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Article ; Online: Patients with an Open Abdomen in Asian, American and European Continents: A Comparative Analysis from the International Register of Open Abdomen (IROA).

Sibilla, Maria Grazia / Cremonini, Camilla / Portinari, Mattia / Carcoforo, Paolo / Tartaglia, Dario / Cicuttin, Enrico / Musetti, Serena / Strambi, Silvia / Sartelli, Massimo / Radica, Margherita Koleva / Catena, Fausto / Chiarugi, Massimo / Coccolini, Federico

World journal of surgery

2022 Volume 47, Issue 1, Page(s) 142–151

Abstract: Background: International register of open abdomen (IROA) enrolls patients from several centers in American, European, and Asiatic continent. The aim of our study is to compare the characteristics, management and clinical outcome of adult patients ... ...

Abstract	Background: International register of open abdomen (IROA) enrolls patients from several centers in American, European, and Asiatic continent. The aim of our study is to compare the characteristics, management and clinical outcome of adult patients treated with OA in the three continents. Material and methods: A prospective analysis of adult patients enrolled in the international register of open abdomen (IROA). Trial registration: NCT02382770. Results: 1183 patients were enrolled from American, European and Asiatic Continent. Median age was 63 years (IQR 49-74) and was higher in the European continent (65 years, p < 0.001); 57% were male. The main indication for OA was peritonitis (50.6%) followed by trauma (15.4%) and vascular emergency (13.5%) with differences among the continents (p < 0.001). Commercial NPWT was preferred in America and Europe (77.4% and 52.3% of cases) while Barker vacuum pack (48.2%) was the preferred temporary abdominal closure technique in Asia (p < 0.001). Definitive abdominal closure was achieved in 82.3% of cases in America (fascial closure in 90.2% of cases) and in 56.4% of cases in Asia (p < 0.001). Prosthesis were mostly used in Europe (17.3%, p < 0.001). The overall entero-atmospheric fistula rate 2.5%. Median open abdomen duration was 4 days (IQR 2-7). The overall intensive care unit and hospital length-of-stay were, respectively, 8 and 11 days (no differences between continents). The overall morbidity and mortality rates for America, Europe, and Asia were, respectively, 75.8%, 75.3%, 91.8% (p = 0.001) and 31.9%, 51.6%, 56.9% (p < 0.001). Conclusion: There is no uniformity in OA management in the different continents. Heterogeneous adherence to international guidelines application is evident. Different temporary abdominal closure techniques in relation to indications led to different outcomes across the continents. Adherence to guidelines, combined with more consistent data, will ultimately allow to improving knowledge and outcome.
MeSH term(s)	Humans ; Male ; Middle Aged ; Female ; Asia ; Europe ; Vacuum
Language	English
Publishing date	2022-11-03
Publishing country	United States
Document type	Journal Article ; Research Support, Non-U.S. Gov't
ZDB-ID	224043-9
ISSN	1432-2323 ; 0364-2313
ISSN (online)	1432-2323
ISSN	0364-2313
DOI	10.1007/s00268-022-06733-4
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Article ; Online: Volume control of the lower limb with graduated compression during different muscle pump activation conditions and the relation to limb circumference variation.

Gianesini, Sergio / Raffetto, Joseph D / Mosti, Giovanni / Maietti, Elisa / Sibilla, Maria Grazia / Zamboni, Paolo / Menegatti, Erica

Journal of vascular surgery. Venous and lymphatic disorders

2020 Volume 8, Issue 5, Page(s) 814–820

Abstract: Background: The literature supports the use of graduated compression stockings (GCS) for leg edema. Nevertheless, there is a paucity of data on the GCS effect on limb edema related to sitting, standing, and walking. Data of different limb shapes and ... ...

