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Villani R, Loizzi D, Sacco AF, Mirabella L, Santoliquido M, Mongiello D, Sollitto F, Serviddio G. Prevalence and clinical relevance of liver dysfunction after thoracic surgery: a retrospective study. Sci Rep 2023; 13:23045. [PMID: 38155193 PMCID: PMC10754851 DOI: 10.1038/s41598-023-49427-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/02/2023] [Accepted: 12/07/2023] [Indexed: 12/30/2023] Open
Abstract
Postoperative elevation of serum aminotransferase or alkaline phosphatase levels after liver and heart surgeries has been widely reported. The prevalence and clinical significance of hypertransaminasemia/liver dysfunction after thoracic surgery remains largely unknown. Significant differences in surgical procedures between thoracic and extra-thoracic surgeries may suggest different risks of liver dysfunction. We retrospectively analyzed data from 224 consecutive patients who underwent thoracic surgery. Liver function tests were recorded the day before surgery, 12 h, 1 day, 5, and 10 days after the surgical procedure. Patients were studied to identify the frequency of hypertransaminasemia and/or hyperbilirubinemia and/or increase of INR levels. 37,5% of patients showed an increase in serum alanine aminotransferase (ALT) level after thoracic surgery, whereas an increase in gamma glutamyl transferase (GGT) serum levels of any grade was observed in 53,6% of patients. Approximately 83% of patients who experienced an increase in the serum GGT or ALT levels showed a grade 1 or 2 change. Operative time was associated with hypertransaminasemia in the univariate and multivariate analyses, whereas the use of metformin was associated with a lower risk of ALT increase.
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Affiliation(s)
- Rosanna Villani
- C.U.R.E. (University Center for Liver Disease Research and Treatment), Liver Unit, Department of Medical and Surgical Sciences, University of Foggia, Viale Pinto 1, 71122, Foggia, Italy.
| | - Domenico Loizzi
- Institute of Thoracic Surgery, Department of Medical and Surgical Sciences, University of Foggia, Foggia, Italy
| | - Antonia Federica Sacco
- C.U.R.E. (University Center for Liver Disease Research and Treatment), Liver Unit, Department of Medical and Surgical Sciences, University of Foggia, Viale Pinto 1, 71122, Foggia, Italy
| | - Lucia Mirabella
- Anesthesia and Intensive Care Unit, Department of Medical and Surgical Sciences, University of Foggia, Foggia, Italy
| | - Mariateresa Santoliquido
- C.U.R.E. (University Center for Liver Disease Research and Treatment), Liver Unit, Department of Medical and Surgical Sciences, University of Foggia, Viale Pinto 1, 71122, Foggia, Italy
| | - Diletta Mongiello
- Institute of Thoracic Surgery, Department of Medical and Surgical Sciences, University of Foggia, Foggia, Italy
| | - Francesco Sollitto
- Institute of Thoracic Surgery, Department of Medical and Surgical Sciences, University of Foggia, Foggia, Italy
| | - Gaetano Serviddio
- C.U.R.E. (University Center for Liver Disease Research and Treatment), Liver Unit, Department of Medical and Surgical Sciences, University of Foggia, Viale Pinto 1, 71122, Foggia, Italy
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Loizzi D, Mongiello D, Bevilacqua MT, Raveglia F, Fiorelli A, Congedo MT, Ardò NP, Sollitto F. Surgical management of compensatory sweating: A systematic review. Front Surg 2023; 10:1160827. [PMID: 37035574 PMCID: PMC10073509 DOI: 10.3389/fsurg.2023.1160827] [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: 02/07/2023] [Accepted: 02/27/2023] [Indexed: 04/11/2023] Open
Abstract
Endoscopic thoracic sympathectomy (ETS) surgery is a highly effective treatment of primary hyperhidrosis (PH) for the palms, face, axillae. Compensatory sweating (CS) is the most common and feared side effect of thoracic sympathectomy. CS is a phenomenon characterized by increased sweating in sites distal to the level of sympathectomy. Compensatory sweating is the main problem for which many patients give up surgery, losing the chance to solve their problem and accepting a poor quality of life. There are still no treatments that offer reliable solutions for compensatory sweating. The treatments proposed in the literature are scarce, with low case histories, and with uncertain results. Factors associated with CS are extension of manipulation of the sympathetic chain, level of sympathetic denervation, and body mass index. Therapeutic options include non surgical treatment and surgical treatment. Non surgical treatments include topical agents, botulinum toxin, systemic anticholinergics, iontophoresis. Surgical treatments include clip removal, extended sympathectomy and sympathetic chain reconstruction, although the efficacy is not well-established for all the methods. In this review we provide an overview of the treatments and outcomes described in the literature for the management of compensatory CS, with focus on surgical treatment.
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Affiliation(s)
- Domenico Loizzi
- Department of Medical and Surgical Science, University of Foggia, Foggia, Italy
- Correspondence: Domenico Loizzi
| | - Diletta Mongiello
- Department of Medical and Surgical Science, University of Foggia, Foggia, Italy
| | | | | | - Alfonso Fiorelli
- Department of Translation Medicine, Thoracic Surgery Unit, Università della Campania “Luigi Vanvitelli”, Naples, Italy
| | - Maria Teresa Congedo
- Dipartimento di Medicina e Chirurgia Traslazionale, Università Cattolica del Sacro Cuore, Roma, Italy
| | - Nicoletta Pia Ardò
- Department of Medical and Surgical Science, University of Foggia, Foggia, Italy
| | - Francesco Sollitto
- Department of Medical and Surgical Science, University of Foggia, Foggia, Italy
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Hossain MN, De Leo V, Tamborra R, Laselva O, Ingrosso C, Daniello V, Catucci L, Losito I, Sollitto F, Loizzi D, Conese M, Di Gioia S. Characterization of anti-proliferative and anti-oxidant effects of nano-sized vesicles from Brassica oleracea L. (Broccoli). Sci Rep 2022; 12:14362. [PMID: 35999223 PMCID: PMC9399156 DOI: 10.1038/s41598-022-17899-1] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2022] [Accepted: 08/02/2022] [Indexed: 11/25/2022] Open
Abstract
In this in vitro study, we test our hypothesis that Broccoli-derived vesicles (BDVs), combining the anti-oxidant properties of their components and the advantages of their structure, can influence the metabolic activity of different cancer cell lines. BDVs were isolated from homogenized fresh broccoli (Brassica oleracea L.) using a sucrose gradient ultracentrifugation method and were characterized in terms of physical properties, such as particle size, morphology, and surface charge by transmission electron microscopy (TEM) and laser doppler electrophoresis (LDE). Glucosinolates content was assessed by RPLC–ESI–MS analysis. Three different human cancer cell lines (colorectal adenocarcinoma Caco-2, lung adenocarcinoma NCI-H441 and neuroblastoma SHSY5Y) were evaluated for metabolic activity by the MTT assay, uptake by fluorescence and confocal microscopy, and anti-oxidant activity by a fluorimetric assay detecting intracellular reactive oxygen species (ROS). Three bands were obtained with average size measured by TEM based size distribution analysis of 52 nm (Band 1), 70 nm (Band 2), and 82 nm (Band 3). Glucobrassicin, glucoraphanin and neoglucobrassicin were found mostly concentrated in Band 1. BDVs affected the metabolic activity of different cancer cell lines in a dose dependent manner compared with untreated cells. Overall, Band 2 and 3 were more toxic than Band 1 irrespective of the cell lines. BDVs were taken up by cells in a dose- and time-dependent manner. Pre-incubation of cells with BDVs resulted in a significant decrease in ROS production in Caco-2 and NCI-H441 stimulated with hydrogen peroxide and SHSY5Y treated with 6-hydroxydopamine, with all three Bands. Our findings open to the possibility to find a novel “green” approach for cancer treatment, focused on using vesicles from broccoli, although a more in-depth characterization of bioactive molecules is warranted.
