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Pegoraro F, Santangelo D, Santangelo A, Pelosio L, Jamshidi A, Camera L, Imbriaco M, Mainolfi CG, Insabato L, Accarino R, Giuliano M, Carlomagno N, D'Alessandro V, Santangelo ML. R0 surgical resection of giant dedifferentiated retroperitoneal liposarcomas in the COVID era with and without nephrectomy: A case report. Oncol Lett 2023; 26:410. [PMID: 37600332 PMCID: PMC10436160 DOI: 10.3892/ol.2023.13996] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2023] [Accepted: 06/13/2023] [Indexed: 08/22/2023] Open
Abstract
Retroperitoneal sarcomas (RPSs) are rare findings that can grow into large masses without eliciting severe symptoms. At present, surgical resection is the only radical therapy, whenever it can be performed with the aim to achieve a complete removal of the tumor. The present report describes two consecutive cases of RPSs that resulted in dedifferentiated liposarcomas (DDLPSs) and these patients underwent R0 surgical resection with and without a nephron-sparing procedure. The diagnostic workup, the surgical approach, the impact of late surgical management due to the COVID pandemic and the latest literature on the topic are discussed and analyzed. The patients, who refused to undergo any medical examination during the prior 2 years due to the COVID pandemic, were admitted to Federico II University Hospital (Naples, Italy) complaining about weight loss and general abdominal discomfort. In the first case, a primitive giant abdominal right neoplasm of retroperitoneal origin enveloping and medializing the right kidney was observed. The second patient had a similar primitive retroperitoneal giant left neoplasm, which did not affect the kidney. Given the characteristics of the masses and the absence of distant metastases, after a multidisciplinary discussion, radical surgical removal was carried out for both patients. The lesions appeared well-defined from the surrounding tissues, and markedly compressed all the adjacent organs, without signs of infiltration. In the first patient, the right kidney was surrounded and undetachable from the tumor and it was removed en bloc with the mass. The second patient benefited from a nephron-sparing resection, due to the existence of a clear cleavage plane. The postoperative courses were uneventful. Both the histological examinations were oriented towards a DDLPS and both patients benefited from adjuvant chemotherapy. In conclusion, the treatment of giant RPS is still challenging and requires multidisciplinary treatment as well as, when possible, radical surgical removal. The lack of tissue infiltration and the avoidance of excision or reconstruction of major organs (including the kidney) could lead to an easier postoperative course and an improved prognosis. When possible, surgical management of recurrences or incompletely resected masses must be pursued. Since the COVID pandemic caused limited medicalization of a number of population groups and delayed diagnosis of other oncologic diseases, an increased number of DDLPSs could be expected in the near future.
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Affiliation(s)
- Francesca Pegoraro
- Operative Unit of Hepato-Biliary-Pancreatic, Minimally Invasive and Robotic Surgery and Kidney Transplantation, Department of Clinical Medicine and Surgery, Federico II University Hospital, I-80131 Naples, Italy
| | - Domenico Santangelo
- Department of Radiology, ‘Scientific Hospitalization and Treatment Institute’ San Raffaele Hospital, I-20132 Milano, Italy
| | - Alfonso Santangelo
- Department of General Surgery and Emergency Surgery, ‘Scientific Hospitalization and Treatment Institute’ San Raffaele Hospital, I-20132 Milano, Italy
| | - Luigi Pelosio
- Operative Unit of General Surgery and Retroperitoneal Diseases, Department of Clinical Medicine and Surgery, Federico II University Hospital, I-80131 Naples, Italy
| | - Akbar Jamshidi
- Operative Unit of General Surgery and Retroperitoneal Diseases, Department of Clinical Medicine and Surgery, Federico II University Hospital, I-80131 Naples, Italy
| | - Luigi Camera
- Operative Unit of Diagnostic Imaging and Radiotherapy, Federico II University Hospital, I-80131 Naples, Italy
| | - Massimo Imbriaco
- Operative Unit of Diagnostic Imaging and Radiotherapy, Federico II University Hospital, I-80131 Naples, Italy
| | - Ciro Gabriele Mainolfi
- Operative Unit of Diagnostic Imaging and Radiotherapy, Federico II University Hospital, I-80131 Naples, Italy
| | - Luigi Insabato
- Operative Unit of Pathology, Department of Advanced Biomedical Science, Federico II University Hospital, I-80131 Naples, Italy
| | - Rossella Accarino
- Operative Unit of Pathology, Department of Advanced Biomedical Science, Federico II University Hospital, I-80131 Naples, Italy
| | - Mario Giuliano
- Operative Unit of Medical Oncology, Department of Clinical Medicine and Surgery, Federico II University Hospital, I-80131 Naples, Italy
| | - Nicola Carlomagno
- Operative Unit of General Surgery and Kidney Transplantation, Department of Advanced Biomedical Science, Federico II University Hospital, I-80131 Naples, Italy
| | - Vincenzo D'Alessandro
- Operative Unit of General Surgery and Retroperitoneal Diseases, Department of Clinical Medicine and Surgery, Federico II University Hospital, I-80131 Naples, Italy
| | - Michele L. Santangelo
- Operative Unit of General Surgery and Kidney Transplantation, Department of Advanced Biomedical Science, Federico II University Hospital, I-80131 Naples, Italy
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Tammaro V, Carlomagno N, Santangelo M, Calogero A, Dodaro CA, Vernillo A, Sica A, Peluso G, Campanile S, Sagnelli E, Sagnelli C. One-stage resection of primary colorectal cancer and hepatic metastases using the Habib Device: analysis of 40 consecutive cases treated in a Unit of general surgery. Minerva Med 2022; 113:846-852. [PMID: 32407049 DOI: 10.23736/s0026-4806.20.06613-6] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Abstract
BACKGROUND More than 50% of patients with colorectal cancer (CRC) present or develop hepatic metastases (HM). The intraoperative use of the Habib 4X® radio frequency probe device is safe in resetting HM and allows a one-stage resection of both CRC and HM with a similar mortality rate than a two-stage surgical treatment. METHODS After an exhaustive residential training at the reference center for hepato-biliary surgery of the Imperial College of London, we treated at our unit of general surgery 40 consecutive patients with CRC and HM with the one-stage resection, using the Habib 4X® intraoperative radiofrequency probe device to reset HM. RESULTS None of the 40 patients died during the intra-operatory and post-operatory periods, none presented liver failures during the postoperative course nor complication related to the Habib's resection procedure (e.g. bleeding, abscess, bile leak). The amount of intra-operative liver bleeding was minimal. New HM arose in 10 (25%) cases, with a mean disease-free interval of 13 months, but the hepatic tissue close to previous resections remained cancer-free. The 69.7% of patients were disease-free at month 24 of the post-operative follow-up and 5-year rate was about 70%. CONCLUSIONS The data suggest that surgeons well trained at a reference center for hepato-biliary surgery may perform with excellent results the one-stage CRC and HM resection with the Habib 4X® device even in a Unit of general surgery.
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Affiliation(s)
- Vincenzo Tammaro
- Department of Advanced Biomedical Sciences, University of Naples Federico II, Naples, Italy -
| | - Nicola Carlomagno
- Department of Advanced Biomedical Sciences, University of Naples Federico II, Naples, Italy
| | - Michele Santangelo
- Department of Advanced Biomedical Sciences, University of Naples Federico II, Naples, Italy
| | - Armando Calogero
- Department of Advanced Biomedical Sciences, University of Naples Federico II, Naples, Italy
| | - Concetta A Dodaro
- Department of Advanced Biomedical Sciences, University of Naples Federico II, Naples, Italy
| | - Antonio Vernillo
- Department of Advanced Biomedical Sciences, University of Naples Federico II, Naples, Italy
| | - Antonello Sica
- Department of Precision Medicine, Luigi Vanvitelli University of Campania, Naples, Italy
| | - Gaia Peluso
- Department of Advanced Biomedical Sciences, University of Naples Federico II, Naples, Italy
| | - Silvia Campanile
- Department of Advanced Biomedical Sciences, University of Naples Federico II, Naples, Italy
| | - Evangelista Sagnelli
- Department of Mental Health and Public Medicine, Luigi Vanvitelli University of Campania, Naples, Italy
| | - Caterina Sagnelli
- Department of Mental Health and Public Medicine, Luigi Vanvitelli University of Campania, Naples, Italy
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Longo N, Calogero A, Creta M, Celentano G, Napolitano L, Capece M, La Rocca R, Sagnelli C, Carlomagno N, Peluso G, Pagano T, Campanile S, Dodaro CA, Sica A, Califano G, Crocetto F, Fusco F, Mangiapia F, Santangelo M. Outcomes of Renal Stone Surgery Performed Either as Predonation or Ex Vivo Bench Procedure in Renal Grafts from Living Donors: A Systematic Review. Biomed Res Int 2020; 2020:6625882. [PMID: 33335926 PMCID: PMC7723480 DOI: 10.1155/2020/6625882] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/23/2020] [Revised: 11/15/2020] [Accepted: 11/18/2020] [Indexed: 12/26/2022]
Abstract
AIMS We aimed to summarize available evidence about intraoperative and postoperative donors' and recipients' outcomes following stone surgery in renal grafts from living donors performed either before donation or as ex vivo bench surgery at the time of living-donor nephrectomy. METHODS A systematic review of PubMed, ISI Web of Knowledge, and Scopus databases was performed in September 2020. We included full papers that met the following criteria: original research, English language, human studies, and describing the results of stone surgery in renal grafts from living donors performed either before transplantation or as ex vivo bench surgery. RESULTS We identified 11 studies involving 106 patients aged between 22 and 72 years. Predonation and bench stone surgery was performed in 9 (8.5%) and 96 (90.6%) patients, respectively. Predonation stone surgery involved extracorporeal shock wave lithotripsy, retrograde intrarenal surgery, and percutaneous nephrolithotomy in 8, 1, and 1 patient, respectively. The overall success rate of predonation stone surgery was 78%, and the complication rate was 0%. Bench stone surgery involved ureteroscopy, pyelolithotomy, or a combination of both in 79 (82.3%), 10 (10.4%), and 7 (7.3%) cases, respectively, with an overall success rate of 95.8% and an overall complication rate of 9.37%. CONCLUSIONS Predonation and bench stone surgery in grafts from living donors represents efficacious and safe procedures. Further studies on wider series with a longer follow-up are required.
