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  1. Book ; Online ; E-Book: Abdominal neuroendocrine tumors

    Carlini, Massimo

    (Updates in surgery)

    2018  

    Author's details Massimo Carlini editor
    Series title Updates in surgery
    Language English
    Size 1 Online-Ressource (xvi, 207 Seiten)
    Publisher Springer
    Publishing place Milano
    Publishing country Italy
    Document type Book ; Online ; E-Book
    Remark Zugriff für angemeldete ZB MED-Nutzerinnen und -Nutzer
    HBZ-ID HT019515934
    ISBN 978-88-470-3955-1 ; 9788847039544 ; 88-470-3955-X ; 8847039541
    DOI 10.1007/978-88-470-3955-1
    Database ZB MED Catalogue: Medicine, Health, Nutrition, Environment, Agriculture

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  2. Article ; Online: The role of transanal total mesorectal excision in the treatment of rectal cancer: a systematic review.

    Grieco, Michele / Marcellinaro, Rosa / Russo, Giulia / Menditto, Rosa / Compalati, Iacopo / Passafiume, Fabiola / Carlini, Massimo

    Minerva surgery

    2023  Volume 78, Issue 4, Page(s) 421–432

    Abstract: Introduction: Total mesorectal excision (TME) during rectal resection is considered the gold standard for the treatment of rectal cancer. Transanal total mesorectal excision (TaTME) was first described in 2010 and has been applied to humans since 2012 ... ...

    Abstract Introduction: Total mesorectal excision (TME) during rectal resection is considered the gold standard for the treatment of rectal cancer. Transanal total mesorectal excision (TaTME) was first described in 2010 and has been applied to humans since 2012 to overcome some of the technical difficulties associated with minimally invasive TMEs.
    Evidence acqusition: A systematic review of the literature was conducted, and it focused on articles published between 2012 and 2022 to analyze the state of the art of surgical techniques and indications, as well as potential technical, oncological, and functional benefits.
    Evidence synthesis: The indications for TaTME are not yet standardized, and structured training programs are necessary to complete a safe learning curve for this new technique. The procedure, when compared with conventional open or minimally invasive TME, is feasible and safe with similar intraoperative and postoperative complications. On the other hand, some new specific complications of this new approach have been described. The short-term pathological and oncologic results are encouraging, especially in terms of the mesorectal specimen quality, distal resection margin and conversion rate. Also, the functional results seem encouraging when compared with other minimally invasive techniques.
    Conclusions: Long-term follow-up and ongoing RCT trials are fundamental to evaluate the possible benefits in terms of local recurrence and survival. This will facilitate the comparison with other minimally invasive rectal resections.
    MeSH term(s) Humans ; Rectum/surgery ; Rectum/pathology ; Laparoscopy/methods ; Treatment Outcome ; Transanal Endoscopic Surgery ; Rectal Neoplasms/surgery
    Language English
    Publishing date 2023-02-06
    Publishing country Italy
    Document type Systematic Review ; Journal Article
    ZDB-ID 3067899-7
    ISSN 2724-5438
    ISSN (online) 2724-5438
    DOI 10.23736/S2724-5691.22.09837-9
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    Zs.A 25: Show issues Location:
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  3. Article: Colorectal Cancer: Current Updates and Future Perspectives.

    Marcellinaro, Rosa / Spoletini, Domenico / Grieco, Michele / Avella, Pasquale / Cappuccio, Micaela / Troiano, Raffaele / Lisi, Giorgio / Garbarino, Giovanni M / Carlini, Massimo

    Journal of clinical medicine

    2023  Volume 13, Issue 1

    Abstract: Colorectal cancer is a frequent neoplasm in western countries, mainly due to dietary and behavioral factors. Its incidence is growing in developing countries for the westernization of foods and lifestyles. An increased incidence rate is observed in ... ...

