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1. Patient-Reported Outcomes and Return to Intended Oncologic Therapy After Colorectal Enhanced Recovery Pathway

Author

The Italian ColoRectal Anastomotic Leakage (iCral3) study group, Marco Catarci, MD, FACS, Giacomo Ruffo, MD, Massimo Giuseppe Viola, MD, Ferdinando Ficari, MD, Paolo Delrio, MD, Felice Pirozzi, MD, Felice Borghi, MD, Raffaele De Luca, MD, Alberto Patriti, MD, Gianluca Garulli, MD, Walter Siquini, MD, Stefano D’Ugo, MD, PhD, FEBS, FACS, Stefano Scabini, MD, Marco Caricato, MD, FACS, Giusto Pignata, MD, Andrea Liverani, MD, Roberto Campagnacci, MD, Pierluigi Marini, MD, Ugo Elmore, MD, Francesco Corcione, MD, Roberto Santoro, MD, Massimo Carlini, MD, FACS, Antonio Giuliani, MD, Mario Sorrentino, MD, Giovanni Ferrari, MD, Gianandrea Baldazzi, MD, Alberto Di Leo, MD, Augusto Verzelli, MD, Giuseppe Sica, MD, Stefano Rausei, MD, Davide Cavaliere, MD, Gian Luca Baiocchi, MD, FACS, Marco Milone, MD, Giovanni Ciaccio, MD, Giovanni Domenico Tebala, MD, FACS, FRCS, Marco Scatizzi, MD, Luigi Boni, MD, FACS, Stefano Mancini, MD, Mario Guerrieri, MD, Roberto Persiani, MD, Andrea Lucchi, MD, FACS, Dario Parini, MD, Antonino Spinelli, MD, Michele Genna, MD, Vincenzo Bottino, MD, Andrea Coratti, MD, Dario Scala, MD, Andrea Muratore, MD, Maurizio Pavanello, MD, Umberto Rivolta, MD, Micaela Piccoli, MD, FACS, Carlo Talarico, MD, Alessandro Carrara, MD, Stefano Guadagni, MD, Mauro Totis, MD, Franco Roviello, MD, Alessandro Anastasi, MD, Gianluca Guercioni, MD, Giuseppe Maria Ettorre, MD, Mauro Montuori, MD, Pierpaolo Mariani, MD, Nicolò de Manzini, MD, Annibale Donini, MD, Mariano Fortunato Armellino, MD, Lucio Taglietti, MD, Gabriele Anania, MD, Mariantonietta Di Cosmo, MD, Carlo Vittorio Feo, MD, Paolo Millo, MD, Corrado Pedrazzani, MD, Silvio Guerriero, MD, Andrea Costanzi, MD, Nereo Vettoretto, MD, Federico Marchesi, MD, Massimo Basti, MD, Graziano Longo, MD, Moreno Cicetti, MD, Paolo Ciano, MD, Michele Benedetti, MD, Leonardo Antonio Montemurro, MD, Maria Sole Mattei, MD, Elena Belloni, MD, Elisa Bertocchi, MD, Gaia Masini, MD, Amedeo Altamura, MD, Francesco Rubichi, MD, Francesco Giudici, MD, Fabio Cianchi, MD, Gabriele Baldini, MD, Ugo Pace, MD, Andrea Fares Bucci, MD, Antonio Sciuto, MD, Desirée Cianflocca, MD, Marco Migliore, MD, Michele Simone, MD, Marcella Lodovica Ricci, MD, Francesco Monari, MD, Alessandro Cardinali, MD, Massimo Sartelli, MD, Marcello Spampinato, MD, PhD, FEBS (HPB), Alessandra Aprile, MD, Domenico Soriero, MD, Gabriella Teresa Capolupo, MD, FACS, Jacopo Andreuccetti, MD, Ilaria Canfora, MD, Andrea Scarinci, MD, Angela Maurizi, MD, Grazia Maria Attinà, MD, Giulia Maggi, MD, Umberto Bracale, MD, Roberto Peltrini, MD, Pietro Amodio, MD, Domenico Spoletini, MD, PhD, FACS, Rosa Marcellinaro, MD, Giovanni Del Vecchio, MD, Massimo Stefanoni, MD, Carmelo Magistro, MD, Diletta Cassini, MD, Lorenzo Crepaz, MD, Andrea Budassi, MD, Bruno Sensi, MD, Silvia Tenconi, MD, Leonardo Solaini, MD, Giorgio Ercolani, MD, Sarah Molfino, MD, Giovanni Domenico De Palma, MD, Paolo Locurto, MD, Antonio Di Cintio, MD, Lorenzo Pandolfini, MD, Alessandro Falsetto, MD, Elisa Cassinotti, MD, Andrea Sagnotta, MD, PhD, Monica Ortenzi, MD, Alberto Biondi, MD, Giacomo Martorelli, MD, Maurizio De Luca, MD, Francesco Carrano, MD, Annalisa Maroli, PhD, Francesca Fior, MD, Antonio Ferronetti, MD, Giuseppe Giuliani, MD, Roberto Benigni, MD, Graziella Marino, MD, Patrizia Marsanic, MD, Nicoletta Sveva Pipitone Federico, MD, Carlo Di Marco, MD, Camillo Leonardo Bertoglio, MD, PhD, Francesca Pecchini, MD, Vincenzo Greco, MD, Michele Motter, MD, Giuseppe Tirone, MD, Marco Clementi, MD, Nicolò Tamini, MD, Riccardo Piagnerelli, MD, Giuseppe Canonico, MD, Simone Cicconi, MD, Marco Colasanti, MD, Enrico Pinotti, MD, Roberta Carminati, MD, Edoardo Osenda, MD, Luigina Graziosi, MD, Ciro De Martino, MD, Giovanna Ioia, MD, Arianna Birindelli, MD, Matteo Chiozza, MD, Daniele Zigiotto, MD, Fioralba Pindozzi, MD, Manuela Grivon, MD, Cristian Conti, MD, Lorenzo Organetti, MD, Michela Monteleone, MD, Emanuele Botteri, MD, Giorgio Dalmonte, MD, Diletta Frazzini, MD, Simone Santoni, MD, Gabriele La Gioia, MD, and Diana Giannarelli, MS, PhD

Subjects
Surgery, RD1-811
Abstract

Objective:. To evaluate the influence of enhanced recovery pathway (ERP) on patient-reported outcome measures (PROMs) and return to intended oncologic therapy (RIOT) after colorectal surgery. Background:. ERP improves early outcomes after colorectal surgery; however, little is known about its influence on PROMs and on RIOT. Methods:. Prospective multicenter enrollment of patients who underwent colorectal resection with anastomosis was performed, recording variables related to patient-, institution-, procedure-level data, adherence to the ERP, and outcomes. The primary endpoints were PROMs (administered before surgery, at discharge, and 6 to 8 weeks after surgery) and RIOT after surgery for malignancy, defined as the intended oncologic treatment according to national guidelines and disease stage, administered within 8 weeks from the index operation, evaluated through multivariate regression models. Results:. The study included 4529 patients, analyzed for PROMs, 1467 of which were analyzed for RIOT. Compared to their baseline preoperative values, all PROMs showed significant worsening at discharge and improvement at late evaluation. PROMs values at discharge and 6 to 8 weeks after surgery, adjusted through a generalized mixed regression model according to preoperative status and other variables, showed no association with ERP adherence rates. RIOT rates (overall 54.5%) were independently lower by aged > 69 years, ASA Class III, open surgery, and presence of major morbidity; conversely, they were independently higher after surgery performed in an institutional ERP center and by ERP adherence rates > median (69.2%). Conclusions:. Adherence to the ERP had no effect on PROMs, whereas it independently influenced RIOT rates after surgery for colorectal cancer.

Published
2023
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2. Early calcitonin levels in medullary thyroid carcinoma: Prognostic role in patients without distant metastases at diagnosis

Author

Clotilde Sparano, Virginia Adornato, Matteo Puccioni, Elena Zago, Giuliano Perigli, Benedetta Badii, Roberto Santoro, Mario Maggi, and Luisa Petrone

Subjects
surgery, persistent disease, calcitonin, prognosis, medullary thyroid cancer, Neoplasms. Tumors. Oncology. Including cancer and carcinogens, RC254-282
Abstract

IntroductionCalcitonin is the most specific marker for medullary thyroid carcinoma, thus, low detectable calcitonin values after surgery can conceal persistent disease. The present study aimed to explore the prognostic role of pre-operative and early calcitonin levels in patients without distant metastases at diagnosis.MethodsA retrospective cohort of patients suffering from medullary thyroid carcinoma was considered (N=55). The final disease status, i.e. complete response (undetectable calcitonin levels and negative radiological assessments) or persistent disease (detectable calcitonin levels and/or positive radiological assessments), was deduced from the last available follow-up. Pre-operative and early calcitonin levels (i.e. six months after surgery) have been correlated to several clinical and histological features, according to the final disease status.ResultsPersistent disease patients showed higher pre-operative and early calcitonin values (p=0.028 and p

Published
2023
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3. Genetics and Epigenetics of Parathyroid Carcinoma

Author

Francesca Marini, Francesca Giusti, Gaia Palmini, Giuliano Perigli, Roberto Santoro, and Maria Luisa Brandi

Subjects
parathyroid carcinoma, gene mutation, tumor suppressor genes, molecular signatures, epigenetic changes, DNA methylation, Diseases of the endocrine glands. Clinical endocrinology, RC648-665
Abstract

Parathyroid carcinoma (PC) is an extremely rare malignancy, accounting less than 1% of all parathyroid neoplasms, and an uncommon cause of primary hyperparathyroidism (PHPT), characterized by an excessive secretion of parathyroid hormone (PTH) and severe hypercalcemia. As opposed to parathyroid hyperplasia and adenomas, PC is associated with a poor prognosis, due to a commonly unmanageable hypercalcemia, which accounts for death in the majority of cases, and an overall survival rate of 78-85% and 49-70% at 5 and 10 years after diagnosis, respectively. No definitively effective therapies for PC are currently available. The mainly employed treatment for PC is the surgical removal of tumoral gland(s). Post-surgical persistent or recurrent disease manifest in about 50% of patients. The comprehension of genetic and epigenetic bases and molecular pathways that characterize parathyroid carcinogenesis is important to distinguish malignant PCs from benign adenomas, and to identify specific targets for novel therapies. Germline heterozygote inactivating mutations of the CDC73 tumor suppressor gene, with somatic loss of heterozygosity at 1q31.2 locus, account for about 50-75% of familial cases; over 75% of sporadic PCs harbor biallelic somatic inactivation/loss of CDC73. Recurrent mutations of the PRUNE2 gene, a recurrent mutation in the ADCK1 gene, genetic amplification of the CCND1 gene, alterations of the PI3K/AKT/mTOR signaling pathway, and modifications of microRNA expression profile and gene promoter methylation pattern have all been detected in PC. Here, we review the current knowledge on gene mutations and epigenetic changes that have been associated with the development of PC, in both familial and sporadic forms of this malignancy.

