Publications by authors named "Selvaggi Francesco"

Article Synopsis
  • Obesity can lead to serious health problems, including memory loss and dementia, because it changes how our brain and body work.
  • When someone is obese, it can cause inflammation and other problems in the brain that make it harder for brain cells to stay healthy.
  • This information helps scientists find ways to prevent brain issues related to obesity, looking at both medicine and lifestyle changes that might help.
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Article Synopsis
  • - The study investigates the occurrence of metachronous colorectal cancer in patients diagnosed with early-onset colorectal cancer (under 50 years old), finding an overall incidence of 2.6%.
  • - It highlights that patients with Lynch syndrome have a significantly higher incidence of metachronous colorectal cancer at 18.43%, while those with a family history have a rate of 10.52%.
  • - The findings suggest that although early-onset colorectal cancer patients have a similar risk as older patients, specific genetic and familial factors significantly increase their risk, indicating the need for personalized management strategies.
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  • Anal fissure is a common condition involving a tear in the anal tissue, leading to pain and bleeding during bowel movements.
  • Chronic anal fissures can severely affect a person's quality of life, requiring various treatment options.
  • This article reviews the historical development of our understanding and treatment of anal fissures, marking significant milestones from ancient times to today.
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Treatment of rectal cancer has improved over the years thanks to a multidisciplinary approach. A correct staging has a fundamental role for risk stratification and to define the best treatment for each patient. Unfortunately, approximately 30% of patients with locally advanced rectal cancers will experience tumor recurrence.

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Article Synopsis
  • This study focuses on comparing different types of surgical connections, called anastomoses, made after ileocolic resection in Crohn's disease patients, specifically looking at handsewn versus stapled techniques.
  • The experiment involves a randomized controlled trial with two international studies in the Netherlands and Italy, aiming to determine which technique leads to less endoscopic disease recurrence and better gastrointestinal function at 6 months post-surgery.
  • Primary outcomes include measuring endoscopic recurrence at 6 months and assessing secondary factors like morbidity, quality of life, and healthcare costs, with a goal of using 165 patients in the Netherlands and 189 in Italy for significant results.
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Synchronous tumors of the rectum and anus are sporadic. Most cases in the literature are rectal adenocarcinomas with concomitant anal squamous cell carcinoma. To date, only two cases of concomitant squamous cell carcinomas of the rectum and anus are reported, and both were treated with up-front surgery and received abdominoperineal resection with colostomy.

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Background: There are reported variations in the intraoperative management of Crohn's disease. This consensus statement aimed to develop a standardised protocol for photographic documentation of intraoperative findings and critical procedural steps in ileocolonic Crohn's disease surgery.

Methods: Colorectal surgeons with a specialist interest in minimally invasive surgery and inflammatory bowel disease were invited as committee members to develop a survey on the use of photo-documentation in Crohn's disease surgery.

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Background: Diabetes Mellitus (DM) may occur in IBD and influence the disease progression.

Aim: To compare disease course and treatment outcomes in IBD patients with and without DM.

Methods: This is a systematic review with meta-analysis comparing patients with IBD plus DM with patients with IBD only.

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Objectives: Patients with inflammatory bowel disease were excluded from trials that led to the approval of anti-COVID-19 vaccines and are worthy of real-life studies providing information on the safety of these vaccines in this clinical setting.

Methods: A prospective observational study was performed to estimate BNT162b2 mRNA COVID-19 Vaccine local and systemic adverse events (AEs) incidence related to administration in patients with inflammatory bowel disease through a questionnaire administered at the first, second, and third doses. Disease activity by Mayo Partial Score and Harvey-Bradshaw Index was also evaluated.

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Background: Ileoanal pouch related fistulae (PRF) are a complication of restorative proctocolectomy often requiring repeated surgical interventions and with a high risk of long-term recurrence and pouch failure.

Aims: To assess the incidence of PRF and to report on the outcomes of available surgical treatments.

Methods: A PRISMA-compliant systematic literature search for articles reporting on PRF in patients with inflammatory bowel diseases (IBD) or familial adenomatous polyposis (FAP) from 1985 to 2020.

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Introduction: Intra-abdominal abscesses complicating Crohn's disease (CD) present an additional challenge as their presence can contraindicate immunosuppressive treatment whilst emergency surgery is associated with high stoma rate and complications. Treatment options include a conservative approach, percutaneous drainage, and surgical intervention. The current multicentre study audited the short-term outcomes of patients who underwent preoperative radiological drainage of intra-abdominal abscesses up to 6 weeks prior to surgery for ileocolonic CD.

