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Article ; Online: Ischemic colitis with non-gangrenous, stenotic evolution following hemorrhagic shock A case report and review of the literature.

Polistena, Andrea / Galasse, Sergio / Sanguinetti, Alessandro / Rozzi, Angelo / Avenia, Stefano / Pennella, Francesca Pennetti / Crocetti, Daniele / Avenia, Nicola

Annali italiani di chirurgia

2021 Volume 10

Abstract: Introduction: Ischemic colitis (IC) accounts for more of the half of total diagnosis of gastrointestinal ischemia. It is a challenging condition due to non-specificity of the symptoms at onset, inconstant behaviour and a wide range of clinical gravity ... ...

Abstract	Introduction: Ischemic colitis (IC) accounts for more of the half of total diagnosis of gastrointestinal ischemia. It is a challenging condition due to non-specificity of the symptoms at onset, inconstant behaviour and a wide range of clinical gravity with a different therapeutic approach. A classification of IC into gangrenous, stricturing and transient forms can be considered. Case report: In the presented case, due to hypovolemic hemorrhagic shock, the patient developed a progressive IC without gangrene but slowly evolving in multiple colonic strictures with general serious clinical condition. Endoscopy was used to confirm diagnosis and to tempt a pneumatic stricture dilation which resulted ineffective. A diverting stoma was required and an elective subtotal colectomy was carried out after resolution of the acute phase. Conclusions: IC may present with a large spectrum of clinical conditions. In acute shocked patients it must be always considered when a complicated abdominal picture is present. Immediate surgery is not always required considering the spontaneous resolutions of the milder forms. Strictures are the most frequent evolution following the intermediate nongangrenous presentation and initially they can be treated conservatively with postponed tailored resection after the healing of the diffuse mucosal injuries. Key words: Ischemic, colitis, Shock, Stricture.
MeSH term(s)	Cecostomy ; Colectomy ; Colitis, Ischemic/diagnosis ; Colitis, Ischemic/etiology ; Colitis, Ischemic/surgery ; Constriction, Pathologic/etiology ; Constriction, Pathologic/surgery ; Humans ; Intestinal Obstruction/diagnosis ; Intestinal Obstruction/etiology ; Intestinal Obstruction/surgery ; Male ; Middle Aged ; Shock, Hemorrhagic/diagnosis ; Shock, Hemorrhagic/etiology ; Shock, Hemorrhagic/therapy
Language	English
Publishing date	2021-03-16
Publishing country	Italy
Document type	Case Reports ; Journal Article ; Review
ZDB-ID	418927-9
ISSN	2239-253X ; 0003-469X
ISSN (online)	2239-253X
ISSN	0003-469X
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Article ; Online: Metastases to the breast. A clinical series from a single institution experience with review of the literature.

Sanguinetti, Alessandro / Avenia, Stefano / Pennella, Francesca Pennetti / Chiummariello, Stefano / Lucchini, Roberta / Galasse, Sergio / Macciò, Tiziana / Avenia, Nicola / Polistena, Andrea

Annali italiani di chirurgia

2021 Volume 92, Page(s) 141–148

Abstract: Introduction: Breast metastases although rare are challenging for diagnostic difficulties and management. Treatment differs according to morphological, immunophenotipycal and biologic features of the primary tumor and their general behaviour is ... ...