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Affiliation(s)
- Md Niamat Hossain
- Department of Medical and Surgical Sciences, University of Foggia, Foggia, Italy
| | | | - Rosanna Tamborra
- Department of Medical and Surgical Sciences, University of Foggia, Foggia, Italy
| | - Onofrio Laselva
- Department of Medical and Surgical Sciences, University of Foggia, Foggia, Italy
| | - Chiara Ingrosso
- National Research Council of Italy-Institute for Physical and Chemical Processes (CNR-IPCF S.S. Bari), c/o Department of Chemistry, University of Bari "A. Moro", Bari, Italy
| | - Valeria Daniello
- Department of Medical and Surgical Sciences, University of Foggia, Foggia, Italy
| | - Lucia Catucci
- Department of Chemistry, University of Bari, Bari, Italy
| | - Ilario Losito
- Department of Chemistry, University of Bari, Bari, Italy
| | - Francesco Sollitto
- Department of Medical and Surgical Sciences, University of Foggia, Foggia, Italy
| | - Domenico Loizzi
- Department of Medical and Surgical Sciences, University of Foggia, Foggia, Italy.
| | - Massimo Conese
- Department of Medical and Surgical Sciences, University of Foggia, Foggia, Italy.
| | - Sante Di Gioia
- Department of Medical and Surgical Sciences, University of Foggia, Foggia, Italy
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Sanguedolce F, Zanelli M, Palicelli A, Cavazza A, DE Marco L, Zizzo M, Ascani S, Landriscina M, Giordano G, Sollitto F, Loizzi D. The classification of neuroendocrine neoplasms of the lung and digestive system according to WHO, 5th Edition: similarities, differences, challenges & unmet needs. Panminerva Med 2022; 64:259-264. [PMID: 35146989 DOI: 10.23736/s0031-0808.22.04602-x] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
Neuroendocrine neoplasms (NENs) are a group of disease entities sharing common morphological, ultrastructural and immunophenotypical features, yet with distinct biological behavior and clinical outcome, ranging from benign to frankly malignant. Accordingly, a spectrum of therapeutic options for each single entity is available, including somatostatin analogues (SSA), mTOR-inhibitors, peptide receptor radionuclide therapy (PRRT), non-platinum and platinum chemotherapy. In the last few decades, several attempts have been made in order to (1) better stratify these lesions refining the pathological classifications, so as to obtain an optimal correspondence between the scientific terminology and, the predictive and prognostic features of each disease subtype, and (2) achieve a global Classification encompassing NENs arising at different anatomical sites. Aim of this review is to analyze, compare and discuss the main features and issues of the latest WHO Classifications of NENs of the lung and the digestive system, in order to point out the strengths and limitations of our current understanding of these complex diseases.
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Affiliation(s)
| | - Magda Zanelli
- Pathology Unit, Azienda USL-IRCCS di Reggio Emilia, Reggio Emilia, Italy
| | - Andrea Palicelli
- Pathology Unit, Azienda USL-IRCCS di Reggio Emilia, Reggio Emilia, Italy
| | - Alberto Cavazza
- Pathology Unit, Azienda USL-IRCCS di Reggio Emilia, Reggio Emilia, Italy
| | - Loredana DE Marco
- Pathology Unit, Azienda USL-IRCCS di Reggio Emilia, Reggio Emilia, Italy
| | - Maurizio Zizzo
- Surgical Oncology Unit, Azienda USL-IRCCS di Reggio Emilia, Reggio Emilia, Italy
| | - Stefano Ascani
- Pathology Unit, Azienda Ospedaliera Santa Maria di Terni, University of Perugia, Terni, Italy
| | - Matteo Landriscina
- Unit of Medical Oncology and Biomolecular Therapy, Department of Medical and Surgical Sciences, Policlinico Riuniti, University of Foggia, Foggia, Italy.,Laboratory of Pre-Clinical and Translational Research, IRCCS, Referral Cancer Center of Basilicata (CROB), Rionero in Vulture, Potenza, Italy
| | - Guido Giordano
- Unit of Medical Oncology and Biomolecular Therapy, Department of Medical and Surgical Sciences, Policlinico Riuniti, University of Foggia, Foggia, Italy
| | | | - Domenico Loizzi
- Institute of Thoracic Surgery, University of Foggia, Foggia, Italy
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5
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Fiorelli A, D'Andrilli A, Carlucci A, Vicidomini G, Argento G, Trabalza Marinucci B, Ardissone F, Rapanà R, Sobrero S, Carbognani P, Ventura L, Bocchialini G, Ragusa M, Tassi V, Sollitto F, Loizzi D, Ardò NP, Anile M, Puma F, Rendina EA, Venuta F, Serra N, Santini M. Pulmonary Hamartoma Associated With Lung Cancer (PHALC Study): Results of a Multicenter Study. Lung 2021; 199:369-378. [PMID: 34302497 PMCID: PMC8416857 DOI: 10.1007/s00408-021-00460-8] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2021] [Accepted: 07/12/2021] [Indexed: 11/24/2022]
Abstract
Purpose Pulmonary hamartoma is the most common benign tumor of the lung. We analyzed a 20-year historical series of patients with pulmonary hamartoma undergoing surgical resection, aiming to evaluate the characteristics, the outcomes, and the association between hamartoma and lung cancer. Methods It was a retrospective multicenter study including the data of all consecutive patients with pulmonary hamartoma undergoing surgical resection. The end-points were to evaluate: (i) the characteristics of hamartoma, (ii) outcomes, and (iii) whether hamartoma was a predictive factor for lung cancer development Results Our study population included 540 patients. Upfront surgical or endoscopic resection was performed in 385 (71%) cases while in the remaining 155 (29%) cases, the lesions were resected 20 ± 3.5 months later due to increase in size. In most cases, lung sparing resection was carried out including enucleation (n = 259; 48%) and wedge resection (n = 230; 43%) while 5 (1%) patients underwent endoscopic resection. Only two patients (0, 2%) had major complications. One patient (0.23%) had recurrence after endoscopic resection, while no cases of malignant degeneration were seen (mean follow-up:103.3 ± 93 months). Seventy-six patients (14%) had associated lung cancer, synchronous in 9 (12%) and metachronous in 67 (88%). Only age > 70-year-old (p = 0.0059) and smokers > 20 cigarettes/day (p < 0.0001) were the significant risk factors for lung cancer. Conclusion PH was a benign tumor, with no evidence of recurrence and/or of malignant degeneration after resection. The association between hamartoma and lung cancer was a spurious phenomenon due to common risk factors.
