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Allievi N, Bianco F, Pisano M, Montori G, Fugazzola P, Coccolini F, Lotti M, Mosconi S, Merelli B, Campanati L, Lucianetti A, Ansaloni L, Magnone S. Hyperthermic intraperitoneal chemotherapy (HIPEC) as adjuvant and therapeutic options for patients with advanced gastric cancer at high risk of recurrence or established peritoneal metastases: a single-centre experience. Updates Surg 2023; 75:159-167. [PMID: 36371549 DOI: 10.1007/s13304-022-01399-y] [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: 03/31/2022] [Accepted: 10/04/2022] [Indexed: 11/13/2022]
Abstract
Peritoneal metastases from gastric cancer (PM-GC) have a detrimental prognostic impact on survival and there is a lack of consensus regarding treatment. Cytoreductive surgery (CRS) and hyperthermic intraperitoneal chemotherapy (HIPEC) may offer a chance for prolonged survival as compared to standard chemotherapy. This study aims to present our experience in the management of GC with CRS and HIPEC. This is a single-centre retrospective study. Patients were divided into two groups: patients with GC at high risk for developing PM-GC (adjuvant HIPEC group) and patients with PM-GC or positive peritoneal cytology (therapeutic CRS and HIPEC group). Overall survival (OS) and disease-free survival (DFS) were considered as outcome measures. A total of 41 patients with a GC primary received surgery and HIPEC: 14 patients (34.1%) were in the adjuvant HIPEC group, while 27 patients (65.9%) were in the therapeutic CRS and HIPEC group. In the adjuvant HIPEC group, the 1- and 3-year OS were 85.7% and 71.4%, while 1- and 3-year DFS were 71.4% and 64.3%, respectively. In the therapeutic CRS and HIPEC group, OS was 60.3% and 35.1% at 1 and 3 years, whereas 1- and 3-year DFS were 38% and 32.6%, respectively. Univariate survival analysis of patients in the therapeutic CRS and HIPEC group showed that the presence of lymph node metastasis and signet ring cell histology predicted worse OS, while PCI > 12 and lymph node metastasis were associated with decreased DFS. Treatment of highly selected patients with GC at high risk of peritoneal recurrence or established PM with CRS and HIPEC showed satisfactory results in terms of OS and DFS.
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Affiliation(s)
- Niccolò Allievi
- First Department of General Surgery, Papa Giovanni XXIII Hospital, Piazza OMS 1, 24127, Bergamo, Italy
| | - Federica Bianco
- First Department of General Surgery, Papa Giovanni XXIII Hospital, Piazza OMS 1, 24127, Bergamo, Italy
| | - Michele Pisano
- First Department of General Surgery, Papa Giovanni XXIII Hospital, Piazza OMS 1, 24127, Bergamo, Italy
| | | | - Paola Fugazzola
- Unit of General Surgery, IRCCS San Matteo Foundation Hospital, Pavia, Italy
| | - Federico Coccolini
- General, Emergency and Trauma Surgery, Pisa University Hospital, Pisa, Italy
| | - Marco Lotti
- Division of General Surgery, Fatebenefratelli Oftalmico Hospital, Milan, Italy
| | | | - Barbara Merelli
- Medical Oncology Unit, Giovanni XXIII Hospital, Bergamo, Italy
| | - Luca Campanati
- First Department of General Surgery, Papa Giovanni XXIII Hospital, Piazza OMS 1, 24127, Bergamo, Italy
| | - Alessandro Lucianetti
- First Department of General Surgery, Papa Giovanni XXIII Hospital, Piazza OMS 1, 24127, Bergamo, Italy
| | - Luca Ansaloni
- Unit of General Surgery, IRCCS San Matteo Foundation Hospital, Pavia, Italy
| | - Stefano Magnone
- First Department of General Surgery, Papa Giovanni XXIII Hospital, Piazza OMS 1, 24127, Bergamo, Italy.
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Lotti M, Capponi MG, Ferrari D, Carrara G, Campanati L, Lucianetti A. Laparoscopic Witzel jejunostomy. J Minim Access Surg 2021; 17:127-130. [PMID: 33353899 PMCID: PMC7945639 DOI: 10.4103/jmas.jmas_248_19] [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] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2019] [Accepted: 11/04/2019] [Indexed: 11/04/2022] Open
Abstract
The placement of a feeding jejunostomy can be indicated in malnourished patients with gastric and oesophagogastric junction cancer to allow for enteral nutritional support. In these patients, the jejunostomy tube can be suitably placed at the time of staging laparoscopy. Several techniques of laparoscopic jejunostomy (LJ) have been described, yet the Witzel approach remains neglected, due to the perceived difficulty of suturing the bowel around the tube and securing them to the abdominal wall. Here, we describe a novel technique for LJ, using a single barbed suture for securing the bowel and tunnelling the jejunostomy catheter according to the Witzel approach.
