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| 1 | Incidence and treatment of mediastinal leakage after esophagectomy:Insights from the multicenter study on mediastinal leaks显示文摘BACKGROUND Mediastinal leakage(ML) is one of the most feared complications of esophagectomy. A standard strategy for its diagnosis and treatment has beendifficult to establish because of the great variability in their incidence and mortality rates reported in the existing series.AIM To assess the incidence, predictive factors, treatment, and associated mortality rate of mediastinal leakage using the standardized definition of mediastinal leaks recently proposed by the Esophagectomy Complications Consensus Group(ECCG).METHODS Seven Italian surgical centers(five high-volume, two low-volume) affiliated with the Italian Society for the Study of Esophageal Diseases designed and implemented a retrospective study including all esophagectomies(n = 501) with intrathoracic esophagogastric anastomosis performed from 2014 to 2017.Anastomotic MLs were defined according to the classification recently proposed by the ECCG.RESULTS Fifty-nine cases of ML were recorded, yielding an overall incidence of 11.8%(95%CI: 9.1%-14.9%). The surgical approach significantly influenced the occurrence of ML: the proportion of leakage was 10.5% and 9% after open and hybrid esophagectomy(HE), respectively, and doubled(20%) after totally minimally invasive esophagectomy(TMIE)(P = 0.016). No other predictive factors were found. The 30-and 90-d overall mortality rates were 1.4% and 3.2%,respectively; the 30-and 90-d leak-related mortality rates were 5.1% and 10.2%,respectively; the 90-d mortality rates for TMIE and HE were 5.9% and 1.8%,respectively. Endoscopy was the first-line treatment in 49% of ML cases, with the need for retreatment in 17.2% of cases. Surgery was needed in 44.1% of ML cases.Endoscopic treatment had the lowest mortality rate(6.9%). Removal of the gastric tube with stoma formation was necessary in 8(13.6%) cases.CONCLUSION The incidence of ML after esophagectomy was high mainly in the TMIE group.However, the general and specific(leak-related) mortality rates were low. Early treatment(surgical or endoscopic) of severe leaks is mandatory to limit related mortality. | Uberto Fumagalli Gian Luca Baiocchi ANDrea Celotti Paolo Parise ANDrea Cossu Luigi Bonavina Daniele Bernardi Giovanni de Manzoni Jacopo Weindelmayer Giuseppe Verlato Stefano Santi Giovanni Pallabazzer Nazario Portolani Maurizio Degiuli Rossella Reddavid Stefano de Pascale | 2019 | World Journal of Gastroenterology2019，25，3： | 3 |
| 2 | Recurrence in node-negative advanced gastric cancer:Novel findings from an in-depth pathological analysis of prognostic factors from a multicentric series显示文摘AIM To analyze the clinicopathological characteristics of patients with both node-negative gastric carcinoma and diagnosis of recurrence during follow-up. METHODS We enrolled 41 patients treated with curative gastrectomy for p T2-4 a N0 gastric carcinoma between 1992 and 2010,who developed recurrence(Group 1). We retrospectively selected this group from the prospectively collected database of 4 centers belonging to the Italian Research Group for Gastric Cancer,and compared them with 437 p T2-4 a N0 patients without recurrence(Group 2). We analyzed lymphatic embolization,microvascular infiltration,perineural infiltration,and immunohistochemical determination of p53,Ki67,and HER2 in Group 1 and in a subgroup of Group 2(Group 2 bis) of 41 cases matched with Group 1 according to demographic and pathological characteristics. RESULTS T4 a stage and diffuse histotype were associated with recurrence in the group of p N0 patients. In-depth pathological analysis of two homogenous groups of p N0 patients,with and without recurrence during longterm follow-up(groups 1 and 2 bis),revealed two striking patterns: lymphatic embolization and perineural infiltration(two parameters that pathologists can easily report),and p53 and Ki67,represent significant factors for recurrence.CONCLUSION The reported pathological features should be considered predictive factors for recurrence and could be useful to stratify node-negative gastric cancer patients for adjuvant treatment and tailored follow-up. | Gian Luca Baiocchi Sarah Molfino Carla Baronchelli Simone Giacopuzzi Daniele Marrelli Paolo Morgagni Maria Bencivenga Luca Saragoni Carla Vindigni Nazario Portolani Maristella Botticini Giovanni De Manzoni | 2017 | World Journal of Gastroenterology2017，23，45： | 3 |
| 3 | Role of aetiology, diabetes,tobacco smoking and hypertension in hepatocellular carcinoma survival 显示文摘 | Raffetti E Portolani N Molfino S | 2015 | Dig Liver Dis2015，47，11： | 1 |
| 4 | Intrahepatic cholangio- carcinoma and combined hepatocellular - cholangiocarcinoma : a West- ern experience 显示文摘 | Portolani N Baiocchi GL Coniglio A | 2008 | Ann Surg Oncol2008，15，7： | 1 |
| 5 | Limited liver resection:a good indication for the treatment of hepatocellular carcinoma in elderly patients显示文摘 | Portolani N Baiocchi GL Coniglio A | 2011 | Jpn J Clin Oncol2011，41，12： | 1 |