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Affiliation(s)
- Nicola Longo
- Department of Neurosciences, Reproductive Sciences and Odontostomatology, University of Naples Federico II, 80131 Naples, Italy
| | - Armando Calogero
- Department of Advanced Biomedical Sciences, University of Naples Federico II, 80131 Naples, Italy
| | - Massimiliano Creta
- Department of Neurosciences, Reproductive Sciences and Odontostomatology, University of Naples Federico II, 80131 Naples, Italy
| | - Giuseppe Celentano
- Department of Neurosciences, Reproductive Sciences and Odontostomatology, University of Naples Federico II, 80131 Naples, Italy
| | - Luigi Napolitano
- Department of Neurosciences, Reproductive Sciences and Odontostomatology, University of Naples Federico II, 80131 Naples, Italy
| | - Marco Capece
- Department of Neurosciences, Reproductive Sciences and Odontostomatology, University of Naples Federico II, 80131 Naples, Italy
| | - Roberto La Rocca
- Department of Neurosciences, Reproductive Sciences and Odontostomatology, University of Naples Federico II, 80131 Naples, Italy
| | - Caterina Sagnelli
- Department of Mental Health and Public Medicine, University of Campania Luigi Vanvitelli, 80131 Naples, Italy
| | - Nicola Carlomagno
- Department of Advanced Biomedical Sciences, University of Naples Federico II, 80131 Naples, Italy
| | - Gaia Peluso
- Department of Advanced Biomedical Sciences, University of Naples Federico II, 80131 Naples, Italy
| | - Teresa Pagano
- Department of Advanced Biomedical Sciences, University of Naples Federico II, 80131 Naples, Italy
| | - Silvia Campanile
- Department of Advanced Biomedical Sciences, University of Naples Federico II, 80131 Naples, Italy
| | - Concetta Anna Dodaro
- Department of Advanced Biomedical Sciences, University of Naples Federico II, 80131 Naples, Italy
| | - Antonello Sica
- Department of Precision Medicine, University of Campania Luigi Vanvitelli, 80131 Naples, Italy
| | - Gianluigi Califano
- Department of Neurosciences, Reproductive Sciences and Odontostomatology, University of Naples Federico II, 80131 Naples, Italy
| | - Felice Crocetto
- Department of Neurosciences, Reproductive Sciences and Odontostomatology, University of Naples Federico II, 80131 Naples, Italy
| | - Ferdinando Fusco
- Department of Woman, Child and General and Specialized Surgery, Urology Unit, University of Campania Luigi Vanvitelli, Naples, Italy
| | - Francesco Mangiapia
- Department of Neurosciences, Reproductive Sciences and Odontostomatology, University of Naples Federico II, 80131 Naples, Italy
| | - Michele Santangelo
- Department of Advanced Biomedical Sciences, University of Naples Federico II, 80131 Naples, Italy
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Calogero A, Gallo M, Sica A, Peluso G, Scotti A, Tammaro V, Carrano R, Federico S, Lionetti R, Amato M, Carlomagno N, Dodaro CA, Sagnelli C, Santangelo M. Gastroenterological complications in kidney transplant patients. Open Med (Wars) 2020; 15:623-634. [PMID: 33336019 PMCID: PMC7712021 DOI: 10.1515/med-2020-0130] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/22/2019] [Revised: 02/23/2020] [Accepted: 04/01/2020] [Indexed: 12/14/2022] Open
Abstract
Kidney transplantation is the surgical operation by which one of the two original kidneys is replaced with another healthy one donated by a compatible individual. In most cases, donors are recently deceased. There is the possibility of withdrawing a kidney from a consenting living subject. Usually, living donors are direct family members, but they could be volunteers completely unrelated to the recipient. A much-feared complication in case of kidney transplantation is the appearance of infections. These tend to arise due to immune-suppressor drugs administered as anti-rejection therapy. In this review, we describe the gastrointestinal complications that can occur in subjects undergoing renal transplantation associated with secondary pathogenic microorganisms or due to mechanical injury during surgery or to metabolic or organic toxicity correlated to anti-rejection therapy. Some of these complications may compromise the quality of life or pose a significant risk of mortality; fortunately, many of them can be prevented and treated without the stopping the immunosuppression, thus avoiding the patient being exposed to the risk of rejection episodes.
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Affiliation(s)
- Armando Calogero
- Department of Advanced Biomedical Sciences, University of Naples Federico II, Naples, Italy
| | - Monica Gallo
- Department of Molecular Medicine and Medical Biotechnology, University of Naples Federico II, Naples, Italy
| | - Antonello Sica
- Department of Precision Medicine, University of Campania Luigi Vanvitelli, Naples, Italy
| | - Gaia Peluso
- Department of Advanced Biomedical Sciences, University of Naples Federico II, Naples, Italy
| | - Alessandro Scotti
- Department of Advanced Biomedical Sciences, University of Naples Federico II, Naples, Italy
| | - Vincenzo Tammaro
- Department of Advanced Biomedical Sciences, University of Naples Federico II, Naples, Italy
| | - Rosa Carrano
- Department of Public Health, University of Naples Federico II, Naples, Italy
| | - Stefano Federico
- Department of Public Health, University of Naples Federico II, Naples, Italy
| | - Ruggero Lionetti
- Department of Public Health, University of Naples Federico II, Naples, Italy
| | - Maurizio Amato
- Department of Clinical Medicine and Surgery, University Federico II, Naples, Italy
| | - Nicola Carlomagno
- Department of Advanced Biomedical Sciences, University of Naples Federico II, Naples, Italy
| | - Concetta Anna Dodaro
- Department of Advanced Biomedical Sciences, University of Naples Federico II, Naples, Italy
| | - Caterina Sagnelli
- Department of Mental Health and Public Medicine, University of Campania Luigi Vanvitelli, Naples, Italy
| | - Michele Santangelo
- Department of Advanced Biomedical Sciences, University of Naples Federico II, Naples, Italy
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Calogero A, Sagnelli C, Peluso G, Sica A, Candida M, Campanile S, Minieri G, Incollingo P, Creta M, Pelosio L, Tammaro V, Scotti A, Jamshidi A, Caggiano M, Sagnelli E, Dodaro CA, Carlomagno N, Santangelo M. Physical activity in elderly kidney transplant patients with multiple renal arteries. Minerva Med 2020; 113:119-127. [PMID: 32338484 DOI: 10.23736/s0026-4806.20.06573-8] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
INTRODUCTION Kidney transplantation (KT) is the gold standard for treatment of patients with end- stage-renal disease. To expand the donor reserve, it is necessary to use marginal/suboptimal kidneys. METHODS We retrospectively evaluated the short/long-term outcome of 34 KT elderly patients who received allografts with vascular abnormalities (MRA group), in comparison with 34 KT patients who received a kidney with a single renal artery (SRA group) pair-matched by age, length of time on dialysis, comorbidity and donor age. RESULTS All participants completed the International Physical Activity Questionnaire at KT, and then 4, 8, and 12 weeks after transplantation. Our data indicate that kidney with vascular anatomical variants may be successfully transplanted, since the overall rate of surgical complications was 20.6% in the SRA group and 17.6% in the MRA group and that the 5-year survival rate after KT was 100% in both groups. CONCLUSIONS The data also underline that individualized physical activity programs induced similar excellent results in both groups, improving physical capacities, arterial pressure, lipid metabolism, insulin sensitivity, quality of life and physical and mental status.
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Affiliation(s)
- Armando Calogero
- General Surgery and Transplant Unit, Department of Advanced Biomedical Sciences, University of Naples Federico II, Naples, Italy.,Department of Nephrology, Urology, General Surgery and Kidney Transplants, Anesthesiology and Intensive Care, University Federico II, Naples, Italy
| | - Caterina Sagnelli
- Department of Mental Health and Public Medicine, University of Campania Luigi Vanvitelli, Naples, Italy
| | - Gaia Peluso
- General Surgery and Transplant Unit, Department of Advanced Biomedical Sciences, University of Naples Federico II, Naples, Italy
| | - Antonello Sica
- Department of Precision Medicine, University of Campania Luigi Vanvitelli, Naples, Italy
| | - Maria Candida
- General Surgery and Transplant Unit, Department of Advanced Biomedical Sciences, University of Naples Federico II, Naples, Italy
| | - Silvia Campanile
- General Surgery and Transplant Unit, Department of Advanced Biomedical Sciences, University of Naples Federico II, Naples, Italy
| | - Gianluca Minieri
- General Surgery and Transplant Unit, Department of Advanced Biomedical Sciences, University of Naples Federico II, Naples, Italy
| | - Paola Incollingo
- General Surgery and Transplant Unit, Department of Advanced Biomedical Sciences, University of Naples Federico II, Naples, Italy
| | - Massimiliano Creta
- Department of Nephrology, Urology, General Surgery and Kidney Transplants, Anesthesiology and Intensive Care, University Federico II, Naples, Italy
| | - Luigi Pelosio
- General Surgery and Transplant Unit, Department of Advanced Biomedical Sciences, University of Naples Federico II, Naples, Italy
| | - Vincenzo Tammaro
- General Surgery and Transplant Unit, Department of Advanced Biomedical Sciences, University of Naples Federico II, Naples, Italy
| | - Alessandro Scotti
- General Surgery and Transplant Unit, Department of Advanced Biomedical Sciences, University of Naples Federico II, Naples, Italy
| | - Akbar Jamshidi
- General Surgery and Transplant Unit, Department of Advanced Biomedical Sciences, University of Naples Federico II, Naples, Italy
| | - Marcello Caggiano
- General Surgery and Transplant Unit, Department of Advanced Biomedical Sciences, University of Naples Federico II, Naples, Italy
| | - Evangelista Sagnelli
- Department of Precision Medicine, University of Campania Luigi Vanvitelli, Naples, Italy -
| | - Concetta A Dodaro
- General Surgery and Transplant Unit, Department of Advanced Biomedical Sciences, University of Naples Federico II, Naples, Italy.,Department of Nephrology, Urology, General Surgery and Kidney Transplants, Anesthesiology and Intensive Care, University Federico II, Naples, Italy
| | - Nicola Carlomagno
- General Surgery and Transplant Unit, Department of Advanced Biomedical Sciences, University of Naples Federico II, Naples, Italy
| | - Michele Santangelo
- General Surgery and Transplant Unit, Department of Advanced Biomedical Sciences, University of Naples Federico II, Naples, Italy.,Department of Nephrology, Urology, General Surgery and Kidney Transplants, Anesthesiology and Intensive Care, University Federico II, Naples, Italy
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Peluso G, Incollingo P, Campanile S, Menkulazi M, Scotti A, Tammaro V, Calogero A, Dodaro C, Carlomagno N, Santangelo ML. Relation Between Wound Complication and Lymphocele After Kidney Transplantation: A Monocentric Study. Transplant Proc 2020; 52:1562-1565. [PMID: 32299707 DOI: 10.1016/j.transproceed.2020.02.053] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2020] [Accepted: 02/05/2020] [Indexed: 12/22/2022]
Abstract
INTRODUCTION Wound complication frequently arises after kidney transplantation and its risk factors are well known. In a previous paper we analyzed these factors, and in this new retrospective study we evaluate the influence of lymphocele in the development of wound complications. PATIENTS AND METHODS From January 2000 to December 2018, 731 consecutive kidney transplants have been performed in our center. We have analyzed the incidence of wound complication and lymphocele and their risk factors. RESULTS Out of 731 kidney transplants, we have observed wound complications in 115 patients (15.7%) and lymphocele in 158 patients (21.7%). Of these, 70 patients developed both complications (9.5%), but 6 patients have been excluded because they were in therapy with mammalian target of rapamycin inhibitors. Twenty-nine patients (45.3%) presented a first level and 35 patients (54.7%) showed second level wound complications. Lymphocele was the only present factor in just 3 cases (4.6%). The other patients showed diabetes in 28 cases (43.7%), overweight/obesity in 38 (59.3%), delayed graft function in 17 (26.5%), and 60 years or more in 38 (57.8%). The association has been found in 30 out 64 patients treated with tacrolimus (46.8%) and in 34 with cyclosporine (53.1%); 40 patients did not receive muscular layer's reconstruction (62.5%). CONCLUSION Our experience shows that lymphocele alone is not a predisposing factor for wound dehiscence after kidney transplantation, and they often coexist because they share the same risk factors, the most important being obesity, diabetes and delayed graft function, older age, and surgical techniques. No relation has been observed with calcineurin inhibitor therapy.
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Affiliation(s)
- Gaia Peluso
- Operative Unit of General Surgery and Kidney Transplantation - Advanced Biomedical Science Department - University Federico II of Naples, Naples, Italy
| | - Paola Incollingo
- Operative Unit of General Surgery and Kidney Transplantation - Advanced Biomedical Science Department - University Federico II of Naples, Naples, Italy
| | - Silvia Campanile
- Operative Unit of General Surgery and Kidney Transplantation - Advanced Biomedical Science Department - University Federico II of Naples, Naples, Italy.
| | - Marsela Menkulazi
- Operative Unit of General Surgery and Kidney Transplantation - Advanced Biomedical Science Department - University Federico II of Naples, Naples, Italy
| | - Alessandro Scotti
- Operative Unit of General Surgery and Kidney Transplantation - Advanced Biomedical Science Department - University Federico II of Naples, Naples, Italy
| | - Vincenzo Tammaro
- Operative Unit of General Surgery and Kidney Transplantation - Advanced Biomedical Science Department - University Federico II of Naples, Naples, Italy
| | - Armando Calogero
- Operative Unit of General Surgery and Kidney Transplantation - Advanced Biomedical Science Department - University Federico II of Naples, Naples, Italy
| | - Concetta Dodaro
- Operative Unit of General Surgery and Kidney Transplantation - Advanced Biomedical Science Department - University Federico II of Naples, Naples, Italy
| | - Nicola Carlomagno
- Operative Unit of General Surgery and Kidney Transplantation - Advanced Biomedical Science Department - University Federico II of Naples, Naples, Italy
| | - Michele L Santangelo
- Operative Unit of General Surgery and Kidney Transplantation - Advanced Biomedical Science Department - University Federico II of Naples, Naples, Italy
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Galatola R, Stanzione A, Sirignano C, Mainolfi C, Guadagno E, Carlomagno N, Insabato L, Santangelo M, Maurea S. Giant Epithelioid Angiomyolipoma: An Imaging-related Differential Diagnosis Among Fat-containing Renal Masses. Clin Genitourin Cancer 2019; 18:e5-e9. [PMID: 31786119 DOI: 10.1016/j.clgc.2019.10.028] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2019] [Accepted: 10/28/2019] [Indexed: 11/25/2022]
Affiliation(s)
- Roberta Galatola
- Department of Advanced Biomedical Sciences, University of Naples "Federico II", Naples, Italy
| | - Arnaldo Stanzione
- Department of Advanced Biomedical Sciences, University of Naples "Federico II", Naples, Italy.