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Affiliation(s)
- Alfonso Fiorelli
- Thoracic Surgery Unit, University of Campania Luigi Vanvitelli, Via Pansini, 7, I-80138, Naples, Italy.
| | - Antonio D'Andrilli
- Thoracic Surgery, Sant'Andrea Hospital, Università La Sapienza, Rome, Italy
| | - Annalisa Carlucci
- Thoracic Surgery Unit, University of Campania Luigi Vanvitelli, Via Pansini, 7, I-80138, Naples, Italy
| | - Giovanni Vicidomini
- Thoracic Surgery Unit, University of Campania Luigi Vanvitelli, Via Pansini, 7, I-80138, Naples, Italy
| | - Giacomo Argento
- Thoracic Surgery, Sant'Andrea Hospital, Università La Sapienza, Rome, Italy
| | | | - Francesco Ardissone
- Department of Oncology, Thoracic Surgery Unit, San Luigi Hospital, University of Torino, Orbassano, Italy
| | - Roberta Rapanà
- Department of Oncology, Thoracic Surgery Unit, San Luigi Hospital, University of Torino, Orbassano, Italy
| | - Simona Sobrero
- Department of Oncology, Thoracic Surgery Unit, San Luigi Hospital, University of Torino, Orbassano, Italy
| | - Paolo Carbognani
- Medicine and Surgery, Thoracic Surgery, University Hospital of Parma, Parma, Italy
| | - Luigi Ventura
- Medicine and Surgery, Thoracic Surgery, University Hospital of Parma, Parma, Italy
| | - Giovanni Bocchialini
- Medicine and Surgery, Thoracic Surgery, University Hospital of Parma, Parma, Italy
| | - Mark Ragusa
- Division of Thoracic Surgery, S. Maria di Terni Hospital, University of Perugia Medical School, Terni, Italy
| | - Valentina Tassi
- Division of Thoracic Surgery, S. Maria di Terni Hospital, University of Perugia Medical School, Terni, Italy
| | | | | | | | - Marco Anile
- Department of Thoracic Surgery, Policlinico Umberto I, University of Rome La Sapienza, Rome, Italy
| | | | | | - Federico Venuta
- Department of Thoracic Surgery, Policlinico Umberto I, University of Rome La Sapienza, Rome, Italy
| | - Nicola Serra
- Statistic Unit, Department of Public Health, University of Federico II, Naples, Italy
| | - Mario Santini
- Thoracic Surgery Unit, University of Campania Luigi Vanvitelli, Via Pansini, 7, I-80138, Naples, Italy
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6
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Sanguedolce F, Zanelli M, Zizzo M, Bisagni A, Soriano A, Cocco G, Palicelli A, Santandrea G, Caprera C, Corsi M, Cerrone G, Sciaccotta R, Martino G, Ricci L, Sollitto F, Loizzi D, Ascani S. Primary Pulmonary B-Cell Lymphoma: A Review and Update. Cancers (Basel) 2021; 13:cancers13030415. [PMID: 33499258 PMCID: PMC7865219 DOI: 10.3390/cancers13030415] [Citation(s) in RCA: 27] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2020] [Revised: 01/10/2021] [Accepted: 01/19/2021] [Indexed: 02/06/2023] Open
Abstract
Simple Summary The group of B-cell lymphomas primarily involving the lung encompasses different histological entities with distinct biological aspects, while sharing some clinical and radiological features related to their common anatomic site of occurrence. Recent molecular advances in the molecular genetics of these lesions have substantially improved of our understanding of the mechanisms of lymphomagenesis, adding novel information to histology in order to better characterize and manage these diseases. This review summarizes the available clinical, radiological, pathological, and molecular data on primary pulmonary B-cell lymphomas, discusses the mechanisms of lymphomagenesis, and highlights the role of a multi-disciplinary management in overcoming the diagnostic and therapeutic challenges in this setting. Abstract Primary pulmonary B-cell lymphomas (PP-BCLs) comprise a group of extranodal non-Hodgkin lymphomas of B-cell origin, which primarily affect the lung without evidence of extrapulmonary disease at the time of diagnosis and up to 3 months afterwards. Primary lymphoid proliferations of the lung are most often of B-cell lineage, and include three major entities with different clinical, morphological, and molecular features: primary pulmonary marginal zone lymphoma of mucosa-associated lymphoid tissue (PP-MZL, or MALT lymphoma), primary pulmonary diffuse large B cell lymphoma (PP-DLBCL), and lymphomatoid granulomatosis (LYG). Less common entities include primary effusion B-cell lymphoma (PEL) and intravascular large B cell lymphoma (IVLBCL). A proper workup requires a multidisciplinary approach, including radiologists, pneumologists, thoracic surgeons, pathologists, hemato-oncologists, and radiation oncologists, in order to achieve a correct diagnosis and risk assessment. Aim of this review is to analyze and outline the clinical and pathological features of the most frequent PP-BCLs, and to critically analyze the major issues in their diagnosis and management.
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Affiliation(s)
- Francesca Sanguedolce
- Pathology Unit, Azienda Ospedaliero-Universitaria, Ospedali Riuniti di Foggia, 71122 Foggia, Italy
- Correspondence: ; Tel.: +39-0881-736315
| | - Magda Zanelli
- Pathology Unit, Azienda USL-IRCCS di Reggio Emilia, 42122 Reggio Emilia, Italy; (M.Z.); (A.B.); (A.P.); (G.S.)
| | - Maurizio Zizzo
- Surgical Oncology Unit, Azienda USL-IRCCS di Reggio Emilia, 42122 Reggio Emilia, Italy;
- Clinical and Experimental Medicine PhD Program, University of Modena and Reggio Emilia, 41121 Modena, Italy
| | - Alessandra Bisagni
- Pathology Unit, Azienda USL-IRCCS di Reggio Emilia, 42122 Reggio Emilia, Italy; (M.Z.); (A.B.); (A.P.); (G.S.)
| | - Alessandra Soriano
- Gastroenterology, Division and Inflammatory Bowel Disease Center, Department of Internal Medicine, Azienda USL-IRCCS di Reggio Emilia, 42122 Reggio Emilia, Italy;
| | - Giorgia Cocco
- Radiotherapy Unit, Azienda Ospedaliero-Universitaria, Ospedali Riuniti di Foggia, 71122 Foggia, Italy;
| | - Andrea Palicelli
- Pathology Unit, Azienda USL-IRCCS di Reggio Emilia, 42122 Reggio Emilia, Italy; (M.Z.); (A.B.); (A.P.); (G.S.)
| | - Giacomo Santandrea
- Pathology Unit, Azienda USL-IRCCS di Reggio Emilia, 42122 Reggio Emilia, Italy; (M.Z.); (A.B.); (A.P.); (G.S.)
| | - Cecilia Caprera
- Pathology Unit, Azienda Ospedaliera S. Maria di Terni, University of Perugia, 05100 Terni, Italy; (C.C.); (M.C.); (G.C.); (R.S.); (G.M.); (L.R.); (S.A.)
| | - Matteo Corsi
- Pathology Unit, Azienda Ospedaliera S. Maria di Terni, University of Perugia, 05100 Terni, Italy; (C.C.); (M.C.); (G.C.); (R.S.); (G.M.); (L.R.); (S.A.)
| | - Giulia Cerrone
- Pathology Unit, Azienda Ospedaliera S. Maria di Terni, University of Perugia, 05100 Terni, Italy; (C.C.); (M.C.); (G.C.); (R.S.); (G.M.); (L.R.); (S.A.)
| | - Raffaele Sciaccotta
- Pathology Unit, Azienda Ospedaliera S. Maria di Terni, University of Perugia, 05100 Terni, Italy; (C.C.); (M.C.); (G.C.); (R.S.); (G.M.); (L.R.); (S.A.)
| | - Giovanni Martino
- Pathology Unit, Azienda Ospedaliera S. Maria di Terni, University of Perugia, 05100 Terni, Italy; (C.C.); (M.C.); (G.C.); (R.S.); (G.M.); (L.R.); (S.A.)
| | - Linda Ricci
- Pathology Unit, Azienda Ospedaliera S. Maria di Terni, University of Perugia, 05100 Terni, Italy; (C.C.); (M.C.); (G.C.); (R.S.); (G.M.); (L.R.); (S.A.)
| | - Francesco Sollitto
- Institute of Thoracic Surgery, University of Foggia, 71122 Foggia, Italy; (F.S.); (D.L.)
| | - Domenico Loizzi
- Institute of Thoracic Surgery, University of Foggia, 71122 Foggia, Italy; (F.S.); (D.L.)
| | - Stefano Ascani
- Pathology Unit, Azienda Ospedaliera S. Maria di Terni, University of Perugia, 05100 Terni, Italy; (C.C.); (M.C.); (G.C.); (R.S.); (G.M.); (L.R.); (S.A.)
