health, The University of Manchester, Manchester, UK
- Achucarro Center for Neuroscience, IKERBASQUE, Bilbao, Spain
- School of Forensic Medicine, China Medical University, Shenyang, China
- State Research Institute Centre for Innovative Medicine, Vilnius, Lithuania
| | - Andreas Villunger
- Institute for Developmental Immunology, Biocenter, Medical University of Innsbruck, Innsbruck, Austria
- The Research Center for Molecular Medicine (CeMM) of the Austrian Academy of Sciences (OeAW), Vienna, Austria
- The Ludwig Boltzmann Institute for Rare and Undiagnosed Diseases (LBI-RUD), Vienna, Austria
| | - Silvia von Karstedt
- Department of Translational Genomics, Faculty of Medicine and University Hospital Cologne, Cologne, Germany
- CECAD Cluster of Excellence, University of Cologne, Cologne, Germany
- Center for Molecular Medicine Cologne (CMMC), Faculty of Medicine and University Hospital Cologne, Cologne, Germany
| | - Anne K Voss
- The Walter and Eliza Hall Institute of Medical Research, Melbourne, Victoria, Australia
- Department of Medical Biology, The University of Melbourne, Melbourne, Victoria, Australia
| | | | - Domagoj Vucic
- Department of Early Discovery Biochemistry, Genentech, South San Francisco, CA, USA
| | - Daniela Vuri
- Department of Experimental Medicine, University of Rome Tor Vergata, TOR, Rome, Italy
| | - Erwin F Wagner
- Department of Laboratory Medicine, Medical University of Vienna, Vienna, Austria
- Department of Dermatology, Medical University of Vienna, Vienna, Austria
| | - Henning Walczak
- Center for Biochemistry, Medical Faculty, University of Cologne, Cologne, Germany
- CECAD Cluster of Excellence, University of Cologne, Cologne, Germany
- Centre for Cell Death, Cancer and Inflammation, UCL Cancer Institute, University College London, London, UK
| | - David Wallach
- Department of Biomolecular Sciences, The Weizmann Institute of Science, Rehovot, Israel
| | - Ruoning Wang
- Center for Childhood Cancer and Blood Diseases, Abigail Wexner Research Institute at Nationwide Children's Hospital, The Ohio State University, Columbus, OH, USA
| | - Ying Wang
- Shanghai Institute of Nutrition and Health, Chinese Academy of Sciences, Shanghai, China
| | - Achim Weber
- University of Zurich and University Hospital Zurich, Department of Pathology and Molecular Pathology, Zurich, Switzerland
- University of Zurich, Institute of Molecular Cancer Research, Zurich, Switzerland
| | - Will Wood
- Centre for Inflammation Research, Queen's Medical Research Institute, University of Edinburgh, Edinburgh, UK
| | - Takahiro Yamazaki
- Department of Radiation Oncology, Weill Cornell Medical College, New York, NY, USA
| | - Huang-Tian Yang
- Shanghai Institute of Nutrition and Health, Chinese Academy of Sciences, Shanghai, China
| | - Zahra Zakeri
- Queens College and Graduate Center, City University of New York, Flushing, NY, USA
| | - Joanna E Zawacka-Pankau
- Department of Medicine Huddinge, Karolinska Institute, Stockholm, Sweden
- Department of Biochemistry, Laboratory of Biophysics and p53 protein biology, Medical University of Warsaw, Warsaw, Poland
| | - Lin Zhang
- Department of Pharmacology & Chemical Biology, UPMC Hillman Cancer Center, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA
| | - Haibing Zhang
- CAS Key Laboratory of Nutrition, Metabolism and Food Safety, Shanghai Institute of Nutrition and Health, Chinese Academy of Sciences, Shanghai, China
| | - Boris Zhivotovsky
- Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden
- Faculty of Medicine, Lomonosov Moscow State University, Moscow, Russia
| | - Wenzhao Zhou
- Laboratory of Cell Engineering, Institute of Biotechnology, Beijing, China
- Research Unit of Cell Death Mechanism, 2021RU008, Chinese Academy of Medical Science, Beijing, China
| | - Mauro Piacentini
- Department of Biology, University of Rome Tor Vergata, Rome, Italy
- National Institute for Infectious Diseases IRCCS "Lazzaro Spallanzani", Rome, Italy
| | - Guido Kroemer
- Metabolomics and Cell Biology Platforms, Gustave Roussy Cancer Center, Université Paris Saclay, Villejuif, France
- Centre de Recherche des Cordeliers, Equipe labellisée par la Ligue contre le cancer, Université de Paris, Sorbonne Université, Inserm U1138, Institut Universitaire de France, Paris, France
- Institut du Cancer Paris CARPEM, Department of Biology, Hôpital Européen Georges Pompidou, AP-HP, Paris, France
| | - Lorenzo Galluzzi
- Department of Radiation Oncology, Weill Cornell Medical College, New York, NY, USA.
- Sandra and Edward Meyer Cancer Center, New York, NY, USA.
- Caryl and Israel Englander Institute for Precision Medicine, New York, NY, USA.
| |
Collapse
|
9
|
Sica GS, Vinci D, Siragusa L, Sensi B, Guida AM, Bellato V, García-Granero Á, Pellino G. Correction: Definition and reporting of lymphadenectomy and complete mesocolic excision for radical right colectomy: a systematic review. Surg Endosc 2023; 37:2418. [PMID: 36333499 PMCID: PMC10017556 DOI: 10.1007/s00464-022-09747-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Affiliation(s)
- Giuseppe S Sica
- Minimally Invasive Unit, Department of Surgical Science, University Tor Vergata, Rome, Italy. .,Department of Surgical Science, Policlinico Tor Vergata - University Tor Vergata, Rome, Italy.
| | - Danilo Vinci
- Department of Surgical Science, Policlinico Tor Vergata - University Tor Vergata, Rome, Italy
| | - Leandro Siragusa
- Minimally Invasive Unit, Department of Surgical Science, University Tor Vergata, Rome, Italy.,Department of Surgical Science, Policlinico Tor Vergata - University Tor Vergata, Rome, Italy
| | - Bruno Sensi
- Minimally Invasive Unit, Department of Surgical Science, University Tor Vergata, Rome, Italy.,Department of Surgical Science, Policlinico Tor Vergata - University Tor Vergata, Rome, Italy
| | - Andrea M Guida
- Department of Surgical Science, Policlinico Tor Vergata - University Tor Vergata, Rome, Italy
| | - Vittoria Bellato
- Department of Surgical Science, Policlinico Tor Vergata - University Tor Vergata, Rome, Italy.,Ospedale IRCCS San Raffaele, Milan, Italy
| | - Álvaro García-Granero
- Colorectal Unit, Hospital Universitario Son Espases, Palma, Spain.,Applied Surgical Anatomy Unit, Human Embryology and Anatomy Department, University of Valencia, Valencia, Spain.,Human Embryology and Anatomy Department, University of Islas Baleares, Palma, Spain
| | - Gianluca Pellino
- Department of Advanced Medical and Surgical Sciences, Università Degli Studi Della Campania "Luigi Vanvitelli", Naples, Italy.,Colorectal Surgery, Vall d'Hebron University Hospital, Barcelona, Spain
| |
Collapse
|
10
|
Sensi B, Siragusa L, Franceschilli M, Pirozzi B, Guida AM, Sica GS. Laparoscopic synchronous CME-right colectomy and D2/3 subtotal gastrectomy following embryological-based principles - A video vignette. Colorectal Dis 2023; 25:520-521. [PMID: 36214610 DOI: 10.1111/codi.16359] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/05/2022] [Revised: 05/23/2022] [Accepted: 05/29/2022] [Indexed: 12/13/2022]
Affiliation(s)
- Bruno Sensi
- Department of Surgery, University of Rome Tor Vergata, Rome, Italy
| | - Leandro Siragusa
- Department of Surgery, University of Rome Tor Vergata, Rome, Italy
| | | | - Brunella Pirozzi
- Department of Surgery, University of Rome Tor Vergata, Rome, Italy
| | - Andrea M Guida
- Department of Surgery, University of Rome Tor Vergata, Rome, Italy
| | - Giuseppe S Sica
- Department of Surgery, University of Rome Tor Vergata, Rome, Italy
| |
Collapse
|
11
|
Siragusa L, Pellino G, Sensi B, Panis Y, Bellato V, Khan J, Sica GS. Ambulatory laparoscopic colectomies: a systematic review. Colorectal Dis 2023. [PMID: 36790358 DOI: 10.1111/codi.16511] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/03/2022] [Revised: 12/29/2022] [Accepted: 01/29/2023] [Indexed: 02/16/2023]
Abstract
AIM Ambulatory laparoscopic colectomy (ALC), meaning discharge within 24 h of surgical colonic resection, has recently been proposed in a few, selected patients. This systematic review was performed with the aim of reviewing protocols for ALC and assessing feasibility, safety and outcomes after ALC. METHOD A PRISMA-compliant systematic review and pooled analysis was performed searching all English studies published until October 2022 in PubMed, Cochrane Library, Web of Science (PROSPERO, CRD42022334463). Inclusion criteria were original articles including patients undergoing ALC, specifying at least one outcome of interest. Exclusion criteria were articles reporting a robotic-assisted procedure; unable to retrieve patient data from articles; the same patient series included in different studies. Primary outcomes were success, overall complications and readmission rates. Secondary outcomes included mortality and specific complications such us surgical site infection, anastomotic leak, ileus, bleeding, rate of ALC acceptance, and unscheduled consultation and reoperation rate. RESULTS Among 1087 studies imported for screening, 11 were included (1296 patients). The success rate was 47% with an overall morbidity of 14%. Readmission and reoperation rates were 5% and 1%, respectively. No mortality was recorded. Protocols of ALC differ significantly among published studies. CONCLUSIONS Overall, ALC appears to be safe and feasible in selected cases with an acceptable success rate and a low risk of readmission after hospital discharge. Future studies should evaluate patients' benefits and discharge criteria, as well as uniformity and standardization of eligibility criteria. This systematic review may help inform on ALC adoption in clinical practice.
Collapse
Affiliation(s)
- Leandro Siragusa
- Department of Surgical Sciences, Università degli studi di Roma 'Tor Vergata', Rome, Italy
| | - Gianluca Pellino
- Department of Advanced Medical and Surgical Sciences, Università degli studi della Campania Luigi Vanvitelli, Naples, Italy.,Vall d'Hebron University Hospital, Universitat Autonoma de Barcelona UAB, Barcelona, Spain
| | - Bruno Sensi
- Department of Surgical Sciences, Università degli studi di Roma 'Tor Vergata', Rome, Italy
| | - Yves Panis
- Colorectal Surgery Center, Groupe Hospitalier Privé Ambroise Paré-Hartmann, Neuilly sur Seine, France
| | - Vittoria Bellato
- Department of Surgical Sciences, Università degli studi di Roma 'Tor Vergata', Rome, Italy
| | - Jim Khan
- Colorectal Surgery, Portsmouth Hospitals University NHS Trust, University of Portsmouth, Portsmouth, UK
| | - Giuseppe S Sica
- Department of Surgical Sciences, Università degli studi di Roma 'Tor Vergata', Rome, Italy
| |
Collapse
|
12
|
Sica GS, Vinci D, Siragusa L, Sensi B, Guida AM, Bellato V, García-Granero Á, Pellino G. Definition and reporting of lymphadenectomy and complete mesocolic excision for radical right colectomy: a systematic review. Surg Endosc 2023; 37:846-861. [PMID: 36097099 PMCID: PMC9944740 DOI: 10.1007/s00464-022-09548-5] [Citation(s) in RCA: 9] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2022] [Accepted: 08/07/2022] [Indexed: 11/30/2022]
Abstract
BACKGROUND Several procedures have been proposed to reduce the rates of recurrence in patients with right-sided colon cancer. Different procedures for a radical right colectomy (RRC), including extended D3 lymphadenectomy, complete mesocolic excision and central vascular ligation have been associated with survival benefits by some authors, but results are inconsistent. The aim of this study was to assess the variability in definition and reporting of RRC, which might be responsible for significant differences in outcome evaluation. METHODS PRISMA-compliant systematic literature review to identify the definitions of RRC. Primary aims were to identify surgical steps and different nomenclature for RRC. Secondary aims were description of heterogeneity and overlap among different RRC techniques. RESULTS Ninety-nine articles satisfied inclusion criteria. Eight surgical steps were identified and recorded as specific to RRC: Central arterial ligation was described in 100% of the included studies; preservation of mesocolic integrity in 73% and dissection along the SMV plane in 67%. Other surgical steps were inconstantly reported. Six differently named techniques for RRC have been identified. There were 35 definitions for the 6 techniques and 40% of these were used to identify more than one technique. CONCLUSIONS The only universally adopted surgical step for RRC is central arterial ligation. There is great heterogeneity and consistent overlap among definitions of all RRC techniques. This is likely to jeopardise the interpretation of the outcomes of studies on the topic. Consistent use of definitions and reporting of procedures are needed to obtain reliable conclusions in future trials. PROSPERO CRD42021241650.
Collapse
Affiliation(s)
- Giuseppe S Sica
- Minimally Invasive Unit, Department of Surgical Science, University Tor Vergata, Rome, Italy. .,Department of Surgical Science, Policlinico Tor Vergata - University Tor Vergata, Rome, Italy.
| | - Danilo Vinci
- Department of Surgical Science, Policlinico Tor Vergata - University Tor Vergata, Rome, Italy
| | - Leandro Siragusa
- Minimally Invasive Unit, Department of Surgical Science, University Tor Vergata, Rome, Italy.,Department of Surgical Science, Policlinico Tor Vergata - University Tor Vergata, Rome, Italy
| | - Bruno Sensi
- Minimally Invasive Unit, Department of Surgical Science, University Tor Vergata, Rome, Italy.,Department of Surgical Science, Policlinico Tor Vergata - University Tor Vergata, Rome, Italy
| | - Andrea M Guida
- Department of Surgical Science, Policlinico Tor Vergata - University Tor Vergata, Rome, Italy
| | - Vittoria Bellato
- Department of Surgical Science, Policlinico Tor Vergata - University Tor Vergata, Rome, Italy.,Ospedale IRCCS San Raffaele, Milan, Italy
| | - Álvaro García-Granero
- Colorectal Unit, Hospital Universitario Son Espases, Palma, Spain.,Applied Surgical Anatomy Unit, Human Embryology and Anatomy Department, University of Valencia, Valencia, Spain.,Human Embryology and Anatomy Department, University of Islas Baleares, Palma, Spain
| | - Gianluca Pellino
- Department of Advanced Medical and Surgical Sciences, Università Degli Studi Della Campania "Luigi Vanvitelli", Naples, Italy.,Colorectal Surgery, Vall d'Hebron University Hospital, Barcelona, Spain
| |
Collapse
|
13
|
Sensi B, Khan J, Warusavitarne J, Nardi A, Spinelli A, Zaghiyan K, Panis Y, Sampietro G, Fichera A, Garcia-Granero E, Espin-Basany E, Konishi T, Siragusa L, Stefan S, Bellato V, Carvello M, Adams E, Frontali A, Artigue M, Frasson M, Marti-Gallostra M, Pellino G, Sica GS. Long-term Oncological Outcome of Segmental Versus Extended Colectomy for Colorectal Cancer in Crohn's Disease: Results from an International Multicentre Study. J Crohns Colitis 2022; 16:954-962. [PMID: 34897426 DOI: 10.1093/ecco-jcc/jjab215] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/03/2021] [Revised: 10/11/2021] [Accepted: 11/22/2021] [Indexed: 12/13/2022]
Abstract
BACKGROUND AND AIMS Crohn's disease increases colorectal cancer risk, with high prevalence of synchronous and metachronous cancers. Current guidelines for colorectal cancer in Crohn's disease recommend pan-proctocolectomy. The aim of this study was to evaluate oncological outcomes of a less invasive surgical approach. METHODS This was a retrospective database analysis of Crohn's disease patients with colorectal cancer undergoing surgery at selected European and US tertiary centres. Outcomes of segmental colectomy were compared with those of extended colectomy, total colectomy, and pan-proctocolectomy. Primary outcome was progression-free survival. Secondary outcomes included overall survival, synchronous and metachronous colorectal cancer, and major postoperative complications. RESULTS Ninety-nine patients were included: 66 patients underwent segmental colectomy and 33 extended colectomy. Segmental colectomy patients were older [p = 0.0429], had less extensive colitis [p = 0.0002] and no preoperatively identified synchronous lesions [p = 0.0109].Median follow-up was 43 [31-62] months. There was no difference in unadjusted progression-free survival [p = 0.2570] or in overall survival [p = 0.4191] between segmental and extended colectomy. Multivariate analysis adjusting for age, sex, ASA score, and AJCC staging, confirmed no difference for progression-free survival (hazard ratio [HR] 1.00, p = 0.9993) or overall survival [HR 0.77, p = 0.6654]. Synchronous and metachronous cancers incidence was 9% and 1.5%, respectively. Perioperative mortality was nil and major complications were comparable [7.58% vs 6.06%, p = 0.9998]. CONCLUSIONS Segmental colectomy seems to offer similar long-term outcomes to more extensive surgery. Incidence of synchronous and metachronous cancers appears much lower than previously described. Further prospective studies are warranted to confirm these results.
