1
|
Lisi G, Mastrangeli MR, Campanelli M, Passaro U, Spoletini D. ScleroEmorrhoidectomy: A new tool for the mucosal bridges - a video vignette. Colorectal Dis 2024. [PMID: 38590006 DOI: 10.1111/codi.16981] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/30/2023] [Revised: 01/04/2024] [Accepted: 01/06/2024] [Indexed: 04/10/2024]
Affiliation(s)
- Giorgio Lisi
- Department of Surgery, Sant'Eugenio Hospital, Rome, Italy
- UniCamillus-Saint Camillus International University of Health Sciences, Rome, Italy
| | | | | | | | | |
Collapse
|
2
|
Pini Prato A, Perretti C, Erculiani M, Mottadelli G, Taverna M, Giordano F, Caruso AM, Magro P, Guanà R, Carretto E, D'Aleo C, Lisi G, Masnata G, Cheli M, Migliazza L. A Structured Training for Trans Anal Irrigation in Pediatric Patients Improves Outcomes and Reduce Failures: Results of an Interventional Multicenter Prospective Study. J Pediatr Surg 2024:S0022-3468(24)00002-2. [PMID: 38245378 DOI: 10.1016/j.jpedsurg.2023.12.024] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/17/2023] [Revised: 12/16/2023] [Accepted: 12/25/2023] [Indexed: 01/22/2024]
Abstract
BACKGROUND Continence issues due to organic causes including previous colorectal surgery or neurological issues might benefit from Transanal irrigation (TAI) that proved to be highly effective but with a number of limitations including a relatively high discontinuation rates. Our study was aimed at evaluating the efficacy of an advanced protocol tailored to each patient to prevent dropout and increase satisfaction, independence, and quality of life. MATERIALS AND METHODS This was a prospective, interventional, multicenter, nonrandomized study involving children aged 4-18 years with bowel dysfunction unresponsive to conventional treatments who required TAI. TAI was performed in accordance to the best standards of care with a total irrigation volume that was determined based on low emission X-Ray barium enemas performed at the very beginning of the study. All patients underwent training and assessments of continence, patients' perspectives and quality of life were performed at different timepoints from enrollment (T0) up to 6 months since TAI was introduced (T3). RESULTS A total of 78 patients were enrolled. Male to female ratio was 1.4:1. Mean age at enrollment was 106.1 ± 42.8 months. Discontinuation was reported by 3 patients (3.8 %). Continence, satisfaction and a number of other outcome measures increased from baseline (T0) to the last visit (T3). In particular, mean Rintala total score increased linearly from 7.8 to 14.8 during the study period (T0 to T3 timepoints). On a multivariate analysis, the only parameter that proved to be inversely associated with continence as well as with other outcome measures was the use of laxatives at enrollment and during the study. CONCLUSIONS This study has demonstrated the high efficacy of this innovative patient-tailored TAI protocol across all assessed scores. Of note, given the negative impact of laxatives, our findings suggest limiting their use in this patient population to further increase the efficacy of the procedure.
Collapse
Affiliation(s)
- A Pini Prato
- Umberto Bosio Center for Digestive Diseases, The Children Hospital, AO SS Antonio e Biagio e Cesare Arrigo, Alessandria, Italy.
| | - C Perretti
- Umberto Bosio Center for Digestive Diseases, The Children Hospital, AO SS Antonio e Biagio e Cesare Arrigo, Alessandria, Italy
| | - M Erculiani
- Umberto Bosio Center for Digestive Diseases, The Children Hospital, AO SS Antonio e Biagio e Cesare Arrigo, Alessandria, Italy
| | - G Mottadelli
- Umberto Bosio Center for Digestive Diseases, The Children Hospital, AO SS Antonio e Biagio e Cesare Arrigo, Alessandria, Italy
| | - M Taverna
- Department of Neurosurgery, Meyer Children's Hospital IRCCS, Florence, Italy
| | - F Giordano
- Department of Neurosurgery, Meyer Children's Hospital IRCCS, Florence, Italy; University of Florence, Italy
| | - A M Caruso
- Pediatric Surgery, Azienda Ospedaliera Civico di Cristina Benfratelli, Palermo, Italy
| | - P Magro
- Medium Intensity Surgery, OIRM Ospedale Infantile Regina Margherita AO Città della Salute e della Sienza, Torino, Italy
| | - R Guanà
- Medium Intensity Surgery, OIRM Ospedale Infantile Regina Margherita AO Città della Salute e della Sienza, Torino, Italy
| | - E Carretto
- Department of Pediatric Surgery and Pediatric Minimally Invasive Surgery and New Technologies, San Bortolo Hospital, Vicenza, Italy
| | - C D'Aleo
- Spina Bifida Center, Azienda Sanitaria Provinciale, Caltanissetta, Italy
| | - G Lisi
- Pediatric Surgery at the Civil Hospital, Pescara, Italy
| | - G Masnata
- Pediatric Urodynamics, Azienda Ospedaliera G Brotzu, Cagliari, Italy
| | - M Cheli
- Pediatric Surgery Unit, ASST Papa Giovanni XXIII, Bergamo, Italy
| | - L Migliazza
- Pediatric Surgery Unit, ASST Papa Giovanni XXIII, Bergamo, Italy
| |
Collapse
|
3
|
Avellaneda N, Al Masri M, Baimakhanov A, Balasubramaniam D, Bhangu A, Bouchagier K, Bozbiyik O, Carpelan A, Chwat C, Cunha M, Dawson BE, Mallen MVD, Ellebæk MB, Gonzalez TE, Elshami M, Fakhradiyev I, Ozkan OF, Fleres F, Futaba K, Gallo G, Ghosh D, Glasbey JC, Harrison E, Hooper RL, Jain R, Kamarajah S, Veetil SK, Kamer E, Keatley J, Knowles CH, Kulimbet M, Lal P, Li E, Polamreddy BM, Minaya-Bravo A, Mittal R, Morton DG, Nadal LRM, Negoi I, Nepogodiev D, Omar O, Pata F, Pinkney T, Potter MA, Rottoli M, Santos G, Smith I, Spinelli A, Venn M, Hooper R, Morton D, Bywater E, Evans J, Magill L, McKay S, Bordom DO, Simões J, Venn ML, Adeyeye A, Avellaneda N, Buchs N, Cato L, Finch D, Umar GI, Bravo AM, Junior HM, Neary P, Poskus T, Roslani A, Samadov E, Sbaih M, Shalaby M, Singh B, Sinha A, Vardanyan A, Chaudhry S, Frasson M, Millward J, Sánchez-Guillén L, Stijns J, Zimmerman DDE, Beard D, Campbell M, Moug S, Aytac E, Blackwell S, Buchwald P, Chowdhury SM, Dardanov D, Dulskas A, Elhadi M, El-Hussuna A, Garoufalia Z, Aslam MI, Kelly M, Knowles C, Mendes B, Ng S, Pellino G, Sebastian S, Sivrikoz E, Tejedor P, Vaizey C, Bianchi R, Christensen P, Lee SH, Lohsiriwat V, Mantoo SK, Mazlan L, Um JW, Wang JY, Watanabe J, Yao H, Bengueddach A, Tidjane A, Tabeti B, Behilil C, Boudjenan-Serradj N, Bensafir S, Meharzi SEI, Aissat A, Ghouali AK, Larabi K, Riffi O, Kacimi SEO, Mesli SN, Rezoug W, Mitidieri A, José A, Pablo C, Rodriguez CA, Panettiere MF, Barbalace N, Juan T, Lucena J, Houdin A, Fernandez E, Lococo J, Pedro L, Loban M, Vecchio P, Grinblat A, Carrie A, Veracierto F, Santillan M, Napolitano M, Rosa SL, Gonzalez CM, Ferro E, Muñoz JP, Ventorutti T, Cabrera C, Carrizo C, Mospane C, Leiro F, Espino J, Trama M, Potolicchio A, Dindri F, Buey L, Lucas N, Catalano P, Astilleta R, Quiroga Y, Valli D, Alexandre F, Martres G, Rosato G, Lemme G, Romero V, Doniquian AM, Pachajoa DAP, Llahi F, Fiorenza JM, Parodi M, Ocaña N, Gallardo A, Valenzuela A, Perriello J, Nador R, Fermani C, Garay L, Blanco P, Villalobos S, Posner F, Vieyra N, Fiorito P, Ciabattari P, de Kort C, Daryanani D, Smit J, Gosselink MP, Janssen N, Feiss A, Lee CHA, Taylor D, Edington J, Chen N, Ong WM, Aigner F, Moitzi G, Gemes G, Braumille M, Mitteregger M, Gerald S, Uranitsch S, Belarmino A, Waha J, Kahn J, Treiber M, Schemmer P, Mikalauskas S, Ibrahimli A, Orujova E, Namazov I, Alikhanli J, Asgarov M, Kutkut A, Almahmeed E, Aljawder H, Juma I, Johnston K, Saeed MF, Khairi S, Matovic E, Omerasevic M, Delibegovic S, Hodzic S, Rudell AG, Fuzari J, Farah JF, Dos Santos MBA, Lupinacci RA, Pereira TS, da Silveira Sete A, Filho AL, de Souza Pires BL, de Queiroz FL, Amaral HAT, Dos Santos MAM, de Miranda Silvestre SC, Hanan B, Reis C, Cassia G, da Luz M, Delgado M, Campanati R, Silva R, Bomfa-Barbosa A, Alves BC, Costa BXM, Cortes BGW, Lemos FHT, Arreguy-Borges K, Silva TB, Assis A, Freitas AH, Rezende D, Silva H, Alvarenga I, Cascais R, Silva T, Pinto H, Silva I, Leite L, Massahud M, Meyer M, Tibúrcio R, Martinez CAR, Espinha DR, Marson FAL, de Oliveira Góes IA, de Souza Artioli LM, Boschiero MN, Takahashi CY, de Oliveira FG, Junior HFL, de Oliveira JCC, Dos Santos JM, Gerber MT, Erdmann TR, Barbosa A, Fernandes A, Júnior AN, Júnior HM, Moreira J, Ribeiro M, Moreira P, Carvalho A, Santos B, Fidelis F, Cruz I, Codes L, Aibe R, Boudoux S, Favacho BC, Pinto F, Gava G, Pivati IR, Vilain LF, Kim N, Nunes RL, Dimitrov D, Peneva K, Karamanliev M, Dimitrova S, Ivanov T, Atanasov B, Dzharov G, Shtereva M, Slavchev M, Belev N, Krastev P, Arabadzhiev A, Tonova D, Tzoneva D, Sokolov M, Gribnev P, Maslyankov S, Pavlov V, Bakmaz B, Dijan E, Ćoza I, Mihanovic J, Kučić J, Sulen N, Katušić Z, Hudáček K, Farkašová M, Marková M, Grolich T, Kala Z, Pazdírek F, Hoch J, Filipová L, Kocián P, Přikryl P, Høgn A, Møller B, Slot DK, Bælum JK, Cour KL, Eriksen ND, Mahmoud A, Abdellatif A, Nafea A, Ewedah M, Soliman M, Yakout N, Argawy O, Sallam I, Kamel I, Sherif M, Ashmawy S, Ali A, Saad M, Ahmed M, Mohamed M, Mohamed N, Mahmoud S, Mahmoud S, Rashed AM, Abd-Errazik MA, Ammar MA, Mohammed R, Ebrahem A, Abd El Aal A, Abdou K, Wagdy M, Qassem M, Taha M, El-Wafa YA, Shehta A, El Metwally A, Hamed H, Ali MA, Elrefai M, El Sorogy M, Abdelkhalek M, Ragab A, Refky B, Metwally IH, Abdelkhalek M, Kamal M, Zuhdy M, Shetiwy M, Sakr A, Elfallal A, Elfeki H, Eldakroury I, Elbahrawy K, Mostafa M, Emile S, Tessema A, Tasew A, Gezahegn H, Bekele K, Belay M, Gudisa Z, Teferu Z, Väyrynen A, Kechagias A, Turunen A, Katunin J, Parhiala M, Pengerma P, Lahti P, Vihervaara H, Huhtinen H, Pasonen J, Heino R, Pakarinen S, Falenius V, Pinard B, Nobile C, Duchalais E, Drissi F, Meurette G, Podevin J, Lepenndu M, Hoetzel A, Jud A, Jauch D, Stefan FF, Neeff H, Holzner P, Nguyen P, Ryl A, Kehl F, Pullig F, Baral J, Münch S, Fütterer C, Reißfelder C, Sandra-Petrescu F, Herrle F, Hardt J, Lamm L, Seyfried S, Gharbi A, Aydin F, Stavrou G, Sperber J, de Deken J, Schwarzkopf K, Widyaningsih R, Polidorou A, Mpakas A, Tokidis E, Loun L, Petropoulou T, Balalis D, Korkolis D, Manatakis D, Assimakopoulou E, Bourazani M, Gklavas A, Kalamara E, Papaconstantinou I, Theodoraki K, Chardalias L, Konstadoulakis M, Theodosopoulos T, Soulioti E, Kavezou F, Filippou J, Papadoliopoulou M, Michalopoulos N, Vassiliu P, Sidiropoulos T, Charakopoulou A, Panagiotou A, Kokkinakis K, Lambridi E, Psarologos M, Maria S, Giannaraki S, Kapiris S, Triantafyllou A, Theodoropoulos C, Matthaiou G, Westzaan N, Etelka S, Triantafyllou T, Schizas D, Mpaili E, Karydakis L, Mpoura M, Danassi D, Karavokyros I, Dimitriou N, Livanou X, Kikira A, Tsourouflis G, Tomara NK, Nikiteas N, Dorovinis P, Tsiotos G, Stamou K, Kocka N, Ballian N, Kalakonas S, Athanasakis E, Chrysos E, Xynos E, Tsiaoussis J, Papadaki K, Xenaki S, Nyktari V, Sarakatsianou C, Bompou E, Arnaoutoglou E, Tzovaras G, Baloyiannis I, Mamaloudis I, Perivoliotis K, Apostolidi E, Mulita F, Karpetas G, Maroulis I, Vailas M, Petra A, Kontis E, Kaouras E, Katsaros I, Katsiaras L, Manikis P, Papadopoulou T, Papadopoulos A, Manioti E, Zeringa G, Katsinelis I, Mouzakis O, Kouki P, Nikolaou V, Marinis A, Alexopoulou K, Papadaki M, Vederaki SA, Samara A, Giakoustidis D, Christodoulidis G, Bareka M, Chatzikomnitsa P, Tsigara S, Papadopoulos V, Zarzava E, Anestiadou E, Lydia L, Apostolakidou M, Ioannidis O, Simeonidis S, Mpitsianis S, Tam PTH, Ng SSM, Lau VNM, Tse WK, Bánky B, Dolhai E, Horváth É, Golub J, Marton J, Lakatos L, Suszták N, Maurya AP, Kumawat H, Saxena P, Lather R, Waindeskar V, Khanduri A, Goyal L, Gupta R, Singh S, Saksena AR, Rayani BK, Kasula J, Raju K, Shah MM, Thammineedi SR, Patnaik SC, Rathod D, Poonia DR, Vishnoi JR, Sharma N, Byshetty R, Yadav RK, Misra S, Dhali A, Dhali GK, Biswas J, Ray S, Ghose T, Pipara A, Singh HM, Roy MK, Desai N, Thambudorai R, Ishwarappagol V, Chaturvedi A, Verma D, Akhtar N, Gupta S, Rajan S, Tiwari T, Kumar V, Mahajan A, Jain D, Liddle D, Jyoti J, Haque PD, Prem W, Lakshminarayana B, S BV, Poojary PH, Bhat RRK, Mathew S, Gupta L, Bains L, Kumar M, Singh N, Sharma A, Kumar A, Garg L, Aggarwal M, Jakhar R, Kumar A, Bose B, Huda F, Thakur N, Dhar P, Seenivasagam RK, Prakash S, Chaudhari A, Shukla A, Mahakalkar C, Saxena G, Mahuli K, Kaple M, Kshirsagar S, Mehraj A, Parray F, Aziz G, Chowdri N, Wani R, Gurcoo S, Shah Z, Madhavan S, Subbarayan S, Vino S, Aravindan U, George G, Ck H, Yadev IP, Chisthi M, Ps R, Sreekumar RC, Vijayan V, Theodore B, Victor C, Jesudason MR, Arulappan N, Philip R, Durai S, Creavin B, Cullinane C, Davis C, Flynn C, Liam D, Cooke F, Earley H, Peter M, Hamilton V, Trani AD, Conversano I, Cianci P, Petta R, Picciariello A, Altomare DF, Martines G, Grasso S, Moffa S, Papagni V, Zanoni A, Belvedere A, Romano A, Croce GD, Tanzanu M, Cardelli S, Lauro A, Sartarelli L, Binetti M, Cervellera M, Tonini V, Sanna B, Pusceddu E, Runfola M, Manunza R, Pisanu A, Cois A, Frongia F, Esposito G, Podda M, Mura P, Marzella A, Scotto B, Cuneo D, Ascari F, Giulino G, Varoli M, Laquatra N, Fortunato C, Marino F, Perrone F, Pace M, Convertini O, Cutellè C, Ammerata G, Sena G, Pignataro M, Scozzafava M, Mazza M, Bruni A, Curro G, Hila J, Ammendola M, Curcio S, Signorelli V, Marano A, Sasia D, Borghi F, Giuffrida MC, Bonardello M, Palmisano S, Testa V, Porta A, Scaltrini F, Iacob G, Gaspa I, Guatteri L, Coladonato M, Zapparoli A, Pesce A, Feo CV, Pindozzi F, Bigoni I, Torchiaro M, Fabbri N, Cianchi F, Staderini F, Elena F, Coratti F, Barbato G, Fortuna L, Romagnoli S, Bergamini C, Villa G, Cecchini I, Martellucci J, Izzo M, Trafeli M, Scheiterle M, Manoocheehri F, Cagnazzo F, Spampinato MG, Adam N, Depalma N, D'Ugo S, Garritano S, Mazzeo C, Cucinotta E, Melita F, Viscosi F, Biondo SA, Tripodi VF, Foppa C, Greco M, Sacchi M, Carvello M, Deac V, Laurenti V, Frontali A, Zappone A, Cammarata F, Colombo F, Ferrario L, Currà MC, Danelli P, Vignali A, Umberto C, Mastriale F, Riccardo R, Turi S, Elmore U, Galimberti A, Ceretti AP, Vespo D, Opocher E, Longhi M, Mariani NM, Flandoli C, Ciulli C, Vaira G, Ripamonti L, Cigagna L, Oldani M, Tamini N, Palumbo A, Castaldi A, Antropoli C, Rupealta N, Palmiero N, Donatiello V, Novi A, Cappiello A, Bianco F, de Luca M, Incollingo P, Esposito R, Gili S, Aprea G, de Simone G, Palomba G, Capuano M, Basile R, D'Angelo S, Tropeano FP, Luglio G, Pagano G, de Palma GD, Cricrì M, Milone M, Manigrasso M, Anoldo P, Boccia G, Raiano G, Nuzzo MMD, Calabria M, Peltrini R, Castiglioni S, Bracale U, Cervone C, Rega D, Caliendo D, Benetti E, Delrio P, Guarino R, de Franciscis S, Coppolino F, Romano FM, Selvaggi F, Sciaudone G, Selvaggi L, de Stefano M, Resendiz A, Carosso F, Degiuli M, Salusso P, Reddavid R, Benetti S, Callari C, Miceli DD, Pardo D, Sabatino G, Licari L, Lirosi MC, Sorce V, Peri A, Mori A, Pugliese L, Filardo M, Nuccio P, Dominioni T, Massimo C, Giuseppina F, Angelo F, Raffaele G, Michele M, Roberto P, Mondini A, Muratore A, Valentino C, Calabro' M, Danna R, Cremonini C, Sbarbaro C, Tartaglia D, Coccolini F, Chiarugi M, Musetti S, Pagani S, Neri CM, Leoni C, Rossi E, Randisi E, Puccini M, Buccianti P, Balestri R, Vasale A, Crescentini G, Ranieri G, Sinibaldi G, Biondi A, Sanesi AP, Vacca C, Lorenzon L, Sollazzi L, Persiani R, Pezzuto R, Ferroni AF, Stipa F, Volturo L, Moretti M, Tierno SM, Marina S, Mingoli A, Fiori E, Pugliese F, Brachini G, Carta G, Sapienza P, Lapolla P, Mazzotta E, Carannante F, Capolupo GT, Masciana G, Sica I, Caricato M, Antonelli S, Fiume D, Spoletini D, Lisi G, Carlini M, Menduni V, Arturi A, Proietto B, de Lucia C, Baldi C, Passantino DG, Romeo G, Paola MD, Sensi B, Sica G, Siragusa L, Dauri M, Franceschill M, Campanelli M, Bellato V, Porcu A, Garau AGG, Masala ML, Oggianu S, Tedde T, Perra T, Pazzola V, Venezia DF, Roviello F, Giacomini G, Carbone L, Marano L, Verre L, Marano M, Ciccarese AA, Bagnardi F, Shahu J, Siciliano W, Iacomino A, Armellin C, Marson F, Zanus G, Santoro GA, de Paoli M, Grossi U, Sekimoto M, Kobayashi T, Horiguchi A, Koike D, Yonekura H, Kato H, Yoshino K, Arakawa S, Asano Y, Alawneh F, Rajab I, Ramadan M, Masri MA, Qaisi MA, Alsamneh M, Mubaidin O, Al-Jarrah A, Ababneh H, Khdair K, Tawarh T, Sabri W, Arida ZA, Dzhumabekov B, Klyshbayeva D, Ispbayeva K, Nadyrov M, Tanabayeva S, Saliev T, Jumanov A, Aitbaeva A, Arynov A, Nadyrov M, Maulenov N, Dushimova Z, Park EJ, Kim H, Kang J, Baik SH, Song Y, Kwak HD, Kim J, Son JH, Chung JS, Lee H, Baek JH, Nam KH, Lee KC, Lee WS, Jeon Y, Kim CW, Park SE, Son GM, Ahn HM, Lee IY, Kim TK, Pcolkins A, Sivins A, Lobovs D, Ancans G, Kreice I, Budnikova I, Jelovskis I, Emhareb A, Abaidalla A, Hammed A, Khairallah M, Jibreel SS, Mohmmad WAS, Hasan W, Venskutonis D, Daugėla E, Dainius E, Juočas J, Kutkevičius J, Vaitkutė K, Bradulskis S, Macas A, Pauzas H, Jokubauskas M, Lizdenis P, Budrikienė R, Svagzdys S, Saladzinskas Z, Volkoviene G, Makauskiene J, Kuliavas J, Bernotaite V, Danys D, Kontrimaviciute E, Poskus E, Kryzauskas M, Jakubauskas M, Jotautas V, Zakaria AD, Kai MWP, Zainy RHM, Tan SS, Zain WZW, Zakaria Z, Yusoff ZM, Raduan F, Sagap I, Razali NYF, Rahman NA, Kanthan SBC, Nie YC, Azman ZAM, Ang CW, Tang CY, Poh KS, Ng K, Hashim NM, Xavier R, Khong TL, Amir AS, Ali CSC, Yew CK, Henry F, Muniandy J, Baharom S, Eng SCR, Hu FSM, Amin-Tai H, Jabar MF, Satar MHSA, Fathi NQ, Rao PS, Podesta AMC, Cini C, Psaila J, Debono M, Sammut M, Spiteri N, Andrejevic P, Muro AG, Leon BP, Perez JAV, Quiñonez JRA, Vera MTR, Gutierrez VMM, Bobadilla BJ, Martinez CM, de León Rendón JL, Hererro JAV, Cuichan MVY, Baez NF, Prevost PG, Hoyos-Torres A, Ruiz-Muñoz EA, Alvarez-Bautista FE, Ortíz-Méndez G, Zamudio-Bautista JL, Salgado-Nesme N, Vergara-Fernández O, Sanchez-Valdivieso E, Martinez G, Navarrete-Aleman J, Perez-Arellano J, Maldonado-Barron R, Hernandez-Krauss R, Ousadden A, Benjelloun EB, Bzikha I, Ibnmajdoub K, Mazaz K, Marghich O, Touzani S, Benkabbou A, Souadka A, El Ahmadi B, Zaari F, Laamri I, Majbar MA, Mohsine R, Van CB, Seuren D, Gillissen F, Aarts F, Konsten J, Van MH, Schlooz S, Naiqiso A, Merrie A, Varghese C, Pugh F, Bissett I, Wilson K, Mitchell S, Dawson C, Hill C, Wright D, Hubley S, Lin A, Jones D, Siggins L, Fagan P, Wu S, Ekwesianya A, Nwoye C, Agara D, Ejiofor G, Sundaynweke N, Kwentoh N, Ewah R, Aremu A, Ballah A, Ningi A, Ohia E, Mienda I, Aliyu M, Oloko N, Okunlola A, Abiyere H, Bolanle OE, Babatunde O, Fatudimu S, Orewole T, Mba EL, Felix MS, Abdulfatah M, Ibrahim N, Masoro U, Fakoya A, Irabor D, Anyadike F, Ulasi I, Orji M, Afuwape O, Ayandipo O, Aremu I, Adegboye K, Gbadegesin P, Aminu B, Aghadi IK, Makama JG, Joshua S, Kache SA, Sheshe AA, Bala AM, Garzali IU, Abdullahi MMM, Muhammad N, Umar NA, Muhammad S, Okoye A, Emegoakor C, Nwosu C, Egwuonwu OA, Ekwunife O, Amadigwe R, Ojiakor S, Akere A, Okereke C, Olaleye O, Ige O, Olubayo O, Olatiilu T, Idris M, Shehu A, Oluyori D, Nwabuoku E, Ukwubile L, Bashir M, Daniyan M, Rauf H, Ali M, Zakaria M, Hameed M, Amanullah N, Chawla T, Waqar U, Jamal A, Butt A, Kerawala A, Samson S, Dodhy AA, Gill AJ, Malik A, Ali D, Mohsin H, Afzal MF, Batool S, Suleman A, Khalid J, Zafar M, Dilawar M, Janjua MH, Sarwar MZ, Naqi SA, Akbar A, Afzal A, Anwar J, Gondal KM, Shaukat M, Waheed M, Sohail M, Mukhtiar N, Ammar AS, Hussain A, Khan AN, Sarwar A, Khan I, Khattak S, Oqaili B, Saada B, Zatari D, Jubran F, Hamdan F, Emar M, Alawi R, Jacome G, Insturain I, Arauz J, Hurtado M, Beron RI, Castaño R, Cao VHB, Kwiatkowski A, Dobkowski G, Bartosiak K, Walędziak M, Możański M, Zadrożna M, Kowalewski P, Fiedziuk A, Wątroba A, Los A, Sitarska M, Rząca M, Zawadzki M, Czarnecki R, Tavares C, Santos F, Borges F, Real JC, Lima MJ, Carlos S, Pereira V, Pacheco A, Gomes G, Pimenta J, Elisiario L, Jervis M, Gonçalves V, Pedro V, Jordão D, Neves FR, Conceição L, Ângelo MD, Marques P, Saraiva RP, Caroço TV, Windels A, Machado A, Ribeiro C, Velez C, Oliveira J, Melo MR, Lima R, Pires A, Lareiro C, Martins R, Revez T, Martins A, Cardoso D, Alegre I, Estevão P, Andrade D, Gomes DC, Duarte MJ, Custódio P, Nemésio RA, Rodrigues S, Correia A, Domingos H, Herrando I, Azevedo J, Fernandez L, Azevedo P, Vieira P, Torre A, Amado A, Paiva M, Saraiva R, Costa S, Mendes T, Queirós T, Silva A, Faustino A, Freitas A, Mendes J, Amaral L, Quintanilha R, Silva R, Coelho AM, Ribeiro A, Pinto C, Ribeiro N, Reis R, Costa S, Fernandes V, Sanches A, Amorim E, Miguel I, Rachadell J, Sanches M, Oliveira S, Baptista V, Roxo A, Devesa H, Teslyak O, Barradas R, Marques S, Martins S, Pepino S, Silva A, Deus AC, Ferreira A, Marinho D, Sousa D, Martins MJ, Matias N, Pinto A, Correia D, Amado F, Cordeiro L, Morales M, Lamas M, Marçal S, Rodrigues AI, Santos A, Marçal A, Oliveira A, Gomes C, Ferreira C, Marques R, Chitul A, Alexandrescu C, Bezede C, Cristian D, Mandi D, Grama F, Ungureanu R, Stoica B, Diaconescu C, Ciubotaru C, Tanase I, Grintescu I, Negoita VM, Calin C, Simeanu C, Ciotarla DC, Caltea M, Mirica RM, Luca A, Pasca A, Vlad C, Bonci EA, Stefanescu I, Achimas-Cadariu PA, Gata VA, Capusan A, Petrisor C, Dindelegan G, Seicean R, Scurtu R, Bintintan V, Fagarasan V, Ionescu C, Crisan D, Zanc L, Ene-Cocis MV, Muresan MS, Mihalcea SM, Dudric V, Musina AM, Ristescu AI, Roata CE, Moglan M, Dimofte MG, Lunca S, Iacob S, Dychko A, Litvin A, Kapustina A, Provozina A, Anokhin E, Zabiyaka M, Shin A, Djumabayev K, Kuznetsova M, Gordeyev S, Kochkina S, Mamedli Z, Markaryan D, Galliamov E, Semina E, Agapov M, Malahov P, Garmanova T, Kakotkin V, Zaycev A, Sumbaev A, Bedzhanyan A, Orman E, Petrenko K, Bredikhin M, Frolova Y, Tulina I, Bashilkina O, Tsarkov P, Rodimov S, Stamov V, Balaban V, Alexnder A, Yanishev A, Rogozhev D, Yakunina N, Chubukova N, Nugmanov R, Karachun A, Petrov A, Domanskiy A, Panaiotti L, Smolina M, Sapronova T, Pelipas Y, Zagaynov E, Khrykov G, Davidovskaja L, Burlov N, Mankevich N, Tverdohlebova T, Bogatikov A, Lodygin AV, Krasnoselsky C, Vasiukova ES, Kopteyev NR, Ovchinnikov T, Kashchenko VA, Novikova A, Terentyeva E, Kuleshov O, Pavlov R, Koshel A, Kostromitsky D, Drozdov E, Klokov S, Camacho A, Khan FN, Bandar MA, Shamim R, Chowdhury S, Kovacevic B, Krdzic I, Zdravkovic M, Kenic M, Milentijevic M, Petkovic N, Radulovic R, Ngu J, Teo NZ, Singh PA, Ong SY, Li S, en Siew B, Chee C, Koh JJM, Lee KY, Tan KK, Wong SC, Loh W, Pujol AF, Rubio JC, Farrés LP, Vendrell LL, Del Olmo MIU, Pedregosa AB, Galmes C, Luckute D, Casanova D, Artigot M, Guedes X, Olivella Y, Sarda MS, Toscano MJ, Damieta MP, Pera M, Gonçalvez SA, Galvez ST, Ruiz SS, Espin-Basany E, Marinello F, Villarino-Villa L, Heras MVL, Martin-Sanchez R, Mata RM, Blanco-Colino R, Otero A, de Lacy AM, Sanahuja JM, Bravo R, Ferraz T, Gonzabay V, Gonzalez F, Menendez P, Del Castillo VCG, Lopez-Pelaez VM, Silva ÁS, Lillo-García C, Tauler EM, Manresa MCE, Pérez SL, Llopis SQ, Rubio AV, Castillo ER, Miramón FJJ, Rodriguez JLR, Rizo-Lamberti LA, Garrido PG, Carneros VJ, Alfonso BA, Sierra BG, Amador CG, Gomendio MDP, Palomino MVR, de La Plaza Llamas R, Cafranga EG, Ramos JLE, Estudillo MC, Pérez RE, Pernas RM, de Lebrusant Fernández S, Bautista WMS, Llamazares AL, Valbuena AL, Moran LA, Alvarez LJ, Raposo LG, Ceron SF, Calvo AC, Valcárcel CR, Peña JP, Gómez LMJ, Díez