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Article ; Online: Right-sided colonic diverticulitis. Short and long-term surgical outcomes and 2-year quality of life.

Lauricella, Sara / Brucchi, Francesco / Palmisano, Dario / Baldazzi, Gianandrea / Bottero, Luca / Cassini, Diletta / Faillace, Giuseppe

World journal of surgery

2024 Volume 48, Issue 2, Page(s) 484–492

Abstract: Aim: We aimed to investigate the short and the long-term outcomes and 2-year Quality of Life (QoL) of patients with right-sided colonic diverticulitis (RCD) surgically managed.: Method: We conducted an ambidirectional cohort study of patients with ... ...

Abstract	Aim: We aimed to investigate the short and the long-term outcomes and 2-year Quality of Life (QoL) of patients with right-sided colonic diverticulitis (RCD) surgically managed. Method: We conducted an ambidirectional cohort study of patients with RCD undergoing surgery between 2012/2022. A colonoscopy was performed at 1-year post surgery. The enrolled patients completed the EuroQoL (EQ-5D-3L) during a regular follow-up visit at 12 and 24 months after surgery. Results: Three hundred nineteen patients with RCD were selected: 223 (70%) patients were treated by non-operative management (NOM) while 33 underwent surgery. Acute diverticulitis occurred in 30 patients: 9 (27.2%) were classified by CT as uncomplicated and 21 (63.6%) as complicated diverticulitis. Additionally, chronic diverticulitis occurred in 3 cases (9.2%). Specifically, 27 patients were classified by CT as 1a (81.8%) and 6 patients as 3 (18.2%). Right hemicolectomy was performed in 30 patients (90.8%), and ileo-caecectomy in 3 (9.2%). Nine (27.27%) experienced postoperative complications: 7 (77.7%) were classified according to the Clavien-Dindo as grade I-II, and 2 (22.2%) as grade III. No disease recurrence or colorectal cancer (CRC) was detected on colonoscopy. Thirty (90.8%) patients completed the 24-month follow-up. A statistically significant difference between preoperative and 24-month QoL index values (median 0.72; IQR = 0.57-0.8 vs. median 0.9; IQR = 0.82-1; p = 0.0003) was observed. Conclusions: The study results demonstrate satisfactory surgical outcomes and a better QoL after surgery. No disease recurrence or CRC was observed at colonoscopy 1 year after surgery.
MeSH term(s)	Humans ; Diverticulitis, Colonic/complications ; Diverticulitis, Colonic/diagnostic imaging ; Diverticulitis, Colonic/surgery ; Quality of Life ; Cohort Studies ; Diverticulitis ; Recurrence ; Treatment Outcome ; Retrospective Studies
Language	English
Publishing date	2024-01-16
Publishing country	United States
Document type	Journal Article
ZDB-ID	224043-9
ISSN	1432-2323 ; 0364-2313
ISSN (online)	1432-2323
ISSN	0364-2313
DOI	10.1002/wjs.12065
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Article ; Online: Operative versus non-operative management in acute surgical diseases during COVID-19 pandemic: a 30-day experience from an Italian hospital in Lombardy.

Spalluto, Marta / Bevilacqua, Emanuele / Baldazzi, Gianandrea / Cassini, Diletta

Minerva chirurgica

2020 Volume 75, Issue 6, Page(s) 457–461

Abstract: The spread of COVID-19 pandemic has determined a huge imbalance between real clinical needs of the population and effective resources availability. The aim of this study was to report how this situation forces surgeons to consider a non-operative ... ...

Abstract	The spread of COVID-19 pandemic has determined a huge imbalance between real clinical needs of the population and effective resources availability. The aim of this study was to report how this situation forces surgeons to consider a non-operative management as an alternative. This is a retrospective monocentric study and we collected data from 60 patients, split in two groups: info from Group A, 28 patients (11 March to 11 April 2020) were compared with info from group B, 32 patients (11 March to 11 April 2019). The most relevant difference between the groups is related to patient's clinical management. The two groups had a considerably different number of cases that were treated with an operative management: 18 cases (64,7%) in group A vs. 28 cases (87,5%) in group B. Otherwise, non-operative approach occurred in 10 cases (35,7%) in group A and only in 4 patients (12,5%) in group B. These data suggest that the drastic reduction of means narrows the range of therapeutic choices. Indeed, in this emergency scenario, the rationing of healthcare resources was the propelling for surgeons to consider alternative therapeutic pathways.
MeSH term(s)	Acute Disease/therapy ; Aged ; COVID-19/epidemiology ; Emergencies/epidemiology ; Female ; Humans ; Italy/epidemiology ; Male ; Middle Aged ; Pandemics ; Retrospective Studies ; SARS-CoV-2 ; Surgical Procedures, Operative/statistics & numerical data ; Time Factors ; Triage
Keywords	covid19
Language	English
Publishing date	2020-09-25
Publishing country	Italy
Document type	Journal Article
ZDB-ID	123603-9
ISSN	1827-1626 ; 0026-4733
ISSN (online)	1827-1626
ISSN	0026-4733
DOI	10.23736/S0026-4733.20.08391-1
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Article ; Online: Jejunal multiple perforations for combined abdominal typhoid fever and miliary peritoneal tuberculosis.

