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  1. Article ; Online: The Role of Three-Dimensional Modeling to Improve Comprehension of Liver Anatomy and Tumor Characteristics for Medical Students and Surgical Residents.

    Alaimo, Laura / Marchese, Andrea / Vignola, Damiano / Roman, Diletta / Conci, Simone / De Bellis, Mario / Pedrazzani, Corrado / Campagnaro, Tommaso / Manzini, Gessica / Guglielmi, Alfredo / Ruzzenente, Andrea

    Journal of surgical education

    2024  Volume 81, Issue 4, Page(s) 597–606

    Abstract: Objective: Studying liver anatomy can be challenging for medical students and surgical residents due to its complexity. Three-dimensional visualization technology (3DVT) allows for a clearer and more precise view of liver anatomy. We sought to assess ... ...

    Abstract Objective: Studying liver anatomy can be challenging for medical students and surgical residents due to its complexity. Three-dimensional visualization technology (3DVT) allows for a clearer and more precise view of liver anatomy. We sought to assess how 3DVT can assist students and surgical residents comprehend liver anatomy.
    Design: Data from 5 patients who underwent liver resection for malignancy at our institution between September 2020 and April 2022 were retrospectively reviewed and selected following consensus among the investigators. Participants were required to complete an online survey to investigate their understanding of tumor characteristics and vascular variations based on patients' computed tomography (CT) and 3DVT.
    Setting: The study was carried out at the General and Hepato-Biliary Surgery Department of the University of Verona.
    Participants: Among 32 participants, 13 (40.6%) were medical students, and 19 (59.4%) were surgical residents.
    Results: Among 5 patients with intrahepatic lesions, 4 patients (80.0%) had at least 1 vascular variation. Participants identified number and location of lesions more correctly when evaluating the 3DVT (84.6% and 80.9%, respectively) compared with CT scans (61.1% and 64.8%, respectively) (both p ≤ 0.001). The identification of any vascular variations was more challenging using the CT scans, with only 50.6% of correct answers compared with 3DVT (72.2%) (p < 0.001). Compared with CT scans, 3DVT led to a 23.5%, 16.1%, and 21.6% increase in the correct definition of number and location of lesions, and vascular variations, respectively. 3DVT allowed for a decrease of 50.8 seconds (95% CI 23.6-78.0) in the time needed to answer the questions. All participants agreed on the usefulness of 3DVT in hepatobiliary surgery.
    Conclusions: The 3DVT facilitated a more precise preoperative understanding of liver anatomy, tumor location and characteristics.
    MeSH term(s) Humans ; Retrospective Studies ; Internship and Residency ; Students, Medical ; Comprehension ; Liver Neoplasms/diagnostic imaging ; Liver Neoplasms/surgery ; Imaging, Three-Dimensional/methods
    Language English
    Publishing date 2024-02-22
    Publishing country United States
    Document type Journal Article
    ZDB-ID 2277538-9
    ISSN 1878-7452 ; 1931-7204
    ISSN (online) 1878-7452
    ISSN 1931-7204
    DOI 10.1016/j.jsurg.2023.12.018
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  2. Article: The Role of Topical Povidone-Iodine in the Management of Infectious Keratitis: A Pilot Study.

    Pedrotti, Emilio / Bonacci, Erika / Kilian, Raphael / Pagnacco, Camilla / Fasolo, Adriano / Anastasi, Marco / Manzini, Gessica / Bosello, Francesca / Marchini, Giorgio

    Journal of clinical medicine

    2022  Volume 11, Issue 3

    Abstract: The aim of this prospective explorative study was to evaluate the safety and the effectiveness of topical polyvinylpyrrolidone-iodine (PVP-I) administered during the time-to-results period for pathogen identification and susceptibility testing in ... ...

    Abstract The aim of this prospective explorative study was to evaluate the safety and the effectiveness of topical polyvinylpyrrolidone-iodine (PVP-I) administered during the time-to-results period for pathogen identification and susceptibility testing in patients with infectious keratitis (IK). A corneal swab (CS) for antimicrobial evaluation was performed at enrollment (T0) and topical 0.66%-PVP-I was administered until the laboratory results were available (T1). Ulcer and infiltrate areas and infiltrate depths were compared between T0 and T1 (i.e., time-to-result period). Patients were then shifted to a specific antimicrobial therapy and followed up until resolution of their infiltrates (Tlast-TL). Twenty-five eyes were enrolled, and none showed clinical worsening leading to protocol withdrawal. At T1, ulcer and infiltrate areas showed significant improvement in Gram-positive IK (
    Language English
    Publishing date 2022-02-05
    Publishing country Switzerland
    Document type Journal Article
    ZDB-ID 2662592-1
    ISSN 2077-0383
    ISSN 2077-0383
    DOI 10.3390/jcm11030848
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  3. Article ; Online: Negative pressure wound therapy for prevention of surgical site infection in patients at high risk after clean-contaminated major pancreatic resections: A single-center, phase 3, randomized clinical trial.

