Publications by authors named "Benedetto F"
Liver transplantation (LT) is a curative strategy for hepatocellular carcinoma (HCC), but the risk of HCC recurrence remains a challenging problem. In patients with HCC recurrence after LT (HCC-R_LT), the locoregional and surgical approaches are complex, and the guidelines do not report evidence-based strategies for the management of immunosuppression. In recent years, immunotherapy has become an effective option for patients with advanced HCC in pre-transplant settings.
View Article and Find Full Text PDFObjective: To validate the ISGPS complexity grading system for minimally invasive pancreaticoduodenectomy (MIPD).
Background: Although concerns about patient safety persist, MIPD is gaining popularity. The ISGPS recently introduced a difficulty grading system to improve patient selection by aligning procedural complexity with surgeon and center expertise.
Minimally invasive liver surgery has become widely accepted as a safe and effective approach, especially with experienced surgeons. Robotic hepatectomy may offer significant benefits in challenging procedures like caudate lobe resection. The caudate lobe's intricate anatomy and deep-seated location make its resection particularly challenging, with limited reports on minimally invasive techniques.
View Article and Find Full Text PDFObjective: The aim of this study was to evaluate the different phases of the learning curve for robotic distal pancreatectomy (RDP) in international expert centers.
Summary Background Data: RDP is an emerging minimally invasive approach; however, only limited, mostly single center data are available on its safe implementation, including the learning curve.
Methods: Consecutive patients undergoing elective RDP from 16 expert centers across three continents were included to assess the learning curve.
Situs viscerum inversus totalis (SIT) is a rare congenital anomaly. Deceased donors with this condition are often declined because of the technical issues in both the organ's procurement and its transplant. Only eight cases of deceased donor organs with SIT were reported to be used for liver transplantation (LT).
View Article and Find Full Text PDFPurpose: To evaluate retrospectively the 2-year outcomes of the Gore Excluder Iliac Branch Endoprosthesis (IBE) in patients with and without coexisting hypogastric artery (HA) aneurysms in a large contemporary multicentric European experience using dedicated bridging devices.
Methods: The study included all consecutive patients treated at participating institutions with the Gore Excluder IBE device who received a covered stent (i.e.
Article Synopsis
- The study analyzed the relationship between the neoangiogenic transcriptomic signature (nTS) and various clinical outcomes in patients with hepatocellular carcinoma (HCC), involving a large cohort of 584 patients.
- Findings showed that nTS is linked to more aggressive disease characteristics, limited treatment options, and poorer overall survival compared to those without nTS, with significant consequences on treatment effectiveness and patient prognosis.
- Repeated transarterial chemoembolization (TACE) was found to convert some patients from nTS- to nTS+, which correlated with worsened survival rates and changes in microRNA patterns, emphasizing the nTS's role in managing and predicting HCC outcomes.
Article Synopsis
- The study evaluated mid-term outcomes of "short" inframalleolar vein bypasses in patients with chronic limb-threatening ischemia (CLTI) who previously experienced failed tibial endovascular treatments.
- A total of 107 CLTI patients were analyzed for early and 3-year outcomes, focusing on survival rates and patency levels; results indicated a 66.7% overall survival at three years.
- Insulin treatment and long-term corticosteroid use were found to negatively impact patency and limb salvage rates, emphasizing the need for careful management of these conditions in patients undergoing such procedures.
Background: Respirable mineral particles can induce lower airway inflammation, but the role they play in asthma of horses is unknown.
Objectives: Respirable mineral particles, particularly respirable silica, are an overlooked determinant of chronic lung inflammation (asthma) in horses.
Animals: Twenty-three horses from an equine hospital population: 11 moderately affected (MEA), 7 severely asthmatic (SEA), and 5 control horses free from respiratory clinical signs.
Article Synopsis
- - Robotic surgery is gaining popularity in the surgical field, especially for liver resections, but its effectiveness near major blood vessels needs further investigation.
- - A study of 1030 patients categorized them into two groups (lesions in contact with major vessels vs. those free from) to compare surgical outcomes before and after adjusting for other variables.
- - Findings indicated that while the Pringle Manoeuvre was more frequently used in surgeries near major vessels, overall operative time, complication rates, and surgery success were similar between both groups, suggesting robotic surgery is safe even for challenging cases.
Introduction: To confirm real-world clinical practice results reported with anatomically fixed bifurcated endograft, a physician-initiated study was designed-AFX2-LIVE registry.
Materials And Methods: From November 2019 to August 2021, investigators enrolled all consecutive patients treated with AFX2 (Endologix Inc., Irvine, CA, USA) endograft.
Article Synopsis
- The study investigates how the length of time taken during liver surgeries affects the likelihood of postoperative complications in patients undergoing different types of liver resections.
- A total of 5,424 patients were analyzed from multiple centers between 2000 and 2022, focusing on procedures like right hemihepatectomy, technically major resection, and left lateral sectionectomy.
- Results show that patients in the longest operative time group had a significantly higher risk of complications, particularly in various surgical approaches like open, laparoscopic, and robotic surgeries.
