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Article: Diagnostic Strategies and Algorithms for Investigating Cancer Predisposition Syndromes in Children Presenting with Malignancy.

Rossini, Linda / Durante, Caterina / Bresolin, Silvia / Opocher, Enrico / Marzollo, Antonio / Biffi, Alessandra

2022 Volume 14, Issue 15

Abstract: In the past recent years, the expanding use of next-generation sequencing has led to the discovery of new cancer predisposition syndromes (CPSs), which are now known to be responsible for up to 10% of childhood cancers. As knowledge in the field is in ... ...

Abstract	In the past recent years, the expanding use of next-generation sequencing has led to the discovery of new cancer predisposition syndromes (CPSs), which are now known to be responsible for up to 10% of childhood cancers. As knowledge in the field is in constant evolution, except for a few "classic" CPSs, there is no consensus about when and how to perform germline genetic diagnostic studies in cancer-bearing children. Several clinical screening tools have been proposed to help identify the patients who carry higher risk, with heterogeneous strategies and results. After introducing the main clinical and molecular features of several CPSs predisposing to solid and hematological malignancies, we compare the available clinical evidence on CPS prevalence in pediatric cancer patients and on the most used decision-support tools in identifying the patients who could benefit from genetic counseling and/or direct genetic testing. This analysis highlighted that a personalized stepwise approach employing clinical screening tools followed by sequencing in high-risk patients might be a reasonable and cost-effective strategy in the care of children with cancer.
Language	English
Publishing date	2022-07-31
Publishing country	Switzerland
Document type	Journal Article ; Review
ZDB-ID	2527080-1
ISSN	2072-6694
ISSN	2072-6694
DOI	10.3390/cancers14153741
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Article ; Online: Correlation Between Indocyanine Green Fluorescence Patterns and Grade of Differentiation of Hepatocellular Carcinoma: A Western Prospective Cohort Study.

Piccolo, Gaetano / Barabino, Matteo / Santambrogio, Roberto / Lecchi, Francesca / Di Gioia, Giulio / Opocher, Enrico / Bianchi, Paolo Pietro

Surgical innovation

2023 Volume 30, Issue 6, Page(s) 770–778

Abstract: Background. ...

Abstract	Background.
MeSH term(s)	Humans ; Carcinoma, Hepatocellular/diagnostic imaging ; Carcinoma, Hepatocellular/surgery ; Indocyanine Green ; Prospective Studies ; Liver Neoplasms/diagnostic imaging ; Liver Neoplasms/surgery ; Hepatectomy/methods ; Optical Imaging/methods
Chemical Substances	Indocyanine Green (IX6J1063HV)
Language	English
Publishing date	2023-02-25
Publishing country	United States
Document type	Journal Article
ZDB-ID	2182571-3
ISSN	1553-3514 ; 1553-3506
ISSN (online)	1553-3514
ISSN	1553-3506
DOI	10.1177/15533506231157171
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Zs.A 4269: Show issues

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Article: Contemporary management of retinoblastoma in the context of a low-resource country.

Ademola-Popoola, Dupe S / Opocher, Enrico / Reddy, M Ashwin

The Nigerian postgraduate medical journal

2019 Volume 26, Issue 2, Page(s) 69–79

Abstract: Retinoblastoma (RB) is the most common ocular cancer, and it typically presents before the age of 5 years in over 90% of cases. In high resource countries, RB patients tend to survive and retain their sight. This is not the case in low-resource countries ...

