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Article ; Online: Treatment and outcomes of patients with chronic radiation proctitis. A single-center experience and review of the literature.

Gentile, Maurizio / Cestaro, Giovanni / Formisano, Cesare / Sivero, Luigi

2021 Volume 91, Page(s) 668–672

Abstract: Chronic radiation proctitis is a frequent complication after radiotherapy for pelvic malignancies. It is reported that 1 to 5% of patients develop chronic radiation proctitis even with recent advances in external radiotherapy. Hematochezia, mucus ... ...

Abstract	Chronic radiation proctitis is a frequent complication after radiotherapy for pelvic malignancies. It is reported that 1 to 5% of patients develop chronic radiation proctitis even with recent advances in external radiotherapy. Hematochezia, mucus discharge, urgency and tenesmus are common symptoms and they can vary in severity but bleeding is often the most debilitating to the patient. Different options are reported for treatment of this condition that always should keep in differential diagnosis in patients with history of pelvic radiotherapy. Treatments range from easy, with topic administration of formalina, to expensive and requiring specialized equipment such as hyperbaric oxygen therapy. Surgery is reserved to patients with failure of conservative treatments due to the high risk of leakage and high morbidity up to 60%. KEY WORDS: Argon beam, Bleeding, Formalin, Radiation, Proctitis, Sucralfate enema.
MeSH term(s)	Enema ; Gastrointestinal Hemorrhage/etiology ; Gastrointestinal Hemorrhage/therapy ; Humans ; Pelvic Neoplasms/radiotherapy ; Proctitis/diagnosis ; Proctitis/etiology ; Proctitis/therapy ; Radiation Injuries/etiology ; Radiation Injuries/therapy ; Sucralfate/therapeutic use ; Treatment Outcome
Chemical Substances	Sucralfate (54182-58-0)
Language	English
Publishing date	2021-02-15
Publishing country	Italy
Document type	Journal Article ; Review
ZDB-ID	418927-9
ISSN	2239-253X ; 0003-469X
ISSN (online)	2239-253X
ISSN	0003-469X
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Article: Harry Potter's Occlusion: Report of a Case of Pumpkin Seed Bezoar Rectal Impact.

Gentile, Maurizio / Vergara, Lorenzo / Schiavone, Vincenzo / Cestaro, Giovanni / Sivero, Luigi

Frontiers in surgery

2022 Volume 9, Page(s) 902701

Abstract: Bezoar is a term from Arabic "bāzahr" or ultimately from Middle Persian "p'tzhl" (pādzahr, "bezoar antidote" or less commonaly ægagropile or egagropile (2-4). It was believed to have the power of a universal antidote that works against any poison, and a ... ...

Abstract	Bezoar is a term from Arabic "bāzahr" or ultimately from Middle Persian "p'tzhl" (pādzahr, "bezoar antidote" or less commonaly ægagropile or egagropile (2-4). It was believed to have the power of a universal antidote that works against any poison, and a glass containing a bezoar could neutralize any poison poured into it. In science, it is a mass of hair or undigested vegetable matter found in a human or animal intestines, similar to a hairball. Otherwise, the name could derive from a kind of Turkish goat whose name is just bezoar. Usually, it is found trapped in every part of the gastrointestinal system and must be distinguished by pseudobezoar, which is an nondigestible object voluntarily introduced into the digestive tract. The most common causes are a previous gastric surgery such as a gastric band (for weight loss) or gastric bypass, a reduced stomach acid (hypochlorhydria) or decreased stomach size, and a delayed gastric emptying, typically due to diabetes, autoimmune disorders, or mixed connective tissue disease. Seed bezoars are usually found in the rectum of patients without predisposing factors, causing constipation and pain. Rectal impaction is common after ingestion of seeds, while a true occlusion is rare. Although several cases of phytobezoars composed of various types of seeds are reported in the literature, bezoars of pumpkin seeds have rarely been reported. The authors report a case of fecal impaction by pumpkin seed bezoars with abdominal pain: a difficulty to void with subsequent rectal inflammation and hemorrhoid enlargement was observed. The patient underwent a successful manual disimpaction.
Language	English
Publishing date	2022-07-14
Publishing country	Switzerland
Document type	Case Reports
ZDB-ID	2773823-1
ISSN	2296-875X
ISSN	2296-875X
DOI	10.3389/fsurg.2022.902701
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Article ; Online: Paraduodenal hernia: a rare cause of bowel obstruction.

