33 research outputs found
Gastrointestinal functions after laparoscopic right colectomy with intracorporeal anastomosis: a pilot randomized clinical trial on effects of abdominal drain, prolonged antibiotic prophylaxis, and D3 lymphadenectomy with complete mesocolic excision
No full textpurpose: routine use of abdominal drain or prolonged antibiotic prophylaxis is no longer part of current clinical practice in colorectal surgery. nevertheless, in patients undergoing laparoscopic right hemicolectomy with intracorporeal anastomosis (ICA), it may reduce perioperative abdominal contamination. furthermore, in cancer patients, prolonged surgery with extensive dissection such as central vascular ligation and complete mesocolon excision with D3 lymphadenectomy (altogether radical right colectomy RRC) is called responsible for affecting postoperative ileus. the aim was to evaluate postoperative resumption of gastrointestinal functions in patients undergoing right hemicolectomy for cancer with ICA and standard D2 dissection or RRC, with or without abdominal drain and prolonged antibiotic prophylaxis. methods: monocentric factorial parallel arm randomized pilot trial including all consecutive patients undergoing laparoscopic right hemicolectomy and ICA for cancer, in 20 months. patients were randomized on a 1:1:1 ratio to receive abdominal drain, prolonged antibiotic prophylaxis or neither (I level), and 1:1 to receive RRC or D2 colectomy (II level). patients were not blinded. the primary aim was the resumption of gastrointestinal functions (time to first gas and stool, time to tolerated fluids and food). secondary aims were length of stay and complications’ rate. clinicalTrials.gov no. NCT04977882. results: fifty-seven patients were screened; according to sample size, 36 were randomized, 12 for each arm for postoperative management, and 18 for each arm according to surgical techniques. a difference in time to solid diet favored the group without drain or antibiotic independently from standard or RRC. furthermore, when patients were divided with respect to surgical technique and into matched cohorts, no differences were seen for primary and secondary outcomes. conclusion: abdominal drainage and prolonged antibiotic prophylaxis in patients undergoing right hemicolectomy for cancer with ICA seem to negatively affect the resumption of a solid diet after laparoscopic right hemicolectomy with ICA for cancer. RRC does not seem to influence gastrointestinal function recovery
Correction to: Safety and efficacy of COVID-19 vaccines in patients on dialysis: a multicentre cohort study in Italy
No full textThe COVIDVaxDia Study Group in html which currently reads Francesca Menniti-Ippolito, Roberto Da Cas, Flavia Chiarotti, Massimo Fabiani, Giuseppe Traversa, Piergiorgio Messa, Alfonso Mele, Salvatore De Masi, Francesca Colavita, Concetta Castilletti, Carmine Zoccali, Aldo Pietro Maggioni, Andrea Lorimer, Martina Ceseri, Ester Baldini, Francesca Bianchini, Laura Sarti, Giovanni Baglio, Andrea Mariano and Eva Alessi. It should read as: Francesca Menniti-Ippolito, Roberto Da Cas, Flavia Chiarotti, Massimo Fabiani, Giuseppe Traversa, Piergiorgio Messa, Alfonso Mele, Salvatore De Masi, Francesca Colavita, Concetta Castilletti, Carmine Zoccali, Aldo Pietro Maggioni, Andrea Lorimer, Martina Ceseri, Ester Baldini, Francesca Bianchini, Laura Sarti, Giovanni Baglio, Andrea Mariano & Eva Alessi, Lorenzo Di Liberato, Luigi Amoroso, Nicola Spetrino, Milva Di Giovanni, Carlo Sapio, Irma Figlia, Roberto Pititto, Teresa Papalia, Rosita