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robotic vs laparoscopic right colectomy—the burden of age and comorbidity in perioperative outcomes: An observational study

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World Journal of Gastrointestinal surgery 2020年第6期12卷 287-297页

作者： Fulvio Tagliabue Morena Burati Marco Chiarelli Luca Fumagalli Angelo Guttadauro Elisa Arborio Matilde De Simone Ugo Cioffi department of robotic and emergency surgery Ospedale A.ManzoniASST LeccoLecco 23900Italy department of surgery University of Milan-BicoccaIstituti Clinici ZucchiMonza 20900Italy department of surgery University of MilanMilano 20122Italy

BACKGROUND Several studies have shown the safety,feasibility and oncologic adequacy of robotic right hemicolectomy(RRH).Laparoscopic right hemicolectomy(LRH)is considered technically *** surgery has been introduced to overcome this technical limitation,but it is related to high *** maximize the benefits of such surgery,only selected patients are candidates for this *** addition,due to progressive aging of the population,an increasing number of minimally invasive procedures are performed on elderly patients with severe comorbidities,who are usually more prone to post-operative *** To investigate the outcomes of RRH vs LRH with regard to age and *** We retrospectively analyzed 123 minimally invasive procedures(68 LRHs vs 55 RRHs)for right colon cancer or endoscopically unresectable adenoma performed in our Center from January 2014 until September *** surgical procedures were performed according to standardized *** primary clinical outcome of the study was the length of hospital stay(LOS)measured in *** outcomes were time to first flatus(TFF)and time to first stool *** robotic technique was considered the exposure and the laparoscopic technique was considered the *** demographic variables were obtained,including age at time of surgery and *** mass index and American Society of Anesthesiologists physical status were *** age-adjusted Charlson Comorbidity Index(ACCI)was calculated;the tumornode-metastasis system,intra-operative variables and post-operative complications were ***-operative follow-up was 180 *** LOS,TFF,and time to first stool were significantly shorter in the robotic group:Median 6[interquartile range(IQR)5-8]vs 7(IQR 6-10.5)d,P=0.028;median 2(IQR 1-3)vs 3(IQR 2-4)d,Probotic technique was confirmed to be predictive

关键词： Right hemicolectomy robotic surgery Laparoscopic surgery Elderly patients Comorbidity Hospital stay

Cerebral fat embolism following autologous fat injection in facial reconstruction:A case report

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World Journal of Clinical Cases 2025年第2期13卷 50-58页

作者： Xiu-Ying Chen Fa Shen Chang Cheng Yu-Han Wang Wen-Chao Cheng De-Zhi Yuan Wen Huang department of Neurology Chongqing Emergency Medical CenterChongqing University Central HospitalChongqing 400000China department of Neurology Xinqiao HospitalThe Army Medical University(Third Military Medical University)Chongqing 400000China

BACKGROUND Autologous fat injection in facial reconstruction is a common cosmetic *** cerebral fat embolism(CFE)as a complication is rare,it carries serious health *** SUMMARY We present a case of a 29-year-old female patient who developed acute CFE following facial fat filling *** the surgery,the patient experienced symptoms including headache,nausea,vomiting,and difficulty breathing,which was followed by neurological symptoms such as slurred speech and left-sided *** physical examination and auxiliary investigations,including blood tests,head and neck computed tomography angiography,and cranial magnetic resonance diffusion-weighted imaging,were performed upon *** clinical diagnosis was acute cerebral embolism following facial fat filling *** included measures to improve cerebral circulation,dehydration for intracranial pressure reduction,nutritional support,and rehabilitation therapy for left limb *** patient showed a significant improvement in symptoms after 2 weeks of *** recovered left limb muscle strength to grade 5,had clear speech,and experienced complete relief of *** Our case highlights the potential occurrence of severe complications in patients undergoing fat injection in facial *** prevent these complications,plastic surgeons should enhance their professional knowledge and skills.

关键词： Cerebral fat embolism Mechanical thrombectomy Thrombolysis Steroid therapy Symptomatic treatment Case report

Rethinking the Barcelona clinic liver cancer guidelines:Intermediate stage and Child-Pugh B patients are suitable for surgery?