Reconstructing the hepatic artery in adult living donor liver transplantation is technically challenging, with complications leading to significant morbidity and mortality. Early arterial thrombosis can result in a mortality rate up to 50%, often necessitating re-transplantation. The most common techniques for arterial anastomosis include end-to-end reconstruction with interrupted or continuous sutures, either using magnifying loupes or a microscope.
View Article and Find Full Text PDFArticle Synopsis
- This study compares outcomes of open liver resection (OLR), laparoscopic liver resection (LLR), and percutaneous thermal ablation (PTA) in elderly patients (≥70 years) with single hepatocellular carcinoma (HCC) ≤30 mm.
- A total of 239 patients were analyzed, revealing that PTA resulted in shorter hospital stays and less morbidity than OLR or LLR, but lower 5-year overall and disease-free survival rates.
- The findings suggest that while PTA is advantageous for specific HCC locations, surgical options (OLR and LLR) offer better long-term survival outcomes for elderly patients.
Countries all over the world are shifting from conventional and fossil fuel-based energy systems to more sustainable energy systems (renewable energy-based systems). To effectively integrate renewable sources of energy, multi-directional power flow and control are required, and to facilitate this multi-directional power flow, peer-to-peer (P2P) trading is employed. For a safe, secure, and reliable P2P trading system, a secure communication gateway and a cryptographically secure data storage mechanism are required.
View Article and Find Full Text PDFDual hypothermic oxygenated perfusion (DHOPE) is increasingly being used to extend liver preservation to improve transplant logistics. However, little is known about its benefits in high-risk liver grafts. This study aimed to investigate whether prolonged DHOPE provides benefits other than improved logistics in all liver types.
View Article and Find Full Text PDFArticle Synopsis
- Recent international guidelines have defined metabolic dysfunction-associated steatotic liver disease (MASLD), leading to a rise in its prevalence as a reason for liver transplantation (LT) in Italy between 2012 and 2022.
- * An analysis of 1,941 patients with MASLD and 11,201 without MASLD revealed that while the prevalence of MASLD patients waiting for LT increased significantly, it did not independently affect patient survival post-transplant.
- * Patients with non-HCC MASLD faced higher mortality rates on the waiting list but projected better 5-year transplant survival benefits than those without MASLD or HCC.
Article Synopsis
- The Barcelona Clinic Liver Cancer (BCLC) staging system is crucial for treating hepatocellular carcinoma (HCC); recent updates allow for BCLC stage B patients to consider liver transplantation, while hepatectomy is now discouraged.
- A systematic review analyzed 31 studies involving 3163 patients to compare survival rates, postoperative complications, and patient selection for liver resection versus transplantation in BCLC stage B patients.
- Results showed that while resection had a 50-month survival and a 15-month recurrence-free period, data on transplantation was limited, with only one study reporting on it, indicating the need for more research in this area.
Background: The challenge of transplant waiting-lists is to provide organs for all candidates while maintaining efficiency and equity.
Aims: We investigated the probability of being transplanted or of waiting-list dropout in Italy.
Methods: Data from 12,749 adult patients waitlisted for primary liver-transplantation from January 2012 to December 2022 were collected from the National Transplant-Registry.
Article Synopsis
- A study was conducted to compare robotic minor liver resections (RMLR) with laparoscopic minor liver resections (LMLR) in patients undergoing surgery on the anterolateral liver segments.
- The analysis included over 10,000 patients and employed propensity score matching to balance the groups for accuracy in comparisons.
- Results indicated RMLR had benefits like less blood loss, lower major morbidity, and shorter hospital stays than LMLR, although the difference in 30-day readmission rates suggested RMLR may have some drawbacks.
Article Synopsis
- Liver transplantation (LT) was once thought not to work for a type of cancer called perihilar cholangiocarcinoma (pCCA), but a new method from the Mayo Clinic showed it could help if patients followed strict rules and took certain treatments first.
- In a study of 22 liver transplant centers in Italy, 53 patients with pCCA were looked at, with some getting special treatment before the transplant and others not.
- The results showed that patients who had the pre-treatment did better after 1, 3, and 5 years compared to those who didn’t, leading to talks about making new rules for how to treat this cancer better in Italy.
: Infections frequently occur after orthotopic liver transplantation (OLT) and are associated with increased mortality. In 2018, we introduced perioperative administration of intravenous immunoglobulin enriched in IgM as an optional therapy in recipients at a high risk of infection. This preliminary study evaluated whether this preparation reduced infections in the early post-transplantation period.
View Article and Find Full Text PDFPancreatic ductal adenocarcinoma (PDAC) still has a poor response to therapies, partly due to their cancer-associated fibroblasts (CAFs). Here, we investigate the synergistic impact of a combinatory approach between a known chemotherapy agent, such as gemcitabine (GEM), and gene-modified human mesenchymal stromal/stem cells (MSCs) secreting the pro-apoptotic soluble (s)TRAIL (sTRAIL MSCs) on both PDAC cells and CAFs. The combo significantly impacts on PDAC survival in 2D and 3D models.
View Article and Find Full Text PDFIntroduction: Enhancing reading efficiency is of paramount importance in various academic, professional and clinical domains. Previous research, mostly from a single laboratory, has shown that externally imposed time constraints by means of text fading can enhance reading fluency in children and adults with varying reading abilities and in different languages.
Methods: In the present study, we aimed at replicating and extending previous results in Italian readers.