0000000000509727

AUTHOR

L. Lorenzon

showing 8 related works from this author

The impact of conversion on the risk of major complication following laparoscopic colonic surgery: an international, multicentre prospective audit.

2018

BACKGROUND: Laparoscopy has now been implemented as a standard of care for elective colonic resection around the world. During the adoption period, studies showed that conversion may be detrimental to patients, with poorer outcomes than both laparoscopic completed or planned open surgery. The primary aim of this study was to determine whether laparoscopic conversion was associated with a higher major complication rate than planned open surgery in contemporary, international practice.METHODS: Combined analysis of the European Society of Coloproctology 2017 and 2015 audits. Patients were included if they underwent elective resection of a colonic segment from the caecum to the rectosigmoid jun…

Laparoscopic surgeryMaleColorectal cancermedicine.medical_treatmentsurgery0302 clinical medicinePostoperative ComplicationsMedicineMajor complicationProspective StudiesLaparoscopySHORT-TERM OUTCOMESColectomyMedical Auditmedicine.diagnostic_testProspective auditGastroenterologyMiddle Agedlaparoscopic surgeryConversion to Open SurgeryColon cancerTreatment OutcomeElective Surgical Procedures030220 oncology & carcinogenesis030211 gastroenterology & hepatologyFemaleColonic surgeryAdultmedicine.medical_specialtyCLINICAL-TRIALNOOPEN COLECTOMY03 medical and health sciencesCOLORECTAL SURGERYCase mix indexgastrointestinal surgeryHumansrectal cancerRECTAL-CANCERAgedta3126business.industryElective resectionmedicine.diseaseRANDOMIZED-TRIALOPEN RESECTIONSurgeryColon cancer; gastrointestinal surgery; laparoscopic surgery; rectal cancer; surgery; GastroenterologyLaparoscopybusinessColorectal disease : the official journal of the Association of Coloproctology of Great Britain and Ireland
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Emergency hernia repair in the elderly: multivariate analysis of morbidity and mortality from an Italian registry

2020

Abstract Purpose The incidence of inguinal hernia is higher in elderly because of aging-related diseases like prostatism, bronchitis, collagen laxity. A conservative management is common in elderly to reduce surgery-related risks, however watchful waiting can expose to obstruction and strangulation. The aim of the present study was to assess the impact of emergency surgery in a large series of elderly with complicated groin hernia and to identify the independent risk factors for postoperative morbidity and mortality. The predictive performance of prognostic risk scores has been also assessed. Methods This is a prospective observational study carried out between January 2017 and June 2018 in…

medicine.medical_specialtymedicine.medical_treatmentSettore MED/18 - CHIRURGIA GENERALENOPostoperative complicationsElderlyLaparotomymedicineHerniaIncarcerated herniabusiness.industryExplorative laparotomyGroin hernia · Incarcerated hernia · Elderly · Postoperative complications · Emergency surgery · Charlson’s comorbidity indexmedicine.diseaseHernia repairComorbiditySurgeryGroin herniaInguinal herniaCharlson’s comorbidity indexEmergency surgerySurgerybusinessWatchful waitingCharlson’s comorbidity index; Elderly; Emergency surgery; Groin hernia; Incarcerated hernia; Postoperative complicationsAbdominal surgery
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Frailty and emergency surgery in the elderly: protocol of a prospective, multicenter study in Italy for evaluating perioperative outcome (The FRAILES…

2018

Improvements in living conditions and progress in medical management have resulted in better quality of life and longer life expectancy. Therefore, the number of older people undergoing surgery is increasing. Frailty is often described as a syndrome in aged patients where there is augmented vulnerability due to progressive loss of functional reserves. Studies suggest that frailty predisposes elderly to worsening outcome after surgery. Since emergency surgery is associated with higher mortality rates, it is paramount to have an accurate stratification of surgical risk in such patients. The aim of our study is to characterize the clinicopathological findings, management, and short-term outcom…

