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Outcomes of surgical Treatment of Skin Cancer at surgical Oncology unit of Donka, Conakry university Hospital

Journal of Cancer Therapy 2017年第12期8卷 1086-1094页

作者： Bangaly Traore Leopold Lamah surgical Oncology unit National Hospital of Donka Conakry University Hospital Conakry Guinea Department of Orthopedics and Traumatology National Hospital of Donka Conakry University Hospital Conakry Guinea

Aim: The main aim of this study was to evaluate outcomes after surgical treatment of skin cancer. Methods: This retrospective cohort study concerned 46 patients who presented 43 skin cancers lesions surgically treated at surgical oncology unit, Conakry university Hospital. There were 29 (61.7%) squamous cell carcinoma, 12 (25.5%) melanoma, 4 (8.5%) sarcomas and 1 (2.1%) porocarcinoma. surgical indications and prognosis factors were analyzed. Results: surgical treatment included simple excision in 2 cases (3.8%), wide excision in 38 cases (71.7%) and amputation/disarticulation in 13 cases (24.5%). Inguinal lymph node dissection was performed in 16 patients (34.3%). Postoperative complications were wound suppuration (5 cases), lower limb lymphedema (4 cases), seroma (2 cases) and skin flap necrosis (1 case). surgical margins were free in 28 (60.9%) patients, infiltrated in 3 patients (6.5%) and unspecified in 15 patients (32.6%). The median follow-up after surgery was 29 months. During the follow-up, 13 patients (28.3%) had a relapse. The relapse was influenced by surgical margins (p = 0.012) and iterative resection (p = 0.04). Overall survival was 65.2%. Factors related to survival in univariate analysis were: iterative resection (p = 0.008), fungated tumor (p = 0.037), the status of surgical margins (p = 0.002) and the occurrence of relapse (p = 0.0000). In multivariate analysis, the status of surgical margins was the only independent prognostic factor. Conclusion: The prognosis after surgical treatment of cutaneous cancers depends on the resection margins.

关键词： Skin Cancer Surgery Prognosis

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Endoscopic techniques for the diagnosis of pancreatic cystic lesions

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World Journal of Gastroenterology 2025年第1期31卷 1-7页

作者： Sahib Singh Saurabh Chandan Rakesh Vinayek Jahnvi Dhar Jayanta Samanta Gabriele Capurso Ivo Boskoski Cristiano Spada Jorge D Machicado Stefano Francesco Crinò Antonio Facciorusso Department of Internal Medicine Sinai HospitalBaltimoreMD 21215United States Division of Gastroenterology and Hepatology Creighton University School of MedicineOmahaNE 68131United States Department of Gastroenterology Sinai Hospital of BaltimoreBaltimoreMD 21215United States Department of Gastroenterology Postgraduate Institute of Medical Education and ResearchChandigarh 160012India Division of Pancreato-Biliary Endoscopy and Endosonography Pancreas Translational and Clinical Research CenterIRCCS San Raffaele Scientific InstituteVita-Salute San Raffaele UniversityMilano 20132Italy Digestive Endoscopy unit Fondazione Policlinico Universitario Agostino Gemelli IRCSSUniversitàCattolica del Sacro Cuore di RomaCenter for Endoscopic Research Therapeutics and TrainingRoma 00168Italy Department of Gastroenterology and Endoscopy Catholic UniversityRoma 00168Italy Department of Gastroenterology University of Michigan HealthAnn ArborMI 48107United States Department of Endoscopy University of VeronaVerona 37121VenetoItaly Gastroenterology unit Department of Medical and Surgical SciencesUniversity of FoggiaFoggia 71122Italy

Pancreatic cysts are mostly incidental findings on computed tomography or magnetic resonance imaging scans,with few patients presenting with abdominal pain or other *** accurate diagnosis of cysts is important as management depends on the type(neoplastic or non-neoplastic).Cross-sectional imaging is fast being replaced with endoscopic ultrasound(EUS)and various techniques based on that such as EUS-guided fine needle aspiration,EUS-guided needle confocal laser endomicroscopy,EUS-through-the-needle biopsy,and contrast-enhanced *** studies have reported varying diagnostic and adverse event rates with these *** addition,American,European,and Kyoto guidelines for the diagnosis and management of pancreatic cysts have provided different *** this editorial,we elaborate on the clinical guidelines,recent studies,and comparison of different endoscopic methods for the diagnosis of pancreatic cysts.

