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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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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: Is there a role for treatment-oriented surgery in liver metastases from gastric cancer?

Uggeri, Fabio / Ripamonti, Lorenzo / Pinotti, Enrico / Scotti, Mauro Alessandro / Famularo, Simone / Garancini, Mattia / Gianotti, Luca / Braga, Marco / Romano, Fabrizio

World journal of clinical oncology

2020 Volume 11, Issue 7, Page(s) 477–494

Abstract: Background: Distant metastases are found in approximately 35% of patients with gastric cancer at their first clinical observation, and of these, 4%-14% involves the liver. Unfortunately, only 0.4%-2.3% of patients with metastatic gastric cancer are ... ...

Abstract	Background: Distant metastases are found in approximately 35% of patients with gastric cancer at their first clinical observation, and of these, 4%-14% involves the liver. Unfortunately, only 0.4%-2.3% of patients with metastatic gastric cancer are eligible for radical surgery. Although surgical resection for gastric cancer metastases is still debated, there have been changes in recent years, although several clinical issues remain to be defined and that must be taken into account before surgery is proposed. Aim: To analyze the clinicopathological factors related to primary gastric tumor and metastases that impact the survival of patients with liver metastatic gastric cancer. Methods: We performed a systematic review of the literature from 2000 to 2018 according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses statement. The study protocol was based on identifying studies with clearly defined purpose, eligibility criteria, methodological analysis, and patient outcome. Results: We selected 47 studies pertaining to the purpose of the review, which involved a total of 2304 patients. Median survival was 7-52.3 mo, median disease-free survival was 4.7-18 mo. The 1-, 2-, 3-, and 5-year overall survival (OS) was 33%-90.1%, 10%-60%, 6%-70.4%, and 0%-40.1%, respectively. Only five papers reported the 10-year OS, which was 5.5%-31.5%. The general recurrence rate was between 55.5% and 96%, and that for hepatic recurrence was between 15% and 94%. Conclusion: Serous infiltration and lymph node involvement of the primary cancer indicate an unfavorable prognosis, while the presence of single metastasis or ≤ 3 metastases associated with a size of < 5 cm may be considered data that do not contraindicate liver resection.
Language	English
Publishing date	2020-07-28
Publishing country	United States
Document type	Journal Article
ZDB-ID	2587357-X
ISSN	2218-4333
ISSN	2218-4333
DOI	10.5306/wjco.v11.i7.477
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Article ; Online: Is It Just a Matter of Surgical Extension to Achieve the Cure of Hepatocarcinoma? A Meta-Analysis of Propensity-Matched and Randomized Studies for Anatomic Versus Parenchyma-Sparing Liver Resection.

Famularo, Simone / Ceresoli, Marco / Giani, Alessandro / Ciulli, Cristina / Pinotti, Enrico / Romano, Fabrizio / Braga, Marco / De Carlis, Luciano / Gianotti, Luca

Journal of gastrointestinal surgery : official journal of the Society for Surgery of the Alimentary Tract

2020 Volume 25, Issue 1, Page(s) 94–103

Abstract: Background: The benefit of anatomic (AR) versus parenchyma-sparing resection (PSR) in hepatocarcinoma (HCC) is still debated. The aim of the study was to compare AR vs. PSR in terms of overall survival (OS) and disease-free survival (DFS).: Methods: ... ...

Abstract	Background: The benefit of anatomic (AR) versus parenchyma-sparing resection (PSR) in hepatocarcinoma (HCC) is still debated. The aim of the study was to compare AR vs. PSR in terms of overall survival (OS) and disease-free survival (DFS). Methods: A systematic review was conducted using Medline and Google Scholar. To reduce intra- and inter-study heterogeneity, only propensity-matched studies and randomized clinical trials (RCT) were evaluated and a generic inverse variance meta-analysis was run. A sub-analysis was performed in case of tumor microvascular invasion (MVI). Results: Eleven propensity-matched and one RCT were evaluated, with a total of 3445 patients (AR = 1776 and PSR = 1669). Tumor burden and liver function were comparable among studies (I Conclusion: When liver function and tumor burden are comparable, AR and PSR achieved similar overall survival. AR improved local control in the early period after surgery. Furthermore, in the presence of MVI, the extension of surgery was not associated with better OS and DFS.
MeSH term(s)	Carcinoma, Hepatocellular/surgery ; Disease-Free Survival ; Hepatectomy ; Humans ; Liver Neoplasms/surgery ; Randomized Controlled Trials as Topic
Language	English
Publishing date	2020-01-02
Publishing country	United States
Document type	Journal Article ; Meta-Analysis ; Systematic Review
ZDB-ID	2012365-6
ISSN	1873-4626 ; 1934-3213 ; 1091-255X
ISSN (online)	1873-4626 ; 1934-3213
ISSN	1091-255X
DOI	10.1007/s11605-019-04494-5
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Zs.A 5207: 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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Article ; Online: Resection of the caudate lobe for the treatment of hilar cholangiocarcinoma.

