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1. The 2023 WSES guidelines on the management of trauma in elderly and frail patients.

Author

De Simone, Belinda, Chouillard, Elie, Podda, Mauro, Pararas, Nikolaos, de Carvalho Duarte, Gustavo, Fugazzola, Paola, Birindelli, Arianna, Coccolini, Federico, Polistena, Andrea, Sibilla, Maria, Kruger, Vitor, Fraga, Gustavo, Montori, Giulia, Russo, Emanuele, Pintar, Tadeja, Ansaloni, Luca, Avenia, Nicola, Di Saverio, Salomone, Leppäniemi, Ari, Lauretta, Andrea, Sartelli, Massimo, Puzziello, Alessandro, Carcoforo, Paolo, Agnoletti, Vanni, Bissoni, Luca, Isik, Arda, Kluger, Yoram, Moore, Ernest, Romeo, Oreste, Abu-Zidan, Fikri, Beka, Solomon, Weber, Dieter, Tan, Edward, Paolillo, Ciro, Cui, Yunfeng, Kim, Fernando, Picetti, Edoardo, Di Carlo, Isidoro, Toro, Adriana, Sganga, Gabriele, Sganga, Federica, Testini, Mario, Di Meo, Giovanna, Kirkpatrick, Andrew, Marzi, Ingo, déAngelis, Nicola, Kelly, Michael, Wani, Imtiaz, Sakakushev, Boris, Bala, Miklosh, Bonavina, Luigi, Galante, Joseph, Shelat, Vishal, Cobianchi, Lorenzo, Mas, Francesca, Pikoulis, Manos, Damaskos, Dimitrios, Coimbra, Raul, Dhesi, Jugdeep, Hoffman, Melissa, Stahel, Philip, Maier, Ronald, Litvin, Andrey, Latifi, Rifat, Biffl, Walter, and Catena, Fausto

Subjects
Ageing, Antibiotics, Delirium, Direct oral anticoagulants management, Elderly, End of life, Frailty, Geriatric patient, Imaging, Laboratory test, Pain control, Palliative care, Resuscitation, Thrombo-prophylaxis, Trauma management, Trauma score, Vitamin K antagonists anticoagulants management, Humans, Wounds and Injuries, Aged, Frail Elderly, Frailty, Aged, 80 and over, Practice Guidelines as Topic, Geriatric Assessment
Abstract

BACKGROUND: The trauma mortality rate is higher in the elderly compared with younger patients. Ageing is associated with physiological changes in multiple systems and correlated with frailty. Frailty is a risk factor for mortality in elderly trauma patients. We aim to provide evidence-based guidelines for the management of geriatric trauma patients to improve it and reduce futile procedures. METHODS: Six working groups of expert acute care and trauma surgeons reviewed extensively the literature according to the topic and the PICO question assigned. Statements and recommendations were assessed according to the GRADE methodology and approved by a consensus of experts in the field at the 10th international congress of the WSES in 2023. RESULTS: The management of elderly trauma patients requires knowledge of ageing physiology, a focused triage, including drug history, frailty assessment, nutritional status, and early activation of trauma protocol to improve outcomes. Acute trauma pain in the elderly has to be managed in a multimodal analgesic approach, to avoid side effects of opioid use. Antibiotic prophylaxis is recommended in penetrating (abdominal, thoracic) trauma, in severely burned and in open fractures elderly patients to decrease septic complications. Antibiotics are not recommended in blunt trauma in the absence of signs of sepsis and septic shock. Venous thromboembolism prophylaxis with LMWH or UFH should be administrated as soon as possible in high and moderate-risk elderly trauma patients according to the renal function, weight of the patient and bleeding risk. A palliative care team should be involved as soon as possible to discuss the end of life in a multidisciplinary approach considering the patients directives, family feelings and representatives desires, and all decisions should be shared. CONCLUSIONS: The management of elderly trauma patients requires knowledge of ageing physiology, a focused triage based on assessing frailty and early activation of trauma protocol to improve outcomes. Geriatric Intensive Care Units are needed to care for elderly and frail trauma patients in a multidisciplinary approach to decrease mortality and improve outcomes.

Published
2024

2. Comparative study between Levobupivacaine and Bupivacaine for hernia surgery in the elderly

Author

Compagna Rita, Vigliotti Gabriele, Coretti Guido, Amato Maurizio, Aprea Giovanni, Puzziello Alessandro, Militello Carmelo, Iacono Fabrizio, Prezioso Domenico, and Amato Bruno

Subjects
Surgery, RD1-811
Abstract

Abstract Background The inguinal hernia is one of the most common diseases in the elderly. Treatment of this type of pathology is exclusively surgical and relies almost always on the use of local anesthesia. While in the past hernia surgery was carried out mainly by general anesthesia, in recent years there has been growing emphasis on the role of local anesthesia. Methods The aim of our study was to compare intra-and postoperative analgesia obtained by the use of levobupivacaine compared with that of bupivacaine. Bupivacaine is one of the main local anesthetics used in the intervention of inguinal hernioplasty. Levobupivacaine is an enantiomer of racemic bupivacaine with less cardiotoxicity and neurotoxicity. The study was conducted from April 2010 to May 2012. We collected data of forty male patients, aged between 73 and 85 years, who underwent inguinal hernioplasty with local anesthesia for the first time. Results Minimal pain is the same in both groups. Mild pain was more frequent in the group who used bupivacaine, moderate pain was slightly more frequent in the group who used levobupivacaine, and the same for intense pain. It is therefore evident how Bupivacaine is slightly less preferred after four and twenty four hours, while the two drugs seem to have the same effect at a distance of twelve and forty-eight hours. Bupivacaine shows a significantly higher number of complications, as already demonstrated by previous studies. The request for an analgesic was slightly higher in patients receiving levobupivacaine. Conclusions After considering all these elements, we can conclude that the clinical efficacy of levobupivacaine and racemic bupivacaine are essentially similar, when used under local intervention of inguinal hernioplasty.

Published
2012
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3. Surgery for a gastric Dieulafoy’s lesion reveals an occult bleeding jejunal diverticulum. A case report

Author

Orlando G, Luppino IM, Gervasi R, Lerose MA, Amato B, Spagnuolo R, Marasco R, Doldo P, and Puzziello A

Subjects
Surgery, RD1-811
Abstract

Abstract Background Jejunal diverticulosis is an uncommon disease and usually asymptomatic. It can be complicated not only by diverticulitis, but by hemorrhage, perforation, intussusception, volvulus, malabsorption and even small bowel obstruction due to enteroliths formed and expelled from these diverticula. Methods We describe a case of an occult bleeding jejunal diverticulum, casually discovered in a patient that was taken to surgery for a Dieulafoy’s lesion after unsuccessful endoscopic treatment. We performed a gastric resection together with an ileocecal resection. Macroscopic and microscopic examinations confirmed the gastric Dieulafoy’s lesion and demonstrated the presence of another source of occult bleeding in asymptomatic jejunal diverticulum. Discussion The current case emphasizes that some gastrointestinal bleeding lesions, although rare, can be multiple and result in potentially life-threatening bleeding. The clinician must be mindful to the possibility of multisite lesions and to the correlation between results of the investigations and clinical condition of the bleeding patient.

Published
2012
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4. Feasibility of capsule endoscopy in elderly patients with obscure gastrointestinal bleeding. An up-to-date report

Author

Orlando G, Luppino IM, Lerose MA, Gervasi R, Amato B, Silecchia G, and Puzziello A

Subjects
Surgery, RD1-811
Abstract

Abstract Background Anemia is the most common hematologic abnormality in older populations. Furthermore, iron deficiency anemia is common and merits investigation and treatment, as it usually results from chronic occult bleeding from the gastrointestinal tract. In view of a wide use of capsule endoscopy as a diagnostic procedure for occult gastrointestinal bleeding and of the growth of aging population, we performed a literature review about the feasibility of capsule endoscopy in the elderly. Methods We conducted a literature search in the PubMed database in July 2012, and all English-language publications on capsule endoscopy in elderly patients since 2005 were retrieved. The potential original articles mainly focused on obscure gastrointestinal bleeding were all identified and full texts were obtained and reviewed for further hand data retrieving. Results We retrieved only six papers based on different primary end-points. Four were retrospective non randomized studies and two were prospective non randomized studies. In the end 65, 70, 80 and 85 years were used as an age cut-off. All studies evaluate the diagnostic yield of capsule endoscopy in iron deficiency anemia. Only three studies assess the feasibility of capsule examination of the elderly. Conclusions Iron deficiency anemia in the elderly with or without obscure gastrointestinal bleeding is the major indication for capsule endoscopy after a negative esophago-gastro-duodenoscopy and colonoscopy. It is safe and effective to identify a small bowel pathology without a great discomfort for the elderly. Inability to swallow the capsule, battery failure before capsule reaches the cecum, and capsule retention are some of the important problems associated with capsule endoscopy in elderly as well as in younger patients.

Published
2012
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5. Feasibility of inguinal hernioplasty under local anaesthesia in elderly patients

Author

Amato Bruno, Compagna Rita, Della Corte Gianni Antonio, Martino Giovanni, Bianco Tommaso, Coretti Guido, Rossi Roberto, Fappiano Francesca, Aprea Giovanni, and Puzziello Alessandro

Subjects
Surgery, RD1-811
Abstract

Abstract Background The aim of this study is to evaluate the feasibility and the safety of hernioplasty under local anaesthesia in elderly patients with significant comorbidity. Methods A total of 218 patients underwent inguinal hernia repair with mesh between June 2009 and July 2012. Presence of comorbid conditions and complications were compared between patients younger and older than 70 years. Results Hernia repair in older patients were more likely associated with comorbid conditions than in their younger counterparts ( hypertension: 25% vs 8.16%; cardiovascular diseases: 50% vs 22%; benign prostatic hypertrophy 60% vs 30%). The most common postoperative complications in both groups were recurrence, wound infection, urinary retention. There was a slightly higher rate of complication in elderly group. Conclusions Inguinal hernia repair with local anaesthesia is quite safe and results in a good success rate in elderly patients despite a higher rate of comorbidity typical of this kind of patient.