Cestaro, Giovanni / DE Monti, Marco / Gentile, Maurizio

Panminerva medica

2021 Volume 63, Issue 4, Page(s) 549–551

MeSH term(s)	Humans ; Intestinal Obstruction/diagnostic imaging ; Intestinal Obstruction/etiology ; Paraduodenal Hernia
Language	English
Publishing date	2021-12-13
Publishing country	Italy
Document type	Journal Article
ZDB-ID	123572-2
ISSN	1827-1898 ; 0031-0808
ISSN (online)	1827-1898
ISSN	0031-0808
DOI	10.23736/S0031-0808.19.03827-8
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Article ; Online: NPWTid in the treatment of infected diabetic foot.

Cestaro, G / Fasolini, F / Regusci, L / Torre, A / De Monti, M

Il Giornale di chirurgia

2020 Volume 40, Issue 5, Page(s) 445–449

Abstract: Negative Pressure Wound Therapy with instillation therapy and dwelling time (NPWTid) represents a good tool to treat severely infected non-healing wounds. This topical treatment consists of negative pressure and retrograde instillation of antiseptic/ ... ...

Abstract	Negative Pressure Wound Therapy with instillation therapy and dwelling time (NPWTid) represents a good tool to treat severely infected non-healing wounds. This topical treatment consists of negative pressure and retrograde instillation of antiseptic/antibiotic Romasolutions into the wound surface, to promote cleansing and consequently the healing process. We reported our initial experience (five cases) in the treatment of severely infected diabetic foot, that can be considered a life-threatening condition. In our case reports, patients presented with clinical signs and symptoms of severe sepsis. Our treatment based on multidisciplinary approach (surgical, NPWTid, interventional radiology, skin grafts) had satisfying results. NPWT represented an important support to treatment of these diabetic patients.
MeSH term(s)	Diabetic Foot/complications ; Diabetic Foot/microbiology ; Diabetic Foot/therapy ; Humans ; Negative-Pressure Wound Therapy
Language	English
Publishing date	2020-01-30
Publishing country	Italy
Document type	Case Reports ; Journal Article
ZDB-ID	605974-0
ISSN	1971-145X ; 0391-9005
ISSN (online)	1971-145X
ISSN	0391-9005
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Article ; Online: HIV screening in patients with anal condylomatosis. An overview about ethical and legal issues.

Cestaro, Giovanni / Velotti, Nunzio / Schiavone, Vincenzo / Musella, Mario / Gentile, Maurizio

Annali italiani di chirurgia

2021 Volume 10

Abstract: Although there is a strong evidence of prevalence of condylomata in the HIV-positive population, literature on HIV prevalence in HIV-unscreened population diagnosed with condylomata is still unconclusive. Our aim is to review literature about HIV ... ...

