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1. Laparoscopic right hemicolectomy: the SICE (Società Italiana di Chirurgia Endoscopica e Nuove Tecnologie) network prospective trial on 1225 cases comparing intra corporeal versus extra corporeal ileo-colic side-to-side anastomosis

Author

Anania G., Agresta F., Artioli E., Rubino S., Resta G., Vettoretto N., Petz W. L., Bergamini C., Arezzo A., Valpiani G., Morotti C., Silecchia G., Adamo V., Agrusa A., Alemanno G., Allaix M. E., Alo A., Altamura A., Ambrosi A., Antoniutti M., Apa D., Arcuri G., Baiocchi G. L., Balani A., Baldazzi G., Basti M., Benvenuto C., Berti S., Boni L., Borghi F., Botteri E., Brachet Contul R., Brescia A., Budassi A., Cafagna L., Calgaro M., Calo P. G., Campagnacci R., Canova G., Canu G. L., Caracino V., Carcoforo P., Carlini M., Casali L., Cassetti D., Cassinotti E., Catarci M., Cesari M., Checcacci P., Ciano P., Clementi M., Cocorullo G., Colombo F., Concone G., Contine A., Coppola M., Coratti A., Corcione F., Corleone P., Covotta L., Cuccurullo D., Cumbo P., D'ambrosio G., De Angelis F., De Luca M., De Manzini N., De Nisco C., De Palma G. D., De Paolis P., Degiuli M., Delogu D., Delrio P., Deserra A., Donini A., Elmore U., Ercolani G., Erdas E., Fabris L., Ferrari G., Feo G., Fidanza F., Foschi D., Galleano R., Garulli G., Gatti F., Gattolin A., Gelati S., Gelmini R., Ghazouani O., Gioffre A., Gobbi S., Grammatico V., Guariniello A., Giannessi S., Guerrieri M., Guerriero L., Gullotta G., Impellizzeri H., Izzo M., Jovine E., Lezoche G., Lirusso C., Lombardi R., Longoni M., Lucchi A., Luzzi A. P., Marini P., Marrosu A. G., Martino A., Mazza R., Mazzoccato S., Medas F., Meloni A., Milone M., Minciotti E., Monari F., Moretto G., Muttillo I. A., Navarra G., Neri S., Oldani A., Olmi S., Opocher E., Osenda E., Ottonello R., Panebianco V., Pavanello M., Pecchini F., Pellegrino L., Pennisi D., Perrotta N., Pertile D., Petri R., Picchetto A., Piccoli M., Pirrera B., Pisani Ceretti A., Pisano M., Podda M., Portolani N., Presenti L., Puzziello A., Razzi S., Rega D., Restini E., Ricci G., Rigamonti M., Rivolta U., Robustelli V., Romairone E., Rosati R., Rosso E., Roviello F., Sala S., Santarelli M., Sarro G., Sartori A., Scabini S., Scognamillo F., Sechi R., Solaini L., Soliani G., Soliani P., Soligo E., Sorrentino M., Spinoglio G., Stratta E., Taddei A., Talamo G., Targa S., Tartaglia N., Testa S., Ubiali P., Valeri A., Vasta F., Verzelli A., Vicentini R., Viola G., Violi V., Zago M., Zampino L., Anania, G., Agresta, F., Artioli, E., Rubino, S., Resta, G., Vettoretto, N., Petz, W. L., Bergamini, C., Arezzo, A., Valpiani, G., Morotti, C., Silecchia, G., Adamo, V., Agrusa, A., Alemanno, G., Allaix, M. E., Alo, A., Altamura, A., Ambrosi, A., Antoniutti, M., Apa, D., Arcuri, G., Baiocchi, G. L., Balani, A., Baldazzi, G., Basti, M., Benvenuto, C., Berti, S., Boni, L., Borghi, F., Botteri, E., Brachet Contul, R., Brescia, A., Budassi, A., Cafagna, L., Calgaro, M., Calo, P. G., Campagnacci, R., Canova, G., Canu, G. L., Caracino, V., Carcoforo, P., Carlini, M., Casali, L., Cassetti, D., Cassinotti, E., Catarci, M., Cesari, M., Checcacci, P., Ciano, P., Clementi, M., Cocorullo, G., Colombo, F., Concone, G., Contine, A., Coppola, M., Coratti, A., Corcione, F., Corleone, P., Covotta, L., Cuccurullo, D., Cumbo, P., D'Ambrosio, G., De Angelis, F., De Luca, M., De Manzini, N., De Nisco, C., De Palma, G. D., De Paolis, P., Degiuli, M., Delogu, D., Delrio, P., Deserra, A., Donini, A., Elmore, U., Ercolani, G., Erdas, E., Fabris, L., Ferrari, G., Feo, G., Fidanza, F., Foschi, D., Galleano, R., Garulli, G., Gatti, F., Gattolin, A., Gelati, S., Gelmini, R., Ghazouani, O., Gioffre, A., Gobbi, S., Grammatico, V., Guariniello, A., Giannessi, S., Guerrieri, M., Guerriero, L., Gullotta, G., Impellizzeri, H., Izzo, M., Jovine, E., Lezoche, G., Lirusso, C., Lombardi, R., Longoni, M., Lucchi, A., Luzzi, A. P., Marini, P., Marrosu, A. G., Martino, A., Mazza, R., Mazzoccato, S., Medas, F., Meloni, A., Milone, M., Minciotti, E., Monari, F., Moretto, G., Muttillo, I. A., Navarra, G., Neri, S., Oldani, A., Olmi, S., Opocher, E., Osenda, E., Ottonello, R., Panebianco, V., Pavanello, M., Pecchini, F., Pellegrino, L., Pennisi, D., Perrotta, N., Pertile, D., Petri, R., Picchetto, A., Piccoli, M., Pirrera, B., Pisani Ceretti, A., Pisano, M., Podda, M., Portolani, N., Presenti, L., Puzziello, A., Razzi, S., Rega, D., Restini, E., Ricci, G., Rigamonti, M., Rivolta, U., Robustelli, V., Romairone, E., Rosati, R., Rosso, E., Roviello, F., Sala, S., Santarelli, M., Sarro, G., Sartori, A., Scabini, S., Scognamillo, F., Sechi, R., Solaini, L., Soliani, G., Soliani, P., Soligo, E., Sorrentino, M., Spinoglio, G., Stratta, E., Taddei, A., Talamo, G., Targa, S., Tartaglia, N., Testa, S., Ubiali, P., Valeri, A., Vasta, F., Verzelli, A., Vicentini, R., Viola, G., Violi, V., Zago, M., Zampino, L., Anania G., Agresta F., Artioli E., Rubino S., Resta G., Vettoretto N., Petz W.L., Bergamini C., Arezzo A., Valpiani G., Morotti C., Silecchia G, and Adamo V, Agrusa A, Alemanno G, Allaix ME, Alò A, Altamura A, Ambrosi A, Antoniutti M, Apa D, Arcuri G, Baiocchi GL, Balani A, Baldazzi G, Basti M, Benvenuto C, Berti S, Boni L, Borghi F, Botteri E, Brachet Contul R, Brescia A, Budassi A, Cafagna L, Calgaro M, Calò PG, Campagnacci R, Canova G, Canu GL, Caracino V, Carcoforo P, Carlini M, Casali L, Cassetti D, Cassinotti E, Catarci M, Cesari M, Checcacci P, Ciano P, Clementi M, Cocorullo G, Colombo F, Concone G, Contine A, Coppola M, Coratti A, Corcione F, Corleone P, Covotta L, Cuccurullo D, Cumbo P, D'Ambrosio G, De Angelis F, De Luca M, De Manzini N, De Nisco C, De Palma GD, De Paolis P, Degiuli M, Delogu D, Delrio P, Deserra A, Donini A, Elmore U, Ercolani G, Erdas E, Fabris L, Ferrari G, Feo C, Fidanza F, Foschi D, Galleano R, Garulli G, Gatti F, Gattolin A, Gelati S, Gelmini R, Ghazouani O, Gioffrè A, Gobbi S, Grammatico V, Guariniello A, Giannessi S, Guerrieri M, Guerriero L, Guerriero G, Impellizzeri H, Izzo M, Jovine E, Lezoche G, Lirusso C, Lombardi R, Longoni M, Lucchi A, Luzzi AP, Marini P, Marrosu AG, Martino A, Mazza R, Mazzoccato S, Medas F, Meloni A, Milone M, Minciotti E, Monari F, Moretto G, Muttillo IA, Navarra G, Neri S, Oldani A, Olmi S, Opocher E, Osenda E, Ottonello R, Panebianco V, Pavanello M, Pecchini F, Pellegrino L, Pennisi D, Perrotta N, Pertile D, Petri R, Picchetto A, Piccoli M, Pirrera B, Pisani Ceretti A, Pisano M, Podda M, Portolani N, Presenti L, Puzziello A, Razzi S, Rega D, Restini E, Ricci G, Rigamonti M, Rivolta U, Robustelli V, Romairone E, Rosati R, Rosso E, Roviello F, Sala S, Santarelli M, Sarro G, Sartori A, Scabini S, Scognamillo F, Sechi R, Solaini L, Soliani G, Soliani P, Soligo E, Sorrentino M, Spinoglio G, Stratta E, Taddei A, Talamo G, Targa S, Tartaglia N, Testa S, Ubiali P, Valeri A, Vasta F, Verzelli A, Vicentini R, Viola G, Violi V, Zago M, Zampino L.

