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Article ; Online: Comment on: Two decades of surgical randomized controlled trials: worldwide trends in volume and methodological quality.

Aiolfi, Alberto / Bonitta, Gianluca / Tosi, Davide / Rausa, Emanuele / Nosotti, Mario / Bona, Davide / Bonavina, Luigi

2023 Volume 110, Issue 11, Page(s) 1556

Language	English
Publishing date	2023-08-07
Publishing country	England
Document type	Journal Article
ZDB-ID	2985-3
ISSN	1365-2168 ; 0263-1202 ; 0007-1323 ; 1355-7688
ISSN (online)	1365-2168
ISSN	0263-1202 ; 0007-1323 ; 1355-7688
DOI	10.1093/bjs/znad251
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Article: Delayed-release oral mesalamine tablet mimicking a small jejunal gastrointestinal stromal tumor: A case report.

Frosio, Fabio / Rausa, Emanuele / Marra, Paolo / Boutron-Ruault, Marie-Christine / Lucianetti, Alessandro

World journal of clinical cases

2022 Volume 10, Issue 19, Page(s) 6710–6715

Abstract: Background: Enteric-coated medications are supposed to pass intact through the gastric environment and to release the drug content into the small intestine or the colon. Before dissolution of the enteric coating, they may appear hyperdense on computed ... ...

Abstract	Background: Enteric-coated medications are supposed to pass intact through the gastric environment and to release the drug content into the small intestine or the colon. Before dissolution of the enteric coating, they may appear hyperdense on computed tomography (CT). Unfortunately, few reports have been published on this topic so far. In this case report, the hyperdense appearance on contrast-enhanced CT of an enteric-coated mesalamine tablet was initially misinterpreted as a jejunal gastrointestinal stromal tumor (GIST). Case summary: An asymptomatic 81-year-old male patient, who had undergone laparoscopic right nephrectomy four years earlier for stage 1 renal carcinoma, was diagnosed with a jejunal GIST at the 4-year follow-up thoraco-abdominal CT scan. He was referred to our hub hospital for gastroenterological evaluation, and subsequently underwent 18-fluorodeoxyglucose positron emission tomography, abdominal magnetic resonance imaging, and video capsule endoscopy. None of these examinations detected any lesion of the small intestine. After reviewing all the CT images in a multidisciplinary setting, the panel estimated that the hyperdense jejunal image was consistent with a tablet rather than a GIST. The tablet was an 800 mg delayed-release enteric-coated oral mesalamine tablet (Asacol Conclusion: Delayed-release oral mesalamine (Asacol
Language	English
Publishing date	2022-07-28
Publishing country	United States
Document type	Case Reports
ISSN	2307-8960
ISSN	2307-8960
DOI	10.12998/wjcc.v10.i19.6710
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Article ; Online: Correction to: Laparoscopic Sleeve-Fundoplication for Morbidly Obese Patients with Gastroesophageal Reflux: Systematic Review and Meta-analysis.

Aiolfi, Alberto / Micheletto, Giancarlo / Marin, Jacopo / Rausa, Emanuele / Bonitta, Gianluca / Bona, Davide

Obesity surgery

2022 Volume 32, Issue 7, Page(s) 2492

Language	English
Publishing date	2022-05-16
Publishing country	United States
Document type	Published Erratum
ZDB-ID	1070827-3
ISSN	1708-0428 ; 0960-8923
ISSN (online)	1708-0428
ISSN	0960-8923
DOI	10.1007/s11695-022-06105-w
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Article ; Online: What is the ideal mesh location for incisional hernia prevention during elective laparotomy? A network meta-analysis of randomized trials.

