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Article ; Online: Minimally invasive surgery for abdominal wall defects: where are we now?

Guerrieri, Mario

2020 Volume 75, Issue 5, Page(s) 277–278

MeSH term(s)	Emergencies ; Hernia, Abdominal/surgery ; Hernia, Inguinal/surgery ; Hernia, Ventral/surgery ; Hernias, Diaphragmatic, Congenital/surgery ; Herniorrhaphy/methods ; Humans ; Minimally Invasive Surgical Procedures ; Secondary Prevention/methods ; Surgical Mesh ; Surgical Stomas/adverse effects
Language	English
Publishing date	2020-10-16
Publishing country	Italy
Document type	Editorial ; Introductory Journal Article
ZDB-ID	123603-9
ISSN	1827-1626 ; 0026-4733
ISSN (online)	1827-1626
ISSN	0026-4733
DOI	10.23736/S0026-4733.20.08582-X
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Article ; Online: Nationwide analysis of inpatient laparoscopic ventral hernia repair in Italy from 2015 to 2020.

Botteri, Emanuele / Ortenzi, Monica / Williams, Sophie / Balla, Andrea / Podda, Mauro / Guerrieri, Mario / Sartori, Alberto

Updates in surgery

2023 Volume 75, Issue 6, Page(s) 1661–1670

Abstract: Since 2010, several guidelines and consensus papers have been proposed to support surgeons in the decision-making process (Cuccurullo et al. in Hernia 17(5):557-566, 2013; Silecchia et al. in Surg Endosc 29:2463-2484, 2015; Bittner et al. in Surg Endosc ... ...

Abstract	Since 2010, several guidelines and consensus papers have been proposed to support surgeons in the decision-making process (Cuccurullo et al. in Hernia 17(5):557-566, 2013; Silecchia et al. in Surg Endosc 29:2463-2484, 2015; Bittner et al. in Surg Endosc 33(11):3511-3549, 2015) with the conclusion that laparoscopic repair (LR) has gained popularity in the treatment of IH.To date, however, it is not yet clear as to the uptake of LR for IH on national basis. Only dated studies encompassing of all types of incisional hernia repairs are available in literature (Bisgaard et al. in Br J Surg 96:1452-1457, 2009). The aim of our study is to present a snapshot of Italian data for LR of ventral hernias, over a 6 years period, including volume of LR, procedural features and major postoperative outcomes. Data were extracted from the Italian Hospital Information System (HIS) that collects clinical and administrative information regarding each hospital admission of every patient discharged from any hospital in Italy. Using Hospital Discharge records regional Databases (HDD), all laparoscopic ventral hernia procedures carried out in public and private hospitals between 2015 and 2020, in patients over 18 years and resident in Italy, were collected based on diagnosis and procedure codes. The National Agency for Regional Health Services (AgeNaS) oversees the management and analysis of data. All hospital admissions that occurred between 2015 and 2020 were analyzed.A total of 154,546 incisional hernia repairs were performed in Italy from 2015 to 2020. Of these, 20,789 (13.45%) were minimally invasive repairs. The number of procedures performed increased significantly over time, constituting 11.96 and 15.24% of all procedures performed in 2015 and 2020 respectively. However, considering the whole period, the mean annual change was-5.58% (CI - 28.6% to 17.44%; p < 0.0001).Urgent minimally invasive repairs were performed in 1968 cases (1.27%). The absolute rate of laparoscopically treated patients needing an urgent surgical procedure increased overtime (from 7.36% in 2015 to 13.418% in 2020). The mean annual change registered over the whole period was 7.42%. 92% (CI - 0.03 to 14.09%; p < 0.0001). However, when considering the period from 2015 to 2019, the mean annual change was 10.42% (CI 6.35 to 14.49%; p < 0.0001). To our knowledge this is the first nationwide Italian report presenting the national workload of surgical units and the main perioperative features of minimally invasive surgery for ventral hernia repairs.
MeSH term(s)	Humans ; Herniorrhaphy/methods ; Incisional Hernia/surgery ; Inpatients ; Hernia, Ventral/surgery ; Hernia, Ventral/etiology ; Laparoscopy/methods ; Surgical Mesh
Language	English
Publishing date	2023-03-14
Publishing country	Italy
Document type	Journal Article
ZDB-ID	2572692-4
ISSN	2038-3312 ; 2038-131X
ISSN (online)	2038-3312
ISSN	2038-131X
DOI	10.1007/s13304-023-01460-4
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Article ; Online: Prospective Italian validation of the Vaizey and Wexner and fecal incontinence severity index (FISI) questionnaires.

