Publications by authors named "Vistoli F"

Background: Hemorrhoidal disease (HD) is a common proctologic disease. Dietary and lifestyle play a role in the genesis of the disease or in its progression to more severe forms, although the exact mechanism is still not fully understood. We performed a pilot observational cross-sectional analytical association study to evaluate the possible association between sport activities and HD.

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Objective: This study aimed to compare robotic pancreatoduodenectomy with vein resection (PD-VR) based on the incidence of severe postoperative complications (SPC).

Background: Robotic pancreatoduodenectomy has been gaining momentum in recent years. Vein resection is frequently required in this operation, but no study has compared robotic and open PD-VR using a matched analysis.

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Background: It is common practice to classify waste from the operating theater as "clinical". The development of sustainable policies could have a significant impact. In the first phase, our study aims to measure general surgery waste and to assess the potential financial and carbon savings of appropriate recycling.

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An increasing number of sensitized patients awaiting transplantation face limited options, leading to fatalities during dialysis and higher costs. The absence of established evidence highlights the need for collaborative consensus. Donor-specific antibodies (DSA)-triggered antibody-mediated rejection (AMR) significantly contributes to kidney graft failure, especially in sensitized patients.

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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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Over the past decade, there has been a growing interest in the development of an artificial pancreas for intraperitoneal insulin delivery. Intraperitoneal implantable pumps guarantee more physiological glycemic control than subcutaneous wearable ones, for the treatment of type 1 diabetes. In this work, a fully implantable artificial pancreas refillable by ingestible pills is presented.

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Background: Newer chemotherapy regimens are reviving the role of pancreatectomy with arterial resection (PAR) in locally advanced pancreatic cancer. However, concerns about the early outcomes and learning curve of PAR remain. This study aimed to define the postoperative results and learning curve of PAR and provide preliminary data on oncologic outcomes.

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Article Synopsis
  • Living donor kidney transplantation (LDKTx) is endorsed by scientific societies for its effectiveness, with 40,663 kidney transplants done in Italy from 2001 to 2022, including 4731 from living donors.
  • The study found no postoperative deaths among living donors, and a high 10-year donor survival rate of 93.38%, though 1.8% of donors developed renal disease post-surgery.
  • The survey revealed that while many transplant centers use minimally invasive techniques and safety checklists, there is a need for improved donor safety protocols and increased experience among surgical teams in Italy.
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The Banff pancreas working schema for diagnosis and grading of rejection is widely used for treatment guidance and risk stratification in centers that perform pancreas allograft biopsies. Since the last update, various studies have provided additional insight regarding the application of the schema and enhanced our understanding of additional clinicopathologic entities. This update aims to clarify terminology and lesion description for T cell-mediated and antibody-mediated allograft rejections, in both active and chronic forms.

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The advent of Machine Perfusion (MP) as a superior form of preservation and assessment for cold storage of both high-risk kidney's and the liver presents opportunities in the field of beta-cell replacement. It is yet unknown whether such techniques, when applied to the pancreas, can increase the pool of suitable donor organs as well as ameliorating the effects of ischemia incurred during the retrieval process. Recent experimental models of pancreatic MP appear promising.

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The prognostic value of carbohydrate antigen 125 (Ca 125) is emerging also in pancreatic cancer (PDAC). In this study, we aim to define the prognostic value of Ca 125 in resected PDAC of the head of the pancreas. This is a single-center, retrospective study.

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Careful preoperative planning is key in minimally invasive radical antegrade modular pancreatosplenectomy (MI-RAMPS). This retrospective study aims to show the practical implications of computed tomography distance between the right margin of the tumor and either the left margin of the spleno-mesenteric confluence (d-SMC) or the gastroduodenal artery (d-GDA). Between January 2011 and June 2022, 48 minimally invasive RAMPS were performed for either pancreatic cancer or malignant intraductal mucinous papillary neoplasms.

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Background: Difficulty scoring systems are important for the safe, stepwise implementation of new procedures. We designed a retrospective observational study for building a difficulty score for robotic pancreatoduodenectomy.