MC, Lindenbaum PD, Mata SK, Ruiz-De-La-Hermosa A, Abad-Motos A, Toribio-Combarro B, Ripollés-Melchor J, Fuenmayor-Valera ML, Ortega-Domene P, Loscos A, Del Pueblo CS, Dziakova J, Mugüerza JM, Carlin PS, Anula R, Mouvet Y, Forero-Torres A, Andrés BDS, Marcos CM, Rubio I, Pascual I, Yague J, Alcolea NG, Alonso A, Diéguez B, Ibañez I, Pérez JL, Losada M, García-Conde M, Hernández M, Blazquez-Martin A, Vera-Mansilla C, Mendoza-Moreno F, Hernandez-Salvan J, Diez-Alonso M, Hernandez-Juara P, Barrena-Blazquez S, Minaya-Bravo AM, Galván-Pérez A, Miguel-Méndez CS, Gonzalez-Gonzalez E, Alvarez-Díez M, García-Ureña MÁ, Llorente-Moreno M, Ruiz-Lozano C, Colás-Ruiz E, Pérez-Calvo J, Gomila-Sanso JA, Álvarez-Llano L, Serrano-Fuentes SC, Soto-Montesinos C, Dedeu-Bastardas I, Perez-Reche I, Labró-Ciurans M, Pardo-López S, Pérez EG, Fernández IO, Canals LO, Espino PC, Ruano PG, Ricardo V, Ros EP, Manuel EM, Buleje JAB, Prats MMC, Baños PAP, González PM, Celdrán RG, Pellicer-Franco EM, Valero-Navarro G, Vicente-Villena JP, Martinez-Mercader MM, Baeza-Murcia M, Mengual-Ballester M, Soria-Aledo V, Fernández-Martínez D, Varela-Rodríguez L, Garcia-Flórez LJ, Fernández-Hevia M, Gonzalez-Diaz MJ, Fernández-Arias S, Puertas CP, de San Pío Carvajal E, Cebolla ES, Brainsa E, Bayo JMM, Castro MC, Blanco RR, Gutierrez E, Pinto FL, Alegre JM, Flores N, ÓSullivan SN, Fernández BF, Alonso JE, Conde JGA, Ropero NM, Bayón RÁ, Dominguez SH, Ramirez S, Martin de Pablos A, Perez-Sanchez A, Cano-Matias A, Del-Rio-Lafuente FJ, Caballero-Delgado J, Valdes-Hernandez J, Gomez-Rosado JC, Martinez C, Cholewa H, Sancho-Muriel J, Alberola MJ, Navasquillo M, Primo V, Moreno V, Espí-Macías A, Moro-Valdezate D, Carrascosa-Morales I, Martín-Arévalo J, Soro-Domingo M, García-Botello S, Pla-Marti V, Abellán AM, Pérez CM, Cortés GFV, Blasco LF, Chornet MR, Martín RS, Diego ARD, Vázquez-Fernández A, Pascual A, de Andrés-Asenjo B, Beltrán de Heredia J, Ruiz-Soriano M, Rodríguez-Jiménez R, Iribarren EM, Rodríguez EVF, Del Carmen Casas García M, García-Señoráns MP, Valderrama ÓC, Rodríguez PF, Santos RS, Currás RP, Vigorita V, Roche CG, Delgado E, Lafuente F, Gascon I, Saudi S, Fraj V, Wickramasinghe D, de Zoysa I, Samarasekera N, Wickramarathne R, Dassanayake V, Balathayalan Y, de Silva D, Perera M, Pulleperuma S, Jayasekara S, Wijenayake W, Gunetilleke B, Abeysinghe N, Chandrasinghe P, Kumarage S, Abdalradiy AG, Widatalla ABH, Ahmed AY, Mohamed HA, Hamid HKS, Ali MH, Eldin SJ, Agger E, Jutesten H, Lindgren J, Lepsenyi M, Azhar N, Hansdotter P, Ekepil A, Lindén Å, Brandström G, Smedberg J, Schiffer E, Ris F, Longchamp G, Meyer J, Dupret L, Galetti K, Regusci L, Grischott M, Malugani M, Mouhandes AEF, Danial AK, Khayat M, Sbahi MHE, Marawy MK, Abdullah MA, Douba Z, Mansour A, Niazi A, Hamza A, Mohamad AH, Awead M, Mohammad S, Salloum S, Jabar AA, Zazo A, Shebli B, Ayoub K, Younes L, Bannoud MH, Zazo R, Saad A, Hamdan A, Wakkaf H, Adra L, Souliman M, Anton M, Hannouf S, Li KL, Cheng KI, Ji SJ, Hsieh YC, Parlak EA, Demir M, Kara U, Peker YS, Yiğit D, Unal N, Iflazoğlu N, Yalkin Ö, Topal S, Gulcu B, Ozturk E, Gümbelek G, Terkanlıoğlu S, Koklucan A, Ince G, Sen M, Isik O, Kural S, Akesen S, Yilmazlar T, Sungurtekin H, Sungurtekin U, Vural U, Ozgen U, Isik A, Onk D, Kurnaz E, Ozker TS, Ipek A, Ferlengez A, Erturk C, Tatar C, Sevik H, Akay O, Sensoy O, Hayirlioglu MB, Aktas S, Ozben V, Aliyeva Z, Mutlu AU, Gökay BV, Saraçoğlu C, Aytaç E, Gülmez M, Işık MÜ, Hacim A, Akbas A, Soyhan F, Turgut MA, Demirgan S, Meric S, Altinel Y, Baris B, Akova E, Kahraman E, Kucuk HF, Saracoglu KT, Kaya S, Lel S, Gurbulak EK, Caz E, Kostek M, Mihmanli M, Yazici P, Oba S, Kırkan EF, Ulgur HS, Kalın M, Dinkci MD, Duzgun O, Ozturk S, Zengin AK, Aşkar A, Şanlı AN, Erginöz E, Özçelik MF, Ergün S, Uludağ SS, Kara D, Yılmaz G, Sarıcı IŞ, Kara Y, Incesu A, Arican C, Atici SD, Kaya T, Gezer T, Kirmizi Y, Aydin G, Namdaroglu O, Adakaya S, Canda AE, Ozzeybek D, Coskun N, Sokmen S, Ozkardesler S, Bisgin T, Miftari A, Caliskan C, Akgun E, Avseren G, Deniz N, Yoldas T, Güreşin A, Zayakov G, Pösteki G, Utkan NZ, Tatar OC, Akçay Ö, Güler SA, Mantoğlu B, Demirel E, Akın E, Gonullu E, Altintoprak F, Palabıyık O, Bayhan Z, Ciftci AB, Colak E, Aybar E, Celik HK, Eraslan H, Yemez K, Ozbilgin SS, Senol S, Gultekin FA, Piskin O, Guler O, Karadere Y, Kakeeto A, Oguttu B, Sikakulya FK, Lule H, Rybachuk A, Shudrak A, Beznosenko A, Lisnyy I, Rozhkova V, Zvirych V, Alawlaqi D, El Jamali F, Balooshi IA, Ahmed M, Albers M, Ali NA, Church R, Dudas G, Wells J, Pavlova M, Sebastiani S, Paterson C, Kaushal M, Patel P, Panchal S, Handa S, Tezas S, Zaidi SN, Raj G, Wright J, Hallam S, Karandikar S, Gates Z, Marshall A, Thompson A, Tennakoon A, Rao M, Callan R, Tufail S, Rajendran G, Polisetty K, Husain N, Clarke N, Naranayanasamy S, Hallett A, Lorejo E, Ward N, Antakia R, Xanthis A, Simillis C, Tweedle E, Panagiotopoulou I, Grimes L, Mounstephen L, Bocancia R, Carden C, Lynch J, Noveros MS, Shaalan R, Khalil T, Marshall W, Hodge K, Balfour J, Mcintosh K, Buijs L, Yule M, Vaughan-Shaw PG, Smith S, Anderson T, Mcdermott FD, Daniels IR, Tapp J, Smart N, Rajaretnam N, Bethune R, Clark T, Delimpalta C, Liao C, Banham G, Induruwage L, Velchuru V, Lawrence A, Rahman A, Bennett J, Badawi M, Harshen R, Bhargava A, Gorrela K, Jumah M, Hanson M, Arya S, Atendido T, Shrestha A, Cook E, Rakhimov I, Collins J, Alamin N, Vigneswaran N, Basnyat P, Shamardal A, Chacko A, Wanshantha D, Bisheet G, Ebdewi H, Abdellatif M, Adu-Poku P, Tore A, Adams F, Allen K, Ahmed K, Kulkarni N, Chitnis A, Patel H, Magsino J, Sarodaya V, Minicozzi A, Dempsy C, Ahmed H, Jayasinghe JD, Okail MH, Thaha M, Hallworth S, Parmar C, Chua L, Pizanias M, Samin R, Young T, Sagar J, Yorkmui L, Cirocchi N, Ahmed S, Barreda SC, Kudchadkar S, Baker A, Jayasankar B, Jackson J, Abdelsaid K, Hassan M, Shetty S, Coldwell C, Davies E, Nader H, Raistrick M, Ryska O, Hawkin P, Raymond T, Witjes C, Van de Steen K, Crabtree N, Boyce S, Somera W, Woodward A, Ryan K, Kassai M, Aleem M, Ghosh A, Rixson D, Lewis E, Lynch N, Shovelton C, Zywicka E, Guest F, Barton J, Purnell R, Bamford R, Teare T, Adams B, Chmielewski G, Smith L, Connolly L, Niblett R, Singh A, Halliwell G, Paraoan M, Doree N, Asaad P, Kilbride C, Carpenter H, Wilson J, Fletcher J, Vijayagopal KA, Abbakar M, Zaimis T, Walsh A, Kubisz-Pudelko A, Nono J, Pippard L, Chowdhary M, Dalton R, Moussa T, Dominguez F, Solla G, Curbelo J, Laurini M, Viola M, Brito N, Al-Alnsi A, Al-Naggar H, Saryah L, Al-Shehari M, Alsayadi R, Al-Hutheifi R, Shream S, Saeed S, Spurring EM. Evaluation of a quality improvement intervention to reduce anastomotic leak following right colectomy (EAGLE): pragmatic, batched stepped-wedge, cluster-randomized trial in 64 countries. Br J Surg 2024; 111:znad370. [PMID: 38029386 PMCID: PMC10771257 DOI: 10.1093/bjs/znad370] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/19/2023] [Revised: 10/10/2023] [Accepted: 10/18/2023] [Indexed: 12/01/2023]
Abstract
BACKGROUND Anastomotic leak affects 8 per cent of patients after right colectomy with a 10-fold increased risk of postoperative death. The EAGLE study aimed to develop and test whether an international, standardized quality improvement intervention could reduce anastomotic leaks. METHODS The internationally intended protocol, iteratively co-developed by a multistage Delphi process, comprised an online educational module introducing risk stratification, an intraoperative checklist, and harmonized surgical techniques. Clusters (hospital teams) were randomized to one of three arms with varied sequences of intervention/data collection by a derived stepped-wedge batch design (at least 18 hospital teams per batch). Patients were blinded to the study allocation. Low- and middle-income country enrolment was encouraged. The primary outcome (assessed by intention to treat) was anastomotic leak rate, and subgroup analyses by module completion (at least 80 per cent of surgeons, high engagement; less than 50 per cent, low engagement) were preplanned. RESULTS A total 355 hospital teams registered, with 332 from 64 countries (39.2 per cent low and middle income) included in the final analysis. The online modules were completed by half of the surgeons (2143 of 4411). The primary analysis included 3039 of the 3268 patients recruited (206 patients had no anastomosis and 23 were lost to follow-up), with anastomotic leaks arising before and after the intervention in 10.1 and 9.6 per cent respectively (adjusted OR 0.87, 95 per cent c.i. 0.59 to 1.30; P = 0.498). The proportion of surgeons completing the educational modules was an influence: the leak rate decreased from 12.2 per cent (61 of 500) before intervention to 5.1 per cent (24 of 473) after intervention in high-engagement centres (adjusted OR 0.36, 0.20 to 0.64; P < 0.001), but this was not observed in low-engagement hospitals (8.3 per cent (59 of 714) and 13.8 per cent (61 of 443) respectively; adjusted OR 2.09, 1.31 to 3.31). CONCLUSION Completion of globally available digital training by engaged teams can alter anastomotic leak rates. Registration number: NCT04270721 (http://www.clinicaltrials.gov).
Collapse
|
4
|
Reza L, Gottgens K, Kleijnen J, Breukink S, Ambe PC, Aigner F, Aytac E, Bislenghi G, Nordholm-Carstensen A, Elfeki H, Gallo G, Grossi U, Gulcu B, Iqbal N, Jimenez-Rodriguez R, Leventoglu S, Lisi G, Litta F, Lung P, Millan M, Ozturk E, Sackitey C, Shalaby M, Stijns J, Tozer P, Zimmerman D. European Society of Coloproctology: Guidelines for diagnosis and treatment of cryptoglandular anal fistula. Colorectal Dis 2024; 26:145-196. [PMID: 38050857 DOI: 10.1111/codi.16741] [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] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/06/2023] [Revised: 07/11/2023] [Accepted: 08/03/2023] [Indexed: 12/07/2023]
Abstract
AIM The primary aim of the European Society of Coloproctology (ESCP) Guideline Development Group (GDG) was to produce high-quality, evidence-based guidelines for the management of cryptoglandular anal fistula with input from a multidisciplinary group and using transparent, reproducible methodology. METHODS Previously published methodology in guideline development by the ESCP has been replicated in this project. The guideline development process followed the requirements of the AGREE-S tool kit. Six phases can be identified in the methodology. Phase one sets the scope of the guideline, which addresses the diagnostic and therapeutic management of perianal abscess and cryptoglandular anal fistula in adult patients presenting to secondary care. The target population for this guideline are healthcare practitioners in secondary care and patients interested in understanding the clinical evidence available for various surgical interventions for anal fistula. Phase two involved formulation of the GDG. The GDG consisted of 21 coloproctologists, three research fellows, a radiologist and a methodologist. Stakeholders were chosen for their clinical and academic involvement in the management of anal fistula as well as being representative of the geographical variation among the ESCP membership. Five patients were recruited from patient groups to review the draft guideline. These patients attended two virtual meetings to discuss the evidence and suggest amendments. In phase three, patient/population, intervention, comparison and outcomes questions were formulated by the GDG. The GDG ratified 250 questions and chose 45 for inclusion in the guideline. In phase four, critical and important outcomes were confirmed for inclusion. Important outcomes were pain and wound healing. Critical outcomes were fistula healing, fistula recurrence and incontinence. These outcomes formed part of the inclusion criteria for the literature search. In phase five, a literature search was performed of MEDLINE (Ovid), PubMed, Embase (Ovid) and the Cochrane Database of Systematic Reviews by eight teams of the GDG. Data were extracted and submitted for review by the GDG in a draft guideline. The most recent systematic reviews were prioritized for inclusion. Studies published since the most recent systematic review were included in our analysis by conducting a new meta-analysis using Review manager. In phase six, recommendations were formulated, using grading of recommendations, assessment, development, and evaluations, in three virtual meetings of the GDG. RESULTS In seven sections covering the diagnostic and therapeutic management of perianal abscess and cryptoglandular anal fistula, there are 42 recommendations. CONCLUSION This is an up-to-date international guideline on the management of cryptoglandular anal fistula using methodology prescribed by the AGREE enterprise.
Collapse
Affiliation(s)
| | | | - Jos Kleijnen
- KSR Ltd & Maastricht University Medical Center (MUMC+) -CAPHRI, Maastricht, Netherlands
| | | | | | | | | | | | | | | | | | - Ugo Grossi
- Treviso Regional Hospital, Treviso, Italy
| | | | | | | | | | | | | | | | - Monica Millan
- La Fe University and Polytechnic Hospital, Valencia, Spain
| | | | | | | | | | | | | |
Collapse
|
5
|
Marcellinaro R, Spoletini D, Grieco M, Avella P, Cappuccio M, Troiano R, Lisi G, Garbarino GM, Carlini M. Colorectal Cancer: Current Updates and Future Perspectives. J Clin Med 2023; 13:40. [PMID: 38202047 PMCID: PMC10780254 DOI: 10.3390/jcm13010040] [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: 10/18/2023] [Revised: 12/12/2023] [Accepted: 12/18/2023] [Indexed: 01/12/2024] Open
Abstract
Colorectal cancer is a frequent neoplasm in western countries, mainly due to dietary and behavioral factors. Its incidence is growing in developing countries for the westernization of foods and lifestyles. An increased incidence rate is observed in patients under 45 years of age. In recent years, the mortality for CRC is decreased, but this trend is slowing. The mortality rate is reducing in those countries where prevention and treatments have been implemented. The survival is increased to over 65%. This trend reflects earlier detection of CRC through routine clinical examinations and screening, more accurate staging through advances in imaging, improvements in surgical techniques, and advances in chemotherapy and radiation. The most important predictor of survival is the stage at diagnosis. The screening programs are able to reduce incidence and mortality rates of CRC. The aim of this paper is to provide a comprehensive overview of incidence, mortality, and survival rate for CRC.
Collapse
Affiliation(s)
- Rosa Marcellinaro
- Department of General Surgery, S. Eugenio Hospital, 00144 Rome, Italy; (D.S.); (M.G.); (R.T.); (G.L.); (M.C.)
| | - Domenico Spoletini
- Department of General Surgery, S. Eugenio Hospital, 00144 Rome, Italy; (D.S.); (M.G.); (R.T.); (G.L.); (M.C.)
| | - Michele Grieco
- Department of General Surgery, S. Eugenio Hospital, 00144 Rome, Italy; (D.S.); (M.G.); (R.T.); (G.L.); (M.C.)
| | - Pasquale Avella
- Department of Clinical Medicine and Surgery, University of Naples “Federico II”, 80138 Naples, Italy; (P.A.); (M.C.)
- Hepatobiliary and Pancreatic Surgery Unit, Pineta Grande Hospital, Castel Volturno, 81030 Caserta, Italy
| | - Micaela Cappuccio
- Department of Clinical Medicine and Surgery, University of Naples “Federico II”, 80138 Naples, Italy; (P.A.); (M.C.)
| | - Raffaele Troiano
- Department of General Surgery, S. Eugenio Hospital, 00144 Rome, Italy; (D.S.); (M.G.); (R.T.); (G.L.); (M.C.)
| | - Giorgio Lisi
- Department of General Surgery, S. Eugenio Hospital, 00144 Rome, Italy; (D.S.); (M.G.); (R.T.); (G.L.); (M.C.)
| | - Giovanni M. Garbarino
- Department of General Surgery, S. Eugenio Hospital, 00144 Rome, Italy; (D.S.); (M.G.); (R.T.); (G.L.); (M.C.)
| | - Massimo Carlini
- Department of General Surgery, S. Eugenio Hospital, 00144 Rome, Italy; (D.S.); (M.G.); (R.T.); (G.L.); (M.C.)
| |
Collapse
|
6
|
Adisa A, Bahrami-Hessari M, Bhangu A, George C, Ghosh D, Glasbey J, Haque P, Ingabire JCA, Kamarajah SK, Kudrna L, Ledda V, Li E, Lillywhite R, Mittal R, Nepogodiev D, Ntirenganya F, Picciochi M, Simões JFF, Booth L, Elliot R, Kennerton AS, Pettigrove KL, Pinney L, Richard H, Tottman R, Wheatstone P, Wolfenden JWD, Smith A, Sayed AE, Goswami AG, Malik A, Mclean AL, Hassan A, Nazimi AJ, Aladna A, Abdelgawad A, Saed A, Abdelmageed A, Ghannam A, Mahmoud A, Alvi A, Ismail A, Adesunkanmi A, Ebrahim A, Al-Mallah A, Alqallaf A, Durrani A, Gabr A, Kirfi AM, Altaf A, Almutairi A, Sabbagh AJ, Ajiya A, Haddud A, Alnsour AAM, Singh A, Mittal A, Semple A, Adeniran A, Negussie A, Oladimeji A, Muhammad AB, Yassin A, Gungor A, Tarsitano A, Soibiharry A, Dyas A, Frankel A, Peckham-Cooper A, Truss A, Issaka A, Ads AM, Aderogba AA, Adeyeye A, Ademuyiwa A, Sleem A, Papa A, Cordova A, Appiah-Kubi A, Meead A, Nacion AJD, Michael A, Forneris AA, Duro A, Gonzalez AR, Altouny A, Ghazal A, Khalifa A, Ozair A, Quzli A, Haddad A, Othman AF, Yahaya AS, Elsherbiny A, Nazer A, Tarek A, Abu-Zaid A, Al-Nusairi A, Azab A, Elagili A, Elkazaz A, Kedwany A, Nuhu AM, Sakr A, Shehta A, Shirazi A, Mohamed AMI, Sherif AE, Awad AK, Abbas AM, Abdelrahman AS, Ammar AS, Azzam AY, Ciftci AB, Dural AC, Sanli AN, Rahy-Martín AC, Tantri AR, Khan A, Al-Touny A, Tariq A, Gmati A, Costas-Chavarri A, Auerkari A, Landaluce-Olavarria A, Puri A, Radhakrishnan A, Ubom AE, Pradhan A, Turna A, Adepiti A, Kuriyama A, Kassam AF, Hassouneh A, El-Hussuna A, Habeebullah A, Ads AM, Mousli A, Biloslavo A, Hoang A, Kirk A, Santini A, Melero AV, Calvache AJN, Baduell A, Chan A, Abrate A, Balduzzi A, Sánchez AC, Navarrete-Peón A, Porcu A, Brolese A, Barranquero AG, Saibene AM, Adam AA, Vagge A, Maquilón AJ, Leon-Andrino A, Sekulić A, Trifunovski A, Mako A, Bedada AG, Broglia A, Coppola A, Giani A, Grandi A, Iacomino A, Moro A, D’amico A, Malagnino A, Tang A, Doyle A, Alfieri A, Haynes A, Wilkins A, Baldwin A, Heriot A, Laird A, Lazarides A, O'connor A, Trulson A, Rokohl AC, Caziuc A, Triantafyllou A, Anesi A, Nikova A, Andrianakis A, Charalabopoulos A, Tsolakidis A, Chirca A, Arnaud AP, Narvaez-Rojas AR, Kavalakat A, Spina A, Recordare A, Annicchiarico A, Conti A, Mohammed AD, Kocataş A, Almhimid A, Arnaout A, Fahmy A, Mangi A, Modabber A, Ulas AB, Mohamedahmed AYY, Frontali A, Moynihan A, Yunus A, Ahmad A, Kent AJ, Khamees A, Ugwu AO, Turan A, Mohammed AAK, Navarro-Barrios A, Yebes A, De Sousa ÁFL, Moreno A, Sethi A, Dawson AC, Othman AAA, Kaur A, Wolde A, Antonelli A, Scifo A, Alhamad A, Davis A, Alderazi A, Harky A, Mohammed-Durosinlorun A, Seguya A, Okhakhu A, Chamakhi A, Sebai A, Souadka A, Asla A, Agrawal A, Persad A, Gupta A, Elgazar A, Kulkarni A, Coates A, Bellés AC, Hadzibegovic AD, Jotic A, Kowark A, Martins A, Pineda AM, Peral A, Gollarte AS, Senent-Boza A, Camarena AIA, Castaño-Leon AM, Bravo AMM, Moro AMG, Musina AM, Tapia-Herrero AM, Kothari A, Gupta A, Raja A, Aljaiuossi A, Taha A, Majbar AM, Prodromidou A, Kanatas A, Gupte A, Zakaria AD, Balla A, Barberis A, Bondurri A, Bottari A, Costantino A, Figus A, Lauretta A, Mingoli A, Romanzi A, Sagnotta A, Scacchi A, Picchetto A, Valadez AEC, Luzzi AP, Älgå A, Fontalis A, Hecker A, Demetriades AK, Serban AM, Văcărașu AB, Cokan A, Isaza-Restrepo A, Beamish A, Schache A, Stevenson A, Yiu A, Cockbain AJ, Litvin A, Abad-Motos A, Becerra A, Ramos ÁC, Chiaradia A, Dell A, Romano A, Pascale A, Marra AA, Dimas A, Kolias A, Cerovac A, Koneru A, Tidjane A, Agbeko AE, Bajaj A, Gosain A, Allan A, Carreras-Castañer A, D'amore A, Dare A, Maffioli A, Palepa A, Paspala A, Konney A, Gatta AND, Ezanno AC, Yiallourou A, Kinnair A, Rayner A, Scafa AK, Bowan AB, Veglia A, Russo A, Maniaci A, Castaldi A, Gil-Moreno A, Maffuz-Aziz A, Meola A, Nenna A, Ferrer AP, Bonilla AR, Ramos-De La Medina A, Infante AR, Santoro A, Laganà AS, Bateman A, Michael ALR, Abozid A, Seidu AS, Lowery A, Tantraworasin A, Rasheed A, Picciariello A, Isik A, Saif A, Anjum A, Ioannidis A, Abeldaño A, Hussain A, Nathan A, Bedzhanyan A, Perfecto A, De Virgilio A, Galvan A, Sablotzki A, Böttcher A, Pellacani A, Gatti A, Ibrahimli A, Menon A, Sahni A, Mwenda AS, Choudhry A, Jayawardane A, Gupta A, Ramasamy A, Mitul AR, Bawa A, Nugur A, Rammohan A, Sachdeva A, Mehraj A, Yildirim A, Alqaseer A, Radwan A, Sallam A, Syllaios A, Tampakis A, Alwael A, Samara A, Eroglu A, Rahman A, Ulkucu A, Zaránd A, Dulskas A, Tawiah A, Zani A, Vas A, Lukosiute-Urboniene A, Adamu A, Aujayeb A, Malik AA, İplikçi A, Mahmud A, Cil AP, Makanjuola A, Akwaisah A, Galandarova A, Saracoglu A, Regan A, Barlas AM, Alhassan BAB, Mostafa B, Hamida BB, Torun BC, Abdullah B, Balagobi B, Banky B, Singh B, Alegbeleye B, Yigit B, Hajjaj BN, Burgos-Blasco B, Seeliger B, Alayande B, Alhazmi B, Enodien B, Torre B, Pérez BG, Tamayo BV, De Andrés-Asenjo B, Quintana-Villamandos B, Girgin B, Barmayehvar B, Beisenov B, Creavin B, Dunne B, Marson B, Waterson B, Martin B, Zucker B, Wong BNX, Ozmen BB, Hammond B, Mbwele B, Núñez B, Dhondt B, Gafsi B, Mcleish B, Lieske B, Tailor B, La Pira B, Picardi B, Zampogna B, Casagranda B, Festa BM, Panda B, Kirmani B, Sulaiman B, Gurung B, Zacharia B, Bette B, Ayana B, Nikolovska B, Vilaró BC, De Vega Sánchez B, Hameed BZ, Diaconescu B, Kovacevic B, Bumber B, Sakakushev B, Tadic B, Malek B, Alrayes B, Thomas B, Gális B, Gallagher B, Knowles B, Cunningham B, Daley B, Mishra B, Ashford B, Pirozzi BM, Berselli B, Martinez-Leo B, Sensi B, Nardo B, Celik B, Giray B, Abud B, Almiqlash B, Pramesh CS, Taskiran C, De Campos Prado CA, Cipolla C, Kumar C, English C, Riccetti C, Vanni C, Brasset C, Downey C, Duffy C, Chwat C, Cutmore C, Sars C, Ratto C, Pacilio CA, De La Infiesta García C, Moreno CG, Magalhães C, Prada C, Zapata CS, Senni C, Flumignan CDQ, Martinez-Perez C, Duarte CL, Garcia CSR, Anderson C, Hing C, Cullinane C, Cina C, Zabkiewicz C, Sohrabi C, Guldogan CE, Ciubotaru C, Desai C, Raut C, Demetriou C, Handford C, Okpani C, Paranjape C, Koh C, Khatri C, Parmar C, Mok CW, Caricato C, Marafante C, Echieh CP, Tan CY, Ong CS, Conso C, Jardinez C, Konrads C, Warner C, Makwe CC, Henein C, Fleming C, Roland CL, Maurus C, Nitschke C, Mittermair C, Mallmann C, Andro C, Harmston C, Kuppler C, Lotz C, Nahm C, Rowe C, Ryalino C, Wallis C, Millward CP, Anthoulakis C, Apostolou C, Chouliaras C, Kalfountzos C, Kaselas C, Vosinakis C, Okereke C, Chean CS, Barlow C, Tatar C, Clancy C, Forde C, Sharpin C, Mccarthy C, Nestor C, Warden C, Ávila CC, Massaguer C, Fang CEH, Martins CP, Guerci C, Mauriello C, Holzmeister C, Miller C, Weber C, Wiesinger CG, Kenington C, Noel C, Sue-Chue-Lam C, Adumah C, Neary C, Sen C, Fitzgerald C, Ezeme C, Nastos C, Mesina C, Bombardini C, Torregrosa C, Valdespino CP, Don CP, Wickramasinghe D, Milanesi D, Armijos D, Asiimwe D, Beswick D, Clerc D, Cox D, Doherty D, Martínez DF, Lechuga DG, Gero D, Gil-Sala D, Lindegger D, Reim D, Shaerf D, Shmukler D, Branzan D, Filipescu D, Rega D, Bernardi D, Bissacco D, Fusario D, Morezzi D, Sabella D, Zimak DM, Vinci D, Sale D, Khan DZ, Thereska D, Andreotti D, Tartaglia D, Abdulai DR, Mukherjee D, Verdi D, Idowu D, John D, Johnson