Abstract	Retinoblastoma (RB) is the most common ocular cancer, and it typically presents before the age of 5 years in over 90% of cases. In high resource countries, RB patients tend to survive and retain their sight. This is not the case in low-resource countries because of late presentation and delayed intervention arising mostly from sociocultural and socioeconomic challenges. RB has no gender or racial predilection; the incidence is estimated as 1:16,000-1:18,000 live-births or 11/1 million children under 5 years. Most of the world's RB cases are found in Asia and Africa while most RB treatment centres are in America and Europe. RB is easy to detect by caregivers as a glowing white 'cat eye reflex' at night or when captured on camera. Health workers at primary care level can detect RB in early life if red reflex test and/or squint (Hirschberg) tests are deployed as part of wellness checks done especially during routine immunisation and well-baby clinics in the first 24 months of life. In most cases of RB, biopsies for histological confirmation are not required for diagnosis and treatment decisions to be made. Clinical information, ophthalmic evaluation and imaging modalities are typically used. There have been significant changes in the management of RB using various treatment modalities such as enucleation with orbital implant, use of chemotherapy delivered through intravenous, intravitreal, periocular and intra-arterial routes and targeted treatment with laser, cryotherapy and brachytherapy. Algorithm for management and development of the national RB program within the context of a low-resource country is presented from review of data extracted from Mendeley library, PubMed library, Google Scholar and One Network; full-text articles were mostly retrieved through the American Academy of Ophthalmology.
MeSH term(s)	Child ; Eye Enucleation ; Health Resources ; Humans ; Infant ; Nigeria ; Program Development ; Retinal Neoplasms/diagnosis ; Retinal Neoplasms/therapy ; Retinoblastoma/diagnosis ; Retinoblastoma/therapy
Language	English
Publishing date	2019-06-11
Publishing country	Nigeria
Document type	Journal Article ; Review
ZDB-ID	2171096-X
ISSN	1117-1936
ISSN	1117-1936
DOI	10.4103/npmj.npmj_21_19
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Zs.A 6015: Show issues

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Article ; Online: Role of Indocyanine Green Fluorescence Imaging in Minimally Invasive Resection of Colorectal Liver Metastases.

Piccolo, Gaetano / Barabino, Matteo / Pesce, Antonio / Diana, Michele / Lecchi, Francesca / Santambrogio, Roberto / Opocher, Enrico / Bianchi, Paolo P / Piozzi, Guglielmo N

Surgical laparoscopy, endoscopy & percutaneous techniques

2022 Volume 32, Issue 2, Page(s) 259–265

Abstract: Indocyanine green (ICG) fluorescence imaging is an easy and reproducible method to detect hepatic lesions, both primary and metastatic. This review reports the potential benefits of this technique as a tactile mimicking visual tool and a navigator guide ... ...

Abstract	Indocyanine green (ICG) fluorescence imaging is an easy and reproducible method to detect hepatic lesions, both primary and metastatic. This review reports the potential benefits of this technique as a tactile mimicking visual tool and a navigator guide in minimally invasive liver resection of colorectal liver metastases (CRLM). PubMed and MEDLINE databases were searched for studies reporting the use of intravenous injection of ICG before minimally invasive surgery for CLRM. The search was performed for publications reported from the first study in 2014 to April 2021. The final review included 13 articles: 6 prospective cohort studies, 1 retrospective cohort study, 3 case series, 1 case report, 1 case-matched study, and 1 clinical trial registry. The administered dose ranged between 0.3 and 0.5 mg/kg, while timing ranged between 1 and 14 days before surgery. CRLM detection rate ranged between 30.3% and 100% with preoperative imaging (abdominal computed tomography/magnetic resonance imaging), between 93.3 and 100% with laparoscopic ultrasound, between 57.6% and 100% with ICG fluorescence, and was 100% with combined modalities (ICG and laparoscopic ultrasound) with weighted averages of 77.42%, 95.97%, 79.03%, and 100%, respectively. ICG fusion imaging also allowed to detect occult small-sized lesions, not diagnosed preoperatively. In addition, ICG is effective in real-time assessment of surgical margins by evaluating the integrity of the fluorescent rim around the CRLM.
MeSH term(s)	Colorectal Neoplasms/pathology ; Colorectal Neoplasms/surgery ; Humans ; Indocyanine Green ; Liver Neoplasms/diagnostic imaging ; Liver Neoplasms/secondary ; Liver Neoplasms/surgery ; Optical Imaging/methods ; Prospective Studies ; Retrospective Studies
Chemical Substances	Indocyanine Green (IX6J1063HV)
Language	English
Publishing date	2022-02-18
Publishing country	United States
Document type	Case Reports ; Journal Article ; Review
ZDB-ID	1475108-2
ISSN	1534-4908 ; 1530-4515 ; 1051-7200
ISSN (online)	1534-4908
ISSN	1530-4515 ; 1051-7200
DOI	10.1097/SLE.0000000000001037
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Zs.A 3200: Show issues

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Article ; Online: Laparoscopic Indocyanine Green Fluorescence Imaging for Intrahepatic Cholangiocarcinoma.

