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Article ; Online: Guest edited collection: current friends and foes in gastrointestinal cancer.

Sica, Giuseppe S

Discover. Oncology

2021 Volume 12, Issue 1, Page(s) 34

Language	English
Publishing date	2021-09-21
Publishing country	United States
Document type	Editorial
ISSN	2730-6011
ISSN (online)	2730-6011
DOI	10.1007/s12672-021-00428-3
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Article ; Online: Laparoscopic Sleeve Gastrectomy with Staple-Line Oversewing in a Patient with Factor XI Deficiency: A Case Report.

Beomonte Zobel, Lorenza / Dhimolea, Sirvjo / Billeci, Federica / Sbraccia, Paolo / Sica, Giuseppe S

The American journal of case reports

2024 Volume 25, Page(s) e942824

Abstract: BACKGROUND Bariatric surgery (BS) has a lower percentage of complications than other abdominal surgeries. Hemorrhage in one of the most common complications and can be life-threatening. Hereditary factor XI (FXI) deficiency is a coagulation disorder that ...

Abstract	BACKGROUND Bariatric surgery (BS) has a lower percentage of complications than other abdominal surgeries. Hemorrhage in one of the most common complications and can be life-threatening. Hereditary factor XI (FXI) deficiency is a coagulation disorder that can result in excessive bleeding requiring intervention to restore hemostasis. Risks over benefits in patients with morbid obesity with BS indication, as well as those with FXI deficiency, should be carefully evaluated. This article reports the case of an obese woman with FXI deficiency -undergoing SG. CASE REPORT A 49-year-old woman with a BMI of 51 kg/m² was diagnosed as having severe FXI deficiency during preoperative exams prior to bariatric surgery. Virus-inactivated homo-group plasma 10 ml/kg infusion was administrated 1 h before surgery, during the entire procedure, and continuing until postoperative day (POD) 4. A very low-calorie ketogenic diet (VLCKD) was proposed to the patient 4 weeks before surgery. Laparoscopic sleeve gastrectomy was performed with staple-line reinforcement by oversewing the seromuscular layer using continuous suture. Subcutaneous enoxaparin 4000 U.I. was administered from POD 1 until POD 25 to prevent any thromboembolic event. The patient was discharged on POD 5 in good clinical condition. CONCLUSIONS Risks of bleeding andor thromboembolic events before or after BS are increased in patient with FXI deficiency. Bariatric surgery in these patients is safe in experienced BS centers, and the risks associated with the obesity seem to exceed those of the coagulopathy and surgery. Careful preoperative counseling, extensive hematological checks, and meticulous surgery are essential to reduce BS risks. Sleeve gastrectomy oversewing the stapler line seems a reasonable choice.
MeSH term(s)	Humans ; Female ; Middle Aged ; Gastrectomy/methods ; Laparoscopy ; Factor XI Deficiency/complications ; Obesity, Morbid/surgery ; Surgical Stapling
Language	English
Publishing date	2024-04-24
Publishing country	United States
Document type	Case Reports ; Journal Article
ZDB-ID	2517183-5
ISSN	1941-5923 ; 1941-5923
ISSN (online)	1941-5923
ISSN	1941-5923
DOI	10.12659/AJCR.942824
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Article: Robotic Lateral Pelvic Lymph Node Dissection in Rectal Cancer: A Feasibility Study from a European Centre.

Chang, Tou Pin / Ali, Oroog / Tsimogiannis, Kostas / Sica, Giuseppe S / Khan, Jim S

Journal of clinical medicine

2023 Volume 13, Issue 1

Abstract: Introduction: The role of robotic lateral pelvic lymph node dissection (LPLND) for lateral pelvic nodal disease (LPND) in rectal cancer has yet to be investigated in the Western hemisphere. This study aims to investigate the safety and feasibility of ... ...

