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Corneal collagen cross-linking in patients with keratoconus from the Dresden protocol to customized solutions:theoretical basis

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international Journal of Ophthalmology(English edition) 2024年第5期17卷 951-962页

作者： Ciro Caruso Luca D’Andrea Mario troisi Michele Rinaldi Raffaele Piscopo Salvatore troisi Ciro Costagliola Corneal Transplant Center Pellegrini HospitalVia Portamedina alla Pignasecca 41Napoli 80127Italy Eye Clinic Department of NeurosciencesReproductive and Odontostomatological SciencesUniversity of Naples Federico IINaples 80131Italy Public Health Department University of Naples Federico IINaples 80131Italy Salerno Hospital University Ophthalmologic UnitBaronissiCampania 84131Italy

Keratoconus is an ectatic condition characterized by gradual corneal thinning,corneal protrusion,progressive irregular astigmatism,corneal fibrosis,and visual *** therapeutic options regarding improvement of visual function include glasses or soft contact lenses correction for initial stages,gas-permeable rigid contact lenses,scleral lenses,implantation of intrastromal corneal ring or corneal transplants for most advanced *** keratoconus cases showing disease progression corneal collagen crosslinking(CXL)has been proven to be an effective,minimally invasive and safe *** consists of a photochemical reaction of corneal collagen by riboflavin stimulation with ultraviolet A radiation,resulting in stromal crosslinks *** aim of this review is to carry out an examination of CXL methods based on theoretical basis and mathematical models,from the original Dresden protocol to the most recent developments in the technique,reporting the changes proposed in the last 15y and examining the advantages and disadvantages of the various treatment ***,the limits of non-standardized methods and the perspectives offered by a customization of the treatment are highlighted.

关键词： corneal collagen cross linking keratoconus custom fast protocol Dresden protocol lambert-beer law Bunsen-roscoe law

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Robotic versus laparoscopic liver resection for huge (≥10 cm) liver tumors: an international multicenter propensity-score matched cohort study of 799 cases

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Hepatobiliary Surgery and Nutrition 2023年第2期12卷 205-215,I0005页

作者： Tan-To Cheung Rong Liu Federica Cipriani Xiaoying Wang Mikhail Efanov David Fuks Gi-Hong Choi Nicholas L.Syn Charing C.N.Chong Fabrizio Di Benedetto Ricardo Robles-Campos Vincenzo Mazzaferro Fernando Rotellar Santiago Lopez-Ben James O.Park Alejandro Mejia iswanto Sucandy Adrian K.H.Chiow Marco V.Marino Mikel Gastaca Jae Hoon Lee TPeter Kingham Mathieu D’Hondt Sung Hoon Choi Robert P.Sutcliffe Ho-Seong Han Chung-Ngai Tang Johann Pratschke roberto i.troisi Go Wakabayashi Daniel Cherqui Felice Giuliante Davit L.Aghayan Bjorn Edwin Olivier Scatton Atsushi Sugioka Tran Cong Duy Long Constantino Fondevila Mohammad Abu Hilal Andrea Ruzzenente Alessandro Ferrero Paulo Herman Kuo-Hsin Chen Luca Aldrighetti Brian K.P.Goh international robotic and laparoscopic liver resection study group investigators Department of Surgery Queen Mary HospitalThe University of Hong KongHong Kong SARChina Faculty of Hepatopancreatobiliary Surgery The First Medical Center of Chinese People’s Liberation Army(PLA)General HospitalBeijingChina Hepatobiliary Surgery Division IRCCS San Raffaele HospitalMilanItaly Department of Liver Surgery and Transplantation Liver Cancer InstituteZhongshan HospitalFudan UniversityShanghaiChina Department of Hepato-Pancreato-Biliary Surgery Moscow Clinical Scientific CenterMoscowRussia Department of Digestive Oncologic and Metabolic SurgeryInstitute Mutualiste MontsourisUniversite Paris DescartesParisFrance Division of Hepatopancreatobiliary Surgery Department of SurgerySeverance HospitalYonsei University College of MedicineSeoulKorea Department of Hepatopancreatobiliary and Transplant Surgery Singapore General Hospital and Yong Loo Lin School of MedicineNational University of SingaporeSingaporeSingapore Division of Hepatobiliary and Pancreatic Surgery Department of SurgeryPrince of Wales HospitalThe Chinese University of Hong KongHong Kong SARChina HPB Surgery and Liver Transplant Unit University of Modena and Reggio EmiliaModenaItaly Department of General Visceral and Transplantation SurgeryClinic and University Hospital Virgen de la ArrixacaIMIB-ARRIXACAMurciaSpain HPB Surgery Hepatology and Liver TransplantationFondazione IRCCS Istituto Nazionale Tumori di MilanoMilanItaly HPB and Liver Transplant Unit Department of General SurgeryClinica Universidad de NavarraUniversidad de NavarraPamplonaSpain institute of Health Research of Navarra(idisNA) PamplonaSpain Hepatobiliary and Pancreatic Surgery Unit Department of SurgeryDr.Josep Trueta HospitalIdIBGiGironaSpain Hepatobiliary Surgical Oncology Department of SurgeryUniversity of Washington Medical CenterSeattleWAUSA The Liver institute Methodist Dallas Medical CenterDallasTXUSA AdventHealth Tampa Digestive Health InstituteTampaFLUSA Hepatopancreatobiliary Unit Department of SurgeryChangi General

