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1. Comparison of operative and postoperative characteristics and outcomes between thoracoscopic segmentectomy and lobectomy for non-small-cell lung cancer: a propensity score matching study from the Italian VATS Group Registry

Author

Dell'Amore, A., Lomangino, I., Cannone, G., Terzi, S., Pangoni, A., Lorenzoni, G., Nicotra, S., Schiavon, M., Zuin, A., Gregori, D., Crisci, R., Curcio, C., Rea, F., Mancuso, M., Pernazza, F., Refai, M., Bortolotti, L., Rizzardi, G., Solli, P., Brandolini, I., Perkmann, R., Zaraca, F., Benvenuti, M., Gavezzoli, D., Cherchi, R., Ferrari, P., Mucilli, F., Camplese, P., Melloni, G., Mazza, F., Cavallesco, G., Maniscalco, P., Voltolini, L., Gonfiotti, A., Stella, F., Argnani, D., Pariscenti, G. L., Iurilli, S., Surrente, C., Lopez, C., Droghett, A., Giovanardi, M., Breda, C., Lo Giudice, F., Alloisio, M., Bottoni, E., Spaggiari, L., Gasparri, R., Torre, M., Rinaldo, A., Nosotti, M., Rosso, L., Negri, G. P., Bandiera, A., Stefani, A., Natali, P., Scarci, M., Pirondini, E., Amore, D., Baietto, G., Casadio, C., Bertani, A., Russo, E., Ampollini, L., Carbognani, P., Puma, F., Vinci, D., Andreetti, C., Poggi, C., Cardillo, G., Margaritora, S., Meacci, E., Luzzi, L., Ghisalberti, M., Zaccagna, G., Lausi, P., Guerrera, F., Fontana, D., Della Beffa, V., Morelli, A., Londero, F., Imperatori, N., Rotolo, A., Terzi, A., Viti, A., Infante, M., and Benato, C.

Subjects
Segmentectomy, Pulmonary and Respiratory Medicine, medicine.medical_specialty, Lung Neoplasms, medicine.medical_treatment, VATS lobectomy, Video-assisted thoracic surgery, Context (language use), Mastectomy, Segmental, Postoperative outcome, Postoperative Complications, Lobectomy, Non-small-cell lung cancer, Carcinoma, Non-Small-Cell Lung, Humans, Medicine, Registries, Thoracotomy, Pneumonectomy, Propensity Score, Lung cancer, Retrospective Studies, Thoracic Surgery, Video-Assisted, business.industry, Confounding, Postoperative complication, General Medicine, medicine.disease, Surgery, Propensity score matching, Non small cell, Cardiology and Cardiovascular Medicine, business
Abstract

OBJECTIVES Only few studies compared the surgical morbidity and mortality of thoracoscopic segmentectomy versus lobectomy for non-small-cell lung cancer, in particular, by relating the segmental resections with the corresponding anatomical lobes. METHODS We enrolled a total of 7487 patients who underwent VATS lobectomy (7269) or segmentectomy (218) from January 2014 to July 2019. A propensity score matching approach was used to account for potential confounding factors between the 2 groups. After matching, 349 lobectomies and 208 segmentectomies were included in the analysis. We analysed the operative and postoperative outcomes of video-assisted anatomical segmentectomy compared with video-assisted lobectomy and, in details, the results of segmentectomy with its corresponding lobectomy in a large cohort of patients from the Italian VATS Group Registry. RESULTS The overall conversion rate to thoracotomy was not statistically different between the groups (27 patients 8% vs 7 patients 3%, P = 0.1). The lobectomy group had a greater number of resected lymph nodes (median 11 vs 8, P = 0.006). No significant differences were detected in 30-day mortality (1.4%, 5 patients vs 0.9%, 2 patients), overall complications (18%, 62 patients vs 14%, 29 patients) and prolonged air leakage (31 patients, 9% vs 12 patients, 6%) between lobectomy and segmentectomy, respectively. No statistical differences were found regarding the median duration of drainage (3.2 days, P = 1) and the overall median length of hospital stay (6.4 days, P = 0.1) between the 2 groups. In the context of segmentectomy versus corresponding lobectomy, the right upper lobectomy compared with right upper segmentectomy showed a higher number of resected lymph nodes (P = 0.027). No statistical differences were reported in terms of conversion rate and postoperative complication and mortality. CONCLUSIONS Segmentectomy could be considered a safe procedure without significant differences compared to thoracoscopic lobectomy in terms of postoperative morbidity and mortality.