D, Moro-Valdezate D, Naumann D, Omar D, Proud D, Roberts D, Guzmán DS, Watson D, Bergkvist DJ, Lumenta DB, Ferrari D, Rizzo D, Degarege D, Castillo DFC, Douglas D, Wright D, Nanjiani D, Bratus D, Altun D, Sievers D, Vaysburg D, Katechia D, Ghosh D, Azize DA, Rodrigues D, Pachajoa DAP, Hayne D, Mutter D, Raimondo D, Eskinazi D, Sasia D, Corallino D, Muduly D, Grewal D, Hadzhiev D, Peristeri D, Pournaras D, Raptis DA, Angelou D, Haidopoulos D, Magouliotis D, Moris D, Schizas D, Symeonidis D, Tsironis D, Korkolis D, Tatsis D, Thekkinkattil D, Bulian DR, Pandey D, Vatansever D, Parker D, Wiedemann D, Borselle D, Pedini D, Schweitzer D, Venskutonis D, Otokwala J, Adamu KM, Pk P, Garod M, Ellafi AAD, Zivkovic D, Jelovac D, Wijeysundera D, Mcpherson D, Ryan É, Ugwu E, Baidoo EI, Shaddad E, Memişoğlu E, Naranjo EPL, Brodkin E, Segalini E, Viglietta E, Hendriks E, Bonci EA, Sá-Marta E, Ortega EN, Gomez EGL, Joviliano EE, Clune E, Horwell E, Mains E, Vasarhelyi E, Caruana EJ, Nevins EJ, Yenli EMTA, Baili E, Lostoridis E, Morgan E, Shiban E, Latif E, Tampaki EC, Ezenwa E, Irune E, Borg E, Eisa E, Gialamas E, Parvez E, Theophilidou E, Toma EA, Arnaoutoglou E, Samadov E, Kantor E, Ulman EA, Colak E, Cassinotti E, Bannone E, Sarjanoja E, Yates E, Vincent E, Lun EWY, Cerovac E, Dif ES, Alkhalifa E, Daketsey E, Fayad EA, Sheikh E, Pontecorvi E, Cammarata E, La Corte E, Rausa E, Odai ED, Guasch E, Cano-Trigueros E, Uldry E, Ros EP, Matthews E, Donmez EE, Giorgakis E, Kapetanakis E, Stamatakis E, Bua E, Schneck E, Nachelleh EA, Ofori EO, Akin E, Gönüllü E, Kirkan EF, Çelik E, Wong E, Capozzi E, Pinotti E, Colás-Ruiz E, González E, Fekaj E, Ohazurike E, Kebede E, Erginöz E, Duran EES, Scott E, Aytac E, Albanese E, Castro EJ, Albayadi E, Kriem E, Siddig E, Otify E, El Tayeb EEABH, Hong EH, Saguil E, Belzile E, Tuyishime E, Panieri E, Martínez EG, Myriokefalitaki E, Wong EG, Samara E, Agbeno EK, Drozdov E, Tokidis E, Shah FA, Barra F, Carbone F, Ferreli F, Marino F, Martinelli F, D'acapito F, Masciello F, Bàmbina F, Issa F, Salameh FT, Kethy F, Mahmood F, Gareb F, Idrees F, Karimian F, Ashraf F, Haji F, Inayat F, Begum F, Nabil F, Rosa F, Haider F, Parray F, Calculli F, Ferracci F, Saraceno F, Coppola F, Coccolini F, Fusini F, Migliorelli F, Pecoraro F, Alconchel F, Coimbra FJF, Trivik-Barrientos F, Naegele F, Almarshad F, Agresta F, Fleming F, Mendoza-Moreno F, Brzeszczyński F, Carannante F, Wu F, Aljanadi F, Hayati F, Campo F, Sorbi F, Milana F, Takeda FR, Shekleton F, Gessler F, Recker F, Grama F, Cherbanyk F, Faponle F, Angelis F, Calabretto F, Gaino F, Toia F, Bianco F, Bussu F, Cammarata F, Castagnini F, Colombo F, Ferrara F, Fleres F, Guerrera F, Litta F, Mongelli F, Pata F, Roscio F, Mulita F, Ardura F, Tejero-Pintor FJ, Calvo FJR, Escobedo FJB, Camacho FJB, Odicino F, Schmitt F, Bloemers F, Hölzle F, Gyamfi FE, Messner F, Koh F, Cáceres F, Smolle-Juettner FM, Herman F, Ayeni F, Djedovic G, De Oliveira GP, Rodrigues G, Wagner G, Bellio G, Giarratano G, Capolupo GT, Budd G, Marom G, Poillucci G, Thiruchandran G, Nicholson G, Groot G, Hoey G, Bass GA, Sachdev G, Agarwal G, Aggarwal G, Cormio G, Mazzarella G, Perrone G, Osterhoff G, Singer G, Dejeu G, Fowler G, Garas G, Gradinariu G, Theodoropoulos G, Tzimas G, Babis G, Wong GKC, Cross GWV, Micha G, Chrysovitsiotis G, Koukoulis G, Peros G, Tsoulfas G, Kapetanios G, Karagiannidis G, Verras GI, Ekwen G, Perrotta G, Petruzzi G, Bertelli G, Calini G, Fiacchini G, Pirola GM, Dolci G, Mendiola G, Baiocchi GL, Palini GM, Prucher GM, D'andrea G, Maggiore G, Cassese G, Franceschini G, Pellino G, Saponaro G, Pattacini GC, Pantuso G, Iannella G, Bonsaana GB, Lever G, Brachini G, Giraudo G, Lisi G, Russo GI, Aprea G, Pascale G, Tomasicchio G, Sandri GBL, Armatura G, Turri G, Zaccaria G, Barugola G, Lantone G, Gasparini G, Iacob G, Sozzi G, Zancana G, Mercante G, Bianco G, Brisinda G, Consorti G, Currò G, Giannaccare G, Palomba G, Pascarella G, Rotunno G, Spriano G, Vizzielli G, Cucinella G, Sica G, Campisi G, Baiocchi G, Guerra GR, Pacheco GMF, Atis G, Augustin G, Šantak G, Chauhan GS, Branagan G, Harris G, Stewart GD, Padmore G, Kocher GJ, Di Franco G, De Jesus Labrador Hernandez G, Christodoulidis G, Neal-Smith G, Yim G, Piozzi GN, Claret G, Yanowsky-Reyes G, Dhaity GD, Cakmak GK, Mohamed G, Kucuk GO, Ancans G, Banipal GS, De Bacco Marangon G, Laporte G, Martinez-Mier G, Recinos G, V GMM, Benshetrit G, Vijgen G, Pickett G, Rodriguez HA, Shiwani H, Derilo H, Awad H, El Assaad H, Raji HO, Hardgrave H, Karakullukcu HK, Abdussalam HO, Mustafa H, Parwaiz H, Khan H, Arbab H, Naga H, Salem H, Ulgur HS, Perez-Chrzanowska H, Greenlee H, Javanmard-Emamghissi H, Lederhuber H, Osman H, Adamou H, Majid HJ, Van Goor H, Spiers HVM, Manesh HF, Mushtaq H, Aljaaly H, Hasan HB, Ahmed HTA, Martinez-Said H, Aguado HJ, Consani H, Chaplin H, Mohan H, Van Vliet H, Lohse HAS, Shah H, Claireaux H, Lule H, Juara H, Abozied H, Bayo HL, Alibrahim H, Kroon HM, Ulman H, Khan H, Yonekura H, Abou-Taleb H, Wong HYF, Carpenter H, Majd HS, Zenha H, Mayer HF, Elghadban H, Abdou H, Elfeki H, Yusefi H, Gomez-Fernandez H, Horsfall HL, Meleiro H, Sungurtekin H, Junior HFL, Moloo H, Bayhan H, Şevi̇k H, Embarek H, Hamid HKS, Pradeep IHDS, Donkin I, Ateca IV, Jafarov I, Salisu I, Abdalaal I, Garzali IU, Sall I, Adebara I, Aghadi I, Ugwu I, Zapardiel I, Reis I, Nwafor I, Fakhradiyev I, Surya IU, Robo I, Njokanma I, Iannone I, Khan I, Correia I, Königsrainer I, Seiwerth I, Linero IB, Kadiri I, Florian IA, Tzima I, Akrida I, Baloyiannis I, Gerogiannis I, Katsaros I, Tsakiridis I, Valioulis I, Negoi I, Yadev I, De Haro Jorge I, Vázquez IO, Dajti I, Russo IS, Afzal I, Wasserman I, Chukwu I, Gracia I, Oliver IM, Hughes I, Mondi I, Ncogoza I, Bsisu I, Rashid I, Balasubramanian I, Omar I, Dominguez-Rosado I, Smati I, Vokshi I, Al-Badawi IA, Saleh IA, Pilkington I, Kirac I, Trostchansky I, Gawron IM, Trebol J, Martellucci J, Andreuccetti J, Abou-Khalil J, Shah J, Manickavasagam J, De Alarcón JR, Mihanovic J, O'riordan J, Archer J, Ashcroft J, Blair J, Hamill J, Munthali J, Park J, Parry J, Ryan J, Tomlinson J, Wheeler J, Wilkins J, Balogun JA, Hodgetts JM, Vatish J, Žatecký J, Dziakova J, Martin J, Beatty JW, Stijns J, Faiz J, Ripollés-Melchor J, Mata J, Vásquez JAG, Mitra JK, Tuech JJ, Mvukiyehe JP, Fallah JM, Díaz JT, Vishnoi JR, Van Den Eynde J, Rickard J, Rolinger J, Kaplowitz J, Meyer J, Reid J, Rossaak J, Smelt J, Thomas JJ, Reyes JAS, Davies J, Luc J, Alonso JAM, Hajiioannou J, Querney J, Van Acker J, Pu JJ, Cama J, Simoes J, Cozens J, Barbosa-Breda J, Ribeiro J, De Haro J, Nigh J, Bowen J, Pollok JM, Strotmann JJ, Doerner J, Edwards J, Green J, Massoud J, Mcgrath J, Squiers J, Street J, Windsor J, Santoshi JA, Meara JG, Abebrese JT, Reilly JJ, Zabaleta J, Phillips J, Herron J, Horsnell J, Dawson J, Sheen J, Kauppila JH, Konsten J, Raurich-Leandro J, Romera JS, Nuñez J, Gass JM, Blanco J, Calvache JA, Iturralde JLF, D’addino JL, Hermosa JMG, Guillen JRO, Beristain-Hernandez JL, Sole-Sedeno JM, Vives JMM, Attwood J, Furey J, Hadaya J, Mckay J, Meilak J, Natale J, Shalhoub J, Jung J, Arthur J, Kealey J, Wright J, Moreau J, Miskovic J, Juloski J, Bauset JCC, Segura-Sampedro JJ, Cisneros JRT, Gomez-Rosado JC, Arneja J, Heider J, Fernández JD, Plata-Bello J, Villanueva J, Olaogun J, Hing JX, Košir JA, Daruwalla J, Yeung J, Wormald J, Seyi-Olajide J, Rani J, Wong KY, Hristova K, Kajal K, Algarni K, Theivendran K, Futaba K, Elsayem K, Kapur K, Bailey K, El-Boghdadly K, Ataya K, Lacorbiniere K, Shah K, Tellez KSM, Szyluk K, Rangasamy K, Iyengar K, Szabómihályová K, Atkinson K, Camargo-Parra K, Galliard K, Dickson K, Singh K, Qader K, Hasan K, Spellar K, Feeney K, Ajenifuja K, Oh KE, Okunade K, Adanu K, Bateman K, Saracoglu K, Ho KW, Enwerem K, Mishra K, Verhoeff K, Bensoltane K, Larabi K, Hamdan KH, Nadi K, Fozo K, Abdelwahab K, Al-Sayaghi K, Dajani K, Algahtany K, Abdel-Galil K, Ahmed K, Bajunaid K, Bhatti K, Sofi K, Abdulsalam K, Tamoos K, Dzhumabaev K, Samo KA, Purich K, Madhvani K, Qin KR, Underwood K, Senanayake KJ, Augestad KM, Sigamoney K, Apostolou K, Bouchagier K, Bouliaris K, Bramis K, Gousias K, Lasithiotakis K, Paraskevopoulos K, Perivoliotis K, Roditis K, Stamatis K, Stroumpoulis K, Paraskevas KI, Govindarajan KK, Šimko K, Olson KA, Khobragade K, Seah KM, Kishore K, Ayad K, Papavasiliou K, Angelou K, Paniagua LC, Czako L, Ching LVK, Rai L, Gupta L, Ismail L, Mbodi L, Dasanayake L, Schröder L, Baiyewu LA, Fortuna L, Fernandez LG, Vivancos LG, Jack L, Keçi L, Lavalle L, Leonard L, Shelmerdine L, Vaassen L, Hasan L, Lazarou L, Tzelves L, Matos L, Siragusa L, Licari L, Lima LS, Solaini L, Lichman L, Moral LT, Cabeza L, Kaplan L, Valeanu L, Kaman L, Karout L, Pieteris L, Chan L, Grüßer L, Zamora L, Catarzi L, Rampersad L, Anyanwu LJ, Cheung LK, Rodríguez LV, Andreani L, Cobianchi L, Petagna L, Howse L, Gonzalez LE, Bains L, Vohra L, Ansaloni L, Bertolaccini L, Ferrario L, Orecchia L, Tirloni L, Zanin L, Morelli L, Scaravilli L, Locatello LG, García LD, Vida L, Carbone L, Heindl LM, Bonavina L, Conti L, Marano L, Verre L, Conte LE, Boccalatte L, Tellez LGS, Loureiro L, Sánchez-Guillén L, Tallon-Aguilar L, Nakano L, Alvarez-Lozada LA, Gonzalez LAS, Flórez LJG, Capitan-Morales LC, Kowalski LP, Widmer LW, Harper L, Render L, Wheldon L, Abdur-Rahman L, Doğan L, Prusty L, Katsiaras L, Gourbault L, Siddiqui MT, Saleh M, Karthigeyan M, Rodriguez M, Chowdhury M, Nagappa M, Sultania M, Bashir M, Alam M, Elshahawy MAM, Elfiky M, Loubani M, Marei M, Mewafy M, Alali M, Nassar MA, Alobied M, Bilfaqirah M, Ahmad M, Rius M, Manangi M, Dornseifer MD, Tripathi M, S M, Sokolov M, Pigeolet M, Alonso MD, Losada M, Carretero MM, Tousidonis M, Cotovio MD, Wijeyaratne M, Boira MA, Franza M, Albdour M, Alkhatieb M, Déserts MDD, Niewiera M, Vallve-Bernal M, Kavanagh MM, Migliore M, Calabrò M, Martino MD, Reicher M, Baia M, Caricato M, Clementi M, De Zuanni M, Fiore M, Giacometti M, Inama M, Maestri M, Materazzo M, Sparavigna M, Pascale MM, Nemeth M, Serra M, Fahim MMF, Soucheiron MC, Papadoliopoulou M, Wittmann M, Sotiropoulou M, García-Conde M, Ranucci MC, Amo MDAD, Boedo MJM, Velázquez MJM, Pissaridou MK, Petersen ML, Sacras ML, Modolo MM, Caubet MM, Di Nuzzo MM, Ntalouka MP, Menna MP, Aguilera-Arevalo ML, Rela M, Capuano M, Hollyman M, Olivos M, Sacdalan MD, Raphael MC, Takkenberg M, Bortul M, Cabrera M, Castaño M, D'oria M, Giuffrida M, Laborde MM, Rodriguez-Lopez M, Trejo-Avila M, Papa MV, Ghobrial M, Kryzauskas M, Anwer M, Cheetham M, Davies M, Higgins M, Siboe M, Tarle M, Velten M, Wurm M, Süleyman M, Bauer M, O’dwyer M, Caretto M, De La Rosa-Estadella M, Fragoso M, Serra ML, Merayo M, Golet MR, Martínez-Sánchez MI, Domingo MMA, Gosselink M, Batstone M, Reichert M, Salö M, Soljic M, Zambon M, Angeles MA, Abdulkhaleq M, Abdelkarim M, Alsefri M, Iwasaki M, Shiota M, Veroux M, Molina-Corbacho M, Frasson M, Serenari M, De Pastena M, Desio M, Risaliti M, Rottoli M, Bence M, Chan M, Watson M, Wiles M, Boisson M, Berselli M, Capobianco M, Di Bartolomeo M, Fehervari M, Pacilli M, Romano M, Zizzo M, Domanin M, Montuori M, Podda M, Zago M, Dzogbefia M, Frountzas M, Thaw MH, Al-Juaifari M, Gharat M, Mohamed M, Hannan MJ, Venketeswaran M, Chisthi M, Dessalegn M, Kaplan M, Çakıcı MÇ, Ulutaş ME, Hassan M, Elsadek M, Mengesha MG, Gómez ME, Elbadawy MA, Pitcher M, Tanal M, Tokocin M, Ergenç M, Çelik MN, Bareka M, Pekcici MR, Cappuccio M, Dasa M, Dewan M, El Boghdady M, Ezeanochie M, Greenhalgh M, Jenkinson M, Kelly M, Spartalis M, Zyskowski M, Racine M, De Cillia M, Chu MJJ, Mallmann MR, Zhu MZL, Klimovskij M, Vailas M, Kisielewski M, Adamina M, Campanelli M, Carvello M, Ammendola M, Manigrasso M, Scopelliti M, White M, Collins ML, Chevallay M, Borges MF, Mayo-Yáñez M, Melo MR, Ruiz-Marín M, Eiras MAF, Cunha MF, Pertea M, Slavchev M, Davidescu M, Prieto M, Agapov M, Gahwagi M, Prats MC, Rudic M, Verbic MS, Kostusiak M, Stoleriu MG, Lucas MA, Barone M, Ahmad M, Alemu MAA, Fatima M, Ida M, Sahu M, Muhaisen M, Salem M, Emara MM, Oludara M, Sotudeh M, Kassab MB, Abdelkhalek M, Alsori M, Anwar M, El-Kassas M, Elbahnasawy M, Eldabaa M, Rabie M, Hassanin MA, Thaha MA, Ali MSM, Alhamid M, Almoshantaf MB, Keramati MR, Bafaquh M, Abuzaid M, Al-Shehari M, Alharthi M, Alkahlan M, Alwash M, Alyousef M, Amir M, Basendowah M, Deputy M, Jibreel M, Alam MS, Alsharif M, Issahalq MD, Omer MEA, Abubakar MK, Draman MR, Elnour MAE, Eltayeb M, Castillo MN, Jawad M, Raut M, Ghalleb M, Katsura M, Lebe M, Abbas M, Abdelrahman M, Shalaby M, Farhan-Alanie M, Farooq M, Musadaq M, Arshad M, Anjum MA, Usman M, Chaudhary MA, Raza MA, Karim MFSA, Chaudhary MH, Janjua MH, Khokhar MI, Malik MIK, Pirzada MT, Younis MU, Elhadi M, Suer MS, Ergenç M, Binnawara M, Emmanuel M, Abbasi M, Naimzada MD, Kulimbet M, Kusunoki M, Eugene M, Chauhan M, Shokor MA, Aljiffry M, Kalın M, Kurawa M, Dincer MB, Tolani MA, Soytas M, Yakubu M, Usman MI, Aremu M, Paranyak M, Talat N, Kausar N, Dudi-Venkata N, Bazzi N, Hasan NB, Van Wyk NN, Shaban N, Almgla N, Kandevani NY, Alzerwi N, Alvarez N, Motas N, Rincón NAR, Blencowe N, Simon N, Aghtarafi N, Ghuman NK, Sharma N, Wijekoon N, Kumar N, Hassan N, Onyemaechi N, Prijović N, Özçay N, Goel N, Segaren N, Sharma N, Kalyva N, Palacios NM, Alonso NFP, Onyeagwara N, Petrucciani N, Daddi N, Lightfoot N, Power N, Segaren N, Starr N, Dreger NM, Cillara N, Colucci N, Eardley N, Tartaglia N, Zanini N, Bacalbasa N, Campuzano N, Mouawad N, Federico NSP, Tamini N, Mariani NM, Beasley N, Adu-Aryee NA, Burlov N, Dimitrokallis N, Gouvas N, Machairas N, Memos N, Thomakos N, Tsakiridis N, Schizas N, Börner N, Theochari N, Al-Saadi N, Glass N, Horesh N, R NE, Gahlot N, Ismail N, Aljirdabi N, Maria NUH, Trabulsi N, Akeel N, Borges N, Moda N, Redondo NV, Nyarko OO, Ginghina O, Enciu O, Okere O, Ekwunife OH, Quadri O, Ogundoyin O, Tucker O, Mateo-Sierra O, Azzis O, Ojewuyi O, Habeeb O, Idowu O, Elebute O, Agboola O, Ladipo-Ajayi O, Oyinloye O, Adebola O, Ekor O, Ogundoyin O, Salamanca O, Vergara-Fernandez O, Wafi O, Aladawi O, Bahassan OM, Tammo Ö, Ozkan OF, Williams OM, Salami O, Akinajo O, Sakhov O, Gallo O, Sole OM, Milella O, Alser O, Bettar OA, Alomar O, Osman OS, Aisuodionoe-Shadrach O, Basnayake O, Bozbiyik O, Hodges O, Ojo O, Yanık Ö, Mutlu ÖPZ, Kazan O, Calavia P, García PR, Urriza PV, Lopez PR, Christidis P, Dorovinis P, Kokoropoulos P, Mourmouris P, Papatheodorou P, Garg PK, Patel P, Vassiliu P, Campennì P, De Nardi P, Bernante P, Ubiali P, Baroffio P, Pizzini P, Sapienza P, Myrelid P, Chatzikomnitsa P, Tsiantoula P, Gada P, Avella P, Cianci P, Romero P, Méndez PS, Pazmiño PAF, Coughlin P, Kirchweger P, Pessaux P, Maguire PJ, Petrone P, Cullis P, Köglberger P, Marriott P, Nankivell P, Santos-Costa P, Martins PN, Panahi P, Botelho P, Teixeira P, Escobar P, Vázquez PJG, Gribnev P, Nolte P, Agbonrofo P, Bobak P, Choong P, Elbe P, Hutchinson P, Labib P, Paal P, Pockney P, Reemst P, Szatmary P, Vaughan-Shaw PG, Alexander P, Pucher P, Stather P, Foessleitner P, Winnand P, Zehnder P, Kruse P, Matos PAW, Lapolla P, Cicerchia PM, Solli P, Di Lascio P, Zarif P, Champagne PO, Anoldo P, Bertoglio P, Fransvea P, Familiari P, Lombardi PM, Stogowski PT, Bruzzaniti P, Tripathi P, D'sa P, Salunke P, Shah PA, Punjabi PPP, Christodoulou P, Hamdan Q, Tawalbeh R, Gadelkareem R, Awad R, Callcut R, Clegg R, Choron R, Payne R, Gefen R, Costea R, Drasovean R, Mirica RM, Ravindra R, Fajardo RT, Nunes RL, Aspide R, Lombardi R, Vidya R, Elboraei R, Saaid R, Ghodke R, Gupta R, Sharma RD, Lunevicius R, Kalayarasan R, Mohan R, Singh R, Sivaprakasam R, Seenivasagam RK, Rajendram R, Radulescu RB, Goicea R, Seshadri RA, Sarı R, Nataraja R, Aslam R, Abdelemam R, Shrestha R, Bharathan R, Pellini R, Guevara R, Agarwal R, Vissapragada R, Alharmi RA, Sayyed R, Browning R, Critchley R, Mallick R, Alarabi R, Beron RI, Függer R, Othman R, Saad R, Amores RR, Colombari RC, Radivojević RC, Patrone R, Novysedlák R, Palacios Huatuco RM, Baertschiger R, Liang R, Luckwell R, Escrevente R, Rezende RF, Cruz RP, Lenzi R, Rosati R, Donovan R, Egan R, Morris R, Page R, Seglenieks R, Unsworth R, Wilkin R, Skipworth RJ, Davies RJ, Bezirci R, Talwar R, Azami R, Bohmer R, Crichton R, Fruscio R, Hooker R, Jach R, Parker R, Pillerstorff R, Sinnerton R, Stabler R, O'connell RM, Ragozzino R, Tutino R, Angelico R, Cammarata R, Colasanti R, Macchiavello R, Peltrini R, Pirrello R, Vaschetti R, Pires RE, Papalia R, Arrangoiz R, Hompes R, Mittal R, Salah R, Pinto R, Flumignan R, Callan R, Cuthbert R, Dennis R, Scaramuzzo R, Macías RM, Sánchez R, Ogu R, Ramely R, Sgarzani R, Ramli R, Hillier R, Thumbadoo R, Ooi R, Abdus-Salam R, Masri R, Hodgson R, Mathew R, Wade R, D'archi S, Khan S, Ngaserin S, Kale S, Hassan S, Merghani S, Benamar S, Muhammad S, Badran S, Elsahli S, Heta S, Hammouche S, Baeesa S, Paiella S, Eldeen STEHT, Arkani S, Mittal S, Hirji S, Tebha S, Emile S, Dbouk S, Bandyopadhyay SK, Muhammad S, Olori S, Asirifi SA, Hailu S, Ling S, Newman S, Ross S, Wanjara S, Kumar S, Seneviratne S, Tamburello S, Suarez SB, Ingallinella S, Irshaidat S, Konswa S, Mambrilla S, Nasser S, Parini S, Pitoni S, Ornaghi S, Rodrigues SC, Abdelmohsen S, Aitken S, Tian S, Badiani S, Ahmad S, Swed S, Muthu S, Lakpriya S, Alzahrani S, Mikalauskas S, Lasrado S, Satoskar S, Bawa S, Altiner S, Garcia S, Stevens S, Demir S, Ken-Amoah S, Tranca S, Ziemann S, Awad S, Atici SD, Subramaniam S, Erel S, Jiang S, Efetov S, Efremov S, Katorkin S, Valladares SC, Contreras SM, Meriç S, Zenger S, Safi S, Leventoğlu S, Elsalhawy S, Shaikh S, Sheik S, Islam S, Shamim S, Waqar SH, Ahmad S, Farid S, Seraj SS, Sundarraju S, Karandikar S, Sambhwani S, Chopra S, Chowdhury S, Laura S, Ahmed S, Wason S, Tan SJH, Fraser S, Williams S, Ghozy S, Abdelmawgoud S, Shehata S, Sharma S, Ahmed S, Al-Touny SA, Ramzanali S, Nah SA, Jansen S, Rajan S, Dindyal S, Amin S, Ahmad S, Shoukrie SIM, Karar S, Patkar S, Abdulsalam S, Lin S, Hegde S, Fiorelli S, Quaresima S, Redondo SV, Palmisano S, Ruggiero S, Balogun S, Cais S, Cole S, Federer S, Le Roux S, Ippoliti S, Meneghini S, Viola S, Manfredelli S, Novello S, Gananadha S, Mesli SN, Kale S, Tani SI, Malik S, Anastasiadou S, Boligo S, Esposito S, Valanci S, Xenaki S, Pejkova S, Bandyopadhyay S, Trungu S, Basu S, Alkhatib S, Pérez-Bertólez S, Flores SL, Donoghue S, Lunca S, Orsoo S, Potamianos S, Devarakonda S, Suresh S, Croghan SM, Turi S, Capella S, Lucchini S, Magnone S, Salizzoni S, Scabini S, Scaringi S, Cioffi SPB, Seyfried S, Degener S, Potten S, Taha-Mehlitz S, Ali S, Angamuthu S, Mcaleer S, Knight SR, White S, Mantziari S, Kykalos S, Goh SK, Chowdhury SP, Ibrahim S, Elzwai S, Bansal S, Tripathy S, Amrayev S, Anwar SL, Banerjee S, Thakar S, Saeed S, Venkatappa SK, Das S, Techapongsatorn S, Dube SK, Lee S, González-Suárez S, Henriques S, Konjevoda S, Gisbertz S, Bravo SL, Mannan S, Bukhari SI, Zafar SN, Batista S, Chin SL, Arif T, Lawal TA, Aktokmakyan TV, Osborn T, Szakmany T, Sztipits T, Triantafyllou T, Valadez TAC, Singh T, Khaliq T, Patel T, Fadalla T, Jichi T, Sammour T, Al-Shaiji T, Naggs T, Barišić T, Nikolouzakis T, Bisgin T, Perra T, Uprak TK, Dagklis T, Liakakos T, Sidiropoulos T, Adjeso TJK, Dölker T, Oung T, Aherne T, Diehl T, Pinkney T, Raymond T, Rhomberg T, Schmitz-Rixen T, Madhuri TK, Lohmann TK, Yeoh T, Zaimis T, Bright T, Vilz TO, Glowka TR, Board T, Hardcastle T, Cohnert T, Mahečić TT, William TG, Klatte T, Abbott T, Watcyn-Jones T, Mendes T, Kulis T, Sečan T, Campagnaro T, Frisoni T, Simoncini T, Violante T, Safranovs TJ, Risteski T, Pang T, Akinyemi T, Yotsov T, Laeke T, Kochiyama T, Sholadoye TT, Alekberli T, Ezomike U, Giustizieri U, Grossi U, Köksoy ÜC, Bork U, Kisser U, Ronellenfitsch U, Saeed U, Bracale U, Jayarajah U, Rauf UHA, Bumbasirevic U, Ferrer UMJ, Ahmed U, Bello UM, Jogiat U, Sadia U, Galandarov V, Narayanan V, Calu V, Bianchi V, Ciniero V, Tonini V, Silvestri V, Vijay V, Dewan V, Lohsiriwat V, Thuduvage V, Mousafeiris V, Dragisic V, Sasireka V, Santric V, Kusuma VRM, Kolli VS, Alonso V, De Simone V, Picotti V, Martínez VM, Panduro-Correa V, Kakotkin V, Angulo VP, Turrado-Rodriguez V, Krishnamoorthy V, Ban VS, Shah V, Maiola V, Giordano V, La Vaccara V, Lizzi V, Papagni V, Schiavone V, Satchithanantham V, Garcia-Virto V, Jimenez V, Kumar V, Shelat V, Bhat V, Sodhai V, Graziadei V, Kutuzov V, Stoyanov V, Oktseloglou V, Flis V, Elhassan WAF, Yang W, Soon WC, Tashkandi W, Al-Khyatt W, Mabood W, Bijou W, Wijenayake W, D W, Krawczyk W, Atkins W, Bolton W, White W, Ceelen W, Vagena X, Gozal Y, Baba YI, Subramani Y, Jansen Y, Mittal Y, Kara Y, Zwain Y, Noureldin Y, Alawneh Y, Aydin Y, Lam YH, Tang Y, Lim Y, Dean Y, Tanas Y, Su YX, Fujimoto Y, Altinel Y, Frolova Y, Oshodi Y, Fadel ZT, Zahid Z, Elahi Z, Djama Z, Zaheen Z, Jawad Z, Demetrashvili Z, Gebremeskel Z, Gudisa Z, Alyami Z, Garoufalia Z, Li Z, Zimak Z, Radin Z, Balogh ZJ. Reducing the environmental impact of surgery on a global scale: systematic review and co-prioritization with healthcare workers in 132 countries. Br J Surg 2023; 110:804-817. [PMID: 37079880 PMCID: PMC10364528 DOI: 10.1093/bjs/znad092] [Citation(s) in RCA: 14] [Impact Index Per Article: 14.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2023] [Revised: 03/03/2023] [Accepted: 03/06/2023] [Indexed: 04/22/2023]
Abstract
BACKGROUND Healthcare cannot achieve net-zero carbon without addressing operating theatres. The aim of this study was to prioritize feasible interventions to reduce the environmental impact of operating theatres. METHODS This study adopted a four-phase Delphi consensus co-prioritization methodology. In phase 1, a systematic review of published interventions and global consultation of perioperative healthcare professionals were used to longlist interventions. In phase 2, iterative thematic analysis consolidated comparable interventions into a shortlist. In phase 3, the shortlist was co-prioritized based on patient and clinician views on acceptability, feasibility, and safety. In phase 4, ranked lists of interventions were presented by their relevance to high-income countries and low-middle-income countries. RESULTS In phase 1, 43 interventions were identified, which had low uptake in practice according to 3042 professionals globally. In phase 2, a shortlist of 15 intervention domains was generated. In phase 3, interventions were deemed acceptable for more than 90 per cent of patients except for reducing general anaesthesia (84 per cent) and re-sterilization of 'single-use' consumables (86 per cent). In phase 4, the top three shortlisted interventions for high-income countries were: introducing recycling; reducing use of anaesthetic gases; and appropriate clinical waste processing. In phase 4, the top three shortlisted interventions for low-middle-income countries were: introducing reusable surgical devices; reducing use of consumables; and reducing the use of general anaesthesia. CONCLUSION This is a step toward environmentally sustainable operating environments with actionable interventions applicable to both high- and low-middle-income countries.