Abstract	Background: The literature supports the use of graduated compression stockings (GCS) for leg edema. Nevertheless, there is a paucity of data on the GCS effect on limb edema related to sitting, standing, and walking. Data of different limb shapes and their impact on GCS-exerted pressure are lacking. This investigation provides evidence-based information on the effect of GCS on edema reduction and the impact of limb circumference gradients on GCS pressure. Methods: Thirty healthy individuals (15 men and 15 women; mean age, 32 ± 5 years) were included. All the participants underwent lower limb volume (Kuhnke formula) measurement, before and after sitting for 30 minutes, wearing below-ankle noncompressive socks. The same assessment was repeated 7 days later, in the same participants, but with wearing of below-knee 16 to 20 mm Hg GCS. At 7-day intervals, 1 week with below-ankle noncompressive socks and 1 week with below-knee 16 to 20 mm Hg GCS, all the participants repeated the same protocol including standing and walking. Ten participants underwent bioimpedance assessment (Biody Xpert II; eBIODY, La Ciotat, France) before and after sitting, standing, and walking. In the same group, B and B1 interface pressure values were measured. Results: Data collection was completed in all 60 limbs. Sitting or walking without GCS led to no significant volume changes, whereas volume was decreased by the use of GCS (-4.8% [P < .00001] and -4.4% [P < .00001], respectively). Standing up without GCS led to an increase in volume (2.7%; P < .0001), whereas limb volume was decreased (4.6%; P < .0001) by use of GCS. Bioimpedance showed extracellular water reduction only while walking with GCS (from 40.55% ± 1.66% to 40.45% ± 1.71%; P < .017). Mean interface pressure was 19 ± 5 mm Hg (B) and 16 ± 5 mm Hg (B1). The interface pressure variation from B to B1 was not homogeneous among participants (mean percentage variation of -13% ± 25%, ranging from -54% to 16%). A negative linear trend between pressure variation and circumference percentage increase was found; the subanalysis excluding the two outliers showed a strong negative linear correlation (Pearson coefficient r = -0.96). Conclusions: GCS led to a significant limb volume reduction irrespective of limb position and muscle pump function. However, extracellular fluid is mobilized only during muscle contraction while walking with GCS. Interestingly, different lower limb circumference variations influence the interface pressure gradient, indicating the importance of proper fitting of both B and B1 during prescription. These data provide a foundation to future investigations dealing with GCS effect on fluid mobilization and with limb geometry impact on compression performance.
MeSH term(s)	Adult ; Body Composition ; Cross-Sectional Studies ; Electric Impedance ; Extracellular Fluid/metabolism ; Female ; Fluid Shifts ; Healthy Volunteers ; Humans ; Leg/blood supply ; Male ; Muscle Contraction ; Prospective Studies ; Sitting Position ; Stockings, Compression ; Time Factors ; Walking
Language	English
Publishing date	2020-02-21
Publishing country	United States
Document type	Comparative Study ; Journal Article
ISSN	2213-3348
ISSN (online)	2213-3348
DOI	10.1016/j.jvsv.2019.12.073
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Article ; Online: A phase II randomized clinical trial for the treatment of recalcitrant chronic leg ulcers using centrifuged adipose tissue containing progenitor cells.

Zollino, Ilaria / Campioni, Diana / Sibilla, Maria Grazia / Tessari, Mirko / Malagoni, Anna Maria / Zamboni, Paolo

Cytotherapy

2018 Volume 21, Issue 2, Page(s) 200–211

Abstract: Background aims: Preclinical and observational reports indicate that adipose tissue (AT) is a safe and promising tool to treat non-healing venous leg ulcers (VLUs).: Methods: From an initial cohort of 38 patients, 16 patients affected by non-healing ... ...

