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Pastoricchio M, Bernardi S, Bortul M, de Manzini N, Dobrinja C. Autofluorescence of parathyroid glands during endocrine surgery with minimally invasive technique. J Endocrinol Invest 2022; 45:1393-1403. [PMID: 35262861 DOI: 10.1007/s40618-022-01774-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/02/2021] [Accepted: 02/18/2022] [Indexed: 10/18/2022]
Abstract
PURPOSE Accidental injury to the parathyroid glands (PTGs) is common during thyroid and parathyroid surgery. To overcome the limitation of naked eye in identifying the PTGs, intraoperative autofluorescence imaging has been embraced by an increasing number of surgeons. The aim of our study was to describe the technique and assess its utility in clinical practice. METHODS Near-infrared (NIR) autofluorescence imaging was carried out during open parathyroid and thyroid surgery in 25 patients (NIR group), while other 26 patients underwent traditional PTG detection based on naked eye alone (NO-NIR group). Primary variables assessed for correlation between traditional approach and autofluorescence were number of PTGs identified and incidence of postoperative hypoparathyroidism (hypoPT). RESULTS 81.9% of PTGs were detected by means of fluorescence imaging and 74.5% with visual inspection alone, with an average of 2.72 PTGs visualized per patient using NIR imaging versus approximately 2.4 per patient using naked eye (p = 0.38). Considering only the more complex total thyroidectomies (TTs), the difference was almost statistically significant (p = 0.06). Although not statistically significant, the observed postoperative hypoPT rate was lower in the NIR group. CONCLUSION Despite the limitations and technical aspects still to be investigated, fluorescence seems to reduce this complication rate by improving the intraoperative detection of the PTGs.
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Affiliation(s)
- M Pastoricchio
- Division of General Surgery, Azienda Sanitaria Universitaria Giuliano Isontina (ASUGI), Gorizia, Italy
| | - S Bernardi
- Department of Medical, Surgical, and Health Sciences, University of Trieste, Cattinara Teaching Hospital UCO Medicina Clinica, 34100, Trieste, Italy
| | - M Bortul
- Division of General Surgery, Department of Medical, Surgical, and Health Sciences, Cattinara Teaching Hospital, University of Trieste, Trieste, Italy
| | - N de Manzini
- Division of General Surgery, Department of Medical, Surgical, and Health Sciences, Cattinara Teaching Hospital, University of Trieste, Trieste, Italy
| | - C Dobrinja
- Division of General Surgery, Department of Medical, Surgical, and Health Sciences, Cattinara Teaching Hospital, University of Trieste, Trieste, Italy.
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Dobrinja C, Samardzic N, Giudici F, Raffaelli M, De Crea C, Sessa L, Docimo G, Ansaldo GL, Minuto M, Varaldo E, Dionigi G, Spiezia S, Boniardi M, Pauna I, De Pasquale L, Testini M, Gurrado A, Pasculli A, Pezzolla A, Lattarulo S, Calò PG, Graceffa G, Massara A, Docimo L, Ruggiero R, Parmeggiani D, Iacobone M, Innaro N, Lombardi CP, de Manzini N. Hemithyroidectomy versus total thyroidectomy in the intermediate-risk differentiated thyroid cancer: the Italian Societies of Endocrine Surgeons and Surgical Oncology Multicentric Study. Updates Surg 2021; 73:1909-1921. [PMID: 34435312 DOI: 10.1007/s13304-021-01140-1] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/18/2021] [Accepted: 05/26/2021] [Indexed: 11/27/2022]
Abstract
The surgical treatment of the intermediate-risk DTC (1-4 cm) remains still controversial. We analyzed the current practice in Italy regarding the surgical management of intermediate-risk unilateral DTC to evaluate risk factors for recurrence and to identify a group of patients to whom propose a total thyroidectomy (TT) vs. hemithyroidectomy (HT). Among 1896 patients operated for thyroid cancer between January 2017 and December 2019, we evaluated 564 (29.7%) patients with unilateral intermediate-risk DTC (1-4 cm) without contralateral nodular lesions on the preoperative exams, chronic autoimmune thyroiditis, familiarity or radiance exposure. Data were collected retrospectively from the clinical register from 16 referral centers. The patients were followed for at least 14 months (median time 29.21 months). In our cohort 499 patients (88.4%) underwent total thyroidectomy whereas 65 patients (11.6%) underwent hemithyroidectomy. 151 (26.8%) patients had a multifocal DTC of whom 57 (10.1%) were bilateral. 21/66 (32.3%) patients were reoperated within 2 months from the first intervention (completion thyroidectomy). Three patients (3/564) developed regional lymph node recurrence 2 years after surgery and required a lymph nodal neck dissection. The single factor related to the risk of reoperation was the histological diameter (HR = 1.05 (1.00-1-09), p = 0.026). Risk stratification is the key to differentiating treatment options and achieving better outcomes. According to the present study, tumor diameter is a strong predictive risk factor to proper choose initial surgical management for intermediate-risk DTC.
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Affiliation(s)
- C Dobrinja
- UOC Clinica Chirurgica di Trieste, Dipartimento Universitario Clinico di Scienze Mediche Chirurgiche e della Salute, Trieste, Italy
| | - N Samardzic
- UOC Clinica Chirurgica di Trieste, Dipartimento Universitario Clinico di Scienze Mediche Chirurgiche e della Salute, Trieste, Italy. .,Division of General Surgery, Department of Medical and Surgical Sciences, Cattinara Hospital, Università degli Studi di Trieste, Strada di Fiume 447, 34149, Trieste, Italy.