Ortenzi, Monica / Guerrieri, Mario / Saraceno, Federica / Reggiani, Angelica / Lepiane, Pasquale / Sileri, Pierpaolo / Balla, Andrea

Updates in surgery

2023 Volume 75, Issue 6, Page(s) 1617–1623

Abstract: Several objective severity measurement questionnaires of the fecal incontinence (FI), are available to describe type, frequency and degree of FI, and their impact on quality of life, aiming to establish baseline scores measure response to treatment over ... ...

Abstract	Several objective severity measurement questionnaires of the fecal incontinence (FI), are available to describe type, frequency and degree of FI, and their impact on quality of life, aiming to establish baseline scores measure response to treatment over time and allow comparison among patients treated using different strategies. Presently, despite their widespread use in clinical practice, none of these questionnaire have been validated in the Italian language. The aim is to test the translated Italian version of the Vaizey and Wexner and Fecal Incontinence Severity Index (FISI) questionnaires assessing their reliability and validity among Italian-speaking patients. Two researchers proficient in spoken English and Italian translated both questionnaires in the Italian language. They independently translated the two questionnaires from English and then they met to produce a single version of the two questionnaires, to solve any possible discrepancy. A forward-backward translation was then obtained by a professional bilingual translator, so as to define the final version of the questionnaires. The questionnaires were independently administered twice to 100 Italian-speaking patients by two different and independent raters. Cronbach's α of the first and second Vaizey and Wexner questionnaire was 0.755 and 0.727, respectively. While Cronbach's α of the first and second FISI questionnaire was 0.810 and 0.806, respectively. Spearman correlation and inter-rater reliability were 0.937 and 0.913 for Vaizey and Wexner questionnaire, respectively, and 0.915 and 0.871 for FISI questionnaire, respectively. Italian version of the Vaizey and Wexner and FISI questionnaires proved good consistency, reliability, reproducibility, showing good psychometric properties.
MeSH term(s)	Humans ; Quality of Life ; Reproducibility of Results ; Prospective Studies ; Fecal Incontinence/diagnosis ; Severity of Illness Index ; Language ; Surveys and Questionnaires ; Italy
Language	English
Publishing date	2023-06-27
Publishing country	Italy
Document type	Journal Article
ZDB-ID	2572692-4
ISSN	2038-3312 ; 2038-131X
ISSN (online)	2038-3312
ISSN	2038-131X
DOI	10.1007/s13304-023-01567-8
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Article ; Online: Transanal endoscopic microsurgery: indications, tips and long-term results. A single center experience.

Ortenzi, Monica / Ghiselli, Roberto / Gesuita, Rosaria / Guerrieri, Mario

Minerva chirurgica

2020 Volume 75, Issue 3, Page(s) 129–140

Abstract: Background: Transanal endoscopic microsurgery (TEM) was introduced to combine the curativeness of full thickness excision with minimum morbidity, while traditional rectal surgery is burdened by high morbidity and mortality rates. However, while it is ... ...

