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Article ; Online: Cholecystocolonic fistula presenting with intestinal obstruction.

Pinotti, Enrico / Montuori, Mauro / Ciocca Vasino, Michele

Digestive and liver disease : official journal of the Italian Society of Gastroenterology and the Italian Association for the Study of the Liver

2020 Volume 52, Issue 4, Page(s) 462

MeSH term(s)	Abdominal Pain/etiology ; Aged, 80 and over ; Cholecystolithiasis/complications ; Cholecystolithiasis/diagnostic imaging ; Cholecystolithiasis/surgery ; Female ; Gallstones/complications ; Gallstones/diagnostic imaging ; Gallstones/surgery ; Humans ; Intestinal Fistula/diagnostic imaging ; Intestinal Fistula/etiology ; Intestinal Fistula/surgery ; Intestinal Obstruction/diagnostic imaging ; Intestinal Obstruction/etiology ; Laparotomy/methods ; Risk Assessment ; Tomography, X-Ray Computed ; Treatment Outcome
Language	English
Publishing date	2020-02-26
Publishing country	Netherlands
Document type	Case Reports ; Journal Article
ZDB-ID	1459373-7
ISSN	1878-3562 ; 1125-8055
ISSN (online)	1878-3562
ISSN	1125-8055
DOI	10.1016/j.dld.2020.01.013
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Article ; Online: Sarcopenia: What a Surgeon Should Know.

Pinotti, Enrico / Montuori, Mauro / Borrelli, Vincenzo / Giuffrè, Monica / Angrisani, Luigi

Obesity surgery

2020 Volume 30, Issue 5, Page(s) 2015–2020

Abstract: Sarcopenia is an increasingly frequent syndrome characterized by generalized and progressive loss of muscle mass, reduction in muscle strength, and resultant functional impairment. This condition is associated with increased risk of falls and fractures, ... ...

Abstract	Sarcopenia is an increasingly frequent syndrome characterized by generalized and progressive loss of muscle mass, reduction in muscle strength, and resultant functional impairment. This condition is associated with increased risk of falls and fractures, disability, and increased risk of death. When a sarcopenic patient undergoes major surgery, it has a higher risk of complications and postoperative mortality because of less resistance to surgical stress. It is not easy to recognize a sarcopenic patient preoperatively, but this is essential to evaluate the correct risk to benefit ratio. The role of sarcopenia in surgical patients has been studied for both oncological and non-oncological surgery. For correct surgical planning, data about sarcopenia are essential to design a correct tailored treatment.
MeSH term(s)	Humans ; Muscle, Skeletal ; Obesity/pathology ; Obesity, Morbid/surgery ; Sarcopenia ; Surgeons
Language	English
Publishing date	2020-03-02
Publishing country	United States
Document type	Journal Article ; Review
ZDB-ID	1070827-3
ISSN	1708-0428 ; 0960-8923
ISSN (online)	1708-0428
ISSN	0960-8923
DOI	10.1007/s11695-020-04516-1
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Zs.A 3381: Show issues

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Article ; Online: Uselessness of microbiological samples in acute appendicitis with frank pus: to collect or not to collect?

Montuori, Mauro / Santurro, Letizia / Gianotti, Luca / Fattori, Luca

European journal of trauma and emergency surgery : official publication of the European Trauma Society

2018 Volume 46, Issue 4, Page(s) 835–839

Abstract: Introduction: Current use of antimicrobial therapy is prophylactic, empirical and broad spectrum. But, the age-old practice of obtaining cultures still remain. The aim of this study was to evaluate bacterial etiology and adequacy of antibiotic ... ...

