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Article ; Online: Risk of ileocolic anastomosis failure after right hemicolectomy for cancer. A comparison between different techniques.

Rossi, Matteo / Solinas, Luigi / Di Meo, Diletta / Sagnotta, Andrea / Battaglia, Benedetto / Loponte, Margherita / Mancini, Stefano

Annali italiani di chirurgia

2023 Volume 94, Page(s) 161–167

Abstract: Background: In recent years, the role of laparoscopic approach in the surgical treatment of right colon cancer has increased. Results comparing the different techniques of ileocolic anastomoses are controversial, with studies only reporting some ... ...

Abstract	Background: In recent years, the role of laparoscopic approach in the surgical treatment of right colon cancer has increased. Results comparing the different techniques of ileocolic anastomoses are controversial, with studies only reporting some advantages of the intracorporeal laparoscopic technique. The aim of this study is to compare the outcomes between laparoscopic versus open hemicolectomy for right colon cancer, focusing on anastomotic techniques (intracorporeal vs extracorporeal in the laparoscopic procedure, and manual vs mechanical in the laparotomic procedure). Methods: This is a retrospective single center study enrolling patients with right colon cancer from January 2016 to December 2020. Primary endpoint of the study was the rate of anastomotic leak (AL). Results: A total of 161 patients who underwent right hemicolectomy were enrolled: 91 were performed with laparoscopic technique, and 70 with open technique. Overall, AL occurred in 15 pts (9.3%). We observed 4 AL in intracorporeal (12.9%) and 6 in extracorporeal (10%) anastomoses, respectively. In the laparotomy group 5 patients (7.1%) developed AL, of which 3 (5.7%) and 2 (11.1%) manually and mechanically performed, respectively. Conclusions: Based on our findings, laparoscopic hemicolectomy has a higher incidence of anastomotic leak. In the laparoscopic group, we observed the lowest rate of AL with extracorporeal mechanical anastomosis. When performed extracorporeally with open technique, hand-sewn anastomosis has better results than mechanical. Key words: Anastomosis, Cancer, Ileotransverse, Leakage, Right Colectomy.
MeSH term(s)	Humans ; Anastomotic Leak/epidemiology ; Anastomotic Leak/etiology ; Anastomotic Leak/surgery ; Retrospective Studies ; Colectomy/adverse effects ; Colectomy/methods ; Anastomosis, Surgical/adverse effects ; Anastomosis, Surgical/methods ; Colonic Neoplasms/surgery ; Colonic Neoplasms/complications ; Laparoscopy/methods ; Treatment Outcome
Language	English
Publishing date	2023-05-19
Publishing country	Italy
Document type	Journal Article
ZDB-ID	418927-9
ISSN	2239-253X ; 0003-469X
ISSN (online)	2239-253X
ISSN	0003-469X
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Article ; Online: A rare case of metachronous neuroendocrine tumor after a colorectal adenocarcinoma: qualitative critical review of synchronous and metachronous gastrointestinal NET.

Lancellotti, Francesco / Solinas, Luigi / Telesco, Davide / Sagnotta, Andrea / Belardi, Augusto / Balsamo, Giuseppina / Mancini, Stefano

Clinical journal of gastroenterology

2020 Volume 14, Issue 1, Page(s) 115–122

Abstract: Gastrointestinal neuroendocrine tumor (NET) associated with a metachronous intestinal adenocarcinoma is rare. We report the case of a 71-year-old man with an ileal NET. Patient has previously undergone a left colectomy for sigmoid cancer. We report a ... ...