Abstract	Introduction: Breast metastases although rare are challenging for diagnostic difficulties and management. Treatment differs according to morphological, immunophenotipycal and biologic features of the primary tumor and their general behaviour is extremely different compared to primary breast cancer. The most frequent primary tumors include melanoma, lymphomas, gynecological, pulmonary, head and neck, gastroenteric and urinary tract cancers. Patient's prognosis is poor being generally associated to disseminated systemic disease with limited survival despite the effects of systemic treatment. Patients and methods: We report the analysis of the diagnostic and therapeutic approach on the institutional experience of four cases of breast metastases originating from melanoma, pulmonary adenocarcinoma and differentiated thyroid carcinomas. Conclusions: The management of breast secondarisms requires focused diagnosis and evaluation in order to provide an adequate treatment with a multidisciplinary approach especially when the primary tumor is unknown. Key words: Breast metastases, Melanoma, Pulmonary, Thyroid.
MeSH term(s)	Adenocarcinoma/diagnosis ; Adenocarcinoma/secondary ; Adenocarcinoma/therapy ; Adult ; Antineoplastic Agents/therapeutic use ; Breast Neoplasms/diagnosis ; Breast Neoplasms/secondary ; Breast Neoplasms/therapy ; Female ; Humans ; Lung Neoplasms/pathology ; Lung Neoplasms/therapy ; Mastectomy, Segmental ; Melanoma/diagnosis ; Melanoma/secondary ; Melanoma/therapy ; Metastasectomy ; Middle Aged ; Prognosis ; Retrospective Studies ; Skin Neoplasms/pathology ; Skin Neoplasms/therapy ; Thyroid Neoplasms/pathology ; Thyroid Neoplasms/therapy ; Thyroidectomy
Chemical Substances	Antineoplastic Agents
Language	English
Publishing date	2021-05-25
Publishing country	Italy
Document type	Case Reports ; Journal Article ; Review
ZDB-ID	418927-9
ISSN	2239-253X ; 0003-469X
ISSN (online)	2239-253X
ISSN	0003-469X
Database	MEDical Literature Analysis and Retrieval System OnLINE

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Article: Robotic Transanal Total Mesorectal Excision (RTaTME): State of the Art.

Rondelli, Fabio / Sanguinetti, Alessandro / Polistena, Andrea / Avenia, Stefano / Marcacci, Claudio / Ceccarelli, Graziano / Bugiantella, Walter / De Rosa, Michele

Journal of personalized medicine

2021 Volume 11, Issue 6

Abstract: Total mesorectal excision (TME) is the gold standard technique for the surgical management of rectal cancer. The transanal approach to the mesorectum was introduced to overcome the technical difficulties related to the distal rectal dissection. Since its ...

Abstract	Total mesorectal excision (TME) is the gold standard technique for the surgical management of rectal cancer. The transanal approach to the mesorectum was introduced to overcome the technical difficulties related to the distal rectal dissection. Since its inception, interest in transanal mesorectal excision has grown exponentially and it appears that the benefits are maximal in patients with mid-low rectal cancer where anatomical and pathological features represent the greatest challenges. Current evidence demonstrates that this approach is safe and feasible, with oncological and functional outcome comparable to conventional approaches, but with specific complications related to the technique. Robotics might potentially simplify the technical steps of distal rectal dissection, with a shorter learning curve compared to the laparoscopic transanal approach, but with higher costs. The objective of this review is to critically analyze the available literature concerning robotic transanal TME in order to define its role in the management of rectal cancer and to depict future perspectives in this field of research.
Language	English
Publishing date	2021-06-21
Publishing country	Switzerland
Document type	Journal Article ; Review
ZDB-ID	2662248-8
ISSN	2075-4426
ISSN	2075-4426
DOI	10.3390/jpm11060584
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Article ; Online: Is routine axillary lymph node dissection needed to tailor systemic treatments for breast cancer patients in the era of molecular oncology? A position paper of the Italian National Association of Breast Surgeons (ANISC).

Rocco, Nicola / Ghilli, Matteo / Curcio, Annalisa / Bortul, Marina / Burlizzi, Stefano / Cabula, Carlo / Cabula, Roberta / Ferrari, Alberta / Folli, Secondo / Fortunato, Lucio / Frittelli, Patrizia / Gentilini, Oreste / Grendele, Sara / Grassi, Massimo Maria / Grossi, Simona / Magnoni, Francesca / Murgo, Roberto / Palli, Dante / Rovera, Francesca /

Sanguinetti, Alessandro / Taffurelli, Mario / Tazzioli, Giovanni / Terribile, Daniela Andreina / Caruso, Francesco / Galimberti, Viviana

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

2024 Volume 50, Issue 2, Page(s) 107954

Abstract: Background: De-escalation of axillary surgery in breast cancer (BC) management began when sentinel lymph node biopsy (SLNB) replaced axillary lymph node dissection (ALND) as standard of care in patients with node-negative BC. The second step ... ...

