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Article ; Online: Prerequisites for introducing neural monitoring in thyroid surgery.

Sun, H / Carcoforo, P / Dionigi, G

European annals of otorhinolaryngology, head and neck diseases

2019 Volume 137, Issue 1, Page(s) 91

MeSH term(s)	Consensus ; Humans ; Laryngeal Nerves ; Recurrent Laryngeal Nerve Injuries ; Thyroid Gland
Language	English
Publishing date	2019-11-04
Publishing country	France
Document type	Letter ; Comment
ZDB-ID	2558008-5
ISSN	1879-730X ; 1879-7296
ISSN (online)	1879-730X
ISSN	1879-7296
DOI	10.1016/j.anorl.2018.05.015
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Article ; Online: Predictive factors for functional failure of ventral mesh rectopexy in the treatment of rectal prolapse and obstructed defecation.

Solari, S / Martellucci, J / Ascanelli, S / Sturiale, A / Annicchiarico, A / Fabiani, B / Prosperi, P / Carcoforo, P / Naldini, G

Techniques in coloproctology

2022 Volume 26, Issue 12, Page(s) 973–979

Abstract: Background: Ventral mesh rectopexy (VMR) is widely accepted for the treatment of rectal prolapse or obstructed defecation. However, despite good anatomical results, the improvement of functional symptoms (constipation or incontinence) cannot always be ... ...

Abstract	Background: Ventral mesh rectopexy (VMR) is widely accepted for the treatment of rectal prolapse or obstructed defecation. However, despite good anatomical results, the improvement of functional symptoms (constipation or incontinence) cannot always be obtained and in some cases these symptoms may even worsen. The aim of the present study was to identify possible predictors of functional failure after VMR. Methods: Data of all consecutive patients who had VMR for the treatment of rectal prolapse and/or obstructed defecation between January 2017 and December 2020 in three different pelvic floor surgical centres in Italy were analysed to identify possible predictors of functional failure, intended as persistence, worsening or new onset of constipation or faecal incontinence. Symptom severity was assessed pre- and postoperatively with the Wexner Constipation score and Obstructed Defecation Syndrome score. Quality of life was assessed, also before and after treatment, with the Patients Assessment of Constipation Quality of Life questionnaire, the Pelvic Floor Disability Index and the Pelvic Floor Impact Questionnaire. Faecal incontinence was evaluated with the Cleveland Clinic Incontinence Score. The functional outcomes before and after surgery were compared. Results: Sixty-one patients were included (M:F ratio 3:60, median age 64 years [range 33-88 years]). Forty-two patients (68.9%) had obstructed defecation syndrome, 12(19.7%) had faecal incontinence and 7 patients (11.5%) had both. A statistically significant reduction between pre- and postoperative Obstructed Defecation Syndrome and Wexner scores was reported (p < 0.0001 in both cases). However, the postoperative presence of constipation occurred in 22 patients (36.1%) (this included 3 cases of new-onset constipation). The presence of redundant colon and the pre-existent constipation were associated with an increased risk of persistence of constipation postoperatively or new-onset constipation (p = 0.004 and p < 0.0001, respectively). The use of postoperative pelvic floor rehabilitation (p = 0.034) may reduce the risk of postoperative constipation. Conclusions: VMR is a safe and effective intervention for correcting the anatomical defect of rectal prolapse. The degree of prolapse, the presence of dolichocolon and pre-existing constipation are risk factors for the persistence or new onset of postoperative constipation. Postoperative rehabilitation treatment may reduce this risk.
MeSH term(s)	Humans ; Adult ; Middle Aged ; Aged ; Aged, 80 and over ; Rectal Prolapse/complications ; Rectal Prolapse/surgery ; Fecal Incontinence/etiology ; Fecal Incontinence/surgery ; Defecation ; Surgical Mesh/adverse effects ; Quality of Life ; Laparoscopy/methods ; Treatment Outcome ; Constipation/etiology ; Constipation/surgery ; Rectum/surgery
Language	English
Publishing date	2022-10-04
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/s10151-022-02708-8
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Article ; Online: Obstructed defecation syndrome associated with paradoxical puborectalis contraction: osteopathic treatment versus anal biofeedback. Results of a pilot study.

