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Sartori PV, Andreani S, De Pasquale L, Pauna I, Bulfamante AM, Aiello PSL, Melcarne R, Giacomelli L, Boniardi M. How to Manage Advanced Differentiated Thyroid Cancer: Step-by-Step Analysis from Two Italian Tertiary Referral Centers. J Clin Med 2024; 13:708. [PMID: 38337400 PMCID: PMC10856418 DOI: 10.3390/jcm13030708] [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: 11/28/2023] [Revised: 01/12/2024] [Accepted: 01/16/2024] [Indexed: 02/12/2024] Open
Abstract
BACKGROUND Differentiated thyroid carcinoma (DTC) has an excellent prognosis; however, advanced disease is associated with a worse prognosis and is relatively common. Surgery followed by RAI treatment remains the mainstream treatment for a large majority of patients with high- and intermediate-risk DTC, but its benefits should be carefully weighed against the potential for harm. The aim of this paper is to critically review the experience in treating advanced DTC at two tertiary referral centers in Italy. METHODS Retrospective analysis of 300 patients who underwent surgery for ADTC over 30 years. RESULTS The complication rate was 50.33%. A total of 135 patients (45%) remained at regular follow-up, 118 (87.4%) were alive, while 17 (12.6%) were deceased. The mean overall survival at 12 years was 84.8% with a mean of 238 months. Eleven patients (8.1%) experienced a relapse after a median of 13 months. CONCLUSIONS ADTC patients adequately treated can achieve prolonged survival even in the case of metastasis or disease relapse. Patients with ADTC should be referred to high-volume centers with the availability of an extended multidisciplinary team to receive tailored treatment.
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Affiliation(s)
| | - Sara Andreani
- Endocrine Surgery Unit, Niguarda Hospital, 20162 Milan, Italy; (S.A.); (I.P.); (P.S.L.A.); (M.B.)
| | - Loredana De Pasquale
- Thyroid and Parathyroid Surgery Service-Otolaryngology Unit, ASST Santi Paolo e Carlo, Department of Health Sciences, University of Milan, 20122 Milan, Italy;
| | - Iuliana Pauna
- Endocrine Surgery Unit, Niguarda Hospital, 20162 Milan, Italy; (S.A.); (I.P.); (P.S.L.A.); (M.B.)
| | - Antonio Mario Bulfamante
- Pediatric Otolaryngology Unit, ASST Fatebenefratelli-Sacco, Buzzi Children Hospital, 20162 Milan, Italy;
| | | | - Rossella Melcarne
- Department of Translational and Precision Medicine, Sapienza University of Rome, AOU Umberto I, 00185 Rome, Italy;
| | - Laura Giacomelli
- Department of General and Specialty Surgery, Sapienza University of Rome, AOU Umberto I, 00185 Rome, Italy;
| | - Marco Boniardi
- Endocrine Surgery Unit, Niguarda Hospital, 20162 Milan, Italy; (S.A.); (I.P.); (P.S.L.A.); (M.B.)
