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Research Interests: Biomarkers, Colorectal cancer, General Surgery, Humans, Clinical Medicine, and 15 moreFemale, Colorectal Surgery, Clinical Sciences, Aged, Adult, Chi Square Distribution, Colon, Blood Loss, Anastomosis, Colectomy, Colorectal Neoplasms, Hepatectomy, Anastomotic leakage, Gastrectomy, and Gastrointestinal surgery
Research Interests: Patient Safety, Medicine, Optical Imaging, General Surgery, Humans, and 12 moreNear Infrared Spectroscopy, Laparoscopic Cholecystectomy-Analgesia, Clinical Sciences, Retrospective Studies, Cholecystectomy, Cholelithiasis, Laparoscopic Cholecystectomy, Postoperative Complications, Perioperative, Cholecystitis, Intraoperative complications, and surgical endoscopy
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The involvement of oesophagus in pemphigus vulgaris is still debated. The aims of this study were to evaluate the prevalence of oesophageal involvement and the gastro-duodenal mucosa appearance before and after high-dose corticosteroid... more
The involvement of oesophagus in pemphigus vulgaris is still debated. The aims of this study were to evaluate the prevalence of oesophageal involvement and the gastro-duodenal mucosa appearance before and after high-dose corticosteroid therapy in a group of patients with oral pemphigus vulgaris. We prospectively studied 28 consecutive patients with oral pemphigus by oesophageal symptom standardised questionnaire, upper gastro-intestinal endoscopy, exfoliative cytology and histological biopsy. After clinical remission, all patients underwent new endoscopy. The prevalence of oesophageal symptoms was 57.1%. Endoscopic examination revealed oesophageal involvement with different degrees of severity in 67.8% of patients. After corticosteroid therapy, endoscopy showed normal oesophageal-gastro-duodenal mucosa. No examination-related exacerbations of the oesophageal lesions were seen. The upper gastro-intestinal endoscopic examination, in oral pemphigus vulgaris patients with oesophageal symptoms, is safe in skilled hands technique and a useful diagnostic tool prior to starting therapy.
Research Interests: Gastroenterology, Medicine, Endoscopy, Biopsy, Prospective studies, and 13 moreHumans, Internal Medicine, Intestinal Mucosa, Digestive and Liver Diseases, PEMPHIGUS VULGARIS, Clinical Sciences, Gastrointestinal Endoscopy, Combination drug therapy, Glucocorticoids, Pemphigus, Gastric mucosa, Immunosuppressive Agents, and Upper Endoscopy
Gallbladder carcinoma is a form of cancer that develops in the gallbladder, an organ located beneath the liver. This condition poses a clinical challenge due to its late diagnosis and aggressive tumor behavior. Risk factors include the... more
Gallbladder carcinoma is a form of cancer that develops in the gallbladder, an organ located beneath the liver. This condition poses a clinical challenge due to its late diagnosis and aggressive tumor behavior. Risk factors include the presence of gallstones, advanced age, and obesity. Diagnosis of gallbladder carcinoma requires the use of various diagnostic techniques such as ultrasound, computed tomography, and magnetic resonance imaging. Cholecystectomy, the surgical removal of the gallbladder, is the primary treatment for gallbladder carcinoma. However, management and treatment may require a multidisciplinary approach, which can also involve chemotherapy, radiation therapy, and targeted therapies. Increased awareness of this disease is necessary to improve early diagnosis and treatment options, ultimately enhancing survival rates and improving the quality of life for patients with gallbladder carcinoma.
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Surgical site infections (SSIs) are recognized as a common surgical complication, occurring in about 2-5% of all surgical procedures. SSIs represent the third most frequent nosocomial infection, accounting for 14.6% of all infections... more
Surgical site infections (SSIs) are recognized as a common surgical complication, occurring in about 2-5% of all surgical procedures. SSIs represent the third most frequent nosocomial infection, accounting for 14.6% of all infections observed in hospitalised patients and 38% of those observed among surgical patients. Strategies for the prevention of SSIs also include surveillance which has proved very effective. The most recent surveillance study carried out at a national level in Italy is Kir-Nos, a multicentric study sponsored by GlaxoSmithKline and performed between April and June 2002 in 32 different General Surgery Units for a total of 2972 surgical patients enrolled. Results emerging from the study clearly indicate that many patients receive inappropriate antimicrobial prophylaxis, especially in terms of drug choice, route and timing of administration. Given the high economic burden that infections provoke, beyond the increased morbidity and mortality, it appears mandatory to ...
