156 results on '"Caprotti, R."'
Search Results
2. Pylephlebitis and mesenteric thrombophlebitis in sigmoid diverticulitis: medical approach, delayed surgery
- Author
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Nobili, C., Uggeri, F., Romano, F., Degrate, L., Caprotti, R., Perego, P., and Franciosi, C.
- Published
- 2007
- Full Text
- View/download PDF
3. Laparoscopic splenectomy using ligasure
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Romano, F., Caprotti, R., Franciosi, C., Fina, S., Colombo, G., and Uggeri, F.
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- 2002
- Full Text
- View/download PDF
4. PANCREATIC RESECTION for PANCREATIC METASTASES FROM BREAST and OVARIAN CARCINOMA: 19
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Bonardi, C, Mussi, C, Angelini, C, Sartori, P, Caprotti, R, and Uggeri, F
- Published
- 2005
5. SURGICAL TREATMENT of SECONDARY TUMOURS TO THE PANCREAS: 8
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Caprotti, R, Crippa, S, Bovo, G, Mussi, C, Bonardi, C, Sartori, P, Angelini, C, and Uggeri, F
- Published
- 2005
6. SURGERY for LIVER METASTASES FROM COLORECTAL CANCER: 36
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Uggeri, F, Crippa, S, Caprotti, R, Angelini, C, Bonardi, C, Mussi, C, and Fontana, A
- Published
- 2005
7. Putative Predictive Parameters for the Outcome of Laparoscopic Splenectomy
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Casaccia, M, Torelli, P, Pasa, A, Sormani, Mp, Rossi, E, Casaccia M, IRLSS C. e. n. t. e. r. s., Valente, U, Spinoglio, G, Prete, F, Logrieco, G, Buccoliero, F, Berta, R, Donini, I, Donini, Annibale, Valeri, A, Prosperi, P, Saviano, M, Gelmini, R, Uggeri, F, Caprotti, R, Romano, F, Colecchia, G, Monteferrante, E, Pedrazzoli, C, Bigi, L, Barbieri, Im, Moraldi, A, Dallatorre, A, Basso, N, Silecchia, G, Rosati, R, Bona, S, Cavaliere, P, Bresadola, F, Terrosu, G, Mosca, F, Pietrabissa, A, Memeo, V, Puglisi, F, Dionigi, R, Benevento, A, Boni, L, Liboni, A, Feo, C, Borghi, F, Geretto, P, Moroni, R, Sorrentino, M, di Sebastiano, P, Ambrosio, A, Verdecchia, Gm, Cavaliere, D., Casaccia, M, Torelli, P, Pasa, A, Sormani, Mp, Rossi, E, Rosati, R, Sormani, M, Valente, U, Spinoglio, G, Prete, F, Logrieco, G, Buccoliero, F, Berta, R, Donini, I, Donini, A, Valeri, A, Prosperi, P, Saviano, M, Gelmini, R, Uggeri, F, Caprotti, R, Romano, F, Colecchia, G, Monteferrante, E, Pedrazzoli, C, Bigi, L, Barbieri, I, Moraldi, A, Dallatorre, A, Basso, N, Silecchia, G, Bona, S, Cavaliere, P, Bresadola, F, Terrosu, G, Mosca, F, Pietrabissa, A, Memeo, V, Puglisi, F, Dionigi, R, Benevento, A, Boni, L, Liboni, A, Feo, C, Borghi, F, Geretto, P, Moroni, R, Sorrentino, M, di Sebastiano, P, Ambrosio, A, Verdecchia, G, and Cavaliere, D
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Registrie ,Adult ,Male ,Laparoscopic surgery ,medicine.medical_specialty ,Multivariate analysis ,Adolescent ,medicine.medical_treatment ,Splenectomy ,Postoperative Complications ,Retrospective Studie ,Risk Factors ,MED/18 - CHIRURGIA GENERALE ,medicine ,Humans ,Registries ,Aged ,Child, Child ,Female ,Italy ,Laparoscopy ,Middle Aged ,Multivariate Analysis ,Retrospective Studies ,Treatment Outcome ,Child ,Multivariate Analysi ,LAPAROSCOPIC SPLENECTOMY ,Aged, 80 and over ,medicine.diagnostic_test ,business.industry ,Risk Factor ,Gold standard ,Retrospective cohort study ,Perioperative ,Surgery ,Endoscopy ,Child, Preschool ,Postoperative Complication ,business ,Human - Abstract
OBJECTIVE: To identify predictive risk factors for conversion to open splenectomy and postoperative complications in patients undergoing elective laparoscopic splenectomy. BACKGROUND: The laparoscopic approach represents the "gold standard" for splenectomy, but its use in the treatment of splenomegaly and malignant disease is controversial. Factors that influence immediate outcome are clinical, anatomic, and pathologic. METHODS: Univariate and multivariate analyses of data from the Italian Registry of Laparoscopic Surgery of the Spleen, a multicenter database supported by 25 referral centers. Analysis of data (1993-2007) was performed on a series of patients (n = 676) undergoing elective laparoscopic splenectomy. Demographic data, the operative indications, the surgical technique applied, and any intra- and/or postoperative complications with respect to the patients were assessed. Records were analyzed retrospectively using the Student t test, the chi test, and logistic regression. RESULTS: Conversion to open splenectomy was necessary in 39 cases (5.8%). Perioperative deaths occurred in 3 cases (0.4%). There were no complications in 560 patients (82.8%), with a mean hospital stay of 5 days (range, 2-54). Overall, morbidity occurred in 116 patients (17.2%). Multivariate analysis found that the body mass index (P = 0.01) and the presence of hematologic malignancy (P < 0.001) were independent predictors for intraoperative complications and surgical conversion. Spleen longitudinal diameter (P = 0.001) and surgical conversion (P = 0.001) were independent predictors for the occurrence of postoperative complications. CONCLUSIONS: This large multicenter study provides evidence for the significance of predictive risk factors for intra- and postoperative complications in laparoscopic splenic surgery. Besides splenic dimensions, other factors like the patient's habitus and the specific underlying hematologic pathology should be recognized by the surgeon to reduce complications and initiate adequate treatment.
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- 2010
8. Prolonged survival of a patient affected by pancreatic adenocarcinoma with massive lymphocytic and dendritic infiltration after IL-2 immunotherapy. Report of a case
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NOBILI, CINZIA, DEGRATE, LUCA, LEONE, BIAGIO EUGENIO, ROMANO, FABRIZIO, UGGERI, FRANCO, UGGERI, FABIO, Caprotti, R, Franciosi, C, Trezzi, R, Nobili, C, Degrate, L, Caprotti, R, Franciosi, C, Leone, B, Trezzi, R, Romano, F, and Uggeri, F
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Male ,Survival ,Prognosi ,Risk Factor ,Pancreatic Neoplasm ,Adenocarcinoma ,Dendritic Cell ,Neoadjuvant Therapy ,Pancreaticoduodenectomy ,Antineoplastic Agent ,Fatal Outcome ,Chemotherapy, Adjuvant ,MED/18 - CHIRURGIA GENERALE ,Interleukin-2 ,Immunotherapy ,Lymphocytes ,Neoplasm Recurrence, Local ,Human ,Aged - Abstract
Several studies have shown that there is a paucity of immune cells within the stroma of pancreatic adenocarcinoma, a very aggressive cancer with a median survival of about 18 months. A 65-year-old man presented with jaundice. Abdominal ultrasound revealed intra- and extrahepatic bile duct dilatation and a 45-mm diameter hypoechoic solid mass within the pancreatic head; a computed tomography scan excluded vascular infiltration and metastatic lesions. The patient received immunotherapy consisting of 6,000,000 IU human recombinant interleukin-2 administered subcutaneously twice a day for 3 consecutive days. Thirty-six hours after the last dose, he underwent a pylorus-preserving pancreatoduodenectomy. Because of the presence of high-grade dysplasia detected by intraoperative histological examination of a distal section, a spleen preserving total pancreatectomy was performed. The postoperative course was uneventful. The patient died 32 months after surgery because of local recurrence. Histopathology showed G3 pancreatic ductal adenocarcinoma infiltrating the anterior and posterior peripancreatic tissue, duodenal wall and intrapancreatic common bile duct, with sarcoma-like foci and a component of intraductal tumor involving the common bile duct. In the distal pancreas, widespread foci of pancreatic intraepithelial neoplasia (PanIN2-3) were found. The Ki-67 proliferation index was 16%. TNM staging was pT3 pN1 R1. Sections were immunostained for the T-lymphocyte marker CD3 and for the dendritic cell marker CD 1a. Intratumoral infiltration was high for CD1a+ cells and mild for CD3+ cells. Preoperative immunotherapy with interleukin-2 may contribute to massive stromal infiltration of immune cells in pancreatic adenocarcinoma. This may prolong the survival even in the presence of negative prognostic factors (age >65 years, tumor diameter >20 mm, Rl, tumor grade G3).