Published
2021
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2. Uniportal and three-portal video-assisted thoracic surgery lobectomy: analysis of the Italian video-assisted thoracic surgery group database

Author

Tosi, D, Nosotti, M, Bonitta, G, Mazzucco, A, Righi, I, Mendogni, P, Rosso, L, Palleschi, A, Rocco, G, Crisci, R, Mancuso, M, Pernazza, F, Refai, M, Bortolotti, L, Rizzardi, G, Gargiulo, G, Dolci, Gp, Perkmann, R, Zaraca, F, Benvenuti, M, Gavezzoli, D, Cherchi, R, Ferrari, P, Mucilli, F, Camplese, P, Melloni, G, Mazza, F, Cavallesco, G, Maniscalco, P, Voltolini, L, Gonfiotti, A, Stella, F, Argnani, D, Pariscenti, Gl, Lurilli, Surrente, C, Lopez, C, Droghetti, A, Giovanardi, M, Breda, C, Lo Giudice, F, Alloisio, M, Bottoni, E, Spaggiari, L, Gasparri, R, Torre, M, Rinaldo, A, Negri, Gp, Bandiera, A, Stefani, A, Natali, P, Scarci, M, Pirondini, E, Curcio, C, Amore, D, Baietto, G, Casadio, C, Nicotra, S, Dell'Amore, A, Bertani, A, Russo, E, Ampollini, L, Carbognani, P, Puma, F, Vinci, D, Andreetti, C, Poggi, C, Cardillo, G, Margaritora, S, Meacci, Elisa, Luzzi, L, Ghisalberti, M, Zaccagna, G, Lausi, P, Guerrera, F, Fontana, D, Della Beffa, V, Morelli, A, Londero, F, Imperatori, A, Rotolo, N, Terzi, A, Viti, A, Infante, M, Benato, C, Tosi, D., Nosotti, M., Bonitta, G., Mazzucco, A., Righi, I., Mendogni, P., Rosso, L., Palleschi, A., Rocco, G., Crisci, R., Mancuso, M., Pernazza, F., Refai, M., Bortolotti, L., Rizzardi, G., Gargiulo, G., Dolci, G. P., Perkmann, R., Zaraca, F., Benvenuti, M., Gavezzoli, D., Cherchi, R., Ferrari, P., Mucilli, F., Camplese, P., Melloni, G., Mazza, F., Cavallesco, G., Maniscalco, P., Voltolini, L., Gonfiotti, A., Stella, F., Argnani, D., Pariscenti, G. L., Surrente, C., Lopez, C., Droghetti, A., Giovanardi, M., Breda, C., Lo Giudice, F., Alloisio, M., Bottoni, E., Spaggiari, L., Gasparri, R., Torre, M., Rinaldo, A., Negri, G, Bandiera, A., Stefani, A., Natali, P., Scarci, M., Pirondini, E., Curcio, C., Amore, D., Baietto, G., Casadio, C., Nicotra, S., Dell'Amore, A., Bertani, A., Russo, E., Ampollini, L., Carbognani, P., Puma, F., Vinci, D., Andreetti, C., Poggi, C., Cardillo, G., Margaritora, S., Meacci, E., Luzzi, L., Ghisalberti, M., Zaccagna, G., Lausi, P., Guerrera, F., Fontana, D., Della Beffa, V., Morelli, A., Londero, F., Imperatori, A., Rotolo, N., Terzi, A., Viti, A., Infante, M., Benato, C., Tosi D., Nosotti M., Bonitta G., Mazzucco A., Righi I., Mendogni P., Rosso L., Palleschi A., Rocco G., Crisci R., Mancuso M., Pernazza F., Refai M., Bortolotti L., Rizzardi G., Gargiulo G., Dolci G.P., Perkmann R., Zaraca F., Benvenuti M., Gavezzoli D., Cherchi R., Ferrari P., Mucilli F., Camplese P., Melloni G., Mazza F., Cavallesco G., Maniscalco P., Voltolini L., Gonfiotti A., Stella F., Argnani D., Pariscenti G.L., Surrente C., Lopez C., Droghetti A., Giovanardi M., Breda C., Lo Giudice F., Alloisio M., Bottoni E., Spaggiari L., Gasparri R., Torre M., Rinaldo A., Negri G.P., Bandiera A., Stefani A., Natali P., Scarci M., Pirondini E., Curcio C., Amore D., Baietto G., Casadio C., Nicotra S., Dell'amore A., Bertani A., Russo E., Ampollini L., Carbognani P., Puma F., Vinci D., Andreetti C., Poggi C., Cardillo G., Margaritora S., Meacci E., Luzzi L., Ghisalberti M., Zaccagna G., Lausi P., Guerrera F., Fontana D., Della Beffa V., Morelli A., Londero F., Imperatori A., Rotolo N., Terzi A., Viti A., Infante M., and Benato C.

