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Article: COVID-free surgical pathways for treating patients with acute calculous cholecystitis: a retrospective comparative study.

Giacopelli, Pietro / Cristaudi, Alessandra / Majno, Pietro / Roesel, Raffaello / Iaquinandi, Fabiano / Mongelli, Francesco

Frontiers in surgery

2024 Volume 11, Page(s) 1393948

Abstract: Introduction: During the Sars-Cov-2 crisis, some of the resources committed to emergency surgery services were transiently reallocated to the care of patients with severe COVID-19, preserving immediate treatment of mostly non-deferrable conditions. ... ...

Abstract	Introduction: During the Sars-Cov-2 crisis, some of the resources committed to emergency surgery services were transiently reallocated to the care of patients with severe COVID-19, preserving immediate treatment of mostly non-deferrable conditions. Moreover, the fear of contracting infections or hindering the treatment of critical COVID-19 patients has caused many individuals to defer seeking emergency care. This situation has then possibly modified the standard of care of some common surgical conditions and the relative outcomes. Our aims was to highlight any difference in surgical outcomes in patients treated for acute cholecystitis before and during the COVID-19 outbreak. Method: This is a retrospective study on a prospectively collected database that included all consecutive patients treated for acute cholecystitis from March 2019 to February 2021 at the Lugano Regional Hospital, a COVID-free hospital for general surgery patients. Patients were divided into pre-and post-COVID-19 outbreak groups. We collected thorough clinical characteristics and intra-and postoperative outcomes. Results: We included 124 patients, of which 60 and 64 were operated on before and after the COVID-19 outbreak respectively. The two groups resulted similar in terms of patients' clinical characteristics (age, gender, body mass index, ASA score, and comorbidities). Patients in the post-outbreak period were admitted to the hospital 0.7 days later than patients in the pre-outbreak period (3.8 ± 6.0 days vs. 3.1 ± 4.1 days, Discussion: Despite more frequent antibiotic therapy that suggests eventually worse inflammatory local status, our results showed similar outcomes for patients treated for acute cholecystitis before and during the COVID-19 pandemic. The local COVID management, reallocating resources, and keeping COVID-free hospitals was key to offering patients a high standard of treatment.
Language	English
Publishing date	2024-04-08
Publishing country	Switzerland
Document type	Journal Article
ZDB-ID	2773823-1
ISSN	2296-875X
ISSN	2296-875X
DOI	10.3389/fsurg.2024.1393948
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Article: Climate change and central banks: what role for monetary policy?

Boneva, Lena / Ferrucci, Gianluigi / Mongelli, Francesco Paolo

Climate policy. 2022 July 03, v. 22, no. 6

2022

Abstract: Climate change has profound effects not only on societies and economies, but also for the ability of central banks to deliver price stability in the future. Among others, climate change impacts the monetary transmission mechanism, the policy space ... ...

Abstract	Climate change has profound effects not only on societies and economies, but also for the ability of central banks to deliver price stability in the future. Among others, climate change impacts the monetary transmission mechanism, the policy space available to central banks, and has implications for the design of the monetary policy framework. Thus, taking no action is not a viable option, even for central banks without an explicit sustainability mandate. This article establishes a framework for the integration of climate change objectives into monetary policy in the context of the existing central bank mandates. Currently, only in a few cases do such mandates refer explicitly to sustainable growth and development as a policy objective for the central bank. The article discusses several possible ways central banks can respond to climate change, ranging from protective actions to more proactive measures aimed at mitigating climate change by supporting green finance and the transition to a low carbon economy. It also focuses on understanding the constraints and opportunities for action in this arena. Key policy insights Increasingly, central banks are being called upon to support an orderly transition to a low-carbon economy, not only in their financial stability capacity, but also with monetary policy measures. Independently of their specific mandate, central banks should consider protective and awareness raising actions, to ensure resilience vis-à-vis emerging climate-related risks and to safeguard the continued smooth conduct of monetary policy. Subject to their mandates, central banks should also consider designing monetary operations with green features to proactively support the environmental goals of their respective government. While proactive measures have the potential to be more impactful, they are also more controversial unless the central bank has a clear mandate to act on climate.
Keywords	carbon ; climate ; climate change ; environmental policy ; finance ; monetary policy ; prices ; sustainable development
Language	English
Dates of publication	2022-0703
Size	p. 770-787.
Publishing place	Taylor & Francis
Document type	Article
ZDB-ID	2051510-8
ISSN	1752-7457 ; 1469-3062
ISSN (online)	1752-7457
ISSN	1469-3062
DOI	10.1080/14693062.2022.2070119
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Article ; Online: Switching from robotic-assisted extended transabdominal preperitoneal (eTAPP) to totally extraperitoneal (eTEP) hernia repair for umbilical and epigastric hernias.

