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  1. Article: Sutureless Repair for Open Treatment of Inguinal Hernia: Three Techniques in Comparison.

    Baldini, Enke / Lori, Eleonora / Morini, Carola / Palla, Luigi / Coletta, Diego / De Luca, Giuseppe M / Giraudo, Giorgio / Intini, Sergio G / Perotti, Bruno / Sorge, Angelo / Sozio, Giampaolo / Arganini, Marco / Beltrami, Elsa / Pironi, Daniele / Ranalli, Massimo / Saviano, Cecilia / Patriti, Alberto / Usai, Sofia / Vernaccini, Nicola /
    Vittore, Francesco / D'Andrea, Vito / Nardi, Priscilla / Sorrenti, Salvatore / Palumbo, Piergaspare

    Journal of clinical medicine

    2024  Volume 13, Issue 2

    Abstract: Currently, groin hernia repair is mostly performed with application of mesh prostheses fixed with or without suture. However, views on safety and efficacy of different surgical approaches are still partly discordant. In this multicentre retrospective ... ...

    Abstract Currently, groin hernia repair is mostly performed with application of mesh prostheses fixed with or without suture. However, views on safety and efficacy of different surgical approaches are still partly discordant. In this multicentre retrospective study, three sutureless procedures, i.e., mesh fixation with glue, application of self-gripping mesh, and Trabucco's technique, were compared in 1034 patients with primary unilateral non-complicated inguinal hernia subjected to open anterior surgery. Patient-related features, comorbidities, and drugs potentially affecting the intervention outcomes were also examined. The incidence of postoperative complications, acute and chronic pain, and time until discharge were assessed. A multivariate logistic regression was used to compare the odds ratio of the surgical techniques adjusting for other risk factors. The application of standard/heavy mesh, performed in the Trabucco's technique, was found to significantly increase the odds ratio of hematomas (
    Language English
    Publishing date 2024-01-19
    Publishing country Switzerland
    Document type Journal Article
    ZDB-ID 2662592-1
    ISSN 2077-0383
    ISSN 2077-0383
    DOI 10.3390/jcm13020589
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  2. Article: Retrospective Study of Indications and Outcomes of Open Abdomen with Negative Pressure Wound Therapy Technique for Abdominal Sepsis in a Tertiary Referral Centre.

    Prete, Francesco / De Luca, Giuseppe Massimiliano / Pasculli, Alessandro / Di Meo, Giovanna / Poli, Elisabetta / Sgaramella, Lucia Ilaria / Panzera, Piercarmine / Vittore, Francesco / Filoia, Antonella / Catena, Fausto / Testini, Mario / Gurrado, Angela

    Antibiotics (Basel, Switzerland)

    2022  Volume 11, Issue 11

    Abstract: In patients with advanced sepsis from abdominal disease, the open abdomen (OA) technique as part of a damage control surgery (DCS) approach enables relook surgery to control infection, defer intestinal anastomosis, and prevent intra-abdominal ... ...

    Abstract In patients with advanced sepsis from abdominal disease, the open abdomen (OA) technique as part of a damage control surgery (DCS) approach enables relook surgery to control infection, defer intestinal anastomosis, and prevent intra-abdominal hypertension. Limited evidence is available on key outcomes, such as mortality and rate of definitive fascial closure (DFC), which are needed for surgeons to select patients and adequate therapeutic strategies. Abdominal closure with negative pressure wound therapy (NPWT) has shown rates of DFC around 90%. We conducted a retrospective study to evaluate in-hospital survival and factors associated with mortality in acute, non-trauma patients treated using the OA technique and NPWT for sepsis from abdominal disease. Fifty consecutive patients treated using the OA technique and NPWT between February 2015 and July 2022 were included. Overall mortality was 32%. Among surviving patients, 97.7% of cases reached DFC, and the overall complication rate was 58.8%, with one case of entero-atmospheric fistula. At univariable analysis, age (p = 0.009), ASA IV status (<0.001), Mannheim Peritonitis Index > 30 (p = 0.001) and APACHE II score (p < 0.001) were associated with increased mortality. At multivariable analysis, higher APACHE II was a predictor of in-hospital mortality (OR 2.136, 95% CI 1.08−4.22; p = 0.029). Although very resource-intensive, DCS and the OA technique are valuable tools to manage patients with advanced abdominal sepsis, allowing reduced mortality and high DFC rates.
    Language English
    Publishing date 2022-10-28
    Publishing country Switzerland
    Document type Journal Article
    ZDB-ID 2681345-2
    ISSN 2079-6382
    ISSN 2079-6382
    DOI 10.3390/antibiotics11111498
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  3. Article ; Online: Autoimmune pancreatitis or pancreatic cancer? A dilemma in a pregnant woman.

