86 results on '"Rossella Angotti"'
Search Results
52. Surgical treatment of retrosternal extraosseous Ewing Sarcoma in a 6-years old female: a clamshell approach with hemysternectomy and application of a non-crosslinked extracellular matrix
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Luca Luzzi, Amalia Schiavetti, Giulia Varrasso, Francesco Molinaro, Piero Paladini, Anna Clerico, Chiara Pellegrino, Mario Messina, Leonardo Casini, and Rossella Angotti
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Clamshell ,medicine.medical_specialty ,lcsh:Surgery ,030204 cardiovascular system & hematology ,Pediatrics ,Extracellular matrix ,03 medical and health sciences ,0302 clinical medicine ,Neuroblastoma ,medicine ,Surgical treatment ,Lung ,Extraosseous Ewing Sarcoma ,business.industry ,Pediatrics, Perinatology and Child Health ,Surgery ,lcsh:RJ1-570 ,Soft tissue ,lcsh:Pediatrics ,lcsh:RD1-811 ,Perinatology and Child Health ,medicine.disease ,lung ,incision ,children ,medicine.anatomical_structure ,030220 oncology & carcinogenesis ,Sarcoma ,business - Abstract
Background Ewing Sarcoma (ES) and Neuroblastoma (NB) belong to a family of tumours of primitive neuroectodermal origin (PNET) that occurs in both bone and soft tissue. Notwithstanding ES and NB are two distinct malignant tumours, sometimes there could be a link between them. Case report We describe a case of an extraosseous ES localized in the retrosternal region and the upper lobe of the right lung, which had been previously treated for NB in a 6 years old female. We treated this case with a clamshell approach which allows, in a one-step surgery, a complete excision of the mass reconstructing the hemysternectomy with a non-crosslinked matrix. Conclusion the clamshell approach is therefore useful to achieve the retrosternal space and the lung with a single surgical access. According to our experience, we consider appropriate to use a non-crosslinked matrix for sternal reconstruction.
- Published
- 2017
53. Analgesic Procedures in Newborns
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Laura Giuntini, Cristina Navarra, Rossella Angotti, and Giovanna Amato
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- 2017
54. Pediatric Presentation of a Celiaco-mesenteric Trunk in Association with a Pelvic Bilateral Renal Ectopia: an Undescribed Association
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M. Messina, Francesco Molinaro, Mario Messina, Margherita Aglianò, Rossella Angotti, and Edoardo Bindi
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Abdominal pain ,medicine.medical_specialty ,Renal ectopia ,business.industry ,Vomiting ,medicine.disease ,Trunk ,Surgery ,Abdominal Pain ,Celiac artery ,Intestinal Volvulus ,Celiac Artery ,medicine.artery ,medicine ,Abdominal Pain, Celiac Artery, Intestinal Volvulus, Mesenteric Artery, Vomiting ,medicine.symptom ,Presentation (obstetrics) ,business ,Mesenteric Artery - Published
- 2017
55. A CASE OF ILEOILEAL INTUSSUSCEPTIONS CAUSED BY BURKITT’S LYMPHOMA
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Francesco Molinaro, Edoardo Bindi, D. Meucci, F. Mariscoli, M. Messina, Rossella Angotti, and M. Sica
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medicine.medical_specialty ,Abdominal pain ,business.industry ,Iliac fossa ,Debulking ,medicine.disease ,Appendicitis ,Surgery ,medicine.anatomical_structure ,Intussusception (medical disorder) ,medicine ,Abdomen ,medicine.symptom ,business ,Burkitt's lymphoma ,Survival rate - Abstract
Introduction Burkitt’s lymphoma is a high grade B-cell tumor described for the first time by the Irish surgeon Dennis Burkitt in 1958 in Africa. The most frequent of the clinical variants, in which it is classified by the World Health Organization (sporadic, endemic, HIV-associated), is the sporadic one, which usually involves the abdomen, in particular the ileocecal tract. Thus, a common clinical presentation is that of a child suffering from abdominal pain with nausea and vomit, until the dramatic case of an intestinal occlusion by an intussusceptions. According to this, the surgeon is the first who diagnoses and treats this tumor, playing an important role for the treatment, in terms of reduction of the metabolic complications of the medical therapy and of improvement of survival rate. In this work we present a case of a child operated for intestinal occlusion by ileoileal intussusception, caused by a Burkitt’s lymphoma, as it was diagnosed by histological examination few days after surgical intervention. Case report A 12-years boy reached the emergency department for abdominal pain and vomit. Two weeks before he had a surgical intervention for a suspected appendicitis at another hospital. An ultrasound examination was performed and it revealed the presence of a complex mass in the right iliac fossa. The day after the patient felt worse and he had an episode of bilious vomit. An x-ray examination of the abdomen was performed and showed the presence of an intestinal obstruction. The patient underwent to surgical intervention. The obstruction was caused by an ileoileal intussusceptions, and it needed to perform a resection followed by anastomosis. Few day after surgical intervention, the result of histological examination indicated the presence of a Burkitt’s lymphoma within the tract resected. A CT scan was performed and showed the involvement of mesenteric lymph nodes. The bone marrow aspirate and the lumbar puncture showed no neoplastic presence. Then the patient started therapy according to protocol. Discussion and Conclusions Burkitt’s lymphoma represents 3-5% of all non-Hodgkin lymphomas, and 40% in pediatric population. Children have an excellent prognosis with contemporary treatment regardless of the disease stage. Patients with limited stage disease are curable with limited treatment, avoiding complications associated with more intensive therapies. Nevertheless surgery is important in the management of this disease, the role of the surgeon has usually been controversial. A surgical intervention can be resolving in case of limited disease, or, in case of a high stage disease, it can be diagnostic or helpful, through the debulking of the mass. However, apart in case of intussusception, the diagnoses of Burkitt can be challenging and the presence of disease can revealed after a story of recurrent abdominal pain or after surgical interventions for appendicitis. In this work we show how a timely diagnosis can be difficult and how it can be an obstacle for treatment. In this case the sudden worsening of clinical conditions permitted an early diagnosis with a complete resection of the ileum involved by Burkitt’s lymphoma has improved the prognosis and reduced therapy’s complications.
