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Article ; Online: Laparoscopic ablation therapies for hepatocellular carcinoma: could specific indications for the laparoscopic approach influence the effectiveness?

Santambrogio, Roberto / Barabino, Matteo / De Nicola, Enrico / Galfrascoli, Elisa / Giovenzana, Marco / Zappa, Marco Antonio

Updates in surgery

2020 Volume 72, Issue 2, Page(s) 435–443

Abstract: Percutaneous thermo-ablation (TA) may be unfeasible for the tumor location: laparoscopic ablation therapies (LATs) are an alternative option. The aim of this study is to assess the efficacy of LATs in the treatment of HCC not eligible for percutaneous TA ...

Abstract	Percutaneous thermo-ablation (TA) may be unfeasible for the tumor location: laparoscopic ablation therapies (LATs) are an alternative option. The aim of this study is to assess the efficacy of LATs in the treatment of HCC not eligible for percutaneous TA or surgical resection. LAT was offered to 503 patients fulfilling at least one of the following criteria: (a) patients with a single nodule or up to three nodules smaller than 3 cm not suitable for surgery; (b) patients not suitable for percutaneous TA; (c) short-term recurrence of HCC (< 3 months). Technical success was achieved with one session in 467 patients (93%). One-month mortality and severe morbidity rates were 0.4% and 2.19%, respectively. During a median follow-up of 38.4 months in the remaining 501 patients, 361 (67%) developed intrahepatic recurrence: it appeared as a local tumor progression (LTP) in 74 cases (15%). Subcapsular lesions showed lower LTP rates (p = 0.008), as well as HCC nodules contiguous to viscera (p = 0.012). In the treatment of HCC, LAT has proved to be a safe and effective technique that enables to treat lesions not eligible for percutaneous approach, with a low morbidity rate.
MeSH term(s)	Adult ; Aged ; Aged, 80 and over ; Carcinoma, Hepatocellular/pathology ; Carcinoma, Hepatocellular/surgery ; Endosonography/methods ; Female ; Follow-Up Studies ; Hepatectomy/methods ; Humans ; Laparoscopy/methods ; Liver Neoplasms/pathology ; Liver Neoplasms/surgery ; Male ; Middle Aged ; Neoplasm Recurrence, Local ; Patient Selection ; Radiofrequency Ablation/methods ; Safety ; Treatment Outcome
Language	English
Publishing date	2020-04-03
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/s13304-020-00759-w
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Article: Calciphylaxis in a dialysis patient treated by intralesional and systemic sodium thiosulphate on top of multifactorial intervention.

Galassi, Andrea / Perna, Francesco / De Nicola, Enrico / Moneghini, Laura / Sganzaroli, Adriana B / Cozzolino, Mario

Clinical kidney journal

2018 Volume 12, Issue 4, Page(s) 546–549

Abstract: Calciphylaxis, or calcific uraemic arteriolopathy (CUA), represents a life-threatening disease. Dialysis patients and those receiving warfarin are seen as populations at higher risk for CUA. Treatments for CUA are still uncertain despite the poor ... ...

Abstract	Calciphylaxis, or calcific uraemic arteriolopathy (CUA), represents a life-threatening disease. Dialysis patients and those receiving warfarin are seen as populations at higher risk for CUA. Treatments for CUA are still uncertain despite the poor survival of the disease. Administration of intravenous sodium thiosulphate (STS) has been purposed to treat CUA in dialysis patients. Due to the poor tolerability of STS, characterized by nausea, hypocalcaemia, metabolic acidosis and QT-interval prolongation, its intralesional administration has been reported. We herein present the improvement of wounds in a haemodialysis patient affected by CUA, treated by multipronged intervention including both intravenous and intralesional STS.
Language	English
Publishing date	2018-12-10
Publishing country	England
Document type	Journal Article
ZDB-ID	2655800-2
ISSN	2048-8513 ; 2048-8505
ISSN (online)	2048-8513
ISSN	2048-8505
DOI	10.1093/ckj/sfy119
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Article ; Online: Surgical Strategy During the COVID-19 Pandemic in a University Metropolitan Hospital in Milan, Italy.

Mariani, Nicolò M / Pisani Ceretti, Andrea / Fedele, Veronica / Barabino, Matteo / Nicastro, Vincenzo / Giovenzana, Marco / Scifo, Giovanna / De Nicola, Enrico / Opocher, Enrico

World journal of surgery

2020 Volume 44, Issue 8, Page(s) 2471–2476

Abstract: The COVID-19 pandemic has spread rapidly, forcing some drastic changes not only in our daily lives, but also in our clinical and surgical activities. Given our extensive Italian experience, we hereby describe how our surgical unit activity has changed ... ...

