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Article ; Online: Open Technique.

Costi, Renato / Baldinu, Manuel / Montali, Filippo / Annicchiarico, Alfredo

2023 Volume 94, Issue 5, Page(s) e2023231

Abstract: ...

Abstract	.
Language	English
Publishing date	2023-10-17
Publishing country	Italy
Document type	Letter
ZDB-ID	2114240-3
ISSN	2531-6745 ; 0392-4203
ISSN (online)	2531-6745
ISSN	0392-4203
DOI	10.23750/abm.v94i5.13541
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Article ; Online: Leiomyosarcoma of the rectum: A systematic review of recent literature.

Annicchiarico, Alfredo / Montali, Filippo / Baldinu, Manuel / Casali, Lorenzo / Virgilio, Edoardo / Costi, Renato

Journal of surgical oncology

2023 Volume 129, Issue 2, Page(s) 365–380

Abstract: Leiomyosarcomas (LMSs) are rare tumors originating from the muscular layer. We performed a literature review of cases of confirmed rectal leiomyosarcomas (rLMSs) to clarify the history of such an infrequent tumor arising at such an uncommon location. In ... ...

Abstract	Leiomyosarcomas (LMSs) are rare tumors originating from the muscular layer. We performed a literature review of cases of confirmed rectal leiomyosarcomas (rLMSs) to clarify the history of such an infrequent tumor arising at such an uncommon location. In this research local recurrence was related to poorly differentiated rLMS and no other association between recurrence and any criteria was found. Concerning overall survival (OS), rLMS patients developing recurrence presented shorter longevity compared with the group without.
MeSH term(s)	Humans ; Leiomyosarcoma/surgery ; Leiomyosarcoma/pathology ; Rectum/surgery ; Rectum/pathology ; Rectal Neoplasms/surgery ; Rectal Neoplasms/pathology ; Pelvis/pathology
Language	English
Publishing date	2023-10-10
Publishing country	United States
Document type	Systematic Review ; Journal Article ; Review
ZDB-ID	82063-5
ISSN	1096-9098 ; 0022-4790
ISSN (online)	1096-9098
ISSN	0022-4790
DOI	10.1002/jso.27481
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Montali, Filippo / Baldinu, Manuel / Annicchiarico, Alfredo / Virgilio, Edoardo / Costi, Renato

Acta bio-medica : Atenei Parmensis

2022 Volume 93, Issue S1, Page(s) e2022273

Abstract: Amyand's hernia (AH) is a rare condition in which the appendix is found in the sac of an inguinal hernia. It occurs in only 1% of adult inguinal hernias. The herniated appendix can occasionally range varying degrees of acute inflammation up to neoplastic ...

Abstract	Amyand's hernia (AH) is a rare condition in which the appendix is found in the sac of an inguinal hernia. It occurs in only 1% of adult inguinal hernias. The herniated appendix can occasionally range varying degrees of acute inflammation up to neoplastic transformation. An appendiceal tumor can be rarely described inside the AH sac. We describe a case of gangrenous appendicitis in AH and offer a review of the literature on AH when presenting with appendicitis associated with appendiceal cancer. As of 2022, only nine cases of AH presenting with appendicitis associated with appendiceal cancer have been reported by the pertinent literature. In order of decreasing frequency, AH, AH-related appendicitis and AH-related appendicitis associated with appendiceal cancer are three rare conditions. Particular attention should be kept in each situation as diagnosis is achieved postoperatively most of the times.
MeSH term(s)	Adult ; Appendiceal Neoplasms/complications ; Appendiceal Neoplasms/pathology ; Appendicitis/complications ; Appendicitis/surgery ; Appendix/pathology ; Data Collection ; Hernia, Inguinal/complications ; Hernia, Inguinal/surgery ; Humans
Language	English
Publishing date	2022-09-22
Publishing country	Italy
Document type	Case Reports ; Journal Article ; Review
ZDB-ID	2114240-3
ISSN	2531-6745 ; 0392-4203
ISSN (online)	2531-6745
ISSN	0392-4203
DOI	10.23750/abm.v93iS1.13322
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Article ; Online: Open surgical cholecystostomy under local anaesthesia as salvage therapy of acute cholecystitis during the 4th COVID-19 wave in Northern Italy: experience from a rural hospital.

