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7. E-consensus on telemedicine in proctology: A RAND/UCLA-modified study

Author

Gallo, G., Grossi, U., Sturiale, A., Di Tanna, G. L., Picciariello, A., Pillon, S., Mascagni, D., Altomare, D. F., Naldini, G., Perinotti, R., Bottini, C., Bracchitta, S., Brusciano, L., Caminati, F., Cantarella, F., Celentano, V., Paola De Nardi, G. C., Ferrara, F., Folliero, C., Giamundo, P., Giani, I., Giannini, I., Giuffrida, M. C., Infantino, A., La Torre, M., Lauretta, A., Lisi, G., Losacco, L., Maffioli, A., Mancini, S., Marino, F., Martellucci, J., Meinero, P., Milito, G., Mistrangelo, M., Mori, L., Orlandi, S., Pata, F., Pessia, B., Pietroletti, R., Pozzo, M., Pucciani, F., Ratto, Carlo, Romano, L., Roveroni, M., Santoro, G., Serventi, A., Telesco, D., Testa, A., Tonello, P., Tricomi, N., Trompetto, M., Tutino, R., Zaffaroni, G., Mayol, J., Ratto C. (ORCID:0000-0002-0556-0037), Gallo, G., Grossi, U., Sturiale, A., Di Tanna, G. L., Picciariello, A., Pillon, S., Mascagni, D., Altomare, D. F., Naldini, G., Perinotti, R., Bottini, C., Bracchitta, S., Brusciano, L., Caminati, F., Cantarella, F., Celentano, V., Paola De Nardi, G. C., Ferrara, F., Folliero, C., Giamundo, P., Giani, I., Giannini, I., Giuffrida, M. C., Infantino, A., La Torre, M., Lauretta, A., Lisi, G., Losacco, L., Maffioli, A., Mancini, S., Marino, F., Martellucci, J., Meinero, P., Milito, G., Mistrangelo, M., Mori, L., Orlandi, S., Pata, F., Pessia, B., Pietroletti, R., Pozzo, M., Pucciani, F., Ratto, Carlo, Romano, L., Roveroni, M., Santoro, G., Serventi, A., Telesco, D., Testa, A., Tonello, P., Tricomi, N., Trompetto, M., Tutino, R., Zaffaroni, G., Mayol, J., and Ratto C. (ORCID:0000-0002-0556-0037)

Abstract

Background: Coronavirus disease 2019 is revolutionizing healthcare delivery. The aim of this study was to reach a consensus among experts as to the possible applications of telemedicine in the proctologic field. Methods: A group of 55 clinical practice recommendations was developed by a clinical guidance group based on coalescence of evidence and expert opinion. The Telemedicine in Proctology Italian Working Group included 47 Italian Society of Colorectal Surgery nominated experts evaluating the appropriateness of each clinical practice recommendations based on published RAND/UCLA methodology in 2 rounds. Results: Stakeholder median age was 53 years (interquartile range limits 40–60), and 38 (81%) were men. Nine (19%) panelists reported no experience with telemedicine before the pandemic. Agreement was obtained on a minimum of 3 to 5 years of practice in the proctologic field before starting teleconsultations, which should be regularly paid, with advice and prescriptions incorporated into a formal report sent to the patient by e-mail along with a receipt. Of the panelists, 35 of 47 (74%) agreed that teleconsultation carries the risk of misdiagnosis of cancer, thus recommending an in-person assessment before scheduling any surgery. Fifteen additional clinical practice recommendations were re-elaborated in the second round and assessed by 44 of 47 (93.6%) panelists. The application of telemedicine for the diagnosis of common proctologic conditions (eg, hemorrhoidal disease, anal abscess and fistula, anal condylomas, and anal fissure) and functional pelvic floor disorders was generally considered inappropriate. Teleconsultation was instead deemed appropriate for the diagnosis and management of pilonidal disease. Conclusion: This e-consensus revealed the boundaries of telemedicine in Italy. Standardization of infrastructures, logistics, and legality remain to be better elucidated.