Methods: The difficulty score (PD-ROBOSCORE) aims at predicting severe postoperative complications after robotic pancreatoduodenectomy.

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Article Synopsis
  • - Open pancreatoduodenectomy with vein resection (OPD-VR) is now standard for patients who respond to neoadjuvant therapies, and the feasibility of robotic pancreatoduodenectomy with vein resection (RPD-VR) has been demonstrated, yet detailed challenges have not been thoroughly addressed.
  • - The study outlines various vascular techniques adopted from OPD-VR and robotic transplant procedures, providing a detailed classification of vein resections into four types, with video demonstrations of each.
  • - Out of 783 pancreatoduodenectomies performed over 13 years, 36 were RPD-VR, showing a 90-day mortality of 8.3% and low conversion to open surgery
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Background: Triangle pancreatoduodenectomy adds to the conventional procedure the en bloc removal of the retroperitoneal lympho-neural tissue included in the triangular area bounded by the common hepatic artery (CHA), the superior mesenteric artery (SMA), and the superior mesenteric vein/portal vein. We herein aim to show the feasibility of "cold" triangle robotic pancreaticoduodenectomy (C-Tr-RPD) for pancreatic cancer (PDAC).

Methods: Cold dissection corresponds to sharp arterial divestment performed using only the tips of robotic scissors.

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Background: This study aims to describe the technique and the results of double-layer continuous suture hepaticojejunostomy (HJ) following pancreatoduodenectomy (PD) and total pancreatectomy (TP).

Methods: A prospectively maintained database was analyzed retrospectively to identify incidence and severity of biliary leaks (BL) (ISGLS definition), as well as of HJ stenosis (HJS), cholangitis, and need for redo-HJ (in patients with a follow-up ≥3 years) in a consecutive series of 800 procedures (PD = 603; TP = 197). Predictors of biliary complications were also identified.

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Background: Transplant nephropathology is a highly specialized field of pathology comprising both the evaluation of organ donor biopsy for organ allocation and post-transplant graft biopsy for assessment of rejection or graft damage. The introduction of digital pathology with whole-slide imaging (WSI) in clinical research, trials and practice has catalyzed the application of artificial intelligence (AI) for histopathology, with development of novel machine-learning models for tissue interrogation and discovery. We aimed to review the literature for studies specifically applying AI algorithms to WSI-digitized pre-implantation kidney biopsy.

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Background: Perivascular epithelioid cell tumors (PEComa)s are mesenchymal neoplasms located at various anatomic sites, which usually express both melanocytic and myogenic markers.

Case Report: A 60-year-old woman underwent laparotomy for a huge, heterogeneous, right ovarian mass. The histological examination of the surgical specimen revealed a neoplasm consisting of both cells with clear or eosinophilic cytoplasm and spindle cells in a myxoid stroma.

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Creating fully implantable robots that replace or restore physiological processes is a great challenge in medical robotics. Restoring blood glucose homeostasis in patients with type 1 diabetes is particularly interesting in this sense. Intraperitoneal insulin delivery could revolutionize type 1 diabetes treatment.

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Article Synopsis
  • * Both simultaneous pancreas-kidney transplantation (SPK) and pancreas transplant alone enhance long-term survival and significantly improve recipients' quality of life, outweighing potential downsides.
  • * SPK performed before dialysis offers better outcomes than after dialysis, which adversely affects survival rates, suggesting that kidney grafts should be preferentially allocated to SPK candidates.
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Comprehensive evidence-based guidelines for the practice of pancreas transplantation are yet to be established. The First World Consensus Conference on Pancreas Transplantation was convened for this purpose. A steering committee selected the participants and defined the questions to be addressed.

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Purpose Of Review: To define recent changes and future directions in the practice of pancreas transplantation (PT). Two major events have occurred in the past 18 months: COVID-19 pandemic, and the first world consensus conference on PT. Several innovative studies were published after the consensus conference.

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