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  1. Article ; Online: Laparoscopic Sleeve Gastrectomy with Staple-Line Oversewing in a Patient with Factor XI Deficiency: A Case Report.

    Beomonte Zobel, Lorenza / Dhimolea, Sirvjo / Billeci, Federica / Sbraccia, Paolo / Sica, Giuseppe S

    The American journal of case reports

    2024  Volume 25, Page(s) e942824

    Abstract: BACKGROUND Bariatric surgery (BS) has a lower percentage of complications than other abdominal surgeries. Hemorrhage in one of the most common complications and can be life-threatening. Hereditary factor XI (FXI) deficiency is a coagulation disorder that ...

    Abstract BACKGROUND Bariatric surgery (BS) has a lower percentage of complications than other abdominal surgeries. Hemorrhage in one of the most common complications and can be life-threatening. Hereditary factor XI (FXI) deficiency is a coagulation disorder that can result in excessive bleeding requiring intervention to restore hemostasis. Risks over benefits in patients with morbid obesity with BS indication, as well as those with FXI deficiency, should be carefully evaluated. This article reports the case of an obese woman with FXI deficiency -undergoing SG. CASE REPORT A 49-year-old woman with a BMI of 51 kg/m² was diagnosed as having severe FXI deficiency during preoperative exams prior to bariatric surgery. Virus-inactivated homo-group plasma 10 ml/kg infusion was administrated 1 h before surgery, during the entire procedure, and continuing until postoperative day (POD) 4. A very low-calorie ketogenic diet (VLCKD) was proposed to the patient 4 weeks before surgery. Laparoscopic sleeve gastrectomy was performed with staple-line reinforcement by oversewing the seromuscular layer using continuous suture. Subcutaneous enoxaparin 4000 U.I. was administered from POD 1 until POD 25 to prevent any thromboembolic event. The patient was discharged on POD 5 in good clinical condition. CONCLUSIONS Risks of bleeding andor thromboembolic events before or after BS are increased in patient with FXI deficiency. Bariatric surgery in these patients is safe in experienced BS centers, and the risks associated with the obesity seem to exceed those of the coagulopathy and surgery. Careful preoperative counseling, extensive hematological checks, and meticulous surgery are essential to reduce BS risks. Sleeve gastrectomy oversewing the stapler line seems a reasonable choice.
    MeSH term(s) Humans ; Female ; Middle Aged ; Gastrectomy/methods ; Laparoscopy ; Factor XI Deficiency/complications ; Obesity, Morbid/surgery ; Surgical Stapling
    Language English
    Publishing date 2024-04-24
    Publishing country United States
    Document type Case Reports ; Journal Article
    ZDB-ID 2517183-5
    ISSN 1941-5923 ; 1941-5923
    ISSN (online) 1941-5923
    ISSN 1941-5923
    DOI 10.12659/AJCR.942824
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  2. Article ; Online: Early Gastric Outlet Obstruction Caused by the Free End of Barbed Sutures Following Laparoscopic Gastric Resection with Roux-en-Y Reconstruction.

    Siragusa, Leandro / Usai, Valeria / Pirozzi, Brunella M / Dhimolea, Sirvjo / Franceschilli, Marzia

    The American journal of case reports

    2023  Volume 24, Page(s) e940661

    Abstract: BACKGROUND Recent developments in surgical suture material include the use of sutures with unidirectional barbs that facilitate laparoscopic suturing thanks to self-anchoring and tension-keeping properties. Complications deriving from the use of barbed ... ...

