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New totally intracorporeal reconstructive approach after robotic total gastrectomy: Technical details and short-term outcomes

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World Journal of Gastroenterology 2017年第23期23卷 4293-4302页

作者： amilcare parisi Francesco Ricci Alessandro Gemini Stefano Trastulli Roberto Cirocchi Giorgio Palazzini Vito D'Andrea Jacopo Desiderio Department of Digestive Surgery St.Mary's Hospital of TerniUniversity of Perugia Department of General Surgery St.Mary's Hospital of TerniUniversity of Perugia Department of Surgical Science “La Sapienza”University

To show outcomes of our series of patients that underwent a total gastrectomy with a robotic approach and highlight the technical details of a proposed solution for the reconstruction *** of gastrectomies performed from May 2014 to October 2016, were extracted and analyzed. Basic characteristics of patients, surgical and clinical outcomes were reported. The technique for reconstruction (parisi Technique) consists on a loop of bowel shifted up antecolic to directly perform the esophago-enteric anastomosis followed by a second loop, measured up to 40 cm starting from the esojejunostomy, fixed to the biliary limb to create an enteroenteric anastomosis. The continuity between the two anastomoses is interrupted just firing a linear stapler, so obtaining the Roux-en-Y by avoiding to interrupt the ***-five patients were considered in the present analysis. Estimated blood loss was 126.55 ± 73 mL, no conversions to open surgery occurred, R0 resections were obtained in all cases. Hospital stay was 5 (3-17) d, no anastomotic leakage occurred. Overall, a fast functional recovery was shown with a median of 3 (3-6) d in starting a solid *** surgery and the adoption of a tailored reconstruction technique have increased the feasibility and safety of a minimally invasive approach for total gastrectomy. The present series of patients shows its implementation in a western center with satisfying short-term outcomes.

关键词： Esophagojejunal anastomosis Gastric cancer Total gastrectomy Robotic surgery Minimally invasive surgery

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Liver resection versus radiofrequency ablation in the treatment of cirrhotic patients with hepatocellular carcinoma

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Hepatobiliary & Pancreatic Diseases International 2013年第3期12卷 270-277页

作者： amilcare parisi Jacopo Desiderio Stefano Trastulli Elisa Castellani Rosario Pasquale Roberto Cirocchi Carlo Boselli Giuseppe Noya Department of Digestive Surgery and Liver Unit St. Maria Hospital Department of General and Oncologic Surgery University of Perugia St. Maria della Misericordia Hospital Department of General and Urgent Surgery University of Perugia

BACKGROUND: Hepatocellular carcinoma is the most common type of primary liver tumor and its incidence is increasing worldwide. The study aimed to compare patients subjected to liver resection or radiofrequency ablation. METHODS: One hundred and forty cirrhotic patients in stage A or B of Child-Pugh with single nodular or multinodular hepatocellular carcinoma were included in this retrospective study. Among them, 87 underwent surgical resection, and 53 underwent percutaneous radiofrequency ablation. Patient charac-teristics, survival, and recurrence-free survival were analyzed. RESULTS: Recurrence-free survival was longer in the resection group in comparison to the radiofrequency group with a median recurrence-free time of 36 versus 26 months, respectively (P=0.01, HR=1.52, 95% CI: 1.05-2.25). In the resection group, median survival was 46 months, with the 1-, 3- and 5-year survival rates of 89.7%, 72.4% and 40.2%. In the radiofrequency group, median survival was 32 months, with the 1-, 3- and 5-year survival rates of 83.0%, 43.4% and 22.6% (P<0.01). CONCLUSIONS: Surgical resection improves the overall survival and recurrence-free survival in comparison with radiofrequency ablation. New evidences are needed to define the real role of the percutaneous technique as an alternative to surgery.

