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22. Preoperative Treatment of focally advanced esophageal carcinoma (Review)

Author

Orditura M., Galizia G., Fabozzi A., Lieto E., Gambardella V., Morgillo F., Del Genio G. M., Fei L., Di Martino N., Ciardiello F., De Vita F., RENDA, ANDREA, Orditura, M., Galizia, G., Fabozzi, A., Lieto, E., Gambardella, V., Morgillo, F., Del Genio, G. M., Fei, L., Di Martino, N., Renda, Andrea, Ciardiello, F., and De Vita, F.

Abstract

Esophageal cancer (EC) is an aggressive malignancy with increasing incidence worldwide. Surgery is still the most effective treatment, however, both the high rate of local and distant recurrences and surgery-related complications led us to investigate new preoperative strategies. In this review, we discuss the role of neoadjuvant therapy for locally advanced EC with a focus on preoperative chemoradiation (trimodality treatment). Furthermore, the last fifteen years of published literature and our experience have been also reviewed. In the preoperative setting, few trials have reported a significant benefit with fluoropyrimidine and platinum compound-based neoadjuvant chemotherapy, compared to surgery alone. A large number of phase III trials and meta-analyses have demonstrated improved outcomes with preoperative chemoradiation vs. neoadjuvant chemotherapy or surgery alone. Therefore, trimodality therapy can be considered the most effective option in the management of locally advanced EC. Addition of drugs targeting VEGF or HER2 to standard chemotherapy appears to be feasible but needs to be explored more accurately. FDG-PET may predict both response to neoadjuvant treatments and prognosis

Published
2013

23. Lapascopic total fundoplication for refractary GERD: haw to achieve otimal long term outcomes by preoperative instrumental assesment and a standardized tecnique. GASTROESOPHAGEAL REFLUX DISEASE

Author

LIMONGELLI, Paolo, TOLONE, SALVATORE, DEL GENIO, Gianmattia, DOCIMO, Giovanni, RUGGIERO, Roberto, D'ALESSANDRO A., ROSSETTI G., BRUSCIANO G., GILI S., TOPATINO A., AMOROSO V., CASALINO G., BOSCO A., DOCIMO L. DEL GENIO G., Limongelli, Paolo, Tolone, Salvatore, DEL GENIO, Gianmattia, D'Alessandro, A., Rossetti, G., Brusciano, G., Docimo, Giovanni, Ruggiero, Roberto, Gili, S., Topatino, A., Amoroso, V., Casalino, G., Bosco, A., and Docimo, L. DEL GENIO G.

Published
2012

25. [Laparoscopic total fundoplication is not an obstacle to oesophageal emptying after oesophago-gastric myotomy for the surgical treatment of achalasia]

Author

Pizza F, Rossetti G, Del Genio G, Maffettone V, Napolitano V, Allaria A, Brusciano L, Montesarchio L, Salvatore Tolone, Di Martino M, Fs, Lucido, Barra L, Giugliano S, D'Alessandro A, Del Genio F, Nl, Pizza, Del Genio A, Pizza, F, Rossetti, G, Del Genio, G, Maffettone, V, Napolitano, V, Allaria, A, Brusciano, L, Montesarchio, L, Tolone, S, Di Martino, M, Lucido, F. S., Barra, L, Giugliano, S, D'Alessandro, A, Del Genio, F, Pizza, N. L., and Del Genio, A

Subjects
Adult, Male, Time Factors, Adolescent, Manometry, Fundoplication, Length of Stay, Middle Aged, Esophageal Achalasia, Treatment Outcome, Gastroesophageal Reflux, Humans, Female, Laparoscopy, Child, Deglutition Disorders, Aged, Follow-Up Studies
Abstract