- Published
- 2008
9. Hepatic resections using a bipolar vessel sealing device
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ROMANO, FABRIZIO, UGGERI, FRANCO, Garancini, M, Caprotti, R, Bovo, G, Conti, M, Perego, E, Romano, F, Garancini, M, Caprotti, R, Bovo, G, Conti, M, Perego, E, and Uggeri, F
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liver surgery, ligasure, biliary leak ,MED/18 - CHIRURGIA GENERALE - Abstract
Introduction. Blood loss and bile leakage are well-known risk factors for morbidity and mortality during liver resection. Bleeding usually occurs during parenchymal transection, and surgical technique should be considered an important factor in preventing intraoperative and postoperative complications. Objective. Many approaches and devices have been developed to limit bleeding and bile leakage. The aim of the present study was to determine whether a bipolar vessel sealing device allows a safe and careful liver transection without routine inflow occlusion, achieving a satisfactory hemostasis and bile stasis, thus reducing blood loss and bile leak and related complications. Patients and methods. A total of 50 consecutive patients (24 males, 26 females, with a mean age of 57 years) underwent major and minor hepatic resections using a bipolar vessel sealing device. A clamp crushing technique followed by energy application was used to perform the parenchymal transection. Inflow occlusion was used when necessary to control blood loss but not as a routine. No other devices were applied to achieve hemostasis. Results. The instrument was effective in 45 patients and failed to achieve hemostasis in 5 cases, all of whom had a cirrhotic liver. Median blood loss was 490 ml (range 100-2500 ml) and intraoperative blood transfusions were required in eight cases (16%). Mean operative time was 178 min (range 50-315 min). Inflow occlusion was necessary in 16 (32%) patients. The postoperative complication rate was 24%, with a postoperative hemorrhage in a cirrhotic patient. There was no clinical evidence of bile leak or procedure-related abdominal abscess. Conclusion. We conclude that the device is a useful tool in standard liver resection, achieving good hemostasis and bile stasis in patients with normal liver parenchyma, but its use should be avoided in cirrhotic patients.
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- 2007
10. Sutureless and stapleless laparoscopic splenectomy using radiofrequency
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Gelmini, R, Quaranta, N, Caprotti, R, Tazzioli, G, Colombo, G, Saviano, M, ROMANO, FABRIZIO, UGGERI, FRANCO, Gelmini, R, Romano, F, Quaranta, N, Caprotti, R, Tazzioli, G, Colombo, G, Saviano, M, and Uggeri, F
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laparoscopic splenectomy, ligasure ,MED/18 - CHIRURGIA GENERALE - Abstract
Background: Bleeding is the main complication and cause of conversion during laparoscopic splenectomy (LS). We present the advantages of the LigaSure vessel sealing system added to the lateral approach for achieving safe vascular control. Methods: We performed 63 consecutive LS in a 3-year period using LigaSure in two affiliated university hospitals. We employed a right semilateral position technique with dissection of the spleen and vessel sealing using LigaSure. Forty-two patients had benign hematological disease, 19 had malignant disease, and two had splenic cysts. Results: A total of 58 LS were completed with five conversions due to hilar bleeding (three cases), difficult dissection (one), and massive splenomegaly (one). In all but five patients, blood loss was less than 100 ml. No transfusions were needed. There were five postoperative complications: portal thrombosis (one case), hemoperitoneum (two), surgical wound infection (one), and pleural effusion (one). Conclusions: The use of LigaSure, and the semilateral position, results in a gain of time and safety. Furthermore, average intraoperative bleeding is very low. © Springer Science+Business Media, Inc. 2006.
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- 2006
11. Laparoscopic repair of a Morgagni-Larrey hernia
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Caprotti, R, Mussi, C, Angelini, C, Scaini, A, ROMANO, FABRIZIO, UGGERI, FRANCO, Caprotti, R, Mussi, C, Angelini, C, Scaini, A, Romano, F, and Uggeri, F
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MED/18 - CHIRURGIA GENERALE ,laparoscopy, Morgagni-Larrey - Abstract
Morgagni-Larrey hernia is a congenital type of diaphragmatic hernia. It is quite uncommon, particularly when it occurs on the left side of the diaphragm. This is a report of a case of a large left-side diaphragmatic hernia through the foramen of Morgagni treated by laparoscopy. The hernia was repaired by incorporating and fixing a polypropylene double-filament mesh into the defect, leaving the sac in mediastinum. The patient recovered promptly after the hernia repair, and there was no recurrence or complaints 30 months after surgery. Our conclusion is that laparoscopically repairs of Morgagni hernias with a prosthetic material are a safe and effective treatment. A literature review also shows that laparoscopic techniques are the gold standard in diaphragmatic hernias repairs.
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- 2005
12. Phase-II randomized study of preoperative IL-2 administration in radically operable gastric cancer patients
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Romano, F., Piacentini, M. G., Franciosi, C., Caprotti, R., Fina, S., Giovanni Cesana, Uggeri, F., Conti, M., Romano, F, Piacentini, M, Franciosi, C, Caprotti, R, De Fina, S, Cesana, G, Uggeri, F, and Conti, M
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Male ,Prognosi ,Injections, Subcutaneous ,CD4-CD8 Ratio ,Adenocarcinoma ,Injections, Subcutaneou ,Risk Assessment ,Drug Administration Schedule ,Postoperative Complications ,Stomach Neoplasm ,Gastrectomy ,Reference Values ,Stomach Neoplasms ,Preoperative Care ,MED/18 - CHIRURGIA GENERALE ,Humans ,Reference Value ,Aged ,Neoplasm Staging ,Dose-Response Relationship, Drug ,Middle Aged ,Prognosis ,Survival Analysis ,CD4 Lymphocyte Count ,Treatment Outcome ,Interleukin-2 ,Female ,Survival Analysi ,Postoperative Complication ,Human - Abstract
BACKGROUND/AIMS: Surgery has appeared to induce lymphocytopenia and this decrease in host defenses during postoperative period could promote both the proliferation of possible micrometastases and the implantation of surgically disseminated tumor cells. The aim of this study is to evaluate if the preoperative subcutaneous injection of IL-2 (interleukin-2) may be able to abrogate surgery-induced immunosuppression in radically operable gastric cancer and to assess its toxicity. METHODOLOGY: This phase II study included 39 consecutive patients with histologically proven gastric adenocarcinoma (M/F 26/13; mean age 68; range 48-82) who underwent radical surgery from October 1999 to December 2000. Patients were randomized to be treated with surgery alone as controls (20 patients) or surgery plus preoperative treatment with recombinant human IL-2 (19 patients). IL-2 was administered subcutaneously, at a dose of 9,000,000 IU, for three consecutive days, followed by surgery within 36 hours from IL-2 withdrawal. We considered the total lymphocyte count and lymphocyte subset (CD4, CD4/CD8) during the preoperative period, before IL-2 administration, and on the 14th and 50th day. RESULTS: Two groups were well matched for type of surgery and extent of disease. All the patients underwent radical surgery plus D2 lymphadenectomy. At baseline, there were no significant differences in total lymphocyte and lymphocyte subsets between groups. The control group showed a significant decrease of total lymphocytes, CD4 cells, and CD4/CD8 ratio at the 14th postoperative day relative to the baseline value. Among the 22 patients evaluated in the control group 13 had a decreased of CD4 under 500 cells/mm3 (65%). Instead in the IL-2 group a significant increase was observed over the control group values of total lymphocytes and CD4 cells (14th ly total and CD4: IL-2 vs. control p
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- 2004
13. Laparoscopic cholecystectomy and unsuspected gallbladder cancer
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ROMANO, FABRIZIO, UGGERI, FRANCO, Franciosi, C, Caprotti, R, De Fina, S, Porta, G, Visintini, G, Romano, F, Franciosi, C, Caprotti, R, De Fina, S, Porta, G, Visintini, G, and Uggeri, F
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unsuspected carcinoma ,neoplasm seeding ,reoperation ,gallbladder neoplasm ,laparoscopic cholecystectomy - Abstract
Gallbladder cancer is a relatively uncommon malignancy. Its presentation is similar to that of gallstone disease and sometimes with non-specific symptoms. Laparoscopic cholecystectomy has become the method of choice for removing the gallbladder in most benign conditions. Occasionally, unsuspected gallbladder carcinoma is encountered in association with laparoscopic cholecystectomy. Overall gallbladder cancers have a poor prognosis, despite surgery or adjuvant therapies. However, in selected cases, a favourable outcome can be expected and the less favourable predicted outcome can be improved. Management of patients with gallbladder cancer in different situations is discussed: gallbladder cancer noted post-operatively on final pathology, gallbladder cancer noted after removal of the gallbladder and opening of the specimen at the time of surgery, difficulty encountered at the time of dissection and resultant suspicion of gallbladder cancer, and diagnosis of extensive disease at initial placement of the laparoscope. (C) 2001 Harcourt Publishers Ltd.
