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1.
Langenbecks Arch Surg ; 409(1): 46, 2024 Jan 24.
Article in English | MEDLINE | ID: mdl-38265492

ABSTRACT

BACKGROUND: This study assesses the feasibility, safety, and clinical utility of vessel-sparing approach in totally robotic sigmoidectomy for adenocarcinoma. MATERIAL AND METHODS: A comprehensive protocol for completely vessel-sparing robotic sigmoidectomy (VsRS) was established at the authors' institution from January 2019 through December 2020. Surgical and pathological outcomes were indagated and compared with results of current literature. RESULTS: The study population consisted of 34 patients. The median number of examined lymph nodes (ELN) was 21 (range 15-28); the median number of positive lymph nodes (PLN) was 0 (range 0-8). Mean operative time was 240 min (sd 43.56, range 180-360 min), and conversion to open rate was 0%. Anastomotic leak rate was 0%. The median follow-up period was 28 months CONCLUSION: This pilot series represents a significant step forward in the development of completely vessel-sparing sigmoidectomy for adenocarcinoma. The study demonstrates the safety and feasibility of this innovative approach, which aims to achieve oncological radicality while preserving vital vascular structures. Notably, the postoperative outcomes observed in this study were comparable to those reported in the existing literature for the current standard of care at high-volume centers. Nevertheless, further validation through prospective and controlled investigations is essential before this technique can be fully incorporated into clinical practice.


Subject(s)
Adenocarcinoma , Robotic Surgical Procedures , Humans , Prospective Studies , Anastomotic Leak , Lymph Nodes
2.
J Gastrointest Surg ; 27(5): 1034-1041, 2023 05.
Article in English | MEDLINE | ID: mdl-36732403

ABSTRACT

BACKGROUND: To assess the feasibility, clinical utility, and safety of intrathoracic robotic-sewn esophageal anastomosis (IrEA) during Ivor Lewis esophagectomy for adenocarcinoma of the lower third of the esophagus, or cancer at the gastro-esophageal junction type I (Siewert classification). METHODS: A protocol for completely robotic Ivor Lewis esophagectomy (CrIE) and intrathoracic robotic-sewn anastomosis (IrEA) was established at the authors' institutions from January 2015 through December 2019. Overall surgery-related postoperative complications were analyzed. Overall survival and disease-free survival analysis were performed using standard methods. RESULTS: The study population consisted of 40 patients. Median operative time was 320 min (sd 62, range 235-500 min), and conversion to open rate was 0%. Anastomotic leak rate was 10%. The mean number of examined lymph nodes (ELN) was 19 (IQR 11-29), and the mean number of positive lymph nodes (PLN) was 3 (IQR 0-5). Short- and long-term surgical and oncological outcomes were comparable at a medium follow-up of 37 months. The median overall survival was 48 months while the mean disease-free survival was 29 months. CONCLUSION: This pilot series, in which an intrathoracic robotic-sewn anastomosis (IrEA) was performed during CrIE, demonstrated the safety and feasibility of this approach. Compared to the current standard of care at a high-volume center, IrEA was associated with better postoperative surgical outcomes and similar oncological outcomes to those reported worldwide today. These results call for further validation in a prospective and controlled setting to be fully incorporated into clinical practice.


Subject(s)
Anastomosis, Surgical , Esophageal Neoplasms , Esophagectomy , Robotic Surgical Procedures , Robotics , Humans , Esophageal Neoplasms/surgery , Anastomosis, Surgical/methods , Treatment Outcome , Postoperative Complications/epidemiology , Postoperative Complications/surgery , Feasibility Studies , Male , Female , Adult , Middle Aged , Aged
3.
Pancreatology ; 22(7): 1057-1058, 2022 Nov.
Article in English | MEDLINE | ID: mdl-35989219

ABSTRACT

The "Medici effect" is known as the effect that arises when the intersection of interrelated disciplines manifests an enriching link for the involved disciplines in their own identity. To a certain extent, we think that the "Medici Effect" can be applied in any field; more specifically we applied this concept in pancreatic surgery. So, may we borrow coronary stents from cardiology to settle pancreatic-jejunostomy (PJ) issues after pancreaticoduodenectomy (PD)?


