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Article ; Online: Colorectal surgery in 2023: BJS Open highlights and editors' choices.

Lorenzon, Laura / McDermott, Frank D

BJS open

2024 Volume 8, Issue 1

Language	English
Publishing date	2024-02-07
Publishing country	England
Document type	Journal Article
ISSN	2474-9842
ISSN (online)	2474-9842
DOI	10.1093/bjsopen/zrae006
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Article ; Online: Conversion rate to open surgery during transanal total mesorectal excision (TaTME) for rectal cancer: a single-center experience.

Tirelli, Flavio / Lorenzon, Laura / Biondi, Alberto / Neri, Ilaria / Santoro, Gloria / Persiani, Roberto

Updates in surgery

2024

Abstract: Minimally invasive techniques for rectal cancer have demonstrated considerable advantages in terms of faster recovery and less post-operative complications. However, due to the complex anatomy and a limited surgical field, conversion to open surgery is ... ...

Abstract	Minimally invasive techniques for rectal cancer have demonstrated considerable advantages in terms of faster recovery and less post-operative complications. However, due to the complex anatomy and a limited surgical field, conversion to open surgery is still sometimes required, with a negative impact on the short-and long-term outcomes. The purpose of this study was to analyse the conversion rate to open abdominal surgery during laparoscopic transanal total mesorectal excision (TaTME) procedures performed at a high-volume Italian referral center. All consecutive TaTME performed for mid-to-low rectal cancer between 2015 and 2023 were reviewed, independently if treated with a primary anastomosis (with/without a diverting ostomy) or an end stoma. All procedures were performed using a standardized approach by the same surgical team. Patients with benign diagnosis that underwent different-from rectal resection procedures and cases pre-operatively scheduled for open surgery were excluded. The primary outcome of interest was the rate of conversion, defined as an un-planned intraoperative switch to open surgery using a midline laparotomy. Secondary aims included the comparison of patients who had a longer vs shorter operative time. Out of 220 patients, 210 were selected. In 187 cases, a primary anastomosis was performed, while 23 patients received a terminal colostomy (1 in the converted group; 22 in the full MIS- TaTME group, 10.6%). A surgical approach modification occurred in two cases, with a conversion rate of 0.95%. Median operative time was 281 min. Reasons for conversions included intra-operative difficulties impairing the mini-invasive procedure without intra-operative complications in one case, and difficulties in the laparoscopic control of an intraoperative bleeding due to a splenic lesion in another patient. Male sex and a higher BMI were found to be statistically significantly associated to longer operative time (respectively: p = 0.001 and p = 0.0025). In a high-volume center, a standardized TaTME is associated to a low conversion rate to open abdominal surgery.
Language	English
Publishing date	2024-04-28
Publishing country	Italy
Document type	Journal Article
ZDB-ID	2572692-4
ISSN	2038-3312 ; 2038-131X
ISSN (online)	2038-3312
ISSN	2038-131X
DOI	10.1007/s13304-024-01844-0
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Article ; Online: Pietro Valdoni (1900-1976): The Father of Italian Modern Surgery.

Lorenzon, Laura

Journal of surgical education

2015 Volume 72, Issue 5, Page(s) 1064–1065

MeSH term(s)	General Surgery/history ; History, 20th Century ; Humans ; Italy
Language	English
Publishing date	2015-09
Publishing country	United States
Document type	Biography ; Historical Article ; Journal Article
ZDB-ID	2277538-9
ISSN	1878-7452 ; 1931-7204
ISSN (online)	1878-7452
ISSN	1931-7204
DOI	10.1016/j.jsurg.2015.06.006
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Article ; Online: Reply to: Tumour Biology and lack of standardization in assessment of ypT0 has an impact on survival in patients with locally advanced rectal cancers achieving complete pathological response after neoadjuvant chemoradiation.

Lorenzon, Laura / Polom, Karol

European journal of surgical oncology : the journal of the European Society of Surgical Oncology and the British Association of Surgical Oncology

2020 Volume 46, Issue 8, Page(s) 1562–1563

MeSH term(s)	Biology ; Humans ; Neoadjuvant Therapy ; Rectal Neoplasms ; Rectum ; Reference Standards
Language	English
Publishing date	2020-04-29
Publishing country	England
Document type	Letter ; Comment
ZDB-ID	632519-1
ISSN	1532-2157 ; 0748-7983
ISSN (online)	1532-2157
ISSN	0748-7983
DOI	10.1016/j.ejso.2020.04.040
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Zs.A 1149: Show issues			Location: Je nach Verfügbarkeit (siehe Angabe bei Bestand) bis Jg. 1994: Bestellungen von Artikeln über das Online-Bestellformular Jg. 1995 - 2021: Lesesall (1.OG) ab Jg. 2022: Lesesaal (EG)
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Article ; Online: '4-Check' protocol for intraoperative anastomotic assessment during transanal total mesorectal excision: retrospective cohort study.

