Publications by authors named "Nicola DeAngelis"
Article Synopsis
- The study aims to provide updated evidence for managing stage I colon cancer (CC) post-surgery, focusing on recurrence rates and risk factors.
- Despite low recurrence risk, some guidelines suggest intensive follow-up is unnecessary, but data on actual recurrence rates is limited.
- The findings reveal a 5% recurrence rate, primarily systemic, with significant risk factors including tumor characteristics and patient demographics, suggesting a need for improved postoperative follow-up strategies.
Background: While total mesorectal excision is the gold standard for rectal cancer, the optimal surgical approach to achieve adequate oncological outcomes remains controversial. This network meta-analysis aims to compare the histopathological outcomes of robotic (R-RR), transanal (Ta-RR), laparoscopic (L-RR), and open (O-RR) resections for rectal cancer.
Materials And Methods: MEDLINE, Embase, and the Cochrane Library were screened from inception to June 2024.
Colorectal surgery is one of the specialties that have significantly benefited from the adoption of robotic technology. Over 20 years since the first robotic rectal resection, the Intuitive Surgical Da Vinci system remains the predominant platform. The introduction of new robotic systems into the market has enabled the first documented total mesorectal excision (TME) using alternative platforms.
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- This study compares outcomes of open liver resection (OLR), laparoscopic liver resection (LLR), and percutaneous thermal ablation (PTA) in elderly patients (≥70 years) with single hepatocellular carcinoma (HCC) ≤30 mm.
- A total of 239 patients were analyzed, revealing that PTA resulted in shorter hospital stays and less morbidity than OLR or LLR, but lower 5-year overall and disease-free survival rates.
- The findings suggest that while PTA is advantageous for specific HCC locations, surgical options (OLR and LLR) offer better long-term survival outcomes for elderly patients.
The introduction of new technologies in current digestive surgical practice is progressively reshaping the operating room, defining the fourth surgical revolution. The implementation of black boxes and control towers aims at streamlining workflow and reducing surgical error by early identification and analysis, while augmented reality and artificial intelligence augment surgeons' perceptual and technical skills by superimposing three-dimensional models to real-time surgical images. Moreover, the operating room architecture is transitioning toward an integrated digital environment to improve efficiency and, ultimately, patients' outcomes.
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- - The study investigated the effectiveness of robotic right colectomy (RRC) compared to laparoscopic right colectomy (LRC) for nonmetastatic pT4 colon cancer, focusing on surgical outcomes like cancer removal success, complication rates, and recovery times.
- - Results showed similar cancer removal rates and lymph node retrieval between RRC and LRC, but RRC had advantages like fewer conversions to open surgery, less blood loss, and fewer postoperative complications.
- - Both surgical methods had comparable long-term survival rates, indicating that RRC is a viable option for treating pT4 right colon cancer with better short-term results than LRC.
The role of robotic surgery for gastrointestinal stromal tumor (GIST) resection remains unclear. This systematic review and meta-analysis aimed to investigate the outcomes of robotic versus laparoscopic surgery in patients requiring surgery for gastric GISTs. MEDLINE, EMBASE, and the Cochrane databases were searched from inception to September 4, 2023.
View Article and Find Full Text PDFBackground: Although minimally invasive distal pancreatectomy (MIDP) is considered a standard approach it still presents a non-negligible rate of conversion to open that is mainly related to some difficulty factors, as obesity. The aim of this study is to analyze the preoperative factors associated with conversion in obese patients with MIDP.
Methods: In this multicenter study, all obese patients who underwent MIDP at 18 international expert centers were included.
Article Synopsis
- Robotic surgery is becoming popular for planned surgeries, but how it works in emergencies is not well known yet.
- A new study called the ROEM study will look at how safe and effective robotic surgery is for emergency cases, like when people have serious stomach problems.
- They will collect information from at least 500 patients across 50 different hospitals to see how well this type of surgery works, while also making sure everything follows ethical rules.
Article Synopsis
- 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.
