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Article ; Online: Rare recurrence of malignant mesothelioma spreading to the perineum.

Marra, Angelo Alessandro / Di Giorgio, Andrea / Ratto, Carlo

BMJ case reports

2023 Volume 16, Issue 2

Abstract: Malignant mesothelioma is a rare aggressive tumour of the mesothelium with a propensity to spread locally and, rarely, to distant organs. The latest advances in its diagnosis and treatment have led to an increase in unusual disease presentations. ... ...

Abstract	Malignant mesothelioma is a rare aggressive tumour of the mesothelium with a propensity to spread locally and, rarely, to distant organs. The latest advances in its diagnosis and treatment have led to an increase in unusual disease presentations. Although a direct invasion of the perineum has been previously described in a men, a malignant mesothelioma spreading to the perianal region was never reported in a women. We presented a rare case of malignant mesothelioma recurrence spreading from the peritoneal cavity to the perineum through the rectovaginal space.
MeSH term(s)	Male ; Humans ; Female ; Mesothelioma, Malignant ; Mesothelioma/diagnosis ; Mesothelioma/therapy ; Mesothelioma/pathology ; Perineum/pathology ; Peritoneal Neoplasms/diagnosis ; Peritoneal Neoplasms/surgery ; Peritoneal Neoplasms/pathology ; Combined Modality Therapy
Language	English
Publishing date	2023-02-14
Publishing country	England
Document type	Case Reports ; Journal Article
ISSN	1757-790X
ISSN (online)	1757-790X
DOI	10.1136/bcr-2022-252441
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Article: Would Surgeons Like to Be Submitted to Anal Fistulotomy? An International Web-Based Survey.

Ratto, Carlo / Marra, Angelo Alessandro / Parello, Angelo / De Simone, Veronica / Campennì, Paola / Litta, Francesco

Journal of clinical medicine

2023 Volume 12, Issue 3

Abstract: Traditional fistulotomy is the most performed surgical procedure in anal fistula surgery. We conducted an international online survey to explore colorectal surgeons' opinions and preferences on fistulotomy. Considering the healing and continence ... ...

Abstract	Traditional fistulotomy is the most performed surgical procedure in anal fistula surgery. We conducted an international online survey to explore colorectal surgeons' opinions and preferences on fistulotomy. Considering the healing and continence impairment rates reported in the literature, surgeons were invited to answer as a hypothetic patient susceptible to being submitted to fistulotomy for low and high anal fistula. A total of 767 surgeons completed the survey from 72 countries. The majority of respondents were consultants, having treated more than 20 anal fistulas in the last year. Most of them declared that anal fistula would be able to negatively affect quality of life and would be worried/anxious about it. Taking into account all aspects, 87.5% and 37.8% of respondents would agree to be treated with a fistulotomy in case of a low and high fistula, respectively, with an acceptance rate that varied worldwide. At multivariate analysis, factors correlated to the acceptance of anal fistulotomy were male gender (
Language	English
Publishing date	2023-01-20
Publishing country	Switzerland
Document type	Journal Article
ZDB-ID	2662592-1
ISSN	2077-0383
ISSN	2077-0383
DOI	10.3390/jcm12030825
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Article ; Online: Technical modifications for cost optimization in robot-assisted ventral mesh rectopexy: an initial experience.

Marra, A A / Campennì, P / De Simone, V / Parello, A / Litta, F / Ratto, C

Techniques in coloproctology

2023 Volume 27, Issue 7, Page(s) 551–557

Abstract: Background: Robot-assisted ventral mesh rectopexy is considered a valid option in the treatment of rectal prolapse. However, it involves higher costs than the laparoscopic approach. The aim of this study is to determine if less expensive robotic surgery ...

