1
|
Fama' F. Breast and Thyroid Surgery in 2021 and Beyond. J Clin Med 2022; 11:jcm11102894. [PMID: 35629020 PMCID: PMC9146074 DOI: 10.3390/jcm11102894] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2022] [Accepted: 05/19/2022] [Indexed: 02/04/2023] Open
Abstract
Several studies in the literature report the association between breast and thyroid pathologies; however, the underlying causes (genetic, environmental, hormonal or immunological) have not yet been well explicated [...]
Collapse
Affiliation(s)
- Fausto Fama'
- Department of Human Pathology in Adulthood and Childhood "G. Barresi", University Hospital "G. Martino" of Messina, 98123 Messina, Italy
| |
Collapse
|
2
|
Malerba P, Agabiti Rosei C, Nardin M, Gaggero A, Chiarini G, Rossini C, Fama' F, Brami V, Coschignano MA, Muiesan ML, Rizzoni D, De Ciuceis C. Early microvascular modifications in patients previously hospitalized for COVID-19: comparison with healthy individuals. Eur Heart J 2021. [PMCID: PMC8767633 DOI: 10.1093/eurheartj/ehab724.3387] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
Abstract
Background SARS-CoV2 infection has been associated to a wide range of clinical scenarios, named COVID-19, ranging from acute respiratory distress syndrome to blood coagulation abnormalities and vascular manifestations related to hyper-inflammation. Recent focus has been addressed to study of microvascular alterations which may explain COVID-19 pathophysiology. Alterations in microvascular structure, identified as increased wall to lumen ratio (WLR) of retinal arterioles, have been extensively described in patients with cardiovascular diseases, such as hypertension or diabetes mellitus. Both inflammation and immune system dysregulation seem to play a role in the pathogenesis of these morphological changes. Purpose Aim of this study was to evaluate through Adaptive Optics microvascular differences of retinal arterioles between patients experienced COVID-19 and controls. Methods Patients were hospitalized between 28th February and 15th April at a Internal Medicine ward in a tertiary care hospital. All patients tested positive for a SARS-CoV-2 nasopharyngeal swab at admission and showed signs of pneumonia and respiratory insufficiency. Adaptive Optics, which allows a non-invasive evaluation of retinal arteriole structure, and blood chemistry exams were performed as part of follow up visits between 2 to 3 months after hospitalization. Baseline characteristics were collected through medical records. COVID-19 patients were compared to age- and sex-matched healthy subjects referred to our center between 2018 and 2019. Results A total of 80 patients were included in this study (of which 40 were COVID-19 patients). Apart from smoking habit, other baseline characteristics (sex, age, cardiovascular risk factors and main comorbidities) did not differ between the two groups. At follow up visit COVID-19 patients showed lower values for leukocytes (6.2 vs. 7.5x103/μL, p=0.015) and lymphocytes (1.9 vs. 2.8x103/μL, p=0.002). Creatinine values were higher in patients who suffered from COVID-19 (1.0 vs 0.8 mg/dl, p=0.004 – Figure 1, panel A). Adaptive Optics showed no differences in terms of internal lumen, wall thickness and WLR of retinal arterioles. However, the wall cross-sectional area (WCSA) was found to be higher in COVID-19 patients (p=0.039 – Figure 1, panel B). Hypertension significantly affected both WCSA and WLR between COVID-19 and healthy individuals, while diabetes only impacted on WLR (Figure 2). Conclusion Previous studies described the presence of leukopenia and lymphopenia during the acute phase of SARS-CoV2 infection. Our study demonstrates that these alterations persist several weeks after symptoms onset. Adaptive Optics showed microvascular alterations occurring in these patients: in particular, higher wall cross-sectional area of retinal arterioles were observed in patients after COVID-19 hospitalization, reflecting the complex pathogenic mechanisms which may explain the wide range of symptoms and clinical severity. Funding Acknowledgement Type of funding sources: None.
Figure 1 ![]() Figure 2 ![]()
Collapse
Affiliation(s)
- P Malerba
- University of Brescia, Internal Medicine, Department of Clinical and Experimental Sciences, Brescia, Italy
| | - C Agabiti Rosei
- University of Brescia, Internal Medicine, Department of Clinical and Experimental Sciences, Brescia, Italy
| | - M Nardin
- University of Brescia, Internal Medicine, Department of Clinical and Experimental Sciences, Brescia, Italy
| | - A Gaggero
- University of Brescia, Internal Medicine, Department of Clinical and Experimental Sciences, Brescia, Italy
| | - G Chiarini
- University of Brescia, Internal Medicine, Department of Clinical and Experimental Sciences, Brescia, Italy
| | - C Rossini
- University of Brescia, Internal Medicine, Department of Clinical and Experimental Sciences, Brescia, Italy
| | - F Fama'
- University of Brescia, Internal Medicine, Department of Clinical and Experimental Sciences, Brescia, Italy
| | - V Brami
- University of Brescia, Internal Medicine, Department of Clinical and Experimental Sciences, Brescia, Italy
| | - M A Coschignano
- University of Brescia, Internal Medicine, Department of Clinical and Experimental Sciences, Brescia, Italy
| | - M L Muiesan
- University of Brescia, Internal Medicine, Department of Clinical and Experimental Sciences, Brescia, Italy
| | - D Rizzoni
- University of Brescia, Division of Medicine, Montichiari Hospital, Brescia, Italy
| | - C De Ciuceis
- University of Brescia, Internal Medicine, Department of Clinical and Experimental Sciences, Brescia, Italy
| |
Collapse
|
3
|
Fama' F, Sindoni A, Donato R, Cascio A, Mondello P, Gaeta R. Tuberculous aortitis in an human immunodeficiency virus-positive Ivorian migrant: A case report. Int J STD AIDS 2021; 32:1361-1364. [PMID: 34410870 DOI: 10.1177/09564624211037523] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
We report an unusual case of a 35-year-old Ivorian migrant with an abdominal mass and medical history relevant for human immunodeficiency virus-2 positivity with a CD4/CD8 ratio of 0.63; Mantoux and lymphocyte stimulation tests (QuantiFERON) were positive. 3D-CT images revealed a voluminous non-homogeneous retroperitoneal mass in the right abdominal region presenting no significant contrast impregnation. Thoraco-abdominal aorta presented diffuse-altered morphology with multiple ectasias throughout its course and an aneurysm at the level of the subrenal tract. The patient underwent vascular surgery. Mycobacterium tuberculosis complex was detected by polymerase chain reaction performed on intraoperative tissue specimens. Postoperative course was uneventful. After surgery, 3D-CT images showed no signs of malfunction of the prosthesis. At last, at 6-month follow-up, the patient was well. Cross-sectional imaging techniques, such as contrasted-CT, are essential and allow for making diagnosis, assessing disease activity, and evaluating post-treatment condition. 3D reconstruction permits an appropriate patient care by means of an excellent visualization and staging of the disease process.
