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2. Effect of centre volume on pathological outcomes and postoperative complications after surgery for colorectal cancer: results of a multicentre national study

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Rottoli, M, Spinelli, A, Pellino, G, Gori, A, Calini, G, Flacco, M, Manzoli, L, Poggioli, G, Romano, A, Belvedere, A, Lanci, A, Parlanti, D, Vago, G, Pezzuto, A, Canavese, A, Dajti, G, Cardelli, S, Catalioto, C, Russo, I, Violante, T, Morezzi, D, Maurino, L, Filippone, E, Cuicchi, D, Bernante, P, Jovine, E, Lombardi, R, Masetti, M, Cipressi, C, Offi, M, Larotonda, C, Puglisi, S, Barbosa, A, Vaiana, R, Bianchi, P, Tonti, C, Codignola, C, Zorcolo, L, Restivo, A, Deidda, S, Marchetti, M, Ippolito, L, Spolverato, G, Pucciarelli, S, Marchegiani, F, Ghio, G, Zagolin, G, Glavas, D, Tomassi, M, Rosati, R, Elmore, U, Gozzini, L, Calef, R, Puccetti, F, Cossu, A, Vignali, A, Morino, M, Allaix, M, Cannata, G, Lombardi, E, Ammirati, C, Piceni, C, Buccianti, P, Balestri, R, Puccini, M, Pezzati, D, D'Ischia, R, Asta, V, Sargenti, B, Taddei, G, Bonari, F, Boni, G, Ferrero, A, Mineccia, M, Gonella, F, Palisi, M, Danese, F, Cherubini, V, Perotti, S, Carvello, M, Carbone, F, Luberto, A, Calafiore, E, De Lucia, F, Sacchi, M, Sasia, D, Giuffrida, M, Ballauri, E, Cardile, M, Armentano, S, Beltrami, E, Preve, G, Vercellone, B, Mozzon, M, Folliero, C, Lirusso, C, Vecchiato, M, Ziccarelli, A, Gattesco, D, Moretti, L, Crestale, S, Banchini, F, Capelli, P, Romboli, A, Palmieri, G, Conti, L, Rizzi, N, Bonfili, D, De Manzini, N, Germani, P, Osenda, E, Cortinovis, S, Giunta, C, Fracon, S, Abdallah, H, Bogoni, S, Portolani, N, Nascimbeni, R, Molfino, S, Tiberio, G, Garosio, I, Lamperti, G, Rigosa, D, Ercolani, G, Solaini, L, Cavaliere, D, Avanzolini, A, D'Acapito, F, Chiarella, L, Di Pietrantonio, D, Annunziata, D, Piccolo, R, Sorrentino, M, Pansini, M, Cojutti, A, Graziano, M, Callegari, F, Balzarotti, L, Dameno, V, Cattaneo, A, Santolamazza, G, Altieri, C, Magarini, R, Pietrabissa, A, Dominioni, T, Pugliese, L, Peri, A, Botti, M, Salvetti, F, Boni, L, Cassinotti, E, Baldari, L, Messina, V, D'Abrosca, V, Cianci, P, Tumolo, R, Gattulli, D, Restini, E, Minafra, M, Sederino, M, Bottalico, B, Pilati, P, Franzato, B, Mattara, G, De Simoni, O, Barina, A, Tonello, M, Muratore, A, Calabro, M, Federico Pipitone, N, Cuzzola, B, Van Nood, E, Passuello, N, Frasson, A, Mammano, E, Faccio, L, Vittadello, F, Bressan, A, Sarzo, G, Tamini, N, Oldani, M, Cigagna, L, Carissimi, F, De Carlo, G, Baccalini, E, Nespoli, L, Giordano, A, Cantafio, S, Grifoni, L, Matani, D, Livi, S, Delogu, D, Scognamillo, F, Marrosu, A, Guerrini, L, Ugolini, G, Ghignone, F, Frascaroli, G, Albertini, N, Zattoni, D, Taffurelli, G, Montroni, I, Colombo, F, Danelli, P, Bondurri, A, Maffioli, A, Bonomi, A, Pezzoli, I, Cammarata, F, Goletti, O, Molteni, M, Assisi, A, Quartierini, G, Da Lio, C, Verdi, D, Mondi, I, Peluso, C, Macchi, L, Tanzanu, M, Zanzi, F, Pellegrini, S, Andreuccetti, J, D'Alessio, R, Pignata, G, De Capua, M, Canfora, I, Ottaviani, L, Lepiane, P, Balla, A, De Carlo, A, Saraceno, F, Scaramuzzo, R, Guida, A, Aguzzi, D, Bellora, P, Gentilli, S, Monni, M, Nikaj, H, Cillara, N, Cannavera, A, Deserra, A, Margiani, C, Cabula, R, Dettori, M, Gramignano, G, Lezoche, G, Ortenzi, M, Orlandoni, E, Curzi, F, Vitali, F, Capomagi, P, Palmieri, M, Del Rio, P, Bonati, E, Loderer, T, Cozzani, F, Rossini, M, Agnesi, S, Capolupo, G, Caricato, M, Carannante, F, Masciana, G, Marrelli, M, Miacci, V, Lauricella, S, Tonini, V, Cervellera, M, Pisconti, S, Lozito, C, Shahu, J, Mongelli, C, Morelli, G, Sartarelli, L, Sica, G, Siragusa, L, Bagaglini, G, Franceschilli, M, Bellato, V, Fiorani, C, Taddei, A, Risaliti, M, Bartolini, I, Ringressi, M, Tirloni, L, Laface, L, Abate, E, Casati, M, Gobbi, P, Opocher, E, Mariani, N, Ceretti, A, Giovenzana, M, Giuliani, B, Sironi, M, Grossi, U, Zanus, G, Santoro, G, Brizzolari, M, De Leo, E, Novello, S, Aquilino, K, Milardi, F, Olmi, S, Uccelli, M, Bonaldi, M, Cesana, G, Bindi, M, Galleano, R, Langone, A, Botto, M, Franceschi, A, Gambino, E, Ronconi, M, Casiraghi, S, Casole, G, Ciulla, S, Terrosu, G, Calandra, S, Scarpa, E, Cherchi, V, Martinuzzo, L, Clocchiatti, L, Muschitiello, D, Romanzi, A, Vignati, B, Vannelli, A, Scolaro, R, Milanesi, M, Rossi, F, Canonico, G, Anastasi, A, Nelli, T, Barlettai, M, Fratarcangeli, R, Di Martino, C, Damigella, A, Adinolfi, E, Birindelli, A, Taglietti, L, Dester, S, Fleres, F, Cucinotta, E, Viscosi, F, Biondo, S, Badessi, G, Catarsini, N, Mazzeo, C, Rega, D, Delrio, P, Cervone, C, Aversano, A, De Franciscis, S, Di Marzo, M, Marra, B, Pace, U, Amato, A, Batistotti, P, Mina, E, Serventi, A, Lapolla, P, Mingoli, A, Sapienza, P, Brachini, G, Cirillo, B, Fiori, E, Crocetti, D, Clementi, I, Martines, G, Picciariello, A, Tomasicchio, G, Dibra, R, Trigiante, G, Rinaldi, M, Lantone, G, Porcu, A, Perra, T, Scanu, A, Feo, C, Fancellu, A, Cossu, M, Ginesu, G, Patriti, A, Coletta, D, Petrelli, F, Greco, P, Spadoni, C, Cassiani, G, Bianchini, F, Arganini, M, Bianchini, M, Perotti, B, Palmeri, M, Scabini, S, Deiana, S, Carganico, G, Pertile, D, Soriero, D, Fioravanti, E, Sperotto, B, Nardo, B, Paglione, D, Crocco, V, Doni, M, Osso, M, Perri, R, Sampietro, G, Corbellini, C, Lorusso, L, Manzo, C, Cigognini, M, Baldi, C, Palomba, G, Aprea, G, Capuano, M, Basile, R, Tutino, R, Massani, M, Marinelli, L, Canitano, N, Pilia, T, Podda, M, Pisanu, A, Murzi, V, Incani, S, Frongia, F, Esposito, G, Luglio, G, Tropeano, F, Pagano, G, Spina, E, De Simone, G, Cricri, M, Catena, F, Vallicelli, C, Zanini, N, Ronconi, D, Favi, F, Mazzucchelli, C, Convertini, G, Vincenti, L, Andriola, V, Bizzoca, C, Fabbri, N, Fazzin, M, Pesce, A, Gennari, S, Torchiaro, M, Severi, S, Frontali, A, Bracchetti, G, Granieri, S, Cotsoglou, C, Carlini, M, Lisi, G, Spoletini, D, Mastrangeli, M, Campanelli, M, Manigrasso, M, Milone, M, De Palma, G, Vertaldi, S, Chini, A, Maione, F, Marello, A, Selvaggi, F, Sciaudone, G, Selvaggi, L, Tasselli, F, Fuschillo, G, Oddis, L, Grande, S, Grande, M, Ascanelli, S, Chimisso, L, Aisoni, F, Rossin, E, Pepe, F, Marchetti, F, Picardi, B, Rossi, S, Del Monte, S, Picarelli, M, Muttillo, I, Ratto, C, Marra, A, Parello, A, Litta, F, Campenni, P, De Simone, V, Pata, F, Riboni, C, Rausa, E, Celentano, V, Rottoli M., Spinelli A., Pellino G., Gori A., Calini G., Flacco M. E., Manzoli L., Poggioli G., Romano A., Belvedere A., Lanci A. L., Parlanti D., Vago G., Pezzuto A. P., Canavese A., Dajti G., Cardelli S., Catalioto C., Russo I. S., Violante T., Morezzi D., Maurino L., Filippone E., Cuicchi D., Bernante P., Jovine E., Lombardi R., Masetti M., Cipressi C., Offi M. F., Larotonda C., Puglisi S. B., Barbosa A., Vaiana R., Bianchi P. M., Tonti C., Codignola C., Zorcolo L., Restivo A., Deidda S., Marchetti M. E., Ippolito L., Spolverato G., Pucciarelli S., Marchegiani F., Ghio G., Zagolin G., Glavas D., Tomassi M., Rosati R., Elmore U., Gozzini L., Calef R., Puccetti F., Cossu A., Vignali A., Morino M., Allaix M. E., Cannata G., Lombardi E., Ammirati C. A., Piceni C., Buccianti P., Balestri R., Puccini M., Pezzati D., D'Ischia R., Asta V. F., Sargenti B., Taddei G., Bonari F., Boni G., Ferrero A., Mineccia M., Gonella F., Palisi M., Danese F., Cherubini V., Perotti S., Carvello M., Carbone F., Luberto A., Calafiore E., De Lucia F., Sacchi M., Sasia D., Giuffrida M. C., Ballauri E., Cardile M., Armentano S., Beltrami E., Preve G., Vercellone B., Mozzon M., Folliero C., Lirusso C., Vecchiato M., Ziccarelli A., Gattesco D., Moretti L., Crestale S., Banchini F., Capelli P., Romboli A., Palmieri G., Conti L., Rizzi N., Bonfili D., De Manzini N., Germani P., Osenda E., Cortinovis S., Giunta C., Fracon S., Abdallah H., Bogoni S., Portolani N., Nascimbeni R., Molfino S., Tiberio G. A. M., Garosio I., Lamperti G., Rigosa D., Ercolani G., Solaini L., Cavaliere D., Avanzolini A., D'Acapito F., Chiarella L. L., Di Pietrantonio D., Annunziata D., Piccolo R., Sorrentino M., Pansini M., Cojutti A., Graziano M., Callegari F., Balzarotti L., Dameno V. R., Cattaneo A., Santolamazza G., Altieri C., Magarini R., Pietrabissa A., Dominioni T., Pugliese L., Peri A., Botti M., Salvetti F., Boni L., Cassinotti E., Baldari L., Messina V., D'Abrosca V., Cianci P., Tumolo R., Gattulli D., Restini E., Minafra M., Sederino M. G., Bottalico B., Pilati P., Franzato B., Mattara G., De Simoni O., Barina A., Tonello M., Muratore A., Calabro M., Federico Pipitone N. S., Cuzzola B., Van Nood E. H., Passuello N., Frasson A., Mammano E., Faccio L., Vittadello F., Bressan A., Sarzo G., Tamini N., Oldani M., Cigagna L., Carissimi F., De Carlo G., Baccalini E., Nespoli L., Giordano A., Cantafio S., Grifoni L., Matani D., Livi S., Delogu D., Scognamillo F., Marrosu A., Guerrini L., Ugolini G., Ghignone F., Frascaroli G., Albertini N., Zattoni D., Taffurelli G., Montroni I., Colombo F., Danelli P., Bondurri A., Maffioli A., Bonomi A., Pezzoli I., Cammarata F., Goletti O., Molteni M., Assisi A., Quartierini G., Da Lio C., Verdi D., Mondi I., Peluso C., MacChi L., Tanzanu M., Zanzi F., Pellegrini S., Andreuccetti J., D'Alessio R., Pignata G., De Capua M., Canfora I., Ottaviani L., Lepiane P., Balla A., De Carlo A., Saraceno F., Scaramuzzo R., Guida A., Aguzzi D., Bellora P., Gentilli S., Monni M., Nikaj H., Cillara N., Cannavera A., Deserra A., Margiani C., Cabula R., Dettori M., Gramignano G., Lezoche G., Ortenzi M., Orlandoni E. S., Curzi F., Vitali F., Capomagi P., Palmieri M., Giuffrida M., Del Rio P., Bonati E., Loderer T., Cozzani F., Rossini M., Agnesi S., Capolupo G. T., Caricato M., Carannante F., Masciana G., Marrelli M., Miacci V., Lauricella S., Tonini V., Cervellera M., Pisconti S., Lozito C., Shahu J., Mongelli C., Morelli G., Sartarelli L., Sica G. S., Siragusa L., Bagaglini G., Guida A. M., Franceschilli M., Bellato V., Fiorani C., Taddei A., Risaliti M., Bartolini I., Ringressi M. N., Tirloni L., Laface L., Abate E., Casati M., Gobbi P., Opocher E., Mariani N. M., Ceretti A. P., Giovenzana M., Giuliani B., Sironi M., Grossi U., Zanus G., Santoro G. A., Brizzolari M., De Leo E., Novello S., Aquilino K., Milardi F., Olmi S., Uccelli M., Bonaldi M., Cesana G. C., Bindi M., Galleano R., Langone A., Botto M., Franceschi A., Gambino E., Ronconi M., Casiraghi S., Casole G., Ciulla S. L., Terrosu G., Calandra S., Scarpa E., Cherchi V., Martinuzzo L., Clocchiatti L., Muschitiello D., Romanzi A., Vignati B., Vannelli A., Scolaro R., Milanesi M., Rossi F., Canonico G., Anastasi A., Nelli T., Barlettai M., Fratarcangeli R., Di Martino C., Damigella A., Adinolfi E., Birindelli A., Taglietti L., Dester S. E., Fleres F., Cucinotta E., Viscosi F., Biondo S. A., Badessi G., Catarsini N., Mazzeo C., Rega D., Delrio P., Cervone C., Aversano A., De Franciscis S., Di Marzo M., Marra B., Pace U., Amato A., Batistotti P., Mina E., Serventi A., Lapolla P., Mingoli A., Sapienza P., Brachini G., Cirillo B., Fiori E., Crocetti D., Clementi I., Martines G., Picciariello A., Tomasicchio G., Dibra R., Trigiante G., Rinaldi M., Lantone G., Porcu A., Perra T., Scanu A. M., Feo C. F., Fancellu A., Cossu M. L., Ginesu G. C., Patriti A., Coletta D., Petrelli F., Greco P. A., Spadoni C., Cassiani G., Bianchini F., Arganini M., Bianchini M., Perotti B., Palmeri M., Scabini S., Deiana S., Carganico G., Pertile D., Soriero D., Fioravanti E., Sperotto B., Nardo B., Paglione D., Crocco V., Doni M., Osso M., Perri R., Sampietro G. M., Corbellini C., Lorusso L., Manzo C. A., Cigognini M., Baldi C., Palomba G., Aprea G., Capuano M., Basile R., Tutino R., Massani M., Marinelli L., Canitano N., Pilia T., Podda M., Pisanu A., Murzi V., Incani S., Frongia F., Esposito G., Luglio G., Tropeano F. P., Pagano G., Spina E., De Simone G., Cricri M., Catena F., Vallicelli C., Zanini N., Ronconi D., Favi F., Mazzucchelli C., Convertini G., Vincenti L., Andriola V., Bizzoca C., Feo C. V., Fabbri N., Fazzin M., Pesce A., Gennari S., Torchiaro M., Severi S., Frontali A., Bracchetti G., Granieri S., Cotsoglou C., Carlini M., Lisi G., Spoletini D., Mastrangeli M. R., Campanelli M., Manigrasso M., Milone M., De Palma G. D., Vertaldi S., Chini A., Maione F., Marello A., Selvaggi F., Sciaudone G., Selvaggi L., Tasselli F. M., Fuschillo G., Oddis L., Grande S., Grande M., Ascanelli S., Chimisso L., Aisoni F., Rossin E., Pepe F., Marchetti F., Picardi B., Rossi S., Del Monte S. R., Picarelli