- Published
- 2016
56. MINI-INVASIVE SURGERY IN THE FIRST THREE YEARS OF LIFE
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Francesco Molinaro, M. Messina, F. Mariscoli, Margherita Aglianò, Rossella Angotti, Edoardo Bindi, and M. Sica
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medicine.medical_specialty ,medicine.diagnostic_test ,business.industry ,medicine.medical_treatment ,Incidentaloma ,Postoperative complication ,Retrospective cohort study ,medicine.disease ,Nephrectomy ,Surgery ,Pediatric surgery ,medicine ,Thoracoscopy ,Diaphragmatic hernia ,business ,Laparoscopy - Abstract
Background: In the last 30 years mini-invasive surgery (MIS) has been widely used becoming an important and irreplaceable method, safe and highly reliable, in both the diagnostic and therapeutic treatment, for a variety of conditions in both the child and the newborn. This has led to a significant increase of the use of this approach in the pediatric population under the age of 3 years, with results similar to the open techniques. Materials and Methods: At the Department of Surgery, Medicine and Neuroscience at the University of Siena we conducted a retrospective study of patients aged less than three years of life underwent minimally invasive procedures. The clinical information was extrapolated from a prospective database. They included all patients treated from June 2003 to October 2014. Were considered for each patient demographics, associated diseases, surgical procedure, MIS approach, the instruments used, the duration of surgery and hospitalization, intraoperative and postoperative complications (early and late). Results: From a total of 933 minimally invasive procedures, 150 (16%) were performed under the age of 3 years. The 76% of patients were males, 24% were females. Twenty-two patients (15%) presented associated diseases. 53 (35%) were diagnostic procedures, 97 (65%) were therapeutic procedures. We treated: 1 3 esophageal atresia, 1 diaphragmatic hernia, 1 congenital cystic adenomatoid malformation (CCAM), 8 stenosis of the ureteropelvic junction , 2 disorders of sexual differentiation (DSD), 20 inguinal hernias, 75 cases of non-palpable testis, 15 cases of Hirschsprung disease, 10 cases of fundoplication, 4 cases of ovarian tumors, 6 cases of nephrectomy, 4 cases of eminefrectomy and 1 case of thymoma. In total we performed 6 (4%) thoracoscopic procedures, 18 (12%) in retroperitoneoscopy and 126 (84%) in laparoscopy. 55 procedures (37%) were performed in "one-trocar" technique. Among the remaining 95 (67%), in 62 (41%) we used a “3 mm” instruments, in 18 (12%) “5 mm” instruments and in 15 (14%) they were mixed (3/5 mm). The duration of the procedure was an average of 59 minutes (range: 20-135 minutes) in diagnostic procedures and 184 minutes (range: 40-370 minutes) in the therapeutic procedures. We converted to an open technique in 14/150 (9%). We reported no postoperative complication and incidentaloma no intraoperative complications. The following is 100% survival. Conclusions:MIS is probably the most important change that has taken place in the field of Pediatric Surgery in the last 30 years. The optimum benefits are to be found in the lesser surgical stress, the lower cavity contamination, the magnification of details, the reduced hospital stay, reduced morbidity or the best aesthetic result.
- Published
- 2016
57. PARTIAL CONGENITAL BOWEL OBSTRUCTION BY DUODENAL ATRESIA WINDSOCKS TYPE: CASE REPORT
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Rossella Angotti, F. Mariscoli, M. Molinaro, M. Sica, M. Messina, and Edoardo Bindi
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medicine.medical_specialty ,medicine.diagnostic_test ,business.industry ,Prenatal diagnosis ,medicine.disease ,Double bubble ,Surgery ,Duodenal atresia ,Endoscopy ,Bowel obstruction ,Atresia ,Concomitant ,Occlusion ,medicine ,business - Abstract
Introduction Duodenal atresia Windsocks type is a rare condition of congenital bowel obstruction. Thanks to recent technological advancements of prenatal diagnosis it is possible to make a diagnosis of duodenal atresia with high degree of certainty through the radiological sign of “double bubble”, but up to date it is not yet possible to identify the type of duodenal atresia. We report the case of a patient with prenatal diagnosis of “double bubble”. The patient had no other concomitant malformations. Case Report The patient came to our attention after prenatal ultrasound that showed a picture of double bubble. At the 27th week of gestation we performed fetal MRI that confirmed the US pattern of double bubble but it did not identify with certainty the type of duodenal atresia. At birth the patient underwent GI rx examination that showed a picture of partial duodenal obstruction compatible with the Windsocks type. On the following day, we performed endoscopy which showed the presence of duodenal membrane, so the patient underwent surgical treatment with a longitudinal duodenal incision in order to treat the wind-sock membrane. After one month a further Upper-GI rx examination showed a regular transit of the contrast. Four months after the first operation the patient underwent new surgical treatment for bowel obstruction by adhesions. The operation was successful and the patient had a complete recover.Conclusions Patients with prenatal diagnosis of “double bubble” require a multidisciplinary approach for proper clinical management. Unfortunately it is not currently possible to identify with certainty by prenatal ultrasound the type of duodenal atresia, but in case of incomplete bowel occlusion , the possibility of an atresia Windsocks type should always be considered, especially for setting the right surgical approach.
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- 2016
58. HYPOSPADIAS: LONG TERM FOLLOW-UP IN A SINGLE CENTER
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M. Messina, Margherita Aglianò, Francesco Molinaro, M. Sica, F. Mariscoli, Rossella Angotti, and Edoardo Bindi
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medicine.medical_specialty ,Long term follow up ,Genitourinary system ,business.industry ,Context (language use) ,Retrospective cohort study ,medicine.disease ,Single Center ,Surgery ,Stenosis ,Hypospadias ,medicine ,In patient ,business - Abstract
Introduction: Hypospadias is one of the most common birth defects that affect the male urogenital tract. It can present as isolated anomaly, but sometimes can arise in the context of complex disorders of sex development (DSD). These malformations are characterized by a great variety of clinical manifestations and compromise the aesthetic appearance, but also functional and psychological impact that the malformation can determine the patient. Materials and Methods: We conducted a retrospective study of patients undergoing surgery for hypospadias from March 2000 to January 2015. The data was extrapolated from a prospective database. It was considered for each patient: demographics; type of hypospadias; surgical technique; average age for surgery; intraoperative and postoperative complications (early and late). Duckett’s classification was used. Results: 343 urethroplasties were performed. 320 (93%) were primary urethroplasties and 23 (7%) reoperations in patients who had performed many other surgical procedures. 7 patients with megameatus were excluded. The hypospadias have been ranked according to Duckett’s classification, 35 patients had associated diseases. In total were performed: 186 (55%) Snodgrass, 71(21%) Duckett,10 (3%) augmented Duckett, 42 (13%) Magpi, 16 (5%) Duplay, 1 (0,3%) Bracka, 1 (0,3%) was a Bianchi’technique and 5 (1,4%) were Standoli. In 4 patients (1%) were used mixed technique. There were no intraoperative complications. The mean age at surgery was 15 months (range 12-22 months). Postoperative complications were 12%. Long term follow up was done with uroflussimetrie at 3 and 6 months in those who had reached the continence and possible urethral calibrations in those who had submitted a stenosis in post-op.Conclusions: The improvement of surgical techniques, the use of optical amplification tools, the use of suture material (PDS) and the experience gained in recent years have enabled us to optimized the results. Though aware of the potential and actual complications that this type of microsurgical correction can lead to the results we have obtained are comparable to those of major international series and can be considered satisfactory, both from an aesthetic and functional.
