Author: "Roberto Santambrogio" - Searchworks@Jio Institute Digital Library Search Results

146 results on '"Roberto Santambrogio"'

1. Impact of Platelet Count on Perioperative Bleeding in Patients With Cirrhosis Undergoing Surgical Treatments of Liver Cancer

Author: Vincenzo Ronca, Matteo Barabino, Roberto Santambrogio, Enrico Opocher, James Hodson, Emanuela Bertolini, Simone Birocchi, Gaetano Piccolo, PierMaria Battezzati, Marco Cattaneo, and Gian Marco Podda
Subjects: Diseases of the digestive system. Gastroenterology, RC799-869
Abstract: In patients with cirrhosis with severe thrombocytopenia (platelet count [PC] 100 × 109/L), intermediate (51‐100 × 109/L), and low (≤50 × 109/L). PC was also analyzed as a continuous covariate on multivariable analysis. The primary endpoint was major perioperative bleeding. The overall event rate of major perioperative bleeding was 8.9% and was not found to differ significantly between the high, intermediate, and low platelet groups (8.1% vs. 10.2% vs. 10.8%, P = 0.48). On multivariable analysis, greater age, aspartate aminotransferase, lower hemoglobin, and treatment with LR (vs. RFA) were found to be significant independent predictors of major perioperative bleeding, with associations with disease etiology and year of surgery also observed. After adjusting for these factors, the association between PC and major perioperative bleeding remained nonsignificant. Conclusion: Major perioperative bleeding was not significantly associated with PC in patients with cirrhosis undergoing surgical treatment of HCC, even when their PC was
Published: 2022
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2. COVID-19 outbreak and acute cholecystitis in a Hub Hospital in Milan: wider indications for percutaneous cholecystostomy

Author: Matteo Barabino, Gaetano Piccolo, Arianna Trizzino, Veronica Fedele, Carlo Ferrari, Vincenzo Nicastro, Andrea Pisani Ceretti, Enrico De Nicola, Nicolò Maria Mariani, Marco Giovenzana, Giovanna Scifo, Massimiliano Mazza, Ruggero Vercelli, Roberto Santambrogio, Carmelo Luigiano, and Enrico Opocher
Subjects: Acute cholecystitis, Percutaneous cholecystostomy, COVID-19, SARS-CoV-2, Bedside, Drainage, Surgery, RD1-811
Abstract: Abstract Background COVID-19 pandemic has impacted the Italian National Health Care system at many different levels, causing a complete reorganization of surgical wards. In this context, our study retrospectively analysed the management strategy for patients with acute cholecystitis. Methods We analysed all patients admitted to our Emergency Department for acute cholecystitis between February and April 2020 and we graded each case according to 2018 Tokyo Guidelines. All patients were tested for positivity to SARS-CoV-2 and received an initial conservative treatment. We focused on patients submitted to cholecystostomy during the acute phase of pandemic and their subsequent disease evolution. Results Thirty-seven patients were admitted for acute cholecystitis (13 grade I, 16 grade II, 8 grade III). According to Tokyo Guidelines (2018), patients were successfully treated with antibiotic only, bedside percutaneous transhepatic gallbladder drainage (PC) and laparoscopic cholecystectomy (LC) in 29.7%, 21.6% and 48.7% of cases respectively. Therapeutic strategy of three out of 8 cases, otherwise fit for surgery, submitted to bedside percutaneous transhepatic gallbladder drainage (37.5%), were directly modified by COVID-19 pandemic: one due to the SARS-CoV-2 positivity, while two others due to unavailability of operating room and intensive care unit for post-operative monitoring respectively. Overall success rate of percutaneous cholecystostomy was of 87.5%. The mean post-procedural hospitalization length was 9 days, and no related adverse events were observed apart from transient parietal bleeding, conservatively treated. Once discharged, two patients required readmission because of acute biliary symptoms. Median time of drainage removal was 43 days and only 50% patients thereafter underwent cholecystectomy. Conclusions Percutaneous cholecystostomy has shown to be an effective and safe treatment thus acquiring an increased relevance in the first phase of the pandemic. Nowadays, considering we are forced to live with the SARS-CoV-2 virus, PC should be considered as a virtuous, alternative tool for potentially all COVID-19 positive patients and selectively for negative cases unresponsive to conservative therapy and unfit for surgery.
Published: 2021
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3. Immunohistochemical evaluation of microsatellite instability in resected colorectal liver metastases: a preliminary experience

Author: Matteo, Barabino, Gaetano, Piccolo, Delfina, Tosi, Riccardo, Masserano, Roberto, Santambrogio, Guglielmo, Piozzi, Claudia, Cigala, Carmelo, Luigiano, Carla, Codecà, Daris, Ferrari, Maria, Ierardi Anna, Gaetano, Bulfamante, Carrafiello, Gianpaolo, and Enrico, Opocher
Published: 2020
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4. Role of Indocyanine Green Fluorescence Imaging in Minimally Invasive Resection of Colorectal Liver Metastases

Author: Gaetano Piccolo, Matteo Barabino, Antonio Pesce, Michele Diana, Francesca Lecchi, Roberto Santambrogio, Enrico Opocher, Paolo P. Bianchi, and Guglielmo N. Piozzi
Subjects: Indocyanine Green, Liver Neoplasms, Optical Imaging, Humans, Prospective Studies, Colorectal Neoplasms, Retrospective Studies
Abstract: Indocyanine green (ICG) fluorescence imaging is an easy and reproducible method to detect hepatic lesions, both primary and metastatic. This review reports the potential benefits of this technique as a tactile mimicking visual tool and a navigator guide in minimally invasive liver resection of colorectal liver metastases (CRLM). PubMed and MEDLINE databases were searched for studies reporting the use of intravenous injection of ICG before minimally invasive surgery for CLRM. The search was performed for publications reported from the first study in 2014 to April 2021. The final review included 13 articles: 6 prospective cohort studies, 1 retrospective cohort study, 3 case series, 1 case report, 1 case-matched study, and 1 clinical trial registry. The administered dose ranged between 0.3 and 0.5 mg/kg, while timing ranged between 1 and 14 days before surgery. CRLM detection rate ranged between 30.3% and 100% with preoperative imaging (abdominal computed tomography/magnetic resonance imaging), between 93.3 and 100% with laparoscopic ultrasound, between 57.6% and 100% with ICG fluorescence, and was 100% with combined modalities (ICG and laparoscopic ultrasound) with weighted averages of 77.42%, 95.97%, 79.03%, and 100%, respectively. ICG fusion imaging also allowed to detect occult small-sized lesions, not diagnosed preoperatively. In addition, ICG is effective in real-time assessment of surgical margins by evaluating the integrity of the fluorescent rim around the CRLM.
Published: 2022
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5. Laparoscopic Microwave Ablation: Which Technologies Improve the Results

Author: Roberto Santambrogio, Maurizio Vertemati, Matteo Barabino, and Marco Antonio Zappa
Subjects: Cancer Research, hepatic surgery, liver tumor, Settore MED/18 - Chirurgia Generale, Oncology, thermoablation, laparoscopy, 3D models, ICG fluorescence imaging, laparoscopic ultrasound, Settore BIO/16 - Anatomia Umana
Abstract: Liver resection is the best treatment for hepatocellular carcinoma (HCC) when resectable. Unfortunately, many patients with HCC cannot undergo liver resection. Percutaneous thermoablation represents a valid alternative for inoperable neoplasms and for small HCCs, but it is not always possible to accomplish it. In cases where the percutaneous approach is not feasible (not a visible lesion or in hazardous locations), laparoscopic thermoablation may be indicated. HCC diagnosis is commonly obtained from imaging modalities, such as CT and MRI, However, the interpretation of radiological images, which have a two-dimensional appearance, during the surgical procedure and in particular during laparoscopy, can be very difficult in many cases for the surgeon who has to treat the tumor in a three-dimensional environment. In recent years, more technologies have helped surgeons to improve the results after ablative treatments. The three-dimensional reconstruction of the radiological images has allowed the surgeon to assess the exact position of the tumor both before the surgery (virtual reality) and during the surgery with immersive techniques (augmented reality). Furthermore, indocyanine green (ICG) fluorescence imaging seems to be a valid tool to enhance the precision of laparoscopic thermoablation. Finally, the association with laparoscopic ultrasound with contrast media could improve the localization and characteristics of tumor lesions. This article describes the use of hepatic three-dimensional modeling, ICG fluorescence imaging and laparoscopic ultrasound examination, convenient for improving the preoperative surgical preparation for personalized laparoscopic approach.
Published: 2023

6. Short and long-term outcomes after minimally invasive liver resection for single small hepatocellular carcinoma: An analysis of 714 patients from the IGoMILS (Italian group of minimally invasive liver surgery) registry

Author: Felice Giuliante, Francesca Ratti, Elena Panettieri, Vincenzo Mazzaferro, Alfredo Guglielmi, Giuseppe M. Ettorre, Salvatore Gruttadauria, Fabrizio Di Benedetto, Umberto Cillo, Luciano De Carlis, Raffaele Dalla Valle, Alessandro Ferrero, Roberto Santambrogio, Francesco Ardito, and Luca Aldrighetti
Subjects: small hepatocellular carcinoma, Hepatology, Settore MED/18 - CHIRURGIA GENERALE, Gastroenterology, laparoscopic liver resection
Published: 2023

7. Augmented reality (AR) in minimally invasive surgery (MIS) training: where are we now in Italy? The Italian Society of Endoscopic Surgery (SICE) ARMIS survey

Author: Balla, Andrea, Sartori, Alberto, Botteri, Emanuele, Podda, Mauro, Ortenzi, Monica, Silecchia, Gianfranco, Guerrieri, Mario, Agresta, Ferdinando, Antonino, Agrusa, Daniele, Aguzzi, Mariantonietta, Alagia, Laura, Alberici, Marco Ettore Allaix, Luisa, Ambrosio, Alfonso, Amendola, Michele, Ammendola, Pietro Maria Amodio, Gabriele, Anania, Jacopo, Andreuccetti, Alfredo, Annichiarico, Pietro, Anoldo, Alessandro, Anselmo, Giovanni, Aprea, Giacomo, Arcuri, Alberto, Arezzo, Giulia, Armatura, Giulia, Bagaglini, Francesco, Bagolini, Beatrice, Bailetti, Gianluca, Baiocchi, Edoardo, Baldini, Elisa, Bannone, Mirko, Barone, Gianluca, Baronio, Raffaele, Basile, Bellucci, Marco, Andrea Benedetti Cacciaguerra, Ilaria, Benzoni, Francesco, Bianco, Giuseppe, Boccia, Cristina, Bombardini, Luigi, Boni, Dario, Bono, Luca Domenico Bonomo, Giulia, Bonventre, Andrea, Bottari, Claudio, Botti, Giacomo, Brentegani, Mattia, Buonomo, Umberto, Bracale, Cosimo, Callari, Luca, Calligaris, Pietro Giorgio Calò, Angelo, Cangiano, Lorenzo, Capezzuoli, Gabriella Teresa Capolupo, Marianna, Capuano, Filippo, Carannante, Eugenia, Cardamone, Teresa, Carfora, Chiara, Caricato, Pietro, Carnevali, Francesco Maria Carrano, Lorenzo, Casali, Gianmaria Casoni Pataccini, Gianluca, Cassese, Simone, Castiglioni, Flavia, Cavicchi, Ceccarelli, Graziano, Giovanni, Cestaro, Pasquale, Cianci, Claudio, Cimmino, Marco, Clementi, Coletta, Diego, Riccardo, Conventi, Corallino, Diletta, Maurizio, Costantini, Lorenzo, Crepaz, Diego, Cuccurullo, Curci, FABIO PIO, Giuseppe, Currò, Giorgio, Dalmonte, Giovanni, D'Alterio, Michele, D'Ambra, D'Ambrosio, Giancarlo, Anna, D'Amore, Michele De Capua, Simona, Deidda, Daniele, Delogu, Maurizio De Luca, Nicolò De Manzini, DE STEFANI, Elena, Giuseppe Di Buono, Marcello Di Martino, DI TOMASO, Anna, Ugo, Elmore, CORDOVA HERENCIA, INGRID ELVA, Giovanni, Emiliani, Sofia, Esposito, Fazio, Federico, Federico, Festa, Marcello, Filotico, Fiocca, Fausto, Irene, Fiume, Francesco, Fleres, Giulia, Fontana, Tommaso, Fontana, Edoardo, Forcignanò, Giampaolo, Formisano, Laura, Fortuna, Uberto Fumagalli Romario, Andrea, Galderisi, Raffaele, Galleano, Carlo, Gazia, Alessio, Giordano, Giorgio, Giraudo, Maria Carmela Giuffrida, Simona, Giura, Anna, Guida, Antonio Maria Iannello, Marco, Inama, Sara, Ingallinella, Iossa, Angelo, Livio, Iudici, Laracca, GIOVANNI GUGLIELMO, LARGHI LAUREIRO, Zoe, Saverio, Latteri, Luca, Leonardi, Pasquale, Lepiane, Edelweiss, Licitra, Paolo, Locurto, Sarah Lo Faso, Nicola, Luciani, Luzza, Luigi, Magaletti, Sara, Michele, Manigrasso, Alessandra, Marano, Francesco, Marchetti, Alessandra, Marello, Nicolò, Mariani, Jacopo Nicolò Marin, Gennaro, Martines, Laura, Mastrangelo, Antonio, Matarangolo, Marco, Materazzo, Mazzarella, Gennaro, Giorgio, Mazzarolo, Maria Paola Menna, Meoli, Francesca, Marco, Milone, Elisabetta, Moggia, Davide, Moioli, Sarah, Molfino, Vitantonio, Mongelli, Roberto, Montalti, Giulia, Montori, Luca, Morelli, Gianluigi, Moretto, Muttillo, EDOARDO MARIA, Irnerio, Muttillo, Francesca, Notte, Alessandro, M Paganini, Gianluca, Pagano, Palmieri, Livia, Giuseppe, Palomba, Valentina, Palumbo, Panetta, Cristina, Giulia, Paradiso, Beniamino, Pascotto, Passannanti, Daniele, Renato, Patrone, Francesca, Pecchini, Francesca, Pego, Fabio, Pelle, Perrotta, Nicola, Wanda, Petz, Biagio, Picardi, Picchetto, Andrea, Chiara, Piceni, Pietricola, Giulia, Enrico, Pinotti, Felice, Pirozzi, Paolo, Pizzini, Poillucci, Gaetano, Ilaria, Puccica, Lorenzo, Ramaci, Rapanotti, Eleonora, Daniela, Rega, Angelica, Reggiani, Giorgio, Romano, Gregorio, Romeo, Luigi, Romeo, Gianluca, Rompianesi, Stefano, Rossi, Edoardo, Saladino, Roberto, Santambrogio, Federica, Saraceno, Giuliano, Sarro, Diego, Sasia, Grazia, Savino, Rosa, Scaramuzzo, Antonio, Sciuto, Michela, Scollica, Giovanni, Scudo, Ardit, Seitaj, Carlo, Serra, Francesco, Serra, Pierpaolo, Sileri, Leandro, Siragusa, Carmen, Sorrentino, Giuseppe, Surfaro, Ernesto, Tartaglia, Beatrice, Torre, Andrea, Tufo, Matteo, Uccelli, Alessandro, Ussia, Vaccari, Samuele, Marina, Valente, Sara, Vertaldi, Alessandro, Vitali, Luca, Zaccherini, Luigi, Zorcolo, Noemi, Zorzetti, Balla, A., Sartori, A., Botteri, E., Podda, M., Ortenzi, M., Silecchia, G., Guerrieri, M., Agresta, F., Agrusa, A., Aguzzi, D., Alagia, M., Alberici, L., Allaix, M. E., Ambrosio, L., Amendola, A., Ammendola, M., Amodio, P. M., Anania, G., Andreuccetti, J., Annichiarico, A., Anoldo, P., Anselmo, A., Aprea, G., Arcuri, G., Arezzo, A., Armatura, G., Bagaglini, G., Bagolini, F., Bailetti, B., Baiocchi, G., Baldini, E., Bannone, E., Barone, M., Baronio, G., Basile, R., Bellucci, M., Cacciaguerra, A. B., Benzoni, I., Bianco, F., Boccia, G., Bombardini, C., Boni, L., Bono, D., Bonomo, L. D., Bonventre, G., Bottari, A., Botti, C., Brentegani, G., Buonomo, M., Bracale, U., Callari, C., Calligaris, L., Calo, P. G., Cangiano, A., Capezzuoli, L., Capolupo, G. T., Capuano, M., Carannante, F., Cardamone, E., Carfora, T., Caricato, C., Carnevali, P., Carrano, F. M., Casali, L., Pataccini, G. C., Cassese, G., Castiglioni, S., Cavicchi, F., Ceccarelli, G., Cestaro, G., Cianci, P., Cimmino, C., Clementi, M., Coletta, D., Conventi, R., Corallino, D., Costantini, M., Crepaz, L., Cuccurullo, D., Curci, F. P., Curro, G., Dalmonte, G., D'Alterio, G., D'Ambra, M., D'Ambrosio, G., D'Amore, A., De Capua, M., Deidda, S., Delogu, D., De Luca, M., De Manzini, N., De Stefani, E., Di Buono, G., Di Martino, M., Di Tomaso, A., Elmore, U., Herencia, I. E. C., Emiliani, G., Esposito, S., Fazio, F., Festa, F., Filotico, M., Fiocca, F., Fiume, I., Fleres, F., Fontana, G., Fontana, T., Forcignano, E., Formisano, G., Fortuna, L., Romario, U. F., Galderisi, A., Galleano, R., Gazia, C., Giordano, A., Giraudo, G., Giuffrida, M. C., Giura, S., Guida, A., Iannello, A. M., Inama, M., Ingallinella, S., Iossa, A., Iudici, L., Laracca, G. G., Laureiro, Z. L., Latteri, S., Leonardi, L., Lepiane, P., Licitra, E., Locurto, P., Faso, S. L., Luciani, N., Luzza, L., Magaletti, S., Manigrasso, M., Marano, A., Marchetti, F., Marello, A., Mariani, N., Marin, J. N., Martines, G., Mastrangelo, L., Matarangolo, A., Materazzo, M., Mazzarella, G., Mazzarolo, G., Menna, M. P., Meoli, F., Milone, M., Moggia, E., Moioli, D., Molfino, S., Mongelli, V., Montalti, R., Montori, G., Morelli, L., Moretto, G., Muttillo, E. M., Muttillo, I., Notte, F., Paganini, A. M., Pagano, G., Palmieri, L., Palomba, G., Palumbo, V., Panetta, C., Paradiso, G., Pascotto, B., Passannanti, D., Patrone, R., Pecchini, F., Pego, F., Pelle, F., Perrotta, N., Petz, W., Picardi, B., Picchetto, A., Piceni, C., Pietricola, G., Pinotti, E., Pirozzi, F., Pizzini, P., Poillucci, G., Puccica, I., Ramaci, L., Rapanotti, E., Rega, D., Reggiani, A., Romano, G., Romeo, G., Romeo, L., Rompianesi, G., Rossi, S., Saladino, E., Santambrogio, R., Saraceno, F., Sarro, G., Sasia, D., Savino, G., Scaramuzzo, R., Sciuto, A., Scollica, M., Scudo, G., Seitaj, A., Serra, C., Serra, F., Sileri, P., Siragusa, L., Sorrentino, C., Surfaro, G., Tartaglia, E., Torre, B., Tufo, A., Uccelli, M., Ussia, A., Vaccari, S., Valente, M., Vertaldi, S., Vitali, A., Zaccherini, L., Zorcolo, L., Zorzetti, N., Balla, Andrea, Sartori, Alberto, Botteri, Emanuele, Podda, Mauro, Ortenzi, Monica, Silecchia, Gianfranco, Guerrieri, Mario, Agresta, Ferdinando, de Manzini, Nicolo, and ARMIS (Augmented Reality in Minimally Invasive Surgery) Collaborative, Group
Subjects: Virtual reality (VR), minimally invasive surgery (MIS), Augmented reality (AR), Minimally invasive surgery (MIS), Mixed reality (MR), Survey, Training, training, augmented reality (AR), mixed reality (MR), survey, virtual reality (VR), Settore MED/18 - Chirurgia Generale, Surgery
Abstract: Minimally invasive surgery (MIS) is a widespread approach in general surgery. Computer guiding software, such as the augmented reality (AR), the virtual reality (VR) and mixed reality (MR), has been proposed to help surgeons during MIS. This study aims to report these technologies' current knowledge and diffusion during surgical training in Italy. A web-based survey was developed under the aegis of the Italian Society of Endoscopic Surgery (SICE). Two hundred and seventeen medical doctors' answers were analyzed. Participants were surgeons (138, 63.6%) and residents in surgery (79, 36.4%). The mean knowledge of the role of the VR, AR and MR in surgery was 4.9 ± 2.4 (range 1-10). Most of the participants (122, 56.2%) did not have experience with any proposed technologies. However, although the lack of experience in this field, the answers about the functioning of the technologies were correct in most cases. Most of the participants answered that VR, AR and MR should be used more frequently for the teaching and training and during the clinical activity (170, 80.3%) and that such technologies would make a significant contribution, especially in training (183, 84.3%) and didactic (156, 71.9%). Finally, the main limitations to the diffusion of these technologies were the insufficient knowledge (182, 83.9%) and costs (175, 80.6%). Based on the present study, in Italy, the knowledge and dissemination of these technologies are still limited. Further studies are required to establish the usefulness of AR, VR and MR in surgical training.
Published: 2023

8. Application of Indocyanine Green Fluorescence as an Adjuvant to Laparoscopic Ultrasound in Minimally Invasive Liver Resection

Author: Emanuele Lo Menzo, Michele Diana, Roberto Santambrogio, Matteo Barabino, Francesca Lecchi, Gaetano Piccolo, Angelo Gabriele Epifani, and Enrico Opocher
Subjects: Indocyanine Green, Liver Cirrhosis, Male, Visceral surgery, medicine.medical_specialty, Fluorescence-lifetime imaging microscopy, genetic structures, medicine.medical_treatment, Liver resections, Endosonography, Resection, 03 medical and health sciences, chemistry.chemical_compound, 0302 clinical medicine, medicine, Hepatectomy, Humans, Ultrasonography, Interventional, Aged, Fluorescent Dyes, Aged, 80 and over, business.industry, Carcinoma, Liver Neoplasms, Optical Imaging, Laparoscopic ultrasound, Middle Aged, eye diseases, Surgery, chemistry, 030220 oncology & carcinogenesis, Female, Laparoscopy, 030211 gastroenterology & hepatology, Radiology, business, Adjuvant, Indocyanine green, Indocyanine green fluorescence
Abstract: Background: Indocyanine green (ICG) fluorescence imaging has been extensively used in a variety of applications in visceral surgery. In minimally invasive liver resections, the detection of small s...
Published: 2021
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9. Micronvasive behaviour of single small hepatocellular carcinoma: which treatment?

