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Article: Bedside Laparoscopy in the Critically Ill: A Review of the Literature.

Palladino, Alessandro / Vallicelli, Carlo / Perrina, Daniele / Convertini, Girolamo / Coccolini, Federico / Ansaloni, Luca / Sartelli, Massimo / Catena, Fausto

Journal of clinical medicine

2024 Volume 13, Issue 6

Abstract: Critically ill patients treated in the intensive care unit (ICU) can present with many abdominal conditions that need a prompt diagnosis and timely treatment because of their general frailty. Clinical evaluation and diagnostic tools like ultrasound or CT ...

Abstract	Critically ill patients treated in the intensive care unit (ICU) can present with many abdominal conditions that need a prompt diagnosis and timely treatment because of their general frailty. Clinical evaluation and diagnostic tools like ultrasound or CT scans are not reliable or feasible in these patients. Bedside laparoscopy (BSL) is a minimally invasive procedure that allows surgeons to assess the abdominal cavity directly in the ICU, thus avoiding unnecessary exploratory laparotomy or incidents related to intra-hospital transfer. We conducted a review of the literature to summarize the state-of-the-art of BSL. The Medline, Cochrane Central Register of Controlled Trials (CENTRAL), and Scopus databases were utilized to identify all relevant publications. Indications, contraindications, technical aspects, and outcomes are discussed. The procedure is safe, feasible, and effective. When other diagnostic tools fail to diagnose or exclude an intra-abdominal condition in ICU patients, BSL should be preferred over exploratory laparotomy.
Language	English
Publishing date	2024-03-07
Publishing country	Switzerland
Document type	Journal Article ; Review
ZDB-ID	2662592-1
ISSN	2077-0383
ISSN	2077-0383
DOI	10.3390/jcm13061530
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Article ; Online: Acute left colonic diverticulitis in the emergency setting: from diagnosis to treatment.

Sartelli, Massimo / DE Simone, Belinda / Coccolini, Federico / Siquini, Walter / Vallicelli, Carlo / Catena, Fausto

Minerva surgery

2023 Volume 78, Issue 4, Page(s) 413–420

Abstract: Acute left colonic diverticulitis (ALCD) is a common clinical condition encountered by physicians in the emergency setting. Clinical presentation of ALCD ranges from uncomplicated acute diverticulitis to diffuse fecal peritonitis. ALCD may be diagnosed ... ...

Abstract	Acute left colonic diverticulitis (ALCD) is a common clinical condition encountered by physicians in the emergency setting. Clinical presentation of ALCD ranges from uncomplicated acute diverticulitis to diffuse fecal peritonitis. ALCD may be diagnosed based on clinical features alone, but imaging is necessary to differentiate uncomplicated from complicated forms. In fact, computed tomography scan of the abdomen and pelvis is the highest accurate radiological examination for diagnosing ALCD. Treatment depends on the clinical picture, the severity of patient's clinical condition and underlying comorbidities. Over the last few years, diagnosis and treatment algorithms have been debated and are currently evolving. The aim of this narrative review was to consider the main aspects of diagnosis and treatment of ALCD.
MeSH term(s)	Humans ; Diverticulitis, Colonic/diagnostic imaging ; Diverticulitis, Colonic/therapy ; Diverticulitis/complications ; Radiography ; Tomography, X-Ray Computed/methods
Language	English
Publishing date	2023-04-06
Publishing country	Italy
Document type	Review ; Journal Article
ZDB-ID	3067899-7
ISSN	2724-5438
ISSN (online)	2724-5438
DOI	10.23736/S2724-5691.23.09857-X
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Article: Management of Intra-Abdominal Infections: The Role of Procalcitonin.

Tian, Brian W C A / Agnoletti, Vanni / Ansaloni, Luca / Coccolini, Federico / Bravi, Francesca / Sartelli, Massimo / Vallicelli, Carlo / Catena, Fausto

Antibiotics (Basel, Switzerland)

2023 Volume 12, Issue 9

Abstract: Patients with intra-abdominal sepsis suffer from significant mortality and morbidity. The main pillars of treatment for intra-abdominal infections are (1) source control and (2) early delivery of antibiotics. Antibiotic therapy should be started as soon ... ...

