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Article: Emergency totally laparoscopic surgery for appendicitis in right Amyand's hernia associated to symptomatic left inguinal hernia: A case report.

Sergi, William / Libia, Annarita / Chiappini, Ambra / D'Ugo, Stefano / Romano, Stefania / Spampinato, Marcello

International journal of surgery case reports

2024 Volume 117, Page(s) 109542

Abstract: Introduction and importance: Amyand's hernia is a rare type of inguinal hernia which contains vermiform appendix in the inguinal sac, seldom complicated by acute appendicitis. It is usually repaired by open inguinal approach, but laparoscopic technique ... ...

Abstract	Introduction and importance: Amyand's hernia is a rare type of inguinal hernia which contains vermiform appendix in the inguinal sac, seldom complicated by acute appendicitis. It is usually repaired by open inguinal approach, but laparoscopic technique has been increasingly described in literature; nevertheless, standard of care is far from being defined. Here we report the case of Amyand's hernia complicated by acute appendicitis and simultaneous symptomatic left inguinal hernia, both repaired by laparoscopic technique. Case presentation: A 85-years-old man presented with acute appendicitis in Amyand's hernia and simultaneous incarcerated left inguinal hernia. Clinical discussion: After complete preoperative work-up, the patient underwent laparoscopic appendectomy and laparoscopic bilateral hernia repair with mesh. Conclusion: Laparoscopic approach may be safe and feasible for Amyand's hernia treatment in emergency setting when performed by expert hands, with minimized risk of surgical site infection (SSI), quick recovery and reduced hospital stay. Laparoscopic hernia repair with mesh can be a reasonable approach in selected cases of bilateral or recurrent hernia, and concomitant intrabdominal inflammation, especially when contamination is scarse and limited to a restricted area.
Language	English
Publishing date	2024-03-16
Publishing country	Netherlands
Document type	Case Reports
ISSN	2210-2612
ISSN	2210-2612
DOI	10.1016/j.ijscr.2024.109542
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Article: Lemmel's syndrome: Case report of a not feasible endoscopic management.

Sergi, William / Libia, Annarita / Stasi, Elisa / Depalma, Norma / D'Ugo, Stefano / Spampinato, Marcello

International journal of surgery case reports

2024 Volume 117, Page(s) 109522

Abstract: Introduction: Lemmel's syndrome is a rare disease presenting with obstructive jaundice, secondary to common bile duct compression by duodenal diverticulum.: Presentation of case: A 79-year-old female was admitted to our emergency department with ... ...

Abstract	Introduction: Lemmel's syndrome is a rare disease presenting with obstructive jaundice, secondary to common bile duct compression by duodenal diverticulum. Presentation of case: A 79-year-old female was admitted to our emergency department with cholangitis and obstructive jaundice, due to choledocal compression by two periampullary diverticula, with major papilla opening near the biggest one (periampullary diverticulum type III). Endoscopic retrograde cholangiopancreatography didn't succeed sphincterotomy, therefore laparoscopic rendez-vous was performed. Discussion: This case is an example of an unusual cause of obstructive jaundice, which should be mentioned along with choledocolithiasis and biliary or ampullary neoplasms, in order to avoid delay in diagnosis and management. Conclusion: The commonest treatment of Lemmel's syndrome reported in literature is ERCP with sphincterotomy, but when endoscopic management fails, interventional radiology and surgery should also be considered.
Language	English
Publishing date	2024-03-11
Publishing country	Netherlands
Document type	Case Reports
ISSN	2210-2612
ISSN	2210-2612
DOI	10.1016/j.ijscr.2024.109522
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Article: Preservation of Peritoneal Dialysis in Liver Surgery with Robotic Technique: A Case Report.