There are different surgical possibilities for the treatment of oesophageal achalasia ranging from a short extramucosal oesophagomyotomy to an extended esophago-gastric myotomy combined with a partial fundoplication to restore the main antireflux barrier. A total 360 degrees fundoplication is generally regarded as an obstacle to oesophageal emptying. The aim of this study was to evaluate the role and efficacy of total 360 degrees laparoscopic Nissen-Rossetti fundoplication after oesophago gastric myotomy in the treatment of oesophageal achalasia. From 1992 to January 2008, a total of 245 patients (112 males, 133 females), mean age 45.1 years (range: 12-79), were submitted to laparoscopic Nissen-Rossetti fundoplication after a Heller myotomy with endoscopic and manometric intraoperative monitoring. In 3 patients (1.2%), conversion to laparotomy was necessary. Mean operative time was 60 +/- 15 minutes. No mortality was observed. The overall morbidity rate was 1.6%. The mean postoperative hospital stay was 3.5 +/- 1.0 days (range: 1-12 days). A mean clinical follow-up of 100.2 +/- 7 months (range: 3-177) was possible for 228 patients (93.1%), and an excellent or good outcome was observed in 209 patients (91.7%) (DeMeester dysphagia score 0-1). No improvement in dysphagia was observed in 5 (2.2%) patients. Pathological gastro-oesophageal reflux was absent in all patients. Laparoscopic Nissen-Rossetti fundoplication after a Heller myotomy is a safe, effective treatment for oesophageal achalasia with excellent results in terms of dysphagia resolution, affording total protection from the onset of gastrooesophageal reflux.

Published
2009

26. THE PROXIMAL MIGRATION OF RFLUX IS RESPONSIBLE OF RESPIRATORY SYMPTOMS IN PATIENTS WITH GASTRO:ESOPHAGEAL REFLUX DISEASE: ASSESSMENT WITH MULTICHANNEL INTRALUMINAL IMPEDANCE (MII)

Author

Del Genio g., Rossetti G., Brusciano L., Pizza f., TOLONE, SALVATORE, Russo F., Di Martino M., Picarella P., Lucido F., Barra L., Giugliano S., D’Alessandro A., Montesarchio L., Napolitano V., ALLARIA, Alfredo, Del Genio A., MAFFETTONE, Vincenzo, Del Genio, G., Rossetti, G., Brusciano, L., Pizza, F., Tolone, Salvatore, Russo, F., Di Martino, M., Picarella, P., Lucido, F., Barra, L., Giugliano, S., D’Alessandro, A., Montesarchio, L., Maffettone, Vincenzo, Napolitano, V., Allaria, Alfredo, and Del Genio, A.

Published
2008

28. COMBINED MII-pH IS USEFUL IN SELECTING PATIENTS FOR LAPAROSCOPIC FUNDOPLICATION

Author

TOLONE, SALVATORE, Del Genio G., Rossetti G., Brusciano L., Russo F., Pizza F., Sagnelli C., NAPOLITANO, Vincenzo, Lucido F., Del Genio A., MAFFETTONE, Vincenzo, Tolone, Salvatore, Del Genio, G., Rossetti, G., Brusciano, L., Russo, F., Pizza, F., Sagnelli, C., Maffettone, Vincenzo, Napolitano, Vincenzo, Lucido, F., and Del Genio, A.

Published
2008

29. The proximal migration of reflux is responsible of respiratory symptoms in patients with gastroesophageal reflux disease: assessment with multichannel intraluminal impedance

Author

Del Genio G, TOLONE, SALVATORE, Rossetti G, Brusciano L, Pizza F, Russo F, Di Martino M, MAFFETTONE, Vincenzo, NAPOLITANO, Vincenzo, Del Genio A., Del Genio, G, Tolone, Salvatore, Rossetti, G, Brusciano, L, Pizza, F, Russo, F, Di Martino, M, Maffettone, Vincenzo, Napolitano, Vincenzo, and Del Genio, A.