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Sanguedolce F, Zanelli M, Ascani S, Zizzo M, Tortorella S, Soriano A, Cavazza A, Sollitto F, Loizzi D. SARS-CoV-2-related lung pathology: macroscopic and histologic features and their clinical implications. Panminerva Med 2020; 64:80-95. [PMID: 33073555 DOI: 10.23736/s0031-0808.20.04157-9] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
The ongoing global coronavirus disease 2019 (COVID-19) pandemic, caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), has been posing challenges to proper patients' management. Lungs are the first, and often the most affected organ by SARS-CoV-2; viral infection involves and damages both epithelial and vascular compartments, sometimes leading to severe and even fatal acute respiratory distress syndrome. Histopathological findings, mainly from postmortem examination of COVID-19 deceased patients, have been increasingly published in the last few months, helping to elucidate the sequence of events resulting in organ injury, and the complex multifactorial pathogenesis of this novel disease. A multidisciplinary approach to autopsy, including light microscopy examination along with the detection of viral proteins and/or RNA in tissue samples through ancillary techniques, provided crucial information on the mechanisms underlying the often-heterogeneous clinical picture of COVID-19.
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Affiliation(s)
- Francesca Sanguedolce
- Pathology Unit, Azienda Ospedaliero-Universitaria, Ospedali Riuniti di Foggia, Foggia, Italy -
| | - Magda Zanelli
- Pathology Unit, Azienda USL-IRCCS di Reggio Emilia, Reggio Emilia, Italy
| | - Stefano Ascani
- Pathology Unit, Azienda Ospedaliera S. Maria di Terni, University of Perugia, Terni, Italy
| | - Maurizio Zizzo
- Surgical Oncology Unit, Azienda USL-IRCCS di Reggio Emilia, Reggio Emilia, Italy.,Clinical and Experimental Medicine PhD Program, University of Modena and Reggio Emilia, Modena, Italy
| | - Simona Tortorella
- Pathology Unit, Azienda Ospedaliero-Universitaria, Ospedali Riuniti di Foggia, Foggia, Italy
| | - Alessandra Soriano
- Gastroenterology, Division and Inflammatory Bowel Disease Center Department of Internal Medicine, Azienda USL-IRCCS di Reggio Emilia, Reggio Emilia, Italy
| | - Alberto Cavazza
- Pathology Unit, Azienda USL-IRCCS di Reggio Emilia, Reggio Emilia, Italy
| | | | - Domenico Loizzi
- Institute of Thoracic Surgery, University of Foggia, Foggia, Italy
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8
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Fiorelli A, D'Andrilli A, Carlucci A, Vicidomini G, Loizzi D, Ardò NP, Marasco RD, Ventura L, Ampollini L, Carbognani P, Bocchialini G, Lococo F, Paci M, Di Stefano TS, Ardissone F, Gagliasso M, Mendogni P, Rosso L, Mazzucco A, Vanni C, Marinucci BT, Potenza R, Matricardi A, Ragusa M, Tassi V, Anile M, Poggi C, Serra N, Sica A, Nosotti M, Sollitto F, Venuta F, Rendina EA, Puma F, Santini M. Prognostic factors of lung cancer in lymphoma survivors (the LuCiLyS study). Transl Lung Cancer Res 2020; 9:90-102. [PMID: 32206557 PMCID: PMC7082280 DOI: 10.21037/tlcr.2019.12.28] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/07/2023]
Abstract
Background Second cancer is the leading cause of death in lymphoma survivors, with lung cancer representing the most common solid tumor. Limited information exists about the treatment and prognosis of second lung cancer following lymphoma. Herein, we evaluated the outcome and prognostic factors of Lung Cancer in Lymphoma Survivors (the LuCiLyS study) to improve the patient selection for lung cancer treatment. Methods This is a retrospective multicentre study including consecutive patients treated for lymphoma disease that subsequently developed non-small cell lung cancer (NSCLC). Data regarding lymphoma including age, symptoms, histology, disease stage, treatment received and lymphoma status at the time of lung cancer diagnosis, and data on lung carcinoma as age, smoking history, latency from lymphoma, symptoms, histology, disease stage, treatment received, and survival were evaluated to identify the significant prognostic factors for overall survival. Results Our study population included 164 patients, 145 of which underwent lung cancer resection. The median overall survival was 63 (range, 58–85) months, and the 5-year survival rate 54%. At univariable analysis no-active lymphoma (HR: 2.19; P=0.0152); early lymphoma stage (HR: 1.95; P=0.01); adenocarcinoma histology (HR: 0.59; P=0.0421); early lung cancer stage (HR: 3.18; P<0.0001); incidental diagnosis of lung cancer (HR: 1.71; P<0.0001); and lung cancer resection (HR: 2.79; P<0.0001) were favorable prognostic factors. At multivariable analysis, no-active lymphoma (HR: 2.68; P=0.004); early lung cancer stage (HR: 2.37; P<0.0001); incidental diagnosis of lung cancer (HR: 2.00; P<0.0001); and lung cancer resection (HR: 2.07; P<0.0001) remained favorable prognostic factors. Patients with non-active lymphoma (n=146) versus those with active lymphoma (n=18) at lung cancer diagnosis presented better median survival (64 vs. 37 months; HR: 2.4; P=0.02), but median lung cancer specific survival showed no significant difference (27 vs. 19 months; HR: 0.3; P=0.17). Conclusions The presence and/or a history of lymphoma should not be a contraindication to resection of lung cancer. Inclusion of lymphoma survivors in a lung cancer-screening program may lead to early detection of lung cancer, and improve the survival.