Grieco, Michele / Polti, Giorgia / Lambiase, Lara / Cassini, Diletta

The Pan African medical journal

2019 Volume 33, Page(s) 51

Abstract: Typhoid fever and tuberculosis, considered rare diseases in western countries, is still considered a notable problem of health issue in developing countries. The gastrointestinal manifestations of typhoid fever are the most common and the typhoid ... ...

Abstract	Typhoid fever and tuberculosis, considered rare diseases in western countries, is still considered a notable problem of health issue in developing countries. The gastrointestinal manifestations of typhoid fever are the most common and the typhoid intestinal perforation (TIP) is considered the most dangerous complication. Abdominal localization of tuberculosis is the 6
MeSH term(s)	Abdomen, Acute/etiology ; Benin ; Child, Preschool ; Female ; Humans ; Intestinal Perforation/diagnosis ; Intestinal Perforation/etiology ; Intestinal Perforation/surgery ; Jejunum/pathology ; Laparotomy/methods ; Peritonitis, Tuberculous/complications ; Peritonitis, Tuberculous/diagnosis ; Tuberculosis, Miliary/complications ; Tuberculosis, Miliary/diagnosis ; Typhoid Fever/complications ; Typhoid Fever/diagnosis
Language	English
Publishing date	2019-05-23
Publishing country	Uganda
Document type	Case Reports
ZDB-ID	2514347-5
ISSN	1937-8688 ; 1937-8688
ISSN (online)	1937-8688
ISSN	1937-8688
DOI	10.11604/pamj.2019.33.51.14664
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Article: Fistula Between a Primary Sigmoid Large B-Cell Lymphoma and an Ovarian Teratoma.

Accardo, Caterina / Ardu, Massimiliano / Di Candido, Francesca / Epifani, Gabriele / Cassini, Diletta / Bono, Francesca / Baldazzi, Gianandrea

ACG case reports journal

2022 Volume 9, Issue 6, Page(s) e00794

Abstract: Primary colorectal lymphoma is a rare neoplasm. We report the case of a fistula between a diffuse large B-cell lymphoma of the sigmoid colon and an ovarian teratoma. An emergent laparotomy for an acute abdomen in a 90-year-old woman was performed. A ... ...

Abstract	Primary colorectal lymphoma is a rare neoplasm. We report the case of a fistula between a diffuse large B-cell lymphoma of the sigmoid colon and an ovarian teratoma. An emergent laparotomy for an acute abdomen in a 90-year-old woman was performed. A pelvic mass of 12 × 9 cm fistulized in the left colon was found with the presence of gas and free liquid within the abdomen. This is an extremely rare condition, and as far as we know, no cases of a fistula between a large B-cell colonic lymphoma and an ovarian teratoma are present in the literature.
Language	English
Publishing date	2022-06-22
Publishing country	United States
Document type	Case Reports
ZDB-ID	2814825-3
ISSN	2326-3253
ISSN	2326-3253
DOI	10.14309/crj.0000000000000794
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Article: Right sided diverticulitis in western countries: A review.

Epifani, Angelo Gabriele / Cassini, Diletta / Cirocchi, Roberto / Accardo, Caterina / Di Candido, Francesca / Ardu, Massimiliano / Baldazzi, Gianandrea

World journal of gastrointestinal surgery

2022 Volume 13, Issue 12, Page(s) 1721–1735

Abstract: Background: Although the treatment guidelines for left sided diverticulitis are clear, the management of right colonic diverticulitis is not well established. This disease can no longer be ignored due to significant spread throughout Asia.: Aim: To ... ...