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- 2001
14. Il trattamento chirurgico del carcinoma gastrico (Esperienza personale su 706 casi)
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Uggeri, F, Porta, G, Caprotti, R, FRANCIOSI, CLAUDIO MARIA, De Fina, S, Musco, F, Romano, F, Sartori, P, COLOMBO, GIOVANNI, Uggeri, F, Porta, G, Caprotti, R, Franciosi, C, De Fina, S, Musco, F, Romano, F, Sartori, P, and Colombo, G
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Adenocarcinoma,Gastrectomy,Lymphnode excision,Stomach neoplasms, surgery - Abstract
Background. Gastric cancer is still one of the most frequent tumors in Western Countries. Until now surgery seems to be the only effective therapy and chemotherapy doesn't improve the long term survival. Extension of exeresis and lymphectomy related to localization and staging of neoplasm are still debated. Methods. From January 1989 to December 1998, 706 patients with gastric adenocarcinoma have been treated at the 1st Surgical Clinic. The males/females ratio was 1.6/1 and the average age was 67.2 years (32-91); 342 neoplasms were of intestinal type of Lauren's classification, 297 were of diffused type, 18 mixed. In 525 cases a curative intervention was performed (resecability 76.6%), with 273 total gastrectomies (248 Roux-en-Y reconstructions), 242 subtotal gastrectomies (237 Billroth 2 gastrojejunal anastomosis, 7 esophagectomies and 1 proximal gastric resection, associated to second level lymph nodes dissection (D2). Results. Mean hospital stay was 13.7 days (9-45). The mortality rate was 4% (21 patients, 14 after total gastrectomy and 7 after gastric resection respectively). Overall morbidity was 18% (95 cases) and specific morbidity was 7.2% (38 cases). Thirty-eight neoplasms (7.2%) were staged as Ia, 62 (11.8%) Ib, 110 (21%) II, 80 (15.2 %) IIIa, 72 (13.8 %) IIIb and 163 (31%) IV. In 213 patients (40.6 %) lymph nodes were not involved by neoplastic infiltration, while 158 cases (30.1%) were N1 and 154 (29.3%) N2. Overall 5 years survival was 31.8%, 87.5% for stage I, 41.3% for stage II, 25.3% for stage III and 5.2% for IV (p
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- 2001
15. Considerazioni sulla terapia chirurgica del prolasso del retto
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GABRIELLI, FRANCESCO, GUTTADAURO, ANGELO, Caprotti, R, Franciosi, C., Gabrielli, F, Guttadauro, A, Caprotti, R, and Franciosi, C
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prolasso rettale, emorroidi - Published
- 2001
16. Sequential endo-laparoscopic treatment in patients with common bile calculi
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Franciosi, C, Caprotti, R, De Fina, S, Sartori, P, Visintini, G, ROMANO, FABRIZIO, COLOMBO, GIANLUCA, UGGERI, FABIO, UGGERI, FRANCO, Franciosi, C, Caprotti, R, De Fina, S, Romano, F, Colombo, G, Uggeri, F, Sartori, P, and Visintini, G
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Aged, 80 and over ,Adult ,Male ,Cholecystectomy, Laparoscopic ,Adolescent ,Retrospective Studie ,Gallstone ,Child, Preschool ,Female ,Middle Aged ,Child ,Human ,Aged - Abstract
Laparoscopic treatment of common bile duct (CBD) stones is gaining great acceptance worldwide, but actually it requires skills and technologies too expensive for a great part of general surgeons. So endoscopic removal of CBD stones before cholecystectomy is usually performed. Since 1991 in our department we started a policy of selective preoperative cholangiopancreatography (ERCP) in patients suspected for choledocholithiasis and waiting for laparoscopic cholecystectomy.
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- 2000
17. Harm free use of diesel additives
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Caprotti, R.
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Automobile industry ,Business - Abstract
Extensive testing is necessary to demonstrate that use of new detergents and defoamers will not create troubles in the field. The contribution made by motor vehicles to air pollution has [...]
- Published
- 1999
18. Extensive Sclerosing Mesenteritis of the Rectosigmoid Colon Associated with Erosive Colitis
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Nobili, C., Degrate, L., Caprotti, R., Franciosi, C., Leone, B. E., Romano, F., Dinelli, M., and Uggeri, Fr.
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Article Subject ,digestive system diseases - Abstract
Sclerosing mesenteritis is a rare, idiopatic, usually benign, inflammatory process of the mesenteric adipose tissue. The most common site of involvement is the small bowel mesentery. We present a case of sclerosing mesenteritis of the rectosigmoid colon as a cause of severe abdominal pain, abdominal obstruction, and ischemic colic mucosal lesions. Contrast enema, colonoscopy, angiography, and CT were the imaging modalities used. A 20 cm diameter, fibrotic mass causing extensive compression of rectosigmoid colon was found at laparotomy. Histological examination showed extended fibrosis, inflammatory cells infiltration, lipophages, and granulomas within the mesenteric adipose tissue associated with erosive colitis. Clinical presentation and treatment are discussed.
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- 2009
- Full Text
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19. Different methods of dissection durino laparoscopic splenectomy
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Gelmini, Roberta, Romano, F, Andreotti, Alessia, Caprotti, R, Franzoni, Chiara, Scaini, A, Saviano, Massimo, and Uggeri, F.
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laparoscopic splenectomy - Published
- 2006
20. The Italian Registry of Laparoscopic Surgery of the Spleen (IRLSS) A retrospective review of 379 patients undergoing laparoscopic splenectomy
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Casaccia, M., Torelli, P., Squarcia, S., Sormani, M. P., Savelli, A., Troilo, B. M., Santori, G., Valente, U., Basso, N., Silecchia, G., Bresadola, F., Terrosu, G., Pietrabissa, A., Valeri, F. M., Prosperi, P., Saviano, M., Gelmini, R., Uggeri, F., Caprotti, R., Romano, F., Logrieco, G., Moraldini, A., Dallatorre, A., Rosati, R., Stefano Bona, Cavaliere, P., Cavaliere, D., Spinoglio, G., Buccoliero, F., Berta, R., Pedrazzolir, C., Bigi, L., Barbieri, I. M., Donini, I., Donini, A., Colecchia, G., Monteferrante, E., Prete, F., Memeo, V., and Puglisi, F.
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Adult ,Male ,Adolescent ,italian registry ,laparoscopic splenectomy ,Videolaparoscopic Surgery ,Medical Records ,Surveys and Questionnaires ,Humans ,Child ,Italian Registry of Laparoscopic Surgery of the Spleen ,Aged ,Retrospective Studies ,Aged, 80 and over ,Splenectomy ,Hematologic Diseases ,IRLSS ,Middle Aged ,Survival Analysis ,Treatment Outcome ,Italy ,Child, Preschool ,Splenomegaly ,Female ,Laparoscopy - Abstract
In December 2000, the Italian Registry of Laparoscopic Surgery of the Spleen (IRLSS) was formally launched under the auspices of the Italian Society for Endoscopic Surgery and New Technologies (SICE). The aim of this multicentre study was to analyse various aspects of the treatment that are still under discussion, such as the extension of the laparoscopic indications in cases of malignancy, independently of the associated splenomegaly, patient selection and operative techniques. A retrospective review of 379 patients undergoing laparoscopic splenectomy for haematological diseases from February 1, 1993, to September 15, 2005, was conducted. Data were collected from the 18 italian centres participating in the IRLSS. The mean length of surgery was 140 minutes (range: 25-420). Conversion was necessary in 25 cases (6.6%), and at least one accessory spleen was found in 30 patients (8%). The mean spleen weight was 1200 g (range: 85-4500). Perioperative death occurred in two cases (0.5%). There were no complications in 312 patients (82.3%), with a mean hospital stay of 5.5 days (range: 2-30). Morbidity occurred in 67 patients (17.8%), mainly consisting in transient fever (n = 22), pleural effusions (n = 16), and actual or suspected haemorrhage (n = 14), requiring re-intervention in 7 patients. This first study carried out on the IRLSS data shows that laparoscopic splenectomy may constitute the gold standard for haematological diseases with a normal-sized spleen. The low morbidity and mortality rates suggest that laparoscopic splenectomy can be successfully proposed also for splenomegaly in haematological malignancies.
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- 2006
21. Sutureless and stapleless laparoscopic splenectmy with radiofrequency
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Romano, F., Gelmini, Roberta, Caprotti, R., Quaranta, Nicola, Uggeri, F., and Saviano, Massimo
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radiofrequency ,laparoscopic splenectomy - Published
- 2005
22. Bipolar vessel sealing system vs. clamp crushing technique for liver parenchyma transection
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Garancini, M, Gianotti, L, Mattavelli, I, Romano, F, Degrate, L, Caprotti, R, Nespoli, A, Uggeri, F, GARANCINI, MATTIA, GIANOTTI, LUCA VITTORIO, MATTAVELLI, ILARIA, ROMANO, FABRIZIO, DEGRATE, LUCA, CAPROTTI, ROBERTO, NESPOLI, ANGELO, UGGERI, FRANCO, Garancini, M, Gianotti, L, Mattavelli, I, Romano, F, Degrate, L, Caprotti, R, Nespoli, A, Uggeri, F, GARANCINI, MATTIA, GIANOTTI, LUCA VITTORIO, MATTAVELLI, ILARIA, ROMANO, FABRIZIO, DEGRATE, LUCA, CAPROTTI, ROBERTO, NESPOLI, ANGELO, and UGGERI, FRANCO
- Abstract
To evaluate the impact of the traditional clamp-crush technique and a radiofrequency bipolar vessel sealing device (BVSD) for liver resection on operative blood loss, transfusion rate, duration of operation, length of hospitalization and morbidity.
