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8 results on '"Mineccia M"'

1. Minimally invasive vs. open segmental resection of the splenic flexure for cancer: a nationwide study of the Italian Society of Surgical Oncology-Colorectal Cancer Network (SICO-CNN).

Author

Degiuli M, Ortenzi M, Tomatis M, Puca L, Cianflocca D, Rega D, Maroli A, Elmore U, Pecchini F, Milone M, La Mendola R, Soligo E, Deidda S, Spoletini D, Cassini D, Aprile A, Mineccia M, Nikaj H, Marchegiani F, Maiello F, Bombardini C, Zuolo M, Carlucci M, Ferraro L, Falato A, Biondi A, Persiani R, Marsanich P, Fusario D, Solaini L, Pollesel S, Rizzo G, Coco C, Di Leo A, Cavaliere D, Roviello F, Muratore A, D'Ugo D, Bianco F, Bianchi PP, De Nardi P, Rigamonti M, Anania G, Belluco C, Polastri R, Pucciarelli S, Gentilli S, Ferrero A, Scabini S, Baldazzi G, Carlini M, Restivo A, Testa S, Parini D, De Palma GD, Piccoli M, Rosati R, Spinelli A, Delrio P, Borghi F, Guerrieri M, and Reddavid R

Subjects
Humans, Treatment Outcome, Retrospective Studies, Postoperative Complications surgery, Minimally Invasive Surgical Procedures, Colon, Transverse surgery, Laparoscopy methods, Surgical Oncology, Colonic Neoplasms surgery
Abstract

Background: Evidence on the efficacy of minimally invasive (MI) segmental resection of splenic flexure cancer (SFC) is not available, mostly due to the rarity of this tumor. This study aimed to determine the survival outcomes of MI and open treatment, and to investigate whether MI is noninferior to open procedure regarding short-term outcomes., Methods: This nationwide retrospective cohort study included all consecutive SFC segmental resections performed in 30 referral centers between 2006 and 2016. The primary endpoint assessing efficacy was the overall survival (OS). The secondary endpoints included cancer-specific mortality (CSM), recurrence rate (RR), short-term clinical outcomes (a composite of Clavien-Dindo > 2 complications and 30-day mortality), and pathological outcomes (a composite of lymph nodes removed ≧12, and proximal and distal free resection margins length ≧ 5 cm). For these composites, a 6% noninferiority margin was chosen based on clinical relevance estimate., Results: A total of 606 patients underwent either an open (208, 34.3%) or a MI (398, 65.7%) SFC segmental resection. At univariable analysis, OS and CSM were improved in the MI group (log-rank test p = 0.004 and Gray's tests p = 0.004, respectively), while recurrences were comparable (Gray's tests p = 0.434). Cox multivariable analysis did not support that OS and CSM were better in the MI group (p = 0.109 and p = 0.163, respectively). Successful pathological outcome, observed in 53.2% of open and 58.3% of MI resections, supported noninferiority (difference 5.1%; 1-sided 95%CI - 4.7% to ∞). Successful short-term clinical outcome was documented in 93.3% of Open and 93.0% of MI procedures, and supported noninferiority as well (difference - 0.3%; 1-sided 95%CI - 5.0% to ∞)., Conclusions: Among patients with SFC, the minimally invasive approach met the criterion for noninferiority for postoperative complications and pathological outcomes, and was found to provide results of OS, CSM, and RR comparable to those of open resection., (© 2022. The Author(s).)

Published
2023
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3. 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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4. Laparoscopic vs open restorative proctocolectomy with IPAA for ulcerative colitis: Impact of surgical technique on creating a well functioning pouch.

Author

Mineccia M, Cravero F, Massucco P, Portigliotti L, Bertolino F, Daperno M, and Ferrero A

Subjects
Adolescent, Adult, Female, Humans, Male, Middle Aged, Postoperative Complications, Retrospective Studies, Treatment Outcome, Colitis, Ulcerative surgery, Colonic Pouches, Laparoscopy methods, Proctocolectomy, Restorative methods
Abstract

