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  1. Article: Transperineal excision of malignant peripheral nerve sheath tumors of the ischiorectal fossa: Case report of a rare tumor in a frequently forgotten anatomical region.

    Eberspacher, Chiara / Arcieri, Stefano / Coletta, Enrico / Pontone, Stefano / Arcieri, Francesco Leone / Mascagni, Domenico

    International journal of surgery case reports

    2023  Volume 110, Page(s) 108674

    Abstract: Introduction and importance: Malignant peripheral nerve sheath tumor is an aggressive tumor that arises from peripheral nerves. Frequently associated with neurofibromatosis, its common localization is in the extremities, trunk (with paravertebral ... ...

    Abstract Introduction and importance: Malignant peripheral nerve sheath tumor is an aggressive tumor that arises from peripheral nerves. Frequently associated with neurofibromatosis, its common localization is in the extremities, trunk (with paravertebral regions), neck and head. Some cases have been found in the pelvis or uterus. In this case report we illustrate one of the rarest localization of this type of tumor in the ischiorectal fossa, with the full recovery of the patient after surgical excision and radiotherapy.
    Case presentation: A 61-year-old woman showed a lump near the anus which was initially diagnosed as a lipoma of the right ischiorectal fossa, by Computed Tomography scan. The tumor was completely removed with a minimal skin incision, and the patient had a complete recovery. Only the pathological examination determined the diagnosis of malignant peripheral nerve sheath tumor, in this unusual localization. In consideration of its high aggressiveness the patient underwent radiotherapy. After more than two years of follow-up there is no sign of recurrence.
    Discussion: In sites far from branches of nerves, malignant peripheral nerve sheath tumors can be considered episodic. Ischiorectal fossa is a rare localization, and the differential diagnosis from benign mesenchymal cell tumors can be challenging. When possible, a biopsy should be performed before surgery.
    Conclusion: Surgical excision of tumors in ischiorectal fossa should be always complete, in consideration of possible histological surprise.
    Language English
    Publishing date 2023-08-18
    Publishing country Netherlands
    Document type Case Reports
    ISSN 2210-2612
    ISSN 2210-2612
    DOI 10.1016/j.ijscr.2023.108674
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  2. Article: Anal excision of perianal fibroadenoma: Expect the unexpected.

    Eberspacher, Chiara / Nardi, Francesco / Fralleone, Lisa / Mascagni, Domenico

    SAGE open medical case reports

    2021  Volume 9, Page(s) 2050313X211035568

    Abstract: Breast fibroadenomas are a common benign tumour in women that may need to be surgically excised. A mammary-like fibroadenoma can exceptionally be found in the pathological report after an anal polyp removal. A 60-year-old woman presented with huge anal ... ...

    Abstract Breast fibroadenomas are a common benign tumour in women that may need to be surgically excised. A mammary-like fibroadenoma can exceptionally be found in the pathological report after an anal polyp removal. A 60-year-old woman presented with huge anal polyp of 25 mm. It was surgically removed transanally. Histologic examination revealed a breast fibroadenoma pattern with glandular structures. Proctologist specialists must be aware that mammary-like tumours are a possible differential diagnosis for anal masses despite their rarity in the literature.
    Language English
    Publishing date 2021-07-28
    Publishing country England
    Document type Case Reports
    ZDB-ID 2736953-5
    ISSN 2050-313X
    ISSN 2050-313X
    DOI 10.1177/2050313X211035568
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  3. Article: A case report of a colouterine fistula treatment: when the patient chooses the steeplechase.

    Pontone, Stefano / Nardis, Pier Giorgio / Eberspacher, Chiara / Mascagni, Domenico

    Annals of coloproctology

    2021  Volume 39, Issue 4, Page(s) 366–370

    Abstract: Colouterine fistula is a rare disease that is primarily treated using surgical approaches. Although invasive surgery is controversial in terms of techniques and results, minimally invasive endoscopic treatments have not been widely described. However, ... ...

    Abstract Colouterine fistula is a rare disease that is primarily treated using surgical approaches. Although invasive surgery is controversial in terms of techniques and results, minimally invasive endoscopic treatments have not been widely described. However, because it is rare for these fistulas to close spontaneously, surgical treatment is often mandatory. Appropriate management of colouterine fistula is complicated, especially when the patient refuses surgery. In this case study, we provide the first description of a minimally invasive endoscopic treatment of an iatrogenic colouterine fistula using a self-expandable metallic stent after an over-the-scope clip malposition.
    Language English
    Publishing date 2021-08-09
    Publishing country Korea (South)
    Document type Case Reports
    ZDB-ID 2711906-3
    ISSN 2287-9722 ; 2287-9714
    ISSN (online) 2287-9722
    ISSN 2287-9714
    DOI 10.3393/ac.2021.00318.0045
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  4. Article ; Online: Indocyanine Green Tattooing During Colonoscopy as a Guide to Laparoscopic Colorectal Cancer Surgery: A Literature Review.

