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1. Surgical treatment of thyroid follicular neoplasms: results of a retrospective analysis of a large clinical series

Author

Conzo, Giovanni, Avenia, Nicola, Ansaldo, Gian Luca, Calò, Piergiorgio, De Palma, Maurizio, Dobrinja, Chiara, Docimo, Giovanni, Gambardella, Claudio, Grasso, Marica, Lombardi, Celestino Pio, Pelizzo, Maria Rosa, Pezzolla, Angela, Pezzullo, Luciano, Piccoli, Micaela, Rosato, Lodovico, Siciliano, Giuseppe, Spiezia, Stefano, Tartaglia, Ernesto, Tartaglia, Francesco, Testini, Mario, Troncone, Giancarlo, and Signoriello, Giuseppe

Published
2017
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3. The THYCOVIT (Thyroid Surgery during COVID-19 pandemic in Italy) study: results from a nationwide, multicentric, case-controlled study.

Author

Medas, Fabio, Ansaldo, Gian Luca, Avenia, Nicola, Basili, Giancarlo, Boniardi, Marco, Bononi, Marco, Bove, Aldo, Carcoforo, Paolo, Casaril, Andrea, Cavallaro, Giuseppe, Chiofalo, Maria Grazia, Conzo, Giovanni, De Pasquale, Loredana, Del Rio, Paolo, Dionigi, Gianlorenzo, Dobrinja, Chiara, Docimo, Giovanni, Graceffa, Giuseppa, Iacobone, Maurizio, and Innaro, Nadia

Abstract

The outbreak of the COVID-19 pandemic has led to a disruption of surgical care. The aim of this multi-centric, retrospective study was to evaluate the impact of the pandemic on surgical activity for thyroid disease among the Italian Units of Endocrine Surgery. Three phases of the pandemic were identified based on the epidemiological situation and the public measures adopted from the Italian Government (1st phase: from 9th March to 3rd May 2020; 2nd phase: from 4th May to 14th June; 3rd phase: from 15th June to 31st). The patients operated upon during these phases were compared to those who underwent surgery during the same period of the previous year. Overall, 3892 patients from 28 Italian endocrine surgical units were included in the study, 1478 (38%) operated upon during COVID-19 pandemic, and 2414 (62%) during the corresponding period of 2019. The decrease in the number of operations was by 64.8%, 44.7% and 5.1% during the three phases of COVID-19 pandemic, compared to 2019, respectively. During the first and the second phases, the surgical activity was dedicated mainly to oncological patients. No differences in post-operative complications were noted between the two periods. Oncological activity for thyroid cancer was adequately maintained during the COVID-19 pandemic. [ABSTRACT FROM AUTHOR]

Published
2021
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4. An H-TERT Mutated Skin Metastasis as First Occurrence in a Case of Follicular Thyroid Carcinoma

Author

Monti, Eleonora, primary, Dono, Mariella, additional, Gonella, Edoardo, additional, Spina, Bruno, additional, Pitto, Francesca, additional, Petrogalli, Floriana, additional, Conte, Lucia, additional, Ambrosetti, Eleonora, additional, Minuto, Michele N., additional, Ansaldo, Gian Luca, additional, Morbelli, Silvia, additional, Zupo, Simona, additional, and Giusti, Massimo, additional

Published
2019
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7. [Modern approach to parathyroidectomy]

Author

Minuto, Michele, Vera, Lara, Ansaldo, GIAN LUCA, Bargetto, G, Cafiero, Ferdinando, and Varaldo, Emanuela

Subjects
Parathyroidectomy, Surgery, Computer-Assisted, Parathyroid Diseases, Humans, Minimally Invasive Surgical Procedures
Abstract

Parathyroid surgery underwent significant innovations in the past 20 years, after both the improvement of the imaging techniques used to localize abnormal parathyroids (ultrasonography and MIBI scintiscan) and the possibility of the intraoperative PTH assay. These two tools, in experienced hands, can correctly differentiate uniglandular (more than 85% of the cases of primary hyperparathyroidism) from multiglandular disease. These technological improvements led to the possibility of limiting the surgical exploration to the single parathyroid responsible for the hyperparathyroidism in the majority of cases, avoiding unnecessary bilateral exploration that might increase both the morbidity of the surgery and its global costs. Furthermore, from a technical point of view, the philosophy of a minimally invasive surgery has also been applied to parathyroidectomy and several techniques have been described which are commonly considered minimally invasive. In this paper, the authors want to summarize their indications to perform a focused parathyroidectomy vs. a more traditional bilateral exploration, their definition of a minimally invasive parathyroidectomy and finally, it is given an overview of the techniques currently used for a parathyroidectomy.

