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Article ; Online: COVID-19 pandemic: new rules of engagement in endocrine surgery.

Lombardi, C P / Gordini, L / D'Amore, A / Bocale, R / Boscherini, M / Bellantone, R

2020 Volume 107, Issue 9, Page(s) e322

MeSH term(s)	COVID-19 ; COVID-19 Testing ; Clinical Laboratory Techniques/methods ; Coronavirus Infections/diagnosis ; Coronavirus Infections/epidemiology ; Coronavirus Infections/prevention & control ; Cross Infection/prevention & control ; Endocrine Surgical Procedures/methods ; Health Priorities ; Humans ; Pandemics/prevention & control ; Pneumonia, Viral/diagnosis ; Pneumonia, Viral/epidemiology ; Pneumonia, Viral/prevention & control
Keywords	covid19
Language	English
Publishing date	2020-07-11
Publishing country	England
Document type	Letter
ZDB-ID	2985-3
ISSN	1365-2168 ; 0263-1202 ; 0007-1323 ; 1355-7688
ISSN (online)	1365-2168
ISSN	0263-1202 ; 0007-1323 ; 1355-7688
DOI	10.1002/bjs.11777
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Article ; Online: Prophylactic mesh reinforcement for midline incisional hernia prevention: systematic review and updated meta-analysis of randomized controlled trials.

Aiolfi, A / Cavalli, M / Gambero, F / Mini, E / Lombardo, F / Gordini, L / Bonitta, G / Bruni, P G / Bona, D / Campanelli, G

Hernia : the journal of hernias and abdominal wall surgery

2022 Volume 27, Issue 2, Page(s) 213–224

Abstract: Background: Incisional hernia (IH) is a common complication after abdominal surgery. Prevention of IH is matter of intense research. Prophylactic mesh reinforcement (PMR) has been shown to be promising in the minimization of IH risk after elective ... ...

Abstract	Background: Incisional hernia (IH) is a common complication after abdominal surgery. Prevention of IH is matter of intense research. Prophylactic mesh reinforcement (PMR) has been shown to be promising in the minimization of IH risk after elective midline laparotomy. Methods: Systematic review and meta-analysis of randomized controlled trials (RCTs) comparing PMR vs. primary suture closure (PSC). Risk ratio (RR) and standardized mean difference (MD) were used as pooled effect size measures whereas 95% confidence intervals (95%CI) were used to assess relative inference. Results: Fourteen RCTs (2332 patients) were included. Overall, 1280 (54.9%) underwent PMR while 1052 (45.1%) PSC. Postoperative follow-up ranged from 12 to 67 months. The incidence of IH was reduced for PMR vs. PSC (13.4% vs. 27.5%). The estimated pooled IH RR for PMR vs. PSC is 0.38 (95% CI 0.24-0.58; p < 0.001). Stratified subgroup analysis according to mesh location shows a risk reduction for intraperitoneal (RR = 0.65; 95% CI 0.48-0.89), preperitoneal (RR = 0.18; 95% CI 0.04-0.81), retromuscular (RR = 0.47; 95% CI 0.24-0.92) and onlay (RR = 0.24; 95% CI 0.12-0.51) compared to PSC. The seroma RR was higher for PMR (RR = 2.05; p = 0.0008). No differences were found for hematoma (RR = 1.49; p = 0.34), surgical site infection (SSI) (RR = 1.17; p = 0.38), operative time (OT) (MD = 0.27; p = 0.413), and hospital length of stay (HLOS) (MD = -0.03; p = 0.237). Conclusions: PMR seems effective in reducing the risk of IH after elective midline laparotomy compared to PSC in the medium-term follow-up. While the risk of postoperative seroma appears higher for PMR, hematoma, SSI, HLOS and OT seems comparable.
MeSH term(s)	Humans ; Incisional Hernia/etiology ; Surgical Mesh/adverse effects ; Seroma ; Herniorrhaphy/adverse effects ; Randomized Controlled Trials as Topic ; Laparotomy/adverse effects ; Surgical Wound Infection/complications ; Abdominal Wound Closure Techniques/adverse effects
Language	English
Publishing date	2022-08-03
Publishing country	France
Document type	Systematic Review ; Meta-Analysis ; Journal Article ; Review
ZDB-ID	1388125-5
ISSN	1248-9204 ; 1265-4906
ISSN (online)	1248-9204
ISSN	1265-4906
DOI	10.1007/s10029-022-02660-4
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Article: Lipoma of the fossa femoralis mimicking a femoral hernia. Report of 2 cases.