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- 2016
59. Re: Continence and Quality of Life with the Modified Heitz-Boyer-Hovelacque Rectal Bladder for Children with Urinary Incontinence following Bladder Exstrophy
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M. Messina, Francesco Molinaro, Francesco Ferrara, Adrian Bianchi, G. Di Maggio, Rossella Angotti, and A.L. Bulotta
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Male ,medicine.medical_specialty ,Adolescent ,Urinary system ,Urology ,Urinary Bladder ,030232 urology & nephrology ,MEDLINE ,Rectum ,Urinary incontinence ,Epispadias ,Pediatrics ,Heitz-Boyer-Hovelacque technique ,03 medical and health sciences ,0302 clinical medicine ,Quality of life ,Humans ,Medicine ,Child ,Urinary bladder ,business.industry ,Urethral sphincter ,Bladder Exstrophy ,Urinary Reservoirs, Continent ,Perinatology and Child Health ,medicine.disease ,Surgery ,Bladder exstrophy ,Rectal bladder ,Urinary Incontinence ,medicine.anatomical_structure ,Pediatrics, Perinatology and Child Health ,030220 oncology & carcinogenesis ,Quality of Life ,Urologic Surgical Procedures ,Female ,medicine.symptom ,business - Abstract
Bladder exstrophy and epispadias are severe congenital anomalies associated with an open bladder and urinary sphincter. Despite modern reconstruction, there is a significant incidence of residual or recurrent urinary incontinence that impacts on quality of life (QoL) and self-esteem, which in turn limits social interaction (Figure). The present study involved 14 patients, mainly from a Middle Eastern country, and reported the early findings with a modification of the Heitz-Boyer-Hovelacque rectal bladder technique for both urinary and faecal control.Fourteen children, with a median age of 8.1 years, with poor quality of life and low self-esteem because of urinary incontinence and small polypoidal open bladders of 5-15 ml volume, mostly after bladder exstrophy surgery, were managed with a modification of the Heitz-Boyer-Hovelacque rectal bladder technique keeping an intact anal sphincter. The retrorectal pulled-through colon was anastomosed to the posterior wall of the rectum just above the external sphincter complex, thereby avoiding any possible injury to the anal sphincter. All patients had a normal colon and a competent anal sphincter without lumbosacral spinal or nerve anomalies.Ten children had a 5- to 10-year follow-up, one child had a 15-year follow-up, and three others, that were also continent, were excluded because of a5-year follow-up. There were no postoperative complications, and all were dry and odour-free by day within 2-4 weeks of surgery. Two children still had minor urinary loss at night. There were no UTIs and renal function remained unimpaired. Eleven years after surgery, one child underwent excision of a pedunculated benign inflammatory polyp from the tip of the left ureter because of recurrent torsion and bleeding, there was no recurrence at the 2-year follow-up. None of the rectal or ureteric biopsies from any of the children showed metaplasia or neoplasia; however, in view of the potential long-term risks, all children were placed on a lifelong 'proctoscopy and biopsy' protocol.The ability to be dry and odour-free, and to wear normal clothing had a striking impact on QoL and psychological well-being of the children and their families. This was reflected in their positive overall approach, voluntary school attendance, and enthusiastic participation in communal events. All agreed that their improved genital appearance markedly contributed to their better body image and increased self-esteem.These significant benefits, at a crucial time in the child's life, outweigh the potential risk of long-term neoplasia. Therefore, the Heitz-Boyer-Hovelacque rectal bladder technique is recommended with long-term proctoscopic follow-up.
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- 2018
60. Robot-assisted Heller myotomy for achalasia
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Francesco Molinaro, Chiara Calani, Francesco Ferrara, Chiara Pellegrino, Rossella Angotti, Edoardo Bindi, Mario Messina, and Giulia Fusi
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Myotomy ,medicine.medical_specialty ,medicine.medical_treatment ,lcsh:Surgery ,Achalasia ,Esophageal Disorder ,Pediatrics ,Child ,Dysphagia ,Robotic surgery ,Pediatrics, Perinatology and Child Health ,Surgery ,03 medical and health sciences ,0302 clinical medicine ,otorhinolaryngologic diseases ,medicine ,Laparoscopy ,Heller myotomy ,medicine.diagnostic_test ,business.industry ,Open surgery ,lcsh:RJ1-570 ,lcsh:Pediatrics ,lcsh:RD1-811 ,Perinatology and Child Health ,medicine.disease ,Botulinum toxin ,Endoscopy ,030220 oncology & carcinogenesis ,030211 gastroenterology & hepatology ,business ,human activities ,medicine.drug - Abstract
Achalasia is a rare neuromuscular esophageal disorder in children. There are many surgical options to treatment including botulinum toxin (Botox) injections, oral pharmacologic therapies with nitrates and calcium channel blockers, pneumatic dilation (PD), and surgical myotomy (open surgery, endoscopy, laparoscopy and recently robotic approach). In pediatric age, usually, Heller's myotomy is the main choice. Laparoscopic approach is known and standardized. Few robotic have been published. We decided to report our first case to share our experience with scientific community. Keywords: Achalasia, Child, Dysphagia, Myotomy, Robotic surgery
- Published
- 2019
61. Multiseptate gallbladder in a child
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Francesco Molinaro, Giuseppe Di Cara, Ilaria Bizzarri, Stefania Ceppi, Mario Messina, Susanna Esposito, Mirko Bertozzi, Rossella Angotti, and Giulia Fusi
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medicine.medical_specialty ,lcsh:Surgery ,BILIARY PAIN ,Laparoscopic surgery ,Pediatrics ,Asymptomatic ,03 medical and health sciences ,0302 clinical medicine ,Medicine ,Children ,Multiseptate gallbladder ,Pediatrics, Perinatology and Child Health ,Surgery ,Laparoscopic cholecystectomy ,business.industry ,Normal laboratory ,lcsh:RJ1-570 ,MULTISEPTATE GALLBLADDER ,lcsh:Pediatrics ,lcsh:RD1-811 ,Perinatology and Child Health ,Recurrent abdominal pain ,030220 oncology & carcinogenesis ,Biliary Stasis ,030211 gastroenterology & hepatology ,Colicky abdominal pain ,Radiology ,medicine.symptom ,business - Abstract
Multiseptate gallbladder (MSG) is a rare congenital anomaly. MSG may be accompanied with other abnormalities of the biliary tree. MSG can be asymptomatic and most cases are detected incidentally. Nevertheless, some patients present with biliary pain or colicky abdominal pain due to biliary stasis and calculi. We report a case of MSG in a girl who presented with recurrent abdominal pain and normal laboratory work-up recovered after laparoscopic cholecystectomy. A pediatric literature review of this rare anomaly is also performed. Keywords: Multiseptate gallbladder, Laparoscopic surgery, Children
- Published
- 2019
62. Comparison between 7th and 8th edition of AJCC TNM staging system for gastric cancer: old problems and new perspectives
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Franco Roviello, Luigi Marano, Daniele Marrelli, Mario Messina, Alessia D'Ignazio, Federico Cammillini, and Rossella Angotti
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Male ,Surgical resection ,medicine.medical_specialty ,medicine.medical_treatment ,TNM staging system ,Causes of cancer ,Young Adult ,03 medical and health sciences ,Therapeutic approach ,0302 clinical medicine ,Stomach Neoplasms ,Humans ,Medicine ,Digestive System Surgical Procedures ,Aged ,Neoplasm Staging ,Retrospective Studies ,Aged, 80 and over ,Hepatology ,business.industry ,General surgery ,Gastroenterology ,Cancer ,Chemoradiotherapy, Adjuvant ,Middle Aged ,Prognosis ,medicine.disease ,Survival Analysis ,United States ,Editorial Commentary ,Treatment Outcome ,Chemotherapy, Adjuvant ,030220 oncology & carcinogenesis ,Female ,030211 gastroenterology & hepatology ,Lymphadenectomy ,Lymph Nodes ,business - Abstract
The purpose of this study was to compare prognostic differentiation performances of the 7th and the 8th edition of American Joint Commission on Cancer (AJCC) staging system for gastric cancer (GC) patients.A total of 1,633 GC patients who underwent curative D2 resection followed by adjuvant chemotherapy alone (CA) or concurrent chemo-radiotherapy (CCRT) from 2004 to 2013 were included. Concordance index (c-index) was applied to compare the discriminatory ability.In the 8th edition, migration of stage was detected in 248 patients (15.2%). Among them, 121 patients were up-staged while 127 patients were down-staged. Overall, there was no statistically significant difference in the discriminatory ability between the 7th and 8th editions. The new edition of staging system, however, showed a trend of better prognostic performance not only in recurrence-free survival (c-index=0.734; 95% confidence interval [CI], 0.706 to 0.762 in the 7th edition vs. c-index=0.740; 95% CI, 0.712 to 0.768 in the 8th edition; p=0.14), but also in overall survival (c-index=0.717; 95% CI, 0.688 to 0.745 in the 7th edition vs. c-index=0.722; 95% CI, 0.694 to 0.751 in the 8th edition; p=0.19), especially in stage III. This finding was repeated in the subgroup analysis regardless of adjuvant CA or CCRT.Generally, the 8th edition of AJCC staging system had failed to show a superior discriminatory ability for curatively D2 resected GC patients than the 7th edition, although there was a trend of better prognostic performance of the new edition, regardless of adjuvant treatment method.