Author: Marco Zappa, Roberto Santambrogio, Marco Gemma, Enrico Opocher, Giulio Iacob, Matteo Barabino, and Valentina D'Alessandro
Subjects: medicine.medical_specialty, Carcinoma, Hepatocellular, Radiofrequency ablation, medicine.medical_treatment, Liver transplantation, Gastroenterology, law.invention, 03 medical and health sciences, 0302 clinical medicine, law, Internal medicine, medicine, Hepatectomy, Humans, Proportional Hazards Models, Retrospective Studies, Ultrasonography, Proportional hazards model, Bile duct, business.industry, Liver Neoplasms, Hazard ratio, medicine.disease, Surgery, Treatment Outcome, medicine.anatomical_structure, Tumor progression, 030220 oncology & carcinogenesis, Hepatocellular carcinoma, Propensity score matching, Catheter Ablation, 030211 gastroenterology & hepatology, Neoplasm Recurrence, Local, business
Abstract: Microinvasion (MI), defined as infiltration of the portal or hepatic vein or bile duct and intrahepatic metastasis are accurate indicators of a poor prognosis for mall hepatocellular carcinomas (HCC). A previous study showed that intraoperative ultrasound (IOUS) definition of MI-HCC had a high concordance with histological findings. Aim of this study is to evaluate overall survival and recurrence patterns of patients with MI-HCC submitted to hepatic resection (HR) or laparoscopic ablation therapies (LAT). A total of 171 consecutive patients (78 h; 93 LAT) with single, small HCC (
Published: 2021
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10. Planning the treatment: preoperative 3D reconstruction

Author: Roberto Santambrogio, Maurizio Vertemati, Edgardo Picardi, and Marco Antonio Zappa
Subjects: liver tumor, Settore MED/18 - Chirurgia Generale, Settore BIO/16 - Anatomia Umana, 3D models, 3D printing, virtual reality (VR), Hepatic surgery, laparoscopy, thermoablation, Radiology, Nuclear Medicine and imaging, Surgery
Published: 2022

11. Fluorescence and Ultrasound-guided Laparoscopic Resection of Caudate Lobe for Hepatocellular Carcinoma Located in the Retrocaval Portion

Author: Roberto Santambrogio, Marco Zappa, Valentina D'Alessandro, and Giulio Iacob
Subjects: Male, medicine.medical_specialty, Carcinoma, Hepatocellular, Blood transfusion, medicine.medical_treatment, Hepatectomy, Humans, Medicine, Caudate lobe, Laparoscopic resection, Child, Ultrasonography, Interventional, Ultrasonography, Aged, 80 and over, business.industry, Liver Neoplasms, Nodule (medicine), Hepatitis C, medicine.disease, Ultrasound guided, Hepatocellular carcinoma, Female, Laparoscopy, Liver function, Radiology, medicine.symptom, business
Abstract: Background Contrast-enhanced intraoperative ultrasonography (CEIOUS) and indocyanine green fluorescence were interesting tool for the visualization of intrahepatic neoplastic nodules. The combinations of the 2 technologies could increase tumor detection and the radicality of resection, allowing the use of a pure laparoscopic approach. Methods The patient was an 81-year-old man with a history of hypertension and treated hepatitis C infection, with a sustained serological response from 2018, previously undergoing laparotomic resection for hepatocellular carcinoma (HCC) in segment 8.During his regular hepatological follow-up, a 25 mm nodule was detected in segment 1, in a retrocaval position. Considering clinical presentation, good liver function (Child A5-MELD 8) and imaging, pure laparoscopic resection of the caudate lobe was performed using fluorescence imaging and CEIOUS navigation guidance. Results The operation last for 205 minutes. Blood loss was 100 mL and no blood transfusion was required. She resumed diet on the next day and was discharged 4 days after the operation. Histopathologic examination showed 27 mm HCC with a clear margin. Contrast computed tomography scan performed 3 months after the operation showed no recurrence of the disease. Conclusions A laparoscopic isolated caudate resection for HCC located in the retrocaval portion of the cirrhotic liver seems to be feasible in selected patients and fluorescence imaging and CEIOUS navigation guidance could guarantee a safe and successful surgery.
Published: 2021
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12. LI-RADS to categorize liver nodules in patients at risk of HCC: tool or a gadget in daily practice?

Author: Salvatore Alessio Angileri, Roberto Santambrogio, Giuseppe Franceschelli, Matteo Barabino, Cecilia Fochesato, Gianpaolo Carrafiello, N. Mariani, Martina Gurgitano, and Enrico Opocher
Subjects: medicine.medical_specialty, medicine.diagnostic_test, business.industry, Focal nodular hyperplasia, Magnetic resonance imaging, Interventional radiology, General Medicine, medicine.disease, Positive predicative value, Hepatocellular carcinoma, medicine, Radiology, Nuclear Medicine and imaging, Radiology, Radiation treatment planning, business, Pathological, Neuroradiology
Abstract: To determine the effectiveness of liver reporting and data system (LI-RADS) to diagnose hepatocellular carcinoma (HCC) and to retrospectively evaluate its impact on the adopted therapeutic strategy. Preoperative imaging of 40 of 350 patients (median age 66, 31 M/9 F) submitted to liver resection for suspected HCC, between January 2008 and August 2019, has been retrospectively analyzed by two radiologists with different expertise, according to CT/MRI LI-RADS® v2018, both blinded to clinical and pathological results and untrained to using aforementioned scoring system. The perfect agreement between the readers was about 62.5% (25/40) (Cohen k: 0.41), better for LR-5 category (16/25) and higher in magnetic resonance imaging (MRI) investigations (68%; 13/19), which has been demonstrated the modality of choice for diagnosis of high probable and certain HCC, with arterial phase hyperenhancement as the most sensitive and accurate major feature. Compared to final histology, LR4 and LR5 scores assigned by senior radiologist reached sensitivity, specificity, positive and negative predictive values (PPV, PNV) and diagnostic accuracy of 90,9%, 29,0%, 93,8%, 62,5% and 87,5%, respectively, slightly higher than junior’s ones. Misdiagnosis of HCC was done by both radiologists in the same two patients: 1 primary hepatic lymphoma (PHL) and 1 regenerative liver nodule (RLN). If LI-RADS would have been applied at the time of pre-surgical imaging, treatment planning would be modified in 10% of patients (4/40); the patient scheduled as LR-3 and finally resulted a focal nodular hyperplasia would have avoided liver resection. Application of LI-RADS, especially on MRI, may provide a more accurate evaluation of suspected HCC. PHL and RLN are the Achille’s heels according to our experience.
Published: 2020
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13. Laparoscopic ablation therapies for hepatocellular carcinoma: could specific indications for the laparoscopic approach influence the effectiveness?

Author: Roberto Santambrogio, Enrico De Nicola, Elisa Galfrascoli, Marco Giovenzana, Matteo Barabino, and Marco Zappa
Subjects: Adult, Male, medicine.medical_specialty, Carcinoma, Hepatocellular, Percutaneous, Radiofrequency ablation, medicine.medical_treatment, Endosonography, law.invention, 03 medical and health sciences, 0302 clinical medicine, law, medicine, Hepatectomy, Humans, Aged, Aged, 80 and over, Radiofrequency Ablation, business.industry, Patient Selection, Mortality rate, Liver Neoplasms, Nodule (medicine), Middle Aged, medicine.disease, Ablation, Surgery, Treatment Outcome, Tumor progression, 030220 oncology & carcinogenesis, Hepatocellular carcinoma, Severe morbidity, Female, Laparoscopy, 030211 gastroenterology & hepatology, Neoplasm Recurrence, Local, Safety, medicine.symptom, business, Follow-Up Studies
Abstract: Percutaneous thermo-ablation (TA) may be unfeasible for the tumor location: laparoscopic ablation therapies (LATs) are an alternative option. The aim of this study is to assess the efficacy of LATs in the treatment of HCC not eligible for percutaneous TA or surgical resection. LAT was offered to 503 patients fulfilling at least one of the following criteria: (a) patients with a single nodule or up to three nodules smaller than 3 cm not suitable for surgery; (b) patients not suitable for percutaneous TA; (c) short-term recurrence of HCC (
Published: 2020
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14. Correlation Between Indocyanine Green Fluorescence Patterns and Grade of Differentiation of Hepatocellular Carcinoma: A Western Prospective Cohort Study

Author: Gaetano Piccolo, Matteo Barabino, Roberto Santambrogio, Francesca Lecchi, Giulio Di Gioia, Enrico Opocher, and Paolo Pietro Bianchi
Subjects: Surgery
Abstract: Background. Most of the available evidence on the use of indocyanine green (ICG) fluorescence in clinical practice consists of articles published by surgeons of the Asian-Pacific area. We performed a prospective cohort study to assess the patterns of ICG fluorescence in Western hepatocellular carcinoma (HCC) counterparts. Methods. From April 2019 to January 2022, a total of 31 consecutive patients who underwent laparoscopic liver resection (LLR) for superficial HCC were enrolled in this prospective study. All patients underwent laparoscopic staging with both laparoscopic ultrasound (LUS) and ICG fluorescence imaging. Results. A total of 38 hepatocellular carcinomas (HCCs) were enrolled: 23 superficial (surfacing at the liver’s Glissonian capsule), 5 exophytic, 5 shallow (10 mm from the hepatic surface). The detection rate with preoperative imaging (abdominal CT/MRI), LUS, ICG fluorescence and combined modalities (ICG and LUS) was 97.4%, 94.9%, 89.7% and 100%, respectively. The five deep seated lesions underwent ultrasound-guided laparoscopic thermal ablation. The other 33 HCCs were treated with minimally invasive liver resection. Intraoperative ultrasound patterns were registered for each single nodule resected. The ICG fluorescence pattern was classified in two types: total fluorescence (all the tumoral tissue showed strong and homogeneous fluorescence), n = 9/33 (27.3%), and non-total fluorescence (partial and rim fluorescence), n = 24/33 (72.7%). There was a statistical correlation between ICG patterns and grade of differentiation. Almost all lesions with uniform fluorescence pattern were well-differentiated HCCs (G1-G2), while partial and rim-type fluorescence pattern were more common among moderately and poorly differentiated HCCs (G3-G4) (88.9% vs 11.1%, 37.5% vs 62.5%, P = .025, respectively). Conclusions. ICG fluorescence imaging could be used to identify early the grade of HCC, ie intraoperatively, thus influencing the intraoperative treatment.
Published: 2023
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15. Nodule-in-nodule Hepatocellular Carcinoma: A Surprise Lesion

Author: Marco Antonio Zappa, Francesca Nava, Edgardo Picardi, Filippo Bianchi, and Roberto Santambrogio
Subjects: Carcinoma, Hepatocellular, Liver Neoplasms, Gastroenterology, Humans, Precancerous Conditions
Published: 2021

16. The thin red line: ileal angiodysplasia versus SARS-CoV-2-related haemorrhagic enteritis

Author: Massimo Francese, Carlo Ferrari, Marco Lotti, Elisa Galfrascoli, Roberto Santambrogio, Anna Maria Ierardi, Claudia Gabiati, and Marco Antonio Zappa
Subjects: General Medicine, Pathology and Forensic Medicine
Published: 2022
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17. Guidelines Adaptation to the COVID-19 Outbreak for the Management of Hepatocellular Carcinoma

Author: Roberto Santambrogio, Gabriella Farina, Marco Zappa, Marco Gemma, Valentina D'Alessandro, and Giulio Iacob
Subjects: Male, medicine.medical_specialty, Carcinoma, Hepatocellular, medicine.medical_treatment, Operative Time, Comorbidity, 03 medical and health sciences, 0302 clinical medicine, Intensive care, medicine, Hepatectomy, Humans, Laparoscopy, Pandemics, Aged, Aged, 80 and over, medicine.diagnostic_test, SARS-CoV-2, business.industry, General surgery, Liver Neoplasms, COVID-19, Disease Management, Postoperative complication, Length of Stay, Middle Aged, Hemothorax, medicine.disease, Surgery, Pneumonia, 030220 oncology & carcinogenesis, Female, 030211 gastroenterology & hepatology, Guideline Adherence, Chest radiograph, business
Abstract: Background: COVID-19 pandemic rendered the surgical approach as well as the surgical indication very complex due to the outstanding consumption of public health system' resources, especially in the intensive care subdivision. A multidisciplinary team-based strategy is necessary to adapt guidelines and medical practices to the actual situation. The aim of this study is to evaluate the changes in the therapeutic algorithm in a small group of patients with hepatocellular carcinoma (HCC) enlisted for surgery during the COVID-19 outbreak. Materials and Methods: A multidisciplinary strategy has been adopted to allocate HCC patients to a treatment that permitted to reduce the risk of complications and the hospital stay, thus preventing contamination by the virus. Nasopharyngeal swab and a chest radiograph were performed in all patients within 48 hours before the surgical procedure: in the suspected cases with negative COVID tests, we prudently postponed surgery and repeated the diagnostic tests after 15 days. Results: During the emergency state, 11 HCC patients were treated (8 laparoscopic ablations and 3 hepatic resections). We reported only 1 postoperative complication (hemothorax) and 1 death during the follow-up for COVID pneumonia. Comparing our performances with those in the same time frame in the past 4 years, we treated a similar number of HCC patients, obtaining a decrease in operative timing (P = .0409) and hospital stay (P = .0412) (Fig. 2b) with similar rates of immediate postoperative complications, without ICU admissions. [Figure: see text] Conclusions: An adapted algorithm for the treatment of HCC to COVID outbreak permitted to manage safely these patients by identifying those most at risk of evolution of the neoplastic disease.
Published: 2021
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18. Timing of surgery following SARS-CoV-2 infection: an international prospective cohort study