Pini, Ramon / Mongelli, Francesco / Iaquinandi, Fabiano / Gaffuri, Paolo / Previsdomini, Marco / Cianfarani, Agnese / La Regina, Davide

Scientific reports

2024 Volume 14, Issue 1, Page(s) 1800

Abstract: Our study aimed to assess the safety and effectiveness of the robotic-assisted extended totally extraperitoneal (eTEP) repair compared to transabdominal preperitoneal (eTAPP) repair with a suprapubic trocar insertion to treat umbilical and epigastric ... ...

Abstract	Our study aimed to assess the safety and effectiveness of the robotic-assisted extended totally extraperitoneal (eTEP) repair compared to transabdominal preperitoneal (eTAPP) repair with a suprapubic trocar insertion to treat umbilical and epigastric hernias. On a prospectively maintained database, we identified patients who underwent either eTEP or eTAPP for treating umbilical and epigastric hernias. During the study period, 53 patients were included, 32 in the eTEP group and 21 in the eTAPP group. The mean age was 59.0 ± 13.9 years, 45 patients (84.9%) were male, and the mean BMI was 28.0 ± 5.9 kg/m
MeSH term(s)	Humans ; Male ; Middle Aged ; Aged ; Female ; Herniorrhaphy/adverse effects ; Robotic Surgical Procedures/adverse effects ; Laparoscopy ; Hernia, Abdominal/surgery ; Hernia, Umbilical/surgery ; Retrospective Studies
Language	English
Publishing date	2024-01-20
Publishing country	England
Document type	Journal Article
ZDB-ID	2615211-3
ISSN	2045-2322 ; 2045-2322
ISSN (online)	2045-2322
ISSN	2045-2322
DOI	10.1038/s41598-024-52165-6
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Article ; Online: Laparoscopic vs. ultrasound-guided transversus abdominis plane (TAP) block in colorectal surgery: a systematic review and meta-analysis of randomized trials.

Iaquinandi, Fabiano / Mongelli, Francesco / Christoforidis, Dimitri / Cianfarani, Agnese / Pini, Ramon / Saporito, Andrea / Popeskou, Sotirios Georgios / La Regina, Davide

Surgical endoscopy

2024 Volume 38, Issue 3, Page(s) 1119–1130

Abstract: Background: The transversus abdominis plane block (TAPB) is effective for postoperative pain management in patients undergoing colorectal surgery. However, evidence regarding the optimal delivery method, either laparoscopic (L-TAPB) or ultrasound-guided ...

