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1. Goodbye Hartmann trial: a prospective, international, multicenter, observational study on the current use of a surgical procedure developed a century ago

Author

Gennaro Perrone, Mario Giuffrida, Fikri Abu-Zidan, Vitor F. Kruger, Marco Livrini, Gabriele Luciano Petracca, Giorgio Rossi, Antonio Tarasconi, Brian W. C. A. Tian, Elena Bonati, Ricardo Mentz, Federico N. Mazzini, Juan P. Campana, Elisabeth Gasser, Reinhold Kafka-Ritsch, Daniel M. Felsenreich, Christopher Dawoud, Stefan Riss, Carlos Augusto Gomes, Felipe Couto Gomes, Ricardo Alessandro Teixeira Gonzaga, Cassio Alfred Brattig Canton, Bruno Monteiro Pereira, Gustavo P. Fraga, Leticia Gonçalves Zem, Vinicius Cordeiro-Fonseca, Renato de Mesquita Tauil, Boyko Atanasov, Nikolay Belev, Nikola Kovachev, L. Juan José Meléndez, Ana Dimova, Stefan Dimov, Zdravko Zelić, Goran Augustin, Branko Bogdanić, Trpimir Morić, Elie Chouillard, Melinda Bajul, Belinda De Simone, Yves Panis, Francesco Esposito, Margherita Notarnicola, Lelde Lauka, Anna Fabbri, Hassen Hentati, Iskander Fnaiech, Venara Aurélien, Marie Bougard, Maxime Roulet, Zaza Demetrashvili, Irakli Pipia, Giorgi Merabishvili, Konstantinos Bouliaris, Georgios Koukoulis, Christos Doudakmanis, Sofia Xenaki, Emmanuel Chrysos, Stamatios Kokkinakis, Panteleimon Vassiliu, Nikolaos Michalopoulos, Ioannis Margaris, Aristotelis Kechagias, Konstantinos Avgerinos, Jevgeni Katunin, Eftychios Lostoridis, Eleni-Aikaterini Nagorni, Antonio Pujante, Francesk Mulita, Ioannis Maroulis, Michail Vailas, Athanasios Marinis, Ioannis Siannis, Eirini Bourbouteli, Dimitrios K. Manatakis, Nikolaos Tasis, Vasileios Acheimastos, Sotiropoulou Maria, Kapiris Stylianos, Harilaos Kuzeridis, Dimitrios Korkolis, Evangelos Fradelos, George Kavalieratos, Thalia Petropoulou, Andreas Polydorou, Ioannis Papacostantinou, Tania Triantafyllou, Despina Kimpizi, Dimitrios Theodorou, Konstantinos Toutouzas, Alexandros Chamzin, Maximos Frountzas, Dimitrios Schizas, Ioannis Karavokyros, Athanasios Syllaios, Alexandros Charalabopoulos, Maria Boura, Efstratia Baili, Orestis Ioannidis, Lydia Loutzidou, Elissavet Anestiadou, Ioannis Tsouknidas, Georgios Petrakis, Eleni Polenta, Lovenish Bains, Rahul Gupta, Sudhir K. Singh, Archana Khanduri, Miklosh Bala, Asaf Kedar, Marcello Pisano, Mauro Podda, Adolfo Pisanu, Gennaro Martines, Giuseppe Trigiante, Giuliano Lantone, Antonino Agrusa, Giuseppe Di Buono, Salvatore Buscemi, Massimiliano Veroux, Rossella Gioco, Gastone Veroux, Luigi Oragano, Sandro Zonta, Federico Lovisetto, Carlo V. Feo, Antonio Pesce, Nicolò Fabbri, Giulio Lantone, Fabio Marino, Fabrizio Perrone, Leonardo Vincenti, Vincenzo Papagni, Arcangelo Picciariello, Stefano Rossi, Biagio Picardi, Simone Rossi Del Monte, Diego Visconti, Giulia Osella, Luca Petruzzelli, Giusto Pignata, Jacopo Andreuccetti, Rossella D’Alessio, Massimo Buonfantino, Eleonora Guaitoli, Stefano Spinelli, Gianluca Matteo Sampietro, Carlo Corbellini, Leonardo Lorusso, Alice Frontali, Isabella Pezzoli, Alessandro Bonomi, Andrea Chierici, Christian Cotsoglou, Giuseppe Manca, Antonella Delvecchio, Nicola Musa, Massimiliano Casati, Laface Letizia, Emmanuele Abate, Giorgio Ercolani, Fabrizio D’Acapito, Leonardo Solaini, Gianluca Guercioni, Simone Cicconi, Diego Sasia, Felice Borghi, Giorgio Giraudo, Giuseppe Sena, Pasquale Castaldo, Eugenia Cardamone, Giuseppe Portale, Matteo Zuin, Ylenia Spolverato, Marialusia Esposito, Roberta Maria Isernia, Maria Di Salvo, Romina Manunza, Giuseppe Esposito, Marcello Agus, Emanuele Luigi Giuseppe Asti, Daniele Tiziano Bernardi, Tommaso Panici Tonucci, Davide Luppi, Massimiliano Casadei, Stefano Bonilauri, Angela Pezzolla, Annunziata Panebianco, Rita Laforgia, Maurizio De Luca, Monica Zese, Dario Parini, Elio Jovine, Giuseppina De Sario, Raffaele Lombardi, Giovanni Aprea, Giuseppe Palomba, Marianna Capuano, Giulio Argenio, Gianluca Orio, Mariano Fortunato Armellino, Marina Troian, Martina Guerra, Carlo Nagliati, Alan Biloslavo, Paola Germani, Giada Aizza, Igor Monsellato, Ali Chaouki Chahrour, Gabriele Anania, Cristina Bombardini, Francesco Bagolini, Gabriele Sganga, Pietro Fransvea, Valentina Bianchi, Paolo Boati, Francesco Ferrara, Francesco Palmieri, Pasquale Cianci, Domenico Gattulli, Enrico Restini, Nicola Cillara, Alessandro Cannavera, Gabriela Elisa Nita, Jlenia Sarnari, Francesco Roscio, Federico Clerici, Ildo Scandroglio, Stefano Berti, Alessandro Cadeo, Alice Filippelli, Luigi Conti, Carmine Grassi, Gaetano Maria Cattaneo, Marina Pighin, Davide Papis, Giovanni Gambino, Vanessa Bertino, Domenico Schifano, Daniela Prando, Luisella Fogato, Fabio Cavallo, Luca Ansaloni, Roberto Picheo, Nicholas Pontarolo, Norma Depalma, Marcello Spampinato, Stefano D’Ugo, Luca Lepre, Michela Giulii Capponi, Rossella Domenica Campa, Giuliano Sarro, Vincenza Paola Dinuzzi, Stefano Olmi, Matteo Uccelli, Davide Ferrari, Marco Inama, Gianluigi Moretto, Michele Fontana, Francesco Favi, Erika Picariello, Alessia Rampini, Andrea Barberis, Antonio Azzinnaro, Alba Oliva, Luigi Totaro, Ilaria Benzoni, Valerio Ranieri, Gabriella Teresa Capolupo, Filippo Carannante, Marco Caricato, Maurizio Ronconi, Silvia Casiraghi, Giovanni Casole, Desire Pantalone, Giovanni Alemanno, Maximilian Scheiterle, Marco Ceresoli, Marco Cereda, Chiara Fumagalli, Federico Zanzi, Stefano Bolzon, Enrico Guerra, Francesca Lecchi, Paola Cellerino, Antonella Ardito, Rosa Scaramuzzo, Andrea Balla, Pasquale Lepiane, Nicola Tartaglia, Antonio Ambrosi, Giovanna Pavone, Gian Marco Palini, Simone Veneroni, Gianluca Garulli, Claudio Ricci, Beatrice Torre, Iris Shari Russo, Matteo Rottoli, Marta Tanzanu, Angela Belvedere, Marco Milone, Michele Manigrasso, Giovanni Domenico De Palma, Micaela Piccoli, Gianmaria Casoni Pattacini, Stefano Magnone, Paolo Bertoli, Michele Pisano, Paolo Massucco, Marco Palisi, Andrea-Pierre Luzzi, Francesco Fleres, Guglielmo Clarizia, Alessandro Spolini, Yoshiro Kobe, Takayuki Toma, Fumihiko Shimamura, Robert Parker, Sinkeet Ranketi, Mercy Mitei, Saulius Svagzdys, Henrikas Pauzas, Justas Zilinskas, Tomas Poskus, Marius Kryzauskas, Matas Jakubauskas, Andee Dzulkarnaen Zakaria, Zaidi Zakaria, Michael Pak-Kai Wong, Asri Che Jusoh, Muhammad Nazreen Zakaria, Daniel Rios Cruz, Aurea Barbara Rodriguez Elizalde, Alejandro Bañon Reynaud, Edgard Efren Lozada Hernandez, Jose maria Victor Palomo Monroy, Diego Hinojosa-Ugarte, Martha Quiodettis, María Esther Du Bois, José Latorraca, Piotr Major, Michał Pędziwiatr, Magdalena Pisarska-Adamczyk, Maciej Walędziak, Andrzej Kwiatkowski, Łukasz Czyżykowski, Silvia Dantas da Costa, Bela Pereira, Ana Rita Oliveira Ferreira, Filipe Almeida, Ricardo Rocha, Carla Carneiro, Diego Pita Perez, João Carvas, Catarina Rocha, Cátia Ferreira, Rita Marques, Urânia Fernandes, Pedro Leao, André Goulart, Rita Gonçalves Pereira, Sara Daniela Direito Patrocínio, Nuno Gonçalo Gonçalves de Mendonça, Maria Isabel Cerqueira Manso, Henrique Manuel Cardoso Morais, Paulo Sebastião Cardoso, Valentin Calu, Adrian Miron, Elena Adelina Toma, Mahir Gachabayov, Abakar Abdullaev, Andrey Litvin, Taras Nechay, Alexander Tyagunov, Anvar Yuldashev, Alison Bradley, Michael Wilson, Arpád Panyko, Zuzana Látečková, Vladimír Lacko, Dusan Lesko, Marek Soltes, Jozef Radonak, Victor Turrado-Rodriguez, Roser Termes-Serra, Xavier Morales-Sevillano, Pierfrancesco Lapolla, Andrea Mingoli, Gioia Brachini, Maurizio Degiuli, Silvia Sofia, Rossella Reddavid, Andrea de Manzoni Garberini, Angelica Buffone, Eduardo Perea del Pozo, Daniel Aparicio-Sánchez, Sandra Dos Barbeito, Mercedes Estaire-Gómez, Rebeca Vitón-Herrero, Mª de los Ángeles Gil Olarte-Marquez, José Gil-Martínez, Felipe Alconchel, Tatiana Nicolás-López, Aida Cristina Rahy-Martin, María Pelloni, Raquel Bañolas-Suarez, Fernando Mendoza-Moreno, Francisca García-Moreno Nisa, Manuel Díez-Alonso, María Elisa Valle Rodas, María Carmona Agundez, María Inmaculada Pérez Andrés, Claudia Cristina Lopes Moreira, Aintzane Lizarazu Perez, Iñigo Augusto Ponce, Ana María González-Castillo, Estela Membrilla-Fernández, Silvia Salvans, Mario Serradilla-Martín, Pablo Sancho Pardo, Daniel Rivera-Alonso, Jana Dziakova, Jose Mugüerza Huguet, Naila Pagès Valle, Enrique Colás Ruiz, Cristina Rey Valcárcel, Cristina Ruiz Moreno, Yeniffer Tatiana Moreno Salazar, Juan Jesús Rubio García, Silvia Sevila Micó, Joaquín Ruiz López, Silvia Pérez Farré, Maite Santamaria Gomez, Nuria Mestres Petit, Alberto Titos-García, Jose Manuel Aranda-Narváez, Laura Romacho-López, Luis Sánchez-Guillén, Veronica Aranaz-Ostariz, Marina Bosch-Ramírez, Aleix Martínez-Pérez, Elías Martínez-López, Juan Carlos Sebastián-Tomás, Granada Jimenez-Riera, Javier Jimenez-Vega, Jose Aurelio Navas Cuellar, Andrea Campos-Serra, Anna Muñoz-Campaña, Raquel Gràcia-Roman, Javier Martínez Alegre, Francisca Lima Pinto, Sara Nuñez O’Sullivan, Francisco Blanco Antona, Beatriz Muñoz Jiménez, Jaime López-Sánchez, Zahira Gómez Carmona, Rocio Torres Fernández, Isabel Blesa Sierra, Laura Román García de León, Verónica Polaino Moreno, Eva Iglesias, Paola Lora Cumplido, Altea Arango Bravo, Ignacio Rey Simó, Carlota López Domínguez, Aloia Guerreiro Caamaño, Rafael Calleja Lozano, Manuel Durán Martínez, Álvaro Naranjo Torres, Javier Tomas Morales Bernaldo de Quiros, Gianluca Pellino, Miriam Moratal Cloquell, Elsa García Moller, Sami Jalal-Eldin, Ahmed K. Abdoun, Hytham K. S. Hamid, Varut Lohsiriwat, Aitsariya Mongkhonsupphawan, Oussama Baraket, Karim Ayed, Imed Abbassi, Ali Ben Ali, Houssem Ammar, Ali Kchaou, Ahmed Tlili, Imen Zribi, Elif Colak, Suleyman Polat, Zehra Alan Koylu, Ali Guner, Mehmet Arif Usta, Murat Emre Reis, Baris Mantoglu, Emre Gonullu, Emrah Akin, Fatih Altintoprak, Zulfu Bayhan, Necattin Firat, Arda Isik, Ufuk Memis, Mehmet Bayrak, Yasemin Altıntaş, Yasin Kara, Mehmet Abdussamet Bozkurt, Ali Kocataş, Koray Das, Ahmet Seker, Nazmi Ozer, Semra Demirli Atici, Korhan Tuncer, Tayfun Kaya, Zeynep Ozkan, Onur Ilhan, Ibrahim Agackiran, Mustafa Yener Uzunoglu, Eren Demirbas, Yuksel Altinel, Serhat Meric, Nadir Adnan Hacım, Derya Salim Uymaz, Nail Omarov, Emre Balık, Giovanni D. Tebala, Hany Khalil, Mridul Rana, Mansoor Khan, Charlotte Florence, Christie Swaminathan, Cosimo Alex Leo, Lampros Liasis, Josef Watfah, Ivan Trostchansky, Edward Delgado, Marcelo Pontillo, Rifat Latifi, Raul Coimbra, Sara Edwards, Ana Lopez, George Velmahos, Ander Dorken, Anthony Gebran, Amanda Palmer, Jeffrey Oury, James M. Bardes, Sirivan Suon Seng, Lauren S. Coffua, Asanthi Ratnasekera, Tanya Egodage, Karla Echeverria-Rosario, Isabella Armento, Lena M. Napolitano, Naveen F. Sangji, Mark Hemmila, Jacob A. Quick, Tyler R. Austin, Theodore S. Hyman, William Curtiss, Amanda McClure, Nicholas Cairl, Walter L. Biffl, Hung P. Truong, Kathryn Schaffer, Summer Reames, Filippo Banchini, Patrizio Capelli, Federico Coccolini, Massimo Sartelli, Francesca Bravi, Carlo Vallicelli, Vanni Agnoletti, Gian Luca Baiocchi, and Fausto Catena