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Eddine Oussama Kacimi, Luis, Boccalatte, Daniel, Cox, Philip, Townend, Felix, Aigner, Irmgard Elisabeth Kronberger, Elgun, Samadov, Amer, Alderazi, Kamral, Hossain, Greg, Padmore, Gabrielle van Ramshorst, Ismaïl, Lawani, Anis, Cerovac, Samir, Delibegovic, Gustavo Mendonça Ataíde Gomes, Igor Lima Buarque, Muhammad, Gohar, Mihail, Slavchev, Chukwuemeka, Nwegbu, Arnav, Agarwal, Janet, Martin, Joshua, Ng-Kamstra, Maricarmen, Olivos, Wenhui, Lou, Dong-Lin, Ren, Jose Andres Calvache, Carlos, J Perez Rivera, Ana Danic Hadzibegovic, Tomislav, Kopjar, Jakov, Mihanovic, Pablo Mijahil Avilés Jiménez, Nikolaos, Gouvas, Jaroslav, Klat, René, Novysedlák, Nicolas, Amisi, Peter, Christensen, Alaa, El-Hussuna, Sylvia, Batista, Eddy, Lincango-Naranjo, Sameh, Emile, Danilo Alfonso Arévalo Sandoval, Hailu, Dhufera, Samuel, Hailu, Mengistu, G Mengesha, Joonas, H Kauppila, Alexis, P Arnaud, Zaza, Demetrashvili, Markus, Albertsmeier, Hans, Lederhuber, Markus, W Löffler, Daniel Kwesi Acquah, Bernard, Ofori, 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Amanda Lira Dos Santos Leite, Laercio, Pol-Fachin, Tainá Santos Bezerra, Alcimar Lavareda Dos Santos Junior Alcimar, Robson, Amorim, Maria Eduarda Bellotti Leão, João José Corrêa Bergamasco, Cintia Cardoso Pinheiro, Rubem Alves Da Silva Neto, Elaine Francisca De Araújo, Lilian, Guimaraes, Tatiana, Liborio-Kimura, Isabelle Melo da Camara, Victor Ripardo Siqueira, Juan, Rodriguez, Jeancarllo, Silva, Rubem Alves Silva Junior, Cláudio, Cardoso, Andre, Guimaraes, Wislene Sarajane Moreira Alves, Agna Soares Da Silva Menezes, Marcelo, Araujo, Kattiucy, Brito, Josie Marcelle Lira Albuquerque, Jairo Alberto Dussan-Sarria, Andressa, Souza, Andre Ricardo Stüker, Tiago, Bresciani, Luciana Cadore Stefani, Leandro Totti Cavazzola, Tainá, Costa, Matheus, Dasqueve, Gustavo De Bacco Marangon, Otávio Ritter Silveira Martins, Josy, Rodrigues, Guilherme Roloff Cardoso, Brasil Silva Neto, Tilaê, Soares, Aline, Zanella, Lucas Torelly Filippi, Enilde Eloena Guerra, Ricardo Pedrini Cruz, Antonio Nocchi Kalil, Gustavo, Laporte, Moacyr, Salem, Murilo de Lima Brazan, Caio Antonio de Campos Prado, Elaine Christine Dantas Moises, Hilda Satie Suto, Alice Gadotti Yasuda, Ana Carolina Tagliatti Zani, Roberto Cardoso Cardoso Dos Santos, Geraldo, Duarte, Edwaldo Edner Joviliano, Carolina Lourenço Gomes Dos Santos, Silvana Maria Quintana, Edwin, Tamashiro, Fabiana Cardoso Pereira Valera, Marília Veccechi Bijos Zaccaro, Isis, Andreotti, Leonardo, Lima, Wilson Salgado Jr, Alonço da Cunha Viana Júnior, Lana, Moutinho, Cora Pichler de Oliveira, Isabela Trindade Martins, Isabela Vieira Toledo, Marco Antonio Correa Guimaraes-Filho, Rodrigo, Arrivabeno, Claudio Bovolenta Murta, Danniel Frade Said, Jose Pontes Junior, Felipe Guimarães Pugliesi, Paulo, Gregorio, Alessandro, Mariani, Fabio, Minamoto, Juliana Lourenço da Silva, Bruno, Muller, Caio, Zanon, Vladimir, C Carvalho, Ana Lucia Munhoz Lima, Priscila, R Oliveira, Jorge Dos Santos Silva, Mariana Faccini Teixeira, Marco, Kulcsar, Leandro, Matos, Kamilla 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Brackstone, Eunice, Chan, Davy, Cheng, Jason, Chui, Nelson, Gonzalez, Brent, Lanting, S Danielle MacNeil, Robert, Mayer, Jacob, Mcgee, Mahesh, Nagappa, Nicholas, Power, Agya, Prempeh, Mehdi, Qiabi, Hassan, Razvi, Emil, Schemitsch, Herman, Sehmbi, Ushma, Shah, Yamini, Subramani, Edward, Vasarhelyi, Kelly, Vogt, Homer, Yang, Ali Ghorbani Abdehgah, Saba, Balvardi, Liane, Feldman, Julio Flavio Fiore Jr, Melissa, Hanson, Brent, Hopkins, Pepa, Kaneva, Lawrence, Lee, Julia, Leonard, Jad, Abou-Khalil, Andre, Martel, James, Stevenson, Susan, Lee, Richard, Merchant, Samuel, Avoine, Laurence, Belanger, Mathieu, Belanger, Etienne, Belzile, Anne-Sophie, Blais, Sofia, Boucher-Kovalik, Cindy, Boulanger-Gobeil, Etienne, Cardinal, Pierre-Olivier, Champagne, Jonathan, Cloutier, Simon, Corriveau-Durand, Mathieu, Cote, Maxime, Cote, Mathilde, Côté, Valérie, Courval, Suzanne, Demers, Christine, Desbiens, Mehdi El Ouazzani, Karine, Girard, Ève-Marie, Girard, Karo, Gosselin, Helene, Khuong, Nathalie, 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Pu, Hanlin, Yin, Camilo, Caicedo, Diego Felipe Tellez Beltran, Alejandro, Escobar, Carolina Perez Granados, Lisbeth Alexandra Urueña Pinzon, Carlos, Bonilla, Diana, Santana, Oscar, Serrano, Andrea, Garcia, Fernando Giron Luque, Nasly, G Patino-Jaramillo, Laura Giselle Contreras Baquero, Nestor Augusto Muñoz Botero, Jhoana Andrea Murillo Castellanos, Andrea Juliana Vega Calvera, Lina, M Acosta Buitrago, Maria Paz Bohórquez-Tarazona, Paulo Andrés Cabrera Rivera, J Felipe Casas, Valeria Cormane Alfaro, Julian, Corso, Bayron, Guerra, Albert Franz Guerrero-Becerra, Akram Kadamani Abiyomaa, Felix Ramon Montes, Manuel Santiago Mosquera Paz, Camilo Andrés Polanía Sandoval, Natalia, Quintana, Carlos Fernando Roman Ortega, Carlos, Santacruz, Manuela, Téllez, Camilo Alejandro Velandia Sánchez, Fernando, Arias-Amézquita, Luis Felipe Cabrera Vargas, Natalia Cortes Murgueitio, Elkin, Escorcia, Kemel Ahmed Ghotme Ghotme, Jorge Luis Gomez-Mayorga, Alvaro Felipe Guerrero Vergel, Gabriel, Herrera-Almario, Eduardo, Londono-Schimmer, Juan, A Mejia, Guillermo, Monsalve, Camilo, Rodriguez, Juan Nicolas Rodriguez Niño, Luis Martín Rodríguez Ortegón, Daniel, Sanabria, Andres, Alvarez, Arnulfo, Andrade, Javier, Ardila-Montealegre, David, Baquero, Edgar Mauricio Barrios Vidales, María Alejandra Caicedo Giraldo, María Camila Carvajal, Maria, Castillo, Maria Carolina Castillo Florez, María Angelica Cendales, Danny Conde Monroy, Henry, Cortes, Mario, Daniel, Jairo De la Peña, Elena Leonor Delgado-Nieto, Hernando, Espitia, Carlos Figueroa Avendaño, Edgar Oswaldo Hernandez Burgos, Andres, Isaza-Restrepo, German, Londono, Margarita Maria Maldonado, Andrea, Montenegro, Juan Carlos Navarro, Jorge, Navarro-Alean, Katherine Parra Abaunza, Eliana, Pulido, Erika, M Ramírez Amaya, Carlos Eduardo Rey Chaves, Natalia Andrea Rivera Rincón, William Mauricio Riveros Castillo, Lizeth Rodriguez Sanchez, Wilson, Rubiano, Maria, Russi, Juan Carlos Sabogal Olarte, Javier Mauricio Salgado Tovar, Maria Juliana Sanchez, David Mauricio Solano Varela, Paula Torres Gomez, Marcial, Trillos, Ana María Vargas Patiño, Felipe, Vargas-Barato, Juan Pablo Villate Leon, María Alejandra Wagner Useche, Jesus, Acosta, Adriana, Almeciga, Luis Becerra Mendez, Rafael Jose Beltran, Ana, Bonilla, Miguel, Buitrago, Marino, Cabrera, Pedro Hernando Calderon Quiroz, Diego, Camacho-Nieto, Carlos Andrés Carvajal Fierro, Sergio Cervera Bonilla, Sandra, Diaz, Helena, Facundo, Jorge, Forero, Mauricio Garcia Mora, Karena Victoria Garcia Tirado, German Fabian Godoy Perez, Felipe, Gonzalez, Oscar, Guevara, Jairo Alonso Hernandez, David Ricardo Herrera Mora, Juan David Lalinde, Carlos, Lehmann, Eduardo Leon Llanos, Byron Eduardo Lopez De Mesa Lopez, Ivan, Mariño, Monica, Medina, Raúl Eduardo Pinilla Morales, Angela, Puerto, Andrea, Quintero-Ortíz, Juliana Rendón Hernández, Elio Fabio Sánchez Cortés, Alvaro Eduardo Sánchez Hernández, Raul, Suarez, Oscar, Suescun, Marco, Vanegas, Rodolfo, Varela, Jorge Luis Velez 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Vanja, Žufić, Matea, Zuzul, Srdan Ante Anzic, Iva, Carevic, Dubravka Heli Litvic, Duska, Markov-Glavas, Tatjana Savic Jovanovic, Goran, Augustin, Jerko, Biloš, Bojan, Biočina, Vedrana, Biosic, Dino, Bobovec, Iva, Botica, Boris, Bumber, Petra, Čerina, Katarina Duric Vukovic, Hrvoje, Gasparovic, Lucija, Gatin, Kresimir, Grsic, Ika Gugić Radojković, Ivan, Jelčić, Zeljko, Kastelan, Juraj, Kolak, Tomislav, Kulis, Kristian, Kunjko, Marjan, Maric, Marcel Marjanović Kavanagh, Borna, Milicic, Trpimir, Morić, Miram, Pasini, Luka, Penezić, Drago, Prgomet, Ratko, Prstacic, Andreja, Prtorić, Rudolf, Radojković, Ivan, Romić, Tomislav, Sečan, Dora Škrljak Šoša, Juraj, Slipac, Mislav, Tomic, Jurica, Zedelj, Toni, Zekulić, Zoran, Zimak, Mia, Lorencin, Ivica, Luksic, Matija, Mamic, Norberto Miranda Espinsa, Ailén Sánchez Cruz, Stavros, A Antoniou, Michael, Kakas, Yiannis, Panayiotou, Heyam, Almezghwi, Kalbim, Arslan, Hasan, Besim, Ali, Özant, Necdet, Özçay, Georgios, Kokkinos, Panayiotis, Papatheodorou, 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Nathalia, Capellan, María Fernanda Cedeño Bruzual, Saray Cordero Spencer, Gabriella Cuevas Lantigua, Luis De Jesus, Gabriela, Díaz, Pedro Pablo Díaz Vásquez, Karla, Disla, Jesús Antonio Echavarría Uceta, Paola Irina Eusebio Jimenez, Damaris, Fernandez, Marlin Fernandez Camilo, Jiomar Manuel Figueroa Germosen, Maruel, Fortunato, Leyla Gabriel Fernández, Alicia German Dihmes, Héctor, Herrera, Elizabeth Leon Cuevas, Jose Alejandro Mata, Mirian Mateo De La Cruz, Dolores Mejia De la Cruz, Marcos, Mirambeaux, Fabio Ortiz De La Cruz, Henry, Paulino, Gabriela, Pelletier, Merycarla, Pichardo, Rodriguez Pumarol Próspero Enrique, Julio, Rivas, Ann Stephany Sanchez Marmolejos, Roman Santana Santana, Irina Suero Almanzar, María Magdalena Vásquez Sánchez, Nicolás, Campuzano, José Ricardo Negrete Ocampo, Maria, Armas, Alvaro Santiago LeMarie Guerra, Gustavo León Vizcaya, Omar Ahmed Abdelwahab, Ahmed, O Elmehrath, Mohammed Ezzat Mostafa, Gamal, Amira, Ibrahim, Sallam, Mohamed, Sherief, Ahmed, Abdelmajeed, Mostafa, Abdou, Ahmed Abo Shanab, Aya, Abodeeb, Roger, Aboelkhel, Nour Eldin Abosamak, Amna Abou Bakr, Samar, Aboubakr, Yossof, Abouelnagah, Omar, Aboumadawy, Dina, Adel, Nermeen, Afifi, Sara, Ahmed, Abedelrahman, Ahmed, Mohamed Al Sayed, Abdelrahman, Alberkamy, Mohamed, Aldahma, Ahmed, Ali, Mostafa, Ali, Mohamed Amin Bakr, Alaa, Anter, Doaa, Asal, Fouad, Ashoush, Olfat, Ashraf, Abdel Rahman Ashraf, Rewan, Atta, Salma, Badr, Mohamed, Bahaaeldin, Mostafa, Bastawesy, Sara, Darwish, Rasha El Kharashy, Ziad, Elassar, Seifeldin, Elbadawy, Dina, Elkhity, Alromisaa, Elsaka, Manal, Elsayed, Mostafa Elsayed Elsayed Hewalla, Mohamed, Elshafey, Youssof, Eshac, Fares, Eshac, Amr, Essameldin, Moataz, Ewedah, Yara, Ezz, Mohamed, Farag, Inas, Gadelkarim, Ziyad, Gadelrab, Dina, Gamal, Mira, Ghaly, Nathalie, Girgis, Omar, Gouda, Nancy, H El Goweini, Nour, Hafez, Youssef, Hafez, Abdelkader Hamed Abdin, Rodina, Hanno, Aliaa, Hassanin, Mohamed, Hassanin, Hanan, M Hemead, Abdelrahman, Hemida, Maher, Hosain, Ahmed, Hossam, Hamza Hussein Aly Salama Aly, Mohamed, Ibrahim, Abdelrahman, Ibrahim, Nourhan, Ibrahim, Noha Mohamed Salah Ibrahim Moussa Hamouda, Monica, Iskander, Islam, Khalifa, Mostafa, Kotb, Nada, Mahmoud, Alaa Mahmoud Abo Shabana, Nora, Mamdouh, Maram, Metwalli, Khaled, Metwally, Mahmoud, Moghazy, Moustafa, Mohamed, Mohamed, Mourad, Esraa, Moustafa, Kamilia, Mubarek, Nour Eldin Nader, Ahmed, Nasser, Samaa, Omar, Mostafa Shehata Qatora, Mohamed, Ragab, Marawan, Ragal, Dina, Ramadan, Rana, Ramadan, Sara, Ramadan, John, Romany, Ahmed, Sabry, Yasmeen, Said, Sara, Salamah, Ahmed Mostafa Saleh, Mona Saleh Mesbah Mohamed Elkaffas, Alaa, Salem, Hashem, Salim, Ahmed, Samih, Ahmed Samir Abdelaal, Ahmed, Shaheen, Yassmeen Sharafeldin Mohammed, Abdelrahman, Shehata, Mohamed, Shemeis, Karim, Shenit, Mennatallah, Sheta, Asmaa, Soffar, Yousef, Tanas, Ahmed, Tarek, Nermin, Yehia, Omar Khaled Mohamed Eid, Ammar Yasser Abdulfattah, Ahmed, Elsaghir, Mohamed Fouad Elganainy, Omar Ibrahim Elsayed, Omar, Elmandouh, Omar, Hamam, Mostafa Ahmed Shehata, Areej, A Abdelaziz, Ahmed, M Abbas, Wael Abd El-Ghani, Hossam Aldein, S Abd Elazeem, Mustafa Abd Elsayed, Ahmed Yassien Abd-Elkariem, Shimaa, Abdalla, Mahmoud, Abdel-Aleem, Khaled, Abdelazeem, Mahmoud, Abdelfattah, Mohammed, Abdelhafez, Mohamed, M Abdelkarem, Ali, Abdelraouf, Lamess, Abdullaha, Hossam, Abubeih, Moaiad Eldin Ahmed, Nagm Eldin Abu Elnga Ahmed, Ahmed, Ahmed, Sarah Ahmed Saad, Sherif, Alaa, Ali, Alhussaini, Abdelrahman Ahmed Abdelrahman Ali, Ibrahim, Ali, Wagdi, Ali, Mohamed Ali Mohamed, Mohamed, Ashraf, Muhammad, Bassiouni, Mohamed, G El-Adawy, Mohammad, El-Sharkawi, Hussein, Elkhayat, Khaled, Elmaghraby, Shady, Elsdfy, Mohamed, Elsharkawy, Almoutaz, Eltayeb, Mohamed Esmat Mohamed, Esraa, Essam, Mahmoud, Fahd, Osama, Farouk, Rabea, Gadelkareem, Ahmed, Ghoneim, Mohammed Hamada Takrouney, Ahmed, Hamdan, Abd El-Rahman Hamed, Ahmad, Hasan, Mohamed Abdelghafor Hassanin, Islam, Hawal, Kerollos, Henes, Mohamed Omar Herdan, Helal, F Hetta, Omar, Ibrahem, Mostafa, Ibrahim, Islam, H Ibrahim, Mahmoud, Kamel, Mohamed, Khallaf, Shrouk, M Elghazaly, Abobakr, Mahfouz, Osman, Mahmoud, Wesam, Mahran, Doha, Mahrous, Abadeer, Marsis, Ayman, Mohamed, Aliae Mohamed Hussein, Amr Mohamed Sayed, Mahmoud, M Mohammed, Ahmed, Mokhtar, Fatma, A Monib, Ahmed, Nageeb, Mariam Albatoul Nageh, Mohammed, Nageh, Nehal Gamal Omar, Abdelrahman, Ragab, Abdelrahman, Ramadan, Abdallah Rashad Temerik, Aya, Sabry, Hadeer, Safwat, Omar, Salah, Ahmed Elhussiny Salah Mahmoud, Ahmed, Saleh, Mahmoud, Sallam, Ahmed, Samir, Reem, Sayad, Esraa, Sayed, Ahmed, S Sedik, Mohammed, Shahine, Antonios, Soliman, Wael, Soliman, Mohamed Gamal Taher, Randa, Wanees, Ebrahim Ahmed Yousof, Ahmed, Youssef, Omar Zein Elabedeen, Ahmed Emad Sayed Hassan, Shrouk Abdel Fattah, Ahmed, Abostate, Samar, Ali, Saad Ali Saad Salama, Mohamed, Allam, Ahmed, Alsadek, Ebrahim, Arafa, Ahmed, Barakat, Mohammed El Sherpiny, Gehad, Elbehairy, Mahmoud, Eleisawy, 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Bahi, Abdurhman, Atea, Ibrahim, Gamal, Mohamed El Kassas, Wael, Omar, Ahmed, Tawheed, Saeid, Al-Oribi, Nuran Khaled Aly, Mahmoud, Elfiky, Alaa Eldine Elmaghraby, Abdulrahman, Elrahmany, Motaz, Elsherbeeny, Youssef, Helmy, Ahmed, Nabil, Ahmed Samir Farahat, Mostafa, Soliman, Amr, Wassef, Abdelrahman, Abdelrahman, Seif, Elsaban, Galal, Ghaly, Rana, Hamdy, Hamada, Mondy, Lubna, Abdallah, Abdelrhman Kz Darwish, Mohamed, Rabea, Mohammed, A Azab, Alzhraa Salah Abbas, Marwa, El-Deeb, Mohamed, Fawzy, Maher, Ibraheem, Abdelrahman, Bakry, Sarah, Elnems, Randa, Elsheikh, Mohamed Ibrahim Gbreel, Mahmoud, Hafez, Mohamed, Jammal, Khaled, M Hamam, Abdelrahman, M Makram, Omar Mohamed Makram, Salma, Rabie, Sherine Yousery Askalany, Mokhtar Mohamed Ibrahim Abushanab, Abdulrahman, Eid, Mohammed Refaat Ibrahiem Amin El Ghalid, Ahmed Adel Abdelaty, Elsayed, A Fayad, Asmaa, Radwan, Moataz, Sallam, Ahmad, Shokry, Ahmed Mohamed Farouk, Ahmed, Elfallal, Hossam, Elfeki, Mohamed, Elsaeed, Mahmoud, Elsaid, Amany, 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Virgilio, Matteo Di Bari, Fabio, Ferreli, Francesca, Gaino, Marco, Gramellini, Carlotta La Raja, Luca, Malvezzi, Salvatore, Marano, Giuseppe, Mercante, Flavio, Milana, Gennaro, Nappo, Georgios, Peros, Francesca, Pirola, Vanessa, Rossi, Elena, Russo, Giuseppe, Spriano, Sara, Tamburello, Alessandro, Zerbi, Alberto, Aiolfi, Davide, Bona, Andrea, Sozzi, Laura, Adamoli, Mohssen, Ansarin, Luca, Bertolaccini, Sabine, Cenciarelli, Francesco, Chu, Rita De Berardinis, Uberto Fumagalli Romario, Giacomo, Pietrobon, Giulia, Sedda, Lorenzo, Spaggiari, Marta, Tagliabue, Antonella, Ardito, Maria, Caputo, Paola, Cellerino, Valentina, D'Alessandro, Elisa, Galfrascoli, Maria Paola Giusti, Marco, Lotti, Roberto, Santambrogio, Marco Antonio Zappa, Andrea, Bondurri, Alessandro Michele Bonomi, Francesco, Colombo, Michele Achille Crespi, Piergiorgio, Danelli, Angelo Gabriele Epifani, Luca, Ferrario, Alice, Frontali, Claudio, Guerci, Anna, Maffioli, Francesco, Ferrara, Luca Antonio Aldrighetti, Domenico, Baccellieri, Luca, Bertoglio, Giulia, Bonavina, Massimo, Candiani, Giorgio, Candotti, Arianna, Casiraghi, Laura Mariangela Castellano, Paolo Ivo Cavoretto, Roberto, Chiesa, Federica, Cipriani, Paola De Nardi, Guido, Fiorentini, Filippo, Gagliardi, Alessandro, Galdini, Alessandro, Grandi, Elena, Marotta, Simonetta, Massaron, Andrea, Melloni, Pietro, Mortini, Gianluca, Nocera, Martina, Piloni, Mirko, Pozzoni, Francesca, Ratti, Riccardo, Rosati, Alessandro Ferdinando Ruffolo, Pierpaolo, Sileri, Alfio, Spina, Andrea, Vignali, Cristina, Barberio, Luigi, Beretta, Francesca, Cavenago, Nora Di Tomasso, Stefano, Fresilli, Giovanni, Landoni, Stefano, Lazzari, Gaetano, Lombardi, Marilena, Marmiere, Fabrizio, Monaco, Gabriele, Todaro, Stefano, Turi, Alberto, Zangrillo, Francesca, Bertolina, Giorgio, Bogani, Stefano, Bonomi, Pierfrancesco, Cadenelli, Valentina, Chiappa, Stefano Piero Bernardo Cioffi, Davide, Citterio, Lara Valentina Comini, Umberto, Cortinovis, Maurizio, Cosimelli, Antonino, Ditto, Massimiliano, Gennaro, Lorenzo, Giannini, Marcello, Guaglio, Marco, Guzzo, Andrea, Leva, Alberto, Macchi, Elena, Manzo, Fabio, Martinelli, Ilaria, Mattavelli, Vincenzo Maria Mazzaferro, Francesco, Raspagliesi, Luigi, Rolli, Laura, Sala, Roberto, Salvioni, Mario, Santinami, Silvia, Segattini, Luca, Sorrentino, Carlotta, Zaborra, Alexandre, Anesi, Gianmaria Casoni Pattacini, Mattia Di Bartolomeo, Francesca, Pecchini, Arrigo, Pellacani, Micaela, Piccoli, Federico, Fusini, Andrea, Gattolin, Marco, Migliore, Roberto, Rimonda, Diego, Sasia, Elisabetta, Travaglio, Federica, Brunetti, Marco, Cereda, Marco, Ceresoli, Luca, Cigagna, Cristina, Dell'Oro, Alessandro, Fogliati, Robert, Fruscio, Tommaso, Grassi, Maini Marzia Isabella, Luca Carlo Nespoli, Massimo, Oldani, Sara, Ornaghi, Nicolò, Tamini, Carmine, Antropoli, Antonio, Castaldi, Alessio, Palumbo, Gaia, Altieri, Umberto, Bracale, Francesco, Corcione, Marcello De Luca, Giovanni Domenico De Palma, Maria Michela Di Nuzzo, Ruggero, Lionetti, Dalila Loredana Lo Bue, Gaetano, Luglio, Gianluca, Pagano, Roberto, Peltrini, Nello, Pirozzi, Francesca Paola Tropeano, Alessia, Aversano, Andrea, Belli, Maria, D'Amico, Paolo, Delrio, Francesco, Izzo, Renato, Patrone, Daniela, Rega, Pietro, Maida, Ester, Marra, Gianpaolo, Marte, Andrea, Tufo, Francesco, Bianco, Antonio, Cappiello, Simona, Gili, Paola, Incollingo, Alessandra, Novi, Giulia, Bagaglini, Claudio, Iovino, Francesco Menegon Tasselli, Maria Paola Menna, Francesco Maria Romano, Settimio, Rossi, Guido, Sciaudone, Francesco, Selvaggi, Lucio, Selvaggi, Francesca, Simonelli, Guido, Coretti, Mario, Pannullo, Adolfo, Renzi, Francesca, Ascari, Giuliano, Barugola, Giacomo, Ruffo, Paolo, Baroffio, Paolo, Bellora, Laura Enrica Benedetti, Cristina, Cerri, Giordana, D'Aloisio, Maurizio, Ferrari, Elisa, Francone, Sergio, Gentilli, Herald, Nikaj, Antonella, Chessa, Alessandro, Fiorini, Luca, Campagnaro, Franco, Chioffi, Pietro, Ciccarino, Roberto, Colasanti, Francesco de Falco, Fotios, Kalfas, Gioacchino, Mattisi, Giulia, Nezi, Matteo, Palma, Angelica, Rizzoli, Domenico, Rossi, Davide, Russo, Renato, Salvador, Francesco, Volpin, Guido, Bissolotti, Stefano, Fusetti, Francesco, Lemma, Vito, Chiantera, Mariano Catello Di Donna, Giulio, Sozzi, Emanuele, Cammarata, Sofia, Campanella, Daniela, Canzonieri, Adriana, Cordova, Federico De Michele, Ettore, Dinoto, Mara, Franza, Leo, Licari, Daniele, Matta, Domenico, Mirabella, Felice, Pecoraro, Roberto, Pirrello, Pierfrancesco, Pugliese, Fernando, Rosatti, Giuseppe, Salamone, Francesca, Toia, Massimiliano, Tripoli, Cosimo, Callari, Dario Di Miceli, Alfredo, Annicchiarico, Luca, Bellanti, Michela, Bergonzani, Roberto, Berretta, Elisa, Cabrini, Vito Andrea Capozzi, Fausto, Catena, Federico, Cozzani, Paolo Del Rio, Marco, Domenichini, Anna, Fornasari, Antonio, Freyrie, Tiziana, Frusca, Mario, Giuffrida, Gennaro, Perrone, Giulia, Rossi, Matteo, Rossini, Andrea, Varazzani, Vittorio, Arici, Antonio, Bozzani, Lorenzo, Cobianchi, Matteo, Filardo, Marika Sharmayne Milani, Franco, Ragni, Andrea de Manzoni Garberini, Edoardo, Baldini, Diana, Carpaneto, Michele, Cauteruccio, Corrado, Ciatti, Luigi, Conti, Serena, Gattoni, Pietro, Maniscalco, Gerardo, Palmieri, Calogero Puma Pagliarello, Giuseppe, Caristo, Raffaele, Galleano, Michele, Malerba, Marcello, Calabrò, Francesca, Farnesi, Elia Giuseppe Lunghi, Andrea, Muratore, Nicoletta Sveva Pipitone Federico, Joel Reuben Abel, Lorenzo, Andreani, Darienzo, Antonio, Vittorio, Aprile, Riccardo, Balestri, Giacomo, Benettini, Stefano, Berrettini, Luca, Bruschini, Massimo, Chiarugi, Federico, Coccolini, Simone, Colangeli, Camilla, Cremonini, Lodovica Cristofani Mencacci, Iacopo, Dallan, Silvia De Santi, Gregorio Di Franco, Lorena Di Girolami, Giacomo, Fiacchini, Niccolò, Furbetta, Stylianos, Korasidis, Marco, Lucchi, Andrea, Morandi, Luca, Morelli, Serena, Musetti, Carlo Maria Neri, Matteo, Palmeri, Miriana, Picariello, Francesco, Porcelli, Marco, Puccini, Nicolo, Roffi, Erica, Statuti, Dario, Tartaglia, Alberto, Tonelli, Matteo, Vianini, Gianluca, Baronio, Mauro, Montuori, Enrico, Pinotti, Stefano Maria Massimiliano Basso, Federica, Maffeis, Paolo, Ubiali, Lorenzo, Aguzzoli, Saverio, Coiro, Giuseppe, Falco, Vincenzo Dario Mandato, Valentina, Mastrofilippo, Simone, Mele, Caterina, Baldi, Carlo, Corbellini, Gianluca Matteo Sampietro, Massimo, Dugo, Mauro, Garino, Chiara, Marafante, Antonio, Masciandaro, Elisabetta, Moggia, Alessandra, Murgese, Felice Eugenio Agro, Gabriella Teresa Capolupo, Filippo, Carannante, Marco, Caricato, Vincenzo, Denaro, Erica, Mazzotta, Rocco, Papalia, Giuseppe, Pascarella, Alessandro, Strumia, Biagio, Zampogna, Matteo, Cinquepalmi, Marco, Colasanti, Celeste Del Basso, Federica, Falaschi, Nicola, Guglielmo, Roberto Luca Meniconi, Alessandra, Pecoraro, Sofia, Usai, Giacomo, Crescentini, Antonella, Larcinese, Emanuele, Picone, Giovanni, Sinibaldi, Annamaria, Agnes, Salvatore, Agnes, Sergio, Alfieri, Francesco, Belia, Valentina, Bianchi, Giuseppe, Bianco, Alberto, Biondi, Paola, Campennì, Valerio, Cozza, Sabatino, D'Archi, Domenico, D'Ugo, Veronica De Simone, Marta Di Grezia, Sofia Di Lorenzo, Federica, Ferracci, Valeria, Fico, Gianluca, Franceschini, Pietro, Fransvea, Giulio, Gasparini, Luca, Gordini, Antonio La Greca, Francesco, Litta, Celestino Pio Lombardi, Angelo Alessandro Marra, Angelo, Parello, Marco Maria Pascale, Romeo, Patini, Gilda, Pepe, Roberto, Persiani, Caterina, Puccioni, Carlo, Ratto, Fausto, Rosa, Gianmarco, Saponaro, Lorenzo, Scardina, Tedesco, Silvia, Giuseppe, Tropeano, Maria, Benevolo, Daniele, Bugada, Flaminia, Campo, Maria Gabriella Dona, Valentina, Manciocco, Paolo, Marchesi, Riccardo, Mastroianni, Francesco, Mazzola, Silvia, Moretto, Raul, Pellini, Gerardo, Petruzzi, Barbara, Pichi, Giuseppe, Simone, Gabriele, Tuderti, Jacopo, Zocchi, Luigi Marino Cosentino, Andrea, Sagnotta, Roberta, Angelico, Vittoria, Bellato, Michela, Campanelli, Marzia, Franceschilli, Michele, Grande, Giorgio, Lisi, Tommaso Maria Manzia, Lorenzo, Petagna, Bruno, Sensi, Giuseppe, Sica, Leandro, Siragusa, Giuseppe, Tisone, Marco, Assenza, Barbara, Binda, Massimo, Biondi, Gioia, Brachini, Placido, Bruzzaniti, Mauro, Casagrande, Flavia, Ciccarone, Pierfranco Maria Cicerchia, Bruno, Cirillo, Daniele, Crocetti, Giancarlo, D'Ambrosio, Vito, D'Andrea, Francesca De Felice, Giorgio De Toma, Carlo Della Rocca, Giulia, Duranti, Pietro, Familiari, Enrico, Fiori, Giovanni Battista Fonsi, Alessandro, Frati, Stefania La Rocca, Filippo La Torre, Pierfrancesco, Lapolla, Giovanni, Marruzzo, Simona, Meneghini, Andrea, Mingoli, Andrea, Picchetto, Antonella, Polimeni, Diego, Ribuffo, Maurizio, Salvati, Antonio, Santoro, Paolo, Sapienza, Luigi, Simonelli, Valentino, Valentini, Martina, Zambon, Giuseppa, Zancana, Emma, Zuppi, Simone, D'Annunzio, Cosimo De Nunzio, Silvia, Fiorelli, Mohsen, Ibrahim, Chiara, Loffredo, Domenico, Massullo, Cecilia, Menna, Rocco, Monica, Massimiliano, Pelli, Erino Angelo Rendina, Leonardo, Teodonio, Andrea, Tubaro, Giulio, Argenio, Giulio, Accarino, Accarino, Giancarlo, Antonio Nicola Giordano, Luca, Cardinali, Elisa, Sebastiani, Grazia, Travaglini, Erika, Andreatta, Emanuele Luigi Giuseppe Asti, Daniele, Bernardi, Luigi, Bonavina, Caterina, Froiio, Andrea, Lovece, Chiara, Copelli, Alfonso, Manfuso, Pasquale Di Maio, Marco, Giudice, Oreste, Iocca, Rosario, Cennamo, Tommaso, Cornali, Francesco Di Marzo, Cristian, Altana, Francesco, Bussu, Giampiero, Capobianco, Anna Giacomina Carta, Sandro, Ciccarello, Maria Laura Cossu, Pietrina, Cottu, Giacomo De Riu, Salvatore, Dessole, Francesco, Dessole, Salvatora, Dettori, Carlo, Doria, Alessandro, Fancellu, Claudio, F Feo, Giorgio Carlo Ginesu, Giuliana, Giuliani, Marco Giuseppe Iannuccelli, Massimo, Madonia, Roberto, Mancino, Olindo, Massarelli, Gianfranco, Meloni, Fabio, Milia, Andrea, Mulliri, Teresa, Perra, Marco, Petrillo, Antonio, Piras, Franco, Piredda, Francesco, Pisanu, Alberto, Porcu, Davide, Rizzo, Angelino, Sanna, Antonio Mario Scanu, Fabrizio, Scognamillo, Damiano, Soma, Anna Rita Tanca, Alessandro, Tedde, Matteo, Tedde, Luigi Angelo Vaira, Andrea Bartalini Cinughi de Pazzi, Osvaldo Carpineto Samorani, Daniele, Fusario, Luigi, Marano, Gaia, Oldrà, Anna Lisa Pesce, Stefania Angela Piccioni, Luca, Resca, Vincenzo, Ricchiuti, Franco, Roviello, Vinno, Savelli, Alberto, Abrate, Pierpaolo, Bordoni, Lorenzo, Bosio, Guglielmo, Clarizia, Francesco, Fleres, Marco, Franzini, Antonio, Fratto, Pierluigi, Giumelli, Alessandro, Grechi, Alessandro, Longhini, Fabrizio, Lorusso, Elisa, Scarnecchia, Federica, Scolari, Alessandro, Spolini, Vincenzo, Maiuri, Matteo, Papandrea, Arturo, Roncone, Lorenzo, Conti, Andrea, Rizzi, Marco, Rovagnati, Alberto, Brolese, Tommaso, Cai, Francesco Antonio Ciarleglio, Francesca, Dalprà, Gianni, Malossini, Liliana, Mereu, Irene, Tamanini, Saverio, Tateo, Giovanni, Viel, Enrico, Battistella, Paolo Boscolo Rizzo, Cristoforo, Fabbris, Marco, Massani, Giacomo, Spinato, Roberta, Tutino, Ugo, Grossi, Alessandro, Iacomino, Simone, Novello, Maurizio, Romano, Serena, Rossi, Giulio, Santoro, Giacomo, Zanus, Sokol, Trungu, Giada, Aizza, Gabriele, Bellio, Selene, Bogoni, Marina, Bortul, Biagio, Casagranda, Sara, Cortinovis, Nicolò de Manzini, Davide, Drigo, Paola, Germani, Manuela, Mastronardi, Lucia, Paiano, Silvia, Palmisano, Pier Luigi Filosso, Francesco, Guerrera, Matteo, Marro, Mauro, Rinaldi, Enrico, Ruffini, Stefano, Salizzoni, Laura, Bardelli, Mattia, Berselli, Giacomo, Borroni, Eugenio, Cocozza, Matteo, Desio, Bottazzoli, Elisa, Giuseppe, Ietto, Valentina, Iori, Domenico, Iovino, Lorenzo, Livraghi, Valentina, Marchionini, Stefano, Megna, Emma Amal Nahal, Mara, Palumbo, Valeria, Quintodei, Alessandra, Zullo, Lucrezia, D'Alimonte, Giovanni, Pirozzolo, Chiara, Vignotto, Tommaso, Campagnaro, Andrea, Caravati, Simone, Conci, Carlotta De Cristofaro, Gabriele, Gecchele, Tommaso, Giuliani, Jacopo, Graziosi, Alfredo, Guglielmi, Salvatore, Paiella, Corrado, 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Yu, Mitsuru, Ida, Masahiko, Kawaguchi, Kenji, Kawamura, Munehiro, Ogawa, Hiroshi, Okada, Shunji, Endo, Yoshinori, Fujiwara, Masaharu, Higashida, Hisako, Kubota, Toshimasa, Okada, Hironori, Tanaka, Tomio, Ueno, Kazuhiko, Yoshimatsu, Motohiro, Kikukawa, Akira, Kuriyama, Susumu, Matsushime, Hishikawa, Hidehiko, Haruaki, Hino, Yoji, Hisamatsu, Akio, Kamiya, Hidefumi, Kinoshita, Masato, Kita, Toshinori, Kobayashi, Taku, Michiura, Hirokazu, Miki, Tomohiro, Murakawa, Hidetaka, Okada, Tomohito, Saito, Ryoichi, Saito, Motohiko, Sugi, Genichiro, Sumi, Yamaki, So, Tomohisa, Yamamoto, Aya, Yoshida, Tatsuya, Kambara, Sayaka, Kanematsu, Okazaki, Satoshi, Takeshi, Hijikawa, Hiroaki, Kitade, Hidesuke, Yanagida, Tomoyuki, Fujita, Satsuki, Fukushima, Naoki, Tadokoro, Taku, Furukawa, Yusuke, Iizuka, Yuji, Otsuka, Masamitsu, Sanui, Ikumi, Sawada, Hideki, Iwahashi, Morikazu, Miyamoto, Masashi, Takano, Tsutomu, Mieda, Chihiro, Ando, Tetsuro, Isada, Taku, Ishizaki, Qaed Bani Amer, Sachi, Ishida, Yasuma, 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Mubaydeen, Husam, Sarayrah, Mohammad Abdel Elah, A Tarawneh, Mohammad Yousef Karasneh, Amany, Zurgan, Mohammad, Alassaf, Sayel, H Alzraikat, Justin, Z Amarin, Ahmed, Hijjawi, Haya, H Suradi, Louay, Y Zaghlol, Ahmad, Abdalah, Ghaida, Abdallah, Ammar Abu Tarieh, Tareq, Abu-Libdeh, Faisal, Abualteen, Murad Al Abdallah, Zakaria Al Bdour, Seif Al Dahabrh, Farah, Al-Kasaji, Zaid Al-Sheikh Ali, Mohammad, Al-Thaher, Tareq, Alnajjar, Mohannad, Alqedrh, Mohammad, Alsaleh, Mohammad, Alzaatreh, Ghandi, Amayreh, Yazeed, Ayasra, Ahmad, Eid, Ibrahim, Ghayada, Khaled Moh'd Ahmed Hasanein, Anas, Hassouneh, Raid, Hijazeen, Majedah, Hmeidan, Ahmed, Khaled, Barihan, Khasawneh, Omar, Kifayeh, Yasser, Lafi, Jasem, Seba, Qusai, Semrin, Fda, Sma, Mohammad, Theab, Haitham, Tumeh, Muna Aba Zaid, Alaa, Abazeed, Bader, Abbad, Osaid, Abbadi, Nizar, Abu-Ishkerih, Malk, Al-Osta, Reham, Al-Zyadat, Bashar Omar Falah Alawneh, Majd, Alhattab, Mohd Mujahed Alkurdieh, Ziad, Awwad, Mohammad, Hammouri, Hamzeh, Hussein, 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Tagleb, Mazahreh, Dina, Nail, Amjad, Nuseir, Asmaa, Rabab'Ah, Taher, Sawadi, Ghina, Zidan, Dima Abu Muhfouz, Abdullah, Nael, Ahmad, Qasim, Amar, Al-Jarrah, Faisal, Rawagah, Dima, Y Abu Ismail, Wedad, Al-Dolat, Mai, Alzoubi, Malak, Alzoubi, Mu'Taz, Alzu'Bi, Ruba, Asha, Ali, Guboug, Hasan, Hussein, Shireen, Rawashdeh, Mohammad, Sanwar, Adnan, Ababneh, Basil, Abu-Eisheh, Haneen Ahmad Alhami, Saif Aldeen Al Dwairi, Hana' Al Shurman, Zakaria Al Yahya, Hussam, Al-Atiyah, Hasan, Al-Balas, Anas, Aljaiuossi, Shatha, Alqawasmi, Sadeel, Alqudah, Mahmoud, Alshourman, Abdulsalam Bani Hamad, Anas Bany Issa, Raed, Ennab, Sara, Hamdoni, Zaid, Hijazi, Ali, Khafaja, Mohamed, Mraiyan, Riyad, Obeidat, Dina, Olaywah, Mohamad, Qudah, Mhamdd, Talal, Askar, Aidarov, Aisulu, Sarmenova, Almat, Kodasbaev, Orazbek, Sakhov, Shynar, Tanabayeva, Sultan, Amrayev, Berik, Dzhumabekov, Maulen, Malgazhdarov, Kanat, Tezekbaev, Yerlan, Kukubassov, Alima, Satanova, Michael, Mwachiro, Robert, Parker, Ian, Simel, Shamshuddin, Mohammedali, Claude, Mwaria, Ralph, Obure, Sayed Shah Nur Hussein Shah, Chetan, Hirani, Muthoni, Kibunyi, Claire, Mailu, Victor, Mwangi, Roy, Ogenya, Lydia, Osea, Davies, Cheruiyot, Omar, Hirsi, Carolyne, Muiru, Samuel, Wanjara, Chang Woo Kim, Suk Hwan Lee, Ahmad, Almulla, Mustafa, Dashti, Omar, Elghany, Abdullah, Sultan, Husain, Al-Mahmeed, Jasim, Alabbad, Ibtisam, Albader, Shuaib, Aldalal, Mahdi, Baba, Fareed, Abdulsalam, Naser, Alhajri, Athari, Alwael, Brook, Ayele, Hatem, Marie, Ahmed, Zaitoun, Ahmad, M AlAli, Ahmed, Alkhamis, Ous, Alozairi, Sulaiman, Almazeedi, Salman, Alsabah, Mostafa, Abdelkarim, Asmaa Al Rashed, Saud Al Subaie, Tariq, Al-Shaiji, Abdullatif, Al-Terki, Omar, Alhunaidi, Ali, Aljewaied, Khaled, Alzamel, Ahmed, Farag, Hussein, Hayati, Salah, Termos, Sarah, Wood, Maha, Al-Gilani, Mutlaq, Al-Sihan, Haifa, Alotaibi, Dmitrijs, Lobovs, Andrejs, Pcolkins, Armands, Sivins, Ingus Arnolds Apse, Annija Evelīna Berga, Anna, Ivanova, Jevgenijs, Demicevs, Igors, Ivanovs, 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Alameen, Rehab, Alarabi, Alarabi, Alarabi, Aisha, Alelwany, Abdulkarim, Alesmail, Noran, Algadi, Khuloud, Almaqrahi, Hadel, Alosta, Mohamed, Alsharedi, Rasha, Bashir, Mahmoud Ben Ghrema, Sari Bin Nour, Sofian, Elbarouni, Ahmed, Elhadi, Abdulmohimen, A Elkhadar, Esraa, Elkouba, Nabiha, Elmsherghi, Abdulmohimen, Gammoudi, Abdulraouf, Ghariba, Fatima Zayed Gjam, Arwa, Haidar, Hala, Helal, Mohammed, Huwaysh, Ahmed Khalid Alhadheeri, Eslam, Kriem, Halim, Osman, Mohamed Ali Ossman, Marwah, Shilfeet, Laila, Turshani, Nouran, Albishty, Abdulmueti, Alhadi, Salem, Ali, Manal Ahmed Altoumi, Sumayyah Ghayth Bahroun, Eman, Younes, Hana, Atarabulsi, Mohamed, Elshaibi, Abdullmujeeb, Othman, Hayat Ben Hasan, Najat Shaban Ben Hasan, Rabab Shaban Ben Hasan, Vidmantas, Barauskas, Edvinas, Dainius, Zilvinas, Dambrauskas, Albertas, Dauksa, Inga, Dekeryte, Rita, Gudaityte, Kristijonas, Jasaitis, Akvilė, Koženiauskaitė, Virgilijus, Krasauskas, Ausra, Lukosiute-Urboniene, Almantas, Maleckas, Romualdas, Riauka, Vygintas, Šlenfuktas, Saulius, Svagzdys, Kestutis, Urbonas, Tomas, Vanagas, Linas, Venclauskas, Donatas, Venskutonis, Justas, Zilinskas, Marijus, Ambrazevicius, Vilius, Syminas, Oleg, Aliosin, Agne, Cizauskaite, Vitalijus, Eismontas, Jonas, Jurgaitis, Vytenis, Mikutaitis, Donatas, Petrauskas, Narimantas Evaldas Samalavicius, Dainius, Simcikas, Algirdas, Slepavicius, Albinas, Tamosiunas, Vaidotas, Turskis, Bernardas, Vasiliauskas, Laura, Aniukstyte, Audrius, Dulskas, Gediminas, Januška, Justas, Kuliavas, Margarita, Montrimaite, Albertas, Cekauskas, Azuolas Algimantas Kaminskas, Sarunas, Kozenevskis, Tomas, Poskus, Kestutis, Strupas, Arunas, Zelvys, Georges, Decker, Audrey, Noël, Maheriandrianina Fanambinana Voahary Rajaonarivony, Randimbinirina Zakarimanana Lucas, Herimampionona, E Andriantsoa, Mamisoa, B Rasamoelina, Rakotonarivo Aina Andrianina Vatosoa, Liantsoa, Andriamanana, Casimir Fp Rahantasoa Finaritra, Aristide Romain Raherison, Tsirimalala, Rajaobelison, Haritiana, Rakotoarisoa, Maharo, Ramifehiarivo, Solonirina Harinarindra Ranaivoson, Hajamihamina Marina Parfaite Randriantsoa, Narindra Njarasoa Mihaja Razafimanjato, Jeannie Ba Razafindrahita, Solofoarimanana, Solofoarimanana, Guillaume Odilon Tsiambanizafy, Rakotonaivo Mamisoa Judicaël, Corinne Eulalie Solo, Tojomamy Herinjaka Ralaizafindraibe, Fanonjomahasoa Safiry Andofenohasina, Hanta, Rasataharifetra, Vanona Barijaona Razafindraibe, Angelin Sablon Herinirina, Andre, Das, Thanga, Ganapathy, Yohesuwary, Gunarasa, Kalyani, Mariapan, Maathichsudhaar, Muniandy, Mohd Firdauss Osman, Mohd Azem Fathi Mohammad Azmi, Jien Yen Soh, Wan Zainira Wan Zain, Andee Dzulkarnaen Zakaria, Zaidi, Zakaria, Kheng Hooi Chan, Firdaus, Hayati, Syamim, Johan, Jin Jiun Mah, Ratha Krishnan Sriram, Sentilnathan, Subramaniam, Nur Shahirah Binti Muhammad Shahimi, Khairul Hazim Hamdan, Mohd Razali Ibrahim, Guhan, Muthkumaran, Ju Ann Tan, Mohana Raj Thanapal, Dayang Anita Abdul Aziz, Mae-Lynn, Bastion, Mohd Hairul Nizam Harun, Farrah-Hani, Imran, Norshamsiah Md Din, Ayesha Mohd Zain, Mushawiahti, Mustapha, Syed, Nabil, Ainal Adlin Naffi, Abd Jabar Nazimi, Roszalina, Ramli, Bee Hong Soon, Pavin, Bal, Joo Qing Cheng, Mohd Rusdi Draman, Ahmad Nazran Fadzli, Sakina, Ghauth, Weipin, Hung, Suniza, Jamaris, Peng Soon Koh, Sivakumar, Krishnasamy, Yeong Sing Lee, Yew Toong Liew, Jeffery Zk Lim, Raymond Chung Siang Lim, Hiong Chin Lim, Siti Farhan Moh Pauzi, Shireen Anne Nah, Ashvin Krishna Nair, Doris Sin Wen Ng, Yuki Julius Ng We Yong, Kamarajan, Ramayah, Rahmah, Saaid, Anand, Sanmugam, Mee Hoong See, Kanesh Kumaran Seevalingam, Neha, Sethi, Srihari, Singaravel, Syeda Nureena Syed Jafer Hussain Zaidi, Chu Yik Tang, Li Ying Teoh, Kian Boon Wong, Ruben, Xavier, Ahmad Shuib Yahaya, Norhafiza, Ab, Rahman, Islah Munjih Ab, Rashid, Mohd Fahmi Abd Aziz, Mohd Norhisham Azmi Abdul Rahman, Nasser Muhammad Amjad, Shahidah Che Alhadi, Faisal, Elagili, Mohd Nazli Kamarulzaman, Azmi Md Nor, Ahmad Faidzal Othman, Mohd Yusof Sainal, Mat Salleh Sarif, Richelle, Chua, Aini Fahriza Ibrahim, Abdul Rauf Bin Ahmad, Yii Ling Lau, Ka Yee Liew, Kandasami, Palayan, Hui Yu Wong, Jasiah, Zakaria, Nor Azimah Abd Aziz, Norazila Abdul Rahim, Noorneza Abdul Rahman, Bahiyah, Abdullah, Mohamed Faizal Bin Sikkandar, Fatin, Firman, Nik Mohd Hazleigh, Intan Kartika Kamarudin, Shahril, Khalid, Mohd Fairudz