| | - Cesare Sirignano
- Istituto di Biostrutture e Bioimmagini, Consiglio Nazionale delle Ricerche, Naples, Italy
| | - Ciro Mainolfi
- Department of Advanced Biomedical Sciences, University of Naples "Federico II", Naples, Italy
| | - Elia Guadagno
- Department of Advanced Biomedical Sciences, University of Naples "Federico II", Naples, Italy
| | - Nicola Carlomagno
- Department of Advanced Biomedical Sciences, University of Naples "Federico II", Naples, Italy
| | - Luigi Insabato
- Department of Advanced Biomedical Sciences, University of Naples "Federico II", Naples, Italy
| | - Michele Santangelo
- Department of Advanced Biomedical Sciences, University of Naples "Federico II", Naples, Italy
| | - Simone Maurea
- Department of Advanced Biomedical Sciences, University of Naples "Federico II", Naples, Italy
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Calogero A, Sagnelli C, Carlomagno N, Tammaro V, Candida M, Vernillo A, Peluso G, Minieri G, Santangelo M, Dodaro CA. Familial Polyposis Coli: The Management of Desmoid Tumor Bleeding. Open Med (Wars) 2019; 14:572-576. [PMID: 31410368 PMCID: PMC6689203 DOI: 10.1515/med-2019-0064] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2019] [Accepted: 06/12/2019] [Indexed: 12/12/2022] Open
Abstract
Background There is currently no standard treatment for desmoid tumors (DTs) associated with familial polyposis coli (FAP). Familial adenomatous polyposis in DT patients is sometimes a life-threatening condition. Methods We enrolled all consecutive patients with FAP treated at Unit of General Surgery and Transplant, University of Naples Federico II and evaluated the incidence of DTs on FAP between 1996 and 2016. Results We observed 45 consecutive patients with FAP; of these 5 were DT-FAP-associated. All 5 cases with FAP were young women, age 25 to 65 years, previously treated by colectomy. Of these, 4 patients presented a parietal localization and had been treated with a wide surgical exeresis; one patient had an intra-abdominal, mesenteric tumor that was unresectable at laparotomy. We performed CT-guided drainage, ureteral stenting, medical therapy (sulindac+tamoxifene), and chemotherapy (dacarba-zine+doxorubicine).All patients were alive and underwent follow-ups for 5 years post-surgery; only 1 patient with parietal localization showed a local relapse after 2 years. Conclusions We propose a modulated approach to the single patient with FAP, with surgery as treatment of choice for parietal localization disease and integrating different kinds of therapies (surgery alone or associated with RT, CT) for the intra-abdominal tumor.
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Affiliation(s)
- Armando Calogero
- General Surgery and Transplant Unit, Department of Advanced Biomedical Sciences, University of Naples Federico II, via S. Pansini, 80131 Naples, Italy
| | - Caterina Sagnelli
- Department of Mental Health and Public Medicine, University of Campania Luigi Vanvitelli, Naples, Italy
| | - Nicola Carlomagno
- General Surgery and Transplant Unit, Department of Advanced Biomedical Sciences, University of Naples Federico II, via S. Pansini, 80131 Naples, Italy
| | - Vincenzo Tammaro
- General Surgery and Transplant Unit, Department of Advanced Biomedical Sciences, University of Naples Federico II, via S. Pansini, 80131 Naples, Italy
| | - Maria Candida
- General Surgery and Transplant Unit, Department of Advanced Biomedical Sciences, University of Naples Federico II, via S. Pansini, 80131 Naples, Italy
| | - Antonio Vernillo
- General Surgery and Transplant Unit, Department of Advanced Biomedical Sciences, University of Naples Federico II, via S. Pansini, 80131 Naples, Italy
| | - Gaia Peluso
- General Surgery and Transplant Unit, Department of Advanced Biomedical Sciences, University of Naples Federico II, via S. Pansini, 80131 Naples, Italy
| | - Gianluca Minieri
- General Surgery and Transplant Unit, Department of Advanced Biomedical Sciences, University of Naples Federico II, via S. Pansini, 80131 Naples, Italy
| | - Michele Santangelo
- General Surgery and Transplant Unit, Department of Advanced Biomedical Sciences, University of Naples Federico II, via S. Pansini, 80131 Naples, Italy
| | - Concetta Anna Dodaro
- General Surgery and Transplant Unit, Department of Advanced Biomedical Sciences, University of Naples Federico II, via S. Pansini, 80131 Naples, Italy
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9
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Palumbo G, De Vita E, Schena E, Massaroni C, Verze P, Carlomagno N, Tammaro V, La Rocca R, Ippolito J, Tosi D, Saccomandi P, Caponero MA, Iadicicco A, Campopiano S. Multidimensional thermal mapping during radiofrequency ablation treatments with minimally invasive fiber optic sensors. Biomed Opt Express 2018; 9:5891-5902. [PMID: 31065401 PMCID: PMC6491021 DOI: 10.1364/boe.9.005891] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/30/2018] [Revised: 09/06/2018] [Accepted: 09/17/2018] [Indexed: 06/09/2023]
Abstract
Temperature mapping is a key asset in supporting the clinician during thermal ablation (TA) treatment of tumors without adding additional risk to the TA procedure. Herein we report our experiments on multidimensional thermal mapping during radio frequency (RF) thermal ablation treatments of an ex-vivo animal organ. The temperature was monitored using several arrays of fiber Bragg gratings properly positioned around the RF applicator. The results show the effectiveness of our proposed method at assessing the TA probe depth and demonstrating how the insertion depth directly influences the maximum temperature and the treated area of the radio frequency ablation.
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Affiliation(s)
- Giovanna Palumbo
- Dept. of Engineering, University of Naples “Parthenope”, Naples, Italy
| | - Elena De Vita
- Dept. of Engineering, University of Naples “Parthenope”, Naples, Italy
- Università Campus Bio-Medico di Roma, Rome, Italy
| | | | | | - Paolo Verze
- Dept. of Urology and Dept. of General Surgery University of Naples “Federico II” Naples, Italy
| | - Nicola Carlomagno
- Dept. of Urology and Dept. of General Surgery University of Naples “Federico II” Naples, Italy
| | - Vincenzo Tammaro
- Dept. of Urology and Dept. of General Surgery University of Naples “Federico II” Naples, Italy
| | - Roberto La Rocca
- Dept. of Urology and Dept. of General Surgery University of Naples “Federico II” Naples, Italy
| | - Juliet Ippolito
- Dept. of Urology and Dept. of General Surgery University of Naples “Federico II” Naples, Italy
| | - Daniele Tosi
- Dept. of Electronic and Computer Engineering, Nazarbayev University, 010000 Astana, Kazakhstan
- National Laboratory Astana, Lab. of Biosensors and Bioinstruments, 010000 Astana, Kazakhstan
| | | | - Michele Arturo Caponero
- Photonics Micro- and Nanostructures Laboratory, Research Center of Frascati-ENEA, Frascati, Rome, Italy
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10
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Peluso G, Incollingo P, Carlomagno N, D'Alessandro V, Tammaro V, Caggiano M, Sandoval Sotelo ML, Rupealta N, Candida M, Mazzoni G, Campanile S, Chiacchio G, Scotti A, Santangelo ML. Our Timing to Remove Peritoneal Catheter Dialysis After Kidney Transplant. Transplant Proc 2018; 51:160-163. [PMID: 30655154 DOI: 10.1016/j.transproceed.2018.04.075] [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] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/10/2018] [Accepted: 04/13/2018] [Indexed: 11/18/2022]
Abstract
BACKGROUND Patients on peritoneal dialysis treatment represent 15% of the global dialysis population. The major complication of peritoneal dialysis is catheter and peritoneal infection. Peritoneal dialysis patients who receive kidney transplants are at increased risk of infection because of immunosuppressive therapy. AIM The purpose of this study is to show our ideal timing to remove peritoneal catheter after kidney transplant, which gives adequate security on renal function recovery and reduction of septic risk. METHOD OF STUDY We analyzed the outcomes of 65 patients on peritoneal dialysis who underwent kidney transplant between 2000 and 2016. RESULTS In 61 cases there was an immediate graft functional recovery. In 4 cases there was a delayed graft function (DGF), and we performed a hemodialysis with temporary placement of a venous catheter. In all patients we removed peritoneal dialysis catheter 30 to 45 days after transplant. There has been 1 case of catheter infection, which was treated with antibiotic therapy. DISCUSSION Our average time to remove the peritoneal dialysis catheter was shorter than times in previous studies, between the 30th and 45th postoperative day. In the 4 cases in which there has been a DGF, we performed hemodialysis treatment to avoid, in the immediate postoperative period, direct insults to the peritoneum by local dialysis procedures. CONCLUSION Our experience show that the 30th to 45th postoperative day is a good time frame, better yet a good watershed between the safe removal of peritoneal catheter when patients have a stabilized renal function and the possibility of leaving it in situ, to resume peritoneal dialysis in case of persistent DGF.
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Affiliation(s)
- G Peluso
- Operative Unit of General Surgery and Kidney Transplantation, Advanced Biomedical Science Department, University Federico II of Naples, Naples, Italy.
| | - P Incollingo
- Operative Unit of General Surgery and Kidney Transplantation, Advanced Biomedical Science Department, University Federico II of Naples, Naples, Italy
| | - N Carlomagno
- Operative Unit of General Surgery and Kidney Transplantation, Advanced Biomedical Science Department, University Federico II of Naples, Naples, Italy
| | - V D'Alessandro
- Kidney Transplantation Center and Retroperitoneal Surgery, University Hospital Federico II of Naples, Naples, Italy
| | - V Tammaro
- Operative Unit of General Surgery and Kidney Transplantation, Advanced Biomedical Science Department, University Federico II of Naples, Naples, Italy
| | - M Caggiano
- Operative Unit of General Surgery and Kidney Transplantation, Advanced Biomedical Science Department, University Federico II of Naples, Naples, Italy
| | - M L Sandoval Sotelo
- Operative Unit of General Surgery and Kidney Transplantation, Advanced Biomedical Science Department, University Federico II of Naples, Naples, Italy
| | - N Rupealta
- Operative Unit of General Surgery and Kidney Transplantation, Advanced Biomedical Science Department, University Federico II of Naples, Naples, Italy
| | - M Candida
- Operative Unit of General Surgery and Kidney Transplantation, Advanced Biomedical Science Department, University Federico II of Naples, Naples, Italy
| | - G Mazzoni
- Operative Unit of General Surgery and Kidney Transplantation, Advanced Biomedical Science Department, University Federico II of Naples, Naples, Italy
| | - S Campanile
- Operative Unit of General Surgery and Kidney Transplantation, Advanced Biomedical Science Department, University Federico II of Naples, Naples, Italy
| | - G Chiacchio
- Operative Unit of General Surgery and Kidney Transplantation, Advanced Biomedical Science Department, University Federico II of Naples, Naples, Italy
| | - A Scotti
- Operative Unit of General Surgery and Kidney Transplantation, Advanced Biomedical Science Department, University Federico II of Naples, Naples, Italy
| | - M L Santangelo
- Operative Unit of General Surgery and Kidney Transplantation, Advanced Biomedical Science Department, University Federico II of Naples, Naples, Italy
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11
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Liccardo R, De Rosa M, Rossi GB, Carlomagno N, Izzo P, Duraturo F. Incomplete Segregation of MSH6 Frameshift Variants with Phenotype of Lynch Syndrome. Int J Mol Sci 2017; 18:ijms18050999. [PMID: 28481244 PMCID: PMC5454912 DOI: 10.3390/ijms18050999] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2017] [Revised: 04/21/2017] [Accepted: 05/02/2017] [Indexed: 12/23/2022] Open
Abstract
Lynch syndrome (LS), the most frequent form of hereditary colorectal cancer, involves mutations in mismatch repair genes. The aim of this study was to identify mutations in MSH6 from 97 subjects negative for mutations in MLH1 and MSH2. By direct sequencing, we identified 27 MSH6 variants, of which, nine were novel. To verify the pathogenicity of these novel variants, we performed in silico and segregation analyses. Three novel variants were predicted by in silico analysis as damaging mutations and segregated with the disease phenotype; while a novel frameshift deletion variant that was predicted to yield a premature stop codon did not segregate with the LS phenotype in three of four cases in the family. Interestingly, another frame-shift variant identified in this study, already described in the literature, also did not segregate with the LS phenotype in one of two affected subjects in the family. In all affected subjects of both families, no mutation was detected in other MMR genes. Therefore, it is expected that within these families, other genetic factors contribute to the disease either alone or in combination with MSH6 variants. We conclude that caution should be exercised in counseling for MSH6-associated LS family members.
