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Bertocchi E, Meoli F, Masini G, Ceccaroni M, Bruni F, Roviglione G, Rossini R, Barugola G, Mazzi C, Ruffo G. Early Quality of Life Assessment After Segmental Colorectal Resection for Deep Infiltrating Endometriosis. J Minim Invasive Gynecol 2024; 31:221-226. [PMID: 38114018 DOI: 10.1016/j.jmig.2023.12.007] [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: 07/04/2023] [Revised: 11/22/2023] [Accepted: 12/15/2023] [Indexed: 12/21/2023]
Abstract
STUDY OBJECTIVE Endometriosis is a benign condition afflicting women of reproductive age that significantly impacts their quality of life (QoL). Given its debilitating symptoms and prevalence, it is essential to define its proper management. In this study, we have assessed patient-reported outcomes among women having undergone segmental colorectal resection for deep infiltrating endometriosis. Any correlation between preoperative nutritional status and overall postoperative complications has also been analyzed. STUDY DESIGN Prospective observational study. SETTING Public medical center. PATIENTS One hundred forty consecutive patients that had undergone segmental colorectal resection for DIE between November 2020 and October 2021 at IRCCS Sacro Cuore Don Calabria Hospital of Negrar of Valpolicella (Verona, Italy). INTERVENTIONS Patient-reported outcomes were measured using data collected from the MD Anderson Symptom Inventory for gastrointestinal surgery patients and Euro-QoL Group EQ-5D-5L (EQ-5Q-5L) questionnaires, which were administered preoperatively (T0), at discharge (T1) and at 4 to 6 weeks after surgery (T2). Nutritional status was examined through the Mini Nutritional Assessment Short form and Prognostic Nutritional Index. MEASUREMENTS AND MAIN RESULTS A significant improvement in the EQ-5Q-5L and MDASI-GI scores was noted between T0 and T2 (p <. 001 and p <. 001, respectively.) No statistically significant differences were found in scores at T2 between patients who had experienced postoperative complications and those who had not. No statistically significant association was observed between the presence of malnutrition and overall postoperative complications and their severity. CONCLUSION This study confirms, through patient-reported outcomes, the pivotal role of surgery in improving the QoL at 4 to 6 weeks of women affected by endometriosis who have previously been unresponsive to medical therapy.
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Affiliation(s)
- Elisa Bertocchi
- General Surgery Unit, IRCCS Sacro Cuore Don Calabria Hospital (Drs. Bertocchi, Masini, Rossini, Barugola, and Ruffo).
| | - Francesca Meoli
- Department of General Surgery and Surgical Specialities (Dr. Meoli), Sapienza University of Rome, Rome, Italy
| | - Gaia Masini
- General Surgery Unit, IRCCS Sacro Cuore Don Calabria Hospital (Drs. Bertocchi, Masini, Rossini, Barugola, and Ruffo)
| | - Marcello Ceccaroni
- Department of Obstetrics and Gynecology (Drs. Ceccaroni, Bruni, and Roviglione)
| | - Francesco Bruni
- Department of Obstetrics and Gynecology (Drs. Ceccaroni, Bruni, and Roviglione)
| | - Giovanni Roviglione
- Department of Obstetrics and Gynecology (Drs. Ceccaroni, Bruni, and Roviglione)
| | - Roberto Rossini
- General Surgery Unit, IRCCS Sacro Cuore Don Calabria Hospital (Drs. Bertocchi, Masini, Rossini, Barugola, and Ruffo)
| | - Giuliano Barugola
- General Surgery Unit, IRCCS Sacro Cuore Don Calabria Hospital (Drs. Bertocchi, Masini, Rossini, Barugola, and Ruffo)
| | - Cristina Mazzi
- Gynecologic Oncology and Minimally Invasive Pelvic Surgery, International School of Surgical Anatomy, IRCCS "Sacro Cuore - Don Calabria" Hospital, Clinical Research Unit, IRCCS Ospedale Sacro Cuore Don Calabria (Dr. Mazzi), Negrar di Valpolicella, Verona
| | - Giacomo Ruffo
- General Surgery Unit, IRCCS Sacro Cuore Don Calabria Hospital (Drs. Bertocchi, Masini, Rossini, Barugola, and Ruffo)
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Rossini R, Oshaghi M, Nekrasov M, Bellanger A, Domaschenz R, Dijkwel Y, Abdelhalim M, Collas P, Tremethick D, Paulsen J. Multi-level 3D genome organization deteriorates during breast cancer progression. bioRxiv 2023:2023.11.26.568711. [PMID: 38076897 PMCID: PMC10705249 DOI: 10.1101/2023.11.26.568711] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Indexed: 12/23/2023]
Abstract
Breast cancer entails intricate alterations in genome organization and expression. However, how three-dimensional (3D) chromatin structure changes in the progression from a normal to a breast cancer malignant state remains unknown. To address this, we conducted an analysis combining Hi-C data with lamina-associated domains (LADs), epigenomic marks, and gene expression in an in vitro model of breast cancer progression. Our results reveal that while the fundamental properties of topologically associating domains (TADs) remain largely stable, significant changes occur in the organization of compartments and subcompartments. These changes are closely correlated with alterations in the expression of oncogenic genes. We also observe a restructuring of TAD-TAD interactions, coinciding with a loss of spatial compartmentalization and radial positioning of the 3D genome. Notably, we identify a previously unrecognized interchromosomal insertion event, wherein a locus on chromosome 8 housing the MYC oncogene is inserted into a highly active subcompartment on chromosome 10. This insertion leads to the formation of de novo enhancer contacts and activation of the oncogene, illustrating how structural variants can interact with the 3D genome to drive oncogenic states. In summary, our findings provide evidence for the degradation of genome organization at multiple scales during breast cancer progression revealing novel relationships between genome 3D structure and oncogenic processes.
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Affiliation(s)
- Roberto Rossini
- Department of Biosciences, Faculty of Mathematics and Natural Sciences, University of Oslo, 0316 Oslo, Norway
| | - Mohammadsaleh Oshaghi
- Department of Biosciences, Faculty of Mathematics and Natural Sciences, University of Oslo, 0316 Oslo, Norway
| | - Maxim Nekrasov
- Department of Genome Sciences, The John Curtin School of Medical Research, The Australian National University, Canberra, Australian Capital Territory, Australia
| | - Aurélie Bellanger
- Department of Molecular Medicine, Institute of Basic Medical Sciences, Faculty of Medicine, University of Oslo, 0317 Oslo, Norway
| | - Renae Domaschenz
- Department of Genome Sciences, The John Curtin School of Medical Research, The Australian National University, Canberra, Australian Capital Territory, Australia
| | - Yasmin Dijkwel
- Department of Genome Sciences, The John Curtin School of Medical Research, The Australian National University, Canberra, Australian Capital Territory, Australia
| | - Mohamed Abdelhalim
- Department of Molecular Medicine, Institute of Basic Medical Sciences, Faculty of Medicine, University of Oslo, 0317 Oslo, Norway
| | - Philippe Collas
- Department of Molecular Medicine, Institute of Basic Medical Sciences, Faculty of Medicine, University of Oslo, 0317 Oslo, Norway
- Department of Immunology and Transfusion Medicine, Oslo University Hospital, 0424 Oslo, Norway
| | - David Tremethick
- Department of Genome Sciences, The John Curtin School of Medical Research, The Australian National University, Canberra, Australian Capital Territory, Australia
| | - Jonas Paulsen
- Department of Biosciences, Faculty of Mathematics and Natural Sciences, University of Oslo, 0316 Oslo, Norway
- Centre for Bioinformatics, Department of Informatics, University of Oslo, 0316 Oslo, Norway
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Ceccaroni M, Ceccarello M, Raimondo I, Roviglione G, Clarizia R, Bruni F, Mautone D, Manzone M, Facci E, Rettore L, Rossini R, Bertocchi E, Barugola G, Ruffo G, Barra F. "A Space Odyssey" on Laparoscopic Segmental Rectosigmoid Resection for Deep Endometriosis: A Seventeen-year Retrospective Analysis of Outcomes and Postoperative Complications among 3050 Patients Treated in a Referral Center. J Minim Invasive Gynecol 2023; 30:652-664. [PMID: 37116746 DOI: 10.1016/j.jmig.2023.04.005] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [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: 02/08/2023] [Revised: 03/28/2023] [Accepted: 04/06/2023] [Indexed: 04/30/2023]
Abstract
STUDY OBJECTIVE To evaluate the feasibility of laparoscopic rectosigmoid resection for bowel endometriosis (RSE), reporting surgical and short-term postoperative outcomes in a consecutive large series of patients. DESIGN A retrospective cohort study. SETTING Third-level national referral center for deep endometriosis (DE). PATIENTS 3050 patients with symptomatic RSE requiring surgical treatment. INTERVENTIONS Nerve-sparing laparoscopic resection for RSE perfomed by a multidisciplinary team. After collecting intraoperative surgical characteristics, postoperative complications were collected by evaluating the risk factors associated with their onset. MEASUREMENTS AND MAIN RESULTS Clavien-Dindo IIIb postoperative complications were noted in 13.1% of patients, with anastomotic leakage and rectovaginal fistula accounting for 3.0% and 1.9%, respectively. Postoperative bladder impairment was observed in 13.9% of patients during hospital discharge but spontaneously decreased to 4.5% at the first evaluation after 30 days, alongside a statistically significant change towards global symptom improvement. Multivariate analyses were done to identify the risk factors for segmental bowel resection in terms of occurrence of postoperative major complications. Ultralow (≤5 cm from the anal verge), low rectal anastomosis (<8 cm, >5 cm), parametrectomy, vaginal resection, and previous surgeries seemed more related to anastomotic leakage, rectovaginal fistula, and bladder retention. CONCLUSIONS Laparoscopic rectosigmoid resection for RSE seems an effective and feasible procedure. The surgical complication rate is not negligible but could be reduced by implementing a multidisciplinary approach, an endless improvement in nerve-sparing techniques and surgical anatomy, as well as technological enhancements. Real future challenges will be to reduce the time for the first diagnosis of DE and the likelihood of surgical indications.