Published
2022
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4. Choice of Alternative Polyadenylation Sites, Mediated by the RNA-Binding Protein Elavl3, Plays a Role in Differentiation of Inhibitory Neuronal Progenitors

Author

Elena Grassi, Roberto Santoro, Alessandro Umbach, Anna Grosso, Salvatore Oliviero, Francesco Neri, Luciano Conti, Ugo Ala, Paolo Provero, Ferdinando DiCunto, and Giorgio R. Merlo

Subjects
neuron differentiation, GABAergic, polyadenylation, RNA binding protein, Elavl3, Neurosciences. Biological psychiatry. Neuropsychiatry, RC321-571
Abstract

Alternative polyadenylation (APA) is a widespread mechanism involving about half of the expressed genes, resulting in varying lengths of the 3′ untranslated region (3′UTR). Variations in length and sequence of the 3′UTR may underlie changes of post-transcriptional processing, localization, miRNA targeting and stability of mRNAs. During embryonic development a large array of mRNAs exhibit APA, with a prevalence of the longer 3′UTR versions in differentiating cells. Little is known about polyA+ site usage during differentiation of mammalian neural progenitors. Here we exploit a model of adherent neural stem (ANS) cells, which homogeneously and efficiently differentiate into GABAergic neurons. RNAseq data shows a global trend towards lengthening of the 3′UTRs during differentiation. Enriched expression of the longer 3′UTR variants of Pes1 and Gng2 was detected in the mouse brain in areas of cortical and subcortical neuronal differentiation, respectively, by two-probes fluorescent in situ hybridization (FISH). Among the coding genes upregulated during differentiation of ANS cells we found Elavl3, a neural-specific RNA-binding protein homologous to Drosophila Elav. In the insect, Elav regulates polyA+ site choice while interacting with paused Pol-II promoters. We tested the role of Elavl3 in ANS cells, by silencing Elavl3 and observed consistent changes in 3′UTR length and delayed neuronal differentiation. These results indicate that choice of the polyA+ site and lengthening of 3′UTRs is a possible additional mechanism of posttranscriptional RNA modification involved in neuronal differentiation.

Published
2019
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5. Early Introduction of Everolimus Immunosuppressive Regimen in Liver Transplantation with Extra-Anatomic Aortoiliac-Hepatic Arterial Graft Anastomosis

Author

Emanuele Felli, Giovanni Vennarecci, Marco Colasanti, Roberto Santoro, Edoardo de Werra, Andrea Scotti, Mirco Burocchi, Giovanni B. Levi Sandri, Alessandra Campanelli, Pasquale Lepiane, and Giuseppe M. Ettorre

Subjects
Surgery, RD1-811
Abstract

Liver transplantation is the treatment of choice for patients with acute and chronic end-stage liver disease, when no other medical treatment is possible. Despite high rates of 1- to 5-year survival, long-term adverse effects of immunosuppressant agents remain of major concern. Current research and clinical efforts are made to develop immunosuppressant agents that minimize adverse effects along with a low rate of graft rejection. Tailoring immunosuppressive therapy to individual patients by the use of proliferation signal inhibitors seems to be the best way to minimize toxicity and increase efficacy. Recently everolimus has been introduced in clinical practice; among its adverse effects an increased incidence of arterial graft thrombosis in renal transplants, vascular anastomosis leakage, impaired wound healing, and thrombotic microangiopathy have been reported. We present the case of a 54-year-old patient submitted to liver transplantation for end-stage liver disease treated by an extra-anatomic aortoiliac-hepatic arterial graft anastomosis and early postoperative introduction of everolimus for acute renal failure. Postoperative period was characterized by two abdominal collections and reactivation of cytomegalovirus infection that were treated by percutaneous drainage and antiviral therapy, respectively; the patient is well after 8-month followup with patency of the arterial conduit and no leakage.

Published
2014
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6. Integral ecology and interculturality : which representations and experiences in University students? = Sostenibilidad e interculturalidad : representaciones y experiencias en estudiantes universitarios

Author

Anna Pileri, Michela Drusian, Juan Sabino López, Marian García, Roberto Santoro, M. S. Villagomez Rodriguez, C. Rivera, R. Iduriaga, L. Marquez, O. Lozano, Maria Sol Villagmez Rodriguez, Celina Rivera, Ruben Iduriaga, Luis Marquez, Oscar Lozano, and Anna Pileri, Michela Drusian, Juan Sabino López, Marian García, Roberto Santoro

Subjects
Representations, Lifestyles, Sustainability and Interculturality, Young University Students
Abstract

The aim of this study is based on the qualitative analysis of the results of a research project, carried out between 2020 and 2021, concerning the representations and experiences of sustainability and intercul- turality of a sample of students belonging to three Salesian universities (IUSVE of Venice Mestre, IUSTO of Turin, CES Don Bosco- Madrid) of the degrees of Pedagogy, Psychology, Communication and Education. On the basis of a previously applied and separate questionnaire on the research topic, general guidelines for its implementation and clarification were formulated using other research techniques such as inter- views and focus groups. The outcomes of the research showed a specific attention of the “Millennials” on issues related to the environment, climate change, environmental volunteering, and advocacy. The influence of the media and social networks on the information-education plan in terms of sustainability and multi/interculturality is highlighted. The work done recognizes the influence of digital technologies and social media on multi/intercultural issues. Finally, we would like to emphasize that the constant scientific dialogue between the researchers in all phases of the research, besides being fruitful, has opened up a particularly valuable horizon of intercultural exchange and networking.

Published
2022

7. Ostomy closure rate during COVID-19 pandemic: an Italian multicentre observational study

Author

Balla Andrea, Saraceno Federica, Di Saverio Salomone, Di Lorenzo Nicola, Lepiane Pasquale, Guerrieri Mario, Sileri Pierpaolo, Laura Agostinelli, Ferdinando Agresta, Gabriele Anania, Laura Antolino, Pietro Anoldo, Emanuele Botteri, Umberto Bracale, Fabio Carbone, Massimo Carlini, Francesco Maria Carrano, Giorgia Casadei, Diego Coletta, Francesco Crafa, Nicola de’Angelis, Paolo Delrio, Giovanni Domenico De Palma, Marcello Di Martino, Ugo Elmore, Lorenzo Gozzini, Michele Grieco, Giovanni Battista Levi Sandri, Edelweiss Licitra, Andrea Lucchi, Marco Massani, Riccardo Memeo, Marco Milone, Dario Oppici, Monica Ortenzi, Alberto Patriti, Francesca Pecchini, Roberto Peltrini, Micaela Piccoli, Adolfo Pisanu, Mauro Podda, Gilberto Poggioli, Maria Chiara Ranucci, Daniela Rega, Riccardo Rosati, Francesco Roscio, Matteo Rottoli, Roberto Santoro, Alberto Sartori, Antonino Spinelli, Serafino Vanella, Giovanni Vennarecci, Nereo Vettoretto, Balla, Andrea, Saraceno, Federica, Di Saverio, Salomone, Di Lorenzo, Nicola, Lepiane, Pasquale, Guerrieri, Mario, Sileri, Pierpaolo, Rosati, Riccardo, and Balla Andrea, Saraceno Federica, Di Saverio Salomone, Di Lorenzo Nicola, Lepiane Pasquale, Guerrieri Mario, Sileri Pierpaolo, Laura Agostinelli, Ferdinando Agresta, Gabriele Anania, Laura Antolino, Pietro Anoldo, Emanuele Botteri, Umberto Bracale, Fabio Carbone, Massimo Carlini, Francesco Maria Carrano, Giorgia Casadei, Diego Coletta, Francesco Crafa, Nicola de’Angelis, Paolo Delrio, Giovanni Domenico De Palma, Marcello Di Martino, Ugo Elmore, Lorenzo Gozzini, Michele Grieco, Giovanni Battista Levi Sandri, Edelweiss Licitra, Andrea Lucchi, Marco Massani, Riccardo Memeo, Marco Milone, Dario Oppici, Monica Ortenzi, Alberto Patriti, Francesca Pecchini, Roberto Peltrini, Micaela Piccoli, Adolfo Pisanu, Mauro Podda, Gilberto Poggioli, Maria Chiara Ranucci, Daniela Rega, Riccardo Rosati, Francesco Roscio, Matteo Rottoli, Roberto Santoro, Alberto Sartori, Antonino Spinelli, Serafino Vanella, Giovanni Vennarecci & Nereo Vettoretto

Subjects
Quality of life (QoL), Colostomy, Corona virus disease 2019 (COVID-19), Cost, Ileostomy, Ostomy, Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), Surgery, Settore MED/18
Abstract

During the corona virus disease 2019 (COVID-19) pandemic, most of the surgical procedures were performed for emergencies or oncologic reasons to the detriment of the remaining elective procedures for benign conditions. Ileostomy or colostomy creation are sequelae of oncologic or emergency colorectal surgery, but their closure does not fall within the definition of oncologic or emergency surgery. The aim of this retrospective multicentre observational study is to report the impact of COVID-19 pandemic on the ostomy closure rate in Italy. Data regarding ileostomy and colostomy creation and closure from 24 Italian centres, during the study period (March 2020-February 2021) and during the control period (March 2019-February 2020) were collected. Three hospitals (12.5%) were COVID free. The number of colostomies and ileostomies created and closed in the same period was lower ( -18.8% and -30%, respectively) in the study period in comparison to the control period (p = 0.1915 and p = 0.0001, respectively), such as the ostomies closed in the analysed periods but created before (colostomy -36.2% and ileostomy -7.4%, p = 0.2211 and p = 0.1319, respectively). Overall, a 19.5% reduction in ostomies closed occurred in the study period. Based on the present study, a reduction in ostomy closure rate occurred in Italy between March 2020 and February 2021. During the pandemic, the need to change the clinical practice probably prolonged deterioration of quality of life in patients with ostomies, increasing number of stomas that will never be closed, and related management costs, even if these issues have not been investigated in this study.

Published
2022

8. Estimating survival after salvage surgery for recurrent salivary gland cancers: Systematic review

Author

Giuditta Mannelli, Lara V. Comini, Andrea Sacchetto, Roberto Santoro, Giuseppe Spinelli, Pierluigi Bonomo, Isacco Desideri, Paolo Bossi, Ester Orlandi, Giammarco Alderotti, Alessandro Franchi, Annarita Palomba, Albino Eccher, Daniele Marchioni, Riccardo Nocini, Cesare Piazza, and Gabriele Molteni

Subjects
Salvage Therapy, Otorhinolaryngology, salvage surgery, salvage surgery outcomes, Humans, recurrent salivary cancer, recurrent salivary tumors, salivary cancer failure, Neoplasm Recurrence, Local, Salivary Gland Neoplasms, Disease-Free Survival, Retrospective Studies
Abstract

Recurrent salivary gland carcinomas (RSCs) are poorly characterized and their clinical features and treatment options have not yet been fully described. The goal of this study was to analyze the therapeutic strategies and oncological outcomes of RSC patients through a literature review analysis. This systematic review was performed according to the PRISMA statements. Inclusion criteria for the systematic review were based on the population, intervention, comparison, and outcomes according to (PICO) framework. Two thousand seven hundred and four records were selected and 1817 recurrences were studied. Three hundred and sixty-five patients underwent salvage surgery (20.1%) and their 5-year mortality rate, overall survival and disease-free survival were 35%, 70%, and 42%, respectively. RSCs are aggressive neoplasms with a high rate of distant metastases (28.9%). Salvage surgery can be considered in patients with limited local and/or regional recurrences, even in case of single distant relapse, appearing within the first 3 years of follow-up.

Published
2022

9. Salvage neck dissection for isolated neck recurrences in head and neck tumors: Intra and postoperative complications

Author

Andrea Martone, Beatrice Le Pera, Livio Presutti, Francesco Mattioli, Roberto Santoro, Daniele Marchioni, Lara Valentina Comini, Giuditta Mannelli, Riccardo Nocini, Sara Bassani, Gabriele Molteni, Michael Ghirelli, and Giuseppe Spinelli

Subjects
Male, medicine.medical_specialty, salvage surgery, medicine.medical_treatment, salvage neck dissection, 03 medical and health sciences, Postoperative Complications, 0302 clinical medicine, medicine, Humans, Aged, Retrospective Studies, Salvage Therapy, head and neck tumors, isolated neck recurrence, surgical complications, Squamous Cell Carcinoma of Head and Neck, business.industry, Incidence (epidemiology), Head and neck tumors, Neck dissection, Retrospective cohort study, Chemoradiotherapy, General Medicine, Prognosis, Combined Modality Therapy, Surgery, Survival Rate, Radiation therapy, Dissection, Italy, Oncology, Head and Neck Neoplasms, 030220 oncology & carcinogenesis, Neck Dissection, Female, 030211 gastroenterology & hepatology, Neoplasm Recurrence, Local, Complication, business, Follow-Up Studies
Abstract

BACKGROUND AND OBJECTIVES The current evidence regarding complications after salvage neck dissection (ND) for isolated regional recurrences (IRRs) in head and neck cancers is poor. The aim of this study is to evaluate the incidence and differences in complication rates of salvage ND after primary surgery, radiotherapy, chemoradiotherapy, or combined treatments. METHODS This was a multicentric retrospective study on 64 patients who underwent salvage ND for IRR in three Italian institutes between 2008 and May 2020. RESULTS Complications were detected in 7 of the 34 patients (20.8%) and surgeons described difficult dissection in 20 patients (58.82%). Accidental vascular ligations or nervous injury during surgery were never detected. None of the variables analyzed were statistically significant in predicting the risk of complications, disease-free survival, or overall survival. CONCLUSIONS IRR represents a rare entity among total relapses. The incidence of complications after salvage ND for IRR is higher than after primary surgery but at an acceptable rate in experienced hands. However, an adequate balance between functional and oncological outcomes is mandatory.