Collapse
Affiliation(s)
- Fausto Fama'
- Department of Human Pathology in Adulthood and Childhood "G. Barresi", 18980University Hospital of Messina, Messina, Italy
| | - Alessandro Sindoni
- Department of Public Health and Infectious Diseases, 9311Sapienza University of Rome, Rome, Italy
- Direzione Sanitaria, Azienda Ospedaliero-Universitaria Policlinico Umberto I, Rome, Italy
| | - Rocco Donato
- Department of Biomedical and Dental Sciences, Morphological and Functional Images, 18980University Hospital of Messina, Messina, Italy
| | - Antonio Cascio
- Department of Health Promotion Sciences, Maternal and Infant Care, Internal Medicine and Medical Specialities, 18998University of Palermo, Palermo, Italy
| | - Placido Mondello
- Department of Clinical and Experimental Medicine, Infectious Diseases Unit, 18980University Hospital of Messina, Messina, Italy
| | - Roberto Gaeta
- Department of Biomedical and Dental Sciences, Morphological and Functional Images, 18980University Hospital of Messina, Messina, Italy
- Senior Fellow of European Association for Cardio-Thoracic Surgery
| |
Collapse
|
4
|
Dionigi G, Fama' F, Pignata SA, Pino A, Pontin A, Caruso E, Fu Y, Li S, Mazzeo C, Sun H, Baldari S. Usefulness of PET-CT scan in recurrent thyroid cancer. World J Otorhinolaryngol Head Neck Surg 2020; 6:182-187. [PMID: 33073214 PMCID: PMC7548382 DOI: 10.1016/j.wjorl.2020.02.008] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2019] [Accepted: 02/16/2020] [Indexed: 11/28/2022] Open
Abstract
The aim of this paper is to discuss the risk of recurrence in patients with differentiated thyroid cancer and emphasize the importance of risk-group stratification, early recurrence identification and application of new imaging modalities, what is the PET-CT. Moreover, follow-up of patients with thyroid carcinoma should be carried out by specialized teams throughout life. Therefore, interdisciplinary case discussions in tumor conferences may improve the use of multimodal therapy especially in patients with poorly differentiated thyroid carcinomas. After baseline follow-up, if there is a suspicion of thyroid carcinoma, early PET-CT should be used for early detection and appropriate planning. Fortunately, due to the good localization possibility, the PET-CT enables a focused surgical procedure with avoidance of an unnecessary tumor search and thereby a reduction of the risk of injury of neighboring structures which is a concern with reoperative neck surgery.
Collapse
Affiliation(s)
- Gianlorenzo Dionigi
- Division for Endocrine and Minimally Invasive Surgery, Department of Human Pathology in Adulthood and Childhood "G. Barresi'', University Hospital G. Martino, University of Messina, Messina, Italy
| | - Fausto Fama'
- Division for Endocrine and Minimally Invasive Surgery, Department of Human Pathology in Adulthood and Childhood "G. Barresi'', University Hospital G. Martino, University of Messina, Messina, Italy
| | - Salvatore Antonio Pignata
- Nuclear Medicine Unit, Department of Biomedical and Dental Sciences and Morpho-Functional Imaging, University Hospital G. Martino, University of Messina, Messina, Italy
| | - Antonella Pino
- Division for Endocrine and Minimally Invasive Surgery, Department of Human Pathology in Adulthood and Childhood "G. Barresi'', University Hospital G. Martino, University of Messina, Messina, Italy
| | - Alessandro Pontin
- Division for Endocrine and Minimally Invasive Surgery, Department of Human Pathology in Adulthood and Childhood "G. Barresi'', University Hospital G. Martino, University of Messina, Messina, Italy
| | - Ettore Caruso
- Division for Endocrine and Minimally Invasive Surgery, Department of Human Pathology in Adulthood and Childhood "G. Barresi'', University Hospital G. Martino, University of Messina, Messina, Italy
| | - Yantao Fu
- Jilin Provincial Key Laboratory of Surgical Translational Medicine, Division of Thyroid Surgery, China- Japan Union Hospital of Jilin University, Changchun, Jilin Province, China
| | - Shijie Li
- Jilin Provincial Key Laboratory of Surgical Translational Medicine, Division of Thyroid Surgery, China- Japan Union Hospital of Jilin University, Changchun, Jilin Province, China
| | - Carmelo Mazzeo
- Division for Emergency Surgery, Department of Human Pathology in Adulthood and Childhood "G. Barresi'', University Hospital G. Martino, University of Messina, Messina, Italy
| | - Hui Sun
- Jilin Provincial Key Laboratory of Surgical Translational Medicine, Division of Thyroid Surgery, China- Japan Union Hospital of Jilin University, Changchun, Jilin Province, China
| | - Sergio Baldari
- Nuclear Medicine Unit, Department of Biomedical and Dental Sciences and Morpho-Functional Imaging, University Hospital G. Martino, University of Messina, Messina, Italy
