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Antegrade scrotal sclerotherapy of internal spermatic veins for varicocele treatment： technique, complications, and results

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Asian Journal of Andrology 2016年第2期18卷 292-295,J0007,J0008页

作者： Alessandro Crestani Gianluca Giannarini Mattia Calandriello Marta Rossanese Mariangela Mancini Giacomo Novara Vincenzo Ficarra Academic Medical Centre Hospital Santa Maria della Misericordia Udine Italy Department of oncologic Surgical and Gastrointestinal Sciences Urologic Unit PadovaItaly Department of Experimental and Clinic Medical Sciences Urology Unit University of Udine Udine Italy.

Varicocele repair is mainly indicated in young adult patients with clinical palpable varicocele and abnormal semen parameters. Varicocele treatment is associated with a significant improvement in sperm concentration, motility, morphology, and pregnancy rate. Antegrade scrotal sclerotherapy （ASS） represented one of the main alternatives to the traditional inguinal or suprainguinal surgical ligation. This article reviews the use of ASS for varicocele treatment. We provide a brief overview of the history of the procedure and present our methods used in ASS. In addition, we review complication and success of ASS, including our own retrospective data of treating 674 patients over the last 17 years. Herein, we analyzed step by step the ASS technique and described our results with an original modified technique with a long follow-up. Between December 1997 and December 2014, we performed 674 ASS. Mean operative time was 14 min （range 9 to 50 min）. No significant intraoperative complications were reported. Within 90 days from the procedure, postoperative complications were recorded in overall 49 （7.2%） patients. No major complications were recorded. A persistent/recurrent varicocele was detected in 40 （5.9%） cases. In 32/40 （80%） cases, patients showed preoperative grade III varicoceles. In patients with a low sperm number before surgery, sperm count improved from 13 x 106 to 21 x 106 m1-1 （P〈 0.001）. The median value of the percentage of progressive motile forms at 1 h improved from 25% to 45% （P 〈 0.001）. Percentage of normal forms increased from 17% before surgery to 35% 1 year after the procedure （P 〈 0.001）. In the subgroup of the 168 infertile patients, 52 （31%） fathered offspring at a 12-month-minimum follow-up. Therefore, ASS is an effective minimal invasive treatment for varicocele with low recurrence/persistence rate.

关键词： antegrade scrotal sclerotherapy male infertility outcomes varicocele

Current position of ALPPS in the surgical landscape of CRLM treatment proposals

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World Journal of Gastroenterology 2013年第39期19卷 6548-6554页

作者： Marcello Donati Gregor A Stavrou Karl J Oldhafer Department of General and Abdominal Surgery Asklepios Hospital Barmbek22291 HamburgGermany Department of Surgery General and Oncologic Surgery UnitVittorio-Emanuele University Hospital of Catania95122 CataniaItaly

The Authors summarize problems,criticisms but also advantages and indications regarding the recent surgical proposal of associating liver partition and portal vein ligation(PVL)for staged hepatectomy(ALPPS)for the surgical management of colorectal liver *** at published data,the technique,when compared with other traditional and well established methods such as PVL/portal vein embolisation(PVE),seems to give real advantages in terms of volumetric gain of future liver ***,major concerns are raised in the literature and some questions remain unanswered,preliminary experiences seem to be *** method has been adopted all over the world over the last 2 years,even if oncological long-term results remain unknown,and benefit for patients is *** prospective studies comparing traditional methods(PVE,PVL or classical 2 staged hepatectomy)with ALPPS are available to *** reinterpretations of the original method were also proposed in order to enhance feasability and increase safety of the *** data about morbidity and mortality are also *** real role of ALPPS is,to date,still to be *** clinical studies,even if,for ethical reasons,in well selected cohorts of patients,are expected to better define the indications for this new surgical strategy.

关键词： Portal ligation In situ split Liver resections Colorectal metastases Liver metastases

Complete mesocolic excision and central vascular ligation in colorectal cancer in the era of minimally invasive surgery

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World Journal of clinical Cases 2021年第25期9卷 7297-7305页

作者： Marzia Franceschilli Sara Di Carlo Danilo Vinci Bruno Sensi Leandro Siragusa Vittoria Bellato Roberto Caronna Piero Rossi Giuseppe Cavallaro Andrea Guida Simone Sibio Department of Surgery Minimally Invasive UnitTor Vergata University of RomeRome 00133Italy Department of Surgical Sciences Unit of Pancreatic and Biliary SurgerySapienza University of RomeRome 00161Italy Department of Surgery P Valdoni Unit of Oncologic and Minimally Invasive SurgerySapienza University of RomeRome 00161Italy