Piccolo, Gaetano / Barabino, Matteo / Lecchi, Francesca / Santambrogio, Roberto / Nava, Claudia / Opocher, Enrico / Bianchi, Paolo Pietro

The American surgeon

2022 Volume 89, Issue 6, Page(s) 2577–2582

Abstract: Background: Indocyanine green fluorescence (ICG) is one of the first fluorophore that found a clinical application in medicine. In the liver, ICG fluorescence is due to the preserved uptake but impaired washout of the dye from hepatocellular cells into ... ...

Abstract	Background: Indocyanine green fluorescence (ICG) is one of the first fluorophore that found a clinical application in medicine. In the liver, ICG fluorescence is due to the preserved uptake but impaired washout of the dye from hepatocellular cells into the bile ducts. Therefore, some hepatobiliary surgeons proposed the technique of intravenous ICG injection before surgery for the detection of superficial hepatocarcinomas (HCCs) and colorectal liver metastases (CRLMs). Little evidence exists regarding the use of ICG to identify other hepatic tumors, such as intrahepatic cholangiocarcinoma (ICC). We report two patients affected by ICC who underwent laparoscopic liver resection with lymphadenectomy, the ICG staining was routinely performed not only to evaluate the site of the hepatic lesions but also to guide the extension of liver resection. Methods: It was injected intravenously a single dose of ICG dye (0.5 mg/kg) during liver function tests 5 days before scheduled surgery. All patients underwent laparoscopic staging with both laparoscopic ultrasound and ICG fluorescence imaging. Results: It was identified two different patter of ICG imaging: rim and segmental fluorescence for mass forming and mixed ICC subtype respectively. Conclusions: Identification of the ICC subtype before definitive histological examination may have an impact on the surgical plan.
MeSH term(s)	Humans ; Indocyanine Green ; Liver Neoplasms/diagnostic imaging ; Liver Neoplasms/surgery ; Optical Imaging/methods ; Cholangiocarcinoma/diagnostic imaging ; Cholangiocarcinoma/surgery ; Hepatectomy/methods ; Laparoscopy/methods ; Bile Ducts, Intrahepatic/diagnostic imaging ; Bile Duct Neoplasms/diagnostic imaging ; Bile Duct Neoplasms/surgery
Chemical Substances	Indocyanine Green (IX6J1063HV)
Language	English
Publishing date	2022-05-23
Publishing country	United States
Document type	Journal Article
ZDB-ID	202465-2
ISSN	1555-9823 ; 0003-1348
ISSN (online)	1555-9823
ISSN	0003-1348
DOI	10.1177/00031348221103659
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Article: Update on Robotic Rectal Prolapse Treatment.

Formisano, Giampaolo / Ferraro, Luca / Salaj, Adelona / Giuratrabocchetta, Simona / Pisani Ceretti, Andrea / Opocher, Enrico / Bianchi, Paolo Pietro

Journal of personalized medicine

2021 Volume 11, Issue 8

Abstract: Rectal prolapse is a condition that can cause significant social impairment and negatively affects quality of life. Surgery is the mainstay of treatment, with the aim of restoring the anatomy and correcting the associated functional disorders. During ... ...

Abstract	Rectal prolapse is a condition that can cause significant social impairment and negatively affects quality of life. Surgery is the mainstay of treatment, with the aim of restoring the anatomy and correcting the associated functional disorders. During recent decades, laparoscopic abdominal procedures have emerged as effective tools for the treatment of rectal prolapse, with the advantages of faster recovery, lower morbidity, and shorter length of stay. Robotic surgery represents the latest evolution in the field of minimally invasive surgery, with the benefits of enhanced dexterity in deep narrow fields such as the pelvis, and may potentially overcome the technical limitations of conventional laparoscopy. Robotic surgery for the treatment of rectal prolapse is feasible and safe. It could reduce complication rates and length of hospital stay, as well as shorten the learning curve, when compared to conventional laparoscopy. Further prospectively maintained or randomized data are still required on long-term functional outcomes and recurrence rates.
Language	English
Publishing date	2021-07-23
Publishing country	Switzerland
Document type	Journal Article ; Review
ZDB-ID	2662248-8
ISSN	2075-4426
ISSN	2075-4426
DOI	10.3390/jpm11080706
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Article: Update on Robotic Total Mesorectal Excision for Rectal Cancer.