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Nicosia L, Andreani S, Ruggieri R, Rusev B, Lawlor R, Pea A, Agolli L, Scarpa A, Corbo V, D'Agosto S, Alongi F. Combinatorial Effect of Magnetic Field and Radiotherapy in Pancreatic Ductal Adenocarcinoma Organoids. Int J Radiat Oncol Biol Phys 2021. [DOI: 10.1016/j.ijrobp.2021.07.831] [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: 11/28/2022]
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Ruan QZ, English W, Hotouras A, Bryant C, Taylor F, Andreani S, Wexner SD, Banerjee S. A systematic review of the literature assessing the outcomes of stapled haemorrhoidopexy versus open haemorrhoidectomy. Tech Coloproctol 2020; 25:19-33. [PMID: 33098498 PMCID: PMC7847454 DOI: 10.1007/s10151-020-02314-6] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/30/2020] [Accepted: 07/16/2020] [Indexed: 12/12/2022]
Abstract
Background Symptomatic haemorrhoids affect a large number of patients throughout the world. The aim of this systematic review was to compare the surgical outcomes of stapled haemorrhoidopexy (SH) versus open haemorrhoidectomy (OH) over a 20-year period. Methods Randomized controlled trials published between January 1998 and January 2019 were extracted from Pubmed using defined search criteria. Study characteristics and outcomes in the form of short-term and long-term complications of the two techniques were analyzed. Any changes in trend of outcomes over time were assessed by comparing article groups 1998–2008 and 2009–2019. Results Twenty-nine and 9 relevant articles were extracted for the 1998–2008 (period 1) and 2009–2019 (period 2) cohorts, respectively. Over the two time periods, SH was found to be a safe procedure, associated with statistically reduced operative time (in 13/21 studies during period 1 and in 3/8 studies during period 2), statistically less intraoperative bleeding (3/7 studies in period 1 and 1/1 study in period 2) and consistently less early postoperative pain on the visual analogue scale (12/15 studies in period 1 and 4/5 studies in period 2) resulting in shorter hospital stay (12/20 studies in period 1 and 2/2 studies in period 2) at the expense of a higher cost. In the longer term, although chronic pain in SH and OH patents is comparable, patient satisfaction with SH may decline with time and at 2-year follow-up OH appeared to be associated with greater patient satisfaction. Conclusions SH appears to be safe with potential advantages, at least in the short term, but the evidence is lacking at the moment to suggest its routine use in clinical practice.
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Affiliation(s)
- Q Z Ruan
- Whipps Cross University Hospital, Barts Health NHS Trust, London, UK
| | - W English
- Whipps Cross University Hospital, Barts Health NHS Trust, London, UK
- National Bowel Research Centre, Blizard Institute, QMUL, 2 Newark Street, London, E1 2AT, UK
| | - A Hotouras
- Whipps Cross University Hospital, Barts Health NHS Trust, London, UK.
- National Bowel Research Centre, Blizard Institute, QMUL, 2 Newark Street, London, E1 2AT, UK.
| | - C Bryant
- Whipps Cross University Hospital, Barts Health NHS Trust, London, UK
| | - F Taylor
- Whipps Cross University Hospital, Barts Health NHS Trust, London, UK
| | - S Andreani
- Whipps Cross University Hospital, Barts Health NHS Trust, London, UK
| | - S D Wexner
- Cleveland Clinic Florida, Fort Lauderdale, FL, USA
| | - S Banerjee
- Barking, Havering and Redbridge University Hospitals NHS Trust, Romford, UK
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Mazzola M, Crippa J, Bertoglio CL, Andreani S, Morini L, Sfondrini S, Ferrari G. Postoperative risk of pancreatic fistula after distal pancreatectomy with or without spleen preservation. Tumori 2020; 107:160-165. [PMID: 32635820 DOI: 10.1177/0300891620936744] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
Abstract
INTRODUCTION Outcomes after distal pancreatectomy with or without splenectomy are controversial. The present study aims to investigate differences in short-term and long-term outcomes between spleen-preserving distal pancreatectomy (SPDP) and distal pancreatectomy with splenectomy (DPS). METHODS In this retrospective review of consecutive patients undergoing distal pancreatectomy with or without splenectomy from January 2011 until December 2017 for benign disease, the primary endpoint was to compare postoperative pancreatic fistula (POPF). The secondary endpoint was to compare duration of surgery, intraoperative blood loss, postoperative complications, length of hospital stay, and long-term outcomes. RESULTS Patients undergoing SPDP had a lower rate of POPF (13.6% vs 46.1%; p = 0.02). Patients undergoing SPDP (n = 22) were discharged earlier than patients undergoing DPS (n = 26) (8 [4-29] vs 12 [6.48] days; p = 0.003). No differences in other intraoperative and postoperative outcomes were found between groups. CONCLUSION Patients undergoing SPDP developed fewer POPF and were discharged earlier compared to patients undergoing DPS.