Abstract	Background: Although the treatment guidelines for left sided diverticulitis are clear, the management of right colonic diverticulitis is not well established. This disease can no longer be ignored due to significant spread throughout Asia. Aim: To analyse epidemiology, diagnosis and treatment of right-sided diverticulitis in western countries. Methods: MEDLINE and PubMed searches were performed using the key words "right-sided diverticulitis'', ''right colon diverticulitis'', ''caecal diverticulitis'', ''ascending colon diverticulitis'' and ''caecum diverticula'' in order to find relevant articles published until 2021. Results: A total of 18 studies with 422 patients were found. Correct diagnosis was made only in 32.2%, mostly intraoperatively or Conclusion: The management of right- sided diverticulitis is not well clarified in the western world and no selective guidelines have been considered even if principles are similar to those with left- sided diverticulitis. Wrong diagnosis is one of the most important problems and CT scan seems to be the best imaging modality. NOM offers a safe and effective treatment; surgery should be considered only in cases of complicated diverticulitis or if malignancy cannot be excluded. Further studies are needed to clarify the correct treatment.
Language	English
Publishing date	2022-01-13
Publishing country	United States
Document type	Journal Article
ZDB-ID	2573700-4
ISSN	1948-9366
ISSN	1948-9366
DOI	10.4240/wjgs.v13.i12.1721
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Article ; Online: Emergency Hartmann's Procedure and its Reversal: A Totally Laparoscopic 2-Step Surgery for the Treatment of Hinchey III and IV Diverticulitis.

Cassini, Diletta / Miccini, Michelangelo / Manoochehri, Farshad / Gregori, Matteo / Baldazzi, Gianandrea

Surgical innovation

2019 Volume 26, Issue 6, Page(s) 770–771

MeSH term(s)	Diverticulitis/surgery ; Humans ; Laparoscopy
Language	English
Publishing date	2019-09-18
Publishing country	United States
Document type	Letter ; Comment
ZDB-ID	2182571-3
ISSN	1553-3514 ; 1553-3506
ISSN (online)	1553-3514
ISSN	1553-3506
DOI	10.1177/1553350619874272
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Zs.A 4269: Show issues

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Article ; Online: Emergency Hartmann's Procedure and Its Reversal: A Totally Laparoscopic 2-Step Surgery for the Treatment of Hinchey III and IV Diverticulitis.

Cassini, Diletta / Miccini, Michelangelo / Manoochehri, Farshad / Gregori, Matteo / Baldazzi, Gianandrea

Surgical innovation

2017 Volume 24, Issue 6, Page(s) 557–565

Abstract: Background: Hartmann's procedure (HP) followed by reversal restoration is the first choice for treatment of diffuse diverticular peritonitis. There is no unanimous consensus regarding the use of laparoscopy to treat the same condition.: Methods: Data ...

Abstract	Background: Hartmann's procedure (HP) followed by reversal restoration is the first choice for treatment of diffuse diverticular peritonitis. There is no unanimous consensus regarding the use of laparoscopy to treat the same condition. Methods: Data from 60 patients with diverticular diffuse peritonitis who underwent urgent HP followed by laparoscopic reversal were retrospectively analyzed. Patients were divided into 2 groups according to the open or laparoscopic HP (OHP, 24 patients; LHP, 36 patients). Outcomes were measured in terms of functional recovery, morbidity, mortality, and length of hospital stay. Results: HPs showed no differences among the groups in terms of operative time, blood loss, and length of intensive care unit stay. Overall morbidity was significantly lower in LHP than in OHP, corresponding to 33.3% and 66.7% respectively ( P = .018). The incidence of both surgical and medical complications was higher in OHP than in LHP (41.7% vs 22.2% [ P = .044] and 45.8% vs 24.3% [ P = .023], respectively). Mortality was 16.6% for each group. LHP showed a faster return to bowel movements and a shorter hospital stay than OHP. The secondary intestinal reversal was possible in 92% of cases, successfully completed laparoscopically in 91.3%. No patients of LHP group required a conversion to open intestinal reversal. Conclusion: LHP for treatment of diverticular diffuse peritonitis showed significantly lower morbidity, faster recovery, shorter hospital stay, and higher rates of successful laparoscopic reversal when compared with OHP.
MeSH term(s)	Adult ; Aged ; Aged, 80 and over ; Cohort Studies ; Colectomy ; Colon, Sigmoid/surgery ; Colostomy ; Diverticulitis/surgery ; Female ; Humans ; Laparoscopy ; Length of Stay ; Male ; Middle Aged ; Peritonitis/surgery ; Postoperative Complications/epidemiology ; Recovery of Function ; Reoperation ; Treatment Outcome
Language	English
Publishing date	2017-07-27
Publishing country	United States
Document type	Journal Article
ZDB-ID	2182571-3
ISSN	1553-3514 ; 1553-3506
ISSN (online)	1553-3514
ISSN	1553-3506
DOI	10.1177/1553350617722226
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Article ; Online: Impact of radiofrequency energy on intraoperative outcomes of laparoscopic colectomy for cancer in obese patients.