Subjects
Hartmann’s procedure, Ostomy, Emergency surgery, Resection, Primary anastomosis, Left side, Surgery, RD1-811, Medical emergencies. Critical care. Intensive care. First aid, RC86-88.9
Abstract

Abstract Background Literature suggests colonic resection and primary anastomosis (RPA) instead of Hartmann’s procedure (HP) for the treatment of left-sided colonic emergencies. We aim to evaluate the surgical options globally used to treat patients with acute left-sided colonic emergencies and the factors that leading to the choice of treatment, comparing HP and RPA. Methods This is a prospective, international, multicenter, observational study registered on ClinicalTrials.gov. A total 1215 patients with left-sided colonic emergencies who required surgery were included from 204 centers during the period of March 1, 2020, to May 31, 2020. with a 1-year follow-up. Results 564 patients (43.1%) were females. The mean age was 65.9 ± 15.6 years. HP was performed in 697 (57.3%) patients and RPA in 384 (31.6%) cases. Complicated acute diverticulitis was the most common cause of left-sided colonic emergencies (40.2%), followed by colorectal malignancy (36.6%). Severe complications (Clavien-Dindo ≥ 3b) were higher in the HP group (P

Published
2024
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2. Emergency Surgery in the Elderly: Could Laparoscopy Be Useful in Frailty? A Single-Center Prospective 2-Year Follow-Up in 120 Consecutive Patients

Author

Monica Zese, Elena Finotti, Giovanni Cestaro, Fabio Cavallo, Daniela Prando, Tobia Gobbi, Riccardo Zese, Salomone Di Saverio, and Ferdinando Agresta

Subjects
laparoscopy, urgent surgery, elderly, frailty, Surgery, RD1-811
Abstract

Background: the general population is aging across the world. Therefore, even surgical interventions in the elderly—in particular those involving emergency surgical admissions—are becoming more frequent. The elderly population is often frail (in multiple physiological systems, this is often defined as age-related cumulative decline). This study involved a 2-year follow-up evaluation of frail elderly patients treated with urgent surgical intervention at Santa Maria Regina della Misericordia Hospital, General Surgery Department, in Adria (Italy). Method: a prospective, single-center, 2-year follow-up study of 120 patients >65 years old, treated at our department for surgical abdominal emergencies. We considered co-morbidities (ASA—American Society of Anesthesiologists Physical Status Classification System—score), type of surgery (laparoscopy, laparotomy or converted), frailty score, mortality, and complications at 30 days and at 2 years. Conclusions: 70 (58.4%) patients had laparoscopy, 49 (40.8) had laparotomy, and in 1 (0.8%) case, surgery was converted from laparoscopy to laparotomy. Mortality strictly depends on the type of surgery (laparotomy vs. laparoscopy), complications during recovery, and a lower Fried frailty criteria score, on average. The long-term follow-up can be a useful tool to highlight a safer surgical approach, such as laparoscopy, in frail elderly patients. We consider the laparoscopic approach feasible in emergency situations, with similar or better outcomes than laparotomy, especially in frail elderly patients.

Published
2021
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3. The SIFIPAC/WSES/SICG/SIMEU guidelines for diagnosis and treatment of acute appendicitis in the elderly (2019 edition)

Author

Paola Fugazzola, Marco Ceresoli, Vanni Agnoletti, Ferdinando Agresta, Bruno Amato, Paolo Carcoforo, Fausto Catena, Osvaldo Chiara, Massimo Chiarugi, Lorenzo Cobianchi, Federico Coccolini, Alessandro De Troia, Salomone Di Saverio, Andrea Fabbri, Carlo Feo, Francesco Gabrielli, Angela Gurrado, Angelo Guttadauro, Leonardo Leone, Daniele Marrelli, Luca Petruzzelli, Nazario Portolani, Francesco Paolo Prete, Alessandro Puzziello, Massimo Sartelli, Giorgio Soliani, Mario Testini, Salvatore Tolone, Matteo Tomasoni, Gregorio Tugnoli, Pierluigi Viale, Monica Zese, Offir Ben Ishay, Yoram Kluger, Andrew Kirkpatrick, and Luca Ansaloni

Subjects
Appendicitis, Elderly, Appendectomy, Surgery in elderly, Surgery, RD1-811, Medical emergencies. Critical care. Intensive care. First aid, RC86-88.9
Abstract

Abstract The epidemiology and the outcomes of acute appendicitis in elderly patients are very different from the younger population. Elderly patients with acute appendicitis showed higher mortality, higher perforation rate, lower diagnostic accuracy, longer delay from symptoms onset and admission, higher postoperative complication rate and higher risk of colonic and appendiceal cancer. The aim of the present work was to investigate age-related factors that could influence a different approach, compared to the 2016 WSES Jerusalem guidelines on general population, in terms of diagnosis and management of elderly patient with acute appendicitis. During the XXIX National Congress of the Italian Society of Surgical Pathophysiology (SIFIPAC) held in Cesena (Italy) in May 2019, in collaboration with the Italian Society of Geriatric Surgery (SICG), the World Society of Emergency Surgery (WSES) and the Italian Society of Emergency Medicine (SIMEU), a panel of experts participated to a Consensus Conference where eight panelists presented a number of statements, which were developed for each of the four topics about diagnosis and management of acute appendicitis in elderly patients, formulated according to the GRADE system. The statements were then voted, eventually modified and finally approved by the participants to the Consensus Conference. The current paper is reporting the definitive guidelines statements on each of the following topics: diagnosis, non-operative management, operative management and antibiotic therapy.

Published
2020
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4. Development of the Italian Clinical Practice Guidelines on Bariatric and Metabolic Surgery: Design and Methodological Aspects

Author

Maurizio De Luca, Marco Antonio Zappa, Monica Zese, Ugo Bardi, Maria Grazia Carbonelli, Francesco Maria Carrano, Giovanni Casella, Marco Chianelli, Sonja Chiappetta, Angelo Iossa, Alessandro Martinino, Fausta Micanti, Giuseppe Navarra, Giacomo Piatto, Marco Raffaelli, Eugenia Romano, Simone Rugolotto, Roberto Serra, Emanuele Soricelli, Antonio Vitiello, Luigi Schiavo, Iris Caterina Maria Zani, Giulia Bandini, Edoardo Mannucci, Benedetta Ragghianti, and Matteo Monami

Subjects
obesity, metabolic/bariatric surgery (MBS), type 2 diabetes (T2D), arterial hypertension (AHI), dyslipidemia (DL), obstructive sleep apnea (OSA), Nutrition. Foods and food supply, TX341-641
Abstract

Development of the Italian clinical practice guidelines on bariatric and metabolic surgery, as well as design and methodological aspects. Background: Obesity and its complications are a growing problem in many countries. Italian Society of Bariatric and Metabolic Surgery for Obesity (Società Italiana di Chirurgia dell’Obesità e delle Malattie Metaboliche—SICOB) developed the first Italian guidelines for the treatment of obesity. Methods: The creation of SICOB Guidelines is based on an extended work made by a panel of 24 members and a coordinator. Grading of Recommendations, Assessment, Development and Evaluations (GRADE) methodology has been used to decide the aims, reference population, and target health professionals. Clinical questions have been created using the PICO (Patient, Intervention, Comparison, Outcome) conceptual framework. The definition of questions used the two-step web-based Delphi method, made by repeated rounds of questionnaires and a consensus opinion from the panel. Results: The panel proposed 37 questions. A consensus was immediately reached for 33 (89.2%), with 31 approved, two rejected and three which did not reach an immediate consensus. The further discussion allowed a consensus with one approved and two rejected. Conclusions: The areas covered by the clinical questions included indications of metabolic/bariatric surgery, types of surgery, and surgical management. The choice of a surgical or a non-surgical approach has been debated for the determination of the therapeutic strategy and the correct indications.

Published
2022
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5. Open Abdomen Management and Candida Infections: A Very Likely Link

Author

Savino Occhionorelli, Monica Zese, Rosario Cultrera, Domenico Lacavalla, Marco Albanese, and Giorgio Vasquez

Subjects
Diseases of the digestive system. Gastroenterology, RC799-869
Abstract

Objective. Laparostomy can be applied in trauma, abdominal sepsis, intra-abdominal hypertension, or compartment syndrome. Systemic infections, especially if complicated by Candida, are associated with a high risk of mortality. Methods. This is a single-centre retrospective case series of 47 cases admitted to our Department, which required laparostomy procedure; we analyzed the type of surgery, temporary abdominal closure, duration of open abdomen, complications, SOFA score, mortality with Candida infections, and empirical or targeted antifungal therapy. Results. We found that patients with Candida infection were related with a statistically significant difference (p

Published
2017
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6. Surgeons' perspectives on artificial intelligence to support clinical decision-making in trauma and emergency contexts: results from an international survey