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Affiliation(s)
- Marcello Ceccaroni
- Department of Obstetrics and Gynecology (Drs. Ceccaroni, Ceccarello, Roviglione, Clarizia, Bruni, Mautone, Manzone, and Barra), Gynecologic Oncology and Minimally Invasive Pelvic Surgery, International School of Surgical Anatomy, IRCCS "Sacro Cuore - Don Calabria" Hospital, Negrar di Valpolicella, Verona, Italy.
| | - Matteo Ceccarello
- Department of Obstetrics and Gynecology (Drs. Ceccaroni, Ceccarello, Roviglione, Clarizia, Bruni, Mautone, Manzone, and Barra), Gynecologic Oncology and Minimally Invasive Pelvic Surgery, International School of Surgical Anatomy, IRCCS "Sacro Cuore - Don Calabria" Hospital, Negrar di Valpolicella, Verona, Italy
| | - Ivano Raimondo
- Gynecology and Breast Care Center (Dr. Raimondo), Mater Olbia Hospital, Olbia, Italy; School in Biomedical Sciences (Dr. Raimondo), University of Sassari, Sassari, Italy
| | - Giovanni Roviglione
- Department of Obstetrics and Gynecology (Drs. Ceccaroni, Ceccarello, Roviglione, Clarizia, Bruni, Mautone, Manzone, and Barra), Gynecologic Oncology and Minimally Invasive Pelvic Surgery, International School of Surgical Anatomy, IRCCS "Sacro Cuore - Don Calabria" Hospital, Negrar di Valpolicella, Verona, Italy
| | - Roberto Clarizia
- Department of Obstetrics and Gynecology (Drs. Ceccaroni, Ceccarello, Roviglione, Clarizia, Bruni, Mautone, Manzone, and Barra), Gynecologic Oncology and Minimally Invasive Pelvic Surgery, International School of Surgical Anatomy, IRCCS "Sacro Cuore - Don Calabria" Hospital, Negrar di Valpolicella, Verona, Italy
| | - Francesco Bruni
- Department of Obstetrics and Gynecology (Drs. Ceccaroni, Ceccarello, Roviglione, Clarizia, Bruni, Mautone, Manzone, and Barra), Gynecologic Oncology and Minimally Invasive Pelvic Surgery, International School of Surgical Anatomy, IRCCS "Sacro Cuore - Don Calabria" Hospital, Negrar di Valpolicella, Verona, Italy
| | - Daniele Mautone
- Department of Obstetrics and Gynecology (Drs. Ceccaroni, Ceccarello, Roviglione, Clarizia, Bruni, Mautone, Manzone, and Barra), Gynecologic Oncology and Minimally Invasive Pelvic Surgery, International School of Surgical Anatomy, IRCCS "Sacro Cuore - Don Calabria" Hospital, Negrar di Valpolicella, Verona, Italy
| | - Maria Manzone
- Department of Obstetrics and Gynecology (Drs. Ceccaroni, Ceccarello, Roviglione, Clarizia, Bruni, Mautone, Manzone, and Barra), Gynecologic Oncology and Minimally Invasive Pelvic Surgery, International School of Surgical Anatomy, IRCCS "Sacro Cuore - Don Calabria" Hospital, Negrar di Valpolicella, Verona, Italy
| | - Enrico Facci
- Department of General Surgery (Drs. Facci, Rettore, Rossini, Bertocchi, Barugola, and Ruffo), IRCSS "Sacro Cuore - Don Calabria" Hospital, Negrar di Valpolicella, Verona, Italy
| | - Lorenzo Rettore
- Department of General Surgery (Drs. Facci, Rettore, Rossini, Bertocchi, Barugola, and Ruffo), IRCSS "Sacro Cuore - Don Calabria" Hospital, Negrar di Valpolicella, Verona, Italy
| | - Roberto Rossini
- Department of General Surgery (Drs. Facci, Rettore, Rossini, Bertocchi, Barugola, and Ruffo), IRCSS "Sacro Cuore - Don Calabria" Hospital, Negrar di Valpolicella, Verona, Italy
| | - Elisa Bertocchi
- Department of General Surgery (Drs. Facci, Rettore, Rossini, Bertocchi, Barugola, and Ruffo), IRCSS "Sacro Cuore - Don Calabria" Hospital, Negrar di Valpolicella, Verona, Italy
| | - Giuliano Barugola
- Department of General Surgery (Drs. Facci, Rettore, Rossini, Bertocchi, Barugola, and Ruffo), IRCSS "Sacro Cuore - Don Calabria" Hospital, Negrar di Valpolicella, Verona, Italy
| | - Giacomo Ruffo
- Department of General Surgery (Drs. Facci, Rettore, Rossini, Bertocchi, Barugola, and Ruffo), IRCSS "Sacro Cuore - Don Calabria" Hospital, Negrar di Valpolicella, Verona, Italy
| | - Fabio Barra
- Department of Obstetrics and Gynecology (Drs. Ceccaroni, Ceccarello, Roviglione, Clarizia, Bruni, Mautone, Manzone, and Barra), Gynecologic Oncology and Minimally Invasive Pelvic Surgery, International School of Surgical Anatomy, IRCCS "Sacro Cuore - Don Calabria" Hospital, Negrar di Valpolicella, Verona, Italy; Department of Health Sciences (DISSAL) (Dr. Barra), University of Genoa, Genoa, Italy
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Rossini R, Kumar V, Mathelier A, Rognes T, Paulsen J. MoDLE: high-performance stochastic modeling of DNA loop extrusion interactions. Genome Biol 2022; 23:247. [PMID: 36451166 PMCID: PMC9710047 DOI: 10.1186/s13059-022-02815-7] [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: 04/13/2022] [Accepted: 11/17/2022] [Indexed: 12/03/2022] Open
Abstract
DNA loop extrusion emerges as a key process establishing genome structure and function. We introduce MoDLE, a computational tool for fast, stochastic modeling of molecular contacts from DNA loop extrusion capable of simulating realistic contact patterns genome wide in a few minutes. MoDLE accurately simulates contact maps in concordance with existing molecular dynamics approaches and with Micro-C data and does so orders of magnitude faster than existing approaches. MoDLE runs efficiently on machines ranging from laptops to high performance computing clusters and opens up for exploratory and predictive modeling of 3D genome structure in a wide range of settings.
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Affiliation(s)
- Roberto Rossini
- grid.5510.10000 0004 1936 8921Department of Biosciences, University of Oslo, 0316 Oslo, Norway
| | - Vipin Kumar
- grid.5510.10000 0004 1936 8921Centre for Molecular Medicine Norway (NCMM), Nordic EMBL Partnership, University of Oslo, 0318 Oslo, Norway
| | - Anthony Mathelier
- grid.5510.10000 0004 1936 8921Centre for Molecular Medicine Norway (NCMM), Nordic EMBL Partnership, University of Oslo, 0318 Oslo, Norway
| | - Torbjørn Rognes
- grid.5510.10000 0004 1936 8921Centre for Bioinformatics, Department of Informatics, University of Oslo, 0316 Oslo, Norway ,grid.55325.340000 0004 0389 8485Department of Microbiology, Oslo University Hospital, Rikshospitalet, 0424 Oslo, Norway
| | - Jonas Paulsen
- grid.5510.10000 0004 1936 8921Department of Biosciences, University of Oslo, 0316 Oslo, Norway ,grid.5510.10000 0004 1936 8921Centre for Bioinformatics, Department of Informatics, University of Oslo, 0316 Oslo, Norway
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Gentile I, Rossini R, Menestrina N, Lodi G, Tubaro A, Zuppini T, Bonadiman S, Misso A, Ruffo G. Effects of an ongoing ERAS® society implementation program on early outcomes in bariatric surgery. Clin Nutr ESPEN 2022. [DOI: 10.1016/j.clnesp.2022.06.094] [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: 11/27/2022]
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Bertocchi E, Barugola G, Ceccaroni M, Guerriero M, Rossini R, Gentile I, Ruffo G. Laparoscopic colorectal resection for deep infiltrating endometriosis: can we reliably predict anastomotic leakage and major postoperative complications in the early postoperative period? Surg Endosc 2021; 36:422-429. [PMID: 33523269 DOI: 10.1007/s00464-021-08301-8] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/04/2020] [Accepted: 01/09/2021] [Indexed: 12/22/2022]
Abstract
BACKGROUND Anastomotic leakage (AL) and major complications after colorectal resection for deep infiltrating endometriosis (DIE) have a remarkable impact on patient outcomes. The aim of this study is to assess the predictive value of C-reactive protein (CRP), procalcitonin (PCT), white blood cell count (WBCs) and the Dutch Leakage Score (DLS) as reliable markers in the early diagnosis of AL and major complications after laparoscopic colorectal resection for DIE. METHODS 262 consecutive women undergoing laparoscopic colorectal resection for DIE between September 2017 and September 2018 were prospectively enrolled. WBCs, CRP, PCT and DLS were recorded at baseline and on postoperative day (POD) 2, 3 and 6 then statistically analyzed as predictors of AL and severe postoperative complications. RESULTS The AL rate was 3.2%. The major morbidity rate was 11.2%. No postoperative mortality was recorded. The postoperative trend of DLS and serum levels of CRP and PCT, but not WBCs, were significantly higher in women developing AL and severe complications. DLS had better sensitivity and specificity than biomarkers on all postoperative days as a predictor of AL and major complications. CRP and PCT have a low positive predictive value (PPV) and a high negative predictive value (NPV) for AL and major complications on POD3 and POD6. The risk of malnutrition was significantly related to AL. CONCLUSIONS The combination of DLS as a standardized postoperative clinical monitoring system and CRP and PCT as serum biomarkers, allows the exclusion of AL and major complications in the early postoperative period after laparoscopic colorectal resection for DIE, thus ensuring a safe patient discharge.