Published
2012
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9. A Prospective Cohort Analysis of the Prevalence and Predictive Factors of Delayed Discharge After Laparoscopic Cholecystectomy in Italy: The DeDiLaCo Study

Author

Cillara, Nicola, Podda, Mauro, Cicalò, Enrico, Sotgiu, Giovanni, Provenzano, Maria, Fransvea, Pietro, Poillucci, Gaetano, Sechi, Raffaele, Deserra, Antonello, DʼAgostino, Francesca, Margiani, Carla, Scabini, Stefano, Pertile, Davide, Rosa, Raffaele De, Prosperi, Paolo, Bruscino, Alessandro, Bella, Annamaria Di, Casati, Massimiliano, Laface, Letizia, Abate, Emmanuele, Frontali, Alice, Bonomi, Alessandro Michele, Ferrario, Luca, Mucilli, Felice, Barone, Mirko, Borghi, Felice, Sasia, Diego, Giraudo, Giorgio, Puzziello, Alessandro, Loffredo, Andrea, Steccanella, Francesca, Donnarumma, Elio, Galleano, Raffaele, Malerba, Michele, Runfola, Matteo, Agus, Marcello, Fortunato, Federica, Calò, Pietro Giorgio, Medas, Fabio, Canu, Gian Luigi, Stella, Marco, Ferrara, Francesco, Baldi, Caterina, Benuzzi, Laura, Pisanu, Adolfo, Saba, Alessandra, Gessa, Emanuela, Muratore, Andrea, Calabrò, Marcello, Cuzzola, Bruno, Garino, Mauro, Marafante, Chiara, Farfaglia, Roberto, Pandolfo, Gianpiero, Pata, Giacomo, Lantone, Giulio, Marino, Fabio, Perrone, Fabrizio, Scognamillo, Fabrizio, Delogu, Daniele, Tilocca, Pier Luigi, Frena, Antonio, Malpaga, Anna, Bertelli, Giacomo, Memeo, Riccardo, Ferraro, Valentina, Libia, Annarita, Sarro, Giuliano, Marconi, Matteo, Nava, Samuele, Pierpaolo, Bordoni, Fleres, Francesco, Clarizia, Guglielmo, Alfieri, Sergio, Rosa, Fausto, Longo, Fabio, Restini, Enrico, Cianci, Pasquale, Capuzzolo, Sabino, Anania, Gabriele, Bombardini, Cristina, Urbani, Alessia, Bona, Davide, Aiolfi, Alberto, Lastraioli, Caterina, Paola, Massimiliano Di, DallʼOglio, Anna, D’Eletto, Marco, Capelli, Patrizio, Conti, Luigi, Luzietti, Enrico, Banchini, Filippo, Manca, Giuseppe, Calo, Gabriele’, Centomze, Antonella, Andreano, Mauro, Sullo, Pasquale, Giuseppina, Oliva, Anastasi, Alessandro, Canonico, Giuseppe, Nelli, Tommaso, Trompetto, Mario, Gallo, Gaetano, Clerico, Giuseppe, Arganini, Marco, Palmeri, Matteo, Bonuso, Claudio, Mirabella, Antonello, Marino, Marco V., Vaccarella, Gianpaolo, Salzano, Francesco, Meccariello, Renato, Mastrorilli, Maurizio, Campanile, Fabio Cesare, Foti, Nicola, Angelis, Monica De, Palma, Giovanni Domenico De, Aprea, Giovanni, Palomba, Giuseppe, Milone, Marco, Capano, Mariana, Manigrasso, Michele, Baldazzi, Gianandrea, Cassini, Diletta, Epifani, Angelo Gabriele, Bottino, Vincenzo, Canfora, Alfonso, Ferronetti, Antonio, de Manzini, Nicolò, Biloslavo, Alan, Fracon, Stefano, Filauro, Marco, Barberis, Andrea, Azzinnaro, Antonio, Oliva, Alba, Razzore, Andrea, Maira, Lorenzo Di, Bima, Carlo, Gibin, Enrico, Peluso, Chiara, Perrotta, Nicola, Celiento, Marta, Scorzelli, Marco, Tuveri, Antonio, Madeddu, Francesco, Fois, Claudia, Russello, Domenico, Latteri, Saverio, Sofia, Maria, Rio, Paolo Del, Cozzani, Federico, Giuffrida, Mario, Mariani, Pierpaolo, Giussani, Martina, Ansaloni, Luca, Maestri, Marcello, Tartaglia, Giuseppe, Caricato, Marco, Capolupo, Gabriella Teresa, Carannante, Filippo, Gambino, Giovanni, Bertino, Vanessa, Bonilauri, Stefano, Frazzetta, Giuseppe, Amodio, Pietro Maria, Siena, Teresa De, Zanzi, Federico, Guariniello, Anna, Rocco, Giuseppe, Mancini, Stefano, Sagnotta, Andrea, Solinas, Luigi, Porta, Andrea, Sambucci, Daniele, Monti, Eleonora, Quaglino, Francesco, Mantova, Serena, Fiore, Alessia, Costi, Renato, Virgilio, Edoardo, Montali, Filippo, Catarci, Marco, Apa, Daniela, Bertoldi, Innocenzo, Camandona, Michele, Bossotti, Maurizio, Palagi, Silvia, Doria, Emaunele, Caltagirone, Alice, Balani, Alessandro, Petronio, Barbara, Terranova, Susanna, Martuzzi, Federica, Romeo, Carlo, Carluccio, Raffaele, Neri, Silvia, Auriemma, Pasquale Pio, Prestigiacomo, Giorgia, Sala, Stefano, Colli, Francesco, Marini, Pierluigi, Cosimo, Carla Di, Gattolin, Andrea, Rimonda, Roberto, Travaglio, Elisabetta, Cotsoglou, Christian, Granieri, Stefano, Chierici, Andrea Piero, Tamini, Nicolò, Pitoni, Ludovica, Vico, Eleonora, Altomare, Donato Francesco, Martines, Gennaro, Tomasicchio, Giovanni, Coppola, Massimiliano, Aprile, Giovanna, Sau, Paolo, Papa, Mauro Del, Manzi, Fulvio, DʼAmata, Gabriele, Cocorullo, Gianfranco, Venturelli, Paolina, Carollo, Giuseppe, Tondolo, Vincenzo, Dore, Andrea, Giorgio, Danilo Di, Gusai, Giovanni Pietro Paolo, Salaris, Claudia, Sanna, Silvia, Pignata, Giusto, Andreuccetti, Jacopo, DʼAlessio, Rossella, Massani, Marco, Tutino, Roberta, Viola, Vincenzo, Stella, Luigi Persico, Diana, Massimo, Sampietro, Gianluca Matteo, Merlini, David Alessio, Sica, Giuseppe, Bagaglini, Giulia, Manzia, Tommaso Maria, Siracusa, Leandro, Tisone, Giuseppe, Ercolani, Giorgio, DʼAcapito, Fabrizio, Pietrantonio, Daniela Di, Fiscon, Valentino, Portale, Giuseppe, Cipollari, Chiara, Sorrentino, Mario, Piccolo, Roberta, Cojutti, Alessandro, Canova, Gualtiero, Nicotera, Antonella, Zago, Marcello, Montis, Giorgio De, Castaldi, Fabio, Morelli, Maria Morena, Parma, Emilio, Paolini, Claudia, Marco, Giovanni De, Elter, Chiara, Feo, Carlo V., Fabbri, Nicolò, Severi, Silvia, Nasto, Aurelio, Patrone, Renato, Conti, Lorenzo, Rizzi, Andrea, Broggi, Luca, Danelli, Piergiorgio, Cammarata, Francesco, Fiore, Luigi, Grande, Michele, Campanelli, Michela, and Grande, Simona

Published
2023
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10. The WSES/SICG/ACOI/SICUT/AcEMC/SIFIPAC guidelines for diagnosis and treatment of acute left colonic diverticulitis in the elderly

Author

Fugazzola, Paola, Ceresoli, Marco, Coccolini, Federico, Gabrielli, Francesco, Puzziello, Alessandro, Monzani, Fabio, Amato, Bruno, Sganga, Gabriele, Sartelli, Massimo, Menichetti, Francesco, Puglisi, Gabriele Adolfo, Tartaglia, Dario, Carcoforo, Paolo, Avenia, Nicola, Kluger, Yoram, Paolillo, Ciro, Zago, Mauro, Leppäniemi, Ari, Tomasoni, Matteo, Cobianchi, Lorenzo, Dal Mas, Francesca, Improta, Mario, Moore, Ernest E., Peitzman, Andrew B., Sugrue, Michael, Agnoletti, Vanni, Fraga, Gustavo P., Weber, Dieter G., Damaskos, Dimitrios, Abu-Zidan, Fikri M., Wani, Imtiaz, Kirkpatrick, Andrew W., Pikoulis, Manos, Pararas, Nikolaos, Tan, Edward, Broek, Richard Ten, Maier, Ronald V., Davies, R. Justin, Kashuk, Jeffry, Shelat, Vishal G., Mefire, Alain Chicom, Augustin, Goran, Magnone, Stefano, Poiasina, Elia, De Simone, Belinda, Chiarugi, Massimo, Biffl, Walt, Baiocchi, Gian Luca, Catena, Fausto, and Ansaloni, Luca

Published
2022
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11. How to Define an Elderly and Frail Patient?

Author

Agresta, Ferdinando, Bergamini, Carlo, Podda, Mauro, Campanile, Fabio Cesare, Anania, Gabriele, Volpato, Stefano, Nobili, Alessandro, Costa, Gianluca, Puzziello, Alessandro, Corcione, Francesco, Melotti, Gianluigi, Agresta, Ferdinando, editor, Podda, Mauro, editor, Campanile, Fabio Cesare, editor, Bergamini, Carlo, editor, and Anania, Gabriele, editor

Published
2021
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12. A pandemic recap: lessons we have learned

Author

Coccolini, Federico, Cicuttin, Enrico, Cremonini, Camilla, Tartaglia, Dario, Viaggi, Bruno, Kuriyama, Akira, Picetti, Edoardo, Ball, Chad, Abu-Zidan, Fikri, Ceresoli, Marco, Turri, Bruno, Jain, Sumita, Palombo, Carlo, Guirao, Xavier, Rodrigues, Gabriel, Gachabayov, Mahir, Machado, Fernando, Eftychios, Lostoridis, Kanj, Souha S., Di Carlo, Isidoro, Di Saverio, Salomone, Khokha, Vladimir, Kirkpatrick, Andrew, Massalou, Damien, Forfori, Francesco, Corradi, Francesco, Delibegovic, Samir, Machain Vega, Gustavo M., Fantoni, Massimo, Demetriades, Demetrios, Kapoor, Garima, Kluger, Yoram, Ansari, Shamshul, Maier, Ron, Leppaniemi, Ari, Hardcastle, Timothy, Vereczkei, Andras, Karamagioli, Evika, Pikoulis, Emmanouil, Pistello, Mauro, Sakakushev, Boris E., Navsaria, Pradeep H., Galeiras, Rita, Yahya, Ali I., Osipov, Aleksei V., Dimitrov, Evgeni, Doklestić, Krstina, Pisano, Michele, Malacarne, Paolo, Carcoforo, Paolo, Sibilla, Maria Grazia, Kryvoruchko, Igor A., Bonavina, Luigi, Kim, Jae Il, Shelat, Vishal G., Czepiel, Jacek, Maseda, Emilio, Marwah, Sanjay, Chirica, Mircea, Biancofiore, Giandomenico, Podda, Mauro, Cobianchi, Lorenzo, Ansaloni, Luca, Fugazzola, Paola, Seretis, Charalampos, Gomez, Carlos Augusto, Tumietto, Fabio, Malbrain, Manu, Reichert, Martin, Augustin, Goran, Amato, Bruno, Puzziello, Alessandro, Hecker, Andreas, Gemignani, Angelo, Isik, Arda, Cucchetti, Alessandro, Nacoti, Mirco, Kopelman, Doron, Mesina, Cristian, Ghannam, Wagih, Ben-Ishay, Offir, Dhingra, Sameer, Coimbra, Raul, Moore, Ernest E., Cui, Yunfeng, Quiodettis, Martha A., Bala, Miklosh, Testini, Mario, Diaz, Jose, Girardis, Massimo, Biffl, Walter L., Hecker, Matthias, Sall, Ibrahima, Boggi, Ugo, Materazzi, Gabriele, Ghiadoni, Lorenzo, Matsumoto, Junichi, Zuidema, Wietse P., Ivatury, Rao, Enani, Mushira A., Litvin, Andrey, Al-Hasan, Majdi N., Demetrashvili, Zaza, Baraket, Oussama, Ordoñez, Carlos A., Negoi, Ionut, Kiguba, Ronald, Memish, Ziad A., Elmangory, Mutasim M., Tolonen, Matti, Das, Korey, Ribeiro, Julival, O’Connor, Donal B., Tan, Boun Kim, Van Goor, Harry, Baral, Suman, De Simone, Belinda, Corbella, Davide, Brambillasca, Pietro, Scaglione, Michelangelo, Basolo, Fulvio, De’Angelis, Nicola, Bendinelli, Cino, Weber, Dieter, Pagani, Leonardo, Monti, Cinzia, Baiocchi, Gianluca, Chiarugi, Massimo, Catena, Fausto, and Sartelli, Massimo