Since the 19th century,appropriate lymphadenectomy has been considered a cornerstone of oncologic surgery and one of the most important prognostic *** approach can be applied to any surgery for gastrointestinal *** surgery for colon and rectal cancer,an adequate portion of the mesentery is removed together with the segment of bowel affected by the *** adequate number of lymph nodes to be removed is standardized and reported by several *** is mandatory to determine the appropriate extent of lymphadenectomy and to balance its oncological benefits with the increased morbidity associated with its execution in cancer *** review focuses on the concept of“complete mesenteric excision(CME)with central vascular ligation(CVL),”a radical lymphadenectomy for colorectal cancer that has gained increasing interest in recent *** aim of this study was to evaluate the evolution of this approach over the years,its potential oncologic benefits and potential risks,and the improvements offered by laparoscopic *** advantages of CME are improved local-relapse rates due to complete removal of the intact mesocolic fascia and improved distance recurrence rates due to ligation of vessels at their origin(CVL)which guarantees removal of a larger number of lymph *** development and worldwide diffusion of laparoscopic techniques minimized postoperative trauma in oncologic surgery,providing the same oncologic results as open *** has been widely applied to colorectal cancer surgery;however,CME entails a technical complexity that can limit its wide minimally-invasive application. This review analyzesresults of these procedures in terms of oncological outcomes, technical feasibilityand complexity, especially within the context of minimally invasive surgery.

关键词： Complete mesenteric excision Central vascular ligation Colorectal cancer Lymphadenectomy Laparoscopy Minimally invasive surgery

Management of mucinous cystic neoplasms of the pancreas

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World Journal of Gastroenterology 2010年第45期16卷 5682-5692页

作者： Mario Testini Angela Gurrado Germana Lissidini Pietro Venezia Luigi Greco Giuseppe Piccinni unit of Endocrine Digestive and Emergency SurgeryDepartment of Biomedical Sciences and Human OncologySection of General and Oncologic SurgeryUniversity Medical School of Bari70124 BariItaly Department of Emergency and Organ Transplantation University Medical School of Bari70124 BariItaly

The purpose of this study was to investigate the actual management of mucinous cystic neoplasm (MCN) of the pancreas. A systematic review was performed in December 2009 by consulting PubMed MEDLINE for publications and matching the "pancreatic mucinous cystic neoplasm", "pancreatic mucinous cystic tumour", "pancreatic mucinous cystic mass", "pancreatic cyst", and "pancreatic cystic neoplasm" to identify English language articles describing the diagnosis and treatment of the mucinous cystic neoplasm of the pancreas. In total, 16 322 references ranging from January 1969 to December 2009 were analysed and 77 articles were identified. No articles published before 1996 were selected because MCNs were not previously considered to be a completely autonomous disease. Definition, epidemiology, anatomopathological findings, clinical presentation, preoperative evaluation, treatment and prognosis were reviewed. MCNs are pancreatic mucinproducing cysts with a distinctive ovarian-type stroma localized in the body-tail of the gland and occurring in middle-aged females. The majority of MCNs are slow growing and asymptomatic. The prevalence of invasive carcinoma varies between 6% and 55%. Preoperative diagnosis depends on a combination of clinical features, tumor markers, computed tomography (CT), magnetic resonance imaging, endoscopic ultrasound with cyst fluid analysis, and positron emission tomography-CT. Surgery is indicated for all MCNs.

关键词： Pancreatic cystic lesion Pancreatic mucinous cystic neoplasm Pancreatic mucin-producing cysts Pancreatic cystic neoplasm Pancreatic ovarian-type stroma

Robotic approach with neoadjuvant chemotherapy in adult Wilms’ tumor: A feasibility study report and a systematic review of the literature

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Asian Journal of Urology 2023年第2期10卷 128-136页

作者： Simone Sforza Valeria Emma Palmieri Maria Rosaria Raspollini Giandomenico Roviello Alberto Mantovani Umberto Basso Maria Carmen Affinita Alberto D’Angelo Lorenzo Antonuzzo Marco Carini Andrea Minervini Lorenzo Masieri Department of oncologic Minimally-Invasive Urology and AndrologyCareggi HospitalUniversity of FlorenceFlorenceItaly Department of Pediatric Urology Meyer Children HospitalUniversity of FlorenceFlorenceItaly clinical oncologic unit Careggi HospitalUniversity of FlorenceFlorenceItaly Histopathology and Molecular Diagnostics Careggi HospitalUniversity of FlorenceFlorenceItaly Medical Oncology unit 1 Istituto Oncologico Veneto IOV IRCCSPaduaItaly Hematology Oncology Division Department of Women’s and Children’s HealthPadova University HospitalPaduaItaly Department of Biology and Biochemistry University of BathBathUK