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Affiliation(s)
- Elisa Bertocchi
- General Surgery Unit, IRCCS Sacro Cuore Don Calabria Hospital, Via Don A. Sempreboni 5, 37024, Negrar di Valpolicella, Verona, Italy.
| | - Giuliano Barugola
- General Surgery Unit, IRCCS Sacro Cuore Don Calabria Hospital, Via Don A. Sempreboni 5, 37024, Negrar di Valpolicella, Verona, Italy
| | - Marcello Ceccaroni
- Department of Obstetrics and Gynecology, Gynecology Oncology and Minimally-Invasive Pelvic Surgery, International School of Surgical Anatomy (ISSA), IRCCS Sacro Cuore Don Calabria Hospital, Negrar di Valpolicella, Verona, Italy
| | - Massimo Guerriero
- Clinical Research Unit, IRCCS Sacro Cuore Don Calabria Hospital and University of Verona, Verona, Italy
| | - Roberto Rossini
- General Surgery Unit, IRCCS Sacro Cuore Don Calabria Hospital, Via Don A. Sempreboni 5, 37024, Negrar di Valpolicella, Verona, Italy
| | - Irene Gentile
- General Surgery Unit, IRCCS Sacro Cuore Don Calabria Hospital, Via Don A. Sempreboni 5, 37024, Negrar di Valpolicella, Verona, Italy
| | - Giacomo Ruffo
- General Surgery Unit, IRCCS Sacro Cuore Don Calabria Hospital, Via Don A. Sempreboni 5, 37024, Negrar di Valpolicella, Verona, Italy
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Ceccaroni M, Ceccarello M, Clarizia R, Fusco E, Roviglione G, Mautone D, Cavallero C, Orlandi S, Rossini R, Barugola G, Ruffo G. Nerve-sparing laparoscopic disc excision of deep endometriosis involving the bowel: a single-center experience on 371 consecutives cases. Surg Endosc 2020; 35:5991-6000. [PMID: 33052528 DOI: 10.1007/s00464-020-08084-4] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [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: 04/16/2020] [Accepted: 10/03/2020] [Indexed: 11/26/2022]
Abstract
BACKGROUND Bowel endometriosis is the most common pattern of Deep Endometriosis (DE). Arising from the posterior portion of the cervix and spreading to the recto-vaginal septum, utero-sacral and parametrial ligaments could lead to a distortion of normal pelvic anatomy, causing pain and infertility. Hormonal therapy is the first-line treatment in non-symptomatic patient. Conversely, laparoscopic surgical treatment has to be considered when symptoms relief are not optimal or with signs of bowel occlusion. METHODS Retrospective experience of consecutive series of patients who referred to a third-level referral center with suspected bowel DE and failure of multiple medical treatments. After an intraoperative evaluation of nodule size with a rectal shaving of its external portion, patients underwent radical DE eradication with concomitant disc excision in rectal nodules < 3 cm with no signs of substantial full-thickness infiltration. RESULTS A total of 371 patients were considered eligible for analysis, with a median age of 37 years. The median operative time of was 180 min, with an estimated blood loss of 100 mL and a median diameter of removed rectal nodule of 25 mm. Early postoperative procedure-related complications were 47 cases of acute rectal bleeding (12.7%), that were managed by rectal endoscopy, 3 bowel anastomotic dehiscence (0.8%), 8 hemoperitoneum (2.2%) and 3 ureteral fistula (0.8%). 22 patients experienced postoperative hyperpyrexia (5.9%), while 17 women underwent transient bladder deficiency (4.6%). Median follow-up was 60 months with a bowel recurrence rate of 2.2%. There was an improvement of all symptoms in the immediate postoperative follow-up (p < 0.0001). Among all patients with childbearing desire, the pregnancy rate found was 42.2% and was obtained by in vitro fertilization (IVF) techniques in 32% of cases. CONCLUSIONS Laparoscopic disc excision for bowel endometriosis is an effective surgical treatment in selected residual rectal nodules < 3.0 cm. The concomitant radical DE excision contributes to a significant improvement of symptoms with an acceptable complications' rate.
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Affiliation(s)
- Marcello Ceccaroni
- Department of Obstetrics and Gynecology, Gynecologic Oncology and Minimally Invasive Pelvic Surgery, International School of Surgical Anatomy, IRCCS "Sacro Cuore-Don Calabria" Hospital, Via Don A. Sempreboni 5, 37024, Negrar di Valpolicella, Verona, Italy
| | - Matteo Ceccarello
- Department of Obstetrics and Gynecology, Gynecologic Oncology and Minimally Invasive Pelvic Surgery, International School of Surgical Anatomy, IRCCS "Sacro Cuore-Don Calabria" Hospital, Via Don A. Sempreboni 5, 37024, Negrar di Valpolicella, Verona, Italy.
| | - Roberto Clarizia
- Department of Obstetrics and Gynecology, Gynecologic Oncology and Minimally Invasive Pelvic Surgery, International School of Surgical Anatomy, IRCCS "Sacro Cuore-Don Calabria" Hospital, Via Don A. Sempreboni 5, 37024, Negrar di Valpolicella, Verona, Italy
| | - Enrico Fusco
- Department of Medical and Surgical Sciences, Institute of Obstetrics and Gynecology, University of Foggia, Foggia, Italy
| | - Giovanni Roviglione
- Department of Obstetrics and Gynecology, Gynecologic Oncology and Minimally Invasive Pelvic Surgery, International School of Surgical Anatomy, IRCCS "Sacro Cuore-Don Calabria" Hospital, Via Don A. Sempreboni 5, 37024, Negrar di Valpolicella, Verona, Italy
| | - Daniele Mautone
- Department of Obstetrics and Gynecology, Gynecologic Oncology and Minimally Invasive Pelvic Surgery, International School of Surgical Anatomy, IRCCS "Sacro Cuore-Don Calabria" Hospital, Via Don A. Sempreboni 5, 37024, Negrar di Valpolicella, Verona, Italy
| | - Camilla Cavallero
- Department of Obstetrics and Gynecology, Gynecologic Oncology and Minimally Invasive Pelvic Surgery, International School of Surgical Anatomy, IRCCS "Sacro Cuore-Don Calabria" Hospital, Via Don A. Sempreboni 5, 37024, Negrar di Valpolicella, Verona, Italy
- Department of Gynaecology and Obstetrics, University of East Piedmont "A. Avogadro", Novara, Italy
| | - Simone Orlandi
- Department of Gastroenterology and Digestive Endoscopy, IRCSS "Sacro Cuore-Don Calabria" Hospital, Negrar di Valpolicella, Verona, Italy
| | - Roberto Rossini
- Department of General Surgery, IRCSS "Sacro Cuore-Don Calabria" Hospital, Negrar di Valpolicella, Verona, Italy
| | - Giuliano Barugola
- Department of General Surgery, IRCSS "Sacro Cuore-Don Calabria" Hospital, Negrar di Valpolicella, Verona, Italy
| | - Giacomo Ruffo
- Department of General Surgery, IRCSS "Sacro Cuore-Don Calabria" Hospital, Negrar di Valpolicella, Verona, Italy
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Mautone D, Clarizia R, Roviglione G, Bruni F, Ceccarello M, Campolo F, Rossini R, Bertocchi E, Barugola G, Ruffo G, Ceccaroni M. 2141 Decision-Making Algorithms for the Right Surgical Approach in Bowel Endometriosis: The Experience of a Single Third-Level Referral Center on More Than 3000 Procedures. J Minim Invasive Gynecol 2019. [DOI: 10.1016/j.jmig.2019.09.342] [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: 10/25/2022]
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Garriboli L, Miccoli T, Damoli I, Rossini R, Sartori CA, Ruffo G, Jannello AM. Hybrid Laparoscopic and Endovascular Treatment for Median Arcuate Ligament Syndrome: Case Report and Review of Literature. Ann Vasc Surg 2019; 63:457.e7-457.e11. [PMID: 31622755 DOI: 10.1016/j.avsg.2019.08.077] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2019] [Revised: 07/30/2019] [Accepted: 08/04/2019] [Indexed: 10/25/2022]
Abstract
Median arcuate ligament syndrome is a rare cause of chronic gastrointestinal ischemia caused by compression of median arcuate ligament on the celiac trunk. A 38-year-old male presented at our institution with unspecific crampy abdominal pain. After several diagnostic examinations, he firstly underwent arcuate ligament resection by laparoscopic approach and 2 months later, he underwent percutaneous transluminal angioplasty with stenting of the stenotic vessel. Postoperatory and follow-up controls showed regular patency of the artery with complete relief of abdominal symptoms. We propose a review of the literature on this uncommon condition, describing different surgical approaches.
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Affiliation(s)
- Luca Garriboli
- Department of Vascular Surgery, IRCCS Sacro Cuore-Don Calabria, Negrar, VR, Italy.
| | - Tommaso Miccoli
- Department of Vascular Surgery, IRCCS Sacro Cuore-Don Calabria, Negrar, VR, Italy
| | - Isacco Damoli
- Department of Vascular Surgery, IRCCS Sacro Cuore-Don Calabria, Negrar, VR, Italy
| | - Roberto Rossini
- Department of General Surgery, IRCCS Sacro Cuore-Don Calabria, Negrar, VR, Italy
| | | | - Giacomo Ruffo
- Department of General Surgery, IRCCS Sacro Cuore-Don Calabria, Negrar, VR, Italy
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Ferlini M, Rossini R, Musumeci G, Grieco N, Trabattoni D, Cornara S, Cardile A, Calchera I, Russo F, Ielasi A, Faggiano P, Castiglioni B, Lettieri C, Klersy C, Oltrona Visconti L. P5531A systematic follow-up strategy after percutaneous coronary intervention based on patient risk profile: the prospective POST-PCI registry. Eur Heart J 2019. [DOI: 10.1093/eurheartj/ehz746.0478] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [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] [Indexed: 11/13/2022] Open
Abstract
Abstract
Background
Redundant clinical and non-invasive examinations after percutaneous coronary intervention (PCI) increase the cost of medical care with no outcome improve. A multidisciplinary consensus document (MCD) providing a follow-up (FU) strategy based on 3 clinical and angiographic risk profile (A high, B intermediate, and C low) has been recently proposed.