Abstract	Although there is a strong evidence of prevalence of condylomata in the HIV-positive population, literature on HIV prevalence in HIV-unscreened population diagnosed with condylomata is still unconclusive. Our aim is to review literature about HIV screening and diagnosis of anal condylomata in order to evaluate medical aspects, ethical and legal issues concerning the management of this disease. We undertook an online search on Pubmed for the keywords "HIV", "screening" and "anal condylomata" and 23 papers were analysed, 2 being randomized controlled trial, 11 comparative studies and 10 reviews. A total of 1270 patients were reviewed. All authors strongly recommend HIV testing in patients with clinical evidence of anal condylomata. In undeveloped countries with high prevalence of HIV, a proctological evaluation could be a could represent an unexpected therapeutic option for HIV infected male patients to prevent anal cancer. Clinical trials and prospective studies are necessary to validate this interesting hypothesis. KEY WORDS: Anal condylomatosis, HIV screening, Papilloma virus.
MeSH term(s)	Anus Neoplasms ; Condylomata Acuminata/diagnosis ; Condylomata Acuminata/epidemiology ; HIV Infections/complications ; HIV Infections/diagnosis ; HIV Infections/epidemiology ; Humans ; Male ; Papillomaviridae ; Papillomavirus Infections ; Prospective Studies
Language	English
Publishing date	2021-11-11
Publishing country	Italy
Document type	Journal Article ; Review
ZDB-ID	418927-9
ISSN	2239-253X ; 0003-469X
ISSN (online)	2239-253X
ISSN	0003-469X
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Article ; Online: Gastrointestinal bezoars: Review of the literature and report of a rare case of pumpkin seed rectal impaction.

Gentile, Maurizio / Illario, Maddalena / De Luca, Vincenzo / Cestaro, Giovanni / Velotti, Nunzio / Sivero, Stefania / Musella, Mario

Asian journal of surgery

2023 Volume 46, Issue 9, Page(s) 3432–3436

Abstract: In science, bezoar is a mass of hair or undigested vegetable matter, found in a human or animal's intestines, similar to a hairball. Usually, it is found trapped in every part of the gastrointestinal system and must be distinguished by pseudobezoar which ...

Abstract	In science, bezoar is a mass of hair or undigested vegetable matter, found in a human or animal's intestines, similar to a hairball. Usually, it is found trapped in every part of the gastrointestinal system and must be distinguished by pseudobezoar which is an indigestive object voluntarily introduced into the digestive tract. The term Bezoar is from Arabic bāzahr, "bezoar" or ultimately from Middle Persian p'tzhl pādzahr, "antidote, bezoar"ægagropile o egagropile It should be a universal antidote that works against any poison, and could neutralize any poison. Otherwise, the name could derive from a kind of Turkish goat whose name is just bezoar. Authors report a case of fecal impaction by pumpkin seeds bezoar with abdominal pain: a difficulty to void with subsequent rectal inflammation and hemorrhoid enlargement was observed. The patient underwent a successful manual disimpaction. Guidelines do not require IRB approval Authors examined the literature about occlusion from bezoar The most common causes of occlusion from bezoar are: a previous gastric surgery such as a gastric band (for weight loss) or gastric bypass, a reduced stomach acid (hypochlorhydria) or decreased stomach size, a delayed gastric emptying, typically due to diabetes, autoimmune disorders, or mixed connective tissue disease. Seed bezoars are usually found in the rectum of patients without predisposing factors, causing constipation and pain. Rectal impaction is common after ingestion of seeds while a true occlusion is rare. Although several cases of phytobezoars composed of various types of seeds are reported in literature, bezoars of pumpkin seeds have rarely been reported.
MeSH term(s)	Humans ; Rectum ; Cucurbita ; Antidotes ; Fecal Impaction/complications ; Bezoars/etiology ; Abdominal Pain
Chemical Substances	Antidotes
Language	English
Publishing date	2023-05-22
Publishing country	Netherlands
Document type	Case Reports ; Journal Article ; Review
ZDB-ID	1068461-x
ISSN	0219-3108 ; 1015-9584
ISSN (online)	0219-3108
ISSN	1015-9584
DOI	10.1016/j.asjsur.2023.05.030
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Article: Small bowel intussusception due to malignant melanoma: primary lesion or metastases? A case report.

De Monti, M / Pacchiarini, L / Cestaro, G / Peloni, G / Fasolini, F

Il Giornale di chirurgia

2018 Volume 39, Issue 3, Page(s) 184–187

Abstract: Intussusception is a rare condition in the adult population: it is responsible for 1% of all bowel obstructions. In most of intussusceptions a malignant tumor is involved; a lot of studies show that approximately 50% of malignant metastases causing small ...

