Papers by Massimo Ippoliti
Diseases of the Colon & Rectum, 1992
... (17) F. Cavaliere, JH Pemberton, V. Fazio, M. Cosimelli, RW Beart, D. Giannarelli Rochester, ... more ... (17) F. Cavaliere, JH Pemberton, V. Fazio, M. Cosimelli, RW Beart, D. Giannarelli Rochester, MN, Cleveland, OH Increasingly, rectal cancer is managed by coloanal anastomosis (CAA) and not abdominal perineal resec-tion. ...
PubMed, Nov 1, 1993
The authors, after some remarks on the pathophysiology of primary alkaline gastritis, analyze the... more The authors, after some remarks on the pathophysiology of primary alkaline gastritis, analyze the main methods, available at present, for diagnosis; they particularly consider the importance of endoscopy and histology, gastroesophageal 24-hours pH-metry and 99mTc HIDA scintigraphy. Successively, they present the criteria for the identification of patients who will predictably benefit from surgical treatment, and examine advantages and limits of the two main corrective surgical techniques for the duodenogastric reflux in patients not previously operated on the gastrointestinal tract: duodenal extramucosal myotomy according to Mattioli, relatively easy to perform, and the "duodenal switch" according to De Meester, technically more complex, but pathophysiologically more acceptable, completely eliminating the duodenogastric reflux.
PubMed, Apr 1, 1995
Colorectal cancer (CRC) is a neoplasm with a steadily growing incidence in Western countries. Mor... more Colorectal cancer (CRC) is a neoplasm with a steadily growing incidence in Western countries. Moreover the age of 50 and over is a critical risk factor. The relationship between dietary, environmental factors and CRC has been evaluated. At present, a number of genetic risk factors such as the genetic susceptibility, tumor suppressor genes and oncogenes are thought to play a major role. The correlation of CRC with adenomatous polyps and chronic inflammatory disease, ulcerative colitis in particular, has been evaluated. Prevention of CRC is mainly based on a rational diet and in the adoption of mass screening programmes.
Hartmann’s reversal as a staged procedure after emergency surgery is a major abdominal operation ... more Hartmann’s reversal as a staged procedure after emergency surgery is a major abdominal operation with undeniable skill-demanding steps. The robotic approach and its advantages seem to be a safe and feasible technique and could overcome necessary technical compromises of laparoscopy, ensuring a significant reduction in restoration failures or conversion.
Background- Glutamine plays a vital role as an energy substrate the inflammatory response, preven... more Background- Glutamine plays a vital role as an energy substrate the inflammatory response, prevention of organ injury and renal acid buffering. Parenteral glutamine supplementation could reduce in-hospital and ICU morbidity and mortality. Objective- Aim of this systematic review and meta-analysis is to investigate the effects of parenteral administration of GLN in adult surgical critically ill ICU patients. Study selection- Two-arm studies about adult surgical ICU patients undergoing postoperative glutamine-enriched parenteral nutrition (experimental cohorts) vs control ones. Endpoints- Primary endpoint was in-hospital outcome (mortality, length of stay, length of mechanical ventilation). Secondary endpoint was the evaluation of nosocomial infections. Results- According to PRISMA ® 2020 flow diagram, eight randomized controlled trials were included for a total of 603 patients. No significant differences about in-hospital and ICU mortality were found (p=0.16 and p=0.53, respectively)...
