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1. The Intraoperative Complications Assessment and Reporting with Universal Standards (ICARUS) Global Surgical Collaboration Project: Development of Criteria for Reporting Adverse Events During Surgical Procedures and Evaluating Their Impact on the Postoperative Course

Author

Cacciamani, G.E. Sholklapper, T. Dell'Oglio, P. Rocco, B. Annino, F. Antonelli, A. Amenta, M. Borghesi, M. Bove, P. Bozzini, G. Cafarelli, A. Celia, A. Leonardo, C. Ceruti, C. Cindolo, L. Crivellaro, S. Dalpiaz, O. Falabella, R. Falsaperla, M. Galfano, A. Gallo, F. Greco, F. Minervini, A. Parma, P. Chiara Sighinolfi, M. Pastore, A.L. Pini, G. Porreca, A. Pucci, L. Sciorio, C. Schiavina, R. Umari, P. Varca, V. Veneziano, D. Verze, P. Volpe, A. Zaramella, S. Lebastchi, A. Abreu, A. Mitropoulos, D. Shekhar Biyani, C. Sotelo, R. Desai, M. Artibani, W. Gill, I. ICARUS Global Surgical Collaboration Working Group

Abstract

Background: Intraoperative adverse events (iAEs) are surgical and anesthesiologic complications. Despite the availability of grading criteria, iAEs are infrequently reported in the surgical literature and in cases for which iAEs are reported, these events are described with significant heterogeneity. Objective: To develop Intraoperative Complications Assessment and Reporting with Universal Standards (ICARUS) Global Surgical Collaboration criteria to standardize the assessment, reporting, and grading of iAEs. The ultimate aim is to improve our understanding of the nature and frequency of iAEs and our ability to counsel patients regarding surgical procedures. Design, setting, and participants: The present study involved the following steps: (1) collecting criteria for assessing, reporting, and grading of iAEs via a comprehensive umbrella review; (2) collecting additional criteria via a survey of a panel of experienced surgeons (first round of a modified Delphi survey); (3) creating a comprehensive list of reporting criteria; (4) combining criteria acquired in the first two steps; and (5) establishing a consensus on clinical and quality assessment utility as determined in the second round of the Delphi survey. Outcome measurements and statistical analysis: Panel inter-rater agreement and consistency were assessed as the overall percentage agreement and Cronbach's α. Results and limitations: The umbrella review led to nine common criteria for assessing, grading, and reporting iAEs, and review of iAE grading systems led to two additional criteria. In the first Delphi round, 35 surgeons responded and two criteria were added. In the second Delphi round, 13 common criteria met the threshold for final guideline inclusion. All 13 criteria achieved the consensus minimum of 70%, with agreement on the usefulness of the criteria for clinical and quality improvement ranging from 74% to 100%. The mean inter-rater agreement was 89.0% for clinical improvement and 88.6% for quality improvement. Conclusions: The ICARUS Global Collaboration criteria might aid in identifying important criteria when reporting iAEs, which will support all those involved in patient care and scientific publishing. Patient summary: We consulted a panel of experienced surgeons to develop a set of guidelines for academic surgeons to follow when publishing surgical studies. The surgeon panel proposed a list of 13 criteria that may improve global understanding of complications during specific procedures and thus improve the ability to counsel patients on surgical risk. © 2022 European Association of Urology

Published
2022

2. Minimally Invasive Pyelolithotomy: Comparison of Robot-assisted and Laparoscopic Techniques

Author

Corsi, P., Daniele D'AGOSTINO, Giampaoli, M., Bianchi, F. M., Romagnoli, D., Crivellaro, S., Saraceni, G., Garofalo, M., Schiavina, R., Brunocilla, E., Artibani, W., Porreca, A., and Corsi P, Daniele D'Agostino D, Giampaoli M, Bianchi FM, Romagnoli D, Crivellaro S, Saraceni G, Garofalo M, Schiavina R, Brunocilla E, Artibani W, Porreca A

Subjects
Kidney Calculi, Treatment Outcome, Robotic Surgical Procedures, Humans, Minimally Invasive Surgical Procedures, Urologic Surgical Procedures, Pyelolithotomy, Comparison, Robot-assisted, Laparoscopic, Laparoscopy, Retrospective Studies
Abstract