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Background: Tailgut cysts are rare congenital lesions that develop in the presacral space. As they can potentially conceal primary neuroendocrine tumors, surgical excision is suggested as the treatment of choice. However, specific... more
Background: Tailgut cysts are rare congenital lesions that develop in the presacral space. As they can potentially conceal primary neuroendocrine tumors, surgical excision is suggested as the treatment of choice. However, specific management guidelines have yet to be developed. A posterior approach is usually preferred for cysts extending to the third sacral vertebral body. Conversely, a transabdominal approach is preferred for lesions extending upward to achieve an optimal view of the surgical field and avoid injuries. Case report: Here, we report a case of a 48-year-old man suffering from perianal pain and constipation. Digital rectal examination and magnetic resonance imaging revealed a presacral mass below the third sacral vertebral body. A laparoscopic transabdominal presacral tumor excision was performed. The final histological diagnosis was a rare primary neuroendocrine tumor arising from a tailgut cyst. The postoperative course was uneventful, and no signs of recurrence were...
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Anastomotic leakage is the most-feared complication of rectal surgery. Transanal devices have been suggested for anastomotic protection as an alternative to defunctioning stoma, although evidence is conflicting, and no single device is... more
Anastomotic leakage is the most-feared complication of rectal surgery. Transanal devices have been suggested for anastomotic protection as an alternative to defunctioning stoma, although evidence is conflicting, and no single device is widely used in clinical practice. The aim of this paper is to investigate the safety and efficacy of a transanal tube for the prevention of leakage following laparoscopic rectal cancer resection. A transanal tube was used in the cases of total mesorectal excision with low colorectal or coloanal anastomosis, undamaged doughnuts, and negative intraoperative air-leak test. The transanal tube was kept in place until the seventh postoperative day. A total of 195 consecutive patients were retrieved from a prospective surgical database and included in the study. Of these, 71.8% received preoperative chemoradiotherapy. The perioperative mortality rate was 1.0%. Anastomotic leakage occurred in 19 patients, accounting for an incidence rate of 9.7%. Among these,...
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Research Interests: Treatment Outcome, Medicine, Humans, Weight Loss, Female, and 15 morePulmonary Embolism, Male, Follow-up studies, Body Mass Index, Obesity Surgery, Clinical Sciences, Adult, Public health systems and services research, Perforation, Lower limb, Venous thromboembolism, Laparoscopy, Laparotomy, Postoperative Complications, and Reoperation
Research Interests: Surgical Oncology, Medicine, Liver diseases, Humans, Liver, and 9 moreFemale, Male, Differential Diagnosis, Aged, Adult, Necrosis, Lesion, Surgical, and Liver neoplasms
I n accordo alla definizione del National Nosocomial Infection Surveillance System (NNIS), per infezione del sito chirurgico (SSI, surgical site infection) è da intendersi un'infezione che si verifica entro 30 giorni... more
I n accordo alla definizione del National Nosocomial Infection Surveillance System (NNIS), per infezione del sito chirurgico (SSI, surgical site infection) è da intendersi un'infezione che si verifica entro 30 giorni dall'intervento chirurgico (o entro 1 anno se in seguito alla procedura chi-rurgica viene lasciato in situ un impianto, ovvero un corpo estraneo impiantabile, di origine non u-mana) e che può interessare il tessuto incisionale o profondo nel sito dell'intervento [1]. La locu-zione "infezione del sito chirurgico" (SSI, surgical site infection) è stata introdotta nel vocabolario me-dico nel 1992 per sostituire quella precedente di "infezione della ferita chirurgica" [2]. Le SSI possono essere classificate in incisionali e organo/spazio. Tra le SSI incisionali si distin-guono quelle superficiali-coinvolgimento esclusivo di cute o di tessuto sottocutaneo dell'incisione-e quelle profonde-coinvolgi-mento della fascia e/o dei muscoli). Le SS...