Published
2014

8. Surgical treatment of thyroid follicular neoplasms: results of a retrospective analysis of a large clinical series

Author

Conzo, Giovanni, primary, Avenia, Nicola, additional, Ansaldo, Gian Luca, additional, Calò, Piergiorgio, additional, De Palma, Maurizio, additional, Dobrinja, Chiara, additional, Docimo, Giovanni, additional, Gambardella, Claudio, additional, Grasso, Marica, additional, Lombardi, Celestino Pio, additional, Pelizzo, Maria Rosa, additional, Pezzolla, Angela, additional, Pezzullo, Luciano, additional, Piccoli, Micaela, additional, Rosato, Lodovico, additional, Siciliano, Giuseppe, additional, Spiezia, Stefano, additional, Tartaglia, Ernesto, additional, Tartaglia, Francesco, additional, Testini, Mario, additional, Troncone, Giancarlo, additional, and Signoriello, Giuseppe, additional

Published
2016
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10. Protocolli gestionali-diagnostico-terapeutico-assistenziali in chirurgica tiroidea. 2° Consensus Conference

Author

Agate, Laura, Ansaldo Gian Luca, Ardito, Guglielmo, Arlandini, Anselmo, Avenia, Nicola, Barbarisi, Alfonso, Bastagli, Amelia, Bellantone, Rocco, Beretta, Edoardo, Bettini, Dario, Bonfitto, Nazario, Boniardi, Marco, Botrugno, Ivan, Bronzetti, Benedetto, Calzolari, Filippo, Campana Francesco Paolo, Cannizzaro Matteo Angelo, Caruso, Giuseppe, Cavallaro, Giuseppe, Cesari, Marco, Chiofalo Maria Grazia, Cofini, Guido, Costanzo, Mario, D’Ajello, Michele, Dal Dosso Ivano, De Martino Daniele, De Nobili Umberto, De Palma Maurizio, De Santis Luigi, De Toma Giorgio, Deandrea, Marisa, Dobrinja, Chiara, Docimo, Giovanni, Donatini, Gianluca, Elisei, Rossella, Falvo, Laura, Faragona, Sandro, Faverio, Francesco, Fonsi Giovanni Battista, Gasparri, Guido, Ginardi, Adriana, Graceffa, Giuseppina, Gurrado, Angela, Hadjiamiri, Hossein, Innaro, Nadia, La Motta Benedetto, Lampugnani, Rinaldo, Lardo, Domenica, Latteri, Adelfio, Leopaldi, Ennio, Lissidini, Germana, Lombardi Celestino Pio, Lombardi, Gaetano, Lupone, Gennaro, Marini Pier Luigi, Marzano Luigi Antonio, Marzano, Tommaso, Masi, Giulia, Miccoli, Paolo, Mobiglia, Alberto, Molinaro, Eleonora, Molinaro, Giulia, Monacelli, Massimo, Mondini, Guido, Montecamozzo, Giulio, Mullineris, Barbara, Nasi Pier Giorgio, Nicolosi, Angelo, Ortensi, Andrea, Palestini, Nicola, Palladino, Simona, Panconesi, Roberto, Pelizzo Maria Rosa, Perigli, Giuliano, Pezzullo, Luciano, Piccoli, Micaela, Pinchera, Aldo, Presenti, Luigi, Pugliese, Raffaele, Residori, Cecilia, Romano, Maurizio, Rosato, Lodovico, Sandonà, Francesco, Sandrini, Alessandro, Spiezia, Stefano, Taffurelli, Mario, Tartaglia, Francesco, Testini, Mario, Viola, David, Zaccaroni, Alberto, and Zarrilli, Lucio

