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Article ; Online: Predictive factors of intestinal necrosis in acute mesenteric ischemia

Canfora Alfonso / Ferronetti Antonio / Marte Gianpaolo / Maio Vittorio Di / Mauriello Claudio / Maida Pietro / Bottino Vincenzo / Aprea Giovanni / Amato Bruno

Open Medicine, Vol 14, Iss 1, Pp 883-

2019 Volume 889

Abstract: Acute mesenteric ischemia (AMI) is a gastrointestinal and vascular emergency in which the detection of patients requiring intestinal resection is mandatory. ...

Abstract	Acute mesenteric ischemia (AMI) is a gastrointestinal and vascular emergency in which the detection of patients requiring intestinal resection is mandatory.
Keywords	acute mesenteric ischemia ; irreversible transmural intestinal necrosis ; explorative laparotomy ; predictive factors ; Medicine ; R
Language	English
Publishing date	2019-12-01T00:00:00Z
Publisher	De Gruyter
Document type	Article ; Online
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Article: Predictive Factors of Intestinal Necrosis in Acute Mesenteric Ischemia.

Canfora, Alfonso / Ferronetti, Antonio / Marte, Gianpaolo / Maio, Vittorio Di / Mauriello, Claudio / Maida, Pietro / Bottino, Vincenzo / Aprea, Giovanni / Amato, Bruno

Open medicine (Warsaw, Poland)

2019 Volume 14, Page(s) 883–889

Abstract: Objectives: Acute mesenteric ischemia (AMI) is a gastrointestinal and vascular emergency in which the detection of patients requiring intestinal resection is mandatory.: Methods: Registered data of 55 consecutive patients admitted to our center ... ...

Abstract	Objectives: Acute mesenteric ischemia (AMI) is a gastrointestinal and vascular emergency in which the detection of patients requiring intestinal resection is mandatory. Methods: Registered data of 55 consecutive patients admitted to our center between January 2010 and December 2016 that underwent an explorative laparotomy for a suspected diagnosis of irreversible transmural intestinal necrosis (ITIN) were analyzed. Demographic, clinical, laboratory and CT findings were statistically analyzed in order to search predictive factors of ITIN and their correlation to its clinical spectre. Results: Tobacco use was the most statistically significant (p<0.01) cardiovascular disease risk factor involved in ITIN. Among lab tests, Serum lactate levels ˃ 2mmol/L resulted in a statistically significant association with ITIN (p=0.0001). Organ failure (defined as Marshall score> 2) and the three main CT findings (decreased bowel wall enhancement, bowel loop dilation and demonstrated vessel occlusion) were strongly associated with ITIN (p values: 0.001, 0.007, 0.0013, 0.0005). Only serum lactate levels>2 mmol/L resulted as statistically significant as predictive factors of ITIN in multivariate analysis using logistic regression (OR 49.66 and p-value 0.0021). Conclusion: Our univariate and multivariate analysis identified multiple factors (Serum lactate levels ˃ 2mmol/L, Organ failure, CT signs) that could suggest patients that require a surgical approach for ITIN.
Language	English
Publishing date	2019-12-17
Publishing country	Poland
Document type	Journal Article
ZDB-ID	2829380-0
ISSN	2391-5463
ISSN	2391-5463
DOI	10.1515/med-2019-0104
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Article ; Online: Laparoscopic versus open gastrectomy with extended lymph node dissection for gastric carcinoma in a Western series: a Propensity Score Matching analysis.

