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1. Current status of liver surgery for non-colorectal non-neuroendocrine liver metastases: the NON.LI.MET. Italian Society for Endoscopic Surgery and New Technologies (SICE) and Association of Italian Surgeons in Europe (ACIE) collaborative international survey

Author

Libia, A, Podda, M, Di Martino, M, Pata, F, Pellino, G, Di Saverio, S, Anselmo, A, Muttillo, E, De Pastena, M, Campanile, F, Ielpo, B, Spampinato, M, Guerrieri, M, Agresta, F, Cuccurullo, D, Sartori, A, D'Ambrosio, G, Anania, G, Agrusa, A, Allaix, M, Balla, A, Botteri, E, Bracale, U, Ceccarelli, G, Milone, M, Moretto, G, Muttillo, I, Perrotta, N, Pirozzi, F, Ortenzi, M, Ioannidis, A, Stavrou, G, Gica, N, Benzoni, E, Rosa, F, Visag-Castillo, V, Award, S, Machairas, N, Manrique, M, Marino, M, De Nobili, G, Sira-gusa, L, Iossa, A, de Santibanes, M, Lisi, G, De Luca, A, Giuliani, A, Perra, T, Porcu, A, Cillara, N, Giordano, A, Laureiro, Z, Papa, M, Clementi, M, Tamini, N, Soreide, K, Mazzarella, G, Pio, L, Dopazo, C, Argenio, G, An-nechiarico, M, Andreuccetti, J, Calvo, M, Cinardi, N, Angelico, R, Nari, G, Saldino, E, Gazia, C, Anis, B, Machian, G, Romic, I, Bellido-luque, J, Pandanapoyana, S, Roscio, F, Pattaccini, G, Frazzetta, G, Lim, R, Delvecchio, A, Primavesi, F, Rodrigeuz-Lopez, M, Formisano, G, Delogu, D, Umar, M, Elisa, S, Del Basso, C, D'Alessandro, A, Sandri, G, Menna, M, De Simone, B, al-Najami, I, Curro, G, Hila, J, Quaresima, S, Cervellera, M, Sanberg, J, Cestaro, G, Capuano, M, Ammendola, M, Pinotti, E, Palomba, G, Tonini, V, Baiocchi, G, Saraceno, F, Calini, G, Reccia, I, Dasari, B, Poillucci, G, Frontali, A, Marconi, M, Bertilone, E, Basile, E, Toneto, M, Coletta, D, Cacciaguerra, A, Umar Younis, M, Merlini, D, Julianov, A, Harish, N, Morelli, L, Marone, M, Lo Conte, D, D'Ugo, S, D'Acapito, F, Saroglu, A, Santambrogio, R, Giuffrida, M, Furbetta, N, Lopez-Lopez, V, Panyko, A, Romano, F, Murillo, G, Spartalis, M, Spartalis, E, Castaldi, A, Koh, P, Koong, J, Santiago, M, Grazi, G, Martinez-Mier, G, Beatriz, D, Gkekas, I, Ioannidis, O, Lujan, S, Carneros, V, Madrid, F, Baroffio, P, Rashid, A, Irkorucu, O, Ros, E, Perez-Bertolez, S, Schizas, D, Machain, G, Altinel, Y, Veroux, M, Corallino, D, Lorenzin, D, Negoi, I, Barabi-no, M, Piccino, M, Grossi, U, Fernandez, A, Saeidi, S, Maritato, S, Picco-lo, G, Serradilla-Martin, M, Esposito, G, Albanesi, F, Lammel-Lindemann, J, Libia A., Podda M., Di Martino M., Pata F., Pellino G., Di Saverio S., Anselmo A., Muttillo E. M., De Pastena M., Campanile F. C., Ielpo B., Spampinato M. G., Guerrieri M., Agresta F., Cuccurullo D., Sartori A., D'Ambrosio G., Anania G., Agrusa A., Allaix M. E., Balla A., Botteri E., Bracale U., Ceccarelli G., Milone M., Moretto G., Muttillo I., Perrotta N., Pirozzi F., Ortenzi M., Ioannidis A., Stavrou G., Gica N., Benzoni E., Rosa F., Visag-Castillo V., Award S. S., Machairas N., Manrique M. M., Marino M., De Nobili G., Sira-gusa L., Iossa A., de Santibanes M., Lisi