Author: "Ficari F" / Publication Year Range: Last 10 years - Searchworks@Jio Institute Digital Library Search Results

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73 results on '"Ficari F"'

1. Abdominal drainage after elective colorectal surgery: propensity score-matched retrospective analysis of an Italian cohort

Author: Guadagni, S, Catarci, M, Masedu, F, Karim, M, Clementi, M, Ruffo, G, Viola, M, Borghi, F, Baldazzi, G, Scatizzi, M, Pirozzi, F, Delrio, P, Garulli, G, Marini, P, Campagnacci, R, De Luca, R, Ficari, F, Sica, G, Scabini, S, Liverani, A, Caricato, M, Patriti, A, Mancini, S, Baiocchi, G, Santoro, R, Siquini, W, Guercioni, G, Basti, M, Pedrazzani, C, Totis, M, Carrara, A, Lucchi, A, Pavanello, M, Muratore, A, D'Ugo, S, Di Leo, A, Pignata, G, Elmore, U, Anania, G, Carlini, M, Corcione, F, Vettoretto, N, Longo, G, Sorrentino, M, Giuliani, A, Ferrari, G, Taglietti, L, Verzelli, A, Di Cosmo, M, Cavaliere, D, Milone, M, Rausei, S, Ciaccio, G, Tebala, G, Brisinda, G, Berti, S, Millo, P, Boni, L, Guerrieri, M, Persiani, R, Parini, D, Spinelli, A, Genna, M, Bottino, V, Coratti, A, Scala, D, Rivolta, U, Piccoli, M, Talarico, C, Roviello, F, Anastasi, A, Ettorre, G, Montuori, M, Mariani, P, de Manzini, N, Donini, A, Armellino, M, Feo, C, Guerriero, S, Costanzi, A, Marchesi, F, Cicetti, M, Ciano, P, Benedetti, M, Montemurro, L, Mattei, M, Belloni, E, Apa, D, Di Carlo, M, Bertocchi, E, Masini, G, Altamura, A, Rubichi, F, Cianflocca, D, Migliore, M, Cassini, D, Pandolfini, L, Falsetto, A, Sciuto, A, Pace, U, Bucci, A, Monari, F, Attina, G, Maurizi, A, Simone, M, Giudici, F, Cianchi, F, Sensi, B, Aprile, A, Soriero, D, Scarinci, A, Capolupo, G, Sisti, V, Ricci, M, Sagnotta, A, Molfino, S, Amodio, P, Cardinali, A, Cicconi, S, Marziali, I, Frazzini, D, Conti, C, Tamini, N, Braga, M, Motter, M, Tirone, G, Martorelli, G, Cacurri, A, Di Marco, C, Marsanic, P, Federico, N, Spampinato, M, Crepaz, L, Andreuccetti, J, Canfora, I, Maggi, G, Chiozza, M, Spoletini, D, Marcellinaro, R, Bracale, U, Peltrini, R, Di Nuzzo, M, Botteri, E, Santoni, S, Stefanoni, M, Del Vecchio, G, Magistro, C, Ruggiero, S, Birindelli, A, Budassi, A, Zigiotto, D, Solaini, L, Ercolani, G, De Palma, G, Tenconi, S, Locurto, P, Di Cintio, A, Chiarello, M, Cariati, M, Gennai, A, Grivon, M, Cassinotti, E, Ortenzi, M, Biondi, A, De Luca, M, Carrano, F, Fior, F, Ferronetti, A, Giuliani, G, Marino, G, Bertoglio, C, Pecchini, F, Greco, V, Piagnerelli, R, Canonico, G, Colasanti, M, Pinotti, E, Carminati, R, Osenda, E, Graziosi, L, De Martino, C, Ioia, G, Pindozzi, F, Organetti, L, Monteleone, M, Dalmonte, G, La Gioia, G, Guadagni S., Catarci M., Masedu F., Karim M. E., Clementi M., Ruffo G., Viola M. G., Borghi F., Baldazzi G., Scatizzi M., Pirozzi F., Delrio P., Garulli G., Marini P., Campagnacci R., De Luca R., Ficari F., Sica G., Scabini S., Liverani A., Caricato M., Patriti A., Mancini S., Baiocchi G. L., Santoro R., Siquini W., Guercioni G., Basti M., Pedrazzani C., Totis M., Carrara A., Lucchi A., Pavanello M., Muratore A., D'Ugo S., Di Leo A., Pignata G., Elmore U., Anania G., Carlini M., Corcione F., Vettoretto N., Longo G., Sorrentino M., Giuliani A., Ferrari G., Taglietti L., Verzelli A., Di Cosmo M., Cavaliere D., Milone M., Rausei S., Ciaccio G., Tebala G., Brisinda G., Berti S., Millo P., Boni L., Guerrieri M., Persiani R., Parini D., Spinelli A., Genna M., Bottino V., Coratti A., Scala D., Rivolta U., Piccoli M., Talarico C., Roviello F., Anastasi A., Ettorre G. M., Montuori M., Mariani P., de Manzini N., Donini A., Armellino M. F., Feo C., Guerriero S., Costanzi A., Marchesi F., Cicetti M., Ciano P., Benedetti M., Montemurro L. A., Mattei M. S., Belloni E., Apa D., Di Carlo M., Bertocchi E., Masini G., Altamura A., Rubichi F., Cianflocca D., Migliore M., Cassini D., Pandolfini L., Falsetto A., Sciuto A., Pace U., Bucci A. F., Monari F., Attina G. M., Maurizi A., Simone M., Giudici F., Cianchi F., Sensi B., Aprile A., Soriero D., Scarinci A., Capolupo G. T., Sisti V., Ricci M. L., Sagnotta A., Molfino S., Amodio P., Cardinali A., Cicconi S., Marziali I., Frazzini D., Conti C., Tamini N., Braga M., Motter M., Tirone G., Martorelli G., Cacurri A., Di Marco C., Marsanic P., Federico N. S. P., Spampinato M., Crepaz L., Andreuccetti J., Canfora I., Maggi G., Chiozza M., Spoletini D., Marcellinaro R., Bracale U., Peltrini R., Di Nuzzo M. M., Botteri E., Santoni S., Stefanoni M., Del Vecchio G., Magistro C., Ruggiero S., Birindelli A., Budassi A., Zigiotto D., Solaini L., Ercolani G., De Palma G. D., Tenconi S., Locurto P., Di Cintio A., Chiarello M. M., Cariati M., Gennai A., Grivon M., Cassinotti E., Ortenzi M., Biondi A., De Luca M., Carrano F., Fior F., Ferronetti A., Giuliani G., Marino G., Bertoglio C. L., Pecchini F., Greco V., Piagnerelli R., Canonico G., Colasanti M., Pinotti E., Carminati R., Osenda E., Graziosi L., De Martino C., Ioia G., Pindozzi F., Organetti L., Monteleone M., Dalmonte G., La Gioia G., Guadagni, S, Catarci, M, Masedu, F, Karim, M, Clementi, M, Ruffo, G, Viola, M, Borghi, F, Baldazzi, G, Scatizzi, M, Pirozzi, F, Delrio, P, Garulli, G, Marini, P, Campagnacci, R, De Luca, R, Ficari, F, Sica, G, Scabini, S, Liverani, A, Caricato, M, Patriti, A, Mancini, S, Baiocchi, G, Santoro, R, Siquini, W, Guercioni, G, Basti, M, Pedrazzani, C, Totis, M, Carrara, A, Lucchi, A, Pavanello, M, Muratore, A, D'Ugo, S, Di Leo, A, Pignata, G, Elmore, U, Anania, G, Carlini, M, Corcione, F, Vettoretto, N, Longo, G, Sorrentino, M, Giuliani, A, Ferrari, G, Taglietti, L, Verzelli, A, Di Cosmo, M, Cavaliere, D, Milone, M, Rausei, S, Ciaccio, G, Tebala, G, Brisinda, G, Berti, S, Millo, P, Boni, L, Guerrieri, M, Persiani, R, Parini, D, Spinelli, A, Genna, M, Bottino, V, Coratti, A, Scala, D, Rivolta, U, Piccoli, M, Talarico, C, Roviello, F, Anastasi, A, Ettorre, G, Montuori, M, Mariani, P, de Manzini, N, Donini, A, Armellino, M, Feo, C, Guerriero, S, Costanzi, A, Marchesi, F, Cicetti, M, Ciano, P, Benedetti, M, Montemurro, L, Mattei, M, Belloni, E, Apa, D, Di Carlo, M, Bertocchi, E, Masini, G, Altamura, A, Rubichi, F, Cianflocca, D, Migliore, M, Cassini, D, Pandolfini, L, Falsetto, A, Sciuto, A, Pace, U, Bucci, A, Monari, F, Attina, G, Maurizi, A, Simone, M, Giudici, F, Cianchi, F, Sensi, B, Aprile, A, Soriero, D, Scarinci, A, Capolupo, G, Sisti, V, Ricci, M, Sagnotta, A, Molfino, S, Amodio, P, Cardinali, A, Cicconi, S, Marziali, I, Frazzini, D, Conti, C, Tamini, N, Braga, M, Motter, M, Tirone, G, Martorelli, G, Cacurri, A, Di Marco, C, Marsanic, P, Federico, N, Spampinato, M, Crepaz, L, Andreuccetti, J, Canfora, I, Maggi, G, Chiozza, M, Spoletini, D, Marcellinaro, R, Bracale, U, Peltrini, R, Di Nuzzo, M, Botteri, E, Santoni, S, Stefanoni, M, Del Vecchio, G, Magistro, C, Ruggiero, S, Birindelli, A, Budassi, A, Zigiotto, D, Solaini, L, Ercolani, G, De Palma, G, Tenconi, S, Locurto, P, Di Cintio, A, Chiarello, M, Cariati, M, Gennai, A, Grivon, M, Cassinotti, E, Ortenzi, M, Biondi, A, De Luca, M, Carrano, F, Fior, F, Ferronetti, A, Giuliani, G, Marino, G, Bertoglio, C, Pecchini, F, Greco, V, Piagnerelli, R, Canonico, G, Colasanti, M, Pinotti, E, Carminati, R, Osenda, E, Graziosi, L, De Martino, C, Ioia, G, Pindozzi, F, Organetti, L, Monteleone, M, Dalmonte, G, La Gioia, G, Guadagni S., Catarci M., Masedu F., Karim M. E., Clementi M., Ruffo G., Viola M. G., Borghi F., Baldazzi G., Scatizzi M., Pirozzi F., Delrio P., Garulli G., Marini P., Campagnacci R., De Luca R., Ficari F., Sica G., Scabini S., Liverani A., Caricato M., Patriti A., Mancini S., Baiocchi G. L., Santoro R., Siquini W., Guercioni G., Basti M., Pedrazzani C., Totis M., Carrara A., Lucchi A., Pavanello M., Muratore A., D'Ugo S., Di Leo A., Pignata G., Elmore U., Anania G., Carlini M., Corcione F., Vettoretto N., Longo G., Sorrentino M., Giuliani A., Ferrari G., Taglietti L., Verzelli A., Di Cosmo M., Cavaliere D., Milone M., Rausei S., Ciaccio G., Tebala G., Brisinda G., Berti S., Millo P., Boni L., Guerrieri M., Persiani R., Parini D., Spinelli A., Genna M., Bottino V., Coratti A., Scala D., Rivolta U., Piccoli M., Talarico C., Roviello F., Anastasi A., Ettorre G. M., Montuori M., Mariani P., de Manzini N., Donini A., Armellino M. F., Feo C., Guerriero S., Costanzi A., Marchesi F., Cicetti M., Ciano P., Benedetti M., Montemurro L. A., Mattei M. S., Belloni E., Apa D., Di Carlo M., Bertocchi E., Masini G., Altamura A., Rubichi F., Cianflocca D., Migliore M., Cassini D., Pandolfini L., Falsetto A., Sciuto A., Pace U., Bucci A. F., Monari F., Attina G. M., Maurizi A., Simone M., Giudici F., Cianchi F., Sensi B., Aprile A., Soriero D., Scarinci A., Capolupo G. T., Sisti V., Ricci M. L., Sagnotta A., Molfino S., Amodio P., Cardinali A., Cicconi S., Marziali I., Frazzini D., Conti C., Tamini N., Braga M., Motter M., Tirone G., Martorelli G., Cacurri A., Di Marco C., Marsanic P., Federico N. S. P., Spampinato M., Crepaz L., Andreuccetti J., Canfora I., Maggi G., Chiozza M., Spoletini D., Marcellinaro R., Bracale U., Peltrini R., Di Nuzzo M. M., Botteri E., Santoni S., Stefanoni M., Del Vecchio G., Magistro C., Ruggiero S., Birindelli A., Budassi A., Zigiotto D., Solaini L., Ercolani G., De Palma G. D., Tenconi S., Locurto P., Di Cintio A., Chiarello M. M., Cariati M., Gennai A., Grivon M., Cassinotti E., Ortenzi M., Biondi A., De Luca M., Carrano F., Fior F., Ferronetti A., Giuliani G., Marino G., Bertoglio C. L., Pecchini F., Greco V., Piagnerelli R., Canonico G., Colasanti M., Pinotti E., Carminati R., Osenda E., Graziosi L., De Martino C., Ioia G., Pindozzi F., Organetti L., Monteleone M., Dalmonte G., and La Gioia G.
Abstract: Background: In Italy, surgeons continue to drain the abdominal cavity in more than 50 per cent of patients after colorectal resection. The aim of this study was to evaluate the impact of abdominal drain placement on early adverse events in patients undergoing elective colorectal surgery. Methods: A database was retrospectively analysed through a 1:1 propensity score-matching model including 21 covariates. The primary endpoint was the postoperative duration of stay, and the secondary endpoints were surgical site infections, infectious morbidity rate defined as surgical site infections plus pulmonary infections plus urinary infections, anastomotic leakage, overall morbidity rate, major morbidity rate, reoperation and mortality rates. The results of multiple logistic regression analyses were presented as odds ratios (OR) and 95 per cent c.i. Results: A total of 6157 patients were analysed to produce two well-balanced groups of 1802 patients: group (A), no abdominal drain(s) and group (B), abdominal drain(s). Group A versus group B showed a significantly lower risk of postoperative duration of stay >6 days (OR 0.60; 95 per cent c.i. 0.51–0.70; P < 0.001). A mean postoperative duration of stay difference of 0.86 days was detected between groups. No difference was recorded between the two groups for all the other endpoints. Conclusion: This study confirms that placement of abdominal drain(s) after elective colorectal surgery is associated with a non-clinically significant longer (0.86 days) postoperative duration of stay but has no impact on any other secondary outcomes, confirming that abdominal drains should not be used routinely in colorectal surgery.
Published: 2024

2. Mechanical bowel preparation in elective colorectal surgery: a propensity score-matched analysis of the Italian colorectal anastomotic leakage (iCral) study group prospective cohorts