Collapse
|
7
|
Cobianchi L, Dal Mas F, Agnoletti V, Ansaloni L, Biffl W, Butturini G, Campostrini S, Catena F, Denicolai S, Fugazzola P, Martellucci J, Massaro M, Previtali P, Ruta F, Venturi A, Woltz S, Kaafarani HM, Loftus TJ, Aapoäÿlu R, Abbott KL, Abdelmalik A, Abebe NS, Abu-Zidan F, Adam YAY, Adamou H, Adamovich DM, Agresta F, Agrusa A, Akin E, Alessiani M, Alexandrino H, Bidoli C, Ali SM, Mihai VA, Almeida PM, Al-Shehari MM, Altomare M, Amico F, Ammendola M, Andreuccetti J, Anestiadou E, Annicchiarico A, Antonelli A, Aparicio-Sanchez D, Ardito A, Argenio G, Arvieux CC, Arvieux C, Askevold IH, Atanasov BT, Augustin G, Awad SS, Bacchiocchi G, Bagnoli C, Bahouth H, Baili E, Bains L, Baiocchi GL, Bala M, Balaguà© C, Balalis D, Baldini E, Baraket O, Baral S, Barone M, Gonzãlez Barranquero A, Barreras JA, Bass GA, Bayhan Z, Bellanova G, Ben-Ishay O, Bert F, Bianchi V, Biancuzzi H, Radulescu RB, Bignell MB, Biloslavo A, Bini R, Bissacco D, Boati P, Boddaert G, Bogdanic B, Bombardini C, Bonavina L, Bonomo L, Bottari A, Bouliaris K, Brachini G, Brillantino A, Brisinda G, Bulanauca MM, Buonomo LA, Burcharth J, Buscemi S, Calabretto F, Calini G, Calu V, Campanile FC, Campo Dall’Orto R, Campos-Serra A, Carvas JM, Cascella M, Pattacini GC, Celentano V, Centonze DC, Ceresoli M, Chatzipetris D, Chessa A, Chiarello MM, Chirica M, Chooklin S, Chouliaras C, Chowdhury S, Cianci P, Cillara N, Cimbanassi S, Cioffi SPB, Colãis-Ruiz E, Colak E, Conti L, Coppola A, de Sa TC, Costa SD, Cozza V, Curro’ G, Dabekaussen KFASA, D’acapito F, Damaskos D, D’Ambrosio G, Das K, Davies RJ, de Beaux AC, De Lebrusant Fernandez SP, De Luca A, De Simone B, De Stefano F, Degrate L, Demetrashvili Z, Demetriades AK, Detanac DS, Dezi A, Di Buono G, Carlo IDI, Di Lascio P, Di Martino M, Di Saverio S, Diaconescu B, Diaz JJ, Dibra R, Dimitrov EN, Dinuzzi VP, Dios-Barbeito S, Diyani JFA, Dogjani A, Domanin M, D’Oria M, Munoz-Cruzado VD, East B, Ekelund M, Ekwen GT, Elbaih AH, Elhadi M, Enninghorst N, Ernisova M, Escalera-Antezana JP, Esposito S, Esposito G, Estaire-Gãmez M, Farã CN, Farre R, Favi F, Ferrario L, Ferrario di Tor Vajana A, Filisetti C, Fleres F, Fonseca VC, Forero-Torres A, Forfori F, Fortuna L, Fradelos E, Fraga GP, Fransvea P, Frassini S, Frazzetta G, Frigerio I, Frountzas M, Gachabayov M, Galeiras R, Garcãa BM, Garcia Vazquez A, Gargarella S, Garzali IU, Ghannam WM, Ghazi FN, Gillman LM, Gioco R, Giordano A, Giordano L, Giove C, Giraudo G, Giuffrida M, Capponi MG, Gois E, Gomes CA, Gomes FC, Gonsaga RAT, Gonullu E, Goosen J, Goranovic T, Gracia-Roman R, Graziano GMP, Griffiths EA, Guagni T, Hadzhiev DB, Haidar MG, Hamid HKS, Hardcastle TC, Hayati F, Healey AJ, Hecker A, Hecker M, Garcia EFH, hodonou AM, huaman EC, Huerta M, Ibrahim AF, Ibrahim BMS, Ietto G, Inama M, Ioannidis O, Isik A, Ismail N, Ismail AMH, Jailani RUHIF, Jang JY, Kalfountzos C, Kalipershad SNR, Kaouras E, Kaplan LJ, Kara Y, Karamagioli E, Karamarkovia A, Katsaros I, Kavalakat AJ, Kechagias A, Kenig J, Kessel BJ, Khan JS, Khokha V, Kim JI, Kirkpatrick AW, Klappenbach R, Kobe Y, Lymperis EK, Kok KYY, Kong V, Korkolis DP, Koukoulis G, Kovacevic B, Kruger VF, Kryvoruchko IA, Kurihara H, Kuriyama A, Landaluce-Olavarria A, Lapolla P, Licari L, Lisi G, Litvin A, Lizarazu A, Bayo HL, Lohsiriwat V, Moreira CCL, Lostoridis E, Luna AT, Luppi D, V. GMM, Maegele M, Maggiore D, Magnone S, Maier RV, Maier RV, Major P, Manangi M, manetti A, Mantoglu B, Marafante C, Mariani F, Marinis A, Mariot ES, Marseglia GR, Martãnez-Pãrez A, Martines G, Perez AM, Martino C, Mascagni P, Massalou D, Matãas-Garcãa B, Mazzarella G, Mazzarolo G, Melo RB, Mendoza-Moreno F, Meric S, Meyer J, Miceli L, Michalopoulos NV, Milana F, Mingoli A, Mishra TS, Mohamed M, Mohamed MIEA, Mohamedahmed AY, Mohammed MJS, Mohan R, Moore EE, Morales-Garcia D, Muhrbeck M, Mulita F, Mustafa SMS, Muttillo EM, Naimzada MD, Navsaria PH, Negoi I, Nespoli L, Nguyen C, Nidaw MK, Nigri G, Nikolopoulos I, O’Connor DB, Ogundipe HD, Oliveri C, Olmi S, Ong ECW, Orecchia L, Osipov AV, Othman MF, Pace M, Pacilli M, Pagani L, Palomba G, Pantalone D, Panyko A, Paolillo C, Papa MV, Papaconstantinou D, Papadoliopoulou M, Papadopoulos A, Papis D, Pararas N, Parreira JG, Parry NG, Pata F, Patel T, Paterson-Brown S, Pavone G, Pecchini F, Pellino G, Pelloni M, Peloso A, del Pozo EP, Pereira RG, Pereira BM, perez AL, Perra T, Perrone G, Pesce A, Petagna L, Petracca G, Phupong V, Picardi B, Picciariello A, Piccoli M, Piccolo D, Picetti E, Pikoulis Pikoulis E, Pintar T, Pirozzolo G, Piscioneri F, Podda M, Porcu A, Privitera F, Punzo C, Quaresima S, Quiodettis MA, Qvist N, Rahim R, de Almeida FR, Ramely RB, Rasa HK, Reichert M, Reinisch-Liese A, Renne A, Riccetti C, Rodriguez-Luna MR, Roizblatt D, Romanzi A, Romeo L, Roscio FPM, Rosnelifaizur RB, Rossi S, Rubiano AM, Ruiz-Úcar E, Sakakushev BE, Salamea JC, Sall I, Samarakoon LB, Sammartano F, Arteaga AS, Sanchez-Cordero S, Santoanastaso DPM, Sasia D, Sato N, Savchuk A, Sawyer RG, Scaioli G, Schizas D, Sebastiani S, Seeliger B, Lohse HAS, Seretis C, Sermonesi G, Serradilla-Martin M, Shelat VG, Shlyapnikov S, Sidiropoulos T, Simoes RL, Siragusa L, Siribumrungwong B, Slavchev M, Solaini L, soldini G, Sopuev A, Soreide K, Sovatzidis A, Stahel PF, Strickland M, Sultan MAH, Sydorchuk R, Sydorchuk L, Syed SMAM, Syed AM, Tallon-Aguilar L, Tamburini AM, Tamini N, Tan ECTH, Tan JH, Tarasconi A, Tartaglia N, Tartaglia G, Tartaglia D, Taylor JV, Tebala GD, Gonsaga RAT, Teuben M, Theodorou A, Tolonen M, Tomasicchio G, Toro A, Torre B, Triantafyllou T, Trigiante Trigiante G, Tripepi M, Trostchansky J, Tsekouras K, Turrado-Rodriguez V, Tutino R, Uccelli M, Uchikov PA, Ugarte-Sierra B, Ukkonen MT, Vailas M, Vassiliu PG, Vazquez AG, Vazquez RG, Verde JE, Verde JM, Veroux M, Viganò J, Vilallonga R, Visconti D, Vittori A, Waledziak M, Wannatoop T, Widmer LW, Wilson MSJ, Wong TH, Xenaki S, Yu B, Yule S, Zachariah SK, Zacharis G, Zaghi C, Zakaria AD, Zambrano DA, Zampitis N, Zampogna B, Zanghã S, Zapsalis K, Zattoni F, Zese M, Farre SP, Atanasov BT, Pegoraro V, Zantedeschi M, Reitano E, Pizzocaro E. Time for a paradigm shift in shared decision-making in trauma and emergency surgery? Results from an international survey. World J Emerg Surg 2023; 18:14. [PMID: 36803568 PMCID: PMC9936681 DOI: 10.1186/s13017-022-00464-6] [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: 09/21/2022] [Accepted: 11/02/2022] [Indexed: 02/19/2023] Open
Abstract
BACKGROUND Shared decision-making (SDM) between clinicians and patients is one of the pillars of the modern patient-centric philosophy of care. This study aims to explore SDM in the discipline of trauma and emergency surgery, investigating its interpretation as well as the barriers and facilitators for its implementation among surgeons. METHODS Grounding on the literature on the topics of the understanding, barriers, and facilitators of SDM in trauma and emergency surgery, a survey was created by a multidisciplinary committee and endorsed by the World Society of Emergency Surgery (WSES). The survey was sent to all 917 WSES members, advertised through the society's website, and shared on the society's Twitter profile. RESULTS A total of 650 trauma and emergency surgeons from 71 countries in five continents participated in the initiative. Less than half of the surgeons understood SDM, and 30% still saw the value in exclusively engaging multidisciplinary provider teams without involving the patient. Several barriers to effectively partnering with the patient in the decision-making process were identified, such as the lack of time and the need to concentrate on making medical teams work smoothly. DISCUSSION Our investigation underlines how only a minority of trauma and emergency surgeons understand SDM, and perhaps, the value of SDM is not fully accepted in trauma and emergency situations. The inclusion of SDM practices in clinical guidelines may represent the most feasible and advocated solutions.
Collapse
Affiliation(s)
- Lorenzo Cobianchi
- Department of Clinical, Diagnostic and Pediatric Sciences, University of Pavia, Via Alessandro Brambilla, 74, 27100, Pavia, PV, Italy. .,IRCCS Policlinico San Matteo Foundation, General Surgery, Pavia, Italy.
| | - Francesca Dal Mas
- grid.7240.10000 0004 1763 0578Department of Management, Ca’ Foscari University of Venice, Venice, Italy
| | - Vanni Agnoletti
- grid.414682.d0000 0004 1758 8744Bufalini Hospital, AUSL Romagna, Cesena, Italy
| | - Luca Ansaloni
- grid.8982.b0000 0004 1762 5736Department of Clinical, Diagnostic and Pediatric Sciences, University of Pavia, Via Alessandro Brambilla, 74, 27100 Pavia, PV Italy ,grid.419425.f0000 0004 1760 3027IRCCS Policlinico San Matteo Foundation, General Surgery, Pavia, Italy
| | - Walter Biffl
- grid.415402.60000 0004 0449 3295Division of Trauma and Acute Care Surgery, Scripps Memorial Hospital La Jolla, La Jolla, CA USA
| | - Giovanni Butturini
- grid.513352.3Department of HPB Surgery, Pederzoli Hospital, Peschiera del Garda, Italy
| | - Stefano Campostrini
- grid.7240.10000 0004 1763 0578Department of Economics, Ca’ Foscari University of Venice, Venice, Italy
| | - Fausto Catena
- grid.414682.d0000 0004 1758 8744Bufalini Hospital, AUSL Romagna, Cesena, Italy
| | - Stefano Denicolai
- grid.8982.b0000 0004 1762 5736Department of Economics and Management, University of Pavia, Pavia, Italy
| | - Paola Fugazzola
- grid.419425.f0000 0004 1760 3027IRCCS Policlinico San Matteo Foundation, General Surgery, Pavia, Italy
| | - Jacopo Martellucci
- grid.24704.350000 0004 1759 9494Department of Surgery, Careggi University Hospital, Florence, Italy
| | - Maurizio Massaro
- grid.7240.10000 0004 1763 0578Department of Management, Ca’ Foscari University of Venice, Venice, Italy
| | - Pietro Previtali
- grid.8982.b0000 0004 1762 5736Department of Economics and Management, University of Pavia, Pavia, Italy
| | - Federico Ruta
- General Direction, ASL BAT (Health Agency), Andria, Italy
| | - Alessandro Venturi
- grid.8982.b0000 0004 1762 5736Department of Political and Social Sciences, University of Pavia, Pavia, Italy ,grid.419425.f0000 0004 1760 3027Bureau of the Presidency, IRCCS Policlinico San Matteo Foundation, Pavia, Italy
| | - Sarah Woltz
- grid.416219.90000 0004 0568 6419Department of Surgery, Spaarne Gasthuis, Hoofddorp, The Netherlands
| | - Haytham M. Kaafarani
- grid.38142.3c000000041936754XHarvard Medical School, Boston, MA USA ,grid.32224.350000 0004 0386 9924Division of Trauma, Emergency Surgery, and Surgical Critical Care, Massachusetts General Hospital, Boston, MA USA
| | - Tyler J. Loftus
- grid.430508.a0000 0004 4911 114XDepartment of Surgery, University of Florida Health, Gainesville, FL USA
| | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | |
Collapse
|
8
|
Lisi G, Gentileschi P, Spoletini D, Passaro U, Orlandi S, Campanelli M. Sclerotherapy for III- and IV-degree hemorrhoids: Results of a prospective study. Front Surg 2022; 9:978574. [PMID: 36117836 PMCID: PMC9474687 DOI: 10.3389/fsurg.2022.978574] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [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: 06/26/2022] [Accepted: 08/08/2022] [Indexed: 01/11/2023] Open
Abstract
BackgroundIn the last 2 years, anorectal surgery has been strongly affected and even surgery for urgent cases cannot be scheduled; also, patients with III- and IV-degree bleeding hemorrhoids should be treated conservatively. The aim was to evaluate the effectiveness of sclerotherapy in patients who had to postpone surgery.MethodsWe included all patients with III- and IV-degree bleeding hemorrhoids who underwent outpatient sclerotherapy. The visual analog scale and the hemorrhoid severity score were used at the baseline and at 4 weeks after the procedure with a telephone interview, and all patients were outpatient-evaluated 1 week, 1 month, and 1 year after the treatment. All pre- and postoperative data were recorded.ResultsFrom October 2020 to November 2021, 19 patients with III- (12 patients; 63%) and IV-degree (7 patients; 37%) bleeding hemorrhoids were enrolled. The mean operative time was 4.5 min, and no intraoperative complications occurred. One case of tenesmus and three failures were detected. Six months after the procedure, the overall success rate was 84%, although all of the patients enrolled reported persistent bleeding at the end of the study period. Of these, 5 patients (26%) were scheduled for surgery and 11 patients (58%) refused surgery and asked to undergo a re-do sclerotherapy.ConclusionSclerotherapy with 3% polidocanol foam is a safe and effective procedure also in III- and IV-degree bleeding hemorrhoids. The long-term data on the length of the foam remain to be evaluated in additional studies.
Collapse
Affiliation(s)
- Giorgio Lisi
- Department of Surgery, Sant’Eugenio Hospital, Rome, Italy
- Correspondence: Giorgio Lisi
| | - Paolo Gentileschi
- Department of Bariatric and Metabolic Surgery, University of Tor Vergata, San Carlo of Nancy Hospital, Rome, Italy
| | | | | | - Simone Orlandi
- Department of Gastroenterology and Digestive Endoscopy, IRCSS Sacro Cuore don Calabria, Negrar di Valpolicella, Italy
| | | |
Collapse
|
9
|
Lisi G, Campanelli M, Benavoli D, Bianciardi E, Spoletini D, Gentileschi P. Benign Anorectal Disorders and Pelvic Floor Disease After Bariatric Surgery. J Clin Med Res 2022; 14:260-263. [PMID: 35974804 PMCID: PMC9365667 DOI: 10.14740/jocmr4713] [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: 04/01/2022] [Accepted: 04/26/2022] [Indexed: 11/22/2022] Open
Abstract
The correlations between morbid obesity, bariatric surgery and gastrointestinal disorders are well known and reported. Symptoms like abdominal pain, constipation, bloating, heartburn and gastroesophageal reflux disease are known to be significantly more prevalent in overweight patients and body mass index is associated positively with abdominal pain and diarrhea. In spite of these conditions, less is known about the lower gastrointestinal tract. Of these, anorectal disorders and pelvic floor disease are both believed to be more frequent in obese patients compared to the general population. Weight loss related to bariatric surgery seems to improve quality of life and weight-related symptoms, although some of these conditions may get worse. All these conditions are rarely studied in patients undergoing bariatric surgery for morbid obesity. This concise review aimed to focus on these conditions in patients undergoing bariatric surgery for morbid obesity in order to improve patient selection and post-operative management.
Collapse
Affiliation(s)
- Giorgio Lisi
- Department of Surgery, Sant’Eugenio Hospital, Piazzale dell’Umanesimo 10, 00144 Rome, Italy
- Corresponding Author: Giorgio Lisi, Department of Surgery, Sant’Eugenio Hospital, Piazzale dell’Umanesimo 10, 00144 Rome, Italy.
| | - Michela Campanelli
- Emergency Surgery Unit, University Hospital of Tor Vergata, viale Oxford 81, 00133 Rome, Italy
- Department of Bariatric and Metabolic Surgery, University of Tor Vergata, San Carlo of Nancy Hospital, via Aurelia 275, 00165 Rome, Italy
| | - Domenico Benavoli
- Department of Bariatric and Metabolic Surgery, University of Tor Vergata, San Carlo of Nancy Hospital, via Aurelia 275, 00165 Rome, Italy
| | - Emanuela Bianciardi
- Department of Systems Medicine, Chair of Psychiatry, University Hospital of Tor Vergata, viale Oxford 81, 00133 Rome, Italy
| | - Domenico Spoletini
- Department of Surgery, Sant’Eugenio Hospital, Piazzale dell’Umanesimo 10, 00144 Rome, Italy
| | - Paolo Gentileschi
- Department of Bariatric and Metabolic Surgery, University of Tor Vergata, San Carlo of Nancy Hospital, via Aurelia 275, 00165 Rome, Italy
| |
Collapse
|
10
|
Lisi G, Campanelli M, Mastrangeli MR, Spoletini D, Menditto R, Grande S, Boccuzzi M, Grande M. The treatment of acute appendicitis in two age-based groups during COVID-19 pandemic: a retrospective experience in a COVID-19 referral hospital. Int J Colorectal Dis 2022; 37:323-328. [PMID: 34738164 PMCID: PMC8567973 DOI: 10.1007/s00384-021-04060-z] [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] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 10/29/2021] [Indexed: 02/04/2023]
Abstract
PURPOSE During the past months, the Italian Government has reduced the restrictions and access to hospitals as well as outpatient. Since then, up to 40% of non-traumatic abdominal emergencies have had unusual delayed treatment. Given the rapidly evolving situation and the absence of evidence to support recommendations during the COVID-19 pandemic, it is useful to assess how the current situation is influencing the management of elderly patients with acute appendicitis. METHODS Between February 2020 and December 2020, all patients 18 years or older undergone appendectomy were included. Patients were divided in two age-based groups (young groups, YG; elderly group, EG). Surgical approach, hospital stay, post-operative complications, radiology reports, and histologic examination were included in the retrospective analysis. RESULTS One hundred eight patients underwent appendectomy, 81 patients into the YG, and 27 in the EG. Laparoscopy was performed in 87.7% of the YG and in 51.8% of the elderly (p < 0.000), while conversion to laparotomy was necessary in 3.7% in the YG vs 22.3% of the other group (p < 0.009). Open procedures were more frequent in the EG, 25.9% vs 8.6% (p value < 0.05). No mortality rate was reported in both groups; moreover, the mean hospital stay was greater in the EG than the YG (p < 0.000). CONCLUSION Our data highlighted a partial delay in diagnosis in the elderly group, and an increase in complicated appendicitis also demonstrated by the need for conversion to laparotomy despite no significant relationship between these findings and the histologic examination was reported.
Collapse
Affiliation(s)
- Giorgio Lisi
- Department of Surgery, Sant'Eugenio Hospital, Piazzale dell'Umanesimo 10, 00144, Rome, Italy.
| | - Michela Campanelli
- Emergency Surgery Unit, University Hospital of Tor Vergata, viale Oxford 81, 00133, Rome, Italy
| | | | - Domenico Spoletini
- Department of Surgery, Sant'Eugenio Hospital, Piazzale dell'Umanesimo 10, 00144, Rome, Italy
| | - Rosa Menditto
- Department of Surgery, Sant'Eugenio Hospital, Piazzale dell'Umanesimo 10, 00144, Rome, Italy
| | - Simona Grande
- Emergency Surgery Unit, University Hospital of Tor Vergata, viale Oxford 81, 00133, Rome, Italy
| | - Massimiliano Boccuzzi
- Department of Surgery, San Sebastiano Hospital, via Tuscolana 1, 00046, Frascati, Rome, Italy
| | - Michele Grande
- Emergency Surgery Unit, University Hospital of Tor Vergata, viale Oxford 81, 00133, Rome, Italy
| |
Collapse
|
11
|
Lisi G, Campanelli M, Mastrangeli MR, Spoletini D, Menditto R, Grande S, Boccuzzi M, Grande M. Correction to: The treatment of acute appendicitis in two age‑based groups during COVID‑19 pandemic: a retrospective experience in a COVID‑19 referral hospital. Int J Colorectal Dis 2022; 37:329. [PMID: 34910232 PMCID: PMC8672857 DOI: 10.1007/s00384-021-04084-5] [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] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Affiliation(s)
- Giorgio Lisi
- Department of Surgery, Sant’Eugenio Hospital, Piazzale dell’Umanesimo 10, 00144 Rome, Italy
| | - Michela Campanelli
- Emergency Surgery Unit, University Hospital of Tor Vergata, viale Oxford 81, 00133 Rome, Italy
| | | | - Domenico Spoletini
- Department of Surgery, Sant’Eugenio Hospital, Piazzale dell’Umanesimo 10, 00144 Rome, Italy
| | - Rosa Menditto
- Department of Surgery, Sant’Eugenio Hospital, Piazzale dell’Umanesimo 10, 00144 Rome, Italy
| | - Simona Grande
- Emergency Surgery Unit, University Hospital of Tor Vergata, viale Oxford 81, 00133 Rome, Italy
| | - Massimiliano Boccuzzi
- Department of Surgery, San Sebastiano Hospital, via Tuscolana 1, 00046 Frascati, Rome, Italy
| | - Michele Grande
- Emergency Surgery Unit, University Hospital of Tor Vergata, viale Oxford 81, 00133 Rome, Italy
| |
Collapse
|
12
|
Campanelli M, Bianciardi E, Benavoli D, Bagaglini G, Lisi G, Gentileschi P. Laparoscopic Banded One Anastomosis Gastric Bypass: A Single-Center Series. J Obes 2022; 2022:4942052. [PMID: 35132363 PMCID: PMC8817855 DOI: 10.1155/2022/4942052] [Citation(s) in RCA: 3] [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] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/10/2021] [Revised: 01/16/2022] [Accepted: 01/17/2022] [Indexed: 02/06/2023] Open
Abstract
INTRODUCTION Laparoscopic one anastomosis gastric bypass (LOAGB) is a relatively new procedure for the treatment of morbid obesity and related comorbidities. On average, this procedure results in good postoperative weight loss with a low complication rate. Recent publications suggest that dumping syndrome and weight regain might be reduced by placing a silicone ring over the gastric pouch during the procedure, so called laparoscopic banded one anastomosis gastric bypass (LBOAGB). METHODS 86 patients undergoing LBOAGB between 2018 and 2020 were enrolled in this retrospective study. Hospital records were used to assess weight loss, comorbidity resolution, and any complications either in the short or medium term. RESULTS 54 Female and 32 male patients were included with a mean age of 43 years (25-64), preoperative body mass index of 42 kg/m2 (35-49), and preoperative weight of 114 kg (86-162). Thirty-four patients presented with type 2 diabetes (39.5%), 42 patients (49%) diagnosed with hypertension, 24 presented with OSAS (28%), and 21 (24%) hypercholesterolaemia patients were included. In total, 36 patients were diagnosed with multiple comorbidities. The operative data showed an average operative time of 48 minutes with 3.4% of patients suffering from early (minor) complications and 2.3% with a late (minor) complication. One patient required reoperation due to intra-abdominal bleeding. The median length of hospital stay was 2.5 days. Median follow-up was 18 months (5-36). In that period, no patient required ring removal or conversion to Roux-en-Y gastric bypass surgery. Food intolerance/vomiting was present in 1 patient (1.1%), bile reflux was present in 1 patient (1.1%), and no stomal ulcers were observed. Mean % excess weight loss at 12 and 24 months was 72% and 80%, respectively. Fifty-two out of 86 patients (60%) had a complete resolution of comorbidities. A CONUT score >2 (mild malnutrition) was found in 40% of patients, while a CONUT score 0-1 was found in 60% of patients. CONCLUSION LBOAGB shows promising results in terms of safety and efficacy in the short term. Further prospective studies will be required to evaluate the consistency of the results in the long term.
Collapse
Affiliation(s)
- Michela Campanelli
- Department of Bariatric and Metabolic Surgery, San Carlo of Nancy Hospital and University of Rome “Tor Vergata”, Rome, Italy
| | - Emanuela Bianciardi
- Chair of Psychiatry, Department of Systems Medicine, University of Rome “Tor Vergata”, Rome, Italy
| | - Domenico Benavoli
- Department of Bariatric and Metabolic Surgery, San Carlo of Nancy Hospital and University of Rome “Tor Vergata”, Rome, Italy
| | - Giulia Bagaglini
- General Surgery Residency School, University of Rome “Tor Vergata”, Rome, Italy
| | - Giorgio Lisi
- Department of Surgery, Sant'Eugenio Hospital, Viale Dell'Umanesimo 10, Rome 00144, Italy
| | - Paolo Gentileschi
- Department of Bariatric and Metabolic Surgery, San Carlo of Nancy Hospital and University of Rome “Tor Vergata”, Rome, Italy
| |
Collapse
|
13
|
Lisi G, Campanelli M, Mastrangeli MR, Grande S, Viarengo MA, Garbarino GM, Vanni G, Grande M. Acute appendicitis in elderly during Covid-19 pandemic. Int J Colorectal Dis 2021; 36:2287-2290. [PMID: 34046696 PMCID: PMC8159028 DOI: 10.1007/s00384-021-03959-x] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 05/21/2021] [Indexed: 02/04/2023]
Abstract
PURPOSE During the past months, the Italian Government has reduced the restrictions and access to hospitals. Since then, up to 40% of non-traumatic abdominal emergencies have had unusual delayed treatment. Given the rapidly evolving situation and the absence of evidence to support recommendations during the pandemic, it is useful to assess how the current situation is influencing the management of elderly with acute appendicitis. METHODS Between February 2020 and December 2020, all patients older than 68 years old undergone appendectomy were included. Surgical approach, hospital stay, post-operative complications, radiology reports, and histologic examination were included in the retrospective analysis and compared with a same sample of the same period before the pandemic. RESULTS Twenty-seven patients underwent appendectomy for acute appendicitis during the pandemic and 34 patients in the pre-outbreak period. Laparoscopic approach was completed in 51.8% of the cases, while conversion to laparotomy in 22.3% of patients and open procedure in the 25.9%, before the pandemic 73.6%, 14.7%, and 11.7%, respectively. During the pandemic, complicated appendicitis occurred in 59.3% of the cases (26.5% before the outbreak). One patient was treated for a pelvic abscess, while no minor complications were detected. No mortality rate was reported, with a mean hospital stay of 5.64 days during the outbreak and 4.21 days before the pandemic. CONCLUSION Our data highlighted a partial delay in diagnosis in the elderly group, and an increase in complicated appendicitis also demonstrated by the need for conversion to laparotomy.
Collapse
Affiliation(s)
- G Lisi
- Department of Surgery, Sant'Eugenio Hospital, Piazzale dell'Umanesimo 10, 00144, Rome, Italy.
| | - M Campanelli
- Emergency Surgery Unit, University Hospital of Tor Vergata, viale Oxford 81, 00133, Rome, Italy
| | - M R Mastrangeli
- Department of Surgery, Sant'Eugenio Hospital, Piazzale dell'Umanesimo 10, 00144, Rome, Italy
| | - S Grande
- Emergency Surgery Unit, University Hospital of Tor Vergata, viale Oxford 81, 00133, Rome, Italy
| | - M A Viarengo
- Day-Case Surgery Unit, Israelitic Hospital, 00144, Rome, Italy
| | - G M Garbarino
- Department of Medical Surgical Sciences and Translational Medicine, Sant'Andrea University, Via di Grottarossa, 1035-39, 00189, Rome, Italy
| | - G Vanni
- Emergency Surgery Unit, University Hospital of Tor Vergata, viale Oxford 81, 00133, Rome, Italy
| | - M Grande
- Emergency Surgery Unit, University Hospital of Tor Vergata, viale Oxford 81, 00133, Rome, Italy
| |
Collapse
|
14
|
Vanni G, Pellicciaro M, Combi F, Papi S, Materazzo M, Segattini S, Rizza S, Chiocchi M, Perretta T, Meucci R, Portarena I, Pistolese CA, Ielpo B, Campanelli M, Lisi G, Chiaravalloti A, Tazzioli G, Buonomo OC. Impact of COVID-19 Pandemic on Surgical Breast Cancer Patients Undergoing Neoadjuvant Therapy: A Multicentric Study. Anticancer Res 2021; 41:4535-4542. [PMID: 34475080 DOI: 10.21873/anticanres.15265] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2021] [Revised: 08/04/2021] [Accepted: 08/06/2021] [Indexed: 11/10/2022]
Abstract
BACKGROUND/AIM Due to the SARS-CoV-2 pandemic, many scientific committees proposed neoadjuvant therapy (NACT) bridging treatment as a novel strategy and indication. The aim of the study was to evaluate the impact of COVID-19 pandemic on breast cancer patients undergoing NACT. PATIENTS AND METHODS All breast cancer patients referred to two Breast Units during COVID-19-pandemic were enrolled. RESULTS Out of 814 patients, 43(5.3%) were enrolled in the COVID-19-group and compared with 94 (7.9%) similar Pre-COVID-19 patients. We observed a reduction in the number of patients undergoing NACT, p=0.0019. No difference was reported in terms of clinical presentation, indications, and tumor response. In contrast, a higher number of vascular adverse events was reported (6.9% vs. 0% p=0.029). Immediate breast cancer reconstructions following invasive surgery suffered a significant slowdown (5.9% vs. 47.7%, p=0.019). CONCLUSION COVID-19 caused a reduction in the number of patients undergoing NACT, with no changes in terms of indications, clinical presentation, and tumor response. Furthermore, there was an increased incidence of vascular events.