G., De Luca A., Giuliani A., Perra T., Porcu A., Cillara N., Giordano A., Laureiro Z. L., Papa M. V., Clementi M., Tamini N., Soreide K., Mazzarella G., Pio L., Dopazo C., Argenio G., An-nechiarico M., Andreuccetti J., Calvo M. P., Cinardi N., Angelico R., Nari G. A., Saldino E., Gazia C., Anis B., Machian G. M., Romic I., Bellido-luque J., Pandanapoyana S., Roscio F., Pattaccini G. C., Frazzetta G., Lim R., Delvecchio A. -L., Primavesi F., Rodrigeuz-Lopez M., Formisano G., Delogu D., Umar M., Elisa S., Del Basso C., d'Alessandro A., Sandri G. B. L., Menna M. P., De Simone B., al-Najami I., Curro G., Hila J., Quaresima S., Cervellera M., Sanberg J., Cestaro G., Capuano M., Ammendola M., Pinotti E., Palomba G., Tonini V., Baiocchi G. L., Saraceno F., Calini G., Reccia I., Dasari B. V. M., Poillucci G., Frontali A., Marconi M., Bertilone E., Basile E., Toneto M. G., Coletta D., Cacciaguerra A. B., Umar Younis M., Merlini D. A., Julianov A., Harish N. L., Morelli L., Marone M., Lo Conte D., D'Ugo S., D'Acapito F., Saroglu A., Santambrogio R., Giuffrida M., Furbetta N., Lopez-Lopez V., Panyko A., Romano F., Murillo G. A. A., Spartalis M., Spartalis E., Castaldi A., Koh P. S., Koong J. K., Santiago M. J. C., Grazi G. L., Martinez-Mier G., Beatriz D. A. -A., Gkekas I., Ioannidis O., Lujan S. A. W., Carneros V. J. E., Madrid F., Baroffio P., Rashid A. -S., Irkorucu O., Ros E. P. N., Perez-Bertolez S., Schizas D., Machain G. M., Altinel Y., Veroux M., Corallino D., Lorenzin D., Negoi I., Barabi-no M., Piccino M., Grossi U., Fernandez A. J. G., Saeidi S., Maritato S., Picco-lo G., Serradilla-Martin M., Esposito G., Albanesi F., Lammel-Lindemann J., Libia, A, Podda, M, Di Martino, M, Pata, F, Pellino, G, Di Saverio, S, Anselmo, A, Muttillo, E, De Pastena, M, Campanile, F, Ielpo, B, Spampinato, M, Guerrieri, M, Agresta, F, Cuccurullo, D, Sartori, A, D'Ambrosio, G, Anania, G, Agrusa, A, Allaix, M, Balla, A, Botteri, E, Bracale, U, Ceccarelli, G, Milone, M, Moretto, G, Muttillo, I, Perrotta, N, Pirozzi, F, Ortenzi, M, Ioannidis, A, Stavrou, G, Gica, N, Benzoni, E, Rosa, F, Visag-Castillo, V, Award, S, Machairas, N, Manrique, M, Marino, M, De Nobili, G, Sira-gusa, L, Iossa, A, de Santibanes, M, Lisi, G, De Luca, A, Giuliani, A, Perra, T, Porcu, A, Cillara, N, Giordano, A, Laureiro, Z, Papa, M, Clementi, M, Tamini, N, Soreide, K, Mazzarella, G, Pio, L, Dopazo, C, Argenio, G, An-nechiarico, M, Andreuccetti, J, Calvo, M, Cinardi, N, Angelico, R, Nari, G, Saldino, E, Gazia, C, Anis, B, Machian, G, Romic, I, Bellido-luque, J, Pandanapoyana, S, Roscio, F, Pattaccini, G, Frazzetta, G, Lim, R, Delvecchio, A, Primavesi, F, Rodrigeuz-Lopez, M, Formisano, G, Delogu, D, Umar, M, Elisa, S, Del Basso, C, D'Alessandro, A, Sandri, G, Menna, M, De Simone, B, al-Najami, I, Curro, G, Hila, J, Quaresima, S, Cervellera, M, Sanberg, J, Cestaro, G, Capuano, M, Ammendola, M, Pinotti, E, Palomba, G, Tonini, V, Baiocchi, G, Saraceno, F, Calini, G, Reccia, I, Dasari, B, Poillucci, G, Frontali, A, Marconi, M, Bertilone, E, Basile, E, Toneto, M, Coletta, D, Cacciaguerra, A, Umar