Subjects
Male, medicine.medical_specialty, Anastomosis, Colon, Intracorporeal anastomosis, Outcomes, Laparoscopic colectomy, Article, Intracorporeal anastomosi, Ileo-colic anastomosis, Laparoscopy, Postoperative complications, Right hemicolectomy, Aged, Anastomosis, Surgical, Colectomy, Colonic Neoplasms, Female, Humans, Prospective Studies, Treatment Outcome, Economica, Surgical, medicine, LS7_1, LS7_4, Right hemicolectomy, Ileo-colic anastomosis, Laparoscopy, Postoperative complications, Intracorporeal anastomosis, Outcomes, Outcome, LS7_9, medicine.diagnostic_test, business.industry, General surgery, Right hemicolectomy · Ileo-colic anastomosis · Laparoscopy · Postoperative complications · Intracorporeal anastomosis · Outcomes, Correction, Postoperative complication, Ileo-colic anastomosi, Prospective trial, Surgery, Side to side anastomosis, business, Laparoscopic right hemicolectomy
Abstract

Background While laparoscopic approach for right hemicolectomy (LRH) is considered appropriate for the surgical treatment of both malignant and benign diseases of right colon, there is still debate about how to perform the ileo-colic anastomosis. The ColonDxItalianGroup (CoDIG) was designed as a cohort, observational, prospective, multi-center national study with the aims of evaluating the surgeons’ attitude regarding the intracorporeal (ICA) or extra-corporeal (ECA) anastomotic technique and the related surgical outcomes. Methods One hundred and twenty-five Surgical Units experienced in colorectal and advanced laparoscopic surgery were invited and 85 of them joined the study. Each center was asked not to change its surgical habits. Data about demographic characteristics, surgical technique and postoperative outcomes were collected through the official SICE website database. One thousand two hundred and twenty-five patients were enrolled between March 2018 and September 2018. Results ICA was performed in 70.4% of cases, ECA in 29.6%. Isoperistaltic anastomosis was completed in 85.6%, stapled in 87.9%. Hand-sewn enterotomy closure was adopted in 86%. Postoperative complications were reported in 35.4% for ICA and 50.7% for ECA; no significant difference was found according to patients’ characteristics and technologies used. Median hospital stay was significantly shorter for ICA (7.3 vs. 9 POD). Postoperative pain in patients not prescribed opioids was significantly lower in ICA group. Conclusions In our survey, a side-to-side isoperistaltic stapled ICA with hand-sewn enterotomy closure is the most frequently adopted technique to perform ileo-colic anastomosis after any indications for elective LRH. According to literature, our study confirmed better short-term outcomes for ICA, with reduction of hospital stay and postoperative pain. Trial registration Clinical trial (Identifier: NCT03934151).

Published
2020

3. Survival after Liver Transplant: Influence of Progression of Disease and of Restoration of the 'Milan' Criteria in Patients with Hepato-cellular Carcinoma undergoing Down-staging Procedures

Author

Giacomoni, A., Di Sandro, S., Donadon, M., Lauterio, A., Luca Saverio Belli, Mangoni, I., Mihaylov, P., Concone, G., Carlis, L., Giacomoni, A, Di Sandro, S, Donadon, M, Lauterio, A, Belli, L, Mangoni, I, Mihaylov, P, Concone, G, and De Carlis, L

Subjects
Adult, Male, Carcinoma, Hepatocellular, Hepatology, Waiting Lists, Patient Selection, Liver Neoplasms, Gastroenterology, Middle Aged, Disease-Free Survival, Liver Transplantation, Cohort Studies, Survival Rate, Treatment Outcome, Disease Progression, Humans, Female, Aged, Neoplasm Staging, Retrospective Studies
Abstract

BACKGROUND/AIMS: Selection of patients with hepa- to-cellular carcinoma for liver transplantation is gen- erally performed according to the so-called Milan cri- teria. The aim of this study was to learn whether, after down-staging loco-regional therapies, patients origi- nally non-fulfilling the MC (Milan-OUT) meet these criteria (Milan-IN).METHODOLOGY: Between January 2000 and December 2008, 172 patients with HCC re- ceived LT at our Department. Of these, 142 were sub- jected to DS before LT.RESULTS: Of the 142 patients who received DS, 115 (81%) were Milan-IN and 27 (19%) were Milan-OUT at the time of their enrollment in the waiting list for LT. After a median follow-up of 50 months, overall 1-, 3-, and 5-year survival and dis- ease recurrence-free survival were not significantly different.CONCLUSIONS: Patients with Milan-OUT HCC can be successfully subjected to LT when they fulfill the MC after being subjected to DS. Imaging progres- sion while on the waiting list is a strong predictor of high rates of HCC recurrence even in patients meet- ing the MC. Lack of imaging progression seems to be a strong predictor of positive LT outcome and should be added to the eligibility criteria for the assessment of LT candidates with HCC.

Published
2016

4. Evolution of robotic nephrectomy for living donation: From hand-assisted to totally robotic technique

Author

Giacomoni, A, Di Sandro, S, Lauterio, A, Concone, G, Mangoni, I, Mihaylov, P, Tripepi, M, De Carlis, L., Giacomoni, A, Di Sandro, S, Lauterio, A, Concone, G, Mangoni, I, Mihaylov, P, Tripepi, M, and DE CARLIS, L

Subjects
Adult, Male, Living Donor, Robotic Surgical Procedure, Intraoperative Complication, Operative Time, Nephrectomy, Robotic-assisted nephrectomy, Kidney transplantation, Robotic Surgical Procedures, Ischemia, Living Donors, Living donation, Humans, Postoperative Period, Intraoperative Complications, Aged, Medicine (all), Computer Science Applications1707 Computer Vision and Pattern Recognition, Middle Aged, Kidney Transplantation, Biophysic, Tissue and Organ Harvesting, Female, Laparoscopy, Surgery, Human
Abstract

Background: The application of robotic-assisted surgery offers EndoWrist instruments and 3-D visualization of the operative field, which are improvements over traditional laparoscopy. The results of the few studies published so far have shown that living donor nephrectomy using the robot-assisted technique is safe, feasible, and offers advantages to patients. Materials and methods: Since November 2009, 16 patients have undergone robotic-assisted living donor nephrectomy at our Institute. Patients were divided into two groups according to the surgical technique adopted for the procedure: Group A, hand-assisted robotic nephrectomy (eight patients); Group B, totally robotic nephrectomy (eight patients). Results: Intra-operative bleeding was similar in the two groups (90 vs 100mL for Group A and B, respectively). Median warm ischemia time was significantly shorter in Group A (2.3 vs 5.1min for Group A and B, respectively, P-value=0.05). Switching to the open procedure was never required. Median operative time was not significantly longer in Group A than Group B (275min vs 250min, respectively). Conclusion: Robotic assisted living kidney recovery is a safe and effective procedure. Considering the overall technical, clinical, and feasibility aspects of living kidney donation, we believe that the robotic assisted technique is the method of choice for surgeon's comfort and donors' safety