OBJECTIVES: To compare the perioperative and short-term outcomes of robotic pyelolithotomy (RP) and laparoscopic pyelolithotomy (LP) for the treatment of renal stones. MATERIALS AND METHODS: We retrospectively evaluated 39 patients who underwent robotic or laparoscopic pyelolithotomy from January 2015 to December 2018. RESULTS: The preoperative characteristics of the two groups were comparable. The mean operative time was 173 ± 51 and 182 ± 62 min in the RP and LP groups, respectively (p=0.6). Blood loss and length of hospital stay with the robotic approach were lower than those with the laparoscopic approach (210 ± 180 ml vs. 639 ± 412 ml, p

Published
2019

3. CHIRURGIA MININVASIVA PER IL TRATTAMENTO DELLA LITIASI DELL’ALTA VIA ESCRETRICE: RISULTATI PRELIMINARI DI CONFRONTO TRA TECNICA ROBOT-ASSISTITA E LAPAROSCOPICA

Author

Savini, A., Salvaggio, A., Cappa, E., Dente, D., D'Agostino, D., Zuccalà, A., Crivellaro, S., SARACENI, GIACOMO, D'ANDREA, MARIA STELLA, BIANCHI, LORENZO, VAGNONI, VALERIO, SCHIAVINA, RICCARDO, BORGHESI, MARCO, MAHMOUD GHANEM, SADAM, GIAMPAOLI, MARCO, MANFERRARI, FABIO, GAROFALO, MARCO, PORRECA, ANGELO, Savini, A., Saraceni, G., Salvaggio, A., Cappa, E., Dente, D., Dandrea, M., D'Agostino, D., Zuccalà, A., Bianchi, L., Vagnoni, V., Schiavina, R., Borghesi, M., Mahmoud Ghanem, S., Giampaoli, M., Manferrari, F., Garofalo, M., Crivellaro, S., and Porreca, A.

Subjects
CHIRURGIA MININVASIVA PER IL TRATTAMENTO DELLA LITIASI DELL’ALTA VIA ESCRETRICE: RISULTATI PRELIMINARI DI CONFRONTO TRA TECNICA ROBOT-ASSISTITA E LAPAROSCOPICA
Published
2016

4. I PAZIENTI CON COMPLICANZE PERIOPERATORIE PRESENTANO UN PIÙ ALTO RISCHIO DI MORTALITÀ CANCRO SPECIFICA DOPO CISTECTOMIA RADICALE: DUE ANNI DI STUDIO MULTICENTRICO ITALIANO

Author

De Nunzio, C., Cindolo, L., Simone, G., Antonelli, Alberto, Alvarez Maestro, M., Bove, P., Celia, A., Ceruti, C., Crivellaro, S., Falsaperla, M., Frea, B., Gallucci, M., Lo Trecchiano, G., Presicce, F., Leonardo, C., Minervini, Andrea, Porreca, A., Rocco, B., Serni, Sergio, Schips, L., Simeone, Felice Carlo, Zaramella, S., and Tubaro, A.

Subjects
COMPLICANZE PERIOPERATORIE, RISCHIO DI MORTALITÀ, CISTECTOMIA RADICALE
Published
2016

5. Multicenter analysis of pathological outcomes of patients eligible for active surveillance according to PRIAS criteria

Author

Grasso, A. A., Cozzi, G., De Lorenzis, E., Ceruti, C., Crivellaro, S., Falsaperla, M., Minervini, A., Masieri, L., Serni, S., Porreca, A., Zaramella, S., and Rocco, Bernardo Maria Cesare

Subjects
Male, Prostatectomy, Treatment Outcome, prias criteria, Multicenter analysis , active surveillance, Biopsy, Humans, Prostatic Neoplasms, Prostatic neoplasms, Watchful waiting, Middle Aged, Neoplasm Grading, Watchful Waiting, Aged, Retrospective Studies
Abstract