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Affiliation(s)
- Raffaella Liccardo
- Department of Molecular Medicine and Medical Biotechnology, Federico II University Medical School, 80131 Naples, Italy.
| | - Marina De Rosa
- Department of Molecular Medicine and Medical Biotechnology, Federico II University Medical School, 80131 Naples, Italy.
| | - Giovanni Battista Rossi
- Endoscopy Unit, Fondazione Pascale National Institute for Study and Care of Tumors, 80131 Naples, Italy.
| | - Nicola Carlomagno
- General Surgery Unit-Advanced Biomedical Science Department, Federico II University Medical School, 80131 Naples, Italy.
| | - Paola Izzo
- Department of Molecular Medicine and Medical Biotechnology, Federico II University Medical School, 80131 Naples, Italy.
- CEINGE-Biotecnologie Avanzate, 80145 Naples, Italy.
| | - Francesca Duraturo
- Department of Molecular Medicine and Medical Biotechnology, Federico II University Medical School, 80131 Naples, Italy.
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12
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Santangelo ML, Grifasi C, Criscitiello C, Giuliano M, Calogero A, Dodaro C, Incollingo P, Rupealta N, Candida M, Chiacchio G, Riccio E, Pisani A, Tammaro V, Carlomagno N. Bowel obstruction and peritoneal carcinomatosis in the elderly. A systematic review. Aging Clin Exp Res 2017; 29:73-78. [PMID: 27837464 DOI: 10.1007/s40520-016-0656-9] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2016] [Accepted: 10/12/2016] [Indexed: 01/30/2023]
Abstract
BACKGROUND There are not guidelines for surgical management of malignant bowel obstruction (MBO) caused by peritoneal carcinomatosis (PC), mainly when it involves elderly; so its treatment is still debated. AIM To outline indications and benefits of palliative surgery for obstructive carcinomatosis and determine what prognostic factors, including age, have independent and significant association with outcome. METHODS We conducted English-language MEDLINE and EMBASE searches of articles published between 1998 and 2016, which reported outcome data after palliative surgery for MBO due to PC. We excluded all articles lacking of surgical cohort and those with main interest in conservative treatment. Of 1275 articles identified, 12 satisfied selection criteria and were included in our analysis. RESULTS Overall, these studies involved 548 patients undergoing palliative surgery for MBO caused by PC. The median age was 58 (range 19-93). Relief of symptoms was achieved in 26.5-100% of cases. Postoperative morbidity ranged between 7 and 44%. Mortality was high (6-22%). The median survival was longer in surgical patients than in those receiving conservative therapy (8-34 vs 4-5 weeks). Factors associated with surgery failure were poor performance status, diffuse carcinomatosis, previous radiotherapy, and obstruction of small bowel. Old age was significantly associated with a poor prognosis upon univariate analysis, while this association vanished upon multivariate analysis. CONCLUSIONS Surgical palliation can provide relief of obstructive symptoms as well as improved survival in well-selected patients, even if elderly.
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Affiliation(s)
- Michele L Santangelo
- Abdominal Surgery and Transplantation, Department of Advanced Biomedical Sciences, University Federico II, via Pansini 5, 80131, Naples, Italy.
| | - Carlo Grifasi
- Abdominal Surgery, Department of Advanced Biomedical Sciences, University Federico II, Naples, Italy
| | - Carmen Criscitiello
- Division of Experimental Cancer Medicine, European Institute of Oncology, Milan, Italy
| | - Mario Giuliano
- Department of Clinical Medicine and Surgery, University Federico II, Naples, Italy
- Cancer Center, Baylor College of Medicine, Houston, TX, USA
| | - Armando Calogero
- Abdominal Surgery, Department of Advanced Biomedical Sciences, University Federico II, Naples, Italy
| | - Concetta Dodaro
- Emergency Surgery, Department of Advanced Biomedical Sciences, University Federico II, Naples, Italy
| | - Paola Incollingo
- Abdominal Surgery and Transplantation, Department of Advanced Biomedical Sciences, University Federico II, via Pansini 5, 80131, Naples, Italy
| | - Niccolò Rupealta
- Abdominal Surgery and Transplantation, Department of Advanced Biomedical Sciences, University Federico II, via Pansini 5, 80131, Naples, Italy
| | - Maria Candida
- Abdominal Surgery, Department of Advanced Biomedical Sciences, University Federico II, Naples, Italy
| | - Gaetano Chiacchio
- Abdominal Surgery, Department of Advanced Biomedical Sciences, University Federico II, Naples, Italy
| | - Eleonora Riccio
- Department of Public Health, University Federico II, Naples, Italy
| | - Antonio Pisani
- Department of Public Health, University Federico II, Naples, Italy
| | - Vincenzo Tammaro
- Abdominal Surgery and Transplantation, Department of Advanced Biomedical Sciences, University Federico II, via Pansini 5, 80131, Naples, Italy
| | - Nicola Carlomagno
- Abdominal Surgery, Department of Advanced Biomedical Sciences, University Federico II, Naples, Italy
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13
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Nardelli C, Iaffaldano L, Pilone V, Labruna G, Ferrigno M, Carlomagno N, Dodaro CA, Forestieri P, Buono P, Salvatore F, Sacchetti L. Changes in the MicroRNA Profile Observed in the Subcutaneous Adipose Tissue of Obese Patients after Laparoscopic Adjustable Gastric Banding. J Obes 2017; 2017:6754734. [PMID: 28386478 PMCID: PMC5366784 DOI: 10.1155/2017/6754734] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/28/2016] [Revised: 02/17/2017] [Accepted: 02/23/2017] [Indexed: 12/29/2022] Open
Abstract
Background. Laparoscopic adjustable gastric banding (LAGB) results in significant lasting weight loss and improved metabolism in obese patients. To evaluate whether epigenetic factors could concur to these benefits, we investigated the subcutaneous adipose tissue (SAT) microRNA (miRNA) profile before (T0) and three years (T1) after LAGB in three morbidly obese women. Case Reports. SAT miRNA profiling, evaluated by TaqMan Array, showed four downexpressed (miR-519d, miR-299-5p, miR-212, and miR-671-3p) and two upexpressed (miR-370 and miR-487a) miRNAs at T1 versus T0. Bioinformatics predicted that these miRNAs regulate genes belonging to pathways associated with the cytoskeleton, inflammation, and metabolism. Western blot analysis showed that PPAR-alpha, which is the target gene of miR-519d, increased after LAGB, thereby suggesting an improvement in SAT lipid metabolism. Accordingly, the number and diameter of adipocytes were significantly higher and lower, respectively, at T1 versus T0. Bioinformatics predicted that the decreased levels of miR-212, miR-299-5p, and miR-671-3p at T1 concur in reducing SAT inflammation. Conclusion. We show that the miRNA profile changes after LAGB. This finding, although obtained in only three cases, suggests that this epigenetic mechanism, by regulating the expression of genes involved in inflammation and lipid metabolism, could concur to improve SAT functionality in postoperative obese patients.
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Affiliation(s)
- Carmela Nardelli
- Dipartimento di Medicina Molecolare e Biotecnologie Mediche, Università di Napoli Federico II, Via S. Pansini 5, 80131 Naples, Italy
- CEINGE-Biotecnologie Avanzate Scarl, Via G. Salvatore 486, 80145 Naples, Italy
| | - Laura Iaffaldano
- Dipartimento di Medicina Molecolare e Biotecnologie Mediche, Università di Napoli Federico II, Via S. Pansini 5, 80131 Naples, Italy
- CEINGE-Biotecnologie Avanzate Scarl, Via G. Salvatore 486, 80145 Naples, Italy
| | - Vincenzo Pilone
- Dipartimento di Medicina e Chirurgia, Università di Salerno, Via Giovanni Paolo II 132, Fisciano, 84084 Salerno, Italy
| | - Giuseppe Labruna
- IRCCS SDN-Istituto di Ricerca Diagnostica e Nucleare, Via Gianturco 113, 80100 Naples, Italy
| | - Maddalena Ferrigno
- CEINGE-Biotecnologie Avanzate Scarl, Via G. Salvatore 486, 80145 Naples, Italy
| | - Nicola Carlomagno
- Dipartimento di Scienze Biomediche Avanzate, Università di Napoli Federico II, Via S. Pansini 5, 80131 Naples, Italy
| | - Concetta Anna Dodaro
- Dipartimento di Scienze Biomediche Avanzate, Università di Napoli Federico II, Via S. Pansini 5, 80131 Naples, Italy
| | - Pietro Forestieri
- Dipartimento di Medicina Clinica e Chirurgia, Università di Napoli Federico II, Via S. Pansini 5, 80131 Naples, Italy
| | - Pasqualina Buono
- IRCCS SDN-Istituto di Ricerca Diagnostica e Nucleare, Via Gianturco 113, 80100 Naples, Italy
- Dipartimento Scienze Motorie e del Benessere, Università di Napoli Parthenope, Via Amm. F. Acton 38, 80133 Naples, Italy
| | - Francesco Salvatore
- Dipartimento di Medicina Molecolare e Biotecnologie Mediche, Università di Napoli Federico II, Via S. Pansini 5, 80131 Naples, Italy
- CEINGE-Biotecnologie Avanzate Scarl, Via G. Salvatore 486, 80145 Naples, Italy
| | - Lucia Sacchetti
- CEINGE-Biotecnologie Avanzate Scarl, Via G. Salvatore 486, 80145 Naples, Italy
- *Lucia Sacchetti:
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14
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Palumbo G, Iadicicco A, Tosi D, Verze P, Carlomagno N, Tammaro V, Ippolito J, Campopiano S. Temperature profile of ex-vivo organs during radio frequency thermal ablation by fiber Bragg gratings. J Biomed Opt 2016; 21:117003. [PMID: 27846343 DOI: 10.1117/1.jbo.21.11.117003] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/06/2016] [Accepted: 10/19/2016] [Indexed: 05/19/2023]
Abstract
We report on the integration of fiber optic sensors with commercial medical instrumentation for temperature monitoring during radio frequency ablation for tumor treatment. A suitable configuration with five fiber Bragg grating sensors bonded to a bipolar radio frequency (RF) probe has been developed to monitor the area under treatment. A series of experiments were conducted on <italic<ex-vivo</italic< animal kidney and liver and the results confirm that we were able to make a multipoint measurement and to develop a real-time temperature profile of the area, with a temperature resolution of 0.1°C and a spatial resolution of 5 mm during a series of different and consecutive RF discharges.