Aim
To evaluate the potential reduction of cardiologic consults (CC), stress tests (ST), and echocardiograms (EC) with the application of the MCD after PCI.
Methods
The Post-PCI registry is a multicenter, observational, prospective data collection carried out during a four-week period that included consecutive patients undergoing PCI at 31 Italian Hospitals both for acute coronary syndromes (ACS) or stable coronary artery disease (SCAD). FU strategies were left at investigator's discretion. A comparison between the CC, ST and EC performed in the first 12-months with the potential suggested by the MCD was evaluated.
Results
A total of 1113 patients were included; 12-months follow up was available in 90% of the cases (mean age 68±11 years old, 58% ACS). Based on MCD risk profile 17% were in A, 74% in B and 9% in C strategy. On average observed CC and ST were significantly lower compared to the expected based on MCD (respectively 1.63±1.07 vs 1.91±0.28, and 0.41±0.59 vs 0.61±0.84; on the contrary EC were significantly higher (0.64±0.73 vs 0.34±0.75, all: p<0.001). The excess rate for CC, ST and EC as compared to MCD was respectively 25%, 14% and 8% for the strategy A, 14%, 25% and 50% for the strategy B and 26%, 54% and 40% for the strategy C. At multivariable logistic analysis the MCD strategy was an independent predictor (in a model with age, sex, consulting physician, public or private hospital) of an increased number of cardiac examination in patients at intermediated and low risk [B group OR 2.56 (95% CI 1.38–4.75), C group 27.00 (95% CI 8.13–89.62)]. The other independent predictor was age, with a reduced number of examination for elderly (>75 years old) patients [OR 0.59 (CI 95% 0.43–0.80)].
Conclusion
Our data suggest that in a real word population of patients undergoing PCI, a follow-up strategy based on clinical and anatomical risk profile would allow to a reduction of cardiac tests and consultations, particularly in patients at intermediated and low risk leading to an increase of appropriateness of prescription and to a cost reduction of medical care.
Acknowledgement/Funding
The Post-PCI registry was supported by the Italian Society of Interventional Cardiology (SICI-GISE) receiving an unrestricted grant from Astra Zeneca
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Affiliation(s)
- M Ferlini
- Foundation IRCCS Polyclinic San Matteo - University of Pavia, Pavia, Italy
| | - R Rossini
- Santa Croce E Carle Hospital, Cuneo, Italy
| | - G Musumeci
- Santa Croce E Carle Hospital, Cuneo, Italy
| | - N Grieco
- Niguarda Ca' Granda Hospital, Milan, Italy
| | | | - S Cornara
- Foundation IRCCS Polyclinic San Matteo - University of Pavia, Pavia, Italy
| | - A Cardile
- AO Ospedale Treviglio, Treviglio, Italy
| | | | - F Russo
- Sant'Anna Hospital, Como, Italy
| | - A Ielasi
- Bolognini Hospital, Seriate, Italy
| | - P Faggiano
- Civil Hospital of Brescia, Brescia, Italy
| | | | | | - C Klersy
- Foundation IRCCS Polyclinic San Matteo - University of Pavia, Pavia, Italy
| | - L Oltrona Visconti
- Foundation IRCCS Polyclinic San Matteo - University of Pavia, Pavia, Italy
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11
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Rossini R, Masiero G, Fruttero C, Passamonti E, Calvaruso E, Cecconi M, Carlucci C, Barzaghi N, Locatelli A, Mojoli M, Parodi G, Talanas G, Pierini S, Angiolillo D, Musumeci G. P2815Antiplatelet therapy with cangrelor in patients undergoing surgery after coronary stent implantation: a real-world bridging protocol experience. Eur Heart J 2019. [DOI: 10.1093/eurheartj/ehz748.1127] [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] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Abstract
Background
Perioperative management of dual antiplatelet therapy (DAPT) after percutaneous coronary intervention (PCI) in patients deemed at high thrombotic risk undergoing non-deferrable surgery remains poorly defined. Cangrelor represents a potential treatment option as a “bridge” from discontinuation of oral P2Y12 receptor antagonists to surgical procedures, but data in this setting are still scant.
Purpose
We sought to describe a real-world experience of a bridging protocol using cangrelor for patients referred to relevant bleeding risk surgery requiring withdrawal of DAPT.
Methods
We collected data from 7 Italian centers on patients with previous PCI, still on DAPT, undergoing non-deferrable surgery which required discontinuation of one or both antiplatelet agents. A standardized bridging protocol using cangrelor infusion before and eventually after surgery was applied (Figure 1).
Results
Between December 2017 and January 2019, a total of 18 patients (mean age 70±10 years; male 85%) were enrolled. In the majority (89%) of patients, the index PCI was performed due to acute coronary syndrome (ACS) and 2±1.7 stents per patient were implanted. All patients required non-deferrable, intermediate-high bleeding risk surgery as pulmonary lobectomy, colectomy, endoscopic bladder surgery, paranasal sinus surgery, coronary artery by-pass surgery and valvular repair, hip replacement, endoscopy sphincterotomy. High thrombotic risk categories included PCI time <1 month, SCA time <3 months, stent failure occurrence, previous Absorb BVS implantation. Due to the surgical bleeding risk, discontinuation of P2Y12 inhibitor was required 5 days before surgery (ticagrelor, n=13; prasugrel=1; clopidogrel, n=5). All patients but 1 maintained aspirin through the perioperative phase. Cangrelor infusion was started at a bridging dose (0.75 mcg/kg/min) 3 days before planned surgery and was discontinued 6.9±1.5 hours before. After surgery, drainages were left in all patients but 3. In 56% of patients, cangrelor was resumed within 24 hours from surgery (mean time 9±7 hours) for a mean of 36±38 hours. Drainages were removed after discontinuation of cangrelor, in order to reduce bleeding complications. Within 2 hours from post-operative cangrelor discontinuation, a 300 mg clopidogrel loading dose was administered. No major ischemic adverse outcomes occurred during hospital stay and up to 30 days follow-up. The mean Hb drop was 2±1.8 g/dl, 7 patients received blood transfusions consistent with the type of surgeries and no life-threatening or fatal bleeding occurred.
Figure 1. Standardized bridging protocol.
Conclusions
Peri-operative bridge therapy with cangrelor is a feasible approach for stented patients at high thrombotic risk referred to non-deferrable surgery requiring DAPT discontinuation. Larger studies are warranted to support the safety of this strategy.
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Affiliation(s)
- R Rossini
- Santa Croce E Carle Hospital, Cuneo, Italy
| | - G Masiero
- Santa Croce E Carle Hospital, Cuneo, Italy
| | - C Fruttero
- Santa Croce E Carle Hospital, Cuneo, Italy
| | | | | | - M Cecconi
- Hospital of Civitanova Marche, Civitanova Marche, Italy
| | - C Carlucci
- Hospital of Civitanova Marche, Civitanova Marche, Italy
| | - N Barzaghi
- Santa Croce E Carle Hospital, Cuneo, Italy
| | | | - M Mojoli
- Santa Maria degli Angeli Hospital, Pordenone, Italy
| | - G Parodi
- University of Sassari, Sassari, Italy
| | - G Talanas
- University of Sassari, Sassari, Italy
| | - S Pierini
- P.O. BASSINI - ASST Nord Milano, Milano, Italy
| | - D Angiolillo
- College of Medicine-Jacksonville, Jacksonville, United States of America
| | - G Musumeci
- Santa Croce E Carle Hospital, Cuneo, Italy
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12
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Ferlini M, Musumeci G, Grieco N, Rossini R, Demarchi A, Cornara S, Somaschini A, Colombo P, Cardile A, Calchera I, Marino M, Ielasi A, Pedretti R, Lettieri C, Oltrona Visconti L. 2227Perceived or calculated bleeding risk in patients undergoing percutaneous coronary intervention: inside the post-pci prospective registry. Eur Heart J 2018. [DOI: 10.1093/eurheartj/ehy565.2227] [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: 11/15/2022] Open
Affiliation(s)
- M Ferlini
- Policlinic Foundation San Matteo IRCCS, Pavia, Italy
| | - G Musumeci
- Santa Croce E Carle Hospital, Cuneo, Italy
| | - N Grieco
- Niguarda Ca' Granda Hospital, Milan, Italy
| | - R Rossini
- Santa Croce E Carle Hospital, Cuneo, Italy
| | - A Demarchi
- Foundation IRCCS Polyclinic San Matteo - University of Pavia, Pavia, Italy
| | - S Cornara
- Foundation IRCCS Polyclinic San Matteo - University of Pavia, Pavia, Italy
| | - A Somaschini
- Foundation IRCCS Polyclinic San Matteo - University of Pavia, Pavia, Italy
| | - P Colombo
- Niguarda Ca' Granda Hospital, Milan, Italy
| | - A Cardile
- AO Ospedale Treviglio, Treviglio, Italy
| | | | - M Marino
- Maggiore Hospital of Crema, Crema, Italy
| | - A Ielasi
- Bolognini Hospital, Seriate, Italy
| | - R Pedretti
- Fondazione Salvatore Maugeri, Tradate, Italy
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13
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Rossini R, Iorio A, Musumeci G, Savonitto S, Trabattoni D, Lettino M, Molfese M, Lettieri C, Ferlini M, Oltrona Visconti L, Piccaluga E, Masiero G, Caporale R, Calchera I, Tarantini G. P2686Role of optimal medical therapy on perioperative outcome in patients with heart failure and coronary artery disease undergoing surgery: insights from the SAS registry. Eur Heart J 2018. [DOI: 10.1093/eurheartj/ehy565.p2686] [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: 11/14/2022] Open
Affiliation(s)
- R Rossini
- Santa Croce E Carle Hospital, Cuneo, Italy
| | - A Iorio
- Ospedale Papa Giovanni XXIII, Bergamo, Italy
| | - G Musumeci
- Santa Croce E Carle Hospital, Cuneo, Italy
| | | | - D Trabattoni
- Centro Cardiologico Monzino, IRCCS, Milano, Milano, Italy
| | - M Lettino
- Istituto Clinico Humanitas, Milano, Italy
| | | | | | - M Ferlini
- Policlinic Foundation San Matteo IRCCS, Pavia, Italy
| | | | | | - G Masiero
- University Hospital of Padova, Padua, Italy
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14
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Collaku E, Trabattoni D, Savonitto S, Musumeci G, Calchera I, Lettino M, Molfese M, Piatti L, Tarantini G, Piccaluga E, Oltrona Visconti L, Ferlini M, Caporale R, Masiero G, Rossini R. P2644The Surgery after Stent (SAS) Registry: a gender-based analysis on clinical outcomes in women undergoing cardiac and non-cardiac surgery. Eur Heart J 2018. [DOI: 10.1093/eurheartj/ehy565.p2644] [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: 11/13/2022] Open
Affiliation(s)
- E Collaku
