Publications by authors named "Ercoli A"

Article Synopsis
  • - Autophagy is a vital cellular process that helps keep cells healthy by breaking down damaged proteins and organelles, especially during stress, and it's essential in maintaining the endometrium and supporting pregnancy.
  • - This process is regulated by various signaling pathways and plays a complex role in preventing tumors by managing cellular homeostasis, but can also promote cancer progression in endometrial carcinoma by supporting nutrient supply for cancer cells.
  • - Investigating autophagy's mechanisms and pathways reveals its potential as a therapeutic target in treating endometrial carcinoma, offering hope for effective treatments and overcoming resistance to existing therapies.
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Background: Literature is lacking strong evidence about comparisons of efficacy and quality of life-related outcomes between laparoscopic total and/or supracervical hysterectomy (LTH/LSCH) with laparoscopic sacrocolpopexy (LSC) and minimally invasive sacrohysteropexy (LSH).

Objective: To summarize and compare available data on this topic providing a useful clinical tool in the treatment decision process.

Search Strategy: We performed a systematic research of PubMed (MEDLINE), Web of Science, and Gooogle Scholar.

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This narrative review describes the state of the art in the management of anastomotic leakage in ovarian cancer. Multiple surgical procedures, including bowel resection, are often required to achieve "optimal" cytoreduction in locally advanced ovarian cancer. Intestinal anastomosis is currently the most common way to restore bowel continuity.

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Article Synopsis
  • The study investigates the outcomes of a new surgical technique called pelvic organ prolapse suspension (POPS) for treating pelvic organ prolapse (POP) and rectal prolapse, focusing on patients who experience recurrence of symptoms after the procedure.
  • The research involved 25 women, primarily menopausal, who mostly had recurrent posterior vaginal wall prolapse and associated obstructed defecation syndrome, with all undergoing laparoscopic ventral rectopexy surgery.
  • Findings indicated no anatomical recurrences after surgery and a significant improvement in patient symptoms, suggesting that a multidisciplinary approach and the use of minimally invasive techniques can be effective for managing recurrent POP.
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Cervical cancer continues to have a significant incidence, despite global efforts in HPV vaccination campaigns. Managing this condition involves a diverse team of healthcare professionals. Research in this field is undergoing a period of great revolution in multiple areas, and international guidelines will soon have to adapt to new scientific evidence.

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Objective: To evaluate complication rate and functional outcomes of nerve-sparing parametrectomy for deep endometriosis in relation to the extension of the surgical procedure, based on recognizable anatomical landmarks.

Methods: This was a prospective single-center study including all patients undergoing parametrectomy for deep endometriosis from September 2020 to June 2023 at our tertiary center. Dorsolateral parametrectomies were divided into parametrectomies medial to the presacral fascia and cranial to the medial rectal artery (superficial parametrectomy), and parametrectomies in which one of the two landmarks was overcome during the surgical procedure, leading to the excision of tissue lateral to the presacral fascia (deep parametrectomy type 1, or DP1) or caudal to the medial rectal artery (DP2).

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Background: The NuvaRing®, a hormonal vaginal contraceptive device, has gained widespread usage due to its favourable efficacy and safety profiles. Exceedingly rare instances of unintended misplacement in the bladder have been reported. This study presents a review of the literature and the first video report illustrating the extraction of an intravesical NuvaRing®, discussing diagnostic and therapeutic approaches.

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Background And Aim: Pelvic inflammatory disease (PID) is usually managed by conservative treatment, but in selected cases, especially in the presence of a tubo-ovarian abscess (TOA), surgical management is a recognized treatment option. We compared the trends in managing PID and short-term outcomes before and during the SARS-CoV-2 pandemic.

Methods: This is a retrospective study performed in three Italian gynecological centers.

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Article Synopsis
  • The study aimed to validate the Betella algorithm specifically for endometrial cancer patients, highlighting its impact on risk assessment according to 2020 ESGO/ESTRO/ESP guidelines.
  • Conducted between March 2021 and March 2023, the research analyzed 102 patients’ molecular characteristics including p53 and mismatch repair protein levels, finding that 97% had complete analyses, which altered risk classifications for 11.1% of patients.
  • The validation of the Betella algorithm allows for more accurate risk classification and can optimize resource use in treatment by reducing unnecessary molecular testing in a significant number of cases.
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This research aimed to evaluate the association between the monthly consumption of fish (differentiated by type) and both gestational and neonatal outcomes. Women who were admitted for delivery in the last 6 months of 2023 were prospectively included and divided according to type of fish consumed (based on DHA and mercury content) and frequency of consumption. Neonatal outcomes included weight, length, head circumference, and 1st and 5th minute Apgar scores.

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Objective: To present a new surgical technique on the basis of an internal thigh fasciocutaneous flap for generating a compliant and sensitive neovagina with preservation of the external genitalia.

Design: Video demonstration of the surgical steps.

