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Article ; Online: Surgical treatment of cyst of the canal of Nuck and prevention of lymphatic complications: A single-center experience.

Cornacchia, C / Dessalvi, S / Boccardo, F

2019 Volume 52, Issue 3, Page(s) 143–148

Abstract: The canal of Nuck is a residue of the peritoneal evagination that runs along the round ligament through the inguinal canal in women. Its partial or total patency can lead to a cystic lymphangioma (CL). CL of the canal of Nuck in an adult female is a rare ...

Abstract	The canal of Nuck is a residue of the peritoneal evagination that runs along the round ligament through the inguinal canal in women. Its partial or total patency can lead to a cystic lymphangioma (CL). CL of the canal of Nuck in an adult female is a rare entity and its clinical diagnosis can be difficult or incorrect. Ultrasonography can be useful to identify the nature of groin masses. A potential CL of the canal of Nuck should always be considered in the differential diagnosis of inguinal swelling in adult females. Even if it is possible to consider conservative treatment, the optimal therapeutic option is surgical excision of the cystic mass and closure of the inguinal ring by an anterior approach. In this study, we report a case series of four women affected by a cyst of the canal of Nuck to underline the surgical treatment's therapeutic role of this pathological condition and the importance of preliminary identification of lymphatic vessels with BPV (Blue Patent Violet) in order to prevent lymphatic injuries such as lymphorrea and lymphocele in the groin after surgery due to the disruption of inguinal lymph nodes and lymphatics.
MeSH term(s)	Adult ; Aged ; Cysts/complications ; Cysts/diagnosis ; Cysts/surgery ; Diagnosis, Differential ; Female ; Humans ; Inguinal Canal/diagnostic imaging ; Inguinal Canal/pathology ; Lymphangioma, Cystic/etiology ; Lymphangioma, Cystic/prevention & control ; Magnetic Resonance Imaging ; Middle Aged ; Treatment Outcome ; Ultrasonography
Language	English
Publishing date	2019-12-23
Publishing country	United States
Document type	Case Reports ; Journal Article
ZDB-ID	80181-1
ISSN	2522-7963 ; 0024-7766
ISSN (online)	2522-7963
ISSN	0024-7766
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Article ; Online: Long-term patency of multiple lymphatic-venous anastomoses in cancer-related lymphedema: A single center observational study.

Boccardo, Francesco / Santori, Gregorio / Villa, Giuseppe / Accogli, Susanna / Dessalvi, Sara

Microsurgery

2022 Volume 42, Issue 7, Page(s) 668–676

Abstract: Objectives: Lymphedema is always initially treated by combined decongestive physiotherapy (CDP). Those cases, refractory to CDP, may be managed by surgical therapy. One of the most used microsurgical procedures is represented by the technique of ... ...

Abstract	Objectives: Lymphedema is always initially treated by combined decongestive physiotherapy (CDP). Those cases, refractory to CDP, may be managed by surgical therapy. One of the most used microsurgical procedures is represented by the technique of lymphatic-venous anastomosis (LVA). But very few papers report long term results of LVA. The aim of this study is to assess the long-term patency of multiple lymphatic-venous anastomosis (MLVA) for the treatment of secondary lymphedemas. Methods: From January 2014 to December 2014, 101 patients (mean age: 56.94 ± 8.98 years; female/male: 86/15) affected by secondary cancer-related lymphedema (38 lower and 63 upper limbs) were treated by MLVA. All lymphedemas had previously been treated by conservative therapy without sustained results. Many patients (78%) had 1-3 episodes of acute lymphangitis/year. Lymphoscintigraphy, venous duplex-ultrasonography, and abdominal or axillary ultrasound investigation were performed preoperatively. MLVA patency was assessed by the lymphatic transport index (LyTI) and lymphoscintigraphic pattern. Results: At 1 year after surgery, excess volume reduction was 75%-90% in the early stage II secondary lymphedemas, and 60%-75% in the late stage II. The decrease in volume maintained stability in the 5-years follow-up period. Two more advanced lower and one upper limb lymphedemas had 45%-60% reduction. LyTI showed a significant decrease between the preoperative mean value (31.7 ± 9.43) and after 18 months from surgery (11.2 ± 1.91) (p < .001). MLVA patency was shown in 98 (97%) patients. No patients had evidence of postoperative lymphangitis. Conclusions: This study demonstrated the long-term patency of MLVA in the treatment of cancer-related lymphedemas.
MeSH term(s)	Aged ; Female ; Humans ; Male ; Middle Aged ; Anastomosis, Surgical/methods ; Lymphangitis/surgery ; Lymphatic Vessels/diagnostic imaging ; Lymphatic Vessels/surgery ; Lymphedema/etiology ; Lymphedema/surgery ; Microsurgery/methods ; Neoplasms/complications ; Neoplasms/surgery ; Treatment Outcome
Language	English
Publishing date	2022-08-02
Publishing country	United States
Document type	Journal Article ; Observational Study
ZDB-ID	605524-2
ISSN	1098-2752 ; 0738-1085
ISSN (online)	1098-2752
ISSN	0738-1085
DOI	10.1002/micr.30944
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Article ; Online: Breast Edema after Conservative Surgery for Early-Stage Breast Cancer: A Retrospective Single-Center Assessment of Risk Factors.