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Affiliation(s)
- Giovanna Palumbo
- University of Naples "Parthenope", Centro Direzionale Isola C4, Naples 80143, Italy
| | - Agostino Iadicicco
- University of Naples "Parthenope", Centro Direzionale Isola C4, Naples 80143, Italy
| | - Daniele Tosi
- Nazarbayev University, School of Engineering, 53 Kabanbay Batyz Avenue, Astana 010000, Kazakhstan
| | - Paolo Verze
- Azienda Ospedaliera Universitaria Federico II of Naples, Urology Unit, Via S. Pansini 5, Naples 80131, Italy
| | - Nicola Carlomagno
- Azienda Ospedaliera Universitaria Federico II of Naples, General Surgery and Transplant Unit, Via S. Pansini 5, Naples 80131, Italy
| | - Vincenzo Tammaro
- Azienda Ospedaliera Universitaria Federico II of Naples, General Surgery and Transplant Unit, Via S. Pansini 5, Naples 80131, Italy
| | - Juliet Ippolito
- Azienda Ospedaliera Universitaria Federico II of Naples, Urology Unit, Via S. Pansini 5, Naples 80131, Italy
| | - Stefania Campopiano
- University of Naples "Parthenope", Centro Direzionale Isola C4, Naples 80143, Italy
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15
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Carlomagno N, Tammaro V, Scotti A, Candida M, Calogero A, Santangelo ML. Is day-surgery laparoscopic cholecystectomy contraindicated in the elderly? Results from a retrospective study and literature review. Int J Surg 2016; 33 Suppl 1:S103-7. [DOI: 10.1016/j.ijsu.2016.06.024] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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16
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Santangelo M, Esposito A, Tammaro V, Calogero A, Criscitiello C, Roberti G, Candida M, Rupealta N, Pisani A, Carlomagno N. What indication, morbidity and mortality for central pancreatectomy in oncological surgery? A systematic review. Int J Surg 2016; 28 Suppl 1:S172-6. [DOI: 10.1016/j.ijsu.2015.12.046] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/19/2023]
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17
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Iaffaldano L, Nardelli C, Pilone V, Labruna G, Alfieri A, Montanaro D, Ferrigno M, Zeccolella MR, Carlomagno N, Renda A, Baldi A, Forestieri P, Sacchetti L, Buono P. Laparoscopic adjustable gastric banding reduces subcutaneous adipose tissue and blood inflammation in nondiabetic morbidly obese individuals. Obes Surg 2015; 24:2161-8. [PMID: 24923694 DOI: 10.1007/s11695-014-1326-7] [Citation(s) in RCA: 3] [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: 12/22/2022]
Abstract
BACKGROUND Significant and sustained excess weight loss (EWL) appears to reduce the risk of obesity-related comorbidities (insulin resistance, hyperlipidemia, and inflammation), but this has been primarily shown in adult diabetic obese patients. We evaluated whether the EWL obtained 3 years after laparoscopic adjustable gastric banding (LAGB) improves the metabolic phenotype in nondiabetic morbidly obese (NDMO) individuals from south Italy. METHODS Serum and subcutaneous adipose tissue (SAT) samples from 20 obese individuals (median BMI=41.5 kg/m(2)) before (T0) and after LAGB (T1) and from 10 controls (median BMI=22.8 kg/m(2)) were taken. Serum leptin, adiponectin, C reactive protein (CRP), and main analyte levels were evaluated by routine methods or immunoassay. In SAT, adipocyte size was measured by hematoxylin/eosin staining, cluster of differentiation 68 (CD68) macrophage infiltration marker by immunohistochemistry, and adiponectin, adiponectin receptors 1 and 2, and interleukin 6 (IL6) messenger RNAs by qRT-PCR. RESULTS The average EWL was 66.7 %, and CRP, triglycerides, hepatic markers, leptin levels, homeostasis model assessment, and the leptin/adiponectin ratio were lower (p<0.05) at T1 than at T0. The expression of small adipocytes and adiponectin was increased (p<0.05), and inflammation markers (CD68 and IL6) decreased (p<0.05) at T1 vs. T0. At linear regression multivariate analysis, over 90 % (R (2)=0.905) of EWL (dependent variable) was explained by CD68, adiponectinemia, triglyceridemia, CRP, and total protein levels. CONCLUSIONS The EWL obtained 3 years after LAGB resulted in an improvement of lipid metabolism and a reduction of inflammation in NDMO patients, thereby decreasing the risk of obesity-associated diseases.
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Affiliation(s)
- Laura Iaffaldano
- CEINGE-Biotecnologie Avanzate S.C.a R.L., Via G. Salvatore 486, 80145, Naples, Italy
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18
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Scotti A, Santangelo M, Federico S, Carrano R, La Tessa C, Carlomagno N, Palmieri DG, Calogero A, Piantadosi M, Renda A. Complicated diverticulitis in kidney transplanted patients: analysis of 717 cases. Transplant Proc 2015; 46:2247-50. [PMID: 25242762 DOI: 10.1016/j.transproceed.2014.07.044] [Citation(s) in RCA: 11] [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: 10/24/2022]
Abstract
INTRODUCTION This study aims to investigate possible risk factors for diverticulitis in kidney transplant recipients affected by colonic diverticulosis. METHODS AND RESULTS We investigated 717 patients transplanted between 2000 and 2010. Diverticular disease was endoscopically diagnosed in 17 of 717 examined patients. Eight patients were diagnosed with autosomal dominant polycystic kidney disease (ADPKD); 9 of 17 patients underwent emergency surgery. We performed Hartmann's procedure on all patients, with a second stage performed at least 6 months later. DISCUSSION Although the incidence of colonic diverticular perforation in kidney transplanted patients is similar to that observed in the general population, perforation in immunosuppressed patients is associated with a higher morbidity/mortality rate. In our study, the incidence of perforation is 1.25% (9 of 717), with almost half of the cases observed in patients with ADPKD (4 of 9). Such an observation is consistent with published data, in which patients with ADPKD are reported to more frequently develop colonic diverticulosis and its complications. One possible explanation might be related to a belated diagnosis of diverticulitis, which could initially simulate an inflammatory disease as a consequence of renal cysts. Also, steroids seem to be a predisposing factor for colonic perforation in these patients. CONCLUSIONS A timely surgery can significantly reduce mortality. In cases of elective surgery, mortality and morbidity are similar to those of immunocompetent patients; accordingly, this is the goal to be pursued. Early signs and symptoms are often masked by immunosuppressive therapy. In these patients, surgeons should always perform (1) abdominal computed tomography scanning and, in the presence of diverticulitis, reduce or withdraw immunosuppressive therapy; and (2) early surgery, with Hartmann's procedure being, in our opinion, the best choice. Before transplantation, elective surgery for colonic resection should be considered in patients with ADPKD or with a history of 1 or more episodes of acute diverticulitis who then regressed with medical therapy.
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Affiliation(s)
- A Scotti
- Department of Surgical Sciences and Nephrology; University Federico II of Naples, Naples, Italy.
| | - M Santangelo
- Department of Surgical Sciences and Nephrology; University Federico II of Naples, Naples, Italy
| | - S Federico
- Department of Surgical Sciences and Nephrology; University Federico II of Naples, Naples, Italy
| | - R Carrano
- Department of Surgical Sciences and Nephrology; University Federico II of Naples, Naples, Italy
| | - C La Tessa
- Department of Surgical Sciences and Nephrology; University Federico II of Naples, Naples, Italy
| | - N Carlomagno
- Department of Surgical Sciences and Nephrology; University Federico II of Naples, Naples, Italy
| | - D G Palmieri
- Department of Surgical Sciences and Nephrology; University Federico II of Naples, Naples, Italy
| | - A Calogero
- Department of Surgical Sciences and Nephrology; University Federico II of Naples, Naples, Italy
| | - M Piantadosi
- Department of Surgical Sciences and Nephrology; University Federico II of Naples, Naples, Italy
| | - A Renda
- Department of Surgical Sciences and Nephrology; University Federico II of Naples, Naples, Italy
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19
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Tammaro V, Vernillo A, Dumani X, Florio I, Pelosio L, Jamshidi A, Romagnuolo R, Calogero A, Carlomagno N, Santangeloa M, Renda A. Prevention of fluid effusion in kidney transplantation with the use of hemostatic biomaterials. Transplant Proc 2015; 46:2203-6. [PMID: 25242751 DOI: 10.1016/j.transproceed.2014.07.048] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Abstract
BACKGROUND Fluid effusion (blood, lymph, or urine) in kidney transplantation may give rise to several complications, directly, such as hematoma, seroma, lymphocele, and/or urinoma, or consequently, such as increased infection risk, longer hospital stay, graft compression--with or without functional impairment--and necessity of further hospitalizations. The aim of this study was to evaluate effectiveness of hemostatic biomaterials in prevention of fluid effusions, especially lymphocele in kidney transplant patients. METHODS We selected 40 patients who underwent kidney transplantation from 2009 to 2012 in which we used hemostatic biomaterials, and compared their results with those of other transplant patients from our center in which we did not used these biomaterials. Evaluated parameters were: fluid effusion, graft function, quality and quantity of drainage, blood count, and operative time. RESULTS There was no difference in operative time. The incidence of complications on which biomaterials can have a role decreased; particularly, we observed a reduction from 24.21% to 7.5% of fluid effusions (lymphocele). There was no evidence of complications due to biomaterials. CONCLUSIONS Hemostasis is important in surgery, and in kidney transplantations lymphostasis also has a significant role. In addition to the traditional hemostatic methods, recently some biomaterials, with the purpose of providing atraumatic hemostasis, were added. In our experience they are easy to use, and their use has proved to be effective for both hemostasis and lymphostasis with consequent reduction of fluid effusions.
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Affiliation(s)
- V Tammaro
- Interdepartmental Kidney Transplantation Center, University Federico II of Naples, Italy.
| | - A Vernillo
- Department of Surgical Sciences and Nephrology, University Federico II, Naples, Italy
| | - Xh Dumani
- Department of Surgical Sciences and Nephrology, University Federico II, Naples, Italy
| | - I Florio
- Department of Surgical Sciences and Nephrology, University Federico II, Naples, Italy
| | - L Pelosio
- Interdepartmental Kidney Transplantation Center, University Federico II of Naples, Italy
| | - A Jamshidi
- Interdepartmental Kidney Transplantation Center, University Federico II of Naples, Italy
| | - R Romagnuolo
- Department of Surgical Sciences and Nephrology, University Federico II, Naples, Italy
| | - A Calogero
- Department of Surgical Sciences and Nephrology, University Federico II, Naples, Italy
| | - N Carlomagno
- Department of Surgical Sciences and Nephrology, University Federico II, Naples, Italy
| | - M Santangeloa
- Interdepartmental Kidney Transplantation Center, University Federico II of Naples, Italy
| | - A Renda
- Interdepartmental Kidney Transplantation Center, University Federico II of Naples, Italy
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Carlomagno N, Duraturo F, Candida M, De Rosa M, Varone V, Ciancia G, Calogero A, Santangelo ML. Multiple splenic hamartomas and familial adenomatous polyposis: a case report and review of the literature. J Med Case Rep 2015; 9:154. [PMID: 26141168 PMCID: PMC4507323 DOI: 10.1186/s13256-015-0627-3] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [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: 01/20/2015] [Accepted: 05/25/2015] [Indexed: 12/13/2022] Open
Abstract
Introduction Splenoma or splenic hamartoma is a rare primary splenic tumor most often discovered radiologically and incidentally. Splenic hamartomas have a strong association with solid and hematological malignancies and, in rare cases, with tuberous sclerosis, but to the best of our knowledge no reports of splenic hamartomas associated with familial adenomatous polyposis have been documented, although it is recognized that familial adenomatous polyposis presents a variety of extracolonic manifestations. Case presentation We report on a very rare case of multiple splenic hamartomas in a 46-year-old white woman who had previously undergone surgery for restorative proctocolectomy for familial adenomatous polyposis. A computed tomography scan of her spleen revealed multiple small lesions which measured less than 1cm in diameter. A splenectomy was performed and a histologic examination of the splenectomy specimen revealed the presence of multiple hamartomas. Conclusion Incidence, differential diagnosis, diagnostic procedures, pathologic findings and treatment of splenic hamartomas are discussed here and hamartomas are considered in a differential diagnosis of splenic tumors. A splenectomy is indicated in cases where malignancy cannot be excluded and in cases of associated hematologic disorders. To the best of our knowledge our patient is the first reported case to have splenic hamartomas identified in a familial adenomatous polyposis-affected patient with mutation in exon 15 of the APC gene. At this time it is not possible to correlate with certainty our multiple splenic hamartomas and familial adenomatous polyposis case as a clinical manifestation of the mutation of APC gene; however, we believe that this case report could be important for further observation of similar cases in the future. Electronic supplementary material The online version of this article (doi:10.1186/s13256-015-0627-3) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Nicola Carlomagno
- General Surgery Unit - Advanced Biomedical Science Department, University Federico II of Naples, Via S. Pansini 5, 80131, Naples, Italy.
| | - Francesca Duraturo
- Molecular Medicine and Medical Biotechnology Department, University Federico II of Naples, Naples, Italy.
| | - Maria Candida
- General Surgery Unit - Advanced Biomedical Science Department, University Federico II of Naples, Via S. Pansini 5, 80131, Naples, Italy.
| | - Marina De Rosa
- Molecular Medicine and Medical Biotechnology Department, University Federico II of Naples, Naples, Italy.
| | - Valeria Varone
- Advanced Biomedical Science Department, University Federico II of Naples, Naples, Italy.
| | - Giuseppe Ciancia
- Advanced Biomedical Science Department, University Federico II of Naples, Naples, Italy.
| | - Armando Calogero
- General Surgery Unit - Advanced Biomedical Science Department, University Federico II of Naples, Via S. Pansini 5, 80131, Naples, Italy.
| | - Michele L Santangelo
- General Surgery Unit - Advanced Biomedical Science Department, University Federico II of Naples, Via S. Pansini 5, 80131, Naples, Italy.