Maida, Pietro / Marte, Gianpaolo / Spedicato, Giorgio A / Ferronetti, Antonio / Mauriello, Claudio / Canfora, Alfonso / Ciorra, Guido / Barra, Luigi / Di Maio, Vittorio

Minerva chirurgica

2019 Volume 74, Issue 1, Page(s) 107–111

MeSH term(s)	Adenocarcinoma/secondary ; Adenocarcinoma/surgery ; Adult ; Aged ; Aged, 80 and over ; Female ; Gastrectomy/methods ; Humans ; Laparoscopy ; Lymph Node Excision/methods ; Lymphatic Metastasis ; Male ; Middle Aged ; Propensity Score ; Retrospective Studies ; Stomach Neoplasms/pathology ; Stomach Neoplasms/surgery
Language	English
Publishing date	2019-01-15
Publishing country	Italy
Document type	Comparative Study ; Journal Article
ZDB-ID	123603-9
ISSN	1827-1626 ; 0026-4733
ISSN (online)	1827-1626
ISSN	0026-4733
DOI	10.23736/S0026-4733.18.07562-4
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Article ; Online: Surgical Resection of Malignancies Invading Inferior

Vicente, Emilio / Quijano, Yolanda / Ielpo, Benedetto / Duran, Hipolito / Diaz, Eduardo / Fabra, Isabel / Malavé, Luis / Ferri, Valentina / Ferronetti, Antonio / Caruso, Riccardo

Anticancer research

2017 Volume 37, Issue 5, Page(s) 2523–2528

Abstract: Background/aim: Abdominal malignancies invading inferior vena cava present high postoperative morbidity and poor prognosis that has been decreasing in the last years. Our aim was to present and discuss a series of resected tumors invading the inferior ... ...

Abstract	Background/aim: Abdominal malignancies invading inferior vena cava present high postoperative morbidity and poor prognosis that has been decreasing in the last years. Our aim was to present and discuss a series of resected tumors invading the inferior vena cava from the origin of the hepatic vein to the common iliac veins (Level I and II). Materials and methods: We retrospectively evaluated from 2005 to 2015 short- and long-term results of 20 consecutive surgical resections of tumors with associated inferior vena cava resection at Levels I and II performed at the Sanchinarro Hospital, Madrid, Spain. Results: The series included 4 leiomyosarcomas, 3 pancreatic cancers, 2 germinal cancers, 5 renal cancers, 4 liver cancers and 2 adrenal cancers. There were 7 circular cava resections, all of them replaced by polytetrafluoroethylene (PTFE) graft and 13 primary repairs. Sapheno-femoral arterio-venous fistulas have been performed in 6 cases. Early postoperative complications occurred in 11 cases (57.9%) and mortality in one case. Graft thrombosis occurred in one case at 14 months from surgery (1/7, 14.2%). Conclusion: Surgical resection with combined inferior vena cava resection can be performed in selected patients with acceptable morbidity and mortality in light of the recent advancement in surgical technique.
MeSH term(s)	Abdominal Neoplasms/pathology ; Abdominal Neoplasms/surgery ; Adult ; Aged ; Female ; Hepatic Veins/pathology ; Humans ; Iliac Vein/pathology ; Lymph Node Excision ; Male ; Middle Aged ; Neoplasm Invasiveness ; Retroperitoneal Space ; Vena Cava, Inferior/pathology ; Vena Cava, Inferior/surgery ; Young Adult
Language	English
Publishing date	2017
Publishing country	Greece
Document type	Journal Article
ZDB-ID	604549-2
ISSN	1791-7530 ; 0250-7005
ISSN (online)	1791-7530
ISSN	0250-7005
DOI	10.21873/anticanres.11594
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Article ; Online: Robot-assisted resection of gastrointestinal stromal tumors (GIST): a single center case series and literature review.

Vicente, Emilio / Quijano, Yolanda / Ielpo, Benedetto / Duran, Hipolito / Diaz, Eduardo / Fabra, Isabel / Malave, Luis / Ferri, Valentina / Ferronetti, Antonio / Caruso, Riccardo

The international journal of medical robotics + computer assisted surgery : MRCAS

2016 Volume 12, Issue 4, Page(s) 718–723

Abstract: Background: Robotic techniques are claimed to be an alternative to laparoscopic and open approaches for gastrointestinal stromal tumors (GIST) treatment. Our aim is to present our single center experience and a literature review.: Materials and ... ...