The aim of this study was to retrospectively analyze the pathological outcomes of patients meeting the Prostate Cancer Research International Active Surveillance (PRIAS) criteria who had undergone radical prostatectomy (RP).Out of 2014 patients recruited for minimally invasive RP between 2008 and 2014 in 7 centers, 226 (11.2%) met the modified PRIAS criteria (clinical stage T1c/T2, PSA10 ng/mL, 1-2 positive biopsy cores and Gleason Score6).At pathological evaluation, Gleason Score upgrade was reported in 47.3% of patients; 74 (32.7%), 10 (4.4%), 9 (3.9%) patients showed RP Gleason sum 7, 8 and 9, respectively. Upstaging was reported in 135 patients (59.7%). Twelve (5.3%) and 4 (1.7%) patients had T3a and T3b pathological stage respectively.Notwithstanding the PRIAS criteria can identify some PCa patients as low-risk, at pathological evaluation some of them harbored intermediate- or high-risk disease. According to our data, patients eligible for AS should be carefully counseled about possible disease understaging.

Published
2016

6. Batson's Paravertebral Venous Plexus and Single Vertebral Metastases from Renal cell Carcinoma

Author

Tosco L, Anna Palazzetti, Crivellaro S, Guaitoli P, Abbinante M, and Frea B

Subjects
Male, Indoles, Adrenal Gland Neoplasms, 030232 urology & nephrology, Nephrectomy, Veins, Sciatica, 03 medical and health sciences, 0302 clinical medicine, Sunitinib, Humans, Pyrroles, Carcinoma, Renal Cell, Psoas Muscles, Lumbar Vertebrae, Spinal Neoplasms, General Medicine, Middle Aged, Decompression, Surgical, Neoplastic Cells, Circulating, Magnetic Resonance Imaging, Kidney Neoplasms, Radiography, Chemotherapy, Adjuvant, 030220 oncology & carcinogenesis, Radiotherapy, Adjuvant, Interferons, Low Back Pain
Abstract

Objectives The presence of a single site bone metastasis in patients with renal cell carcinoma (RCC) is a rare clinical event. We report a single case of RCC with solitary vertebral metastasis and review of literature about renal tumor spreading in order to understand the anatomic explanation for this peculiar clinical case. Methods We have considered the single case and reviewed current and past literature to describe the anatomic and functional background of this clinical situation. Results There are rare cases of single vertebral metastasis from RCC and these are characterized from a contemporary neoplastic thrombus. The neoplastic thrombus could justify the tumoral back-flow into the paravertebral anasthomoses and so into vertebral venous sinusoids. The rich anasthomotic system that surrounds kidneys and the experimental evidence of anasthomotic links among perirenal Lejars venous system and paravertebral Batson's venous system could explain these clinical evidences. Conclusion Enrolment of para-vertebral Batson's venous system could have a major role in the RCC vertebral metastatic diffusion.

Published
2010

11. Margini chirurgici positivi dopo prostatectomia radicale mini-invasiva: studio multicentrico [Positive surgical margin status after minimally invasive radical prostatectomy: a multicenter study]

Author

Tafa, A., Grasso, A., Antonelli, A., Bove, P., Celia, A., Ceruti, C., Crivellaro, S., Falsaperla, M., Minervini, A., Parma, P., Porreca, A., Zaramella, S., De Lorenzis, E., Cozzi, G., and Rocco, Bernardo Maria Cesare

Subjects
Prostate cancer, Minimally invasive surgery, Laparoscopy, Positive margins, Robotic prostatectomy
Published
2015

12. Systematic review of surgical treatment of post radical prostatectomy stress urinary incontinence

Author

Crivellaro S, Morlacco A, Bodo G, Ef, Agro, Gozzi C, Pistolesi D, Giulio Del Popolo, and Ficarra V

Subjects
Male, Prostatectomy, Incontinence, Urologic Surgical Procedures, Male, Urinary Incontinence, Stress, Urology, Device, Radical prostatectomy, Neurology (clinical), Settore MED/24 - Urologia, Postoperative Complications, Treatment Outcome, Humans, device, incontinence, radical prostatectomy
Abstract