关键词： hepatocellular carcinoma liver resection radiofrequency ablation

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Fluorescence image-guided lymphadenectomy using indocyanine green and near infrared technology in robotic gastrectomy

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Chinese Journal of Cancer Research 2018年第5期30卷 568-570页

作者： Jacopo Desiderio Stefano Trastulli AlessANDro Gemini Domenico Di Nardo Giorgio Palazzini amilcare parisi Vito D'ANDrea Department of Digestive Surgery St.Mary's HospitalTerni Department of Surgical Sciences "La Sapienza" University of Rome

In recent years, some researchers have tried to find a way to improve the surgical identification of the lymphatic drainage routes and lymph node stations during radical gastrectomy, thus starting a new research frontier in this field called ＂navigation surgery＂. Among the different reported solutions, the introduction of the indocyanine green （ICG） has drawn attention for its characteristics, a fluorescence dye that can be detected in the near infrared spectral band （NIR）. A fluorescence imaging technology has been integrated in the latest version of the Da Vinci robotic system and surgeons have extensively reported their experiences in colorectal and hepato-biliary surgery for tumors, vascular and lymphatic structures visualization. However, up to date, the combined use of fluorescence imaging and robotic technology has not been adequately investigated during lymphadenectomy in gastric cancer.

关键词： Gastric cancer fluorescence guided surgery robotic surgery

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Long-term survival of patients with stage Ⅱ and Ⅲgastric cancer who underwent gastrectomy with inadequate nodal assessment

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World Journal of Gastrointestinal Surgery 2021年第11期13卷 1463-1483页

作者： Jacopo Desiderio Andrea Sagnotta Irene Terrenato Eleonora Garofoli Claudia Mosillo Stefano Trastulli Federica Arteritano Federico Tozzi Vito D'Andrea Yuman Fong Yanghee Woo Sergio Bracarda amilcare parisi Department of Digestive Surgery St.Mary’s HospitalTerni 05100Italy Department of Surgical Sciences Sapienza University of RomeRome 00161Italy Department of General Surgery and Surgical Oncology San Filippo Neri HospitalRome 00135Italy Biostatistics and Bioinformatic Unit Scientific DirectionIRCCS Regina Elena National Cancer InstituteRome 00144Italy Department of Medical Oncology St.Mary’s HospitalTerni 05100Italy Division of Surgical Oncology and Endocrine Surgery Mays Cancer CenterUniversity of Texas Health Science Center San AntonioSan AntonioTX 78229United States Division of Surgical Oncology Department of SurgeryCity of Hope National Medical CenterDuarteLA91010United States

BACKGROUND Gastric cancer is an aggressive disease with frequent lymph node(LN)*** NCCN recommends a D2 lymphadenectomy and the harvesting of at least 16 *** threshold has been the subject of great debate,not only for the extent of surgery but also for more appropriate *** reclassification of stage IIB through IIIC based on N3b nodal staging in the eighth edition of the American Joint Committee on Cancer(AJCC)staging system highlights the efforts to more accurately discriminate survival expectancy based on nodal ***,studies have suggested that pathologic assessment of 30 or more LNs improve prognostic accuracy and is required for proper staging of *** To evaluate the long-term survival of advanced gastric cancer patients who deviated from expected survival curves because of inadequate nodal *** Eligible patients were identified from the Surveillance,Epidemiology,and End Results *** with stage II-III gastric cancer were considered for *** groups were compared based on the number of analyzed *** were inadequate LN assessment(ILA,<16 LNs),adequate LN assessment(ALA,16-29 LNs),and optimal LN assessment(OLA,≥30 LNs).The main outcomes were overall survival(OS)and cancer-specific *** were analyzed by the Kaplan-Meier product-limit method,log-rank test,hazard risk,and Cox proportional univariate and multivariate *** score matching(PSM)was used to compare the ALA and OLA *** The analysis included 11607 *** had advanced T stages(T3=48%;T4=42%).The pathological AJCC stage distribution was IIA=22%,IIB=18%,IIIA=26%,IIIB=22%,and IIIC=12%.The overall sample divided by the study objective included ILA(50%),ALA(35%),and OLA(15%).Median OS was 24 mo for the ILA group,29 mo for the ALA group,and 34 mo for the OLA group(P<0.001).Univariate analysis showed that the ALA and OLA groups had better OS than the ILA group[ALA hazard ratio(HR)=0.84,95%co