Greco, Francesca Leone, Francesco Maria D’Agostino, Mariangela Campolo, Maria Rosa La Gamba, Francesca Mallamaci, Vincenzo Panuccio, Giovanna Parlongo, Giuseppe Natale, Domenico Tramontana, Ivania Maria Figliano, Santo Vitiello, Anna Maria Frangiosa, Domenico Caserta, Pasqualina Acconcia, Nunzia Paudice, Alfonso De Maio, Salvatore Cascone, Marilina Siani, Mario Cioffi, Nataliya Romanyuk, Franca Pagnano, Antonio De Donato, Ersilia Satta, Alessandra Perna, Francesco Trepiccione, Alessandro Cerrone, Gianluca Garofalo, Giancarlo Marinelli, Roberta D’Amato, Enrico De Felice, Alfredo Vacca, Salvatore Coppola, Vincenzo Cuomo, Maria Palma Iavarone, Annalisa Ciotola, Vincenzo Puglia, Pio Granato, Carla Lamberti, Giorgio Capasso, Domenico Bonanno, Marco Ventre, Veronica Amendola, Fabio Cappabianca, Elena Mancini, Davide Ricci, Daniela Cecilia Cannarile, Roberta Benevento, Bianca Perciaccante, Alda Storari, Yuri Battaglia, Giovanni Piva, Giovanni Mosconi, Alessandra Spazzoli, Paolo Ferdinando Bruno, Katia Ambri, Barbara Veterani, Sara Signorotti, Marcora Mandreoli, Renato Mario Rapanà, Maria Teresa Benedetto, Laura Patregnani, Maddalena Zambelli, Gaetano Alfano, Mariacristina Gregorini, Silvia Mattei, Francesca Iannuzzella, Elena Pelizzaro, Luca Camparini, Giuseppe Battaglino, Dino Romanini, Antonio Irlando, Lojze Celik, Giuseppa Natale, Maria Cristina Torre, Ilaria Umbro, Nicola Pirozzi, Loredana Fazzari, Lucia Pantano, Antonio Paone, Marco Galliani, Veronica Baglio, Eleonora Moscaritolo, Sabrina Fierimonte, Maria De Cristofaro, Elena Nebuloso, Paolo Menè, Francesca Romana Festuccia, Giulia Talarico, Claudia Fofi, Maria Elena Bracaccia, Ernesto Anselmo Cioffi, Fabio Mazza, Pasquale Polito, David Micarelli, Roberto Addesse, Lida Tartaglione, Sandro Feriozzi, Francesca Romana Della Rovere, Natalia Chipilova, Micol Manzuoli, Paolo Sacco, Francesca Ansaldo, Chiara Bottaro, Sonia Marre, Francesc Viazzi, Valeria Falqui, Novella Conti, Angelica Parodi, Valentina Zanetti, Francesca Cappadona, Andrea Speciale, Giancarlo Mancuso, Monica Repetto, Emanuela Chiara Vigo, Cairo Montenotte, Anna Maria Murgia, Piero Ruggenenti, Patrizia Ondei, Carmela Giuseppina Condemi, Sivia Bernardi, Francesco Scolari, Paola Gaggia, Federico Alberico, Chiara Manenti, Brunella Valzorio, Corrado Camerini, Agnese Gallico, Michela Tonoli, Federico Daffara, Roberto Zubbani, Simona Guerini, Mattia Zappa, Nicole Zambetti, Alessandra Dalla Gassa, Paola Baldan, Luca Fraizzoli, Sergio Bisegna, Nicola Palmieri, Marco Petrilli, Giusy Mandanici, Francesca Serena Stefani, Valeria Ogliari, Cristina Tantardini, Fabio Malberti, Paola Pecchini, Vincenzo La Milia, Carlo Maria Guastoni, Annalisa Neri, Marina Cornacchiari, Marco Farina, Francesco Barbisoni, Milena Maggio, Mario Cozzolino, Matthias Cassia, Michela Frittoli, Lorenza Magagnoli, Rossella De Leonardis, Roberta Casazza, Simone Vettoretti, Emanuele Grimaldi, Matteo Abinti, Francesca Maria Ida Carminati, Silvia Giuliani, Matteo Benedetti, Nicholas Delfrate, Elisa Colombo, Angela Cervesato, Enrico Eugenio Minetti, Alberto Montoli, Chiara Brunati, Valerae Li Bergolis, Maurizio Galllieni, Cristina Airaghi, Monique Buskermolen, Laura Cosmai, Maria Antonietta Orani, Cristina De Salvo, Giuseppe Vezzoli, Giorgio Slaviero, Chiara Lanzani, Federico Pieruzzi, Gina Contaldo, Barbara Trezzi, Teresa Rampino, Fabrizio Grosjean, Paola Borille, Ciro Esposito, Giuseppe Sileno, Marta Arazzi, Gianvincenzo Melfa, Mariagiulia Tettamanti, Anna Tosetti, Marco D’Amico, Maria Giulia Magatti, Silvia Peiti, Luciano