Montali, Filippo / Virgilio, Edoardo / Ballabeni, Lucia / Bignone, Maddalena / Rollo, Alessio / Costi, Renato

Acta bio-medica : Atenei Parmensis

2023 Volume 94, Issue S1, Page(s) e2023208

Abstract: The COVID-19 pandemic outbreak delayed interventions of elective surgery worldwide. In Italy, the first western country to be affected, 410000 operations formerly planned were cancelled with the beginning of the first wave. Symptomatic cholelithiasis ... ...

Abstract	The COVID-19 pandemic outbreak delayed interventions of elective surgery worldwide. In Italy, the first western country to be affected, 410000 operations formerly planned were cancelled with the beginning of the first wave. Symptomatic cholelithiasis represents one of the most common, benign medical conditions in the world leading the affected patients to general surgeons'attention; in 0.5% of cases gallstones (symptomatic or not) can complicate with acute lithiasic cholecystitis (ALC) whose universally acknowledged treatment of choice is laparoscopic cholecystectomy. Delaying in surgery of ALC can increase the rate of complications like severe ALC, acute cholangitis and sepsis. The 4th wave of COVID 19 in Northern Italy induced further stress on the healthcare system. In fact, the occurrence of difficult communication and delays in ALC patients transfer between first and second level hospitals lead to the re-emergence of obsolete surgical procedures. In our rural hospital, in fact, a 92 years old patient affected with ALC and several comorbidities was treated with a successful emergency surgical procedure of transperitoneal cholecistostomy in lieu of a radiological transperitoneal approach. Such a choice was dictated by the absence of an interventional radiology unit in our hospital as well as the unavailability of patient transfer to our central referral hub (the hospital of Parma) due to hospital overcrowding secondary to the 4th wave of COVID 19 pandemic.
MeSH term(s)	Humans ; Aged, 80 and over ; Cholecystostomy/methods ; Cholecystitis/surgery ; Hospitals, Rural ; Salvage Therapy ; Anesthesia, Local ; Pandemics ; COVID-19 ; Cholecystitis, Acute/surgery ; Treatment Outcome ; Retrospective Studies
Language	English
Publishing date	2023-07-24
Publishing country	Italy
Document type	Journal Article
ZDB-ID	2114240-3
ISSN	2531-6745 ; 0392-4203
ISSN (online)	2531-6745
ISSN	0392-4203
DOI	10.23750/abm.v94iS1.13586
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Article ; Online: Hypothermic Machine Perfusion and Spontaneous Kidney Allograft Rupture: Causation or Correlation? A Case Report and Review of Pertinent Literature.

Montali, Filippo / Annicchiarico, Alfredo / Grisales, Paula / Panarese, Alessandra / Pisani, Francesco

Transplantation proceedings

2022

Abstract: Background: Spontaneous kidney allograft rupture (KAR) is a severe complication of kidney transplant. KAR occurs when no identifiable injuries noted at the time of the organ retrieval are present. KAR is associated with acute rejection, renal vein ... ...

Abstract	Background: Spontaneous kidney allograft rupture (KAR) is a severe complication of kidney transplant. KAR occurs when no identifiable injuries noted at the time of the organ retrieval are present. KAR is associated with acute rejection, renal vein thrombosis, severe acute tubular necrosis, or trauma. In recent years, the introduction of hypothermic machine perfusion (HMP) has provided an excellent option for kidney allograft preservation reducing the incidence of delayed graft function. On the other hand, HMP can also represent a potentially traumatic event for a fragile graft, especially one belonging to expanded criteria donor. Case presentation: Here, to our knowledge, we report the first case of KAR after the use of HMP, which occurred in 60-year-old women undergoing a single kidney transplant from a donation after brain death donor belonging to the expanded criteria donor category. The allograft was perfused for 240 minutes with HMP with passive oxygenation. The post-transplant course was unremarkable with early graft function, but on post operatory day 14 the patient complained of severe pain over the transplant site. A computed tomography scan showed a massive fluid collection in the perigraft region. Immediate surgical exploration showed 2 lacerations of 10 cm and 5 cm length at the upper and midpole of the kidney, requiring transplantectomy. Histologically, the graft did not show features of acute rejection. Conclusions: In the presented case, the repair and salvage of the kidney allograft was not possible. However, the review of the pertinent literature does not report another case linking HMP to KAR.
Language	English
Publishing date	2022-11-21
Publishing country	United States
Document type	Case Reports
ZDB-ID	82046-5
ISSN	1873-2623 ; 0041-1345
ISSN (online)	1873-2623
ISSN	0041-1345
DOI	10.1016/j.transproceed.2022.09.021
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Article ; Online: Proposal of a Classification System for Adenocarcinoma Involving the Ileocecal Valve (Bauhin's Valve): A Retrospective Study of 689 Right Hemicolectomized Patients.