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Affiliation(s)
- Alfonso Fiorelli
- Translational Medical and Surgical Science, University of Campania Luigi Vanvitelli, Naples, Italy
| | - Antonio D'Andrilli
- Thoracic Surgery, Università La Sapienza, Sant'Andrea Hospital, Rome, Italy
| | - Annalisa Carlucci
- Translational Medical and Surgical Science, University of Campania Luigi Vanvitelli, Naples, Italy
| | - Giovanni Vicidomini
- Translational Medical and Surgical Science, University of Campania Luigi Vanvitelli, Naples, Italy
| | | | | | | | - Luigi Ventura
- Medicine and Surgery, Thoracic Surgery, University Hospital of Parma, Parma, Italy
| | - Luca Ampollini
- Medicine and Surgery, Thoracic Surgery, University Hospital of Parma, Parma, Italy
| | - Paolo Carbognani
- Medicine and Surgery, Thoracic Surgery, University Hospital of Parma, Parma, Italy
| | - Giovanni Bocchialini
- Medicine and Surgery, Thoracic Surgery, University Hospital of Parma, Parma, Italy
| | - Filippo Lococo
- Department of General Thoracic Surgery, Fondazione Policlinico Universitario "Agostino Gemelli" IRCCS, Università Cattolica del Sacro Cuore, Rome, Italy
| | - Massimiliano Paci
- Unit of Thoracic Surgery, Azienda Unità Sanitaria Locale-IRCCS di Reggio Emilia, Reggio Emilia, Italy
| | | | - Francesco Ardissone
- Department of Oncology, Thoracic Surgery Unit, University of Torino, San Luigi Hospital, Orbassano, Italy
| | - Matteo Gagliasso
- Department of Oncology, Thoracic Surgery Unit, University of Torino, San Luigi Hospital, Orbassano, Italy
| | - Paolo Mendogni
- Thoracic Surgery and Lung Transplant Unit, Foundation IRCCS Ca'Granda Ospedale Maggiore Policlinico, Milan, Italy
| | - Lorenzo Rosso
- Thoracic Surgery and Lung Transplant Unit, Foundation IRCCS Ca'Granda Ospedale Maggiore Policlinico, Milan, Italy
| | - Alessandra Mazzucco
- Thoracic Surgery and Lung Transplant Unit, Foundation IRCCS Ca'Granda Ospedale Maggiore Policlinico, Milan, Italy
| | - Camilla Vanni
- Thoracic Surgery, Università La Sapienza, Sant'Andrea Hospital, Rome, Italy
| | | | | | | | - Mark Ragusa
- Thoracic Surgery Unit, S. Maria Hospital at Terni, Perugia University Medical School, Terni, Italy
| | - Valentina Tassi
- Thoracic Surgery Unit, S. Maria Hospital at Terni, Perugia University Medical School, Terni, Italy
| | - Marco Anile
- Unit of Thoracic Surgery, Policlinico Umberto I, University of Rome La Sapienza, Rome, Italy
| | - Camilla Poggi
- Unit of Thoracic Surgery, Policlinico Umberto I, University of Rome La Sapienza, Rome, Italy
| | - Nicola Serra
- Statistic Unit, Department of Public Health, University of Federico II, Naples, Italy
| | - Antonello Sica
- Department of Precision Medicine, University of Campania Luigi Vanvitelli, Naples, Italy
| | - Mario Nosotti
- Thoracic Surgery and Lung Transplant Unit, Foundation IRCCS Ca'Granda Ospedale Maggiore Policlinico, Milan, Italy
| | | | - Federico Venuta
- Unit of Thoracic Surgery, Policlinico Umberto I, University of Rome La Sapienza, Rome, Italy
| | | | | | - Mario Santini
- Translational Medical and Surgical Science, University of Campania Luigi Vanvitelli, Naples, Italy
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Sollitto F, Ardò NP, De Bellis R, Marasco RD, Loizzi D. Extrapleural pneumonectomy in atypical mycobacteriosis: the modern use of "Sarot procedure". Chirurgia (Bucur) 2019. [DOI: 10.23736/s0394-9508.18.04828-3] [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: 11/08/2022]
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10
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Fiorelli A, Poggi C, Ardò NP, Messina G, Andreetti C, Venuta F, Rendina EA, Santini M, Loizzi M, Serra N, Sollitto F, Loizzi D. Flow-Volume Curve Analysis for Predicting Recurrence After Endoscopic Dilation of Airway Stenosis. Ann Thorac Surg 2019; 108:203-210. [PMID: 30872098 DOI: 10.1016/j.athoracsur.2019.01.075] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/09/2018] [Revised: 12/23/2018] [Accepted: 01/29/2019] [Indexed: 11/30/2022]
Abstract
BACKGROUND The flow-volume curve is a simple test for diagnosing upper airway obstruction. We evaluated its use to predict recurrence in patients undergoing endoscopic dilation for treatment of benign upper airway stenosis. METHODS The data of 89 consecutive patients undergoing endoscopic dilation of simple upper airway stenosis were retrospectively reviewed. Morphologic distortion of flow-volume loop (visual analysis) and quantitative criteria, including maximal expiratory flow rate at 50% of the vital capacity (MEF50%)/maximal inspiratory flow rate at 50% of the vital capacity (MIF50%) of less than 0.3 or more than 1.0, forced expiratory volume in 1 second/MEF exceeding 10, and forced expiratory volume in 1 second/forced expiratory volume in .05 second exceeding 1.5, were considered predictive of recurrence. In all cases, the recurrence was confirmed by radiologic or bronchoscopic findings, or both. The sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV), and accuracy of visual, quantitative, and aggregate criteria for detecting recurrence were computed and compared. RESULTS Of 89 patients treated, 27 (30%) had a recurrence. Visual analysis presented a sensitivity, specificity, PPV, NPV, and accuracy of 63%, 83.9%, 63%, 83.9%, and 77.5%, respectively. Among the quantitative criterion, the MEF50%/MIF50% was the most accurate, having a sensitivity, specificity, PPV, NPV, and accuracy of 77.8%, 79%, 61.8%, and 89.1%, and 78.7%, respectively. Aggregate criterion presented the best yield compared with other criteria in sensitivity (81.5%), specificity (91.9%), PPV (81.5%), NPV (91.9%), and accuracy (88.8%). CONCLUSIONS The flow-volume curve is a simple and noninvasive method to monitor patients undergoing endoscopic dilation of upper airway stenosis. Morphologic changes in the flow-volume loop and in the MEF50%/MIF50% ratio are suggestive of recurrence and guide the physician to implement the follow-up with further diagnostic (non)invasive examinations.
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Affiliation(s)
- Alfonso Fiorelli
- Thoracic Surgery Unit, University Campania "Luigi Vanvitelli," Naples, Italy.
| | - Camilla Poggi
- Thoracic Surgery Unit, University La Sapienza, Policlinico Hospital, Rome, Italy
| | | | - Gaetana Messina
- Thoracic Surgery Unit, University Campania "Luigi Vanvitelli," Naples, Italy
| | - Claudio Andreetti
- Thoracic Surgery Unit, University La Sapienza, Sant'Andrea Hospital, Rome, Italy
| | - Federico Venuta
- Thoracic Surgery Unit, University La Sapienza, Policlinico Hospital, Rome, Italy
| | - Erino Angelo Rendina
- Thoracic Surgery Unit, University La Sapienza, Sant'Andrea Hospital, Rome, Italy
| | - Mario Santini
- Thoracic Surgery Unit, University Campania "Luigi Vanvitelli," Naples, Italy
| | | | - Nicola Serra
- Statistic Unit, Department of Public Health, University of Federico II, Naples, Italy
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Rauseo M, Mirabella L, Grasso S, Cotoia A, Spadaro S, D'Antini D, Valentino F, Tullo L, Loizzi D, Sollitto F, Cinnella G. Peep titration based on the open lung approach during one lung ventilation in thoracic surgery: a physiological study. BMC Anesthesiol 2018; 18:156. [PMID: 30382819 PMCID: PMC6211445 DOI: 10.1186/s12871-018-0624-3] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2018] [Accepted: 10/19/2018] [Indexed: 12/22/2022] Open
Abstract
BACKGROUND During thoracic surgery in lateral decubitus, one lung ventilation (OLV) may impair respiratory mechanics and gas exchange. We tested a strategy based on an open lung approach (OLA) consisting in lung recruitment immediately followed by a decremental positive-end expiratory pressure (PEEP) titration to the best respiratory system compliance (CRS) and separately quantified the elastic properties of the lung and the chest wall. Our hypothesis was that this approach would improve gas exchange. Further, we were interested in documenting the impact of the OLA on partitioned respiratory system mechanics. METHODS In thirteen patients undergoing upper left lobectomy we studied lung and chest wall mechanics, transpulmonary pressure (PL), respiratory system and transpulmonary driving pressure (ΔPRS and ΔPL), gas exchange and hemodynamics at two time-points (a) during OLV at zero end-expiratory pressure (OLVpre-OLA) and (b) after the application of the open-lung strategy (OLVpost-OLA). RESULTS The external PEEP selected through the OLA was 6 ± 0.8 cmH2O. As compared to OLVpre-OLA, the PaO2/FiO2 ratio went from 205 ± 73 to 313 ± 86 (p = .05) and CL increased from 56 ± 18 ml/cmH2O to 71 ± 12 ml/cmH2O (p = .0013), without changes in CCW. Both ΔPRS and ΔPL decreased from 9.2 ± 0.4 cmH2O to 6.8 ± 0.6 cmH2O and from 8.1 ± 0.5 cmH2O to 5.7 ± 0.5 cmH2O, (p = .001 and p = .015 vs OLVpre-OLA), respectively. Hemodynamic parameters remained stable throughout the study period. CONCLUSIONS In our patients, the OLA strategy performed during OLV improved oxygenation and increased CL and had no clinically significant hemodynamic effects. Although our study was not specifically designed to study ΔPRS and ΔPL, we observed a parallel reduction of both after the OLA. TRIAL REGISTRATION TRN: ClinicalTrials.gov , NCT03435523 , retrospectively registered, Feb 14 2018.
