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  1. Article: Huge mesenchymal hamartoma in a young adult: a case report.

    Pinelli, Domenico / Guerci, Claudio / Cammarata, Francesco / Cirelli, Riccardo / Scatigno, Agnese / Colledan, Michele

    Journal of surgical case reports

    2024  Volume 2024, Issue 4, Page(s) rjae184

    Abstract: Mesenchymal hamartoma of the liver (MHL) is rare. Less than 50 adult cases have been described. Due to their potential degeneration or recurrence, a complete surgical resection must be performed. We describe a case of a 26-year-old with a palpable solid ... ...

    Abstract Mesenchymal hamartoma of the liver (MHL) is rare. Less than 50 adult cases have been described. Due to their potential degeneration or recurrence, a complete surgical resection must be performed. We describe a case of a 26-year-old with a palpable solid lesion, which displaced abdominal organs. Percutaneous needle biopsies suggested the diagnosis of MHL. A right hemi-hepatectomy without segment 1 was performed; the post-operative course was uneventful. The mesenchymal component of the tumour was reactive to desmin and smooth muscle actin. Low proliferation index was confirmed (MIB1). Genetic counselling: the sequencing analysis of DICER1 and CDKN1C gene was negative, DNA methylation analysis on the chromosome 11p15 region was normal. After 42 months, there was no recurrence. In conclusion, clinicians should consider MHL in the differential diagnosis. The dimension and the need of radicality impose major liver resections or liver transplantations, which should be performed in referral centres.
    Language English
    Publishing date 2024-04-01
    Publishing country England
    Document type Case Reports
    ZDB-ID 2580919-2
    ISSN 2042-8812
    ISSN 2042-8812
    DOI 10.1093/jscr/rjae184
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  2. Article ; Online: Emergency surgical treatment of colonic acute diverticulitis: a multicenter observational study on behalf of the Italian society of colorectal surgery (SICCR) Lombardy committee.

    Ferrara, Francesco / Guerci, Claudio / Bondurri, Andrea / Spinelli, Antonino / De Nardi, Paola

    Updates in surgery

    2023  Volume 75, Issue 4, Page(s) 863–870

    Abstract: Colonic diverticulitis can be treated conservatively, but some cases require surgery. Patients can undergo Hartmann's procedure (H) or resection with primary anastomosis (RA), with or without diverting stoma. This multicenter observational retrospective ... ...

    Abstract Colonic diverticulitis can be treated conservatively, but some cases require surgery. Patients can undergo Hartmann's procedure (H) or resection with primary anastomosis (RA), with or without diverting stoma. This multicenter observational retrospective study aims to evaluate the adherence to current guidelines by assessing the rate of RA and H in Lombardy, Italy, and to analyze differences in patients' features. This study included data collected from nine surgical units performing emergency surgery in Lombardy, in 2019 and 2021. Data for each year were retrospectively collected through a survey among Italian Society of Colorectal Surgery (SICCR) Lombardy members. Additional data were about: Hinchey's classification, laparoscopic (VLS) or converted procedures, procedures with more than two operators, procedures in which the first operator was older than 40 years, night or weekend procedures, older-than-80 patients, COVID-19 positivity (just 2021). The total number of operations performed was 254, 115 RA and 130 H (45.3% and 51.2%, diff. 12%, p = 0.73), and 9 (3.5%) other procedures. RAs were more frequent for Hinchey 1 and 2 patients, whereas Hs were more frequent for Hinchey 3 and 4. RAs without ileostomy were significantly less than Hs (66 vs. 130, p = 0.04). Laparoscopy was more used for RA compared to H (57 vs. 21, p = 0.03), whereas no difference was found between RA and H with respect to conversion rate, the presence of more than two operators in the team, the presence of a first operator older than 40 years, night or weekend operations, and for older-than-80 patients. This study confirms the adherence to current guidelines for the treatment of acute colonic diverticulitis in Lombardy, Italy. It can be considered as a preliminary survey with interesting results that may open the way to a further prospective observational study to clarify some aspects in the management of this disease.
    MeSH term(s) Humans ; Diverticulitis, Colonic/surgery ; Retrospective Studies ; Colorectal Surgery ; COVID-19 ; Diverticulitis/surgery ; Colostomy ; Anastomosis, Surgical/methods ; Laparoscopy/methods ; Intestinal Perforation/surgery ; Treatment Outcome ; Peritonitis/surgery
    Language English
    Publishing date 2023-03-19
    Publishing country Italy
    Document type Observational Study ; Multicenter Study ; Journal Article
    ZDB-ID 2572692-4
    ISSN 2038-3312 ; 2038-131X
    ISSN (online) 2038-3312
    ISSN 2038-131X
    DOI 10.1007/s13304-023-01487-7
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  3. Article: Case Report: Ileo-Ileal Intussusception Secondary to Inflammatory Fibroid Polyp: A Rare Cause of Intestinal Obstruction.