M., Muttillo I. A., Ratto C., Marra A. A., Parello A., Litta F., Campenni P., De Simone V., Pata F., Riboni C., Rausa E., Celentano V., Rottoli, M, Spinelli, A, Pellino, G, Gori, A, Calini, G, Flacco, M, Manzoli, L, Poggioli, G, Romano, A, Belvedere, A, Lanci, A, Parlanti, D, Vago, G, Pezzuto, A, Canavese, A, Dajti, G, Cardelli, S, Catalioto, C, Russo, I, Violante, T, Morezzi, D, Maurino, L, Filippone, E, Cuicchi, D, Bernante, P, Jovine, E, Lombardi, R, Masetti, M, Cipressi, C, Offi, M, Larotonda, C, Puglisi, S, Barbosa, A, Vaiana, R, Bianchi, P, Tonti, C, Codignola, C, Zorcolo, L, Restivo, A, Deidda, S, Marchetti, M, Ippolito, L, Spolverato, G, Pucciarelli, S, Marchegiani, F, Ghio, G, Zagolin, G, Glavas, D, Tomassi, M, Rosati, R, Elmore, U, Gozzini, L, Calef, R, Puccetti, F, Cossu, A, Vignali, A, Morino, M, Allaix, M, Cannata, G, Lombardi, E, Ammirati, C, Piceni, C, Buccianti, P, Balestri, R, Puccini, M, Pezzati, D, D'Ischia, R, Asta, V, Sargenti, B, Taddei, G, Bonari, F, Boni, G, Ferrero, A, Mineccia, M, Gonella, F, Palisi, M, Danese, F, Cherubini, V, Perotti, S, Carvello, M, Carbone, F, Luberto, A, Calafiore, E, De Lucia, F, Sacchi, M, Sasia, D, Giuffrida, M, Ballauri, E, Cardile, M, Armentano, S, Beltrami, E, Preve, G, Vercellone, B, Mozzon, M, Folliero, C, Lirusso, C, Vecchiato, M, Ziccarelli, A, Gattesco, D, Moretti, L, Crestale, S, Banchini, F, Capelli, P, Romboli, A, Palmieri, G, Conti, L, Rizzi, N, Bonfili, D, De Manzini, N, Germani, P, Osenda, E, Cortinovis, S, Giunta, C, Fracon, S, Abdallah, H, Bogoni, S, Portolani, N, Nascimbeni, R, Molfino, S, Tiberio, G, Garosio, I, Lamperti, G, Rigosa, D, Ercolani, G, Solaini, L, Cavaliere, D, Avanzolini, A, D'Acapito, F, Chiarella, L, Di Pietrantonio, D, Annunziata, D, Piccolo, R, Sorrentino, M, Pansini, M, Cojutti, A, Graziano, M, Callegari, F, Balzarotti, L, Dameno, V, Cattaneo, A, Santolamazza, G, Altieri, C, Magarini, R, Pietrabissa, A, Dominioni, T, Pugliese, L, Peri, A, Botti, M, Salvetti, F, Boni, L, Cassinotti, E, Baldari, L, Messina, V, D'Abrosca, V, Cianci, P, Tumolo, R, Gattulli, D, Restini, E, Minafra, M, Sederino, M, Bottalico, B, Pilati, P, Franzato, B, Mattara, G, De Simoni, O, Barina, A, Tonello, M, Muratore, A, Calabro, M, Federico Pipitone, N, Cuzzola, B, Van Nood, E, Passuello, N, Frasson, A, Mammano, E, Faccio, L, Vittadello, F, Bressan, A, Sarzo, G, Tamini, N, Oldani, M, Cigagna, L, Carissimi, F, De Carlo, G, Baccalini, E, Nespoli, L, Giordano, A, Cantafio, S, Grifoni, L, Matani, D, Livi, S, Delogu, D, Scognamillo, F, Marrosu, A, Guerrini, L, Ugolini, G, Ghignone, F, Frascaroli, G, Albertini, N, Zattoni, D, Taffurelli, G, Montroni, I, Colombo, F, Danelli, P, Bondurri, A, Maffioli, A, Bonomi, A, Pezzoli, I, Cammarata, F, Goletti, O, Molteni, M, Assisi, A, Quartierini, G, Da Lio, C, Verdi, D, Mondi, I, Peluso, C, Macchi, L, Tanzanu, M, Zanzi, F, Pellegrini, S, Andreuccetti, J, D'Alessio, R, Pignata, G, De Capua, M, Canfora, I, Ottaviani, L, Lepiane, P, Balla, A, De Carlo, A, Saraceno, F, Scaramuzzo, R, Guida, A, Aguzzi, D, Bellora, P, Gentilli, S, Monni, M, Nikaj, H, Cillara, N, Cannavera, A, Deserra, A, Margiani, C, Cabula, R, Dettori, M, Gramignano, G, Lezoche, G, Ortenzi, M, Orlandoni, E, Curzi, F, Vitali, F, Capomagi, P, Palmieri, M, Del Rio, P, Bonati, E, Loderer, T, Cozzani, F, Rossini, M, Agnesi, S, Capolupo, G, Caricato, M, Carannante, F, Masciana, G, Marrelli, M, Miacci, V, Lauricella, S, Tonini, V, Cervellera, M, Pisconti, S, Lozito, C, Shahu, J, Mongelli, C, Morelli, G, Sartarelli, L, Sica, G, Siragusa, L, Bagaglini, G, Franceschilli, M, Bellato, V, Fiorani, C, Taddei, A, Risaliti, M, Bartolini, I, Ringressi, M, Tirloni, L, Laface, L, Abate, E, Casati, M, Gobbi, P, Opocher, E, Mariani, N, Ceretti, A, Giovenzana, M, Giuliani, B, Sironi, M, Grossi, U, Zanus, G, Santoro, G, Brizzolari, M, De Leo, E, Novello, S, Aquilino, K, Milardi, F, Olmi, S, Uccelli, M, Bonaldi, M, Cesana, G, Bindi, M, Galleano, R, Langone, A, Botto, M, Franceschi, A, Gambino, E, Ronconi, M, Casiraghi, S, Casole, G, Ciulla, S, Terrosu, G, Calandra, S, Scarpa, E, Cherchi, V, Martinuzzo, L, Clocchiatti, L, Muschitiello, D, Romanzi, A, Vignati, B, Vannelli, A, Scolaro, R, Milanesi, M, Rossi, F, Canonico, G, Anastasi, A, Nelli, T, Barlettai, M, Fratarcangeli, R, Di Martino, C, Damigella, A, Adinolfi, E, Birindelli, A, Taglietti, L, Dester, S, Fleres, F, Cucinotta, E, Viscosi, F, Biondo, S, Badessi, G, Catarsini, N, Mazzeo, C, Rega, D, Delrio, P, Cervone, C, Aversano, A, De Franciscis, S, Di Marzo, M, Marra, B, Pace, U, Amato, A, Batistotti, P, Mina, E, Serventi, A, Lapolla, P, Mingoli, A, Sapienza, P, Brachini, G, Cirillo, B, Fiori, E, Crocetti, D, Clementi, I, Martines, G, Picciariello, A, Tomasicchio, G, Dibra, R, Trigiante, G, Rinaldi, M, Lantone, G, Porcu, A, Perra, T, Scanu, A, Feo, C, Fancellu, A, Cossu, M, Ginesu, G, Patriti, A, Coletta, D, Petrelli, F, Greco, P, Spadoni, C, Cassiani, G, Bianchini, F, Arganini, M, Bianchini, M, Perotti, B, Palmeri, M, Scabini, S, Deiana, S, Carganico, G, Pertile, D, Soriero, D, Fioravanti, E, Sperotto, B, Nardo, B, Paglione, D, Crocco, V, Doni, M, Osso, M, Perri, R, Sampietro, G, Corbellini, C, Lorusso, L, Manzo, C, Cigognini, M, Baldi, C, Palomba, G, Aprea, G, Capuano, M, Basile, R, Tutino, R, Massani, M, Marinelli, L, Canitano, N, Pilia, T, Podda, M, Pisanu, A, Murzi, V, Incani, S, Frongia, F, Esposito, G, Luglio, G, Tropeano, F, Pagano, G, Spina, E, De Simone, G, Cricri, M, Catena, F, Vallicelli, C, Zanini, N, Ronconi, D, Favi, F, Mazzucchelli, C, Convertini, G, Vincenti, L, Andriola, V, Bizzoca, C, Fabbri, N, Fazzin, M, Pesce, A, Gennari, S, Torchiaro, M, Severi, S, Frontali, A, Bracchetti, G, Granieri, S, Cotsoglou, C, Carlini, M, Lisi, G, Spoletini, D, Mastrangeli, M, Campanelli, M, Manigrasso, M, Milone, M, De Palma, G, Vertaldi, S, Chini, A, Maione, F, Marello, A, Selvaggi, F, Sciaudone, G, Selvaggi, L, Tasselli, F, Fuschillo, G, Oddis, L, Grande, S, Grande, M, Ascanelli, S, Chimisso, L, Aisoni, F, Rossin, E, Pepe, F, Marchetti, F, Picardi, B, Rossi, S, Del Monte, S, Picarelli, M, Muttillo, I, Ratto, C, Marra, A, Parello, A, Litta, F, Campenni, P, De Simone, V, Pata, F, Riboni, C, Rausa, E, Celentano, V, Rottoli M., Spinelli A., Pellino G., Gori A., Calini G., Flacco M. E., Manzoli L., Poggioli G., Romano A., Belvedere A., Lanci A. L., Parlanti D., Vago G., Pezzuto A. P., Canavese A., Dajti G., Cardelli S., Catalioto C., Russo I. S., Violante T., Morezzi D., Maurino L., Filippone E., Cuicchi D., Bernante P., Jovine E., Lombardi R., Masetti M., Cipressi C., Offi M. F., Larotonda C., Puglisi S. B., Barbosa A., Vaiana R., Bianchi P. M., Tonti C., Codignola C., Zorcolo L., Restivo A., Deidda S., Marchetti M. E., Ippolito L., Spolverato G., Pucciarelli S., Marchegiani F., Ghio G., Zagolin G., Glavas D., Tomassi M., Rosati R., Elmore U., Gozzini L., Calef R., Puccetti F., Cossu A., Vignali A., Morino M., Allaix M. E., Cannata G., Lombardi E., Ammirati C. A., Piceni C., Buccianti P., Balestri R., Puccini M., Pezzati D., D'Ischia R., Asta V. F., Sargenti B., Taddei G., Bonari F., Boni G., Ferrero A., Mineccia M., Gonella F., Palisi M., Danese F., Cherubini V., Perotti S., Carvello M., Carbone F., Luberto A., Calafiore E., De Lucia F., Sacchi M., Sasia D., Giuffrida M. C., Ballauri E., Cardile M., Armentano S., Beltrami E., Preve G., Vercellone B., Mozzon M., Folliero C., Lirusso C., Vecchiato M., Ziccarelli A., Gattesco D., Moretti L., Crestale S., Banchini F., Capelli P., Romboli A., Palmieri G., Conti L., Rizzi N., Bonfili D., De Manzini N., Germani P., Osenda E., Cortinovis S., Giunta C., Fracon S., Abdallah H., Bogoni S., Portolani N., Nascimbeni R., Molfino S., Tiberio G. A. M., Garosio I., Lamperti G., Rigosa D., Ercolani G., Solaini L., Cavaliere D., Avanzolini A., D'Acapito F., Chiarella L. L., Di Pietrantonio D., Annunziata D., Piccolo R., Sorrentino M., Pansini M., Cojutti A., Graziano M., Callegari F., Balzarotti L., Dameno V. R., Cattaneo A., Santolamazza G., Altieri C., Magarini R., Pietrabissa A., Dominioni T., Pugliese L., Peri A., Botti M., Salvetti F., Boni L., Cassinotti E., Baldari L., Messina V., D'Abrosca V., Cianci P., Tumolo R., Gattulli D., Restini E., Minafra M., Sederino M. G., Bottalico B., Pilati P., Franzato B., Mattara G., De Simoni O., Barina A., Tonello M., Muratore A., Calabro M., Federico Pipitone N. S., Cuzzola B., Van Nood E. H., Passuello N., Frasson A., Mammano E., Faccio L., Vittadello F., Bressan A., Sarzo G., Tamini N., Oldani M., Cigagna L., Carissimi F., De Carlo G., Baccalini E., Nespoli L., Giordano A., Cantafio S., Grifoni L., Matani D., Livi S., Delogu D., Scognamillo F., Marrosu A., Guerrini L., Ugolini G., Ghignone F., Frascaroli G., Albertini N., Zattoni D., Taffurelli G., Montroni I., Colombo F., Danelli P., Bondurri A., Maffioli A., Bonomi A., Pezzoli I., Cammarata F., Goletti O., Molteni M., Assisi A., Quartierini G., Da Lio C., Verdi D., Mondi I., Peluso C., MacChi L., Tanzanu M., Zanzi F., Pellegrini S., Andreuccetti J., D'Alessio R., Pignata G., De Capua M., Canfora I., Ottaviani L., Lepiane P., Balla A., De Carlo A., Saraceno F., Scaramuzzo R., Guida A., Aguzzi D., Bellora P., Gentilli S., Monni M., Nikaj H., Cillara N., Cannavera A., Deserra A., Margiani C., Cabula R., Dettori M., Gramignano G., Lezoche G., Ortenzi M., Orlandoni E. S., Curzi F., Vitali F., Capomagi P., Palmieri M., Giuffrida M., Del Rio P., Bonati E., Loderer T., Cozzani F., Rossini M., Agnesi S., Capolupo G. T., Caricato M., Carannante F., Masciana G., Marrelli M., Miacci V., Lauricella S., Tonini V., Cervellera M., Pisconti S., Lozito C., Shahu J., Mongelli C., Morelli G., Sartarelli L., Sica G. S., Siragusa L., Bagaglini G., Guida A. M., Franceschilli M., Bellato V., Fiorani C., Taddei A., Risaliti M., Bartolini I., Ringressi M. N., Tirloni L., Laface L., Abate E., Casati M., Gobbi P., Opocher E., Mariani N. M., Ceretti A. P., Giovenzana M., Giuliani B., Sironi M., Grossi U., Zanus G., Santoro G. A., Brizzolari M., De Leo E., Novello S., Aquilino K., Milardi F., Olmi S., Uccelli M., Bonaldi M., Cesana G. C., Bindi M., Galleano R., Langone A., Botto M., Franceschi A., Gambino E., Ronconi M., Casiraghi S., Casole G., Ciulla S. L., Terrosu G., Calandra S., Scarpa E., Cherchi V., Martinuzzo L., Clocchiatti L., Muschitiello D., Romanzi A., Vignati B., Vannelli A., Scolaro R., Milanesi M., Rossi F., Canonico G., Anastasi A., Nelli T., Barlettai M., Fratarcangeli R., Di Martino C., Damigella A., Adinolfi E., Birindelli A., Taglietti L., Dester S. E., Fleres F., Cucinotta E., Viscosi F., Biondo S. A., Badessi G., Catarsini N., Mazzeo C., Rega D., Delrio P., Cervone C., Aversano A., De Franciscis S., Di Marzo M., Marra B., Pace U., Amato A., Batistotti P., Mina E., Serventi A., Lapolla P., Mingoli A., Sapienza P., Brachini G., Cirillo B., Fiori E., Crocetti D., Clementi I., Martines G., Picciariello A., Tomasicchio G., Dibra R., Trigiante G., Rinaldi M., Lantone G., Porcu A., Perra T., Scanu A. M., Feo C. F., Fancellu A., Cossu M. L., Ginesu G. C., Patriti A., Coletta D., Petrelli F., Greco P. A., Spadoni C., Cassiani G., Bianchini F., Arganini M., Bianchini M., Perotti B., Palmeri M., Scabini S., Deiana S., Carganico G., Pertile D., Soriero D., Fioravanti E., Sperotto B., Nardo B., Paglione D., Crocco V., Doni M., Osso M., Perri R., Sampietro G. M., Corbellini C., Lorusso L., Manzo C. A., Cigognini M., Baldi C., Palomba G., Aprea G., Capuano M., Basile R., Tutino R., Massani M., Marinelli L., Canitano N., Pilia T., Podda M., Pisanu A., Murzi V., Incani S., Frongia F., Esposito G., Luglio G., Tropeano F. P., Pagano G., Spina E., De Simone G., Cricri M., Catena F., Vallicelli C., Zanini N., Ronconi D., Favi F., Mazzucchelli C., Convertini G., Vincenti L., Andriola V., Bizzoca C., Feo C. V., Fabbri N., Fazzin M., Pesce A., Gennari S., Torchiaro M., Severi S., Frontali A., Bracchetti G., Granieri S., Cotsoglou C., Carlini M., Lisi G., Spoletini D., Mastrangeli M. R., Campanelli M., Manigrasso M., Milone M., De Palma G. D., Vertaldi S., Chini A., Maione F., Marello A., Selvaggi F., Sciaudone G., Selvaggi L., Tasselli F. M., Fuschillo G., Oddis L., Grande S., Grande M., Ascanelli S., Chimisso L., Aisoni F., Rossin E., Pepe F., Marchetti F., Picardi B., Rossi S., Del Monte S. R., Picarelli M., Muttillo I. A., Ratto C., Marra A. A., Parello A., Litta F., Campenni P., De Simone V., Pata F., Riboni C., Rausa E., and Celentano V.