Author

Cobianchi, Lorenzo, Piccolo, Daniele, Dal Mas, Francesca, Agnoletti, Vanni, Ansaloni, Luca, Balch, Jeremy, Biffl, Walter, Butturini, Giovanni, Catena, Fausto, Coccolini, Federico, Denicolai, Stefano, De Simone, Belinda, Frigerio, Isabella, Fugazzola, Paola, Marseglia, Gianluigi, Marseglia, Giuseppe Roberto, Martellucci, Jacopo, Modenese, Mirko, Previtali, Pietro, Ruta, Federico, Venturi, Alessandro, Kaafarani, Haytham M, Loftus, Tyler J, Kenneth Lyle Abbott, Abubaker Abdelmalik, Nebyou Seyoum Abebe, Fikri Abu-Zidan, Yousif Abdallah Yousif Adam, Harissou Adamou, Dmitry Mikhailovich Adamovich, Ferdinando Agresta, Antonino Agrusa, Emrah Akin, Mario Alessiani, Henrique Alexandrino, Syed Muhammad Ali, Vasilescu Alin Mihai, Pedro Miguel Almeida, Mohammed Mohammed Al-Shehari, Michele Altomare, Francesco Amico, Michele Ammendola, Jacopo Andreuccetti, Elissavet Anestiadou, Peter Angelos, Alfredo Annicchiarico, Amedeo Antonelli, Daniel Aparicio-Sanchez, Antonella Ardito, Giulio Argenio, Catherine Claude Arvieux, Ingolf Harald Askevold, Boyko Tchavdarov Atanasov, Goran Augustin, Selmy Sabry Awad, Giulia Bacchiocchi, Carlo Bagnoli, Hany Bahouth, Efstratia Baili, Lovenish Bains, Gian Luca Baiocchi, Miklosh Bala, Carmen Balagué, Dimitrios Balalis, Edoardo Baldini, Oussama Baraket, Suman Baral, Mirko Barone, Alberto Gonzãlez Barranquero, Jorge Arturo Barreras, Gary Alan Bass, Zulfu Bayhan, Giovanni Bellanova, Offir Ben-Ishay, Fabrizio Bert, Valentina Bianchi, Helena Biancuzzi, Chiara Bidoli, Raluca Bievel Radulescu, Mark Brian Bignell, Alan Biloslavo, Daniele Bissacco, Roberto Bini, Paolo Boati, Guillaume Boddaert, Branko Bogdanic, Cristina Bombardini, Luigi Bonavina, Luca Bonomo, Andrea Bottari, Konstantinos Bouliaris, Gioia Brachini, Antonio Brillantino, Giuseppe Brisinda, Maloni Mamada Bulanauca, Luis Antonio Buonomo, Jakob Burcharth, Salvatore Buscemi, Francesca Calabretto, Giacomo Calini, Valentin Calu, Fabio Cesare Campanile, Riccardo Campo Dall Orto, Andrea Campos-Serra, Stefano Campostrini, Recayi Capoglu, Joao Miguel Carvas, Marco Cascella, Gianmaria Casoni Pattacini, Valerio Celentano, Danilo Corrado Centonze, Marco Ceresoli, Dimitrios Chatzipetris, Antonella Chessa, Maria Michela Chiarello, Mircea Chirica, Serge Chooklin, Christos Chouliaras, Sharfuddin Chowdhury, Pasquale Cianci, Nicola Cillara, Stefania Cimbanassi, Stefano Piero Bernardo Cioffi, Elif Colak, Enrique Colás Ruiz, Luigi Conti, Alessandro Coppola, Tiago Correia De Sa, Silvia Dantas Costa, Valerio Cozza, Giuseppe Curro', Kirsten Felicia Ann-Sophie Aimee Dabekaussen, Fabrizio D'Acapito, Dimitrios Damaskos, Giancarlo D'Ambrosio, Koray Das, Richard Justin Davies, Andrew Charles De Beaux, Sara Patricia De Lebrusant Fernandez, Alessandro De Luca, Francesca De Stefano, Luca Degrate, Zaza Demetrashvili, Andreas Kyriacou Demetriades, Dzemail Smail Detanac, Agnese Dezi, Giuseppe Di Buono, Isidoro Di Carlo, Pierpaolo Di Lascio, Marcello Di Martino, Salomone Di Saverio, Bogdan Diaconescu, Jose J Diaz, Rigers Dibra, Evgeni Nikolaev Dimitrov, Vincenza Paola Dinuzzi, Sandra Dios-Barbeito, Jehangir Farman Ali Diyani, Agron Dogjani, Maurizio Domanin, Mario D'Oria, Virginia Duran Munoz-Cruzado, Barbora East, Mikael Ekelund, Gerald Takem Ekwen, Adel Hamed Elbaih, Muhammed Elhadi, Natalie Enninghorst, Mairam Ernisova, Juan Pablo Escalera-Antezana, Sofia Esposito, Giuseppe Esposito, Mercedes Estaire, Camilla Nikita Farè, Roser Farre, Francesco Favi, Luca Ferrario, Antonjacopo Ferrario di Tor Vajana, Claudia Filisetti, Francesco Fleres, Vinicius Cordeiro Fonseca, Alexander Forero-Torres, Francesco Forfori, Laura Fortuna, Evangelos Fradelos, Gustavo P Fraga, Pietro Fransvea, Simone Frassini, Giuseppe Frazzetta, Erica Pizzocaro, Maximos Frountzas, Mahir Gachabayov, Rita Galeiras, Alain A Garcia Vazquez, Simone Gargarella, Ibrahim Umar Garzali, Wagih Mommtaz Ghannam, Faiz Najmuddin Ghazi, Lawrence Marshall Gillman, Rossella Gioco, Alessio Giordano, Luca Giordano, Carlo Giove, Giorgio Giraudo, Mario Giuffrida, Michela Giulii Capponi, Emanuel Gois Jr, Carlos Augusto Gomes, Felipe Couto Gomes, Ricardo Alessandro Teixeira Gonsaga, Emre Gonullu, Jacques Goosen, Tatjana Goranovic, Raquel Gracia-Roman, Giorgio Maria Paolo Graziano, Ewen Alexander Griffiths, Tommaso Guagni, Dimitar Bozhidarov Hadzhiev, Muad Gamil Haidar, Hytham K S Hamid, Timothy Craig Hardcastle, Firdaus Hayati, Andrew James Healey, Andreas Hecker, Matthias Hecker, Edgar Fernando Hernandez Garcia, Adrien Montcho Hodonou, Eduardo Cancio Huaman, Martin Huerta, Aini Fahriza Ibrahim, Basil Mohamed Salabeldin Ibrahim, Giuseppe Ietto, Marco Inama, Orestis Ioannidis, Arda Isik, Nizar Ismail, Azzain Mahadi Hamid Ismail, Ruhi Fadzlyana Jailani, Ji Young Jang, Christos Kalfountzos, Sujala Niatarika Rajsain Kalipershad, Emmanouil Kaouras, Lewis Jay Kaplan, Yasin Kara, Evika Karamagioli, Aleksandar Karamarkovia, Ioannis Katsaros, Alfie J Kavalakat, Aristotelis Kechagias, Jakub Kenig, Boris Juli Kessel, Jim S Khan, Vladimir Khokha, Jae Il Kim, Andrew Wallace Kirkpatrick, Roberto Klappenbach, Yoram Kluger, Yoshiro Kobe, Efstratios Kofopoulos Lymperis, Kenneth Yuh Yen Kok, Victor Kong, Dimitris P Korkolis, Georgios Koukoulis, Bojan Kovacevic, Vitor Favali Kruger, Igor A Kryvoruchko, Hayato Kurihara, Akira Kuriyama, Aitor Landaluce-Olavarria, Pierfrancesco Lapolla, Ari Leppäniemi, Leo Licari, Giorgio Lisi, Andrey Litvin, Aintzane Lizarazu, Heura Llaquet Bayo, Varut Lohsiriwat, Claudia Cristina Lopes Moreira, Eftychios Lostoridis, Agustãn Tovar Luna, Davide Luppi, Gustavo Miguel Machain V, Marc Maegele, Daniele Maggiore, Stefano Magnone, Ronald V Maier, Piotr Major, Mallikarjuna Manangi, Andrea Manetti, Baris Mantoglu, Chiara Marafante, Federico Mariani, Athanasios Marinis, Evandro Antonio Sbalcheiro Mariot, Gennaro Martines, Aleix Martinez Perez, Costanza Martino, Pietro Mascagni, Damien Massalou, Maurizio Massaro, Belen Matías-García, Gennaro Mazzarella, Giorgio Mazzarolo, Renato Bessa Melo, Fernando Mendoza-Moreno, Serhat Meric, Jeremy Meyer, Luca Miceli, Nikolaos V Michalopoulos, Flavio Milana, Andrea Mingoli, Tushar S Mishra, Muyed Mohamed, Musab Isam Eldin Abbas Mohamed, Ali Yasen Mohamedahmed, Mohammed Jibreel Suliman Mohammed, Rajashekar Mohan, Ernest E Moore, Dieter Morales-Garcia, Mã Ns Muhrbeck, Francesk Mulita, Sami Mohamed Siddig Mustafa, Edoardo Maria Muttillo, Mukhammad David Naimzada, Pradeep H Navsaria, Ionut Negoi, Luca Nespoli, Christine Nguyen, Melkamu Kibret Nidaw, Giuseppe Nigri, Ioannis Nikolopoulos, Donal Brendan O'Connor, Habeeb Damilola Ogundipe, Cristina Oliveri, Stefano Olmi, Ernest Cun Wang Ong, Luca Orecchia, Aleksei V Osipov, Muhammad Faeid Othman, Marco Pace, Mario Pacilli, Leonardo Pagani, Giuseppe Palomba, Desire' Pantalone, Arpad Panyko, Ciro Paolillo, Mario Virgilio Papa, Dimitrios Papaconstantinou, Maria Papadoliopoulou, Aristeidis Papadopoulos, Davide Papis, Nikolaos Pararas, Jose Gustavo Parreira, Neil Geordie Parry, Francesco Pata, Tapan Patel, Simon Paterson-Brown, Giovanna Pavone, Francesca Pecchini, Veronica Pegoraro, Gianluca Pellino, Maria Pelloni, Andrea Peloso, Eduardo Perea Del Pozo, Rita Goncalves Pereira, Bruno Monteiro Pereira, Aintzane Lizarazu Perez, Silvia Pérez, Teresa Perra, Gennaro Perrone, Antonio Pesce, Lorenzo Petagna, Giovanni Petracca, Vorapong Phupong, Biagio Picardi, Arcangelo Picciariello, Micaela Piccoli, Edoardo Picetti, Emmanouil Pikoulis Pikoulis, Tadeja Pintar, Giovanni Pirozzolo, Francesco Piscioneri, Mauro Podda, Alberto Porcu, Francesca Privitera, Clelia Punzo, Silvia Quaresima, Martha Alexa Quiodettis, Niels Qvist, Razrim Rahim, Filipe Ramalho de Almeida, Rosnelifaizur Bin Ramely, Huseyin Kemal Rasa, Martin Reichert, Alexander Reinisch-Liese, Angela Renne, Camilla Riccetti, Maria Rita Rodriguez-Luna, Daniel Roizblatt, Andrea Romanzi, Luigi Romeo, Francesco Pietro Maria Roscio, Ramely Bin Rosnelifaizur, Stefano Rossi, Andres M Rubiano, Elena Ruiz-Ucar, Boris Evgeniev Sakakushev, Juan Carlos Salamea, Ibrahima Sall, Lasitha Bhagya Samarakoon, Fabrizio Sammartano, Alejandro Sanchez Arteaga, Sergi Sanchez-Cordero, Domenico Pietro Maria Santoanastaso, Massimo Sartelli, Diego Sasia, Norio Sato, Artem Savchuk, Robert Grant Sawyer, Giacomo Scaioli, Dimitrios Schizas, Simone Sebastiani, Barbara Seeliger, Helmut Alfredo Segovia Lohse, Charalampos Seretis, Giacomo Sermonesi, Mario Serradilla-Martin, Vishal G Shelat, Sergei Shlyapnikov, Theodoros Sidiropoulos, Romeo Lages Simoes, Leandro Siragusa, Boonying Siribumrungwong, Mihail Slavchev, Leonardo Solaini, Gabriele Soldini, Andrey Sopuev, Kjetil Soreide, Apostolos Sovatzidis, Philip Frank Stahel, Matt Strickland, Mohamed Arif Hameed Sultan, Ruslan Sydorchuk, Larysa Sydorchuk, Syed Muhammad Ali Muhammad Syed, Luis Tallon-Aguilar, Andrea Marco Tamburini, Nicolò Tamini, Edward C T H Tan, Jih Huei Tan, Antonio Tarasconi, Nicola Tartaglia, Giuseppe Tartaglia, Dario Tartaglia, John Vincent Taylor, Giovanni Domenico Tebala, Michel Teuben, Alexis Theodorou, Matti Tolonen, Giovanni Tomasicchio, Adriana Toro, Beatrice Torre, Tania Triantafyllou, Giuseppe Trigiante Trigiante, Marzia Tripepi, Julio Trostchansky, Konstantinos Tsekouras, Victor Turrado-Rodriguez, Roberta Tutino, Matteo Uccelli, Petar Angelov Uchikov, Bakarne Ugarte-Sierra, Mika Tapani Ukkonen, Michail Vailas, Panteleimon G Vassiliu, Alain Garcia Vazquez, Rita Galeiras Vazquez, George Velmahos, Juan Ezequiel Verde, Juan Manuel Verde, Massimiliano Veroux, Jacopo Viganò, Ramon Vilallonga, Diego Visconti, Alessandro Vittori, Maciej Waledziak, Tongporn Wannatoop, Lukas Werner Widmer, Michael Samuel James Wilson, Sarah Woltz, Ting Hway Wong, Sofia Xenaki, Byungchul Yu, Steven Yule, Sanoop Koshy Zachariah, Georgios Zacharis, Claudia Zaghi, Andee Dzulkarnaen Zakaria, Diego A Zambrano, Nikolaos Zampitis, Biagio Zampogna, Simone Zanghì, Maristella Zantedeschi, Konstantinos Zapsalis, Fabio Zattoni, Monica Zese, Lorenzo, Cobianchi, Daniele, Piccolo, Francesca, Dal Ma, Vanni, Agnoletti, Luca, Ansaloni, Jeremy, Balch, Walter, Biffl, Giovanni, Butturini, Fausto, Catena, Federico, Coccolini, Stefano, Denicolai, Belinda, De Simone, Isabella, Frigerio, Paola, Fugazzola, Gianluigi, Marseglia, Giuseppe Roberto, Marseglia, Jacopo, Martellucci, Mirko, Modenese, Pietro, Previtali, Federico, Ruta, Alessandro, Venturi, Haytham M, Kaafarani, Tyler J, Loftu, Lyle Abbott, Kenneth, Abdelmalik, Abubaker, Seyoum Abebe, Nebyou, Abu-Zidan, Fikri, Abdallah Yousif Adam, Yousif, Adamou, Harissou, Mikhailovich Adamovich, Dmitry, Agresta, Ferdinando, Agrusa, Antonino, Akin, Emrah, Alessiani, Mario, Alexandrino, Henrique, Muhammad Ali, Syed, Alin Mihai, Vasilescu, Miguel Almeida, Pedro, Mohammed Al-Shehari, Mohammed, Altomare, Michele, Amico, Francesco, Ammendola, Michele, Andreuccetti, Jacopo, Anestiadou, Elissavet, Angelos, Peter, Annicchiarico, Alfredo, Antonelli, Amedeo, Aparicio-Sanchez, Daniel, Ardito, Antonella, Argenio, Giulio, Claude Arvieux, Catherine, Harald Askevold, Ingolf, Tchavdarov Atanasov, Boyko, Augustin, Goran, Sabry Awad, Selmy, Bacchiocchi, Giulia, Bagnoli, Carlo, Bahouth, Hany, Baili, Efstratia, Bains, Lovenish, Luca Baiocchi, Gian, Bala, Miklosh, Balagué, Carmen, Balalis, Dimitrio, Baldini, Edoardo, Baraket, Oussama, Baral, Suman, Barone, Mirko, Gonzãlez Barranquero, Alberto, Arturo Barreras, Jorge, Alan Bass, Gary, Bayhan, Zulfu, Bellanova, Giovanni, Ben-Ishay, Offir, Bert, Fabrizio, Bianchi, Valentina, Biancuzzi, Helena, Bidoli, Chiara, Bievel Radulescu, Raluca, Brian Bignell, Mark, Biloslavo, Alan, Bissacco, Daniele, Bini, Roberto, Boati, Paolo, Boddaert, Guillaume, Bogdanic, Branko, Bombardini, Cristina, Bonavina, Luigi, Bonomo, Luca, Bottari, Andrea, Bouliaris, Konstantino, Brachini, Gioia, Brillantino, Antonio, Brisinda, Giuseppe, Mamada Bulanauca, Maloni, Antonio Buonomo, Lui, Burcharth, Jakob, Buscemi, Salvatore, Calabretto, Francesca, Calini, Giacomo, Calu, Valentin, Cesare Campanile, Fabio, Campo Dall Orto, Riccardo, Campos-Serra, Andrea, Campostrini, Stefano, Capoglu, Recayi, Miguel Carvas, Joao, Cascella, Marco, Casoni Pattacini, Gianmaria, Celentano, Valerio, Corrado Centonze, Danilo, Ceresoli, Marco, Chatzipetris, Dimitrio, Chessa, Antonella, Michela Chiarello, Maria, Chirica, Mircea, Chooklin, Serge, Chouliaras, Christo, Chowdhury, Sharfuddin, Cianci, Pasquale, Cillara, Nicola, Cimbanassi, Stefania, Piero Bernardo Cioffi, Stefano, Colak, Elif, Colás Ruiz, Enrique, Conti, Luigi, Coppola, Alessandro, Correia De Sa, Tiago, Dantas Costa, Silvia, Cozza, Valerio, Curro', Giuseppe, Felicia Ann-Sophie Aimee Dabekaussen, Kirsten, D'Acapito, Fabrizio, Damaskos, Dimitrio, D'Ambrosio, Giancarlo, Das, Koray, Justin Davies, Richard, Charles De Beaux, Andrew, Patricia De Lebrusant Fernandez, Sara, De Luca, Alessandro, De Stefano, Francesca, Degrate, Luca, Demetrashvili, Zaza, Kyriacou Demetriades, Andrea, Smail Detanac, Dzemail, Dezi, Agnese, Di Buono, Giuseppe, Di Carlo, Isidoro, Di Lascio, Pierpaolo, Di Martino, Marcello, Di Saverio, Salomone, Diaconescu, Bogdan, J Diaz, Jose, Dibra, Riger, Nikolaev Dimitrov, Evgeni, Paola Dinuzzi, Vincenza, Dios-Barbeito, Sandra, Farman Ali Diyani, Jehangir, Dogjani, Agron, Domanin, Maurizio, D'Oria, Mario, Duran Munoz-Cruzado, Virginia, East, Barbora, Ekelund, Mikael, Takem Ekwen, Gerald, Hamed Elbaih, Adel, Elhadi, Muhammed, Enninghorst, Natalie, Ernisova, Mairam, Pablo Escalera-Antezana, Juan, Esposito, Sofia, Esposito, Giuseppe, Estaire, Mercede, Nikita Farè, Camilla, Farre, Roser, Favi, Francesco, Ferrario, Luca, Ferrario di Tor Vajana, Antonjacopo, Filisetti, Claudia, Fleres, Francesco, Cordeiro Fonseca, Viniciu, Forero-Torres, Alexander, Forfori, Francesco, Fortuna, Laura, Fradelos, Evangelo, P Fraga, Gustavo, Fransvea, Pietro, Frassini, Simone, Frazzetta, Giuseppe, Pizzocaro, Erica, Frountzas, Maximo, Gachabayov, Mahir, Galeiras, Rita, A Garcia Vazquez, Alain, Gargarella, Simone, Umar Garzali, Ibrahim, Mommtaz Ghannam, Wagih, Najmuddin Ghazi, Faiz, Marshall Gillman, Lawrence, Gioco, Rossella, Giordano, Alessio, Giordano, Luca, Giove, Carlo, Giraudo, Giorgio, Giuffrida, Mario, Giulii Capponi, Michela, Gois Jr, Emanuel, Augusto