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Gastrointestinal stromal tumor and mitosis,pay attention

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World Journal of Gastroenterology 2012年第6期18卷 587-588页

作者： federico coccolini Fausto Catena Luca Ansaloni Antonio Daniele Pinna General and Emergency Surgery Department Ospedali Riuniti 24128 BergamoItaly General and Transplant Surgery Department Sant'Orsola-Malpighi University Hospital24128 BolognaItaly

The difference between stages Ⅰ and Ⅲ of gastric gastrointestinal stromal tumor depends principally on the number of *** with TNM classification,the presence in the tumor of high mitotic rate determines the *** studies exposed different count techniques in evaluating the number of *** international standardized method to assess mitotic rate is needed.

关键词：有丝分裂胃肠道肿瘤间质技术评估国际标准化 TNM

WSES/SIS-E/WSIS/AAST/GAIS制定的免疫功能低下患者急腹症管理指南解读

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中华危重病急救医学 2022年第3期34卷 239-244页

作者：郑飞波杨春勇崔云峰张雅敏 federico coccolini 天津市职业病防治院外科天津300011 天津医科大学南开临床学院天津300070 赤峰学院附属医院普通外科内蒙古自治区赤峰024000 天津市南开医院肝胆胰外科天津300100 天津市第一中心医院肝胆外科天津300100 比萨大学医院普通外科/急创外科比萨56124意大利

世界急诊外科学会(WSES)联合欧洲外科感染学会(SIS-E)、世界外科感染学会(WSIS)、美国创伤外科协会(AAST)和全球外科感染联盟(GAIS)制定了有关免疫功能低下患者急腹症管理的指南,并于2021年8月9日在《世界急诊外科杂志》(WJES)上发表。... 详细信息

世界急诊外科学会(WSES)联合欧洲外科感染学会(SIS-E)、世界外科感染学会(WSIS)、美国创伤外科协会(AAST)和全球外科感染联盟(GAIS)制定了有关免疫功能低下患者急腹症管理的指南,并于2021年8月9日在《世界急诊外科杂志》(WJES)上发表。该指南从免疫功能低下患者的定义、分类、诊断、治疗进行了详尽的阐述。此外,基于循证医学证据就免疫功能低下患者特异性急性腹腔感染、移植患者常见急性腹腔感染、人类免疫缺陷病毒(HIV)感染者或获得性免疫缺陷综合征(AIDS)患者的诊断和治疗以及围手术期类固醇的管理给出了指导意见。本文对该指南进行解读,以更好地理解免疫功能低下患者急腹症的诊治现状以及推荐意见,并就其局限性提出建议。

关键词：免疫功能低下急腹症疾病管理指南世界急诊外科学会联合欧洲外科感染学会世界外科感染学会美国创伤外科协会全球外科感染联盟

The artificial intelligence evidence-based medicine pyramid

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World Journal of Critical Care Medicine 2023年第2期12卷 89-91页

作者： Valentina Bellini federico coccolini Francesco Forfori Elena Bignami Department of Medicine and Surgery University of ParmaAnesthesiologyCritical Care and Pain Medicine DivisionParma 43126Italy Department of General Emergency and Trauma SurgeryPisa University HospitalPisa 56124Italy Department of Anesthesia and Intensive Care University of PisaPisa 53126Italy

Several studies exist in the literature regarding the exploitation of artificial intelligence in intensive ***,an important gap between clinical research and daily clinical practice still exists that can only be bridg... 详细信息

关键词： Artificial intelligence Intensive care Intensive care unit Evidence-based medicine Clinical research

Esophagogastric junction gastrointestinal stromal tumor:Resection vs enucleation

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World Journal of Gastroenterology 2010年第35期16卷 4374-4376页

作者： federico coccolini Fausto Catena Luca Ansaloni Daniel Lazzareschi Antonio Daniele Pinna Unit of General Emergency and Transplant SurgerySt.Orsola-Malpighi University Hospital Department of Integrative Biology University of CaliforniaBerkeley

Esophageal gastrointestinal stromal tumors(GISTs) are extremely uncommon,representing approximately 5% of GISTs with the majority of esophageal GISTs occurring at the esophagogastric junction(EGJ).The treatment options available for these GISTs are fairly *** different options are nowadays at our *** surgery to the target therapies we have the possibility to treat the majority of GISTs,including those which are defined as *** EGJ GISTs represent a stimulating challenge for the *** anatomical location increases the possibility of postoperative *** the role of negative margins in GIST surgery is still controversial and the eff icacy of target therapy has been demonstrated,why not treat EGJ GISTs with enucleation and,where indicated,adjuvant target therapy?