    Tedeschi, Michele / Vittore, Francesco / Di Fronzo, Pasquale / Gurrado, Angela / Piccinni, Giuseppe / Testini, Mario

    Annali italiani di chirurgia

    2015  Volume 86, Issue 1, Page(s) 66–69

    Abstract: Introduction: Autoimmune pancreatitis is now a defined entity and it could mimic a pancreatic malignancy. True oncological emergencies in pregnant patients are rare.: Case report: A 39 years-old pregnant woman was admitted to our emergency unit due ... ...

    Abstract Introduction: Autoimmune pancreatitis is now a defined entity and it could mimic a pancreatic malignancy. True oncological emergencies in pregnant patients are rare.
    Case report: A 39 years-old pregnant woman was admitted to our emergency unit due to right upper quadrant abdominal pain and evidence of obstructive jaundice. Since computed tomography-scan and endoscopic retrograde cholangiopancreatography are contraindicated in pregnant woman, a cholangio-Nuclear Magnetic Resonance was performed, confirming the biliary tract dilatation with stenosis of the intrapancreatic portion of the common bile duct and a shaded image of a mass in the pancreatic head. An endoscopic ultrasound with fine needle aspiration biopsy were performed. US-guided external percutaneous trans-hepatic biliary drainage was successfully performed. The cytological examination showed the presence of erythrocytes, granulocytes, histiocytes and rare lymphocytes; a diagnosis of AIP was supposed, and steroid therapy with metilprednisolone was started. Laboratory tests and jaundice were normalized within 15 days, and the fetus was born in very good health, 22 weeks after. The follow-up was uneventful and a CT-scan confirmed the complete normalization of the pancreatic gland, 12 months after hospital discharge.
    Conclusion: Autoimmune pancreatitis should be taken into account in the differential diagnosis of a not well defined pancreatic mass; in the event of pancreatic mass-forming disease in pregnancy, the differential diagnosis should be early and accurate, because destructive surgery involves an high rate of morbidity and may interrupt pregnancy. A US-guided FNAB and the response to the corticosteroid therapy should lead to a correct diagnosis.
    MeSH term(s) Adult ; Anti-Inflammatory Agents/therapeutic use ; Autoimmune Diseases/diagnostic imaging ; Autoimmune Diseases/drug therapy ; Biopsy, Fine-Needle ; Cholangiopancreatography, Magnetic Resonance ; Diagnosis, Differential ; Endosonography ; Female ; Humans ; Image-Guided Biopsy ; Immunosuppressive Agents/therapeutic use ; Infant, Newborn ; Methylprednisolone/therapeutic use ; Pancreatic Neoplasms/diagnosis ; Pancreatitis/diagnostic imaging ; Pancreatitis/drug therapy ; Pancreatitis/pathology ; Pregnancy ; Pregnancy Complications/diagnostic imaging ; Pregnancy Complications/drug therapy ; Pregnancy Complications/pathology ; Pregnancy Complications, Neoplastic/diagnosis
    Chemical Substances Anti-Inflammatory Agents ; Immunosuppressive Agents ; Methylprednisolone (X4W7ZR7023)
    Language English
    Publishing date 2015-01
    Publishing country Italy
    Document type Case Reports ; Journal Article
    ZDB-ID 418927-9
    ISSN 2239-253X ; 0003-469X
    ISSN (online) 2239-253X
    ISSN 0003-469X
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  4. Article ; Online: Hypercalcaemic crisis due to primary hyperparathyroidism - a systematic literature review and case report.

    Gurrado, Angela / Piccinni, Giuseppe / Lissidini, Germana / Di Fronzo, Pasquale / Vittore, Francesco / Testini, Mario

    Endokrynologia Polska

    2012  Volume 63, Issue 6, Page(s) 494–502

    Abstract: Hypercalcaemic crisis is an uncommon and potentially life-threatening manifestation of primary hyperparathyroidism, and it is associated with rapid deterioration of the central nervous system, and cardiac, gastrointestinal, and renal function. We present ...