Context Stress urinary incontinence (SUI) after radical prostatectomy (RP) continues to be a significant problem with several implications including patient quality of life and other critical postoperative outcomes. Objectives To report the results in terms of efficacy (pad count, 24 hr pad test, QOL questionnaires) and safety (complication rate and type of complications) of all surgical devices approved for the treatment of SUI after RP. Evidence Acquisition A systematic review was conducted in accordance with the PRISMA Statement. A literature search was carried out through the PubMed/Medline, SCOPUS, and Web of Science databases using the keywords "incontinence," "radical prostatectomy," and "'treatment". Inclusion criteria were: number of patients higher than 30, mean follow up longer than 12 months and definition of a successful outcome as the use of 0 to 1 safety pads a day. Evidence Synthesis 113 papers underwent primary review. 51 papers met the inclusion criteria with a total sample size of 4022 patients. Efficacy (0-1 safety pads) was on average 65.7% for AUS, 48.2% for Invance Sling, 48.8% for Advance Sling, 64.2% for ProACT. Twenty four hour pad test and QOL questionnaires were respectively available only in 4 and 18 studies. The overall complication rate was 19.43% for AUS, 7.4% for Invance Sling, 12.3% for Advance Sling, 12.3% for ProACT. Authors' Conclusions Due to the poor overall quality of available studies, it was impossible to identify or refute clinically important differences between the alternative surgical procedures. Although our data seems to suggest that AUS has the highest efficacy in the treatment of SUI following RP it is also associated with the highest complication rate, but this may be due to the longest follow up. Larger rigorous trials are needed in order to support this evidence. Neurourol. Urodynam. 35:875-881, 2016. © 2015 Wiley Periodicals, Inc.

Published
2015

14. Prostate Biopsy after Abdominoperineal Resection: A Diagnostic Challenge

Author

Morlacco, A., Bierti, S., Abbinante, M., Frea, B., and Crivellaro, S.

Subjects
Aged, 80 and over, Image-Guided Biopsy, Male, Interventional, Biopsy, Biopsy, Needle, Prostate, Rectum, Prostatic Neoplasms, Neoplasms, Second Primary, General Medicine, Adenocarcinoma, Middle Aged, Perineum, Second Primary, Neoplasms, Abdomen, Colorectal Neoplasms, Humans, Ultrasonography, Interventional, 80 and over, Needle, Aged, Ultrasonography
Abstract

Prostate biopsy in patients who underwent abdominoperineal resection (APR) of the rectum is commonly considered a technical challenge even for experienced urologists, although tissue diagnosis is essential in prostate cancer management. Transperitoneal, transperineal and transgluteal approaches have been reported, under US, CT or MRI guidance. Transperineal biopsy seems to be the safest and most cost-effective technique. At our institution we developed a modified transperineal biopsy approach with combined transperineal and suprapubic US guidance. Here we report the cases of two patients who came to our institution for PSA raise years after APR procedure, describing in detail the modified transperineal technique and the results of tissue sampling.

Published
2013

15. Assessment of predictive factors of perioperative complications after minimally invasive radical prostatectomy: A multicentre study

Author

Grasso, A.A.C., De Lorenzis, E., Randi, G., Rosso, M., Cozzi, G., Zaramella, S., Zacchero, M., Antonelli, A., Parma, P., Celia, A., Ricciardulli, S., Crivellaro, S., Falsaperla, M., Bove, P., Iacovelli, V., Cindolo, L., Dente, D., Cappa, E., Minervini, A., Masieri, L., Serni, S., Carini, M., Simeone, C., Porreca, A., Rocco, B., and Agile, Group

Subjects
Predictive factors, Minimally invasive radical prostatectomy, Multicentre study
Published
2014

19. PATIENTS WITH PERIOPERATIVE COMPLICATIONS PRESENTED AN HIGHER RISK OF CANCER SPECIFIC MORTALITY AFTER RADICAL CYSTECTOMY: A TWO YEAR MULTICENTRE ITALIAN REAL-LIFE ANALYSIS

Author

De Nunzio, C., Cindolo, L., Presicce, F., Simone, G., Antonelli, A., Bove, P., Celia, A., Ceruti, C., Crivellaro, S., Falsaperla, M., Frea, B., Gallucci, M., Lo Trecchiano, G., Lombardo, R., Leonardo, C., Minervini, A., Porreca, A., Rocco, B., Serni, S., Simeone, C., Zaramella, S., and Tubaro, A.