Published
2021
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17. Antibiotic Prophylaxis for Hepato-Biliopancreatic Surgery—A Systematic Review

Author

Francesca Steccanella, Paolo Amoretti, Maria Rachele Barbieri, Fabio Bellomo, and Alessandro Puzziello

Subjects
antibiotic prophylaxis, hepato-biliopancreatic surgery, surgical site infections, Therapeutics. Pharmacology, RM1-950
Abstract

Background: Surgical site infections (SSIs) are among the most important determinants of morbidity after HBP surgery. Their frequency after HPB surgery is variable, from 1–2% after elective cholecystectomy to 25% after PD. Methods: A systematic review was performed to assess the role of antimicrobial prophylaxis (AP) in HPB elective surgery. Articles published between 2015 and 2021 were obtained; those before 2015 were not included because they antedate the WHO guidelines on SSI prevention. We conducted three different research methods for liver resection, elective cholecystectomy and pancreatic and biliary surgery regarding patients requiring preoperative biliary drainage. Results: Hepatic surgery, improvement in surgical technique and perioperative management lead to a very low SSI. One preoperative 2 g cefazolin dose may be adequate for surgical prophylaxis. From preoperative biliary drainage, we can derive that patients’ homeostasis rather than AP plays a paramount role in reducing postoperative morbidity. The time from biliary drainage could be an essential element in decision making for surgical prophylaxis. In the case of low-risk cholecystectomy, it is not easy to draw definitive conclusions about the effect of AP. Data from the literature are inconsistent, and some risk factors cannot be predicted before surgery. Conclusion: in our opinion, a strict preoperative cefazolin dose strategy can be reasonable in HBP surgery until a large-scale, multicentric RCT brings definitive conclusions.

Published
2022
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18. Acute cholecystitis during COVID-19 pandemic: a multisocietary position statement

Author

Campanile, Fabio Cesare, Podda, Mauro, Arezzo, Alberto, Botteri, Emanuele, Sartori, Alberto, Guerrieri, Mario, Cassinotti, Elisa, Muttillo, Irnerio, Pisano, Marcello, Brachet Contul, Riccardo, D’Ambrosio, Giancarlo, Cuccurullo, Diego, Bergamini, Carlo, Allaix, Marco Ettore, Caracino, Valerio, Petz, Wanda Luisa, Milone, Marco, Silecchia, Gianfranco, Anania, Gabriele, Agrusa, Antonino, Di Saverio, Salomone, Casarano, Salvatore, Cicala, Caterina, Narilli, Piero, Federici, Sara, Carlini, Massimo, Paganini, Alessandro, Bianchi, Paolo Pietro, Salaj, Adelona, Mazzari, Andrea, Meniconi, Roberto Luca, Puzziello, Alessandro, Terrosu, Giovanni, De Simone, Belinda, Coccolini, Federico, Catena, Fausto, and Agresta, Ferdinando

Published
2020
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19. Surgery in COVID-19 patients: operational directives

Author

Coccolini, Federico, Perrone, Gennaro, Chiarugi, Massimo, Di Marzo, Francesco, Ansaloni, Luca, Scandroglio, Ildo, Marini, Pierluigi, Zago, Mauro, De Paolis, Paolo, Forfori, Francesco, Agresta, Ferdinando, Puzziello, Alessandro, D’Ugo, Domenico, Bignami, Elena, Bellini, Valentina, Vitali, Pietro, Petrini, Flavia, Pifferi, Barbara, Corradi, Francesco, Tarasconi, Antonio, Pattonieri, Vittoria, Bonati, Elena, Tritapepe, Luigi, Agnoletti, Vanni, Corbella, Davide, Sartelli, Massimo, and Catena, Fausto

Published
2020
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20. The SIFIPAC/WSES/SICG/SIMEU guidelines for diagnosis and treatment of acute appendicitis in the elderly (2019 edition)

Author

Fugazzola, Paola, Ceresoli, Marco, Agnoletti, Vanni, Agresta, Ferdinando, Amato, Bruno, Carcoforo, Paolo, Catena, Fausto, Chiara, Osvaldo, Chiarugi, Massimo, Cobianchi, Lorenzo, Coccolini, Federico, De Troia, Alessandro, Di Saverio, Salomone, Fabbri, Andrea, Feo, Carlo, Gabrielli, Francesco, Gurrado, Angela, Guttadauro, Angelo, Leone, Leonardo, Marrelli, Daniele, Petruzzelli, Luca, Portolani, Nazario, Prete, Francesco Paolo, Puzziello, Alessandro, Sartelli, Massimo, Soliani, Giorgio, Testini, Mario, Tolone, Salvatore, Tomasoni, Matteo, Tugnoli, Gregorio, Viale, Pierluigi, Zese, Monica, Ishay, Offir Ben, Kluger, Yoram, Kirkpatrick, Andrew, and Ansaloni, Luca

Published
2020
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21. Multidisciplinary management of elderly patients with rectal cancer: recommendations from the SICG (Italian Society of Geriatric Surgery), SIFIPAC (Italian Society of Surgical Pathophysiology), SICE (Italian Society of Endoscopic Surgery and new technologies), and the WSES (World Society of Emergency Surgery) International Consensus Project

Author

Fabio Rondelli, Francesco Pata, Francesco Gabrielli, Federica Gaiani, Michael Sugrue, Tiziana Meschi, Simona Bui, Ernest E. Moore, Patricia Tejedor, Antonio Crucitti, Monica Ortenzi, Dario Parini, Ari Leppäniemi, Fabio Cesare Campanile, Mauro Podda, Antonio Biondi, Walter L. Biffl, Salomone Di Saverio, Neil J. Smart, Belinda De Simone, Vanni Agnoletti, Massimo Sartelli, Andrea Polistena, Massimo De Filippo, Gustavo Pereira Fraga, Andrea Loffredo, Adolfo Pisanu, Paolo Carcoforo, Gilberto Poggioli, Gian Luigi de’Angelis, Justin Davies, Gian Luca Baiocchi, Michel Adamina, Marco Vacante, Alessandro Puzziello, Mario Guerrieri, Angelo Guttadauro, Luca Ansaloni, Fausto Catena, Nicola Avenia, Claudia Commisso, Ferdinando Agresta, Giorgio Ercolani, Nicola de’Angelis, Yoram Kluger, Patricia Sylla, Alberto Arezzo, Federico Coccolini, Podda, M, Sylla, P, Baiocchi, G, Adamina, M, Agnoletti, V, Agresta, F, Ansaloni, L, Arezzo, A, Avenia, N, Biffl, W, Biondi, A, Bui, S, Campanile, F, Carcoforo, P, Commisso, C, Crucitti, A, De'Angelis, N, De'Angelis, G, De Filippo, M, De Simone, B, Di Saverio, S, Ercolani, G, Fraga, G, Gabrielli, F, Gaiani, F, Guerrieri, M, Guttadauro, A, Kluger, Y, Leppaniemi, A, Loffredo, A, Meschi, T, Moore, E, Ortenzi, M, Pata, F, Parini, D, Pisanu, A, Poggioli, G, Polistena, A, Puzziello, A, Rondelli, F, Sartelli, M, Smart, N, Sugrue, M, Tejedor, P, Vacante, M, Coccolini, F, Davies, J, Catena, F, Podda M., Sylla P., Baiocchi G., Adamina M., Agnoletti V., Agresta F., Ansaloni L., Arezzo A., Avenia N., Biffl W., Biondi A., Bui S., Campanile F.C., Carcoforo P., Commisso C., Crucitti A., De'Angelis N., De'Angelis G.L., De Filippo M., De Simone B., Di Saverio S., Ercolani G., Fraga G.P., Gabrielli F., Gaiani F., Guerrieri M., Guttadauro A., Kluger Y., Leppaniemi A.K., Loffredo A., Meschi T., Moore E.E., Ortenzi M., Pata F., Parini D., Pisanu A., Poggioli G., Polistena A., Puzziello A., Rondelli F., Sartelli M., Smart N., Sugrue M.E., Tejedor P., Vacante M., Coccolini F., Davies J., and Catena F.

Subjects
medicine.medical_specialty, Consensus, RD1-811, Population, Consensu, Review, 030230 surgery, NO, 03 medical and health sciences, 0302 clinical medicine, Quality of life (healthcare), Elderly, Multidisciplinary approach, Epidemiology, Multidisciplinary management, medicine, Rectal cancer, humans, education, Research question, LS7_4, Geriatrics, education.field_of_study, Frailty, business.industry, RC86-88.9, elderly, frailty, multidisciplinary management, rectal cancer, aged, disease management, Italy, rectal neoplasms, Medical emergencies. Critical care. Intensive care. First aid, Colorectal surgery, 3. Good health, Geriatric oncology, 030220 oncology & carcinogenesis, Family medicine, Emergency Medicine, Surgery, business, Human
Abstract

Background and aims Although rectal cancer is predominantly a disease of older patients, current guidelines do not incorporate optimal treatment recommendations for the elderly and address only partially the associated specific challenges encountered in this population. This results in a wide variation and disparity in delivering a standard of care to this subset of patients. As the burden of rectal cancer in the elderly population continues to increase, it is crucial to assess whether current recommendations on treatment strategies for the general population can be adopted for the older adults, with the same beneficial oncological and functional outcomes. This multidisciplinary experts’ consensus aims to refine current rectal cancer-specific guidelines for the elderly population in order to help to maximize rectal cancer therapeutic strategies while minimizing adverse impacts on functional outcomes and quality of life for these patients. Methods The discussion among the steering group of clinical experts and methodologists from the societies’ expert panel involved clinicians practicing in general surgery, colorectal surgery, surgical oncology, geriatric oncology, geriatrics, gastroenterologists, radiologists, oncologists, radiation oncologists, and endoscopists. Research topics and questions were formulated, revised, and unanimously approved by all experts in two subsequent modified Delphi rounds in December 2020–January 2021. The steering committee was divided into nine teams following the main research field of members. Each conducted their literature search and drafted statements and recommendations on their research question. Literature search has been updated up to 2020 and statements and recommendations have been developed according to the GRADE methodology. A modified Delphi methodology was implemented to reach agreement among the experts on all statements and recommendations. Conclusions The 2021 SICG-SIFIPAC-SICE-WSES consensus for the multidisciplinary management of elderly patients with rectal cancer aims to provide updated evidence-based statements and recommendations on each of the following topics: epidemiology, pre-intervention strategies, diagnosis and staging, neoadjuvant chemoradiation, surgery, watch and wait strategy, adjuvant chemotherapy, synchronous liver metastases, and emergency presentation of rectal cancer.