Abstract	Patients with intra-abdominal sepsis suffer from significant mortality and morbidity. The main pillars of treatment for intra-abdominal infections are (1) source control and (2) early delivery of antibiotics. Antibiotic therapy should be started as soon as possible. However, the duration of antibiotics remains a matter of debate. Prolonged antibiotic delivery can lead to increased microbial resistance and the development of nosocomial infections. There has been much research on biomarkers and their ability to aid the decision on when to stop antibiotics. Some of these biomarkers include interleukins, C-reactive protein (CRP) and procalcitonin (PCT). PCT's value as a biomarker has been a focus area of research in recent years. Most studies use either a cut-off value of 0.50 ng/mL or an >80% reduction in PCT levels to determine when to stop antibiotics. This paper performs a literature review and provides a synthesized up-to-date global overview on the value of PCT in managing intra-abdominal infections.
Language	English
Publishing date	2023-09-04
Publishing country	Switzerland
Document type	Journal Article ; Review
ZDB-ID	2681345-2
ISSN	2079-6382
ISSN	2079-6382
DOI	10.3390/antibiotics12091406
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Article: Antibiotic Prophylaxis for Surgical Site Infection in General Surgery: Oncological Treatments and HIPEC.

Vallicelli, Carlo / Coccolini, Federico / Sartelli, Massimo / Ansaloni, Luca / Bui, Simona / Catena, Fausto

Antibiotics (Basel, Switzerland)

2021 Volume 11, Issue 1

Abstract: The procedure of cytoreductive surgery (CRS) and hyperthermic intraperitoneal chemotherapy (HIPEC) is a combined surgical and oncological treatment for peritoneal carcinomatosis of various origins. Antibiotic prophylaxis is usually center-related and ... ...

Abstract	The procedure of cytoreductive surgery (CRS) and hyperthermic intraperitoneal chemotherapy (HIPEC) is a combined surgical and oncological treatment for peritoneal carcinomatosis of various origins. Antibiotic prophylaxis is usually center-related and should be discussed together with the infectious disease specialist, taking into account the advanced oncologic condition of the patient, the complexity of surgery-often requiring multiorgan resections-and the risk of post-HIPEC neutropenia. The incidence of surgical site infection (SSI) after CRS and HIPEC ranges between 11 and 46%. These patients are also at high risk of postoperative abdominal infections and septic complications, and a bacterial translocation during HIPEC has been hypothesized. Many authors have proposed aggressive screening protocols and a high intra and postoperative alert, in order to minimize and promptly identify all possible infectious complications following CRS and HIPEC.
Language	English
Publishing date	2021-12-30
Publishing country	Switzerland
Document type	Journal Article
ZDB-ID	2681345-2
ISSN	2079-6382
ISSN	2079-6382
DOI	10.3390/antibiotics11010043
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Article: Sepsis Team Organizational Model to Decrease Mortality for Intra-Abdominal Infections: Is Antibiotic Stewardship Enough?

Vallicelli, Carlo / Santandrea, Giorgia / Sartelli, Massimo / Coccolini, Federico / Ansaloni, Luca / Agnoletti, Vanni / Bravi, Francesca / Catena, Fausto

Antibiotics (Basel, Switzerland)

2022 Volume 11, Issue 11

Abstract: ... ...

Abstract	Introduction
Language	English
Publishing date	2022-10-23
Publishing country	Switzerland
Document type	Journal Article ; Review
ZDB-ID	2681345-2
ISSN	2079-6382
ISSN	2079-6382
DOI	10.3390/antibiotics11111460
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Article: Antibiotic De-Escalation in Emergency General Surgery.