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Affiliation(s)
- Michele Mazzola
- Division of Oncologic and Minimally-invasive Surgery, ASST Grande Ospedale Metropolitano Niguarda, Milan, Italy
| | - Jacopo Crippa
- Division of Oncologic and Minimally-invasive Surgery, ASST Grande Ospedale Metropolitano Niguarda, Milan, Italy
| | - Camillo L Bertoglio
- Division of Oncologic and Minimally-invasive Surgery, ASST Grande Ospedale Metropolitano Niguarda, Milan, Italy
| | - Sara Andreani
- Division of Oncologic and Minimally-invasive Surgery, ASST Grande Ospedale Metropolitano Niguarda, Milan, Italy
| | - Lorenzo Morini
- Division of Oncologic and Minimally-invasive Surgery, ASST Grande Ospedale Metropolitano Niguarda, Milan, Italy
| | - Stefano Sfondrini
- Division of Oncologic and Minimally-invasive Surgery, ASST Grande Ospedale Metropolitano Niguarda, Milan, Italy
| | - Giovanni Ferrari
- Division of Oncologic and Minimally-invasive Surgery, ASST Grande Ospedale Metropolitano Niguarda, Milan, Italy
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Maddalo M, Moschini I, Benecchi G, Calabri E, Rossi R, Losardo P, Bergamini M, Dell’Anna C, Ceccon G, Grondelli C, Nurmahomed S, Gianni S, Rossi R, Manicone M, Andreani S, Ghetti F, Salaroli F, Ghetti C, D’Abbiero N. 42. The role of emphysema on radiation-induced lung toxicity and the feasibility of a “functional treatment plan”. Phys Med 2018. [DOI: 10.1016/j.ejmp.2018.04.052] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/27/2022] Open
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Maddalo M, Benecchi G, Grondelli C, Calabri E, Rossi R, Losardo P, Bergamini M, Dell’Anna C, Ceccon G, Nurmahomed S, Gianni S, Rossi R, Manicone M, Andreani S, Ghetti F, Salaroli F, Ghetti C, D’Abbiero N. 172. Predictors of cardiac dose reduction achieved with deep inspiration breath hold technique over free breathing technique in left breast radiotherapy. Phys Med 2018. [DOI: 10.1016/j.ejmp.2018.04.183] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
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Torrente S, Andreani S, Badenchini F, Rancati T, Marenghi C, Avuzzi B, Morlino S, Bedini N, Villa S, Noris Chiorda B, Palorini F, Andreoli L, Di Florio T, Catanzaro M, Stagni S, Biasoni D, Torelli T, Tesone A, Nicolai N, Valdagni R. Clinical Results for an Active Surveillance Cohort with Localized Prostate Cancer Receiving RT after Exiting Active Surveillance. Int J Radiat Oncol Biol Phys 2018. [DOI: 10.1016/j.ijrobp.2018.07.282] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
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Grondelli C, Benecchi G, Maddalo M, Nurmohamed S, Gianni S, Rossi R, Manicone M, Andreani S, Ghetti F, Salaroli F, Calabri E, Rossi R, Moschini I, Dell'Anna C, Ceccon G, Bergamini M, Losardo P, Ghetti C, D'Abbiero N. EP-1965: Predictors of cardiac dose reduction achieved with deep inspiration breath hold. Radiother Oncol 2018. [DOI: 10.1016/s0167-8140(18)32274-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/14/2022]
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Naik R, Warren G, Andreani S. Measuring and improving safety culture in theatres: A closed-loop audit. Int J Surg 2016. [DOI: 10.1016/j.ijsu.2016.08.291] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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Magistri P, Andreani S, Lo Conte D, Ferrari GC, Forgione A, Pugliese R. Autotransplantation of pancreatic islets. A single-center first experience. Ann Ital Chir 2016; 87:268-270. [PMID: 27345954] [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: 06/06/2023]
Abstract
INTRODUCTION Islets auto-transplantation (IAT) is a well-known procedure that may improve glycemic control after total or completion pancreatectomy compared to insulin therapy alone. CASE REPORT We herein report our experience in IAT with the case of a sixty years old woman underwent completion pancreatectomy for recurrent pancreatitis. She received IAT by percutaneous trans-hepatic intra-portal injection. The patient recovered well, except for a surgical wound infection that was treated with vacuum therapy. She was discharged on p.o.d. 27th in good general conditions and tolerating a diet. DISCUSSION Data in literature demonstrate that IAT is cost-effective on the long-run compared to insulin therapy in patients with diabetes. 30-days mortality rate for islets auto-transplantation (IAT) following total pancreatectomy is 5%, which is comparable with previous reports on total pancreatectomy without IAT. Our report may expand the literature on this procedure in order to further develop and improve both technique and outcomes, and clarify the correct indication to surgery. KEY WORDS Auto-transplantation, Chronic pancreatitis, IAT, Pancreatic islets, Total pancreatectomy.