| | - F Giudici
- UOC Clinica Chirurgica di Trieste, Dipartimento Universitario Clinico di Scienze Mediche Chirurgiche e della Salute, Trieste, Italy
| | - M Raffaelli
- UNITÀ OPERATIVA COMPLESSA Chirurgia Endocrina e Metabolica, Dipartimento Scienze mediche e chirurgiche, Policlinico Gemelli, Roma, Italy
| | - C De Crea
- UNITÀ OPERATIVA COMPLESSA Chirurgia Endocrina e Metabolica, Dipartimento Scienze mediche e chirurgiche, Policlinico Gemelli, Roma, Italy
| | - L Sessa
- UNITÀ OPERATIVA COMPLESSA Chirurgia Endocrina e Metabolica, Dipartimento Scienze mediche e chirurgiche, Policlinico Gemelli, Roma, Italy
| | - G Docimo
- UOSD Chirurgia Tiroidea Università della Campania "Luigi Vanvitelli", Caserta, Italy
| | - G L Ansaldo
- U.O.S. di Chirurgia Endocrina, IRCCS Ospedale Policlinico San Martino di Genova, Genoa, Italy
| | - M Minuto
- U.O.S. di Chirurgia Endocrina, IRCCS Ospedale Policlinico San Martino di Genova, Genoa, Italy
| | - E Varaldo
- U.O.S. di Chirurgia Endocrina, IRCCS Ospedale Policlinico San Martino di Genova, Genoa, Italy
| | - G Dionigi
- UOSD di Chirurgia Endocrina e Mininvasiva, Policlinico Gaetano Martino MESSINA Azienda Ospedaliera Universitaria, Messina, Italy
| | | | - M Boniardi
- Chirurgia Endocrina-Chirurgia Oncologica e Mininvasiva, Ospedale Niguarda di Milano, Milan, Italy
| | - I Pauna
- Chirurgia Endocrina-Chirurgia Oncologica e Mininvasiva, Ospedale Niguarda di Milano, Milan, Italy
| | - L De Pasquale
- Servizio di Chirurgia di Tiroide e Paratiroidi, U.O. ORL Asst Santi Paolo e Carlo, Ospedale Polo Universitario San Paolo, Via A. di Rudinì, 8, 20142, Milano, Italy
| | - M Testini
- U.O.C. di Chirurgia Generale Universitaria "V. Bonomo", Azienda Ospedaliero Universitaria Policlinico di Bari. Dipartimento di Scienze Biomediche ed Oncologia Umana, Università degli Studi "A. Moro" di Bari, Bari, Italy
| | - A Gurrado
- U.O.C. di Chirurgia Generale Universitaria "V. Bonomo", Azienda Ospedaliero Universitaria Policlinico di Bari. Dipartimento di Scienze Biomediche ed Oncologia Umana, Università degli Studi "A. Moro" di Bari, Bari, Italy
| | - A Pasculli
- U.O.C. di Chirurgia Generale Universitaria "V. Bonomo", Azienda Ospedaliero Universitaria Policlinico di Bari. Dipartimento di Scienze Biomediche ed Oncologia Umana, Università degli Studi "A. Moro" di Bari, Bari, Italy
| | - A Pezzolla
- Policlinico di Bari, UOS Videolaparoscopica, Bari, Italy
| | - S Lattarulo
- Policlinico di Bari, UOS Videolaparoscopica, Bari, Italy
| | - P G Calò
- Chirurgia Generale Polispecialistica, Azienda Ospedaliero-Universitaria di Cagliari, Cagliari, Italy
| | - G Graceffa
- UO CH ONCOLOGICA, Policlinico P. Giaccone di Palermo, Università degli Studi di Palermo, Palermo, Italy
| | - A Massara
- UO CH ONCOLOGICA, Policlinico P. Giaccone di Palermo, Università degli Studi di Palermo, Palermo, Italy
| | - L Docimo
- XI Chirurgia Generale, Universita' della Campania Luigi Vanvitelli, Via Pansini 5, Naples, Italy
| | - R Ruggiero
- XI Chirurgia Generale, Universita' della Campania Luigi Vanvitelli, Via Pansini 5, Naples, Italy
| | - D Parmeggiani
- XI Chirurgia Generale, Universita' della Campania Luigi Vanvitelli, Via Pansini 5, Naples, Italy
| | - M Iacobone
- Endocrinochirurgia- Azienda Ospedaliera di Padova, Padua, Italy
| | - N Innaro
- Unità Operativa di Endocrinochirurgia, Azienda Ospedaliero-Universitaria Mater Domini, Catanzaro, Italy
| | - C P Lombardi
- Unità Operativa Complessa Chirurgia Endocrina, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Rome, Italy
| | - N de Manzini
- UOC Clinica Chirurgica di Trieste, Dipartimento Universitario Clinico di Scienze Mediche Chirurgiche e della Salute, Trieste, Italy
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Bernardi L, Cipolat Mis T, Troian M, de Manzini N. Left-sided laparoscopic retroperitoneal lymph node dissection for a non-seminomatous testicular tumour - a video vignette. Colorectal Dis 2020; 22:1793-1794. [PMID: 32579718 DOI: 10.1111/codi.15210] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/22/2020] [Accepted: 06/02/2020] [Indexed: 02/08/2023]
Affiliation(s)
- L Bernardi
- Department of General Surgery, ASUGI, Trieste, Italy
| | - T Cipolat Mis
- Department of General Surgery, ASUGI, Trieste, Italy
| | - M Troian
- Department of General Surgery, ASUGI, Trieste, Italy
| | - N de Manzini
- Department of General Surgery, ASUGI, Trieste, Italy
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Pastoricchio M, Cubisino A, Lanzaro A, Troian M, Zanconati F, Bernardi S, Fabris B, de Manzini N, Dobrinja C. Impact of the Italian Society of Anatomic Pathology and Diagnostic Cytology Classification of Thyroid Nodules in the Treatment of Indeterminate Follicular Lesions: Five-Year Results at a Single Center. Int J Endocrinol 2020; 2020:7325260. [PMID: 32351561 PMCID: PMC7178537 DOI: 10.1155/2020/7325260] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/16/2019] [Revised: 03/03/2020] [Accepted: 03/09/2020] [Indexed: 01/21/2023] Open
Abstract
PURPOSE Aim of the study was to assess the impact of the Italian Society of Anatomic Pathology and Diagnostic Cytology (SIAPEC) classification of 2014, on the treatment of indeterminate thyroid lesions (TIR3). METHODS We retrospectively analyzed patients undergoing thyroid surgery for TIR3 lesions between 2013 and 2018, at the General Surgery Department of Trieste University Hospital. According to the SIAPEC classification, patients were divided into TIR3A and TIR3B groups. All patients treated before 2014 underwent surgical treatment, and surgical specimens were retrospectively classified after revision of fine-needle aspiration cytology. Starting 2014, TIR3A patients were treated only when symptomatic (i.e., coexistent bilateral thyroid goiter or growing TIR3A nodules), whereas TIR3B patients always received surgical treatment. Hemithyroidectomy (HT) was the procedure of choice. Total thyroidectomy (TT) was performed in case of concurrent bilateral goiter, autoimmune thyroid disease, and/or presence of BRAF and/or RAS mutation. Lastly, we analyzed the malignancy rate in the two groups. RESULTS 29 TIR3A and 90 TIR3B patients were included in the study. HT was performed in 10 TIR3A patients and 37 TIR3B patients, respectively, with need for reoperation in 4 TIR3B (10.8%) patients due to histological findings of follicular thyroid carcinoma >1 cm. The malignancy rates were 17.2% in TIR3A and 31.1% in TIR3B, (p = 0.16). Predictability of malignancy was almost 89% in BRAF mutation and just 47% in RAS mutation. CONCLUSIONS The new SIAPEC classification in association with biomolecular markers has improved diagnostic accuracy, patient selection, and clinical management of TIR3 lesions.