Collapse
Affiliation(s)
- Bruno Sensi
- University of Rome Tor Vergata, Department of Surgery, Rome, Italy
| | - Jim Khan
- Portsmouth Hospital, NHS trust, Surgery, Portsmouth, UK
| | | | - Alessandra Nardi
- University of Rome Tor Vergata, Department of Mathematics, Rome, Italy
| | | | | | - Yves Panis
- Beaujon Hospital, Colorectal Surgery, Paris, France
| | | | | | | | | | | | - Leandro Siragusa
- University of Rome Tor Vergata, Department of Surgery, Rome, Italy
| | - Samuel Stefan
- Portsmouth Hospital, NHS trust, Surgery, Portsmouth, UK
| | | | | | - Evan Adams
- Cedars Sinai Hospital, Surgery, Los Angeles, CA, USA
| | | | | | | | | | - Gianluca Pellino
- Hospital Universitario Val d'Hebron, Surgery, Barcelona, Spain.,Department of Advanced Medical and Surgical Sciences, Università degli Studi della Campania "Luigi Vanvitelli", Naples,Italy
| | - Giuseppe S Sica
- University of Rome Tor Vergata, Department of Surgery, Rome, Italy
| |
Collapse
|
14
|
Sensi B, Khan J, Warusavitarne J, Nardi A, Spinelli A, Zaghiyan K, Panis Y, Sampietro G, Fichera A, Garcia-Granero E, Espin-Basany E, Konishi T, Siragusa L, Stefan S, Bellato V, Carvello M, Adams E, Frontali A, Artigue M, Frasson M, Marti-Gallostra M, Pellino G, Sica GS. Corrigendum to: Long-term Oncological Outcome of Segmental Versus Extended Colectomy for Colorectal Cancer in Crohn's Disease: Results from an International Multicentre Study. J Crohns Colitis 2022; 16:1009. [PMID: 35171229 DOI: 10.1093/ecco-jcc/jjac022] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/08/2023]
Affiliation(s)
- Bruno Sensi
- University of Rome Tor Vergata, Department of Surgery, Rome, Italy
| | - Jim Khan
- Portsmouth Hospital, NHS trust, Surgery, Portsmouth, UK
| | | | - Alessandra Nardi
- University of Rome Tor Vergata, Department of Mathematics, Rome, Italy
| | | | | | - Yves Panis
- Beaujon Hospital, Colorectal Surgery, Paris, France
| | | | | | | | | | | | - Leandro Siragusa
- University of Rome Tor Vergata, Department of Surgery, Rome, Italy
| | - Samuel Stefan
- Portsmouth Hospital, NHS trust, Surgery, Portsmouth, UK
| | | | | | - Evan Adams
- Cedars Sinai Hospital, Surgery, Los Angeles, CA, USA
| | | | | | | | | | - Gianluca Pellino
- Hospital Universitario Val d'Hebron, Surgery, Barcelona, Spain.,Department of Advanced Medical and Surgical Sciences, Università degli Studi della Campania "Luigi Vanvitelli", Naples, Italy
| | - Giuseppe S Sica
- University of Rome Tor Vergata, Department of Surgery, Rome, Italy
| |
Collapse
|
15
|
Guida AM, Sensi B, Formica V, D'Angelillo RM, Roselli M, Del Vecchio Blanco G, Rossi P, Capolupo GT, Caricato M, Sica GS. Total neoadjuvant therapy for the treatment of locally advanced rectal cancer: a systematic minireview. Biol Direct 2022; 17:16. [PMID: 35698084 PMCID: PMC9195214 DOI: 10.1186/s13062-022-00329-7] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2022] [Accepted: 05/30/2022] [Indexed: 12/13/2022] Open
Abstract
Colorectal carcinoma is the second leading cause of cancer-related deaths, and indeed, rectal cancer accounting for approximately one third of newly diagnosed patients. Gold standard in the treatment of rectal cancer is a multimodality approach, aiming at a good control of the local disease. Distant recurrences are the major cause of mortality. Currently, Locally Advanced Rectal Cancer (LARC) patients undergo a combined treatment of chemotherapy and radiotherapy, followed by surgery. Eventually, more chemotherapy, namely adjuvant chemotherapy (aCT), may be necessary. Total Neoadjuvant Therapy (TNT) is an emerging approach aimed to reduce distant metastases and improve local control. Several ongoing studies are analyzing whether this new approach could improve oncological outcomes. Published results were encouraging, but the heterogeneity of protocols in use, makes the comparison and interpretation of data rather complex. One of the major concerns regarding TNT administration is related to its effect on larger and more advanced cancers that might not undergo similar down-staging as smaller, early-stage tumors. This minireview, based on a systematic literature search of randomized clinical trials and meta-analysis, summarizes current knowledge on TNT. The aim was to confirm or refute whether or not current practice of TNT is based on relevant evidence, to establish the quality of that evidence, and to address any uncertainty or variation in practice that may be occurring. A tentative grouping of general study characteristics, clinical features and treatments characteristics has been undertaken to evaluate if the reported studies are sufficiently homogeneous in terms of subjects involved, interventions, and outcomes to provide a meaningful idea of which patients are more likely to gain from this treatment.
Collapse
Affiliation(s)
- Andrea M Guida
- Department of Surgery, Minimally Invasive Unit, University of Rome Tor Vergata, 00133, Rome, Italy
| | - Bruno Sensi
- Department of Surgery, Minimally Invasive Unit, University of Rome Tor Vergata, 00133, Rome, Italy
| | - Vincenzo Formica
- Department of Systems Medicine, Medical Oncology Unit, Policlinico Tor Vergata, Rome, Italy
| | - Rolando M D'Angelillo
- Department of Biomedicine and Prevention, Radiation Oncology, University of Rome Tor Vergata, 00133, Rome, Italy
| | - Mario Roselli
- Department of Systems Medicine, Medical Oncology Unit, Policlinico Tor Vergata, Rome, Italy
| | | | - Piero Rossi
- Department of Surgery, Minimally Invasive Unit, University of Rome Tor Vergata, 00133, Rome, Italy
| | - Gabriella T Capolupo
- Department of Colorectal Surgery, Colorectal Surgery Unit, Campus Bio-Medico University, 00128, Rome, Italy
| | - Marco Caricato
- Department of Colorectal Surgery, Colorectal Surgery Unit, Campus Bio-Medico University, 00128, Rome, Italy
| | - Giuseppe S Sica
- Department of Surgery, Minimally Invasive Unit, University of Rome Tor Vergata, 00133, Rome, Italy. .,Department of Surgery, Policlinico Tor Vergata, University of Rome, Tor Vergata, Viale Oxford 81, 00133, Rome, Italy.
| |
Collapse
|
16
|
Zwanenburg ES, Gehrels AM, Bastiaenen VP, Aalbers AGJ, Arjona-Sánchez A, Bellato V, van der Bilt JDW, D'Hoore AD, Espinosa-Redondo E, Klaver CEL, Kusters M, Nagtegaal ID, van Ramshorst B, van Santvoort HC, Sica GS, Snaebjornsson P, Wasmann KATGM, de Wilt JHW, Wolthuis AM, Tanis PJ. Metachronous peritoneal metastases in patients with pT4b colon cancer: An international multicenter analysis of intraperitoneal versus retroperitoneal tumor invasion. Eur J Surg Oncol 2022; 48:2023-2031. [PMID: 35729015 DOI: 10.1016/j.ejso.2022.05.028] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2022] [Accepted: 05/27/2022] [Indexed: 11/17/2022] Open
Abstract
BACKGROUND It was hypothesized that colon cancer with only retroperitoneal invasion is associated with a low risk of peritoneal dissemination. This study aimed to compare the risk of metachronous peritoneal metastases (mPM) between intraperitoneal and retroperitoneal invasion. METHODS In this international, multicenter cohort study, patients with pT4bN0-2M0 colon cancer who underwent curative surgery were categorized as having intraperitoneal invasion (e.g. bladder, small bowel, stomach, omentum, liver, abdominal wall) or retroperitoneal invasion only (e.g. ureter, pancreas, psoas muscle, Gerota's fascia). Primary outcome was 5-year mPM cumulative rate, assessed by Kaplan-Meier analysis. RESULTS Out of 907 patients with pT4N0-2M0 colon cancer, 198 had a documented pT4b category, comprising 170 patients with intraperitoneal invasion only, 12 with combined intra- and retroperitoneal invasion, and 16 patients with retroperitoneal invasion only. At baseline, only R1 resection rate significantly differed: 4/16 for retroperitoneal invasion only versus 8/172 for intra- +/- retroperitoneal invasion (p = 0.010). Overall, 22 patients developed mPM during a median follow-up of 45 months. Two patients with only retroperitoneal invasion developed mPM, both following R1 resection. The overall 5-year mPM cumulative rate was 13% for any intraperitoneal invasion and 14% for retroperitoneal invasion only (Log Rank, p = 0.878), which was 13% and 0%, respectively, in patients who had an R0 resection (Log Rank, p = 0.235). CONCLUSION This study suggests that pT4b colon cancer patients with only retroperitoneal invasion who undergo an R0 resection have a negligible risk of mPM, but this is difficult to prove because of its rarity. This observation might have implications regarding individualized follow-up.
Collapse
Affiliation(s)
- E S Zwanenburg
- Department of Surgery, Amsterdam UMC, University of Amsterdam, Cancer Center Amsterdam, Amsterdam, the Netherlands
| | - A M Gehrels
- Department of Surgery, Amsterdam UMC, University of Amsterdam, Cancer Center Amsterdam, Amsterdam, the Netherlands
| | - V P Bastiaenen
- Department of Surgery, Amsterdam UMC, University of Amsterdam, Cancer Center Amsterdam, Amsterdam, the Netherlands
| | - A G J Aalbers
- Department of Surgery, the Netherlands Cancer Institute, Amsterdam, the Netherlands
| | - A Arjona-Sánchez
- Unit of Surgical Oncology, Department of Surgery, Reina Sofia University Hospital and GE09 Research in Peritoneal and Retroperitoneal Oncological Surgery, (IMIBIC), Cordoba, Spain
| | - V Bellato
- Department of Surgical Science, University Hospital Tor Vergata, Rome, Italy
| | - J D W van der Bilt
- Department of Surgery, Amsterdam UMC, University of Amsterdam, Cancer Center Amsterdam, Amsterdam, the Netherlands; Department of Surgery, Flevoziekenhuis, Almere, the Netherlands
| | - A D D'Hoore
- Department of Abdominal Surgery, University Hospital Leuven, Leuven, Belgium
| | - E Espinosa-Redondo
- Unit of Surgical Oncology, Department of Surgery, Reina Sofia University Hospital and GE09 Research in Peritoneal and Retroperitoneal Oncological Surgery, (IMIBIC), Cordoba, Spain
| | - C E L Klaver
- Department of Surgery, Amsterdam UMC, University of Amsterdam, Cancer Center Amsterdam, Amsterdam, the Netherlands
| | - M Kusters
- Department of Surgery, Amsterdam UMC, University of Amsterdam, Cancer Center Amsterdam, Amsterdam, the Netherlands
| | - I D Nagtegaal
- Department of Pathology, Radboud University Medical Center, Nijmegen, the Netherlands
| | - B van Ramshorst
- Department of Surgery, St. Antonius Hospital, Nieuwegein, the Netherlands
| | - H C van Santvoort
- Department of Surgery, St. Antonius Hospital, Nieuwegein, the Netherlands
| | - G S Sica
- Department of Surgical Science, University Hospital Tor Vergata, Rome, Italy
| | - P Snaebjornsson
- Department of Pathology, the Netherlands Cancer Institute, Amsterdam, the Netherlands
| | - K A T G M Wasmann
- Department of Surgery, Amsterdam UMC, University of Amsterdam, Cancer Center Amsterdam, Amsterdam, the Netherlands
| | - J H W de Wilt
- Department of Pathology, Radboud University Medical Center, Nijmegen, the Netherlands
| | - A M Wolthuis
- Department of Abdominal Surgery, University Hospital Leuven, Leuven, Belgium
| | - P J Tanis
- Department of Surgery, Amsterdam UMC, University of Amsterdam, Cancer Center Amsterdam, Amsterdam, the Netherlands; Department of Oncological and Gastrointestinal Surgery, Erasmus MC, Rotterdam, the Netherlands.
| |
Collapse
|
17
|
Abstract
INTRODUCTION Stoma prolapse is a common complication associated with ostomy creation, causing leakage, obstruction, and sometimes incarceration. Sometimes ileostomy prolapse cannot be treated with resection and alternative methods must be applied. We propose a new surgical revisional technique for ileostomy prolapse. TECHNIQUE Under general anesthesia, the prolapsed stoma is dissected and freed from the fascia and skin. The bowel is everted to create a nipple of 2-3 cm and subsequently fixed with a 3-row linear stapler, creating a "Phillips ileostomy." The ileostomy is then sutured to the skin with 3-0 full thickness stitches. RESULTS In our center, 3 patients were treated in a day surgery setting, and no complication occurred. One patient reported a prolapse recurrence after 6 months and was successfully treated with the same technique with no recurrence at 1 year. CONCLUSIONS The 3-row stapler fixation of prolapsed ileostomy is simple to perform, preserves the bowel, and can be performed in the day surgery setting.