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Background: Microsatellite instability (MSI) is a predictive biomarker for immune checkpoint inhibitors. The main goal was to investigate the discordance between IHC and PCR/NGS for MSI testing in gastrointestinal cancers.

Methods: Two series were analyzed through IHC for mismatch-repair-system proteins (MMRP) and PCR, with one series of 444 colorectal cancers (CRC) and the other of 176 gastric cancers (GC).

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Background: External rectal prolapse (ERP) is a debilitating condition in which surgery plays an important role. The aim of this study was to evaluate the outcomes of abdominal approaches (AA) and perineal approaches (PA) to ERP.

Methods: This was a PRISMA-compliant systematic review with meta-analysis.

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Background: The efficacy of a single administration of darvadstrocel (expanded allogeneic adipose-derived mesenchymal stem cells) for treating complex perianal fistulas in patients with Crohn's disease was demonstrated in a randomized, double-blind trial (ADMIRE-CD [Adipose Derived Mesenchymal Stem Cells for Induction of Remission in Perianal Fistulizing Crohn\'s Disease] trial). The current chart review study (INSPECT [A retrospectIve chart review study evaluatINg the longer-term effectiveneSs of darvadstrocel in PatiEnts who CompleTed ADMIRE-CD]) evaluated the longer-term effectiveness and safety of darvadstrocel.

Methods: Eligible patients had completed at least 52 weeks in the ADMIRE-CD trial.

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Background: Ileal pouch anal anastomosis is a complex procedure associated with significant morbidity, with several complications after ileal pouch anal anastomosis surgery leading to pouch failure. The aim of the study is to evaluate the heterogeneity surrounding the technique of ileoanal J-pouch surgery by assessing the safety and quality of published online peer-reviewed surgical videos.

Methods: Ileal pouch anal anastomosis videos published on peer-reviewed surgical journals and video channels were edited and anonymized to demonstrate specific steps of the surgical procedure: mobilization and division of the rectum, formation of the ileoanal J-pouch reservoir, anastomosis, and lengthening techniques.

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Background: Darvadstrocel is an expanded allogeneic adipose-derived mesenchymal stem cell therapy for the treatment of complex perianal fistulas in patients with Crohn's disease. Safety and efficacy outcomes from the clinical trial known as "Adipose derived mesenchymal stem cells for induction of remission in perianal fistulizing Crohn's disease," or ADMIRE-CD (NCT01541579), from up to 52 weeks posttreatment were previously reported. Here, the outcomes from an extended 104-week follow-up are reported.

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Background: Colonic lipomas are rare and can sometimes cause intussusception. The aim of this review was to define the presentation and possible management for colocolic intussusception caused by colonic lipomas.

Methods: A systematic search for patients with colocolic intussusception caused by colonic lipoma, including all available reports up to 2021.

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Article Synopsis
  • This article is the second part of a two-part series on the management of ulcerative colitis (UC) by the European Crohn's and Colitis Organisation (ECCO).
  • While the first article covered medical management, this one focuses on treating acute severe UC (ASUC) and surgical options for patients who don't respond to medical treatment.
  • The article also offers guidance on preoperative preparations, surgical techniques, and addresses various common clinical situations to update ECCO's recommendations for managing UC.
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Hepatocellular carcinoma (HCC) is one of the leading causes of death worldwide. The use of local treatment, such as surgical resection, liver transplant, and local ablation, has improved the survival of patients with HCC detected at an early stage. Until recently, the treatment of patients with metastatic disease was limited to the use of the multikinase inhibitor (MKI) sorafenib with a marginal effect on survival outcome.

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A subset of colorectal cancer (CRC) with a mesenchymal phenotype (CMS4) displays an aggressive disease, with an increased risk of recurrence after surgery, reduced survival, and resistance to standard treatments. It has been shown that the AXL and TGFβ signaling pathways are involved in epithelial-to-mesenchymal transition, migration, metastatic spread, and unresponsiveness to targeted therapies. However, the prognostic role of the combination of these biomarkers and the anti-tumor effect of AXL and TGFβ inhibition in CRC still has to be assessed.

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Preoperative staging represents a crucial point for the management, type of surgery, and candidacy for neoadjuvant therapy in patient with rectal cancer. The most recent clinical guidelines in oncology recommend an accurate preoperative evaluation in order to address early and advanced tumors to different therapeutic options. In particular, potential pitfalls may occur in the assessment of T3 tumors, which represents the most common stage at diagnosis.

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