Published
2014

5. Problemi chirurgici nel trapianto di rene e di pancreas - Position paper [Surgical overview on kidney and pancreas transplantation]

Author

Capocasale, E., Berardinelli, L., Beretta, C., Berloco, P., Boggi, U., Boschiero, L., Bretto, P., Carmellini, M., Citterio, F., Concone, G., De Carlis, L., De Rosa, P., Del Gaudio, M., Di Sandro, S., Di Tonno, P., Faenza, A., Famulari, A., Giacomoni, A., Giovannoni, M., Iaria, M., Lauterio, A., Lasaponara, F., Mazzoni, M. P., Nicita, G., Orsenigo, E., Parolini, D. C., Pietrabissa, A., Pinna, A. D., Pisani, F., Ravaioli, M., Rigotti, P., Romagnoli, J., Rossetti, O., Secchi, A., Socci, C., and Vistoli, F.

Subjects
failed allograft, kidney and pancreas transplantation, kidney preservation, living donation, recipient selection, failed allograft, living donation, kidney and pancreas transplantation, recipient selection, kidney preservation
Published
2016

16. Surgical overview on kidney and pancreas transplantation,Problemi chirurgici nel trapianto di rene e di pancreas - Position paper

Author

Capocasale, E., Berardinelli, L., Beretta, C., Berloco, P., Boggi, U., Boschiero, L., Bretto, P., Carmellini, M., Citterio, F., Concone, G., Carlis, L., Rosa, P., Del Gaudio, M., Di Sandro, S., Di Tonno, P., Faenza, A., Famulari, A., Giacomoni, A., Giovannoni, M., Iaria, M., Lauterio, A., Lasaponara, F., Mazzoni, M. P., Nicita, G., Orsenigo, E., Parolini, D. C., Pietrabissa, A., Pinna, A. D., Pisani, F., Matteo Ravaioli, Rigotti, P., Romagnoli, J., Rossetti, O., Secchi, A., Socci, C., and Vistoli, F.

17. [Surgical overview on kidney and pancreas transplantation]

Author

Capocasale, Enzo, Berardinelli, Luisa, Beretta, Claudio, Berloco, Pasquale, UGO BOGGI, Boschiero, Luigino, Bretto, Piero, Carmellini, Mario, Citterio, Franco, Concone, Giacomo, Carlis, Luciano, Rosa, Paride, Del Gaudio, Massimo, Di Sandro, Stefano, Di Tonno, Pasquale, Faenza, Alessandro, Famulari, Antonio, Giacomoni, Alessandro, Giovannoni, Massimo, Iaria, Maurizio, Lauterio, Andrea, Lasaponara, Fedele, Mazzoni, Maria Patrizia, Nicita, Giulio, Orsenigo, Elena, Parolini, Danilo Carlo, Pietrabissa, Andrea, Pinna, Antonio Daniele, Pisani, Franco, Ravaioli, Matteo, Rigotti, Paolo, Romagnoli, Jacopo, Rossetti, Ornella, Secchi, Antonio, Socci, Carlo, FABIO VISTOLI, Capocasale, E., Berardinelli, L., Beretta, C., Berloco, P., Boggi, U., Boschiero, L., Bretto, P., Carmellini, M., Citterio, F., Concone, G., De Carlis, L., De Rosa, P., Del Gaudio, M., Di Sandro, S., Di Tonno, P., Faenza, A., Famulari, A., Giacomoni, A., Giovannoni, M., Iaria, M., Lauterio, A., Lasaponara, F., Mazzoni, M. P., Nicita, G., Orsenigo, E., Parolini, D. C., Pietrabissa, A., Pinna, A. D., Pisani, F., Ravaioli, M., Rigotti, P., Romagnoli, J., Rossetti, O., Secchi, A., Socci, C., Vistoli, F., Capocasale, E, Berardinelli, L, Beretta, C, Berloco, P, Boggi, U, Boschiero, L, Bretto, P, Carmellini, M, Citterio, F, Concone, G, De Carlis, L, De Rosa, P, Del Gaudio, M, Di Sandro, S, Di Tonno, P, Faenza, A, Famulari, A, Giacomoni, A, Giovannoni, M, Iaria, M, Lauterio, A, Lasaponara, F, Mazzoni, M, Nicita, G, Orsenigo, E, Parolini, D, Pietrabissa, A, Pinna, A, Pisani, F, Ravaioli, M, Rigotti, P, Romagnoli, J, Rossetti, O, Secchi, A, Socci, C, and Vistoli, F

Subjects
Settore MED/18 - CHIRURGIA GENERALE, Medicine (all), Patient Selection, Pancreatic Diseases, Humans, Kidney Diseases, Nephrectomy, Pancreatectomy, Perioperative Care, Postoperative Complications, Practice Guidelines as Topic, Tissue and Organ Harvesting, Kidney Transplantation, Pancreas Transplantation
Abstract

The main purpose of this paper, written by a group of Italian expert transplant surgeons, is to provide clinical support and to help through the decision-making process over pre-transplant surgical procedures in potential kidney recipients, as well as selection of pancreas transplant candidates and perioperative management of kidney recipient. Current topics such as different approaches in minimally invasive donor nephrectomy, methods of graft preservation and treatment of failed allograft were addressed.

Published
2016

18. Correction to: Laparoscopic right hemicolectomy: the SICE (Società Italiana di Chirurgia Endoscopica e Nuove Tecnologie) network prospectivetrial on 1225 cases comparing intra corporeal versus extra corporeal ileo‑colic side‑to‑side anastomosis (Surgical Endoscopy, (2019), 10.1007/s00464-019-07255-2)