Subjects
Male, Lung Neoplasms, Thoracic, Italian VATS Group, computer.software_genre, Postoperative pain, Settore MED/21 - CHIRURGIA TORACICA, Carcinoma, Non-Small-Cell Lung, Lobectomy, Three-portal, Uniportal, Video-assisted thoracic surgery, Aged, Equipment Design, Female, Humans, Neoplasm Staging, Operative Time, Pneumonectomy, Retrospective Studies, Thoracic Surgery, Video-Assisted, Tomography, X-Ray Computed, Stage (cooking), Non-Small-Cell Lung, Tomography, Database, Thoracic Surgery, X-Ray Computed, Cardiothoracic surgery, Cohort, Cardiology and Cardiovascular Medicine, Pulmonary and Respiratory Medicine, Italian VATS Group, Lobectomy, Postoperative pain, Three-portal, Uniportal, Video-assisted thoracic surgery, medicine.medical_specialty, VATS lobectomy, Video-Assisted, NO, medicine, Lung cancer, business.industry, Carcinoma, Odds ratio, medicine.disease, Confidence interval, Propensity score matching, Surgery, business, computer
Abstract

OBJECTIVES This study compares the uniportal with the 3-portal video-assisted thoracic surgery (VATS) by examining the data collected in the Italian VATS Group Database. The primary end point was early postoperative pain; secondary end points were intraoperative and postoperative complications, surgical time, number of dissected lymph nodes and length of stay. METHODS This was an observational, retrospective, cohort, multicentre study on data collected by 49 Italian thoracic units. Inclusion criteria were clinical stage I–II non-small-cell lung cancer, uniportal or 3-portal VATS lobectomy and R0 resection. Exclusion criteria were cT3 disease, previous thoracic malignancy, induction therapy, significant comorbidities and conversion to other techniques. The pain parameter was dichotomized: the numeric rating scale ≤3 described mild pain, whereas the numeric rating scale score >3 described moderate/severe pain. The propensity score-adjusted generalized estimating equation was used to compare the uniportal with 3-portal lobectomy. RESULTS Among 4338 patients enrolled from January 2014 to July 2017, 1980 met the inclusion criteria; 1808 patients underwent 3-portal lobectomy and 172 uniportal surgery. The adjusted generalized estimating equation regression model using the propensity score showed that over time pain decreased in both groups (P CONCLUSIONS Data from the Italian VATS Group Database showed that in clinical practice uniportal lobectomy seems to entail a higher risk of moderate/severe pain on second and third postoperative days.

Published
2019

3. What counts more: The patient, the surgical technique, or the hospital? A multivariable analysis of factors affecting perioperative complications of pulmonary lobectomy by video-assisted thoracoscopic surgery from a large nationwide registry

Author

Infante, Maurizio V, Benato, Cristiano, Silva, Ronaldo, Rocco, Gaetano, Bertani, Alessandro, Bertolaccini, Luca, Gonfiotti, Alessandro, Giovannetti, Riccardo, Bonadiman, Cinzia, Lonardoni, Alessandro, Canneto, Barbara, Falezza, Giovanni, Gandini, Paola, Curcio, Carlo, Crisci, Roberto, Alloisio, M, Amore, D, Ampollini, L, Andreetti, C, Argnani, D, Baietto, G, Bandiera, A, Benato, C, Benvenuti, M, Bertani, A, Bertolaccini, L, Bortolotti, L, Bottoni, E, Breda, C, Camplese, P, Carbognani, P, Cardillo, G, Casadio, C, Cavallesco, G, Cherchi, R, Crisci, R, Curcio, C, Dell'Amore, A, Beffa, V, Dolci, G, Droghetti, A, Ferrari, Pa, Fontana, D, Gargiulo, G, Gasparri, R, Gavezzoli, D, Ghisalberti, M, Giovanardi, M, Gonfiotti, A, Guerrera, F, Imperatori, A, Infante, M, Iurilli, L, Lausi, P, Logiudice, F, Londero, F, Lopez, C, Luzzi, L, Mancuso, M, Maniscalco, P, Margaritora, S, Meacci, E, Melloni, G, Morelli, A, Mucilli, F, Natali, P, Negri, G, Nicotra, S, Nosotti, M, Pariscenti, G, Perkmann, R, Pernazza, F, Pirondini, E, Poggi, C, Puma, F, Refai, M, Rinaldo, A, Rizzardi, G, Rosso, L, Rotolo, N, Russo, E, Sabbatini, A, Scarci, M, Spaggiari, L, Stefani, A, Solli, P, Surrente, C, Terzi, A, Torre, M, Vinci, D, Viti, A, Voltolini, L, Zaccagna, G, Zaraca, F., Infante M.V., Benato C., Silva R., Rocco G., Bertani A., Bertolaccini L., Gonfiotti A., Giovannetti R., Bonadiman C., Lonardoni A., Canneto B., Falezza G., Gandini P., Curcio C., Crisci R., Zaraca F., Alloisio M., Amore D., Ampollini L., Andreetti C., Argnani D., Baietto G., Bandiera A., Benvenuti M., Bortolotti L., Bottoni E., Breda C., Camplese P., Carbognani P., Cardillo G., Casadio C., Cavallesco G., Cherchi R., Dell'Amore A., Beffa V., Dolci G., Droghetti A., Ferrari P.A., Fontana D., Gargiulo G., Gasparri R., Gavezzoli D., Ghisalberti M., Giovanardi M., Guerrera F., Imperatori A., Iurilli L., Lausi P., Lo Giudice F., Londero F., Lopez C., Luzzi L., Mancuso M., Maniscalco P., Margaritora S., Meacci E., Melloni G., Morelli A., Mucilli F., Natali P., Negri G., Nicotra S., Nosotti M., Pariscenti G., Perkmann R., Pernazza F., Pirondini E., Poggi C., Puma F., Refai M., Rinaldo A., Rizzardi G., Rosso L., Rotolo N., Russo E., Sabbatini A., Scarci M., Spaggiari L., Stefani A., Solli P., Surrente C., Terzi A., Torre M., Vinci D., Viti A., Voltolini L., Zaccagna G., Infante, M. V., Benato, C., Silva, R., Rocco, G., Bertani, A., Bertolaccini, L., Gonfiotti, A., Giovannetti, R., Bonadiman, C., Lonardoni, A., Canneto, B., Falezza, G., Gandini, P., Curcio, C., Crisci, R., the Italian VATS group, Member, and Negri, G.