Frontiers of Radiation Therapy and Oncology, 1997
Diseases of the Colon & Rectum, 1999
PURPOSE: Lymph-node involvement is the most important prognostic factor in colorectal cancers. Ma... more PURPOSE: Lymph-node involvement is the most important prognostic factor in colorectal cancers. Many staging systems adopted node status as a parameter of tumor classification. However, the number of identified and positive glands varies across articles, depending on specimen examination. There is a consistent risk of substaging tumors and undertreating patients. Aim of this study was to investigate the prognostic significance of different pathologic methods. METHODS: Eight hundred one patients who underwent curative resection of colorectal cancer entered the study and were divided into two groups. In Group 1 the specimen was "en bloc" fixed, and nodes were identified by sight and palpation. In Group 2 the mesentery of the excised specimen was dissected away from the bowel, stretched, and pinned to cork board. The mesenteric segment surrounding the origin of principal vessels was divided from the segment surrounding the colic vessels. All specimen segments were fixed, node identification being performed by sight and palpation. Examined and positive nodes were recorded, and metastatic rate and incidence was calculated in the two groups. Patients were classified with use of different staging systems. Survival rates were calculated, related to tumor stage, and compared statistically. Pathologic procedures were included in a multivariate analysis. RESULTS: A significantly higher number of detected and positive nodes and metastatic rate (37.5 vs. 30.2 percent; P < 0.05) were observed in Group 2; 45.2 percent of Group 2 and 25.3 percent of Group 1 cases had more than three positive nodes (P < 0.05). In Group 2 several patients shifted from earlier to more advanced stages compared with Group 1 cases. Five-year and ten-year survival rates were significantly higher (P = 0.04) in Group 2 (81.5 and 77.2 percent) than in Group 1 (76.7 and 61.5 percent), mostly in patients with TNM Stage NO. Survival analysis related to Astler and Cob let's and Tang's classifications confirmed such features. Higller rates of local recurrences and distant metastases were found in Group 1, particularly if related to node status
Updates in Surgery
The identification of high-risk patients in the early stages of infected pancreatic necrosis (IPN... more The identification of high-risk patients in the early stages of infected pancreatic necrosis (IPN) is critical, because it could help the clinicians to adopt more effective management strategies. We conducted a post hoc analysis of the MANCTRA-1 international study to assess the association between clinical risk factors and mortality among adult patients with IPN. Univariable and multivariable logistic regression models were used to identify prognostic factors of mortality. We identified 247 consecutive patients with IPN hospitalised between January 2019 and December 2020. History of uncontrolled arterial hypertension (p = 0.032; 95% CI 1.135–15.882; aOR 4.245), qSOFA (p = 0.005; 95% CI 1.359–5.879; aOR 2.828), renal failure (p = 0.022; 95% CI 1.138–5.442; aOR 2.489), and haemodynamic failure (p = 0.018; 95% CI 1.184–5.978; aOR 2.661), were identified as independent predictors of mortality in IPN patients. Cholangitis (p = 0.003; 95% CI 1.598–9.930; aOR 3.983), abdominal compartment...
Pigment Cell & Melanoma Research, 2020
Staging process is a critical factor to determine treatment and prognosis in melanoma patients. T... more Staging process is a critical factor to determine treatment and prognosis in melanoma patients. To date all the prognostic factors are static measurements since they are exclusively related to histological evaluation. However each melanoma growths with very different rates, and this is a fundamental parameter to consider. Our study introduces a new dynamic parameter that links an histological factor, mitosis number, to time, in order to capture aspects missed by conventional indices. Although this parameter is determined on the basis of nonobjective data because reported by patient, it can be considered as independent prognostic factors of recurrence risk.
Journal of Thoracic Oncology, 2018
(84%); 2% were incomplete. When compared with M-VATS, U-VATS was associated with superior complet... more (84%); 2% were incomplete. When compared with M-VATS, U-VATS was associated with superior completeness of resection (p¼0.0159), superior lobe-specific lymphadenectomy (p¼0.0004), and superior subcarinal lymphadenectomy (p¼0.0064). The highest mediastinal lymph node station dissected was not different between the approaches. The patients who underwent U-VATS had shorter hospital stays (mean: 4.4 days vs 6.2 days, p¼0.0001) and less thoracic drainage (mean: 4.7 days vs 5.8 days, p¼0.0004). There was no difference in operative mortality (p¼0.3024) (Table 1). Conclusion: In our institution, most VATS lobectomies were uncertain resections due to the lymph node evaluation by IASLC definition. Using U-VATS is not inferior to M-VATS in accomplishing a complete oncologic resection thoracoscopically.
