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| 1 | Hepatocellular carcinoma in cirrhotic patients with portal hypertension:Is liver resection always contraindicated?显示文摘AIM:To analyze the outcome of hepatocellular car-cinoma(HCC)resection in cirrhosis patients,related to presence of portal hypertension(PH)and extent of hepatectomy.METHODS:A retrospective analysis of 135 patients with HCC on a background of cirrhosis was submitted to curative liver resection.RESULTS:PH was present in 44(32.5%)patients.Overall mortality and morbidity were 2.2% and 33.7%,respectively.Median survival time in patients with or without PH was 31.6 and 65.1 mo,respectively(P=0.047);in the subgroup with Child-Pugh class A cirrhosis,median survival was 65.1 mo and 60.5 mo,respectively(P=0.257).Survival for patients submitted to limited liver resection was not significantly different in presence or absence of PH.Conversely,median survival for patients after resection of 2 or more segments with or without PH was 64.4 mo and 163.9 mo,respectively(P=0.035).CONCLUSION:PH is not an absolute contraindication to liver resection in Child-Pugh class A cirrhotic patients,but resection of 2 or more segments should not be recommended in patients with PH. | Andrea Ruzzenente Alessandro Valdegamberi Tommaso Campagnaro Simone Conci Silvia Pachera Calogero Iacono Alfredo Guglielmi | 2011 | World Journal of Gastroenterology2011，17，46： | 20 |
| 2 | Hepatocellular carcinoma:Surgical perspectives beyond the barcelona clinic liver cancer recommendations显示文摘The barcelona clinic liver cancer(BCLC)staging system has been approved as guidance for hepatocellular carcinoma(HCC)treatment guidelines by the main Western clinical liver associations.According to the BCLC classification,only patients with a small single HCC nodule without signs of portal hypertension or hyperbilirubinemia should undergo liver resection.In contrast,patients with intermediate-advanced HCC should be scheduled for palliative therapies,even if the lesion is resectable.Recent studies report good short-term and long-term outcomes in patients with intermediate-advanced HCC treated by liver resection.Therefore,this classification has been criticised because it excludes many patients who could benefit from curative resection.The aim of this review was to evaluate the role of surgery beyond the BCLC recommendations.Safe liver resection can be performed in patients with portal hypertension and well-compensated liver function with a 5-year survival rate of 50%.Surgery also offers good long-term result in selected patients with multiple or large HCCs with a reported 5-year survival rate of over 50%and 40%,respectively.Although macrovascular invasion is associated with a poor prognosis,liver resection provides better long-term results than palliative therapies or best supportive care.Recently,researchers have identified several genes whose altered expression influences the prognosis of patients with HCC.These genes may be useful for classifying the biological behaviour of different tumours.A revision of the BCLC classification should be introduced to provide the best treatment strategy and to ensure the best prognosis in patients with HCC. | Alfredo Guglielmi rea Ruzzenente Simone Conci Alessro Valdegamberi Marco Vitali Francesca Bertuzzo Michela De Angelis Guido Mantovani Calogero Iacono | 2014 | World Journal of Gastroenterology2014，20，24： | 16 |