Tirelli, Flavio / Lorenzon, Laura / Biondi, Alberto / Neri, Ilaria / Santoro, Gloria / Persiani, Roberto

BJS open

2023 Volume 7, Issue 4

Abstract: Background: Anastomotic leakage is a major complication following rectal cancer surgery. The primary aim of this study was to investigate the efficacy of a protocol based on a quadruple intraoperative anastomotic assessment (4-Check) during transanal ... ...

Abstract	Background: Anastomotic leakage is a major complication following rectal cancer surgery. The primary aim of this study was to investigate the efficacy of a protocol based on a quadruple intraoperative anastomotic assessment (4-Check) during transanal total mesorectal excision (TaTME). Methods: Patients who underwent TaTME for rectal cancer with primary anastomosis were reviewed and divided into two groups: before (pre-4-Check: April 2015 - April 2019) and after the implementation of the 4-Check protocol (May 2019 - May 2022). This protocol consisted of a multimodal anastomotic integrity assessment, including indocyanine green-evaluation of colonic stump and intraluminal anastomosis perfusion, a reverse air leak test and anastomotic doughnuts assessment. The primary outcome was incidence of clinical and/or radiological anastomotic leakage. The secondary outcome included intraoperative anastomosis defects and repairs and 30-day complication rate. Propensity score matching and multivariable analyses were performed. Results: Of 186 patients, 160 were selected: 86 patients in the pre-4-Check and 74 in the 4-Check group. After propensity score matching, there was no difference in postoperative anastomotic leakage (pre-4-Check versus 4-Check: 11.1 per cent versus 7.4 per cent; P = 0.50). However, in the 4-Check group, the intraoperative detection of defects and repairs was significantly increased (P = 0.03), and the number of complications was reduced (pre-4-Check versus 4-Check: 33.3 per cent versus 9.3 per cent, P = 0.004). Multivariable analyses confirmed that the use of the 4-Check protocol, the detection of anastomotic defects and increased albumin levels were associated with a reduced number of complications. Conclusion: The 4-Check protocol allowed the intraoperative detection and repair of anastomotic defects. Anastomotic leakage rates were not reduced; however, 30-day complication rates were lower after implementation of this protocol.
MeSH term(s)	Humans ; Anastomotic Leak/diagnosis ; Anastomotic Leak/etiology ; Retrospective Studies ; Rectum/surgery ; Anastomosis, Surgical/adverse effects ; Rectal Neoplasms/surgery
Language	English
Publishing date	2023-08-03
Publishing country	England
Document type	Journal Article
ISSN	2474-9842
ISSN (online)	2474-9842
DOI	10.1093/bjsopen/zrad072
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Article ; Online: Impact of Randomized Controlled Trials in the Social Media: Does Science Trend As Much As Everyday Events?

Lorenzon, Laura / Grossman, Rebecca C / Soreide, Kjetil

World journal of surgery

2020 Volume 45, Issue 1, Page(s) 88–96

Abstract: Background: The approach to the scientific literature is evolving. Currently, dissemination of articles happens in real time through social media (SoMe) channels, and little is known about its impact in medicine. The aim of this study was to investigate ...

