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How to identify early complications in patients undergoing distal gastrectomy?

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World Journal of Gastrointestinal Surgery 2024年第4期16卷 974-981页

作者： giuseppe Tropeano Maria Michela Chiarello Valeria fico giuseppe Brisinda Emergency Surgery and Trauma Center Fondazione Policlinico Universitario A Gemelli IRCCSRome 00168Italy Department of Surgery Azienda Sanitaria Provinciale di CosenzaCosenza 87100Italy Department of Medical and Surgical Sciences UniversitàCattolica del Sacro CuoreRome 00168Italy

In this editorial we comment on the article by Zhang et al published in a recent issue of the World Journal of Gastrointestinal *** with appropriate lymph node dissection is still standard curative treatment in locally advanced gastric *** studies point out that gastric cancer surgery is a complex procedure that leads to a high risk of morbidity and *** factors can contribute to the onset of complications with consequent effects on prognosis and increased *** complications can be divided in complications related to anastomosis,to motility and to surgical site *** study presented by Zhang B et al represent an interesting analysis on the possibility to prevent postoperative *** study was performed on 131 patients with distal gastric cancer who underwent gastrectomy with D2 lymph node *** these patients,16%developed early postoperative *** univariate analysis showed that prealbumin level,hypertension,diabetes,history of abdominal surgery,R0 resection,and blood transfusion were factors influencing early postoperative complications after distal ***,the inclusion of the above significant variables in the logistic regression analysis revealed that hypertension,diabetes,a history of abdominal surgery,and blood transfusion were independent predictors of postoperative *** conclusion,preoperative and intraoperative factors can be used to establish an early postoperative nomogram *** results of the study presented by Zhang et al suggest that the prediction model can be used to guide the detection of postoperative complications and has clinical reference value.

关键词： Gastric cancer Gastrectomy Lymph node dissection Morbidity Mortality Surgical site infections

Therapeutic strategies in Crohn’s disease in an emergency surgical setting

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World Journal of Gastroenterology 2022年第18期28卷 1902-1921页

作者： Maria Michela Chiarello Gilda Pepe Valeria fico Valentina Bianchi giuseppe Tropeano Gaia Altieri giuseppe Brisinda Department of Surgery San Giovanni in Fiore HospitalAzienda Sanitaria Provinciale di CosenzaCosenza 87100Italy Emergency Surgery and Trauma Center Fondazione Policlinico Universitario A Gemelli IRCCSRome 00168Italy Department of Surgery Fondazione Policlinico Universitario A Gemelli IRCCSRome 00168Italy Medical and Surgical Science UniversitàCattolica del Sacro CuoreRome 00168Italy

Crohn’s disease(CD)remains a chronic,incurable disorder that presents unique challenges to the *** factors must be considered to allow development of an appropriate treatment *** therapy often precedes or complements the surgical *** indications for operative management of CD include acute and chronic disease complications and failed medical *** surgery comes into play when patients are refractory to medical treatment if they have an obstructive *** colitis,acute obstruction,perforation,acute abscess,or massive hemorrhage represent indications for emergency *** patients are generally in critical conditions and present with intra-abdominal sepsis and a preoperative status of immunosuppression and malnutrition that exposes them to a higher risk of complications and mortality.A multidisciplinary team including surgeons,gastroenterologists,radiologists,nutritional support services,and enterostomal therapists are required for optimal patient care and decision *** of each emergency should be individualized based on patient age,disease type and duration,and patient goals of ***,the recurrent nature of disease mandates that we continue searching for innovative medical therapies and operative techniques that reduce the need to repeat surgical *** this review,we aimed to discuss the acute complications of CD and their treatment.

关键词： Crohn’s disease Intestinal obstruction Free perforation Intra-abdominal sepsis Perineal sepsis Acute bleeding

Early gastric cancer:A challenge in Western countries

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World Journal of Gastroenterology 2022年第7期28卷 693-703页

作者： Maria Michela Chiarello Valeria fico Gilda Pepe giuseppe Tropeano Neill James Adams Gaia Altieri giuseppe Brisinda Department of Surgery Azienda Sanitaria Provinciale di CrotoneOspedale San Giovanni di DioCrotone 88900Italy Emergency Surgery and Trauma Center Fondazione Policlinico Universitario A Gemelli IRCCSRome 00168Italy Health Sciences Clinical Microbiology UnitMagna Grecia UniversityCatanzaro 88100Italy Department of Medical and Surgical Sciences Catholic School of MedicineRome 00168Italy Department of Surgery Fondazione Policlinico Universitario A Gemelli IRCCSRome 00168Italy