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World Journal of Gastroenterology 2021年第21期27卷 2784-2794页

作者： Fabrizio Romano Marco Chiarelli Mattia Garancini Mauro Scotti Mauro Zago Gerardo Cioffi Matilde De Simone Ugo Cioffi department of surgery School of Medicine and SurgeryUniversity of Milano-BicoccaMonza 20900Italy emergency and robotic surgery A.Manzoni HospitalASST LeccoLecco 23900Italy department of General surgery San Gerardo HospitalMonza 20900Italy department of Sciences and Technologies Universitàdegli Studi del Sannio di BeneventoBenevento 82100Italy department of surgery University of MilanMilano 20122Italy

According to Barcelona Clinic Liver Cancer recommendations,intermediate stage hepatocellular carcinomas(stage B)are excluded from liver resection and are referred to palliative ***,Child-Pugh B patients are not usually candidates for liver ***,many hepatobiliary centers in the world manage patients with intermediate stage hepatocellular carcinoma or Child-Pugh B cirrhosis with liver resection,maintaining that hepatic resection is not contraindicated in selected patients with non–early-stage hepatocellular carcinoma and without normal liver *** studies demonstrate that resection provides the best survival benefit for selected patients in very early/early and even in intermediate stages of Barcelona Clinic Liver Cancer classification,and this treatment gives good results in the setting of multinodular,large tumors in patients with portal hypertension and/or Child-Pugh B *** this review we explore this controversial topic,and we show through the literature analysis how liver resection may improve the short-and long-term survival rate of carefully selected Barcelona Clinic Liver Cancer B and Child-Pugh B hepatocellular carcinoma ***,other large clinical studies are needed to clarify which patients with intermediate stage hepatocellular carcinoma are most likely to benefit from liver resection.

关键词： Liver surgery Hepatocellular carcinoma Barcelona liver clinic cancer Child B Intermediate stage

Left colonic metastasis from primary hepatocellular carcinoma: A case report

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World Journal of Clinical Cases 2019年第15期7卷 2044-2048页

作者： Fulvio Tagliabue Morena Burati Marco Chiarelli Alessandro Marando Matilde De Simone Ugo Cioffi department of emergency and robotic surgery Ospedale“A Manzoni”Lecco via Dell’Eremo 9/11Lecco 23900Italy department of Pathology Ospedale“A Manzoni”Lecco via Dell’Eremo 9/11Lecco 23900Italy department of surgery University of MilanMilano 20122Italy

BACKGROUND Hepatocellular carcinoma(HCC)accounts for 5-6%of all human *** the extrahepatic metastasis,the main organs involved are lymphnodes,lung,bone and adrenal *** colon metastasis is very rare,especially on the left sided *** SUMMARY We report a case of a 70 years-old man hepatitis B carrier with HCC treated four times with trans-arterial chemoembolization,presented to our surgical department complaining of gastrointestinal bleeding.A colonoscopy revealed a mass of 4 cm of the sigmoid colon with signs of *** computed tomography showed a mass originated from the sigmoid colon of 3.5 cm,and the presence of HCC in segment VI and VII,without portal vein *** to the large size of the mass and the active bleeding,the patient underwent a left *** postoperative period was uneventful,and the patient was discharged in fifth post-operative *** examination revealed that the neoplasm was characterized by a diffuse proliferation of epithelial cells with an hepatoid ***,the presence of a history of HCC of the liver and the histopathological features supported the diagnosis of metastasis from the *** Although rare,colon metastasis from an HCC can be left-sided and can present with acute bleeding.

关键词： Hepatocellular carcinoma Colon metastasis Case report

robotic-assisted placement of hepatic artery infusion pump for the treatment of colorectal liver metastases:Role of indocyanine green(with video)

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Hepatobiliary & Pancreatic Diseases International 2022年第4期21卷 387-391页

作者： Mario Spaggiari Kiara A Tulla Gabriela Aguiluz Pierpaolo Di Cocco Lola Castro Gil Enrico Benedetti Ivo G Tzvetanov Pier Cristoforo Giulianotti Division of Transplantation Department of SurgeryUniversity of Illinois at ChicagoChicagoILUSA Division of General Minimally Invasiveand Robotic SurgeryDepartment of SurgeryUniversity of Illinois at ChicagoChicagoILUSA

Surgical resection remains the only definitive treatment for colorectal liver metastasis(CRLM). However, only a minority of cases are deemed resectable at the time of diagnosis. Systemic chemotherapy along with hepatic artery infusion(HAI) is an effective and safe regional chemotherapy modality for the downstaging of patients with isolated unresectable CRLM [1].