- Ospedale Papa Giovanni XXIII, Bergamo, Italy
| | - D Trabattoni
- Centro Cardiologico Monzino, IRCCS, Milano, Milano, Italy
| | | | - G Musumeci
- Santa Croce E Carle Hospital, Cuneo, Italy
| | | | - M Lettino
- Istituto Clinico Humanitas, Milan, Italy
| | | | - L Piatti
- Alessandro Manzoni Hospital, Lecco, Italy
| | | | | | | | - M Ferlini
- Policlinic Foundation San Matteo IRCCS, Pavia, Italy
| | | | - G Masiero
- University Hospital of Padova, Padua, Italy
| | - R Rossini
- Santa Croce E Carle Hospital, Cuneo, Italy
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15
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Ferlini M, Musumeci G, Grieco N, Rossini R, Demarchi A, Cornara S, Somaschini A, Trabattoni D, Zavalloni Parenti D, Martinoni A, Castiglioni B, Faggiano P, Oliva F, Lettiieri C, Oltrona Visconti L. 2228Are perceived or calculated bleeding risk related to dapt choice in patients undergoing percutaneous coronary intervention? Eur Heart J 2018. [DOI: 10.1093/eurheartj/ehy565.2228] [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: 11/12/2022] Open
Affiliation(s)
- M Ferlini
- Policlinic Foundation San Matteo IRCCS, Pavia, Italy
| | - G Musumeci
- Santa Croce E Carle Hospital, Cuneo, Italy
| | - N Grieco
- Niguarda Ca' Granda Hospital, Milan, Italy
| | - R Rossini
- Santa Croce E Carle Hospital, Cuneo, Italy
| | - A Demarchi
- Foundation IRCCS Polyclinic San Matteo - University of Pavia, Pavia, Italy
| | - S Cornara
- Foundation IRCCS Polyclinic San Matteo - University of Pavia, Pavia, Italy
| | - A Somaschini
- Foundation IRCCS Polyclinic San Matteo - University of Pavia, Pavia, Italy
| | | | | | | | | | - P Faggiano
- Civil Hospital of Brescia, Brescia, Italy
| | - F Oliva
- Niguarda Ca' Granda Hospital, Milan, Italy
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16
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Rossini R, Lisi G, Gentile I, Barugola G, Ruffo G. Intracorporeal Ileocolic Anastomosis in Laparoscopic Right Colectomy: A New Way to Make it Simple? Surg Technol Int 2018; 32:115-118. [PMID: 29611154] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/08/2023]
Abstract
Although there has been a recent increase in the use of laparoscopy in colorectal surgery, the percentage of patients who undergo surgery using entirely minimally invasive techniques is still quite low, and there are substantial differences among centers. It has been argued that the limiting factor in the use of laparoscopic procedures is not the tumor or patient characteristics, but rather the number of surgeons with adequate skills to perform an entirely laparoscopic colectomy. To address this issue, we report here our totally laparoscopic right colectomy technique, with particular focus on a new way to perform the enterotomy closure, which may simplify ileocolic anastomosis.
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Affiliation(s)
- Roberto Rossini
- Department of General Surgery, Sacro Cuore - Don Calabria Hospital, Negrar, Italy
| | - Giorgio Lisi
- Department of General and Pancreatic Surgery, University Hospital of Verona Verona, Italy
| | - Irene Gentile
- Department of General Surgery, Sacro Cuore - Don Calabria Hospital, Negrar, Italy
| | - Giuliano Barugola
- Department of General Surgery, Sacro Cuore - Don Calabria Hospital, Negrar, Italy
| | - Giacomo Ruffo
- Department of General Surgery, Sacro Cuore - Don Calabria Hospital, Negrar, Italy
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17
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Bertocchi E, Barugola G, Benini M, Bocus P, Rossini R, Ceccaroni M, Ruffo G. Colorectal Anastomotic Stenosis: Lessons Learned after 1643 Colorectal Resections for Deep Infiltrating Endometriosis. J Minim Invasive Gynecol 2018; 26:100-104. [PMID: 29678755 DOI: 10.1016/j.jmig.2018.03.033] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.0] [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: 01/05/2018] [Revised: 03/12/2018] [Accepted: 03/13/2018] [Indexed: 12/12/2022]
Abstract
STUDY OBJECTIVE To evaluate the incidence, risk factors, and treatment of colorectal anastomotic stenosis in patients who undergo rectosigmoid resection for deep infiltrating endometriosis (DIE). DESIGN Retrospective analysis of a prospective database (Canadian Task Force classification III). SETTING Public medical center. PATIENTS All women who underwent laparoscopic rectosigmoid resections for DIE at our hospital between January 2002 and December 2016. INTERVENTION All patients were evaluated clinically and endoscopically at 1 month and 3 months after bowel resection. Stenosis was defined as a lack of passage through the anastomosis of a 12-mm proctoscope. Symptomatic stenosis was defined as the presence of endoscopically confirmed stricture accompanied by at least 2 of the following symptoms: constipation, need to push, tenesmus, and ribbon stools. Only patients with symptomatic stenosis were studied. Demographic data, surgical techniques, and postoperative complications were recorded prospectively. Treatments and outcomes of anastomotic symptomatic strictures were analyzed. MEASUREMENTS AND MAIN RESULTS A total of 1643 patients underwent laparoscopic rectosigmoid resection at our hospital between January 2002 and December 2016. Among these, 104 patients (6.3%) presented with symptomatic anastomotic stenosis. The median patient age was 27 years (range, 23-44 years), and the median interval between diagnosis and the onset of symptomatic stenosis was 57 days (range, 21-64 days). The only statistically significant predictors of anastomotic stenosis were the presence of ileostomy (p = .01) and previous pelvic surgery (p = .002). Treatment of choice was always conservative. Of the 104 patients in the study cohort, 90 (86.5%) underwent 3 endoscopic dilatations. No patient required reoperation. CONCLUSION The anastomotic stricture is a recognized complication in patients following intestinal resection for DIE, and protective ileostomy is the sole modifiable factor related to anastomotic stenosis. Endoscopic dilatation is a valid option to treat this complication.
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Affiliation(s)
- Elisa Bertocchi
- Department of Surgery, Sacred Heart-Don Calabria Hospital, Negrar, Verona, Italy.
| | - Giuliano Barugola
- Department of Surgery, Sacred Heart-Don Calabria Hospital, Negrar, Verona, Italy
| | - Marco Benini
- Department of Gastroenterology and Endoscopy, Sacred Heart-Don Calabria Hospital, Negrar, Verona, Italy
| | - Paolo Bocus
- Department of Gastroenterology and Endoscopy, Sacred Heart-Don Calabria Hospital, Negrar, Verona, Italy
| | - Roberto Rossini
- Department of Surgery, Sacred Heart-Don Calabria Hospital, Negrar, Verona, Italy
| | - Marcello Ceccaroni
- Department of Gynecology, Sacred Heart-Don Calabria Hospital, Negrar, Verona, Italy
| | - Giacomo Ruffo
- Department of Surgery, Sacred Heart-Don Calabria Hospital, Negrar, Verona, Italy
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18
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Rossini R, Lisi G, Pesci A, Ceccaroni M, Zamboni G, Gentile I, Rettore L, Ruffo G. Depth of Intestinal Wall Infiltration and Clinical Presentation of Deep Infiltrating Endometriosis: Evaluation of 553 Consecutive Cases. J Laparoendosc Adv Surg Tech A 2018; 28:152-156. [DOI: 10.1089/lap.2017.0440] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Affiliation(s)
- Roberto Rossini
- Department of General Surgery, Sacro Cuore Don Calabria Hospital, Negrar, Italy
| | - Giorgio Lisi
- Department of General and Pancreatic Surgery, Borgo Roma University Hospital, Verona, Italy
| | - Anna Pesci
- Department of Pathology, Sacro Cuore Don Calabria Hospital, Negrar, Italy
| | - Marcello Ceccaroni
- Department of Gynecology and Obstetrics, Sacro Cuore Don Calabria Hospital, Negrar, Italy
| | - Giuseppe Zamboni
- Department of Pathology, Sacro Cuore Don Calabria Hospital, Negrar, Italy
| | - Irene Gentile
- Department of General Surgery, Sacro Cuore Don Calabria Hospital, Negrar, Italy
| | - Lorenzo Rettore
- Department of General Surgery, Sacro Cuore Don Calabria Hospital, Negrar, Italy
| | - Giacomo Ruffo
- Department of General Surgery, Sacro Cuore Don Calabria Hospital, Negrar, Italy
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19
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Lisi G, Rossini R, Gentile I, Ruffo G. Over-Sewing of Staple Line in Laparoscopic Sleeve Gastrectomy: Initial Experience of a Comparative Study. Surg Technol Int 2017; 31:106-110. [PMID: 29029355] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/07/2023]
Abstract
INTRODUCTION The main drawback of laparoscopic sleeve gastrectomy (LSG) is the severity of postoperative complications. Staple line reinforcement (SLR) is strongly advocated. Recently, over-sewing has been proposed as a cost-effective and helpful method for reinforcing the staple line. The purpose of this study was to report our initial experience with LSG comparing over-sewing over the entire staple line with the upper-third staple line. MATERIALS AND METHODS All obese patients seen at Negrar Sacro Cuore, Don Calabria Hospital were entered into our prospective database and were retrospectively evaluated. Complications (divided as major complications: leaks and bleeding; and minor complications: dysphagia, esophagitis, and reflux disease) and reoperations were recorded for all patients. Complications were graded according to the Clavien classification system. RESULTS From February 2015 to March 2016, 30 patients underwent LSG. Patients were divided in two groups according to over-sewing: Group A-over-sewing over the entire staple line; and Group B upper-third over-sewing. Mean total operative time was longer in Group A-90 minutes-compared with 85 minutes in Group B. In regard to minor complications, we reported one esophagitis and two cases of dysphagia in Group B and one dysphagia in Group A. Gastroesophageal reflux was higher in Group B than in Group A (3 vs. 1, p=0.149). Three major complications were observed (10%): two bleeding and one hematoma in Group B and no major complications occurred in Group A. All major complications were conservatively treated. No leaks were reported in both groups. No mortality was observed. CONCLUSIONS Over-sewing of the staple line was associated with fewer leaks but no conclusions can be drawn regarding the effects of over-sewing on staple line bleedings. Before standardizing surgical techniques further, trials are necessary to improve our knowledge about over-sewing in LSG.