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Affiliation(s)
- Marco Lotti
- Advanced Surgical Oncology Unit, Department of General Surgery 1, Papa Giovanni XXIII Hospital, Bergamo, Italy
| | | | - Denise Ferrari
- Department of General Surgery 1, Papa Giovanni XXIII Hospital, Bergamo, Italy
| | - Giulia Carrara
- Advanced Surgical Oncology Unit, Department of General Surgery 1, Papa Giovanni XXIII Hospital, Bergamo, Italy
| | - Luca Campanati
- Department of General Surgery 1, Papa Giovanni XXIII Hospital, Bergamo, Italy
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Giulii Capponi M, Campanati L, Lotti M. Wilkie's syndrome: a serendipitous diagnosis. ANZ J Surg 2020; 91:1623-1625. [PMID: 33270966 DOI: 10.1111/ans.16468] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2020] [Accepted: 11/20/2020] [Indexed: 11/26/2022]
Affiliation(s)
| | - Luca Campanati
- General Surgery 1 Unit, Papa Giovanni XXIII Hospital, Bergamo, Italy
| | - Marco Lotti
- Advanced Surgical Oncology Unit, Papa Giovanni XXIII Hospital, Bergamo, Italy
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Lotti M, Giulii Capponi M, Magnone S, Campanati L, Lucianetti A. Beware of the acute bowel disease in COVID-19 patients. ANZ J Surg 2020; 90:2586-2588. [PMID: 33010090 PMCID: PMC7675254 DOI: 10.1111/ans.16384] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/20/2020] [Accepted: 09/28/2020] [Indexed: 12/12/2022]
Affiliation(s)
- Marco Lotti
- Advanced Surgical Oncology Unit, Department of General Surgery 1, Papa Giovanni XXIII Hospital, Bergamo, Italy
| | | | - Stefano Magnone
- Department of General Surgery 1, Papa Giovanni XXIII Hospital, Bergamo, Italy
| | - Luca Campanati
- Department of General Surgery 1, Papa Giovanni XXIII Hospital, Bergamo, Italy
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Pisano M, Ceresoli M, Cimbanassi S, Gurusamy K, Coccolini F, Borzellino G, Costa G, Allievi N, Amato B, Boerma D, Calcagno P, Campanati L, Campanile FC, Casati A, Chiara O, Crucitti A, di Saverio S, Filauro M, Gabrielli F, Guttadauro A, Kluger Y, Magnone S, Merli C, Poiasina E, Puzziello A, Sartelli M, Catena F, Ansaloni L. 2017 WSES and SICG guidelines on acute calcolous cholecystitis in elderly population. World J Emerg Surg 2019; 14:10. [PMID: 30867674 PMCID: PMC6399945 DOI: 10.1186/s13017-019-0224-7] [Citation(s) in RCA: 41] [Impact Index Per Article: 8.2] [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: 10/23/2018] [Accepted: 01/28/2019] [Indexed: 12/18/2022] Open
Abstract
Background Gallstone disease is very common afflicting 20 million people in the USA. In Europe, the overall incidence of gallstone disease is 18.8% in women and 9.5% in men. The frequency of gallstones related disease increases by age. The elderly population is increasing worldwide. Aim The present guidelines aims to report the results of the World Society of Emergency Surgery (WSES) and Italian Surgical Society for Elderly (SICG) consensus conference on acute calcolous cholecystitis (ACC) focused on elderly population. Material and methods The 2016 WSES guidelines on ACC were used as baseline; six questions have been used to investigate the particularities in elderly population; the answers have been developed in terms of differences compared to the general population and to statements of the 2016 WSES Guidelines. The Consensus Conference discusses, voted, and modified the statements. International experts contributed in the elaboration of final statements and evaluation of the level of scientific evidences. Results The quality of the studies available decreases when we approach ACC in elderly. Same admission laparoscopic cholecystectomy should be suggested for elderly people with ACC; frailty scores as well as clinical and surgical risk scores could be adopted but no general consensus exist. The role of cholecystostomy is uncertain. Discussion and conclusions The evaluation of pro and cons for surgery or for alternative treatments in elderly suffering of ACC is more complex than in young people; also, the oldest old age is not a contraindication for surgery; however, a larger use of frailty and surgical risk scores could contribute to reach the best clinical judgment by the surgeon. The present guidelines offer the opportunity to share with the scientific community a baseline for future researches and discussion.
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Affiliation(s)
- Michele Pisano
- 1st Surgical Unit, Department of Emergency, Papa Giovanni Hospital XXIII, Bergamo, Italy
| | - Marco Ceresoli
- 2General Surgery Department, Milano-Bicocca University, School of Medicine and Surgery, Monza, Italy
| | | | - Kurinchi Gurusamy
- 4Division of Surgery and Interventional Science, University College London, London, UK
| | - Federico Coccolini
- 5General, Emergency and Trauma Surgery, Bufalini Hospital, Cesena, Italy
| | | | - Gianluca Costa
- 7Surgical and Medical Department of Translational Medicine, Sant'Andrea Teaching Hospital, "Sapienza" University of Rome, Rome, Italy
| | - Niccolò Allievi
- 1st Surgical Unit, Department of Emergency, Papa Giovanni Hospital XXIII, Bergamo, Italy
| | - Bruno Amato
- 8Department of Clinical Medicine and Surgery, University of Naples Federico II, Medical School, Naples, Italy
| | - Djamila Boerma
- 9Department of Surgery, St. Antonius Hospital, Nieuwegein, Netherlands
| | - Pietro Calcagno
- 1st Surgical Unit, Department of Emergency, Papa Giovanni Hospital XXIII, Bergamo, Italy
| | - Luca Campanati
- 1st Surgical Unit, Department of Emergency, Papa Giovanni Hospital XXIII, Bergamo, Italy
| | | | | | - Osvaldo Chiara
- 3Milano Trauma Network, ASST Niguarda Hospital, Milan, Italy
| | - Antonio Crucitti
- 12General and Minimally Invasive Surgery Unit, Cristo Re Hospital, Sacro Cuore Catholic University, Rome, Italy
| | - Salomone di Saverio
- 13Cambridge Colorectal Unit, Box 201,Cambridge University Hospitals NHS Foundation Trust, Addenbrooke's Hospital, Cambridge Biomedical Campus, Cambridge, UK
| | - Marco Filauro
- 14E.O.Ospedale Galliera di Genova, SC Chirurgia generale ed epatobiliopancreatica, Genova, Italy
| | - Francesco Gabrielli
- 2General Surgery Department, Milano-Bicocca University, School of Medicine and Surgery, Monza, Italy
| | - Angelo Guttadauro
- 2General Surgery Department, Milano-Bicocca University, School of Medicine and Surgery, Monza, Italy
| | - Yoram Kluger
- Department of General Surgery, Division of Surgery, Rambam Health Care Campus, Haifa, Israel
| | - Stefano Magnone
- 1st Surgical Unit, Department of Emergency, Papa Giovanni Hospital XXIII, Bergamo, Italy
| | - Cecilia Merli
- 16Unit of Emergency Medicine Bufalini Hospital, Cesena, Italy
| | - Elia Poiasina
- 1st Surgical Unit, Department of Emergency, Papa Giovanni Hospital XXIII, Bergamo, Italy
| | - Alessandro Puzziello
- 17General and Day Surgery Unit, San Giovanni di Dio Hospital, University of Salerno, Fisciano, Italy
| | | | - Fausto Catena
- Department of Emergency Surgery, Parma Maggiore Hospital, Parma, Italy
| | - Luca Ansaloni
- 6Department of Surgery, University Hospital of Verona, Verona, Italy
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Calcagno P, Lotti M, Campanati L, Greco S, Trezzi R, Assolari A, Vaterlini E, Bertani C, Allievi N, Giulii Capponi M. Emergency Presentation of Gastric Ectopic Pancreas. Cureus 2018; 10:e3565. [PMID: 30648097 PMCID: PMC6325026 DOI: 10.7759/cureus.3565] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [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: 11/06/2022] Open
Abstract
Ectopic pancreas is a rare embryological abnormality apparently not in association with others. Stomach and duodenum are the most common organs involved. Symptoms are nonspecific. Patients may complain of dyspepsia, abdominal pain or intestinal obstruction. Malignant evolution of ectopic pancreatic cells has been reported. Diagnosis can be very challenging due to the rarity of the disease and the absence of specific symptoms and radiological findings. We report two cases of young-adult men admitted to the emergency department due to acute upper gastro-intestinal and pancreatic symptoms. In both cases, during upper gastrointestinal endoscopy no mucosal vegetations were found. Endoscopic ultrasonography revealed gastric lesions originating from the muscularis propria, with a pattern suspected but not conclusive for malignancy. Fine needle aspiration was inconclusive in both cases. The patients underwent abdominal computed tomography, that showed gastric masses originating from the antrum and the lesser curvature of the stomach, with enlarged locoregional lymph nodes. According to the patients’ symptoms, family history, radiological and cytological findings, the patients were scheduled for an explorative laparoscopy. In both cases, gastric ectopic pancreas was found. Clinical presentation of ectopic pancreas is heterogeneous and the diagnosis can be challenging, especially in an emergency setting. Endoscopic ultrasonography and fine needle aspiration can be useful for the diagnosis and clinical staging, but they can be unspecific. Diagnostic-therapeutic laparoscopy should be considered in symptomatic patients.
