Publications by authors named "Giovanni Battista Levi Sandri"

Background: The prognosis for liver cancer (LC) is dismal. Researchers recently discovered cuproptosis, a novel form of controlled cell death whose expression in LC and prognosis are unclear. This study reveals a gene signature to predict LC prognosis.

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Background: Inguinal lymph node dissection plays an important role in the management of melanoma, penile and vulval cancer. Inguinal lymph node dissection is associated with various intraoperative and postoperative complications with significant heterogeneity in classification and reporting. This lack of standardization challenges efforts to study and report inguinal lymph node dissection outcomes.

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The multidisciplinary management of patients suffering from colorectal cancer (CRC) has significantly increased survival over the decades and surgery remains the only potentially curative option for it. However, despite the implementation of minimally invasive surgery and ERAS pathway, the overall morbidity and mortality remain quite high, especially in rural populations because of urban - rural disparities. The aim of the study is to analyze the characteristics and the surgical outcomes of a series of unselected CRC patients residing in two similar rural areas in Italy.

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Article Synopsis
  • The SUPER guideline was developed to improve the quality of surgical technique reporting, addressing gaps in existing guidelines to ensure comprehensive documentation across various surgical disciplines and innovations.
  • Created through a collaborative process involving surgeons, editors, and experts from different countries, the guideline includes 22 essential items organized into six sections, covering everything from background and rationale to preoperative preparations and postoperative considerations.
  • The implementation of SUPER aims to enhance transparency in surgical reporting, aiding not just surgeons but also journal editors, reviewers, and practitioners who need clear and reproducible surgical techniques.
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  • Tumor size (TS) impacts intraoperative outcomes in laparoscopic major hepatectomy (L-MH), with this study aiming to clarify its effects and find optimal TS cutoffs for assessing surgical difficulty.
  • The analysis, which included 1396 patients from a larger pool of 3008 undergoing L-MH, identified two critical TS cutoffs at 50 mm and 100 mm that segmented patients into three distinct groups.
  • Results showed that larger TS correlated with increased open conversion rates, longer operation times, higher blood loss, and more intraoperative blood transfusions, while postoperative complications remained similar across the groups.
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Background & Aims: Numerous studies have evaluated the role of human albumin (HA) in managing various liver cirrhosis-related complications. However, their conclusions remain partially controversial, probably because HA was evaluated in different settings, including indications, patient characteristics, and dosage and duration of therapy.

Methods: Thirty-three investigators from 19 countries with expertise in the management of liver cirrhosis-related complications were invited to organise an International Special Interest Group.

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  • Despite advancements in minimally invasive liver surgery, open surgeries are still common, and this study examines the factors that lead to conversions from minimally invasive techniques to open surgery during major hepatectomies.
  • Data from 3880 surgical cases showed that 10.28% resulted in open conversions, with several risk factors identified, such as male sex, liver cirrhosis, and larger tumor sizes, which are linked to increased conversion risk.
  • The study found that those who experienced open conversions had worse outcomes, including longer operation times and higher rates of postoperative complications, although robotic surgery had a lower conversion rate compared to laparoscopic techniques, it still led to significant challenges when conversions did occur.
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  • The study aimed to compare outcomes of robotic major hepatectomy (R-MH) versus laparoscopic major hepatectomy (L-MH), exploring whether R-MH offers any advantages.
  • An analysis of 4822 patient cases across 59 centers revealed that R-MH resulted in significantly less blood loss, fewer applications of the Pringle maneuver, and lower rates of conversion to open surgery.
  • Moreover, R-MH showed reduced postoperative morbidity and shorter hospital stays for patients with cirrhosis compared to L-MH, indicating its potential benefits.
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Background: The aim of this multicentric study was to investigate the impact of tumor location and size on the difficulty of Laparoscopic-Left Hepatectomy (L-LH).

Methods: Patients who underwent L-LH performed across 46 centers from 2004 to 2020 were analyzed. Of 1236 L-LH, 770 patients met the study criteria.