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Affiliation(s)
- M. Pastoricchio
- Division of Clinical Surgery, Department of Medical, Surgical and Health Sciences, University of Trieste, Cattinara Teaching Hospital, Trieste 34149, Italy
| | - A. Cubisino
- Division of Clinical Surgery, Department of Medical, Surgical and Health Sciences, University of Trieste, Cattinara Teaching Hospital, Trieste 34149, Italy
| | - A. Lanzaro
- Division of Clinical Surgery, Department of Medical, Surgical and Health Sciences, University of Trieste, Cattinara Teaching Hospital, Trieste 34149, Italy
| | - M. Troian
- Division of Clinical Surgery, Department of Medical, Surgical and Health Sciences, University of Trieste, Cattinara Teaching Hospital, Trieste 34149, Italy
| | - F. Zanconati
- Department of Medical, Surgical and Health Sciences, Università Degli Studi di Trieste, Cattinara Teaching Hospital, Strada di Fiume 447, 34149 Trieste, Italy
| | - S. Bernardi
- Department of Medical, Surgical and Health Sciences, Università Degli Studi di Trieste, Cattinara Teaching Hospital, Strada di Fiume 447, 34149 Trieste, Italy
- Endocrinology Unit—Azienda Sanitaria Universitaria Integrata Trieste, Cattinara Teaching Hospital, Strada di Fiume 447, 34149 Trieste, Italy
| | - B. Fabris
- Department of Medical, Surgical and Health Sciences, Università Degli Studi di Trieste, Cattinara Teaching Hospital, Strada di Fiume 447, 34149 Trieste, Italy
- Endocrinology Unit—Azienda Sanitaria Universitaria Integrata Trieste, Cattinara Teaching Hospital, Strada di Fiume 447, 34149 Trieste, Italy
| | - N. de Manzini
- Division of Clinical Surgery, Department of Medical, Surgical and Health Sciences, University of Trieste, Cattinara Teaching Hospital, Trieste 34149, Italy
| | - C. Dobrinja
- Division of Clinical Surgery, Department of Medical, Surgical and Health Sciences, University of Trieste, Cattinara Teaching Hospital, Trieste 34149, Italy
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Cucchetti A, Russolillo N, Johnson P, Tarchi P, Ferrero A, Cucchi M, Serenari M, Ravaioli M, de Manzini N, Cescon M, Ercolani G. Impact of primary cancer features on behaviour of colorectal liver metastases and survival after hepatectomy. BJS Open 2018; 3:186-194. [PMID: 30957066 PMCID: PMC6433312 DOI: 10.1002/bjs5.100] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2018] [Accepted: 07/26/2018] [Indexed: 01/08/2023] Open
Abstract
Background Markers of tumour biology may be valuable prognostic indicators after hepatic resection of colorectal cancer liver metastases (CRLMs). Identification of the aggressiveness of these metastases might inform the appropriateness of hepatic surgery. Methods Patients undergoing liver resection for CRLMs between January 2001 and July 2013 in four tertiary hospitals were reviewed. A mathematical model to estimate CRLM doubling times was constructed for patients with metachronous metastases. Tumour doubling time was investigated in relation to the features of colorectal cancer, including KRAS status. The hazard rate for recurrence and death following hepatectomy was explored through the Kernel‐smoothed estimator. Results Of 1063 patients undergoing liver resection for CRLMs, 361 with metachronous metastases undergoing single‐stage hepatectomy were analysed. The mean doubling time in patients not receiving chemotherapy between surgery for colorectal cancer and CRLM was 71·4 days. Tumour doubling time was shorter in patients with more advanced primary tumour stages, with mutant KRAS and in those who did not receive chemotherapy. For fast‐growing CRLMs (doubling time less than 48 days), the risk of recurrence was highest within the first postoperative year, and was about 7 per cent per month. Conclusion Primary features of colorectal cancer were linked to aggressiveness of CRLMs as measured by doubling time.
