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1. The Italian Unitary Society of Colon-Proctology (Società Italiana Unitaria di Colonproctologia) guidelines for the management of acute and chronic hemorrhoidal disease

Author: Antonio Brillantino, Adolfo Renzi, Pasquale Talento, Luigi Brusciano, Luigi Marano, Maurizio Grillo, Mauro Natale Maglio, Fabrizio Foroni, Alessio Palumbo, Maria Laura Sandoval Sotelo, Luciano Vicenzo, Michele Lanza, Giovanna Frezza, Massimo Antropoli, Claudio Gambardella, Luigi Monaco, Ilaria Ferrante, Domenico Izzo, Alfredo Giordano, Michele Pinto, Corrado Fantini, Marcello Gasparrini, Michele Schiano Di Visconte, Francesca Milazzo, Giovanni Ferreri, Andrea Braini, Umberto Cocozza, Massimo Pezzatini, Valeria Gianfreda, Alberto Di Leo, Vincenzo Landolfi, Umberto Favetta, Sergio Agradi, Giovanni Marino, Massimiliano Varriale, Massimo Mongardini, Claudio Eduardo Fernando Antonio Pagano, Riccardo Brachet Contul, Nando Gallese, Giampiero Ucchino, Michele D’Ambra, Roberto Rizzato, Giacomo Sarzo, Bruno Masci, Francesca Da Pozzo, Simona Ascanelli, Patrizia Liguori, Angela Pezzolla, Francesca Iacobellis, Erika Boriani, Eugenio Cudazzo, Francesca Babic, Carmelo Geremia, Alessandro Bussotti, Mario Cicconi, Antonia Di Sarno, Federico Maria Mongardini, Antonio Brescia, Leonardo Lenisa, Massimiliano Mistrangelo, Matteo Zuin, Marta Mozzon, Alessandro Paolo Chiriatti, Vincenzo Bottino, Antonio Ferronetti, Corrado Rispoli, Ludovico Carbone, Giuseppe Calabrò, Antonino Tirrò, Domenico de Vito, Giovanna Ioia, Giovanni Luca Lamanna, Lorenzo Asciore, Ettore Greco, Pierluigi Bianchi, Giuseppe D’Oriano, Alessandro Stazi, Nicola Antonacci, Raffaella Marina Di Renzo, Gianmario Edoardo Poto, Giuseppe Paolo Ferulano, Antonio Longo, and Ludovico Docimo
Subjects: hemorrhoids, stapled hemorrhoidopexy, hemorrhoidopexy, hemorrhoidal artery ligation and mucopexy, laser hemorrhoidoplasty, Diseases of the digestive system. Gastroenterology, RC799-869
Abstract: The aim of these evidence-based guidelines is to present a consensus position from members of the Italian Unitary Society of Colon-Proctology (Società Italiana Unitaria di Colon-Proctologia, SIUCP) on the diagnosis and management of hemorrhoidal disease, with the goal of guiding physicians in the choice of the best treatment option. A panel of experts was charged by the Board of the SIUCP to develop key questions on the main topics related to the management of hemorrhoidal disease and to perform an accurate and comprehensive literature search on each topic, in order to provide evidence-based answers to the questions and to summarize them in statements. All the clinical questions were discussed by the expert panel in multiple rounds through the Delphi approach and, for each statement, a consensus among the experts was reached. The questions were created according to PICO (patients, intervention, comparison, and outcomes) criteria, and the statements were developed adopting the GRADE (Grading of Recommendations, Assessment, Development, and Evaluations) methodology. In cases of grade 1 hemorrhoidal prolapse, outpatient procedures including hemorrhoidal laser procedure and sclerotherapy may be considered the preferred surgical options. For grade 2 prolapse, nonexcisional procedures including outpatient treatments, hemorrhoidal artery ligation and mucopexy, laser hemorrhoidoplasty, the Rafaelo procedure, and stapled hemorrhoidopexy may represent the first-line treatment options, whereas excisional surgery may be considered in selected cases. In cases of grades 3 and 4, stapled hemorrhoidopexy and hemorrhoidectomy may represent the most effective procedures, even if, in the expert panel opinion, stapled hemorrhoidopexy represents the gold-standard treatment for grade 3 hemorrhoidal prolapse.
Published: 2024
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2. The Italian Unitary Society of Colon-proctology (SIUCP: Società Italiana Unitaria di Colonproctologia) guidelines for the management of anal fissure

Author: Antonio Brillantino, Adolfo Renzi, Pasquale Talento, Francesca Iacobellis, Luigi Brusciano, Luigi Monaco, Domenico Izzo, Alfredo Giordano, Michele Pinto, Corrado Fantini, Marcello Gasparrini, Michele Schiano Di Visconte, Francesca Milazzo, Giovanni Ferreri, Andrea Braini, Umberto Cocozza, Massimo Pezzatini, Valeria Gianfreda, Alberto Di Leo, Vincenzo Landolfi, Umberto Favetta, Sergio Agradi, Giovanni Marino, Massimilano Varriale, Massimo Mongardini, Claudio Eduardo Fernando Antonio Pagano, Riccardo Brachet Contul, Nando Gallese, Giampiero Ucchino, Michele D’Ambra, Roberto Rizzato, Giacomo Sarzo, Bruno Masci, Francesca Da Pozzo, Simona Ascanelli, Fabrizio Foroni, Alessio Palumbo, Patrizia Liguori, Angela Pezzolla, Luigi Marano, Antonio Capomagi, Eugenio Cudazzo, Francesca Babic, Carmelo Geremia, Alessandro Bussotti, Mario Cicconi, Antonia Di Sarno, Federico Maria Mongardini, Antonio Brescia, Leonardo Lenisa, Massimiliano Mistrangelo, Maria Laura Sandoval Sotelo, Luciano Vicenzo, Antonio Longo, and Ludovico Docimo
Subjects: Anal fissure, Anal spasm, Endoanal ultrasound, Anal manometry, Anal dilatation, Sphincterotomy, Surgery, RD1-811
Abstract: Abstract Introduction The aim of these evidence-based guidelines is to present a consensus position from members of the Italian Unitary Society of Colon-Proctology (SIUCP: Società Italiana Unitaria di Colon-Proctologia) on the diagnosis and management of anal fissure, with the purpose to guide every physician in the choice of the best treatment option, according with the available literature. Methods A panel of experts was designed and charged by the Board of the SIUCP to develop key-questions on the main topics covering the management of anal fissure and to performe an accurate search on each topic in different databanks, in order to provide evidence-based answers to the questions and to summarize them in statements. All the clinical questions were discussed by the expert panel in different rounds through the Delphi approach and, for each statement, a consensus among the experts was reached. The questions were created according to the PICO criteria, and the statements developed adopting the GRADE methodology. Conclusions In patients with acute anal fissure the medical therapy with dietary and behavioral norms is indicated. In the chronic phase of disease, the conservative treatment with topical 0.3% nifedipine plus 1.5% lidocaine or nitrates may represent the first-line therapy, eventually associated with ointments with film-forming, anti-inflammatory and healing properties such as Propionibacterium extract gel. In case of first-line treatment failure, the surgical strategy (internal sphincterotomy or fissurectomy with flap), may be guided by the clinical findings, eventually supported by endoanal ultrasound and anal manometry.
Published: 2023
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3. Surgical stress and metabolic response after totally laparoscopic right colectomy

Author: Marco Milone, Antonella Desiderio, Nunzio Velotti, Michele Manigrasso, Sara Vertaldi, Umberto Bracale, Michele D’Ambra, Giuseppe Servillo, Giuseppe De Simone, Fatima Domenica Elisa De Palma, Giuseppe Perruolo, Gregory Alexander Raciti, Claudia Miele, Francesco Beguinot, and Giovanni Domenico De Palma
Subjects: Medicine, Science
Abstract: Abstract No clear consensus on the need to perform an intracorporeal anastomosis (IA) after laparoscopic right colectomy is currently available. One of the potential benefits of intracorporeal anastomosis may be a reduction in surgical stress. Herein, we evaluated the surgical stress response and the metabolic response in patients who underwent right colonic resection for colon cancer. Fifty-nine patients who underwent laparoscopic resection for right colon cancer were randomized to receive an intracorporeal or an extracorporeal anastomosis (EA). Data including demographics (age, sex, BMI and ASA score), pathological (AJCC tumour stage and tumour localization) and surgical results were recorded. Moreover, to determine the levels of the inflammatory response, mediators, such as C-reactive protein (CRP), tumour necrosis factor (TNF), interleukin 1β (IL-1β), IL-6, IL-10, and IL-13, were evaluated. Similarly, cortisol and insulin levels were evaluated as hormonal responses to surgical stress. We found that the proinflammatory mediator IL-6, CRP, TNF and IL-1β levels, were significantly reduced in IA compared to EA. Concurrently, an improved profile of the anti-inflammatory cytokines IL-10 and IL-13 was observed in the IA group. Relative to the hormone response to surgical stress, cortisol was increased in patients who underwent EA, while insulin was reduced in the EA group. Based on these results, surgical stress and metabolic response to IA justify advocating the adoption of a totally laparoscopic approach when performing a right colectomy for cancer. This trial is registered on ClinicalTrials.gov (ID: NCT03422588).
Published: 2021
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4. Neuroendocrine tumor in a longstanding tailgut cyst: a case report

Author: Mirella Pace, Raduan Franca, Pasquale Cretella, Maria Nuzzo, Roberto Peltrini, Michele ambra, Maria Caro, and Maria Armiento
Abstract: Background: Retrocecal hamartomas are rare cystic lesions due to the persistence of the tailgut. Sometimes the epithelial or mesenchymal components of the cyst wall undergo neoplastic transformation, and, within them, carcinomas and sarcomas can develop. Case Presentation: We present the case of a multicystic lesion, discovered in a patient with perineal pain, which the imaging investigations have localized in the retrocecal space. The histological evaluation performed on his excisional biopsy demonstrates a retrocecal hamartoma harboring a neuroendocrine neoplasm. Conclusion: Tailgut cysts (TGC) are quite rare, only sometimes symptomatic, and infrequently, they also undergo a malignant transformation; in particular, the literature reviews report a higher frequency of adenocarcinomas. The differential diagnosis between lesions with different prognoses and pathogenesis that can develop in the retrocecal space requires a histological examination, which in some cases, becomes essential if we consider the potential for metastatic and local recurrence of any malignant neoplasm that arose in this site.
Published: 2022
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5. Augmented reality (AR) in minimally invasive surgery (MIS) training: where are we now in Italy? The Italian Society of Endoscopic Surgery (SICE) ARMIS survey