Author: Catarci, M, Guadagni, S, Masedu, F, Ruffo, G, Viola, M, Borghi, F, Baldazzi, G, Pirozzi, F, Delrio, P, Garulli, G, Marini, P, Patriti, A, Campagnacci, R, Sica, G, Caricato, M, Montemurro, L, Ciano, P, Benedetti, M, Guercioni, G, Scatizzi, M, De Luca, R, Ficari, F, Scabini, S, Liverani, A, Mancini, S, Baiocchi, G, Santoro, R, Siquini, W, Basti, M, Pedrazzani, C, Totis, M, Carrara, A, Lucchi, A, Pavanello, M, Muratore, A, D'Ugo, S, Di Leo, A, Pignata, G, Elmore, U, Anania, G, Carlini, M, Corcione, F, Vettoretto, N, Longo, G, Sorrentino, M, Giuliani, A, Ferrari, G, Taglietti, L, Verzelli, A, Di Cosmo, M, Cavaliere, D, Milone, M, Rausei, S, Ciaccio, G, Tebala, G, Brisinda, G, Berti, S, Millo, P, Boni, L, Guerrieri, M, Persiani, R, Parini, D, Spinelli, A, Genna, M, Bottino, V, Coratti, A, Scala, D, Rivolta, U, Piccoli, M, Talarico, C, Roviello, F, Anastasi, A, Ettorre, G, Montuori, M, Mariani, P, de Manzini, N, Donini, A, Armellino, M, Feo, C, Guerriero, S, Costanzi, A, Marchesi, F, Cicetti, M, Mattei, M, Belloni, E, Apa, D, Di Carlo, M, Cicconi, S, Marziali, I, Clementi, M, Bertocchi, E, Masini, G, Altamura, A, Rubichi, F, Cianflocca, D, Migliore, M, Cassini, D, Sciuto, A, Pace, U, Bucci, A, Monari, F, Attina, G, Sisti, V, Ricci, M, Maurizi, A, Sensi, B, Capolupo, G, Pandolfini, L, Falsetto, A, Simone, M, Giudici, F, Cianchi, F, Baldini, G, Aprile, A, Soriero, D, Scarinci, A, Sagnotta, A, Molfino, S, Amodio, P, Cardinali, A, Frazzini, D, Conti, C, Tamini, N, Braga, M, Motter, M, Tirone, G, Martorelli, G, Cacurri, A, Di Marco, C, Marsanic, P, Federico, N, Spampinato, M, Crepaz, L, Andreuccetti, J, Canfora, I, Maggi, G, Chiozza, M, Spoletini, D, Marcellinaro, R, Lisi, G, Bracale, U, Peltrini, R, Di Nuzzo, M, Botteri, E, Santoni, S, Stefanoni, M, Del Vecchio, G, Magistro, C, Ruggiero, S, Birindelli, A, Budassi, A, Zigiotto, D, Solaini, L, Ercolani, G, De Palma, G, Tenconi, S, Locurto, P, Di Cintio, A, Chiarello, M, Cariati, M, Gennai, A, Grivon, M, Cassinotti, E, Ortenzi, M, Biondi, A, De Luca, M, Carrano, F, Fior, F, Ferronetti, A, Giuliani, G, Marino, G, Bertoglio, C, Pecchini, F, Greco, V, Piagnerelli, R, Canonico, G, Colasanti, M, Pinotti, E, Carminati, R, Osenda, E, Graziosi, L, De Martino, C, Ioia, G, Pindozzi, F, Organetti, L, Monteleone, M, Dalmonte, G, La Gioia, G, Catarci M., Guadagni S., Masedu F., Ruffo G., Viola M. G., Borghi F., Baldazzi G., Pirozzi F., Delrio P., Garulli G., Marini P., Patriti A., Campagnacci R., Sica G., Caricato M., Montemurro L. A., Ciano P., Benedetti M., Guercioni G., Scatizzi M., De Luca R., Ficari F., Scabini S., Liverani A., Mancini S., Baiocchi G. L., Santoro R., Siquini W., Basti M., Pedrazzani C., Totis M., Carrara A., Lucchi A., Pavanello M., Muratore A., D'Ugo S., Di Leo A., Pignata G., Elmore U., Anania G., Carlini M., Corcione F., Vettoretto N., Longo G., Sorrentino M., Giuliani A., Ferrari G., Taglietti L., Verzelli A., Di Cosmo M., Cavaliere D., Milone M., Rausei S., Ciaccio G., Tebala G., Brisinda G., Berti S., Millo P., Boni L., Guerrieri M., Persiani R., Parini D., Spinelli A., Genna M., Bottino V., Coratti A., Scala D., Rivolta U., Piccoli M., Talarico C., Roviello F., Anastasi A., Ettorre G. M., Montuori M., Mariani P., de Manzini N., Donini A., Armellino M. F., Feo C., Guerriero S., Costanzi A., Marchesi F., Cicetti M., Mattei M. S., Belloni E., Apa D., Di Carlo M., Cicconi S., Marziali I., Clementi M., Bertocchi E., Masini G., Altamura A., Rubichi F., Cianflocca D., Migliore M., Cassini D., Sciuto A., Pace U., Bucci A. F., Monari F., Attina G. M., Sisti V., Ricci M. L., Maurizi A., Sensi B., Capolupo G. T., Pandolfini L., Falsetto A., Simone M., Giudici F., Cianchi F., Baldini G., Aprile A., Soriero D., Scarinci A., Sagnotta A., Molfino S., Amodio P., Cardinali A., Frazzini D., Conti C., Tamini N., Braga M., Motter M., Tirone G., Martorelli G., Cacurri A., Di Marco C., Marsanic P., Federico N. S. P., Spampinato M., Crepaz L., Andreuccetti J., Canfora I., Maggi G., Chiozza M., Spoletini D., Marcellinaro R., Lisi G., Bracale U., Peltrini R., Di Nuzzo M. M., Botteri E., Santoni S., Stefanoni M., Del Vecchio G., Magistro C., Ruggiero S., Birindelli A., Budassi A., Zigiotto D., Solaini L., Ercolani G., De Palma G. D., Tenconi S., Locurto P., Di Cintio A., Chiarello M. M., Cariati M., Gennai A., Grivon M., Cassinotti E., Ortenzi M., Biondi A., De Luca M., Carrano F., Fior F., Ferronetti A., Giuliani G., Marino G., Bertoglio C. L., Pecchini F., Greco V., Piagnerelli R., Canonico G., Colasanti M., Pinotti E., Carminati R., Osenda E., Graziosi L., De Martino C., Ioia G., Pindozzi F., Organetti L., Monteleone M., Dalmonte G., La Gioia G., Catarci, M, Guadagni, S, Masedu, F, Ruffo, G, Viola, M, Borghi, F, Baldazzi, G, Pirozzi, F, Delrio, P, Garulli, G, Marini, P, Patriti, A, Campagnacci, R, Sica, G, Caricato, M, Montemurro, L, Ciano, P, Benedetti, M, Guercioni, G, Scatizzi, M, De Luca, R, Ficari, F, Scabini, S, Liverani, A, Mancini, S, Baiocchi, G, Santoro, R, Siquini, W, Basti, M, Pedrazzani, C, Totis, M, Carrara, A, Lucchi, A, Pavanello, M, Muratore, A, D'Ugo, S, Di Leo, A, Pignata, G, Elmore, U, Anania, G, Carlini, M, Corcione, F, Vettoretto, N, Longo, G, Sorrentino, M, Giuliani, A, Ferrari, G, Taglietti, L, Verzelli, A, Di Cosmo, M, Cavaliere, D, Milone, M, Rausei, S, Ciaccio, G, Tebala, G, Brisinda, G, Berti, S, Millo, P, Boni, L, Guerrieri, M, Persiani, R, Parini, D, Spinelli, A, Genna, M, Bottino, V, Coratti, A, Scala, D, Rivolta, U, Piccoli, M, Talarico, C, Roviello, F, Anastasi, A, Ettorre, G, Montuori, M, Mariani, P, de Manzini, N, Donini, A, Armellino, M, Feo, C, Guerriero, S, Costanzi, A, Marchesi, F, Cicetti, M, Mattei, M, Belloni, E, Apa, D, Di Carlo, M, Cicconi, S, Marziali, I, Clementi, M, Bertocchi, E, Masini, G, Altamura, A, Rubichi, F, Cianflocca, D, Migliore, M, Cassini, D, Sciuto, A, Pace, U, Bucci, A, Monari, F, Attina, G, Sisti, V, Ricci, M, Maurizi, A, Sensi, B, Capolupo, G, Pandolfini, L, Falsetto, A, Simone, M, Giudici, F, Cianchi, F, Baldini, G, Aprile, A, Soriero, D, Scarinci, A, Sagnotta, A, Molfino, S, Amodio, P, Cardinali, A, Frazzini, D, Conti, C, Tamini, N, Braga, M, Motter, M, Tirone, G, Martorelli, G, Cacurri, A, Di Marco, C, Marsanic, P, Federico, N, Spampinato, M, Crepaz, L, Andreuccetti, J, Canfora, I, Maggi, G, Chiozza, M, Spoletini, D, Marcellinaro, R, Lisi, G, Bracale, U, Peltrini, R, Di Nuzzo, M, Botteri, E, Santoni, S, Stefanoni, M, Del Vecchio, G, Magistro, C, Ruggiero, S, Birindelli, A, Budassi, A, Zigiotto, D, Solaini, L, Ercolani, G, De Palma, G, Tenconi, S, Locurto, P, Di Cintio, A, Chiarello, M, Cariati, M, Gennai, A, Grivon, M, Cassinotti, E, Ortenzi, M, Biondi, A, De Luca, M, Carrano, F, Fior, F, Ferronetti, A, Giuliani, G, Marino, G, Bertoglio, C, Pecchini, F, Greco, V, Piagnerelli, R, Canonico, G, Colasanti, M, Pinotti, E, Carminati, R, Osenda, E, Graziosi, L, De Martino, C, Ioia, G, Pindozzi, F, Organetti, L, Monteleone, M, Dalmonte, G, La Gioia, G, Catarci M., Guadagni S., Masedu F., Ruffo G., Viola M. G., Borghi F., Baldazzi G., Pirozzi F., Delrio P., Garulli G., Marini P., Patriti A., Campagnacci R., Sica G., Caricato M., Montemurro L. A., Ciano P., Benedetti M., Guercioni G., Scatizzi M., De Luca R., Ficari F., Scabini S., Liverani A., Mancini S., Baiocchi G. L., Santoro R., Siquini W., Basti M., Pedrazzani C., Totis M., Carrara A., Lucchi A., Pavanello M., Muratore A., D'Ugo S., Di Leo A., Pignata G., Elmore U., Anania G., Carlini M., Corcione F., Vettoretto N., Longo G., Sorrentino M., Giuliani A., Ferrari G., Taglietti L., Verzelli A., Di Cosmo M., Cavaliere D., Milone M., Rausei S., Ciaccio G., Tebala G., Brisinda G., Berti S., Millo P., Boni L., Guerrieri M., Persiani R., Parini D., Spinelli A., Genna M., Bottino V., Coratti A., Scala D., Rivolta U., Piccoli M., Talarico C., Roviello F., Anastasi A., Ettorre G. M., Montuori M., Mariani P., de Manzini N., Donini A., Armellino M. F., Feo C., Guerriero S., Costanzi A., Marchesi F., Cicetti M., Mattei M. S., Belloni E., Apa D., Di Carlo M., Cicconi S., Marziali I., Clementi M., Bertocchi E., Masini G., Altamura A., Rubichi F., Cianflocca D., Migliore M., Cassini D., Sciuto A., Pace U., Bucci A. F., Monari F., Attina G. M., Sisti V., Ricci M. L., Maurizi A., Sensi B., Capolupo G. T., Pandolfini L., Falsetto A., Simone M., Giudici F., Cianchi F., Baldini G., Aprile A., Soriero D., Scarinci A., Sagnotta A., Molfino S., Amodio P., Cardinali A., Frazzini D., Conti C., Tamini N., Braga M., Motter M., Tirone G., Martorelli G., Cacurri A., Di Marco C., Marsanic P., Federico N. S. P., Spampinato M., Crepaz L., Andreuccetti J., Canfora I., Maggi G., Chiozza M., Spoletini D., Marcellinaro R., Lisi G., Bracale U., Peltrini R., Di Nuzzo M. M., Botteri E., Santoni S., Stefanoni M., Del Vecchio G., Magistro C., Ruggiero S., Birindelli A., Budassi A., Zigiotto D., Solaini L., Ercolani G., De Palma G. D., Tenconi S., Locurto P., Di Cintio A., Chiarello M. M., Cariati M., Gennai A., Grivon M., Cassinotti E., Ortenzi M., Biondi A., De Luca M., Carrano F., Fior F., Ferronetti A., Giuliani G., Marino G., Bertoglio C. L., Pecchini F., Greco V., Piagnerelli R., Canonico G., Colasanti M., Pinotti E., Carminati R., Osenda E., Graziosi L., De Martino C., Ioia G., Pindozzi F., Organetti L., Monteleone M., Dalmonte G., and La Gioia G.
Abstract: Retrospective evaluation of the effects of mechanical bowel preparation (MBP) on data derived from two prospective open-label observational multicenter studies in Italy regarding elective colorectal surgery. MBP for elective colorectal surgery remains a controversial issue with contrasting recommendations in current guidelines. The Italian ColoRectal Anastomotic Leakage (iCral) study group, therefore, decided to estimate the effects of no MBP (treatment variable) versus MBP for elective colorectal surgery. A total of 8359 patients who underwent colorectal resection with anastomosis were enrolled in two consecutive prospective studies in 78 surgical centers in Italy from January 2019 to September 2021. A retrospective PSMA was performed on 5455 (65.3%) cases after the application of explicit exclusion criteria to eliminate confounders. The primary endpoints were anastomotic leakage (AL) and surgical site infections (SSI) rates; the secondary endpoints included SSI subgroups, overall and major morbidity, reoperation, and mortality rates. Overall length of postoperative hospital stay (LOS) was also considered. Two well-balanced groups of 1125 patients each were generated: group A (No MBP, true population of interest), and group B (MBP, control population), performing a PSMA considering 21 covariates. Group A vs. group B resulted significantly associated with a lower risk of AL [42 (3.5%) vs. 73 (6.0%) events; OR 0.57; 95% CI 0.38–0.84; p = 0.005]. No difference was recorded between the two groups for SSI [73 (6.0%) vs. 85 (7.0%) events; OR 0.88; 95% CI 0.63–1.22; p = 0.441]. Regarding the secondary endpoints, no MBP resulted significantly associated with a lower risk of reoperation and LOS > 6 days. This study confirms that no MBP before elective colorectal surgery is significantly associated with a lower risk of AL, reoperation rate, and LOS < 6 days when compared with MBP.
Published: 2024

3. Three-row versus two-row circular staplers for left-sided colorectal anastomosis: a propensity score-matched analysis of the iCral 2 and 3 prospective cohorts

Author: Catarci, M, Guadagni, S, Masedu, F, Ruffo, G, Viola, M, Borghi, F, Baldazzi, G, Scatizzi, M, Pirozzi, F, Delrio, P, Garulli, G, Marini, P, Campagnacci, R, De Luca, R, Ficari, F, Sica, G, Scabini, S, Liverani, A, Caricato, M, Patriti, A, Mancini, S, Baiocchi, G, Santoro, R, Siquini, W, Guercioni, G, Basti, M, Pedrazzani, C, Totis, M, Carrara, A, Lucchi, A, Pavanello, M, Muratore, A, D'Ugo, S, Di Leo, A, Pignata, G, Elmore, U, Anania, G, Carlini, M, Corcione, F, Vettoretto, N, Longo, G, Sorrentino, M, Giuliani, A, Ferrari, G, Taglietti, L, Verzelli, A, Di Cosmo, M, Cavaliere, D, Milone, M, Rausei, S, Ciaccio, G, Tebala, G, Brisinda, G, Berti, S, Millo, P, Boni, L, Guerrieri, M, Persiani, R, Parini, D, Spinelli, A, Genna, M, Bottino, V, Coratti, A, Scala, D, Rivolta, U, Piccoli, M, Talarico, C, Roviello, F, Anastasi, A, Ettorre, G, Montuori, M, Mariani, P, de Manzini, N, Donini, A, Armellino, M, Feo, C, Guerriero, S, Costanzi, A, Marchesi, F, Cicetti, M, Ciano, P, Benedetti, M, Montemurro, L, Mattei, M, Belloni, E, Apa, D, Di Carlo, M, Clementi, M, Bertocchi, E, Masini, G, Altamura, A, Rubichi, F, Cianflocca, D, Migliore, M, Cassini, D, Pandolfini, L, Falsetto, A, Sciuto, A, Pace, U, Bucci, A, Monari, F, Attina, G, Maurizi, A, Simone, M, Giudici, F, Cianchi, F, Baldini, G, Sensi, B, Aprile, A, Soriero, D, Scarinci, A, Capolupo, G, Sisti, V, Ricci, M, Sagnotta, A, Molfino, S, Amodio, P, Cardinali, A, Cicconi, S, Marziali, I, Frazzini, D, Conti, C, Tamini, N, Braga, M, Motter, M, Tirone, G, Martorelli, G, Cacurri, A, Di Marco, C, Marsanic, P, Federico, N, Spampinato, M, Crepaz, L, Andreuccetti, J, Canfora, I, Maggi, G, Chiozza, M, Spoletini, D, Marcellinaro, R, Lisi, G, Bracale, U, Peltrini, R, Di Nuzzo, M, Botteri, E, Santoni, S, Stefanoni, M, Del Vecchio, G, Magistro, C, Ruggiero, S, Birindelli, A, Budassi, A, Zigiotto, D, Solaini, L, Ercolani, G, De Palma, G, Tenconi, S, Locurto, P, Di Cintio, A, Chiarello, M, Cariati, M, Gennai, A, Grivon, M, Cassinotti, E, Ortenzi, M, Biondi, A, De Luca, M, Carrano, F, Fior, F, Ferronetti, A, Giuliani, G, Marino, G, Bertoglio, C, Pecchini, F, Greco, V, Piagnerelli, R, Canonico, G, Colasanti, M, Pinotti, E, Carminati, R, Osenda, E, Graziosi, L, De Martino, C, Ioia, G, Pindozzi, F, Organetti, L, Monteleone, M, Dalmonte, G, La Gioia, G, Catarci M., Guadagni S., Masedu F., Ruffo G., Viola M. G., Borghi F., Baldazzi G., Scatizzi M., Pirozzi F., Delrio P., Garulli G., Marini P., Campagnacci R., De Luca R., Ficari F., Sica G., Scabini S., Liverani A., Caricato M., Patriti A., Mancini S., Baiocchi G. L., Santoro R., Siquini W., Guercioni G., Basti M., Pedrazzani C., Totis M., Carrara A., Lucchi A., Pavanello M., Muratore A., D'Ugo S., Di Leo A., Pignata G., Elmore U., Anania G., Carlini M., Corcione F., Vettoretto N., Longo G., Sorrentino M., Giuliani A., Ferrari G., Taglietti L., Verzelli A., Di Cosmo M., Cavaliere D., Milone M., Rausei S., Ciaccio G., Tebala G., Brisinda G., Berti S., Millo P., Boni L., Guerrieri M., Persiani R., Parini D., Spinelli A., Genna M., Bottino V., Coratti A., Scala D., Rivolta U., Piccoli M., Talarico C., Roviello F., Anastasi A., Ettorre G. M., Montuori M., Mariani P., de Manzini N., Donini A., Armellino M. F., Feo C., Guerriero S., Costanzi A., Marchesi F., Cicetti M., Ciano P., Benedetti M., Montemurro L. A., Mattei M. S., Belloni E., Apa D., Di Carlo M., Clementi M., Bertocchi E., Masini G., Altamura A., Rubichi F., Cianflocca D., Migliore M., Cassini D., Pandolfini L., Falsetto A., Sciuto A., Pace U., Bucci A. F., Monari F., Attina G. M., Maurizi A., Simone M., Giudici F., Cianchi F., Baldini G., Sensi B., Aprile A., Soriero D., Scarinci A., Capolupo G. T., Sisti V., Ricci M. L., Sagnotta A., Molfino S., Amodio P., Cardinali A., Cicconi S., Marziali I., Frazzini D., Conti C., Tamini N., Braga M., Motter M., Tirone G., Martorelli G., Cacurri A., Di Marco C., Marsanic P., Federico N. S. P., Spampinato M., Crepaz L., Andreuccetti J., Canfora I., Maggi G., Chiozza M., Spoletini D., Marcellinaro R., Lisi G., Bracale U., Peltrini R., Di Nuzzo M. M., Botteri E., Santoni S., Stefanoni M., Del Vecchio G., Magistro C., Ruggiero S., Birindelli A., Budassi A., Zigiotto D., Solaini L., Ercolani G., De Palma G. D., Tenconi S., Locurto P., Di Cintio A., Chiarello M. M., Cariati M., Gennai A., Grivon M., Cassinotti E., Ortenzi M., Biondi A., De Luca M., Carrano F., Fior F., Ferronetti A., Giuliani G., Marino G., Bertoglio C. L., Pecchini F., Greco V., Piagnerelli R., Canonico G., Colasanti M., Pinotti E., Carminati R., Osenda E., Graziosi L., De Martino C., Ioia G., Pindozzi F., Organetti L., Monteleone M., Dalmonte G., La Gioia G., Catarci, M, Guadagni, S, Masedu, F, Ruffo, G, Viola, M, Borghi, F, Baldazzi, G, Scatizzi, M, Pirozzi, F, Delrio, P, Garulli, G, Marini, P, Campagnacci, R, De Luca, R, Ficari, F, Sica, G, Scabini, S, Liverani, A, Caricato, M, Patriti, A, Mancini, S, Baiocchi, G, Santoro, R, Siquini, W, Guercioni, G, Basti, M, Pedrazzani, C, Totis, M, Carrara, A, Lucchi, A, Pavanello, M, Muratore, A, D'Ugo, S, Di Leo, A, Pignata, G, Elmore, U, Anania, G, Carlini, M, Corcione, F, Vettoretto, N, Longo, G, Sorrentino, M, Giuliani, A, Ferrari, G, Taglietti, L, Verzelli, A, Di Cosmo, M, Cavaliere, D, Milone, M, Rausei, S, Ciaccio, G, Tebala, G, Brisinda, G, Berti, S, Millo, P, Boni, L, Guerrieri, M, Persiani, R, Parini, D, Spinelli, A, Genna, M, Bottino, V, Coratti, A, Scala, D, Rivolta, U, Piccoli, M, Talarico, C, Roviello, F, Anastasi, A, Ettorre, G, Montuori, M, Mariani, P, de Manzini, N, Donini, A, Armellino, M, Feo, C, Guerriero, S, Costanzi, A, Marchesi, F, Cicetti, M, Ciano, P, Benedetti, M, Montemurro, L, Mattei, M, Belloni, E, Apa, D, Di Carlo, M, Clementi, M, Bertocchi, E, Masini, G, Altamura, A, Rubichi, F, Cianflocca, D, Migliore, M, Cassini, D, Pandolfini, L, Falsetto, A, Sciuto, A, Pace, U, Bucci, A, Monari, F, Attina, G, Maurizi, A, Simone, M, Giudici, F, Cianchi, F, Baldini, G, Sensi, B, Aprile, A, Soriero, D, Scarinci, A, Capolupo, G, Sisti, V, Ricci, M, Sagnotta, A, Molfino, S, Amodio, P, Cardinali, A, Cicconi, S, Marziali, I, Frazzini, D, Conti, C, Tamini, N, Braga, M, Motter, M, Tirone, G, Martorelli, G, Cacurri, A, Di Marco, C, Marsanic, P, Federico, N, Spampinato, M, Crepaz, L, Andreuccetti, J, Canfora, I, Maggi, G, Chiozza, M, Spoletini, D, Marcellinaro, R, Lisi, G, Bracale, U, Peltrini, R, Di Nuzzo, M, Botteri, E, Santoni, S, Stefanoni, M, Del Vecchio, G, Magistro, C, Ruggiero, S, Birindelli, A, Budassi, A, Zigiotto, D, Solaini, L, Ercolani, G, De Palma, G, Tenconi, S, Locurto, P, Di Cintio, A, Chiarello, M, Cariati, M, Gennai, A, Grivon, M, Cassinotti, E, Ortenzi, M, Biondi, A, De Luca, M, Carrano, F, Fior, F, Ferronetti, A, Giuliani, G, Marino, G, Bertoglio, C, Pecchini, F, Greco, V, Piagnerelli, R, Canonico, G, Colasanti, M, Pinotti, E, Carminati, R, Osenda, E, Graziosi, L, De Martino, C, Ioia, G, Pindozzi, F, Organetti, L, Monteleone, M, Dalmonte, G, La Gioia, G, Catarci M., Guadagni S., Masedu F., Ruffo G., Viola M. G., Borghi F., Baldazzi G., Scatizzi M., Pirozzi F., Delrio P., Garulli G., Marini P., Campagnacci R., De Luca R., Ficari F., Sica G., Scabini S., Liverani A., Caricato M., Patriti A., Mancini S., Baiocchi G. L., Santoro R., Siquini W., Guercioni G., Basti M., Pedrazzani C., Totis M., Carrara A., Lucchi A., Pavanello M., Muratore A., D'Ugo S., Di Leo A., Pignata G., Elmore U., Anania G., Carlini M., Corcione F., Vettoretto N., Longo G., Sorrentino M., Giuliani A., Ferrari G., Taglietti L., Verzelli A., Di Cosmo M., Cavaliere D., Milone M., Rausei S., Ciaccio G., Tebala G., Brisinda G., Berti S., Millo P., Boni L., Guerrieri M., Persiani R., Parini D., Spinelli A., Genna M., Bottino V., Coratti A., Scala D., Rivolta U., Piccoli M., Talarico C., Roviello F., Anastasi A., Ettorre G. M., Montuori M., Mariani P., de Manzini N., Donini A., Armellino M. F., Feo C., Guerriero S., Costanzi A., Marchesi F., Cicetti M., Ciano P., Benedetti M., Montemurro L. A., Mattei M. S., Belloni E., Apa D., Di Carlo M., Clementi M., Bertocchi E., Masini G., Altamura A., Rubichi F., Cianflocca D., Migliore M., Cassini D., Pandolfini L., Falsetto A., Sciuto A., Pace U., Bucci A. F., Monari F., Attina G. M., Maurizi A., Simone M., Giudici F., Cianchi F., Baldini G., Sensi B., Aprile A., Soriero D., Scarinci A., Capolupo G. T., Sisti V., Ricci M. L., Sagnotta A., Molfino S., Amodio P., Cardinali A., Cicconi S., Marziali I., Frazzini D., Conti C., Tamini N., Braga M., Motter M., Tirone G., Martorelli G., Cacurri A., Di Marco C., Marsanic P., Federico N. S. P., Spampinato M., Crepaz L., Andreuccetti J., Canfora I., Maggi G., Chiozza M., Spoletini D., Marcellinaro R., Lisi G., Bracale U., Peltrini R., Di Nuzzo M. M., Botteri E., Santoni S., Stefanoni M., Del Vecchio G., Magistro C., Ruggiero S., Birindelli A., Budassi A., Zigiotto D., Solaini L., Ercolani G., De Palma G. D., Tenconi S., Locurto P., Di Cintio A., Chiarello M. M., Cariati M., Gennai A., Grivon M., Cassinotti E., Ortenzi M., Biondi A., De Luca M., Carrano F., Fior F., Ferronetti A., Giuliani G., Marino G., Bertoglio C. L., Pecchini F., Greco V., Piagnerelli R., Canonico G., Colasanti M., Pinotti E., Carminati R., Osenda E., Graziosi L., De Martino C., Ioia G., Pindozzi F., Organetti L., Monteleone M., Dalmonte G., and La Gioia G.
Abstract: Background: Since most anastomoses after left-sided colorectal resections are performed with a circular stapler, any technological change in stapling devices may influence the incidence of anastomotic adverse events. The aim of the present study was to analyze the effect of a three-row circular stapler on anastomotic leakage and related morbidity after left-sided colorectal resections. Materials and methods: A circular stapled anastomosis was performed in 4255 (50.9%) out of 8359 patients enrolled in two prospective multicenter studies in Italy, and, after exclusion criteria to reduce heterogeneity, 2799 (65.8%) cases were retrospectively analyzed through a 1:1 propensity score-matching model including 20 covariates relative to patient characteristics, to surgery and to perioperative management. Two well-balanced groups of 425 patients each were obtained: group (A) – true population of interest, anastomosis performed with a three-row circular stapler; group (B) – control population, anastomosis performed with a two-row circular stapler. The target of inferences was the average treatment effect in the treated (ATT). The primary endpoints were overall and major anastomotic leakage and overall anastomotic bleeding; the secondary endpoints were overall and major morbidity and mortality rates. The results of multiple logistic regression analyses for the outcomes, including the 20 covariates selected for matching, were presented as odds ratios (OR) and 95% confidence intervals (95% CI). Results: Group A versus group B showed a significantly lower risk of overall anastomotic leakage (2.1 vs. 6.1%; OR 0.33; 95% CI 0.15–0.73; P = 0.006), major anastomotic leakage (2.1 vs. 5.2%; OR 0.39; 95% CI 0.17–0.87; P = 0.022), and major morbidity (3.5 vs. 6.6% events; OR 0.47; 95% CI 0.24–0.91; P = 0.026). Conclusion: The use of three-row circular staplers independently reduced the risk of anastomotic leakage and related morbidity after left-sided colorectal resection. Twenty-five pati
Published: 2023

