We review herein the available data regarding the potential relationship between antidepressants ... more We review herein the available data regarding the potential relationship between antidepressants and breast cancer. According to some studies, the biological rationale leading correlation among antidepressants and mammary carcinogenesis is represented by the increase in prolactin levels and by the promotion of cell proliferation. However, these studies seem to be spoiled by an unsatisfactory statistical design and by the lack of a good control for confounding elements. Thus, experimental and clinical data remain controversial, even though recent studies tend to exclude a causative link between depressive disorders and breast malignancies. We have also investigated whether the concomitant use of selective serotonin re-uptake inhibitors and hormonal therapy influences cancer-related risk of death in ER-positive breast cancer patients treated with adjuvant anti-estrogen therapy. Even here an unequivocal consensus seems to be lacking, most of the studies suggest that women in hormonal adjuvant therapy experiencing depression can be safely treated with SSRI, without a negative impact on breast cancer prognosis. Whether depression and antidepressant have a role in breast tumour development, a reverse correlation is undeniably present. We reviewed the Literature to assess if there is a relationship between antidepressants and breast cancer risk and if antidepressants use may affect breast cancer patients' prognosis. We also provide a thorough list of potential pharmacological interactions between the molecules currently used for breast cancer treatment and antidepressants.
Background: Endoscopic and laparoscopic local resection of gastric tumors has increasingly been p... more Background: Endoscopic and laparoscopic local resection of gastric tumors has increasingly been performed in recent years. This article describes the technical considerations and early results of laparoscopic-endoscopic rendezvous resection of gastric lesions. Patients and Methods: Rendezvous resection was performed in 26 patients with submucosal gastric tumors (n = 22) and early gastric cancer (n = 4). Laparoscopic wedge resection (LWR) was performed in 16 patients with anterior wall tumors and laparoscopic intragastric resection (LIR) in 7 patients with posterior wall tumors. Conversion to open surgery was carried out in 3 cases. Results: Operation times were 53 min (range 35–115) for LWR and 83 min (range 56–130) for LIR, respectively. In submucosal lesions the mean tumor size was 36 mm (range 16–47) and in early gastric cancer 17.3 mm (range 16–20). Rendezvous resection was performed with curative intent and clear resection margins in all patients without lymphatic or vessel per...
In the laparoscopic era, the use of the stapler is a common practice and it adds to the possible ... more In the laparoscopic era, the use of the stapler is a common practice and it adds to the possible causes of post-operative bowel adhesions with obstruction. In this study, we reviewed the Literature in order to study the pathogenesis and the incidence of bowel obstruction after using the laparoscopic stapler. Furthermore, we report a case of a woman who went to our observation for incoming bowel obstruction after laparoscopic ileal resection. In the emergency setting, the laparoscopic exploration revealed that a staple created adherence between an intestinal loop and its mesentery with consequent internal hernia and volvulus. The patient was treated by laparoscopy with removal of the offending staple and resection of the intestinal necrotic segment. Tips and tricks of the surgical technique for avoiding such rare but threatful complication, are discussed. KEY WORDS: Internal hernia, Mechanical bowel obstruction, Laparoscopic stapler, Volvulus.
The Authors discuss on a laparoscopic-assisted approach for excision of a sessile villous adenoma... more The Authors discuss on a laparoscopic-assisted approach for excision of a sessile villous adenomatous polyp of the cecum, unresectable by endoscopy. Because of the large implant of the polyp, endoscopic polypectomy was considered at high risk and a surgical laparoscopic procedure was scheduled for removal of the lesion. After right colon mobilization, an intraoperative endoscopy confirmed the location of th polyp in the posterior wall of the cecum, closed to the ileo-cecal valve. A small 10 cm laparotomy, through which the cecum was pulled out the abdominal cavity, was performed. Then, a minimal colotomy along the intestinal taenia was carried out to allow a safe and complete excision of the polyp. This laparoscopic approach differs from the other laparoscopic-assisted methods reported in the Literature since it provides at the same time the postoperative advantages associated with minimal access surgery and a safe oncological removal of the polyp with low risks of complications.