Amato, G / Romano, G / Agrusa, A / Rodolico, V / Gordini, L / Calò, P G

International journal of surgery case reports

2018 Volume 49, Page(s) 223–227

Abstract: Introduction: Lipoma of the femoral fossa is uncommon. Often asymptomatic, femoral lipoma may growth within the circumscribed space of the femoral fossa causing pain and discomfort. A worsening pain caused by a lipomatous mass in the femoral area is a ... ...

Abstract	Introduction: Lipoma of the femoral fossa is uncommon. Often asymptomatic, femoral lipoma may growth within the circumscribed space of the femoral fossa causing pain and discomfort. A worsening pain caused by a lipomatous mass in the femoral area is a clinical feature that can mislead the diagnosis, resembling the more common condition of femoral hernia. Methods: Two cases of symptomatic lipomas of the femoral fossa mimicking an incarcerated femoral hernia are presented. In both, Caucasian female, patients clinical examination and ultrasound of the femoral region revealed a painful neoplasm suspected for incarcerated femoral hernia. Results: Intraoperatively, a mass of encapsulated fat arising from the bottom of the fossa femoralis was found. No visceral protrusion through the femoral ring could be documented. The neoplasms were removed in toto. Histology of the excised specimens evidenced the diagnosis of femoral lipomas suffering by chronic compressive damages. In a midterm postoperative follow up, both patients were symptom- free. Discusion: A correct preoperative diagnosis of femoral lipoma is challenging, even following an accurate diagnostic pathway. The cases highlighted herewith seem to confirm that lipoma of the femoral fossa can be mistaken with a femoral hernia. Conclusions: The clinical and histological features evidenced could result helpful in the differentiation of a lipomatous mass of the femoral fossa from a genuine femoral hernia.
Language	English
Publishing date	2018-07-19
Publishing country	Netherlands
Document type	Journal Article
ISSN	2210-2612
ISSN	2210-2612
DOI	10.1016/j.ijscr.2018.07.009
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Article ; Online: COVID-19 pandemic

Lombardi, C. P. / Gordini, L. / D'Amore, A. / Bocale, R. / Boscherini, M. / Bellantone, R.

British Journal of Surgery

new rules of engagement in endocrine surgery ; COVID-19 pandemic: New rules of engagement in endocrine surgery

2020 Volume 107, Issue 9, Page(s) e322–e322

Keywords	Surgery ; covid19
Language	English
Publisher	Wiley
Publishing country	us
Document type	Article ; Online
ZDB-ID	2985-3
ISSN	0263-1202 ; 0007-1323 ; 1355-7688
ISSN	0263-1202 ; 0007-1323 ; 1355-7688
DOI	10.1002/bjs.11777
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Article ; Online: Does antithrombotic prophylaxis worsen early outcomes of total thyroidectomy? - a retrospective cohort study.

Erdas, E / Medas, F / Sanna, S / Gordini, L / Pisano, G / Canu, G L / Calò, P G

BMC surgery

2019 Volume 18, Issue Suppl 1, Page(s) 82

Abstract: Background: Currently, there is no strong evidence on the effectiveness and safety of pharmacological antithrombotic prophylaxis in thyroid surgery. The aim of this study was to establish whether the prophylactic use of low-molecular-weight heparin ( ... ...