Gomes, Carlo, Couto Gomes, Felipe, Alessandro Teixeira Gonsaga, Ricardo, Gonullu, Emre, Goosen, Jacque, Goranovic, Tatjana, Gracia-Roman, Raquel, Maria Paolo Graziano, Giorgio, Alexander Griffiths, Ewen, Guagni, Tommaso, Bozhidarov Hadzhiev, Dimitar, Gamil Haidar, Muad, S Hamid, Hytham K, Craig Hardcastle, Timothy, Hayati, Firdau, James Healey, Andrew, Hecker, Andrea, Hecker, Matthia, Fernando Hernandez Garcia, Edgar, Montcho Hodonou, Adrien, Cancio Huaman, Eduardo, Huerta, Martin, Fahriza Ibrahim, Aini, Mohamed Salabeldin Ibrahim, Basil, Ietto, Giuseppe, Inama, Marco, Ioannidis, Oresti, Isik, Arda, Ismail, Nizar, Mahadi Hamid Ismail, Azzain, Fadzlyana Jailani, Ruhi, Young Jang, Ji, Kalfountzos, Christo, Niatarika Rajsain Kalipershad, Sujala, Kaouras, Emmanouil, Jay Kaplan, Lewi, Kara, Yasin, Karamagioli, Evika, Karamarkovia, Aleksandar, Katsaros, Ioanni, J Kavalakat, Alfie, Kechagias, Aristoteli, Kenig, Jakub, Juli Kessel, Bori, S Khan, Jim, Khokha, Vladimir, Il Kim, Jae, Wallace Kirkpatrick, Andrew, Klappenbach, Roberto, Kluger, Yoram, Kobe, Yoshiro, Kofopoulos Lymperis, Efstratio, Yuh Yen Kok, Kenneth, Kong, Victor, P Korkolis, Dimitri, Koukoulis, Georgio, Kovacevic, Bojan, Favali Kruger, Vitor, A Kryvoruchko, Igor, Kurihara, Hayato, Kuriyama, Akira, Landaluce-Olavarria, Aitor, Lapolla, Pierfrancesco, Leppäniemi, Ari, Licari, Leo, Lisi, Giorgio, Litvin, Andrey, Lizarazu, Aintzane, Llaquet Bayo, Heura, Lohsiriwat, Varut, Cristina Lopes Moreira, Claudia, Lostoridis, Eftychio, Tovar Luna, Agustãn, Luppi, Davide, V, Gustavo Miguel Machain, Maegele, Marc, Maggiore, Daniele, Magnone, Stefano, V Maier, Ronald, Major, Piotr, Manangi, Mallikarjuna, Manetti, Andrea, Mantoglu, Bari, Marafante, Chiara, Mariani, Federico, Marinis, Athanasio, Antonio Sbalcheiro Mariot, Evandro, Martines, Gennaro, Martinez Perez, Aleix, Martino, Costanza, Mascagni, Pietro, Massalou, Damien, Massaro, Maurizio, Matías-García, Belen, Mazzarella, Gennaro, Mazzarolo, Giorgio, Bessa Melo, Renato, Mendoza-Moreno, Fernando, Meric, Serhat, Meyer, Jeremy, Miceli, Luca, V Michalopoulos, Nikolao, Milana, Flavio, Mingoli, Andrea, S Mishra, Tushar, Mohamed, Muyed, Isam Eldin Abbas Mohamed, Musab, Yasen Mohamedahmed, Ali, Jibreel Suliman Mohammed, Mohammed, Mohan, Rajashekar, E Moore, Ernest, Morales-Garcia, Dieter, Ns Muhrbeck, Mã, Mulita, Francesk, Mohamed Siddig Mustafa, Sami, Maria Muttillo, Edoardo, David Naimzada, Mukhammad, H Navsaria, Pradeep, Negoi, Ionut, Nespoli, Luca, Nguyen, Christine, Kibret Nidaw, Melkamu, Nigri, Giuseppe, Nikolopoulos, Ioanni, Brendan O'Connor, Donal, Damilola Ogundipe, Habeeb, Oliveri, Cristina, Olmi, Stefano, Cun Wang Ong, Ernest, Orecchia, Luca, V Osipov, Aleksei, Faeid Othman, Muhammad, Pace, Marco, Pacilli, Mario, Pagani, Leonardo, Palomba, Giuseppe, Pantalone, Desire', Panyko, Arpad, Paolillo, Ciro, Virgilio Papa, Mario, Papaconstantinou, Dimitrio, Papadoliopoulou, Maria, Papadopoulos, Aristeidi, Papis, Davide, Pararas, Nikolao, Gustavo Parreira, Jose, Geordie Parry, Neil, Pata, Francesco, Patel, Tapan, Paterson-Brown, Simon, Pavone, Giovanna, Pecchini, Francesca, Pegoraro, Veronica, Pellino, Gianluca, Pelloni, Maria, Peloso, Andrea, Perea Del Pozo, Eduardo, Goncalves Pereira, Rita, Monteiro Pereira, Bruno, Lizarazu Perez, Aintzane, Pérez, Silvia, Perra, Teresa, Perrone, Gennaro, Pesce, Antonio, Petagna, Lorenzo, Petracca, Giovanni, Phupong, Vorapong, Picardi, Biagio, Picciariello, Arcangelo, Piccoli, Micaela, Picetti, Edoardo, Pikoulis Pikoulis, Emmanouil, Pintar, Tadeja, Pirozzolo, Giovanni, Piscioneri, Francesco, Podda, Mauro, Porcu, Alberto, Privitera, Francesca, Punzo, Clelia, Quaresima, Silvia, Alexa Quiodettis, Martha, Qvist, Niel, Rahim, Razrim, Ramalho de Almeida, Filipe, Bin Ramely, Rosnelifaizur, Kemal Rasa, Huseyin, Reichert, Martin, Reinisch-Liese, Alexander, Renne, Angela, Riccetti, Camilla, Rita Rodriguez-Luna, Maria, Roizblatt, Daniel, Romanzi, Andrea, Romeo, Luigi, Pietro Maria Roscio, Francesco, Bin Rosnelifaizur, Ramely, Rossi, Stefano, M Rubiano, Andre, Ruiz-Ucar, Elena, Evgeniev Sakakushev, Bori, Carlos Salamea, Juan, Sall, Ibrahima, Bhagya Samarakoon, Lasitha, Sammartano, Fabrizio, Sanchez Arteaga, Alejandro, Sanchez-Cordero, Sergi, Pietro Maria Santoanastaso, Domenico, Sartelli, Massimo, Sasia, Diego, Sato, Norio, Savchuk, Artem, Grant Sawyer, Robert, Scaioli, Giacomo, Schizas, Dimitrio, Sebastiani, Simone, Seeliger, Barbara, Alfredo Segovia Lohse, Helmut, Seretis, Charalampo, Sermonesi, Giacomo, Serradilla-Martin, Mario, G Shelat, Vishal, Shlyapnikov, Sergei, Sidiropoulos, Theodoro, Lages Simoes, Romeo, Siragusa, Leandro, Siribumrungwong, Boonying, Slavchev, Mihail, Solaini, Leonardo, Soldini, Gabriele, Sopuev, Andrey, Soreide, Kjetil, Sovatzidis, Apostolo, Frank Stahel, Philip, Strickland, Matt, Arif Hameed Sultan, Mohamed, Sydorchuk, Ruslan, Sydorchuk, Larysa, Muhammad Ali Muhammad Syed, Syed, Tallon-Aguilar, Lui, Marco Tamburini, Andrea, Tamini, Nicolò, H Tan, Edward C T, Huei Tan, Jih, Tarasconi, Antonio, Tartaglia, Nicola, Tartaglia, Giuseppe, Tartaglia, Dario, Vincent Taylor, John, Domenico Tebala, Giovanni, Teuben, Michel, Theodorou, Alexi, Tolonen, Matti, Tomasicchio, Giovanni, Toro, Adriana, Torre, Beatrice, Triantafyllou, Tania, Trigiante Trigiante, Giuseppe, Tripepi, Marzia, Trostchansky, Julio, Tsekouras, Konstantino, Turrado-Rodriguez, Victor, Tutino, Roberta, Uccelli, Matteo, Angelov Uchikov, Petar, Ugarte-Sierra, Bakarne, Tapani Ukkonen, Mika, Vailas, Michail, G Vassiliu, Panteleimon, Garcia Vazquez, Alain, Galeiras Vazquez, Rita, Velmahos, George, Ezequiel Verde, Juan, Manuel Verde, Juan, Veroux, Massimiliano, Viganò, Jacopo, Vilallonga, Ramon, Visconti, Diego, Vittori, Alessandro, Waledziak, Maciej, Wannatoop, Tongporn, Werner Widmer, Luka, Samuel James Wilson, Michael, Woltz, Sarah, Hway Wong, Ting, Xenaki, Sofia, Yu, Byungchul, Yule, Steven, Koshy Zachariah, Sanoop, Zacharis, Georgio, Zaghi, Claudia, Dzulkarnaen Zakaria, Andee, A Zambrano, Diego, Zampitis, Nikolao, Zampogna, Biagio, Zanghì, Simone, Zantedeschi, Maristella, Zapsalis, Konstantino, Zattoni, Fabio, Zese, Monica, Cobianchi L., Piccolo D., Mas F.D., Agnoletti V., Ansaloni L., Balch J., Biffl W., Butturini G., Catena F., Coccolini F., Denicolai S., De Simone B., Frigerio I., Fugazzola P., Marseglia G., Marseglia G.R., Martellucci J., Modenese M., Previtali P., Ruta F., Venturi A., Kaafarani H.M., Loftus T.J., Laboratoire des sciences de l'ingénieur, de l'informatique et de l'imagerie (ICube), École Nationale du Génie de l'Eau et de l'Environnement de Strasbourg (ENGEES)-Université de Strasbourg (UNISTRA)-Institut National des Sciences Appliquées - Strasbourg (INSA Strasbourg), Institut National des Sciences Appliquées (INSA)-Institut National des Sciences Appliquées (INSA)-Institut National de Recherche en Informatique et en Automatique (Inria)-Les Hôpitaux Universitaires de Strasbourg (HUS)-Centre National de la Recherche Scientifique (CNRS)-Matériaux et Nanosciences Grand-Est (MNGE), Université de Strasbourg (UNISTRA)-Université de Haute-Alsace (UHA) Mulhouse - Colmar (Université de Haute-Alsace (UHA))-Institut National de la Santé et de la Recherche Médicale (INSERM)-Institut de Chimie du CNRS (INC)-Centre National de la Recherche Scientifique (CNRS)-Université de Strasbourg (UNISTRA)-Université de Haute-Alsace (UHA) Mulhouse - Colmar (Université de Haute-Alsace (UHA))-Institut National de la Santé et de la Recherche Médicale (INSERM)-Institut de Chimie du CNRS (INC)-Centre National de la Recherche Scientifique (CNRS)-Réseau nanophotonique et optique, Université de Strasbourg (UNISTRA)-Université de Haute-Alsace (UHA) Mulhouse - Colmar (Université de Haute-Alsace (UHA))-Centre National de la Recherche Scientifique (CNRS)-Université de Strasbourg (UNISTRA)-Centre National de la Recherche Scientifique (CNRS), Team Dynamics Study Group, Cobianchi, L, Piccolo, D, Dal Mas, F, Agnoletti, V, Ansaloni, L, Balch, J, Biffl, W, Butturini, G, Catena, F, Coccolini, F, Denicolai, S, De Simone, B, Frigerio, I, Fugazzola, P, Marseglia, G, Martellucci, J, Modenese, M, Previtali, P, Ruta, F, Venturi, A, Kaafarani, H, Loftus, T, Abbott, K, Abdelmalik, A, Abebe, N, Abu-Zidan, F, Adam, Y, Adamou, H, Adamovich, D, Agresta, F, Agrusa, A, Akin, E, Alessiani, M, Alexandrino, H, Ali, S, Mihai, V, Almeida, P, Al-Shehari, M, Altomare, M, Amico, F, Ammendola, M, Andreuccetti, J, Anestiadou, E, Angelos, P, Annicchiarico, A, Antonelli, A, Aparicio-Sanchez, D, Ardito, A, Argenio, G, Arvieux, C, Askevold, I, Atanasov, B, Augustin, G, Awad, S, Bacchiocchi, G, Bagnoli, C, Bahouth, H, Baili, E, Bains, L, Baiocchi, G, Bala, M, Balague, C, Balalis, D, Baldini, E, Baraket, O, Baral, S, Barone, M, Barranquero, A, Barreras, J, Bass, G, Bayhan, Z, Bellanova, G, Ben-Ishay, O, Bert, F, Bianchi, V, Biancuzzi, H, Bidoli, C, Radulescu, R, Bignell, M, Biloslavo, A, Bini, R, Bissacco, D, Boati, P, Boddaert, G, Bogdanic, B, Bombardini, C, Bonavina, L, Bonomo, L, Bottari, A, Bouliaris, K, Brachini, G, Brillantino, A, Brisinda, G, Bulanauca, M, Buonomo, L, Burcharth, J, Buscemi, S, Calabretto, F, Calini, G, Calu, V, Campanile, F, Dall'Orto, R, Campos-Serra, A, Campostrini, S, Capoglu, R, Carvas, J, Cascella, M, Pattacini, G, Celentano, V, Centonze, D, Ceresoli, M, Chatzipetris, D, Chessa, A, Chiarello, M, Chirica, M, Chooklin, S, Chouliaras, C, Chowdhury, S, Cianci, P, Cillara, N, Cimbanassi, S, Cioffi, S, Colak, E, Ruiz, E, Conti, L, Coppola, A, De Sa, T, Costa, S, Cozza, V, Curro', G, Dabekaussen, K, D'Acapito, F, Damaskos, D, D'Ambrosio, G, Das, K, Davies, R, De Beaux, A, Fernandez, S, De Luca, A, De Stefano, F, Degrate, L, Demetrashvili, Z, Demetriades, A, Detanac, D, Dezi, A, Di Buono, G, Di Carlo, I, Di Lascio, P, Di Martino, M, Di Saverio, S, Diaconescu, B, Diaz, J, Dibra, R, Dimitrov, E, Dinuzzi, V, Dios-Barbeito, S, Diyani, J, Dogjani, A, Domanin, M, D'Oria, M, Munoz-Cruzado, V, East, B, Ekelund, M, Ekwen, G, Elbaih, A, Elhadi, M, Enninghorst, N, Ernisova, M, Escalera-Antezana, J, Esposito, S, Esposito, G, Estaire, M, Fare, C, Farre, R, Favi, F, Ferrario, L, Vajana, A, Filisetti, C, Fleres, F, Fonseca, V, Forero-Torres, A, Forfori, F, Fortuna, L, Fradelos, E, Fraga, G, Fransvea, P, Frassini, S, Frazzetta, G, Pizzocaro, E, Frountzas, M, Gachabayov, M, Galeiras, R, Vazquez, A, Gargarella, S, Garzali, I, Ghannam, W, Ghazi, F, Gillman, L, Gioco, R, Giordano, A, Giordano, L, Giove, C, Giraudo, G, Giuffrida, M, Capponi, M, Gois, E, Gomes, C, Gomes, F, Gonsaga, R, Gonullu, E, Goosen, J, Goranovic, T, Gracia-Roman, R, Graziano, G, Griffiths, E, Guagni, T, Hadzhiev, D, Haidar, M, Hamid, H, Hardcastle, T, Hayati, F, Healey, A, Hecker, A, Hecker, M, Garcia, E, Hodonou, A, Huaman, E, Huerta, M, Ibrahim, A, Ibrahim, B, Ietto, G, Inama, M, Ioannidis, O, Isik, A, Ismail, N, Ismail, A, Jailani, R, Jang, J, Kalfountzos, C, Kalipershad, S, Kaouras, E, Kaplan, L, Kara, Y, Karamagioli, E, Karamarkovia, A, Katsaros, I, Kavalakat, A, Kechagias, A, Kenig, J, Kessel, B, Khan, J, Khokha, V, Kim, J, Kirkpatrick, A, Klappenbach, R, Kluger, Y, Kobe, Y, Lymperis, E, Kok, K, Kong, V, Korkolis, D, Koukoulis, G, Kovacevic, B, Kruger, V, Kryvoruchko, I, Kurihara, H, Kuriyama, A, Landaluce-Olavarria, A, Lapolla, P, Leppaniemi, A, Licari, L, Lisi, G, Litvin, A, Lizarazu, A, Bayo, H, Lohsiriwat, V, Moreira, C, Lostoridis, E, Luna, A, Luppi, D, Machain, V, Maegele, M, Maggiore, D, Magnone, S, Maier, R, Major, P, Manangi, M, Manetti, A, Mantoglu, B, Marafante, C, Mariani, F, Marinis, A, Mariot, E, Martines, G, Perez, A, Martino, C, Mascagni, P, Massalou, D, Massaro, M, Matias-Garcia, B, Mazzarella, G, Mazzarolo, G, Melo, R, Mendoza-Moreno, F, Meric, S, Meyer, J, Miceli, L, Michalopoulos, N, Milana, F, Mingoli, A, Mishra, T, Mohamed, M, Mohamedahmed, A, Mohammed, M, Mohan, R, Moore, E, Morales-Garcia, D, Muhrbeck, M, Mulita, F, Mustafa, S, Muttillo, E, Naimzada, M, Navsaria, P, Negoi, I, Nespoli, L, Nguyen, C, Nidaw, M, Nigri, G, Nikolopoulos, I, O'Connor, D, Ogundipe, H, Oliveri, C, Olmi, S, Ong, E, Orecchia, L, Osipov, A, Othman, M, Pace, M, Pacilli, M, Pagani, L, Palomba, G, Pantalone, D, Panyko, A, Paolillo, C, Papa, M, Papaconstantinou, D, Papadoliopoulou, M, Papadopoulos, A, Papis, D, Pararas, N, Parreira, J, Parry, N, Pata, F, Patel, T, Paterson-Brown, S, Pavone, G, Pecchini, F, Pegoraro, V, Pellino, G, Pelloni, M, Peloso, A, Del Pozo, E, Pereira, R, Pereira, B, Perez, S, Perra, T, Perrone, G, Pesce, A, Petagna, L, Petracca, G, Phupong, V, Picardi, B, Picciariello, A, Piccoli, M, Picetti, E, Pikoulis, E, Pintar, T, Pirozzolo, G, Piscioneri, F, Podda, M, Porcu, A, Privitera, F, Punzo, C, Quaresima, S, Quiodettis, M, Qvist, N, Rahim, R, de Almeida, F, Ramely, R, Rasa, H, Reichert, M, Reinisch-Liese, A, Renne, A, Riccetti, C, Rodriguez-Luna, M, Roizblatt, D, Romanzi, A, Romeo, L, Roscio, F, Rosnelifaizur, R, Rossi, S, Rubiano, A, Ruiz-Ucar, E, Sakakushev, B, Salamea, J, Sall, I, Samarakoon, L, Sammartano, F, Arteaga, A, Sanchez-Cordero, S, Santoanastaso, D, Sartelli, M, Sasia, D, Sato, N, Savchuk, A, Sawyer, R, Scaioli, G, Schizas, D, Sebastiani, S, Seeliger, B, Lohse, H, Seretis, C, Sermonesi, G, Serradilla-Martin, M, Shelat, V, Shlyapnikov, S, Sidiropoulos, T, Simoes, R, Siragusa, L, Siribumrungwong, B, Slavchev, M, Solaini, L, Soldini, G, Sopuev, A, Soreide, K, Sovatzidis, A, Stahel, P, Strickland, M, Sultan, M, Sydorchuk, R, Sydorchuk, L, Syed, S, Tallon-Aguilar, L, Tamburini, A, Tamini, N, Tan, E, Tan, J, Tarasconi, A, Tartaglia, N, Tartaglia, G, Tartaglia, D, Taylor, J, Tebala, G, Teuben, M, Theodorou, A, Tolonen, M, Tomasicchio, G, Toro, A, Torre, B, Triantafyllou, T, Trigiante, G, Tripepi, M, Trostchansky, J, Tsekouras, K, Turrado-Rodriguez, V, Tutino, R, Uccelli, M, Uchikov, P, Ugarte-Sierra, B, Ukkonen, M, Vailas, M, Vassiliu, P, Vazquez, R, Velmahos, G, Verde, J, Veroux, M, Vigano, J, Vilallonga, R, Visconti, D, Vittori, A, Waledziak, M, Wannatoop, T, Widmer, L, Wilson, M, Woltz, S, Wong, T, Xenaki, S, Yu, B, Yule, S, Zachariah, S, Zacharis, G, Zaghi, C, Zakaria, A, Zambrano, D, Zampitis, N, Zampogna, B, Zanghi, S, Zantedeschi, M, Zapsalis, K, Zattoni, F, and Zese, M

