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  1. Article: Robotic resection of left renal vein with preservation of left kidney for leiomyosarcoma: Case report and review of the literature.

    Lodoli, Claudio / El Halabieh, Miriam Attalla / Santullo, Francesco / Abatini, Carlo / Gallotta, Valerio / Pacelli, Fabio

    International journal of surgery case reports

    2024  Volume 116, Page(s) 109381

    Abstract: Introduction: Radical surgical resection with negative margins is the mainstay of treatment for retroperitoneal vascular leiomyosarcomas. Given the retroperitoneal location of these tumors, open surgery is, historically, the chosen surgical approach, ... ...

    Abstract Introduction: Radical surgical resection with negative margins is the mainstay of treatment for retroperitoneal vascular leiomyosarcomas. Given the retroperitoneal location of these tumors, open surgery is, historically, the chosen surgical approach, however, it is burdened with high postoperative morbidity. In selected cases, the small dimension of the tumor and a favorable location, allow to perform a minimally invasive treatment.
    Presentation of case: A 67-year-old female patient with a diagnosis of a leiomyosarcoma arising from the left renal vein underwent a robotic resection of the left renal vein with preservation of the left kidney and a relative outflow trough the gonadal vessels. The patient was discharged on the fourth postoperative day without any complications and there was no tumor recurrence noted during the 24-month follow-up period.
    Discussion: Vascular retroperitoneal leiomyosarcomas are very rare tumors requiring a complete en bloc gross tumor resection in order to achieving microscopically negative margins on the vein of origin. Thanks to the preoperative histological diagnosis and radiological study of the neoplasm, it was possible to proceed to a highly personalized and minimally invasive treatment with respect of oncological criteria.
    Conclusion: In selected cases, a minimally invasive surgery of vascular leiomyosarcoma could be a feasible and safe treatment option.
    Language English
    Publishing date 2024-02-15
    Publishing country Netherlands
    Document type Case Reports
    ISSN 2210-2612
    ISSN 2210-2612
    DOI 10.1016/j.ijscr.2024.109381
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  2. Article ; Online: Hyperthermic intrathoracic chemotherapy combined to iterative cytoreductive surgery to treat a pleural carcinosis from psudomixoma peritonei. A case report.

    Lococo, F / Di Giorgio, A / Iaffaldano, A / Schinzari, G / Tabacco, D / Aceto, P / Abatini, C / Sollazzi, L / Margaritora, S

    European review for medical and pharmacological sciences

    2021  Volume 25, Issue 1, Page(s) 362–365

    Abstract: Pseudomyxoma peritonei (PMP) is an uncommon disease with locally-invasive attitude. Intrathoracic spread is rarely reported and its management extremely challenging. A 51-year-old Caucasian female presented with left pleural carcinosis 9-months after two ...

    Abstract Pseudomyxoma peritonei (PMP) is an uncommon disease with locally-invasive attitude. Intrathoracic spread is rarely reported and its management extremely challenging. A 51-year-old Caucasian female presented with left pleural carcinosis 9-months after two sequential abdominal surgical procedures combined with HIPEC for low-grade PMP. Cytoreductive surgery (pleurectomy/decortication) was followed by 60-minutes hyperthermic intrathoracic chemotherapy mitomycin-C (215 mg/m2) infusing at same temperature (42°C) and intrapleural pression (2-4 mmH2O). No intra-operative complication occurred, the post-op stay was uneventful and no sign of recurrence was observed 9-months after surgery. Cytoreductive thoracic surgery and hyperthermic chemotherapy (HITHOC) could be a feasible therapeutic option in very selected cases.
    MeSH term(s) Antibiotics, Antineoplastic/administration & dosage ; Antibiotics, Antineoplastic/therapeutic use ; Chemotherapy, Cancer, Regional Perfusion ; Combined Modality Therapy ; Cytoreduction Surgical Procedures ; Female ; Humans ; Hyperthermia, Induced ; Middle Aged ; Mitomycin/administration & dosage ; Mitomycin/therapeutic use ; Pleural Neoplasms/therapy ; Pseudomyxoma Peritonei/therapy
    Chemical Substances Antibiotics, Antineoplastic ; Mitomycin (50SG953SK6)
    Language English
    Publishing date 2021-01-27
    Publishing country Italy
    Document type Case Reports ; Journal Article
    ZDB-ID 605550-3
    ISSN 2284-0729 ; 1128-3602 ; 0392-291X
    ISSN (online) 2284-0729
    ISSN 1128-3602 ; 0392-291X
    DOI 10.26355/eurrev_202101_24403
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  3. Article ; Online: Totally intracorporeal colorectal anastomosis after segmental sigmoid resection with inferior mesenteric artery preservation for deep infiltrating endometriosis.