Elderly patient; Emergency surgery; Frailty; Geriatric; Risk assessment; Scores; Aged; Aged 80 and over; Clinical Protocols; Emergencies; Female; Frailty; Humans; Italy; Logistic Models; Male; Multivariate Analysis; Outcome Assessment Health Care; Postoperative Complications; Prognosis; Prospective Studies; ROC Curve; Risk Assessment; Frail ElderlyMaleOutcome Assessment030230 surgerylaw.invention0302 clinical medicinePostoperative ComplicationsQuality of lifeClinical ProtocolslawOutcome Assessment Health Care80 and overProspective StudiesProspective cohort studyMultivariate AnalysiAged 80 and overEmergencieFrailtyMortality rateScoreScoresPrognosisIntensive care unitElderly patient; Emergency surgery; Frailty; Geriatric; Risk assessment; Scores; Aged; Aged 80 and over; Clinical Protocols; Emergencies; Female; Frailty; Humans; Italy; Logistic Models; Male; Multivariate Analysis; Outcome Assessment (Health Care); Postoperative Complications; Prognosis; Prospective Studies; ROC Curve; Risk Assessment; Frail ElderlyItaly030220 oncology & carcinogenesiselderly patient emergency surgery frailty geriatric risk assessment scoresEmergency surgeryFemaleRisk assessmentElderly patientHumanmedicine.medical_specialtyElderly patient; Emergency surgery; Frailty; Geriatric; Risk assessment; Scores;Logistic ModelPrognosiFrail ElderlyRisk AssessmentNO03 medical and health sciencesOutcome Assessment (Health Care)medicineHumansClinical ProtocolAgedbusiness.industryPerioperativeElderly patient; Emergency surgery; Frailty; Geriatric; Risk assessment; ScoresSurgeryHealth CareProspective StudieSettore MED/18 - Chirurgia GeneraleLogistic ModelsROC CurveEmergency medicineMultivariate AnalysisLife expectancyObservational studySurgeryPostoperative ComplicationEmergenciesbusinessGeriatric
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Surgeons' fear of getting infected by COVID19: A global survey

2020

During the last three months, COVID- 19 pandemic had led to a serious backlog of operations globally, and plans for restarting operation are imperative. Recommendations for surgical activities were studied, aiming to protect the surgical staff from being infected. In the meantime, it is also important to give attention to the surgeon’s personal feeling during work. We conducted a survey to investigate global surgi- cal practices during the COVID-19 pandemic, and the surgeon’s personal feeling was also investigated in the sur- vey. In this special letter, we performed multivariate analysis to explore factors that associated with surgeon’s fear of getting infected by COVID-19.

Surgery COVID-19medicine.medical_specialty2019-20 coronavirus outbreakInfectious Disease Transmission Patient-to-Professionalsurvey covid19Coronavirus disease 2019 (COVID-19)Attitude of Health PersonnelSettore MED/18 - CHIRURGIA GENERALESevere acute respiratory syndrome coronavirus 2 (SARS-CoV-2)Infectious Disease TransmissionCOVID-19. Global surgery.MEDLINEGlobal HealthNOPatient-to-ProfessionalTumours of the digestive tract Radboud Institute for Health Sciences [Radboudumc 14]Surveys and QuestionnairesCorrespondencemedicineGlobal healthInfection controlHumansGeneralPersonal protective equipmentPersonal Protective EquipmentLS7_4SurgeonsInfection Controlcovid-19; pandemic; surgerySARS-CoV-2business.industrypandemicVaccinationCOVID-19covidFearSettore MED/18Occupational DiseasesCOVID-19; Global Health; Humans; Infection Control; Occupational Diseases; Personal Protective Equipment; Surgeons; Surveys and Questionnaires; Attitude of Health Personnel; Fear; Infectious Disease Transmission Patient-to-ProfessionalSurgeon - infection - COVID19 - surveyFamily medicineSurgerybusiness
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Evaluating the incidence of pathological complete response in current international rectal cancer practice: the barriers to widespread safe deferral …