Subject(s)
Coronary Vessels , Pancreaticojejunostomy , Humans , Coronary Vessels/surgery , Pancreaticoduodenectomy , Anastomosis, Surgical , Stents , Pancreatic Fistula/surgery , Postoperative Complications/surgery
4.
Ann Med Surg (Lond) ; 44: 79-82, 2019 Aug.
Article in English | MEDLINE | ID: mdl-31341616

ABSTRACT

It is known that Duodenal adenocarcinoma (DA) is a rare malignant solid tumor that cause occlusion symptoms with orthodox dysphagia when locally advanced. Pancreatic neuroendocrine tumors (PanNETs) account for about 2% of all pancreatic neoplasms. The combination of these two lesions, with the synchronous presence of ectopic pancreatic tissue (EPT) of the duodenum, has never been described in literature, to our knowledge. Here we report a case of combined DA, EPT and PanNET affecting a 71-year-old woman.

5.
G Chir ; 34(4): 125-7, 2013 Apr.
Article in English | MEDLINE | ID: mdl-23660165

ABSTRACT

Secretory carcinoma of the breast is a rare tumor initially described in children but occurring equally in adult population. This unusual breast cancer subtype has a generally favorable prognosis, although several cases have been described in adults with increased aggressiveness and a risk of metastases. However, surgery is still considered the most appropriate treatment for this pathology. We describe the case of a 50 -year-old woman who has undergone a breast conservative surgery for a little tumor, preoperatively diagnosticated by a fine needle aspiration biopsy (FNAB) as a well differentiated infiltrating carcinoma.


Subject(s)
Breast Neoplasms/surgery , Carcinoma/surgery , Mastectomy, Segmental , Breast Neoplasms/pathology , Carcinoma/pathology , Female , Humans , Middle Aged , Prognosis , Treatment Outcome
6.
Sci Total Environ ; 255(1-3): 97-111, 2000 Jun 08.
Article in English | MEDLINE | ID: mdl-10898398

ABSTRACT

The concentrations of 13 elements in peripheral parts of the epiphytic lichen Xanthoria parietina were measured at 200 stations of Veneto (NE Italy). For each element, two maps are presented, showing, respectively, geographic patterns and deviations from background levels. The results are summarized by a map, showing the joint distribution of elements with concentrations close to Italian backgrounds, and of those strongly deviating from background levels. The results allow selection of high-risk areas for instrumental monitoring.


Subject(s)
Air Pollutants/analysis , Environmental Monitoring/methods , Lichens/chemistry , Trace Elements/analysis , Cluster Analysis , Environmental Monitoring/statistics & numerical data , Italy , Spectrophotometry, Atomic
7.
Minerva Chir ; 48(12): 721-4, 1993 Jun 30.
Article in Italian | MEDLINE | ID: mdl-8414119

ABSTRACT

The starch peritonitis is a rare disease which is present in the patients recently submitted to a laparotomy. The ethology is an allergic reaction to the surgical glove starch. The symptoms are a continuous temperature, a leucocytosis and a eosinophilia. Macroscopically there is a micronodular dissemination of peritoneum with adhesion and a limited ascitis. Microscopically, there are gigantocellular granulomas with birifrangent inclusions to polarizing light. A diagnosis is difficult before surgery. The laparoscopy and the microscopic examination of ascitis can give a piece of information. The therapy is medical.


Subject(s)
Gloves, Surgical , Granuloma, Foreign-Body/etiology , Peritonitis/etiology , Starch/adverse effects , Adult , Female , Humans
8.
Minerva Chir ; 48(9): 505-8, 1993 May 15.
Article in Italian | MEDLINE | ID: mdl-8355880

ABSTRACT

The authors report a case of associated injuries (thoracoabdominal trauma with multiple rib and sternum fractures, perforation of the small intestine, abdominal cutaneous ecchymosis) caused by a seat belt, and describe the possible seat-belt mechanisms of lesion in road accidents. Some clinical aspects are discussed; in particular the diagnostic problems concerning a seat-belt syndrome as well as the limits of effectiveness in the use of belts.


Subject(s)
Abdominal Injuries/etiology , Multiple Trauma/etiology , Seat Belts/adverse effects , Thoracic Injuries/etiology , Abdominal Injuries/diagnosis , Abdominal Injuries/surgery , Accidents, Traffic , Aged , Female , Humans , Multiple Trauma/diagnosis , Multiple Trauma/surgery , Thoracic Injuries/diagnosis , Thoracic Injuries/surgery
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