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  1. 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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    Zs.A 3884: Show issues Location:
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  2. Article: Long-Term Results of Fixation-Free Incisional Hernia Repair Using a Tentacle-Shaped Implant.

    Amato, Giuseppe / Romano, Giorgio / Goetze, Thorsten / Gordini, Luca / Erdas, Enrico / Medas, Fabio / Calò, Piergiorgio

    Surgical technology international

    2017  Volume 30, Page(s) 175–181

    Abstract: Introduction: The fixation and the overlap of the mesh represent an open issue in incisional hernia repair. An exclusively designed prosthesis has been developed to assure a suture-free repair and a broader coverage of the abdominal wall. This study ... ...

    Abstract Introduction: The fixation and the overlap of the mesh represent an open issue in incisional hernia repair. An exclusively designed prosthesis has been developed to assure a suture-free repair and a broader coverage of the abdominal wall. This study describes the long-term results of incisional hernia procedures carried out positioning a tentacle-shaped implant through a specifically developed surgical technique.
    Materials and methods: A proprietary symmetrically-shaped flat mesh constituted by a large central body with integrated radiating arms was used to repair incisional hernias in 68 patients. The prosthesis was placed in preperitoneal/retromuscular sublay. The friction of the straps passing through myotendineal structures of the abdomen was intended to assure an adequate grip to firmly hold the device in place with a broad overlap of the hernia defect in a fixation-free fashion. All tentacle straps were positioned through a special needle passer crossing the abdominal wall laterally from the defect borders then cut short in the subcutaneous layer.
    Results: In a long-term follow-up of 12 to 96 months (mean 58 months), 11 seromas occurred. No infections, hematomas, chronic pain, mesh dislocation, or recurrence have been reported.
    Conclusions: The tentacle strap system of the prosthesis effectively ensured reduced skin incision and an easier implant placement avoiding the need for suturing the mesh. Regularly performed computed tomography (CT) and ultrasound (US) investigations proved that the arms of the implant ensured a proper orientation and stabilization of the mesh in association with a broad defect overlap. The specifically developed surgical procedure showed a quick postoperative recovery, a very low complication rate, and no recurrences, even in the long-term.
    MeSH term(s) Abdominal Wall/surgery ; Adult ; Aged ; Aged, 80 and over ; Female ; Follow-Up Studies ; Herniorrhaphy/adverse effects ; Herniorrhaphy/methods ; Herniorrhaphy/statistics & numerical data ; Humans ; Incisional Hernia/surgery ; Male ; Middle Aged ; Prostheses and Implants ; Prosthesis Design ; Surgical Mesh
    Language English
    Publishing date 2017-08-24
    Publishing country United States
    Document type Journal Article
    ZDB-ID 1225512-9
    ISSN 1090-3941
    ISSN 1090-3941
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  3. Article: Benign Multicystic Peritoneal Mesothelioma in a Male Patient with Previous Wilms' Tumor: A Case Report and Review of the Literature.

    Canu, Gian Luigi / Medas, Fabio / Columbano, Giulio / Gordini, Luca / Saba, Luca / Erdas, Enrico / Calò, Pietro Giorgio

    Case reports in surgery

    2018  Volume 2018, Page(s) 4324986

    Abstract: Benign multicystic peritoneal mesothelioma (BMPM) is a rare condition, more common in females of reproductive age, which arises from the peritoneal mesothelium. A 33-year-old male presented to our unit with abdominal pain and constipation. His past ... ...

