6 results on '"Graziano Ceccarelli"'
Search Results
2. Minimally invasive robotic-assisted combined colorectal and liver excision surgery: feasibility, safety and surgical technique in a pilot series
- Author
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Aldo Rocca, Graziano Ceccarelli, Andrea Fontani, Michele De Rosa, Enrico Andolfi, Walter Bugiantella, Giovanni Battista Levi Sandri, and Fabio Ermili
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Colectomies ,medicine.medical_specialty ,Robotic assisted ,Liver resections ,03 medical and health sciences ,0302 clinical medicine ,Robotic Surgical Procedures ,Medicine ,Hepatectomy ,Humans ,Rectal resection ,In patient ,Major complication ,Laparoscopy ,medicine.diagnostic_test ,business.industry ,Liver excision ,Liver Neoplasms ,Surgery ,Liver resection · Dropout · Recurrence · Propensity score match ,Liver ,030220 oncology & carcinogenesis ,Feasibility Studies ,030211 gastroenterology & hepatology ,business ,Colorectal Neoplasms - Abstract
Different strategies may be adopted in patients with synchronous colorectal liver metastases (LM). The role of laparoscopy has been investigated to define the benefits of minimally invasive surgery in a single-stage operation. In our study, we report our experience of 28 Minimally Invasive Robotic-Assisted combined Colorectal and Liver Excision Surgery (MIRACLES). From October 2012 to December 2019, 135 Robotic liver resections and 218 Robotic Colorectal resections were performed in our center. Twenty-eight patients underwent MIRACLES resection with 37 nodules removed. Fifty-two lesions in 28 patients were resected in minimally invasive robot-assisted surgery. Eighteen lesions were located in postero-superior liver segments (eight in segment VII, two in segment VIII, eight in segment IVa). Nine right colectomies, seven left colectomies, ten anterior rectal resections, one Hartmann and one MILES procedures were performed. The median surgical time of MIRACLES procedures was 332 min. Two conversions to open approach were necessary. Four major complications (> III) were observed. No postoperative mortality was recorded. The median hospital stay was 8 days. The median overall survival was 27.5 months. The MIRACLES approach is feasible and safe for colorectal resection and hepatic nodules located in all segments, with a low rate of postoperative complications. Surgical technique is demanding and should be reserved, presently, to tertiary centers.
- Published
- 2020
3. Transanal total mesorectal excision (TaTME): single-centre early experience in a selected population
- Author
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Fabio Rondelli, Antonio Giuliani, Walter Bugiantella, Marcello Boni, Fabio Ermili, Michele De Rosa, Graziano Ceccarelli, and Lorenzo Mariani
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Laparoscopic surgery ,Adult ,Male ,medicine.medical_specialty ,medicine.medical_treatment ,Settore MED/18 - CHIRURGIA GENERALE ,Population ,Operative Time ,Blood Loss, Surgical ,Rectum ,Anal Canal ,Adenocarcinoma ,03 medical and health sciences ,0302 clinical medicine ,medicine ,Rectal Adenocarcinoma ,Animals ,Humans ,Rectal cancer ,education ,Laparoscopy ,Digestive System Surgical Procedures ,Mesorectal ,Aged ,education.field_of_study ,medicine.diagnostic_test ,business.industry ,Rectal Neoplasms ,TME ,Anal canal ,Middle Aged ,Total mesorectal excision ,Surgery ,Transanal surgery ,medicine.anatomical_structure ,Treatment Outcome ,030220 oncology & carcinogenesis ,030211 gastroenterology & hepatology ,Female ,business - Abstract
Total mesorectal excision (TME) represents the key principle in the surgical treatment of rectal cancer. Transanal mesorectal excision was introduced as a complement to conventional surgery to overcome its technical difficulties. The aim of this study was to evaluate the early surgical results following the introduction of this novel technique at our Unit. Between January and May 2016, 12 patients diagnosed with mid-low rectal adenocarcinoma were enrolled into this study and evaluated with regards demography, histopathology, peri-operative data and postoperative complications. The tumor was located in the middle rectum in 6 patients (50%), in the lower rectum in 6 patients (50%). Mean operative time was 356.5 ± 76.2 min (range 240–494). Eleven out 12 patients (91.6%) had less than 200 mL of intraoperative blood loss. Mean hospital stay was 10.9 ± 4.6 days (range 5–19). No mortality was recorded. Intraoperative complications were recorded in 1, while early post-operative complications (
- Published
- 2018
4. Correction to: Diffusion, outcomes and implementation of minimally invasive liver surgery: a snapshot from the I Go MILS (Italian Group of Minimally Invasive Liver Surgery) Registry
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Annamaria Ferrero, Luigi Boni, S. Guerriero, Giuseppe Navarra, Luca Aldrighetti, Fulvio Calise, Giovanni Sgroi, Graziano Ceccarelli, F. Di Benedetto, A. Percivale, P. Reggiani, Salvatore Gruttadauria, Alberto Patriti, Michele Colledan, A. Frena, L. De Carlis, P. Mezzatesta, L. Vincenti, Antonio Daniele Pinna, U. Tedeschi, U. Cillo, Elio Jovine, Giuseppe Tisone, Guido Torzilli, Giuseppe Maria Ettorre, Luca Morelli, G. Griseri, A. Parisi, Fausto Zamboni, Antonio Floridi, Giorgio Ercolani, Roberto Santambrogio, Vincenzo Mazzaferro, S. Berti, L. Veneroni, Ugo Boggi, Felice Giuliante, Giuseppe Zimmitti, A. Antonucci, M. Filauro, A. Coratti, Antonio Giuliani, P. Maida, Abdallah Slim, R. Dalla Valle, G.L. Grazi, Francesca Ratti, Alfredo Guglielmi, R. Romito, Giulio Belli, and Alberto Brolese
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Liver surgery ,medicine.medical_specialty ,business.industry ,Medicine ,Snapshot (computer storage) ,Surgery ,business - Abstract
A technical error led to incorrect rendering of the author group in this article. The correct authorship is as follows.