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Affiliation(s)
| | - Marco Lotti
- Surgery, Papa Giovanni Xxiii Hospital, Bergamo, ITA
| | | | - Salvatore Greco
- Internal Medicine, Papa Giovanni Xxiii Hospital, Bergamo, ITA
| | | | - Andrea Assolari
- Internal Medicine, Papa Giovanni Xxiii Hospital, Bergamo, ITA
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Lotti M, Poiasina E, Panyor G, Marini M, Capponi MG, Paderno N, Calcagno P, Poletti E, Campanati L. A standardised and simplified technique for laparoscopic resection of the splenic flexure. J Minim Access Surg 2018; 15:268-272. [PMID: 29974872 PMCID: PMC6561073 DOI: 10.4103/jmas.jmas_118_18] [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] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/03/2022] Open
Abstract
The splenic flexure is an uncommon location of colorectal cancer, being involved in 2%–3% of cases. The low chance of being engaged in resecting cancer of the splenic flexure can make it difficult for surgeons to build their learning curve and to achieve a reliable experience. As the majority of colectomies are still performed by low-volume surgeons, there is growing agreement that providing local services with adequate surgical education and training could be an effective strategy to improve outcomes and global health. Arming surgeons with simplified and easy-to-learn surgical techniques could be an important step of this strategy. A novel simplified technique for laparoscopic resection of the splenic flexure is presented, which combines laparoscopic mobilisation of the right colon with extracorporeal vascular ligation and bowel anastomosis.
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Affiliation(s)
- Marco Lotti
- Department of General Surgery, Advanced Surgical Oncology Unit, Papa Giovanni Xxiii Hospital, Bergamo, Italy
| | - Elia Poiasina
- Department of General Surgery, Papa Giovanni Xxiii Hospital, Bergamo, Italy
| | - Gabor Panyor
- Department of General Surgery, Papa Giovanni Xxiii Hospital, Bergamo, Italy
| | - Michele Marini
- Department of General Surgery, Papa Giovanni Xxiii Hospital, Bergamo, Italy
| | | | - Nadiane Paderno
- Department of General Surgery, Papa Giovanni Xxiii Hospital, Bergamo, Italy
| | - Pietro Calcagno
- Department of General Surgery, Papa Giovanni Xxiii Hospital, Bergamo, Italy
| | - Eugenio Poletti
- Department of General Surgery, Papa Giovanni Xxiii Hospital, Bergamo, Italy
| | - Luca Campanati
- Department of General Surgery, Papa Giovanni Xxiii Hospital, Bergamo, Italy
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Montori G, Allievi N, Coccolini F, Solaini L, Campanati L, Ceresoli M, Fugazzola P, Manfredi R, Magnone S, Tomasoni M, Ansaloni L. Negative Pressure Wound Therapy versus modified Barker Vacuum Pack as temporary abdominal closure technique for Open Abdomen management: a four-year experience. BMC Surg 2017; 17:86. [PMID: 28732537 PMCID: PMC5521106 DOI: 10.1186/s12893-017-0281-3] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.3] [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: 12/08/2016] [Accepted: 07/11/2017] [Indexed: 12/16/2022] Open
Abstract
Background We reviewed our experience with patients presenting with trauma and peritonitis who underwent an open abdomen (OA) procedure, and compared outcomes between Negative Pressure Wound Therapy (NPWT) and a modified Barker Vacuum Pack (mBVP) technique. Methods In this descriptive study, we retrospectively analyzed data regarding all patients who underwent OA for intra-abdominal sepsis or abdominal trauma at our Centre from January 2012 to December 2015. Demographic data, co-morbidities, indications to surgery, intra-operative details and Björck classification grade were considered. Outcomes included were: time to closure in days, fascial closure rates, ICU and hospital stay, in-hospital and overall mortality, and entero-atmospheric fistula rate. Results A total of 83 cases were considered. Mean closure time was 6 days versus 6.5 days (p = 0.71) in NPWT and mBVP groups, respectively; the fascial closure rate was 75.4% versus 93.8% (p = 0.10). At multivariate analysis, in-hospital and overall mortality were significantly higher within the mBVP, as compared to NPWT (OR 3.8, 95% CI 1.1 to 13.1, p = 0.02 – OR 4.2, 95% CI 1.2 to 14.1, p = 0.01). Entero-atmospheric fistula rate was 2.6% in the two groups. Conclusions NPWT as a temporary abdominal closure technique, as compared to mBVP, appears to be associated with better outcomes in terms of mortality. Electronic supplementary material The online version of this article (doi:10.1186/s12893-017-0281-3) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Giulia Montori
- Unit of General Surgery, Papa Giovanni XXIII Hospital, P.zza OMS 1, 24127, Bergamo, Italy
| | - Niccolò Allievi
- Unit of General Surgery, Papa Giovanni XXIII Hospital, P.zza OMS 1, 24127, Bergamo, Italy.