    Abstract Benign multicystic peritoneal mesothelioma (BMPM) is a rare condition, more common in females of reproductive age, which arises from the peritoneal mesothelium. A 33-year-old male presented to our unit with abdominal pain and constipation. His past medical history included a previous unilateral nephrectomy for Wilms' tumor and the previous incidental finding of some intra-abdominal cystic formations at the level of the mesentery. After performing a CT scan, an exploratory laparotomy was done and a voluminous cystic mesenteric mass, composed of 3 confluent formations, was observed. Some other similar but significantly smaller lesions were found. An en bloc resection of the mesenteric mass together with the corresponding intestinal loops, an appendicectomy, and some peritoneal biopsies were performed. The postoperative period was complicated by a peritonitis due to dehiscence of the intestinal anastomosis, which required another operation, and a delayed return of normal bowel function, which was resolved through prokinetic therapy. Through histological examination, a BMPM was diagnosed. At 8 months of follow-up, the patient is free of symptoms. BMPM exact etiopathogenesis still remains uncertain. Given his high recurrence rate, a long-term follow-up is recommended.
    Language English
    Publishing date 2018-08-01
    Publishing country United States
    Document type Case Reports
    ZDB-ID 2657697-1
    ISSN 2090-6919 ; 2090-6900
    ISSN (online) 2090-6919
    ISSN 2090-6900
    DOI 10.1155/2018/4324986
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  4. Article ; Online: Gallstone ileus in elderly patients.

    Erdas, Enrico / Medas, Fabio / Salaris, Claudia / Canu, Gian L / Sanna, Silvia / Gordini, Luca / Pisano, Giuseppe / Calò, Pietro G

    Minerva chirurgica

    2018  Volume 73, Issue 6, Page(s) 620–623

    MeSH term(s) Aged ; Aged, 80 and over ; Cholelithiasis/complications ; Comorbidity ; Female ; Gallstones ; Humans ; Ileus/diagnostic imaging ; Ileus/etiology ; Ileus/surgery ; Jejunal Diseases/diagnostic imaging ; Jejunal Diseases/etiology ; Jejunal Diseases/surgery ; Male ; Recurrence ; Tomography, X-Ray Computed ; Ultrasonography
    Language English
    Publishing date 2018-05-24
    Publishing country Italy
    Document type Journal Article
    ZDB-ID 123603-9
    ISSN 1827-1626 ; 0026-4733
    ISSN (online) 1827-1626
    ISSN 0026-4733
    DOI 10.23736/S0026-4733.18.07718-0
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    Zs.A 25: Show issues Location:
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  5. Article ; Online: The Septum Inguinalis: A Clue to Hernia Genesis?

    Amato, Giuseppe / Calò, Piergiorgio / Rodolico, Vito / Puleio, Roberto / Agrusa, Antonino / Gulotta, Leonardo / Gordini, Luca / Romano, Giorgio

    Journal of investigative surgery : the official journal of the Academy of Surgical Research

    2018  Volume 33, Issue 3, Page(s) 231–239

    Abstract: Purpose: ...

    Abstract Purpose:
    MeSH term(s) Abdominal Wall/pathology ; Abdominal Wall/surgery ; Aged ; Aged, 80 and over ; Female ; Hernia, Inguinal/etiology ; Hernia, Inguinal/pathology ; Hernia, Inguinal/surgery ; Herniorrhaphy ; Humans ; Inguinal Canal/pathology ; Inguinal Canal/surgery ; Male ; Middle Aged
    Language English
    Publishing date 2018-10-31
    Publishing country United States
    Document type Journal Article ; Observational Study
    ZDB-ID 639444-9
    ISSN 1521-0553 ; 0894-1939
    ISSN (online) 1521-0553
    ISSN 0894-1939
    DOI 10.1080/08941939.2018.1497734
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    Zs.A 2364: Show issues Location:
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  6. Article: Emergency Laparoscopic Repair of Giant Left Diaphragmatic Hernia following Minimally Invasive Esophagectomy: Description of a Case and Review of the Literature.

    Erdas, Enrico / Canu, Gian Luigi / Gordini, Luca / Mura, Paolo / Laconi, Giulia / Pisano, Giuseppe / Medas, Fabio / Calò, Pietro Giorgio

    Case reports in surgery

    2018  Volume 2018, Page(s) 2961517

    Abstract: Postoperative diaphragmatic hernia (PDH) is an increasingly reported complication of esophageal cancer surgery. PDH occurs more frequently when minimally invasive techniques are employed, but very little is known about its pathogenesis. Currently, no ... ...