Pedrini, Annalisa Feliciani, Elena Pezzini, Silvio Volmer Bertoli, Daniele Ciurlino, Silvia Tedoldi, Vania Prettico, Giulia Maria Magni, Antonietta Gazo, Maurizio Nai, Silvia Muciaccia, Graziana Battini, Lino Merlino, Paola Casanova, Federica Lencia, Maddalena Ricci, Andrea Ranghino, Mauro Valente, Carolina Finale, Eleonora Guerrini, Marta Canonici, Stefano Santarelli, Rosa Maria Agostinelli, Marina Di Luca, Mauro Martello, Cristina Silvestri, Veronica Bertuzzi, Assunta Cardillo, Valentina Nastasi, Sara Belcastro, Marco Manganaro, Emanuele Luigi Parodi, Valentina Vaccaro, Antonella Giolito, Stefano Cusinato, Michele Battista, Elena Ragazzoni, Paola Marcella Carpani, Emanuele Stramignoni, Silvana Savoldi, Guido Martina, Chiara Deagostini, Marica Magnetti, Stefania Bussolino, Federica Ventrella, Sonia Santi, Marita Marengo, Daniela Falconi, Ilaria Serra, Luca Besso, Davide Diena, Doriana Chiari Notti, Paola David, Luciana Gravellone, Corrado Vitale, Silvia Berutti, Silvia Ganci, Federica Neve Vigotti, Giulio Cesano, Maurizio Borzumati, Patrizia Bio, Stefania Gioira, Oliviero Filiberti, fabiola Pagani, Simonetta Ottone, Carlo Lomonte, Vincenzo Montinaro, Vito Pepe, Elisabetta Manno, Salvatore Di Paolo, Luigi Natalicchio, Carmela Gallo, Francesca pansini, Rossella Varvara, Filomena D’Elia, NIcola Coviello, Concetta Prisciandaro, Lucia Vernò, Fernanda Misceo, Pierfelice Zazzera, Antonella Matrella, Loreto Gesualdo, Anna Maria Di Palma, Virginia Pronzo, Federica Cassone, Salvatore Di Paolo, Tiziana Piccolo, Dora Porcelluzzi, Antonella Di Franco, Mario Giannetto, Chiara Villani, Luigi Vernaglione, Angelo Specchio, Laura Stoico, Giovanni Stallone, Vincenzo Losappio, Barbara Infante, Luigi Morrone, Anna Lisa Marangi, Angela Rodio, Christian D’Altri, Paolo Venerito, Francesca Cianciotta, Filippo Aucella, Gaetano Ferrara, Anna Rachele Nardella, Luigi Francesco Pio Morrone, Maria Grazia Corallo, Giuseppina D’Ettorre, Francesco Caccetta, Davide Gianfreda, Antonello Pani, Gianfranca Cabiddu, Stefania Caria, Maria Maddalena Romano, Ciro Adamo, Giovanni Giorgio Battaglia, Barbara Pocorobba, Emanuela Prencipe, Margherita Saraceno, Luana Scuderi, Salvatore Randone, Francesca Bruno, Rossella Rita Marchese, Antonio Granata, Daniela Puliatti, Carmelita Marcantoni, Luca Zanoli, Ambra D’anca, Domenico Santoro, Guido Gembillo, Alfio Eduardo Giuffrida, Vincenzo Labbozzetta, Angelo Tralongo, Gioacchino Li Cavoli, Carmela Zaggarigo, Paolo Conti, Sofia Giovannini, Silvia Farsetti, Pietro Claudio Giovanni Dattolo, Aris Tsalouchos, Stefano Michelassi, Marco Gallo, Irene Bandor, Nadia Sami, Daniela Riccomi, Lorena Traversari, Maria Grazia Tabbi, Maria Luisa Bonincontro, Vera Bonell, Giuliano Brunori, Diana Zarantonello, Alessandro Laudon, Antonio Selvi, Stefania Santoni, Davide Massimiani, Davide Rossi, Lorenzo Calò, Barbara Rossi, Giuseppe Scaparrotta, Fulvio Fiorini, Valentina Iacono, Carlo Rugiu, Monica Slaviero, Maurizio Nordio, Riccarda Maria Puggia, Adriana Caberlotto, Flavio Scanferla, Vincenzo Casoria, Federica Gramegna, Gina Meneghel, Ilenia Filippi, Anna Giacomini, Claudio Ronco, Anna Giuliani, Sabrina Milan Manani, Monica Zanella
A Low-Grade Appendiceal Mucinous Neoplasia and Neuroendocrine Appendiceal Collision Tumor: A Case Report and Review of the Literature