| | - Federico Coccolini
- Unit of General Surgery, Papa Giovanni XXIII Hospital, P.zza OMS 1, 24127, Bergamo, Italy
| | - Leonardo Solaini
- Unit of General Surgery, Papa Giovanni XXIII Hospital, P.zza OMS 1, 24127, Bergamo, Italy
| | - Luca Campanati
- Unit of General Surgery, Papa Giovanni XXIII Hospital, P.zza OMS 1, 24127, Bergamo, Italy
| | - Marco Ceresoli
- Unit of General Surgery, Papa Giovanni XXIII Hospital, P.zza OMS 1, 24127, Bergamo, Italy
| | - Paola Fugazzola
- Unit of General Surgery, Papa Giovanni XXIII Hospital, P.zza OMS 1, 24127, Bergamo, Italy
| | - Roberto Manfredi
- Unit of General Surgery, Papa Giovanni XXIII Hospital, P.zza OMS 1, 24127, Bergamo, Italy
| | - Stefano Magnone
- Unit of General Surgery, Papa Giovanni XXIII Hospital, P.zza OMS 1, 24127, Bergamo, Italy
| | - Matteo Tomasoni
- Unit of General Surgery, Papa Giovanni XXIII Hospital, P.zza OMS 1, 24127, Bergamo, Italy
| | - Luca Ansaloni
- Unit of General Surgery, Papa Giovanni XXIII Hospital, P.zza OMS 1, 24127, Bergamo, Italy
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Lotti M, Giulii Capponi M, Campanati L, Poiasina E, Ansaloni L, Poletti E, Frigerio L. The Onset of Intra-Abdominal Adhesions During Closed-Abdomen Hyperthermic Intraperitoneal Chemotherapy. J Laparoendosc Adv Surg Tech A 2016; 26:997-1002. [PMID: 27705085 DOI: 10.1089/lap.2016.0396] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022] Open
Abstract
INTRODUCTION Hyperthermic intraperitoneal chemotherapy (HIPEC) is delivered after cytoreductive surgery (CRS) in selected patients with peritoneal carcinomatosis. The closed-abdomen technique, preferred by many centers, prevents heat loss and drug spillage, but does not warrant homogeneous distribution of the perfusion fluid (PF). The hypothesized formation of intra-abdominal adhesions during the closed-abdomen perfusion period has never been described. MATERIALS AND METHODS From March 2014 to April 2016, 10 consecutive patients with peritoneal carcinomatosis, selected for CRS, underwent the Laparoscopy-Enhanced HIPEC technique to explore the abdominal cavity during the perfusion. The aim of the study was to investigate the incidence and the extent of intra-abdominal adhesions that are formed after CRS during the perfusion period of closed-abdomen HIPEC. RESULTS During the perfusion, adhesions developed in 70% of the patients. Adhesions developed mainly in the period between the closure of the abdomen and the subsequent filling of the abdomen with the PF. After their first division, during the following perfusion period, adhesions between the bowel and the abdominal wall reformed in 3 patients (30%). CONCLUSIONS Intra-abdominal adhesions are frequently formed during closed-abdomen HIPEC and can hamper the adequate circulation of the PF. The Laparoscopy-Enhanced technique enables the early detection and the division of any intra-abdominal adhesions.
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Affiliation(s)
- Marco Lotti
- 1 Advanced Surgical Oncology Unit, Department of General Surgery 1, Papa Giovanni XXIII Hospital , Bergamo, Italy
| | | | - Luca Campanati
- 2 Department of General Surgery 1, Papa Giovanni XXIII Hospital , Bergamo, Italy
| | - Elia Poiasina
- 2 Department of General Surgery 1, Papa Giovanni XXIII Hospital , Bergamo, Italy
| | - Luca Ansaloni
- 2 Department of General Surgery 1, Papa Giovanni XXIII Hospital , Bergamo, Italy
| | - Eugenio Poletti
- 2 Department of General Surgery 1, Papa Giovanni XXIII Hospital , Bergamo, Italy
| | - Luigi Frigerio
- 3 Department of Gynecology and Obstetrics, Papa Giovanni XXIII Hospital , Bergamo, Italy
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Lotti M, Capponi MG, Campanati L, Bertoli P, Palamara F, Coccolini F, Ansaloni L. Laparoscopic right colectomy: Miles away or just around the corner? J Minim Access Surg 2016; 12:41-6. [PMID: 26917918 PMCID: PMC4746974 DOI: 10.4103/0972-9941.158960] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [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] [Indexed: 12/23/2022] Open
Abstract
BACKGROUND: Despite the drive toward centralization of surgery in high-volume centers, the majority of colectomies are still performed by low- or medium-volume surgeons. MATERIALS AND METHODS: A modification of the technique of laparoscopic right colectomy (LRC) originally described by Young-Fadok and Nelson was developed. The key points of that technique were maintained, but a different port-site layout and a counterclockwise approach were adopted, to warrant better trocar triangulation, to reduce the need of right colon manipulation and to avoid dissection along false planes. This modified technique was applied in 82 patients by 16 surgeons with no previous experience in LRC. RESULTS: Average operative time was 125 ± 35 min. Conversion occurred in 10 cases (12.2%). Grade III postoperative complications occurred in 3 patients (3.6%). No postoperative mortality was observed. Average number of lymph nodes retrieved was 19 ± 6. Average length of stay was 7 ± 4 days. CONCLUSION: Providing low-volume surgeons with simplified and easy-to-learn surgical techniques could improve outcomes and lead to an increased use of laparoscopy.
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Affiliation(s)
- Marco Lotti
- Department of General Surgery 1, Papa Giovanni XXIII Hospital, Bergamo, Italy
| | | | - Luca Campanati
- Advanced Surgical Oncology Unit, Papa Giovanni XXIII Hospital, Bergamo, Italy
| | - Paolo Bertoli
- Advanced Surgical Oncology Unit, Papa Giovanni XXIII Hospital, Bergamo, Italy
| | - Fabrizio Palamara
- Advanced Surgical Oncology Unit, Papa Giovanni XXIII Hospital, Bergamo, Italy
| | - Federico Coccolini
- Advanced Surgical Oncology Unit, Papa Giovanni XXIII Hospital, Bergamo, Italy
| | - Luca Ansaloni
- Advanced Surgical Oncology Unit, Papa Giovanni XXIII Hospital, Bergamo, Italy
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Montori G, Coccolini F, Manfredi R, Ceresoli M, Campanati L, Magnone S, Pisano M, Poiasina E, Nita G, Catena F, Ansaloni L. One year experience of swine dermal non-crosslinked collagen prostheses for abdominal wall repairs in elective and emergency surgery. World J Emerg Surg 2015; 10:28. [PMID: 26136817 PMCID: PMC4487506 DOI: 10.1186/s13017-015-0023-8] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [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: 03/26/2015] [Accepted: 06/22/2015] [Indexed: 02/08/2023] Open
Abstract
Introduction The approach to the abdominal wall surgical repair is dramatically changed in the last years. This study evaluates our institutional outcomes about the usage of biological meshes for abdominal wall repair in different setting: in elective surgery, in emergency surgery and in abdominal wall repair following open abdomen (OA) procedure. Methods A database was prospectively conducted (January–December 2014) and data were reviewed for patients who underwent to an abdominal wall reconstruction with swine dermal non-cross linked collagens prostheses either in elective or emergency setting, and following OA/laparostomy procedure. Demographic data, co-morbidities, indications for surgery, intra-operative details, post-operative complications and outcome (peri-operative, 3, 6, 9-months) were analyzed. Results A total of 30 cases were reported: 9 in elective surgery (Group 1), 4 in emergency surgery (Group 2) and 17 with abdominal wall closure following OA management (Group 3). Two meshes were removed: 1 in the Group 1 and 1 in the Group 3. During follow-up only one patient in the Group 3 had a recurrence of the incisional hernia. Mortality rate was 11.1 % at 3 months in Group 1, 0 % in the Group 2, and 29.4 % in peri-operative period in the Group 3. Conclusions The use of non-cross linked biological meshes can be safe and versatile in different situations from elective to emergency surgery, and also for the reconstruction of the abdominal wall after OA procedure, with an acceptable recurrence and mortality rate.
