0000000001230484
AUTHOR
Calogero Ricotta
Impact of Italian Score for Organ Allocation System on Deceased Donor Liver Transplantation: A Monocentric Competing Risk Time-to-Event Analysis
Background: Liver transplantation (LT) is the only definitive and curative treatment for patients with end-stage liver disease and hepatocellular carcinoma. We aimed to evaluate the impact of the Italian score for organ allocation (ISO) in terms of the waiting-list mortality, probability of LT, and patient survival after LT. Patient and methods: All of the adult patients on the waiting list for LT at our institute from January 2014 to December 2017 were included in the study. The probabilities of death while on the waiting list, dropout from the list, and LT were compared by means of cumulative incidence functions, in a competing risk time-to-event analysis setting. Uni- and multivariable l…
Left Spigelian Hernia in Super-Obese Patient: A Case-Report.
Abstract: We report a case in which a giant Spigelian hernia presented with severe, persistent abdominal pain in a 62- year-old super-obese woman with a history of total abdominal hysterectomy-bilateral salpingo-oopherectomy at the age of 40 years for benign neoplasia, who later underwent open hernia repair (maximal diameter of the hernia sac: 21 cm) because of the development of compartment syndrome. Afterward, although a large incarcerated hernia disease was found, the sac removal was technically difficult and an open procedure was carried out, with double-mesh placement. No complications were recorded during the post-operative course. We report a difficult issue related to the diagnosis …
Case report: Trans-papillary free stenting of the cystic duct and of the common bile duct in a double biliary ducts anastomoses of a right lobe living donor transplantation.
Abstract Background One of the major issues related to the living donor liver transplantation recipient outcome is still the high rate of biliary complication, especially when multiple biliary ducts are present and multiple anastomoses have to be performed. Case presentation and conclusion We report a case of adult-to-adult right lobe living donor liver transplantation performed for a recipient affected by alcohol-related cirrhosis with MELD score of 17. End-stage liver disease was complicated by refractory ascites, portal hypertension, small esophageal varices and portal gastropathy, hypersplenism, and abundant right pleural effusion. Here in the attached video we described the adult-to-ad…
Predictive value of IL-6 and IL-10 serum levels in anastomotic leakage in elderly patients undergoing surgery for colorectal cancer
Methods The study group is yet represented by 33 patients: 17 males and 16 females (median age 76, range 70–89). The location of cancer was respectively: 5 (15, 15%) in the rectum, 15 (45, 45%) in the left colon, 11 (33, 33%) in the right colon, 1 (3, 3%) in the transverse colon, 1 (3, 3%) synchronous in the caecum and the sigmoid colon. The associated diseases observed were: chronic obstructive pulmonary disease, hypertension, diabetes mellitus, ischemic heart disease arterial vasculopathy.
Internal sphincterotomy reduces postoperative pain after Milligan Morgan haemorrhoidectomy
Abstract Background Over the last few years, there has been increasing attention on surgical procedures to treat haemorrhoids. The Milligan-Morgan haemorrhoidectomy is still one of the most popular surgical treatments of haemorrhoids. The aim of the present work is to assess postoperative pain, together with other early and late complications, after Milligan-Morgan haemorrhoidectomy as we could observe in our experience before and after performing an internal sphincterotomy. Methods from January 1980 to May 2007, we operated 850 patients, but only 699 patients (median age 53) were included in the present study because they satisfied our inclusion criteria. The patients were divided into two…
Enhanced Recovery after Implementation of Surgery Protocol in Living Kidney Donors: The ISMETT Experience
Abstract Introduction Laparoscopic living donor nephrectomy (LLDN) has become the standard procedure for living kidney transplantation. Enhanced recovery after surgery (ERAS) is a multimodal perioperative management aimed at facilitating rapid patient recovery after major surgery by modifying the response to stress induced by exposure to surgery. This association can further reduce hospital stay, surgical stress, and perioperative morbidity of living kidney donors. Material and methods In this retrospective analysis conducted at our institute, we compared the first 21 patients who underwent LLDN enrolled with the ERAS protocol with 55 patients who underwent LLDN with the fast-track protocol…
Prognostic value of IL-6 and IL-10 serum levels and immunonutritional assessment in determining postoperative complications after geriatric surgery
The onset of postoperative septic complications has recently been associated to serum levels of interleukin (IL) IL-6 and IL-10. Patients with complications have higher serum levels than patients without complication after surgery. IL-6 has been recognized as early marker of postoperative septic events. Furthermore IL-6 increases with age, expecially if there are associated diseases. It is a sign of functional deterioration of different organs. The disregulation in interleukin production, anesthetic drugs, hemorrhage and transfusions may lead to the onset of postoperative complications. The latter are more frequent in oncologic patients. The aim of our study is to evaluate pre- and postoper…
Crucial Role of Extended Criteria Donors in Deceased Donor Single Kidney Transplantation to Face Chronic Shortage in the Heart of the Mediterranean Basin: A Single-Center Experience.