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Affiliation(s)
- Giorgio Lisi
- Department of General and Pancreatic Surgery, University Hospital of Verona Verona, Italy
| | - Roberto Rossini
- Department of General Surgery, Don Calabria Hospital, Verona, Italy
| | - Irene Gentile
- Department of General Surgery, Don Calabria Hospital, Verona, Italy
| | - Giacomo Ruffo
- Department of General Surgery, Don Calabria Hospital, Verona, Italy
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20
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Rossini R, Monsellato D, Bertolaccini L, Pesci A, Zamboni G, Ceccaroni M, Ruffo G. Lymph Node Involvement in Deep Infiltrating Intestinal Endometriosis: Does It Really Mean Anything? J Minim Invasive Gynecol 2016; 23:787-92. [DOI: 10.1016/j.jmig.2016.03.021] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2016] [Revised: 03/29/2016] [Accepted: 03/29/2016] [Indexed: 12/19/2022]
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21
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Mabrouk M, Clarizia R, Grassi T, Ruffo G, Roviglione G, Bruni F, Pontrelli G, Scarperi S, Rettore L, Rossini R, Ceccaroni M. Protective Ileostomy in Colorectal Resection for Endometriosis: Is It Truly Protective? J Minim Invasive Gynecol 2015; 22:S177. [PMID: 27678956 DOI: 10.1016/j.jmig.2015.08.652] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Affiliation(s)
- M Mabrouk
- Obseterics & Gynecology, Minimally Invasive Pelvic Surgey and Gynecologic Oncology Department, Sacred Heart-Don Clabria Institute, Negrar, Negrar, Verona, Italy
| | - R Clarizia
- Obseterics & Gynecology, Minimally Invasive Pelvic Surgey and Gynecologic Oncology Department, Sacred Heart-Don Clabria Institute, Negrar, Negrar, Verona, Italy
| | - T Grassi
- Obseterics & Gynecology, Minimally Invasive Pelvic Surgey and Gynecologic Oncology Department, Sacred Heart-Don Clabria Institute, Negrar, Negrar, Verona, Italy
| | - G Ruffo
- General Surgery, Sacred Heart-Don Clabria Institute, Negrar, Negrar, Verona, Italy
| | - G Roviglione
- Obseterics & Gynecology, Minimally Invasive Pelvic Surgey and Gynecologic Oncology Department, Sacred Heart-Don Clabria Institute, Negrar, Negrar, Verona, Italy
| | - F Bruni
- Obseterics & Gynecology, Minimally Invasive Pelvic Surgey and Gynecologic Oncology Department, Sacred Heart-Don Clabria Institute, Negrar, Negrar, Verona, Italy
| | - G Pontrelli
- Obseterics & Gynecology, Minimally Invasive Pelvic Surgey and Gynecologic Oncology Department, Sacred Heart-Don Clabria Institute, Negrar, Negrar, Verona, Italy
| | - S Scarperi
- Obseterics & Gynecology, Minimally Invasive Pelvic Surgey and Gynecologic Oncology Department, Sacred Heart-Don Clabria Institute, Negrar, Negrar, Verona, Italy
| | - L Rettore
- General Surgery, Sacred Heart-Don Clabria Institute, Negrar, Negrar, Verona, Italy
| | - R Rossini
- General Surgery, Sacred Heart-Don Clabria Institute, Negrar, Negrar, Verona, Italy
| | - M Ceccaroni
- Obseterics & Gynecology, Minimally Invasive Pelvic Surgey and Gynecologic Oncology Department, Sacred Heart-Don Clabria Institute, Negrar, Negrar, Verona, Italy
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22
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Bozzani A, Ferlini M, Rossini R, Musumeci G, Arici V, Bramucci E, Setacci C. Antiplatelet therapy management in patients with coronary stent undergoing vascular surgery. J Cardiovasc Surg (Torino) 2015; 56:681-683. [PMID: 25008060] [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] [Subscribe] [Scholar Register] [Indexed: 06/03/2023]
Affiliation(s)
- A Bozzani
- Division of Vascular Surgery, Foundation I.R.C.C.S. Policlinico San Matteo, Pavia, Italy -
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De Luca L, Bolognese L, Valgimigli M, Ceravolo R, Danzi GB, Piccaluga E, Rakar S, Cremonesi A, Bovenzi FM, Abbate R, Andreotti F, Bolognese L, Biondi-Zoccai G, Bovenzi FM, Capodanno D, Caporale R, Capranzano P, Carrabba N, Casella G, Cavallini C, Ceravolo R, Colombo P, Conte MR, Cordone S, Cremonesi A, Danzi GB, Del Pinto M, De Luca G, De Luca L, De Servi S, Di Lorenzo E, Di Pasquale G, Esposito G, Farina R, Fiscella A, Formigli D, Galli S, Giudice P, Gonzi G, Greco C, Grieco NB, La Vecchia L, Lazzari M, Lettieri C, Lettino M, Limbruno U, Lupi A, Macchi A, Marini M, Marzilli M, Montinaro A, Musumeci G, Navazio A, Olivari Z, Oltrona Visconti L, Oreglia JA, Ottani F, Parodi G, Pasquetto G, Patti G, Perkan A, Perna GP, Piccaluga E, Piscione F, Prati F, Rakar S, Ravasio R, Ronco F, Rossini R, Rubboli A, Saia F, Sardella G, Satullo G, Savonitto S, Sbarzaglia P, Scorcu G, Signore N, Tarantini G, Terrosu P, Testa L, Tubaro M, Valente S, Valgimigli M, Varbella F, Vatrano M. ANMCO/SICI-GISE paper on antiplatelet therapy in acute coronary syndrome. Eur Heart J Suppl 2014. [DOI: 10.1093/eurheartj/suu030] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
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Capodanno D, Musumeci G, Lettieri C, Limbruno U, Senni M, Calabrese A, Guagliumi G, Gavazzi A, Angiolillo D, Rossini R. "Bridging therapy" with low molecular weight heparin in patients with coronary stents undergoing surgery. Eur Heart J 2013. [DOI: 10.1093/eurheartj/eht308.1978] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
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Rossini R, Musumeci G, Capodanno D, Lettieri C, Limbruno U, Valsecchi O, Russo N, Guagliumi G, Angiolillo D, Gavazzi A. Perioperative management of oral antiplatelet therapy in patients with coronary stents undergoing surgery. Eur Heart J 2013. [DOI: 10.1093/eurheartj/eht310.p4843] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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26
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Capretti MG, Marsico C, Lazzarotto T, Gabrielli L, Bagni A, De Angelis M, Rossini R, Faldella G. Herpes Simplex Virus 1 infection: misleading findings in an infant with disseminated disease. New Microbiol 2013; 36:307-313. [PMID: 23912873] [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] [Subscribe] [Scholar Register] [Received: 01/21/2013] [Accepted: 04/02/2013] [Indexed: 06/02/2023]
Abstract
Neonatal Herpes Simplex Virus (HSV) infection is a serious illness with significant mortality and morbidity for disseminated disease. Clinical diagnosis of neonatal HSV infection is often difficult without evidence of HSV exposure, for example, absence of a rash or the presence of non-specified manifestations in an infant. Early recognition and treatment with high-dose Acyclovir may dramatically improve the short and long-term outcomes. We describe an infant with disseminated disease due to HSV-1 infection, who first presented clinical and radiologic features of pneumonia. The diagnosis was performed post-mortem by Real-Time Polymerase Chain Reaction (PCR) analysis of blood, cerebrospinal fluid and pleural liquid of the infant. Tissue PCR revealed a disseminated HSV-1 infection, with a high viral load detected in liver, lungs, brain, heart, striated muscle, kidneys, and thymus tissues. This case report highlights the need for neonatologists to raise awareness about the different clinical manifestations of disseminated neonatal HSV infection. HSV infections should be prominent in the differential diagnosis of an infant under four weeks of age with fever, pneumonia, unexplained seizures or sepsis-like disease, particularly if unresponsive to antibiotics. Early initiation of appropriate antiviral therapy for high-risk infants undergoing testing for HSV infection can be essential to prevent significant morbidity and mortality.