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Affiliation(s)
- Giulia Montori
- Unit of General and Emergency Surgery, Papa Giovanni XXIII Hospital, P.zza OMS 1, 24128 Bergamo, Italy
| | - Federico Coccolini
- Unit of General and Emergency Surgery, Papa Giovanni XXIII Hospital, P.zza OMS 1, 24128 Bergamo, Italy
| | - Roberto Manfredi
- Unit of General and Emergency Surgery, Papa Giovanni XXIII Hospital, P.zza OMS 1, 24128 Bergamo, Italy
| | - Marco Ceresoli
- Unit of General and Emergency Surgery, Papa Giovanni XXIII Hospital, P.zza OMS 1, 24128 Bergamo, Italy
| | - Luca Campanati
- Unit of General and Emergency Surgery, Papa Giovanni XXIII Hospital, P.zza OMS 1, 24128 Bergamo, Italy
| | - Stefano Magnone
- Unit of General and Emergency Surgery, Papa Giovanni XXIII Hospital, P.zza OMS 1, 24128 Bergamo, Italy
| | - Michele Pisano
- Unit of General and Emergency Surgery, Papa Giovanni XXIII Hospital, P.zza OMS 1, 24128 Bergamo, Italy
| | - Elia Poiasina
- Unit of General and Emergency Surgery, Papa Giovanni XXIII Hospital, P.zza OMS 1, 24128 Bergamo, Italy
| | - Gabriela Nita
- Unit of General and Emergency Surgery, Papa Giovanni XXIII Hospital, P.zza OMS 1, 24128 Bergamo, Italy
| | - Fausto Catena
- General surgery department, Ospedale Maggiore, Parma, Italy
| | - Luca Ansaloni
- Unit of General and Emergency Surgery, Papa Giovanni XXIII Hospital, P.zza OMS 1, 24128 Bergamo, Italy
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Coccolini F, Campanati L, Catena F, Ceni V, Ceresoli M, Jimenez Cruz J, Lotti M, Magnone S, Napoli J, Rossetti D, De Iaco P, Frigerio L, Pinna A, Runnebaum I, Ansaloni L. Hyperthermic intraperitoneal chemotherapy with cisplatin and paclitaxel in advanced ovarian cancer: a multicenter prospective observational study. J Gynecol Oncol 2015; 26:54-61. [PMID: 25376916 PMCID: PMC4302286 DOI: 10.3802/jgo.2015.26.1.54] [Citation(s) in RCA: 62] [Impact Index Per Article: 6.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/10/2014] [Revised: 10/09/2014] [Accepted: 10/15/2014] [Indexed: 12/21/2022] Open
Abstract
OBJECTIVE Cytoreductive surgery (CRS) and hyperthermic intraperitoneal chemotherapy (HIPEC) have been recently reported with favorable oncological outcomes as treatment of advanced epithelial ovarian cancer (EOC). The aim of this study was to demonstrate the feasibility of CRS+HIPEC with cisplatin and paclitaxel for the treatment of advanced EOC. METHODS This is a prospective observational study of 54 patients, from April 2007 to October 2013, with primary or recurrent peritoneal carcinomatosis due to EOC. The mean age was 54.51±9.34. Thirty patients (59%) had primary EOC, and 24 patients (41%) had recurrent disease. RESULTS Mean peritoneal cancer index was 10.11 (range, 0 to 28), complete cytoreduction (CC0) was achieved for 47 patients (87%), CC1 for seven patients (13%). Patients with suboptimal cytoreduction (CC2 and CC3) were not included in the study. The mean stay in intensive care unit was 4.73±5.51 days and the mean hospitalization time was 24.0±10.03 days. We did not observe any intraoperative death. Seven patients (13%) required additional operations. Three patients (5.6%) died within 30 days from the procedure. Severe complications were seen in 19 patients (35.2%). During the follow-up period, disease recurred in 33 patients (61.1%); the median disease-free survival time was 12.46 months and the median overall survival time was 32.91 months. CONCLUSION CRS+HIPEC with cisplatin and paclitaxel for advanced EOC is feasible with acceptable morbidity and mortality. Additional follow-up and further studies are needed to determine the effects of HIPEC on long term survival.
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Affiliation(s)
| | - Luca Campanati
- Unit of General Surgery I, Papa Giovanni XXIII Hospital, Bergamo, Italy
| | - Fausto Catena
- Unit of General, Emergency and Transplant Surgery, Sant'Orsola-Malpighi Hospital, University of Bologna, Bologna, Italy
| | - Valentina Ceni
- Unit of Gynecologic Surgery, Papa Giovanni XXIII Hospital, Bergamo, Italy
| | - Marco Ceresoli
- Unit of General Surgery I, Papa Giovanni XXIII Hospital, Bergamo, Italy.