Author: Balla, Andrea, Sartori, Alberto, Botteri, Emanuele, Podda, Mauro, Ortenzi, Monica, Silecchia, Gianfranco, Guerrieri, Mario, Agresta, Ferdinando, Antonino, Agrusa, Daniele, Aguzzi, Mariantonietta, Alagia, Laura, Alberici, Marco Ettore Allaix, Luisa, Ambrosio, Alfonso, Amendola, Michele, Ammendola, Pietro Maria Amodio, Gabriele, Anania, Jacopo, Andreuccetti, Alfredo, Annichiarico, Pietro, Anoldo, Alessandro, Anselmo, Giovanni, Aprea, Giacomo, Arcuri, Alberto, Arezzo, Giulia, Armatura, Giulia, Bagaglini, Francesco, Bagolini, Beatrice, Bailetti, Gianluca, Baiocchi, Edoardo, Baldini, Elisa, Bannone, Mirko, Barone, Gianluca, Baronio, Raffaele, Basile, Bellucci, Marco, Andrea Benedetti Cacciaguerra, Ilaria, Benzoni, Francesco, Bianco, Giuseppe, Boccia, Cristina, Bombardini, Luigi, Boni, Dario, Bono, Luca Domenico Bonomo, Giulia, Bonventre, Andrea, Bottari, Claudio, Botti, Giacomo, Brentegani, Mattia, Buonomo, Umberto, Bracale, Cosimo, Callari, Luca, Calligaris, Pietro Giorgio Calò, Angelo, Cangiano, Lorenzo, Capezzuoli, Gabriella Teresa Capolupo, Marianna, Capuano, Filippo, Carannante, Eugenia, Cardamone, Teresa, Carfora, Chiara, Caricato, Pietro, Carnevali, Francesco Maria Carrano, Lorenzo, Casali, Gianmaria Casoni Pataccini, Gianluca, Cassese, Simone, Castiglioni, Flavia, Cavicchi, Ceccarelli, Graziano, Giovanni, Cestaro, Pasquale, Cianci, Claudio, Cimmino, Marco, Clementi, Coletta, Diego, Riccardo, Conventi, Corallino, Diletta, Maurizio, Costantini, Lorenzo, Crepaz, Diego, Cuccurullo, Curci, FABIO PIO, Giuseppe, Currò, Giorgio, Dalmonte, Giovanni, D'Alterio, Michele, D'Ambra, D'Ambrosio, Giancarlo, Anna, D'Amore, Michele De Capua, Simona, Deidda, Daniele, Delogu, Maurizio De Luca, Nicolò De Manzini, DE STEFANI, Elena, Giuseppe Di Buono, Marcello Di Martino, DI TOMASO, Anna, Ugo, Elmore, CORDOVA HERENCIA, INGRID ELVA, Giovanni, Emiliani, Sofia, Esposito, Fazio, Federico, Federico, Festa, Marcello, Filotico, Fiocca, Fausto, Irene, Fiume, Francesco, Fleres, Giulia, Fontana, Tommaso, Fontana, Edoardo, Forcignanò, Giampaolo, Formisano, Laura, Fortuna, Uberto Fumagalli Romario, Andrea, Galderisi, Raffaele, Galleano, Carlo, Gazia, Alessio, Giordano, Giorgio, Giraudo, Maria Carmela Giuffrida, Simona, Giura, Anna, Guida, Antonio Maria Iannello, Marco, Inama, Sara, Ingallinella, Iossa, Angelo, Livio, Iudici, Laracca, GIOVANNI GUGLIELMO, LARGHI LAUREIRO, Zoe, Saverio, Latteri, Luca, Leonardi, Pasquale, Lepiane, Edelweiss, Licitra, Paolo, Locurto, Sarah Lo Faso, Nicola, Luciani, Luzza, Luigi, Magaletti, Sara, Michele, Manigrasso, Alessandra, Marano, Francesco, Marchetti, Alessandra, Marello, Nicolò, Mariani, Jacopo Nicolò Marin, Gennaro, Martines, Laura, Mastrangelo, Antonio, Matarangolo, Marco, Materazzo, Mazzarella, Gennaro, Giorgio, Mazzarolo, Maria Paola Menna, Meoli, Francesca, Marco, Milone, Elisabetta, Moggia, Davide, Moioli, Sarah, Molfino, Vitantonio, Mongelli, Roberto, Montalti, Giulia, Montori, Luca, Morelli, Gianluigi, Moretto, Muttillo, EDOARDO MARIA, Irnerio, Muttillo, Francesca, Notte, Alessandro, M Paganini, Gianluca, Pagano, Palmieri, Livia, Giuseppe, Palomba, Valentina, Palumbo, Panetta, Cristina, Giulia, Paradiso, Beniamino, Pascotto, Passannanti, Daniele, Renato, Patrone, Francesca, Pecchini, Francesca, Pego, Fabio, Pelle, Perrotta, Nicola, Wanda, Petz, Biagio, Picardi, Picchetto, Andrea, Chiara, Piceni, Pietricola, Giulia, Enrico, Pinotti, Felice, Pirozzi, Paolo, Pizzini, Poillucci, Gaetano, Ilaria, Puccica, Lorenzo, Ramaci, Rapanotti, Eleonora, Daniela, Rega, Angelica, Reggiani, Giorgio, Romano, Gregorio, Romeo, Luigi, Romeo, Gianluca, Rompianesi, Stefano, Rossi, Edoardo, Saladino, Roberto, Santambrogio, Federica, Saraceno, Giuliano, Sarro, Diego, Sasia, Grazia, Savino, Rosa, Scaramuzzo, Antonio, Sciuto, Michela, Scollica, Giovanni, Scudo, Ardit, Seitaj, Carlo, Serra, Francesco, Serra, Pierpaolo, Sileri, Leandro, Siragusa, Carmen, Sorrentino, Giuseppe, Surfaro, Ernesto, Tartaglia, Beatrice, Torre, Andrea, Tufo, Matteo, Uccelli, Alessandro, Ussia, Vaccari, Samuele, Marina, Valente, Sara, Vertaldi, Alessandro, Vitali, Luca, Zaccherini, Luigi, Zorcolo, Noemi, Zorzetti, Balla, A., Sartori, A., Botteri, E., Podda, M., Ortenzi, M., Silecchia, G., Guerrieri, M., Agresta, F., Agrusa, A., Aguzzi, D., Alagia, M., Alberici, L., Allaix, M. E., Ambrosio, L., Amendola, A., Ammendola, M., Amodio, P. M., Anania, G., Andreuccetti, J., Annichiarico, A., Anoldo, P., Anselmo, A., Aprea, G., Arcuri, G., Arezzo, A., Armatura, G., Bagaglini, G., Bagolini, F., Bailetti, B., Baiocchi, G., Baldini, E., Bannone, E., Barone, M., Baronio, G., Basile, R., Bellucci, M., Cacciaguerra, A. B., Benzoni, I., Bianco, F., Boccia, G., Bombardini, C., Boni, L., Bono, D., Bonomo, L. D., Bonventre, G., Bottari, A., Botti, C., Brentegani, G., Buonomo, M., Bracale, U., Callari, C., Calligaris, L., Calo, P. G., Cangiano, A., Capezzuoli, L., Capolupo, G. T., Capuano, M., Carannante, F., Cardamone, E., Carfora, T., Caricato, C., Carnevali, P., Carrano, F. M., Casali, L., Pataccini, G. C., Cassese, G., Castiglioni, S., Cavicchi, F., Ceccarelli, G., Cestaro, G., Cianci, P., Cimmino, C., Clementi, M., Coletta, D., Conventi, R., Corallino, D., Costantini, M., Crepaz, L., Cuccurullo, D., Curci, F. P., Curro, G., Dalmonte, G., D'Alterio, G., D'Ambra, M., D'Ambrosio, G., D'Amore, A., De Capua, M., Deidda, S., Delogu, D., De Luca, M., De Manzini, N., De Stefani, E., Di Buono, G., Di Martino, M., Di Tomaso, A., Elmore, U., Herencia, I. E. C., Emiliani, G., Esposito, S., Fazio, F., Festa, F., Filotico, M., Fiocca, F., Fiume, I., Fleres, F., Fontana, G., Fontana, T., Forcignano, E., Formisano, G., Fortuna, L., Romario, U. F., Galderisi, A., Galleano, R., Gazia, C., Giordano, A., Giraudo, G., Giuffrida, M. C., Giura, S., Guida, A., Iannello, A. M., Inama, M., Ingallinella, S., Iossa, A., Iudici, L., Laracca, G. G., Laureiro, Z. L., Latteri, S., Leonardi, L., Lepiane, P., Licitra, E., Locurto, P., Faso, S. L., Luciani, N., Luzza, L., Magaletti, S., Manigrasso, M., Marano, A., Marchetti, F., Marello, A., Mariani, N., Marin, J. N., Martines, G., Mastrangelo, L., Matarangolo, A., Materazzo, M., Mazzarella, G., Mazzarolo, G., Menna, M. P., Meoli, F., Milone, M., Moggia, E., Moioli, D., Molfino, S., Mongelli, V., Montalti, R., Montori, G., Morelli, L., Moretto, G., Muttillo, E. M., Muttillo, I., Notte, F., Paganini, A. M., Pagano, G., Palmieri, L., Palomba, G., Palumbo, V., Panetta, C., Paradiso, G., Pascotto, B., Passannanti, D., Patrone, R., Pecchini, F., Pego, F., Pelle, F., Perrotta, N., Petz, W., Picardi, B., Picchetto, A., Piceni, C., Pietricola, G., Pinotti, E., Pirozzi, F., Pizzini, P., Poillucci, G., Puccica, I., Ramaci, L., Rapanotti, E., Rega, D., Reggiani, A., Romano, G., Romeo, G., Romeo, L., Rompianesi, G., Rossi, S., Saladino, E., Santambrogio, R., Saraceno, F., Sarro, G., Sasia, D., Savino, G., Scaramuzzo, R., Sciuto, A., Scollica, M., Scudo, G., Seitaj, A., Serra, C., Serra, F., Sileri, P., Siragusa, L., Sorrentino, C., Surfaro, G., Tartaglia, E., Torre, B., Tufo, A., Uccelli, M., Ussia, A., Vaccari, S., Valente, M., Vertaldi, S., Vitali, A., Zaccherini, L., Zorcolo, L., Zorzetti, N., Balla, Andrea, Sartori, Alberto, Botteri, Emanuele, Podda, Mauro, Ortenzi, Monica, Silecchia, Gianfranco, Guerrieri, Mario, Agresta, Ferdinando, de Manzini, Nicolo, and ARMIS (Augmented Reality in Minimally Invasive Surgery) Collaborative, Group
Subjects: Virtual reality (VR), minimally invasive surgery (MIS), Augmented reality (AR), Minimally invasive surgery (MIS), Mixed reality (MR), Survey, Training, training, augmented reality (AR), mixed reality (MR), survey, virtual reality (VR), Settore MED/18 - Chirurgia Generale, Surgery
Abstract: Minimally invasive surgery (MIS) is a widespread approach in general surgery. Computer guiding software, such as the augmented reality (AR), the virtual reality (VR) and mixed reality (MR), has been proposed to help surgeons during MIS. This study aims to report these technologies' current knowledge and diffusion during surgical training in Italy. A web-based survey was developed under the aegis of the Italian Society of Endoscopic Surgery (SICE). Two hundred and seventeen medical doctors' answers were analyzed. Participants were surgeons (138, 63.6%) and residents in surgery (79, 36.4%). The mean knowledge of the role of the VR, AR and MR in surgery was 4.9 ± 2.4 (range 1-10). Most of the participants (122, 56.2%) did not have experience with any proposed technologies. However, although the lack of experience in this field, the answers about the functioning of the technologies were correct in most cases. Most of the participants answered that VR, AR and MR should be used more frequently for the teaching and training and during the clinical activity (170, 80.3%) and that such technologies would make a significant contribution, especially in training (183, 84.3%) and didactic (156, 71.9%). Finally, the main limitations to the diffusion of these technologies were the insufficient knowledge (182, 83.9%) and costs (175, 80.6%). Based on the present study, in Italy, the knowledge and dissemination of these technologies are still limited. Further studies are required to establish the usefulness of AR, VR and MR in surgical training.
Published: 2023

6. Risk of appendiceal neoplasm after interval appendectomy for complicated appendicitis: A systematic review and meta-analysis

Author: Ruggero Lionetti, Michele D'Ambra, Francesco Corcione, Umberto Bracale, Roberta Green, Marcello De Luca, Alberto Cuocolo, Roberto Peltrini, Valeria Cantoni, Carolina Bartolini, Peltrini, Roberto, Cantoni, Valeria, Green, Roberta, Lionetti, Ruggero, D'Ambra, Michele, Bartolini, Carolina, De Luca, Marcello, Bracale, Umberto, Cuocolo, Alberto, and Corcione, Francesco
Subjects: medicine.medical_specialty, Adenoma, Complicated appendiciti, Adenocarcinoma, law.invention, Randomized controlled trial, Appendiceal neoplasm, law, Internal medicine, medicine, Appendectomy, Humans, Neoplasm, Appendicular inflammatory ma, Interval appendectomy, Randomized Controlled Trials as Topic, Retrospective Studies, business.industry, Complicated appendicitis, Appendicitis, medicine.disease, Mucinous Neoplasm, Appendiceal Neoplasms, Meta-analysis, Surgery, business
Abstract: Background Non-operative management is often the treatment of choice in cases of complicated appendicitis and routine interval appendectomy is not usually recommended. Actually, recent studies show an alarming number of appendiceal neoplasms following interval appendectomy. The aim of this study is to evaluate the prevalence of appendiceal neoplasms and their histological types after interval appendectomy for complicated appendicitis in adults. Methods A comprehensive literature search of the PubMed, Scopus and Web of Science databases was conducted according to the PRISMA statement. Studies reporting appendiceal neoplasm rates after interval appendectomy and histopathological characteristics were included. The most recent World Health Organization (WHO) classification of malignant tumours was considered. A pooled prevalence analysis for both prevalence and pathology was performed. Results A total of eight studies was included: seven retrospective series and one randomized controlled trial. The pooled prevalence of neoplasms after interval appendectomy was 11% (95% CI 7-15; I2 = 37.5%, p = 0.13). Appendiceal mucinous neoplasms occurred in 43% (95% CI 19-68), adenocarcinoma in 29% (95% CI 6-51), appendiceal neuroendocrine neoplasm in 21% (95% CI 6-36), globet cell carcinoma in 13% (95% CI -2-28), adenoma or serrated lesions in 20% (95% CI -0-41) of cases. Conclusion The risk of appendiceal neoplasm in patients treated with interval appendectomy for complicated appendicitis is 11%; mucinous neoplasm is the most common histopathological type. Further studies should investigate this association in order to clarify the biological pathway and clinical implications.
Published: 2021
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7. Relação Pessoal: Liberdade, Amor E Mistério

Author: Michele D’Ambra
Abstract: O objetivo do presente artigo é identificar e descrever elementos fundamentais da relação pessoal, particularmente entre seres humanos. Após breve análise histórica e delimitação da perspectiva antropológica em questão, são descritos e analisados liberdade, amor e mistério como elementos que caracterizam a relação humana. A principal referência é a antropologia filosófica de Edith Stein, embora o artigo inclua referências à filosofia moderna e contemporânea.
Published: 2021
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8. Prevention of incisional hernia at the site of stoma closure with different reinforcing mesh types: a systematic review and meta-analysis

Author: Simone Castiglioni, Maria Michela Di Nuzzo, Umberto Bracale, Francesco Corcione, Gaia Altieri, Roberto Peltrini, Nicola Imperatore, Michele D'Ambra, Luciano Grimaldi, Ruggero Lionetti, Peltrini, Roberto, Imperatore, Nicola, Altieri, Gaia, Castiglioni, Simone, DI NUZZO, MARIA MICHELA, Grimaldi, Luciano, D'Ambra, Michele, Lionetti, Ruggero, Bracale, Umberto, and Corcione, Francesco
Subjects: medicine.medical_specialty, Synthetic mesh, Incisional hernia, medicine.medical_treatment, Stoma reversal, Review, Lower risk, Prosthesis, Biologic mesh, Stoma, Ileostomy, medicine, Humans, Incisional Hernia, Herniorrhaphy, business.industry, Prevention, Colostomy, Surgical Stomas, Prostheses and Implants, Surgical Mesh, medicine.disease, Surgery, Seroma, business, Abdominal surgery
Abstract: Purpose To evaluate safety and efficacy of a mesh reinforcement following stoma reversal to prevent stoma site incisional hernia (SSIH) and differences across the prostheses used. Methods A systematic search of PubMed/MEDLINE, EMBASE, SCOPUS and Cochrane databases was conducted to identify comparative studies until September 2020. A meta-analysis of postoperative outcomes and a network meta-analysis for a multiple comparison of the prostheses with each other were performed. Results Seven studies were included in the analysis (78.4% ileostomy and 21.6% colostomy) with a total of 1716 patients with (n = 684) or without (n = 1032) mesh. Mesh placement was associated with lower risk of SSIH (7.8%vs18.1%, OR0.266,95% CI 0.123–0.577, p p p = 0.66), seroma formation (4.4% vs 7.1%, OR 1.052, 95% CI 0.64–1.73, p = 0.84), anastomotic leakage (3.7% vs 2.7%, OR 1.598, 95% CI 0.846–3.019, p = 0.149) and length of stay (SMD − 0.579,95% CI − 1.261 to 0.102, p = 0.096) between mesh and no mesh groups. Use of prosthesis was associated with a significant lower need for a reoperation than no mesh group (8.1% vs 12.1%, OR 0.332, 95% CI 0.119–0.930, p = 0.036). Incidence of seroma is lower with biologic than polypropylene meshes but they showed a trend towards poor results compared with polypropylene or biosynthetic meshes. Conclusion Despite longer operative time, mesh prophylactic reinforcement at the site of stoma seems a safe and effective procedure with lower incidence of SSIH, need for reoperation and comparable short-term outcomes than standard closure technique. A significant superiority of a specific mesh type was not identified.
Published: 2021

9. Could Stoma Be Avoided after Laparoscopic Low Anterior Resection for Rectal Cancer? Experience with Transanal Tube in 195 Cases