    Abstract BACKGROUND Recent developments in surgical suture material include the use of sutures with unidirectional barbs that facilitate laparoscopic suturing thanks to self-anchoring and tension-keeping properties. Complications deriving from the use of barbed sutures have been previously reported. In this report we present the case of a patient with gastric outlet obstruction by the free end of a V-Loc™ barbed suture (Medtronic, Dublin, Ireland) following Roux-en-Y gastric resection. CASE REPORT In February 2023, a 77-year-old man who underwent laparoscopic subtotal gastrectomy for cancer followed by Roux-en-Y reconstruction developed symptoms of gastric outlet obstruction a few days after discharge. The patient was readmitted to the hospital due to vomiting 4 days after being discharged after an uneventful postoperative course. Imaging confirmed the presence of an occlusion at the level of the jejunojejunal anastomosis, with a noticeable change in caliber. During laparoscopy, a loop of bowel was entrapped around the tail of the barbed suture used to close the common enterotomy of jejunojejunal anastomosis. Following laparoscopic division of the anchoring suture, the bowel regained its normal caliber. CONCLUSIONS Although complications from the use of unidirectional barbed surgical sutures are rare, this report highlights bowel obstruction as a recognized postoperative complication. The preferred treatment is laparoscopic division of the suture's tail. To prevent complications related to barbed sutures, it is essential to ensure that all barbs of the suture are properly unfolded.
    MeSH term(s) Male ; Humans ; Aged ; Suture Techniques/adverse effects ; Gastrectomy/adverse effects ; Gastrectomy/methods ; Laparoscopy/methods ; Postoperative Complications/surgery ; Postoperative Complications/etiology ; Gastric Outlet Obstruction/etiology ; Gastric Outlet Obstruction/surgery ; Sutures/adverse effects
    Language English
    Publishing date 2023-10-09
    Publishing country United States
    Document type Case Reports ; Journal Article
    ZDB-ID 2517183-5
    ISSN 1941-5923 ; 1941-5923
    ISSN (online) 1941-5923
    ISSN 1941-5923
    DOI 10.12659/AJCR.940661
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  3. Article ; Online: Immunonutrition reduces complications rate and length of stay after laparoscopic total gastrectomy: a single unit retrospective study.

    Franceschilli, Marzia / Siragusa, Leandro / Usai, Valeria / Dhimolea, Sirvjo / Pirozzi, Brunella / Sibio, Simone / Di Carlo, Sara

    Discover. Oncology

    2022  Volume 13, Issue 1, Page(s) 62

    Abstract: Background: Preoperative immunonutrition (IN) reduces the incidence of postoperative complications in malnourished patients undergoing upper gastrointestinal surgery. However, its effect in norm-nourished patients remains unclear. Furthermore, patients ... ...

    Abstract Background: Preoperative immunonutrition (IN) reduces the incidence of postoperative complications in malnourished patients undergoing upper gastrointestinal surgery. However, its effect in norm-nourished patients remains unclear. Furthermore, patients with gastric cancer undergoing laparoscopic total gastrectomy (LTG) are not routinely included in protocols of enhanced recovery after surgery (ERAS).
    Objective: The aim of this study was to investigate the effects of perioperative IN in patients undergoing laparoscopic total gastrectomy (LTG) within an established ERAS pathway.
    Methods: A comparative retrospective study of patients undergoing LTG, receiving an immune-enhancing feed plus maltodextrin load the day of surgery (Group A) versus patients who had the same operation but no IN nor fast track management (group B).
    Results: There were no significant differences in patient demographic characteristics between the two groups but the medium age of patients in group A was older. Thirty-days postoperative complications were respectively 8.7% in Group A and 33.3% in Group B (p 0.04). Mean and median LOS for Group A and B were also significantly different: 7.2 ± 4.4 vs 10.3 ± 5.4 and 7 vs 10 days respectively.
    Conclusion: Preoperative IN associated with ERAS protocol in normo-nourished patient undergoing LTG seems to reduce postoperative complications. Reduction in LOS is possibly associated to the ERAS protocol. Clinical trial registration Clinical trials.gov: NCT05259488.
    Language English
    Publishing date 2022-07-11
    Publishing country United States
    Document type Journal Article
    ISSN 2730-6011
    ISSN (online) 2730-6011
    DOI 10.1007/s12672-022-00490-5
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  4. Article: Acute Abdomen in a 91-Year-Old Male due to Perforated Jejunal Diverticulitis.