Aiolfi, Alberto / Bona, Davide / Gambero, Fabio / Sozzi, Andrea / Bonitta, Gianluca / Rausa, Emanuele / Bruni, Piero G / Cavalli, Marta / Campanelli, Giampiero

International journal of surgery (London, England)

2023 Volume 109, Issue 5, Page(s) 1373–1381

Abstract: Background: Incisional hernia (IH) represents an important complication after surgery. Prophylactic mesh reinforcement (PMR) with different mesh locations [onlay (OL), retromuscular (RM), preperitoneal (PP), and intraperitoneal (IP)] has been described ... ...

Abstract	Background: Incisional hernia (IH) represents an important complication after surgery. Prophylactic mesh reinforcement (PMR) with different mesh locations [onlay (OL), retromuscular (RM), preperitoneal (PP), and intraperitoneal (IP)] has been described to possibly reduce the risk of postoperative IH. However, data reporting the 'ideal' mesh location are sparse. The aim of this study was to evaluate the optimal mesh location for IH prevention during elective laparotomy. Methods: Systematic review and network meta-analysis of randomized controlled trials (RCTs). OL, RM, PP, IP, and no mesh (NM) were compared. The primary aim was postoperative IH. Risk ratio (RR) and weighted mean difference (WMD) were used as pooled effect size measures, whereas 95% credible intervals (CrI) were used to assess relative inference. Results: Fourteen RCTs (2332 patients) were included. Overall, 1052 (45.1%) had no mesh (NM) while 1280 (54.9%) underwent PMR stratified in IP ( n =344 pts), PP ( n =52 pts), RM ( n =463 pts), and OL ( n =421 pts) placement. Follow-up ranged from 12 months to 67 months. RM (RR=0.34; 95% CrI: 0.10-0.81) and OL (RR=0.15; 95% CrI: 0.044-0.35) were associated with significantly reduced IH RR compared to NM. A tendency toward reduced IH RR was noticed for PP versus NM (RR=0.16; 95% CrI: 0.018-1.01), while no differences were found for IP versus NM (RR=0.59; 95% CrI: 0.19-1.81). Seroma, hematoma, surgical site infection, 90-day mortality, operative time and hospital length of stay were comparable among treatments. Conclusions: RM or OL mesh placement seems associated with reduced IH RR compared to NM. PP location appears promising; however, future studies are warranted to corroborate this preliminary indication.
MeSH term(s)	Humans ; Incisional Hernia/etiology ; Incisional Hernia/prevention & control ; Incisional Hernia/surgery ; Laparotomy/adverse effects ; Network Meta-Analysis ; Surgical Mesh/adverse effects ; Randomized Controlled Trials as Topic
Language	English
Publishing date	2023-05-01
Publishing country	United States
Document type	Systematic Review ; Meta-Analysis ; Journal Article
ZDB-ID	2212038-5
ISSN	1743-9159 ; 1743-9191
ISSN (online)	1743-9159
ISSN	1743-9191
DOI	10.1097/JS9.0000000000000250
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Article ; Online: Therapeutic Challenges for Gastric Neuroendocrine Neoplasms: Take It or Leave It?

Cavalcoli, Federica / Gallo, Camilla / Coltro, Lorenzo Andrea / Rausa, Emanuele / Cantù, Paolo / Invernizzi, Pietro / Massironi, Sara

Medicina (Kaunas, Lithuania)

2023 Volume 59, Issue 10

Abstract: Background and ... ...

Abstract	Background and Objectives
MeSH term(s)	Humans ; Retrospective Studies ; Stomach Neoplasms/surgery ; Stomach Neoplasms/pathology ; Neuroendocrine Tumors/surgery ; Endoscopy ; Endoscopic Mucosal Resection ; Treatment Outcome
Language	English
Publishing date	2023-10-01
Publishing country	Switzerland
Document type	Journal Article ; Review
ZDB-ID	2188113-3
ISSN	1648-9144 ; 1010-660X
ISSN (online)	1648-9144
ISSN	1010-660X
DOI	10.3390/medicina59101757
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Article ; Online: Detection of (pre)cancerous colorectal lesions in Lynch syndrome patients by microsatellite instability liquid biopsy.