Abstract	Background: Transanal endoscopic microsurgery (TEM) was introduced to combine the curativeness of full thickness excision with minimum morbidity, while traditional rectal surgery is burdened by high morbidity and mortality rates. However, while it is still a matter of considerable debate whether local excision is an adequate approach for curative resection of rectal cancer, new minimally invasive operative techniques have been introduced. The purpose of this paper was to show the indications, the tips and long term results of this technique through the review of the largest single-center database available to date. The showed results derived from the single center experience of the Clinica Chirurgica of Polytechnic University of Marche. Methods: We retrospectively reviewed a 25-year database from May 1992 to May 2017. We divided the patients into three different groups of patients according to the preoperative diagnosis: rectal cancers, adenomas and other rectal lesions. Rectal adenomas were divided into two groups according to their diameter (> or <5 cm). Rectal cancer patients were divided into two groups according to the preoperative staging: early rectal cancer and irradiated rectal cancer. Results: Among the 1324 patients who had rectal tumors excised with TEM at our institution, preoperative histology was rectal adenoma in 729 (55%) patients, adenocarcinoma in 536 (40.5%) patients and other lesions in the remaining 59 (4.4%) patients. 5 years overall survival (OS) and Recurrence free survival (RFS) were 93.3% and 98.6% for patients with rectal adenomas and 86.8% and 70.9% for patients with rectal cancer. Conclusions: TEM can be a valid alternative for the treatment of both benign and malignant rectal lesions, further studies are needed to define more specific indications to justify the survival of this technique in the future.
MeSH term(s)	Adenocarcinoma/mortality ; Adenocarcinoma/pathology ; Adenocarcinoma/surgery ; Adenoma/mortality ; Adenoma/pathology ; Adenoma/surgery ; Age Factors ; Aged ; Aged, 80 and over ; Databases, Factual/statistics & numerical data ; Female ; Humans ; Italy ; Male ; Middle Aged ; Operative Time ; Progression-Free Survival ; Rectal Neoplasms/mortality ; Rectal Neoplasms/pathology ; Rectal Neoplasms/surgery ; Retrospective Studies ; Transanal Endoscopic Microsurgery/methods ; Treatment Outcome
Language	English
Publishing date	2020-03-17
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/S0026-4733.20.08201-2
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Article ; Online: Telemedicine in surgery during COVID-19 pandemic: are we doing enough?

Sartori, Alberto / Balla, Andrea / Agresta, Ferdinando / Guerrieri, Mario / Ortenzi, Monica

Minerva surgery

2021 Volume 77, Issue 1, Page(s) 50–56

Abstract: Introduction: The aim of this systematic review was to report and to analyze if there is and what is the impact of telemedicine in the surgical practice during COVID-19 pandemic. Many authors have posited that the pandemic urged a high implementation of ...

Abstract	Introduction: The aim of this systematic review was to report and to analyze if there is and what is the impact of telemedicine in the surgical practice during COVID-19 pandemic. Many authors have posited that the pandemic urged a high implementation of the telemedicine service even in surgical specialties, however, the impact of this change of the clinical practice has been variably reported and its utilization in general surgery is uncertain. Evidence acquisition: All articles from any country written in English, Italian, Spanish, or French, about the use of telemedicine for indication to surgical treatment or for 30-day postoperative follow-up in general surgery during the COVID 19 outbreak, from the March 1, 2020, to December 1, 2020, were included. Evidence synthesis: Two hundred nine articles were fully analyzed, and 207 further articles were excluded. Finally, 2 articles, both published in October 2020, were included in the present systematic review. Conclusions: In conclusion, the rapid spread of SARS-CoV-2 pandemic has forced to review the traditional methods to deliver surgical assistance and urged surgeons to find alternative methods to continue their practice. The literature about this topic is yet scarce and many questions regarding its efficacy in improving patients' health, cost-effectiveness and user satisfaction remain unsolved.
MeSH term(s)	Aftercare/statistics & numerical data ; COVID-19/epidemiology ; General Surgery/statistics & numerical data ; Humans ; Pandemics ; Postoperative Care/statistics & numerical data ; SARS-CoV-2 ; Telemedicine/statistics & numerical data
Language	English
Publishing date	2021-10-25
Publishing country	Italy
Document type	Journal Article ; Systematic Review
ZDB-ID	3067899-7
ISSN	2724-5438
ISSN (online)	2724-5438
DOI	10.23736/S2724-5691.21.09100-0
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Article ; Online: COVID-19 pandemic: is it time for shared surgical guidelines? A systematic review of the literature.

Ortenzi, Monica / Balla, Andrea / Botteri, Emanuele / Lepiane, Pasquale / Guerrieri, Mario / Arezzo, Alberto / Sartori, Alberto

Minerva surgery

2022 Volume 77, Issue 2, Page(s) 171–179

Abstract: Introduction: The recent COrona Virus Disease 2019 (COVID-19) pandemic caused a massive disruption of surgical activity and after a year from its first outbreak surgeons still struggle to keep their regular activity coexisting with the virus exhausting ... ...