关键词： Endoscopic ultrasound Fine needle aspiration Needle confocal laser endomicroscopy Through-the-needle biopsy Contrast-enhanced endoscopic ultrasound

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Psycho-gastroenterological profile of an Italian population of children with disorders of gut-brain interaction:A case-control study

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World Journal of Clinical Pediatrics 2025年第1期14卷 69-77页

作者： Valentina Giorgio Ilaria Venezia Licia Pensabene Elisa Blasi Donato Rigante Paolo Mariotti Giuseppe Stella Gaia Margiotta Giovanna Quatrale Giuseppe Marano Marianna Mazza Antonio Gasbarrini Eleonora Gaetani Pediatric unit Department of WomenChildren and Public Health SciencesFondazione Policlinico Universitario“A.Gemelli”IRCCSUniversitàCattolica del Sacro CuoreRome 00168Italy Child Neuropsychiatry unit ASST Santi Paolo e CarloSan Paolo HospitalMilan 20142Italy Child Neuropsychiatry unit Department of WomenChildren and Public Health SciencesFondazione Policlinico Universitario“A.Gemelli”IRCCSUniversitàCattolica del Sacro CuoreRome 00168Italy Department of Medical and surgical Sciences Pediatric UnitUniversity Magna GraeciaCatanzaro 88100Italy unit of Psychiatry Fondazione Policlinico Universitario“A.Gemelli”IRCCSRome 00168Italy Department of Neurosciences UniversitàCattolica del Sacro CuoreRome 00168Italy Department of Internal Medicine and Gastroenterology Fondazione Policlinico Universitario"A.Gemelli"IRCCSRome 00168Italy Department of Medical and surgical Sciences Fondazione Policlinico Universitario"A.Gemelli"IRCCSUniversitàCattolica del Sacro CuoreRome 00168Italy

BACKGROUND Disorders of gut-brain interaction(DGBI)are common,but knowledge about their physiopathology is still poor,nor valid tools have been used to evaluate them in *** To develop a psycho-gastroenterological questionnaire(PGQ)to assess the psycho-gastroenterological profile and social characteristics of a pediatric population with and without *** One hundred and nineteen Italian children(age 11-18)were included:28 outpatient patients with DGBI(Rome IV criteria)and 91 healthy *** filled the PGQ,faces pain scale revised(FPS-R),Bristol stool chart,ga-strointestinal symptoms rating scale,state-trait anxiety inventory,Toronto alexithymia scale 20,perceived self-efficacy in the management of negative emotions and expression of positive emotions(APEN-G,APEP-G),irritable bowel syndrome-quality of life questionnaire,school performances,tobacco use,early life events,degree of *** Compared to controls,patients had more medical examinations(35%of them went to the doctor more than five times),a higher school performance(23%vs 13%,P<0.05),didn’t use tobacco(never vs 16%,P<0.05),had early life events(28%vs 1%P<0.05)and a higher percentage of pain classified as 4 in the FPS-R during the examination(14%vs 7%,P<0.05).CONCLUSION Pediatric outpatients with DGBI had a higher prevalence of early life events,a lower quality of life,more medical examinations rising health care costs,lower anxiety levels.

关键词： Disorders of gut-brain interaction Functional gastrointestinal disorders Psycho-gastroenterological profile Gut-brain axis Rome IV criteria Pediatric patients

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Noncoding RNAs as drivers of the phenotypic plasticity of oesophageal mucosa

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World Journal of Gastroenterology 2017年第43期23卷 7653-7656页

作者： Matteo Fassan Sonia Facchin Giada Munari Giuseppe Nicolò Fanelli Greta Lorenzon Edoardo Savarino surgical Pathology unit Department of MedicineUniversity of Padua Gas-troenterology unit Department of Surgical Oncology and GastroenterologyUniversity of Padua

The histological commitment of the lower oesophageal mucosa largely depends on a complex molecular landscape. After extended inflammatory insult due to gastroesophageal reflux disease,squamous oesophageal mucosa may differentiate into columnar metaplastic mucosa. In this setting,the presence of intestinal metaplasia is considered the starting point of Barrett's carcinogenetic cascade. Aside from secondary prevention strategies for Barrett's mucosa(BM) patients,there are multiple endoscopic ablative therapies available for BM eradication and for the replacement of metaplastic epithelia with a neosquamous mucosa. However,BM frequently recurs in a few years,which supports the notable phenotypic plasticity of the oesophageal mucosa. In recent years,several reports pinpointed a class of small noncoding RNAs,the micro RNAs(mi RNAs),as principal effectors and regulators of oesophageal mucosa metaplastic(and neoplastic) transformation. Because of mi RNAs notable stability in fixed archival diagnostic specimens,expression profiling of mi RNAs represent an innovative diagnostic,prognostic and predictive tool in the stratification of phenotypic alterations in the oesophageal mucosa.