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- 2019
63. Caudal ‘duplication’ or ‘split’ syndrome: Is there a misnomer?
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E. Cerchia, G. Di Maggio, Francesco Molinaro, Rossella Angotti, Mario Messina, A. Bianchi, and A.L. Bulotta
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endocrine system ,medicine.medical_specialty ,Caudal duplication syndrome ,Misnomer ,Pubic symphysis ,Pediatrics ,Urogenital duplication ,Vulva ,Gene duplication ,medicine ,Omphalocele ,urogenital system ,business.industry ,Caudal split syndrome ,Anatomy ,Perinatology and Child Health ,medicine.disease ,Perineum ,Surgery ,medicine.anatomical_structure ,Urethra ,Pediatrics, Perinatology and Child Health ,Diastasis ,business - Abstract
‘Caudal duplication syndrome’ was coined to describe the apparent duplication of organs derived from the hindgut, the neural tube and the adjacent mesoderm. Review of the anatomy suggests that the word ‘duplication’ may be a misnomer. This paper describes the management of 2 girls with caudal duplication syndrome who underwent multistage reconstructive surgery. Both had a large omphalocele and a severe diastasis of the pubic symphysis. The first patient also had an apparent duplication of the vulva, the perineum and the anus to either side of a wide midline. Each vulva contained a urethra, a hemi-clitoris with ipsilateral labium minor, and a hemi-vagina with hemi-uterus. The second child had an infrapubic sequestrated appendico-cecal duplication lying between two hemi-bladders each with ipsilateral ureter and urethra. The everted duplication split the single vulva longitudinally in the midline as far as the fourchette. To each side were a hemi-clitoris, and a hemi-vagina with hemi-uterus and ipsilateral fallopian tube. Analysis of our patients' anatomy and a literature review indicates for the most part ‘hemi’ organs on either side and suggests that the term ‘duplication’ is a misnomer such that caudal ‘split’ syndrome may be a more appropriate title.
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- 2013
64. Isolated Vaginal Agenesis Associated with Multiple Gastrointestinal Anomalies: A Case Report
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Francesco Ferrara, A.L. Bulotta, M. Sica, Edoardo Bindi, Francesco Molinaro, Rossella Angotti, and Mario Messina
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medicine.medical_specialty ,Bowel duplication ,lcsh:Surgery ,Case Report ,Tracheoesophageal fistula ,03 medical and health sciences ,0302 clinical medicine ,Anorectal malformation ,Esophageal atresia ,Mullerian anomalies ,Medicine ,business.industry ,General surgery ,lcsh:RJ1-570 ,lcsh:Pediatrics ,lcsh:RD1-811 ,medicine.disease ,Surgery ,030220 oncology & carcinogenesis ,Atresia ,Pediatrics, Perinatology and Child Health ,030211 gastroenterology & hepatology ,Vaginal agenesis ,business - Abstract
More than 50% of infants with esophageal atresia have associated anomalies. We present a case report of a 46XX neonate with long-gap esophageal atresia and tracheoesophageal fistula (EA/TEF), anorectal malformation, bowel duplication and vaginal agenesis. This is an unusual association of abnormalities which had not yet described in literature.
- Published
- 2016
65. Esophageal Atresia of Newborns
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M. Messina, Francesco Molinaro, Alfredo Garzi, and Rossella Angotti
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medicine.medical_specialty ,business.industry ,Internal medicine ,Atresia ,Medicine ,business ,medicine.disease ,Gastroenterology - Published
- 2016
66. Rare Surgical Emergencies of Newborns
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Francesco Molinaro, Mario Messina, and Rossella Angotti
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business.industry ,Medicine ,business - Published
- 2016
67. Prenatal diagnosis, 3-D virtual rendering and lung sparing surgery by ligasure device in a baby with 'cCAM and intralobar pulmonary sequestration'
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Mario Messina, Francesco Molinaro, Rossella Angotti, Alfredo Garzi, Antonio Cortese, and Vincenzo Giuseppe Di Crescenzo
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medicine.medical_specialty ,Congenital cystic lung ,Significant group ,Congenital lobar emphysema ,Prenatal diagnosis ,Pulmonary sequestration ,medicine ,Thoracoscopy ,Pediatric thoracic surgery ,Intralobar pulmonary sequestration ,Lung Sparing Surgery ,Medicine (all) ,Lung ,medicine.diagnostic_test ,business.industry ,General Medicine ,medicine.disease ,Surgery ,medicine.anatomical_structure ,Special Issue on Italian Society for the Study of Vascular Anomalies ,Congenital Cystic Adenomatoid Malformation ,Medicine ,Radiology ,business - Abstract
Congenital cystic lung lesions are a rare but clinically significant group of anomalies, including congenital cystic adenomatoid malformation (CCAM), pulmonary sequestration, congenital lobar emphysema (CLE) and bronchogenic cysts. Despite the knowledge of these lesions increasing in the last years, some aspects are still debated and controversial. The diagnosis is certainly one aspect which underwent many changes in the last 15 years due to the improvement of antenatal scan and the introduction of 3-D reconstruction techniques. As it is known, a prompt diagnosis has an essential role in the management of these children. The new imaging studies as 3D Volume rendering system are the focus of this paper. We describe our preliminary experience in a case of hybrid lung lesion, which we approached by thoracoscopy after a preoperative study with 3D VR reconstruction. Our final balance is absolutely positive.