Ascanelli, S / Portinari, M / Canella, M / Solari, S / Dall'Omo, F / Danese, S / De Troia, A / Carcoforo, P

Techniques in coloproctology

2021 Volume 25, Issue 5, Page(s) 589–595

Abstract: Background: Biofeedback is the most widespread rehabilitative therapy for the treatment of anismus after failed conservative treatment. Osteopathy represents an alternative therapy for constipation. The aim of this study was to evaluate short- and long- ... ...

Abstract	Background: Biofeedback is the most widespread rehabilitative therapy for the treatment of anismus after failed conservative treatment. Osteopathy represents an alternative therapy for constipation. The aim of this study was to evaluate short- and long-term results of osteopathic treatment as compared to biofeedback in patients with dyssynergic defecation. Methods: This was a prospective cohort pilot study on 30 patients with dyssynergic defecation enrolled at the Colorectal Clinic of the University Hospital of Ferrara, Italy, from May 2015 to May 2016 and followed until May 2020. Dyssynergic defecation was defined as the inappropriate contraction of the pelvic floor or less than 20% relaxation of basal resting sphincter pressure (on anal manometry) with adequate propulsive forces during attempted defecation. Dyssynergic patients were divide into 2 treatment groups: 15 patients had osteopathy and 15 patients had biofeedback. Before and 3 months after rehabilitation treatment, all patients had anorectal manometry, defecography, and ultrasound, and were evaluated with the Cleveland Clinic Florida (CCF) constipation score, obstructed defecation syndrome (ODS) score, Colo-rectal-anal Distress Inventory (CRADI-8), Colo-rectal-anal Impact Questionnaire (CRAIQ-7), and the Brusciano Score (BS). To evaluate the efficacy of osteopathy and biofeedback in the long-term, all patients completed the above-mentioned questionnaires 5 years later via a telephone interview. Results: The two treatments were similarly effective in the short term with reduction in questionnaires scores, and increase in the percentage of anal sphincter release at straining at anorectal manometry in both groups. The ODS score was significantly reduced in biofeedback group (p = 0.021). The 3-month post-treatment BS was lower in the osteopathy group, but this just failed to reach statistical significance (p = 0.050). Periodic rehabilitation reinforcements were provided. The CCF constipation score decreased significantly in the osteopathy group (p = 0.023) after 5 years. Conclusions: Osteopathy is a promising treatment for dyssynergic defecation, and it can be associated with biofeedback.
MeSH term(s)	Anal Canal ; Biofeedback, Psychology ; Constipation/etiology ; Constipation/therapy ; Defecation ; Humans ; Italy ; Manometry ; Pelvic Floor ; Pilot Projects ; Prospective Studies
Language	English
Publishing date	2021-02-27
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/s10151-020-02381-9
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Article: Radioguided sentinel lymph node biopsy in patients with papillary thyroid carcinoma.

Portinari, Mattia / Carcoforo, Paolo

Gland surgery

2017 Volume 5, Issue 6, Page(s) 591–602

Abstract: Background: The ATA guidelines do not recommend prophylactic central compartment neck dissection in patients with T1-T2 papillary thyroid carcinoma (PTC) with no clinical evidence of lymph node metastasis, however patients' staging is recommended. Lymph ...