Abstract	Background: Robotic techniques are claimed to be an alternative to laparoscopic and open approaches for gastrointestinal stromal tumors (GIST) treatment. Our aim is to present our single center experience and a literature review. Materials and methods: From June 2012 to August 2014, six patients with preoperative diagnosis of GIST were treated by robotic surgery at Sanchinarro University Hospital. Results: Two GIST tumors were localized in the second part of the duodenum, one in the first portion, two in the gastricantrum and another in the angular notch. Surgical procedures performed were two subtotal gastrectomies, one gastric wedge resection and three duodenal enucleations. None of the interventions needed conversion to open surgery. Mean operative time was 245 min (150-540). Mean hospital stay was 10.5 days (6-24). All lesions had microscopically negative resection margins. Mean follow-up was 24 months (8-33) with a disease-free survival rate of 100%. Conclusions: A robotic approach for GIST tumors is a safe and feasible procedure with a well-accepted oncological surgical result. Copyright © 2015 John Wiley & Sons, Ltd.
MeSH term(s)	Adult ; Aged ; Disease-Free Survival ; Female ; Gastrectomy/methods ; Gastrointestinal Stromal Tumors/surgery ; Humans ; Laparoscopy ; Male ; Middle Aged ; Operative Time ; Robotic Surgical Procedures/methods ; Spain ; Stomach Neoplasms/surgery ; Treatment Outcome
Language	English
Publishing date	2016-12
Publishing country	England
Document type	Journal Article ; Review
ZDB-ID	2151860-9
ISSN	1478-596X ; 1478-5951
ISSN (online)	1478-596X
ISSN	1478-5951
DOI	10.1002/rcs.1712
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Zs.A 6382: Show issues

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Article ; Online: Efficacy and safety of ultrasound-guided placement of central venous port systems via the right internal jugular vein in elderly oncologic patients: our single-center experience and protocol.

Canfora, Alfonso / Mauriello, Claudio / Ferronetti, Antonio / Marte, Gianpaolo / Di Maio, Vittorio / Ciorra, Guido / Esposito, Maria Grazia / Giuliano, Maria Elena / Fregola, Giovanni / Barra, Luigi / Cuzzovaglia, Salvatore / Bottino, Vincenzo / Maida, Pietro

Aging clinical and experimental research

2017 Volume 29, Issue Suppl 1, Page(s) 127–130

Abstract: Background: Ultrasound-guidance has become the routine method for internal jugular vein (IJV) catheterization reducing dramatically failure and complication rates for central venous port (CVP) placement.: Aims: The aim of this study was to determine ... ...

Abstract	Background: Ultrasound-guidance has become the routine method for internal jugular vein (IJV) catheterization reducing dramatically failure and complication rates for central venous port (CVP) placement. Aims: The aim of this study was to determine the safety and efficacy of ultrasound-guided IJV CVP placement in elderly oncologic patients. Methods: Between January 2013 and December 2015, 101 elderly oncological patients underwent right IJV CVP placement under ultrasound-guidance. The length of catheter introduction ranged from 18 to 21 cm. Intraoperative fluoroscopy (IF) was always performed intraoperatively. Chest X-ray (CXR) was always performed 30 min after the end of the procedure. Results: The morbidity rate was 1.98%; two arterial punctures were reported with one self-limiting hematoma. Two patients (1.98%) had catheter misplacements, recognized by intraoperative IF. No patients (0%) experienced pneumothorax (PNX), confirmed at CXR. Patients were all discharged at maximum 6 h from the procedure. Discussion: The risk of catheter misplacement, PNX, and arterial/nerve puncture remains present with this technique. Lower rates of catheter misplacement have been reported after right IJV puncture, probably for its straight vertical course. Our results are in accordance with literature (1 counter-lateral subclavian vein and 1 counter-lateral internal jugular vein misplacements). All misplacements were detected intraoperatively. The PNX rates after cannulation of the IJV vary between 0.0 and 0.5%. We had no PNX occurrence. Conclusion: Ultrasonography (US) has improved safety and effectiveness of port system placements. While routine post-procedural CXR seems avoidable, IF should be considered mandatory.
MeSH term(s)	Aged ; Aged, 80 and over ; Catheterization, Central Venous/adverse effects ; Catheterization, Central Venous/instrumentation ; Catheterization, Central Venous/methods ; Female ; Humans ; Italy ; Jugular Veins/surgery ; Male ; Monitoring, Intraoperative/methods ; Oncology Service, Hospital/statistics & numerical data ; Outcome and Process Assessment (Health Care) ; Postoperative Complications/diagnosis ; Postoperative Complications/therapy ; Retrospective Studies ; Surgery, Computer-Assisted/adverse effects ; Surgery, Computer-Assisted/methods ; Ultrasonography/methods ; Vascular Access Devices
Language	English
Publishing date	2017-02
Publishing country	Germany
Document type	Journal Article
ZDB-ID	2104785-6
ISSN	1720-8319 ; 1594-0667
ISSN (online)	1720-8319
ISSN	1594-0667
DOI	10.1007/s40520-016-0680-9
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Zs.A 3343: Show issues