| 3 | Endoscopic ablation of Barrett's esophagus using high power setting argon plasma coagulation: A prospective study显示文摘AIM: This prospective study evaluated the effectiveness of 90 W argon plasma coagulation (APC) for the ablation of Barrett's esophagus (BE) that is considered to be the main risk factor for the development of esophageal adenocarcinoma.METHODS: The results from 25 patients, observed at the First Department of General Surgery, University of Verona, Italy, from October 2000 to October 2003, who underwent APC for histologically proven BE were prospectively analyzed.RESULTS: The ablation treatment was completed in all the patients but one (96%). The mean number of APC sessions needed to complete ablation was 1.6 (total number: 40). The eradication was obtained in the majority of cases by one session only (60%), two sessions were required in 24% of the cases and three or more in 16%.About 43% of the sessions were complicated. Retrosternal pain (22.5%) and fever (17.5%) were the most frequent symptoms. Only one major complication occurred, it was an hemorrhage due to ulcer formation on the treated esophagus that required urgent endoscopic sclerosis and admission. The follow-up was accomplished in all the patients with a mean period of 26.3 mo and 20 patients (84%) with a follow-up period longer than 24 mo. Only one patient showed a relapse of metaplastic mucosa 12 mo after the completion of ablation. The patient was hence re-treated and now is free from recurrence 33 mo later.CONCLUSION: High power setting (90 W) APC showed to be safe and effective. The effects persist at a mean follow-up period of two years with a comparable cost in term of complications with respect to standard power settings. Further studies with greater number of patients are required to confirm these results and to assess if ablation reduces the incidence of malignant progression. | Corrado Pedrazzani Filippo Catalano Mara Festini Germana Zerman Anna Tomezzoli Andrea Ruzzenente Alfredo Guglielmi Giovanni de Manzoni | 2005 | World Journal of Gastroenterology2005，11，12： | 14 |
| 4 | Central pancreatectomy: The Dagradi Serio Iacono operation. Evolution of a surgical technique from the pioneers to the robotic approach显示文摘Central pancreatectomy(CP) is a parenchyma-sparing surgical procedure. The aims are to clarify the history and the development of CP and to give credits to those from whom it came. Ehrhardt, in 1908, described segmental neck resection(SNR) followed, in 1910, by Finney without reconstructive part. In 1950 Honjyo described two cases of SNR combined with gastrectomy for gastric cancer infiltrating the neck of the pancreas. Guillemin and Bessot(1957) and Letton and Wilson(1959) dealt only with the reconstructive aspect of CP. Dagradi and Serio, in 1982, performed the first CP including the resective and reconstructive aspects. Subsequently Iacono has validated it with functional endocrine and exocrine tests and popularized it worldwide. In 2003, Baca and Bokan performed laparoscopic CP and, In 2004, Giulianotti et al performed a robotic assisted CP. CP is performed worldwide either by open surgery or by using minimally-invasive or robotic approaches. This confirms that the operation does not belong to whom introduced it but to everyone who carries out it; however credit must be given to those from whom it came. | Calogero Iacono Andrea Ruzzenente Luca Bortolasi Alfredo Guglielmi | 2014 | World Journal of Gastroenterology2014，20，42： | 13 |
| 5 | Prognostication and response assessment in liver and pancreatic tumors:The new imaging显示文摘Diffusion-weighted imaging(DWI), dynamic contrastenhanced magnetic resonance imaging(DCE-MRI) and perfusion computed tomography(CT) are technical improvements of morphologic imaging that can evaluate functional properties of hepato-bilio-pancreatic tumors during conventional MRI or CT examinations.Nevertheless, the term 'functional imaging' is commonly used to describe molecular imaging techniques, as positron emission tomography(PET)CT/MRI, which still represent the most widely used methods for the evaluation of functional properties of solid neoplasms; unlike PET or single photon emission computed tomography, functional imaging techniques applied to conventional MRI/CT examinations do not require the administration of radiolabeled drugs or specific equipments. Moreover, DWI and DCE-MRI can be performed during the same session, thus providing a comprehensive 'one-step' morphological and functional