Early gastric cancer(EGC)is an invasive carcinoma involving only the stomach mucosa or submucosa,independently of lymph node *** represents over 50%of cases in Japan and in South Korea,whereas it accounts only for approximately 20%of all newly diagnosed gastric cancers in Western *** main classification systems of EGC are the Vienna histopathologic classification and the Paris endoscopic classification of polypoid and non-polypoid lesions.A careful endoscopic assessment is fundamental to establish the best treatment of ***,EGCs are curable if the lesion is completely removed by endoscopic resection or *** types of EGC can be resected endoscopically;for others the most appropriate treatment is surgical resection and D2 lymphadenectomy,especially in Western *** favorable oncological prognosis,the extended lymphadenectomy and the reconstruction of the intestinal continuity that excludes the duodenum make the prophylactic cholecystectomy mandatory to avoid the onset of biliary complications.

关键词： Early gastric cancer Diagnosis Treatment Endoscopic resection Surgery Lymph nodes metastases

Indocyanine green:The guide to safer and more effective surgery

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World Journal of Gastrointestinal Surgery 2024年第3期16卷 641-649页

作者： Pietro Fransvea Maria Michela Chiarello Valeria fico Maria Cariati giuseppe Brisinda Emergency Surgery and Trauma Center Fondazione Policlinico Universitario Agostino Gemelli IRCCSRome 00168Italy Department of Surgery Azienda Sanitaria Provinciale di CosenzaCosenza 87100Italy Department of Surgery Azienda Sanitaria Provinciale di CrotoneCrotone 88900Italy Department of Abdominal and Endocrine Metabolic Medical and Surgical Sciences Fondazione Policlinico Universitario A Gemelli IRCCSRome 00168Italy

In this editorial we comment on the article by Kalayarasan and co-workers published in the recent issue of the World Journal of Gastrointestinal *** authors present an interesting review on the use of indocyanine green fluo-rescence in different aspects of abdominal *** also highlight future perspectives of the use of indocyanine green in mini-invasive ***-cyanine green,used for fluorescence imaging,has been approved by the Food and Drug Administration and is safe for use in *** can be administered in-travenously or *** its advent,there have been several advance-ments in the applications of indocyanine green,especially in the surgical field,such as intraoperative mapping and biopsy of sentinel lymph node,measurement of hepatic function prior to resection,in neurosurgical cases to detect vascular anomalies,in cardiovascular cases for patency and assessment of vascular ab-normalities,in predicting healing following amputations,in helping visualization of hepatobiliary anatomy and blood vessels,in reconstructive surgery,to assess flap viability and for the evaluation of tissue perfusion following major trauma and *** these reasons,the intraoperative use of indocyanine green has become common in a variety of surgical specialties and transplant ***-lorectal surgery has just lately begun to adopt this technique,particularly for perfusion visualization to prevent anastomotic *** regular use of in-docyanine green coupled with fluorescence angiography has recently been pro-posed as a feasible tool to help improve patient *** the best available data,it has been shown that routine use of indocyanine green in colorectal surgery reduces the rates of anastomotic *** use of indocyanine green is proven to be safe,feasible,and effective in both elective and emergency ***,additional robust evidence from larger-scale,high-quality studies is essential before incorporating indocyanine g

关键词： Indocyanine green Colorectal surgery Fluorescence-guided surgery Gastrointestinal surgery Hepato-biliary surgery Pancreatic surgery Surgical oncology

The spectrum of pneumatosis intestinalis in the adult.A surgical dilemma

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World Journal of Gastrointestinal Surgery 2023年第4期15卷 553-565页

作者： giuseppe Tropeano Marta Di Grezia Caterina Puccioni Valentina Bianchi Gilda Pepe Valeria fico Gaia Altieri giuseppe Brisinda Emergency Surgery and Trauma Center Fondazione Policlinico Universitario A Gemelli IRCCSRome 00168Italy Department of Surgery UniversitàCattolica del Sacro CuoreRome 00168Italy