Mucinous adenocarcinoma of the small bowel is very rare, and only few cases have been described i... more Mucinous adenocarcinoma of the small bowel is very rare, and only few cases have been described in the literature. Association of this tumor with celiac disease has never been published. The authors report a unique case of jejunal mucinous adenocarcinoma in which a concomitant celiac disease has been histologically recognized. The difficult diagnosis, the role of laparoscopic surgery and the relationship between small bowel tumors and celiac disease are discussed. A 49-year-old man presented with recurrent melena, nausea, vomiting and anemia. A stenosis of the jejunum was documented by means of CT scan and video capsule enteroscopy. A laparoscopy was scheduled. A tumor, found in the first jejunal loop, was removed by laparoscopic surgery. Histopathology revealed a rare mucinous adenocarcinoma associated with epithelial changes secondary to celiac disease. Although small bowel tumors are rare entity, in patients with celiac disease complaining of symptoms related to altered intestina...
Laparoscopic colo-rectal surgery has been increasingly accepted and performed in several surgical... more Laparoscopic colo-rectal surgery has been increasingly accepted and performed in several surgical centres. However, there are still concerns about the intra-operative risks and therefore on the safety of the procedure especially during the learning curve. As a matter of fact, in approximately one third of laparoscopic colo-rectal procedures, an intra-operative complication, mainly bleeding or iatrogenic injuries, may occur. In this paper, according to our experience, we analyse step by step the surgical technique of the laparoscopic left colectomy and evaluate the technical difficulties and complications in order to avoid them.
INTRODUCTION Appendicular schwannoma is a rare benign neoplastic proliferation of the appendicula... more INTRODUCTION Appendicular schwannoma is a rare benign neoplastic proliferation of the appendicular Schwann cells. It is often asymptomatic until it occludes the appendicular lumen thus causing appendicitis-like symptoms. EVIDENCE ACQUISITION The neoplastic proliferation of the Schwann cells, although benign, may rarely degenerate into a malignant neoplasm, thus denoting the importance of diagnosis. Some Authors in the Literature used the term "neuroma" or "neurinoma" to indicate either a hyperplastic proliferation of the Schwann cells or its neoplastic but benign proliferation, thus raising the important question of a probable mistaking of these two different histologic entities. The hyperplastic proliferation is usually subsequent to a chronic appendicular inflammation, and it is a more common finding in specimen of appendectomy. EVIDENCE SYNTHESIS Aim of the study is to review the published scientific papers about the rare histologic entity of appendicular schw...
Paratubal cysts represent approximately 10% of all adnexal masses. In most cases they are very sm... more Paratubal cysts represent approximately 10% of all adnexal masses. In most cases they are very small, but very few cases are reported in the literature where they exceed 15 cm of diameter. Furthermore, giant paratubal cysts complicated by bilateral hydronephrosis are unique. The Authors describe a case of a huge paratubal cyst (30 cm in diameter), in a 14 year old obese girl, treated by complete laparoscopic enucleation.
Journal of Laparoendoscopic & Advanced Surgical Techniques, 2009
Giant ovarian cysts are very rare. Recently, laparoscopic treatment, with extirpation of the gian... more Giant ovarian cysts are very rare. Recently, laparoscopic treatment, with extirpation of the giant cyst and associated oophorectomy, has been reported. In this article, we describe the first case of complete laparoscopic enucleating of a giant serous cystoadenomyoma with preservation of residual ovarian parenchyma in an 18-year-old girl.
Pediatric surgery is now in the forefront of minimal access procedures. Although pediatric surgeo... more Pediatric surgery is now in the forefront of minimal access procedures. Although pediatric surgeons have been skeptic about laparoscopic splenectomy, recently minimally invasive approach for spleen removal has been revaluated also in young patients. Purpose of this study was to report Authors' personal experience in patients under eighteen who underwent laparoscopic splenectomy. Results of the procedure were evaluated. A retrospective review was undertaken in 18 splenectomised patients under the age of eighteen. Indications were hereditary spherocytosis in 10 patients, β-thalassemia in 4, idiopathic thrombocytopenic purpura in 3 and a splenic cyst in 1 child. No intra-operative complications occurred. No conversion to open surgery was reported. During the follow-up one case of portal vein thrombosis, treated by medical therapy, was encountered and no other postoperative complications were observed. Laparoscopic approach has to be preferable for all those children undergoing sple...
This case report describes a 69-year-old man presenting with an extensive subcutaneous emphysema ... more This case report describes a 69-year-old man presenting with an extensive subcutaneous emphysema in his neck and generalized peritonitis caused by a lower gastrointestinal tract perforation. This case emphasizes that subcutaneous emphysema patients with negative thoracic findings should be scrutinized for signs of retroperitoneal hollow viscus perforation.
