Background/aim: The Controlling Nutritional status (CONUT) score, a valuable tool evaluating the preoperative conditions of patients from a nutritional point of view, has been successfully adopted for a plethora of malignancies including colorectal cancer (CRC). However, since rectal cancer has characteristics that differ from colon cancer (CC) and because, as of 2024, investigations targeted to surgical CC patients are lacking in the pertinent literature, we decided to assess the predictive role of this scoring system in relation to postoperative course and survival of surgical patients affected only by this malignancy. However, as of 2024, the existing literature on CONUT has typically treated colorectal cancer (CRC) as a single homogeneous entity, often combining results for both colon cancer (CC) and rectal cancer (RC).
View Article and Find Full Text PDFBackground: According to the latest guidelines, in patients with high-risk nodules with indeterminate cytology, diagnostic lobectomy should be the preferable surgical approach in the absence of factors that suggest a total thyroidectomy.
Methods: This retrospective observational study has as its main aim the evaluation of the cases that underwent surgery, for Bethesda class IV nodules in our iodocarent geographical area. Particular attention was paid to carcinoma incidence, preoperative nodule size, histological characteristics of the neoplasm, surgical approach and eventual need of radiometabolic treatment.
J Laparoendosc Adv Surg Tech A
June 2023
A preliminary analysis from the COVID-Advanced Gastrointestinal Cancer Surgical Treatment (AGICT) study showed that the rate of minimally invasive surgery (MIS) for elective and urgent procedures did not decrease during the pandemic year. In this article, we aimed to perform a subgroup analysis using data from the COVID-AGICT study to evaluate the trend of MIS during the COVID-19 pandemic period in Italy. This study was conducted collecting data of MIS patients from the COVID-AGICT database.
View Article and Find Full Text PDFSurg Oncol
April 2023
Background: This Italian multicentric retrospective study aimed to investigate the possible changes in outcomes of patients undergoing surgery for gastrointestinal cancers during the COVID-19 pandemic.
Method: Our primary endpoint was to determine whether the pandemic scenario increased the rate of patients with colorectal, gastroesophageal, and pancreatic cancers resected at an advanced stage in 2020 compared to 2019. Considering different cancer staging systems, we divided tumors into early stages and advanced stages, using pathological outcomes.
Background: The detection of nodal status is based on examination of lymph nodes (LN) after the tumor surgical resection and the current guidelines recommend examining at least 12 regional LN. An inadequate number of examined LN may lead to a lower N stage or to a false-negative nodal disease. To overcome these issues, many authors proposed to consider the metastatic lymph node ratio (mLNR).
View Article and Find Full Text PDFPurpose: The aim of this study was firstly to report the experience of intermittent intraoperative neuromonitoring (I-IONM) and evaluate the impact of loss of signal (LOS) in staged thyroidectomy management.
Methods: We retrospectively reviewed patients who underwent total thyroidectomy, performed by a single surgeon in two years. All patients have been subjected to I-IONM.
Background: Primary hyperparathyroidism (pHPT) is an endocrinological disorder characterized by excessive secretion of parathormone. Minimally invasive approach has become a widespread surgical method for pHPT treatment due to the improvement of preoperative gland localization imaging techniques and the use of intraoperative PTH dosage (IOPTH). We discuss the results of different imaging technique.
View Article and Find Full Text PDFAim: Evaluate impact of lymph node ratio as prognostic factor in gastric cancer.
Methods: We studied 463 patients with gastric cancer who underwent curative gastric surgery with D1 or D2 lymphadenectomy, Data were collected from May 1996 through December 2010 at Department of General Surgery of Parma University Hospital. We divided patients in two groups according to number of nodes removed Results: The results of the present nonrandomized retrospective single centre study confirm the promising role of the LNR as an independent prognostic factor.
In scientific literature there are numerous authors that have highlighted how the outcome of patients undergoing surgical treatment, such as intraoperative or postoperative complications, surgical time, mean hospital stay, is related to the surgeon's experience based on the number of cases treated per year for a specific disease. In our study we decided to verify if, in our clinical practice, there are significant differences in postoperative outcomes between procedures performed by a senior surgeon, a young specialist or a surgical resident, evaluating if surgical experience affects positively either on intraoperative complications such as bleeding, hypocalcemia, dysphonia, or on surgical time, mean hospital stay and postoperative complications. In this retrospective study we examined all cases of patients that underwent surgery for thyroid disease at our Operative Unit, from January 1, 2015 to December 31, 2019.
View Article and Find Full Text PDFObjective: Evaluate the impact of Covid-19 in a critical area and analyze the changes in the daily activities in a General Surgery Unit of a tertiary Covid-Hospital.
Methods: We report and compared all the surgical procedures performed between two periods (March and April 2019 and March and April 2020) at General Surgery Department of Parma University Hospital, a tertiary Covid-Hospital.
Results: Between March and April 2019, a total of 232 surgical procedures were performed.
Background And Aims: Assessment of wounds morphology can be considered, in the everyday medical activity, the first step for the correct pathway of diagnosis. Authors present a pilot study focused on the statistical analysis of 32 cases of wounds measurements conducted by both the traditional method (paper ruler) both the digital smartphone analysis.