Objective:The incidence of Wilms’tumor(WT)among adult individuals accounts for less than 1%of kidney cancer cases,with a prognosis usually less favorable when compared to younger individuals and an overall survival rate of 70%for the adult patients versus 90%for the pediatric *** diagnosis and treatment of WT are complex in the preoperative setting;neoadjuvant chemotherapy(NAC)or robotic surgery has rarely been *** study aimed to review the literature of robotic surgery in WT and report the first adult WT management using both NAC and robotic ***:We reported a case of WT managed in a multidisciplinary ***,according to Preferred Reporting Items for Systematic reviews and Meta-Analyses recommendations,a systematic review of the literature until August 2020 of WT treated with a robotic approach was carried ***:A 33-year-old female had a diagnosis of *** was scheduled to NAC,and according to the clinical and radiological response to a robotic radical nephrectomy with aortic lymph nodes dissection,she was managed with no intraoperative rupture,a favorable surgical outcome,and a follow-up of 25 months,which did not show any *** systematic review identified a total number of 230 cases of minimally invasive surgery reported in the literature for *** these,approximately 15 patients were carried out using robotic surgery in adolescents while none in ***,NAC has not been administered before minimally invasive surgery in adults up until ***:WT is a rare condition in adults with only a few cases treated with either NAC or minimally invasive approach so *** advantage of NAC followed by the robotic approach could lead to favorable outcomes in this complex ***,additional cases of adult WT need to be identified and investigated to improve the oncological outcome.

关键词： Nephroblastoma Nephrectomy Renal neoplasm Minimally invasive surgery Rare tumor

Management protocol for Fournier’s gangrene in sanitary regime caused by SARS-CoV-2 pandemic:A case report

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World Journal of clinical Cases 2021年第5期9卷 1215-1220页

作者： Agnieszka Grabińska Łukasz Michalczyk Beata Banaczyk Tomasz Syryło Tomasz Ząbkowski Department of Urology Military Institute of MedicineWarsaw 04-141Poland Department of Urology and oncologic Urology Praski Hospital in WarsawWarsaw 04-141Poland

BACKGROUND Fournier's gangrene(FG)is a serious,aggressive and often deadly polymicrobial infection of the soft tissues of the perineum,the rectum and the external genital *** is an anatomical subcategory of necrotizing fasciitis,which has a similar etiology and treatment *** SUMMARY A 60-year-old man was admitted to the hospital during severe acute respiratory syndrome coronavirus 2 pandemic with complaints of fever up to 38.9°C,abdominal pain,and edema of the scrotum,the penis,the perineum,and the right gluteal region for 2 *** tomography of the abdomen and the pelvis revealed extensive inflammatory infiltrations of the subcutaneous tissue of the hypogastrium,and the penis;along with liquefaction and presence of gas in the subcutaneous tissues of the scrotum,the perineum,and the right gluteal *** patient was diagnosed with FG,and was urgently qualified to undergo surgery in the Department of *** performing the necessary examinations,a resection of the necrotic tissues with bilateral orchiectomy and excision of the penile and scrotal skin was *** surgery,he was transferred to the intensive care unit for further *** Early management prevents the resection of the other organs by inhibiting the contiguous spread of infection.

关键词： Fournier’s gangrene Management Negative pressure wound therapy Treatment Orchiectomy Case report Necrotic tissues SARS-CoV-2

Which octogenarian patients are at higher risk after cholecystectomy for symptomatic gallstone disease? A single center cohort study

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World Journal of clinical Cases 2022年第24期10卷 8556-8567页

作者： Fabrizio D'Acapito Leonardo Solaini Daniela Di Pietrantonio Francesca Tauceri Maria Teresa Mirarchi ElenaAntelmi Francesca Flamini Alessio Amato Massimo Framarini Giorgio Ercolani Department of General and oncologic Surgery Morgagni-Pierantoni HospitalAUSL RomagnaForlì47121Italy Department of Medical and Surgical Sciences University of BolognaBologna 40126Italy