Abstract	Background: The transversus abdominis plane block (TAPB) is effective for postoperative pain management in patients undergoing colorectal surgery. However, evidence regarding the optimal delivery method, either laparoscopic (L-TAPB) or ultrasound-guided (U-TAPB) is lacking. Our study aimed to compare the effectiveness of these delivery methods. Methods: We carried out a literature search of PubMed, Cochrane Library, Web of Science, and Google Scholar databases to include randomized studies comparing patients receiving either L-TAPB or U-TAPB during minimally invasive colorectal surgery. The primary endpoint was opioid consumption in the first 24 h after surgery. Risk of bias was assessed with the RoB-2 tool. Effect size was estimated for each study with 95% confidence interval and overall effect measure was estimated with a random effect model. Results: The literature search revealed 294 articles, of which four randomized trials were eligible. A total of 359 patients were included, 176 received a L-TAPB and 183 received a U-TAPB. We established the non-inferiority of L-TAPB, as the absolute difference of - 2.6 morphine-mg (95%CI - 8.3 to 3.0) was below the pooled non-inferiority threshold of 8.1 morphine-mg (low certainty level). No difference in opioid consumption was noted at 2, 6, 12, and 48 h (low to very low certainty level). Postoperative pain, nausea and vomiting were similar between groups at different timepoints (low to very low certainty level). No TAPB-related complications were recorded. Finally, the length of hospital stay was similar between groups. Conclusion: For postoperative multimodal analgesia both L-TAPB and U-TAPB may result in little to no difference in outcome in patients undergoing colorectal surgery. Registration Prospero CRD42023421141.
MeSH term(s)	Humans ; Analgesics, Opioid/therapeutic use ; Anesthetics, Local ; Colorectal Surgery ; Abdominal Muscles/surgery ; Randomized Controlled Trials as Topic ; Laparoscopy/methods ; Pain, Postoperative/etiology ; Pain, Postoperative/prevention & control ; Pain, Postoperative/surgery ; Morphine ; Ultrasonography, Interventional/adverse effects ; Benzamidines
Chemical Substances	Analgesics, Opioid ; Anesthetics, Local ; 1,3-bis(4-amidinophenoxy)-2-(4-amidinophenoxymethyl)ethylpropane (115044-37-6) ; Morphine (76I7G6D29C) ; Benzamidines
Language	English
Publishing date	2024-01-22
Publishing country	Germany
Document type	Meta-Analysis ; Systematic Review ; Journal Article ; Review
ZDB-ID	639039-0
ISSN	1432-2218 ; 0930-2794
ISSN (online)	1432-2218
ISSN	0930-2794
DOI	10.1007/s00464-023-10658-x
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Article ; Online: Safety and feasibility of emergency robot-assisted transabdominal preperitoneal repair for the treatment of incarcerated inguinal hernia: A retrospective study.

Murgante Testa, Nicole / Mongelli, Francesco / Sabbatini, Flaminia / Iaquinandi, Fabiano / Prouse, Giorgio / Pini, Ramon / La Regina, Davide

World journal of surgery

2024 Volume 48, Issue 3, Page(s) 622–628

Abstract: Background: Few studies assessed robotic in emergency setting and no solid evidence was demonstrated. The aim of this study was to evaluate the feasibility and safety of robot-assisted transabdominal preperitoneal (R-TAPP) repair for the treatment of ... ...

Abstract	Background: Few studies assessed robotic in emergency setting and no solid evidence was demonstrated. The aim of this study was to evaluate the feasibility and safety of robot-assisted transabdominal preperitoneal (R-TAPP) repair for the treatment of incarcerated inguinal hernia. Methods: We retrospectively searched from a prospectively maintained database patients who underwent R-TAPP or open surgery for incarcerated inguinal hernias from January 2018 to March 2023. The primary endpoint was to assess safety and feasibility of the R-TAPP compared to the standard approach. For eligible patients, data was extracted and analyzed using a propensity score-matching (PSM). Results: Thirty-four patients were retrieved from our database, 15 underwent R-TAPP, while 19 underwent open surgery. Mean age was 73.1 ± 14.6 years, 30 patients (88.2%) were male and mean BMI was 23.5 ± 3.2 kg/m Conclusions: Despite its limitations, our study appears to endorse the safety and feasibility of the robotic-assisted treatment for incarcerated inguinal hernia. This approach yielded comparable results to open surgery, albeit in a limited number of patients, suggesting it might be a viable alternative.
MeSH term(s)	Humans ; Male ; Middle Aged ; Aged ; Aged, 80 and over ; Female ; Robotics ; Retrospective Studies ; Hernia, Inguinal/surgery ; Feasibility Studies ; Laparoscopy/methods ; Herniorrhaphy/methods ; Treatment Outcome ; Surgical Mesh
Language	English
Publishing date	2024-01-12
Publishing country	United States
Document type	Journal Article
ZDB-ID	224043-9
ISSN	1432-2323 ; 0364-2313
ISSN (online)	1432-2323
ISSN	0364-2313
DOI	10.1002/wjs.12063
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Zs.A 1336: Show issues