Virgilio, Edoardo / Montali, Filippo / Costi, Renato / Cavallini, Marco

Anticancer research

2020 Volume 40, Issue 7, Page(s) 4053–4057

Abstract: Background/aim: As of 2020, adenocarcinoma arising in the ileocecal valve (ICV-A) has been examined along with cecal and right colon cancer (RCC) under the collective heading "ileocecal" tumor. We propose a new classification system for this cancer.: ... ...

Abstract	Background/aim: As of 2020, adenocarcinoma arising in the ileocecal valve (ICV-A) has been examined along with cecal and right colon cancer (RCC) under the collective heading "ileocecal" tumor. We propose a new classification system for this cancer. Patients and methods: We retrospectively analyzed RCC patients from 2003 to 2019. The scheme was: i) Type I cancer for adenocarcinomas residing in ICV; ii) Type II, if they reside 1 to 5 mm from ICV; iii) Type III, 6 mm to 10 mm from ICV; iv) Type IV, at 1,1 to 5 cm; v) Type V, at more than 5 cm (ascending colon cancer). Results: Of 689 hemicolectomized patients, there were 91 (13.2%) Type I, 87 Type II (12.6%), 38 (5.5%) Type III, 157 (22.8%) Type IV and 314 (45.6%) Type V. Each type was associated with at least one clinicopathologic feature. Conclusion: ICV-A was classified into five types (I-V) according to the distance from ICV. Further studies are needed in order to corroborate our findings.
MeSH term(s)	Adenocarcinoma/classification ; Adenocarcinoma/pathology ; Adenocarcinoma/surgery ; Aged ; Cecal Neoplasms/classification ; Cecal Neoplasms/pathology ; Cecal Neoplasms/surgery ; Colectomy ; Colonic Neoplasms/classification ; Colonic Neoplasms/pathology ; Colonic Neoplasms/surgery ; Female ; Humans ; Ileocecal Valve/pathology ; Male ; Retrospective Studies
Language	English
Publishing date	2020-07-03
Publishing country	Greece
Document type	Journal Article
ZDB-ID	604549-2
ISSN	1791-7530 ; 0250-7005
ISSN (online)	1791-7530
ISSN	0250-7005
DOI	10.21873/anticanres.14402
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Article ; Online: Transplant Renal Artery Stenosis: A Case Report of Functional Recovery Six Months After Angioplasty.

Montali, Filippo / Panarese, Alessandra / Binda, Barbara / Lancione, Laura / Pisani, Francesco

Transplantation proceedings

2021 Volume 53, Issue 4, Page(s) 1272–1274

Abstract: Transplant renal artery stenosis (TRAS) is a common vascular complication after kidney transplantation, leading to worsening or refractory hypertension, deterioration in renal function, and possible cause of graft loss. Early diagnosis and an appropriate ...

Abstract	Transplant renal artery stenosis (TRAS) is a common vascular complication after kidney transplantation, leading to worsening or refractory hypertension, deterioration in renal function, and possible cause of graft loss. Early diagnosis and an appropriate treatment are crucial for organ preservation. Endovascular treatment, including percutaneous transluminal angioplasty and stent implantation, is considered the first-line therapy for TRAS. Here we report the case of a 69-year-old woman with end-stage renal disease for chronic kidney disease not biopsy proven, who underwent a kidney transplant from expanded criteria donors on December 2018. Postoperative course was characterized by delayed graft function. Doppler ultrasonography (US) showed an increase of peak systolic velocity at the origin of the renal artery, and parvus-tardus waveform in periferic graft arteries and an abdominal computed tomography scan confirmed a stenosis at the origin of the main renal artery (TRAS). The patient underwent a percutaneous transluminal angioplasty. It was not possible to place a stent at the particular location of the stenosis at the anastomosis. Despite the improvement of the graft's perfusion, monitored with Doppler US, the patient showed a very poor improvement in renal function and remained on hemodialysis for months. A percutaneous needle biopsy reported a normal renal parenchyma and excluded acute rejection. During this period, the patient received immunosuppressive therapy. About 6 months after the transplant, the patient had an unexpected and slow renal function recovery until she was weaned completely from hemodialysis.
MeSH term(s)	Aged ; Angioplasty/methods ; Female ; Humans ; Kidney Failure, Chronic/complications ; Kidney Failure, Chronic/surgery ; Kidney Transplantation/adverse effects ; Postoperative Complications/etiology ; Postoperative Complications/surgery ; Recovery of Function ; Renal Artery/physiopathology ; Renal Artery/surgery ; Renal Artery/transplantation ; Renal Artery Obstruction/etiology ; Renal Artery Obstruction/surgery
Language	English
Publishing date	2021-04-22
Publishing country	United States
Document type	Case Reports ; Journal Article
ZDB-ID	82046-5
ISSN	1873-2623 ; 0041-1345
ISSN (online)	1873-2623
ISSN	0041-1345
DOI	10.1016/j.transproceed.2021.03.019
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Article ; Online: MRI and correlation between TNM and CEA, CA19.9, AFP in rectal cancer Experience of a single academic surgical center.