Subjects
PERIOPERATIVE COMPLICATIONS ,RADICAL CYSTECTOMY, A TWO YEAR MULTICENTRE ITALIAN REAL-LIFE ANALYSIS
Published
2014

20. PATHOLOGICAL OUTCOMES IN PATIENTS CANDIDABLE FOR ACTIVE SURVEILLANCE TREATED WITH RADICAL PROSTATECTOMY. ARE THEY REALLY LOW RISK PATIENTS?

Author

Minervini, Andrea, De Lorenzis, E., Grasso, A., Conti, A., Falsaperla, M., Porreca, A., Cindolo, L., Celia, A., Antonelli, Alberto, Parma, P., Crivellaro, S., Zaramella, S., Di Domenico, A., Del Biondo, D., Bove, P., Gacci, Mauro, Lanciotti, Michele, Serni, Sergio, and Rocco, B.

Subjects
PATHOLOGICAL OUTCOMES , RADICAL PROSTATECTOMY
Published
2013

22. Robotic-assisted versus open partial nephrectomy: A prospective multicenter comparison study of perioperative outcomes (AGILE project)

Author

Minervini, A., Vittori, G., Antonelli, A., Celia, A., Crivellaro, S., Dente, D., Di Santo, V., Frea, B., Gacci, M., Gritti, A., Masieri, L., Morlacco, A., Porreca, A., Rocco, B., Parma, P., Serni, S., Simeone, C., Zaramella, S., and Carini, M.

Subjects
stomatognathic system, Robotic-assisted versus open partial nephrectomy: Prospective multicenter comparison study
Published
2013

23. ASSESSMENT OF PREDICTIVE FACTORS OF PERIOPERATIVE COMPLICATIONS AFTER MINIMALLY INVASIVE RADICAL PROSTATECTOMY: A MULTICENTRE STUDY

Author

Porreca, A., De Lorenzis, E., Randi, G., Rosso, M., Cozzi, G., Zaramella, S., Zacchero, M., Antonelli, A., Parma, P., Celia, A., Ricciardulli, S., Crivellaro, S., Falsaperla, M., Bove, P., Iacovelli, V., Cindolo, L., Dente, D., Cappa, E., Minervini, A., Masieri, L., Serni, S., Carini, M., Simeone, C., and Rocco, B.

Subjects
PREDICTIVE FACTORS, PERIOPERATIVE COMPLICATIONS ,RADICAL PROSTATECTOMY
Published
2013

26. Longer operative time and hospital stay are associated with post operative cystectomy complications: a modified Clavien classification system analysis

Author

De Nunzio, C., Cindolo, L., Leonardo, C., Antonelli, A., Brassetti, A., Carini, M., Cerasini, M., Ceruti, Carlo, De Dominicis, C., De Luca, F., Destefanis, Paolo Giuseppe, Disanto, V., Falsaperla, M., Fattahi, H., Gallucci, M., Gonzales, E., Maestro, M., Maugeri, G., Minervini, A., Pagliarulo, V., Parma, P., Perdonà, S., Porreca, A., Rocco, B., Schips, L., Serni, S., Serrago, M., Simeone, C., Simone, G., Spadavecchia, R., Terrone, Carlo, Tizzani, Alessandro, Tubaro, A., Celia, A., Bove, P., Zaramella, S., Crivellaro, S., Nucciotti, R., Salvaggio, A., Petrucci, F., Bianchi, D., Frea, Bruno, and Pizzuti, V.

Published
2012

27. AGE AND STAGE AS PREDICTIVE FACTORS FOR A ORTHOTOPIC NEOBLDDER AFTER RADICAL CYSTECTOMY: RESULTS ON 290 CASES.AGILE GROUP EXPERIENCE

Author

Porreca, A., Cindolo, L., De Nunzio, C., Antonelli, A., Rocco, B., Pagliarulo, V., Celia, A., Bove, P., Zaramella, S., Crivellaro, S., Nucciotti, R., Ceruti, C., Falsaperla, M., Parma, P., Salvaggio, A., Schips, L., Simeone, Claudio, Serrago, M., Spadavecchia, R., Petrucci, F., Bianchi, D., Terrone, C., Frea, B., Pizzuti, V., Destefanis, P., Maugeri, G., De Luca, F., Carini, M., and Minervini, A.