| |
Collapse
|
5
|
Sindoni A, Di Maria A, Fama' F. Orbital metastases in infiltrating lobular carcinoma of the breast. J Surg Oncol 2020; 122:569. [PMID: 32476134 DOI: 10.1002/jso.26045] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2020] [Accepted: 05/16/2020] [Indexed: 11/11/2022]
Affiliation(s)
- Alessandro Sindoni
- Department of Public Health and Infectious Diseases, Sapienza University of Rome, Rome, Italy
| | - Alessandra Di Maria
- Department of Ophthalmology, Humanitas Research Hospital - IRCCS, Milan, Italy
| | - Fausto Fama'
- Department of Human Pathology in Adulthood and Childhood "G. Barresi", University Hospital of Messina, Messina, Italy
| |
Collapse
|
6
|
Sindoni A, Fama' F, Vinciguerra P, Dionigi G, Manara SAAM, Gaeta R, Gioffre'-Florio M, Di Maria A. Orbital metastases from breast cancer: A single institution case series. J Surg Oncol 2020; 122:170-175. [PMID: 32297325 DOI: 10.1002/jso.25927] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [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: 02/05/2020] [Revised: 03/11/2020] [Accepted: 03/27/2020] [Indexed: 11/12/2022]
Abstract
BACKGROUND AND OBJECTIVES Among orbital tumors, metastatic lesions have a prevalence of 1% to 13%; on the other hand, breast cancer is the most common malignancy causing orbital metastases. The aim of this study is to present our experience dealing with orbital metastases caused by breast cancer, to assess characteristics and clinic-pathological data of patients suffering from this rare occurrence and to find indexes related with their prognosis and survival. METHODS Records of 28 patients diagnosed with orbital metastases from breast cancer at the Department of Ophthalmology, Humanitas Clinical and Research Centre of Milano over a 27-year period (1992-2018) were retrieved and analyzed. RESULTS Mean patients' age at breast cancer diagnosis was 56.29 ± 14.63 years. Mean time interval between breast cancer diagnosis and orbital metastasis occurrence was 5 ± 4.17 years. All lesions were estrogen receptor-positive; 79% of patients harbored progesterone receptor-positive lesions. Interestingly, the majority of deceased patients presented orbital lesions with MIB-1 index >50% (P = .0265) and had concomitant lung metastases (P = .0452). CONCLUSIONS The occurrence of orbital metastasis from breast cancer represents a challenging finding. Patients' clinical picture can include exophthalmos, edema, tumefaction, proptosis and/or diplopia. Significant symptomatic improvement can be achieved through surgery and other adjuvant treatments, such as radiation therapy and chemotherapy.
Collapse
Affiliation(s)
- Alessandro Sindoni
- Department of Public Health and Infectious Diseases, Sapienza University of Rome, Italy
| | - Fausto Fama'
- Department of Human Pathology in Adulthood and Childhood "G. Barresi", University Hospital of Messina, Italy
| | - Paolo Vinciguerra
- Department of Ophthalmology, Humanitas Research Hospital - IRCCS, Rozzano/Milano, Italy
| | - Gianlorenzo Dionigi
- Department of Human Pathology in Adulthood and Childhood "G. Barresi", University Hospital of Messina, Italy
| | | | - Roberto Gaeta
- Department of Biomedical and Dental Sciences and of Morphological and Functional Images, University Hospital of Messina, Italy
| | - Maria Gioffre'-Florio
- Department of Human Pathology in Adulthood and Childhood "G. Barresi", University Hospital of Messina, Italy
| | - Alessandra Di Maria
- Department of Ophthalmology, Humanitas Research Hospital - IRCCS, Rozzano/Milano, Italy
| |
Collapse
|
7
|
Fama' F, Di Maria A, Cicciu' M, Buccheri G, Gioffre'-Florio M, Benvenga S, Sindoni A. Intraoperative sonography for nonpalpable breast lesions: Additional indications for a consolidate technique. Breast J 2019; 26:479-483. [PMID: 31524310 DOI: 10.1111/tbj.13575] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [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: 02/24/2019] [Revised: 08/15/2019] [Accepted: 08/16/2019] [Indexed: 11/29/2022]
Abstract
This prospective study evaluated the intraoperative ultrasound scan (IUSS) for nonpalpable breast lesions' detection. A total of 108 consecutive female patients underwent surgery using IUSS: Frozen sections demonstrated clear margins in 95.5% of neoplastic patients. Only four (4.5%) patients underwent local re-excision in the same operation. IUSS demonstrated to be quick, accurate, useful, effective, and safe for the intraoperative management of neoplastic nonpalpable breast lesions when performed by a surgeon who has undergone US training, particularly for people in whom alternative approaches can show some limitations due to contraindications or because of scheduling constraints, costs, and patient discomfort.