    Sammartino, Francesco / Selvaggio, Ivana / Montalto, Gioacchino Maria / Pasecinic, Carolina / Dhimolea, Sirvjo / Krizzuk, Dimitri

    Case reports in gastroenterology

    2020  Volume 14, Issue 3, Page(s) 598–603

    Abstract: Non-Meckel small intestine diverticular disease is a rare and mostly asymptomatic condition. However, rare cases of acute and emergent complications bear a high mortality rate. We report a case of a 91-year-old male that presented with an acute abdomen ... ...

    Abstract Non-Meckel small intestine diverticular disease is a rare and mostly asymptomatic condition. However, rare cases of acute and emergent complications bear a high mortality rate. We report a case of a 91-year-old male that presented with an acute abdomen due to perforated jejunal diverticulitis. A review of the literature and key points of the condition are depicted. Although jejunal diverticulosis is rare, it must be considered in the differential diagnosis, especially in the elderly with signs of ambiguous abdominal pain and peritonitis.
    Language English
    Publishing date 2020-11-04
    Publishing country Switzerland
    Document type Case Reports
    ZDB-ID 2440540-1
    ISSN 1662-0631
    ISSN 1662-0631
    DOI 10.1159/000509529
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  5. Article ; Online: Laparoscopic versus Open Total Gastrectomy for Locally Advanced Gastric Cancer: Short and Long-Term Results.

    Di Carlo, Sara / Siragusa, Leandro / Fassari, Alessia / Fiori, Enrico / La Rovere, Francesca / Izzo, Paolo / Usai, Valeria / Cavallaro, Giuseppe / Franceschilli, Marzia / Dhimolea, Sirvjo / Sibio, Simone

    Current oncology (Toronto, Ont.)

    2022  Volume 29, Issue 11, Page(s) 8442–8455

    Abstract: Background: Laparoscopic gastrectomy for early gastric cancer is widely accepted and routinely performed. However, it is still debated whether the laparoscopic approach is a valid alternative to open gastrectomy in advanced gastric cancer (AGC). The aim ...

    Abstract Background: Laparoscopic gastrectomy for early gastric cancer is widely accepted and routinely performed. However, it is still debated whether the laparoscopic approach is a valid alternative to open gastrectomy in advanced gastric cancer (AGC). The aim of this study is to compare short-and long-term outcomes of laparoscopic (LG) and open (OG) total gastrectomy with D2 lymphadenectomy in patients with AGC.
    Methods: A retrospective comparative study was conducted on patients who underwent LG and OG for ACG between January 2015 and December 2021. Primary endpoints were the following: recurrence rate, 3-year disease-free survival, 3-year and 5-year overall survival. Univariate and multivariate analysis was conducted to compare variables influencing outcomes and survival.
    Results: Ninety-two patients included: fifty-three OG and thirty-nine LG. No difference in morbidity and mortality. LG was associated with lower recurrence rates (OG 22.6% versus LG 12.8%,
    Conclusion: LG for AGC seems to provide satisfactory clinical and oncological outcomes in medium volume centers, improved postoperative results and possibly lower recurrence rates.
    MeSH term(s) Humans ; Stomach Neoplasms/pathology ; Retrospective Studies ; Treatment Outcome ; Gastrectomy/methods ; Laparoscopy/methods ; Neoplasms, Second Primary
    Language English
    Publishing date 2022-11-06
    Publishing country Switzerland
    Document type Journal Article
    ZDB-ID 1236972-x
    ISSN 1718-7729 ; 1198-0052
    ISSN (online) 1718-7729
    ISSN 1198-0052
    DOI 10.3390/curroncol29110665
    Database MEDical Literature Analysis and Retrieval System OnLINE

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