Abstract	Background: Currently, there is no strong evidence on the effectiveness and safety of pharmacological antithrombotic prophylaxis in thyroid surgery. The aim of this study was to establish whether the prophylactic use of low-molecular-weight heparin (LMWH) could negatively affect the early outcomes of patients undergoing total thyroidectomy. Methods: Data from patients submitted to total thyroidectomy between February 2013 and October 2017 were retrospectively collected and analysed. Only patients with indication to antithrombotic prophylaxis according to current guidelines were included in the study. Eligible cases were divided into two groups, which corresponded to two distinct periods of our surgical practice: Group A, which included 178 consecutive patients who were submitted to antithrombotic prophylaxis with LMWH, and Group B, which included 348 consecutive patients who did not receive prophylaxis. Primary endpoints were the incidence of post-operative cervical haematomas (POCH) and thromboembolic events. Secondary endpoint was the length of postoperative hospital stay. Statistical analysis was performed by using Student's t test for continuous variables and Chi-square test for categorical variables. A P value of less than 0.05 was considered statistically significant. Results: The two groups of patients were comparable in terms of age, gender, thyroid disease, duration of surgery, and weight of the thyroid gland. Overall, no thromboembolic events were registered. The comparative analysis of the other outcome measures, showed no significant differences between the two groups (POCH: 2 cases (1.12%) in Group A vs 8 cases (2.30%) in Group B - p 0.349; Postoperative hospital stay: 2.90 ± 0.86 days in Group A vs 2.89 ± 0.99 days in Group B - p 0.908). Conclusions: Data from this study do not support or contraindicate the use of antithrombotic prophylaxis in thyroid surgery. However, since thyroidectomy is a closed-space procedure, and even modest bleeding may quickly result in airway compression and death by asphyxia, mechanical prophylaxis should be preferred to LMWH whenever possible. Trial registration: ISRCTN ISRCTN12029395. Registered 05/02/2018 retrospectively registered.
MeSH term(s)	Aged ; Cohort Studies ; Female ; Fibrinolytic Agents/administration & dosage ; Hemorrhage/epidemiology ; Heparin, Low-Molecular-Weight/administration & dosage ; Humans ; Length of Stay ; Male ; Middle Aged ; Retrospective Studies ; Thyroid Gland/surgery ; Thyroidectomy/methods
Chemical Substances	Fibrinolytic Agents ; Heparin, Low-Molecular-Weight
Language	English
Publishing date	2019-04-24
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/s12893-018-0407-2
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Article ; Online: External hernia of the supravesical fossa: Rare or simply misidentified?

Amato, G / Romano, G / Erdas, E / Medas, F / Gordini, L / Podda, F / Calò, P

International journal of surgery (London, England)

2017 Volume 41, Page(s) 119–126

Abstract: Background: External hernias of the supravesical fossa are considered rare, perhaps wrongly. Highlighting clinical and anatomical features could be useful for correct, preoperative diagnosis, thus avoiding the risk of complications such as incarceration. ...

Abstract	Background: External hernias of the supravesical fossa are considered rare, perhaps wrongly. Highlighting clinical and anatomical features could be useful for correct, preoperative diagnosis, thus avoiding the risk of complications such as incarceration. The study aims to demonstrate that the incidence of external protrusions of the supravesical fossa is higher that supposed. Probably, being mistaken for direct hernias, these hernia types are misidentified and not included in current classifications. This issue deserves attention due to the elevated risk of incarceration related to its distinctive structure. Material and methods: 249 consecutive open anterior inguinal hernia procedures were analyzed. Hernias were categorized according to the Nyhus classification. A subgroup of direct hernias involved true hernias of the supravesical fossa. Multiple ipsilateral, as well as combined hernias having a multi-component structure, were also considered. Results: 13 true hernias of the supravesical fossa and 19 multiple ipsilateral or combined hernias composed of direct and/or indirect hernia, together with one hernia of the supravesical fossa were identified. 4 true hernias of the supravesical fossa presented signs of incarceration. In three other combined protrusions, the herniated component of the supravesical fossa also showed incarceration of the visceral content. Conclusions: Hernias of the supravesical fossa would appear to be more frequent than imagined. These protrusions show a diverticular shape and the base is often tightened by the stiffer medial umbilical fold. This explains the apparently higher tendency to incarceration that distinguishes this hernia type. Preoperative signs of inguinal pain and irreducibility are pathognomonic for correct diagnosis. In these cases, surgical treatment in the short term is recommended.
Language	English
Publishing date	2017-05
Publishing country	England
Document type	Journal Article ; Review
ZDB-ID	2212038-5
ISSN	1743-9159 ; 1743-9191
ISSN (online)	1743-9159
ISSN	1743-9191
DOI	10.1016/j.ijsu.2017.03.075
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Article: Differentiated thyroid cancer: feasibility of loboisthmectomy in an endemic region.

Calò, G / Erdas, E / Medas, F / Gordini, L / Longheu, A / Pisano, G / Nicolosi, A

Il Giornale di chirurgia

2016 Volume 36, Issue 6, Page(s) 257–262

Abstract: Aim: The aim of the present retrospective study was to assess the feasibility of loboisthmectomy for the treatment of differentiated thyroid cancer in a endemic area, evaluating the histopathological features and the results of a case series of 1154 ... ...