Subjects
Settore SECS-P/10 - Organizzazione Aziendale, Settore MED/18 - Chirurgia Generale, Artificial intelligence, Settore SECS-P/07 - Economia Aziendale, Decision aid, Emergency Medicine, Decision aids, Surgery, [SDV.IB]Life Sciences [q-bio]/Bioengineering, Trauma and emergency surgery, Clinical decision-making, Survey
Abstract

Background Artificial intelligence (AI) is gaining traction in medicine and surgery. AI-based applications can offer tools to examine high-volume data to inform predictive analytics that supports complex decision-making processes. Time-sensitive trauma and emergency contexts are often challenging. The study aims to investigate trauma and emergency surgeons’ knowledge and perception of using AI-based tools in clinical decision-making processes. Methods An online survey grounded on literature regarding AI-enabled surgical decision-making aids was created by a multidisciplinary committee and endorsed by the World Society of Emergency Surgery (WSES). The survey was advertised to 917 WSES members through the society’s website and Twitter profile. Results 650 surgeons from 71 countries in five continents participated in the survey. Results depict the presence of technology enthusiasts and skeptics and surgeons' preference toward more classical decision-making aids like clinical guidelines, traditional training, and the support of their multidisciplinary colleagues. A lack of knowledge about several AI-related aspects emerges and is associated with mistrust. Discussion The trauma and emergency surgical community is divided into those who firmly believe in the potential of AI and those who do not understand or trust AI-enabled surgical decision-making aids. Academic societies and surgical training programs should promote a foundational, working knowledge of clinical AI.

Published
2023

7. The COVID - AGICT study: COVID–19 and advanced gastro-intestinal cancer surgical treatment. A multicentric Italian study on the SARS-CoV-2 pandemic impact on gastro-intestinal cancers surgical treatment during the 2020. Analysis of perioperative and short-term oncological outcomes

Author

Giuseppe Giuliani, Francesco Guerra, Simona Messinese, Francesco Santelli, Lucia Salvischiani, Sofia Esposito, Luca Ferraro, Alessandro Esposito, Matteo De Pastena, Daniela Rega, Paolo Delrio, Carlotta La Raja, Antonino Spinelli, Simonetta Massaron, Paola De Nardi, Emanuele Federico Kauffmann, Ugo Boggi, Simona Deidda, Angelo Restivo, Alessandra Marano, Felice Borghi, Micaela Piccoli, Norma Depalma, Stefano D'Ugo, Marcello Spampinato, Federico Cozzani, Paolo Del Rio, Rosa Marcellinaro, Massimo Carlini, Raffaele De Rosa, Stefano Scabini, Fabio Maiello, Roberto Polastri, Giulia Turri, Corrado Pedrazzani, Monica Zese, Dario Parini, Andrea Casaril, Gianluigi Moretto, Antonio De Leo, Marco Catarci, Renza Trapani, Sandro Zonta, Patrizia Marsanic, Andrea Muratore, Gregorio Di Franco, Luca Morelli, Alessandro Coppola, Damiano Caputo, Jacopo Andreuccetti, Giusto Pignata, Laura Mastrangelo, Elio Jovine, Michele Mazzola, Giovanni Ferrari, Lorenzo Mariani, Graziano Ceccarelli, Rocco Giuseppe, Stefano Bolzon, Mariateresa Grasso, Silvio Testa, Paola Germani, Nicolò de Manzini, Serena Langella, Alessandro Ferrero, Diego Coletta, Paolo Pietro Bianchi, Carmelo Bengala, Andrea Coratti, Lorenzo De Franco, Roberto Benigni, Angela Tribuzi, Ubaldo Marra, Michele Di Marino, Chiara Cova, Beatrice Bianchi, Sara Nobile, Luigi Zorcolo, Giorgio Lisi, Fabrizio Allisiardi, Michele Grieco, Carolina Righetti, Marco Frisini, Alberto Brolese, Michele Grassia, Andrea Lucchi, Giulia Bagaglini, Giuseppe S. Sica, Michele Manara, Luca Turati, Lorenzo Macone, Roberta Carminati, Pierpaolo Mariani, Gianluca Rizzo, Claudio Coco, Francesca Pennetti Pennella, Fabio Rondelli, Lucia Romano, Antonio Giuliani, Raffaele Palaia, Andrea Belli, Vittorio Albino, Maddalena Leongito, Giulia David, Pasquale Misitano, Silvia Pasulo, Gian Luca Baiocchi, Roberta La Mendola, Mohamnad Abu Hilal, Ludovica Baldari, Elisa Cassinotti, Luigi Boni, Gabriella Teresa Capolupo, Marco Caricato, Enrico Pinotti, Mauro Montuori, Cristina Bombardini, Gabriele Anania, Rigers Dibra, Gennaro Martines, Leonardo Solaini, Giorgio Ercolani, Renato Oliva, Maria Vittoria Carati, Gian Luca Grazi, Giacomo Ghio, Francesco Marchegiani, Salvatore Pucciarelli, Filippo La Torre, Immacolata Iannone, Dimitri Krizzuk, Francesco Sammartino, Giorgia Catalano, Paolo Strignano, Renato Romagnoli, Domenico Piccione, Bruno Nardo, Rossella Reddavid, Maurizio Degiuli, Martino Gerosa, Dario Maggioni, Michele Zuolo, Marco Rigamonti, Omar Ghazouani, Raffaele Galleano, Andrea Percivale, Luca Tirloni, Luca Moraldi, Nicolò Fabbri, Carlo Vittorio Feo, Samuele Colombo, Salomone Di Saverio, Giuseppe Barbato, Francesco Coratti, Andrea Sagnotta, Stefano Mancini, Nicola Cillara, Antonello Deserra, Alessandro Cannavera, and Giampaolo Formisano

Subjects
Settore MED/18 - Chirurgia Generale, Oncology, gastrointestinal cancer, Advanced cancer, Gastroesophageal cancer, COVID-19, Colorectal cancer, Gastrointestinal cancers, Pancreatic cancer, Surgery
Published
2023

8. Emergency Surgery in the Elderly: Could Laparoscopy Be Useful in Frailty? A Single-Center Prospective 2-Year Follow-Up in 120 Consecutive Patients

Author

Riccardo Zese, Elena Finotti, Salomone Di Saverio, Ferdinando Agresta, Fabio Cavallo, Daniela Prando, Tobia Gobbi, Giovanni Cestaro, Monica Zese, Zese, Monica [0000-0002-4768-6746], Zese, Riccardo [0000-0001-8352-6304], Di Saverio, Salomone [0000-0001-5685-5022], and Apollo - University of Cambridge Repository

Subjects
medicine.medical_specialty, Aging, medicine.medical_treatment, health care facilities, manpower, and services, Population, laparoscopy, lcsh:Surgery, 32 Biomedical and Clinical Sciences, frailty, 030230 surgery, Single Center, elderly, 6 Evaluation of treatments and therapeutic interventions, 03 medical and health sciences, 0302 clinical medicine, Emergency surgery, Clinical Research, Laparotomy, Elderly population, medicine, Laparoscopy, education, 3202 Clinical Sciences, education.field_of_study, Surgical approach, urgent surgery, medicine.diagnostic_test, business.industry, General surgery, General Medicine, lcsh:RD1-811, Emergency situations, humanities, 030220 oncology & carcinogenesis, Patient Safety, business, 6.4 Surgery
Abstract

Background: the general population is aging across the world. Therefore, even surgical interventions in the elderly—in particular those involving emergency surgical admissions—are becoming more frequent. The elderly population is often frail (in multiple physiological systems, this is often defined as age-related cumulative decline). This study involved a 2-year follow-up evaluation of frail elderly patients treated with urgent surgical intervention at Santa Maria Regina della Misericordia Hospital, General Surgery Department, in Adria (Italy). Method: a prospective, single-center, 2-year follow-up study of 120 patients &gt, 65 years old, treated at our department for surgical abdominal emergencies. We considered co-morbidities (ASA—American Society of Anesthesiologists Physical Status Classification System—score), type of surgery (laparoscopy, laparotomy or converted), frailty score, mortality, and complications at 30 days and at 2 years. Conclusions: 70 (58.4%) patients had laparoscopy, 49 (40.8) had laparotomy, and in 1 (0.8%) case, surgery was converted from laparoscopy to laparotomy. Mortality strictly depends on the type of surgery (laparotomy vs. laparoscopy), complications during recovery, and a lower Fried frailty criteria score, on average. The long-term follow-up can be a useful tool to highlight a safer surgical approach, such as laparoscopy, in frail elderly patients. We consider the laparoscopic approach feasible in emergency situations, with similar or better outcomes than laparotomy, especially in frail elderly patients.