Boeri, Mattia / Signoroni, Stefano / Ciniselli, Chiara Maura / Gariboldi, Manuela / Zanutto, Susanna / Rausa, Emanuele / Segale, Miriam / Zanghì, Anna / Ricci, Maria Teresa / Verderio, Paolo / Sozzi, Gabriella / Vitellaro, Marco

Cancer gene therapy

2024

Abstract: Lynch syndrome (LS) is an inherited condition characterized by an increased risk of developing cancer, in particular colorectal cancer (CRC). Microsatellite instability (MSI) is the main feature of (pre)cancerous lesions occurring in LS patients. Close ... ...

Abstract	Lynch syndrome (LS) is an inherited condition characterized by an increased risk of developing cancer, in particular colorectal cancer (CRC). Microsatellite instability (MSI) is the main feature of (pre)cancerous lesions occurring in LS patients. Close endoscopic surveillance is the only option available to reduce CRC morbidity and mortality. However, it may fail to intercept interval cancers and patients' compliance to such an invasive procedure may decrease over the years. The development of a minimally invasive test able to detect (pre)cancerous colorectal lesions, could thus help tailor surveillance programs in LS patients. Taking advantage of an endoscopic surveillance program, we retrospectively assessed the instability of five microsatellites (BAT26, BAT25, NR24, NR21, and Mono27) in liquid biopsies collected at baseline and possibly at two further endoscopic rounds. For this purpose, we tested a new multiplex drop-off digital polymerase chain reaction (dPCR) assay, reaching mutant allele frequencies (MAFs) as low as 0.01%. Overall, 78 plasma samples at the three time-points from 18 patients with baseline (pre)cancerous lesions and 18 controls were available for molecular analysis. At baseline, the MAFs of BAT26, BAT25 and NR24 were significantly higher in samples of patients with lesions but did not differ with respect to the grade of dysplasia or any other clinico-pathological characteristics. When all markers were combined to determine MSI in blood, this test was able to discriminate lesion-bearing patients with an AUC of 0.80 (95%CI: 0.66; 0.94).
Language	English
Publishing date	2024-02-09
Publishing country	England
Document type	Journal Article
ZDB-ID	1212513-1
ISSN	1476-5500 ; 0929-1903
ISSN (online)	1476-5500
ISSN	0929-1903
DOI	10.1038/s41417-023-00721-z
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Article ; Online: Effect of complete mesocolic excision (cme) on long-term survival after right colectomy for cancer: multivariate meta-analysis and restricted mean survival time estimation.

Aiolfi, Alberto / Bona, Davide / Rausa, Emanuele / Manara, Michele / Biondi, Antonio / Basile, Francesco / Campanelli, Giampiero / Kelly, Michael E / Bonitta, Gianluca / Bonavina, Luigi

Langenbeck's archives of surgery

2024 Volume 409, Issue 1, Page(s) 80

Abstract: Introduction: Debate exists concerning the impact of complete mesocolic excision (CME) on long-term oncological outcomes. The aim of this review was to condense the updated literature and assess the effect of CME on long-term survival after right ... ...