Abstract	Introduction: Current use of antimicrobial therapy is prophylactic, empirical and broad spectrum. But, the age-old practice of obtaining cultures still remain. The aim of this study was to evaluate bacterial etiology and adequacy of antibiotic prophylaxis in patients diagnosed with acute appendicitis to help determine the utility of intraoperative cultures in guiding clinical decision-making. Materials and methods: A retrospective analysis of a prospectively constructed database of all patients who underwent appendectomy from September 2013 to November 2016 was performed. Results: 456 patients underwent surgery for acute appendicitis in our academic hospital. 101 patients (22.1%) had intraoperative swabs taken, and the cultures were positive in 57.4% of patients. These 101 patients comprise our study group. The most commonly recovered species were E. coli, Streptococcus spp., Bacteroides fragilis, Enterococcus faecium, Pseudomonas aeruginosa, Klebsiella pneumoniae, and Proteus. In the comparison between positive and negative swab, there were no differences in terms of surgical site infection, deep infection, and in terms of Clavien-Dindo classification. An appropriate empiric therapy was set in 88.5% and inappropriate in 11.5%. No differences in terms of surgical site infection or in length of stay (p = 0.657) were found, with a median of 7 days in both groups. Conclusion: The etiological agents causing peritonitis due to acute appendicitis are predictable and empiric-targeted antibiotic therapy is effective in a high percentage of patients. The postoperative patient outcome may be dependent on the severity of the appendicitis more than on the results of the swab at the time of surgery. In this study, intraoperative culture was not associated with the choice of antibiotics, incidence of SSI, DPI or the length of stay.
MeSH term(s)	Adolescent ; Adult ; Anti-Bacterial Agents/therapeutic use ; Antibiotic Prophylaxis ; Appendectomy ; Appendicitis/drug therapy ; Appendicitis/microbiology ; Appendicitis/surgery ; Bacterial Infections/drug therapy ; Bacterial Infections/microbiology ; Decision Making ; Female ; Humans ; Male ; Microbial Sensitivity Tests ; Retrospective Studies ; Suppuration/microbiology
Chemical Substances	Anti-Bacterial Agents
Language	English
Publishing date	2018-10-12
Publishing country	Germany
Document type	Journal Article
ZDB-ID	2275480-5
ISSN	1863-9941 ; 1863-9933
ISSN (online)	1863-9941
ISSN	1863-9933
DOI	10.1007/s00068-018-1031-7
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Zs.A 1221: Show issues			Location: Je nach Verfügbarkeit (siehe Angabe bei Bestand) bis Jg. 1994: Bestellungen von Artikeln über das Online-Bestellformular Jg. 1995 - 2021: Lesesall (1.OG) ab Jg. 2022: Lesesaal (EG)
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Article ; Online: Should radical surgery for rectal cancer be offered to elderly population? A propensity-matching analysis on short- and long-term outcomes.

Tamini, Nicolò / Giani, Alessandro / Famularo, Simone / Montuori, Mauro / Giardini, Vittorio / Gianotti, Luca

Updates in surgery

2020 Volume 72, Issue 3, Page(s) 801–809

Abstract: Elderly patients with rectal tumor are often undertreated if compared to younger ones. The reasons for this attitude are not fully clear.The aim of this study was to determine the feasibility of radical treatments for rectal cancer in subjects with an ... ...

Abstract	Elderly patients with rectal tumor are often undertreated if compared to younger ones. The reasons for this attitude are not fully clear.The aim of this study was to determine the feasibility of radical treatments for rectal cancer in subjects with an age ≥ 75 years (group 1) and to compare short- and long-term outcomes of these patients with patients with an age of less that 75 years (group 2). 311 consecutive patients who underwent radical surgery for rectal cancer were evaluated. A propensity-matching analysis on short- and long-term outcomes was conducted to compare older and younger patients. Overall postoperative complication rate was 23.8% (19/80) in the group 2 and 33.8% (27/80) in group 1 (p = 0.162). OS at 1, 3 and 5 years was 96.2%, 88.4% and 75.9% in under 75 and 92.5%, 64.3% and 50.6% in over 75 group, respectively (p = 0.001). However, TSS was considered, no significant difference was found. Major complications were comparable within groups: 10 (12.5%) versus 11 (13.8%) in groups 2 and 1, respectively (p = 0.633). This study suggests that major rectal cancer surgery with curative intent should not be denied to an elderly population on the basis of age alone. Specific oncologic features and comorbidities are better long-term mortality predictors than aging.
MeSH term(s)	Age Factors ; Aged ; Aged, 80 and over ; Comorbidity ; Contraindications, Procedure ; Digestive System Surgical Procedures/adverse effects ; Digestive System Surgical Procedures/methods ; Feasibility Studies ; Female ; Humans ; Male ; Middle Aged ; Postoperative Complications/epidemiology ; Propensity Score ; Rectal Neoplasms/surgery ; Rectum/surgery ; Time Factors ; Treatment Outcome
Language	English
Publishing date	2020-02-08
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/s13304-020-00717-6
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Article ; Online: Surgical treatment of liver metastases from kidney cancer: a systematic review.

Pinotti, Enrico / Montuori, Mauro / Giani, Alessandro / Uggeri, Fabio / Garancini, Mattia / Gianotti, Luca / Romano, Fabrizio

ANZ journal of surgery

2019 Volume 89, Issue 1-2, Page(s) 32–37

Abstract: Background: Liver metastases are present in 20.3% of metastatic kidney cancers. The aim of this literature review was to assess the efficacy of surgical treatment for hepatic metastasis from kidney cancer.: Methods: An extended web search of the ... ...