    Varanese, Marzia / Arcieri, Stefano / Lauro, Augusto / Panetta, Cristina / Eberspacher, Chiara / Palma, Rossella / Mascagni, Domenico / Pontone, Stefano

    Surgical innovation

    2023  Volume 31, Issue 1, Page(s) 103–110

    Abstract: Background: Endoscopic tattooing of colorectal lesions has been performed employing several markers. The indocyanine green (ICG) that uses near infrared fluorescence technology, has been recently adopted in laparoscopic colorectal cancer surgery. This ... ...

    Abstract Background: Endoscopic tattooing of colorectal lesions has been performed employing several markers. The indocyanine green (ICG) that uses near infrared fluorescence technology, has been recently adopted in laparoscopic colorectal cancer surgery. This study aims to systematically review the international literature to validate the ICG in laparoscopic colorectal surgery, in order to include the ICG in the therapeutic protocol.
    Methods: Following AMSTAR 2 criteria, we performed a systematic review to evaluate the use of green indocyanine as a marker for preoperative endoscopic tattooing and for lymph nodes mapping. The study selection was conducted using the PubMed database from January 1989 to July 2022.
    Results: We identified 25 eligible studies. 13 based on fluorescent tumor localization in laparoscopic colorectal surgery using ICG while 12 of them reported the lymphatic road mapping and sentinel node identification by ICG using a near-infrared camera system. One study analyzed both topics.
    Conclusions: In laparoscopic colorectal cancer surgery indocyanine green can be used to localize fluorescent tumors and mapping fluorescence lymph node. The use of ICG appears to be a valid and safe technique that helps the surgeon to achieve a better oncological radicality. However, the protocols need to be clarified by further studies.
    MeSH term(s) Humans ; Indocyanine Green ; Tattooing ; Coloring Agents ; Lymph Nodes/pathology ; Laparoscopy/methods ; Colonoscopy ; Colorectal Neoplasms/diagnostic imaging ; Colorectal Neoplasms/surgery ; Colorectal Neoplasms/pathology ; Sentinel Lymph Node Biopsy/methods
    Chemical Substances Indocyanine Green (IX6J1063HV) ; Coloring Agents
    Language English
    Publishing date 2023-11-03
    Publishing country United States
    Document type Systematic Review ; Journal Article ; Review
    ZDB-ID 2182571-3
    ISSN 1553-3514 ; 1553-3506
    ISSN (online) 1553-3514
    ISSN 1553-3506
    DOI 10.1177/15533506231209127
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  5. Article ; Online: Perirectal hematoma after stapled surgery for hemorrhoidal prolapse and obstructed defecation syndrome: case series management to avoid panic-guided treatment.

    Mascagni, Domenico / Eberspacher, Chiara / Naldini, Gabriele / Arcieri, Francesco Leone / Mascagni, Pietro / Cirocchi, Roberto / Popivanov, Georgi / Sileri, Pierpaolo / Arcieri, Stefano

    Updates in surgery

    2023  Volume 75, Issue 3, Page(s) 627–634

    Abstract: Perirectal hematoma (PH) is one of the most feared complications of stapling procedures. Literature reviews have reported only a few works on PH, most of them describing isolated treatment approaches and severe outcomes. The aim of this study was to ... ...

    Abstract Perirectal hematoma (PH) is one of the most feared complications of stapling procedures. Literature reviews have reported only a few works on PH, most of them describing isolated treatment approaches and severe outcomes. The aim of this study was to analyze a homogenous case series of PH and to define a treatment algorithm for huge postoperative PHs. A retrospective analysis of a prospective database of three high-volume proctology units was performed between 2008 and 2018, and all PH cases were analyzed. In all, 3058 patients underwent stapling procedures for hemorrhoidal disease or obstructed defecation syndrome with internal prolapse. Among these, 14 (0.46%) large PH cases were reported, and 12 of these hematomas were stable and treated conservatively (antibiotics and CT/laboratory test monitoring); most of them were resolved with spontaneous drainage. Two patients with progressive PH (signs of active bleeding and peritonism) were submitted to CT and arteriography to evaluate the source of bleeding, which was subsequently closed by embolization. This approach helped ensure that no patients with PH were referred for major abdominal surgery. Most PH cases are stable and treatable with a conservative approach, evolving with self-drainage. Progressive hematomas are rare and should undergo angiography with embolization to minimize the possibility of major surgery and severe complications.
    MeSH term(s) Humans ; Hemorrhoids/surgery ; Defecation ; Retrospective Studies ; Surgical Stapling/adverse effects ; Surgical Stapling/methods ; Prolapse ; Hematoma/etiology ; Hematoma/therapy ; Treatment Outcome ; Postoperative Complications/therapy ; Postoperative Complications/surgery
    Language English
    Publishing date 2023-03-10
    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/s13304-023-01490-y
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  6. Article ; Online: Sizzling Fat-Curative Endoscopic Resection of a Giant Lipoma Causing Colo-Colic Intussusception.

