Ileocecal valve syndrome and vitamin b12 deficiency after surgery: a multicentric prospective study
AbstractPatients undergoing colon resection are often concerned about their functional outcomes after surgery. The primary aim of this prospective, multicentric study was to assess the intestinal activity and health-related quality-of-life (HRQL) after ileocecal valve removal. The secondary aim was to evaluate any vitamin B12 deficiency. The study included patients undergoing right colectomy, extended right colectomy and ileocecal resection for either neoplastic or benign disease. Selected items of GIQLI and EORTC QLQ-CR29 questionnaires were used to investigate intestinal activity and HRQL before and after surgery. Blood ...
Source: Updates in Surgery - July 9, 2020 Category: Surgery Source Type: research

New prognostic western score predicting survival after curative resection of gastric cancer
AbstractThe aim of our study was to develop a prognostic score for gastric cancer patients who underwent R0 resection with curative intent, to identify high-risk patients. Three thirty three patients curatively operated for gastric adenocarcinoma were enrolled in the study. To define our prognostic score pre-operative inflammation sieric markers such as neutrophil to lymphocytes ratio, platelet count, platelet to lymphocytes ratio, and other clinical pathological and surgical characteristics of our patients such as albumin preoperative level, CRP sieric level, hystological Lauren ’s subtype, tumor location, lymphonod...
Source: Updates in Surgery - July 8, 2020 Category: Surgery Source Type: research

Current Italian surgical resident trends regarding elective rotations abroad
(Source: Updates in Surgery)
Source: Updates in Surgery - July 8, 2020 Category: Surgery Source Type: research

Laparoscopic tubularized  gastrostomy: a valid alternative to percutaneous endoscopic gastrostomy
(Source: Updates in Surgery)
Source: Updates in Surgery - July 8, 2020 Category: Surgery Source Type: research

Enhanced recovery after surgery in colon and rectal surgery: identification of predictive variables of failure in a monocentric series including 733 patients
AbstractTo identify factors associated with early deviation and delayed discharge within an Enhanced Recovery after Surgery (ERAS) pathway. This is a retrospective review of prospectively collected data of consecutive patients who underwent laparoscopic or open colorectal surgery and managed with a standardized ERAS pathway between April 2015 and October 2018. ERAS items were assessed within 48  h after surgery. Patients with early complications were excluded. The influence of factors on length of stay was calculated by univariate and multivariate analysis. A binary logistic regression was used to model a predicting s...
Source: Updates in Surgery - July 8, 2020 Category: Surgery Source Type: research

The prognostic impact of neoadjuvant chemoradiotherapy on lymph node sampling in patients with locally advanced rectal cancer
In this study, we evaluated the effect of NACRT on lymph node retrieval and prognosis in patients with LARC. We performed an observational study of 142 patients with LARC. Although our analysis was retrospective, data were collected prospectively. Half the patients were treated with NACRT and total mesorectal excision (TME) and the other half underwent TME only. The number of lymph nodes retrieved and the number of metastatic lymph nodes were significantly reduced in the NACRT group (P >  0.001). In the univariate and multivariate analyses, only NACRT and patient age were significantly associated with redu...
Source: Updates in Surgery - July 6, 2020 Category: Surgery Source Type: research

Italian multi-society modified Delphi consensus on the definition and management of anastomotic leakage in colorectal surgery
ConclusionsThis Delphi survey identified items that expert colorectal surgeons agreed were important to be applied in the prevention, diagnosis, and management of AL. This represents the first consensus involving all relevant national scientific societies, defining important and shared concepts in the diagnosis and management of AL. (Source: Updates in Surgery)
Source: Updates in Surgery - July 1, 2020 Category: Surgery Source Type: research

Fluorescence-guided lymphadenectomy in gastric cancer: a prospective western series
ConclusionsFluorescence lymphography –guided lymphadenectomy is a promising new technique that combines a high feasibility rate with considerable ease of use. Regarding its diagnostic value, the key finding from this prospective series is that no metastatic nodes were found outside fluorescent lymph node stations. Further studies are needed to investigate whether this technique can help surgeons performing standard lymphadenectomy and selecting cases for D2 + lymphadenectomy. (Source: Updates in Surgery)
Source: Updates in Surgery - June 30, 2020 Category: Surgery Source Type: research