Subjects
Male, Registrie, Conversion, Morbidity, Postoperative complications, Video-assisted thoracoscopic surgery lobectomy, Lung Neoplasms, Intraoperative Complication, Aged, Female, Hospitals, Humans, Intraoperative Complications, Lung, Middle Aged, Pneumonectomy, Postoperative Complications, Registries, Retrospective Studies, Risk Factors, Thoracic Surgery, Video-Assisted, medicine.medical_treatment, Interquartile range, Retrospective Studie, Settore MED/21 - CHIRURGIA TORACICA, Conversion, Morbidity, Postoperative complications, Video-assisted thoracoscopic surgery lobectomy, Thoracic Surgery, General Medicine, Video-assisted thoracoscopic surgery, Cardiology and Cardiovascular Medicine, Human, Pulmonary and Respiratory Medicine, medicine.medical_specialty, VATS lobectomy, Video-Assisted, NO, Hospital, medicine, business.industry, Risk Factor, Retrospective cohort study, Perioperative, medicine.disease, Comorbidity, Surgery, Postoperative complication, Lung Neoplasm, Complication, business
Abstract

OBJECTIVESInherent technical aspects of pulmonary lobectomy by video-assisted thoracoscopic surgery (VATS) may limit surgeons’ ability to deal with factors predisposing to complications. We analysed complication rates after VATS lobectomy in a prospectively maintained nationwide registry.METHODSThe registry was queried for all consecutive VATS lobectomy procedures from 49 Italian Thoracic Units. Baseline condition, tumour features, surgical techniques, devices, postoperative care, complications, conversions and the reasons thereof were detailed. Univariable and multivariable regressions were used to assess factors potentially linked to complications.RESULTSFour thousand one hundred and ninety-one VATS lobectomies in 4156 patients (2480 men, 1676 women) were analysed. The median age-adjusted Charlson index of the patients was 4 (interquartile range 3–6). Grade 1 and 2 and Grade 3–5 complications were observed in 20.1% and in 5.8%, respectively. Ninety-day mortality was 0.55%. The overall conversion rate was 9.2% and significantly higher in low-volume centres (CONCLUSIONSVATS lobectomy is a safe procedure even in medically compromised patients. An improved classification system for conversions is proposed and prevention strategies are suggested to reduce conversion rates and possibly complications in less-experienced centres.

Published
2019

4. Corrigendum to: What counts more: The patient, the surgical technique, or the hospital? A multivariable analysis of factors affecting perioperative complications of pulmonary lobectomy by video-assisted thoracoscopic surgery from a large nationwide registry (European Journal of Cardio-thoracic Surgery (2019) DOI: 10.1093/ejcts/ezz187)

Author

Infante, M. V., Benato, C., Silva, R., Rocco, G., Bertani, A., Bertolaccini, L., Gonfiotti, A., Giovannetti, R., Bonadiman, C., Lonardoni, A., Canneto, B., Falezza, G., Gandini, P., Curcio, C., Crisci, R., Zaraca, F., Alloisio, M., Amore, D., Ampollini, L., Andreetti, C., Argnani, D., Baietto, G., Bandiera, A., Benvenuti, M., Bortolotti, L., Bottoni, E., Breda, C., Camplese, P., Carbognani, P., Cardillo, G., Casadio, C., Cavallesco, G., Cherchi, R., Dell'Amore, A., Beffa, V., Dolci, G, Droghetti, A, Ferrari, P. A., Fontana, D., Gargiulo, G., Gasparri, R., Gavezzoli, D., Ghisalberti, M., Giovanardi, M., Guerrera, F., Imperatori, A., Iurilli, L., Lausi, P., Lo Giudice, F., Londero, F., Lopez, C., Luzzi, L., Mancuso, M., Maniscalco, P., Margaritora, S., Meacci, E., Melloni, G., Morelli, A., Mucilli, F., Natali, P., Negri, G., Nicotra, S., Nosotti, M., Pariscenti, G., Perkmann, R., Pernazza, F., Pirondini, E., Poggi, C., Puma, F., Refai, M., Rinaldo, A., Rizzardi, G, Rosso, L., Rotolo, N., Russo, E., Sabbatini, A., Scarci, M., Spaggiari, L., Stefani, A., Solli, P., Surrente, C., Terzi, A., Torre, M., Vinci, D., Viti, A., Voltolini, L., Zaccagna, G., and the Italian VATS group members