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Article: Intestinal ischemia due to internal hernia beneath the right external iliac artery after laparoscopic hysterectomy and lymphadenectomy: A case report.

Zanca, Kostas Mario / Marcantonio, Maria / Pini, Ramon / Mongelli, Francesco / La Regina, Davide / Cianfarani, Agnese

International journal of surgery case reports

2023 Volume 106, Page(s) 108187

Abstract: Introduction and importance: The occurrence of an internal hernia beneath the external iliac artery is rare but may occur after pelvic lymphadenectomy. The challenging treatment of this rare condition should be tailored to the patient's clinical and ... ...

Abstract	Introduction and importance: The occurrence of an internal hernia beneath the external iliac artery is rare but may occur after pelvic lymphadenectomy. The challenging treatment of this rare condition should be tailored to the patient's clinical and anatomical characteristics. Case presentation: We present the case of a 77-year-old woman with previous history of laparoscopic hysterectomy and adnexectomy with extended pelvic lymphadenectomy for endometrial cancer. The patient was admitted in the emergency department because of severe abdominal pain and a computed tomography scan showed signs of internal hernia. The laparoscopy confirmed such a finding below the right external iliac artery. A small bowel resection was deemed necessary and the defect was closed with an absorbable mesh. The post-operative course was uneventful. Clinical discussion: Internal hernia beneath the iliac artery is a rare condition after pelvic lymphadenectomy. The first challenge is the hernia reduction, which can be safely carried out laparoscopically. Secondly, a patch or a mesh should be used to close the defect if a primary peritoneal suture is not feasible, but it requires to be fixed in the small pelvis. The use of absorbable material is a valuable option and should leave a fibrotic area that covers the hernia defect. Conclusion: A strangulated internal hernia beneath the external iliac artery is a possible complication after extensive pelvic lymph node dissection. The laparoscopic approach to treat bowel ischemia and to close the peritoneal defect with a mesh, should reduce as much as possible the risk of internal hernia recurrence.
Language	English
Publishing date	2023-04-12
Publishing country	Netherlands
Document type	Case Reports
ISSN	2210-2612
ISSN	2210-2612
DOI	10.1016/j.ijscr.2023.108187
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Article ; Online: Laparoscopic-Assisted Transversus Abdominis Plane (TAP) Block Versus Port-Site Infiltration with Local Anesthetics in Bariatric Surgery: a Double-Blind Randomized Controlled Trial.

Mongelli, Francesco / Marengo, Michele / Bertoni, Maria Vittoria / Volontè, Francesco / Ledingham, Nicola Susan / Garofalo, Fabio

Obesity surgery

2023 Volume 33, Issue 11, Page(s) 3383–3390

Abstract: Background: The transversus abdominis plane (TAP) block has shown great potential usefulness in the management of postoperative pain; however, there is lacking evidence regarding its use in bariatric surgery. This randomized double-blind trial was aimed ...