Abstract	Background aims: Preclinical and observational reports indicate that adipose tissue (AT) is a safe and promising tool to treat non-healing venous leg ulcers (VLUs). Methods: From an initial cohort of 38 patients, 16 patients affected by non-healing VLUs were randomly allocated to the experimental arm (5 men and 3 women) and control arm (5 men and 3 women). In the experimental arm, wounds were treated by debridement, centrifuged adipose tissue (CAT), advanced dressings and compression. No experimental treatment (CAT) was administered to the control arm. We investigated the functional and the immunophenotypical features of the harvested CAT-derived stem cells. The primary outcome measures were healing time and safety of the cell treatment. Secondary outcomes were pain evaluated by numeric rating scale (NRS), complete wound healing at 24 weeks by Margolis Index and wound-healing process expressed in square centimeters per week. The various immunophenotypic and functional characteristics of CAT-derived stem cells were then correlated with the clinical outcomes. Results: No major adverse events were recorded. The healing time was significantly faster by applying CAT, 17.5 ± 7.0 weeks versus 24.5 ± 4.9 weeks recorded in the control arm (P < 0.036). NRS dropped after the first week to 2.7 ± 2.0 in the experimental arm versus 6.6 ± 3.0 in the control group (P < 0.01). The rate of healing at the 24th week was not significantly different between arms. Interestingly, we found a strong reverse correlation between the percent of CD34 Conclusions: CAT is safe and may accelerate healing time in VLUs as well as reduce wound pain. The percentage of CD34
MeSH term(s)	Adipose Tissue/cytology ; Aged ; Aged, 80 and over ; Centrifugation/methods ; Chronic Disease ; Cohort Studies ; Female ; Humans ; Immunophenotyping ; Male ; Middle Aged ; Stem Cell Transplantation/adverse effects ; Stem Cell Transplantation/methods ; Treatment Outcome ; Varicose Ulcer/therapy ; Wound Healing
Language	English
Publishing date	2018-12-22
Publishing country	England
Document type	Clinical Trial, Phase II ; Journal Article ; Randomized Controlled Trial
ZDB-ID	2039821-9
ISSN	1477-2566 ; 1465-3249
ISSN (online)	1477-2566
ISSN	1465-3249
DOI	10.1016/j.jcyt.2018.10.012
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Article ; Online: Mini-invasive foam sclerotherapy-assisted ligation versus surgical flush ligation for incompetent sapheno-popliteal junction treatment.

Gianesini, Sergio / Menegatti, Erica / Sibilla, Maria Grazia / Neuhardt, Diana / Maietti, Elisa / Tessari, Mirko / Zamboni, Paolo

Phlebology

2019 Volume 34, Issue 9, Page(s) 604–610

MeSH term(s)	Female ; Follow-Up Studies ; Humans ; Ligation ; Male ; Middle Aged ; Popliteal Vein ; Retrospective Studies ; Saphenous Vein ; Sclerotherapy ; Varicose Veins ; Venous Insufficiency/therapy
Language	English
Publishing date	2019-02-26
Publishing country	England
Document type	Journal Article
ZDB-ID	645172-x
ISSN	1758-1125 ; 0268-3555
ISSN (online)	1758-1125
ISSN	0268-3555
DOI	10.1177/0268355519833229
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Article ; Online: Lower limb volume in healthy individuals after walking with compression stockings.

Gianesini, Sergio / Mosti, Giovanni / Sibilla, Maria Grazia / Maietti, Elisa / Diaz, Jose Antonio / Raffetto, Joseph D / Zamboni, Paolo / Menegatti, Erica

Journal of vascular surgery. Venous and lymphatic disorders

2019 Volume 7, Issue 4, Page(s) 557–561

Abstract: Objective: Despite the modern appeal of wearing compressive garments during physical activities, the literature is lacking in quality data and controversial in the investigations dealing with the pathophysiologic mechanism by which graduated compression ...