BACKGROUND Incidence of gallstones in those aged≥80 years is as high as 38%-53%.The decision-making process to select those oldest old patients who could benefit from cholecystectomy is *** To assess the risk of morbidity of the“oldest-old”patients treated with cholecystectomy in order to provide useful data that could help surgeons in the decision-making process leading to surgery in this *** A retrospective study was conducted between 2010 and *** variables were collected and compared between patients who had postoperative complications.A model was created and tested to predict severe postoperative *** The 269 patients were included in the study(193 complicated).The 9.7%of complications were grade 3 or 4 according to the Clavien-Dindo *** levels were lower in patients who did not have any postoperative *** Society of Anesthesiologists scale 4 patients,performing a choledocholithotomy and bilirubin levels were associated with Clavien-Dindo>2 complications(P<0.001).The decision curve analysis showed that the proposed model had a higher net benefit than the treating all/none options between threshold probabilities of 11%and 32%of developing a severe *** Patients with American Society of Anesthesiologists scale 4,higher level of bilirubin and need of choledocholithotomy are at the highest risk of a severely complicated postoperative *** endoscopic or percutaneous treatments should be considered in this subgroup of octogenarians.

关键词： Cholecystitis Gallstones Choledocholithotomy Elderly Post-operative complications

Relationship between Full-Field Digital Mammographic Features and Clinicopathologic Characteristics in 176 Cases with Breast Cancer

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Chinese Journal of clinical Oncology 2005年第5期2卷 781-786页

作者： Zhe Sun Hongwei Liang Huimian Xu Department of oncologic Surgery First Affiliated Hospital China Medical University Shenyang 110001 China.

OBJECTIVE Different mammographic features are probably predictive of different prognosis. However, ambiguity still exists in understanding the relationship between them. In resent years, digital mammography has been available for clinical use which has led to a revolution in the resolving of images and an increase in early-stage breast cancer detection. Based on the above knowledge, this study was performed to evaluate the relationship between full-field digital mammographic features and clinicopathologic characteristics in breast cancer. METHODS Digital mammograms of 176 patients with pathologically proven breast cancer were reviewed. Also, clinical and pathologic records （histological types and axillary lymph nodes status） were retrospectively examined. RESULTS Most of the patients with a solitary microcalcification were young women under the age of 50（84.4%）, but the majority of the patients with microcalcifications complicated by a mass were elderly women. Microcalcifications detected by mammography occurred frequently in ductal carcinoma in situ （28.1%） and in early invasive carcinoma （15.6%）. Breast cancers with expression of microcalcifications combined with a spiculate mass had a high metastatic rate of axillary lymph nodes （69.4%）. A high metastatic rate of axillary lymph nodes was also found in the patients with solitary worm-like microcalcifications （57.1%）, solitary spiculate mass （53.7%） and solitary non-worm-like microcalcifications （44.4%）. Simple worm-like microcalcifications accompanied with metastasis of 4 to 9 axillary lymph nodes occurred in 42.9% of the（6/14） cases. The patients with microcalcifications combined by a spiculate mass and with metastasis of 4 to 9 axillary lymph nodes accounted for 27.8% （10/36） of the cases, and those with metastases of 10 and over accounted for 16.7% （6/36）. CONCLUSION Solitary microcalcifications occur frequently in young women and are usually associated with early breast cancer. There is a close relationship be

关键词： breast neoplasms full-field digital mammography microcaldflcations.

Chondrosarcoma of the Hand: A Literature Review

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Journal of Cancer Therapy 2014年第4期5卷 403-409页

作者： Daniele Stomeo Antonio Tulli Antonio Ziranu Federica Mariotti Giulio Maccauro Hand Surgery unit Department of Geriatrics Neuroscience and Orthopedics Catholic University Rome Italy Orthopedic oncologic unit Department of Geriatrics Neuroscience and Orthopedics Catholic University Rome Italy

Chondrosarcoma (CS) is a malignant neoplasm of mesenchymal origin characterized by the formation of cartilaginous matrix by neoplastic cells. It is very variable in presentation, clinical, genetic and anatomo-pathological features. CS is more often found in the pelvis and the proximal long bones (femur, humerus). Localization to the small bones of the hand is very rare and it represents a diagnostic and therapeutic challenge. CSs are malignancies resistant to both radiation and chemotherapy . Surgical treatment is the only mean available. As opposed to CSs located elsewhere, CS of the hand is characterized by local recurrence and very low metastatic potential. In order to definitely set a diagnosis of chondrosarcoma in this region, comparison of histological and radiological findings is paramount. The principle goal of surgery shall be minimizing functional impairment. This provides the rationale for performing curettage, local adjuvant therapy and bone grafting in low-grade lesions.

关键词： Chondrosarcoma Chondrogenic Tumour Hand Finger Digit Treatment Surgery VEGF