    Abstract Postoperative diaphragmatic hernia (PDH) is an increasingly reported complication of esophageal cancer surgery. PDH occurs more frequently when minimally invasive techniques are employed, but very little is known about its pathogenesis. Currently, no consensus exists concerning preventive measures and its management. A 71-year-old man underwent minimally invasive esophagectomy for esophageal cancer. Three months later, he developed a giant PDH, which was repaired by direct suture via laparoscopic approach. A hypertensive pneumothorax occurred during surgery. This complication was managed by the anaesthesiologist through a high fraction of inspired O
    Language English
    Publishing date 2018-09-12
    Publishing country United States
    Document type Case Reports
    ZDB-ID 2657697-1
    ISSN 2090-6919 ; 2090-6900
    ISSN (online) 2090-6919
    ISSN 2090-6900
    DOI 10.1155/2018/2961517
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  7. Article ; Online: Neomyogenesis in 3D Dynamic Responsive Prosthesis for Inguinal Hernia Repair.

    Amato, Giuseppe / Romano, Giorgio / Puleio, Roberto / Agrusa, Antonino / Goetze, Thorsten / Gulotta, Eliana / Gordini, Luca / Erdas, Enrico / Calò, Piergiorgio

    Artificial organs

    2018  Volume 42, Issue 12, Page(s) 1216–1223

    Abstract: Despite undisputed improvements, prosthetics hernia repair continues to be affected by unacceptable rates of complications. Postoperative adverse events such as discomfort and chronic pain represent a subject of increasing concern among the surgical ... ...

    Abstract Despite undisputed improvements, prosthetics hernia repair continues to be affected by unacceptable rates of complications. Postoperative adverse events such as discomfort and chronic pain represent a subject of increasing concern among the surgical community. Poor quality biologic response, stiff scar plates, and mesh shrinkage, a typical effect of conventional static meshes and plugs, are all indicated as the main reasons for many of the complications related to inguinal hernia repair. Even the conventional concept of treatment based upon a supposed reinforcement of the groin consequent to the fibrotic incorporation of meshes, would appear to be inadequate in the light of the latest scientific evidence concerning the degenerative genesis of inguinal hernia. Following these recent studies, a newly conceived 3D dynamically responsive implant has been developed. It concerns a multilamellar shaped prosthesis, intended to be placed fixation-free to obliterate the hernia defect. This 3D structure has already demonstrated to induce a probiotic biological response with development of viable tissue, instead of the fibrotic plaque typical of conventional meshes. Newly formed elastic fibers, neo-angiogenesis, and neo-nerve genesis in a surrounding of well perfused connective tissue are the typical elements of the biologic response in the newly conceived implant. In addition to these elements, muscle fibers have also been detected in the implant structure. The aim of this research was to determine the ingrowth of muscle fibers in the implant by assessing the quantity and quality of muscle development in the short, medium, and long term post-implantation. Histological examination of biopsy samples excised from patients who underwent dynamic hernia repair with the 3D dynamic implant showed the presence of muscular elements that in the short term could be described as multiple spots of myocytes in the early stage of development. Over the mid- to long-term, muscle fibers increased in number and level of maturation, assuming the typical aspect of standard muscle bundles in the final phase. Effectively, long term, myocytes histologically evidenced the distinctive arrangement of the muscle structure, with nuclei and striated elements being similar to normal muscle elements. The development of this highly specialized connective tissue in the 3D dynamic responsive implant seems to document the finalization of an enhanced biologic response leading to the ingrowth of typical tissue components of the groin. Reverting degenerative pathogenesis into effective regeneration recognized in the newly conceived 3D prosthesis would appear to represent a significant concept change in the repair of inguinal hernias.
    MeSH term(s) Aged ; Follow-Up Studies ; Hernia, Inguinal/surgery ; Herniorrhaphy/methods ; Humans ; Male ; Middle Aged ; Muscle Cells/cytology ; Muscle Development ; Prosthesis Implantation
    Language English
    Publishing date 2018-10-14
    Publishing country United States
    Document type Journal Article ; Multicenter Study
    ZDB-ID 441812-8
    ISSN 1525-1594 ; 0160-564X
    ISSN (online) 1525-1594
    ISSN 0160-564X
    DOI 10.1111/aor.13286
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    Zs.A 1463: Show issues Location:
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  8. Article ; Online: Endocrine surgery during COVID-19 pandemic

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

    do we need an update of indications in Italy?