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Lallas A, Pyne J, Kyrgidis A, Andreani S, Argenziano G, Cavaller A, Giacomel J, Longo C, Malvestiti A, Moscarella E, Piana S, Specchio F, Hofmann-Wellenhof R, Zalaudek I. The clinical and dermoscopic features of invasive cutaneous squamous cell carcinoma depend on the histopathological grade of differentiation. Br J Dermatol 2015; 172:1308-15. [PMID: 25363081 DOI: 10.1111/bjd.13510] [Citation(s) in RCA: 64] [Impact Index Per Article: 7.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/24/2014] [Indexed: 12/31/2022]
Abstract
BACKGROUND Little is known about the variability of the dermoscopic criteria of squamous cell carcinoma (SCC) according to the histopathological differentiation grade. OBJECTIVES To evaluate whether specific dermoscopic criteria can predict the diagnosis of poorly differentiated SCC compared with well- and moderately differentiated SCC. METHODS Clinical and dermoscopic images of SCCs were retrospectively evaluated for the presence of predefined criteria. Univariate and adjusted odds ratios were calculated. Discriminant functions were used to plot receiver-operator characteristic curves. RESULTS Of 143 SCCs included, 48 (33·5%) were well differentiated, 45 (31·5%) were moderately differentiated and 50 (35·0%) were poorly differentiated. Flat tumours had a fourfold increased probability of being poorly differentiated. Dermoscopically, the presence of a predominantly red colour posed a 13-fold possibility of poor differentiation, whereas a predominantly white and white-yellow colour decreased the odds of poorly differentiated SCC by 97% each. The presence of vessels in more than 50% of the tumour's surface, a diffuse distribution of vessels and bleeding were significantly associated with poor differentiation, while scale/keratin was a potent predictor of well- or moderately differentiated tumours. CONCLUSIONS Dermoscopy may be regarded as a reliable preoperative tool to distinguish poorly from well- and moderately differentiated SCC. Given that poor differentiation of SCC represents an independent risk factor for recurrence, metastasis and disease-specific death, identifying poorly differentiated tumours in vivo may enhance their appropriate management.
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Affiliation(s)
- A Lallas
- Skin Cancer Unit, Arcispedale Santa Maria Nuova IRCCS, Viale Risorgimento 80, 42100, Reggio Emilia, Italy
| | - J Pyne
- School of Medicine, The University of Queensland, Brisbane, Australia
| | - A Kyrgidis
- Skin Cancer Unit, Arcispedale Santa Maria Nuova IRCCS, Viale Risorgimento 80, 42100, Reggio Emilia, Italy
| | - S Andreani
- Dermatology Service Hospital Salvador, Santiago, Chile
| | - G Argenziano
- Skin Cancer Unit, Arcispedale Santa Maria Nuova IRCCS, Viale Risorgimento 80, 42100, Reggio Emilia, Italy
| | | | - J Giacomel
- Skin Spectrum Medical Services, Como, Western Australia, Australia
| | - C Longo
- Skin Cancer Unit, Arcispedale Santa Maria Nuova IRCCS, Viale Risorgimento 80, 42100, Reggio Emilia, Italy
| | - A Malvestiti
- Albert Einstein Israelite Hospital, São Paulo, Brazil
| | - E Moscarella
- Skin Cancer Unit, Arcispedale Santa Maria Nuova IRCCS, Viale Risorgimento 80, 42100, Reggio Emilia, Italy
| | - S Piana
- Pathology Unit, Arcispedale Santa Maria Nuova IRCCS, Viale Risorgimento 80, 42100, Reggio Emilia, Italy
| | - F Specchio
- Department of Dermatology, University of Rome Tor Vergata, Italy
| | | | - I Zalaudek
- Department of Dermatology, Medical University of Graz, Graz, Austria
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Human S, Andreani S, Sihono S, Indriatama W. Stability Test For Sorghum Mutant Lines Derived From Induced Mutations with Gamma-Ray Irradiation. Atom Indo 2011. [DOI: 10.17146/aij.2011.76] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022] Open