    Santullo, F / Attalla El Halabieh, M / Lodoli, C / Abatini, C / Rosati, A / Ianieri, M / Scambia, G / De Cicco Nardone, A

    Techniques in coloproctology

    2021  Volume 25, Issue 6, Page(s) 745–746

    MeSH term(s) Anastomosis, Surgical ; Colon, Sigmoid/surgery ; Colorectal Neoplasms ; Endometriosis/surgery ; Female ; Humans ; Laparoscopy ; Mesenteric Artery, Inferior/surgery ; Rectal Diseases/surgery ; Rectum/surgery
    Language English
    Publishing date 2021-01-15
    Publishing country Italy
    Document type Journal Article
    ZDB-ID 2083309-X
    ISSN 1128-045X ; 1123-6337
    ISSN (online) 1128-045X
    ISSN 1123-6337
    DOI 10.1007/s10151-020-02405-4
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  4. Article ; Online: Prophylactic surgery plus hyperthermic intraperitoneal chemotherapy (HIPEC CO2) versus standard surgery for gastric carcinoma at high risk of peritoneal carcinomatosis: short and long-term outcomes (GOETH STUDY)-a collaborative randomized controlled trial by ACOI, FONDAZIONE AIOM, SIC, SICE, and SICO.

    Di Giorgio, A / Gerardi, C / Abatini, C / Melotti, G / Bonavina, L / Torri, V / Santullo, F / Garattini, S / De Luca, M / Rulli, Erica / Rulli, Eliana / Pacelli, F

    Trials

    2022  Volume 23, Issue 1, Page(s) 969

    Abstract: Introduction: At the time of diagnosis, 15-20% of gastric carcinomas are in stage T4 or T4b. Furthermore, 5-20% of patients undergoing potentially curative surgery suffer from synchronous or metachronous peritoneal metastases. To date, neither surgery ... ...

    Abstract Introduction: At the time of diagnosis, 15-20% of gastric carcinomas are in stage T4 or T4b. Furthermore, 5-20% of patients undergoing potentially curative surgery suffer from synchronous or metachronous peritoneal metastases. To date, neither surgery nor systemic chemotherapy successfully controls peritoneal dissemination, offering a limited impact on survival. Peritoneal metastases are in fact responsible for death in around 60% of gastric cancer patients. Several Eastern studies in the past have focused on hyperthermic intraperitoneal chemotherapy (HIPEC) as a prophylactic measure in patients with serosal extension, nodal involvement, and positive peritoneal fluid cytology. Therefore, a new multimodal therapeutic strategy based on aggressive surgery plus new locoregional treatment may prolong survival in this particular clinical scenario.
    Methods: This study compares the efficacy of prophylactic surgery (radical gastric resection, appendectomy, resection of the round ligament of the liver, and bilateral adnexectomy) plus hybrid CO2 HIPEC system versus standard surgery in patients with T3-T4 N0-N + gastric adenocarcinoma. Patients will be randomly assigned (1:1 ratio) to the experimental arm or standard surgery. The primary endpoint is to establish the difference in disease-free survival between the groups. The secondary objective is to compare the safety and tolerability of prophylactic surgery plus HIPEC CO
    Discussion: Considering the poor prognosis of patients with peritoneal dissemination from gastric cancer, a prophylactic strategy to prevent peritoneal metastases may be beneficial. In patients with gastric cancer at high risk of peritoneal carcinomatosis, we propose aggressive surgical treatment with radical gastrectomy, removal of organs at risk of harbouring tumour cells, and HIPEC.
    Trial registration: ClinicalTrials.gov NCT03917173. Registered on 16 April 2019.
    Protocol version: v1, March 27, 2019. Protocol number: IRFMN-GCC-7813. EudraCT number: 2019-001478-27.
    MeSH term(s) Female ; Humans ; Hyperthermic Intraperitoneal Chemotherapy ; Peritoneal Neoplasms/therapy ; Stomach Neoplasms/therapy ; Carbon Dioxide ; Adenocarcinoma
    Chemical Substances Carbon Dioxide (142M471B3J)
    Language English
    Publishing date 2022-12-01
    Publishing country England
    Document type Randomized Controlled Trial ; Journal Article
    ZDB-ID 2040523-6
    ISSN 1745-6215 ; 1468-6694 ; 1745-6215
    ISSN (online) 1745-6215
    ISSN 1468-6694 ; 1745-6215
    DOI 10.1186/s13063-022-06880-y
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  5. Article ; Online: Gastric cancer with peritoneal metastases: a single center outline and comparison of different surgical and intraperitoneal treatments.