Collapse
Affiliation(s)
- Vittoria Bellato
- Department of Surgery, Amsterdam University Medical Centers, Meibergdreef, Amsterdam, Netherlands
- Department of Surgery, University of Rome, Tor Vergata, Rome, Italy
| | - Pieter J Tanis
- Department of Surgery, Amsterdam University Medical Centers, Meibergdreef, Amsterdam, Netherlands
| | - Roel Hompes
- Department of Surgery, Amsterdam University Medical Centers, Meibergdreef, Amsterdam, Netherlands
| | - Christianna J Buskens
- Department of Surgery, Amsterdam University Medical Centers, Meibergdreef, Amsterdam, Netherlands
| | - Giuseppe S Sica
- Department of Surgery, University of Rome, Tor Vergata, Rome, Italy
| | - Willem A Bemelman
- Department of Surgery, Amsterdam University Medical Centers, Meibergdreef, Amsterdam, Netherlands
| |
Collapse
|
18
|
Sica GS. Guest edited collection: current friends and foes in gastrointestinal cancer. Discov Oncol 2021; 12:34. [PMID: 35201474 PMCID: PMC8777544 DOI: 10.1007/s12672-021-00428-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/19/2022] Open
|
19
|
Selvaggi L, Menegon Tasselli F, Sciaudone G, Kontovounisios C, Cosenza A, Sica GS, Selvaggi F, Pellino G. Shifting paradigms in two common abdominal surgical emergencies during the pandemic. Br J Surg 2021; 108:e127-e128. [PMID: 33793730 DOI: 10.1093/bjs/znaa158] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2020] [Accepted: 12/04/2020] [Indexed: 11/13/2022]
Abstract
During the pandemic there was a reduction in access to the hospital and surgical treatment of appendicitis and cholecystitis at a global level. Some strategies adopted during this challenging time could be applied even after the emergency has been controlled.
Collapse
Affiliation(s)
- L Selvaggi
- Department of Advanced Medical and Surgical Sciences, Università degli Studi della Campania 'Luigi Vanvitelli', Naples, Italy
| | - F Menegon Tasselli
- Department of Advanced Medical and Surgical Sciences, Università degli Studi della Campania 'Luigi Vanvitelli', Naples, Italy
| | - G Sciaudone
- Department of Advanced Medical and Surgical Sciences, Università degli Studi della Campania 'Luigi Vanvitelli', Naples, Italy
| | - C Kontovounisios
- Department of Surgery and Cancer, Imperial College, London, UK.,Department of Colorectal Surgery, Royal Marsden Hospital, London, UK.,Department of Colorectal Surgery, Chelsea and Westminster NHS Foundation Trust, London, UK
| | - A Cosenza
- Department of Advanced Medical and Surgical Sciences, Università degli Studi della Campania 'Luigi Vanvitelli', Naples, Italy
| | - G S Sica
- Department of Surgery, Minimally Invasive Unit, Università degli Studi di Roma 'Tor Vergata', Rome, Italy
| | - F Selvaggi
- Department of Advanced Medical and Surgical Sciences, Università degli Studi della Campania 'Luigi Vanvitelli', Naples, Italy
| | - G Pellino
- Department of Advanced Medical and Surgical Sciences, Università degli Studi della Campania 'Luigi Vanvitelli', Naples, Italy.,Colorectal Surgery, Vall d'Hebron University Hospital, Barcelona, Spain
| |
Collapse
|
20
|
Bellato V, An Y, Cerbo D, Campanelli M, Franceschilli M, Khanna K, Sensi B, Siragusa L, Rossi P, Sica GS. Feasibility and outcomes of ERAS protocol in elective cT4 colorectal cancer patients: results from a single-center retrospective cohort study. World J Surg Oncol 2021; 19:196. [PMID: 34215273 PMCID: PMC8253238 DOI: 10.1186/s12957-021-02282-7] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2021] [Accepted: 06/02/2021] [Indexed: 02/06/2023] Open
Abstract
Background Programs of Enhanced Recovery After Surgery reduces morbidity and shorten recovery in patients undergoing colorectal resections for cancer. Patients presenting with more advanced disease such as T4 cancers are frequently excluded from undergoing ERAS programs due to the difficulty in applying established protocols. The primary aim of this investigation was to evaluate the possibility of applying a validated ERAS protocol in patients undergoing colorectal resection for T4 colon and rectal cancer and to evaluate the short-term outcome. Methods Single-center, retrospective cohort study. All patients with a clinical diagnosis of stage T4 colorectal cancer undergoing surgery between November 2016 and January 2020 were treated following the institutional fast track protocol without exclusion. Short-term postoperative outcomes were compared to those of a control group treated with conventional care and that underwent surgical resection for T4 colorectal cancer at the same institution from January 2010 to October 2016. Data from both groups were collected retrospectively from a prospectively maintained database. Results Eighty-two patients were diagnosed with T4 cancer, 49 patients were included in the ERAS cohort and 33 in the historical conventional care cohort. Both, the mean time of tolerance to solid food diet and postoperative length of stay were significantly shorter in the ERAS group than in the control group (3.14 ± 1.76 vs 4.8 ± 1.52; p < 0.0001 and 6.93 ± 3.76 vs 9.50 ± 4.83; p = 0.0084 respectively). No differences in perioperative complications were observed. Conclusions Results from this cohort study from a single-center registry support the thesis that the adoption of the ERAS protocol is effective and applicable in patients with colorectal cancer clinically staged T4, reducing significantly their length of stay and time of tolerance to solid food diet, without affecting surgical postoperative outcomes.
Collapse
Affiliation(s)
- Vittoria Bellato
- Minimally Invasive Unit, Department of Surgery, Università "Tor Vergata", Viale Oxford 81, 00133, Rome, Italy.,Department of Colorectal Surgery, St Mark's Academic Hospital, London, UK
| | - Yongbo An
- Department of General Surgery, Beijing Friendship Hospital, Capital Medical University, Beijing, China
| | - Daniele Cerbo
- Minimally Invasive Unit, Department of Surgery, Università "Tor Vergata", Viale Oxford 81, 00133, Rome, Italy
| | - Michela Campanelli
- Minimally Invasive Unit, Department of Surgery, Università "Tor Vergata", Viale Oxford 81, 00133, Rome, Italy
| | - Marzia Franceschilli
- Minimally Invasive Unit, Department of Surgery, Università "Tor Vergata", Viale Oxford 81, 00133, Rome, Italy
| | - Krishn Khanna
- Department of Surgery, Rush University Medical Center, Chicago, IL, USA
| | - Bruno Sensi
- Minimally Invasive Unit, Department of Surgery, Università "Tor Vergata", Viale Oxford 81, 00133, Rome, Italy
| | - Leandro Siragusa
- Minimally Invasive Unit, Department of Surgery, Università "Tor Vergata", Viale Oxford 81, 00133, Rome, Italy
| | - Piero Rossi
- Minimally Invasive Unit, Department of Surgery, Università "Tor Vergata", Viale Oxford 81, 00133, Rome, Italy
| | - Giuseppe S Sica
- Minimally Invasive Unit, Department of Surgery, Università "Tor Vergata", Viale Oxford 81, 00133, Rome, Italy.
| |
Collapse
|
21
|
Sensi B, Bagaglini G, Bellato V, Cerbo D, Guida AM, Khan J, Panis Y, Savino L, Siragusa L, Sica GS. Management of Low Rectal Cancer Complicating Ulcerative Colitis: Proposal of a Treatment Algorithm. Cancers (Basel) 2021; 13:cancers13102350. [PMID: 34068058 PMCID: PMC8152518 DOI: 10.3390/cancers13102350] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2021] [Revised: 04/29/2021] [Accepted: 05/05/2021] [Indexed: 01/04/2023] Open
Abstract
Simple Summary This article expresses the viewpoint of the authors’ management of low rectal cancer in ulcerative colitis (UC). This subject suffers from a paucity of literature and therefore management decision is very difficult to take. The aim of this paper is to provide a structured approach to a challenging situation. It is subdivided into two parts: a first part where the existing literature is reviewed critically, and a second part in which, on the basis of the literature review and their extensive clinical experience, a management algorithm is proposed by the authors to offer guidance to surgical and oncological practices. This text adds to the literature a useful guide for the treatment of these complex clinical scenarios. Abstract Low rectal Carcinoma arising at the background of Ulcerative Colitis poses significant management challenges to the clinicians. The complex decision-making requires discussion at the multidisciplinary team meeting. The published literature is scarce, and there are significant variations in the management of such patients. We reviewed treatment protocols and operative strategies; with the aim of providing a practical framework for the management of low rectal cancer complicating UC. A practical treatment algorithm is proposed.
Collapse
Affiliation(s)
- Bruno Sensi
- Minimally Invasive Surgery, Department of Surgery, Policlinico Tor Vergata, 00133 Rome, Italy; (G.B.); (V.B.); (D.C.); (A.M.G.); (L.S.); (G.S.S.)
- Correspondence: ; Tel.: +39-338-535-2902
| | - Giulia Bagaglini
- Minimally Invasive Surgery, Department of Surgery, Policlinico Tor Vergata, 00133 Rome, Italy; (G.B.); (V.B.); (D.C.); (A.M.G.); (L.S.); (G.S.S.)
| | - Vittoria Bellato
- Minimally Invasive Surgery, Department of Surgery, Policlinico Tor Vergata, 00133 Rome, Italy; (G.B.); (V.B.); (D.C.); (A.M.G.); (L.S.); (G.S.S.)
| | - Daniele Cerbo
- Minimally Invasive Surgery, Department of Surgery, Policlinico Tor Vergata, 00133 Rome, Italy; (G.B.); (V.B.); (D.C.); (A.M.G.); (L.S.); (G.S.S.)
| | - Andrea Martina Guida
- Minimally Invasive Surgery, Department of Surgery, Policlinico Tor Vergata, 00133 Rome, Italy; (G.B.); (V.B.); (D.C.); (A.M.G.); (L.S.); (G.S.S.)
| | - Jim Khan
- Colorectal Surgery Department, Queen Alexandra Hospital, Portsmouth NHS Trust, Portsmouth PO6 3LY, UK;
| | - Yves Panis
- Service de Chirurgie Colorectale, Pôle des Maladies de L’appareil Digestif (PMAD), Université Denis-Diderot (Paris VII), Hôpital Beaujon, Assistance Publique-Hôpitaux de Paris (AP-HP), 100, Boulevard du Général-Leclerc, 92110 Clichy, France;
| | - Luca Savino
- Pathology, Department of Biomedicine and Prevention, Policlinico Tor Vergata, 00133 Rome, Italy;
| | - Leandro Siragusa
- Minimally Invasive Surgery, Department of Surgery, Policlinico Tor Vergata, 00133 Rome, Italy; (G.B.); (V.B.); (D.C.); (A.M.G.); (L.S.); (G.S.S.)
| | - Giuseppe S. Sica
- Minimally Invasive Surgery, Department of Surgery, Policlinico Tor Vergata, 00133 Rome, Italy; (G.B.); (V.B.); (D.C.); (A.M.G.); (L.S.); (G.S.S.)
| |
Collapse
|
22
|
Siragusa L, Sensi B, Vinci D, Franceschilli M, Pathirannehalage Don C, Bagaglini G, Bellato V, Campanelli M, Sica GS. Volume-outcome relationship in rectal cancer surgery. Discov Oncol 2021; 12:11. [PMID: 35201453 PMCID: PMC8777490 DOI: 10.1007/s12672-021-00406-9] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/25/2021] [Accepted: 04/02/2021] [Indexed: 02/06/2023] Open
Abstract
INTRODUCTION Hospital centralization effect is reported to lower complications and mortality for high risk and complex surgery operations, including colorectal surgery. However, no linear relation between volume and outcome has been demonstrated. Aim of the study was to evaluate the increased surgical volume effect on early outcomes of patient undergoing laparoscopic restorative anterior rectal resection (ARR). METHODS A retrospective analysis of all consecutive patients undergoing ARR with primary anastomosis between November 2016 and December 2020 after centralization of rectal cancer cases in an academic Centre. Short-term outcomes are compared to those of patients operated in the same unit during the previous 10 years before service centralization. The primary outcome was estimated anastomotic leak rate. Mean operative time, need of conversion, postoperative use of blood transfusion, radicality, in-hospital stay, number and type of complications, readmission and reoperation rate, mortality and 1-year and stoma persistence rates were evaluated as secondary outcomes. RESULTS 86 patients were operated in the study period and outcomes compared to those of 101 patients operated during the previous ten years. Difference in volume of surgery was significant between the two periods (p 0.019) and the estimated leak rate was significantly lower in the higher volume unit (p 0.047). Mean operative time, need of conversion, postoperative use of blood transfusion and in-hospital stay (p < 0.05) were also significantly reduced in Group A. CONCLUSION This study suggests that the shift toward higher volume in rectal cancer surgery is associated to decreased anastomotic leak rate. Potentiation of lower volume surgical units may yield optimal perioperative outcomes.
Collapse
Affiliation(s)
- L Siragusa
- Department of Surgical Science, University Tor Vergata, Viale Oxford 81, 00133, Rome, Italy.
| | - B Sensi
- Department of Surgical Science, University Tor Vergata, Viale Oxford 81, 00133, Rome, Italy
| | - D Vinci
- Department of Surgical Science, University Tor Vergata, Viale Oxford 81, 00133, Rome, Italy
| | - M Franceschilli
- Department of Surgical Science, University Tor Vergata, Viale Oxford 81, 00133, Rome, Italy
| | - C Pathirannehalage Don
- Department of Surgical Science, University Tor Vergata, Viale Oxford 81, 00133, Rome, Italy
| | - G Bagaglini
- Department of Surgical Science, University Tor Vergata, Viale Oxford 81, 00133, Rome, Italy
| | - V Bellato
- Department of Surgical Science, University Tor Vergata, Viale Oxford 81, 00133, Rome, Italy
| | - M Campanelli
- Department of Surgical Science, University Tor Vergata, Viale Oxford 81, 00133, Rome, Italy
| | - G S Sica
- Department of Surgical Science, University Tor Vergata, Viale Oxford 81, 00133, Rome, Italy
| |
Collapse
|
23
|
Tesauro M, Guida AM, Siragusa L, Sensi B, Bellato V, Di Daniele N, Divizia A, Franceschilli M, Sica GS. Preoperative Immunonutrition vs. Standard Dietary Advice in Normo-Nourished Patients Undergoing Fast-Track Laparoscopic Colorectal Surgery. J Clin Med 2021; 10:jcm10030413. [PMID: 33499058 PMCID: PMC7865842 DOI: 10.3390/jcm10030413] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/03/2021] [Revised: 01/17/2021] [Accepted: 01/18/2021] [Indexed: 12/11/2022] Open
Abstract
Immunonutrition (IN) appears to reduce infective complications and in-hospital length of stay (LOS) after major gastrointestinal surgery, but its use in normo-nourished patients is still controversial. The primary aim of this comparative observational study was to evaluate if pre-operative IN reduces in-hospital stay in patients undergoing laparoscopic colorectal resection for cancer under an enhanced recovery after surgery (ERAS) program. The influence of IN on time to first bowel movements, time to full oral diet tolerance, number and type of complications, reasons of prolonged LOS and readmission rate was evaluated as secondary outcome. Patients undergoing ERAS laparoscopic colorectal resection between December 2016 and December 2019 were reviewed. Patients who have received preoperative IN (group A) were compared to those receiving standard dietary advice (group B). Mean in-hospital LOS was significantly shorter in patients receiving preoperative IN than standard dietary advice (4.85 ± 2.25 days vs. 6.06 ± 3.95 days; p < 0.0492). No differences in secondary outcomes were observed. Preoperative IN associated with ERAS protocol in normo-nourished patients undergoing laparoscopic colorectal cancer resection seems to reduce LOS.