Published
2021

10. Correction: ERas and COLorectal endoscopic surgery: an Italian society for endoscopic surgery and new technologies (SICE) national report

Author

Milone, Marco, Elmore, Ugo, Manigrasso, Michele, Ortenzi, Monica, Botteri, Emanuele, Arezzo, Alberto, Silecchia, Gianfranco, Guerrieri, Mario, De Palma, Giovanni Domenico, Agresta, Ferdinando, Francesco, Pizza, Dario, D'Antonio, Francesco, Amalfitano, Francesco, Selvaggi, Sciaudone, Guido, Lucio, Selvaggi, Daniela, Prando, Fabio, Cavallo, Giovanni, Lezoche, Diego, Cuccurullo, Ernesto, Tartaglia, Carlo, Sagnelli, Andrea, Coratti, Angela, Tribuzi, Michele Di Marino, Gabriele, Anania, Cristina, Bombardini, Mauro Pietro Zago, Fulvio, Tagliabue, Morena, Burati, Salomone Di Saverio, Samuele, Colombo, Sara El Adla, Maurizio De Luca, Monica, Zese, Dario, Parini, Paolo, Prosperi, Giovanni, Alemanno, Jacopo, Martellucci, Stefano, Olmi, Alberto, Oldani, Matteo, Uccelli, Dario, Bono, Donatella, Scaglione, Roberto, Saracco, Mauro, Podda, Adolfo, Pisanu, Valentina, Murzi, Antonino, Agrusa, Salvatore, Buscemi, Irnerio Angelo Muttillo, Biagio, Picardi, Edoardo Maria Muttillo, Leonardo, Solaini, Davide, Cavaliere, Giorgio, Ercolani, Francesco, Corcione, Roberto, Peltrini, Umberto, Bracale, Andrea, Lucchi, Laura, Vittori, Michele, Grassia, Alberto, Porcu, Teresa, Perra, Claudio, Feo, Pierluigi, Angelini, Domenico, Izzo, Luigi, Ricciardelli, Mario, Trompetto, Gaetano, Gallo, Alberto Realis Luc, Andrea, Muratore, Marcello, Calabrò, Bruno, Cuzzola, Andrea, Barberis, Federico, Costanzo, Giulio, Angelini, Graziano, Ceccarelli, Fabio, Rondelli, Michele De Rosa, Elisa, Cassinotti, Luigi, Boni, Ludovica, Baldari, Paolo Pietro Bianchi, Giampaolo, Formisano, Giuseppe, Giuliani, Andrea Alessandro Pisani Ceretti, Nicolò Maria Mariani, Marco, Giovenzana, Roberto, Farfaglia, Paolo, Marcianò, Valeria, Arizzi, Micaela, Piccoli, Francesca, Pecchini, Gianmaria Casoni Pattacini, Nereo, Vettoretto, Claudio, Guarnieri, Letizia, Laface, Emmanuele, Abate, Massimiliano, Casati, Carlo, Feo, Nicolò, Fabri, Antonio, Pesce, Piero, Maida, Giampaolo, Marte, Roberta, Abete, Lorenzo, Casali, Alessandro, Marchignoli, Matteo, Dall'Aglio, Stefano, Scabini, Davide, Pertile, Alessandra, Aprile, Jacopo, Andreuccetti, Alberto Di Leo, Lorenzo, Crepaz, Francesco, Maione, Sara, Vertaldi, Alessia, Chini, Riccardo, Rosati, Francesco, Puccetti, Giulia, Maggi, Andrea, Cossu, Alberto, Sartori, Giacomo, Piatto, Nicola, Perrotta, Marta, Celiento, Marco, Scorzelli, Vincenzo, Pilone, Salvatore, Tramontano, Pietro, Calabrese, Raffaele, Sechi, Nicola, Cillara, Giaime, Putzu, Michele Guido Podda, Mauro, Montuori, Enrico, Pinotti, Giuseppe, Sica, Marzia, Franceschilli, Bruno, Sensi, Maurizio, Degiuli, Rossella, Reddavid, Lucia, Puca, Marco, Farsi, Alessio, Minuzzo, Elena, Gia, Gian Luca Baiocchi, Valerio, Ranieri, Andrea, Celotti, Francesco, Bianco, Sebastiano, Grassia, and Alessandra, Novi

Subjects
Surgery, Settore MED/18
Published
2022

11. ERas and COLorectal endoscopic surgery: an Italian society for endoscopic surgery and new technologies (SICE) national report

Author

Marco, Milone, Ugo, Elmore, Michele, Manigrasso, Monica, Ortenzi, Emanuele, Botteri, Alberto, Arezzo, Silecchia, Gianfranco, Mario, Guerrieri, Giovanni Domenico De Palma, Ferdinando, Agresta, Francesco, Pizza, Dario, D???antonio, Francesco, Amalfitano, Francesco, Selvaggi, Guido, Sciaudone, Lucio, Selvaggi, Daniela, Prando, Fabio, Cavallo, Giovanni, Lezoche, Diego, Cuccurullo, Ernesto, Tartaglia, Carlo, Sagnelli, Andrea, Coratti, Angela, Tribuzi, Michele Di Marino, Gabriele, Anania, Cristina, Bombardini, Mauro Pietro Zago, Fulvio, Tagliabue, Morena, Burati, Salomone Di Saverio, Samuele, Colombo, Sara El Adla, Maurizio De Luca, Monica, Zese, Dario, Parini, Paolo, Prosperi, Giovanni, Alemanno, Jacopo, Martellucci, Stefano, Olmi, Alberto, Oldani, Matteo, Uccelli, Dario, Bono, Donatella, Scaglione, Roberto, Saracco, Mauro, Podda, Adolfo, Pisanu, Valentina, Murzi, Antonino, Agrusa, Salvatore, Buscemi, Irnerio Angelo Muttillo, Biagio, Picardi, Leonardo, Solaini, Davide, Cavaliere, Giorgio, Ercolani, Francesco, Corcione, Roberto, Peltrini, Umberto, Bracale, Andrea, Lucchi, Laura, Vittori, Michele, Grassia, Alberto, Porcu, Teresa, Perra, Claudio, Feo, Pierluigi, Angelini, Domenico, Izzo, Luigi, Ricciardelli, Mario, Trompetto, Gallo, Gaetano, Alberto Realis Luc, Andrea, Muratore, Marcello, Calabr??, Bruno, Cuzzola, Andrea, Barberis, Federico, Costanzo, Giulio, Angelini, Graziano, Ceccarelli, Fabio, Rondelli, Michele De Rosa, Elisa, Cassinotti, Luigi, Boni, Ludovica, Baldari, Paolo Pietro Bianchi, Giampaolo, Formisano, Giuseppe, Giuliani, Andrea Alessandro Pisani Ceretti, Nicol?? Maria Mariani, Marco, Giovenzana, Roberto, Farfaglia, Paolo, Marcian??, Valeria, Arizzi, Micaela, Piccoli, Francesca, Pecchini, Gianmaria Casoni Pattacini, Nereo, Vettoretto, Claudio, Guarnieri, Letizia, Laface, Emmanuele, Abate, Massimiliano, Casati, Carlo, Feo, Nicol??, Fabri, Antonio, Pesce, Piero, Maida, Giampaolo, Marte, Roberta, Abete, Lorenzo, Casali, Alessandro, Marchignoli, Matteo, Dall???aglio, Stefano, Scabini, Davide, Pertile, Alessandra, Aprile, Jacopo, Andreuccetti, Alberto Di Leo, Lorenzo, Crepaz, Francesco, Maione, Sara, Vertaldi, Alessia, Chini, Riccardo, Rosati, Francesco, Puccetti, Giulia, Maggi, Andrea, Cossu, Alberto, Sartori, Giacomo, Piatto, Nicola, Perrotta, Marta, Celiento, Marco, Scorzelli, Vincenzo, Pilone, Salvatore, Tramontano, Pietro, Calabrese, Raffaele, Sechi, Nicola, Cillara, Giaime, Putzu, Michele Guido Podda, Mauro, Montuori, Enrico, Pinotti, Giuseppe, Sica, Marzia, Franceschilli, Bruno, Sensi, Maurizio, Degiuli, Rossella, Reddavid, Lucia, Puca, Marco, Farsi, Alessio, Minuzzo, Elena, Gia, Gian Luca Baiocchi, Valerio, Ranieri, Andrea, Celotti, Francesco, Bianco, Sebastiano, Grassia, Alessandra, Novi, Muttillo, EDOARDO MARIA, Milone, Marco, Elmore, Ugo, Manigrasso, Michele, Ortenzi, Monica, Botteri, Emanuele, Arezzo, Alberto, Silecchia, Gianfranco, Guerrieri, Mario, De Palma, Giovanni Domenico, Agresta, Ferdinando, and Rosati, Riccardo

Subjects
colorectal, ERAS, enhanced recovery, minimally invasive, Length of Stay, Postoperative Complications, Enhanced Recovery, Humans, Surgery, Laparoscopy, Prospective Studies, Minimally invasive, Colorectal Neoplasms, Colorectal Surgery, Colorectal
Abstract

Background Several reports demonstrated a strong association between the level of adherence to the protocol and improved clinical outcomes after surgery. However, it is difficult to obtain full adherence to the protocol into clinical practice and has still not been identified the threshold beyond which improved functional results can be reached. Methods The ERCOLE (ERas and COLorectal Endoscopic surgery) study was as a cohort, prospective, multi-centre national study evaluating the association between adherence to ERAS items and clinical outcomes after minimally invasive colorectal surgery. The primary endpoint was to associate the percentage of ERAS adherence to functional recovery after minimally invasive colorectal cancer surgery. The secondary endpoints of the study was to validate safety of the ERAS programme evaluating complications’ occurrence according to Clavien-Dindo classification and to evaluate the compliance of the Italian surgeons to each ERAS item. Results 1138 patients were included. Adherence to the ERAS protocol was full only in 101 patients (8.9%), > 75% of the ERAS items in 736 (64.7%) and > 50% in 1127 (99%). Adherence to > 75% was associated with a better functional recovery with 90.2 ± 98.8 vs 95.9 ± 33.4 h (p = 0.003). At difference, full adherence to the ERAS components 91.7 ± 22.1 vs 92.2 ± 31.6 h (p = 0.8) was not associated with better recovery. Conclusions Our results were encouraging to affirm that adherence to the ERAS program up to 75% could be considered satisfactory to get the goal. Our study could be considered a call to simplify the ERAS protocol facilitating its penetrance into clinical practice.

Published
2022

12. Conservative treatment of hemorrhoids

Author

Fabio Cavallo, Daniela Prando, Ferdinando Agresta, Giovanni Cestaro, and Monica Zese

Subjects
Conservative treatment, medicine.medical_specialty, Hemorrhoids, business.industry, Medicine, Surgery, business, medicine.disease
Published
2021

13. Single Anastomosis Jejuno-ileal (SAJI): a New Model of Malabsorptive Revisional Procedure for Insufficient Weight Loss or Weight Regain After Roux-en-Y Gastric Bypass

Author

Maurizio De Luca, Giacomo Piatto, Alberto Sartori, Monica Zese, Cesare Lunardi, Simone Targa, Cristiano Giardiello, Paolo Gentileschi, and Jacques Himpens

Subjects
Reoperation, Nutrition and Dietetics, Diabetes Mellitus, Type 2, Gastrectomy, Endocrinology, Diabetes and Metabolism, Weight Loss, Gastric Bypass, Humans, Surgery, Laparoscopy, Weight Gain, Obesity, Morbid, Retrospective Studies
Abstract

In case of insufficient weight loss or weight regain or relapse of weight-related comorbidities after Roux-en-Y gastric bypass (RYGB), other procedures such as reduction of a large gastric pouch and stoma, lengthening of the Roux limb, conversion to sleeve gastrectomy and/or bilio-pancreatic diversion with duodenal switch have been advocated. Single anastomosis jejuno-ileal (SAJI) is a new revisional simple operation performed after RYGB failure which adds malabsorption to the previous gastric bypass.SAJI includes a single jejuno-ileal anastomosis specifically joining the ileum 250-300 cm proximal to the ileo-caecal valve and the jejunum 30 cm below the gastro-jejunal anastomosis on the Roux limb of the previous RYGB. Thirty-one patients underwent SAJI for insufficient weight loss and/or weight regain after RYGB. The percent total weight loss (%TWL) after RYGB and before SAJI was 21.8 ± 7.8. All SAJI operations were performed laparoscopically. The SAJI mean operating time was 145 min.Regarding weight loss after SAJI, %TWL is 27.2 ± 7.4, 31.2 ± 6.4, 33.7 ± 5.9 and 32.9 ± 5.2 at 12, 24, 36 and 48 months, respectively. Our series recorded a low rate of peri-operative and medium-term complications with a low grade of severity (Clavien-Dindo classification grade). One patient required reoperation 36 days after SAJI for epigastrium incarcerated incisional hernia at the previous RYGB laparotomy site. Mortality was 0. Comorbidity reduction/resolution after SAJI is 83.2% for type 2 diabetes mellitus, 42.8% for arterial hypertension, 72.8% for dyslipidemia and 45.3% for OSA.Treatment of failed RYGB is challenging. SAJI is a less complicated, purely low invasive malabsorptive operation that should reach satisfactory %TWL and comorbidity reduction/resolution.

Published
2021

14. The SIFIPAC/WSES/SICG/SIMEU guidelines for diagnosis and treatment of acute appendicitis in the elderly (2019 edition)

Author

Andrew W Kirkpatrick, Osvaldo Chiara, Daniele Marrelli, Massimo Sartelli, Pierluigi Viale, Ferdinando Agresta, Nazario Portolani, Angelo Guttadauro, Luca Petruzzelli, Mario Testini, Luca Ansaloni, Paolo Carcoforo, Vanni Agnoletti, Lorenzo Cobianchi, Salvatore Tolone, Angela Gurrado, Andrea Fabbri, Fausto Catena, Yoram Kluger, Paola Fugazzola, Federico Coccolini, Francesco Paolo Prete, Monica Zese, Francesco Gabrielli, Matteo Tomasoni, Bruno Amato, Marco Ceresoli, Alessandro De Troia, Alessandro Puzziello, Offir Ben Ishay, Salomone Di Saverio, Giorgio Soliani, Leonardo Leone, Massimo Chiarugi, Carlo V. Feo, Gregorio Tugnoli, Apollo - University of Cambridge Repository, Fugazzola, P., Ceresoli, M., Agnoletti, V., Agresta, F., Amato, B., Carcoforo, P., Catena, F., Chiara, O., Chiarugi, M., Cobianchi, L., Coccolini, F., De Troia, A., Di Saverio, S., Fabbri, A., Feo, C., Gabrielli, F., Gurrado, A., Guttadauro, A., Leone, L., Marrelli, D., Petruzzelli, L., Portolani, N., Prete, F. P., Puzziello, A., Sartelli, M., Soliani, G., Testini, M., Tolone, S., Tomasoni, M., Tugnoli, G., Viale, P., Zese, M., Ishay, O. B., Kluger, Y., Kirkpatrick, A., Ansaloni, L., Fugazzola, P, Ceresoli, M, Agnoletti, V, Agresta, F, Amato, B, Carcoforo, P, Catena, F, Chiara, O, Chiarugi, M, Cobianchi, L, Coccolini, F, De Troia, A, Di Saverio, S, Fabbri, A, Feo, C, Gabrielli, F, Gurrado, A, Guttadauro, A, Leone, L, Marrelli, D, Petruzzelli, L, Portolani, N, Prete, F, Puzziello, A, Sartelli, M, Soliani, G, Testini, M, Tolone, S, Tomasoni, M, Tugnoli, G, Viale, P, Zese, M, Ishay, O, Kluger, Y, Kirkpatrick, A, Ansaloni, L, Fugazzola P., Ceresoli M., Agnoletti V., Agresta F., Amato B., Carcoforo P., Catena F., Chiara O., Chiarugi M., Cobianchi L., Coccolini F., De Troia A., Di Saverio S., Fabbri A., Feo C., Gabrielli F., Gurrado A., Guttadauro A., Leone L., Marrelli D., Petruzzelli L., Portolani N., Prete F.P., Puzziello A., Sartelli M., Soliani G., Testini M., Tolone S., Tomasoni M., Tugnoli G., Viale P., Zese M., Ishay O.B., Kluger Y., Kirkpatrick A., and Ansaloni L.

