Minerva chirurgica最新文献

{"title":"Ongoing clinical trials on axillary management.","authors":"Andriana Kouloura,&nbsp;Sophocles Lanitis,&nbsp;Evangelos Filopoulos,&nbsp;Michail-Periklis Angelopoulos,&nbsp;Sofia P Kosmidis,&nbsp;Nikolaos Arkadopoulos","doi":"10.23736/S0026-4733.20.08490-4","DOIUrl":"https://doi.org/10.23736/S0026-4733.20.08490-4","url":null,"abstract":"<p><strong>Introduction: </strong>Within the last 50 years the management of patients with breast cancer has changed dramatically with a significant de-escalation of the role and magnitude of surgery, both for the management of the primary tumor and for the management of the axilla. In the management of the axilla of patients with early stage breast cancer (EBC) and clinically uninvolved axilla (cN0), axillary lymph node dissection (ALND) was gradually replaced by sentinel lymph node biopsy (SLNB) saving more than 60-70% of patients from an unnecessary dissection. Further studies confirmed that isolated tumor cells or micrometastases found on the SLN had no further benefit from ALND sparing even more patients from an unnecessary ALND. Eventually, the Z0011 and other studies showed that even patients with 1-2 positive SLN can be spared from ALND provided they fulfill certain criteria. Still though there were many flaws in these studies and further research was necessary to generalize the results of these studies to a wider target group. Meanwhile, there is a clear view that many low risk patients if they have their axilla evaluated via US and are not found to have suspicious nodes, it is highly unlikely to have involved axilla. This let to studies evaluating the non-surgical management of the axilla. Finally, in the post neoadjuvant setting 3 randomized controlled trials showed that under certain circumstances SLNB can be done after the NAC even in patients who initially had involved axilla and was converted to clinically uninvolved (cN1→cN0).</p><p><strong>Evidence acquisition: </strong>PubMed, Medline, the Cochrane Library Controlled Trials Register as well as National Institutes of Health ClinicalTrials.Gov database have been consulted up to May 2020.</p><p><strong>Evidence synthesis: </strong>We studied and described the ongoing trials on patients not undergoing neoadjuvant chemotherapy and we discussed the eligibility criteria, the comparison arms and the expected outcomes. We further examined the ongoing trials on patients undergoing neoadjuvant chemotherapy in the same manner.</p><p><strong>Conclusions: </strong>Although we have covered a long way in the journey of eliminating axillary surgery, there are still lots of questions to be answered and trials to be conducted. We anticipate the results of the ongoing trials to provide the necessary evidence to safely de-escalate more the axillary surgery, both in the non-neoadjuvant as well as in the neoadjuvant setting, hoping that in the not so far future the axillary surgery will eventually perish.</p>","PeriodicalId":18714,"journal":{"name":"Minerva chirurgica","volume":"75 6","pages":"408-418"},"PeriodicalIF":1.3,"publicationDate":"2020-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"38735854","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Management of surgical working in an Italian neighborhood hospital during the COVID-19 pandemic.","authors":"Pietro F Bagnoli,&nbsp;Farhad Nehchiri,&nbsp;Monica Lucini,&nbsp;Maria E Messina,&nbsp;Andrea Morlacchi,&nbsp;Giovanni Lenna,&nbsp;Pasquale Ferrante","doi":"10.23736/S0026-4733.20.08398-4","DOIUrl":"https://doi.org/10.23736/S0026-4733.20.08398-4","url":null,"abstract":"<p><p>The novel SARS-CoV-2 pandemic arose in China in the late 2019 and soon after spread in the rest of the world. The management of SARS-CoV-2 is a serious challenge for all the healthcare professionals. The management of this disease has caused an epochal change in all of the hospitals. The surgical departments too were not excluded from management of COVID-19 patients, because of the disease itself, or as complication of surgical procedure. The surgeons too had to quickly adapt their skills, in order to recognize and treat this life-threatening problem. In the meantime, the surgeons had to ensure continuity of the oncall availability for the emergency procedures, meanwhile the regular scheduled surgical activities were suspended. We present here our experience in a neighborhood hospital located in Milan, Italy.