Author: Antonio Sciuto, Roberto Peltrini, Federica Andreoli, Andrea Gianmario Di Santo Albini, Maria Michela Di Nuzzo, Nello Pirozzi, Marcello Filotico, Federica Lauria, Giuseppe Boccia, Michele D’Ambra, Ruggero Lionetti, Carlo De Werra, Felice Pirozzi, Francesco Corcione, Sciuto, Antonio, Peltrini, Roberto, Andreoli, Federica, DI SANTO ALBINI, ANDREA GIANMARIO, DI NUZZO, MARIA MICHELA, Pirozzi, Nello, Filotico, Marcello, Lauria, Federica, Boccia, Giuseppe, D'Ambra, Michele, Lionetti, Ruggero, DE WERRA, Carlo, Pirozzi, Felice, and Corcione, Francesco
Subjects: transanal tube, defunctioning stoma, laparoscopy, colorectal cancer, colorectal surgery, transanal stent, General Medicine, low anterior resection, postoperative outcome, anastomotic leakage, postoperative outcomes
Abstract: Anastomotic leakage is the most-feared complication of rectal surgery. Transanal devices have been suggested for anastomotic protection as an alternative to defunctioning stoma, although evidence is conflicting, and no single device is widely used in clinical practice. The aim of this paper is to investigate the safety and efficacy of a transanal tube for the prevention of leakage following laparoscopic rectal cancer resection. A transanal tube was used in the cases of total mesorectal excision with low colorectal or coloanal anastomosis, undamaged doughnuts, and negative intraoperative air-leak test. The transanal tube was kept in place until the seventh postoperative day. A total of 195 consecutive patients were retrieved from a prospective surgical database and included in the study. Of these, 71.8% received preoperative chemoradiotherapy. The perioperative mortality rate was 1.0%. Anastomotic leakage occurred in 19 patients, accounting for an incidence rate of 9.7%. Among these, 13 patients underwent re-laparoscopy and ileostomy, while 6 patients were managed conservatively. Overall, the stoma rate was 6.7%. The use of a transanal tube may be a suitable strategy for anastomotic protection following restorative rectal cancer resection. This approach could avoid the burden of a stoma in selected patients with low anastomoses.
Published: 2022

10. Complete Mesocolic Excision with Central Vascular Ligation during Laparoscopic Right Hemicolectomy: Technical Notes

Author: Maria Michela Di Nuzzo, Roberto Peltrini, Luigi Vanni, Michele D’Ambra, Umberto Bracale, Francesco Corcione, DI NUZZO, MARIA MICHELA, Peltrini, Roberto, Vanni, Luigi, D'Ambra, Michele, Bracale, Umberto, and Corcione, Francesco
Published: 2022

11. First Application of the Orbeye™ 4K 3D Exoscope in Recurrent Papillary Thyroid Cancer Surgery

Author: Michele D’Ambra, Anna Tedesco, Biancamaria Iacone, Umberto Bracale, Francesco Corcione, Roberto Peltrini, D'Ambra, Michele, Tedesco, Anna, Iacone, Biancamaria, Bracale, Umberto, Corcione, Francesco, and Peltrini, Roberto
Subjects: General Medicine
Abstract: Reoperation for recurrent papillary thyroid cancer (RPTC) is much more complex than primary surgery is, with a higher rate of complications. We describe, for the first time, the use of the Orbeye™ surgical microscope/exoscope for the treatment of RPTC with lymphadenectomy. This system offers 4K, three-dimensional magnified and illuminated imaging without the need for eyepieces. Magnification of the field of view facilitates a more precise dissection, preserving the anatomical structure. Currently, the Orbeye™ is regularly used in neurosurgery; however, its potential in conventional open surgery has not yet been fully exploited. Owing to its magnification capacity, the Orbeye™ exoscope is a valuable tool to help surgeons identify and preserve the integrity of the recurrent laryngeal nerves and parathyroids during thyroid surgery.
Published: 2023
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12. Risk of anastomotic bleeding after left colectomy with preservation of inferior mesenteric artery for diverticular disease: preliminary results

Author: Michele D'Ambra, Pasquale Dolce, Roberto Peltrini, Umberto Bracale, Vania Silvestri, Gaia Altieri, Francesco Corcione, Maria Michela Di Nuzzo, Ruggero Lionetti, Bracale, Umberto, Peltrini, Roberto, DI Nuzzo, Maria M, Altieri, Gaia, Silvestri, Vania, Dolce, Pasquale, D'Ambra, Michele, Lionetti, Ruggero, and Corcione, Francesco
Subjects: Diverticular Diseases, medicine.medical_specialty, Staple line reinforcement, business.industry, Diverticular Disease, Left colectomy, Anastomotic Leak, Mesenteric Artery, Inferior, Colorectal anastomosis, Perioperative, Inferior mesenteric artery, Surgery, Anastomotic leakage, Retrospective Studie, medicine.artery, medicine, Diverticular disease, Humans, Anastomotic bleeding, business, Colectomy, Retrospective Studies, Human
Abstract: Background The inferior mesenteric artery (IMA) preservation in elective laparoscopic left colectomy for diverticular disease may reduce the risk of anastomotic leakage. However, an increased risk of bleeding is assumed. The purpose of this study is to investigate the risk of colorectal anastomosis bleeding, when IMA is resected or preserved during left colectomy. Methods A retrospective review of a prospectively collected database was performed. All patients who underwent elective left colectomy, from December 2018 to September 2020, were included. Patients' data and clinical information were collected and analyzed. Patients were categorized in two group: IMA resected (IMAR) and IMA preserving (IMA-P) left colectomy. Perioperative outcomes between the two groups were compared. Results Sixty-three consecutive patients who underwent left colectomy over a period of three years were enrolled: 42 in IMA-R group and 22 in the IMA-P group. There were no significant differences in demographic and intraoperative characteristics between the two groups, except for patients' age and primary disease. Six patients (9.37%) developed anastomotic bleeding during recovery, more frequently in the IMA-P than IMA-R group, although the difference is not statistically significative (13.6% and 7.3%; p=0.406). All bleedings were self-limited and only one needed red blood cells transfusion. Using the bioabsorbable staple line reinforcement (BSLR) has proved to be advantageous in preventing anastomotic bleeding in the IMA-P group. Conclusions IMA preserving left colectomy seems to be associated with a higher risk of mostly selflimited anastomotic bleeding during recovery. BSLR seems to be effective in this group of patients.
Published: 2021
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13. Clinics and pathology of Krukenberg tumor: a systematic review and meta-analysis

Author: Michele D'Ambra, Maria D'Armiento, Marcello De Luca, Luigi Insabato, Francesco Corcione, Umberto Bracale, Ruggero Lionetti, Alberto Coppellotti, Fulvio Zullo, Roberto Peltrini, Antonio Travaglino, Antonio Raffone, Lionetti, Ruggero, DE LUCA, Marcello, Raffone, Antonio, Travaglino, Antonio, Coppellotti, Alberto, Peltrini, Roberto, Bracale, Umberto, D'Ambra, Michele, Insabato, Luigi, Zullo, Fulvio, D'Armiento, Maria, and Corcione, Francesco
Subjects: Ovarian Neoplasms, medicine.medical_specialty, business.industry, Stomach, Obstetrics and Gynecology, medicine.disease, Krukenberg tumor, Asymptomatic, Gastroenterology, Primary tumor, Appendix, Krukenberg Tumor, medicine.anatomical_structure, Internal medicine, Meta-analysis, Ascites, medicine, Humans, Female, medicine.symptom, business, Pathological
Abstract: Background Krukenberg tumor (KT) is defined as a secondary neoplasm of the ovary. While ovarian metastases account for about 30% of ovarian tumors, KTs are rare, accounting for about 1-2% of the total. The rarity of KT is at least in part responsible for the lack of a precise clinic-pathological characterization of these tumors. Clinically, KT may have a subtle clinical presentation, with few symptomatic manifestations and nonspecific clinical signs, even though in Literature there is disagreement about the clinical presentation of these patients; such difficulties in the diagnostic framework often leads to a delayed diagnosis with serious consequences on the patient outcome. Objectives We aimed to provide a clinico-pathological characterization of Krukenberg Tumor (KT) through a systematic review and meta-analysis. Methods Electronic databases were searched for all studies assessing clinicopathological features of KT series. Pooled prevalence of each clinical or pathological factor was calculated according to the random-effect model. Results Forty-eight studies with 3025 KT patients were included; 39.7% of patients were ≥50 and 39.8% were postmenopausal. The most common primary tumor sites were stomach (42.5%), colon-rectum (26.1%), breast (9.3%), and appendix (5%); 48.7% of KTs were synchronous with the primary tumor, 64.3% were bilateral, 40.5% had a diameter ≥10 cm; 55.3% showed extraovarian extent and 49% showed peritoneal involvement. The most common presenting symptoms were ascites (51.7%), palpable mass (31.3%), pain (29.3%), abdominal distention (28.7%), irregular bleeding (9.1%), asymptomatic (11.2%); 27.5% of patients showed increased serum level of CA125, while 29.4% showed increased CEA levels. Cytokeratin-7 was positive in 34.5% of cases and cytokeratin-20 in 34.3%. Conclusions KT shows a highly variable presentation. Understanding the prevalence of clinico-pathological factors may be helpful to improve the diagnosis and management of KT.
Published: 2021

14. Chemotherapy-Induced Remission of Steroid-Dependent Ulcerative Colitis Associated With Rectal Hodgkin Lymphoma

Author: Massimo Mascolo, Imma Di Luna, Roberto de Sire, Marco Picardi, Antonio Travaglino, Antonio Rispo, Francesco Corcione, Michele D'Ambra, Fabiana Castiglione, de Sire, Roberto, Castiglione, Fabiana, Picardi, Marco, Mascolo, Massimo, Di Luna, Imma, Corcione, Francesco, D'Ambra, Michele, Travaglino, Antonio, and Rispo, Antonio
Subjects: Adult, medicine.medical_specialty, medicine.medical_treatment, IBD, Antineoplastic Agents, chemotherapy, Gastroenterology, Chemotherapy induced, Internal medicine, endoscopic remission, medicine, Immunology and Allergy, Humans, ulcerative colitis, Chemotherapy, business.industry, Remission Induction, medicine.disease, Ulcerative colitis, Hodgkin Disease, Steroid dependency, Hodgkin lymphoma, Colitis, Ulcerative, Female, Steroids, business
Published: 2021

15. Intraoperative use of indocyanine green fluorescence imaging in rectal cancer surgery: The state of the art

Author: Maurizio Sodo, Ruggero Lionetti, Gaetano Luglio, Felice Mucilli, Roberto Peltrini, Michele D'Ambra, Salomone Di Saverio, Maria Michela Di Nuzzo, Simone Castiglioni, Francesco Corcione, Mauro Podda, Umberto Bracale, Peltrini, R., Podda, M., Castiglioni, S., Di Nuzzo, M. M., D'Ambra, M., Lionetti, R., Sodo, M., Luglio, G., Mucilli, F., Di Saverio, S., Bracale, U., and Corcione, F.
Subjects: Indocyanine Green, Fluorescence-lifetime imaging microscopy, medicine.medical_specialty, genetic structures, Colorectal cancer, Near infrared, Anastomotic Leak, Review, Fluorescence imaging, chemistry.chemical_compound, Medicine, Humans, Anastomotic leakage, Rectal cancer, Lymph node, Lymphatic chain, business.industry, Rectal Neoplasms, Optical Imaging, Gastroenterology, Rectum, General Medicine, medicine.disease, Total mesorectal excision, eye diseases, Dissection, medicine.anatomical_structure, chemistry, Radiology, business, Indocyanine green, Abdominal surgery, Human
Abstract: Indocyanine green (ICG) fluorescence imaging is widely used in abdominal surgery. The implementation of minimally invasive rectal surgery using new methods like robotics or a transanal approach required improvement of optical systems. In that setting, ICG fluorescence optimizes intraoperative vision of anatomical structures by improving blood and lymphatic flow. The purpose of this review was to summarize all potential applications of this upcoming technology in rectal cancer surgery. Each type of use has been separately addressed and the evidence was investigated. During rectal resection, ICG fluorescence angiography is mainly used to evaluate the perfusion of the colonic stump in order to reduce the risk of anastomotic leaks. In addition, ICG fluorescence imaging allows easy visualization of organs such as the ureter or urethra to protect them from injury. This intraoperative technology is a valuable tool for conducting lymph node dissection along the iliac lymphatic chain or to better identifying the rectal dissection planes when a transanal approach is performed. This is an overview of the applications of ICG fluorescence imaging in current surgical practice and a synthesis of the results obtained from the literature. Although further studies are need to investigate the real clinical benefits, these findings may enhance use of ICG fluorescence in current clinical practice and stimulate future research on new applications.
Published: 2021

16. Laparoscopic segmental resection for tumours of the Angle of Treitz: a challenging but feasible surgical option. Results from a retrospective case-series analysis

Author: Ruggero Lionetti, Roberto Peltrini, Filippo Carannante, Antonio Sciuto, Emanuele Pontecorvi, Umberto Bracale, Andrea Coppola, Diego Cuccurullo, Francesco Corcione, Vania Silvestri, Felice Pirozzi, Michele D'Ambra, Bracale, U., Pontecorvi, E., Silvestri, V., Cuccurullo, D., D'Ambra, M., Lionetti, R., Coppola, A., Carannante, F., Pirozzi, F., Peltrini, R., Sciuto, A., and Corcione, F.
Subjects: Male, Endoscopy, Gastrointestinal, Retrospective Studie, Gastrointestinal Stromal Tumor, Medicine, Overall survival, Laparoscopy, Prospective cohort study, Gastrointestinal Neoplasms, Aged, 80 and over, GiST, medicine.diagnostic_test, Angle of Treitz, Sarcoma, Middle Aged, Survival Rate, Jejunum, Treatment Outcome, Gastrointestinal Neoplasm, Original Article, Female, Segmental resection, Duodenal cancer, GIST, Colon, Transverse, Human, Adult, medicine.medical_specialty, Gastrointestinal Stromal Tumors, Duodenum, Operative Time, Adenocarcinoma, Rare Diseases, Rare Disease, Humans, Neoplasm Invasiveness, Retrospective Studies, Aged, Neoplasm Invasivene, business.industry, Duodenal segmental resection, Transverse colon, medicine.disease, Surgery, Feasibility Studie, Feasibility Studies, business, Rare disease
Abstract: Tumours of the small intestine are rare and account for about 5% of gastrointestinal tract neoplasms. The angle of Treitz (AT) could be defined as the intestinal loop comprised between the third duodenal portion and the first 10 cm of jejunum. A gold standard surgical treatment for AT neoplasm has not yet been well defined. This paper is focused on a very rare disease and at the best of our knowledge this is the largest case series in the literature about the Laparoscopic Segmental Resection (LSR) of AT tumours. Using a prospectively collected database, all data of consecutive patients, from January 2007 to May 2019, who underwent LSR for AT tumours at two different institutions were analysed. Patients’ demographics, intra and post-operative data, 30-day mortality and overall survival were collected. A total of 16 patients were retrieved from our database. The mean operative time was 206,5 ± 79 min. Conversion to open surgery was needed in two cases due to tumor size and, respectively, invasion of the transverse colon which required a multivisceral resection. The mean distal and proximal resection margins were 7.4 ± 2.2 and 3.9 ± 1.2 cm. The median number of harvested nodes was 9 ± 3. Pathological diagnosis was GIST in 11 cases, adenocarcinoma in 4 and sarcoma in 1 case. In conclusion, in experienced hands, LSR appears to be a safe and effective treatment option for tumours of the AT. Prospective studies are needed to confirm these findings. Electronic supplementary material The online version of this article (10.1007/s13304-020-00910-7) contains supplementary material, which is available to authorized users.
Published: 2021