Cassini, Diletta / Miccini, Michelangelo / Gregori, Matteo / Manoochehri, Farshad / Baldazzi, Gianandrea

Updates in surgery

2017 Volume 69, Issue 4, Page(s) 471–477

Abstract: Nowadays laparoscopic approach is accepted as a valid alternative to open surgery for the treatment of colorectal cancer. Several studies consider this approach to be safe and feasible also in obese patients, even if dissection in these patients may ... ...

Abstract	Nowadays laparoscopic approach is accepted as a valid alternative to open surgery for the treatment of colorectal cancer. Several studies consider this approach to be safe and feasible also in obese patients, even if dissection in these patients may require a longer operative time and involve higher blood loss. To facilitate laparoscopic approach, more difficult in these patients, several energy sources for laparoscopic dissection and sealing, has been adopted recently. The aim of this study is to investigate the possible intraoperative advantages of radiofrequency energy in terms of blood loss and operative time in obese patients undergoing laparoscopic resection for cancer. All patients who underwent laparoscopic surgery for colorectal cancer from January 2010 to December 2015 were registered in a prospective database. Patients with a body mass index BMI (kg/m
MeSH term(s)	Aged ; Catheter Ablation/adverse effects ; Catheter Ablation/methods ; Colectomy/methods ; Colorectal Neoplasms/complications ; Colorectal Neoplasms/surgery ; Female ; Humans ; Intraoperative Period ; Laparoscopy/methods ; Male ; Obesity/complications ; Retrospective Studies
Language	English
Publishing date	2017-12
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/s13304-017-0454-8
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Zs.B 101: Show issues

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Article ; Online: Robotic pelvic dissection as surgical treatment of complicated diverticulitis in elective settings: a comparative study with fully laparoscopic procedure.

Cassini, Diletta / Depalma, Norma / Grieco, Michele / Cirocchi, Roberto / Manoochehri, Farshad / Baldazzi, Gianandrea

Surgical endoscopy

2018 Volume 33, Issue 8, Page(s) 2583–2590

Abstract: Background: Recently, minimally invasive treatment of complicated sigmoid diverticulitis is becoming a valid alternative to standard procedures. Robotic approach may be useful to allow more precise dissection in arduous pelvic dissection as in ... ...