Giuratrabocchetta, Simona / Formisano, Giampaolo / Salaj, Adelona / Opocher, Enrico / Ferraro, Luca / Toti, Francesco / Bianchi, Paolo Pietro

Journal of personalized medicine

2021 Volume 11, Issue 9

Abstract: The minimally invasive treatment of rectal cancer with Total Mesorectal Excision is a complex and challenging procedure due to technical and anatomical issues which could impair postoperative, oncological and functional outcomes, especially in a defined ... ...

Abstract	The minimally invasive treatment of rectal cancer with Total Mesorectal Excision is a complex and challenging procedure due to technical and anatomical issues which could impair postoperative, oncological and functional outcomes, especially in a defined subgroup of patients. The results from recent randomized controlled trials comparing laparoscopic versus open surgery are still conflicting and trans-anal bottom-up approaches have recently been developed. Robotic surgery represents the latest consistent innovation in the field of minimally invasive surgery that may potentially overcome the technical limitations of conventional laparoscopy thanks to an enhanced dexterity, especially in deep narrow operative fields such as the pelvis. Results from population-based multicenter studies have shown the potential advantages of robotic surgery when compared to its laparoscopic counterpart in terms of reduced conversions, complication rates and length of stay. Costs, often advocated as one of the main drawbacks of robotic surgery, should be thoroughly evaluated including both the direct and indirect costs, with the latter having the potential of counterbalancing the excess of expenditure directly related to the purchase and maintenance of robotic equipment. Further prospectively maintained or randomized data are still required to better delineate the advantages of the robotic platform, especially in the subset of most complex and technically challenging patients from both an anatomical and oncological standpoint.
Language	English
Publishing date	2021-09-08
Publishing country	Switzerland
Document type	Journal Article ; Review
ZDB-ID	2662248-8
ISSN	2075-4426
ISSN	2075-4426
DOI	10.3390/jpm11090900
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Article ; Online: Bottom-up suprapubic approach for robotic right colectomy: technical aspects and preliminary outcomes.

Bianchi, Paolo P / Giuliani, Giuseppe / Salaj, Adelona / Ferraro, Luca / Opocher, Enrico / Toti, Francesco / Formisano, Giampaolo

Minerva surgery

2021 Volume 76, Issue 2, Page(s) 129–137

Abstract: Background: Complete mesocolic excision (CME) for right colectomy increase the technical complexity of a laparoscopic approach especially when an intracorporeal anastomosis (IA) is associated. The robotic platform, with its intrinsic technical ... ...

Abstract	Background: Complete mesocolic excision (CME) for right colectomy increase the technical complexity of a laparoscopic approach especially when an intracorporeal anastomosis (IA) is associated. The robotic platform, with its intrinsic technical advantages, could potentially overcome the limitations of conventional laparoscopy. This study aimed to describe the robotic bottom-up technique and to evaluate short-terms outcomes of robotic right colectomy (RRC) with CME and IA. Methods: Data from patients who underwent RRC for cancer with bottom-up suprapubic approach from October 2016 to April 2020 were prospectively collected and retrospectively analyzed. Intraoperative outcomes and complications, conversion rate, 30-day postoperative outcomes, incisional hernia rate and pathological outcomes were the variables assessed. Results: A total of 109 patients were submitted to bottom-up suprapubic approach for RRC with CME and IA during the study period. Mean operative time was 179 min, no intraoperative complications were observed, and the conversion rate was 3.6%. Mean postoperative stay was 4.6 days and the overall 30-day complication rate was 15.6%. Thirteen patients (12%) had minor complications, while major postoperative complications occurred in 4 patients (3.6%). Anastomotic leak was recorded in 1 patient (0.9%) and the 30-day re-admission rate was 0.9%. Mean number of harvested lymph nodes was 22.6. Incisional hernia rate at the specimen extraction site was 0.9%. Conclusions: Bottom-up approach for RRC with CME and IA carries a low rate of conversions, intraoperative and short-term postoperative complications.
MeSH term(s)	Colectomy ; Humans ; Mesocolon/surgery ; Operative Time ; Retrospective Studies ; Robotic Surgical Procedures/adverse effects
Language	English
Publishing date	2021-01-12
Publishing country	Italy
Document type	Journal Article
ZDB-ID	3067899-7
ISSN	2724-5438
ISSN (online)	2724-5438
DOI	10.23736/S2724-5691.20.08664-2
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Article ; Online: Micronvasive behaviour of single small hepatocellular carcinoma: which treatment?