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Article ; Online: Robotic Liver Surgery: Early Experience From a Single Surgical Center.

Quijano, Yolanda / Vicente, Emilio / Ielpo, Benedetto / Duran, Hipolito / Diaz, Eduardo / Fabra, Isabel / Olivares, Sergio / Ferri, Valentina / Ortega, Irene / Malavé, Luis / Ferronetti, Antonio / Piccinni, Giuseppe / Caruso, Riccardo

Surgical laparoscopy, endoscopy & percutaneous techniques

2016 Volume 26, Issue 1, Page(s) 66–71

Abstract: Introduction: The use of robotic surgery in liver resection is still limited. Our aim is to present our early experience of robotic liver resection.: Materials and methods: It is a retrospective review of Sanchinarro University hospital experience of ...

Abstract	Introduction: The use of robotic surgery in liver resection is still limited. Our aim is to present our early experience of robotic liver resection. Materials and methods: It is a retrospective review of Sanchinarro University hospital experience of robotic liver resection performed from 2011 to 2014. Clinicopathologic characteristics, and perioperative and postoperative outcomes were recorded and analyzed. Results: Twenty-one procedures have been performed and 13 (65%) of them were for malignancy. There were 2 left hepatectomies, 1 right hepatectomy, 1 associated liver partition and portal vein ligation staged procedure (both steps by robotic approach), 1 bisegmentectomy and 3 segmentectomies, 9 wedge resections, and 3 pericystectomies. The mean operating time was 282 minutes (range, 90 to 540 min). Overall conversion rate and postoperative complication rate were 4.7% and 19%, respectively. The mean length of hospital stay was 13.4 days (range, 4 to 64 d). Conclusion: From our early experience, robotic liver surgery is a safe and feasible procedure, especially for major hepatectomies.
MeSH term(s)	Adult ; Aged ; Blood Loss, Surgical/statistics & numerical data ; Blood Transfusion/statistics & numerical data ; Cholecystectomy/methods ; Conversion to Open Surgery/statistics & numerical data ; Feasibility Studies ; Female ; Hepatectomy/methods ; Humans ; Laparoscopy/methods ; Length of Stay ; Liver/surgery ; Liver Neoplasms/surgery ; Lymph Node Excision/methods ; Male ; Middle Aged ; Operative Time ; Patient Positioning ; Retrospective Studies ; Robotic Surgical Procedures/methods ; Treatment Outcome
Language	English
Publishing date	2016-02
Publishing country	United States
Document type	Evaluation Studies ; Journal Article
ZDB-ID	1475108-2
ISSN	1534-4908 ; 1530-4515 ; 1051-7200
ISSN (online)	1534-4908
ISSN	1530-4515 ; 1051-7200
DOI	10.1097/SLE.0000000000000227
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Zs.A 3200: Show issues

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Article ; Online: Full robot-assisted gastrectomy: surgical technique and preliminary experience from a single center.