Article Synopsis
- This study evaluates three minimally invasive surgical techniques for total mesorectal excision (TME) in treating low/mid locally advanced rectal cancer: laparoscopic, robotic, and transanal TME.
- An analysis of 468 patients revealed that robotic and transanal TME had lower complication and conversion rates compared to laparoscopic TME, with robotic TME showing fewer anastomotic leaks.
- The study concludes that robotic and transanal TME approaches can lead to quicker recovery times and fewer postoperative issues compared to laparoscopic TME, indicating their potential advantages for patient outcomes.
Primary segmental omental torsion (PSOT) is a very rare cause of acute abdominal pain, and it may often imitate the clinical picture of acute appendicitis. In instances of acute abdominal pain without anorexia, nausea, and vomiting, omental torsion should be included in the differential diagnosis. Any misdiagnosis may lead to major complications such as intraabdominal abscesses and adhesions.
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- The study looked at how well emergency surgeons use certain guidelines to treat serious problems from diseases like ulcerative colitis and Crohn's disease.
- A survey was sent to surgeons worldwide to find out what they know and how they handle these tricky cases, with 242 surgeons answering.
- Results showed that while many surgeons followed most guidelines, they struggled with some key areas, showing that teamwork between doctors is really important for treating these diseases.
Article Synopsis
- * Higher levels of procalcitonin (>0.5 ng/mL) were found to be independent risk factors for complications, surgery, and even mortality in these patients.
- * The research suggests that measuring procalcitonin levels in the emergency department could be a valuable tool for risk stratification in managing this condition.
Purpose: To determine whether access to a website with an educational video would decrease postoperative opioid use in patients undergoing arthroscopic partial meniscectomy.
Methods: Enrolled patients who underwent arthroscopic partial meniscectomy at a single center were randomized to either the intervention or control group prior to surgery. The intervention group received a card with access to an online educational video regarding opioids with their postoperative instructions; the control group did not.
Background: The Coronavirus 2019 (COVID-19) pandemic has favored the growth of telemedicine systems and in this context the idea of Metaverse was born and developed. A 3D reality in which people can interact with each other through digital reproductions of themselves. Metaverse has already been tested in numerous medical fields due to its ability to combine visual and auditory information with tactile sensations.
View Article and Find Full Text PDFBackground: Liver resection is the mainstay for a curative treatment for patients with resectable hepatocellular carcinoma (HCC), also in elderly population. Despite this, the evaluation of patient condition, liver function and extent of disease remains a demanding process with the aim to reduce postoperative morbidity and mortality.
Aim: To identify new perioperative risk factors that could be associated with higher 90- and 180-d mortality in elderly patients eligible for liver resection for HCC considering traditional perioperative risk scores and to develop a risk score.
Background: Despite advances and improvements in the management of surgical patients, emergency and trauma surgery is associated with high morbidity and mortality. This may be due in part to delays in definitive surgical management in the operating room (OR). There is a lack of studies focused on OR prioritization and resource allocation in emergency surgery.
View Article and Find Full Text PDFThe ecological sustainability of the operating room (OR) is a matter of recent interest. The present systematic review aimed to review the current literature assessing the carbon footprint of surgical procedures in different surgical fields. Following to the PRISMA statement checklist, three databases (MEDLINE, EMBASE, Cochrane Library) were searched by independent reviewers, who screened records on title and abstract first, and then on the full text.
View Article and Find Full Text PDFBackground: This systematic review and meta-analysis assessed the effectiveness of robotic surgery compared to laparoscopy or open surgery for inguinal (IHR) and ventral (VHR) hernia repair.
Methods: PubMed and EMBASE were searched up to July 2022. Meta-analyses were performed for postoperative complications, surgical site infections (SSI), seroma/hematoma, hernia recurrence, operating time (OT), intraoperative blood loss, intraoperative bowel injury, conversion to open surgery, length of stay (LOS), mortality, reoperation rate, readmission rate, use of opioids, time to return to work and time to return to normal activities.