Mohd Miswan, Akmal Zulayla Mohd Zahid, Norasyikin, Mustafa, Kadhim, Obaid, Mohd Yusoff Bin Yahaya Yahaya, Ahmad Ramzi Yusoff, Predrag, Andrejevic, Jeremy Borg Myatt, Svetlana, Brincat, Clifford, Caruana, Kurt Lee Chircop, Francesca, Chircop, Daniel Mario Chircop, Charles, Cini, Viktoria, Czok, Melanie, Farrugia, Gabriella, Grima, Fatimah Mj Hassan Almukhariq, Esther, Muscat, Darryl, Pisani, Mohsin Hassan Khan Roshan, Nicholas, Schembri, Mohamed, Shoukry, Neville, Spiteri, Gilbert, Tanti, Ziad Aboharp Hasan, Alberto Bazan Soto, Cedillo Rodrìguez Jonathan Rubén, Gustavo Esteban Lugo Zamudio, David Gerardo Miranda Gómez, José Alfredo Pérez Meave, Victor Pinto Angulo, Antonio Rojas Aguilar, Erik Efrain Sosa Duran, Alejandro Vàzquez Perez, Diego, Arroyo, Jose, Corona-Cruz, Hector, Martinez-Said, Heriberto, Medina-Franco, Manuel, Mendez, Teresa Moreno, Y Suárez Ma, Dolores Orta Díaz, Martha Patricia Pérez de León Vázquez, Angélica Azucena Soto Carvajal, Fidel Soto Hernández, Juan Ignacio Stenner, Adriana Valenzuela López, Mauricio Rene Hernandez, Rey Jesus Romero, Aldo Bernal Hernandez, Ana Olivia Cortes-Flores, Carlos Jose Zuloaga Fernandez Del Valle, Carlos Andres Colunga Tinajero, Jaime, Orozco-Perez, Laura Gabriela Peña Balboa, Guillermo, Yanowsky-Reyes, Víctor Hugo Alcalá Torres, Francisco José Barbosa Camacho, Irma Valeria Brancaccio Perez, Miguel Angel Calderon-Llamas, Aldo Camacho Gomez, Edgar-Joaquin, Cortes-Torres, Esteban, Cueva-Martinez, Oscar Durán Anguiano, Isaac Esparza Estrada, Roberto, Fierro-Rizo, Paola Flores Becerril, Clotilde Fuentes Orozco, Miguel García Castillo, Alejandro Gonzalez Ojeda, Ana Sofia Gonzalez Rubio, Erick Alonso González-García de Rojas, Luis Humberto Govea-Camacho, Jose Aldo Guzman Barba, Juan Carlos Ibarrola Peña, César Íñiguez Martínez, Francisco Javier Llamas-Macias, Ruben Eduardo Morán Galaviz, Cesar, Nuño-Escobar, Oscar-Everardo, Olvera-Flores, Jaqueline, Osuna-Rubio, Jose Victor Pérez-Navarro, Rodrigo, Prieto-Aldape, Luis Ricardo Ramirez Gonzalez, Marco Vinicio Ramírez Sánchez, Emilio, Reyes, Olaya Moramay Romero-Limón, Carlos Beas Ruiz-Velasco, José Antonio Sánchez Martínez, Guillermo, Sanchez-Villaseñor, Ismael, Sedano-Portillo, Gabriela Ambriz Gonzalez, Pedro Berrones Moreno Berrones Moreno, Ana Beatriz Calderon Alvarado, José de Jesús Cárdenas Barón, Araceli, Hernández, Francisco Javier León Frutos, Edgard Efren Lozada Hernandez, Eduardo Morales Valencia, Karla Daniela Pérez, Francina, Bolanos-Morales, Julio, Herrera-Zamora, Patricio, Santillan-Doherty, David Omar Arriaga Zavala, Salvador Francisco Campos Campos, Lizette, Carmona, Antonio Galindo Nava, Blanca, Santos, Juan Roberto Torres Cisneros, Katya, Bozada-Gutiérrez, Jose Jesus Herrera, Mucio Moreno Portillo, Francisco Pérez López, Mario, Trejo-Avila, Carlos Valenzuela Salazar, Maria Regina Alvarez, Fernando, Cordera, Marco Antonio de la Rosa Abaroa, Antonio, Gómez-Pedraza, Roberto, Hernandez, Antonio, Maffuz-Aziz, José Antonio Posada, Carlos Robles Vidal, Jose-Luis, Beristain-Hernandez, Blas Eduardo Quintero Sada, Nicolás Uxmal Soruco Heredia, Ernesto, Anaya, Ricardo, Arceo-Olaiz, Bernardo Gutiérrez Sougarret, Sonia Lopez Flores, Francisco, J Ochoa Carrillo, Raymundo Alfredo Pérez Uribe, Ludwigvan Adriano Bustamante Silva, Arianne, I Lupián-Angulo, Christian Enrique Soulé Martínez, Francisco César Becerra García, Ernesto Javier Guerrero Casillas, Edgar, Uribe, Nereida Esparza Arias, J Mindy Hernández-Nava, David, Isla-Ortiz, Javier, Melchor-Ruan, Esmeralda Romero Bañuelos, Rosa, Salcedo-Hernández, Diana, Vilar-Compte, Paola Zinser Peniche, Jorge, L Aguilar Frasco, Alejandro, Alfaro-Goldaracena, Gabriela Alejandra Buerba, Emma, Castro, Carlos, Chan, Ruben, Cortes, Ismael, Dominguez-Rosado, Daniel Garay Lechuga, Miguel, Herrera, Carlos, Hinojosa, Gabriel, Lopez-Pena, Edgar, Martos, Miguel Ángel Mercado, Paulina Moctezuma Velázquez, Roberto, Moguel, Mariano, Oropeza, Emmanuel Peña Gómez Portugal, Oscar Emmanuel Posadas-Trujillo, Noel, Salgado-Nesme, Oscar Santes Jasso, Catherine, Sarre, Karla Yareli Hernandez Skewes, Cristian, Jimenez, Roque Delfino Licona-Meníndez, Guillermo, Montiel, Alberto, Navarrete-Peón, Shannat, Ortega, Fernanda Romero Lechuga, Oscar, Roque, Fernando, Sevilla, Rogelio, González-López, Roberto Ángel Núñez-González, José Antonio Ortega-Jiménez, Antonio, Alvarado, Alfonso Alvarez Manilla Orendain, José Alberto Atristain Pesquera, Diego, Frutos, Felipe, Garcia, Juan Antonio González León, Marlin, Guzman, Dorihela, Herappe, Jesús Giovanni Inzunza Miranda, Miguel Angel Jimenez Botello, Ricardo, Lerma, Fabián Hilario 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Josep, M Segur, Thomaz, E Topczewski, Jorge, Torales, Ramon, Torné, Pere, Torner, Ricard, Valero, Marian, Vives-Barquiel, Eulalia, Ballester, Alberto Basterra Rincon, Vitiello, Giulia, Belén Martin Arnau, Marta, Gil, Silvia, Martin, Monica, Serrano-Navidad, Mauricio Agüero Mariño, Núria Casanova Torrequebrada, Berta Fabregó Capdevila, Adrián López Campillo, Gemma, Mancebo, Ester, Miralpeix, Blanca, Montcusí, Marina, Munarriz, Ariadna, Salvadó, Josep, M Sole-Sedeno, Clara Téllez Marquès, Ana Centeno Álvarez, Ruth Lopez Gonzalez, Luisana Riba Combatti, Andrea Sanz Llorente, Miguel Bejarano Serrano, Blanca Capdevila Vilaró, Maria Coronas Soucheiron, Mario Cuesta Argos, Irene de Haro Jorge, Yaiza Galvañ Félix, Luis, García-Aparicio, Rebeca, Leal, Albert Malet Contreras, Irene, Martínez-Padilla, Clara, Massaguer, Ines Moraleda Gudayol, María Elena Muñoz Fernández, Paco, Parri, Cristina Pérez Costoya, Javier, Rojas-Ticona, Leopoldo Tapia Moral, Francisco, Vicario, Francesc Angles Crespo, 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Marqueta De Salas, Paula Martinez Pascual, Almudena Ortiz Simón, Laura, Osuna, Marta Perez Gonzalez, Antonio Ramos Bonilla, Lorena Rodríguez Gómez, Jose Luis Uquillas, Miguel Angel Alonso Prieto, Marta, Ballesteros-Pomar, Sara Busto Suarez, Mario, Castaño, Laura Castillo Pardo, Mario De Arriba Alonso, Fernando Diez Burón, Anna Farrés Rabanal, Diego Fernández-Samos Fernández, David, Garcia, Cristina García Pérez, Miguel García Sanz, Cesar, Gracia, Javier, Gualis, Gonzalo Gutiérrez Carrillo, Mateo, Hevia, Eva Higuera Miguélez, Gregorio, Laguna, Cristina Lombardia Gonzalez de Lera, Pablo López Martínez, Pasquale, Maiorano, Sergio Marcos Contreras, Elio Martín Gutiérrez, Marta, Molina, Irene, Perez, Teresa Renedo Villar, Luis Angel Suarez Gonzalez, Eva Alvarez Torres, Luz Bueno Rey, Zulay Adriana Calderon Barajas, Ana, M Castaño-Leon, Aida, Fernández, Pablo Garcia Pimentel, Luis, Jimenez-Roldan, Meta, Levstek, Rosalia Navarro Casado, Claudia Olea Vielba, Ana Maria Parada Rodriguez, Igor, Paredes, Patricia, Pascual-Cambero, Miguel Saiz Sánchez-Buitrago, Claudia Sarrais Polo, Victor Zarza Fernandez de Alegria, Mireya, Bonet, Alberto Encinas Vicente, Jose Miguel Villacampa Auba, Maria Dolores Burgueño, Patricia Serrano Méndez, Thomas, W Jorgensen, Mercedes, Martin, Mónica, Huecas, Felipe, Velasco, Verónica Alen Villamayor, Santiago Alonso Bartolomé, Miguel Alonso Juarranz, Luis Felipe Ávila-Ramírez, Javier Buendia Pérez, Barbara, Burgos-Blasco, Enrique Camarero Rodríguez, Paula Campelos Fernández, Claudia, Celotti, Marco Ciappara Paniagua, Ignacio, Cristobal, Alejandro Encinas Bascones, Elena, Fernandez-Martin, Inés Gil Prados, Jesus Gimeno Hernandez, Maria Alejandra Giraldo, Manuel Gomez Cervantes, Noemi Guemes Villahoz, Araceli Hernández Ramos, Maria Cruz Iglesias Moreno, Bibiana Lasses Martínez, Francisco Leyva Rodríguez, Leyre López Antoñanzas, Javier Martín Monterrubio, Jose Maria Martinez-de-la-Casa, Lourdes Montero Cruces, Jesús Moreno Sierra, Jose Maria Muguerza, Alexia Victoria Paluso Montero, Natalia Pérez Romero, Adriana, Poch, Jaime Rodríguez de Alarcón, Adriana Ruano Campos, Rebeca Ruiz Roman, Patricia Saez Carlin, Cristina Sánchez Del Pueblo, Lidia Sotillo Valenzuela, Armando, Galvan, Miguel Ángel García Ureña, Enrique, González, Manuel Medina Pedrique, Alvaro Robin Valle de Lersundi, Carlos San Miguel, Juan, Aragón-Chamizo, Monica, Ballon, Jose, M Barrio, Beatriz Castro Catalan, Laura Cebolla Rojas, Renan Carlo Colombari, Miguel Cuende Diez, Paula Dujovne Lindenbaum, Oscar, Gil-de-Sagredo, Silvia Kayser Mata, Pablo Lozano Lominchar, Yeniffer Tatiana Moreno Salazar, Angela, Moreno-Gutierrez, Melanie, Morote, Uxue, Murgoitio, Nikolas Palma Caucig, Lucía Polanco Pujol, Alejandro, Prosperi, María Belén Ramírez Senent, Diego Fernando Ruiz Chiriboga, Mercedes, Sanz, Maria, Tudela, María Adrien Lara, Raquel, Alarza, Isabel Alonso Sebastian, Mariano Artés Caselles, Laura, Calles-Sastre, Marcos Casas Sánchez, Aritz Equisoain Azcona, Lucía, Fuentes, Lucia Gil Cidoncha, Sofía Herrero Gámiz, Eva Iglesias Garcia, Jose Luis Lucena De La Poza, Mª Eugenia Marín Martínez, Pilar Martín Rodrigo, Joaquin Manuel Muñoz Rodríguez, Verónica, Polaino, Alberto Pueyo Rabanal, Xabier Remirez Arriaga, Xiana, Rial, Miguel Sánchez Suárez, Maria Eugenia Torguet Muñoz, Borja Bazán Inostroza, Lara Blanco Terés, Alba Correa Bonito, Angela de la Hoz, Gustavo, Eisenberg, Javier Garcia Septiem, Jose Maria Lopesino, Rocio, Maqueda, Elena, Martin-Perez, Jose Luis Muñoz de Nova, Julia Revuelta Ramírez, Ana Rodríguez Sánchez, Álvaro Valdés de Anca, Laura Colao García, David Díaz Pérez, Enrique Esteban Agustí, Pablo Galindo Jara, Ana Belén Gallardo, Cesar, Garcia, Maria Gutierrez Samaniego, Miguel Angel Hernandez Bartolome, Lorenzo, Rabadan, Barriga Sánchez Raquel, Beatriz, Diéguez, Miguel, Hernández-García, Carolina Alfonso Carrillo, María Belén Alonso Bartolomé, Estibaliz, Alvarez, Mario, Alvarez-Gallego, Paula, Aragón-Ramos, Pablo Cesar Arteaga Asensio, Luis Asensio Gomez, Diego, Carrion, Nuria, Chavarrias, Alvaro de Arriba, Jose Antonio Gazo Martínez Gazo, Alberto Gegúndez Simón, Juan Gómez Rivas, Natalia Gonzalez Alcolea, Carolina, Gonzalez-Gomez, Sara Gortázar de Las Casas, María Alexandra Heras Garceau, Alicia Hernández Gutierrez, Luis, Lassaletta, Fuad Samir Lopez Fernández, Marta, Mancheño, Blanca, Mateos-Serrano, Isabel Pascual Miguelañez, Maria Fernanda Pedrero Escalas, Julio, Peñarrocha, Yolanda, Perez, Maria Isabel Prieto-Nieto, Teresa Rivera Schmitz, Laura, Rodrigáñez, Ines, Rubio-Perez, Isabel Sanchez Cuadrado, José Ignacio Sánchez Méndez, Jorge Fernando Tone, Carlos Toribio Vazquez, Aitor, Urbieta, Diego Córdova García, Francisca Garcia-Moreno Nisa, Laura, Jiménez, Inmaculada, Lasa, Belen, Matías-García, Fernando, Mendoza-Moreno, Marina Pérez González, Ana Sánchez Gollarte, Alejandro Sanchez Pellejero, Cristina Vera Mansilla, Rafael, Barberá, Lourdes, Montes-Jovellar, Sara Fra Fernández, Nicolas Moreno Mata, Barbara, Algar-Yañez, Gutiérrez, Bérénice, Olga De La Varga-Martínez, Paula, Fernandez-Valdes-Bango, Sandra Maria Gadin-Lopez, José María Martínez-Gómiz, Elena, Nieto-Moreno, Ana, Nieto-Moreno, Montserrat Ocampos Hernandez, Maria Laura Pelegrina-Lopez, Alicia Ruiz Escobar, Elena, Sáez-Ruiz, Beatriz, Vazquez-Rivero, Antonio, Lara, Belén Vielva Del Campo, Fernando Alcaide Matas, Simbad, Costas-Ochoa, José María García Pérez, Elizabeth, Marmol, Paula Troncoso Pereira, Maria Del Pilar Concejo Cutoli, Juan Ramón Gómez López, Juan Carlos Martín Del Olmo, Paloma Guillamot Ruano, Javier Páramo Zunzunegui, Antonio Albarracín Marín Blázquez, Alfonso, Aliaga-Sanchez, Marta María Arroyo Domingo, Miriam Artés Artés, Ana Isabel Avellaneda Camarena, Aida, Blaya, Emny Rochell Bobadilla Romero, Pedro Vicente Fernández-Fernández, Lorena Galindo Iñiguez, Víctor Javier García Porcel, Clara Giménez Francés, Antonio Javier Gomez Poveda, Rebeca Gonzalez Celdran, Francisco Miguel González Valverde, Laura Guillamon Vivancos, Elena, Gurrea-Almela, Alejandra Jara Maquilón, Jose David Jimenez Parra, Abd Al Aziz Lanagrán Torres, Raquel Lax Perez, Carmen Maria Lopez Lopez, Francisco, Machado, Alfonso Marco Garrido, Florencio Manuel Marin Martinez, Victoria Martínez Muñoz, Esther, Medina, Olimpia, Molina, José Manuel Muñoz Camarena, Julian, Onate, Pedro Antonio Parra Baños, Emilio Peña Ros, Enrique, Rubio, Marina Sánchez Robles, Carlos Sanchez Rodriguez, María Valero Soriano, María Teresa Yepes García, Felipe, Alconchel, Andrés Balaguer Román, Valentín, Cayuela, Ana, Conesa, Ana Delegido García, Pedro José Gil Vázquez, Paula Gómez Valles, Francisco, Gómez-Bosch, Vicente, J León-Muñoz, Francisco, Martínez, Alvaro, Navarro-Barrios, Tatiana, Nicolás-López, Pablo Ramirez Romero, Emiliano, Cano-Trigueros, María Concepcion Alonso González, Leticia Gómez Viana, Ana Pastor Zapata, Elisa Contreras Saiz, Tamara Díaz Vico, Maria, Fernandez-Hevia, Luis Joaquín García Flórez, Raquel, Rodríguez-Uria, Sandra, Sanz, Lorena, Solar-Garcia, Aida Suárez Sánchez, Jaume, Gelonch, Dietmar, Reinaldo, Miriam Abdulkarim Polo, Asier, Aguirre, Marta Alomar Bofill, Santiago, Baena, Ashish, Bartakke, Carmen Cabeza Oliver, Marta Castro Suárez, José Andrés Cifuentes Rodenas, Olga Claramonte Bellmunt, Ant Onia Crespí Mir, Anabel De La Llave Serralvo, Mar, Escales, Isabel Rosa Fernández Burgos, Pablo Gandia Gonzalez, Juan Lliteras Jorge, María Cristina Martínez Canto, Javier, Mata, Andreu, Morell, Naila, Pagès, Sara Pérez Palao, Cristian Plaza Valiente, Catalina Ramon Barcelo, Carmen Reyero Fernández, Albert Reyes Claret, Leticia Rodriguez Vaquero, Maialen Saez de Vicuña Salinas, Pilar Santos Cidon, Concepcion, Segura, Aina, Serra, Maria Serra Guivernau, Maria Soler Pedrola, Marta, Tasende, Marta Torrent Lluch, María Inmaculada Valldeperas Hernández, Rosa-Maria, Yañez-Lpez, Andrea, Craus-Miguel, Laura Fernández Vega, Natalia Pujol Cano, Juan José Segura-Sampedro, Laura Colet Oliver, Ivan Dot Pascuet, Mireia, Duart, Isabel Tello Galindo, Eduardo Arrea Salto, Jaume Cámara Cabrera, Marta Camats Terré, Juan Gabriel Castro Ríos, Marta de la Rosa-Estadella, Anna, Fernandez-Colorado, Anna, Gasulla-Rodriguez, Antonio, Gimenez-Gaibar, Elena, Gonzalez, Yeray Maldonado Sotoca, Matilde, Molina-Corbacho, Montserrat Monfort Mira, Josep, Rodoreda, Marta Santos Espí, Arnau Verdaguer Figuerola, Elisa Angela Diego-Alonso, Jaime, López-Sánchez, Luis, Muñoz-Bellvis, Jacobo, Trebol, Borja, Aguinagalde, Cristina Gabriela Alzate Arsuaga, Ainhoa Andres Imaz, Iñigo, Arana, Coro Aranzabal Urrutia, Mikel, Armendariz, Lorena, Arrabal, Iñigo, Augusto, Adolfo, Beguiristain, Laura, Busto, Ainhoa, Cuevas, Itziar De Ariño, Alejandro, Elúa, Leticia, Fernandez, Arantza, Fernandez-Monge, Lander, Gallego, Alba, Garcia, Amaia Garcia Dominguez, Gregorio, Garmendia, Carmen, Grañén, Pelayo Hevia Rodríguez, Maria, Iraola, José Miguel Izquierdo, Aintzane, Lizarazu, Jon Ander Lizarbe, Claudia Cristina Lopes Moreira, Iker, López, Ruth Marquina González, Tania, Pastor, Adrián Recio Ayesa, Ana Paula Riverola Aso, Carballo, Rodríguez, Araceli, Rodrìguez, Maria Inmaculada Ruiz Montesinos, Patricia, Torres, Jose, Undabeitia, Ainara, Villafruela, Maria Barrionuevo Ramos, David, Blanco, Marta, Calderón, Eva Corral Rubio, Angel, Cuadrado-García, Daniela, Cubek, Ignacio, Fariña, Maria Fernandez LLorente, Natalia Flores Amador, Mariana García Virosta, Luis Garcia-Sancho Tellez, Adelina Gonzalez Martinez, María, Hernandez, Rubén Herreros Ruiz-Valdepeñas, Carmen Jimenez Sanchez, Eduardo Llamazares Cobo, María, López, Javier, López-Martin, Teresa Martínez Marivela, Luis Miguel Martinez Parra, Paloma Maté Mate, Paloma, Medrano, Manuel Moriche Carretero, Sara Núñez O'Sullivan, Manuel Ortega Oria de Rueda, María Begoña Pastor Nieto, Clara, Pérez, Antonio, L Picardo, Remedios Revilla Amores, Carmen Rodríguez Haro, Jose Alberto Rojo López, Fatima Sanchez Cabezudo Noguera, Cristina, Sanz, Daniel Serralta de Colsa, Cristina Valor Garcia, Marta Velasco Martinez, Iván Andújar Lara, Aranzazu, Calero-Lillo, Enrique, López-Ruiz, Alberto Díaz García, Alejandro Menéndez Moreno, Luis Eduardo Pérez-Sánchez, Ángela, Pascual, Miguel Adeba García, Marta Alonso Fernández, Javier Alvarez Gama, Roberto, Ballestero, Loreto Berjon De La Vega, Paola Calleja Hermosa, Mariana, Carrillo-Rivas, Alfonso, Casado, Andrea, Cerveró, Bonifacio Cimadevilla Calvo, Patricia Corriols Noval, Paloma de la Dehesa Cueto-Felgueroso, Miren Jasone Diez Zapirain, José Estevez Tesouro, José Antonio Fernández-Dívar Sánchez, Lucia Garcia Alcalde, Juan García Cardo, Tito García Moreno, Daniel, García-López, Belen Garcia-Montesinos Perea, Miren Gonzalez Benito, Rocio, Gonzalez-Aguado, Miguel Ángel Gordo Vega Gordo-Vega, Jose, Gutierrez-Banos, Jaime Jimeno Fraile, Yolanda Jubete Castañeda, Patricia Lopez Gomez, Antonia Jesús López López, David Mato Mañas, Carmelo, Morales-Angulo, Dieter, Morales-Garcia, Sara, Naranjo, Jose Luis Rabago, Jose Manuel Rabanal, Rocio Revuelta Zorrilla, Adriana Reyes Echeverría, Juan Carlos Rodríguez-Sanjuán, Juan Ramón Sanz, Isabel Simal Badiola, Guillermo, Tejón, Enrique Toledo Martínez, Raquel Varea Malo, Begoña, Fadrique, Tania, Funes, Elena González Revilla, Isaias, Alarcón, Daniel Aparicio Sánchez, Pablo Beltran Miranda, Carmen, Cepeda-Franco, María Josefa Cuevas López, Sandra, Dios-Barbeito, Virginia María Durán Muñoz-Cruzado, Carlos Gonzalez De Pedro, Rosa, M Jimenez-Rodriguez, Francisco, Manresa-Manresa, Gabriel, Marin, Cristobalina, Martin-Garcia, Sara, Martínez-Núñez, Juan Manuel Martos Martinez, Lucas, Mengíbar, Felipe Pareja Ciuro, Eduardo Perea Del Pozo, Veronica Pino Diaz, José, Pintor-Tortolero, Claudia, Quintero-Pérez, Maria Luisa Reyes Diaz, Mercedes Rubio Manzanares Dorado, Alejandro Sanchez Arteaga, Ana, Senent-Boza, Luis, Tallon-Aguilar, Jose, Tinoco-Gonzalez, Luis-Cristobal, Capitan-Morales, Juan Cintas Catena, Javier, Valdes-Hernandez, María Del Campo Lavilla, Alina López De Fernández, Miriam Abellan Lucas, Alba Diaz Padillo, Maria Gómez Romero, Linda Grace Puerto Tamayo, El Mostafa El Yaqine Er Raoudi, Melody García Domínguez, María Ángeles Gascón Domínguez, Marta González Pérez, Alba Hernáez Arzoz, Joana San Anton, Cristian, Ruminot, Hander Guillermo Acosta Diaz, Daniella, Laguado, Kristina, Aghababyan, Alba, Jr, Enrique, Artigues, Rocío, Belda, Miguel, Beltran, Jose Ignacio Blanes, Elena Campos Carot, Miriam, Cantos, Laura, Costa, Carolina Ferrer Gomez, José María Gallego Sánchez, Oscar, Gil-Albarova, Juan, Gilabert-Estellés, Emilio Lopez Alcina, Isabel López Sánchez, Severiano Marin Bertolin, Carolina, Martinez-Perez, Antonio Melero Abellán, Claudia Mulas Fernández, Beatriz, Novoa, Ruth, Nuñez, Pablo Renovell Ferrer, Guijarro-Jorge, Ricardo, Carolina Soledad Romero Garcia, Miguel Sanfeliu Giner, Silvia, M West, Enrique, Zapater, Ignacio, Miranda, Ana, Monís, Alejandro Roselló Añón, María José Sangüesa, Jorge Sanz Romera, Marcos, Adrianzén, Maria Barrios Carvajal, Mireia, Bauzá, Ana Benítez Riesco, Jose Antonio Carbonell Lopez, María-Carmen, Fernández-Moreno, Ricardo Gadea Mateo, Francisco, Garcia, Maris Luisa García-Pérez, Luisa Paola Garzon, Ana, Izquierdo, Maria Lapeña Rodríguez, Carlos, León-Espinoza, Fernando, Lopez, Rosa Martí Fernández, Sara Martínez Castro, Berta Monleón López, Isabel Mora Oliver, David, Moro-Valdezate, Ernesto Muñoz Sornosa, Sara Palomares Casasús, Leticia Pérez Santiago, Mara Albert Fort, Reyes, Balanzá, Lorena Bermell Marco, Carla Carratalá Pérez, Claudia Pilar Clemente Tomas, Marta, Córcoles, Jose Ángel Diez Ares, Carlos Domingo Del Pozo, Nuria Estellés Vidagany, Gonzalo, Garrigos, Mar Gimeno Gimeno Vicente, Blanca Alastrue Giner, Segundo, Gomez-Abril, Paloma, Gonzalez, Paula Gonzálvez Guardiola, Guillermo Sebastian Martínez Fernández, Charo Martínez García, Lucía, Martínez-Costa, Luz María Moratalla Charcos, Sergio Navarro Martínez, Carmen, Payá-Llorente, Álvaro Pérez Rubio, Nuria, Peris, Eduardo Picazo Pineda, Jordi Planelles Gómez, Francisco Ripoll Vidal, Andrea, Roca, Enrique, Salmerón-González, Raquel Segura Roselló, Ramon Trullenque Juan, Cristina Verdejo Gimeno, Jose Miguel Zaragozá García, Gema Zomeño Bravo, Marcos Bruna Esteban, Hanna, Cholewa, Milton de Jesus, Matteo, Frasson, Luis Oliver García, Héctor, J Aguado, Antonio Jose Alonso Villalba, Francisco, Ardura, Carmen Elena Badillo Bercebal, María Bedate Núnez, Alvarez-Ramos Begoña Aranzazu, Juan Beltrán de Heredia, Hugo, Bermejo, Juan Berrocal Cuadrado, Maria Bragado González, Juan, Bustamante-Munguira, Raul Calvo Gonzalez, Yolanda, Carrascal, Ana Belén Casas Marcos, María Carmen Cervera, Sergio Chávez Valladares, Ángel Cilleruelo Ramos, Susana, Cortes, Jesús, Crespo-Sanjuán, María, Cuaresma, Luis Antonio Cuellar Martin, Carlos Ferreras García, Alvaro, Fuentes-Martín, Abel, Ganso, Elena García García, Luis, Garcia-Florez, Virginia, Garcia-Virto, Juan, Gatón, Julio Alberto Gobernado Tejedor, Tania Gómez Sanz, Jose Ignacio González Martín, María Begoña Gregorio Crespo, Ana Herranz Arriero, Jose, Herreros, Marta Ibáñez Nieto, César, Infante, Carlos, Jezieniecki, Moises, Juarez, Gregorio de Jesus Labrador Hernandez, Ana Patricia Legido Morán, Ricardo León Fernández, Alejandro, Leon-Andrino, Almudena, Llorente, Maria Lopez Pais, Mauricio Loucel Bellino, Sergio, Martin, Miguel Angel Martin-Ferrero, Gonzalo Martinez Municio, Elvira Mateos Alvarez, José María Matilla, Luis María Merino Peñacoba, Mario, Montes-Manrique, Fernando Natal Álvarez, David, C Noriega, Henar Nuñez Del Barrio, Francisco Javier Ortiz de Solórzano Aurusa, Lucía, Pañeda, Victoria Pascual Escudero, Miguel Pascual Samaniego, Adela, Pereda, Marta Pérez Febles, Laura, Pesquera, Maria, Plata, Emma Puertas Ruiz, Mario, Rodriguez-Lopez, Alejandro Romero de Diego, Ana, Ruano, María Ruiz Soriano, Cristina Sánchez Torralvo, Silvia Santiago Maniega, Bárbara, Segura-Méndez, Clarisa Simon Perez, José, Soro-García, Paula Suárez Mansilla Suárez-Mansilla, Jeancarlos Trujillo Díaz, Mª Esther Valsero Herguedas, Andrea Vazquez Fernandez, Eduardo Velasco García, Ana, Zabalza, Álvaro Zamora Horcajada, Fernando Acebes García, Enrique Asensio Díaz, Martín, Bailón, Alejandro David Bueno Cañones, Alvaro Centeno Velasco, Ekta Choolani Bhojwani, Fernando Labarga Rodríguez, Sara, Mambrilla, Pablo, Marcos-Santos, Toledano, Miguel, David Pacheco Sánchez, Baltasar, Pérez-Saborido, Pilar, Pinto, Katherine, Plua, Javier Sanchez Gonzalez, Vicente, Simo, Rosalía Velasco López, Sandra Veleda Belanche, Fabiola Eugenia Michel Campos, Iciar Muñoz Lindez, Maria, Balluerca, Maite, Camuera, Pablo, Helguera, Imanol, Herrero, Patricia Paunero Vazquez, María, Sánchez-Rubio, Isami, Soeda, María Dolores Arribas Del Amo, Vicente Manuel Borrego Estella, Estefania, Casas, Néstor Castán Villanueva, Daniel Delfau Lafuente, Elena Delgado Blanco, María, Domingo, Ismael Gil Romea, Azucena, Gonzalo, Emilio Lagunas Lostao, Noelia Lete Aguirre, Yaiza Martinez 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Sivasuriya, Sivaganesh, Chamal, Fernando, Nishantha, Mendis, Balasingam, Balagobi, Balasupramaniam, Sathesan, Lanka, Dasanayake, Malitha, Patabendige, Wickramasooriya, Dj, Kugarajh, Ganeshapillai, Sathyamoorthy, Prasanna, Dileepa, Ediriweera, Sumudu, Kumarage, Asanka, Jayawardane, Athula, Kaluarachchi, Pituwala Liyanage Adithya Sirisena, Abubakr, Abubakr, Hozifa, Mohamed, Ismail, Mustafa, Mogahid, Sharfeldein, Samir, Ismail, Reem, Musa, Monira, Sarih, Mussab, Abaker, Eman Adam Abdalla, Mohamad, Abdelbagi, Alsafe, Adlan, Ahmed, Alnaeem, Safa, Atyah, Yasir, Awad, Rsheeda, Dawelbait, Mohamed El Hag, Ibrahim, Elbashir, Sami, Eldirdiri, Samwal, Eldirdiri, Mohammed Eltahier Abdalla Omer, Lana Abdalgadir Ahmed Mohamed, Hiba Hassan Rehmtallah Ahmed, Mohammed Balla Yousif Balla, Abdulmoiz, Aljafari, Abdulmalek, Aljafari, Elsagad, Mohamed, Abdulkader, Mohammad, Abdulkader, Shaar, Mohamed Nafea Shaar, Maab Hussein Yousif Elhafiz, Mohammed Husien Yosif Elhafiz, Abubakr Ali Mohammed Alhassan Humidan, Almigdad, Ali, Hisham, Eljack, Mohamedyasin, Elrashid, Manhal, Ahmed, Albrra, Alhag, Douaa, Ali, Mohammed Ahmed Babikir, Imad, Bakheit, Hytham K, S Hamid, Sami, Mohamed, Walid, Shaban, Nidhal, Siddig, Mohamed, Suliman, Rihab Yasir Abdelmagid, Abubaker, Yassin, Omer, Abbas, Eltahir, Abdelrahim, Muhammed, Ahmed, Mohamed, Elobaid, Adil, Hashim, Ali, Mohamed, Omer, Mohamed, Khalid, Osman, Abdallah, Yousif, Safaa, Abdulaal, Marwa, Elsadig, Mohammed, Hussain, Malaz Amir Ataalmanan, Doha Amir AtaAlmanan, Tebyan Amir AtaAlmanan, Alaa, Elgaili, Maria, Mohamed, Usra, Omara, Alkhansa, Osman, Amna, Osman, Safaa, Saad, Abdelkareem, Ahmed, Ali Adil Ali Karar, Aya, Alhassan, Mohanad, Alsidig, Mohamed, Eljack, Mohammed Ibrahim Mohammed Ali, Awad Kamal Awad Osman, Liena, Mohamed, Samah Ibrahim Omer Mohamed Osman Mohamed Osman, Altayeb, Mohammed, Ayman, Mohammed, Khadija, Muhmmed, Eltahir, Musa, Egbal Sahal Abdelmajed, Khalid Z M, Y Hamid, Omnia M, M Yousif, Mahmoud, Saleh, Osman, Bashir, Yassein, Elhussein, Omar, Madani, Eva, Angenete, Jennifer, Park, Lars, Gillberg, Monir, Jawad, Linas, Pieteris, Yousif, Saeed, Sergej, Safonov, Martin, Spångfors, Henrik, Andersson, Hans, Bahlmann, Karin Björnström Karlsson, Michelle, Chew, Lara, Daham, Lina De Geer, Helen, Didriksson, Gunilla, Gagnö, Carina, Jonsson, Anna, Oscarsson, Pamela, Buchwald, Mathilde, Delorme, Marie-Louise, Lydrup, Shahin, Mohseni, Arvid, Pourlotfi, Souheil, Reda, Kajsa, Anderin, Nina, Blomme, Josefin, Segelman, Malin, Simlund, Anders, Thorell, Fredrik, Wogensen, Daniel, Danielsson, Peter, Elbe, Rebecka, Hultgren, Boel, Hynning, Fredrik, Klevebro, Karin, Lind, Ebba, K Lindqvist, Carl, Montan, Ernesto, Sparrelid, Clara Svenberg Lind, Jeremy, Wales, Andreas, Älgå, Martin, Nordberg, Emil, Pieniowski, Ioannis, Gkekas, Niklas, Löfgren, Karolina, Niska, Robert, Zürner, Silvio, Däster, Otto, Kollmar, Savas, Soysal, Stephanie, Taha-Mehlitz, Athanasios, Tampakis, Dominik Valentin Flury, Marie, Heyne-Pietschmann, 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Patricia, Shinondo, Chabwera, Shumba, Penias, Tembo, Shelton, Chivanga, Ngqabutho, Dube, Handsome, Dube, Daniel, Dzinotyiwei, Ronald, Makanda, Moses, Mangena, Partson, Maphosa, Derek, Matsika, Proud, Mawere, Nkosikhona, Moyo, Assel, Moyo, Arnold, Muguwu, Simbarashe, Mungazi, Garikai, Mwale, Gamuchirai, Ndabvonga, Mambote Crispin Olivier Ntoto, Hardlife, Ranganai, Ernesto Sánchez Castillo, Oltah, Tshuma, Grace, Gwini, Vimbai Moyana Muguto, Gilbert, Moyo, Trust, Mushawarima, Tinashe, Shoko, Rorisang, Jamela, Marvellous, Machiri, Eric, Shumba, Antony, Chengahomwe, Yemurai, Bikwa, Maxwell, Chimhina, Jeremy, Marume, Kudzayi, Munanzvi, Precious G, T Mutambanengwe, Federico, Ferrari, Marco, Fontanella, Franco, Odicino, Romano, Vito, Nepogodiev D, Emanuele Cammarata, Sofia Campanella, Daniela Canzonieri, Adriana Cordova, Federico De Michele, Ettore Dinoto, Mara Franza, Leo Licari, Daniele Matta, Domenico Mirabella, Felice Pecoraro, Roberto Pirrello, Pierfrancesco Pugliese, Fernando Rosatti, Giuseppe Salamone, Francesca Toia, Massimiliano Tripoli, Nepogodiev, D, Rosati, R, Surgery, Medicine and Pharmacy academic/administration, Basic (bio-) Medical Sciences, Surgical clinical sciences, Faculty of Medicine and Pharmacy, Gastroenterology, Medical Oncology, Clinical sciences, Breda, João, ARD - Amsterdam Reproduction and Development, Paediatric Surgery, AGEM - Amsterdam Gastroenterology Endocrinology Metabolism, AGEM - Endocrinology, metabolism and nutrition, Graduate School, Tytgat Institute for Liver and Intestinal Research, Laura Alberici, Filippo Antonacci, Alessandro Arena, Angela Belvedere, Fabio Bernagozzi, Paolo Bernante, Pietro Bertoglio, Lorenzo Bianchi, Maria Bisulli, Barbara Bonfanti, Safia Boussedra, Jury Brandolini, Crescenzo Cacciapuoti, Stefano Cardelli, Riccardo Casadei, Matteo Cescon, Alessandro Cipolli, Riccardo Cipriani, Alfredo Conti, Luca Contu, Francesco Costa, Niccolo’ Daddi, Eugenia De Crescenzo, Pierandrea De Iaco, Alessandra De Palma, Massimo Del Gaudio, Anna Nunzia Della Gatta, Giampiero Dolci, Giulia Dondi, Matteo Droghetti, Sergio Nicola Forti Parri, Elena Garelli, Chiara Gelati, Giuliana Germinario, Federico A. Giorgini, Carlo Ingaldi, Elio Jovine, Kenji Kawamukai, Antonio Lanci Lanci, Raffaele Lombardi, Maria Elisa Lozano Miralles, Claudio Marchetti, Michele Masetti, Francesco Minni, Daniele Morezzi, Daniele Parlanti, Alice Pellegrini, Anna Myriam Perrone, Anna paola Pezzuto, Marco Pignatti, Gianluigi Pilu, Valentina Pinto, Gilberto Poggioli, Silvana Bernadetta Puglisi, Diego Raimondo, Matteo Ravaioli, Claudio Ricci, Sara Ricciardi, Francesco Ricotta, Roberta Rizzo, Angela Romano, Matteo Rottoli, Riccardo Schiavina, Renato Seracchioli, Matteo Serenari, Margherita Serra, Piergiorgio Solli, Gioia Sorbi, Mario Taffurelli, Marta Tanzanu, Achille Tarsitano, Marco Tesei, Gabriele Vago, Tommaso Violante, Simone Zanotti, Tommaso Frisoni, leonardo solaini, giorgio ercolani, Fruscio, R, Ornaghi, S, Collaborative, Covidsurg, Collaborative, Globalsurg, Palmisano, Silvia, de Manzini, Nicolo', Žundienė, Laura, Dulskas, Audrius, Kuliavas, Justas, Čekauskas, Albertas, Kielaitė-Gulla, Aistė, Poškus, Tomas, Strupas, Kęstutis, Želvys, Arūnas, COVIDSurg Collaborative, GlobalSurg Collaborative, Department of Surgery, HUS Abdominal Center, Simoes, Jff, Li, E, Picciochi, M, Glasbey, Jc, Baiocchi, G, Blanco-Colino, R, Chaudhry, D, Alameer, E, El-Boghdadly, K, Wuraola, F, Ghosh, D, Gujjuri, Rr, Harrison, Em, Lule, H, Kaafarani, H, Khosravi, M, Kronberger, I, Leventoglu, S, Mann, H, Mclean, Ka, Mengistu, Gm, Modolo, Mm, Ntirenganya, F, Norman, L, Outani, O, Pius, R, Pockney, P, Qureshi, Au, Roslani, Ac, Satoi, S, Shaw, C, Bhangu, A, Omar, Om, Ahmed, Wur, Argus, L, Ball, A, Bywater, Ep, Brar, A, Dawson, Be, Duran, I, Elhadi, M, Jones, C, Kamarajah, Sk, Keatley, Jm, Lawday, S, Marson, Ej, Ots, R, Santos, I, Taylor, Eh, Trout, Im, Varghese, C, Venn, Ml, Xu, W, Dajti, I, Gjata, A, Kacimi, Seo, Boccalatte, L, Cox, D, Townend, P, Aigner, F, Kronberger, Ie, Samadov, E, Alderazi, A, Hossain, K, Padmore, G, van Ramshorst, G, Lawani, I, Cerovac, A, Delibegovic, S, Gomes, Gma, Buarque, Il, Gohar, M, Slavchev, M, Nwegbu, C, Agarwal, A, Martin, J, Ng-Kamstra, J, Olivos, M, Lou, Wh, Ren, Dl, Calvache, Ja, Rivera, Cjp, Hadzibegovic, Ad, Kopjar, T, Mihanovic, J, Jimenez, Pma, Gouvas, N, Klat, J, Novysedlak, R, Amisi, N, Christensen, P, El-Hussuna, A, Batista, S, Lincango-Naranjo, E, Emile, S, Sandoval, Daa, Dhufera, H, Hailu, S, Mengesha, Mg, Kauppila, Jh, Arnaud, Ap, Demetrashvili, Z, Albertsmeier, M, Lederhuber, H, Loffler, Mw, Acquah, Dk, Ofori, B, Tabiri, S, Metallidis, S, Tsoulfas, G, Aguilera-Arevalo, Ml, Recinos, G, Mersich, T, Wettstein, D, Kembuan, G, Milan, Pb, Khosravi, Mh, Mozafari, M, Hilmi, A, Mohan, H, Zmora, O, Gallo, G, Pata, F, Pellino, G, Fujimoto, Y, Kuroda, N, Abou Chaar, Mk, Ayasra, F, Fakhradiyev, I, Hamdun, Ih, Jin-Young, J, Jamal, M, Karout, L, Gulla, A, Rasoaherinomenjanahary, F, Samison, Lh, Sanchez, Iid, Gonzalez, D, Martinez, L, Martinez, Mj, Nayen, A, and Ramos-De la Medina, A
Subjects: Male, Vascular damage Radboud Institute for Health Sciences [Radboudumc 16], MULTICENTER, infectious diseases, 0302 clinical medicine, 030202 anesthesiology, Anesthesiology, Cirugía, 80 and over, Prospective Studies, Young adult, Child, Lung, Aged, 80 and over, COVID-19, delay, SARS-CoV-2, surgery, timing, SARS‐CoV‐2 infection, Operative, Child, Preschool, Pneumonia & Influenza, Infection, Cohort study, Human, medicine.medical_specialty, Clinical Sciences, Sars-cov-2, GlobalSurg Collaborative, Settore MED/28 - MALATTIE ODONTOSTOMATOLOGICHE, 03 medical and health sciences, Clinical Research, Biodefense, Correspondence, Humans, PULMONARY COMPLICATIONS, CRIANÇAS EM IDADE PRÉ-ESCOLAR, Aged, Science & Technology, Cirurgia, Prevention, Infant, Odds ratio, Pneumonia, Prospective Studie, Clinical research, Surgery, Human medicine, 610 Medizin und Gesundheit, 1109 Neurosciences, Internationality, Settore MED/29 - CHIRURGIA MAXILLOFACCIALE, Settore MED/18 - CHIRURGIA GENERALE, Adolescent, Adult, Cohort Studies, Female, Middle Aged, Surgical Procedures, Operative, Time, Young Adult, Practice Guidelines as Topic, gastroenterology, Medicine and Health Sciences, 030212 general & internal medicine, Prospective cohort study, Mortality rate, Covid19, Infectious Diseases, Patient Safety, medicine.symptom, 6.4 Surgery, Life Sciences & Biomedicine, 610 Medicine & health, COVID-19, SARS-CoV-2, delay, surgery, timing, Asymptomatic, NO, COVIDSurg Collaborative, Vaccine Related, All institutes and research themes of the Radboud University Medical Center, medicine, Mortalitat, ddc:610, Mortality, Preschool, LS7_4, Surgical Procedures, business.industry, Neurosciences, Evaluation of treatments and therapeutic interventions, 1103 Clinical Sciences, 3126 Surgery, anesthesiology, intensive care, radiology, Reconstructive and regenerative medicine Radboud Institute for Health Sciences [Radboudumc 10], Anesthesiology and Pain Medicine, Emerging Infectious Diseases, Good Health and Well Being, Mortalidad, Cohort Studie, business
Abstract: Peri-operative SARS-CoV-2 infection increases postoperative mortality. The aim of this study was to determine the optimal duration of planned delay before surgery in patients who have had SARS-CoV-2 infection. This international, multicentre, prospective cohort study included patients undergoing elective or emergency surgery during October 2020. Surgical patients with pre-operative SARS-CoV-2 infection were compared with those without previous SARS-CoV-2 infection. The primary outcome measure was 30-day postoperative mortality. Logistic regression models were used to calculate adjusted 30-day mortality rates stratified by time from diagnosis of SARS-CoV-2 infection to surgery. Among 140,231 patients (116 countries), 3127 patients (2.2%) had a pre-operative SARS-CoV-2 diagnosis. Adjusted 30-day mortality in patients without SARS-CoV-2 infection was 1.5% (95%CI 1.4-1.5). In patients with a pre-operative SARS-CoV-2 diagnosis, mortality was increased in patients having surgery within 0-2 weeks, 3-4 weeks and 5-6 weeks of the diagnosis (odds ratio (95%CI) 4.1 (3.3-4.8), 3.9 (2.6-5.1) and 3.6 (2.0-5.2), respectively). Surgery performed ≥ 7 weeks after SARS-CoV-2 diagnosis was associated with a similar mortality risk to baseline (odds ratio (95%CI) 1.5 (0.9-2.1)). After a ≥ 7 week delay in undertaking surgery following SARS-CoV-2 infection, patients with ongoing symptoms had a higher mortality than patients whose symptoms had resolved or who had been asymptomatic (6.0% (95%CI 3.2-8.7) vs. 2.4% (95%CI 1.4-3.4) vs. 1.3% (95%CI 0.6-2.0), respectively). Where possible, surgery should be delayed for at least 7 weeks following SARS-CoV-2 infection. Patients with ongoing symptoms ≥ 7 weeks from diagnosis may benefit from further delay. ispartof: ANAESTHESIA vol:76 issue:6 pages:748-758 ispartof: location:England status: published
Published: 2021
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19. Laparoscopic Indocyanine Green Fluorescence Imaging for Intrahepatic Cholangiocarcinoma