Published
2021

25. The WSES/SICG/ACOI/SICUT/AcEMC/SIFIPAC guidelines for diagnosis and treatment of acute left colonic diverticulitis in the elderly

Author

Fugazzola, P, Ceresoli, M, Coccolini, F, Gabrielli, F, Puzziello, A, Monzani, F, Amato, B, Sganga, G, Sartelli, M, Menichetti, F, Puglisi, G, Tartaglia, D, Carcoforo, P, Avenia, N, Kluger, Y, Paolillo, C, Zago, M, Leppaniemi, A, Tomasoni, M, Cobianchi, L, Dal Mas, F, Improta, M, Moore, E, Peitzman, A, Sugrue, M, Agnoletti, V, Fraga, G, Weber, D, Damaskos, D, Abu-Zidan, F, Wani, I, Kirkpatrick, A, Pikoulis, M, Pararas, N, Tan, E, Broek, R, Maier, R, Davies, R, Kashuk, J, Shelat, V, Mefire, A, Augustin, G, Magnone, S, Poiasina, E, De Simone, B, Chiarugi, M, Biffl, W, Baiocchi, G, Catena, F, Ansaloni, L, Fugazzola P., Ceresoli M., Coccolini F., Gabrielli F., Puzziello A., Monzani F., Amato B., Sganga G., Sartelli M., Menichetti F., Puglisi G. A., Tartaglia D., Carcoforo P., Avenia N., Kluger Y., Paolillo C., Zago M., Leppaniemi A., Tomasoni M., Cobianchi L., Dal Mas F., Improta M., Moore E. E., Peitzman A. B., Sugrue M., Agnoletti V., Fraga G. P., Weber D. G., Damaskos D., Abu-Zidan F. M., Wani I., Kirkpatrick A. W., Pikoulis M., Pararas N., Tan E., Broek R. T., Maier R. V., Davies R. J., Kashuk J., Shelat V. G., Mefire A. C., Augustin G., Magnone S., Poiasina E., De Simone B., Chiarugi M., Biffl W., Baiocchi G. L., Catena F., Ansaloni L., Fugazzola, P, Ceresoli, M, Coccolini, F, Gabrielli, F, Puzziello, A, Monzani, F, Amato, B, Sganga, G, Sartelli, M, Menichetti, F, Puglisi, G, Tartaglia, D, Carcoforo, P, Avenia, N, Kluger, Y, Paolillo, C, Zago, M, Leppaniemi, A, Tomasoni, M, Cobianchi, L, Dal Mas, F, Improta, M, Moore, E, Peitzman, A, Sugrue, M, Agnoletti, V, Fraga, G, Weber, D, Damaskos, D, Abu-Zidan, F, Wani, I, Kirkpatrick, A, Pikoulis, M, Pararas, N, Tan, E, Broek, R, Maier, R, Davies, R, Kashuk, J, Shelat, V, Mefire, A, Augustin, G, Magnone, S, Poiasina, E, De Simone, B, Chiarugi, M, Biffl, W, Baiocchi, G, Catena, F, Ansaloni, L, Fugazzola P., Ceresoli M., Coccolini F., Gabrielli F., Puzziello A., Monzani F., Amato B., Sganga G., Sartelli M., Menichetti F., Puglisi G. A., Tartaglia D., Carcoforo P., Avenia N., Kluger Y., Paolillo C., Zago M., Leppaniemi A., Tomasoni M., Cobianchi L., Dal Mas F., Improta M., Moore E. E., Peitzman A. B., Sugrue M., Agnoletti V., Fraga G. P., Weber D. G., Damaskos D., Abu-Zidan F. M., Wani I., Kirkpatrick A. W., Pikoulis M., Pararas N., Tan E., Broek R. T., Maier R. V., Davies R. J., Kashuk J., Shelat V. G., Mefire A. C., Augustin G., Magnone S., Poiasina E., De Simone B., Chiarugi M., Biffl W., Baiocchi G. L., Catena F., and Ansaloni L.

Abstract

Acute left colonic diverticulitis (ALCD) in the elderly presents with unique epidemiological features when compared with younger patients. The clinical presentation is more nuanced in the elderly population, having higher in-hospital and postoperative mortality. Furthermore, geriatric comorbidities are a risk factor for complicated diverticulitis. Finally, elderly patients have a lower risk of recurrent episodes and, in case of recurrence, a lower probability of requiring urgent surgery than younger patients. The aim of the present work is to study age-related factors that may support a unique approach to the diagnosis and treatment of this problem in the elderly when compared with the WSES guidelines for the management of acute left-sided colonic diverticulitis. During the 1° Pisa Workshop of Acute Care & Trauma Surgery held in Pisa (Italy) in September 2019, with the collaboration of the World Society of Emergency Surgery (WSES), the Italian Society of Geriatric Surgery (SICG), the Italian Hospital Surgeons Association (ACOI), the Italian Emergency Surgery and Trauma Association (SICUT), the Academy of Emergency Medicine and Care (AcEMC) and the Italian Society of Surgical Pathophysiology (SIFIPAC), three panel members presented a number of statements developed for each of the four themes regarding the diagnosis and management of ALCD in older patients, formulated according to the GRADE approach, at a Consensus Conference where a panel of experts participated. The statements were subsequently debated, revised, and finally approved by the Consensus Conference attendees. The current paper is a summary report of the definitive guidelines statements on each of the following topics: diagnosis, management, surgical technique and antibiotic therapy.

Published
2022

26. 2017 WSES and SICG guidelines on acute calcolous cholecystitis in elderly population

Author

Pisano, Michele, Ceresoli, Marco, Cimbanassi, Stefania, Gurusamy, Kurinchi, Coccolini, Federico, Borzellino, Giuseppe, Costa, Gianluca, Allievi, Niccolò, Amato, Bruno, Boerma, Djamila, Calcagno, Pietro, Campanati, Luca, Campanile, Fabio Cesare, Casati, Alberto, Chiara, Osvaldo, Crucitti, Antonio, di Saverio, Salomone, Filauro, Marco, Gabrielli, Francesco, Guttadauro, Angelo, Kluger, Yoram, Magnone, Stefano, Merli, Cecilia, Poiasina, Elia, Puzziello, Alessandro, Sartelli, Massimo, Catena, Fausto, and Ansaloni, Luca

Published
2019
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27. Antimicrobial stewardships and post-operative intrabdominal infections: a single center experience

Author

Santella, B., primary, Steccanella, F., additional, Amoretti, P., additional, Manente, R., additional, Folliero, V., additional, Dell'Annunziata, F., additional, Pagliano, P., additional, Longanella, W., additional, Fortino, L., additional, De Filippis, A., additional, Schiavo, L., additional, Galdiero, M., additional, Boccia, G., additional, Puzziello, A., additional, and Franci, G., additional

Published
2023
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32. Immunohistochemical algorithms and gene expression profiling in primary cutaneous B-cell lymphoma

Author

Pasquale Cretella, Anna Lucia Peluso, Caterina Picariello, Immacolata Cozzolino, Massimo Triggiani, Alessandro Puzziello, Valentina Giudice, Francesco Sabbatino, Antonio Ieni, Pio Zeppa, Alessandro Caputo, Cretella, P., Peluso, A. L., Picariello, C., Cozzolino, I., Triggiani, M., Puzziello, A., Giudice, V., Sabbatino, F., Ieni, A., Zeppa, P., and Caputo, A.

Subjects
Aged, 80 and over, Male, Lymphoma, B-Cell, Cell of Origin, Gene Expression, Cell Biology, Middle Aged, Immunohistochemistry, Gene expression profiling, Pathology and Forensic Medicine, Nodal diffuse large B-cell lymphoma, Italy, Primary cutaneous B-cell lymphoma, Case-Control Studies, Biomarkers, Tumor, Humans, Female, Algorithms, Aged, Retrospective Studies
Abstract

Objective: to assess whether immunohistochemical (IHC) algorithms used to classify the cell of origin (COO) of nodal Diffuse Large B-cell lymphoma (nDLBCL) in Germinal Center type (GCB) and non-GCB subtypes may be applied to Primary Cutaneous B-cell lymphoma (PCBCL) too, and which of these algorithms performs better on PCBCL. Design: Retrospective case control study. Setting: Pathology Department of the University Hospital “San Giovanni di Dio e Ruggi d′Aragona” Salerno, Italy. Participants: Fourteen PCBCL, including Primary Cutaneous follicle centre lymphoma (PCFCL) and primary cutaneous diffuse large B-cell lymphoma, Leg type (PCDLBCL-LT) and 14 nDLBCL were evaluated for 7-year period (January 2011 to December 2017). Primary cutaneous marginal zone cell lymphoma (PCMZL) cases were not included in the present study. Intervention: Evaluation of immunohistochemical CD10, BCL6, MUM1/IRF4, BCL2, MYC and Ki-67 expression and classification according to three different algorithms. Gene expression profiling (GEP) was performed on the same series using Lymph2Cx assay (Nanostring). The data obtained were compared and analysed. Results: All the IHC algorithms showed 13 GCB and 15 non-GCB. GEP showed 12 GCB, 12 activated B cell–type and 4 unclassified. Conclusions: The PCBCL were classifiable as GCB and non-GCB like the nDLBCL as IHC algorithms were concordant to GEP and produced the same results.

Published
2022

33. Multidisciplinary management of elderly patients with rectal cancer: recommendations from the SICG (Italian Society of Geriatric Surgery), SIFIPAC (Italian Society of Surgical Pathophysiology), SICE (Italian Society of Endoscopic Surgery and new technologies), and the WSES (World Society of Emergency Surgery) International Consensus Project

Author

Podda, M, Sylla, P, Baiocchi, G, Adamina, M, Agnoletti, V, Agresta, F, Ansaloni, L, Arezzo, A, Avenia, N, Biffl, W, Biondi, A, Bui, S, Campanile, F, Carcoforo, P, Commisso, C, Crucitti, A, De'Angelis, N, De'Angelis, G, De Filippo, M, De Simone, B, Di Saverio, S, Ercolani, G, Fraga, G, Gabrielli, F, Gaiani, F, Guerrieri, M, Guttadauro, A, Kluger, Y, Leppaniemi, A, Loffredo, A, Meschi, T, Moore, E, Ortenzi, M, Pata, F, Parini, D, Pisanu, A, Poggioli, G, Polistena, A, Puzziello, A, Rondelli, F, Sartelli, M, Smart, N, Sugrue, M, Tejedor, P, Vacante, M, Coccolini, F, Davies, J, Catena, F, Podda M., Sylla P., Baiocchi G., Adamina M., Agnoletti V., Agresta F., Ansaloni L., Arezzo A., Avenia N., Biffl W., Biondi A., Bui S., Campanile F. C., Carcoforo P., Commisso C., Crucitti A., De'Angelis N., De'Angelis G. L., De Filippo M., De Simone B., Di Saverio S., Ercolani G., Fraga G. P., Gabrielli F., Gaiani F., Guerrieri M., Guttadauro A., Kluger Y., Leppaniemi A. K., Loffredo A., Meschi T., Moore E. E., Ortenzi M., Pata F., Parini D., Pisanu A., Poggioli G., Polistena A., Puzziello A., Rondelli F., Sartelli M., Smart N., Sugrue M. E., Tejedor P., Vacante M., Coccolini F., Davies J., Catena F., Podda, M, Sylla, P, Baiocchi, G, Adamina, M, Agnoletti, V, Agresta, F, Ansaloni, L, Arezzo, A, Avenia, N, Biffl, W, Biondi, A, Bui, S, Campanile, F, Carcoforo, P, Commisso, C, Crucitti, A, De'Angelis, N, De'Angelis, G, De Filippo, M, De Simone, B, Di Saverio, S, Ercolani, G, Fraga, G, Gabrielli, F, Gaiani, F, Guerrieri, M, Guttadauro, A, Kluger, Y, Leppaniemi, A, Loffredo, A, Meschi, T, Moore, E, Ortenzi, M, Pata, F, Parini, D, Pisanu, A, Poggioli, G, Polistena, A, Puzziello, A, Rondelli, F, Sartelli, M, Smart, N, Sugrue, M, Tejedor, P, Vacante, M, Coccolini, F, Davies, J, Catena, F, Podda M., Sylla P., Baiocchi G., Adamina M., Agnoletti V., Agresta F., Ansaloni L., Arezzo A., Avenia N., Biffl W., Biondi A., Bui S., Campanile F. C., Carcoforo P., Commisso C., Crucitti A., De'Angelis N., De'Angelis G. L., De Filippo M., De Simone B., Di Saverio S., Ercolani G., Fraga G. P., Gabrielli F., Gaiani F., Guerrieri M., Guttadauro A., Kluger Y., Leppaniemi A. K., Loffredo A., Meschi T., Moore E. E., Ortenzi M., Pata F., Parini D., Pisanu A., Poggioli G., Polistena A., Puzziello A., Rondelli F., Sartelli M., Smart N., Sugrue M. E., Tejedor P., Vacante M., Coccolini F., Davies J., and Catena F.