Subjects
Male, Pulmonary and Respiratory Medicine, medicine.medical_specialty, Lung Neoplasms, Thoracic, medicine.medical_treatment, MEDLINE, NO, Postoperative Complications, Risk Factors, Pulmonary lobectomy, Humans, Medicine, Registries, Intraoperative Complications, Pneumonectomy, Lung, Aged, Retrospective Studies, Thoracic Surgery, Video-Assisted, business.industry, General surgery, General Medicine, Perioperative, Middle Aged, Corrigenda, Hospitals, Video-assisted thoracoscopic surgery, Female, Surgery, Cardiology and Cardiovascular Medicine, business
Abstract

OBJECTIVES: Inherent technical aspects of pulmonary lobectomy by video-assisted thoracoscopic surgery (VATS) may limit surgeons’ ability to deal with factors predisposing to complications. We analysed complication rates after VATS lobectomy in a prospectively maintained nationwide registry. METHODS: The registry was queried for all consecutive VATS lobectomy procedures from 49 Italian Thoracic Units. Baseline condition, tumour features, surgical techniques, devices, postoperative care, complications, conversions and the reasons thereof were detailed. Univariable and multivariable regressions were used to assess factors potentially linked to complications. RESULTS: Four thousand one hundred and ninety-one VATS lobectomies in 4156 patients (2480 men, 1676 women) were analysed. The median age-adjusted Charlson index of the patients was 4 (interquartile range 3–6). Grade 1 and 2 and Grade 3–5 complications were observed in 20.1% and in 5.8%, respectively. Ninety-day mortality was 0.55%. The overall conversion rate was 9.2% and significantly higher in low-volume centres (

Published
2019

5. First italian consensus conference on VATS lobectomy for NSCLC

Author

Nosotti, Mario, Droghetti, Andrea, Luzzi, Luca, Solli, Piergiorgio, Crisci, Roberto, VATS Group Italia, Alloisio, M, Amore, D, Ampollini, D, Andreetti, C, Aresu, Argnani, D, Baletto, G, Bandiera, A, Benato, C, Bertani, A, Bertolaccini, L, Bortolotti, L, Camplese, P, Carbognani, P, Cardillo, G, Carleo, F, Cavallesco, G, Curcio, C, Dell’Amore, D, De Monte, L, Denegri, A, De Vico, A, Di Rienzo, G, Divisi, D, Dolci, Gp, Ghisalberti, M, Giovanardi, M, Gonfiotti, A, Gotti, G, Imperatori, A, Infante, M, Lo faso, F, Lopez, C, Magnanelli, G, Maineri, P, Mancuso, M, Maniscalco, P, Marulli, G, Morelli, A, Mucilli, F, Muriana, G, Negri, Gp, Nicotra, S, Palleschi, A, Perkmann, R, Pernazza, F, Poggi, C, Puma, F, Rinaldo, A, Rizzardi, G, Roncon, A, Rosso, L, Rotolo, N, Solaini, L, Stella, F, Terzi, A, Torre, M, Vinci, D, Voltolini, L, and Zaraca, F

Subjects
medicine.medical_specialty, Surgical strategy, medicine, consensus conference, medicine.medical_treatment, VATS lobectomy, practical recommendations, thoracotomy, 030204 cardiovascular system & hematology, carcinoma, lung neoplasms, 03 medical and health sciences, 0302 clinical medicine, Carcinoma, Non-Small-Cell Lung, Medicine, Thoracotomy, lung cancer, non-small-cell lung, humans, Italy, thoracic surgery, video-assisted, oncology, cancer research, video-assisted, Perioperative management, business.industry, Thoracic Surgery, Video-Assisted, General surgery, Consensus conference, General Medicine, thoracic surgery, 030228 respiratory system, Cardiothoracic surgery, business
Abstract