Abstract	Introduction: Debate exists concerning the impact of complete mesocolic excision (CME) on long-term oncological outcomes. The aim of this review was to condense the updated literature and assess the effect of CME on long-term survival after right colectomy for cancer. Methods: PubMed, MEDLINE, Scopus, and Web of Science were searched through July 2023. The included studies evaluated the effect of CME on survival. The primary outcome was long-term overall survival. Restricted mean survival time difference (RMSTD), hazard ratio (HR), and 95% confidence intervals (CI) were used as pooled effect size measures. GRADE methodology was used to summarize the certainty of evidence. Results: Ten studies (3665 patients) were included. Overall, 1443 (39.4%) underwent CME. The RMSTD analysis shows that at 60-month follow-up, stage I-III CME patients lived 2.5 months (95% CI 1.1-4.1) more on average compared with noCME patients. Similarly, stage III patients that underwent CME lived longer compared to noCME patients at 55-month follow-up (6.1 months; 95% CI 3.4-8.5). The time-dependent HRs analysis for CME vs. noCME (stage I-III disease) shows a higher mortality hazard in patients with noCME at 6 months (HR 0.46, 95% CI 0.29-0.71), 12 months (HR 0.57, 95% CI 0.43-0.73), and 24 months (HR 0.73, 95% CI 0.57-0.92) up to 27 months. Conclusions: This study suggests that CME is associated with unclear OS benefit in stage I-III disease. Caution is recommended to avoid overestimation of the effect of CME in stage III disease since the marginal benefit of a more extended resection may have been influenced by tumor biology/molecular profile and multimodal adjuvant treatments.
MeSH term(s)	Humans ; Treatment Outcome ; Disease-Free Survival ; Survival Rate ; Colonic Neoplasms/pathology ; Colectomy/methods
Language	English
Publishing date	2024-03-02
Publishing country	Germany
Document type	Meta-Analysis ; Journal Article ; Review
ZDB-ID	1423681-3
ISSN	1435-2451 ; 1435-2443
ISSN (online)	1435-2451
ISSN	1435-2443
DOI	10.1007/s00423-024-03273-4
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Article ; Online: Laparoscopic Sleeve-Fundoplication for Morbidly Obese Patients with Gastroesophageal Reflux: Systematic Review and Meta-analysis.

Aiolfi, Alberto / Micheletto, Giancarlo / Marin, Jacopo / Rausa, Emanuele / Bonitta, Gianluca / Bona, Davide

Obesity surgery

2021 Volume 31, Issue 4, Page(s) 1714–1721

Abstract: Introduction: Laparoscopic sleeve gastrectomy (LSG) has rapidly become popular with excellent results. However, LSG may exacerbate or increase the risk of "de novo" gastroesophageal reflux disease (GERD). Adding a fundoplication has been proposed to ... ...

Abstract	Introduction: Laparoscopic sleeve gastrectomy (LSG) has rapidly become popular with excellent results. However, LSG may exacerbate or increase the risk of "de novo" gastroesophageal reflux disease (GERD). Adding a fundoplication has been proposed to increase the lower esophageal sphincter competency. The aim of this study was to examine the current evidence and outcomes of sleeve-fundoplication (Sleeve-F). Materials and methods: Systematic review and meta-analysis. Web of Science, PubMed, and Embase data sets were consulted. Results: Six studies (485 patients) met the inclusion criteria. The age of the patient population ranged from 17 to 72 years old and 82% were females. All patients underwent sleeve-fundoplication. Rossetti, Collis-Nissen, and Nissen were the most commonly performed fundoplications. The estimated pooled prevalence of postoperative leak, gastric perforation, and overall complications were 1.0% (95% CI = 0.0-2.0%), 2.9% (95% CI = 0.0-8.3%), and 9.8% (95% CI = 6.7-13.4%), respectively. The pooled reoperation rate was 4.1% (95% CI = 1.3-10%). There was no mortality. At 12-month follow-up, the estimated pooled BMI and %EWL were 29.9 kg/m Conclusions: This systematic review and meta-analysis shows that current evidence for Sleeve-F is limited with high postoperative gastric perforation and overall complication rates. Weight loss and GERD resolution seem promising in the short term; however, further studies are warranted to explore long-term effects with instrumental investigations. Sleeve-F should be considered cautiously while future well-structured randomized trials are warranted.
MeSH term(s)	Adolescent ; Adult ; Aged ; Female ; Fundoplication ; Gastroesophageal Reflux/epidemiology ; Gastroesophageal Reflux/etiology ; Gastroesophageal Reflux/surgery ; Humans ; Laparoscopy ; Male ; Middle Aged ; Obesity, Morbid/surgery ; Postoperative Complications/epidemiology ; Treatment Outcome ; Young Adult
Language	English
Publishing date	2021-01-03
Publishing country	United States
Document type	Journal Article ; Meta-Analysis ; Systematic Review
ZDB-ID	1070827-3
ISSN	1708-0428 ; 0960-8923
ISSN (online)	1708-0428
ISSN	0960-8923
DOI	10.1007/s11695-020-05189-6
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Article ; Online: Comment on "Is Pfannenstiel Incision the "One-Size-Fits-All" Solution for Specimen Retrieval in Colorectal Surgery?"