    Santullo, Francesco / Ferracci, Federica / Abatini, Carlo / Halabieh, Miriam Attalla El / Lodoli, Claudio / D'Annibale, Giorgio / Di Cesare, Ludovica / D'Agostino, Luca / Pecere, Silvia / Di Giorgio, Andrea / Strippoli, Antonia / Pacelli, Fabio

    Langenbeck's archives of surgery

    2023  Volume 408, Issue 1, Page(s) 437

    Abstract: Introduction: Gastric cancer with peritoneal metastasis (GCPM) has an unfavourable prognosis. Cytoreductive surgery plus hyperthermic intraperitoneal chemotherapy (CRS + HIPEC) and pressurized intraperitoneal aerosol chemotherapy (PIPAC) are promising ... ...

    Abstract Introduction: Gastric cancer with peritoneal metastasis (GCPM) has an unfavourable prognosis. Cytoreductive surgery plus hyperthermic intraperitoneal chemotherapy (CRS + HIPEC) and pressurized intraperitoneal aerosol chemotherapy (PIPAC) are promising treatment options that have been shown to improve survival. The aim of this study was to assess the impact of different treatments such as systemic chemotherapy, systemic chemotherapy + PIPAC, and CRS + HIPEC in patients with GCPM.
    Material and methods: This single-centre retrospective study included 82 patients with GCPM treated between January 2016 and June 2021. After first-line chemotherapy, depending on disease response and burden, the patients were divided into three treatment groups: chemotherapy alone, chemotherapy + PIPAC, and CRS + HIPEC. The primary outcome was overall survival (OS) from diagnosis, which was compared among the treatment groups.
    Results: Thirty-seven (45.1%) patients were administered systemic chemotherapy alone, 25 (30.4%) received chemotherapy + PIPAC, and 20 (24.4%) underwent CRS + HIPEC. The CRS + HIPEC group had better OS (median 24 months) than the PIPAC group (15 months, p = 0.01) and chemotherapy group (5 months, p = 0.0001). Following CRS + HIPEC, the postoperative grade 3-4 complication rate was 25%, and no postoperative in-hospital deaths occurred. The median disease-free survival (DFS) was 12 months. Multivariate analysis identified peritoneal carcinomatosis index (PCI) > 7 as an independent predictor of worse DFS. No independent predictors of OS were identified.
    Conclusion: Among patients with GCPM, we identified a highly selected population with oligometastatic disease. In this group, CRS + HIPEC provided a significant survival advantage with an acceptable major complication rate compared with other available therapies (systemic chemotherapy alone or in combination with PIPAC).
    MeSH term(s) Humans ; Stomach Neoplasms/pathology ; Peritoneal Neoplasms/drug therapy ; Combined Modality Therapy ; Retrospective Studies ; Chemotherapy, Cancer, Regional Perfusion ; Cytoreduction Surgical Procedures ; Postoperative Complications/therapy ; Hyperthermia, Induced ; Antineoplastic Combined Chemotherapy Protocols/therapeutic use ; Survival Rate
    Language English
    Publishing date 2023-11-16
    Publishing country Germany
    Document type Journal Article
    ZDB-ID 1423681-3
    ISSN 1435-2451 ; 1435-2443
    ISSN (online) 1435-2451
    ISSN 1435-2443
    DOI 10.1007/s00423-023-03163-1
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  6. Article ; Online: Tips and tricks for ileostomy closure after diverting ileostomy for gynecological cancer surgery.