Purpose Video-assisted thoracoscopic surgery (VATS) lobectomy has become an accepted procedure for the treatment of selected cases of lung cancer. The aim of this project was to establish national practical recommendations for the management of patients suitable for VATS lobectomy. Methods The Scientific Committee of the VATS Lobectomy Group (a branch of the Italian Society of Thoracic Surgery) identified the consensus conference as an appropriate tool for a national debate. The consensus conference was organized following indications of the Italian Department of Health: a panel of experts reviewed the literature, the jury board revised the experts’ reports, and the national conference discussed and voted on statements. The strength of recommendation for a statement was classified as weak, fair, or high when the total score ranged between 51% and 67%, 68% and 84%, or 85% and 100%, respectively. Results Eighty-six Italian thoracic surgeons attended the 1st Italian Consensus Conference on VATS lobectomy in Giulianova, Italy, on October 29-30, 2015. Thirty-three topics were discussed: indications, surgical strategy, perioperative management, and training were the main topics. Consensus was reached on 24 statements that were consequently recommended. Conclusions The Italian Consensus Conference is the first attempt to discuss VATS lobectomy-related issues in a national scientific community. Such experience determined an improvement in epistemic knowledge among the Italian thoracic surgeons and could be a suggestion for other national communities.

Published
2017

6. Prevalence of nonpolypoid colorectal neoplasia: an italian multicenter observational study

Author

Bianco, Ma, Cipolletta, L, Rotondano, G, Buffoli, F, Gizzi, G, Tessari, F, Crotta, S, Strini, G, Orsello, M, Ballare, M, Gallo, M, Salacone, P, Asnaghi, G, Manca, A, Rizzi, R, Predebon, S, Quattrone, P, Vanni, R, Di Placido, R, Bastardini, R, Cristoni, Mv, Praiano, F, Meroni, E, Fasoli, A, Coccia, G, Allegretti, A, Manes, G, Cesari, P, Rolfi, F, Zambelli, A, Manfredi, G, Lisi, S, Cestari, R, Lancini, Gp, Crosta, C, Fiori, G, De Roberto, G, Dal Fante, M, Fazzini, L, Dinelli, M, Frego, R, Parente, F, Bargiggia, S, Paggi, S, Viale, E, Testoni, Pa, Iiritano, E, Andrian, G, Dinca, M, Germana, B, Lecis, P, Cappiello, R, Sablich, R, Tonello, C, Buri, L, Cannizzaro, R, Maiero, S, Fasoli, R, Ceroni, L, Eusebi, Lh, Iori, V, Tioli, C, Villani, V, Cortini, C, Maltoni, S, Forti, E, Solmi, L, Giovanardi, M, Calella, F, Tarantino, O, Widmayer, C, Silvestrelli, M, Bou Serhal, T, Feliciangeli, G, Tombesi, G, Anti, M, Pastorelli, A, Costamagna, G, Petruzziello, L, Cesaro, P, De Masi, E, Errico, A, Di Giulio, E, Carnuccio, A, Gabbrielli, Armando, Pandolfi, M, Lamazza, A, Femia, S, Morini, S, Lorenzetti, R, Del Vecchio Blanco, G, Grasso, E, Ferrara, M, Apuzzo, M, Iacopini, F, Milano, A, Balatsinou, C, Spadaccini, A, Silla, M, Ingrosso, M, Pirozzi, Ga, De Luca, L, De Bellis, M, Tempesta, A, De Palma GD, Siciliano, S, Di Giorgio, P, Giannattasio, F, Galloro, G, Grimaldi, E, Ciarleglio, A, Sarrantonio, G, Delle Cave, M, Lamanda, R, De Stefano, S, Labianca, O, Maisto, T, Montanaro, F, Pasquale, L, Di Girolamo, E, Piscopo, R, De Seta, M, Romano, M, Borgheresi, P, Gravina, Ag, Sarracco, P, Scaglione, G, Marmo, R, Salerno, R, Gentile, M, Annese, V, Della Valle, N, Muscatiello, N, Di Matteo, G, Giorgio, P, Fregola, G, Quatraro, F, Pisani, A, Tonti, P, Stoppino, G, Corazza, L, D'Ascoli, B, Ciuffi, M, Ignomirelli, O, Giglio, A, Rodino, S, Scanu, Am, Loriga, P, Murgia, R, Giacobbe, G, Grande, D, Montalbano, L, Linea, C., Bianco, Ma, Cipolletta, L, Rotondano, G, Buffoli, F, Gizzi, G, Tessari, F, Testoni, PIER ALBERTO, Flat Lesions Italian, Network, DE PALMA, GIOVANNI DOMENICO, Ma, Bianco, L., Cipolletta, G., Rotondano, F., Buffoli, G., Gizzi, F., Tessari, Romano, Marco, Gravina, A. G., Maria Antonia, Bianco, Livio, Cipolletta, Gianluca, Rotondano, Federico, Buffoli, Giuseppe, Gizzi, Francesco, Tessari, and Galloro, Giuseppe

Subjects
Male, medicine.medical_specialty, Colorectal cancer, Prevalence, Colonic Polyps, Colonoscopy, Colorectal Neoplasm, colonoscopy, flat lesions, colorectal neoplasia, Gastroenterology, Internal medicine, Epidemiology, medicine, Humans, Prospective Studies, Aged, Intraepithelial neoplasia, medicine.diagnostic_test, business.industry, Cancer, Histology, Middle Aged, medicine.disease, Colonic Polyp, Prospective Studie, Italy, Observational study, Female, Colorectal Neoplasms, business, Human
Abstract