    Guerci, Claudio / Colombo, Francesco / Goi, Gloria / Zerbi, Pietro / Pirrò, Barbara / Danelli, Piergiorgio

    Frontiers in surgery

    2022  Volume 9, Page(s) 876396

    Abstract: Introduction: Intussusception is a telescoping of a bowel segment into another and it can be a surgical urgency. Most adult intussusceptions arise from a lead point which can be benign or malignant. For this reason, intussusception in adults should ... ...

    Abstract Introduction: Intussusception is a telescoping of a bowel segment into another and it can be a surgical urgency. Most adult intussusceptions arise from a lead point which can be benign or malignant. For this reason, intussusception in adults should undergo surgery. Here we describe a case of ileal inflammatory fibroid polyp (IFP), presenting with ileo-ileal intussusception and obstruction.
    Case report: A 54-year-old Caucasian woman presented for acute abdominal pain. A radiography and a CT of the abdomen were performed, which showed signs of occlusion due to an ileo-ileal intussusception. An urgent laparoscopy was performed, the intussusception was extracorporeally reduced, the ileal segment involved was resected, and an ileo-ileal anastomosis was performed. The intussusception seemed to be caused by a 3-cm intra-mural lesion.
    Discussion: Intussusception is a surgical concern. While most cases are idiopathic in children, 90% of adult intussusceptions are caused by underlying diseases. Therefore, intussusception in adults should undergo surgery. Radiology is necessary for the diagnosis: the CT scan helps localizing the lesion and shows pathognomonic signs. This case report analyzes an intussusception caused by an inflammatory fibroid polyp. Accurate diagnosis of IFP is only possible with histopathological examination, helped by immunohistochemistry. The differential diagnosis is important because some lesions are malignant.
    Conclusion: We reported a case of intussusception caused by an IFP. The diagnosis was made with a CT scan together with intraoperative findings and histopathological examination, which excluded potential differential diagnoses. The patient underwent an explorative laparoscopy, with an ileal resection and anastomosis. Due to the risk of malignancy, surgery is mandatory.
    Language English
    Publishing date 2022-04-15
    Publishing country Switzerland
    Document type Case Reports
    ZDB-ID 2773823-1
    ISSN 2296-875X
    ISSN 2296-875X
    DOI 10.3389/fsurg.2022.876396
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  4. Article ; Online: Recurrent oncocytic adrenocortical carcinoma: implementing diagnostic criteria in a case report with the longest survival.

    Guerci, Claudio / Maffioli, Anna / Goi, Gloria / Zaffaroni, Gloria / Aseni, Paolo / Gambitta, Pietro / Spiropoulos, Jean

    Annali italiani di chirurgia

    2021  Volume 92, Page(s) 293–298

    Abstract: Introduction: Oncocytic adrenocortical tumors represent a subtype of the adrenal cortex neoplasms. These tumors can be divided into oncocytomas, oncocytic neoplasms of uncertain malignancy and carcinomas (OACs). To date, only 34 cases of OAC have been ... ...

    Abstract Introduction: Oncocytic adrenocortical tumors represent a subtype of the adrenal cortex neoplasms. These tumors can be divided into oncocytomas, oncocytic neoplasms of uncertain malignancy and carcinomas (OACs). To date, only 34 cases of OAC have been reported.
    Case experience: We reported a case of a 54-year-old male patient with a history of laparoscopic right adrenalectomy for an OAC and subsequent chemotherapy for a recurrence. He was referred to our emergency room for diffuse abdominal pain, vomit, change in bowel habits, fever, asthenia. He underwent a laparotomy and a complete excision of the known bilobate lesion. The histopathological findings matched the features of a recurrent OAC. No chemotherapy was administered after surgery and the patient was disease-free after a follow-up of twenty-eight months.
    Results - discussion: The most questionable issue in treating adrenocortical oncocytic neoplasms is the determination of malignancy. According to the Helsinki Score, which is the best prognostic system, the primary lesion was an OAC. We also implemented the score systems to the recurrent lesion, that seemed to be malignant. We believe that the adjuvant treatment can delay a recurrent lesion development, but finally, radical surgical excision is necessary. Moreover, we reported the longest survival after the primary adrenalectomy.
    Conclusions: This study described the first case of recurrent oncocytic adrenocortical carcinoma with the longest followup. Adrenocortical oncocytoma is an extremely rare tumor of the adrenal gland with variable biological behavior without definitive consensus about diagnostic criteria. This was also the first case in which different histopathological criteria have been implemented in a recurrence.
    Key words: Oncocytic adrenocortical carcinoma, Surgical oncology, Survival.
    MeSH term(s) Adenoma, Oxyphilic/diagnosis ; Adenoma, Oxyphilic/surgery ; Adrenal Cortex Neoplasms/diagnosis ; Adrenal Cortex Neoplasms/surgery ; Adrenalectomy ; Adrenocortical Carcinoma/diagnosis ; Adrenocortical Carcinoma/surgery ; Humans ; Laparoscopy ; Laparotomy ; Male ; Middle Aged ; Neoplasm Recurrence, Local/diagnosis ; Neoplasm Recurrence, Local/surgery ; Reoperation
    Language English
    Publishing date 2021-05-10
    Publishing country Italy
    Document type Case Reports ; Journal Article
    ZDB-ID 418927-9
    ISSN 2239-253X ; 0003-469X
    ISSN (online) 2239-253X
    ISSN 0003-469X
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  5. Article ; Online: COVID-19: How can a department of general surgery survive in a pandemic?