4. Implementing Enhanced Perioperative Care in Emergency General Surgery: A Prospective Multicenter Observational Study

Author: Ceresoli, M, Biloslavo, A, Bisagni, P, Ciuffa, C, Fortuna, L, La Greca, A, Tartaglia, D, Zago, M, Ficari, F, Foti, G, Braga, M, Armao, F, Bottari, A, Ballabio, M, Beretta, L, Bondi, C, Calcinati, S, Carlucci, M, Chiarugi, M, Ciravegna, A, Coccolini, F, Cozza, V, Cremonini, C, Ferraina, F, Fico, V, Fogliata, M, Germani, P, Gianotti, L, Grandi, S, Guiotto, L, Lena, E, Longhi, M, Lorenzi, I, Malagnino, A, Montino, M, Paiano, L, Pesenti, G, Riccadonna, S, Romanò, B, Russo, A, Somigli, R, Tomajer, V, Tripodi, V, Ceresoli M., Biloslavo A., Bisagni P., Ciuffa C., Fortuna L., La Greca A., Tartaglia D., Zago M., Ficari F., Foti G., Braga M., Armao F. T., Bottari A., Ballabio M., Beretta L., Bondi C., Calcinati S., Carlucci M., Chiarugi M., Ciravegna A. L., Coccolini F., Cozza V., Cremonini C., Ferraina F., Fico V., Fogliata M., Germani P., Gianotti L., Grandi S., Guiotto L., Lena E., Longhi M., Lorenzi I., Malagnino A., Montino M., Paiano L., Pesenti G., Riccadonna S., Romanò B., Russo A., Somigli R., Tomajer V., Tripodi V., Ceresoli, M, Biloslavo, A, Bisagni, P, Ciuffa, C, Fortuna, L, La Greca, A, Tartaglia, D, Zago, M, Ficari, F, Foti, G, Braga, M, Armao, F, Bottari, A, Ballabio, M, Beretta, L, Bondi, C, Calcinati, S, Carlucci, M, Chiarugi, M, Ciravegna, A, Coccolini, F, Cozza, V, Cremonini, C, Ferraina, F, Fico, V, Fogliata, M, Germani, P, Gianotti, L, Grandi, S, Guiotto, L, Lena, E, Longhi, M, Lorenzi, I, Malagnino, A, Montino, M, Paiano, L, Pesenti, G, Riccadonna, S, Romanò, B, Russo, A, Somigli, R, Tomajer, V, Tripodi, V, Ceresoli M., Biloslavo A., Bisagni P., Ciuffa C., Fortuna L., La Greca A., Tartaglia D., Zago M., Ficari F., Foti G., Braga M., Armao F. T., Bottari A., Ballabio M., Beretta L., Bondi C., Calcinati S., Carlucci M., Chiarugi M., Ciravegna A. L., Coccolini F., Cozza V., Cremonini C., Ferraina F., Fico V., Fogliata M., Germani P., Gianotti L., Grandi S., Guiotto L., Lena E., Longhi M., Lorenzi I., Malagnino A., Montino M., Paiano L., Pesenti G., Riccadonna S., Romanò B., Russo A., Somigli R., Tomajer V., and Tripodi V.
Abstract: Introduction: ERAS pathway has been proposed as the standard of care in elective abdominal surgery. Guidelines on ERAS in emergency surgery have been recently published; however, few evidences are still available in the literature. The aim of this study was to evaluate the feasibility of an enhanced recovery protocol in a large cohort of patients undergoing emergency surgery and to identify possible factors impacting postoperative protocol compliance. Methods: This is a prospective multicenter observational study including patients who underwent major emergency general surgery for either intra-abdominal infection or intestinal obstruction. The primary endpoint of the study is the adherence to ERAS postoperative protocol. Secondary endpoints are 30-day mortality and morbidity rates, and length of hospital stay. Results: A total of 589 patients were enrolled in the study, 256 (43.5%) of them underwent intestinal resection with anastomosis. Major complications occurred in 92 (15.6%) patients and 30-day mortality was 6.3%. Median adherence occurred on postoperative day (POD) 1 for naso-gastric tube removal, on POD 2 for mobilization and urinary catheter removal, and on POD 3 for oral intake and i.v. fluid suspension. Laparoscopy was significantly associated with adherence to postoperative protocol, whereas operative fluid infusion > 12 mL/Kg/h, preoperative hyperglycemia, presence of a drain, duration of surgery and major complications showed a negative association. Conclusions: The present study supports that an enhanced recovery protocol in emergency surgery is feasible and safe. Laparoscopy was associated with an earlier recovery, whereas preoperative hyperglycemia, fluid overload, and abdominal drain were associated with a delayed recovery.
Published: 2023

5. P988 Preliminary report on short-term post-operative outcomes of robotic versus laparoscopic approach for restorative procto-colectomy with ileal-pouch-anal anastomosis in ulcerative colitis: a comparative study

Author: Emma, E P, primary, Palleschi, C V, additional, Mariatti, M, additional, Minuzzo, A, additional, Perna, F, additional, Gia, E, additional, Ferrara, A, additional, Ficari, F, additional, and Scaringi, S, additional
Published: 2024
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6. P240 PREOPERATIVE OPTIMISATION FOR A PATIENT WITH HEART FAILURE UNDERGOING MAJOR NON–CARDIAC SURGERY: AN EXAMPLE OF COLLABORATION BETWEEN THE MULTIMODAL PREHABILITATION CENTRE AND THE HEART FAILURE CLINIC AT CAREGGI UNIVERSITY HOSPITAL

Author: Testa, G, primary, Livi, F, additional, Foti, L, additional, Verga, F, additional, Salucci, C, additional, D‘Errico, G, additional, Perini, E, additional, Fiorindi, C, additional, Cianchi, F, additional, Ficari, F, additional, Scaringi, S, additional, Tognozzi, C, additional, Amatucci, S, additional, Marmorale, S, additional, Ungar, A, additional, Romagnoli, S, additional, Orso, F, additional, Baldasseroni, S, additional, and Baldini, G, additional
Published: 2023
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7. Implementing Enhanced Perioperative Care in Emergency General Surgery: A Prospective Multicenter Observational Study

Author: Ceresoli M., Biloslavo A., Bisagni P., Ciuffa C., Fortuna L., La Greca A., Tartaglia D., Zago M., Ficari F., Foti G., Braga M., Armao F. T., Bottari A., Ballabio M., Beretta L., Bondi C., Calcinati S., Carlucci M., Chiarugi M., Ciravegna A. L., Coccolini F., Cozza V., Cremonini C., Ferraina F., Fico V., Fogliata M., Germani P., Gianotti L., Grandi S., Guiotto L., Lena E., Longhi M., Lorenzi I., Malagnino A., Montino M., Paiano L., Pesenti G., Riccadonna S., Romanò B., Russo A., Somigli R., Tomajer V., Tripodi V., Ceresoli, M, Biloslavo, A, Bisagni, P, Ciuffa, C, Fortuna, L, La Greca, A, Tartaglia, D, Zago, M, Ficari, F, Foti, G, Braga, M, Armao, F, Bottari, A, Ballabio, M, Beretta, L, Bondi, C, Calcinati, S, Carlucci, M, Chiarugi, M, Ciravegna, A, Coccolini, F, Cozza, V, Cremonini, C, Ferraina, F, Fico, V, Fogliata, M, Germani, P, Gianotti, L, Grandi, S, Guiotto, L, Lena, E, Longhi, M, Lorenzi, I, Malagnino, A, Montino, M, Paiano, L, Pesenti, G, Riccadonna, S, Romanò, B, Russo, A, Somigli, R, Tomajer, V, and Tripodi, V
Subjects: emergency surgery, era
Abstract: Introduction: ERAS pathway has been proposed as the standard of care in elective abdominal surgery. Guidelines on ERAS in emergency surgery have been recently published; however, few evidences are still available in the literature. The aim of this study was to evaluate the feasibility of an enhanced recovery protocol in a large cohort of patients undergoing emergency surgery and to identify possible factors impacting postoperative protocol compliance. Methods: This is a prospective multicenter observational study including patients who underwent major emergency general surgery for either intra-abdominal infection or intestinal obstruction. The primary endpoint of the study is the adherence to ERAS postoperative protocol. Secondary endpoints are 30-day mortality and morbidity rates, and length of hospital stay. Results: A total of 589 patients were enrolled in the study, 256 (43.5%) of them underwent intestinal resection with anastomosis. Major complications occurred in 92 (15.6%) patients and 30-day mortality was 6.3%. Median adherence occurred on postoperative day (POD) 1 for naso-gastric tube removal, on POD 2 for mobilization and urinary catheter removal, and on POD 3 for oral intake and i.v. fluid suspension. Laparoscopy was significantly associated with adherence to postoperative protocol, whereas operative fluid infusion > 12 mL/Kg/h, preoperative hyperglycemia, presence of a drain, duration of surgery and major complications showed a negative association. Conclusions: The present study supports that an enhanced recovery protocol in emergency surgery is feasible and safe. Laparoscopy was associated with an earlier recovery, whereas preoperative hyperglycemia, fluid overload, and abdominal drain were associated with a delayed recovery.
Published: 2023

8. Early Postoperative Low Compliance to Enhanced Recovery Pathway in Rectal Cancer Patients

Author: Ceresoli, M, Pedrazzani, C, Pellegrino, L, Muratore, A, Ficari, F, Polastri, R, Scatizzi, M, Totis, M, Tamini, N, Ripamonti, L, Braga, M, Ceresoli M., Pedrazzani C., Pellegrino L., Muratore A., Ficari F., Polastri R., Scatizzi M., Totis M., Tamini N., Ripamonti L., Braga M., Ceresoli, M, Pedrazzani, C, Pellegrino, L, Muratore, A, Ficari, F, Polastri, R, Scatizzi, M, Totis, M, Tamini, N, Ripamonti, L, Braga, M, Ceresoli M., Pedrazzani C., Pellegrino L., Muratore A., Ficari F., Polastri R., Scatizzi M., Totis M., Tamini N., Ripamonti L., and Braga M.
Abstract: Early postoperative low compliance to enhanced recovery protocols has been associated with morbidity following colon surgery. The purpose of this study is to evaluate the possible causes of early postoperative low compliance to the enhanced recovery pathway and its relationship with morbidity following rectal surgery for cancer. A total of 439 consecutive patients who underwent elective surgery for rectal cancer have been included in the study. Compliance to enhanced recovery protocol on postoperative day (POD) 2 was evaluated in all patients. Indicators of compliance were naso-gastric tube and urinary catheter removal, recovery of both oral feeding and mobilization, and the stopping of intravenous fluids. Low compliance on POD 2 was defined as non- adherence to two or more items. One-third of patients had low compliance on POD 2. Removal of urinary catheter, intravenous fluids stop, and mobilization were the items with lowest adherence. Advanced age, duration of surgery, open surgery and diverting stoma were predictive factors of low compliance at multivariate analysis. Overall morbidity and major complications were significantly higher (p < 0.001) in patients with low compliance on POD 2. At multivariate analysis, failure to remove urinary catheter on POD 2 (OR = 1.83) was significantly correlated with postoperative complications. Low compliance to enhanced recovery protocol on POD 2 was significantly associated with morbidity. Failure to remove the urinary catheter was the most predictive indicator. Advanced age, long procedure, open surgery and diverting stoma were independent predictive factors of low compliance.
Published: 2022

9. Early non compliance to enhanced recovery pathway might be an alert for underlying complications following colon surgery

Author: Ceresoli, M, Pedrazzani, C, Pellegrino, L, Ficari, F, Braga, M, Muratore, A, Tamini, N, Beretta, L, Azzola, M, Radrizzani, D, Borghi, F, Missana, G, Scatizzi, M, Totis, M, Crespi, M, Bima, C, Bouzari, H, Valenti, A, Ceretti, A, Polastri, R, Longhin, R, Maurizi, A, Cassini, D, Di Marzo, F, Fumagalli, S, Muratori, S, Casati, M, Ceresoli M., Pedrazzani C., Pellegrino L., Ficari F., Braga M., Muratore A., Tamini N., Beretta L., Azzola M., Radrizzani D., Borghi F., Missana G., Scatizzi M., Totis M., Crespi M., Bima C., Bouzari H., Valenti A., Ceretti A. P., Polastri R., Longhin R., Maurizi A., Cassini D., Di Marzo F., Fumagalli S., Muratori S., Casati M., Ceresoli, M, Pedrazzani, C, Pellegrino, L, Ficari, F, Braga, M, Muratore, A, Tamini, N, Beretta, L, Azzola, M, Radrizzani, D, Borghi, F, Missana, G, Scatizzi, M, Totis, M, Crespi, M, Bima, C, Bouzari, H, Valenti, A, Ceretti, A, Polastri, R, Longhin, R, Maurizi, A, Cassini, D, Di Marzo, F, Fumagalli, S, Muratori, S, Casati, M, Ceresoli M., Pedrazzani C., Pellegrino L., Ficari F., Braga M., Muratore A., Tamini N., Beretta L., Azzola M., Radrizzani D., Borghi F., Missana G., Scatizzi M., Totis M., Crespi M., Bima C., Bouzari H., Valenti A., Ceretti A. P., Polastri R., Longhin R., Maurizi A., Cassini D., Di Marzo F., Fumagalli S., Muratori S., and Casati M.
Abstract: Purpose: Early non compliance to postoperative ERAS pathway has been reported in 20–30% of patients who underwent elective colon surgery. The aim of the present study is to investigate the possible relationship between early non compliance and postoperative complications. Methods: We reviewed a prospective database including 1391 consecutively collected patients undergoing elective colon surgery in 22 Italian hospitals between January 2017 and June 2020. Early compliance to ERAS protocol was assessed on postoperative day (POD) 2. Failure of oral feeding, urinary catheter removal, intravenous fluids stop, and adequate mobilization were indicators of non compliance. Postoperative follow-up was carried out for 30 days after hospital discharge. The association among early postoperative ERAS compliance and the occurrence of complications was assessed with uni- and multivariate analysis. Results: A total of 1089 (78.3%) patients had malignancy and minimally invasive surgery was successfully performed in 1174 (84.3%) patients. Postoperative morbidity occurred in 403 (29.0%) patients. At multivariate analysis, male gender, open surgery, and each of the four non compliance indicators on POD 2 were significantly associated to postoperative complications. Morbidity progressively increased from 16.8% in patients with full compliance to ERAS protocol to 47.2% in patients with two non compliance indicators and 69.2% in patients with all four indicators (p < 0.001). Conclusions: Early non compliance to ERAS protocol was significantly associated with postoperative morbidity.
Published: 2022

10. OC.14.6 ATTITUDES TOWARDS VACCINATIONS IN AN ITALIAN COHORT OF IBD PATIENTS

Author: Costantino, A., primary, Michelon, M., additional, Noviello, D., additional, Leone, S., additional, Aloi, M., additional, Armuzzi, A., additional, Bossa, F., additional, Ficari, F., additional, Manguso, F., additional, Mocci, G., additional, Orlando, A., additional, Pironi, L., additional, Radice, S., additional, Rizzello, F., additional, Tongiorgi, A., additional, Costantino, C., additional, Vecchi, M., additional, and Caprioli, F.A., additional
Published: 2023
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11. P449 Minimally invasive IPAA in UC: Preliminary results from a referral center

Author: Fortuna, L, primary, Bottari, A, additional, Ficari, F, additional, Cricchio, M, additional, Cianchi, F, additional, and Scaringi, S, additional
Published: 2023
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12. Anastomosis configuration and technique following ileocaecal resection for Crohn’s disease: a multicentre study