| | | | - Marco Lotti
- Unit of General Surgery I, Papa Giovanni XXIII Hospital, Bergamo, Italy
| | - Stefano Magnone
- Unit of General Surgery I, Papa Giovanni XXIII Hospital, Bergamo, Italy
| | | | - Diego Rossetti
- Unit of Gynecologic Surgery, Papa Giovanni XXIII Hospital, Bergamo, Italy
| | - Pierandrea De Iaco
- Unit of Gynecologic Oncology, Sant'Orsola-Malpighi Hospital, University of Bologna, Bologna, Italy
| | - Luigi Frigerio
- Unit of Gynecologic Surgery, Papa Giovanni XXIII Hospital, Bergamo, Italy
| | - Antonio Pinna
- Unit of General, Emergency and Transplant Surgery, Sant'Orsola-Malpighi Hospital, University of Bologna, Bologna, Italy
| | - Ingo Runnebaum
- Unit of Gynaecology, Jena University Hospital, Jena, Germany
| | - Luca Ansaloni
- Unit of General Surgery I, Papa Giovanni XXIII Hospital, Bergamo, Italy
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Magnone S, Coccolini F, Manfredi R, Piazzalunga D, Agazzi R, Arici C, Barozzi M, Bellanova G, Belluati A, Berlot G, Biffl W, Camagni S, Campanati L, Castelli CC, Catena F, Chiara O, Colaianni N, De Masi S, Di Saverio S, Dodi G, Fabbri A, Faustinelli G, Gambale G, Capponi MG, Lotti M, Marchesi G, Massè A, Mastropietro T, Nardi G, Niola R, Nita GE, Pisano M, Poiasina E, Poletti E, Rampoldi A, Ribaldi S, Rispoli G, Rizzi L, Sonzogni V, Tugnoli G, Ansaloni L. Management of hemodynamically unstable pelvic trauma: results of the first Italian consensus conference (cooperative guidelines of the Italian Society of Surgery, the Italian Association of Hospital Surgeons, the Multi-specialist Italian Society of Young Surgeons, the Italian Society of Emergency Surgery and Trauma, the Italian Society of Anesthesia, Analgesia, Resuscitation and Intensive Care, the Italian Society of Orthopaedics and Traumatology, the Italian Society of Emergency Medicine, the Italian Society of Medical Radiology -Section of Vascular and Interventional Radiology- and the World Society of Emergency Surgery). World J Emerg Surg 2014; 9:18. [PMID: 24606950 PMCID: PMC3975341 DOI: 10.1186/1749-7922-9-18] [Citation(s) in RCA: 44] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2014] [Accepted: 02/24/2014] [Indexed: 11/30/2022] Open
Abstract
Hemodynamically Unstable Pelvic Trauma is a major problem in blunt traumatic injury. No cosensus has been reached in literature on the optimal treatment of this condition. We present the results of the First Italian Consensus Conference on Pelvic Trauma which took place in Bergamo on April 13 2013. An extensive review of the literature has been undertaken by the Organizing Committee (OC) and forwarded to the Scientific Committee (SC) and the Panel (JP). Members of them were appointed by surgery, critical care, radiology, emergency medicine and orthopedics Italian and International societies: the Italian Society of Surgery, the Italian Association of Hospital Surgeons, the Multi-specialist Italian Society of Young Surgeons, the Italian Society of Emergency Surgery and Trauma, the Italian Society of Anesthesia, Analgesia, Resuscitation and Intensive Care, the Italian Society of Orthopaedics and Traumatology, the Italian Society of Emergency Medicine, the Italian Society of Medical Radiology, Section of Vascular and Interventional Radiology and the World Society of Emergency Surgery. From November 2012 to January 2013 the SC undertook the critical revision and prepared the presentation to the audience and the Panel on the day of the Conference. Then 3 recommendations were presented according to the 3 submitted questions. The Panel voted the recommendations after discussion and amendments with the audience. Later on a email debate took place until December 2013 to reach a unanimous consent. We present results on the 3 following questions: which hemodynamically unstable patient needs an extraperitoneal pelvic packing? Which hemodynamically unstable patient needs an external fixation? Which hemodynamically unstable patient needs emergent angiography? No longer angiography is considered the first therapeutic maneuver in such a patient. Preperitoneal pelvic packing and external fixation, preceded by pelvic binder have a pivotal role in the management of these patients. Hemodynamically Unstable Pelvic Trauma is a frequent death cause among people who sustain blunt trauma. We present the results of the First Italian Consensus Conference.
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Affiliation(s)
- Stefano Magnone
- First General Surgery Unit, Ospedale Papa Giovanni XXIII, Bergamo, Italy.
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14
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Lotti M, Busci LM, Campanati L, Catena F, Coccolini F, Bakrin N, Iaco PD, Ercolani G, Grosso G, Pisano M, Poiasina E, Rossetti D, Rossi M, Zamagni C, Bertoli P, Pinna AD, Frigerio L, Ansaloni L. Cytoreductive surgery and HIPEC after neoadjuvant chemotherapy for advanced epithelial ovarian cancer. World J Obstet Gynecol 2013; 2:167-175. [DOI: 10.5317/wjog.v2.i4.167] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [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: 02/21/2013] [Revised: 04/23/2013] [Accepted: 07/11/2013] [Indexed: 02/05/2023] Open
Abstract
AIM: To reduce postoperative complications and to make possible an optimal cytoreduction, neoadjuvant chemotherapy (NACT) followed by interval debulking surgery has been applied with encouraging results.
METHODS: Between December 2009 and February 2012, patients with stage IIIC-IV epithelial ovarian cancer (EOC) underwent diagnostic laparoscopy, to assess the feasibility of optimal debulking surgery. The modified Fagotti score was applied to assess the feasibility of resection with zero residual tumor. Patients who were not candidate for upfront debulking surgery were submitted to NACT, then reassessed according to the RECIST 1.1 criteria and submitted to cytoreductive surgery (CRS) and hyperthermic intraperitoneal chemotherapy (HIPEC) if they showed clinical response or stable disease. The remaining cycles of adjuvant systemic chemotherapy (ASCT) were administered postoperatively, to complete 6 cycles of systemic chemotherapy.
RESULTS: Nine patients were included. Clinical response to NACT was complete in 3 patients and partial in 5 patients; one patient had stable disease. All patients underwent CRS resulting in CC0 disease prior to HIPEC. Average operative time was 510 min. Average intensive care unit stay was 2 d. Average postoperative hospital stay was 25 d. No postoperative mortality was observed. One patient experienced pelvic abscess. One patient refused ASCT. The remaining 8 patients started ASCT. Average time to chemotherapy was 36 d. All patients are alive, with an average follow up of 11 mo. Eight patients are disease-free at follow up.
CONCLUSION: HIPEC after CRS for advanced EOC is feasible with acceptable morbidity and mortality. NACT may increase the chance for achieving complete cytoreduction. Phase 3 studies are needed to determine the effects of HIPEC on survival.
