0000000000933397
AUTHOR
R. Tutino
showing 16 related works from this author
Mapping the centers performing endocrine neck surgery in Italy
2020
Background. Quality of care and provider’s experience seem to be strictly connected in any field of surgery. Aim of this study is to identify a method to classify the centers on the basis of the number of thyroidectomies and parathyroidectomies performed. Methods. We listed 666 centers performing endocrine neck surgery in 2015, from the database of the Italian Health Ministry. We performed a descriptive statistic analysis with a dedicated software. We identified the outliers, according to a previous literature review, in those centers performing >1000 and < 10 thyroidectomies, >100 and < 3 parathyroidectomies and we excluded them to our analysis. The remaining centers were group…
Rectal perforation during defecography: extraluminal barium impaction removed by TEM (Transanal Endoscopic Microsurgery).
2016
Defecography is the standard diagnostic technique for the diagnosis of functional disorders of the posterior pelvic compartment. However it has some limits as radiation exposure, low-contrast resolution, some degrees of embarrassment and discomfort for the patients. Furthermore it often fails to directly visualize the changes that affect the pararectal space. Here we present a never described case of rectal perforation after defecography with barium impaction removed by TEM (Transanal Endoscopic Microsurgery).We present a case of a 50 years old woman with extraluminal barium impaction due to perforation occurred during defecography. Both pelvic MR and endoanal ultrasound confirmed the prese…
Polypoid anal melanoma. A case report and review of the literature
2016
Ano-rectal melanoma is an uncommon finding in patients complaining of rectal bleeding and/or anal mass often misinterpreted as a haemorroidal pile.A 55-years-old woman, complaining of rectal bleeding, frequent anal pain and anal mass suspected for haemorroidal thrombosis was referred for evaluation and possible treatment. A brown polypoid mass arising from the anal canal/lower rectum with a maximum diameter of 6 cm was diagnosed. The hystological examination of the neoplasm, transanally removed, revealed the presence of a polypoid melanoma partially involving the resection margin. Nor metastases nor limph-node involvement were found at the total-body CT scan and at a CT-PET. C-KIT examinati…
Autologous adipose-derived stromal vascular fraction and platelet concentrates for the treatment of complex perianal fistulas
2022
Abstract Background Complex perianal fistulas are a major challenge for modern surgery since 10–35% of patients have functional problems after treatment. Sphincter-saving techniques have a wide range of efficacy (10–80%). We hypothesised that autologous adipose-derived stromal vascular fraction in combination with platelet rich plasma is a new therapeutic strategy with enhanced cure and function preservation rates. Methods Adult patients with complex cryptoglandular perianal fistulas were treated with injection of autologous adipose-derived stromal vascular fraction in combination with platelet rich plasma around and inside the fistulous tract between May 2018 and April 2019 at the General …
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…
Benign multicystic mesothelioma: A case report of recurrent disease in a young adult with familiarity for renal cell carcinoma
2019
Benign multi-cystic peritoneal mesothelioma (BMCM) is a very rare disease (about 150 cases observed). The aetiology is currently little-known, and the data collected, without having achieved conclusive re sults, identify two possible causes: neoplastic and reactive inflammatory. This case report refers to a recidivism of BCMC in a patient whose brother, few months before, underwent a left nephrectomy and right renal Radio Frequency Termo Ablation (RFTA) for bilateral papillary renal cell carcinoma. For the recurring trend, the onset in a male young patient without chronic inflammatory diseases evidence, the presence of a first degree relative with a rare carcinoma we supposed a neoplastic a…
SARS-CoV-2 vaccination modelling for safe surgery to save lives: data from an international prospective cohort study
2021
Abstract Background Preoperative SARS-CoV-2 vaccination could support safer elective surgery. Vaccine numbers are limited so this study aimed to inform their prioritization by modelling. Methods The primary outcome was the number needed to vaccinate (NNV) to prevent one COVID-19-related death in 1 year. NNVs were based on postoperative SARS-CoV-2 rates and mortality in an international cohort study (surgical patients), and community SARS-CoV-2 incidence and case fatality data (general population). NNV estimates were stratified by age (18–49, 50–69, 70 or more years) and type of surgery. Best- and worst-case scenarios were used to describe uncertainty. Results NNVs were more favourable in su…
Complication of endoscopic tattooing: a case report of covered perforation
2016
Aim Laparoscopy is considered a good approach in treatment of colorectal neoplastic diseases; the endoscopic tattooing is then recommended (Evidence Level III and grade of recommendation A) to mark a lesion or a polypectomy site for intraoperative identification. We describe the case of perforation after tattoing treated conservatively. Case report 63 years old woman, underwent colonoscopy for lipoma tattooing with India ink SPOT® solution kit and saline test. Immediately after the procedure the patient has been referred the appearance of colic epi-mesogastric pain and fever; Computed Tomography (CT) without MDC identified an irregular thickening of transverse colon with some microbubbles c…
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.