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The annular pancreas is a congenital anomaly in which pancreatic tissue partially or completely surrounds the second portion of the duodenum. Its often located above of papilla of Vater (85%), rarely below (15%). This pancreatic tissue is... more
The annular pancreas is a congenital anomaly in which pancreatic tissue partially or completely surrounds the second portion of the duodenum. Its often located above of papilla of Vater (85%), rarely below (15%). This pancreatic tissue is often easly dissociable to the duodenum but there is same cases where it the tissue is into the muscolaris wall of the duodenum. We describe three case of annular pancreas hospitalized in our facility between January 2004 to January 2009. There were 2 male 65 and 69 years old respectively and 1 female of 60 years old, presented complaining of repeated episodes of mild epigastric pain. Laboratory tests (including tumor markers), a direct abdomen x-ray with enema, EGDS and total body CT scan were performed to study to better define the diagnosis. EUS showed the presence of tissue infiltrating the muscle layer all around the first part of duodenum. Biopsies performed found the presence of pancreatic tissue with focal areas of adenocarcinoma. Subtotal gastrectomy with Roux was performed. The histological examinations shows an annular pancreas of D1 with multiple focal area of adenocarcinoma. (T1aN0M0). We performed a follow up at 5 years. One patients died after 36 months for cardiovascular hit. Two patients, one male and one female, was 5-years desease-free. Annular pancreas is an uncommon congenital anomaly which usually presents itself in infants and newborn. Rarely it can present in late adult life with wide range of clinical severities thereby making its diagnosis difficult. Pre-operative diagnosis is often difficult. CT scan can illustrate the pancreatic tissue encircling the duodenum. ERCP and MRCP are useful in outlining the annular pancreatic duct. Surgery still remains necessary to confirm diagnosis and bypassing the obstructed segment.
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Lipomas are the most common benign mesenchymal tumours; they are composed by mature lipocytes and are usually located in the subcutaneous tissue. They may occur at any place in which there is adipose tissue, most of them are found in the... more
Lipomas are the most common benign mesenchymal tumours; they are composed by mature lipocytes and are usually located in the subcutaneous tissue. They may occur at any place in which there is adipose tissue, most of them are found in the upper part of the body, especially in the trunk and neck, although they may also develop in other sites, including the hand. Most lipomas are small, weigh only a few grams, and usually the maximum diameter is smaller than 2 cm. Whereas, to be referred to as ''giant'', the lipoma must be at least 10 cm in diameter or weigh a minimum of 1,000 g. Because of the excessive size, giant lipomas may cause functional limitations, such as lymphedema, pain syndromes or nerve compression. Because of the peculiarity of this condition, the great size of the lesion and the difficulties in its diagnosis and treatment, we reported a case of a giant fibrolipoma in the thigh in a 27 years old woman.
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Laparoscopic cholecystectomy is characterized by a higher incidence of iatrogenic biliary lesions. The Authors evaluate the role of hepaticojejunostomy in the treatment of iatrogenic biliary lesions following laparoscopic cholecystectomy... more
Laparoscopic cholecystectomy is characterized by a higher incidence of iatrogenic biliary lesions. The Authors evaluate the role of hepaticojejunostomy in the treatment of iatrogenic biliary lesions following laparoscopic cholecystectomy in 51 patients observed in the Campania region, Italy from 1991 to 2003. The Authors report the data of a retrospective multicentric study of 51 patients -39 women (76.47%), 12 men (13.53%)-reoperated on for major biliary lesions following laparoscopic cholecystectomy. Hepaticojejunostomy in 20 cases (39.21%) and T-Tube plasty in 20 cases (39.21%) were performed. The mean follow-up was 25.01 months. The mean hospital stay was 25.7 days. 1/51 patients (1.9%) died from intraoperative incontrollable hemorrhage while cumulative postoperative mortality was 9.8% (5/51 patients). Therapeutic success rate of hepaticojejunostomy was 70% with a T-Tube plasty success rate of 65%. 9/51 patients (17.64%) were reoperated while in 4/51 (7.84%) a biliary stent was ...