    Andrianello, Stefano / Landoni, Luca / Bortolato, Cecilia / Iudici, Livio / Tuveri, Massimiliano / Pea, Antonio / De Pastena, Matteo / Malleo, Giuseppe / Bonamini, Deborah / Manzini, Gessica / Bassi, Claudio / Salvia, Roberto

    Surgery

    2020  Volume 169, Issue 5, Page(s) 1069–1075

    Abstract: Background: Surgical site infections are an important burden of pancreatic surgery, prolonging hospitalization and delaying adjuvant treatment. The aim of this study was to compare negative pressure wound therapy with standard sterile dressing in terms ... ...

    Abstract Background: Surgical site infections are an important burden of pancreatic surgery, prolonging hospitalization and delaying adjuvant treatment. The aim of this study was to compare negative pressure wound therapy with standard sterile dressing in terms of the prevention of non-organ-space surgical site infection (superficial and deep surgical site infection) in the high-risk setting.
    Methods: The trial was conducted at the University of Verona Hospital Trust, Verona, Italy, from July 25, 2018, through October 10, 2019, among adults undergoing surgery for periampullary neoplasms. Only patients at high-risk for surgical site infection based on body mass index, diabetes, steroids, neoadjuvant therapy, American Society of Anesthesiologists score, Charlson comorbidity index, duration of surgery, and blood loss were included and randomized.
    Results: A total of 351 patients were screened, 100 met the inclusion criteria and were 1:1 allocated in the 2 arms. The difference in terms of non-organ-space surgical site infection comparing negative pressure wound therapy with standard sterile dressing was not significant (10.9 vs 12.2%, risk ratio [RR] 1.144, confidence interval [CI] 95% 0.324-4.040, P = 1.000). Hematomas (4.3 vs 2%, RR 1.565, CI 95% 0.312-7.848, P = .609) and organ-space infections (46.7 vs 43.8%, RR 1.059, CI 95% 0.711-1.576, P = .836) were similar. Negative pressure wound therapy prevented the development of seromas (0 vs 12.2%, RR 0.483, CI 95% 0.390-0.599, P = .027). The aesthetic result assessed on postoperative day 7 was better in the negative pressure wound therapy group (visual analogue scale, 8 vs 7, P = .029; Stony Brook Scar Evaluation Scale, 3.2 vs 2.5, P = .009), but it was no more evident on postoperative day 30 after a total number of 23 dropouts.
    Conclusion: Compared with standard sterile dressing, negative pressure wound therapy is not associated with an improved rate of non-organ-space surgical site infection after surgery for periampullary neoplasms in patients at high risk for surgical site infection. Additional studies will help identify the population that could benefit most from this intervention.
    MeSH term(s) Aged ; Aged, 80 and over ; Female ; Humans ; Male ; Middle Aged ; Negative-Pressure Wound Therapy/instrumentation ; Pancreaticoduodenectomy/adverse effects ; Surgical Wound Infection/etiology ; Surgical Wound Infection/prevention & control
    Language English
    Publishing date 2020-11-27
    Publishing country United States
    Document type Clinical Trial, Phase III ; Journal Article ; Randomized Controlled Trial ; Research Support, Non-U.S. Gov't
    ZDB-ID 202467-6
    ISSN 1532-7361 ; 0039-6060
    ISSN (online) 1532-7361
    ISSN 0039-6060
    DOI 10.1016/j.surg.2020.10.029
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    Uk I Zs.129: Show issues Location:
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  4. Article ; Online: A phase II trial proposal of total neoadjuvant treatment with primary chemotherapy, stereotactic body radiation therapy, and intraoperative radiation therapy in borderline resectable pancreatic adenocarcinoma.

    Paiella, Salvatore / Malleo, Giuseppe / Simoni, Nicola / Micera, Renato / Guariglia, Stefania / Cavedon, Carlo / Marchegiani, Giovanni / Esposito, Alessandro / Landoni, Luca / Casetti, Luca / Tuveri, Massimiliano / Milella, Michele / Secchettin, Erica / Manzini, Gessica / Bovo, Chiara / De Pastena, Matteo / Fontana, Martina / Salvia, Roberto / Mazzarotto, Renzo /
    Bassi, Claudio

    BMC cancer

    2021  Volume 21, Issue 1, Page(s) 165

    Abstract: Background: The current management guidelines recommend that patients with borderline resectable pancreatic adenocarcinoma (BRPC) should initially receive neoadjuvant chemotherapy. The addition of advanced radiation therapy modalities, including ... ...