Published
2021

13. Résumés des communications libres / Abstracts of free communications

Author

Ginès, A., Fernández-Esparrach, G., Pellisé, M., Pérez-Corona, T., Mata, A., Llach, J., Bordas, J. M., Sánchez, M., Pages, M., Martinez, G., López-Boado, M. A., Membrillo, A., Ayuso, C., Fernández-Cruz, L., Durivage, G., Pujol, B., Napoléon, B., Hervieu, V., Labadie, M., Napolitano, V., Russo, G., Rossetti, G., Brusciano, L., Sagnelli, C., Pacchioni, Donatella, Bosco, M., Accinelli, Grazia, Curri, Francesca, De Angelis, C., Bussolati, G., Gincoul, Rodica, Modolell, Ines, Lefort, Christine, Scoazec, J. Y., Souquet, J. C., Chayvialle, J. A., Săftoiu, A., Cazacu, S., Popescu, Carmen, and Ciurea, T.

Published
2005
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26. The Authors Reply

Author

Brusciano, L., Ayabaca, S. M., Pescatori, M., Ravo, B., Accarpio, G. M., Dodi, G., Cavallari, F., and Annibali, R.

Published
2006
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29. Costs of laparoscopic and open liver and pancreatic resection: A systematic review

Author

LIMONGELLI, Paolo, Vitiello C, Belli A, Pai M, TOLONE, SALVATORE, DEL GENIO, Gianmattia, Brusciano L, DOCIMO, Giovanni, Habib N, Belli G, Jiao LR, DOCIMO, Ludovico, Limongelli, Paolo, Vitiello, C, Belli, A, Pai, M, Tolone, Salvatore, DEL GENIO, Gianmattia, Brusciano, L, Docimo, Giovanni, Habib, N, Belli, G, Jiao, Lr, and Docimo, Ludovico

Published
2014

31. The impact of age and oral calcium and vitamin D supplements on postoperative hypocalcemia after total thyroidectomy. A prospective study

Author

TOLONE, SALVATORE, Brusciano L, Amoroso V, Casalino G, Verde I, Bosco A, D'Alessandro A, Pirozzi R, Rossetti G, RUGGIERO, Roberto, DEL GENIO, Gianmattia, PARMEGGIANI, Domenico, LIMONGELLI, Paolo, DOCIMO, Ludovico, Tolone, Salvatore, Ruggiero, Roberto, DEL GENIO, Gianmattia, Brusciano, L, Parmeggiani, Domenico, Amoroso, V, Casalino, G, Verde, I, Bosco, A, D'Alessandro, A, Pirozzi, R, Rossetti, G, Limongelli, Paolo, and Docimo, Ludovico

Published
2013

32. Long term quality of life after laparoscopic antireflux surgery for the elderly

Author

TOLONE, SALVATORE, Brusciano L, Verde I, Gili S, Vitiello C, D'Alessandro A, Casalino G, Lucido F, Leone N, Pirozzi R, DOCIMO, Giovanni, DEL GENIO, Gianmattia, RUGGIERO, Roberto, DOCIMO, Ludovico, Tolone, Salvatore, Docimo, Giovanni, DEL GENIO, Gianmattia, Brusciano, L, Verde, I, Gili, S, Vitiello, C, D'Alessandro, A, Casalino, G, Lucido, F, Leone, N, Pirozzi, R, Ruggiero, Roberto, and Docimo, Ludovico

Published
2013

33. Multimodal treatment of constipation: surgery, riabilitation or both?

Author

Brusciano L, Di Stazio C, Del Genio GM, TOLONE, SALVATORE, Sansone S, Lucido F, Verde I, D'Alessandro A, Gili S, Topatino A, Amoroso V, Casalino P, DOCIMO, Ludovico, LIMONGELLI, Paolo, RUGGIERO, Roberto, DOCIMO, Giovanni, Brusciano, L, Di Stazio, C, Limongelli, Paolo, Del Genio, Gm, Tolone, Salvatore, Sansone, S, Lucido, F, Verde, I, D'Alessandro, A, Ruggiero, Roberto, Gili, S, Topatino, A, Amoroso, V, Casalino, P, Docimo, Giovanni, and Docimo, Ludovico