evaluation of hepato-bilio-pancreatic tumors. Literature data reveal that functional imaging techniques could be proposed for the evaluation of these tumors before treatment, given that they may improve staging and predict prognosis or clinical outcome. Microscopic changes within neoplastic tissues induced by treatments can be detected and quantified with functional imaging,therefore these techniques could be used also for posttreatment assessment, even at an early stage. The aim of this editorial is to describe possible applications of new functional imaging techniques apart frommolecular imaging to hepatic and pancreatic tumors through a review of up-to-date literature data, with a particular emphasis on pathological correlations,prognostic stratification and post-treatment monitoring. | Riccardo De Robertis Paolo Tinazzi Martini Emanuele Demozzi Gino Puntel Silvia Ortolani Sara Cingarlini Andrea Ruzzenente Alfredo Guglielmi Giampaolo Tortora Claudio Bassi Paolo Pederzoli Mirko D'Onofrio | 2015 | World Journal of Gastroenterology2015，21，22： | 10 |
| 6 | Elevated fibrinogen plasma level is not an independent predictor of poor prognosis in a large cohort of Western patients undergoing surgery for colorectal cancer显示文摘AIM To evaluate the clinical significance of the preoperative fibrinogen plasma level as a prognostic marker after surgery for colorectal cancer.METHODS This retrospective study analysed 652 patients undergoing surgery for stage Ⅰ-Ⅳ colorectal cancer between January 2005 and December 2012, at the Division of General Surgery A, University of Verona Hospital Trust, in whom preoperative fibrinogen plasma values were assessed at baseline. Fibrinogen is involved in tumourigenesis as well as tumour progression in several malignancies. Correlations between preoperative plasma fibrinogen values and clinicopathological characteristics were investigated. Univariate and multivariate survival analyses were performed to identify factors associated with overall and tumour-related survival.RESULTS Among the 652 patients, the fibrinogen value was higher than the threshold of 400 mg/dL in 345 patients(53%). The preoperative mean ± SD of fibrinogen was 426.2 ± 23.2 mg/dL(median: 409 mg/dL; range: 143-1045 mg/d L). Preoperative fibrinogen values correlated with age(P = 0.003), completeness of tumour resection, potentially curative vs palliative(P < 0.001), presence of systemic metastasis(P < 0.001), depth of tumour invasion p T(P < 0.001), nodes involvement p N(P = 0.001) and CEA serum level(P < 0.001). The mean fibrinogen value(± SD) was 395.6 ± 120.4 mg/d L in G1 tumours, 424.1 ± 121.4 mg/dL in G2 tumours and 453.4 ± 131.6 mg/dL in G3 tumours(P = 0.045). The overall survival and tumourrelated survival were significantly higher in patients with fibrinogen values ≤ 400 mg/d L(P < 0.001). However, hyperfibrinogenemia did not retain statistical significance regarding either overall(P = 0.313) or tumour-related survival(P = 0.355) after controlling for other risk factors in a multivariate analysis.CONCLUSION Preoperative fibrinogen levels correlate with cancer severity but do not help in predicting patient prognosis after colorectal cancer surgery. | Corrado Pedrazzani Guido Mantovani Gian Luca Salvagno Elisabeth Baldiotti Andrea Ruzzenente Calogero Iacono Giuseppe Lippi Alfredo Guglielmi | 2016 | World Journal of Gastroenterology2016，22，45： | 5 |
| 7 | Surgical Resection Versus Local Ablation for HCC on Cirrhosis: Results from a Propensity Case-Matched Study显示文摘 | Andrea Ruzzenente Alfredo Guglielmi Marco Sandri Tommaso Campagnaro Alessandro Valdegamberi Simone Conci Fabio Bagante Gianni Turcato Mirko D’Onofrio Calogero Iacono | 2012 | Journal of Gastrointestinal Surgery2012，，2： | 3 |