Abstract	Objective: Despite the modern appeal of wearing compressive garments during physical activities, the literature is lacking in quality data and controversial in the investigations dealing with the pathophysiologic mechanism by which graduated compression stockings (GCS) affect the calf pump activation in healthy individuals. The aim of the investigation was to provide insight into the clinical effects of GCS use during a standardized walking exercise. Methods: Twenty physically active healthy volunteers (mean age, 34 ± 5 years; body mass index, 22 ± 2 kg/m Results: All individuals had normal venous and arterial ultrasound examination findings. No significant postural defects were reported. Both legs were assessed in all 20 individuals for a total of 40 cases with and 40 cases without GCS. In the baseline group, the median (interquartile range) lower limb volume changed from 2496 (770) mL before exercise to 2512 (805) mL (P = .2597) after exercise. The compression group reported a significant lower limb volume change from 2466 (670) mL before exercise to 2276 (567) mL (P = .0001) after exercise. Mean perceived exertion was 13 (11) and 11 (1) in the baseline and compression groups, respectively (P = .0001). The interface pressure exerted by the GCS was 24 (2) mm Hg. No complaints in terms of discomfort were reported after use of GCS. Conclusions: In healthy individuals, GCS (24 [2] mm Hg) use during a continuous standardized walk of 30 minutes is associated with a significant decrease in lower limb volume and a decrease in perceived exertion. The mechanism by which GCS impart their effect during physical activity may involve improved muscle pump function and reductions in inflammatory pathways. Further study will need to validate the mechanisms of the function of GCS used during physical exercise.
MeSH term(s)	Adult ; Cross-Over Studies ; Female ; Healthy Volunteers ; Humans ; Lower Extremity/anatomy & histology ; Lower Extremity/blood supply ; Male ; Muscle Contraction ; Prospective Studies ; Regional Blood Flow ; Stockings, Compression ; Time Factors ; Walking
Language	English
Publishing date	2019-03-25
Publishing country	United States
Document type	Journal Article
ISSN	2213-3348
ISSN (online)	2213-3348
DOI	10.1016/j.jvsv.2019.02.001
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Article ; Online: Inherited genetic predispositions in F13A1 and F13B genes predict abdominal adhesion formation: identification of gender prognostic indicators.

Gemmati, Donato / Occhionorelli, Savino / Tisato, Veronica / Vigliano, Marco / Longo, Giovanna / Gonelli, Arianna / Sibilla, Maria G / Serino, Maria L / Zamboni, Paolo

Scientific reports

2018 Volume 8, Issue 1, Page(s) 16916

Abstract: Abdominal adhesions (AA) account for the most common complication of peritoneal surgery with bowel obstruction being the severest problem in the absence of effective predicting biomarkers. Anti-AA-barriers or adhesiolysis did not completely prevent bowel ...

Abstract	Abdominal adhesions (AA) account for the most common complication of peritoneal surgery with bowel obstruction being the severest problem in the absence of effective predicting biomarkers. Anti-AA-barriers or adhesiolysis did not completely prevent bowel obstruction, although there is evidence they might reduce related complications requiring reoperation. In addition, gender-related predispositions have not been adequately investigated. We explored the role of coagulation Factor XIII (F13A1 and F13B subunit-genes) in patients following laparotomy, mostly median/lower median incision line. Globally, 426 patients (54%,♀), were PCR-SNP-genotyped for FXIIIA V34L (rs5985), FXIIIA P564L (rs5982), FXIIIA Y204F (rs3024477) and FXIIIB H95R (rs6003). Patients' clinical phenotypes were: Group-A (n = 212), those who developed AA, and 55.2% of them developed bowel obstruction (subgroup-A1), the remaining were subgroup-A2; Group B (n = 214) were those who did not develop AA (subgroup-B1; 53.3%) or symptoms/complications (subgroup-B2). Among different laparotomy, colon surgery associated with AA at a major extent (OR = 5.1; 3.24-7.8; P < 0.0001) with different gender scores (♀OR = 5.33; 2.32-12.23; P < 0.0001 and ♂OR = 3.44; 1.58-7.49; P < 0.0001). Among SNPs, P564L (OR = 4.42; 1.45-13.4; P = 0.008) and Y204F (OR = 7.78; 1.62-37.3; P = 0.01) significantly predicted bowel obstruction and survival-analyses yielded interesting gender distinctions (♀HR = 5.28; 2.36-11.8; P = 0.00005; ♂HR = 2.22; 1.31-3.85; P = 0.0034). Active compounds preventing AA belong to the anticoagulant/fibrinolysis areas, suggesting them candidate investigation targets. We identified novel prognostic markers to predict AA/bowel obstruction giving insights to design novel therapeutic and gender prevention programs.
MeSH term(s)	Aged ; Aged, 80 and over ; Alleles ; Biomarkers ; Digestive System Surgical Procedures/adverse effects ; Factor XIII/genetics ; Female ; Genetic Predisposition to Disease ; Genotype ; Humans ; Intestinal Obstruction/etiology ; Male ; Middle Aged ; Odds Ratio ; Polymorphism, Single Nucleotide ; Postoperative Complications ; Tissue Adhesions/complications ; Tissue Adhesions/etiology
Chemical Substances	Biomarkers ; Factor XIII (9013-56-3)
Language	English
Publishing date	2018-11-16
Publishing country	England
Document type	Journal Article ; Research Support, Non-U.S. Gov't
ZDB-ID	2615211-3
ISSN	2045-2322 ; 2045-2322
ISSN (online)	2045-2322
ISSN	2045-2322
DOI	10.1038/s41598-018-35185-x
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Article ; Online: Autologous adipose-derived stem cells: Basic science, technique, and rationale for application in ulcer and wound healing.