Abstract	Gastrointestinal neuroendocrine tumor (NET) associated with a metachronous intestinal adenocarcinoma is rare. We report the case of a 71-year-old man with an ileal NET. Patient has previously undergone a left colectomy for sigmoid cancer. We report a complete review both of the metachronous and synchronous NET. A comprehensive systematic literature search in PubMed, EMBASE, and MEDLINE identified a total of 35 relevant studies. This study includes an analysis of review articles, case reports, case series, retrospective studies and population-based studies. In the English literature to date, there are 21 case reports (19 synchronous cases and 2 metachronous cases), 3 case series and 3 review articles, and less than 10 retrospective studies or population-based studies. A total of 31 patients in 24 articles were included in the study: 28 patients with a synchronous gastrointestinal NET and colorectal adenocarcinoma and 3 patients with metachronous gastrointestinal NET and colorectal adenocarcinoma. The incidence of synchronous cancer (particularly for colorectal and gastric cancer) with a gastrointestinal NET ranges from 10 to 50%, while for the metachronous ones it is still unclear. This is the third metachronous case report and the first descriptive case of gastrointestinal NET diagnosed 2 years after a colorectal adenocarcinoma. An endoscopic follow-up program for gastrointestinal NET patients and/or for first-degree relatives of NET patients appears recommendable.
MeSH term(s)	Adenocarcinoma/surgery ; Aged ; Colorectal Neoplasms/surgery ; Humans ; Male ; Neoplasms, Multiple Primary/surgery ; Neoplasms, Second Primary/surgery ; Neuroendocrine Tumors/surgery ; Retrospective Studies ; Stomach Neoplasms
Language	English
Publishing date	2020-10-12
Publishing country	Japan
Document type	Case Reports ; Journal Article ; Review
ZDB-ID	2429411-1
ISSN	1865-7265 ; 1865-7257
ISSN (online)	1865-7265
ISSN	1865-7257
DOI	10.1007/s12328-020-01255-9
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Article ; Online: Giant extraluminal leiomyoma of the colon: rare cause of symptomatic pelvic mass.

Sagnotta, Andrea / Sparagna, Alessandra / Uccini, Stefania / Mercantini, Paolo

International surgery

2015 Volume 100, Issue 5, Page(s) 805–808

Abstract: Leiomyomas (LMs) may appear throughout the entire gastrointestinal tract but are rarely seen in the colon-rectum and only 5 of those measured greater than 15 cm in diameter. Pain and palpable abdominal mass are the most common symptoms. Surgical ... ...

Abstract	Leiomyomas (LMs) may appear throughout the entire gastrointestinal tract but are rarely seen in the colon-rectum and only 5 of those measured greater than 15 cm in diameter. Pain and palpable abdominal mass are the most common symptoms. Surgical resection is the treatment of choice for most LMs. We here describe a case of a 46-year-old woman who presented with a 3-month history of abdominal pain associated with worsening constipation and abdominal distension. A pelvic solid, polylobulate, left-sided mass was noted on examination. Preoperative findings revealed a dishomogeneous sigmoid mass with calcified spots compressing small intestine and bladder. At laparotomy, a large polylobulate and well-circumscribed mass arising from the descending colon mesentery and displacing small intestine, uterus, and ovaries. A segmental colon resection was performed. An extraluminal 18- × 12- × 5-cm paucicellular sigmoid colon leiomyoma was histologically diagnosed. Our case is one of the few giant (>15 cm) sigmoid colon LMs reported in the literature. Although rare and benign in nature, LMs of the colon can cause life-threatening complications that could require emergency treatment and they should be included in the differential diagnosis of large abdominopelvic masses. Follow-up after surgery is necessary for tumors with any atypia or mitotic activity.
MeSH term(s)	Colectomy ; Colonic Neoplasms/diagnosis ; Colonic Neoplasms/surgery ; Diagnosis, Differential ; Female ; Humans ; Leiomyoma/diagnosis ; Leiomyoma/surgery ; Middle Aged
Language	English
Publishing date	2015-05
Publishing country	Italy
Document type	Case Reports ; Journal Article
ZDB-ID	80343-1
ISSN	2520-2456 ; 0020-8868
ISSN (online)	2520-2456
ISSN	0020-8868
DOI	10.9738/INTSURG-D-14-00054.1
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Article ; Online: Pathologic stage of ypT0N+ rectal cancers following neo-adjuvant treatment: clinical interpretation of an orphan status.