Patient(s): An 18-year-old woman with Müllerian agenesis confirmed at ultrasound and magnetic resonance imaging.

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Article Synopsis
  • A study assessed the role of abnormal p53 expression in 370 patients with low-risk endometrial cancer (EC), discovering that 4.9% had p53 abnormalities, which could indicate a higher recurrence risk.
  • Among the patients, 3.6% experienced recurrences, with those exhibiting abnormal p53 expression having a 5.23 times higher odds of recurrence compared to those with normal p53.
  • Although there was no significant difference in overall survival between the two groups, the findings suggest that molecular classification for p53 abnormalities may help tailor treatment in future studies of low-risk EC patients.
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About 50% of High Grade Serous Ovarian Cancer exhibit a high degree of genomic instability due to mutation of genes involved in Homologous Recombination (HRD) and such defect accounts for synthetic lethality mechanism of PARP inhibitors (PARP-i). Several clinical trials have shown how BRCA and HRD mutational status profoundly affect first line chemotherapy as well as response to maintenance therapy with PARP-i, hence Progression Free Survival and Overall Survival. Consequently, there is urgent need for the development of increasingly reliable HRD tests, overcoming present limitations, as they play a key role in the diagnostic and therapeutic process as well as have a prognostic and predictive value.

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Vaccination against SARS-CoV-2 has played a critical role in controlling the spread of the pandemic. The main side effects of SARS-CoV-2 vaccination include fever and fatigue; however, the potential impacts on menstrual cycles are to be determined. Given the limited number of studies suggesting menstrual changes post vaccination, this study investigates the correlation between COVID-19 vaccines and menstrual cycle changes in fertile-aged Italian women.

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Pelvic exenteration (PE) is a radical oncological surgical procedure proposed in patients with recurrent or persistent gynecological cancers. The radical alteration of pelvic anatomy and of pelvic floor integrity can cause major postoperative complications. Fortunately, PE can be combined with reconstructive procedures to decrease complications and functional and support problems of pelvic floor, reducing morbility and mortality and increasing quality of life.

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Squamous cervical carcinoma (SCC) requires particular attention in diagnostic and clinical management. New diagnostic tools, such as (positron emission tomography-magnetic resonance imaging) PET-MRI, consent to ameliorate clinical staging accuracy. The availability of new technologies in radiation therapy permits to deliver higher dose lowering toxicities.

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Objective: To evaluate pre-operative predictors of early (<30 days) severe complications (grade Dindo 3+) in patients with gynecological malignancy submitted to pelvic exenteration (PE).

Methods: We retrospectively analyzed 129 patients submitted to surgery at Fondazione Policlinico Gemelli between 2010 and 2019. We included patients affected by primary or recurrent/persistent cervical, endometrial, or vulvar/vaginal cancers.

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Pelvic exenteration is a radical procedure representing a salvage option in patients with recurrent or persistent gynaecological malignancies. It can be performed with an open or minimally invasive approach. Different studies have demonstrated optimal peri-operative outcomes of minimally invasive pelvic exenteration with no survival difference when compared with an open approach.

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Robot-assisted surgery has been proven to offer improvements in term of surgical learning curve and feasibility of minimally invasive surgery, but has often been criticized for its longer operative times compared to conventional laparoscopy. Additional times can be split into time required for system set-up, robotic arms docking and calibration of robotic instruments; secondly, surgeon's learning curve. One of the newest systems recently launched on the market is the Hugo™ RAS (MEDTRONIC Inc, United States).

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Article Synopsis
  • Sacral colpopexy, using autologous tissue, is being examined as a safe and effective alternative to standard procedures involving synthetic mesh for treating advanced apical prolapse.
  • A systematic review was conducted, finding that 7 eligible studies reported cure rates between 94.7% and 100% with medium-term follow-up, and high satisfaction levels among patients.
  • Complication rates varied from 0% to 36.8%, with most being minor, suggesting that sacral colpopexy with autologous fascia can be considered in specific clinical cases.
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The realm of prenatal diagnosis has witnessed remarkable advancements in recent years, primarily due to the widespread use of ultrasonography [...

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The aims of our study were to evaluate the maternal and fetal outcomes of intrahepatic cholestasis of pregnancy (ICP). In this observational, retrospective case-control study, we included all pregnant women who gave birth with a diagnosis of ICP between January 2010 and December 2020 at the Unit of Obstetrics and Gynecology, University Hospital of Messina. The data were compared with those from a control group of pregnant women who did not have ICP.

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Objective: To compare objective and subjective outcomes of laparoscopic sacral colpopexy with supracervical hysterectomy (L-SCP) and robotic sacral hysteropexy (R-SHP).

Methods: This is a multicenter retrospective propensity score matched study. In the period between January 2014 and December 2018, we enrolled 161 patients with apical prolapse stage 2 or above, alone or with multicompartment descensus.

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Scar pregnancy is a rare and potentially life-threatening condition that occurs when an embryo implants and grows within a previous cesarean section scar or other uterine scars [...

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