Published
2012

34. Laparoscopic total fundoplication for refractary GERD: how to achieve optimal long-term outcomes by preoperative instrumental assesment and a standardized tecnique

Author

LIMONGELLI, Paolo, TOLONE, SALVATORE, DEL GENIO, Gianmattia, D'ALESSANDRO A., ROSSETTI G., BRUSCIANO L., DOCIMO, Giovanni, RUGGIERO, Roberto, GILI S., TOPATINO A., AMOROSO V., CASALINO G., BOSCO A., DEL GENIO A., DOCIMO, Ludovico, Limongelli, Paolo, Tolone, Salvatore, DEL GENIO, Gianmattia, D'Alessandro, A., Rossetti, G., Brusciano, L., Docimo, Giovanni, Ruggiero, Roberto, Gili, S., Topatino, A., Amoroso, V., Casalino, G., Bosco, A., Docimo, Ludovico, and DEL GENIO, A.

Published
2012

35. Role of pre and post operative calcium and vitamin D supplements in prevention of hypocalcemia,after total thyroidectomy

Author

DOCIMO, Giovanni, TOLONE, SALVATORE, PASQUALI, Daniela, CONZO, Giovanni, D'Alessandro A, Casalino G, Gili S, Brusciano L, DEL GENIO, Gianmattia, RUGGIERO, Roberto, DOCIMO, Ludovico, GUBITOSI, Adelmo, Docimo, Giovanni, Tolone, Salvatore, Pasquali, Daniela, Conzo, Giovanni, D'Alessandro, A, Casalino, G, Gili, S, Brusciano, L, Gubitosi, Adelmo, DEL GENIO, Gianmattia, Ruggiero, Roberto, and Docimo, Ludovico

Subjects
Hypocalcemia, Thyroidectomy, Calcium
Published
2012

37. Laparoscopic reoperation with total fundoplication for failed Heller myotomy: is it a possible option? Personal experience and review of literature

Author

Rossetti, G., Del Genio, G., Maffettone, V., Fei, L., Brusciano, L., Limongelli, P., Pizza, F., Tolone, S., Di Martino, M., Federica del Genio, Del Genio, A., Rossetti, G, DEL GENIO, Gianmattia, Maffettone, Vincenzo, Fei, Landino, Brusciano, L, Limongelli, Paolo, Pizza, F, Tolone, Salvatore, Di Martino, M, Del Genio, F, and Del Genio, A.

Subjects
Esophageal Achalasia, Male, Reoperation, Treatment Outcome, Fundoplication, Humans, Female, Laparoscopy, Treatment Failure, Length of Stay, Digestive System Surgical Procedures
Abstract

Laparoscopic Heller myotomy with antireflux procedure seems the procedure of choice in the treatment of patients with esophageal achalasia. Persistent or recurrent symptoms occur in 10% to 20% of patients. Few reports on reoperation after failed Heller myotomy have been published. No author has reported the realization of a total fundoplication in these patient groups. The aim of this study is to evaluate the efficacy of laparoscopic reoperation with the realization of a total fundoplication after failed Heller myotomy for esophageal achalasia. From 1992 to December 2007, 5 out of a series of 242 patients (2.1%), along with 2 patients operated elsewhere, underwent laparoscopic reintervention for failed Heller myotomy. Symptoms leading to reoperation included persistent dysphagia in 3 patients, recurrent dysphagia in another 3, and heartburn in 1 patient. Mean time from the first to the second operation was 49.7 months (range, 4-180 months). Always, the intervention was completed via a laparoscopic approach and a Nissen-Rossetti fundoplication was realized or left in place after a complete Heller myotomy. Mean operative time was 160 minutes (range, 60-245 minutes). Mean postoperative hospital stay was 3.1 +/- 1.5 days. No major morbidity or mortality occurred. At a mean follow-up of 16.1 months, reoperation must be considered successful in 5 out of 7 patients (71.4%). The dysphagia DeMeester score fell from 2.71 +/- 0.22 to 0.91 +/- 0.38 postoperatively. The regurgitation score changed from 2.45 +/- 0.34 to 0.68 +/- 0.23. Laparoscopic reoperation for failed Heller myotomy with the realization of a total fundoplication is safe and is associated with good long-term results if performed by an experienced surgeon in a center with a long tradition of esophageal surgery.