Pneumatosis intestinalis(PI) is a striking radiological diagnosis. Formerly a rare diagnostic finding, it is becoming more frequently diagnosed due to the wider availability and improvement of computed tomography scan imaging. Once associated only with poor outcome, its clinical and prognostic significance nowadays has to be cross-referenced to the nature of the underlying *** mechanisms of pathogenesis have been debated and multiple causes have been detected during the years. All this contributes to creating a broad range of clinical and radiological presentations. The management of patients presenting PI is related to the determining cause if it is identified. Otherwise, in particular if an association with portal venous gas and/or pneumoperitoneum is present, the eventual decision between surgery and non-operative management is challenging,even for stable patients, since this clinical condition is traditionally associated to intestinal ischemia and consequently to pending clinical collapse if not *** the wide variety of origin and outcomes, PI still remains for surgeons a demanding clinical entity. The manuscript is an updated narrative review and gives some suggestions that may help make the decisional process easier,identifying patients who can benefit from surgical intervention and those who can benefit from non-operative management avoiding unnecessary procedures.

关键词： Pneumatosis intestinalis Risk factors Treatment Portal venous gas Portomesenteric pneumatosis

Anastomotic leakage in rectal cancer surgery:Retrospective analysis of risk factors

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World Journal of Clinical Cases 2022年第36期10卷 13321-13336页

作者： giuseppe Brisinda Maria Michela Chiarello Gilda Pepe Maria Cariati Valeria fico Paolo Mirco Valentina Bianchi Department of Medical and Surgical Sciences Fondazione Policlinico Universitario A Gemelli IRCCSRome 00168Italy Department of Surgery UniversitàCattolica S CuoreRome 00168Italy Department of Surgery Azienda Sanitaria Provinciale di CosenzaCosenza 87100Italy Emergency Surgery and Trauma Center Fondazione Policlinico Universitario A Gemelli IRCCSRome 00168Italy Department of Surgery Azienda Sanitaria Provinciale di CrotoneCrotone 88900Italy

BACKGROUND Anastomotic leakage(AL)after restorative surgery for rectal cancer(RC)is associated with significant morbidity and *** To ascertain the risk factors by examining cases of AL in rectal surgery in this retrospective cohort *** To identify risk factors for AL,a review of 583 patients who underwent rectal resection with a double-stapling colorectal anastomosis between January 2007 and January 2022 was ***,demographic and operative features,intraoperative outcomes and oncological characteristics were *** The incidence of AL was 10.4%,with a mean time interval of 6.2±2.1 *** mortality was 0.8%.Mortality was higher in patients with AL(4.9%)than in patients without leak(0.4%,P=0.009).Poor bowel preparation,blood transfusion,median age,prognostic nutritional index<40 points,tumor diameter and intraoperative blood loss were identified as risk factors for *** of anastomosis,number of stapler cartridges used to divide the rectum,diameter of circular stapler,level of vascular section,T and N status and stage of disease were also correlated to AL in our *** diverting ileostomy did not reduce the leak rate,while the use of the transanastomic tube significantly *** Clinical,surgical and pathological factors are associated with an increased risk of *** adversely affects the morbidity and mortality of RC patients.

关键词： Anastomosis Leak Anterior resection Morbidity Mortality Rectal surgery

Surgical complications of oncological treatments: A narrative review

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World Journal of Gastrointestinal Surgery 2023年第6期15卷 1056-1067页

作者： Valeria fico Gaia Altieri Marta Di Grezia Valentina Bianchi Maria Michela Chiarello Gilda Pepe giuseppe Tropeano giuseppe Brisinda Emergency Surgery and Trauma Center Fondazione Policlinico Universitario A Gemelli IRCCSRome 00168Italy Department of Surgery Azienda Sanitaria Provinciale di CosenzaCosenza 87100Italy Department of Medicine and Surgery Catholic School of MedicineRome 00168Italy