Abstract

Background and aims: Although rectal cancer is predominantly a disease of older patients, current guidelines do not incorporate optimal treatment recommendations for the elderly and address only partially the associated specific challenges encountered in this population. This results in a wide variation and disparity in delivering a standard of care to this subset of patients. As the burden of rectal cancer in the elderly population continues to increase, it is crucial to assess whether current recommendations on treatment strategies for the general population can be adopted for the older adults, with the same beneficial oncological and functional outcomes. This multidisciplinary experts’ consensus aims to refine current rectal cancer-specific guidelines for the elderly population in order to help to maximize rectal cancer therapeutic strategies while minimizing adverse impacts on functional outcomes and quality of life for these patients. Methods: The discussion among the steering group of clinical experts and methodologists from the societies’ expert panel involved clinicians practicing in general surgery, colorectal surgery, surgical oncology, geriatric oncology, geriatrics, gastroenterologists, radiologists, oncologists, radiation oncologists, and endoscopists. Research topics and questions were formulated, revised, and unanimously approved by all experts in two subsequent modified Delphi rounds in December 2020–January 2021. The steering committee was divided into nine teams following the main research field of members. Each conducted their literature search and drafted statements and recommendations on their research question. Literature search has been updated up to 2020 and statements and recommendations have been developed according to the GRADE methodology. A modified Delphi methodology was implemented to reach agreement among the experts on all statements and recommendations. Conclusions: The 2021 SICG-SIFIPAC-SICE-WSES consensus for the multidisciplinary

Published
2021

34. A pandemic recap: lessons we have learned

Author

Coccolini, F, Cicuttin, E, Cremonini, C, Tartaglia, D, Viaggi, B, Kuriyama, A, Picetti, E, Ball, C, Abu-Zidan, F, Ceresoli, M, Turri, B, Jain, S, Palombo, C, Guirao, X, Rodrigues, G, Gachabayov, M, Machado, F, Eftychios, L, Kanj, S, Di Carlo, I, Di Saverio, S, Khokha, V, Kirkpatrick, A, Massalou, D, Forfori, F, Corradi, F, Delibegovic, S, Machain Vega, G, Fantoni, M, Demetriades, D, Kapoor, G, Kluger, Y, Ansari, S, Maier, R, Leppaniemi, A, Hardcastle, T, Vereczkei, A, Karamagioli, E, Pikoulis, E, Pistello, M, Sakakushev, B, Navsaria, P, Galeiras, R, Yahya, A, Osipov, A, Dimitrov, E, Doklestic, K, Pisano, M, Malacarne, P, Carcoforo, P, Sibilla, M, Kryvoruchko, I, Bonavina, L, Kim, J, Shelat, V, Czepiel, J, Maseda, E, Marwah, S, Chirica, M, Biancofiore, G, Podda, M, Cobianchi, L, Ansaloni, L, Fugazzola, P, Seretis, C, Gomez, C, Tumietto, F, Malbrain, M, Reichert, M, Augustin, G, Amato, B, Puzziello, A, Hecker, A, Gemignani, A, Isik, A, Cucchetti, A, Nacoti, M, Kopelman, D, Mesina, C, Ghannam, W, Ben-Ishay, O, Dhingra, S, Coimbra, R, Moore, E, Cui, Y, Quiodettis, M, Bala, M, Testini, M, Diaz, J, Girardis, M, Biffl, W, Hecker, M, Sall, I, Boggi, U, Materazzi, G, Ghiadoni, L, Matsumoto, J, Zuidema, W, Ivatury, R, Enani, M, Litvin, A, Al-Hasan, M, Demetrashvili, Z, Baraket, O, Ordonez, C, Negoi, I, Kiguba, R, Memish, Z, Elmangory, M, Tolonen, M, Das, K, Ribeiro, J, O'Connor, D, Tan, B, Van Goor, H, Baral, S, De Simone, B, Corbella, D, Brambillasca, P, Scaglione, M, Basolo, F, De'Angelis, N, Bendinelli, C, Weber, D, Pagani, L, Monti, C, Baiocchi, G, Chiarugi, M, Catena, F, Sartelli, M, Coccolini F., Cicuttin E., Cremonini C., Tartaglia D., Viaggi B., Kuriyama A., Picetti E., Ball C., Abu-Zidan F., Ceresoli M., Turri B., Jain S., Palombo C., Guirao X., Rodrigues G., Gachabayov M., Machado F., Eftychios L., Kanj S. S., Di Carlo I., Di Saverio S., Khokha V., Kirkpatrick A., Massalou D., Forfori F., Corradi F., Delibegovic S., Machain Vega G. M., Fantoni M., Demetriades D., Kapoor G., Kluger Y., Ansari S., Maier R., Leppaniemi A., Hardcastle T., Vereczkei A., Karamagioli E., Pikoulis E., Pistello M., Sakakushev B. E., Navsaria P. H., Galeiras R., Yahya A. I., Osipov A. V., Dimitrov E., Doklestic K., Pisano M., Malacarne P., Carcoforo P., Sibilla M. G., Kryvoruchko I. A., Bonavina L., Kim J. I., Shelat V. G., Czepiel J., Maseda E., Marwah S., Chirica M., Biancofiore G., Podda M., Cobianchi L., Ansaloni L., Fugazzola P., Seretis C., Gomez C. A., Tumietto F., Malbrain M., Reichert M., Augustin G., Amato B., Puzziello A., Hecker A., Gemignani A., Isik A., Cucchetti A., Nacoti M., Kopelman D., Mesina C., Ghannam W., Ben-Ishay O., Dhingra S., Coimbra R., Moore E. E., Cui Y., Quiodettis M. A., Bala M., Testini M., Diaz J., Girardis M., Biffl W. L., Hecker M., Sall I., Boggi U., Materazzi G., Ghiadoni L., Matsumoto J., Zuidema W. P., Ivatury R., Enani M. A., Litvin A., Al-Hasan M. N., Demetrashvili Z., Baraket O., Ordonez C. A., Negoi I., Kiguba R., Memish Z. A., Elmangory M. M., Tolonen M., Das K., Ribeiro J., O'Connor D. B., Tan B. K., Van Goor H., Baral S., De Simone B., Corbella D., Brambillasca P., Scaglione M., Basolo F., De'Angelis N., Bendinelli C., Weber D., Pagani L., Monti C., Baiocchi G., Chiarugi M., Catena F., Sartelli M., Coccolini, F, Cicuttin, E, Cremonini, C, Tartaglia, D, Viaggi, B, Kuriyama, A, Picetti, E, Ball, C, Abu-Zidan, F, Ceresoli, M, Turri, B, Jain, S, Palombo, C, Guirao, X, Rodrigues, G, Gachabayov, M, Machado, F, Eftychios, L, Kanj, S, Di Carlo, I, Di Saverio, S, Khokha, V, Kirkpatrick, A, Massalou, D, Forfori, F, Corradi, F, Delibegovic, S, Machain Vega, G, Fantoni, M, Demetriades, D, Kapoor, G, Kluger, Y, Ansari, S, Maier, R, Leppaniemi, A, Hardcastle, T, Vereczkei, A, Karamagioli, E, Pikoulis, E, Pistello, M, Sakakushev, B, Navsaria, P, Galeiras, R, Yahya, A, Osipov, A, Dimitrov, E, Doklestic, K, Pisano, M, Malacarne, P, Carcoforo, P, Sibilla, M, Kryvoruchko, I, Bonavina, L, Kim, J, Shelat, V, Czepiel, J, Maseda, E, Marwah, S, Chirica, M, Biancofiore, G, Podda, M, Cobianchi, L, Ansaloni, L, Fugazzola, P, Seretis, C, Gomez, C, Tumietto, F, Malbrain, M, Reichert, M, Augustin, G, Amato, B, Puzziello, A, Hecker, A, Gemignani, A, Isik, A, Cucchetti, A, Nacoti, M, Kopelman, D, Mesina, C, Ghannam, W, Ben-Ishay, O, Dhingra, S, Coimbra, R, Moore, E, Cui, Y, Quiodettis, M, Bala, M, Testini, M, Diaz, J, Girardis, M, Biffl, W, Hecker, M, Sall, I, Boggi, U, Materazzi, G, Ghiadoni, L, Matsumoto, J, Zuidema, W, Ivatury, R, Enani, M, Litvin, A, Al-Hasan, M, Demetrashvili, Z, Baraket, O, Ordonez, C, Negoi, I, Kiguba, R, Memish, Z, Elmangory, M, Tolonen, M, Das, K, Ribeiro, J, O'Connor, D, Tan, B, Van Goor, H, Baral, S, De Simone, B, Corbella, D, Brambillasca, P, Scaglione, M, Basolo, F, De'Angelis, N, Bendinelli, C, Weber, D, Pagani, L, Monti, C, Baiocchi, G, Chiarugi, M, Catena, F, Sartelli, M, Coccolini F., Cicuttin E., Cremonini C., Tartaglia D., Viaggi B., Kuriyama A., Picetti E., Ball C., Abu-Zidan F., Ceresoli M., Turri B., Jain S., Palombo C., Guirao X., Rodrigues G., Gachabayov M., Machado F., Eftychios L., Kanj S. S., Di Carlo I., Di Saverio S., Khokha V., Kirkpatrick A., Massalou D., Forfori F., Corradi F., Delibegovic S., Machain Vega G. M., Fantoni M., Demetriades D., Kapoor G., Kluger Y., Ansari S., Maier R., Leppaniemi A., Hardcastle T., Vereczkei A., Karamagioli E., Pikoulis E., Pistello M., Sakakushev B. E., Navsaria P. H., Galeiras R., Yahya A. I., Osipov A. V., Dimitrov E., Doklestic K., Pisano M., Malacarne P., Carcoforo P., Sibilla M. G., Kryvoruchko I. A., Bonavina L., Kim J. I., Shelat V. G., Czepiel J., Maseda E., Marwah S., Chirica M., Biancofiore G., Podda M., Cobianchi L., Ansaloni L., Fugazzola P., Seretis C., Gomez C. A., Tumietto F., Malbrain M., Reichert M., Augustin G., Amato B., Puzziello A., Hecker A., Gemignani A., Isik A., Cucchetti A., Nacoti M., Kopelman D., Mesina C., Ghannam W., Ben-Ishay O., Dhingra S., Coimbra R., Moore E. E., Cui Y., Quiodettis M. A., Bala M., Testini M., Diaz J., Girardis M., Biffl W. L., Hecker M., Sall I., Boggi U., Materazzi G., Ghiadoni L., Matsumoto J., Zuidema W. P., Ivatury R., Enani M. A., Litvin A., Al-Hasan M. N., Demetrashvili Z., Baraket O., Ordonez C. A., Negoi I., Kiguba R., Memish Z. A., Elmangory M. M., Tolonen M., Das K., Ribeiro J., O'Connor D. B., Tan B. K., Van Goor H., Baral S., De Simone B., Corbella D., Brambillasca P., Scaglione M., Basolo F., De'Angelis N., Bendinelli C., Weber D., Pagani L., Monti C., Baiocchi G., Chiarugi M., Catena F., and Sartelli M.