Implementation of intracorporeal anastomosis in laparoscopic right colectomy is safe and associated with a shorter hospital stay
This study aims to assess the safety of implementing IA in LRC, and to compare its perioperative outcomes with EA during an institution ’s learning curve. Patients undergoing elective LRC with IA or EA in a teaching university hospital between January 2015 and December 2018 were included. Demographic, clinical, perioperative and histopathological data were collated and outcomes investigated. One hundred and twenty-two patients wer e included; forty-three (35.2%) had an IA. The main indication for surgery was cancer in both groups (83.7% for IA and 79.8% for EA;p = 0.50). Operative time was longer for IA...
Source: Updates in Surgery - June 30, 2020 Category: Surgery Source Type: research

Contralateral internal iliac artery transposition for retroperitoneal sarcoma involving common iliac artery
AbstractComplete resection for retroperitoneal sarcoma (RPS) involving major vessels frequently requires vascular resection and reconstruction. The use of artificial grafts often leads to postoperative vascular graft infection (VGI), which usually requires reoperation and sometimes leads to death. In the present study, the data of RPS patients who underwent contralateral iliac artery (IIA) transposition for reconstruction of the common iliac artery (CIA) after RPS resection from 2015 –2019 were retrospectively analyzed. Clinical, intraoperative, and postoperative outcomes were described. Contralateral IIA transpositi...
Source: Updates in Surgery - June 29, 2020 Category: Surgery Source Type: research

Clinical findings of patients with pseudomyxoma peritonei of appendiceal origin undergoing Cytoreductive surgery (CRS) and hyperthermic intraperitoneal chemotherapy (HIPEC)
(Source: Updates in Surgery)
Source: Updates in Surgery - June 29, 2020 Category: Surgery Source Type: research

Dynamic transperineal ultrasonography correlates with prolonged pudendal nerve latency in female with fecal incontinence
AbstractThe pelvic floor is a complex anatomical entity and its neuromuscular assessment is evaluated through debated neurophysiological tests. An innovative approach is the study of pelvic floor through dynamic transperineal ultrasound (DTU). The aim of this study is to evaluate DTU sensitivity in recognizing patients with fecal incontinence and to evaluate its concordance with the results of the motor latency studied via pudendal nerve terminal motor latency (PNTML). Female patients affected by FI addressed to our center of coloproctology were prospectively assessed. After a coloproctological evaluation, comprising the P...
Source: Updates in Surgery - June 28, 2020 Category: Surgery Source Type: research

Infrarenal versus supraceliac aorto-hepatic arterial revascularisation in adult liver transplantation: multicentre retrospective study
AbstractWhen the standard arterial reconstruction is not feasible during liver transplantation (LT), aorto-hepatic arterial reconstruction (AHAR) can be the only solution to save the graft. AHAR can be performed on the infrarenal (IR) or supraceliac (SC) tract of the aorta, but the possible effect on outcome of selecting SC versus IR reconstruction is still unclear. One hundred and twenty consecutive patients who underwent liver transplantation with AHAR in six European centres between January 2003 and December 2018 were retrospectively analysed to ascertain whether the incidence of hepatic artery thrombosis (HAT) was infl...
Source: Updates in Surgery - June 27, 2020 Category: Surgery Source Type: research

I-ACTSS-COVID-19 —the Italian acute care and trauma surgery survey for COVID-19 pandemic outbreak
AbstractThe sudden COVID-19 outbreak in Italy has challenged our health systems and doctors faced the challenge of treating a large number of critically ill patients in a short time interval. Acute care surgeons, although not directly involved in treating COVID-19  + patients, have often modified their daily activity to help in this crisis. We have designed the first Italian survey on the effect of COVID-19 outbreak on Acute Care Surgery activity and submitted it to emergency surgeons in all the country to evaluate the experiences, trends, attitudes and p ossible educational outcomes that this emergency broug...
Source: Updates in Surgery - June 24, 2020 Category: Surgery Source Type: research