Abstract	The COVID-19 pandemic has spread rapidly, forcing some drastic changes not only in our daily lives, but also in our clinical and surgical activities. Given our extensive Italian experience, we hereby describe how our surgical unit activity has changed and how, in some cases, it was necessary to modify surgical strategies. We hope our experience can be shared with our global colleagues who are suffering under similar condition.
MeSH term(s)	Aged ; Aged, 80 and over ; Betacoronavirus ; COVID-19 ; Coronavirus Infections ; Female ; General Surgery/legislation & jurisprudence ; Hospitals, University ; Hospitals, Urban ; Humans ; Italy ; Male ; Middle Aged ; Pandemics ; Pneumonia, Viral ; SARS-CoV-2
Keywords	covid19
Language	English
Publishing date	2020-05-16
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	10.1007/s00268-020-05595-y
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Article ; Online: COVID-19 outbreak and acute cholecystitis in a Hub Hospital in Milan: wider indications for percutaneous cholecystostomy.

Barabino, Matteo / Piccolo, Gaetano / Trizzino, Arianna / Fedele, Veronica / Ferrari, Carlo / Nicastro, Vincenzo / Pisani Ceretti, Andrea / De Nicola, Enrico / Mariani, Nicolò Maria / Giovenzana, Marco / Scifo, Giovanna / Mazza, Massimiliano / Vercelli, Ruggero / Santambrogio, Roberto / Luigiano, Carmelo / Opocher, Enrico

BMC surgery

2021 Volume 21, Issue 1, Page(s) 180

Abstract: Background: COVID-19 pandemic has impacted the Italian National Health Care system at many different levels, causing a complete reorganization of surgical wards. In this context, our study retrospectively analysed the management strategy for patients ... ...

Abstract	Background: COVID-19 pandemic has impacted the Italian National Health Care system at many different levels, causing a complete reorganization of surgical wards. In this context, our study retrospectively analysed the management strategy for patients with acute cholecystitis. Methods: We analysed all patients admitted to our Emergency Department for acute cholecystitis between February and April 2020 and we graded each case according to 2018 Tokyo Guidelines. All patients were tested for positivity to SARS-CoV-2 and received an initial conservative treatment. We focused on patients submitted to cholecystostomy during the acute phase of pandemic and their subsequent disease evolution. Results: Thirty-seven patients were admitted for acute cholecystitis (13 grade I, 16 grade II, 8 grade III). According to Tokyo Guidelines (2018), patients were successfully treated with antibiotic only, bedside percutaneous transhepatic gallbladder drainage (PC) and laparoscopic cholecystectomy (LC) in 29.7%, 21.6% and 48.7% of cases respectively. Therapeutic strategy of three out of 8 cases, otherwise fit for surgery, submitted to bedside percutaneous transhepatic gallbladder drainage (37.5%), were directly modified by COVID-19 pandemic: one due to the SARS-CoV-2 positivity, while two others due to unavailability of operating room and intensive care unit for post-operative monitoring respectively. Overall success rate of percutaneous cholecystostomy was of 87.5%. The mean post-procedural hospitalization length was 9 days, and no related adverse events were observed apart from transient parietal bleeding, conservatively treated. Once discharged, two patients required readmission because of acute biliary symptoms. Median time of drainage removal was 43 days and only 50% patients thereafter underwent cholecystectomy. Conclusions: Percutaneous cholecystostomy has shown to be an effective and safe treatment thus acquiring an increased relevance in the first phase of the pandemic. Nowadays, considering we are forced to live with the SARS-CoV-2 virus, PC should be considered as a virtuous, alternative tool for potentially all COVID-19 positive patients and selectively for negative cases unresponsive to conservative therapy and unfit for surgery.
MeSH term(s)	COVID-19/epidemiology ; COVID-19/surgery ; Cholecystitis, Acute/surgery ; Cholecystostomy ; Disease Outbreaks ; Hospitals ; Humans ; Italy/epidemiology ; Retrospective Studies ; Treatment Outcome
Language	English
Publishing date	2021-04-06
Publishing country	England
Document type	Journal Article
ZDB-ID	2050442-1
ISSN	1471-2482 ; 1471-2482
ISSN (online)	1471-2482
ISSN	1471-2482
DOI	10.1186/s12893-021-01137-y
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Article ; Online: Management of Leaks Following Laparoscopic Sleeve Gastrectomy Using Specifically Designed Large Covered Metal Stents.