17. Surgical stress and metabolic response after totally laparoscopic right colectomy

Author: Gregory Alexander Raciti, Giovanni Domenico De Palma, Giuseppe De Simone, Sara Vertaldi, Francesco Beguinot, Claudia Miele, Antonella Desiderio, Nunzio Velotti, Fatima Domenica Elisa De Palma, Umberto Bracale, Michele Manigrasso, Marco Milone, Giuseppe Servillo, Michele D'Ambra, Giuseppe Perruolo, Milone, M., Desiderio, A., Velotti, N., Manigrasso, M., Vertaldi, S., Bracale, U., D'Ambra, M., Servillo, G., De Simone, G., De Palma, F. D. E., Perruolo, G., Raciti, G. A., Miele, C., Beguinot, F., De Palma, G. D., 'Federico II' University of Naples Medical School, Institute of Experimental Endocrinology and Oncology (IEOS), Consiglio Nazionale delle Ricerche (CNR), Centre de Recherche des Cordeliers (CRC (UMR_S_1138 / U1138)), École pratique des hautes études (EPHE), and Université Paris sciences et lettres (PSL)-Université Paris sciences et lettres (PSL)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Sorbonne Université (SU)-Université de Paris (UP)
Subjects: Male, medicine.medical_specialty, Surgical stress, Colorectal cancer, medicine.medical_treatment, Science, Urology, [SDV.CAN]Life Sciences [q-bio]/Cancer, [SDV.MHEP.CHI]Life Sciences [q-bio]/Human health and pathology/Surgery, Anastomosis, [SDV.IMM.II]Life Sciences [q-bio]/Immunology/Innate immunity, Article, Extracorporeal, Proinflammatory cytokine, 03 medical and health sciences, 0302 clinical medicine, Medical research, Humans, Medicine, Colectomy, Aged, Inflammation, Multidisciplinary, Molecular medicine, Tumor Necrosis Factor-alpha, business.industry, Interleukins, Insulin, Anastomosis, Surgical, Cancer, [SDV.MHEP.HEG]Life Sciences [q-bio]/Human health and pathology/Hépatology and Gastroenterology, medicine.disease, 3. Good health, C-Reactive Protein, Oncology, [SDV.IMM.IA]Life Sciences [q-bio]/Immunology/Adaptive immunology, 030220 oncology & carcinogenesis, Colonic Neoplasms, Right Colectomy, Female, Laparoscopy, 030211 gastroenterology & hepatology, business, Biomarkers
Abstract: No clear consensus on the need to perform an intracorporeal anastomosis (IA) after laparoscopic right colectomy is currently available. One of the potential benefits of intracorporeal anastomosis may be a reduction in surgical stress. Herein, we evaluated the surgical stress response and the metabolic response in patients who underwent right colonic resection for colon cancer. Fifty-nine patients who underwent laparoscopic resection for right colon cancer were randomized to receive an intracorporeal or an extracorporeal anastomosis (EA). Data including demographics (age, sex, BMI and ASA score), pathological (AJCC tumour stage and tumour localization) and surgical results were recorded. Moreover, to determine the levels of the inflammatory response, mediators, such as C-reactive protein (CRP), tumour necrosis factor (TNF), interleukin 1β (IL-1β), IL-6, IL-10, and IL-13, were evaluated. Similarly, cortisol and insulin levels were evaluated as hormonal responses to surgical stress. We found that the proinflammatory mediator IL-6, CRP, TNF and IL-1β levels, were significantly reduced in IA compared to EA. Concurrently, an improved profile of the anti-inflammatory cytokines IL-10 and IL-13 was observed in the IA group. Relative to the hormone response to surgical stress, cortisol was increased in patients who underwent EA, while insulin was reduced in the EA group. Based on these results, surgical stress and metabolic response to IA justify advocating the adoption of a totally laparoscopic approach when performing a right colectomy for cancer.This trial is registered on ClinicalTrials.gov (ID: NCT03422588).
Published: 2021
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18. Use of the ORBEYETM Exoscope in General Surgery: The Advent of Video-Assisted Open Surgery

Author: Umberto Bracale, Ruggero Lionetti, Francesco Corcione, Giovanni Merola, Michele D'Ambra, Roberto Peltrini, Nello Pirozzi, Vania Silvestri, Emanuele Pontecorvi, Corcione, F., Silvestri, V., Merola, G., Dambra, M., Lionetti, R., Pirozzi, N., Peltrini, R., Pontecorvi, E., and Bracale, U.
Subjects: medicine.medical_specialty, general surgery, Microsurgery, medicine.medical_treatment, Magnification, Neurosurgical Procedure, 03 medical and health sciences, 0302 clinical medicine, Medicine, Video assisted, exoscope, Microscopy, training, business.industry, General surgery, Open surgery, Gold standard, medicine.disease, Esophagectomy, Inguinal hernia, Dissection, ORBEYE, 030220 oncology & carcinogenesis, Surgery, Neurosurgery, Asthenopia, business, 030217 neurology & neurosurgery, Human
Abstract: Background. Microsurgery has quickly become the “gold standard” approach for vascular surgical steps during neurosurgery. However, despite its advantages, the microscope has not been widely adopted in general surgery. A new 3D‐surgical exoscope, the ORBEYETM, has been developed and introduced to some surgical specialties. Herein, we present our preliminary experience with the ORBEYETM exoscope as applied to a number of general surgical procedures. Method. Throughout February 2020, 7 patients had undergone varying surgical procedures at our institute utilizing the ORBEYETM in some of specific procedural steps where the surgeons felt that the surgery would benefit from more enhanced magnification. Upon completion, all the surgeons who had taken part in the procedure were asked if they had experienced any nausea, dizziness, or eyestrain during its use. Results. The ORBEYETM was employed in a number of surgical steps for the following procedures: throughout an inguinal hernia repair, during a duodeno-cephalo-pancreatectomy, for a subtotal gastrectomy, during para-aortic mass dissection, and during Ivor Lewis procedure. None of the surgeons involved in the procedures reported experiencing any nausea, dizziness nor eyestrain, nor any other physical discomforts. Conclusion. To the best of our knowledge, ours is the very first report on the employment of the ORBEYE exoscope during general surgery. Our experience assures us that this highly ergonomic technology with its high-resolution 4K 3D optical system allows the surgeon to perform safe and precise surgery in several dedicated steps in which adequate magnification is required with no adverse effects to the surgeon or the surgical procedure itself.
Published: 2021

19. Extraovarian dysgerminoma in a pregnant woman: an extremely rare finding

Author: Daniela Russo, Luigi Insabato, Maria Raffaela Campanino, Michele D'Ambra, Annarita Gencarelli, Elia Guadagno, Francesco Corcione, Filippo De Rosa, Guadagno, E., Gencarelli, A., Russo, D., Campanino, M. R., De Rosa, F., D'Ambra, M., Corcione, F., and Insabato, L.
Subjects: 0301 basic medicine, Adult, Cancer Research, medicine.medical_specialty, Dysgerminoma, 03 medical and health sciences, 0302 clinical medicine, Pregnancy, Medicine, Humans, Ovarian Neoplasms, Fetus, Extraovarian, business.industry, Obstetrics, medicine.disease, Abdominal mass, Rare tumor, 030104 developmental biology, Oncology, 030220 oncology & carcinogenesis, Female, Germ cell tumors, Pregnant Women, Ultrasonography, medicine.symptom, business
Abstract: Extraovarian germ cell tumors are very rare and their occurrence during pregnancy is exceptional. In this case report an abdominal mass was shown by ultrasonography, during a routine monitoring of a 26-year-old pregnant woman. The patient was left under radiological control in the following months in order to bring the pregnancy to term. A few months after the delivery, the patient underwent surgery and a diagnosis of extraovarian (abdominal) dysgerminoma was made. To the best of our knowledge, there are only 3 other case reports describing an extra-gonadal dysgerminoma occurring during pregnancy. The aim of this study was to report an extremely rare tumor, whose management can be challenging first because this neoplasm has some differences from its ovarian and testicular counterparts. Furthermore, the occurrence during pregnancy makes the multidisciplinary approach mandatory since 3 distinct but not independent entities are involved (tumor, mother and fetus).
Published: 2020

20. Promoting Laparoscopic Anterior Approach for a Very Low Presacral Primary Neuroendocrine Tumor Arising in a Tailgut Cyst

Author: Maria Michela Di Nuzzo, Carlo De Werra, Mirella Pace, Raduan Ahmed Franca, Maria D’Armiento, Umberto Bracale, Ruggero Lionetti, Michele D’Ambra, Armando Calogero, Di Nuzzo, Maria Michela, De Werra, Carlo, Pace, Mirella, Franca, Raduan Ahmed, D'Armiento, Maria, Bracale, Umberto, Lionetti, Ruggero, D'Ambra, Michele, and Calogero, Armando
Subjects: Health Information Management, Leadership and Management, Health Policy, laparoscopy, tailgut cyst, Health Informatics, neuroendocrine tumor
Abstract: Background: Tailgut cysts are rare congenital lesions that develop in the presacral space. As they can potentially conceal primary neuroendocrine tumors, surgical excision is suggested as the treatment of choice. However, specific management guidelines have yet to be developed. A posterior approach is usually preferred for cysts extending to the third sacral vertebral body. Conversely, a transabdominal approach is preferred for lesions extending upward to achieve an optimal view of the surgical field and avoid injuries. Case report: Here, we report a case of a 48-year-old man suffering from perianal pain and constipation. Digital rectal examination and magnetic resonance imaging revealed a presacral mass below the third sacral vertebral body. A laparoscopic transabdominal presacral tumor excision was performed. The final histological diagnosis was a rare primary neuroendocrine tumor arising from a tailgut cyst. The postoperative course was uneventful, and no signs of recurrence were observed at the six-month follow-up. Conclusions: This study may help establish more well-grounded recommendations for the surgical management of rectal tumors, demonstrating that the laparoscopic transabdominal technique is safe and feasible, even for lesions below the third sacral vertebral body. This approach provided an adequate view of the presacral space, facilitating the preservation of cyst integrity, which is essential in cases of malignant pathologies.
Published: 2022
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21. Effects of the first and second wave of the COVID-19 pandemic on patients with colorectal cancer: what has really changed in the outcomes?

Author: M M Di Nuzzo, Francesco Corcione, Michele D'Ambra, Roberto Peltrini, Nicola Imperatore, Umberto Bracale, Peltrini, R., Imperatore, N., Di Nuzzo, M. M., D'Ambra, M., Bracale, U., and Corcione, F.
Subjects: medicine.medical_specialty, 2019-20 coronavirus outbreak, Delayed Diagnosis, AcademicSubjects/MED00910, Coronavirus disease 2019 (COVID-19), Colorectal cancer, Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), Colorectal Neoplasm, Health Services Accessibility, Internal medicine, Pandemic, Research Letter, medicine, Humans, Antigens, Tumor-Associated, Carbohydrate, Pandemics, Colectomy, business.industry, Delayed Diagnosi, COVID-19, medicine.disease, Carcinoembryonic Antigen, Italy, Lymph Node Excision, Surgery, AcademicSubjects/MED00010, Colorectal Neoplasms, business, Human
Published: 2021
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22. Laparoscopic sigmoid colectomy with preservation of the inferior mesenteric artery for diverticular disease – a video vignette

Author: Francesco Corcione, Roberto Peltrini, Michele D'Ambra, Emanuele Pontecorvi, Carolina Bartolini, Umberto Bracale, Vania Silvestri, Peltrini, R., Pontecorvi, E., Silvestri, V., Bartolini, C., D'Ambra, M., Bracale, U., and Corcione, F.
Subjects: Diverticular Diseases, medicine.medical_specialty, business.industry, Gastroenterology, Mesenteric Artery, Inferior, Inferior mesenteric artery, Surgery, Vignette, Colon, Sigmoid, medicine.artery, Diverticular disease, Humans, Medicine, Laparoscopy, Laparoscopic sigmoid colectomy, business, Colectomy
Published: 2020

23. Laparoscopic right hemicolectomy for cT4b caecal adenocarcinoma involving the bladder – a video vignette

Author: Ruggero Lionetti, Carolina Bartolini, Roberto Peltrini, Francesco Corcione, Michele D'Ambra, Umberto Bracale, Peltrini, R., D'Ambra, M., Bartolini, C., Lionetti, R., Bracale, U., and Corcione, F.
Subjects: medicine.medical_specialty, business.industry, General surgery, Urinary Bladder, Gastroenterology, MEDLINE, Cecal Neoplasms, Adenocarcinoma, medicine.disease, Text mining, Vignette, Colonic Neoplasms, medicine, Humans, Laparoscopy, business, Colectomy, Laparoscopic right hemicolectomy
Published: 2020

24. Robotic cholecystectomy for acute cholecystitis

Author: Umberto Bracale, G.D. De Palma, Gianluca Cassese, Marco Milone, Sara Vertaldi, Michele Manigrasso, Michele D'Ambra, Milone, M., Vertaldi, S., Bracale, U., D'Ambra, M., Cassese, G., Manigrasso, M., and De Palma, G. D.
Subjects: Male, medicine.medical_specialty, Nausea, medicine.medical_treatment, Cholecystitis, Acute, Operative Time, Blood Loss, Surgical, 03 medical and health sciences, 0302 clinical medicine, Robotic Surgical Procedures, Blood loss, medicine, Acute cholecystitis, Cholecystectomy, Robotic surgery, 030212 general & internal medicine, Leukocytosis, Aged, business.industry, General Medicine, Length of Stay, Middle Aged, medicine.disease, Surgery, 030220 oncology & carcinogenesis, Cholecystitis, Vomiting, Female, Postoperative Complication, medicine.symptom, business, Human
Abstract: Introduction Nowadays laparoscopic cholecystectomy is considered as criterion standard for surgical treatment of acute calculous cholecystitis. During the last few years, there has been growing interest about the robotic approach. Several authors have reported the superiority of robotic cholecystectomy, associated with a lower percentage of conversion especially in patients with intraoperative diagnosis of acute or gangrenous cholecystitis. We report 3 case reports of moderate acute cholecystitis successfully treated by robotic cholecystectomy. Patient concerns Three patients presented moderate acute calculous cholecystitis with leukocytosis, fever, nausea, vomiting, and pain. Diagnosis Three patients of our study population had clinical and laboratory suspicion of moderate acute calculous cholecystitis verified by abdominal ultrasound examination, which found out cholelitiasis in all 3 cases. Final diagnosis was confirmed by intraoperative findings and histopathological examination, with two empyematous cholecystitis and one perforated cholecystitis. Interventions All patients underwent robotic cholecystectomy with the da Vinci Robotic Surgical System. The entire procedure required a mean operation time of 128 minutes and the average blood loss was 60 mL, without any intraoperative complications. Outcomes In all 3 cases postoperative period was uneventfull. All the patients were discharged within 24 hours and no readmissions were reported during a 30 days' follow-up. Conclusions Robotic cholecystectomy for ACC is feasible and safe. Several studies have demonstrated that robotic approach reduces the risk of conversion to open surgery in case of acute or gangrenous cholecystitis. Our results are in line with current literature. In fact, we have successfully treated 2 patients with empyematous acute cholecystitis and 1 with gangrenous cholecystitis with a totally robotic approach, without any complications or need of conversion to open surgery. In conclusion, our results confirm that it is the time to include robotic surgery in the emergency setting.
Published: 2019
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25. Totally robotic splenic flexure resection with intracorporeal anastomosis – a video vignette