Subjects
medicine.medical_specialty, Perforation (oil well), Population, lcsh:Surgery, Appendectomy, Appendicitis, Elderly, Surgery in elderly, Review, 030230 surgery, NO, 03 medical and health sciences, 0302 clinical medicine, Elderly, Emergency surgery, Epidemiology, Humans, Medicine, Appendectomy, Appendicitis, Surgery in elderly, Appendiciti, education, Aged, Aged, 80 and over, education.field_of_study, business.industry, General surgery, Age Factors, lcsh:Medical emergencies. Critical care. Intensive care. First aid, Consensus conference, Postoperative complication, lcsh:RD1-811, lcsh:RC86-88.9, medicine.disease, 030220 oncology & carcinogenesis, Acute Disease, Acute appendicitis, Emergency Medicine, Surgery, business
Abstract

The epidemiology and the outcomes of acute appendicitis in elderly patients are very different from the younger population. Elderly patients with acute appendicitis showed higher mortality, higher perforation rate, lower diagnostic accuracy, longer delay from symptoms onset and admission, higher postoperative complication rate and higher risk of colonic and appendiceal cancer. The aim of the present work was to investigate age-related factors that could influence a different approach, compared to the 2016 WSES Jerusalem guidelines on general population, in terms of diagnosis and management of elderly patient with acute appendicitis. During the XXIX National Congress of the Italian Society of Surgical Pathophysiology (SIFIPAC) held in Cesena (Italy) in May 2019, in collaboration with the Italian Society of Geriatric Surgery (SICG), the World Society of Emergency Surgery (WSES) and the Italian Society of Emergency Medicine (SIMEU), a panel of experts participated to a Consensus Conference where eight panelists presented a number of statements, which were developed for each of the four topics about diagnosis and management of acute appendicitis in elderly patients, formulated according to the GRADE system. The statements were then voted, eventually modified and finally approved by the participants to the Consensus Conference. The current paper is reporting the definitive guidelines statements on each of the following topics: diagnosis, non-operative management, operative management and antibiotic therapy.

Published
2020
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15. Open abdomen management for severe peritonitis in elderly. Results from the prospective International Register of Open Abdomen (IROA): Cohort study

Author

Stefano Rausei, Vincenzo Pappalardo, Marco Ceresoli, Fausto Catena, Massimo Sartelli, Massimo Chiarugi, Yoram Kluger, Andrew Kirkpatrick, Luca Ansaloni, Federico Coccolini, Giulia Montori, Fracensco Salvetti, Paola Fugazzola, Ionut Negoi, Monica Zese, Savino Occhionorelli, Sergei Shlyapnikov, Zaza Demetrashvili, Daniele Dondossola, Orestis Ioannidis, Giuseppe Novelli, Mirco Nacoti, Desmond Khor, Kenji Inaba, Demetrios Demetriades, Torsten Kaussen, Asri Che Jusoh, Wagih Ghannam, Boris Sakakushev, Ohad Guetta, Agron Dogjani, Stefano Costa, Sandeep Singh, Dimitrios Damaskos, Arda Isik, Kuo-Ching Yuan, Francesco Trotta, Aleix Martinez-Perez, Giovanni Bellanova, Vinicius Cordeiro Fonseca, Fernando Hernández, Athanasios Marinis, Wellington Fernandes, Martha Quiodettis, Miklosh Bala, Andras Vereczkei, Rafael Curado, Gustavo Pereira Fraga, Bruno M. Pereira, Mahir Gachabayov, Guillermo Perez Chagerben, Miguel Leon Arellano, Sefa Ozyazici, Gianluca Costa, Tugan Tezcaner, Matteo Porta, Yousheng Li, Faruk Karateke, Dimitrios Manatakis, Federico Mariani, Federico Lora, Ivan Sahderov, Boyko Atanasov, Sergio Zegarra, Luca Fattori, Rao Ivatury, Jimmy Xiao, Andrea Lippi, Mario Improta, Francesca Gubbiotti, Andrey Zharikov, Vincent Dubuisson, Michael Sugrue, Rausei, S, Pappalardo, V, Ceresoli, M, Catena, F, Sartelli, M, Chiarugi, M, Kluger, Y, Kirkpatrick, A, Ansaloni, L, Coccolini, F, Montori, G, Salvetti, F, Fugazzola, P, Negoi, I, Zese, M, Occhionorelli, S, Shlyapnikov, S, Demetrashvili, Z, Dondossola, D, Ioannidis, O, Novelli, G, Nacoti, M, Khor, D, Inaba, K, Demetriades, D, Kaussen, T, Jusoh, A, Ghannam, W, Sakakushev, B, Guetta, O, Dogjani, A, Costa, S, Singh, S, Damaskos, D, Isik, A, Yuan, K, Trotta, F, Martinez-Perez, A, Bellanova, G, Fonseca, V, Hernandez, F, Marinis, A, Fernandes, W, Quiodettis, M, Bala, M, Vereczkei, A, Curado, R, Fraga, G, Pereira, B, Gachabayov, M, Chagerben, G, Arellano, M, Ozyazici, S, Costa, G, Tezcaner, T, Porta, M, Li, Y, Karateke, F, Manatakis, D, Mariani, F, Lora, F, Sahderov, I, Atanasov, B, Zegarra, S, Fattori, L, Ivatury, R, Xiao, J, Lippi, A, Improta, M, Gubbiotti, F, Zharikov, A, Dubuisson, V, and Sugrue, M

Subjects
Male, medicine.medical_specialty, Sepsi, Peritonitis, NO, Sepsis, 03 medical and health sciences, Elderly, Intra-abdominal infection, Open abdomen management, Source control, 0302 clinical medicine, Postoperative Complications, Abdomen, Medicine, Humans, Prospective Studies, Registries, Open abdomen, Aged, Aged, 80 and over, Univariate analysis, business.industry, Potential risk, Age Factors, Mean age, General Medicine, medicine.disease, Surgery, 030220 oncology & carcinogenesis, 030211 gastroenterology & hepatology, Observational study, Female, business, Cohort study
Abstract

Background Analyzing the data of the International Register of Open Abdomen (IROA), the feasibility of open abdomen treatment has been demonstrated at every age. This new analysis on the IROA database investigates the risk factors for mortality in elderly patients treated with open abdomen for intra-abdominal infection. Methods Data were derived from the IROA, a prospective observational international cohort study that enrolled patients treated with open abdomen worldwide. A univariate analysis of potential risk factors was performed. Inclusion criteria were patients older than 65 years and treated with open abdomen for intra-abdominal infection. End point was overall mortality, calculated within 30 days after open abdomen management, after 1-month and 1-year follow-up. Results A total of 116 patients was analyzed with mean age of 76 ± 7 years. Definitive closure was achieved in 93 patients (93/116, 80.2%) for a mean open abdomen duration of 5.0 ± 5.0 days. Complicated patients were 101 (101/116, 87.1%) for a total of 201 complications. Overall, 62 out of 116 patients (53.4%) died: 23 patients (23/62, 37.1%) during open abdomen management, 29 patients (46.8%) within 30 days after abdominal closure, 9 patients (14.5%) after 1-month follow-up, and 1 patient (1.6%) after 1-year follow-up. Age did not affect mortality (75 ± 6 years in alive patients versus 77 ± 7 years in dead patients, p = 0.773). Definitive abdominal closure was the most important factor to prevent mortality. Conclusions This study confirmed that age alone cannot be considered a determinant for death, even in elderly patients managed with open abdomen for severe intra-abdominal infection.

Published
2020

16. Open Abdomen in Obese Patients: Pay Attention! New Evidences from IROA, the International Register of Open Abdomen

Author

Marco Ceresoli, Francesco Salvetti, Yoram Kluger, Marco Braga, Jacopo Viganò, Paola Fugazzola, Massimo Sartelli, Luca Ansaloni, Fausto Catena, Federico Coccolini, Ionut Negoi, Monica Zese, Savino Occhionorelli, Francesca Gubbiotti, Sergei Shlyapnikov, Christian Galatioto, Massimo Chiarugi, Zaza Demetrashvili, Daniele Dondossola, Orestis Ioannidis, Giuseppe Novelli, Mirco Nacoti, Desmond Khor, Kenji Inaba, Demetrios Demetriades, Torsten Kaussen, Asri Che Jusoh, Wagih Ghannam, Boris Sakakushev, Ohad Guetta, Agron Dogjani, Stefano Costa, Sandeep Singh, Dimitrios Damaskos, Arda Isik, Kuo-Ching Yuan, Francesco Trotta, Stefano Rausei, Aleix Martinez-Perez, Giovanni Bellanova, Vinicius Cordeiro Fonseca, Fernando Hernández, Athanasios Marinis, Wellington Fernandes, Martha Quiodettis, Miklosh Bala, Andras Vereczkei, Rafael Curado, Gustavo Pereira Fraga, Bruno M Pereira, Mahir Gachabayov, Guillermo Perez Chagerben, Miguel Leon Arellano, Sefa Ozyazici, Gianluca Costa, Tugan Tezcaner, Matteo Porta, Yousheng Li, Faruk Karateke, Dimitrios Manatakis, Federico Mariani, Federic Lora, Ivan Sahderov, Boyko Atanasov, Sergio Zegarra, Luca Fattori, Alice Nigro, Andrew Kirkpatrick, Anton Parfenov, Giulia Montori, Paolo Dionigi, Michael Sugrue, Vincent Dubuisson, Joel Noutakdie Tochie, Rao Ivatury, Ceresoli, M, Salvetti, F, Kluger, Y, Braga, M, Viganò, J, Fugazzola, P, Sartelli, M, Ansaloni, L, Catena, F, Coccolini, F, Negoi, I, Zese, M, Occhionorelli, S, Gubbiotti, F, Shlyapnikov, S, Galatioto, C, Chiarugi, M, Demetrashvili, Z, Dondossola, D, Ioannidis, O, Novelli, G, Nacoti, M, Khor, D, Inaba, K, Demetriades, D, Kaussen, T, Che Jusoh, A, Ghannam, W, Sakakushev, B, Guetta, O, Dogjani, A, Costa, S, Singh, S, Damaskos, D, Isik, A, Yuan, K, Trotta, F, Rausei, S, Martinez-Perez, A, Bellanova, G, Cordeiro Fonseca, V, Hernández, F, Marinis, A, Fernandes, W, Quiodettis, M, Bala, M, Vereczkei, A, Curado, R, Pereira Fraga, G, M Pereira, B, Gachabayov, M, Perez Chagerben, G, Leon Arellano, M, Ozyazici, S, Costa, G, Tezcaner, T, Porta, M, Li, Y, Karateke, F, Manatakis, D, Mariani, F, Lora, F, Sahderov, I, Atanasov, B, Zegarra, S, Fattori, L, Nigro, A, Kirkpatrick, A, Parfenov, A, Montori, G, Dionigi, P, Sugrue, M, Dubuisson, V, Noutakdie Tochie, J, and Ivatury, R

Subjects
Adult, Male, medicine.medical_specialty, Abdominal compartment syndrome, Fistula, open abdomen, NO, 03 medical and health sciences, 0302 clinical medicine, Postoperative Complications, Acute care, Abdomen, Female, Humans, Intensive Care Units, Length of Stay, Middle Aged, Obesity, Registries, medicine, business.industry, Fascia, medicine.disease, Cardiac surgery, Surgery, medicine.anatomical_structure, Cardiothoracic surgery, 030220 oncology & carcinogenesis, 030211 gastroenterology & hepatology, business, Trauma surgery, Abdominal surgery
Abstract

Background: Open abdomen is the cornerstone of damage control strategies in acute care and trauma surgery. The role of BMI has not been well investigated. The aim of the study was to assess the role of BMI in determining outcomes after open abdomen. Methods: This is an analysis of patients recorded into the International Register of Open Abdomen; patients were classified in two groups according to BMI using a cutoff of 30 kg/m2. The primary outcome was in-hospital mortality; secondary outcomes were primary fascia closure rate, length of treatment, complication rate, entero-atmospheric fistula rate and length of ICU stay. Results: A total of 591 patients were enrolled from 57 centers, and obese patients were 127 (21.5%). There was no difference in mortality between the two groups; complications developed during the open treatment were higher in obese patients (63.8% vs. 53.4%, p = 0.038) while post-closure complications rate was similar. Obese patients had a significantly longer duration of the open treatment (9.1 ± 11.5 days vs. 6.3 ± 7.5 days; p = 0,002) and lower primary fascia closure rate (75.5% vs. 89.5%; p < 0,001). No differences in fistula rate were found. There was a linear correlation between the duration of open abdomen and the BMI (Pearson’s linear correlation coefficient = 0,201; p < 0,001). Conclusions: Open abdomen in obese patients seems to be safe as in non-obese patients with similar mortality; however, in obese patients the length of open abdomen is significantly higher with higher complication rate, longer ICU length of stay and lower primary fascia closure rate. Trial registration number: ClinicalTrials.gov, Identifier: NCT02382770.

Published
2019

17. Open Abdomen Management and Candida Infections: A Very Likely Link

Author

Domenico Lacavalla, Monica Zese, Marco Albanese, Savino Occhionorelli, Rosario Cultrera, and Giorgio Vasquez

Subjects
Colonization, medicine.medical_specialty, Article Subject, Guidelines, 030230 surgery, Candida infections, NO, Association, Sepsis, 03 medical and health sciences, Abdominal sepsis, 0302 clinical medicine, Failure assessment score, Risk of mortality, Risks, Medicine, lcsh:RC799-869, Open abdomen, Hepatology, business.industry, Septic shock, Significant difference, Gastroenterology, 030208 emergency & critical care medicine, Classification, medicine.disease, Surgery, Intensive-care-unit, lcsh:Diseases of the digestive system. Gastroenterology, SOFA score, Complication, business
Abstract

Objective. Laparostomy can be applied in trauma, abdominal sepsis, intra-abdominal hypertension, or compartment syndrome. Systemic infections, especially if complicated by Candida, are associated with a high risk of mortality. Methods. This is a single-centre retrospective case series of 47 cases admitted to our Department, which required laparostomy procedure; we analyzed the type of surgery, temporary abdominal closure, duration of open abdomen, complications, SOFA score, mortality with Candida infections, and empirical or targeted antifungal therapy. Results. We found that patients with Candida infection were related with a statistically significant difference (p<0.05) with a complication after OA closure, total complications, time elapsed after OA application, time spent on the first surgical OA application, type of temporary abdominal closure that is used, and duration of the open abdomen. The use of empirical and targeted antifungal therapy is related to the duration of open abdomen too. Conclusions. Management of the OA is often burdened by sepsis or septic shock, especially when complicated by Candida infection. Candida score is a validated tool to identify patients who can be treated empirically, but every situation must be considered on an individual basis.