No full textBACKGROUND Incidental appendiceal neoplasms account for 1-2% of appendectomies. Mucinous neoplasms and carcinoids are the most frequent lesions, with an incidence of 0.6% and 0.3-0.9%, respectively. Appendiceal collision tumors are extremely rare and result from the proliferation of 2 different cellular lines. This report describes a young woman with a collision tumor composed of a low-grade appendiceal mucinous neoplasia (LAMN) and an appendiceal neuroendocrine tumor (ANET). CASE REPORT A 31-year-old woman was admitted to our institution presenting with abdominal pain and dysuria. After ultrasound assessment of a dilated appendix with wall thickening and distension by anechogenic material, a diagnosis of acute appendicitis was made. The patient, after a period of antibiotic therapy and observation, underwent an urgent laparoscopic appendectomy due to worsening condition. Surprisingly, the histological exam revealed a Tis LAMN extending from the base of the appendix to the resection margins, and a T3 grade-1 ANET, chromogranin-A and synaptophysin-positive, with a Ki67 less than 1%. On the basis of histological examination and European Neuroendocrine Tumor Network guidelines, in light of the positive LAMN resection margin and ANET mesoappendiceal invasion, after multidisciplinary team discussion, an elective laparoscopic hemicolectomy was indicated. The patient is now in good condition following a regular 5-year follow-up. CONCLUSIONS A collision LAMN and ANET is an exceedingly rare condition. The heterogeneity of clinical presentation and lack of solid evidence seem to recommend a tailored management. Laparoscopy is a safe and useful tool in localized mass excision
Screening policies, preventive measures and in-hospital infection of COVID-19 in global surgical practices
No full textBackground: In a surgical setting, COVID-19 patients may trigger in-hospital outbreaks and have worse postoperative outcomes. Despite these risks, there have been no consistent statements on surgical guidelines regarding the perioperative screening or management of COVID-19 patients, and we do not have objective global data that describe the current conditions surrounding this issue. This study aimed to clarify the current global surgical practice including COVID-19 screening, preventive measures and in-hospital infection under the COVID-19 pandemic, and to clarify the international gaps on infection control policies among countries worldwide.Methods: During April 2-8, 2020, a cross-sectional online survey on surgical practice was distributed to surgeons worldwide through international surgical societies, social media and personal contacts. Main outcome and measures included preventive measures and screening policies of COVID-19 in surgical practice and centers' experiences of in-hospital COVID-19 infection. Data were analyzed by country's cumulative deaths number by April 8, 2020 (high risk, >5000; intermediate risk, 100-5000; low risk, <100).Results: A total of 936 centers in 71 countries responded to the survey (high risk, 330 centers; intermediate risk, 242 centers; low risk, 364 centers). In the majority (71.9%) of the centers, local guidelines recommended preoperative testing based on symptoms or suspicious radiologic findings. Universal testing for every surgical patient was recommended in only 18.4% of the centers. In-hospital COVID-19 infection was reported from 31.5% of the centers, with higher rates in higher risk countries (high risk, 53.6%; intermediate risk, 26.4%; low risk, 14.8%; P < 0.001). Of the 295 centers that experienced in-hospital COVID-19 infection, 122 (41.4%) failed to trace it and 58 (19.7%) reported the infection originating from asymptomatic patients/staff members. Higher risk countries adopted more preventive measures including