Collapse
Affiliation(s)
- Fausto Fama'
- Department of Human Pathology in Adulthood and Childhood "G. Barresi", University Hospital of Messina, Italy
| | - Alessandra Di Maria
- Department of Ophthalmology, Humanitas Clinical and Research Center, Rozzano/Milano, Italy
| | - Marco Cicciu'
- Department of Biomedical and Dental Sciences and of Morphological and Functional Images, University Hospital of Messina, Italy
| | - Giancarlo Buccheri
- Department of Human Pathology in Adulthood and Childhood "G. Barresi", University Hospital of Messina, Italy
| | - Maria Gioffre'-Florio
- Department of Human Pathology in Adulthood and Childhood "G. Barresi", University Hospital of Messina, Italy
| | - Salvatore Benvenga
- Department of Clinical and Experimental Medicine, University Hospital of Messina, Italy
| | - Alessandro Sindoni
- Department of Public Health and Infectious Diseases, Sapienza University of Rome, Italy
| |
Collapse
|
8
|
Fama' F, Vita R, Sindoni A, Vinci SL, Giorgianni G, Grasso L, Gioffre'-Florio M, Benvenga S. High frequency of empty sella, with gender differences, in the early neuroradiology evaluation of patients with traumatic brain injury. A prospective study. J Clin Transl Endocrinol 2018; 15:54-61. [PMID: 30622899 PMCID: PMC6317284 DOI: 10.1016/j.jcte.2018.12.008] [Citation(s) in RCA: 4] [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] [Subscribe] [Scholar Register] [Received: 11/12/2018] [Revised: 12/11/2018] [Accepted: 12/29/2018] [Indexed: 01/04/2023]
Abstract
One-hundred four persons aged ≥ 18 years (62 males and 42 females) who were admitted for traumatic brain injury (TBI) underwent brain computed tomography (CT) scan and assay of serum cortisol, insulin-like growth factor 1 (IGF-1), thyrotropin (TSH) and free thyroxine (FT4). The main purpose was to assess any gender difference and the rate of empty sella (ES). Women were more likely to have empty sella (19/42 [45.2%] vs 19/62 [30.6%], P = 0.15, OR = 1.9), which was more frequently total ES or TES (16/19 [84.2%] vs 3/19 [15.8%], P = 0.0025, OR = 11.6). Neuroradiology was normal in the remaining 65 patients. Patients with TES were approximately 20–30 years older than both patients with partial ES (PES) and normal sella, but only the comparison with normal sella was significant (P = 0.001 all patients, P = 0.005 males). Presumed deficiency of IGF-1, cortisol or TSH occurred in 33 persons (31.7%; 20 Males [32.2%], 13 Females [30.9%]), 14 (13.5%; 10 M [16.2%], 4F [9.5%]) or 8 (7.7%; 1 M [1.7%], 7F [16.7%]), with only TSH deficiency having significant intergender difference (P = 0.007). The highest or lowest rates of IGF-1 deficiency occurred in men with PES (41.7%) or men with TES (14.3%), of cortisol deficiency in men with PES (33.3%) or women with PES (zero), and TSH deficiency in women with TES (18.7%) or both men and women with PES (zero) and men with normal sella (zero). Within ES, males with no deficiency were older compared to males with at least one hormone deficiency (75.7 ± 17.4 vs 55.6 ± 18.9, P = 0.022); in turn, the former males were also older compared with normal sella males having no hormone deficiency (54.1 ± 25.2, P = 0.023). In conclusion, ES is detectable in almost 40% of persons who undergo CT within 24 h from TBI. A number of intergender differences concerning ES and the hormones evaluated are apparent.
Collapse
Affiliation(s)
- Fausto Fama'
- Department of Human Pathology in Adulthood and Childhood "G. Barresi", University of Messina, Italy
| | - Roberto Vita
- Department of Clinical and Experimental Medicine, University of Messina, Italy
| | - Alessandro Sindoni
- Department of Public Health and Infectious Diseases, Sapienza University of Rome, Italy
| | - Sergio Lucio Vinci
- Department of Biomedical and Dental Sciences, Morphological and Functional Images, University of Messina, Italy
| | - Grazia Giorgianni
- Department of Biomedical and Dental Sciences, Morphological and Functional Images, University of Messina, Italy
| | - Loredana Grasso
- Department of Biomedical and Dental Sciences, Morphological and Functional Images, University of Messina, Italy
| | - Maria Gioffre'-Florio
- Department of Human Pathology in Adulthood and Childhood "G. Barresi", University of Messina, Italy
| | - Salvatore Benvenga
- Department of Clinical and Experimental Medicine, University of Messina, Italy.,Master Program on Childhood, Adolescent and Women's Endocrine Health, University of Messina, Italy.,Interdepartmental Program on Molecular & Clinical Endocrinology, and Women's Endocrine Health, University Hospital of Messina, 98125 Messina, Italy
| |
Collapse
|
9
|
Sindoni A, Fama' F, Rosano' A, Scisca C, Dionigi G, Koch CA, Gioffrè-Florio M, Benvenga S. Thyroid nodules coexisting with either cystic or solid breast nodules: a new clue for this association between nodules coming from ultrasonography. Gland Surg 2017; 6:630-637. [PMID: 29302478 DOI: 10.21037/gs.2017.09.11] [Citation(s) in RCA: 5] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/10/2023]
Abstract
Background Thyroid and breast nodules (BNs) are common, their prevalence varying based mainly on the population (including age, residence in area of different iodine availability) studied and methods used. The coincidence of thyroid and breast diseases remains controversial and the majority of the studies evaluate the association between breast cancer and thyroid disorders. Here we describe our experience of such association in a non-oncological series. Methods Between the years 2000 and 2005, 3,372 patients from outpatient clinics were referred for thyroid ultrasonography (US) at our University Hospital; concurrent breast US in the 1,896 women revealed the presence of BNs in 127. The 127 women were divided into two groups, based on the cystic or solid nature of the BN(s). Results In 84/127 (66.1%) the single or multiple BN was/were cystic (group 1), while in the remaining 43 (33.9%) the single or multiple BN was/were solid [group 2; 19/43 had one thyroid nodule (TN) and the remaining 24/43 had ≥2 TNs]. When BN were cystic the coexisting TN(s) was/were more likely to be concordant in localization (i.e., right/right or left/left localization) whereas, when the BN were solid, the coexisting thyroid nodule/nodules was/were more likely to be discordant. In women with cystic BNs (CBNs), TNs were more frequently multiple (64% of cases), whereas in cases with solid BNs (SBNs), the frequency of single and multiple TNs was approximately the same. In patients with TNs/CBNs, TNs tend to be subcentimetric and localized in the inferior pole of either thyroid lobe. In patients with TNs/SBNs, TNs tend to be larger and localized in the middle of either thyroid lobe. Conclusions In women with BNs associated with TNs, there are interesting differences concerning TNs when patients are stratified based on the cystic or solid nature of the BN.