Abstract	Background: De-escalation of axillary surgery in breast cancer (BC) management began when sentinel lymph node biopsy (SLNB) replaced axillary lymph node dissection (ALND) as standard of care in patients with node-negative BC. The second step consolidated ALND omission in selected subgroups of BC patients with up to two macrometastases and recognized BC molecular and genomic implication in predicting prognosis and planning adjuvant treatment. Outcomes from the recent RxPONDER and monarchE trials have come to challenge the previous cut-off of two SLN in order to inform decisions on systemic therapies for hormone receptor-positive (HR+), human epidermal growth factor receptor type-2 (HER2) negative BC, as the criteria included a cut-off of respectively three and four SLNs. In view of the controversy that this may lift in surgical practice, the Italian National Association of Breast Surgeons (Associazione Nazionale Italiana Senologi Chirurghi, ANISC) reviewed data regarding the latest trials on this topic and proposes an implementation in clinical practice. Material and methods: We reviewed the available literature offering data on the pathological nodal status of cN0 breast cancer patients. Results: The rates of pN2 status in cN0 patients ranges from 3.5 % to 16 %; pre-surgical diagnostic definition of axillary lymph node status in cN0 patients by ultrasound could be useful to inform about a possible involvement of ≥4 lymph nodes in this specific sub-groups of women. Conclusions: The Italian National Association of Breast Surgeons (ANISC) considers that for HR + HER2-/cN0-pN1(sn) BC patients undergoing breast conserving treatment the preoperative workup should be optimized for a more detailed assessment of the axilla and the technique of SLNB should be optimized, if considered appropriate by the surgeon, not considering routine ALND always indicated to determine treatment recommendations according to criteria of eligibility to RxPONDER and monarch-E trials.
MeSH term(s)	Humans ; Female ; Breast Neoplasms/pathology ; Lymphatic Metastasis/pathology ; Lymph Node Excision ; Sentinel Lymph Node Biopsy/methods ; Surgeons ; Axilla/pathology ; Italy ; Sentinel Lymph Node/pathology
Language	English
Publishing date	2024-01-06
Publishing country	England
Document type	Journal Article ; Review
ZDB-ID	632519-1
ISSN	1532-2157 ; 0748-7983
ISSN (online)	1532-2157
ISSN	0748-7983
DOI	10.1016/j.ejso.2024.107954
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Article: Effect of Antibiotic Prophylaxis on Surgical Site Infection in Thyroid and Parathyroid Surgery: A Systematic Review and Meta-Analysis.

Polistena, Andrea / Prete, Francesco Paolo / Avenia, Stefano / Cavallaro, Giuseppe / Di Meo, Giovanna / Pasculli, Alessandro / Rondelli, Fabio / Sanguinetti, Alessandro / Sgaramella, Lucia Ilaria / Avenia, Nicola / Testini, Mario / Gurrado, Angela

Antibiotics (Basel, Switzerland)

2022 Volume 11, Issue 3

Abstract: Thyroid and parathyroid surgery are considered clean procedures, with an incidence of surgical site infection (SSI) after thyroidectomy ranging from 0.09% to 2.9%. International guidelines do not recommend routine antibiotic prophylaxis (AP), while AP ... ...

Abstract	Thyroid and parathyroid surgery are considered clean procedures, with an incidence of surgical site infection (SSI) after thyroidectomy ranging from 0.09% to 2.9%. International guidelines do not recommend routine antibiotic prophylaxis (AP), while AP seems to be employed commonly in clinical practice. The purpose of this systematic review is analyzing whether the postoperative SSI rate in thyroid and parathyroid surgery is altered by the practice of AP. We searched Pubmed, Scopus, the Cochrane Library, and Web of Science (WOS) for studies comparing AP to no preoperative antibiotics up to October 2021. Data on the SSI rate was evaluated and summarized as relative risks (RR) with 95% confidence intervals (95% CI). Risk of bias of studies were assessed with standard methods. Nine studies (4 RCTs and 5 nRCTs), including 8710 participants, were eligible for quantitative analysis. A meta-analysis showed that the SSI rate was not significantly different between AP and no preoperative antibiotics (SSI rate: 0.6% in AP vs. 2.4% in control group; RR 0.69, 0.43-1.10 95% CI,
Language	English
Publishing date	2022-02-22
Publishing country	Switzerland
Document type	Journal Article ; Review
ZDB-ID	2681345-2
ISSN	2079-6382
ISSN	2079-6382
DOI	10.3390/antibiotics11030290
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Article: Management of Low-Risk Thyroid Cancers: Is Active Surveillance a Valid Option? A Systematic Review of the Literature.

