Publications by authors named "Marcello Spampinato"

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.

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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.
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Background: The rising diffusion of vascular resections during complex pancreatectomy for malignancy, for both oncological and technical matters, brought with it the use of vascular shunts, either temporary or definitive, to prevent bowel congestion and liver ischemia. This study aimed to systematically review the literature on the technical feasibility of vascular shunts during advanced pancreatic surgery, analyzing intraoperative and postoperative outcomes.

Methods: A systematic literature search was performed on PubMed, Scopus, Web of Science, and the Cochrane Library Central, according to PRISMA guidelines.

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  • Minimally invasive liver surgery has become safer and more feasible over time, prompting this study to explore its effectiveness in elderly patients.
  • The research analyzed data from 1070 robotic liver resections across nine European hospitals, focusing on 131 major liver resections and comparing outcomes between patients under and over 65 years old.
  • Results show that while elderly patients had some increased complications, overall short-term outcomes for robotic major liver resection in this group were still satisfactory.
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  • The study focused on the perioperative outcomes of pancreatic cancer surgeries during the COVID-19 pandemic, comparing data from 2019 and 2020.
  • Researchers analyzed 1815 patients, finding no significant difference in cancer stages between the two years, but noted a decrease in neoadjuvant chemotherapy use and an increase in minimally invasive procedures in 2020.
  • Despite some changes in treatment protocols and a rise in medical complications during surgery in 2020, the overall outcome for patients undergoing surgery for pancreatic cancer remained largely unaffected.
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  • This study compares two surgical methods, Hartmann's procedure (HP) and resection with primary anastomosis (RPA), for treating acute left-sided colonic emergencies among 1215 patients from 204 centers globally.
  • Results showed that while HP was the more common treatment (57.3%), RPA was favored for younger patients with fewer health issues and those needing surgery sooner.
  • The study concluded that although HP is still widely used, RPA might be the better option, emphasizing the importance of patient characteristics and surgeon experience in determining treatment choice.
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Screening methods available for colorectal cancer (CRC) to date are burdened by poor reliability and low patient adherence and compliance. An altered pattern of volatile organic compounds (VOCs) in exhaled breath has been proposed as a non-invasive potential diagnostic tool for distinguishing CRC patients from healthy controls (HC). The aim of this study was to evaluate the reliability of an innovative portable device containing a micro-gas chromatograph in enabling rapid, on-site CRC diagnosis through analysis of patients' exhaled breath.

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Introduction And Importance: Amyand's hernia is a rare type of inguinal hernia which contains vermiform appendix in the inguinal sac, seldom complicated by acute appendicitis. It is usually repaired by open inguinal approach, but laparoscopic technique has been increasingly described in literature; nevertheless, standard of care is far from being defined. Here we report the case of Amyand's hernia complicated by acute appendicitis and simultaneous symptomatic left inguinal hernia, both repaired by laparoscopic technique.

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Introduction: Lemmel's syndrome is a rare disease presenting with obstructive jaundice, secondary to common bile duct compression by duodenal diverticulum.

Presentation Of Case: A 79-year-old female was admitted to our emergency department with cholangitis and obstructive jaundice, due to choledocal compression by two periampullary diverticula, with major papilla opening near the biggest one (periampullary diverticulum type III). Endoscopic retrograde cholangiopancreatography didn't succeed sphincterotomy, therefore laparoscopic rendez-vous was performed.

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Article Synopsis
  • The REDISCOVER consensus conference focused on creating guidelines for the perioperative care of patients with borderline-resectable and locally advanced pancreatic ductal adenocarcinoma (PDAC).
  • Using a structured methodology and expert consensus, the conference developed 34 recommendations on various aspects of surgical care, patient selection, and management of pancreatic cancer.
  • Despite the low evidence quality for most recommendations, participants highlighted the importance of establishing an international registry to enhance understanding and care for this patient group.
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Introduction: During the last year, the features of peritoneal dialysis patients have changed, and the cases in which there is a need to perform abdominal surgery are growing. Reports of abdominal surgery in patients who are able to continue peritoneal dialysis are increasing. The minimally invasive techniques represent the preferred and safest approach.