Author: Gaetano Piccolo, Matteo Barabino, Francesca Lecchi, Roberto Santambrogio, Claudia Nava, Enrico Opocher, and Paolo Pietro Bianchi
Subjects: General Medicine
Abstract: Background Indocyanine green fluorescence (ICG) is one of the first fluorophore that found a clinical application in medicine. In the liver, ICG fluorescence is due to the preserved uptake but impaired washout of the dye from hepatocellular cells into the bile ducts. Therefore, some hepatobiliary surgeons proposed the technique of intravenous ICG injection before surgery for the detection of superficial hepatocarcinomas (HCCs) and colorectal liver metastases (CRLMs). Little evidence exists regarding the use of ICG to identify other hepatic tumors, such as intrahepatic cholangiocarcinoma (ICC). We report two patients affected by ICC who underwent laparoscopic liver resection with lymphadenectomy, the ICG staining was routinely performed not only to evaluate the site of the hepatic lesions but also to guide the extension of liver resection. Methods It was injected intravenously a single dose of ICG dye (0.5 mg/kg) during liver function tests 5 days before scheduled surgery. All patients underwent laparoscopic staging with both laparoscopic ultrasound and ICG fluorescence imaging. Results It was identified two different patter of ICG imaging: rim and segmental fluorescence for mass forming and mixed ICC subtype respectively. Conclusions Identification of the ICC subtype before definitive histological examination may have an impact on the surgical plan.
Published: 2022
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20. 3D reconstruction procedures to aid the laparoscopic resection of colorectal metastasis located in the first segment