Clinical evaluation of the Mannheim Prognostic Index in post-operative peritonitis: a prospective cohort study
AbstractPostoperative peritonitis (PoP), despite their relatively low incidence, are associated with high mortality. Such poor outcomes are also related to the high proportion of aged patients, whose intra-abdominal infections are difficult to manage. The study included 84 consecutive patients with PoP. The aim was the validation of the Mannheim Prognostic Index (MPI) in the context of PoP and the assessment of the prognostic impact of age and other clinical factors in a large series from a tertiary center. PoP had an incidence of 3.9% in all the abdominal surgeries in the study period. Surgical control of POP focus was ac...
Source: Updates in Surgery - June 23, 2020 Category: Surgery Source Type: research

The bridge stenting-based internal drainage in pancreatic trauma patients with main pancreatic duct injury
AbstractPancreatic trauma is associated with high mortality and morbidity, especially in main pancreatic duct (MPD) injuries. Here, we introduce a novel technique via the placement of bridge stenting-based internal drainage (BSID) along the injured MPD to restore pancreatic tissue integrity. Twelve patients with MPD injury underwent unobstructed BSID as physical support for healing. Six patients with peripheral organ injuries underwent operative end-to-end anastomosis of the MPD by using a polyurethane central venous catheter for the BSID, and the other six patients with isolated proximal MPD rupture received BSID via endo...
Source: Updates in Surgery - June 22, 2020 Category: Surgery Source Type: research

The impact of COVID-19 pandemic on surgical residency programmes in Italy: a nationwide analysis on behalf of the Italian Polyspecialistic Young Surgeons Society (SPIGC)
AbstractIntroductionRecently, Italy has been heavily hit by COVID-19 pandemic and today it is still one of the most affected countries in the world. The subsequent necessary lockdown decreed by the Italian Government had an outstanding impact on the daily life of the entire population, including that of Italian surgical residents ’ activity. Our survey aims to evaluate the impact of COVID-19 on the training programme of Italian surgical residents.Materials and methodsWe designed a 12-item-electronic anonymous questionnaire on SurveyMonkey © web application. The survey was composed of different sections concernin...
Source: Updates in Surgery - June 16, 2020 Category: Surgery Source Type: research

Shifting from donor to donor-recipient matching perspective in defining indications for machine perfusion in liver transplantation
We present a case of a liver transplant performed in an extremely sick patient suffering from HBV-related fulminant hepatitis, in which a compatible graft from a 76-year-old deceased donor became available only after 3  days of waiting time, during which his conditions further deteriorated. Given the suboptimal matching, normothermic machine perfusion was applied to minimize ischemia-reperfusion injury. Use of machine perfusion could find an indication to modulate the risk associated with an unfavorable donor-rec ipient matching in high-risk cases. (Source: Updates in Surgery)
Source: Updates in Surgery - June 15, 2020 Category: Surgery Source Type: research

Impact of COVID-19 on thyroid cancer surgery and adjunct therapy
AbstractCOVID-19 has profoundly modified the way healthcare is delivered. Jordan imposed lockdown and restrictive policies between March 17 and May 20, 2020. We aimed to assess the impact of such measures on thyroid cancer treatment plans. In the specified period, 12 patients were scheduled for surgery. Since papillary carcinoma was the preoperative diagnosis in all cases, radioactive iodine ablation (RIA) therapy was also planned 3 –4 weeks following surgery after withdrawing thyroxine and achieving a thyroid stimulating hormone (TSH) level >  30 mU/L. Thyroxine withdrawal is the routine m...
Source: Updates in Surgery - June 14, 2020 Category: Surgery Source Type: research

Is it still reasonable to raise doubts on ICG-fluorescence cholangiography during laparoscopic cholecystectomy?
(Source: Updates in Surgery)
Source: Updates in Surgery - June 14, 2020 Category: Surgery Source Type: research

Feasibility of enhanced recovery after surgery program in colorectal surgery during COVID-19 pandemic in Italy: should we change something?
(Source: Updates in Surgery)
Source: Updates in Surgery - June 13, 2020 Category: Surgery Source Type: research