Luigiano, Carmelo / Di Leo, Milena / Eusebi, Leonardo Henry / Barabino, Matteo / De Nicola, Enrico / Giovenzana, Marco / Opocher, Enrico / Iabichino, Giuseppe / Palamara, Maria Angela / Giacobbe, Giuseppa / Tortora, Andrea / Virgilio, Clara / Abenavoli, Ludovico / Pallio, Socrate / Consolo, Pierluigi

Reviews on recent clinical trials

2021 Volume 16, Issue 3, Page(s) 303–308

Abstract: Background: Leaks are the major complication associated with laparoscopic sleeve gastrectomy.: Objective: The study aimed to assess the efficacy and safety of specifically designed large covered metal stents for the management of post-laparoscopic ... ...

Abstract	Background: Leaks are the major complication associated with laparoscopic sleeve gastrectomy. Objective: The study aimed to assess the efficacy and safety of specifically designed large covered metal stents for the management of post-laparoscopic sleeve gastrectomy leaks. Methods: Prospectively collected databases from three Italian Endoscopy Units were reviewed. The primary outcome of the study was to evaluate the clinical success of stents placement, defined as complete resolution of clinical and laboratory signs of sepsis with radiological evidence of leak closure. Secondary outcomes were stent-related adverse events and mortality. Results: Twenty-one patients (67% females, mean age 45 years) were included in the study and a total of 26 stents were placed. Technical success of stent placement was achieved in all cases (100%). Clinical success was observed in 85.5% of patients. Stent-related adverse events occurred in 9 patients (43%), with stent migration as the most frequent complication (33%). Adverse events were more frequently observed in patients who had undergone bariatric surgery prior to laparoscopic sleeve gastrectomy compared to patients without previous surgery (83% et al. 27%, p=0.018). Conclusion: The placement of specifically designed covered metal stents appears to be an effective and safe therapeutic approach for post-laparoscopic sleeve gastrectomy leaks. Stent migration can be a frequent complication.
MeSH term(s)	Anastomotic Leak/diagnostic imaging ; Anastomotic Leak/etiology ; Anastomotic Leak/surgery ; Female ; Gastrectomy/adverse effects ; Humans ; Laparoscopy ; Male ; Middle Aged ; Retrospective Studies ; Stents ; Treatment Outcome
Language	English
Publishing date	2021-02-09
Publishing country	United Arab Emirates
Document type	Journal Article
ZDB-ID	2251879-4
ISSN	1876-1038 ; 1574-8871
ISSN (online)	1876-1038
ISSN	1574-8871
DOI	10.2174/1574887116666210204142417
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Article: Surgical Strategy During the COVID-19 Pandemic in a University Metropolitan Hospital in Milan, Italy

Mariani, Nicolò M / Pisani Ceretti, Andrea / Fedele, Veronica / Barabino, Matteo / Nicastro, Vincenzo / Giovenzana, Marco / Scifo, Giovanna / De Nicola, Enrico / Opocher, Enrico

World J Surg

Abstract	The COVID-19 pandemic has spread rapidly, forcing some drastic changes not only in our daily lives, but also in our clinical and surgical activities. Given our extensive Italian experience, we hereby describe how our surgical unit activity has changed and how, in some cases, it was necessary to modify surgical strategies. We hope our experience can be shared with our global colleagues who are suffering under similar condition.
Keywords	covid19
Publisher	WHO
Document type	Article
Note	WHO #Covidence: #276428
Database	COVID19

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Article ; Online: Surgical Strategy During the COVID-19 Pandemic in a University Metropolitan Hospital in Milan, Italy

Mariani, Nicolò M. / Pisani Ceretti, Andrea / Fedele, Veronica / Barabino, Matteo / Nicastro, Vincenzo / Giovenzana, Marco / Scifo, Giovanna / De Nicola, Enrico / Opocher, Enrico

World Journal of Surgery

2020 Volume 44, Issue 8, Page(s) 2471–2476

Keywords	Surgery ; covid19
Language	English
Publisher	Springer Science and Business Media LLC
Publishing country	us
Document type	Article ; Online
ZDB-ID	224043-9
ISSN	1432-2323 ; 0364-2313
ISSN (online)	1432-2323
ISSN	0364-2313
DOI	10.1007/s00268-020-05595-y
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Article ; Online: Clinical outcomes and quality of life associated with the use of a biosynthetic mesh for complex ventral hernia repair: analysis of the "Italian Hernia Club" registry.