Pinotti, Enrico / Sandini, Marta / Famularo, Simone / Tamini, Nicolò / Romano, Fabrizio / Gianotti, Luca

Minerva chirurgica

2018 Volume 74, Issue 4, Page(s) 348–358

Abstract: Introduction: Whether the resection of the caudate lobe, in association with major hepatectomy, improves outcomes in hilar cholangiocarcinoma is controversial.: Evidence acquisition: We performed a systematic literature review on all studies ... ...

Abstract	Introduction: Whether the resection of the caudate lobe, in association with major hepatectomy, improves outcomes in hilar cholangiocarcinoma is controversial. Evidence acquisition: We performed a systematic literature review on all studies published from June 1979 to September 2016. Inclusion criteria for eligibility were the presence of parallel-groups of patients treated with major hepatectomy with either caudate lobe resection (CLR), or not (NCLR), in adult population, reporting data on overall survival (OS). We ran out a random-effect meta-analysis for survival data. Evidence synthesis: Six retrospective studies with 969 patients (643 CLR and 326 NCLR) were included. The probability of death was significantly lower in CLR group than in NCLR group (HR 0.65; 95% CI: 0.44-0.97; P=0.035). The median survival time was in favor of CLR (WMD 3.46; 95% CI: 1.02-5.90, P=0.005]. Patients who underwent CLR were more likely to receive a R0 resection than those who did not (OR 8.26; 95% CI: 2.45-27.87; P=0.001). No moderator effects were detected at meta-regression for operative time, postoperative complication rate and pathologic findings. Conclusions: Despite the paucity of data and the retrospective nature of the included studies, our results suggest that major hepatectomy plus caudate lobe resection may improve the likelihood of R0 resection and the overall survival in patients with hilar cholangiocarcinoma.
MeSH term(s)	Bile Duct Neoplasms/surgery ; Hepatectomy/methods ; Humans ; Klatskin Tumor/surgery
Language	English
Publishing date	2018-04-13
Publishing country	Italy
Document type	Journal Article ; Systematic Review
ZDB-ID	123603-9
ISSN	1827-1626 ; 0026-4733
ISSN (online)	1827-1626
ISSN	0026-4733
DOI	10.23736/S0026-4733.18.07498-9
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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: Disseminated and late metastatic disease from nasal pit leiomyosarcoma after radical surgical resection. Case report of a singular presentation of a rare disease.

Pinotti, Enrico / Sandini, Marta / Famularo, Simone / Jaconi, Marta / Romano, Fabrizio / Nespoli, Luca / Gianotti, Luca

Clinical sarcoma research

2017 Volume 7, Page(s) 12

Abstract: Background: Leiomyosarcoma of the head and neck is a rare cancer with high local aggressiveness. Radical surgery and adjuvant treatment offer the best chance for cure, nonetheless 5-years recurrence rate remains high. Despite international guidelines ... ...

Abstract	Background: Leiomyosarcoma of the head and neck is a rare cancer with high local aggressiveness. Radical surgery and adjuvant treatment offer the best chance for cure, nonetheless 5-years recurrence rate remains high. Despite international guidelines are available for soft tissue sarcomas, no recommendations are specifically endorsed for leiomyosarcoma of the head and neck, due to the rarity of its presentation and consequently scarcity of data on long-term outcome. Case presentation: A 50-year old woman, operated 10 years before for leiomyosarcoma of the nasal pit and with negative 5-years follow-up, was admitted to our ward for impairment of the hepatic function. Total-body CT scan detected multiple localizations at lungs, kidneys, pancreas, bones, muscles, lymph nodes and thyroid. The pathologic report after lung biopsy confirmed the diagnosis of metastasis from leiomyosarcoma and the patients was scheduled for first line chemo-radiotherapy. Conclusions: Despite adequate primary treatment, distant and disseminated metastatic disease may be not excluded in leiomyosarcoma of the head and neck.
Language	English
Publishing date	2017-06-06
Publishing country	England
Document type	Case Reports
ZDB-ID	2623217-0
ISSN	2045-3329
ISSN	2045-3329
DOI	10.1186/s13569-017-0078-2
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Article ; Online: Surgical and oncological outcomes of hepatic resection for BCLC-B hepatocellular carcinoma: a retrospective multicenter analysis among 474 consecutive cases.

Di Sandro, Stefano / Centonze, Leonardo / Pinotti, Enrico / Lauterio, Andrea / De Carlis, Riccardo / Romano, Fabrizio / Gianotti, Luca / De Carlis, Luciano

Updates in surgery

2019 Volume 71, Issue 2, Page(s) 285–293

Abstract: The Barcelona clinic liver cancer (BCLC) algorithm is the most widely accepted staging system form hepatocellular carcinoma (HCC). Liver resection is traditionally proposed to early stage HCC (BCLC-0/A), even if recent reports have shown that surgical ... ...