Cornacchia, C / Dessalvi, S / Santori, G / Canobbio, F / Atzori, G / De Paoli, F / Diaz, R / Franchelli, S / Gipponi, M / Murelli, F / Sparavigna, M / Pitto, F / Fozza, A / Boccardo, F / Friedman, D / Fregatti, P

Lymphology

2023 Volume 55, Issue 4, Page(s) 167–177

Abstract: Breast-conserving surgery (BCS) is the standard of care for early-stage breast cancer. We retrospectively enrolled 530 patients (mean age: 62.96 ± 12.69 years) undergoing BCS between January 1, 2018, and December 31, 2019. During the COVID-19 pandemic, ... ...

Abstract	Breast-conserving surgery (BCS) is the standard of care for early-stage breast cancer. We retrospectively enrolled 530 patients (mean age: 62.96 ± 12.69 years) undergoing BCS between January 1, 2018, and December 31, 2019. During the COVID-19 pandemic, all patients with at least 1 year of follow-up were telephonically asked after surgery to provide clinical signs and symptoms attributable to postoperative breast cancer-related lymphedema of the breast (BCRL-B). Thirty-one (5.8%) patients reported breast edema and were visited to measure the tissue dielectric constant (TDC) and to assess the induration of the skin. There was a difference seen in treatment with lumpectomy + ALND performed more frequently in patients with (29%) than without (12%) BCRL-B. In the subgroup of patients with BCRL-B (n=31), significantly higher values of local total water were calculated in the nine patients who underwent Lump + ALND procedure (1.86 ± 0.48 vs. 1.48 ± 0.38; p = 0.046). Among patients with BCRL-B (n=31), in eight patients (25.8%) tissue induration measured with SkinFibroMeter was >0.100 N, thus suggesting tissue fibrosis. Cumulative survival probability at 1-year after surgery was 0.992. No statistical differences in 1-year survival after surgery were found for type of surgery (p = 0.890) or absence/presence of BCRL-B (p = 0.480). In univariate logistic regression, only lumpectomy + ALND surgery (p = 0.009) and any subsequent axillary lymph node removal surgery (p = 0.003) were associated with BCRL-B. Both of these variables were also found to be statistically significant in the multivariate regression model. Further prospective research is warranted to analyze potentential predictors of BCRL-B and to reduce/ prevent this complication.
Language	English
Publishing date	2023-08-08
Publishing country	United States
Document type	Journal Article
ZDB-ID	80181-1
ISSN	2522-7963 ; 0024-7766
ISSN (online)	2522-7963
ISSN	0024-7766
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Article ; Online: Decreasing and preventing lymphatic-injury-related complications in patients undergoing venous surgery: A new diagnostic and therapeutic protocol.

Dessalvi, S / Villa, G / Campisi, C C / Campisi, C / Boccardo, F

Lymphology

2018 Volume 51, Issue 2, Page(s) 57–65

Abstract: Lymphatic complications following great and small saphenous vein surgery show a varying and non-negligible incidence in the literature. We undertook this study to investigate a new protocol to reduce lymphatic injuries in patients undergoing venous ... ...

