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Spoletini D, Lisi G, Levi Sandri GB, Grieco M, Marcellinaro R, Sorrentino F, Carlini M. Technique of laparoscopic splenectomy. ANNALS OF LAPAROSCOPIC AND ENDOSCOPIC SURGERY 2020. [DOI: 10.21037/ales.2020.03.12] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
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Lisi G, Campanelli M, Spoletini D, Carlini M. The possible impact of COVID-19 on colorectal surgery in Italy. Colorectal Dis 2020; 22:641-642. [PMID: 32227609 DOI: 10.1111/codi.15054] [Citation(s) in RCA: 40] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/21/2020] [Accepted: 03/24/2020] [Indexed: 12/22/2022]
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La Torre M, Lisi G, Milito G, Campanelli M, Clementi I. Sphinkeeper™ for faecal incontinence: a preliminary report. Colorectal Dis 2020; 22:80-85. [PMID: 31373152 PMCID: PMC6972515 DOI: 10.1111/codi.14801] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/27/2019] [Accepted: 07/09/2019] [Indexed: 12/13/2022]
Abstract
AIM A new artificial anal sphincter placed into the intersphincteric space, SphinKeeper™, has recently been proposed to improve outcomes in the treatment of faecal incontinence (FI). We report our preliminary results with short-term follow-up, comparing preoperative and postoperative data after implant of SphinKeeper™ in patients suffering from FI. METHODS All patients older than 18 years were included with FI of at least 6 months, incontinence episodes occurring more than once a week and resistance to other conservative treatments. Anorectal manometry, endoanal ultrasound, Cleveland Clinic FI Score, FI Quality of Life score and total number of episodes of FI per week were recorded preoperatively and at the end of the 6-month follow-up period. RESULTS Thirteen consecutive patients were treated with SphinKeeper™. No intra-operative nor postoperative complications were reported. Two cases of prosthesis extrusion occurred, and in one case an anterior dislocation was detected. Maximum resting pressure, total number of episodes of FI per week and Cleveland Clinic FI Score were improved after 6 months (P < 0.05). CONCLUSIONS SphinKeeper™ could be a minimally invasive procedure for FI with good postoperative outcomes. If these results are confirmed by studies with more patients and longer follow-up, it could be a first-line approach in FI.
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Lisi G, Campanelli M, Villa M, Grande S, Grande M. Colorectal emergency surgery in a COVID-19 referral hospital during the phase 2 in Italy. Int J Colorectal Dis 2020; 35:2137-2138. [PMID: 32607618 PMCID: PMC7326622 DOI: 10.1007/s00384-020-03684-x] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 06/25/2020] [Indexed: 02/04/2023]
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Lisi G, Garbarino GM, Del Giudice R, Spoletini D, Carlini M. Laparoscopic resection of splenic flexure colon cancer - a video vignette. Colorectal Dis 2019; 21:1090-1091. [PMID: 31091341 DOI: 10.1111/codi.14708] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/08/2019] [Accepted: 05/15/2019] [Indexed: 02/08/2023]
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Garbarino GM, Lisi G, Del Giudice R, Spoletini D, Carlini M. Tips and tricks in laparoscopic management of left colonic vessels - a video vignette. Colorectal Dis 2019; 21:725-726. [PMID: 30903726 DOI: 10.1111/codi.14621] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/12/2019] [Accepted: 03/16/2019] [Indexed: 01/12/2023]
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Lisi G, Campanelli M, Mascagni D, Grande S, Grande M, Milito G. Radiofrequency hemorrhoidectomy: less is less? Results of a comparative study. MINERVA GASTROENTERO 2019; 65:95-99. [DOI: 10.23736/s1121-421x.18.02509-6] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