关键词： Esophagogastric junction Gastrointestinal stromal tumor Surgical approach Resection Enucleation

Peritoneal carcinomatosis

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World Journal of Gastroenterology 2013年第41期19卷 6979-6994页

作者： federico coccolini federico Gheza Marco Lotti Salvatore Virzì Domenico Iusco Claudio Ghermandi Rita Melotti Gianluca Baiocchi Stefano Maria Giulini Luca Ansaloni Fausto Catena Department of General Surgery Papa Giovanni ⅩⅩⅢ Hospital24127 BergamoItaly Surgical Clinic University of Brescia25123 BresciaItaly Department of General Surgery Bentivoglio Hospital40010 BentivoglioItaly Department of Anesthesiology Sant’ Orsola-Malpighi Hospital40100 BolognaItaly Regional Health Agency of Emilia Romagna 40100 BolognaItaly Department of Emergency Surgery Ospedale Maggiore43100 ParmaItaly

Several gastrointestinal and gynecological malignancies have the potential to disseminate and grow in the peritoneal *** occurrence of peritoneal carcinomatosis(PC)has been shown to significantly decrease overall survival in patients with liver and/or extraperitoneal metastases from gastrointestinal *** the last three decades,the understanding of the biology and pathways of dissemination of tumors with intraperitoneal spread,and the understanding of the protective function of the peritoneal barrier against tumoral seeding,has prompted the concept that PC is a loco-regional disease:in absence of other systemic metastases,multimodal approaches combining aggressive cytoreductive surgery,intraperitoneal hyperthermic chemotherapy and systemic chemotherapy have been proposed and are actually considered promising methods to improve loco-regional control of the disease,and ultimately to increase *** aim of this review article is to present the evidence on treatment of PC in different tumors,in order to provide patients with a proper surgical and multidisciplinary treatment focused on optimal control of their locoregional disease.

关键词： Carcinosis Peritoneal Ovarian Gastric Colorectal Hipec Intraperitoneal chemotherapy Cytoreductive surgery Cancer Advanced

Acute appendicitis: Epidemiology, treatment and outcomesanalysis of 16544 consecutive cases

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World Journal of Gastrointestinal Surgery 2016年第10期8卷 693-699页

作者： Marco Ceresoli Alberto Zucchi Niccolò Allievi Asaf Harbi Michele Pisano Giulia Montori Arianna Heyer Gabriela E Nita Luca Ansaloni federico coccolini General Surgery Unit Papa Giovanni XXIII Hospital24127 Bergamo Italy Epidemiology unit ATS Provincia Bergamo24128 Bergamo Italy University of California Berkeley CA 94720United States

AIM To investigate the epidemiology,treatment and outcomes of acute appendicitis(AA) in a large population *** This is a retrospective cohort study derived from the administrative dataset of the Bergamo district healthcare system(more than 1 million inhabitants) from 1997 to *** about treatment,surgery,length of stay were *** for each patients were registered data about relapse of appendicitis and hospital admission due to intestinal *** From 1997 to 2013 in the Bergamo district we collected 16544 cases of AA,with a crude incidence rate of 89/100000 inhabitants per year; mean age was 24.51 ± 16.17,54.7% were male and the mean Charlson's comorbidity index was 0.32 ± *** was < 0.0001%.Appendectomy was performed in 94.7% of the patients and the mean length of stay was 5.08 ± 2.88 d; the cumulative hospital stay was 5.19 ± 3.36 d and 1.2% of patients had at least one further hospitalization due intestinal *** appendectomy was performed in 48% of *** of 5.34 the patients were treated conservatively with a mean length of stay of 3.98 ± 3.96 d; the relapse rate was 23.1% and the cumulative hospital stay during the study period was 5.46 ± 6.05 *** The treatment of acute appendicitis in Northern Italy is slowly changing,with the large diffusion of laparoscopic approach; conservative treatment of non-complicated appendicitis is still a neglected option,but rich of promising results.

关键词： Acute appendicitis Conservative treatment Epidemiology Laparoscopic appendectomy Intestinal obstruction

Advanced gastric cancer:what we know and what we stillhave to learn

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World Journal of Gastroenterology 2016年第3期22卷 1139-1159页

作者： federico coccolini Giulia Montori Marco Ceresoli Simona Cima Maria Carla Valli Gabriela E Nita Arianna Heyer Fausto Catena Luca Ansaloni Department of General Surgery Papa Giovanni XXIII Hospital24127 BergamoItaly Radiation Oncology Center Department of ExperimentalDiagnostic and Specialty Medicine-DIMESSant’Orsola-Malpighi HospitalUniversity of Bologna40138 BolognaItaly Maria Carla Valli Radiation Oncology UnitOncology Institute of Southern Switzerland6500 BellinzonaSwitzerland University of California BerkeleyCA 94720-5800United States Department of General and Emergency Surgery Maggiore hospital43100 ParmaItaly