关键词： Gastric Cancer Lymphadenectomy Gastrectomy Staging N stage Surveillance,Epidemiology,and End Results

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新辅助化疗期间肌肉指数变化值预测胃癌根治术预后的临床价值

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中华消化外科杂志 2021年第9期20卷 955-966页

作者：唐逸辉马玉滨 Desiderio Jacopo 林建贤刘奕楠李平谢建伟王家镔陆俊陈起跃曹龙龙郑朝辉 amilcare parisi 黄昌明福建医科大学附属协和医院胃外科福州350001 青海大学附属医院胃肠外科西宁810000 圣玛丽亚医院消化外科意大利特尔尼05100

目的探讨新辅助化疗期间肌肉指数变化值预测胃癌根治术预后的临床价值。方法采用回顾性队列研究方法。收集2010年1月至2017年12月3家医学中心收治的362例(福建医科大学附属协和医院163例、青海大学附属医院141例、圣玛丽亚医院58例)行... 详细信息

目的探讨新辅助化疗期间肌肉指数变化值预测胃癌根治术预后的临床价值。方法采用回顾性队列研究方法。收集2010年1月至2017年12月3家医学中心收治的362例(福建医科大学附属协和医院163例、青海大学附属医院141例、圣玛丽亚医院58例)行新辅助化疗联合胃癌根治术病人的临床病理资料;男270例,女92例;中位年龄为61岁,年龄范围为26~79岁。362例病人中,福建医科大学附属协和医院与青海大学附属医院收治的304例病人设为建模组;圣玛丽亚医院收治的58例病人设为验证组。观察指标:(1)建模组病人行新辅助化疗期间身体成分、肿瘤标志物及应激状态指标变化情况。(2)随访及生存情况。(3)影响建模组病人预后因素分析。(4)预后预测模型的构建与比较。(5)预后预测模型评价。采用门诊、电话、信件方式进行随访,了解病人术后生存情况。随访时间截至2021年4月。正态分布的计量资料以x±s表示。偏态分布的计量资料以M(范围)表示。计数资料以绝对数表示。单因素和多因素分析采用COX比例风险模型。采用Kaplan-Meier法计算生存时间,采用Log-rank检验进行生存分析。结果(1)建模组病人行新辅助化疗期间身体成分、肿瘤标志物及应激状态指标变化情况。建模组304例病人行新辅助化疗前皮下脂肪指数、内脏脂肪指数、肌肉指数、癌胚抗原(CEA)、CA19-9、体质量指数(BMI)、预后营养指数(PNI)、修正全身炎症评分(mSIS)分别为31.2 cm^(2)/m^(2)(0.6~96.0 cm^(2)/m^(2)),25.1 cm^(2)/m^(2)(0.1~86.3 cm^(2)/m^(2)),47.1 cm^(2)/m^(2)(27.6~76.6 cm^(2)/m^(2)),43.2μg/L(0.2~1000.0μg/L),108.7 U/mL(0.6~1000.0 U/mL),21.9 kg/m^(2)(15.6~29.7 kg/m^(2)),46.8(28.6~69.0),(1.0±0.8)分;行胃癌根治术前上述指标分别为32.5 cm^(2)/m^(2)(5.1~112.0 cm^(2)/m^(2)),25.4 cm^(2)/m^(2)(0.2~89.0 cm^(2)/m^(2)),47.0 cm^(2)/m^(2)(16.8~67.0 cm^(2)/m^(2)),17.0μg/L(0.2~1000.0μg/L),43.9 U/mL(0.6~1000.0 U/mL),21.6 kg/m^(2)(31.1~29.0 kg/m^(2)),47.7(30.0~84.0),(1.0±0.8)分;行新辅助化疗期间上述指标变化值分别为1.4 cm^(2)/m^(2)(-31.0~35.1 cm^(2)/m^(2)),0.2 cm^(2)/m^(2)(-23.5~32.6 cm^(2)/m^(2)),-0.1 cm^(2)/m^(2)(-18.2~15.9 cm^(2)/m^(2)),-26.2μg/L(-933.5~89.9μg/L),-64.9 U/mL(-992.1~178.6 U/mL),-0.3 kg/m^(2)(-9.7~7.1 kg/m^(2)),0.9(-27.1~38.2),(0.0±0.8)分。(2)随访及生存情况。建模组304例病人中,284获得随访,随访时间为3~130个月,中位随访时间为36个月;随访期间,130例病人因肿瘤复发转移死亡,9例病人因非肿瘤原因死亡,病人5年总体生存率为54.6%。验证组58例病人中,52例获得随访,随访时间为2~91个月,中位随访时间为29个月;随访期间,21例病人死亡,病人5年总体生存率为63.8%。(3)影响建模组病人预后因素分析。单因素分析结果显示:术后病理学类型、术后病理学分期是影响建模组304例胃癌病人行胃癌根治术后5年总体生存率[风险比=1.685,2.619,95%可信区间(CI)为1.139~2.493,1.941~3.533,P<0.05]和5年疾病无进展生存率的相关因素(风险比=1.468,2.577,95%CI为1.000~2.154,1.919~3.461,P<0.05)。多因素分析结果显示:术后病理学类型、术后病理学分期是建模组304例病人行胃癌根治术后5年总体生存率的独立影响因素(风险比=1.508,2.287,95%CI为1.013~2.245,1.691~3.093,P<0.05);术后病理学分期是建模组304例病人行胃癌根治术后5年疾病无进展生存率的独立影响因素(风险比=2.317,95%CI为1.719~3.123,P<0.05)。(4)预后预测模型的构建与比较。304例建模组胃癌病人皮下脂肪指数变化值、内脏脂肪指数变化值、CEA变化值、CA19-9变化值、