universal testing, routine testing of hospital staff and use of dedicated personal protective equipment in operation theatres, but there were remarkable discrepancies across the countries.Conclusions: This large international survey captured the global surgical practice under the COVID-19 pandemic and highlighted the insufficient preoperative screening of COVID-19 in the current surgical practice. More intensive screening programs will be necessary particularly in severely affected countries/institutions.Study registration: Registered in ClinicalTrials.gov: NCT04344197.</p
Correction to: Safety and efficacy of COVID-19 vaccines in patients on dialysis: a multicentre cohort study in Italy
No full textThe COVIDVaxDia Study Group in html which currently reads Francesca Menniti-Ippolito, Roberto Da Cas, Flavia Chiarotti, Massimo Fabiani, Giuseppe Traversa, Piergiorgio Messa, Alfonso Mele, Salvatore De Masi, Francesca Colavita, Concetta Castilletti, Carmine Zoccali, Aldo Pietro Maggioni, Andrea Lorimer, Martina Ceseri, Ester Baldini, Francesca Bianchini, Laura Sarti, Giovanni Baglio, Andrea Mariano and Eva Alessi. It should read as: Francesca Menniti-Ippolito, Roberto Da Cas, Flavia Chiarotti, Massimo Fabiani, Giuseppe Traversa, Piergiorgio Messa, Alfonso Mele, Salvatore De Masi, Francesca Colavita, Concetta Castilletti, Carmine Zoccali, Aldo Pietro Maggioni, Andrea Lorimer, Martina Ceseri, Ester Baldini, Francesca Bianchini, Laura Sarti, Giovanni Baglio, Andrea Mariano & Eva Alessi, Lorenzo Di Liberato, Luigi Amoroso, Nicola Spetrino, Milva Di Giovanni, Carlo Sapio, Irma Figlia, Roberto Pititto, Teresa Papalia, Rosita Greco, Francesca Leone, Francesco Maria D’Agostino, Mariangela Campolo, Maria Rosa La Gamba, Francesca Mallamaci, Vincenzo Panuccio, Giovanna Parlongo, Giuseppe Natale, Domenico Tramontana, Ivania Maria Figliano, Santo Vitiello, Anna Maria Frangiosa, Domenico Caserta, Pasqualina Acconcia, Nunzia Paudice, Alfonso De Maio, Salvatore Cascone, Marilina Siani, Mario Cioffi, Nataliya Romanyuk, Franca Pagnano, Antonio De Donato, Ersilia Satta, Alessandra Perna, Francesco Trepiccione, Alessandro Cerrone, Gianluca Garofalo, Giancarlo Marinelli, Roberta D’Amato, Enrico De Felice, Alfredo Vacca, Salvatore Coppola, Vincenzo Cuomo, Maria Palma Iavarone, Annalisa Ciotola, Vincenzo Puglia, Pio Granato, Carla Lamberti, Giorgio Capasso, Domenico Bonanno, Marco Ventre, Veronica Amendola, Fabio Cappabianca, Elena Mancini, Davide Ricci, Daniela Cecilia Cannarile, Roberta Benevento, Bianca Perciaccante, Alda Storari, Yuri Battaglia, Giovanni Piva, Giovanni Mosconi, Alessandra Spazzoli, Paolo Ferdinando Bruno, Katia Ambri, Barbara Veterani, Sara Signorotti, Marcora Mandreoli, Renato Mario Rapanà, Maria Teresa Benedetto, Laura Patregnani, Maddalena Zambelli, Gaetano Alfano, Mariacristina Gregorini, Silvia Mattei, Francesca Iannuzzella, Elena Pelizzaro, Luca Camparini, Giuseppe Battaglino, Dino Romanini, Antonio Irlando, Lojze Celik, Giuseppa Natale, Maria Cristina Torre, Ilaria Umbro, Nicola Pirozzi, Loredana Fazzari, Lucia Pantano, Antonio Paone, Marco Galliani, Veronica Baglio, Eleonora Moscaritolo, Sabrina Fierimonte, Maria De Cristofaro, Elena Nebuloso, Paolo Menè, Francesca Romana Festuccia, Giulia Talarico, Claudia Fofi, Maria Elena Bracaccia, Ernesto Anselmo Cioffi, Fabio Mazza, Pasquale Polito, David Micarelli, Roberto Addesse, Lida Tartaglione, Sandro Feriozzi, Francesca Romana Della Rovere, Natalia Chipilova, Micol Manzuoli, Paolo Sacco, Francesca Ansaldo, Chiara Bottaro, Sonia Marre, Francesc Viazzi, Valeria