Abstract	Background: Robot-assisted ventral mesh rectopexy is considered a valid option in the treatment of rectal prolapse. However, it involves higher costs than the laparoscopic approach. The aim of this study is to determine if less expensive robotic surgery for rectal prolapse can be safely performed. Methods: This study was conducted on consecutive patients who underwent robot-assisted ventral mesh rectopexy at Fondazione Policlinico Universitario "A. Gemelli" IRCCS, Rome, from 7 November 2020 to 22 November 2021. The cost of hospitalization, surgical procedure, robotic materials, and operating room resources in patients undergoing robot-assisted ventral mesh rectopexy with the da Vinci Xi Surgical Systems was analyzed before and after technical modifications, including the reduction of robotic arms and instruments, and the execution of a double minimal peritoneal incision at the pouch of Douglas and sacral promontory (instead of the traditional inverted J incision). Results: Twenty-two robot-assisted ventral mesh rectopexies were performed [21 females, 95.5%, median age 62.0 (54.8-70.0) years]. After an initial experience performing traditional robot-assisted ventral mesh rectopexy in four patients, we adopted technical modifications in other cases. No major complication or conversion to open surgery occurred. In total, mean cost of hospitalization, surgical procedure, robotic materials, and operating room resources was €6995.5 ± 1058.0, €5912.7 ± 877.0, €2797.6 ± 545.6, and €2608.3 ± 351.5, respectively. Technical modifications allowed a significant reduction in the overall cost of hospitalization (€6604.5 ± 589.5 versus €8755.0 ± 906.4, p = 0.001), number of robotic instruments (3.1 ± 0.2 versus 4.0 ± 0.8 units, p = 0.026), and operating room time (201 ± 26 versus 253 ± 16 min, p = 0.003). Conclusions: Considering our preliminary results, robot-assisted ventral mesh rectopexy with appropriate technical modifications can be cost-effective and safe.
MeSH term(s)	Female ; Humans ; Middle Aged ; Rectal Prolapse/surgery ; Robotics ; Laparoscopy/methods ; Surgical Mesh ; Treatment Outcome ; Robotic Surgical Procedures/methods
Language	English
Publishing date	2023-02-18
Publishing country	Italy
Document type	Journal Article
ZDB-ID	2083309-X
ISSN	1128-045X ; 1123-6337
ISSN (online)	1128-045X
ISSN	1123-6337
DOI	10.1007/s10151-023-02756-8
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Article ; Online: Anxiety and depression should be considered more in rectal prolapse surgery: an analysis of long-term results after ventral mesh rectopexy.

Marra, Angelo A / Porfiri, Federica / Biffoni, Beatrice / Parello, Angelo / Campennì, Paola / Simone, Veronica De / Litta, Francesco / Ratto, Carlo

Surgery

2023 Volume 174, Issue 6, Page(s) 1486–1487

MeSH term(s)	Humans ; Depression ; Rectal Prolapse/surgery ; Surgical Mesh ; Anxiety/etiology
Language	English
Publishing date	2023-06-26
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.2023.05.043
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Article ; Online: Fistulotomy plus end-to-end primary sphincteroplasty - a video vignette.

Ratto, Carlo / Litta, Francesco / Marra, Angelo Alessandro / Campennì, Paola / De Simone, Veronica / Parello, Angelo

Colorectal disease : the official journal of the Association of Coloproctology of Great Britain and Ireland

2021 Volume 23, Issue 8, Page(s) 2213–2214

MeSH term(s)	Digestive System Surgical Procedures ; Humans ; Rectal Fistula/surgery ; Treatment Outcome
Language	English
Publishing date	2021-06-17
Publishing country	England
Document type	Letter ; Video-Audio Media
ZDB-ID	1440017-0
ISSN	1463-1318 ; 1462-8910
ISSN (online)	1463-1318
ISSN	1462-8910
DOI	10.1111/codi.15745
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Article ; Online: Modified robotic ventral mesh rectopexy - A video vignette.

Ratto, Carlo / Marra, Angelo Alessandro / Campennì, Paola / De Simone, Veronica / Litta, Francesco / Parello, Angelo

Colorectal disease : the official journal of the Association of Coloproctology of Great Britain and Ireland

2021 Volume 24, Issue 1, Page(s) 142

MeSH term(s)	Digestive System Surgical Procedures ; Humans ; Laparoscopy ; Rectal Prolapse/surgery ; Rectum/surgery ; Robotic Surgical Procedures ; Robotics ; Surgical Mesh ; Treatment Outcome
Language	English
Publishing date	2021-10-10
Publishing country	England
Document type	Letter ; Video-Audio Media
ZDB-ID	1440017-0
ISSN	1463-1318 ; 1462-8910
ISSN (online)	1463-1318
ISSN	1462-8910
DOI	10.1111/codi.15929
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Article: The Emborrhoid Technique for Treatment of Bleeding Hemorrhoids in Patients with High Surgical Risk.

