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Solid pseudopapillary tumor of the pancreas:A systematic review of clinical,surgical and oncological characteristics of 1384 patients underwent pancreatic surgery

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Hepatobiliary & Pancreatic Diseases International 2024年第4期23卷 331-338页

作者： Gennaro Mazzarella Edoardo Maria Muttillo Diego Coletta Biagio Picardi Stefano Rossi Simone Rossi Del Monte Vito Gomes Irnerio Angelo Muttillo Division of General and Emergency surgery San Filippo Neri Hospital00136 RomeItaly department of surgery“pietro valdoni” Sapienza University of RomeViale del Policlinico 15500161 RomeItaly Surgical and Medical department of Translational Medicine Sant’Andrea HospitalSapienza University of Rome00185 RomeItaly department of Surgical Sciences Umberto I University HospitalSapienza University of Rome00136 RomeItaly department of General surgery Ospedali Riuniti Marche Nord61121 PesaroItaly department of Pathology San Filippo Neri Hospital00136 RomeItaly

Background:Pancreatic solid pseudopapillary tumors(SPTs)are rare clinical entity,with low malignancy and still unclear *** account for less than 2%of exocrine pancreatic *** study aimed to perform a systematic review of the main clinical,surgical and oncological characteristics of pancreatic *** sources:MEDLINE/PubMed,Web of Science and Scopus databases were systematically searched for the main clinical,surgical and oncological characteristics of pancreatic SPTs up to April 2021,in accordance with the preferred reporting items for systematic reviews and meta-analyses(PRISMA)*** endpoints were to analyze treatments and oncological ***:A total of 823 studies were recorded,86 studies underwent full-text reviews and 28 met inclusion ***,1384 patients underwent pancreatic *** age was 30 years and 1181 patients(85.3%)were *** most common clinical presentation was non-specific abdominal pain(52.6%of cases).Mean overall survival was 98.1%.Mean recurrence rate was 2.8%.Mean follow-up was 4.2 ***:Pancreatic SPTs are rare,and predominantly affect young women with unclear *** resection is the gold standard of treatment achieving good oncological impact and a favorable prognosis in a yearly life-long follow-up.

关键词： Frantz’s tumor Pancreas Pancreatic neoplasms Pancreatic surgery Solid pseudopapillary tumor

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Extent of lymphadenectomy and perioperative therapies:two open issues in gastric cancer

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World Journal of Gastroenterology 2014年第14期20卷 3889-3904页

作者： Andrea Giuliani Michelangelo Miccini Luigi Basso department of surgery "pietro valdoni" "Sapienza" University of RomeMedical School

Gastric cancer is one of the leading causes of death for cancer worldwide,although geographical variations in incidence *** the last decades,its incidence and mortality have gradually decreased in Western countries,while these have increased,or remained stable,in the other world *** cancer is often diagnosed at an advanced stage,with the only notable exception of Japan,where nationwide screening programs are enforced,due to local high *** surgery(i.e.,gastrectomy,total or partial,and lymphadenectomy)remains the cornerstone of treatment of gastric *** has been debated about the extent of lymph node dissection and,although it is a valuable contribution to staging and cure,operative treatment only represents one aspect of overall effective management,as the risk of both locoregional and distant recurrences are high,and bear a poor *** a matter of fact,surgery,as a single modality treatment,has probably achieved its maximum efficacy for local control and survival,while other accompanying nonsurgical treatment modalities have to be taken into account,although their role is still the subject of considerable *** authors in this review present an update on the outcome of treatment of gastric cancer in relation to the extent of lymphadenectomy and of various nonsurgical preoperative,intraoperative,and postoperative strategies.

关键词： Gastric cancer Adenocarcinoma Postoperative Preoperative Chemoradiotherapy Chemotherapy Radiotherapy Intraperitoneal Randomized controlled trial Meta-analysis

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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

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Radical cholecystectomy without liver resection for peritoneal side early incidental gallbladder cancer

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World Journal of Gastroenterology 2024年第32期30卷 3739-3742页

作者： Gaetano Piccolo Matteo Barabino Guglielmo NiccolòPiozzi Paolo pietro Bianchi department of Health Sciences(DISS) University of MilanSan Paolo HospitalMilan 20142LombardyItaly department of Colorectal surgery Portsmouth Hospitals University NHS TrustPortsmouthUnited Kingdom

Gallbladder cancer(GBC)is a rare disease with a poor *** cholecystectomy may be an adequate treatment only for very early disease(Tis,T1a),whereas reoperation is recommended for more advanced disease(T1b and T2).Radical cholecystectomy should have two fundamental objectives:To radically resect the liver parenchyma and to achieve adequate clearance of the lymph ***,recent studies have shown that compared with lymph node dissection alone,liver resection does not improve survival *** oncological roles of lymphadenectomy and liver resection is ***,for patients with incidental GBC without liver invasion,hepatic resection is not always mandatory.