Published
2021

10. T1 Glottic Cancer: Does Anterior Commissure Involvement Worsen Prognosis?

Author

Cesare Piazza, Isacco Desideri, Alfredo Vannacci, Lara Valentina Comini, Alessandra Bettiol, Pierluigi Bonomo, Giuditta Mannelli, and Roberto Santoro

Subjects
Oncology, Cancer Research, medicine.medical_specialty, Multivariate analysis, medicine.medical_treatment, Anterior commissure, lcsh:RC254-282, Article, Anterior commissure involvement, Early glottic cancer, Independent prognostic factor, Prognosis, 03 medical and health sciences, 0302 clinical medicine, Internal medicine, medicine, otorhinolaryngologic diseases, Transoral laser microsurgery, 030223 otorhinolaryngology, early glottic cancer, business.industry, Local failure, Retrospective cohort study, lcsh:Neoplasms. Tumors. Oncology. Including cancer and carcinogens, Radiation therapy, Increased risk, Glottic cancer, 030220 oncology & carcinogenesis, independent prognostic factor, prognosis, business, anterior commissure involvement
Abstract

Radiotherapy (RT) and transoral laser microsurgery (TLM) represent the main treatment modalities for early glottic carcinoma. Local failure is notoriously more frequent in T1b glottic cancer in comparison to T1a and T2 tumors. In this scenario, the role of anterior commissure (AC) involvement is still controversial. The aim of the present study was therefore to determine its potential prognostic power in worsening patients&rsquo, survival and outcomes. We categorized different tumor glottic fold locations with respect to the involvement of one (T1a) or both vocal cords, with or without AC involvement. We analyzed a retrospective cohort of 74 patients affected by Stage I glottic cancer, treated between 2011 and 2018 by TLM or RT at a single academic institution. There were 22 T1a (30%) and 52 T1b (70%) cases. The median follow-up period was 30 months (mean, 32.09 &plusmn, 18.738 months, range, 12&ndash, 79). Three-year overall survival (OS), disease-specific survival (DSS), recurrence-free survival (RFS), and laryngectomy-free survival (LFS) were compared according to tumor location, extension, and cT category. According to both uni- and multivariate analyses, an increased risk for recurrence in T1b with AC involvement and T1a tumors was 7.31 and 9.45 times, respectively (p-values of 0.054 and 0.030, respectively). Among the 17 recurrences, T1b with AC involvement experienced 15 tumor relapses (88.2%), thus significantly affecting both the RFS and LFS in comparison to the other two tumor subcategories (T1a, p = 0.028 and T1b without AC involvement, p = 0.043). The deteriorating prognosis in the presence of AC involvement likely reflects the need to power the hazard consistency and discrimination of the T1b category when associated with such a risk factor, thus deserving an independent T category.

Published
2020
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12. The surgical treatment of cerebrospinal fistula: Qualitative and quantitative analysis of indications and results

Author

Giovanni Paolo Santoro, Maria Silvia Lazio, Roberto Santoro, Alessandra Iavarone, Lara Valentina Comini, Federica Martelli, Paolo Luparello, Oliviero De Luca, Giuditta Mannelli, and Giammarco Alderotti

Subjects
Leak, medicine.medical_specialty, Fistula, cerebrospinal fistula, endoscopic treatment, meta-analysis, systematic review, transnasal endoscopic surgery, Surgical Flaps, 03 medical and health sciences, 0302 clinical medicine, medicine, Humans, 030223 otorhinolaryngology, Surgical treatment, Retrospective Studies, Anterior skull base, Skull Base, Cerebrospinal Fluid Leak, business.industry, Endoscopy, Plastic Surgery Procedures, medicine.disease, Surgery, Clinical Practice, Otorhinolaryngology, Meta-analysis, business, Endoscopic treatment, 030217 neurology & neurosurgery
Abstract

Cerebrospinal fistula might occur in different ways. CSF closure techniques have undergone significant evolution that has led to the consolidation of the transnasal endoscopic approach. Despite the existence of multiple publications, meaningful information is still lacking in clinical practice and the literature about the ideal method, material, and timing for repair of CSF. The purpose of this review was to summarize the success rate of endoscopic CSF leak repair as well as whether specific techniques or materials influence the primary success rate through a review of the latest advancements in endoscopic CSF management published in the past 10 years. The principles of multilayer reconstructions and the routine use of vascularized flaps in expanded endonasal surgery have reduced postoperative CSF leaks' failure rates between 5% and 10% (4% in this meta-analysis). Effective endoscopic anterior skull base (ASB) closure may be achieved by multiple reconstructive techniques, which should be tailored case by case according to the patient and defect conditions.

Published
2020

13. Impact of implementation of the ERAS program in colorectal surgery. a multi-center study based on the 'Lazio Network' collective database

Author

Massimo Carlini, Antonio Brescia, Emanuele Santoro, Michele Grieco, Raffaele Macarone Palmieri, Antonio Crucitti, Laura Lorenzon, R. Persiani, Graziano Pernazza, Roberto Santoro, Marco Sacchi, and Francesco Stipa

Subjects
Adult, Male, Reoperation, medicine.medical_specialty, Multivariate analysis, Databases, Factual, Settore MED/18 - CHIRURGIA GENERALE, Outcomes, Audit, 030230 surgery, Anastomosis, computer.software_genre, Logistic regression, 03 medical and health sciences, Colonic Diseases, Young Adult, 0302 clinical medicine, Postoperative Complications, Colorectal surgery, Patient-Centered Care, ERAS guidelines, medicine, Humans, Fast track, Aged, Aged, 80 and over, Database, business.industry, colorectal surgery, eras guidelines, fast track, outcomes, Gastroenterology, Length of Stay, Middle Aged, Patient Outcome Assessment, Rectal Diseases, Italy, 030220 oncology & carcinogenesis, Multi center study, Critical Pathways, Observational study, Female, business, computer, Program Evaluation
Abstract

ERAS implementation improved outcomes in patients undergoing colorectal surgery. The process of incorporating this pathway in clinical practice may be challenging. This observational study investigated the impact of systematic ERAS implementation on surgical outcomes in patients undergoing colorectal resections in a regional network of 10 institutions. Implementation of ERAS pathway was designed using regular audits and a common protocol. All patients undergoing elective colorectal surgery between 2016 and 2017 were considered eligible. A collective database including 18 ERAS items, clinical and surgical data, and outcomes was designed. Univariate and multivariate analyses were performed for the following outcomes: morbidity, anastomotic leak, reinterventions, hospital stay, and readmissions. A total of 827 patients were included, and a mean of 11.3 ERAS items applied/patient was reported. Logistic regression indicated that an increased number of ERAS items applied reduced overall and severe morbidity (OR 0.86 and 0.87, respectively 95%CI 0.8197–0.9202 and 95%CI 0.7821–0.9603), hospitalization (OR 0.53 95%CI 0.4917–0.5845) and reinterventions (OR 0.84 95%CI 0.7536–0.9518) in the entire series. The same results were obtained for a prolonged hospitalization differentiating right-sided (OR 0.48 95%CI 0.4036–0.5801), left-sided (OR 0.48 95%CI 0.3984–0.5815), and rectal resections (OR 0.46 95%CI 0.3753–0.5851). An inverse correlation was found between the application of ERAS items and morbidity in right-sided and rectal procedures (OR 0.89 and 0.84, respectively 95%CI 0.7976–0.9773 and 95%CI 0.7418–0.9634). Systematic implementation of the ERAS pathway using multi-institutional audits can increase protocol adherence and improve surgical outcomes in patients undergoing colorectal surgery.

Published
2020

14. The surgical treatment of unilateral vocal cord paralysis (UVCP): qualitative review analysis and meta-analysis study

Author

Giuditta Mannelli, Lara Valentina Comini, Maria Rosaria Barillari, P Graziani, S Coscarelli, Giammarco Alderotti, F Granato, Federica Martelli, Roberto Santoro, O Le Seac, Paolo Luparello, S Carucci, Granato, F., Martelli, F., Comini, L. V., Luparello, P., Coscarelli, S., Le Seac, O., Carucci, S., Graziani, P., Santoro, R., Alderotti, G., Barillari, M. R., and Mannelli, G.

Subjects
Comparative Effectiveness Research, medicine.medical_specialty, Voice Quality, Unilateral vocal cord paralysis, Laryngoplasty, 03 medical and health sciences, Postoperative Complications, 0302 clinical medicine, Physical medicine and rehabilitation, medicine, Paralysis, Humans, Meta-analysi, 030223 otorhinolaryngology, Surgical treatment, Laryngeal paralysi, business.industry, General Medicine, Injection laryngoplasty, Plastic Surgery Procedures, Thyroplasty, medicine.disease, Review analysis, Otorhinolaryngology, Laryngeal paralysis, 030220 oncology & carcinogenesis, Meta-analysis, Systematic review, Neurosurgery, medicine.symptom, business, Vocal Cord Paralysis
Abstract

PURPOSE: The objectives of this meta-analysis were to summarize the key surgical procedures for UVCP and to evaluate which of these is associated with better results in terms of vocal improvement. METHODS: A systematic review of the literature was conducted in search of articles focused on the comparison of voice outcome between different techniques for the UVCP treatment. Then, a quantitative analysis was carried out for papers published from 2013 onwards, reporting only adult patients with unilateral paralysis for each study, and each surgical technique was evaluated for its capability of achieving good functional outcomes in terms of GRBAS-I scale and maximum phonation time in seconds (MPT). RESULTS: The search identified 1853 publications. A total of 159 articles were stratified and included according to our selection criteria. 21 out of 159 articles were selected for quantitative synthesis. For trans-oral techniques: the mean GRBAS-I scale were 2.33 before injection and 0.41 after injection. The mean MPT before injection were 4.78 and 12.50 after injection. For open techniques the mean GRBAS-I scale were 2.43 before surgery and 0.68 after surgery. For open technique, the mean MPT were 3.50 before surgery and 12.40 after surgery. CONCLUSIONS: The two types of techniques lead to an improvement in terms of vocal outcomes emphasizing that from the examined literature an indication emerges to perform an early injection because this could reduce the possible need for a more invasive intervention of permanent medialization in the future.