Author: Roberto Santambrogio, Maurizio Vertemati, Edgardo Picardi, and Marco Antonio Zappa
Subjects: Materials Chemistry
Published: 2022
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21. 3D technology and 3D-printed models for liver surgery

Author: Roberto Santambrogio, Maurizio Vertemati, Edgardo Picardi, and Marco Antonio Zappa
Subjects: Materials Chemistry
Published: 2022
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22. Examples of virtual reality environment during laparoscopic treatments of liver tumors

Author: Roberto Santambrogio, Maurizio Vertemati, Edgardo Picardi, and Marco Antonio Zappa
Subjects: Materials Chemistry
Published: 2022
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23. An Anti-MICA/B Antibody and IL-15 Rescue Altered NKG2D-Dependent NK Cell Responses in Hepatocellular Carcinoma

Author: S. Bernuzzi, Matteo Donadon, Stefania Varchetta, Silvia Chiellino, Barbara Oliviero, Camillo Porta, Mario U. Mondelli, Roberto Santambrogio, Florence Lhospice, Enrico Opocher, Manel Kraiem, Matteo Barabino, Claudia Cigala, Marcello Maestri, Barbara Franceschini, Cristiana Soldani, Angelo Sangiovanni, Dalila Mele, Stefania Mantovani, Guido Torzilli, Paolo Pedrazzoli, and Gaetano Piccolo
Subjects: 0301 basic medicine, Sorafenib, Cancer Research, medicine.medical_treatment, chemical and pharmacologic phenomena, lcsh:RC254-282, Article, 03 medical and health sciences, 0302 clinical medicine, medicine, HCC, Receptor, innate immunity, natural killer cells, biology, business.industry, Degranulation, Immunotherapy, lcsh:Neoplasms. Tumors. Oncology. Including cancer and carcinogens, medicine.disease, NKG2D, digestive system diseases, 030104 developmental biology, Oncology, Interleukin 15, 030220 oncology & carcinogenesis, Hepatocellular carcinoma, biology.protein, Cancer research, sorafenib, immunotherapy, Antibody, business, medicine.drug
Abstract: Natural killer (NK) cells play a pivotal role in cancer immune surveillance, and activating the receptor/ligand interaction may contribute to control the development and evolution of hepatocellular carcinoma (HCC). We investigated the role of the natural killer group 2 member D (NKG2D) activating receptor and its ligand, the major histocompatibility complex class I chain-related protein A and B (MICA/B) in patients with cirrhosis and HCC subjected to surgical resection, patients with cirrhosis and no HCC, and healthy donors (HD). The NKG2D-mediated function was determined in peripheral blood (PB), in tumor-infiltrating lymphocytes (NK-TIL), and in matched surrounding liver tissue (NK-LIL). A group of patients treated with sorafenib because of clinically advanced HCC was also studied. A humanized anti-MICA/B monoclonal antibody (mAb) was used in in vitro experiments to examine NK cell-mediated antibody-dependent cellular cytotoxicity. Serum concentrations of soluble MICA/B were evaluated by ELISA. IL-15 stimulation increased NKG2D-dependent activity which, however, remained dysfunctional in PB NK cells from HCC patients, in line with the reduced NKG2D expression on NK cells. NK-TIL showed a lower degranulation ability than NK-LIL, which was restored by IL-15 stimulation. Moreover, in vitro IL-15 stimulation enhanced degranulation and interferon-&gamma, production by PB NK from patients at month one of treatment with sorafenib. Anti-MICA/B mAb associated with IL-15 was able to induce PB NK cytotoxicity for primary HCC cells in HD and patients with HCC, who also showed NK-TIL degranulation for autologous primary HCC cells. Our findings highlight the key role of the NKG2D-MICA/B axis in the regulation of NK cell responses in HCC and provide evidence in support of a potentially important role of anti-MICA/B mAb and IL-15 stimulation in HCC immunotherapy.
Published: 2020

24. Five recommendations for loco-regional treatments of hepatocellular carcinoma during the COVID-19 pandemic

Author: Roberto Santambrogio, Marco Zappa, and Elisa Galfrascoli
Subjects: Adult, Male, China, 2019-20 coronavirus outbreak, Carcinoma, Hepatocellular, Coronavirus disease 2019 (COVID-19), Pneumonia, Viral, Article, Young Adult, Betacoronavirus, Nasopharynx, Pandemic, medicine, Carcinoma, Humans, Pandemics, Aged, Aged, 80 and over, biology, Hepatology, Clinical Laboratory Techniques, Diagnostic Tests, Routine, business.industry, SARS-CoV-2, Liver Neoplasms, Gastroenterology, COVID-19, Middle Aged, medicine.disease, biology.organism_classification, Virology, Pneumonia, Hepatocellular carcinoma, Female, business, Coronavirus Infections
Abstract: Since the outbreak of coronavirus disease (COVID-19) in Wuhan in December 2019, by March 10, 2020, a total of 80,932 confirmed cases have been reported in China. Two consecutively negative RT-PCR test results in respiratory tract specimens is required for the evaluation of discharge from hospital, and oropharyngeal swabs were the most common sample. However, false negative results occurred in the late stage of hospitalization, and avoiding false negative result is critical essential.We reviewed the medical record of 353 patients who received tests with both specimens simultaneously, and compared the performance between nasopharyngeal and oropharyngeal swabs.Of the 353 patients (outpatients, 192; inpatients, 161) studied, the median age was 54 years, and 177 (50.1%) were women. Higher positive rate (positive tests/total tests) was observed in nasopharyngeal swabs than oropharyngeal swabs, especially in inpatients. Nasopharyngeal swabs from inpatients showed higher positive rate than outpatients. Nasopharyngeal swabs from male showed higher positive rate than female, especially in outpatients. Detection with both specimens slightly increased the positive rate than nasopharyngeal swab only. Moreover, the consistency between from nasopharyngeal and oropharyngeal swabs were poor (Kappa=0.308).In conclusion, our study suggests that nasopharyngeal swabs may be more suitable than oropharyngeal swab at this stage of COVID-19 outbreak.
Published: 2020
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25. COVID-19 outbreak and acute cholecystitis in a Hub Hospital in Milan: wider indications for percutaneous cholecystostomy

Author: Matteo Barabino, Gaetano Piccolo, Arianna Trizzino, Veronica Fedele, Carlo Ferrari, Vincenzo Nicastro, Andrea Pisani Ceretti, Enrico De Nicola, Nicolò Maria Mariani, Marco Giovenzana, Giovanna Scifo, Massimiliano Mazza, Ruggero Vercelli, Roberto Santambrogio, Carmelo Luigiano, and Enrico Opocher
Subjects: SARS-CoV-2, Cholecystitis, Acute, lcsh:Surgery, COVID-19, lcsh:RD1-811, Hospitals, Disease Outbreaks, Acute cholecystitis, Treatment Outcome, Bedside, Italy, Humans, Drainage, Cholecystostomy, Percutaneous cholecystostomy, Retrospective Studies, Research Article
Abstract: Background COVID-19 pandemic has impacted the Italian National Health Care system at many different levels, causing a complete reorganization of surgical wards. In this context, our study retrospectively analysed the management strategy for patients with acute cholecystitis. Methods We analysed all patients admitted to our Emergency Department for acute cholecystitis between February and April 2020 and we graded each case according to 2018 Tokyo Guidelines. All patients were tested for positivity to SARS-CoV-2 and received an initial conservative treatment. We focused on patients submitted to cholecystostomy during the acute phase of pandemic and their subsequent disease evolution. Results Thirty-seven patients were admitted for acute cholecystitis (13 grade I, 16 grade II, 8 grade III). According to Tokyo Guidelines (2018), patients were successfully treated with antibiotic only, bedside percutaneous transhepatic gallbladder drainage (PC) and laparoscopic cholecystectomy (LC) in 29.7%, 21.6% and 48.7% of cases respectively. Therapeutic strategy of three out of 8 cases, otherwise fit for surgery, submitted to bedside percutaneous transhepatic gallbladder drainage (37.5%), were directly modified by COVID-19 pandemic: one due to the SARS-CoV-2 positivity, while two others due to unavailability of operating room and intensive care unit for post-operative monitoring respectively. Overall success rate of percutaneous cholecystostomy was of 87.5%. The mean post-procedural hospitalization length was 9 days, and no related adverse events were observed apart from transient parietal bleeding, conservatively treated. Once discharged, two patients required readmission because of acute biliary symptoms. Median time of drainage removal was 43 days and only 50% patients thereafter underwent cholecystectomy. Conclusions Percutaneous cholecystostomy has shown to be an effective and safe treatment thus acquiring an increased relevance in the first phase of the pandemic. Nowadays, considering we are forced to live with the SARS-CoV-2 virus, PC should be considered as a virtuous, alternative tool for potentially all COVID-19 positive patients and selectively for negative cases unresponsive to conservative therapy and unfit for surgery.
Published: 2020
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26. Correction to: Immunohistochemical evaluation of microsatellite instability in resected colorectal liver metastases: a preliminary experience

Author: Matteo Barabino, Roberto Santambrogio, Guglielmo Niccolò Piozzi, Claudia Cigala, Anna Maria Ierardi, Gianpaolo Carrafiello, Gaetano Piccolo, Daris Ferrari, Carla Codecà, Carmelo Luigiano, Enrico Opocher, Riccardo Masserano, Gaetano Bulfamante, and Delfina Tosi
Subjects: Cancer Research, medicine.medical_specialty, Oncology, business.industry, medicine, Immunohistochemistry, Microsatellite instability, Mistake, Hematology, General Medicine, Radiology, medicine.disease, business
Abstract: The original version of this article unfortunately contained a mistake. All the authors first name and second name has been inadvertently interchanged. Now the authors name are corrected.
Published: 2020
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27. LI-RADS to categorize liver nodules in patients at risk of HCC: tool or a gadget in daily practice?

