Publications by authors named "Cobianchi Lorenzo"

Colorectal cancer (CRC) is the third most diagnosed cancer worldwide and the second most common cause of cancer death. About 20% of patients diagnosed with rectal cancer present with emergency symptoms. Typical symptoms include acute bleeding, obstruction, and perforation.

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Pancreatic cancer has an increasing incidence and prevalence trend. Its prognosis is negatively affected by poor/altered nutritional status. Therefore, nutritional interventions play a critical/pivotal role at any stage.

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Acute calculous cholecystitis (ACC) and acute biliary pancreatitis (ABP) are significant complications of gallstone disease. This review aims to provide a comprehensive analysis of current management practices for ACC and ABP. The Tokyo Guidelines (TG) and World Society of Emergency Surgery (WSES) guidelines recommend early laparoscopic cholecystectomy (ELC) as the treatment of choice for ACC.

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Article Synopsis
  • * A thorough literature review led to the selection of 287 studies, which informed the development of 39 key statements addressing surgical indications, timing, and techniques for SSRF.
  • * The consensus document serves to clarify best practices in managing rib fractures, helping clinicians make informed decisions about the surgical treatment process.
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Aims: The international literature underlines that physical activity has a role in preventing cancer and is beneficial for cancer recovery and rehabilitation. Therefore, patient education is essential to stimulate training. Telemedicine and e-health tools like apps and wearables can support patients' education and the monitoring of their health condition and progress.

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  • Decellularized ECM bioscaffolds are being explored as a new 3D model for studying radiation effects on cancer cells, specifically radioresistant cell lines HMV-II and PANC-1.
  • The study involved irradiating these cells in porcine liver-derived scaffolds with high- and low-energy radiation to evaluate their biological responses in a more realistic in vivo-like environment.
  • Results showed that cells maintained their specific characteristics and responded differently to high LET radiation, with Carbon Ions causing more significant damage than photons, indicating that these bioscaffolds could be valuable for future radiobiological research.
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  • The trauma mortality rate is higher in elderly patients due to age-related physiological changes and frailty, necessitating specialized management guidelines to improve outcomes and minimize unnecessary procedures.
  • Expert surgeons reviewed literature and developed evidence-based recommendations for geriatric trauma care, focusing on frailty assessment, early activation of trauma protocols, and multimodal pain management.
  • Key practices include administering antibiotics selectively for certain traumatic injuries, ensuring timely venous thromboembolism prevention, and involving palliative care teams to address end-of-life discussions with a holistic approach.
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  • The PUECOF study seeks expert consensus on the best organizational practices for Pancreas Units, involving 30 surgical leaders across 14 countries in a Delphi survey.
  • *Surgeons emphasize the importance of multidisciplinary meetings, leadership development, and measurable outcomes, while viewing clinical professionals and patients as key stakeholders.
  • *Although the technical aspects of pancreatic surgery will remain unchanged, Pancreas Units could enhance surgeons' workflows, professional growth, and collaborative opportunities, ultimately improving patient outcomes.
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Introduction: A textbook outcome patient is one in which the operative course passes uneventful, without complications, readmission or mortality. There is a lack of publications in terms of TO on acute cholecystitis.

Objetive: The objective of this study is to analyze the achievement of TO in patients with urgent early cholecystectomy (UEC) for Acute Cholecystitis.

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Background And Study Aim: The development of a new cholangioscope, the SpyGlass™ Discover (Boston Scientific), has allowed the laparoscopic transcystic common bile duct exploration and stone clearance. The possibility of simultaneous treatment of choledocholithiasis during early laparoscopic cholecystectomy offers the opportunity to enormously reduce the time between acute cholecystitis diagnosis and the execution of cholecystectomy with better outcomes for patients. Furthermore, an altered anatomy of the gastrointestinal tract is not an obstacle to this technique.

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Background: The importance of environmental sustainability is acknowledged in all sectors, including healthcare. To meet the United Nations Sustainable Development Goals 2030 Agenda, healthcare will need a paradigm shift toward more environmentally sustainable practices that will also impact clinical decision-making. The study investigates trauma and emergency surgeons' perception, acceptance, and employment of environmentally friendly habits.

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Background: The aim of this study is to provide a meta-analysis of randomized controlled trials (RCT) comparing conservative and surgical treatment in a population of adults with uncomplicated acute appendicitis.