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…
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…
A primary subcutaneous hydatid cyst in the thigh. A case report
2016
Hydatid disease is a parasitic disease considered endemic in many parts of the world such as South America, Middle East, Africa, Australia and the Mediterranean regions. Liver and lung hydatid disease accounts for 90% of all echinococcal cysts. Primary hydatid disease of subcutaneous sites is rare and the subcutaneous localization of a solitary hydatid cyst accounts for 1.6%. Not enough data exist for this localization, and only many heterogeneous data are described in order to define this rare condition.We present the case of a 68-year-old-woman affected by a mass in upper-medial side of her right thigh with a 12-year-growing history. Anamnestic data were accurately collected. Many differe…
Diffuse malignant biphasic peritoneal mesothelioma with cystic areas
2016
We report a case of peritoneal biphasic mesothelioma with cystic areas in a patient with professional exposure to asbestos. It showed focal epithelial glandular and papillary proliferations, also presenting fluid filled cysts, whose wall consisted of a proliferation of spindle cells. Atypia and mitoses were very scanty. EMA, vimentin, CK5/6, D2-40, calretinin and P53 were positive and desmin was negative in both epithelial and spindle areas, including the ones surrounding the cystic spaces. These findings gave an essential aid in the differential diagnosis with a benign cystic mesothelioma and with a cystic epithelial mesothelioma with secondary pseudosarcomatous myofibroblastic proliferati…
The critical view of safety during laparoscopic cholecystectomy: Strasberg Yes or No? An Italian Multicentre study
2020
Abstract Background Laparoscopic cholecystectomy is considered the gold standard for the treatment of gallbladder lithiasis; nevertheless, the incidence of bile duct injuries (BDI) is still high (0.3–0.8%) compared to open cholecystectomy (0.2%). In 1995, Strasberg introduced the "Critical View of Safety" (CVS) to reduce the risk of BDI. Despite its widespread use, the scientific evidence supporting this technique to prevent BDI is controversial. Methods Between March 2017 and March 2019, the data of patients submitted to laparoscopic cholecystectomy in 30 Italian surgical departments were collected on a national database. A survey was submitted to all members of Italian Digestive Pathology…
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 …
Three-port colectomy: reduced port laparoscopy for general surgeons. A single center experience
2016
To evaluate three-port colectomy as an alternative reduced-port laparoscopy technique in colonic surgery.Retrospective study carried out through the analysis of 32 consecutive patients that underwent alternatively to a three ports left colectomy or a conventional laparoscopic colectomy for colonic diseases in order to evaluate the benefits of the reduced-port technique. A multivariate analysis among duration of surgery, hospital stay and conversion rate was performed using the OLS regression and the binary logistic regression.We found a reduced operative time in the three-port colectomy in comparison to the four-port technique (p=0.07). The hospital stay was not found related to the number …