Abstract

Background: The association between volume, complications and pathological outcomes is still under debate regarding colorectal cancer surgery. The aim of the study was to assess the association between centre volume and severe complications, mortality, less-than-radical oncologic surgery, and indications for neoadjuvant therapy. Methods: Retrospective analysis of 16,883 colorectal cancer cases from 80 centres (2018-2021). Outcomes: 30-day mortality; Clavien-Dindo grade >2 complications; removal of ≥ 12 lymph nodes; non-radical resection; neoadjuvant therapy. Quartiles of hospital volumes were classified as LOW, MEDIUM, HIGH, and VERY HIGH. Independent predictors, both overall and for rectal cancer, were evaluated using logistic regression including age, gender, AJCC stage and cancer site. Results: LOW-volume centres reported a higher rate of severe postoperative complications (OR 1.50, 95% c.i. 1.15-1.096, P = 0.003). The rate of ≥ 12 lymph nodes removed in LOW-volume (OR 0.68, 95% c.i. 0.56-0.85, P < 0.001) and MEDIUM-volume (OR 0.72, 95% c.i. 0.62-0.83, P < 0.001) centres was lower than in VERY HIGH-volume centres. Of the 4676 rectal cancer patients, the rate of ≥ 12 lymph nodes removed was lower in LOW-volume than in VERY HIGH-volume centres (OR 0.57, 95% c.i. 0.41-0.80, P = 0.001). A lower rate of neoadjuvant chemoradiation was associated with HIGH (OR 0.66, 95% c.i. 0.56-0.77, P < 0.001), MEDIUM (OR 0.75, 95% c.i. 0.60-0.92, P = 0.006), and LOW (OR 0.70, 95% c.i. 0.52-0.94, P = 0.019) volume centres (vs. VERY HIGH). Conclusion: Colorectal cancer surgery in low-volume centres is at higher risk of suboptimal management, poor postoperative outcomes, and less-than-adequate oncologic resections. Centralisation of rectal cancer cases should be taken into consideration to optimise the outcomes.