Author: Matteo, Barabino, Martina, Gurgitano, Cecilia, Fochesato, Salvatore Alessio, Angileri, Giuseppe, Franceschelli, Roberto, Santambrogio, Nicolò Maria, Mariani, Enrico, Opocher, and Gianpaolo, Carrafiello
Subjects: Male, Carcinoma, Hepatocellular, Liver Neoplasms, Image Enhancement, Magnetic Resonance Imaging, Sensitivity and Specificity, Diagnosis, Differential, Predictive Value of Tests, Image Interpretation, Computer-Assisted, Humans, Female, Tomography, X-Ray Computed, Algorithms, Aged, Retrospective Studies
Abstract: To determine the effectiveness of liver reporting and data system (LI-RADS) to diagnose hepatocellular carcinoma (HCC) and to retrospectively evaluate its impact on the adopted therapeutic strategy.Preoperative imaging of 40 of 350 patients (median age 66, 31 M/9 F) submitted to liver resection for suspected HCC, between January 2008 and August 2019, has been retrospectively analyzed by two radiologists with different expertise, according to CT/MRI LI-RADSThe perfect agreement between the readers was about 62.5% (25/40) (Cohen k: 0.41), better for LR-5 category (16/25) and higher in magnetic resonance imaging (MRI) investigations (68%; 13/19), which has been demonstrated the modality of choice for diagnosis of high probable and certain HCC, with arterial phase hyperenhancement as the most sensitive and accurate major feature. Compared to final histology, LR4 and LR5 scores assigned by senior radiologist reached sensitivity, specificity, positive and negative predictive values (PPV, PNV) and diagnostic accuracy of 90,9%, 29,0%, 93,8%, 62,5% and 87,5%, respectively, slightly higher than junior's ones. Misdiagnosis of HCC was done by both radiologists in the same two patients: 1 primary hepatic lymphoma (PHL) and 1 regenerative liver nodule (RLN). If LI-RADS would have been applied at the time of pre-surgical imaging, treatment planning would be modified in 10% of patients (4/40); the patient scheduled as LR-3 and finally resulted a focal nodular hyperplasia would have avoided liver resection.Application of LI-RADS, especially on MRI, may provide a more accurate evaluation of suspected HCC. PHL and RLN are the Achille's heels according to our experience.
Published: 2020

28. Risk-adjusted benchmarks in laparoscopic liver surgery in a national cohort

Author: Nadia Russolillo, L. Vincenti, M. Iaria, R. Lo Tesoriere, Giulio Belli, R. Dalla Valle, Enrico Gringeri, Alberto Brolese, Roberto Santambrogio, Luca Aldrighetti, F. Di Benedetto, Fausto Zamboni, L. De Carlis, Giuseppe Zimmitti, Felice Giuliante, Vincenzo Mazzaferro, Elio Jovine, Graziano Ceccarelli, G.B. Levi Sandri, Alfredo Guglielmi, Fabio Ferla, P. Mezzatesta, Matteo Virdis, S. Berti, Fulvio Calise, Giuseppe Navarra, Salvatore Gruttadauria, Annamaria Ferrero, Francesco Ardito, Umberto Cillo, E. Rossi, A. Coratti, R. Lombardi, Francesca Ratti, Guido Torzilli, Ugo Boggi, Matteo Ravaioli, Andrea Ruzzenente, Giuseppe Maria Ettorre, Russolillo, N, Aldrighetti, L, Cillo, U, Guglielmi, A, Ettorre, G, Giuliante, F, Mazzaferro, V, Dalla Valle, R, De Carlis, L, Jovine, E, Ferrero, A, Russolillo N., Aldrighetti L., Cillo U., Guglielmi A., Ettorre G.M., Giuliante F., Mazzaferro V., Dalla Valle R., De Carlis L., Jovine E., Ferrero A., Ratti F., Lo Tesoriere R., Gringeri E., Ruzzenente A., Levi Sandri G.B., Ardito F., Virdis M., Iaria M., Ferla F., Lombardi R., Di Benedetto F., Gruttadauria S., Boggi U., Torzilli G., Rossi E., Vincenti L., Berti S., Ceccarelli G., Belli G., Zamboni F., Calise F., Coratti A., Santambrogio R., Brolese A., Navarra G., Mezzatesta P., Zimmitti G., Ravaioli M., Russolillo, N., Aldrighetti, L., Cillo, U., Guglielmi, A., Ettorre, G. M., Giuliante, F., Mazzaferro, V., Dalla Valle, R., De Carlis, L., Jovine, E., Ferrero, A., Ratti, F., Lo Tesoriere, R., Gringeri, E., Ruzzenente, A., Levi Sandri, G. B., Ardito, F., Virdis, M., Iaria, M., Ferla, F., Lombardi, R., Di Benedetto, F., Gruttadauria, S., Boggi, U., Torzilli, G., Rossi, E., Vincenti, L., Berti, S., Ceccarelli, G., Belli, G., Zamboni, F., Calise, F., Coratti, A., Santambrogio, R., Brolese, A., Navarra, G., Mezzatesta, P., Zimmitti, G., and Ravaioli, M.
Subjects: Liver surgery, Male, ACHIEVABLE BENCHMARKS, Cirrhosis, medicine.medical_treatment, Settore MED/18 - CHIRURGIA GENERALE, ESTABLISHING BENCHMARKS, CARE, COMPLICATIONS, PROPOSAL, 030230 surgery, 0302 clinical medicine, Postoperative Complications, Risk Factors, benchmarks, Registries, Laparoscopy, liver surgery, medicine.diagnostic_test, Bowel resection, Benchmarking, Treatment Outcome, Italy, liver resection, 030211 gastroenterology & hepatology, Female, medicine.medical_specialty, National cohort, Coronavirus, SARS-CoV-2COVID-19Pandemic, Obesity, Bariatric surgery, 03 medical and health sciences, Internal medicine, medicine, Hepatectomy, Humans, Obesity, Quality of Health Care, Bariatric surgery, major morbidity, business.industry, Minimally Invasive Liver Surgery, laparoscopic liver surgery, Odds ratio, Risk adjustment, medicine.disease, Coronavirus, benchmarks, laparoscopic, SARS-CoV-2COVID-19Pandemic, Surgery, business
Abstract: This study aimed to assess the best achievable outcomes in laparoscopic liver resection (LLR) after risk adjustment based on surgical technical difficulty using a national registry.LLRs registered in the Italian Group of Minimally Invasive Liver Surgery registry from November 2014 to March 2018 were considered. Benchmarks were calculated according to the Achievable Benchmark of Care (ABC™). LLRs at each centre were divided into three clusters (groups I, II and III) based on the Kawaguchi classification. ABCs for overall and major morbidity were calculated in each cluster. Multivariable analysis was used to identify independent risk factors for overall and major morbidity. Significant variables were used in further risk adjustment.A total of 1752 of 2263 patients fulfilled the inclusion criteria: 1096 (62·6 per cent) in group I, 435 (24·8 per cent) in group II and 221 (12·6 per cent) in group III. The ABCs for overall morbidity (7·8, 14·2 and 26·4 per cent for grades I, II and II respectively) and major morbidity (1·4, 2·2 and 5·7 per cent) increased with the difficulty of LLR. Multivariable analysis showed an increased risk of overall morbidity associated with multiple LLRs (odds ratio (OR) 1·35), simultaneous intestinal resection (OR 3·76) and cirrhosis (OR 1·83), and an increased risk of major morbidity with intestinal resection (OR 4·61). ABCs for overall and major morbidity were 14·4 and 3·2 per cent respectively for multiple LLRs, 30 and 11·1 per cent for intestinal resection, and 14·9 and 4·8 per cent for cirrhosis.Overall morbidity benchmarks for LLR ranged from 7·8 to 26·4 per cent, and those for major morbidity from 1·4 to 5·7 per cent, depending on complexity. Benchmark values should be adjusted according to multiple LLRs or simultaneous intestinal resection and cirrhosis.Este estudio tuvo como objetivo evaluar los mejores resultados que se pueden conseguir en la resección hepática laparoscópica (laparoscopic liver resection, LLR) después del ajuste por riesgos basado en la dificultad de la técnica quirúrgica utilizando un registro nacional. MÉTODOS: Se consideraron las LLRs incluidas en el Registro del Grupo Italiano de Cirugía Hepática Mínimamente Invasiva desde 11/2014 a 03/2018. Los resultados de referencia (benchmarks) se calcularon de acuerdo con el Achievable Benchmark of Care (ABC™). Las LLRs de cada uno de los centros se dividieron en 3 grupos (Grupo I, II y III) en base a la clasificación de Kawaguchi. Se calculó el ABC de la morbilidad global y de la morbilidad mayor para cada grupo. Se realizó un análisis multivariable para identificar los factores independientes de riesgos para la morbilidad global y morbilidad mayor. Se utilizaron variables significativas para realizar ajustes de riesgo adicionales.Un total de 1.752 pacientes de los 2.263 cumplían los criterios de inclusión, de los cuales 1.096 (62,6%) se incluyeron en el Grupo I, 435 (24,8%) en el Grupo II y 221 (12,6%) en el Grupo III. El ABC de la morbilidad global (7,8%, 14,2%, 26,4%) y de la morbilidad mayor (1,4%, 2,2%, 5,7%) aumentó del Grupo I al Grupo III. El análisis multivariable mostró un incremento del riesgo para la morbilidad global asociada con múltiples LLRs (razón de oportunidades, odds ratio, OR 1,349), resección intestinal simultánea (OR 3,760) y cirrosis (OR 1,825), y para la morbilidad mayor con la resección intestinal (OR 4,606). Los ABC de la morbilidad global y morbilidad mayor fueron 14,4% y 3,2% para las LLR múltiples, 30% y 11% para la resección intestinal, y 14,9% y 4,8% para la cirrosis, respectivamente. CONCLUSIÓN: Los resultados de referencia (benchmark) para la morbilidad global y morbilidad mayor en la LLR variaron entre un 8% y un 26% y entre un 1,4% y un 5,7%, dependiendo de la complejidad. Los valores de referencia deberían ajustarse de acuerdo con la práctica de LLRs múltiples o resección intestinal simultánea y cirrosis.
Published: 2020

29. Impact of COVID-19 Pandemic on Cirrhotics with Hepatocellular Carcinoma During Follow-Up: Direct Consequences or Collateral Damages?

Author: Marco Zappa, Matteo Barabino, Carlo Ferrari, Roberto Santambrogio, Crespi M, Marco Gemma, Danelli Pg, D’Alessandro, Giulio Iacob, and Enrico Opocher
Subjects: medicine.medical_specialty, business.industry, Incidence (epidemiology), Mortality rate, Retrospective cohort study, Population health, medicine.disease, Institutional review board, Pneumonia, Informed consent, Pandemic, Emergency medicine, medicine, business
Abstract: Background & Aims: COVID-19 posed a major worldwide threat to population health as well as to patients with comorbidities, but its impact on patients with cirrhosis and hepatocellular carcinoma is currently poorly understood. This study aimed at evaluating the effects of COVID-19 outbreak both on the clinical outcome of these patients and on their follow-up. Methods: We conducted a phone survey off all patients living in Lombardy (the region with the highest incidence of Covid-19 infections in our country) included in our database and treated for hepatocellular carcinoma from January 2017 to April 2020. Results: We analyzed the database concerning 187 patients submitted to surgical treatment for HCC: 35 patients died before the pandemic. Therefore, we obtained a complete answer to the questionnaire from 131 patients while in other 7 cases we gained information by a family member because the patient had died in the meanwhile; 14 cases were unreachable (9%). We identified 7 cases of Covid-19 among the 138 patients (5%): 5 confirmed and 2 probables. One patient died for COVID-19 pneumonia. During the lockdown period (March-April 2020), we registered 7 deaths: 1 patient for Covid-19 pneumonia, 2 patients for diffuse HCC recurrence and the remnant 4 for other causes. (crude death rate: 46.4). In the same period of 2018, we registered a crude death rate of 25.6 while in the 2019 a crude death rate of 10. Conclusions: irrespective of a low rate of Covid infections in a group of frailty patients, we observed a higher rate of mortality due to other causes: the reduced access to health services due to the disruption of the normal activities and the forced reassurance of sick patients could be the primary causes of this increase. Funding Statement: None. Declaration of Interests: All authors declare that they have no conflicts of interest or financial ties to disclose. Ethics Approval Statement: This retrospective study protocol was approved by our Institutional Review Board and waived the requirement for informed consent. Research involving human participants and/or animals Institutional review research board approval was granted by ASST Fatebenefratelli Sacco, and appropriate good clinical and research practices were followed.
Published: 2020
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30. One stage laparoscopic ICG guided liver resection for bilateral colorectal liver metastases

Author: Enrico Opocher, B. Giuliani, Marco Giovenzana, Giovanna Scifo, E. De Nicola, Matteo Barabino, Roberto Santambrogio, G. Tarchi, A. Pisani Ceretti, Gaetano Piccolo, and N. Mariani
Subjects: medicine.medical_specialty, Hepatology, business.industry, Gastroenterology, medicine, One stage, Radiology, business, Resection
Published: 2021
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31. Lymph node staging for colorectal cancer: Green is the new black

Author: Roberto, Santambrogio, primary, Piergiorgio, Danelli, additional, and Antonio, Zappa Marco, additional
Published: 2020
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32. COVID-19 outbreak and acute cholecystitis in a Hub Hospital in Milan: wider indications for percutaneous cholecystostomy.

Author: Matteo, Barabino, primary, Gaetano, Piccolo, additional, Arianna, Trizzino, additional, Veronica, Fedele, additional, Carlo, Ferrari, additional, Vincenzo, Nicastro, additional, Andrea, Pisani Ceretti, additional, Enrico, De Nicola, additional, Maria, Mariani Nicolò, additional, Marco, Giovenzana, additional, Giovanna, Scifo, additional, Massimiliano, Mazza, additional, Ruggero, Vercelli, additional, Roberto, Santambrogio, additional, Carmelo, Luigiano, additional, and Enrico, Opocher, additional
Published: 2020
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33. Surgical Resection vs. Ablative Therapies Through a Laparoscopic Approach for Hepatocellular Carcinoma: a Comparative Study

Author: Savino Bruno, Nirvana Maroni, Matteo Barabino, Roberto Santambrogio, Emanuela Bertolini, N. Mariani, Giuseppe Franceschelli, and Enrico Opocher
Subjects: Adult, Male, medicine.medical_specialty, Carcinoma, Hepatocellular, Radiofrequency ablation, medicine.medical_treatment, Disease, law.invention, 03 medical and health sciences, Liver disease, 0302 clinical medicine, law, Hepatectomy, Humans, Medicine, Laparoscopy, Aged, Ultrasonography, Radiofrequency Ablation, Intraoperative Care, medicine.diagnostic_test, business.industry, Liver Neoplasms, Gastroenterology, Middle Aged, medicine.disease, Ablation, Surgery, Treatment Outcome, 030220 oncology & carcinogenesis, Hepatocellular carcinoma, Female, 030211 gastroenterology & hepatology, Liver function, business
Abstract: When compatible with the liver functional reserve, laparoscopic hepatic resection remains the treatment of choice for hepatocellular carcinoma while laparoscopic ablation therapies appear as a promising less invasive alternative. The aim of the study is to compare two homogeneous groups of patients submitted to either hepatic resection or thermoablation for the treatment of single hepatocellular carcinoma (≤ 3 cm). We enrolled 264 cirrhotic patients out of 905 cases consecutively evaluated for hepatocellular carcinoma. We performed 59 hepatic resections and 205 thermoablations through a laparoscopic approach, and they were then followed for similar follow-up (41.7 ± 31.5 months for laparoscopic hepatic resection vs. 38.7±32.3 for laparoscopic ablation therapy). Outcomes included short- and long-term morbidities, tumoral recurrence, and overall survival. Short-term morbidity was significantly higher in the resection group (but the two groups had similar rates for severe complications) while, during follow-up, recurrence was more frequent in patients treated with thermoablation, with a clear disadvantage in terms of survival. At multivariate analysis, only the type of surgical treatment was an independent predictor of disease recurrence, while plasmatic alpha-fetoprotein and Hb values, model for end-stage liver disease score, time to recurrence, and the type of surgical treatment were independent predictors of overall survival. Our data ultimately support some therapeutic advantages for hepatic resection in patients with a single nodule and preserved liver function. However, thermoablation is an adequate alternative in patients with nodules that would require complex surgical resections or imply a poor prognosis that might therefore better tolerate a less invasive procedure.
Published: 2017
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34. Résection hépatique vs thermo-ablation laparoscopique dans les carcinomes hépatocellulaires postéro-supérieurs

Author: L. Cayre, Valentina D'Alessandro, P. Giusti, Marco Zappa, Matteo Barabino, and Roberto Santambrogio
Subjects: Surgery
Abstract: Les patients atteints de carcinome hepatocellulaire (CHC) au niveau des segments hepatiques postero-superieurs (PS) (1, 4A, 7 et 8) sont consideres mauvais candidats pour la thermo-ablation percutanee sous guidage echographique : la thermo-ablation laparoscopique (TAL) pourrait etre une alternative valable. Cette etude evalue les resultats cliniques suite a TAL ou a resection hepatique (RH) chez les patients atteints de CHC localise dans les PS. Nous avons analyse 222 patients Child-Pugh A, ayant subi une RH (n = 71) ou une TAL (n = 151) d’un seul nodule de CHC (≤ 3 cm) situe dans les PS. Nous avons estime les taux de complications postoperatoires, de progression tumorale locale (PTL), de recidive intrahepatique (RIH), de survie sans maladie (SSM) et de survie globale (SG). Les donnees ont ete extraites d’une base de donnees electronique mise a jour de facon prospective. Les taux de complications majeures (Dindo–Clavien > 2) ont ete significativement plus eleves dans le groupe RH (31 % vs 5 % ; p = 0,0001). La PTL etait significativement plus eleve pour le groupe TAL (15 % vs 1,5 % ; p = 0,003). La RIH n’etait pas significativement differente (p = 0,495). La SSM a 5 ans etait de 35 % (RH) vs 21 % (TAL) (p = 0,009). Aucune difference significative n’a ete trouvee pour la SG a 5 ans (respectivement 62 % vs 40 % ; p = 0,114). Dans le cas d’un seul petit nodule de CHC situe dans les segments PS, la RH doit etre le traitement principal si fonction hepatique et conditions generales sont suffisamment bonnes. La LAT a montre une SG acceptable comparee a la RH et pourrait donc etre envisagee comme traitement alternatif pour les patients non eligibles pour la RH.
Published: 2020
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35. Local recurrences and complications after laparoscopic thermoablation for problematic HCC

Author: E. Galfrascoli, Matteo Barabino, G. Grande, M.A. Zappa, and Roberto Santambrogio
Subjects: medicine.medical_specialty, Hepatology, business.industry, Gastroenterology, medicine, business, Surgery
Published: 2020
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36. Laparoscopic thermoablation for hepatocellular carcinoma in patients with liver cirrhosis: an effective procedure for tricky tumors

Author: Elisa Galfrascoli, Enrico Opocher, Marco Zappa, Massimo Zuin, Valentina D'Alessandro, Gaetano Piccolo, Matteo Barabino, and Roberto Santambrogio
Subjects: Adult, Liver Cirrhosis, Male, Cancer Research, medicine.medical_specialty, Percutaneous, Cirrhosis, Carcinoma, Hepatocellular, Thermal ablation, Resection, 03 medical and health sciences, 0302 clinical medicine, Medicine, Humans, In patient, Ultrasonography, Interventional, Aged, business.industry, Optimal treatment, Liver Neoplasms, Laparoscopic ultrasound, Hematology, General Medicine, Middle Aged, medicine.disease, digestive system diseases, Treatment Outcome, Oncology, Surgery, Computer-Assisted, 030220 oncology & carcinogenesis, Hepatocellular carcinoma, Catheter Ablation, Female, Laparoscopy, Radiology, business
Abstract: The optimal treatment for hepatocellular carcinoma (HCC) is surgical resection. However, only a small percentage of patients are amenable to this option. Percutaneous radiofrequency interstitial thermal ablation (TA) proved to be effective in the treatment of unresectable HCC. Recent advances in laparoscopic ultrasound have improved the accuracy in detecting small intrahepatic HCC nodules missed by pre-operative imaging techniques. Our objective was to evaluate an operative combination of laparoscopic ultrasound with laparoscopic thermoablation (LTA) in the treatment of HCC not amenable to liver resection. The aim of our review was to evaluate the advantages and limits of the laparoscopic approach according the criteria of the evidence-based medicine. LTA of HCC proved to be a safe and effective technique both in the short- and long-term follow-up period. This technique may be indicated in selected cases when the percutaneous approach to the lesion is very difficult or contraindicated.
Published: 2019

37. Laparoscopic liver resection of hepatocellular carcinoma located in unfavorable segments: a propensity score-matched analysis from the I Go MILS (Italian Group of Minimally Invasive Liver Surgery) Registry

Author: G.L. Grazi, Fausto Zamboni, Fulvio Calise, Giovanni Sgroi, Giorgio Rossi, Antonio Giuliani, G.B. Levi Sandri, S. Berti, Abdallah Slim, Antonio Floridi, Roberto Santambrogio, P. Mezzatesta, Felice Giuliante, Giulio Belli, Giovanni Vennarecci, Salvatore Gruttadauria, Vincenzo Mazzaferro, R. Dalla Valle, Alberto Brolese, Alessandro Ferrero, A. Coratti, Francesca Ratti, Nadia Russolillo, Andrea Ruzzenente, Giuseppe Maria Ettorre, A. Antonucci, Giuseppe Navarra, M. Iaria, L. Vincenti, P. Bonsignore, P. Maida, Ugo Boggi, G. Griseri, A. Parisi, Alfredo Guglielmi, Elio Jovine, Enrico Gringeri, Guido Torzilli, Umberto Cillo, Michele Colledan, F. Di Benedetto, Paolo Magistri, A. Frena, Fabio Ferla, Andrea Scotti, Matteo Virdis, A.D. Pinna, Luca Aldrighetti, L. De Carlis, Graziano Ceccarelli, Sandri, Gbl, Ettorre, Gm, Aldrighetti, L, Cillo, U, Dalla Valle, R, Guglielmi, A, Mazzaferro, V, Ferrero, A, Di Benedetto, F, Gruttadauria, S, De Carlis, L, Vennarecci, G, Antonucci, A, Belli, G, Berti, S, Boggi, U, Bonsignore, P, Brolese, A, Calise, F, Ceccarelli, G, Colledan, M, Coratti, A, Ferla, F, Floridi, A, Frena, A, Giuliani, A, Giuliante, F, Grazi, Gl, Gringeri, E, Griseri, G, Iaria, M, Jovine, E, Paolo, M, Maida, P, Mezzatesta, P, Russolillo, N, Navarra, G, Parisi, A, Pinna, Ad, Ratti, F, Rossi, Ge, Ruzzenente, A, Santambrogio, R, Scotti, A, Sgroi, G, Slim, A, Torzilli, G, Vincenti, L, Virdis, M, Zamboni, F, Levi Sandri G.B., Ettorre G.M., Aldrighetti L., Cillo U., Dalla Valle R., Guglielmi A., Mazzaferro V., Ferrero A., Di Benedetto F., Gruttadauria S., De Carlis L., Vennarecci G., Antonucci A., Belli G., Berti S., Boggi U., Bonsignore P., Brolese A., Calise F., Ceccarelli G., Colledan M., Coratti A., Ferla F., Floridi A., Frena A., Giuliani A., Giuliante F., Grazi G.L., Gringeri E., Griseri G., Iaria M., Jovine E., Magistri P., Maida P., Mezzatesta P., Russolillo N., Navarra G., Parisi A., Pinna A.D., Ratti F., Rossi G.E., Ruzzenente A., Santambrogio R., Scotti A., Sgroi G., Slim A., Torzilli G., Vincenti L., Virdis M., Zamboni F., Levi Sandri, G, Ettorre, G, Grazi, G, Magistri, P, Pinna, A, and Rossi, G
Subjects: Laparoscopic surgery, Registrie, Male, Hepatocellular carcinoma, medicine.medical_treatment, Settore MED/18 - CHIRURGIA GENERALE, Laparoscopic HCC, Posterior segment, Hepatocellular carcinoma, IGoMILS, Child B, Laparoscopic liver resection, 0302 clinical medicine, Postoperative Complications, Prospective Studies, Registries, Laparoscopy, Prospective cohort study, medicine.diagnostic_test, Laparoscopic HCC, Liver Neoplasms, Margins of Excision, IGoMILS, Middle Aged, Laparoscopic liver resection, Child B, Italy, Liver Neoplasm, 030220 oncology & carcinogenesis, 030211 gastroenterology & hepatology, Female, Human, medicine.medical_specialty, Carcinoma, Hepatocellular, Matched-Pair Analysis, Operative Time, NO, 03 medical and health sciences, medicine, Humans, Hepatectomy, Blood Transfusion, Matched-Pair Analysi, Posterior segment, Aged, Postoperative Care, LS7_4, Surgery, business.industry, Carcinoma, Hepatocellular, Perioperative, medicine.disease, digestive system diseases, Child B, Hepatocellular carcinoma, IGoMILS, Laparoscopic HCC, Laparoscopic liver resection, Posterior segment, Aged, Blood Transfusion, Carcinoma, Hepatocellular, Female, Humans, Italy, Liver Neoplasms, Male, Margins of Excision, Matched-Pair Analysis, Middle Aged, Operative Time, Postoperative Care, Postoperative Complications, Prospective Studies, Registries, Hepatectomy, Laparoscopy, Prospective Studie, Propensity score matching, Postoperative Complication, business, Abdominal surgery
Abstract: Objective: Laparoscopic liver resection (LLR) for Hepatocellular Carcinoma (HCC) is one of the most important indications for the minimally invasive approach. Our study aims to analyze the experience of the Italian Group of Minimally Invasive Liver Surgery with laparoscopic surgical treatment of HCC, with a focus on tumor location and how it affects morbidity and mortality. Methods: 38 centers participated in this study; 372 cases of LLR for HCC were prospectively enrolled. Patients were divided into two groups according to the HCC nodule location. Group 1 favorable location and group 2 unfavorable location. Perioperative outcomes were compared between the two groups before and after a propensity score match (PS) 1:1. Results: Before PS in group 2 surgical time was longer; conversion rate was higher; postoperative transfusion and comprehensive complication index were also higher. PS was performed with a cohort of 298 patients (from 18 centers), with 66 and 232 patients with HCC in unfavorable and favorable locations, respectively. After PS matching, 62 patients from group 1 and group 2 each were compared. Operative and postoperative course were similar in patients with HCC in favorable and unfavorable LLR locations. Surgical margins were found to be identical before and after PS. Conclusions: These results show that LLR in patients with HCC can be safely performed in all segments because of the extensive experience of all surgeons from multiple centers in performing traditional open liver surgery as well as laparoscopic surgery.
Published: 2019