Collapse
Affiliation(s)
- Manfredi Tesauro
- Department of Systems Medicine, University Tor Vergata, 00133 Rome, Italy; (M.T.); (N.D.D.)
| | - Andrea M. Guida
- Department of Surgical Science, University Tor Vergata, 00133 Rome, Italy; (A.M.G.); (L.S.); (B.S.); (V.B.); (A.D.); (M.F.)
| | - Leandro Siragusa
- Department of Surgical Science, University Tor Vergata, 00133 Rome, Italy; (A.M.G.); (L.S.); (B.S.); (V.B.); (A.D.); (M.F.)
| | - Bruno Sensi
- Department of Surgical Science, University Tor Vergata, 00133 Rome, Italy; (A.M.G.); (L.S.); (B.S.); (V.B.); (A.D.); (M.F.)
| | - Vittoria Bellato
- Department of Surgical Science, University Tor Vergata, 00133 Rome, Italy; (A.M.G.); (L.S.); (B.S.); (V.B.); (A.D.); (M.F.)
| | - Nicola Di Daniele
- Department of Systems Medicine, University Tor Vergata, 00133 Rome, Italy; (M.T.); (N.D.D.)
| | - Andrea Divizia
- Department of Surgical Science, University Tor Vergata, 00133 Rome, Italy; (A.M.G.); (L.S.); (B.S.); (V.B.); (A.D.); (M.F.)
| | - Marzia Franceschilli
- Department of Surgical Science, University Tor Vergata, 00133 Rome, Italy; (A.M.G.); (L.S.); (B.S.); (V.B.); (A.D.); (M.F.)
| | - Giuseppe S. Sica
- Department of Surgical Science, University Tor Vergata, 00133 Rome, Italy; (A.M.G.); (L.S.); (B.S.); (V.B.); (A.D.); (M.F.)
- Correspondence: ; Tel.: +39-(06)-2090-2922
| |
Collapse
|
24
|
Petagna L, Antonelli A, Ganini C, Bellato V, Campanelli M, Divizia A, Efrati C, Franceschilli M, Guida AM, Ingallinella S, Montagnese F, Sensi B, Siragusa L, Sica GS. Pathophysiology of Crohn's disease inflammation and recurrence. Biol Direct 2020; 15:23. [PMID: 33160400 PMCID: PMC7648997 DOI: 10.1186/s13062-020-00280-5] [Citation(s) in RCA: 61] [Impact Index Per Article: 15.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2020] [Accepted: 10/30/2020] [Indexed: 02/07/2023] Open
Abstract
Chron’s Disease is a chronic inflammatory intestinal disease, first described at the beginning of the last century. The disease is characterized by the alternation of periods of flares and remissions influenced by a complex pathogenesis in which inflammation plays a key role. Crohn’s disease evolution is mediated by a complex alteration of the inflammatory response which is characterized by alterations of the innate immunity of the intestinal mucosa barrier together with a remodeling of the extracellular matrix through the expression of metalloproteins and increased adhesion molecules expression, such as MAcCAM-1. This reshaped microenvironment enhances leucocytes migration in the sites of inflammation, promoting a TH1 response, through the production of cytokines such as IL-12 and TNF-α. IL-12 itself and IL-23 have been targeted for the medical treatment of CD. Giving the limited success of medical therapies, the treatment of the disease is invariably surgical. This review will highlight the role of inflammation in CD and describe the surgical approaches for the prevention of the almost inevitable recurrence.
Collapse
Affiliation(s)
- L Petagna
- Department of Surgical Science, University Tor Vergata, Viale Oxford 81, 00133, Rome, Italy
| | - A Antonelli
- Department of Surgical Science, University Tor Vergata, Viale Oxford 81, 00133, Rome, Italy
| | - C Ganini
- Torvergata Oncoscience Research Centre of Excellence, TOR, Department of Experimental Medicine, University Tor Vergata, Rome, Italy
| | - V Bellato
- Department of Surgical Science, University Tor Vergata, Viale Oxford 81, 00133, Rome, Italy
| | - M Campanelli
- Department of Surgical Science, University Tor Vergata, Viale Oxford 81, 00133, Rome, Italy
| | - A Divizia
- Department of Surgical Science, University Tor Vergata, Viale Oxford 81, 00133, Rome, Italy
| | - C Efrati
- Ospedale Israelitico, Department of Gastroenterology, Rome, Italy
| | - M Franceschilli
- Department of Surgical Science, University Tor Vergata, Viale Oxford 81, 00133, Rome, Italy
| | - A M Guida
- Department of Surgical Science, University Tor Vergata, Viale Oxford 81, 00133, Rome, Italy
| | - S Ingallinella
- Department of Surgical Science, University Tor Vergata, Viale Oxford 81, 00133, Rome, Italy
| | - F Montagnese
- Nuovo Ospedale dei Castelli, Endoscopy Unit, Rome, Italy
| | - B Sensi
- Department of Surgical Science, University Tor Vergata, Viale Oxford 81, 00133, Rome, Italy
| | - L Siragusa
- Department of Surgical Science, University Tor Vergata, Viale Oxford 81, 00133, Rome, Italy
| | - G S Sica
- Department of Surgical Science, University Tor Vergata, Viale Oxford 81, 00133, Rome, Italy. .,Torvergata Oncoscience Research Centre of Excellence, TOR, Department of Experimental Medicine, University Tor Vergata, Rome, Italy.
| |
Collapse
|
25
|
Franzè E, Dinallo V, Laudisi F, Di Grazia A, Di Fusco D, Colantoni A, Ortenzi A, Giuffrida P, Di Carlo S, Sica GS, Di Sabatino A, Monteleone G. Interleukin-34 Stimulates Gut Fibroblasts to Produce Collagen Synthesis. J Crohns Colitis 2020; 14:1436-1445. [PMID: 32271873 DOI: 10.1093/ecco-jcc/jjaa073] [Citation(s) in RCA: 25] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
BACKGROUND AND AIM The mechanisms underlying the formation of intestinal fibrostrictures [FS] in Crohn's disease [CD] are not fully understood, but activation of fibroblasts and excessive collagen deposition are supposed to contribute to the development of FS. Here we investigated whether interleukin-34 [IL-34], a cytokine that is over-produced in CD, regulates collagen production by gut fibroblasts. METHODS IL-34 and its receptor macrophage colony-stimulating factor receptor 1 [M-CSFR-1] were evaluated in inflammatory [I], FS CD, and control [CTR] ileal mucosal samples by real-time polymerase chain reaction [RT-PCR], western blotting, and immunohistochemistry. IL-34 and M-CSFR-1 expression was evaluated in normal and FS CD fibroblasts. Control fibroblasts were stimulated with IL-34 in the presence or absence of a MAP kinase p38 inhibitor, and FS CD fibroblasts were cultured with a specific IL-34 antisense oligonucleotide, and collagen production was evaluated by RT-PCR, western blotting, and Sircol assay. The effect of IL-34 on the wound healing capacity of fibroblasts was evaluated by scratch test. RESULTS We showed enhanced M-CSFR-1 and IL-34 RNA and protein expression in FS CD mucosal samples as compared with ICD and CTR samples. Immunohistochemical analysis showed that stromal cells were positive for M-CSFR-1 and IL-34. Enhanced M-CSFR-1 and IL-34 RNA and protein expression was seen in FS CD fibroblasts as compared with CTR. Stimulation of control fibroblasts with IL-34 enhanced COL1A1 and COL3A1 expression and secretion of collagen through a p38 MAP kinase-dependent mechanism, and wound healing. IL-34 knockdown in FS CD fibroblasts was associated with reduced collagen production and wound repair. CONCLUSIONS Data indicate a prominent role of IL-34 in the control of intestinal fibrogenesis.
Collapse
Affiliation(s)
- Eleonora Franzè
- Department of Systems Medicine, University of Rome 'TOR VERGATA', Rome, Italy
| | - Vincenzo Dinallo
- Department of Systems Medicine, University of Rome 'TOR VERGATA', Rome, Italy
| | - Federica Laudisi
- Department of Systems Medicine, University of Rome 'TOR VERGATA', Rome, Italy
| | - Antonio Di Grazia
- Department of Systems Medicine, University of Rome 'TOR VERGATA', Rome, Italy
| | - Davide Di Fusco
- Department of Systems Medicine, University of Rome 'TOR VERGATA', Rome, Italy
| | - Alfredo Colantoni
- Department of Systems Medicine, University of Rome 'TOR VERGATA', Rome, Italy
| | - Angela Ortenzi
- Department of Systems Medicine, University of Rome 'TOR VERGATA', Rome, Italy
| | - Paolo Giuffrida
- Department of Internal Medicine, San Matteo Hospital Foundation, University of Pavia, Pavia, Italy
| | - Sara Di Carlo
- Department of Surgery, University 'TOR VERGATA' of Rome, Rome, Italy
| | - Giuseppe S Sica
- Department of Surgery, University 'TOR VERGATA' of Rome, Rome, Italy
| | - Antonio Di Sabatino
- Department of Internal Medicine, San Matteo Hospital Foundation, University of Pavia, Pavia, Italy
| | - Giovanni Monteleone
- Department of Systems Medicine, University of Rome 'TOR VERGATA', Rome, Italy
| |
Collapse
|
26
|
An Y, Bellato V, Konishi T, Pellino G, Sensi B, Siragusa L, Franceschilli M, Sica GS. Surgeons' fear of getting infected by COVID19: A global survey. Br J Surg 2020; 107:e543-e544. [PMID: 32808678 PMCID: PMC7461173 DOI: 10.1002/bjs.11833] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/27/2020] [Accepted: 05/29/2020] [Indexed: 02/05/2023]
Affiliation(s)
- Yongbo An
- Department of General Surgery, Beijing Friendship Hospital, Capital Medical University, Beijing, China
- Department of Surgery, Amsterdam UMC, University of Amsterdam, the Netherlands
| | - Vittoria Bellato
- Department of Surgery, Minimally Invasive Unit, Università degli Studi di Roma “Tor Vergata”, Rome, Italy
| | - Tsuyoshi Konishi
- Department of Gastroenterological Surgery, Cancer Institute Hospital of the Japanese Foundation for Cancer Research, Tokyo, Japan
| | - Gianluca Pellino
- Department of Advanced Medical and Surgical Sciences, Università degli Studi della Campania “Luigi Vanvitelli”, Naples, Italy
- Department of Colorectal Surgery, Vall d'Hebron University Hospital, Barcelona, Spain
| | - Bruno Sensi
- Department of Surgery, Minimally Invasive Unit, Università degli Studi di Roma “Tor Vergata”, Rome, Italy
| | - Leandro Siragusa
- Department of Surgery, Minimally Invasive Unit, Università degli Studi di Roma “Tor Vergata”, Rome, Italy
| | - Marzia Franceschilli
- Department of Surgery, Minimally Invasive Unit, Università degli Studi di Roma “Tor Vergata”, Rome, Italy
| | - Giuseppe S Sica
- Department of Surgery, Minimally Invasive Unit, Università degli Studi di Roma “Tor Vergata”, Rome, Italy
- Correspondence to: Address: Giuseppe Sica, MD, PhD. Department of Surgery, Minimally Invasive Unit, Università degli Studi di Roma “Tor Vergata”, Rome, Italy, Address: Tor vergata hospital, Viale Oxford 81, 00133, Rome, Italy, Phone/Fax: +39 338 533 3659,
| |
Collapse
|
27
|
Bellato V, Konishi T, Pellino G, An Y, Piciocchi A, Sensi B, Siragusa L, Khanna K, Pirozzi BM, Franceschilli M, Campanelli M, Efetov S, Sica GS. Impact of asymptomatic COVID-19 patients in global surgical practice during the COVID-19 pandemic. Br J Surg 2020; 107:e364-e365. [PMID: 32767367 PMCID: PMC7929295 DOI: 10.1002/bjs.11800] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/21/2020] [Accepted: 05/21/2020] [Indexed: 02/05/2023]
Affiliation(s)
- V Bellato
- Department of Surgery, Minimally Invasive Unit, Università degli Studi di Roma “Tor Vergata”, Rome, Italy
| | - T Konishi
- Department of Gastroenterological Surgery, Cancer Institute Hospital of the Japanese Foundation for Cancer Research, Tokyo, Japan
| | - G Pellino
- Department of Advanced Medical and Surgical Sciences, Università degli Studi della Campania “Luigi Vanvitelli”, Naples, Italy
- Department of Colorectal Surgery, Vall d'Hebron University Hospital, Barcelona, Spain
| | - Y An
- Department of General Surgery, Beijing Friendship Hospital, Capital Medical University, Beijing, China
| | | | - B Sensi
- Department of Surgery, Minimally Invasive Unit, Università degli Studi di Roma “Tor Vergata”, Rome, Italy
| | - L Siragusa
- Department of Surgery, Minimally Invasive Unit, Università degli Studi di Roma “Tor Vergata”, Rome, Italy
| | - K Khanna
- Department of Orthopaedic surgery, Rush university medical center, Chicago, IL
| | - B M Pirozzi
- Department of Surgery, Minimally Invasive Unit, Università degli Studi di Roma “Tor Vergata”, Rome, Italy
| | - M Franceschilli
- Department of Surgery, Minimally Invasive Unit, Università degli Studi di Roma “Tor Vergata”, Rome, Italy
| | - M Campanelli
- Department of Surgery, Minimally Invasive Unit, Università degli Studi di Roma “Tor Vergata”, Rome, Italy
| | - S Efetov
- Department of Surgery, I.M. Sechenov First Moscow State Medical University, Moscow, Russia
| | - G S Sica
- Department of Surgery, Minimally Invasive Unit, Università degli Studi di Roma “Tor Vergata”, Rome, Italy
| |
Collapse
|
28
|
Milone M, Degiuli M, Allaix ME, Ammirati CA, Anania G, Barberis A, Belli A, Bianchi PP, Bianco F, Bombardini C, Burati M, Cavaliere D, Coco C, Coratti A, De Luca R, De Manzoni G, De Nardi P, De Rosa M, Delrio P, Di Cataldo A, Di Leo A, Donini A, Elmore U, Fontana A, Gallo G, Gentilli S, Giannessi S, Giuliani G, Graziosi L, Guerrieri M, Li Destri G, Longhin R, Manigrasso M, Mineccia M, Monni M, Morino M, Ortenzi M, Pecchini F, Pedrazzani C, Piccoli M, Pollesel S, Pucciarelli S, Reddavid R, Rega D, Rigamonti M, Rizzo G, Robustelli V, Rondelli F, Rosati R, Roviello F, Santarelli M, Saraceno F, Scabini S, Sica GS, Sileri P, Simone M, Siragusa L, Sofia S, Solaini L, Tribuzi A, Trompetto M, Turri G, Urso EDL, Vertaldi S, Vignali A, Zuin M, Zuolo M, D'Ugo D, De Palma GD. Mid-transverse colon cancer and extended versus transverse colectomy: Results of the Italian society of surgical oncology colorectal cancer network (SICO CCN) multicenter collaborative study. Eur J Surg Oncol 2020; 46:1683-1688. [PMID: 32220542 DOI: 10.1016/j.ejso.2020.01.006] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/07/2019] [Accepted: 01/03/2020] [Indexed: 02/06/2023] Open
Abstract
INTRODUCTION Transverse colon cancer (TCC) is poorly studied, and TCC cases are often excluded from large prospective randomized trials because of their complexity and their potentially high complication rate. The best surgical approach for TCC has yet to be established. The aim of this large retrospective multicenter Italian series is to investigate the advantages and disadvantages of both hemicolectomy and transverse colectomy in order to identify the best surgical approach. MATERIALS AND METHODS This was a retrospective cohort study of patients with mid-transverse colon cancer treated with a segmental colon resection or an extended hemicolectomy (right or left) between 2006 and 2016 in 28 high-volume (more than 70 procedures/year) Italian referral centers for colorectal surgery. RESULTS The study included 1529 patients, 388 of whom underwent a segmental resection while 1141 underwent an extended resection. A higher number of complications has been reported in the segmental group than in the extended group (30.1% versus 23.6%; p 0.010). In 42 cases the main complication was the anastomotic leak (4.4% versus 2.2%; p 0.020). Recovery outcomes also showed statistical differences: time to first flatus (p 0.014), time to first mobilization (p 0.040), and overall hospital stay (p < 0.001) were significantly shorter in the extended group. Even if overall survival were similar between the groups (95.1% versus 97%; p 0.384), 3-year disease-free survival worsened after segmental resection (78.1% versus 86.2%; p 0.001). CONCLUSIONS According to our results, an extended right colon resection for TCC seems to be surgically safer and more oncologically valid.