Abstract	Intussusception is a rare condition in the adult population: it is responsible for 1% of all bowel obstructions. In most of intussusceptions a malignant tumor is involved; a lot of studies show that approximately 50% of malignant metastases causing small bowel intussusception are metastatic melanomas. In present paper a case of a small bowel intussusception probably due to metastases of an occult melanoma, in a 69-year-old patient, is presented. Surgery resection, careful research of possible primitive neoplasms and an accurate follow-up program has been the treatment of choice. All the investigations carried out did not allow to identify a possible primitive neoplasm. The last whole body PET carried out 44 months after surgery resulted disease-free.
MeSH term(s)	Carcinoma, Squamous Cell ; Humans ; Intussusception/etiology ; Jejunal Diseases/etiology ; Jejunal Neoplasms/complications ; Jejunal Neoplasms/secondary ; Jejunal Neoplasms/surgery ; Laryngeal Neoplasms ; Lymphatic Metastasis ; Male ; Melanoma/complications ; Melanoma/secondary ; Melanoma/surgery ; Middle Aged ; Neoplasms, Second Primary/complications ; Neoplasms, Second Primary/surgery ; Neoplasms, Unknown Primary
Language	English
Publishing date	2018-06-20
Publishing country	Italy
Document type	Case Reports ; Journal Article
ZDB-ID	605974-0
ISSN	1971-145X ; 0391-9005
ISSN (online)	1971-145X
ISSN	0391-9005
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Article: Treatment of fistula in ano with fibrin glue: preliminary results from a prospective study.

Cestaro, G / De Rosa, M / Gentile, M

Minerva chirurgica

2014 Volume 69, Issue 4, Page(s) 225–228

Abstract: Aim: This prospective study was done to evaluate the efficacy of commercial fibrin glue application in the healing of patients with fistulas-in-ano from a short follow up period (one year).: Methods: This randomized clinical trial of 26 patients was ... ...

Abstract	Aim: This prospective study was done to evaluate the efficacy of commercial fibrin glue application in the healing of patients with fistulas-in-ano from a short follow up period (one year). Methods: This randomized clinical trial of 26 patients was performed during the period from January 2012 to July 2012. Nineteen men and seven women were treated for a fistula-in-ano with a commercial fibrin glue injection. In the operating room, the patients underwent an anorectal examination under spinal anesthesia. The external and internal fistula tract openings were then identified and the fistula tract was accurately curetted. Fibrin glue was introduced by a loaded double-channel syringe into the external fistula opening until the fibrin glue tip could be seen emerging from the internal opening. Results: The initial success rate was 76.9% (20/26). Recurrence rate was 23% (6/26). Four patients underwent a re-application of fibrin glue and the fistulas of these patients closed. Total recurrence rate was 7.6% (2/26). The overall success rate was 69.2% (18/26). Conclusion: Fibrin glue application was thus found to be an easy, safe, successful alternative treatment in the management of fistulas-in-ano. Specifically, this therapeutic option demonstrated his efficacy for simple non-ramificated transsphincteric and intersphincteric fistulas. Multicentric randomized clinical trials with more representative sample seem to be necessary to investigate the best patients to treat by fibrin glue injection and the optimal application technique to improve these results.
MeSH term(s)	Adult ; Colonoscopy ; Curettage/methods ; Female ; Fibrin Tissue Adhesive/administration & dosage ; Fibrin Tissue Adhesive/therapeutic use ; Follow-Up Studies ; Humans ; Injections, Intralesional ; Male ; Middle Aged ; Prospective Studies ; Rectal Fistula/diagnosis ; Rectal Fistula/drug therapy ; Rectal Fistula/surgery ; Recurrence ; Risk Assessment ; Severity of Illness Index ; Time Factors ; Tissue Adhesives/administration & dosage ; Tissue Adhesives/therapeutic use ; Treatment Outcome
Chemical Substances	Fibrin Tissue Adhesive ; Tissue Adhesives
Language	English
Publishing date	2014-08
Publishing country	Italy
Document type	Journal Article ; Randomized Controlled Trial
ZDB-ID	123603-9
ISSN	1827-1626 ; 0026-4733
ISSN (online)	1827-1626
ISSN	0026-4733
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Article ; Online: Correction to: Transanal irrigation in functional bowel disorders and LARS: short‑term results from an Italian national study.