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Coccolini F, Giulii Capponi M, Campanati L, Piazzalunga D, Manfredi R, Colaianni N, Lotti M, Poiasina E, Ansaloni L. Intraperitoneal chemotherapy in advanced gastric cancer. Meta-analysis of randomized trials. Eur J Surg Oncol 2013. [DOI: 10.1016/j.ejso.2013.07.021] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022] Open
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16
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Biasoli D, Kahn SA, Cornélio TA, Furtado M, Campanati L, Chneiweiss H, Moura-Neto V, Borges HL. Retinoblastoma protein regulates the crosstalk between autophagy and apoptosis, and favors glioblastoma resistance to etoposide. Cell Death Dis 2013; 4:e767. [PMID: 23949216 PMCID: PMC3763445 DOI: 10.1038/cddis.2013.283] [Citation(s) in RCA: 45] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2013] [Revised: 06/11/2013] [Accepted: 06/25/2013] [Indexed: 12/15/2022]
Abstract
Glioblastomas (GBMs) are devastating tumors of the central nervous system, with a poor prognosis of 1-year survival. This results from a high resistance of GBM tumor cells to current therapeutic options, including etoposide (VP-16). Understanding resistance mechanisms may thus open new therapeutic avenues. VP-16 is a topoisomerase inhibitor that causes replication fork stalling and, ultimately, the formation of DNA double-strand breaks and apoptotic cell death. Autophagy has been identified as a VP-16 treatment resistance mechanism in tumor cells. Retinoblastoma protein (RB) is a classical tumor suppressor owing to its role in G1/S cell cycle checkpoint, but recent data have shown RB participation in many other cellular functions, including, counterintuitively, negative regulation of apoptosis. As GBMs usually display an amplification of the EGFR signaling involving the RB protein pathway, we questioned whether RB might be involved in mechanisms of resistance of GBM cells to VP-16. We observed that RB silencing increased VP-16-induced DNA double-strand breaks and p53 activation. Moreover, RB knockdown increased VP-16-induced apoptosis in GBM cell lines and cancer stem cells, the latter being now recognized essential to resistance to treatments and recurrence. We also showed that VP-16 treatment induced autophagy, and that RB silencing impaired this process by inhibiting the fusion of autophagosomes with lysosomes. Taken together, our data suggest that RB silencing causes a blockage on the VP-16-induced autophagic flux, which is followed by apoptosis in GBM cell lines and in cancer stem cells. Therefore, we show here, for the first time, that RB represents a molecular link between autophagy and apoptosis, and a resistance marker in GBM, a discovery with potential importance for anticancer treatment.
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Affiliation(s)
- D Biasoli
- Instituto de Ciências Biomédicas, Universidade Federal do Rio de Janeiro, Rio de Janeiro, Brazil
| | - S A Kahn
- Instituto de Ciências Biomédicas, Universidade Federal do Rio de Janeiro, Rio de Janeiro, Brazil
| | - T A Cornélio
- Instituto de Ciências Biomédicas, Universidade Federal do Rio de Janeiro, Rio de Janeiro, Brazil
| | - M Furtado
- Instituto de Ciências Biomédicas, Universidade Federal do Rio de Janeiro, Rio de Janeiro, Brazil
- Australian Regenerative Medicine Institute, Monash University, Melbourne, VIC, Australia
| | - L Campanati
- Instituto de Ciências Biomédicas, Universidade Federal do Rio de Janeiro, Rio de Janeiro, Brazil
| | - H Chneiweiss
- Glial Plasticity Laboratory, Center for Psychiatry and Neuroscience, U894 Inserm, Paris Descartes University, Paris, France
| | - V Moura-Neto
- Instituto de Ciências Biomédicas, Universidade Federal do Rio de Janeiro, Rio de Janeiro, Brazil
| | - H L Borges
- Instituto de Ciências Biomédicas, Universidade Federal do Rio de Janeiro, Rio de Janeiro, Brazil
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17
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Coccolini F, Ansaloni L, Manfredi R, Campanati L, Poiasina E, Bertoli P, Capponi MG, Sartelli M, Di Saverio S, Cucchi M, Lazzareschi D, Pisano M, Catena F. Peritoneal adhesion index (PAI): proposal of a score for the "ignored iceberg" of medicine and surgery. World J Emerg Surg 2013; 8:6. [PMID: 23369320 PMCID: PMC3573980 DOI: 10.1186/1749-7922-8-6] [Citation(s) in RCA: 71] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2012] [Accepted: 01/29/2013] [Indexed: 12/24/2022] Open
Abstract
Peritoneal adhesions describe a condition in which pathological bonds form between the omentum, the small and large bowels, the abdominal wall, and other intra-abdominal organs. Different classification systems have been proposed, but they do not resolve the underlying problem of ambiguity in the quantification and definition of adhesions. We therefore propose a standardized classification system of adhesions to universalize their definition based on the macroscopic appearance of adhesions and their diffusion to different regions of the abdomen. By scoring with these criteria, the peritoneal adhesion index (PAI) can range from 0 to 30, unambiguously specifying precise adhesion scenarios. The standardized classification and quantification of adhesions would enable different studies to more meaningfully integrate their results, thereby facilitating a more comprehensive approach to the treatment and management of this pathology.
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Affiliation(s)
- Federico Coccolini
- General and Emergency Surgery department, Papa Giovanni XXIII hospital, Piazza OMS-Organizzazione Mondiale della Sanità 1, 24128, Bergamo, Italy.
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18
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Coccolini F, Lotti M, Bertoli P, Manfredi R, Piazzalunga D, Magnone S, Campanati L, Ansaloni L. Thoracic wall reconstruction with Collamend® in trauma: report of a case and review of the literature. World J Emerg Surg 2012; 7:39. [PMID: 23259462 PMCID: PMC3562256 DOI: 10.1186/1749-7922-7-39] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/26/2012] [Accepted: 12/20/2012] [Indexed: 11/10/2022] Open
Abstract
UNLABELLED INTRODUCTION Despite progress in reconstructive techniques, rebuilding portions of the thorax remains challenging, in particular when large resections, contamination or infection are involved. No other cases of thoracic reconstruction in trauma patients with biological prosthesis have been described since now. METHODS We report a case of thoracic reconstruction in highly infected field in a trauma patient. We also performed a literature review about the topic. CONCLUSION Collamend® demonstrated its usefulness in thoracic wall reconstruction even in trauma patients and infected fields.
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Affiliation(s)
- Federico Coccolini
- General and Emergency Surgery dept, Ospedali Riuniti, Largo Barozzi, 1-26128, Bergamo, Italy.
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19
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Campanati L, Gadelha AP, Monteiro-Leal LH. Electron and video-light microscopy analysis of the in vitro effects of pyrantel pamoate on Giardia lamblia. Exp Parasitol 2001; 97:9-14. [PMID: 11207109 DOI: 10.1006/expr.2000.4578] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.6] [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: 11/22/2022]
Abstract
Electron and video-light microscopy analysis of the in vitro effects of pyrantel pamoate on Giardia lamblia. Experimental Parasitology 97, 9-14. Giardia infection is predominant in the small intestine of vertebrates, where the trophozoites attach to epithelial cells and adversely affect the microvilli and other epithelial cell structures. Giardiasis, the disease caused by this protozoan, is very common in developing countries and mainly affects children. Drugs currently used to treat Giardia infection, such as some benzimidazole derivatives, were originally designed to treat helminthic infections. Many of the drugs are known to cause severe side effects and disturbances to the patient. Using transmission electron microscopy and video-light microscopy, we studied the effects of pyrantel pamoate, a drug commonly used in the treatment of helminthic infections in horses and ruminants, on Giardia lamblia trophozoites. Pyrantel pamoate was administered to Giardia cells in four different concentrations. Using video-light microscopy, we observed the decrease in flagella beating frequency and severe changes in the lateral flange and in the general aspect of the cell. Using transmission electron microscopy, we observed changes in the cytoplasm and peripheral vesicles. The flagella and adhesive disk structure were not affected. Apparently, the effects of pyrantel pamoate are irreversible.