Collapse
Affiliation(s)
- M Milone
- Department of Clinical Medicine and Surgery, Federico II University of Naples, Naples, Italy.
| | - M Degiuli
- Department of Oncology, Surgical Oncology and Digestive Surgery Unit, San Luigi University Hospital, Orbassano, Turin, Italy
| | - M E Allaix
- Department of Surgical Sciences, University of Turin, Turin, Italy
| | - C A Ammirati
- Oncologic Surgical Unit, Hospital Policlinic San Martino, Genova, Italy
| | - G Anania
- Department of Morphology, Experimental Medicine and Surgery, Section of General and Thoracic Surgery, University of Ferrara, Italy
| | - A Barberis
- Unit of General and Hepatobiliopancreatic Surgery, Galliera Hospital, Genova, Italy
| | - A Belli
- Division of Surgical Oncology, Department of Abdominal Oncology, IRCCS Fondazione "G. Pascale", Naples, Italy
| | - P P Bianchi
- Department of General and Minimally Invasive Surgery, Misericordia Hospital, Grosseto, Italy
| | - F Bianco
- Division of Surgical Oncology, Department of Abdominal Oncology, IRCCS Fondazione "G. Pascale", Naples, Italy
| | - C Bombardini
- Department of Morphology, Experimental Medicine and Surgery, Section of General and Thoracic Surgery, University of Ferrara, Italy
| | - M Burati
- Department of Clinical Medicine and Surgery, Federico II University of Naples, Naples, Italy
| | - D Cavaliere
- General and Oncologic Surgery, Morgagni-Pierantoni Hospital, Forlì, Italy
| | - C Coco
- Department of General Surgery, Sacred Heart Catholic University, Rome, Italy
| | - A Coratti
- Division of Oncological and Robotic General Surgery, Careggi University Hospital, Florence, Italy
| | - R De Luca
- Department of Surgical Oncology, National Cancer Research Center, Giovanni Paolo II Tumor Institute, Bari, Italy
| | - G De Manzoni
- Department of Surgery, General and Upper GI, Surgery Division, University of Verona, Verona, Italy
| | - P De Nardi
- Division of Gastrointestinal Surgery, San Raffaele Scientific Institut, Milan, Italy
| | - M De Rosa
- Department of General Surgery, San Giovanni Battista Hospital, Foligno, Italy
| | - P Delrio
- Colorectal Abdominal Surgery Division, IRCCS Fondazione "G. Pascale", Naples, Italy
| | - A Di Cataldo
- Department of General Surgery and Medical-Surgical Specialties, University of Catania, Catania, Italy
| | - A Di Leo
- Department of Surgery, General and Upper GI, Surgery Division, University of Verona, Verona, Italy
| | - A Donini
- Department of General and Emergency Surgery, University of Perugia, Perugia, Italy
| | - U Elmore
- Division of Gastrointestinal Surgery, San Raffaele Scientific Institut, Milan, Italy
| | - A Fontana
- Department of HPB and Digestive Surgery, Ospedale Mauriziano Umberto I, Turin, Italy
| | - G Gallo
- Department of Colorectal Surgery, Santa Rita Clinic, Vercelli, Italy
| | - S Gentilli
- Department of General Surgery, Maggiore della Carità Hospital, Novara, Italy
| | - S Giannessi
- Operative Unit of General Surgery, San Jacopo Hospital, Pistoia, Italy
| | - G Giuliani
- Department of General and Minimally Invasive Surgery, Misericordia Hospital, Grosseto, Italy
| | - L Graziosi
- Department of General and Emergency Surgery, University of Perugia, Perugia, Italy
| | - M Guerrieri
- Department of General Surgery, Università Politecnica delle Marche, Ancona, Italy
| | - G Li Destri
- Department of General Surgery and Medical-Surgical Specialties, University of Catania, Catania, Italy
| | - R Longhin
- Unit of General and Hepatobiliopancreatic Surgery, Galliera Hospital, Genova, Italy
| | - M Manigrasso
- Department of Clinical Medicine and Surgery, Federico II University of Naples, Naples, Italy
| | - M Mineccia
- Department of HPB and Digestive Surgery, Ospedale Mauriziano Umberto I, Turin, Italy
| | - M Monni
- Department of General Surgery, Maggiore della Carità Hospital, Novara, Italy
| | - M Morino
- Department of Surgical Sciences, University of Turin, Turin, Italy
| | - M Ortenzi
- Department of General Surgery, Università Politecnica delle Marche, Ancona, Italy
| | - F Pecchini
- Department of General and Emergency Surgery, Azienda Ospedaliera Universitaria Modena, Modena, Italy
| | - C Pedrazzani
- Division of General and Hepatobiliary Surgery, Department of Surgical Sciences, Dentistry, Gynecology and Pediatrics, Unit of Colorectal Surgery, University of Verona, Verona, Italy
| | - M Piccoli
- Department of General and Emergency Surgery, Azienda Ospedaliera Universitaria Modena, Modena, Italy
| | - S Pollesel
- Department of General Surgery and Surgical Oncology, University of Siena, Italy
| | - S Pucciarelli
- Department of Surgical, Oncological and Gastroenterological Sciences, University of Padova, Padova, Italy
| | - R Reddavid
- Department of Oncology, Surgical Oncology and Digestive Surgery Unit, San Luigi University Hospital, Orbassano, Turin, Italy
| | - D Rega
- Colorectal Abdominal Surgery Division, IRCCS Fondazione "G. Pascale", Naples, Italy
| | - M Rigamonti
- Operative Unit of General Surgery, Valli del Noce Hospital, Cles, Trento, Italy
| | - G Rizzo
- Department of General Surgery, Sacred Heart Catholic University, Rome, Italy
| | - V Robustelli
- Operative Unit of General Surgery, San Jacopo Hospital, Pistoia, Italy
| | - F Rondelli
- Department of General Surgery, San Giovanni Battista Hospital, Foligno, Italy
| | - R Rosati
- Division of Gastrointestinal Surgery, San Raffaele Scientific Institut, Milan, Italy
| | - F Roviello
- Department of General Surgery and Surgical Oncology, University of Siena, Italy
| | - M Santarelli
- Division of General and Emergency Surgery, Molinette Hospital, Turin, Italy
| | - F Saraceno
- Department of General Surgery, University of Rome Tor Vergata, Rome, Italy
| | - S Scabini
- Oncologic Surgical Unit, Hospital Policlinic San Martino, Genova, Italy
| | - G S Sica
- Department of Minimally Invasive and GI Surgery, Policlinico Tor Vergata, Rome, Italy
| | - P Sileri
- Department of General Surgery, University of Rome Tor Vergata, Rome, Italy
| | - M Simone
- Department of Surgical Oncology, National Cancer Research Center, Giovanni Paolo II Tumor Institute, Bari, Italy
| | - L Siragusa
- Department of Minimally Invasive and GI Surgery, Policlinico Tor Vergata, Rome, Italy
| | - S Sofia
- Department of Oncology, Surgical Oncology and Digestive Surgery Unit, San Luigi University Hospital, Orbassano, Turin, Italy
| | - L Solaini
- General and Oncologic Surgery, Morgagni-Pierantoni Hospital, Forlì, Italy
| | - A Tribuzi
- Division of Oncological and Robotic General Surgery, Careggi University Hospital, Florence, Italy
| | - M Trompetto
- Department of Colorectal Surgery, Santa Rita Clinic, Vercelli, Italy
| | - G Turri
- Division of General and Hepatobiliary Surgery, Department of Surgical Sciences, Dentistry, Gynecology and Pediatrics, Unit of Colorectal Surgery, University of Verona, Verona, Italy
| | - E D L Urso
- Department of Surgical, Oncological and Gastroenterological Sciences, University of Padova, Padova, Italy
| | - S Vertaldi
- Department of Clinical Medicine and Surgery, Federico II University of Naples, Naples, Italy
| | - A Vignali
- Division of Gastrointestinal Surgery, San Raffaele Scientific Institut, Milan, Italy
| | - M Zuin
- Department of Surgical, Oncological and Gastroenterological Sciences, University of Padova, Padova, Italy
| | - M Zuolo
- Operative Unit of General Surgery, Valli del Noce Hospital, Cles, Trento, Italy
| | - D D'Ugo
- Department of Surgery, Università Cattolica del Sacro Cuore, Rome, Italy
| | - G D De Palma
- Department of Clinical Medicine and Surgery, Federico II University of Naples, Naples, Italy
| |
Collapse
|
29
|
D'Ugo S, Romano F, Sibio S, Bagaglini G, Sensi B, Biancone L, Monteleone G, Sica GS. Impact of surgery on quality of life in Crohn's disease: short- and mid-term follow-up. Updates Surg 2020; 72:773-780. [PMID: 32185677 DOI: 10.1007/s13304-020-00738-1] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/19/2019] [Accepted: 03/04/2020] [Indexed: 02/06/2023]
Abstract
Active Crohn's disease has a substantial impact on Quality of Life (QoL). Medical management could be associated to side effects, hospitalization, long treatment period and requires patient's compliance, impacting QoL. Ileocecal resection (ICR) is often required, open or laparoscopic. Aim of the study was to assess Health-Related (HR) QoL changes following ICR, and to identify factors impacting on QoL in the short and mid-term. From a single institution, we created a prospective database of patients undergoing ICR from 01/2009 to 12/2015. HRQoL was analysed with Cleveland Global Quality of Life (CGQL) score, Overall Quality of Happiness (OQH), and asking patients if they would have surgery again. QoL scores were recorded at 30 days, 6, 12 and 36 months postoperatively and compared according to follow-up timing, technique, medical treatment and demographics. Statistical analysis included 187 patients. Mean follow-up was 3.8 ± 2.9 years. Both at 30 days and 6 months postoperatively, CGQL, its items and OQH increased significantly (p < 0.001). Increased values were also recorded at 1 and 3 years; 88% of patients would undergo surgery again. Laparoscopy was associated with improved CGQL scores, while preoperative steroids with worsen data. Young female patients, with penetrating pattern, experienced greater HRQoL improvements. Surgery is associated with improvements of HRQoL and patients' happiness in the short and mid-term. Laparoscopy, steroid-free and young patients showed the best results. ICR should be considered a reasonable alternative to non-operative strategies in selected cases.
Collapse
Affiliation(s)
- Stefano D'Ugo
- Gastrointestinal Surgery Unit, Tor Vergata University Hospital, Viale Oxford 81, 00133, Rome, Italy.
- Department of Surgery, "Vito Fazzi" Hospital, Piazza F. Muratore, 73100, Lecce, Italy.
| | - Francesca Romano
- Gastrointestinal Surgery Unit, Tor Vergata University Hospital, Viale Oxford 81, 00133, Rome, Italy
| | - Simone Sibio
- Department of Surgery, La Sapienza University, P.le A. Moro, Rome, Italy
| | - Giulia Bagaglini
- Gastrointestinal Surgery Unit, Tor Vergata University Hospital, Viale Oxford 81, 00133, Rome, Italy
| | - Bruno Sensi
- Gastrointestinal Surgery Unit, Tor Vergata University Hospital, Viale Oxford 81, 00133, Rome, Italy
| | - Livia Biancone
- Gastroenterology Unit, Tor Vergata University Hospital, Viale Oxford 81, 00133, Rome, Italy
| | - Giovanni Monteleone
- Gastroenterology Unit, Tor Vergata University Hospital, Viale Oxford 81, 00133, Rome, Italy
| | - Giuseppe S Sica
- Gastrointestinal Surgery Unit, Tor Vergata University Hospital, Viale Oxford 81, 00133, Rome, Italy
| |
Collapse
|
30
|
Franzè E, Monteleone I, Laudisi F, Rizzo A, Dinallo V, Di Fusco D, Colantoni A, Ortenzi A, Giuffrida P, Di Carlo S, Sica GS, Di Sabatino A, Monteleone G. Cadherin-11 Is a Regulator of Intestinal Fibrosis. J Crohns Colitis 2020; 14:406-417. [PMID: 31504344 DOI: 10.1093/ecco-jcc/jjz147] [Citation(s) in RCA: 21] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
BACKGROUND AND AIMS Although the mechanisms underlying the formation of intestinal fibrostrictures in Crohn's disease [CD] are not fully understood, activation of fibroblasts and excessive collagen deposition are supposed to contribute to the development of such complications. Here, we investigated the role of cadherin-11 [CDH-11], a fibroblast-derived protein that induces collagen production in various organs, in intestinal fibrosis. METHODS CDH-11 expression was evaluated in inflammatory [I] and fibrostricturing [FS] CD mucosal samples, ulcerative colitis [UC] mucosal samples, and ileal and colonic control samples, by real-time polymerase chain reaction, western blotting, and immunohistochemistry. CDH-11 expression was evaluated in normal and in CD intestinal fibroblasts stimulated with inflammatory/fibrogenic cytokines. FS CD fibroblasts were cultured either with a specific CDH-11 antisense oligonucleotide [AS], or activating CDH-11 fusion protein and activation of RhoA/ROCK, and TGF-β pathways and collagen production were evaluated by western blotting. Finally, we assessed the susceptibility of CDH-11-knockout [KO] mice to colitis-induced intestinal fibrosis. RESULTS CDH-11 RNA and protein expression were increased in both CD and UC as compared with controls. In CD, the greater expression of CDH-11 was seen in FS samples. Stimulation of fibroblasts with TNF-α, interleukin [IL]-6, IFN-γ, IL-13, and IL-1β enhanced CDH-11 expression. Knockdown of CDH-11 in FS CD fibroblasts impaired RhoA/ROCK/TGF-β signalling and reduced collagen synthesis, whereas activation of CDH-11 increased collagen secretion. CDH-11 KO mice were largely protected from intestinal fibrosis. CONCLUSIONS Data show that CDH-11 expression is up-regulated in inflammatory bowel disease [IBD] and suggest a role for this protein in the control of intestinal fibrosis.