    Abstract Colorectal cancer is a frequent neoplasm in western countries, mainly due to dietary and behavioral factors. Its incidence is growing in developing countries for the westernization of foods and lifestyles. An increased incidence rate is observed in patients under 45 years of age. In recent years, the mortality for CRC is decreased, but this trend is slowing. The mortality rate is reducing in those countries where prevention and treatments have been implemented. The survival is increased to over 65%. This trend reflects earlier detection of CRC through routine clinical examinations and screening, more accurate staging through advances in imaging, improvements in surgical techniques, and advances in chemotherapy and radiation. The most important predictor of survival is the stage at diagnosis. The screening programs are able to reduce incidence and mortality rates of CRC. The aim of this paper is to provide a comprehensive overview of incidence, mortality, and survival rate for CRC.
    Language English
    Publishing date 2023-12-21
    Publishing country Switzerland
    Document type Journal Article ; Review
    ZDB-ID 2662592-1
    ISSN 2077-0383
    ISSN 2077-0383
    DOI 10.3390/jcm13010040
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  4. Article: The Role of Antibiotic Prophylaxis in Anastomotic Leak Prevention during Elective Colorectal Surgery: Systematic Review and Meta-Analysis of Randomized Controlled Trials.

    Castagneto-Gissey, Lidia / Russo, Maria Francesca / Casella-Mariolo, James / Serao, Angelo / Marcellinaro, Rosa / D'Andrea, Vito / Carlini, Massimo / Casella, Giovanni

    Antibiotics (Basel, Switzerland)

    2023  Volume 12, Issue 2

    Abstract: ... ...

    Abstract Introduction
    Language English
    Publishing date 2023-02-16
    Publishing country Switzerland
    Document type Journal Article ; Review
    ZDB-ID 2681345-2
    ISSN 2079-6382
    ISSN 2079-6382
    DOI 10.3390/antibiotics12020397
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  5. Article ; Online: How to reduce the colorectal anastomotic leakage? The MIRACLe protocol experience in a cohort in a single high-volume centre.

    Marcellinaro, Rosa / Grieco, Michele / Spoletini, Domenico / Troiano, Raffaele / Avella, Pasquale / Brachini, Gioia / Mingoli, Andrea / Carlini, Massimo

    Updates in surgery

    2023  Volume 75, Issue 6, Page(s) 1559–1567

    Abstract: This article reports the results of a novel perioperative treatment implementing the gut microbiota to prevent anastomotic fistula and leakage (AL) in patients undergoing laparoscopic colorectal resections for cancer and represents the continuation of ... ...

    Abstract This article reports the results of a novel perioperative treatment implementing the gut microbiota to prevent anastomotic fistula and leakage (AL) in patients undergoing laparoscopic colorectal resections for cancer and represents the continuation of our pilot study on 60 cases. A series of 131 patients underwent elective colorectal surgery at the S. Eugenio Hospital (Rome-Italy) between December 1, 2020, and November 30, 2022, and received a perioperative preparation following the Microbiota Implementation to Reduce Anastomotic Colorectal Leaks (MIRACLe) protocol comprising oral antibiotics, mechanical bowel preparation and perioperative probiotics. The results obtained in the MIRACLe group (MG) were compared to those registered in a Control group (CG) of 500 patients operated on between March 2015 and November 30, 2020, who received a standard ERAS protocol. Propensity score-matching (PSM) analysis was performed to overcome patients' selection bias. Patients were categorised according to perioperative preparation (MIRACLe protocol vs standard ERAS protocol) into two groups: 118 patients were in post-matched MIRACLe group (pmMG) and 356 were in post-matched Control group (pmCG). In the pmMG, only 2 anastomotic leaks were registered, and the incidence of AL was just 1.7% vs. 6.5% in the pmCG (p = 0.044). The incidence of surgical site infections (1.7% vs. 3.1%; p = 0.536), reoperations (0.8% vs. 4.2%; p = 0.136) and postoperative mortality (0% vs. 2.0%; p = 0.200) was lower in pmMG. Additionally, the postoperative outcomes were better: the times to first flatus, to first stool and to oral feeding were shorter (1 vs. 2, 2 vs. 3 and 2 vs. 3 days, respectively; p < 0.001). The postoperative recovery was faster, with a shorter time to discharge (5 vs. 6 days; p < 0.001). The MIRACLe protocol was confirmed to be safe and significantly able to reduce anastomotic leaks in patients receiving elective laparoscopic colorectal surgery for cancer.
    MeSH term(s) Humans ; Anastomotic Leak/epidemiology ; Anastomotic Leak/prevention & control ; Anastomotic Leak/etiology ; Pilot Projects ; Surgical Wound Infection/prevention & control ; Laparoscopy/adverse effects ; Laparoscopy/methods ; Colorectal Neoplasms/surgery ; Colorectal Neoplasms/complications ; Microbiota ; Postoperative Complications/epidemiology
    Language English
    Publishing date 2023-07-15
    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/s13304-023-01588-3
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    Zs.B 101: Show issues Location:
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  6. Article ; Online: Nutritional support in surgical oncology: A survey by SICO in collaboration with the Intersociety Italian Working Group for Nutritional Support in Cancer Patients.