Quijano, Yolanda / Vicente, Emilio / Ielpo, Benedetto / Duran, Hipolito / Diaz, Eduardo / Fabra, Isabel / Malave, Luis / Ferri, Valentina / Ferronetti, Antonio / Plaza, Carlos / D'Andrea, Vito / Caruso, Riccardo

Journal of robotic surgery

2016 Volume 10, Issue 4, Page(s) 297–306

Abstract: The treatment of gastric cancer requires a multidisciplinary approach in which surgery plays the main role. The diffusion of minimally invasive surgery for gastric cancer treatment is limited by the complexity of performing an extended lymphadenectomy. ... ...

Abstract	The treatment of gastric cancer requires a multidisciplinary approach in which surgery plays the main role. The diffusion of minimally invasive surgery for gastric cancer treatment is limited by the complexity of performing an extended lymphadenectomy. This surgical step can be facilitated through the use of a robot-assisted system. To date, there are few published articles discussing a full robotic approach that precisely show the different surgical steps. The aim of this study is to describe our experience, surgical techniques and the short-term results of a consecutive series of full robotic gastrectomies using the Da Vinci Surgical System. From November 2011 to January 2015, 17 patients with gastric cancer underwent curative resection by robotic approach for locally advanced tumors. In summary, there were 15 total gastrectomies with a Roux-en-Y esophagojejunostomy, one total gastrectomy with transverse colectomy and one sub-total gastrectomy. Resection margins were negative in all cases. Conversions occurred in two patients. Robot-assisted gastrectomy with extended lymphadenectomy is a safe technique and successfully allows an adequate lymph node harvest and optimal R0-resection rates with low postoperative morbidity. The learning curve appears to be shorter than in laparoscopic surgery. Further follow-up and randomized clinical trials are required to confirm the role of a robotic approach in gastric cancer surgery.
MeSH term(s)	Adenocarcinoma/drug therapy ; Adenocarcinoma/surgery ; Adult ; Aged ; Aged, 80 and over ; Anastomosis, Roux-en-Y ; Antineoplastic Combined Chemotherapy Protocols/therapeutic use ; Blood Loss, Surgical/statistics & numerical data ; Blood Transfusion/statistics & numerical data ; Capecitabine/administration & dosage ; Combined Modality Therapy ; Drug Administration Schedule ; Epirubicin/administration & dosage ; Female ; Gastrectomy/methods ; Humans ; Infusions, Intravenous ; Learning Curve ; Male ; Middle Aged ; Operative Time ; Organoplatinum Compounds/administration & dosage ; Perioperative Care/methods ; Prospective Studies ; Robotic Surgical Procedures/methods ; Stomach Neoplasms/drug therapy ; Stomach Neoplasms/surgery ; Young Adult
Chemical Substances	Organoplatinum Compounds ; oxaliplatin (04ZR38536J) ; Epirubicin (3Z8479ZZ5X) ; Capecitabine (6804DJ8Z9U)
Keywords	covid19
Language	English
Publishing date	2016-12
Publishing country	England
Document type	Comparative Study ; Journal Article
ZDB-ID	2268283-1
ISSN	1863-2491 ; 1863-2483
ISSN (online)	1863-2491
ISSN	1863-2483
DOI	10.1007/s11701-016-0591-y
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Article ; Online: Morpho-functional gastric pre-and post-operative changes in elderly patients undergoing laparoscopic cholecystectomy for gallstone related disease

Aprea Giovanni / Canfora Alfonso / Ferronetti Antonio / Giugliano Antonio / Guida Francesco / Braun Antonio / Battaglini Ciciriello Melania / Tovecci Federica / Mastrobuoni Giovanni / Cardin Fabrizio / Amato Bruno

BMC Surgery, Vol 12, Iss Suppl 1, p S

2012 Volume 5

Abstract: Abstract Background Cholecystectomy, gold standard treatment for gallbladder lithiasis, is closely associated with increased bile reflux into the stomach as amply demonstrated by experimental studies. The high prevalence of gallstones in the population ... ...