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Meinero P, La Torre M, Lisi G, Stazi A, Carbone A, Regusci L, Fasolini F. Endoscopic pilonidal sinus treatment (EPSiT) in recurrent pilonidal disease: a prospective international multicenter study. Int J Colorectal Dis 2019; 34:741-746. [PMID: 30719564 DOI: 10.1007/s00384-019-03256-8] [Citation(s) in RCA: 32] [Impact Index Per Article: 6.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 01/23/2019] [Indexed: 02/04/2023]
Abstract
BACKGROUND Pilonidal disease (PD) is a common disease of the natal cleft, which can lead to complications including infection and abscess formation. Various operative management options are available, but the ideal technique is still debatable. Recurrent PD after surgical treatment is frequent event for the 25-30% of cases. The present study evaluated endoscopic pilonidal sinus treatment (EPSiT) in recurrent and multi-recurrent PD. METHODS Of the consecutive prospective patients with recurrent PD, 122 were enrolled in a prospective international multicenter study conducted at a secondary and tertiary colorectal surgery centers. Primary endpoint was to evaluate short- and long-term outcomes: healing rate/time, morbidity rate, re-recurrence rate, and patient's quality of life (QoL). RESULTS Complete wound healing rate was occurred in 95% of the patient, with a mean complete wound healing time of 29 ± 12 days. The incomplete healing rate (5%) was significantly related to the number of external openings (p = 0.008), and recurrence was reported in six cases (5.1%). Normal daily activity was established on the first postoperative day, and the mean duration before patients returned to work was 3 days. QoL significantly increased between the preoperative stage and 30 days after the EPSiT procedure (45.3 vs. 7.9; p < 0.0001). CONCLUSIONS The EPSiT procedure seems to be a safe and effective technique in treating even complex recurrent PD. It enables excellent short- and long-term outcomes than various other techniques that are more invasive.
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Lisi G, Garbarino GM, Giudice RD, Spoletini D, Carlini M. Synchronous laparoscopic right colectomy and rectal resection - a video vignette. Colorectal Dis 2019; 21:370-371. [PMID: 30578736 DOI: 10.1111/codi.14540] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/26/2018] [Accepted: 12/07/2018] [Indexed: 02/08/2023]
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Garbarino GM, Lisi G, Del Giudice R, Spoletini D, Carlini M. Laparoscopic right colectomy with complete mesocolic excision: a three-trocar technique - a video vignette. Colorectal Dis 2019; 21:371-372. [PMID: 30658011 DOI: 10.1111/codi.14561] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/30/2018] [Accepted: 12/21/2018] [Indexed: 02/08/2023]
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Lisi G, Campanelli M, Grande S, Mascagni D, Aronadio E, Palmieri G, Grande M. Seromucinous borderline tumor of the peritoneum. GAZZETTA MEDICA ITALIANA ARCHIVIO PER LE SCIENZE MEDICHE 2019. [DOI: 10.23736/s0393-3660.18.03751-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
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Rossini R, Lisi G, Gentile I, Barugola G, Ruffo G. Intracorporeal Ileocolic Anastomosis in Laparoscopic Right Colectomy: A New Way to Make it Simple? Surg Technol Int 2018; 32:115-118. [PMID: 29611154] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/08/2023]
Abstract
Although there has been a recent increase in the use of laparoscopy in colorectal surgery, the percentage of patients who undergo surgery using entirely minimally invasive techniques is still quite low, and there are substantial differences among centers. It has been argued that the limiting factor in the use of laparoscopic procedures is not the tumor or patient characteristics, but rather the number of surgeons with adequate skills to perform an entirely laparoscopic colectomy. To address this issue, we report here our totally laparoscopic right colectomy technique, with particular focus on a new way to perform the enterotomy closure, which may simplify ileocolic anastomosis.