    Abstract Background: The current management guidelines recommend that patients with borderline resectable pancreatic adenocarcinoma (BRPC) should initially receive neoadjuvant chemotherapy. The addition of advanced radiation therapy modalities, including stereotactic body radiation therapy (SBRT) and intraoperative radiation therapy (IORT), could result in a more effective neoadjuvant strategy, with higher rates of margin-free resections and improved survival outcomes.
    Methods/design: In this single-center, single-arm, intention-to-treat, phase II trial newly diagnosed BRPC will receive a "total neoadjuvant" therapy with FOLFIRINOX (5-fluorouracil, irinotecan and oxaliplatin) and hypofractionated SBRT (5 fractions, total dose of 30 Gy with simultaneous integrated boost of 50 Gy on tumor-vessel interface). Following surgical exploration or resection, IORT will be also delivered (10 Gy). The primary endpoint is 3-year survival. Secondary endpoints include completion of neoadjuvant treatment, resection rate, acute and late toxicities, and progression-free survival. In the subset of patients undergoing resection, per-protocol analysis of disease-free and disease-specific survival will be performed. The estimated sample size is 100 patients over a 36-month period. The trial is currently recruiting.
    Trial registration: NCT04090463 at clinicaltrials.gov.
    MeSH term(s) Adenocarcinoma/pathology ; Adenocarcinoma/therapy ; Adult ; Aged ; Antineoplastic Combined Chemotherapy Protocols/therapeutic use ; Chemoradiotherapy/methods ; Clinical Trials, Phase II as Topic ; Combined Modality Therapy ; Female ; Follow-Up Studies ; Humans ; Intraoperative Care ; Male ; Middle Aged ; Neoadjuvant Therapy/methods ; Pancreatic Neoplasms/pathology ; Pancreatic Neoplasms/therapy ; Prognosis ; Radiosurgery/methods ; Survival Rate
    Language English
    Publishing date 2021-02-16
    Publishing country England
    Document type Clinical Trial Protocol ; Journal Article
    ISSN 1471-2407
    ISSN (online) 1471-2407
    DOI 10.1186/s12885-021-07877-7
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  5. Article ; Online: Laser Treatment of Pancreatic Cancer with Immunostimulating Interstitial Laser Thermotherapy Protocol: Safety and Feasibility Results From Two Phase 2a Studies.

    Paiella, Salvatore / Casetti, Luca / Ewald, Jacques / Marchese, Ugo / D'Onofrio, Mirko / Garnier, Jonathan / Landoni, Luca / Gilabert, Marine / Manzini, Gessica / Esposito, Alessandro / Secchettin, Erica / Malleo, Giuseppe / Lionetto, Gabriella / De Pastena, Matteo / Bassi, Claudio / Delpero, Jean Robert / Salvia, Roberto / Turrini, Olivier

    The Journal of surgical research

    2020  Volume 259, Page(s) 1–7

    Abstract: Purpose: Ablative techniques have emerged as new potential therapeutic options for patients with locally advanced pancreatic cancer (LAPC). We explored the safety and feasibility of using TRANBERG|Thermal Therapy System (Clinical Laserthermia Systems AB, ...

    Abstract Purpose: Ablative techniques have emerged as new potential therapeutic options for patients with locally advanced pancreatic cancer (LAPC). We explored the safety and feasibility of using TRANBERG|Thermal Therapy System (Clinical Laserthermia Systems AB, Lund, Sweden) in feedback mode for immunostimulating Interstitial Laser Thermotherapy (imILT) protocol, the newest ablative technique introduced for the treatment of LAPC.
    Methods: The safety and feasibility results after the use of imILT protocol treatment in 15 patients of a prospective series of postsystemic therapy LAPC in two high-volume European institutions, the General and Pancreatic Unit of the Pancreas Institute, of the University of Verona, Italy, and the Department of Surgical Oncology of the Institut Paoli-Calmettes of Marseille, France, were assessed.
    Results: The mean age was 66 ± 5 years, with a mean tumor size of 34.6 (±8) mm. The median number of cycles of pre-imILT chemotherapy was 6 (6-12). The procedure was performed in 13 of 15 (86.6%) cases; indeed, in two cases, the procedure was not performed; in one, the procedure was considered technically demanding; in the other, liver metastases were found intraoperatively. In all treated cases, the procedure was completed. Three late pancreatic fistulas developed over four overall adverse events (26.6%) and were attributed to imILT. Mortality was nil. A learning curve is necessary to interpret and manage the laser parameters.
    Conclusions: Safety, feasibility, and device handling outcomes of using TRANBERG|Thermal Therapy System with temperature probes in feedback mode and imILT protocol on LAPC were not satisfactory. The metastatic setting may be appropriate to evaluate the hypothetic abscopal effect.#NCT02702986 and #NCT02973217.
    MeSH term(s) Aged ; Clinical Trials, Phase II as Topic ; Feasibility Studies ; Female ; France ; Humans ; Hyperthermia, Induced/adverse effects ; Hyperthermia, Induced/instrumentation ; Hyperthermia, Induced/methods ; Immunotherapy/adverse effects ; Immunotherapy/instrumentation ; Immunotherapy/methods ; Italy ; Laser Therapy/adverse effects ; Laser Therapy/instrumentation ; Laser Therapy/methods ; Male ; Middle Aged ; Multicenter Studies as Topic ; Pancreas/immunology ; Pancreas/pathology ; Pancreas/radiation effects ; Pancreas/surgery ; Pancreatic Fistula/epidemiology ; Pancreatic Fistula/etiology ; Pancreatic Fistula/pathology ; Pancreatic Neoplasms/immunology ; Pancreatic Neoplasms/pathology ; Pancreatic Neoplasms/therapy ; Prospective Studies ; Treatment Outcome
    Language English
    Publishing date 2020-12-02
    Publishing country United States
    Document type Journal Article ; Research Support, Non-U.S. Gov't
    ZDB-ID 80170-7
    ISSN 1095-8673 ; 0022-4804
    ISSN (online) 1095-8673
    ISSN 0022-4804
    DOI 10.1016/j.jss.2020.10.027
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    Zs.A 178: Show issues Location:
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    Jg. 1995 - 2021: Lesesall (1.OG)
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  6. Article ; Online: Is there a role for near-infrared technology in laparoscopic resection of pancreatic neuroendocrine tumors? Results of the COLPAN "colour-and-resect the pancreas" study.