Abstract	Introduction: The role of robotic lateral pelvic lymph node dissection (LPLND) for lateral pelvic nodal disease (LPND) in rectal cancer has yet to be investigated in the Western hemisphere. This study aims to investigate the safety and feasibility of robotic LPLND by utilising a well-established totally robotic TME protocol. Methods: We conducted a retrospective study on 17 consecutive patients who underwent robotic LPLND for LPND ± TME for rectal cancer between 2015 and 2021. A single docking totally robotic approach from the left hip with full splenic mobilisation was performed using the X/Xi da Vinci platform. All patients underwent a tri-compartmental robotic en bloc excision of LPND with preservation of the obturator nerve and pelvic nerve plexus, leaving a well-skeletonised internal iliac vessel and its branches. Results: The median operative time was 280 min, which was 40 min longer than our standard robotic TME. The median BMI was 26, and there were no conversions. The median inpatient stay was 7 days with no Clavien-Dindo > 3 complications. One patient (6%) developed local recurrence and metastatic disease within 5 months. The proportion of histologically confirmed LPND was 41%, of which 94% were well to moderately differentiated adenocarcinoma. Median pre-operative lateral pelvic node size was significantly higher in positive nodes (14 mm vs. 8 mm ( Discussion: Robotic LPLND is safe and feasible with good peri-operative and short-term outcomes, with the ergonomic advantages of a robotic TME docking protocol readily transferrable in LPLND.
Language	English
Publishing date	2023-12-23
Publishing country	Switzerland
Document type	Journal Article
ZDB-ID	2662592-1
ISSN	2077-0383
ISSN	2077-0383
DOI	10.3390/jcm13010090
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Article ; Online: The "Phillips" Ileostomy Correction Technique for Prolapsed Stoma.

Bellato, Vittoria / Tanis, Pieter J / Hompes, Roel / Buskens, Christianna J / Sica, Giuseppe S / Bemelman, Willem A

Diseases of the colon and rectum

2022 Volume 65, Issue 3, Page(s) e176–e178

Abstract: Introduction: Stoma prolapse is a common complication associated with ostomy creation, causing leakage, obstruction, and sometimes incarceration. Sometimes ileostomy prolapse cannot be treated with resection and alternative methods must be applied. We ... ...

Abstract	Introduction: Stoma prolapse is a common complication associated with ostomy creation, causing leakage, obstruction, and sometimes incarceration. Sometimes ileostomy prolapse cannot be treated with resection and alternative methods must be applied. We propose a new surgical revisional technique for ileostomy prolapse. Technique: Under general anesthesia, the prolapsed stoma is dissected and freed from the fascia and skin. The bowel is everted to create a nipple of 2-3 cm and subsequently fixed with a 3-row linear stapler, creating a "Phillips ileostomy." The ileostomy is then sutured to the skin with 3-0 full thickness stitches. Results: In our center, 3 patients were treated in a day surgery setting, and no complication occurred. One patient reported a prolapse recurrence after 6 months and was successfully treated with the same technique with no recurrence at 1 year. Conclusions: The 3-row stapler fixation of prolapsed ileostomy is simple to perform, preserves the bowel, and can be performed in the day surgery setting.
MeSH term(s)	Adult ; Crohn Disease/surgery ; Female ; Humans ; Ileostomy/adverse effects ; Ileostomy/methods ; Intestinal Diseases/surgery ; Male ; Middle Aged ; Postoperative Complications/diagnosis ; Postoperative Complications/etiology ; Postoperative Complications/surgery ; Proctocolectomy, Restorative/adverse effects ; Proctocolectomy, Restorative/methods ; Prolapse ; Reoperation/methods ; Risk Factors ; Surgical Stomas/adverse effects ; Treatment Outcome
Language	English
Publishing date	2022-03-28
Publishing country	United States
Document type	Case Reports ; Journal Article
ZDB-ID	212581-x
ISSN	1530-0358 ; 0012-3706
ISSN (online)	1530-0358
ISSN	0012-3706
DOI	10.1097/DCR.0000000000002150
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Article ; Online: Laparoscopic synchronous CME-right colectomy and D2/3 subtotal gastrectomy following embryological-based principles - A video vignette.