- Published
- 2011
23. Putative predictive parameters for the outcome of laparoscopic splenectomy: A multicenter analysis performed on the italian registry of laparoscopic surgery of the spleen
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Casaccia, M, Torelli, P, Pasa, A, Sormani, M, Rossi, E, Valente, U, Spinoglio, G, Prete, F, Logrieco, G, Buccoliero, F, Berta, R, Donini, I, Donini, A, Valeri, A, Prosperi, P, Saviano, M, Gelmini, R, Uggeri, F, Caprotti, R, Romano, F, Colecchia, G, Monteferrante, E, Pedrazzoli, C, Bigi, L, Barbieri, I, Moraldi, A, Dallatorre, A, Basso, N, Silecchia, G, Rosati, R, Bona, S, Cavaliere, P, Bresadola, F, Terrosu, G, Mosca, F, Pietrabissa, A, Memeo, V, Puglisi, F, Dionigi, R, Benevento, A, Boni, L, Liboni, A, Feo, C, Borghi, F, Geretto, P, Moroni, R, Sorrentino, M, di Sebastiano, P, Ambrosio, A, Verdecchia, G, Cavaliere, D, Sormani, MP, Donini I, Donini A, Valeri A, Prosperi P, Saviano M, Gelmini R, Colecchia G, Monteferrante E, Pedrazzoli C, Bigi L, Barbieri IM, Moraldi A, Dallatorre A, Basso N, Silecchia G, Rosati R, Bona S, Cavaliere P, Bresadola F, Terrosu G, Mosca F, Pietrabissa A, Memeo V, Puglisi F, Dionigi R, Benevento A, Boni L, Liboni A, Feo C, Borghi F, Geretto P, Torelli P, Moroni R, Sorrentino M, di Sebastiano P, Ambrosio A, Verdecchia GM, Cavaliere D., UGGERI, FRANCO, ROMANO, FABRIZIO, Casaccia, M, Torelli, P, Pasa, A, Sormani, M, Rossi, E, Valente, U, Spinoglio, G, Prete, F, Logrieco, G, Buccoliero, F, Berta, R, Donini, I, Donini, A, Valeri, A, Prosperi, P, Saviano, M, Gelmini, R, Uggeri, F, Caprotti, R, Romano, F, Colecchia, G, Monteferrante, E, Pedrazzoli, C, Bigi, L, Barbieri, I, Moraldi, A, Dallatorre, A, Basso, N, Silecchia, G, Rosati, R, Bona, S, Cavaliere, P, Bresadola, F, Terrosu, G, Mosca, F, Pietrabissa, A, Memeo, V, Puglisi, F, Dionigi, R, Benevento, A, Boni, L, Liboni, A, Feo, C, Borghi, F, Geretto, P, Moroni, R, Sorrentino, M, di Sebastiano, P, Ambrosio, A, Verdecchia, G, Cavaliere, D, Sormani, MP, Donini I, Donini A, Valeri A, Prosperi P, Saviano M, Gelmini R, Colecchia G, Monteferrante E, Pedrazzoli C, Bigi L, Barbieri IM, Moraldi A, Dallatorre A, Basso N, Silecchia G, Rosati R, Bona S, Cavaliere P, Bresadola F, Terrosu G, Mosca F, Pietrabissa A, Memeo V, Puglisi F, Dionigi R, Benevento A, Boni L, Liboni A, Feo C, Borghi F, Geretto P, Torelli P, Moroni R, Sorrentino M, di Sebastiano P, Ambrosio A, Verdecchia GM, Cavaliere D., UGGERI, FRANCO, and ROMANO, FABRIZIO
- Abstract
OBJECTIVE: To identify predictive risk factors for conversion to open splenectomy and postoperative complications in patients undergoing elective laparoscopic splenectomy. BACKGROUND: The laparoscopic approach represents the "gold standard" for splenectomy, but its use in the treatment of splenomegaly and malignant disease is controversial. Factors that influence immediate outcome are clinical, anatomic, and pathologic. METHODS: Univariate and multivariate analyses of data from the Italian Registry of Laparoscopic Surgery of the Spleen, a multicenter database supported by 25 referral centers. Analysis of data (1993-2007) was performed on a series of patients (n = 676) undergoing elective laparoscopic splenectomy. Demographic data, the operative indications, the surgical technique applied, and any intra- and/or postoperative complications with respect to the patients were assessed. Records were analyzed retrospectively using the Student t test, the chi test, and logistic regression. RESULTS: Conversion to open splenectomy was necessary in 39 cases (5.8%). Perioperative deaths occurred in 3 cases (0.4%). There were no complications in 560 patients (82.8%), with a mean hospital stay of 5 days (range, 2-54). Overall, morbidity occurred in 116 patients (17.2%). Multivariate analysis found that the body mass index (P = 0.01) and the presence of hematologic malignancy (P < 0.001) were independent predictors for intraoperative complications and surgical conversion. Spleen longitudinal diameter (P = 0.001) and surgical conversion (P = 0.001) were independent predictors for the occurrence of postoperative complications. CONCLUSIONS: This large multicenter study provides evidence for the significance of predictive risk factors for intra- and postoperative complications in laparoscopic splenic surgery. Besides splenic dimensions, other factors like the patient's habitus and the specific underlying hematologic pathology should be recognized by the surgeon to reduce complications
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- 2010
24. Energy-based hemostatic devices in laparoscopic adrenalectomy
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Sartori, P, Romano, F, Uggeri, F, Colombo, G, Caprotti, R, Giannattasio, C, Scotti, M, Delitala, A, Prada, M, Sartori, PV, Scotti, MA, ROMANO, FABRIZIO, UGGERI, FABIO, GIANNATTASIO, CRISTINA, DELITALA, ALBERTO, UGGERI, FRANCO, Sartori, P, Romano, F, Uggeri, F, Colombo, G, Caprotti, R, Giannattasio, C, Scotti, M, Delitala, A, Prada, M, Sartori, PV, Scotti, MA, ROMANO, FABRIZIO, UGGERI, FABIO, GIANNATTASIO, CRISTINA, DELITALA, ALBERTO, and UGGERI, FRANCO
- Abstract
PURPOSE: In literature, few papers compare different hemostatic devices in laparoscopic adrenalectomy. This sequential cohort study analyzes the outcomes of laparoscopic adrenalectomy performed by different hemostatic instruments, to evaluate if any of them has any advantage over the other and as secondary endpoints, the impact of body mass index (BMI) and tumor size on the indication, and the outcome of laparoscopic adrenalectomy. METHODS: Forty-six patients, aged 54.6 +/- 46 years, underwent laparoscopic adrenalectomy over 5 years. Mean BMI was 27 +/- 4.8 kg/m(2). Twenty-four patients had a left tumor, and 22 had a right one. Patients were divided into two groups according to the hemostatic device: Ultracision was used in 26 patients, and Ligasure was used in 20. Groups were well matched for histology, tumor size and site, BMI, gender, and age. RESULTS: Mean operating time was 126.5 +/- 52 min, blood losses were 101 +/- 169 mm, conversion rate was 6.5%, morbidity was 26%, and hospitalization was 5.3 +/- 2.5 days. Groups did not differ for surgical time, blood losses, complications, and conversion rate; BMI and length of surgery were not related. Tumor side and size did not affect surgical time, regardless of the hemostatic tool. Patients submitted to left adrenalectomy bled more (p = 0.007) and had more complications (p = 0.016) than those undergone operation on the right side. CONCLUSIONS: Obesity (BMI > 30) and large masses do not contraindicate laparoscopic adrenalectomy. Left adrenalectomies bleed more and have a higher morbidity. Hemostatic device choice is up to surgeon's preference.
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- 2010
25. Challenging diagnosis of ileal gastrointestinal stromal tumor presenting with obscure digestive bleeding
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Degrate, L, Nobili, C, Garancini, M, Scotti, M, Romano, F, Franciosi, C, Caprotti, R, Uggeri, F, Scotti, MA, ROMANO, FABRIZIO, UGGERI, FRANCO, Degrate, L, Nobili, C, Garancini, M, Scotti, M, Romano, F, Franciosi, C, Caprotti, R, Uggeri, F, Scotti, MA, ROMANO, FABRIZIO, and UGGERI, FRANCO
- Abstract
We report a case of a patient observed in emergency condition for recurrent episodes of massive obscure gastrointestinal bleeding that required surgical control. At laparotomy we found an ileal mass with the characteristics of a gastrointestinal stromal tumor (GIST) at histopathological analysis. GISTs should always be considered as a possible cause of obscure gastrointestinal bleeding, although they are often difficult to diagnose preoperatively. Laparotomy is sometimes the only way to obtain a diagnosis. Starting from this case, we reviewed the literature about GISTs, focusing our attention on their diagnosis and the possible surgical and nonsurgical therapies.
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- 2009
26. Extensive sclerosing mesenteritis of the rectosigmoid colon associated with erosive colitis
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Nobili, C, Degrate, L, Caprotti, R, Franciosi, C, Leone, B, Romano, F, Dinelli, M, Uggeri, F, LEONE, BIAGIO EUGENIO, ROMANO, FABRIZIO, UGGERI, FRANCO, Nobili, C, Degrate, L, Caprotti, R, Franciosi, C, Leone, B, Romano, F, Dinelli, M, Uggeri, F, LEONE, BIAGIO EUGENIO, ROMANO, FABRIZIO, and UGGERI, FRANCO
- Abstract
Sclerosing mesenteritis is a rare, idiopatic, usually benign, inflammatory process of the mesenteric adipose tissue. The most common site of involvement is the small bowel mesentery. We present a case of sclerosing mesenteritis of the rectosigmoid colon as a cause of severe abdominal pain, abdominal obstruction, and ischemic colic mucosal lesions. Contrast enema, colonoscopy, angiography, and CT were the imaging modalities used. A 20 cm diameter, fibrotic mass causing extensive compression of rectosigmoid colon was found at laparotomy. Histological examination showed extended fibrosis, inflammatory cells infiltration, lipophages, and granulomas within the mesenteric adipose tissue associated with erosive colitis. Clinical presentation and treatment are discussed.