    Grieco, Michele / Delrio, Paolo / Lorenzon, Laura / Agnes, Amedea Luciana / Caccialanza, Riccardo / Pedrazzoli, Paolo / Santoro, Gloria / Roviello, Franco / Carlini, Massimo

    Surgical oncology

    2022  Volume 43, Page(s) 101788

    Abstract: Purpose: Nutritional support is a keystone component in perioperative care in patients undergoing oncological surgery with a direct impact on surgical outcomes. This study aimed to evaluate how nutritional support in the surgical setting is managed and ... ...

    Abstract Purpose: Nutritional support is a keystone component in perioperative care in patients undergoing oncological surgery with a direct impact on surgical outcomes. This study aimed to evaluate how nutritional support in the surgical setting is managed and applied in Italian hospitals.
    Methods: A national survey was designed by the Italian Society of Surgical Oncology (SICO) and disseminated in early 2021. The results were analyzed for the entire population and for comparing the following different subgroups: northern vs. southern regions; high-volume vs. low-volume centers; and junior vs. senior surgeons.
    Results: Out of the 141 responses collected from all Italian regions, 43.2% of the participants worked in a surgical unit where nutritional status evaluations and interventions were not routinely practiced, although the key features (nutritional counseling, oral supplementation, enteral and parenteral nutrition) were available in 77.3% of the hospitals. Among the participating centers, the ERAS protocol was systematically applied in only 29.5% of cases, and in 25.5% of cases, most of the items were followed, although not systematically. Among the surgeons who practiced in compliance with the ERAS pathways, almost half of the participants declared that the protocol was applied only for low-risk patients. No significant differences were documented when comparing Italian regions, high-volume vs. low-volume institutions or junior vs. senior participants.
    Conclusion: Nutritional support in oncological surgery is frequently neglected in Italian hospitals, regardless of the geographic distribution and volumes of the institutions. A cultural change and an improvement in the availability of nutritional services are needed for widespread implementation.
    MeSH term(s) Humans ; Italy/epidemiology ; Neoplasms/surgery ; Nutritional Support ; Perioperative Care ; Surgical Oncology
    Language English
    Publishing date 2022-06-10
    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.2022.101788
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    Zs.A 3409: Show issues Location:
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  7. Article ; Online: Laparoscopic right colectomy: changes in surgical technique and perioperative management allow better postoperative results in a comparative series of 361 patients.

    Grieco, Michele / Marcellinaro, Rosa / Spoletini, Domenico / Menditto, Rosa / Lisi, Giorgio / Russo, Giulia / Napoleone, Vincenzo / Carlini, Massimo

    Updates in surgery

    2022  Volume 74, Issue 3, Page(s) 883–890

    Abstract: To compare the short-term outcomes in patients who underwent laparoscopic right colectomy with a traditional minimally invasive approach versus patients who underwent a laparoscopic colectomy with an enhanced perioperative pathway. A retrospective ... ...

    Abstract To compare the short-term outcomes in patients who underwent laparoscopic right colectomy with a traditional minimally invasive approach versus patients who underwent a laparoscopic colectomy with an enhanced perioperative pathway. A retrospective analysis was conducted on a consecutive series of patients who underwent elective laparoscopic right colectomy for neoplastic disease between January 1, 2011 and December 31, 2020. The patients were divided into two groups: the first cohort (FC), who underwent a traditional laparoscopic colectomy, mainly with extracorporeal anastomosis, between January 1, 2011 and December 31, 2015 and the second cohort (SC), who underwent a laparoscopic colectomy with an enhanced intraoperative (intracorporeal anastomosis) and perioperative pathway (ERAS protocol) between January 1, 2016 and December 31, 2020. There were a total of 361 patients, including 177 in the FC and 184 in the SC. In the SC a higher number of intracorporeal anastomoses was performed (91.8% vs. 19.2%, p < 0.001), drains were placed in 42 patients only (22.8% vs. 100% in the FC) and nasogastric tubes were placed in 21 patients only (11.4% vs. 100% in the FC). In the initial period of the SC. the procedures required a slightly longer operative time (median 105 vs. 95 min; p = 0.002), but postoperative surgical complications were lower (12% vs. 17.4%, p = 0.179). Postoperative recovery was faster in SC along with time to discharge (4 vs. 7 days; p < 0.001). Intraoperative anastomosis and enhanced pathways in right laparoscopic colectomy seem to guarantee better results with lower surgical complications and faster postoperative recovery.
    MeSH term(s) Anastomosis, Surgical/methods ; Colectomy/methods ; Colonic Neoplasms/surgery ; Humans ; Laparoscopy/methods ; Operative Time ; Perioperative Care/methods ; Postoperative Complications/epidemiology ; Postoperative Complications/prevention & control ; Retrospective Studies ; Treatment Outcome
    Language English
    Publishing date 2022-04-12
    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/s13304-022-01287-5
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    Zs.B 101: Show issues Location:
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  8. Article ; Online: Implementation of the gut microbiota prevents anastomotic leaks in laparoscopic colorectal surgery for cancer:the results of the MIRACLe study.