Falqui, Novella Conti, Angelica Parodi, Valentina Zanetti, Francesca Cappadona, Andrea Speciale, Giancarlo Mancuso, Monica Repetto, Emanuela Chiara Vigo, Cairo Montenotte, Anna Maria Murgia, Piero Ruggenenti, Patrizia Ondei, Carmela Giuseppina Condemi, Sivia Bernardi, Francesco Scolari, Paola Gaggia, Federico Alberico, Chiara Manenti, Brunella Valzorio, Corrado Camerini, Agnese Gallico, Michela Tonoli, Federico Daffara, Roberto Zubbani, Simona Guerini, Mattia Zappa, Nicole Zambetti, Alessandra Dalla Gassa, Paola Baldan, Luca Fraizzoli, Sergio Bisegna, Nicola Palmieri, Marco Petrilli, Giusy Mandanici, Francesca Serena Stefani, Valeria Ogliari, Cristina Tantardini, Fabio Malberti, Paola Pecchini, Vincenzo La Milia, Carlo Maria Guastoni, Annalisa Neri, Marina Cornacchiari, Marco Farina, Francesco Barbisoni, Milena Maggio, Mario Cozzolino, Matthias Cassia, Michela Frittoli, Lorenza Magagnoli, Rossella De Leonardis, Roberta Casazza, Simone Vettoretti, Emanuele Grimaldi, Matteo Abinti, Francesca Maria Ida Carminati, Silvia Giuliani, Matteo Benedetti, Nicholas Delfrate, Elisa Colombo, Angela Cervesato, Enrico Eugenio Minetti, Alberto Montoli, Chiara Brunati, Valerae Li Bergolis, Maurizio Galllieni, Cristina Airaghi, Monique Buskermolen, Laura Cosmai, Maria Antonietta Orani, Cristina De Salvo, Giuseppe Vezzoli, Giorgio Slaviero, Chiara Lanzani, Federico Pieruzzi, Gina Contaldo, Barbara Trezzi, Teresa Rampino, Fabrizio Grosjean, Paola Borille, Ciro Esposito, Giuseppe Sileno, Marta Arazzi, Gianvincenzo Melfa, Mariagiulia Tettamanti, Anna Tosetti, Marco D’Amico, Maria Giulia Magatti, Silvia Peiti, Luciano Pedrini, Annalisa Feliciani, Elena Pezzini, Silvio Volmer Bertoli, Daniele Ciurlino, Silvia Tedoldi, Vania Prettico, Giulia Maria Magni, Antonietta Gazo, Maurizio Nai, Silvia Muciaccia, Graziana Battini, Lino Merlino, Paola Casanova, Federica Lencia, Maddalena Ricci, Andrea Ranghino, Mauro Valente, Carolina Finale, Eleonora Guerrini, Marta Canonici, Stefano Santarelli, Rosa Maria Agostinelli, Marina Di Luca, Mauro Martello, Cristina Silvestri, Veronica Bertuzzi, Assunta Cardillo, Valentina Nastasi, Sara Belcastro, Marco Manganaro, Emanuele Luigi Parodi, Valentina Vaccaro, Antonella Giolito, Stefano Cusinato, Michele Battista, Elena Ragazzoni, Paola Marcella Carpani, Emanuele Stramignoni, Silvana Savoldi, Guido Martina, Chiara Deagostini, Marica Magnetti, Stefania Bussolino, Federica Ventrella, Sonia Santi, Marita Marengo, Daniela Falconi, Ilaria Serra, Luca Besso, Davide Diena, Doriana Chiari Notti, Paola David, Luciana Gravellone, Corrado Vitale, Silvia Berutti, Silvia Ganci, Federica Neve Vigotti, Giulio Cesano, Maurizio Borzumati, Patrizia Bio, Stefania Gioira, Oliviero Filiberti, fabiola Pagani, Simonetta Ottone, Carlo Lomonte, Vincenzo Montinaro, Vito Pepe, Elisabetta Manno, Salvatore Di Paolo, Luigi Natalicchio, Carmela Gallo, Francesca pansini, Rossella Varvara, Filomena D’Elia, NIcola Coviello, Concetta Prisciandaro, Lucia Vernò, Fernanda Misceo, Pierfelice Zazzera, Antonella Matrella, Loreto Gesualdo, Anna Maria Di Palma, Virginia Pronzo, Federica Cassone, Salvatore Di Paolo, Tiziana Piccolo, Dora Porcelluzzi, Antonella Di Franco, Mario Giannetto, Chiara Villani, Luigi Vernaglione, Angelo Specchio, Laura Stoico, Giovanni Stallone, Vincenzo Losappio, Barbara Infante, Luigi Morrone, Anna Lisa Marangi, Angela Rodio, Christian D’Altri, Paolo Venerito, Francesca Cianciotta, Filippo Aucella, Gaetano Ferrara, Anna Rachele Nardella, Luigi Francesco Pio Morrone, Maria Grazia Corallo, Giuseppina