Abstract	Abstract Background Cholecystectomy, gold standard treatment for gallbladder lithiasis, is closely associated with increased bile reflux into the stomach as amply demonstrated by experimental studies. The high prevalence of gallstones in the population and the consequent widespread use of surgical removal of the gallbladder require an assessment of the relationship between cholecystectomy and gastric mucosal disorders. Morphological evaluations performed on serial pre and post – surgical biopsies have provided new acquisitions about gastric damage induced by bile in the organ. Methods 62 elderly patients with gallstone related disease were recruited in a 30 months period. All patients were subjected to the most appropriate treatment (Laparoscopic cholecystectomy). The subjects had a pre-surgical evaluation with: • dyspeptic symptoms questionnaire, • gastric endoscopy with body, antrum, and fundus random biopsies, • histo-pathological analysis of samples and elaboration of bile reflux index (BRI). The same evaluation was repeated at a 6 months follow-up. Results In our series the duodeno-gastric reflux and the consensual biliary gastritis, assessed histologically with the BRI, was found in 58% of the patients after 6 months from cholecystectomy. The demonstrated bile reflux had no effect on H. pylori’s gastric colonization nor on the induction of gastric precancerous lesions. Conclusions Cholecystectomy, gold standard treatment for gallstone-related diseases, is practiced in a high percentage of patients with this condition. Such procedure, considered by many harmless, was, in our study, associated with a significant risk of developing biliary gastritis after 6 months during the postoperative period.
Keywords	Surgery ; RD1-811 ; Medicine ; R ; DOAJ:Surgery ; DOAJ:Medicine (General) ; DOAJ:Health Sciences
Subject code	610
Language	English
Publishing date	2012-11-01T00:00:00Z
Publisher	BioMed Central
Document type	Article ; Online
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Article ; Online: Diverticular disease hospital cost impact analysis

Aprea Giovanni / Giugliano Antonio / Canfora Alfonso / Cardin Fabrizio / Ferronetti Antonio / Guida Francesco / Braun Antonio / Battaglini Ciciriello Melania / Tovecci Federica / Mastrobuoni Giovanni / Amato Bruno

BMC Surgery, Vol 12, Iss Suppl 1, p S

evaluation of testings and surgical procedures in inpatient and outpatient admissions

2012 Volume 3

Abstract: Abstract Background Diverticular Disease (DD) is a common condition in Italy and in other western countries. There is not much data concerning DD’s impact on budget and activity in hospitals. Methods The aim is to detect the clinical workload and the ... ...

Abstract	Abstract Background Diverticular Disease (DD) is a common condition in Italy and in other western countries. There is not much data concerning DD’s impact on budget and activity in hospitals. Methods The aim is to detect the clinical workload and the financial impact of diverticular disease in hospitals. Retrospective observational study of all patients treated for diverticular disease during the period of seven years in AOU Federico II. Analysis of inpatient and outpatient investigations, treatment, hospitalization and financial refunds. Results A total of 738 patients were treated and 840 hospital discharge records were registered. There were a total number of 4101 hospitalization days and 753 outpatient accesses. The investigations generated were 416 endoscopies, 197 abdominal CT scans, 177 abdominal ultrasound scans, 109 X-rays tests. A total of 193 surgical operations were performed. The total cost of this activity was € 1.656.802 or 0.2% of the total budget of the hospital. € 1.346.218, were attributable to the department of general surgery, 0.9% of the department’s budget . Conclusions The limited impact of diverticular disease on the budget and activity of AOU Federico II of Naples is mainly due to the absence of an emergency department.
Keywords	Surgery ; RD1-811 ; Medicine ; R ; DOAJ:Surgery ; DOAJ:Medicine (General) ; DOAJ:Health Sciences
Subject code	630
Language	English
Publishing date	2012-11-01T00:00:00Z
Publisher	BioMed Central
Document type	Article ; Online
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