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Affiliation(s)
- A Cucchetti
- Department of Medical and Surgical Sciences (DIMEC), Alma Mater Studiorum University of Bologna Bologna Italy
| | - N Russolillo
- Department of General and Oncological Surgery Ospedale Mauriziano Umberto I Turin Italy
| | - P Johnson
- Department of Molecular and Clinical Cancer Medicine University of Liverpool Liverpool UK
| | - P Tarchi
- General Surgery Unit, Department of Medical, Surgical and Health Sciences Cattinara University Hospital, Azienda Sanitaria Universitaria Integrata di Trieste Trieste Italy
| | - A Ferrero
- Department of General and Oncological Surgery Ospedale Mauriziano Umberto I Turin Italy
| | - M Cucchi
- Department of Medical and Surgical Sciences (DIMEC), Alma Mater Studiorum University of Bologna Bologna Italy
| | - M Serenari
- Department of Medical and Surgical Sciences (DIMEC), Alma Mater Studiorum University of Bologna Bologna Italy
| | - M Ravaioli
- Department of Medical and Surgical Sciences (DIMEC), Alma Mater Studiorum University of Bologna Bologna Italy
| | - N de Manzini
- General Surgery Unit, Department of Medical, Surgical and Health Sciences Cattinara University Hospital, Azienda Sanitaria Universitaria Integrata di Trieste Trieste Italy
| | - M Cescon
- Department of Medical and Surgical Sciences (DIMEC), Alma Mater Studiorum University of Bologna Bologna Italy
| | - G Ercolani
- Department of Medical and Surgical Sciences (DIMEC), Alma Mater Studiorum University of Bologna Bologna Italy
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Selene B, Silvestri M, Fabio P, de Manzini N. Laparoscopic repair of right congenital diaphragmatic hernia with intrathoracic kidney - a video vignette. Colorectal Dis 2018; 20:162-163. [PMID: 29105275 DOI: 10.1111/codi.13953] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/30/2017] [Accepted: 10/10/2017] [Indexed: 12/30/2022]
Affiliation(s)
- B Selene
- General Surgery, Azienda Sanitaria Universitaria Integrata di Trieste (ASUITS), Strada di Fiume 447, Trieste, 34149, Italy
| | - M Silvestri
- General Surgery, Azienda Sanitaria Universitaria Integrata di Trieste (ASUITS), Strada di Fiume 447, Trieste, 34149, Italy
| | - P Fabio
- General Surgery, Azienda Sanitaria Universitaria Integrata di Trieste (ASUITS), Strada di Fiume 447, Trieste, 34149, Italy
| | - N de Manzini
- General Surgery, Azienda Sanitaria Universitaria Integrata di Trieste (ASUITS), Strada di Fiume 447, Trieste, 34149, Italy
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Dobrinja C, Troian M, Cipolat Mis T, Rebez G, Bernardi S, Fabris B, Piscopello L, Makovac P, Di Gregorio F, de Manzini N. Rationality in prophylactic central neck dissection in clinically node-negative (cN0) papillary thyroid carcinoma: Is there anything more to say? A decade experience in a single-center. Int J Surg 2018; 41 Suppl 1:S40-S47. [PMID: 28506412 DOI: 10.1016/j.ijsu.2017.01.113] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2016] [Revised: 01/27/2017] [Accepted: 01/30/2017] [Indexed: 01/22/2023]
Abstract
AIM Papillary thyroid carcinoma (PTC) is the most common thyroid malignancy. Despite its extremely favorable prognosis, cervical lymph node metastases are a common feature of PTC and a known independent risk factor for local recurrence. However, the role of prophylactic central neck dissection (PCND) remains a matter of debate in patients with clinically node-negative (cN0) PTC. To better clarify the current role of PCND in the surgical treatment of PTC, evaluating advantages and disadvantages of PCND and outcome of cN0 PTC patients who have been treated with either total thyroidectomy alone or in combination with PCND. A review of recent literature data is performed. METHODS Between January 2000 and December 2015, 186 consecutive patients with cN0 PTC were identified to be included in the present study. 74 of these underwent total thyroidectomy associated with PCND, while 112 patients underwent total thyroidectomy alone. The epidemiological and clinical-pathological data of all patients included were collected at diagnosis and during follow-up. RESULTS Overall complication rate was significantly higher in the group of patients undergoing PCND (39.2% vs. 17.8%, p = 0.0006). To be specific, they presented a considerably increased risk of temporary recurrent laryngeal nerve injury (p = 0.009) and of permanent hypothyroidism (p = 0.016). Overall survival and recurrence rates did not differ between those undergoing PCND and those undergoing total thyroidectomy alone (p = 1.000 and p = 0.715, respectively). CONCLUSIONS The results of the present study do not support the routine use of PCND in the treatment of cN0 PTC patients.
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Affiliation(s)
- C Dobrinja
- Division of General Surgery, Department of Medical, Surgical and Health Sciences, Cattinara Teaching Hospital, Strada di Fiume, 34149, Trieste, Italy.
| | - M Troian
- Division of General Surgery, Department of Medical, Surgical and Health Sciences, Cattinara Teaching Hospital, Strada di Fiume, 34149, Trieste, Italy
| | - T Cipolat Mis
- Division of General Surgery, Department of Medical, Surgical and Health Sciences, Cattinara Teaching Hospital, Strada di Fiume, 34149, Trieste, Italy
| | - G Rebez
- Division of General Surgery, Department of Medical, Surgical and Health Sciences, Cattinara Teaching Hospital, Strada di Fiume, 34149, Trieste, Italy
| | - S Bernardi
- SS Endocrinologia (UCO Medicina Clinica), Azienda Ospedaliero-Universitaria di Trieste, Department of Medical, Surgical and Health Sciences, Cattinara Teaching Hospital, Strada di Fiume, 34149, Trieste, Italy
| | - B Fabris
- SS Endocrinologia (UCO Medicina Clinica), Azienda Ospedaliero-Universitaria di Trieste, Department of Medical, Surgical and Health Sciences, Cattinara Teaching Hospital, Strada di Fiume, 34149, Trieste, Italy
| | - L Piscopello
- Division of Endocrinology, Azienda Ospedaliero-Universitaria di Trieste, Maggiore Hospital, Piazza dell'Ospitale, Trieste, Italy
| | - P Makovac
- Division of General Surgery, Department of Medical, Surgical and Health Sciences, Cattinara Teaching Hospital, Strada di Fiume, 34149, Trieste, Italy
| | - F Di Gregorio
- Nuclear Medicine Unit, Ospedale S. Misericordia Udine, Italy
| | - N de Manzini
- Division of General Surgery, Department of Medical, Surgical and Health Sciences, Cattinara Teaching Hospital, Strada di Fiume, 34149, Trieste, Italy
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8
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Silvestri M, Guerra M, Giacca M, Casagranda B, Palmisano S, de Manzini N. Laparoscopic ileocolic iterative resection with fluorescence-guided lymphatic mapping - a video vignette. Colorectal Dis 2017; 19:945-946. [PMID: 28906577 DOI: 10.1111/codi.13881] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/13/2017] [Accepted: 08/01/2017] [Indexed: 02/08/2023]
Affiliation(s)
- M Silvestri
- General Surgery, Azienda Sanitaria Universitaria Integrata di Trieste (ASUITS), Trieste, Italy
| | - M Guerra
- General Surgery, Azienda Sanitaria Universitaria Integrata di Trieste (ASUITS), Trieste, Italy
| | - M Giacca
- General Surgery, Azienda Sanitaria Universitaria Integrata di Trieste (ASUITS), Trieste, Italy
| | - B Casagranda
- General Surgery, Azienda Sanitaria Universitaria Integrata di Trieste (ASUITS), Trieste, Italy
| | - S Palmisano
- General Surgery, Azienda Sanitaria Universitaria Integrata di Trieste (ASUITS), Trieste, Italy
| | - N de Manzini
- General Surgery, Azienda Sanitaria Universitaria Integrata di Trieste (ASUITS), Trieste, Italy
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Abstract
AIM The onset of symptoms after removal of the ileocaecal valve (ICV) may be perceived as an unwanted effect of surgery and induce patients to bring unnecessary litigation against surgeons. The aim of our study is to assess the real impact on the quality of life of patients whose ICV has been surgically removed, using three validated questionnaires. METHOD In patients who had their ICV removed surgically, the Gastrointestinal Quality of life (GIQLI) questionnaire and those used by the European Organization for research and Treatment of Cancer (EORTC) were administered before and after surgery. The empirical rule effect size method was used to evaluate the clinical significance of the statistical data. RESULTS We interviewed 225 patients. Data collected through the three questionnaires highlighted a trend towards postoperative improvement of the selected gastrointestinal symptoms compared with the baseline. The GIQLI questionnaire showed a statistically significant improvement in 'pain', 'nausea' and 'constipation' during the follow-up. Constipation appeared more frequently in patients older than 70 years compared with younger ones. The EORTC-QLQ-C30 questionnaire showed a significant correlation between diarrhoea and extended right colectomy at 3 months after surgery, which was not confirmed at 6 months. The EORTC QLQ-CR29 questionnaire showed a slight deterioration of 'leakage of stools from the anal opening' at 6 months after surgery, but this symptom was not deemed clinically significant. CONCLUSION We found that bowel functions in most patients after surgical removal of the ICV were satisfactory. Providing patients with a comprehensive and exhaustive informed consent during preoperative consultations could promote patient trust and avoid misunderstandings.