关键词： Barrett's mucosa Biomarkers Noncoding RNAs Micro RNAs Metaplasia

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Surgery for inflammatory bowel disease in the era of laparoscopy

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World Journal of Gastroenterology 2013年第16期19卷 2445-2448页

作者： Giuseppe S Sica Livia Biancone GastroIntestinal surgical unit Tor Vergata University of Rome

During the course of inflammatory bowel disease (IBD), surgery may be needed. Approximately 20% of patients with ulcerative colitis (UC) will require surgery, whereas up to 80% of Crohn's disease (CD) patients will undergo an operation during their lifetime. For UC patients requiring surgery, total proctocolectomy and ileoanal pouch anastomosis (IPAA) is the operation of choice as it provides a permanent cure and good quality of life. Nevertheless a permanent stoma is a good option in selected patients, especially the elderly. Minimally invasive surgery has replaced the conventional open approach in many specialized centres worldwide. Laparoscopic colectomy and restorative IPAA is rapidly becoming the standard of care in the treatment of UC requiring surgery, whilst laparoscopic ileo-cecal resection is already the new gold standard in the treatment of complicated CD of terminal ileum. Short term advantages of laparoscopic surgery includes faster recovery time and reduced requirement for analgesics. It is, however, in the long term that minimally invasive surgery has demonstrated its superiority over the open approach. A better cosmesis, a reduced number of incisional hernias and fewer adhesions are the long term advantages of laparoscopy in IBD surgery. A reduction in abdominal adhesions is of great benefit when a second operation is needed in CD and this influences positively the pregnancy rate in young women undergoing restorative IPAA. In developing the therapeutic plan for IBD patients it should be recognized that the surgical approach to the abdomen has changed and that surgical treatment of complicated IBD can be safely performed with a true minimally invasive approach with great patient satisfaction.

关键词： Laparoscopy Ulcerative colitis Surgery Inflammatory bowel disease Laparoscopic surgery Proctocolectomy Ileoanal pouch anastomosis

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Is the Bismuth-Corlette IIIb stage really an unfavorable situation for resectability of Klatskin tumors?A critical appraisal

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Hepatobiliary & Pancreatic Diseases International 2020年第5期19卷 505-506页

作者： Marcello Donati Michela Zanatta Francesco Basile Department of Surgery and Medical surgical Specialties Surgical Clinic UnitUniversity Hospital of Catania95123 CataniaItaly

We read with considerable interest the paper from Passeri et al.[1]questioning how the IIIb preoperative determination of a Klatskin tumor could be considered a risk factor for unresectability,and we could not refrain from making some critical recommendations about *** the paper was nicely written,in our opinion,no meaningful conclusion should however be drawn from it,due to the small sample size of the reported series.

关键词： al. critical really

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Prospective evaluation of a new device for the treatment of anal fistulas

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World Journal of Gastroenterology 2016年第30期22卷 6936-6943页

作者： Carlo Ratto Francesco Litta Lorenza Donisi Angelo Parello proctology unit Department of Surgical Sciences Catholic University 00168 Rome Italy

AIM: To evaluate the safety of the implantation of a new device for the treatment of anal fistulas. The short-term clinical efficacy was also assessed. METHODS: This study took place at a tertiary care university hospital. Patients with a complex anal fistula of cryptoglandular origin were enrolled in the study and were treated with insertion of the new device. All patients were evaluated by clinical and physical examination, including an endoanal ultrasound at the baseline, and then at the 2 wk and 1, 2, 3 and 6-mo follow-up visits. RESULTS: Morbidity, continence status, and success rate were the main outcome measures. Ten patients underwent the placement of the new device. The fistulas were transphincteric in eight patients and extrasphincteric in the remaining two. The median duration of the surgical procedure was 34.5(range, 27-42) min. Neither intra- nor postoperative complications occurred, and all patients were discharged the day after the procedure. At the 6-mo follow-up evaluation, the final success rate was 70%. Three failures were registered: a device expulsion(on the 10 th postoperative day), the persistence of inflammatory tissue around the fistula tract(at the 2-mo follow up), and the persistence of serum discharge(at the 6-mo follow up). No patient experienced any change incontinence, as assessed by the Cleveland Clinic Fecal Incontinence score. CONCLUSION: The technical procedure is simple and has low risk of perioperative morbidity. The pre- and post-operative continence status did not change in any of the patients. The initial results at the 6-mo follow up seem to be promising. However, a longer follow-up period and a larger sample size are needed to confirm these preliminary results.