Abstract	Lymphatic complications following great and small saphenous vein surgery show a varying and non-negligible incidence in the literature. We undertook this study to investigate a new protocol to reduce lymphatic injuries in patients undergoing venous surgery. Eighty-six patients with lower limb venous insufficiency and varices were treated. Lymphoscintigraphy was performed preoperatively in 65 of them and postoperatively in 19. Blue dye was used in all patients and blue lymph nodes and lymphatics were identified intra-operatively and preserved or used to perform multiple lymphatic-venous anastomoses (MLVA). Patients were followed up fora period varying from 3 months to 6 years. Sixty-six patients were treated by greater saphenectomy and varicectomy, 12 patients had crossectomy and varicectomy, 4 patients underwent greater saphenectomy and varicectomy associated with MLVA, and 4 patients were treated by small saphenous vein stripping and varicectomy. No lymphatic complications occurred in any of the patients. A decrease of over 75% of excess volume was observed in 4 patients treated by MLVA. Lymphoscintigraphy showed normalization in the Transport Index in 4 patients treated with MLVA. Our results demonstrate that accurate diagnostic investigation and proper surgical technique is of paramount importance in the effort to avoid lymphatic complications during venous surgery.
MeSH term(s)	Adult ; Aged ; Aged, 80 and over ; Female ; Humans ; Lymphatic Vessels/injuries ; Lymphedema/complications ; Lymphedema/diagnosis ; Lymphedema/etiology ; Lymphedema/surgery ; Lymphoscintigraphy ; Male ; Microsurgery/adverse effects ; Microsurgery/methods ; Middle Aged ; Postoperative Complications/diagnosis ; Postoperative Complications/etiology ; Postoperative Complications/prevention & control ; Postoperative Complications/therapy ; Severity of Illness Index ; Veins/surgery ; Young Adult
Language	English
Publishing date	2018-09-25
Publishing country	United States
Document type	Journal Article ; Review
ZDB-ID	80181-1
ISSN	2522-7963 ; 0024-7766
ISSN (online)	2522-7963
ISSN	0024-7766
Database	MEDical Literature Analysis and Retrieval System OnLINE

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Article ; Online: Conservative management of chylous ascites after oncological surgery for peripheral neuroblastic tumors in pediatric patients.

Pio, L / Boccardo, F / Avanzini, S / Paraboschi, I / Granata, C / Garaventa, A / Dessalvi, S / Martucciello, G / Mattioli, G

Lymphology

2019 Volume 52, Issue 1, Page(s) 25–34

Abstract: Chylous ascites may complicate the postoperative course of abdominal surgery mainly due to the iatrogenic disruption of the lymphatic channels during extensive retroperitoneal dissection. Sparse data are available regarding treatment; however, in many ... ...

Abstract	Chylous ascites may complicate the postoperative course of abdominal surgery mainly due to the iatrogenic disruption of the lymphatic channels during extensive retroperitoneal dissection. Sparse data are available regarding treatment; however, in many cases a recommended first-line treatment approach is by way of enteral feeding, consisting of a formula high in medium-chain triglycerides (MCTs) together with a complete total parenteral nutrition teamed with somatostatin (or an equivalent). Nonetheless, the ligation of chylous fistulae, together with the application of Fibrin glue, as well as the creation of peritoneal-venous shunts have also been documented. The aims of this study are to document incidence of postoperative chylous ascites following resection of abdominal peripheral neuroblastic tumors, evaluate efficacy of the management of chylous ascites, and investigate the main risk factors. A survey was carried out over a span of six years, from March 2010 to March 2016 at Giannina Gaslini Children's Hospital involving seventy-seven children with resections of peripheral neuroblastic tumors. Incidence rate of postoperative chylous ascites following a normal diet was 9% (n=7). Treatment using total parenteral nutrition with octreotide resulted in a complete recovery from chylous ascites within a 20 day period without recurrence. Length of operative time, nephrectomy, and the extension of lymphadenectomy were all significantly associated with a higher incidence of postoperative chylous ascites (p<0.05) which also lengthened hospital stay (p<0.05) and possibly delayed beginning adjuvant chemotherapy.
MeSH term(s)	Adolescent ; Adult ; Child ; Child, Preschool ; Chylous Ascites/diagnosis ; Chylous Ascites/etiology ; Combined Modality Therapy/methods ; Disease Management ; Female ; Humans ; Infant ; Length of Stay ; Lymph Node Excision/adverse effects ; Male ; Nephrectomy/adverse effects ; Peripheral Nervous System Neoplasms/complications ; Peripheral Nervous System Neoplasms/diagnosis ; Peripheral Nervous System Neoplasms/surgery ; Postoperative Complications ; Risk Factors ; Treatment Outcome ; Young Adult
Language	English
Publishing date	2019-05-22
Publishing country	United States
Document type	Journal Article
ZDB-ID	80181-1
ISSN	2522-7963 ; 0024-7766
ISSN (online)	2522-7963
ISSN	0024-7766
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Article ; Online: Synthesis of 3-substituted 2,3-dihydropyrazino[1,2-

Goggiamani, Antonella / Arcadi, Antonio / Ciogli, Alessia / De Angelis, Martina / Dessalvi, Stefano / Fabrizi, Giancarlo / Iavarone, Federica / Iazzetti, Antonia / Sferrazza, Alessio / Zoppoli, Roberta

RSC advances

2023 Volume 13, Issue 15, Page(s) 10090–10096

Abstract: The synthesis of 2,3-dihydropyrazino[1,2- ...