    Guerci, Claudio / Maffioli, Anna / Bondurri, Andrea A / Ferrario, Luca / Lazzarin, Francesco / Danelli, Piergiorgio

    Surgery

    2020  Volume 167, Issue 6, Page(s) 909–911

    MeSH term(s) Betacoronavirus ; COVID-19 ; Coronavirus Infections/epidemiology ; Coronavirus Infections/prevention & control ; Coronavirus Infections/transmission ; Coronavirus Infections/virology ; Disease Outbreaks ; Elective Surgical Procedures/standards ; General Surgery/standards ; Global Health ; Humans ; Pandemics/prevention & control ; Pneumonia, Viral/epidemiology ; Pneumonia, Viral/prevention & control ; Pneumonia, Viral/transmission ; Pneumonia, Viral/virology ; SARS-CoV-2
    Keywords covid19
    Language English
    Publishing date 2020-03-31
    Publishing country United States
    Document type Letter
    ZDB-ID 202467-6
    ISSN 1532-7361 ; 0039-6060
    ISSN (online) 1532-7361
    ISSN 0039-6060
    DOI 10.1016/j.surg.2020.03.012
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    Uk I Zs.129: Show issues Location:
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  6. Article ; Online: COVID-19 and surgical training in Italy: Residents and young consultants perspectives from the battlefield.

    Ferrario, Luca / Maffioli, Anna / Bondurri, Andrea A / Guerci, Claudio / Lazzarin, Francesco / Danelli, Piergiorgio

    American journal of surgery

    2020  Volume 220, Issue 4, Page(s) 850–852

    MeSH term(s) Betacoronavirus ; COVID-19 ; Consultants ; Coronavirus Infections/epidemiology ; Education, Medical, Graduate/methods ; Humans ; Internship and Residency/methods ; Italy ; Pandemics ; Pneumonia, Viral/epidemiology ; SARS-CoV-2
    Keywords covid19
    Language English
    Publishing date 2020-06-01
    Publishing country United States
    Document type Editorial
    ZDB-ID 2953-1
    ISSN 1879-1883 ; 0002-9610
    ISSN (online) 1879-1883
    ISSN 0002-9610
    DOI 10.1016/j.amjsurg.2020.05.036
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  7. Article ; Online: COVID-19: HOW CAN A DEPARTMENT OF GENERAL SURGERY SURVIVE TO A PANDEMIC?

    Guerci, Claudio / Maffioli, Anna / Bondurri, Andrea A. / Ferrario, Luca / Lazzarin, Francesco / Danelli, Piergiorgio

    Surgery

    Keywords covid19
    Publisher Elsevier
    Document type Article ; Online
    DOI 10.1016/j.surg.2020.03.012
    Database COVID19

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  8. Article: COVID-19 and surgical training in Italy: Residents and young consultants perspectives from the battlefield

    Ferrario, Luca / Maffioli, Anna / Bondurri, Andrea A / Guerci, Claudio / Lazzarin, Francesco / Danelli, Piergiorgio

    Am J Surg

    Keywords covid19
    Publisher WHO
    Document type Article
    Note WHO #Covidence: #457452
    Database COVID19

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  9. Article: COVID-19: How can a department of general surgery survive in a pandemic?

    Guerci, Claudio / Maffioli, Anna / Bondurri, Andrea A / Ferrario, Luca / Lazzarin, Francesco / Danelli, Piergiorgio

    Surgery

    Keywords covid19
    Publisher WHO
    Document type Article
    Note WHO #Covidence: #71618
    Database COVID19

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  10. Article ; Online: COVID-19

    Guerci, Claudio / Maffioli, Anna / Bondurri, Andrea A. / Ferrario, Luca / Lazzarin, Francesco / Danelli, Piergiorgio

    Surgery

    How can a department of general surgery survive in a pandemic?

    2020  Volume 167, Issue 6, Page(s) 909–911

    Keywords Surgery ; covid19
    Language English
    Publisher Elsevier BV
    Publishing country us
    Document type Article ; Online
    ZDB-ID 202467-6
    ISSN 1532-7361 ; 0039-6060
    ISSN (online) 1532-7361
    ISSN 0039-6060
    DOI 10.1016/j.surg.2020.03.012
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