Author

M. Sorrentino, A. Alo, G. L. Canu, F. Monari, A. G. Marrosu, E. Soligo, Wanda Petz, A. Gattolin, R. Vicentini, S. Razzi, M. Zago, S. Neri, A. Pisani Ceretti, D. Apa, F. Gatti, A. Donini, F. Medas, D. Cassetti, S. Rubino, R. Lombardi, G. D. DePalma, Alberto Arezzo, G. Soliani, P. Checcacci, G. Concone, Emanuele Botteri, F. Scognamillo, Ferdinando Agresta, Pierluigi Marini, S. Gelati, Luigi Boni, A. Coratti, Andrea Picchetto, G. Guerriero, M. Calgaro, Francesca Pecchini, A. Contine, Andrea Valeri, N. DeManzini, M. Clementi, A. Balani, F. Fidanza, R. Galleano, Carlo Bergamini, A. Brescia, G. Arcuri, Elio Jovine, E. Rosso, A. Oldani, E. Artioli, Nereo Vettoretto, Giuseppe Navarra, G. Sarro, E. Restini, Chiara Morotti, S. Giannessi, F. DeAngelis, M. Degiuli, G. Talamo, G. Alemanno, L. Cafagna, P. Cumbo, V. Violi, S. Targa, Irnerio Angelo Muttillo, A. Martino, M. DeLuca, Elisa Cassinotti, Alessandro Puzziello, S. Sala, Riccardo Rosati, E. Erdas, R. Petri, A. Deserra, A. Gioffre, G. Viola, E. Stratta, Mario Guerrieri, E. Minciotti, Mauro Podda, Giuseppe Spinoglio, F. Borghi, Micaela Piccoli, C. DeNisco, P. Carcoforo, D. Delogu, Giuseppe Resta, P. Corleone, D. Pennisi, Gianfranco Silecchia, E. Opocher, A. Taddei, A. Budassi, Paolo Delrio, A. Meloni, Marco E. Allaix, A. Ambrosi, H. Impellizzeri, N. Portolani, L. Guerriero, G. Ercolani, A. Guariniello, M. Antoniutti, M. Cesari, A. P. Luzzi, M. Izzo, M. Longoni, R. Mazza, C. Benvenuto, S. Gobbi, P. G. Calo, C. Feo, Antonino Agrusa, L. Covotta, L. Presenti, V. Adamo, Gian Luca Baiocchi, E. Osenda, R. Ottonello, Giancarlo D'Ambrosio, F. Roviello, V. Grammatico, G. Moretto, L. Zampino, Valerio Caracino, Giovanni Ferrari, D. Rega, V. Robustelli, Diego Cuccurullo, F. Vasta, Ugo Elmore, R. Campagnacci, Gianfranco Cocorullo, O. Ghazouani, G. Ricci, S. Berti, F. Colombo, Alberto Sartori, S. Scabini, S. Mazzoccato, B. Pirrera, A. Altamura, N. Tartaglia, E. Romairone, G. Baldazzi, Marco Catarci, G. Garulli, Lorenzo Casali, S. Testa, R. Brachet Contul, M. Basti, U. Rivolta, D. Pertile, M. Pavanello, M. Pisano, Marco Milone, A. Verzelli, P. Ubiali, L. Solaini, M. Coppola, G Anania, Massimo Carlini, F. Corcione, P. DePaolis, P. Ciano, M. Santarelli, V. Panebianco, Nicola Perrotta, R. Sechi, M. Rigamonti, G. Lezoche, L. Fabris, C. Lirusso, D. Foschi, G. Canova, P. Soliani, Roberta Gelmini, Stefano Olmi, A. Lucchi, Giorgia Valpiani, L. Pellegrino, Anania, G., Agresta, F., Artioli, E., Rubino, S., Resta, G., Vettoretto, N., Petz, W. L., Bergamini, C., Arezzo, A., Valpiani, G., Morotti, C., Silecchia, G., Adamo, V., Agrusa, A., Alemanno, G., Allaix, M. E., Alo, A., Altamura, A., Ambrosi, A., Antoniutti, M., Apa, D., Arcuri, G., Baiocchi, G. L., Balani, A., Baldazzi, G., Basti, M., Benvenuto, C., Berti, S., Boni, L., Borghi, F., Botteri, E., Brachet Contul, R., Brescia, A., Budassi, A., Cafagna, L., Calgaro, M., Calo, P. G., Campagnacci, R., Canova, G., Canu, G. L., Caracino, V., Carcoforo, P., Carlini, M., Casali, L., Cassetti, D., Cassinotti, E., Catarci, M., Cesari, M., Checcacci, P., Ciano, P., Clementi, M., Cocorullo, G., Colombo, F., Concone, G., Contine, A., Coppola, M., Coratti, A., Corcione, F., Corleone, P., Covotta, L., Cuccurullo, D., Cumbo, P., D'Ambrosio, G., Deangelis, F., Deluca, M., Demanzini, N., Denisco, C., Depalma, G. D., Depaolis, P., Degiuli, M., Delogu, D., Delrio, P., Deserra, A., Donini, A., Elmore, U., Ercolani, G., Erdas, E., Fabris, L., Ferrari, G., Feo, C., Fidanza, F., Foschi, D., Galleano, R., Garulli, G., Gatti, F., Gattolin, A., Gelati, S., Gelmini, R., Ghazouani, O., Gioffre, A., Gobbi, S., Grammatico, V., Guariniello, A., Giannessi, S., Guerrieri, M., Guerriero, L., Guerriero, G., Impellizzeri, H., Izzo, M., Jovine, E., Lezoche, G., Lirusso, C., Lombardi, R., Longoni, M., Lucchi, A., Luzzi, A. P., Marini, P., Marrosu, A. G., Martino, A., Mazza, R., Mazzoccato, S., Medas, F., Meloni, A., Milone, M., Minciotti, E., Monari, F., Moretto, G., Muttillo, I. A., Navarra, G., Neri, S., Oldani, A., Olmi, S., Opocher, E., Osenda, E., Ottonello, R., Panebianco, V., Pavanello, M., Pecchini, F., Pellegrino, L., Pennisi, D., Perrotta, N., Pertile, D., Petri, R., Picchetto, A., Piccoli, M., Pirrera, B., Pisani Ceretti, A., Pisano, M., Podda, M., Portolani, N., Presenti, L., Puzziello, A., Razzi, S., Rega, D., Restini, E., Ricci, G., Rigamonti, M., Rivolta, U., Robustelli, V., Romairone, E., Rosati, R., Rosso, E., Roviello, F., Sala, S., Santarelli, M., Sarro, G., Sartori, A., Scabini, S., Scognamillo, F., Sechi, R., Solaini, L., Soliani, G., Soliani, P., Soligo, E., Sorrentino, M., Spinoglio, G., Stratta, E., Taddei, A., Talamo, G., Targa, S., Tartaglia, N., Testa, S., Ubiali, P., Valeri, A., Vasta, F., Verzelli, A., Vicentini, R., Viola, G., Violi, V., Zago, M., and Zampino, L.

Subjects
medicine.medical_specialty, colon cancer right hemcolectomy, business.industry, medicine, Surgery, business, Side to side anastomosis, Surgical endoscopy, Laparoscopic right hemicolectomy, NO, LS7_4
Abstract

Due to an error in production the members of SICE CoDIG (Colon Dx Italian Group) listed in the Acknowledgments were not tagged correctly as authors in the XML of this article. This listing is presented again here:.

Published
2019

19. Dual Kidney Transplantation: Evaluation of Recipient Selection Criteria at Niguarda Hospital

Author

G. Concone, Iacopo Mangoni, M. Tripepi, Fabio Ferla, Andrea Lauterio, O. Rossetti, Anna Mariani, E. Covucci, L. De Carlis, R. De Carlis, Mariani, A, Ferla, F, De Carlis, R, Rossetti, O, Covucci, E, Tripepi, M, Concone, G, Lauterio, A, Mangoni, I, and De Carlis, L

Subjects
Male, Dual kidney transplantation, medicine.medical_specialty, medicine.medical_treatment, Tissue Donor, Delayed Graft Function, Kidney, Sepsis, Hospital, Postoperative Complications, Retrospective Studie, medicine, Humans, Age Factor, Medical history, Donor pool, Aged, Retrospective Studies, Transplantation, business.industry, Patient Selection, Graft Survival, Age Factors, Transplant Waiting List, Middle Aged, medicine.disease, Kidney Transplantation, Hospitals, Tissue Donors, Surgery, Italy, Female, Both kidneys, Postoperative Complication, Hemodialysis, business, Human
Abstract

Background Dual kidney transplantation (DKT) is a largely accepted strategy to enlarge the donor pool. Niguarda Hospital started this program in December 2010, and 38 DKT have been performed. In our series, we included recipients older than those in the other series published in literature. The aim of this study was to know if our recipient selection criteria for DKT are safe. Methods We reviewed our data base of DKT and analyzed recipients' medical history, surgical technique, post-operative complications, graft survival, morbidity, and mortality. We then compared our results with the literature. Results From December 2010 to April 2015, 38 DKT were performed in Niguarda Hospital. Delayed graft function was present in 21 recipients. Explantation of both kidneys was performed in 1 patient and explantation of 1 kidney in 6 patients. Post-operative complications were present in 8 patients. Five patients returned to hemodialysis after DKT. One recipient died of medical post-operative sepsis. The mean follow-up was 24 months. Graft survival and patient survival were 86.84% and 97.93%, respectively. Compared with the literature, our series had similar mortality and morbidity rates, even if recipients' age was higher than in other series. Conclusions The strategy of DKT allocation in elderly recipients is safe. Further studies have to be performed to optimized selection of the recipients for DKT not to disadvantage younger patients in the transplant waiting list and to improve the technique of organ evaluation and preservation to refine graft allocation.