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Affiliation(s)
- Michela Rauseo
- Department of Anesthesia and Intensive care, University of Foggia, Viale Pinto, 1-71100, Foggia, Italy. .,Interdepartmental Division of Critical Care Medicine, University of Toronto, Toronto, ON, Canada.
| | - Lucia Mirabella
- Department of Anesthesia and Intensive care, University of Foggia, Viale Pinto, 1-71100, Foggia, Italy
| | - Salvatore Grasso
- Department of Anesthesia and Intensive care, University of Bari, Bari, Italy
| | - Antonella Cotoia
- Department of Anesthesia and Intensive care, University of Foggia, Viale Pinto, 1-71100, Foggia, Italy
| | - Savino Spadaro
- Department of Anesthesia and Intensive care, University of Ferrara, Ferrara, Italy
| | - Davide D'Antini
- Department of Anesthesia and Intensive care, University of Foggia, Viale Pinto, 1-71100, Foggia, Italy
| | - Franca Valentino
- Department of Anesthesia and Intensive care, University of Foggia, Viale Pinto, 1-71100, Foggia, Italy
| | - Livio Tullo
- Department of Anesthesia and Intensive care, University of Foggia, Viale Pinto, 1-71100, Foggia, Italy
| | - Domenico Loizzi
- Department of Thoracic Surgery, University of Foggia, Foggia, Italy
| | | | - Gilda Cinnella
- Department of Anesthesia and Intensive care, University of Foggia, Viale Pinto, 1-71100, Foggia, Italy
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Ardò NP, Loizzi D, Sollitto F. Ambulation for enhanced recovery in thoracic surgery: how far can we walk? Video-assist Thorac Surg 2018. [DOI: 10.21037/vats.2018.09.05] [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: 11/06/2022]
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13
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Marasco RD, Loizzi D, Ardò NP, Fatone FN, Sollitto F. Spontaneous Pneumomediastinum After Electronic Cigarette Use. Ann Thorac Surg 2018; 105:e269-e271. [DOI: 10.1016/j.athoracsur.2017.12.037] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/21/2017] [Accepted: 12/26/2017] [Indexed: 11/29/2022]
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Ardò NP, Loizzi D, Panariti S, Piccinin I, Sollitto F. Enhanced recovery pathways in thoracic surgery from Italian VATS group: nursing care program. J Thorac Dis 2018; 10:S529-S534. [PMID: 29629199 DOI: 10.21037/jtd.2017.12.85] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [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: 12/21/2022]
Abstract
Enhanced recovery after surgery (ERAS) is an interprofessional program that can lead to hastened patient recovery and reduced time in hospital. Nursing staff play a key role in the implementation of enhanced recovery protocols. This issue focalizes the role of nurses in ERAS program for patients submitted to Thoracic Surgery, in particular for cases of major lung resection performed by a minimally invasive surgical approach (VATS, video assisted thoracic surgery).
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Affiliation(s)
- Nicoletta Pia Ardò
- Thoracic Surgery Unit, Department of Medical and Surgical Sciences, University of Foggia, Foggia, Italy
| | - Domenico Loizzi
- Thoracic Surgery Unit, Department of Medical and Surgical Sciences, University of Foggia, Foggia, Italy
| | | | - Ivana Piccinin
- Thoracic Surgery Unit, Ospedale San Raffaele, Milano, Italy
| | - Francesco Sollitto
- Thoracic Surgery Unit, Department of Medical and Surgical Sciences, University of Foggia, Foggia, Italy
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Moffa AP, Stoppino LP, Loizzi D, Milillo P. Spontaneous Disappearance of a Pericardial Cyst: Case Report and Literature Review. Korean J Thorac Cardiovasc Surg 2018; 51:72-75. [PMID: 29430434 PMCID: PMC5796623 DOI: 10.5090/kjtcs.2018.51.1.72] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/25/2017] [Revised: 10/21/2017] [Accepted: 10/23/2017] [Indexed: 11/16/2022]
Abstract
Pericardial cysts are rare benign anomalies generally discovered as incidental findings on radiographic images. Rarely, pericardial cysts cause symptoms and may lead to complications. A 56-year-old woman presented to the emergency department for mild chest pain. A cardiovascular and respiratory examination revealed no abnormalities, while a chest X-ray and subsequent thoracic computed tomography (CT) showed a pericardial cyst. The patient refused both percutaneous treatment and thoracic surgery. Three years later, a thoracic CT scan showed that the pericardial cyst had disappeared. Although the spontaneous resolution of these lesions is rare, this article highlights the possibility of conservative management in select cases.
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Affiliation(s)
- Alfonso Fiorelli
- Thoracic Surgery Unit, Università degli Studi della Campania "Luigi Vanvitelli", Naples, Italy
| | - Domenico Loizzi
- Thoracic Surgery Unit, Università degli Studi di Foggia, Foggia, Italy
| | - Mario Santini
- Thoracic Surgery Unit, Università degli Studi della Campania "Luigi Vanvitelli", Naples, Italy
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Caronia FP, Loizzi D, Nicolosi T, Castorina S, Fiorelli A. Tubeless tracheal resection and reconstruction for management of benign stenosis. Head Neck 2017; 39:E114-E117. [DOI: 10.1002/hed.24942] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/24/2016] [Revised: 07/15/2017] [Accepted: 07/28/2017] [Indexed: 11/11/2022] Open
Affiliation(s)
| | - Domenico Loizzi
- Thoracic Surgery Unit; Università degli Studi di Foggia; Foggia Italy
| | - Tommaso Nicolosi
- Dipartimento di Chirurgia Toracica; Centro Clinico e Diagnostico Morgagni; Catania Italy
| | - Sergio Castorina
- Dipartimento di Chirurgia Toracica; Centro Clinico e Diagnostico Morgagni; Catania Italy
| | - Alfonso Fiorelli
- Thoracic Surgery Unit; Università della Campania “Luigi Vanvitelli”; Naples Italy
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Carbonelli C, Giuffreda E, Palmiotti A, Loizzi D, Lococo F, Carpagnano E, Lacedonia D, Sollitto F, Foschino MP. Coexistent Sarcoidosis and Tuberculosis: A Case Report. Respiration 2017; 93:296-300. [DOI: 10.1159/000457804] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2016] [Accepted: 01/20/2017] [Indexed: 11/19/2022] Open
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Sanguedolce F, Loizzi D, Sollitto F, Di Bisceglie M, Lucarelli G, Carrieri G, Bufo P, Cormio L. Bladder Metastases from Lung Cancer: Clinical and Pathological Implications: A Systematic Review. Oncology 2017; 92:125-134. [DOI: 10.1159/000454731] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2016] [Accepted: 11/15/2016] [Indexed: 11/19/2022]
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Loizzi D, Pacella G, Quercia R, Tota F, Cialdella F, Sollitto F. P2.04-046 A Rare Case of Pleuro-Pulmonary Epitheliod Hemangioendothelioma. J Thorac Oncol 2017. [DOI: 10.1016/j.jtho.2016.11.1426] [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: 11/15/2022]
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De Palma A, Sollitto F, Loizzi D, Di Gennaro F, Scarascia D, Carlucci A, Giudice G, Armenio A, Ludovico R, Loizzi M. Chest wall stabilization and reconstruction: short and long-term results 5 years after the introduction of a new titanium plates system. J Thorac Dis 2016; 8:490-8. [PMID: 27076945 DOI: 10.21037/jtd.2016.02.64] [Citation(s) in RCA: 26] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
Abstract