    Eberspacher, Chiara / Arcieri, Stefano / Lauro, Augusto / Palma, Rossella / Coletta, Enrico / Arcieri, Francesco Leone / Mascagni, Domenico / Pontone, Stefano

    Digestive diseases and sciences

    2023  Volume 68, Issue 11, Page(s) 4123–4126

    Abstract: Giant colonic lipomas, tumors that infrequently occur in the gastrointestinal tract, can manifest as bleeding, abdominal pain and, in few cases, obstruction with intussusception. Surgery is usually the treatment of choice. We report the case of a 78 ... ...

    Abstract Giant colonic lipomas, tumors that infrequently occur in the gastrointestinal tract, can manifest as bleeding, abdominal pain and, in few cases, obstruction with intussusception. Surgery is usually the treatment of choice. We report the case of a 78 years-old woman with abdominal pain, constipation, and bleeding due to a giant lipoma of the sigmoid colon causing intussusception. After an initial diagnostic colonoscopy, the patient underwent an endoscopic mucosal resection (EMR) without complications. Even if surgery is traditionally the primary therapeutic approach for giant colonic lipomas, selected cases can be successfully treated with EMR.
    Language English
    Publishing date 2023-09-21
    Publishing country United States
    Document type Journal Article
    ZDB-ID 304250-9
    ISSN 1573-2568 ; 0163-2116
    ISSN (online) 1573-2568
    ISSN 0163-2116
    DOI 10.1007/s10620-023-08087-w
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  7. Article ; Online: Collagen treatment of complex anorectal fistula

    Maternini Matteo / Guttadauro Angelo / Avella Pasquale / Buondonno Antonio / Mascagni Domenico / Milito Giovanni / Stuto Angelo / Renzi Adolfo / Rennis Maria / Bottini Corrado / Quarto Gennaro / Nudo Raffaele / Del Re Luca / Amato Bruno / Gabrielli Francesco

    Open Medicine, Vol 18, Iss 1, Pp 501-

    3 years follow-up

    2023  Volume 6

    Abstract: Fistula in ano is a common anorectal disease in adults. Currently, surgery remains the definitive therapeutic approach, but in some cases, it can lead to serious complications as faecal or gas incontinence. Therefore, sphincter sparing treatments should ... ...

    Abstract Fistula in ano is a common anorectal disease in adults. Currently, surgery remains the definitive therapeutic approach, but in some cases, it can lead to serious complications as faecal or gas incontinence. Therefore, sphincter sparing treatments should be considered for complex fistulas. One of the sphincteric preserving treatment is the filling with a dermal extract commonly called “collagen glue” as Salvecoll-E® gel. This is a multicentric, prospective, observational study on the use of Salvecoll-E® gel in treatment of complex anal fistulas. We treated 70 patients from May 2016 to May 2017. In the first phase, we debrided the fistula tract using a loose seton kept for 4–6 weeks. In the second phase, the seton was removed and the fistula tract was filled with Salvecoll-E® gel. In this article, we report results at 36 months of follow-up. Fifty patients (71.4%) had completely healed fistula within 36 months of follow-up. Twenty-eight patients (28.2%) had recurrences. Among these failures, 65% were within 6 months. All low transphincteric fistulas healed. Recurrences occurred only in median and high transphincteric fistulas. No patient had a worsening of continence status measured with Cleveland Clinic Florida Incontinence Severity score. Salvecoll-E® gel is a recent finding among sphincter-sparing treatments. In this study, we demonstrate that it is a safe option in the treatment of complex fistulas. Final results are satisfactory and in line with the best results published in literature among mini-invasive treatments.
    Keywords complex anal fistula ; salvecoll ; permacol ; sphincter-sparing treatment ; non-cutting technique ; mini-invasive treatment ; Medicine ; R
    Subject code 616
    Language English
    Publishing date 2023-07-01T00:00:00Z
    Publisher De Gruyter
    Document type Article ; Online
    Database BASE - Bielefeld Academic Search Engine (life sciences selection)

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  8. Article: Self-Mechanical Anal Dilatation: A Simple Trick to Minimize Postoperative Pain and Stenosis Following Hemorrhoidectomy With Radiofrequency.