    Paiella, Salvatore / De Pastena, Matteo / Landoni, Luca / Esposito, Alessandro / Casetti, Luca / Miotto, Marco / Ramera, Marco / Salvia, Roberto / Secchettin, Erica / Bonamini, Deborah / Manzini, Gessica / D'Onofrio, Mirko / Marchegiani, Giovanni / Bassi, Claudio

    Surgical endoscopy

    2017  Volume 31, Issue 11, Page(s) 4478–4484

    Abstract: Background: The intraoperative identification of pancreatic neuroendocrine tumors (PanNETs) is of utmost importance to drive their laparoscopic resection. Near-infrared (NIR) surgery has emerged as a new technique for localizing tumors or neoplastic ... ...

    Abstract Background: The intraoperative identification of pancreatic neuroendocrine tumors (PanNETs) is of utmost importance to drive their laparoscopic resection. Near-infrared (NIR) surgery has emerged as a new technique for localizing tumors or neoplastic tissue. This study aimed to explore the results of the application of NIR in the laparoscopic resection of PanNETs.
    Methods: Per protocol we enrolled ten subjects undergoing laparoscopic pancreatic surgery for PanNET from March 2016 to October 2016. During surgery, the patients were injected with indocyanine green dye (ICG, 25 mg given in 5 boli of 5 mg each). The switch-activation of NIR was performed to identify PanNETs. An ex-post analysis of the images was realized using ImageJ Software® to calculate the fluorescence signal.
    Results: NIR imaging identified all ten PanNETs. Nine (90%) laparoscopic distal pancreatectomy with splenectomy and one (10%) laparoscopic enucleation were performed. The mean maximum tumor dimension was 2.4 cm (range 1-4 cm). Eight non-functioning PanNETs (80%) and two insulinomas (20%) were found at the final pathology. Nine out of ten (90%) PanNETs were detected after the second ICG bolus. The mean latency time was 80 s and the mean visibility time was 220 s. The peak of tumor visualization was reached 20 min after the last bolus. This finding was confirmed by the ex-post analysis of the fluorescence signal (mean signal-to-background ratio of 7.7, p = 0.001). NIR identified two additional lesions, which turned out to be normal lymph nodes at final pathology. A fluorescent signal was identified at the bed of the enucleation, and thus, a further exeresis was performed and final pathology revealed that is was residual neoplastic tissue.
    Conclusions: This explorative study shows that NIR with ICG can have a role in laparoscopic pancreatic resection of PanNETs. Further studies are needed to assess the proper setting and role of this new and promising technology.
    MeSH term(s) Adult ; Aged ; Color ; Coloring Agents ; Female ; Humans ; Indocyanine Green ; Laparoscopy/methods ; Male ; Middle Aged ; Neuroendocrine Tumors/surgery ; Optical Imaging/methods ; Pancreas/diagnostic imaging ; Pancreas/pathology ; Pancreas/surgery ; Pancreatectomy/methods ; Pancreatic Neoplasms/diagnostic imaging ; Pancreatic Neoplasms/surgery
    Chemical Substances Coloring Agents ; Indocyanine Green (IX6J1063HV)
    Language English
    Publishing date 2017
    Publishing country Germany
    Document type Clinical Trial ; 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/s00464-017-5501-5
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