Ria, Paolo / Garritano, Stefano / Martella, Vilma / De Pascalis, Antonio / Zito, Anna / Napoli, Marcello / Spampinato, Marcello / D'Ugo, Stefano

Case reports in nephrology and dialysis

2024 Volume 14, Issue 1, Page(s) 15–19

Abstract: Introduction: During the last year, the features of peritoneal dialysis patients have changed, and the cases in which there is a need to perform abdominal surgery are growing. Reports of abdominal surgery in patients who are able to continue peritoneal ... ...

Abstract	Introduction: During the last year, the features of peritoneal dialysis patients have changed, and the cases in which there is a need to perform abdominal surgery are growing. Reports of abdominal surgery in patients who are able to continue peritoneal dialysis are increasing. The minimally invasive techniques represent the preferred and safest approach. Such techniques are associated with reduced hospitalization time, less invasiveness, peritoneal integrity preservation, and reduced intra-abdominal inflammation due to regenerative processes. Case presentation: In this case report, we present a case of major abdominal surgery, in the form of hepatic metastasectomy, performed with the robotic-assisted technique, which allowed catheter and intracorporeal dialysis preservation. The patient showed a strong determination to continue with peritoneal dialysis as long as possible. During the switch to hemodialysis, he performed prophylactic antibiotic therapy to preserve the peritoneal catheter, and the patient was instructed to have a reduced water intake, avoiding excessive ultrafiltration potentially deteriorating the residual renal function. Special care was also taken to avoid any nephrotoxic drug. The peritoneal treatment was restarted after 3 weeks with low volume exchange for the first 10 days, and the pre-surgery dialysis volumes were then re-established. After surgery, the patient showed adequate clearance of solutes and ultrafiltration similar to the preoperative period. The patient did not encounter any wound complications. Conclusion: Robotic surgery represents a further aid in peritoneal dialysis preservation after abdominal surgery. A detailed communication with the patient before performing this kind of procedure and a strong will to preserve the peritoneal method are essential.
Language	English
Publishing date	2024-01-31
Publishing country	Switzerland
Document type	Case Reports
ZDB-ID	2809879-1
ISSN	2296-9705
ISSN	2296-9705
DOI	10.1159/000536139
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Article: Laparoscopic treatment of symptomatic Dunbar syndrome: a case report.

Sergi, William / Depalma, Norma / D'Ugo, Stefano / Botrugno, Ivan / Manoochehri, Farshad / Spampinato, Marcello

International journal of surgery case reports

2022 Volume 93, Page(s) 106925

Abstract: Introduction and aim of the study: Dunbar syndrome is a rare disorder due to the external compression of the celiac trunk by the median arcuate ligament. The symptoms include abdominal pain, nausea and vomiting with a significative reduction in patients' ...

Abstract	Introduction and aim of the study: Dunbar syndrome is a rare disorder due to the external compression of the celiac trunk by the median arcuate ligament. The symptoms include abdominal pain, nausea and vomiting with a significative reduction in patients' quality of life. Laparoscopy has proven to be a safe procedure. The aim of this study is to present a case of Dunbar syndrome undergoing laparoscopic surgery. Case presentation: A 40-year-old male patient presented at Emergency Room with upper abdominal pain and dyspepsia, related to food intake. A selective arteriography of the celiac trunk revealed stenosis due to compression of the celiac artery. Clinical discussion: Laparoscopic decompression of the celiac trunk by the median arcuate ligament was performed. Postoperative course was uneventful and the patient was discharged on the 5th postoperative day. Conclusion: Minimally invasive surgical division of the arcuate ligament is feasible and safe and it can restore patients' quality of life.
Language	English
Publishing date	2022-03-09
Publishing country	Netherlands
Document type	Journal Article
ISSN	2210-2612
ISSN	2210-2612
DOI	10.1016/j.ijscr.2022.106925
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Article ; Online: Hemorrhoids and anal fissures in inflammatory bowel disease.