Gastric cancer is a common neoplastic disease and, more precisely, is the third leading cause of cancer death in the world, with differences amongst geographic areas. The definition of advanced gastric cancer is still debated. Different stadiating systems lead to slightly different stadiation of the disease, thus leading to variations between the single countries in the treatment and outcomes. In the present review all the possibilities of treatment for advanced gastric cancer have been analyzed. Surgery, the cornerstone of treatment for advanced gastric cancer, is analyzed first, followed by an investigation of the different forms and drugs of chemotherapy and radiotherapy. New frontiers in treatment suggest the growing consideration for intraperitoneal administration of chemotherapeutics and combination of traditional drugs with new ones. Moreover, the necessity to prevent the relapse of the disease leads to the consideration of administering intraperitoneal chemotherapy earlier in the therapeutical algorithm.

关键词： Advanced gastric cancer Chemotherapy hypertermic intraperitoneal chemotherapy IntraTOPIC peritoneal Surgery Definition

Preoperative colonic stents vs emergency surgery for acute left-sided malignant colonic obstruction: meta-analysis with systematic review of the literature

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World Journal of Meta-Analysis 2017年第1期5卷 1-13页

作者： Belinda De Simone Fausto Catena federico coccolini Salomone Di Saverio Massimo Sartelli Arianna Heyer Nicola De Angelis Gian Luigi De Angelis Luca Ansaloni Department of Emergency and Trauma Surgery University Hospital of Parma Department of General and Emergency Surgery Papa XXIII Hospital Department of General Surgery Maggiore Hospital of Bologna Department of Emergency and General Surgery Macerata’s Hospital Department of Medical Sciences University of California Liver Transplantation and General Surgery Unit Henry Mondor Hospital Department of Gastroenterology University Hospital of Parma

AIM To investigate by meta-analytic study and systematic review, advantages of colonic stent placement in comparison with emergency *** We conducted an extensive literature search by PubMed, Google Scholar, Embase and the Cochrane Libraries. We searched for all the papers in English published till February 2016, by applying combinations of the following terms: Obstructive colon cancer, colon cancer in emergency, colorectal stenting, emergency surgery for colorectal cancer, guidelines for obstructive colorectal cancer, stenting vs emergency surgery in the treatment of obstructive colorectal cancer, selfexpanding metallic stents, stenting as bridge to surgery. The study was designed following the PrismaStatement. By our search, we identified 452 studies, and 57 potentially relevant studies in full-text were reviewed by 2 investigators; ultimately, 9 randomized controlled trials were considered for meta-analysis and all the others were considered for systematic *** In the meta-analysis, by comparing colonic stenting(CS) as bridge to surgery and emergency surgery, the pooled analysis showed no significant difference between the two techniques in terms of mortality [odds ratio(oR) = 0.91], morbidity(oR = 2.38) or permanent stoma rate(oR = 1.67); primary anastomosis was more frequent in the stent group(oR = 0.45; P = 0.004) and stoma creation was more frequent in the emergency surgery group(oR = 2.36; P = 0.002). No statistical difference was found in disease-free survival and overall survival. The pooled analysis showed a significant difference between the colonic stent and emergency surgery groups(oR = 0.37), with a significantly higher 1-year recurrence rate in the stent group(P = 0.007).CONCLUSION CS improves primary anastomosis rate with significantly high 1-year follow-up recurrence and no statistical difference in terms of disease-free survival and overall survival.

关键词： Colonic stent Self-expandable metallic stent Obstructive left colon cancer Emergency surgery Endo-laparoscopic approach Oncological outcome

Peritoneal seeding from appendiceal carcinoma:A case report and review of the literature

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World Journal of Gastrointestinal Surgery 2010年第8期2卷 265-269页

作者： Valentina R Bertuzzo federico coccolini Antonio D Pinna Department of General Emergency and Transplant Surgery Sant'Orsola-Malpighi University Hospital

Non-carcinoid appendiceal malignancies are rare entities,representing less than 0.5% of all gastrointestinal *** of their rarity and particular biological behavior,a substantial number of patients affected by these neoplasms do not receive appropriate surgical *** this report,we describe a rare case of primary signetring cell carcinoma of the appendix with peritoneal seeding which occurred in a 40-year old man admitted at the Emergency Surgery Department with the clinical suspicion of acute *** a surgical debulking and right hemicolectomy,the patient had systemic chemotherapy according to FOLFOX *** completion of the latter,the patient underwent cytoreductive surgery plus hyperthermic intraperitoneal *** report offers a brief review of the literature and suggests an algorithm for the management of non-carci-noid appendiceal tumors with peritoneal dissemination.

关键词： Appendiceal neoplasms Signetring cell carcinoma Peritoneal carcinomatosis Hyperthermic intra-peritoneal chemotherapy Therapeutic algorithm