Published
2024

4. Use of critical care resources during the first 2 weeks (February 24–March 8, 2020) of the Covid-19 outbreak in Italy

Author

Tonetti T., Grasselli G., Zanella A., Pizzilli G., Fumagalli R., Piva S., Lorini L., Iotti G., Foti G., Colombo S., Vivona L., Rossi S., Girardis M., Agnoletti V., Campagna A., Gordini G., Navalesi P., Boscolo A., Graziano A., Valeri I., Vianello A., Cereda D., Filippini C., Cecconi M., Locatelli F., Bartoletti M., Giannella M., Viale P., Antonelli M., Nava S., Pesenti A., Ranieri V. M., Albano G., Alborghetti A., Aldegheri G., Antonini B., Belgiorno N., Bellani G., Beretta E., Bonazzi S., Borelli M., Cabrini L., Carnevale L., Carnevale S., Castelli G., Catena E., Chiumello D., Coluccello A., Coppini D., Covello D., DeFilippi G., DeiPoli M., Dughi P., Gallioli G., Gnesin P., Greco S., Guatteri L., Guzzon D., Keim R., Landoni G., Langer T., Lombardo A., Marino G., Merli G., Merlo D., Mojoli F., Muttini S., Natalini G., Petrucci N., Pezzi A., Radrizzani D., Raimondi M., Riccio M., Storti E., Tavola M., Vitale G., Bosco E., Calo M. A., Danzi V., DeRosa S., Farnia A., Lazzari F., Meggiolaro M., Munari M., Saia M., Sella N., Serra E., Tiberio I., Baiocchi M., Benedetto M., Bordini M., Caramelli F., Cilloni N., DellaGiovampaola M., Fanelli A., Frascaroli G., Fusari M., Maitan S., Martino C., Melotti R. M., Merola R., Minardi F., Moro F., Nardi G., Nolli M., Pierucci E., Potalivo A., Repetti F., Salsi P., Terzitta M., Tosi M., Venturi S., Volta C. A., Zani G., Zanoni A (COVID-19 Northern Italian ICU Network), Landoni G, Tonetti, Tommaso, Grasselli, Giacomo, Zanella, Alberto, Pizzilli, Giacinto, Fumagalli, Roberto, Piva, Simone, Lorini, Luca, Iotti, Giorgio, Foti, Giuseppe, Colombo, Sergio, Vivona, Luigi, Rossi, Sandra, Girardis, Massimo, Agnoletti, Vanni, Campagna, Anselmo, Gordini, Giovanni, Navalesi, Paolo, Boscolo, Annalisa, Graziano, Alessandro, Valeri, Ilaria, Vianello, Andrea, Cereda, Danilo, Filippini, Claudia, Cecconi, Maurizio, Locatelli, Franco, Bartoletti, Michele, Giannella, Maddalena, Viale, Pierluigi, Antonelli, Massimo, Nava, Stefano, Pesenti, Antonio, Ranieri, V Marco, Tonetti, T, Grasselli, G, Zanella, A, Pizzilli, G, Fumagalli, R, Piva, S, Lorini, L, Iotti, G, Foti, G, Colombo, S, Vivona, L, Rossi, S, Girardis, M, Agnoletti, V, Campagna, A, Gordini, G, Navalesi, P, Boscolo, A, Graziano, A, Valeri, I, Vianello, A, Cereda, D, Filippini, C, Cecconi, M, Locatelli, F, Bartoletti, M, Giannella, M, Viale, P, Antonelli, M, Nava, S, Pesenti, A, Ranieri, V, Langer, T, Tonetti, T., Grasselli, G., Zanella, A., Pizzilli, G., Fumagalli, R., Piva, S., Lorini, L., Iotti, G., Foti, G., Colombo, S., Vivona, L., Rossi, S., Girardis, M., Agnoletti, V., Campagna, A., Gordini, G., Navalesi, P., Boscolo, A., Graziano, A., Valeri, I., Vianello, A., Cereda, D., Filippini, C., Cecconi, M., Locatelli, F., Bartoletti, M., Giannella, M., Viale, P., Antonelli, M., Nava, S., Pesenti, A., Ranieri, V. M., Albano, G., Alborghetti, A., Aldegheri, G., Antonini, B., Belgiorno, N., Bellani, G., Beretta, E., Bonazzi, S., Borelli, M., Cabrini, L., Carnevale, L., Carnevale, S., Castelli, G., Catena, E., Chiumello, D., Coluccello, A., Coppini, D., Covello, D., Defilippi, G., Deipoli, M., Dughi, P., Gallioli, G., Gnesin, P., Greco, S., Guatteri, L., Guzzon, D., Keim, R., Landoni, G., Langer, T., Lombardo, A., Marino, G., Merli, G., Merlo, D., Mojoli, F., Muttini, S., Natalini, G., Petrucci, N., Pezzi, A., Radrizzani, D., Raimondi, M., Riccio, M., Storti, E., Tavola, M., Vitale, G., Bosco, E., Calo, M. A., Danzi, V., Derosa, S., Farnia, A., Lazzari, F., Meggiolaro, M., Munari, M., Saia, M., Sella, N., Serra, E., Tiberio, I., Baiocchi, M., Benedetto, M., Bordini, M., Caramelli, F., Cilloni, N., Dellagiovampaola, M., Fanelli, A., Frascaroli, G., Fusari, M., Maitan, S., Martino, C., Melotti, R. M., Merola, R., Minardi, F., Moro, F., Nardi, G., Nolli, M., Pierucci, E., Potalivo, A., Repetti, F., Salsi, P., Terzitta, M., Tosi, M., Venturi, S., Volta, C. A., Zani, G., Zanoni, A (COVID-19 Northern Italian ICU Network), and Landoni, G

Subjects
medicine.medical_specialty, Coronavirus disease 2019 (COVID-19), Respiratory rate, Socio-culturale, Critical Care and Intensive Care Medicine, Acute respiratory failure, acute respiratory failure, COVID-19, ICU, non-invasive ventilation, rationing, 03 medical and health sciences, 0302 clinical medicine, Anesthesiology, Intensive care, Retrospective analysis, Medicine, 030212 general & internal medicine, Non-invasive ventilation, Rationing, Case report form, business.industry, Research, lcsh:Medical emergencies. Critical care. Intensive care. First aid, Outbreak, lcsh:RC86-88.9, Settore MED/38 - PEDIATRIA GENERALE E SPECIALISTICA, 030228 respiratory system, Emergency medicine, Base excess, business
Abstract

Background A Covid-19 outbreak developed in Lombardy, Veneto and Emilia-Romagna (Italy) at the end of February 2020. Fear of an imminent saturation of available ICU beds generated the notion that rationing of intensive care resources could have been necessary. Results In order to evaluate the impact of Covid-19 on the ICU capacity to manage critically ill patients, we performed a retrospective analysis of the first 2 weeks of the outbreak (February 24–March 8). Data were collected from regional registries and from a case report form sent to participating sites. ICU beds increased from 1545 to 1989 (28.7%), and patients receiving respiratory support outside the ICU increased from 4 (0.6%) to 260 (37.0%). Patients receiving respiratory support outside the ICU were significantly older [65 vs. 77 years], had more cerebrovascular (5.8 vs. 13.1%) and renal (5.3 vs. 10.0%) comorbidities and less obesity (31.4 vs. 15.5%) than patients admitted to the ICU. PaO2/FiO2 ratio, respiratory rate and arterial pH were higher [165 vs. 244; 20 vs. 24 breath/min; 7.40 vs. 7.46] and PaCO2 and base excess were lower [34 vs. 42 mmHg; 0.60 vs. 1.30] in patients receiving respiratory support outside the ICU than in patients admitted to the ICU, respectively. Conclusions Increase in ICU beds and use of out-of-ICU respiratory support allowed effective management of the first 14 days of the Covid-19 outbreak, avoiding resource rationing.

Published
2020
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5. Correction to: Portal Vein Embolization is Associated with Reduced Liver Failure and Mortality in High-Risk Resections for Perihilar Cholangiocarcinoma (Annals of Surgical Oncology, (2020), 10.1245/s10434-020-08258-3)

Author

Olthof P. B., Aldrighetti L., Alikhanov R., Cescon M., Groot Koerkamp B., Jarnagin W. R., Nadalin S., Pratschke J., Schmelzle M., Sparrelid E., Lang H., Guglielmi A., van Gulik T. M., Andreou A., Bartsch F., Benzing C., Buettner S., Capobianco I., de Reuver P., de Savornin Lohman E., Dejong C. H. C., Efanov M., Erdmann J. I., Franken L. C., Frascaroli G., Giglio M. C., Gomez-Gavara C., Heid F., IJzermans J. N. M., Jansson H., Ligthart M. A. P., Maithel S. K., Malago M., Malik H. Z., Muiesan P., Olde Damink S. W. M., Pando E., Quinn L. M., Ratti F., Roberts K. J., Rolinger J., Ruzzenente A., Schadde E., Serenari M., Sultana A., Troisi R., van Laarhoven S., van Vugt J. L. A., Olthof, P. B., Aldrighetti, L., Alikhanov, R., Cescon, M., Groot Koerkamp, B., Jarnagin, W. R., Nadalin, S., Pratschke, J., Schmelzle, M., Sparrelid, E., Lang, H., Guglielmi, A., van Gulik, T. M., Andreou, A., Bartsch, F., Benzing, C., Buettner, S., Capobianco, I., de Reuver, P., de Savornin Lohman, E., Dejong, C. H. C., Efanov, M., Erdmann, J. I., Franken, L. C., Frascaroli, G., Giglio, M. C., Gomez-Gavara, C., Heid, F., Ijzermans, J. N. M., Jansson, H., Ligthart, M. A. P., Maithel, S. K., Malago, M., Malik, H. Z., Muiesan, P., Olde Damink, S. W. M., Pando, E., Quinn, L. M., Ratti, F., Roberts, K. J., Rolinger, J., Ruzzenente, A., Schadde, E., Serenari, M., Sultana, A., Troisi, R., van Laarhoven, S., and van Vugt, J. L. A.

Abstract

In the original article Moritz Schmelzle’s last name is spelled wrong. It is correct as reflected here.

Published
2020

6. Portal Vein Embolization is Associated with Reduced Liver Failure and Mortality in High-Risk Resections for Perihilar Cholangiocarcinoma

Author

Olthof, P. B., Aldrighetti, L., Alikhanov, R., Cescon, M., Groot Koerkamp, B., Jarnagin, W. R., Nadalin, S., Pratschke, J., Schmelze, M., Sparrelid, E., Lang, H., Guglielmi, A., van Gulik, T. M., Andreou, A., Bartsch, F., Benzing, C., Buettner, S., Capobianco, I., de Reuver, P., de Savornin Lohman, E., Dejong, C. H. C., Efanov, M., Erdmann, J. I., Franken, L. C., Frascaroli, G., Giglio, M. C., Gomez-Gavara, C., Heid, F., IJzermans, J. N. M., Jansson, H., Ligthart, M. A. P., Maithel, S. K., Malago, M., Malik, H. Z., Muiesan, P., Olde Damink, S. W. M., Pando, E., Quinn, L. M., Ratti, F., Roberts, K. J., Rolinger, J., Ruzzenente, A., Schadde, E., Serenari, M., Sultana, A., Troisi, R., van Laarhoven, S., van Vugt, J. L. A., Surgery, Academic Medical Center, AGEM - Amsterdam Gastroenterology Endocrinology Metabolism, Olthof, P. B., Aldrighetti, L., Alikhanov, R., Cescon, M., Groot Koerkamp, B., Jarnagin, W. R., Nadalin, S., Pratschke, J., Schmelze, M., Sparrelid, E., Lang, H., Guglielmi, A., van Gulik, T. M., Andreou, A., Bartsch, F., Benzing, C., Buettner, S., Capobianco, I., de Reuver, P., de Savornin Lohman, E., Dejong, C. H. C., Efanov, M., Erdmann, J. I., Franken, L. C., Frascaroli, G., Giglio, M. C., Gomez-Gavara, C., Heid, F., Ijzermans, J. N. M., Jansson, H., Ligthart, M. A. P., Maithel, S. K., Malago, M., Malik, H. Z., Muiesan, P., Olde Damink, S. W. M., Pando, E., Quinn, L. M., Ratti, F., Roberts, K. J., Rolinger, J., Ruzzenente, A., Schadde, E., Serenari, M., Sultana, A., Troisi, R., van Laarhoven, S., and van Vugt, J. L. A.