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Rossini R, Lisi G, Pesci A, Ceccaroni M, Zamboni G, Gentile I, Rettore L, Ruffo G. Depth of Intestinal Wall Infiltration and Clinical Presentation of Deep Infiltrating Endometriosis: Evaluation of 553 Consecutive Cases. J Laparoendosc Adv Surg Tech A 2018; 28:152-156. [DOI: 10.1089/lap.2017.0440] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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Lisi G, Rossini R, Gentile I, Ruffo G. Over-Sewing of Staple Line in Laparoscopic Sleeve Gastrectomy: Initial Experience of a Comparative Study. Surg Technol Int 2017; 31:106-110. [PMID: 29029355] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/07/2023]
Abstract
INTRODUCTION The main drawback of laparoscopic sleeve gastrectomy (LSG) is the severity of postoperative complications. Staple line reinforcement (SLR) is strongly advocated. Recently, over-sewing has been proposed as a cost-effective and helpful method for reinforcing the staple line. The purpose of this study was to report our initial experience with LSG comparing over-sewing over the entire staple line with the upper-third staple line. MATERIALS AND METHODS All obese patients seen at Negrar Sacro Cuore, Don Calabria Hospital were entered into our prospective database and were retrospectively evaluated. Complications (divided as major complications: leaks and bleeding; and minor complications: dysphagia, esophagitis, and reflux disease) and reoperations were recorded for all patients. Complications were graded according to the Clavien classification system. RESULTS From February 2015 to March 2016, 30 patients underwent LSG. Patients were divided in two groups according to over-sewing: Group A-over-sewing over the entire staple line; and Group B upper-third over-sewing. Mean total operative time was longer in Group A-90 minutes-compared with 85 minutes in Group B. In regard to minor complications, we reported one esophagitis and two cases of dysphagia in Group B and one dysphagia in Group A. Gastroesophageal reflux was higher in Group B than in Group A (3 vs. 1, p=0.149). Three major complications were observed (10%): two bleeding and one hematoma in Group B and no major complications occurred in Group A. All major complications were conservatively treated. No leaks were reported in both groups. No mortality was observed. CONCLUSIONS Over-sewing of the staple line was associated with fewer leaks but no conclusions can be drawn regarding the effects of over-sewing on staple line bleedings. Before standardizing surgical techniques further, trials are necessary to improve our knowledge about over-sewing in LSG.
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Milito G, Lisi G, Venditti D, Campanelli M, Aronadio E, Grande M. Surgical Treatment of Rectovaginal Fistula in Crohn's Disease: A Tertiary Center Experience. Surg Technol Int 2017; 30:113-116. [PMID: 28395390] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/07/2023]
Abstract
BACKGROUND Rectovaginal fistula (RVF) is a disastrous complication of Crohn's disease (CD) that is exceedingly difficult to treat. It is a disabling condition that negatively impacts a woman's quality of life. Current treatment algorithms range from observation to medical management to the need for surgical intervention. A wide variety of success rates have been reported for all management options. The choice of surgical repair methods depends on various fistula and patient characteristics, and its published success rates vary with initial success being around 50% rising to 80% with repeated surgery. Several surgical and sphincter sparing approaches have been described for the management of rectovaginal fistula, aimed to minimize the recurrence and to preserve the continence. MATERIALS AND METHODS A retrospective study was performed for RVF repair between 2008 and 2014 in our tertiary centre at the University Hospital of Tor Vergata, Italy. All the patients were affected by Crohn's disease and underwent surgery for an RVF under the same senior surgeon. All patients were prospectively evaluated. RESULTS All 43 patients that underwent surgery for RVF were affected by Crohn's disease. The median age was 43 years (range 21-53). Four different surgical approaches were performed: drainage and seton, rectal advacenment flap (RAF), vaginal advancement flap (VAF), transperineal approach using porcine dermal matrix (PDM), and martius flap (MF). The median time to success was six months (range 2-11). None of the patients were lost during the 18 months of follow-up. The failure group rate was 19% in contrast with the healing rate group that was 81%. No demographic of disease-related factors were found to influence healing. CONCLUSION The case series of this study supports the dogma that "there are no absolute rules when treating Crohn's fistula". There is no gold standard technique; however, it is mandatory to minimize the recurrence with a sphincter saving technique. Randomized trials are needed to find a standard surgical approach.