Abstract	Introduction: The recent COrona Virus Disease 2019 (COVID-19) pandemic caused a massive disruption of surgical activity and after a year from its first outbreak surgeons still struggle to keep their regular activity coexisting with the virus exhausting requests of healthcare resources. The aim of this paper is to offer a comprehensive overview of the most important recommendations by the International Guidelines about general surgery, and possibly to invite building common shared guidelines to preserve the potential to provide surgical assistance despite the pandemic. Evidence acquisition: This systematic review was conducted according to the Preferred Reporting Items for Systematic Review and Meta-Analysis statement. PubMed, Embase, Cochrane and Web of Science databases were searched. Evidence synthesis: The searches revealed a total of 18579 articles published up to the end of February 2021. Five articles published between March and May 2020, were included in the present study: Guidelines from The European Society of Trauma and Emergency Surgery (ESTES), The Society of American Gastrointestinal and Endoscopic Surgeons (SAGES) and The European Association for Endoscopic Surgeons (EAES), The Endoscopic and Laparoscopic Surgeons of Asia (ELSA), The European Hernia Society (EHS) and The International Organization for the Study of Inflammatory Bowel Disease (IOS-IBD). Conclusions: In the likely scenario that the SARS-CoV-2 pandemic will become an endemic chronic problem, we should not be forced to choose between COVID-19 or surgery in the future and find a way to make both coexisting.
MeSH term(s)	COVID-19/epidemiology ; Humans ; Laparoscopy ; Pandemics ; SARS-CoV-2 ; Surgeons
Language	English
Publishing date	2022-04-12
Publishing country	Italy
Document type	Journal Article ; Systematic Review
ZDB-ID	3067899-7
ISSN	2724-5438
ISSN (online)	2724-5438
DOI	10.23736/S2724-5691.21.09166-8
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Article ; Online: Nationwide analysis of laparoscopic groin hernia repair in Italy from 2015 to 2020.

Ortenzi, Monica / Botteri, Emanuele / Balla, Andrea / Podda, Mauro / Guerrieri, Mario / Sartori, Alberto

Updates in surgery

2022

Abstract: Since its introduction, the minimally invasive treatment of groin hernias has become widely accepted as a viable alternative to open surgery. Still, the rates and reasons for its adoption vary highly among countries and the regions within a country. ... ...

Abstract	Since its introduction, the minimally invasive treatment of groin hernias has become widely accepted as a viable alternative to open surgery. Still, the rates and reasons for its adoption vary highly among countries and the regions within a country. After almost thirty years since its introduction, its spread is still limited. The present study, conducted under the auspices of AGENAS (Italian National Agency for Regional Services), aims at giving a snapshot of the spreading of minimally invasive and robotic techniques for the treatment of groin hernia in Italy. This study is retrospective, with data covering the period from 1st January 2015 to 31st December 2020. AGENAS provided data using the operation and diagnosis codes used at discharge and reported in the International Classification of Diseases 9th revision (ICD9 2002 version). Admissions performed on an outpatient basis, i.e., without an overnight stay of at least one night in hospital, were excluded. A total of 33,925 laparoscopic hernia repairs were performed during the considered period. Overall, a slight increase in the number of procedures performed was observed from 2015 to 2019, with a mean annual change of 8.60% (CI: 6.46-10.74; p < 0.0001). The number of laparoscopic procedures dropped in 2020, and when considering the whole period, the mean annual change was - 0.98% (CI: - 7.41-5.45; p < 0.0001). Urgent procedures ranged from 335 in 2015 to 508 in 2020 referring to absolute frequencies, and from 0.87% to 9.8% in relative frequencies of overall procedures in 2017 and 2020, respectively (mean = 4.51%; CI = 3.02%-6%; p < 0.001). The most relevant observation that could be made according to our analysis was that the adoption of the laparoscopic approach knew a slow but steady increase from 2015 onward.
Language	English
Publishing date	2022-09-07
Publishing country	Italy
Document type	Journal Article
ZDB-ID	2572692-4
ISSN	2038-3312 ; 2038-131X
ISSN (online)	2038-3312
ISSN	2038-131X
DOI	10.1007/s13304-022-01374-7
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Article ; Online: Transanal endoscopic microsurgery after the attempt of endoscopic removal of rectal polyps.

