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  1. Article ; Online: Does crural repair with biosynthetic mesh improve outcomes of revisional surgery for recurrent hiatal hernia?

    Panici Tonucci, T / Aiolfi, A / Bona, D / Bonavina, L

    Hernia : the journal of hernias and abdominal wall surgery

    2024  

    Abstract: Background: Laparoscopic revisional surgery for recurrent hiatal hernia (HH) is technically demanding. Re-recurrences are common and esophageal hiatus mesh reinforcement might improve durability of the repair, thus minimizing the risk of re-herniation.!# ...

    Abstract Background: Laparoscopic revisional surgery for recurrent hiatal hernia (HH) is technically demanding. Re-recurrences are common and esophageal hiatus mesh reinforcement might improve durability of the repair, thus minimizing the risk of re-herniation.
    Purpose: Assess safety and effectiveness of simple suture repair (no mesh group) vs. crural augmentation with a biosynthetic absorbable mesh (mesh group) in patients with recurrent HH.
    Methods: Observational retrospective study from September 2012 to December 2022. Only patients undergoing redo surgery for previous failures of hiatal hernia repair were enrolled. Surgical failure was defined as symptomatic recurrent HH with > 2 cm of gastric tissue above the diaphragmatic impression at upper gastrointestinal endoscopy and/or swallow study. Gastro-Esophageal Reflux Disease Health-Related Quality of Life (GERD-HRQL) and Short Form-36 (SF-36) questionnaires were used to assess and preoperative and postoperative symptoms and quality of life.
    Results: One hundred four patients were included. Overall, 60 patients (57.7%) underwent mesh-reinforced cruroplasty, whereas 44 (42.3%) underwent simple suture cruroplasty. Mesh and no mesh groups had similar baseline demographics, symptoms, prevalence of esophagitis and Barrett's esophagus, and HH size. A composite crural repair was most commonly performed in the mesh group (38.3% vs. 20.5%; p = 0.07). In addition to cruroplasty, most patients (91%) underwent a Toupet fundoplication. The 90-day postoperative complication rate was 8.6%, and there was no mortality. Recurrent HH was diagnosed in 21 patients (20.2%) with a clinical trend toward reduced incidence in the mesh group (16.7% vs. 25%; p = 0.06). Compared to baseline, there was a statistically significant improvement of median GERD-HRQL score (p < 0.01) and all SF-36 items (p < 0.01).
    Conclusions: Laparoscopic revisional surgery for recurrent HH is safe and effective. Selective use of biosynthetic mesh may protect from early recurrence and has the potential to reduce re-herniation in the long-term.
    Language English
    Publishing date 2024-03-29
    Publishing country France
    Document type Journal Article
    ZDB-ID 1388125-5
    ISSN 1248-9204 ; 1265-4906
    ISSN (online) 1248-9204
    ISSN 1265-4906
    DOI 10.1007/s10029-024-03023-x
    Database MEDical Literature Analysis and Retrieval System OnLINE

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    In stock of ZB MED Cologne/Königswinter

    Zs.A 5390: Show issues Location:
    Je nach Verfügbarkeit (siehe Angabe bei Bestand)
    bis Jg. 1994: Bestellungen von Artikeln über das Online-Bestellformular
    Jg. 1995 - 2021: Lesesall (2.OG)
    ab Jg. 2022: Lesesaal (EG)

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  2. Article ; Online: Safety and Efficacy of Crura Augmentation with Phasix ST Mesh for Large Hiatal Hernia: 3-Year Single-Center Experience.

    Panici Tonucci, Tommaso / Asti, Emanuele / Sironi, Andrea / Ferrari, Davide / Bonavina, Luigi

    Journal of laparoendoscopic & advanced surgical techniques. Part A

    2020  Volume 30, Issue 4, Page(s) 369–372

    Abstract: Background: ...

    Abstract Background:
    MeSH term(s) Absorbable Implants ; Adult ; Aged ; Aged, 80 and over ; Female ; Follow-Up Studies ; Hernia, Hiatal/surgery ; Herniorrhaphy/instrumentation ; Herniorrhaphy/methods ; Humans ; Laparoscopy ; Male ; Middle Aged ; Patient Safety ; Quality of Life ; Recurrence ; Reoperation/statistics & numerical data ; Retrospective Studies ; Surgical Mesh
    Language English
    Publishing date 2020-01-07
    Publishing country United States
    Document type Journal Article ; Observational Study
    ZDB-ID 1381909-4
    ISSN 1557-9034 ; 1092-6429
    ISSN (online) 1557-9034
    ISSN 1092-6429
    DOI 10.1089/lap.2019.0726
    Database MEDical Literature Analysis and Retrieval System OnLINE

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    Zs.A 3246: Show issues Location:
    Je nach Verfügbarkeit (siehe Angabe bei Bestand)
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    Jg. 1995 - 2021: Lesesall (2.OG)
    ab Jg. 2022: Lesesaal (EG)

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  3. Article ; Online: Esophageal foreign bodies: observational cohort study and factors associated with recurrent impaction.