Collapse
Affiliation(s)
- Alessandro Sindoni
- Unit of Nuclear Medicine, IRCCS-CRO Aviano National Cancer Institute, Aviano, Pordenone, Italy
| | - Fausto Fama'
- Division of Endocrine Surgery, Department of Human Pathology in Adulthood and Childhood "G. Barresi", University Hospital of Messina, Messina, Italy
| | - Antonio Rosano'
- Master Program on Childhood, Adolescence and Women's Endocrine Health, University of Messina, Messina, Italy
| | - Claudio Scisca
- Department of Clinical & Experimental Medicine, University Hospital of Messina, Messina, Italy
| | - Gianlorenzo Dionigi
- Division of Endocrine Surgery, Department of Human Pathology in Adulthood and Childhood "G. Barresi", University Hospital of Messina, Messina, Italy
| | - Christian A Koch
- Division of Endocrinology, Endocrine Tumor Program, Cancer Institute, University of Mississippi Medical Center, Jackson, MS, USA
| | - Maria Gioffrè-Florio
- Division of Endocrine Surgery, Department of Human Pathology in Adulthood and Childhood "G. Barresi", University Hospital of Messina, Messina, Italy
| | - Salvatore Benvenga
- Master Program on Childhood, Adolescence and Women's Endocrine Health, University of Messina, Messina, Italy.,Department of Clinical & Experimental Medicine, University Hospital of Messina, Messina, Italy.,Interdepartmental Program of Molecular & Clinical Endocrinology, and Women's Endocrine Health, University Hospital of Messina, Messina, Italy
| |
Collapse
|
10
|
Fama' F, Gioffrè-Florio M. Surgical Treatment of Chronic Anal Fissure. Acta Med Iran 2017; 55:538. [PMID: 29034654] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/07/2017] [Indexed: 06/07/2023] Open
Affiliation(s)
- Fausto Fama'
- Department of Human Pathology, University Hospital of Messina, Messina, Italy
| | | |
Collapse
|
11
|
Fama' F, Sindoni A, Gioffre'-Florio M. Comment on Article Entitled "Parathyroid Autotransplantation During Thyroid Surgery: A Novel Technique Using a Cell Culture Nutrient Solution": Reply. World J Surg 2017; 41:1654-1655. [PMID: 28265734 DOI: 10.1007/s00268-017-3967-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Affiliation(s)
- Fausto Fama'
- Department of Human Pathology, University Hospital of Messina, Via Consolare Valeria, 1, 98125, Messina, Italy.
| | - Alessandro Sindoni
- Department of Biomedical and Dental Sciences, Morphological and Functional Images, University of Messina, Via Consolare Valeria, 1, 98125, Messina, Italy
| | - Maria Gioffre'-Florio
- Department of Human Pathology, University Hospital of Messina, Via Consolare Valeria, 1, 98125, Messina, Italy
| |
Collapse
|
12
|
Fama' F, Licata L, Villari A, Palella J, Speciale G, Gioffre'-Florio M. Late recurrent cutaneous breast angiosarcoma in an elderly woman: A case report. Oncol Lett 2016; 11:3247-3250. [PMID: 27123098 PMCID: PMC4840955 DOI: 10.3892/ol.2016.4389] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [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: 03/09/2015] [Accepted: 01/12/2016] [Indexed: 11/07/2022] Open
Abstract
Breast angiosarcomas are malignant tumours of the vascular endothelium that arise frequently following radiation therapy. Their clinical and radiological aspects are highly heterogeneous. The current study reports an unusual case, never previously reported, of a late recurrent breast angiosarcoma occurring in an 83-year old female patient 11 years after a breast-conserving surgery followed by radiation therapy for an invasive ductal carcinoma, and 5 years after her initial angiosarcoma excision. The first physician to examine the patient noted a palpable mass near the scar and, following ultrasonography, described the breast lesion as suggestive of an abscess, despite the previous history of neoplasia. Typically, recurrences of breast angiosarcoma occur within the first postsurgical year. The present patient remains alive at 25 months after her last surgical treatment, and no evidence of any local or distant disease is observable.