Background:The use of laparoscopic(LLR)and robotic liver resections(RLR)has been safely performed in many institutions for liver tumours.A large scale international multicenter study would provide stronger evidence and insight into application of these techniques for huge liver tumours≥10 ***:This was a retrospective review of 971 patients who underwent LLR and RLR for huge(≥10 cm)tumors at 42 international centers between ***:One hundred RLR and 699 LLR which met study criteria were *** comparison between the 2 approaches for patients with huge tumors were performed using 1:3 propensity-score matching(PSM)(73 vs.219).Before PSM,LLR was associated with significantly increased frequency of previous abdominal surgery,malignant pathology,liver cirrhosis and increased median *** PSM,RLR and LLR was associated with no significant difference in key perioperative outcomes including media operation time(242 vs.290 min,P=0.286),transfusion rate rate(19.2%vs.16.9%,P=0.652),median blood loss(200 vs.300 mL,P=0.694),open conversion rate(8.2%vs.11.0%,P=0.519),morbidity(28.8%vs.21.9%,P=0.221),major morbidity(4.1%vs.9.6%,P=0.152),mortality and postoperative length of stay(6 vs.6 days,P=0.435).Conclusions:RLR and LLR can be performed safely for selected patients with huge liver tumours with excellent *** was no significant difference in perioperative outcomes after RLR or LLR.

关键词： Laparoscopic liver resection(LLR) robotic liver resection(RLR) hepatocellular carcinoma colorectal liver metastases huge

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Big size is not all, even better!

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Hepatobiliary Surgery and Nutrition 2019年第5期8卷 539-540页

作者： roberto ivan troisi Mariano Cesare Giglio roberto Montalti Department of Clinical Medicine and Surgery Federico II University of NaplesNaplesItaly Department of Liver and Small Bowel Transplantation Hepato-Biliary and Pancreatic SurgeryKing Faisal Specialist Hospital and Research CenterRiyadhKingdom of Saudi Arabia Department of Public Health Federico II University of NaplesNaplesItaly

We read with interest the article entitled"Comprehensive Complication index validates improved outcomes over time despiteincreased complexity in 3707 consecutive hepatectomies"by Cloydet al.(1).This article focused on... 详细信息

关键词： entitled consecutive despite

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Artificial intelligence in the diagnosis and management of colorectal cancer liver metastases

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World Journal of Gastroenterology 2022年第1期28卷 108-122页