Abstract	Background: The ATA guidelines do not recommend prophylactic central compartment neck dissection in patients with T1-T2 papillary thyroid carcinoma (PTC) with no clinical evidence of lymph node metastasis, however patients' staging is recommended. Lymph node metastasis may be present also in small PTC, but preoperative ultrasound identifies suspicious cervical lymphadenopathy in 20-30% of patients. The role of sentinel lymph node biopsy (SLNB) remain open to debate. It has been shown that the identification rate of SLN in PTC patients is improved using a radiotracer compared to a dye technique. The aim of this systematic review was to evaluate the role of radioguided SLNB (rSLNB) in the treatment of PTC patients. Methods: A systematic search was performed in the PubMed and Embase database to identify all original articles regarding the application of rSLNB in PTC patients. The primary outcome was false negative rate (FNR) of the rSLNB; the secondary outcomes were SLN intraoperative identification rate (IIR), site of lymph node metastasis, and persistent disease during follow up. Results: Twelve studies were included. Most of PTC patients were T1-T2. The overall SLN IIR, SLN metastatic rate, and FNR were 92.1%, 33.6%, and 25.4%, respectively. Overall, lymph node metastasis were found in the central compartment (23.0%) and in the lateral compartments (10.6%). The persistent disease in patients who underwent SLNB associated to lymph node dissection (LND) in the same compartment of the SLN regardless of the SLN status was 0.6%. Conclusions: In all PTC patients, also in T1-T2 stage, due to the high FNR the SLNB performed alone should be abandoned and converted into a technique to guide the lymphadenectomy in a specific neck compartment (i.e., central or lateral) based on the radioactivity, regardless of the SLN status, for better lymph node staging and selection of patients for postoperative radioiodine ablation.
Language	English
Publishing date	2017-01-18
Publishing country	China (Republic : 1949- )
Document type	Journal Article
ZDB-ID	3016969-0
ISSN	2227-8575 ; 2227-684X
ISSN (online)	2227-8575
ISSN	2227-684X
DOI	10.21037/gs.2016.11.08
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Article: The application of drains in thyroid surgery.

Portinari, Mattia / Carcoforo, Paolo

Gland surgery

2017 Volume 6, Issue 5, Page(s) 563–573

Abstract: It has been shown that the use of drain in thyroid surgery does not reduce the reoperation rate for hemorrhage. The aim of this systematic review was to update the knowledge of the role of drain in thyroid surgery in term of postoperative complications, ... ...

Abstract	It has been shown that the use of drain in thyroid surgery does not reduce the reoperation rate for hemorrhage. The aim of this systematic review was to update the knowledge of the role of drain in thyroid surgery in term of postoperative complications, pain and hospital length of stay (LOS). A systematic search was performed in the PubMed and Embase database to identify all randomized controlled trials (RCTs) comparing clinical outcomes in patients who underwent thyroidectomy or lobectomy with or without drainage. The primary outcome was reoperation rate for bleeding; the secondary outcomes were development of hematoma, seroma, and wound infection; postoperative pain evaluated by Visual Analogue Scale (VAS) at the postoperative day (POD) 1, and hospital LOS. Risk ratios (RRs) and 95% confident intervals (95% CI) were used for dichotomous variables; mean differences (MDs) and 95% CI for continuous variables. Statistical heterogeneity was evaluated and its degree was quantified by the I2 statistic. Twenty RCTs were included, with 2,204 patients enrolled. No difference was found between the two groups in term of reoperation [RR 1.13 (0.43, 2.95); I2 =0%], hematoma [RR 1.18 (0.71, 1.95); I2 =0%], and seroma [RR 0.82 (0.44, 1.53); I2 =0%]. Patients with drain had higher postoperative pain [MD 1.91 (1.30, 2.53); I2 =97%], prolonged hospital LOS [MD 1.34 (0.91, 1.76) days; I2 =98%], and increased wound infection rate [RR 2.82 (1.36, 5.86); I2 =0%], even though the latter was not confirmed in the sensitivity analysis including only studies with ≥100 patients per trial. The use of drain after thyroid surgery increase postoperative pain and hospital LOS, with no decrease of reoperation rate, hematoma and seroma formation. An increased wound infection rate in patients with drain is suggested, but a large RCT should be performed to confirm this correlation.
Language	English
Publishing date	2017-01-17
Publishing country	China (Republic : 1949- )
Document type	Journal Article ; Review
ZDB-ID	3016969-0
ISSN	2227-8575 ; 2227-684X
ISSN (online)	2227-8575
ISSN	2227-684X
DOI	10.21037/gs.2017.07.04
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Article: Full-Dose Intraoperative Electron Radiotherapy for Early Breast Cancer: Evidence from a Single Center's Experience.