Abstract	Background: Recently, minimally invasive treatment of complicated sigmoid diverticulitis is becoming a valid alternative to standard procedures. Robotic approach may be useful to allow more precise dissection in arduous pelvic dissection as in complicated diverticulitis. The aim of this study is to investigate effectiveness, potential benefits and short-term outcomes of robotic-assisted laparoscopic surgical resection, compared with fully laparoscopic resection in complicated diverticulitis. Methods: Between January 2009 and December 2017, 156 consecutive patients with history of complicated diverticular disease were referred to our Department of General, Mininvasive and Robotic Surgery. All patients underwent elective colonic resections performed by the same colorectal surgeon and followed a perioperative ERAS program. Demographic and clinical features, surgical data, postoperative data, 30-day morbidity and mortality, VAS for surgeon's compliance were evaluated. Results: One hundred and fifty-six consecutive patients underwent elective colonic resection: 92 fully laparoscopic (FL) colorectal resections and 64 procedures with robotic hybrid approach (RHA). Conversion rate was none in the RHA group versus 6.5% in the FL group, because of poor vision due to bowel distension, inflammatory pseudotumor and peritoneal adhesions. No 30-day mortality was observed. Mean operative time was 167.5 ± 54.4 min (80-420) in the FL group and 172.5 ± 55.64 min (110-325) in the RHA group (p 0.079), mean intraoperative blood loss was 144.6 ± 40.6 ml (40-200) with the FL technique and 138.4 ± 28.3 ml (20-185) with the RHA (p 0.295). Mean hospital stay for FL was 5 ± 4.1 days (range 3-45) and 5 ± 2.7 days (range 3-20) for RHA (p 0.974). Overall postoperative morbidity rate was 21.6% in the FL group and 12.3% in the RHA (p 0.067). Major postoperative morbidity (Clavien-Dindo 3 and 4) represented 13% and 4.6%, respectively (p 0.091). VAS for surgeon's compliance revealed a better performance in the robotic arm (p 0.059). Conclusions: This preliminary study highlights the potential benefits of robotic-assisted laparoscopy in colorectal resections for complicated diverticular disease in terms of surgical efficacy, postoperative morbidity and better surgeon's compliance.
MeSH term(s)	Adult ; Aged ; Aged, 80 and over ; Colon/surgery ; Diverticulitis/surgery ; Diverticulum, Colon/surgery ; Elective Surgical Procedures/methods ; Female ; Humans ; Laparoscopy/adverse effects ; Laparoscopy/methods ; Length of Stay ; Male ; Middle Aged ; Operative Time ; Postoperative Complications/epidemiology ; Robotic Surgical Procedures/adverse effects
Language	English
Publishing date	2018-11-07
Publishing country	Germany
Document type	Comparative Study ; Journal Article
ZDB-ID	639039-0
ISSN	1432-2218 ; 0930-2794
ISSN (online)	1432-2218
ISSN	0930-2794
DOI	10.1007/s00464-018-6553-x
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Zs.A 2214: Show issues

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Article ; Online: Laparoscopic lavage and drainage for Hinchey III diverticulitis: review of technical aspects.

Gregori, Matteo / Cassini, Diletta / Depalma, Norma / Miccini, Michelangelo / Manoochehri, Farshad / Baldazzi, Gianandrea A

Updates in surgery

2018 Volume 71, Issue 2, Page(s) 237–246

Abstract: The surgical treatment for patients with generalized peritonitis complicating sigmoid diverticulitis is currently debated; particularly in case of diffuse purulent contamination (Hinchey 3). Laparoscopic lavage and drainage (LLD) has been proposed by ... ...

Abstract	The surgical treatment for patients with generalized peritonitis complicating sigmoid diverticulitis is currently debated; particularly in case of diffuse purulent contamination (Hinchey 3). Laparoscopic lavage and drainage (LLD) has been proposed by some authors as a safe and effective alternative to single- or multi-stage resective surgery. However, among all the different studies on LLD, there is no uniformity in terms of surgical technique adopted and data show significant differences in postoperative outcomes. Aim of this review was to analyze the differences and similarities among the authors in terms of application, surgical technique and outcomes of LLD in Hinchey 3 patients. A bibliographical research was performed by referring to PubMed and Cochrane. "Purulent peritonitis", "Hinchey 3 diverticulitis", "acute diverticulitis", "colonic perforation" and "complicated diverticulitis" were used as key words. Twenty-eight papers were selected, excluding meta-analysis, reviews and case reports with a very small number of patients. The aim of this review was to establish how LLD should be done, suggesting important technical tricks. We found agreement in terms of indications, preoperative management, ports' positioning, antibiotics, enteral feeding and drain management. On the contrast, different statements regarding indications, adhesiolysis and management of colonic hole and failure of laparoscopic lavage are reported. A widespread diffusion of LLD and standardization of its technique are impossible because of data heterogeneity and selection bias in the limited RCTs. It is necessary to wait for long terms results from randomized clinical trials (RCTs) in progress to establish the efficacy and safety of this technique. More importantly, an increased number of highly skilled and dedicated colorectal laparoscopic surgeons are required to standardized the procedure.
MeSH term(s)	Acute Disease ; Diverticulitis, Colonic/complications ; Diverticulitis, Colonic/surgery ; Drainage/methods ; Humans ; Laparoscopy/methods ; Peritonitis/complications ; Peritonitis/surgery ; Sigmoid Diseases/surgery ; Therapeutic Irrigation/methods
Language	English
Publishing date	2018-08-10
Publishing country	Italy
Document type	Journal Article ; Systematic Review
ZDB-ID	2572692-4
ISSN	2038-3312 ; 2038-131X
ISSN (online)	2038-3312
ISSN	2038-131X
DOI	10.1007/s13304-018-0576-7
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