Falletto, E / Martellucci, J / Rossitti, P / Bondurri, A / Zaffaroni, G / Ascanelli, S / Chimisso, L / Lauretta, A / Mirafiori, M / Clementi, I / Ripetti, V / Luffarelli, P / Cestaro, G / Bottini, C / Bellini, M / Lambiase, C / Di Candido, F / Zattoni, D / Cornaglia, S /

Tonello, P / Zucchi, E

Techniques in coloproctology

2023 Volume 27, Issue 12, Page(s) 1413–1414

Language	English
Publishing date	2023-10-23
Publishing country	Italy
Document type	Published Erratum
ZDB-ID	2083309-X
ISSN	1128-045X ; 1123-6337
ISSN (online)	1128-045X
ISSN	1123-6337
DOI	10.1007/s10151-023-02871-6
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Article ; Online: Transanal irrigation in functional bowel disorders and LARS: short-term results from an Italian national study.

Falletto, E / Martellucci, J / Rossitti, P / Bondurri, A / Zaffaroni, G / Ascanelli, S / Chimisso, L / Lauretta, A / Mirafiori, M / Clementi, I / Ripetti, V / Lufarelli, P / Cestaro, G / Bottini, C / Bellini, M / Lambiase, C / Di Candido, F / Zattoni, D / Cornaglia, S /

Tonello, P / Zucchi, E

Techniques in coloproctology

2023 Volume 27, Issue 6, Page(s) 481–490

Abstract: Purpose: To evaluate the potential benefits associated with the short-term (6 months) treatment with transanal irrigation (TAI) in patients suffering from functional constipation (FC), functional fecal incontinence (FI), and low anterior resection ... ...

Abstract	Purpose: To evaluate the potential benefits associated with the short-term (6 months) treatment with transanal irrigation (TAI) in patients suffering from functional constipation (FC), functional fecal incontinence (FI), and low anterior resection syndrome (LARS). Methods: A multicenter observational study (12 centers; 369 patients) was conducted to assess the following primary and secondary objectives: to evaluate the level of satisfaction regarding bowel control and quality of life (QoL); to evaluate bowel symptoms severity and dropout frequency and reason. To this aim, validated questionnaires were provided to the patients at baseline (T0) and after 6 months of TAI treatment (T6) performed with the medical device Peristeen Results: A 6-month treatment with TAI enabled a statistically significant (p < 0.05) improvement of QoL scores, satisfaction scores regarding bowel control, and severity indexes of disorder-related symptoms in patients suffering from FC, FI, and LARS. Globally, 8.0% of patients discontinued the treatment after 6 months as a result of occurrence of symptoms (2.4%) or other justifications (3.8%) such as personal reasons. None of the dropouts were due to treatment inefficacy. Conclusion: Results of the present study suggest that short-term TAI treatment is beneficial for patients suffering from functional bowel disorders and LARS. Future analysis of prospective data will focus on the clinical outcomes associated with the long-term use (up to 24 months) of TAI when dealing with these types of medical conditions.
MeSH term(s)	Humans ; Quality of Life ; Postoperative Complications ; Prospective Studies ; Rectal Neoplasms ; Irritable Bowel Syndrome/therapy ; Low Anterior Resection Syndrome
Language	English
Publishing date	2023-04-25
Publishing country	Italy
Document type	Multicenter Study ; Observational Study ; Journal Article
ZDB-ID	2083309-X
ISSN	1128-045X ; 1123-6337
ISSN (online)	1128-045X
ISSN	1123-6337
DOI	10.1007/s10151-023-02800-7
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