| 6 | Possible additional value of 18 FDG-PET in managing pancreas intraductal papillary mucinous neoplasms: preliminary results 显示文摘 | Baiocchi GL Portolani N Bertagna F | 2008 | J Exp Clin Cancer Res2008，，27： | 1 |
| 7 | Non-specific febrile illness by Coxsackievirus A16 in a 6-day-old newborn 显示文摘 | Portolani M Bartoletti AM Pietrosemoli P | 2004 | Minerva Pediatr2004，56，3： | 1 |
| 8 | Limited liver re- section:a good indication for the treatment of hepatocellular carcinoma in elderly patients显示文摘 | Portolani N Baiocchi GL Coniglio A | 2011 | Jpn J Clin Oncol2011，41，12： | 1 |
| 9 | Increased risk of second malignancy in pancreatic intraductal papillary mucinous tumors: Review of the literature显示文摘AIM: To analyze the available evidence about the risk of extrapancreatic malignancies and pancreatic ductal adenocarcinoma associated to pancreatic intraductal papillary mucinous tumors(IPMNs).METHODS: A systematic search of literature was undertaken using MEDLINE, EMBASE, Cochrane and Web-of-Science libraries. No limitations for year of publication were considered; preference was given to English papers. All references in selected articles were further screened for additional publications. Both clinical series and Literature reviews were selected. For all eligible studies, a standard data extraction form was filled in and the following data were extracted: study design, number of patients, prevalence of pancreatic cancer and extrapancreatic malignancies in IPMN patients and control groups, if available.RESULTS: A total of 805 abstracts were selected and read; 25 articles were considered pertinent and 17 were chosen for the present systematic review. Eleven monocentric series, 1 multicentric series, 1 casecontrol study, 1 population-based study and 3 case report were included. A total of 2881 patients were globally analyzed as study group, and the incidence of pancreatic cancer and/or extrapancreatic malignancies ranged from 5% to 52%, with a mean of 28.71%.When a control group was analyzed(6 papers), the same incidence was as low as 9.4%.CONCLUSION: The available Literature is unanimous in claiming IPMNs to be strongly associated with pancreatic and extrapancreatic malignancies. The consequences in IPMNs management are herein discussed. | Gian Luca Baiocchi Sarah Molfino Barbara Frittoli Graziella Pigozzi Federico Gheza Giacomo Gaverini Antonio Tarasconi Chiara Ricci Francesco Bertagna Luigi Grazioli Guido AM Tiberio Nazario Portolani | 2015 | World Journal of Gastroenterology2015，21，23： | 1 |
| 10 | Intrahepatic cholangiocarcinoma and combined hepatocellular-cholangiocarcinoma:a Western experience显示文摘 | Portolani N Baiocchi GL Coniglio A | 2008 | Ann Surg Oncol2008，15，7： | 1 |
| 11 | Early and late recurrence after liver resection for hepatocellular carcinoma:prognostic and therapeutic implications显示文摘 | Portolani N Coniglio A Ghidoni S | 2006 | Ann Surg2006，243，2： | 1 |
| 12 | Early and late recurrence after liver resection for hepatocellular carcinoma: prognostic and therapeutic implications 显示文摘 | Portolani N Coniglio A Ghidoni S | 2006 | Ann Surg2006，243，2： | 1 |
| 13 | Possible additionalvalue of 18FDG-PET in managing pancreas intraductal papil-lary mucinous neoplasms: preliminary results 显示文摘 | Baiocchi GL Portolani N Bertagna F | 2008 | J Exp ClinCancer Res2008，27，1： | 1 |
| 14 | Arterial Chemoembolization in hepatocellular carcinomar suitable for resective surgery显示文摘 | Nazario Portolani Guido Alberto Massimo Tiberio Stefano Bonardelli | 1996 | Hepato-gastroenterology1996，43，12： | 1 |
| 15 | Searching for Indicators of Malignancy in Pancreatic Intraductal Papillary Mucinous Neoplasms: The Value of 18FDG–PET Confirmed显示文摘 | Gian Baiocchi Francesco Bertagna Federico Gheza Luigi Grazioli David Calanducci Raffaele Giubbini Nazario Portolani Stefano Giulini | 2012 | Annals of Surgical Oncology2012，，： | 1 |
| 16 | Early and late recurrence after liver resection for hepatocellular carcinoma: prognostic and therapeutic implications显示文摘 | Portolani N Coniglio A Ghidoni S Giovanelli M Benetti A Tiberio G A | 2006 | Ann Surg2006，243，： | 1 |
| 17 | Early and late recurrence after liver resection for hepatocellular carcinoma: progrlostic and therapeutic implications显示文摘 | Portolani N Coniglio A Giulini SM | 2006 | Ann Surg2006，243，2： | 1 |
| 18 | Early and late recurrence after liver resection for hepatocellular carcinoma: prognostic and therapeutic implications 显示文摘 | Portolani N Coniglio A Ghidoni S | 2006 | Ann Surg2006，243，2： | 1 |
| 19 | Early andlate recurrence after liver resection for hepatocellular carcinoma:prognostic and therapeutic implications显示文摘 | PORTOLANI N CONIGLIO A GHIDONI S | 2006 | Ann Surg2006，243，2： | 1 |
| 20 | Parietal and peritoneal local- izations of hepatocellular carcinoma: is there a place h~r a curative surgery显示文摘 | Portolani N Baiocchi GL Gheza F | 2014 | World I Surg Oneol2014，25，12： | 1 |
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