Abstract	Background: Liver metastases are present in 20.3% of metastatic kidney cancers. The aim of this literature review was to assess the efficacy of surgical treatment for hepatic metastasis from kidney cancer. Methods: An extended web search of the literature was independently performed in March 2018 by two authors according to the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) statement. Results: Through electronic searches, we identified 935 potentially relevant citations. Thirteen articles were finally included in the systematic review. Median survival after resection ranged from 15 to 142 months while the 1-, 3- and 5-year overall survival ranged from 69% to 100%, 26% to 83.3% and 0% to 62%, respectively. Median disease-free survival ranged from 7.2 to 27 months. Conclusion: Surgical treatment of hepatic metastases is performed in approximately 1% of patients with liver metastases and in select patients may be potentially curative. Surgical resection of liver metastases from kidney cancer represents a valid option for selected patients with metastatic renal cancer.
MeSH term(s)	Aged ; Colorectal Neoplasms/surgery ; Disease-Free Survival ; Female ; Hepatectomy/methods ; Hepatectomy/mortality ; Humans ; Kidney Neoplasms/complications ; Kidney Neoplasms/pathology ; Kidney Neoplasms/secondary ; Liver Neoplasms/mortality ; Liver Neoplasms/pathology ; Liver Neoplasms/secondary ; Liver Neoplasms/surgery ; Lymphatic Metastasis/pathology ; Male ; Middle Aged ; Observational Studies as Topic ; Survival Analysis
Language	English
Publishing date	2019-01-26
Publishing country	Australia
Document type	Journal Article ; Meta-Analysis ; Systematic Review
ZDB-ID	2050749-5
ISSN	1445-2197 ; 1445-1433 ; 0004-8682
ISSN (online)	1445-2197
ISSN	1445-1433 ; 0004-8682
DOI	10.1111/ans.15000
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Article ; Online: COVID-19: how the pandemic impacted the emergency department and urgent surgical activity in a medium-size Italian hospital

Pinotti, Enrico / Carissimi, Francesca / Baronio, Gianluca / Montuori, Mauro / Ongaro, Deborah / Vasino, Michele Ciocca

medRxiv

Abstract: Backgrounds: COVID-19 has grown rapidly in Lombardy, particularly in the province of Bergamo. To deal with the pressure the pandemic has exerted on the Italian health system; many hospitals have had to reorganize their medical and surgical activities. ... ...

Abstract	Backgrounds: COVID-19 has grown rapidly in Lombardy, particularly in the province of Bergamo. To deal with the pressure the pandemic has exerted on the Italian health system; many hospitals have had to reorganize their medical and surgical activities. The aim of this study was to evaluate how the pandemic influenced the emergency department and urgent surgical activity in a medium-size hospital in the province of Bergamo. Methods: In this retrospective observational study, we analyzed the number of admissions to the medical and surgical Emergency Room and their severity compared with those in the same period in previous years (2011-2019). Admission in the medical and surgical department and urgent surgical operation was also assessed. Results: From March 7th to April 5th, 2020, we observe a reduction in emergency department access (-53%) when compared with the corresponding period of previous years. The number of medical admissions was similar to the past years (+0.9%), we observed a drastic reduction of surgical patients (-82.5%). We experienced a significant increase in hospitalizations in the medical department (+359%) and a reduction of admission in the surgical department (- 71.2%). Conclusion: SARS-CoV2 disease has spread so suddenly and severely that it has stressed Italian health system, in particular the Lombard one. Our data show the rise of critical medical ER accesses and the significant expansion in hospitalisation in the medical department with the necessary hospital reorganisation to face COVID-19 emergency. We also observed a reduction in both surgical ER accesses and urgent surgical activity.
Keywords	covid19
Language	English
Publishing date	2020-11-20
Publisher	Cold Spring Harbor Laboratory Press
Document type	Article ; Online
DOI	10.1101/2020.11.19.20234856
Database	COVID19

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Article ; Online: Computed tomography in suspected anastomotic leakage after colorectal surgery: evaluating mortality rates after false-negative imaging.