作者： Gianluca Rompianesi Francesca Pegoraro Carlo DL Ceresa roberto Montalti roberto ivan troisi Division of Hepato-Bilio-Pancreatic Minimally Invasive and Robotic SurgeryDepartment of Clinical Medicine and SurgeryFederico II University HospitalNaples 80125Italy Department of Hepato-Pancreato-Biliary Surgery Oxford University Hospitals NHS Foundation TrustOxford OX39ESUnited Kingdom Division of Hepato-Bilio-Pancreatic Minimally Invasive and Robotic SurgeryDepartment of Public HealthFederico II University HospitalNaples 80125Italy

Colorectal cancer(CRC)is the third most common malignancy worldwide,with approximately 50%of patients developing colorectal cancer liver metastasis(CRLM)during the follow-up *** of CRLM is best achieved via a multidisciplinary approach and the diagnostic and therapeutic decision-making process is *** order to optimize patients’survival and quality of life,there are several unsolved challenges which must be *** primarily include a timely diagnosis and the identification of reliable prognostic ***,to allow optimal treatment options,a precision-medicine,personalized approach is *** widespread digitalization of healthcare generates a vast amount of data and together with accessible high-performance computing,artificial intelligence(Ai)technologies can be *** increasing diagnostic accuracy,reducing timings and costs,the application of Ai could help mitigate the current shortcomings in CRLM *** this review we explore the available evidence of the possible role of Ai in all phases of the CRLM natural *** analysis and convolutional neural networks(CNN)which combine computed tomography(CT)images with clinical data have been developed to predict CRLM development in CRC *** models have also proven themselves to perform similarly or better than expert radiologists in detecting CRLM on CT and magnetic resonance scans or identifying them from the noninvasive analysis of patients’exhaled *** application of Ai and machine learning(ML)in diagnosing CRLM has also been extended to histopathological examination in order to rapidly and accurately identify CRLM tissue and its different histopathological growth *** and CNN have shown good accuracy in predicting response to chemotherapy,early local tumor progression after ablation treatment,and patient survival after surgical treatment or *** the initial enthusiasm and the accumulating evidence,Ai technologies’role i

关键词： Colorectal cancer Liver metastases Artificial intelligence Machine learning Deep learning Neural networks Radiomics

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Liquid biopsy in cholangiocarcinoma:Current status and future perspectives

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World Journal of Gastrointestinal Oncology 2021年第5期13卷 332-350页

作者： Gianluca Rompianesi Marcello Di Martino Alex Gordon-Weeks roberto Montalti roberto troisi Hepato-Bilio-Pancreatic Minimally Invasive and Robotic Surgery UnitDepartment of Clinical Medicine and SurgeryFederico II University HospitalNapoli 80131Italy Hepato-Bilio-Pancreatic Surgery Unit Department of General and Digestive SurgeryHospital Universitario La PrincesaMadrid 28006Spain Nuffield Department of Surgical Sciences University of OxfordOxford OX39DUUnited Kingdom

Cholangiocarcinoma(CCA)are a heterogeneous group of tumors in terms of aetiology,natural history,morphological subtypes,molecular alterations and management,but all sharing complex diagnosis,management,and poor *** mutated genes and epigenetic changes have been detected in CCA,with the potential to identify diagnostic and prognostic biomarkers and therapeutic *** tumoral components and genetic material is therefore crucial for the diagnosis,management and selection of targeted therapies;but sampling tumor tissue,when possible,is often risky and difficult to be repeated at different time *** biopsy(LB)represents a way to overcome these issues and comprises a diverse group of methodologies centering around detection of tumor biomarkers from fluid *** to the traditional tissue sampling methods LB is less invasive and can be serially repeated,allowing a real-time monitoring of the tumor genetic profile or the response to *** this review,we analysis the current evidence on the possible roles of LB(circulating DNA,circulating RNA,exosomes,cytokines)in the diagnosis and management of patients affected by CCA.