Abstract	The synthesis of 2,3-dihydropyrazino[1,2-
Language	English
Publishing date	2023-03-29
Publishing country	England
Document type	Journal Article
ISSN	2046-2069
ISSN (online)	2046-2069
DOI	10.1039/d3ra01335a
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Article: Chyloperitoneum: Diagnostic and Therapeutic Options.

Dessalvi, S / Boccardo, F / Molinari, L / Spinaci, S / Campisi, C / Ferrari, G M

Lymphology

2016 Volume 49, Issue 1, Page(s) 1–7

MeSH term(s)	Adult ; Anastomosis, Surgical/methods ; Child ; Child, Preschool ; Chylous Ascites/diagnostic imaging ; Chylous Ascites/therapy ; Diet Therapy ; Female ; Gastrointestinal Agents/therapeutic use ; Humans ; Infant ; Lymphatic Vessels/surgery ; Lymphography ; Lymphoscintigraphy ; Magnetic Resonance Imaging ; Male ; Microsurgery/methods ; Middle Aged ; Octreotide/therapeutic use ; Parenteral Nutrition, Total ; Tomography, X-Ray Computed ; Veins/surgery ; Young Adult
Chemical Substances	Gastrointestinal Agents ; Octreotide (RWM8CCW8GP)
Language	English
Publishing date	2016
Publishing country	United States
Document type	Journal Article
ZDB-ID	80181-1
ISSN	0024-7766
ISSN	0024-7766
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Article ; Online: Microsurgery for groin lymphocele and lymphedema after oncologic surgery.

Boccardo, Francesco / Dessalvi, Sara / Campisi, Corrado / Molinari, Lidia / Spinaci, Stefano / Talamo, Giuseppina / Campisi, Corradino

Microsurgery

2014 Volume 34, Issue 1, Page(s) 10–13

Abstract: Groin lymphocele (GL) is a frequent complication of inguinal lymph node dissection, and conservative treatment is not always successful. Different surgical methods have been used to treat lymphoceles arising from lymphatics injured during groin surgery. ... ...

Abstract	Groin lymphocele (GL) is a frequent complication of inguinal lymph node dissection, and conservative treatment is not always successful. Different surgical methods have been used to treat lymphoceles arising from lymphatics injured during groin surgery. However, they all involve the closure of lymphatics merging at the lymphocele, increasing the risk of postoperative lower limb lymphedema or of worsening lymphedema if already clinically evident. We assessed the efficacy of a diagnostic and therapeutic protocol to manage inguinal lymphoceles using lymphoscintigraphy (LS) and microsurgical procedures. Sixteen GL [seven associated with leg lymphedema (LL)] were studied by LS preoperatively and treated by complete excision of lymphocele and microsurgical lymphatic-venous anastomoses between afferent lymphatics and a collateral branch of great saphenous vein. Lower limb lymphatics were identified intraoperatively using Patent Blue dye injection. Nine patients without lymphedema had complete healing of lymphocele and no appearance of lower limb postoperative lymphedema. The other seven patients with associated secondary lymphedema had complete disappearance of lymphocele and a remarkable reduction of leg volume. Four of them completely recovered without the need of any compression garment, after the first year postoperative. Inguinal lymphocele nonresponsive to conservative treatment can be advantageously studied by LS and successfully treated by microsurgical reconstructive procedures, above all if associated to LL.
MeSH term(s)	Adult ; Groin ; Humans ; Lymphedema/diagnostic imaging ; Lymphedema/surgery ; Lymphocele/diagnostic imaging ; Lymphocele/surgery ; Lymphoscintigraphy ; Microsurgery ; Middle Aged ; Neoplasms/surgery ; Postoperative Complications/diagnostic imaging ; Postoperative Complications/surgery
Language	English
Publishing date	2014-01
Publishing country	United States
Document type	Journal Article
ZDB-ID	605524-2
ISSN	1098-2752 ; 0738-1085
ISSN (online)	1098-2752
ISSN	0738-1085
DOI	10.1002/micr.22129
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Article: Chylopericardium: a case report demonstrating utility of lymphography combined with 3D computed tomography for corrective surgical treatment using VATS.