    Abstract Hypercalcaemic crisis is an uncommon and potentially life-threatening manifestation of primary hyperparathyroidism, and it is associated with rapid deterioration of the central nervous system, and cardiac, gastrointestinal, and renal function. We present the case of a 76 year-old man in a sudden coma due to hypercalcaemic crisis as a first manifestation of primary hyperparathyroidism. At first, the patient was treated conservatively, his mental status gradually improved in the next three days. On the ninth day after the initiation of therapy, a minimally invasive radio-guided parathyroidectomy was performed. Histologically, the tumour consisted of densely arranged chief cells immunohistochemically positive for PTH antigens, suggesting adenoma. Calcaemia level and PTH were normalised in the immediate postoperative period. A systematic review was performed by consulting PubMed MEDLINE for publications from 1958 to 2011. This review found a total of 499 reported cases of hypercalcaemic crisis due to primary hyperparathyroidism. Manifestations are neurological alterations, and cardiac, renal and gastrointestinal dysfunctions associated with markedly elevated serum calcium and parathyroid hormone levels. The most frequent histology is the parathyroid adenoma. In untreated cases, mortality is 100%. Despite advances in its management, the mortality rate is still 93.5% in patients treated only conservatively. Medical therapy followed by expeditious parathyroidectomy should be considered as the treatment of choice for patients affected by hypercalcaemic crisis due to a primary hyperparathyroidism.
    MeSH term(s) Aged ; Calcium/blood ; Humans ; Hypercalcemia/etiology ; Hypercalcemia/physiopathology ; Hypercalcemia/surgery ; Hyperparathyroidism, Primary/complications ; Hyperparathyroidism, Primary/physiopathology ; Hyperparathyroidism, Primary/surgery ; Male ; Parathyroid Hormone/blood ; Parathyroidectomy/methods ; Treatment Outcome
    Chemical Substances Parathyroid Hormone ; Calcium (SY7Q814VUP)
    Language English
    Publishing date 2012
    Publishing country Poland
    Document type Case Reports ; Journal Article ; Review
    ZDB-ID 419270-9
    ISSN 2299-8306 ; 0423-104X
    ISSN (online) 2299-8306
    ISSN 0423-104X
    Database MEDical Literature Analysis and Retrieval System OnLINE

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    In stock of ZB MED Cologne/Königswinter

    Zs.A 204: Show issues Location:
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  5. Article ; Online: The critical view of safety during laparoscopic cholecystectomy: Strasberg Yes or No? An Italian Multicentre study.

    Sgaramella, Lucia Ilaria / Gurrado, Angela / Pasculli, Alessandro / de Angelis, Nicola / Memeo, Riccardo / Prete, Francesco Paolo / Berti, Stefano / Ceccarelli, Graziano / Rigamonti, Marco / Badessi, Francesco Giuseppe Aldo / Solari, Nicola / Milone, Marco / Catena, Fausto / Scabini, Stefano / Vittore, Francesco / Perrone, Gennaro / de Werra, Carlo / Cafiero, Ferdinando / Testini, Mario

    Surgical endoscopy

    2020  Volume 35, Issue 7, Page(s) 3698–3708

    Abstract: Background: Laparoscopic cholecystectomy is considered the gold standard for the treatment of gallbladder lithiasis; nevertheless, the incidence of bile duct injuries (BDI) is still high (0.3-0.8%) compared to open cholecystectomy (0.2%). In 1995, ... ...

    Abstract Background: Laparoscopic cholecystectomy is considered the gold standard for the treatment of gallbladder lithiasis; nevertheless, the incidence of bile duct injuries (BDI) is still high (0.3-0.8%) compared to open cholecystectomy (0.2%). In 1995, Strasberg introduced the "Critical View of Safety" (CVS) to reduce the risk of BDI. Despite its widespread use, the scientific evidence supporting this technique to prevent BDI is controversial.
    Methods: Between March 2017 and March 2019, the data of patients submitted to laparoscopic cholecystectomy in 30 Italian surgical departments were collected on a national database. A survey was submitted to all members of Italian Digestive Pathology Society to obtain data on the preoperative workup, the surgical and postoperative management of patients and to judge, at the end of the procedure, if the isolation of the elements was performed according to the CVS. In the case of a declared critical view, iconographic documentation was obtained, finally reviewed by an external auditor.
    Results: Data from 604 patients were analysed. The study population was divided into two groups according to the evidence (Group A; n = 11) or absence (Group B; N = 593) of BDI and perioperative bleeding. The non-use of CVS was found in 54.6% of procedures in the Group A, and 25.8% in the Group B, and evaluating the operator-related variables the execution of CVS was associated with a significantly lower incidence of BDI and intraoperative bleeding.
    Conclusions: The CVS confirmed to be the safest technique to recognize the elements of the Calot triangle and, if correctly performed, it significantly impacted on preventing intraoperative complications. Additional educational programs on the correct application of CVS in clinical practice would be desirable to avoid extreme conditions that may require additional procedures.
    MeSH term(s) Bile Duct Diseases ; Bile Ducts ; Cholecystectomy, Laparoscopic/adverse effects ; Gallbladder ; Humans ; Intraoperative Complications/epidemiology ; Intraoperative Complications/prevention & control ; Italy/epidemiology
    Language English
    Publishing date 2020-08-11
    Publishing country Germany
    Document type Journal Article ; Multicenter Study ; 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/s00464-020-07852-6
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