Abstract	Aim: The aim of the present retrospective study was to assess the feasibility of loboisthmectomy for the treatment of differentiated thyroid cancer in a endemic area, evaluating the histopathological features and the results of a case series of 1154 patients. Patients and methods: The clinical records of 1154 patients submitted to total thyroidectomy in our Department were retrospectively reviewed to analyze the histopathological characters and the results. Results: In 1044 cases (90.5%) a papillary cancer was observed, in 110 (9.5%) a follicular carcinoma; microcarcinomas were 399 (34.5%). Multifocality was present in 323 cases (28%), in 142 unilateral (12.3%) and in 181 bilateral (15.7%). Thyroiditis coexisted in 472 patients (40.9%), multinodular goiter in 404 (35%), Graves' disease in 48 (4.1%), and multinodular toxic goiter in 38 (3.3%). Complications were: postoperative bleeding in 20 patients (1.7%), transient unilateral vocal cord paralysis in 20 (1.7%) definitive in 10 (0.86%), a transient bilateral paralysis in 1 (0.08%), a transient hypoparathyroidism in 351 (30.4%), and a definitive in 24 (2.07%). Nodal recurrence occurred in 25 patients (2.16%). Conclusions: Total thyroidectomy remains the safest treatment in differentiated thyroid cancer, especially if performed in high volume centers in which complications can be minimized. Loboisthmectomy can be a viable and safe alternative in small (< 1 cm) unifocal tumors in patients at low risk. Loboisthmectomy is limited in endemic areas by the association with other thyroid diseases. A correct and detailed information of the patient is essential before planning surgery.
MeSH term(s)	Feasibility Studies ; Female ; Humans ; Male ; Middle Aged ; Retrospective Studies ; Thyroid Neoplasms/pathology ; Thyroid Neoplasms/surgery ; Thyroidectomy/methods
Language	English
Publishing date	2016-02-17
Publishing country	Italy
Document type	Journal Article
ZDB-ID	605974-0
ISSN	1971-145X ; 0391-9005
ISSN (online)	1971-145X
ISSN	0391-9005
DOI	10.11138/gchir/2015.36.6.257
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Article ; Online: Fixation free femoral hernia repair with a 3D dynamic responsive implant. A case series report.

Amato, G / Romano, G / Agrusa, A / Gordini, L / Gulotta, E / Erdas, E / Calò, P G

International journal of surgery (London, England)

2018 Volume 54, Issue Pt A, Page(s) 70–75

Abstract: Background: To date, no gold standard for the surgical treatment of femoral hernia exists. Pure tissue repair as well as mesh/plug implantation, open or laparoscopic, are the most performed methods. Nevertheless, all these techniques need sutures or ... ...

Abstract	Background: To date, no gold standard for the surgical treatment of femoral hernia exists. Pure tissue repair as well as mesh/plug implantation, open or laparoscopic, are the most performed methods. Nevertheless, all these techniques need sutures or mesh fixation. This implies the risk of damaging sensitive structures of the femoral area, along with complications related to tissue tear and postoperative discomfort consequent to poor quality mesh incorporation. The present retrospective multicenter case series highlights the results of femoral hernia repair procedures performed with a 3D dynamic responsive implant in a cohort of 32 patients during a mean follow up of 27 months. Materials and methods: Aiming to simplify the surgical procedure and reduce complications, a 3D dynamic responsive implant was delivered for femoral hernia repair, in a patient cohort. After returning the hernia sack to the abdominal cavity, the implant was simply delivered into the hernia defect where it remained, thanks to its inherent centrifugal expansion, obliterating the hernia opening without need of fixation. Postoperative pain assessment was determined using the VAS score system. Results: The use of the 3D prosthetic device allowed for easier and faster surgical repair in a fixation free fashion. None of the typical fixation related complications occurred in the examined patients. Postoperative pain assessment with VAS score showed a very low level of pain, allowing the return of patients to normal activities in extremely reduced times. In the late postoperative period, no discomfort or chronic pain was reported. Conclusions: Femoral hernia repair with the 3D dynamic revealed a quick and safe placement procedure. The reduced pain intensity, as well as the absence of adverse events consequent to sutures or mesh fixation, seems to be a significant benefit of the motile compliance of the device. Furthermore, this 3D prosthesis has already proven to induce an enhanced probiotic response showing ingrowth in the implant of the typical tissue components of the abdominal wall, instead of the low quality tissue ingrowth typical in conventional meshes and plugs. The highlighted features seem to represent a more physiologic and updated repair concept of femoral protrusions.
MeSH term(s)	Female ; Follow-Up Studies ; Hernia, Femoral/surgery ; Herniorrhaphy/adverse effects ; Herniorrhaphy/instrumentation ; Herniorrhaphy/methods ; Humans ; Male ; Middle Aged ; Pain, Postoperative/etiology ; Prostheses and Implants ; Prosthesis Implantation/adverse effects ; Prosthesis Implantation/methods ; Retrospective Studies ; Treatment Outcome
Language	English
Publishing date	2018-04-23
Publishing country	England
Document type	Evaluation Studies ; Journal Article ; Multicenter Study
ZDB-ID	2212038-5
ISSN	1743-9159 ; 1743-9191
ISSN (online)	1743-9159
ISSN	1743-9191
DOI	10.1016/j.ijsu.2018.04.031
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Article: COVID-19 pandemic: new rules of engagement in endocrine surgery