Published
2008

30. ELECTRICAL STIMULATION AS A CONSERVATIVE TREATMENT FOR PATHOLOGIC DUODENO_GASTRIC REFLUX (DGR) ASSOCIATED TO DELAYED GASTRI EMPTYING: INITIAL EXPERIENCE

Author

Del Genio G., Rossetti G., Brusciano L., Pizza F., TOLONE, SALVATORE, Russo F., Di Martino M., Picarella P., Lucido F., Barra L., Giugliano S., D’Alessandro A., Montesarchio L., Napolitano V., ALLARIA, Alfredo, Del Genio A., MAFFETTONE, Vincenzo, Del Genio, G., Rossetti, G., Brusciano, L., Pizza, F., Tolone, Salvatore, Russo, F., Di Martino, M., Picarella, P., Lucido, F., Barra, L., Giugliano, S., D’Alessandro, A., Montesarchio, L., Maffettone, Vincenzo, Napolitano, V., Allaria, Alfredo, and Del Genio, A.

Published
2008

32. CAN COMBINED MII-pH BECOME A USEFUL GOAL FOR SURGEON IN SELECTING PATIENTS FOR LAPAROSCOPIC FUNDOPLICATION?

Author

Del Genio G., Rossetti G., Brusciano L., Pizza F., TOLONE, SALVATORE, Russo F., Di Martino M., Picarella P., Lucido F., Barra L., Giugliano S., D’Alessandro A., Montesarchio L., Napolitano V., ALLARIA, Alfredo, Del Genio A., MAFFETTONE, Vincenzo, Del Genio, G., Rossetti, G., Brusciano, L., Pizza, F., Tolone, Salvatore, Russo, F., Di Martino, M., Picarella, P., Lucido, F., Barra, L., Giugliano, S., D’Alessandro, A., Montesarchio, L., Maffettone, Vincenzo, Napolitano, V., Allaria, Alfredo, and Del Genio, A.

Published
2008

33. DOES THE INEFFECTIVE MOTILITY EFFECT THE CLINICAL OUTCOME OF TOTAL FUNDOPLICATION. INITIAL STUDY WITH COMBINED MULTICHANNEL INTRALUMINAL IMPEDANCE AND ESOPHAGEAL MANOMETRY

Author

Del Genio G., Rossetti G., Brusciano L., Pizza F., TOLONE, SALVATORE, Russo F., Di Martino M., Picarella P., Lucido F., Barra L., Giugliano S., D’Alessandro A., Montesarchio L., Napolitano V., ALLARIA, Alfredo, Del Genio A., MAFFETTONE, Vincenzo, Del Genio, G., Rossetti, G., Brusciano, L., Pizza, F., Tolone, Salvatore, Russo, F., Di Martino, M., Picarella, P., Lucido, F., Barra, L., Giugliano, S., D’Alessandro, A., Montesarchio, L., Maffettone, Vincenzo, Napolitano, V., Allaria, Alfredo, and Del Genio, A.

Published
2008

35. BILARY LITHIASIS IN PATIENTS WITH GASTRO-ESOPHAGEAL REFLUX (ACID AND ALKALINE)

Author

Del Genio A., Rossetti G., NAPOLITANO, Vincenzo, Del Genio G., Brusciano L., Pizza F., Di Martino M., TOLONE, SALVATORE, MAFFETTONE, Vincenzo, Spinger-Verlag Italia Ed, Del Genio, A., Rossetti, G., Maffettone, Vincenzo, Napolitano, Vincenzo, Del Genio, G., Brusciano, L., Pizza, F., Di Martino, M., and Tolone, Salvatore

Published
2008

36. THE PROXIMAL MIGRATION OF REFLUX IS RESPONSIBLE OF RESPIRATORY SYMPTOMS IN PATIENTS WITH GASTRO-ESOPHAGEAL REFLUX DISEASE: ASSESSMENT WITH MULTICHANNEL INTRALUMINAL IMPEDANCE (MII)

Author

Del Genio G., TOLONE, SALVATORE, NAPOLITANO, Vincenzo, Rossetti G., Brusciano L., Pizza F., Russo F., Di Martino M., Del Genio A., MAFFETTONE, Vincenzo, Del Genio, G., Tolone, Salvatore, Maffettone, Vincenzo, Napolitano, Vincenzo, Rossetti, G., Brusciano, L., Pizza, F., Russo, F., Di Martino, M., and Del Genio, A.