Author: Celentano, V, Pellino, G, Spinelli, A, Selvaggi, F, SICCR Current status of Crohn’s disease surgery collaborative, Rottoli, M, Poggioli, G, Sica, G, Giglio, Mc, Campanelli, M, Coco, C, Rizzo, G, Sionne, F, Colombo, F, Sampietro, G, Lamperti, G, Foschi, D, Ficari, F, Vacca, L, Cricchio, M, Giudici, F, Selvaggi, L, Sciaudone, G, Peltrini, R, Manfreda, A, Bucci, L, Galleano, R, Ghazouani, O, Zorcolo, L, Deidda, S, Restivo, A, Braini, A, Di Candido, F, Sacchi, M, Carvello, M, Martorana, S, Bordignon, G, Angriman, I, Variola, A, Di Ruscio, M, Barugola, G, Geccherle, A, Tropeano, Fp, Luglio, G, Tanzanu, M, Sasia, D, Migliore, M, Giuffrida, Mc, Marrano, E, Moretto, G, Impellizzeri, H, Gallo, G, Vescio, G, Sammarco, G, Terrosu, G, Calini, G, Bondurri, A, Maffioli, A, Zaffaroni, G, Resegotti, A, Mistrangelo, M, Allaix, Me, Botti, F, Prati, M, Boni, L, Perotti, S, Mineccia, M, Giuliani, A, Romano, L, Graziano, Gmp, Pugliese, L, Pietrabissa, A, Delaini, G, on behalf of the Italian Society of Colorectal Surgery SICCR., Celentano, Valerio, Pellino, Gianluca, Spinelli, Antonino, Selvaggi, Francesco, Rottoli, Matteo, Poggioli, Gilberto, Sica, Giuseppe, Giglio, Mariano Cesare, Campanelli, Michela, Coco, Claudio, Rizzo, Gianluca, Sionne, Francesco, Colombo, Francesco, Sampietro, Gianluca, Lamperti, Giulia, Foschi, Diego, Ficari, Ferdinando, Vacca, Ludovica, Cricchio, Marta, Giudici, Francesco, Selvaggi, Lucio, Sciaudone, Guido, Peltrini, Roberto, Manfreda, Andrea, Bucci, Luigi, Galleano, Raffaele, Ghazouani, Omar, Zorcolo, Luigi, Deidda, Simona, Restivo, Angelo, Braini, Andrea, Di Candido, Francesca, Sacchi, Matteo, Carvello, Michele, Martorana, Stefania, Bordignon, Giovanni, Angriman, Imerio, Variola, Angela, Di Ruscio, Mirko, Barugola, Giuliano, Geccherle, Andrea, Tropeano, Francesca Paola, Luglio, Gaetano, Tanzanu, Marta, Sasia, Diego, Migliore, Marco, Giuffrida, Maria Carmela, Marrano, Enrico, Moretto, Gianluigi, Impellizzeri, Harmony, Gallo, Gaetano, Vescio, Giuseppina, Sammarco, Giuseppe, Terrosu, Giovanni, Calini, Giacomo, Bondurri, Andrea, Maffioli, Anna, Zaffaroni, Gloria, Resegotti, Andrea, Mistrangelo, Massimiliano, Allaix, Marco Ettore, Botti, Fiorenzo, Prati, Matteo, Boni, Luigi, Perotti, Serena, Mineccia, Michela, Giuliani, Antonio, Romano, Lucia, Graziano, Giorgio Maria Paolo, Pugliese, Luigi, Pietrabissa, Andrea, Delaini, GianGaetano, Celentano, V., Pellino, G., Spinelli, A., Selvaggi, F., Rottoli, M., Poggioli, G., Sica, G., Giglio, M. C., Campanelli, M., Coco, C., Rizzo, G., Sionne, F., Colombo, F., Sampietro, G., Lamperti, G., Foschi, D., Ficari, F., Vacca, L., Cricchio, M., Giudici, F., Selvaggi, L., Sciaudone, G., Peltrini, R., Manfreda, A., Bucci, L., Galleano, R., Ghazouani, O., Zorcolo, L., Deidda, S., Restivo, A., Braini, A., Di Candido, F., Sacchi, M., Carvello, M., Martorana, S., Bordignon, G., Angriman, I., Variola, A., Di Ruscio, M., Barugola, G., Geccherle, A., Tropeano, F. P., Luglio, G., Tanzanu, M., Sasia, D., Migliore, M., Giuffrida, M. C., Marrano, E., Moretto, G., Impellizzeri, H., Gallo, G., Vescio, G., Sammarco, G., Terrosu, G., Calini, G., Bondurri, A., Maffioli, A., Zaffaroni, G., Resegotti, A., Mistrangelo, M., Allaix, M. E., Botti, F., Prati, M., Boni, L., Perotti, S., Mineccia, M., Giuliani, A., Romano, L., Graziano, G. M. P., Pugliese, L., Pietrabissa, A., Delaini, G. G., Delaini, Giangaetano, Jinodg, G., Candido, F. D., and Ruscio, M. D.
Subjects: Ileocaecal resection, Male, Crohn’s disease, Leak, Settore MED/18 - CHIRURGIA GENERALE, Anastomotic Leak, Inflammatory bowel disease, Postoperative Complications, 0302 clinical medicine, Crohn Disease, Retrospective Studie, Surgical, 80 and over, Clinical endpoint, Colorectal surgery, National audit, Adolescent, Adult, Aged, Aged, 80 and over, Anastomosis, Surgical, Cecum, Digestive System Surgical Procedures, Elective Surgical Procedures, Female, Humans, Ileum, Laparoscopy, Length of Stay, Middle Aged, Reconstructive Surgical Procedures, Retrospective Studies, Treatment Outcome, Young Adult, Crohn's disease, 030220 oncology & carcinogenesis, 030211 gastroenterology & hepatology, Human, medicine.medical_specialty, Anastomosis, 03 medical and health sciences, medicine, Performed Procedure, Reconstructive Surgical Procedure, colorectal surgery, national audit, Elective Surgical Procedure, business.industry, Digestive System Surgical Procedure, Plastic Surgery Procedures, medicine.disease, Settore MED/18, Surgery, Crohn’s disease · Inflammatory bowel disease · Ileocaecal resection · Colorectal surgery · National audit, Postoperative Complication, business
Abstract: A limited ileocaecal resection is the most frequently performed procedure for ileocaecal CD and different anastomotic configurations and techniques have been described. This manuscript audited the different anastomotic techniques used in a national study and evaluated their influence on postoperative outcomes following ileocaecal resection for primary CD. This is a retrospective, multicentre, observational study promoted by the Italian Society of Colorectal Surgery (SICCR), including all adults undergoing elective ileocaecal resection for primary CD from June 2018 May 2019. Postoperative morbidity within 30days of surgery was the primary endpoint. Postoperative length of hospital stay (LOS) and anastomotic leak rate were the secondary outcomes. 427 patients were included. The side to side anastomosis was the chosen configuration in 380 patients (89%). The stapled anastomotic (n = 286; 67%), techniques were preferred to hand-sewn (n = 141; 33%). Postoperative morbidity was 20.3% and anastomotic leak 3.7%. Anastomotic leak was independent of the type of anastomosis performed, while was associated with an ASA grade ≥ 3, presence of perianal disease and ileocolonic localization of disease. Four predictors of LOS were identified after multivariate analysis. The laparoscopic approach was the only associated with a reduced LOS (p = 0.017), while age, ASA grade ≥ 3 or administration of preoperative TPN were associated with increased LOS. The side to side was the most commonly used anastomotic configuration for ileocolic reconstruction following primary CD resection. There was no difference in postoperative morbidity according to anastomotic technique and configuration. Anastomotic leak was associated with ASA grade ≥ 3, a penetrating phenotype of disease and ileo-colonic distribution of CD. A limited ileocaecal resection is the most frequently performed procedure for ileocaecal CD and different anastomotic configurations and techniques have been described. This manuscript audited the different anastomotic techniques used in a national study and evaluated their influence on postoperative outcomes following ileocaecal resection for primary CD. This is a retrospective, multicentre, observational study promoted by the Italian Society of Colorectal Surgery (SICCR), including all adults undergoing elective ileocaecal resection for primary CD from June 2018 May 2019. Postoperative morbidity within 30days of surgery was the primary endpoint. Postoperative length of hospital stay (LOS) and anastomotic leak rate were the secondary outcomes. 427 patients were included. The side to side anastomosis was the chosen configuration in 380 patients (89%). The stapled anastomotic (n = 286; 67%), techniques were preferred to hand-sewn (n = 141; 33%). Postoperative morbidity was 20.3% and anastomotic leak 3.7%. Anastomotic leak was independent of the type of anastomosis performed, while was associated with an ASA grade ≥ 3, presence of perianal disease and ileocolonic localization of disease. Four predictors of LOS were identified after multivariate analysis. The laparoscopic approach was the only associated with a reduced LOS (p = 0.017), while age, ASA grade ≥ 3 or administration of preoperative TPN were associated with increased LOS. The side to side was the most commonly used anastomotic configuration for ileocolic reconstruction following primary CD resection. There was no difference in postoperative morbidity according to anastomotic technique and configuration. Anastomotic leak was associated with ASA grade ≥ 3, a penetrating phenotype of disease and ileo-colonic distribution of CD.
Published: 2021

13. Correction to: Single-incision laparoscopic surgery (SILS) for the treatment of ileocolonic Crohn’s disease: a propensity score–matched analysis (International Journal of Colorectal Disease, (2021), 36, 3, (605-608), 10.1007/s00384-020-03821-6)

Author: Celentano V., Pellino G., Rottoli M., Colombo F., Sampietro G., Spinelli A., Selvaggi F., Poggioli G., Sica G., Giglio M. C., Campanelli M., Coco C., Rizzo G., Sionne F., Lamperti G., Foschi D., Ficari F., Vacca L., Cricchio M., Giudici F., Selvaggi L., Sciaudone G., Peltrini R., Manfreda A., Bucci L., Galleano R., Ghazouani O., Zorcolo L., Deidda S., Restivo A., Braini A., Di Candido F., Sacchi M., Carvello M., Martorana S., Bordignon G., Angriman I., Variola A., Di Ruscio M., Barugola G., Geccherle A., Tropeano F. P., Luglio G., Tanzanu M., Sasia D., Migliore M., Giuffrida M. C., Marrano E., Moretto G., Impellizzeri H., Gallo G., Vescio G., Sammarco G., Terrosu G., Calini G., Bondurri A., Maffioli A., Zaffaroni G., Resegotti A., Mistrangelo M., Allaix M. E., Botti F., Prati M., Boni L., Perotti S., Mineccia M., Giuliani A., Romano L., Graziano G. M. P., Pugliese L., Pietrabissa A., Delaini G. G., Celentano, V., Pellino, G., Rottoli, M., Colombo, F., Sampietro, G., Spinelli, A., Selvaggi, F., Poggioli, G., Sica, G., Giglio, M. C., Campanelli, M., Coco, C., Rizzo, G., Sionne, F., Lamperti, G., Foschi, D., Ficari, F., Vacca, L., Cricchio, M., Giudici, F., Selvaggi, L., Sciaudone, G., Peltrini, R., Manfreda, A., Bucci, L., Galleano, R., Ghazouani, O., Zorcolo, L., Deidda, S., Restivo, A., Braini, A., Di Candido, F., Sacchi, M., Carvello, M., Martorana, S., Bordignon, G., Angriman, I., Variola, A., Di Ruscio, M., Barugola, G., Geccherle, A., Tropeano, F. P., Luglio, G., Tanzanu, M., Sasia, D., Migliore, M., Giuffrida, M. C., Marrano, E., Moretto, G., Impellizzeri, H., Gallo, G., Vescio, G., Sammarco, G., Terrosu, G., Calini, G., Bondurri, A., Maffioli, A., Zaffaroni, G., Resegotti, A., Mistrangelo, M., Allaix, M. E., Botti, F., Prati, M., Boni, L., Perotti, S., Mineccia, M., Giuliani, A., Romano, L., Graziano, G. M. P., Pugliese, L., Pietrabissa, A., and Delaini, G. G.
Abstract: All authors and affiliations of the SICCR Current status of Crohn’s disease surgery collaborative are listed in Appendix 1 and Specification of authors’ contribution is detailed in Appendix 2 of the original version of the above article however, the names were not cited nor reflected online. Thus, the namesarenowpresentedandcitedcorrectly.Allauthorstobe indexed on Pubmed. TheaffiliationofFrancescoColomboaco-authoroftheabove articleis affiliatedto“GeneralSurgeryUnit,Departmentof Biomedical and ClinicalSciences “L. Sacco”. University of Milan, AAST Fatebenefratelli Sacco, Milan, Italy” instead of “Division of General and HPB Surgery, Department of Surgery, ASST Rhodense- Rho Memorial Hospital,20017 Rho, Milan, Italy”. The original article has been corrected.
Published: 2021

14. Correction to: Single-incision laparoscopic surgery (SILS) for the treatment of ileocolonic Crohn’s disease: a propensity score–matched analysis (International Journal of Colorectal Disease, (2020), 10.1007/s00384-020-03821-6)

Author: Celentano, V., Pellino, G., Rottoli, M., Colombo, F., Sampietro, G., Spinelli, A., Selvaggi, F., Poggioli, G., Sica, G., Giglio, M. C., Campanelli, M., Coco, C., Rizzo, G., Sionne, F., Lamperti, G., Foschi, D., Ficari, F., Vacca, L., Cricchio, M., Giudici, F., Selvaggi, L., Sciaudone, G., Peltrini, R., Manfreda, A., Bucci, L., Galleano, R., Ghazouani, O., Zorcolo, L., Deidda, S., Restivo, A., Braini, A., Di Candido, F., Sacchi, M., Carvello, M., Martorana, S., Bordignon, G., Angriman, I., Variola, A., Di Ruscio, M., Barugola, G., Geccherle, A., Tropeano, F. P., Luglio, G., Tanzanu, M., Sasia, D., Migliore, M., Giuffrida, M. C., Marrano, E., Moretto, G., Impellizzeri, H., Gallo, G., Vescio, G., Sammarco, G., Terrosu, G., Calini, G., Bondurri, A., Maffioli, A., Zaffaroni, G., Resegotti, A., Mistrangelo, M., Allaix, M. E., Botti, F., Prati, M., Boni, L., Perotti, S., Mineccia, M., Giuliani, A., Romano, L., Graziano, G. M. P., Pugliese, L., Pietrabissa, A., Delaini, G. G., Celentano, V., Pellino, G., Rottoli, M., Colombo, F., Sampietro, G., Spinelli, A., Selvaggi, F., Poggioli, G., Sica, G., Giglio, M. C., Campanelli, M., Coco, C., Rizzo, G., Sionne, F., Lamperti, G., Foschi, D., Ficari, F., Vacca, L., Cricchio, M., Giudici, F., Selvaggi, L., Sciaudone, G., Peltrini, R., Manfreda, A., Bucci, L., Galleano, R., Ghazouani, O., Zorcolo, L., Deidda, S., Restivo, A., Braini, A., Di Candido, F., Sacchi, M., Carvello, M., Martorana, S., Bordignon, G., Angriman, I., Variola, A., Di Ruscio, M., Barugola, G., Geccherle, A., Tropeano, F. P., Luglio, G., Tanzanu, M., Sasia, D., Migliore, M., Giuffrida, M. C., Marrano, E., Moretto, G., Impellizzeri, H., Gallo, G., Vescio, G., Sammarco, G., Terrosu, G., Calini, G., Bondurri, A., Maffioli, A., Zaffaroni, G., Resegotti, A., Mistrangelo, M., Allaix, M. E., Botti, F., Prati, M., Boni, L., Perotti, S., Mineccia, M., Giuliani, A., Romano, L., Graziano, G. M. P., Pugliese, L., Pietrabissa, A., and Delaini, G. G.
Subjects: sils, crohn's disease, sils, crohn's disease, ileo-colonic, ileo-colonic
Abstract: All authors and affiliations of the SICCR Current status of Crohn’s disease surgery collaborative are listed in Appendix 1 and Specification of authors’ contribution is detailed in Appendix 2 of the original version of the above article however, the names were not cited nor reflected online. Thus, the names are now presented and cited correctly. All authors to be indexed on Pubmed. The original article has been corrected.
Published: 2021

15. P527 Telemedicine in IBD patients: results of a national survey of the Italian IBD patients’ association (AMICI Onlus)

Author: Costantino, A, primary, Caprioli, F, additional, Vecchi, M, additional, Stocco, D, additional, Aloi, M, additional, Armuzzi, A, additional, Ficari, F, additional, Manguso, F, additional, Mocci, G, additional, Orlando, A, additional, Pironi, L, additional, Radice, S, additional, Rizzello, F, additional, Tongiorgi, A, additional, Leone, S, additional, and Bossa, F, additional
Published: 2022
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16. AF.49 DETERMINANTS OF COVID-19 VACCINE HESITANCY IN PATIENTS WITH INFLAMMATORY BOWEL DISEASE (IBD): RESULTS OF A NATIONAL SURVEY OF THE ITALIAN IBD PATIENTS’ ASSOCIATION (AMICI ONLUS)

Author: Costantino, A., primary, Noviello, D., additional, Conforti, F.S., additional, Aloi, M., additional, Armuzzi, A., additional, Bossa, F., additional, Ficari, F., additional, Leone, S., additional, Manguso, F., additional, Mocci, G., additional, Orlando, A., additional, Pironi, L., additional, Radice, S., additional, Rizzello, F., additional, Tongiorgi, A., additional, Costantino, C., additional, Vecchi, M., additional, and Caprioli, F., additional
Published: 2021
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17. P463 COVID-19 vaccination willingness and hesitancy in patients with Inflammatory Bowel Diseases (IBD): analysis of determinants in a national survey of the Italian IBD patients’ association (AMICI Onlus)

Author: Costantino, A, primary, Noviello, D, additional, Conforti, F S, additional, Aloi, M, additional, Armuzzi, A, additional, Bossa, F, additional, Ficari, F, additional, Leone, S, additional, Manguso, F, additional, Mocci, G, additional, Orlando, A, additional, Pironi, L, additional, Radice, S, additional, Rizzello, F, additional, Tongiorgi, A, additional, Costantino, C, additional, Vecchi, M, additional, and Caprioli, F, additional
Published: 2021
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18. Anastomosis configuration and technique following ileocaecal resection for Crohn’s disease: a multicentre study

Author: Celentano, V., Pellino, G., Spinelli, A., Selvaggi, F., Selvaggi, L., Sciaudone, G., Rottoli, M., Poggioli, G., Tanzanu, M., Sica, G., Campanelli, M., Giglio, M. C., Coco, C., Rizzo, G., Sionne, F., Colombo, F., Sampietro, G., Lamperti, G., Foschi, D., Ficari, F., Vacca, L., Cricchio, M., Giudici, F., Peltrini, R., Manfreda, A., Bucci, L., Galleano, R., Ghazouani, O., Zorcolo, L., Deidda, S., Restivo, A., Braini, A., Candido, F. D., Sacchi, M., Carvello, M., Martorana, S., Bordignon, G., Angriman, I., Variola, A., Ruscio, M. D., Barugola, G., Geccherle, A., Tropeano, F. P., Luglio, G., Sasia, D., Migliore, M., Giuffrida, M. C., Marrano, E., Moretto, G., Gallo, G., Vescio, G., Sammarco, G., Terrosu, G., Calini, G., Bondurri, A., Maffioli, A., Zaffaroni, G., Resegotti, A., Mistrangelo, M., Botti, F., Prati, M., Boni, L., Perotti, S., Mineccia, M., Giuliani, A., Romano, L., Graziano, G. M. P., Pugliese, L., Pietrabissa, A., Coco C. (ORCID:0000-0002-4713-7093), Rizzo G., Sionne F., Giuliani A. (ORCID:0000-0002-0773-2162), Celentano, V., Pellino, G., Spinelli, A., Selvaggi, F., Selvaggi, L., Sciaudone, G., Rottoli, M., Poggioli, G., Tanzanu, M., Sica, G., Campanelli, M., Giglio, M. C., Coco, C., Rizzo, G., Sionne, F., Colombo, F., Sampietro, G., Lamperti, G., Foschi, D., Ficari, F., Vacca, L., Cricchio, M., Giudici, F., Peltrini, R., Manfreda, A., Bucci, L., Galleano, R., Ghazouani, O., Zorcolo, L., Deidda, S., Restivo, A., Braini, A., Candido, F. D., Sacchi, M., Carvello, M., Martorana, S., Bordignon, G., Angriman, I., Variola, A., Ruscio, M. D., Barugola, G., Geccherle, A., Tropeano, F. P., Luglio, G., Sasia, D., Migliore, M., Giuffrida, M. C., Marrano, E., Moretto, G., Gallo, G., Vescio, G., Sammarco, G., Terrosu, G., Calini, G., Bondurri, A., Maffioli, A., Zaffaroni, G., Resegotti, A., Mistrangelo, M., Botti, F., Prati, M., Boni, L., Perotti, S., Mineccia, M., Giuliani, A., Romano, L., Graziano, G. M. P., Pugliese, L., Pietrabissa, A., Coco C. (ORCID:0000-0002-4713-7093), Rizzo G., Sionne F., and Giuliani A. (ORCID:0000-0002-0773-2162)
Abstract: A limited ileocaecal resection is the most frequently performed procedure for ileocaecal CD and different anastomotic configurations and techniques have been described. This manuscript audited the different anastomotic techniques used in a national study and evaluated their influence on postoperative outcomes following ileocaecal resection for primary CD. This is a retrospective, multicentre, observational study promoted by the Italian Society of Colorectal Surgery (SICCR), including all adults undergoing elective ileocaecal resection for primary CD from June 2018 May 2019. Postoperative morbidity within 30 days of surgery was the primary endpoint. Postoperative length of hospital stay (LOS) and anastomotic leak rate were the secondary outcomes. 427 patients were included. The side to side anastomosis was the chosen configuration in 380 patients (89%). The stapled anastomotic (n = 286; 67%), techniques were preferred to hand-sewn (n = 141; 33%). Postoperative morbidity was 20.3% and anastomotic leak 3.7%. Anastomotic leak was independent of the type of anastomosis performed, while was associated with an ASA grade ≥ 3, presence of perianal disease and ileocolonic localization of disease. Four predictors of LOS were identified after multivariate analysis. The laparoscopic approach was the only associated with a reduced LOS (p = 0.017), while age, ASA grade ≥ 3 or administration of preoperative TPN were associated with increased LOS. The side to side was the most commonly used anastomotic configuration for ileocolic reconstruction following primary CD resection. There was no difference in postoperative morbidity according to anastomotic technique and configuration. Anastomotic leak was associated with ASA grade ≥ 3, a penetrating phenotype of disease and ileo-colonic distribution of CD.
Published: 2021