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Chiara O, Cimbanassi S, Andreani S, Sammartano F, Pizzilli G, Girotti P, Mariani A, Bassi G, Baticci F, Fontana A, Mariani M, Massi M, Pozzi C, Ardizzone MVR, Sansonna F, Vesconi S, Pugliese R. [The model of the Niguarda Hospital Trauma Team in Milan]. Chir Ital 2008; 60:627-640. [PMID: 19062485] [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: 05/27/2023]
Abstract
The aim of this work was to describe the model and clinical results obtained by the Niguarda Trauma Team referral center for major trauma, in Milan. The Trauma Team is organized as a trauma service, where general surgeons, anesthesiologists, orthopedic surgeons and neurosurgeons work on a 24 hour rotation. When not in duty in the rotations, specialists work in their specific elective activities. The director of the Trauma Team has the responsibility for discussion and application of protocols, clinical assistance, quality assessment and training. The results of 1334 consecutive cases of major trauma during a 51 month period were reviewed using the trauma registry. 39% overtriage, which increased over the years, and 1.12% undertriage were recorded. Mortality of patients with injury severity scores > 15 was 21%, with a progressive decrease over the years. Blunt trauma accounted for 91.75% and were road-related in most cases. Skeletal injuries were the most frequent findings, but brain and thoraco-abdominal injuries were associated with a higher risk of death. 1476 surgical procedures (16.93% general surgery and 111 interventional angiographic studies) were performed. Quality assessment revealed a significant decrease in preventable deaths within the first 72 hours, after excluding patients admitted in extremis. The results presented in this study demonstrate the possibility of realising a model of organized trauma care in an emergency department in Italy, with patient outcomes comparable to those obtained in Trauma Center in other countries.
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Affiliation(s)
- Osvaldo Chiara
- Dipartimento DEA-EAS, Ospedale Niguarda Ca' Granda, Milano
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Chiara O, Cimbanassi S, Andreani S, Girotti P, Pizzilli G, Vesconi S. Niguarda Trauma Team: outcome of three years of activity. Minerva Anestesiol 2008; 74:11-15. [PMID: 18216763] [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: 05/25/2023]
Abstract
BACKGROUND The aim of this study was to prove the existence of a direct relationship between the comprehensive strategy of trauma management and an enhancement in outcome. Tests were carried out on the impact of the Niguarda Trauma Team System on mortality rates due to severe trauma. METHODS The epidemiological data was retrospectively reviewed along with, the severity scores: Abbreviated Injury Scale (AIS), Injury Severity Score (ISS), Revised Trauma Score (RTS), Probability of survival (Ps) and the outcome of severe trauma admitted to Niguarda hospital between October 2002 and September 2005. All data were collected from the Trauma Registry of the Niguarda Hospital. Two subsequent periods of 20 and 16 months were compared. RESULTS Nine hundred forty-two severe traumas (94.05% blunt trauma) were recorded with an overtriage rate of 36.09%. Most patients were admitted for bone and muscular injuries (52.22%). Excluding the patients who were overtriaged, there were 129 patients who died. Comparing the two periods, the Authors observed a significant reduction in mortality from 22.56% to 19.75%, mainly related to a decrease in early mortality due to hemodynamic instability. Central nervous system injury was the main cause of death (65%). Average hospital stay significantly decreased from 17.01+/-12.07 days to 14.97+/-10.34 days. CONCLUSION Introducing a comprehensive strategy of severe trauma management, the Niguarda Trauma Team System had a significant impact on mortality rates and hospital stay.