Background: The gap between organ availability and patients on the waiting list for deceased donor kidney transplants has resulted in the wide use of extended criteria donors (ECDs).We aimed to compare the surgical outcomes of single kidney transplantation (KT) performed at our institute with standard criteria donor (SCD) or ECD grafts, according to the Organ Procurement and Transplantation Network definition. Patients and methods. Our retrospective analysis studied 115 adult recipients of KT from January 2016 to July 2018, with kidney grafts procured from adult donors after brain or circulatory death, performed at our institute. Among the 2 recipients’ groups, we compared the incidence of …
ERAS Protocol for Perioperative Care of Patients Treated with Laparoscopic Nonanatomic Liver Resection for Hepatocellular Carcinoma: The ISMETT Experience
Background: Liver resection (LR) remains the best therapeutic option for patients with early-stage hepatocellular carcinoma (HCC) with preserved hepatic function and who are not eligible for liver transplantation. After its inception, the enhanced recovery after surgery (ERAS) protocol was widely used for treating patients with liver cancer, although there are still no clear indications for improving upon it in both open and laparoscopic surgery. Objective: This study aims to describe our institute's experience in the application of the ERAS protocol in a cohort of HCC patients, and to explore possible factors that could have an impact on postoperative outcomes. Materials and Methods: We re…
LAPAROSCOPIC LEFT LIVER SECTIONECTOMY (LLLS) FOR PEDIATRIC LIVING RELATED LIVER TRANSPLANTATION (LRLT)
PURPOSE: LRLT in children is a method to provide organs for transplantation. We report 2 cases of LLLS for pediatric LRLT. METHOD: Donor position: lithotomy with surgeon in French position. Trocars: three 12 mm, placed 2 cm upper the supra-umbilical mid-line and sub-costal bi-lateral on the nipple lines; one 5 mm in epigastrium. Special instrumentation: harmonic scissor, ligasure®, Hem-O-Lock clips, and Endo Catch-II® bag. Main steps: division of round, falciform, left triangular ligaments and of lesser omentum; inspection of anatomy; hepatic hilum dissection with exposure of the left hepatic artery; dissection of the right side of the falciform ligament with exposure of the left branch of …
The addition of simvastatin administration to cold storage solution of explanted whole liver grafts for facing ischemia/reperfusion injury in an area with a low rate of deceased donation: a monocentric randomized controlled double-blinded phase 2 study.
Abstract Background Liver transplantation is the best treatment for end-stage liver disease. The interruption of the blood supply to the donor liver during cold storage damages the liver, affecting how well the liver will function after transplant. The drug Simvastatin may help to protect donor livers against this damage and improve outcomes for transplant recipients. The aim of this study is to evaluate the benefits of treating the donor liver with Simvastatin compared with the standard transplant procedure. Patient and methods We propose a prospective, double-blinded, randomized phase 2 study of 2 parallel groups of eligible adult patients. We will compare 3-month, 6-month, and 12-month g…
Additional file 1 of Case report: Trans-papillary free stenting of the cystic duct and of the common bile duct in a double biliary ducts anastomoses of a right lobe living donor transplantation
Additional file 1: Video. Imaging evaluation and surgical maneuvers.