Author: Marco Milone, Michele D'Ambra, Michele Manigrasso, G.D. De Palma, Milone, M., Manigrasso, M., D'Ambra, M., and De Palma, G. D.
Subjects: Splenic flexure, medicine.medical_specialty, Vignette, Intracorporeal anastomosis, business.industry, Gastroenterology, medicine, Anastomosis, Video-Audio Media, business, Surgery, Resection
Published: 2019
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26. Spirit and Soul in Hedwig Conrad-Martius’s Metaphysical Dialogues: From Nature to the Human Being

Author: Michele D’Ambra
Subjects: Human spirit, Constitution, media_common.quotation_subject, Philosophy, Metaphysics, Epistemology, Mathematics (miscellaneous), Argument, Geist, Ontology, Soul, Order (virtue), media_common
Abstract: Through the analysis of Conrad-Martius Metaphysical Dialogues, our aim is show the relevance of the concept of spirit (Geist) and soul (Seele) to clarify the constitution of the human being. In order to understand Conrad-Martius’ phenomenological description, it is necessary to explain Husserl’s and Stein’s approaches to the same argument. Briefly their position is described at the beginning of the essay and then the main points of Conrad-Martius’ book are pinpointed. Human being is understandable in the complex of the degrees of nature, that is, with reference to the organic life—plants and animals. Mental-spirit life is the distinguishing element regarding the human being.
Published: 2008
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27. ¿Qué ha cambiado en la adrenalectomía? De la cirugía abierta a la laparoscópica

Author: Hendrik J. Plaggemars, Manuel Trias, Gijs Van Couwelaar, Xavier Rius, Anna Curell Garcia, Pere Rebasa, Eduardo M. Targarona, and Michele D’ambra
Subjects: business.industry, Medicine, Surgery, business, Humanities
Abstract: Resumen Introduccion Tras la introduccion del abordaje laparoscopico en la cirugia adrenal, esta tecnica se ha convertido en el estandar de referencia para el tratamiento de las enfermedades quirurgicas adrenales. A pesar de ello, los estudios comparativos con el abordaje abierto son escasos, y no se conoce el impacto que las tecnicas laparoscopicas pueden haber tenido en su tratamiento. Objetivo Evaluar la experiencia en cirugia adrenal durante un periodo de 14 anos, antes y despues de la introduccion de la adrenalectomia laparoscopica, y analizar la influencia de esta tecnica en el abordaje quirurgico de las enfermedades adrenales. Pacientes y metodo Entre enero de 1990 y junio de 2004 se realizo una adrenalectomia en 78 pacientes. En el periodo 1990-1998 se efectuo una adrenalectomia abierta en 24 pacientes, mientras que entre 1999 y 2004 se realizaron 53 abordajes por via laparoscopica y 1 por via abierta. Los datos del grupo abierto fueron revisados retrospectivamente, y los del grupo laparoscopico fueron registrados prospectivamente en la base de datos de cirugia laparoscopica avanzada del Hospital de Sant Pau. Resultados La edad media de los grupos de adrenalectomia abierta y laparoscopica fue, respectivamente, de 47 (rango, 16-75) y 49 anos (rango, 17-77) (p = NS). La distribucion por indicaciones de la cirugia fueron similares en ambos periodos en cuanto a hiperaldosteronismo primario, hipercortisolismo y feocromocitoma, con un incremento significativo de los casos indicados por malignidad (1 frente a 4) o incidentaloma (2 frente a 13) (p Conclusiones El abordaje laparoscopico ha favorecido una mejoria de los resultados quirurgicos inmediatos (tiempo operatorio, morbilidad y estancia hospitalaria). Es evidente el incremento en el numero de adrenalectomias, especialmente respecto a los incidentalomas, debido a las mejores exploraciones diagnosticas y la disponibilidad de un abordaje menos agresivo.
Published: 2005
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28. Intracorporeal versus extracorporeal anastomosis. Results from a multicentre comparative study on 512 right-sided colorectal cancers

Author: Francesco Milone, Riccardo Rosati, Mario Musella, Ugo Pace, Marco Clemente, Maria Rachele Angiolini, Ugo Elmore, Giuseppe Paolo Ferulano, Enrico Di Salvo, Gaetano Luglio, Umberto Bracale, Luigi Bucci, Paolo Delrio, Marco Milone, Michele D'Ambra, Carmine Napolitano, Milone, Marco, Elmore, Ugo, DI SALVO, Enrico, Delrio, Paolo, Bucci, Luigi, Ferulano, GIUSEPPE PAOLO, Napolitano, Carmine, Angiolini, Maria Rachele, Bracale, Umberto, Clemente, Marco, D'Ambra, Michele, Luglio, Gaetano, Musella, Mario, Pace, Ugo, Rosati, Riccardo, Milone, Francesco, Milone, M, Elmore, U, Di Salvo, E, Delrio, P, Bucci, L, Ferulano, Gp, Napolitano, C, Angiolini, Mr, Bracale, U, Clemente, M, D'Ambra, M, Luglio, G, Musella, M, Pace, U, and Milone, F.
Subjects: Male, medicine.medical_specialty, Operative Time, Anastomosis, Extracorporeal, law.invention, Postoperative Complications, Randomized controlled trial, law, Internal medicine, medicine, Humans, Stage (cooking), Colectomy, Aged, Right colectomy, Anastomosis, Intracorporeal, Extracorporeal, Totally laparoscopic, Video-assisted, business.industry, General surgery, Anastomosis, Surgical, Hepatology, Surgery, Treatment Outcome, Italy, Right Colectomy, Operative time, Female, Laparoscopy, business, Colorectal Neoplasms, Abdominal surgery
Abstract: Although nowadays considered as feasible and effective surgery in terms of short- and long-term results and oncological radicality, laparoscopic right colectomy is performed by a small number of surgeons, and in the vast majority of cases, this technique was performed with an extracorporeal anastomosis. Current literature failed to solve the controversies between intracorporeal and extracorporeal anastomosis after laparoscopic right colectomy. A multicenter case-controlled study has been designed, including 286 patients who underwent laparoscopic right hemicolectomy with intracorporeal anastomosis (IA) compared with 226 matched patients who underwent laparoscopic right hemicolectomy with extracorporeal anastomosis (EA). There was no significant difference in terms of age, sex, BMI, and ASA score between the two groups. Surgical post history, tumor localization, and stage of disease according to AJCC/UICC TNM were similar too. Although similar oncologic radicality in term of number of lymph nodes harvested (25.7 ± 10.7 of IA group vs. 24.8 ± 8.7 of EA group; p = 0.3), as well as similar operative time (166 ± 43.7 min. in IA group vs. 157.5 ± 67.2 min in EA group) have been registered, time to flatus was statistically lower after intracorporeal anastomosis (40.8 ± 24.3 h in TLRC group vs. 55.2 ± 19.2 h in LARC group; p
Published: 2014

29. Laparoscopic drainage of a recurrent psoas abscess

Author: Benedetto, Neola, Michele, D'Ambra, Stefano, Capasso, Milena, Russo, and Giuseppe Paolo, Ferulano
Subjects: Adult, Recurrence, Drainage, Humans, Psoas Abscess, Female, Laparoscopy
Abstract: Many Authors suggest that psoas abscess should initially undergo an antibiotic therapy, with or without percutaneous drainage. In their opinion, surgical drainage should be done in case of failure or complicated recurrences. Herein we report a laparoscopic drainage of a recurrent and multilocular psoas abscess.A 43-year-old woman presented to our department with a 4-week history of fever, anorexia, difficulty in walking, and pain in her right flank, lower back and hip. She had a 20-year history of recurrent lower back pain and fever treated with cyclic antibiotic therapy. Abdominal CT scan showed a complex multilocular right psoas abscess and a 17 mm hypodense area in the sixth liver segment. A drainage of the abscess through a laparoscopic access with intraoperative laparoscopic ultrasound of the liver was decided.The patient was discharged on the 3 th postoperative day. Her white blood cell count was normal and she was symptom free. At 1-, 6-, 12- and 24-months-follow-up, neither fever nor lower back pain were reported.According to our experience, laparoscopic drainage of iliopsoas abscess is safe and effective. However, further studies comparing laparoscopic drainage with open drainage and percutaneous drainage are required in order to define the specific indications of laparoscopic drainage.Negli ultimi anni, gli ascessi del muscolo ileopsoas sono stati riportati in letteratura con crescente frequenza, probabilmente a causa del largo impiego della TC nella diagnostica differenziale delle algie lombari. Qui presentiamo il caso di una paziente che ha sviluppato un ascesso dell’ileopsoas post-traumatico. Una donna di 43 anni riferiva febbre da 4 settimane, anoressia, dolore al fianco destro e alla regione lombare e difficoltà alla deambulazione. Tale sintomatologia, insorta per la prima volta 20 anni prima in seguito ad una caduta da cavallo, si ripresentava ciclicamente. Per il controllo della febbre e del dolore, la paziente assumeva una terapia antibiotica empirica. Al momento del ricovero gli esami ematochimici mostravano una moderata leucocitosi. La TC dell’addome evidenziava un grosso ascesso multiloculato dello psoas destro ed una lesione ipodensa del sesto segmento epatico. Considerando la lunga storia di infezioni ricorrenti e l’indicazione ad investigare ulteriormente la lesione epatica, si optava per il drenaggio laparoscopico della lesione: aperta completamente la parete dell’ascesso, venivano drenati 550ml di liquido purulento la cui coltura evidenziava la presenza di Stafilococco aureo. Una ecografia del fegato intraoperatoria con sonda laparoscopica escludeva la presenza di una lesione resecabile del sesto segmento epatico e ne confermava la natura infiammatoria. La paziente veniva dimessa in terza giornata operatoria con terapia antibiotica mirata sull’antibiogramma. Nè febbre, nè dolore sono stati più riferiti ai successivi controlli a 1, 6, 12 e 24 mesi dall’intervento. Molti Autori ritengono che gli ascessi dell’ileopsoas possano essere controllati con terapia antibiotica ed eventualmente attraverso il drenaggio percutaneo, riservando il drenaggio chirurgico ai casi complessi o recidivanti. Tuttavia la letteratura non chiarisce se sia da preferire il drenaggio chirurgico con accesso open o laparoscopico. Nella nostra esperienza, il drenaggio laparoscopico è sicuro e consente un drenaggio completo anche degli ascessi multiloculati; inoltre consente la visualizzazione delle strutture anatomiche contigue che potrebbero essere coinvolte dal processo infettivo. Infine l’accesso laparoscopico permette una precoce dimissione e minimi esiti cicatriziali.
Published: 2014

30. Laparoscopic One-Stage vs Endoscopic Plus Laparoscopic Management of Common Bile Duct Stones – A Prospective Randomized Study

Author: Piero Di Silverio, Michele Rutigliano, Giuseppe Paolo Ferulano, Dilillo S, Stefano Capasso, Michele D'Ambra, Ruggero Lionetti, and Domenico Pelaggi
Subjects: Endoscopic ultrasound, medicine.medical_specialty, education.field_of_study, medicine.diagnostic_test, Common bile duct, business.industry, General surgery, medicine.medical_treatment, Population, Gallstones, Gallbladder Stone, Biliary colic, medicine.disease, medicine.anatomical_structure, Cholangiography, medicine, Cholecystectomy, medicine.symptom, education, business
Abstract: The incidence of gallstones is rather high and is referred as approximately 13%-17% among the western population, [Bateson, 2000; Barbara et al., 1987; Everhart et al., 1999; Pixley et al., 1985]. It is well known that most of the people with gallstones are asymptomatic and often they are absolutely unaware of their presence, it is even referred that no more than 15-20% of them has the probability of suffering from a biliary colic later on [Attili et al., 1995], which, once occurred, could recur more easily causing sometime serious complications, such as pancreatitis by stone’s migration and biliary obstruction, that over a 10-year period can be expected to occur in 2–3% of patients with initially silent gallbladder stones [Gracie & Ransohoff, 1982]. The incidence of common bile duct (CBD) stones has been reported as ranging between 5% to 18% of patients undergoing cholecystectomy for gallstones, and patients with symptoms suggestive of choledocholithiasis have an even higher incidence, also increasing with age [Martin et al., 2006]. Because of the continuous developing of the diagnostic and therapeutic techniques from the introduction of intra-operative cholangiography by Mirizzi in 1932, the choose of the most effective strategy in the management of the common bile duct (CBD) stones associated with gallstones is object of close discussions far from any conclusive agreement. The new diagnostic techniques as magnetic resonance cholangiography (MRC) and endoscopic ultrasound (EUS), give the opportunity to visualize the biliary tree without any invasive exploration of the ducts and share the same idea as the minimally invasive laparoscopic surgical approach. They are progressively evolving as well as the standard of care for the management of common bile duct (CBD) stones, historically performed via
Published: 2011
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31. [Timing and results of the surgical treatment of the diverticular disease of the colon]