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Carlomagno N, Schonauer F, Tammaro V, Di Martino A, Criscitiello C, Santangelo ML. A multidisciplinary approach to an unusual medical case of locally advanced gastric cancer: a case report. J Med Case Rep 2015; 9:13. [PMID: 25619316 PMCID: PMC4407615 DOI: 10.1186/1752-1947-9-13] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [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: 07/28/2014] [Accepted: 12/05/2014] [Indexed: 01/08/2023] Open
Abstract
INTRODUCTION Complete abdominal wall infiltration with neoplastic gastrocutaneous fistula is an unexpected and out of the ordinary presentation of locally advanced gastric cancer. It is very rare to encounter case reports presenting diffuse abdominal wall invasion, but a complete parietal destruction is an exceptional event. CASE PRESENTATION Here we describe the case of an 81-year-old Caucasian woman presenting a carcinoma perforating her anterior gastric wall and infiltrating all layers of her abdominal wall. The gastric tumor infiltrated her transverse mesocolon, the rectus abdominis muscles bilaterally and overran them anteriorly, causing a large parietal deficit and a complete external fistula. Treatment consisted of a complex surgical procedure requiring general and reconstructive surgery cooperation in order to perform an en bloc gastric resection including colon and abdominal wall, followed by a parietal reconstruction through positioning of prosthesis and reverse abdominoplasty. CONCLUSIONS Clinical presentation, histology and therapeutic options are discussed. The importance of a multidisciplinary approach when encountering extremely rare clinical presentations is emphasized.
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Affiliation(s)
- Nicola Carlomagno
- General Surgery, Department of Advanced Biomedical Science, University Federico II, Via S, Pansini 5, 80131 Naples, Italy.
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Carlomagno N, Santangelo ML, Amato B, Calogero A, Saracco M, Cremone C, Miranda A, Dodaro C, Renda A. Total colectomy for cancer: Analysis of factors linked to patients' age. Int J Surg 2014; 12 Suppl 2:S135-S139. [DOI: 10.1016/j.ijsu.2014.08.363] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2014] [Accepted: 06/15/2014] [Indexed: 02/07/2023]
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Carlomagno N, Calogero A, Saracco M, Santangelo M, Dodaro C, Renda A. Simultaneous quadruple carcinoma of colon Case report and literature review. Ann Ital Chir 2014; 85:495-500. [PMID: 25600443] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/04/2023]
Abstract
INTRODUCTION Multiple primary malignancies can arise in the large bowel as simultaneous, synchronous and/or metachronous. All tumors must be distant from each other to be considered as primitive, none have to be the result of metastasis from other tumors. CASE REPORT We present a case of a 71 years old woman who was admitted to our hospital for a 3-year history of not well defined abdominal pain and hematochezia. The patient had no family history of cancer. Colonoscopy revealed 4 simultaneous tumors located at 4 and 20 cm from the ileocecal valve and at 23,2 and 19 cm from the anal verge. At CT scan there were no distant metastases, neither lymphonode node involvement. A quadruple adenocarcinoma of the colon was confirmed by the pathologist. Patient was operated on total colectomy with ileo-rectal anastomosis. DISCUSSION Two or three synchronous tumors of the colon have been already described in literature in about 1,8-14% of cases, but the presence of four simultaneous cancers, as in our case, is very interesting and unusual without an history of FAP or familiar cancer. CONCLUSION Comprehensive preoperative study, extensive intraoperative exploration, and radical resection can improve surgical results and survival rate, remaining unquestioned the cause.
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Carlomagno N, Santangelo ML, Mastromarino R, Calogero A, Dodaro C, Renda A. Rare multiple primary malignancies among surgical patients-a single surgical unit experience. Ecancermedicalscience 2014; 8:438. [PMID: 24966890 PMCID: PMC4060960 DOI: 10.3332/ecancer.2014.438] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2014] [Indexed: 12/21/2022] Open
Abstract
BACKGROUND A remarkable number of patients presents with multiple primary malignancies (MPM) over their lifetimes. In most cases inherited syndromes, iatrogenic, or viral factors are implicated, while in some cases it is not possible to ascertain a clear aetiopathogenesis. METHODS Starting from a series of 315 patients with MPM, we focused our attention on those with extremely infrequent combinations of tumours. We retrospectively analysed patients' characteristics, type of first and second tumour and the interval between the two tumours. We made a comparison between our own data and data from surveillance, epidemiology, and end results cancer registries, the largest global series on this topic. RESULTS Six patients presented with unusual associations, namely, central nervous system (CNS)/colon, testis/stomach, colon/CNS, CNS/kidney, uterus/soft tissue, and bone/breast. The median age was 50.5 years at the diagnosis of second neoplasm and the male:female ratio was 1:1. All six patients underwent surgery for both tumours. The median interval between the first and the second tumour was 11.3 years (range 1-36 years). Five patients were given chemotherapy as adjuvant systemic treatment, and two of them with CNS tumours also received radiotherapy. DISCUSSION We analysed the behaviour of these rare tumours as first and second neoplasms. More frequent combinations and possible aetiological factors were evaluated. CONCLUSIONS Follow-up for patients recovering from a first tumour must be strict, as there is the risk of developing MPM, even after a long time period. Advancement in biomolecular knowledge and cooperation among different specialists are strongly needed to reduce mortality related to MPM and to foresee their occurrence.
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Affiliation(s)
- Nicola Carlomagno
- General Surgery, Department of Advanced Biomedical Sciences, University of Naples Federico II, via S. Pansini, 80131 Naples, Italy
| | - Michele L Santangelo
- General Surgery and Transplant Unit, Department of Advanced Biomedical Sciences, University of Naples Federico II, via S. Pansini, 80131 Naples, Italy
| | - Rossella Mastromarino
- General Surgery, Department of Advanced Biomedical Sciences, University of Naples Federico II, via S. Pansini, 80131 Naples, Italy
| | - Armando Calogero
- General Surgery, Department of Advanced Biomedical Sciences, University of Naples Federico II, via S. Pansini, 80131 Naples, Italy
| | - Concetta Dodaro
- General Surgery, Department of Advanced Biomedical Sciences, University of Naples Federico II, via S. Pansini, 80131 Naples, Italy
| | - Andrea Renda
- General Surgery, Department of Advanced Biomedical Sciences, University of Naples Federico II, via S. Pansini, 80131 Naples, Italy
- General Surgery and Transplant Unit, Department of Advanced Biomedical Sciences, University of Naples Federico II, via S. Pansini, 80131 Naples, Italy
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Grifasi C, Calogero A, Carlomagno N, Campione S, D'Armiento FP, Renda A. Intraperitoneal dedifferentiated liposarcoma showing MDM2 amplification: case report. World J Surg Oncol 2013; 11:305. [PMID: 24279301 PMCID: PMC4222875 DOI: 10.1186/1477-7819-11-305] [Citation(s) in RCA: 11] [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: 07/25/2013] [Accepted: 11/09/2013] [Indexed: 11/30/2022] Open
Abstract
Background Liposarcoma is the most common type of soft tissue sarcoma (STS). It is divided into five groups according to histological pattern: well-differentiated, myxoid, round cell, pleomorphic, and dedifferentiated. Dedifferentiated liposarcoma most commonly occurs in the retroperitoneum, while an intraperitoneal location is extremely rare. Only seven cases have been reported in literature. Many pathologists recognize that a large number of intra-abdominal poorly differentiated sarcomas are dedifferentiated liposarcomas. We report a case initially diagnosed as undifferentiated sarcoma that was reclassified as intraperitoneal dedifferentiated liposarcoma showing an amplification of the MDM2 gene. Case presentation A 59-year-old woman with abdominal pain and constipation was referred to the Department of Advanced Biomedical Sciences, University of Naples Federico II, Naples, Italy, in November 2012. On physical examination, a very large firm mass was palpable in the meso-hypogastrium. Computed tomography (CT) scan showed a heterogeneous density mass (measuring 10 × 19 cm) that was contiguous with the mesentery and compressed the third part of the duodenum and jejunum. At laparotomy, a large mass occupying the entire abdomen was found, adhering to the first jejunal loop and involving the mesentery. Surgical removal of the tumor along with a jejunal resection was performed because the first jejunal loop was firmly attached to the tumor. Macroscopic examination showed a solid, whitish, cerebroid, and myxoid mass, with variable hemorrhage and cystic degeneration, measuring 26 × 19 × 5 cm. Microscopic examination revealed two main different morphologic patterns: areas with spindle cells in a myxoid matrix and areas with pleomorphic cells. The case was initially diagnosed as undifferentiated pleomorphic sarcoma. Histological review showed areas of well-differentiated liposarcoma. Fluorescence in situ hybridization (FISH) analysis was performed and demonstrated an amplification of the MDM2 gene. Definitive diagnosis was intraperitoneal dedifferentiated liposarcoma. No adjuvant therapy was given, but 5 months after laparotomy, the patient presented with a locoregional recurrence and chemotherapy with high-dose ifosfamide was started. Conclusions No guidelines are available for the management of intraperitoneal dedifferentiated liposarcoma. We report this case to permit the collection of a larger number of cases to improve understanding and management of this tumor. Moreover, this study strongly suggests that poorly differentiated sarcomas should prompt extensive sampling to demonstrate a well-differentiated liposarcoma component and, if possible, FISH analysis.
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Affiliation(s)
- Carlo Grifasi
- Department of Advanced Biomedical Sciences, Section of General Surgery, University of Naples Federico II, Naples, Italy.
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L Santangelo M, Carlomagno N, Spiezia S, Danilo Palmieri D, Clemente M, Piantadosi MP, Palumbo F, Docimo G, Normanno N, Andrea Renda AX. Use of biological prostheses in transplant patients with incisional hernias. Preliminary experience. Ann Ital Chir 2013; 84:471-475. [PMID: 23135483] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/01/2023]
Abstract
AIM The use of synthetic mesh in transplant patients is still under debate. In this paper the authors report their preliminary experience on biological prosthesis for surgical treatment of incisional hernias in transplant patients. MATERIAL OF STUDY Between 2009-2010, 10 patients with incisional hernia underwent surgery using a biological prosthesis (porcine dermis collagen). All patients were transplanted: 9 kidney transplants and 1 liver transplant. RESULTS In all patients postoperative course was uneventful and were not observed complications related to surgery, kind of prosthesis or transplanted organs. At follow up, laparoplasty was associated with good functional outcome. DISCUSSION Transplant patients are at risk for use of synthetic prostheses, as immunosuppressed. In our preliminary experience biological prostheses compared to synthetic ones showed a greater ability to integrate into tissues, to resist bacterial colonization and to reduce cytotoxic or allergenic reactions, providing similar functional results. Moreover it must be added that biological prostheses did not require reductions/suspensions of immunosuppressive therapy and resulted to be versatile. All these features are particularly sought in incisional hernias surgery of transplanted patients. CONCLUSIONS Surgery of incisional hernias in transplanted patients requires a prosthesis with characteristics as close as possible to the ideal one and, in this sense, biological prostheses would seem to outweigh synthetic ones. In our experience, biological prostheses have shown to be safe, effective and reliable; therefore they seem to be able to open new horizons in the treatment of wall defects in this group of patients.