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Background: To date, no standardized protocols nor a quantitative assessment of the near-infrared fluorescence angiography with indocyanine green (NIR-ICG) are available. The aim of this study was to evaluate the timing of fluorescence as a reproducible parameter and its efficacy in predicting anastomotic leakage (AL) in colorectal surgery.

Methods: A consecutive cohort of 108 patients undergoing minimally invasive elective procedures for colorectal cancer was prospectively enrolled.

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  • There is ongoing debate about the effectiveness of surgery for non-colorectal non-neuroendocrine liver metastases (NCNNLM), despite an increase in liver resections for these cases.
  • A preliminary international survey was conducted among surgeons to gather insights on current clinical practices and to assess the feasibility of an International Registry for NCNNLM, utilizing an online questionnaire that received responses from 141 surgeons across 27 countries.
  • The survey revealed that a majority of participating surgeons work in general surgery units, with a high rate of multidisciplinary discussions for surgical indications, and noted that parenchymal-sparing resections are common, although significant post-operative complications were reported in some cases.
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Acinar cystic transformation (ACT), also known as 'acinar cell cystadenoma', is an uncommon cystic neoplasm of pancreas with unknown malignant potential. This case regards a woman with symptomatic pancreatic head ACT, revealed with pathological exam of specimen after pancreaticoduodenectomy. A 57-years-old patient presented mild hyperbilirubinemia and recurrent cholangitis; she underwent to ERCP, EUS and MRI, and these exams revealed a large cyst of the pancreatic head that caused biliary compression.

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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.

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Solid pseudopapillary tumour is a rare low-grade malignant potential carcinoma of the pancreas that typically occurs in females in their third decade. It most commonly occurs in the tail of the pancreas, although any site can be affected. Surgical resection is the standard treatment and offers an excellent prognosis.

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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.

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Introduction And Importance: Burned-out testicular cancer is a rare phenomenon to be taken into account for differential diagnosis in males presenting with retroperitoneal lymphadenopathy.

Case Presentation: A 54-years-old male complaining of abdominal pain over the past several months was found on CT to have a large mass adjacent to the inferior vena cava, with the imaging features of a malignant lymphadenopathy.

Clinical Discussion: The hematologist who evaluated the case suggested a biopsy of the retroperitoneal mass: a seminoma was diagnosed on pathological examination.

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Introduction And Aim Of The Study: Dunbar syndrome is a rare disorder due to the external compression of the celiac trunk by the median arcuate ligament. The symptoms include abdominal pain, nausea and vomiting with a significative reduction in patients' quality of life. Laparoscopy has proven to be a safe procedure.

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Introduction And Importance: Burkitt's lymphoma is one of the fastest growing human cancers and it needs a rapid diagnosis.

Case Presentation: A young woman presented to our institution with acute abdominal pain, tenderness and constipation. Ultrasound reported a right ovarian mass; at laparoscopy, we discovered ascites, peritoneal carcinomatosis and a voluminous pelvic mass.

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Epithelial-mesenchymal transition (EMT) is a process by which tumour cells lose epithelial characteristics, become mesenchymal and highly motile. EMT pathways also induce stem cell features and resistance to apoptosis. Identifying and targeting this pool of tumour cells is a major challenge.

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Background: The superior mesenteric artery (SMA) syndrome is a rare entity presenting with upper gastrointestinal tract obstruction and weight loss. Studies to determine the optimal methods of diagnosis and treatment are required.

Aims And Methods: This study aims at analyzing the clinical presentation, diagnosis, and management of SMA syndrome.

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Background And Aims: Gallbladder carcinoma is a rare but aggressive malignant neoplasm. The incidence of intra- or post-operative incidental gallbladder carcinoma diagnosis following laparoscopic cholecystectomy is estimated to be 1-2%. Aggressive re-resection is warranted as the majority of patients have residual disease either in the liver or the lymph nodes.

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Purpose. To analyse perioperative and oncological outcomes of minimally invasive simultaneous resection of primary colorectal neoplasm with synchronous liver metastases. Methods.

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Background: With the advance of modern laparoscopic technology, laparoscopic colorectal surgery and laparoscopic liver surgery are both worldwide accepted. Preliminary brief series have shown the feasibility of combined laparoscopic resection of colorectal cancer (CRC) and synchronous colorectal liver metastases (SCRLM). We aim to report a large International multicenter series of laparoscopic simultaneous resection of CRC and SCRLM.

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