Collapse
Affiliation(s)
- Eleonora Franzè
- Department of Systems Medicine, University of Rome 'TOR VERGATA', Rome, Italy
| | - Ivan Monteleone
- Department of Systems Medicine, University of Rome 'TOR VERGATA', Rome, Italy
| | - Federica Laudisi
- Department of Systems Medicine, University of Rome 'TOR VERGATA', Rome, Italy
| | - Angelamaria Rizzo
- Department of Systems Medicine, University of Rome 'TOR VERGATA', Rome, Italy
| | - Vincenzo Dinallo
- Department of Systems Medicine, University of Rome 'TOR VERGATA', Rome, Italy
| | - Davide Di Fusco
- Department of Systems Medicine, University of Rome 'TOR VERGATA', Rome, Italy
| | - Alfredo Colantoni
- Department of Systems Medicine, University of Rome 'TOR VERGATA', Rome, Italy
| | - Angela Ortenzi
- Department of Systems Medicine, University of Rome 'TOR VERGATA', Rome, Italy
| | - Paolo Giuffrida
- Department of Internal Medicine, San Matteo Hospital Foundation, University of Pavia, Pavia, Italy
| | - Sara Di Carlo
- Department of Surgery, University 'TOR VERGATA' of Rome, Rome, Italy
| | - Giuseppe S Sica
- Department of Surgery, University 'TOR VERGATA' of Rome, Rome, Italy
| | - Antonio Di Sabatino
- Department of Internal Medicine, San Matteo Hospital Foundation, University of Pavia, Pavia, Italy
| | - Giovanni Monteleone
- Department of Systems Medicine, University of Rome 'TOR VERGATA', Rome, Italy
| |
Collapse
|
31
|
Sibio S, Di Giorgio A, D'Ugo S, Palmieri G, Cinelli L, Formica V, Sensi B, Bagaglini G, Di Carlo S, Bellato V, Sica GS. Histotype influences emergency presentation and prognosis in colon cancer surgery. Langenbecks Arch Surg 2019; 404:841-851. [PMID: 31760472 DOI: 10.1007/s00423-019-01826-6] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/27/2018] [Accepted: 09/13/2019] [Indexed: 02/06/2023]
Abstract
AIM To investigate whether differences in histotype in colon cancer correlate with clinical presentation and if they might influence oncological outcomes and survival. METHODS Data regarding colon cancer patients operated both electively or in emergency between 2009 and 2014 were retrospectively collected from a prospectively maintained database and analyzed for the purpose of this study. Rectal cancer was excluded from this analysis. Statistical univariate and multivariate analyses were performed to investigate possible significant variables influencing clinical presentation, as well as oncological outcomes and survival. RESULTS Data from 219 patients undergoing colorectal resection for cancer of the colon only were retrieved. One hundred seventy-four patients had an elective procedure and forty-five had an emergency colectomy. Emergency presentation was more likely to occur in mucinous (p < 0.05) and signet ring cell (p < 0.01) tumors. No definitive differences in 5-year overall (44.7% vs. 60.6%, p = 0.078) and disease-free (51.2% vs. 64.4%, p = 0.09) survival were found between the two groups as a whole, but the T3 emergency patients showed worse prognosis than the elective (p < 0.03). Lymph node invasion, laparoscopy, histology, and blood transfusions were independent variables found to influence survival. Distribution assessed for pTNM stage showed T3 cancers were more common in emergency (p < 0.01). CONCLUSIONS AND DISCUSSION Mucinous and signet ring cell tumors are related to emergency presentation, pT3 stage, poorest outcomes, and survival. Disease-free survival in patients who had emergency surgery for T3 colon cancer seems related to the histotype.
Collapse
Affiliation(s)
- Simone Sibio
- Department of Surgery "Pietro Valdoni", Sapienza University of Rome, Viale del Policlinico 155, 00161, Rome, Italy. .,Department of Surgery "Pietro Valdoni", Sapienza University of Rome, Via Lancisi 2, 00155, Rome, Italy.
| | - A Di Giorgio
- Department of Surgery, Tor Vergata Hospital, Tor Vergata University of Rome, Viale Oxford 81, 00133, Rome, Italy
| | - S D'Ugo
- Department of Surgery, Tor Vergata Hospital, Tor Vergata University of Rome, Viale Oxford 81, 00133, Rome, Italy
| | - G Palmieri
- Department of Surgery, Tor Vergata Hospital, Tor Vergata University of Rome, Viale Oxford 81, 00133, Rome, Italy
| | - L Cinelli
- Department of Surgery, Tor Vergata Hospital, Tor Vergata University of Rome, Viale Oxford 81, 00133, Rome, Italy
| | - V Formica
- Department of Surgery, Tor Vergata Hospital, Tor Vergata University of Rome, Viale Oxford 81, 00133, Rome, Italy
| | - B Sensi
- Department of Surgery, Tor Vergata Hospital, Tor Vergata University of Rome, Viale Oxford 81, 00133, Rome, Italy
| | - G Bagaglini
- Department of Surgery, Tor Vergata Hospital, Tor Vergata University of Rome, Viale Oxford 81, 00133, Rome, Italy
| | - S Di Carlo
- Department of Surgery, Tor Vergata Hospital, Tor Vergata University of Rome, Viale Oxford 81, 00133, Rome, Italy
| | - V Bellato
- Department of Surgical Sciences, Sapienza University of Rome, Viale del Policlinico 155, 00161, Rome, Italy
| | - G S Sica
- Department of Surgery, Tor Vergata Hospital, Tor Vergata University of Rome, Viale Oxford 81, 00133, Rome, Italy
| |
Collapse
|
32
|
Cardi M, Ibrahim K, Alizai SW, Mohammad H, Garatti M, Rainone A, Di Marzo F, La Torre G, Paschetto M, Carbonari L, Mingarelli V, Mingoli A, Sica GS, Sibio S. Injury patterns and causes of death in 953 patients with penetrating abdominal war wounds in a civilian independent non-governmental organization hospital in Lashkargah, Afghanistan. World J Emerg Surg 2019; 14:51. [PMID: 31832085 PMCID: PMC6868865 DOI: 10.1186/s13017-019-0272-z] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2019] [Accepted: 10/17/2019] [Indexed: 11/10/2022] Open
Abstract
Background Management of penetrating abdominal war injuries centers upon triage, echeloned care, and damage control. A civilian hospital based in a war zone can rarely rely upon these principles because it normally has limited resources and lacks rapid medical evacuation. We designed this study to describe organ injury patterns and factors related to mortality in patients with penetrating abdominal war injuries in a civilian hospital in an active war zone in Afghanistan, examine how these findings differ from those in a typical military setting, and evaluate how they might improve patients’ care. Methods We reviewed the records of all patients admitted at the Lashkargah “Emergency” hospital with penetrating abdominal injuries treated from January 2006 to December 2016. Demographic and clinical data were recorded; univariate and multivariate analyses were used to identify variables significantly associated with death. Results We treated 953 patients for penetrating abdominal injury. The population was mainly civilian (12.1% women and 21% under 14). Mean age was 23 years, and patients with blast injuries were younger than in the other groups. The mechanism of injury was bullet injury in 589 patients, shell injury in 246, stab wound in 97, and mine injury in 21. The most frequent abdominal lesion was small bowel injury (46.3%). Small and large bowel injuries were the most frequent in the blast groups, stomach injury in stab wounds. Overall mortality was 12.8%. Variables significantly associated with death were age > 34 years, mine and bullet injury, length of stay, time since injury > 5 h, injury severity score > 17, and associated injuries. Conclusions Epidemiology and patterns of injury in a civilian hospital differ from those reported in a typical military setting. Our population is mainly civilian with a significant number of women and patients under 14 years. BI are more frequent than blast injuries, and gastrointestinal injuries are more common than injuries to solid organs. In this austere setting, surgeons need to acquire a wide range of skills from multiple surgical specialties. These findings might guide trauma and general surgeons treating penetrating abdominal war wounds to achieve better care and outcome.
Collapse
Affiliation(s)
- Maurizio Cardi
- Emergency NGO Medical Division, Lashkargah Hospital, Lashkargah, Afghanistan.,2Dipartimento di Chirurgia "P. Valdoni", Sapienza Università di Roma, Viale del Policlinico155, 00161 Rome, Italy
| | - Khushal Ibrahim
- Emergency NGO Medical Division, Lashkargah Hospital, Lashkargah, Afghanistan
| | - Shah Wali Alizai
- Emergency NGO Medical Division, Lashkargah Hospital, Lashkargah, Afghanistan
| | - Hamayoun Mohammad
- Emergency NGO Medical Division, Lashkargah Hospital, Lashkargah, Afghanistan
| | - Marco Garatti
- Emergency NGO Medical Division, Lashkargah Hospital, Lashkargah, Afghanistan.,Chirurgia Generale, Fondazione Poliambulanza, Istituto Ospedaliero, Via Bissolati 57, Brescia, Italy
| | - Antonio Rainone
- Emergency NGO Medical Division, Lashkargah Hospital, Lashkargah, Afghanistan
| | - Francesco Di Marzo
- 4Chirurgia Generale, Ospedale Versilia, Via Aurelia 335, 55041 Lido di Camaiore, LU Italy
| | - Giuseppe La Torre
- 5Dipartimento di Sanità Pubblica e Malattie Infettive, Sapienza Università di Roma, Viale del Policlinico155, 00161 Rome, Italy
| | - Michela Paschetto
- Emergency NGO Medical Division, Lashkargah Hospital, Lashkargah, Afghanistan
| | - Ludovica Carbonari
- 2Dipartimento di Chirurgia "P. Valdoni", Sapienza Università di Roma, Viale del Policlinico155, 00161 Rome, Italy
| | - Valentina Mingarelli
- 2Dipartimento di Chirurgia "P. Valdoni", Sapienza Università di Roma, Viale del Policlinico155, 00161 Rome, Italy
| | - Andrea Mingoli
- 2Dipartimento di Chirurgia "P. Valdoni", Sapienza Università di Roma, Viale del Policlinico155, 00161 Rome, Italy
| | - Giuseppe S Sica
- 6Dipartimento di Chirurgia, Università Tor Vergata, Viale Oxford 81, 00133 Rome, Italy
| | - Simone Sibio
- Emergency NGO Medical Division, Lashkargah Hospital, Lashkargah, Afghanistan
| |
Collapse
|
33
|
Sedda S, Franzè E, Bevivino G, Di Giovangiulio M, Rizzo A, Colantoni A, Ortenzi A, Grasso E, Giannelli M, Sica GS, Fantini MC, Monteleone G. Reciprocal Regulation Between Smad7 and Sirt1 in the Gut. Front Immunol 2018; 9:1854. [PMID: 30147698 PMCID: PMC6097015 DOI: 10.3389/fimmu.2018.01854] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2018] [Accepted: 07/27/2018] [Indexed: 12/22/2022] Open
Abstract
In inflammatory bowel disease (IBD) mucosa, there is over-expression of Smad7, an intracellular inhibitor of the suppressive cytokine transforming growth factor-β1, due to post-transcriptional mechanisms that enhance Smad7 acetylation status thus preventing ubiquitination-mediated proteosomal degradation of the protein. IBD-related inflammation is also marked by defective expression of Sirt1, a class III NAD+-dependent deacetylase, which promotes ubiquitination-mediated proteosomal degradation of various intracellular proteins and triggers anti-inflammatory signals. The aim of our study was to determine whether, in IBD, there is a reciprocal regulation between Smad7 and Sirt1. Smad7 and Sirt1 were examined in mucosal samples of IBD patients and normal controls by Western blotting and immunohistochemistry, and Sirt1 activity was assessed by a fluorimetric assay. To determine whether Smad7 is regulated by Sirt1, normal or IBD lamina propria mononuclear cells (LPMC) were cultured with either Sirt1 inhibitor (Ex527) or activator (Cay10591), respectively. To determine whether Smad7 controls Sirt1 expression, ex vivo organ cultures of IBD mucosal explants were treated with Smad7 sense or antisense oligonucleotide. Moreover, Sirt1 expression was evaluated in LPMC isolated from Smad7-transgenic mice given dextran sulfate sodium (DSS). Upregulation of Smad7 was seen in both the epithelial and lamina propria compartments of IBD patients and this associated with reduced expression and activity of Sirt1. Activation of Sirt1 in IBD LPMC with Cay10591 reduced acetylation and enhanced ubiquitination-driven proteasomal-mediated degradation of Smad7, while inhibition of Sirt1 activation in normal LPMC with Ex527 increased Smad7 expression. Knockdown of Smad7 in IBD mucosal explants enhanced Sirt1 expression, thus suggesting a negative effect of Smad7 on Sirt1 induction. Consistently, mucosal T cells of Smad7-transgenic mice contained reduced levels of Sirt1, a defect that was amplified by induction of DSS colitis. The data suggest the existence of a reciprocal regulatory mechanism between Smad7 and Sirt1, which could contribute to amplify inflammatory signals in the gut.
Collapse
Affiliation(s)
- Silvia Sedda
- Department of Systems Medicine, University of Rome Tor Vergata, Rome, Italy
| | - Eleonora Franzè
- Department of Systems Medicine, University of Rome Tor Vergata, Rome, Italy
| | - Gerolamo Bevivino
- Department of Systems Medicine, University of Rome Tor Vergata, Rome, Italy
| | | | - Angelamaria Rizzo
- Department of Systems Medicine, University of Rome Tor Vergata, Rome, Italy
| | - Alfredo Colantoni
- Department of Systems Medicine, University of Rome Tor Vergata, Rome, Italy
| | - Angela Ortenzi
- Department of Systems Medicine, University of Rome Tor Vergata, Rome, Italy
| | - Enrico Grasso
- Department of Systems Medicine, University of Rome Tor Vergata, Rome, Italy
| | - Mario Giannelli
- Department of Systems Medicine, University of Rome Tor Vergata, Rome, Italy
| | - Giuseppe S Sica
- Department of Surgery, University of Rome Tor Vergata, Rome, Italy
| | | | | |
Collapse
|
34
|
De Simone V, Ronchetti G, Franzè E, Colantoni A, Ortenzi A, Fantini MC, Rizzo A, Sica GS, Sileri P, Rossi P, MacDonald TT, Pallone F, Monteleone G, Stolfi C. Interleukin-21 sustains inflammatory signals that contribute to sporadic colon tumorigenesis. Oncotarget 2016; 6:9908-23. [PMID: 25839161 PMCID: PMC4496406 DOI: 10.18632/oncotarget.3532] [Citation(s) in RCA: 41] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2014] [Accepted: 02/17/2015] [Indexed: 02/07/2023] Open
Abstract
Interleukin (IL)-21 triggers inflammatory signals that contribute to the growth of neoplastic cells in mouse models of colitis-associated colorectal cancer (CRC). Because most CRCs are sporadic and arise in the absence of overt inflammation we have investigated the role of IL-21 in these tumors in mouse and man. IL-21 was highly expressed in human sporadic CRC and produced mostly by IFN-γ-expressing T-bet/RORγt double-positive CD3+CD8− cells. Stimulation of human CRC cell lines with IL-21 did not directly activate the oncogenic transcription factors STAT3 and NF-kB and did not affect CRC cell proliferation and survival. In contrast, IL-21 modulated the production of protumorigenic factors by human tumor infiltrating T cells. IL-21 was upregulated in the neoplastic areas, as compared with non-tumor mucosa, of Apcmin/+ mice, and genetic ablation of IL-21 in such mice resulted in a marked decrease of both tumor incidence and size. IL-21 deficiency was associated with reduced STAT3/NF-kB activation in both immune cells and neoplastic cells, diminished synthesis of protumorigenic cytokines (that is, IL-17A, IL-22, TNF-α and IL-6), downregulation of COX-2/PGE2 pathway and decreased angiogenesis in the lesions of Apcmin/+ mice. Altogether, data suggest that IL-21 promotes a protumorigenic inflammatory circuit that ultimately sustains the development of sporadic CRC.