Gut microbiota and colorectal surgery
(Source: Updates in Surgery)
Source: Updates in Surgery - June 10, 2020 Category: Surgery Source Type: research

Telephone-based postoperative surveillance protocol for hepatobiliary cancer during the COVID-19 outbreak
(Source: Updates in Surgery)
Source: Updates in Surgery - June 10, 2020 Category: Surgery Source Type: research

Laparoscopy improves failure to rescue compared to open surgery for emergent colectomy
AbstractEmergent colectomy is performed in thousands of Americans each year and carries significant morbidity and mortality. Although laparoscopy has gained favor in the elective setting, its impact on failure to rescue has not been studied on a population level for emergent colectomy. The purpose of this study was to compare failure to rescue following laparoscopic versus open colectomy in the emergency setting. This was a retrospective cohort study of The American College of Surgeons National Surgical Quality Improvement Program. Adult patients undergoing emergent colectomy between 2005 and 2018 were selected and stratif...
Source: Updates in Surgery - June 9, 2020 Category: Surgery Source Type: research

Bariatric surgery and the COVID-19 pandemic: SICOB recommendations on how to perform surgery during the outbreak and when to resume the activities in phase 2 of lockdown
AbstractThe severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) and its related disease, coronavirus disease 2019 (COVID-19), has been rapidly spreading all over the world and is responsible for the current pandemic. The current pandemic has found the Italian national health system unprepared to provide an appropriate and prompt response, heavily affecting surgical activities. Based on the limited data available in the literature and personal experiences, the Societ à Italiana di Chirurgia dell’OBesità e Malattie Metaboliche (SICOB) provides recommendations regarding the triage of bariatric sur...
Source: Updates in Surgery - June 8, 2020 Category: Surgery Source Type: research

Intrauterine infusion of platelet-rich plasma for severe Asherman syndrome: a cutting-edge approach
We report a case of AS with adhesion recurrence and endometrial atrophy who was successfully treated with intrauterine autologous platelet –rich plasma (PRP) infusion. This therapy allowed endometrial tissue regeneration, leading to increased vascularity and endometrium thickness, and restoration of endometrial function that led to a successful pregnancy. Though there is limited experience supporting the use of PRP to improve endomet rial function, it has been safely used in other fields of medicine; besides, it is easy to obtain, not expensive, and harmless being an autologous source. Future studies are encouraged t...
Source: Updates in Surgery - June 8, 2020 Category: Surgery Source Type: research

Side-to-side duodenojejunostomy after resection of third and fourth duodenal portions with pancreatic preservation
AbstractInfra-ampullary duodenal lesions are rare and surgical management is controversial. Reconstruction after resection is usually performed by end-to-end or end-to-side duodenojejunostomy. The goal was to analyze our experience, perioperative management, and results after side-to-side duodenojejunostomy. Therefore, we retrospectively evaluated short- and long-term results of surgical resections of third and fourth duodenal portions for several kinds of lesions and reconstruction through duodenojejunostomy performed in our facilities between January 2012 and December 2018. In total, 12 patients were selected for our stu...
Source: Updates in Surgery - June 5, 2020 Category: Surgery Source Type: research

Clinical implications of COVID-19 in patients with chronic liver disease and liver tumor
(Source: Updates in Surgery)
Source: Updates in Surgery - June 5, 2020 Category: Surgery Source Type: research

Continuing our work: transplant surgery and surgical oncology in a tertiary referral COVID-19 center
AbstractCOVID-19 is rapidly spreading worldwide. Healthcare systems are struggling to properly allocate resources while ensuring cure for diseases outside of the infection. The aim of this study was to demonstrate how surgical activity was affected by the virus outbreak and show the changes in practice in a tertiary referral COVID-19 center. The official bulletins of the Italian National Institute for the Infectious Diseases “L. Spallanzani” were reviewed to retrieve the number of daily COVID-19 patients. Records of consecutive oncological and transplant procedures performed during the outbreak were reviewed. P...
Source: Updates in Surgery - June 4, 2020 Category: Surgery Source Type: research