Published
2010

39. [Laparoscopic total fundoplication is not an obstacle to oesophageal emptying after oesophago-gastric myotomy for the surgical treatment of achalasia]

Author

Pizza F, Rossetti G, Del Genio G, Maffettone V, Napolitano V, Allaria A, Brusciano L, Montesarchio L, Salvatore Tolone, Di Martino M, Fs, Lucido, Barra L, Giugliano S, D'Alessandro A, Del Genio F, Nl, Pizza, Del Genio A, Pizza, F, Rossetti, G, Del Genio, G, Maffettone, V, Napolitano, V, Allaria, A, Brusciano, L, Montesarchio, L, Tolone, S, Di Martino, M, Lucido, F. S., Barra, L, Giugliano, S, D'Alessandro, A, Del Genio, F, Pizza, N. L., and Del Genio, A

Subjects
Adult, Male, Time Factors, Adolescent, Manometry, Fundoplication, Length of Stay, Middle Aged, Esophageal Achalasia, Treatment Outcome, Gastroesophageal Reflux, Humans, Female, Laparoscopy, Child, Deglutition Disorders, Aged, Follow-Up Studies
Abstract

There are different surgical possibilities for the treatment of oesophageal achalasia ranging from a short extramucosal oesophagomyotomy to an extended esophago-gastric myotomy combined with a partial fundoplication to restore the main antireflux barrier. A total 360 degrees fundoplication is generally regarded as an obstacle to oesophageal emptying. The aim of this study was to evaluate the role and efficacy of total 360 degrees laparoscopic Nissen-Rossetti fundoplication after oesophago gastric myotomy in the treatment of oesophageal achalasia. From 1992 to January 2008, a total of 245 patients (112 males, 133 females), mean age 45.1 years (range: 12-79), were submitted to laparoscopic Nissen-Rossetti fundoplication after a Heller myotomy with endoscopic and manometric intraoperative monitoring. In 3 patients (1.2%), conversion to laparotomy was necessary. Mean operative time was 60 +/- 15 minutes. No mortality was observed. The overall morbidity rate was 1.6%. The mean postoperative hospital stay was 3.5 +/- 1.0 days (range: 1-12 days). A mean clinical follow-up of 100.2 +/- 7 months (range: 3-177) was possible for 228 patients (93.1%), and an excellent or good outcome was observed in 209 patients (91.7%) (DeMeester dysphagia score 0-1). No improvement in dysphagia was observed in 5 (2.2%) patients. Pathological gastro-oesophageal reflux was absent in all patients. Laparoscopic Nissen-Rossetti fundoplication after a Heller myotomy is a safe, effective treatment for oesophageal achalasia with excellent results in terms of dysphagia resolution, affording total protection from the onset of gastrooesophageal reflux.

Published
2009

40. BILARY LITHIASIS IN PATIENTS WITH GASTRO-ESOPHAGEAL REFLUX (ACID AND ALKALINE)

Author

Del Genio A., Rossetti G., NAPOLITANO, Vincenzo, Del Genio G., Brusciano L., Pizza F., Di Martino M., TOLONE, SALVATORE, MAFFETTONE, Vincenzo, Spinger-Verlag Italia Ed, Del Genio, A., Rossetti, G., Maffettone, Vincenzo, Napolitano, Vincenzo, Del Genio, G., Brusciano, L., Pizza, F., Di Martino, M., and Tolone, Salvatore

Published
2008

41. THE PROXIMAL MIGRATION OF RFLUX IS RESPONSIBLE OF RESPIRATORY SYMPTOMS IN PATIENTS WITH GASTRO:ESOPHAGEAL REFLUX DISEASE: ASSESSMENT WITH MULTICHANNEL INTRALUMINAL IMPEDANCE (MII)