Ortenzi, Monica / Arezzo, Alberto / Ghiselli, Roberto / Allaix, Marco Ettore / Guerrieri, Mario / Morino, Mario

Surgical endoscopy

2022 Volume 36, Issue 10, Page(s) 7738–7746

MeSH term(s)	Humans ; Microsurgery ; Neoplasm Recurrence, Local/surgery ; Polyps/surgery ; Proctoscopy ; Rectal Neoplasms/surgery ; Transanal Endoscopic Microsurgery ; Treatment Outcome
Language	English
Publishing date	2022-03-04
Publishing country	Germany
Document type	Journal Article ; Research Support, Non-U.S. Gov't
ZDB-ID	639039-0
ISSN	1432-2218 ; 0930-2794
ISSN (online)	1432-2218
ISSN	0930-2794
DOI	10.1007/s00464-022-09162-5
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Article ; Online: Minimally invasive versus open adrenalectomy for adrenocortical carcinoma: the keys surgical factors influencing the outcomes-a collective overview.

Giordano, Alessio / Feroci, Francesco / Podda, Mauro / Botteri, Emanuele / Ortenzi, Monica / Montori, Giulia / Guerrieri, Mario / Vettoretto, Nereo / Agresta, Ferdinando / Bergamini, Carlo

Langenbeck's archives of surgery

2023 Volume 408, Issue 1, Page(s) 256

Abstract: Purpose: Adrenocortical carcinoma (A.C.C.) is a rare tumour, often discovered at an advanced stage and associated with a poor prognosis. Surgery is the treatment of choice. We aimed to review the different surgical approaches trying to compare their ... ...

Abstract	Purpose: Adrenocortical carcinoma (A.C.C.) is a rare tumour, often discovered at an advanced stage and associated with a poor prognosis. Surgery is the treatment of choice. We aimed to review the different surgical approaches trying to compare their outcome. Methods: This comprehensive review has been carried out according to the PRISMA statement. The literature search was performed in PubMed, Scopus, the Cochrane Library and Google Scholar. Results: Among all studies identified, 18 were selected for the review. A total of 14,600 patients were included in the studies, of whom 4421 were treated by mini-invasive surgery (M.I.S.). Ten studies reported 531 conversions from M.I.S. to an open approach (OA) (12%). Differences were reported for operative times as well as for postoperative complications more often in favour of OA, whereas differences for hospitalization time in favour of M.I.S. Some studies showed an R0 resection rate from 77 to 89% for A.C.C. treated by OA and 67 to 85% for tumours treated by M.I.S. The overall recurrence rate ranged from 24 to 29% for A.C.C. treated by OA and from 26 to 36% for tumours treated by M.I.S. Conclusions: OA should still be considered the standard surgical management of A.C.C. Laparoscopic adrenalectomy has shown shorter hospital stays and faster recovery compared to open surgery. However, the laparoscopic approach resulted in the worst recurrence rate, time to recurrence and cancer-specific mortality in stages I-III ACC. The robotic approach had similar complications rate and hospital stays, but there are still scarce results about oncologic follow-up.
MeSH term(s)	Humans ; Adrenocortical Carcinoma/surgery ; Adrenalectomy ; Hospitalization ; Length of Stay ; Adrenal Cortex Neoplasms/surgery
Language	English
Publishing date	2023-06-30
Publishing country	Germany
Document type	Journal Article ; Review
ZDB-ID	1423681-3
ISSN	1435-2451 ; 1435-2443
ISSN (online)	1435-2451
ISSN	1435-2443
DOI	10.1007/s00423-023-02997-z
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Article ; Online: Correction: Safety of laparoscopic cholecystectomy performed by trainee surgeons with different cholangiographic techniques (SCOTCH): a prospective non-randomized trial on the impact of fluorescent cholangiography during laparoscopic cholecystectomy performed by trainees.

Ortenzi, Monica / Corallino, Diletta / Botteri, Emanuele / Balla, Andrea / Arezzo, Alberto / Sartori, Alberto / Reddavid, Rossella / Montori, Giulia / Guerrieri, Mario / Williams, Sophie / Podda, Mauro

Surgical endoscopy

2024 Volume 38, Issue 2, Page(s) 1116

Language	English
Publishing date	2024-01-17
Publishing country	Germany
Document type	Published Erratum
ZDB-ID	639039-0
ISSN	1432-2218 ; 0930-2794
ISSN (online)	1432-2218
ISSN	0930-2794
DOI	10.1007/s00464-024-10698-x
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