</p>","PeriodicalId":18714,"journal":{"name":"Minerva chirurgica","volume":"75 6","pages":"462-465"},"PeriodicalIF":1.3,"publicationDate":"2020-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"38245856","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Unexpected evolution of COVID-19 in a heart transplant patient with multimorbidity recently submitted to thoracic surgery.","authors":"Giuseppe Mangiameli,&nbsp;Charles Al Zreibi,&nbsp;Julia Caudron,&nbsp;Alex Arame,&nbsp;Francoise Le Pimpec-Barthes","doi":"10.23736/S0026-4733.20.08367-4","DOIUrl":"https://doi.org/10.23736/S0026-4733.20.08367-4","url":null,"abstract":"","PeriodicalId":18714,"journal":{"name":"Minerva chirurgica","volume":"75 6","pages":"467-468"},"PeriodicalIF":1.3,"publicationDate":"2020-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"38735855","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Gauze technique: a simple method of dissection in laparoscopic inguinal hernia repair.","authors":"Francesco Coratti,&nbsp;Martina Trafeli,&nbsp;Giuseppe Barbato,&nbsp;Cristina Maggioni,&nbsp;Andrea Manetti,&nbsp;Fabio Cianchi","doi":"10.23736/S0026-4733.20.08335-2","DOIUrl":"https://doi.org/10.23736/S0026-4733.20.08335-2","url":null,"abstract":"<p><strong>Background: </strong>Hernia repair is one of the most frequent operation in general surgery. The aim of this is study is to present a new preperitoneal atraumatic dissection of peritoneal flap during laparoscopic transabdominal preperitoneal inguinal hernia repair.</p><p><strong>Methods: </strong>From January 2019 to December 2019, 30 patients (19 male, 11 female) attended TAPP inguinal hernia repairs. The inclusion's criteria were: patients from 32 to 88 years; male and woman; bilateral inguinal hernia.</p><p><strong>Results: </strong>The median age of patients was 46,46 (32-88). The median time of operation was 63,8 (45-100) minutes. All procedures were performed without complications and convertions.</p><p><strong>Conclusions: </strong>Based on our experience the soft technique is a safe and feasible way to create a preperitoneal flap. Operating time is drastically reduced and the learning curve is reduced even for less experienced surgeons.</p>","PeriodicalId":18714,"journal":{"name":"Minerva chirurgica","volume":"75 6","pages":"426-429"},"PeriodicalIF":1.3,"publicationDate":"2020-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"37975935","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Thulium cyber laser-assisted uniportal thoracoscopic resection of a pulmonary metastasis from colorectal cancer.","authors":"Filippo Lococo,&nbsp;Amedeo Iaffaldano,&nbsp;Edoardo Zanfrini,&nbsp;Luca Pogliani,&nbsp;Diomira Tabacco,&nbsp;Carolina Sassorossi,&nbsp;Ciro Mazzarella,&nbsp;Stefano Margaritora","doi":"10.23736/S0026-4733.20.08416-3","DOIUrl":"https://doi.org/10.23736/S0026-4733.20.08416-3","url":null,"abstract":"","PeriodicalId":18714,"journal":{"name":"Minerva chirurgica","volume":"75 6","pages":"475-477"},"PeriodicalIF":1.3,"publicationDate":"2020-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"38445760","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"COVID-19 and acute perforated diverticulitis: management and surgical timing.","authors":"Andrea Costanzi,&nbsp;Michela Monteleone,&nbsp;Marco Confalonieri,&nbsp;Gaia Colletti,&nbsp;Colomba Frattaruolo,&nbsp;Carla Magni,&nbsp;Lucia Corizia,&nbsp;Abe Fingerhut","doi":"10.23736/S0026-4733.20.08487-4","DOIUrl":"https://doi.org/10.23736/S0026-4733.20.08487-4","url":null,"abstract":"","PeriodicalId":18714,"journal":{"name":"Minerva chirurgica","volume":"75 6","pages":"468-470"},"PeriodicalIF":1.3,"publicationDate":"2020-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"38418012","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Primary laparoscopic approach to repair perforated peptic ulcer. A retrospective cohort study.","authors":"Gianrocco Manco,&nbsp;Stefania Caramaschi,&nbsp;Giovanni Rolando,&nbsp;Marzio Malagoli,&nbsp;Giuliana Zanelli,&nbsp;Luca Reggiani Bonetti,&nbsp;Aldo Rossi","doi":"10.23736/S0026-4733.20.08287-5","DOIUrl":"https://doi.org/10.23736/S0026-4733.20.08287-5","url":null,"abstract":"<p><strong>Background: </strong>Perforated peptic ulcer is a serious complication of peptic ulcer disease and carries high risk for morbidity and mortality. Although the incidence of peptic ulcer disease has decreased in recent decades, the percentage of patients with perforated peptic ulcer requiring emergency surgery remains constant. The use of laparoscopic management as a first choice for the treatment of the perforation is growing but is not routine in many centers.