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Affiliation(s)
- S Palmisano
- Department of Medical, Surgical and Health Sciences, General Surgery Clinic, University Hospital of Trieste, Trieste, Italy
| | - M Silvestri
- Department of Medical, Surgical and Health Sciences, General Surgery Clinic, University Hospital of Trieste, Trieste, Italy
| | - M Troian
- Department of Medical, Surgical and Health Sciences, General Surgery Clinic, University Hospital of Trieste, Trieste, Italy
| | - P Germani
- Department of Medical, Surgical and Health Sciences, General Surgery Clinic, University Hospital of Trieste, Trieste, Italy
| | - F Giudici
- Department of Medical, Surgical and Health Sciences, General Surgery Clinic, University Hospital of Trieste, Trieste, Italy
| | - N de Manzini
- Department of Medical, Surgical and Health Sciences, General Surgery Clinic, University Hospital of Trieste, Trieste, Italy
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Leon P, Balduzzi A, Troian M, de Manzini N. Trans-anal full-thickness endoscopic resection of a rectal neuroendocrine neoplasm performed with a TEO ® (Karl Storz microsurgery device) and laparoscopic indocyanine-green-guided lymphatic sampling - a video vignette. Colorectal Dis 2017; 19:399-400. [PMID: 28208236 DOI: 10.1111/codi.13631] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/02/2016] [Accepted: 11/22/2016] [Indexed: 02/08/2023]
Affiliation(s)
- P Leon
- Department of General Surgery, Cattinara Hospital, University of Trieste, Trieste (TS), Italy
| | - A Balduzzi
- Department of General Surgery, Cattinara Hospital, University of Trieste, Trieste (TS), Italy
| | - M Troian
- Department of General Surgery, Cattinara Hospital, University of Trieste, Trieste (TS), Italy
| | - N de Manzini
- Department of General Surgery, Cattinara Hospital, University of Trieste, Trieste (TS), Italy
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11
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Giuricin M, Nagliati C, Palmisano S, Simeth C, Urban F, Buri L, Balani A, de Manzini N. Short- and long-term efficacy of intragastric air-filled balloon (Heliosphere® BAG) among obese patients. Obes Surg 2013; 22:1686-9. [PMID: 22820924 DOI: 10.1007/s11695-012-0700-6] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/14/2023]
Abstract
BACKGROUND Obesity is an increasing health problem worldwide. The intragastric balloon as a temporary endoscopic treatment of obesity can play an important role among the aforementioned group of obese individuals. It can also be used as a preoperative test before subjecting patients to restrictive bariatric surgery. Furthermore, the intragastric device may be applied to patients affected by severe obesity as a "bridge treatment" before they undergo major surgery in order to reduce chances of operation-related risks. To date, there are insufficient data in the literature on the long-term results of the intragastric balloon. METHODS Our study includes an analysis of our experience with Heliosphere® BAG from 2006 through to 2010, concerning early weight loss and weight loss maintenance over at least 18 months since the device's removal. The 32 patients who completed the 6-month treatment had recorded a mean weight loss of 12.66 kg and a mean overweight loss of 24.37 % (SD, 12.74). RESULTS A total of 16 patients are subjected to an 18-month follow-up. Their pretreatment and long-term body mass index (BMI) were calculated: 6 months later, when devices were removed, they showed a mean weight of 99.75 kg (SD, 17.90; p < 0.001) and a mean weight loss of 13.62 kg and 26.14 % (SD, 12.79). 18 months after removing Heliosphere® BAG, the 16 patients' mean BMI was 37.28 kg/m² (SD, 5.41; p = 0.004), with a mean weight of 103.56 kg (SD 17.25; p = 0.0125), and a mean weight loss of 9.8 kg or 18.2 % (SD, 12.07). CONCLUSIONS Heliosphere® BAG enables modest short-term weight loss with little side effects, although mid/long-term follow-up may entail partial weight gain. We believe it can be considered a useful bridge treatment in bariatric surgery in order to reduce chances of preoperative risks.
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Affiliation(s)
- M Giuricin
- Department of General Surgery, University Hospital of Trieste, Strada di Fiume, 447, Trieste, Italy.
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12
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Makovac P, Dobrinja C, Guerrini J, de Manzini N. Co-existing chronic lymphocytic thyroiditis and papillary thyroid carcinoma. Impact on presentation, management, and outcome. Eur J Surg Oncol 2012. [DOI: 10.1016/j.ejso.2012.07.100] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022] Open
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13
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Dobrinja C, Guerrini J, Makovac P, de Manzini N. Prophylactic central lymph node dissection for papillary thyroid carcinoma: What role today? Eur J Surg Oncol 2012. [DOI: 10.1016/j.ejso.2012.07.098] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
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14
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Palmisano S, de Manzini N, De Pellegrin A, Zanconati F. Sentinel node in colon cancer: a multimodal approach. BMC Geriatr 2009. [PMCID: PMC4290893 DOI: 10.1186/1471-2318-9-s1-a5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
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15
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Roseano M, Ressetta G, Pozzetto B, Babich F, de Manzini N. The treatment of inguinal hernia in the elderly: open technique or laparoscopic approach? Acta Biomed 2005; 76 Suppl 1:52-5. [PMID: 16450512] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/06/2023]
Abstract
Well defined and shared quality standards characterize the ideal treatment of inguinal hernia: it should be the least traumatic as regards both the requested type of anaesthesia and the operative technique and the least expensive; it should have the least per-and post-operative morbidity. The chosen technique should be also the easiest to learn and to perform; and his positive results should be the most reproducible. While there are a lot of studies about the comparison between open and laparoscopic surgery, the number of the studies about the specific evaluation of the problem in the aged is very limited. Aim of the paper is to aid in evaluation of the problem in a group of patients, on the basis of the reports and on an initial departmental experience. In conclusion the laparoscopic repair is a complementary choice and not an alternative to the open surgery in the elderly patients.