Younis, M, Merlini, D, Julianov, A, Harish, N, Morelli, L, Marone, M, Lo Conte, D, D'Ugo, S, D'Acapito, F, Saroglu, A, Santambrogio, R, Giuffrida, M, Furbetta, N, Lopez-Lopez, V, Panyko, A, Romano, F, Murillo, G, Spartalis, M, Spartalis, E, Castaldi, A, Koh, P, Koong, J, Santiago, M, Grazi, G, Martinez-Mier, G, Beatriz, D, Gkekas, I, Ioannidis, O, Lujan, S, Carneros, V, Madrid, F, Baroffio, P, Rashid, A, Irkorucu, O, Ros, E, Perez-Bertolez, S, Schizas, D, Machain, G, Altinel, Y, Veroux, M, Corallino, D, Lorenzin, D, Negoi, I, Barabi-no, M, Piccino, M, Grossi, U, Fernandez, A, Saeidi, S, Maritato, S, Picco-lo, G, Serradilla-Martin, M, Esposito, G, Albanesi, F, Lammel-Lindemann, J, Libia A., Podda M., Di Martino M., Pata F., Pellino G., Di Saverio S., Anselmo A., Muttillo E. M., De Pastena M., Campanile F. C., Ielpo B., Spampinato M. G., Guerrieri M., Agresta F., Cuccurullo D., Sartori A., D'Ambrosio G., Anania G., Agrusa A., Allaix M. E., Balla A., Botteri E., Bracale U., Ceccarelli G., Milone M., Moretto G., Muttillo I., Perrotta N., Pirozzi F., Ortenzi M., Ioannidis A., Stavrou G., Gica N., Benzoni E., Rosa F., Visag-Castillo V., Award S. S., Machairas N., Manrique M. M., Marino M., De Nobili G., Sira-gusa L., Iossa A., de Santibanes M., Lisi G., De Luca A., Giuliani A., Perra T., Porcu A., Cillara N., Giordano A., Laureiro Z. L., Papa M. V., Clementi M., Tamini N., Soreide K., Mazzarella G., Pio L., Dopazo C., Argenio G., An-nechiarico M., Andreuccetti J., Calvo M. P., Cinardi N., Angelico R., Nari G. A., Saldino E., Gazia C., Anis B., Machian G. M., Romic I., Bellido-luque J., Pandanapoyana S., Roscio F., Pattaccini G. C., Frazzetta G., Lim R., Delvecchio A. -L., Primavesi F., Rodrigeuz-Lopez M., Formisano G., Delogu D., Umar M., Elisa S., Del Basso C., d'Alessandro A., Sandri G. B. L., Menna M. P., De Simone B., al-Najami I., Curro G., Hila J., Quaresima S., Cervellera M., Sanberg J., Cestaro G., Capuano M., Ammendola M., Pinotti E., Palomba G., Tonini V., Baiocchi G. L., Saraceno F., Calini G., Reccia I., Dasari B. V. M., Poillucci G., Frontali A., Marconi M., Bertilone E., Basile E., Toneto M. G., Coletta D., Cacciaguerra A. B., Umar Younis M., Merlini D. A., Julianov A., Harish N. L., Morelli L., Marone M., Lo Conte D., D'Ugo S., D'Acapito F., Saroglu A., Santambrogio R., Giuffrida M., Furbetta N., Lopez-Lopez V., Panyko A., Romano F., Murillo G. A. A., Spartalis M., Spartalis E., Castaldi A., Koh P. S., Koong J. K., Santiago M. J. C., Grazi G. L., Martinez-Mier G., Beatriz D. A. -A., Gkekas I., Ioannidis O., Lujan S. A. W., Carneros V. J. E., Madrid F., Baroffio P., Rashid A. -S., Irkorucu O., Ros E. P. N., Perez-Bertolez S., Schizas D., Machain G. M., Altinel Y., Veroux M., Corallino D., Lorenzin D., Negoi I., Barabi-no M., Piccino M., Grossi U., Fernandez A. J. G., Saeidi S., Maritato S., Picco-lo G., Serradilla-Martin M., Esposito G., Albanesi F., and Lammel-Lindemann J.