Background: Patients with ulcerative colitis are often young, and proctocolectomy with restorative ileo-pouch anal anastomosis is a crucial act that can improve or worsen the quality of the rest of their lives. The literature is scant on long-term functional outcomes after laparoscopy. The purpose of this study was to investigate results in terms of pouch function after standardized total laparoscopic technique compared with open intervention., Materials and Methods: This was a retrospective comparative study. Cases were collected from the prospectively-maintained database of the Unit of General and Oncologic Surgery, XXX, Torino, Italy. Patients treated between May 2005 and May 2015 with three-stage laparoscopic or open proctocolectomy and ileo-pouch anal anastomosis were enrolled. The primary study endpoint was the percentage of well-functioning pouches. Secondary endpoints were postoperative early and late outcomes such as morbidity and pouch survival., Results: Of the 78 patients identified, 48 underwent the open technique and 30 underwent laparoscopy. Median follow-up was 4 years. The overall complication rates were 19% and 13% (p = 0.5), and there were major complications (Clavien-Dindo III-IV) in 14.6% and 13.3% of patients in the open and laparoscopic groups, respectively (p = 0.8). Late complications occurred in 26 patients. Nine (18.8%) and 5 (16.7%) patients had pouchitis (p = 0.8), and 6 (12.5%) and 2 (6.7%) had cuffitis in the open and laparoscopic groups, respectively (p = 0.70). Pouch failure occurred in 2 patients (4.2%) in the open group and 2 (6.7%) in the laparoscopic group. The pouch was observed to be functioning very well in 18 patients (37.5%) in the open group and in 17 patients (56%) in the laparoscopic group (p = 0.09). The study was limited by its retrospective, nonrandomized design., Conclusion: Our data demonstrated similar early and late results after total laparoscopic and open proctocolectomy, in particular concerning pouch function., (Copyright © 2018. Published by Elsevier Ltd.)

Published
2018
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5. Outcome of laparoscopic colorectal resection.

Author

Degiuli M, Mineccia M, Bertone A, Arrigoni A, Pennazio M, Spandre M, Cavallero M, and Calvo F

Subjects
Aged, Anastomosis, Surgical statistics & numerical data, Colectomy methods, Colectomy statistics & numerical data, Colorectal Neoplasms surgery, Diverticulitis, Colonic surgery, Female, Follow-Up Studies, Humans, Intraoperative Complications epidemiology, Italy epidemiology, Laparotomy statistics & numerical data, Length of Stay statistics & numerical data, Male, Middle Aged, Neoplasm Recurrence, Local, Postoperative Complications epidemiology, Retrospective Studies, Survival Rate, Treatment Outcome, Colonic Diseases surgery, Laparoscopy statistics & numerical data, Rectal Diseases surgery
Abstract

Background: The aim of this study was to assess the feasibility and safety of laparoscopic surgery for colorectal diseases., Methods: A retrospective review was undertaken of all patients undergoing a laparoscopic colorectal procedure (LCP) for large bowel disease. All operations were performed by a single experienced team. Patients were divided chronologically into three consecutive groups (G1, G2, and G3). Data collection included the incidence and cause of both "proper" and "mandatory" conversions to laparotomy, the incidence and type of early and late postoperative complications, incidence of operative mortality, and the length of hospital stay. The incidences of conversion to laparotomy and of early and late postoperative complications were also determined as related to diagnosis, type of LCP attempted, and chronological group., Results: Between January 1996 and December 2001, a total of 108 patients (49 men and 59 women) with a mean age of 65.1 years underwent an LCP for colorectal disease. Proper conversion to open surgery was necessary in five patients (4.6%), whereas a mandatory conversion was needed in 10 with patients advanced cancer (9.2%). The overall morbidity rate was 11.9%. There were no anastomotic leaks. In two patients (1.85%) developed a complication requiring reoperation. Postoperative mortality was nil. Mean postoperative hospital stay was 7.2 days. The rates of conversion and of early and late complications decreased through the three chronological periods. No trocar site recurrences were observed in the cancer patients., Conclusion: Laparoscopic colorectal surgery performed in experienced centers is safe; the observed morbidity and mortality rates are low and acceptable and compare favorably to those observed after standard open surgery.

Published
2004
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6. Segmental transverse colectomy. Minimally invasive versus open approach: results from a multicenter collaborative study