Rosa, G M / Campisi, C / Bioccardo, F / Dorighi, U / Parodi, A / Molinari, L / Spinaci, S / Dessalvi, S / Brunelli, C

Lymphology

2014 Volume 47, Issue 1, Page(s) 40–43

Abstract: We present a case of a 58 year-old woman with primary chylopericardium associated with chylothorax. Chylopericardium is a condition in which chylous fluid containing a high concentration of triglycerides accumulates in the pericardial cavity, and it can ... ...

Abstract	We present a case of a 58 year-old woman with primary chylopericardium associated with chylothorax. Chylopericardium is a condition in which chylous fluid containing a high concentration of triglycerides accumulates in the pericardial cavity, and it can form for many different reasons. 3D computed tomography with lymphography precisely depicted the specific location of the lymphatic leak in this patient, which was successfully repaired using targeted video assisted thoracic surgery (VATS).
MeSH term(s)	Female ; Humans ; Imaging, Three-Dimensional ; Lymphography ; Middle Aged ; Pericardial Effusion/diagnostic imaging ; Pericardial Effusion/surgery ; Predictive Value of Tests ; Radiographic Image Interpretation, Computer-Assisted ; Thoracic Surgery, Video-Assisted ; Tomography, X-Ray Computed ; Treatment Outcome
Language	English
Publishing date	2014-03
Publishing country	United States
Document type	Case Reports ; Journal Article
ZDB-ID	80181-1
ISSN	0024-7766
ISSN	0024-7766
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Article: Surgical prevention and treatment of lymphedema after lymph node dissection in patients with cutaneous melanoma.

Boccardo, F / De Cian, F / Campisi, C C / Molinari, L / Spinaci, S / Dessalvi, S / Talamo, G / Campisi, Caterina / Villa, G / Bellini, C / Parodi, A / Santi, P L / Campisi, C

Lymphology

2013 Volume 46, Issue 1, Page(s) 20–26

Abstract: Despite the development of minimal access dissection techniques, use of superficial groin dissection alone, and other recommendations to reduce morbidity in melanoma treatment, the incidence of lymphedema is still significant. The purpose of the current ... ...

Abstract	Despite the development of minimal access dissection techniques, use of superficial groin dissection alone, and other recommendations to reduce morbidity in melanoma treatment, the incidence of lymphedema is still significant. The purpose of the current study was to assess the efficacy of microsurgical methods to limit the morbidity of inguinal lymphadenectomy. We conducted a retrospective review of patients who underwent groin dissection for melanoma treatment from February 2006 to April 2009. A total of 59 melanoma patients with positive groin lymph nodes comprised 18 patients (T-group) with melanoma in the trunk and 41 patients (E-group) who had melanoma in an extremity and currently have lymphedema. The T-group patients underwent primary prevention of lymphedema with microsurgical lymphatic-venous anastomoses (LVA) performed simultaneously with groin dissection. The E-group patients underwent LVA to treat the secondary lymphedema after an accurate oncological and lymphological assessment. Limb volume measurements and lymphoscintigraphy were performed pre- and postoperatively to assess short and long term outcome. No lymphedema occurred after microsurgical primary preventive approach in the T- group. Significant (average 80% reduction of pre-op excess volume) reduction of lymphedema resulted after microsurgical treatment for secondary leg lymphedema. Post-operative lymphoscintigraphy in 35 patients demonstrated patency of microsurgical anastomoses in all cases with an average follow-up of 42 months. Study results demonstrate that microsurgical LVA primary prevention prevented lymphedema after inguinal lymphadenectomy in the T-group patients. In addition, lymphatic-venous multiple anastomoses proved to be a successful treatment for clinical lymphedema with particular success if treated at the early stages.
MeSH term(s)	Adult ; Aged ; Anastomosis, Surgical ; Female ; Follow-Up Studies ; Groin ; Humans ; Lymph Node Excision ; Lymphatic Metastasis ; Lymphatic Vessels/surgery ; Lymphedema/prevention & control ; Lymphoscintigraphy ; Male ; Melanoma/secondary ; Middle Aged ; Postoperative Complications ; Prognosis ; Retrospective Studies ; Skin Neoplasms/pathology ; Young Adult
Language	English
Publishing date	2013-03
Publishing country	United States
Document type	Journal Article
ZDB-ID	80181-1
ISSN	0024-7766
ISSN	0024-7766
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