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Carlomagno N, Grifasi C, Dumani X, Lo Conte D, Renda A. Clinical management of Crohn's disease in the elderly. Ann Ital Chir 2013; 84:263-267. [PMID: 23000717] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/01/2023]
Abstract
INTRODUCTION Crohn's Disease (CD) occurs in the elderly in 5 - 25% of cases. Aim of our study: to define the features of clinical presentation, diagnostic tools and therapy of CD in old age. METHODS In the last ten years we observed in our Department 47 patients affected by CD. We divided them into two groups: A (42 patients < 65 years old) and B (5 patients ≥ 65 years old). A retrospective survey evaluated the clinical presentation, diagnosis and treatments with relative outcomes. RESULTS Group A: 23/42 patients (54,76%) were operated on. The most important indication for surgery was intestinal obstruction (15/42 pts, 65,2%). Small bowel resection was the most frequent surgical procedure (13/42 pts, 56,2%). Overall, 2/23 (8,7%) of the patients developed postoperative complications. There was no postoperative mortality. 8 pts (34,7 %) developed recrudescence of CD. Group B: 3 of 5 pts were operated on. Intestinal obstruction was the indication for surgery in all cases (100%). Two patients underwent small bowel resection (66,6%) and the third patient was submitted to an ileo-colic resection (33,3%). There was no mortality in the aftermath of surgery. In 2/3 operated patients (66,6%) recurrence occurred. All operations in the old patients were performed in urgency. CONCLUSIONS Surgery of CD in the elderly appears in our experience to have the same indications and procedures as in young patients. The postoperative morbidity, mortality and recurrence rates are similar in two groups even if we observed slightly higher postoperative morbidity rates in elderly due to the presence of comorbidity.
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Santangelo ML, Bracale UM, Carlomagno N, De Rosa D, Spiezia S, Scotti A, Tammaro V, Porcellini M, Renda A. Kidney transplantation and large anastomotic pseudoaneurysm. Transplant management considerations. Ann Ital Chir 2013; 84:275-279. [PMID: 23135415] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/01/2023]
Abstract
AIM Pseudoaneurysm (PA) at the anastomosis site in kidney transplantation is a rare but serious complication that usually requires graft nephrectomy. Literature reports are sporadic and usually focused on limb rather than graft salvage. In this paper we focus on this last point. MATERIAL OF STUDY 6 patients presenting large PA at the anastomosis between iliac and graft artery were identified in our series. The diagnosis was performed with US, AngioTC scan and angiography. Blood cultures and labeled leukocyte scintigraphy were also performed. All patients underwent open surgery. RESULTS Transplant nephrectomy was needed in all cases except one, in which it was possible to perform a graft replanting on hypogastric artery. Our perioperative mortality and morbidity rate was recorded. DISCUSSION Etiology of PA is multifactorial, however an association with chronic rejection or infection must be also considered. Our mortality and morbidity rates are in accordance to literature. In our experience we observed only large PA so to require an open surgery but this approach has allowed the rescue of graft functioning just in a single case. Endovascular procedures are linked to higher rate of graft salvage than surgery but they can be used just in selected cases. CONCLUSIONS Our experience and literature review led us to believe that the rate of graft salvage in patients with large PA at anastomosis site could be improved only by a planned therapeutic program that includes surgical and endovascular approach, taking the advantages of both technique and overcoming their limits.
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Carlomagno N, Santangelo ML, Grassia S, La Tessa C, Renda A. Intraluminal migration of a surgical drain. Report of a very rare complication and literature review. Ann Ital Chir 2013; 84:219-223. [PMID: 23103757] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/01/2023]
Abstract
INTRODUCTION Gastric or intestinal foreign bodies may cause heterogeneous symptoms ranging from asymptomatic conditions to chronic pain and, in some cases, occlusion and/or perforation. There are sporadic reports of intraluminal migration of medical devices. Most commonly they are sponges, hernia meshes, gastrotomy tubes, while surgical drains are very rarely reported. METHODS A 79 year-old female who consulted our department in May 2009 for abdominal pain and constipation. Her symptomatology started in 2006 some months after an anterior resection for sigmoid diverticulitis associated to obstructed incisional hernia. The symptoms had begun a few months after the operation and were progressively increased month by month. An abdominal CT- scan showed the presence of an intra-peritoneal foreign body and at laparotomy a drain fragment was found inside a small bowel loop and pulled out through a small enterotomy. RESULTS Post-operative course was regular and the patient was discharged at 7th day. DISCUSSION The observation of this case and a literature review led us to analyze the origin and the clinical problems of this very rare complication. Incidence, symptomatology, diagnosis and treatment were analysed. CONCLUSIONS The intraluminal migration of a surgical drain is very rare. The diagnosis is easy by abdominal plan radiogram or CT-scan, but it is casually achieved, because, as it almost always occurs in case of intra-peritoneal foreign bodies, the clinical suspicion is focused on other conditions that most frequently cause abdominal symptoms. When a foreign body is found in intraluminal position and its endoscopic removal is not feasible, then surgery is mandatory and resolutive.
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Dumani X, Rizzo G, Grassia S, Tammaro V, Carlomagno N, Renda A. Simultaneous surgical treatment of liver metastases from colorectal cancer in the elderly through Habib's technique. BMC Surg 2013. [PMCID: PMC3847344 DOI: 10.1186/1471-2482-13-s1-a49] [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: 12/03/2022] Open
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Carlomagno N, Santangelo M, Grassia S, La Tessa C, Renda A. Laparoscopic retrieval of retained intraperitoneal drain in the immediate postoperative period Report of two cases. Ann Ital Chir 2012; 2012:S2239253X12020208. [PMID: 23092944] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/01/2023]
Abstract
AIM: The purpose of this study is to analyze a "rare" complication on the management of abdominal surgical drains: abdominal drainage's retention. Starting from our experience we reviewed literature on this topic MATERIAL OF STUDY: We report two cases (occurred on 2004 and 2010) of retained intraperitoneal drain occurred in the immediate postoperative period after laparoscopic cholecystectomy. RESULTS: Both patients were successfully treated by early laparoscopic removal. DISCUSSION: We compared our experience with literature. Incidence, ethiology, prevention, diagnosis and treatment of this rare complication are analysed. We also considered the guidelines in the placement of intraperitoneal drains, the different fixation techniques, the causes of fragmentation of the drainage and removal techniques. CONCLUSIONS: Retained intraperitoneal drain secondary to fracture and adhesion in the immediate postoperative period is rare but probably underestimated surgical complication. It is impossible to know its real incidence. The role of laparoscopy is emphasized because this approach is cosmetically acceptable, contributes to early recovery and discharge of the patient, and helps to lessen the friction in worsening doctor-patient relationship. KEY WORDS: Abdominal drainage, Drain-related complications, Laparoscopy, Retained intraperitoneal drain.
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Grassia S, La Tessa C, Spiezia S, Romagnuolo R, Carlomagno N, Dodaro C, Renda A. Is total colectomy for colorectal cancer contraindicated in elderly patients? BMC Geriatr 2011. [PMCID: PMC3194350 DOI: 10.1186/1471-2318-11-s1-a24] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
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Tammaro V, Carlomagno N, Lombari P, Tedesco G, Renda A. [Prognostic value of splenectomy and lymph-node dissection during gastric cancer resection]. Chir Ital 2006; 58:163-70. [PMID: 16734164] [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: 05/09/2023]
Abstract
Gastric carcinoma is the second most common cause of digestive tumour-related death in Europe, North America and Asia. Today, the gold standard of treatment is still surgery, but outcomes to date are unsatisfactory. The Japanese Society for Research in Gastric Cancer (JSRGC) recommends the routine execution of splenectomy during gastrectomy. This recommendation is contested by western Authors because of increased morbidity and mortality without any real advantage in terms of survival. Patients treated for gastric cancer in our department between 1993 and 2002 were selected for this study. The 132 patients recruited were divided into two groups: a) those treated for gastric cancer without splenectomy; and b) those in whom splenectomy was performed in conjunction with gastrectomy. We analysed: the extent of lymph node dissection, the execution of the splenectomy, and the prognostic importance of factors relating to the patient, tumour and surgeon. Splenectomy was not associated with any increase in morbidity. Complications, especially of the septic type, and perioperative mortality were similar in both groups, and the same was true of survival at both 3 and 5 years. In our opinion, splenectomy should not be routinely combined with surgery for gastric cancer but could be considered for T3-T4 neoplasms or those localized in the upper two thirds of the stomach.
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Affiliation(s)
- Vincenzo Tammaro
- Cattedra di Chirurgia Generale, Dipartimento Universitario di Scienze Chirurgiche, Anestesiologiche e dell'Emergenza Università di Napoli Federico II
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Zorcolo L, Covotta L, Carlomagno N, Bartolo DCC. Toward lowering morbidity, mortality, and stoma formation in emergency colorectal surgery: the role of specialization. Dis Colon Rectum 2003; 46:1461-7; discussion 1467-8. [PMID: 14605562 DOI: 10.1007/s10350-004-6793-9] [Citation(s) in RCA: 60] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/08/2023]
Abstract
INTRODUCTION Surgical management of left-sided large bowel emergencies has been evolving toward single-staged procedures. Selection for single or staged resection remains the most controversial issue. METHODS The results from a series of 336 emergency colorectal procedures performed between January 1990 and December 2000 for cancer and diverticular disease by two different surgical units in one hospital are reported: one with a specific interest in colorectal surgery, and one specialized in upper gastrointestinal surgery. RESULTS A primary anastomosis was performed in 142 (64.3 percent) patients by colorectal surgeons and in 42 (36.5 percent) by noncolorectal surgeons (P < 0.0001). The overall morbidity and mortality rates were lower for colon and rectal surgeons (14.5 vs. 24.3 percent and 10.4 vs. 17.4 percent, respectively). Trainees were more likely to perform anastomoses when assisted by colorectal consultants (72.1 percent of cases) than when a noncolorectal consultant was present (47.5 percent of cases; P < 0.05). The 30-day mortality for patients with primary anastomosis was 6 percent, and anastomotic dehiscence occurred in nine (4.9 percent) patients. The mortality for patients undergoing staged resections (21.1 percent) was significantly higher than those who had primary resections performed (P < 0.001). CONCLUSIONS Primary anastomosis for left-sided colorectal diseases can be performed with low morbidity and mortality in selected patients. Specialization increased anastomotic rates and reduced morbidity. This study suggests that colon and rectal surgeons should manage colorectal emergencies, and trainees should not be left unsupervised.
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Affiliation(s)
- Luigi Zorcolo
- Department of Colorectal Surgery, The Western General Hospital, Edinburgh, UK
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37
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Abstract
BACKGROUND The surgical management of left-sided large bowel emergency patients remains controversial. There has been an increasing trend towards primary reconstructive surgery. The main dilemma remains appropriate patient selection for primary anastomosis. METHODS The records of 323 patients who presented as acute emergencies and underwent surgery between January 1990 and December 2000 for left-sided colorectal cancer and diverticular disease were reviewed, to compare the outcome of resection and primary anastomosis with Hartmann's procedure. Patients were stratified into 3 groups according to whether the presentation was with localized or generalized peritonitis, or with obstruction. RESULTS Resection and anastomosis was carried out in 176 (55.7%) patients with a 30-day mortality of 5.7%. Anastomotic dehiscence occurred in 9 (5.1%) patients, with no difference between the three groups. Wound sepsis occurred in 8 (4.5%) patients, and the median hospital stay was 13 days. Hartmann's resection was associated with a higher incidence of systemic and surgical morbidity (39.5% and 24.3%, respectively). The mortality rates in those selected for primary anastomosis (5.7%) compared favourably with those undergoing Hartmann's resections (20.4%) (P < 0.001). CONCLUSION Emergency primary anastomosis in left-sided disease can be performed with a low morbidity and mortality in selected patients, even in the presence of a free perforation with diffuse peritonitis. Patients selected for staged resection, were those with major comorbid disease.
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Affiliation(s)
- L Zorcolo
- Department of Surgery, Royal Infirmary of Edinburgh, Lauriston Place, Edinburgh EH3 9YW, Scotland, UK
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38
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Carlomagno N, Nastro P, Lombari P, Tammaro V, Gargiulo S, Borrelli A, Pettinato G, Renda A. [Polyembrioma of the testis: case report following chemotherapy for non-Hodgkin's lymphoma]. G Chir 2002; 23:65-70. [PMID: 12109226] [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: 02/25/2023]
Abstract
Testicular tumours represent 2% of all male malignancies, mostly concerning young men (20-40 years old). The polyembryoma is one of the uncommonest lesions and just recently it has been identified as autonomous nosographic entity. The reported case is peculiar because the patient was older than the most ones described in the literature and the tumour arose after polychemotherapy for non Hodgkins' disease. The Authors analyse some aspects concerning etiology, pathology and clinical approach to such rare neoplasm.