    Ferrari, Davide / Siboni, Stefano / Riva, Carlo Galdino / Aiolfi, Alberto / Panici Tonucci, Tommaso / Asti, Emanuele / Bonavina, Luigi

    European journal of gastroenterology & hepatology

    2020  Volume 32, Issue 7, Page(s) 827–831

    Abstract: Background and aim: Esophageal foreign bodies, including food bolus impaction, represent a common clinical problem. The prevalence of underlying esophageal disease depends on study design and degree of suspicion of a structural or functional esophageal ... ...

    Abstract Background and aim: Esophageal foreign bodies, including food bolus impaction, represent a common clinical problem. The prevalence of underlying esophageal disease depends on study design and degree of suspicion of a structural or functional esophageal abnormality. Aim of this study was to analyze factors associated with recurrent impaction.
    Methods: The prospectively collected database at a University Hospital and Swallowing Center was reviewed from January 2012 to June 2019 to identify all patients admitted for esophageal foreign bodies. Patients who underwent an emergency endoscopic procedure represented the final study sample. Patient characteristics, including history of previous esophageal foreign bodies, and type of endoscopic procedure were collected.
    Results: Sixty-five patients, 41 males and 24 females with a median age of 59 years, underwent emergency endoscopy for esophageal foreign bodies during the study period. Food bolus was the most common foreign body (n = 43, 66%). Flexible endoscopy was successful in retrieving or pushing the foreign bodies in the stomach in 91% of patients. In 54% of patients, impaction was secondary to an underlying esophageal disorder, which was previously unrecognized in half of them. Recurrent impaction was more common in patients with esophageal disease (P < 0.011). Surgical therapy was required in 4 patients (6.1%).
    Conclusions: Food bolus impaction is a common sentinel event in patients with underlying esophageal disease and is associated with recurrent impaction. Diagnostic endoscopy with biopsies should possibly be performed at the first episode of impaction. Patients with negative biopsies should undergo barium swallow study and high-resolution esophageal manometry.
    MeSH term(s) Cohort Studies ; Endoscopy ; Esophagus/diagnostic imaging ; Esophagus/surgery ; Female ; Foreign Bodies/complications ; Foreign Bodies/diagnostic imaging ; Foreign Bodies/epidemiology ; Humans ; Male ; Middle Aged ; Retrospective Studies ; Upper Gastrointestinal Tract
    Language English
    Publishing date 2020-03-30
    Publishing country England
    Document type Journal Article ; Observational Study
    ZDB-ID 1034239-4
    ISSN 1473-5687 ; 0954-691X
    ISSN (online) 1473-5687
    ISSN 0954-691X
    DOI 10.1097/MEG.0000000000001717
    Database MEDical Literature Analysis and Retrieval System OnLINE

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    Zs.A 2932: Show issues Location:
    Je nach Verfügbarkeit (siehe Angabe bei Bestand)
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    Jg. 1995 - 2021: Lesesall (2.OG)
    ab Jg. 2022: Lesesaal (EG)

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  4. Article: Early vedolizumab trough levels predict treatment persistence over the first year in inflammatory bowel disease.

    Guidi, Luisa / Pugliese, Daniela / Panici Tonucci, Tommaso / Bertani, Lorenzo / Costa, Francesco / Privitera, Giuseppe / Tolusso, Barbara / Di Mario, Clara / Albano, Eleonora / Tapete, Gherardo / Gremese, Elisa / Papa, Alfredo / Gasbarrini, Antonio / Rapaccini, Gian Ludovico / Armuzzi, Alessandro

    United European gastroenterology journal

    2019  Volume 7, Issue 9, Page(s) 1189–1197

    Abstract: Background: Data from trials of vedolizumab for inflammatory bowel disease and from real-world studies suggest an exposure-response relationship, such that vedolizumab trough levels may predict clinical and endoscopic outcomes.: Objective: The ... ...