BACKGROUND AND OBJECTIVES Laparoscopic surgery is a widely used surgical technique, whose benefit... more BACKGROUND AND OBJECTIVES Laparoscopic surgery is a widely used surgical technique, whose benefits either for patients or for surgeons are well-recognized. Despite the rise in the use of this technique, the ergonomics of the operating room is still very low. The consequence is that injuries and illness related to laparoscopic surgery are present. The aims of this study are to investigate how an increase in the surgeon' perception of the fatigue during the execution of the intervention influences the surgeon' health, and to evaluate if there is a correlation between the increase in fatigue and the operating field dimension. MATERIALS AND METHODS The observation was conducted on a single laparoscopist working at our Institution and the Borg CR 0-10 scale was used to perform this study. Two groups of 20 surgical procedures each were analysed. Group A included laparoscopic procedures whose operating field comprehended only one abdominal quadrant. Group B included laparoscopic pr...
PURPOSE Nowadays, there is no standardization in surgical procedures for treatment of colon cance... more PURPOSE Nowadays, there is no standardization in surgical procedures for treatment of colon cancer. Since its introduction, laparoscopic surgery has gained increasing interest in colorectal surgery and it is now performed worldwide for treatment of colon cancer. Following the concept of total mesocolic excision introduced by Heald in 1988 in order to reduce local recurrence after surgical treatment of mid/low rectal tumors, the idea of complete removal of the mesocolon mesocolic envelope has been developed also for colon cancer, has evolved longtime and complete mesocolic excision has been recently adopted as the optimal approach for colon cancer. However, complete mesocolic excision, whose purpose is to remove all lymphatics and lymph nodes draining the tumor, is still discussed as far as oncologic results are concerned. Moreover, the role of laparoscopic approach for complete removal of mesocolon has to be defined. METHODS Selection of studies. A MEDLINE-PubMed database search of ...
Archivio italiano di urologia, andrologia : organo ufficiale [di] Societa italiana di ecografia urologica e nefrologica, 2020
Urolithiasis is one of the most frequent disease in the population and it represents one of the m... more Urolithiasis is one of the most frequent disease in the population and it represents one of the most frequent causes of access to emergency department. In addition. congenital anomalies occur more often in the kidney than in any other organ and the association of both renal abnormalities and stones is of clinical relevance. In this report, we discuss a case of a women with pelvic ectopic kidney affected by a large pyelic stone treated with ESWL (Extracorporeal Shockwave Lithotripsy).
We review herein the available data regarding the potential relationship between antidepressants ... more We review herein the available data regarding the potential relationship between antidepressants and breast cancer. According to some studies, the biological rationale leading correlation among antidepressants and mammary carcinogenesis is represented by the increase in prolactin levels and by the promotion of cell proliferation. However, these studies seem to be spoiled by an unsatisfactory statistical design and by the lack of a good control for confounding elements. Thus, experimental and clinical data remain controversial, even though recent studies tend to exclude a causative link between depressive disorders and breast malignancies. We have also investigated whether the concomitant use of selective serotonin re-uptake inhibitors and hormonal therapy influences cancer-related risk of death in ER-positive breast cancer patients treated with adjuvant anti-estrogen therapy. Even here an unequivocal consensus seems to be lacking, most of the studies suggest that women in hormonal adjuvant therapy experiencing depression can be safely treated with SSRI, without a negative impact on breast cancer prognosis. Whether depression and antidepressant have a role in breast tumour development, a reverse correlation is undeniably present. We reviewed the Literature to assess if there is a relationship between antidepressants and breast cancer risk and if antidepressants use may affect breast cancer patients' prognosis. We also provide a thorough list of potential pharmacological interactions between the molecules currently used for breast cancer treatment and antidepressants.
Background: Endoscopic and laparoscopic local resection of gastric tumors has increasingly been p... more Background: Endoscopic and laparoscopic local resection of gastric tumors has increasingly been performed in recent years. This article describes the technical considerations and early results of laparoscopic-endoscopic rendezvous resection of gastric lesions. Patients and Methods: Rendezvous resection was performed in 26 patients with submucosal gastric tumors (n = 22) and early gastric cancer (n = 4). Laparoscopic wedge resection (LWR) was performed in 16 patients with anterior wall tumors and laparoscopic intragastric resection (LIR) in 7 patients with posterior wall tumors. Conversion to open surgery was carried out in 3 cases. Results: Operation times were 53 min (range 35–115) for LWR and 83 min (range 56–130) for LIR, respectively. In submucosal lesions the mean tumor size was 36 mm (range 16–47) and in early gastric cancer 17.3 mm (range 16–20). Rendezvous resection was performed with curative intent and clear resection margins in all patients without lymphatic or vessel per...