Vallicelli, Carlo / Minghetti, Margherita / Sartelli, Massimo / Coccolini, Federico / Ansaloni, Luca / Agnoletti, Vanni / Bravi, Francesca / Catena, Fausto

Antibiotics (Basel, Switzerland)

2022 Volume 11, Issue 9

Abstract: Background. ...

Abstract	Background.
Language	English
Publishing date	2022-08-24
Publishing country	Switzerland
Document type	Journal Article
ZDB-ID	2681345-2
ISSN	2079-6382
ISSN	2079-6382
DOI	10.3390/antibiotics11091148
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Article ; Online: Intracorporeal anastomosis versus extracorporeal anastomosis after laparoscopic right hemicolectomy for colon cancer: morbidity comparison at long-term follow-up.

Veneroni, Simone / Palini, Gian M / Pirrera, Basilio / Fantini, Enrico / Monari, Francesco / Alagna, Vincenzo / Vallicelli, Carlo / Garulli, Gianluca

Minerva surgery

2022 Volume 77, Issue 6, Page(s) 531–535

Abstract: Background: Minimally invasive right hemicolectomy is nowadays considered the gold standard for treatment of malignant right colon disease. What is still debated is instead the choice between intracorporeal or extracorporeal anastomosis. The aim of this ...

Abstract	Background: Minimally invasive right hemicolectomy is nowadays considered the gold standard for treatment of malignant right colon disease. What is still debated is instead the choice between intracorporeal or extracorporeal anastomosis. The aim of this study was to compare morbidity and the long-term results between these two techniques. Methods: This retrospective, double-center cohort study was performed between January 2013 and December 2014. A total of 197 patients were enrolled after laparoscopic right hemicolectomy for malignant disease. The extracorporeal anastomosis group (ECA) included 95 patients, while the intracorporeal anastomosis group (ICA) included 102 patients. All patients were followed up for 5 years after surgery. Data analysis was performed in February 2021. Results: The ICA group showed a reduced rate of non-surgical complications Clavien-Dindo grade I-II (10% vs. 31%; P=0.001) as well as a lower rate of wound infections (2% vs. 12%; P=0.01). Most importantly, a decreased risk of incisional hernias in a five-year follow-up period (1% vs. 8%; P=0.01) has been underlined. Conclusions: Intracorporeal anastomosis technique after totally laparoscopic right hemicolectomy showed better outcomes as it significantly reduces the risk for short and long-term complications, namely, incisional hernias.
MeSH term(s)	Humans ; Follow-Up Studies ; Incisional Hernia/surgery ; Retrospective Studies ; Cohort Studies ; Anastomosis, Surgical/adverse effects ; Laparoscopy/adverse effects ; Colectomy/adverse effects ; Colonic Neoplasms/surgery ; Morbidity
Language	English
Publishing date	2022-03-01
Publishing country	Italy
Document type	Journal Article
ZDB-ID	3067899-7
ISSN	2724-5438
ISSN (online)	2724-5438
DOI	10.23736/S2724-5691.22.09281-4
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Article ; Online: Prophylaxis and treatment of peritoneal carcinomatosis of gastric origin using hyperthermic intraperitoneal chemotherapy: a systematic review and meta-analysis of randomized trials.

Stefano, Mauro / Perrina, Daniele / Vallicelli, Carlo / Ansaloni, Luca / Fugazzola, Paola / Coccolini, Federico / Agnoletti, Vanni / Frassineti, Giovanni Luca / Passardi, Alessandro / Tamberi, Stefano / Framarini, Massimo / Tassinari, Davide / Matteucci, Laura / Sturaro, Chiara / Gallo, Graziana / Catena, Fausto

Journal of gastrointestinal surgery : official journal of the Society for Surgery of the Alimentary Tract

2024

Abstract: Background: Peritoneal carcinomatosis significantly worsens the prognosis of patients with gastric cancer. Cytoreduction + hyperthermic intraperitoneal chemotherapy (HIPEC) has shown promising results in the prevention and treatment of peritoneal ... ...