19. National variations in perioperative assessment and surgical management of Crohn’s disease: a multicentre study

Author: Celentano, V., Pellino, G., Rottoli, M., Poggioli, G., Sica, G., Giglio, M. C., Campanelli, M., Coco, Claudio, Rizzo, Gianluca, Sionne, Francesco, Colombo, F., Sampietro, G., Lamperti, G., Foschi, D., Ficari, F., Vacca, L., Cricchio, M., Giudici, F., Selvaggi, L., Sciaudone, G., Peltrini, R., Manfreda, A., Bucci, L., Galleano, R., Ghazouani, O., Zorcolo, L., Deidda, S., Restivo, A., Braini, A., Di Candido, F., Sacchi, M., Carvello, M., Martorana, S., Bordignon, G., Angriman, I., Variola, A., Di Ruscio, M., Barugola, G., Geccherle, A., Tropeano, F. P., Luglio, G., Tanzanu, M., Sasia, D., Migliore, M., Giuffrida, M. C., Marrano, E., Moretto, G., Impellizzeri, H., Gallo, G., Vescio, G., Sammarco, G., Terrosu, G., Calini, G., Bondurri, A., Maffioli, A., Zaffaroni, G., Resegotti, A., Mistrangelo, M., Allaix, M. E., Botti, F., Prati, M., Boni, L., Perotti, S., Mineccia, M., Giuliani, A., Romano, L., Graziano, G. M. P., Pugliese, L., Pietrabissa, A., Delaini, G., Spinelli, A., Selvaggi, F., Coco C. (ORCID:0000-0002-4713-7093), Rizzo G., Sionne F., Celentano, V., Pellino, G., Rottoli, M., Poggioli, G., Sica, G., Giglio, M. C., Campanelli, M., Coco, Claudio, Rizzo, Gianluca, Sionne, Francesco, Colombo, F., Sampietro, G., Lamperti, G., Foschi, D., Ficari, F., Vacca, L., Cricchio, M., Giudici, F., Selvaggi, L., Sciaudone, G., Peltrini, R., Manfreda, A., Bucci, L., Galleano, R., Ghazouani, O., Zorcolo, L., Deidda, S., Restivo, A., Braini, A., Di Candido, F., Sacchi, M., Carvello, M., Martorana, S., Bordignon, G., Angriman, I., Variola, A., Di Ruscio, M., Barugola, G., Geccherle, A., Tropeano, F. P., Luglio, G., Tanzanu, M., Sasia, D., Migliore, M., Giuffrida, M. C., Marrano, E., Moretto, G., Impellizzeri, H., Gallo, G., Vescio, G., Sammarco, G., Terrosu, G., Calini, G., Bondurri, A., Maffioli, A., Zaffaroni, G., Resegotti, A., Mistrangelo, M., Allaix, M. E., Botti, F., Prati, M., Boni, L., Perotti, S., Mineccia, M., Giuliani, A., Romano, L., Graziano, G. M. P., Pugliese, L., Pietrabissa, A., Delaini, G., Spinelli, A., Selvaggi, F., Coco C. (ORCID:0000-0002-4713-7093), Rizzo G., and Sionne F.
Abstract: Aim: Crohn's disease (CD) requires a multidisciplinary approach and surgery should be undertaken by dedicated colorectal surgeons with audited outcomes. We present a national, multicentre study, with the aim to collect benchmark data on key performance indicators in CD surgery, to highlight areas where standards of CD surgery excel and to facilitate targeted quality improvement where indicated. Methods: All patients undergoing ileocaecal or redo ileocolic resection in the participating centres for primary and recurrent CD from June 2018 to May 2019 were included. The main objective was to collect national data on hospital volume and practice variations. Postoperative morbidity was the primary outcome. Laparoscopic surgery and stoma rate were the secondary outcomes. Results: In all, 715 patients were included: 457 primary CD and 258 recurrent CD with a postoperative morbidity of 21.6% and 34.7%, respectively. Laparoscopy was used in 83.8% of primary CD compared to 31% of recurrent CD. Twenty-five hospitals participated and the total number of patients per hospital ranged from 2 to 169. Hospitals performing more than 10 primary CD procedures per year showed a higher adoption of laparoscopy and bowel sparing surgery. Conclusions: There is significant heterogeneity in the number of CD surgeries performed per year nationally in Italy. Our data suggest that high-volume hospitals perform more complex procedures, with a higher adoption of bowel sparing surgery. The rate of laparoscopy in high-volume hospitals is higher for primary CD but not for recurrent CD compared with low-volume hospitals.
Published: 2021

20. Analysis of oxidative stress-related markers in Crohn’s disease patients at surgery and correlations with clinical findings

Author: Luceri, C., Bigagli, E., Agostiniani, Sara, Giudici, F., Zambonin, D., Scaringi, S., Ficari, F., Lodovici, M., and Malentacchi, C.
Subjects: Biomarkers, Crohn’ disease, Oxidative stress
Published: 2019

21. P188 Evaluation of Global Leadership Initiative on Malnutrition (GLIM) criteria for the diagnosis of malnutrition in patients affected by inflammatory bowel disease (IBD) candidates for elective surgery

Author: Fiorindi, C, primary, Cricchio, M, additional, Ficari, F, additional, Alpigiano, G, additional, Scaringi, S, additional, and Giudici, F, additional
Published: 2020
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22. Impact of laparoscopy on adherence to an enhanced recovery pathway and readiness for discharge in elective colorectal surgery: Results from the PeriOperative Italian Society registry

Author: Braga, M, Borghi, F, Scatizzi, M, Missana, G, Guicciardi, MA, Bona, S, Ficari, F, Maspero, M, Pecorelli, N, Pellegrino, L, Radrizzani, D, Beretta, L, Casiraghi, U, Muratore, A, Crespi, M, Iuliani, R, Bima, C, Bouzari, H, Ceretti, A, Braga, M, Borghi, F, Scatizzi, M, Missana, G, Guicciardi, M, Bona, S, Ficari, F, Maspero, M, Pecorelli, N, Pellegrino, L, Radrizzani, D, Beretta, L, Casiraghi, U, Muratore, A, Crespi, M, Iuliani, R, Bima, C, Bouzari, H, Ceretti, A, Braga, Marco, Borghi, Felice, Scatizzi, Marco, Missana, Giancarlo, Guicciardi, Marco Azzola, Bona, Stefano, Ficari, Ferdinando, Maspero, Marianna, Pecorelli, Nicolo, on behalf of PeriOperative Italian, Society, and Beretta, Luigi
Subjects: Laparoscopic surgery, Adult, Male, Registrie, medicine.medical_specialty, Enhanced recovery pathway, medicine.medical_treatment, 03 medical and health sciences, 0302 clinical medicine, Time to readiness for discharge, Colorectal surgery, Retrospective Studie, medicine, Humans, Prospective Studies, Registries, Postoperative Period, Prospective cohort study, Laparoscopy, Retrospective Studies, Aged, Postoperative Care, medicine.diagnostic_test, Elective Surgical Procedure, business.industry, Retrospective cohort study, Perioperative, Length of Stay, Middle Aged, Length of hospital stay, Conversion to Open Surgery, Patient Discharge, Surgery, Postoperative complication, Prospective Studie, Italy, Elective Surgical Procedures, 030220 oncology & carcinogenesis, 030211 gastroenterology & hepatology, Female, Guideline Adherence, business, Abdominal surgery, Human
Abstract: Introduction: Previous studies reported that laparoscopic surgery (LPS) improved postoperative outcomes in patients undergoing colorectal surgery within an enhanced recovery program (ERP). However, the effect of minimally invasive surgery on each ERP item has not been clarified, yet. The aim of this study is to assess the impact of LPS on adherence to ERP items and recovery as measured by time to readiness for discharge (TRD). Methods: Prospectively collected data entered in an electronic Italian registry specifically designed for ERP were reviewed. Patients undergoing elective colorectal surgery were divided into three groups: successful laparoscopy, conversion to open surgery, primary open surgery. Adherence to 19 ERP elements and postoperative outcomes were compared among groups. Multivariate regression analysis was used to identify whether LPS had an independent role to improve ERP adherence and postoperative outcomes. Results: 714 patients (successful LPS 531, converted 42, open 141) underwent elective colorectal surgery within an ERP. Epidural analgesia was used in the 75.1% of open group patients versus 49.9% of LPS group patients (p = 0.012). After surgery, oral feeding recovery, i.v. fluids suspension, removal of both urinary and epidural catheters occurred earlier in the LPS group both in the overall series and in uneventful patients only. Mean TRD and length of hospital stay were significantly shorter in the LPS group (p < 0.001 for both). Overall morbidity rate was 18.7% in the LPS group versus 32.6% in the open group (p = 0.001). At multivariate analysis, LPS was significantly associated to an increased adherence to postoperative ERP items, a shorter TRD, and a reduced overall morbidity, whereas rectal surgery and new stoma formation impaired postoperative recovery. Conclusions: The present study showed that a successful laparoscopic procedure had an independent role to increase the adherence to postoperative ERP and to improve short-term postoperative outcome.
Published: 2017

23. Enhanced recovery pathways in colorectal surgery: A consensus paper by the Associazione Chirurghi Ospedalieri Italiani (ACOI) and the PeriOperative Italian Society (POIS)

Author: Ficari, F., Borghi, F., Catarci, Marco, Scatizzi, M., Alagna, V., Bachini, I., Baldazzi, G., Bardi, U., Benedetti, Marta, Beretta, Carlo Luigi, Bertocchi, E., Caliendo, D., Campagnacci, R., Cardinali, A., Carlini, M., Cascella, M., Cassini, D., Ciotti, S. -M., Cirio, A., Coata, P., Conti, Daniela, Delrio, P., Di Marco, C., Ferla, L., Fiorindi, C., Garulli, G., Genzano, C., Guercioni, G., Marra, B., Maurizi, A., Monzani, R., Pace, U., Pandolfini, L., Parisi, Carmelo Maria Antonio, Pavanello, M., Pecorelli, N., Pellegrino, Luca, Persiani, Roberto, Pirozzi, F., Pirrera, B., Rizzo, A., Rolfo, M., Romagnoli, Stella, Ruffo, G., Sciuto, A., Marini, P., Catarci M., Benedetti M., Beretta L. (ORCID:0000-0001-9924-2066), Conti D., Parisi A., Pellegrino L., Persiani R. (ORCID:0000-0002-1537-5097), Romagnoli S., Ficari, F., Borghi, F., Catarci, Marco, Scatizzi, M., Alagna, V., Bachini, I., Baldazzi, G., Bardi, U., Benedetti, Marta, Beretta, Carlo Luigi, Bertocchi, E., Caliendo, D., Campagnacci, R., Cardinali, A., Carlini, M., Cascella, M., Cassini, D., Ciotti, S. -M., Cirio, A., Coata, P., Conti, Daniela, Delrio, P., Di Marco, C., Ferla, L., Fiorindi, C., Garulli, G., Genzano, C., Guercioni, G., Marra, B., Maurizi, A., Monzani, R., Pace, U., Pandolfini, L., Parisi, Carmelo Maria Antonio, Pavanello, M., Pecorelli, N., Pellegrino, Luca, Persiani, Roberto, Pirozzi, F., Pirrera, B., Rizzo, A., Rolfo, M., Romagnoli, Stella, Ruffo, G., Sciuto, A., Marini, P., Catarci M., Benedetti M., Beretta L. (ORCID:0000-0001-9924-2066), Conti D., Parisi A., Pellegrino L., Persiani R. (ORCID:0000-0002-1537-5097), and Romagnoli S.
Abstract: Enhanced Recovery After Surgery (ERAS) pathway is a multi-di-sciplinary, patient-centered protocol relying on the implementation of the best evidence-based perioperative practice. In the field of colorectal surgery, the application of ERAS programs is associated with up to 50% reduction of morbidity rates and up to 2.5 days reduction of postoperative hospital stay. However, widespread adoption of ERAS pathways is still yet to come, mainly because of the lack of proper information and communication. Purpose of this paper is to support the diffusion of ERAS pathways through a critical review of the existing evidence by members of the two national societies dealing with ERAS pathways in Italy, the PeriOperative Italian Society (POIS) and the Associazione Italiana Chirurghi Ospedalieri (ACOI), showing the results of a consensus development conference held at Matera, Italy, during the national ACOI Congress on June 10, 2019.
Published: 2019

24. Enhanced recovery pathway in elderly patients undergoing colorectal surgery: is there an effect of increasing ages? Results from the perioperative Italian Society Registry

Author: Braga, M, Beretta, L, Pecorelli, N, Maspero, M, Casiraghi, U, Borghi, F, Pellegrino, L, Bona, S, Monzani, R, Ferrari, G, Radrizzani, D, Iuliani, R, Bima, C, Scatizzi, M, Missana, G, Guicciardi Marco, A, Muratore, A, Crespi, M, Bouzari, H, Ceretti Andrea, P, Ficari, F, Braga Marco, Beretta Luigi, Pecorelli Nicolò, Maspero Marianna, Casiraghi Umberto, Borghi Felice, Pellegrino Luca, Bona Stefano, Monzani Roberta, Ferrari Gianluigi, Radrizzani Danilo, Iuliani Riccardo, Bima Carlo, Scatizzi Marco, Missana Giancarlo, Guicciardi Marco Azzola, Muratore Andrea, Crespi Michele, Bouzari Hedayat, Ceretti Andrea Pisani, Ficari Ferdinando, Braga, M, Beretta, L, Pecorelli, N, Maspero, M, Casiraghi, U, Borghi, F, Pellegrino, L, Bona, S, Monzani, R, Ferrari, G, Radrizzani, D, Iuliani, R, Bima, C, Scatizzi, M, Missana, G, Guicciardi Marco, A, Muratore, A, Crespi, M, Bouzari, H, Ceretti Andrea, P, Ficari, F, Braga Marco, Beretta Luigi, Pecorelli Nicolò, Maspero Marianna, Casiraghi Umberto, Borghi Felice, Pellegrino Luca, Bona Stefano, Monzani Roberta, Ferrari Gianluigi, Radrizzani Danilo, Iuliani Riccardo, Bima Carlo, Scatizzi Marco, Missana Giancarlo, Guicciardi Marco Azzola, Muratore Andrea, Crespi Michele, Bouzari Hedayat, Ceretti Andrea Pisani, and Ficari Ferdinando
Abstract: Previous studies reported that enhanced recovery pathway (ERP) is safe in elderly who did not require a specifically tailored protocol. In previous studies, elderly have been considered as a homogeneous cohort and the cut-off value to identify them was different. The aim of the present study is to assess the compliance to ERP and its impact on postoperative outcome in three subgroups of elderly patients with increasing ages. Prospectively collected data entered in an electronic Italian registry specifically designed for ERP were reviewed. 315 elderly patients undergoing elective colorectal resection were divided into three groups. Group 1: 71–75 years (n = 105), Group 2: 76–80 years (n = 117), Group 3: over 80 years (n = 93). Primary endpoints of the study were adherence to ERP and time to readiness for discharge (TRD). Compliance to ERP was similar in the three groups. No difference among groups was found for mortality, overall morbidity, major complications, reoperation rate and readmission rate. Median TRD and length of hospital stay (LOS) were progressively longer with increasing age (p = 0.018 and p = 0.078, respectively). Increasing age did not impact on adherence to ERP and postoperative morbidity, but delayed both TRD and LOS.
Published: 2018

25. Identification of core items in the enhanced recovery pathway

Author: Braga, M, Scatizzi, M, Borghi, F, Missana, G, Radrizzani, D, Gemma, M, Beretta, L, Bona, S, Monzani, R, Azzola, M, Muratore, A, Crespi, M, Iuliani, R, Bima, C, Bouzari, H, Ceretti, A, Pellegrino, L, Maspero, M, Pecorelli, N, Casiraghi, U, Ficari, F, Braga, Marco, Scatizzi, Marco, Borghi, Felice, Missana, Giancarlo, Radrizzani, Danilo, Gemma, Marco, Beretta, Luigi, Bona, Stefano, Monzani, Roberta, Azzola, Marco, Muratore, Andrea, Crespi, Michele, Iuliani, Riccardo, Bima, Carlo, Bouzari, Hedayat, Ceretti, Andrea Pisani, Pellegrino, Luca, Maspero, Marianna, Pecorelli, Nicolò, Casiraghi, Umberto, Ficari, Ferdinando, Braga, M, Scatizzi, M, Borghi, F, Missana, G, Radrizzani, D, Gemma, M, Beretta, L, Bona, S, Monzani, R, Azzola, M, Muratore, A, Crespi, M, Iuliani, R, Bima, C, Bouzari, H, Ceretti, A, Pellegrino, L, Maspero, M, Pecorelli, N, Casiraghi, U, Ficari, F, Braga, Marco, Scatizzi, Marco, Borghi, Felice, Missana, Giancarlo, Radrizzani, Danilo, Gemma, Marco, Beretta, Luigi, Bona, Stefano, Monzani, Roberta, Azzola, Marco, Muratore, Andrea, Crespi, Michele, Iuliani, Riccardo, Bima, Carlo, Bouzari, Hedayat, Ceretti, Andrea Pisani, Pellegrino, Luca, Maspero, Marianna, Pecorelli, Nicolò, Casiraghi, Umberto, and Ficari, Ferdinando
Abstract: Background & aims: The Enhanced Recovery After Surgery (ERAS) pathway represents an optimal approach in patients undergoing colorectal surgery but complexity in implementing its items could limit its application. The aim of this study is to identify possible core items within an ERAS pathway following elective colorectal resection. Methods: This is a retrospective review of data prospectively collected between January 2014 and September 2015 by 14 Italian Hospitals in an electronic registry dedicated to an ERAS protocol. 722 patients undergoing elective colorectal surgery within an ERAS protocol have been included in the study. Adherence to ERAS items was assessed in all patients. A secondary analysis was restricted to pre- and intraoperative ERAS items. Time to readiness for discharge (TRD) was the primary endpoint of the study. Postoperative overall morbidity was the secondary endpoint. Results: Multivariate analyses showed that active intraoperative warming (p = 0.008), early stop of intravenous fluids (p = 0.0001), and early removal of urinary catheter (p = 0.0001) were associated to a shorter TRD, while early stop of intravenous fluids (p < 0.001) also reduced morbidity. When the analysis was restricted to pre- and intraoperative items, removal of NGT at the end of surgery had an independent role to shorten TRD (p < 0.001) and to reduce overall morbidity (p = 0.019), while the absence of oral bowel preparation reduced postoperative overall morbidity (p = 0.021). Conclusions: In implementing an ERAS pathway, hospitals could initially focus on active intraoperative warming, early stop of intravenous fluids, early removal of urinary catheter, removal of NGT at the end of surgery, and absence of oral bowel preparation, keeping on continuous effort to apply the complete ERAS protocol.
Published: 2018

26. P657 Postoperative outcome in Crohn’s disease: Observational study of 1283 surgical patients

Author: Zambonin, D, primary, Lavorini, E, additional, Giudici, F, additional, Ficari, F, additional, Bagnoli, S, additional, and Scaringi, S, additional
Published: 2018
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27. P599 Short- and long-term outcome of minimally invasive approach for Crohn’s disease: Comparison between single incision, robotic-assisted and conventional laparoscopy