Patrone, Renato / Velotti, Nunzio / Masone, Stefania / Conzo, Alessandra / Flagiello, Luigi / Cacciatore, Chiara / Filardo, Marco / Granata, Vincenza / Izzo, Francesco / Testa, Domenico / Avenia, Stefano / Sanguinetti, Alessandro / Polistena, Andrea / Conzo, Giovanni

Journal of clinical medicine

2021 Volume 10, Issue 16

Abstract: Thyroid cancer is the most common endocrine malignancy, representing 2.9% of all new cancers in the United States. It has an excellent prognosis, with a five-year relative survival rate of 98.3%.Differentiated Thyroid Carcinomas (DTCs) are the most ... ...

Abstract	Thyroid cancer is the most common endocrine malignancy, representing 2.9% of all new cancers in the United States. It has an excellent prognosis, with a five-year relative survival rate of 98.3%.Differentiated Thyroid Carcinomas (DTCs) are the most diagnosed thyroid tumors and are characterized by a slow growth rate and indolent course. For years, the only approach to treatment was thyroidectomy. Active surveillance (AS) has recently emerged as an alternative approach; it involves regular observation aimed at recognizing the minority of patients who will clinically progress and would likely benefit from rescue surgery. To better clarify the indications for active surveillance for low-risk thyroid cancers, we reviewed the current management of low-risk DTCs with a systematic search performed according to a PRISMA flowchart in electronic databases (PubMed, Web of Science, Scopus, and EMBASE) for studies published before May 2021. Fourteen publications were included for final analysis, with a total number of 4830 patients under AS. A total of 451/4830 (9.4%) patients experienced an increase in maximum diameter by >3 mm; 609/4830 (12.6%) patients underwent delayed surgery after AS; metastatic spread to cervical lymph nodes was present in 88/4213 (2.1%) patients; 4/3589 (0.1%) patients had metastatic disease outside of cervical lymph nodes. Finally, no subject had a documented mortality due to thyroid cancer during AS. Currently, the American Thyroid Association guidelines do not support AS as the first-line treatment in patients with PMC; however, they consider AS to be an effective alternative, particularly in patients with high surgical risk or poor life expectancy due to comorbid conditions. Thus, AS could be an alternative to immediate surgery for patients with very-low-risk tumors showing no cytologic evidence of aggressive disease, for high-risk surgical candidates, for those with concurrent comorbidities requiring urgent intervention, and for patients with a relatively short life expectancy.
Language	English
Publishing date	2021-08-13
Publishing country	Switzerland
Document type	Journal Article ; Review
ZDB-ID	2662592-1
ISSN	2077-0383
ISSN	2077-0383
DOI	10.3390/jcm10163569
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Article: Impact of Epithelial-Mesenchymal Immunophenotype on Local Aggressiveness in Papillary Thyroid Carcinoma Invading the Airway.

Mandarano, Martina / Andolfi, Marco / Colella, Renato / Monacelli, Massimo / Polistena, Andrea / Moretti, Sonia / Bellezza, Guido / Puxeddu, Efisio / Sanguinetti, Alessandro / Sidoni, Angelo / Avenia, Nicola / Puma, Francesco / Vannucci, Jacopo

Journal of clinical medicine

2021 Volume 10, Issue 19

Abstract: Primary thyroid tumours show different levels of aggressiveness, from indolent to rapidly growing infiltrating malignancies. The most effective therapeutic option is surgery when radical resection is feasible. Biomarkers of aggressiveness may help in ... ...