Subjects
Male, medicine.medical_specialty, medicine.medical_treatment, education, 030230 surgery, Preoperative care, Tumours of the digestive tract Radboud Institute for Health Sciences [Radboudumc 14], 03 medical and health sciences, 0302 clinical medicine, Retrospective Studie, Preoperative Care, medicine, Hepatectomy, Humans, Embolization, Abscess, Bile Duct Neoplasm, Aged, Retrospective Studies, portal vein embolization, portal vein embolisation, Perihilar cholangiocarcinoma, Portal Vein, business.industry, Incidence (epidemiology), Liver Neoplasms, Correction, Retrospective cohort study, Middle Aged, Jaundice, medicine.disease, Embolization, Therapeutic, Surgery, Bile Duct Neoplasms, Oncology, Liver Neoplasm, Hepatobiliary Tumors, 030220 oncology & carcinogenesis, Propensity score matching, Cohort, medicine.symptom, business, Liver Failure, Human, Klatskin Tumor
Abstract

Background Preoperative portal vein embolization (PVE) is frequently used to improve future liver remnant volume (FLRV) and to reduce the risk of liver failure after major liver resection. Objective This paper aimed to assess postoperative outcomes after PVE and resection for suspected perihilar cholangiocarcinoma (PHC) in an international, multicentric cohort. Methods Patients undergoing resection for suspected PHC across 20 centers worldwide, from the year 2000, were included. Liver failure, biliary leakage, and hemorrhage were classified according to the respective International Study Group of Liver Surgery criteria. Using propensity scoring, two equal cohorts were generated using matching parameters, i.e. age, sex, American Society of Anesthesiologists classification, jaundice, type of biliary drainage, baseline FLRV, resection type, and portal vein resection. Results A total of 1667 patients were treated for suspected PHC during the study period. In 298 patients who underwent preoperative PVE, the overall incidence of liver failure and 90-day mortality was 27% and 18%, respectively, as opposed to 14% and 12%, respectively, in patients without PVE (p p = 0.005). After propensity score matching, 98 patients were enrolled in each cohort, resulting in similar baseline and operative characteristics. Liver failure was lower in the PVE group (8% vs. 36%, p p p = 0.01), and 90-day mortality (7% vs. 18%, p = 0.03). Conclusion PVE before major liver resection for PHC is associated with a lower incidence of liver failure, biliary leakage, abscess formation, and mortality. These results demonstrate the importance of PVE as an integral component in the surgical treatment of PHC.

Published
2020

7. Correction to: Portal Vein Embolization is Associated with Reduced Liver Failure and Mortality in High-Risk Resections for Perihilar Cholangiocarcinoma (Annals of Surgical Oncology, (2020), 10.1245/s10434-020-08258-3)

Author

Olthof, P.B. (Pim B.), Aldrighetti, L.A. (L.), Alikhanov, R. (Ruslan), Cescon, M. (Matteo), Groot Koerkamp, B. (Bas), Jarnagin, W.R. (William R.), Nadalin, S. (S.), Pratschke, J. (Johann), Schmelzle, M. (Moritz), Sparrelid, E. (Ernesto), Lang, H. (Hauke), Guglielmi, A. (Alfredo), Gulik, T.M. (Thomas) van, Andreou, A. (A.), Bartsch, F. (F.), Benzing, C. (C.), Büttner, S. (Stefan), Capobianco, I. (I.), Reuver, P.R. (Philip) de, de Savornin Lohman, E. (E.), Dejong, C.H. (Cees), Efanov, M. (M.), Erdmann, J.I. (J. I.), Franken, L.C. (L. C.), Frascaroli, G. (G.), Giglio, M.C. (M. C.), Gomez-Gavara, C. (C.), Heid, F. (F.), IJzermans, J.N.M. (Jan), Jansson, H. (H.), Ligthart, M.A.P. (M. A.P.), Maithel, S.K. (Shishir K.), Malago, M. (M.), Malik, H.Z. (H. Z.), Muiesan, P. (Paolo), Olde Damink, S.W.M. (Steven), Pando, E. (E.), Quinn, L.M. (L. M.), Ratti, F. (F.), Roberts, K.J. (K. J.), Rolinger, J. (J.), Ruzzenente, A. (Andrea), Schadde, E. (E.), Serenari, M. (M.), Sultana, A. (A.), Troisi, R.I., van Laarhoven, S. (S.), Vugt, J.L.A. (Jeroen) van, Olthof, P.B. (Pim B.), Aldrighetti, L.A. (L.), Alikhanov, R. (Ruslan), Cescon, M. (Matteo), Groot Koerkamp, B. (Bas), Jarnagin, W.R. (William R.), Nadalin, S. (S.), Pratschke, J. (Johann), Schmelzle, M. (Moritz), Sparrelid, E. (Ernesto), Lang, H. (Hauke), Guglielmi, A. (Alfredo), Gulik, T.M. (Thomas) van, Andreou, A. (A.), Bartsch, F. (F.), Benzing, C. (C.), Büttner, S. (Stefan), Capobianco, I. (I.), Reuver, P.R. (Philip) de, de Savornin Lohman, E. (E.), Dejong, C.H. (Cees), Efanov, M. (M.), Erdmann, J.I. (J. I.), Franken, L.C. (L. C.), Frascaroli, G. (G.), Giglio, M.C. (M. C.), Gomez-Gavara, C. (C.), Heid, F. (F.), IJzermans, J.N.M. (Jan), Jansson, H. (H.), Ligthart, M.A.P. (M. A.P.), Maithel, S.K. (Shishir K.), Malago, M. (M.), Malik, H.Z. (H. Z.), Muiesan, P. (Paolo), Olde Damink, S.W.M. (Steven), Pando, E. (E.), Quinn, L.M. (L. M.), Ratti, F. (F.), Roberts, K.J. (K. J.), Rolinger, J. (J.), Ruzzenente, A. (Andrea), Schadde, E. (E.), Serenari, M. (M.), Sultana, A. (A.), Troisi, R.I., van Laarhoven, S. (S.), and Vugt, J.L.A. (Jeroen) van

Abstract

In the original article Moritz Schmelzle’s last name is spelled wrong. It is correct as reflected here.

Published
2020
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8. Portal Vein Embolization is Associated with Reduced Liver Failure and Mortality in High-Risk Resections for Perihilar Cholangiocarcinoma

Author

Olthof, P.B. (Pim B.), Aldrighetti, L.A. (L.), Alikhanov, R. (Ruslan), Cescon, M. (Matteo), Groot Koerkamp, B. (Bas), Jarnagin, W.R. (William R.), Nadalin, S. (S.), Pratschke, J. (Johann), Schmelze, M. (Moritz), Sparrelid, E. (Ernesto), Lang, H. (Hauke), Guglielmi, A. (Alfredo), Gulik, T.M. (Thomas) van, Andreou, A. (A.), Bartsch, F. (F.), Benzing, C. (C.), Büttner, S. (Stefan), Capobianco, I. (I.), Reuver, P.R. (Philip) de, de Savornin Lohman, E. (E.), Dejong, C.H.C. (C. H.C.), Efanov, M. (M.), Erdmann, J.I. (Joris), Franken, L.C. (L. C.), Frascaroli, G. (G.), Giglio, M.C. (M. C.), Gomez-Gavara, C. (C.), Heid, F. (F.), IJzermans, J.N.M. (Jan), Jansson, H. (H.), Ligthart, M.A.P. (M. A.P.), Maithel, S.K. (Shishir K.), Malago, M. (M.), Malik, H.Z. (H. Z.), Muiesan, P. (Paolo), Olde Damink, S.W.M. (Steven), Pando, E. (E.), Quinn, L.M. (L. M.), Ratti, F. (F.), Roberts, K.J. (K. J.), Rolinger, J. (J.), Ruzzenente, A. (Andrea), Schadde, E. (E.), Serenari, M. (M.), Sultana, A. (A.), Troisi, R.I., van Laarhoven, S. (S.), Vugt, J.L.A. (Jeroen) van, Olthof, P.B. (Pim B.), Aldrighetti, L.A. (L.), Alikhanov, R. (Ruslan), Cescon, M. (Matteo), Groot Koerkamp, B. (Bas), Jarnagin, W.R. (William R.), Nadalin, S. (S.), Pratschke, J. (Johann), Schmelze, M. (Moritz), Sparrelid, E. (Ernesto), Lang, H. (Hauke), Guglielmi, A. (Alfredo), Gulik, T.M. (Thomas) van, Andreou, A. (A.), Bartsch, F. (F.), Benzing, C. (C.), Büttner, S. (Stefan), Capobianco, I. (I.), Reuver, P.R. (Philip) de, de Savornin Lohman, E. (E.), Dejong, C.H.C. (C. H.C.), Efanov, M. (M.), Erdmann, J.I. (Joris), Franken, L.C. (L. C.), Frascaroli, G. (G.), Giglio, M.C. (M. C.), Gomez-Gavara, C. (C.), Heid, F. (F.), IJzermans, J.N.M. (Jan), Jansson, H. (H.), Ligthart, M.A.P. (M. A.P.), Maithel, S.K. (Shishir K.), Malago, M. (M.), Malik, H.Z. (H. Z.), Muiesan, P. (Paolo), Olde Damink, S.W.M. (Steven), Pando, E. (E.), Quinn, L.M. (L. M.), Ratti, F. (F.), Roberts, K.J. (K. J.), Rolinger, J. (J.), Ruzzenente, A. (Andrea), Schadde, E. (E.), Serenari, M. (M.), Sultana, A. (A.), Troisi, R.I., van Laarhoven, S. (S.), and Vugt, J.L.A. (Jeroen) van

Abstract

Background: Preoperative portal vein embolization (PVE) is frequently used to improve future liver remnant volume (FLRV) and to reduce the risk of liver failure after major liver resection. Objective: This paper aimed to assess postoperative outcomes after PVE and resection for suspected perihilar cholangiocarcinoma (PHC) in an international, multicentric cohort. Methods: Patients undergoing resection for suspected PHC across 20 centers worldwide, from the year 2000, were included. Liver failure, biliary leakage, and hemorrhage were classified according to the respective International Study Group of Liver Surgery criteria. Using propensity scoring, two equal cohorts were generated using matching parameters, i.e. age, sex, American Society of Anesthesiologists classification, jaundice, type of biliary drainage, baseline FLRV, resection type, and portal vein resection. Results: A total of 1667 patients were treated for suspected PHC during the study period. In 298 patients who underwent preoperative PVE, the overall incidence of liver failure and 90-day mortality was 27% and 18%, respectively, as opposed to 14% and 12%, respectively, in patients without PVE (p < 0.001 and p = 0.005). After propensity score matching, 98 patients were enrolled in each cohort, resulting in similar baseline and operative characteristics. Liver failure was lower in the PVE group (8% vs. 36%, p < 0.001), as was biliary leakage (10% vs. 35%, p < 0.01), intra-abdominal abscesses (19% vs. 34%, p = 0.01), and 90-day mortality (7% vs. 18%, p = 0.03). Conclusion: PVE before major liver resection for PHC is associated with a lower incidence of liver failure, biliary leakage, abscess formation, and mortality. These results demonstrate the importance of PVE as an integral component in the surgical treatment of PHC.

