Papers by Savino Occhionorelli
[Adenomyomatosis of the gallbladder. Our experience]
PubMed, May 1, 1997
Adenomyomatosis is a rare affection of the gallbladder and it's infrequen... more Adenomyomatosis is a rare affection of the gallbladder and it's infrequently reported in the Literature. Having observed eighteen cases of adenomyomatosis of the gallbladder in the last five years and considering the difficulties in making an early diagnosis of gallbladder cancer, the authors suggest the importance of cholecystectomy in this pathology.
The Octreotide in the Prophylaxis of Linphorrea Following Axillary Node Dissection for Breast Cancer
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Radiology Case Reports, Dec 1, 2017
[Atraumatic skin closure with Fasterzip]
PubMed, 1996
The Authors report their experience of skin closure using a new device, a surgical "zipper", with... more The Authors report their experience of skin closure using a new device, a surgical "zipper", without applying any sort of sutures. The application of this device, the functional and aesthetic advantages and the results obtained are described.
Iperplasia Miointimale Da Sutura Vascolare. Case Report e Considerazioni Generali
Smooth muscle cell proliferation is a step of the repair process after vascular injury. A similar... more Smooth muscle cell proliferation is a step of the repair process after vascular injury. A similar process occurs after percutaneus transluminal angioplasty and can lead to intimal hyperplasia and vascular restenosis. We have recently observed this process in an anastomotic restenosis after saphenous vein bypass in the popliteal artery. We suppose that myointimal hyperplasia can also be an aspecific response to surgical intimal injury
Surgical Endoscopy
Background Perforated peptic ulcer (PPU) remain a surgical emergency accounting for 37% of all pe... more Background Perforated peptic ulcer (PPU) remain a surgical emergency accounting for 37% of all peptic ulcer-related deaths. Surgery remains the standard of care. The benefits of laparoscopic approach have been well-established even in the elderly. However, because of inconsistent results with specific regard to some technical aspects of such technique surgeons questioned the adoption of laparoscopic approach. This leads to choose the type of approach based on personal experience. The aim of our study was to critically appraise the use of the laparoscopic approach in PPU treatment comparing it with open procedure. Methods A retrospective study with propensity score matching analysis of patients underwent surgical procedure for PPU was performed. Patients undergoing PPU repair were divided into: Laparoscopic approach (LapA) and Open approach (OpenA) groups and clinical-pathological features of patients in the both groups were compared. Results A total of 453 patients underwent PPU simple repair. Among these, a LapA was adopted in 49% (222/453 patients). After propensity score matching, 172 patients were included in each group (the LapA and the OpenA). Analysis demonstrated increased operative times in the OpenA [OpenA: 96.4 ± 37.2 vs LapA 88.47 ± 33 min, p = 0.035], with shorter overall length of stay in the LapA group [OpenA 13 ± 12 vs LapA 10.3 ± 11.4 days p = 0.038]. There was no statistically significant difference in mortality [OpenA 26 (15.1%) vs LapA 18 (10.5%), p = 0.258]. Focusing on morbidity, the overall rate of 30-day postoperative morbidity was significantly lower in the LapA group [OpenA 67 patients (39.0%) vs LapA 37 patients (21.5%) p = 0.002]. When stratified using the Clavien-Dindo classification, the severity of postoperative complications was statistically different only for C-D 1-2. Conclusions Based on the present study, we can support that laparoscopic suturing of perforated peptic ulcers, apart from being a safe technique, could provide significant advantages in terms of postoperative complications and hospital stay. The incidence of peptic ulcer disease has decreased, particularly in Western countries after the introduction of proton-pump inhibitors (PPI) along with antibiotic therapy for Helicobacter pylori eradication. Nowadays, peptic ulcer disease has a reported annual incidence between 0.03 and 0.19% worldwide . However, although the number of patients with ulcer is decreased to less than one third, there was no marked decrease in the number of deaths from ulcer, and perforated peptic ulcer (PPU) remain a surgical emergency associated with increased mortality, accounting for 37% of all peptic ulcer-related deaths . This indicates that the clinical picture of ulcer became more severe, in particular, combined use of LDA (low-dose aspirin) and nonsteroidal anti-inflammatory drugs (NSAIDs) and advanced age serve as risk factors for the occurrence of LDAinduced ulcer and also increase the risk of haemorrhage and Other Interventional Techniques