In the laparoscopic era, the use of the stapler is a common practice and it adds to the possible ... more In the laparoscopic era, the use of the stapler is a common practice and it adds to the possible causes of post-operative bowel adhesions with obstruction. In this study, we reviewed the Literature in order to study the pathogenesis and the incidence of bowel obstruction after using the laparoscopic stapler. Furthermore, we report a case of a woman who went to our observation for incoming bowel obstruction after laparoscopic ileal resection. In the emergency setting, the laparoscopic exploration revealed that a staple created adherence between an intestinal loop and its mesentery with consequent internal hernia and volvulus. The patient was treated by laparoscopy with removal of the offending staple and resection of the intestinal necrotic segment. Tips and tricks of the surgical technique for avoiding such rare but threatful complication, are discussed. KEY WORDS: Internal hernia, Mechanical bowel obstruction, Laparoscopic stapler, Volvulus.
The Authors discuss on a laparoscopic-assisted approach for excision of a sessile villous adenoma... more The Authors discuss on a laparoscopic-assisted approach for excision of a sessile villous adenomatous polyp of the cecum, unresectable by endoscopy. Because of the large implant of the polyp, endoscopic polypectomy was considered at high risk and a surgical laparoscopic procedure was scheduled for removal of the lesion. After right colon mobilization, an intraoperative endoscopy confirmed the location of th polyp in the posterior wall of the cecum, closed to the ileo-cecal valve. A small 10 cm laparotomy, through which the cecum was pulled out the abdominal cavity, was performed. Then, a minimal colotomy along the intestinal taenia was carried out to allow a safe and complete excision of the polyp. This laparoscopic approach differs from the other laparoscopic-assisted methods reported in the Literature since it provides at the same time the postoperative advantages associated with minimal access surgery and a safe oncological removal of the polyp with low risks of complications.
Mucinous adenocarcinoma of the small bowel is very rare, and only few cases have been described i... more Mucinous adenocarcinoma of the small bowel is very rare, and only few cases have been described in the literature. Association of this tumor with celiac disease has never been published. The authors report a unique case of jejunal mucinous adenocarcinoma in which a concomitant celiac disease has been histologically recognized. The difficult diagnosis, the role of laparoscopic surgery and the relationship between small bowel tumors and celiac disease are discussed. A 49-year-old man presented with recurrent melena, nausea, vomiting and anemia. A stenosis of the jejunum was documented by means of CT scan and video capsule enteroscopy. A laparoscopy was scheduled. A tumor, found in the first jejunal loop, was removed by laparoscopic surgery. Histopathology revealed a rare mucinous adenocarcinoma associated with epithelial changes secondary to celiac disease. Although small bowel tumors are rare entity, in patients with celiac disease complaining of symptoms related to altered intestina...
Laparoscopic colo-rectal surgery has been increasingly accepted and performed in several surgical... more Laparoscopic colo-rectal surgery has been increasingly accepted and performed in several surgical centres. However, there are still concerns about the intra-operative risks and therefore on the safety of the procedure especially during the learning curve. As a matter of fact, in approximately one third of laparoscopic colo-rectal procedures, an intra-operative complication, mainly bleeding or iatrogenic injuries, may occur. In this paper, according to our experience, we analyse step by step the surgical technique of the laparoscopic left colectomy and evaluate the technical difficulties and complications in order to avoid them.
INTRODUCTION Appendicular schwannoma is a rare benign neoplastic proliferation of the appendicula... more INTRODUCTION Appendicular schwannoma is a rare benign neoplastic proliferation of the appendicular Schwann cells. It is often asymptomatic until it occludes the appendicular lumen thus causing appendicitis-like symptoms. EVIDENCE ACQUISITION The neoplastic proliferation of the Schwann cells, although benign, may rarely degenerate into a malignant neoplasm, thus denoting the importance of diagnosis. Some Authors in the Literature used the term "neuroma" or "neurinoma" to indicate either a hyperplastic proliferation of the Schwann cells or its neoplastic but benign proliferation, thus raising the important question of a probable mistaking of these two different histologic entities. The hyperplastic proliferation is usually subsequent to a chronic appendicular inflammation, and it is a more common finding in specimen of appendectomy. EVIDENCE SYNTHESIS Aim of the study is to review the published scientific papers about the rare histologic entity of appendicular schw...