关键词： Liquid biopsy Cholangiocarcinoma Circulating biomarkers Biliary tumors Circulating DNA Circulating RNA Exosomes Cytokines

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Laparoscopic surgery for colorectal liver metastases:moving forward while keeping feet on the ground

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Hepatobiliary Surgery and Nutrition 2021年第1期10卷 107-109页

作者： Mariano Cesare Giglio roberto ivan troisi Division of HPB Minimally Invasive and Robotic SurgeryDepartment of Clinical Medicine and SurgeryFederico II University HospitalNaplesItaly

The laparoscopic approach to the surgical treatment of colorectal liver metastases(CRLMs)is supported nowadays by high evidence(1).in the hand of expert surgeons,patients undergoing laparoscopic liver surgery(LLS)for CLRMs benefit from a number of advantages,including a shorter postoperative in-hospital stay,less pain,fewer complications and a faster recovery(1).More importantly,all these profits are achieved while preserving the oncological outcomes,which are not-inferior to those achieved by open procedures(1).Recently published long-term results of randomized trials have shown similar patient survival after laparoscopic and open surgery for CRLM(2).

关键词： surgery colorectal faster

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Perioperative thromboprophylaxis in liver transplant patients

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World Journal of Gastroenterology 2018年第27期24卷 2931-2948页

作者： Lesley De Pietri roberto Montalti Daniele Nicolini roberto ivan troisi Federico Moccheggiani Marco Vivarelli Division of Anaesthesiology and intensive Care Unit Department of General SurgeryAUSL Reggio Emilia-IRCCSReggio Emilia 42123Italy Hepatobiliary and Abdominal Transplantation Surgery Department of Experimental and Clinical MedicinePolytechnic University of MarcheAncona 60126Italy Department of General Hepatobiliary and Liver Transplantation SurgeryGhent University Hospital Medical SchoolGhent 185 3K3 9000Belgium

improvements in surgical and anesthetic procedures have increased patient survival after liver transplantation(LT). However, the perioperative period of LT can still be affected by several complications. Among these, thromboembolic complications(intracardiac thrombosis, pulmonary embolism, hepatic artery and portal vein thrombosis) are relatively common causes of increased morbidity and mortality. The benefit of thromboprophylaxis in general surgical patients has already been established, but it is not the standard of care in LT recipients. LT is associated with a high bleeding risk, as it is performed in a setting of already unstable hemostasis. For this reason, the role of routine perioperative prophylactic anticoagulation is usually restricted. However, recent data have shown that the bleeding tendency of cirrhotic patients is not an expression of an acquired bleeding disorder but rather of coexisting factors(portal hypertension, hypervolemia and infections). Furthermore, in cirrhotic patients, the new paradigm of ‘‘rebalanced hemostasis' ' can easily tip towards hypercoagulability because of the recently described enhanced thrombin generation, procoagulant changes in fibrin structure and platelet hyperreactivity. This new coagulation balance, along with improvements in surgical techniques and critical support, has led to a dramatic reduction in transfusion requirements, and the intraoperative thromboembolic-favoring factors(venous stasis, vessels clamping, surgical injury) have increased the awareness of thrombotic complications and led clinicians to reconsider the limited use of anticoagulants or antiplatelets in the postoperative period of LT.

关键词： Anticoagulation Liver transplantation Antiplatelets Thrombosis Coagulation Heparin Thromboelastography Thromboprophylaxis Hepatic artery thrombosis Portal vein thrombosis

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Emergence of bariatric psychiatry as a new subspecialty

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World Journal of Psychiatry 2022年第1期12卷 108-116页

作者： Alfonso troisi Department of Systems Medicine University of Rome Tor VergataRome 00133Italy