Eurasian Journal of Medicine and Oncology, 2020
The COVID-19 outbreak has profoundly changed both the management and scheduling of surgical patie... more The COVID-19 outbreak has profoundly changed both the management and scheduling of surgical patients, necessitating a reduction in the number of elective cases and reserving priority for high-risk classes, such as oncological and emergency surgery. Notwithstanding the introduction of new protocols, much about the disease still remains unknown and surgical approaches, including minimally invasive surgery, are being examined for potential biohazard risks. The purpose of this article is to provide some clarification and to offer some recommendations to minimize the risk of diffusion of the virus during abdominal surgery.
Diseases of the Colon & Rectum, 1996
British Journal of Surgery, 1992
The prognostic power of the extent of tumour invasion is indisputable; Dukes' classification ... more The prognostic power of the extent of tumour invasion is indisputable; Dukes' classification has repeatedly been proven to be strongly correlated with patient survival. Modifications have led only to confusion, resulting in caution being required in the classification of patients with Dukes' A tumours. In the UK, the American tumour node metastasis and Australian clinicopathological systems are frequently considered too complex for routine clinical use. Meanwhile, Jass's classification may be complicated by observer variation between pathologists, and recent evidence suggests that it offers no advantage over that of Dukes. All the conventional staging systems also fail to take the skill of the surgeon into account when determining outcome. Attempts at quantifying tumour structure have not heralded the expected major advance. For instance, the expense and uncertain prognostic value of tumour DNA content assessed by flow cytometry are likely to restrict widespread use of t...
Eurasian Journal of Medicine and Oncology, 2020
Il Giornale di chirurgia, 2005
Il feocromocitoma e un tumore estremamente raro che si localizza nel 98% dei casi a livello del s... more Il feocromocitoma e un tumore estremamente raro che si localizza nel 98% dei casi a livello del surrene; nelle forme familiari e sovente bilaterale. E presente in sindromi quali la MEN2, la sindrome di von Hippel-Lindau e la neurofibromatosi di tipo 1. Gli Autori descrivono il caso di una giovane donna con feocromocitoma del surrene di cospicue dimensioni ed esordio clinico con addome acuto, che ha richiesto un intervento di laparotomia esplorativa con adrenalectomica unilaterale. La terapia del feocromocitoma e chirurgica eventualmente associata nelle forme maligne (10%) a chemioterapia, radioterapia e trattamento con 131IMIBG (metaiodiobenzilguanidina marcata). In tutti i casi, mancando una correlazione tra aspetto microscopico e comportamento clinico, e necessario un follow-up attento e protratto nel tempo.
Severe acute respiratory syndrome coronavirus 2 (SARSCoV-2), causing coronavirus disease 2019 (CO... more Severe acute respiratory syndrome coronavirus 2 (SARSCoV-2), causing coronavirus disease 2019 (COVID-19), has been declared a global pandemic. Belonging to betacoronavirus species, infection causes a spectrum of potentially life-threatening symptoms, such as acute distress respiratory disease. Moreover, COVID-2019 patients have often to struggle with also severe gastrointestinal complications, including ischemia [1]. SARS-CoV-2 RNA has been detected in several infected tissues, including peritoneal fluid [2]. However, its clinical relevance as far as pathophysiological mechanisms are still unclear. Although viral tropism for angiotensin-converting enzyme 2 (ACE 2) has been clearly demonstrated, as a target domain for serine protease coupled cell entry mechanism, to this date, no clear evidences about ACE2 peritoneal expression are available. Since the SARS-COV-2 Spike (S) glycoprotein complex processed by the cellular protease TMPRSS2 represents a critical step in the suppression of...
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Papers by Massimo Ippoliti