Sensi, Bruno / Siragusa, Leandro / Franceschilli, Marzia / Pirozzi, Brunella / Guida, Andrea M / Sica, Giuseppe S

Colorectal disease : the official journal of the Association of Coloproctology of Great Britain and Ireland

2022 Volume 25, Issue 3, Page(s) 520–521

MeSH term(s)	Humans ; Lymph Node Excision ; Laparoscopy ; Gastrectomy ; Colectomy ; Colonic Neoplasms/surgery
Language	English
Publishing date	2022-11-14
Publishing country	England
Document type	Video-Audio Media ; Letter
ZDB-ID	1440017-0
ISSN	1463-1318 ; 1462-8910
ISSN (online)	1463-1318
ISSN	1462-8910
DOI	10.1111/codi.16359
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Article ; Online: Ambulatory laparoscopic colectomies: a systematic review.

Siragusa, Leandro / Pellino, Gianluca / Sensi, Bruno / Panis, Yves / Bellato, Vittoria / Khan, Jim / Sica, Giuseppe S

Colorectal disease : the official journal of the Association of Coloproctology of Great Britain and Ireland

2023 Volume 25, Issue 6, Page(s) 1102–1115

Abstract: Aim: Ambulatory laparoscopic colectomy (ALC), meaning discharge within 24 h of surgical colonic resection, has recently been proposed in a few, selected patients. This systematic review was performed with the aim of reviewing protocols for ALC and ... ...

Abstract	Aim: Ambulatory laparoscopic colectomy (ALC), meaning discharge within 24 h of surgical colonic resection, has recently been proposed in a few, selected patients. This systematic review was performed with the aim of reviewing protocols for ALC and assessing feasibility, safety and outcomes after ALC. Method: A PRISMA-compliant systematic review and pooled analysis was performed searching all English studies published until October 2022 in PubMed, Cochrane Library, Web of Science (PROSPERO, CRD42022334463). Inclusion criteria were original articles including patients undergoing ALC, specifying at least one outcome of interest. Exclusion criteria were articles reporting a robotic-assisted procedure; unable to retrieve patient data from articles; the same patient series included in different studies. Primary outcomes were success, overall complications and readmission rates. Secondary outcomes included mortality and specific complications such us surgical site infection, anastomotic leak, ileus, bleeding, rate of ALC acceptance, and unscheduled consultation and reoperation rate. Results: Among 1087 studies imported for screening, 11 were included (1296 patients). The success rate was 47% with an overall morbidity of 14%. Readmission and reoperation rates were 5% and 1%, respectively. No mortality was recorded. Protocols of ALC differ significantly among published studies. Conclusions: Overall, ALC appears to be safe and feasible in selected cases with an acceptable success rate and a low risk of readmission after hospital discharge. Future studies should evaluate patients' benefits and discharge criteria, as well as uniformity and standardization of eligibility criteria. This systematic review may help inform on ALC adoption in clinical practice.
MeSH term(s)	Humans ; Surgical Wound Infection ; Anastomotic Leak ; Reoperation ; Colectomy/methods ; Laparoscopy/methods ; Postoperative Complications/epidemiology ; Postoperative Complications/etiology ; Treatment Outcome
Language	English
Publishing date	2023-02-28
Publishing country	England
Document type	Systematic Review ; Journal Article ; Review
ZDB-ID	1440017-0
ISSN	1463-1318 ; 1462-8910
ISSN (online)	1463-1318
ISSN	1462-8910
DOI	10.1111/codi.16511
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Article ; Online: Correction: Definition and reporting of lymphadenectomy and complete mesocolic excision for radical right colectomy: a systematic review.