Author

Del Genio g., Rossetti G., Brusciano L., Pizza f., TOLONE, SALVATORE, Russo F., Di Martino M., Picarella P., Lucido F., Barra L., Giugliano S., D’Alessandro A., Montesarchio L., Napolitano V., ALLARIA, Alfredo, Del Genio A., MAFFETTONE, Vincenzo, Del Genio, G., Rossetti, G., Brusciano, L., Pizza, F., Tolone, Salvatore, Russo, F., Di Martino, M., Picarella, P., Lucido, F., Barra, L., Giugliano, S., D’Alessandro, A., Montesarchio, L., Maffettone, Vincenzo, Napolitano, V., Allaria, Alfredo, and Del Genio, A.

Published
2008

43. COMBINED MII-pH IS USEFUL IN SELECTING PATIENTS FOR LAPAROSCOPIC FUNDOPLICATION

Author

TOLONE, SALVATORE, Del Genio G., Rossetti G., Brusciano L., Russo F., Pizza F., Sagnelli C., NAPOLITANO, Vincenzo, Lucido F., Del Genio A., MAFFETTONE, Vincenzo, Tolone, Salvatore, Del Genio, G., Rossetti, G., Brusciano, L., Russo, F., Pizza, F., Sagnelli, C., Maffettone, Vincenzo, Napolitano, Vincenzo, Lucido, F., and Del Genio, A.

Published
2008

44. The proximal migration of reflux is responsible of respiratory symptoms in patients with gastroesophageal reflux disease: assessment with multichannel intraluminal impedance

Author

Del Genio G, TOLONE, SALVATORE, Rossetti G, Brusciano L, Pizza F, Russo F, Di Martino M, MAFFETTONE, Vincenzo, NAPOLITANO, Vincenzo, Del Genio A., Del Genio, G, Tolone, Salvatore, Rossetti, G, Brusciano, L, Pizza, F, Russo, F, Di Martino, M, Maffettone, Vincenzo, Napolitano, Vincenzo, and Del Genio, A.

Published
2008

45. ELECTRICAL STIMULATION AS A CONSERVATIVE TREATMENT FOR PATHOLOGIC DUODENO_GASTRIC REFLUX (DGR) ASSOCIATED TO DELAYED GASTRI EMPTYING: INITIAL EXPERIENCE

Author

Del Genio G., Rossetti G., Brusciano L., Pizza F., TOLONE, SALVATORE, Russo F., Di Martino M., Picarella P., Lucido F., Barra L., Giugliano S., D’Alessandro A., Montesarchio L., Napolitano V., ALLARIA, Alfredo, Del Genio A., MAFFETTONE, Vincenzo, Del Genio, G., Rossetti, G., Brusciano, L., Pizza, F., Tolone, Salvatore, Russo, F., Di Martino, M., Picarella, P., Lucido, F., Barra, L., Giugliano, S., D’Alessandro, A., Montesarchio, L., Maffettone, Vincenzo, Napolitano, V., Allaria, Alfredo, and Del Genio, A.

Published
2008

46. The role of flexible endoscopy in laparoscopic Roux-en-Y gastric bypass

Author

DEL GENIO, Gianmattia, Rossetti G, Brusciano L, del Genio F, Pizza F, Di Martino M, TOLONE, SALVATORE, PEZZULLO, Angelo, NAPOLITANO, Vincenzo, ALLARIA, Alfredo, MAFFETTONE, Vincenzo, del Genio A., DEL GENIO, Gianmattia, Rossetti, G, Brusciano, L, del Genio, F, Pizza, F, Di Martino, M, Tolone, Salvatore, Pezzullo, Angelo, Napolitano, Vincenzo, Allaria, Alfredo, Maffettone, Vincenzo, and del Genio, A.