Published
2016

20. Robot-Assisted Harvesting of Kidneys for Transplantation and Global Complications for the Donor

Author

M. Gregorini, L. De Carlis, Andrea Lauterio, M. Tripepi, Fabio Ferla, S. Di Sandro, Alessandro Giacomoni, Vincenzo Buscemi, G. Concone, Giacomo Colussi, Arianna Ciravegna, Leonardo Centonze, R. De Carlis, Giacomoni, A, Centonze, L, Di Sandro, S, Lauterio, A, Ciravegna, A, Buscemi, V, Ferla, F, Tripepi, M, Concone, G, De Carlis, R, Colussi, G, Gregorini, M, and De Carlis, L

Subjects
Adult, Male, Living Donor, Transfusion rate, medicine.medical_specialty, Intraoperative Complication, Anemia, medicine.medical_treatment, 030232 urology & nephrology, 030230 surgery, Nephrectomy, 03 medical and health sciences, 0302 clinical medicine, Postoperative Complications, Retrospective Studie, Aged, Female, Humans, Intraoperative Complications, Kidney Transplantation, Middle Aged, Retrospective Studies, Robotics, Tissue and Organ Harvesting, Living Donors, medicine, Kidney transplantation, Transplantation, business.industry, Significant difference, Retrospective cohort study, medicine.disease, Robotic, Surgery, Postoperative Complication, business, Body mass index, Human
Abstract

Introduction Robot-assisted kidney harvesting from living donors is feasible and safe. We report the results of a mono-centric experience relative to 98 consecutive robotic nephrectomies with emphasis on global donor complications. Materials and Methods This is a retrospective cohort study. Donors underwent robot-assisted kidney harvesting. The preferred kidney was the left one even in the presence of vascular anomalies. In the first cases we used a robotic hand–assisted technique, then the totally robotic technique, and finally the modified totally robot-assisted technique. Postoperative complications were ranked according to the five-grade Clavien-Dindo classification. Results Between November 2009 and November 2016, 98 living donors underwent nephrectomy. We experienced 14 complications. The 3 intraoperative ones (3.06%) were 1 pneumothorax and 2 acute bleedings, 1 of them requiring transfusion. The 11 postoperative complications (11.22%) were as follows: 5 wound seromas, 1 rhabdomyolisis (Clavien I), 1 paretic ileum, 1 anemia requiring transfusion, 1 hypertensive crisis (Clavien II), and 2 chylus collections drained by interventional radiologists (Clavien III). Transfusion rate was 2.1%; conversions, reoperations, and mortality were nil. No statistically significant difference was observed between the patients with complications and without in terms of gender, age, anatomical anomalies, body mass index (BMI), and learning curve. We observed a longer global operation length of time in patients with complications. Conclusion Robotic assistance results in shorter and simpler learning curves for the harvesting of kidneys from living donors. It enables an easier and more efficient management of possible intraoperative complications. The rate of postoperative complications is comparable with the rate of complications encountered in traditional laparoscopic series with high numbers of harvestings.

Published
2017

21. Robotic nephrectomy for living donation: Surgical technique and literature systematic review

Author

Vincenzo Buscemi, G. Concone, O. Rossetti, Stefano Di Sandro, Alessandro Giacomoni, Andrea Lauterio, Luciano De Carlis, Giacomoni, A, Di Sandro, S, Lauterio, A, Concone, G, Buscemi, V, Rossetti, O, and De Carlis, L

Subjects
Adult, Graft Rejection, Male, medicine.medical_specialty, Robotic Surgical Procedure, Living Donor, Adolescent, medicine.medical_treatment, Operative Time, 030232 urology & nephrology, Blood Loss, Surgical, Nephrectomy, Robotic-assisted nephrectomy, 03 medical and health sciences, Patient safety, Young Adult, 0302 clinical medicine, Robotic Surgical Procedures, medicine, Living Donors, Living donation, Humans, 030212 general & internal medicine, Laparoscopy, Survival rate, Kidney transplantation, medicine.diagnostic_test, business.industry, Graft Survival, General Medicine, Perioperative, Length of Stay, Middle Aged, medicine.disease, Kidney Transplantation, Surgery, Survival Rate, Treatment Outcome, Systematic review, Female, Patient Safety, Complication, business, Human
Abstract

Background As compared with traditional laparoscopy, robotic-assisted surgery provides better EndoWrist instruments and three-dimensional visualization of the operative field. Studies published so far indicate that living donor nephrectomy using the robot-assisted technique is safe, feasible, and provides remarkable advantages for the patients. Methods From 5 papers reporting detailed descriptions of surgical technique for robotic assisted nephrectomy (RAN) in living donor kidney transplantation, we have gathered information about the surgical techniques as well as about patients’ intra- and postoperative outcome. Data from these articles were analyzed together with the data from our own experience (33 cases) so that the total number of analyzed cases was 292. Results In the analyzed populations, no case of donor death occurred, and no case developed complication above grade 2 of Clavien score. Perioperative complications occurred in 37 of the 292 patients (12.6%). Accidental acute hemorrhage occurred in 5 of the 292 cases (1.7%). The average overall intraoperative blood loss was 67.8 mL (range 10 to 1,500). The average warm ischemia time was 3.5 minutes (range .58 to 7.6). Conversion to the open technique occurred in only 4 cases (1.3%). The average overall operative time was 192 minutes (range 60 to 400). The average length of the hospital stay was 2.7 days (range 1 to 10). Conclusions Safety and feasibility of RAN are pointed out in all the reviewed article, both as hand-assisted and as totally robotic technique. RAN appears to be significantly easier for the surgeons and the results are comparable with the ones obtained with the pure laparoscopic technique.

Published
2016

22. Current status and perspectives in split liver transplantation

Author

Riccardo De Carlis, Luciano De Carlis, Stefano Di Sandro, G. Concone, Andrea Lauterio, Alessandro Giacomoni, Lauterio, A, Di Sandro, S, Concone, G, De Carlis, R, Giacomoni, A, and De Carlis, L

Subjects
medicine.medical_specialty, genetic structures, Waiting Lists, medicine.medical_treatment, Waiting list, Tissue Donor, Economic shortage, Liver transplantation, Risk Assessment, In situ, Donor Selection, Risk Factors, Segmental liver, Medicine, Humans, Age Factor, Organ donation, Allocation policy, Topic Highlight, Intensive care medicine, Ethical issues, Graft sharing, Donor selection, business.industry, Risk Factor, Patient Selection, Whole liver, Gastroenterology, Age Factors, General Medicine, Tissue Donors, Surgery, Ex vivo, Liver Transplantation, Treatment Outcome, Liver anatomy, Organ shortage, Split liver transplantation, business, Split liver, Human
Abstract

Growing experience with the liver splitting technique and favorable results equivalent to those of whole liver transplant have led to wider application of split liver transplantation (SLT) for adult and pediatric recipients in the last decade. Conversely, SLT for two adult recipients remains a challenging surgical procedure and outcomes have yet to improve. Differences in organ shortages together with religious and ethical issues related to cadaveric organ donation have had an impact on the worldwide distribution of SLT. Despite technical refinements and a better understanding of the complex liver anatomy, SLT remains a technically and logistically demanding surgical procedure. This article reviews the surgical and clinical advances in this field of liver transplantation focusing on the role of SLT and the issues that may lead a further expansion of this complex surgical procedure.