Del Rio, Paolo / Loderer, Tommaso / Bresciani, Paolo / Montali, Filippo / Dell'Abate, Paolo / Sianesi, Mario

Annali italiani di chirurgia

2022 Volume 92, Page(s) 645–653

Abstract: In our study we examined 75 patients treated for rectal cancer in the period between 01/01/2011 and 31/12/2014. Out of these 75 patients, we considered those 36 staged through MRI. We then compared the TNM stage obtained through MRI with the one emerged ... ...

Abstract	In our study we examined 75 patients treated for rectal cancer in the period between 01/01/2011 and 31/12/2014. Out of these 75 patients, we considered those 36 staged through MRI. We then compared the TNM stage obtained through MRI with the one emerged from histological examination. The correlation between the two TNM stages was assessed considering all patients staged through MRI and dividing the cases according to the submission or not to a neoadjuvant treatment. Finally, we analyzed serum levels of tumor markers CEA, CA 19.9 and AFP, relating them with the final disease stage. Data analysis showed a statistically significant correlation in the T stages, especially in the population not subjected to neoadjuvant treatment. Instead, for N, we found no statistically significant correlation. Similarly, none of the tumor markers presented a statistically significant correlation with disease stage. However, according to the positivity of tumor markers, we associated the following score: 0, (no positive marker)1 (only one marker positive) 2 (two markers positive) 3 (three markers positive). In presence of three markers positive, meaning the highest score, we found a statistically significant correlation with N + staging of the disease, obtained by postoperative pathologic examination. The conclusion is that MRI is certainly effective in T stage evaluation. Probably, for limph node involvement evaluation, more reliable parameters for establishing possible lymph node malignancy need to be found. The role of the tumor markers CEA, CA 19.9, AFP during preoperative evaluation of rectal tumors remains undefined. KEY WORDS: MRI, Rectal cancer, Tumor markes, Tumor regression, T stage.
MeSH term(s)	Biomarkers, Tumor ; Carcinoembryonic Antigen ; Humans ; Magnetic Resonance Imaging ; Neoplasm Staging ; Prognosis ; Rectal Neoplasms/diagnostic imaging ; Rectal Neoplasms/surgery ; alpha-Fetoproteins
Chemical Substances	Biomarkers, Tumor ; Carcinoembryonic Antigen ; alpha-Fetoproteins
Language	English
Publishing date	2022-02-15
Publishing country	Italy
Document type	Journal Article
ZDB-ID	418927-9
ISSN	2239-253X ; 0003-469X
ISSN (online)	2239-253X
ISSN	0003-469X
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Article ; Online: Omental torsion at the time of COVID-19 in Northern Italy: a case report of conservative management with a review of the pertinent literature.

Montali, Filippo / Costi, Renato / Virgilio, Edoardo / Presicci, Cristina / Sartorio, Carlotta / Pedrazzini, Massimo

Acta bio-medica : Atenei Parmensis

2022 Volume 93, Issue S1, Page(s) e2022123

Abstract: Background and aim: In middle-aged men, omental torsion (OT) can be a cause of acute abdomen.The right side of the omentum is longer, heavier and more mobile than the left one and, as a consequence, it can twist more easily on its vascular axis. ... ...