Collapse
Affiliation(s)
- Fausto Fama'
- Department of Human Pathology, University Hospital of Messina, Messina 98125, Italy
| | - Luana Licata
- Department of Human Pathology, University Hospital of Messina, Messina 98125, Italy
| | - Alessandra Villari
- Department of Human Pathology, University Hospital of Messina, Messina 98125, Italy
| | - Jessica Palella
- Department of Human Pathology, University Hospital of Messina, Messina 98125, Italy
| | - Giuseppe Speciale
- Department of Human Pathology, University Hospital of Messina, Messina 98125, Italy
| | | |
Collapse
|
13
|
Sindoni A, Fama' F. Extent of lymph node dissection in papillary thyroid cancer. Surgery 2016; 160:518. [PMID: 27063342 DOI: 10.1016/j.surg.2016.02.035] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2016] [Revised: 02/26/2016] [Accepted: 02/29/2016] [Indexed: 11/24/2022]
Affiliation(s)
- Alessandro Sindoni
- Department of Biomedical and Dental Sciences and of Morphological and Functional Images, University Hospital of Messina, Messina, Italy.
| | - Fausto Fama'
- Department of Human Pathology, University Hospital of Messina, Messina, Italy
| |
Collapse
|
14
|
Fama' F, Ieni A, Tchernev G, Chokoeva AA, Maximov GK, Wollina U, Lotti T, Patterson JW, Fioranelli M, Roccia MG, Guarneri C, Gioffre-Florio M. Pilomatrixoma of the breast in a patient with type 1 myotonic dystrophy: successful surgical approach. J BIOL REG HOMEOS AG 2016; 30:1-6. [PMID: 27373126] [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: 06/06/2023]
Abstract
Malherbes calcifying epithelioma is an uncommon cutaneous tumour that originates from the matrix cells of hair follicle. It was initially described by Malherbe as a benign calcifying epithelioma. Several ultra-structural and electron-microscopic studies later demonstrated its origin from matrix cells and the term pilomatrixoma was introduced. The treatment of this tumour remains mainly surgical. Malignant cases with post-surgical recurrences have been described in literature and recurrences have been related to an incomplete surgical treatment or tumour aggressiveness. We present the case of 31-year-old female patient with pilomatrixoma of the breast, which was very similar to fibroadenoma, in terms of size and other clinical features. We successfully treated this patient surgically, and the aesthetic results were good, despite the proximity of the tumour to the areola-nipple complex. Fifteen months later, the patient is doing well, free of any clinical local recurrence.
Collapse
Affiliation(s)
- F Fama'
- Department of Human Pathology; University Hospital of Messina, Messina, Italy
| | - A Ieni
- Department of Human Pathology; University Hospital of Messina, Messina, Italy
| | - G Tchernev
- Medical Institute of Ministry of Interior (MVR-Sofia), Department of Dermatology, Venereology and Dermatologic Surgery, Sofia, Bulgaria
| | - A A Chokoeva
- "Onkoderma"- Policlinic for Dermatology and Dermatologic Surgery, Sofia, Bulgaria; Department of Dermatology and Venereology, Medical University of Plovdiv, Medical Faculty, Plovdiv, Bulgaria
| | - G K Maximov
- Department Medicinal Information and Non-Interventional studies, Bulgarian Drug Agency, Sofia, Bulgaria
| | - U Wollina
- Department of Dermatology and Allergology, Academic Teaching Hospital Dresden-Friedrichstadt, Dresden, Germany
| | - T Lotti
- Department of Dermatology, University of Rome G. Marconi Rome, Italy
| | - J W Patterson
- University of Virginia Health System, Department of Pathology, Charlottesville, VA USA
| | - M Fioranelli
- History Department, G. Marconi University, Rome, Italy
| | - M G Roccia
- University B.I.S. Group of Institutions, Punjab Technical University, Punjab, India
| | - C Guarneri
- Department of Clinical and Experimental Medicine, Unit of Dermatology University Hospital of Messina, Messina, Italy
| | - M Gioffre-Florio
- Department of Human Pathology; University Hospital of Messina, Messina, Italy
| |
Collapse
|
15
|
Fama' F, Villari A, Lo Presti D, Gioffre'-Florio M. A fatal anal impalement. J Emerg Trauma Shock 2016; 9:45. [PMID: 26957831 PMCID: PMC4766769 DOI: 10.4103/0974-2700.161660] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Affiliation(s)
- Fausto Fama'
- Department of Human Pathology "Gaetano Barresi", University Hospital of Messina, 98125 Messina, Italy E-mail:
| | - Alessandra Villari
- Department of Human Pathology "Gaetano Barresi", University Hospital of Messina, 98125 Messina, Italy E-mail:
| | - Dario Lo Presti
- Department of Human Pathology "Gaetano Barresi", University Hospital of Messina, 98125 Messina, Italy E-mail:
| | - Maria Gioffre'-Florio
- Department of Human Pathology "Gaetano Barresi", University Hospital of Messina, 98125 Messina, Italy E-mail:
| |
Collapse
|
16
|
Fama' F, Dattola V, Cicciu' M, Buccafusca M, Russo M, Lo Presti D, Dattilo G, Di Bella G. Natalizumab treatment for multiple sclerosis inducing a toxic acute myocardial damage. Is there any relationship? Int J Cardiol 2016; 206:127-8. [PMID: 26788687 DOI: 10.1016/j.ijcard.2016.01.089] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/09/2015] [Accepted: 01/02/2016] [Indexed: 11/16/2022]
Affiliation(s)
- Fausto Fama'
- Department of Human Pathology, University Hospital of Messina, Via Consolare Valeria n.1, 98125 Messina, Italy.