关键词：胃肿瘤新辅助化疗身体成分预后预测模型

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Minimally invasive surgery for gastric cancer: A comparison between robotic, laparoscopic and open surgery

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World Journal of Gastroenterology 2017年第13期23卷 2376-2384页

作者： amilcare parisi Daniel Reim Felice Borghi Ninh T Nguyen Feng Qi Andrea Coratti Fabio Cianchi Maurizio Cesari Francesca Bazzocchi Orhan Alimoglu Johan Gagnière Graziano Pernazza Simone D'Imporzano Yan-Bing Zhou Juan-Santiago Azagra Olivier Facy Steven T Brower Zhi-Wei Jiang Lu Zang Arda Isik Alessandro Gemini Stefano Trastulli Alexander Novotny Alessandra Marano Tong Liu Mario Annecchiarico Benedetta Badii Giacomo Arcuri Andrea Avanzolini Metin Leblebici Denis Pezet Shou-Gen Cao Martine Goergen Shu Zhang Giorgio Palazzini Vito D'Andrea Jacopo Desiderio Department of Digestive Surgery St.Mary's HospitalUniversity of Perugia Klinik und Poliklinik fuer Chirurgie Klinikum Rechts der IsarTechnical University Munich Department of Surgery General and Oncologic Surgery UnitSanta Croce e Carle Hospital Department of Surgery Division of Gastrointestinal SurgeryUniversity of CaliforniaIrvine Medical Center Gastrointestinal Surgery Tianjin Medical University General Hospital Division of Oncological and Robotic Surgery Department of OncologyCareggi University Hospital Unit of general and endocrine surgery Center of oncologic minimally invasive surgery(COMIS)Careggi University Hospital Department of General Surgery Hospital of Cittàdi CastelloUSL1 Umbria Department of General Surgery Division of GeneralGastroenterologic and Minimally Invasive SurgeryG.B.Morgagni Hospital Department of General Surgery School of MedicineIstanbul Medeniyet University Department of Digestive and Hepatobiliary Surgery Estaing University Hospital Department of Surgery Robotic General Surgery UnitSan Giovanni Addolorata Hospital Esophageal Surgery Unit Tuscany Regional Referral Center for the Diagnosis and Treatment of Esophageal DiseaseMedical University of Pisa Department of General Surgery The Affiliated Hospital of Qingdao University Unitédes Maladies de l'Appareil Digestif et Endocrine Centre Hospitalier de Luxembourg Service de Chirurgie Digestive et Cancérologique CHU Bocage Department of Surgical Oncology and HPB Surgery Englewood Hospital and Medical Center Department of General Surgery Jinling HospitalMedical SchoolNanjing University Department of Surgery Ruijin HospitalShanghai Jiaotong UniversitySchool of Medicine Department of General Surgery Erzincan UniversitySchool of Medicine Department of Surgical Science “La Sapienza”University Department of Digestive Surgery St.Mary's Hospital of Terni-University of Perugia