    Angeles, Martina Aida / Lago, Victor / Bizzarri, Nicolò / Chantalat, Elodie / Abatini, Carlo / Frasson, Matteo / Martinez, Alejandra / Domingo, Santiago / Fagotti, Anna / Ferron, Gwenael

    International journal of gynecological cancer : official journal of the International Gynecological Cancer Society

    2023  Volume 33, Issue 6, Page(s) 1001–1002

    MeSH term(s) Humans ; Ileostomy/adverse effects ; Intestine, Small/surgery ; Neoplasms ; Gynecology ; Postoperative Complications ; Retrospective Studies ; Rectal Neoplasms ; Anastomosis, Surgical
    Language English
    Publishing date 2023-06-05
    Publishing country England
    Document type Journal Article
    ZDB-ID 1070385-8
    ISSN 1525-1438 ; 1048-891X
    ISSN (online) 1525-1438
    ISSN 1048-891X
    DOI 10.1136/ijgc-2022-004085
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  7. Article ; Online: Vascular- and nerve-sparing bowel resection for deep endometriosis: A retrospective single-center study.

    Ianieri, Manuel Maria / De Cicco Nardone, Alessandra / Benvenga, Greta / Greco, Pierfrancesco / Pafundi, Pia Clara / Alesi, Maria Vittoria / Campolo, Federica / Lodoli, Claudio / Abatini, Carlo / Attalla El Halabieh, Miriam / Pacelli, Fabio / Scambia, Giovanni / Santullo, Francesco

    International journal of gynaecology and obstetrics: the official organ of the International Federation of Gynaecology and Obstetrics

    2023  Volume 164, Issue 1, Page(s) 277–285

    Abstract: Objective: Surgical management of bowel endometriosis is still controversial. Recently, many authors have pointed out the potential benefits of preserving the superior rectal artery, thus ensuring better perfusion of the anastomosis. The aim of this ... ...

    Abstract Objective: Surgical management of bowel endometriosis is still controversial. Recently, many authors have pointed out the potential benefits of preserving the superior rectal artery, thus ensuring better perfusion of the anastomosis. The aim of this study was to evaluate the complication rate and functional outcomes of a bowel resection technique for deep endometriosis (DE) involving a nerve- and vascular-sparing approach.
    Methods: A single-center retrospective study was conducted by enrolling patients who underwent segmental resection of the rectus sigmoid for DE in our department between September 2019 and April 2022. Intraoperative and postoperative complications were recorded for each woman, and functional outcomes relating to the pelvic organs were assessed using validated questionnaires (Knowles-Eccersley-Scott-Symptom [KESS] questionnaire and Gastro-Intestinal Quality of Life Index [GIQLI] for bowel function, Bristol Female Lower Urinary Tract Symptoms [BFLUTS] for urinary function, and Female Sexual Function Index [FSFI] for sexual function). These were evaluated preoperatively and postoperatively after 6 months from surgery.
    Results: Sixty-one patients were enrolled. No patients had Clavien-Dindo grade 3 or 4 complications, there were no rectovaginal fistulas or ureteral lesions, and in no cases was it necessary to reoperate. Temporary bladder voiding deficits were reported in 8.2% of patients, which were treated with self-catheterizations, always resolving within 45 days of surgery. Gastrointestinal function evaluated by KESS and GIQLI improved significantly after surgery, whereas sexual function appeared to worsen, although without reaching the level of statistically significant validity.
    Conclusion: Our vascular- and nerve-sparing segmental bowel resection technique for DE had a low intraoperative and postoperative complication rate and produced an improvement in gastrointestinal function after surgery.
    MeSH term(s) Humans ; Female ; Retrospective Studies ; Rectal Diseases ; Endometriosis/complications ; Quality of Life ; Treatment Outcome ; Postoperative Complications/epidemiology ; Postoperative Complications/etiology ; Laparoscopy/methods
    Language English
    Publishing date 2023-08-09
    Publishing country United States
    Document type Journal Article
    ZDB-ID 80149-5
    ISSN 1879-3479 ; 0020-7292
    ISSN (online) 1879-3479
    ISSN 0020-7292
    DOI 10.1002/ijgo.15019
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  8. Article ; Online: Cytoreductive surgery and mitomycin C hyperthermic intraperitoneal chemotherapy with CO