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- 2009
27. Short-term preoperative IL-2 immunotherapy in operable pancreatic cancer: A randomized study
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Uggeri, F, Caprotti, R, De Grate, L, Crippa, S, Nobili, C, Penati, C, Romano, F, UGGERI, FRANCO, ROMANO, FABRIZIO, Uggeri, F, Caprotti, R, De Grate, L, Crippa, S, Nobili, C, Penati, C, Romano, F, UGGERI, FRANCO, and ROMANO, FABRIZIO
- Abstract
BACKGROUND/AIMS: A cell-mediated immunodeficiency is demonstrated to occur in advanced cancer patients. Lymphocytopenia predicts a poor prognosis, moreover, the surgical trauma can worsen the impaired immune surveillance and favor disease recurrence. This study investigates the effectiveness of preoperative interleukin-2 administration to improve lymphocyte counts' postoperative recovery in pancreatic cancer. METHODOLOGY: 31 patients with pancreatic cancer who underwent radical surgery were randomized according to 3 different groups. Group A: 9 patients treated with human recombinant IL-2 subcutaneously at 9 million IU/day for 3 days before surgery; group B: 9 patients treated with IL-2 at 12 million IU/day for 3 days before surgery; group C: 13 patients treated with surgery alone. Assessment of total and T helper lymphocyte counts were studied at hospital admission and in 7th and 14th postoperative day. RESULTS: Toxicity of IL-2 treatment was mild in all groups. Postoperative lymphocytopenia was observed in group A and C, without statistical differences, whereas group B had mean lymphocyte levels within the normal values in the postoperative period. CONCLUSIONS: This preliminary result suggests that preoperative subcutaneously IL-2 immunotherapy at 12 million IU for 3 consecutive days before surgery is able to abrogate the effects of the surgical trauma and recover a normal immunofunction in pancreatic cancer patients., Background/Aims: A cell-mediated immunodeficiency is demonstrated to occur in advanced cancer patients. Lymphocytopenia predicts a poor prognosis, moreover, the surgical trauma can worsen the impaired immune surveillance and favor disease recurrence. This study investigates the effectiveness of preoperative interleukin-2 administration to improve lymphocyte counts' postoperative recovery in pancreatic cancer. Methodology: 31 patients with pancreatic cancer who underwent radical surgery were randomized according to 3 different groups. Group A: 9 patients treated with human recombinant IL-2 subcutaneously at 9 million IU/day for 3 days before surgery; group B: 9 patients treated with IL-2 at 12 million IU/day for 3 days before surgery; group C: 13 patients treated with surgery alone. Assessment of total and T helper lymphocyte counts were studied at hospital admission and in 7th and 14th postoperative day. Results: Toxicity of IL-2 treatment was mild in all groups. Postoperative lymphocytopenia was observed in group A and C, without statistical differences, whereas group B had mean lymphocyte levels within the normal values in the postoperative period. Conclusions: This preliminary result suggests that preoperative subcutaneously IL-2 immunotherapy at 12 million IU for 3 consecutive days before surgery is able to abrogate the effects of the surgical trauma and recover a normal immunofunction in pancreatic cancer patients. © H.G.E. Update Medical Publishing S.A.
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- 2009
28. Interleukin-2 immunotherapy action on innate immunity cells in peripheral blood and tumoral tissue of pancreatic adenocarcinoma patients
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Degrate, L, Nobili, C, Franciosi, C, Caprotti, R, Brivio, F, Romano, F, Leone, B, Trezzi, R, Uggeri, F, LEONE, BIAGIO EUGENIO, ROMANO, FABRIZIO, UGGERI, FRANCO, Degrate, L, Nobili, C, Franciosi, C, Caprotti, R, Brivio, F, Romano, F, Leone, B, Trezzi, R, Uggeri, F, LEONE, BIAGIO EUGENIO, ROMANO, FABRIZIO, and UGGERI, FRANCO
- Abstract
Background and aims: Innate immunity cells play a crucial role in host anticancer defense: cancer patients with high levels of natural killer (NK) cells and eosinophils have a better prognosis. Recombinant interleukin-2 (rIL-2) immunotherapy stimulates innate immunity cells. This study aims to evaluate the toxicity of pre- and postoperative rIL-2 treatment and the effects on innate immunity both in peripheral blood and in cancer tissue of patients with resectable pancreatic adenocarcinoma. Materials and methods: Seventeen patients received high dose rIL-2 preoperative subcutaneous administration and two low dose postoperative cycles. We evaluated NK cell and eosinophil count in blood and in pancreatic surgical specimens. Results: Toxicity was moderate. In the early postoperative period, blood NK cells and eosinophils significantly increased compared to basal values (p < 0.02). Histopathological analysis did not find significant intratumoral infiltration of NK cells nor of eosinophils. Conclusions: Preoperative high dose rIL-2 administration is able to counteract surgery-induced deficiency of NK cells and eosinophils in peripheral blood in the early postoperative period, although it cannot overcome local mechanisms of immune tumor escape in cancer tissue. The amplification of innate immunity, induced by immunotherapy, may improve the control of metastatic cells spreading in the perioperative period. © 2008 Springer-Verlag.
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- 2009
29. Prolonged survival of a patient affected by pancreatic adenocarcinoma with massive lymphocytic and dendritic infiltration after IL-2 immunotherapy. Report of a case
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Nobili, C, Degrate, L, Caprotti, R, Franciosi, C, Leone, B, Trezzi, R, Romano, F, Uggeri, F, NOBILI, CINZIA, DEGRATE, LUCA, LEONE, BIAGIO EUGENIO, ROMANO, FABRIZIO, UGGERI, FRANCO, UGGERI, FABIO, Nobili, C, Degrate, L, Caprotti, R, Franciosi, C, Leone, B, Trezzi, R, Romano, F, Uggeri, F, NOBILI, CINZIA, DEGRATE, LUCA, LEONE, BIAGIO EUGENIO, ROMANO, FABRIZIO, UGGERI, FRANCO, and UGGERI, FABIO
- Abstract
Several studies have shown that there is a paucity of immune cells within the stroma of pancreatic adenocarcinoma, a very aggressive cancer with a median survival of about 18 months. A 65-year-old man presented with jaundice. Abdominal ultrasound revealed intra- and extrahepatic bile duct dilatation and a 45-mm diameter hypoechoic solid mass within the pancreatic head; a computed tomography scan excluded vascular infiltration and metastatic lesions. The patient received immunotherapy consisting of 6,000,000 IU human recombinant interleukin-2 administered subcutaneously twice a day for 3 consecutive days. Thirty-six hours after the last dose, he underwent a pylorus-preserving pancreatoduodenectomy. Because of the presence of high-grade dysplasia detected by intraoperative histological examination of a distal section, a spleen preserving total pancreatectomy was performed. The postoperative course was uneventful. The patient died 32 months after surgery because of local recurrence. Histopathology showed G3 pancreatic ductal adenocarcinoma infiltrating the anterior and posterior peripancreatic tissue, duodenal wall and intrapancreatic common bile duct, with sarcoma-like foci and a component of intraductal tumor involving the common bile duct. In the distal pancreas, widespread foci of pancreatic intraepithelial neoplasia (PanIN2-3) were found. The Ki-67 proliferation index was 16%. TNM staging was pT3 pN1 R1. Sections were immunostained for the T-lymphocyte marker CD3 and for the dendritic cell marker CD 1a. Intratumoral infiltration was high for CD1a+ cells and mild for CD3+ cells. Preoperative immunotherapy with interleukin-2 may contribute to massive stromal infiltration of immune cells in pancreatic adenocarcinoma. This may prolong the survival even in the presence of negative prognostic factors (age >65 years, tumor diameter >20 mm, Rl, tumor grade G3).
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- 2008
30. Low-dose interleukin-2 administered pre-operatively to patients with gastric cancer activates peripheral and peritumoral lymphocytes but does not affect prognosis.
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Cesana, G, Romano, F, Piacentini, M, Scotti, M, Brenna, A, Bovo, G, Vaghi, M, Aletti, G, Caprotti, R, Kaufman, H, Uggeri, F, Cesana, GC, Piacentini, MG, ROMANO, FABRIZIO, UGGERI, FRANCO, Cesana, G, Romano, F, Piacentini, M, Scotti, M, Brenna, A, Bovo, G, Vaghi, M, Aletti, G, Caprotti, R, Kaufman, H, Uggeri, F, Cesana, GC, Piacentini, MG, ROMANO, FABRIZIO, and UGGERI, FRANCO
- Abstract
Background: There is evidence that cancer is immunogenic under certain situations. IL-2 is described to stimulate an effective antitumor immune response in vitro and in vivo. The ability of cancer patients to undergo surgical resection is still the most important prognostic factor for many solid tumors, including gastric adenocarcinoma. The host immune system may be further compromised by surgical procedures leading to a generalized state of immunodepression in the post-operative period. The aim of this randomized case-control study is to evaluate the effects of pre-operative low-dose IL-2 treatment on patients with gastric adenocarcinoma who undergo surgery. Methods: Sixty-eight patients with gastric adenocarcinoma were enrolled in the study and randomized in two groups: 36 patients were pre-treated with IL-2 and 32 underwent surgery without any treatment. Total peripheral WBC, neutrophils, CD3+ T, CD4+ T, CD8+ T and NK cells were obtained before and after surgery, at different times. Peritumoral infiltration was analyzed on all surgical specimens. Overall survival and relapse-free survival were studied with a median follow-up of 51 months. Results: Low-dose IL-2 treatment resulted in an increase peritumoral lymphocytic and eosinophilic infiltrations and in a minor decrease in CD3+ T and CD4+ T cells after surgery (P < 0.05). A stepwise multivariate analysis revealed that overall survival and relapse-free survival were affected only by stage of tumor and age of patients. Conclusions: According to our data low-doses of IL-2 administered pre-operatively to patients with gastric cancer activate peripheral and peri-tumoral lymphocytes but did not affect prognosis. © 2007 Society of Surgical Oncology.