Bariatric surgery is the branch of surgery aimed at helping a person with obesity lose *** implementation of surgical treatment of obesity is growing at an impressive *** expected,the expanding implementation of bariatric procedures has progres-sively revealed critical issues that were not evident when the number of obese patients treated with surgery was relatively *** critical issue is the importance of mental health assessment and care of bariatric *** aim of this review is to provide readers with an up-to-date summary of the goals,methods,and clinical strategies of bariatric *** aims can be grouped into three distinct ***,to ascertain that there are no psychiatric contraindications to safe bariatric ***,to diagnose and treat pre-surgery mental conditions that could predict poor weight ***,to diagnose and treat post-surgery mental conditions associated with poor quality of *** bariatric psychiatry has gained the status of a new subspecialty within the field of mental health and psychopathology,many clinical questions remain *** need more long-term data on outcome measures such as quality of life,adherence to behavioral guidelines,risk of suicide,and postsurgery prevalence of psychological disturbances and mental disorders.

关键词： Bariatric surgery Psychiatry Weight loss Mental health Quality of life Preoperative assessment Postoperative follow-up

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Genetics of adult attachment and the endogenous opioid system

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World Journal of Psychiatry 2022年第8期12卷 1105-1107页

作者： Alfonso troisi Department of Systems Medicine University of Rome Tor VergataRome 00133Italy

Since the pioneering work by Panksepp et al,the neurobiological bases of attachment behavior have been closely linked with opioid *** gene studies of adult individuals have shown that variation in the muopioid receptor gene(OPRM1)influences attachment *** maternal care and the A/A genotype of the A118G polymorphism interact in modulating levels of fearful *** to their counterparts carrying the A/A genotype,individuals expressing the minor 118G allele show lower levels of avoidant attachment and experience more pleasure in social *** imaging research has strengthened the biological plausibility of candidate gene *** avoidance dimension of attachment correlates negatively with muopioid receptor availability in the thalamus and anterior cingulate cortex,as well as the frontal cortex,amygdala,and ***,findings from human studies combined with those from animal models suggest that research on the genetic bases of attachment should include the endogenous opioid system among the investigated variables.

关键词： Genetics Avoidant attachment Fearful attachment Endogenous opioids OPRM1 A118G polymorphism

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Portal vein embolization failure:Current strategies and future perspectives to improve liver hypertrophy before major oncological liver resection

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World Journal of Gastrointestinal Oncology 2022年第11期14卷 2088-2096页

作者： Gianluca Cassese Ho-Seong Han Boram Lee Jai Young Cho Hae Won Lee Boris Guiu Fabrizio Panaro roberto ivan troisi Clinical Medicine and Surgery Federico II UniversityNaples 80131Italy Department of Surgery Seoul National University College of MedicineSeongnam 13620South Korea Department of Surgery Seoul National University Bundang HospitalSeongnam 13620South Korea Department of Medical imaging and interventional Radiology St-Eloi University HospitalMontpellier 34295France Digestive Surgery and Transplantation CHU de MontpellierMontpellier 34295France

Portal vein embolization(PVE)is currently considered the standard of care to improve the volume of an inadequate future remnant liver(FRL)and decrease the risk of post-hepatectomy liver failure(PHLF).PHLF remains a significant limitation in performing major liver surgery and is the main cause of mortality after *** degree of hypertrophy obtained after PVE is variable and depends on multiple *** to 20%of patients fail to undergo the planned surgery because of either an inadequate FRL growth or tumor progression after the PVE procedure(usually 6-8 wk are needed before surgery).The management of PVE failure is still debated,with a lack of consensus regarding the best clinical *** additional techniques have been proposed,such as sequential transarterial chemoembolization followed by PVE,segment 4 PVE,intra-portal administration of stem cells,dietary supplementation,and hepatic vein *** aim of this review is to summarize the up-to-date strategies to overcome such difficult situations and discuss future perspectives on improving FRL hypertrophy.

关键词： Portal vein embolization Portal vein embolization failure Rescue associating liver partition and portal vein ligation Hepatic vein embolization Liver venous deprivation Segment 4 portal vein embolization

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