Abstract

Despite the increasing trend in liver resections for non-colorectal non-neuroendocrine liver metastases (NCNNLM), the role of surgery for these liver malignancies is still debated. Registries are an essential, reliable tool for assessing epidemiology, diagnosis, and therapeutic approach in a single hub, especially when data are dispersive and inconclusive, as in our case. The dissemination of this preliminary survey would allow us to understand if the creation of an International Registry is a viable option, while still offering a snapshot on this issue, investigating clinical practices worldwide. The steering committee designed an online questionnaire with Google Forms, which consisted of 37 questions, and was open from October 5th, 2022, to November 30th, 2022. It was disseminated using social media and mailing lists of the Italian Society of Endoscopic Surgery and New Technologies (SICE), the Association of Italian Surgeons in Europe (ACIE), and the Spanish Chapter of the American College of Surgeons (ACS). Overall, 141 surgeons (approximately 18% of the total invitations sent) from 27 countries on four continents participated in the survey. Most respondents worked in general surgery units (62%), performing less than 50 liver resections/year (57%). A multidisciplinary discussion was currently performed to validate surgical indications for NCNNLM in 96% of respondents. The most commonly adopted selection criteria were liver resectability, RECIST criteria, and absence of extrahepatic disease. Primary tumors were generally of gastrointestinal (42%), breast (31%), and pancreaticobiliary origin (13%). The most common interventions were parenchymal-sparing resections (51% of respondents) of metachronous metastases with an open approach. Major post-operative complications (Clavien–Dindo > 2) occurred in up to 20% of the procedures, according to 44% of respondents. A subset analysis of data from high-volume centers (> 100 cases/year) showed lower post-operative com

Published
2024

2. Tyre parameter identification from road tests on a complete vehicle

Author

Lo Conte, D. (author) and Lo Conte, D. (author)

Abstract

Vehicle manufacturers notice a difference between the tyre behaviour observed in road tests with a complete vehicle and the behaviour of the tyre as provided by the tyre manufacturers. To improve the tyre characterization and avoid appointing its behaviour each time using trial-and-error, Centro Ricerche Fiat requests the development of an application that can identify the tyre parameters consistently and automatically. This thesis describes the process of developing the TyreEstimator, the application written for the identification of the tyre parameters. The application is built to minimize the difference between the vehicle model data and the experimental data using an optimization algorithm. Two vehicle models are implemented to identify the tyre parameters. The tyre behaviour is described using the Magic Formula tyre model. Due to the sensitivity of the optimization problem, the application is constructed to cope with different options for finding the tyre parameters. Afterwards an empirical analysis, using the TyreEstimator, is performed. This results in an option set for each vehicle model, which approaches the tyre behaviour best., Precision and Microsystems Engineering, Mechanical, Maritime and Materials Engineering

Published
2010

3. Autotransplantation of pancreatic islets. A single-center first experience

Author

Paolo Magistri, Andreani S, Lo Conte D, Gc, Ferrari, Forgione A, and Pugliese R

Subjects
Auto-transplantation, Reoperation, Chronic pancreatitis, IAT, Pancreatic islets, Total pancreatectomy, Islets of Langerhans Transplantation, Middle Aged, Combined Modality Therapy, Transplantation, Autologous, Pancreaticoduodenectomy, Pancreatectomy, Postoperative Complications, Recurrence, Pancreatitis, Chronic, Diabetes Mellitus, Humans, Insulin, Surgical Wound Infection, Female, Negative-Pressure Wound Therapy
Abstract