Abstract	Primary thyroid tumours show different levels of aggressiveness, from indolent to rapidly growing infiltrating malignancies. The most effective therapeutic option is surgery when radical resection is feasible. Biomarkers of aggressiveness may help in scheduling extended resections such as airway infiltration, avoiding a non-radical approach. The aim of the study is to evaluate the prognostic role of E-cadherin, N-cadherin, Aryl hydrocarbon receptor (AhR), and CD147 in different biological behaviours. Fifty-five samples from three groups of thyroid carcinomas were stained: papillary thyroid carcinomas (PTCs) infiltrating the airway (PTC-A), papillary intra-thyroid carcinomas (PTC-B) and poorly differentiated or anaplastic thyroid carcinomas (PDTC/ATC). High expressions of N-cadherin and AhR were associated with higher locoregional tumour aggressiveness (
Language	English
Publishing date	2021-09-24
Publishing country	Switzerland
Document type	Journal Article
ZDB-ID	2662592-1
ISSN	2077-0383
ISSN	2077-0383
DOI	10.3390/jcm10194351
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Article: The Role of IONM in Reducing the Occurrence of Shoulder Syndrome Following Lateral Neck Dissection for Thyroid Cancer.

Polistena, Andrea / Ranalli, Monia / Avenia, Stefano / Lucchini, Roberta / Sanguinetti, Alessandro / Galasse, Sergio / Rondelli, Fabio / Vannucci, Jacopo / Patrone, Renato / Velotti, Nunzio / Conzo, Giovanni / Avenia, Nicola

Journal of clinical medicine

2021 Volume 10, Issue 18

Abstract: Lateral neck dissection (LND) leads to a significant morbidity involving accessory nerve injury. Modified radical neck dissection (MRND) aims at preservation of the accessory nerve, but patients often present with negative functional outcomes after ... ...

Abstract	Lateral neck dissection (LND) leads to a significant morbidity involving accessory nerve injury. Modified radical neck dissection (MRND) aims at preservation of the accessory nerve, but patients often present with negative functional outcomes after surgery. The role of neuromonitoring (IONM) in the prevention of shoulder syndrome has not yet been defined in comparison to nerve visualization only. We retrospectively analyzed 56 thyroid cancer patients who underwent MRND over a period of six years (2015-2020) in a high-volume institution. Demographic variables, type of surgical procedure, removed lymph nodes and the metastatic node ratio, pathology, adoption of IONM and shoulder functional outcome were investigated. The mean number of lymph nodes removed was 15.61, with a metastatic node ratio of 0.2745. IONM was used in 41.07% of patients, with a prevalence of 68% in the period 2017-2020. IONM adoption showed an effect on post-operative shoulder function. There were no effects in 89.29% of cases, and temporary and permanent effects in 8.93% and 1.79%, respectively. Confidence intervals and two-sample tests for equality of proportions were used when applicable. Expertise in high-volume centres and IONM during MRND seem to be correlated with a reduced prevalence of accessory nerve lesions and limited functional impairments. These results need to be confirmed by larger prospective randomized controlled trials.
Language	English
Publishing date	2021-09-18
Publishing country	Switzerland
Document type	Journal Article
ZDB-ID	2662592-1
ISSN	2077-0383
ISSN	2077-0383
DOI	10.3390/jcm10184246
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Article ; Online: Interleukin-6 and pro inflammatory status in the breast tumor microenvironment.

Sanguinetti, Alessandro / Santini, Donatella / Bonafè, Massimiliano / Taffurelli, Mario / Avenia, Nicola

World journal of surgical oncology

2015 Volume 13, Page(s) 129

Abstract: Background: Greater than 50,000 new cases of breast cancer cases were diagnosed in Italy during 2013, with nearly 15,000 women succumbing to the disease. These epidemiological statistics highlight the overwhelming clinical dilemma of breast cancer and ... ...