Published
2008

37. TOTAL FUNDOPLICATION IS EFFECTIVE IN CONTROLLING EXTRAESOPHAGEAL SYMPTOMS RESISTANT TO MEDICAL THERAPY: THREE CONSECUTIVE PATIENTS WITH COMBINED MII-pH BEFORE AND AFTER SURGERY

Author

TOLONE, SALVATORE, Del Genio G., Rossetti G., Brusciano L., Russo F., Pizza F., Sagnelli C., MAFFETTONE, Vincenzo, Napolitano V., Lucido F., Del Genio A., Tolone, Salvatore, Del Genio, G., Rossetti, G., Brusciano, L., Russo, F., Pizza, F., Sagnelli, C., Maffettone, Vincenzo, Napolitano, V., Lucido, F., and Del Genio, A.

Published
2008

39. ESOFAGECTOMIA

Author

Del Genio A., Rossetti G., Brusciano L., Del Genio G., Russo G., MAFFETTONE, Vincenzo, Elsevier Masson Editor, Del Genio, A., Rossetti, G., Maffettone, Vincenzo, Brusciano, L., Del Genio, G., and Russo, G.

Published
2007

40. RISULTATI A LUNGO TERMINE DELLA TERAPIA CHIRURGICA DEL CARCINOMA GASTRICO

Author

TOLONE, SALVATORE, MAFFETTONE, Vincenzo, Napolitano V., Rossetti G., Del Genio G., Brusciano L., Russo G., IZZO, Giuseppe, Pizza F., Del Genio A., Tolone, Salvatore, Maffettone, Vincenzo, Napolitano, V., Rossetti, G., Del Genio, G., Brusciano, L., Russo, G., Izzo, Giuseppe, Pizza, F., and Del Genio, A.

Published
2007

41. LA FUNDOPLICATIO TOTALE COME GOLD STANDARD NELLA RISOLUZIONE DEI SINTOMI EXTRAESOFAGEI RESISTENTI A TERAPIA MEDICA? STUDIO INIZIALE CON PH-IMPEDENZIOMETRIA INTRALUMINALE MULTICANALE PRE E POST-OPERATORIO

Author

TOLONE, SALVATORE, Del Genio G., Rossetti G., NAPOLITANO, Vincenzo, Brusciano L., Barra L., Lucido F., Del Genio A., MAFFETTONE, Vincenzo, Tolone, Salvatore, Del Genio, G., Rossetti, G., Maffettone, Vincenzo, Napolitano, Vincenzo, Brusciano, L., Barra, L., Lucido, F., and Del Genio, A.

Published
2007

44. LA FUNDOPLICATIO SEC. NISSEN-ROSSETTI LAPAROSCOPICA E’ EFFICACE NEL CONTRASTARE IL REFLUSSO GASTRO-ESOFAGEO E FARINGEO, IDENTIFICATP ALLA pH-IMPEDENZIOMETRIA ESOFAGEA DELLE 24 ORE (MII-pH)

Author

Del Genio G., Amato G., ALLARIA, Alfredo, TOLONE, SALVATORE, Russo G., LIMONGELLI, Paolo, Sagnelli C., Guadagni I., Lucido F., Del Genio A., MAFFETTONE, Vincenzo, Del Genio, G., Amato, G., Maffettone, Vincenzo, Allaria, Alfredo, Tolone, Salvatore, Russo, G., Limongelli, Paolo, Sagnelli, C., Guadagni, I., Lucido, F., and Del Genio, A.

Published
2007

47. HELLER MYOTOMY AND NISSEN-ROSSETTI FUNDOPLICATIO IN THE TREATMENT OF ESOPHAGEAL ACHALASIA

Author

MAFFETTONE, Vincenzo, Izzo D., Amato G., NAPOLITANO, Vincenzo, ALLARIA, Alfredo, Rossetti G., Brusciano L., Del Genio G., Russo G., LIMONGELLI, Paolo, Del Genio A., Maffettone, Vincenzo, Izzo, D., Amato, G., Napolitano, Vincenzo, Allaria, Alfredo, Rossetti, G., Brusciano, L., Del Genio, G., Russo, G., Limongelli, Paolo, and Del Genio, A.

Published
2006

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