Published
2009

15. Is Euthyroidism the Goal of Surgical Treatment of Diffuse Toxic Goitre?

Author

Torre, Giancarlo, Borgonovo, Giacomo, Arezzo, Alberto, Costantini, Massimo, Varaldo, Emanuela, Ansaldo, Gian Luca, and Mattioli, Francesco Paolo

Subjects
GOITER treatment, HYPOTHYROIDISM
Abstract

Objective. To find out by studying a homogeneous group of patients whether euthyroidism is achievable by surgical treatment of diffuse toxic goitre. Design. Retrospective study Setting. Teaching hospital, Italy. Subjects. 128 of the 152 patients operated on for diffuse toxic goitre during the period January 1971–December 1994 and followed up for a median of 83 months (range 6–289). Intervention. Standard subtotal thyroidectomy. Main outcome measures. Operative mortality, recurrence, hypothyroidism and late complications. Results. There were no operative deaths. After 10 years follow up, 11 patients (9%) had developed recurrences and 61 (48%) were euthyroid. In the univariate analysis the risk of hypothyroidism was significantly associated with the year of operation (p = 0.04), the duration of symptoms (p < 0.01), and the degree of lymphocytic infiltration (p < 0.01). The last two were confirmed by multivariate analysis. Conclusion. Subtotal thyroidectomy seems to be an effective treatment of diffuse toxic goitre as a stable euthyroid state can be achieved in nearly half the patients after a prolonged follow up. [ABSTRACT FROM AUTHOR]

Published
1998
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16. The THYCOVIT (Thyroid Surgery during COVID-19 pandemic in Italy) study: results from a nationwide, multicentric, case-controlled study