| | - Vincenzo Dattola
- Department of Clinical and Experimental Medicine, University Hospital of Messina, Via Consolare Valeria n.1, 98125 Messina, Italy
| | - Marco Cicciu'
- Department of Human Pathology, University Hospital of Messina, Via Consolare Valeria n.1, 98125 Messina, Italy
| | - Maria Buccafusca
- Department of Clinical and Experimental Medicine, University Hospital of Messina, Via Consolare Valeria n.1, 98125 Messina, Italy
| | | | - Dario Lo Presti
- Department of Human Pathology, University Hospital of Messina, Via Consolare Valeria n.1, 98125 Messina, Italy
| | - Giuseppe Dattilo
- Department of Clinical and Experimental Medicine, University Hospital of Messina, Via Consolare Valeria n.1, 98125 Messina, Italy
| | - Gianluca Di Bella
- Department of Clinical and Experimental Medicine, University Hospital of Messina, Via Consolare Valeria n.1, 98125 Messina, Italy
| |
Collapse
|
17
|
Fama' F, Piquard A, Pallela J, Lo Presti D, Saint-Marc O, Gioffre'-Florio M. Unusual presentation of a distal cholangiocarcinoma. Clin Case Rep 2016; 3:1052-3. [PMID: 26734145 PMCID: PMC4693710 DOI: 10.1002/ccr3.415] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [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: 05/13/2015] [Revised: 06/30/2015] [Accepted: 09/18/2015] [Indexed: 11/16/2022] Open
Abstract
We report a case of a 51‐year‐old male presented with abdominal pain and itching, whereas jaundice occurred afterwards. Diagnosis was made by means of CT and better assessed by MRI and endoscopic ultrasounds. Patient was treated with an open Whipple's procedure, and after an 18‐month follow‐up he was doing well.
Collapse
Affiliation(s)
- Fausto Fama'
- Department of Human Pathology University Hospital of Messina Via Consolare Valeria, 1 98100 Messina Italy
| | - Arnaud Piquard
- Department of General, Endocrine and Thoracic Surgery Regional Hospital of Orleans 14 Avenue de l'Hôpital 45067 Orléans (Cedex 2) France
| | - Jessica Pallela
- Department of Human Pathology University Hospital of Messina Via Consolare Valeria, 1 98100 Messina Italy
| | - Dario Lo Presti
- Department of Human Pathology University Hospital of Messina Via Consolare Valeria, 1 98100 Messina Italy
| | - Olivier Saint-Marc
- Department of General, Endocrine and Thoracic Surgery Regional Hospital of Orleans 14 Avenue de l'Hôpital 45067 Orléans (Cedex 2) France
| | - Maria Gioffre'-Florio
- Department of Human Pathology University Hospital of Messina Via Consolare Valeria, 1 98100 Messina Italy
| |
Collapse
|
18
|
Fama' F, Scibilia G, Ieni A, Presti DL, Villari A, Gioffrè Florio M. Atraumatic splenic rupture: an atypical presentation in a previously healthy patient. Ann Ital Chir 2015; 86:S2239253X1502438X. [PMID: 26969116] [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: 06/05/2023]
Abstract
UNLABELLED Atraumatic splenic rupture represents a life-threatening abdominal event that requires immediate diagnosis and prompt surgical treatment to ensure the survival of the patient. Atraumatic rupture is relatively uncommon and can occur either in pathological spleens or, more rarely, in normal ones. It has a high morbidity, frequently with few and non specific signs suggesting its presence, can be associated to other pathologies incidentally discovered by imaging. We present a case, successfully treated, of a 51-year-old man, previously healthy, that referred to our hospital for arterial hypertension and abdominal pain; the patient, for an idiopathic splenic rupture with haemoperitoneum, underwent an open splenectomy whose histology examination showed a normal spleen. KEY WORDS Atraumatic splenic rupture, Normal spleen, Spontaneos haemoperitoneum - Full text is available at: www.annaliitalianidichirurgia.it.
Collapse
|
19
|
Fama' F, Linard C, Bierlaire D, Gioffre'-Florio M, Fusciardi J, Laffon M. Influence of needle diameter on spinal anaesthesia puncture failures for caesarean section: A prospective, randomised, experimental study. Anaesth Crit Care Pain Med 2015; 34:277-80. [PMID: 26453527 DOI: 10.1016/j.accpm.2015.05.005] [Citation(s) in RCA: 6] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2014] [Accepted: 05/19/2015] [Indexed: 10/23/2022]
Abstract
OBJECTIVES Spinal anaesthesia represents the technique of choice for elective caesarean section. The purpose of this study was to compare the puncture failure rates with 25, 26 or 27 gauge (G) pencil-point, Whitacre type (with introducer) needles during spinal anaesthesia for caesarean section. STUDY DESIGN Prospective, randomised, experimental study in healthy subjects. PATIENTS AND METHODS We recruited 330 adults, consecutively scheduled parturients, randomised into three groups. The subarachnoid puncture procedure was standardised. The flexibility of the three needle types was assessed in vitro, and a force was applied using a dynamometer. The occurrence of postdural puncture headache was also evaluated. RESULTS The number of spinal puncture failures was significantly higher in the 27G group, than in the 25G (P=0.006) group and the 26G (P<0.001) group, but did not differ between the 25G and 26G groups (P=0.606). Ten postdural puncture headaches were observed without significant differences among the groups. CONCLUSIONS This prospective study showed that puncture failures occur less frequently with the use of 25G or 26G pencil-point needles as compared to 27G needles, probably due to the higher flexibility of the latter. This characteristic was demonstrated in vitro, in a reproducible model. This experiment suggests that a 26G pencil-point needle is the optimal gauge for performing spinal anaesthesia for scheduled caesarean sections.