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- 2007
31. Hepatic resections using a bipolar vessel sealing device
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Romano, F, Garancini, M, Caprotti, R, Bovo, G, Conti, M, Perego, E, Uggeri, F, ROMANO, FABRIZIO, UGGERI, FRANCO, Romano, F, Garancini, M, Caprotti, R, Bovo, G, Conti, M, Perego, E, Uggeri, F, ROMANO, FABRIZIO, and UGGERI, FRANCO
- Abstract
Introduction. Blood loss and bile leakage are well-known risk factors for morbidity and mortality during liver resection. Bleeding usually occurs during parenchymal transection, and surgical technique should be considered an important factor in preventing intraoperative and postoperative complications. Objective. Many approaches and devices have been developed to limit bleeding and bile leakage. The aim of the present study was to determine whether a bipolar vessel sealing device allows a safe and careful liver transection without routine inflow occlusion, achieving a satisfactory hemostasis and bile stasis, thus reducing blood loss and bile leak and related complications. Patients and methods. A total of 50 consecutive patients (24 males, 26 females, with a mean age of 57 years) underwent major and minor hepatic resections using a bipolar vessel sealing device. A clamp crushing technique followed by energy application was used to perform the parenchymal transection. Inflow occlusion was used when necessary to control blood loss but not as a routine. No other devices were applied to achieve hemostasis. Results. The instrument was effective in 45 patients and failed to achieve hemostasis in 5 cases, all of whom had a cirrhotic liver. Median blood loss was 490 ml (range 100-2500 ml) and intraoperative blood transfusions were required in eight cases (16%). Mean operative time was 178 min (range 50-315 min). Inflow occlusion was necessary in 16 (32%) patients. The postoperative complication rate was 24%, with a postoperative hemorrhage in a cirrhotic patient. There was no clinical evidence of bile leak or procedure-related abdominal abscess. Conclusion. We conclude that the device is a useful tool in standard liver resection, achieving good hemostasis and bile stasis in patients with normal liver parenchyma, but its use should be avoided in cirrhotic patients.
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- 2007
32. Pylephlebitis and mesenteric thrombophlebitis in sigmoid diverticulitis: medical approach, delayed surgery.
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Nobili, C, Uggeri, F, Romano, F, Degrate, L, Caprotti, R, Perego, P, Franciosi, C, NOBILI, CINZIA, UGGERI, FRANCO, ROMANO, FABRIZIO, DEGRATE, LUCA, UGGERI, FABIO, Nobili, C, Uggeri, F, Romano, F, Degrate, L, Caprotti, R, Perego, P, Franciosi, C, NOBILI, CINZIA, UGGERI, FRANCO, ROMANO, FABRIZIO, DEGRATE, LUCA, and UGGERI, FABIO
- Abstract
A 57-year-old woman presented with fever, vomiting and arthralgia, with a history of rheumatoid arthritis. Laboratory tests showed leucocytes, anaemia and elevation of C-reactive-protein (CRP). Blood cultures were positive for Gram negative bacteria and Streptococcus viridans. Patient underwent abdominal Computed Tomography (CT) scan revealing sigmoid acute diverticulitis with peridiverticular abscesses and thrombophlebitis within the inferior mesenteric and portal veins. She started antibiotic and anticoagulant therapy. After 20 days, a second CT revealed a thrombosis involving the superior mesenteric vein also. After 22 days of therapy the patient was discharged with the resolution of the septic status. Two months after discharge the patient underwent left hemicolectomy for a histopathologically documented diverticulitis with an uneventful postoperative course. This is a description of a rare association of septic thrombosis within the portal, inferior mesenteric and superior mesenteric veins during acute sigmoid diverticulitis with abdominal abscesses. Our therapeutic strategy was a first line medical approach and delayed surgery. © 2007 Editrice Gastroenterologica Italiana S.r.l.
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- 2007
33. A case of pancreatic heterotopy of duodenal wall, intraductal papillary mucinous tumor and intraepithelial neoplasm of pancreas, papillary carcinoma of kidney in a single patient
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Nobili, C, Franciosi, C, Degrate, L, Caprotti, R, Romano, F, Perego, E, Trezzi, A, Leone, B, Uggeri, F, ROMANO, FABRIZIO, LEONE, BIAGIO EUGENIO, UGGERI, FRANCO, Nobili, C, Franciosi, C, Degrate, L, Caprotti, R, Romano, F, Perego, E, Trezzi, A, Leone, B, Uggeri, F, ROMANO, FABRIZIO, LEONE, BIAGIO EUGENIO, and UGGERI, FRANCO
- Abstract
We report a case of the contemporaneous presence of two histologically different pancreatic neoplasms, one renal cancer and one embryogenic duodenal anomaly in a single patient. A 66-year-old man underwent ultrasound examination because of urinary disorders; a solid neoformation within the inferior pole of the left kidney was observed. Computed tomography confirmed the renal lesion, but also a heterogeneous mass within the pancreatic head appeared without bile ducts dilatation. Abdominal magnetic resonance revealed a multiloculated cystic component of the pancreatic mass. A second CT scan confirmed the renal and biliary findings, but it revealed a modest enlargement of the pancreatic asymptomatic mass. A resection of the left kidney inferior pole and a pylorus-preserving pancreaticoduodenectomy were performed. Histopathologic analysis of the surgical specimen revealed mild differentiated papillary renal carcinoma, intraductal papillary mucinous adenoma of the pancreatic head, foci of intraepithelial pancreatic neoplasm and pancreatic heterotopy of duodenal muscular and submucosal layers. The coexistence of several primaries and anomalies in one patient led us to suppose a genetic predisposition to different lesions, even in the absence of known familial genetic syndromes. The study of such cases may help to improve the investigation of molecular correlations and etiological factors of different solid tumors. Nowadays, surgery is the only effective cure.
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- 2006
34. Sutureless and stapleless laparoscopic splenectomy using radiofrequency: LigaSure device
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Gelmini, R, Romano, F, Quaranta, N, Caprotti, R, Tazzioli, G, Colombo, G, Saviano, M, Uggeri, F, ROMANO, FABRIZIO, UGGERI, FRANCO, Gelmini, R, Romano, F, Quaranta, N, Caprotti, R, Tazzioli, G, Colombo, G, Saviano, M, Uggeri, F, ROMANO, FABRIZIO, and UGGERI, FRANCO
- Abstract
Background: Bleeding is the main complication and cause of conversion during laparoscopic splenectomy (LS). We present the advantages of the LigaSure vessel sealing system added to the lateral approach for achieving safe vascular control. Methods: We performed 63 consecutive LS in a 3-year period using LigaSure in two affiliated university hospitals. We employed a right semilateral position technique with dissection of the spleen and vessel sealing using LigaSure. Forty-two patients had benign hematological disease, 19 had malignant disease, and two had splenic cysts. Results: A total of 58 LS were completed with five conversions due to hilar bleeding (three cases), difficult dissection (one), and massive splenomegaly (one). In all but five patients, blood loss was less than 100 ml. No transfusions were needed. There were five postoperative complications: portal thrombosis (one case), hemoperitoneum (two), surgical wound infection (one), and pleural effusion (one). Conclusions: The use of LigaSure, and the semilateral position, results in a gain of time and safety. Furthermore, average intraoperative bleeding is very low. © Springer Science+Business Media, Inc. 2006.
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- 2006
35. Preoperative IL-2 immunotherapy enhances tumor infiltrating lymphocytes (TILs) in gastric cancer patients
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Romano, F, Cesana, G, Caprotti, R, Bovo, G, Uggeri, F, Piacentini, M, Crippa, S, ROMANO, FABRIZIO, CESANA, GIANCARLO, UGGERI, FRANCO, PIACENTINI, MARIA GAIA, CRIPPA, STEFANIA, UGGERI, FABIO, Romano, F, Cesana, G, Caprotti, R, Bovo, G, Uggeri, F, Piacentini, M, Crippa, S, ROMANO, FABRIZIO, CESANA, GIANCARLO, UGGERI, FRANCO, PIACENTINI, MARIA GAIA, CRIPPA, STEFANIA, and UGGERI, FABIO
- Abstract
Background/Aims: Tumor infiltrating lymphocytes (TILs), recognized as a tumor-host reaction, have been linked to prognosis in various tumors, with a clear positive correlation between the density of the lymphoid infiltrate at the advancing margin of the tumor and the prognosis of the patients. TILs are somewhat activated by tumor associated antigens and by IL-2 endogenous release. The aim of this study is to verify if subcutaneously administered IL-2 is able to enhance TILs in gastric cancer patients and is able to influence the prognosis of the patients. Methodology: We enrolled 39 consecutive patients with gastric adenocarcinoma. Patients were randomized to be treated with surgery alone (control group, 20 patients) or with surgery plus preoperative IL-2 (Interleukin-2) administration (treated group, 19 patients). Total lymphocytes, CD4 and CD4/CD8 were evaluated pre- and postoperatively. Peritumoral stromal reaction, neutrophils, lymphocytes and eosinophils infiltration in tumor histology were evaluated as well as survival curves and compared between the groups. Results: IL-2 treatment was safe and well tolerated, and in the IL-2 treated group a significant increase over the baseline pretreatment values of the total lymphocyte, CD4 and CD4/CD8 on both the 14th and 50th postoperative days was observed (p<0.05). Peritumoral stromal reaction, neutrophils and eosinophils infiltration did not shown any statistical difference between the two groups. Otherwise we observed a statistically significant difference in the peri- and intratumoral lymphocytes infiltration between IL-2 treated and control patients (p=0.000026). Median overall and disease-free survivals were longer, even if not significantly, in the IL-2 group than in the control arm (p=0.089 and p=0.09 respectively). Conclusions: Our data shows that IL-2 seems to be able to induce substantial changes in the inflammatory infiltration of the neoplasm, improving the host activity toward the tumor and enhancing the T
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- 2006
36. Elective laparoscopic splenectomy and thrombosis of the spleno-portal axis. A prospective study with ecocolordoppler ultrasound
- Author
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Romano, F, Caprotti, R, Scaini, A, Conti, M, Scotti, M, Colombo, G, Uggeri, F, ROMANO, FABRIZIO, UGGERI, FRANCO, Romano, F, Caprotti, R, Scaini, A, Conti, M, Scotti, M, Colombo, G, Uggeri, F, ROMANO, FABRIZIO, and UGGERI, FRANCO
- Abstract
Thrombosis of the portal system is a potentially life-threatening but otherwise underappreciated complication after splenectomy. Nonspecific and mild onset symptoms are the cause of delay in diagnosis, and the short hospital stay after laparoscopic approach could even contribute to the difficulty of early detection of this condition. The aim of this study was to verify if planned imaging controls are able to discover this complication leading to a prompt treatment. Thirty-eight patients (19 males and 19 females with a mean age of 24 years) who underwent laparoscopic splenectomy at our institution were studied to identify clinical signs of thrombosis of the portal venous system and eventually associated factors. All the patients were enrolled in a protocol of imaging surveillance using a doppler ultrasound method. Postoperative thrombosis of the spleno-portal axis occurred in 7 patients (18.9%) of the series. In 3 cases (8.1%) the thrombus extended from the splenic vein to occlude the portal axis. The complication was symptomatic in 4 cases (10.8%), whereas in 3 cases, the thrombosis was an ultrasonographic surprise in totally asymptomatic patients. Thrombosis occurred even as late as 2 months after splenectomy. Splenomegaly was the only significant factor predictive of thrombosis. Only those patients who had an early detection of portal or splenic vein thrombosis had a recanalization of the veins with anticoagulant therapy. Patients with splenomegaly who underwent laparoscopic splenectomy are at risk of thrombosis of the portal system and should undergo strict imaging surveillance and aggressive anticoagulation therapy. Copyright © 2006 by Lippincott Williams & Wilkins.