Published
2019

15. How to avoid life-threatening complications following head and neck space infections: an algorithm-based approach to apply during times of emergency. When and why to hospitalise a neck infection patient

Author

Roberto Santoro, Oreste Gallo, Maria Silvia Lazio, and Giuditta Mannelli

Subjects
Adult, medicine.medical_specialty, Scoring system, Time Factors, Otorhinolaryngologic Surgical Procedures, Adolescent, 03 medical and health sciences, Young Adult, 0302 clinical medicine, Infection, Algorithms, Emergencies, Risk Factors, Delayed surgery, Medicine, Humans, Major complication, 030223 otorhinolaryngology, Head and neck, Surgical treatment, Child, Aged, Retrospective Studies, Aged, 80 and over, Respiratory Distress Syndrome, business.industry, Mortality rate, Incidence, Soft Tissue Infections, General Medicine, Bacterial Infections, Middle Aged, Prognosis, Surgery, Anti-Bacterial Agents, Hospitalization, Survival Rate, Otorhinolaryngology, Debridement, Italy, 030220 oncology & carcinogenesis, business, Clinical risk factor, Algorithm, Neck, Follow-Up Studies
Abstract

Background:Head and neck space infections present with a potential mortality rate of 40–50 per cent. This paper proposes an algorithm-based management of head and neck space infection to prevent life-threatening events.Methods:A total of 225 patients with head and neck space infection were prospectively analysed at our institution. An experimental scoring system determined the level of clinical risk for the development of major complications. Accordingly, patients were classified into three risk groups: low-, intermediate- and high-risk.Results:Only intermediate- and high-risk patients were hospitalised. Intermediate-risk patients received intravenous medical therapy with daily re-evaluation; 18 of them required delayed surgery. Of the high-risk patients, three required immediate surgical treatment and five received delayed surgery, while in five cases medical therapy was the only treatment received. Low-risk patients were treated in an out-patient setting.Conclusion:The algorithm-based management of head and neck space infection was successful in enabling the avoidance of lethal complications onset.

Published
2017

16. Yttrium-90 Radioembolization for Hepatocellular Carcinoma Prior to Liver Transplantation

Author

Giuseppe Pizzi, Adriano M. Pellicelli, Rita Golfieri, Marco Colasanti, Gianpiero D'Offizi, Raffaella Lionetti, Mario Antonini, Giovanni Vennarecci, Giovanni Battista Levi Sandri, Rosa Sciuto, Andrea Laurenzi, Roberto Santoro, Giuseppe Maria Ettorre, Pasquale Lepiane, Roberto Cianni, Roberto Luca Meniconi, and Ettorre GM, Levi Sandri GB, Laurenzi A,Colasanti M, Meniconi RL, Lionetti R, Santoro R, Lepiane P, Sciuto R, Pizzi G, Cianni R, Golfieri R, D’Offizi G, Pellicelli AM, Antonini M, Vennarecci G

Subjects
Adult, Male, medicine.medical_specialty, Liver Transplantation Tace Barcelona Clinic Liver Cancer Milan Criterion Microvascular Invasion, Carcinoma, Hepatocellular, medicine.medical_treatment, Liver transplantation, Milan criteria, Preoperative care, Gastroenterology, 03 medical and health sciences, 0302 clinical medicine, Internal medicine, Preoperative Care, Carcinoma, Medicine, Humans, Yttrium Radioisotopes, Survival analysis, Aged, Retrospective Studies, business.industry, Liver Neoplasms, Retrospective cohort study, Middle Aged, medicine.disease, Embolization, Therapeutic, Liver Transplantation, 030220 oncology & carcinogenesis, Hepatocellular carcinoma, 030211 gastroenterology & hepatology, Female, Surgery, Radiopharmaceuticals, business, Abdominal surgery
Abstract

BACKGROUND: Liver transplantation (LT) is a well-established procedure for hepatocellular carcinoma (HCC) within the Milan criteria. Yttrium-90 microspheres radioembolization (Y90-RE) has shown to be an effective and safe treatment of primary liver tumors. We retrospectively evaluate the efficacy of the Y90-RE in patients with HCC prior to LT. METHODS: From January 2002 to December 2015, 365 patients were transplanted at the San Camillo Hospital Center. One hundred forty-three patients were transplanted for HCC, and in 22 cases the patients were treated with Y90-RE before LT. RESULTS: Three patients were treated with Y90-RE within the Milan criteria, and 19 patients were out of criteria before Y90-RE. Four patients had an increasing MELD score between Y90-RE and LT. On the other hand, alpha-fetoprotein decreases after Y90-RE treatment in all cases. No patient death was observed in Y90-RE procedure or at LT. In 78.9 % of cases, a successful downstaging was observed, and in 100 % of cases bridging was achieved. From Y90-RE treatment overall survival was 43.9 months. From LT, overall mean survival was 30.2 months with a free survival of 29.6 months. The overall survival after LT analysis between the patients treated with Y90-RE and patients without was not significant (p = 0.113). Free survival analysis was not significant (p = 0.897) between the two populations. CONCLUSIONS: We successfully performed LT in patients after Y90-RE treatment both as bridging and downstaging for HCC and obtained a similar overall and free survival of LT for HCC within Milan criteria. Y90-RE becomes a real option to provide curative therapy for patients who traditionally are not considered eligible for surgery.

Published
2017

17. Sedano: A News Stream Processor for Business

Author

Giuliano Mega, Ugo Scaiella, Giacomo Berardi, and Roberto Santoro

Subjects
FOS: Computer and information sciences, Information retrieval, Computer science, business.industry, Search engine indexing, InformationSystems_INFORMATIONSTORAGEANDRETRIEVAL, Newspaper, Computer Science - Information Retrieval, Set (abstract data type), Stream processing, Entity linking, Order (business), Scalability, Business intelligence, business, Information Retrieval (cs.IR)
Abstract

We present Sedano, a system for processing and indexing a continuous stream of business-related news. Sedano defines pipelines whose stages analyze and enrich news items (e.g., newspaper articles and press releases). News data coming from several content sources are stored, processed and then indexed in order to be consumed by Atoka, our business intelligence product. Atoka users can retrieve news about specific companies, filtering according to various facets. Sedano features both an entity-linking phase, which finds mentions of companies in news, and a classification phase, which classifies news according to a set of business events. Its flexible architecture allows Sedano to be deployed on commodity machines while being scalable and fault-tolerant., 2 pages, 1 figure. SIGIR '16 July 17-21, 2016, Pisa, Italy

Published
2016

18. Total abdominal approach for postero-superior segments (7, 8) in laparoscopic liver surgery: a multicentric experience

Author

Giuseppe Tarantino, Roberto Santoro, Giuseppe Maria Ettorre, Paolo Bianco, Fabrizio Di Benedetto, Luca Aldrighetti, Emanuele Felli, Antonio Giuliani, Francesca Ratti, Giuliani, A, Aldrighetti, L, Di Benedetto, F, Ettorre, Gm, Bianco, P, Ratti, F, Tarantino, G, Santoro, R, and Felli, E

Subjects
Adult, Male, Liver surgery, Laparoscopic surgery, Segmentectomy, medicine.medical_specialty, Hepatic resection, Hepatocellular carcinoma, medicine.medical_treatment, Operative Time, Liver colorectal metastasis, Abdominal approach, Risk Assessment, Patient Positioning, Cohort Studies, Abdominal wall, Blood loss, Laparotomy, Abdomen, Hepatectomy, Humans, Minimally Invasive Surgical Procedures, Medicine, Laparoscopic resection, Aged, Retrospective Studies, business.industry, Liver Neoplasms, Length of Stay, Middle Aged, Laparoscopic liver resection, Laparoscopes, Surgery, Survival Rate, Treatment Outcome, medicine.anatomical_structure, Italy, Female, Laparoscopy, Radiology, business, Follow-Up Studies
Abstract

Laparoscopic liver resections are frequently performed for peripheral lesions located in the antero-inferior segments. Resection of postero-superior segments is more demanding and dangerous than other segmentectomies, resulting in a longer operation time and increased blood loss. To reduce technical challenges, some authors advocated a modified surgical approach for these segments with the patient placed in the left lateral decubitus with the right arm suspended and suggested technical variations like the use of an additional intercostal trocar, the placement of one or two additional trans-thoracic trocars, a hand-assisted approach or a hybrid method with a median laparotomy. In the present series of 88 patients from four hepatobiliary centers with high volume of activity in Italy, a standard lithotomic position has been routinely used without the need for left lateral decubitus or semi-prone position and through abdominal wall without use of trans-thoracic trocars. This approach allows a more comfortable use of the Pringle maneuver that we used routinely in hepatic resection for PS segments; and, a very short time is needed for conversion, whenever it is required. In our series, laparoscopic resection of liver tumors located in the postero-superior segments of the liver with a total abdominal approach is technically feasible and safe with short-term results similar to other laparoscopic liver resections.

Published
2015

19. Is elective neck dissection necessary in cases of laryngeal recurrence after previous radiotherapy for early glottic cancer?

Author

Alberto Deganello, Fabiola Paiar, Oreste Gallo, Giuseppe Meccariello, Giuditta Mannelli, B. Bini, and Roberto Santoro

Subjects
Larynx, Male, medicine.medical_specialty, Glottis, Fistula, medicine.medical_treatment, Laryngeal cancer, Laryngectomy, Neck dissection, Radiotherapy, Salvage therapy, Vocal cords, Aged, Elective Surgical Procedures, Female, Humans, Kaplan-Meier Estimate, Laryngeal Neoplasms, Lymph Nodes, Lymphatic Metastasis, Middle Aged, Multivariate Analysis, Neck Dissection, Neoplasm Recurrence, Local, Radiography, Retrospective Studies, Salvage Therapy, Otorhinolaryngology2734 Pathology and Forensic Medicine, medicine, business.industry, General Medicine, Laryngeal Neoplasm, medicine.disease, Recurrent Laryngeal Carcinoma, Surgery, Radiation therapy, medicine.anatomical_structure, Neoplasm Recurrence, Larynx carcinoma, neck dissection, Otorhinolaryngology, Local, business
Abstract

Objectives:To assess the clinical utility of elective neck dissection in node-negative recurrent laryngeal carcinoma after curative radiotherapy for initial early glottic cancer.Methods:A retrospective review was undertaken of 110 consecutive early glottic cancer patients who developed laryngeal recurrence after radiotherapy (34 recurrent T1, 36 recurrent T2, 29 recurrent T3 and 11 recurrent T4a) and received salvage laryngeal surgery between 1995 and 2005.Results:Six patients presented with laryngeal and neck recurrence and underwent salvage laryngectomy with therapeutic neck dissection, 97 patients with recurrent node-negative tumours underwent salvage laryngeal surgery without neck dissection and only 7 underwent elective neck dissection. No occult positive lymph nodes were documented in neck dissection specimens. During follow up, only three patients with neck failure were recorded, all in the group without neck dissection. There was no significant association between the irradiation field (larynx plus neck vs larynx) and the development of regional failure. A higher rate of post-operative pharyngocutaneous fistula development occurred in the neck dissection group than in the group without neck dissection (57.2 per cent vs 13.4 per cent, p = 0.01). Multivariate logistic regression analysis showed that early (recurrent tumour-positive, node-positive) or delayed (recurrent tumour-positive, node-negative) neck relapse was not significantly related to the stage of the initial tumour or the recurrent tumour. An age of less than 60 years was significantly associated with early neck failure (recurrent tumour-positive, node-positive).Conclusion:Owing to the low occult neck disease rate and high post-operative fistula rate, elective neck dissection is not recommended for recurrent node-negative laryngeal tumours after radiation therapy if the initial tumour was an early glottic cancer.