Islets auto-transplantation (IAT) is a well-known procedure that may improve glycemic control after total or completion pancreatectomy compared to insulin therapy alone.We herein report our experience in IAT with the case of a sixty years old woman underwent completion pancreatectomy for recurrent pancreatitis. She received IAT by percutaneous trans-hepatic intra-portal injection. The patient recovered well, except for a surgical wound infection that was treated with vacuum therapy. She was discharged on p.o.d. 27th in good general conditions and tolerating a diet.Data in literature demonstrate that IAT is cost-effective on the long-run compared to insulin therapy in patients with diabetes. 30-days mortality rate for islets auto-transplantation (IAT) following total pancreatectomy is 5%, which is comparable with previous reports on total pancreatectomy without IAT. Our report may expand the literature on this procedure in order to further develop and improve both technique and outcomes, and clarify the correct indication to surgery.Auto-transplantation, Chronic pancreatitis, IAT, Pancreatic islets, Total pancreatectomy.L’autotrapianto d’isole pancreatiche (IAT) è una procedura ben nota che consente di migliorare il controllo glicemico dopo una pancreasectomia totale (o completamento di pancreasectomia dopo duodenocefalopancreasectomia) rispetto alla sola terapia insulinica. In questo lavoro presentiamo la nostra esperienza nel campo dell’ IAT riportando il caso clinico di una donna di sessanta anni, sottoposta a completamento di pancreasectomia per episodi ricorrenti di acuzie in un quadro di pancreatite cronica. Il trattamento IAT è stato somministrato mediante iniezione trans-epatica intra-portale. Il recupero post-procedurale è stato ottimale, fatta eccezione per un’infezione di ferita che ha richiesto un trattamento con tecnologia a pressione negativa. La paziente è stata dimessa in ventisettesima giornata postoperatoria, in buone condizioni generali, dopo regolare ripresa dell’alimentazione e della canalizzazione. I dati presenti in letteratura dimostrano che la IAT è una procedura sicura, garantendo nel lungo periodo un vantaggio rispetto alla terapia insulinica in termini di rapporto costo-beneficio. Riguardo alla procedura chirurgica, è qui utile ricordare che la mortalità a 30 giorni dopo pancreasectomia totale associata a IAT è del 5%, ed è pertanto sovrapponibile ai risultati della pancreasectomia totale senza IAT. Riportando questa esperienza intendiamo contribuire alla crescita della casistica chirurgica attuale in questo campo, proponendo nel futuro un più ampio sviluppo e una più estesa applicazione di tale approccio.

4. ICG-Guided Lymphadenectomy during Surgery for Colon and Rectal Cancer-Interim Analysis of the GREENLIGHT Trial.

Author

Ribero D, Mento F, Sega V, Lo Conte D, Mellano A, and Spinoglio G

Abstract

Lymphadenectomy is crucial for an optimal oncologic resection of colon and rectal cancers. However, without a direct visualization, an aberrant route of lymph node (LN) diffusion might remain unresected. Indocyanine-green (ICG) lymphatic mapping permits a real-time LNs visualization. We designed the GREENLIGHT trial to explore in 100 patients undergoing robotic colorectal resection the clinical significance of a D3 ICG-guided lymphadenectomy. The primary endpoint was the number of patients in whom ICG changed the extent of lymphadenectomy. We report herein the interim analysis on the first 70 patients. After endoscopic ICG injection 24 h (n = 49) or 72 h (n = 21) ahead, 19, 20, and 31 patients underwent right colectomy, left colectomy, and anterior rectal resection. The extent of lymphadenectomy changed in 35 (50%) patients, mostly (29 (41.4%)) for the identification of LNs (median two) outside the standard draining basin. Identification of such LNs was less frequent in rectal tumors that had undergone chemoradiotherapy (26.3%) (p > 0.05). A non-significant correlation between time-to-ICG injection and identification of aberrant LNs was observed (48.9% at 24 h vs. 23.8% at 72 h). The presence of LN metastases did not affect a proper fluorescent mapping. These data indicate that ICG lymphatic mapping provides relevant information in 50% of patients, thus increasing the accuracy of potentially curative resections.

Published
2022
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5. Autotransplantation of pancreatic islets. A single-center first experience.

Author

Magistri P, Andreani S, Lo Conte D, Ferrari GC, Forgione A, and Pugliese R

Subjects
Combined Modality Therapy, Diabetes Mellitus drug therapy, Diabetes Mellitus etiology, Female, Humans, Insulin therapeutic use, Middle Aged, Negative-Pressure Wound Therapy, Pancreatectomy adverse effects, Pancreaticoduodenectomy adverse effects, Pancreatitis, Chronic surgery, Postoperative Complications drug therapy, Recurrence, Reoperation, Surgical Wound Infection therapy, Transplantation, Autologous, Diabetes Mellitus surgery, Islets of Langerhans Transplantation methods, Postoperative Complications surgery
Abstract

Introduction: Islets auto-transplantation (IAT) is a well-known procedure that may improve glycemic control after total or completion pancreatectomy compared to insulin therapy alone., Case Report: We herein report our experience in IAT with the case of a sixty years old woman underwent completion pancreatectomy for recurrent pancreatitis. She received IAT by percutaneous trans-hepatic intra-portal injection. The patient recovered well, except for a surgical wound infection that was treated with vacuum therapy. She was discharged on p.o.d. 27th in good general conditions and tolerating a diet., Discussion: Data in literature demonstrate that IAT is cost-effective on the long-run compared to insulin therapy in patients with diabetes. 30-days mortality rate for islets auto-transplantation (IAT) following total pancreatectomy is 5%, which is comparable with previous reports on total pancreatectomy without IAT. Our report may expand the literature on this procedure in order to further develop and improve both technique and outcomes, and clarify the correct indication to surgery., Key Words: Auto-transplantation, Chronic pancreatitis, IAT, Pancreatic islets, Total pancreatectomy.