Distal pancreatectomy with en bloc celiac axis resection for pancreatic cancer: a pooled analysis of 109 cases
In conclusion, DP-CAR for locally advanced pancreatic body/tail cancer can be performed safely with low mortality and provides survi val benefit when combined with neoadjuvant treatment. (Source: Updates in Surgery)
Source: Updates in Surgery - June 3, 2020 Category: Surgery Source Type: research

Resuming elective surgery in the time of COVID-19: a safe and comprehensive strategy
This article provides an overview on how to safely deliver essential surgical care in the time of COIVD-19. (Source: Updates in Surgery)
Source: Updates in Surgery - June 3, 2020 Category: Surgery Source Type: research

The role of bursectomy in the surgical management of gastric cancer: a meta-analysis and systematic review
AbstractIn order to delineate the exact role of bursectomy (BS) in gastric cancer surgery, we designed and conducted the present meta-analysis. This meta-analysis adhered to the PRISMA guidelines and the Cochrane Handbook for Systematic Reviews of Interventions. A systematic literature review of the electronic databases (Medline, Scopus, Web of Science) was performed. Trial sequential analysis (TSA) was introduced for the validation of the pooled analyses. The level of evidence was attributed based on the GRADE approach. Overall, nine studies and 3599 patients were included in our meta-analysis. BS did not lead to an incre...
Source: Updates in Surgery - June 3, 2020 Category: Surgery Source Type: research

Feasibility and safety of an enhanced recovery protocol (ERP) for upper GI surgery in elderly patients ( ≥ 75 years) in a high-volume surgical center
AbstractEnhanced recovery protocols (ERP) have demonstrated their efficacy after esophagectomy and gastrectomy but little is known about their feasibility and safety in elderly patients. Patients submitted to Ivor-Lewis esophagectomy or gastrectomy for cancer between January 2016 and June 2019 were divided into three age groups: young-age group, YG ( ≤ 65 years,n = 130); middle-age group, MG (66–74 years,n = 101); old-age group, OG (≥ 75 years,n = 74). The groups were compared for adherence to our ERP, morbidity and mortality rates. After es...
Source: Updates in Surgery - June 2, 2020 Category: Surgery Source Type: research

How to obtain a 3D printed model of renal cell carcinoma (RCC) with venous tumor thrombus extension (VTE) for surgical simulation (phase I NCT03738488)
The objective of this phase is to obtain a 3D printed model of RCC with VTE that is feasible, accurate, reproducible, suitable for surgical simulation, and affordable. A specific protocol was developed to obtain the computed tomography (CT) image: early arterial and nephrogenic phase. ITK-snap® and VirSSPA Software® were used to segment the areas of interest. The resulting 3D mesh was processed with MeshMixer® and Cura®. Ten models from seven different cases were segmented and printed using different 3D printers and materials. We evaluated the material, scale, wall thickness, anatomy printed, 3D conformatio...
Source: Updates in Surgery - June 1, 2020 Category: Surgery Source Type: research

A systematic review on the cost evaluation of two different laparoscopic surgical techniques among 996 appendectomies from a single center
AbstractAcute appendicitis is one of the main indications for urgent surgery representing a high-volume procedure worldwide. The current spending review in Italy (and not only in this country) affects the health service and warrants care regarding the use of different surgical devices. The aim of our study is to perform a cost evaluation, comparing the use of endoloops and staplers in complicated acute appendicitis (phlegmonous and gangrenous), taking into consideration the cost of the device in relation to the management of any associated postoperative complications. We retrospectively evaluated 996 laparoscopic appendect...
Source: Updates in Surgery - May 30, 2020 Category: Surgery Source Type: research

Foreword
(Source: Updates in Surgery)
Source: Updates in Surgery - May 30, 2020 Category: Surgery Source Type: research

The robotic single-port platform for gynecologic surgery: a systematic review of the literature and meta-analysis
AbstractSince the first robotic single-site hysterectomy was performed, the research focused on the use of robotic single-site surgery (RSSS) for all gynecological conditions. This review aims to examine the studies available in the literature on RSSS in gynecology both for benign and malignant indications. The systematic review was carried out in agreement with the preferred reporting items for systematic reviews and meta-analyses statement (PRISMA). All the articles were grouped into three sets based on the surgical indication (Group 1, 2, and 3 for benign, malignant, and mixed diseases, respectively). Two hundred and fi...
Source: Updates in Surgery - May 29, 2020 Category: Surgery Source Type: research