Collapse
Affiliation(s)
- Gianluca Vanni
- Breast Unit, Department of Surgical Science, Policlinico Tor Vergata University, Rome, Italy
| | - Marco Pellicciaro
- Breast Unit, Department of Surgical Science, Policlinico Tor Vergata University, Rome, Italy;
| | - Francesca Combi
- Division of Breast Surgical Oncology Department of Medical and Surgery, Maternal-infantile and Adult Sciences, University Hospital of Modena and Reggio Emilila, Modena, Italy
| | - Simona Papi
- Division of Breast Surgical Oncology Department of Medical and Surgery, Maternal-infantile and Adult Sciences, University Hospital of Modena and Reggio Emilila, Modena, Italy
| | - Marco Materazzo
- Breast Unit, Department of Surgical Science, Policlinico Tor Vergata University, Rome, Italy
| | - Silvia Segattini
- Division of Breast Surgical Oncology Department of Medical and Surgery, Maternal-infantile and Adult Sciences, University Hospital of Modena and Reggio Emilila, Modena, Italy
| | - Stefano Rizza
- Department of Systems Medicine, University of Rome Tor Vergata, Rome, Italy
| | - Marcello Chiocchi
- Department of Diagnostic Imaging, Molecular Imaging, Interventional Radiology and Radiotherapy, University of Rome, Rome, Italy
| | - Tommaso Perretta
- Department of Diagnostic Imaging, Molecular Imaging, Interventional Radiology and Radiotherapy, University of Rome, Rome, Italy
| | - Rosaria Meucci
- Department of Diagnostic Imaging, Molecular Imaging, Interventional Radiology and Radiotherapy, University of Rome, Rome, Italy
| | - Ilaria Portarena
- Department of Oncology, Policlinico Tor Vergata University, Rome, Italy
| | - Chiara Adriana Pistolese
- Department of Diagnostic Imaging, Molecular Imaging, Interventional Radiology and Radiotherapy, University of Rome, Rome, Italy
| | - Benedetto Ielpo
- Unidad de Chirugia Hepatobiliopancreática, Hospital Universitario del Mar, Barcelona, Spain
| | | | - Giorgio Lisi
- Department of Surgery, Sant'Eugenio Hospital, Rome, Italy
| | - Agostino Chiaravalloti
- Department of Biomedicine and Prevention, Policlinico Tor Vergata University, Rome, Italy.,IRCCS Neuromed, UOC Medicina Nucleare, Pozzilli, Italy
| | - Giovanni Tazzioli
- Division of Breast Surgical Oncology Department of Medical and Surgery, Maternal-infantile and Adult Sciences, University Hospital of Modena and Reggio Emilila, Modena, Italy
| | - Oreste Claudio Buonomo
- Breast Unit, Department of Surgical Science, Policlinico Tor Vergata University, Rome, Italy
| |
Collapse
|
15
|
Costa G, Fransvea P, Lepre L, Rondelli F, Costa A, Campanelli M, Lisi G, Mastrangeli MR, Laracca GG, Garbarino GM, Ceccarelli G. 2D vs 3D laparoscopic right colectomy: A propensity score-matching comparison of personal experience with systematic review and meta-analysis. World J Gastrointest Surg 2021; 13:597-619. [PMID: 34194617 PMCID: PMC8223707 DOI: 10.4240/wjgs.v13.i6.597] [Citation(s) in RCA: 4] [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] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/15/2021] [Revised: 05/04/2021] [Accepted: 05/18/2021] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND The benefits of laparoscopic approach for right colectomy have been well established. However, the technical difficulty to construct the intra-corporeal anastomosis is still cumbersome.
AIM To analyze the results of 3D and 2D laparoscopic right colectomy and to compare it to the published series through a systematic review and meta-analysis.
METHODS A retrospective study with propensity score matching analysis of patients undergoing laparoscopic right colectomy at Umbria2 Hospitals from January 2014 to March 2020 was performed. A systematic review was accomplished comparing 2D and 3D right colectomy.
RESULTS In the personal series 47 patients of the 2D group were matched to 47 patients of the 3D group. The 3D group showed a favorable trend in terms of mean operative time (170.7 ± 32.9 min vs 183.8 ± 35.4 min; P = 0.053) and a significant lower anastomotic time (16.9 ± 2.3 min vs 19.6 ± 2.9 min, P < 0.001). The complete mesocolic excision (CME) subgroups analysis showed a shorter anastomotic time (16.5 ± 1.8 min vs 19.9 ± 3.0 min; P < 0.001) and operative time (175.0 ± 38.5 min vs 193.7 ± 37.1 min; P = 0.063) in the 3D group. Six studies and our series were included in the meta-analysis with 551 patients (2D group: 291; 3D group: 260).The pooled analysis demonstrated a significant difference in favour of the 3D group regarding the operative time (P < 0.001) and the anastomotic time (P < 0.001) while no differences were identified between groups in terms of blood loss (P = 0.827), LNH yield (P = 0.243), time to first flatus (P = 0.333), postoperative complications (P = 0.718) and length of stay (P = 0.835).
CONCLUSION The meta-analysis results showed that 3D laparoscopic right colectomy shortens operative and anastomotic time without affecting the standard lymphadenectomy. In our series, the advantage of the 3D system becomes evident when CME and/or more complex associated procedure are requested significantly reducing both the total operative and the anastomotic time.
Collapse
Affiliation(s)
| | - Pietro Fransvea
- Department of Emergency and Trauma Surgery, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome 00168, Italy
| | - Luca Lepre
- General Surgery Unit, Santo Spirito in Sassia Hospital, Rome 00193, Italy
| | - Fabio Rondelli
- Department of Surgical Science, University of Perugia, Santa Maria Teaching Hospital, Terni 05100, Italy
| | - Alessandro Costa
- Catholic University “Our Lady of Good Council” School of Medicine, Tirane 1023, Albania
| | - Michela Campanelli
- Department of Emergency Surgery, Tor Vergata University Hospital, Rome 00133, Italy
| | - Giorgio Lisi
- Department of General Surgery, Sant'Eugenio Hospital, Rome 00144, Italy
| | | | - Giovanni Guglielmo Laracca
- Department of Medical Surgical Science and Translational Medicine, Sapienza University of Rome, Sant'Andrea Hospital, Rome 00189, Italy
| | - Giovanni Maria Garbarino
- Department of Medical Surgical Science and Translational Medicine, Sapienza University of Rome, Sant'Andrea Hospital, Rome 00189, Italy
| | | |
Collapse
|
16
|
Lisi G, Campanelli M, Mastrangeli MR, Menditto R, Grande M, Milito G. Radiofrequency haemorrhoidectomy: technical guide to our standardized technique - a video vignette. Colorectal Dis 2021; 23:1272-1273. [PMID: 33484088 DOI: 10.1111/codi.15540] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/12/2020] [Revised: 01/10/2021] [Accepted: 01/14/2021] [Indexed: 02/08/2023]
Affiliation(s)
- Giorgio Lisi
- Department of Surgery, Sant'Eugenio Hospital, Rome, Italy
| | | | | | - Rosa Menditto
- Department of Surgery, Sant'Eugenio Hospital, Rome, Italy
| | | | | |
Collapse
|
17
|
Litta F, Bracchitta S, Naldini G, Mistrangelo M, Tricomi N, La Torre M, Altomare DF, Mozzon M, Testa A, Zigiotto D, Sica G, Tutino R, Lisi G, Marino F, Luglio G, Vergari R, Terrosu G, Cantarella F, Foti N, Giuliani A, Moroni R, Ratto C. FISSIT (Fistula Surgery in Italy) study: A retrospective survey on the surgical management of anal fistulas in Italy over the last 15 years. Surgery 2021; 170:689-695. [PMID: 33846008 DOI: 10.1016/j.surg.2021.02.055] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2020] [Revised: 02/21/2021] [Accepted: 02/23/2021] [Indexed: 02/07/2023]
Abstract
BACKGROUND Surgical treatment of anal fistulas is still a challenge. The aims of this study were to evaluate the adoption and healing rates for the different surgical techniques used in Italy over the past 15 years. METHODS This was a multicenter retrospective observational study of patients affected by simple and complex anal fistulas of cryptoglandular origin who were surgically treated in the period 2003-2017. Surgical techniques were grouped as sphincter-cutting or sphincter-sparing and as technology-assisted or techno-free. All patients included in the study were followed for at least 12 months. RESULTS A total of 9,536 patients (5,520 simple; 4,016 complex fistulas) entered the study. For simple fistulas, fistulotomy was the most frequently used procedure, although its adoption significantly decreased over the years (P < .0005), with an increase in sphincter-sparing approaches; the overall healing rate in simple fistulas was 81.1%, with a significant difference between sphincter-cutting (91.9%) and sphincter-sparing (65.1%) techniques (P = .001). For complex fistulas, the adoption of sphincter-cutting approaches decreased, while sphincter-sparing techniques were mildly preferred (P < .0005). Moreover, there was a significant trend toward the use of technology-assisted procedures. The overall healing rate for complex fistulas was 69.0%, with a measurable difference between sphincter-cutting (81.1%) and sphincter-sparing (61.4%; P = .001) techniques and between techno-free and technology-assisted techniques (72.5% and 55.0%, respectively; P = .001). CONCLUSION Surgical treatment of anal fistulas has changed, with a trend toward the use of sphincter-sparing techniques. The overall cure rate has remained stable, even if the most innovative procedures have achieved a lower success rate.
Collapse
Affiliation(s)
- Francesco Litta
- Proctology Unit, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Rome, Italy.
| | | | - Gabriele Naldini
- Proctology and Pelvic Floor Clinical Centre, University Hospital of Pisa, Italy
| | - Massimiliano Mistrangelo
- Surgical Science Department, University of Turin, Città della Salute e della Scienza Hospital, Turin, Italy
| | | | - Marco La Torre
- Coloproctology Unit, Salvator Mundi International Hospital, UPMC (University of Pittsburgh Medical College), Rome, Italy
| | | | - Marta Mozzon
- Chirurgia Generale, Azienda Ospedaliero Universitaria Friuli Centrale, Udine, Italy
| | | | - Daniele Zigiotto
- Proctological and Perineal Surgical Unit, Ospedale Civile Maggiore, University of Verona, Verona, Italy
| | - Giuseppe Sica
- Department of Surgical Science, University Hospital Tor Vergata, Rome, Italy
| | - Roberta Tutino
- Department of Surgical, Oncological and Stomatological Disciplines (Di. Chir. On. S.), University of Palermo, Italy
| | - Giorgio Lisi
- General Surgery, Sant'Eugenio Hospital, Rome, Italy
| | - Fabio Marino
- Unit of Surgery, National Institute of Gastroenterology "Saverio de Bellis", Research Hospital, Castellana Grotte, Bari, Italy
| | - Gaetano Luglio
- Department of Public Health, School of Medicine Federico II of Naples, Naples, Italy
| | - Roberto Vergari
- Clinica Chirurgica, Azienda Ospedaliero Universitaria Ospedali Riuniti di Ancona, Italy
| | | | | | - Nicola Foti
- UOC Chirurgia Generale e Week Surgery, Ospedale "Andosilla" di Civita Castellana (VT), Italy
| | - Antonio Giuliani
- U.O.C. Chirurgia Generale Universitaria, San Salvatore Hospital. Department of Biotechnological and Applied Clinical Sciences, University of L'Aquila, Italy
| | - Rossana Moroni
- Direzione Scientifica, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Rome, Italy
| | - Carlo Ratto
- Proctology Unit, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Rome, Italy; Catholic University of Rome, Italy
| | | |
Collapse
|
18
|
Spoletini D, Lisi G, Grieco M, Levi Sandri GB, Marcellinaro R, Carlini M. Technique of laparoscopic splenectomy: how I do it. Ann Laparosc Endosc Surg 2021. [DOI: 10.21037/ales-20-81] [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: 11/06/2022]
|
19
|
Knight SR, Shaw CA, Pius R, Drake TM, Norman L, Ademuyiwa AO, Adisa AO, Aguilera ML, Al-Saqqa SW, Al-Slaibi I, Bhangu A, Biccard BM, Brocklehurst P, Costas-Chavarri A, Chu K, Dare A, Elhadi M, Fairfield CJ, Fitzgerald JE, Ghosh D, Glasbey J, van Berge Henegouwen MI, Ingabire JA, Kingham TP, Lapitan MC, Lawani I, Lieske B, Lilford R, Martin J, McLean KA, Moore R, Morton D, Nepogodiev D, Ntirenganya F, Pata F, Pinkney T, Qureshi AU, Ramos-De la Medina A, Riad A, Salem HK, Simões J, Spence R, Smart N, Tabiri S, Thomas H, Weiser TG, West M, Whitaker J, Harrison EM, Gjata A, Modolo MM, King S, Chan E, Nahar SN, Waterman A, Vervoort D, Lawani I, Bedada AG, De Azevedo B, Figueiredo AG, Sokolov M, Barendegere V, Ekwen G, Agarwal A, Dare A, Liu Q, Camilo Correa J, Malemo KL, Bake J, Mihanovic J, Kuncarová K, Orhalmi J, Salem H, Teras J, Kechagias A, Arnaud AP, Lindert J, Tabiri S, Kalles V, Aguilera-Arevalo ML, Recinos G, Baranyai Z, Kumar B, Neelamraju Lakshmi H, Zachariah SK, Alexander P, Kumar Venkatappa S, Pramesh C, Amandito R, Fleming C, Ansaloni L, Pata F, Pellino G, Altibi AM, Nour I, Hamdun I, Elhadi M, Ghellai AM, Venskutonis D, Poskus T, Zilinskas J, Whitaker J, Malemia P, Tew YY, Borg E, Ellul S, Ramos-De la Medina A, Wafqui FZ, Borowski DW, van Dalen AS, Wells C, Adamou H, Ademuyiwa A, Adisa A, Søreide K, Qureshi AU, Al-Slaibi I, Al Saqqa S, Alser O, Tahboub H, Segovia Lohse HA, Shu Yip S, Lapitan MC, Major P, Simões J, Sampaio Soares A, Bratu MR, Litvin A, Vardanyan A, Allen Ingabire JC, Costas-Chavarri A, Gudal A, Albati N, Juloski J, Lieske B, Rems M, Rayne S, Van Straten S, Moodley Y, Chu K, Moore R, Ortega Vázquez I, Ruiz-Tovar J, Senanayake KJ, Thalgaspitiya SPB, Omer OA, Homeida A, Cengiz Y, Clerc D, Alshaar M, Bouaziz H, Altinel Y, Doe M, Freigofer M, Teasdale E, Kabariti R, Clements JM, Knight SR, Ashfaq A, Azodo I, Wagner G, Trostchansky I, Maimbo M, Linyama D, Nina H, Zeko A, Fermani CG, Modolo MM, Villalobos S, Carballo F, Farina P, Guckenheimer S, Dickfos M, Ajmera A, Chong C, Gourlay R, Hussaini S, Lee YJ, Majid A, Martin P, Miles R, Morris OJ, Phua J, Ridley W, Saluja T, Tan RR, Teh J, Wells A, Arora B, Dollie Q, Ho D, Ma Y, Perera OM, Truong A, Dawson AC, Lim B, Pahalawatta U, Phan J, Woon-Shoo-Tong XMS, Yeoh A, Charman L, Drane A, Laura S, Lo CCW, Mozes A, Poon R, Tan HH, Wall E, Chopra P, De Giovanni J, Dhital B, Draganic B, Duller A, Gani J, Goh YK, Jeong JY, McManus B, Nagappan P, Pockney P, Rugendyke A, Sarrami M, Smith S, Wills V, Wong HV, Ye G, Zhang G, Brooker E, Feng D, Lau B, Ngai C, Birks S, Gyorki D, Otero de Pablos J, Abbosh A, Gillespie C, Mahmoud A, Kwan B, Lawson J, Warwick A, Bingham J, Cockbain AJ, Dudi-Venkata NN, Ellaby-Hall J, Finlay B, Humphries E, Pisaniello J, Pisaniello M, Salih S, Sammour T, Abd Wahab HH, De Silva A, Hayward N, Iyer K, Maddern G, Prevost GA, Annapureddy N, Settipalli KP, Yeo J, Hempenstall L, Pham L, Purcell S, Talavera C, Vaska AI, Chaggar G, Chrapko P, Cocco A, Coulter-Nile SMCJ, Ctercteko G, French J, Gong H, Gosselink M, Jegathees T, Jin I, Kalachov M, Kiefhaber K, Lee K, Luong J, Phan S, Pleass H, Veale K, Zeng Z, Au A, DeBiasio A, Deng I, Myooran J, Nair A, Stewart P, Stift A, Unger LW, Wimmer K, Ahmed N, Hasan S, Rahman S, O'Shea M, Padmore G, Peters A, Perduca P, Pulcina G, Tinton N, Buxant F, Dabin E, Garofalo G, Dossou F, Lawani I, Gnangnon FHR, Imorou Souaibou Y, Bedada AG, Motlaleselelo P, Tlhomelang O, Lima Buarque I, Mendonça Ataíde Gomes G, Vieira Barros A, Batashki I, Damianov N, Stoyanov V, Dardanov D, Maslyankov S, Petkov P, Sokolov M, Todorov G, Zhivkov E, Akisheva A, Castilla Moreno MA, Genov G, Ilieva I, Ivanov T, Karamanliev M, Khan A, Mitkov E, Yotsov T, Atanasov B, Belev N, Slavchev M, Nsengiyumva C, Jones E, Stock S, Ekwen G, Kyota S, Brown J, Mabanza K. T, Nigo Samuel L, Otuneme C, Prosper N, Umenze F, Boutros M, Caminsky N, Dumitra S, Garfinkle R, Morency D, Salama E, Banks A, Ferri L, He H, Katz A, Liberman AS, Meterissian S, Pang A, Parvez E, Agarwal A, Dare A, Hameed U, Osman F, Sequeira S, Coburn N, Dare A, Jaffer A, Karanicolas P, Mosseler M, Musselman R, Liu X, Yip CW, Garces-Otero JS, Guzman C, Sierra S, Uribe Valencia A, Cabrera Rivera PA, Camelo S, Gonzalez A, González-Orozco A, Mosquera Paz MS, Perez Rivera CJ, Gonzalez F, Isaza-Restrepo A, Nino- Torres L, Arias Madrid N, Mendoza Arango MC, Sierra S, Bake J, Tsandiraki J, Jemendžic D, Kocman B, Šuman O, Canic R, Jurišic D, Karakas I, Krizanovic Rupcic A, Pitlovic V, Samardžic J, Kopljar M, Bacic I, Domini E, Karlo R, Mihanovic J, Miljanic D, Simic A, Ahmed M, Al Nassrallah M, Altaf R, Amjad T, Eltoum R, Haidar H, Hassan A, Khalil O, Qasem M, Ramesh R, Sajith G, Wisal M, Žatecký J, Bujda M, Jirankova K, Paclik A, Abdallah A, Abdulgawad Almogy M, Ayman El-sawy E, ElFayoumy AM, Elghareeb N, Esmat NA, Fadel A, Habater A, Hamdy H, Hefni A, Kamal M, Mohamed Abobakr N, Sayed A, Shaker N, Taha E, Tharwat H, Zakaria O, Abdelmotaleb I, Al-Dhufri A, Al-Himyari HS, El sheikh E, Eldmaty A, Elkhalawy A, M.Elkhashen A, Magdy K, Mostafa S, Sadia HD, Saleh MM, Samir D, Yahia Mohamed Ali M, A. Nassar M, Abdelhady S, Abdelrazek A, Abdelsalam I, El-Sawy A, Essam E, Gadelkarim M, Ghaly K, Hassabalnaby M, Masarani R, Mohamed Shaaban N, Sabry A, Salem M, Soliman NA, Zahran D, Abou El.soud MR, Badr ET, Borham H, Elmeslemany N, Elsayed M, Elsherif F, Eslam S, Gaber G, Ibrahim S, Kamh Y, Mahmoud A, Mohamed SG, Morshedy E, Omar C, Salem Soliman F, Abdelkawy S, Abdelmohsen N, Abdelshakour M, Dahy A, Gamal N, Gamal M, Hasan A, Hetta H, Mousa N, Omar M, Rabie S, Saad M, Saleh B, Sayed Mohamed M, Shawqi M, Abdelhady Mousa H, Alnoury M, Elbealawy M, Elshafey A, Essam Ibrahim El Desouki Muhammad Ahmed M, Ghonaim M, Hgag F, Ibrahim M, Morsy M, Reda Loaloa M, Refaat A, Samir H, Shahien F, Sobhy M, Sroor F, Abdellatif E, Adel M, Afifi AA, Afifi E, Antaky M, Dawoud A, El Zoghby N, El-remaily A, Elzanfaly AA, Gadallah A, Gamal FA, Hashem O, Medhat Youssef S, Muhammad Attyah A, Munir M, Shazly O, Taha E, Wilson K, Adel S, Ali A, Eid E, Elhelow E, Elmahdy M, Elshatby B, Hossam el-din Zakaria A, Hossny A, Ibrahim E, M.Yonis A, Metwalli M, Yousry B, Zid E, A Yacoub M, Abdelhakim A, Abouelsoad N, Alkhatib M, Ashraf A, Ashraf A, Elazab Y, Elfanty M, Elkabir O, Elsayed M, Elshimy A, Elsobky H, Eskander J, Gad A, Hamsho W, Khaled Abdelwahed N, Magdy M, Moharam D, Osama A, Ramadan S, Roum R, Sayed T, Shehada T, Zidan AM, Abbas K, Ali A, Attia M, Balata M, El Nakeeb A, Elewaily MIE, Elfallal A, Elfeki H, Elkhadragy A, Emile S, Ezzat H, Hosni H, Mansour I, Omar W, Othman G, Sadek K, Shalaby M, Shehab-Eldeen N, Anas khalifa R, Badr H, Eldeep M, Eldeep A, Eldoseuky mohammed A, Khallaf S, Magdy Hegazy E, Mahmoud R, Mikhail P, Morsi M, Mowafy S, Raafat D, Safy A, Sera M, Sera AS, AbdAllah MSM, Abdelkader M, Abdou AO, Ahmed A, Gaafar S, Ibrahim negm F, Lapic M, Maher A, Mahmoud H, Mostafa A, Samir M, Samy F, Semeda N, Shalaby HI, El-taweel A, Galal Elnagar A, Hemidan AG, Hussein M, Kandil A, Moawad M, Nasser Hamamah AA, Soliman M, Abdelkhalek M, Abdelmaksoud Tawakel N, Abdelwahed AM, Abdou A, Atallah K, Elsherbeny MY, Emara E, Hamdy M, Hamdy O, Haron A, Ismail S, Metwally IH, Mohamed Hamed Elgaml N, Nassar A, Refky B, Sadek M, Saleh M, Yunes A, Zakaria M, Zuhdy M, Fayed N, Mohammed MMH, Kütner S, Melnik P, Seire I, Teras J, Ümarik T, Ainoa E, Eerola V, Koppatz H, Koskenvuo L, Sallinen V, Takala S, Katunin J, Kechagias A, Turunen A, Christou N, Mathonnet M, Lavoue V, Nyangoh Timoh K, Soulabaille L, Lesourd R, Merdrignac A, Sulpice L, André B, Chantalat E, Vaysse C, Dousset B, Gaujoux S, Martin G, Clonda O, Juodis D, Kienle K, Mravik A, Palmer S, Szabadhegyi G, Agbeko AE, Gyabaah S, Gyamfi FE, Naabo N, Owusu senior A, Yorke J, Owusu F, Abantanga F, Anyomih TTK, Muntaka AJM, Owusu Abem E, Sheriff M, Tabiri S, Wondoh PM, Balalis D, Korkolis D, Gkiokas G, Pantiora E, Theodosopoulos T, Ioannidis A, Konstantinidis K, Konstantinidou S, Machairas N, Paspala A, Prodromidou A, Chouliaras C, Papadopoulos K, Baloyiannis I, Mamaloudis I, Tzovaras G, Akrida I, Argentou MI, Germanos S, Iliopoulos E, Maroulis I, Skroubis G, Theofanis G, Chatzakis C, Ioannidis O, Loutzidou L, Kalles V, Karathanasis P, Michalopoulos N, Theodoropoulos C, Theodorou D, Triantafyllou T, Garoufalia Z, Hasemaki N, Kontos M, Kouraklis G, Kykalos S, Liakakos T, Mpaili E, Papalampros A, Schizas D, Syllaios A, Tampaki EC, Tsimpoukelis A, Antonopoulou MI, Deskou E, Manatakis DK, Papageorgiou D, Zoulamoglou M, Anthoulakis C, Margaritis M, Nikoloudis N, Campo V, Ceballos A, Flores MA, Giron W, Ko D, Martinez G, Recinos G, Rivera Lara V, Rueda N, Sanchez A, Tejeda Garrido JCG, Aguilera-Arevalo ML, Alvarez Rivera AE, Bamaca Ixcajoc EB, Barreda Zelaya LE, Chacòn-Herrera P, Corea Ruiz LM, Echeverria-Davila G, Garcia M, García D, Gutiérrez Mayen EF, José N, Mazariegos N, Méndez D, Paniagua Espinoza M, Baranyai Z, Bardos D, Benke M, Illes K, Kokas BA, Szabó R, Appukuttan A, Asok A, D.k V, Malik K, Ravishankaran P, Tapkire R, Moorthy G, Abraham J, Muthuvel R, Alapatt J, Kattepur A, Pareekutty N, Garod M, Harris C, Wanniang C, Gupta A, Nehra D, Parshad S, Acharya R, Badwe R, Bhandare M, Jain U, Kirti K, Nair N, Shrikhande S, Thakkar P, Anandan P, C S A, Holenarasipur Narasannaiah A, Jagarlamudi T, Kumar Venkatappa S, M R R, Manangi M, Raghavendra A, Rao KS, S V, Sajjan V, Shenoy A, Shivashankar Chikkanayakanahalli S, Tharanath K, V S, Adidharma P, Agarwal R, Amandito R, Anggita Gultom P, Arifin GR, Billy M, Elfizri Z, Fahira A, Felicia D, Gunardi TH, Johanna N, Nugrahadi NR, Panigoro SS, Rahmayanti S, Sihotang RC, Brata SY, Winoto H, Barati N, Karami M, Khorshidi H, Naderifar H, Abdulla MA, Coleman M, Doherty RJ, Hannon R, Murphy B, Stakelum A, Winter D, Aljohmani L, Farnan R, Seldon Y, Tan T, Varghese S, Alherz M, Ather M, Bajilan M, Graziadei V, Pilkington I, Quidwai O, Ridgway P, Shiwani H, Tahir AAR, Blunnie E, Burke D, Kennedy N, Macdonagh K, O'Neill M, Rooney S, Falco G, Ferrari G, Mele S, Nita GE, Ugoletti L, Zizzo M, Confalonieri G, Pesenti G, Tagliabue F, Baronio G, Ongaro D, Pata G, Compagnoni B, Salvadori R, Taglietti L, D'Alessandro N, Di Lascio P, Pascale G, Bortolasi L, Campagnaro T, Carlini M, Lisi G, Lombardi D, Pedrazzani C, Spoletini D, Turri G, Violi P, Altomare DF, Aquilino F, Musa N, Papagni V, Picciariello A, Vincenti L, Andreotti D, Occhionorelli S, Tondo M, Basso SMM, Cirelli R, Maino MEM, Piozzi GN, Picone E, Scaramuzzo R, Sinibaldi G, Amendola A, Anastasio L, Bucci L, Caruso E, Castaldi A, Di Maso S, Dinuzzi VP, Esposito G, Gaudiello M, Giglio MC, Greco PA, Luglio G, Manfreda A, Marra E, Mastella F, Pagano G, Peltrini R, Pepe V, Sacco M, Sollazzo V, Spiezio G, Cianchetti E, Menduni N, Carvello MM, Di Candido F, Spinelli A, Corsi F, Sorrentino L, Marino F, Asti ELG, Bonavina L, Rausa E, Asta M, Belli A, Bianco F, Cervone C, Delrio P, Falato A, Fares Bucci A, Guarino R, Pace U, Rega D, De Luca E, Gallo G, Sammarco G, Sena G, Vescio G, Santandrea L, Ugolini G, Zattoni D, Chetta N, Logrieco G, Vanella S, Garulli G, Zanini N, Bondurri A, Cammarata F, Colombo F, Foschi D, Lamperti GMB, Maffioli A, Sampietro GM, Yakushkina A, Zaffaroni G, Ansaloni L, Cicuttin E, Sibilla MG, Impellizzeri H, Inama M, Moretto G, Mochet S, Ponte E, Usai A, Mancini S, Sagnotta A, Solinas L, Bolzonaro E, Tamini N, Curletti G, Galleano R, Malerba M, Campanella S, Cocorullo G, Colli F, De Marco P, Falco N, Fontana T, Kamdem Mambou LJ, La Brocca A, Licari L, Randisi B, Rizzo G, Rotolo G, Salamone G, Tutino R, Venturelli P, Malabarba S, Sgrò A, Vella I, Cirillo B, Crocetti D, De Toma G, Lapolla P, Mingoli A, Sapienza P, Belvedere A, Bianchini S, Binetti M, Birindelli A, Tonini V, Podda M, Pulighe F, De Rosa M, Bono L, Borghi F, Geretto P, Giuffrida MC, Lauro C, Marano A, Pellegrino L, Salusso P, Sasia D, Campanelli M, Realis Luc A, Trompetto M, Cardia R, Cillara N, Giordano AN, Costanzo A, Giovilli MA, Turati L, Canonico S, Pellino G, Sciaudone G, Selvaggi F, Selvaggi L, Albsoul N, AlBsoul A, Alkhatib AA, Alsallaq O, Amarin JZ, Ayoub R, Bsisu I, El Muhtaseb MS, Jabaiti M, Melhem J, Nour I, Qwaider YZ, Salameh MH, Suleihat A, Suradi HH, Alammarin M, Aljaafreh A, Bani hani M, Bani hani Z, Bani Hani F, Fahmawee T, Hamouri S, Katanani C, Tawalbeh R, Tawalbeh T, Zawahrah H, Abou Chaar MK, Abusalem L, Al-Masri M, Al-Najjar H, Barghuthi L, Ahmed Z, Maulana A, Ngotho O, Kamau C, Stanley Mwenda A, Bosire F, Mwachiro E, Parker R, Simel I, Sylvester K, Althini AAM, Elbarouni S, Elbeshina AE, Gwea A, Malek A, Masoud Farag WA, Abdalei A, Abdel Malik AB, Abo-khammash A, Abuhlaiga M, Adnan N, Albaggar M, Alfitory A, Aljanfi A, Almuzghi F, Altumei Z, Alzabti F, Ashoushan H, Assalhi M, Azzubia J, Bnhameida S, Delhen M, Elshafei H, Elteir H, Esbaga