Abstract	Background: Peritoneal carcinomatosis significantly worsens the prognosis of patients with gastric cancer. Cytoreduction + hyperthermic intraperitoneal chemotherapy (HIPEC) has shown promising results in the prevention and treatment of peritoneal carcinomatosis in advanced gastric cancer (AGC); however, its application remains controversial owing to the variability of the approaches used to perform it and the lack of high-quality evidence. This systematic review and meta-analysis aimed to investigate the role of surgery and HIPEC in the prevention and treatment of peritoneal carcinomatosis of gastric origin. Methods: We conducted a systematic review and meta-analysis of randomized controlled trials comparing surgery + HIPEC vs surgery + chemotherapy for the prophylaxis of peritoneal carcinomatosis and cytoreduction + HIPEC vs chemotherapy or other palliative options for the treatment of peritoneal carcinomatosis. Results: Sixteen studies enrolling 1641 patients were included. Surgery + HIPEC significantly improved overall survival in both prophylactic (hazard ratio [HR], 0.56) and therapeutic (HR, 0.57) settings. When surgery + HIPEC was performed with prophylactic intent, the pooled 3-year mortality rate was 32%, whereas for the control group it was 55%. The overall and peritoneal recurrence rates were also reduced (risk ratio [RR], 0.59 and 0.40, respectively). No significant difference was found in morbidity between groups (RR, 0.92). Conclusion: Based on the current knowledge, HIPEC in AGC seems to be a safe and effective tool for prophylaxis and a promising resource for the treatment of peritoneal carcinomatosis. Regarding the treatment of peritoneal carcinomatosis, the scarcity of large-cohort studies and the heterogeneity of the techniques adopted prevented us from achieving a definitive recommendation.
Language	English
Publishing date	2024-04-08
Publishing country	Netherlands
Document type	Journal Article ; Review
ZDB-ID	2012365-6
ISSN	1873-4626 ; 1934-3213 ; 1091-255X
ISSN (online)	1873-4626 ; 1934-3213
ISSN	1091-255X
DOI	10.1016/j.gassur.2024.04.007
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Article ; Online: Outcomes of pelvic exenteration for recurrent and primary locally advanced rectal cancer.

Rottoli, Matteo / Vallicelli, Carlo / Boschi, Luca / Poggioli, Gilberto

International journal of surgery (London, England)

2017 Volume 48, Page(s) 69–73

Abstract: Background: Pelvic exenteration is the only radical treatment for locally advanced (ARC) or recurrent (RRC) rectal cancers. The long-term results of the procedure are variably reported in the literature, with recent series suggesting similar survival ... ...

Abstract	Background: Pelvic exenteration is the only radical treatment for locally advanced (ARC) or recurrent (RRC) rectal cancers. The long-term results of the procedure are variably reported in the literature, with recent series suggesting similar survival between ARC and RRC. The study aimed to analyze and compare the long-term survival and perioperative outcomes of patients undergoing pelvic exenteration for ARC and RRC in a tertiary center. Materials and methods: This was a retrospective analysis of prospectively collected data. Comparison of variables was performed using Chi-square, Fisher's exact or Wilcoxon rank sum test as appropriate. The Kaplan Meier method was used to analyze the disease-free survival (DFS) and the log-rank test to compare the two groups. Results: Since 2002, 46 patients underwent pelvic exenteration for ARC (28, 60.9%) and RRC (18, 39.1%). The groups had comparable characteristics, perioperative results, including postoperative complications, and rate of adjuvant chemotherapy. A R0 resection was obtained in 71.4% and 55.6% (p 0.41) and a T4 stage was diagnosed in 75% and 94.4% (p 0.22) of ARC and RRC patients, respectively. After a median follow-up time of 32.5 and 56.6 months (p 0.01), the 5-year DFS was significantly lower in the RRC group (23.6 vs 46.2%, p 0.006), even after exclusion of R1 cases (30 vs 54.5%, p 0.044). Conclusion: The long-term disease free survival of patients undergoing pelvic exenteration is significantly worse when the procedure is performed for RRC, regardless of the tumor involvement of the resection margins.
MeSH term(s)	Adult ; Aged ; Aged, 80 and over ; Chemotherapy, Adjuvant/mortality ; Chi-Square Distribution ; Disease-Free Survival ; Female ; Humans ; Kaplan-Meier Estimate ; Male ; Margins of Excision ; Middle Aged ; Neoplasm Staging ; Pelvic Exenteration/mortality ; Postoperative Complications/mortality ; Prospective Studies ; Rectal Neoplasms/mortality ; Rectal Neoplasms/pathology ; Rectal Neoplasms/surgery ; Rectum/pathology ; Retrospective Studies ; Statistics, Nonparametric ; Treatment Outcome
Language	English
Publishing date	2017-12
Publishing country	England
Document type	Evaluation Studies ; Journal Article
ZDB-ID	2212038-5
ISSN	1743-9159 ; 1743-9191
ISSN (online)	1743-9159
ISSN	1743-9191
DOI	10.1016/j.ijsu.2017.09.069
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Article ; Online: Gracilis muscle transposition for the treatment of recurrent rectovaginal and pouch-vaginal fistula: is Crohn's disease a risk factor for failure? A prospective cohort study.