Author

Medas, F., Ansaldo, G. L., Avenia, N., Basili, G., Boniardi, M., Bononi, M., Bove, A., Carcoforo, P., Casaril, A., Cavallaro, G., Chiofalo, M. G., Conzo, G., De Pasquale, L., Del Rio, P., Dionigi, G., Dobrinja, C., Docimo, G., Graceffa, G., Iacobone, M., Innaro, N., Lombardi, C. P., Palestini, N., Pedicini, F., Perigli, G., Pezzolla, A., Scerrino, G., Spiezia, S., Testini, M., Calo, P. G., Anedda, G., Antonelli, G., Arrigoni, G., Badii, B., Bonati, E., Bulfamante, A. M., Candalise, V., Cangiano, A., Canu, G. L., Cappellacci, F., Caracciolo, A., Caruso, E., Annamaria, D. A., Ide, E. C., Chiappini, A., Cipolla, C., Costigliola, L., Cozzani, F., Crocco, A., Crocetti, D., Demanzini, N., Digioia, A., Diresta, V., Eramo, R., Erdas, E., Ferriolo, S., Filardo, M., Filograna Pignatelli, M., Gervasi, R., Giudici, F., Gordini, L., Gurrado, A., Impellizzeri, H., Inama, M., Koleva Radica, M., Laforgia, R., Lattarulo, S., Loderer, T., Lucchini, R., Mascioli, F., Marcellinaro, R., Menditto, R., Melfa, G., Minuto, M., Misso, C., Offi, C., Orlando, G., Ossola, P., Pagetta, C., Pasculli, A., Patrone, R., Pauna, I., Pennetti Pennella, F., Pietrasanta, D., Pino, A., Pinto, V. L., Piras, S., Polistena, A., Portinari, M., Reina, S., Rotolo, G., Russo, G., Scalise, E., Sgaramella, L. I., Sibilla, M. G., Spinelli, S., Spoletini, D., Curto, L. S., Tascone, M., Torresan, F., Varaldo, E., Viviani, E., Zucca, A., Medas, Fabio, Ansaldo, Gian Luca, Avenia, Nicola, Basili, Giancarlo, Boniardi, Marco, Bononi, Marco, Bove, Aldo, Carcoforo, Paolo, Casaril, Andrea, Cavallaro, Giuseppe, Chiofalo, Maria Grazia, Conzo, Giovanni, De Pasquale, Loredana, Del Rio, Paolo, Dionigi, Gianlorenzo, Dobrinja, Chiara, Docimo, Giovanni, Graceffa, Giuseppa, Iacobone, Maurizio, Innaro, Nadia, Lombardi, Celestino Pio, Palestini, Nicola, Pedicini, Francesco, Perigli, Giuliano, Pezzolla, Angela, Scerrino, Gregorio, Spiezia, Stefano, Testini, Mario, Calò, Pietro Giorgio, Calogero, Cipolla, Medas, F., Ansaldo, G. L., Avenia, N., Basili, G., Boniardi, M., Bononi, M., Bove, A., Carcoforo, P., Casaril, A., Cavallaro, G., Chiofalo, M. G., Conzo, G., De Pasquale, L., Del Rio, P., Dionigi, G., Dobrinja, C., Docimo, G., Graceffa, G., Iacobone, M., Innaro, N., Lombardi, C. P., Palestini, N., Pedicini, F., Perigli, G., Pezzolla, A., Scerrino, G., Spiezia, S., Testini, M., Calo, P. G., Anedda, G., Antonelli, G., Arrigoni, G., Badii, B., Bonati, E., Bulfamante, A. M., Candalise, V., Cangiano, A., Canu, G. L., Cappellacci, F., Caracciolo, A., Caruso, E., Annamaria, D. A., Ide, E. C., Chiappini, A., Cipolla, C., Costigliola, L., Cozzani, F., Crocco, A., Crocetti, D., Demanzini, N., Digioia, A., Diresta, V., Eramo, R., Erdas, E., Ferriolo, S., Filardo, M., Filograna Pignatelli, M., Gervasi, R., Giudici, F., Gordini, L., Gurrado, A., Impellizzeri, H., Inama, M., Koleva Radica, M., Laforgia, R., Lattarulo, S., Loderer, T., Lucchini, R., Mascioli, F., Marcellinaro, R., Menditto, R., Melfa, G., Minuto, M., Misso, C., Offi, C., Orlando, G., Ossola, P., Pagetta, C., Pasculli, A., Patrone, R., Pauna, I., Pennetti Pennella, F., Pietrasanta, D., Pino, A., Pinto, V. L., Piras, S., Polistena, A., Portinari, M., Reina, S., Rotolo, G., Russo, G., Scalise, E., Sgaramella, L. I., Sibilla, M. G., Spinelli, S., Spoletini, D., Curto, L. S., Tascone, M., Torresan, F., Varaldo, E., Viviani, E., and Zucca, A.

Subjects
COVID-19, Endocrine surgery, SARS-CoV-2, Thyroid carcinoma, Thyroidectomy, medicine.medical_specialty, medicine.medical_treatment, Thyroid Gland, Humans, Italy, Retrospective Studies, Pandemics, NO, Retrospective Studie, Pandemic, Epidemiology, medicine, Thyroid cancer, LS7_4, business.industry, Thyroid disease, Case-control study, Retrospective cohort study, medicine.disease, Surgery, Original Article, business, Human
Abstract

The outbreak of the COVID-19 pandemic has led to a disruption of surgical care. The aim of this multi-centric, retrospective study was to evaluate the impact of the pandemic on surgical activity for thyroid disease among the Italian Units of Endocrine Surgery. Three phases of the pandemic were identified based on the epidemiological situation and the public measures adopted from the Italian Government (1st phase: from 9th March to 3rd May 2020; 2nd phase: from 4th May to 14th June; 3rd phase: from 15th June to 31st). The patients operated upon during these phases were compared to those who underwent surgery during the same period of the previous year. Overall, 3892 patients from 28 Italian endocrine surgical units were included in the study, 1478 (38%) operated upon during COVID-19 pandemic, and 2414 (62%) during the corresponding period of 2019. The decrease in the number of operations was by 64.8%, 44.7% and 5.1% during the three phases of COVID-19 pandemic, compared to 2019, respectively. During the first and the second phases, the surgical activity was dedicated mainly to oncological patients. No differences in post-operative complications were noted between the two periods. Oncological activity for thyroid cancer was adequately maintained during the COVID-19 pandemic.