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Affiliation(s)
- O Chiara
- DEA-EAS Department, SSD Trauma Team, Niguarda Ca' Granda Hospital, Milan, Italy.
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Andreani S, Cimbanassi S, Pugliese R, Chiara O. [An unusual cause of small bowel obstruction in the elderly]. Ann Ital Chir 2006; 77:513-6. [PMID: 17343236] [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: 05/14/2023]
Abstract
Paraduodenal hernia is an unusual form of internal hernia that results from a congenital midgut malrotation. It is classified as either right or left, depending on anatomic features, and embryologic origin. Left hernias are three times more common than right. Clinical symptoms may be intermittent and non-specific, as nausea, distension and abdominal pain or sometimes acute small bowel obstruction or ischemia. The average age at diagnosis is usually 38 years. We report a case of right paraduodenal hernia in a 79 years old man admitted to the emergency department with an acute small bowel obstruction.
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Affiliation(s)
- Sara Andreani
- SSD Trauma Team, Dipartimento DEA-EAS, Ospedale Niguarda Ca' Granda, Milano
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Chiara O, Cimbanassi S, Castelli F, Spagnolo R, Girotti P, Pizzilli G, Pitidis A, Andreani S, Pugliese R, Capitani D. Protocol-driven approach of bleeding abdominal and pelvic trauma. World J Emerg Surg 2006; 1:17. [PMID: 16780596 PMCID: PMC1540410 DOI: 10.1186/1749-7922-1-17] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2006] [Accepted: 06/17/2006] [Indexed: 12/03/2022] Open
Affiliation(s)
- Osvaldo Chiara
- Dipartimento di Emergenza Accettazione – Trauma Team Ospedale Niguarda Ca'Granda Milano, Scuola di Specializzazione in Chirurgia Generale, Universita' degli Studi di Milano, Italy
| | - Stefania Cimbanassi
- Dipartimento di Emergenza Accettazione – Trauma Team Ospedale Niguarda Ca'Granda Milano, Scuola di Specializzazione in Chirurgia Generale, Universita' degli Studi di Milano, Italy
| | - Fabio Castelli
- Divisione di Orto-Traumatologia, Ospedale Niguarda Ca'Granda Milano, Scuola di Specializzazione in Ortopedia, Universita' degli Studi di Milano, Italy
| | - Rosario Spagnolo
- Divisione di Orto-Traumatologia, Ospedale Niguarda Ca'Granda Milano, Scuola di Specializzazione in Ortopedia, Universita' degli Studi di Milano, Italy
| | - Paolo Girotti
- Dipartimento di Emergenza Accettazione – Trauma Team Ospedale Niguarda Ca'Granda Milano, Scuola di Specializzazione in Chirurgia Generale, Universita' degli Studi di Milano, Italy
| | - Giacinto Pizzilli
- Dipartimento di Emergenza Accettazione – Trauma Team Ospedale Niguarda Ca'Granda Milano, Scuola di Specializzazione in Chirurgia Generale, Universita' degli Studi di Milano, Italy
| | - Alessio Pitidis
- Istituto Superiore di Sanita' del Ministero della Salute, Roma, Italy
| | - Sara Andreani
- Dipartimento di Emergenza Accettazione – Trauma Team Ospedale Niguarda Ca'Granda Milano, Scuola di Specializzazione in Chirurgia Generale, Universita' degli Studi di Milano, Italy
| | - Raffaele Pugliese
- Divisione di Chirurgia Generale e Videolaparoscopica Scuola di Specializzazione in Chirurgia Generale, Universita' degli Studi di Milano, Italy
| | - Dario Capitani
- Divisione di Orto-Traumatologia, Ospedale Niguarda Ca'Granda Milano, Scuola di Specializzazione in Ortopedia, Universita' degli Studi di Milano, Italy