2018

INTRODUCTION: The mainstay of management for locally advanced rectal cancer is chemoradiotherapy followed by surgical resection. Following chemoradiotherapy, a complete response may be detected clinically and radiologically (cCR) prior to surgery or pathologically after surgery (pCR). We aim to report the overall complete pathological response (pCR) rate and the reliability of detecting a cCR by conventional pre-operative imaging.METHODS: A pre-planned analysis of the European Society of Coloproctology (ESCP) 2017 audit was performed. Patients treated by elective rectal resection were included. A pCR was defined as a ypT0 N0 EMVI negative primary tumour; a partial response represented any r…

MaleColorectal cancerdeferral of surgery; neoadjuvant therapy; pathology; radiology; rectal cancer; Rectal surgery; surgical oncology; Gastroenterology0302 clinical medicineProspective StudiesProspective cohort studyComplete responseMedical Auditintegumentary systemIncidence (epidemiology)IncidenceRemission InductionGastroenterologyMiddle AgedMagnetic Resonance ImagingPeer reviewEuropeTreatment Outcomedeferral of surgeryResponse Evaluation Criteria in Solid Tumors030220 oncology & carcinogenesisPreoperative Period030211 gastroenterology & hepatologyFemaleAdultmedicine.medical_specialtyRectal surgeryNO03 medical and health sciencessurgical oncologymedicineHumansneoadjuvant therapyIntensive care medicineDeferralrectal cancerPathologicalResponse Evaluation Criteria in Solid TumorsAgedNeoplasm Stagingta3126business.industryRectal NeoplasmsReproducibility of ResultsChemoradiotherapy Adjuvantmedicine.diseaseradiologyRectal Neoplasms/diagnostic imagingpathologyNeoplasm Staging/methodsbusiness
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An international multicentre prospective audit of elective rectal cancer surgery; operative approach versus outcome, including transanal total mesore…

2018

Introduction: Transanal total mesorectal excision (TaTME) has rapidly emerged as a novel approach for rectal cancer surgery. Safety profiles are still emerging and more comparative data is urgently needed. This study aimed to compare indications and short-term outcomes of TaTME, open, laparoscopic, and robotic TME internationally. Methods: A pre-planned analysis of the European Society of Coloproctology (ESCP) 2017 audit was performed. Patients undergoing elective total mesorectal excision (TME) for malignancy between 1 January 2017 and 15 March 2017 by any operative approach were included. The primary outcome measure was anastomotic leak. Results: Of 2579 included patients, 76.2% (1966/257…

MaleLaparoscopic surgerymedicine.medical_specialtyColorectal cancermedicine.medical_treatmentOperative TimeAnastomosisMalignancyrectal cancer ; laparoscopic surgery ; TME ; transanal TME ; TaTME ; robotic surgery ; randomized clinical-trial ; short-term outcomes ; laparoscopic-assisted resection ; pathological outcomes ; anastomotic leakage ; initial-experience ; riskNO03 medical and health sciencesPostoperative Complications0302 clinical medicineRobotic Surgical Proceduresrobotic surgerytransanal TMEHumansMedicineRobotic surgeryProspective Studieslaparoscopic surgery; Rectal cancer; robotic surgery; TaTME; TME; transanal TME; GastroenterologyRectal cancerAgedTransanal Endoscopic Surgeryta3126Medical AuditUnivariate analysisProctectomyRectal Neoplasmsbusiness.industryRectumGastroenterologyTMEMargins of ExcisionMiddle Agedmedicine.diseaseTotal mesorectal excisionTaTMElaparoscopic surgerySurgeryTreatment OutcomeElective Surgical Procedures030220 oncology & carcinogenesisRectal cancer surgeryFemaleLaparoscopy030211 gastroenterology & hepatologybusiness
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Clinical strategies for the management of intestinal obstruction and pseudo-obstruction. A Delphi Consensus study of SICUT (Società Italiana di Chiru…