Published
2021

17. Surgical treatment of thyroid follicular neoplasms: results of a retrospective analysis of a large clinical series

Author

Maria Rosa Pelizzo, Piergiorgio Calò, Giancarlo Troncone, Maurizio De Palma, Angela Pezzolla, Giovanni Conzo, Chiara Dobrinja, Giuseppe Signoriello, Marica Grasso, Giuseppe Siciliano, Gian Luca Ansaldo, Lodovico Rosato, Claudio Gambardella, Luciano Pezzullo, Mario Testini, Micaela Piccoli, Nicola Avenia, Celestino Pio Lombardi, Stefano Spiezia, Ernesto Tartaglia, Francesco Tartaglia, Giovanni Docimo, Conzo, Giovanni, Avenia, Nicola, Ansaldo, Gian Luca, Calò, Piergiorgio, De Palma, Maurizio, Dobrinja, Chiara, Docimo, Giovanni, Gambardella, Claudio, Grasso, Marica, Lombardi, Celestino Pio, Pelizzo, Maria Rosa, Pezzolla, Angela, Pezzullo, Luciano, Piccoli, Micaela, Rosato, Lodovico, Siciliano, Giuseppe, Spiezia, Stefano, Tartaglia, Ernesto, Tartaglia, Francesco, Testini, Mario, Troncone, Giancarlo, Signoriello, Giuseppe, Conzo, G., Avenia, N., Ansaldo, G. L., Calo, P., De Palma, M., Dobrinja, C., Docimo, G., Gambardella, C., Grasso, M., Lombardi, C. P., Pelizzo, M. R., Pezzolla, A., Pezzullo, L., Piccoli, M., Rosato, L., Siciliano, G., Spiezia, S., Tartaglia, E., Tartaglia, F., Testini, M., Troncone, G., Signoriello, G., and de Palma, Maurizio

Subjects
Male, Fine needle cytology, Follicular neoplasm, Hemithyroidectomy, Thyroid cancer, Total thyroidectomy, Endocrinology, Diabetes and Metabolism, medicine.medical_treatment, Thyroid Gland, Thyroiditis, Postoperative Complications, 0302 clinical medicine, Endocrinology, Risk Factors, Retrospective Studie, Adenocarcinoma, Follicular, Thyroid Neoplasm, Adult, Aged, Female, Humans, Hypoparathyroidism, Middle Aged, Retrospective Studies, Thyroid Neoplasms, Thyroidectomy, Treatment Outcome, Thyroid, Diabetes and Metabolism, medicine.anatomical_structure, 030220 oncology & carcinogenesis, Human, Thyroid nodules, medicine.medical_specialty, 030209 endocrinology & metabolism, Adenocarcinoma, Malignancy, 03 medical and health sciences, medicine, business.industry, Risk Factor, Follicular, medicine.disease, Surgery, Endocrine surgery, Postoperative Complication, business
Abstract