Tamini, Nicolò / Cassini, Diletta / Giani, Alessandro / Angrisani, Marco / Famularo, Simone / Oldani, Massimo / Montuori, Mauro / Baldazzi, Gianandrea / Gianotti, Luca

European journal of trauma and emergency surgery : official publication of the European Trauma Society

2019 Volume 46, Issue 5, Page(s) 1049–1053

Abstract: Purposes: We sought to investigate the accuracy of abdominal CT scanning for anastomotic leakage and the effect of false-negative scans on the delay in therapeutic intervention and clinical outcome.: Method: Data from a prospectively bi- ... ...

Abstract	Purposes: We sought to investigate the accuracy of abdominal CT scanning for anastomotic leakage and the effect of false-negative scans on the delay in therapeutic intervention and clinical outcome. Method: Data from a prospectively bi-institutionally maintained database of all patients who underwent elective colorectal surgery with primary anastomosis for malignant or benign disease between 2010 and 2017 were reviewed. Patients with confirmed anastomotic dehiscence at reintervention who underwent a postoperative CT scan for suspected leakage were identified and radiological reports were retrieved. Results: Seventy-six patients with anastomotic dehiscence were included in the study. American Society of Anesthesiologists score, sex, type of surgical procedure, malignancy, and type of anastomosis do not correlate with postoperative false-negative CT imaging. Postoperative false-negative CT scan, however, led to delayed reintervention (3 vs. 6 h, p = 0.023) and increased mortality (five deaths vs. no deaths, p = 0.043). Free abdominal air (p = 0.001) and extraluminal contrast extravasation (p = 0.001) were found to be predictive of accuracy in anastomotic leakage diagnosis. Conclusion: The suboptimal specificity of a postoperative CT scan in suspected anastomotic leakage after colorectal surgery can delay reintervention and increase mortality.
MeSH term(s)	Aged ; Anastomotic Leak/diagnostic imaging ; Anastomotic Leak/mortality ; Colorectal Surgery ; Contrast Media ; False Negative Reactions ; Female ; Humans ; Male ; Prospective Studies ; Tomography, X-Ray Computed/methods
Chemical Substances	Contrast Media
Language	English
Publishing date	2019-02-08
Publishing country	Germany
Document type	Journal Article ; Multicenter Study
ZDB-ID	2275480-5
ISSN	1863-9941 ; 1863-9933
ISSN (online)	1863-9941
ISSN	1863-9933
DOI	10.1007/s00068-019-01083-8
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Zs.A 1221: Show issues			Location: Je nach Verfügbarkeit (siehe Angabe bei Bestand) bis Jg. 1994: Bestellungen von Artikeln über das Online-Bestellformular Jg. 1995 - 2021: Lesesall (1.OG) ab Jg. 2022: Lesesaal (EG)
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Article ; Online: Integrated Approaches for the Management of Staple Line Leaks following Sleeve Gastrectomy.

Montuori, Mauro / Benavoli, Domenico / D'Ugo, Stefano / Di Benedetto, Luca / Bianciardi, Emanuela / Gaspari, Achille L / Gentileschi, Paolo

Journal of obesity

2017 Volume 2017, Page(s) 4703236

Abstract: ... ...

Abstract	Introduction
MeSH term(s)	Adult ; Female ; Gastrectomy ; Humans ; Italy/epidemiology ; Laparoscopy ; Male ; Middle Aged ; Obesity, Morbid/surgery ; Postoperative Complications/prevention & control ; Reoperation ; Retrospective Studies ; Surgical Stapling/methods ; Surgical Wound Dehiscence/diagnostic imaging ; Surgical Wound Dehiscence/epidemiology ; Surgical Wound Dehiscence/prevention & control
Language	English
Publishing date	2017
Publishing country	United States
Document type	Journal Article
ZDB-ID	2573566-4
ISSN	2090-0716 ; 2090-0708
ISSN (online)	2090-0716
ISSN	2090-0708
DOI	10.1155/2017/4703236
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Article ; Online: Customized bariatric stents for sleeve gastrectomy leak: are they superior to conventional esophageal stents? A systematic review and proportion meta-analysis.

Hamid, Hytham K S / Emile, Sameh H / Saber, Alan A / Dincer, Mürşit / de Moura, Diogo T H / Gilissen, Lennard P L / Almadi, Majid A / Montuori, Mauro / Vix, Michel / Perisse, Luis G S / Quezada, Nicolás / Garofalo, Fabio / Pescarus, Radu

Surgical endoscopy

2020 Volume 35, Issue 3, Page(s) 1025–1038

Abstract: Objective: Recently, there has been a burgeoning interest in the utilization of customized bariatric stents (CBS) for management of sleeve gastrectomy leak (SGL). We aimed to conduct a proportion meta-analysis to evaluate the cumulative efficacy and ... ...