F, Gobbi AA, Hamouda F, Hilan H, Ismail R, Jebran F, Kasbour M, Maderi G, Mohammad S, Mohammed B, Murtadi H, Mustafa H, Rajab M, Trenba S, Wafaa M, Al Sagheir E, Almigheerbi A, Alzahaf A, Bahroun SG, Ben Dallah N, Elshaibani M, Eswaye H, Karar M, Omar S, Younes E, Younes M, Zreeg D, Abujamra S, Ashour F, Elgammudi M, Omar F. Aljadidi W, Saddouh E, Sharif R, Alabuzidi A, Alwerfally A, Aribi S, Bibas F, Elfaituri T, Elhajjaji Y, Khaled A, Khalil W, Layas T, Soula E, Tarek A, Abu hallalah MFK, Abujamra S, Ahmed HA, Alsharef T, Ben Saoud AA, El Gharmoul T, Elhadi A, Elrais S, Shebani A, Zarti H, Zeiton A, Ambrazevicius M, Kaselis N, Stakyte M, Aliosin O, Cizauskaite A, Dailidenas S, Eismontas V, Kybransiene M, Nutautiene V, Samalavicius N, Simcikas D, Slepavicius A, Tamosiunas A, Ubartas N, Zeromskas P, Bradulskis S, Dainius E, Juocas J, Kubiliute E, Kutkevicius J, Opolskis A, Parseliunas A, Subocius A, Venskutonis D, Virbickaite E, Zuikyte D, Bogusevicius A, Buzaite K, Cepuliene D, Cesleviciene I, Cesna V, Gribauskaite J, Ignatavicius P, Jokubauskas M, Liugailaite M, Margelis E, Mazelyte R, Pankratjevaite L, Pažusis M, Rackeviciute A, Saladyte J, Škimelyte M, Šlenfuktas V, Sudeikyte M, Tamelis A, Vanagas T, Žumbakys Ž, Atkociunas A, Dulskas A, Kuliavas J, Birutis J, Paškevicius S, Šatkauskas M, Danys D, Jakubauskas M, Jakubauskiene L, Kryzauskas M, Lipnickas V, Makunaite G, Rasoaherinomenjanahary F, Rasolofonarivo H, Samison LH, Banda B, Malemia P, Msosa V, Ahmad Izzuddin AI, Das A, Gan YY, Shong Sheng T, Siaw JY, Ab Rahim MF, Abang Jamari DZH, Che Husin N, Kamarulzaman MY, Lim YP, Mohamed Kamil NA, Mohd Hassan MR, Mohd Sahid S, Mustafa J, Ng EHB, Wan Khazim WK, Chang Ern N, Lingeshan P, Sulaiman SE, Ang SE, Bin Mohamad Sithik MN, Cheong YJ, Deva Tata M, Jia Xian L, Kadravello A, Koh IE, Ng LY, Ng We Yong YJ, Palayan K, Sam CX, Siow Jin P, Tan Ern Hwei J, Tang Y, Ter AZ, Wong MPK, Zakaria AD, Zakaria Z, Henry F, Kalaiselvan T, Abd Karim MFS, Abdul Aziz MR, Abdul Aziz N, Khong TL, Lau PC, Lim HC, Roslani AC, Seak JCK, Wong SW, Wong LF, Yeen Chin L, Anyanwu MC, Borg E, Busuttil Z, Calleja T, Chircop KL, Cutajar R, Dimech AM, Ellul S, Galea J, Gascon Perai K, Gatt R, Kelman L, Micallef E, Nwolu F, Sammut K, Thompson J, Warwicker S, Zammit M, Cordera F, Cruz González E, Sánchez-García J, Barbosa Camacho FJ, Barrera López FJ, Zuloaga Fernandez del Valle CJ, Acosta E, González Espinoza IR, Moreno P, Cortes-Flores AO, Fuentes Orozco C, Gonzalez Ojeda A, Corro Díaz González S, Martinez L, Ramos-De la Medina A, Mosqueda Amador B, Novoa A, Olazo Espejo DA, Jimenez A, Lopez Rosales F, Vanoye EG, Garcia Gonzalez LA, Miranda-Ackerman RC, Solano-Genesta M, Alvarez-Cano A, Romero-Garza HH, Medina-Franco H, Mejía-Fernández L, Salgado-Nesme N, Vergara-Fernandez O, Gutiérrez-Mota GM, Hernandez Vera FX, Llantada Lopez A, Morgan Villela G, Ramirez Padilla FDJ, Tapia Marin W, Martínez Maldonado M, Sánchez Suárez R, Troche JM, Benyaiche C, Outani O, Amine S, Benkabbou A, Majbar AM, Mohsine R, Rafik A, Oung T, Tin MM, Borowski DW, Plarre P, Borowski DW, Plarre P, Alberga A, Sluiter N, Tuynman J, Blok R, Cömert D, Hompes R, Kalff M, Stellingwerf ME, Tanis P, van Berge Henegouwen M, van Praag EM, Wisselink D, Gerhards M, Lopes Cardozo J, Westerduin E, de Jonge J, van Geloven A, van Schilt K, den Boer F, Stoots S, Vlek S, Adams J, Al-Busaidi IS, Budd G, Choi SI, Chu MJJ, Ganugapati A, McKinstry L, Pascoe R, Richards S, Rosser K, Stevenson A, White R, Farik S, Kwun J, Murad A, Cowan S, Hall T, Hayton M, Malam Sani L, Oumarou Garba S, Adamou H, Amadou Magagi I, Habou O, Aliyu H, Daniyan M, Sholadoye TT, Abdullahi L, Anyanwu LJ, Mohammad Mohammad A, Muhammad AB, Sheshe AA, Suleiman I, Adesina A, Awolowo A, Onuoha C, Salami O, Taiwo O, Taiwo A, Kache S, Makama JG, Sale D, Abiola O, Ajao A, Ajiboye A, Etonyeaku A, Olaogun J, Adebanjo A, Adesanya O, Afolayan MO, Balogun O, Makanjuola A, Nwokocha S, Ojewola RW, Olajide TO, Aderounmu A, Adesunkanmi AR, Adisa A, Agbakwuru A, Akeem Aderogba A, Alatise OI, Arowolo O, Lawal O, Mohammed T, Ndegbu C, Olasehinde O, Wuraola F, Akinkuolie A, Etonyeaku A, Mosanya A, Ayandipo O, Elemile P, Lawal TA, Ali SANI S, Garba S, Hauwa SANI R, Olori S, Onyebuashi H, Umoke I, Adenuga A, Adeyeye A, Habeeb O, Lawal B, Nasir A, Aahlin EK, Kjønås D, Myrseth E, Abbasy J, Alvi A, Saleem O, Afzal A, Nazir A, Farooq M, Liaqat A, Naqi SA, Raza A, Sarfraz M, Sarwar M, Banglani M, Munir A, Sehrish R, Ayub B, Sayyed R, Altaf A, Ayub S, Qureshi AU, Saeed K, Syed B, Akbar SA, Anwer AW, Khan RN, Khan AI, Khattak S, Mohtasham S, Parvaiz MA, Syed AA, Ansari AB, Shahzad N, Khaliq T, Rashid I, Waqar SH, Abu Al-saleem H, Abu Alqumboz A, Alqadi M, Amro A, Assa R, Awesat E, Ayyad R, Hammad M, Haymony A, Hijazi B, Hmeidat B, Lahaseh R, Qawasmi A, Rajabi A, Shehada M, Shkokani S, Yaghi Y, Yaghi N, AlZohour M, Farid M, Habes YM, Juba W, Nubani Y, Rabee A, Sa'deh M, Abed S, Al basos I, Alswerki M, Ashour D, Awad I, Diab S, El Jamassi A, El-Kahlout S, Elhout S, Hajjaj ANK, Hasanain D, Nabil hajjaj B, Obaid M, Saikaly E, Salhi A, Al-Tammam H, Almasri M, Baniowda M, Beshtawi D, Horoub A, Misk R, Mohammad B, Qasrawi R, Sholi T, Abu-Nimeh S, Abu-srour A, Abukhalaf SA, Adawi S, Alsalameh B, Ayesh K, Elqadi M, Hammouri A, Karim Mustafa F, Marzouqa N, Melhem S, Miqdad D, Mohamad B, Rawhi M, Abu Ahammala AB, Abu Ataya A, Abu Jayyab I, Al-Shwaikh S, Alagha O, Alasttal M, Awadallah H, Elblbessy M, Fares J, Jarbou A, Mahfouz I, Albahnasawi MA, Abo mahadi A, Abuelhatal H, Abuelqomboz A, Almoqayyad A, Alwali A, Balaawi R, Hamouda M, Humeid M, Jedyan A, Mahmoud Abu hamam T, Matar G, Salem A, Samra T, Shaheen N, Shihada K, A.Nemer A, Abu Al Amrain M, Abu Alamrain A, Abu Jamie N, Abu-Rous MR, Alfarra N, AlTaweel M, Alwhaidi N, Hamed R, Saqqa B, Shaheen A, Aljaber D, Aljaberi L, Alwaheidi M, Jawaada A, Khaldi H, Qahoush R, Qari J, Saadeh R, Salim A, Yacoub A, Abbas A, Abu shua`ib R, Abu Zainah B, AbuSirrees M, Babaa B, Barhoush O, Belal qadomi A, Daraghmeh L, Haji R, Khatatbeh A, Khatib L, Qarariah S, Quzmar Y, Safadi K, Salameh R, Hassan M, Herzallah S, Massad L, Nazzal A, Nazzal R, Escobar D, Machain V GM, Rodriguez Gonzalez A, Chachaima Mar JE, Chinchihualpa Paredes NO, Cuba V, Lopez W, Niquen Jimenez MM, Sanchez Bartra NA, Sapallanay Ojeda O, Sequeiros D, Toscano Pacheco A, Vergara M, Abarca S, Alcorta R, Borda-Luque G, Eusebio Zegarra IE, Luján López C, Marrufo M, Mogrovejo C, Nomura A, Rodríguez Angeles Y, Vidal Meza MR, Zavala G, Castillo Arrascue JN, Hidrogo Cabrera JC, Larrea vera JJM, Osorio M, Ylatoma Díaz EA, Fontanilla MA, Fuentes JR, Salazar AL, Dominguez G, Lopez MP, Macalindong S, Onglao MA, Ramirez A, Sacdalan MD, Tampo MM, Uy GL, Mangahas J, Yabut K, Cañete JP, Cansana BE, Castro EJ, Lipana MK, Roxas MF, Zara VJ, Chrol M, Franczak P, Orlowski M, Budzynski P, Budzynski A, Bury P, Czerwinska A, Dworak J, Dziedzic J, Kisielewski M, Kulawik J, Lasek A, Major P, Malczak P, Migaczewski M, Pedziwiatr M, Pisarska M, Radkowiak D, Rubinkiewicz M, Rzepa A, Skoczylas T, Stanek M, Truszkiewicz K, Wierdak M, Winiarski M, Zarzycki P, Zub-Pokrowiecka A, Kowalewski P, Roszkowski R, Waledziak M, Tomé M, Patrocinio S, Guerreiro I, Almeida F, de Sousa X, Monteiro N, Costa Santos MT, de Oliveira D, Lopes Serra M, Morgado D, Neves C, Oliveira AC, Pimentel A, Silva S, Carvalho M, Carvalho L, Magalhães J, Matos L, Monteiro T, Ramos C, Santos V, Barbosa J, Costa-Maia J, Devezas V, Fareleira A, Fernandes C, Gonçalves D, Mora H, Morais M, Silva de Sousa F, Catarino Santos S, Logrado A, Tojal A, Amorim E, Cunha MF, Fazenda A, Melo Neves JP, Sampaio da Nóvoa Gomes Miguel II, Veiga D, Azevedo J, Cardoso Louro H, Leite M, Azevedo J, Bairos Menezes M, Gama B, Brito D, Cruz Martins MC, Graça e Magalhães A, Longras AC, Lourenço R, Matos D, Castro L, Policarpo F, Romano J, Leite M, Monteiro C, Pinto D, Duarte M, Fortuna Martins S, Oliveira M, Galvão D, Martins L, Silva A, Taranu V, Vieira B, Neves J, Oliveira S, Ribeiro H, Cinza M, Felix R, Machado A, Oliveira J, Patrício J, Pedroso de Lima R, Pereira M, Rocha Melo M, Velez C, Abreu da Silva A, Claro M, Costa Santos D, Ferreira A, Capote H, Rosado D, Taré F, Nogueira O, Ângelo M, Baiao JM, Guimarães A, Marques J, Nico Albano M, Silva M, Valente da Costa A, Vieira Caroço T, Almeida Braga S, Capunge I, Fragoso M, Guimarães J, Pinto B, Ribeiro J, Angel M, Fialho G, Guerrero M, Campos Costa F, Cardoso D, Cardoso V, Alves M, Estalagem I, Louro T, Marques C, Martelo R, Morgado M, Canotilho R, Correia AM, Martins P, Peyroteo M, Gomes J, Monteiro R, Romano M, Alves DM, Peixoto R, Quintela C, Jervis MJ, Melo D, Pacheco A, Paixão V, Pedro V, Pimenta J, Pimenta de Castro J, Rocha A, Beuran M, Bratu MR, Ciubotaru C, Diaconescu B, Hostiuc S, Negoi I, Stoica B, NA NA, Anokhin E, Kuznetsov G, Oganezov G, Paramzin F, Romanova E, Rutkovskii V, Rutkovskii V, Shushval M, Zabiyaka M, Dzhumabaev K, Ivanov V, Mamedli Z, Achkasov S, Balkarov A, Nabiev E, Nagudov M, Rybakov E, Saifutdinova K, Sushkov O, Vardanyan A, Costas-Chavarri A, Joseph L, Ndayishimiye I, Allen Ingabire JC, Faustin N, Mutabazi AZ, Mvukiyehe JP, Nsengimana VJ, Uwakunda C, Abbas MM, Akeel N, Aljiffry M, Awaji K, Farsi A, Jamjoum G, Khoja A, Maghrabi A, Malibary N, Nassif M, Saleem A, Sultan A, Tashkandi W, Tashkandi H, Trabulsi N, Ba MB, Diallo AC, Ndong A, Cuk V, Jankovic U, Juloski J, Koh SZ, Koh F, Lee KC, Lee KY, Lee S, Leong WQ, Lieske B, Lui SA, Prakash P, Grosek J, Norcic G, Tomazic A, Fitchat N, Jaich R, Wineberg D, Koto MZ, Baiocchi D, Clarke D, Steenkamp CJ, Van Straten S, Bannister S, Boutall A, Chinnery G, Coccia A, Dell A, Karjiker P, Kloppers C, Loxton N, Mabogoane T, Malherbe F, Panieri E, Rayamajhi S, Spence R, van Wyngaard T, Warden C, Madiba TE, Moodley Y, Pillay N, Brooks S, Kruger C, Van Der Merwe LH, Gool F, Kariem M, Bougard H, Chu K, Kariem N, Noor F, Pillay R, Steynfaardt L, González González L, Marín Santos JM, Martín-Borregón P, Martínez Caballero J, Nevado García C, Rodriguez Fraga P, De Castro Parga G, Fernández Veiga MP, Garrido López L, Infante Pino H, Lages Cal I, López Otero M, Nogueira Sixto M, Paniagua García Señorans M, Rodríguez Fernández L, Ruano Poblador A, Rufo Crespo E, Sanchez-Santos R, Vigorita V, Alonso Batanero E, Asnel D, Cifrian Canales I, Contreras Saiz E, De Santiago Alvarez I, Díaz Vico T, Fernandez Arias S, Fernández Martínez D, García Bernardo C, García Flórez LJ, Garcia Gutierrez C, García Munar M, Márquez Zorrilla Molina CA, Merayo M, Michi Campos JL, Moreno Gijon M, Otero-Diez JL, Rodicio Miravalles JL, Solar-Garcia L, Suárez Sánchez A, Truan N, Alejandre Villalobos C, Caballero Díaz Y, Jimenez M, Montesdeoca D, Navarro-Sánchez A, Vega V, Beltrán de Heredia J, Gómez Z, Jezieniecki C, Legido Morán AP, Montes-Manrique M, Rodriguez-Lopez M, Ruiz Soriano M, Trujillo Díaz J, Vazquez Fernandez A, Argudo N, Pera M, Torrent Jansà L, García Domínguez M, Goded I, Roldón Golet M, Talal El-Abur I, Utrilla Fornals A, Zambrana Campos V, Aguilar Martinez MDM, Bosch M, García-Catalá L, Sánchez-Guillén L, Artigau E, Gomez Romeu N, Julià Bergkvist D, Espina Perez B, Morató O, Olona C, Diéguez B, Forero-Torres A, Losada M, Gomez-Abril S, Gonzálvez P, Martinez R, Navarro Martínez S, Payá-Llorente C, Pérez Rubio Á, Santarrufina Martinez S, Sebastián Tomás JC, Trullenque Juan R, Gegúndez Simón A, Maté P, Prieto-Nieto MI, Rubio-Perez I, Urbieta A, Vicario Bravo M, Abelló D, Frasson M, Garcia-Granero A, Abad Gurumeta A, Abad-Motos A, Lucena-de Pablo E, Nozal B, Ripollés-Melchor J, Salvachúa R, Ferrero E, Garcia-Sancho Tellez L, Ortega Vázquez I, Picardo AL, Rojo López JA, Zorrilla Matilla LP, Cagigas Fernandez C, Castanedo Bezanilla S, Estevez Tesouro J, Fernandez-Diaz MJ, García Cardo J, Gomez Ruiz M, Gonzalez-Tolaretxipi E, Jimeno Fraile J, Poch C, Rodriguez-Aguirre M, Troche Pesqueira N, Trugeda-Carrera MS, de la Torre J, Blanco-Colino R, Espin-Basany E, Espinosa-Bravo M, Morales Comas C, Reyes Afonso E, Rivero Déniz J, Siso Raber C, Verdaguer Tremolosa M, Chandrasinghe P, Kumarage S, Wijekoon Arachchilage N, Senanayake KJ, Abdalla Ahmed Elkamel A, A. Adam M, Saleh M, Blomme N, Thorell A, Wogensen F, Älgå A, Ansarei D, Celebioglu F, Heinius G, Nigard L, Pieniowski E, Ahlqvist S, Björklund I, Cengiz Y, Frånberg A, Håkansson M, Adamo K, Franklin O, Sund M, Wiberg R, Andersson Y, Chabok A, Nikberg M, Kugelberg A, Canonica C, Christoforidis D, Fasolini F, Gaffuri P, Giuliani M, Meani F, Popeskou SG, Pozza S, Wandschneider W, Peterer L, Widmer LW, Zimmermann B, Bakoleas P, Chanousi I, Charalampidou L, Grochola LF, Heid F, Ntaoulas S, Outos M, Peros G, Podolska-Skoczek H, Reinisch KB, Zielasek C, Clerc D, Demartines N, Gilgien J, Kefleyesus A, St-Amour P, Toussaint A, Alhimyar M, Alsaid B, Alyafi A, Alkhaledi A, Kouz B, Omarain A, Al-Sabbagh Y, Alkhatib H, Sara S, Alhaj A, Danial A, Kadoura L, Maa Albared S, Monawar Y, Nahas L, Abd B, Saad A, Wakkaf H, Bouaziz H, Bouzaiene H, Ghalleb M, Akaydin E, Akbaba AC, Atakul O, Baltaci E, Besli S, Burgu G, Cenal U, de Muijnck C, Demirkaya HC, Dogruoz A, Gezer ZI, Gündogdu Y, Kara M, Korkmaz HK, Kurtoglu GK, Ozben V, Ozmen BB, Pektas AM, Sel EK, Yenidünya N, Bengur FB, Oral BM, Yozgatli TK, Abdullayev S, Gunes ME, Sahbaz NA, Banaz T, Kargici K, Kuyumcu OF, Yanikoglu E, Yesilsancak M, Yilmaz D, Aktas MK, Rencuzogullari A, Isik A, Leventoglu S, Yalçinkaya A, Yüksel O, Kalayci MU, Kara Y, Sarici IS, Akin A, Alemdag GN, Arslan E, Baki BE, Bodur MS, Calik A, Candas Altinbas B, Cihanyurdu I, Erkul O, Gül B, Guner A, Köse B, Semiz A, Sevim S, Tayar S, Tomas K, Tüfek OY, Türkyilmaz S, Ulusahin M, Usta A, Yildirim R, Güler SA, Tatar OC, Varol E, Kirimtay B, Uysal M, Yildiz A, Kose E, Ciftci AB, Çolak E, Eraslan H, Kucuk GO, Yemez K, Lule H, Bienfait M, Lule H, Bua E, Doe M, Okalany N, Birindelli A, Basarab M, Bielosludtsev O, Freigofer M, Kolhanova K, Perepelytsia K, Romanukha K, Savenkov D, Siryi S, Tereshchenko M, Viacheslav N, Volovetskyi A, Kebkalo A, Tryliskyy Y, Tyselskiy V, Bruce E, Chow BL, Iddles E, McGuckin S, Newall N, Ramsay G, Sharma P, Stewart C, Wong J, Badran A, Bath M, Belais F, Butt E, Joshi K, Kapur M, Shaw M, Townson A, Williams CYK, Gray T, Greig R, Husain M, Murray E, Mustafa A, Asif A, Gokul A, Shah M, Akitikori MT, Charalabopoulos A, Davidson S, McNally S, Rupani S, Juma F, Mills SC, Muirhead L, Sellars K, Walsh U, Warren O, Chambers A, Hunt R, Teasdale E, Boyce S, Cornwall H, Tol I, Argyriou EO, Eardley N, Povey M, Aithie JMS, Irfan A, McGuigan MC, Starr R, Warren CR, Archibald J, Kirby G, Kisyov I, Khoo CK, Lee R, Photiou D, Davis R, Prasad U, Yang PZ, Bird J, Leung E, Summerour V, Currow C, Kiam J, Tan GJS, Muthusami A, Pegba-Otemolu I, Urbonas T, Nunoo-Mensah J, Smolskas E, Boddy A, Gravante G, Hunter D, Andrew D, Koh A, Thompson A, Adams L, Clements HA, De Silva K, Ekpete O, Haque S, Henderson S, Ibrahim B, Jayasinghe T, Livie J, Mailley K, Nair G, Tan D, Baggaley C, Dawidziuk A, Szyszka B, Barter C, Gandhi N, Hassell K, Hitchin S, Kelsall J, Nagy E, Nessa A, Whisker L, Yanni F, Ali M, Arora D, Hediwattege S, Kumarasinghe N, Rathore M, Tennakoon A, Ali Ahmad SM, Bajomo O, Nadira F, Celentano V, Bhangu A, Glasbey J, Griffiths E, Karri RS, Mak JKC, Nepogodiev D, Pipe M, Bhatti MI, Rabie M, Boyle C, Hamilton D, Mihuna A, Ng JCK, Nicholson G, Oliwa A, Pearson R, Rose A, Yong SQ, Boereboom C, Hanna M, Walter C, Greensmith TS, Mitchell R, Monaghan E, Crawford J, Moug S, Blackwell J, Boyd-Carson H, Herrod P, Al-Allaf O, Beattie M, Bullock C, Burman S, Clark G, Flamey N, Flannery O, Harding A, Kodiatt B, Lawday S, Mahapatra S, Mukundu Nagesh N, Ng M, Rye D, Yoong A, Clark L, Deans C, Edirisooriya M, Fairfield CJ, Harrison EM, Carrington EV, Wong TLE, Yusuf B, Chamberlain C, Duke K, Kmiotek E, Botes A, Condie N, Schrire T, Shah R, Thomas-Jones I, Yates C, Anthony N, Matthews E, Sahnan K, Tankel J, Tucker S, Winter Beatty J, Ziprin P, Duggan W, Kantartzi A, Sridhar S, Khaw RA, Srivastava P, Underwood C, Alves do Canto Brum H, Chopra S, Davis L, Hughes R, Tulley J, Alberts J, Athisayaraj T, Olugbemi M, Ahmad K, Chan C, Chapman G, Fleming H, Fox B, Grewar J, Hulse K, Rutherford D, Sinead M, Smith S, Speake D, Vaughan-Shaw PG, Christodoulides N, Kudhail S, Welch M, Husaini SM, Lambracos S, Anyanwu C, Suresh R, Thomas JS, Gleeson E, Platoff R, Saif A, Enumah Z, Etchill E, Gabre-Kidan A, Bernstein M, Carrano FM, Connors J, Lynn P, Melis M, Newman E, Foster DS, Perrone K, Titan A, Weiser TG, Ahmad S, Bafford ACM, Dal Molin M, Hanna N, Zafar SN, Hemmila M, Napolitano L, Wong JJ, Chandler J, Wood L, Wren S, Ottesen T, You L, Yu K, Arciénega Yañez MDP, Ferreira Fernandes M, González D, Cubas S, González MC, Zubiaurre V, Demolin R, Giroff N, Sciuto P, Campos M, Rodríguez Cantera G, Wagner G, Deepika G, Maimbo M, Simuchimba E, Bulaya A, Chibuye C, Chirengendure B, Kabale MR, Kabongo K, Linyama D, Munthali J, Mweso O, Pikiti F, Otieno J, Chan E, Lai LT, Blackman B, Richards S, Subramaniam S, Karim R, Kok N, Lee YD, Ali S, Sinha A, Corrigan R, Barnes N, Wong F, Dennis G, Jedamzik J, Phillips E, Piette W, Van hentenryck M, Koco H, Lawani S, Kassa MW, Santos Bezerra T, Gribnev P, Dimitrov D, Krastev P, Oum S, Bonghaseh DT, Al Farsi M, Alsharqawi N, Agarwal A, Acevedo V, Castillo Barbosa AC, Giron F, Leon Rodriguez JP, Kucan D, Rosko D, Barsic N, Župan D, Hegazi A, Truncíková V, Fryba V, Mohamed M, Sultan A, Nagi A, Rashad Temerik A, Elshawy ME, Mahmoud MI, Omar S, Anwar M, Rageh T, Elmokadem A, Gaballa K, Teppo S, Turunen A, Pengermä P, Ballouhey Q, Bergeat D, Weyl A, Hain E, Gyedu A, Yenli E, Osei-Poku D, Rompou VA, Zoikas A, Gaitanidis A, Koukis G, Perivoliotis K, Tavlas P, Galanos-Demiris K, Zografos G, Karavokyros I, Xanthopoulou G, Iordanidou E, Ayau F, Garcia A, Damján P, Wason D, B L A, Rangganata E, Kamath P, O'Connor DB, Pinto M, Perrone F, Tropeano FP, Troilo F, Bossi D, Scala D, Pulitanò L, Carella M, Pietrabissa A, Gori A, Giraudo G, De Simone V, Russo AA, Braccio B, Al-Taher R, Athamneh S, Parker A, Sawiee A, Kattia A, Salem M, Tababa O, Shaeeb Z, Syminas V, Jurgaitis J, Damuleviciene G, Svagzdys S, Poskus T, Razafimanjato NNM, Chieng Loo L, Tiong IC, Wan Muhmad WF, Vijeyan H, Li Ying T, Grech G, Arrangoiz R, Jimenez Ley VB, Arizpe D, Jimenez Ley VB, Lagunes Lara E, Castro López EV, Eaazim J, Gordinou de Gouberville M, Bastiaenen V, Rottier S, Nahab F, Ji MY, Seyoji M, Nwachukwu C, Emeghara O, Muhammed SE, Idowu A, Sowemimo O, Ogundoyin O, Akande O, Lott A, Nadeem M, Laghari AA, Loya A, Mushtaq H, Abdullah MT, Abuhilal B, Atawneh M, Hamdan H, Alhabil B, Srour A, Mousa I, Da Silva Medina L, Sacdalan MD, Lapitan MC, Sacdalan MD, Sacdalan MD, Bartosiak K, Ferreira P, Francisco V, Lemos R, Frutuoso L, Fernandes S, Fonseca T, Pereira J, Rachadell J, Torre A, Madeira Martins F, Carvalho AC, Rodrigues Ferreira J, Ribeiro da Silva B, Devesa H, Vieira A, Mónica I, Amaro M, Sousa D, Reia M, Louro J, Martins A, Dominguez J, Santos I, Freitas Oliveira NM, Pereira JC, Silva-Vaz P, Freire L, Escrevente R, Negoita VM, Shakhmatov D, Nezerwa Y, Radulovic R, Moore R, Obery G, Viljoen F, Mendes T, Suarez A, Moncada E, Fernandez-Hevia M, Curtis Martínez C, Gil Garcia JM, González Zunzarren M, Idris T, Eklöv K, Grahn O, Amin L, Blomqvist M, Ajani C, Kraus R, Seeger N, Willemin M, Rayya F, Ayash M, Msouti R, Kannas I, Abazid E, Esper A, Slim S, Kavcar AS, Aytac E, Dural AC, Ilker A, Eray IC, Kurnaz E, Altiner S, Tepe MD, Sahin C, Savli E, Innocent A, Babirye L, Diachenko A, Hordoskiy V, Curry H, Chau CYC, Robertson H, Mahmoud A, Lennon H, Loi L, Kirkham E, McCann C, Watts D, Gurung B, Wilson M, Tribedi T, Garofalo E, Zahra B, MacDonald S, Daniels I, Ng N, Khosla S, Olivier J, Yue SYP, Suresh G, Wellington J, Lorejo E, Mossaad M, Tryliskyy Y, Crutcher M, Alimi M, Baiu I, Abdou H, Conway A, Peck C, Wagner G, Perdomo Perez MA, Trostchansky I, Zulu S, Nakazwe M, Knight SR, Drake TM, Nepogodiev D, Fitzgerald JE, Ademuyiwa A, Alexander P, Ingabire JA, Al-Saqqa SW, Biccard BM, Borda-Luque G, Borowski DW, Burger S, Chu K, Clarke D, Costas-Chavarri A, Davies J, Donaldson R, Ede C, Garden OJ, Ghosh D, Glasbey J, Kingham TP, Salem HK, Anyomih TTK, Koto MZ, Lapitan MC, Lawani I, Lesetedi C, Aguilera-Arevalo ML, Mabedi C, Maimbo M, Magill L, Makinde Alakaloko F, Makupe A, Martin J, Ramos-De la Medina A, Monahan M, Moore R, Msosa V, Mulira S, Mutabazi AZ, Muller E, Musowoyo J, Adisa AO, Olory-Togbe JL, Pius R, Qureshi AU, Rayne S, Roberts T, Sacdalan MD, Shaw CA, Smart N, Smith M, Spence R, Van Straten S, Tabiri S, Tayler V, Weiser TG, Windsor J, Yorke J, Yepez R, Lilford R, Morton D, Bhangu A, Sundar S, Harrison EM, Runigamugabo E, Verjee A, Chen J, Daya L, El Aroussi N, Farina V, Gnintedeme Olivier T, Gonzales Nacarino M, Hammani A, Honjo S, Jacobs R, Kimura H, Litvin A, Nkoronko M, Nour I, Oscullo Yepez JJ, Pagano G, Pata F, Pin Hung W, Raj A, Romani Pozo A, Rommaneh M, Sassamela Fabiano SC, Shiroma Gago CM, Shu Yip S, Srinivas A, Sung CY, Tai A, Valle Aranda YC, Venturini S, Vervoort D, Wilguens Lartigue J. Global variation in postoperative mortality and complications after cancer surgery: a multicentre, prospective cohort study in 82 countries. Lancet 2021; 397:387-397. [PMID: 33485461 PMCID: PMC7846817 DOI: 10.1016/s0140-6736(21)00001-5] [Citation(s) in RCA: 104] [Impact Index Per Article: 34.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/05/2020] [Revised: 12/02/2020] [Accepted: 12/17/2020] [Indexed: 02/07/2023]
Abstract
BACKGROUND 80% of individuals with cancer will require a surgical procedure, yet little comparative data exist on early outcomes in low-income and middle-income countries (LMICs). We compared postoperative outcomes in breast, colorectal, and gastric cancer surgery in hospitals worldwide, focusing on the effect of disease stage and complications on postoperative mortality. METHODS This was a multicentre, international prospective cohort study of consecutive adult patients undergoing surgery for primary breast, colorectal, or gastric cancer requiring a skin incision done under general or neuraxial anaesthesia. The primary outcome was death or major complication within 30 days of surgery. Multilevel logistic regression determined relationships within three-level nested models of patients within hospitals and countries. Hospital-level infrastructure effects were explored with three-way mediation analyses. This study was registered with ClinicalTrials.gov, NCT03471494. FINDINGS Between April 1, 2018, and Jan 31, 2019, we enrolled 15 958 patients from 428 hospitals in 82 countries (high income 9106 patients, 31 countries; upper-middle income 2721 patients, 23 countries; or lower-middle income 4131 patients, 28 countries). Patients in LMICs presented with more advanced disease compared with patients in high-income countries. 30-day mortality was higher for gastric cancer in low-income or lower-middle-income countries (adjusted odds ratio 3·72, 95% CI 1·70-8·16) and for colorectal cancer in low-income or lower-middle-income countries (4·59, 2·39-8·80) and upper-middle-income countries (2·06, 1·11-3·83). No difference in 30-day mortality was seen in breast cancer. The proportion of patients who died after a major complication was greatest in low-income or lower-middle-income countries (6·15, 3·26-11·59) and upper-middle-income countries (3·89, 2·08-7·29). Postoperative death after complications was partly explained by patient factors (60%) and partly by hospital or country (40%). The absence of consistently available postoperative care facilities was associated with seven to 10 more deaths per 100 major complications in LMICs. Cancer stage alone explained little of the early variation in mortality or postoperative complications. INTERPRETATION Higher levels of mortality after cancer surgery in LMICs was not fully explained by later presentation of disease. The capacity to rescue patients from surgical complications is a tangible opportunity for meaningful intervention. Early death after cancer surgery might be reduced by policies focusing on strengthening perioperative care systems to detect and intervene in common complications. FUNDING National Institute for Health Research Global Health Research Unit.