Rausa, Emanuele / Bonitta, Gianluca / Bonavina, Luigi

Annals of surgery

2018 Volume 270, Issue 2, Page(s) e37–e38

MeSH term(s)	Colectomy ; Colorectal Surgery ; Humans ; Incisional Hernia ; Laparoscopy
Language	English
Publishing date	2018-10-04
Publishing country	United States
Document type	Letter ; Comment
ZDB-ID	340-2
ISSN	1528-1140 ; 0003-4932
ISSN (online)	1528-1140
ISSN	0003-4932
DOI	10.1097/SLA.0000000000003076
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Article ; Online: Intratumor Microbiome in Neuroendocrine Neoplasms: A New Partner of Tumor Microenvironment? A Pilot Study.

Massironi, Sara / Facciotti, Federica / Cavalcoli, Federica / Amoroso, Chiara / Rausa, Emanuele / Centonze, Giovanni / Cribiù, Fulvia Milena / Invernizzi, Pietro / Milione, Massimo

Cells

2022 Volume 11, Issue 4

Abstract: Neuroendocrine neoplasms (NENs) are rare neoplasms with heterogeneous clinical behavior. Alteration in human microbiota was reported in association with carcinogenesis in different solid tumors. However, few studies addressed the role of microbiota in ... ...

Abstract	Neuroendocrine neoplasms (NENs) are rare neoplasms with heterogeneous clinical behavior. Alteration in human microbiota was reported in association with carcinogenesis in different solid tumors. However, few studies addressed the role of microbiota in NEN. We here aimed at evaluating the presence of bacterial infiltration in neuroendocrine tumoral tissue. To assess the presence of bacteria, 20 specimens from pancreatic NEN (pan-NEN) and 20 from intestinal NEN (I-NEN) were evaluated through Fluorescent In situ Hybridization and confocal microscopy. Demographic data, pre-operative investigations, operative findings, pathological diagnosis, follow-up, and survival data were evaluated. Among I-NEN, bacteria were detected in 15/20 (75%) specimens, with high variability in microbial distribution. In eight patients, a high infiltration of microorganisms was observed. Among pan-NEN, 18/20 (90%) showed microorganisms' infiltration, with a homogeneous microbial distribution. Bacterial localization in pan-NEN was observed in the proximity of blood vessels. A higher bacterial infiltration in the tumoral specimen as compared with non-tumoral tissue was reported in 10/20 pan-NEN (50%). No significant differences were observed in mean bacterial count according to age, sex, ki67%, site, tumor stage. Mean bacterial count did not result to be a predictor of disease-specific survival. This preliminary study demonstrates the presence of a significant microbiota in the NEN microenvironment. Further research is needed to investigate the potential etiological or clinical role of microbiota in NEN.
MeSH term(s)	Humans ; In Situ Hybridization, Fluorescence ; Microbiota ; Neuroendocrine Tumors/pathology ; Pilot Projects ; Tumor Microenvironment
Language	English
Publishing date	2022-02-16
Publishing country	Switzerland
Document type	Journal Article
ZDB-ID	2661518-6
ISSN	2073-4409 ; 2073-4409
ISSN (online)	2073-4409
ISSN	2073-4409
DOI	10.3390/cells11040692
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