BACKGROUND We report short and long-term results with the dedicated Synthes(®) titanium plates system, introduced 5 years ago, for chest wall stabilization and reconstruction. METHODS We retrospectively analyzed (January 2010 to December 2014) 27 consecutive patients (22 males, 5 females; range 16-83 years, median age 60 years), treated with this system: primary [3] and secondary [8] chest wall tumor; flail chest [5]; multiple ribs fractures [5]; sternal dehiscence-diastasis [3]; sternal fracture [1]; sternoclavicular joint dislocation [1]; Poland syndrome [1]. Short-term results were evaluated as: operating time, post-operative morbidity, mortality, hospital stay; long-term results as: survival, plates-related morbidity, spirometric values, chest pain [measured with Verbal Rating Scale (VRS) and SF12 standard V1 questionnaire]. RESULTS Each patient received from 1 to 10 (median 2) titanium plates/splints; median operating time was 150 min (range: 115-430 min). Post-operative course: 15 patients (55.6%) uneventful, 10 (37%) minor complications, 2 (7.4%) major complications; no post-operative mortality. Median post-operative hospital stay was 13 days (range: 5-129 days). At a median follow-up of 20 months (range: 1-59 months), 21 patients (78%) were alive, 6 (22%) died. Three patients presented long-term plates-related morbidity: plates rupture [2], pin plate dislodgment [1]; two required a second surgical look. One-year from surgery median spirometric values were: FVC 3.31 L (90%), FEV1 2.46 L (78%), DLCO 20.9 mL/mmHg/min (76%). On 21 alive patients, 7 (33.3%) reported no pain (VRS score 0), 10 (47.6%) mild (score 2), 4 (19.1%) moderate (score 4), no-one severe (score >4); 15 (71.5%) reported none or mild, 6 (28.5%) moderate pain influencing quality of life. CONCLUSIONS An optimal chest wall stabilization and reconstruction was achieved with the Synthes(®) titanium plates system, with minimal morbidity, no post-operative mortality, acceptable operating time and post-operative hospital stay. Long-term restoration of a normal respiratory function was achieved, with minimal plates-related morbidity and chest pain.
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Affiliation(s)
- Angela De Palma
- 1 Section of Thoracic Surgery, Department of Emergency and Organ Transplantation, University of Bari "Aldo Moro", Bari, Italy ; 2 Section of Thoracic Surgery, Department of Medical and Surgical Sciences, University of Foggia, Foggia, Italy ; 3 Section of Plastic Surgery and Burn Center, Department of Emergency and Organ Transplantation, University of Bari "Aldo Moro", Bari, Italy
| | - Francesco Sollitto
- 1 Section of Thoracic Surgery, Department of Emergency and Organ Transplantation, University of Bari "Aldo Moro", Bari, Italy ; 2 Section of Thoracic Surgery, Department of Medical and Surgical Sciences, University of Foggia, Foggia, Italy ; 3 Section of Plastic Surgery and Burn Center, Department of Emergency and Organ Transplantation, University of Bari "Aldo Moro", Bari, Italy
| | - Domenico Loizzi
- 1 Section of Thoracic Surgery, Department of Emergency and Organ Transplantation, University of Bari "Aldo Moro", Bari, Italy ; 2 Section of Thoracic Surgery, Department of Medical and Surgical Sciences, University of Foggia, Foggia, Italy ; 3 Section of Plastic Surgery and Burn Center, Department of Emergency and Organ Transplantation, University of Bari "Aldo Moro", Bari, Italy
| | - Francesco Di Gennaro
- 1 Section of Thoracic Surgery, Department of Emergency and Organ Transplantation, University of Bari "Aldo Moro", Bari, Italy ; 2 Section of Thoracic Surgery, Department of Medical and Surgical Sciences, University of Foggia, Foggia, Italy ; 3 Section of Plastic Surgery and Burn Center, Department of Emergency and Organ Transplantation, University of Bari "Aldo Moro", Bari, Italy
| | - Daniele Scarascia
- 1 Section of Thoracic Surgery, Department of Emergency and Organ Transplantation, University of Bari "Aldo Moro", Bari, Italy ; 2 Section of Thoracic Surgery, Department of Medical and Surgical Sciences, University of Foggia, Foggia, Italy ; 3 Section of Plastic Surgery and Burn Center, Department of Emergency and Organ Transplantation, University of Bari "Aldo Moro", Bari, Italy
| | - Annalisa Carlucci
- 1 Section of Thoracic Surgery, Department of Emergency and Organ Transplantation, University of Bari "Aldo Moro", Bari, Italy ; 2 Section of Thoracic Surgery, Department of Medical and Surgical Sciences, University of Foggia, Foggia, Italy ; 3 Section of Plastic Surgery and Burn Center, Department of Emergency and Organ Transplantation, University of Bari "Aldo Moro", Bari, Italy
| | - Giuseppe Giudice
- 1 Section of Thoracic Surgery, Department of Emergency and Organ Transplantation, University of Bari "Aldo Moro", Bari, Italy ; 2 Section of Thoracic Surgery, Department of Medical and Surgical Sciences, University of Foggia, Foggia, Italy ; 3 Section of Plastic Surgery and Burn Center, Department of Emergency and Organ Transplantation, University of Bari "Aldo Moro", Bari, Italy
| | - Andrea Armenio
- 1 Section of Thoracic Surgery, Department of Emergency and Organ Transplantation, University of Bari "Aldo Moro", Bari, Italy ; 2 Section of Thoracic Surgery, Department of Medical and Surgical Sciences, University of Foggia, Foggia, Italy ; 3 Section of Plastic Surgery and Burn Center, Department of Emergency and Organ Transplantation, University of Bari "Aldo Moro", Bari, Italy
| | - Rossana Ludovico
- 1 Section of Thoracic Surgery, Department of Emergency and Organ Transplantation, University of Bari "Aldo Moro", Bari, Italy ; 2 Section of Thoracic Surgery, Department of Medical and Surgical Sciences, University of Foggia, Foggia, Italy ; 3 Section of Plastic Surgery and Burn Center, Department of Emergency and Organ Transplantation, University of Bari "Aldo Moro", Bari, Italy
| | - Michele Loizzi
- 1 Section of Thoracic Surgery, Department of Emergency and Organ Transplantation, University of Bari "Aldo Moro", Bari, Italy ; 2 Section of Thoracic Surgery, Department of Medical and Surgical Sciences, University of Foggia, Foggia, Italy ; 3 Section of Plastic Surgery and Burn Center, Department of Emergency and Organ Transplantation, University of Bari "Aldo Moro", Bari, Italy
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Fiorelli A, Caronia F, Daddi N, Loizzi D, Ampollini L, Ardò N, Potenza R, Carbognani P, Ardissone F, Sollitto F, Mattioli S, Puma F, Santini M, Ragusa M. F-080SUBLOBAR RESECTIONS VERSUS LOBECTOMY FOR STAGE I NON-SMALL-CELL LUNG CANCER: AN APPROPRIATE CHOICE IN HIGH-RISK ELDERLY PATIENTS? Interact Cardiovasc Thorac Surg 2015. [DOI: 10.1093/icvts/ivv204.80] [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: 11/14/2022] Open
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Caronia FP, Loizzi D, Fiorelli A. P-193TRACHEAL RESECTION WITH PATIENT UNDER LOCAL ANAESTHESIA AND SEDATION. Interact Cardiovasc Thorac Surg 2015. [DOI: 10.1093/icvts/ivv204.193] [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: 11/13/2022] Open
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Sollitto F, Ardò N, Tota F, Cialdella F, Loizzi D. P-288OESOPHAGEAL BYPASS IN PALLIATIVE TREATMENT OF A MALIGNANT BRONCHO-OESOPHAGEAL FISTULA. Interact Cardiovasc Thorac Surg 2015. [DOI: 10.1093/icvts/ivv204.288] [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: 11/12/2022] Open
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De Palma A, Pagliarulo V, Ardò N, Loizzi D. Surgical treatment of a rare case of epithelioid hemangioendothelioma of the azygos vein. Interact Cardiovasc Thorac Surg 2011; 14:91-3. [PMID: 22108950 DOI: 10.1093/icvts/ivr064] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022] Open
Abstract
Epithelioid hemangioendothelioma (EHE) of soft tissues is a rare low-grade vascular tumour, with variable malignancy. Mediastinal localization is exceptional. We report the first case of a radically resected EHE of the azygos vein (AV). A 47-year old man presented to our institution with an asymptomatic incidental neck-chest computerized tomography (CT) evidence of a 3 cm mediastinal mass, resembling a station 4R lymphadenopathy, with rather distinct margins, strictly adjacent to the AV. (18)F-fluorodeoxyglucose positron emission tomography (FDG-PET)/CT revealed a SUV max of 2.3. Fiberbronchoscopy with EBUS-trans-tracheal needle aspiration of station 4R yielded nondiagnostic cytology result. A right lateral thoracotomy revealed an ovoidal mediastinal mass originating from the AV, unresectable from it but showing cleavage from the superior vena cava. The mass with the involved AV was resected en bloc by vascular stapler. Histopathology revealed a venous EHE arising from the AV. For the low mitotic rate and small tumour size, no adjuvant therapy was administered. Total body CT scan at one year from surgery shows neither local recurrence, nor distant metastases. EHE should be considered in the differential diagnosis of mediastinal masses in adult patients. After radical removal prognosis is generally favourable, but strict follow-up must be performed because aggressive forms have been described.