    Eberspacher, Chiara / Mascagni, Pietro / Zeri, Kenneth Paul / Fralleone, Lisa / Naldini, Gabriele / Mascagni, Domenico

    Frontiers in surgery

    2021  Volume 8, Page(s) 711958

    Abstract: Aim: ...

    Abstract Aim:
    Language English
    Publishing date 2021-08-30
    Publishing country Switzerland
    Document type Journal Article
    ZDB-ID 2773823-1
    ISSN 2296-875X
    ISSN 2296-875X
    DOI 10.3389/fsurg.2021.711958
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  9. Article: Mesenchymal Stem Cells for Cryptoglandular Anal Fistula: Current State of Art.

    Eberspacher, Chiara / Mascagni, Domenico / Ferent, Iulia Catalina / Coletta, Enrico / Palma, Rossella / Panetta, Cristina / Esposito, Anna / Arcieri, Stefano / Pontone, Stefano

    Frontiers in surgery

    2022  Volume 9, Page(s) 815504

    Abstract: Anal fistula is a common disease that needs surgical treatment to be resolved. Despite a variety of surgical options, the major problem is still to cure complex fistulas without any recurrence in the long-term follow-up but, at the same time, to avoid an ...

    Abstract Anal fistula is a common disease that needs surgical treatment to be resolved. Despite a variety of surgical options, the major problem is still to cure complex fistulas without any recurrence in the long-term follow-up but, at the same time, to avoid an impairment of continence. In recent years, one solution has been the application of mesenchymal stem cells derived from adipose tissue, especially in association with other treatments, such as the use of fibrin glue or the previous application of a seton. Their initial use in fistulas associated with Crohn's disease has shown encouraging results. In this non-systematic review our aim is to analyze the use in cryptoglandular fistulas: the rate of healing is not so high, and the number of studies is limited. Therefore, further randomized controlled trials are needed to establish their efficacy in the case of complex cryptoglandular anal fistulas and their possible complications.
    Language English
    Publishing date 2022-02-16
    Publishing country Switzerland
    Document type Journal Article ; Review
    ZDB-ID 2773823-1
    ISSN 2296-875X
    ISSN 2296-875X
    DOI 10.3389/fsurg.2022.815504
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  10. Article ; Online: Pesky Pesce: A Forgettable Fish Dinner with a Late Surprise, a Perianal Abscess.

    Mascagni, Domenico / Lauro, Augusto / Arcieri, Stefano / Coletta, Enrico / Arcieri, Francesco Leone / Tarroni, Danilo / Eberspacher, Chiara / Felli, Emanuele

    Digestive diseases and sciences

    2022  Volume 67, Issue 9, Page(s) 4369–4372

    Abstract: Clinical presentation after ingestion of foreign body is a common finding in surgical practice. Perianal sepsis due to a foreign body is, usually, secondary to introduction via the trans-anal route. The case here reported is extremely rare since an ... ...

    Abstract Clinical presentation after ingestion of foreign body is a common finding in surgical practice. Perianal sepsis due to a foreign body is, usually, secondary to introduction via the trans-anal route. The case here reported is extremely rare since an ingested fishbone passed asymptomatically through most of the gastrointestinal tract, with resultant late-onset ischiorectal abscess. Moreover, clinical evidence of the perianal abscess manifested one month after the fishbone had been ingested. The final localization of the fishbone-lying anterior to the sacrum-complicated the preoperative and intraoperative detection of the ingested foreign body.
    MeSH term(s) Abscess/complications ; Abscess/etiology ; Animals ; Anus Diseases/etiology ; Anus Diseases/surgery ; Fishes ; Foreign Bodies/complications ; Foreign Bodies/diagnostic imaging ; Foreign Bodies/surgery ; Meals
    Language English
    Publishing date 2022-07-20
    Publishing country United States
    Document type Journal Article
    ZDB-ID 304250-9
    ISSN 1573-2568 ; 0163-2116
    ISSN (online) 1573-2568
    ISSN 0163-2116
    DOI 10.1007/s10620-022-07625-2
    Database MEDical Literature Analysis and Retrieval System OnLINE

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