    Abstract Background: Data from trials of vedolizumab for inflammatory bowel disease and from real-world studies suggest an exposure-response relationship, such that vedolizumab trough levels may predict clinical and endoscopic outcomes.
    Objective: The purpose of this study was to evaluate in a prospective observational study the utility of an early vedolizumab trough level assay for predicting the first-year vedolizumab therapy outcome.
    Methods: This prospective observational study included consecutive inflammatory bowel disease patients. We measured vedolizumab trough levels and anti-vedolizumab antibodies at weeks 6 and 14. Clinical outcome was assessed at weeks 6, 14, 22 and 54. The primary endpoint was the correlation between early vedolizumab trough levels and vedolizumab persistence over the first year of treatment, defined as the maintenance of vedolizumab therapy due to sustained clinical benefit.
    Results: We included 101 patients initiating vedolizumab. A cut-off vedolizumab trough level of 16.55 µg/ml at week 14 predicted vedolizumab persistence within the first year of therapy, with 73.3% sensitivity and 59.4% specificity (
    Conclusion: High vedolizumab trough level at week 14 was associated with a higher probability of maintaining vedolizumab therapy over the first year due to sustained clinical benefit.
    MeSH term(s) Adult ; Antibodies, Monoclonal, Humanized/blood ; Antibodies, Monoclonal, Humanized/therapeutic use ; Cohort Studies ; Female ; Gastrointestinal Agents/blood ; Gastrointestinal Agents/therapeutic use ; Humans ; Inflammatory Bowel Diseases/drug therapy ; Male ; Medication Adherence ; Middle Aged ; Prognosis ; Prospective Studies ; Treatment Outcome
    Chemical Substances Antibodies, Monoclonal, Humanized ; Gastrointestinal Agents ; vedolizumab (9RV78Q2002)
    Language English
    Publishing date 2019-09-03
    Publishing country England
    Document type Journal Article ; Observational Study ; Research Support, Non-U.S. Gov't
    ZDB-ID 2728585-6
    ISSN 2050-6414 ; 2050-6406
    ISSN (online) 2050-6414
    ISSN 2050-6406
    DOI 10.1177/2050640619873784
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  5. Article ; Online: Therapeutic Drug Monitoring is More Cost-Effective than a Clinically Based Approach in the Management of Loss of Response to Infliximab in Inflammatory Bowel Disease: An Observational Multicentre Study.

    Guidi, Luisa / Pugliese, Daniela / Panici Tonucci, Tommaso / Berrino, Alexandra / Tolusso, Barbara / Basile, Michele / Cantoro, Laura / Balestrieri, Paola / Civitelli, Fortunata / Bertani, Lorenzo / Marzo, Manuela / Felice, Carla / Gremese, Elisa / Costa, Francesco / Viola, Franca / Cicala, Michele / Kohn, Anna / Gasbarrini, Antonio / Rapaccini, Gian Lodovico /
    Ruggeri, Matteo / Armuzzi, Alessandro

    Journal of Crohn's & colitis

    2018  Volume 12, Issue 9, Page(s) 1079–1088

    Abstract: Background and aims: Empirical dose intensification and therapeutic drug monitoring [TDM] of infliximab [IFX] trough levels [ITLs] and antibody to infliximab [ATI] assays are recognized approaches for managing loss of response [LoR] in patients with ... ...

    Abstract Background and aims: Empirical dose intensification and therapeutic drug monitoring [TDM] of infliximab [IFX] trough levels [ITLs] and antibody to infliximab [ATI] assays are recognized approaches for managing loss of response [LoR] in patients with inflammatory bowel disease [IBD]. The aim of the study was to compare these two interventions in a clinical setting, in terms of effectiveness and cost savings.
    Methods: Consecutive IBD patients experiencing LoR were clinically managed according to a TDM algorithm. A historical group of empirically treated patients, for whom sera for ITLs and ATI assays had been collected, served as the control group. Clinical outcomes 12 weeks after the therapeutic interventions were compared between the two groups. A cost-minimization analysis was performed to compare the economic impact of these two approaches.
    Results: Ninety-six patients were enrolled prospectively and compared with 52 controls. The two cohorts were similar in characteristics and in the distribution of TDM results. In the prospective cohort, however, we observed less IFX dose escalations compared with in the controls [45% versus 71%, p = 0.003]. Also, more patients were switched to a different anti-TNFα in the prospective cohort than in the control cohort [25% versus 4%, p = 0.001]. The percentages of patients achieving a clinical response at 12 weeks were 52% and 54% for the prospective and control groups, respectively. By cost analysis, we estimated a savings of 15% if the TDM algorithm was applied.
    Conclusions: In our population, applying a TDM algorithm for LoR to IFX resulted in less dose escalations, without loss of efficacy, compared with empirical adjustment. In addition, the TDM approach was cost-effective.
    MeSH term(s) Adolescent ; Algorithms ; Child ; Cohort Studies ; Cost-Benefit Analysis ; Drug Monitoring/economics ; Female ; Gastrointestinal Agents/therapeutic use ; Humans ; Inflammatory Bowel Diseases/drug therapy ; Infliximab/therapeutic use ; Male ; Treatment Outcome
    Chemical Substances Gastrointestinal Agents ; Infliximab (B72HH48FLU)
    Language English
    Publishing date 2018-05-07
    Publishing country England
    Document type Journal Article ; Multicenter Study ; Observational Study
    ZDB-ID 2390120-2
    ISSN 1876-4479 ; 1873-9946
    ISSN (online) 1876-4479
    ISSN 1873-9946
    DOI 10.1093/ecco-jcc/jjy076
    Database MEDical Literature Analysis and Retrieval System OnLINE

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    In stock of ZB MED Cologne/Königswinter

    Zs.A 6634: Show issues Location:
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    bis Jg. 2021: Bestellungen von Artikeln über das Online-Bestellformular
    ab Jg. 2022: Lesesaal (EG)

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