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MESH Headings
- Acyclovir/therapeutic use
- Brain/virology
- DNA, Viral/blood
- Diagnosis, Differential
- Early Diagnosis
- Fatal Outcome
- Heart/virology
- Herpes Simplex/diagnostic imaging
- Herpes Simplex/drug therapy
- Herpes Simplex/pathology
- Herpes Simplex/virology
- Herpesvirus 1, Human/drug effects
- Herpesvirus 1, Human/isolation & purification
- Humans
- Infant, Newborn
- Kidney/virology
- Liver/virology
- Liver Diseases/virology
- Lung/virology
- Lymphoid Tissue/virology
- Male
- Muscle, Striated/virology
- Organ Specificity
- Pneumonia, Viral/diagnostic imaging
- Pneumonia, Viral/drug therapy
- Pneumonia, Viral/pathology
- Pneumonia, Viral/virology
- Pregnancy Complications, Infectious/diagnostic imaging
- Pregnancy Complications, Infectious/drug therapy
- Pregnancy Complications, Infectious/pathology
- Pregnancy Complications, Infectious/virology
- Radiography
- Real-Time Polymerase Chain Reaction
- Viral Load
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Affiliation(s)
- Maria Grazia Capretti
- Department of Obstetrical, Gynaecological and Paediatric Sciences, Operative Unit of Neonatology, St. Orsola-Malpighi General Hospital, University of Bologna, Italy
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Malleo G, Bassi C, Rossini R, Manfredi R, Butturini G, Massignani M, Paini M, Pederzoli P, Salvia R. Growth pattern of serous cystic neoplasms of the pancreas: observational study with long-term magnetic resonance surveillance and recommendations for treatment. Gut 2012; 61:746-51. [PMID: 21940725 DOI: 10.1136/gutjnl-2011-300297] [Citation(s) in RCA: 83] [Impact Index Per Article: 6.9] [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] [Indexed: 12/12/2022]
Abstract
BACKGROUND AND AIMS The natural history and growth pattern of pancreatic serous cystic neoplasms (SCNs) are not well understood. This study was designed in order to get insight into the growth rate of SCNs and to suggest recommendations for their management. METHODS Patients with well-documented incidentally discovered or minimally symptomatic SCNs who underwent yearly surveillance MRI were analysed using a linear mixed model. The growth rate and the effects of different fixed factors (sex, personal history of other non-pancreatic malignancies, radiological pattern, clinical presentation, tumour site) and random factors (age and tumour diameter at the time of diagnosis) on tumour growth were investigated. RESULTS Study population consisted of 145 patients. Estimated overall mean growth rate was 0.28 cm/year, but the growth curve analysis showed a different trend between the first 7 years after the baseline evaluation (growth rate of 0.1 cm/year) and the subsequent period (years 7 to 10, growth rate of 0.6 cm/year, p<0.0001). Tests for fixed effects demonstrated that an oligocystic/macrocystic pattern and a personal history of other tumours are significant predictors of a more rapid mean tumour growth (p<0.0001 and 0.022, growth rates of 0.34 cm/year). Furthermore, tumour growth significantly increased with age (p = 0.0001). CONCLUSION Overall, SCNs grow slowly, and an initial non-operative approach is feasible in all the asymptomatic or minimally symptomatic patients. The oligocystic/macrocystic variant, a history of other non-pancreatic malignancies and patients' age impact on tumour growth. In any case, a significant growth is unlikely to occur before 7 years from the baseline evaluation. Tumour size at the time of diagnosis should not be used for decisional purposes.
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Affiliation(s)
- Giuseppe Malleo
- Department of Surgery, General Surgery B, GB Rossi Hospital, Ple LA Scuro 10, 37134 Verona, Italy
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Butturini G, Partelli S, Crippa S, Malleo G, Rossini R, Casetti L, Melotti GL, Piccoli M, Pederzoli P, Bassi C. Perioperative and long-term results after left pancreatectomy: a single-institution, non-randomized, comparative study between open and laparoscopic approach. Surg Endosc 2011; 25:2871-8. [PMID: 21424200 DOI: 10.1007/s00464-011-1634-0] [Citation(s) in RCA: 31] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2010] [Accepted: 01/28/2011] [Indexed: 12/15/2022]
Abstract
BACKGROUND Laparoscopic left pancreatic resections are being increasingly performed. In this study, we provide a nonrandomized comparison between laparoscopic and open left pancreatectomy (OLP) for benign and borderline tumors, focusing on both perioperative and long-term results. METHODS Demographic, pathologic, and perioperative details from patients who underwent laparoscopic and OLP between 1999 and 2006 were retrieved from our database and analyzed. Long-term results, including resume to full-time work, occurrence of incisional hernias, and incidence of exocrine and endocrine insufficiency also were evaluated. RESULTS A total of 116 patients were included in the analysis; 43 (37.1%) were managed laparoscopically and 73 (62.9%) underwent the open procedure. There were no significant differences regarding clinical and pathological data. All of the resections attempted laparoscopically were completed. The rate of splenic preservation was significantly higher in the laparoscopic group (P = 0.0001). Postoperative outcomes were similar between the two groups. Longitudinal comparison between two time periods (1999-June 2004 vs. July 2004-2006) showed that pancreatic fistula and hospital stay significantly diminished over time in the laparoscopic group (P = 0.04 and P = 0.004, respectively). Median follow-up was 53 months. The incidence of exocrine insufficiency and incisional hernias was significantly higher after open resections (both P = 0.05). After hospital discharge, median time to resume full-time work was 6 weeks in the open group and 3 weeks after laparoscopic resections (P < 0.0001). Laparoscopy also resulted as an independent factor for an early resume to full-time activities in the multivariate analysis (P < 0.0001). CONCLUSIONS Laparoscopic left pancreatectomy is a safe procedure for benign and borderline tumors, with similar perioperative outcomes compared with the open procedure. In the long term, the laparoscopic approach is likely to be superior thanks to a more rapid resume of full-time activities and to the lower incidence of incisional hernias and exocrine insufficiency. Clearly, these results have yet to be confirmed in large, randomized trials.
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Affiliation(s)
- Giovanni Butturini
- Department of Surgery, G.B. Rossi Hospital, University of Verona, P.Le L.A. Scuro 10, 37134 Verona, Italy.
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Lodigiani C, Di Micco P, Ferrazzi P, Librè L, Arfuso V, Polatti F, Michela B, Rossini R, Morenghi E, Rota L, Brenner B, Levi S. P.76 Low molecular weight heparin in women with repeated implantation failure. Thromb Res 2011. [DOI: 10.1016/s0049-3848(11)70131-1] [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: 10/18/2022]
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30
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Malleo G, Crippa S, Butturini G, Salvia R, Partelli S, Rossini R, Bacchion M, Pederzoli P, Bassi C. Delayed gastric emptying after pylorus-preserving pancreaticoduodenectomy: validation of International Study Group of Pancreatic Surgery classification and analysis of risk factors. HPB (Oxford) 2010; 12:610-8. [PMID: 20961369 PMCID: PMC2999788 DOI: 10.1111/j.1477-2574.2010.00203.x] [Citation(s) in RCA: 77] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
OBJECTIVES This study evaluates the incidence and clinical features and associated risk factors of delayed gastric emptying (DGE) after pancreaticoduodenectomy, employing the International Study Group of Pancreatic Surgery (ISGPS) consensus definition. METHODS Demographic, pathological and surgical details for 260 consecutive patients who underwent pylorus-preserving pancreaticoduodenectomy at a single institution were analysed using univariate and multivariate models. RESULTS Postoperative complications occurred in 108 (41.5%) and DGE was diagnosed in 36 (13.8%) of 260 patients. Among the 36 DGE patients, 16 had grade A, 18 grade B and two grade C DGE. Resumption of a solid diet (P < 0.001), time to passage of stool (P= 0.002) and hospital discharge (P < 0.001) occurred later in DGE patients. The need for total parenteral nutrition was significantly higher in DGE grade B/C patients (P < 0.001). In the univariate analysis, abdominal collections (P≤ 0.001), pancreatic fistula (PF) grades B and C (P < 0.001), biliary fistula (P= 0.002), pulmonary complications (P < 0.001) and sepsis (P= 0.002) were associated with DGE. Only abdominal collections (P= 0.009), PF grade B/C (P < 0.001) and sepsis (P= 0.024) were associated with clinically relevant DGE. In the multivariate analysis, PF grade B/C (P= 0.004) and biliary fistula (P= 0.039) were independent risk factors for DGE. CONCLUSIONS The ISGPS classification and grading systems correlate well with the clinical course of DGE and are feasible for patient management. The principal risk factors for DGE seem to be pancreatic and biliary fistulas.
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Affiliation(s)
- Giuseppe Malleo
- Department of Surgery, General Surgery B Unit, G. B. Rossi Hospital, University of Verona, Verona, Italy
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van der Straten KM, Leung LKP, Rossini R, Johnston SD. Cryopreservation of spermatozoa of black marlin, Makaira indica (Teleostei: Istiophoridae). Cryo Letters 2006; 27:203-9. [PMID: 16990948] [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] [Subscribe] [Scholar Register] [Indexed: 05/11/2023]
Abstract
As a first step towards the development of a method for the cryopreservation of black marlin spermatozoa, this study investigated the effect of dimethylsulfoxide (DMSO) concentration and pellet size on post-thaw spermatozoal motility. Spermatozoa were recovered from the spermatic duct of testes retrieved post-mortem from four adult black marlin caught in the Coral Sea spawning grounds of Australia. Undiluted spermatozoa were stored on ice for 4 to 10 hours during transport to shore, then evaluated for motility after activation in seawater (1:10 v:v). Spermatozoa were prepared for cryopreservation in pellets by extension (1:3 v:v) in a defined fish Ringer's solution to give two final DMSO concentrations of 2.5% or 5.0%. Diluted spermatozoa were frozen directly on a dry ice block in pellet sizes of either 0.25 ml or 0.50 ml. Frozen pellets were thawed in a water bath at 40 degrees C for 60 seconds and assessed for post-thaw motility following activation in seawater. Spermatozoa recovered within 50 minutes of death and chilled on ice for 4 to 10 hours showed a mean (+/- SEM) motility immediately following activation of 91.6 +/- 7.9%. 50% of the spermatozoa remained motile for approximately 4 to 5 minutes. Following cryopreservation, mean motility declined significantly across all cryoprotectant and pellet size combinations (P < 0.001) but spermatozoa frozen in 2.5% DMSO showed higher motility than those frozen in 5.0% DMSO (P = 0.014). Pellet size had no effect on post-thaw motility (P = 0.179).