AIM To investigate the role of minimally invasive surgery for gastric cancer and determine surgical, clinical, and oncological *** This is a propensity score-matched case-control study, comparing three treatment arms: robotic gastrectomy(RG), laparoscopic gastrectomy(LG), open gastrectomy(OG). Data collection started after sharing a specific study protocol. Data were recorded through a tailored and protected web-based system. Primary outcomes: harvested lymph nodes, estimated blood loss, hospital stay, complications rate. Among the secondary outcomes, there are: operative time, R0 resections, POD of mobilization, POD of starting liquid diet and soft solid diet. The analysis includes the evaluation of type and grade of postoperative complications. Detailed information of anastomotic leakages is also *** The present analysis was carried out of 1026 gastrectomies. To guarantee homogenous distribution of cases, patients in the RG, LG and OG groups were 1:1:2 matched using a propensity score analysis with a caliper = 0.2. The successful matching resulted in a total sample of 604 patients(RG = 151; LG = 151; OG = 302). The three groups showed no differences in all baseline patients characteristics, type of surgery(P = 0.42) and stage of the disease(P = 0.16). Intraoperative blood loss was significantly lower in the LG(95.93 ± 119.22) and RG(117.91 ± 68.11) groups compared to the OG(127.26 ± 79.50, P = 0.002). The mean number of retrieved lymph nodes was similar between the RG(27.78 ± 11.45), LG(24.58 ± 13.56) and OG(25.82 ± 12.07) approach. A benefit in favor of the minimally invasive approaches was found in the length of hospital stay(P < 0.0001). A similar complications rate was found(P = 0.13). The leakage rate was not different(P = 0.78) between *** Laparoscopic and robotic surgery can be safely performed and proposed as possible alternative to open surgery. The main highlighted benefit is a faster postoperative functional recov

关键词： Gastric cancer Gastrectomy Minimally invasive surgery Robotic Robot-assisted Laparoscopy

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Stable and Accurate Second-Order Formulation of the Shifted Wave Equation

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Communications in Computational Physics 2010年第1期7卷 103-137页

作者： Ken Mattsson Florencia parisi Department of Information Technology Uppsala UniversityP.O.Box 337S-75105 UppsalaSweden FaMAF Universidad Nacional de CordobaMedina Allende S/N Ciudad Universitaria5000 CordobaArgentina

High order finite difference approximations are derived for a one-dimensional model of the shifted wave equation written in second-order form. Thedomain is discretized using fully compatible summation by parts operators and theboundary conditions are imposed using a penalty method, leading to fully explicittime integration. This discretization yields a strictly stable and efficient scheme. Theanalysis is verified by numerical simulations in one-dimension. The present study isthe first step towards a strictly stable simulation of the second-order formulation ofEinstein’s equations in three spatial dimensions.