- Published
- 2016
68. Retroperitoneoscopic Varicocelectomy in Adolescents: Long-term Follow-up in Two Italian Centres
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Rossella, Angotti, primary, Francesco, Molinaro, additional, Giovanni, Cobellis, additional, Elisa, Cerchia, additional, Francesco, Ferrara, additional, Rosella, Tallarico, additional, Marina, Sica, additional, Carmine, Noviello, additional, Ascanio, Martino, additional, and Mario, Messina, additional
- Published
- 2017
- Full Text
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69. Herlyn-Werner-Wunderlich syndrome: An 'early' onset case report and review of Literature
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Edoardo Bindi, E. Cerchia, M. Sica, Francesco Molinaro, A.L. Bulotta, Rossella Angotti, and Mario Messina
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medicine.medical_specialty ,Pediatrics ,Abdominal pain ,Congenital mullerian anomaly ,Herlyn-Werner-Wunderlich syndrome ,Surgery ,Vaginoscopy ,medicine.diagnostic_test ,business.industry ,Prenatal diagnosis ,Case Report ,Cystoscopy ,Abdominal mass ,Uterus didelphys ,medicine ,medicine.symptom ,Differential diagnosis ,Presentation (obstetrics) ,Herlyn–Werner–Wunderlich syndrome ,business - Abstract
Highlights • We describe a case of a 3 years old girl, with all features of Herlyn–Werner–Wunderlich syndrome (HWWS) who came to our attention for lower abdominal mass. • Only six cases are reported in Literature with early onset of this syndrome under 5 years. • The aim of this article is to share our experience and focus the attention on the importance of high level of suspicion of HWWS in neonatal period to early diagnosis and treatment. • The possible early presentation of this syndrome should be suspected in all neonates (females) with renal agenesia confirmed postnatally or with prenatal diagnosis. • An error of evaluation with planning of removal of mass, that can damage patients in term of chance for a successful reproductive outcome. • Our team consider HWWS as differential diagnosis in newborn with prenatal ultrasonography of a cystic mass behind the urinary bladder in the absence of a kidney and plan a pelvic ultrasound (with aim to identify an uterus, normal or dydhelfus, and presence or absence of pelvic mass), an examination under anesthesia and cisto-vaginoscopy, if it is necessary. A high level of suspicion, indeed, is the key to early diagnosis., Herlyn–Werner–Wunderlich syndrome (HWWS) is a rare congenital mullerian anomaly consisting of uterus didelphys, hemivaginal septum, and unilateral renal agenesis [1,2]. Most authors reported cases of Herlyn–Werner–Wunderlich syndrome with prepuberal or postpuberal onset with cyclical abdominal pain and a vaginal mass (3–8). Only six cases are reported in Literature with early onset of this syndrome under 5 years (9–14). Our case is about 3 years old girl, with all the features of this syndrome who came to our attention for lower abdominal mass. The aim of this article is to share our experience and focus the attention on the importance of high level of suspicion of HWWS in neonatal period to early diagnosis and treatment. The possible early presentation of this syndrome should be suspected in all neonates (females) with renal agenesia confirmed postnatally or with prenatal diagnosis. It is common, in fact, an error of evaluation with planning of removal of mass, that can damage patients in term of chance for a successful reproductive outcome. For all these reasons, our team consider HWWS as differential diagnosis in newborn with prenatal ultrasonography of a cystic mass behind the urinary bladder in the absence of a kidney and plan a pelvic ultrasound (with aim to identify an uterus, normal or dydhelfus, and presence or absence of pelvic mass), an examination under anesthesia and cystoscopy and vaginoscopy, if it is necessary. A high level of suspicion, indeed, is the key to early diagnosis.
- Published
- 2015
70. A CASE OF APPENDIX CARCINOID IN A PEDIATRIC PATIENT. A SUBTILE CLINICAL PRESENTATION
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A.L. Bulotta, Edoardo Bindi, M. Messina, Francesco Molinaro, E. Cerchia, M. Sica, and Rossella Angotti
- Subjects
medicine.medical_specialty ,Gastrointestinal tumors ,business.industry ,General surgery ,Incidence (epidemiology) ,Peritonitis ,medicine.disease ,digestive system diseases ,Appendix ,Surgery ,Diarrhea ,Pediatric patient ,medicine.anatomical_structure ,Acute abdomen ,medicine ,medicine.symptom ,Presentation (obstetrics) ,business ,neoplasms - Abstract
The appendix carcinoid, although rare (with an incidence of 0,08%), is the more frequent gastrointestinal tumor in children and teen. In most cases these tumors cannot be diagnosed or they can be incidentally found during a surgical exploration for acute abdomen. Only in few cases there are symptoms of a carcinoid’s syndrome (flushing, diarrhea and wheezing). In this work we present the manegement of a patient with an appendix carcinoid revealed during an appendicectomy performed for a peritonitis caused by a perforated appendicitis, underlining the importance of diagnosis and long term follow-up.
- Published
- 2014
71. PRENATAL DIAGNOSIS AND SURGICAL INNOVATIONS IN CONGENITAL DIAPHRAGMATIC HERNIA: EVALUATION OF PRE- AND POST-OPERATIVE MANAGEMENT
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E. Cerchia, M. Messina, K. Bici, F. Mariscoli, Rossella Angotti, E. Brandigi, Francesco Molinaro, and M. Sica
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medicine.medical_specialty ,business.industry ,medicine.medical_treatment ,Congenital diaphragmatic hernia ,Prenatal diagnosis ,medicine.disease ,Intensive care unit ,Surgery ,law.invention ,law ,Laparotomy ,Failure to thrive ,Pediatric surgery ,Medicine ,Diaphragmatic hernia ,medicine.symptom ,business ,Survival rate - Abstract
Introduction. Congenital diaphragmatic hernia (CDH) is still today considered a challenge from surgeons. Considerable progress in prenatal diagnosis, intensive care unit of neonates and surgical techniques, with the possibility to perform minimally access surgery, widely increased survival rates. The aim of this study is to analyze our series about long and short-term outcomes, also considering the progress made by minimally invasive techniques. Methods. The study was performed at Pediatric Surgery of Siena. It is a retrospective study that analyzed all patients with CDH (Bochdalek) treated in the last 14 years, from 2000 to 2013. Sex, side of the defect, presence of prenatal diagnosis, age of onset and symptoms, associate malformation, herniated organs, surgical technique and site of surgery, complications, recurrences, survival and followup were analyzed. Results. We included 23 patients. Five of them, were ruled out because of affected by diaphragmatic eventration or acquired diaphragmatic hernia. Forteen patients (77%) presented left CDH and 4 patients (23%) a right one. The male female ratio were 14:4. Prenatal diagnosis was performed in 5 patients (27,5%) at a mean gestational age of 29 weeks. Forteen patients (77%) had an early onset of symptoms (first day of life). Most common symptoms were respiratory distress and cyanosis; 4 patients (23%) had a late onset of symptoms, at a mean age of 9 months, and most common symptoms were failure to thrive and vomiting. Seven patients (39%) had associated malformation: common mesenterium (5 pts-71%). The colon was the most commonly herniated organ, present in 15 patients (83%), followed by small intestine in 13 patients (72%), stomach in 11 patients (61%), spleen in 9 patients (50%) and liver in 4 patients (23%). Seventeen patients (94,5%) underwent open surgery: 10 of them (59%) underwent a subcostal laparotomy approach, 7 of them (41%) underwent a supraumbelical laparotomy approach; 1 patient (5%) underwent minimally access surgery with thoracoscopy access. We performed performed surgery in the intensive care unit in 3 patients (16,5%). Six patients (33%) developed minor postoperatory complications. No patient had recurrence. Four patients died so we report a mortality rate of 23%. A follow-up investigation, with an average duration of 87 months, it is still going on in 5 patients (27,5%). Conclusions. The our survival rate was 77% and it reflects the encouraging reported data in the recent literature. These results are due to the reliability of the new resuscitation strategies, such as high-frequency oscillatory ventilation and the use of NO, the ability to perform surgery in the neonatal intensive care unit and, especially, to successfully perform minimally invasive surgery in newborn. The improvement of the survival showed the increasing of long-term morbidity end the requirement of a multidisciplinary followup. For these reasons, a multidisciplinary pathway for the management of young patients has been created, to follow them in a standardized way as early as the prenatal diagnosis.