Zollino, Ilaria / Zuolo, Michele / Gianesini, Sergio / Pedriali, Massimo / Sibilla, Maria Grazia / Tessari, Mirko / Carinci, Francesco / Occhionorelli, Savino / Zamboni, Paolo

Phlebology

2017 Volume 32, Issue 3, Page(s) 160–171

Abstract: Objectives The present review represents a translational boundary between basic research and surgery, particularly focusing on the promising application of adipose-derived stem cells harvested intra-operatively during debridement of venous leg ulcers. ... ...

Abstract	Objectives The present review represents a translational boundary between basic research and surgery, particularly focusing on the promising application of adipose-derived stem cells harvested intra-operatively during debridement of venous leg ulcers. Methods We reviewed 830 out of 5578 articles on MEDLINE starting from 1997 and sorted by the relevance option. Results The technique currently used for adipose-derived stem cells intra-operative harvesting is presented, including a safety evaluation on a cohort of 5089 revised patients who underwent plastic surgery and maxillo-facial surgical procedures. Complications were reported in 169 cases (3.3%). One hundred and forty-one (2.77%) patients were classified as having minor complications, specifically: nodularity/induration 93 (1.83%), dysesthesia 14 (0.26%), hematoma 12 (0.23%), superficial infection 11 (0.21%), pain 7 (0.13%), poor cosmesis 3 (0.06%), and abnormal breast secretion 1 (0.02%), while 28 patients (0.55%) were classified as having major complications, specifically: deep infection 22 (0.43%), sepsis 3 (0.06%), abdominal hematoma 2 (0.04%), and pneumothorax 1 (0.02%). Application of cell therapy in venous leg ulcer is currently used only for patients not responding to the standard treatment. The review shows the lack of randomized clinical trials for application of adipose-derived stem cells among treatments for venous leg ulcer. Finally, adipose-derived stem cells implantation at the wound site promotes a new tissue formation rich in vascular structures and remodeling collagen. Conclusion Adipose-derived stem cells strategy represents a great opportunity for the treatment of chronic wounds, due to the simplicity of the technique and the application of cell treatment in the operating room immediately following debridement. However, clinical studies and data from randomized trials are currently lacking.
MeSH term(s)	Adipose Tissue/cytology ; Adipose Tissue/metabolism ; Animals ; Autografts ; Cell- and Tissue-Based Therapy/adverse effects ; Cell- and Tissue-Based Therapy/methods ; Humans ; Stem Cell Transplantation ; Stem Cells/cytology ; Stem Cells/metabolism ; Varicose Ulcer/metabolism ; Varicose Ulcer/therapy ; Wound Healing
Language	English
Publishing date	2017-04
Publishing country	England
Document type	Journal Article ; Review
ZDB-ID	645172-x
ISSN	1758-1125 ; 0268-3555
ISSN (online)	1758-1125
ISSN	0268-3555
DOI	10.1177/0268355516641546
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Article: Routine prophylactic ureteral stenting before cytoreductive surgery and hyperthermic intraperitoneal chemotherapy: Safety and usefulness from a single-center experience.