BACKGROUND AND STUDY AIM: The aim of this study was to assess the prevalence of nonpolypoid lesions (NPLs) in Italy and their risk of containing neoplasia or advanced histology. PATIENTS AND METHODS: This was a multicenter cross-sectional observational study on consecutive patients undergoing total colonoscopy over a 3-month period in 80 Italian centers. RESULTS: In all, 27,400 total colonoscopies were analyzed. Cancer was diagnosed in 801 patients (2.9 %). A total of 6553 precancerous lesions were detected in 5609 patients. Of these, 4154 patients (74.1 %) had polypoid lesions and 1455 patients (25.9 %) had NPLs. Therefore, the prevalence of NPLs was 5.3 % (95 %CI 5.0 - 5.6). NPLs larger than 10 mm were detected in 254 patients (17.5 %). NPLs were more predominant in the proximal colon (OR 2.92, 95 %CI 2.56 - 3.43; P < 0.0001 vs. polypoid lesions). Neoplastic tissue was diagnosed in 79.0 % and advanced histology (high-grade intraepithelial neoplasia or more) in 20.9 % of resected lesions. The risk of advanced histology was similar for polypoid and nonpolypoid lesions when adjusted for size. Depressed lesions had the highest risk of advanced histology (OR 10.56, 95 %CI 6.02 - 18.55; P < 0.0000 vs. flat-elevated). Age was an independent predictor of both neoplasia and advanced histology ( P = 0.0001). CONCLUSIONS: NPLs are relatively common in the Italian population, with a prevalence similar to that in other Western series. NPLs are not more aggressive than polypoid lesions, except for those with depressed morphology. Georg Thieme Verlag KG Stuttgart. New York.

Published
2010

7. Haft and sord factors in place branding: Between functionalism and representationalism

Author

Massimo Giovanardi, Giovanardi M, and Giovanardi Massimo

Subjects
Marketing, Attractiveness, business.industry, Strategy and Management, Social change, soft factors, functionalism, Public relations, Public diplomacy, Direct and indirect realism, Epistemology, Place branding, Corporate branding, Framing (social sciences), representationalism, Sociology, Political philosophy, place branding, business, place branding, city branding, haft, sord, representationalism, functionalism, hard factors
Abstract

This conceptual article intends to refi ne the understanding of place branding, in particular city branding, by framing place attractiveness as a mixture of haft and sord factors. This conceptualisation, by challenging the distinction ‘ hard versus soft factors ’ characterising the traditional place marketing discourses, allows to better look at the functional and representational dimensions interconnected in every brand and, even more, in every place brand. This article urges scholars and place managers to rearticulate these dimensions depending on the different groups of brand users involved, and claims for a closer collaboration between marketers and other professionals involved in policymaking. The advantages offered by these conceptualisations are explored with respect to some issues within the place brand literature, which still require to be fully understood, like the need to rearticulate the functional / physical and representational / symbolic dimensions in city branding.

Published
2012

8. Correlation of computed tomography densitometry and pathological grading of emphysema with the variation of respiratory function after lobectomy for lung cancer

Author

Stefano Sestini, Andrea Ballarin, Alessandro Bandiera, Michele Giovanardi, Angelo Carretta, Giulio Melloni, Piero Zannini, Paola Ciriaco, Carretta, A, Ciriaco, P, Melloni, G, Ballarin, A, Bandiera, A, Sestini, S, Giovanardi, M, and Zannini, P

Subjects
Male, Pulmonary and Respiratory Medicine, medicine.medical_specialty, Lung Neoplasms, Functional Residual Capacity, medicine.medical_treatment, Vital Capacity, Maximal Midexpiratory Flow Rate, Severity of Illness Index, Preoperative care, Pulmonary function testing, Pneumonectomy, Airway resistance, Functional residual capacity, Predictive Value of Tests, Carcinoma, Non-Small-Cell Lung, Forced Expiratory Volume, medicine, Humans, Lung volumes, Respiratory function, Prospective Studies, Lung, Aged, business.industry, Airway Resistance, Total Lung Capacity, Recovery of Function, Middle Aged, Respiratory Function Tests, Residual Volume, Treatment Outcome, medicine.anatomical_structure, Pulmonary Emphysema, Female, Surgery, Radiology, Cardiology and Cardiovascular Medicine, business, Tomography, Spiral Computed
Abstract