D'Ugo, S / Stasi, E / Gaspari, A L / Sileri, P

Minerva gastroenterologica e dietologica

2015 Volume 61, Issue 4, Page(s) 223–233

Abstract: Perianal disease is a common complication of inflammatory bowel disease (IBD). It includes different conditions from more severe and potentially disabling ones, such as abscesses and fistulas, to more benign conditions such as hemorrhoids, skin tags and ... ...

Abstract	Perianal disease is a common complication of inflammatory bowel disease (IBD). It includes different conditions from more severe and potentially disabling ones, such as abscesses and fistulas, to more benign conditions such as hemorrhoids, skin tags and fissures. Most literature has been focused on anal sepsis and fistulae, as they carry the majority of disease burden and often alter the natural course of the disease. Hemorrhoids and anal fissures in patients with IBD have been overlooked, although they can represent a challenging problem. The management of hemorrhoids and fissures in IBD patients may be difficult and may significantly differ compared to the non-affected population. Historically surgery was firmly obstructed, and hemorrhoidectomy or sphincterotomy in patients with associated diagnosis of IBD was considered harmful, although literature data is scant and based on small series. Various authors reported an incidence of postoperative complications higher in IBD than in the general populations, with potential severe events. Considering that a spontaneous healing is possible, the first line management should be a medical therapy. In patients non-responding to conservative measures it is possible a judicious choice of surgical options on a highly selective basis; this can lead to acceptable results, but the risk of possible complications needs to be considered. In this review it is analyzed the current literature on the incidence, symptoms and treatment options of hemorrhoids and anal fissures in patients with Crohn's disease and ulcerative colitis.
MeSH term(s)	Fissure in Ano/etiology ; Fissure in Ano/therapy ; Hemorrhoids/etiology ; Hemorrhoids/therapy ; Humans ; Inflammatory Bowel Diseases/complications ; Risk Factors
Language	English
Publishing date	2015-12
Publishing country	Italy
Document type	Journal Article ; Review
ZDB-ID	1077354-x
ISSN	1827-1642 ; 1121-421X ; 0026-4776
ISSN (online)	1827-1642
ISSN	1121-421X ; 0026-4776
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Article: Impact of Resected Gastric Volume on Postoperative Weight Loss after Laparoscopic Sleeve Gastrectomy.

D'Ugo, Stefano / Bellato, Vittoria / Bianciardi, Emanuela / Gentileschi, Paolo

Gastroenterology research and practice

2019 Volume 2019, Page(s) 3742075

Abstract: Among the bariatric surgery community, it has recently emerged the idea of a possible association between resected gastric volume (RGV) and weight loss after laparoscopic sleeve gastrectomy (LSG). If the size of the sleeve depends on the bougie caliber, ... ...

Abstract	Among the bariatric surgery community, it has recently emerged the idea of a possible association between resected gastric volume (RGV) and weight loss after laparoscopic sleeve gastrectomy (LSG). If the size of the sleeve depends on the bougie caliber, the resected volume of the stomach remains something which is not possible to standardize. The aim of the study was to investigate a possible relationship between RGV and weight loss after LSG. We developed a mathematical method to calculate the RGV, based on the specimen size removed during LSG. Ninety-one patients (63 females and 28 males) affected by morbid obesity were included in the study. They underwent LSG between 2014 and 2016. Mean preoperative BMI was 45 ± 6.4. At 1 year after LSG, the mean BMI was 30 ± 5.3 and the EWL% was 65 ± 20.2. The statistical analysis of RGV, BMI, and EWL% at 1-year follow-up did not find any correlation between the volume of stomach removed and the weight loss after LSG. Further studies in the future should clarify the potential role of RGV during LSG. This trial is registered with ClinicalTrials.gov NCT03938025.
Language	English
Publishing date	2019-12-01
Publishing country	Egypt
Document type	Journal Article
ZDB-ID	2435460-0
ISSN	1687-630X ; 1687-6121
ISSN (online)	1687-630X
ISSN	1687-6121
DOI	10.1155/2019/3742075
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Article ; Online: Banded Sleeve Gastrectomy Improves Weight Loss Compared to Nonbanded Sleeve: Midterm Results from a Prospective Randomized Study.