Published
2020
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9. Use of critical care resources during the first 2 weeks (February 24–March 8, 2020) of the Covid-19 outbreak in Italy

Author

Tonetti, T., Grasselli, G., Zanella, A., Pizzilli, G., Fumagalli, R., Piva, S., Lorini, L., Iotti, G., Foti, G., Colombo, S., Vivona, L., Rossi, S., Girardis, M., Agnoletti, V., Campagna, A., Gordini, G., Navalesi, P., Boscolo, A., Graziano, A., Valeri, I., Vianello, A., Cereda, D., Filippini, C., Cecconi, M., Locatelli, Franco, Bartoletti, M., Giannella, M., Viale, P., Antonelli, M., Nava, S., Pesenti, A., Ranieri, V. M., Albano, G., Alborghetti, A., Aldegheri, G., Antonini, B., Belgiorno, N., Bellani, G., Beretta, E., Bonazzi, S., Borelli, M., Cabrini, L., Carnevale, L., Carnevale, S., Castelli, G., Catena, E., Chiumello, D., Coluccello, A., Coppini, D., Covello, D., Defilippi, G., Deipoli, M., Dughi, P., Gallioli, G., Gnesin, P., Greco, S., Guatteri, L., Guzzon, D., Keim, R., Landoni, G., Langer, T., Lombardo, A., Marino, G., Merli, G., Merlo, D., Mojoli, F., Muttini, S., Natalini, G., Petrucci, N., Pezzi, A., Radrizzani, D., Raimondi, M., Riccio, M., Storti, E., Tavola, M., Vitale, G., Bosco, E., Calo, M. A., Danzi, V., Derosa, S., Farnia, A., Lazzari, F., Meggiolaro, M., Munari, M., Saia, M., Sella, N., Serra, E., Tiberio, I., Baiocchi, M., Benedetto, M., Bordini, M., Caramelli, F., Cilloni, N., Dellagiovampaola, M., Fanelli, A., Frascaroli, G., Fusari, M., Maitan, S., Martino, C., Melotti, R. M., Merola, R., Minardi, F., Moro, F., Nardi, G., Nolli, M., Pierucci, E., Potalivo, A., Repetti, F., Salsi, P., Terzitta, M., Tosi, M., Venturi, S., Volta, C. A., Zani, G., Zanoni, A., Locatelli F. (ORCID:0000-0002-7976-3654), Tonetti, T., Grasselli, G., Zanella, A., Pizzilli, G., Fumagalli, R., Piva, S., Lorini, L., Iotti, G., Foti, G., Colombo, S., Vivona, L., Rossi, S., Girardis, M., Agnoletti, V., Campagna, A., Gordini, G., Navalesi, P., Boscolo, A., Graziano, A., Valeri, I., Vianello, A., Cereda, D., Filippini, C., Cecconi, M., Locatelli, Franco, Bartoletti, M., Giannella, M., Viale, P., Antonelli, M., Nava, S., Pesenti, A., Ranieri, V. M., Albano, G., Alborghetti, A., Aldegheri, G., Antonini, B., Belgiorno, N., Bellani, G., Beretta, E., Bonazzi, S., Borelli, M., Cabrini, L., Carnevale, L., Carnevale, S., Castelli, G., Catena, E., Chiumello, D., Coluccello, A., Coppini, D., Covello, D., Defilippi, G., Deipoli, M., Dughi, P., Gallioli, G., Gnesin, P., Greco, S., Guatteri, L., Guzzon, D., Keim, R., Landoni, G., Langer, T., Lombardo, A., Marino, G., Merli, G., Merlo, D., Mojoli, F., Muttini, S., Natalini, G., Petrucci, N., Pezzi, A., Radrizzani, D., Raimondi, M., Riccio, M., Storti, E., Tavola, M., Vitale, G., Bosco, E., Calo, M. A., Danzi, V., Derosa, S., Farnia, A., Lazzari, F., Meggiolaro, M., Munari, M., Saia, M., Sella, N., Serra, E., Tiberio, I., Baiocchi, M., Benedetto, M., Bordini, M., Caramelli, F., Cilloni, N., Dellagiovampaola, M., Fanelli, A., Frascaroli, G., Fusari, M., Maitan, S., Martino, C., Melotti, R. M., Merola, R., Minardi, F., Moro, F., Nardi, G., Nolli, M., Pierucci, E., Potalivo, A., Repetti, F., Salsi, P., Terzitta, M., Tosi, M., Venturi, S., Volta, C. A., Zani, G., Zanoni, A., and Locatelli F. (ORCID:0000-0002-7976-3654)

Abstract

Background: A Covid-19 outbreak developed in Lombardy, Veneto and Emilia-Romagna (Italy) at the end of February 2020. Fear of an imminent saturation of available ICU beds generated the notion that rationing of intensive care resources could have been necessary. Results: In order to evaluate the impact of Covid-19 on the ICU capacity to manage critically ill patients, we performed a retrospective analysis of the first 2 weeks of the outbreak (February 24–March 8). Data were collected from regional registries and from a case report form sent to participating sites. ICU beds increased from 1545 to 1989 (28.7%), and patients receiving respiratory support outside the ICU increased from 4 (0.6%) to 260 (37.0%). Patients receiving respiratory support outside the ICU were significantly older [65 vs. 77 years], had more cerebrovascular (5.8 vs. 13.1%) and renal (5.3 vs. 10.0%) comorbidities and less obesity (31.4 vs. 15.5%) than patients admitted to the ICU. PaO2/FiO2 ratio, respiratory rate and arterial pH were higher [165 vs. 244; 20 vs. 24 breath/min; 7.40 vs. 7.46] and PaCO2 and base excess were lower [34 vs. 42 mmHg; 0.60 vs. 1.30] in patients receiving respiratory support outside the ICU than in patients admitted to the ICU, respectively. Conclusions: Increase in ICU beds and use of out-of-ICU respiratory support allowed effective management of the first 14 days of the Covid-19 outbreak, avoiding resource rationing.

Published
2020

10. HCV and Kidney Transplantation: Pushing the Limits for Living Donation. Case Report and Mini Review

Author

Rossetto, A, primary, Comai, G, additional, Cuna, V, additional, Morelli, MC, additional, Siniscalchi, A, additional, Corradetti, V, additional, Del Gaudio, M, additional, Zanfi, C, additional, Bertuzzo, V, additional, Maroni, L, additional, Odaldi, F, additional, Frascaroli, G, additional, La Manna, G, additional, D’Errico, A, additional, and Ravaioli, M, additional

Published
2019
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12. Extracorporeal membrane oxygenation for the treatment of refractory cardiogenic shock in adults: strategies, results, and predictors of mortality = Sistemi di ossigenazione a membrana extracorporea come trattamento per lo shock cardiogeno refrattario nella popolazione adulta: strategie, risultati e predittori di mortalità

Author

Loforte A, Pilato E, Folesani G, Jafrancesco G, Castrovinci S, Cefarelli M, Magnani G, Caramelli F, Frascaroli G, MARTIN SUAREZ, SOFIA, POTENA, LUCIANO, GRIGIONI, FRANCESCO, DI BARTOLOMEO, ROBERTO, MARINELLI, GIUSEPPE, Loforte A, Pilato E, Martin Suarez S, Folesani G, Jafrancesco G, Castrovinci S, Cefarelli M, Potena L, Magnani G, Grigioni F, Caramelli F, Frascaroli G, Di Bartolomeo R, and Marinelli G.

Subjects
surgical procedures, operative, Heart failure
Abstract

The RotaFlow (Maquet, Jostra Medizintechnik AG, Hirrlingen, Germany) and Levitronix CentriMag (Levitronix LCC, Waltham, MA, USA) veno-arterial extracorporeal membrane oxygenation (ECMO) support systems have been investigated as treatment for refractory cardiogenic shock. METHODS: Between 2004 and 2012, 119 consecutive adult patients were supported on RotaFlow (n=104) or CentriMag (n=15) ECMO at our Institution (79 men; mean age 57.3 ± 12.5 years, range 19-78 years). Indications for support were: failure to wean from cardiopulmonary bypass in the setting of postcardiotomy (n=47) and primary graft failure (n=26); post-acute myocardial infarction cardiogenic shock (n=11); acute myocarditis (n=3), and cardiogenic shock on chronic heart failure (n=32). RESULTS: A central ECMO setting was established in 64 (53.7%) patients while peripherally in 55 (46.2%). Overall mean support time was 10.9 ± 8.7 days (range 1-43 days). Forty-two (35.2%) patients died on ECMO. Overall success rate, in terms of survival on ECMO (n=77), weaning from mechanical support (n=51; 42.8%) and bridge to heart transplantation (n=26; 21.8%), was 64.7%. Sixty-eight (57.1%) patients were successfully discharged. Stepwise logistic regression identified blood lactate levels and creatine kinase-MB relative index at 72h after ECMO initiation, and number of packed red blood cells (PRBCs) transfused on ECMO as significant predictors of mortality. Central ECMO population had a higher rate of continuous veno-venous hemofiltration need and bleeding events compared with the peripheral setting. CONCLUSIONS: ECMO support provides encouraging results in different subsets of patients in cardiogenic shock. Blood lactate levels, creatine kinase-MB relative index and PRBCs transfused should be strictly monitored during veno-arterial ECMO running. Type of ECMO implantation, if peripheral or central, should be decided according to the specific patient subset.

Published
2014

13. Fenoldopam to prevent renal replacement therapy after cardiac surgery. Design of the FENO-HSR study

Author

Landoni, G, Bove, T, Pasero, D, Comis, M, Orando, S, Pinelli, F, Guarracino, F, Corcione, A, Galdieri, N, Zucchetti, M, Maglioni, E, Biagioli, B, Pala, G, Frontini, M, Caramelli, F, Persi, B, Renzini, M, Paoletti, F, Lorini, F, Morelli, A, Alvaro, G, Bianco, R, Pittarello, D, Manzato, A, Pedersini, G, Mizzi, A, Lojacono, N, Leoncini, P, Iovino, T, Cariello, C, Baldassarri, R, Camata, A, Padua, G, Frascaroli, G, Leonardi S, Bignami, E, Zangrillo, A, Landoni G, Bove T, Pasero D, Comis M, Orando S, Pinelli F, Guarracino F, Corcione A, Galdieri N, Zucchetti M, Maglioni E, Biagioli B, Pala G, Frontini M, Caramelli F, Persi B, Renzini M, Paoletti F, Lorini F, Morelli A, Alvaro G, Bianco R, Pittarello D, Manzato A, Pedersini G, Mizzi A, Lojacono N, Leoncini P, Iovino T, Cariello C, Baldassarri R, Camata AM, Padua G, Frascaroli G, Bignami E, Zangrillo A, Landoni, G, Bove, T, Pasero, D, Comis, M, Orando, S, Pinelli, F, Guarracino, F, Corcione, A, Galdieri, N, Zucchetti, M, Maglioni, E, Biagioli, B, Pala, G, Frontini, M, Caramelli, F, Persi, B, Renzini, M, Paoletti, F, Lorini, F, Morelli, A, Alvaro, G, Bianco, R, Pittarello, D, Manzato, A, Pedersini, G, Mizzi, A, Lojacono, N, Leoncini, P, Iovino, T, Cariello, C, Baldassarri, R, Camata, A, Padua, G, Frascaroli, G, Leonardi S, Bignami, E, Zangrillo, A, Landoni G, Bove T, Pasero D, Comis M, Orando S, Pinelli F, Guarracino F, Corcione A, Galdieri N, Zucchetti M, Maglioni E, Biagioli B, Pala G, Frontini M, Caramelli F, Persi B, Renzini M, Paoletti F, Lorini F, Morelli A, Alvaro G, Bianco R, Pittarello D, Manzato A, Pedersini G, Mizzi A, Lojacono N, Leoncini P, Iovino T, Cariello C, Baldassarri R, Camata AM, Padua G, Frascaroli G, Bignami E, and Zangrillo A

Abstract

Introduction: Acute kidney injury requiring renal replacement therapy is a serious complication following cardiac surgery associated with poor clinical outcomes. Until now no drug showed nephroprotective effects. Fenoldopam is a dopamine-1 receptor agonist which seems to be effective in improving postoperative renal function. The aim of this paper is to describe the design of the FENO-HSR study, planned to assess the effect of a continuous infusion of fenoldopam in reducing the need for renal replacement therapy in patients with acute kidney injury after cardiac surgery. Methods: We're performing a double blind, placebo-controlled multicentre randomized trial in over 20 Italian hospitals. Patients who develop acute renal failure defined as R of RIFLE score following cardiac surgery are randomized to receive a 96-hours continuous infusion of either fenoldopam (0.025-0.3 µg/kg/min) or placebo. Results: The primary endpoint will be the rate of renal replacement therapy. Secondary endpoints will be: mortality, time on mechanical ventilation, length of intensive care unit and hospital stay, peak serum creatinine and the rate of acute renal failure (following the RIFLE score). Conclusions: This trial is planned to assess if fenoldopam could improve relevant outcomes in patients undergoing cardiac surgery who develop acute renal dysfunction. Results of this double-blind randomized trial could provide important insights to improve the management strategy of patients at high risk for postoperative acute kidney injury.