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Milito G, Lisi G, Venditti D, Campanelli M, Aronadio E, Grande S, Cabry F, Grande M. Endoluminal Vacuum Therapy as Treatment for Anastomotic Colorectal Leakage. Surg Technol Int 2017; 30:125-130. [PMID: 28072899] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/06/2023]
Abstract
BACKGROUND The clinical leakage rate after anterior resection varies from 2.8-20%, with a 6-22% mortality rate and a 10-80% risk of permanent stoma. Endo-SPONGE® (B. Braun Melsungen AG, Melsungen, Germany) may treat extraperitoneal anastomotic leakage in the lesser pelvis. It consists of an open-pored sponge inserted into the cavity. A drainage tube fixed to a low vacuum drainage system is then connected to the sponge through the anus. MATERIAL AND METHODS Between January 2007 and December 2014, 14 patients with anastomotic leakage following low anterior resection were treated with Endo-SPONGE® and were prospectively evaluated. In all patients, a CT-scan was performed and they received an intravenous antibiotic therapy with piperacillin+tazobactam (4.5g,3 times/daily). Complete healing was defined as endoscopically proven closure of the insufficiency cavity with a normal mucosa. RESULTS Stapled straight end to end, colorectal anastomoses were performed in all patients between 3-7 cm above the anal verge, a protective loop ileostomy was performed in every patient. The diagnosis of anastomotic leakage was performed after a median interval of 14 days, the median size of the cavity was 81x46 mm. Fluid collection was drained, percutaneosly in 12 cases, surgically in two patients. The median duration of therapy was 35 days, with 3-14 sponge exchanges for each patient. Median healing time was 37 days. No intraoperative complications were recorded, however, we found five cases of mild anal pain treated medically. CONCLUSION Considering the literature and our results, the Endo-SPONGE® seems an effective, minimally invasive procedure to treat extraperitoneal anastomotic leakage, reducing morbidity, mortality, and hospital stay.
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Grande M, Lisi G, Campanelli M, Grande S, Venditti D, Nigro C, Cabry F, Villa M. Laparoscopic Treatment of Giant Ventral Hernia: Experience of 35 Patients. Surg Technol Int 2017; 30:165-169. [PMID: 28072903] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/06/2023]
Abstract
BACKGROUND Minimal access surgery for incisional hernia repair is still debated, especially for giant wall defects. Laparoscopic repair may reduce pain and hospital stay. This study was designed to evaluate the feasibility of the laparoscopic technique in giant hernia. MATERIALS AND METHODS From 2007 to 2013, 35 consecutive patients with giant ventral hernia, according to the Chevrel classification, underwent laparoscopic repair. Fourteen patients were obese, with a body mass index (BMI) > 30 and in 21 patients the mean BMI was 24 (range 22-28). In all patients, the wall defect was larger than 20 cm. RESULTS Mean operative time was 159±30 minutes, and, for defects larger than 25 cm, it was 210±20 minutes. Patient conversion did not occur. In 29 patients, the mean wall defect was 20x25 cm, and in six patients the mean wall defect was 26x31 cm, and, as measured from within the peritoneal cavity, the mean overlap was 5 cm (range 3-6). Short-term antibiotic prophylaxis consisted of Cefazolin 2 g IV (intravenous) the day of surgery. All patients were discharged within 72-96 hrs. The mean follow-up was 24 months. No infection occurred and no chronic pain was recorded. However, three seroma were observed (outpatient treatment) and two xiphoid recurrences were observed. CONCLUSIONS Laparoscopic hernia repair is technically feasible and is safe in patients with giant fascial defects as well as obese patients. This operation decreases postoperative pain, hastens the recovery period, and reduces postoperative morbidity and recurrence. This approach should be reserved for patients with no history of previous hernia repair. Further studies are expected to confirm these promising results.