Author: Zambonin, D, primary, Giudici, F, additional, Ficari, F, additional, Rogai, F, additional, and Scaringi, S, additional
Published: 2018
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28. Impatto economico dell’immunonutrizione nei pazienti chirurgici oncologici

Author: D'Angela, D, De Luca, R, Ficari, F, Gasbarrini, A, Marrocco, W, Montorsi, M, and Spandonaro, F
Subjects: Settore SECS-P/06 - Economia Applicata
Published: 2016

29. Enhanced Recovery Program in High-Risk Patients Undergoing Colorectal Surgery: Results from the PeriOperative Italian Society Registry

Author: Braga, M, Pecorelli, N, Scatizzi, M, Borghi, F, Missana, G, Radrizzani, D, Azzola, M, Beretta, L, Bima, C, Bona, S, Bouzari, H, Casiraghi, U, Ceretti, A, Crespi, M, Ficari, F, Iuliani, R, Maspero, M, Monzani, R, Muratore, A, Pellegrino, L, Braga, Marco, Pecorelli, Nicolò, Scatizzi, Marco, Borghi, Felice, Missana, Giancarlo, Radrizzani, Danilo, Azzola, Marco, Beretta, Luigi, Bima, Carlo, Bona, Stefano, Bouzari, Hedayat, Casiraghi, Umberto, Ceretti, Andrea Pisani, Crespi, Michele, Ficari, Ferdinando, Iuliani, Riccardo, Maspero, Marianna, Monzani, Roberta, Muratore, Andrea, Pellegrino, Luca, Braga, M, Pecorelli, N, Scatizzi, M, Borghi, F, Missana, G, Radrizzani, D, Azzola, M, Beretta, L, Bima, C, Bona, S, Bouzari, H, Casiraghi, U, Ceretti, A, Crespi, M, Ficari, F, Iuliani, R, Maspero, M, Monzani, R, Muratore, A, Pellegrino, L, Braga, Marco, Pecorelli, Nicolò, Scatizzi, Marco, Borghi, Felice, Missana, Giancarlo, Radrizzani, Danilo, Azzola, Marco, Beretta, Luigi, Bima, Carlo, Bona, Stefano, Bouzari, Hedayat, Casiraghi, Umberto, Ceretti, Andrea Pisani, Crespi, Michele, Ficari, Ferdinando, Iuliani, Riccardo, Maspero, Marianna, Monzani, Roberta, Muratore, Andrea, and Pellegrino, Luca
Abstract: Background: Enhanced recovery after surgery (ERAS) pathways represent the optimal approach for patients undergoing colorectal surgery. Elderly or low physical status patients have been often excluded from ERAS pathways because considered at high risk. The aim of this study is to assess the adherence to ERAS protocol and its impact on short-term postoperative outcome in patients with different surgical risk undergoing elective colorectal resection. Methods: Prospectively collected data entered in an electronic Italian registry specifically designed for ERAS were reviewed. Patients were divided into four groups according to age (70-year-old cutoff) and preoperative physical status as measured by the ASA grade (I–II vs. III–IV). Adherence to 18 ERAS elements and postoperative outcomes were compared between groups. Regression analysis was used to identify independent factors associated with improved outcomes. Results: Eleven Italian hospitals reported data on 706 patients undergoing elective colorectal surgery within an ERAS protocol. Patients with low physical status had reduced adherence to preoperative carbohydrate loading, epidural analgesia, PONV prophylaxis, and early urinary catheter removal. No difference was found between groups for adherence to other perioperative elements. Major complications occurred in 37 (5.2 %) patients without significant differences among groups (p = 0.384). Median (IQR) time to readiness for discharge (TRD) was 4 (3–6) days, length of hospital stay (LOS) was 6 (4–7) days, and both were significantly shorter by only 1 day in the groups of younger patients (p < 0.001). At multivariate analysis, laparoscopy increased adherence to ERAS items and reduced TRD, LOS, and morbidity. A high ASA grade was significantly associated with lower adherence, whereas older age significantly prolonged TRD and LOS. Conclusion: ERAS pathway can be safely applied in elderly and low physical status patients yielding slight differences in postoperative morbidi
Published: 2017

30. Early Postoperative Low Compliance to Enhanced Recovery Pathway in Rectal Cancer Patients

Author: Marco Ceresoli, Corrado Pedrazzani, Luca Pellegrino, Andrea Muratore, Ferdinando Ficari, Roberto Polastri, Marco Scatizzi, Mauro Totis, Nicolò Tamini, Lorenzo Ripamonti, Marco Braga, Ceresoli, M, Pedrazzani, C, Pellegrino, L, Muratore, A, Ficari, F, Polastri, R, Scatizzi, M, Totis, M, Tamini, N, Ripamonti, L, and Braga, M
Subjects: Cancer Research, enhanced recovery, Oncology, overall morbidity, rectal surgery, low pneumoperitoneum, ERAS compliance, TAP block
Abstract: Early postoperative low compliance to enhanced recovery protocols has been associated with morbidity following colon surgery. The purpose of this study is to evaluate the possible causes of early postoperative low compliance to the enhanced recovery pathway and its relationship with morbidity following rectal surgery for cancer. A total of 439 consecutive patients who underwent elective surgery for rectal cancer have been included in the study. Compliance to enhanced recovery protocol on postoperative day (POD) 2 was evaluated in all patients. Indicators of compliance were naso-gastric tube and urinary catheter removal, recovery of both oral feeding and mobilization, and the stopping of intravenous fluids. Low compliance on POD 2 was defined as non- adherence to two or more items. One-third of patients had low compliance on POD 2. Removal of urinary catheter, intravenous fluids stop, and mobilization were the items with lowest adherence. Advanced age, duration of surgery, open surgery and diverting stoma were predictive factors of low compliance at multivariate analysis. Overall morbidity and major complications were significantly higher (p < 0.001) in patients with low compliance on POD 2. At multivariate analysis, failure to remove urinary catheter on POD 2 (OR = 1.83) was significantly correlated with postoperative complications. Low compliance to enhanced recovery protocol on POD 2 was significantly associated with morbidity. Failure to remove the urinary catheter was the most predictive indicator. Advanced age, long procedure, open surgery and diverting stoma were independent predictive factors of low compliance.
Published: 2022
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31. COVID-19 Vaccination Willingness and Hesitancy in Patients With Inflammatory Bowel Diseases: Analysis of Determinants in a National Survey of the Italian IBD Patients’ Association

Author: Simona Radice, Francesco Conforti, Claudio Costantino, Marina Aloi, Ferdinando Ficari, S. Leone, A. Armuzzi, Francesco Manguso, Andrea Costantino, Giammarco Mocci, Maurizio Vecchi, Loris Pironi, Ambrogio Orlando, Daniele Noviello, Alessandra Tongiorgi, Fernando Rizzello, Fabrizio Bossa, Flavio Caprioli, Costantino A., Noviello D., Conforti F.S., Aloi M., Armuzzi A., Bossa F., Ficari F., Leone S., Manguso F., Mocci G., Orlando A., Pironi L., Radice S., Rizzello F., Tongiorgi A., Costantino C., Vecchi M., Caprioli F., and Costantino Andrea, Noviello Daniele, Conforti Francesco Simone, Aloi Marina, Armuzzi Alessandro, Bossa Fabrizio, Ficari Ferdinando, Leone Salvo, Manguso Francesco, Mocci Giammarco, Orlando Amrbogio, Pironi Loris, Radice Simona, Rizzello Fernando, Tongiorgi Alessandra, Costantino Claudio, Vecchi Maurizio, Caprioli Flavio
Subjects: medicine.medical_specialty, 2019-20 coronavirus outbreak, COVID-19 Vaccines, Coronavirus disease 2019 (COVID-19), Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), IBD, Brief Report - Clinical, Internal medicine, medicine, Humans, Immunology and Allergy, In patient, AcademicSubjects/MED00260, SARS-CoV-2, business.industry, Vaccination, Gastroenterology, COVID-19, Inflammatory Bowel Diseases, COVID-19 Vaccines Human, IBD, Crohn, Ulcerative Colitis, Vaccination, Covid 19, Sars-Cov 2, COVID-19 vaccine, vaccine hesitancy, business
Abstract: The coronavirus disease 2019 (COVID-19) pandemic has not finished yet, and the most promising option towards its ending is widespread vaccination. Because patients with inflammatory bowel diseases (IBDs), namely Crohn’s disease (CD) and ulcerative colitis (UC), often require immune-modifying treatment, which might increase the risk of opportunistic infection,1 their vaccination history for several infectious diseases is routinely checked, and when inadequate, vaccination is performed at diagnosis or ideally before immune suppressive treatment is started.1 However, IBD patients were not found to be at an increased risk of developing COVID-19 or of experiencing a more severe disease course.2
Published: 2021
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32. Early non compliance to enhanced recovery pathway might be an alert for underlying complications following colon surgery

Author: Marco Ceresoli, Corrado Pedrazzani, Luca Pellegrino, Ferdinando Ficari, Marco Braga, Andrea Muratore, Nicolò Tamini, Luigi Beretta, Marco Azzola, Danilo Radrizzani, Felice Borghi, Giancarlo Missana, Marco Scatizzi, Mauro Totis, Michele Crespi, Carlo Bima, Hedayat Bouzari, Antonio Valenti, Andrea Pisani Ceretti, Roberto Polastri, Roberta Longhin, Angela Maurizi, Diletta Cassini, Francesco Di Marzo, Sergio Fumagalli, Simone Muratori, Massimiliano Casati, Ceresoli, M, Pedrazzani, C, Pellegrino, L, Ficari, F, Braga, M, Muratore, A, Tamini, N, Beretta, L, Azzola, M, Radrizzani, D, Borghi, F, Missana, G, Scatizzi, M, Totis, M, Crespi, M, Bima, C, Bouzari, H, Valenti, A, Ceretti, A, Polastri, R, Longhin, R, Maurizi, A, Cassini, D, Di Marzo, F, Fumagalli, S, Muratori, S, and Casati, M
Subjects: Colon surgery, Oncology, Prognostic score, Surgery, General Medicine, ERAS compliance, Postoperative morbidity, Enhanced recovery
Abstract: Purpose: Early non compliance to postoperative ERAS pathway has been reported in 20–30% of patients who underwent elective colon surgery. The aim of the present study is to investigate the possible relationship between early non compliance and postoperative complications. Methods: We reviewed a prospective database including 1391 consecutively collected patients undergoing elective colon surgery in 22 Italian hospitals between January 2017 and June 2020. Early compliance to ERAS protocol was assessed on postoperative day (POD) 2. Failure of oral feeding, urinary catheter removal, intravenous fluids stop, and adequate mobilization were indicators of non compliance. Postoperative follow-up was carried out for 30 days after hospital discharge. The association among early postoperative ERAS compliance and the occurrence of complications was assessed with uni- and multivariate analysis. Results: A total of 1089 (78.3%) patients had malignancy and minimally invasive surgery was successfully performed in 1174 (84.3%) patients. Postoperative morbidity occurred in 403 (29.0%) patients. At multivariate analysis, male gender, open surgery, and each of the four non compliance indicators on POD 2 were significantly associated to postoperative complications. Morbidity progressively increased from 16.8% in patients with full compliance to ERAS protocol to 47.2% in patients with two non compliance indicators and 69.2% in patients with all four indicators (p < 0.001). Conclusions: Early non compliance to ERAS protocol was significantly associated with postoperative morbidity.
Published: 2022

33. Single-incision laparoscopic surgery (SILS) for the treatment of ileocolonic Crohn’s disease: a propensity score–matched analysis

Author: Celentano, V, Pellino, G, Rottoli, M, Colombo, F, Sampietro, G, Spinelli, A, Selvaggi, F, Valerio Celentano, SICCR Current status of Crohn’s disease surgery collaborative., Gianluca, Pellino, Matteo, Rottoli, Poggioli, Gilberto, Giuseppe, Sica, Mariano Cesare Giglio, Michela, Campanelli, Claudio, Coco, Gianluca, Rizzo, Francesco, Sionne, Francesco, Colombo, Gianluca, Sampietro, Giulia, Lamperti, Diego, Foschi, Ferdinando, Ficari, Ludovica, Vacca, Marta, Cricchio, Francesco, Giudici, Lucio, Selvaggi, Guido, Sciaudone, Roberto, Peltrini, Andrea, Manfreda, Luigi, Bucci, Raffaele, Galleano, Omar, Ghazouani, Luigi, Zorcolo, Simona, Deidda, Angelo, Restivo, Andrea, Braini, Francesca Di Candido, Matteo, Sacchi, Michele, Carvello, Stefania, Martorana, Giovanni, Bordignon, Imerio, Angriman, Angela, Variola, Mirko Di Ruscio, Giuliano, Barugola, Andrea, Geccherle, Francesca Paola Tropeano, Gaetano, Luglio, Marta, Tanzanu, Sasia, Diego, Migliore, Marco, Maria Carmela Giuffrida, Enrico, Marrano, Gianluigi, Moretto, Harmony, Impellizzeri, Gaetano, Gallo, Giuseppina, Vescio, Giuseppe, Sammarco, Giovanni, Terrosu, Giacomo, Calini, Andrea, Bondurri, Anna, Maffioli, Gloria, Zaffaroni, Andrea, Resegotti, Mistrangelo, Massimiliano, Allaix, Marco Ettore, Fiorenzo, Botti, Matteo, Prati, Luigi, Boni, Serena, Perotti, Mineccia, Michela, Antonio, Giuliani, Lucia, Romano, Giorgio Maria Paolo Graziano, Luigi, Pugliese, Andrea, Pietrabissa, Giangaetano, Delaini, Antonino, Spinelli, Francesco, Selvaggi, Celentano, V., Pellino, G., Rottoli, M., Colombo, F., Sampietro, G., Spinelli, A., Selvaggi, F., Poggioli, G., Sica, G., Giglio, M. C., Campanelli, M., Coco, C., Rizzo, G., Sionne, F., Lamperti, G., Foschi, D., Ficari, F., Vacca, L., Cricchio, M., Giudici, F., Selvaggi, L., Sciaudone, G., Peltrini, R., Manfreda, A., Bucci, L., Galleano, R., Ghazouani, O., Zorcolo, L., Deidda, S., Restivo, A., Braini, A., Di Candido, F., Sacchi, M., Carvello, M., Martorana, S., Bordignon, G., Angriman, I., Variola, A., Di Ruscio, M., Barugola, G., Geccherle, A., Tropeano, F. P., Luglio, G., Tanzanu, M., Sasia, D., Migliore, M., Giuffrida, M. C., Marrano, E., Moretto, G., Impellizzeri, H., Gallo, G., Vescio, G., Sammarco, G., Terrosu, G., Calini, G., Bondurri, A., Maffioli, A., Zaffaroni, G., Resegotti, A., Mistrangelo, M., Allaix, M. E., Botti, F., Prati, M., Boni, L., Perotti, S., Mineccia, M., Giuliani, A., Romano, L., Graziano, G. M. P., Pugliese, L., Pietrabissa, A., Delaini, G. G., Celentano, Valerio, Pellino, Gianluca, Rottoli, Matteo, Colombo, Francesco, Sampietro, Gianluca, Poggioli, Gilberto, Spinelli, Antonino, and Selvaggi, Francesco
Subjects: Crohn’s disease, Tumor Necrosis Factor Inhibitor, Short Communication, tumor necrosis factor inhibitors, Inflammatory Bowel Disease, Gastroenterology, inflammatory bowel sisease, Length of Stay, Single-incision laparoscopic surgery . Inflammatory BowelDisease . Crohn’s disease, single-incision laparoscopic surgery, humans, length of stay, postoperative complications, propensity score, retrospective studies, treatment outcome, Crohn disease, laparoscopy, 03 medical and health sciences, 0302 clinical medicine, Treatment Outcome, Crohn Disease, Single-incision laparoscopic surgery, Retrospective Studie, 030220 oncology & carcinogenesis, 030211 gastroenterology & hepatology, Laparoscopy, Postoperative Complication, Propensity Score, Human
Abstract: Introduction Single-incision laparoscopic surgery (SILS) aims to minimize the surgical access trauma by reducing the number of abdominal incisions to a single site, potentially offering better cosmetic results and decreased postoperative pain. In this study, we compare the results of SILS ileocolic resection for Crohn’s disease (CD) to conventional laparoscopy and open surgery using a propensity score–matched analysis in a retrospective national multicentre study. Methods All consecutive patients undergoing elective SILS ileocaecal or redo ileocolic resection for primary and recurrent CD from 1 June 2018 to 31 May 2019 were included. Patients were matched 1:1:1 with laparoscopy and open surgery according to perianal disease, recurrent disease, penetrating phenotype of CD, history of previous abdominal surgery, preoperative medical treatment with steroids and anti-TNF. Postoperative morbidity within 30 days of surgery was the primary endpoint. Results Fifty-eight patients were included in each group, for a total of 174 patients. The conversion rate for SILS and laparoscopy was 10.3% and 12%, respectively, with no difference in the incidence of postoperative complications (13.8% and 12%, p = 0.77), whilst open surgery demonstrated a worse morbidity profile, with a complication rate of 25.9% (p < 0.0001). Median length of hospital stay following SILS ileocolic resection was 5 days, significantly shorter compared to 7 days for laparoscopy and 9 for open surgery (p < 0.0001). Conclusions SILS ileocolonic resection for CD demonstrated a comparable morbidity profile compared to laparoscopy in selected patients, with a reduced length of postoperative hospital stay.
Published: 2021

34. Enhanced Recovery Program in High-Risk Patients Undergoing Colorectal Surgery: Results from the PeriOperative Italian Society Registry

Author: Braga, Marco, Pecorelli, Nicolò, Scatizzi, Marco, Borghi, Felice, Missana, Giancarlo, Radrizzani, Danilo, Azzola, Marco, Beretta, Luigi, Bima, Carlo, Bona, Stefano, Bouzari, Hedayat, Casiraghi, Umberto, Ceretti, Andrea Pisani, Crespi, Michele, Ficari, Ferdinando, Iuliani, Riccardo, Maspero, Marianna, Monzani, Roberta, Muratore, Andrea, Pellegrino, Luca, Braga, M, Pecorelli, N, Scatizzi, M, Borghi, F, Missana, G, Radrizzani, D, Azzola, M, Beretta, L, Bima, C, Bona, S, Bouzari, H, Casiraghi, U, Ceretti, A, Crespi, M, Ficari, F, Iuliani, R, Maspero, M, Monzani, R, Muratore, A, Pellegrino, L, and on behalf of the PeriOperative Italian, Society
Subjects: Male, Registrie, Health Status, Health Statu, Postoperative Complications, 0302 clinical medicine, Clinical Protocols, Risk Factors, Retrospective Studie, Medicine, Age Factor, Registries, Postoperative Period, Laparoscopy, Dietary Carbohydrate, Colectomy, Early Ambulation, Aged, 80 and over, medicine.diagnostic_test, Age Factors, Nausea, Middle Aged, Colorectal surgery, Analgesia, Epidural, Italy, Elective Surgical Procedures, Cardiothoracic surgery, 030220 oncology & carcinogenesis, Female, 030211 gastroenterology & hepatology, Guideline Adherence, Elective Surgical Procedure, Human, Urinary Catheter, medicine.medical_specialty, Vomiting, Urinary Catheters, Perioperative Care, 03 medical and health sciences, Dietary Carbohydrates, Humans, Clinical Protocol, Device Removal, Retrospective Studies, Aged, business.industry, Risk Factor, Retrospective cohort study, Recovery of Function, Perioperative, Length of Stay, Vascular surgery, Surgery, Postoperative Complication, business, Abdominal surgery
Abstract: Background: Enhanced recovery after surgery (ERAS) pathways represent the optimal approach for patients undergoing colorectal surgery. Elderly or low physical status patients have been often excluded from ERAS pathways because considered at high risk. The aim of this study is to assess the adherence to ERAS protocol and its impact on short-term postoperative outcome in patients with different surgical risk undergoing elective colorectal resection. Methods: Prospectively collected data entered in an electronic Italian registry specifically designed for ERAS were reviewed. Patients were divided into four groups according to age (70-year-old cutoff) and preoperative physical status as measured by the ASA grade (I–II vs. III–IV). Adherence to 18 ERAS elements and postoperative outcomes were compared between groups. Regression analysis was used to identify independent factors associated with improved outcomes. Results: Eleven Italian hospitals reported data on 706 patients undergoing elective colorectal surgery within an ERAS protocol. Patients with low physical status had reduced adherence to preoperative carbohydrate loading, epidural analgesia, PONV prophylaxis, and early urinary catheter removal. No difference was found between groups for adherence to other perioperative elements. Major complications occurred in 37 (5.2 %) patients without significant differences among groups (p = 0.384). Median (IQR) time to readiness for discharge (TRD) was 4 (3–6) days, length of hospital stay (LOS) was 6 (4–7) days, and both were significantly shorter by only 1 day in the groups of younger patients (p
Published: 2016
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35. Identification of core items in the enhanced recovery pathway