Gentileschi, Paolo / Bianciardi, Emanuela / Siragusa, Leandro / Tognoni, Valeria / Benavoli, Domenico / D'Ugo, Stefano

Journal of obesity

2020 Volume 2020, Page(s) 9792518

Abstract: Background: Weight regain after laparoscopic sleeve gastrectomy (LSG) is nowadays a growing concern. Sleeve dilatation and loss of food restriction is considered the main mechanism. The placement of a silicon ring around the gastric tube seems to give ... ...

Abstract	Background: Weight regain after laparoscopic sleeve gastrectomy (LSG) is nowadays a growing concern. Sleeve dilatation and loss of food restriction is considered the main mechanism. The placement of a silicon ring around the gastric tube seems to give benefits in the short term. We report the results of a randomized study comparing LSG and laparoscopic banded sleeve gastrectomy (LBSG) over a 4-year follow-up. Objectives: To evaluate the efficacy of banded sleeve gastrectomy compared to standard sleeve in the midterm. Methods: Between 01/2014 and 01/2015, we randomly assigned 50 patients to receive one of the two procedures. Patients' management was exactly the same, apart from the band placement. We analyzed differences in weight loss, operative time, complication rate, and mortality, with a median follow-up of 4 years. Results: Twenty five patients were assigned to receive LSG (Group A) and 25 LBSG (Group B). The mean preoperative BMI (body mass index) was 47.3 ± 6.58 kg/m Conclusions: LBSG is a safe procedure, with no impact on postoperative complications. The banded sleeve showed a significant greater weight loss in the midterm follow-up. Considering the issue of weight regain observed after LSG, the placement of a perigastric ring during the first procedure may be a strategy to improve the results. This trial is registered with NCT04228185.
MeSH term(s)	Adult ; Body Mass Index ; Female ; Gastrectomy ; Humans ; Laparoscopy ; Male ; Middle Aged ; Obesity, Morbid/surgery ; Postoperative Complications ; Prospective Studies ; Treatment Outcome ; Weight Loss
Language	English
Publishing date	2020-05-28
Publishing country	United States
Document type	Journal Article ; Randomized Controlled Trial
ZDB-ID	2573566-4
ISSN	2090-0716 ; 2090-0708
ISSN (online)	2090-0716
ISSN	2090-0708
DOI	10.1155/2020/9792518
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Article: NIR ICG-Enhanced Fluorescence: A Quantitative Evaluation of Bowel Microperfusion and Its Relation to Central Perfusion in Colorectal Surgery.

Depalma, Norma / D'Ugo, Stefano / Manoochehri, Farshad / Libia, Annarita / Sergi, William / Marchese, Tiziana R L / Forciniti, Stefania / Del Mercato, Loretta L / Piscitelli, Prisco / Garritano, Stefano / Castellana, Fabio / Zupo, Roberta / Spampinato, Marcello Giuseppe

Cancers

2023 Volume 15, Issue 23

Abstract: Background: To date, no standardized protocols nor a quantitative assessment of the near-infrared fluorescence angiography with indocyanine green (NIR-ICG) are available. The aim of this study was to evaluate the timing of fluorescence as a reproducible ...