</p><p><strong>Methods: </strong>Clinical and surgical data on 42 patients underwent surgical treatment for perforated peptic ulcer from January 2012 to December 2016 were collected. Laparoscopic repair of the perforation with a three-port technique was made in all cases. The Boey scoring system was used to predict the prognosis.</p><p><strong>Results: </strong>All patients underwent suture-closure of the ulcer, and omental patch through laparoscopy without conversion to open surgery. Duodenal leakages occurred in 3 patients (7.1%), then treated with a conservative approach and resolved on the 10^th postoperative day. Two patients (4.7%) had deep space infections in the first week after surgery, therefore subdiaphragmatic and pelvic abscess were drained by ultrasound guidance. Four patients (9.5%) died up to 30-day post-surgery due to progression of multisystem organ failure in absence of leakages or infections. All these patients were American Society of Anesthesiologists Classification >III and Boey Score 3.</p><p><strong>Conclusions: </strong>Our data show that a primary laparoscopic approach in patients with peptic ulcer perforation is associated with postoperative advantages and acceptable rates of morbidity and mortality, essentially related to high Boey Score. Therefore, we suggest that the surgical repair of PPU could be always started laparoscopically.</p>","PeriodicalId":18714,"journal":{"name":"Minerva chirurgica","volume":"75 6","pages":"436-441"},"PeriodicalIF":1.3,"publicationDate":"2020-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"37978003","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Hernia surgery in the COVID-19 era: does it require special attention?","authors":"Damiano Chiari","doi":"10.23736/S0026-4733.20.08359-5","DOIUrl":"https://doi.org/10.23736/S0026-4733.20.08359-5","url":null,"abstract":"","PeriodicalId":18714,"journal":{"name":"Minerva chirurgica","volume":"75 6","pages":"466"},"PeriodicalIF":1.3,"publicationDate":"2020-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"38245851","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Efficacy and safety of injection treatment after internal urethrotomy on the prevention of stricture recurrence: a network meta-analysis.","authors":"Fangshi Xu, Yibing Guan, Li Xue, Xi Lan, Ke Gao, Tie Chong","doi":"10.23736/S0026-4733.20.08301-7","DOIUrl":"10.23736/S0026-4733.20.08301-7","url":null,"abstract":"","PeriodicalId":18714,"journal":{"name":"Minerva chirurgica","volume":"75 6","pages":"471-473"},"PeriodicalIF":1.3,"publicationDate":"2020-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"38245415","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Prevention of withdrawal symptoms in alcoholic patients with head and neck cancer.","authors":"Melissa Laus,&nbsp;Marianna Trignani,&nbsp;Domenico Crescenzi,&nbsp;Marco Radici,&nbsp;Adelchi Croce","doi":"10.23736/S0026-4733.20.08316-9","DOIUrl":"https://doi.org/10.23736/S0026-4733.20.08316-9","url":null,"abstract":"<p><strong>Background: </strong>The role of alcohol abuse is common in the onset of cancer of the upper aerodigestive tract, especially that affecting the tongue, floor of the mouth, palatine tonsil and piriform sinus. The consequences of the abuse of alcohol immediately after surgery in these patients are less known. But they are very important to achieve good final results.</p><p><strong>Methods: </strong>To try to understand the best treatment for withdrawal symptoms in a group of Italian patient with head and neck cancers, we administered a 10-item questionnaire. Subsequently, we decided to send the questionnaire to the main Italian centers of head and neck oncology using the platform of online surveys SurveyMonkey.</p><p><strong>Results: </strong>The results show clearly that it is not easy, within the Italian \"latin\" culture and lifestyle to correctly identify the alcoholic patient (patients in the last stage of the of the disease with a \"behavioral dependency\") and that the centers which address these problems mostly use a drug treatment, employing in particular two classes of drugs, associated or not with thiamine, with a varying quantity of other vitamins.</p><p><strong>Conclusions: </strong>It is important to know the early withdrawal syndrome to assess the ideal treatment. We propose a personal protocol to present this complication.</p>","PeriodicalId":18714,"journal":{"name":"Minerva chirurgica","volume":"75 6","pages":"430-435"},"PeriodicalIF":1.3,"publicationDate":"2020-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"38245416","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}