- Published
- 2014
72. Preoperative distraction in children: hand-held videogames vs clown therapy
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D. Meucci, E. Cerchia, E. Brandigi, A.L. Bulotta, M. Messina, Rossella Angotti, Francesco Molinaro, and L. Giuntini
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Male ,medicine.medical_specialty ,clowntherapy, children, surgery, videogames ,media_common.quotation_subject ,lcsh:Surgery ,Psychological intervention ,Anxiety ,Quality of life (healthcare) ,children ,Enuresis ,Distraction ,Preoperative Care ,medicine ,Humans ,Apathy ,videogames ,Laughter Therapy ,Child ,media_common ,business.industry ,lcsh:RJ1-570 ,lcsh:Pediatrics ,lcsh:RD1-811 ,clowntherapy ,Video Games ,Feeling ,Child, Preschool ,Pediatrics, Perinatology and Child Health ,Quality of Life ,Physical therapy ,Female ,Surgery ,Temperament ,medicine.symptom ,business - Abstract
Anxiety in children undergoing surgery is characterized by feelings of tension, apprehension, nervousness and fear which may manifest differently. Postoperative behavioural changes such as nocturnal enuresis, feeding disorders, apathy, and sleep disturbances may stem from postoperative anxiety. Some Authors pointed out that over 60% of children undergoing surgery are prone to developing behavioural alterations 2 weeks after surgery. Variables such as age, temperament and anxiety both in children and parents are considered predictors of such changes.1 Studies were published describing how psycho-behavioural interventions based on play, learning and entertainment in preparing children for surgery, may reduce preoperative anxiety. Clown-therapy is applied in the most important paediatric facilities and has proved to diminish children’s emotional distress and sufferance, as well as consumption of both analgesics and sedatives and to facilitate the achievement of therapeutic goals. The aim of our study was to evaluate the efficacy of clown-therapy during the child’s hospital stay, with a view to optimizing treatment and care, preventing behavioural alterations and enhancing the child’s overall life quality.
- Published
- 2014
73. Split-appendix technique: Alternative urinary diversion for pediatric complete incontinence
- Author
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Francesco Molinaro, Rossella Angotti, M. Sica, E. Cerchia, Adrian Bianchi, and Mario Messina
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Split-appendix technique ,Appendicocecostomy ,medicine.medical_specialty ,business.industry ,General surgery ,medicine.medical_treatment ,Urinary diversion ,complete incontinence ,lcsh:Diseases of the genitourinary system. Urology ,lcsh:RC870-923 ,digestive system ,digestive system diseases ,Appendix ,appendicovesicostomy ,surgical procedures, operative ,medicine.anatomical_structure ,appendicocecostomy ,Split-appendix technique, appendicovesicostomy, complete incontinence, appendicocecostomy ,medicine ,business - Abstract
We report our series of selected patients with complete incontinence in whom the appendix was divided and utilized for creating two continent catheterizable stomas. All patients were treated for urinary and fecal incontinence by split appendix technique. The appendix was divided into two different parts preserving adequate perfusion and used for creating an appendicocecostomy (ACE) and an appendicovesicostomy at the same time. After a clinical and radiological follow up, our patients referred a good acceptance and an easily management of the stomas in order to stay dry for all day from urine and feces with improving of their quality of life. The combination of ACE and Mitrofanoff principle have revolutionized the management of urinary and fecal incontinence in patients who are unable to utilize their urethra to keep themselves dry.
- Published
- 2017
74. Rare case of an adrenocortical neoplasm: A case report and review of literature
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Mario Messina, A.L. Bulotta, Francesco Molinaro, Rossella Angotti, E. Brandigi, and Giovanni Di Maggio
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Cancer Research ,medicine.medical_specialty ,Pediatrics ,adrenal glands ,medicine.diagnostic_test ,business.industry ,Feminization (biology) ,Incidence (epidemiology) ,adrenal glands, neoplasm, infant ,Cancer ,Magnetic resonance imaging ,Articles ,medicine.disease ,infant ,Oncology ,Pediatric surgery ,Rare case ,medicine ,Adrenocortical Neoplasm ,business ,Pathological ,neoplasm - Abstract
Adrenocortical neoplasms (ACNs) are rare and poorly characterized in infants. The true incidence of ACNs is not well known and it appears to vary substantially across different geographical areas. ACNs are more common in females and two peaks of incidence have been identified: The first year of life and between the age of nine and 16 years. Due to the heterogeneity and rarity of ACNs, their pathological and prognostic classification is challenging. The current study describes the case of a seven-year-old male, who presented to the Department of Pediatric Surgery, University of Siena (Siena, Italy) with a feminization syndrome and increased somatic growth that was associated with a unilateral adrenal mass, which was diagnosed by magnetic resonance imaging. Surgical excision of the mass was performed and histological analysis determined that it was an ACN, with a low risk of malignity; however, the pathological classification of the tumor was challenging. At present, the future behavior of ACNs is unpredictable. Therefore, increasing the knowledge surrounding this type of tumor may aid in its diagnosis, treatment and prognosis. Due to the rarity of pediatric ACNs, no single pediatric oncology center has acquired extensive experience treating this type of tumor. Thus, the initiation of an international tumor registry may aid with the management of patients presenting with ACNs.
- Published
- 2014
75. Uncommon surgical emergencies in neonatology
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Francesco Ferrara, Mario Messina, Francesco Molinaro, Rossella Angotti, A.L. Bulotta, E. Cerchia, and D. Meucci
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intestinal occlusion ,Male ,medicine.medical_specialty ,Pediatrics ,Gastrointestinal rare surgical emergencies ,lcsh:Surgery ,Prenatal diagnosis ,Gestational Age ,Tertiary care ,Infant, Newborn, Diseases ,Tertiary Care Centers ,Prenatal Diagnosis ,medicine ,Overall survival ,Humans ,neonatal intestinal perforation ,Neonatology ,neonatal emergencies ,Retrospective Studies ,business.industry ,lcsh:RJ1-570 ,Infant, Newborn ,Gestational age ,lcsh:Pediatrics ,lcsh:RD1-811 ,Length of Stay ,Hospitalization ,Pediatrics, Perinatology and Child Health ,Etiology ,Surgery ,Female ,Presentation (obstetrics) ,Emergencies ,business ,Oral feeding ,Follow-Up Studies - Abstract
Objective. Over the past decade, multiple factors have changed the pattern of neonatal surgical emergencies. An increase in prenatal screenings and the development of neonatal tertiary care centres have changed the clinical approach to these kids. Materials and methods. Between 1995 to 2011 were retrospectively reviewed 34 patients with diagnosis of uncommon rare neonatal surgical emergencies at our institute. We analyzed: sex, gestational age, weight at birth, primary pathology, prenatal diagnosis, associated anomalies, age and weight at surgery, clinical presentation, start of oral feeding and hospitalization. The follow-up was performed at 6,12, 24 and 36 months. Results. There were 21 male and 13 female. The gestational age ranged between 28 and 36 weeks. The weight at birth ranged between 700 and 1400 grams. Oral feeding was started between 4th and 10th postoperative day. The average hospitalization was about 70.47 days. To date, all patients have finished the followup. They are healthy. Conclusion. The outcome of the patients with uncommon surgical emergencies is different based on the etiology. Overall survival is generally good but is influenced by the associated anomalies.