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Biadi O, Rossini R, Musumeci G, Frediani L, Masullo M, Ramacciotti CE, Dell'Osso L, Paoli R, Mariotti R, Cassano GB, Mariani M. Cardiopulmonary exercise test in young women affected by anorexia nervosa. Ital Heart J 2001; 2:462-7. [PMID: 11453584] [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] [Subscribe] [Scholar Register] [Indexed: 02/20/2023]
Abstract
BACKGROUND The aim of this study was to evaluate exercise performance in patients affected by anorexia nervosa. METHODS We studied 19 patients (all females, mean age 23.1 +/- 5.2 years) affected by anorexia nervosa (mean weight 37.3 kg, body mass index 14.04 +/- 1.4 kg/m2) and 20 constitutionally thin women, matched for age, height and physical activity, with a body mass index < 19 kg/m2. All these women underwent clinical examination, standard ECG and a cardiopulmonary stress test. RESULTS Patients affected by anorexia nervosa showed a lower heart rate and systolic blood pressure at peak exercise (148.8 +/- 13.8 vs 171 +/- 9.2 b/min, p < 0.001, and 130 +/- 9.5 vs 152 +/- 11.2 mmHg, p < 0.001), work load (85.5 +/- 15.1 vs 117.2 +/- 20.3 W, p < 0.001), rate-pressure product (19 371 +/- 2391 vs 25,986 +/- 2218 b/min/mmHg, p < 0.001), oxygen uptake (VO2) at rest and maximum VO2 (5.4 +/- 1.7 vs 7.1 +/- 1.1 ml/kg/min, p < 0.001, and 28.08 +/- 6.3 vs 40.2 +/- 7.1 ml/kg/min, p < 0.001), anaerobic threshold (15.7 +/- 1.9 vs 20.4 +/- 2.1 ml/kg/min, p < 0.001), VO2 during exercise (9.5 +/- 1.2 vs 12.8 +/- 1.3 ml/min/W, p < 0.001), maximum minute ventilation (34.5 +/- 9.9 vs 48.4 +/- 10.3 /min, p < 0.001), and oxygen pulse (7.2 +/- 2 vs 10.9 +/- 2.4 ml/b, p < 0.001). CONCLUSIONS These data show an abnormal working capacity and cardiovascular responses to exercise in patients affected by anorexia nervosa. The low VO2, both at rest and during exercise, allows them to maintain a relatively high level of physical activity, which contributes to increase the energy expenditure needed for weight loss.
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Affiliation(s)
- O Biadi
- Cardio Thoracic Department, University of Pisa, Italy
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Oselladore D, Rossini R. Remote-controlled videoendoscopy. Endoscopy 1991; 23:106. [PMID: 2050004 DOI: 10.1055/s-2007-1010628] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [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: 12/30/2022]
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Bonifazi F, Antonicelli L, Pieretti C, Piunti E, Rossini R, Patalano F, Ruggieri F. Double-blind crossover trial to compare the activity of nedocromil sodium and placebo in antigen challenge. Allergol Immunopathol (Madr) 1987; 15:151-3. [PMID: 2821784] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/02/2023]
Abstract
In a double-blind crossover placebo controlled study, the inhibitory effects of three different doses of nedocromil sodium on the immediate bronchoconstrictor response to antigen challenge were compared with a placebo. All the test treatments were inhaled three hours before challenge. Four asthmatic patients took part in the study and the test treatments were taken in a randomized order. All three doses of nedocromil sodium significantly reduced the bronchoconstrictor response and protected the patients against antigen challenge, compared with placebo. The highest dose of 2 mg was the most effective dose. All test doses of nedocromil sodium were safe and well tolerated by the patients.
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Affiliation(s)
- F Bonifazi
- Allergy Respiratory Unit, Regional General Hospital, Rome, Italy
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Acocella M, Cossio M, Barucci M, Ciardetti A, Archi G, Rossini R, Bassini E, Lusetti W. [Extreme degree familial hypobetalipoproteinemia caused by hypothetic double heterozygosity in a subject with severe mental deficiency]. Pediatr Med Chir 1984; 6:843-52. [PMID: 6545600] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/05/2023] Open
Abstract
We described the case of an adult male patient, seriously mentally deficient, hospitalised in Psychiatric Hospital for a period of many years, suffering from a familial hypobetalipoproteinemia with extremely low levels of plasmatic betalipoproteins. The patient has been followed and tested several times over a period of six years. Numerous members of his family, which is part of a restricted ethnic nucleus in a locality (Iolo) of the Comune of Prato in the Provincia of Florence, were examined and tested too. Consanguinity between his parents is not demonstrable. The diagnosis of homozygous hypobetalipoproteinemia is discarded, but it does not seem that the heterozygous one is to be accepted as weel. On the ground of the existence of two syndromes which are quite unlike each other, but both explainable as form of familial heterozygous hypobetalipoproteinemia, one of them present in his father, the other one in his mother and in the maternal relatives as in the patient's brother respectively, a hypothesis of a double heterozygosis could be formulated. Extant is the support of the recent literature data, depending on them the possibility of making the hypothesis of a multiplicity of the genes regulating the apolipoprotein B synthesis. We do not exclude that the peculiarity of the event of a double heterozygosis can also be directly responsible of the patient's serious mental deficiency, being at the same time more supportable the hypothesis of a encephalopathy in his early childhood.
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Gualandi S, Govoni M, Ricciardelli P, Rossini R, Tazzari R. [Separation of N-acetyl-beta-hexosaminidase isoenzymes. Methological note]. Boll Soc Ital Biol Sper 1984; 60:937-943. [PMID: 6235823] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/21/2023]
Abstract
We examined the activity of total N-acetyl-beta-hexosaminidase and of its isoenzyme forms, that represent different stages of the maturation of the lysosomal hydrolase. In both methods the enzyme catalyzes the separation of 4-methylumbelliferone, a fluorescent substance, from 4-methylumelliferyl-2-acetamido-2-deoxy-beta-D-glucopyranoside. We used Leaback's method for the fluorimetric assay of total enzyme, and Ellis's DEAE-cellulose microcolum chromatography for the assay of its components. We obtained a clear separation of each fraction. We will apply these methods in our further studies of children with renal damage, because hexosaminidase seems to be one of the most sensitive markers of tubular damage.
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Pirazzoli G, Casadio L, Rossini R, Gualandi S, Tazzari R, Corsini F. [Correlation between tryptophan, NEFA and albumins in the nephrotic syndrome]. Boll Soc Ital Biol Sper 1983; 59:1-7. [PMID: 6849691] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/22/2023]
Abstract
Many connections were considered between bound and free tryptophan and albumins, NEFA and other aminoacids in 18 proofs in ten subjects of paediatric age affected by nephrotic syndrome. A decrease of total tryptophan and a tendency to increase of free tryptophan were showed in our experience. NEFA, at normal concentrations, should not be responsible for this; and this could suggest that the binding sites on albumins for NEFA and tryptophan are different. Besides there is appearance of a positive correlation between albumins and bound tryptophan and a negative correlation between albumins and free tryptophan. These results can suggest that the reduction of the total tryptophan is due to the loss of the fractions bound to albumins, but urinary tryptophan is not increased in our studies. As the albumins get fewer, there is a lost in linked tryptophan and an increase of free tryptophan. A total reduction of other aromatic aminoacids can also explain, through a reduced intestinal absorption, the decrease of the tryptophan in the nephrotic syndrome.
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Rossini R, Gaspari L, Gualandi S, Tazzari R. [Diagnostic value of determination of urinary alpha-glucosidase in children]. Minerva Nefrol 1981; 28:519-24. [PMID: 7041010] [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: 01/23/2023]
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Tazzari R, Beltrandi E, Rossini R. [Evaluation of immune reactivity in relation to the therapeutic and clinical response of the nephrotic syndrome in children]. Minerva Nefrol 1981; 28:209-13. [PMID: 6977107] [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: 01/22/2023]
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Rossini R. Physiopathology of epileptic seizure. J Neurosurg Sci 1975; 19:110-2. [PMID: 1221089] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
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Ferrari W, Rossini R, Bonasegla F, Boncinelli A, Prandi G, Greggia A. [Combined treatment of parkinsonian syndromes with amantadine and gamma hydroxybutyric acid]. Minerva Med 1971; 62:3958-9. [PMID: 5125051] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/13/2023]
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Rossini R. [Historical and critical study of hypnotism]. Minerva Med 1970; 61:5977-83. [PMID: 5499846] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/15/2023]
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Rossini R. [Historical and clinical considerations on hypnosis]. Minerva Med 1969; 60:1921-7. [PMID: 4892057] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/12/2023]
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44
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Di Piazza P, Gori EC, Rossini R. [Relation between dreams and deliria]. Riv Sper Freniatr Med Leg Alien Ment 1968; 92:757-62. [PMID: 5714902] [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: 01/16/2023]
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45
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Bonasegla F, Cavalca GG, Rossini R. [Observations and experiences with the use of lithium salts in the therapy of manic-depressive psychoses]. Riv Sper Freniatr Med Leg Alien Ment 1967; 91:818-24. [PMID: 5614834] [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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46
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Rossini R. [Sleep, dreams and neuropsychopathology]. Riv Sper Freniatr Med Leg Alien Ment 1966; 90:1037-58. [PMID: 5997221] [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: 01/17/2023]
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