The most appropriate surgical management of "follicular neoplasm/suspicious for follicular neoplasm" lesions (FN), considering their low definitive malignancy rate and the limited predictive power of preoperative clinic-diagnostic factors, is still controversial. On behalf of the Italian Association of Endocrine Surgery Units (U.E.C. CLUB), we collected and analyzed the experience of 26 endocrine centers by computerized questionnaire. 1379 patients, surgically treated after a FN diagnosis from January 2012 and December 2103, were evaluated. Histological features, surgical complications, and medium-term outcomes were reported. Total thyroidectomy (TT) was performed in 1055/1379 patients (76.5 %), while hemithyroidectomy (HT) was carried out in 324/1379 cases (23.5 %). Malignancy rate was higher in TT than in HT groups (36.4 vs. 26.2 %), whereas the rates of transient and definitive hypoparathyroidism following TT were higher than after HT. Consensual thyroiditis (16.8 vs. 9.9 %) and patient age (50.9 vs. 47.9 %) also differed between groups. A cytological FN diagnosis was associated to a not negligible malignancy rate (469/1379 patients; 34 %), that was higher in TT than in HT groups. However, a lower morbidity rate was observed in HT, which should be considered the standard of care in solitary lesions in absence of specific risk factors. Malignancy could not be preoperatively assessed and clinical decision-making is still controversial. Further efforts should be spent to more accurately preoperatively classify FN thyroid nodules. The most appropriate surgical management of “follicular neoplasm/suspicious for follicular neoplasm” lesions (FN), considering their low definitive malignancy rate and the limited predictive power of preoperative clinic-diagnostic factors, is still controversial. On behalf of the Italian Association of Endocrine Surgery Units (U.E.C. CLUB), we collected and analyzed the experience of 26 endocrine centers by computerized questionnaire. 1379 patients, surgically treated after a FN diagnosis from January 2012 and December 2103, were evaluated. Histological features, surgical complications, and medium-term outcomes were reported. Total thyroidectomy (TT) was performed in 1055/1379 patients (76.5 %), while hemithyroidectomy (HT) was carried out in 324/1379 cases (23.5 %). Malignancy rate was higher in TT than in HT groups (36.4 vs. 26.2 %), whereas the rates of transient and definitive hypoparathyroidism following TT were higher than after HT. Consensual thyroiditis (16.8 vs. 9.9 %) and patient age (50.9 vs. 47.9 %) also differed between groups. A cytological FN diagnosis was associated to a not negligible malignancy rate (469/1379 patients; 34 %), that was higher in TT than in HT groups. However, a lower morbidity rate was observed in HT, which should be considered the standard of care in solitary lesions in absence of specific risk factors. Malignancy could not be preoperatively assessed and clinical decision-making is still controversial. Further efforts should be spent to more accurately preoperatively classify FN thyroid nodules.

Published
2017

18. The bowel cleansing for colonoscopy. A randomized trial comparing three methods.

Author

De Salvo L, Borgonovo G, Ansaldo GL, Varaldo E, Floris F, Assalino M, and Gianiorio F

Subjects
Aged, Anthraquinones administration & dosage, Bisacodyl administration & dosage, Chi-Square Distribution, Electrolytes administration & dosage, Female, Humans, Magnesium Sulfate administration & dosage, Male, Middle Aged, Patient Compliance, Polyethylene Glycols administration & dosage, Preoperative Care, Senna Extract administration & dosage, Sennosides, Solutions, Solvents administration & dosage, Cathartics administration & dosage, Colonoscopy, Phosphates
Abstract

Introduction: Colonoscopy is the procedure of choice for the detection and ablation of small lesions o the colonic mucosa. A proper bowel cleansing is mandatory. So far several regimens have been proposed but rather none has shown a clear-cut advantage over the others. Aim of this study was to compare cleansing ability and patients' compliance of three oral regimens., Patients and Methods: Two-hundred and seventy-three patients were block randomised into three groups. Group A (92 patients) received tablets containing senna 12 mg and Magnesium Sulphate 15 mg the day before colonoscopy. Group B (98 patients) received a Polyethylene Glycol-based solution of two litres plus 4 tablets of Bisacodyl the day before the exam. Group C (83 patients) received Sodium Phosphate 40 milliliters the day before and the day of colonoscopy. Results of 265 patients were available for the analysis. Eight patients were excluded because inability to follow prescription. The lower incidence of constipation in group C was not significant. The other parameters were homogeneously distributed in the three groups., Results: The 79 patients of the group C achieved a better bowel cleansing as compared with the 90 of group A (p = 0.0003) and the 96 of group B (p = 0.034). Constipated patients had a significantly better cleansing with Sodium Phosphate preparation compared with senna plus Magnesium Sulphate (p = 0.017), but not significantly better compared with Golytely solution. Compliance and rate of total colonoscopy performed were not statistically different in the three groups., Conclusions: Sodium Phosphate solution gave better bowel preparation, with the same compliance, than either senna or Polyethylene solution. In constipated patients Sodium Phosphate showed good efficacy resulting in good cleansing rates similar to that of non-constipated patients. The poor results obtained by Polyethylene were related to the little amount of solution taken even if associated to Bisacodyl.

Published
2006

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