Published
2010

14. Predicting mortality risk in patients undergoing venovenous ECMO for ARDS due to influenza A (H1N1) pneumonia: the ECMOnet score

Author

Pappalardo F, Pieri M, Greco T, Patroniti N, Pesenti A, Arcadipane A, Ranieri VM, Gattinoni L, Landoni G, Holzgraefe B, Beutel G, Zangrillo A, Italian E.C.M.O.n.e.t. Scandroglio AM, Calabrò MG, Bove T, De Bonis M, Foti G, Bombino M, Peris A, Cianchi G, Pasquini A, Braschi A, Mojoli F, Zanierato M, Iotti GA, Belliato M, Carnevale L, Terragni P, Urbino R, Del Sorbo L, Fanelli V, Panarello G, Antonelli M, Bello G, Maviglia R, Lissoni A, Crotti S, Pietropaoli P, Rocco M, Morelli A, Frascaroli G, Caramelli F, Bruno F, Grasso S, Lorini L, Ori C., TUFANO, ROSALBA, IANNUZZI, MICHELE, Pappalardo, F, Pieri, M, Greco, T, Patroniti, N, Pesenti, A, Arcadipane, A, Ranieri, V, Gattinoni, L, Landoni, G, Holzgraefe, B, Beutel, G, Zangrillo, A, Lorini, F, Ranieri, Vm, Federico Pappalardo, Marina Pieri, Teresa Greco, Nicolò Patroniti, Antonio Pesenti, Antonio Arcadipane, V. Marco Ranieri, Luciano Gattinoni, Giovanni Landoni, Bernhard Holzgraefe, Gernot Beutel, Alberto Zangrillo, Scandroglio AM, Italian E. C. M. O. n. e. t., Calabrò, Mg, Bove, T, De Bonis, M, Foti, G, Bombino, M, Peris, A, Cianchi, G, Pasquini, A, Braschi, A, Mojoli, F, Zanierato, M, Iotti, Ga, Belliato, M, Carnevale, L, Terragni, P, Urbino, R, Del Sorbo, L, Fanelli, V, Panarello, G, Antonelli, M, Bello, G, Maviglia, R, Lissoni, A, Crotti, S, Pietropaoli, P, Rocco, M, Morelli, A, Frascaroli, G, Caramelli, F, Tufano, Rosalba, Iannuzzi, Michele, Bruno, F, Grasso, S, Lorini, L, and Ori, C.

Subjects
Adult, Male, medicine.medical_specialty, ARDS, medicine.medical_treatment, ECMO -ARDS - H1N1, venovenous extracorporeal membrane oxygenation (VV ECMO), H1N1 virus, Critical Care and Intensive Care Medicine, Risk Assessment, Veins, Cohort Studies, Influenza A Virus, H1N1 Subtype, Acute respiratory distress syndrome, ECMO, Extracorporeal membrane oxygenation, Mortality, Multiple organ failure, Female, Humans, Influenza, Human, Prospective Studies, Respiratory Distress Syndrome, Adult, Survival Rate, Extracorporeal Membrane Oxygenation, Anesthesiology, Influenza A Virus, Medicine, H1N1 Subtype, MED/41 - ANESTESIOLOGIA, Intensive care medicine, Prospective cohort study, Survival rate, Respiratory Distress Syndrome, business.industry, medicine.disease, Influenza, ECMO: H1N1, Pneumonia, surgical procedures, operative, Respiratory failure, business, Cohort study, Human
Abstract

PURPOSE: The decision to start venovenous extracorporeal membrane oxygenation (VV ECMO) is commonly based on the severity of respiratory failure, with little consideration of the extrapulmonary organ function. The aim of the study was to identify predictors of mortality and to develop a score allowing a better stratification of patients at the time of VV ECMO initiation. METHODS: This was a prospective multicenter cohort study on 60 patients with influenza A (H1N1)-associated respiratory distress syndrome participating in the Italian ECMOnet data set in the 2009 pandemic. Criteria for ECMO institution were standardized according to national guidelines. RESULTS: The survival rate in patients treated with ECMO was 68%. Significant predictors of death before ECMO institution by multivariate analysis were hospital length of stay before ECMO institution (OR=1.52, 95% CI 1.12-2.07, p=0.008); bilirubin (OR=2.32, 95% CI 1.52-3.52, p&nbsp

Published
2013

15. Fenoldopam to prevent renal replacement therapy after cardiac surgery. Design of the FENO-HSR study

Author

Landoni G, Bove T, Pasero D, Comis M, Orando S, Pinelli F, Guarracino F, Corcione A, Galdieri N, Zucchetti M, Maglioni E, Biagioli B, Pala G, Frontini M, Caramelli F, Persi B, Renzini M, Paoletti F, Lorini F, Morelli A, Alvaro G, Bianco R, Pittarello D, Manzato A, Pedersini G, Mizzi A, Lojacono N, Leoncini P, Iovino T, Cariello C, Baldassarri R, Camata AM, Padua G, Frascaroli G, Leonardi S, Bignami E, Zangrillo A, Landoni, Giovanni, Bove, T, Pasero, D, Comis, M, Orando, S, Pinelli, F, Guarracino, F, Corcione, A, Galdieri, N, Zucchetti, M, Maglioni, E, Biagioli, B, Pala, G, Frontini, M, Caramelli, F, Persi, B, Renzini, M, Paoletti, F, Lorini, L, Morelli, A, Alvaro, G, Bianco, R, Pittarello, D, Manzato, A, Pedersini, G, Mizzi, A, Lojacono, N, Leoncini, P, Iovino, T, Cariello, C, Baldassarri, R, Camata, Am, Padua, G, Frascaroli, G, Leonardi, S, Bignami, E, Zangrillo, Alberto, Landoni, G, Lorini, F, Camata, A, Leonardi S, and Zangrillo, A

Subjects
cardiac surgical procedure, Research-Article, fenoldopam, anesthesia, cardiac surgical procedures, acute renal failure, renal replacement therapy, cardiac surgery
Abstract

Introduction: Acute kidney injury requiring renal replacement therapy is a serious complication following cardiac surgery associated with poor clinical outcomes. Until now no drug showed nephroprotective effects. Fenoldopam is a dopamine-1 receptor agonist which seems to be effective in improving postoperative renal function. The aim of this paper is to describe the design of the FENO-HSR study, planned to assess the effect of a continuous infusion of fenoldopam in reducing the need for renal replacement therapy in patients with acute kidney injury after cardiac surgery. Methods: We're performing a double blind, placebo-controlled multicentre randomized trial in over 20 Italian hospitals. Patients who develop acute renal failure defined as R of RIFLE score following cardiac surgery are randomized to receive a 96-hours continuous infusion of either fenoldopam (0.025-0.3 µg/kg/min) or placebo. Results: The primary endpoint will be the rate of renal replacement therapy. Secondary endpoints will be: mortality, time on mechanical ventilation, length of intensive care unit and hospital stay, peak serum creatinine and the rate of acute renal failure (following the RIFLE score). Conclusions: This trial is planned to assess if fenoldopam could improve relevant outcomes in patients undergoing cardiac surgery who develop acute renal dysfunction. Results of this double-blind randomized trial could provide important insights to improve the management strategy of patients at high risk for postoperative acute kidney injury.

Published
2010

16. Human cytomegalovirus differentially controls B-cell and T–cell responses through effects on plasmacytoid dendritic cells

Author

STEFANIA VARANI, Cederarv, M., Feld, S., Tammik, C., Frascaroli, G., Landini, M. P., Söderberg-Nauclér, C., VARANI S., CEDERARV M., FELD S., TAMMIK C., FRASCAROLI G., LANDINI M.P., and SÖDERBERG-NAUCLER C.

Subjects
B CELLS, viruses, virus diseases, hemic and immune systems, biochemical phenomena, metabolism, and nutrition, VIRAL, DENDRITIC CELLS
Abstract

Plasmacytoid dendritic cells (PDCs), the main producers of type I IFN in response to viral infection, are essential in antiviral immunity. In this study, we assessed the effect of human CMV (HCMV) infection on PDC function and on downstream B- and T-cell responses in vitro. HCMV infection of human PDCs was nonpermissive, as immediate-early but not late viral antigens were detected. HCMV led to partial maturation of PDCs and up-regulated MHC class II and CD83 molecules but not the costimulatory molecules CD80 and CD86. Regardless of viral replication, PDCs secreted cytokines after contact with HCMV, including IFN-alpha secretion that was blocked by inhibitory CpG, suggesting an engagement of the TLR7 and/or TLR9 pathways. In the presence of B-cell receptor stimulation, soluble factors produced by HCMV-matured PDCs triggered B-cell activation and proliferation. Through PDC stimulation, HCMV prompted B-cell activation, but only induced Ab production in the presence of T cells or T-cell secreted IL-2. Conversely, HCMV hampered the allostimulatory ability of PDCs, leading to decreased proliferation of CD4+ and CD8+ T cells. These findings reveal a novel mechanism by which HCMV differentially controls humoral and cell-mediate immune responses through effects on PDCs.

Published
2007

20. Outcome of cardiac surgery in low birth weight and premature infants

Author

Oppido G, Napoleone CP, Formigari R, Gabbieri D, PACINI, DAVIDE, Frascaroli G, GARGIULO, GAETANO DOMENICO, Oppido G, Napoleone CP, Formigari R, Gabbieri D, Pacini D, Frascaroli G, and Gargiulo G.

Abstract

Low birth weight or premature infants may require early surgical treatment of congenital cardiac lesions because of their poor clinical status. Even thought early repair or palliation is carried out with incremental risk factor for morbidity and mortality, it has been demonstrated to be preferable to medical management and delayed surgery. This retrospective study was undertaken to evaluate early and mid-term results in infants, weighing less than 2500 g, who underwent surgery other than patent ductus arteriosus closure. METHODS: Since January 1993 to August 2002, 60 consecutive patients underwent early surgical treatment of congenital heart malformations at our institution. 27 patients were premature (born before 37 weeks of gestation). Ninety percent were severely symptomatic. Mean age at operation was 15.5 days (range 4-68 days). Mean weight was 2120 g (range 900-2500 g). Indications for surgery were: coarctation complex 11, transposition of great arteries 9, interrupted or severely hypoplastic aortic arch 9, hypoplastic left heart syndrome 7, truncus arteriosus 5, other 19. Thirty-five patients were operated on CPB, Deep Hypothermia with Circulatory Arrest was used in 9. Complete repair was achieved in 32 patients. Aortic arch reconstruction was required in 32 cases. RESULTS: There were nine early deaths (15%): heart failure (5), multiorgan failure (3), sepsis (1). Age, weight, prematurity, type of surgery and use of cardio pulmonary by-pass did not influence early mortality. Mean intensive care unit stay and duration of mechanical ventilation were 5.8 days and 75.5 h, respectively. Postoperative neurological complications did not occur in any patient. At follow-up (mean 48 months) there were nine late deaths. Kaplan-Meier survival at 60 months was 70%. CONCLUSIONS: Surgery for congenital heart disease can be performed in low weight critically ill infants with reduced, but still acceptable early and mid-term survival

Published
2004

21. Extracorporeal Membrane Oxygenation Support in Refractory Cardiogenic Shock: Outcome, Treatment Strategies and Analysis of Risk Factors

Author

Loforte, A., primary, Pilato, E., additional, Martin Suarez, S., additional, Jafrancesco, G., additional, Castrovinci, S., additional, Cefarelli, M., additional, Potena, L., additional, Masetti, M., additional, Magnani, G., additional, Grigioni, F., additional, Frascaroli, G., additional, and Marinelli, G., additional

Published
2015
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22. Extracorporeal Membrane Oxygenation Support in Refractory Cardiogenic Shock: Treatment Strategies and Analysis of Risk Factors

Author

Loforte, A., primary, Marinelli, G., additional, Musumeci, F., additional, Pilato, E., additional, Martin Suarez, S., additional, Montalto, A., additional, Folesani, G., additional, Castrovinci, S., additional, Iafrancesco, G., additional, Lilla Della Monica, P., additional, Grigioni, F., additional, Potena, L., additional, Frascaroli, G., additional, and Arpesella, G., additional

Published
2014
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34. La perfusione del sistema splancnico in anestesia

Author

Martinelli, G., Baroncini, S., Bernardi, E., Cagnetti, V., Corticelli, Mauro Alessandro, Faenza, S., Frascaroli, G., Petrini, F., Piancastelli, E., Zanello, M., and Zanoni, A.

