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4 results on '"Forchino F"'

1. Ultrasound liver map technique for laparoscopic liver resections: perioperative outcomes are not impaired by technical complexity.

Author

Ferrero A, Russolillo N, Langella S, Forchino F, Stasi M, Fazio F, and Lo Tesoriere R

Subjects
Adult, Aged, Aged, 80 and over, Blood Loss, Surgical statistics & numerical data, Female, Humans, Length of Stay statistics & numerical data, Male, Margins of Excision, Middle Aged, Operative Time, Treatment Outcome, Hepatectomy methods, Laparoscopy methods, Liver diagnostic imaging, Liver surgery, Surgery, Computer-Assisted methods, Ultrasonography
Abstract

Intraoperative liver ultrasound has a crucial role to guide open liver surgery. A 4-step ultrasound liver map technique for laparoscopic liver resection (LLR) has been standardized in our center. The aim of this study was to evaluate outcomes of our technique according to the hepatectomy technical complexity. A difficulty scale (DS) ranging from 1 to 10 was applied to each LLR. A cumulative sum control-chart analysis identified 3 periods of gradually increasing DS. Perioperative outcomes of the 3 periods were compared. 300 LLRs performed between 2006 and 2018 were analyzed. Median DS was 3 for first 100 cases (P1), 5 for cases 101-200 (P2) and 6 for cases 201-300 (P3). A significantly greater percentage of postero-superior segments resections (P1 11%, P2 36%, P3 46%, p < 0.001) were performed in P3. P3 LLRs had a significantly longer transection time (p < 0.001) and wider cut surface area (p < 0.001), but median blood losses were similar among the 3 periods (P1 100 cc, P2 100 cc, P3 140 cc). There were no differences among periods in overall morbidity (P1 12%, P2 17%, P3 17%), major morbidity (P1 1%, P2 2%, P3 3%) and length of hospital stay (5 days in all the three groups). Despite the increasing surgical complexity of LLR, ultrasound liver map technique allows good perioperative outcomes.

Published
2019
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3. Importance of primary indication and liver function between stages: results of a multicenter Italian audit of ALPPS 2012-2014

Author

Michele Masetti, Fabio Forchino, Elena Toschi, Elio Jovine, Roberto Montalti, Marco Vivarelli, Enrico Gringeri, Antonio Daniele Pinna, Giuseppe Maria Ettorre, Matteo Serenari, Luca Aldrighetti, Vincenzo Mazzaferro, Salvatore Gruttadauria, Erik Schadde, Gian Luca Grazi, Umberto Cillo, Christian Cotsoglou, Giorgio Ercolani, Marco Massani, Francesca Ratti, Bruno Nardo, Nicolò Bassi, Giovanni Vennarecci, Alessandro Ferrero, Matteo Zanello, Serenari, M., Zanello, M., Schadde, E., Toschi, E., Ratti, F., Gringeri, E., Masetti, M., Cillo, U., Aldrighetti, L., Jovine, E., Montalti, R., Vivarelli, M., Grazi, G. L., Vennarecci, G., Ettorre, G. M., Massani, M., Bassi, N., Cotsoglou, C., Mazzaferro, V., Nardo, B., Forchino, F., Ferrero, A., Gruttadauria, S., Ercolani, G., Pinna, A. D., Serenari, Matteo, Zanello, Matteo, Schadde, Erik, Toschi, Elena, Ratti, Francesca, Gringeri, Enrico, Masetti, Michele, Cillo, Umberto, Aldrighetti, Luca, Jovine, Elio, Montalti, Roberto, Vivarelli, Marco, Grazi, GIAN LUCA, Vennarecci, Giovanni, Ettorre, Giuseppe Maria, Massani, Marco, Bassi, Nicolò, Cotsoglou, Christian, Mazzaferro, Vincenzo, Nardo, Bruno, Forchino, Fabio, Ferrero, Alessandro, Gruttadauria, Salvatore, Ercolani, Giorgio, Pinna, ANTONIO DANIELE, Serenari, M, Zanello, M, Schadde, E, Toschi, E, Ratti, F, Gringeri, E, Masetti, M, Cillo, U, Aldrighetti, L, and Jovine, E

Subjects
Male, hepatocellular carcinoma, hepatic resection, metastases, Time Factors, medicine.medical_treatment, 030230 surgery, Muscle hypertrophy, Cholangiocarcinoma, 0302 clinical medicine, Liver Function Tests, Risk Factors, Medicine, Registries, Medical Audit, medicine.diagnostic_test, Portal Vein, Gastroenterology, Organ Size, hepatocellular carcinoma, Middle Aged, Liver regeneration, Treatment Outcome, Italy, Liver, Hepatology, 030220 oncology & carcinogenesis, Female, Original Article, Adult, medicine.medical_specialty, hepatic resection, NO, 03 medical and health sciences, Predictive Value of Tests, Internal medicine, Hepatectomy, Humans, metastases, Ligation, Aged, Proportional Hazards Models, business.industry, Bilirubin, Hypertrophy, Liver Regeneration, Surgery, Logistic Models, Bile Duct Neoplasms, Multivariate Analysis, Liver function, Complication, business, Liver function tests, Biomarkers, Hospitals, High-Volume, Liver Failure
Abstract

Background: Posthepatectomy liver failure is one of the most feared complications in extended hepatic resections. In 2012, a novel two-stage liver resection was developed, able to induce rapid and extensive hypertrophy by portal vein ligation and in situ liver splitting - Associating Liver Partition and Portal vein ligation for Staged hepatectomy (ALPPS). The technique became more widely employed but its use remained controversial due to reporting of high complication and mortality rates. Method: A national audit was performed to gather information about the safety of the procedure and to better understand the complications. The audit was offered to all high-volume hepatobiliary centers in Italy. Results: Of all Italian centers approached in January 2012, 12 centers with experience in ALPPS enrolled and participated in collection of data. Fifty patients underwent ALPPS between 2012 and 2014. In 48/50 patients completion of hepatectomy was performed successfully. Major morbidity occurred in 54% with a 20% 90-day mortality. Uni- and multivariate analysis showed that ALPPS for cholangiocarcinoma and a peak of bilirubin over 5 mg/dl between stages was associated with increase of 90 day mortality and worse survival. Discussion: It is proposed that a moratorium be introduced for classic ALPPS in cholangiocarcinoma and to abort ALPPS in patients who develop an interstage increase in bilirubin, due to the high risk of liver failure and mortality.

Published
2016

4. Laparoscopic left liver resections and right portal vein ligation: first step of two stage hepatectomy for colorectal liver metastases.

Author

Lo Tesoriere, R., Russolillo, N., Langella, S., Forchino, F., Perotti, S., and Ferrero, A.

Subjects
*PORTAL vein surgery, *LIVER metastasis, *PORTAL vein, *LIVER surgery, *HEPATECTOMY, *LIVER, *HEPATIC veins
Abstract

B Background: b Hepatic resection is the treatment of choice for patients with colorectal liver metastases but 75-85% of patients are unresectable at diagnosis. B Results: b The video shows the case of a patient with 3 liver metastases scheduled for a laparoscopic right hepatectomy and atypical resection of segment 4a, after neoadjuvant chemotherapy. [Extracted from the article]

Published
2019
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