Author: Hedayat Bouzari, Umberto Casiraghi, Felice Borghi, Marco Azzola, Ferdinando Ficari, Andrea Pisani Ceretti, Riccardo Iuliani, Luigi Beretta, Marianna Maspero, Marco Scatizzi, Stefano Bona, Roberta Monzani, Luca Pellegrino, Danilo Radrizzani, Andrea Muratore, Giancarlo Missana, Michele Crespi, Nicolò Pecorelli, Marco Braga, Carlo Bima, Marco Gemma, Braga, M, Scatizzi, M, Borghi, F, Missana, G, Radrizzani, D, Gemma, M, Beretta, L, Bona, S, Monzani, R, Azzola, M, Muratore, A, Crespi, M, Iuliani, R, Bima, C, Bouzari, H, Ceretti, A, Pellegrino, L, Maspero, M, Pecorelli, N, Casiraghi, U, Ficari, F, Braga, Marco, Scatizzi, Marco, Borghi, Felice, Missana, Giancarlo, Radrizzani, Danilo, Gemma, Marco, Beretta, Luigi, Bona, Stefano, Monzani, Roberta, Azzola, Marco, Muratore, Andrea, Crespi, Michele, Iuliani, Riccardo, Bima, Carlo, Bouzari, Hedayat, Ceretti, Andrea Pisani, Pellegrino, Luca, Maspero, Marianna, Pecorelli, Nicolò, Casiraghi, Umberto, and Ficari, Ferdinando
Subjects: Male, medicine.medical_specialty, Time Factors, Multivariate analysis, Colon, Health Status, Endocrinology, Diabetes and Metabolism, Postoperative morbidity, Perioperative Care, 03 medical and health sciences, Postoperative Complications, 0302 clinical medicine, Endocrinology, Enhanced recovery, Core ERAS item, Risk Factors, Colorectal surgery, Secondary analysis, Clinical endpoint, medicine, Humans, In patient, Hospital Mortality, Registries, Urinary catheter, Digestive System Surgical Procedures, Aged, Retrospective Studies, Core (anatomy), Hospital stay, Nutrition and Dietetics, business.industry, Rectum, Recovery of Function, Length of Stay, Middle Aged, Patient Discharge, Surgery, Diabetes and Metabolism, Outcome and Process Assessment, Health Care, Treatment Outcome, Italy, 030220 oncology & carcinogenesis, Female, 030211 gastroenterology & hepatology, business
Abstract: Background & aims: The Enhanced Recovery After Surgery (ERAS) pathway represents an optimal approach in patients undergoing colorectal surgery but complexity in implementing its items could limit its application. The aim of this study is to identify possible core items within an ERAS pathway following elective colorectal resection. Methods: This is a retrospective review of data prospectively collected between January 2014 and September 2015 by 14 Italian Hospitals in an electronic registry dedicated to an ERAS protocol. 722 patients undergoing elective colorectal surgery within an ERAS protocol have been included in the study. Adherence to ERAS items was assessed in all patients. A secondary analysis was restricted to pre- and intraoperative ERAS items. Time to readiness for discharge (TRD) was the primary endpoint of the study. Postoperative overall morbidity was the secondary endpoint. Results: Multivariate analyses showed that active intraoperative warming (p = 0.008), early stop of intravenous fluids (p = 0.0001), and early removal of urinary catheter (p = 0.0001) were associated to a shorter TRD, while early stop of intravenous fluids (p < 0.001) also reduced morbidity. When the analysis was restricted to pre- and intraoperative items, removal of NGT at the end of surgery had an independent role to shorten TRD (p < 0.001) and to reduce overall morbidity (p = 0.019), while the absence of oral bowel preparation reduced postoperative overall morbidity (p = 0.021). Conclusions: In implementing an ERAS pathway, hospitals could initially focus on active intraoperative warming, early stop of intravenous fluids, early removal of urinary catheter, removal of NGT at the end of surgery, and absence of oral bowel preparation, keeping on continuous effort to apply the complete ERAS protocol.
Published: 2018

36. Enhanced recovery pathway in elderly patients undergoing colorectal surgery: is there an effect of increasing ages? Results from the perioperative Italian Society Registry

Author: Marco Braga, Stefano Bona, Gianluigi Ferrari, Andrea Muratore, Riccardo Iuliani, Luigi Beretta, Luca Pellegrino, Marianna Maspero, Giancarlo Missana, Marco Scatizzi, Michele Crespi, Marco Azzola Guicciardi, Ferdinando Ficari, Felice Borghi, Roberta Monzani, Danilo Radrizzani, Hedayat Bouzari, Andrea Pisani Ceretti, Umberto Casiraghi, Nicolò Pecorelli, Carlo Bima, Braga, M, Beretta, L, Pecorelli, N, Maspero, M, Casiraghi, U, Borghi, F, Pellegrino, L, Bona, S, Monzani, R, Ferrari, G, Radrizzani, D, Iuliani, R, Bima, C, Scatizzi, M, Missana, G, Guicciardi Marco, A, Muratore, A, Crespi, M, Bouzari, H, Ceretti Andrea, P, Ficari, F, Braga, Marco, Beretta, Luigi, Pecorelli, Nicolò, Maspero, Marianna, Casiraghi, Umberto, Borghi, Felice, Pellegrino, Luca, Bona, Stefano, Monzani, Roberta, Ferrari, Gianluigi, Radrizzani, Danilo, Iuliani, Riccardo, Bima, Carlo, Scatizzi, Marco, Missana, Giancarlo, Guicciardi, Marco Azzola, Muratore, Andrea, Crespi, Michele, Bouzari, Hedayat, Ceretti, Andrea Pisani, and Ficari, Ferdinando
Subjects: Reoperation, medicine.medical_specialty, Postoperative morbidity, Patient Readmission, Perioperative Care, 03 medical and health sciences, 0302 clinical medicine, Elderly, Postoperative Complications, Enhanced recovery, Colorectal surgery, Medicine, Postoperative outcome, Humans, Major complication, Registries, Colectomy, Aged, Retrospective Studies, Aged, 80 and over, business.industry, Age Factors, Rectum, Perioperative, Length of Stay, Readmission rate, Surgery, Treatment Outcome, Italy, Homogeneous, 030220 oncology & carcinogenesis, Cohort, Practice Guidelines as Topic, Length of stay, 030211 gastroenterology & hepatology, Guideline Adherence, business, Enhanced recovery after surgery, Follow-Up Studies
Abstract: Previous studies reported that enhanced recovery pathway (ERP) is safe in elderly who did not require a specifically tailored protocol. In previous studies, elderly have been considered as a homogeneous cohort and the cut-off value to identify them was different. The aim of the present study is to assess the compliance to ERP and its impact on postoperative outcome in three subgroups of elderly patients with increasing ages. Prospectively collected data entered in an electronic Italian registry specifically designed for ERP were reviewed. 315 elderly patients undergoing elective colorectal resection were divided into three groups. Group 1: 71-75years (n=105), Group 2: 76-80years (n=117), Group 3: over 80years (n=93). Primary endpoints of the study were adherence to ERP and time to readiness for discharge (TRD). Compliance to ERP was similar in the three groups. No difference among groups was found for mortality, overall morbidity, major complications, reoperation rate and readmission rate. Median TRD and length of hospital stay (LOS) were progressively longer with increasing age (p=0.018 and p=0.078, respectively). Increasing age did not impact on adherence to ERP and postoperative morbidity, but delayed both TRD and LOS.
Published: 2017

37. The Interplay among Wnt/β-catenin Family Members in Colorectal Adenomas and Surrounding Tissues.

Author: D'Antonio DL, Fantini F, Moscatello C, Ferrone A, Scaringi S, Valanzano R, Ficari F, Efthymakis K, Neri M, Aceto GM, and Curia MC
Abstract: Background: The colorectal adenoma undergoes neoplastic progression via the normal epithelium-adenoma-adenocarcinoma sequence as reported in the Vogelgram. The hazard of developing a tumor is deeply associated with the number and size of adenomas and their subtype. Adenomatous polyps are histologically categorized as follows: approximately 80-90% are tubular, 5-15% are villous, and 5-10% are tubular/villous. Given the higher risk of a malignant transformation observed in tubular/villous adenomas, patients diagnosed with adenomatous polyposis are at an improved risk of developing CRC. The Wnt/β-catenin pathway plays a key role in the onset of colorectal adenoma; in particular, intestinal cells first acquire loss-of-function mutations in the APC gene that induce the formation of adenomas., Methods: Wnt/β-catenin pathway APC , Wnt3a , Wnt5a , LEF1 , and BCL9 genes and protein expression analyses were conducted by qRT-PCR and western blot in 68 colonic samples (polyps and adjacent mucosa) from 41 patients, of which 17 were affected by FAP. Ten normal colonic mucosal samples were collected from 10 healthy donors., Results: In this study, both the APC gene and protein were less expressed in the colon tumor compared to the adjacent colonic mucosa. Conversely, the activated β-catenin was more expressed in polyps than in the adjacent mucosa. All results confirmed the literature data on carcinomas. A statistically significant correlation between Wnt3a and BCL9 both in polyps and in the adjacent mucosa underlines that the canonical Wnt pathway is activated in early colon carcinogenesis and that the adjacent mucosa is already altered., Conclusion: This is the first study analyzing the difference in expression of the Wnt/β-catenin pathway in human colorectal adenomas. Understanding the progression from adenomas to colorectal carcinomas is essential for the development of new therapeutic strategies and improving clinical outcomes with the use of APC and β-catenin as biomarkers.
Published: 2024
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38. Early non compliance to enhanced recovery pathway might be an alert for underlying complications following colon surgery.

Author: Ceresoli M, Pedrazzani C, Pellegrino L, Ficari F, and Braga M
Subjects: Humans, Male, Female, Aged, Middle Aged, Colonic Neoplasms surgery, Italy, Elective Surgical Procedures, Colectomy adverse effects, Prospective Studies, Minimally Invasive Surgical Procedures, Enhanced Recovery After Surgery, Postoperative Complications epidemiology, Guideline Adherence
Abstract: Purpose: Early non compliance to postoperative ERAS pathway has been reported in 20-30% of patients who underwent elective colon surgery. The aim of the present study is to investigate the possible relationship between early non compliance and postoperative complications., Methods: We reviewed a prospective database including 1391 consecutively collected patients undergoing elective colon surgery in 22 Italian hospitals between January 2017 and June 2020. Early compliance to ERAS protocol was assessed on postoperative day (POD) 2. Failure of oral feeding, urinary catheter removal, intravenous fluids stop, and adequate mobilization were indicators of non compliance. Postoperative follow-up was carried out for 30 days after hospital discharge. The association among early postoperative ERAS compliance and the occurrence of complications was assessed with uni- and multivariate analysis., Results: A total of 1089 (78.3%) patients had malignancy and minimally invasive surgery was successfully performed in 1174 (84.3%) patients. Postoperative morbidity occurred in 403 (29.0%) patients. At multivariate analysis, male gender, open surgery, and each of the four non compliance indicators on POD 2 were significantly associated to postoperative complications. Morbidity progressively increased from 16.8% in patients with full compliance to ERAS protocol to 47.2% in patients with two non compliance indicators and 69.2% in patients with all four indicators (p < 0.001)., Conclusions: Early non compliance to ERAS protocol was significantly associated with postoperative morbidity., Competing Interests: Declaration of Competing interest All the authors have no conflict of interest to declare., (Copyright © 2022 Elsevier Ltd, BASO ~ The Association for Cancer Surgery, and the European Society of Surgical Oncology. All rights reserved.)
Published: 2024
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39. Abdominal drainage after elective colorectal surgery: propensity score-matched retrospective analysis of an Italian cohort.

Author: Guadagni S, Catarci M, Masedu F, Karim ME, Clementi M, Ruffo G, Viola MG, Borghi F, Baldazzi G, Scatizzi M, Pirozzi F, Delrio P, Garulli G, Marini P, Campagnacci R, De Luca R, Ficari F, Sica G, Scabini S, Liverani A, Caricato M, and Patriti A
Subjects: Humans, Retrospective Studies, Propensity Score, Drainage methods, Surgical Wound Infection epidemiology, Surgical Wound Infection prevention & control, Colorectal Surgery adverse effects
Abstract: Background: In Italy, surgeons continue to drain the abdominal cavity in more than 50 per cent of patients after colorectal resection. The aim of this study was to evaluate the impact of abdominal drain placement on early adverse events in patients undergoing elective colorectal surgery., Methods: A database was retrospectively analysed through a 1:1 propensity score-matching model including 21 covariates. The primary endpoint was the postoperative duration of stay, and the secondary endpoints were surgical site infections, infectious morbidity rate defined as surgical site infections plus pulmonary infections plus urinary infections, anastomotic leakage, overall morbidity rate, major morbidity rate, reoperation and mortality rates. The results of multiple logistic regression analyses were presented as odds ratios (OR) and 95 per cent c.i., Results: A total of 6157 patients were analysed to produce two well-balanced groups of 1802 patients: group (A), no abdominal drain(s) and group (B), abdominal drain(s). Group A versus group B showed a significantly lower risk of postoperative duration of stay >6 days (OR 0.60; 95 per cent c.i. 0.51-0.70; P < 0.001). A mean postoperative duration of stay difference of 0.86 days was detected between groups. No difference was recorded between the two groups for all the other endpoints., Conclusion: This study confirms that placement of abdominal drain(s) after elective colorectal surgery is associated with a non-clinically significant longer (0.86 days) postoperative duration of stay but has no impact on any other secondary outcomes, confirming that abdominal drains should not be used routinely in colorectal surgery., (© The Author(s) 2024. Published by Oxford University Press on behalf of BJS Society Ltd.)
Published: 2024
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40. Implementing Enhanced Perioperative Care in Emergency General Surgery: A Prospective Multicenter Observational Study.

Author: Ceresoli M, Biloslavo A, Bisagni P, Ciuffa C, Fortuna L, La Greca A, Tartaglia D, Zago M, Ficari F, Foti G, and Braga M
Subjects: Humans, Prospective Studies, Elective Surgical Procedures, Device Removal, Length of Stay, Postoperative Complications epidemiology, Perioperative Care
Abstract: Introduction: ERAS pathway has been proposed as the standard of care in elective abdominal surgery. Guidelines on ERAS in emergency surgery have been recently published; however, few evidences are still available in the literature. The aim of this study was to evaluate the feasibility of an enhanced recovery protocol in a large cohort of patients undergoing emergency surgery and to identify possible factors impacting postoperative protocol compliance., Methods: This is a prospective multicenter observational study including patients who underwent major emergency general surgery for either intra-abdominal infection or intestinal obstruction. The primary endpoint of the study is the adherence to ERAS postoperative protocol. Secondary endpoints are 30-day mortality and morbidity rates, and length of hospital stay., Results: A total of 589 patients were enrolled in the study, 256 (43.5%) of them underwent intestinal resection with anastomosis. Major complications occurred in 92 (15.6%) patients and 30-day mortality was 6.3%. Median adherence occurred on postoperative day (POD) 1 for naso-gastric tube removal, on POD 2 for mobilization and urinary catheter removal, and on POD 3 for oral intake and i.v. fluid suspension. Laparoscopy was significantly associated with adherence to postoperative protocol, whereas operative fluid infusion > 12 mL/Kg/h, preoperative hyperglycemia, presence of a drain, duration of surgery and major complications showed a negative association., Conclusions: The present study supports that an enhanced recovery protocol in emergency surgery is feasible and safe. Laparoscopy was associated with an earlier recovery, whereas preoperative hyperglycemia, fluid overload, and abdominal drain were associated with a delayed recovery., (© 2023. The Author(s).)
Published: 2023
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41. Correction to: Surgical treatment of colonic Crohn's disease: a national snapshot study.

Author: Celentano V, Pellino G, Rottoli M, Poggioli G, Sica G, Giglio MC, Campanelli M, Coco C, Rizzo G, Sionne F, Colombo F, Sampietro G, Lamperti G, Foschi D, Ficari F, Vacca L, Cricchio M, Giudici F, Selvaggi L, Sciaudone G, Peltrini R, Manfreda A, Bucci L, Galleano R, Ghazouani O, Zorcolo L, Deidda S, Restivo A, Braini A, Di Candido F, Sacchi M, Carvello M, Martorana S, Bordignon G, Angriman I, Variola A, Barugola G, Di Ruscio M, Tanzanu M, Geccherle A, Tropeano FP, Luglio G, Sasia D, Migliore M, Giuffrida MC, Marrano E, Moretto G, Impellizzeri H, Gallo G, Vescio G, Sammarco G, Terrosu G, Calini G, Bondurri A, Maffioli A, Zaffaroni G, Resegotti A, Mistrangelo M, Allaix ME, Botti F, Prati M, Boni L, Perotti S, Mineccia M, Giuliani A, Romano L, Graziano GMP, Pugliese L, Pietrabissa A, Delaini G, Spinelli A, and Selvaggi F
Published: 2022
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42. Inadequate food literacy is related to the worst health status and limitations in daily life in subjects with inflammatory bowel disease.

Author: Fiorindi C, Coppolino G, Leone S, Previtali E, Cei G, Luceri C, Ficari F, Russo E, and Giudici F
Subjects: Humans, Female, Quality of Life, Prospective Studies, Health Status, Health Literacy, Inflammatory Bowel Diseases
Abstract: Purpose: Diet affects Inflammatory Bowel Disease (IBD) patients' quality of life. An adequate Food Literacy (FL) level enables adequate food choices. Currently, there is a lack of knowledge on the FL degree in patients with IBD. To deepen this item, we measured for the first time the degree of FL in IBD patients and then we analyzed its correlation with health and socio-demographic variables., Methods: This is an observational prospective study includingsubjects with IBD belonging to A.M.I.C.I. ONLUS association. We first measured the degree of FL through Literacy Survey (FLS-IT) questionnaire (containing the Newest Vital Sign (NVS)). In addition, we analyzed the relationship between FL individual level and health and sociodemographic variables, evaluating which of these aspects have a positive or negative correlation with FL level. In detail, continuous variables were analyzed by Mann Whitney test. Differences among proportions were assessed using the chi-square test. A Spearman's rank correlation analysis was performed to correlate the sociodemographic and health status variable with FL index and NVS. A stepwise linear regression analysis with backward selection was performed to identify possible predictor of good food literary skills in IBS patients., Results: Overall, 450 IBD subjects completed the FLS-IT questionnaire. Among them, 69.78% (n = 314) showed an inadequate FL level. Concerning NVS test, 14.22% showed an insufficient ability to interpret food labels. In addition, higher FL level was associated to better subjective health conditions (r = 0.1513; p = 0.0013), less limitations in daily living activities (r = 0.1430; p = 0.0026), higher physical activity (r = 1200; p = 0.0110) and no alcohol consumption (p = 0.0020). Finally, higher NVS scores were shown by women (r = 0.1408; p = 0.0028) and by younger subjects (r = -0.1686; p = 0.0003)., Conclusions: We showed that an inadequate level of FL, related to the worst health status and the presence of several limitations in daily life, is widespread among our Italian cohort of IBD patients, and health and social status influence the ability to make adequate food choices. For this reason, it is necessary to investigate the problem and identify effective intervention strategies that will improve the patient's nutritional awareness., Competing Interests: Declaration of competing interest The authors declare no conflict of interest., (Copyright © 2022 European Society for Clinical Nutrition and Metabolism. Published by Elsevier Ltd. All rights reserved.)
Published: 2022
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43. Is the age at surgery in Crohn's disease clinically relevant? Differences and peculiarities: a wide single centre experience after long-term follow-up.