Subjects
anestesia, perfusione, termografia
Published
1991

40. In vitro and in vivo regulation of chemokine receptors

Author

Sozzani S, Bonecchi R, Giovanna D'Amico, Frascaroli G, Vecchi A, Allavena P, and Mantovani A

Subjects
Inflammation, Gene Expression Regulation, Leukocytes, Animals, Humans, Receptors, Chemokine, In Vitro Techniques, Up-Regulation

44. Medullary thyroid carcinoma: Clinical presentation and outcome in 219 patients,Carcinoma medular de tiroides: estudio multicéntrico. Presentación y evolución en 219 pacientes

Author

Califano, I., Deutsch, S., Castro Jozami, L., Fassi, J., Lowenstein, A., Balzaretti, M., Novelli, J. L., Marcelo Figari, Olstein, G., Sansó, G., Barontini, M., Iorcansky, S., Cabezón, C., Abalovich, M., Alcaraz, G., Brenta, G., Calabrese, M. C., Corino, M., Faure, E., Frascaroli, G., Gauna, A., Gutiérrez, S., Ilera, V., Jaeger, M., Kiejzik, M., Martínez, M. P., Orlandi, A. M., Pitoia, F., Puscar, A., Roccatagliata, G., Ruso Picasso, F., Sala, M., Sartorio, G., Schnitman, M., Silva Croome, M., Sklate, R., Sobrado, P., Storani, M. E., and Vázquez, A.

47. Brain ischemic injury in COVID‐19‐infected patients: a series of 10 post‐mortem cases

Author

Caterina Giannini, Raffaele Aspide, Guido Frascaroli, Giovanna Cenacchi, Liliana Gabrielli, Antonietta D'Errico, Pietro Cortelli, Carmine Gallo, Viscardo Paolo Fabbri, Tiziana Lazzarotto, Maria Pia Foschini, Mattia Riefolo, Fabbri V.P., Foschini M.P., Lazzarotto T., Gabrielli L., Cenacchi G., Gallo C., Aspide R., Frascaroli G., Cortelli P., Riefolo M., Giannini C., D'Errico A., Fabbri, Viscardo P, Foschini, Maria P, Lazzarotto, Tiziana, Gabrielli, Liliana, Cenacchi, Giovanna, Gallo, Carmine, Aspide, Raffaele, Frascaroli, Guido, Cortelli, Pietro, Riefolo, Mattia, Giannini, Caterina, and D'Errico, Antonietta

Subjects
Male, 0301 basic medicine, 2019-20 coronavirus outbreak, Coronavirus disease 2019 (COVID-19), viruses, Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), Clinical Neurology, Brain Ischemia, Pathology and Forensic Medicine, 03 medical and health sciences, 0302 clinical medicine, Medicine, Letters to the Editor, Postmortem Change, Letter to the Editor, Aged, SARS-CoV-2, business.industry, General Neuroscience, brain, CoViD-19, SARS-CV-2, COVID-19, virus diseases, Ischemic injury, Middle Aged, 030104 developmental biology, medicine.anatomical_structure, Immunology, Female, Autopsy, Neurology (clinical), business, 030217 neurology & neurosurgery, Human, Respiratory tract
Abstract

The coronavirus disease 2019 (COVID‐19) is caused by the severe acute respiratory syndrome coronavirus 2 (SARS‐CoV‐2). COVID‐19 symptoms are not limited to the respiratory tract, but complications have been described involving other organs including brain. At present, data on SARS‐CoV‐2 neuropathological features are limited [4, 5, 8, 10] and most frequently focused on cases presenting neurological symptoms.

Published
2020
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48. The Relationship between Timing of Pretransplant Kidney Biopsy, Graft Loss, and Survival in Kidney Transplantation:An Italian Cohort Study

Author

Francesco Vasuri, Massimo Del Gaudio, Matteo Ravaioli, Maurizio Sessa, Matteo Serenari, Deborah Malvi, Olga Baraldi, Gaetano La Manna, Giuliana Germinario, Vania Cuna, Irene Capelli, Federica Odaldi, Giorgia Comai, Raffaele Bova, Giacomo Frascaroli, Lorenzo Maroni, Antonietta D'Errico, Valentina Rosa Bertuzzo, Gabriela Sangiorgi, Chiara Zanfi, Odaldi F., Serenari M., Comai G., La Manna G., Bova R., Frascaroli G., Malvi D., Maroni L., Vasuri F., Germinario G., Baraldi O., Capelli I., Cuna V., Sangiorgi G., D'Errico A., Del Gaudio M., Bertuzzo V.R., Zanfi C., Sessa M., and Ravaioli M.

Subjects
Graft Rejection, Male, medicine.medical_specialty, Biopsy, Urology, Kidney biopsy, Kidney, Cold Ischemia Time, Cohort Studies, Solid tumors, Medicine, Humans, Kidney clinical, Kidney transplantation, Aged, Outcome, Aged, 80 and over, medicine.diagnostic_test, business.industry, Graft Survival, Graft survival, Middle Aged, medicine.disease, Kidney Transplantation, Confidence interval, Tissue Donors, Transplantation, Survival Rate, medicine.anatomical_structure, Italy, Propensity score matching, Preoperative Period, Female, business, Cohort study
Abstract

Introduction: Kidney biopsy is performed to assess if an extended criteria graft can be used for transplantation. It may be performed before or after cross-clamping during organ procurement. This study aims to evaluate whether the timing of biopsy may modify cold ischemia times (CIT) and/or graft outcomes. Methods: Kidney transplants performed in our center from January 2007 to December 2017 were analyzed. Grafts with preimplantation kidney biopsy were included. Biopsies were performed during surgical back table (ex situ kidney biopsy [ESKB]) until 2012 and since then before the aortic cross-clamping (in situ kidney biopsy [ISKB]). To overcome biases owing to different distributions, a propensity score model was developed. The study population consists in 322 patients, 115 ESKB, and 207 ISKB. Results: CIT was significantly lower for ISKB (730 min ISKB vs. 840 min ESKB, p value = 0.001). In both crude (OR 0.27; 95% confidence interval, 95% CI 0.12–0.60; p value = 0.002) and adjusted analyses (OR 0.37; 95% CI 0.14–0.94; p value = 0.039), ISKB was associated with a reduced odd of graft loss when compared to ESKB. Discussion/Conclusion: Performing preimplantation kidney biopsy during the recovery, prior to the aortic cross-clamping, may be a strategy to reduce CIT and improve transplant outcomes.

Published
2022
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49. Pre-transplant Psoas Muscle Density as a Ready-to-Use and Low-cost Predictor of Patient Survival After Liver Transplant

Author

Lidia Strigari, S. Pellegrini, Matteo Cescon, Alfredo Clemente, Antonio Colecchia, Daniele Spinelli, Giacomo Frascaroli, Matteo Renzulli, Lorenzo Maroni, Antonio Daniele Pinna, Matteo Ravaioli, Giuliano Peta, Valentina Rosa Bertuzzo, Rita Golfieri, Anna Maria Ierardi, Elton Dajti, Gianpaolo Carrafiello, Alessandro Cucchetti, Bertuzzo V.R., Renzulli M., Clemente A., Cucchetti A., Maroni L., Frascaroli G., Pellegrini S., Dajti E., Spinelli D., Peta G., Ierardi A.M., Carrafiello G., Strigari L., Colecchia A., Golfieri R., Pinna A.D., Ravaioli M., and Cescon M.

Subjects
Sarcopenia, medicine.medical_specialty, Complications, Cirrhosis, Liver Transplant, 030230 surgery, Muscle Density, 03 medical and health sciences, 0302 clinical medicine, medicine, Respiratory system, Adverse effect, Hepatology, business.industry, Malnutrition, Postoperative complication, Patient survival, Transplant Waiting List, medicine.disease, MELD, Surgery, Infectious Diseases, Radiological weapon, 030211 gastroenterology & hepatology, Infection, business, Complication
Abstract

Background: Sarcopenia, defined as low muscle mass with reduced function, is frequently encountered in cirrhotic patients and is a major predictor of adverse events, including post-liver transplant (LT) outcome. Objectives: This study assessed the impact of sarcopenia using computed tomography (CT)-based measurements on post-LT mortality and complications. Methods: From January 2008 to June 2016, 646 adult patients underwent 613 LTs at our institution. We analyzed the postoperative outcome of 287 patients who had pathologically proven cirrhosis on the explanted liver and who had performed a CT examination three months before LT. Psoas muscle density (PMD) was detected for every patient using standard instruments present in the radiological workstation and was related to postoperative survival rates and complications. Statistical analysis was carried out using the appropriate tests. Results: Postoperative mortality was 6.3%. At least one grade III-IV postoperative complication was experienced by 121 patients. Respiratory and infective complications occurred in 30 and 32 patients, respectively. Also, PMD was an independent predictor of postoperative mortality (P = 0.021), respiratory complications (P = 0.015), and infections (P = 0.010). The ROC analysis identified a PMD ≤ 43.72 HU as the best cutoff value for predicting 90-day mortality after LT. Conclusions: Psoas muscle density accurately predicted post-LT mortality and complications. Its ease and low-cost determination can allow widespread use of this parameter to improve clinical care and help with the decision to give these patients some priority on the transplant waiting list.

Published
2021
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50. Restoration of portal flow with varix in liver transplantation for patients with total portal vein thrombosis: An effective strategy in the largest center experience

Author

Antonio Daniele Pinna, Matteo Cescon, Antonio Siniscalchi, Giacomo Frascaroli, Lorenzo Maroni, Enrico Prosperi, Federica Odaldi, Guido Fallani, Matteo Ravaioli, Matteo Serenari, Ravaioli M., Prosperi E., Pinna A., Siniscalchi A., Fallani G., Frascaroli G., Maroni L., Odaldi F., Serenari M., and Cescon M.

Subjects
medicine.medical_specialty, Blood transfusion, Left gastric vein, medicine.medical_treatment, portal reconstruction, 030230 surgery, Anastomosis, Liver transplantation, Varicose Veins, gastric varix, 03 medical and health sciences, 0302 clinical medicine, medicine, Humans, portal vein thrombosi, Venous Thrombosis, Transplantation, Varix, liver transplantation, Portal Vein, business.industry, Liver Neoplasms, portal hypertension, Gastric varices, medicine.disease, coronary-portal anastomosi, Portal vein thrombosis, Surgery, Liver Neoplasm, Portal hypertension, 030211 gastroenterology & hepatology, Neoplasm Recurrence, Local, business, Human, Varicose Vein
Abstract

Introduction: Postoperative complications and worse prognosis still burden liver transplantations (LT) with complex portal vein thrombosis (CPVT). When an engorged left gastric vein (LGV) is present, the portal inflow is restorable with an anastomosis between the graft portal vein and the LGV of the recipient. We analyzed short- and long-term results of this procedure in 12 LT with CPVT. Methods: Between 2005 and 2019, 55 patients with CPVT underwent LT. We applied this technique in 12 patients. In six cases, we placed a vascular graft to obtain a tension-free structure. We evaluated patency, short- and long-term results. Results: No intraoperative complication was observed. The median duration of LT, blood transfusion, deceased donor age, and MELD score of the recipients were 7h, 1250mL, 72years, and 19. Seven patients were affected by hepatocellular carcinoma. No major complications or PVT recurrence were observed. One patient required a liver re-transplantation for primary non-functioning syndrome. The mean hospital stay was 20days. The actuarial patient survival was 85% with a mean FU of 4years. The two late deaths were due to hepatocellular carcinoma recurrence and sepsis for cholangitis. Conclusions: This technique in presence of both CPVT and engorged LGV is feasible and safe for patients, with good short- and long-term results.

Published
2021
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