    Carlini, Massimo / Grieco, Michele / Spoletini, Domenico / Menditto, Rosa / Napoleone, Vincenzo / Brachini, Gioia / Mingoli, Andrea / Marcellinaro, Rosa

    Updates in surgery

    2022  Volume 74, Issue 4, Page(s) 1253–1262

    Abstract: The aim of this pilot study was to evaluate the effects of a novel perioperative treatment for the implementation of the gut microbiota, to prevent anastomotic fistula and leakage (AL) in patients undergoing laparoscopic colorectal resections for cancer. ...

    Abstract The aim of this pilot study was to evaluate the effects of a novel perioperative treatment for the implementation of the gut microbiota, to prevent anastomotic fistula and leakage (AL) in patients undergoing laparoscopic colorectal resections for cancer. A series of 60 patients who underwent elective colorectal surgery at S. Eugenio Hospital (Rome-Italy) between December 1, 2020 and November 30, 2021 and received a novel perioperative preparation following the MIRACLe (Microbiota Implementation to Reduce Anastomotic Colorectal Leaks) protocol (oral antibiotics, mechanical bowel preparation and perioperative probiotics), was compared to a group of 500 patients (control group) operated on between March 2015 and November 30, 2020, who received a standard ERAS protocol. In the MIRACLe Group only 1 anastomotic leak was registered. In this group the incidence of AL was just 1.7% vs. 6.4% in the control group (p = 0.238) and the incidence of surgical site infections (1.7% vs. 3.6%; p = 0.686), reoperations (1.7% vs. 4.2%; p = 0.547) and postoperative mortality (0% vs. 2.2%; p = 0.504) were lower. The postoperative outcomes were also better: the times to first flatus, to first stool and to oral feeding were shorter (1 vs. 2, 2 vs. 3 and 2 vs. 3 days, respectively; p < 0.001). Additionally, the postoperative recovery was faster, with a shorter time to discharge (4 vs. 6 days; p < 0.001). In this pilot study, the MIRACLe protocol appeared to be safe and considerably reduced anastomotic leaks in elective laparoscopic colorectal surgery for cancer, even if not statistically significant, due to the small number of cases.
    MeSH term(s) Anastomotic Leak/epidemiology ; Anastomotic Leak/etiology ; Anastomotic Leak/prevention & control ; Colorectal Neoplasms/complications ; Colorectal Neoplasms/surgery ; Colorectal Surgery ; Gastrointestinal Microbiome ; Humans ; Laparoscopy/methods ; Pilot Projects ; Postoperative Complications/epidemiology
    Language English
    Publishing date 2022-06-23
    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/s13304-022-01305-6
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  9. Article ; Online: Subcuticular sutures in laparoscopic colorectal surgery: a comparative study to evaluate wound infection rates and cosmetic results.

    Grieco, Michele / Spoletini, Domenico / Marcasciano, Marco / Grattarola, Emanuela / Shihab, Viktoria / Carlini, Massimo

    Updates in surgery

    2020  Volume 72, Issue 4, Page(s) 1005–1011

    Abstract: Laparoscopic colorectal surgery is categorized as clean-contaminated surgery. It is important to prevent incisional surgical site infections (SSIs), because SSIs can prolong hospital stays, increase medical costs and produce negative cosmetic outcomes ... ...