Collapse
Affiliation(s)
- Veronica De Simone
- Department of Systems Medicine, University of Rome "Tor Vergata", Rome, Italy
| | - Giulia Ronchetti
- Department of Systems Medicine, University of Rome "Tor Vergata", Rome, Italy
| | - Eleonora Franzè
- Department of Systems Medicine, University of Rome "Tor Vergata", Rome, Italy
| | - Alfredo Colantoni
- Department of Systems Medicine, University of Rome "Tor Vergata", Rome, Italy
| | - Angela Ortenzi
- Department of Systems Medicine, University of Rome "Tor Vergata", Rome, Italy
| | - Massimo C Fantini
- Department of Systems Medicine, University of Rome "Tor Vergata", Rome, Italy
| | - Angelamaria Rizzo
- Department of Systems Medicine, University of Rome "Tor Vergata", Rome, Italy
| | - Giuseppe S Sica
- Department of Surgery, University of Rome "Tor Vergata", Rome, Italy
| | - Pierpaolo Sileri
- Department of Surgery, University of Rome "Tor Vergata", Rome, Italy
| | - Piero Rossi
- Department of Surgery, University of Rome "Tor Vergata", Rome, Italy
| | - Thomas T MacDonald
- Centre for Immunology and Infectious Disease, Blizard Institute of Cell and Molecular Science, Barts and the London School of Medicine and Dentistry, London, UK
| | - Francesco Pallone
- Department of Systems Medicine, University of Rome "Tor Vergata", Rome, Italy
| | - Giovanni Monteleone
- Department of Systems Medicine, University of Rome "Tor Vergata", Rome, Italy
| | - Carmine Stolfi
- Department of Systems Medicine, University of Rome "Tor Vergata", Rome, Italy
| |
Collapse
|
35
|
De Simone V, Franzè E, Ronchetti G, Colantoni A, Fantini MC, Di Fusco D, Sica GS, Sileri P, MacDonald TT, Pallone F, Monteleone G, Stolfi C. Th17-type cytokines, IL-6 and TNF-α synergistically activate STAT3 and NF-kB to promote colorectal cancer cell growth. Oncogene 2015; 34:3493-503. [PMID: 25174402 PMCID: PMC4493653 DOI: 10.1038/onc.2014.286] [Citation(s) in RCA: 383] [Impact Index Per Article: 42.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2014] [Revised: 07/09/2014] [Accepted: 07/23/2014] [Indexed: 12/17/2022]
Abstract
Colorectal cancers (CRCs) often show a dense infiltrate of cytokine-producing immune/inflammatory cells. The exact contribution of each immune cell subset and cytokine in the activation of the intracellular pathways sustaining CRC cell growth is not understood. Herein, we isolate tumor-infiltrating leukocytes (TILs) and lamina propria mononuclear cells (LPMCs) from the tumor area and the macroscopically unaffected, adjacent, colonic mucosa of patients who underwent resection for sporadic CRC and show that the culture supernatants of TILs, but not of LPMCs, potently enhance the growth of human CRC cell lines through the activation of the oncogenic transcription factors signal transducer and activator of transcription 3 (STAT3) and nuclear factor-kappa B (NF-kB). Characterization of immune cell complexity of TILs and LPMCs reveals no differences in the percentages of T cells, natural killer T cells, natural killer (NK) cells, macrophages and B cells. However, T cells from TILs show a functional switch compared with those from LPMCs to produce large amounts of T helper type 17 (Th17)-related cytokines (that is, interleukin-17A (IL-17A), IL-17F, IL-21 and IL-22), tumor necrosis factor-α (TNF-α) and IL-6. Individual neutralization of IL-17A, IL-17F, IL-21, IL-22, TNF-α or IL-6 does not change TIL-derived supernatant-driven STAT3 and NF-kB activation, as well as their proproliferative effect in CRC cells. In contrast, simultaneous neutralization of both IL-17A and TNF-α, which abrogates NF-kB signaling, and IL-22 and IL-6, which abrogates STAT3 signaling, reduces the mitogenic effect of supernatants in CRC cells. IL-17A, IL-21, IL-22, TNF-α and IL-6 are also produced in excess in the early colonic lesions in a mouse model of sporadic CRC, associated with enhanced STAT3/NF-kB activation. Mice therapeutically given BP-1-102, an orally bioavailable compound targeting STAT3/NF-kB activation and cross-talk, exhibit reduced colon tumorigenesis and diminished expression of STAT3/NF-kB-activating cytokines in the neoplastic areas. These data suggest that strategies aimed at the cotargeting of STAT3/NF-kB activation and interaction between them might represent an attractive and novel approach to combat CRC.
Collapse
Affiliation(s)
- V De Simone
- Department of Systems Medicine, University of Rome ‘Tor Vergata', Rome, Italy
| | - E Franzè
- Department of Systems Medicine, University of Rome ‘Tor Vergata', Rome, Italy
| | - G Ronchetti
- Department of Systems Medicine, University of Rome ‘Tor Vergata', Rome, Italy
| | - A Colantoni
- Department of Systems Medicine, University of Rome ‘Tor Vergata', Rome, Italy
| | - M C Fantini
- Department of Systems Medicine, University of Rome ‘Tor Vergata', Rome, Italy
| | - D Di Fusco
- Department of Systems Medicine, University of Rome ‘Tor Vergata', Rome, Italy
| | - G S Sica
- Department of Surgery, University of Rome ‘Tor Vergata', Rome, Italy
| | - P Sileri
- Department of Surgery, University of Rome ‘Tor Vergata', Rome, Italy
| | - T T MacDonald
- Centre for Immunology and Infectious Disease, Blizard Institute of Cell and Molecular Science, Barts and the London School of Medicine and Dentistry, London, UK
| | - F Pallone
- Department of Systems Medicine, University of Rome ‘Tor Vergata', Rome, Italy
| | - G Monteleone
- Department of Systems Medicine, University of Rome ‘Tor Vergata', Rome, Italy
| | - C Stolfi
- Department of Systems Medicine, University of Rome ‘Tor Vergata', Rome, Italy
| |
Collapse
|
36
|
Fiorani C, Biancone L, Tema G, Porokhnavets K, Tesauro M, Gaspari AL, Sica GS. Laparoscopic ileocolic resection for Crohn's disease associated with midgut malrotation. JSLS 2014; 18:12-11-192. [PMID: 25419109 PMCID: PMC4236081 DOI: 10.4293/jsls.2014.11192] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
Abstract
Midgut malrotation is an anomaly of fetal intestinal rotation. Its incidence in adults is rare. A case of midgut malrotation in a 51-year-old man with complicated Crohn's disease of the terminal ileum is presented. Symptoms, diagnosis, and treatment are reviewed. Preoperative workup led to correct surgical planning that ultimately allowed a successful laparoscopic resection.
Collapse
Affiliation(s)
- Cristina Fiorani
- Department of Surgery, Tor Vergata University of Rome, Rome, Italy
| | - Livia Biancone
- Department of Medicine, Tor Vergata University of Rome, Rome, Italy
| | - Giorgia Tema
- Department of Surgery, Tor Vergata University of Rome, Rome, Italy
| | | | - Manfredi Tesauro
- Department of Medicine, Tor Vergata University of Rome, Rome, Italy
| | | | - Giuseppe S Sica
- Department of Surgery, Tor Vergata University of Rome, Rome, Italy
| |
Collapse
|
37
|
Sica GS, Divizia A, Picone E, Gaspari AL. An unusual case of intestinal obstruction. Dig Liver Dis 2014; 46:1051. [PMID: 25088771 DOI: 10.1016/j.dld.2014.06.014] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/02/2014] [Revised: 06/21/2014] [Accepted: 06/30/2014] [Indexed: 12/11/2022]
Affiliation(s)
- Giuseppe S Sica
- Department of Surgery, Policlinico Tor Vergata, Tor Vergata University, Rome, Italy.
| | - Andrea Divizia
- Department of Surgery, Policlinico Tor Vergata, Tor Vergata University, Rome, Italy
| | - Emanuele Picone
- Department of Surgery, Policlinico Tor Vergata, Tor Vergata University, Rome, Italy
| | - Achille L Gaspari
- Department of Surgery, Policlinico Tor Vergata, Tor Vergata University, Rome, Italy
| |
Collapse
|
38
|
Caruso R, Marafini I, Franzè E, Stolfi C, Zorzi F, Monteleone I, Caprioli F, Colantoni A, Sarra M, Sedda S, Biancone L, Sileri P, Sica GS, MacDonald TT, Pallone F, Monteleone G. Defective expression of SIRT1 contributes to sustain inflammatory pathways in the gut. Mucosal Immunol 2014; 7:1467-79. [PMID: 24850427 DOI: 10.1038/mi.2014.35] [Citation(s) in RCA: 65] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/08/2013] [Accepted: 04/15/2014] [Indexed: 02/04/2023]
Abstract
In inflammatory bowel disease (IBD), tissue damage is driven by an excessive immune response, poorly controlled by counter-regulatory mechanisms. SIRT1, a class III NAD+-dependent deacetylase, regulates negatively the expression of various proteins involved in the control of immune-inflammatory pathways, such as Stat3, Smad7, and NF-κB. Here we examined the expression, regulation, and function of SIRT1 in IBD. SIRT1 RNA and protein expression was less pronounced in whole biopsies and lamina propria mononuclear cells (LPMCs) of IBD patients in comparison with normal controls. SIRT1 expression was downregulated in control LPMC by tumor necrosis factor (TNF)-α and interleukin (IL)-21, and upregulated in IBD LPMC by neutralizing TNF-α and IL-21antibodies. Consistently, SIRT1 expression was increased in mucosal samples taken from IBD patients successfully treated with Infliximab. Treatment of IBD LPMC with Cay10591, a specific SIRT1 activator, reduced NF-κB activation and inhibited inflammatory cytokine synthesis, whereas Ex527, an inhibitor of SIRT1, increased interferon (IFN)-γ in control LPMC. SIRT1 was also reduced in mice with colitis induced by 2,4,6-trinitrobenzenesulphonic acid or oxazolone. Cay10591 prevented and cured experimental colitis whereas Ex527 exacerbated disease by modulating T cell-derived cytokine response. Data indicate that SIRT1 is downregulated in IBD patients and colitic mice and suggest that SIRT1 activation can help attenuate inflammatory signals in the gut.
Collapse
Affiliation(s)
- R Caruso
- Department of Systems Medicine, University of Rome "Tor Vergata", Rome, Italy
| | - I Marafini
- Department of Systems Medicine, University of Rome "Tor Vergata", Rome, Italy
| | - E Franzè
- Department of Systems Medicine, University of Rome "Tor Vergata", Rome, Italy
| | - C Stolfi
- Department of Systems Medicine, University of Rome "Tor Vergata", Rome, Italy
| | - F Zorzi
- Department of Systems Medicine, University of Rome "Tor Vergata", Rome, Italy
| | - I Monteleone
- Department of Systems Medicine, University of Rome "Tor Vergata", Rome, Italy
| | - F Caprioli
- Unit of Gastroenterology, Fondazione IRCCS Ca' Granda-Ospedale Maggiore Policlinico, Milan, Italy
| | - A Colantoni
- Department of Systems Medicine, University of Rome "Tor Vergata", Rome, Italy
| | - M Sarra
- Department of Systems Medicine, University of Rome "Tor Vergata", Rome, Italy
| | - S Sedda
- Department of Systems Medicine, University of Rome "Tor Vergata", Rome, Italy
| | - L Biancone
- Department of Systems Medicine, University of Rome "Tor Vergata", Rome, Italy
| | - P Sileri
- Department of Surgery, University of Rome "Tor Vergata", Rome, Italy
| | - G S Sica
- Department of Surgery, University of Rome "Tor Vergata", Rome, Italy
| | - T T MacDonald
- Barts and the London School of Medicine and Dentistry, London, UK
| | - F Pallone
- Department of Systems Medicine, University of Rome "Tor Vergata", Rome, Italy
| | - G Monteleone
- Department of Systems Medicine, University of Rome "Tor Vergata", Rome, Italy
| |
Collapse
|
39
|
Sica GS, Di Carlo S, Tema G, Montagnese F, Del Vecchio Blanco G, Fiaschetti V, Maggi G, Biancone L. Treatment of peri-anal fistula in Crohn's disease. World J Gastroenterol 2014; 20:13205-13210. [PMID: 25309057 PMCID: PMC4188878 DOI: 10.3748/wjg.v20.i37.13205] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/11/2014] [Revised: 06/03/2014] [Accepted: 07/11/2014] [Indexed: 02/06/2023] Open
Abstract
Anal fistulas are a common manifestation of Crohn’s disease (CD). The first manifestation of the disease is often in the peri-anal region, which can occur years before a diagnosis, particularly in CD affecting the colon and rectum. The treatment of peri-anal fistulas is difficult and always multidisciplinary. The European guidelines recommend combined surgical and medical treatment with biologic drugs to achieve best results. Several different surgical techniques are currently employed. However, at the moment, none of these techniques appear superior to the others in terms of healing rate. Surgery is always indicated to treat symptomatic, simple, low intersphincteric fistulas refractory to medical therapy and those causing disabling symptoms. Utmost attention should be paid to correcting the balance between eradication of the fistula and the preservation of fecal continence.
Collapse
|
40
|
Stolfi C, De Simone V, Colantoni A, Franzè E, Ribichini E, Fantini MC, Caruso R, Monteleone I, Sica GS, Sileri P, MacDonald TT, Pallone F, Monteleone G. A functional role for Smad7 in sustaining colon cancer cell growth and survival. Cell Death Dis 2014; 5:e1073. [PMID: 24556688 PMCID: PMC3944263 DOI: 10.1038/cddis.2014.49] [Citation(s) in RCA: 52] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/03/2014] [Accepted: 01/09/2014] [Indexed: 02/07/2023]
Abstract
Initially identified as an inhibitor of transforming growth factor (TGF)-β mainly owing to its ability to bind TGF-β receptor type I and abrogate TGF-β-driven signaling, Smad7 can interact with additional intracellular proteins and regulate TGF-β-independent pathways, thus having a key role in the control of neoplastic processes in various organs. Genome-wide association studies have shown that common alleles of Smad7 influence the risk of colorectal cancer (CRC), even though the contribution of Smad7 in colon carcinogenesis is not fully understood. In this study, we assessed the expression and role of Smad7 in human and mouse models of sporadic CRC. We document a significant increase of Smad7 in human CRC relative to the surrounding nontumor tissues and show that silencing of Smad7 inhibits the growth of CRC cell lines both in vitro and in vivo after transplantation into immunodeficient mice. Knockdown of Smad7 results in enhanced phosphorylation of the cyclin-dependent kinase (CDK)2, accumulation of CRC cells in S phase and enhanced cell death. Smad7-deficient CRC cells have lower levels of CDC25A, a phosphatase that dephosphorylates CDK2, and hyperphosphorylated eukaryotic initiation factor 2 (eIF2)α, a negative regulator of CDC25 protein translation. Consistently, knockdown of Smad7 associates with inactivation of eIF2α, lower CDC25A expression and diminished fraction of proliferating cells in human CRC explants, and reduces the number of intestinal tumors in Apcmin/+ mice. Altogether, these data support a role for Smad7 in sustaining colon tumorigenesis.