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Affiliation(s)
- L Campanati
- Department of Histology and Embryology, Laboratory of Microscopy and Image Processing, State University of Rio de Janeiro, Av. Prof. Manoel de Abreu, 48 3 degrees andar, Maracanã, Rio de Janeiro, CEP 20550-170, Brazil
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20
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Abstract
By means of immunofluorescence, immunoelectron microscopy and immunoblotting, we show that polyglycylation, a posttranslational modification of tubulin widely spread among eukaryotes, is present in the diplomonad, Giardia lamblia, a putative ancestral cell possessing a highly developed microtubular cytoskeleton. This modification was recently discovered in the ciliated protist, Paramecium, and was not found in the Euglenozoa, a lineage considered as ancient. We used two monoclonal antibodies (mAbs), TAP 952 and AXO 49, specifically recognizing mono- and polyglycylated tubulin isoforms, to detect this modification in Giardia extracts and to localize it in the different classes of microtubules within the cell. The alpha- and beta-tubulin subunits were recognized by the two mAbs, indicating that both tubulin subunits are glycylated, in agreement with lately reported mass spectrometry results. Noticeably, Giardia tubulin was much more reactive with AXO 49 than with TAP 952. In situ, AXO 49 intensely labeled the microtubules present in the four pairs of flagella and the median body, and lightly decorated the microtubules from the adhesive disc. In contrast, TAP 952 intensely labeled only the microtubules of the median body. The results indicate a differential expression of glycylated isoforms within various microtubular structures of Giardia lamblia. They also suggest that the complete set of enzymes required for polyglycylation is expressed in very divergent eukaryotes.
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Affiliation(s)
- L Campanati
- Universidade do Estado do Rio de Janeiro, Departamento de Histologia e Embriologia, Brazil
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21
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Arosio E, Albani AP, Campanati L, Grizzi F, Gatti S, Orsenigo R, Fassati LR, Gridelli B. Photoconversion to identify DiI-marked cells after hepatocellular transplantation. Transplant Proc 1994; 26:3387-8. [PMID: 7998186] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/28/2023]
Affiliation(s)
- E Arosio
- Centro Studi Medicina Teoretica, University of Milan, Italy
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22
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Fassati LR, Doglia M, Galmarini D, Armiraglio E, Campanati L, Melada E, Romito R. Older and fatty liver for hepatic transplantation (OLT). Transplant Proc 1994; 26:3610-1. [PMID: 7998291] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/28/2023]
Affiliation(s)
- L R Fassati
- Istituto di Chirurgia Sperimentale e dei Trapianti dell'Università di Milano, Italy
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23
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Albani AP, Campanati L, Arosio E, Gatti S, Gridelli B, Orsenigo R, Grizzi F, Doglia M, Fassati LR, Galmarini D. Hepatocyte injection in Gunn rats' thymus and spleen. Transplant Proc 1994; 26:3443-5. [PMID: 7998212] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/28/2023]
Affiliation(s)
- A P Albani
- Institute of Experimental Surgery and Transplantation, University of Milan, Italy
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24
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Langer M, Pezzi A, Gridelli B, Campanati L, Prato P, Di Mauro P, Quarenghi E, Peta M, Pifferi S, Proietti D. Beta-adrenergic antagonists to prevent bleeding from esophageal varices: a risk during liver transplantation? Transplant Proc 1994; 26:3675-6. [PMID: 7998318] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/28/2023]
Affiliation(s)
- M Langer
- Istituto di Anestesia e Rianimazione, Ospedale Maggiore IRCCS, Milan, Italy
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25
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Gatti S, Rossi G, Albani AP, Reggiani P, Caccamo L, Gridelli B, Lucianetti A, Paone G, Campanati L, Melada E. Orthotopic liver-small bowel allotransplantation--surgical technique in the pig. Transplant Proc 1994; 26:1627-8. [PMID: 8030064] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/28/2023]
Affiliation(s)
- S Gatti
- Istituto di Chirurgia Sperimentale e dei Trapianti, Università degli Studi di Milano, Ospedale Maggiore di Milano IRCCS, Italy
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26
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Gridelli B, Gatti S, Piazzini A, Reggiani P, Langer M, DeKlerk W, Stark JH, Bonara P, Cristina S, Campanati L. Xenogeneic orthotopic liver transplantation in nonhuman primates. Transplant Proc 1993; 25:457-61. [PMID: 8438378] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/30/2023]
Affiliation(s)
- B Gridelli
- Department of Experimental Surgery, University of Milan, Italy
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Valtorta F, Tarelli FT, Campanati L, Villa A, Greengard P. Synaptophysin and synapsin I as tools for the study of the exo-endocytotic cycle. Cell Biol Int Rep 1989; 13:1023-38. [PMID: 2517595 DOI: 10.1016/0309-1651(89)90017-9] [Citation(s) in RCA: 20] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/01/2023]
Abstract
Synaptophysin, an integral protein of the synaptic vesicle membrane, and synapsin I, a phosphoprotein associated with the cytoplasmic side of synaptic vesicles, represent useful markers that allow to follow the movements of the vesicle membrane during recycling. The use of antibodies against these proteins to label nerve terminals during experimental treatments which stimulate secretion has provided evidence that during the exo-endocytotic cycle synaptic vesicles transiently fuse with the axolemma, from which they are specifically recovered. When recycling is blocked, exocytosis leads to the permanent incorporation of the synaptic vesicle membrane into the axolemma and to diffusion of the vesicle components in the plane of the membrane.
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Affiliation(s)
- F Valtorta
- Bruno Ceccarelli Center for the Study of Peripheral Neuropathies and Neuromuscular Diseases, University of Milano Medical School
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28
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Beltrami CA, Fabris G, Campanati L, Soliani-Raschini C. [Radiological and histopatholical study of a rare case of bilateral lesion of the jaw]. Riv Patol Clin Sper 1970; 11:235-45. [PMID: 5526254] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/15/2023]
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