Abstract	Background: The approach to the scientific literature is evolving. Currently, dissemination of articles happens in real time through social media (SoMe) channels, and little is known about its impact in medicine. The aim of this study was to investigate if SoMe dissemination followed trends independent from articles type and content. Methods: First, the SoMe engagement of a popular theme (#BlackFriday) and a relevant theme (#ClimateChange) was compared using a SoMe analytic tool to test if the popular theme would reach more engagement. In a second analysis, themes in colorectal surgery in the SoMe community were explored. Altmetric Explorer was searched for the term "colorectal surgery" and the outputs were categorized into 'randomized controlled trials' (RCTs) and 'other studies'. Subgroups were compared for the Altmetric scores using statistical analyses. Results: The analytic tool documented that #BlackFriday outnumbered #ClimateChange in mentions and engagement (1.6 million vs 127.000 mentions). Following, Altmetric Explorer identified 1381 articles, including 92 RCTs (7.1%). Overall, 25,554 mentions were documented from 1205 outputs (97.0% by Twitter). A greater percentage of "other studies" ranked in the lower Altmetric score categories (p = 0.0007). Similarly, the median Altmetric score was higher in the RCT subgroup comparing with "other studies" (6.5 vs. 2.0, Mann-Whitney p = 0.0001). Conclusions: In this study, RCTs represented just the 7.1% of the studies and produced 11% of Twitter outputs. The median Altmetric scores obtained by RCTs were higher than those of other studies.
MeSH term(s)	Bibliometrics ; Humans ; Information Dissemination ; Journal Impact Factor ; Medicine/statistics & numerical data ; Randomized Controlled Trials as Topic ; Social Media/statistics & numerical data
Language	English
Publishing date	2020-09-05
Publishing country	United States
Document type	Journal Article
ZDB-ID	224043-9
ISSN	1432-2323 ; 0364-2313
ISSN (online)	1432-2323
ISSN	0364-2313
DOI	10.1007/s00268-020-05769-8
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Zs.A 1336: Show issues

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Article ; Online: Probable awake bruxism - prevalence and associated factors: a cross-sectional study.

Hilgenberg-Sydney, Priscila Brenner / Lorenzon, Ana Laura / Pimentel, Giovanna / Petterle, Ricardo Rasmussen / Bonotto, Daniel

Dental press journal of orthodontics

2022 Volume 27, Issue 4, Page(s) e2220298

Abstract: Introduction: Bruxism is defined as a repetitive activity of masticatory muscles, characterized by the clenching or grinding of the teeth, which can occur during wakefulness (awake bruxism) or during sleep (sleep bruxism).: Objectives: The objectives ...

Abstract	Introduction: Bruxism is defined as a repetitive activity of masticatory muscles, characterized by the clenching or grinding of the teeth, which can occur during wakefulness (awake bruxism) or during sleep (sleep bruxism). Objectives: The objectives of the present study were to determine the prevalence of awake bruxism and its associated factors. Methods: Sample was composed by 50 participants of both genders, aged between 18 and 60 years, submitted to a clinical examination - to observe the presence of tooth wear, marks on the mucosa, or masseter muscles hypertrophy - and self-applied questionnaires, which evaluated the presence of TMD signs and symptoms, oral behaviors, lifestyles, anxiety level and sleep quality. Results: The prevalence of awake bruxism was 48%. Its presence was statistically and significantly associated with the presence of signs and symptoms of TMD (p= 0.002), poor sleep quality (p = 0.032), buccal mucosa indentations (p < 0.001) and tongue (p = 0.011). Age, gender, social characteristics, habits (such as coffee ingestion, smoking, alcoholism and physical activity) and tooth wear were variables that had no significant association with awake bruxism. Conclusions: It was concluded that awake bruxism shows a high prevalence and a positive association with signs and symptoms of TMD and worst sleep quality. In addition, awake bruxism is more likely to occur in individuals who have buccal mucosa indentation and who present high rates of oral habits and oral behaviors.
MeSH term(s)	Adolescent ; Adult ; Bruxism/diagnosis ; Bruxism/epidemiology ; Cross-Sectional Studies ; Female ; Humans ; Male ; Middle Aged ; Prevalence ; Sleep Bruxism/diagnosis ; Sleep Bruxism/epidemiology ; Tooth Wear ; Wakefulness ; Young Adult
Language	English
Publishing date	2022-08-15
Publishing country	Brazil
Document type	Journal Article
ZDB-ID	2721511-8
ISSN	2177-6709 ; 2177-6709
ISSN (online)	2177-6709
ISSN	2177-6709
DOI	10.1590/2177-6709.27.4.e2220298.oar
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Article: Quality Over Volume: Modeling Centralization of Gastric Cancer Resections in Italy.

Lorenzon, Laura / Biondi, Alberto / Agnes, Annamaria / Scrima, Ottavio / Persiani, Roberto / D'Ugo, Domenico

Journal of gastric cancer

2022 Volume 22, Issue 1, Page(s) 35–46

Abstract: Background: The correlation between hospital volume and postoperative outcomes has led to the centralization of complex procedures in several countries. However, the results reported in relation to gastric cancer (GC) are contradictory. This study aimed ...