Collapse
|
20
|
Lisi G, Campanelli M, Grande S, Milito G, Grande M. Sclerotherapy with 3% polidocanol foam for third- and fourth-degree hemorrhoids as "bridge treatment" during the COVID-19 pandemic in Italy. Int J Colorectal Dis 2021; 36:1321-1322. [PMID: 33452908 PMCID: PMC7811334 DOI: 10.1007/s00384-021-03848-3] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 01/13/2021] [Indexed: 02/04/2023]
Abstract
PURPOSE In Italy, colorectal surgery has been strongly affected with the vast majority (90%) of operations treating benign diseases, with an estimated overall 12-week cancellation rate of 72%. Little is known on how to best manage patients with benign diseases and the consequences this interruption of care will have in post-pandemic times. Proctologic diseases have social, psychological, and healthcare repercussions for their high incidence and great impact on the quality of life. METHODS We decided to treated 10 urgent cases affected from III- and IV-degree hemorrhoids with 3% polidocanol foam in attempt to reduce hemorrhoidal symptoms while waiting for surgery so called "bridge treatment". RESULTS During the follow-up no complications were occurred, and all patients had resolution of bleeding and pruritus with a mean VAS of 1 (range, 0-1). CONCLUSIONS This treatment could reduce the bleeding that is the main symptom from which patients suffer and for which they underwent proctological evaluation and surgery. According to our preliminary experience in the impossibility of accessing the surgery during the COVID-19 pandemic, ST could be considered as the treatment of choice in those patients who are suffering from grade III- and IV-degree hemorrhoids while waiting for surgery.
Collapse
Affiliation(s)
- Giorgio Lisi
- Department of Surgery, Sant'Eugenio Hospital, Viale dell'Umanesimo 10, 00144, Rome, Italy.
| | - M Campanelli
- Emergency Surgery Unit, University Hospital of Tor Vergara, viale Oxford 81, 00133, Rome, Italy
| | - S Grande
- Emergency Surgery Unit, University Hospital of Tor Vergara, viale Oxford 81, 00133, Rome, Italy
| | - G Milito
- Emergency Surgery Unit, University Hospital of Tor Vergara, viale Oxford 81, 00133, Rome, Italy
| | - M Grande
- Emergency Surgery Unit, University Hospital of Tor Vergara, viale Oxford 81, 00133, Rome, Italy
| |
Collapse
|
21
|
Marcellinaro R, Lisi G, Mastrangeli MR, Spoletini D, Grieco M, Carlini M. Preservation of inferior mesenteric vessels. Laparoscopic sigmoidectomy for cancer - a video vignette. Colorectal Dis 2020; 22:2348-2350. [PMID: 32810899 DOI: 10.1111/codi.15321] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/23/2020] [Accepted: 08/11/2020] [Indexed: 02/08/2023]
Affiliation(s)
- R Marcellinaro
- Department of Surgery, Sant' Eugenio Hospital, Rome, Italy
| | - G Lisi
- Department of Surgery, Sant' Eugenio Hospital, Rome, Italy
| | | | - D Spoletini
- Department of Surgery, Sant' Eugenio Hospital, Rome, Italy
| | - M Grieco
- Department of Surgery, Sant' Eugenio Hospital, Rome, Italy
| | - M Carlini
- Department of Surgery, Sant' Eugenio Hospital, Rome, Italy
| |
Collapse
|
22
|
Mandoli G, Pastore M, Benfari G, Maccherini M, Lisi G, Cameli P, Lisi M, Lisi E, Tsioulpas C, Carrucola C, Vigna M, Montesi G, Valente S, Mondillo S, Cameli M. Left atrial strain as a pre-operative prognostic marker for patients with severe primary mitral regurgitation. Eur Heart J 2020. [DOI: 10.1093/ehjci/ehaa946.0054] [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] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Abstract
Background
For patients with severe mitral regurgitation (MR), new indices are needed to optimize surgical timing before irreversible myocardial dysfunction.
Purpose
We investigated the prognostic role of left atrial (LA) strain by speckle tracking echocardiography after mitral surgery for severe MR, and its association with LA fibrosis.
Methods
70 patients with primary severe MR undergoing echocardiography before mitral surgery were enrolled. Patients with other valvular disease > moderate, left bundle branch block, coronary artery disease, heart failure (HF), pacemaker implantation, heart transplantation, poor acoustic window, were excluded. The primary composite endpoint included HF and mortality; the secondary endpoint was post-operative functional capacity (NYHA and Borg CR10). LA fibrosis was assessed by atrial biopsy specimens.
Results
Of 62 patients eligible, 32 had composite events (medium follow-up: 3.3±2.5 years for event-group, 7.6±1 years for non-event group). Characteristics of our study population are summarized in Table 1. With Kaplan-Meier analysis (Fig. 1), PALS provided a good risk stratification; it also was an independent and incremental predictor of outcome in four multivariate Cox adjusted models. There was a strong association between PALS and secondary endpoint (NYHA: r2=0.11, p=0.04; Borg CR10: r2=0.10, p=0.02) and an inverse correlation between PALS <21% and LA fibrosis (r2=0.80; 76.6±20.7% vs 31.9±20.8%; p<0.0001).
Conclusions
Global PALS emerged as a reliable predictor of outcome and functional capacity for severe primary MR, and as a marker of LA fibrosis.
Figure 1
Funding Acknowledgement
Type of funding source: None
Collapse
Affiliation(s)
- G.E Mandoli
- University of Siena, Department of Cardiovascular Diseases, Siena, Italy
| | - M.C Pastore
- University of Siena, Department of Cardiovascular Diseases, Siena, Italy
| | - G Benfari
- University of Verona, Division of Cardiology, Department of Medicine, Verona, Italy
| | | | - G Lisi
- University of Siena, Siena, Italy
| | - P Cameli
- University of Siena, Siena, Italy
| | - M Lisi
- University of Siena, Department of Cardiovascular Diseases, Siena, Italy
| | - E Lisi
- Imperial College London, London, United Kingdom
| | | | - C Carrucola
- University of Siena, Department of Cardiovascular Diseases, Siena, Italy
| | - M Vigna
- University of Siena, Department of Cardiovascular Diseases, Siena, Italy
| | | | - S Valente
- University of Siena, Department of Cardiovascular Diseases, Siena, Italy
| | - S Mondillo
- University of Siena, Department of Cardiovascular Diseases, Siena, Italy
| | - M Cameli
- University of Siena, Department of Cardiovascular Diseases, Siena, Italy
| |
Collapse
|
23
|
Spoletini D, Lisi G, Levi Sandri GB, Grieco M, Marcellinaro R, Sorrentino F, Carlini M. Technique of laparoscopic splenectomy. Ann Laparosc Endosc Surg 2020. [DOI: 10.21037/ales.2020.03.12] [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: 11/06/2022]
|
24
|
Lisi G, Campanelli M, Spoletini D, Carlini M. The possible impact of COVID-19 on colorectal surgery in Italy. Colorectal Dis 2020; 22:641-642. [PMID: 32227609 DOI: 10.1111/codi.15054] [Citation(s) in RCA: 39] [Impact Index Per Article: 9.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/21/2020] [Accepted: 03/24/2020] [Indexed: 12/22/2022]
Affiliation(s)
- G Lisi
- Department of Surgery, Sant'Eugenio Hospital, Rome, Italy
| | - M Campanelli
- Mininvasive Surgery Unit, University Hospital of Tor Vergata, Rome, Italy
| | - D Spoletini
- Department of Surgery, Sant'Eugenio Hospital, Rome, Italy
| | - M Carlini
- Department of Surgery, Sant'Eugenio Hospital, Rome, Italy
| |
Collapse
|
25
|
Abstract
AIM A new artificial anal sphincter placed into the intersphincteric space, SphinKeeper™, has recently been proposed to improve outcomes in the treatment of faecal incontinence (FI). We report our preliminary results with short-term follow-up, comparing preoperative and postoperative data after implant of SphinKeeper™ in patients suffering from FI. METHODS All patients older than 18 years were included with FI of at least 6 months, incontinence episodes occurring more than once a week and resistance to other conservative treatments. Anorectal manometry, endoanal ultrasound, Cleveland Clinic FI Score, FI Quality of Life score and total number of episodes of FI per week were recorded preoperatively and at the end of the 6-month follow-up period. RESULTS Thirteen consecutive patients were treated with SphinKeeper™. No intra-operative nor postoperative complications were reported. Two cases of prosthesis extrusion occurred, and in one case an anterior dislocation was detected. Maximum resting pressure, total number of episodes of FI per week and Cleveland Clinic FI Score were improved after 6 months (P < 0.05). CONCLUSIONS SphinKeeper™ could be a minimally invasive procedure for FI with good postoperative outcomes. If these results are confirmed by studies with more patients and longer follow-up, it could be a first-line approach in FI.
Collapse
Affiliation(s)
- M. La Torre
- Department of SurgeryPoliclinico Umberto PrimoSapienza UniversityRomeItaly
| | - G. Lisi
- Department of General SurgerySant'Eugenio HospitalRomeItaly
| | - G. Milito
- Department of General SurgeryClinica Valle GiuliaRomeItaly
| | - M. Campanelli
- Department of General SurgeryUniversity of Modena and Reggio EmiliaModenaItaly
| | - I. Clementi
- Department of EmergencyPoliclinico Umberto PrimoSapienza UniversityRomeItaly
| |
Collapse
|
26
|
Lisi G, Campanelli M, Villa M, Grande S, Grande M. Colorectal emergency surgery in a COVID-19 referral hospital during the phase 2 in Italy. Int J Colorectal Dis 2020; 35:2137-2138. [PMID: 32607618 PMCID: PMC7326622 DOI: 10.1007/s00384-020-03684-x] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 06/25/2020] [Indexed: 02/04/2023]
Affiliation(s)
- Giorgio Lisi
- University Hospital of Tor Vergata, viale Oxford 81, 00133, Rome, Italy.
| | - M Campanelli
- Mininvasive Surgery Unit, University Hospital of Tor Vergata, viale Oxford 81, 00133, Rome, Italy
| | - M Villa
- Emergency Surgery Unit, University Hospital of Tor Vergata, viale Oxford 81, 00133, Rome, Italy
| | - S Grande
- Emergency Surgery Unit, University Hospital of Tor Vergata, viale Oxford 81, 00133, Rome, Italy
| | - M Grande
- Emergency Surgery Unit, University Hospital of Tor Vergata, viale Oxford 81, 00133, Rome, Italy
| |
Collapse
|
27
|
Lisi G, Garbarino GM, Del Giudice R, Spoletini D, Carlini M. Laparoscopic resection of splenic flexure colon cancer - a video vignette. Colorectal Dis 2019; 21:1090-1091. [PMID: 31091341 DOI: 10.1111/codi.14708] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/08/2019] [Accepted: 05/15/2019] [Indexed: 02/08/2023]
Affiliation(s)
- G Lisi
- Department of Surgery, Sant'Eugenio Hospital, Rome, Italy
| | - G M Garbarino
- Department of Surgery, Sant'Eugenio Hospital, Rome, Italy
| | - R Del Giudice
- Department of Surgery, Sant'Eugenio Hospital, Rome, Italy
| | - D Spoletini
- Department of Surgery, Sant'Eugenio Hospital, Rome, Italy
| | - M Carlini
- Department of Surgery, Sant'Eugenio Hospital, Rome, Italy
| |
Collapse
|
28
|
Garbarino GM, Lisi G, Del Giudice R, Spoletini D, Carlini M. Tips and tricks in laparoscopic management of left colonic vessels - a video vignette. Colorectal Dis 2019; 21:725-726. [PMID: 30903726 DOI: 10.1111/codi.14621] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/12/2019] [Accepted: 03/16/2019] [Indexed: 01/12/2023]
Affiliation(s)
- G M Garbarino
- Department of Surgery, Sant'Eugenio Hospital, Rome, Italy
| | - G Lisi
- Department of Surgery, Sant'Eugenio Hospital, Rome, Italy
| | - R Del Giudice
- Department of Surgery, Sant'Eugenio Hospital, Rome, Italy
| | - D Spoletini
- Department of Surgery, Sant'Eugenio Hospital, Rome, Italy
| | - M Carlini
- Department of Surgery, Sant'Eugenio Hospital, Rome, Italy
| |
Collapse
|
29
|
Lisi G, Campanelli M, Mascagni D, Grande S, Grande M, Milito G. Radiofrequency hemorrhoidectomy: less is less? Results of a comparative study. MINERVA GASTROENTERO 2019; 65:95-99. [DOI: 10.23736/s1121-421x.18.02509-6] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
|
30
|
Meinero P, La Torre M, Lisi G, Stazi A, Carbone A, Regusci L, Fasolini F. Endoscopic pilonidal sinus treatment (EPSiT) in recurrent pilonidal disease: a prospective international multicenter study. Int J Colorectal Dis 2019; 34:741-746. [PMID: 30719564 DOI: 10.1007/s00384-019-03256-8] [Citation(s) in RCA: 32] [Impact Index Per Article: 6.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 01/23/2019] [Indexed: 02/04/2023]
Abstract
BACKGROUND Pilonidal disease (PD) is a common disease of the natal cleft, which can lead to complications including infection and abscess formation. Various operative management options are available, but the ideal technique is still debatable. Recurrent PD after surgical treatment is frequent event for the 25-30% of cases. The present study evaluated endoscopic pilonidal sinus treatment (EPSiT) in recurrent and multi-recurrent PD. METHODS Of the consecutive prospective patients with recurrent PD, 122 were enrolled in a prospective international multicenter study conducted at a secondary and tertiary colorectal surgery centers. Primary endpoint was to evaluate short- and long-term outcomes: healing rate/time, morbidity rate, re-recurrence rate, and patient's quality of life (QoL). RESULTS Complete wound healing rate was occurred in 95% of the patient, with a mean complete wound healing time of 29 ± 12 days. The incomplete healing rate (5%) was significantly related to the number of external openings (p = 0.008), and recurrence was reported in six cases (5.1%). Normal daily activity was established on the first postoperative day, and the mean duration before patients returned to work was 3 days. QoL significantly increased between the preoperative stage and 30 days after the EPSiT procedure (45.3 vs. 7.9; p < 0.0001). CONCLUSIONS The EPSiT procedure seems to be a safe and effective technique in treating even complex recurrent PD. It enables excellent short- and long-term outcomes than various other techniques that are more invasive.
Collapse
Affiliation(s)
- Piercarlo Meinero
- Colorectal Unit Sanatrix Clinic, Rome, Italy.,Department of Surgery, EOC Hospital, Mendrisio, Switzerland
| | - Marco La Torre
- Colorectal Unit Sanatrix Clinic, Rome, Italy.,General Surgery and Proctology, University Pittsburgh Medical Center - Salvator Mundi International Hospital, Rome, Italy
| | - Giorgio Lisi
- Department of Surgery, Sant'Eugenio Hospital, Rome, Italy. .,Department of General Surgery, Sant'Eugenio Hospital, Rome, Italy.
| | - Alessandro Stazi
- Pelvic Care Center, Madonna delle Grazie Hospital, Velletri, Rome, Italy
| | - Antonella Carbone
- Colorectal Unit Sanatrix Clinic, Rome, Italy.,Policlinico Umberto I Hospital, Sapienza University of Rome, Rome, Italy
| | - Luca Regusci
- Department of Surgery, EOC Hospital, Mendrisio, Switzerland
| | | |
Collapse
|
31
|
Lisi G, Garbarino GM, Giudice RD, Spoletini D, Carlini M. Synchronous laparoscopic right colectomy and rectal resection - a video vignette. Colorectal Dis 2019; 21:370-371. [PMID: 30578736 DOI: 10.1111/codi.14540] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/26/2018] [Accepted: 12/07/2018] [Indexed: 02/08/2023]
Affiliation(s)
- G Lisi
- Department of Surgery, Ospedale Sant'Eugenio, Viale dell'Umanesimo, Rome, 00144, Italy
| | - G M Garbarino
- Department of Surgery, Azienda Ospedaliera Sant'Andrea, Rome, Italy
| | - R D Giudice
- Department of Surgery, Ospedale Sant'Eugenio, Viale dell'Umanesimo, Rome, 00144, Italy
| | - D Spoletini
- Department of Surgery, Ospedale Sant'Eugenio, Viale dell'Umanesimo, Rome, 00144, Italy
| | - M Carlini
- Department of Surgery, Ospedale Sant'Eugenio, Viale dell'Umanesimo, Rome, 00144, Italy
| |
Collapse
|
32
|
Garbarino GM, Lisi G, Del Giudice R, Spoletini D, Carlini M. Laparoscopic right colectomy with complete mesocolic excision: a three-trocar technique - a video vignette. Colorectal Dis 2019; 21:371-372. [PMID: 30658011 DOI: 10.1111/codi.14561] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/30/2018] [Accepted: 12/21/2018] [Indexed: 02/08/2023]
Affiliation(s)
- G M Garbarino
- Department of Surgery, University Hospital of Sant'Andrea, Rome, Italy
| | - G Lisi
- Department of Surgery, Sant'Eugenio Hospital, Rome, Italy
| | - R Del Giudice
- Department of Surgery, Sant'Eugenio Hospital, Rome, Italy
| | - D Spoletini
- Department of Surgery, Sant'Eugenio Hospital, Rome, Italy
| | - M Carlini
- Department of Surgery, Sant'Eugenio Hospital, Rome, Italy
| |
Collapse
|
33
|
Lisi G, Campanelli M, Grande S, Mascagni D, Aronadio E, Palmieri G, Grande M. Seromucinous borderline tumor of the peritoneum. Gazz Med Ital - Arch Sci Med 2019. [DOI: 10.23736/s0393-3660.18.03751-8] [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: 11/08/2022]
|
34
|
Rossini R, Lisi G, Gentile I, Barugola G, Ruffo G. Intracorporeal Ileocolic Anastomosis in Laparoscopic Right Colectomy: A New Way to Make it Simple? Surg Technol Int 2018; 32:115-118. [PMID: 29611154] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/08/2023]
Abstract
Although there has been a recent increase in the use of laparoscopy in colorectal surgery, the percentage of patients who undergo surgery using entirely minimally invasive techniques is still quite low, and there are substantial differences among centers. It has been argued that the limiting factor in the use of laparoscopic procedures is not the tumor or patient characteristics, but rather the number of surgeons with adequate skills to perform an entirely laparoscopic colectomy. To address this issue, we report here our totally laparoscopic right colectomy technique, with particular focus on a new way to perform the enterotomy closure, which may simplify ileocolic anastomosis.
Collapse
Affiliation(s)
- Roberto Rossini
- Department of General Surgery, Sacro Cuore - Don Calabria Hospital, Negrar, Italy
| | - Giorgio Lisi
- Department of General and Pancreatic Surgery, University Hospital of Verona Verona, Italy
| | - Irene Gentile
- Department of General Surgery, Sacro Cuore - Don Calabria Hospital, Negrar, Italy
| | - Giuliano Barugola
- Department of General Surgery, Sacro Cuore - Don Calabria Hospital, Negrar, Italy
| | - Giacomo Ruffo
- Department of General Surgery, Sacro Cuore - Don Calabria Hospital, Negrar, Italy
| |
Collapse
|
35
|
Rossini R, Lisi G, Pesci A, Ceccaroni M, Zamboni G, Gentile I, Rettore L, Ruffo G. Depth of Intestinal Wall Infiltration and Clinical Presentation of Deep Infiltrating Endometriosis: Evaluation of 553 Consecutive Cases. J Laparoendosc Adv Surg Tech A 2018; 28:152-156. [DOI: 10.1089/lap.2017.0440] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Affiliation(s)
- Roberto Rossini
- Department of General Surgery, Sacro Cuore Don Calabria Hospital, Negrar, Italy
| | - Giorgio Lisi
- Department of General and Pancreatic Surgery, Borgo Roma University Hospital, Verona, Italy
| | - Anna Pesci
- Department of Pathology, Sacro Cuore Don Calabria Hospital, Negrar, Italy
| | - Marcello Ceccaroni
- Department of Gynecology and Obstetrics, Sacro Cuore Don Calabria Hospital, Negrar, Italy
| | - Giuseppe Zamboni
- Department of Pathology, Sacro Cuore Don Calabria Hospital, Negrar, Italy
| | - Irene Gentile
- Department of General Surgery, Sacro Cuore Don Calabria Hospital, Negrar, Italy
| | - Lorenzo Rettore
- Department of General Surgery, Sacro Cuore Don Calabria Hospital, Negrar, Italy
| | - Giacomo Ruffo
- Department of General Surgery, Sacro Cuore Don Calabria Hospital, Negrar, Italy
| |
Collapse
|
36
|
Lisi G, Rossini R, Gentile I, Ruffo G. Over-Sewing of Staple Line in Laparoscopic Sleeve Gastrectomy: Initial Experience of a Comparative Study. Surg Technol Int 2017; 31:106-110. [PMID: 29029355] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/07/2023]
Abstract
INTRODUCTION The main drawback of laparoscopic sleeve gastrectomy (LSG) is the severity of postoperative complications. Staple line reinforcement (SLR) is strongly advocated. Recently, over-sewing has been proposed as a cost-effective and helpful method for reinforcing the staple line. The purpose of this study was to report our initial experience with LSG comparing over-sewing over the entire staple line with the upper-third staple line. MATERIALS AND METHODS All obese patients seen at Negrar Sacro Cuore, Don Calabria Hospital were entered into our prospective database and were retrospectively evaluated. Complications (divided as major complications: leaks and bleeding; and minor complications: dysphagia, esophagitis, and reflux disease) and reoperations were recorded for all patients. Complications were graded according to the Clavien classification system. RESULTS From February 2015 to March 2016, 30 patients underwent LSG. Patients were divided in two groups according to over-sewing: Group A-over-sewing over the entire staple line; and Group B upper-third over-sewing. Mean total operative time was longer in Group A-90 minutes-compared with 85 minutes in Group B. In regard to minor complications, we reported one esophagitis and two cases of dysphagia in Group B and one dysphagia in Group A. Gastroesophageal reflux was higher in Group B than in Group A (3 vs. 1, p=0.149). Three major complications were observed (10%): two bleeding and one hematoma in Group B and no major complications occurred in Group A. All major complications were conservatively treated. No leaks were reported in both groups. No mortality was observed. CONCLUSIONS Over-sewing of the staple line was associated with fewer leaks but no conclusions can be drawn regarding the effects of over-sewing on staple line bleedings. Before standardizing surgical techniques further, trials are necessary to improve our knowledge about over-sewing in LSG.
Collapse
Affiliation(s)
- Giorgio Lisi
- Department of General and Pancreatic Surgery, University Hospital of Verona Verona, Italy
| | - Roberto Rossini
- Department of General Surgery, Don Calabria Hospital, Verona, Italy
| | - Irene Gentile
- Department of General Surgery, Don Calabria Hospital, Verona, Italy
| | - Giacomo Ruffo
- Department of General Surgery, Don Calabria Hospital, Verona, Italy
| |
Collapse
|
37
|
Milito G, Lisi G, Venditti D, Campanelli M, Aronadio E, Grande M. Surgical Treatment of Rectovaginal Fistula in Crohn's Disease: A Tertiary Center Experience. Surg Technol Int 2017; 30:113-116. [PMID: 28395390] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/07/2023]
Abstract
BACKGROUND Rectovaginal fistula (RVF) is a disastrous complication of Crohn's disease (CD) that is exceedingly difficult to treat. It is a disabling condition that negatively impacts a woman's quality of life. Current treatment algorithms range from observation to medical management to the need for surgical intervention. A wide variety of success rates have been reported for all management options. The choice of surgical repair methods depends on various fistula and patient characteristics, and its published success rates vary with initial success being around 50% rising to 80% with repeated surgery. Several surgical and sphincter sparing approaches have been described for the management of rectovaginal fistula, aimed to minimize the recurrence and to preserve the continence. MATERIALS AND METHODS A retrospective study was performed for RVF repair between 2008 and 2014 in our tertiary centre at the University Hospital of Tor Vergata, Italy. All the patients were affected by Crohn's disease and underwent surgery for an RVF under the same senior surgeon. All patients were prospectively evaluated. RESULTS All 43 patients that underwent surgery for RVF were affected by Crohn's disease. The median age was 43 years (range 21-53). Four different surgical approaches were performed: drainage and seton, rectal advacenment flap (RAF), vaginal advancement flap (VAF), transperineal approach using porcine dermal matrix (PDM), and martius flap (MF). The median time to success was six months (range 2-11). None of the patients were lost during the 18 months of follow-up. The failure group rate was 19% in contrast with the healing rate group that was 81%. No demographic of disease-related factors were found to influence healing. CONCLUSION The case series of this study supports the dogma that "there are no absolute rules when treating Crohn's fistula". There is no gold standard technique; however, it is mandatory to minimize the recurrence with a sphincter saving technique. Randomized trials are needed to find a standard surgical approach.
Collapse
Affiliation(s)
- Giovanni Milito
- Department of Surgery, University Hospital of Tor Vergata "PTV", Rome, Italy
| | - Giorgio Lisi
- Department of Surgery, University Hospital of Borgo Roma, Verona, Italy
| | - Dario Venditti
- Department of Surgery, University Hospital of Tor Vergata "PTV", Rome, Italy
| | | | - Elena Aronadio
- Department of Surgery, University Hospital of Tor Vergata "PTV", Rome, Italy
| | - Michele Grande
- Department of Surgery, University Hospital of Tor Vergata "PTV", Rome, Italy
| |
Collapse
|
38
|
Milito G, Lisi G, Venditti D, Campanelli M, Aronadio E, Grande S, Cabry F, Grande M. Endoluminal Vacuum Therapy as Treatment for Anastomotic Colorectal Leakage. Surg Technol Int 2017; 30:125-130. [PMID: 28072899] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/06/2023]
Abstract
BACKGROUND The clinical leakage rate after anterior resection varies from 2.8-20%, with a 6-22% mortality rate and a 10-80% risk of permanent stoma. Endo-SPONGE® (B. Braun Melsungen AG, Melsungen, Germany) may treat extraperitoneal anastomotic leakage in the lesser pelvis. It consists of an open-pored sponge inserted into the cavity. A drainage tube fixed to a low vacuum drainage system is then connected to the sponge through the anus. MATERIAL AND METHODS Between January 2007 and December 2014, 14 patients with anastomotic leakage following low anterior resection were treated with Endo-SPONGE® and were prospectively evaluated. In all patients, a CT-scan was performed and they received an intravenous antibiotic therapy with piperacillin+tazobactam (4.5g,3 times/daily). Complete healing was defined as endoscopically proven closure of the insufficiency cavity with a normal mucosa. RESULTS Stapled straight end to end, colorectal anastomoses were performed in all patients between 3-7 cm above the anal verge, a protective loop ileostomy was performed in every patient. The diagnosis of anastomotic leakage was performed after a median interval of 14 days, the median size of the cavity was 81x46 mm. Fluid collection was drained, percutaneosly in 12 cases, surgically in two patients. The median duration of therapy was 35 days, with 3-14 sponge exchanges for each patient. Median healing time was 37 days. No intraoperative complications were recorded, however, we found five cases of mild anal pain treated medically. CONCLUSION Considering the literature and our results, the Endo-SPONGE® seems an effective, minimally invasive procedure to treat extraperitoneal anastomotic leakage, reducing morbidity, mortality, and hospital stay.
Collapse
Affiliation(s)
- Giovanni Milito
- Department of Surgery, University Hospital of Tor Vergata, Rome, Italy
| | - Giorgio Lisi
- Department of Surgery, University Hospital of Borgo Roma, Verona, Italy
| | - Dario Venditti
- Department of Surgery, University Hospital of Tor Vergata, Rome, Italy
| | | | - Elena Aronadio
- Department of Surgery, University Hospital of Tor Vergata, Rome, Italy
| | - Simona Grande
- Department of Surgery, University Hospital of Messina, Messina, Italy
| | - Francesca Cabry
- Department of Surgery, University Hospital of Modena, Modena, Italy
| | - Michele Grande
- Department of Surgery, University Hospital of Tor Vergata, Rome, Italy
| |
Collapse
|
39
|
Grande M, Lisi G, Campanelli M, Grande S, Venditti D, Nigro C, Cabry F, Villa M. Laparoscopic Treatment of Giant Ventral Hernia: Experience of 35 Patients. Surg Technol Int 2017; 30:165-169. [PMID: 28072903] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/06/2023]
Abstract
BACKGROUND Minimal access surgery for incisional hernia repair is still debated, especially for giant wall defects. Laparoscopic repair may reduce pain and hospital stay. This study was designed to evaluate the feasibility of the laparoscopic technique in giant hernia. MATERIALS AND METHODS From 2007 to 2013, 35 consecutive patients with giant ventral hernia, according to the Chevrel classification, underwent laparoscopic repair. Fourteen patients were obese, with a body mass index (BMI) > 30 and in 21 patients the mean BMI was 24 (range 22-28). In all patients, the wall defect was larger than 20 cm. RESULTS Mean operative time was 159±30 minutes, and, for defects larger than 25 cm, it was 210±20 minutes. Patient conversion did not occur. In 29 patients, the mean wall defect was 20x25 cm, and in six patients the mean wall defect was 26x31 cm, and, as measured from within the peritoneal cavity, the mean overlap was 5 cm (range 3-6). Short-term antibiotic prophylaxis consisted of Cefazolin 2 g IV (intravenous) the day of surgery. All patients were discharged within 72-96 hrs. The mean follow-up was 24 months. No infection occurred and no chronic pain was recorded. However, three seroma were observed (outpatient treatment) and two xiphoid recurrences were observed. CONCLUSIONS Laparoscopic hernia repair is technically feasible and is safe in patients with giant fascial defects as well as obese patients. This operation decreases postoperative pain, hastens the recovery period, and reduces postoperative morbidity and recurrence. This approach should be reserved for patients with no history of previous hernia repair. Further studies are expected to confirm these promising results.