Lorenzon, Laura / De Luca, Raffaele / Santoro, Gloria / Parini, Dario / Rega, Daniela / Mellano, Alfredo / Vigorita, Vincenzo / Jiménez-Rosellón, Raquel / Sandin, Marta / Andriola, Valeria / Gallo, Gaetano / Marino, Graziella / Turati, Luca / Marsanic, Patrizia / Marano, Luigi / Lucarini, Alessio / Aprile, Alessandra / Sagnotta, Andrea / Biondi, Alberto

Pathology, research and practice

2022 Volume 237, Page(s) 154002

Abstract: Approximately 20% of locally advanced rectal cancers treated with neoadjuvant therapy achieve a pathologic complete response, but approximately 10% of them present residual nodal metastases (ypT0N+). We aimed this research to compare the survival rates ... ...

Abstract	Approximately 20% of locally advanced rectal cancers treated with neoadjuvant therapy achieve a pathologic complete response, but approximately 10% of them present residual nodal metastases (ypT0N+). We aimed this research to compare the survival rates of ypT0/ypTisN+ and stage 3a rectal cancer patients. A large multicenter study recently investigated ypT0/ypTis rectal cancers treated between 2005 and 2015 in Italy and Spain. ypT0/ypTisN+ were selected and compared with stage 3a rectal cancers treated at the same institutions with upfront surgery (ySICO group). Additionally, the SEER database was searched for patients with stage 3a rectal cancers treated with surgery in the same years. Overall survival (OS), disease-free survival (DFS), and disease-specific survival (DSS) were analyzed using Kaplan-Meier curves and random survival forest analysis (RSF). The ySICO study population consisted of 19 ypT0/2ypTisN+ (mean follow-up 41.8 months) and 72 Stage 3a patients (mean follow-up 56.9 months). These subgroups were comparable, but stage 3a patients were treated more frequently with adjuvant therapy (90.5% vs 61.9%, p 0.0001). No significant differences were reported between the ySICO subgroups for the OS, DFS, and DSS curves. When the 1213 SEER patients were added to Stage 3a, the RFS model failed to differentiate OS between groups that presented identical survival. Root analysis showed that adjuvant therapy was the only variable differentiating OS and DSS in the ySICO population. These findings suggest that ypT0/ypTisN+ and stage 3a rectal cancers could be ranked together based on their similar outcomes and pathologic assessment, and they stress the importance of adjuvant therapy in patients presenting with residual nodal metastases.
MeSH term(s)	Humans ; Neoadjuvant Therapy ; Neoplasm Staging ; Rectal Neoplasms/pathology ; Disease-Free Survival ; Rectum/pathology ; Retrospective Studies ; Treatment Outcome
Language	English
Publishing date	2022-07-03
Publishing country	Germany
Document type	Multicenter Study ; Journal Article
ZDB-ID	391889-0
ISSN	1618-0631 ; 0344-0338
ISSN (online)	1618-0631
ISSN	0344-0338
DOI	10.1016/j.prp.2022.154002
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Article: Long-term survival of patients with stage II and III gastric cancer who underwent gastrectomy with inadequate nodal assessment.

Desiderio, Jacopo / Sagnotta, Andrea / Terrenato, Irene / Garofoli, Eleonora / Mosillo, Claudia / Trastulli, Stefano / Arteritano, Federica / Tozzi, Federico / D'Andrea, Vito / Fong, Yuman / Woo, Yanghee / Bracarda, Sergio / Parisi, Amilcare

World journal of gastrointestinal surgery

2021 Volume 13, Issue 11, Page(s) 1463–1483

Abstract: Background: Gastric cancer is an aggressive disease with frequent lymph node (LN) involvement. The NCCN recommends a D2 lymphadenectomy and the harvesting of at least 16 LNs. This threshold has been the subject of great debate, not only for the extent ... ...