Author: Giuseppe P, Ferulano, Saverio, Dilillo, Michele, D'Ambra, Cecilia, Saviano, Rossella, Brunaccino, Ruggero, Lionetti, and Domenico, Fico
Subjects: Male, Time Factors, Colonoscopy, Middle Aged, Combined Modality Therapy, Severity of Illness Index, Diverticulitis, Colonic, Anti-Infective Agents, Colon, Sigmoid, Metronidazole, Humans, Female, Colectomy, Aged, Retrospective Studies
Abstract: To evaluate retrospectively the outcome of the curative open and laparoscopic surgical approach to the diverticular disease according to timed steps based on the pathologic stage.From 1989 83 out of 242 outpatients underwent surgery in emergency or after medical failure and at least two acute attacks requiring hospital admittance, or complicated diverticulitis. Modified Hinchey classification staged the disease. Clinic and instrumental criteria, surgical procedures, early and late complications were statistically evaluated (Students t-test and exact Fischer test, p0.05) in comparison with the different steps of therapeutic strategy.Twenty nine patients were classified as Hinchey 0, 26 as I, 14 as II, 11 as III, 3 as IV. Clinical characteristics of the lap and open groups overlapped, with higher rate of earlier age in first and advanced stages in the second group. 16 patients (19.3%) underwent surgery at the first attack in emergency or in delayed emergency (5 TC-guided drainages). 30 open and 53 lap procedures were done: 21 two-stage: 18 primary resections + ileostomy and 3 Hartmann; 61 single stage: 49 sigmoidectomy, 12 left colectomy. 4 conversions (7.5%), 12 early (14.5%) and 10 late (12.1%) complications were observed.Complications rate was higher in the open group including more advanced stages. Elective surgery performed following conservative therapy, 4 weeks from the first acute attack in younger people (age55yrs.) and after two attacks in elder (age55yrs.) showed a significant lower complications' incidence (p0.05) compared to the 8 weeks delayed operations.Surgery of diverticulitis must follow standardized criteria. The laparoscopic approach could be performed in more severe stages, provided that conditions of delayed emergency were achieved.
Published: 2007

32. Laparoscopic One-Stage vs Endoscopic Plus Laparoscopic Management of Common Bile Duct Stones – A Prospective Randomized Study

Author: Giuseppe P. Ferulano, Saverio Dilillo, Michele D’Ambra, Ruggero Lionetti, Piero Di Silverio, Stefano Capasso, Domenico Pelaggi, Michele Rutigliano, Giuseppe P. Ferulano, Saverio Dilillo, Michele D’Ambra, Ruggero Lionetti, Piero Di Silverio, Stefano Capasso, Domenico Pelaggi, and Michele Rutigliano
Published: 2011
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33. Reply

Author: Giuseppe P. Ferulano, Saverio Dilillo, Michele D'Ambra, Ruggero Lionetti, Rossella Brunaccino, Domenico Fico, and Domenico Pelaggi
Subjects: Hepatology, Gastroenterology
Published: 2008
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34. Changes in surgicaL behaviOrs dUring the CoviD-19 pandemic. The SICE CLOUD19 Study