Abstract	Background: To date, no standardized protocols nor a quantitative assessment of the near-infrared fluorescence angiography with indocyanine green (NIR-ICG) are available. The aim of this study was to evaluate the timing of fluorescence as a reproducible parameter and its efficacy in predicting anastomotic leakage (AL) in colorectal surgery. Methods: A consecutive cohort of 108 patients undergoing minimally invasive elective procedures for colorectal cancer was prospectively enrolled. The difference between macro and microperfusion (ΔT) was obtained by calculating the timing of fluorescence at the level of iliac artery division and colonic wall, respectively. Results: Subjects with a ΔT ≥ 15.5± 0.5 s had a higher tendency to develop an AL ( Conclusions: The analysis of the timing of fluorescence provides a quantitative, easy evaluation of tissue perfusion. A ΔT/HR interaction ≥832 may be used as a real-time parameter to guide surgical decision making in colorectal surgery.
Language	English
Publishing date	2023-11-22
Publishing country	Switzerland
Document type	Journal Article
ZDB-ID	2527080-1
ISSN	2072-6694
ISSN	2072-6694
DOI	10.3390/cancers15235528
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Article: Symptomatic acinar cell cystadenoma of the pancreas.

Sergi, William / D'Ugo, Stefano / Libia, Annarita / Depalma, Norma / Marchese, Tiziana / Garritano, Stefano / Vadrucci, Stefania / Stasi, Elisa / Botrugno, Ivan / Manoochehri, Farshad / Spampinato, Marcello

Journal of surgical case reports

2023 Volume 2023, Issue 6, Page(s) rjad360

Abstract: Acinar cystic transformation (ACT), also known as 'acinar cell cystadenoma', is an uncommon cystic neoplasm of pancreas with unknown malignant potential. This case regards a woman with symptomatic pancreatic head ACT, revealed with pathological exam of ... ...

Abstract	Acinar cystic transformation (ACT), also known as 'acinar cell cystadenoma', is an uncommon cystic neoplasm of pancreas with unknown malignant potential. This case regards a woman with symptomatic pancreatic head ACT, revealed with pathological exam of specimen after pancreaticoduodenectomy. A 57-years-old patient presented mild hyperbilirubinemia and recurrent cholangitis; she underwent to ERCP, EUS and MRI, and these exams revealed a large cyst of the pancreatic head that caused biliary compression. The discussion of the case by the multidisciplinary group indicated surgical resection. Pancreatic ACT is so rare, and its preoperative diagnosis is difficult. The symptoms of the patients and the features of the cyst are the criteria to choose a surgical resection.
Language	English
Publishing date	2023-06-27
Publishing country	England
Document type	Case Reports
ZDB-ID	2580919-2
ISSN	2042-8812
ISSN	2042-8812
DOI	10.1093/jscr/rjad360
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Article: Robotic-assisted distal pancreatectomy with splenectomy in a paediatric patient for solid pseudopapillary tumour.

Sergi, William / Depalma, Norma / Marchese, Tiziana / Manoochehri, Farshad / D'Ugo, Stefano / Garritano, Stefano / Botrugno, Ivan / Chiappini, Ambra / Libia, Annarita / Atzeni, Carlo Olla / Stasi, Elisa / Spampinato, Marcello G

Journal of surgical case reports

2023 Volume 2023, Issue 3, Page(s) rjad145

Abstract: Solid pseudopapillary tumour is a rare low-grade malignant potential carcinoma of the pancreas that typically occurs in females in their third decade. It most commonly occurs in the tail of the pancreas, although any site can be affected. Surgical ... ...

Abstract	Solid pseudopapillary tumour is a rare low-grade malignant potential carcinoma of the pancreas that typically occurs in females in their third decade. It most commonly occurs in the tail of the pancreas, although any site can be affected. Surgical resection is the standard treatment and offers an excellent prognosis. We report a case of a 17-year-old female with an acute onset abdominal pain and a radiological diagnosis of a cystic lesion in the distal pancreas. A robotic-assisted distal pancreatectomy with splenectomy was performed. Robotic-assisted surgery is an emerging technique for the treatment of pancreatic neoplasms. This approach can be considered for younger patients, thanks to the potential advantages of the robotic Da Vinci Xi System.
Language	English
Publishing date	2023-03-28
Publishing country	England
Document type	Case Reports
ZDB-ID	2580919-2
ISSN	2042-8812
ISSN	2042-8812
DOI	10.1093/jscr/rjad145
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