Publications by authors named "Saverio S"

Article Synopsis
  • * A thorough literature review led to the selection of 287 studies, which informed the development of 39 key statements addressing surgical indications, timing, and techniques for SSRF.
  • * The consensus document serves to clarify best practices in managing rib fractures, helping clinicians make informed decisions about the surgical treatment process.
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Commentary on the article written and published by Peng , investigating the role of endoscopic ultrasound (EUS)-guided biliary drainage for palliation of malignant biliary obstruction after failed endoscopic retrograde cholangiopancreatography (ERCP). For 40 years endoscopic biliary drainage was synonymous with ERCP, and EUS was used mainly for diagnostic purposes. The advent of therapeutic EUS has revolutionized the field, especially with the development of a novel device such as electrocautery-enhanced lumen-apposing metal stents.

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Introduction: Diabetic Foot Complications (DFCs) are a growing cause of morbidity and mortality with less than one third of physicians able to discern the signs of diabetes related peripheral neuropathy. DFCs and resultant amputations account for a considerable proportion of surgeries in Fiji, with very limited literature available to verify the factors that influence these alarming figures. This study aimed to explore Health Care Workers' (HCWs) perspectives on diabetic foot complications and challenges of foot care management in Fiji.

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Background: Patients with acute cholecystitis (AC) presenting with unfavorable systemic or local conditions are often managed with percutaneous cholecystostomy (PC) as a temporary measure. The clinical outcomes of interval cholecystectomy following PC remain unclear. The aim of the study was to identify the association between the timing of cholecystectomy following PC for AC and perioperative complication rates at interval cholecystectomy.

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Aim: Solitary rectal ulcer syndrome (SRUS) is a benign and poorly understood disorder with complex management. Typical symptoms include straining during defaecation, rectal bleeding, tenesmus, mucoid secretion, anal pain and a sense of incomplete evacuation. Diagnosis is based on characteristic clinical symptoms and endoscopic/histological findings.

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The Nurse Navigator is a highly specialized nurse with technical and non-technical skills that offers individualized assistance to cancer patients, their family and caregivers to overcome health system barriers and facilitate access to care. This role was introduced in the General Surgery Unit of the Madonna del Soccorso Hospital in San Benedetto del Tronto from 1st January 2023. The primary endpoint is to compare the times taken for each step of the diagnostic-therapeutic pathway comparing the study group followed by Oncology Nurse Navigator (ONN) and the group not followed by this role.

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Background: Colorectal (CRC) cancer is becoming a disease of the elderly. Ageing is the most significant risk factor for presenting CRC. Early diagnosis of CRC and management is the best way in achieving good outcomes and longer survival but patients aged ≥75 years are usually not screened for CRC.

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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.
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Fluorescence imaging is a real-time intraoperative navigation modality to enhance surgical vision and it can guide emergency surgeons while performing difficult, high-risk surgical procedures. The aim of this study is to assess current knowledge, attitudes, and practices of emergency surgeons in the use of indocyanine green (ICG) in emergency settings. Between March 08, 2023 and April 10, 2023, a questionnaire composed of 27 multiple choice and open-ended questions was sent to 200 emergency surgeons who had previously joined the ARtificial Intelligence in Emergency and trauma Surgery (ARIES) project promoted by the WSES.

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Background: There is lack of data on the association between socioeconomic factors, guidelines compliance and clinical outcomes among patients with acute biliary pancreatitis (ABP).

Methods: Post-hoc analysis of the international MANCTRA-1 registry evaluating the impact of regional disparities as indicated by the Human Development Index (HDI), and guideline compliance on ABP clinical outcomes. Multivariable logistic regression models were employed to identify prognostic factors associated with mortality and readmission.

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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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Article Synopsis
  • The study surveyed general surgeons from April to May 2023 to understand their workload, academic involvement, and rest after on-call duty, receiving 1,046 responses with diverse representation, particularly from Europe and North America.
  • Over 78% of respondents engaged in research activities, with European surgeons averaging more published studies yearly, while teaching participation was highest in North America and Africa.
  • Results indicated significant disparities in on-call frequencies and post-shift days off, with only 35.1% of surgeons receiving a day off afterwards, influenced by factors like Human Development Index (HDI) and hospital capacity.
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Article Synopsis
  • The study aimed to identify risk factors linked to the failure of non-operative treatment in patients with certain types of diverticular abscesses, using a multicentre case-control approach.
  • Among the 116 patients who experienced treatment failure (27.04%), significant predictors included the Hinchey classification IIb, smoking, and the presence of air bubbles within the abscess.
  • The findings highlight the effectiveness of non-operative treatments but suggest that young smokers with IIb Hinchey diverticulitis need closer monitoring and that further research should focus on the role of image-guided drainage.
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Background: Simulation is an innovative tool for developing complex skills required for surgical training. The objective of this study was to determine the advancement of laparoscopic and robotic skills through simulation in participants with limited or no previous experience.

Methods: This is a systematic review and meta-analysis of randomized controlled trials (RCTs) in keeping with the Preferred Reporting Items for Systematic Reviews and Meta-analysis guidelines.

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Percutaneous cholecystostomy (PC) is often preferred over early cholecystectomy (EC) for elderly patients presenting with acute cholecystitis (AC). However, there is a lack of solid data on this issue. Following the PRISMA guidelines, we searched the Medline and Web of Science databases for reports published before December 2022.

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To determine if preoperative-intraoperative factors such as age, comorbidities, American Society of Anesthesiologists (ASA) classification, body mass index (BMI), and severity of peritonitis affect the rate of morbidity and mortality in patients undergoing a primary anastomosis (PA) or Hartmann Procedure (HP) for perforated diverticulitis. This is a systematic review and meta-analysis, conducted according to PRISMA, with an electronic search of the PubMed, Medline, Cochrane Library, and Google Scholar databases. The search retrieved 614 studies, of which 11 were included.

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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.

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Background: Laparoscopy is widely adopted across nearly all surgical subspecialties in the elective setting. Initially finding indication in minor abdominal emergencies, it has gradually become the standard approach in the majority of elective general surgery procedures. Despite many technological advances and increasing acceptance, the laparoscopic approach remains underutilized in emergency general surgery and in abdominal trauma.

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Article Synopsis
  • 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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Emergency Resuscitative Thoracotomy (ERT) is a lifesaving procedure in selected patients. Outcome mostly in blunt trauma is believed to be poor. The primary aim of this study was to determine the predictors of postoperative mortality following ERT.

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Introduction: Endoscopic retrograde appendicitis therapy has been proposed as an alternative strategy for treating appendicitis, but debate exists on its role compared with conventional treatment.

Methods: This systematic review was performed on MEDLINE, Cochrane Central Register of Controlled Trials, and EMBASE. The last search was in April of 2023.

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