Author: Bracale, U., Podda, Maria Vittoria, Castiglioni, S., Peltrini, R., Sartori, Alessandra, Arezzo, A., Corcione, F., Agresta, F., Antonucci, A., Zanframundo, C., Cavallo, F., Mazzarolo, G., Agrusa, A., Di Buono, G., Aldrighetti, L., Fiorentini, G., Lucianetti, A., Magnone, S., Alfieri, Sergio, Rosa, Fausto, Altomare, D. F., Picciariello, A., Parisi, Carmelo Maria Antonio, Di Cintio, A., Amisano, M. F., Cravero, F., Ammendola, M., Ammerata, G., Anastasi, A., Canonico, G., Gattolin, A., Travaglio, E., De Palma, M., Angelini, P., Galante, F., Benevento, A., Rausei, S., Serao, A., Abbatini, F., Annecchiarico, M., Varricchio, A., Annessi, V., Tumiati, D., Annicchiarico, A., Mirabella, A., Marino, M. V., Spinelli, A., Braun, A., Santi, H. T., Romano, L., Antoniutti, M., Armellino, M. F., Argenio, G., Verzelli, A., Budassi, A., Baiocchi, G., Alfano, M. S., Balani, A., Barone, M., Baldazzi, G., Cassini, D., Canger, R. C. B., Zabbialini, G., Belli, Andrea, Izzo, Filippo, Bertolino, F., Brunetti, Maria Mercede, Bianco, Flaviana, Cappiello, A., Boccia, L., Boffi, B., Perna, Francesco, Bonilauri, S., Frazzetta, G., Bordoni, P., Fleres, F., Borghi, F., Giraudo, G., Bottino, V., Canfora, A., Piccoli, F. B., Calligaris, L., Nipote, B., Nasti, A. G., Bufalari, A., Bettarini, F., Buononato, M., Greco, M., Calo, P. G., Medas, F., Cardamone, E., Castaldo, P., Carlini, M., Spoletini, D., De Nisco, C., Pulighe, F., Feo, C. V., Fabbri, N., Antropoli, C., Foroni, F., Carnazza, M., Ragazzi, S., Cassinotti, E., Boni, L., Catena, F., Giuffrida, M., Perrone, Giuseppe, Ccotsoglou, C., Granieri, S., Ceccarelli, G., Bugiantella, W., Cedolini, C., Seriau, L., Cesari, Matteo, Contine, A., Chiara, Osvaldo, Cimbanassi, S., Cocozza, E., Berselli, M., Fantini, C., Costi, R., Casali, L., Morini, A., Crafa, F., Vanela, S., Curro, G., Orsini, V., Da Lio, C., Biral, Maria Francesca, Danelli, P., Guerci, C., Scala, D., Marino, Giuseppe, De Carlis, L., Lauterio, A., De Giorgi, D., Sciannamea, G., De Manzini, N., Losurdo, P., Sangiuliano, N., Degiuli, M., Caterina, F., Del Rio, P., Bonati, E., Di Lernia, S., Ardizzone, M. V. R., Di Saverio, S., Franchi, C., Di Venere, B., Miglio, R., Cuccurullo, D., Sagnelli, C., Docimo, L., Tolone, S., Longoni, M., Faillace, G., Rondelli, F., Pennella, F. P., Colucci, V., Carfora, T., Muttillo, I. A., Picardi, B., Stefano, R., Campagnacci, R., Maurizi, A., Tricarico, F., Montagna, M., Amedeo, E., Scollica, M. C., Lauro, E., Laterza, E., Molinari, E., Berta, G., Bono, D., Fabozzi, Simone Michele, Romano, M., Facci, E., Parini, D., Farfaglia, R., Arizzi, V., Farsi, M., Miranda, E., Fei, L., Flavio, G., Pirozzi, F., Sciuto, A., Ferrero, A., Palisi, M., Filauro, M., Barberis, A., Azzinnaro, A., Fiscon, V., Vigna, S., D'Ambra, M., Pontecorvi, E., Anania, G., Bombardini, C., Galizia, G., Auricchio, Anna Maria, Cardella, F., Genna, M., Gentilli, S., Herald, N., Castagnoli, G., Bartoli, A., Gianotti, L., Garancini, M., Bellanova, G., Palazzo, P., De Palma, G., Milone, Maria, Ferrari, G., Magistro, C., Giuliani, Antonio, Di Natale, Maria Grazia, Brisinda, Giuseppe, Cavallaro, G., Sammarco, G., Gallo, Giuseppe, Goletti, O., Macchini, D., Greco, Viviana, Amoroso, V., Guercioni, G., Benedetti, M., Guzzo, G., Pata, F., Scandroglio, I., Roscio, F., Jovine, E., Lombardi, Roberto, La Rocca, F., Di Capua, F., Lanci, C., Leli, R., Borasi, A., Lepiane, P., Balla, A., Liberatore, E., Morelli, L., Di Franco, G., Lucchi, A., Vittori, L., Bonavina, L., Asti, Emilio Fabrizio, Maggioni, D., Martino, G., Manca, Gavina, Delvecchio, A., Tedesco, M., Gambardella, D., Marafioti, S., De Marco, M. L., Guicciardi, M. A., Motta, M., Calgaro, M., Adamo, V., Guerrieri, Maria Chiara, Coletta, P., Ortenzi, M., Martines, G., Lantone, G., Martinotti, M., Fassardi, G., Castriconi, M., Squillante, S., De Luca, M., Pavanello, M., Di Marco, C., Ronconi, M., Casiraghi, Maria Stella, Mazzaferro, V., Battiston, C., Perrotta, M., Ripa, C., Giancarlo, M., Panizzo, V., Millo, P., Contul, R. B., Ferraro, V., Molino, C., Crolla, E., Moretto, G., Bacchion, M., Morino, M., Allaix, M. E., Motterlini, E., Petracca, Martina, Muratore, A., Musella, Martina, Vitiello, A., Nardo, B., Crocco, V., Navarra, G., Lazzara, S., Navarra, G. G., Cuoghi, M., Olmi, S., Oldani, Alberto, Uccelli, M., Opocher, E., Giovenzana, M., De Paolis, P., Santarelli, M., Delrio, P., Carbone, F., Bianchi, P. P. G., Formisano, Capelli, P., Baldini, E., Festa, P., Mottola, Armando, Merola, G., Perrotta, N., Celiento, M., Personnettaz, E., Muzio, S., Petitti, T., Melchiorre, A., Piccoli, M., Pecchini, F., Frontali, A., Maffioli, A., Maida, P., Tammaro, P., Pignata, G., Andreuccetti, J., Pilone, V., Renzulli, M., Pintaldi, S., Ceretti, A. P., Mariani, N. M., Pisanu, A., Polastri, R., Maiello, F., Porcu, A., Perra, T., Mucilli, F., Troisi, R., Montalti, R., Scognamillo, F., Delogu, D., Galleano, R., Malerba, M., Salfi, R., Pisano, M., Sechi, R., Cillara, N., Ramuscello, S., De Leo, E., Restini, E., Tumolo, R., Cianci, P., Capuzzolo, S., Rizzo, M., Recordare, A., Santoro, Roberto, Amodio, P. M., Rocca, A., Cecere, G., Romito, R., Portigliotti, L., Rosati, R., Elmore, U., Russello, D., Latteri, S., Costarella, S. M., Massa, S., Capasso, L., Santangelo, M., Sodo, M., Sarro, G., Rivolta, U., Scabini, S., Pertile, D., Selvaggi, F., Rossi, S., Pellino, G., Sganga, Gabriele, Fransvea, P., Testa, S., De Rosa, Maria Cristina, Siquini, W., Trana, C., Solej, M., Bolzon, S., Guerra, Eliana, Stella, M., Ferrara, F., Stipa, F., Stringhi, E., Celotti, A., Taglietti, L., Del Giudice, R., Talarico, C. A., Ruggiero, Miriam, Tirone, G., Romario, U. F., Petz, W., Caracino, V., Rossetti, V., Verza, L. A., Vescovi, L., Marini, M., Vettoretto, N., Botteri, E., Vincenti, L., Giannandrea, G., Viora, T., Maganuco, L., Veronesi, P., Zani, B., Zanus, G., Brizzolari, M., Zanzi, F., Guariniello, A., Zappa, M. A., Galfrascoli, E., Zonta, S., Oragano, L., Zuliani, W., Chiari, D., Bracale, Umberto, Podda, Mauro, Castiglioni, Simone, Peltrini, Roberto, Sartori, Alberto, Arezzo, Alberto, Corcione, Francesco, Agresta, Ferdinando, Rosati, Riccardo, Umberto, Bracale, Mauro, Podda, Simone, Castiglioni, Roberto, Peltrini, Alberto, Sartori, Alberto, Arezzo, Francesco, Corcione, Ferdinando, Agresta, CLOUD-19 Collaborative Group Adelmo Antonucci, Claudia, Zanframundo, Fabio, Cavallo, Giorgio, Mazzarolo, Antonio, Agrusa, Giuseppe Di Buono, Luca, Aldrighetti, Guido, Fiorentini, Alessandro, Lucianetti, Stefano, Magnone, Sergio, Alfieri, Fausto, Rosa, Altomare, Donato F., Arcangelo, Picciariello, Amilcare, Parisi, Antonio Di Cintio, Marco Francesco Amisano, Francesca, Cravero, Michele, Ammendola, Giorgio, Ammerata, Alessandro, Anastasi, Giuseppe, Canonico, Andra, Gattolin, Elisabetta, Travaglio, Andrea, Sartori, Massimiliano De Palma, Pierluigi, Angelini, Francesco, Galante, Angelo, Benevento, Stefano, Rausei, Angelo, Serao, Francesca, Abbatini, Mario, Annecchiarico, Antonio, Varricchio, Valerio, Annessi, David, Tumiati, Alfredo, Annicchiarico, Antonello, Mirabella, Marino, Marco V., Antonino, Spinelli, Antonio, Braun, Hong Tham Santi, Lucia, Romano, Michele, Antoniutti, Mariano Fortunato Armellino, Giulio, Argenio, Augusto, Verzelli, Andrea, Budassi, Gianluca, Baiocchi, Marie Sophie Alfano, Alessandro, Balani, Marco, Barone, Gianandrea, Baldazzi, Diletta, Cassini, Ruben Carlo Balzarotti Canger, Gianpietro, Zabbialini, Andrea, Belli, Francesco, Izzo, Franco, Bertolino, Marco, Brunetti, Francesco, Bianco, Antonio, Cappiello, Luigi, Boccia, Bernardo, Boffi, Federico, Perna, Stefano, Bonilauri, Giuseppe, Frazzetta, Pierpaolo, Bordoni, Francesco, Flere, Felice, Borghi, Giorgio, Giraudo, Vincenzo, Bottino, Alfonso, Canfora, Fabrizio Briganti Piccoli, Luca, Calligari, Bruno, Nipote, Aniello Gennaro Nasti, Andrea, Bufalari, Francesca, Bettarini, Massimo, Buononato, Marco, Greco, Pietro Giorgio Calò, Fabio, Meda, Eugenia, Cardamone, Pasquale, Castaldo, Massimo, Carlini, Domenico, Spoletini, Carlo De Nisco, Fabio, Pulighe, Feo, Carlo V., Nicolò, Fabbri, Carmine, Antropoli, Fabrizio, Foroni, Maurizio, Carnazza, Salvatore, Ragazzi, Elisa, Cassinotti, Luigi, Boni, Fausto, Catena, Mario, Giuffrida, Gennaro, Perrone, Christian, Ccotsoglou, Stefano, Granieri, Graziano, Ceccarelli, Walter, Bugiantella, Carla, Cedolini, Luca, Seriau, Maurizio, Cesari, Alessandro, Contine, Osvaldo, Chiara, Stefania, Cimbanassi, Eugenio, Cocozza, Mattia, Berselli, Corrado, Fantini, Renato, Costi, Lorenzo, Casali, Andrea, Morini, Francesco, Crafa, Serafino, Vanela, Giuseppe, Currò, Vincenzo, Orsini, Corrado Da Lio, Mario, Biral, Piergiorgio, Danelli, Claudio, Guerci, Dario, Scala, Graziella, Marino, Luciano De Carlis, Andrea, Lauterio, Donato De Giorgi, Gianluca, Sciannamea, Nicolo De Manzini, Pasquale, Losurdo, Maurizio De Palma, Nicola, Sangiuliano, Maurizio, Degiuli, Franco, Caterina, Paolo Del Rio, Elena, Bonati, Stefano Di Lernia, Marco Vittorio Rossi Ardizzone, Salomone Di Saverio, Caterina, Franchi, Beatrice Di Venere, Rosanna, Miglio, Diego, Cuccurullo, Carlo, Sagnelli, Docimo, Ludovico, Tolone, Salvatore, Mauro, Longoni, Giuseppe, Faillace, Fabio, Rondelli, Francesca Pennetti Pennella, Vincenzo, Colucci, Teresa, Carfora, Irnerio Angelo Muttillo, Biagio, Picardi, Rossi, Stefano, Roberto, Campagnacci, Angela, Maurizi, Fausto, Tricarico, Marco, Montagna, Elio, Amedeo, Scollica, Michela C., Enrico, Lauro, Ernesto, Laterza, Enrico, Molinari, Berta, G., Dario, Bono, Massimiliano, Fabozzi, Mafalda, Romano, Enzo, Facci, Dario, Parini, Roberto, Farfaglia, Valeria, Arizzi, Marco, Farsi, Egidio, Miranda, Fei, Landino, Giordano, Flavio, Felice, Pirozzi, Antonio, Sciuto, Alessandro, Ferrero, Marco, Palisi, Marco, Filauro, Andrea, Barberi, Antonio, Azzinnaro, Valentino, Fiscon, Silvia, Vigna, Michele, D’Ambra, Emanuele, Pontecorvi, Gabriele, Anania, Cristina, Bombardini, Galizia, Gennaro, Auricchio, Annamaria, Cardella, Francesca, Michele, Genna, Sergio, Gentilli, Nikaj, Herald, Giampaolo, Castagnoli, Alberto, Bartoli, Luca, Gianotti, Mattia, Garancini, Giovanni, Bellanova, Paola, Palazzo, Giovanni De Palma, Marco, Milone, Giovanni, Ferrari, Carmelo, Magistro, Antonio, Giuliani, Giuseppe Di Natale, Giuseppe, Brisinda, Giuseppe, Cavallaro, Giuseppe, Sammarco, Gaetano, Gallo, Orlando, Goletti, Daniele, Macchini, Vincenzo, Greco, Vincenzo, Amoroso, Gianluca, Guercioni, Michele, Benedetti, Guglielmo, Guzzo, Francesco, Pata, Ildo, Scandroglio, Francesco, Roscio, Elio, Jovine, Raffaele, Lombardi, Francesco La Rocca, Francesca Di Capua, Carmine, Lanci, Renzo, Leli, Andrea, Borasi, Pasquale, Lepiane, Andrea, Balla, Edoardo, Liberatore, Luca, Morelli, Gregorio Di Franco, Andrea, Lucchi, Laura, Vittori, Luigi, Bonavina, Emanuele, Asti, Dario, Maggioni, Gerosa, Martino, Giuseppe, Manca, Antonella, Delvecchio, Manfredo, Tedesco, Denise, Gambardella, Salvatore, Marafioti, Maria Luisa De Marco, Marco Azzola Guicciardi, Massimo, Motta, Marco, Calgaro, Vincenzo, Adamo, Mario, Guerrieri, Pietro, Coletta, Monica, Ortenzi, Gennaro, Martine, Giuliano, Lantone, Mario, Martinotti, Giuseppe, Fassardi, Maurizio, Castriconi, Simone, Squillante, Maurizio De Luca, Maurizio, Pavanello, Carlo Di Marco, Maurizio, Ronconi, Silvia, Casiraghi, Vincenzo, Mazzaferro, Carlo, Battiston, Michele, Perrotta, Carmine, Ripa, Micheletto, Giancarlo, Valerio, Panizzo, Paolo, Millo, Riccardo Brachet Contul, Valentina, Ferraro, Carlo, Molino, Enrico, Crolla, Gianluigi, Moretto, Matilde, Bacchion, Mario, Morino, Marco Ettore Allaix, Enrico, Motterlini, Michele, Petracca, Andrea, Muratore, Mario, Musella, Antonio, Vitiello, Bruno, Nardo, Veronica, Crocco, Giuseppe, Navarra, Salvatore, Lazzara, Giuseppe Giovanni Navarra, Manuela, Cuoghi, Stefano, Olmi, Alberto, Oldani, Matteo, Uccelli, Enrico, Opocher, Marco, Giovenzana, Paolo De Paolis, Mauro, Santarelli, Paolo, Delrio, Fabio, Carbone, Paolo Pietro Giampaolo Bianchi, Formisano, Patrizio, Capelli, Edoardo, Baldini, Patrizio, Festa, Arianna, Mottola, Giovanni, Merola, Nicola, Perrotta, Marta, Celiento, Eraldo, Personnettaz, Stefania, Muzio, Tommaso, Petitti, Antonietta, Melchiorre, Micaela, Piccoli, Francesca, Pecchini, Alice, Frontali, Anna, Maffioli, Pietro, Maida, Pasquale, Tammaro, Giusto, Pignata, Jacopo, Andreuccetti, Vincenzo, Pilone, Michele, Renzulli, Salvatore, Pintaldi, Andrea Pisani Ceretti, Nicolò Maria Mariani, Adolfo, Pisanu, Roberto, Polastri, Fabio, Maiello, Alberto, Porcu, Teresa, Perra, Felice, Mucilli, Mirko, Barone, Roberto, Troisi, Roberto, Montalti, Fabrizio, Scognamillo, Daniele, Delogu, Raffaele, Galleano, Michele, Malerba, Raffaele, Salfi, Marcello, Pisano, Raffaele, Sechi, Nicola, Cillara, Salvatore, Ramuscello, Eugenio De Leo, Enrico, Restini, Rocco, Tumolo, Pasquale, Cianci, Sabino, Capuzzolo, Maurizio, Rizzo, Alfonso, Recordare, Roberto, Santoro, Pietro Maria Amodio, Aldo, Rocca, Giuseppe, Cecere, Raffaele, Romito, Luca, Portigliotti, Riccardo, Rosati, Ugo, Elmore, Domenico, Russello, Saverio, Latteri, Salvatore Maria Costarella, Salvatore, Massa, Lorenzo, Capasso, Michele, Santangelo, Maurizio, Sodo, Giuliano, Sarro, Umberto, Rivolta, Stefano, Scabini, Davide, Pertile, Federico, Selvaggi, Selene, Rossi, Selvaggi, Francesco, Pellino, Gianluca, Gabriele, Sganga, Pietro, Fransvea, Silvio, Testa, Clemente De Rosa, Walter, Siquini, Cristian, Tranà, Mario, Solej, Stefano, Bolzon, Enrico, Guerra, Marco, Stella, Francesco, Ferrara, Francesco, Stipa, Enrico, Stringhi, Andrea, Celotti, Lucio, Taglietti, Roberto Del Giudice, Carlo Alessandro Talarico, Michele, Ruggiero, Giuseppe, Tirone, Uberto Fumagalli Romario, Wanda, Petz, Valerio, Caracino, Valentina, Rossetti, Luca Andrea Verza, Lorenzo, Vescovi, Michele, Marini, Nereo, Vettoretto, Emanuele, Botteri, Leonardo, Vincenti, Giusy, Giannandrea, Tiziana, Viora, Lorenzo, Maganuco, Paolo, Veronesi, Bruno, Zani, Giacomo, Zanu, Marco, Brizzolari, Federico, Zanzi, Anna, Guariniello, Marco Antonio Zappa, Elisa, Galfrascoli, Sandro, Zonta, Luigi, Oragano, Walter Zuliani &amp, Damiano, Chiari, de Manzini, Nicolo', Agresta, Ferdinando, Agrusa, Antonino, Di Buono, Giuseppe, Bracale, U., Podda, M., Castiglioni, S., Peltrini, R., Sartori, A., Arezzo, A., Corcione, F., Agresta, F., Antonucci, A., Zanframundo, C., Cavallo, F., Mazzarolo, G., Agrusa, A., Di Buono, G., Aldrighetti, L., Fiorentini, G., Lucianetti, A., Magnone, S., Alfieri, S., Rosa, F., Altomare, D. F., Picciariello, A., Parisi, A., Di Cintio, A., Amisano, M. F., Cravero, F., Ammendola, M., Ammerata, G., Anastasi, A., Canonico, G., Gattolin, A., Travaglio, E., De Palma, M., Angelini, P., Galante, F., Benevento, A., Rausei, S., Serao, A., Abbatini, F., Annecchiarico, M., Varricchio, A., Annessi, V., Tumiati, D., Annicchiarico, A., Mirabella, A., Marino, M. V., Spinelli, A., Braun, A., Santi, H. T., Romano, L., Antoniutti, M., Armellino, M. F., Argenio, G., Verzelli, A., Budassi, A., Baiocchi, G., Alfano, M. S., Balani, A., Barone, M., Baldazzi, G., Cassini, D., Canger, R. C. B., Zabbialini, G., Belli, A., Izzo, F., Bertolino, F., Brunetti, M., Bianco, F., Cappiello, A., Boccia, L., Boffi, B., Perna, F., Bonilauri, S., Frazzetta, G., Bordoni, P., Fleres, F., Borghi, F., Giraudo, G., Bottino, V., Canfora, A., Piccoli, F. B., Calligaris, L., Nipote, B., Nasti, A. G., Bufalari, A., Bettarini, F., Buononato, M., Greco, M., Calo, P. G., Medas, F., Cardamone, E., Castaldo, P., Carlini, M., Spoletini, D., De Nisco, C., Pulighe, F., Feo, C. V., Fabbri, N., Antropoli, C., Foroni, F., Carnazza, M., Ragazzi, S., Cassinotti, E., Boni, L., Catena, F., Giuffrida, M., Perrone, G., Ccotsoglou, C., Granieri, S., Ceccarelli, G., Bugiantella, W., Cedolini, C., Seriau, L., Cesari, M., Contine, A., Chiara, O., Cimbanassi, S., Cocozza, E., Berselli, M., Fantini, C., Costi, R., Casali, L., Morini, A., Crafa, F., Vanela, S., Curro, G., Orsini, V., Da Lio, C., Biral, M., Danelli, P., Guerci, C., Scala, D., Marino, G., De Carlis, L., Lauterio, A., De Giorgi, D., Sciannamea, G., De Manzini, N., Losurdo, P., Sangiuliano, N., Degiuli, M., Caterina, F., Del Rio, P., Bonati, E., Di Lernia, S., Ardizzone, M. V. R., Di Saverio, S., Franchi, C., Di Venere, B., Miglio, R., Cuccurullo, D., Sagnelli, C., Docimo, L., Tolone, S., Longoni, M., Faillace, G., Rondelli, F., Pennella, F. P., Colucci, V., Carfora, T., Muttillo, I. A., Picardi, B., Stefano, R., Campagnacci, R., Maurizi, A., Tricarico, F., Montagna, M., Amedeo, E., Scollica, M. C., Lauro, E., Laterza, E., Molinari, E., Bono, D., Fabozzi, M., Romano, M., Facci, E., Parini, D., Farfaglia, R., Arizzi, V., Farsi, M., Miranda, E., Fei, L., Flavio, G., Pirozzi, F., Sciuto, A., Ferrero, A., Palisi, M., Filauro, M., Barberis, A., Azzinnaro, A., Fiscon, V., Vigna, S., D'Ambra, M., Pontecorvi, E., Anania, G., Bombardini, C., Galizia, G., Auricchio, A., Cardella, F., Genna, M., Gentilli, S., Herald, N., Castagnoli, G., Bartoli, A., Gianotti, L., Garancini, M., Bellanova, G., Palazzo, P., De Palma, G., Milone, M., Ferrari, G., Magistro, C., Giuliani, A., Di Natale, G., Brisinda, G., Cavallaro, G., Sammarco, G., Gallo, G., Goletti, O., Macchini, D., Greco, V., Amoroso, V., Guercioni, G., Benedetti, M., Guzzo, G., Pata, F., Scandroglio, I., Roscio, F., Jovine, E., Lombardi, R., La Rocca, F., Di Capua, F., Lanci, C., Leli, R., Borasi, A., Lepiane, P., Balla, A., Liberatore, E., Morelli, L., Di Franco, G., Lucchi, A., Vittori, L., Bonavina, L., Asti, E., Maggioni, D., Martino, G., Manca, G., Delvecchio, A., Tedesco, M., Gambardella, D., Marafioti, S., De Marco, M. L., Guicciardi, M. A., Motta, M., Calgaro, M., Adamo, V., Guerrieri, M., Coletta, P., Ortenzi, M., Martines, G., Lantone, G., Martinotti, M., Fassardi, G., Castriconi, M., Squillante, S., De Luca, M., Pavanello, M., Di Marco, C., Ronconi, M., Casiraghi, S., Mazzaferro, V., Battiston, C., Perrotta, M., Ripa, C., Giancarlo, M., Panizzo, V., Millo, P., Contul, R. B., Ferraro, V., Molino, C., Crolla, E., Moretto, G., Bacchion, M., Morino, M., Allaix, M. E., Motterlini, E., Petracca, M., Muratore, A., Musella, M., Vitiello, A., Nardo, B., Crocco, V., Navarra, G., Lazzara, S., Navarra, G. G., Cuoghi, M., Olmi, S., Oldani, A., Uccelli, M., Opocher, E., Giovenzana, M., De Paolis, P., Santarelli, M., Delrio, P., Carbone, F., Bianchi, P. P. G., Capelli, P., Baldini, E., Festa, P., Mottola, A., Merola, G., Perrotta, N., Celiento, M., Personnettaz, E., Muzio, S., Petitti, T., Melchiorre, A., Piccoli, M., Pecchini, F., Frontali, A., Maffioli, A., Maida, P., Tammaro, P., Pignata, G., Andreuccetti, J., Pilone, V., Renzulli, M., Pintaldi, S., Ceretti, A. P., Mariani, N. M., Pisanu, A., Polastri, R., Maiello, F., Porcu, A., Perra, T., Mucilli, F., Troisi, R., Montalti, R., Scognamillo, F., Delogu, D., Galleano, R., Malerba, M., Salfi, R., Pisano, M., Sechi, R., Cillara, N., Ramuscello, S., De Leo, E., Restini, E., Tumolo, R., Cianci, P., Capuzzolo, S., Rizzo, M., Recordare, A., Santoro, R., Amodio, P. M., Rocca, A., Cecere, G., Romito, R., Portigliotti, L., Rosati, R., Elmore, U., Russello, D., Latteri, S., Costarella, S. M., Massa, S., Capasso, L., Santangelo, M., Sodo, M., Sarro, G., Rivolta, U., Scabini, S., Pertile, D., Selvaggi, F., Rossi, S., Pellino, G., Sganga, G., Fransvea, P., Testa, S., De Rosa, C., Siquini, W., Trana, C., Solej, M., Bolzon, S., Guerra, E., Stella, M., Ferrara, F., Stipa, F., Stringhi, E., Celotti, A., Taglietti, L., Del Giudice, R., Talarico, C. A., Ruggiero, M., Tirone, G., Romario, U. F., Petz, W., Caracino, V., Rossetti, V., Verza, L. A., Vescovi, L., Marini, M., Vettoretto, N., Botteri, E., Vincenti, L., Giannandrea, G., Viora, T., Maganuco, L., Veronesi, P., Zani, B., Zanus, G., Brizzolari, M., Zanzi, F., Guariniello, A., Zappa, M. A., Galfrascoli, E., Zonta, S., Oragano, L., Zuliani, W., Chiari, D., Bracale, U, Podda, M, Castiglioni, S, Peltrini, R, Sartori, A, Arezzo, A, Corcione, F, Agresta, F, Antonucci, A, Zanframundo, C, Cavallo, F, Mazzarolo, G, Agrusa, A, Di Buono, G, Aldrighetti, L, Fiorentini, G, Lucianetti, A, Magnone, S, Alfieri, S, Rosa, F, Altomare, D, Picciariello, A, Parisi, A, Di Cintio, A, Amisano, M, Cravero, F, Ammendola, M, Ammerata, G, Anastasi, A, Canonico, G, Gattolin, A, Travaglio, E, De Palma, M, Angelini, P, Galante, F, Benevento, A, Rausei, S, Serao, A, Abbatini, F, Annecchiarico, M, Varricchio, A, Annessi, V, Tumiati, D, Annicchiarico, A, Mirabella, A, Marino, M, Spinelli, A, Braun, A, Santi, H, Romano, L, Antoniutti, M, Armellino, M, Argenio, G, Verzelli, A, Budassi, A, Baiocchi, G, Alfano, M, Balani, A, Barone, M, Baldazzi, G, Cassini, D, Canger, R, Zabbialini, G, Belli, A, Izzo, F, Bertolino, F, Brunetti, M, Bianco, F, Cappiello, A, Boccia, L, Boffi, B, Perna, F, Bonilauri, S, Frazzetta, G, Bordoni, P, Fleres, F, Borghi, F, Giraudo, G, Bottino, V, Canfora, A, Piccoli, F, Calligaris, L, Nipote, B, Nasti, A, Bufalari, A, Bettarini, F, Buononato, M, Greco, M, Calo, P, Medas, F, Cardamone, E, Castaldo, P, Carlini, M, Spoletini, D, De Nisco, C, Pulighe, F, Feo, C, Fabbri, N, Antropoli, C, Foroni, F, Carnazza, M, Ragazzi, S, Cassinotti, E, Boni, L, Catena, F, Giuffrida, M, Perrone, G, Ccotsoglou, C, Granieri, S, Ceccarelli, G, Bugiantella, W, Cedolini, C, Seriau, L, Cesari, M, Contine, A, Chiara, O, Cimbanassi, S, Cocozza, E, Berselli, M, Fantini, C, Costi, R, Casali, L, Morini, A, Crafa, F, Vanela, S, Curro, G, Orsini, V, Da Lio, C, Biral, M, Danelli, P, Guerci, C, Scala, D, Marino, G, De Carlis, L, Lauterio, A, De Giorgi, D, Sciannamea, G, De Manzini, N, Losurdo, P, Sangiuliano, N, Degiuli, M, Caterina, F, Del Rio, P, Bonati, E, Di Lernia, S, Ardizzone, M, Di Saverio, S, Franchi, C, Di Venere, B, Miglio, R, Cuccurullo, D, Sagnelli, C, Docimo, L, Tolone, S, Longoni, M, Faillace, G, Rondelli, F, Pennella, F, Colucci, V, Carfora, T, Muttillo, I, Picardi, B, Stefano, R, Campagnacci, R, Maurizi, A, Tricarico, F, Montagna, M, Amedeo, E, Scollica, M, Lauro, E, Laterza, E, Molinari, E, Berta, G, Bono, D, Fabozzi, M, Romano, M, Facci, E, Parini, D, Farfaglia, R, Arizzi, V, Farsi, M, Miranda, E, Fei, L, Flavio, G, Pirozzi, F, Sciuto, A, Ferrero, A, Palisi, M, Filauro, M, Barberis, A, Azzinnaro, A, Fiscon, V, Vigna, S, D'Ambra, M, Pontecorvi, E, Anania, G, Bombardini, C, Galizia, G, Auricchio, A, Cardella, F, Genna, M, Gentilli, S, Herald, N, Castagnoli, G, Bartoli, A, Gianotti, L, Garancini, M, Bellanova, G, Palazzo, P, De Palma, G, Milone, M, Ferrari, G, Magistro, C, Giuliani, A, Di Natale, G, Brisinda, G, Cavallaro, G, Sammarco, G, Gallo, G, Goletti, O, Macchini, D, Greco, V, Amoroso, V, Guercioni, G, Benedetti, M, Guzzo, G, Pata, F, Scandroglio, I, Roscio, F, Jovine, E, Lombardi, R, La Rocca, F, Di Capua, F, Lanci, C, Leli, R, Borasi, A, Lepiane, P, Balla, A, Liberatore, E, Morelli, L, Di Franco, G, Lucchi, A, Vittori, L, Bonavina, L, Asti, E, Maggioni, D, Martino, G, Manca, G, Delvecchio, A, Tedesco, M, Gambardella, D, Marafioti, S, De Marco, M, Guicciardi, M, Motta, M, Calgaro, M, Adamo, V, Guerrieri, M, Coletta, P, Ortenzi, M, Martines, G, Lantone, G, Martinotti, M, Fassardi, G, Castriconi, M, Squillante, S, De Luca, M, Pavanello, M, Di Marco, C, Ronconi, M, Casiraghi, S, Mazzaferro, V, Battiston, C, Perrotta, M, Ripa, C, Giancarlo, M, Panizzo, V, Millo, P, Contul, R, Ferraro, V, Molino, C, Crolla, E, Moretto, G, Bacchion, M, Morino, M, Allaix, M, Motterlini, E, Petracca, M, Muratore, A, Musella, M, Vitiello, A, Nardo, B, Crocco, V, Navarra, G, Lazzara, S, Cuoghi, M, Olmi, S, Oldani, A, Uccelli, M, Opocher, E, Giovenzana, M, De Paolis, P, Santarelli, M, Delrio, P, Carbone, F, Bianchi, P, Capelli, P, Baldini, E, Festa, P, Mottola, A, Merola, G, Perrotta, N, Celiento, M, Personnettaz, E, Muzio, S, Petitti, T, Melchiorre, A, Piccoli, M, Pecchini, F, Frontali, A, Maffioli, A, Maida, P, Tammaro, P, Pignata, G, Andreuccetti, J, Pilone, V, Renzulli, M, Pintaldi, S, Ceretti, A, Mariani, N, Pisanu, A, Polastri, R, Maiello, F, Porcu, A, Perra, T, Mucilli, F, Troisi, R, Montalti, R, Scognamillo, F, Delogu, D, Galleano, R, Malerba, M, Salfi, R, Pisano, M, Sechi, R, Cillara, N, Ramuscello, S, De Leo, E, Restini, E, Tumolo, R, Cianci, P, Capuzzolo, S, Rizzo, M, Recordare, A, Santoro, R, Amodio, P, Rocca, A, Cecere, G, Romito, R, Portigliotti, L, Rosati, R, Elmore, U, Russello, D, Latteri, S, Costarella, S, Massa, S, Capasso, L, Santangelo, M, Sodo, M, Sarro, G, Rivolta, U, Scabini, S, Pertile, D, Selvaggi, F, Rossi, S, Pellino, G, Sganga, G, Fransvea, P, Testa, S, De Rosa, C, Siquini, W, Trana, C, Solej, M, Bolzon, S, Guerra, E, Stella, M, Ferrara, F, Stipa, F, Stringhi, E, Celotti, A, Taglietti, L, Del Giudice, R, Talarico, C, Ruggiero, M, Tirone, G, Romario, U, Petz, W, Caracino, V, Rossetti, V, Verza, L, Vescovi, L, Marini, M, Vettoretto, N, Botteri, E, Vincenti, L, Giannandrea, G, Viora, T, Maganuco, L, Veronesi, P, Zani, B, Zanus, G, Brizzolari, M, Zanzi, F, Guariniello, A, Zappa, M, Galfrascoli, E, Zonta, S, Oragano, L, Zuliani, W, and Chiari, D
Subjects: Laparoscopic surgery, Settore MED/18 - CHIRURGIA GENERALE, medicine.medical_treatment, laparoscopy, COVID-19, Elective surgery, Emergency surgery, Survey, Oral Health, cross infection (MeSH), Surveys and Questionnaires, Epidemiology, Pandemic, Infection control, Practice Patterns, Physicians', emergency surgery, Laparoscopy, humans, medicine.diagnostic_test, General Commentary, laparoscopic surgery, infection control, Italy, physicians', Original Article, Elective Surgical Procedure, Human, heating ventilation air conditioning, medicine.medical_specialty, Coronavirus disease 2019 (COVID-19), fallow period, elective surgical procedures, pandemics, NO, aerosol generating procedures, elective surgery, survey, practice patterns, physicians', SARS-CoV-2, surveys and questionnaires, medicine, Infection Control, business.industry, General surgery, practice patterns, Surgery, business
Abstract: Background The spread of the SARS-CoV2 virus, which causes COVID-19 disease, profoundly impacted the surgical community. Recommendations have been published to manage patients needing surgery during the COVID-19 pandemic. This survey, under the aegis of the Italian Society of Endoscopic Surgery, aims to analyze how Italian surgeons have changed their practice during the pandemic. Methods The authors designed an online survey that was circulated for completion to the Italian departments of general surgery registered in the Italian Ministry of Health database in December 2020. Questions were divided into three sections: hospital organization, screening policies, and safety profile of the surgical operation. The investigation periods were divided into the Italian pandemic phases I (March–May 2020), II (June–September 2020), and III (October–December 2020). Results Of 447 invited departments, 226 answered the survey. Most hospitals were treating both COVID-19-positive and -negative patients. The reduction in effective beds dedicated to surgical activity was significant, affecting 59% of the responding units. 12.4% of the respondents in phase I, 2.6% in phase II, and 7.7% in phase III reported that their surgical unit had been closed. 51.4%, 23.5%, and 47.8% of the respondents had at least one colleague reassigned to non-surgical COVID-19 activities during the three phases. There has been a reduction in elective (> 200 procedures: 2.1%, 20.6% and 9.9% in the three phases, respectively) and emergency ( Conclusion This survey offers three faithful snapshots of how the surgical community has reacted to the COVID-19 pandemic during its three phases. The significant reduction in surgical activity indicates that better health policies and more evidence-based guidelines are needed to make up for lost time and surgery not performed during the pandemic.
Published: 2021