Collapse
Affiliation(s)
- C Stolfi
- Department of Systems Medicine, University of 'Tor Vergata', Rome, Italy
| | - V De Simone
- Department of Systems Medicine, University of 'Tor Vergata', Rome, Italy
| | - A Colantoni
- Department of Systems Medicine, University of 'Tor Vergata', Rome, Italy
| | - E Franzè
- Department of Systems Medicine, University of 'Tor Vergata', Rome, Italy
| | - E Ribichini
- Department of Systems Medicine, University of 'Tor Vergata', Rome, Italy
| | - M C Fantini
- Department of Systems Medicine, University of 'Tor Vergata', Rome, Italy
| | - R Caruso
- Department of Systems Medicine, University of 'Tor Vergata', Rome, Italy
| | - I Monteleone
- Department of Systems Medicine, University of 'Tor Vergata', Rome, Italy
| | - G S Sica
- Department of Surgery, University of 'Tor Vergata', Rome, Italy
| | - P Sileri
- Department of Surgery, University of 'Tor Vergata', Rome, Italy
| | - T T MacDonald
- Centre for Immunology and Infectious Disease, Blizard Institute, Barts and The London School of Medicine and Dentistry, London, UK
| | - F Pallone
- Department of Systems Medicine, University of 'Tor Vergata', Rome, Italy
| | - G Monteleone
- Department of Systems Medicine, University of 'Tor Vergata', Rome, Italy
| |
Collapse
|
41
|
Sica GS, Biancone L. Surgery for inflammatory bowel disease in the era of laparoscopy. World J Gastroenterol 2013; 19:2445-2448. [PMID: 23674844 PMCID: PMC3646133 DOI: 10.3748/wjg.v19.i16.2445] [Citation(s) in RCA: 54] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/19/2012] [Revised: 03/05/2013] [Accepted: 03/23/2013] [Indexed: 02/06/2023] Open
Abstract
During the course of inflammatory bowel disease (IBD), surgery may be needed. Approximately 20% of patients with ulcerative colitis (UC) will require surgery, whereas up to 80% of Crohn’s disease (CD) patients will undergo an operation during their lifetime. For UC patients requiring surgery, total proctocolectomy and ileoanal pouch anastomosis (IPAA) is the operation of choice as it provides a permanent cure and good quality of life. Nevertheless a permanent stoma is a good option in selected patients, especially the elderly. Minimally invasive surgery has replaced the conventional open approach in many specialized centres worldwide. Laparoscopic colectomy and restorative IPAA is rapidly becoming the standard of care in the treatment of UC requiring surgery, whilst laparoscopic ileo-cecal resection is already the new gold standard in the treatment of complicated CD of terminal ileum. Short term advantages of laparoscopic surgery includes faster recovery time and reduced requirement for analgesics. It is, however, in the long term that minimally invasive surgery has demonstrated its superiority over the open approach. A better cosmesis, a reduced number of incisional hernias and fewer adhesions are the long term advantages of laparoscopy in IBD surgery. A reduction in abdominal adhesions is of great benefit when a second operation is needed in CD and this influences positively the pregnancy rate in young women undergoing restorative IPAA. In developing the therapeutic plan for IBD patients it should be recognized that the surgical approach to the abdomen has changed and that surgical treatment of complicated IBD can be safely performed with a true minimally invasive approach with great patient satisfaction.
Collapse
|
42
|
Sica GS, Iaculli E, Biancone L, Carlo SD, Scaramuzzo R, Fiorani C, Gentileschi P, Gaspari AL. Comparative study of laparoscopic vs open gastrectomy in gastric cancer management. World J Gastroenterol 2011; 17:4602-6. [PMID: 22147966 PMCID: PMC3226983 DOI: 10.3748/wjg.v17.i41.4602] [Citation(s) in RCA: 44] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/01/2010] [Revised: 01/05/2011] [Accepted: 01/12/2011] [Indexed: 02/06/2023] Open
Abstract
AIM: To compare long-term results of gastric cancer patients undergoing laparoscopic and open gastrectomy in a single unit.
METHODS: From February 2000 to September 2004, all patients with adenocarcinoma of the stomach were assessed to entry in this longitudinal prospective non-randomized trial. Primary endpoint was cancer-related survival and secondary endpoints were overall survival, evaluation of surgical complications and mortality.
RESULTS: Fifty-eight patients were enrolled. Forty-seven patients were followed-up (range 11-103, median 38 mo). Four patients were lost at follow up. Twenty-two patients underwent a laparoscopic gastric surgery (LGS) and 25 had a standard open procedure (OGS). No statistical difference was found between the two groups in terms of 5 years cancer-related mortality rate (50% vs 52%, P = 1), and 5 years overall mortality rate (54.5% vs 56%, P = 1). Accordingly, cancer-related and overall survival probability by Kaplan-Meier method showed comparable results (P = 0.81 and P = 0.83, respectively). We found no differences in surgical complications in the 2 groups. There was no conversion to open surgery in this series.
CONCLUSION: LGS is as effective as OGS in the management of advanced gastric cancer. However LGS cannot be recommended routinely over OGS for the treatment of advanced gastric cancer.
Collapse
|
43
|
Sica GS, Di Carlo S, Biancone L, Gentileschi P, Pallone F, Gaspari AL. Single access laparoscopic ileocecal resection in complicated Crohn's disease. Surg Innov 2010; 17:359-60. [PMID: 20817639 DOI: 10.1177/1553350610382014] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
|
44
|
Onali S, Calabrese E, Petruzziello C, Zorzi F, Sica GS, Lolli E, Ascolani M, Condino G, Pallone F, Biancone L. Endoscopic vs ultrasonographic findings related to Crohn's disease recurrence: a prospective longitudinal study at 3 years. J Crohns Colitis 2010; 4:319-28. [PMID: 21122521 DOI: 10.1016/j.crohns.2009.12.010] [Citation(s) in RCA: 45] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/07/2009] [Revised: 12/20/2009] [Accepted: 12/20/2009] [Indexed: 02/08/2023]
Abstract
BACKGROUND AND AIMS Ileocolonoscopy (IC) is the gold standard for assessing Crohn's Disease (CD) recurrence after ileo-colonic resection. In a prospective longitudinal study we compared findings related to CD recurrence when using techniques visualizing either the luminal or the extraluminal surface (IC and small bowel follow through, SBFT vs Small Intestine Contrast Ultrasonography, SICUS). METHODS From 2003 to 2008, 25 CD patients undergoing ileo-colonic resection were enrolled. Clinical assessment (CDAI) was performed at 1, 2 and 3 years. IC was performed at 1 (n=25) and 3 years (n=15), SBFT at 2 years (n=21) and SICUS at 1 (n=25), 2 (n=21) and 3 years (n=15). Recurrence was assessed by SBFT and SICUS (bowel wall thickness, BWT) when using IC as gold standard. RESULTS At 1 year, all patients were inactive and recurrence was detected by IC in 24/25 (96%) and by SICUS in 25/25 patients. At 2 years, 6/21 patients (29%) were active and recurrence was detected by SBFT in 12/21 (57%) and by SICUS in 21/21 patients. At 3 years, 5/15 patients (33%) were active, IC showed recurrence in 14/15 (93%), and SICUS in 15/15 patients. The endoscopic score at 1 year was higher in patients developing relapse at 2 years (n=5) than in patients maintaining remission (n=10) (median: 4, range 3-4 vs 2, range 0-3; p=0.003). The same finding was not observed by using SICUS (median BWT at 1 year: 5, range 4-7 vs 3.7, range 3.5-6; p=0.19). CONCLUSIONS Although IC and SICUS provide a different view of the bowel wall, in experienced hands SICUS provides findings compatible with endoscopic recurrence after ileo-colonic resection for CD. Discrepant findings may be observed in a low proportion of patients with minor lesions related to CD recurrence.
Collapse
Affiliation(s)
- S Onali
- Unità di Gastroenterologia, Dipartimento di Medicina Interna, Università "Tor Vergata" di Roma, Italy
| | | | | | | | | | | | | | | | | | | |
Collapse
|
45
|
Biancone L, Onali S, Calabrese E, Petruzziello C, Zorzi F, Condino G, Sica GS, Pallone F. Non-invasive techniques for assessing postoperative recurrence in Crohn's disease. Dig Liver Dis 2008; 40 Suppl 2:S265-70. [PMID: 18598999 DOI: 10.1016/s1590-8658(08)60536-8] [Citation(s) in RCA: 33] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
Postoperative recurrence after ileo-colonic resection is a feature of Crohn's Disease (CD), almost 73% of patients show endoscopic recurrence at 1 year and 90% at 3 years. After surgical resection for CD, symptoms may be related to the surgical resection itself. Moreover, the development of an early severe endoscopic recurrence within 1 year represents a risk factor for early clinical recurrence. On the basis of these observations, the early detection and assessment of asymptomatic endoscopic recurrence may allow a timely and appropriate treatment of CD patients after ileo-colonic resection. At this purpose, conventional colonoscopy with ileoscopy currently represents the gold standard for assessing CD recurrence, graded according to the Rutgeerts' score. Lesions compatible with CD recurrence can be also detected by conventional radiology, including small bowel follow through and enema, both associated with a high radiation exposure. Due to the ineluctable course of CD after resection, and to the need of a proper follow up for assessing CD recurrence, several alternative, non invasive techniques have been searched in order to assess the post-operative recurrence, including: faecal alpha 1-antitrypsin clearance, faecal calprotectin, 99Tc-HMPAO scintigraphy, virtual colonoscopy, ultrasonography and, more recently, wireless capsule endoscopy (WCE) and Small Intestine Contrast Ultrasonography (SICUS). Among these, current evidences suggest that in experienced hands, ultrasound examination by SICUS represents a non-invasive technique useful for assessing recurrence in CD patients under regular follow up after surgery. The same findings are suggested for WCE, although the impact risk related to the recurrence or to the surgical anastomosis itself limits the use of this non-invasive technique for assessing CD recurrence after surgery.
Collapse
Affiliation(s)
- L Biancone
- Departments of Medicine and Surgery, University of Rome Tor Vergata, Rome, Italy.
| | | | | | | | | | | | | | | |
Collapse
|
46
|
Biancone L, Sica GS, Calabrese E, Onali S, Petruzziello C, Pallone F. Frequency and pattern of endoscopic recurrence in Crohn's disease patients with ileocolonic resection using a laparoscopic versus laparotomic approach: a prospective longitudinal study. Am J Gastroenterol 2008; 103:809-11. [PMID: 18341511 DOI: 10.1111/j.1572-0241.2007.01612_14.x] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
|
47
|
Biancone L, Calabrese E, Petruzziello C, Onali S, Caruso A, Palmieri G, Sica GS, Pallone F. Wireless capsule endoscopy and small intestine contrast ultrasonography in recurrence of Crohn's disease. Inflamm Bowel Dis 2007; 13:1256-65. [PMID: 17577246 DOI: 10.1002/ibd.20199] [Citation(s) in RCA: 71] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
BACKGROUND The best available tool to assess recurrence of Crohn's disease (CD) is ileocolonoscopy (CC). Small intestine contrast ultrasonography (SICUS) and wireless capsule endoscopy (WCE) are noninvasive techniques able to detect small bowel lesions. In a prospective longitudinal study, we aimed to investigate the usefulness of SICUS and WCE for assessing postoperative recurrence of CD 1 year after surgery, using CC as the gold standard. METHODS Twenty-two patients (11 men, median age 33 years, range 22-67 years) undergoing ileocolonic resection for CD were prospectively followed from July 2003 to May 2006, with the Crohn's Disease Activity Index (CDAI) used for clinical assessment every 3 months for 1 year. At 1 year, recurrence was assessed by SICUS and CC, followed by WCE. CD recurrence was assessed by CC (Rutgeerts score). SICUS was performed after ingestion of polyethylene glycol, and WCE was performed with Given M2A equipment. RESULTS At 1 year, all 22 patients had inactive CD (CDAI < 150). In 5 patients, WCE was not performed because of luminal narrowing or stenosis. Seventeen of the 22 patients had all 3 techniques performed. CC detected recurrence in 21 of 22 patients. Lesions compatible with recurrence were detected by SICUS in all 22 patients (1 false positive). When considering only the 17 patients studied by all 3 techniques, recurrence was detected by CC in 16 of 17 patients, whereas lesions compatible with recurrence were detected by SICUS in all 17 patients (16 true positives [TPs], 1 FP) and by WCE in 16 of 17 patients (16 TPs, 1 true negative). CONCLUSIONS The present findings suggest that SICUS and WCE may be used as noninvasive techniques for the assessment of recurrence of CD in patients being regularly followed up after ileocolonic resection.
Collapse
Affiliation(s)
- Livia Biancone
- Cattedra di Gastroenterologia, Dipartimento di Medicina Interna, Università Tor Vergata di Roma, Rome, Italy.
| | | | | | | | | | | | | | | |
Collapse
|
48
|
Gentileschi P, Sica GS, Lirosi F, Benavoli D, Sileri P, Bianciardi E, Gaspari AL. P88. Surg Obes Relat Dis 2007. [DOI: 10.1016/j.soard.2007.03.156] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
|
49
|
Abstract
There have been previous reports suggesting an association between von Recklinghausen's neurofibromatosis and esophageal dysmotility. We report the first case of true Recklinghausen's neurofibromatosis of the esophagus leading to end-stage pseudoachalasia. The diagnosis and management of this condition is discussed together with the pathogenesis and pathology of this rare entity.
Collapse
Affiliation(s)
- Giuseppe S Sica
- Department of Surgery, John Radcliffe Hospital, Headington, Oxford, United Kingdom.
| | | | | | | |
Collapse
|
50
|
Sica GS, Sileri P, Gaspari AL. Laparoscopic treatment of Bouveret's syndrome presenting as acute pancreatitis. JSLS 2005; 9:472-5. [PMID: 16381370 PMCID: PMC3015637] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/02/2022] Open
Abstract
Gastric outlet obstruction as a result of gallstone (Bouveret's syndrome) is a rare but serious complication of cholelithiasis. Although patients present with persistent vomiting, colicky epigastric pain and dehydration, the clinical features of the Bouveret's syndrome are not pathognomonic. Due to its rarity, the diagnosis and treatment represent a challenge for the surgeon. In most of the reported cases, the diagnosis was made at the time of laparotomy. We report an unusual clinical presentation of Bouveret's syndrome with mild acute pancreatitis that was treated laparoscopically. To our knowledge, this is the first described case. Cause, clinical presentation, methods of diagnosis, and options for management of Bouveret's syndrome are also discussed.
Collapse
Affiliation(s)
- Giuseppe S Sica
- Department of Surgery, University of Rome Tor Vergata, Italy.
| | | | | |
Collapse
|