Abstract	Objective: Recently, there has been a burgeoning interest in the utilization of customized bariatric stents (CBS) for management of sleeve gastrectomy leak (SGL). We aimed to conduct a proportion meta-analysis to evaluate the cumulative efficacy and safety of these new stents and to compare them with the conventional esophageal stents (CES). Methods: A systematic literature search of the PubMed, Cochrane Library, Scopus, Web of Science and Google Scholar databases was conducted through May 1, 2020. Primary outcomes were technical and clinical success and post-procedure adverse events of CBS and CES. Secondary outcomes were number of stents and endoscopic sessions per patient, and time to leak closure. A proportion meta-analysis was performed on outcomes using a random-effects model, and the weighted pooled rates (WPRs) or mean difference with 95% confidence interval (CI) were calculated. Results: The WPR with 95% CI of technical success, clinical success, and stent migration for CBS were 99% (93-100%) I Conclusions: In treatment of SGL, there is very low level evidence that CES are superior to CBS in terms of clinical success and migration rate, though may require more stent insertions and endoscopic procedures. The evidence however remains very uncertain. Perhaps relevant to some types of stents, CBS are promising; however design modification is strongly recommended to improve outcomes.
MeSH term(s)	Adult ; Anastomotic Leak/etiology ; Bariatric Surgery/adverse effects ; Endoscopy ; Esophagus/surgery ; Female ; Gastrectomy/adverse effects ; Humans ; Male ; Stents/adverse effects ; Treatment Outcome
Language	English
Publishing date	2020-11-06
Publishing country	Germany
Document type	Journal Article ; Meta-Analysis ; Systematic Review
ZDB-ID	639039-0
ISSN	1432-2218 ; 0930-2794
ISSN (online)	1432-2218
ISSN	0930-2794
DOI	10.1007/s00464-020-08147-6
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Zs.A 2214: Show issues

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Article: Inflammatory fibroid polyp. A case report and review of the literature.

Rossi, Piero / Montuori, Mauro / Balassone, Valerio / Ricciardi, Edoardo / Anemona, Lucia / Manzelli, Antonio / Petrella, Giuseppe

Annali italiani di chirurgia

2012 Volume 83, Issue 4, Page(s) 347–351

Abstract: Introduction: The Inflammatory fibroid polyp (IFP) is a mesenchymal polypoid lesion of the gastrointestinal tract that follows a benign course. Incidence is extremely low: from 0,1% to 2 %. Histologically, it consists of a sub mucous proliferation of ... ...

Abstract	Introduction: The Inflammatory fibroid polyp (IFP) is a mesenchymal polypoid lesion of the gastrointestinal tract that follows a benign course. Incidence is extremely low: from 0,1% to 2 %. Histologically, it consists of a sub mucous proliferation of vascolarized fibromuscolar tissue with a high eosinophils inflammatory infiltration. IFP can arise everywhere in the gastrointestinal tract but is described more frequently in the gastric antrum (70%). Case report: We report a case of a 71-year-old woman presented to our department with a worsening history of lack's appetite, nausea and early satiety. We performed a review of the literature from 1949 to 2011. 196 cases of IFPs were found. Conclusion: Clinical symptoms are heterogeneous and endoscopy's examination revealed only presence of a sub-mucosal lesion, and their biopsies often gave not diagnostic localization. In the differential diagnosis, it's important to discern between eosinophilic gastroenteritis, gastrointestinal stromal tumor, inflammatory pseudotumor, hemangioendothelioma, and hemangiopericytoma. Eco-endoscopic appearance and biopsies associated may provide useful informations, that can steer to the diagnostic suspect of IFP. Despite this is a benign lesion, this one often needs a surgical excision on healthy margin. In literature is also described high local recurrence, specially when incomplete excision proceeded. Keywords: Gastric sub-mucosal tumor, Inflammatory fibroid polyp, Stomach, Vanek's Tumor.
MeSH term(s)	Aged ; Female ; Humans ; Inflammation/complications ; Inflammation/pathology ; Polyps/complications ; Polyps/pathology ; Stomach Neoplasms/complications ; Stomach Neoplasms/pathology
Language	English
Publishing date	2012-07
Publishing country	Italy
Document type	Case Reports ; Journal Article ; Review
ZDB-ID	418927-9
ISSN	2239-253X ; 0003-469X
ISSN (online)	2239-253X
ISSN	0003-469X
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