Effects of hospital facilities on patient outcomes after cancer surgery: an international, prospective, observational study
The Lancet Global Health
Emergency Therapeutic Laparoscopy
102 patients underwent videoassisted laparoscopy for urgency surgery. The indications were 11 per... more 102 patients underwent videoassisted laparoscopy for urgency surgery. The indications were 11 perforation of peptic ulcer, 48 acute cholecystitis, 29 acute appendicitis, 6 extrauterine pregnancy, 6 postoperative adhesions syndrome and 2 traumatic rupture of the spleen. The nearly immediate mobilisation, the pain less, the nearly immediate restarting of peristalsis and the very good aesthetical results are the power points tho emphasize the use of laparoscopy for diagnosis and, if possible, for treatment in urgency surger
Coartazione Sottorenale Dell'Aorta. Presentazione DI Un Caso Clinico
Coarctation of abdominal aorta constitutes a rare group of vascular abnormalities, including segm... more Coarctation of abdominal aorta constitutes a rare group of vascular abnormalities, including segmental stenoses and extended hypoplasia below the restriction. Usually hypertension is the only clinical evidence. The natural history of the surgically untreated disease foresees a decline of life expectancy; while surgical operation permit an almost complete "restitutio ad integrum". The Authors report a case of coarctation of the abdominal aorta come to their observation whose particularly was determined by the absence of high blood pressure, the aortic stenoses being located under the renal arteries
Coartazione Istmica Dell'Aorta
ISTHMIC COARCTATION OF THE AORTA. DESCRIPTION OF AN ANOMALOUS CLINICAL CAS
Large-Scale Isolation and Cryopreservation of human hepatocytes from all whole livers unsuitable for transplant; hepatocyte bank is a reality
Isolated human hepatocytes would represent an ideal in vitro model for biomedical research. Prima... more Isolated human hepatocytes would represent an ideal in vitro model for biomedical research. Primary hepatocytes are widely studied as such, or engineered for clinical applications such as cell transplant and bioartificial livers. An adequate source is required for the various applications, and also for emergency use. Banking is therefore necessary and thus also a structure able to isolate and store large quantities of such cells
Importanza della ecografia H/R intraoperatoria in corso di chirurgia dei tronchi sopra aortici
THe Authors relate their experience about the use of H/R intraoperative Echography during periphe... more THe Authors relate their experience about the use of H/R intraoperative Echography during peripheral and carotid surgery. 52 patients underwent the above procedure (32 of them were operated on for carotid T.E.A.) with Biosound 2000 SA with 4 cm and 7,5 MHz Probe. The high sensibility / sensitivity of this procedure suggests its use a routine intraoperative control rather than invasive methods like angiography, The Authors suggest the H/R intraoperative echography as a gold standard examination
USE OF MEDIASTINOSCOPY ("optical" and videoassisted). ANALYSIS OF 201 CASES
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L' Ultrasonografia Endoluminale Nella Stadiazione Pre-Operatoria Del Cancro Rettale
Valutazione Della Sensibilita' e Della Specificita' Della Tireoglobulina e Degli Ab Anti-Tireoglobulina Per La Determinazione Del Rischio DI Recidiva e Nel Follow Up Dei Pazienti Affetti Da Carcinoma Ben Differenziato Della Tiroide
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Neoplasie rare dell’ileo: diagnostica e trattamento
Annali Italiani Di Chirurgia, 2001
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Anaesthesia, 2021
SummaryPeri‐operative SARS‐CoV‐2 infection increases postoperative mortality. The aim of this stu... more SummaryPeri‐operative SARS‐CoV‐2 infection increases postoperative mortality. The aim of this study was to determine the optimal duration of planned delay before surgery in patients who have had SARS‐CoV‐2 infection. This international, multicentre, prospective cohort study included patients undergoing elective or emergency surgery during October 2020. Surgical patients with pre‐operative SARS‐CoV‐2 infection were compared with those without previous SARS‐CoV‐2 infection. The primary outcome measure was 30‐day postoperative mortality. Logistic regression models were used to calculate adjusted 30‐day mortality rates stratified by time from diagnosis of SARS‐CoV‐2 infection to surgery. Among 140,231 patients (116 countries), 3127 patients (2.2%) had a pre‐operative SARS‐CoV‐2 diagnosis. Adjusted 30‐day mortality in patients without SARS‐CoV‐2 infection was 1.5% (95%CI 1.4–1.5). In patients with a pre‐operative SARS‐CoV‐2 diagnosis, mortality was increased in patients having surgery wi...