Campennì, Paola / Iezzi, Roberto / Marra, Angelo Alessandro / Posa, Alessandro / Parello, Angelo / Litta, Francesco / De Simone, Veronica / Ratto, Carlo

Journal of clinical medicine

2022 Volume 11, Issue 19

Abstract: The Emborrhoid is an innovative non-surgical technique for the treatment of severe hemorrhoidal bleeding. Patient selection and the impact on quality of life have not been fully investigated. This prospective observational study aims to evaluate the ... ...

Abstract	The Emborrhoid is an innovative non-surgical technique for the treatment of severe hemorrhoidal bleeding. Patient selection and the impact on quality of life have not been fully investigated. This prospective observational study aims to evaluate the clinical outcomes after Emborrhoid in patients with high surgical risk. All patients with high surgical risk and anemia due to hemorrhoids were enrolled. Clinical data and previous blood transfusions were collected. The Hemorrhoidal Disease Symptom Score and Short Health Scala were completed before the procedure and during the follow-up visits at 1, 6 and 12 months. Transfusions and serum hemoglobin level variations were registered. Perioperative complications and the recurrence of bleeding were assessed. Trans-radial/femoral embolization of superior rectal artery, and/or middle rectal artery was performed with Interlock and Detachable Embolization Coils. From September 2020 to February 2022, 21 patients underwent a superselective embolization of all branches of the superior rectal artery. The transradial approach was most frequently performed compared to transfemoral access. After the procedure, no signs of ischemia were identified; three minor complications were observed. The mean follow-up was 18.5 ± 6.0 months. At the last follow-up, the mean increase of hemoglobin for patients was 1.2 ± 1.6 g/dL. Three patients needed transfusions during follow-up for recurrent hemorrhoidal bleeding. The Hemorrhoidal Disease Symptom Score and Short Health Scala decreased from 11.1 ± 4.2 to 4.7 ± 4.6 (p < 0.0001) and from 18.8 ± 4.8 to 10.2 ± 4.9 (p < 0.0001), respectively. Patients who had given up on their daily activities due to anemia have returned to their previous lifestyle. Emborrhoid seems to be a safe and effective option for the treatment of bleeding hemorrhoids in frail patients. The low complication rate and the significant reduction of post-defecation bleeding episodes are related to the improvement of the hemorrhoidal symptoms and patients’ quality of life.
Language	English
Publishing date	2022-09-21
Publishing country	Switzerland
Document type	Journal Article
ZDB-ID	2662592-1
ISSN	2077-0383
ISSN	2077-0383
DOI	10.3390/jcm11195533
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Article: Human Amniotic Membrane for the Treatment of Cryptoglandular Anal Fistulas.

Ratto, Carlo / Parolini, Ornella / Marra, Angelo Alessandro / Orticelli, Valentina / Parello, Angelo / Campennì, Paola / De Simone, Veronica / Trojan, Diletta / Litta, Francesco

Journal of clinical medicine

2022 Volume 11, Issue 5

Abstract: Background: Implantation of the amniotic membrane and their derivatives can have a beneficial effect on tissue repair and regeneration. We report for the first time the implant of an amniotic membrane in a patient affected by cryptoglandular anal ... ...

Abstract	Background: Implantation of the amniotic membrane and their derivatives can have a beneficial effect on tissue repair and regeneration. We report for the first time the implant of an amniotic membrane in a patient affected by cryptoglandular anal fistula. Methods: A patch of human amniotic membrane was implanted in a female patient affected by an anterior transphincteric fistula. Following an accurate curettage of the anal fistula, the cryopreserved amniotic membrane was thawed and then washed in the operating room; one side of the membrane was transfixed with a resorbable suture thus creating an implantable fusiform patch. The membrane was subsequently implanted into the fistula tract from the external to the internal opening. The inner and outer parts of the membrane were then sutured to the internal and external fistula openings. Results: No intraoperative or postoperative complications occurred. The patient was discharged one day after the procedure after an uneventful hospitalization. At the 1-week, 1- and 3-month follow-up visits no pain (VAS 0) was referred by the patient and no inflammation was evident at the level of the previous external fistula opening. Conclusions: The implant of human amniotic membrane in a patient affected by cryptoglandular anal fistula was safely and easily performed. Moreover, future studies to assess the efficacy in the long-term follow-up are needed.
Language	English
Publishing date	2022-03-01
Publishing country	Switzerland
Document type	Journal Article
ZDB-ID	2662592-1
ISSN	2077-0383
ISSN	2077-0383
DOI	10.3390/jcm11051350
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Article: A Prospective Study on the Efficacy of Two Different Phlebotonic Therapies as a Bridge to Surgery in Patients with Advanced Hemorrhoidal Disease.