Stefanelli, Antonio / Farina, Eleonora / Mastella, Edoardo / Fabbri, Sara / Turra, Alessandro / Bonazza, Simona / De Troia, Alessandro / Radica, Margherita K / Carcoforo, Paolo

Cancers

2023 Volume 15, Issue 12

Abstract: To evaluate the clinical response rate and cosmetic outcome after full-dose intraoperative electron radiotherapy (IOERT) in early breast cancer (BC) treated with conserving surgery. Inclusion criteria were: >60 years old, clinical tumor size ≤2 cm, ... ...

Abstract	To evaluate the clinical response rate and cosmetic outcome after full-dose intraoperative electron radiotherapy (IOERT) in early breast cancer (BC) treated with conserving surgery. Inclusion criteria were: >60 years old, clinical tumor size ≤2 cm, luminal A carcinoma, patological negative lymph nodes, excluded lobular carcinoma histology. IOERT was delivered with a dose of 21 Gy at 90% isodose. Clinical, cosmetic and/or instrumental follow-up were performed 45 days after IOERT, 6 months after the first check, and every 12 months thereafter. Acute and late toxicities were assessed with the CTCAE v.4.03 and EORTC-RTOG scales, respectively. Cosmetic outcome was evaluated using the Harvard/NSABO/RTOG Breast Cosmesis Grading Scale. Overall, 162 consecutive patients were included in this analysis (median follow-up: 54 months, range: 1-98 months). The overall response rate was 97.5% (CI 95%: 0.93-0.99%). Locoragional relapse occurred in 2.5% of patients. No patient showed distant metastases. No patient showed radiation-related acute complications, with 3.7% showing late G2-3 toxicity. Only 3.7% of patients showed poor cosmetic results. Our data confirmed that IOERT is a feasible and valid therapeutic option in low-risk BC patients treated with lumpectomy. A low local recurrence rate combined with good cosmetic results validates the settings of our operative method in routinely clinical practice.
Language	English
Publishing date	2023-06-19
Publishing country	Switzerland
Document type	Journal Article
ZDB-ID	2527080-1
ISSN	2072-6694
ISSN	2072-6694
DOI	10.3390/cancers15123239
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Article ; Online: Lymph Node Biopsy in Patients With Papillary Thyroid Cancer.

Portinari, Mattia / Carcoforo, Paolo

JAMA otolaryngology-- head & neck surgery

2017 Volume 143, Issue 4, Page(s) 428–429

MeSH term(s)	Humans ; Lymph Nodes ; Lymphoscintigraphy ; Sentinel Lymph Node Biopsy ; Single Photon Emission Computed Tomography Computed Tomography ; Thyroid Neoplasms/surgery
Language	English
Publishing date	2017-01-25
Publishing country	United States
Document type	Journal Article ; Comment
ZDB-ID	2701825-8
ISSN	2168-619X ; 2168-6181
ISSN (online)	2168-619X
ISSN	2168-6181
DOI	10.1001/jamaoto.2016.3650
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Article ; Online: Predictive Factors of Recurrence After Laparoscopic Incisional Hernia Repair: A Retrospective Multicentre Cohort Study.

Soliani, Giorgio / De Troia, Alessandro / Pesce, Antonio / Portinari, Mattia / Fabbri, Nicolò / Leonardi, Luca / Neri, Silvia / Carcoforo, Paolo / Feo, Carlo V

Journal of laparoendoscopic & advanced surgical techniques. Part A

2023 Volume 33, Issue 5, Page(s) 427–433

Abstract: Background: ...

Abstract	Background:
MeSH term(s)	Humans ; Incisional Hernia/surgery ; Cohort Studies ; Retrospective Studies ; Laparoscopy/methods ; Herniorrhaphy/methods ; Surgical Mesh ; Hernia, Ventral/surgery
Language	English
Publishing date	2023-01-20
Publishing country	United States
Document type	Multicenter Study ; Journal Article
ZDB-ID	1381909-4
ISSN	1557-9034 ; 1092-6429
ISSN (online)	1557-9034
ISSN	1092-6429
DOI	10.1089/lap.2022.0465
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Article ; Online: Intraoperative Laparoscopic Fixation Sutures to Prevent Neorectal Prolapse After Transanal Total Mesorectal Excision.