38. Hem-o-Lok clip migration into the duodenum after laparoscopic digestive surgery: a systematic review

Author: Carmelo Luigiano, Rinaldo Pellicano, Erika Andreatta, Gaetano Piccolo, Micol Polizzi, Roberto Santambrogio, Maria A Palamara, Matteo Barabino, Enrico Opocher, Pierluigi Consolo, Marco Giovenzana, Giacobbe G, and Andrea Pisani Ceretti
Subjects: Adult, Male, Laparoscopic surgery, medicine.medical_specialty, Abdominal pain, Duodenum, medicine.medical_treatment, MEDLINE, Asymptomatic, Foreign-body migration, Digestive system endoscopy, Laparoscopy, Duodenum, 03 medical and health sciences, Postoperative Complications, 0302 clinical medicine, Occlusion, medicine, Humans, Foreign-body migration, Laparoscopy, Digestive System Surgical Procedures, Aged, medicine.diagnostic_test, business.industry, Middle Aged, Digestive system endoscopy, Surgical Instruments, Surgery, medicine.anatomical_structure, 030220 oncology & carcinogenesis, Female, 030211 gastroenterology & hepatology, Cholecystectomy, medicine.symptom, business
Abstract: Introduction The wide use of hemoclips during laparoscopic surgery has led to a variety of unusual complications, among these, there is the migration of Hem-o-Lok clip into the duodenum. We performed a literature review of all cases of Hem-o-Lok clip migration into the duodenum after laparoscopic digestive surgery reported in literature. Evidence acquisition All relevant articles were extracted up to June 2019 based on the results of searches in MEDLINE, PubMed, Scopus, Web of Science and Google Scholar. Evidence synthesis At the time of this review, a total of seven cases have been described. The mean age was 49 years and the majority of these patients were women (57%). Previous laparoscopic surgery was performed for cholecystectomy (four patients), cholecystectomy with common bile duct exploration (one patient), right hemicolectomy (one patient) and distal gastrectomy (one patient). Symptoms occurred from 3 months to 2 years after laparoscopic surgery. The majority of patients developed symptoms of bowel occlusion and abdominal pain. Three patients remained asymptomatic. In many cases the Hem-o-Lok wedged into the wall of the first or second portion of the duodenum. In all cases, esophageal gastroduodenoscopy was the primary modality to make the diagnosis. Initial treatment was conservative with watch-and-wait strategy or proton pump inhibitors followed by endoscopic removal, while surgical treatment was required in two cases. Conclusions The application of Hem-o-Lok clip during laparoscopic surgery is safe and effective. Postoperative Hem-o-Lok migration into the duodenum is rare. The treatment could be conservative in the majority of cases.
Published: 2019

39. 'Wandering spleen' as a rare cause of recurrent abdominal pain: a systematic review

Author: Roberto Santambrogio, Sharmila Fagoonee, Pierluigi Consolo, Marco Giovenzana, Giacobbe G, Anna Maria Ierardi, Enrico Opocher, Andrea Pisani, Carmelo Luigiano, Leonardo Henry Eusebi, Maria A Palamara, Matteo Barabino, and Rinaldo Pellicano
Subjects: medicine.medical_specialty, Abdominal pain, Ligamentous laxity, medicine.medical_treatment, Splenectomy, 03 medical and health sciences, 0302 clinical medicine, Recurrence, Wandering spleen, Abdominal pain, Splenectomy, medicine, Humans, Pelvis, business.industry, Wandering spleen, Gold standard, medicine.disease, Abdominal mass, Surgery, Settore MED/18 - Chirurgia Generale, medicine.anatomical_structure, Abdominal Pain, Wandering Spleen, 030220 oncology & carcinogenesis, Splenic infarction, 030211 gastroenterology & hepatology, medicine.symptom, business
Abstract: Introduction Wandering spleen (WS) is a rare and generally acquired condition, resulting from abnormal ligamentous laxity failing to fixate the spleen in its normal location in the left upper quadrant, thus leading to its migration to the pelvis due to gravity. Such migration leads to an elongated vascular pedicle, which is prone to torsion causing splenic infarction; thus, a prompt surgical intervention is recommended. Since this adverse event affects childbearing women or children, it is crucial to choose the most appropriate surgical strategy, such as splenectomy or splenopexy, both effective and widely diffused options. The aim of this paper is to perform a literature review on WS reports treated by surgery. We also present a case of symptomatic WS migrated in pelvis in a young female treated by splenectomy. Evidence acquisition All relevant articles from 1895 up to December 2017 were identified by literature searches in PubMed, Scopus and Google Scholar. Evidence synthesis A total of 376 patients treated with surgical approach for WS were identified. The most common presentations were abdominal pain and abdominal mass, and approximately half of the patients had an acute clinical onset. Radiology is essential for the diagnosis. Surgical strategy changed over the time; splenectomy is the most reported treatment although in the last years there is an increasing trend towards a more conservative strategy, preferring splenopexy or a laparoscopic approach. Conclusions Surgery is the gold standard strategy, and laparoscopic approach is recommended, for the treatment of wandering spleen. Both splenopexy or splenectomy are effective and safe surgical options.
Published: 2019
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40. CEIOUS and ICG in the treatment of HCC of segment 7

Author: Roberto Santambrogio, Valentina D'Alessandro, M.A. Zappa, and M.P. Giusti
Subjects: medicine.medical_specialty, Hepatology, business.industry, Gastroenterology, medicine, Radiology, business
Published: 2021
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41. Comparison of Laparoscopic Microwave to Radiofrequency Ablation of Small Hepatocellular Carcinoma (≤3 cm)

Author: Enrico Opocher, Jason Chiang, Fabio Melchiorre, Roberto Santambrogio, Franca Meloni, Matteo Barabino, and Emanuela Bertolini
Subjects: Male, medicine.medical_specialty, Carcinoma, Hepatocellular, Radio Waves, Radiofrequency ablation, medicine.medical_treatment, Thermal ablation, Cumulative survival, Article, law.invention, 03 medical and health sciences, Postoperative Complications, 0302 clinical medicine, Surgical oncology, law, Humans, Medicine, Major complication, Microwaves, Aged, Neoplasm Staging, business.industry, Liver Neoplasms, Microwave ablation, medicine.disease, Ablation, Surgery, Survival Rate, Treatment Outcome, surgical procedures, operative, Oncology, 030220 oncology & carcinogenesis, Hepatocellular carcinoma, Catheter Ablation, Female, Laparoscopy, 030211 gastroenterology & hepatology, business, therapeutics
Abstract: Laparoscopic thermal ablation is a common alternative to surgical resection in treating hepatic tumors, particularly in those located in difficult-to-reach locations. The aim of this study was to compare the safety and long-term efficacy of laparoscopic radiofrequency ablation (RFA) and microwave ablation (MWA) in treating hepatocellular carcinoma (HCC). From February 2009 to May 2015, data from patients with HCC nodules who had undergone either laparoscopic MWA or laparoscopic RFA were examined. Complications, complete ablation rates, local tumor progression (LTP) rates, and disease-free and cumulative survival rates were compared between the two treatment groups. A total of 154 patients with HCC (60 MWA and 94 RFA) were treated via the laparoscopic approach. Major complication rates were identified as 1 and 2 % in the RFA and MWA groups, respectively (p = 0.747). Complete ablation rates were 95 % for both treatment groups (p = 0.931), and LTP rates were 21.2 % for RFA and 8.3 % for MWA (p = 0.034). Disease-free survival rates at 5 years were 19 % in the RFA group and 12 % in the MWA group (p = 0.434), while cumulative survival rates at 5 years were 50 % in the RFA group and 37 % in the MWA group (p = 0.185). Laparoscopic RFA and MWA appear to be safe in the treatment of early-stage HCC. The LTP rates were lower in the laparoscopic MWA group compared with the laparoscopic RFA group, but their respective overall and disease-free survival rates remained similar.
Published: 2016
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42. Traitement d’un seul petit carcinome hépatocellulaire micro-invasif : quel est le traitement optimal ?

Author: L. Cayre, Valentina D'Alessandro, Marco Gemma, Roberto Santambrogio, Matteo Barabino, and Marco Zappa
Subjects: Surgery
Abstract: Les petits carcinomes hepatocellulaires (CHC) sont accessibles par resection hepatique (RH) ou par ablation. Le CHC micro-invasif (MI), definit par l’infiltration des veines porte ou hepatiques ou du canal biliaire ainsi que par les metastases intrahepatiques, sont les indicateurs plus precis de mauvais pronostic. Nous avons montre dans une autre etude que l’identification echographique par ultrasons intraoperatoire (USIO) d’un MI-CHC avait une concordance elevee avec les resultats histologiques. Le but de cette etude est de comparer la survie globale (SG) et le taux de recidive des patients atteints de CHC-MI identifie par USIO et traites par RH ou par thermo-ablation laparoscopique (TAL). Nous avons evalue 156 patients ayant un seul petit CHC (
Published: 2020
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43. Does laparoscopic liver resection provide better outcomes than thermoablation in patients with hepatocellular carcinoma?—A systematic review

Author: Elisa Galfrascoli, Roberto Santambrogio, Valentina D'Alessandro, Marco Zappa, and Matteo Barabino
Subjects: medicine.medical_specialty, Hepatic resection, business.industry, Cochrane Library, medicine.disease, Gastroenterology, Resection, Postoperative mortality, Hepatocellular carcinoma, Internal medicine, medicine, Radiology, Nuclear Medicine and imaging, Surgery, In patient, Complication rate, business
Abstract: Background: A systematic review has been accomplished to compare the outcomes of laparoscopic hepatic resection (LHR) with those of thermo-ablation (TA) therapies for hepatocellular carcinoma (HCC). Methods: A literature search has been accomplished to choose relevant studies published analyzing the EMBASE and PubMed databases and the Cochrane Library. Studies comparing the outcomes of LHR versus TA for HCC were included in the analysis. Results: The present meta-analysis included 9 studies for a total of 918 patients. It found that the complication rate in the TA group was significantly lower than that of the LHR group (OR: 0.52, 95% CI: 0.36–0.75, P=0.0005). Severe complications occurred in a range of 0–10% in the LHR group and in a range of 0–5% in the TA group. No postoperative mortality has been shown in both groups. The meta-analysis of the nine studies showed that the local recurrence rates were lower in LHR group than in TA group (OR: 6.43; 95% CI: 4.01–10.29; P Conclusions: Patients submitted to LHR had a better OS and a lower local recurrence rate than those submitted to TA. However, TA treatments have a low impact in the postoperative course of cirrhotic patients. In the future guidelines, LHR should have a primary role in first-line treatment for HCC, while in the situations that the condition of patients is not suitable to perform operation, TA might be the solution.
Published: 2020
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44. Intraoperative ultrasound predictors of microinvasion of small hepatocarcinoma (<3 cm)

Author: E. Galfrascoli, Matteo Barabino, M.A. Zappa, G. Grande, Roberto Santambrogio, and Claudia Cigala
Subjects: medicine.medical_specialty, Hepatology, business.industry, Gastroenterology, Medicine, Radiology, business, Intraoperative ultrasound
Published: 2020
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45. Risk Factors for Prolonged Postoperative Ileus in Adult Patients Undergoing Elective Colorectal Surgery: An Observational Cohort Study

Author: Marco Longhi, Marco Giovenzana, Matteo Barabino, Roberto Santambrogio, Andrea Pisani Ceretti, Nirvana Maroni, Giovanni Radaelli, Enrico Opocher, and Carmelo Luigiano
Subjects: Adult, Male, medicine.medical_specialty, Time Factors, Ileus, Nausea, prolonged postoperative ileus, medicine.medical_treatment, laparoscopy, Cohort Studies, 03 medical and health sciences, Young Adult, 0302 clinical medicine, Postoperative Complications, Risk Factors, medicine, Humans, ERAS, Colectomy, Aged, Pharmacology, Aged, 80 and over, Univariate analysis, Proctectomy, business.industry, Incidence, General Medicine, Odds ratio, Perioperative, Middle Aged, medicine.disease, Colorectal surgery, Surgery, Settore MED/18 - Chirurgia Generale, Elective Surgical Procedures, 030220 oncology & carcinogenesis, colorectal surgery, incidence, risk factors, 030211 gastroenterology & hepatology, Female, medicine.symptom, business, Colorectal Neoplasms, Abdominal surgery
Abstract: PURPOSE Prolonged Postoperative Ileus (PPOI) after abdominal surgery may affect unfavourably the patient recovery. The aim of this study was to estimate the incidence of PPOI in patients elective for colorectal resection and investigate perioperative variables associated with PPOI. METHODS A consecutive series of 428 patients undergoing colorectal resection (median age 72, range 24-92, years; men/women ratio 1.14) were analyzed. Data were extracted retrospectively throughout a five-year period from an electronic prospectively maintained database. PPOI was defined as the need for postoperative insertion of a nasogastric tube in a patient experiencing nausea and two episodes of vomiting and further showing absence of adequate bowel function (absence of flatus/stool) with lack of bowel sounds and abdominal distension. RESULTS Incidence of PPOI was 7% [95% confidence interval (95%CI), 4.8-9.9%]. Mean hospital stay was 8 days longer in patients with PPOI. Male gender, cancer, cardiac and respiratory co-morbidity, rectal resection, open/converted access, duration of operation, stoma formation and body mass index were associated with PPOI at univariate analysis (0.001< P< 0.048). PPOI was independently associated with male gender [adjusted odds ratio (OR), 4.2; 95%CI, 1.5-11.5], stoma formation (OR, 2.8; 95%CI, 1.2-6.8) and obesity (OR of obese vs. normal weight patients, 3.8, 95%CI, 1.2-12.0). CONCLUSION After colorectal resection, PPOI leads to a prolonged hospital stay and slower patient's recovery. An international standardized definition of PPOI is strongly needed to make comparable results from researches and to reliably identify patients with increased risk, also to improve the therapeutic preventive policies in these patients.
Published: 2018

46. Deficient Natural Killer Cell NKp30-Mediated Function and Altered NCR3 Splice Variants in Hepatocellular Carcinoma

Author: Francesco Negro, Roberto Santambrogio, Enrico Opocher, Dalila Mele, Guido Torzilli, Giorgio Rossi, Paolo Pedrazzoli, Cristiana Soldani, Sophie Clément, Matteo Donadon, Stefania Varchetta, Laura Rubbia-Brandt, Barbara Oliviero, Stefania Mantovani, Armando Rossello, Andrea Lombardi, Marcello Maestri, Claudio De Vito, Angelo Sangiovanni, Mario U. Mondelli, Camillo Porta, Silvia Chiellino, and S. Bernuzzi
Subjects: EXPRESSION, 0301 basic medicine, Carcinoma, Hepatocellular, ddc:616.07, medicine.disease_cause, Natural killer cell, 03 medical and health sciences, 0302 clinical medicine, Immune system, medicine, Tumor Cells, Cultured, Humans, Protein Isoforms, CYTOTOXICITY, Interferon gamma, ddc:616, ACTIVATING RECEPTOR, Natural Cytotoxicity Triggering Receptor 3, INTERFERON-GAMMA, Hepatology, biology, Liver Neoplasms, Degranulation, Killer Cells, Natural, SORAFENIB, 030104 developmental biology, medicine.anatomical_structure, B7-H6, Interleukin 15, biology.protein, Cancer research, CHRONIC HEPATITIS-C, NKP30 ISOFORMS, NK CELLS, LIGAND, 030211 gastroenterology & hepatology, Antibody, Carcinogenesis, medicine.drug
Abstract: The activating natural cytotoxicity receptor NKp30 is critical for natural killer (NK) cell function and tumor immune surveillance. The natural cytotoxicity receptor-3 (NCR3) gene is transcribed into several splice variants whose physiological relevance is still incompletely understood. In this study, we investigated the role of NKp30 and its major ligand B7 homolog 6 (B7-H6) in patients with hepatocellular carcinoma (HCC). Peripheral blood NK cell phenotype was skewed toward a defective/exhausted immune profile with decreased frequencies of cells expressing NKp30 and natural killer group 2, member D and an increased proportion of cells expressing T-cell immunoglobulin and mucin-domain containing-3. Moreover, NKp30-positive NK cells had a reduced expression of NCR3 immunostimulatory splice variants and an increased expression of the inhibitory variant in patients with advanced tumor, resulting in deficient NKp30-mediated functionality. Tumor-infiltrating lymphocytes showed a prevalent inhibitory NKp30 isoform profile, consistent with decreased NKp30-mediated function. Of note, there were significant differences in the cytokine milieu between the neoplastic and the surrounding non-neoplastic tissue, which may have further influenced NKp30 function. Exposure of NK cells to B7-H6-expressing HCC cells significantly down-modulated NKp30, that was prevented by small interfering RNA-mediated knockdown, suggesting a role for this ligand in inhibiting NKp30-mediated responses. Interestingly, B7-H6 expression was reduced in HCC tissue and simultaneously augmented as a soluble form in HCC patients, particularly those with advanced staging or larger nodule size. Conclusion: These findings provide evidence in support of a role of NKp30 and its major ligand in HCC development and evolution.
Published: 2018

47. Long-term outcome of laparoscopic ablation therapies for unresectable hepatocellular carcinoma: a single European center experience of 426 patients

Author: Massimo Zuin, Roberto Santambrogio, Franca Meloni, Matteo Barabino, M. Costa, Enrico Opocher, Andrea Pisani Ceretti, Savino Bruno, and Maria Rachele Angiolini
Subjects: Adult, Male, medicine.medical_specialty, Carcinoma, Hepatocellular, Percutaneous, Radiofrequency ablation, medicine.medical_treatment, Catheter ablation, Liver transplantation, law.invention, 03 medical and health sciences, 0302 clinical medicine, law, medicine, Hepatectomy, Humans, Survival rate, Aged, Aged, 80 and over, business.industry, Liver Neoplasms, Middle Aged, Prognosis, medicine.disease, Surgery, Survival Rate, Treatment Outcome, 030220 oncology & carcinogenesis, Hepatocellular carcinoma, Catheter Ablation, Portal hypertension, Female, Laparoscopy, 030211 gastroenterology & hepatology, Neoplasm Recurrence, Local, business
Abstract: Radiofrequency ablation (RFA) is widely used as a first-line option in patients with hepatocellular carcinoma (HCC). However, since percutaneous approach of RFA may be, in some cases, unfeasible by the tumor size and its location, laparoscopic ablation therapies (LATs) were used as an alternative. Objective of the present study was to assess the efficacy of laparoscopic ultrasound examination in addition to LATs in the treatment of HCC in patients not eligible for percutaneous RFA or surgical resection. Four hundred and twenty-six patients who underwent LATs were analyzed. Laparoscopic approach was offered to patients fulfilling at least one of the following criteria: (a) patients with a single nodule or up to three nodules smaller than 3 cm not suitable for liver transplantation or not eligible for HR because of severe portal hypertension, impaired liver function, or coexistent comorbidities; (b) patients not suitable for percutaneous RFA because of inconvenient tumor location; and (c) short-term recurrence of HCC (
Published: 2015
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48. Correction to: Diffusion, outcomes and implementation of minimally invasive liver surgery: a snapshot from the I Go MILS (Italian Group of Minimally Invasive Liver Surgery) Registry

Author: Annamaria Ferrero, Luigi Boni, S. Guerriero, Giuseppe Navarra, Luca Aldrighetti, Fulvio Calise, Giovanni Sgroi, Graziano Ceccarelli, F. Di Benedetto, A. Percivale, P. Reggiani, Salvatore Gruttadauria, Alberto Patriti, Michele Colledan, A. Frena, L. De Carlis, P. Mezzatesta, L. Vincenti, Antonio Daniele Pinna, U. Tedeschi, U. Cillo, Elio Jovine, Giuseppe Tisone, Guido Torzilli, Giuseppe Maria Ettorre, Luca Morelli, G. Griseri, A. Parisi, Fausto Zamboni, Antonio Floridi, Giorgio Ercolani, Roberto Santambrogio, Vincenzo Mazzaferro, S. Berti, L. Veneroni, Ugo Boggi, Felice Giuliante, Giuseppe Zimmitti, A. Antonucci, M. Filauro, A. Coratti, Antonio Giuliani, P. Maida, Abdallah Slim, R. Dalla Valle, G.L. Grazi, Francesca Ratti, Alfredo Guglielmi, R. Romito, Giulio Belli, and Alberto Brolese
Subjects: Liver surgery, medicine.medical_specialty, business.industry, Medicine, Snapshot (computer storage), Surgery, business
Abstract: A technical error led to incorrect rendering of the author group in this article. The correct authorship is as follows.
Published: 2017

49. Intraoperative ultrasound for prediction of hepatocellular carcinoma biological behaviour: Prospective comparison with pathology

Author: Roberto Santambrogio, Gaetano Bulfamante, Marco Maggioni, Matteo Barabino, Enrico Opocher, Emanuela Bertolini, Savino Bruno, Claudia Cigala, and Giovanna Scifo
Subjects: Male, medicine.medical_specialty, Pathology, Cirrhosis, Carcinoma, Hepatocellular, Radiofrequency ablation, medicine.medical_treatment, Biopsy, Liver transplantation, Intraoperative ultrasound, law.invention, 03 medical and health sciences, 0302 clinical medicine, Double-Blind Method, law, Predictive Value of Tests, Risk Factors, medicine, Hepatectomy, Humans, Neoplasm Invasiveness, Prospective Studies, Radiation treatment planning, Grading (tumors), Aged, Ultrasonography, Radiofrequency Ablation, Intraoperative Care, Hepatology, business.industry, Ultrasound, Liver Neoplasms, Cell Differentiation, medicine.disease, digestive system diseases, Tumor Burden, Treatment Outcome, 030220 oncology & carcinogenesis, Hepatocellular carcinoma, 030211 gastroenterology & hepatology, Female, Radiology, Neoplasm Grading, Neoplasm Recurrence, Local, business
Abstract: BACKGROUND & AIMS Preoperative prediction of both microinvasive hepatocellular carcinoma and histological grade of hepatocellular carcinoma is pivotal to treatment planning and prognostication. The aim of this study was to evaluate whether some intraoperative ultrasound features correlate with both the presence of same histological patterns and differentiation grade of hepatocellular carcinoma on the histological features of the primary resected tumour. METHODS All patients with single, small hepatocellular carcinoma that underwent hepatic resection were included in this prospective double-blind study: the intraoperative ultrasound patterns of nodule were registered and compared with similar histological features. RESULTS A total of 179 patients were enclosed in this study: 97 (54%) patients (34% in HCC ≤2 cm) had a microinvasive hepatocellular carcinoma at ultrasound examination, while 82 (46%) patients (41% in HCC ≤2 cm) at histological evaluation. Statistical analysis showed that diameters ≤2 cm, presence of satellites and microinvasive hepatocellular carcinoma at ultrasound examination were the variables with the strongest association with the histological findings. In the multivariate analysis, the vascular microinfiltration and infiltrative hepatocellular carcinoma aspect were independent predictors for grading. CONCLUSIONS In patients with cirrhosis and hepatocellular carcinoma, the prevalence of microinvasive hepatocellular carcinoma is high, even in cases of HCC ≤2 cm. Intraoperative ultrasound findings strongly correlated with histopathological criteria in detecting microinvasive patterns and are useful to predict neoplastic differentiation. The knowledge of these features prior to treatment are highly desired (this can be obtained by an intraoperative ultrasound examination), as they could help in providing optimal management of patients with hepatocellular carcinoma.
Published: 2017

50. Intraoperative Local Ablative Therapies Combined with Surgery for the Treatment of Bilobar Colorectal Liver Metastases

Author: Roberto Santambrogio, Micol Polizzi, Enrico Opocher, Matteo Barabino, Andrea Gatti, and Carmelo Luigiano
Subjects: Ablation Techniques, Adult, Male, Cancer Research, medicine.medical_specialty, medicine.medical_treatment, Local ablation, Thermal ablation, Gastroenterology, Resection, 03 medical and health sciences, 0302 clinical medicine, Internal medicine, Ablative case, medicine, Hepatectomy, Humans, Aged, Univariate analysis, Tumor size, business.industry, Liver Neoplasms, General Medicine, Middle Aged, Survival Analysis, Tumor recurrence, Tumor Burden, Oncology, 030220 oncology & carcinogenesis, 030211 gastroenterology & hepatology, Female, Neoplasm Recurrence, Local, business, Colorectal Neoplasms, Adjuvant
Abstract: AIM To investigate the role of intraoperative local ablation techniques (LATs) in bilobar colorectal liver metastases (bCRLM). PATIENTS AND METHODS Among patients who underwent LAT for CRLM between 2005 and 2015, we selected 33 patients with bilobar disease submitted to thermal ablation alone or associated to liver resection. Primary end-point was complete local response at one month (CLR). Secondary end-points were morbidity, mortality, disease-free survival (DFS), local tumor recurrence (LTR) and long-term survival. RESULTS CLR was observed in 100% of cases, while LTR occurred in 8 cases (22%). DFS at 1, 3 and 5 years was 37%, 5% and 5%. Overall survival (OS), in the same interval, was 95%, 49% and 26%. Univariate analysis found a significant correlation between LTR and tumor size (11% ≤20 mm vs. 50% >20 mm; p=0.009). CONCLUSION LAT is an effective adjuvant strategy in bCRLM for nodules within 20 mm diameter.
Published: 2017

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