Materials And Methods: 32 lesions were morphologically evaluated.
Background Multifocality is usually detected afterwards surgery for papillary thyroid cancer (PTC) and has been reported in 18-87% of PTC. Methods This is a retrospective single-center study involving a series of 238 patients that underwent thyroidectomy or lobectomy after preoperative fine needle aspiration (FNA) diagnosis of Thyr 5 or Thyr 6, according to Bethesda classification, from January 2015 to December 2019 at the General Surgery Unit of the University - Hospital of Parma. We divided patients into two main groups: patients with multifocal papillary thyroid cancer at postoperative diagnosis and patients with unifocal papillary thyroid cancer.
View Article and Find Full Text PDFBackground And Aims: The concept of WBP (wound bed preparation) has revolutionized the way to diagnose and correctly identify the best therapeutic path about the widespread clinical problem of difficult wounds. Starting from the modified TIME-H, authors conducted a preliminary study with the aim of assessing the impact of skin lesions and soft tissues for the surgical patient.
Materials And Methods: 38 patients were preliminarily evaluated.
A great number of surgical diagnostic procedures are performed every year for thyroid nodules that are included in undetermined cytological classes that reveal to be malignant thyroid carcinomas in one-third of cases. In the most recent guidelines, lobectomy is the most recommended surgical approach for this classes of nodules, but total thyroidectomy is the recommended treatment for undetermined nodules larger than 4 cm. The main study aim is to support or question the dimensional criteria as an independent clinical decision element for undetermined thyroid nodules management.
View Article and Find Full Text PDFThe external branch of the superior laryngeal nerve (EBSLN) provides motor function to the cricothyroid muscle (CTM). EBSLN damage produces changes in voice quality and projection. Intraoperative neuromonitoring (IONM) in thyroid surgery aims to optimize EBSLN control during dissection.
View Article and Find Full Text PDFWe present the clinical case of a patient who developed acute hypercalcemia diagnosed after presenting acute pancreatitis.Male patient, age 67, arrived at the Emergency Department of the University Hospital of Parma for upper abdominal pain, radiated to the back, and associated with nausea. Laboratory tests showed elevation of lipase, serum calcium levels, PTH levels and serum creatinine.
View Article and Find Full Text PDFCribiform-morular thyroid carcinoma is a rare variant of papillary thyroid carcinoma. It is usually related to Familial Adenomatous Polyposis (FAP) but rarely it may be sporadic. This variant of PTC occurs in young females and it is rare in the elderly.
View Article and Find Full Text PDFBackground: The diagnosis of thyroid carcinoma has changed in last decades, as the surgical technique during thyroidectomy (endoscopic surgery, robotic surgery, new energy device, intraoperative neuromonitoring).
Methods: We analyzed patients undergone to thyroidectomy or lobectomy for thyroid carcinoma from January 2010 to December 2019 at the General Surgery Unit of the Hospital - University of Parma. We divided patients into two groups, based on the use or not of IONM.
Objective Evaluate the impact of Covid-19 in a critical area and analyze the changes in the daily activities in a General Surgery Unit of a tertiary Covid-Hospital. Methods We report and compared all the surgical procedures performed between two periods (March and April 2019 and March and April 2020) at General Surgery Department of Parma University Hospital, a tertiary Covid-Hospital. Results Between March and April 2019, a total of 232 surgical procedures were performed.
View Article and Find Full Text PDFPerioperative medicine is a patient-centered, multidisciplinary and integrated clinical practice that starts from the moment of contemplation of surgery until full recovery. Every perioperative phase (preoperative, intraoperative and postoperative) must be studied and planned in order to optimize the entire patient management. Perioperative optimization does not only concern a short-term outcome improvement, but it has also a strong impact on long term survival.
View Article and Find Full Text PDFIn order to continue the oncological surgical activity and the surgical emergencies, we have elaborated a reorganization of the surgical department. In particular, differentiated pathways for COVID-19 and NON-COVID-19 patients were promptly planned. This arrangement has involved structural and organizational changes almost daily, with great efforts of the health personnel, but allowing our hospital to be the only one in the area still able to guarantee patients safe access to surgical treatment.
View Article and Find Full Text PDFBackground: Endocrine surgery recent evolution has been characterized by introduction of mini-invasive video-assisted technique. When a new technique is introduced in surgical use the rate of adverse events must be the same of previous standardized technique. In MIVAT procedure complication rate and in particular nerve injury risk is associated surgeon's experience.
View Article and Find Full Text PDFBackground: In the past decades the right colon cancer showed a higher incidence rate than left colon cancer. This trend is known as "proximal shift" or "rightwards shift." We evaluated rightward shift phenomenon in our region.
View Article and Find Full Text PDFBackground: The injury of laryngeal recurrent nerve (RLN) is one of the most severe adverse event in thyroid surgery. The rate in literature is reported as 2-11% for transient palsy and 0,6-1,6% for permanent palsy (after 6 months from surgical procedure).
Methods: The patients undergoing thyroid surgery associated to Intraoperative Neuromonitoring (IONM were enrolled consecutively from 21/08/2014 to 30/08/2018.