    Rotolo, Stefano / Di Giorgio, Andrea / Santullo, Francesco / Attalla El Halabieh, Miriam / Lodoli, Claudio / Abatini, Carlo / Pacelli, Fabio

    Updates in surgery

    2021  Volume 73, Issue 4, Page(s) 1443–1448

    Abstract: Peritoneal dissemination from colorectal cancer (CRC) has long been associated with unfavorable prognosis. However, in the last decades, the combination of cytoreductive surgery (CRS) and hyperthermic intraperitoneal chemotherapy (HIPEC) was able to ... ...

    Abstract Peritoneal dissemination from colorectal cancer (CRC) has long been associated with unfavorable prognosis. However, in the last decades, the combination of cytoreductive surgery (CRS) and hyperthermic intraperitoneal chemotherapy (HIPEC) was able to obtain up to 30% 5-year survival rate in selected centers. Despite the wide diffusion of CRS and HIPEC, until now, there are no clear recommendations on the drug of choice for HIPEC nor its technique, and safety and efficacy data of HIPEC regimens and techniques are lacking. We performed a retrospective analysis of a prospectively maintained database of 26 CRS and mitomycin C HIPEC with CO
    MeSH term(s) Antineoplastic Combined Chemotherapy Protocols ; Carbon Dioxide ; Colorectal Neoplasms/therapy ; Combined Modality Therapy ; Cytoreduction Surgical Procedures ; Humans ; Hyperthermia, Induced ; Hyperthermic Intraperitoneal Chemotherapy ; Mitomycin/therapeutic use ; Peritoneal Neoplasms/drug therapy ; Prognosis ; Retrospective Studies ; Survival Rate
    Chemical Substances Carbon Dioxide (142M471B3J) ; Mitomycin (50SG953SK6)
    Language English
    Publishing date 2021-03-29
    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/s13304-021-01034-2
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  9. Article ; Online: Prophylactic surgery plus hyperthermic intraperitoneal chemotherapy (HIPEC CO2) versus standard surgery in colorectal carcinoma at high risk of peritoneal carcinomatosis: short-term and long-term outcomes from the CHECK study - protocol for a randomised, multicentre, phase 3 trial.

    Pacelli, Fabio / Gerardi, Chiara / Rulli, Eliana / Abatini, Carlo / Rotolo, Stefano / Garattini, Silvio / Melotti, Gianluigi / Torri, Valter / Galli, Fabio / Rulli, Erica / Di Giorgio, Andrea

    BMJ open

    2022  Volume 12, Issue 8, Page(s) e051324

    Abstract: Introduction: Up to one-fifth of patients with colorectal cancer will develop peritoneal metastases, frequently without other districts' involvement. Despite the recent unsuccesses of hyperthermic intraperitoneal chemotherapy (HIPEC) for colorectal ... ...