Abstract	Background: Greater than 50,000 new cases of breast cancer cases were diagnosed in Italy during 2013, with nearly 15,000 women succumbing to the disease. These epidemiological statistics highlight the overwhelming clinical dilemma of breast cancer and emphasize the need for novel therapeutic targets and prevention strategies. Countless studies in the fields of mammary gland development and breast cancer have led to an appreciation of a breast tumor microenvironment that actively contributes to the heterogeneous nature of breast cancer. Methods: The current review will focus on the impact of IL-6 and in the breast tumor microenvironment. Excessive IL-6 has been demonstrated in primary breast tumors and breast cancer patient sera and is associated with poor clinical outcomes in breast cancer. These clinical associations are corroborated by emerging preclinical data revealing that IL-6 is a potent growth factor and promotes an epithelial-mesenchyme (EMT) phenotype in breast cancer cells to indicate that IL-6 in the breast tumor microenvironment is clinically relevant. Results: High serum levels of interleukin-6 correlate with poor outcome in breast cancer patients. However, few data are yet available on the relationship between IL-6 and stem/progenitor cells, which may fuel the genesis of breast cancer in vivo. Mammospheres (MS) from node invasive breast carcinoma tissues express IL-6 mRNA at higher levels than MS from matched non-neoplastic mammary glands. IL-6 mRNA is detectable only in basal-like breast carcinoma tissues; our results reveal that IL-6 triggers a Notch-3-dependent upregulation of the Notch ligand Jagged-1, whose interaction with Notch-3 promotes the growth of MS and Michigan Cancer Foundation-7 (MCF-7)-derived spheroids. IL-6 induces a Notch-3-dependent upregulation of the carbonic anhydrase IX gene and promotes a hypoxia-resistant/invasive phenotype in MCF-7 cells and MS. Conclusions: In conclusion, our data support the hypothesis that IL-6 induces malignant features in Notch-3-expressing, stem/progenitor cells from human ductal breast carcinoma and normal mammary gland.
MeSH term(s)	Biomarkers, Tumor/genetics ; Biomarkers, Tumor/metabolism ; Breast/metabolism ; Breast Neoplasms/genetics ; Breast Neoplasms/metabolism ; Breast Neoplasms/pathology ; Carcinoma, Ductal, Breast/genetics ; Carcinoma, Ductal, Breast/metabolism ; Carcinoma, Ductal, Breast/pathology ; Female ; Gene Expression Regulation, Neoplastic ; Humans ; Immunoenzyme Techniques ; Inflammation Mediators/metabolism ; Interleukin-6/genetics ; Interleukin-6/metabolism ; Prognosis ; RNA, Messenger/genetics ; Real-Time Polymerase Chain Reaction ; Receptor, Notch3 ; Receptors, Notch/genetics ; Receptors, Notch/metabolism ; Reverse Transcriptase Polymerase Chain Reaction ; Tumor Microenvironment
Chemical Substances	Biomarkers, Tumor ; IL6 protein, human ; Inflammation Mediators ; Interleukin-6 ; NOTCH3 protein, human ; RNA, Messenger ; Receptor, Notch3 ; Receptors, Notch
Language	English
Publishing date	2015-03-28
Publishing country	England
Document type	Journal Article
ZDB-ID	2118383-1
ISSN	1477-7819 ; 1477-7819
ISSN (online)	1477-7819
ISSN	1477-7819
DOI	10.1186/s12957-015-0529-2
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Article: Breast metastasis from a pulmonary adenocarcinoma: Case report and review of the literature.

Sanguinetti, Alessandro / Puma, Francesco / Lucchini, Roberta / Santoprete, Stefano / Cirocchi, Roberto / Corsi, Alessia / Triola, Roberta / Avenia, Nicola

Oncology letters

2019 Volume 18, Issue 6, Page(s) 6305

Abstract: This retracts the article DOI: 10.3892/ol.2012.995.]. ...

Abstract	[This retracts the article DOI: 10.3892/ol.2012.995.].
Language	English
Publishing date	2019-10-04
Publishing country	Greece
Document type	Journal Article ; Retraction of Publication
ZDB-ID	2573196-8
ISSN	1792-1082 ; 1792-1074
ISSN (online)	1792-1082
ISSN	1792-1074
DOI	10.3892/ol.2019.10965
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