Abstract	Background: Gastric cancer is an aggressive disease with frequent lymph node (LN) involvement. The NCCN recommends a D2 lymphadenectomy and the harvesting of at least 16 LNs. This threshold has been the subject of great debate, not only for the extent of surgery but also for more appropriate staging. The reclassification of stage IIB through IIIC based on N3b nodal staging in the eighth edition of the American Joint Committee on Cancer (AJCC) staging system highlights the efforts to more accurately discriminate survival expectancy based on nodal number. Furthermore, studies have suggested that pathologic assessment of 30 or more LNs improve prognostic accuracy and is required for proper staging of gastric cancer. Aim: To evaluate the long-term survival of advanced gastric cancer patients who deviated from expected survival curves because of inadequate nodal evaluation. Methods: Eligible patients were identified from the Surveillance, Epidemiology, and End Results database. Those with stage II-III gastric cancer were considered for inclusion. Three groups were compared based on the number of analyzed LNs. They were inadequate LN assessment (ILA, < 16 LNs), adequate LN assessment (ALA, 16-29 LNs), and optimal LN assessment (OLA, ≥ 30 LNs). The main outcomes were overall survival (OS) and cancer-specific survival. Data were analyzed by the Kaplan-Meier product-limit method, log-rank test, hazard risk, and Cox proportional univariate and multivariate models. Propensity score matching (PSM) was used to compare the ALA and OLA groups. Results: The analysis included 11607 patients. Most had advanced T stages (T3 = 48%; T4 = 42%). The pathological AJCC stage distribution was IIA = 22%, IIB = 18%, IIIA = 26%, IIIB = 22%, and IIIC = 12%. The overall sample divided by the study objective included ILA (50%), ALA (35%), and OLA (15%). Median OS was 24 mo for the ILA group, 29 mo for the ALA group, and 34 mo for the OLA group ( Conclusion: Proper nodal staging is a critical issue in gastric cancer. Assessment of an inadequate number of LNs places patients at high risk of adverse long-term survival outcomes.
Language	English
Publishing date	2021-12-14
Publishing country	United States
Document type	Journal Article
ZDB-ID	2573700-4
ISSN	1948-9366
ISSN	1948-9366
DOI	10.4240/wjgs.v13.i11.1463
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Article ; Online: Gastrectomy for stage IV gastric cancer: a comparison of different treatment strategies from the SEER database.

Desiderio, Jacopo / Sagnotta, Andrea / Terrenato, Irene / Annibale, Bruno / Trastulli, Stefano / Tozzi, Federico / D'Andrea, Vito / Bracarda, Sergio / Garofoli, Eleonora / Fong, Yuman / Woo, Yanghee / Parisi, Amilcare

Scientific reports

2021 Volume 11, Issue 1, Page(s) 7150

Abstract: In the West, more than one third of newly diagnosed subjects show metastatic disease in gastric cancer (mGC) with few care options available. Gastrectomy has recently become a subject of debate, with some evidence showing advantages in survival beyond ... ...

Abstract	In the West, more than one third of newly diagnosed subjects show metastatic disease in gastric cancer (mGC) with few care options available. Gastrectomy has recently become a subject of debate, with some evidence showing advantages in survival beyond the sole purpose of treatment tumor-related complications. We investigated the survival benefit of different strategies in mGC patients, focusing on the role and timing of gastrectomy. Data were extracted from the SEER database. Groups were determined according to whether patients received gastrectomy, chemotherapy, supportive care. Patients receiving a multimodality treatment were further divided according to timing of surgery, whether performed before (primary gastrectomy, PG) or after chemotherapy (secondary gastrectomy, SG). 16,596 patients were included. Median OS was significantly higher (p < 0.001) in the SG (15 months) than in the PG (13 months), gastrectomy alone (6 months), and chemotherapy (7 months) groups. In the multivariate analysis, SG showed better OS (HR = 0.22, 95%CI = 0.18-0.26, p < 0.001) than PG (HR = 0.25, 95%CI = 0.23-0.28, p < 0.001), gastrectomy (HR = 0.40, 95%CI = 0.36-0.44, p < 0.001), and chemotherapy (HR = 0.42, 95%CI = 0.4-0.44, p < 0.001). The survival benefits persisted even after the PSM analysis. This study shows survival advantages of gastrectomy as multimodality strategy after chemotherapy. In selected patients, SG can be proposed to improve the management of stage IV disease.
MeSH term(s)	Aged ; Chemotherapy, Adjuvant/statistics & numerical data ; Female ; Follow-Up Studies ; Gastrectomy/methods ; Gastrectomy/statistics & numerical data ; Humans ; Kaplan-Meier Estimate ; Male ; Middle Aged ; Neoadjuvant Therapy/methods ; Neoadjuvant Therapy/statistics & numerical data ; Neoplasm Staging ; Prognosis ; SEER Program/statistics & numerical data ; Stomach/pathology ; Stomach/surgery ; Stomach Neoplasms/diagnosis ; Stomach Neoplasms/mortality ; Stomach Neoplasms/pathology ; Stomach Neoplasms/therapy ; Time-to-Treatment/statistics & numerical data ; Treatment Outcome
Language	English
Publishing date	2021-03-30
Publishing country	England
Document type	Comparative Study ; Journal Article
ZDB-ID	2615211-3
ISSN	2045-2322 ; 2045-2322
ISSN (online)	2045-2322
ISSN	2045-2322
DOI	10.1038/s41598-021-86352-6
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Article ; Online: Short course radiotherapy and delayed surgery for locally advanced rectal cancer in frail patients: is it a valid option?