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  • Minimal invasive liver resections (MLRs) are safer alternatives to traditional open surgery, but the effects of neoadjuvant chemotherapy (NAT) on their difficulty are not well understood.
  • This study analyzed data from 1,034 patients across 57 centers who underwent laparoscopic and robotic MLRs for colorectal liver metastases (CRLM), comparing those who received NAT to those who did not using statistical matching methods.
  • Results showed no significant differences in perioperative outcomes after matching, although the NAT group experienced slightly higher blood loss but shorter hospital stays, indicating that NAT has minimal impact on the difficulty and overall outcomes of MLRs for CRLM.*
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Objectives: To identify reporting guidelines related to surgical technique and propose recommendations for areas that require improvement.

Study Design And Setting: A protocol-guided scoping review was conducted. A literature search of MEDLINE, the EQUATOR Network Library, Google Scholar, and Networked Digital Library of Theses and Dissertations was conducted to identify surgical technique reporting guidelines published up to December 31, 2021.

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Background: Tumor size (TS) represents a critical parameter in the risk assessment of laparoscopic liver resections (LLR). Moreover, TS has been rarely related to the extent of liver resection. The aim of this study was to study the relationship between tumor size and difficulty of laparoscopic left lateral sectionectomy (L-LLS).

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Introduction: Immune checkpoint inhibitors (ICIs) are effective for the treatment of various cancers, but can lead to immune-mediated hepatotoxicity (IMH). The aim of this study was to analyze the risk factors for IMH in cancer patients treated with ICIs.

Areas Covered: The PubMed, EMBASE, and Cochrane Library databases were searched.

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Background And Objective: The liver is the main site of metastatic disease, and cancer metastases remain the main limit to successfully managing the malignant disease. Liver resection (LR) for the treatment of metastatic cancer has been described for over a hundred years and is widely accepted. The role of surgery in managing non-colorectal non-neuroendocrine liver metastasis (NCNNLM), evidence is still lacking due to different factors: the paucity of cases, the wide variety of histological subtypes of the primary disease and its biological behavior, and the absence of prospective studies.

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Background: Circular RNAs (circRNAs) are important for the process of cancer initiation and progression. However, the role of circRNAs in hepatocellular carcinoma (HCC) remains incompletely understood. Therefore, we further explored the expression network of circRNAs in HCC.

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Introduction: The Iwate Score (IS) have not been well-validated for specific procedures, especially for right posterior sectionectomy (RPS). In this study, the utility of the IS was determined for laparoscopic (L)RPS and the effect of tumor location on surgical outcomes was investigated.

Methods: Post-hoc analysis of 647 L-RPS performed in 40 international centers of which 596L-RPS cases met the inclusion criteria.

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Background: Presently, according to different difficulty scoring systems, there is no difference in complexity estimation of laparoscopic liver resection (LLR) of segments 7 and 8. However, there is no published data supporting this assumption. To date, no studies have compared the outcomes of laparoscopic parenchyma-sparing resection of the liver segments 7 and 8.

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Background: Despite the rapid advances that minimally invasive liver resection has gained in recent decades, open conversion is still inevitable in some circumstances. In this study, we aimed to determine the risk factors for open conversion after minimally invasive left lateral sectionectomy, and its impact on perioperative outcomes.

Methods: This is a post hoc analysis of 2,445 of 2,678 patients who underwent minimally invasive left lateral sectionectomy at 45 international centers between 2004 and 2020.

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Background: Few studies have analyzed outcomes of liver transplantation (LT) when the recipient hepatic artery (HA) was not usable.

Methods: We retrospectively evaluated the outcomes of LT performed using the different alternative sites to HA.

Results: Between 2002 and 2017, 1,677 LT were performed in our institution among which 141 (8.

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Article Synopsis
  • Laparoscopic liver resection (LLR) is considered a safe option for treating hepatocellular carcinoma (HCC), though repeat surgeries are often needed, and the role of minimally invasive liver surgery (MILS) is still being clarified.
  • This study, involving data from 52 medical centers and 1054 patients, aims to compare outcomes between first-time LLR and repeat LLR while also looking at the difference between primary open surgery and MILS.
  • After matching the groups, the results showed no significant differences in outcomes between first and repeat LLR or between the open and MILS approaches, indicating that MILS is a feasible and safe option for repeat liver resections.
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Shortages of grafts for liver transplant remain a persistent problem. The use of lacerated livers for liver transplant can add an option for extended criteria donations, especially during the COVID-19 pandemic. We present the case of a successful liver transplant performed using a high-grade lacerated liver previously treated with superselective arterial embolization and packing for bleeding control.

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