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Affiliation(s)
- M Roseano
- Department of Surgery, Institute of Clinical Surgery, University of Trieste, Trieste, Italy
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16
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Meyer C, Firtion O, Rohr S, de Manzini N, Le JV, Thiry LC. [Results of fundoplication by laparoscopic approach in the treatment of gastroesophageal reflux. Apropos of 224 cases]. Chirurgie 1998; 123:257-62. [PMID: 9752516 DOI: 10.1016/s0001-4001(98)80117-7] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
STUDY AIM The aim of this paper is to evaluate prospectively immediate and 2-year results of laparoscopic fundoplicature (LF) for gastroesophageal reflux disease (GERD). PATIENTS AND METHODS Patients presenting GERD who had been previously submitted to a long-term medical treatment were included in this study. Preoperative workup included upper GI tract endoscopy, esophageal manometry and 24-hour pHmetry. Standard surgical procedure incorporated a Nissen-Rossetti 360 degrees fundoplicature. Short vessels division (Nissen operation) was performed in case of high strength of the wrap and a partial fundoplicature (Toupet 270 degrees) was performed when motility disorders of the esophagus were demonstrated by manometry. Postoperative morbidity and results were evaluated, with a clinical appreciation at 3 and 22 months, and by manometry and pHmetry at 3 months. RESULTS Two hundred and thirty-five patients were observed, and 224 included in the study (143 men and 92 women). Nissen-Rossetti fundoplication was performed in 169 cases (80%), Nissen in 30 (14%) and Toupet in 13 (6%). In 12 cases (5%). LF was converted to an open Nissen-Rossetti procedure. There was no hospital mortality and complications were noted in three cases (1.5%): pneumonia (n = 2) and gastroplegia (n = 1). With a mean 22-month follow up, among the 103 patients who answered to a questionnaire, the rate of relapse of GERD was 14%, dysphagia was present in 2% and four patients had been reoperated on (one for a slipped Nissen, one for a stenosis of the esogastric junction and two incisional hernias). CONCLUSION On the basis of this experience, LF for GERD is a safe and efficient operation, with 86% of good results at 2 years.
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Affiliation(s)
- C Meyer
- Service de chirurgie générale et digestive, centre hospitalier universitaire de Strasbourg Hautepierre, France
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17
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Rohr S, Firtion O, de Manzini N, Gentine A, Stierle JL, Conraux C, Meyer C. [Tonometric monitoring of the viability of free transplants of the jejunum and the stomach after total circulary pharyngolaryngectomy]. J Chir (Paris) 1997; 133:389-91. [PMID: 9296006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Abstract
A prospective study concerning the tonometric viability supervision of 9 digestive free autografts after total pharyngolaryngectomy was conducted. This technic is based on the Henderson and Hasselbalch's equation which calculates the intramucosal pH (pHi) in the graft using a tonometric catheter. When the pHi is under 7.10, there is a graft ischemia. This invasive technique seems to be sensitive and specific provided that minimally rigorous measurement procedures are used. Late graft necrosis is the major limitation of the technique.
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Affiliation(s)
- S Rohr
- Service de Chirurgie Générale et Digestive, CHU Hautepierre, Strasbourg
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18
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Rohr S, Meyer C, Alvarez G, Abram F, Firtion O, de Manzini N. [Immediate resection-anastomosis after intra-operative colonic irrigation in cancer of the left colon with obstruction]. J Chir (Paris) 1996; 133:195-200. [PMID: 8999039] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Abstract
In a consecutive series of 38 patients over 5 years, who required emergency surgery for obstructing left colonic carcinoma, 24 had primary bowel resection with immediate anastomosis, after intraoperative anterograde colonic irrigation. Complete colonic obstruction was present in all cases. There were 7 Dukes B tumors, 11 Dukes C tumors and 6 Dukes D tumors. The operative mortality was 8.3% (2 patients, with one from anastomotic leakage), anastomotic leakage rate was 4%. Superficial wound infection occurred in 4% of patients. The median postoperative hospital stay was 19.5 days. The Kaplan-Meier survival curve showed a 41% survival rate after 5 years. This technique was found to be safe and effective to perform a primary anastomosis, without requiring temporary colostomies, after emergency resection of selected left colonic carcinoma obstruction.
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Affiliation(s)
- S Rohr
- Service de Chirurgie Générale et Digestive, Hôpitaux Universitaires de Strasbourg-Hautepierre
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19
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Rohr S, Thiry CL, Sadok H, de Manzini N, Hollender LF, Meyer C. [Complicated colonic diverticulosis. Changes in treatment and results over 22 years]. Presse Med 1994; 23:834-8. [PMID: 7937603] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/27/2023] Open
Abstract
OBJECTIVES The aim of this study was to analyse the clinical course, surgical strategy and results in patients with complicated colonic diverticular disease. METHODS We retrospectively compared two groups of patients who underwent surgery for complicated colonic diverticulosis from 1970 to 1984 (Group A, n = 94, mean age 60 years, 49 males, 45 females) and from 1985 to 1992 (Group B, n = 76, mean age 63.5, 32 males, 44 females). RESULTS Patients in the two groups were comparable; only the rate of peritonitis (20 vs 8%) was different (p < 0.05). The most frequent operations in Group A were colostomy-drainage (43%) and Hartman's procedure (26%) in emergency situations and resection with immediate anastomosis (63%) or resection-anastomosis with diverting stomy (19%) in elective cases. In Group B, surgical strategy led to a different pattern of operations, 4 and 56% in emergency, and 94 and 2% in elective surgery, respectively. Overall mortality was 11%, with 17% and 4% in Groups A and B respectively (p < 0.01). This major drop in mortality was particularly important in emergency cases (31 vs 4%; p < 0.02). Morbidity in emergency surgery fell from 21 to 4% (P < 0.0006). Interrupting the use of colostomy-drainage was a major factor in reducing mortality followed by a sharp fall in mortality after Hartmann's procedure (28.5 vs 0%). CONCLUSION The marked improvement in results between the two groups was mainly due to preferring resections of pathological colonic segments over colostomy-drainage.