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Cameli M, Bombardini T, Dokollari A, Sassi CG, Losito M, Sparla S, Lisi G, Bernazzali S, Davoli G, Capannini G, Andriani S, Martinelli R, Diciolla F, Mondillo S, Maccherini M. Longitudinal Strain Stress-Echo Evaluation of Aged Marginal Donor Hearts: Feasibility in the Adonhers Project. Transplant Proc 2017; 48:399-401. [PMID: 27109965 DOI: 10.1016/j.transproceed.2015.12.036] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2015] [Accepted: 12/30/2015] [Indexed: 11/25/2022]
Abstract
BACKGROUND The Adonhers (aged donor heart rescue by stress-echo protocol) Project was created to resolve the current shortage of donor hearts. One of the great limits of stress echo is the operator dependency. Speckle-tracking echocardiography (STE), offering a quantitative objective analysis of myocardial deformation, may help to overcome this limit. This study aimed to verify feasibility of a stress-strain echo analysis in selection of aged donor hearts for heart transplant. METHODS From February 2014 to October 2015, 22 marginal candidate donors (16 men) ages 58 ± 4 years were initially enrolled. After legal declaration of brain death, all marginal donors underwent bedside echocardiography, with baseline and (when resting echocardiography was normal) dipyridamole (0.84 mg/kg in 6 minutes) stress echo. In all patients, left ventricular (LV) longitudinal myocardial deformation was obtained by STE in the 4-, 2-, and 3-chamber views, obtaining the average global longitudinal strain (GLS). GLS was assessed at baseline and at the peak of stress echo. RESULTS Baseline echocardiography showed wall motion abnormalities in 9 patients (excluded from donation). Stress echocardiography was performed in the remaining 13 patients. Results were normal in 8, who were uneventfully transplanted in marginal recipients. Stress results were abnormal in 5 (excluded from donation). STE was obtained in all cases (100% feasibility) and ΔGLS was significantly different between normal and pathological stress-echo (+13.2 ± 5.2 versus -6.1% ± 3.1%, P = .0001, respectively). CONCLUSIONS STE showed an excellent feasibility in analysis of LV myocardial longitudinal strain at baseline and at the peak of stress echo of marginal heart donors. Further experience is needed to confirm STE as a valuable additional mean to better interpret stress echo in marginal donors.
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Milito G, Lisi G, Aronadio E, Campanelli M, Venditti D, Grande S, Grande M. May radiofrequency be the best choice for III-IV degree hemorrhoids? Minerva Gastroenterol (Torino) 2016; 63:38-43. [PMID: 27845508 DOI: 10.23736/s1121-421x.16.02348-5] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
BACKGROUND Hemorrhoidectomy is considered the most efficient method to treat hemorrhoids of III and IV grades. The aim of this study was to compare conventional diathermy hemorrhoidectomy and radiofrequency hemorrhoidectomy based on a large series of patients. METHODS Between June 2001 and June 2014, 1000 patients have been treated with radiofrequency hemorrhoidectomy (group A) and 500 patients have been treated with diathermy (group B) as a day-case procedure. Operating time, postoperative pain score, hospital stay, early and late postoperative complications, wound healing time and time to return to normal activities were assessed. RESULTS The mean follow-up was seven years. The mean operating time for radiofrequency hemorrhoidectomy was shorter than diathermy but not significantly. Patients treated with radiofrequency had significantly less postoperative pain (measured on a Visual Analogue Scale; P=0.001), a shorter wound healing time, less time off work and postoperative complications (P=0.001) than patients who had diathermy. Neither wound healing nor mean hospital stay (day-case surgery) was significantly different. CONCLUSIONS Radiofrequency hemorrhoidectomyis a valid alternative to the conventional diathermy technique, due to the reduction of operative time, postoperative pain, early and late complication rate.