Rognoni, Carla / Cuccurullo, Diego / Borsoi, Ludovica / Bonavina, Luigi / Asti, Emanuele / Crovella, Feliciano / Bassi, Uberto Andrea / Carbone, Gabriele / Guerini, Francesca / De Paolis, Paolo / Pessione, Silvia / Greco, Vincenzo Maria / Baccarini, Elisabetta / Soliani, Giorgio / Sagnelli, Carlo / Crovella, Clotilde / Trapani, Vincenzo / De Nisco, Carlo / Eugeni, Emilio /

Zanzi, Federico / De Nicola, Enrico / Marioni, Antonio / Rosignoli, Alessandro / Silvestro, Roberto / Tarricone, Rosanna / Piccoli, Micaela

Scientific reports

2020 Volume 10, Issue 1, Page(s) 10706

Abstract: With the development of newer meshes and approaches to hernia repair, it is currently difficult to evaluate their performances while considering the patients' perspective. The aim of the study was to assess the clinical outcomes and quality of life ... ...

Abstract	With the development of newer meshes and approaches to hernia repair, it is currently difficult to evaluate their performances while considering the patients' perspective. The aim of the study was to assess the clinical outcomes and quality of life consequences of abdominal hernia repairs performed in Italy using Phasix and Phasix ST meshes through the analysis of real-world data to support the choice of new generation biosynthetic meshes. An observational, prospective, multicentre study was conducted in 10 Italian clinical centres from May 2015 to February 2018 and in 15 Italian clinical centres from March 2018 to May 2019. The evaluation focused on patients with VHWG grade II-III who underwent primary ventral hernia repair or incisional hernia intervention with a follow-up of at least 18 months. Primary endpoints included complications' rates, and secondary outcomes focused on patient quality of life as measured by the EuroQol questionnaire. Seventy-five patients were analysed. The main complications were: 1.3% infected mesh removal, 4.0% superficial infection requiring procedural intervention, 0% deep/organ infection, 8.0% recurrence, 5.3% reintervention, and 6.7% drained seroma. The mean quality of life utility values ranged from 0.768 (baseline) to 0.967 (36 months). To date, Phasix meshes have proven to be suitable prostheses in preventing recurrence, with promising outcomes in terms of early and late complications and in improving patient quality of life.
MeSH term(s)	Abdominal Wall/pathology ; Adult ; Aged ; Aged, 80 and over ; Biocompatible Materials/therapeutic use ; Electronic Health Records/statistics & numerical data ; Female ; Hernia, Inguinal/surgery ; Hernia, Ventral/surgery ; Herniorrhaphy/adverse effects ; Herniorrhaphy/methods ; Humans ; Italy ; Male ; Middle Aged ; Prospective Studies ; Quality of Life/psychology ; Recurrence ; Secondary Prevention ; Surgical Mesh ; Surveys and Questionnaires ; Treatment Outcome
Chemical Substances	Biocompatible Materials
Keywords	covid19
Language	English
Publishing date	2020-07-01
Publishing country	England
Document type	Journal Article ; Multicenter Study ; Observational Study ; Research Support, Non-U.S. Gov't
ZDB-ID	2615211-3
ISSN	2045-2322 ; 2045-2322
ISSN (online)	2045-2322
ISSN	2045-2322
DOI	10.1038/s41598-020-67821-w
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Article ; Online: Budget Impact Analysis of a Biosynthetic Mesh for Incisional Hernia Repair.

Rognoni, Carla / Bassi, Uberto Andrea / Cataldo, Michele / Crovella, Clotilde / Crovella, Feliciano / Cuccurullo, Diego / Cudemo, Maria / De Nicola, Enrico / De Paolis, Paolo / Greco, Vincenzo Maria / Marioni, Antonio / Pessione, Silvia / Piccoli, Micaela / Rosignoli, Alessandro / Sagnelli, Carlo / Silvestro, Roberto / Tarricone, Rosanna / Trapani, Vincenzo / Soliani, Giorgio

Clinical therapeutics

2018 Volume 40, Issue 11, Page(s) 1830–1844.e4

Abstract: Purpose: With the development of newer prostheses for hernia repair, it is nowadays difficult to understand the total cost of managing patients treated with these advanced medical devices, especially in the complex abdomen, in which various ... ...