Abstract

On January 2020, the WHO Director General declared that the outbreak constitutes a Public Health Emergency of International Concern. The world has faced a worldwide spread crisis and is still dealing with it. The present paper represents a white paper concerning the tough lessons we have learned from the COVID-19 pandemic. Thus, an international and heterogenous multidisciplinary panel of very differentiated people would like to share global experiences and lessons with all interested and especially those responsible for future healthcare decision making. With the present paper, international and heterogenous multidisciplinary panel of very differentiated people would like to share global experiences and lessons with all interested and especially those responsible for future healthcare decision making.

Published
2021

35. The SIFIPAC/WSES/SICG/SIMEU guidelines for diagnosis and treatment of acute appendicitis in the elderly (2019 edition)

Author

Andrew W Kirkpatrick, Osvaldo Chiara, Daniele Marrelli, Massimo Sartelli, Pierluigi Viale, Ferdinando Agresta, Nazario Portolani, Angelo Guttadauro, Luca Petruzzelli, Mario Testini, Luca Ansaloni, Paolo Carcoforo, Vanni Agnoletti, Lorenzo Cobianchi, Salvatore Tolone, Angela Gurrado, Andrea Fabbri, Fausto Catena, Yoram Kluger, Paola Fugazzola, Federico Coccolini, Francesco Paolo Prete, Monica Zese, Francesco Gabrielli, Matteo Tomasoni, Bruno Amato, Marco Ceresoli, Alessandro De Troia, Alessandro Puzziello, Offir Ben Ishay, Salomone Di Saverio, Giorgio Soliani, Leonardo Leone, Massimo Chiarugi, Carlo V. Feo, Gregorio Tugnoli, Apollo - University of Cambridge Repository, Fugazzola, P., Ceresoli, M., Agnoletti, V., Agresta, F., Amato, B., Carcoforo, P., Catena, F., Chiara, O., Chiarugi, M., Cobianchi, L., Coccolini, F., De Troia, A., Di Saverio, S., Fabbri, A., Feo, C., Gabrielli, F., Gurrado, A., Guttadauro, A., Leone, L., Marrelli, D., Petruzzelli, L., Portolani, N., Prete, F. P., Puzziello, A., Sartelli, M., Soliani, G., Testini, M., Tolone, S., Tomasoni, M., Tugnoli, G., Viale, P., Zese, M., Ishay, O. B., Kluger, Y., Kirkpatrick, A., Ansaloni, L., Fugazzola, P, Ceresoli, M, Agnoletti, V, Agresta, F, Amato, B, Carcoforo, P, Catena, F, Chiara, O, Chiarugi, M, Cobianchi, L, Coccolini, F, De Troia, A, Di Saverio, S, Fabbri, A, Feo, C, Gabrielli, F, Gurrado, A, Guttadauro, A, Leone, L, Marrelli, D, Petruzzelli, L, Portolani, N, Prete, F, Puzziello, A, Sartelli, M, Soliani, G, Testini, M, Tolone, S, Tomasoni, M, Tugnoli, G, Viale, P, Zese, M, Ishay, O, Kluger, Y, Kirkpatrick, A, Ansaloni, L, Fugazzola P., Ceresoli M., Agnoletti V., Agresta F., Amato B., Carcoforo P., Catena F., Chiara O., Chiarugi M., Cobianchi L., Coccolini F., De Troia A., Di Saverio S., Fabbri A., Feo C., Gabrielli F., Gurrado A., Guttadauro A., Leone L., Marrelli D., Petruzzelli L., Portolani N., Prete F.P., Puzziello A., Sartelli M., Soliani G., Testini M., Tolone S., Tomasoni M., Tugnoli G., Viale P., Zese M., Ishay O.B., Kluger Y., Kirkpatrick A., and Ansaloni L.

Subjects
medicine.medical_specialty, Perforation (oil well), Population, lcsh:Surgery, Appendectomy, Appendicitis, Elderly, Surgery in elderly, Review, 030230 surgery, NO, 03 medical and health sciences, 0302 clinical medicine, Elderly, Emergency surgery, Epidemiology, Humans, Medicine, Appendectomy, Appendicitis, Surgery in elderly, Appendiciti, education, Aged, Aged, 80 and over, education.field_of_study, business.industry, General surgery, Age Factors, lcsh:Medical emergencies. Critical care. Intensive care. First aid, Consensus conference, Postoperative complication, lcsh:RD1-811, lcsh:RC86-88.9, medicine.disease, 030220 oncology & carcinogenesis, Acute Disease, Acute appendicitis, Emergency Medicine, Surgery, business
Abstract

The epidemiology and the outcomes of acute appendicitis in elderly patients are very different from the younger population. Elderly patients with acute appendicitis showed higher mortality, higher perforation rate, lower diagnostic accuracy, longer delay from symptoms onset and admission, higher postoperative complication rate and higher risk of colonic and appendiceal cancer. The aim of the present work was to investigate age-related factors that could influence a different approach, compared to the 2016 WSES Jerusalem guidelines on general population, in terms of diagnosis and management of elderly patient with acute appendicitis. During the XXIX National Congress of the Italian Society of Surgical Pathophysiology (SIFIPAC) held in Cesena (Italy) in May 2019, in collaboration with the Italian Society of Geriatric Surgery (SICG), the World Society of Emergency Surgery (WSES) and the Italian Society of Emergency Medicine (SIMEU), a panel of experts participated to a Consensus Conference where eight panelists presented a number of statements, which were developed for each of the four topics about diagnosis and management of acute appendicitis in elderly patients, formulated according to the GRADE system. The statements were then voted, eventually modified and finally approved by the participants to the Consensus Conference. The current paper is reporting the definitive guidelines statements on each of the following topics: diagnosis, non-operative management, operative management and antibiotic therapy.

Published
2020
Full Text
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37. Immunohistochemical algorithms and gene expression profiling in primary cutaneous B-cell lymphoma

Author

Cretella, Pasquale, primary, Peluso, Anna Lucia, additional, Picariello, Caterina, additional, Cozzolino, Immacolata, additional, Triggiani, Massimo, additional, Puzziello, Alessandro, additional, Giudice, Valentina, additional, Sabbatino, Francesco, additional, Ieni, Antonio, additional, Zeppa, Pio, additional, and Caputo, Alessandro, additional

Published
2022
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39. The WSES/SICG/ACOI/SICUT/AcEMC/SIFIPAC guidelines for diagnosis and treatment of acute left colonic diverticulitis in the elderly

Author

Fugazzola, Paola Ceresoli, Marco Coccolini, Federico and Gabrielli, Francesco Puzziello, Alessandro Monzani, Fabio and Amato, Bruno Sganga, Gabriele Sartelli, Massimo Menichetti, Francesco Puglisi, Gabriele Adolfo Tartaglia, Dario and Carcoforo, Paolo Avenia, Nicola Kluger, Yoram Paolillo, Ciro and Zago, Mauro Leppaniemi, Ari Tomasoni, Matteo Cobianchi, Lorenzo Dal Mas, Francesca Improta, Mario Moore, Ernest E. and Peitzman, Andrew B. Sugrue, Michael Agnoletti, Vanni and Fraga, Gustavo P. Weber, Dieter G. Damaskos, Dimitrios and Abu-Zidan, Fikri M. Wani, Imtiaz Kirkpatrick, Andrew W. and Pikoulis, Manos Pararas, Nikolaos Tan, Edward Ten Broek, Richard Maier, V, Ronald Davies, R. Justin Kashuk, Jeffry and Shelat, Vishal G. Mefire, Alain Chicom Augustin, Goran and Magnone, Stefano Poiasina, Elia De Simone, Belinda Chiarugi, Massimo Biffl, Walt Baiocchi, Gian Luca Catena, Fausto and Ansaloni, Luca

Abstract

Acute left colonic diverticulitis (ALCD) in the elderly presents with unique epidemiological features when compared with younger patients. The clinical presentation is more nuanced in the elderly population, having higher in-hospital and postoperative mortality. Furthermore, geriatric comorbidities are a risk factor for complicated diverticulitis. Finally, elderly patients have a lower risk of recurrent episodes and, in case of recurrence, a lower probability of requiring urgent surgery than younger patients. The aim of the present work is to study age-related factors that may support a unique approach to the diagnosis and treatment of this problem in the elderly when compared with the WSES guidelines for the management of acute left-sided colonic diverticulitis. During the 1 degrees Pisa Workshop of Acute Care & Trauma Surgery held in Pisa (Italy) in September 2019, with the collaboration of the World Society of Emergency Surgery (WSES), the Italian Society of Geriatric Surgery (SICG), the Italian Hospital Surgeons Association (ACOI), the Italian Emergency Surgery and Trauma Association (SICUT), the Academy of Emergency Medicine and Care (AcEMC) and the Italian Society of Surgical Pathophysiology (SIFIPAC), three panel members presented a number of statements developed for each of the four themes regarding the diagnosis and management of ALCD in older patients, formulated according to the GRADE approach, at a Consensus Conference where a panel of experts participated. The statements were subsequently debated, revised, and finally approved by the Consensus Conference attendees. The current paper is a summary report of the definitive guidelines statements on each of the following topics: diagnosis, management, surgical technique and antibiotic therapy.

Published
2022

41. Antibiotic Prophylaxis for Hepato-Biliopancreatic Surgery-A Systematic Review

Author

Francesca Steccanella, Paolo Amoretti, Maria Rachele Barbieri, Fabio Bellomo, and Alessandro Puzziello

Subjects
Microbiology (medical), Infectious Diseases, antibiotic prophylaxis, hepato-biliopancreatic surgery, surgical site infections, Pharmacology (medical), General Pharmacology, Toxicology and Pharmaceutics, Biochemistry, Microbiology
Abstract

Background: Surgical site infections (SSIs) are among the most important determinants of morbidity after HBP surgery. Their frequency after HPB surgery is variable, from 1–2% after elective cholecystectomy to 25% after PD. Methods: A systematic review was performed to assess the role of antimicrobial prophylaxis (AP) in HPB elective surgery. Articles published between 2015 and 2021 were obtained; those before 2015 were not included because they antedate the WHO guidelines on SSI prevention. We conducted three different research methods for liver resection, elective cholecystectomy and pancreatic and biliary surgery regarding patients requiring preoperative biliary drainage. Results: Hepatic surgery, improvement in surgical technique and perioperative management lead to a very low SSI. One preoperative 2 g cefazolin dose may be adequate for surgical prophylaxis. From preoperative biliary drainage, we can derive that patients’ homeostasis rather than AP plays a paramount role in reducing postoperative morbidity. The time from biliary drainage could be an essential element in decision making for surgical prophylaxis. In the case of low-risk cholecystectomy, it is not easy to draw definitive conclusions about the effect of AP. Data from the literature are inconsistent, and some risk factors cannot be predicted before surgery. Conclusion: in our opinion, a strict preoperative cefazolin dose strategy can be reasonable in HBP surgery until a large-scale, multicentric RCT brings definitive conclusions.