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Milito G, Lisi G, Aronadio E, Campanelli M, Venditti D, Grande S, Grande M. LigasureTM hemorrhoidectomy: how we do. Minerva Gastroenterol (Torino) 2016; 63:44-49. [PMID: 27768009 DOI: 10.23736/s1121-421x.16.02343-6] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
Abstract
BACKGROUND Hemorrhoidectomy is considered the gold standard and the most effective and definitive treatment for grades 3 or 4 hemorrhoids, and Milligan-Morgan's and Ferguson's procedures are the most widely used techniques throughout the world. The aim of the study was to present our surgical technique using LigasureTM vessel sealing, focus on technical aspects and surgical tricks showing our results with a huge number of patients and a long-term follow-up. METHODS Between June 2001 and June 2014 at the University Hospital of Tor Vergata, Rome, Italy, 1000 patients were selected to underwent LigasureTM hemorrhoidectomy for III and IV degree hemorrhoids. Age range 19-80 years, ASA I-II-III. Operating time, postoperative pain score, hospital stay, early and late postoperative complications, wound healing time and time to return to normal activities were assessed. Patients were followed-up at one week, one month, six, and twelve months after the operation and after 60 months they responded to the follow-up telephone interview and replied to the questionnaire. RESULTS One-thousand patients were undergone LigasureTM hemorrhoidectomy. The mean follow-up was 7 years and 110 (11%) patients was lost from the follow-up after the first postoperative month. Among early postoperative complications, 21 patients (2.1%) has urinary retention treated with a urinary catheter and removed before the discharge. 3 (0.3%) patients had a minor bleeding that required a package of hemostatic absorbable sponge, as late complications, in 35 patients (4%) anal fissure due to hard stool, an incomplete healing was observed in 11 patients (1.1%) after the first month. Three transphincteric anal fistulas (0.3%) were collected and four perianal abscess (0.4%) were observed during the first month of the follow-up and they required a delayed surgical treatment. At the end of the seven years of follow-up 70 recurrences (7.8%) and 35 anal stenosis (4%) were detected. CONCLUSIONS If technical guidelines are respected rigorously and the device is applied correctly, feared late complications, such as impaired fecal continence, anal stricture and postoperative pain can be minimized.
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Milito G, Lisi G, Venditti D, Campanelli M, Grande M. Endo-SPONGE®: conservative treatment of an anastomotic leak. MINERVA GASTROENTERO 2016; 62:267-268. [PMID: 27404262] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/06/2023]
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Ichikawa N, Okamoto Y, Okada G, Lisi G, Yahata N, Morimoto J, Kawato M, Matsuo K, Yamagata H, Watanabe Y, Yamawaki S. Neuroimaging Biomarker of Major Depressive Disorder. Eur Psychiatry 2016. [DOI: 10.1016/j.eurpsy.2016.01.1811] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/27/2022] Open
Abstract
IntroductionRecent studies have shown that it is important to understand the brain mechanism specifically by focusing on the common and unique functional connectivity in each disorder including depression.ObjectivesTo specify the biomarker of major depressive disorder (MDD), we applied the sparse machine learning algorithm to classify several types of affective disorders using the resting state fMRI data collected in multiple sites, and this study shows the results of depression as a part of those results.AimsThe aim of this study is to understand some specific pattern of functional connectivity in MDD, which would support diagnosis of depression and development of focused and personalized treatments in the future.MethodsThe neuroimaging data from patients with major depressive disorder (MDD, n = 100) and healthy control adults (HC: n = 100) from multiple sites were used for the training dataset. A completely separate dataset (n = 16) was kept aside for testing. After all preprocessing of fMRI data, based on one hundred and forty anatomical region of interests (ROIs), 9730 functional connectivities during resting states were prepared as the input of the sparse machine-learning algorithm.ResultsAs results, 20 functional connectivities were selected with the classification performance of Accuracy: 83.0% (Sensitivity: 81.0%, Specificity: 85.0%). The test data, which was completely separate from the training data, showed the performance accuracy of 83.3%.ConclusionsThe selected functional connectivities based on the sparse machine learning algorithm included the brain regions which have been associated with depression.Disclosure of interestThe authors have not supplied their declaration of competing interest.