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34 results on '"Michele D’Ambra"'

1. The Italian Unitary Society of Colon-Proctology (Società Italiana Unitaria di Colonproctologia) guidelines for the management of acute and chronic hemorrhoidal disease

2. The Italian Unitary Society of Colon-proctology (SIUCP: Società Italiana Unitaria di Colonproctologia) guidelines for the management of anal fissure

3. Surgical stress and metabolic response after totally laparoscopic right colectomy

4. Neuroendocrine tumor in a longstanding tailgut cyst: a case report

5. Augmented reality (AR) in minimally invasive surgery (MIS) training: where are we now in Italy? The Italian Society of Endoscopic Surgery (SICE) ARMIS survey

6. Risk of appendiceal neoplasm after interval appendectomy for complicated appendicitis: A systematic review and meta-analysis

7. Relação Pessoal: Liberdade, Amor E Mistério

8. Prevention of incisional hernia at the site of stoma closure with different reinforcing mesh types: a systematic review and meta-analysis

9. Could Stoma Be Avoided after Laparoscopic Low Anterior Resection for Rectal Cancer? Experience with Transanal Tube in 195 Cases

10. Complete Mesocolic Excision with Central Vascular Ligation during Laparoscopic Right Hemicolectomy: Technical Notes

11. First Application of the Orbeye™ 4K 3D Exoscope in Recurrent Papillary Thyroid Cancer Surgery

12. Risk of anastomotic bleeding after left colectomy with preservation of inferior mesenteric artery for diverticular disease: preliminary results

13. Clinics and pathology of Krukenberg tumor: a systematic review and meta-analysis

14. Chemotherapy-Induced Remission of Steroid-Dependent Ulcerative Colitis Associated With Rectal Hodgkin Lymphoma

15. Intraoperative use of indocyanine green fluorescence imaging in rectal cancer surgery: The state of the art

16. Laparoscopic segmental resection for tumours of the Angle of Treitz: a challenging but feasible surgical option. Results from a retrospective case-series analysis

17. Surgical stress and metabolic response after totally laparoscopic right colectomy

18. Use of the ORBEYETM Exoscope in General Surgery: The Advent of Video-Assisted Open Surgery

19. Extraovarian dysgerminoma in a pregnant woman: an extremely rare finding

20. Promoting Laparoscopic Anterior Approach for a Very Low Presacral Primary Neuroendocrine Tumor Arising in a Tailgut Cyst

21. Effects of the first and second wave of the COVID-19 pandemic on patients with colorectal cancer: what has really changed in the outcomes?

22. Laparoscopic sigmoid colectomy with preservation of the inferior mesenteric artery for diverticular disease – a video vignette

23. Laparoscopic right hemicolectomy for cT4b caecal adenocarcinoma involving the bladder – a video vignette

24. Robotic cholecystectomy for acute cholecystitis

25. Totally robotic splenic flexure resection with intracorporeal anastomosis – a video vignette

26. Spirit and Soul in Hedwig Conrad-Martius’s Metaphysical Dialogues: From Nature to the Human Being

27. ¿Qué ha cambiado en la adrenalectomía? De la cirugía abierta a la laparoscópica

28. Intracorporeal versus extracorporeal anastomosis. Results from a multicentre comparative study on 512 right-sided colorectal cancers

29. Laparoscopic drainage of a recurrent psoas abscess

30. Laparoscopic One-Stage vs Endoscopic Plus Laparoscopic Management of Common Bile Duct Stones – A Prospective Randomized Study

31. [Timing and results of the surgical treatment of the diverticular disease of the colon]

32. Laparoscopic One-Stage vs Endoscopic Plus Laparoscopic Management of Common Bile Duct Stones – A Prospective Randomized Study

33. Reply

34. Changes in surgicaL behaviOrs dUring the CoviD-19 pandemic. The SICE CLOUD19 Study

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