Published
2015

23. Repeat Hepatectomy for Recurrent Colorectal Liver Metastases: Is it Worth the Challenge?

Author

Alessandro Giacomoni, Andrea Lauterio, Stefano Di Sandro, C. Cusumano, Iacopo Mangoni, Fabio Ferla, Mahmoud Ali, Valeria Rotiroti, Luciano De Carlis, G. Concone, Ali, M, Di Sandro, S, Lauterio, A, Concone, G, Mangoni, I, Ferla, F, Rotiroti, V, Cusumano, C, Giacomoni, A, and De Carlis, L

Subjects
Male, Reoperation, medicine.medical_specialty, Sh groups, Liver tumor, medicine.medical_treatment, Repeat hepatectomy, Colorectal Neoplasm, Gastroenterology, Internal medicine, medicine, Humans, Hepatectomy, Risk factor, Survival rate, Multivariate Analysi, Survival analysis, Colorectal metastase, Aged, Liver resection, business.industry, General surgery, Incidence (epidemiology), Incidence, Liver Neoplasms, Middle Aged, medicine.disease, Survival Analysis, Survival Rate, Liver Neoplasm, Multivariate Analysis, Female, Surgery, Survival Analysi, Neoplasm Recurrence, Local, Colorectal Neoplasms, business, Human
Abstract

Introduction: Repeat hepatectomy (RH) is considered a valuable option for management of recurrent colorectal liver metastases (R-CLM). Here, the outcome of RH for R-CLM was compared to that of patients who underwent single hepatectomy (SH) after subdividing the later according to re-recurrence status. Methods: Between 2001 and 2013, patients who received hepatectomy for CLM and R-CLM were included in study. Patients with non-resectable R-CLM were excluded. Results: One hundred sixteen patients were included: 86 patients in SH group and 30 patients in RH group. Repeat hepatectomy group had more synchronous CLM (76.7 versus 50 %, p = 0.011). From the 86 patients who underwent SH, 69 patients did not have R-CLM. Survival analysis was done from the time of first hepatectomy for the no R-CLM group and the time of RH for the RH group. The 3- and 5-year survival rates for the no R-CLM group were 66.4 and 48.8%, respectively, and for the RH group were 56 and 44.8% respectively (p = 0.841). Multivariate analysis showed that larger size of R-CLM is an independent risk factor for survival after RH. Conclusion: Repeat hepatectomy for R-CLM shows a comparable OS to non-recurrent CLM after single hepatectomy, despite the RH group had higher incidence of synchronous CLM.

Published
2015

24. The meaning of surgeon's comfort in robotic surgery

Author

Stefano Di Sandro, Alessandro Giacomoni, Luciano De Carlis, G. Concone, Andrea Lauterio, Giacomoni, A, Concone, G, Di Sandro, S, Lauterio, A, and DE CARLIS, L

Subjects
medicine.medical_specialty, business.industry, Medicine (all), Robotics, General Medicine, Robotic, Aesthetics, Surgical Procedures, Operative, Physical therapy, Humans, Medicine, Robotic surgery, Surgery, Meaning (existential), Artificial intelligence, Clinical Competence, Clinical competence, business, Human
Published
2014

25. Totally robotic liver resection for hepatocellular carcinoma in cirrhotic patients: safety and feasibility

Author

P. Mihaylov, Luciano De Carlis, G. Concone, Iacopo Mangoni, Andrea Lauterio, Stefano Di Sandro, Alessandro Giacomoni, Di Sandro, S, Lauterio, A, Giacomoni, A, Concone, G, Mangoni, I, Mihaylov, P, and De Carlis, L

Subjects
Liver surgery, medicine.medical_specialty, Cirrhosis, Fresh frozen plasma units, business.industry, Hepatocellular carcinoma, Tumor resection, Health Informatics, Totally robotic liver resection, medicine.disease, Gastroenterology, Resection, Surgery, Cardiac surgery, Liver cirrhosi, Liver cirrhosis, Internal medicine, medicine, business
Abstract

Although the application of robotic-assisted techniques is widespread in urology, gynecology, and in thoracic, general and cardiac surgery, few studies have assessed the feasibility and advantages of robotic-assisted surgery for liver tumors. In particular, no authors have assessed the benefits of the application of totally robotic LR (TR-LR) to the specific setting of HCC on liver cirrhosis. Between March and December 2011, 18 TR-LRs were performed at our institute. The operation was performed on account of a single nodule of HCC associated with liver cirrhosis in 10 (56 %) patients, who were included in the study. To expand the significance of study results, patients were compared to a series of ten selected totally laparoscopic LR (TL-LR) of HCC on liver cirrhosis (also performed at our institute) by case-matching analysis. Analysis of the peri-operative data disclosed significant differences in the median number of packed red blood cell units transfused (TR-LR 0.3 vs TL-LR 0.8: P value = 0.008) and of fresh frozen plasma units transfused (TR-LR 0.7 vs TL-LR 1.3: P value = 0.035). Oncological features in the two groups were similar. In our experience, at present TR-LR appears to be the major minimally invasive technique that has the best chance of reproducing the results achieved with open liver surgery. TR-LR significantly reduces the risk of bleeding and transfusion. Furthermore, and probably more importantly, the risk of non-radical tumor resection appears to be lower for TR-LR than TL-LR.

Published
2014

26. Split-liver full-left full-right: Proposal for an operative protocol

Author

F, Ferla, A, Lauterio, S, Di Sandro, I, Mangoni, C, Poli, G, Concone, C, Cusumano, A, Giacomoni, E, Andorno, L, De Carlis, L, De Carlis Luciano, Ferla, F, Lauterio, A, Di Sandro, S, Mangoni, I, Poli, C, Concone, G, Cusumano, C, Giacomoni, A, Andorno, E, and DE CARLIS, L

Subjects
Adult, Male, medicine.medical_specialty, medicine.medical_treatment, Tissue Donor, Economic shortage, Liver transplantation, law.invention, Donor Selection, law, Retrospective Studie, medicine, Humans, Age Factor, Retrospective Studies, Protocol (science), Transplantation, business.industry, Donor selection, Patient Selection, Medicine (all), Body Weight, Age Factors, Retrospective cohort study, Middle Aged, Intensive care unit, Tissue Donors, Surgery, Liver Transplantation, Italy, Split liver transplantation, Female, business, Human
Abstract

Introduction Worldwide, organ shortage is a major limiting factor to transplantations. One possible way to face graft scarcity is splitting full livers into hemilivers; this procedure would allow transplantation in 2 adult recipients with the use of a single organ from a deceased donor.Objective The goal of this study was to describe an adult-to-adult split liver operative protocol and share it between centers interested in exploring this procedure.Materials and Methods A literature review was first conducted to elaborate on the present protocol; second, selection criteria for suitable deceased donors were identified. The technical aspects of performing the procurement were also analyzed; finally, the recipient selection criteria and the transplantation criteria were determined.Results The donor characteristics should be consistent with the following: age 55 years; weight 70 kg; body mass index 28 kg/m;bsupesup intensive care unit stay 7 days; sodium level 160 mEq/L if the intensive care unit stay is 2 days; maximum transaminase value 3 times normal; hemodynamic stability; negative for hepatitis B surface antigen, hepatitis C virus, and human immunodeficiency virus; macrosteatosis ;lt macroscopic adequacy; and absence of anatomic anomalies requiring complex reconstruction. The procurement hospital should provide the preoperative computed tomography scan, liver dissector, and the intraoperative ultrasound. Indication for in situ or ex situ splitting depends on the hepatic vein outflow anatomy. Graft-to-recipient weight ratio should be 1%, and the graft-to-recipient spleen size ratio should be 0.6. United Network for Organ Sharing status 1 and 2A recipients are excluded, as are patients with transjugular intrahepatic portosystemic shunts. Hemiliver transplants are performed as in living-donor liver transplantation, and portal hyperflow is corrected by splenic artery ligation, splenectomy, and portal infusion of vasoactive drugs.Conclusions The present protocol was proposed to test the validity of the full-left full-right split liver procedure. A retrospective analysis found that 130 transplantations were suitable for this procedure according to the present protocol in the period January 1, 2008, through December 31, 2011 (65 donors). We believe that these numbers could be greatly increased once this procedure is proven feasible and safe within the proposed criteria

Published
2014

27. Hepatocellular Carcinoma Progression While on Waiting List for Liver Transplantation

Author

G. Concone, Andrea Lauterio, Luciano De Carlis, Stefano Di Sandro, Alessandro Giacomoni, Giacomoni, A, Concone, G, Di Sandro, S, Lauterio, A, and De Carlis, L