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Novitsky Y, Fayezizadeh M, Majumder A, Yee S, Petro C, Orenstein S, Woeste G, Reinisch A, Bechstein WO, Rosen M, Carbonell A, Cobb W, Bauer J, Selzer D, Chao J, Harmaty M, Poulose B, Matthews B, Goldblatt M, Jacobsen G, Rosman C, Hansson B, Prabhu A, Fathi A, Skipworth J, Younis I, Floyd D, Shankar A, Olmi S, Cesana G, Ciccarese F, Uccelli M, Carrieri D, Castello G, Legnani G, Lyo V, Irwin C, Xu X, Harris H, Zuvela M, Galun D, Petrovic J, Palibrk I, Koncar I, Basaric D, Tian W, Fei Y, Pittman M, Jones E, Schwartz J, Mikami D, Perrakis A, Knüttel D, Klein P, Croner RS, Hohenberger W, Perrakis E, Müller V, Grande M, Villa M, Lisi G, Esser A, De Sanctis F, Petrella G, Birolini C, Miranda JS, Tanaka EY, Utiyama EM, Rasslan S, Shi Y, Guo XB, Zhuo HQ, Li LP, Liu HJ, Bauder A, Gerety P, Epps G, Pannucci C, Fischer J, Kovach S. Incisional Hernia: Difficult Cases 2. Hernia 2015; 19 Suppl 1:S105-11. [PMID: 26518784 DOI: 10.1007/bf03355335] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
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Mattioli G, Barabino A, Aloi M, Arrigo S, Caldaro T, Carlucci M, Cucchiara S, De Angelis P, Di Leo G, Illiceto MT, Impellizzeri P, Leonelli L, Lisi G, Lombardi G, Martelossi S, Martinelli M, Miele E, Randazzo A, Romano C, Romeo C, Romeo E, Selvaggi F, Valenti S, Dall'Oglio L. Paediatric ulcerative colitis surgery: Italian survey. J Crohns Colitis 2015; 9:558-64. [PMID: 25895877 DOI: 10.1093/ecco-jcc/jjv065] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/07/2015] [Accepted: 04/13/2015] [Indexed: 02/08/2023]
Abstract
BACKGROUND AND AIMS Recent epidemiological studies showed an increase in ulcerative colitis among children, especially in its aggressive form, requiring surgical treatment. Although medical therapeutic strategies are standardized, there is still no consensus regarding indications, timing and kind of surgery. This study aimed to define the surgical management of paediatric ulcerative colitis and describe attitudes to it among paediatric surgeons. METHODS This was a retrospective cohort study. All national gastroenterology units were invited to participate. From January 2009 to December 2013, data on paediatric patients diagnosed with ulcerative colitis that required surgery were collected. RESULTS Seven units participated in the study. Seventy-one colectomies were performed (77.3% laparoscopically). Main surgical indications were a severe ulcerative colitis attack (33.8%) and no response to medical therapies (56.3%). A three-stage strategy was chosen in 71% of cases. Straight anastomosis was performed in 14% and J-pouch anastomosis in 86% of cases. A reconstructive laparoscopic approach was used in 58% of patients. Ileo-anal anastomosis was performed by the Knight-Griffen technique in 85.4% and by the pull-through technique in 9.1% of patients. Complications after colectomy, after reconstruction and after stoma closure were reported in 12.7, 19.3 and 35% of cases, respectively. CONCLUSIONS This study shows that there is general consensus regarding indications for surgery. The ideal surgical technique remains under debate. Laparoscopy is a procedure widely adopted for colectomy but its use in reconstructive surgery remains limited. Longer follow-up must be planned to define the quality of life of these patients.
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Cadeddu F, Salis F, Lisi G, Ciangola I, Milito G. Complex anal fistula remains a challenge for colorectal surgeon. Int J Colorectal Dis 2015; 30:595-603. [PMID: 25566951 DOI: 10.1007/s00384-014-2104-7] [Citation(s) in RCA: 31] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 12/15/2014] [Indexed: 02/04/2023]
Abstract
AIM Anal fistula is a common proctological problem to both patient and physician throughout surgical history. Several surgical and sphincter-sparing approaches have been described for the management of fistula-in-ano, aimed to minimize the recurrence and to preserve the continence. We aimed to systematically review the available studies relating to the surgical management of anal fistulas. MATERIAL AND METHODS A Medline search was performed using the PubMed, Ovid, Embase, and Cochrane databases to identify articles reporting on fistula-in-ano management, aimed to find out the current techniques available, the new technologies, and their effectiveness in order to delineate a gold standard treatment algorithm. RESULTS The management of low anal fistulas is usually straightforward, given that fistulotomy is quite effective, and if the fistula has been properly evaluated, continence disturbance is minimal. On the contrary, high complex fistulas are challenging, because cure and continence are directly competing priorities. CONCLUSIONS Conventional fistula surgery techniques have their place, but new technologies such as fibrin glues, dermal collagen injection, the anal fistula plugs, and stem cell injection offer alternative approaches whose long-term efficacy needs to be further clarified in large long-term randomized trials.
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