D’Ettorre, Francesco Caccetta, Davide Gianfreda, Antonello Pani, Gianfranca Cabiddu, Stefania Caria, Maria Maddalena Romano, Ciro Adamo, Giovanni Giorgio Battaglia, Barbara Pocorobba, Emanuela Prencipe, Margherita Saraceno, Luana Scuderi, Salvatore Randone, Francesca Bruno, Rossella Rita Marchese, Antonio Granata, Daniela Puliatti, Carmelita Marcantoni, Luca Zanoli, Ambra D’anca, Domenico Santoro, Guido Gembillo, Alfio Eduardo Giuffrida, Vincenzo Labbozzetta, Angelo Tralongo, Gioacchino Li Cavoli, Carmela Zaggarigo, Paolo Conti, Sofia Giovannini, Silvia Farsetti, Pietro Claudio Giovanni Dattolo, Aris Tsalouchos, Stefano Michelassi, Marco Gallo, Irene Bandor, Nadia Sami, Daniela Riccomi, Lorena Traversari, Maria Grazia Tabbi, Maria Luisa Bonincontro, Vera Bonell, Giuliano Brunori, Diana Zarantonello, Alessandro Laudon, Antonio Selvi, Stefania Santoni, Davide Massimiani, Davide Rossi, Lorenzo Calò, Barbara Rossi, Giuseppe Scaparrotta, Fulvio Fiorini, Valentina Iacono, Carlo Rugiu, Monica Slaviero, Maurizio Nordio, Riccarda Maria Puggia, Adriana Caberlotto, Flavio Scanferla, Vincenzo Casoria, Federica Gramegna, Gina Meneghel, Ilenia Filippi, Anna Giacomini, Claudio Ronco, Anna Giuliani, Sabrina Milan Manani, Monica Zanella
TGF-β1-mediated downregulation of L1CAM in pancreatic ductal adenocarcinoma drives upregulation of collagen 17A1 and MMP2, facilitating tumor invasiveness and metastasis
No full textThe highly fibrotic microenvironment of pancreatic ductal adenocarcinoma (PDAC) poses significant challenges for effective treatment, particularly in drug delivery and tumor progression. Our study investigates the role of collagen dynamics in PDAC, revealing that TGF-β1 negatively regulates the expression of L1 cell adhesion molecule (L1CAM), leading to a more invasive tumor phenotype. We identify a subset of PDAC cells with low L1CAM expression (L1low) that actively influences collagen deposition and remodeling, as evidenced by the upregulation of collagen 17A1 (COL17A1) and matrix metalloproteinase 2 (MMP2), both associated with poor prognosis. In vivo studies demonstrate that L1low cells correlate with increased collagen deposition, reduced sensitivity to gemcitabine, and heightened liver metastasis. The secretion of COL17A1 and MMP2 by these cells enhances their migratory capabilities and contributes to the formation of a fibrotic stroma that facilitates tumor progression. This interaction underscores the critical role of collagen in shaping the tumor microenvironment and promoting aggressive tumor behavior. Notably, treatment with Tranilast significantly reduced collagen deposition and MMP2 levels while promoting L1CAM expression, suggesting a therapeutic avenue for counteracting the aggressive characteristics of L1low cells. By modulating collagen dynamics and enhancing drug delivery, Tranilast may improve treatment outcomes for patients with low L1CAM-expressing tumors. Understanding the mechanisms by which L1low cells contribute to collagen secretion and tumor aggressiveness is essential for developing effective interventions in pancreatic cancer
A Randomized Phase III Trial of Complete Mesocolic Excision Compared with Conventional Surgery for Right Colon Cancer: Interim Analysis of a Nationwide Multicenter Study of the Italian Society of Surgical Oncology Colorectal Cancer Network (CoME-in trial)