- Published
- 2017
5. Non-cirrhotic liver tolerance to intermittent inflow occlusion during laparoscopic liver resection
- Author
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Cecilia Ceribelli, Luciano Casciola, R. Bellochi, Alberto Patriti, Alberto Bartoli, and Graziano Ceccarelli
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robotic ,Male ,liver tumor ,medicine.medical_specialty ,Liver tumor ,Ischemia ,ischemia ,laparoscopic ,Constriction ,Resection ,Pneumoperitoneum ,inflow occlusion ,liver ,liver metastases ,pringle ,resection ,medicine ,Hepatectomy ,Humans ,cardiovascular diseases ,Ischemic Preconditioning ,Aged ,Retrospective Studies ,Non cirrhotic liver ,business.industry ,Liver Neoplasms ,Retrospective cohort study ,Robotics ,Middle Aged ,medicine.disease ,Surgery ,body regions ,Treatment Outcome ,Liver ,Reperfusion Injury ,Female ,Laparoscopy ,Inflow occlusion ,business - Abstract
While inflow occlusion techniques are accepted methods to reduce bleeding during open liver surgery, their use in laparoscopic liver resections are limited by possible effects of pneumoperitoneum on ischemia-reperfusion liver damage. This retrospective study was designed to investigate the impact of intermittent pedicle clamping (IPC) on patients with normal liver undergoing minor laparoscopic liver resections. Three matched groups of patients were retrospectively selected from our in-house database: 11 patients who underwent robot-assisted liver resection with IPC, and 16 and 11 patients who underwent robot-assisted liver resection without IPC and open liver resection with IPC, respectively. The primary end point was to assess differences in postoperative serum alanine, aspartate aminotransferase (ALT and AST) and bilirubin levels. The curves of serum AST, ALT and bilirubin levels in a span of time of five postoperative days were not significantly different between the three groups. IPC has no relevant effects on ischemia-reperfusion liver damage even in the presence of pneumoperitoneum.
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- 2012
6. Robotic-assisted transperitoneal nephron-sparing surgery for small renal masses with associated surgical procedures: surgical technique and preliminary experience
- Author
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Alberto Patriti, Massimo Codacci-Pisanelli, Alessia Biancafarina, Cecilia Ceribelli, Luciano Casciola, and Graziano Ceccarelli
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robotic ,Adult ,Male ,medicine.medical_specialty ,laparoscopy ,nephron sparing surgery ,nephron-sparing ,partial nephrectomy ,robotic surgery ,small renal tumors ,surgery ,Pleural effusion ,Nephrectomy ,Collecting duct carcinoma ,Hematoma ,Postoperative Complications ,Medicine ,Humans ,Robotic surgery ,Radical surgery ,Laparoscopy ,Carcinoma, Renal Cell ,Aged ,Neoplasm Staging ,Retrospective Studies ,medicine.diagnostic_test ,business.industry ,Nephrons ,Robotics ,Length of Stay ,Middle Aged ,medicine.disease ,Thrombosis ,Kidney Neoplasms ,Surgery ,Leiomyoma ,Treatment Outcome ,Surgery, Computer-Assisted ,Female ,Radiology ,Peritoneum ,business ,Tomography, X-Ray Computed ,Follow-Up Studies - Abstract
Small renal masses (T1a) are commonly diagnosed incidentally and can be treated with nephron-sparing surgery, preserving renal function and obtaining the same oncological results as radical surgery. Bigger lesions (T1b) may be treated in particular situations with a conservative approach too. We present our surgical technique based on robotic assistance for nephron-sparing surgery. We retrospectively analysed our series of 32 consecutive patients (two with 2 tumours and one with 4 bilateral tumours), for a total of 37 robotic nephron-sparing surgery (RNSS) performed between June 2008 and July 2012 by a single surgeon (G.C.). The technique differs depending on tumour site and size. The mean tumour size was 3.6 cm; according to the R.E.N.A.L. Nephrometry Score 9 procedures were considered of low, 14 of moderate and 9 of hight complexity with no conversion in open surgery. Vascular clamping was performed in 22 cases with a mean warm ischemia time of 21.5 min and the mean total procedure time was 149.2 min. Mean estimated blood loss was 187.1 ml. Mean hospital stay was 4.4 days. Histopathological evaluation confirmed 19 cases of clear cell carcinoma (all the multiple tumours were of this nature), 3 chromophobe tumours, 1 collecting duct carcinoma, 5 oncocytomas, 1 leiomyoma, 1 cavernous haemangioma and 2 benign cysts. Associated surgical procedures were performed in 10 cases (4 cholecystectomies, 3 important lyses of peritoneal adhesions, 1 adnexectomy, 1 right hemicolectomy, 1 hepatic resection). The mean follow-up time was 28.1 months ± 12.3 (range 6-54). Intraoperative complications were 3 cases of important bleeding not requiring conversion to open or transfusions. Regarding post-operative complications, there were a bowel occlusion, 1 pleural effusion, 2 pararenal hematoma, 3 asymptomatic DVT (deep vein thrombosis) and 1 transient increase in creatinine level. There was no evidence of tumour recurrence in the follow-up. RNSS is a safe and feasible technique. Challenging situations are hilar, posterior or intraparenchymal tumour localization. In our experience, robotic technology made possible a safe minimally invasive management, including vascular clamping, tumour resection and parenchyma reconstruction.
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- 2012
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