Paratubal cysts represent approximately 10% of all adnexal masses. In most cases they are very sm... more Paratubal cysts represent approximately 10% of all adnexal masses. In most cases they are very small, but very few cases are reported in the literature where they exceed 15 cm of diameter. Furthermore, giant paratubal cysts complicated by bilateral hydronephrosis are unique. The Authors describe a case of a huge paratubal cyst (30 cm in diameter), in a 14 year old obese girl, treated by complete laparoscopic enucleation.
Journal of Laparoendoscopic & Advanced Surgical Techniques, 2009
Giant ovarian cysts are very rare. Recently, laparoscopic treatment, with extirpation of the gian... more Giant ovarian cysts are very rare. Recently, laparoscopic treatment, with extirpation of the giant cyst and associated oophorectomy, has been reported. In this article, we describe the first case of complete laparoscopic enucleating of a giant serous cystoadenomyoma with preservation of residual ovarian parenchyma in an 18-year-old girl.
Pediatric surgery is now in the forefront of minimal access procedures. Although pediatric surgeo... more Pediatric surgery is now in the forefront of minimal access procedures. Although pediatric surgeons have been skeptic about laparoscopic splenectomy, recently minimally invasive approach for spleen removal has been revaluated also in young patients. Purpose of this study was to report Authors' personal experience in patients under eighteen who underwent laparoscopic splenectomy. Results of the procedure were evaluated. A retrospective review was undertaken in 18 splenectomised patients under the age of eighteen. Indications were hereditary spherocytosis in 10 patients, β-thalassemia in 4, idiopathic thrombocytopenic purpura in 3 and a splenic cyst in 1 child. No intra-operative complications occurred. No conversion to open surgery was reported. During the follow-up one case of portal vein thrombosis, treated by medical therapy, was encountered and no other postoperative complications were observed. Laparoscopic approach has to be preferable for all those children undergoing sple...
This case report describes a 69-year-old man presenting with an extensive subcutaneous emphysema ... more This case report describes a 69-year-old man presenting with an extensive subcutaneous emphysema in his neck and generalized peritonitis caused by a lower gastrointestinal tract perforation. This case emphasizes that subcutaneous emphysema patients with negative thoracic findings should be scrutinized for signs of retroperitoneal hollow viscus perforation.
BACKGROUND AND OBJECTIVES Laparoscopic surgery is a widely used surgical technique, whose benefit... more BACKGROUND AND OBJECTIVES Laparoscopic surgery is a widely used surgical technique, whose benefits either for patients or for surgeons are well-recognized. Despite the rise in the use of this technique, the ergonomics of the operating room is still very low. The consequence is that injuries and illness related to laparoscopic surgery are present. The aims of this study are to investigate how an increase in the surgeon' perception of the fatigue during the execution of the intervention influences the surgeon' health, and to evaluate if there is a correlation between the increase in fatigue and the operating field dimension. MATERIALS AND METHODS The observation was conducted on a single laparoscopist working at our Institution and the Borg CR 0-10 scale was used to perform this study. Two groups of 20 surgical procedures each were analysed. Group A included laparoscopic procedures whose operating field comprehended only one abdominal quadrant. Group B included laparoscopic pr...
PURPOSE Nowadays, there is no standardization in surgical procedures for treatment of colon cance... more PURPOSE Nowadays, there is no standardization in surgical procedures for treatment of colon cancer. Since its introduction, laparoscopic surgery has gained increasing interest in colorectal surgery and it is now performed worldwide for treatment of colon cancer. Following the concept of total mesocolic excision introduced by Heald in 1988 in order to reduce local recurrence after surgical treatment of mid/low rectal tumors, the idea of complete removal of the mesocolon mesocolic envelope has been developed also for colon cancer, has evolved longtime and complete mesocolic excision has been recently adopted as the optimal approach for colon cancer. However, complete mesocolic excision, whose purpose is to remove all lymphatics and lymph nodes draining the tumor, is still discussed as far as oncologic results are concerned. Moreover, the role of laparoscopic approach for complete removal of mesocolon has to be defined. METHODS Selection of studies. A MEDLINE-PubMed database search of ...
Archivio italiano di urologia, andrologia : organo ufficiale [di] Societa italiana di ecografia urologica e nefrologica, 2020
Urolithiasis is one of the most frequent disease in the population and it represents one of the m... more Urolithiasis is one of the most frequent disease in the population and it represents one of the most frequent causes of access to emergency department. In addition. congenital anomalies occur more often in the kidney than in any other organ and the association of both renal abnormalities and stones is of clinical relevance. In this report, we discuss a case of a women with pelvic ectopic kidney affected by a large pyelic stone treated with ESWL (Extracorporeal Shockwave Lithotripsy).
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Papers by Eva Intagliata