The presence of emphysema may lead to an underestimation of postoperative respiratory function after lobectomy when evaluated by standard functional assessment. The aim of the study was to assess the correlation between computed tomography (CT) densitometry, pathological grading of emphysema and variation of pulmonary function after lobectomy for lung cancer. Forty-one patients entered the study. Respiratory function was assessed preoperatively and after a mean period of 4.04 months following surgery. Postoperative function remained unchanged or increased after surgery in nine patients (Group A). In the remaining 32 patients (Group B) postoperative function was reduced after surgery. Preoperative forced expiratory volume in 1 s (FEV1)% was 68.5±13.1% in Group A and 91.7±21.0% in Group B. CT densitometry of the lobe to be resected was -877.8±57.6 HU in Group A and -827.5±64.4 HU in Group B. Pathological grading of emphysema of the resected lobe (range 0-10) was 4.1±2.2 in Group A and 3.1±1.2 in Group B. A significant correlation was observed (Spearman rank correlation) between the variation of FEV, and preoperative FEV, (P=0.003; r=-0.455), CT quantitative assessment (P=0.036; r=-0.430) and pathological grading (P=0.008; r=0.673). Patients with a higher degree of emphysema had a lower reduction of respiratory function after lobectomy and CT densitometry and pathological grading of emphysema correlated with the variation in respiratory function. © 2010 Published by European Association for Cardio-Thoracic Surgery. All rights reserved.

Published
2010

9. Surgical treatment of multiple primary adenocarcinomas of the lung

Author

Piero Zannini, Giulio Melloni, Angelo Carretta, Armando Puglisi, Alessandro Bandiera, Paola Ciriaco, Lidia Libretti, Michele Giovanardi, Carretta, A, Ciriaco, P, Melloni, G, Bandiera, A, Libretti, L, Puglisi, A, Giovanardi, M, and Zannini, P

Subjects
Pulmonary and Respiratory Medicine, Male, medicine.medical_specialty, Lung Neoplasms, Time Factors, medicine.medical_treatment, Kaplan-Meier Estimate, Adenocarcinoma, Risk Assessment, Neoplasms, Multiple Primary, Pneumonectomy, medicine, Humans, Thoracotomy, Aged, Neoplasm Staging, Proportional Hazards Models, Lung, Proportional hazards model, business.industry, Thoracic Surgery, Video-Assisted, Incidence (epidemiology), Histology, Middle Aged, medicine.disease, Surgery, medicine.anatomical_structure, Logistic Models, Treatment Outcome, Cardiothoracic surgery, Female, Radiology, Cardiology and Cardiovascular Medicine, business, Tomography, X-Ray Computed
Abstract

Introduction: The incidence of lung adenocarci- nomas has steadily increased over the last de- cades. The aim of this study was to assess the re- sults of surgical treatment of multiple primary adenocarcinomas of the lung (MPAL) analyzing the radiological and histological features. Methods: From 1988 to 2005, 26 patients under- went surgical treatment for MPAL at our depart- ment, for a total of 52 tumors. Three patients had synchronous and 23 had metachronous tumors. Results: Thirty-seven tumors were classified as solid, two as ground-glass opacities (GGO) and 13 as mixed solid/GGO tumors on the basis of CT scan evaluation. Histology revealed 26 adenocar- cinomas, five adenocarcinomas with a bronchio- loalveolar (BAC) pattern and 21 BAC. There was no postoperative mortality. Five-year survival of patients with synchronous tumors was 66%. Sur- vival of patients with metachronous tumors was 95% and 70% from the first and second operation. Patients with stage II and IIIa tumors had signifi- cantly reduced survival rates (p< 0.05). Survival was 60% after lobectomy and 78% after wedge re- section. Conclusions: Surgical treatment of MPAL is asso- ciated with favorable results. Sublobar resec- tions, when technically feasible, provide ad- equate oncological management. " thoracic surgery l " pulmonary l " adenocarcinoma

Published
2009

10. Transient thoracic duct obstruction in a patient with thoracic outlet syndrome

Author

Michele Giovanardi, Giulio Melloni, Angela De Gaspari, Piero Zannini, Melloni, G, Giovanardi, M, DE GASPERI, A, and Zannini, Piero

Subjects
Pulmonary and Respiratory Medicine, medicine.medical_specialty, Thoracic outlet syndrome, Posture, Thoracic duct, Thoracic Duct, Medicine, Humans, Lymphedema, business.industry, Lymph duct, Mediastinum, General Medicine, Middle Aged, medicine.disease, Magnetic Resonance Imaging, Thoracic Outlet Syndrome, medicine.anatomical_structure, Arm, Surgery, Female, Radiology, Cardiology and Cardiovascular Medicine, business, Sleep, MRI
Abstract

Fig. 2. A MRI revealed a lymphoedema of the neck and mediastinum (arrow) (A, STIR image) that spontaneously disappeared in a few days. A MRI performed after a week was completely normal (B, T2-weighted image). The patient was conservatively treated. A physiotherapy program was started and she was encouraged to sleep with arms by the side. At the time of writing, 1 year after the event, the patient had experienced no further episode of cervical oedema.

Published
2006

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