Published
2021

45. The SIFIPAC/WSES/SICG/SIMEU guidelines for diagnosis and treatment of acute appendicitis in the elderly (2019 edition)

Author

Fugazzola, P, Ceresoli, M, Agnoletti, V, Agresta, F, Amato, B, Carcoforo, P, Catena, F, Chiara, O, Chiarugi, M, Cobianchi, L, Coccolini, F, De Troia, A, Di Saverio, S, Fabbri, A, Feo, C, Gabrielli, F, Gurrado, A, Guttadauro, A, Leone, L, Marrelli, D, Petruzzelli, L, Portolani, N, Prete, F, Puzziello, A, Sartelli, M, Soliani, G, Testini, M, Tolone, S, Tomasoni, M, Tugnoli, G, Viale, P, Zese, M, Ishay, O, Kluger, Y, Kirkpatrick, A, Ansaloni, L, Fugazzola P., Ceresoli M., Agnoletti V., Agresta F., Amato B., Carcoforo P., Catena F., Chiara O., Chiarugi M., Cobianchi L., Coccolini F., De Troia A., Di Saverio S., Fabbri A., Feo C., Gabrielli F., Gurrado A., Guttadauro A., Leone L., Marrelli D., Petruzzelli L., Portolani N., Prete F. P., Puzziello A., Sartelli M., Soliani G., Testini M., Tolone S., Tomasoni M., Tugnoli G., Viale P., Zese M., Ishay O. B., Kluger Y., Kirkpatrick A., Ansaloni L., Fugazzola, P, Ceresoli, M, Agnoletti, V, Agresta, F, Amato, B, Carcoforo, P, Catena, F, Chiara, O, Chiarugi, M, Cobianchi, L, Coccolini, F, De Troia, A, Di Saverio, S, Fabbri, A, Feo, C, Gabrielli, F, Gurrado, A, Guttadauro, A, Leone, L, Marrelli, D, Petruzzelli, L, Portolani, N, Prete, F, Puzziello, A, Sartelli, M, Soliani, G, Testini, M, Tolone, S, Tomasoni, M, Tugnoli, G, Viale, P, Zese, M, Ishay, O, Kluger, Y, Kirkpatrick, A, Ansaloni, L, Fugazzola P., Ceresoli M., Agnoletti V., Agresta F., Amato B., Carcoforo P., Catena F., Chiara O., Chiarugi M., Cobianchi L., Coccolini F., De Troia A., Di Saverio S., Fabbri A., Feo C., Gabrielli F., Gurrado A., Guttadauro A., Leone L., Marrelli D., Petruzzelli L., Portolani N., Prete F. P., Puzziello A., Sartelli M., Soliani G., Testini M., Tolone S., Tomasoni M., Tugnoli G., Viale P., Zese M., Ishay O. B., Kluger Y., Kirkpatrick A., and Ansaloni L.

Abstract

The epidemiology and the outcomes of acute appendicitis in elderly patients are very different from the younger population. Elderly patients with acute appendicitis showed higher mortality, higher perforation rate, lower diagnostic accuracy, longer delay from symptoms onset and admission, higher postoperative complication rate and higher risk of colonic and appendiceal cancer. The aim of the present work was to investigate age-related factors that could influence a different approach, compared to the 2016 WSES Jerusalem guidelines on general population, in terms of diagnosis and management of elderly patient with acute appendicitis. During the XXIX National Congress of the Italian Society of Surgical Pathophysiology (SIFIPAC) held in Cesena (Italy) in May 2019, in collaboration with the Italian Society of Geriatric Surgery (SICG), the World Society of Emergency Surgery (WSES) and the Italian Society of Emergency Medicine (SIMEU), a panel of experts participated to a Consensus Conference where eight panelists presented a number of statements, which were developed for each of the four topics about diagnosis and management of acute appendicitis in elderly patients, formulated according to the GRADE system. The statements were then voted, eventually modified and finally approved by the participants to the Consensus Conference. The current paper is reporting the definitive guidelines statements on each of the following topics: diagnosis, non-operative management, operative management and antibiotic therapy.

Published
2020

47. Laparoscopic right hemicolectomy: the SICE (Società Italiana di Chirurgia Endoscopica e Nuove Tecnologie) network prospective trial on 1225 cases comparing intra corporeal versus extra corporeal ileo-colic side-to-side anastomosis

Author

Anania G., Agresta F., Artioli E., Rubino S., Resta G., Vettoretto N., Petz W. L., Bergamini C., Arezzo A., Valpiani G., Morotti C., Silecchia G., Adamo V., Agrusa A., Alemanno G., Allaix M. E., Alo A., Altamura A., Ambrosi A., Antoniutti M., Apa D., Arcuri G., Baiocchi G. L., Balani A., Baldazzi G., Basti M., Benvenuto C., Berti S., Boni L., Borghi F., Botteri E., Brachet Contul R., Brescia A., Budassi A., Cafagna L., Calgaro M., Calo P. G., Campagnacci R., Canova G., Canu G. L., Caracino V., Carcoforo P., Carlini M., Casali L., Cassetti D., Cassinotti E., Catarci M., Cesari M., Checcacci P., Ciano P., Clementi M., Cocorullo G., Colombo F., Concone G., Contine A., Coppola M., Coratti A., Corcione F., Corleone P., Covotta L., Cuccurullo D., Cumbo P., D'ambrosio G., De Angelis F., De Luca M., De Manzini N., De Nisco C., De Palma G. D., De Paolis P., Degiuli M., Delogu D., Delrio P., Deserra A., Donini A., Elmore U., Ercolani G., Erdas E., Fabris L., Ferrari G., Feo G., Fidanza F., Foschi D., Galleano R., Garulli G., Gatti F., Gattolin A., Gelati S., Gelmini R., Ghazouani O., Gioffre A., Gobbi S., Grammatico V., Guariniello A., Giannessi S., Guerrieri M., Guerriero L., Gullotta G., Impellizzeri H., Izzo M., Jovine E., Lezoche G., Lirusso C., Lombardi R., Longoni M., Lucchi A., Luzzi A. P., Marini P., Marrosu A. G., Martino A., Mazza R., Mazzoccato S., Medas F., Meloni A., Milone M., Minciotti E., Monari F., Moretto G., Muttillo I. A., Navarra G., Neri S., Oldani A., Olmi S., Opocher E., Osenda E., Ottonello R., Panebianco V., Pavanello M., Pecchini F., Pellegrino L., Pennisi D., Perrotta N., Pertile D., Petri R., Picchetto A., Piccoli M., Pirrera B., Pisani Ceretti A., Pisano M., Podda M., Portolani N., Presenti L., Puzziello A., Razzi S., Rega D., Restini E., Ricci G., Rigamonti M., Rivolta U., Robustelli V., Romairone E., Rosati R., Rosso E., Roviello F., Sala S., Santarelli M., Sarro G., Sartori A., Scabini S., Scognamillo F., Sechi R., Solaini L., Soliani G., Soliani P., Soligo E., Sorrentino M., Spinoglio G., Stratta E., Taddei A., Talamo G., Targa S., Tartaglia N., Testa S., Ubiali P., Valeri A., Vasta F., Verzelli A., Vicentini R., Viola G., Violi V., Zago M., Zampino L., Anania, G., Agresta, F., Artioli, E., Rubino, S., Resta, G., Vettoretto, N., Petz, W. L., Bergamini, C., Arezzo, A., Valpiani, G., Morotti, C., Silecchia, G., Adamo, V., Agrusa, A., Alemanno, G., Allaix, M. E., Alo, A., Altamura, A., Ambrosi, A., Antoniutti, M., Apa, D., Arcuri, G., Baiocchi, G. L., Balani, A., Baldazzi, G., Basti, M., Benvenuto, C., Berti, S., Boni, L., Borghi, F., Botteri, E., Brachet Contul, R., Brescia, A., Budassi, A., Cafagna, L., Calgaro, M., Calo, P. G., Campagnacci, R., Canova, G., Canu, G. L., Caracino, V., Carcoforo, P., Carlini, M., Casali, L., Cassetti, D., Cassinotti, E., Catarci, M., Cesari, M., Checcacci, P., Ciano, P., Clementi, M., Cocorullo, G., Colombo, F., Concone, G., Contine, A., Coppola, M., Coratti, A., Corcione, F., Corleone, P., Covotta, L., Cuccurullo, D., Cumbo, P., D'Ambrosio, G., De Angelis, F., De Luca, M., De Manzini, N., De Nisco, C., De Palma, G. D., De Paolis, P., Degiuli, M., Delogu, D., Delrio, P., Deserra, A., Donini, A., Elmore, U., Ercolani, G., Erdas, E., Fabris, L., Ferrari, G., Feo, G., Fidanza, F., Foschi, D., Galleano, R., Garulli, G., Gatti, F., Gattolin, A., Gelati, S., Gelmini, R., Ghazouani, O., Gioffre, A., Gobbi, S., Grammatico, V., Guariniello, A., Giannessi, S., Guerrieri, M., Guerriero, L., Gullotta, G., Impellizzeri, H., Izzo, M., Jovine, E., Lezoche, G., Lirusso, C., Lombardi, R., Longoni, M., Lucchi, A., Luzzi, A. P., Marini, P., Marrosu, A. G., Martino, A., Mazza, R., Mazzoccato, S., Medas, F., Meloni, A., Milone, M., Minciotti, E., Monari, F., Moretto, G., Muttillo, I. A., Navarra, G., Neri, S., Oldani, A., Olmi, S., Opocher, E., Osenda, E., Ottonello, R., Panebianco, V., Pavanello, M., Pecchini, F., Pellegrino, L., Pennisi, D., Perrotta, N., Pertile, D., Petri, R., Picchetto, A., Piccoli, M., Pirrera, B., Pisani Ceretti, A., Pisano, M., Podda, M., Portolani, N., Presenti, L., Puzziello, A., Razzi, S., Rega, D., Restini, E., Ricci, G., Rigamonti, M., Rivolta, U., Robustelli, V., Romairone, E., Rosati, R., Rosso, E., Roviello, F., Sala, S., Santarelli, M., Sarro, G., Sartori, A., Scabini, S., Scognamillo, F., Sechi, R., Solaini, L., Soliani, G., Soliani, P., Soligo, E., Sorrentino, M., Spinoglio, G., Stratta, E., Taddei, A., Talamo, G., Targa, S., Tartaglia, N., Testa, S., Ubiali, P., Valeri, A., Vasta, F., Verzelli, A., Vicentini, R., Viola, G., Violi, V., Zago, M., Zampino, L., Anania G., Agresta F., Artioli E., Rubino S., Resta G., Vettoretto N., Petz W.L., Bergamini C., Arezzo A., Valpiani G., Morotti C., Silecchia G, and Adamo V, Agrusa A, Alemanno G, Allaix ME, Alò A, Altamura A, Ambrosi A, Antoniutti M, Apa D, Arcuri G, Baiocchi GL, Balani A, Baldazzi G, Basti M, Benvenuto C, Berti S, Boni L, Borghi F, Botteri E, Brachet Contul R, Brescia A, Budassi A, Cafagna L, Calgaro M, Calò PG, Campagnacci R, Canova G, Canu GL, Caracino V, Carcoforo P, Carlini M, Casali L, Cassetti D, Cassinotti E, Catarci M, Cesari M, Checcacci P, Ciano P, Clementi M, Cocorullo G, Colombo F, Concone G, Contine A, Coppola M, Coratti A, Corcione F, Corleone P, Covotta L, Cuccurullo D, Cumbo P, D'Ambrosio G, De Angelis F, De Luca M, De Manzini N, De Nisco C, De Palma GD, De Paolis P, Degiuli M, Delogu D, Delrio P, Deserra A, Donini A, Elmore U, Ercolani G, Erdas E, Fabris L, Ferrari G, Feo C, Fidanza F, Foschi D, Galleano R, Garulli G, Gatti F, Gattolin A, Gelati S, Gelmini R, Ghazouani O, Gioffrè A, Gobbi S, Grammatico V, Guariniello A, Giannessi S, Guerrieri M, Guerriero L, Guerriero G, Impellizzeri H, Izzo M, Jovine E, Lezoche G, Lirusso C, Lombardi R, Longoni M, Lucchi A, Luzzi AP, Marini P, Marrosu AG, Martino A, Mazza R, Mazzoccato S, Medas F, Meloni A, Milone M, Minciotti E, Monari F, Moretto G, Muttillo IA, Navarra G, Neri S, Oldani A, Olmi S, Opocher E, Osenda E, Ottonello R, Panebianco V, Pavanello M, Pecchini F, Pellegrino L, Pennisi D, Perrotta N, Pertile D, Petri R, Picchetto A, Piccoli M, Pirrera B, Pisani Ceretti A, Pisano M, Podda M, Portolani N, Presenti L, Puzziello A, Razzi S, Rega D, Restini E, Ricci G, Rigamonti M, Rivolta U, Robustelli V, Romairone E, Rosati R, Rosso E, Roviello F, Sala S, Santarelli M, Sarro G, Sartori A, Scabini S, Scognamillo F, Sechi R, Solaini L, Soliani G, Soliani P, Soligo E, Sorrentino M, Spinoglio G, Stratta E, Taddei A, Talamo G, Targa S, Tartaglia N, Testa S, Ubiali P, Valeri A, Vasta F, Verzelli A, Vicentini R, Viola G, Violi V, Zago M, Zampino L.