Published
2014

20. Ear, nose and throat (ENT) involvement in zoonotic diseases: a systematic review

Author

Alfonso J. Rodriguez-Morales, Francesco Galletti, Valentina Katia Mannella, Roberto Santoro, Francesco Freni, Claudio Galletti, Bruno Galletti, Antonio Cascio, GALLETTI, Bruno, MANNELLA, VALENTINA KATIA, SANTORO, ROBERTO, Rodriguez Morales AJ, FRENI, Francesco, GALLETTI, Claudio, GALLETTI, Francesco, and CASCIO, Antonio

Subjects
Mastoiditis, medicine.medical_specialty, Pathology, Microbiology, Zoonosis, Otology, Virology, Zoonoses, Nose Diseases, otorhinolaryngologic diseases, Medicine, Animals, Humans, Sinusitis, Ear Diseases, ENTO, torhinolaryngology, Zoonoses, Nose, Sinus (anatomy), Otorrinolaringología, business.industry, General Medicine, Pharyngeal Diseases, medicine.disease, Dermatology, Pharyngitis, Infectious Diseases, medicine.anatomical_structure, Otitis, Otorhinolaryngology, Parasitology, medicine.symptom, business
Abstract

Introducción: Las zoonosis son infecciones de transmisión del animal al hombre, ya sea directamente (a través del contacto directo o contacto con productos de origen animal) o indirectamente (a través de un vector intermedio, tal como un artrópodo). Los agentes causales incluyen bacterias, parásitos, virus y hongos. El propósito de esta revisión es hacer un examen preciso de todas las enfermedades zoonóticas que pueden ser responsables de oído, nariz y garganta (ENT) participación. Metodología: Se realizó una búsqueda en PubMed combinando los términos (otorrinolaringología o Rinología o laringología o otología or mastoiditis u otitis o sinusitis o laringitis o rinitis o faringitis o de la epiglotitis o disfonía o la oreja o la laringe o la nariz or faringe) con cada uno de los agentes etiológicos de las zoonosis para el período entre enero de 1997 y agosto de 2012 sin restricciones de lenguaje. Resultados: Se seleccionaron un total de 164 artículos y se examina. Laringe es el órgano más frecuentemente afectado ENT, seguido de la cavidad oral, faringe, y el cuello. Las bacterias fueron los microorganismos más representativos implicados. La nariz y las glándulas salivales mayores fueron los más afectados frecuentemente por protozoos; senos paranasales, cavidad oral, el oído, el cuello, los nervios y las vías respiratorias superiores por las bacterias, y laringe por hongos. Conclusiones: La clínica de otorrinolaringología y signos pueden estar presentes en muchas de las enfermedades zoonóticas, algunos de los cuales también están presentes en los países industrializados. La mayoría de las enfermedades zoonóticas no son comúnmente encontrados por los especialistas ENT. La apreciación de la posible aparición de estas enfermedades es importante para un enfoque microbiológico correcto , que a menudo requiere medios de cultivo especiales y técnicas de diagnóstico. Introduction: Zoonoses are infections transmitted from animal to man, either directly (through direct contact or contact with animal products) or indirectly (through an intermediate vector, such as an arthropod). The causative agents include bacteria, parasites, viruses, and fungi. The purpose of this review is to make an accurate examination of all zoonotic diseases that can be responsible of ear, nose, and throat (ENT) involvement. Methodology: A PubMed search was performed combining the terms (otorhinolaryngology OR rhinology OR laryngology OR otology OR mastoiditis OR otitis OR sinusitis OR laryngitis OR rhinitis OR pharyngitis OR epiglottitis OR dysphonia OR ear OR larynx OR nose OR pharynx) with each one of the etiological agents of zoonoses for the period between January 1997 and August 2012 without language restrictions. Results: A total of 164 articles were selected and examined. Larynx was the most commonly involved ENT organ, followed by oral cavity, pharynx, and neck. Bacteria were the most representative microorganisms involved. Nose and major salivary glands were affected most frequently by protozoa; paranasal sinus, oral cavity, ear, neck, nerves and upper airway by bacteria; and larynx by fungi. Conclusions: ENT symptoms and signs may be present in many zoonotic diseases, some of which are also present in industrialized countries. Most zoonotic diseases are not commonly encountered by ENT specialists. Appreciation of the possible occurrence of these diseases is important for a correct microbiological approach, which often requires special culture media and diagnostic techniques.

Published
2014

21. Is open tracheotomy performed by residents in otorhinolaryngology a safe procedure? a retrospective cohort study

Author

Roberto Santoro, Giuditta Mannelli, Oreste Gallo, Francesca Romana Fiorini, Giuseppe Meccariello, and Alberto Deganello

Subjects
Male, medicine.medical_specialty, Percutaneous, Quality Assurance, Health Care, medicine.medical_treatment, Cohort Studies, Otolaryngology, Postoperative Complications, Tracheotomy, Risk Factors, Physicians, Outcome Assessment, Health Care, Humans, Medicine, Surgeon · Supervised resident · Tracheotomy · Surgical training · complication · Quality of care, Aged, Retrospective Studies, business.industry, Internship and Residency, Retrospective cohort study, General Medicine, Subcutaneous Emphysema, Surgery, Trachea, Italy, Otorhinolaryngology, Female, Clinical Competence, Neurosurgery, medicine.symptom, business, Complication, Subcutaneous emphysema, Cohort study
Abstract

Surgical or percutaneous tracheotomy is one of the commonest operations in the ENT practice and one of the first procedures to be taught to residents. No study exists that demonstrates the safety of this surgical procedure performed by unexperienced surgeons. The purpose was to compare outcomes of tracheotomies performed by supervised residents and surgeons in terms of postoperative complications and mortality, and identify risk factors for the onset of complications. Retrospective cohort study. Otolaryngology-Head and Neck Surgery Department, University of Florence, Italy. We included all patients undergoing tracheotomy from July 2008 to January 2013 and compared tracheotomies performed by supervised residents or surgeons. During the study period, 304 patients were submitted to tracheotomy. Patients operated by surgeons had a significantly higher number of tracheal rings fracture (p = 0.05), subcutaneous emphysema (p = 0.003) and tracheostomy tube displacement (p = 0.003), while supervised residents had a higher number of tracheitis/pneumonia (p = 0.04) as early complications. Patients operated by supervised residents had a significantly higher number of tube obstructions as late complication (p = 0.04). Using multivariate model, risk factors for early postoperative complications were male sex (p = 0.04) and delayed time to substitution with cuffless tube (p = 0.01), while only a trend to statistical significance was observed for urgent tracheotomies concerning the risk for late postoperative complications (p = 0.08). The current practice where residents perform tracheotomies supervised by a surgeon should not be disheartened. Our study demonstrates that it is safe and does not lead to higher risk of complications nor negatively affects the quality of care.

Published
2014

22. Use of Cold-Stored Vein Allografts for Venous Reconstruction During Pancreaticoduodenectomy

Author

Roberto Luca Meniconi, Giovanni Vennarecci, Pasquale Lepiane, Andrea Laurenzi, Lidia Colace, Roberto Santoro, Marco Colasanti, and Giuseppe Maria Ettorre

Subjects
Male, medicine.medical_specialty, medicine.medical_treatment, Vascular infiltration, Pancreaticoduodenectomy, Veins, Mesenteric Veins, Allograft, Cadaver, Pancreatic cancer, medicine, Humans, Prospective Studies, Reconstructive Surgical Procedures, Vascular resection, Superior mesenteric vein, Vein, Aged, business.industry, Portal Vein, Gastroenterology, Vein reconstruction, Female, Middle Aged, Organ Preservation, Allografts, Cold Temperature, Vascular Surgical Procedures, Surgery, Plastic Surgery Procedures, medicine.disease, Stenosis, medicine.anatomical_structure, Radiology, Cadaveric spasm, business
Abstract

Venous resections and reconstructions of portal vein and/or superior mesenteric vein in course of pancreaticoduodenectomy are becoming a common practice and many surgical options have been described, from simple tangential resection and venorrhaphy to large segmental resections followed by interposition grafting. The aim of this study was to report the first experience of using fresh cadaveric vein allografts for venous reconstruction during pancreaticoduodenectomy focusing on technical feasibility and postoperative outcomes. From January 2001 to October 2012, out of 151 patients undergoing pancreaticoduodenectomy for pancreatic head tumor, 22 (14.5 %) received a vascular resection of the mesentericoportal axis. In five of these patients, vascular reconstruction was accomplished by using cold-stored venous allografts of iliac and femoral veins from donor cadaver. Patients’ data, surgical techniques, and clinical outcomes were analyzed. Five patients undergoing pancreaticoduodenectomy were selected to receive a vascular reconstruction using a fresh venous allograft for patch closure in three cases, conduit interposition in one case and a Y-shaped graft in the last case. No graft thrombosis or stenosis occurred postoperatively and at long-term follow-up. Mortality rate was zero. The use of fresh vein allografts is a feasible and effective technique for venous reconstruction during pancreaticoduodenectomy. However, prospective surveys including large cohorts of patients are necessary to confirm these results.

Published
2013

23. Dealing with the patient’s body in nursing: nurses’ ambiguous experience in clinical practice

Author

Lorenza Garrino, E Picco, and Roberto Santoro

Subjects
Coping (psychology), medicine.medical_specialty, Attitude of Health Personnel, body, care, in-depth interviews, medical anthropology, nurse–patient relationships, Nursing Methodology Research, Nursing Staff, Hospital, Nurse's Role, Conflict, Psychological, Personal Space, Nursing, Kinesics, Surveys and Questionnaires, Adaptation, Psychological, Medicine, Humans, Nurse education, General Nursing, Primary nursing, Nursing Assessment, Qualitative Research, Defense Mechanisms, Geriatrics, Human Body, Interpretative phenomenological analysis, business.industry, Nursing Outcomes Classification, Team nursing, Italy, Privacy, Touch, Western World, Job satisfaction, Clinical Competence, Empathy, business, Nurse-Patient Relations, Prejudice
Abstract

PICCO E, SANTORO R and GARRINO L. Nursing Inquiry 2010; 17: 39–46 Dealing with the patient’s body in nursing: nurses’ ambiguous experience in clinical practice The core of nursing in western countries is interaction with the patient and with his/her body in particular. As all nursing practices revolve around caring for the patient’s body, nurses need to understand the frailty of the body, the intimacy surrounding it, the story it tells, as well as the discomfort and difficulties both illness and close contact can generate in the nurse–patient relationship. With this study, we wanted to explore the ward experiences of a small group of nurses in their day-to-day interaction with patients and their bodies, to highlight their perceptions and possible difficulties in providing care. We collected qualitative data from in-depth interviews with 14 nurses working in departments of general internal medicine, neurology, and geriatrics. The interviews were conducted between April and June 2006 and interpreted using an interpretive phenomenological approach. Analysis of the interview transcripts revealed that while the nurses recognize the centrality of the body in nursing, they also expressed a certain ambiguity toward it: being able to improve a patient’s well-being through attentive care to the body is a major source of job satisfaction, but various coping and defense strategies are deployed to overcome care-giving situations that elicit avoidance or refusal reactions to the patient’s body.