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The purpose of this experimental study was to evaluate the efficacy of five synthetic absorbable suture materials in intestinal anastomoses in rats together with their interference with the normal physiopathological cicatrization process.... more
The purpose of this experimental study was to evaluate the efficacy of five synthetic absorbable suture materials in intestinal anastomoses in rats together with their interference with the normal physiopathological cicatrization process. The materials analysed were polyglycolic acid (Dexon), polygluconate (Maxon), polydioxanone (PDS), polygalactic acid (Vycril) and Glycomer 631 (Byosin). An anatomopathological study, performed in three groups of rats undergoing postmortem examinations after 6, 20 and 90 days showed that the least interference was caused by Glycomer 631, while polyglycolic acid and polygluconate yielded very good results though giving rise to a greater fibrous component. Polydioxanone and polygalactic acid yielded less satisfactory results. In addition, immunohistochemical techniques were applied to Glycomer 631. The evaluation of the surgical characteristics enabled us to divide the materials studied into two different groups, one in which characteristics such as s...
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An higher incidence rate of iatrogenic bile duct injuries is reported in cholecystectomy performed with the laparoscopy than with the laparotomy approach. The aim of this study was to provide a multicentre report on surgical treatment and... more
An higher incidence rate of iatrogenic bile duct injuries is reported in cholecystectomy performed with the laparoscopy than with the laparotomy approach. The aim of this study was to provide a multicentre report on surgical treatment and the outcome of biliary complications during and following laparoscopic cholecystectomy. A questionnaire was mailed to all surgeons with experience in laparoscopic cholecystectomy in the Campania region. Data were collected from January 1991 to December 2003. Each patient was requested to indicate age, gender, associated diseases, site and type of lesion, surgical experience, diagnosis, treatment and complications. Twenty-six surgeons answered the questionnaire. Fifty-one patients (36 F/15 M; mean age: 42.5 +/- 11.9, range 13-91 years) with bile duct injuries following laparoscopic cholecystectomy were reported. The most frequent lesions were main bile duct partial or total transection. The intraoperative mortality rate was 1/51 (1.9%) due to a comp...
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Lipomas are the most common benign mesenchymal tumours; they are composed by mature lipocytes and are usually located in the subcutaneous tissue. They may occur at any place in which there is adipose tissue, most of them are found in the... more
Lipomas are the most common benign mesenchymal tumours; they are composed by mature lipocytes and are usually located in the subcutaneous tissue. They may occur at any place in which there is adipose tissue, most of them are found in the upper part of the body, especially in the trunk and neck, although they may also develop in other sites, including the hand. Most lipomas are small, weigh only a few grams, and usually the maximum diameter is smaller than 2 cm. Whereas, to be referred to as ''giant'', the lipoma must be at least 10 cm in diameter or weigh a minimum of 1,000 g. Because of the excessive size, giant lipomas may cause functional limitations, such as lymphedema, pain syndromes or nerve compression. Because of the peculiarity of this condition, the great size of the lesion and the difficulties in its diagnosis and treatment, we reported a case of a giant fibrolipoma in the thigh in a 27 years old woman. KEY WORDS Giant lipoma, Lipoma, Lipoma of the leg.
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BACKGROUND/AIMS Laparoscopic cholecystectomy is characterized by a higher incidence of iatrogenic biliary lesions. The Authors evaluate the role of hepaticojejunostomy in the treatment of iatrogenic biliary lesions following laparoscopic... more
BACKGROUND/AIMS Laparoscopic cholecystectomy is characterized by a higher incidence of iatrogenic biliary lesions. The Authors evaluate the role of hepaticojejunostomy in the treatment of iatrogenic biliary lesions following laparoscopic cholecystectomy in 51 patients observed in the Campania region, Italy from 1991 to 2003. METHODOLOGY The Authors report the data of a retrospective multicentric study of 51 patients -39 women (76.47%), 12 men (13.53%)-reoperated on for major biliary lesions following laparoscopic cholecystectomy. Hepaticojejunostomy in 20 cases (39.21%) and T-Tube plasty in 20 cases (39.21%) were performed. RESULTS The mean follow-up was 25.01 months. The mean hospital stay was 25.7 days. 1/51 patients (1.9%) died from intraoperative incontrollable hemorrhage while cumulative postoperative mortality was 9.8% (5/51 patients). Therapeutic success rate of hepaticojejunostomy was 70% with a T-Tube plasty success rate of 65%. 9/51 patients (17.64%) were reoperated while ...