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- 2006
37. Thrombosis of the splenoportal axis after splenectomy
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Romano, F, Caprotti, R, Conti, M, Piacentini, M, Uggeri, F, Motta, V, Pogliani, E, ROMANO, FABRIZIO, PIACENTINI, MARIA GAIA, UGGERI, FRANCO, POGLIANI, ENRICO MARIA, UGGERI, FABIO, Romano, F, Caprotti, R, Conti, M, Piacentini, M, Uggeri, F, Motta, V, Pogliani, E, ROMANO, FABRIZIO, PIACENTINI, MARIA GAIA, UGGERI, FRANCO, POGLIANI, ENRICO MARIA, and UGGERI, FABIO
- Abstract
Background and aims: Thrombosis of the portal system is a potentially life-threatening complication after splenectomy. The reported incidence is low (≅1%), however may be underestimated due to difficult in making the diagnosis. The factors associated with its development and the clinical outcome are poorly characterized. The aim of this study was to assess the incidence, risk factors, treatment, and outcome in series of consecutive cases. Materials and methods: All patients who had undergone a splenectomy (both open and laparoscopic) between January 1997 and December 2004 at the Department of Surgery of University of Milan Bicocca were retrospectively reviewed. Twelve cases of thrombosis (7.6%) among 158 splenectomies were identified. No significant differences were noted in age, gender, and surgical approach between patients who developed thrombosis and those who did not. Indication for splenectomy in patients with thrombosis were myeloproliferative disorders (n=5), hemolytic disease (n=4), and lymphoproliferative disorder (n=3). All patients had splenomegaly (mean 1.380 kg, range 0.400-3.120 kg). Results: Among patients with myeloproliferative disorders, five (33%) developed the complication, compared with 4 of 35 (11.5%) with hemolytic disease. Patients with both splenic weight >2.500 kg and myeloproliferative disorders had 80% incidence of portal thrombosis. Preoperative prophylactic anticoagulant therapy with low molecular weight heparin was administered in each case. All these patients had fever, abdominal pain, or leukocytosis. All diagnoses were made by contrast-enhanced computed tomography (CT) scan and ecocolordoppler ultrasonography, and anticoagulation therapy was initiated immediately. Treatment within 15 days after splenectomy was successful in all patients, while delayed treatment was ineffective. Conclusions: Portal thrombosis should be suspected in patients with fever or abdominal pain after splenectomy. Patients with myeloproliferative disorders an
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- 2006
38. Management of small bowel tumors: personal experience and new diagnostic tools
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Mussi, C, Caprotti, R, Scaini, A, Angelini, C, Crippa, S, Uggeri, F, Sartori, P, Sartori, P., UGGERI, FABIO, UGGERI, FRANCO, Mussi, C, Caprotti, R, Scaini, A, Angelini, C, Crippa, S, Uggeri, F, Sartori, P, Sartori, P., UGGERI, FABIO, and UGGERI, FRANCO
- Abstract
Small bowel tumors are uncommon lesions that are infrequently suspected. We analyzed the clinical presentation, traditional and new diagnostic tools, surgical treatment, and survival in our experience. This was a retrospective review of 45 patients with small bowel neoplasm over a 20-year period. Preoperative diagnosis was made only in 17 cases (38%). One lesion was shown using a new diagnostic system: wireless capsule endoscopy (WCE). All patients underwent surgery. Mean 5-year overall survival for malignancies was 23%. Female sex and localized disease were positive prognostic factors for survival. Small bowel neoplasms must be considered in differential diagnosis in patients with abdominal symptoms, weight loss, and intestinal bleeding. Because the preoperative diagnosis rarely is made with traditional diagnostic tools, patients are seen late in the course of the disease, and the prognosis is poor. WCE is useful for identifying lesions earlier than by other diagnostic procedures.
- Published
- 2005
39. Phase-II randomized study of preoperative IL-2 administration in radically operable gastric cancer patients
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Romano, F, Piacentini, M, Franciosi, C, Caprotti, R, De Fina, S, Cesana, G, Uggeri, F, Conti, M, ROMANO, FABRIZIO, UGGERI, FABIO, UGGERI, FRANCO, Piacentini, MG, Romano, F, Piacentini, M, Franciosi, C, Caprotti, R, De Fina, S, Cesana, G, Uggeri, F, Conti, M, ROMANO, FABRIZIO, UGGERI, FABIO, UGGERI, FRANCO, and Piacentini, MG
- Abstract
BACKGROUND/AIMS: Surgery has appeared to induce lymphocytopenia and this decrease in host defenses during postoperative period could promote both the proliferation of possible micrometastases and the implantation of surgically disseminated tumor cells. The aim of this study is to evaluate if the preoperative subcutaneous injection of IL-2 (interleukin-2) may be able to abrogate surgery-induced immunosuppression in radically operable gastric cancer and to assess its toxicity. METHODOLOGY: This phase II study included 39 consecutive patients with histologically proven gastric adenocarcinoma (M/F 26/13; mean age 68; range 48-82) who underwent radical surgery from October 1999 to December 2000. Patients were randomized to be treated with surgery alone as controls (20 patients) or surgery plus preoperative treatment with recombinant human IL-2 (19 patients). IL-2 was administered subcutaneously, at a dose of 9,000,000 IU, for three consecutive days, followed by surgery within 36 hours from IL-2 withdrawal. We considered the total lymphocyte count and lymphocyte subset (CD4, CD4/CD8) during the preoperative period, before IL-2 administration, and on the 14th and 50th day. RESULTS: Two groups were well matched for type of surgery and extent of disease. All the patients underwent radical surgery plus D2 lymphadenectomy. At baseline, there were no significant differences in total lymphocyte and lymphocyte subsets between groups. The control group showed a significant decrease of total lymphocytes, CD4 cells, and CD4/CD8 ratio at the 14th postoperative day relative to the baseline value. Among the 22 patients evaluated in the control group 13 had a decreased of CD4 under 500 cells/mm3 (65%). Instead in the IL-2 group a significant increase was observed over the control group values of total lymphocytes and CD4 cells (14th ly total and CD4: IL-2 vs. control p<0.05). Moreover in this group only 3 patients had CD4 under 500 cells/mm3 (15%). This difference in CD4 count, is signi
- Published
- 2004
40. Cystic liver metastases from lung adenocarcinoma: a case report
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Romano, F, Porta, A, Caprotti, R, Uggeri, F, Conti, M, ROMANO, FABRIZIO, Uggeri, F., UGGERI, FABIO, Romano, F, Porta, A, Caprotti, R, Uggeri, F, Conti, M, ROMANO, FABRIZIO, Uggeri, F., and UGGERI, FABIO
- Abstract
Cystic hepatic metastases arising from lung cancer are rare. We herein describe a case of a 71-year-old women admitted to our hospital for abdominal pain 6 months after the resection of a lung adenocarcinoma. Two cystic lesions of the liver were discovered at abdominal ultrasonography and computerized tomography scan. An ERCP excluded a biliary adenoma or adenocarcinoma, and an ultrasound-guided liver biopsy was negative for malignant cells. For persistence of symptoms and lack of a diagnosis, the patient underwent an exploratory laparotomy, a surgical biopsy with a diagnosis of adenocarcinoma, and a consequent right hepatectomy. After 2 years of follow-up, the patient is well and disease free. Although cystic liver metastasis are rare and a differential diagnosis difficult, the malignant nature should always be considered in the differential diagnosis of hepatic cysts to offer the patient the best treatment.