| 8 | Transhepatic fibrinolysis of mesenteric and portal vein thrombosis in a patient with uIterative colitis: A case report显示文摘AIM: To present a case of acute mesenteric and portal vein thrombosis treated with thrombolytic therapy in a patient with ulcerative colitis in acute phase and to review the literature on thrombolytic therapy of mesenteric-portal system. Treatment of acute portal vein thrombosis has ranged from conservative treatment with thrombolysis and anticoagulation therapy to surgical treatment with thrombectomy and/or intestinal resection.METHODS: We treated our patient with intraportal infusion of plasminogen activator and then heparin through a percutaneous transhepatic catheter.RESULTS: Thrombus resolved despite premature interruption of the thrombolytic treatment for neurological complications, which subsequently resolved.CONCLUSION: Conservative management with plasminogen activator, could be considered as a good treatment for patients with acute porto-mesenteric thrombosis. | Alfredo Guglielmi Francesca Fior Orsolya Halmos Gian Franco Veraldi Lorenzo Rossaro Andrea Ruzzenente Claudio Cordiano | 2005 | World Journal of Gastroenterology2005，11，13： | 3 |
| 9 | Intrahepatic Cholangiocarcinoma: Prognostic Factors After Surgical Resection显示文摘 | Alfredo Guglielmi Andrea Ruzzenente Tommaso Campagnaro Silvia Pachera Alessandro Valdegamberi Paola Nicoli Alessandro Cappellani Giulio Malfermoni Calogero Iacono | 2009 | World Journal of Surgery2009，，6： | 3 |
| 10 | Radiofrequency Ablation Versus Surgical Resection for the Treatment of Hepatocellular Carcinoma in Cirrhosis显示文摘 | Alfredo Guglielmi Andrea Ruzzenente Alessandro Valdegamberi Silvia Pachera Tommaso Campagnaro Mirko D'Onofrio Enrico Martone Paola Nicoli Calogero Iacono | 2008 | Journal of Gastrointestinal Surgery2008，，1： | 2 |
| 11 | The Dagradi-Serio-Iacono Operation Central Pancreatectomy显示文摘 | Calogero Iacono Luca Bortolasi Enrico Facci Filippo Nifosì Silvia Pachera Andrea Ruzzenente Alfredo Guglielmi | 2007 | Journal of Gastrointestinal Surgery2007，，3： | 2 |
| 12 | The ROMA (risk of ovarian malignancy algorithm) for estimating the risk of epithelial ovarian cancer in women presenting with pelvic mass:is it really useful? 显示文摘 | Montagnana M Danese E Ruzzenente O | 2011 | Clin Chem Lab Med2011，49，3： | 1 |
| 13 | The utility of serum humanepididymisprotein4 (HE4) in patientswithapelvicmass 显示文摘 | Montagnana M Lippi G Ruzzenente O | 2009 | J Clin Lab Anal2009，23，5： | 1 |
| 14 | A re- emerging marker for prognosis in hepatocellular carcinoma: the add- value of fishing C- myc gene for early relapse 显示文摘 | PEDICA F RUZZENENTE A BAGANTE F | 2013 | PLoS One2013，8，68： | 1 |
| 15 | Time-to- peak values can estimate hepatic functional reserve in patients undergoing surgical resection: a comparison between per:usion CT and indocyanine green retention test显示文摘 | D' Onofrio M De Robertis R Ruzzenente A | 2014 | J Comput Assist To- mogr2014，38，5： | 1 |
| 16 | The utility of serum human epididymis protein 4 (HE4) in patient: with a pelvic mass显示文摘 | Montagnana M Lippi G Ruzzenente O | 2009 | J Clin Lab Anal2009，23，5： | 1 |
| 17 | The utility of serum human epididym is protein 4(HE4)in patients with a pelvic mass显示文摘 | Montagnana M Lippi G Ruzzenente O | 2009 | J Clin Lab Anal2009，23，5： | 1 |
| 18 | The ROMA (Risk of Ovarian Malignancy Algorithm) for estimating the risk of epithelial ovarian cancer in women presenting with pelvic mass:is it really useful?显示文摘 | Montagnana M Danese E Ruzzenente O | 2011 | Clin Chem Lab Med2011，49，3： | 1 |
| 19 | Radiofrequency Ablation Versus Surgical Resection for theTreatment of Hepatocellular Carcinoma in Cirrhosis显示文摘 | Alfredo Guglielmi Andrea Ruzzenente Alessandro Valdegamberi etal | 2008 | J Gastroin-test Surg2008，12，4： | 1 |
| 20 | Clinical associations of anti-CENP-B and anti-Scl70 antibody levels measured by multiplexed fluorescent microsphere immunoassay in systemic sclerosis显示文摘 | Alessandro Volpe Orazio Ruzzenente Paola Caramaschi Sara Pieropan Ilaria Tinazzi Antonio Carletto Lisa Maria Bambara Domenico Biasi | 2009 | Rheumatology International2009，，9： | 1 |
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