- Published
- 2014
76. Esophagogastric dissociation reduces the re-operation rate for persistent gastroesophageal reflux in severely neurologically impaired children
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Francesco Molinaro, E. Cerchia, Edoardo Bindi, Rossella Angotti, F. Mariscoli, and M. Messina
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Male ,Reoperation ,medicine.medical_specialty ,Dissociation (neuropsychology) ,Adolescent ,Treatment outcome ,Fundoplication ,Esophagus ,Postoperative Complications ,Pediatric surgery ,medicine ,Humans ,Neurologically impaired children ,Child ,Neurologically impaired ,Retrospective Studies ,Gastrostomy ,business.industry ,Reflux ,Retrospective cohort study ,General Medicine ,Esophagus surgery ,Treatment Outcome ,Italy ,Gastroesophageal reflux ,Anesthesia ,Pediatrics, Perinatology and Child Health ,Surgery ,Female ,Esophagogastric dissociation ,Nervous System Diseases ,business ,Gastroesophageal reflux, Neurologically impaired children, Fundoplication, Esophagogastric dissociation - Abstract
In this study we want to demonstrate the effectiveness of the esophagogastric dissociation as a first level operation in treatment of the gastroesophageal reflux in severe neurologically impaired children, in term of a reduction of reoperation rate.We divided patients operated from 1998 to 2005 in a group A, composed by children treated with fundoplication, and in a group AR, composed by the patients of group A who had a recurrence of reflux and that was treated with esophagogastric dissociation. Patients operated from 2005 to 2013 were selected on the basis of the severity of the neurological impairment and were divided in a group B, treated with fundoplication, and in a group C of more severe impaired children, treated with esophagogastric dissociation. Data regarding the complications of the A and C groups were analyzed with Fisher's test.We evaluated 63 patients: 34 (54%) in group A, 11 in group AR, 15 (23.6%) in group B, 14 (22.4%) in group C. The Fisher's test showed a non significant difference with a p value of 0.2.Despite of statistic result we believe that TOGD is a useful procedure as the first choice of surgical management in severe neurological impaired children affected by gastroesophageal reflux.
- Published
- 2014
77. Cervical Lymphadenitis by Mycobacterium triplex in an Immunocompetent Child: Case Report and Review
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Mario Messina, E. Benicchi, Francesco Molinaro, E. Cerchia, Rossella Angotti, and G. Caruso
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Pathology ,medicine.medical_specialty ,biology ,business.industry ,Short Communication ,Pulmonary disease ,Cervical lymphadenitis ,biology.organism_classification ,Microbiology ,Dermatology ,Nontuberculous mycobacterium ,Mycobacterium triplex ,Medical microbiology ,medicine ,business ,Mycobacterium triplex Cervical lymphadenitis Immunocompetent child - Abstract
Mycobacterium triplex was first described in 1996. This nontuberculous Mycobacterium causes a severe pulmonary disease in immunocompromised patients but it can involve also healthy patients. A literature search was made on the PubMed database and it produced only few cases of children with cervical lymphadenitis due to this Mycobacterium Triplex. We are describing a case of M. triplex cervical lymphadenitis in an immunocompetent child.
- Published
- 2013
78. Thoracoscopic thimectomy in children: our preliminary experience
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Giovanni Di Maggio, Jean Stephane Valla, Rossella Angotti, Alfredo Garzi, Francesco Molinaro, Mario Messina, and E. Cerchia
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Male ,medicine.medical_specialty ,Thymoma ,medicine.medical_treatment ,Video-Assisted ,Asymptomatic ,medicine ,Humans ,Thoracoscopic thymectomy ,Child ,Retrospective Studies ,business.industry ,Thoracic Surgery, Video-Assisted ,Female ,Thymectomy ,Thymus Neoplasms ,Thoracic Surgery ,Retrospective cohort study ,Mediastinal mass ,medicine.disease ,Surgery ,Cardiothoracic surgery ,Radiological weapon ,medicine.symptom ,business - Abstract
The aim of this study is to present a preliminary series of six children affected by an anterior mediastinal mass, resulting in a thymoma. We treated this pediatric population by a video-assisted thoracoscopic thymectomy.We performed a retrospective study from January 2000 to January 2012 of all children affected by an anterior mediastinal mass, resulting in a thymoma. Data included sex, age at surgery, clinical and radiological features, surgical procedure, follow-up, and complications.Video-assisted thoracoscopic thymectomy was performed in six children (five boys and one girl). Four patients presented with dyspnea and/or thoracic pain treated with analgesic and corticosteroid therapy without any benefits. Two patients were asymptomatic. Preoperatively, exams included radiological imaging, blood, and immunological test. All 6 patients were treated with a thoracoscopic approach; of these patients, 5 were treated with a thoracoscopic right-side thymectomy and 1 with a left-side approach. Patients were treated by a three-trocar technique, and thymectomy was performed using Valleylab (now Covidien) (Boulder, CO) LigaSure™. The mean operative time was 120 minutes. The mean hospital stay was 5 days. In all cases histological findings revealed no malignancy. The mean follow-up was 38 months.Thoracoscopic thymectomy facilitated the goal of early thymectomy. The right-side approach is preferred because it gains a good visualization of the venous anatomy for dissection. The left side allows a good extended resection of both the thymus and perithymic fat. Thoracoscopic thymectomy should be consider a valid, less invasive alternative to the most radical open approach.
- Published
- 2013
79. Congenital diaphragmatic hernia
- Author
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Francesca Astra Borruto, Francesco Ferrara, Mario Messina, Francesco Molinaro, François Becmeur, and Rossella Angotti
- Subjects
medicine.medical_specialty ,Lung ,Thoracic cavity ,business.industry ,Congenital diaphragmatic hernia ,Diaphragmatic breathing ,medicine.disease ,Costal margin ,Surgery ,Diaphragm (structural system) ,Diaphragmatic defect ,medicine.anatomical_structure ,medicine ,Gestation ,business - Abstract
Congenital diaphragmatic hernia (CDH) is a defect of development of the pericardioperitoneal canals. In general, it occurs at 6–7 weeks of gestation. It is responsible for herniation of the abdominal organs into the thoracic cavity. CDH is delimited anteriorly by the diaphragm, sideways by the diaphragmatic pillars and posteriorly by the costal margin. CDH causes lung compression on the side of the diaphragmatic defect, precluding normal development of the lung (“lung hypoplasia”) [1, 2]. CDH has an incidence of 1 case per 3,000–5,000 in live births with a male predominance. CDH is not a hereditary disease. CDH is on the left side in 86% of cases (Figs 19.1 and 19.2).
- Published
- 2013
80. Gastric Burkitt's lymphoma in a child: A rare case
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Mario Messina, Mario Marini, G. Giannotti, A. Burgio, D. Meucci, M. Pavone, and Rossella Angotti
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Cancer Research ,Pathology ,medicine.medical_specialty ,Abdominal pain ,Constipation ,Burkitt's lymphoma ,PAEDIATRIC TUMOR ,business.industry ,Cancer ,Ileum ,Articles ,medicine.disease ,Lymphoma ,Cecum ,medicine.anatomical_structure ,Oncology ,Weight loss ,medicine ,Gastric mucosa ,medicine.symptom ,business - Abstract
Burkitt’s lymphoma (BL) is a high-grade lymphoma which represents 8-10% of all tumors in individuals younger than 15 years old. It may occur as an abdominal tumor, which in rare cases may include gastric mucosa, although in most cases, the tumor is located in the ileum or cecum. Primary gastric lymphoma constitutes as low as 1.48% of all gastric cancers in children. In this study, we described a case of gastric BL in a 4-year-old child, presenting discontinuous abdominal pain, weight loss, constipation and irritability. Despite its rarity in children, this tumor should be treated aggressively and long-term survival has been reported.