Lombardi, C P / Gordini, L / D039, / Amore, A / Bocale, R / Boscherini, M / Bellantone, R

Br J Surg

Keywords	covid19
Publisher	WHO
Document type	Article
Note	WHO #Covidence: #638835
Database	COVID19

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Article ; Online: Endocrine surgery during COVID-19 pandemic: do we need an update of indications in Italy?

Lombardi, Celestino Pio / D'Amore, Annamaria / Grani, Giorgio / Ramundo, Valeria / Boscherini, Mauro / Gordini, Luca / Marzi, Federica / Tedesco, Silvia / Bocale, Raffaella

Endocrine

2020 Volume 68, Issue 3, Page(s) 485–488

Abstract: The ongoing spread of the coronavirus disease 2019 (COVID-19) caused by severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) poses a significant threat to global health. As the coronavirus outbreak began spreading, hospitals were forced to ... ...

Abstract	The ongoing spread of the coronavirus disease 2019 (COVID-19) caused by severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) poses a significant threat to global health. As the coronavirus outbreak began spreading, hospitals were forced to relocate resources to treat the growing number of COVID-19 patients. As a consequence, doctors across the country canceled tens of thousands of nonurgent surgeries. However, recognizing that the COVID-19 situation may be highly variable and fluid in different communities across the country, elective surgery could be still allowed in some centers for patients included in the high-priority class. The majority of endocrine disorders requiring surgical treatment in patients identifiable as first-priority class, or needing hospitalization within 30 days, are generally represented by malignant thyroid tumors, hyperthyroidism, hyperparathyroidism, and some adrenal disorders. The need for urgent intervention is evaluated on a case-by-case basis according to the severity of the symptoms, the likelihood of progression, and global clinical judgment. On the basis of the above indications, during the last 4 weeks, we performed 18 planned surgical treatments in patients with thyroid cancer (total thyroidectomies, plus lymph node dissection if needed) or multinodular toxic goiter. In no case, postoperative ventilatory support was needed, and the average hospital stay was 3 days. The negative COVID-19 status for all the treated patients was appropriately evaluated beforehand. Nobody knows how long the current COVID-19 pandemic will be lasting. Certainly, we will be requested in the next future to incrementally offer surgical services for endocrine disorders that have been deferred for the COVID-19 pandemic.
MeSH term(s)	Adrenal Gland Diseases/surgery ; Betacoronavirus ; COVID-19 ; Coronavirus Infections/epidemiology ; Elective Surgical Procedures ; Emergency Treatment ; Endocrine Surgical Procedures ; Endocrine System Diseases/surgery ; Humans ; Hyperparathyroidism/surgery ; Hyperthyroidism/surgery ; Italy/epidemiology ; Pandemics ; Pneumonia, Viral/epidemiology ; Practice Guidelines as Topic ; Prognosis ; SARS-CoV-2 ; Severity of Illness Index ; Thyroid Neoplasms/surgery
Keywords	covid19
Language	English
Publishing date	2020-06-04
Publishing country	United States
Document type	Journal Article
ZDB-ID	1194484-5
ISSN	1559-0100 ; 1355-008X ; 0969-711X
ISSN (online)	1559-0100
ISSN	1355-008X ; 0969-711X
DOI	10.1007/s12020-020-02357-7
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