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An higher incidence rate of iatrogenic bile duct injuries is reported in cholecystectomy performed with the laparoscopy than with the laparotomy approach. The aim of this study was to provide a multicentre report on surgical treatment and... more
An higher incidence rate of iatrogenic bile duct injuries is reported in cholecystectomy performed with the laparoscopy than with the laparotomy approach. The aim of this study was to provide a multicentre report on surgical treatment and the outcome of biliary complications during and following laparoscopic cholecystectomy. A questionnaire was mailed to all surgeons with experience in laparoscopic cholecystectomy in the Campania region. Data were collected from January 1991 to December 2003. Each patient was requested to indicate age, gender, associated diseases, site and type of lesion, surgical experience, diagnosis, treatment and complications. Twenty-six surgeons answered the questionnaire. Fifty-one patients (36 F/15 M; mean age: 42.5 +/- 11.9, range 13-91 years) with bile duct injuries following laparoscopic cholecystectomy were reported. The most frequent lesions were main bile duct partial or total transection. The intraoperative mortality rate was 1/51 (1.9%) due to a comp...
Research Interests:
The purpose of this experimental study was to evaluate the efficacy of five synthetic absorbable suture materials in intestinal anastomoses in rats together with their interference with the normal physiopathological cicatrization process.... more
The purpose of this experimental study was to evaluate the efficacy of five synthetic absorbable suture materials in intestinal anastomoses in rats together with their interference with the normal physiopathological cicatrization process. The materials analysed were polyglycolic acid (Dexon), polygluconate (Maxon), polydioxanone (PDS), polygalactic acid (Vycril) and Glycomer 631 (Byosin). An anatomopathological study, performed in three groups of rats undergoing postmortem examinations after 6, 20 and 90 days showed that the least interference was caused by Glycomer 631, while polyglycolic acid and polygluconate yielded very good results though giving rise to a greater fibrous component. Polydioxanone and polygalactic acid yielded less satisfactory results. In addition, immunohistochemical techniques were applied to Glycomer 631. The evaluation of the surgical characteristics enabled us to divide the materials studied into two different groups, one in which characteristics such as s...
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Hydatid disease of the liver is a relatively frequent disease. Although the natural history is almost completely known, several complications may occur. The aim of this study was to show that radical surgical resection of the hepatic... more
Hydatid disease of the liver is a relatively frequent disease. Although the natural history is almost completely known, several complications may occur. The aim of this study was to show that radical surgical resection of the hepatic hydatid cyst is a safe and very effective technique, based on our results after 30-year experience. A review of most significant studies was carried out. We retrospectively evaluated our surgical cases. From January 1973 to December 2003 we treated 216 patients, 98 males and 118 females. Survival was compared with the Kaplan-Meier test, using log-rank analysis to compare data. Differences with a p value less than 0.05 were considered significant. A total of 279 cysts were excised. We performed pericystectomy in 122 cases, 73 of which closed. We also performed 19 atypical resections, 10 segmentectomies, 20 lobectomies and 2 percutaneous treatments. In more than 90% of cases, preoperative data collection was completed by preoperative ultrasound. The cumul...
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Laparoscopic cholecystectomy is characterized by a higher incidence of iatrogenic biliary lesions. The Authors evaluate the role of hepaticojejunostomy in the treatment of iatrogenic biliary lesions following laparoscopic cholecystectomy... more
Laparoscopic cholecystectomy is characterized by a higher incidence of iatrogenic biliary lesions. The Authors evaluate the role of hepaticojejunostomy in the treatment of iatrogenic biliary lesions following laparoscopic cholecystectomy in 51 patients observed in the Campania region, Italy from 1991 to 2003. The Authors report the data of a retrospective multicentric study of 51 patients -39 women (76.47%), 12 men (13.53%)-reoperated on for major biliary lesions following laparoscopic cholecystectomy. Hepaticojejunostomy in 20 cases (39.21%) and T-Tube plasty in 20 cases (39.21%) were performed. The mean follow-up was 25.01 months. The mean hospital stay was 25.7 days. 1/51 patients (1.9%) died from intraoperative incontrollable hemorrhage while cumulative postoperative mortality was 9.8% (5/51 patients). Therapeutic success rate of hepaticojejunostomy was 70% with a T-Tube plasty success rate of 65%. 9/51 patients (17.64%) were reoperated while in 4/51 (7.84%) a biliary stent was ...