Orefice, Raffaele / Litta, Francesco / Parello, Angelo / De Simone, Veronica / Campennì, Paola / Marra, Angelo Alessandro / Ratto, Carlo

Journal of clinical medicine

2021 Volume 10, Issue 8

Abstract: The aims of this study were to evaluate the efficacy of two different phlebotonic therapies, preoperatively administered in advanced hemorrhoidal disease (HD) patients with recommendation for surgery, and to assess patient satisfaction after treatment. ... ...

Abstract	The aims of this study were to evaluate the efficacy of two different phlebotonic therapies, preoperatively administered in advanced hemorrhoidal disease (HD) patients with recommendation for surgery, and to assess patient satisfaction after treatment. In this prospective observational study, 100 patients were preoperatively treated either with micronized purified flavonoid fraction (group A) or sublingual nano-emulsion flavonoid (group B). HD symptoms, local inflammation signs and patients' satisfaction were evaluated at baseline visit (T0), after 4 weeks of therapy (T1) and 8 weeks after its discontinuation (T2). In group A, a significant improvement for all HD symptoms and inflammation signs was observed after therapy (T1), followed by a reduction of efficacy in T2, except for itching and edema. In group B, therapy had a significant benefit on symptoms and local inflammation at T1, which persisted after its discontinuation for all symptoms, and edematous hemorrhoids. In both groups, the satisfaction rate was "good" in 60% of patients and patients were statistically significant more satisfied at T1 compared with T2 (
Language	English
Publishing date	2021-04-07
Publishing country	Switzerland
Document type	Journal Article
ZDB-ID	2662592-1
ISSN	2077-0383
ISSN	2077-0383
DOI	10.3390/jcm10081549
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Article ; Online: Outpatient Transradial Emborrhoid Technique: A Pilot Study.

Iezzi, Roberto / Campenni, Paola / Posa, Alessandro / Parello, Angelo / Rodolfino, Elena / Marra, Angelo Alessandro / Ratto, Carlo / Manfredi, Riccardo

Cardiovascular and interventional radiology

2021 Volume 44, Issue 8, Page(s) 1300–1306

Abstract: Purpose: To determine whether outpatient transradial emborrhoid technique can be performed safely and effectively in the treatment of symptomatic hemorrhoids.: Materials and methods: The transradial emborrhoid technique was used to treat 12 patients ... ...

Abstract	Purpose: To determine whether outpatient transradial emborrhoid technique can be performed safely and effectively in the treatment of symptomatic hemorrhoids. Materials and methods: The transradial emborrhoid technique was used to treat 12 patients with symptomatic hemorrhoids in an outpatient setting during a 4-month period. After percutaneous catheterization of the left radial artery, a 5-Fr sheath was introduced to catheterize the inferior mesenteric artery and a microcatheter was advanced into the branches of the superior rectal artery for embolization with 0.018-inch detachable coils (Interlock and IDC-interlocking detachable coils). After embolization, the sheath was withdrawn and puncture site hemostasis was achieved using a wrist band. All patients were evaluated 6 h after the procedure to determine whether they meet the discharge criteria and were discharged the following day. The results of the emborrhoid treatment were assessed at the 4-week follow-up. Results: The emborrhoid technique was successful in all patients. There was no major complication associated with the procedure. All patients met the discharge criteria 6 h after the procedure. Reduction of local edema and of hemorrhoidal congestion was observed in all patients. At the follow-up visit, the mean Rorvik score (HDSS + SHS-HD) decreased from 31.50 (7.50) to 13.11 (8.33) (p < .001). Conclusions: Transradial rectal artery embolization is a safe and effective treatment option for patients with chronic symptoms of hemorrhoid disease.
MeSH term(s)	Aged ; Embolization, Therapeutic/methods ; Female ; Hemorrhoids/therapy ; Humans ; Male ; Outpatients ; Pilot Projects ; Prospective Studies ; Rectum/blood supply ; Treatment Outcome
Language	English
Publishing date	2021-05-11
Publishing country	United States
Document type	Journal Article ; Observational Study
ZDB-ID	603082-8
ISSN	1432-086X ; 0342-7196 ; 0174-1551
ISSN (online)	1432-086X
ISSN	0342-7196 ; 0174-1551
DOI	10.1007/s00270-021-02856-8
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