Gastrointestinal complications are common in patients undergoing various forms of cancer treatments,including chemotherapy,radiation therapy,and moleculartargeted *** complications of oncologic therapies can occur in the upper gastrointestinal tract,small bowel,colon,and *** mechanisms of action of these therapies are *** includes cytotoxic drugs,which block the activity of cancer cells by targeting intracellular DNA,RNA,or *** symptoms are very common during chemotherapy,due to a direct effect on the intestinal mucosa resulting in edema,inflammation,ulceration,and *** adverse events have been described as complications of molecular targeted therapies,including bowel perforation,bleeding,and pneumatosis intestinalis,which may require surgical *** is a local anti-cancer therapy,which uses ionizing radiation to cause inhibition of cell division and ultimately lead to cell *** related to radiotherapy can be both acute and *** therapies,including radiofrequency,laser,microwave,cryoablation,and chemical ablation with acetic acid or ethanol,can cause thermal or chemical injuries to the nearby *** of the different gastrointestinal complications should be tailored to the individual patient and based on the underlying pathophysiology of the ***,it is important to know the stage and prognosis of the disease,and a multidisciplinary approach is necessary to personalize the surgical *** purpose of this narrative review is to describe complications related to different oncologic therapies that may require surgical interventions.

关键词： Cancer Chemotherapy Radiotherapy Complications Bowel perforation Gastrointestinal bleeding

Influence of sarcopenia and frailty in the management of elderly patients with acute appendicitis

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World Journal of Clinical Cases 2024年第33期12卷 6580-6586页

作者： Pietro Fransvea Maria Michela Chiarello Valeria fico Maria Cariati giuseppe Brisinda Emergency and Trauma Surgery Unit Fondazione Policlinico Universitario Agostino Gemelli IRCCSRoma 00168Italy Department of Surgery Provincial Health AuthorityCosenza 87100Italy Department of Surgery Provincial Health AuthorityCrotone 88900Italy Translational Medicine and Surgery Catholic School of MedicineRoma 00168Italy

In developed countries,the average life expectancy has been increasing and is now well over 80 *** life expectancy is associated with an increased number of emergency surgical procedures performed in later age *** appendicitis is one of the most common surgical diseases,with a lifetime risk of 8%.A growing incidence of acute appendicitis has been registered in the elderly population and in the oldest groups(>80 years).Among patients>50-year-old who present to the emergency department for acute abdominal pain,15%have acute *** these patients,emergency surgery for acute appendicitis is challenging,and some important aspects must be *** the elderly,surgical treatment outcomes are influenced by *** must be considered a precursor of frailty,a risk factor for physical function *** has a negative impact on both elective and emergency surgery regarding mortality and *** from morbidity and mortality,the most crucial outcomes for older patients requiring emergency surgery are reduction in function decline and preoperative physical function ***,prediction of function decline is *** emergency surgery,preoperative interventions are difficult to implement because of the narrow time window before *** this editorial,we highlight the unique aspects of acute appendicitis in elderly patients and the influence of sarcopenia and frailty on the results of surgical treatment.

关键词： Acute appendicitis Appendectomy Elderly Frailty Sarcopenia

Sub-percent precision measurement of neutrino oscillation parameters with JUNO

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Chinese Physics C 2022年第12期46卷 28-49页