Subjects
Oncology, medicine.medical_specialty, Carcinoma, Hepatocellular, Time Factors, Time Factor, Waiting Lists, medicine.medical_treatment, Liver transplantation, Disease-Free Survival, Neoplasm Recurrence, Retrospective Studie, Risk Factors, Internal medicine, Carcinoma, Humans, Medicine, Chemoembolization, Therapeutic, Neoadjuvant therapy, Retrospective Studies, Transplantation, business.industry, Risk Factor, Liver Neoplasms, Disease progression, Retrospective cohort study, medicine.disease, Neoadjuvant Therapy, Liver Transplantation, Treatment Outcome, Liver Neoplasm, Waiting List, Waiting list, Hepatocellular carcinoma, Catheter Ablation, Disease Progression, Neoplasm Recurrence, Local, business, Human
Published
2015

28. Initial experience with robot-assisted nephrectomy for living-donor kidney transplantation: feasibility and technical notes

Author

C. Poli, S. Di Sandro, G. Concone, Iacopo Mangoni, Alessandro Giacomoni, M. Tripepi, C. Cusumano, L. De Carlis, P. Mihaylov, Andrea Lauterio, Giacomoni, A, Di Sandro, S, Lauterio, A, Mangoni, I, Mihaylov, P, Concone, G, Tripepi, M, Poli, C, Cusumano, C, and DE CARLIS, L

Subjects
Adult, Male, Living Donor, medicine.medical_specialty, medicine.medical_treatment, Living donor, Nephrectomy, Port (medical), medicine, Living Donors, Humans, Ligature, Laparoscopy, Kidney transplantation, Aged, Transplantation, medicine.diagnostic_test, Warm Ischemia Time, business.industry, technology, industry, and agriculture, Robotics, Middle Aged, medicine.disease, Kidney Transplantation, Robotic, Surgery, Feasibility Studie, body regions, surgical procedures, operative, Feasibility Studies, Female, business, human activities, Human
Abstract

Background Robot-assisted surgery provide endowrist instruments and 3-dimensional visualization of the operative field that are improvements over traditional laparoscopy. The few research studies published so far have demonstrated that living-donor nephrectomy using the robot-assisted technique is safe and feasible, providing advantages for patients. Methods Since November 2009, we performed 20 robot-assisted living-donor nephrectomies. Eight patients underwent hand-assisted robotic nephrectomy, whereas 20, totally robotic nephrectomy. Results Median intraoperative bleeding was 174 mL (range, 10-750) but no patient needed intraoperative transfusion with blood cells. The median warm ischemia time was 3.16 minutes (range, 0.30-6.5). There was no case of conversion to an open procedure. The median operative time was 311 minutes (range, 85-530); the median console time was 160 minutes (range, 135-220). Conclusion Robot-assisted living-donor kidney recovery was a safe and effective procedure. The totally robotic recovery is an evolving technique. The prospect of robotic staplers, endowrist ligature, and robotic single port may further increase these advantages. © 2013 by Elsevier Inc. All rights reserved

Published
2013

29. Living-donor liver transplantation: Donor selection criteria and postoperative outcomes. A single-center experience with a 10-year follow-up

Author

M. Tripepi, Alessandro Giacomoni, C. Poli, Iacopo Mangoni, G. Concone, P. Mihaylov, Andrea Lauterio, C. Cusumano, S. Di Sandro, L. De Carlis, Lauterio, A, Poli, C, Cusumano, C, Di Sandro, S, Tripepi, M, Mangoni, I, Mihaylov, P, Concone, G, Giacomoni, A, and DE CARLIS, L

Subjects
Adult, Male, medicine.medical_specialty, Living Donor, medicine.medical_treatment, Liver transplantation, Single Center, Follow-Up Studie, Young Adult, Median follow-up, Living Donors, medicine, Humans, Vein, Transplantation, business.industry, Donor selection, Retrospective cohort study, Middle Aged, Surgery, Liver Transplantation, medicine.anatomical_structure, Treatment Outcome, Female, Hepatectomy, business, Follow-Up Studies, Human
Abstract

Background Donor safety must be considered to be a priority in live-donor liver transplantation (LDLT). The aim of this study was to evaluate these outcomes with special attention to surgical complications and their treatment. Methods From March 2001 to March 2012, 80 live donors underwent right hepatectomy (5-8 segments). The middle hepatic vein was always left in the donor. Our retrospective study analyzed surgical outcomes and complications according to the Clavien classification modified for live donors. Results With a median follow up of 63.2 ± 12.6 months, the mortality was 0%. Two donors experienced intraoperative complications, but all of them had complete recovery there after. Among the 22 complications in 17 donors (21.2%), 7 (8.7%) were major complications (Clavien grade 2b) but only 2 donors required surgical treatment. Conclusions LDLT is a safe and feasible modality to alleviate the cadaveric donor shortage. The efficacy of this procedure is similar to that with deceased donors. © 2013 by Elsevier Inc. All rights reserved

Published
2013

30. Robotic nephrectomy for living donation: surgical technique and literature systematic review.

Author

Giacomoni A, Di Sandro S, Lauterio A, Concone G, Buscemi V, Rossetti O, and De Carlis L

Subjects
Adolescent, Adult, Blood Loss, Surgical, Female, Graft Rejection, Graft Survival, Humans, Kidney Transplantation adverse effects, Length of Stay, Male, Middle Aged, Operative Time, Survival Rate, Treatment Outcome, Young Adult, Kidney Transplantation methods, Living Donors, Nephrectomy methods, Patient Safety, Robotic Surgical Procedures methods
Abstract

Background: As compared with traditional laparoscopy, robotic-assisted surgery provides better EndoWrist instruments and three-dimensional visualization of the operative field. Studies published so far indicate that living donor nephrectomy using the robot-assisted technique is safe, feasible, and provides remarkable advantages for the patients., Methods: From 5 papers reporting detailed descriptions of surgical technique for robotic assisted nephrectomy (RAN) in living donor kidney transplantation, we have gathered information about the surgical techniques as well as about patients' intra- and postoperative outcome. Data from these articles were analyzed together with the data from our own experience (33 cases) so that the total number of analyzed cases was 292., Results: In the analyzed populations, no case of donor death occurred, and no case developed complication above grade 2 of Clavien score. Perioperative complications occurred in 37 of the 292 patients (12.6%). Accidental acute hemorrhage occurred in 5 of the 292 cases (1.7%). The average overall intraoperative blood loss was 67.8 mL (range 10 to 1,500). The average warm ischemia time was 3.5 minutes (range .58 to 7.6). Conversion to the open technique occurred in only 4 cases (1.3%). The average overall operative time was 192 minutes (range 60 to 400). The average length of the hospital stay was 2.7 days (range 1 to 10)., Conclusions: Safety and feasibility of RAN are pointed out in all the reviewed article, both as hand-assisted and as totally robotic technique. RAN appears to be significantly easier for the surgeons and the results are comparable with the ones obtained with the pure laparoscopic technique., (Copyright © 2015 Elsevier Inc. All rights reserved.)

Published
2016
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31. [Surgical overview on kidney and pancreas transplantation].

Author

Capocasale E, Berardinelli L, Beretta C, Berloco P, Boggi U, Boschiero L, Bretto P, Carmellini M, Citterio F, Concone G, De Carlis L, De Rosa P, Del Gaudio M, Di Sandro S, Di Tonno P, Faenza A, Famulari A, Giacomoni A, Giovannoni M, Iaria M, Lauterio A, Lasaponara F, Mazzoni MP, Nicita G, Orsenigo E, Parolini DC, Pietrabissa A, Pinna AD, Pisani F, Ravaioli M, Rigotti P, Romagnoli J, Rossetti O, Secchi A, Socci C, and Vistoli F

Subjects
Humans, Kidney Diseases complications, Nephrectomy methods, Pancreatectomy methods, Pancreatic Diseases complications, Patient Selection, Perioperative Care, Postoperative Complications etiology, Practice Guidelines as Topic, Tissue and Organ Harvesting, Kidney Diseases surgery, Kidney Transplantation, Pancreas Transplantation, Pancreatic Diseases surgery
Abstract

The main purpose of this paper, written by a group of Italian expert transplant surgeons, is to provide clinical support and to help through the decision-making process over pre-transplant surgical procedures in potential kidney recipients, as well as selection of pancreas transplant candidates and perioperative management of kidney recipient. Current topics such as different approaches in minimally invasive donor nephrectomy, methods of graft preservation and treatment of failed allograft were addressed.