Sica, Giuseppe S / Vinci, Danilo / Siragusa, Leandro / Sensi, Bruno / Guida, Andrea M / Bellato, Vittoria / García-Granero, Álvaro / Pellino, Gianluca

Surgical endoscopy

2022 Volume 37, Issue 3, Page(s) 2418

Language	English
Publishing date	2022-11-04
Publishing country	Germany
Document type	Published Erratum
ZDB-ID	639039-0
ISSN	1432-2218 ; 0930-2794
ISSN (online)	1432-2218
ISSN	0930-2794
DOI	10.1007/s00464-022-09747-0
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Article ; Online: Definition and reporting of lymphadenectomy and complete mesocolic excision for radical right colectomy: a systematic review.

Sica, Giuseppe S / Vinci, Danilo / Siragusa, Leandro / Sensi, Bruno / Guida, Andrea M / Bellato, Vittoria / García-Granero, Álvaro / Pellino, Gianluca

Surgical endoscopy

2022 Volume 37, Issue 2, Page(s) 846–861

Abstract: Background: Several procedures have been proposed to reduce the rates of recurrence in patients with right-sided colon cancer. Different procedures for a radical right colectomy (RRC), including extended D3 lymphadenectomy, complete mesocolic excision ... ...

Abstract	Background: Several procedures have been proposed to reduce the rates of recurrence in patients with right-sided colon cancer. Different procedures for a radical right colectomy (RRC), including extended D3 lymphadenectomy, complete mesocolic excision and central vascular ligation have been associated with survival benefits by some authors, but results are inconsistent. The aim of this study was to assess the variability in definition and reporting of RRC, which might be responsible for significant differences in outcome evaluation. Methods: PRISMA-compliant systematic literature review to identify the definitions of RRC. Primary aims were to identify surgical steps and different nomenclature for RRC. Secondary aims were description of heterogeneity and overlap among different RRC techniques. Results: Ninety-nine articles satisfied inclusion criteria. Eight surgical steps were identified and recorded as specific to RRC: Central arterial ligation was described in 100% of the included studies; preservation of mesocolic integrity in 73% and dissection along the SMV plane in 67%. Other surgical steps were inconstantly reported. Six differently named techniques for RRC have been identified. There were 35 definitions for the 6 techniques and 40% of these were used to identify more than one technique. Conclusions: The only universally adopted surgical step for RRC is central arterial ligation. There is great heterogeneity and consistent overlap among definitions of all RRC techniques. This is likely to jeopardise the interpretation of the outcomes of studies on the topic. Consistent use of definitions and reporting of procedures are needed to obtain reliable conclusions in future trials. PROSPERO CRD42021241650.
MeSH term(s)	Humans ; Colonic Neoplasms/surgery ; Lymph Node Excision/methods ; Dissection/methods ; Ligation ; Colectomy/methods ; Mesocolon/surgery ; Laparoscopy/methods
Language	English
Publishing date	2022-09-12
Publishing country	Germany
Document type	Systematic Review ; Journal Article ; Review ; Research Support, Non-U.S. Gov't
ZDB-ID	639039-0
ISSN	1432-2218 ; 0930-2794
ISSN (online)	1432-2218
ISSN	0930-2794
DOI	10.1007/s00464-022-09548-5
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Article: Preoperative Immunonutrition vs. Standard Dietary Advice in Normo-Nourished Patients Undergoing Fast-Track Laparoscopic Colorectal Surgery.

Tesauro, Manfredi / Guida, Andrea M / Siragusa, Leandro / Sensi, Bruno / Bellato, Vittoria / Di Daniele, Nicola / Divizia, Andrea / Franceschilli, Marzia / Sica, Giuseppe S

Journal of clinical medicine

2021 Volume 10, Issue 3

Abstract: Immunonutrition (IN) appears to reduce infective complications and in-hospital length of stay (LOS) after major gastrointestinal surgery, but its use in normo-nourished patients is still controversial. The primary aim of this comparative observational ... ...