Lancellotti, Francesco / Solinas, Luigi / Sagnotta, Andrea / Mancini, Stefano / Cosentino, Luigi Pio Marino / Belardi, Augusto / Battaglia, Benedetto / Mirri, Maria Alessandra / Ciabattoni, Antonella / Salerno, Francesca / Loponte, Margherita

European journal of surgical oncology : the journal of the European Society of Surgical Oncology and the British Association of Surgical Oncology

2021 Volume 47, Issue 8, Page(s) 2046–2052

Abstract: Objective: The endpoint of the present study was to evaluate the outcomes of short-course radiotherapy (SCRT) and SCRT with delayed surgery (SCRT-DS) on a selected subgroup of frail patients with locally advanced middle/low rectal adenocarcinoma.: ... ...

Abstract	Objective: The endpoint of the present study was to evaluate the outcomes of short-course radiotherapy (SCRT) and SCRT with delayed surgery (SCRT-DS) on a selected subgroup of frail patients with locally advanced middle/low rectal adenocarcinoma. Methods: From January 2008 to December 2018, a total of 128 frail patients with locally advanced middle-low rectal adenocarcinoma underwent SCRT and subsequent restaging for eventual delayed surgery. Rates of complete pathological response, down-staging, disease free survival (DFS) and overall survival (OS) were analyzed. Results: 128 patients completed 5 × 5 Gy pelvic radiotherapy. 69 of these were unfit for surgery; 59 underwent surgery 8 weeks (average time: 61 days) after radiotherapy. Downstaging of T occurred in 64% and down-staging of N in 50%. The median overall survival (OS) of SCRT alone was 19.5 months. The 1-year, 2-year, 3-year and 5-year OS was 48%, 22%, 14% and 0% respectively. In the surgical group, the median disease-free survival (DFS) and median OS were, respectively, 67 months (95% CI 49.8-83.1 months) and 72.1 months (95% CI 57.5-86.7 months). The 1, 2, 3, 5-year OS was 88%, 75%, 51%, 46%, respectively. Post-operative morbidity was 22%, mortality was 3.4%. Conclusions: Frail patients with advanced rectal cancer are often "unfit" for long-term neoadjuvant chemoradiation. A SCRT may be considered a valid option for this group of patients. Once radiotherapy is completed, patients can be re-evaluated for surgery. If feasible, SCRT and delayed surgery is the best option for frail patients.
MeSH term(s)	Abscess/epidemiology ; Adenocarcinoma/complications ; Adenocarcinoma/pathology ; Adenocarcinoma/physiopathology ; Adenocarcinoma/therapy ; Aged ; Aged, 80 and over ; Cancer Pain/etiology ; Cancer Pain/physiopathology ; Colectomy ; Digestive System Fistula/epidemiology ; Disease-Free Survival ; Female ; Frailty/complications ; Humans ; Male ; Middle Aged ; Neoadjuvant Therapy/methods ; Neoplasm Staging ; Postoperative Complications/epidemiology ; Proctectomy/methods ; Radiotherapy, Conformal/methods ; Rectal Neoplasms/complications ; Rectal Neoplasms/pathology ; Rectal Neoplasms/physiopathology ; Rectal Neoplasms/therapy ; Retrospective Studies ; Surgical Wound Infection/epidemiology ; Survival Rate
Language	English
Publishing date	2021-03-18
Publishing country	England
Document type	Journal Article
ZDB-ID	632519-1
ISSN	1532-2157 ; 0748-7983
ISSN (online)	1532-2157
ISSN	0748-7983
DOI	10.1016/j.ejso.2021.03.230
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Article ; Online: Perioperative transfusion risk assessment with elective hepatectomy.