Published
2010

24. Survivin-Igm Immuno Complex: A Novel Candidate Biomarker Of Cirrhosis To Monitor Patients Progression Towards Hepatocellular Carcinoma

Author

Claudio Puoti, L. Beneduce, A. Antenucci, Guido Rasi, P Pierimarchi, J. Zuin, Claudia Matteucci, L. Belli, Giovanni Vennarecci, Roberto Santoro, Giuseppe Maria Ettorre, and R Sorrentino

Subjects
medicine.medical_specialty, Cirrhosis, Hepatology, business.industry, Gastroenterology, medicine.disease, Settore MED/07 - Microbiologia e Microbiologia Clinica, Hepatocellular carcinoma, Internal medicine, Survivin, medicine, Cancer research, Biomarker (medicine), business
Published
2009

28. Changes in surgicaL behaviOrs dUring the CoviD-19 pandemic. The SICE CLOUD19 Study

Author

Bracale, U., Podda, Maria Vittoria, Castiglioni, S., Peltrini, R., Sartori, Alessandra, Arezzo, A., Corcione, F., Agresta, F., Antonucci, A., Zanframundo, C., Cavallo, F., Mazzarolo, G., Agrusa, A., Di Buono, G., Aldrighetti, L., Fiorentini, G., Lucianetti, A., Magnone, S., Alfieri, Sergio, Rosa, Fausto, Altomare, D. F., Picciariello, A., Parisi, Carmelo Maria Antonio, Di Cintio, A., Amisano, M. F., Cravero, F., Ammendola, M., Ammerata, G., Anastasi, A., Canonico, G., Gattolin, A., Travaglio, E., De Palma, M., Angelini, P., Galante, F., Benevento, A., Rausei, S., Serao, A., Abbatini, F., Annecchiarico, M., Varricchio, A., Annessi, V., Tumiati, D., Annicchiarico, A., Mirabella, A., Marino, M. V., Spinelli, A., Braun, A., Santi, H. T., Romano, L., Antoniutti, M., Armellino, M. F., Argenio, G., Verzelli, A., Budassi, A., Baiocchi, G., Alfano, M. S., Balani, A., Barone, M., Baldazzi, G., Cassini, D., Canger, R. C. B., Zabbialini, G., Belli, Andrea, Izzo, Filippo, Bertolino, F., Brunetti, Maria Mercede, Bianco, Flaviana, Cappiello, A., Boccia, L., Boffi, B., Perna, Francesco, Bonilauri, S., Frazzetta, G., Bordoni, P., Fleres, F., Borghi, F., Giraudo, G., Bottino, V., Canfora, A., Piccoli, F. B., Calligaris, L., Nipote, B., Nasti, A. G., Bufalari, A., Bettarini, F., Buononato, M., Greco, M., Calo, P. G., Medas, F., Cardamone, E., Castaldo, P., Carlini, M., Spoletini, D., De Nisco, C., Pulighe, F., Feo, C. V., Fabbri, N., Antropoli, C., Foroni, F., Carnazza, M., Ragazzi, S., Cassinotti, E., Boni, L., Catena, F., Giuffrida, M., Perrone, Giuseppe, Ccotsoglou, C., Granieri, S., Ceccarelli, G., Bugiantella, W., Cedolini, C., Seriau, L., Cesari, Matteo, Contine, A., Chiara, Osvaldo, Cimbanassi, S., Cocozza, E., Berselli, M., Fantini, C., Costi, R., Casali, L., Morini, A., Crafa, F., Vanela, S., Curro, G., Orsini, V., Da Lio, C., Biral, Maria Francesca, Danelli, P., Guerci, C., Scala, D., Marino, Giuseppe, De Carlis, L., Lauterio, A., De Giorgi, D., Sciannamea, G., De Manzini, N., Losurdo, P., Sangiuliano, N., Degiuli, M., Caterina, F., Del Rio, P., Bonati, E., Di Lernia, S., Ardizzone, M. V. R., Di Saverio, S., Franchi, C., Di Venere, B., Miglio, R., Cuccurullo, D., Sagnelli, C., Docimo, L., Tolone, S., Longoni, M., Faillace, G., Rondelli, F., Pennella, F. P., Colucci, V., Carfora, T., Muttillo, I. A., Picardi, B., Stefano, R., Campagnacci, R., Maurizi, A., Tricarico, F., Montagna, M., Amedeo, E., Scollica, M. C., Lauro, E., Laterza, E., Molinari, E., Berta, G., Bono, D., Fabozzi, Simone Michele, Romano, M., Facci, E., Parini, D., Farfaglia, R., Arizzi, V., Farsi, M., Miranda, E., Fei, L., Flavio, G., Pirozzi, F., Sciuto, A., Ferrero, A., Palisi, M., Filauro, M., Barberis, A., Azzinnaro, A., Fiscon, V., Vigna, S., D'Ambra, M., Pontecorvi, E., Anania, G., Bombardini, C., Galizia, G., Auricchio, Anna Maria, Cardella, F., Genna, M., Gentilli, S., Herald, N., Castagnoli, G., Bartoli, A., Gianotti, L., Garancini, M., Bellanova, G., Palazzo, P., De Palma, G., Milone, Maria, Ferrari, G., Magistro, C., Giuliani, Antonio, Di Natale, Maria Grazia, Brisinda, Giuseppe, Cavallaro, G., Sammarco, G., Gallo, Giuseppe, Goletti, O., Macchini, D., Greco, Viviana, Amoroso, V., Guercioni, G., Benedetti, M., Guzzo, G., Pata, F., Scandroglio, I., Roscio, F., Jovine, E., Lombardi, Roberto, La Rocca, F., Di Capua, F., Lanci, C., Leli, R., Borasi, A., Lepiane, P., Balla, A., Liberatore, E., Morelli, L., Di Franco, G., Lucchi, A., Vittori, L., Bonavina, L., Asti, Emilio Fabrizio, Maggioni, D., Martino, G., Manca, Gavina, Delvecchio, A., Tedesco, M., Gambardella, D., Marafioti, S., De Marco, M. L., Guicciardi, M. A., Motta, M., Calgaro, M., Adamo, V., Guerrieri, Maria Chiara, Coletta, P., Ortenzi, M., Martines, G., Lantone, G., Martinotti, M., Fassardi, G., Castriconi, M., Squillante, S., De Luca, M., Pavanello, M., Di Marco, C., Ronconi, M., Casiraghi, Maria Stella, Mazzaferro, V., Battiston, C., Perrotta, M., Ripa, C., Giancarlo, M., Panizzo, V., Millo, P., Contul, R. B., Ferraro, V., Molino, C., Crolla, E., Moretto, G., Bacchion, M., Morino, M., Allaix, M. E., Motterlini, E., Petracca, Martina, Muratore, A., Musella, Martina, Vitiello, A., Nardo, B., Crocco, V., Navarra, G., Lazzara, S., Navarra, G. G., Cuoghi, M., Olmi, S., Oldani, Alberto, Uccelli, M., Opocher, E., Giovenzana, M., De Paolis, P., Santarelli, M., Delrio, P., Carbone, F., Bianchi, P. P. G., Formisano, Capelli, P., Baldini, E., Festa, P., Mottola, Armando, Merola, G., Perrotta, N., Celiento, M., Personnettaz, E., Muzio, S., Petitti, T., Melchiorre, A., Piccoli, M., Pecchini, F., Frontali, A., Maffioli, A., Maida, P., Tammaro, P., Pignata, G., Andreuccetti, J., Pilone, V., Renzulli, M., Pintaldi, S., Ceretti, A. P., Mariani, N. M., Pisanu, A., Polastri, R., Maiello, F., Porcu, A., Perra, T., Mucilli, F., Troisi, R., Montalti, R., Scognamillo, F., Delogu, D., Galleano, R., Malerba, M., Salfi, R., Pisano, M., Sechi, R., Cillara, N., Ramuscello, S., De Leo, E., Restini, E., Tumolo, R., Cianci, P., Capuzzolo, S., Rizzo, M., Recordare, A., Santoro, Roberto, Amodio, P. M., Rocca, A., Cecere, G., Romito, R., Portigliotti, L., Rosati, R., Elmore, U., Russello, D., Latteri, S., Costarella, S. M., Massa, S., Capasso, L., Santangelo, M., Sodo, M., Sarro, G., Rivolta, U., Scabini, S., Pertile, D., Selvaggi, F., Rossi, S., Pellino, G., Sganga, Gabriele, Fransvea, P., Testa, S., De Rosa, Maria Cristina, Siquini, W., Trana, C., Solej, M., Bolzon, S., Guerra, Eliana, Stella, M., Ferrara, F., Stipa, F., Stringhi, E., Celotti, A., Taglietti, L., Del Giudice, R., Talarico, C. A., Ruggiero, Miriam, Tirone, G., Romario, U. F., Petz, W., Caracino, V., Rossetti, V., Verza, L. A., Vescovi, L., Marini, M., Vettoretto, N., Botteri, E., Vincenti, L., Giannandrea, G., Viora, T., Maganuco, L., Veronesi, P., Zani, B., Zanus, G., Brizzolari, M., Zanzi, F., Guariniello, A., Zappa, M. A., Galfrascoli, E., Zonta, S., Oragano, L., Zuliani, W., Chiari, D., Bracale, Umberto, Podda, Mauro, Castiglioni, Simone, Peltrini, Roberto, Sartori, Alberto, Arezzo, Alberto, Corcione, Francesco, Agresta, Ferdinando, Rosati, Riccardo, Umberto, Bracale, Mauro, Podda, Simone, Castiglioni, Roberto, Peltrini, Alberto, Sartori, Alberto, Arezzo, Francesco, Corcione, Ferdinando, Agresta, CLOUD-19 Collaborative Group Adelmo Antonucci, Claudia, Zanframundo, Fabio, Cavallo, Giorgio, Mazzarolo, Antonio, Agrusa, Giuseppe Di Buono, Luca, Aldrighetti, Guido, Fiorentini, Alessandro, Lucianetti, Stefano, Magnone, Sergio, Alfieri, Fausto, Rosa, Altomare, Donato F., Arcangelo, Picciariello, Amilcare, Parisi, Antonio Di Cintio, Marco Francesco Amisano, Francesca, Cravero, Michele, Ammendola, Giorgio, Ammerata, Alessandro, Anastasi, Giuseppe, Canonico, Andra, Gattolin, Elisabetta, Travaglio, Andrea, Sartori, Massimiliano De Palma, Pierluigi, Angelini, Francesco, Galante, Angelo, Benevento, Stefano, Rausei, Angelo, Serao, Francesca, Abbatini, Mario, Annecchiarico, Antonio, Varricchio, Valerio, Annessi, David, Tumiati, Alfredo, Annicchiarico, Antonello, Mirabella, Marino, Marco V., Antonino, Spinelli, Antonio, Braun, Hong Tham Santi, Lucia, Romano, Michele, Antoniutti, Mariano Fortunato Armellino, Giulio, Argenio, Augusto, Verzelli, Andrea, Budassi, Gianluca, Baiocchi, Marie Sophie Alfano, Alessandro, Balani, Marco, Barone, Gianandrea, Baldazzi, Diletta, Cassini, Ruben Carlo Balzarotti Canger, Gianpietro, Zabbialini, Andrea, Belli, Francesco, Izzo, Franco, Bertolino, Marco, Brunetti, Francesco, Bianco, Antonio, Cappiello, Luigi, Boccia, Bernardo, Boffi, Federico, Perna, Stefano, Bonilauri, Giuseppe, Frazzetta, Pierpaolo, Bordoni, Francesco, Flere, Felice, Borghi, Giorgio, Giraudo, Vincenzo, Bottino, Alfonso, Canfora, Fabrizio Briganti Piccoli, Luca, Calligari, Bruno, Nipote, Aniello Gennaro Nasti, Andrea, Bufalari, Francesca, Bettarini, Massimo, Buononato, Marco, Greco, Pietro Giorgio Calò, Fabio, Meda, Eugenia, Cardamone, Pasquale, Castaldo, Massimo, Carlini, Domenico, Spoletini, Carlo De Nisco, Fabio, Pulighe, Feo, Carlo V., Nicolò, Fabbri, Carmine, Antropoli, Fabrizio, Foroni, Maurizio, Carnazza, Salvatore, Ragazzi, Elisa, Cassinotti, Luigi, Boni, Fausto, Catena, Mario, Giuffrida, Gennaro, Perrone, Christian, Ccotsoglou, Stefano, Granieri, Graziano, Ceccarelli, Walter, Bugiantella, Carla, Cedolini, Luca, Seriau, Maurizio, Cesari, Alessandro, Contine, Osvaldo, Chiara, Stefania, Cimbanassi, Eugenio, Cocozza, Mattia, Berselli, Corrado, Fantini, Renato, Costi, Lorenzo, Casali, Andrea, Morini, Francesco, Crafa, Serafino, Vanela, Giuseppe, Currò, Vincenzo, Orsini, Corrado Da Lio, Mario, Biral, Piergiorgio, Danelli, Claudio, Guerci, Dario, Scala, Graziella, Marino, Luciano De Carlis, Andrea, Lauterio, Donato De Giorgi, Gianluca, Sciannamea, Nicolo De Manzini, Pasquale, Losurdo, Maurizio De Palma, Nicola, Sangiuliano, Maurizio, Degiuli, Franco, Caterina, Paolo Del Rio, Elena, Bonati, Stefano Di Lernia, Marco Vittorio Rossi Ardizzone, Salomone Di Saverio, Caterina, Franchi, Beatrice Di Venere, Rosanna, Miglio, Diego, Cuccurullo, Carlo, Sagnelli, Docimo, Ludovico, Tolone, Salvatore, Mauro, Longoni, Giuseppe, Faillace, Fabio, Rondelli, Francesca Pennetti Pennella, Vincenzo, Colucci, Teresa, Carfora, Irnerio Angelo Muttillo, Biagio, Picardi, Rossi, Stefano, Roberto, Campagnacci, Angela, Maurizi, Fausto, Tricarico, Marco, Montagna, Elio, Amedeo, Scollica, Michela C., Enrico, Lauro, Ernesto, Laterza, Enrico, Molinari, Berta, G., Dario, Bono, Massimiliano, Fabozzi, Mafalda, Romano, Enzo, Facci, Dario, Parini, Roberto, Farfaglia, Valeria, Arizzi, Marco, Farsi, Egidio, Miranda, Fei, Landino, Giordano, Flavio, Felice, Pirozzi, Antonio, Sciuto, Alessandro, Ferrero, Marco, Palisi, Marco, Filauro, Andrea, Barberi, Antonio, Azzinnaro, Valentino, Fiscon, Silvia, Vigna, Michele, D’Ambra, Emanuele, Pontecorvi, Gabriele, Anania, Cristina, Bombardini, Galizia, Gennaro, Auricchio, Annamaria, Cardella, Francesca, Michele, Genna, Sergio, Gentilli, Nikaj, Herald, Giampaolo, Castagnoli, Alberto, Bartoli, Luca, Gianotti, Mattia, Garancini, Giovanni, Bellanova, Paola, Palazzo, Giovanni De Palma, Marco, Milone, Giovanni, Ferrari, Carmelo, Magistro, Antonio, Giuliani, Giuseppe Di Natale, Giuseppe, Brisinda, Giuseppe, Cavallaro, Giuseppe, Sammarco, Gaetano, Gallo, Orlando, Goletti, Daniele, Macchini, Vincenzo, Greco, Vincenzo, Amoroso, Gianluca, Guercioni, Michele, Benedetti, Guglielmo, Guzzo, Francesco, Pata, Ildo, Scandroglio, Francesco, Roscio, Elio, Jovine, Raffaele, Lombardi, Francesco La Rocca, Francesca Di Capua, Carmine, Lanci, Renzo, Leli, Andrea, Borasi, Pasquale, Lepiane, Andrea, Balla, Edoardo, Liberatore, Luca, Morelli, Gregorio Di Franco, Andrea, Lucchi, Laura, Vittori, Luigi, Bonavina, Emanuele, Asti, Dario, Maggioni, Gerosa, Martino, Giuseppe, Manca, Antonella, Delvecchio, Manfredo, Tedesco, Denise, Gambardella, Salvatore, Marafioti, Maria Luisa De Marco, Marco Azzola