Abstract	Background and aim: In middle-aged men, omental torsion (OT) can be a cause of acute abdomen.The right side of the omentum is longer, heavier and more mobile than the left one and, as a consequence, it can twist more easily on its vascular axis. Consequently, OT localization in the lower right quadrant is more frequent, and therefore it can mimic acute appendicitis clinical onset.In most cases, OT is defined as "primary" in the absence of any other underlying pathologies, or, rarely, "secondary", when caused by other intra-abdominal diseases such as inguinal hernia, tumors, cysts or post-surgical scarring. To date, clinical diagnosis of OT still remains a challenging one in a preoperative setting and most cases are diagnosed intraoperatively. If diagnosis is correctly achieved preoperatively by adequate imaging examinations, most patients presenting with OT do not undergo surgery anymore. Such considerations gain importance at the time of COVID 19 pandemic, where a conservative management and an early discharge may be preferred owing to in-hospital morbidity after abdominal surgery whenever surgery may be avoided. Methods and results: We present a case of an OT successfully treated in a non-operative manner during COVID-19 outbreak in Norhern Italy and offer a review of the literature that supports such a clinical attitude. Conclusions: OT preoperative diagnosis is challenging and is usually achieved by abdominal CT-scan. The suggested OT initial management is conservative, leaving a surgical approach, preferably by laparoscopy, for the 15% of cases not improving with a non-surgical approach.
MeSH term(s)	Appendicitis ; COVID-19 ; Conservative Treatment ; Humans ; Male ; Middle Aged ; Omentum/blood supply ; Omentum/pathology ; Omentum/surgery ; Peritoneal Diseases/diagnosis ; Peritoneal Diseases/surgery ; Torsion Abnormality/diagnosis ; Torsion Abnormality/pathology ; Torsion Abnormality/surgery
Language	English
Publishing date	2022-04-14
Publishing country	Italy
Document type	Case Reports ; Journal Article ; Review
ZDB-ID	2114240-3
ISSN	2531-6745 ; 0392-4203
ISSN (online)	2531-6745
ISSN	0392-4203
DOI	10.23750/abm.v93iS1.11903
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Article ; Online: The double challenge (preoperative diagnosis and surgical approach) of primary leiomyosarcoma of the sigmoid colon.

Lorenzo Pagliai / Annicchiarico, Alfredo / Morini, Andrea / Montali, Filippo / Virgilio, Edoardo / Costi, Renato

Acta bio-medica : Atenei Parmensis

2022 Volume 93, Issue S1, Page(s) e2022124

Abstract: Background and aim: Primary colonic leiomyosarcoma (cLMS) is a rare malignancy of muscularis mucosae or muscularis propria showing highly aggressive behaviour and poor prognosis. To date, making a preoperative diagnosis and performing the most ... ...

Abstract	Background and aim: Primary colonic leiomyosarcoma (cLMS) is a rare malignancy of muscularis mucosae or muscularis propria showing highly aggressive behaviour and poor prognosis. To date, making a preoperative diagnosis and performing the most appropriate treatment represent laborious tasks for the clinicians. On the one hand, in fact, cLMS diagnosis is often difficult to achieve preoperatively because of the low specificity of clinical, radiological and bioptical features: for these motives, the diagnosis is usually obtained at postoperative histology/immune-histochemistry. On the other hand, although surgery represents the mainstay of multi-modal treatment, in the current era of minimally invasive surgery the optimal approach to cLMS is debated: in the absence of a standardized and unanimous algorithm, in fact, laparoscopy is usually proposed for small tumors, whereas laparotomy for masses exceeding 4 cm in diameter. Our aim was to elucidate such two aspects by reporting our experience. Methods: We present the case of a 51-year-old man affected with a 6-cm LMS of the sigmoid colon. Results: Preoperative diagnosis was achieved through a preoperative echo-endoscopic biopsy. The lesion was successfully and safely managed by laparoscopic surgery. Conclusions: Our case suggests that a preoperative diagnosis of cLMS is possible in an appropriate setting. Moreover, laparoscopy seems to be a safe and successful approach to resect cancers even larger than the common 4 centimetres proposed by the current literature.
MeSH term(s)	Colon, Sigmoid/surgery ; Colonic Neoplasms/diagnosis ; Colonic Neoplasms/surgery ; Humans ; Laparoscopy ; Laparotomy ; Leiomyosarcoma/diagnosis ; Leiomyosarcoma/surgery ; Male ; Middle Aged
Language	English
Publishing date	2022-04-14
Publishing country	Italy
Document type	Case Reports ; Journal Article
ZDB-ID	2114240-3
ISSN	2531-6745 ; 0392-4203
ISSN (online)	2531-6745
ISSN	0392-4203
DOI	10.23750/abm.v93iS1.11652
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