Ascanelli, Simona / Marcello, Daniele / Soliani, Giorgio / Feo, Carlo Vittorio / De Troia, Alessandro / Campagnaro, Alberto / Carcoforo, Paolo

Diseases of the colon and rectum

2023 Volume 67, Issue 1, Page(s) e3–e4

MeSH term(s)	Humans ; Proctectomy ; Rectum/surgery ; Laparoscopy/adverse effects ; Prolapse ; Rectal Neoplasms/surgery ; Sutures ; Transanal Endoscopic Surgery ; Postoperative Complications/surgery ; Treatment Outcome
Language	English
Publishing date	2023-08-30
Publishing country	United States
Document type	Journal Article
ZDB-ID	212581-x
ISSN	1530-0358 ; 0012-3706
ISSN (online)	1530-0358
ISSN	0012-3706
DOI	10.1097/DCR.0000000000002735
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Article ; Online: PROPHYlactic Implantation of BIOlogic Mesh in peritonitis (PROPHYBIOM): a prospective multicentric randomized controlled trial.

Coccolini, F / Tarasconi, A / Petracca, G L / Perrone, G / Giuffrida, M / Disisto, C / Sartelli, M / Carcoforo, P / Ansaloni, L / Catena, F

Trials

2022 Volume 23, Issue 1, Page(s) 198

Abstract: Background: Patients undergoing emergency surgery for peritonitis are at increased risk of abdominal wall-related complications. In patients with peritonitis, the risk of incisional hernia (IH) is extremely elevated. The evaluation of quality of life of ...

Abstract	Background: Patients undergoing emergency surgery for peritonitis are at increased risk of abdominal wall-related complications. In patients with peritonitis, the risk of incisional hernia (IH) is extremely elevated. The evaluation of quality of life of patients with incisional hernia showed lower mean scores on physical components of health-related quality of life and body image. Furthermore, the arise of a post-operative abdominal wall complication (i.e., wound dehiscence, evisceration and IH) greatly increases morbidity and mortality rates and prolongs the hospitalization. Methods: The present study aims to evaluate the efficacy of the use of a swine dermal collagen prosthesis implanted preperitoneally as a prophylactic procedure in urgency/emergency setting against abdominal wall complications in patients operated with contaminated/infected field in peritonitis. The sample size was defined in 90 patients divided in two arms (prosthesis positioning versus normal wall abdominal closure). The follow-up will be performed at 3, 6, and 12 months after surgery. The percentage of incisional hernias, wound infections, and adverse events will be investigated by physical examination and ultrasound. Discussion: The objective is to evaluate the possibility to reduce the incisional hernia rate in patients undergoing urgent/emergent laparotomy in contaminated/infected field with peritonitis by using swine dermal collagen prosthesis preperitoneal positioning as a prophylactic procedure. Trial registration: ClinicalTrials.gov NCT04681326. Registered (retrospectively after first patient recruited) on 23 December 2020.
MeSH term(s)	Abdominal Wall/surgery ; Abdominal Wound Closure Techniques/adverse effects ; Biological Products ; Humans ; Incisional Hernia/etiology ; Incisional Hernia/prevention & control ; Incisional Hernia/surgery ; Peritonitis/etiology ; Peritonitis/prevention & control ; Peritonitis/surgery ; Prospective Studies ; Prostheses and Implants/adverse effects ; Quality of Life ; Retrospective Studies ; Surgical Mesh/adverse effects
Chemical Substances	Biological Products
Language	English
Publishing date	2022-03-04
Publishing country	England
Document type	Journal Article ; Randomized Controlled Trial
ZDB-ID	2040523-6
ISSN	1745-6215 ; 1468-6694 ; 1745-6215
ISSN (online)	1745-6215
ISSN	1468-6694 ; 1745-6215
DOI	10.1186/s13063-022-06103-4
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