Published
2016

6. Is primary surgery for locally advanced/metastatic breast cancer a better choice than chemotherapic treatment?

Author

Di Libero L, Varricchio A, Iannace C, Lo Conte D, Tartaglia E, Candela G, Colantuoni G, and Testa A

Subjects
Breast Neoplasms mortality, Breast Neoplasms pathology, Female, Humans, Middle Aged, Neoadjuvant Therapy, Neoplasm Metastasis, Neoplasm Staging, Survival Rate, Treatment Outcome, Breast Neoplasms drug therapy, Breast Neoplasms surgery
Abstract

Introduction: A part of the literature supports the undoubtful advantage of neoadjuvant chemotherapy on the overall survival and for the possibility of surgical conservative treatment in locally advanced tumours after downstaging. Other authors report that primitive tumour's surgical removal at first, improves survival in cases with locally advanced /metastatic disease. The advantages were improvement of patient's health status, removal of a reservoir of neoplastic cell neoangiogenic cytokines and growth factors,and cytoreduction., Materials and Methods: Aim of this study is to evaluate the effectiveness on the survival of a primary surgical treatment of the locally advanced tumours comparing two homogeneous groups. In the first group (GROUP 1) 40 patients were enrolled with stage III A, III B,IV tumours and were treated with primary surgery. The second group (GROUP 2) was made up of 40 patients with similar stage treated with neoadjuvant chemotherapy. The surgical treatment had the intention to remove the entire primary tumour., Results: After a median follow up of 48,2 months,22,5 % of GROUP 1 died and 30 % of GROUP 2. The average survival of patients in GROUP 1 was 27,1 months while in GROUP 2 there was an average survival of 16,8 months., Conclusion: In conclusion surgical treatment plays a key role in the treatment of advanced/metastatic disease and is an independent factor associated with survival.

Published
2014

7. Successful use of rFVIIa for major breast surgery prophylaxis in congenital factor VII deficiency: a case report.

Author

Varricchio A, Schettino M, Ciampa A, Iannace C, Lo Conte D, Di Libero L, Donnarumma B, Vigorito R, and Lepore M

Subjects
Breast Neoplasms complications, Breast Neoplasms surgery, Female, Humans, Middle Aged, Paget's Disease, Mammary complications, Paget's Disease, Mammary surgery, Recombinant Proteins therapeutic use, Factor VII Deficiency complications, Factor VIIa therapeutic use, Postoperative Hemorrhage etiology, Postoperative Hemorrhage prevention & control, Preoperative Care
Abstract

Introduction: Factor VII deficiency is a rare cause of haemorrhagic syndrome. The Authors describe a case of a 46 years old patient with congenital factor VII deficiency that successfully underwent breast surgery after treatment with Novoseven® before the procedure., Materials and Methods: The AA used the schedule reported below to value the levels of PT and aPTT in the patient. Blood Collection: Venous blood from patient and control was collected in glass tubes for routine serum preparation and into plastic tubes (0.129 M sodium citrate, Becton-Dickinson Vacutainer Systems) in a ratio of blood to anticoagulant of 9:1. Platelet Poor Plasma (PPP) was obtained by centrifugation at 4.000 x g for 15 minutes at room temperature. The plasma was recentrifuged for another 10 min at 12000 g to fully eliminate platelet concentration. A normal control plasma pool was prepared by mixing equal volumes of platelet-free plasma obtained from at least 50 normal volunteers. Prothrombin time (PT) was measured with Recombiplastin (IL, Milano Italy). Activated partial thromboplastin times (APTT) was measured with APTT-SP (IL, Milano Italy). They were performed on the coagulation analyzer ACL 1000 (IL, Milano Italy)., Results: The results were interpreted from the ratio of the patient times to the normal control times (Table I)., Conclusion: The infusion of Novoseven solved the clotting problems enabling the surgical procedure, without risks for the patient.