Ramacciato, Giovanni / Sagnotta, Andrea / Nigri, Giuseppe

Annals of surgery

2011 Volume 253, Issue 3, Page(s) 629–30; author reply 630–1

MeSH term(s)	Blood Loss, Surgical ; Blood Transfusion/statistics & numerical data ; Blood Transfusion, Autologous/statistics & numerical data ; Carcinoma, Hepatocellular/blood ; Carcinoma, Hepatocellular/surgery ; Decision Support Techniques ; Hemoglobinometry ; Hepatectomy/statistics & numerical data ; Humans ; International Normalized Ratio ; Liver Neoplasms/blood ; Liver Neoplasms/secondary ; Liver Neoplasms/surgery ; Platelet Count ; Preoperative Care ; Probability ; Prothrombin Time ; Risk Assessment/statistics & numerical data
Language	English
Publishing date	2011-03
Publishing country	United States
Document type	Comment ; Letter
ZDB-ID	340-2
ISSN	1528-1140 ; 0003-4932
ISSN (online)	1528-1140
ISSN	0003-4932
DOI	10.1097/SLA.0b013e31820dcca4
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Article ; Online: In vivo

Magistri, Paolo / Battistelli, Cecilia / Toietta, Gabriele / Strippoli, Raffaele / Sagnotta, Andrea / Forgione, Antonello / Di Benedetto, Fabrizio / Uccini, Stefania / Vittorioso, Paola / D'Angelo, Francesco / Aurello, Paolo / Ramacciato, Giovanni / Nigri, Giuseppe

Journal of microscopy and ultrastructure

2019 Volume 7, Issue 3, Page(s) 136–140

Abstract: Background: In this study we aimed to develop a new : Methods: HCT 116 cells were transducted with pLenti6/V5-DEST-fLuc for constitutive expression of firefly luciferase. Infection was monitored analyzing endogenous bioluminescence using the IVIS ... ...

Abstract	Background: In this study we aimed to develop a new Methods: HCT 116 cells were transducted with pLenti6/V5-DEST-fLuc for constitutive expression of firefly luciferase. Infection was monitored analyzing endogenous bioluminescence using the IVIS Lumina II Results: We found that Conclusions: Our
Language	English
Publishing date	2019-08-28
Publishing country	India
Document type	Journal Article
ISSN	2213-8803
ISSN (online)	2213-8803
DOI	10.4103/JMAU.JMAU_51_18
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Article: Surgical management for acute cholangitis in patient with a left lobe liver lesion.

Balducci, Genoveffa / Dente, Mario / Sagnotta, Andrea / Mercantini, Paolo

The American surgeon

2009 Volume 75, Issue 4, Page(s) 344–346

MeSH term(s)	Acute Disease ; Aged ; Cholangiopancreatography, Endoscopic Retrograde ; Cholangiopancreatography, Magnetic Resonance ; Cholangitis/diagnosis ; Cholangitis/etiology ; Cholangitis/surgery ; Cholelithiasis/complications ; Cholelithiasis/diagnosis ; Cholelithiasis/surgery ; Diagnosis, Differential ; Follow-Up Studies ; Hepatectomy/methods ; Humans ; Male ; Tomography, X-Ray Computed
Language	English
Publishing date	2009-04
Publishing country	United States
Document type	Case Reports ; Letter
ZDB-ID	202465-2
ISSN	1555-9823 ; 0003-1348
ISSN (online)	1555-9823
ISSN	0003-1348
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