    Abstract Laparoscopic colorectal surgery is categorized as clean-contaminated surgery. It is important to prevent incisional surgical site infections (SSIs), because SSIs can prolong hospital stays, increase medical costs and produce negative cosmetic outcomes for patients. The aim of this study is to evaluate the efficacy of subcuticular skin sutures following colorectal laparoscopic surgery in terms of wound infection rates and aesthetic results. A retrospective analysis on a database of a consecutive series of unselected patients was conducted. Patients underwent elective colorectal laparoscopic surgery in a single center between October 1st of 2016 and October 30th of 2017. Data on patients' demographics, operative details, short-term and long-term outcomes and aesthetic satisfaction were prospectively recorded. A total of 100 patients were selected and divided in 2 groups: 43 patients who had received subcuticular sutures, 57 patients who had received separate stitch sutures. Wound infection rates were lower, with no statistical significance in the subcuticular suture group (6.9% versus 15.8%, p = 0.182), but the patient-reported cosmetic results were superior in the subcuticular suture group (1.9 versus 2.9, p < 0.001). Multivariate analyses identified high BMI and low preoperative hemoglobin level as possible risk factors associated with wound infection after colorectal laparoscopic surgery. Subcuticular sutures could improve cosmetic results in patients undergoing elective laparoscopic surgery for colorectal cancer with comparable risks of wound infection. In this population, high BMI and low preoperative hemoglobin levels appear to be risk factors associated with wound infections.
    MeSH term(s) Aged ; Body Mass Index ; Colon/surgery ; Digestive System Surgical Procedures/methods ; Elective Surgical Procedures/methods ; Esthetics ; Female ; Hemoglobins/metabolism ; Humans ; Laparoscopy/methods ; Male ; Patient Satisfaction ; Rectum/surgery ; Risk Factors ; Surgical Wound Infection/epidemiology ; Surgical Wound Infection/etiology ; Surgical Wound Infection/prevention & control ; Suture Techniques ; Treatment Outcome
    Chemical Substances Hemoglobins
    Language English
    Publishing date 2020-03-12
    Publishing country Italy
    Document type Comparative Study ; Journal Article
    ZDB-ID 2572692-4
    ISSN 2038-3312 ; 2038-131X
    ISSN (online) 2038-3312
    ISSN 2038-131X
    DOI 10.1007/s13304-020-00740-7
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  10. Article: Evaluation of the Performance of ACR TI-RADS Also Considering Those Nodules with No Indication of FNAC: A Single-Center Experience.

    Amendola, Stefano / Wolde Sellasie, Sium / Pedicini, Francesco / Carlini, Massimo / Russo, Giulia / Ossola, Nicola / Leoncini, Andrea / Botti, Flavia / Bonanno, Elena / Trimboli, Pierpaolo / Uccioli, Luigi

    Journal of clinical medicine

    2023  Volume 12, Issue 2

    Abstract: Background: Several US risk stratification score systems (RSSs) have been developed to standardize a thyroid nodule risk of malignancy. It is still a matter of debate which RSS is the most reliable. The purpose of this study is to evaluate: (1) the ... ...

    Abstract Background: Several US risk stratification score systems (RSSs) have been developed to standardize a thyroid nodule risk of malignancy. It is still a matter of debate which RSS is the most reliable. The purpose of this study is to evaluate: (1) the concordance between the American College of Radiology TI-RADS (ACR TI-RADS) and fine needle aspiration cytology (FNAC), (2) the cancer rate in the ACR TI-RADS categories, (3) the characteristics of nodules evaluated by FNAC even if not formally indicated according to ACR TI-RADS ('not indicated FNACs").
    Methods: From January 2021 to September 2022, patients attending the Endocrinology Unit of the CTO Hospital of Rome for evaluation of thyroid nodules were included.
    Results: 830 nodules had negative cytology, belonging to TIR2 and TIR1C. One hundred and thirteen nodules were determined to be suspicious for or consistent with malignancy belonging to TIR3B/TIR4/TIR5. Of this last group, 94% were classified as TR4/TR5 nodules. In total, 87/113 underwent surgery. Among these, 73 had histologically proven cancer, 14 turned out to be benign. "Not indicated FNACs" was 623. Among these, 42 cancers were present.
    Conclusions: This study confirmed the diagnostic power of ACR TI-RADS. In addition, these data suggest revising the ACR TI-RADS indication to FNAC, especially for TR4.
    Language English
    Publishing date 2023-01-04
    Publishing country Switzerland
    Document type Journal Article
    ZDB-ID 2662592-1
    ISSN 2077-0383
    ISSN 2077-0383
    DOI 10.3390/jcm12020398
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