Author: Luceri C, Dragoni G, Zambonin D, Pesi B, Russo E, Scaringi S, Ficari F, Cianchi F, and Giudici F
Subjects: Adolescent, Adult, Aged, Aged, 80 and over, Humans, Middle Aged, Young Adult, Follow-Up Studies, Recurrence, Retrospective Studies, Risk Factors, Treatment Outcome, Age Factors, Crohn Disease surgery, Health Status Disparities
Abstract: Purpose: The Montreal classification for Crohn's disease includes "age at diagnosis" as a parameter but few is reported about the age at surgery. The aim of this study is to evaluate the short- and long-term differences in the postoperative surgical outcome and disease behaviour, according to the age at the first surgery., Methods: Patients consecutively operated for abdominal Crohn's disease during the period 1986-2012 at our centre were systematically analysed according to their age at first surgery. In our retrospective cohort, the age at first surgery ranged from 13 to 83 years, and patients were arbitrarily divided into four groups: ≤ 19 (G1), 20-39 (G2), 40-59 (G3) and ≥ 60 (G4) years old., Results: In total, 1051 patients were included with a median follow-up time of 232 months. The four groups exhibited statistically significant differences in age at diagnosis, smoke habit, time between diagnosis and surgery, disease location and behaviour, history of perianal fistula or abscess, severe malnutrition requiring total parental nutrition before surgery, type of surgery, total length of resected bowel, median duration of hospitalization, incidence of abdominal recurrences and number of surgical recurrences. G1 displays an inverse linear trend with time in the severity of clinical characteristics when compared to G4 groups. On the contrary, the incidence of short-term complications, types of abdominal recurrence and presence of concomitant perianal disease did not vary among groups. In addition, at multivariate analysis, the age at surgery and the disease location were the only independent risk factors for abdominal surgical recurrence., Conclusion: Despite first surgery is extremely more frequent between 20 and 59 years, patients from G1 and G4 groups showed clinical differences and peculiarities when compared to the other age groups. The most indolent CD behaviour and occurrence of surgical recurrence was observed in patients having their first abdominal surgery in the elderly, while patients operated before the age of 19 experienced a more aggressive disease course., (© 2022. The Author(s).)
Published: 2022
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44. Adherence to mediterranean diet in patients with inflammatory bowel disease.

Author: Fiorindi C, Dinu M, Gavazzi E, Scaringi S, Ficari F, Nannoni A, Sofi F, and Giudici F
Subjects: Humans, Quality of Life, Colitis, Ulcerative, Crohn Disease, Diet, Mediterranean, Inflammatory Bowel Diseases
Abstract: Background & Aims: Mediterranean diet may be beneficial for inflammatory bowel disease (IBD). The aim of this study was to evaluate the level of adherence to MD in Italian patients with IBD., Methods: Eighty consecutive outpatients with IBD, 62 with Crohn's Disease (CD) and 18 with Ulcerative Colitis (UC) were included in the study. Demographic and clinical data, previous and current medical history, nutritional status and Quality of Life (QoL) assessed with the Short Inflammatory Bowel Disease Questionnaire (SIBDQ) were assessed. Adherence to MD was studied with the Medi-Lite questionnaire., Results: IBD patients reported a mean Medi-Lite score of 10.4 with no significant differences between CD and UC patients (p = 0.543). Among CD patients, adherence to MD was higher in patients with inactive disease (p < 0.001) than in patients during the active phase, while no significant difference was found regarding disease activity in UC patients. A significant negative correlation of the Medi-Lite score with SIBDQ score (r = -0.2; p = 0.040) was found. MD adherence was lower in CD patients who had undergone ≥2 surgeries, whereas for patients with UC we found no significant differences in MD adherence in relation to pervious surgery., Conclusions: Adherence to MD in IBD is influenced by disease activity, QoL and patients' surgical history. A greater adherence to MD achieved with nutritional education may help improve quality of life and modulate disease activity., Competing Interests: Declaration of competing interest No Conflicts of Interest were present and Ethical Adherence was applied. On behalf of all authors, the corresponding author states that there is no conflict of interest. The authors declare that the manuscript has not been submitted to any other journal., (Copyright © 2021 European Society for Clinical Nutrition and Metabolism. Published by Elsevier Ltd. All rights reserved.)
Published: 2021
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45. Relationship between Nutritional Screening Tools and GLIM in Complicated IBD Requiring Surgery.

Author: Fiorindi C, Dragoni G, Scaringi S, Staderini F, Nannoni A, Ficari F, and Giudici F
Subjects: Adult, Aged, Female, Humans, Length of Stay, Male, Malnutrition complications, Middle Aged, Postoperative Period, Preoperative Care, Reproducibility of Results, Risk Factors, Young Adult, Colitis, Ulcerative complications, Colitis, Ulcerative surgery, Crohn Disease complications, Crohn Disease surgery, Malnutrition diagnosis, Nutrition Assessment, Nutritional Status
Abstract: Background: Accurate identification of malnutrition and preoperative nutritional care in Inflammatory Bowel Disease (IBD) surgery is mandatory. There is no validated nutritional screening tool for IBD patients. We developed a novel nutritional screening tool for IBD patients requiring surgery and compared it with other tools., Methods: we included 62 consecutive patients scheduled for elective surgery. The IBD Nutritional Screening tool (NS-IBD) was developed to screen patients for further comprehensive assessment. NRS-2002, MUST, MST, MIRT, SaskIBD-NR are compared with the new test. All screening tests were subsequently related to new GLIM criteria., Results: according to GLIM criteria, 25 (40%) IBD patients were malnourished (15 CD and 10 UC, 33% vs. 63%, p = 0.036). Stage 1 malnutrition was reported in ten patients, while stage 2 was detected in 15 patients. The comparison of each nutritional risk tool with GLIM criteria showed sensitivity of 0.52, 0.6, 0.6, 0.84, 0.84 and 0.92 for SASKIBD-NR, MUST, MST, NRS-2002, MIRT, and the new NS-IBD, respectively., Conclusions: in IBD, currently adopted nutritional screening tools are characterized by a low sensitivity when malnutrition diagnosis is performed with recent GLIM criteria. Our proposed tool to detect malnutrition performed the best in detecting patients that may require nutritional assessment and preoperative intervention.
Published: 2021
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46. Diving into Inflammation: A Pilot Study Exploring the Dynamics of the Immune-Microbiota Axis in Ileal Tissue Layers of Patients with Crohn's Disease.

Author: Russo E, Giudici F, Ricci F, Scaringi S, Nannini G, Ficari F, Luceri C, Niccolai E, Baldi S, D'Ambrosio M, Ramazzotti M, and Amedei A
Subjects: Adult, Aged, Case-Control Studies, Crohn Disease pathology, Cytokines metabolism, Female, Humans, Ileum pathology, Intestinal Mucosa metabolism, Intestinal Mucosa pathology, Male, Middle Aged, Pilot Projects, Recurrence, Crohn Disease etiology, Crohn Disease metabolism, Gastrointestinal Microbiome, Ileum metabolism, Ileum microbiology
Abstract: Background and Aims: The pathogenesis of Crohn's disease [CD] is still unclear. Disorders in the mucosal immunoregulation and its crosstalk with the microbiota may represent an important component in tissue injury. We aimed to characterize the molecular immune response distribution within the ileal layers and to evaluate the correlated microbiota in pathological/healthy settings comparing first surgery/relapse clinical conditions., Methods: We enrolled 12 CD patients. A comprehensive analysis of an ileal mucosa, submucosa and serosa broad-spectrum cytokine panel was performed through a multiplex approach. In addition, ileal microbiota composition was assessed through next generation sequencing., Results: We observed a distinct profile [of IL1-α, IL-1β, IL-4, IL-8, ICAM-1, E-Selectin, P-Selectin, IP-10, IL 6 and IL 18] across the CD vs healthy ileal layers; and a different distribution of IFN- γ, P-Selectin, IL-27 and IL-21 in first surgery vs relapse patients. In addition, the phylum Tenericutes, the family Ruminococcaceae, and the genera Mesoplasma and Mycoplasma were significantly enriched in the pathological setting. Significant microbiota differences were observed between relapse and first surgery patients regarding the class Bacteroidia, and the genera Prevotella, Flavobacterium, Tepidimonas and Escherichia/Shigella. Finally, the abundance of the genus Mycoplasma was positively correlated with IL-18., Conclusions: We describe a dissimilarity of cytokine distribution and microbiota composition within CD and adjacent healthy ileal tissue layers and between first operation and surgical relapse. Our results give potential insight into the dynamics of the gut microbiota-immune axis in CD patients, leading to detection of new biomarkers., (© The Author(s) 2021. Published by Oxford University Press on behalf of European Crohn’s and Colitis Organisation. All rights reserved. For permissions, please email: journals.permissions@oup.com.)
Published: 2021
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47. Effect of long-lasting nutritional prehabilitation on postoperative outcome in elective surgery for IBD.

Author: Fiorindi C, Cuffaro F, Piemonte G, Cricchio M, Addasi R, Dragoni G, Scaringi S, Nannoni A, Ficari F, and Giudici F
Subjects: Adult, Aged, Colitis, Ulcerative physiopathology, Counseling, Crohn Disease physiopathology, Dietary Supplements, Digestive System Surgical Procedures adverse effects, Enhanced Recovery After Surgery, Female, Humans, Male, Malnutrition etiology, Malnutrition prevention & control, Middle Aged, Nutrition Assessment, Nutritional Status, Postoperative Complications etiology, Preoperative Exercise, Prospective Studies, Treatment Outcome, Colitis, Ulcerative therapy, Crohn Disease therapy, Nutrition Therapy methods, Postoperative Complications prevention & control, Preoperative Care methods
Abstract: Background & Aims: Preoperative patient care optimisation appears to be crucial for obtaining good surgical outcomes. Enhanced Recovery After Surgery (ERAS) underlines the necessity to recognize and treat malnutrition perioperatively and to prehabilitate with interventions that can modulate the lean body mass before and after surgery. This procedure has been extensively reported in colorectal cancer patients but in Inflammatory Bowel Disease (IBD) it has not yet been clearly evaluated. The aim of this study was to implement the perioperative nutritional items in surgical Crohn's disease (CD) and ulcerative colitis (UC) patients electively operated in an ERAS setting, thus to clarify the impact of a long-lasting prehabilitation program in IBD., Methods: Consecutive adult patients (age ≥18) were included as soon as scheduled for elective surgery for CD or UC. The nutritional intervention included personalized dietary counseling and oral nutritional supplements when necessary. Data prospectively recorded in each phase were: FFM, FM, FFMI and phase angle detected with BIVA, weight, BMI, unintended weight loss, DASI, energy and nutritional intake, gastrointestinal symptoms and bowel functions. Nutritional risk was detected according to the NRS 2002 screening tool. The impact of early oral nutrition on postoperative recovery was analysed., Results: A total of 61 IBD patients (45 CD and 16 UC) were included. Muscle wasting was present at baseline assessment in 28% of cases, significantly associated with the presence of ileostomy (p < 0.011) and of a previous IBD surgery (p < 0.011). During the preoperative phase, there was a significant improvement in weight, BMI, FFM (CD p = 0.035; UC p = 0.017), FFMI (CD ns; UC p = 0.011) and phase angle (CD p = 0.014; UC p = 0.027). During the intra-hospital phase, weight and FFM decreased due to the catabolic effect of surgery, but in the whole perioperative period, both CD and UC patients did not change significantly in terms of body composition. Patients with earlier resumption of oral feeding had a significantly shorter hospital stay and a faster recovery of bowel function with no significant relationship with early postoperative complications., Conclusions: Nutritional prehabilitation positively modulated the body composition of IBD patients scheduled for elective surgery and therefore could represent a beneficial strategy to attenuate the impact of the surgical stress response on lean tissue in an ERAS setting. This effect is even more evident in high nutritional risk patients. Early postoperative oral feeding seems feasible and well tolerated in IBD. This approach positively influences the restoration of bowel function and the duration of hospital stay., Competing Interests: Conflict of Interest The authors have nothing to disclose. No Conflicts of Interest were present and Ethical Adherence was applied. The authors declare that the manuscript has not been submitted to any other journal., (Copyright © 2020 Elsevier Ltd and European Society for Clinical Nutrition and Metabolism. All rights reserved.)
Published: 2021
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48. Long-Term Follow-Up, Association between CARD15/NOD2 Polymorphisms, and Clinical Disease Behavior in Crohn's Disease Surgical Patients.

Author: Giudici F, Cavalli T, Luceri C, Russo E, Zambonin D, Scaringi S, Ficari F, Fazi M, Amedei A, Tonelli F, and Malentacchi C
Subjects: Adult, Female, Gene Frequency genetics, Genetic Predisposition to Disease, Humans, Male, Nod2 Signaling Adaptor Protein genetics, Young Adult, Crohn Disease genetics, Crohn Disease surgery, Nod2 Signaling Adaptor Protein metabolism, Polymorphism, Single Nucleotide genetics
Abstract: Background: CARD15/NOD2 is the most significant genetic susceptibility in Crohn's disease (CD) even though a relationship between the different polymorphisms and clinical phenotype has not been described yet. The study is aimed at analyzing, in a group of CD patients undergoing surgery, the relationship between CARD15/NOD2 polymorphisms and the clinical CD behavior after a long-term follow-up, in order to identify potential clinical biomarkers of prognosis., Methods: 191 surgical CD patients were prospectively characterized both for the main single nucleotide polymorphisms of CARD15/NOD2 and for many other environmental risk factors connected with the severe disease form. After a mean follow-up of 7.3 years, the correlations between clinical features and CD natural history were analyzed., Results: CARD15/NOD2 polymorphisms were significantly associated with younger age at diagnosis compared to wild type cases ( p < 0.05). Moreover, patients carrying a 3020insC polymorphism presented a larger Δ between diagnosis and surgery ( p = 0.0344). Patients carrying an hz881 and a 3020insC exhibited, respectively, a lower rate of responsiveness to azathioprine ( p = 0.012), but no difference was found in biologic therapy. Finally, the risk of surgical recurrence was significantly associated, respectively, to age at diagnosis, to familial CD history, to diagnostic delay, to arthritis, and to the presence of perioperative complications., Conclusions: 3020insC CARD15 polymorphism is associated with an earlier CD onset, and age at CD diagnosis < 27 years was confirmed to have a detrimental effect on its clinical course. In addition, the familiarity seems to be connected with a more aggressive postoperative course. Finally, for the first time, we have observed a lower rate of responsiveness to azathioprine in patients carrying an hz881 and a 3020insC., Competing Interests: The authors declare that they have no competing interests., (Copyright © 2021 Francesco Giudici et al.)
Published: 2021
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49. Anastomosis configuration and technique following ileocaecal resection for Crohn's disease: a multicentre study.

Author: Celentano V, Pellino G, Spinelli A, Selvaggi F, Celentano V, Pellino G, Rottoli M, Poggioli G, Sica G, Giglio MC, Campanelli M, Coco C, Rizzo G, Sionne F, Colombo F, Sampietro G, Lamperti G, Foschi D, Ficari F, Vacca L, Cricchio M, Giudici F, Selvaggi L, Sciaudone G, Peltrini R, Manfreda A, Bucci L, Galleano R, Ghazouani O, Zorcolo L, Deidda S, Restivo A, Braini A, Di Candido F, Sacchi M, Carvello M, Martorana S, Bordignon G, Angriman I, Variola A, Di Ruscio M, Barugola G, Geccherle A, Tropeano FP, Luglio G, Tanzanu M, Sasia D, Migliore M, Giuffrida MC, Marrano E, Moretto G, Impellizzeri H, Gallo G, Vescio G, Sammarco G, Terrosu G, Calini G, Bondurri A, Maffioli A, Zaffaroni G, Resegotti A, Mistrangelo M, Allaix ME, Botti F, Prati M, Boni L, Perotti S, Mineccia M, Giuliani A, Romano L, Graziano GMP, Pugliese L, Pietrabissa A, Delaini G, Spinelli A, and Selvaggi F
Subjects: Adolescent, Adult, Aged, Aged, 80 and over, Anastomosis, Surgical adverse effects, Anastomotic Leak epidemiology, Digestive System Surgical Procedures adverse effects, Elective Surgical Procedures methods, Female, Humans, Laparoscopy adverse effects, Length of Stay statistics & numerical data, Male, Middle Aged, Postoperative Complications epidemiology, Postoperative Complications etiology, Plastic Surgery Procedures methods, Retrospective Studies, Treatment Outcome, Young Adult, Anastomosis, Surgical methods, Anastomotic Leak etiology, Cecum surgery, Crohn Disease surgery, Digestive System Surgical Procedures methods, Ileum surgery, Laparoscopy methods
Abstract: A limited ileocaecal resection is the most frequently performed procedure for ileocaecal CD and different anastomotic configurations and techniques have been described. This manuscript audited the different anastomotic techniques used in a national study and evaluated their influence on postoperative outcomes following ileocaecal resection for primary CD. This is a retrospective, multicentre, observational study promoted by the Italian Society of Colorectal Surgery (SICCR), including all adults undergoing elective ileocaecal resection for primary CD from June 2018 May 2019. Postoperative morbidity within 30 days of surgery was the primary endpoint. Postoperative length of hospital stay (LOS) and anastomotic leak rate were the secondary outcomes. 427 patients were included. The side to side anastomosis was the chosen configuration in 380 patients (89%). The stapled anastomotic (n = 286; 67%), techniques were preferred to hand-sewn (n = 141; 33%). Postoperative morbidity was 20.3% and anastomotic leak 3.7%. Anastomotic leak was independent of the type of anastomosis performed, while was associated with an ASA grade ≥ 3, presence of perianal disease and ileocolonic localization of disease. Four predictors of LOS were identified after multivariate analysis. The laparoscopic approach was the only associated with a reduced LOS (p = 0.017), while age, ASA grade ≥ 3 or administration of preoperative TPN were associated with increased LOS. The side to side was the most commonly used anastomotic configuration for ileocolic reconstruction following primary CD resection. There was no difference in postoperative morbidity according to anastomotic technique and configuration. Anastomotic leak was associated with ASA grade ≥ 3, a penetrating phenotype of disease and ileo-colonic distribution of CD.
Published: 2021
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50. Nutritional adequacy in surgical IBD patients.

Author: Fiorindi C, Dragoni G, Alpigiano G, Piemonte G, Scaringi S, Staderini F, Nannoni A, Ficari F, and Giudici F
Subjects: Adolescent, Adult, Aged, Diet, Humans, Middle Aged, Nutrition Assessment, Nutritional Status, Young Adult, Eating, Inflammatory Bowel Diseases epidemiology, Inflammatory Bowel Diseases surgery
Abstract: Background & Aims: Despite little evidence available to date, the dietary intake assessment is considered a useful tool to optimize dietary intervention for the improvement of the nutritional status of IBD patients. The primary aim was to compare the dietary intake of IBD patients scheduled for surgery with the dietary reference values (DRVs) for the Italian population (LARN) and the ESPEN guidelines for clinical nutrition in IBD. The secondary aim was to describe the dietary patterns of patients with CD and UC in relation to the disease-specific and nutritional parameters and to compare these results to a control group in order to evaluate if similar nutritional intakes than in oncologic patients are found in IBD., Methods: Between January 2019 and March 2020, 62 consecutive IBD patients (46 CD and 16 UC) with age from 18 to 79 years scheduled for surgery were recruited. Patients received a comprehensive nutritional assessment, including food or nutrition-related history, anthropometric and body composition measurements. A group of 61 oncologic patients scheduled for colorectal cancer (CRC) surgery was used as control., Results: IBD patients showed a higher caloric and nutritional intake than CRC group, despite a higher frequency of underweight, and a lower prevalence of overweight and obesity. IBD patients showed an inadequate intake of proteins, n-3 PUFA, fiber, iron, calcium, potassium, magnesium, zinc, vitamin D and vitamin B12 according to ESPEN guidelines for clinical nutrition in IBD and LARN. Oral intake was not influenced by gender, IBD subtype, longer duration of disease and previous surgery. In CD, fistulizing behaviour negatively influenced oral intake., Conclusions: in IBD patients, the evaluation of macronutrients and micronutrients intake before surgery, can contribute to evaluate and to correct the onset of nutritional deficiencies. Specific dietary recommendations seem required, in order to integrate specific nutritional inadequacies. IBD patients referred to surgery have to be considered at high nutritional risk like oncologic patients are., Competing Interests: Declaration of competing interest No Conflicts of Interest were present and Ethical Adherence was applied. On behalf of all authors, the corresponding author states that there is no conflict of interest. The authors declare that the manuscript has not been submitted to any other journal., (Copyright © 2020 European Society for Clinical Nutrition and Metabolism. Published by Elsevier Ltd. All rights reserved.)
Published: 2021
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