Abstract	Purpose: With the development of newer prostheses for hernia repair, it is nowadays difficult to understand the total cost of managing patients treated with these advanced medical devices, especially in the complex abdomen, in which various complications may occur. The aim of this study was to determine the economic implications of these prostheses in order to inform decision making in the management of incisional hernia repair. Methods: A budget impact analysis model was developed to evaluate the economic consequences related to the management of patients undergoing complex (Centers for Disease Control and Prevention wound class II-III or Ventral Hernia Working Group grade 2/3) incisional hernia repair through biosynthetic, synthetic, or biological meshes, from the hospital perspective in Italy. The model was populated with complication rates mainly retrieved from the literature to compare the current scenario with 60%, 10%, and 30% rates of synthetic, biosynthetic, and biological mesh utilization, respectively, with future hypothetical scenarios that consider increasing rates of biosynthetic mesh utilization with respect to the other types of mesh in the next 5 years. Hospital costs of the different events were estimated based on health care resource consumption derived from an electronic survey addressed to key opinion leaders in the field. Findings: The analysis compared the current scenario with future hypothetical scenarios that consider increasing utilization rates of biosynthetic meshes of 25%, 38%, and 44% in the next 1, 3, and 5 years, as estimated by clinicians. Considering 40,000 incisional hernia repairs per year, an increasing use of the biosynthetic meshes may result in a decrease in the total hospital budget of about €153 million in the next 5 years, with a savings per patient of about €770. Implications: The findings of this study support the use of biosynthetic meshes for complex abdominal wall repairs in Italy, showing a potential decrease in the hospital budget in Italy after the diffusion of the new biosynthetic prostheses. Further studies and data from clinical practice would provide additional information to increase the understanding of the economic sustainability of these advanced devices.
MeSH term(s)	Abdominal Wall/surgery ; Hernia, Ventral/surgery ; Herniorrhaphy/economics ; Herniorrhaphy/methods ; Humans ; Incisional Hernia/economics ; Incisional Hernia/surgery ; Italy ; Prostheses and Implants ; Surgical Mesh
Language	English
Publishing date	2018-10-20
Publishing country	United States
Document type	Journal Article ; Research Support, Non-U.S. Gov't ; Review
ZDB-ID	603113-4
ISSN	1879-114X ; 0149-2918
ISSN (online)	1879-114X
ISSN	0149-2918
DOI	10.1016/j.clinthera.2018.09.003
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Article: Metastasi del colon da tumore primitivo del polmone. Caso clinico.

Ceretti, Andrea Pisani / Goi, Gloria / Barabino, Matteo / De Nicola, Enrico / Strada, Daniela / Bislenghi, Gabriele / Opocher, Enrico

Annali italiani di chirurgia

2011 Volume 82, Issue 3, Page(s) 229–232

Abstract: Lung cancer is the most common cause of cancer-related death in both men and women in Western countries. About one-half of patients with lung cancer have metastatic disease at the time of initial diagnosis. Metastasis to the gastrointestinal tract from ... ...

Title translation	Colonic metastasis from primary carcinoma of the lung. Case report.
Abstract	Lung cancer is the most common cause of cancer-related death in both men and women in Western countries. About one-half of patients with lung cancer have metastatic disease at the time of initial diagnosis. Metastasis to the gastrointestinal tract from primary lung cancer has rarely been described. The most common metastatic site is the small bowel whereas large bowel secondary lesions are very rare. The majority of patients are referred to a surgeon only after the intestinal secondary lesion becomes symptomatic posing a threat to the patient's life. Although the outcome is still unfavourable, the development of chemotherapy and of surgical techniques allows aggressive treatment when facing a single intestinal metastasis from lung cancer. We report on a case of a patient who came to our observation for a neoplastic stenosis of the descending colon with a single liver secondarism. Histology proved both lesions to be metastases of primitive adenocarcinoma of the lung.
MeSH term(s)	Adenocarcinoma/secondary ; Aged ; Colonic Neoplasms/secondary ; Humans ; Lung Neoplasms/pathology ; Male
Language	Italian
Publishing date	2011-05
Publishing country	Italy
Document type	Case Reports ; English Abstract ; Journal Article
ZDB-ID	418927-9
ISSN	2239-253X ; 0003-469X
ISSN (online)	2239-253X
ISSN	0003-469X
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