Santambrogio, Roberto / Barabino, Matteo / D'Alessandro, Valentina / Iacob, Giulio / Opocher, Enrico / Gemma, Marco / Zappa, Marco Antonio

Updates in surgery

2021 Volume 73, Issue 4, Page(s) 1359–1369

Abstract: Background: Microinvasion (MI), defined as infiltration of the portal or hepatic vein or bile duct and intrahepatic metastasis are accurate indicators of a poor prognosis for mall hepatocellular carcinomas (HCC). A previous study showed that ... ...

Abstract	Background: Microinvasion (MI), defined as infiltration of the portal or hepatic vein or bile duct and intrahepatic metastasis are accurate indicators of a poor prognosis for mall hepatocellular carcinomas (HCC). A previous study showed that intraoperative ultrasound (IOUS) definition of MI-HCC had a high concordance with histological findings. Aim of this study is to evaluate overall survival and recurrence patterns of patients with MI-HCC submitted to hepatic resection (HR) or laparoscopic ablation therapies (LAT). Methods: A total of 171 consecutive patients (78 h; 93 LAT) with single, small HCC (< 3 cm) with a MI pattern at IOUS examination were compared analyzing overall survival and recurrence patterns using univariate and multivariate analysis and weighting by propensity score. Results: Overall recurrences were similar in the 2 groups (HR: 51 patients (65%); LAT: 66 patients (71%)). The rate of local tumor progression in the HR group was very low (5 pts; 6%) in comparison to LAT group (22 pts; 24%; p = 0.002). The overall survival curves of HR are significantly better than that of the LAT group (p = 0.0039). On the propensity score Cox model, overall mortality was predicted by the surgical treatment with a Hazard ratio 1.68 (1.08-2.623) (p = 0.022). Conclusions: If technically feasible and in patients fit for surgery, HR with an adequate tumor margin should be preferred to LAT in patients with MI-HCC at IOUS evaluation, to eradicate MI features near the main nodule, which are relatively frequent even in small HCC (< 3 cm).
MeSH term(s)	Carcinoma, Hepatocellular/surgery ; Catheter Ablation ; Hepatectomy ; Humans ; Liver Neoplasms/surgery ; Neoplasm Recurrence, Local/surgery ; Proportional Hazards Models ; Retrospective Studies ; Treatment Outcome ; Ultrasonography
Language	English
Publishing date	2021-04-05
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/s13304-021-01036-0
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Article ; Online: Application of Indocyanine Green Fluorescence as an Adjuvant to Laparoscopic Ultrasound in Minimally Invasive Liver Resection.

Piccolo, Gaetano / Barabino, Matteo / Diana, Michele / Lo Menzo, Emanuele / Epifani, Angelo Gabriele / Lecchi, Francesca / Santambrogio, Roberto / Opocher, Enrico

Journal of laparoendoscopic & advanced surgical techniques. Part A

2021 Volume 31, Issue 5, Page(s) 517–523

Abstract: Background: ...

Abstract	Background:
MeSH term(s)	Aged ; Aged, 80 and over ; Carcinoma/diagnostic imaging ; Carcinoma/surgery ; Endosonography/methods ; Female ; Fluorescent Dyes ; Hepatectomy/methods ; Humans ; Indocyanine Green ; Laparoscopy/methods ; Liver Cirrhosis/surgery ; Liver Neoplasms/diagnostic imaging ; Liver Neoplasms/surgery ; Male ; Middle Aged ; Optical Imaging/methods ; Ultrasonography, Interventional/methods
Chemical Substances	Fluorescent Dyes ; Indocyanine Green (IX6J1063HV)
Language	English
Publishing date	2021-03-02
Publishing country	United States
Document type	Journal Article ; Video-Audio Media
ZDB-ID	1381909-4
ISSN	1557-9034 ; 1092-6429
ISSN (online)	1557-9034
ISSN	1092-6429
DOI	10.1089/lap.2020.0895
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