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Affiliation(s)
- S Rohr
- Service de Chirurgie Générale et Digestive, Hôpital de Hautepierre, Strasbourg
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20
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Meyer C, Rohr S, de Manzini N, Dai B. Reliable procedure for closing the duodenal stump for bleeding posterior duodenal ulcer. World J Surg 1994; 18:286-8; discussion 288-9. [PMID: 8042336 DOI: 10.1007/bf00294417] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/28/2023]
Abstract
Bleeding posterior duodenal ulcers is a critical problem especially in patients of advanced age. Surgical treatment should obtain efficient and stable hemostasis and avoid digestive fistulas due to leakage of the duodenal stump. The main difficulty lies in the closure of the duodenal stump. A procedure using intramural dissection of the duodenum and closure by means of a stapler is reported for a series of 40 patients without recurrent bleeding or duodenal fistula. Seven patients (17%) died from associated diseases, especially respiratory insufficiency (3 patients) and cirrhotic liver failure (2 patients).
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Affiliation(s)
- C Meyer
- Department of General and Digestive Surgery, Hôpitaux Universitaires de Strasbourg-Hautepierre, France
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21
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Meyer C, de Manzini N, Rohr S. Prospective randomized comparison of teres cardiopexy and Nissen fundoplication in the surgical therapy of gastro-oesophageal reflux disease. Br J Surg 1994; 81:153-4. [PMID: 8313108 DOI: 10.1002/bjs.1800810170] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/29/2023]
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22
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Meyer C, de Manzini N, Rohr S, Thiry CL, Perim-Kalil FC, Bachellier-Billot C. [1000 cases of cholecystectomy: 500 by laparotomy versus 500 by laparoscopy]. J Chir (Paris) 1993; 130:501-6. [PMID: 8163612] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/29/2023]
Abstract
The authors report 1,000 cases of cholecystectomy for cholelithiasis, excluding all cases with associated common bile duct surgery. The aim of the study was to compare two groups of cholecystectomies, one of 500 laparotomic procedures, evaluated retrospectively, and one of 500 laparoscopic ones, evaluated prospectively. Sex ratio was the same in both groups, and mean age was higher in the second group (54 vs 60) (p < 0.05): acute cholecystitis ratio was similar in both groups (23% vs 19%; NS). During the laparoscopic period, 84 laparotomic interventions were performed (17%), with a 0% mortality and a 18% morbidity rate. Mean operating time was 69' in the first group vs 91' in the second one, with a mean hospital stay of 11 vs 4.5 days (p < 0.001). Mortality rate was 1% vs 0% (p < 0.03) for laparotomic and laparoscopic procedures, and morbidity rate was respectively 11% and 1% (p < 0.001). Conversion rate in laparoscopic surgery was 7%. Two cases (0.4%) in laparoscopic group had a common bile duct lesion diagnosed intraoperatively and 1 case (0.2%) had a residual stone in common bile duct. Laparoscopic surgery is at present the standard technique for the treatment of cholelithiasis and laparotomic cholecystectomy seems only indicated when laparoscopic procedure is contraindicated or impossible.
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Affiliation(s)
- C Meyer
- Service de Chirurgie Générale et Digestive, C.H.U. de Strasbourg-Hautepierre
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23
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Calderoli H, Rohr S, Thiry CL, de Manzini N, Bachellier-Billot C, Meyer C. [The musculocutaneous flap of the latissimus dorsi in the treatment of recurrences of breast cancer]. J Chir (Paris) 1993; 130:374-377. [PMID: 8253887] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/22/2023]
Abstract
Breast cancers local recurrence treatment usually requires a large chirurgical resection. Latissimus dorsi myocutaneous flap was used after mastectomy in 27 patients. This technique was performed in 14 patients who had a recurrence after exclusive radiotherapy treatment. The follow-up of all the patients was more than 5 years. A 42% survival rate has been quoted in this group, after a 11 years period. Latissimus dorsi myocutaneous flap seems to be a satisfactory alternative when performing reconstruction after wall excision under 300 cm2, excepted for recurrence of fast kinetic cancers.
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Affiliation(s)
- H Calderoli
- Service de Chirurgie Générale et Digestive, Hôpital de Hautepierre, Hôpitaux Universitaires de Strasbourg
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24
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Meyer C, Rohr S, de Manzini N, Thiry CL, Hollender LF. [The surgical therapy of liver trauma]. Ann Ital Chir 1992; 63:707-11. [PMID: 1305372] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
Abstract
The different therapeutic patterns of liver trauma are presented; they should be chosen on the basis of both clinical assessment, particularly looking for hemodynamic impairment and associated bowel lesions, and CT scan data. Surgical abstention should be considered for a great number of blunt liver trauma; open or severe blunt trauma should be preferably treated by elective hemostasis and biliostasis, with only rare use of hepatic resection "à la demande", on partially sectioned or devitalized tissues. Cavo-suprahepatic wounds remain the most important technical problem and continue to worse the prognosis in liver trauma.