Published
2017

18. Laparoscopic versus open transverse-incision right hemicolectomy: a retrospective comparison study

Author

Alberto Porcu, Simone Targa, Alessandro Fancellu, Giorgio Carlo Ginesu, Claudio F. Feo, Carlo V. Feo, Giuseppe Cherchi, and Monica Zese

Subjects
Adult, Male, medicine.medical_specialty, Normal diet, Colorectal cancer, Incisional hernia, NO, 03 medical and health sciences, 0302 clinical medicine, Medicine, Humans, Laparoscopy, Colectomy, Aged, Retrospective Studies, Aged, 80 and over, Laparoscopy, Colon cancer, Right colectomy, Transverse incision, medicine.diagnostic_test, business.industry, Incidence (epidemiology), Right colectomy, General Medicine, Middle Aged, medicine.disease, Transverse incision, Surgery, Colon cancer, 030220 oncology & carcinogenesis, Right Colectomy, Colonic Neoplasms, Defecation, 030211 gastroenterology & hepatology, Female, business
Abstract

BACKGROUND The optimal surgical approach to right colon cancer is still under debate. The aim of the present study was to compare the short- and long-term outcomes of laparoscopic and transverse-incision open approaches to right hemicolectomy for colon cancer. METHODS Data on 99 adult patients with right-side colon cancer undergoing either laparoscopic or open transverse-incision right hemicolectomy at two different university hospitals, between January 2013 and December 2016, were retrospectively reviewed. Data concerning patients' characteristics, operative details and post-operative recovery were retrieved from prospective databases and analysed. RESULTS Forty-nine subjects were operated on laparoscopically, while 50 through an open transverse incision. Operating time was significantly longer in the laparoscopic group compared with the open group (182 versus 105 min; P

Published
2019

19. A rare case of ileo-ileal intussusception due to a bleeding lipomatous mass treated by laparoscopic ileal resection

Author

Feo, C. V., Monica Zese, Tralli, G., Targa, S., Galeotti, R., and Rizzati, R.

Subjects
Ileal Neoplasms, Male, Intussusception, Lipoma, Ileum, Laparoscopy, Bleeding, Ileal Diseases, Ileum, Bleeding, Humans, Laparoscopy, Lipoma, Gastrointestinal Hemorrhage, Intussusception, Aged, NO
Abstract

Adult intussusception is a rare cause of bowel obstruction with atypical presentation. It can be associated with primary or secondary intestinal tumors and, rarely, with lipomatous masses.We report the case of a 69-year old man presenting with a history of gastrointestinal bleeding and anemia. Upper and lower endoscopies were negative for bleeding. On abdominal contrast enhanced computerized tomography (CT) scan, a trans-omental hernia in the right lower abdominal quadrant was diagnosed with no active bleeding or evidence of tumor. On exploratory laparoscopy we detected an ileo-ileal intussusception caused by a submucosal mass in the distal ileum, which was reduced and we then performed a segmental resection of the involved small bowel tract. The patient fully recovered by postoperative day 3 when he was discharged home. Final pathology confirmed an ileal lipoma.Ileal intussusception caused by lipoma is a rare condition, which can be diagnosed with endoscopy, barium enema, and abdominal ultrasound or CT scanning, but preoperative diagnosis may be difficult. The treatment of choice is the reduction of the intussusception and the resection (laparoscopic or open) of the involved tract.Intussusception, Lipoma, Ileum, Laparoscopy, Bleeding.L’intussuscezione intestinale dell’adulto è una rara condizione di occlusione intestinale che spesso ha una presentazione atipica. Può essere associato a tumori intestinali primitivi o secondari e, raramente, a masse lipomatose. Anche se l’esatto meccanismo per cui avviene l’intussuscezione non è conosciuto, si ritiene che sia associato a movimenti anomali della parete intestinale, che causerebbero l’ostruzione.Riportiamo il caso clinico di un uomo di 69 anni che si presenta alla nostra osservazione con una storia di sanguinamento gastrointestinale e anemizzazione. Gli esami endoscopici (EGDS e coloscopia) erano entrambi negativi per sanguinamento. La Tc addome con mezzo di contrasto evidenziava un’ernia transomentale nel quadrante addominale inferiore destro senza segni di sanguinamento attivo o evidenza di tumore. La successiva laparoscopia esplorativa ha rilevato una intussuscezione ileo-ileale causata da una massa sottomucosa nell’ileo distale; pertanto è stata eseguita la riduzione laparoscopica e resezione segmentale del tratto ileale coinvolto. Il paziente è stato dimesso in III giornata post-operatoria in buone condizioni cliniche generali. L’esame istologico ha confermato l’origine lipomatosa della lesione. CONCLUSIONE: l’intussuscezione ileale causata da lipoma è una condizione rara, che può essere diagnosticata con metodiche di imaging, ma spesso la diagnosi preoperatoria è difficile. Il trattamento di scelta è la riduzione chirurgica dell’intussuscezione e la resezione (laparoscopica o laparotomica) del tratto in questione.

Published
2019

20. Fish bone ingestion: Complications and legal implications

Author

Savino Occhionorelli, Monica Zese, Lorenzo Cappellari, Rocco Stano, Daniela Tartarini, and Giorgio Vasquez

Subjects
Foreign bodies, Surgery, Intestinal perforation, Small intestine, Peritonitis, Abscess, NO
Published
2018

21. IROA: International Register of Open Abdomen, preliminary results

Author

Arda Isik, Luca Ansaloni, Tugan Tezcaner, Fausto Catena, Rao R. Ivatury, Federico Coccolini, András Vereczkei, Giulia Montori, Guillermo Perez Chagerben, Francesco Salvetti, Fernando Hernández, Sergei Shlyapnikov, Torsten Kaussen, Mahir Gachabayov, Kuo-Ching Yuan, Boris Sakakushev, Francesco Trotta, Martha Quiodettis, Paola Fugazzola, Zaza Demetrashvili, Rafael L. Curado, Stefano Rausei, Christian Galatioto, Marco Ceresoli, Athanasios Marinis, Ionut Negoi, Desmond Khor, Dimitrios Damaskos, Yovcho Yovtchev, Sefa Ozyazici, Giovanni Bellanova, Aleix Martínez-Pérez, Massimo Chiarugi, Monica Zese, Gianluca Costa, Giuseppe Novelli, Michael Sugrue, Davide Corbella, Miguel Leon Arellano, Gustavo Pereira Fraga, Ohad Guetta, Stefano Costa, Bruno M. Pereira, Demetrios Demetriades, Asri Che Jusoh, Savino Occhionorelli, Orestis Ioannidis, Daniele Dondossola, Wagih Ghannam, Miklosh Bala, Wellington Fernandes, Kenji Inaba, Vinicius Cordeiro Fonseca, Agron Dogjani, Sandeep Singh, Stefano Maccatrozzo, Massimo Sartelli, Mirco Nacoti, Coccolini, F, Montori, G, Ceresoli, M, Catena, F, Ivatury, R, Sugrue, M, Sartelli, M, Fugazzola, P, Corbella, D, Salvetti, F, Negoi, I, Zese, M, Occhionorelli, S, Maccatrozzo, S, Shlyapnikov, S, Galatioto, C, Chiarugi, M, Demetrashvili, Z, Dondossola, D, Yovtchev, Y, Ioannidis, O, Novelli, G, Nacoti, M, Khor, D, Inaba, K, Demetriades, D, Kaussen, T, Jusoh, A, Ghannam, W, Sakakushev, B, Guetta, O, Dogjani, A, Costa, S, Singh, S, Damaskos, D, Isik, A, Yuan, K, Trotta, F, Rausei, S, Martinez-Perez, A, Bellanova, G, Fonseca, V, Hernandez, F, Marinis, A, Fernandes, W, Quiodettis, M, Bala, M, Vereczkei, A, Curado, R, Fraga, G, Pereira, B, Gachabayov, M, Chagerben, G, Arellano, M, Ozyazici, S, Costa, G, Tezcaner, T, and Ansaloni, L

Subjects
Male, Internationality, Fistula, Kaplan-Meier Estimate, 030230 surgery, Barker, Cohort Studies, 0302 clinical medicine, Ischemia, Abdomen, Epidemiology, Prospective Studies, Registries, Bogotà bag, Commercial, Compartment, IROA, Negative pressure, Non-commercial, Open abdomen, Peritonitis, Register, Skin, Trauma, Vascular emergencies, Witmann, Child, Digestive System Surgical Procedures, Peritoniti, Abdominal Wound Closure Techniques, Middle Aged, Bogota bag, Vascular emergencie, Child, Preschool, 030220 oncology & carcinogenesis, Emergency Medicine, Female, Erratum, Cohort study, Adult, medicine.medical_specialty, NO, 03 medical and health sciences, Emergency surgery, medicine, Humans, Aged, Adult patients, business.industry, medicine.disease, Surgery, Wounds and Injuries, Pancreatitis, business
Abstract

Background: No definitive data about open abdomen (OA) epidemiology and outcomes exist. The World Society of Emergency Surgery (WSES) and the Panamerican Trauma Society (PTS) promoted the International Register of Open Abdomen (IROA). Methods: A prospective observational cohort study including patients with an OA treatment. Data were recorded on a web platform (Clinical Registers (R)) through a dedicated website: www.clinicalregisters.org. Results: Four hundred two patients enrolled. Adult patients: 369 patients; Mean age: 57.39 +/- 18.37; 56% male; Mean BMI: 36 +/- 5.6. OA indication: Peritonitis (48.7%), Trauma (20.5%), Vascular Emergencies/Hemorrhage (9.4%), Ischemia (9.1%), Pancreatitis (4.2%), Post-operative abdominal-compartment-syndrome (3.9%), Others (4.2%). The most adopted Temporary-abdominal-closure systems were the commercial negative pressure ones (44.2%). During OA 38% of patients had complications; among them 10.5% had fistula. Definitive closure: 82.8%; Mortality during treatment: 17.2%. Mean duration of OA: 5.39(+/- 4.83) days; Mean number of dressing changes: 0.88(+/- 0.88). After-closure complications: (49.5%) and Mortality: (9%). No significant associations among TACT, indications, mortality, complications and fistula. A linear correlationexists between days of OA and complications (Pearson linear correlation = 0.326 p

Published
2017

22. Erratum to: IROA: International Register of Open Abdomen, preliminary results

Author

Giuseppe Novelli, Fernando Hernández, Giovanni Bellanova, Massimo Chiarugi, Luca Ansaloni, Mahir Gachabayov, Asri Che Jusoh, Boris Sakakushev, Mirco Nacoti, Savino Occhionorelli, Francesco Salvetti, Giulia Montori, Gustavo Pereira Fraga, Zaza Demetrashvili, Guillermo Perez Chagerben, Gianluca Costa, Wagih Ghannam, Athanasios Marinis, Monica Zese, Davide Corbella, Rao R. Ivatury, Sefa Ozyazici, Federico Coccolini, Michael Sugrue, Vinicius Cordeiro Fonseca, Kuo-Ching Yuan, Wellington Fernandes, Orestis Ioannidis, Paola Fugazzola, Stefano Costa, Miklosh Bala, Ionut Negoi, Desmond Khor, Daniele Dondossola, Bruno M. Pereira, Yovcho Yovtchev, Rafael L. Curado, Arda Isik, Sandeep Singh, Sergei Shlyapnikov, Stefano Rausei, Dimitrios Damaskos, Stefano Maccatrozzo, Aleix Martínez-Pérez, Miguel Leon Arellano, Massimo Sartelli, Ohad Guetta, Christian Galatioto, Demetrios Demetriades, Marco Ceresoli, Kenji Inaba, Agron Dogjani, Tugan Tezcaner, Fausto Catena, András Vereczkei, Torsten Kaussen, Francesco Trotta, and Martha Quiodettis

Subjects
MEDLINE, Peritonitis, 030230 surgery, Trauma, Barker, 03 medical and health sciences, 0302 clinical medicine, Ischemia, Medicine, Open abdomen, Skin, Compartment, business.industry, Commercial, Published Erratum, Bogotà bag, Vascular emergencies, Register, medicine.disease, Negative pressure, IROA, Register (music), Non-commercial, Emergency Medicine, Surgery, Medical emergency, business, Research Article, Witmann
Abstract

Background No definitive data about open abdomen (OA) epidemiology and outcomes exist. The World Society of Emergency Surgery (WSES) and the Panamerican Trauma Society (PTS) promoted the International Register of Open Abdomen (IROA). Methods A prospective observational cohort study including patients with an OA treatment. Data were recorded on a web platform (Clinical Registers®) through a dedicated website: www.clinicalregisters.org. Results Four hundred two patients enrolled. Adult patients: 369 patients; Mean age: 57.39±18.37; 56% male; Mean BMI: 36±5.6. OA indication: Peritonitis (48.7%), Trauma (20.5%), Vascular Emergencies/Hemorrhage (9.4%), Ischemia (9.1%), Pancreatitis (4.2%),Post-operative abdominal-compartment-syndrome (3.9%), Others (4.2%). The most adopted Temporary-abdominal-closure systems were the commercial negative pressure ones (44.2%). During OA 38% of patients had complications; among them 10.5% had fistula. Definitive closure: 82.8%; Mortality during treatment: 17.2%. Mean duration of OA: 5.39(±4.83) days; Mean number of dressing changes: 0.88(±0.88). After-closure complications: (49.5%) and Mortality: (9%). No significant associations among TACT, indications, mortality, complications and fistula. A linear correlationexists between days of OA and complications (Pearson linear correlation = 0.326 p

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23. A rare case of a double phytobezoar causing gastric and jejunum obstruction in an adult man: a case report

Author

Giorgio Vasquez, Savino Occhionorelli, L. Cappellari, Rocco Stano, Simone Targa, and Monica Zese

Subjects
Male, Enterotomy, Abdominal pain, medicine.medical_specialty, Physical examination, Case Report, NO, Bezoars, 03 medical and health sciences, 0302 clinical medicine, Occlusion, Phytobezoars, medicine, Humans, Medical history, Aged, Gastrostomy, Medicine(all), medicine.diagnostic_test, business.industry, Gastric Outlet Obstruction, Medicine (all), Small bowel obstruction, Stomach, Gastric outlet obstruction, General Medicine, medicine.disease, Surgery, Abdominal Pain, Jejunum, 030220 oncology & carcinogenesis, Phytobezoar, 030211 gastroenterology & hepatology, Differential diagnosis, medicine.symptom, business, Tomography, X-Ray Computed, Intestinal Obstruction
Abstract

Background Bezoars are an uncommon cause of mechanical intestinal occlusion. There are four different kinds of bezoars: phytobezoars, made of vegetables and fibers; trichobezoars, resulting from the ingestion of hair and frequently an expression of psychiatric disorders; lactobezoars, which are formed of milk curd; and pharmacobezoars, caused by drugs and medications. Symptoms are classically indistinguishable from one another and from more common causes of intestinal occlusion, so it can be difficult to establish a correct diagnosis in order to apply the correct treatment. We present a rare case of two different phytobezoars causing intestinal occlusion (gastric and jejunal). We also describe the correct techniques for making a correct and fast diagnosis of occlusion caused by phytobezoars, and the possible conservative and operative treatments. Case presentation We present the case of a double phytobezoar that was surgically treated with a double enterotomy. Our patient was a 68-year-old Caucasian man with a medical history of hypertension, a previous open appendectomy, and open repair of a perforated gastric ulcer. He was admitted with a 5-day history of abdominal pain located in his upper quadrants along with vomiting. After a preoperative examination, he was taken to the operating room. He was discharged in a good clinical condition 11 days after surgical intervention. A physical examination at 6 months demonstrated our patient was in good health. Conclusions Diagnosing bezoars is difficult because of their rarity. However, they must be taken into consideration in a differential diagnosis because their treatment is not always surgical. In fact, it may be conservative in many cases and a correct diagnosis will guide towards the correct therapy.

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