关键词： Incidental gallbladder cancer Reoperation Radical cholecystectomy Early stage Liver resection

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Autoimmune pancreatitis:Cornerstones and future perspectives

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World Journal of Gastroenterology 2024年第8期30卷 817-832页

作者： Camilla Gallo Giulia Dispinzieri Nicola Zucchini pietro Invernizzi Sara Massironi Division of Gastroenterology and Center for Autoimmune Liver Diseases Department of Medicine and SurgeryFondazione IRCCS San Gerardo dei TintoriUniversity of Milano-BicoccaMonza 20900Italy department of Pathology Fondazione IRCCS San Gerardo dei TintoriMonza 20900Italy

Autoimmune pancreatitis(AIP)is an autoimmune subtype of chronic pancreatitis resulting from the aberrant immune response against the pancreas,leading to inflammation and *** AIP is rare,its incidence is increasing and is often misdiagnosed as other pancreatic *** is commonly classified into two *** 1 AIP(AIP-1)is typically associated with elevated serum immunoglobulin G4(IgG4)levels and systemic manifestations,while type 2 AIP is typically a more localized form of the disease,and may coexist with other autoimmune disorders,especially inflammatory bowel ***,there is emerging recognition of a third type(type 3 AIP),which refers to immunotherapy-triggered AIP,although this classification is still gaining acceptance in medical *** clinical manifestations of AIP mainly include painless jaundice and weight *** serum IgG4 levels are particularly characteristic of *** relies on a combination of clinical,laboratory,radiological,and histological findings,given the similarity of AIP symptoms to other pancreatic *** mainstay of treatment for AIP is steroid therapy,which is effective in most *** cases might require additional imm-unosuppressive *** review aims to summarize the current knowledge of AIP,encompassing its epidemiology,etiology,clinical presentation,diagnosis,and treatment *** also address the challenges and controversies in diagnosing and treating AIP,such as distinguishing it from pancreatic cancer and managing long-term treatment,highlighting the need for increased awareness and knowledge of this complex disease.

关键词： Autoimmunity Pancreatitis Autoimmune pancreatitis Immunoglobulin G4 Steroids Relapse

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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

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Current highlights on solid pseudopapillary neoplasm of the pancreas

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World Journal of Hepatology 2022年第1期14卷 300-303页

作者： Simone Sibio Sara Di Carlo department of surgery pietro valdoni Sapienza University of RomeUmberto I HospitalRome 00161Italy Minimally Invasive surgery Unit Tor Vergata HospitalTor Vergata University of RomeRome 00133Italy

Solid pseudopapillary neoplasm of the pancreas is a low-grade malignant tumor that predominantly affects young women in their third and fourth *** and risk factors are *** symptoms are aspecific and most commonly due to mass *** is made by computed tomography scan or magnetic resonance imaging and histological characterization is obtained by endoscopic ultrasound-guided fine needle ***,these lesions are composed by both solid and pseudopapillary structures with necrotic and hemorrhagic ***,the biological behavior is aggressive with tumor recurrence and distant ***,curative R0 surgical resection is the best option able to provide long term survival even in advanced *** disease is the main predictor of poor *** and radiotherapy regimens are not well ***,they could be effective in reducing tumor size as neoadjuvant treatment or disease control in palliative *** complete surgical resection provides a cure rate of>95%,considering young age of the patients and morbidity associated to pancreatic surgery,further studies are needed to better investigate risk factors and responsiveness to hormones in order to allow early diagnosis and follow up strategies that could avoid unnecessary surgery in less aggressive disease.