Fugazzola, Paola / Coccolini, Federico / Tomasoni, Matteo / Cicuttin, Enrico / Sibilla, Maria Grazia / Gubbiotti, Francesca / Lippi, Andrea / Improta, Mario / Montori, Giulia / Ceresoli, Marco / Pisano, Michele / Ansaloni, Luca

Turkish journal of urology

2019 Volume 45, Issue 5, Page(s) 372–376

Abstract: Objective: There are very few evidences about safety and usefulness of routine prophylactic ureteral stenting (PUS) before cytoreductive surgery (CRS) and hyperthermic intraperitoneal chemotherapy (HIPEC).: Material and methods: An analysis of ... ...

Abstract	Objective: There are very few evidences about safety and usefulness of routine prophylactic ureteral stenting (PUS) before cytoreductive surgery (CRS) and hyperthermic intraperitoneal chemotherapy (HIPEC). Material and methods: An analysis of prospectively collected data about patients who underwent CRS and HIPEC for different sites of primary disease was carried out focusing on ureteral complications. Results: A total of 138 patients who underwent CRS and HIPEC between December 2010 and June 2017 were considered. All patients underwent PUS before CRS and HIPEC. Of them, 91 (66.4%) patients received pelvic peritonectomy, 49 (35.8%) pelvic lymphadenectomy, 31 (22.6%) left hemicolectomy, 44 (32.4%) right hemicolectomy, 46 (33.6%) rectal resection, 56 (40.9%) hysteroannessiectomy, and 39 (28.5%) appendectomy. There was one (0.7%) postoperative ureteral fistula. The cumulative risk of ureteral stent-related major complications was 4.3% (two patients (1.4%) had protracted gross hematuria, two patients (1.4%) had urinary sepsis, and three patients (2.9%) developed hydronephrosis after a period from removing ureteral stents and required restenting. Morbidity due to ureteral stenting was associated with a longer length of stay (LOS) (p=0.053). A total of 52 patients (44.1%) developed renal dysfunction according to the RIFLE (Risk, Injury, Failure, Loss of kidney function, End-stage kidney-disease) criteria: 19.5% were in risk class, 10.2% in acute renal injury class, and 14.4% in acute renal failure class. Conclusion: PUS could be a useful tool for reducing iatrogenic ureteral injury, but it is associated with a non-negligible morbidity, which implies longer LOS. A more accurate patient selection for PUS is necessary.
Language	English
Publishing date	2019-09-01
Publishing country	Turkey
Document type	Journal Article
ISSN	2149-3235
ISSN	2149-3235
DOI	10.5152/tud.2019.19025
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Article ; Online: Conservative treatment of acute appendicitis.

Coccolini, Federico / Fugazzola, Paola / Sartelli, Massimo / Cicuttin, Enrico / Sibilla, Maria Grazia / Leandro, Gioacchino / De' Angelis, Gian Luigi / Gaiani, Federica / Di Mario, Francesco / Tomasoni, Matteo / Catena, Fausto / Ansaloni, Luca

Acta bio-medica : Atenei Parmensis

2018 Volume 89, Issue 9-S, Page(s) 119–134

Abstract: Acute appendicitis has been considered by surgeons a progressive disease leading to perforation for more than 100 years. In the last decades the theories about this concept gained attention, especially in adults. However, appendectomy for acute ... ...