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De Pasquale L, Sommaruga L, Andreani S, Bastagli A. [Hashimoto's thyroiditis and medullary carcinoma in the same gland: a purely random occurrence?]. Chir Ital 2004; 56:557-62. [PMID: 15452996] [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: 04/30/2023]
Abstract
In this paper the authors describe the case of 64-year-old woman who had been suffering from poorly defined thyroid disease for 30 years and Hashimoto's thyroiditis for 3 years, with recent detection of high serum calcitonin and CEA. Her family history was negative for endocrinological diseases and her general medical history was not significant for any diseases, except for mild hypertension. There were no pathological findings at physical examination. Cervical ultrasound showed 2 nodular lesions of the right lobe of the thyroid and the isthmus. FNABs of these nodules were performed under ultrasound control and proved non-diagnostic. The patient underwent total thyroidectomy. Intra-operative frozen sections were negative for cancer. Definitive histological examination was positive for medullary carcinoma of the right thyroid lobe (diameter 0.6 cm) in Hashimoto's thyroiditis. The association between thyroid cancers deriving from follicular cells and Hashimoto's thyroiditis is documented in the literature and would appear to determine a better prognosis. Cases such as the one presented in this paper, however, are rare and it is debated whether lymphocyte infiltration may predispose to the onset of medullary carcinoma or whether it is a defence against the tumour.
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Affiliation(s)
- Loredana De Pasquale
- Unità di Chirurgia Endocrina, Azienda Ospedaliera, Polo Universitario San Paolo, Milano
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Alvear J, Andreani S, Cortés F. [Fetal alcohol syndrome and fetal alcohol effects: importance of early diagnosis and nutritional treatment]. Rev Med Chil 1998; 126:407-12. [PMID: 9699371] [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
BACKGROUND Fetal alcohol syndrome (FAS) and fetal alcohol effects (FAE) encompass a pattern of birth defects in persons whose mothers ingested alcohol during pregnancy. People with FAE display fewer of the FAS traits. AIM To assess the prevalence and features of these affections in a secondary nutritional recovery centre. PATIENTS AND METHODS All charts of children admitted between 1985 and 1995 were reviewed, and those children diagnosed as having a FAS or FAE by a geneticist were considered for this study. Birth, maternal, social and economic characteristics, psychomotor abilities (using Denver test) and response to nutritional treatment were assessed. RESULTS During the study period, 1572 infants were admitted to the centre, and 1.97% (70% female) were diagnosed as having a FAS or FAE. These infants were admitted at 11.1 +/- 4.5 months of age and discharged after 96.7 +/- 58.1 months of hospitalisation. Mean mother's age was 33 +/- 7 years, and all belonged to low socioeconomic levels. Mean birth weight was 2048 +/- 431 g and 2469 +/- 619 g in children with FAS and FAE respectively (p < 0.03). Children with FAE performed better for gross and fine motor abilities than those with FAS. No differences were observed for language performance. Sixty five percent of children with FAS and 71% of children with FAE had an adequate weight and height increment during nutritional therapy. A multiple regression analysis showed that age at admission and gestational age were significant predictors of weight gain during therapy. CONCLUSIONS Alcohol has teratogenic effects on the foetus that affect craneal size and psychomotor development. Alcohol also affects pre and post natal growth.