关键词： High-order finite difference methods wave equation numerical stability second derivatives Einstein’s equations

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Neuroinflammation as a target for glaucoma therapy

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Neural Regeneration Research 2019年第3期14卷 391-394页

作者： Adornetto Annagrazia Rossella Russo parisi Vincenzo Department of Pharmacy Health and Nutritional Sciences Section of Preclinical and Translational Pharmacology University of Calabria Visual Neurophysiology and Neurophthalmology Research Unit IRCCS G.B.Bietti Foundation

The pathogenesis of glaucoma is still not fully clarified but a growing body of evidence suggests that neuroinflammation and immune response are part of the sequence of pathological events leading to the optic neuropathy. Indeed, inflammation-involving the activation and proliferation of resident glial cells(astrocytes, Muller cells and microglia) and the release of a plethora of anti-and pro-inflammatory cytokines, chemokines and reactive oxygen species-has been reported as common features in clinical and experimental glaucoma. In the insulted retina, as for other neuronal tissues, pathogenic and reparative aspects coexist in the inflammatory process, with extent and persistency affecting the final outcome. In view of this, therapies aimed at modulating the immune and inflammatory responses may represent a promising approach for limiting the optic nerve damage and the loss of retinal ganglion cells associated with glaucoma.

关键词： glaucoma retinal ganglion cells neuroinflammation neurodegeneration microglia oxidative stress inflammasome immune response

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Catalyst-Free Synthesis and Shape Control of CdTe Nanowires

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Nano Research 2011年第9期4卷 824-835页

作者： Xiaoping Jin Marta Kruszynska Jurgen parisi Joanna Kolny-Olesiak University of Oldenburg Department of Physics Energy and Semiconductor Research Laboratory Carl-von-Ossietzky-Str. 9-11 26129Oldenburg Germany

The procedure reported here allows for the size and shape control of CdTe nanowires by means of colloidal chemistry. Thus, ultrathin, straight, saw-tooth-like and one-sided branched nanowires with zinc blende structures could be synthesized. Their formation does not require any catalyst and is most likely due to the oriented attachment of nanoparticles formed in the beginning of the reaction. The use of oleylamine as a solvent turned out to be crucial in order to achieve CdTe nanowires. The reaction between oleic acid and oleylamine in the presence of CdO proved to be essential, not only to activate the Cd precursor but also to provide reaction conditions facilitating nanowire formation by oriented attachment.

关键词： Nanowires CdTe amine activation oriented attachment shape control

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Endotics system vs colonoscopy for the detection of polyps

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World Journal of Gastroenterology 2010年第43期16卷 5452-5456页

作者： Emanuele Tumino Rodolfo Sacco Marco Bertini Michele Bertoni Giuseppe parisi Alfonso Capria Operative Unit of Gastroenterology and Metabolic Diseases Department of Gastroenterology Pisa University Hospital Institute of Internal Medicine University of Foggia

AIM: To compare the endotics system (ES), a set of new medical equipment for diagnostic colonoscopy, with video-colonoscopy in the detection of polyps. METHODS: Patients with clinical or familial risk of colonic polyps/carcinomas were eligible for this study. After a standard colonic cleaning, detection of polyps by the ES and by video-colonoscopy was performed in each patient on the same day. In each single patient, the assessment of the presence of polyps was performed by two independent endoscopists, who were randomly assigned to evaluate, in a blind fashion, the presence of polyps either by ES or by standard colonoscopy. The frequency of successful procedures (i.e. reaching to the cecum), the time for endoscopy, and the need for sedation were recorded. Sensitivity, specificity, positive predictive value (PPV) and negative predictive value (NPV) of the ES were also calculated. RESULTS: A total of 71 patients (40 men, mean age51.9 ± 12.0 years) were enrolled. The cecum was reached in 81.6% of ES examinations and in 94.3% of colonoscopies (P = 0.03). The average time of endoscopy was 45.1 ± 18.5 and 23.7 ± 7.2 min for the ES and traditional colonoscopy, respectively (P < 0.0001). No patient required sedation during ES examination, compared with 19.7% of patients undergoing colonoscopy (P < 0.0001). The sensitivity and specificity of ES for detecting polyps were 93.3% (95% CI: 68-98) and 100% (95% CI: 76.8-100), respectively. PPV was 100% (95% CI: 76.8-100) and NPV was 97.7% (95% CI: 88-99.9). CONCLUSION: The ES allows the visualization of the entire colonic mucosa in most patients, with good sensitivity/specificity for the detection of lesions and without requiring sedation.

关键词： Colonoscopy Diagnosis Endotics system Polyps Sedation

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