Collapse
Affiliation(s)
- Fausto Fama'
- University Hospital of Messina, Department of Human Pathology, Via Consolare Valeria, 1, 98125 Messina, Italy.
| | - Cecile Linard
- University Hospital of Messina, Department of Human Pathology, Via Consolare Valeria, 1, 98125 Messina, Italy
| | - Damien Bierlaire
- University Hospital of Tours, Department of Anaesthesiology and Intensive Care, Hôpital Bretonneau, 2, boulevard Tonnellé, 37044 Tours cedex 9, France
| | - Maria Gioffre'-Florio
- University Hospital of Messina, Department of Human Pathology, Via Consolare Valeria, 1, 98125 Messina, Italy
| | - Jacques Fusciardi
- University Hospital of Tours, Department of Anaesthesiology and Intensive Care, Hôpital Bretonneau, 2, boulevard Tonnellé, 37044 Tours cedex 9, France
| | - Marc Laffon
- University Hospital of Tours, Department of Anaesthesiology and Intensive Care, Hôpital Bretonneau, 2, boulevard Tonnellé, 37044 Tours cedex 9, France
| |
Collapse
|
20
|
Fama' F, Galati M, Buccheri G, Palella J, Mento F, Gioffre'-Florio M. Laparoscopic repair of an incarcerated Bochdalek hernia in an elderly man. ANZ J Surg 2015; 87:1053-1054. [PMID: 25943696 DOI: 10.1111/ans.13158] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Affiliation(s)
- Fausto Fama'
- Human Pathology Department, University Hospital of Messina, Messina, Italy
| | - Marica Galati
- Human Pathology Department, University Hospital of Messina, Messina, Italy
| | | | - Jessica Palella
- Human Pathology Department, University Hospital of Messina, Messina, Italy
| | - Francesco Mento
- General Surgery Department, Community Hospital of Patti, Patti, Italy
| | | |
Collapse
|
21
|
Fama' F, Berry MG, Linard C, Gioffre'-Florio M, Metois D. Successful unilateral thoracoscopy for bilateral ectopic mediastinal parathyroidectomy. Thorac Cardiovasc Surg 2010; 58:187-9. [PMID: 20376735 DOI: 10.1055/s-0029-1185594] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
Ectopic parathyroid glands are frequently located in the thymus and may become hyperplasic in patients with secondary hyperparathyroidism. When medical management fails, surgical removal is required, using either a traditional open sternotomy approach or video-assisted thoracic surgery (VATS). We were able to excise large, bilateral, mediastinal parathyroid glands using only left VATS. To the authors' knowledge, this is the first reported case of the use of unilateral thoracoscopic subtotal thymectomy for the excision of bilateral ectopic mediastinal parathyroid glands.
Collapse
Affiliation(s)
- F Fama'
- Department of Human Pathology, University Hospital of Messina, Messina, Italy.
| | | | | | | | | |
Collapse
|
22
|
Berry M, Fitoussi A, Fama F, Couturaud B, Salmon R. Oncoplastic breast surgery for cancer: the first 20 years. Eur J Surg Oncol 2009. [DOI: 10.1016/j.ejso.2009.07.133] [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: 11/30/2022] Open
|
23
|
Pidoto RR, Fama' F, Giacobbe G, Gioffre' Florio MA, Cogliandolo A. Quality of life and predictors of long-term outcome in patients undergoing open Nissen fundoplication for chronic gastroesophageal reflux. Am J Surg 2006; 191:470-8. [PMID: 16531138 DOI: 10.1016/j.amjsurg.2006.01.004] [Citation(s) in RCA: 11] [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] [Received: 12/09/2004] [Revised: 05/25/2005] [Indexed: 10/24/2022]
Abstract
BACKGROUND Long-term outcome of antireflux operations as well as pre- and postoperative parameters able to predict their clinical results are still controversial. The aim of the present study was to evaluate long-term quality of life of patients undergoing open fundoplication for chronic GERD and to investigate pre- and early postoperative functional parameters possibly related to persistence or recurrence of symptoms. METHODS A cohort of 25 patients who underwent open Nissen fundoplications was reviewed for an evaluation of long-term residual symptoms and quality of life at an average follow-up of more than 10 years. Clinical evaluation was performed by using a symptom-specific score (DeMeester's score), 3 health-related quality of life scores, a GERD-specific (GERD-HRQL score) score, and 2 generic scores (SF-36) evaluating physical and psychological well-being. Subjective satisfaction grade of the patients was also investigated. In addition, a univariate analysis is provided, according to the long-term presence or absence of residual symptoms (120.6-month follow-up), taking into account pre- and postoperative (6-month follow-up) data of endoscopy, 24-hour pH monitoring, stationary manometry, and gastric-emptying test. RESULTS Persistence or recurrence of GERD-specific symptoms (heartburn and regurgitation) were reported by 8 patients (32%); 2 patients (8%) were reoperated on for persistent dysphagia, whereas 17 patients (68%) were asymptomatic. GERD-HRQL and SF-36 scores displayed significant postoperative improvement, which continued in long-term follow-up. Twenty patients (80%) had repeat fundoplication. Among tested parameters, only postoperative mean supine esophageal clearance and gastric emptying half-time, although on average improved significantly after the antireflux procedure, differed significantly in long-term asymptomatic and symptomatic subgroups. In long-term asymptomatic patients, postoperative (6 month) mean supine esophageal clearance was 0.8 +/- 0.3 minutes (P = .011) and 2.4 +/- 0.2 minutes in symptomatic patients. Postoperative (6 month) mean gastric emptying half-time of long-term asymptomatic patients was 93.3 +/- 8.9 minutes, whereas in symptomatic patients it was 127.5 +/- 14.3 minutes (P = .047). CONCLUSIONS Patients undergoing Nissen fundoplication had a satisfactory long-term quality of life. Clinical results did not deteriorate over time and showed to be related to postoperative esophageal clearance and gastric emptying, which could be regarded as early postoperative predictors of long-term clinical outcome.
Collapse
Affiliation(s)
- Rocco Roberto Pidoto
- Department of General Surgery, University of Messina, Via Trapani 6, 98100 Messina, Italy
| | | | | | | | | |
Collapse
|