Abstract	The Barcelona clinic liver cancer (BCLC) algorithm is the most widely accepted staging system form hepatocellular carcinoma (HCC). Liver resection is traditionally proposed to early stage HCC (BCLC-0/A), even if recent reports have shown that surgical resection could provide a safe and effective treatment also for intermediate-stage HCC (BCLC-B). In this study, we focused on surgical and oncological outcomes of hepatic resection in BLCB-B patients. Patients who received hepatic resection for early- (BCLC-0/A) or intermediate-stage (BCLC-B) HCC in two tertiary hepatobiliary centers between January 2003 and December 2016 were included in study. Four-hundred and twenty-nine patients were included in the analysis. At the time of resection, 298 patients were classified as BCLC-A/0 and 131 as BCLC-B. Despite a higher complication rate in BCLC-B group (49.6% vs 32.9%; p = 0.001), the incidence of clinically relevant complications did not differ significantly between the two groups (16.0% vs 10.1%; p = 0.079); moreover, postoperative mortality (4.6% vs 2.7%; p = 0.309) and relapse-free survival (RFS) were similar between BCLC-0/A and BCLC-B group (1-, 3-, and 5-year RFS: 74, 43, and 31% vs 59, 38, and 34%; p = 0.180). Overall survival was slightly worse in BCLC-B group (1-, 3-, and 5-year overall survival of 89, 70, and 52% vs. 77, 51, and 44%; p = 0.004). Focusing on BCLC-B group, a Child-Pugh score B (HR 2.47; p = 0.003), growing number of nodules (HR 3.04; p = 0.003), and R1 resection (HR 2.43; p = 0.005) beard a higher risk of tumor recurrence, while overall survival was negatively affected by the presence of more than two nodules (HR 3.66; p = 0.0001) and R1 resection (HR 3.06; p = 0.0001); patients presenting single-large HCC experienced a better overall survival (HR 0.53; p = 0.014) and lower recurrence-rate (HR 0.60; p = 0.046). Hepatic resection for intermediate-stage HCC shows acceptable results in terms of perioperative morbidity and mortality, with better oncological outcomes in patients with lower number of lesions despite of their size.
MeSH term(s)	Adolescent ; Adult ; Aged ; Carcinoma, Hepatocellular/mortality ; Carcinoma, Hepatocellular/pathology ; Carcinoma, Hepatocellular/surgery ; Female ; Hepatectomy ; Humans ; Liver Neoplasms/mortality ; Liver Neoplasms/pathology ; Liver Neoplasms/surgery ; Male ; Middle Aged ; Neoplasm Recurrence, Local/epidemiology ; Neoplasm Staging/methods ; Retrospective Studies ; Survival Rate ; Treatment Outcome ; Young Adult
Language	English
Publishing date	2019-04-02
Publishing country	Italy
Document type	Journal Article ; Multicenter Study
ZDB-ID	2572692-4
ISSN	2038-3312 ; 2038-131X
ISSN (online)	2038-3312
ISSN	2038-131X
DOI	10.1007/s13304-019-00649-w
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Article: Prognostic Factors Affecting Long-Term Survival after Resection for Noncolorectal, Nonneuroendocrine, and Nonsarcoma Liver Metastases.

Uggeri, Fabio / Pinotti, Enrico / Sandini, Marta / Nespoli, Luca / Gianotti, Luca / Romano, Fabrizio

Gastroenterology research and practice

2017 Volume 2017, Page(s) 5184146

Abstract: Aim: To evaluate feasibility and long-term outcome after hepatic resection for noncolorectal, nonneuroendocrine, and nonsarcoma (NCNNNS) liver metastases in a single center.: Methods: We retrospectively reviewed our experience on patients who ... ...

Abstract	Aim: To evaluate feasibility and long-term outcome after hepatic resection for noncolorectal, nonneuroendocrine, and nonsarcoma (NCNNNS) liver metastases in a single center. Methods: We retrospectively reviewed our experience on patients who underwent surgery for NCNNNS liver metastases from 1995 to 2015. Patient baseline characteristics, tumor features, treatment options, and postoperative outcome were retrieved. Results: We included 47 patients. The overall 5-year survival (OS) rate after hepatectomy was 27.6%, with a median survival of 21 months. Overall survival was significantly longer for patients operated for nongastrointestinal liver metastases when compared with gastrointestinal (41 versus 10 months; Conclusion: Liver resection represents a possible curative option for patients with NCNNNS metastases. The origin of the primary tumor and the timing of metastases presentation may help clinicians to better select which patients could take advantages from surgical intervention.
Language	English
Publishing date	2017-07-24
Publishing country	Egypt
Document type	Journal Article
ZDB-ID	2435460-0
ISSN	1687-630X ; 1687-6121
ISSN (online)	1687-630X
ISSN	1687-6121
DOI	10.1155/2017/5184146
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