No full textBackground: Although complete mesocolic excision (CME) is supposed to be associated with a higher lymph node (LN) yield, decreased local recurrence, and survival improvement, its implementation currently is debated because the evidence level of these data is rather low and still not supported by randomized controlled trials. Method: This is a multicenter, randomized, superiority trial (NCT04871399). The 3-year disease-free survival (DFS) was the primary end point of the study. The secondary end points were safety (duration of operation, perioperative complications, hospital length of stay), oncologic outcomes (number of LNs retrieved, 3- and 5-year overall survival, 5-year DFS), and surgery quality (specimen length, area and integrity rate of mesentery, length of ileocolic and middle-colic vessels). The trial design required the LN yield to be higher in the CME group at interim analysis. Results: Interim data analysis is presented in this report. The study enrolled 258 patients in nine referral centers. The number of LNs retrieved was significantly higher after CME (25 vs. 20; p = 0.012). No differences were observed with respect to intra- or post-operative complications, postoperative mortality, or duration of surgery. The hospital stay was even shorter after CME (p = 0.039). Quality of surgery indicators were higher in the CME arm of the study. Survival data still were not available. Conclusions: Interim data show that CME for right colon cancer in referral centers is safe and feasible and does not increase perioperative complications. The study documented with evidence that quality of surgery and LN yield are higher after CME, and this is essential for continuation of patient recruitment and implementation of an optimal comparison. Trial registration The trial was registered at ClinicalTrials.gov with the code NCT04871399 and with the acronym CoME-In trial
Improved outcomes with cyanoacrylate glue for ileocolic anastomosis in right colectomy: a multicenter study
No full textPurpose Anastomotic leaks (AL) remain a major complication following right colectomy for colon cancer. This multicenter, prospective, observational study evaluated the efficacy of Glubran 2, a cyanoacrylate-based sealant, in reducing the incidence of AL by reinforcing ileocolic anastomoses. Methods The study enrolled 380 patients undergoing right colectomy for colon cancer across 7 Italian hospitals. Glubran 2 was applied to reinforce ileocolic anastomoses. The primary endpoint was a 50% reduction in AL incidence from a baseline of 6.18% within 10 days after surgery. Secondary endpoints included examining the correlation between AL and preexisting risk factors and determining the rate of anastomotic bleeding. Statistical analyses employed binomial tests and logistic regression. Results The AL rate was reduced to 1.85% compared to the reference rate of 6.18% (P0.05). Surgical technique (P=0.687), anastomosis technique (P=0.998), and anastomosis type (P=0.998) did not influence AL rates. Operation time was similar across groups (P=0.613), and anastomotic bleeding occurred in 1.3% of cases, with no association with AL (P=0.989). Conclusion Glubran 2 was safely applied to ileocolic anastomoses, significantly reducing AL rates and potentially providing a protective effect even in patients with known risk factors. Its hemostatic and bacteriostatic properties support improved postoperative outcomes, highlighting its potential as an effective adjunct in colorectal surgery. Further studies are warranted to confirm these findings and explore broader applications
Identification of candidate children for maturity-onset diabetes of the young type 2 (MODY2) gene testing: A seven-item clinical flowchart (7-iF)
No full text