Abstract	Background: The transversus abdominis plane (TAP) block has shown great potential usefulness in the management of postoperative pain; however, there is lacking evidence regarding its use in bariatric surgery. This randomized double-blind trial was aimed at comparing the effectiveness of the TAP block and port-site infiltration (PSI) in patients undergoing bariatric surgery. Methods: We included patients ≥ 18 years old undergoing bariatric surgery. From July 2020 to July 2021, all eligible patients were randomized to receive either laparoscopic-assisted TAP block or PSI. Demographic and clinical data were collected and analyzed. Results: During the study period, we included 113 patients. Fifty-one were allocated to the TAP block group and 62 to the PSI group. The mean age was 47.9 ± 11.2 years, 88 (77.9%) patients were female, and mean BMI was 40.5 ± 5.9 kg/m Conclusions: Patients undergoing bariatric surgery and receiving either the TAP block or the PSI had similar postoperative pain, nausea, length of stay, and satisfaction. As PSI is technically easier and more reproducible, it might be the first choice for postoperative multimodal analgesia in bariatric surgery.
MeSH term(s)	Humans ; Female ; Adult ; Middle Aged ; Adolescent ; Male ; Anesthetics, Local ; Obesity, Morbid/surgery ; Laparoscopy ; Pain, Postoperative/drug therapy ; Double-Blind Method ; Abdominal Muscles ; Bariatric Surgery ; Analgesics, Opioid
Chemical Substances	Anesthetics, Local ; Analgesics, Opioid
Language	English
Publishing date	2023-09-23
Publishing country	United States
Document type	Randomized Controlled Trial ; Journal Article
ZDB-ID	1070827-3
ISSN	1708-0428 ; 0960-8923
ISSN (online)	1708-0428
ISSN	0960-8923
DOI	10.1007/s11695-023-06825-7
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Zs.A 3381: Show issues

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Article ; Online: Long-term outcomes in elderly patients after elective surgery for colorectal cancer within an ERAS protocol: a retrospective analysis.

Navarra, Andrea / Porcellini, Iride / Mongelli, Francesco / Popeskou, Sotirios Georgios / Grass, Fabian / Christoforidis, Dimitri

Langenbeck's archives of surgery

2023 Volume 408, Issue 1, Page(s) 438

Abstract: Purpose: The number of elderly patients with a diagnosis of colorectal cancer (CRC) is increasing. Considering short life expectancy and multiple comorbidities, surgery may not always be the best treatment option.: Methods: We included all ... ...

Abstract	Purpose: The number of elderly patients with a diagnosis of colorectal cancer (CRC) is increasing. Considering short life expectancy and multiple comorbidities, surgery may not always be the best treatment option. Methods: We included all consecutive patients aged 80 years and older who underwent elective resection for CRC following Enhanced Recovery after Surgery (ERAS) protocol between January 2011 and May 2021. The primary endpoint was overall survival, secondary endpoints were 30-day morbidity, and the rate of return to pre-operative living conditions 3 months after surgery. Results: Ninety-four patients were included. Mean age was 84.6 ± 3.6 years, 49 patients (52%) were female. Most patients (77.6%) were ASA score ≥ 3. Laparoscopic resections were performed in 85 patients (90.4%), involving 69 (73.4%) colonic and 25 (26.6%) rectal resections. A stoma was constructed in 22 patients (23%), and reversed in 12 (54.5%). Twenty-two patients (23.4%) experienced a Clavien-Dindo ≥ 3 complication, and 2 patients (2.1%) died. The median length of hospital stay was 8 (interquartiles: 6-15) days. Sixty-six patients (70.2%) were discharged home directly and 26 (27.7%) to rehabilitation or postacute care institutes. At three months after surgery, eighty-two patients (96.5%) returned to their pre-operative living conditions directly or after short-term rehabilitation. Mean follow-up was 53 ± 33 months, estimated 5-year overall survival was 60.3% (95%CI 49.5-71.1%), and disease-free survival was 86.3% (95%CI 78.1-94.4%). Conclusions: Our study suggests that elderly patients undergoing elective surgery have a high potential to return to preoperative living conditions and good overall- and disease-free survivals, despite significant postoperative morbidity.
MeSH term(s)	Aged ; Humans ; Female ; Aged, 80 and over ; Male ; Enhanced Recovery After Surgery ; Retrospective Studies ; Postoperative Complications/etiology ; Laparoscopy/methods ; Length of Stay ; Colorectal Neoplasms/surgery ; Colorectal Neoplasms/complications
Language	English
Publishing date	2023-11-17
Publishing country	Germany
Document type	Journal Article
ZDB-ID	1423681-3
ISSN	1435-2451 ; 1435-2443
ISSN (online)	1435-2451
ISSN	1435-2443
DOI	10.1007/s00423-023-03179-7
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Uk I Zs.10: Show issues