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Affiliation(s)
- C Meyer
- Service de Chirurgie Générale et Digestive, Chu de Strasbourg-Hautepierre, Strasbourg
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25
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Jaeck D, Pâris F, de Manzini N. [Treatment of liver metastases of rectal cancer]. Ann Ital Chir 1992; 63:317-20. [PMID: 1443997] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
Affiliation(s)
- D Jaeck
- Service de Chirurgie Générale et Endocrinienne, CHU de Strasbourg-Hautepierre, Francia
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26
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Meyer C, Rohr S, de Manzini N, Dai B, Bachellier-Billot C. [Trans-suture mechanical colorectal anastomosis in the treatment of rectal cancer. Apropos of 78 cases]. Ann Ital Chir 1992; 63:287-90. [PMID: 1443992] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
Affiliation(s)
- C Meyer
- Service de Chirurgie Générale et Digestive, CHU de Strasbourg-Hautepierre, Francia
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27
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Vogt F, Rohr S, de Manzini N, Dai B, Meyer C. [Liver injuries]. J Chir (Paris) 1991; 128:522-4. [PMID: 1809753] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
Affiliation(s)
- F Vogt
- Service de Chirurgie Générale et Digestive, C.H.U. Strasbourg Hautepierre
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28
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de Manzini N, Rohr S, Vogt F, Meyer C. [Preparation to laparoscopic cholecystectomy]. Ann Ital Chir 1991; 62:317-8. [PMID: 1837434] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022]
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29
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de Manzini N, Rohr S, Zheng M, Dai B, Meyer C. [Indications and counterindications in laparoscopic cholecystectomy]. Ann Ital Chir 1991; 62:311-5. [PMID: 1837433] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022]
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30
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Hollender LF, de Manzini N. [The development of surgical therapeutic concepts of acute severe pancreatitis]. Bull Acad Natl Med 1989; 173:1083-9; discussion 1089-91. [PMID: 2699265] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/02/2023]
Abstract
The actual surgical concepts concerning the treatment of acute pancreatitis are described. Owing to sonography and above all to computed tomography, constantly compared with clinical data, the surgical decisions can be more easily conducted. In acute pancreatitis of biliary origin, endoscopic sphincterotomy is mandatory in a great number of cases, followed by complete de-obstruction of the common bile duct. That procedure has the advantage of reducing notably mortality and morbidity. In idiopathic pancreatitis, 4 therapeutic behaviours which correspond to 4 different clinical types, are to be faced: --or after 5 to 6 days, division of the left hypochondrium with performing of a meticulous cleaning, followed by a large drainage lavage, --if all reanimation measures have failed, earlier surgery, often of the last chance, consisting in necrosectomy as extended as necessary, --in right away appearing pancreatic phlegmon, a very large drainage, --or, a more expecting attitude in cases in which resorption of the necrotic spots appears to be very slow on CT-Scan, but without any clinical abnormality. Figures support these concepts and prove their warranty.
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Fritsch A, Hollender LF, de Manzini N, Peiper HJ, Trede M. [Comment on the topic: "How do you manage the pancreatic tail in partial duodenopancreatectomy?"]. Langenbecks Arch Chir 1989; 374:189-92. [PMID: 2739488 DOI: 10.1007/bf01261732] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/02/2023]
Affiliation(s)
- A Fritsch
- Chirurgische Klinik und Poliklinik der Technischen Universität, Klinikum rechts der Isar, München 80
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32
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Hollender LF, Bahnini J, de Manzini N. [What are the surgical indications for non-complicated duodenal and gastric ulcers?]. Bull Acad Natl Med 1989; 173:377-85; discussion 385-6. [PMID: 2790526] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/02/2023]
Abstract
Taking into account recent medical progress and on the basis of their own experience, the authors define the up-to-date surgical management of non-complicated duodenal and gastric ulcers. Chronic duodenal ulcers still remain to be submitted to surgery in case of resistance to different types of medical drugs, in case of concomitant disease requiring a specific treatment contraindicated in ulcer disease, in case of patients refusing drugs or developing side-effects, and last, in posteriorly localized or bleeding ulcers. In these situations proximal gastric vagotomy (P.G.V.) still remains the best procedure owing to its low mortality (less than 0.5%) and morbidity rates, and its very satisfactory functional results. The recurrence risk, estimated between 10 to 15%, might burden the long-term results. But in a high percentage of cases it is related to technical inefficiencies. It has to be recalled that only 30% of these patients will undergo reoperation. But it should be emphasized that prepyloric ulcers are a poor indication for P.G.V. and should be submitted to truncular vagotomy with antrectomy. In gastric ulcers, the surgical treatment is mandated whenever endoscopic signs don't disappear under medical treatment or if biopsies remain suspicious. The most satisfying procedure is a gastric resection always involving the lesion and followed by a gastroduodenal anastomosis according to Péan-Billroth I.
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33
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Hollender LF, Meyer C, Bahnini J, de Manzini N. [Current data concerning the treatment of perforated duodenal ulcer]. MINERVA CHIR 1989; 44:197-202. [PMID: 2651980] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/02/2023]
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34
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Bahnini J, de Manzini N, Hollender LF. [Surgery of the left colon]. J Chir (Paris) 1988; 125:744-51. [PMID: 3068241] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/04/2023]
Abstract
Some basic technical principles make the left colon surgery as safe as possible. The authors recall the surgical anatomy and the vascularization of the left colon and describe the technic of a left hemicolectomy, of the Hartmann procedure with restoration of the intestinal continuity and the closure of a lateral colostomy. Mastering these technics should help to face and resolve any urgent or regular pathological pattern of the left colon.
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Affiliation(s)
- J Bahnini
- Service de Chirurgie Digestive et Générale 1, C.H.U. de Strasbourg-Hautepierre, Strasbourg
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35
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Calderoli H, de Manzini N, Keiling R. Role of chemotherapy in acute breast cancer. Analysis of 41 cases. Int Surg 1988; 73:112-5. [PMID: 3397256] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/05/2023] Open
Abstract
Clinical and therapeutic results in a series of 41 patients treated for inflammatory cancer of the breast lend emphasis to the selection criteria to be included in a short (approximately two months) clinical history to complement Haagensen's criteria. Chemotherapy improved the previous very poor results obtained in this condition. Survival after surgery and radiotherapy were less than 5% at five years, and this is compared with the prognosis in the series study. However, these results are still only fair in absolute terms and there is still no currently available alternative solution to attempt to achieve a marked improvement in the course of the lesion.
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Affiliation(s)
- H Calderoli
- Service de Radiothérapie, Faculté de Médecine, CHRU de Strasbourg, France
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36
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Hollender LF, Bahnini J, Meyer C, Karydakis P, de Manzini N. [Long-term recurrence and complications of 300 supra-selective vagotomies for simple chronic duodenal ulcer]. J Chir (Paris) 1987; 124:231-5. [PMID: 3584282] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/06/2023]
Abstract
Three hundred H.S.V. for chronic duodenal ulcer, performed between 1972 and 1982, are reviewed. A thorough analysis of intra and post-operative complications points out that only ulcer recurrence still set problems. These concern their definition, frequency, diagnosis and treatment. The personal experience of the authors leads them, in case of failure of the medical treatment with and endoscopically proved ulcer--what happened in 6 patients of 17 (35,8%)--to prefer gastric resection to re-vagotomies, the performance of which is often difficult and the results uncertain.
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