Abstract	Background: The correlation between hospital volume and postoperative outcomes has led to the centralization of complex procedures in several countries. However, the results reported in relation to gastric cancer (GC) are contradictory. This study aimed to analyze GC surgical volumes and 30-day postoperative mortality in Italy and to provide a simulation for modeling centralization of GC resections based on district case volumes. Methods: A national registry was used to identify all GC resections, record mortality rates, and track the national in-border GC resection health travel. Hospitals were grouped according to caseload. Centralization of all GC procedures performed within the same district was modeled. The outcome measures were a minimal volume of 25 GC resections/year and the 30-day postoperative mortality. Results: In 2018, 5,873 GC resections were performed in 498 Italian hospitals (mean resections per hospital per year: 11.8); the postoperative mortality rate (5.51%) was tracked from 2016-2018. GC resection health travel ranged from 2% to 50.5%, with a significant (P<0.001) difference between northern and central/southern Italy. The mean mortality rate was 7.7% in hospitals performing one to 3 GC resections per year, compared with 4.7% in those with >17 GC resections/year (P≤0.01). Most Italian districts achieved 25 procedures/year after centralization; however, 66.3% of GC cases in southern Italy vs. 42.2% in central and 52.7% in the northern regions (P<0.001) required reallocation. Conclusion: Postoperative mortality after GC resection correlated with hospital volume. Despite health travel, most Italian districts can reach a high-volume threshold, but discrepancies in mortality rates are alarming.Trial Registration
Language	English
Publishing date	2022-02-24
Publishing country	Korea (South)
Document type	Journal Article
ZDB-ID	2637180-7
ISSN	2093-5641 ; 2093-582X
ISSN (online)	2093-5641
ISSN	2093-582X
DOI	10.5230/jgc.2022.22.e4
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Article ; Online: Openly accessed and openly published: a celebration of international high-impact surgical research.

Sallinen, Ville / Darvall, Katy / Lorenzon, Laura / McDermott, Frank / Marchegiani, Giovanni

BJS open

2021 Volume 5, Issue 5

MeSH term(s)	Humans ; Publications
Language	English
Publishing date	2021-09-17
Publishing country	England
Document type	Journal Article
ISSN	2474-9842
ISSN (online)	2474-9842
DOI	10.1093/bjsopen/zrab100
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Article ; Online: The definition of "R1" lymph node dissection status in patients undergoing curative-aim gastrectomy for gastric carcinoma: A proof of concept study.

Biondi, Alberto / Agnes, Annamaria / Laurino, Antonio / Moretta, Pasquale / Lorenzon, Laura / D'Ugo, Domenico / Persiani, Roberto

Surgical oncology

2023 Volume 48, Page(s) 101908

Abstract: Introduction: The aim of this study was to define and investigate the prognostic impact of "R1-Lymph-node dissection" during gastrectomy.: Methods: This was a retrospective study conducted with 499 patients undergoing curative-aim gastrectomy. We ... ...

Abstract	Introduction: The aim of this study was to define and investigate the prognostic impact of "R1-Lymph-node dissection" during gastrectomy. Methods: This was a retrospective study conducted with 499 patients undergoing curative-aim gastrectomy. We defined R1-Lymph dissection as an involvement of lymph node stations anatomically connected with lymph node stations outside the declared level of dissection (D1 to D2+). The primary outcomes were disease-free and disease-specific survival (DFS and DSS). Results: At multivariable analysis, the type of gastrectomy, pT and pN were associated with DFS, and the type of gastrectomy, R1-Margin status, R1-Lymph status, pT, pN and adjuvant therapy were associated with DSS. Moreover, pT and R1-Lymph status were the only factors associated with overall loco-regional recurrence. Conclusions: In this study, we introduced the concept of R1-Lymph-node dissection, which was significantly associated with DSS and appeared to be a stronger prognostic factor for loco-regional recurrence than the R1 status on the resection margin.
MeSH term(s)	Humans ; Retrospective Studies ; Proof of Concept Study ; Lymph Node Excision ; Gastrectomy ; Stomach Neoplasms/pathology ; Carcinoma/surgery
Language	English
Publishing date	2023-02-02
Publishing country	Netherlands
Document type	Journal Article
ZDB-ID	1107810-8
ISSN	1879-3320 ; 0960-7404
ISSN (online)	1879-3320
ISSN	0960-7404
DOI	10.1016/j.suronc.2023.101908
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