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Article ; Online: Assessment of gastric pouch blood supply with indocyanine green fluorescence in conversional and revisional bariatric surgery: a prospective comparative study.

Mongelli, Francesco / Garofalo, Fabio / Giacopelli, Pietro / Munini, Martino / Volontè, Francesco / Marengo, Michele

Scientific reports

2023 Volume 13, Issue 1, Page(s) 9152

Abstract: Our study aimed to evaluate the usefulness of indocyanine green (ICG) angiography during conversional or revisional bariatric surgery. We prospectively enrolled all patients scheduled for reoperative bariatric surgery with gastric pouch resizing and ICG ... ...

Abstract	Our study aimed to evaluate the usefulness of indocyanine green (ICG) angiography during conversional or revisional bariatric surgery. We prospectively enrolled all patients scheduled for reoperative bariatric surgery with gastric pouch resizing and ICG assessment and we compared them with a retrospective series of similar patients who did not receive ICG. The primary outcome was the rate of intraoperative change in the surgical strategy due to the ICG test. We included 32 prospective patients receiving intraoperatively an ICG perfusion test and 48 propensity score-matched controls. The mean age was 50.7 ± 9.7 years, 67 (83.7%) patients were female, and the mean BMI was 36.8 ± 5.3 kg/m
MeSH term(s)	Indocyanine Green/chemistry ; Indocyanine Green/metabolism ; Humans ; Male ; Female ; Middle Aged ; Adult ; Bariatric Surgery/methods ; Bariatric Surgery/standards ; Fluorescent Dyes/metabolism ; Fluorescein Angiography/standards ; Reoperation/methods ; Reoperation/standards ; Intraoperative Period
Chemical Substances	Indocyanine Green (IX6J1063HV) ; Fluorescent Dyes
Language	English
Publishing date	2023-06-06
Publishing country	England
Document type	Journal Article
ZDB-ID	2615211-3
ISSN	2045-2322 ; 2045-2322
ISSN (online)	2045-2322
ISSN	2045-2322
DOI	10.1038/s41598-023-36442-4
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Article: Risk aversion and bank loan pricing

Camba-Mendez, Gonzalo / Mongelli, Francesco Paolo

Economics letters. 2021 Mar., v. 200

2021

Abstract: How much of the heterogeneity in bank loan pricing is explained by disparities in banks’ attitude towards risk? The answer to this question is not simple because there are only very weak proxies for gauging the degree of a bank’s risk aversion. We handle ...

Abstract	How much of the heterogeneity in bank loan pricing is explained by disparities in banks’ attitude towards risk? The answer to this question is not simple because there are only very weak proxies for gauging the degree of a bank’s risk aversion. We handle this constraint by means of a novel econometric approach that allows us to disentangle the amount of risk faced by banks and the price they charge for holding that risk. Some of our results are aligned with previous studies and confirm that disparities in market power, banks’ funding costs, and banks’ funding risks are reflected in bank lending rates. However, our new modelling framework reveals that the heterogeneity in bank lending rates is also a reflection of the non-negligible disparities in banks’ risk aversion.
Keywords	econometrics ; funding ; loans ; market power ; models ; prices ; risk
Language	English
Dates of publication	2021-03
Publishing place	Elsevier B.V.
Document type	Article
Note	NAL-light
ISSN	0165-1765
DOI	10.1016/j.econlet.2020.109723
Database	NAL-Catalogue (AGRICOLA)

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