Abstract	Immunonutrition (IN) appears to reduce infective complications and in-hospital length of stay (LOS) after major gastrointestinal surgery, but its use in normo-nourished patients is still controversial. The primary aim of this comparative observational study was to evaluate if pre-operative IN reduces in-hospital stay in patients undergoing laparoscopic colorectal resection for cancer under an enhanced recovery after surgery (ERAS) program. The influence of IN on time to first bowel movements, time to full oral diet tolerance, number and type of complications, reasons of prolonged LOS and readmission rate was evaluated as secondary outcome. Patients undergoing ERAS laparoscopic colorectal resection between December 2016 and December 2019 were reviewed. Patients who have received preoperative IN (group A) were compared to those receiving standard dietary advice (group B). Mean in-hospital LOS was significantly shorter in patients receiving preoperative IN than standard dietary advice (4.85 ± 2.25 days vs. 6.06 ± 3.95 days;
Language	English
Publishing date	2021-01-22
Publishing country	Switzerland
Document type	Journal Article
ZDB-ID	2662592-1
ISSN	2077-0383
ISSN	2077-0383
DOI	10.3390/jcm10030413
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Article ; Online: Surgery for inflammatory bowel disease in the era of laparoscopy.

Sica, Giuseppe S / Biancone, Livia

World journal of gastroenterology

2013 Volume 19, Issue 16, Page(s) 2445–2448

Abstract: During the course of inflammatory bowel disease (IBD), surgery may be needed. Approximately 20% of patients with ulcerative colitis (UC) will require surgery, whereas up to 80% of Crohn's disease (CD) patients will undergo an operation during their ... ...

Abstract	During the course of inflammatory bowel disease (IBD), surgery may be needed. Approximately 20% of patients with ulcerative colitis (UC) will require surgery, whereas up to 80% of Crohn's disease (CD) patients will undergo an operation during their lifetime. For UC patients requiring surgery, total proctocolectomy and ileoanal pouch anastomosis (IPAA) is the operation of choice as it provides a permanent cure and good quality of life. Nevertheless a permanent stoma is a good option in selected patients, especially the elderly. Minimally invasive surgery has replaced the conventional open approach in many specialized centres worldwide. Laparoscopic colectomy and restorative IPAA is rapidly becoming the standard of care in the treatment of UC requiring surgery, whilst laparoscopic ileo-cecal resection is already the new gold standard in the treatment of complicated CD of terminal ileum. Short term advantages of laparoscopic surgery includes faster recovery time and reduced requirement for analgesics. It is, however, in the long term that minimally invasive surgery has demonstrated its superiority over the open approach. A better cosmesis, a reduced number of incisional hernias and fewer adhesions are the long term advantages of laparoscopy in IBD surgery. A reduction in abdominal adhesions is of great benefit when a second operation is needed in CD and this influences positively the pregnancy rate in young women undergoing restorative IPAA. In developing the therapeutic plan for IBD patients it should be recognized that the surgical approach to the abdomen has changed and that surgical treatment of complicated IBD can be safely performed with a true minimally invasive approach with great patient satisfaction.
MeSH term(s)	Colitis, Ulcerative/diagnosis ; Colitis, Ulcerative/surgery ; Colonic Pouches/adverse effects ; Crohn Disease/diagnosis ; Crohn Disease/surgery ; Humans ; Laparoscopy/adverse effects ; Patient Satisfaction ; Patient Selection ; Postoperative Complications/etiology ; Proctocolectomy, Restorative/adverse effects ; Risk Factors ; Treatment Outcome
Language	English
Publishing date	2013-04-16
Publishing country	United States
Document type	Editorial
ZDB-ID	2185929-2
ISSN	2219-2840 ; 1007-9327
ISSN (online)	2219-2840
ISSN	1007-9327
DOI	10.3748/wjg.v19.i16.2445
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