Anaesthesia, 2021
SummarySARS‐CoV‐2 has been associated with an increased rate of venous thromboembolism in critica... more SummarySARS‐CoV‐2 has been associated with an increased rate of venous thromboembolism in critically ill patients. Since surgical patients are already at higher risk of venous thromboembolism than general populations, this study aimed to determine if patients with peri‐operative or prior SARS‐CoV‐2 were at further increased risk of venous thromboembolism. We conducted a planned sub‐study and analysis from an international, multicentre, prospective cohort study of elective and emergency patients undergoing surgery during October 2020. Patients from all surgical specialties were included. The primary outcome measure was venous thromboembolism (pulmonary embolism or deep vein thrombosis) within 30 days of surgery. SARS‐CoV‐2 diagnosis was defined as peri‐operative (7 days before to 30 days after surgery); recent (1–6 weeks before surgery); previous (≥7 weeks before surgery); or none. Information on prophylaxis regimens or pre‐operative anti‐coagulation for baseline comorbidities was no...
The tip of the iceberg of colorectal perforation from enema: a systematic review and meta-analysis
Techniques in Coloproctology, 2020
Although rare, perforation following an enema used to treat constipation is a dangerous complicat... more Although rare, perforation following an enema used to treat constipation is a dangerous complication. However, no recommendations or guidelines for enema use are available. So, in common clinical practice, the diagnostic approach and the treatment are not standardized. In an attempt to resolve this clinical dilemma associated with high mortality and potential medicolegal claims for malpractice, we have performed a systematic review and meta-analysis of studies reporting on colorectal perforation secondary to enema use for adult patients with constipation. A systematic search of PubMed, Web of Science and Scopus was performed according to the PRISMA statement up until February 2020. Studies that reported on colorectal perforation from enema use in adult patients with constipation were included. The primary outcomes were the rate of hospital mortality and pooled prevalence estimates of mortality from perforation secondary to enema use. The secondary outcomes were the administration of rectal enemas, site of visceral perforation, signs, symptoms, radiological evaluation, and type of treatment A total of 15 studies were included in the final analysis (49 patients). Across all studies, the pooled prevalence estimate of mortality for patients with perforation secondary to enema use was 38.5%, (95% CI [22.7%, 55.5%]). This rate was lower in patients who had surgery (35%) than in patients treated conservatively (57.1%). The sites of perforation were intraoperatively reported in 84% of cases, but in 16% of patients the rectal perforation was undiagnosed, and surgical decision making was problematic. The primary location of the perforation was the rectum in 80.9% of the patients. The enema was administered by a nurse in 90% of the cases, self-administered in 7.5% and a family doctor in 2.5%. The main objective of emergency surgery in this setting is resection of the perforation caused by the enema; when it is not possible to resect the perforated rectum, faecal diversion is needed. Hartmann’s procedure was most commonly performed by the surgeons in this review (60.7%), with other reported treatments included a diverting proximal loop colostomy and sigmoid segment exteriorization Considering the studies available, it is not possible to undertake a thorough evaluation of enema use, including the associated complications and their management. Further data are required to allow the development of guidelines to advice on safe enema use and management of complications.
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Papers by Savino Occhionorelli