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Affiliation(s)
- N Carlomagno
- Dipartimento di Scienze Chirurgiche, Anestesiologico-Rianimatorie e dell'Emergenza, Università degli Studi Federico II, Napoli
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Carlomagno N, Scarano MI, Gargiulo S, De Rosa M, Panariello L, Izzo P, Renda A. [Familial colonic polyposis: effect of molecular analysis on the diagnostic-therapeutic approach]. Ann Ital Chir 2001; 72:207-14. [PMID: 11552476] [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: 02/21/2023]
Abstract
Germline mutations of the Adenomatous polyposis gene (APC) are responsible for Familial Adenomatous Polyposis (FAP), an inherited condition that predisposes to the development of hundreds to thousands benign adenomas in the colo-rectum. If not surgically removed, they inevitably progress into malignant adenocarcinoma. To date more than 450 germline mutations have been described allowing the establishment of genotype/phenotype correlation between the site and type of molecular defects and their morbid consequences. Authors reviewed their experience concerning 22 FAP affected patients and their 26 first degree relatives, in whom the mutational analysis of the APC gene had been carried out. Site and type of mutations were associated with clinical parameters (age of onset, rectal involvement, extracolonic manifestations, presence of colorectal cancer) and treatments. The impact of mutational analyses on the clinical approach could be very interesting in the future, modifying both surveillance programs and therapeutical choices.
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Affiliation(s)
- N Carlomagno
- Chirurgia Generale ad Indirizzo Addominale, Università Federico II, Napoli.
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Affiliation(s)
- M I Scarano
- Dipartimento di Biochimica e Biotecnologie Mediche, CEINGE-Biotechnologie Avanzate, Naples, Italy
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41
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Scarano MI, De Rosa M, Panariello L, Carlomagno N, Riegler G, Rossi GB, Bucci L, Pesce G, Toni F, Renda A, Izzo P. Familial adenomatous polyposis coli: five novel mutations in exon 15 of the adenomatous polyposis coli (APC) gene in Italian patients. Mutations in brief no. 225. Online. Hum Mutat 2000; 13:256-7. [PMID: 10090483 DOI: 10.1002/(sici)1098-1004(1999)13:3<256::aid-humu12>3.0.co;2-m] [Citation(s) in RCA: 15] [Impact Index Per Article: 0.6] [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: 11/08/2022]
Abstract
Germline mutations within the adenomatous polyposis coli (APC) gene, a tumor suppressor gene, are responsible for most cases of familial adenomatous polyposis (FAP), an autosomal dominantly inherited predisposition to colorectal cancer. To date, more than 300 germ-line causative mutations within this gene have been described (Beroud and Soussi, 1996). Of these, about 95% are chain-terminating mutations, and more than 60% have been localized within exon 15 (Nagase and Nakamura, 1993, Beroud and Soussi, 1996). Using polymerase chain reaction-single strand conformation polymorphism, protein truncation test (PTT) and DNA sequencing we have identified five new frameshift mutations (2523insCTTA, 2638delA, 2803insA, 3185delAA, 4145delTCATGT), all occurring within exon 15 and giving rise to truncated protein products. Two of these new mutations are of particular interest because of the unusual phenotypic features shown by probands. The phenotype of the proband bearing the 2523insCTTA mutation at codon 842 was very aggressive with onset of the symptoms at 12 years, while the patient bearing the 3185delAA mutation at codon 1062 exhibited features of an attenuated form of FAP (AAPC). Our data reiterate the great heterogeneity of the mutational spectrum in FAP that gives rise to an extreme variability of the clinical expression.
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Affiliation(s)
- M I Scarano
- Dip. Biochimica e Biotecnologie Mediche, CEINGE-Biotecnologie Avanzate, Universitá di Napoli Federico II, Italy
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42
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De Rosa M, Scarano MI, Panariello L, Carlomagno N, Rossi GB, Tempesta A, Borgheresi P, Renda A, Izzo P. Three submicroscopic deletions at the APC locus and their rapid detection by quantitative-PCR analysis. Eur J Hum Genet 1999; 7:695-703. [PMID: 10482959 DOI: 10.1038/sj.ejhg.5200344] [Citation(s) in RCA: 23] [Impact Index Per Article: 0.9] [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: 11/09/2022] Open
Abstract
We describe three unrelated kindreds, affected by familial adenomatous polyposis (FAP), with 5q submicroscopic deletions that encompass the entire adenomatous polyposis coli (APC) gene and the adjacent DP1 gene. In one family the deletion encompasses also the MCC (mutated in colon cancer) gene. Affected members of these families had dysplastic adenomatous polyps and congenital hypertrophy of the retinal pigment epithelium (CHRPE); no individual was affected by mental retardation or facial dysmorphism. The deletions were detected by linkage analysis with several intragenic and closely flanking polymorphic markers and confirmed by a quantitative PCR analysis. This procedure could have an impact on the detection of the molecular defect in FAP patients in whom mutational analysis fails to identify the specific mutation.
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Affiliation(s)
- M De Rosa
- Dipartimento di Biochimica e Biotecnologie Mediche, CEINGE-Biotecnologie Avanzate, Università di Napoli Federico II, Naples, Italy
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Scarano MI, De Rosa M, Panariello L, Carlomagno N, Riegler G, Rossi GB, Bucci L, Pesce G, Toni F, Renda A, Izzo P. Familial adenomatous polyposis coli: Five novel mutations in exon 15 of the adenomatous polyposis coli (APC) gene in Italian patients. Hum Mutat 1999. [DOI: 10.1002/(sici)1098-1004(1999)13:3<256::aid-humu13>3.0.co;2-j] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
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Scarano MI, De Rosa M, Panariello L, Carlomagno N, Riegler G, Rossi GB, Bucci L, Pesce G, Toni F, Renda A, Izzo P. Familial adenomatous polyposis coli: Five novel mutations in exon 15 of the adenomatous polyposis coli (APC) gene in Italian patients Communicated by: R.G.H. Cotton Online Citation: Human Mutation, Mutation in Brief #225 (1999) Online http://journals.wiley.com/1059-7794/pdf/mutation/225.pdf. Hum Mutat 1999. [DOI: 10.1002/(sici)1098-1004(1999)13:3<256::aid-humu13>3.3.co;2-a] [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: 12/31/2022]
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45
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Resta N, Simone C, Mareni C, Montera M, Gentile M, Susca F, Gristina R, Pozzi S, Bertario L, Bufo P, Carlomagno N, Ingrosso M, Rossini FP, Tenconi R, Guanti G. STK11 mutations in Peutz-Jeghers syndrome and sporadic colon cancer. Cancer Res 1998; 58:4799-801. [PMID: 9809980] [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: 02/09/2023]
Abstract
A potential tumor suppressor gene, STK11 , encoding a serine threonine kinase, has recently been identified on chromosome 19p13. Germ-line mutations of this gene have been found in patients with Peutz-Jeghers syndrome (PJS). To further investigate the relevance of STK11 mutations in PJS, we analyzed its coding sequence in nine patients and identified two deletions and three missense mutations. Because intestinal carcinomas have been observed to develop in association with PJS, we analyzed tumors from 71 patients for allelic deletions (loss of heterozygosity) and STK11 gene mutations, to elucidate the etiological role of STK11 gene in sporadic colorectal cancer. Loss of heterozygosity, evaluated using the microsatellite D19S886, was observed in 10 of 52 informative cases. No somatic mutations were detected except for a missense alteration in one tumor. Our data indicate the heterogeneity of PJS and the infrequent involvement of the STK11 gene in colorectal cancer.
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Affiliation(s)
- N Resta
- Dipartimento di Medicina Interna e del Lavoro, Sezione di Genetica Medica, Bari, Italy
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Capasso L, Carlomagno N, De Vita F, Orditura M, Paternoster M, Catalano G, Renda A. [Leiomyosarcoma of the small intestines: case reports]. Ann Ital Chir 1997; 68:845-50. [PMID: 9646547] [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: 02/08/2023]
Abstract
Intestinal malignant neoplasms are extremely rare (1% of all solid tumours) and leiomyosarcomas represent 20% of them. The authors report the experience of 5 cases (M:F ratio = 0.6), aged 30-69 yrs old, treated in the period 1985-95. The best results have been obtained in 2 cases, characterized by low grading and submitted to curative resections. The others presented local and distant (mostly hepatic) extensions with a poorer prognosis (1-3 yrs. survival). Leiomyosarcomas are particularly binding because of their rarity and aspecific symptomatology, determining late diagnosis in most cases. The clinical course, the surgical and complementary management, the istology and the prognosis have been analysed. Nowadays 5 yrs-survival is very low and the prognosis remains severe because of local and distant metastases, already present at laparotomy. New chances may come out from better diagnostic techniques and from new complementary chemotherapeutical associations.
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Affiliation(s)
- L Capasso
- Chirurgia Generale e Trapianti d'Organo, Università degli Studi Federico II di Napoli
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47
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De Rosa M, Scarano M, Nappo A, Panariello L, Carlomagno N, Renda A, Rossi G, Salvatore F, Izzo P. 140 O - Molecular analysis of APC mutations in familial adenomatous polyposis. Eur J Cancer 1996. [DOI: 10.1016/0959-8049(96)84891-x] [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: 11/17/2022]
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48
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Renda A, Carlomagno N, Toni F, Capasso L, Peluso P, Paterno M. [Possibility of presymptomatic diagnosis of familial polyposis coli]. Ann Ital Chir 1994; 65:345-9; discussion 349-50. [PMID: 7887588] [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: 01/27/2023]
Abstract
Familial polyposis coli (FPC) is an autosomal dominant inherited disease characterized by an incidence of 1:7000-23000 born alive and by an onset of colorectal cancer in all untreated patients. This diagnosis is obtained mostly in presence of symptoms and in a low percentage after a screening, so it would be very important to have a clinical, biochemical or genetic marker to identify the affected subjects before the onset of the colonic polyps. In the last years many Authors have tested the hypertrophy of retinal pigmented epithelium (CHRPE) in the FPC affected families with interesting results. The aim of our study is to evaluate the predictive role of this clinical marker. 87 subjects have been submitted to ophthalmoscopy: 17 FPC affected patients, 40 first degree relatives and 30 no-polyposis colorectal cancer affected patients. The positivity (CHRPE +) was respectively 88.2%, 45% and 0. The first relatives degree aged more than ten years old have been submitted to the rectosigmoidoscopy and 8/9 CHRPE + persons resulted affected, while all CHRPE--examined were healthy. We have analysed the characteristics of CHRPE, its incidence and sensitivity and in FPC affected patients and in their first degree relatives, with positive results. At the end the CHRPE research and in our and in other experiences presents many advantages: low cost, easy feasibility, repeatability, high sensitivity and specificity. We consider that until the advent of valid routinary genetic tests it can be a good clinical marker in FPC affected families.
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Affiliation(s)
- A Renda
- Istituto di Chirurgia Generale e Trapianti d'Organo, Università degli Studi di Napoli Federico II
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Orditura M, De Vita F, Gugliotti G, Renda A, Carlomagno N, Catalano G. [Primary lymphoma of the parotid: a rare location]. Recenti Prog Med 1994; 85:101-3. [PMID: 8184185] [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
Primary lymphoma of the parotid gland is uncommon: we report a case in an 82-year-old man, classified according to the Working Formulation as a low-grade lymphoma. After parotidectomy the patient was treated with radiation therapy and, subsequently, with polychemotherapy (endoxan, vincristine and prednisone) for six cycles. At follow-up examination one year after, the patient is in complete remission. The major problem encountered was the correct diagnosis that became possible only when the surgical specimen was available. The authors review the pathological features of this extranodal form of lymphoma and discuss the treatment.
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Affiliation(s)
- M Orditura
- Dipartimento di Internistica Clinica e Sperimentale F. Magrassi, 2a Università, Napoli
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50
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Carlomagno N, Dodaro C, Boccia L, Mazzarella L, Renda A. [Desmoid tumors of the abdominal wall]. G Chir 1992; 13:312-4. [PMID: 1307711] [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 authors report their experience in the management of desmoid tumors, rare benign neoplasias, locally aggressive and potentially recurrent after surgery. Etiopathogenetic, diagnostic, and therapeutic features of these tumors are analysed and the value of surgery as well as chemo- or radiotherapy is considered.
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Affiliation(s)
- N Carlomagno
- II Facoltà di Medicina e Chirurgia, Chirurgia Generale e Trapianti d'Organo, Università degli Studi Federico II di Napoli
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