Collapse
Affiliation(s)
- Michele Grande
- Department of Surgery, University Hospital of Tor Vergata, Rome, Italy
| | - Giorgio Lisi
- Department of Surgery, University Hospital of Borgo Roma, Verona, Italy
| | | | - Simona Grande
- Department of Surgery, University Hospital of Messina, Messina, Italy
| | - Dario Venditti
- Department of Surgery, University Hospital of Tor Vergata, Rome, Italy
| | - Casimiro Nigro
- Department of Surgery, University Hospital of Tor Vergata, Rome, Italy
| | - Francesca Cabry
- Department of Surgery, University Hospital of Modena, Modena, Italy
| | - Massimo Villa
- Department of Surgery, University Hospital of Tor Vergata, Rome, Italy
| |
Collapse
|
40
|
Cameli M, Bombardini T, Dokollari A, Sassi CG, Losito M, Sparla S, Lisi G, Bernazzali S, Davoli G, Capannini G, Andriani S, Martinelli R, Diciolla F, Mondillo S, Maccherini M. Longitudinal Strain Stress-Echo Evaluation of Aged Marginal Donor Hearts: Feasibility in the Adonhers Project. Transplant Proc 2017; 48:399-401. [PMID: 27109965 DOI: 10.1016/j.transproceed.2015.12.036] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2015] [Accepted: 12/30/2015] [Indexed: 11/25/2022]
Abstract
BACKGROUND The Adonhers (aged donor heart rescue by stress-echo protocol) Project was created to resolve the current shortage of donor hearts. One of the great limits of stress echo is the operator dependency. Speckle-tracking echocardiography (STE), offering a quantitative objective analysis of myocardial deformation, may help to overcome this limit. This study aimed to verify feasibility of a stress-strain echo analysis in selection of aged donor hearts for heart transplant. METHODS From February 2014 to October 2015, 22 marginal candidate donors (16 men) ages 58 ± 4 years were initially enrolled. After legal declaration of brain death, all marginal donors underwent bedside echocardiography, with baseline and (when resting echocardiography was normal) dipyridamole (0.84 mg/kg in 6 minutes) stress echo. In all patients, left ventricular (LV) longitudinal myocardial deformation was obtained by STE in the 4-, 2-, and 3-chamber views, obtaining the average global longitudinal strain (GLS). GLS was assessed at baseline and at the peak of stress echo. RESULTS Baseline echocardiography showed wall motion abnormalities in 9 patients (excluded from donation). Stress echocardiography was performed in the remaining 13 patients. Results were normal in 8, who were uneventfully transplanted in marginal recipients. Stress results were abnormal in 5 (excluded from donation). STE was obtained in all cases (100% feasibility) and ΔGLS was significantly different between normal and pathological stress-echo (+13.2 ± 5.2 versus -6.1% ± 3.1%, P = .0001, respectively). CONCLUSIONS STE showed an excellent feasibility in analysis of LV myocardial longitudinal strain at baseline and at the peak of stress echo of marginal heart donors. Further experience is needed to confirm STE as a valuable additional mean to better interpret stress echo in marginal donors.
Collapse
Affiliation(s)
- M Cameli
- Department of Cardiovascular Diseases, University of Siena, Italy.
| | - T Bombardini
- Institute of Clinical Physiology, National Research Council, Pisa, Italy
| | - A Dokollari
- Department of Cardiac Surgery, University of Siena, Italy
| | - C G Sassi
- Department of Cardiac Surgery, University of Siena, Italy
| | - M Losito
- Department of Cardiovascular Diseases, University of Siena, Italy
| | - S Sparla
- Department of Cardiovascular Diseases, University of Siena, Italy
| | - G Lisi
- Department of Cardiac Surgery, University of Siena, Italy
| | - S Bernazzali
- Department of Cardiac Surgery, University of Siena, Italy
| | - G Davoli
- Department of Cardiac Surgery, University of Siena, Italy
| | - G Capannini
- Department of Cardiac Surgery, University of Siena, Italy
| | - S Andriani
- Department of Cardiac Surgery, University of Siena, Italy
| | - R Martinelli
- Department of Cardiac Surgery, University of Siena, Italy
| | - F Diciolla
- Department of Cardiac Surgery, University of Siena, Italy
| | - S Mondillo
- Department of Cardiovascular Diseases, University of Siena, Italy
| | - M Maccherini
- Department of Cardiac Surgery, University of Siena, Italy
| |
Collapse
|
41
|
Milito G, Lisi G, Aronadio E, Campanelli M, Venditti D, Grande S, Grande M. May radiofrequency be the best choice for III-IV degree hemorrhoids? Minerva Gastroenterol (Torino) 2016; 63:38-43. [PMID: 27845508 DOI: 10.23736/s1121-421x.16.02348-5] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
BACKGROUND Hemorrhoidectomy is considered the most efficient method to treat hemorrhoids of III and IV grades. The aim of this study was to compare conventional diathermy hemorrhoidectomy and radiofrequency hemorrhoidectomy based on a large series of patients. METHODS Between June 2001 and June 2014, 1000 patients have been treated with radiofrequency hemorrhoidectomy (group A) and 500 patients have been treated with diathermy (group B) as a day-case procedure. Operating time, postoperative pain score, hospital stay, early and late postoperative complications, wound healing time and time to return to normal activities were assessed. RESULTS The mean follow-up was seven years. The mean operating time for radiofrequency hemorrhoidectomy was shorter than diathermy but not significantly. Patients treated with radiofrequency had significantly less postoperative pain (measured on a Visual Analogue Scale; P=0.001), a shorter wound healing time, less time off work and postoperative complications (P=0.001) than patients who had diathermy. Neither wound healing nor mean hospital stay (day-case surgery) was significantly different. CONCLUSIONS Radiofrequency hemorrhoidectomyis a valid alternative to the conventional diathermy technique, due to the reduction of operative time, postoperative pain, early and late complication rate.
Collapse
Affiliation(s)
- Giovanni Milito
- Department of Surgery, University Hospital of Tor Vergata, Rome, Italy
| | - Giorgio Lisi
- Department of Surgery, University Hospital of Verona, Borgo Roma, Verona, Italy -
| | - Elena Aronadio
- Department of Surgery, University Hospital of Tor Vergata, Rome, Italy
| | - Michela Campanelli
- Department of Surgery, University Hospital of Modena e Reggio Emilia, Modena, Italy
| | - Dario Venditti
- Department of Surgery, University Hospital of Tor Vergata, Rome, Italy
| | - Simona Grande
- Department of Surgery, University Hospital of Messina, Messina, Italy
| | - Michele Grande
- Department of Surgery, University Hospital of Tor Vergata, Rome, Italy
| |
Collapse
|
42
|
Abstract
BACKGROUND Hemorrhoidectomy is considered the gold standard and the most effective and definitive treatment for grades 3 or 4 hemorrhoids, and Milligan-Morgan's and Ferguson's procedures are the most widely used techniques throughout the world. The aim of the study was to present our surgical technique using LigasureTM vessel sealing, focus on technical aspects and surgical tricks showing our results with a huge number of patients and a long-term follow-up. METHODS Between June 2001 and June 2014 at the University Hospital of Tor Vergata, Rome, Italy, 1000 patients were selected to underwent LigasureTM hemorrhoidectomy for III and IV degree hemorrhoids. Age range 19-80 years, ASA I-II-III. Operating time, postoperative pain score, hospital stay, early and late postoperative complications, wound healing time and time to return to normal activities were assessed. Patients were followed-up at one week, one month, six, and twelve months after the operation and after 60 months they responded to the follow-up telephone interview and replied to the questionnaire. RESULTS One-thousand patients were undergone LigasureTM hemorrhoidectomy. The mean follow-up was 7 years and 110 (11%) patients was lost from the follow-up after the first postoperative month. Among early postoperative complications, 21 patients (2.1%) has urinary retention treated with a urinary catheter and removed before the discharge. 3 (0.3%) patients had a minor bleeding that required a package of hemostatic absorbable sponge, as late complications, in 35 patients (4%) anal fissure due to hard stool, an incomplete healing was observed in 11 patients (1.1%) after the first month. Three transphincteric anal fistulas (0.3%) were collected and four perianal abscess (0.4%) were observed during the first month of the follow-up and they required a delayed surgical treatment. At the end of the seven years of follow-up 70 recurrences (7.8%) and 35 anal stenosis (4%) were detected. CONCLUSIONS If technical guidelines are respected rigorously and the device is applied correctly, feared late complications, such as impaired fecal continence, anal stricture and postoperative pain can be minimized.
Collapse
Affiliation(s)
- Giovanni Milito
- Department of Surgery, University Hospital of Tor Vergata, Rome, Italy
| | - Giorgio Lisi
- Department of Surgery, University Hospital of Verona, Borgo Roma, Verona, Italy -
| | - Elena Aronadio
- Department of Surgery, University Hospital of Tor Vergata, Rome, Italy
| | - Michela Campanelli
- Department of Surgery, University Hospital of Modena e Reggio Emilia, Modena, Italy
| | - Dario Venditti
- Department of Surgery, University Hospital of Tor Vergata, Rome, Italy
| | - Simona Grande
- Department of Surgery, University Hospital of Messina, Messina, Italy
| | - Michele Grande
- Department of Surgery, University Hospital of Tor Vergata, Rome, Italy
| |
Collapse
|
43
|
Milito G, Lisi G, Venditti D, Campanelli M, Grande M. Endo-SPONGE®: conservative treatment of an anastomotic leak. MINERVA GASTROENTERO 2016; 62:267-268. [PMID: 27404262] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/06/2023]
Affiliation(s)
- Giovanni Milito
- Department of Surgery, Tor Vergata University Hospital, Rome, Italy -
| | | | | | | | | |
Collapse
|
44
|
Ichikawa N, Okamoto Y, Okada G, Lisi G, Yahata N, Morimoto J, Kawato M, Matsuo K, Yamagata H, Watanabe Y, Yamawaki S. Neuroimaging Biomarker of Major Depressive Disorder. Eur Psychiatry 2016. [DOI: 10.1016/j.eurpsy.2016.01.1811] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/27/2022] Open
Abstract
IntroductionRecent studies have shown that it is important to understand the brain mechanism specifically by focusing on the common and unique functional connectivity in each disorder including depression.ObjectivesTo specify the biomarker of major depressive disorder (MDD), we applied the sparse machine learning algorithm to classify several types of affective disorders using the resting state fMRI data collected in multiple sites, and this study shows the results of depression as a part of those results.AimsThe aim of this study is to understand some specific pattern of functional connectivity in MDD, which would support diagnosis of depression and development of focused and personalized treatments in the future.MethodsThe neuroimaging data from patients with major depressive disorder (MDD, n = 100) and healthy control adults (HC: n = 100) from multiple sites were used for the training dataset. A completely separate dataset (n = 16) was kept aside for testing. After all preprocessing of fMRI data, based on one hundred and forty anatomical region of interests (ROIs), 9730 functional connectivities during resting states were prepared as the input of the sparse machine-learning algorithm.ResultsAs results, 20 functional connectivities were selected with the classification performance of Accuracy: 83.0% (Sensitivity: 81.0%, Specificity: 85.0%). The test data, which was completely separate from the training data, showed the performance accuracy of 83.3%.ConclusionsThe selected functional connectivities based on the sparse machine learning algorithm included the brain regions which have been associated with depression.Disclosure of interestThe authors have not supplied their declaration of competing interest.
Collapse
|
45
|
Novitsky Y, Fayezizadeh M, Majumder A, Yee S, Petro C, Orenstein S, Woeste G, Reinisch A, Bechstein WO, Rosen M, Carbonell A, Cobb W, Bauer J, Selzer D, Chao J, Harmaty M, Poulose B, Matthews B, Goldblatt M, Jacobsen G, Rosman C, Hansson B, Prabhu A, Fathi A, Skipworth J, Younis I, Floyd D, Shankar A, Olmi S, Cesana G, Ciccarese F, Uccelli M, Carrieri D, Castello G, Legnani G, Lyo V, Irwin C, Xu X, Harris H, Zuvela M, Galun D, Petrovic J, Palibrk I, Koncar I, Basaric D, Tian W, Fei Y, Pittman M, Jones E, Schwartz J, Mikami D, Perrakis A, Knüttel D, Klein P, Croner RS, Hohenberger W, Perrakis E, Müller V, Grande M, Villa M, Lisi G, Esser A, De Sanctis F, Petrella G, Birolini C, Miranda JS, Tanaka EY, Utiyama EM, Rasslan S, Shi Y, Guo XB, Zhuo HQ, Li LP, Liu HJ, Bauder A, Gerety P, Epps G, Pannucci C, Fischer J, Kovach S. Incisional Hernia: Difficult Cases 2. Hernia 2015; 19 Suppl 1:S105-11. [PMID: 26518784 DOI: 10.1007/bf03355335] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Affiliation(s)
- Y Novitsky
- Case Comprehensive Hernia Center, Cleveland, USA
| | | | - A Majumder
- Case Comprehensive Hernia Center, Cleveland, USA
| | - S Yee
- Case Comprehensive Hernia Center, Cleveland, USA
| | - C Petro
- Case Comprehensive Hernia Center, Cleveland, USA
| | - S Orenstein
- Case Comprehensive Hernia Center, Cleveland, USA
| | - G Woeste
- Department of Surgery, Goethe University, Frankfurt, Germany
| | - A Reinisch
- Department of Surgery, Goethe University, Frankfurt, Germany
| | - W O Bechstein
- Department of Surgery, Goethe University, Frankfurt, Germany
| | - M Rosen
- Cleveland Clinic Foundation, Cleveland, USA
| | | | | | | | | | | | | | | | | | | | | | | | | | | | - A Fathi
- Case Comprehensive Hernia Center, Cleveland, USA
| | - J Skipworth
- Hospital Complex Hernia Unit, Royal Free and University College London, London, UK
| | - I Younis
- Hospital Complex Hernia Unit, Royal Free and University College London, London, UK
| | - D Floyd
- Hospital Complex Hernia Unit, Royal Free and University College London, London, UK
| | - A Shankar
- Hospital Complex Hernia Unit, Royal Free and University College London, London, UK
| | - S Olmi
- School of General Surgery, University of Milan, Milan, Italy.,General and Oncologic Surgery Department, S. Marco Hospital, Zingonia, BG, Italy
| | - G Cesana
- School of General Surgery, University of Milan, Milan, Italy.,General and Oncologic Surgery Department, S. Marco Hospital, Zingonia, BG, Italy
| | - F Ciccarese
- School of General Surgery, University of Milan, Milan, Italy.,General and Oncologic Surgery Department, S. Marco Hospital, Zingonia, BG, Italy
| | - M Uccelli
- School of General Surgery, University of Milan, Milan, Italy.,General and Oncologic Surgery Department, S. Marco Hospital, Zingonia, BG, Italy
| | - D Carrieri
- General and Oncologic Surgery Department, S. Marco Hospital, Zingonia, BG, Italy
| | - G Castello
- General and Oncologic Surgery Department, S. Marco Hospital, Zingonia, BG, Italy
| | - G Legnani
- General and Oncologic Surgery Department, S. Marco Hospital, Zingonia, BG, Italy
| | - V Lyo
- Division of General Surgery, University of California San Francisco, San Francisco, USA
| | - C Irwin
- Division of Plastic & Reconstructive Surgery, University of California San Francisco, San Francisco, USA
| | - X Xu
- Division of Plastic & Reconstructive Surgery, University of California San Francisco, San Francisco, USA
| | - H Harris
- Division of General Surgery, University of California San Francisco, San Francisco, USA
| | - M Zuvela
- Clinical center of Serbia, University Clinic for Digestive Surgery, Belgrade, Serbia.,Medical School, University of Belgrade, Belgrade, Serbia
| | - D Galun
- Clinical center of Serbia, University Clinic for Digestive Surgery, Belgrade, Serbia.,Medical School, University of Belgrade, Belgrade, Serbia
| | - J Petrovic
- Clinical center of Serbia, University Clinic for Digestive Surgery, Belgrade, Serbia
| | - I Palibrk
- Medical School, University of Belgrade, Belgrade, Serbia.,Clinical center of Serbia, Clinic for vascular and endovascular surgery, Belgrade, Serbia
| | - I Koncar
- Clinical center of Serbia, University Clinic for Digestive Surgery, Belgrade, Serbia.,Medical School, University of Belgrade, Belgrade, Serbia
| | - D Basaric
- Clinical center of Serbia, University Clinic for Digestive Surgery, Belgrade, Serbia
| | - W Tian
- Department of General Surgery, 1st affiliated hospital of PLA general hospital, Beijing, China
| | | | - M Pittman
- The Ohio State University Medical Center, Columbus, USA
| | | | | | | | - A Perrakis
- Department of Surgery, University Hospital of Erlangen, Erlangen, Germany
| | - D Knüttel
- Department of Surgery, University Hospital of Erlangen, Erlangen, Germany
| | - P Klein
- Department of Surgery, University Hospital of Erlangen, Erlangen, Germany
| | - R S Croner
- Department of Surgery, University Hospital of Erlangen, Erlangen, Germany
| | - W Hohenberger
- Department of Surgery, University Hospital of Erlangen, Erlangen, Germany
| | - E Perrakis
- Department of Surgery, Omilos Iatrikoo Kentrou Athinon, Iatriko Kentro Peristeriou, Athens, Greece
| | - V Müller
- Department of Surgery, University Hospital of Erlangen, Erlangen, Germany
| | - M Grande
- University Hospital of Tor Vergata, Rome, Italy
| | - M Villa
- University Hospital of Tor Vergata, Rome, Italy
| | - G Lisi
- University Hospital of Tor Vergata, Rome, Italy
| | - A Esser
- University Hospital of Tor Vergata, Rome, Italy
| | | | - G Petrella
- University Hospital of Tor Vergata, Rome, Italy
| | - C Birolini
- Abdominal Wall and Hernia Surgery, University of São Paulo, School of Medicine, São Paulo, Brazil
| | - J S Miranda
- Abdominal Wall and Hernia Surgery, University of São Paulo, School of Medicine, São Paulo, Brazil
| | - E Y Tanaka
- Abdominal Wall and Hernia Surgery, University of São Paulo, School of Medicine, São Paulo, Brazil
| | - E M Utiyama
- Abdominal Wall and Hernia Surgery, University of São Paulo, School of Medicine, São Paulo, Brazil
| | - S Rasslan
- Abdominal Wall and Hernia Surgery, University of São Paulo, School of Medicine, São Paulo, Brazil
| | - Y Shi
- Department of Gastrointestinal Surgery, Provincial Hospital Affiliated to Shandong University, Jinan, China
| | | | | | | | | | - A Bauder
- Division of Plastic Surgery, University of Pennsylvania, Philadelphia, USA
| | - P Gerety
- Division of Plastic Surgery, University of Pennsylvania, Philadelphia, USA
| | - G Epps
- Division of Plastic Surgery, University of Pennsylvania, Philadelphia, USA
| | - C Pannucci
- Division of Plastic and Reconstructive Surgery, University of Utah, Salt Lake City, USA
| | - J Fischer
- Division of Plastic Surgery, University of Pennsylvania, Philadelphia, USA
| | - S Kovach
- Division of Plastic Surgery, University of Pennsylvania, Philadelphia, USA
| |
Collapse
|
46
|
Mattioli G, Barabino A, Aloi M, Arrigo S, Caldaro T, Carlucci M, Cucchiara S, De Angelis P, Di Leo G, Illiceto MT, Impellizzeri P, Leonelli L, Lisi G, Lombardi G, Martelossi S, Martinelli M, Miele E, Randazzo A, Romano C, Romeo C, Romeo E, Selvaggi F, Valenti S, Dall'Oglio L. Paediatric ulcerative colitis surgery: Italian survey. J Crohns Colitis 2015; 9:558-64. [PMID: 25895877 DOI: 10.1093/ecco-jcc/jjv065] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/07/2015] [Accepted: 04/13/2015] [Indexed: 02/08/2023]
Abstract
BACKGROUND AND AIMS Recent epidemiological studies showed an increase in ulcerative colitis among children, especially in its aggressive form, requiring surgical treatment. Although medical therapeutic strategies are standardized, there is still no consensus regarding indications, timing and kind of surgery. This study aimed to define the surgical management of paediatric ulcerative colitis and describe attitudes to it among paediatric surgeons. METHODS This was a retrospective cohort study. All national gastroenterology units were invited to participate. From January 2009 to December 2013, data on paediatric patients diagnosed with ulcerative colitis that required surgery were collected. RESULTS Seven units participated in the study. Seventy-one colectomies were performed (77.3% laparoscopically). Main surgical indications were a severe ulcerative colitis attack (33.8%) and no response to medical therapies (56.3%). A three-stage strategy was chosen in 71% of cases. Straight anastomosis was performed in 14% and J-pouch anastomosis in 86% of cases. A reconstructive laparoscopic approach was used in 58% of patients. Ileo-anal anastomosis was performed by the Knight-Griffen technique in 85.4% and by the pull-through technique in 9.1% of patients. Complications after colectomy, after reconstruction and after stoma closure were reported in 12.7, 19.3 and 35% of cases, respectively. CONCLUSIONS This study shows that there is general consensus regarding indications for surgery. The ideal surgical technique remains under debate. Laparoscopy is a procedure widely adopted for colectomy but its use in reconstructive surgery remains limited. Longer follow-up must be planned to define the quality of life of these patients.
Collapse
Affiliation(s)
- G Mattioli
- DINOGMI, University of Genova, Genova, Italy Pediatric Surgery Unit, G. Gaslini Children's Hospital-IRCCS, Genova, Italy
| | - A Barabino
- Pediatric Gastroenterology Unit, G. Gaslini Children's Hospital-IRCCS, Genova, Italy
| | - M Aloi
- Department of Pediatrics, Sapienza University of Rome, Rome, Italy
| | - S Arrigo
- Pediatric Gastroenterology Unit, G. Gaslini Children's Hospital-IRCCS, Genova, Italy
| | - T Caldaro
- Surgery and Digestive Endoscopy Unit, Bambino Gesù Children's Hospital, IRCCS, Rome, Italy
| | - M Carlucci
- DINOGMI, University of Genova, Genova, Italy Pediatric Surgery Unit, G. Gaslini Children's Hospital-IRCCS, Genova, Italy
| | - S Cucchiara
- Department of Pediatrics, Sapienza University of Rome, Rome, Italy
| | - P De Angelis
- Surgery and Digestive Endoscopy Unit, Bambino Gesù Children's Hospital, IRCCS, Rome, Italy
| | - G Di Leo
- Gastroenterology Unit, Institute for Maternal and Child Health, IRCCS Burlo Garofolo, Trieste, Italy
| | - M T Illiceto
- Department of Pediatrics, Unit of Pediatric Gastroenterology and Digestive Endoscopy - Ospedale Civile Spirito Santo, Pescara, Italy
| | - P Impellizzeri
- Pediatric Surgery Unit, Department of Pediatric, Gynecological, Microbiological and Biomedical Sciences, University of Messina, Messina, Italy
| | - L Leonelli
- DINOGMI, University of Genova, Genova, Italy Pediatric Surgery Unit, G. Gaslini Children's Hospital-IRCCS, Genova, Italy
| | - G Lisi
- Pediatric Surgery Unit, 'G. d'Annunzio' University of Chieti, Chieti Italy
| | - G Lombardi
- Department of Pediatrics, Unit of Pediatric Gastroenterology and Digestive Endoscopy - Ospedale Civile Spirito Santo, Pescara, Italy
| | - S Martelossi
- Gastroenterology Unit, Institute for Maternal and Child Health, IRCCS Burlo Garofolo, Trieste, Italy
| | - M Martinelli
- Department of Translational Medical Science, Section of Pediatrics, University of Naples 'Federico II', Naples, Italy
| | - E Miele
- Department of Translational Medical Science, Section of Pediatrics, University of Naples 'Federico II', Naples, Italy
| | - A Randazzo
- IBD Unit Pediatric Department,University of Messina, Messina, Italy
| | - C Romano
- IBD Unit Pediatric Department,University of Messina, Messina, Italy
| | - C Romeo
- Pediatric Surgery Unit, Department of Pediatric, Gynecological, Microbiological and Biomedical Sciences, University of Messina, Messina, Italy
| | - E Romeo
- Surgery and Digestive Endoscopy Unit, Bambino Gesù Children's Hospital, IRCCS, Rome, Italy
| | - F Selvaggi
- Unit of General Surgery, University of Naples 'Fedrico II', Naples, Italy
| | - S Valenti
- IBD Unit Pediatric Department,University of Messina, Messina, Italy
| | - L Dall'Oglio
- Surgery and Digestive Endoscopy Unit, Bambino Gesù Children's Hospital, IRCCS, Rome, Italy
| |
Collapse
|
47
|
Abstract
AIM Anal fistula is a common proctological problem to both patient and physician throughout surgical history. Several surgical and sphincter-sparing approaches have been described for the management of fistula-in-ano, aimed to minimize the recurrence and to preserve the continence. We aimed to systematically review the available studies relating to the surgical management of anal fistulas. MATERIAL AND METHODS A Medline search was performed using the PubMed, Ovid, Embase, and Cochrane databases to identify articles reporting on fistula-in-ano management, aimed to find out the current techniques available, the new technologies, and their effectiveness in order to delineate a gold standard treatment algorithm. RESULTS The management of low anal fistulas is usually straightforward, given that fistulotomy is quite effective, and if the fistula has been properly evaluated, continence disturbance is minimal. On the contrary, high complex fistulas are challenging, because cure and continence are directly competing priorities. CONCLUSIONS Conventional fistula surgery techniques have their place, but new technologies such as fibrin glues, dermal collagen injection, the anal fistula plugs, and stem cell injection offer alternative approaches whose long-term efficacy needs to be further clarified in large long-term randomized trials.
Collapse
Affiliation(s)
- F Cadeddu
- Department of Surgery, San Francesco Hospital, Via Mannironi, 08020, Nuoro, Italy,
| | | | | | | | | |
Collapse
|
48
|
Grande M, Lisi G, De Sanctis F, Grande S, Esser A, Campanelli M, Balassone V, Milito G, Villa M. Does a relationship still exist between gastroesophageal reflux and Helicobacter pylori in patients with reflux symptoms? World J Surg Oncol 2014; 12:375. [PMID: 25479911 PMCID: PMC4396562 DOI: 10.1186/1477-7819-12-375] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.7] [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: 04/08/2014] [Accepted: 11/18/2014] [Indexed: 01/06/2023] Open
Abstract
Background The nature of the relationship between Helicobacter pylori and reflux esophagitis (RE) is not fully understood. In addition, the effect of H. pylori eradication on RE and gastroesophageal reflux disease (GERD) is unclear. This study was designed to investigate the relationship between H. pylori infection and the grade of GERD in patients with reflux symptoms. Methods Between January 2010 and July 2013, 184 consecutive patients with daily reflux symptoms for at least one year were evaluated at the ambulatory for functional esophageal disease, Tor Vergata University Hospital, Rome, Italy. All patients underwent a pretreatment evaluation, which included anamnesis, clinical examination, Esophagogastroduodenoscopy (EGDS) with biopsy, esophageal manometry and 24-hour pH-metry. All statistical elaborations were obtained using Statigraphies 5 plus for Window XP. Results There was no statistical difference regarding Lower Esophageal Sphincter (LES) pressure between patients who were H. pylori-positive and H. Pylori-negative (19.2 ± 9.5 (range: 3.7 to 46.2) and 19.7 ± 11.0 (range: 2.6 to 61), respectively). Further, no significant difference was evidenced in esophageal wave length (mean value: 3.1 seconds in H. pylori-negative patients versus 3.2 seconds in H. pylori-positive patients) or in esophageal wave height (mean value: 72.2 ± 39.3 in H. pylori-negative patients versus 67.7 ± 28.4 in H. pylori-positive patients). We observed that hiatal hernia (P = 0.01), LES opening (P = 0.05), esophageal wave length (P = 0.01) and pathological reflux number (P = 0.05) were significantly related to the presence of esophagitis. However, H. pylori infection was not significantly related to the presence of reflux esophagitis. Conclusions Our clinical, endoscopic, manometric and pH-metric data shows no significant role of H. pylori infection in the development of GERD or in the pathogenesis of reflux esophagitis. However, current data do not provide sufficient evidence to define this relationship and further prospective large studies are needed.
Collapse
Affiliation(s)
- Michele Grande
- Department of Experimental Science and Surgery, Policlinico "Tor Vergata", Viale Oxford, 81, 00133, Rome, Italy. .,Department of Surgery, University Hospital Tor Vergata, Viale Oxford, 81, 00133, Rome, Italy.
| | - Giorgio Lisi
- Department of Experimental Science and Surgery, Policlinico "Tor Vergata", Viale Oxford, 81, 00133, Rome, Italy.
| | - Flavio De Sanctis
- Department of Experimental Science and Surgery, Policlinico "Tor Vergata", Viale Oxford, 81, 00133, Rome, Italy.
| | - Simona Grande
- Department of Experimental Science and Surgery, Policlinico "Tor Vergata", Viale Oxford, 81, 00133, Rome, Italy.
| | - Alessia Esser
- Department of Experimental Science and Surgery, Policlinico "Tor Vergata", Viale Oxford, 81, 00133, Rome, Italy.
| | - Michela Campanelli
- Department of Experimental Science and Surgery, Policlinico "Tor Vergata", Viale Oxford, 81, 00133, Rome, Italy.
| | - Valerio Balassone
- Department of Experimental Science and Surgery, Policlinico "Tor Vergata", Viale Oxford, 81, 00133, Rome, Italy.
| | - Giovanni Milito
- Department of Experimental Science and Surgery, Policlinico "Tor Vergata", Viale Oxford, 81, 00133, Rome, Italy.
| | - Massimo Villa
- Department of Experimental Science and Surgery, Policlinico "Tor Vergata", Viale Oxford, 81, 00133, Rome, Italy.
| |
Collapse
|
49
|
Bernazzali S, Seri L, Cameli M, Lisi G, Bombardini T, Sani G, Mondillo S, Maccherini M. Marginal Donors: Improvement in Quality of Hearts Transplanted and Mid-Term Survival By Echo-Stress Evaluation. J Heart Lung Transplant 2014. [DOI: 10.1016/j.healun.2014.01.435] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
|
50
|
Cameli M, Bernazzali S, Lisi M, Tsioulpas C, Croccia MG, Lisi G, Maccherini M, Mondillo S. Right ventricular longitudinal strain and right ventricular stroke work index in patients with severe heart failure: left ventricular assist device suitability for transplant candidates. Transplant Proc 2013; 44:2013-5. [PMID: 22974895 DOI: 10.1016/j.transproceed.2012.06.018] [Citation(s) in RCA: 40] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
BACKGROUND Right ventricular (RV) systolic function has a critical role in determining the clinical outcome and the success of using left ventricular assist devices in patients with refractory heart failure. RV deformation analysis by speckle tracking echocardiography (STE) has recently allowed the analysis of RV longitudinal function. Using cardiac catheterization as the reference standard, this study aimed to explore the correlation between RV longitudinal function by STE and RV stroke work index (RVSWI) among patients referred for cardiac transplantation. METHODS Right heart catheterization and transthoracic echo-Doppler were simultaneously performed in 47 patients referred for cardiac transplant assessment due to refractory heart failure (ejection fraction 25.1 ± 4.5%). Thermodilution RV stroke volume and invasive pulmonary pressures were used to obtain RVSWI. RV longitudinal strain (RVLS) by STE was assessed averaging RV free-wall segments (free-wall RVLS). We also calculated. Tricuspid S' and tricuspid annular plane systolic excursion (TAPSE). RESULTS No significant correlation was observed for TAPSE on tricuspid S' with RV stroke volume (r = 0.14 and r = 0.06, respectively). A close negative correlation between free-wall RVLS and RVSWI was found (r = -0.82; P < .0001). Furthermore, free-wall RVLS showed the highest diagnostic accuracy (area under the curve of 0.90) with good sensitivity and specificity of 95% and 91%, respectively, to predict depressed RVSWI using a cutoff value less than -11.8%. CONCLUSIONS Among patients referred for heart transplantation, TAPSE and tricuspid S' did not correlate with invasively obtained RVSWI. RV longitudinal deformation analysis by STE correlated with RVSWI, providing a better estimate of RV systolic performance.
Collapse
Affiliation(s)
- M Cameli
- Department of Cardiovascular Diseases, University of Siena, Siena, Italy.
| | | | | | | | | | | | | | | |
Collapse
|