    Abstract Introduction: Up to one-fifth of patients with colorectal cancer will develop peritoneal metastases, frequently without other districts' involvement. Despite the recent unsuccesses of hyperthermic intraperitoneal chemotherapy (HIPEC) for colorectal cancer peritoneal metastases treatment, the rationale in the prophylactic setting remains strong. Several clinical and pharmacokinetic data suggest that the efficacy of intraperitoneal chemotherapy is highest when the disease is microscopic. However, robust evidence demonstrating whether the addition of HIPEC for high-risk colorectal cancers offers better control of local recurrence is lacking.
    Methods and analysis: This is a multicentre randomised phase 3 trial comparing prophylactic surgery plus HIPEC CO2 with mitomycin, over standard surgical excision in patients with colorectal cancer at high risk of peritoneal carcinomatosis; 388 patients will be included in this study. The primary objective is to compare the efficacy of prophylactic surgery (radical colorectal resection, omentectomy, appendectomy, round ligament of the liver resection and bilateral adnexectomy) plus HIPEC CO2 with mitomycin and standard surgery in terms of local recurrence-free survival. The main secondary endpoints are disease-free survival (DFS), overall survival (OS) and safety. The primary endpoint will be described with a cumulative incidence function and will be analysed with Grey test to take account of the competing risks. DFS and OS will be described with the Kaplan-Meier method.
    Ethics and dissemination: This trial has been evaluated by the Italian Medicines Agency, local ethics committees and will be submitted to the Ministry of Health to notify the start of the trial according to the regulation of trials on devices with CE mark/certification.The results will be submitted for presentation at academic meetings and for publication in a peer-reviewed journal, whatever the findings.
    Trial registration number: NCT03914820.
    MeSH term(s) Antineoplastic Combined Chemotherapy Protocols/therapeutic use ; Carbon Dioxide ; Clinical Trials, Phase III as Topic ; Colorectal Neoplasms/drug therapy ; Combined Modality Therapy ; Cytoreduction Surgical Procedures/methods ; Female ; Humans ; Hyperthermia, Induced/methods ; Hyperthermic Intraperitoneal Chemotherapy ; Mitomycins/therapeutic use ; Multicenter Studies as Topic ; Peritoneal Neoplasms/secondary ; Randomized Controlled Trials as Topic
    Chemical Substances Mitomycins ; Carbon Dioxide (142M471B3J)
    Language English
    Publishing date 2022-08-01
    Publishing country England
    Document type Clinical Trial Protocol ; Journal Article ; Research Support, Non-U.S. Gov't
    ZDB-ID 2599832-8
    ISSN 2044-6055 ; 2044-6055
    ISSN (online) 2044-6055
    ISSN 2044-6055
    DOI 10.1136/bmjopen-2021-051324
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  10. Article: The Road to Technical Proficiency in Cytoreductive Surgery for Peritoneal Carcinomatosis: Risk-Adjusted Cumulative Summation Analysis.

    Santullo, Francesco / Abatini, Carlo / Attalla El Halabieh, Miriam / Ferracci, Federica / Lodoli, Claudio / Barberis, Lorenzo / Giovinazzo, Francesco / Di Giorgio, Andrea / Pacelli, Fabio

    Frontiers in surgery

    2022  Volume 9, Page(s) 877970

    Abstract: Background: Cytoreductive surgery (CRS) is a technically demanding procedure, and there is considerable debate about its safe application. This study investigated the learning curve for CRS and the clinical outcomes of consecutive patients treated by a ... ...

    Abstract Background: Cytoreductive surgery (CRS) is a technically demanding procedure, and there is considerable debate about its safe application. This study investigated the learning curve for CRS and the clinical outcomes of consecutive patients treated by a single surgeon at a single institution.
    Methods: We collected 251 consecutive patients who underwent CRS for peritoneal metastases by a single surgeon at Fondazione Policlinico Universitario A. Gemelli IRCCS, between January 2016 and December 2020. The learning curve was estimated using the cumulative summation analysis (CUSUM) for operative time (OT). Risk-adjusted CUSUM (RA-CUSUM) charts were developed using a composite variable (surgical failure), defined as the occurrence of at least one of the following events: major postoperative complications (Clavien-Dindo grade ≥3), blood loss ≥500 mL, incomplete cytoreduction. Three learning phases were thus derived from the RA-CUSUM analysis, and were compared in terms of perioperative outcomes.
    Results: CUSUM-OT showed that the operation time improved significantly after the 161
    Conclusion: The CRS failure rate stabilized after the first 99 cases, and the complete surgical proficiency was achieved after 189 cases. A standardised and mentored learning model is a safer strategy to shorten the learning process, to reduce morbidity and mortality, to improve oncologic outcomes.
    Language English
    Publishing date 2022-05-18
    Publishing country Switzerland
    Document type Journal Article
    ZDB-ID 2773823-1
    ISSN 2296-875X
    ISSN 2296-875X
    DOI 10.3389/fsurg.2022.877970
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