Methods: A systematic literature review was performed according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. A comprehensive search was conducted in MEDLINE, Embase, and CENTRAL.

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  • Preserving hormone and reproductive functions in young female cancer patients undergoing pelvic radiation is crucial, yet the effects of carbon ion radiotherapy on fertility are not well understood.
  • This study highlights a successful pregnancy resulting from a case involving carbon ion radiotherapy for sacral chondrosarcoma.
  • A coordinated medical approach was used to position the ovaries and uterus away from radiation, allowing for both effective cancer treatment and the preservation of reproductive abilities, culminating in the birth of a healthy infant.
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Metastasis to the gastrointestinal tract is a rare instance in the natural history of breast cancer, usually in association with lobular histology and widespread dissemination of disease. We report the case of a 74-year-old woman with a history of invasive lobular carcinoma presenting with a pancreatic metastasis mimicking a primary pancreatic adenocarcinoma; we also present a systematic review of the relevant literature. The presentation of pancreatic metastasis in the setting of breast cancer is unspecific, and histology is of paramount importance for a correct diagnosis; surgical metastasectomy could be of some benefit in the correct clinical setting.

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Background: Laparoscopy is widely adopted across nearly all surgical subspecialties in the elective setting. Initially finding indication in minor abdominal emergencies, it has gradually become the standard approach in the majority of elective general surgery procedures. Despite many technological advances and increasing acceptance, the laparoscopic approach remains underutilized in emergency general surgery and in abdominal trauma.

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Bioprinting offers new opportunities to obtain reliable 3Dmodels of the liver for testing new drugs and studying pathophysiological mechanisms, thanks to its main feature in controlling the spatial deposition of cell-laden hydrogels. In this context, decellularized extracellular matrix (dECM)-based hydrogels have caught more and more attention over the last years because of their characteristic to closely mimic the tissue-specific microenvironment from a biological point of view. In this work, we describe a new concept of designing dECM-based hydrogels; in particular, we set up an alternative and more practical protocol to develop a hepatic lyophilized dECM (lyo-dECM) powder as an 'off-the-shelf' and free soluble product to be incorporated as a biomimetic component in the design of 3D-printable hybrid hydrogels.

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The definition of Early Cholecystectomy (EC) is still debatable. This paper aims to find whether the timing of EC affects outcomes. The article reports a multicentric prospective observational study including patients with acute calculous cholecystitis (ACC) who had cholecystectomy within ten days from the onset of symptoms.

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Background: Existing guidelines for predicting common bile duct stones (CBDS) are not specific for acute calculous cholecystitis (ACC). This paper is a posthoc analysis of the S.P.

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Endoscopy plays a central role in diagnostic and therapeutic approaches to biliary disease in both benign and malignant conditions. A cholangioscope is an endoscopic instrument that allows for the direct exploration of the biliary tree. Over the years, technology has improved endoscopic image quality and allowed for the development of an operative procedure that can be performed during cholangioscopy.

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Background: Incisional hernia is a common short- and long-term complication of laparotomy and can lead to significant morbidity. The aim of this systematic review and meta-analysis is to provide an up-to-date overview of the laparotomy closure method in elective and emergency settings with the prophylactic mesh augmentation technique.

Methods: The Scopus, PubMed, and Web of Science databases were screened without time restrictions up to 21 June 2022 using the keywords 'laparotomy closure', 'mesh', 'mesh positioning', and 'prophylactic mesh', and including medical subject headings terms.

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Laparotomy incisions provide easy and rapid access to the peritoneal cavity in case of emergency surgery. Incisional hernia (IH) is a late manifestation of the failure of abdominal wall closure and represents frequent complication of any abdominal incision: IHs can cause pain and discomfort to the patients but also clinical serious sequelae like bowel obstruction, incarceration, strangulation, and necessity of reoperation. Previous guidelines and indications in the literature consider elective settings and evidence about laparotomy closure in emergency settings is lacking.

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To date, mortality rates associated with heart diseases are dangerously increasing, making them the leading cause of death globally. From this point of view, digital technologies can provide health systems with the necessary support to increase prevention and monitoring, and improve care delivery. The present study proposes a review of the literature to understand the state of the art and the outcomes of international experiences.

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