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Affiliation(s)
- J Alvear
- Unidad de Genética y Enfermedades Metabólicas, INTA, Universidad de Chile
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Bedini AV, Valente M, Andreani S, Ravasi G. Reverse flap of distal latissimus dorsi for diaphragm reconstruction in the adult: specification of the technical procedure and report on six cases. J Thorac Cardiovasc Surg 1997; 114:846-8. [PMID: 9375617 DOI: 10.1016/s0022-5223(97)70091-6] [Citation(s) in RCA: 14] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Affiliation(s)
- A V Bedini
- Thoracic Surgery Department, National Cancer Institute, Milan, Italy
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Abstract
BACKGROUND Many oncologists have now accepted a combined radiosurgical approach as the treatment of choice in patients with Pancoast tumour but most reports show an incorrect assessment of the disease. METHODS Stage III lung cancer was classified as Pancoast tumour if the pulmonary extent was limited to the upper apical segment and if at least one of the features of Pancoast syndrome, indicating tumour spread to the para-apical structures, was present. Between 1984 and 1988 15 consecutive patients were treated with primary radiotherapy followed by surgery or with primary excision and subsequent radiotherapy in the absence of an initial histological diagnosis. RESULTS The mortality of patients given the combined treatment was 6.6% (one death due to pulmonary embolism), and the five year survival rate was 26.6% for all patients and 57% for those who underwent complete resection without N2 disease. Long-term survival was 0% for those cases with incomplete resection, N2 disease, or malignant invasion of the first rib. CONCLUSIONS Stage III lung cancer, classified as Pancoast tumour according to strict, consistent criteria, is best treated by primary radiotherapy; combined treatment should be used only for patients with potentially resectable cancer without N2 disease and/or malignant invasion of the first rib.
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Affiliation(s)
- G Muscolino
- Istituto Nazionale Tumori, Department of Thoracic Surgery, Milan, Italy
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Infante M, Valente M, Andreani S, Catanese C, Dal Fante M, Pizzetti P, Giudice G, Basilico M, Spinelli P, Ravasi G. Conservative management of esophageal leaks by transluminal endoscopic drainage of the mediastinum or pleural space. Surgery 1996; 119:46-50. [PMID: 8560385 DOI: 10.1016/s0039-6060(96)80212-1] [Citation(s) in RCA: 18] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/31/2023]
Abstract
BACKGROUND The management of postoperative leaks into the mediastinum or pleural cavities after esophageal surgery yields unsatisfactory results. A recently described method, drainage of the mediastinum or pleural cavity through suture line defects, has been used in our department with eight patients. METHODS A suction tube was advanced over an endoscopically placed guide wire into the abscess from inside the esophagus, and gentle aspiration was used to remove saliva and secretions. Intravenous antibiotics and total parenteral nutrition were also given. RESULTS The sepsis was rapidly controlled, and the abscess cavity progressively collapsed in all cases. Seven patients recovered and were discharged 34 to 61 days after operation; one died of concomitant complications. CONCLUSIONS This method seems promising for the management of intrathoracic esophageal leaks.
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Pastorino U, Muscolino G, Valente M, Andreani S, Tavecchio L, Infante M, Terno G, Ravasi G. Safety of absorbable suture for sternal closure after pulmonary or mediastinal resection. J Thorac Cardiovasc Surg 1994; 107:596-9. [PMID: 8302079] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/29/2023]
Abstract
The reliability of polyglyconate monofilament (Maxon) suture for sternal closure was tested on 216 consecutive sternotomies, performed on 208 patients in our department from January 1986 to December 1990. The reason of sternotomy was primary lung cancer in 34 cases (16%), lung metastases in 127 (59%), and disorders of the thymus in 55 (25%). Mean age was 38 years (range 3 to 78 years); multiple lung resections were performed in 102 patients (average 7 lesions, range 2 to 30); maximum extent of the operation was pneumonectomy in 2 cases, lobectomy in 53, segmentectomy in 27, and wedge resection in 74. Prior chemotherapy had been administered in 75 cases (35%). A second sternotomy was performed in 8 cases. No cases of sternal dehiscence, sternal infection, or empyema were observed, after a median follow-up of 27 months. Overall perioperative mortality was 0.9% (2/216). Our series demonstrates the safety of polyglyconate monofilament (Maxon) suture for sternal closure. Absorbable sutures appear to be a safe alternative to steel wire closure in patients undergoing extended pulmonary or mediastinal resection.
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Affiliation(s)
- U Pastorino
- Department of Thoracic Surgery, Istituto Nazionale Tumori, Milan, Italy
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Pastorino U, Muscolino G, Valente M, Andreani S, Tavecchio L, Infante M, Terno G, Ravasi G. Safety of absorbable suture for sternal closure after pulmonary or mediastinal resection. J Thorac Cardiovasc Surg 1994. [DOI: 10.1016/s0022-5223(94)70108-3] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
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