Author

Milone, M., Degiuli, M., Velotti, N., Manigrasso, M., Vertaldi, S., D'Ugo, D., De Palma, G. D., Bruzzese, D., Servillo, G., De Simone, G., Di Lauro, K., Pavanello, Sofia, Ettore Allaix, M., Morino, M., Reddavid, R., Rega, D., Alberto Ammirati, C., Scabini, S., Anania, G., Barberis, A., Longhin, R., Belli, A., Bianco, F., Formisano, G., Giuliani, G., Pietro Bianchi, P., Cavaliere, D., Solaini, L., Coco, C., Rizzo, G., Coratti, A., Tribuzi, A., De Luca, R., Simone, M., Di Leo, A., De Manzoni, G., De Nardi, P., Elmore, U., Rosati, R., Vignali, A., Delrio, P., Pace, U., Di Cataldo, A., Li Destri, G., Donini, A., Graziosi, L., Fontana, A., Mineccia, M., Gentilli, S., Monni, M., Guerrieri, M., Ortenzi, M., Pecchini, F., Piccoli, M., Pedrazzani, C., Turri, G., Pollesel, S., Roviello, F., Rigamonti, M., Zuolo, M., Santarelli, M., Saraceno, F., Sileri, P., Sigismondo Sica, G., Siragusa, L., Pucciarelli, S., Zuin, M., Bombardini, C., Milone, Marco, Degiuli, Maurizio, Velotti, Nunzio, Manigrasso, Michele, Vertaldi, Sara, D'Ugo, Domenico, De Palma, Giovanni Domenico, Dario Bruzzese, Giuseppe Servillo, Giuseppe De Simone, Katia Di Lauro, Silvia Sofia, Marco Ettore Allaix, Mario Morino, Rossella Reddavid, Carlo Alberto Ammirati, Stefano Scabini, Gabriele Anania, Cristina Bombardini, Andrea Barberis, Roberta Longhin, Andrea Belli, Francesco Bianco, Giampaolo Formisano, Giuseppe Giuliani, Paolo Pietro Bianchi, Davide Cavaliere, Leonardo Solaini, Claudio Coco, Gianluca Rizzo, Andrea Coratti, Raffaele De Luca, Michele Simone, Alberto Di Leo, Giovanni De Manzoni, Paola De Nardi, Ugo Elmore, Riccardo Rosati, Andrea Vignali, Paolo Delrio, Ugo Pace, Daniela Rega, Antonio Di Cataldo, Giovanni Li Destri, Annibale Donini, Luigina Graziosi, Andrea Fontana, Michela Mineccia, Sergio Gentilli, Manuela Monni, Mario Guerrieri, Monica Ortenzi, Francesca Pecchini, Micaela Piccoli, Italy. Corrado Pedrazzani, Giulia Turri, Sara Pollesel, Franco Roviello, Marco Rigamonti, Michele Zuolo, Mauro Santarelli, Federica Saraceno, Pierpaolo Sileri Giuseppe Sigismondo Sica, Luigi Siragusa Salvatore Pucciarelli, Matteo Zuin, and Rosati, Riccardo

Subjects
medicine.medical_specialty, Ileus, Nausea, Anemia, Operative Time, Anastomosis, Postoperative Complications, Laparoscopic, Robotic Surgical Procedures, Minimally invasive surgery, Tumor stage, medicine, Transverse Colectomy, Humans, Robotic surgery, Colectomy, Retrospective Studies, Robotic, Transverse colon cancer, Length of Stay, Treatment Outcome, Colonic Neoplasms, Laparoscopy, business.industry, medicine.disease, Surgery, Settore MED/18, medicine.symptom, business
Abstract

The role of minimally invasive surgery in the treatment of transverse colon cancer is still controversial. The aim of this study is to investigate the advantages of a totally laparoscopic technique comparing open versus laparoscopic/robotic approach. Three hundred and eighty-eight patients with transverse colon cancer, treated with a segmental colon resection, were retrospectively analyzed. Demographic data, tumor stage, operative time, intraoperative complications, number of harvested lymph nodes and recovery outcomes were recorded. Recurrences and death were also evaluated during the follow-up. No differences were found between conventional and minimally invasive surgery, both for oncological long-term outcomes (recurrence rate p = 0.28; mortality p = 0.62) and postoperative complications (overall rate p = 0.43; anemia p = 0.78; nausea p = 0.68; infections p = 0.91; bleeding p = 0.62; anastomotic leak p = 0.55; ileus p = 0.75). Nevertheless, recovery outcomes showed statistically significant differences in favor of minimally invasive surgery in terms of time to first flatus (p = 0.001), tolerance to solid diet (p = 0.017), time to first mobilization (p = 0.001) and hospital stay (p = 0.004). Compared with laparoscopic approach, robotic surgery showed significantly better results for time to first flatus (p = 0.001), to first mobilization (p = 0.005) and tolerance to solid diet (p = 0.001). Finally, anastomosis evaluation confirmed the superiority of intracorporeal approach which showed significantly better results for time to first flatus (p = 0.001), to first mobilization (p = 0.003) and tolerance to solid diet (p = 0.001); moreover, we recorded a statistical difference in favor of intracorporeal approach for infection rate (p = 0.04), bleeding (p = 0.001) and anastomotic leak (p = 0.03). Minimally invasive approach is safe and effective as the conventional open surgery, with comparable oncological results but not negligible advantages in terms of recovery outcomes. Moreover, we demonstrated that robotic approach may be considered a valid option and an intracorporeal anastomosis should always be preferred.

Published
2022

7. 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

8. 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

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