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Affiliation(s)
- Angela De Palma
- Department of Thoracic Surgery, University of Bari, Bari, Italy.
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Abstract
Doubts still exist concerning the mechanisms involved in ocular ischemic syndrome (OIS) and its dependence on carotid disease. We report findings from 14 surgical patients undergoing carotid artery reconstruction for symptomatic cerebrovascular disease. All of them had fluorescein angiography (FA) of the eye ipsilateral to the carotid operation before surgery and 3 months after to provide information regarding retinal circulation time. Before the surgical procedure, the mean circulation time was 29.4 ± 9.4 seconds (CI 95%: 24.5-34.3). After 3 months, a significant (P < .001) decrease in the circulation time was observed: 18.9 ± 8.4 seconds (CI 95%: 14.5-23.4). The present series demonstrates that carotid revascularization surgery improved retinal flow in approximately 80% of the patients.
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Affiliation(s)
- Giuseppe Cardia
- Unità Operativa Chirurgia G. Marinaccio, Università di Bari, Italy
| | | | | | - Domenico Loizzi
- Dipartimento di Scienze Chirurgiche, Università di Foggia, Italy
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De Palma A, Loizzi D, Sollitto F, Loizzi M. Surgical treatment of a rare case of tracheal inflammatory pseudotumor in pediatric age. Interact Cardiovasc Thorac Surg 2009; 9:1035-7. [PMID: 19783544 DOI: 10.1510/icvts.2009.216499] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022] Open
Abstract
Tracheal inflammatory pseudotumor (IPT) is a rare solid lesion with an unpredictable biological course. Treatment can vary and surgical resection may sometimes be necessary, even in pediatric age. We report the case of a 12-year-old male patient who presented to our institution with sudden dyspnoea after some months of wheezing and cough, wrongly considered and treated as asthma. Neck-chest CT-scan and fiberbronchoscopy showed an intraluminal tracheal mass, originating from the left antero-lateral wall at the level of the 5th cartilagineous tracheal ring, involving three rings, that was removed by rigid bronchoscopy. Histopathology revealed a tracheal IPT. Due to rapid tendency to recurrence of the lesion, two more endoscopic recanalizations were performed, but a new recurrence appeared, with CT evidence of transmural involvement of the tracheal wall. Resection of the three involved tracheal rings and termino-terminal tracheal anastomosis were successfully performed through cervicotomy and sternal split. CT-scan and fiberbronchoscopy at 17 months from surgery show a stable tracheal lumen without signs of recurrence. A tracheal IPT should be suspected in any pediatric patients with tracheal mass and asthmatic symptoms. After radical removal prognosis is generally excellent and recurrences after tracheal resection are rare.
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Affiliation(s)
- Angela De Palma
- Sezione di Chirurgia Toracica, Università degli Studi di Bari, Piazza Giulio Cesare 11, 70124 Bari, Italy.
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Amico A, Brigiani MS, Vallabini A, Ferrante B, Marzovillo A, Loizzi D, Carbone C. PulseCath, a new short-term ventricular assist device: our experience in off-pump coronary artery bypass graft surgery. J Cardiovasc Med (Hagerstown) 2008; 9:423-6. [DOI: 10.2459/jcm.0b013e3282eee851] [Citation(s) in RCA: 14] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
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Loizzi M, De Palma A, Lacitignola A, Genualdo M, Loizzi D, Capotorto G, Spada E, Sollitto F. [Autofluorescence bronchoscopy in early diagnosis of pulmonary carcinoma]. MINERVA CHIR 2005; 60:497-503. [PMID: 16402004] [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: 05/06/2023]
Abstract
AIM Autofluorescence bronchoscopy (AFB) has been proposed to widen traditional white light bronchoscopy (WLB) possibilities of early diagnosis of neoplastic and preneoplastic lesions of the tracheo-bronchial mucosa in high risk groups. The authors report their study on AFB with the aim of establishing its role in the early diagnosis of bronchogenic carcinoma and its positive predictive value (PPV) compared and associated to WLB. METHODS From May 2002 to May 2004 we performed WLB and AFB in 213 patients (177 males, 36 females), mean age 63.7 years (range 18-84 years), who were divided into 2 main groups (group A: patients at risk for bronchogenic carcinoma, n=82; group B: patients to be operated on for bronchogenic carcinoma, n=131). In total, 237 WLB-AFB were performed (101 in group A, 136 in group B) and 77 biopsies for pathological examination. RESULTS The 2 tools (WLB and AFB) were concordant in 156 (66%) and discordant in 81 (34%) cases. Considering the biopsies performed, we obtained a PPV of 26% for lesions visible with WLB, of 40% for those visible with AFB, of 38% for those visible with the association of both. In group A, in 56 patients of the follow-up subgroup, we found 2 dysplastic areas and 1 carcinoma in situ. In group B there was a discordant extension of the pathologic area visible with WLB and with AFB in 30 cases which was positive in 18 of them at histological examination. CONCLUSIONS In our experience, AFB has revealed to be a valid tool for both early diagnosis of neoplastic recurrences or a second primary lung neoplasia in patients in follow-up after resection and preoperative evaluation of resection margins in patients candidate to surgery. More studies are needed to widen its indications in the early diagnosis in high risk groups, to improve its potentialities and optimize its learning curve in order to establish the procedural guide lines.
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Affiliation(s)
- M Loizzi
- U.O.C. di Chirurgia Toracica, Università degli Studi di Bari, Bari.
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