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- 2012
81. True Duplicate Bladder Extrophy: A Case Report and Review of the Literature
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Francesco Ferrara, Doski Kader, G. Giannotti, Mario Messina, Giovanni Di Maggio, M. Pavone, and Rossella Angotti
- Subjects
business.industry ,Medicine ,Bladder extrophy ,Omics ,business ,Bioinformatics - Published
- 2012
82. IN THE ERA OF 'RED NOSE': CAN THE CLOWN-THERAPY REDUCE THE NURSING STAFF ANXIETY? OUR EXPERIENCE IN A DEPARTMENT OF PEDIATRIC SURGERY
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Rossella Angotti, Daniela Meucci, Francesco Molinaro, Anna Lavinia Bulotta, Edoardo Bindi, Elisa Cerchia, Giovanni Vaccarella, and Mario Messina
- Published
- 2013
83. Retroperitoneoscopic Varicocelectomy in Adolescents: Long-term Follow-up in Two Italian Centres.
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Francesco, Molinaro, Giovanni, Cobellis, Elisa, Cerchia, Francesco, Ferrara, Rosella, Tallarico, Marina, Sica, Carmine, Noviello, Ascanio, Martino, Rossella, Angotti, and Mario, Messina
- Subjects
SURGICAL complications ,SURGERY ,HEALTH outcome assessment ,CRYPTORCHISM ,SURGICAL excision ,SEMEN analysis ,MALE reproductive organ surgery ,CLINICAL trials ,MALE reproductive organs ,LAPAROSCOPY ,LONGITUDINAL method ,SPERMATOZOA ,VARICOCELE - Abstract
Background: The varicocele is the most commonly diagnosed pre-pubertal andrological condition with an incidence of 10%-15% between adolescents. The aim of this study was to evaluate the efficacy of retroperitoneoscopic varicocelectomy (RV) in two Italian centres with particular attention to post-operative testicular volume and semen analysis after 18 years of life.Materials and Methods: From 1999 to 2010, 286 adolescents underwent retroperitoneoscopic left varicocelectomy. Of these patients, 67 were evaluated by clinical examination, ultrasound and semen analysis, allowing an adequate long-term follow-up.Results: Surgery was performed at a mean age of 13 years (range 10-17) without intraoperative complications. There were two recurrences (3%), two left testis hypotrophy (3%) and four hydroceles (6%), not yet undergone surgery because asymptomatic or without tension. Currently, 44 patients accepted to perform semen analysis which showed a reduction in sperm motility in 12 cases, with associated morphological alterations in 3 and reducing number of spermatozoa in one case.Conclusions: In consideration of morphological and biomolecular spermatic alterations reported in adolescent varicocele that could interfere with cellular migration, differentiation and nutrition, it is fundamental to consider the correction of varicocele, not only for the classical indications, but also as a choice for arresting the progressive damage that inevitably acts for several years on the adolescent testis. The RV in adolescents is a safe and feasible procedure for experienced paediatric laparoscopic surgeons with early good clinical outcomes, but more studies occur to understand the real impact of adolescent varicocelectomy on testicular function. [ABSTRACT FROM AUTHOR]- Published
- 2017
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84. Rectal duplication cyst in previous anorectal malformation and Down syndrome
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Molinaro, F., Ferrara, F., Cerchia, E., Brandigi, E., Rossella Angotti, Mariscoli, F., and Messina, M.
- Subjects
Pediatrics, Perinatology and Child Health ,Medicine (all) ,Perinatology and Child Health ,Pediatrics
85. Chromosome 18q-Syndrome and 1p terminal duplication in a patient with bilateral vesico-ureteral reflux: case report and literature revision
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A.L. Bulotta, Mario Messina, Francesco Molinaro, E. Brandigi, Rossella Angotti, and M. Pavone
- Subjects
medicine.medical_specialty ,Chromosome Disorders ,Case Report ,Deletion of 18q ,urologic and male genital diseases ,Ultrasonography, Prenatal ,Intellectual Disability ,Chromosome Duplication ,Gene duplication ,Humans ,Medicine ,Abnormalities, Multiple ,Hernia ,Child ,Vesico-Ureteral Reflux ,Kidney ,Duplication of 1p ,Psychomotor retardation ,business.industry ,Single umbilical artery ,Reflux ,medicine.disease ,Surgery ,Umbilical hernia ,Clubfoot ,Single Umbilical Artery ,Treatment Outcome ,medicine.anatomical_structure ,Chromosomes, Human, Pair 1 ,Dimercaptosuccinic acid ,Face ,Karyotyping ,Female ,Chromosome Deletion ,medicine.symptom ,Chromosomes, Human, Pair 18 ,business ,Vesico-ureteral reflux, Deletion of 18q, Duplication of 1p ,Hernia, Umbilical ,medicine.drug - Abstract
Background: Vesico-ureteral reflux (VUR) is a dynamic event in which a retrograde flow of urine is present into the upper tracts. VUR may occur isolated or in association with other congenital abnormalities or as part of syndromic entities. We present a patient with a bilateral primary VUR, syndromic disease caused by a large deletion of 18q (18q21.3-qter) and terminal duplication of 1p (1p36.32-p36.33). Case report: The patient was 8 years old female with a disease including moderate growth retardation, psychomotor retardation, facial dysmorphism, single umbilical artery, umbilical hernia, urachal remnant, bilateral congenital clubfeet and renal-urinary disease. Chromosomal analysis and Array-CGH revealed two heterozygous chromosomal rearrangements: 1p terminal duplication and de novo 18q terminal deletion. She referred to our clinic to evaluation of bilateral hydronephrosis and right renal cortex thinning. Voiding cystourethrography demonstrated bilateral grade IV VUR and dimercaptosuccinic acid renal scintigraphy confirmed right renal cortex thinning and showed a cortical uptake of 75% of the left kidney and 25% of the right kidney. The patient underwent ureterovesical reimplantation after failure of 3 endoscopic submeatal Deflux injections with VUR resolution. Conclusions: This is the first report involving a patient with 18q-syndrome and contemporary presence of 1p chromosomal terminal duplication. The coexistence of two chromosomal rearrangements complicates the clinical picture and creates a chimeric disorder (marked by characteristics of both chromosomal anomalies). Kidney problems, primarily VUR is reported in 15% of patients affected by 18-q syndrome and no cases is reported in the literature regarding a correlation between VUR and 1p36 chromosomal duplication.
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86. Juvenile granulosa cell tumor of the testis: prenatal diagnosis and prescrotal approach
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Rossella Angotti, Mario Messina, Giovanni Di Maggio, A.L. Bulotta, Edoardo Bindi, Francesco Ferrara, and Francesco Molinaro
- Subjects
Adult ,Male ,Pathology ,medicine.medical_specialty ,endocrine system ,endocrine system diseases ,Case Report ,Prenatal diagnosis ,urologic and male genital diseases ,Ultrasonography, Prenatal ,Human chorionic gonadotropin ,Diagnosis, Differential ,Testicular Neoplasms ,Pregnancy ,Ultrasound ,Humans ,Medicine ,Neoplasm ,Orchiectomy ,Granulosa Cell Tumor ,Gynecology ,Alpha fetoprotein ,Gonadal sex cord stromal tumor, Orchiectomy, Alpha fetoprotein, Ultrasound, Human chorionic gonadotropin ,business.industry ,urogenital system ,Infant, Newborn ,lcsh:RJ1-570 ,Gonadal sex cord stromal tumor ,lcsh:Pediatrics ,medicine.disease ,Juvenile granulosa cell tumor ,Treatment Outcome ,Female ,Differential diagnosis ,Alpha-fetoprotein ,business ,Follow-Up Studies - Abstract
Neonatal testicular tumors are rare and should be considered in the differential diagnosis of newborn scrotal masses. Juvenile granulosa cell tumor (JGCT) accounts for about 5% of all prepubertal testis tumors. As a benign neoplasm, radical orchiectomy is sufficient for treatment. We report a case of a newborn with a prenatal diagnosis of scrotal mass. After surgery, the histological diagnosis was juvenile granulosa cell tumor. To date the patient is healthy.
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