关键词： Pseudopapillary neoplasm Pancreatic tumor Pancreaticoduodenectomy Distal pancreatectomy Pancreas surgery

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Isolated Multifocal Sclerosing Thyroiditis: Case Report

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Surgical Science 2013年第3期4卷 213-215页

作者： Annalisa Paliotta Giuseppe Pedullà Daniele Crocetti Giuseppe Cavallaro Giuseppe D’Ermo Andrea Polistena Giorgio De Toma department of surgery “pietro valdoni” Policlinico Umberto I University of Rome “Sapienza” Rome Italy

Multifocal fibrosclerosis is a very rare fibroproliferative syndrome involving multiple organ systems. In our report we present the case of multifocal sclerosing thyroiditis characterized by multiple fibroelastic foci similar to breast “radial scar”, which can be misdiagnosed as multifocal papillary carcinoma. The diagnosis of multifocal sclerosing thyroiditis, in according with Armed Forces Institute of Pathology (AFIP) textbook on thyroid tumors, was made only after histological and himmunohistochemical examination. We consider the multifocal sclerosing thyroiditis as the first stage of multifocal IgG4-related sclerosing disease for the presence of IgG4 within fibrosclerotic tissue of thyroid. Total body CT-scan and plamatic IgG4 levels must be investigated in order to exclude or confirm the presence of systemic disease.

关键词： Multifocal Sclerosing Thyroiditis surgery IgG4-Related Sclerosing

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Giant xanthogranuloma of the pelvis with S1 origin: Complete removal with only posterior approach, technical note

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World Journal of Clinical Cases 2015年第1期3卷 77-80页

作者： Nicola Marotta Alessandro Landi Cristina Mancarella Pierluigi Rocco Andrea Pietrantonio Gaspare Galati Antonio Bolognese Roberto Delfini department of Neurology and Psychiatry Division of NeurosurgeryPoliclinico Umberto I "La Sapienza" Università di Roma00161 Rome Italy department of General surgery "pietro valdoni" Policlinico Umberto I "La Sapienza" Università di Roma 00161 Rome Italy

Xanthogranulomas(XG) are benign proliferative disorder of histiocytes, a non-Langerhans cell histiocytosis. Whose etiology is unknown. The nature of these lesions is controversial and could be either reactive or neoplastic;the presence of monoclonal cells does, however, favor the second hypothesis. Xanthogranuloma is frequently found in young adults and children(under 20 years old), mainly in the skin. In about 5%-10% of all Juvenile XG(JXG) cases xanthogranuloma are extracutaneous. Within this group, the site most frequently involved is the eye. Other involved organs are heart, liver, adrenals, oropharynx, lung, spleen, central nervous system and subcutaneous tissue, although involvement of the spine is uncommon. Isolated lesions involving the sacral region are extremely rare. To date, this is the first reported case of a giant JXG arising from S1 with extension into the pelvic region in an adult spine.

关键词： Xanthogranulomas Non-Langerhans cell histiocytosis Touton giant cells Congenital xanthoma Neurofibromatosis

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Benefits of minimally invasive surgery in the treatment of gastric cancer

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World Journal of Gastroenterology 2022年第30期28卷 4227-4230页

作者： Simone Sibio Francesca La Rovere Sara Di Carlo department of surgery P.valdoni Unit of Oncologic and Minimally Invasive SurgerySapienza University of RomeUmberto I University HospitalRome 00161Italy Minimally Invasive surgery Unit Department of SurgeryTor Vergata UniversityRome 00133Italy

We read with great interest the article that retrospectively analyzed 814 patients with primary gastric cancer,who underwent minimally invasive R0 gastrectomy between 2009 and 2014 by grouping them in laparoscopic vs robotic *** results of the study highlighted that age,American Society of Anesthesiologists status,gastrectomy type and pathological T and N status were the main prognostic factors of minimally invasive gastrectomy and showed how the robotic approach may improve long-term outcomes of advanced gastric *** to most of the current literature,robotic surgery is associated with a statistically longer operating time when compared to open and laparoscopic surgery;however,looking at the adequacy of resection,defined by negative surgical margins and number of lymph nodes removed,it seems that robotic surgery gives better results in terms of the 5-year overall survival and recurrencefree *** robotic approach to gastric cancer surgery aims to overcome the difficulties and technical limitations of laparoscopy in major *** threedimensional vision,articulation of the instruments and good ergonomics for the surgeon allow for accurate and precise movements which facilitate the complex steps of surgery such as lymph node dissection,esophagus-jejunal anastomosis packaging and reproducing the technical accuracy of open *** the literature,as well as the analyzed study,offers us countless data regarding the short-term oncological results of robotic surgery in the treatment of gastric cancer,satisfactory data on long-term follow-up are lacking,so future studies are necessary.

关键词： Gastric cancer Robotic gastrectomy Laparoscopy D2 lymphadenectomy Long-term outcomes Morbidity

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