Published
2014

8. Advantages and disadvantages of day surgery in a department of general surgery.

Author

Dodaro CA, Grifasi C, Lo Conte D, and Romagnuolo R

Subjects
Costs and Cost Analysis, Humans, Retrospective Studies, Ambulatory Surgical Procedures economics, General Surgery, Surgery Department, Hospital economics, Surgery Department, Hospital organization & administration
Abstract

Introduction: We make our study of day surgery to awaken health worker that is possible to reduce the mean hospitalization time for each type of procedure: it needs improvement in communication, organizational and medical skills with a specific training both for medical and nursing staff., Material of Study: A retrospective study on all patients who underwent day surgery procedures from 1st January 2008 to 31st December 2011. Out of 486 hospitalizations for programmed surgery, 177 (36.41%) were made in Day Surgery (DS) for a total of 450 operations. Of those patients, 105 (59.3%) stayed Overnight., Results: Re-conversion rate of day surgery hospitalization reached 1% and referred to haemorrhagy post-hemorroidectomy., Discussion: Nowadays in Italy many surgical procedures that could be performed in day surgery, are made in routine hospitalization with an higher cost for NHS. In our department DS is made for small surgery but even other procedures (hernioplasty, hemorroidectomy, stripping of vein safena, etc.). Our day surgery activity has had some negative aspects both for the availability of operating rooms and for the possibility of improvement of specific skills in our health staff., Conclusions: Day surgery permits a better use of resources and also a cut of costs. The dates of our series demonstrate the necessity of improving DS, considering trends of the most part of European Countries. The Authors highlight the importance of creating specific Units for Day-Surgery activity to permit a training for all health staff.

Published
2013

9. Clinical management of Crohn's disease in the elderly.

Author

Carlomagno N, Grifasi C, Dumani X, Lo Conte D, and Renda A

Subjects
Age Factors, Aged, Humans, Middle Aged, Retrospective Studies, Crohn Disease surgery
Abstract

Introduction: Crohn's Disease (CD) occurs in the elderly in 5 - 25% of cases. Aim of our study: to define the features of clinical presentation, diagnostic tools and therapy of CD in old age., Methods: In the last ten years we observed in our Department 47 patients affected by CD. We divided them into two groups: A (42 patients < 65 years old) and B (5 patients ≥ 65 years old). A retrospective survey evaluated the clinical presentation, diagnosis and treatments with relative outcomes., Results: Group A: 23/42 patients (54,76%) were operated on. The most important indication for surgery was intestinal obstruction (15/42 pts, 65,2%). Small bowel resection was the most frequent surgical procedure (13/42 pts, 56,2%). Overall, 2/23 (8,7%) of the patients developed postoperative complications. There was no postoperative mortality. 8 pts (34,7 %) developed recrudescence of CD. Group B: 3 of 5 pts were operated on. Intestinal obstruction was the indication for surgery in all cases (100%). Two patients underwent small bowel resection (66,6%) and the third patient was submitted to an ileo-colic resection (33,3%). There was no mortality in the aftermath of surgery. In 2/3 operated patients (66,6%) recurrence occurred. All operations in the old patients were performed in urgency., Conclusions: Surgery of CD in the elderly appears in our experience to have the same indications and procedures as in young patients. The postoperative morbidity, mortality and recurrence rates are similar in two groups even if we observed slightly higher postoperative morbidity rates in elderly due to the presence of comorbidity.

Published
2013

10. Cat scratch disease presenting as breast cancer: a report of an unusual case.

Author

Iannace C, Lo Conte D, Di Libero L, Varricchio A, Testa A, Vigorito R, Gagliardi G, Lepore M, and Caracciolo F

Abstract

Benign lymphoreticulosis (cat scratch disease, CSD) may have a clinical course that varies from the most common lymphadenitis localized in the site of inoculation, preceded by the typical "primary lesion," to a context of severe systemic involvement. Among these uncommon clinical aspects, there is mammarian granulomatous lymphadenitis which may appear as a mastitis or a solitary intraparenchymal mass, giving the impression of a breast tumor. In these cases, intensive clinical, instrumental, and laboratory investigations are necessary to exclude malignancy. Because of its rarity, in equivocal cases, it is reasonable to use surgical excision for accurate histological examination. We report a case of CSD of the breast in a 59-year-old woman, analyzing the clinical, histopathological, and instrumental appearance and also performing a literature review.

Published
2013
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