Guicciardi, Massimo, Motta, Marco, Calgaro, Vincenzo, Adamo, Mario, Guerrieri, Pietro, Coletta, Monica, Ortenzi, Gennaro, Martine, Giuliano, Lantone, Mario, Martinotti, Giuseppe, Fassardi, Maurizio, Castriconi, Simone, Squillante, Maurizio De Luca, Maurizio, Pavanello, Carlo Di Marco, Maurizio, Ronconi, Silvia, Casiraghi, Vincenzo, Mazzaferro, Carlo, Battiston, Michele, Perrotta, Carmine, Ripa, Micheletto, Giancarlo, Valerio, Panizzo, Paolo, Millo, Riccardo Brachet Contul, Valentina, Ferraro, Carlo, Molino, Enrico, Crolla, Gianluigi, Moretto, Matilde, Bacchion, Mario, Morino, Marco Ettore Allaix, Enrico, Motterlini, Michele, Petracca, Andrea, Muratore, Mario, Musella, Antonio, Vitiello, Bruno, Nardo, Veronica, Crocco, Giuseppe, Navarra, Salvatore, Lazzara, Giuseppe Giovanni Navarra, Manuela, Cuoghi, Stefano, Olmi, Alberto, Oldani, Matteo, Uccelli, Enrico, Opocher, Marco, Giovenzana, Paolo De Paolis, Mauro, Santarelli, Paolo, Delrio, Fabio, Carbone, Paolo Pietro Giampaolo Bianchi, Formisano, Patrizio, Capelli, Edoardo, Baldini, Patrizio, Festa, Arianna, Mottola, Giovanni, Merola, Nicola, Perrotta, Marta, Celiento, Eraldo, Personnettaz, Stefania, Muzio, Tommaso, Petitti, Antonietta, Melchiorre, Micaela, Piccoli, Francesca, Pecchini, Alice, Frontali, Anna, Maffioli, Pietro, Maida, Pasquale, Tammaro, Giusto, Pignata, Jacopo, Andreuccetti, Vincenzo, Pilone, Michele, Renzulli, Salvatore, Pintaldi, Andrea Pisani Ceretti, Nicolò Maria Mariani, Adolfo, Pisanu, Roberto, Polastri, Fabio, Maiello, Alberto, Porcu, Teresa, Perra, Felice, Mucilli, Mirko, Barone, Roberto, Troisi, Roberto, Montalti, Fabrizio, Scognamillo, Daniele, Delogu, Raffaele, Galleano, Michele, Malerba, Raffaele, Salfi, Marcello, Pisano, Raffaele, Sechi, Nicola, Cillara, Salvatore, Ramuscello, Eugenio De Leo, Enrico, Restini, Rocco, Tumolo, Pasquale, Cianci, Sabino, Capuzzolo, Maurizio, Rizzo, Alfonso, Recordare, Roberto, Santoro, Pietro Maria Amodio, Aldo, Rocca, Giuseppe, Cecere, Raffaele, Romito, Luca, Portigliotti, Riccardo, Rosati, Ugo, Elmore, Domenico, Russello, Saverio, Latteri, Salvatore Maria Costarella, Salvatore, Massa, Lorenzo, Capasso, Michele, Santangelo, Maurizio, Sodo, Giuliano, Sarro, Umberto, Rivolta, Stefano, Scabini, Davide, Pertile, Federico, Selvaggi, Selene, Rossi, Selvaggi, Francesco, Pellino, Gianluca, Gabriele, Sganga, Pietro, Fransvea, Silvio, Testa, Clemente De Rosa, Walter, Siquini, Cristian, Tranà, Mario, Solej, Stefano, Bolzon, Enrico, Guerra, Marco, Stella, Francesco, Ferrara, Francesco, Stipa, Enrico, Stringhi, Andrea, Celotti, Lucio, Taglietti, Roberto Del Giudice, Carlo Alessandro Talarico, Michele, Ruggiero, Giuseppe, Tirone, Uberto Fumagalli Romario, Wanda, Petz, Valerio, Caracino, Valentina, Rossetti, Luca Andrea Verza, Lorenzo, Vescovi, Michele, Marini, Nereo, Vettoretto, Emanuele, Botteri, Leonardo, Vincenti, Giusy, Giannandrea, Tiziana, Viora, Lorenzo, Maganuco, Paolo, Veronesi, Bruno, Zani, Giacomo, Zanu, Marco, Brizzolari, Federico, Zanzi, Anna, Guariniello, Marco Antonio Zappa, Elisa, Galfrascoli, Sandro, Zonta, Luigi, Oragano, Walter Zuliani &amp, Damiano, Chiari, de Manzini, Nicolo', Agresta, Ferdinando, Agrusa, Antonino, Di Buono, Giuseppe, Bracale, U., Podda, M., Castiglioni, S., Peltrini, R., Sartori, A., Arezzo, A., Corcione, F., Agresta, F., Antonucci, A., Zanframundo, C., Cavallo, F., Mazzarolo, G., Agrusa, A., Di Buono, G., Aldrighetti, L., Fiorentini, G., Lucianetti, A., Magnone, S., Alfieri, S., Rosa, F., Altomare, D. F., Picciariello, A., Parisi, A., Di Cintio, A., Amisano, M. F., Cravero, F., Ammendola, M., Ammerata, G., Anastasi, A., Canonico, G., Gattolin, A., Travaglio, E., De Palma, M., Angelini, P., Galante, F., Benevento, A., Rausei, S., Serao, A., Abbatini, F., Annecchiarico, M., Varricchio, A., Annessi, V., Tumiati, D., Annicchiarico, A., Mirabella, A., Marino, M. V., Spinelli, A., Braun, A., Santi, H. T., Romano, L., Antoniutti, M., Armellino, M. F., Argenio, G., Verzelli, A., Budassi, A., Baiocchi, G., Alfano, M. S., Balani, A., Barone, M., Baldazzi, G., Cassini, D., Canger, R. C. B., Zabbialini, G., Belli, A., Izzo, F., Bertolino, F., Brunetti, M., Bianco, F., Cappiello, A., Boccia, L., Boffi, B., Perna, F., Bonilauri, S., Frazzetta, G., Bordoni, P., Fleres, F., Borghi, F., Giraudo, G., Bottino, V., Canfora, A., Piccoli, F. B., Calligaris, L., Nipote, B., Nasti, A. G., Bufalari, A., Bettarini, F., Buononato, M., Greco, M., Calo, P. G., Medas, F., Cardamone, E., Castaldo, P., Carlini, M., Spoletini, D., De Nisco, C., Pulighe, F., Feo, C. V., Fabbri, N., Antropoli, C., Foroni, F., Carnazza, M., Ragazzi, S., Cassinotti, E., Boni, L., Catena, F., Giuffrida, M., Perrone, G., Ccotsoglou, C., Granieri, S., Ceccarelli, G., Bugiantella, W., Cedolini, C., Seriau, L., Cesari, M., Contine, A., Chiara, O., Cimbanassi, S., Cocozza, E., Berselli, M., Fantini, C., Costi, R., Casali, L., Morini, A., Crafa, F., Vanela, S., Curro, G., Orsini, V., Da Lio, C., Biral, M., Danelli, P., Guerci, C., Scala, D., Marino, G., De Carlis, L., Lauterio, A., De Giorgi, D., Sciannamea, G., De Manzini, N., Losurdo, P., Sangiuliano, N., Degiuli, M., Caterina, F., Del Rio, P., Bonati, E., Di Lernia, S., Ardizzone, M. V. R., Di Saverio, S., Franchi, C., Di Venere, B., Miglio, R., Cuccurullo, D., Sagnelli, C., Docimo, L., Tolone, S., Longoni, M., Faillace, G., Rondelli, F., Pennella, F. P., Colucci, V., Carfora, T., Muttillo, I. A., Picardi, B., Stefano, R., Campagnacci, R., Maurizi, A., Tricarico, F., Montagna, M., Amedeo, E., Scollica, M. C., Lauro, E., Laterza, E., Molinari, E., Bono, D., Fabozzi, M., Romano, M., Facci, E., Parini, D., Farfaglia, R., Arizzi, V., Farsi, M., Miranda, E., Fei, L., Flavio, G., Pirozzi, F., Sciuto, A., Ferrero, A., Palisi, M., Filauro, M., Barberis, A., Azzinnaro, A., Fiscon, V., Vigna, S., D'Ambra, M., Pontecorvi, E., Anania, G., Bombardini, C., Galizia, G., Auricchio, A., Cardella, F., Genna, M., Gentilli, S., Herald, N., Castagnoli, G., Bartoli, A., Gianotti, L., Garancini, M., Bellanova, G., Palazzo, P., De Palma, G., Milone, M., Ferrari, G., Magistro, C., Giuliani, A., Di Natale, G., Brisinda, G., Cavallaro, G., Sammarco, G., Gallo, G., Goletti, O., Macchini, D., Greco, V., Amoroso, V., Guercioni, G., Benedetti, M., Guzzo, G., Pata, F., Scandroglio, I., Roscio, F., Jovine, E., Lombardi, R., La Rocca, F., Di Capua, F., Lanci, C., Leli, R., Borasi, A., Lepiane, P., Balla, A., Liberatore, E., Morelli, L., Di Franco, G., Lucchi, A., Vittori, L., Bonavina, L., Asti, E., Maggioni, D., Martino, G., Manca, G., Delvecchio, A., Tedesco, M., Gambardella, D., Marafioti, S., De Marco, M. L., Guicciardi, M. A., Motta, M., Calgaro, M., Adamo, V., Guerrieri, M., Coletta, P., Ortenzi, M., Martines, G., Lantone, G., Martinotti, M., Fassardi, G., Castriconi, M., Squillante, S., De Luca, M., Pavanello, M., Di Marco, C., Ronconi, M., Casiraghi, S., Mazzaferro, V., Battiston, C., Perrotta, M., Ripa, C., Giancarlo, M., Panizzo, V., Millo, P., Contul, R. B., Ferraro, V., Molino, C., Crolla, E., Moretto, G., Bacchion, M., Morino, M., Allaix, M. E., Motterlini, E., Petracca, M., Muratore, A., Musella, M., Vitiello, A., Nardo, B., Crocco, V., Navarra, G., Lazzara, S., Navarra, G. G., Cuoghi, M., Olmi, S., Oldani, A., Uccelli, M., Opocher, E., Giovenzana, M., De Paolis, P., Santarelli, M., Delrio, P., Carbone, F., Bianchi, P. P. G., Capelli, P., Baldini, E., Festa, P., Mottola, A., Merola, G., Perrotta, N., Celiento, M., Personnettaz, E., Muzio, S., Petitti, T., Melchiorre, A., Piccoli, M., Pecchini, F., Frontali, A., Maffioli, A., Maida, P., Tammaro, P., Pignata, G., Andreuccetti, J., Pilone, V., Renzulli, M., Pintaldi, S., Ceretti, A. P., Mariani, N. M., Pisanu, A., Polastri, R., Maiello, F., Porcu, A., Perra, T., Mucilli, F., Troisi, R., Montalti, R., Scognamillo, F., Delogu, D., Galleano, R., Malerba, M., Salfi, R., Pisano, M., Sechi, R., Cillara, N., Ramuscello, S., De Leo, E., Restini, E., Tumolo, R., Cianci, P., Capuzzolo, S., Rizzo, M., Recordare, A., Santoro, R., Amodio, P. M., Rocca, A., Cecere, G., Romito, R., Portigliotti, L., Rosati, R., Elmore, U., Russello, D., Latteri, S., Costarella, S. M., Massa, S., Capasso, L., Santangelo, M., Sodo, M., Sarro, G., Rivolta, U., Scabini, S., Pertile, D., Selvaggi, F., Rossi, S., Pellino, G., Sganga, G., Fransvea, P., Testa, S., De Rosa, C., Siquini, W., Trana, C., Solej, M., Bolzon, S., Guerra, E., Stella, M., Ferrara, F., Stipa, F., Stringhi, E., Celotti, A., Taglietti, L., Del Giudice, R., Talarico, C. A., Ruggiero, M., Tirone, G., Romario, U. F., Petz, W., Caracino, V., Rossetti, V., Verza, L. A., Vescovi, L., Marini, M., Vettoretto, N., Botteri, E., Vincenti, L., Giannandrea, G., Viora, T., Maganuco, L., Veronesi, P., Zani, B., Zanus, G., Brizzolari, M., Zanzi, F., Guariniello, A., Zappa, M. A., Galfrascoli, E., Zonta, S., Oragano, L., Zuliani, W., Chiari, D., Bracale, U, Podda, M, Castiglioni, S, Peltrini, R, Sartori, A, Arezzo, A, Corcione, F, Agresta, F, Antonucci, A, Zanframundo, C, Cavallo, F, Mazzarolo, G, Agrusa, A, Di Buono, G, Aldrighetti, L, Fiorentini, G, Lucianetti, A, Magnone, S, Alfieri, S, Rosa, F, Altomare, D, Picciariello, A, Parisi, A, Di Cintio, A, Amisano, M, Cravero, F, Ammendola, M, Ammerata, G, Anastasi, A, Canonico, G, Gattolin, A, Travaglio, E, De Palma, M, Angelini, P, Galante, F, Benevento, A, Rausei, S, Serao, A, Abbatini, F, Annecchiarico, M, Varricchio, A, Annessi, V, Tumiati, D, Annicchiarico, A, Mirabella, A, Marino, M, Spinelli, A, Braun, A, Santi, H, Romano, L, Antoniutti, M, Armellino, M, Argenio, G, Verzelli, A, Budassi, A, Baiocchi, G, Alfano, M, Balani, A, Barone, M, Baldazzi, G, Cassini, D, Canger, R, Zabbialini, G, Belli, A, Izzo, F, Bertolino, F, Brunetti, M, Bianco, F, Cappiello, A, Boccia, L, Boffi, B, Perna, F, Bonilauri, S, Frazzetta, G, Bordoni, P, Fleres, F, Borghi, F, Giraudo, G, Bottino, V, Canfora, A, Piccoli, F, Calligaris, L, Nipote, B, Nasti, A, Bufalari, A, Bettarini, F, Buononato, M, Greco, M, Calo, P, Medas, F, Cardamone, E, Castaldo, P, Carlini, M, Spoletini, D, De Nisco, C, Pulighe, F, Feo, C, Fabbri, N, Antropoli, C, Foroni, F, Carnazza, M, Ragazzi, S, Cassinotti, E, Boni, L, Catena, F, Giuffrida, M, Perrone, G, Ccotsoglou, C, Granieri, S, Ceccarelli, G, Bugiantella, W, Cedolini, C, Seriau, L, Cesari, M, Contine, A, Chiara, O, Cimbanassi, S, Cocozza, E, Berselli, M, Fantini, C, Costi, R, Casali, L, Morini, A, Crafa, F, Vanela, S, Curro, G, Orsini, V, Da Lio, C, Biral, M, Danelli, P, Guerci, C, Scala, D, Marino, G, De Carlis, L, Lauterio, A, De Giorgi, D, Sciannamea, G, De Manzini, N, Losurdo, P, Sangiuliano, N, Degiuli, M, Caterina, F, Del Rio, P, Bonati, E, Di Lernia, S, Ardizzone, M, Di Saverio, S, Franchi, C, Di Venere, B, Miglio, R, Cuccurullo, D, Sagnelli, C, Docimo, L, Tolone, S, 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Subjects
Laparoscopic surgery, Settore MED/18 - CHIRURGIA GENERALE, medicine.medical_treatment, laparoscopy, COVID-19, Elective surgery, Emergency surgery, Survey, Oral Health, cross infection (MeSH), Surveys and Questionnaires, Epidemiology, Pandemic, Infection control, Practice Patterns, Physicians', emergency surgery, Laparoscopy, humans, medicine.diagnostic_test, General Commentary, laparoscopic surgery, infection control, Italy, physicians', Original Article, Elective Surgical Procedure, Human, heating ventilation air conditioning, medicine.medical_specialty, Coronavirus disease 2019 (COVID-19), fallow period, elective surgical procedures, pandemics, NO, aerosol generating procedures, elective surgery, survey, practice patterns, physicians', SARS-CoV-2, surveys and questionnaires, medicine, Infection Control, business.industry, General surgery, practice patterns, Surgery, business
Abstract