Laparoscopic versus open complete mesocolic excision: a systematic review by updated meta-analysis
AbstractRecent evidence has proven the non-inferiority of laparoscopic complete mesocolic excision (LCME) to open complete mesocolic excision (OCME) with regard to feasibility and oncological safety. However, the differences in survival benefits between the 2 procedures have not been assessed. The aim of this study was to evaluate whether or not one procedure was superior to the other using updated meta-analysis. A systematic search for relevant literature was performed in Pubmed, Embase, Cochrane library and Google scholar databases. This meta-analysis included retrospective studies and one randomised controlled trial com...
Source: Updates in Surgery - May 29, 2020 Category: Surgery Source Type: research

Perspectives from Italy during the COVID-19 pandemic: nationwide survey-based focus on minimally invasive HPB surgery
AbstractThe safety of minimally invasive procedures during COVID pandemic remains hotly debated, especially in a country, like Italy, where minimally invasive techniques have progressively and pervasively entered clinical practice, in both the hepatobiliary and pancreatic community. A nationwide snapshot of the management of HPB minimally invasive surgery activity during COVID-19 pandemic is provided: a survey was developed and conducted within AICEP (Italian Association of HepatoBilioPancreatic Surgeons) with the final aim of conveying the experience, knowledge, and opinions into a unitary report enabling more efficient c...
Source: Updates in Surgery - May 29, 2020 Category: Surgery Source Type: research

The Italian National Registry for minimally invasive pancreatic surgery: an initiative of the Italian Group of Minimally Invasive Pancreas Surgery (IGoMIPS)
AbstractThe value of minimally invasive pancreatic surgery (MIPS) is still uncertain, despite the growing number of publications, including reviews and meta-analyses, and the quick diffusion of these procedures worldwide. The Italian Group of Minimally Invasive Pancreas Surgery (IGoMIPS) was created under the auspices of three Scientific Societies: Associazione Italiana Studio Pancreas (AISP), Associazione Italiana Chirurgia Epato-Bilio-Pancreatica (AICEP, former IT-IHPBA), and Societ à Italiana di Chirurgia Endoscopica (SICE). The main aim of IGoMIPS is to develop and implement a national registry for MIPS. IGoMIPS...
Source: Updates in Surgery - May 29, 2020 Category: Surgery Source Type: research

MRI of mucinous pancreatic cystic lesions: a new updated morphological approach for the differential diagnosis
AbstractPancreatic cystic lesions (PCLs) have been increasingly identified over the past 2  decades due to the widespread use of high-resolution non-invasive abdominal imaging. They cover a vast spectrum, from benign to malignant and invasive lesions, thus they constitute a significant clinical entity. Among PCLs, mucin-producing lesions are those at risk of progression to malignancy. Th ey include mucinous cystic neoplasms (MCN) and intraductal papillary mucinous neoplasms (IPMN). The diagnosis and management of these cystic lesions are a dilemma since there is a significant overlap in the morphology of benign and pr...
Source: Updates in Surgery - May 27, 2020 Category: Surgery Source Type: research

The fight against COVID-19: disinfection protocol and turning over of CleanSpace ® HALO™ in a Singapore Hospital
(Source: Updates in Surgery)
Source: Updates in Surgery - May 27, 2020 Category: Surgery Source Type: research

Gangrenous cholecystitis during hospitalization for SARS-CoV2 infection
(Source: Updates in Surgery)
Source: Updates in Surgery - May 26, 2020 Category: Surgery Source Type: research

The rise of one anastomosis gastric bypass: insights from surgeons and dietitians
AbstractOne anastomosis gastric bypass/Mini Gastric Bypass (OAGB/MGB) is an emerging bariatric surgery (BS) technique. We evaluated and compared attitudes of bariatric surgeons and dietitians towards the considerations for choosing BS-type ( “Decision-making”), the contributing factors to the rise of OAGB/MGB in Israel (“OAGB/MGB-rise”) and notions regarding the occurrence of gastrointestinal (GI) symptoms and nutritional deficiencies following OAGB/MGB. Anonymous online surveys were distributed. The participants were asked to r ate by a 10-point Likert scale (0 = not at all; 100&thins...
Source: Updates in Surgery - May 25, 2020 Category: Surgery Source Type: research