2016

Intestinal obstructions/pseudo-obstruction of the small/large bowel are frequent conditions but their management could be challenging. Moreover, a general agreement in this field is currently lacking, thus SICUT Society designed a consensus study aimed to define their optimal workout.The Delphi methodology was used to reach consensus among 47 Italian surgical experts in two study rounds. Consensus was defined as an agreement of 75.0% or greater. Four main topic areas included nosology, diagnosis, management and treatment.A bowel obstruction was defined as an obstacle to the progression of intestinal contents and fluids generally beginning with a sudden onset. The panel identified four major…

HerniaDelphi TechniqueContrast MediaAcidosis; Conservative Treatment; Contrast Media; Delphi Technique; Diatrizoate Meglumine; Disease Management; Emergencies; Emergency Medicine; General Surgery; Hernia; Humans; Intestinal Obstruction; Intestinal Pseudo-Obstruction; Intubation Gastrointestinal; Laparotomy; Societies Medical; Stents; Symptom Assessment; Tomography X-Ray ComputedConservative TreatmentStentHumansLarge bowel obstructionIntubation GastrointestinalSocieties MedicalDiatrizoate MeglumineEmergencieLaparotomyIntestinal Pseudo-ObstructionDisease ManagementSmall bowelDelphi study Intestinal obstruction Large bowel obstruction Pseudo-obstruction Small bowelDelphi studyAcidosiGeneral SurgeryEmergency MedicineStentsEmergenciesSymptom AssessmentAcidosisTomography X-Ray ComputedPseudo-obstructionIntestinal ObstructionHuman
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Impact of asymptomatic COVID-19 patients in global surgical practice during the COVID-19 pandemic

2020

The rapid spread of COVID-19 has changed the global surgical care. Patients infected with COVID-19 may present without typical symptoms, and such asymptomatic patients may potentially trigger in-hospital outbreaks by transmitting the disease to health care providers and other hospitalized patients. Further, asymptomatic COVID-19 patients have worse postop- erative outcomes with an unexpectedly high morbidity and mortality, reaching 20⋅5 per cent deaths. However, we do not have objective global data on this issue. In an attempt to clarify the current global surgical practice under the COVID-19 pandemic particularly focusing on the preoperative screening of asymptomatic COVID-19 patients, we …

2019-20 coronavirus outbreakmedicine.medical_specialtyCoronavirus disease 2019 (COVID-19)covid-19 pandemic surgerySevere acute respiratory syndrome coronavirus 2 (SARS-CoV-2)Settore MED/18 - CHIRURGIA GENERALEMEDLINECOVID-19. Global surgery.AsymptomaticCOVID-19 Critical Pathways Cross Infection Cross-Sectional Studies Health Care Surveys Humans Pandemics Postoperative Complications SARS-CoV-2 Surgical Procedures Operative Asymptomatic InfectionsCOVID-19; Critical Pathways; Cross Infection; Cross-Sectional Studies; Health Care Surveys; Humans; Pandemics; Postoperative Complications; SARS-CoV-2; Surgical Procedures Operative; Asymptomatic InfectionsNOsurgeryTumours of the digestive tract Radboud Institute for Health Sciences [Radboudumc 14]Postoperative ComplicationsPandemicCorrespondencemedicineHumansPandemicsAsymptomatic InfectionsLS7_4COVIDCross InfectionSurgical ProceduresCritical pathwaysbusiness.industrySARS-CoV-2pandemicCOVID-19Surgical proceduresOperativeSettore MED/18covid 19 surgical practiceCOVID-19 - surgeryCross-Sectional StudiesSurgical Procedures OperativeHealth Care SurveysEmergency medicineCritical Pathwaysmedicine.symptombusiness
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