Subjects
laparoscopic roux-en-y, gastric by pa, Flexible endoscopy
Abstract

Background the intraoperative flexible endoscopy is recently gaining popularity as an additional tool to increase the safety in gastrointestinal (GI) surgery; however, its role in bariatric surgery is currently not known. The aim of the study was to evaluate the effectiveness of the routine use of flexible endoscopy (FE) as an added tool to increase safety in laparoscopic Roux-en-Y gastric bypass (LGBP) for morbid obesity. Methods Since 1979, in our University Division of Surgery more than 10,000 patients underwent intraoperative FE at the time of GI surgery to exclude anasthomotic technical errors. We transferred this long-term experience with FE on laparoscopic bariatric procedures. Thus, an intraoperative endoscopy was accomplished at the end of LGBP to check the caliber of the gastro-jejunal anasthomosis and to exclude a leak by simultaneous endoscopic air insufflation and laparoscopic irrigation. Results Fifty-two consecutive patients underwent LGBP. Mean age was 42.1 years (range, 28–59); mean BMI was 52.2 (range, 41–72). Mean operative time was 160 min (range, 95–660). All of the five patients (9.6%) were converted to conventional surgery occurred during the first ten cases. Mortality was nil. A postoperative leak occurred in three patients (5.7%) during the first eight cases. This was located in all the cases at the gastro-jejunal anasthomosis. All these patient healed with a conservative approach, and in no cases reoperation was necessary. Conclusion The routine use of intraoperative FE helped to maintain low the postoperative leak rate. This tool seems to increase the safety of the operation during the learning curve.

Published
2008

47. CAN COMBINED MII-pH BECOME A USEFUL GOAL FOR SURGEON IN SELECTING PATIENTS FOR LAPAROSCOPIC FUNDOPLICATION?

Author

Del Genio G., Rossetti G., Brusciano L., Pizza F., TOLONE, SALVATORE, Russo F., Di Martino M., Picarella P., Lucido F., Barra L., Giugliano S., D’Alessandro A., Montesarchio L., Napolitano V., ALLARIA, Alfredo, Del Genio A., MAFFETTONE, Vincenzo, Del Genio, G., Rossetti, G., Brusciano, L., Pizza, F., Tolone, Salvatore, Russo, F., Di Martino, M., Picarella, P., Lucido, F., Barra, L., Giugliano, S., D’Alessandro, A., Montesarchio, L., Maffettone, Vincenzo, Napolitano, V., Allaria, Alfredo, and Del Genio, A.

Published
2008

48. DOES THE INEFFECTIVE MOTILITY EFFECT THE CLINICAL OUTCOME OF TOTAL FUNDOPLICATION. INITIAL STUDY WITH COMBINED MULTICHANNEL INTRALUMINAL IMPEDANCE AND ESOPHAGEAL MANOMETRY

Author

Del Genio G., Rossetti G., Brusciano L., Pizza F., TOLONE, SALVATORE, Russo F., Di Martino M., Picarella P., Lucido F., Barra L., Giugliano S., D’Alessandro A., Montesarchio L., Napolitano V., ALLARIA, Alfredo, Del Genio A., MAFFETTONE, Vincenzo, Del Genio, G., Rossetti, G., Brusciano, L., Pizza, F., Tolone, Salvatore, Russo, F., Di Martino, M., Picarella, P., Lucido, F., Barra, L., Giugliano, S., D’Alessandro, A., Montesarchio, L., Maffettone, Vincenzo, Napolitano, V., Allaria, Alfredo, and Del Genio, A.

Published
2008

50. THE PROXIMAL MIGRATION OF REFLUX IS RESPONSIBLE OF RESPIRATORY SYMPTOMS IN PATIENTS WITH GASTRO-ESOPHAGEAL REFLUX DISEASE: ASSESSMENT WITH MULTICHANNEL INTRALUMINAL IMPEDANCE (MII)

Author

Del Genio G., TOLONE, SALVATORE, NAPOLITANO, Vincenzo, Rossetti G., Brusciano L., Pizza F., Russo F., Di Martino M., Del Genio A., MAFFETTONE, Vincenzo, Del Genio, G., Tolone, Salvatore, Maffettone, Vincenzo, Napolitano, Vincenzo, Rossetti, G., Brusciano, L., Pizza, F., Russo, F., Di Martino, M., and Del Genio, A.

Published
2008

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