Abstract	Acute appendicitis has been considered by surgeons a progressive disease leading to perforation for more than 100 years. In the last decades the theories about this concept gained attention, especially in adults. However, appendectomy for acute appendicitis remains the most common urgent/emergent surgical procedure. At present, accumulating evidences are showing the changing in clinical practice towards the non-operative management of several cases of acute appendicitis either non-complicated or complicated. The present review aims to show the literature results regarding the non-operative management of acute appendicitis in non-complicated and in complicated cases.
MeSH term(s)	Abdominal Abscess/etiology ; Adult ; Analgesics/therapeutic use ; Anti-Bacterial Agents/therapeutic use ; Appendectomy ; Appendicitis/complications ; Appendicitis/drug therapy ; Appendicitis/surgery ; Child ; Conservative Treatment/trends ; Follow-Up Studies ; Humans ; Length of Stay ; Meta-Analysis as Topic ; Multicenter Studies as Topic ; Observational Studies as Topic ; Peritonitis/drug therapy ; Peritonitis/etiology ; Randomized Controlled Trials as Topic ; Recurrence ; Treatment Outcome ; Unnecessary Procedures
Chemical Substances	Analgesics ; Anti-Bacterial Agents
Language	English
Publishing date	2018-12-17
Publishing country	Italy
Document type	Journal Article ; Review
ZDB-ID	2114240-3
ISSN	2531-6745 ; 0392-4203
ISSN (online)	2531-6745
ISSN	0392-4203
DOI	10.23750/abm.v89i9-S.7905
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Article ; Online: An approach to complicated diverticular disease. A retrospective study in an Acute Care Surgery service recently established.

Occhionorelli, Savino / Zese, Monica / Tartarini, Daniela / Lacavalla, Domenica / Maccatrozzo, Stefano / Groppo, Giacomo / Sibilla, Maria Grazia / Stano, Rocco / Cappellari, Lorenzo / Vasquez, Giorgio

Annali italiani di chirurgia

2016 Volume 87, Page(s) 553–563

Abstract: Aim: Acute diverticulitis is a frequent disease in the Western Countries. The increase number of patients admitted in the Surgery Departments led the necessity of new Scores and Classifications in order to clarify, in absence of clear guidelines, the ... ...

Abstract	Aim: Acute diverticulitis is a frequent disease in the Western Countries. The increase number of patients admitted in the Surgery Departments led the necessity of new Scores and Classifications in order to clarify, in absence of clear guidelines, the best treatments to offer in the different situations. Methods: A retrospective study of ninety-nine patients treated in our Department from June 2010 and March 2015. Results: In our study 41 patients were treated conservatively, the remaining 58 were operated, 56 laparotomic and 2 laparoscopic. 5 patients submitted US guided drainage of abscess which failed in 2 cases. 25 submitted Hartmann's Procedure (HP), 29 Primary Resection and Anastomosis (PRA), 3 Contemporary Closure of Perforated Diverticula (CC) and just 2 Laparoscopic Peritoneal Lavage and Drainage (LPL). We related different Hinchey groups and up-groups with the treatments approached, identifying patients risk factors, ASA score and complications. Discussion: The treatment of perforated diverticulitis is debated. CT scan is becoming an useful instrument to make a correct diagnosis. Hinchey I and II patients are preferentially treated conservatively except in cases of complicated presentations. Hinchey III and IV are necessarily treated with surgical approach. We analyze the different types of intervention currently approached. Conclusion: We believe in PRA in Hinchey III and IV selected patients, HP is the gold standard in higher ASA scores patients but the low number of stoma reversal remains an open problem. Many studies are ongoing concerning LPL and now there are insufficient data to think of a widespread use of this technique. Key words: CT scan, Diverticular Disease, Hartmann's Procedure, Intr-abdominal abscess, Laparoscopic Peritoneal Lavage and Drainage (LPL), Peritonitis, Primary Resection and Anastomosis (PRAHinchey Classification, US and CT guided drainage.
MeSH term(s)	Adult ; Aged ; Aged, 80 and over ; Diverticulitis, Colonic/complications ; Diverticulitis, Colonic/surgery ; Female ; Humans ; Male ; Middle Aged ; Retrospective Studies ; Surgicenters
Language	English
Publishing date	2016
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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In stock of ZB MED Cologne/Königswinter

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In stock of ZB MED Cologne/Königswinter

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Order via subito

Inter-library loan at ZB MED

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Order via subito

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In stock of ZB MED Cologne/Königswinter

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More links

Kategorien

Order via subito

Inter-library loan at ZB MED

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In stock of ZB MED Cologne/Königswinter

Order via subito

More links

Kategorien

In stock of ZB MED Cologne/Königswinter

Order via subito