Published
2012

29. LONGER OPERATIVE TIME AND HOSPITAL STAY ARE ASSOCIATED WITH POST-OPERATIVE CYSTECTOMY COMPLICATIONS: A MODIFIED CLAVIEN CLASSIFICATION SYSTEM ANALYSIS

Author

De Nunzio, C., Cindolo, L., Leonardo, C., Antonelli, Alberto, Brassetti, A., Carini, Marco, Cerasini, M., Ceruti, C., De Dominicis, C., De Luca, F., Deste fanis, P., Di Santo, V., Falsaperla, M., Fattahi, H., Gallucci, M., Gonzales, E., Maestro, M., Maugeri, G., Minervini, Andrea, Pagliarulo, V., Parma, P., Per donà, S., Porreca, A., Rocco, B., Schips, L., Serni, Sergio, Serrago, M., Sime one, C., Simone, G., Spadavecchia, R., Terrone, C., Tizzani, A., Tubaro, A., Celia, A., Bove, P., Zaramella, S., Crivellaro, S., Nucciotti, R., Salvaggio, A., Petrucci, Federica, Bianchi, D., Frea, B., and Pizzuti, V.

Subjects
POST-OPERATIVE CYSTECTOMY COMPLICATIONS
Published
2012

31. AGE AND STAGE AS PREDICTIVE FACTORS FOR A ORTHOTOP- IC NEOBLADDER AFTER RADICAL CYSTECTOMY: RESULTS ON 290 CASES. AGILE GROUP EXPERIENCE

Author

Porreca, A., Cindolo, L., De Nunzio, C., Antonelli, Alberto, Rocco, B., Pa gliarulo, V., Celia, A., Bove, P., Zaramella, S., Crivellaro, S., Nucciotti, R., Ceruti, C., Falsaperla, M., Parma, P., Salvaggio, A., Schips, L., Simeone, C., Serrago, M., Spadavecchia, R., Petrucci, Federica, Bianchi, D., Terrone, C., Frea, B., Pizzuti, V., Destefanis, P., Maugeri, G., De Luca, F., Carini, Marco, and Minervini, Andrea

Subjects
AGE , STAGE,PREDICTIVE FACTORS, ORTHOTOP IC NEOBLADDER AGILE GROUP EXPERIENCE
Published
2012

33. [The role of non-invasive urodynamics in bladder outlet obstruction diagnosis in male patients]

Author

Anna Palazzetti, Tosco L, Crivellaro S, Guaitoli P, Abbinante M, and Frea B

Subjects
Male, Manometry, Diagnostic Techniques, Urological, Ultrasonography, Doppler, General Medicine, Equipment Design, Sensitivity and Specificity, Condoms, Urinary Bladder Neck Obstruction, Urodynamics, Pressure, Humans, Rheology, Urinary Catheterization
Abstract

Purpose Many Methods have been suggested to assess bladder outlet obstruction, as defined by the gold standard of pressure flow studies. A comprehensive review of the literature on the different methods used to diagnose bladder outlet obstruction by non-invasive means was performed in order to compare those methods to invasive urodynamics in terms of sensitivity and specificity. Materials and Methods A MEDLINE search was done of the published literature covering from December 2003 on non-invasive methods, including only single measures to diagnose bladder outlet obstruction. We performed a comparison between all methods in terms of sensitivity and specificity for each test. For many techniques these values were calculated directly from the data presented in the article. Results There has been applied many methods to diagnose bladder outlet obstruction. Those methods were divided into uroflowmetry condom-catheter method, penile cuff method and Doppler ultrasonography urodynamics. Each method has been described and discussed in terms of its role in adding information to the diagnostic work-up for bladder outlet obstruction. Conclusions Pressure flow studies still remain the gold standard for assessing bladder outlet obstruction. However non-invasive urodynamics is a promising branch. Probably the most reliable information is given by the association of numerous methods together.

Published
2010

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