Prevention of the “slippage” effect in right hemicolectomy
(Source: Updates in Surgery)
Source: Updates in Surgery - May 25, 2020 Category: Surgery Source Type: research

Evolution and time trends of nipple-sparing mastectomy: a single-center experience
AbstractNipple Sparing Mastectomy (NSM) requires the entire breast tissue to be removed, maintaining the nipple-areola complex, and represents nowadays the gold standard of the demolitive breast surgery. Although it represents the evolution of conservative breast surgery, NSM presents some limitations in the selection of women candidates for treatment, and still there are no real guidelines regarding its indications, but simply objective data to address the choice. How the breast surgery approach to demolitive and conservative surgery has changed over time? We evaluated throughout the years (from 2009 up to 2018) the time ...
Source: Updates in Surgery - May 24, 2020 Category: Surgery Source Type: research

Use of machine perfusion in livers showing steatosis prior to transplantation: a systematic review
The objective of the current study was to provide a systematic review to evaluate the role of MP in the setting of MaS livers.MethodsA systematic review, according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines was performed. Eligible articles published up to April 2019 were included using the MEDLINE, Scopus, and Google Scholar databases.ResultsAmong the 422 articles screened, only 16 papers met the inclusion criteria. A total of 54 cases of MP use before liver transplantation were included. Sixteen (29.6%) grafts were from donors after circulatory death. In 22 (40.7%) cases,...
Source: Updates in Surgery - May 24, 2020 Category: Surgery Source Type: research

Post surgical rectovaginal fistula: who really benefits from stoma diversion?
AbstractTo analyze the role of stoma diversion and timing of stoma maintenance in the healing of post-surgical Recto Vaginal Fistulae (psRVF). A retrospective analysis of a prospectively maintained registry. All patients with a psRVF diagnosed at IRCCS Sacro Cuore —Don Calabria Hospital of Negrar di Valpolicella from January 2002 to December 2016 were analyzed. The baseline treatment was a fecal diversion. Patients were divided into two groups according to healing time:   6 months (Group 2). 2043 women underwent rectal resections in the study period. We recorded 37 patients with psRVF (1.8%). Ninet...
Source: Updates in Surgery - May 24, 2020 Category: Surgery Source Type: research

Preventing transmission among operating room staff during COVID-19 pandemic: the role of the Aerosol Box and other personal protective equipment
AbstractThe COVID-19 pandemic is highly challenging for the operating room staff and healthcare workers in emergency departments. SARS-CoV-2 is a positive-sense single-stranded RNA beta-coronavirus that primarily targets the human respiratory system, with fever, cough, myalgia, and pneumonia as the most common manifestations. However, since SARS-CoV-2 RNA was detected in stool specimens much more attention has been paid to gastrointestinal symptoms such as loss of appetite, nausea, and diarrhea. Furthermore, the expression of ACE-2 receptors in absorptive enterocytes from ileum and colon suggests that these organs should a...
Source: Updates in Surgery - May 24, 2020 Category: Surgery Source Type: research

Is the outcome after hepatectomy for transitional hepatocholangiocarcinoma different from that of hepatocellular carcinoma and mass-forming cholangiocarcinoma? A case-matched analysis
AbstractHepatocholangiocarcinoma (HCC-CC) is a rare malignancy containing features of both hepatocellular carcinoma (HCC) and mass-forming cholangiocarcinoma (MFCCC), of which the outcome after hepatectomy remains to be clarified. The aim of this study was to analyze the characteristics and outcomes of patients with transitional HCC-CC and compare them with those of patients with HCC and MFCCC. Our prospectively maintained database was queried, and 14 transitional HCC-CC patients were identified over a total of 406 consecutive hepatic resections. A 1:1:1 match was performed with HCC and MFCCC patients operated in the same ...
Source: Updates in Surgery - May 22, 2020 Category: Surgery Source Type: research