关键词： chemotherapy liver artery treatment metastasis

New parameter in diagnosis of acute appendicitis:Platelet distribution width

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World Journal of Gastroenterology 2015年第6期21卷 1821-1826页

作者： Bulent Dinc Alten Oskay Selcan Enver Dinc Bilge Bas Sabri Tekin department of General surgery Ataturk State Hospital department of emergency Denizli State Hospital department of emergency Isparta State Hospital department of Gastroenterology Ataturk State Hospital department of surgery Medical Park Hospitals

AIM:To investigate the diagnostic accuracy of the mean platelet volume and platelet distribution width in acute ***:This retrospective,case-controlled study compared 295 patients with acute appendicitis(Group?Ⅰ),100 patients with other intra-abdominal infections(GroupⅡ),and 100 healthy individuals(GroupⅢ)between January 2012 and January *** age,gender,and white blood cell count,neutrophil percentage,mean platelet volume,and platelet distribution width values from blood samples were compared among the *** analyses were performed using SPSS for Windows 21.0 *** addition,the sensitivity,specificity,positive and negative predictive values and likelihood ratios,and diagnostic accuracy were ***:The mean ages of patients were 29.9±12.0years for Group?Ⅰ,31.5±14.0 years for GroupⅡ,and30.4±13.0 years for GroupⅢ.Demographic features such as age and gender were not significantly different among the *** blood cell count,neutrophil percentage and platelet distribution width were significantly higher in Group?Ⅰ?compared to groupsⅡandⅢ(P<0.05).Diagnostically,the sensitivity,specificity and diagnostic accuracy were 73.1%,94.0%,and 78%for white blood cell count,70.0%,96.0%,and 76.0%for neutrophil percentage,29.5%,49.0%,and 34.0%for mean platelet volume,and 97.1%,93.0%,and 96.0%for platelet distribution width,*** highest diagnostic accuracy detected was for platelet distribution width between Group?Ⅰ?and GroupⅢ(P<0.01).CONCLUSION:Platelet distribution width analysis can be used for diagnosis of acute appendicitis without requiring additional tests,thus reducing the cost and loss of time.

关键词： Appendicitis Diagnosis Platelet function test Plat

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

Trauma-induced“Macklin effect”with pneumothorax and large pneumomediastinum,disguised by allergy

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Frontiers of Medicine 2013年第3期7卷 386-388页

作者： Salomone Di Saverio Kenji Kawamukai Andrea Biscardi Silvia Villani Luca Zucchini Gregorio Tugnoli departments of emergency and surgery Emergency Surgery and Trauma Surgery UnitTrauma CenterMaggiore Hospital-Bologna Local Health DistrictBolognaItaly department of Thoracic surgery Trauma CenterMaggiore HospitalBolognaItaly Accident and emergency Trauma CenterMaggiore HospitalBolognaItaly

A 56-year-old man presented spontaneously to the emergency department complaining of facial and neck oedema after assumption of nonsteroidal anti-inflammatory drugs(NSAIDS).The triage nurse assigned the patient to Accident&emergency(A&E)doctor as probable allergic reaction to *** X-ray(CXR),ordered after 24 hours,revealed a huge subcutaneous chest and neck emphysema without clearly visible *** chest CT scan showed a small left pneumothorax and a large amount of air in the *** patient was conservatively treated since he was eupnoeic and hemodynamically *** pathophysiology of pneumomediastinum was first described by Macklin in *** Macklin effect involves alveolar ruptures with air dissection along bronchovascular sheaths to the *** this case the patient did not report in his history a recent blunt thoracic trauma and the initial suspicion of an allergic reaction has prevented physicians to immediately achieve the correct diagnosis.

关键词： thoracic trauma differential diagnosis critical care pneumothorax pneumomediastinum CT scan pitfalls lung and airways physiology

Guidelines for navigation-assisted spine surgery

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Frontiers of Medicine 2020年第4期14卷 518-527页

作者： Wei Tian Bo Liu Da He Yajun Liu Xiaoguang Han Jingwei Zhao Mingxing Fan International Society for Computer Assisted Orthopaedic surgery 1 department of Spine surgery Beijing Jishuitan HospitalBeijing 100035China Beijing Key Laboratory of robotic Orthopaedics Beijing 100035China

Spinal surgery is a technically demanding and challenging procedure because of the complicated anatomical structures of the spine and its proximity to several important *** landmarks and fluoroscopy have been used for pedicle screw insertion but are found to produce inaccuracies in *** the safety and accuracy of spinal surgery has increasingly become a clinical *** navigation is an extension and application of precision medicine in orthopaedic surgery and has significantly improved the accuracy of spinal ***,no clinical guidelines have been published for this relatively new and fast-growing technique,thus potentially limiting its *** accordance with the consensus of consultant specialists,literature reviews,and our local experience,these guidelines include the basic concepts of the navigation system,workflow of navigation-assisted spinal surgery,some common pitfalls,and recommended *** work helps to standardize navigation-assisted spinal surgery,improve its clinical efficiency and precision,and shorten the clinical learning curve.

关键词： guidelines spine surgery computer-assisted navigation