    2020  

    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.
    Keywords COVID-19 ; Endocrine emergencies ; Endocrine surgery ; Thyroid cancer ; covid19
    Subject code 610
    Language English
    Publishing country it
    Document type Article ; Online
    Database BASE - Bielefeld Academic Search Engine (life sciences selection)

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  9. Article ; Online: Endocrine surgery during COVID-19 pandemic

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

    Endocrine

    do we need an update of indications in Italy?

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

    Keywords covid19
    Language English
    Publisher Springer Science and Business Media LLC
    Publishing country us
    Document type Article ; Online
    ZDB-ID 1194484-5
    ISSN 1355-008X ; 0969-711X
    ISSN 1355-008X ; 0969-711X
    DOI 10.1007/s12020-020-02357-7
    Database BASE - Bielefeld Academic Search Engine (life sciences selection)

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    Zs.A 3884: Show issues Location:
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  10. Article ; Online: Fixation-free incisional hernia repair in the elderly: our experience with a tentacle-shaped implant.

    Romano, Giorgio / Calò, Pier Giorgio / Erdas, Enrico / Medas, Fabio / Gordini, Luca / Podda, Francesco / Amato, Giuseppe

    Aging clinical and experimental research

    2017  Volume 29, Issue Suppl 1, Page(s) 173–177

    Abstract: Background: Incisional hernia in aged patients represents a challenge even for experienced surgeons. Besides increased risk of complications due to comorbidities, mesh fixation and assuring a sufficient mesh overlap of the defect are the main issues in ... ...

    Abstract Background: Incisional hernia in aged patients represents a challenge even for experienced surgeons. Besides increased risk of complications due to comorbidities, mesh fixation and assuring a sufficient mesh overlap of the defect are the main issues in carrying out the repair.
    Aims: In order to assure broader coverage of the abdominal wall and a tension- and fixation-free repair, a specifically designed prosthesis was developed for the surgical treatment of incisional hernias. The results of a fixation-free incisional hernia repair carried out in elderly patients using a tentacle-shaped implant are reported herewith.
    Methods: A tentacle-shaped flat mesh with a large central body and integrated arms was used to repair incisional hernia in 23 elderly patients. The mesh was placed fixation-free and secured in place through the friction exerted by the tentacles. All tentacle straps were positioned with a special passer needle. Implant placement was preperitoneal in 18 patients and retromuscular sublay in five.
    Results: In a follow-up of 18 to 59 months (mean 36 months), four seromas occurred. Postoperative fast track helped avoid the typical complications affecting this patient subset. No infection, hematoma, chronic pain, mesh dislocation or recurrence have been reported to date.
    Discussion: The tentacle strap system allowed for reduced skin incision thus minimizing surgical trauma and ensuring easier and faster implant placement.
    Conclusion: The tentacle arms of the implant ensured mesh stability and broad defect overlap. Besides a very low complication rate, none of the typical postoperative complications of aged patients occurred.
    MeSH term(s) Abdominal Wound Closure Techniques/adverse effects ; Abdominal Wound Closure Techniques/instrumentation ; Aged ; Aged, 80 and over ; Female ; Hernia, Ventral/surgery ; Humans ; Incisional Hernia/surgery ; Male ; Outcome and Process Assessment (Health Care) ; Postoperative Complications/surgery ; Prostheses and Implants ; Recurrence ; Surgical Mesh
    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/s40520-016-0651-1
    Database MEDical Literature Analysis and Retrieval System OnLINE

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