Background The spread of the SARS-CoV2 virus, which causes COVID-19 disease, profoundly impacted the surgical community. Recommendations have been published to manage patients needing surgery during the COVID-19 pandemic. This survey, under the aegis of the Italian Society of Endoscopic Surgery, aims to analyze how Italian surgeons have changed their practice during the pandemic. Methods The authors designed an online survey that was circulated for completion to the Italian departments of general surgery registered in the Italian Ministry of Health database in December 2020. Questions were divided into three sections: hospital organization, screening policies, and safety profile of the surgical operation. The investigation periods were divided into the Italian pandemic phases I (March–May 2020), II (June–September 2020), and III (October–December 2020). Results Of 447 invited departments, 226 answered the survey. Most hospitals were treating both COVID-19-positive and -negative patients. The reduction in effective beds dedicated to surgical activity was significant, affecting 59% of the responding units. 12.4% of the respondents in phase I, 2.6% in phase II, and 7.7% in phase III reported that their surgical unit had been closed. 51.4%, 23.5%, and 47.8% of the respondents had at least one colleague reassigned to non-surgical COVID-19 activities during the three phases. There has been a reduction in elective (> 200 procedures: 2.1%, 20.6% and 9.9% in the three phases, respectively) and emergency ( Conclusion This survey offers three faithful snapshots of how the surgical community has reacted to the COVID-19 pandemic during its three phases. The significant reduction in surgical activity indicates that better health policies and more evidence-based guidelines are needed to make up for lost time and surgery not performed during the pandemic.

Published
2021

29. Subtotal gastrectomy for gastric cancer.

Author

Santoro R, Ettorre GM, and Santoro E

Subjects
Cost-Benefit Analysis, Gastrectomy adverse effects, Gastrectomy economics, Health Care Costs, Humans, Lymph Node Excision, Lymphatic Metastasis, Neoplasm Staging, Postoperative Complications etiology, Plastic Surgery Procedures, Stomach Neoplasms economics, Stomach Neoplasms mortality, Stomach Neoplasms pathology, Time Factors, Treatment Outcome, Gastrectomy methods, Stomach Neoplasms surgery
Abstract

Although a steady decline in the incidence and mortality rates of gastric carcinoma has been observed in the last century worldwide, the absolute number of new cases/year is increasing because of the aging of the population. So far, surgical resection with curative intent has been the only treatment providing hope for cure; therefore, gastric cancer surgery has become a specialized field in digestive surgery. Gastrectomy with lymph node (LN) dissection for cancer patients remains a challenging procedure which requires skilled, well-trained surgeons who are very familiar with the fast-evolving oncological principles of gastric cancer surgery. As a matter of fact, the extent of gastric resection and LN dissection depends on the size of the disease and gastric cancer surgery has become a patient and "disease-tailored" surgery, ranging from endoscopic resection to laparoscopic assisted gastrectomy and conventional extended multivisceral resections. LN metastases are the most important prognostic factor in patients that undergo curative resection. LN dissection remains the most challenging part of the operation due to the location of LN stations around major retroperitoneal vessels and adjacent organs, which are not routinely included in the resected specimen and need to be preserved in order to avoid dangerous intra- and postoperative complications. Hence, the surgeon is the most important non-TMN prognostic factor in gastric cancer. Subtotal gastrectomy is the treatment of choice for middle and distal-third gastric cancer as it provides similar survival rates and better functional outcome compared to total gastrectomy, especially in early-stage disease with favorable prognosis. Nonetheless, the resection range for middle-third gastric cancer cases and the extent of LN dissection at early stages remains controversial. Due to the necessity of a more extended procedure at advanced stages and the trend for more conservative treatments in early gastric cancer, the indication for conventional subtotal gastrectomy depends on multiple variables. This review aims to clarify and define the actual landmarks of this procedure and the role it plays compared to the whole range of new and old treatment methods.

Published
2014
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30. Liver transplantation for recurrent hepatic adenoma.

Author

Vennarecci G, Santoro R, Antonini M, Ceribelli C, Laurenzi A, Moroni E, Burocchi M, Lepiane P, and Ettorre GM

Abstract

Hepatic adenoma (HA) is a rare indication for liver transplantation (LTx). So far 20 cases of LTx for HA are reported in PubMed. In rare cases HA presents as multiple hepatic adenomas or recurrent adenoma after initial liver resection and in such cases LTx is the only potential cure and prevents the risk of bleeding or cancer transformation into hepatocellular carcinoma. We report the case of a 56 years old lady who underwent a left hepatectomy for giant adenoma in 2005 and resection of segment V-VI for recurrence of liver adenoma in 2007. She developed a second recurrence of HA with 3 new lesions in the right liver in 2008. The patient underwent LTx. After 3 years the patient is alive with no evidence of disease. LTx is indicated in patients with HA in which resection is not technically feasible.

Published
2013
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