Subjects
Male, medicine.medical_specialty, Anastomosis, Colon, Intracorporeal anastomosis, Outcomes, Laparoscopic colectomy, Article, Intracorporeal anastomosi, Ileo-colic anastomosis, Laparoscopy, Postoperative complications, Right hemicolectomy, Aged, Anastomosis, Surgical, Colectomy, Colonic Neoplasms, Female, Humans, Prospective Studies, Treatment Outcome, Economica, Surgical, medicine, LS7_1, LS7_4, Right hemicolectomy, Ileo-colic anastomosis, Laparoscopy, Postoperative complications, Intracorporeal anastomosis, Outcomes, Outcome, LS7_9, medicine.diagnostic_test, business.industry, General surgery, Right hemicolectomy · Ileo-colic anastomosis · Laparoscopy · Postoperative complications · Intracorporeal anastomosis · Outcomes, Correction, Postoperative complication, Ileo-colic anastomosi, Prospective trial, Surgery, Side to side anastomosis, business, Laparoscopic right hemicolectomy
Abstract

Background While laparoscopic approach for right hemicolectomy (LRH) is considered appropriate for the surgical treatment of both malignant and benign diseases of right colon, there is still debate about how to perform the ileo-colic anastomosis. The ColonDxItalianGroup (CoDIG) was designed as a cohort, observational, prospective, multi-center national study with the aims of evaluating the surgeons’ attitude regarding the intracorporeal (ICA) or extra-corporeal (ECA) anastomotic technique and the related surgical outcomes. Methods One hundred and twenty-five Surgical Units experienced in colorectal and advanced laparoscopic surgery were invited and 85 of them joined the study. Each center was asked not to change its surgical habits. Data about demographic characteristics, surgical technique and postoperative outcomes were collected through the official SICE website database. One thousand two hundred and twenty-five patients were enrolled between March 2018 and September 2018. Results ICA was performed in 70.4% of cases, ECA in 29.6%. Isoperistaltic anastomosis was completed in 85.6%, stapled in 87.9%. Hand-sewn enterotomy closure was adopted in 86%. Postoperative complications were reported in 35.4% for ICA and 50.7% for ECA; no significant difference was found according to patients’ characteristics and technologies used. Median hospital stay was significantly shorter for ICA (7.3 vs. 9 POD). Postoperative pain in patients not prescribed opioids was significantly lower in ICA group. Conclusions In our survey, a side-to-side isoperistaltic stapled ICA with hand-sewn enterotomy closure is the most frequently adopted technique to perform ileo-colic anastomosis after any indications for elective LRH. According to literature, our study confirmed better short-term outcomes for ICA, with reduction of hospital stay and postoperative pain. Trial registration Clinical trial (Identifier: NCT03934151).

Published
2020

48. Implementation of the ERAS program in gastric surgery: a nationwide survey in Italy.

Author

Romario, Uberto Fumagalli, Ascari, Filippo, De Pascale, Stefano, GIRCG, Rausei, Stefano, Bencini, Lapo, Cocozza, Eugenio, Cotsoglou, Christian, Degiuli, Maurizio, Palma, Giovanni, Ferrari, Giovanni, Lucianetti, Alessandro, Marchesi, Federico, Merigliano, Stefano, Millo, Paolo, Navarra, Giuseppe, Petri, Roberto, Portolani, Nazario, Puzziello, Alessandro, and Rosati, Riccardo

Abstract

Enhanced recovery after surgery (ERAS) programs have been developed by combining several evidence-based techniques for perioperative care, with the intention of reducing the stress response and organ dysfunction, thus allowing improved clinical results. ERAS programs have been widely adopted for colorectal surgery; however, their adoption for upper gastrointestinal surgery has been challenging even though good results have been reported in the literature. Our intent was to investigate the adoption of ERAS programs for resective gastric surgery in Italy. A survey was conducted among 20 departments of surgery belonging to the Italian Group for Research on Gastric Cancer (GC). Analysis of our survey showed that several evidence-based practices and many items of the ERAS guidelines for gastric surgery are not implemented in real practice in Italian centers dedicated to GC. This situation may be related to the hesitation of surgeons to introduce radical changes to the traditional postoperative management after gastrectomy. A multidisciplinary approach to the perioperative care of these patients is not routinely applied in many Italian centers. A strict collaboration of all clinicians involved in the perioperative care of patients undergoing gastrectomy for GC is key for the future implementation of ERAS in gastric surgery in our departments. [ABSTRACT FROM AUTHOR]

Published
2023
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49. Multidisciplinary management of elderly patients with rectal cancer : recommendations from the SICG (Italian Society of Geriatric Surgery), SIFIPAC (Italian Society of Surgical Pathophysiology), SICE (Italian Society of Endoscopic Surgery and new technologies), and the WSES (World Society of Emergency Surgery) International Consensus Project

Author

Podda, Mauro, Sylla, Patricia, Baiocchi, Gianluca, Adamina, Michel, Agnoletti, Vanni, Agresta, Ferdinando, Ansaloni, Luca, Arezzo, Alberto, Avenia, Nicola, Biffl, Walter, Biondi, Antonio, Bui, Simona, Campanile, Fabio C., Carcoforo, Paolo, Commisso, Claudia, Crucitti, Antonio, De'Angelis, Nicola, De'Angelis, Gian Luigi, De Filippo, Massimo, De Simone, Belinda, Di Saverio, Salomone, Ercolani, Giorgio, Fraga, Gustavo P., Gabrielli, Francesco, Gaiani, Federica, Guerrieri, Mario, Guttadauro, Angelo, Kluger, Yoram, Leppäniemi, Ari K., Loffredo, Andrea, Meschi, Tiziana, Moore, Ernest E., Ortenzi, Monica, Pata, Francesco, Parini, Dario, Pisanu, Adolfo, Poggioli, Gilberto, Polistena, Andrea, Puzziello, Alessandro, Rondelli, Fabio, Sartelli, Massimo, Smart, Neil, Sugrue, Michael E., Tejedor, Patricia, Vacante, Marco, Coccolini, Federico, Davies, Justin, Catena, Fausto, HUS Abdominal Center, and II kirurgian klinikka

Subjects
Consensus, Frailty, LAPAROSCOPIC-ASSISTED RESECTION, TOTAL MESORECTAL EXCISION, PREOPERATIVE SHORT-COURSE, OBSTRUCTIVE COLORECTAL-CANCER, 3126 Surgery, anesthesiology, intensive care, radiology, CLINICAL COMPLETE RESPONDERS, MINIMALLY INVASIVE SURGERY, Elderly, QUALITY-OF-LIFE, Multidisciplinary management, LONG-COURSE CHEMORADIATION, SHORT-COURSE RADIOTHERAPY, Rectal cancer, ENDOLUMINAL LOCOREGIONAL RESECTION
Abstract

Background and aims Although rectal cancer is predominantly a disease of older patients, current guidelines do not incorporate optimal treatment recommendations for the elderly and address only partially the associated specific challenges encountered in this population. This results in a wide variation and disparity in delivering a standard of care to this subset of patients. As the burden of rectal cancer in the elderly population continues to increase, it is crucial to assess whether current recommendations on treatment strategies for the general population can be adopted for the older adults, with the same beneficial oncological and functional outcomes. This multidisciplinary experts' consensus aims to refine current rectal cancer-specific guidelines for the elderly population in order to help to maximize rectal cancer therapeutic strategies while minimizing adverse impacts on functional outcomes and quality of life for these patients. Methods The discussion among the steering group of clinical experts and methodologists from the societies' expert panel involved clinicians practicing in general surgery, colorectal surgery, surgical oncology, geriatric oncology, geriatrics, gastroenterologists, radiologists, oncologists, radiation oncologists, and endoscopists. Research topics and questions were formulated, revised, and unanimously approved by all experts in two subsequent modified Delphi rounds in December 2020-January 2021. The steering committee was divided into nine teams following the main research field of members. Each conducted their literature search and drafted statements and recommendations on their research question. Literature search has been updated up to 2020 and statements and recommendations have been developed according to the GRADE methodology. A modified Delphi methodology was implemented to reach agreement among the experts on all statements and recommendations. Conclusions The 2021 SICG-SIFIPAC-SICE-WSES consensus for the multidisciplinary management of elderly patients with rectal cancer aims to provide updated evidence-based statements and recommendations on each of the following topics: epidemiology, pre-intervention strategies, diagnosis and staging, neoadjuvant chemoradiation, surgery, watch and wait strategy, adjuvant chemotherapy, synchronous liver metastases, and emergency presentation of rectal cancer.

Published
2021

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