Published
2016

32. Repeat Hepatectomy for Recurrent Colorectal Liver Metastases: Is it Worth the Challenge?

Author

Ali MA, Di Sandro S, Lauterio A, Concone G, Mangoni I, Ferla F, Rotiroti V, Cusumano C, Giacomoni A, and De Carlis L

Subjects
Aged, Female, Humans, Incidence, Liver Neoplasms mortality, Male, Middle Aged, Multivariate Analysis, Neoplasm Recurrence, Local mortality, Reoperation, Survival Analysis, Survival Rate, Colorectal Neoplasms pathology, Hepatectomy, Liver Neoplasms secondary, Liver Neoplasms surgery, Neoplasm Recurrence, Local surgery
Abstract

Introduction: Repeat hepatectomy (RH) is considered a valuable option for management of recurrent colorectal liver metastases (R-CLM). Here, the outcome of RH for R-CLM was compared to that of patients who underwent single hepatectomy (SH) after subdividing the later according to re-recurrence status., Methods: Between 2001 and 2013, patients who received hepatectomy for CLM and R-CLM were included in study. Patients with non-resectable R-CLM were excluded., Results: One hundred sixteen patients were included: 86 patients in SH group and 30 patients in RH group. Repeat hepatectomy group had more synchronous CLM (76.7 versus 50 %, p = 0.011). From the 86 patients who underwent SH, 69 patients did not have R-CLM. Survival analysis was done from the time of first hepatectomy for the no R-CLM group and the time of RH for the RH group. The 3- and 5-year survival rates for the no R-CLM group were 66.4 and 48.8%, respectively, and for the RH group were 56 and 44.8% respectively (p = 0.841). Multivariate analysis showed that larger size of R-CLM is an independent risk factor for survival after RH., Conclusion: Repeat hepatectomy for R-CLM shows a comparable OS to non-recurrent CLM after single hepatectomy, despite the RH group had higher incidence of synchronous CLM.

Published
2015
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33. Current status and perspectives in split liver transplantation.

Author

Lauterio A, Di Sandro S, Concone G, De Carlis R, Giacomoni A, and De Carlis L

Subjects
Age Factors, Donor Selection, Humans, Liver Transplantation adverse effects, Patient Selection, Risk Assessment, Risk Factors, Treatment Outcome, Waiting Lists, Liver Transplantation methods, Tissue Donors supply & distribution
Abstract

Growing experience with the liver splitting technique and favorable results equivalent to those of whole liver transplant have led to wider application of split liver transplantation (SLT) for adult and pediatric recipients in the last decade. Conversely, SLT for two adult recipients remains a challenging surgical procedure and outcomes have yet to improve. Differences in organ shortages together with religious and ethical issues related to cadaveric organ donation have had an impact on the worldwide distribution of SLT. Despite technical refinements and a better understanding of the complex liver anatomy, SLT remains a technically and logistically demanding surgical procedure. This article reviews the surgical and clinical advances in this field of liver transplantation focusing on the role of SLT and the issues that may lead a further expansion of this complex surgical procedure.

Published
2015
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34. Hepatocellular Carcinoma Progression While on Waiting List for Liver Transplantation.

Author

Giacomoni A, Concone G, Di Sandro S, Lauterio A, and De Carlis L

Subjects
Carcinoma, Hepatocellular mortality, Carcinoma, Hepatocellular surgery, Disease Progression, Disease-Free Survival, Humans, Liver Neoplasms mortality, Liver Neoplasms surgery, Neoplasm Recurrence, Local, Retrospective Studies, Risk Factors, Time Factors, Treatment Outcome, Carcinoma, Hepatocellular pathology, Carcinoma, Hepatocellular therapy, Catheter Ablation adverse effects, Catheter Ablation mortality, Chemoembolization, Therapeutic adverse effects, Chemoembolization, Therapeutic mortality, Liver Neoplasms pathology, Liver Neoplasms therapy, Liver Transplantation adverse effects, Liver Transplantation mortality, Neoadjuvant Therapy adverse effects, Neoadjuvant Therapy mortality, Waiting Lists
Published
2015
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35. Survival after Liver Transplant: Influence of Progression of Disease and of Restoration of the "Milan" Criteria in Patients with Hepato-cellular Carcinoma undergoing Down-staging Procedures.

Author

Giacomoni A, Di Sandro S, Donadon M, Lauterio A, Belli L, Mangoni I, Mihaylov P, Concone G, and De Carlis L

Subjects
Adult, Aged, Carcinoma, Hepatocellular pathology, Cohort Studies, Disease Progression, Disease-Free Survival, Female, Humans, Liver Neoplasms pathology, Male, Middle Aged, Neoplasm Staging, Retrospective Studies, Survival Rate, Treatment Outcome, Waiting Lists, Carcinoma, Hepatocellular surgery, Liver Neoplasms surgery, Liver Transplantation, Patient Selection
Abstract

Background/aims: Selection of patients with hepa- to-cellular carcinoma for liver transplantation is gen- erally performed according to the so-called Milan cri- teria. The aim of this study was to learn whether, after down-staging loco-regional therapies, patients origi- nally non-fulfilling the MC (Milan-OUT) meet these criteria (Milan-IN)., Methodology: Between January 2000 and December 2008, 172 patients with HCC re- ceived LT at our Department. Of these, 142 were sub- jected to DS before LT., Results: Of the 142 patients who received DS, 115 (81%) were Milan-IN and 27 (19%) were Milan-OUT at the time of their enrollment in the waiting list for LT. After a median follow-up of 50 months, overall 1-, 3-, and 5-year survival and dis- ease recurrence-free survival were not significantly different., Conclusions: Patients with Milan-OUT HCC can be successfully subjected to LT when they fulfill the MC after being subjected to DS. Imaging progres- sion while on the waiting list is a strong predictor of high rates of HCC recurrence even in patients meet- ing the MC. Lack of imaging progression seems to be a strong predictor of positive LT outcome and should be added to the eligibility criteria for the assessment of LT candidates with HCC.

Published
2015

37. Evolution of robotic nephrectomy for living donation: from hand-assisted to totally robotic technique.

Author

Giacomoni A, Di Sandro S, Lauterio A, Concone G, Mangoni I, Mihaylov P, Tripepi M, and De Carlis L

Subjects
Adult, Aged, Female, Humans, Intraoperative Complications, Ischemia, Living Donors, Male, Middle Aged, Operative Time, Postoperative Period, Tissue and Organ Harvesting, Kidney Transplantation methods, Laparoscopy methods, Nephrectomy methods, Robotic Surgical Procedures
Abstract

Background: The application of robotic-assisted surgery offers EndoWrist instruments and 3-D visualization of the operative field, which are improvements over traditional laparoscopy. The results of the few studies published so far have shown that living donor nephrectomy using the robot-assisted technique is safe, feasible, and offers advantages to patients., Materials and Methods: Since November 2009, 16 patients have undergone robotic-assisted living donor nephrectomy at our Institute. Patients were divided into two groups according to the surgical technique adopted for the procedure: Group A, hand-assisted robotic nephrectomy (eight patients); Group B, totally robotic nephrectomy (eight patients)., Results: Intra-operative bleeding was similar in the two groups (90 vs 100 mL for Group A and B, respectively). Median warm ischemia time was significantly shorter in Group A (2.3 vs 5.1 min for Group A and B, respectively, P-value = 0.05). Switching to the open procedure was never required. Median operative time was not significantly longer in Group A than Group B (275 min vs 250 min, respectively)., Conclusion: Robotic assisted living kidney recovery is a safe and effective procedure. Considering the overall technical, clinical, and feasibility aspects of living kidney donation, we believe that the robotic assisted technique is the method of choice for surgeon's comfort and donors' safety., (Copyright © 2014 John Wiley & Sons, Ltd.)

Published
2014
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