关键词： Anal fistula Device Fistula plug Faecal incontinence Recurrence Endoanal ultrasound

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Changing clinical profile,management strategies and outcome of patients with biliary tract injuries at atertiary care center in SriLanka

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Hepatobiliary & Pancreatic Diseases International 2011年第5期10卷 526-532页

作者： Jasin Arachchige Saman Bingumal Jayasundara Waradana Mohan Malith de Silva Ajith Aloka Pathirana university surgical unit Colombo South Teaching Hospital Kalubowila Sri Lanka

BACKGROUND: Biliary tract injuries are mostly iatrogenic Related data are limited in developing countries. There are lessons to be learned by revisiting the clinical profiles management issues and outcome of patients referred to a tertiary care center in Sri Lanka, compared with the previous data from the same center published in 2006. Such a review is particularly relevant at a time of changing global perceptions of iatrogenic biliary injuries. This study aimed to analyze and compare the changes in the injury pattern, management and outcome following biliary tract injury in a Sri Lankan study population treated at a tertiary care center. METHODS: A retrospective analysis was made of 67 patients treated between May 2002 and February 2011. The profiles of the last 38 patients treated from October 2006 to February 2011 were compared with those of the first 29 patients treated from May 2002 to September 2006. Definitive management options included endoscopic biliary stenting, reconstructive hepaticojejunostomy with creation of gastric access loops and biliary stricture dilation. Post-treatment jaundice cholangitis and abdominal pain needing intervention were considered as treatment failures. RESULTS: In the 67 patients, 55 were women and 12 men Their mean age was 40.6 (range 19-80) years. Five patients had traumatic injuries. Thirty-seven injuries (23 during the second study period) were due to laparoscopic cholecystectomy and 25 (10 during the second study period) to open cholecystectomy The identification rate of intra-operative injury was 19% in the laparoscopic group and 8% in the open group. Bismuth typeI, II, III and IV injuries were seen in 18, 18, 15 and 12 patients, respectively. Endoscopic stenting was the definitive treatment in 20 patients. In 35 patients who had hepaticojejunostomy, 33 underwent creation of the gastric access loop. Twenty- two reconstructions were performed during the second study period. A gastric access loop was used for endotherapy in t

关键词： gastric access loop hepaticojejunostomy endoscopic biliary stenting biliary tract injuries

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Splenic lymphangiomatosis showing rapid growth during lactation:A case report

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World Journal of Gastroenterology 2010年第9期16卷 1155-1157页

作者： Rosalia Patti Emilio Iannitto Gaetano Di Vita General Surgery unit Department of Surgical and Oncological SciencesUniversity of Palermo Haematological Division University of Palermo

Splenic lymphangiomatosis is a very rare condition that,from 1990 to date,has been described only nine *** the present report,we describe the first case of splenic lymphangiomatosis with rapid growth during lactation in a 35-year-old *** also underline the difficultly in making an accurate preoperative diagnosis,despite more modern imaging *** splenectomy was considered to be the treatment needed,both to make a definitive diagnosis and to exclude the presence of malignancy.

关键词： Lymphangiomatosis Spleen Lactation

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Mesenchymal stromal cell-based therapy: Regulatory and translational aspects in gastroenterology

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World Journal of Gastroenterology 2016年第41期22卷 9057-9068页

作者： Giovanni Dothel Emanuel Raschi Roberto Rimondini Fabrizio De Ponti Pharmacology unit Department of Medical and Surgical Sciences Alma Mater Studiorum University of Bologna

The past decade has witnessed an outstanding scientific production focused towards the possible clinical applications of mesenchymal stromal cells(MSCs) in autoimmune and chronic inflammatory diseases. This raised the need of novel standards to adequately address quality, efficacy and safety issues of this advanced therapy. The development of a streamlined regulation is currently hampered by the complexity of analyzing dynamic biological entities rather than chemicals. Although numerous pieces of evidence show efficacy in reducing intestinal inflammation, some inconsistencies between the mechanisms of action of rodent vs human MSCs suggest caution before assigning translational value to preclinical studies. Preliminary evidence from clinical trials showed efficacy of MSCs in the treatment of fistulizing Crohn's disease(CD), and preparations of heterologous MSCs for CD treatment are currently tested in ongoing clinical trials. However, safety issues, especially in longterm treatment, still require solid clinical data. In this regard, standardized guidelines for appropriate dosing and methods of infusion could enhance the likelihood to predict more accurately the number of responders and the duration of remission periods. In addition, elucidating MSC mechanisms of action could lead to novel and more reliable formulations such as those derived from the MSCs themselves(e.g., supernatants).

关键词： Mesenchymal stromal cells Mesenchymal stem cells Inflammatory bowel diseases Intestinal disorders Translational medicine

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