Rottoli, Matteo / Vallicelli, Carlo / Boschi, Luca / Cipriani, Riccardo / Poggioli, Gilberto

Updates in surgery

2018 Volume 70, Issue 4, Page(s) 485–490

Abstract: Background: The surgical management of rectovaginal fistulae associated with Crohn's disease is often frustrated by poor results regardless of the different techniques. The outcomes of the gracilis muscle transposition (GMT) for the treatment of ... ...

Abstract	Background: The surgical management of rectovaginal fistulae associated with Crohn's disease is often frustrated by poor results regardless of the different techniques. The outcomes of the gracilis muscle transposition (GMT) for the treatment of recurrent Crohn's-associated fistulae are still debated. The aim of the study is to determine whether the success rate of GMT is similar in Crohn's disease patients and in a control group. Materials and methods: All patients undergoing GMT for rectovaginal or pouch-vaginal fistula were collected from a prospectively maintained database (2005-2016). The primary study outcome was the comparison of the success rate of GMT in Crohn's disease and control group patients. Results: Twenty-one patients with a rectovaginal fistula due to Crohn's disease (8, 38.1%) or other etiologies (13, 61.9%) were included. The groups had similar characteristics and postoperative outcomes. After a median follow-up time of 81 and 57 months (p 0.34), the success rate of GMT was 75% in patients with Crohn's disease and 68.4% in control group (p 0.6). The median time to recurrence was 3.5 months (1-12). The success rate in patients who had more than two previous attempts of repair was lower regardless of the etiology (50 vs 79.4%, p 0.1). Conclusion: GMT is associated with a high success rate, especially in Crohn's disease-related rectovaginal fistula. In consideration of the low morbidity rate and the fact that an increasing number of previous local operations might be associated with failure, the procedure should be considered as a first line of treatment for recurrent rectovaginal fistulae.
MeSH term(s)	Adult ; Aged ; Crohn Disease/complications ; Female ; Follow-Up Studies ; Gracilis Muscle/surgery ; Humans ; Intraoperative Complications ; Middle Aged ; Postoperative Complications ; Prospective Studies ; Rectovaginal Fistula/etiology ; Rectovaginal Fistula/surgery ; Recurrence ; Risk Factors ; Surgical Flaps ; Treatment Outcome ; Vaginal Fistula/etiology ; Vaginal Fistula/surgery
Language	English
Publishing date	2018-07-07
Publishing country	Italy
Document type	Journal Article
ZDB-ID	2572692-4
ISSN	2038-3312 ; 2038-131X
ISSN (online)	2038-3312
ISSN	2038-131X
DOI	10.1007/s13304-018-0558-9
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