作者： Angel Abusleme Thomas Adam Shakeel Ahmad Rizwan Ahmed Sebastiano Aiello Muhammad Akram Abid Aleem Fengpeng An Qi An giuseppe Andronico Nikolay Anfimov Vito Antonelli Tatiana Antoshkina Burin Asavapibhop João Pedro Athayde Marcondes de André Didier Auguste Weidong Bai Nikita Balashov Wander Baldini Andrea Barresi Davide Basilico Eric Baussan Marco Bellato Antonio Bergnoli Thilo Birkenfeld Sylvie Blin David Blum Simon Blyth Anastasia Bolshakova Mathieu Bongrand Clément Bordereau Dominique Breton Augusto Brigatti Riccardo Brugnera Riccardo Bruno Antonio Budano Jose Busto Ilya Butorov Anatael Cabrera Barbara Caccianiga Hao Cai Xiao Cai Yanke Cai Zhiyan Cai Riccardo Callegari Antonio Cammi Agustin Campeny Chuanya Cao Guofu Cao Jun Cao Rossella Caruso Cédric Cerna Chi Chan Jinfan Chang Yun Chang Guoming Chen Pingping Chen Po-An Chen Shaomin Chen Xurong Chen Yixue Chen Yu Chen Zhiyuan Chen Zikang Chen Jie Cheng Yaping Cheng Yu Chin Cheng Alexey Chetverikov Davide Chiesa Pietro Chimenti Artem Chukanov Gérard Claverie Catia Clementi Barbara Clerbaux Selma Conforti Di Lorenzo Daniele Corti Flavio Dal Corso Olivia Dalager Christophe De La Taille Zhi Deng Ziyan Deng Wilfried Depnering Marco Diaz Xuefeng Ding Yayun Ding Bayu Dirgantara Sergey Dmitrievsky Tadeas Dohnal Dmitry Dolzhikov Georgy Donchenko Jianmeng Dong Evgeny Doroshkevich Marcos Dracos Frédéric Druillole Ran Du Shuxian Du Stefano Dusini Martin Dvorak Timo Enqvist Heike Enzmann Andrea Fabbri Donghua Fan Lei Fan Jian Fang Wenxing Fang Marco Fargetta Dmitry Fedoseev Zhengyong Fei Li-Cheng Feng Qichun Feng Richard Ford Amélie Fournier Haonan Gan Feng Gao Alberto Garfagnini Arsenii Gavrikov Marco Giammarchi Nunzio Giudice Maxim Gonchar Guanghua Gong Hui Gong Yuri Gornushkin Alexandre Göttel Marco Grassi Vasily Gromov Minghao Gu Xiaofei Gu Yu Gu Mengyun Guan Yuduo Guan Nunzio Guardone Cong Guo Jingyuan Guo Wanlei Guo Xinheng Guo Yuhang Guo Paul Hackspacher Caren Hagner Ran Han Yang Han Miao He Wei He Tobias Heinz Patrick Hellmuth Yuekun Heng Rafael Herrera YuenKeung Ho Yerevan Physics Institute YerevanArmenia UniversiéLibre de Bruxelles BrusselsBelgium Universidade Estadual de Londrina LondrinaBrazil Pontificia Universidade Catolica do Rio de Janeiro Rio de JaneiroBrazil Pontificia Universidad Católica de Chile SantiagoChile Universidad Tecnica Federico Santa Maria ValparaisoChile Beijing Institute of Spacecraft Environment Engineering BeijingChina Beijing Normal University BeijingChina China Institute of Atomic Energy BeijingChina Institute of High Energy Physics BeijingChina North China Electric Power University BeijingChina School of Physics Peking UniversityBeijingChina Tsinghua University BeijingChina University of Chinese Academy of Sciences BeijingChina Jilin University ChangchunChina College of Electronic Science and Engineering National University of Defense TechnologyChangshaChina Chongqing University ChongqingChina Dongguan University of Technology DongguanChina Jinan University GuangzhouChina Sun Yat-Sen University GuangzhouChina Harbin Institute of Technology HarbinChina University of Science and Technology of China HefeiChina The Radiochemistry and Nuclear Chemistry Group in University of South China HengyangChina Wuyi University JiangmenChina Shandong University JinanChinaand Key Laboratory of Particle Physics and Particle Irradiation of Ministry of EducationShandong UniversityQingdaoChina Institute of Modern Physics Chinese Academy of SciencesLanzhouChina Nanjing University NanjingChina Guangxi University NanningChina East China University of Science and Technology ShanghaiChina School of Physics and Astronomy Shanghai Jiao Tong UniversityShanghaiChina Tsung-Dao Lee Institute Shanghai Jiao Tong UniversityShanghaiChina Institute of Hydrogeology and Environmental Geology Chinese Academy of Geological SciencesShijiazhuangChina Nankai University TianjinChina Wuhan University WuhanChina Xi'an Jiaotong University Xi'anChina Xiamen University XiamenChina School of Physics and Microelectronics Zhengzhou UniversityZhengzhou

JUNO is a multi-purpose neutrino observatory under construction in the south of *** publication presents new sensitivity estimates for the measurement of the △m_(31)^(2),△m_(21)^(2),sin^(2)θ_(12),and sin^(2)θ_(13) oscillation parameters using reactor antineutrinos,which is one of the primary physics goals of the *** sensitivities are obtained using the best knowledge available to date on the location and overburden of the experimental site,the nuclear reactors in the surrounding area and beyond,the detector response uncertainties,and the reactor antineutrino spectral shape constraints expected from the TAO satellite *** is found that the △m_(21)^(2) and sin^(2)θ_(12) oscillation parameters will be determined to 0.5%precision or better in six years of data *** the same period,the △m_(31)^(2) parameter will be determined to about 0.2%precision for each mass ordering *** new precision represents approximately an order of magnitude improvement over existing constraints for these three parameters.

关键词： neutrino oscillation reactor antineutrino precision measurement JUNO