- Published
- 2004
41. Immunodeficiency in different histotypes of radically operable gastrointestinal cancers
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Romano, F, Uggeri, F, Crippa, S, Di Stefano, G, Scotti, M, Scaini, A, Caprotti, R, ROMANO, FABRIZIO, UGGERI, FRANCO, UGGERI, FABIO, Romano, F, Uggeri, F, Crippa, S, Di Stefano, G, Scotti, M, Scaini, A, Caprotti, R, ROMANO, FABRIZIO, UGGERI, FRANCO, and UGGERI, FABIO
- Abstract
Cell-mediated immunodeficiency, with Total and T lymphocytes count decrease, is well established in cancer patients and it predicts a poor prognosis and poor survival rates. Furthermore, major surgery induces a transient immunodeficiency, too. Nevertheless, cell-mediated immunity in pancreatic cancer, which has a very poor prognosis, has not been completely outlined. Aim of this study is to evaluate the cell-mediated IL-2 dependent immune status in operable pancreatic cancer patients and to compare it with other gastrointestinal tumors. One hundred and twenty-one cancer patients (22 pancreatic, 48 gastric and 51 colorectal), with a median age of 66 years (range 42-83), 55 males and 66 females, were enrolled. Total lymphocyte count and lymphocytes subset (T helper count - CD4+) were assessed preoperatively and on the 14th and 50th postoperative day. Results obtained were compared between the groups and related to nodal involvement (NO versus N+). Colorectal and gastric cancer patients showed quantitative lymphocyte deficiency at baseline in 29% and 41% of cases, respectively. Fourteen days after surgery values below normal range were found in 44% and 54% (Total) and 53% and 67% (T helper), respectively. Recovery of postoperative surgery-related lymphocytopenia occurred late only in patients with normal count at baseline. According to regional nodal involvement (pN0/N+) T helper deficiency was significantly more frequent in patients with nodal involvement than in patients without. In pancreatic cancer, percentage of immunodepressed patients at baseline was higher compared to the other two groups (71%). Lymphocyte count was significantly different between pancreatic and gastric/colorectal cancer, reaching a statistical significance at baseline and on the 14th and 50th postoperative day. No differences of T helper deficiency were noted according to nodal involvement (NO versus N+) neither at baseline nor in the postoperative period. In conclusion, the degree of immunosu
- Published
- 2004
42. Performance of Diesel containing Bio-Hydrogenated Component
- Author
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Caprotti, R., primary, Tang, T., additional, Ishibe, N., additional, In-ochanon, R., additional, Tipdecho, C., additional, and Silapakampeerapap, S., additional
- Published
- 2011
- Full Text
- View/download PDF
43. Radical surgery does not recover immunodeficiency associated with gastric cancer
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Romano, F, Caprotti, R, Bravo, A, Conti, M, Colombo, G, Piacentini, G, Uggeri, F, ROMANO, FABRIZIO, UGGERI, FRANCO, UGGERI, FABIO, Bravo, AF, Romano, F, Caprotti, R, Bravo, A, Conti, M, Colombo, G, Piacentini, G, Uggeri, F, ROMANO, FABRIZIO, UGGERI, FRANCO, UGGERI, FABIO, and Bravo, AF
- Abstract
Cell-mediated immunodeficiency is known to occur in advanced cancer patients, but it is less characterized in earlier stages. Pre-existing immunodeficiency may impair the recovery of postoperative lymphocytopenia, occurring generally within 8-14 days after surgical stress. This study was aimed to verify whether immunodeficiency exists in patients with operable gastric adenocarcinoma and whether radical surgery may restore a count of peripheral blood T helper cells (CD4) and CD4/CD8 ratio within physiological normal values in the late postoperative period. Thirty-five consecutive patients (M/F 18/17; mean age 67 years, range 42-82) with histologically proven gastric adenocarcinoma, undergoing surgery with radical intent, were studied. Assessment of total lymphocyte count and lymphocyte subsets was performed by FAC scan at baseline, then postoperatively 14 and 50 days after surgery. Normal reference values were according to CDC criteria for HIV immunodeficiency (total lymphocyte >1500/mmc; CD4 cells >500/mmc; CD4/CD8 >1.2). Surgical interventions, including D2 locoregional lymphadenectomy, were as follows: 19 Roux Y total gastrectomies; 3 Roux Y subtotal gastrectomies and 13 Billroth II subtotal gastrectomies. Pathological nodal staging was pN0 in 18 and pN in 17 cases. Hystotype was intestinal in 14 patients, diffuse in 14 and unclassifiable in 7. Grading was G1 n=7; G2 n=7; G3 n=21. Lymphocyte immunodeficiency was found at baseline in 41% of patients and at 14 days after surgery in 67% of patients. Recovery of postoperative surgery-induced lymphocytopenia occurred on the 50th day only in those patients with normal values at baseline (59%). CD4 deficiency was significantly more frequent in pN vs. pNO patients, either at baseline (p<0.001), on the 14th day (p<0.02) and on the 50th day (p<0.007) postoperatively. Cancer-related CD4 deficiency was a frequent finding in our consecutive series of gastric cancer patients; this systemic immune impairment was not restored aft
- Published
- 2003
44. Retraction to: “Laparoscopic cholecystectomy and unsuspected gallbladder cancer” [European Journal of Surgical Oncology 27 (2001) 225–228]
- Author
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Romano, F., primary, Franciosi, C., additional, Caprotti, R., additional, De Fina, S., additional, Porta, G., additional, Visintini, G., additional, and Uggeri, F., additional
- Published
- 2009
- Full Text
- View/download PDF
45. Considerazioni sulla terapia chirurgica del prolasso del retto
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Gabrielli, F, Guttadauro, A, Caprotti, R, Franciosi, C, GABRIELLI, FRANCESCO, GUTTADAURO, ANGELO, Franciosi, C., Gabrielli, F, Guttadauro, A, Caprotti, R, Franciosi, C, GABRIELLI, FRANCESCO, GUTTADAURO, ANGELO, and Franciosi, C.
- Published
- 2001
46. Laparoscopic cholecystectomy and unsuspected gallbladder cancer
- Author
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Romano, F, Franciosi, C, Caprotti, R, De Fina, S, Porta, G, Visintini, G, Uggeri, F, ROMANO, FABRIZIO, UGGERI, FRANCO, Romano, F, Franciosi, C, Caprotti, R, De Fina, S, Porta, G, Visintini, G, Uggeri, F, ROMANO, FABRIZIO, and UGGERI, FRANCO
- Abstract
Gallbladder cancer is a relatively uncommon malignancy. Its presentation is similar to that of gallstone disease and sometimes with non-specific symptoms. Laparoscopic cholecystectomy has become the method of choice for removing the gallbladder in most benign conditions. Occasionally, unsuspected gallbladder carcinoma is encountered in association with laparoscopic cholecystectomy. Overall gallbladder cancers have a poor prognosis, despite surgery or adjuvant therapies. However, in selected cases, a favourable outcome can be expected and the less favourable predicted outcome can be improved. Management of patients with gallbladder cancer in different situations is discussed: gallbladder cancer noted post-operatively on final pathology, gallbladder cancer noted after removal of the gallbladder and opening of the specimen at the time of surgery, difficulty encountered at the time of dissection and resultant suspicion of gallbladder cancer, and diagnosis of extensive disease at initial placement of the laparoscope. (C) 2001 Harcourt Publishers Ltd.
- Published
- 2001
47. Control of regulated emissions with additive technology in base Diesel fuels of varing quality
- Author
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Caprotti R., Bertoli C. 1, Del Giacomo N. 1, and Iorio B. 1
- Published
- 1992
48. Relation between surgery-induced prolactin increase and the menstrual cycle phase at time of surgery in premenopausal breast cancer
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Mandelli D, A. Sormani, Paolo Lissoni, Archili C, Barni S, Real G, Caprotti R, and Tancini G
- Subjects
0301 basic medicine ,Adult ,Cancer Research ,medicine.medical_specialty ,media_common.quotation_subject ,Clinical Biochemistry ,Mammary gland ,Breast Neoplasms ,Pathology and Forensic Medicine ,03 medical and health sciences ,0302 clinical medicine ,Breast cancer ,medicine ,Humans ,Postoperative Period ,Estrogen Receptor Status ,Menstrual cycle ,Menstrual Cycle ,media_common ,business.industry ,Venous blood ,Middle Aged ,medicine.disease ,Prolactin ,Surgery ,Menstrual cycle phase ,030104 developmental biology ,medicine.anatomical_structure ,Oncology ,030220 oncology & carcinogenesis ,Female ,business ,Breast carcinoma - Abstract
It has been suggested that both the menstrual cycle phase and postoperative changes in prolactin (PRL) secretion at the time of surgery may influence the prognosis of breast cancer. The present study was carried out to evaluate the relation between menstrual cycle period and surgery-induced PRL variations. We evaluated 32 premenopausal women with operable breast carcinoma; 17 were in perimenstrual phase (days 1-6 and 21-28) and 15 were in the mid-cycle (days 7-20) period at’ the time of surgery. To investigate serum levels of PRL, venous blood samples were collected before and 7 days after surgery. Postoperative hyperprolactinemia occurred in 17/32 patients and it was statistically more frequent in patients surgically treated during the perimenstrual phase than in the mid-cycle phase (12/17 vs 5/15; p < 0.05), while no other parameter (including axillary node and estrogen receptor status) showed a significant influence on hyperprolactinemia rate. The results suggest that in premenopausal breast cancer patients surgery-induced hyperprolactinemia may be influenced by the menstrual cycle phase at the time of surgery.
- Published
- 1991
49. The influence of automotive Diesel back-end volatility and new fuel additive technology on regulated emissions
- Author
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Bertoli C. 1, Del Giacomo N. 1, Caprotti R., Smith A.K., and Dphil M.A.
- Published
- 1991
50. 71 POSTER Non colorectal non neuroendocrine liver metastases. Surgical approach
- Author
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Romano, F., primary, Uggeri, F., additional, Conti, M., additional, Caprotti, R., additional, Cesana, G., additional, and Motta, V., additional
- Published
- 2006
- Full Text
- View/download PDF
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