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| 1 | Follow-up after curative resection for gastric cancer: Is it time to tailor it?显示文摘There is still no consensus on the follow-up frequency and regimen after curative resection for gastric cancer.Moreover,controversy exists regarding the utility of follow-up in improving survival,and the recommendations of experts and societies vary considerably.The main reason to establish surveillance programs is to diagnose tumor recurrence or metachronous cancers early and to thereby provide prompt treatment and prolong survival.In the setting of gastric malignancies,other reasons have been put forth:(1)the detection of adverse effects of a previous surgery,such as malnutrition or digestive sequelae;(2)the collection of data;and(3)the identification of psychological and/or social problems and provision of appropriate support to the patients.No randomized controlled trials on the role of follow-up after curative resection of gastric carcinoma have been published.Herein,the primary retrospective series and systematic reviews on this subject are analyzed and discussed.Furthermore,the guidelines from international and national scientific societies are discussed.Followup is recommended by the majority of institutions;however,there is no real evidence that follow-up can improve long-term survival rates.Several studies have demonstrated that it is possible to stratify patients submitted to curative gastrectomy into different classes according to the risk of recurrence.Furthermore,promising studies have identified several molecular markers that are related to the risk of relapse and to prognosis.Based on these premises,a promising strategy will be to tailor follow-up in relation to the patient and tumor characteristics,molecular marker status,and individual risk of recurrence. | Paolo Aurello Niccolò Petrucciani Laura Antolino Diego Giulitti Francesco D'Angelo Giovanni Ramacciato | 2017 | World Journal of Gastroenterology2017，23，19： | 1 |
| 2 | Duodenopancreatectomy: Open or minimally invasive approach?显示文摘 | Giuseppe Nigri Niccolò Petrucciani Marco LaTorre Paolo Magistri Stefano Valabrega Paolo Aurello Giovanni Ramacciato | 2014 | The Surgeon2014，，： | 1 |
| 3 | Giant colonic diverticulum,clinical presentation,diagnosis and treatment: Systematic review of 166 cases显示文摘AIM: To investigate the clinical presentation,diagnosis,and treatment of giant colonic diverticulum(GCD,by means of a complete and updated literature review).GCD is a rare manifestation of diverticular disease of the colon.Less than 200 studies on GCD were published in the literature,predominantly case reports or small patient series.METHODS: A systematic review of the literature was performed using the Embase and PubM ed databases toidentify all the GCD studies.The following MESH search headings were used: 'giant colonic diverticulum'; 'giant sigmoid diverticulum'.The 'related articles' function was used to broaden the search,and all of the abstracts,studies,and citations were reviewed by two authors.The following outcomes were of interest: the disease and patient characteristics,study design,indications for surgery,type of operation,and postoperative outcomes.Additionally,a subgroup analysis of cases treated in the last 5 years was performed to show the current trends in the treatment of GCD.A GCD case in an elderly patient treated in our department by a sigmoidectomy with primary anastomosis and a diverting ileostomy is presented as a typical example of the disease.RESULTS: In total,166 GCD cases in 138 studies were identified in the literature.The most common clinical presentation was abdominal pain,which occurred in 69% of the cases.Among the physical signs,an abdominal mass was detected in 48% of the cases,whereas 20% of the patients presented with fever and 14% with abdominal tenderness.Diagnosis is based predominantly on abdominal computed tomography.The most frequent treatment was colic resection with en-bloc resection of the diverticulum,performed in 57.2% of cases,whereas Hartmann's procedure was followed in 11.4% of the cases and a diverticulectomy in 10.2%.An analysis of sixteen cases reported in the last 5 years showed that the majority of patients were treated with sigmoidectomy and en-bloc resection of the diverticulum; the postoperative mortality was null,morbidity was very low(1 patient was hospitalized in the intensive care unit for postoperative hypotension),and the patients were discharged 4-14 d after surgery.CONCLUSION: Giant colonic diverticulum is a rare manifestation of diverticular diseases.Surgical treatment,consisting predominantly of colonic resection with en bloc resection of the diverticulum,is thepreferred option for GCD and guarantees excellent results. | Giuseppe Nigri Niccolò Petrucciani Giulia Giannini Paolo Aurello Paolo Magistri Marcello Gasparrini Giovanni Ramacciato | 2015 | World Journal of Gastroenterology2015，21，1： | 3 |
| 4 | Does Portal-Superior Mesenteric Vein Invasion Still Indicate Irresectability for Pancreatic Carcinoma?显示文摘 | Giovanni Ramacciato MD FACS Paolo Mercantini MD PhD Niccolò Petrucciani MD Valentina Giaccaglia MD Giuseppe Nigri MD Matteo Ravaioli MD Matteo Cescon MD Alessandro Cucchetti MD Massimo Del Gaudio MD | 2009 | Annals of Surgical Oncology2009，，4： | 1 |
| 5 | Does Portal-Superior Mesenteric Vein Invasion Still Indicate Irresectability for Pancreatic Carcinoma?显示文摘 | Giovanni Ramacciato MD FACS Paolo Mercantini MD PhD Niccolò Petrucciani MD Valentina Giaccaglia MD Giuseppe Nigri MD Matteo Ravaioli MD Matteo Cescon MD Alessandro Cucchetti MD Massimo Del Gaudio MD | 2009 | Annals of Surgical Oncology2009，，4： | 1 |
| 6 | Management of duodenal stump fistula after gastrectomy for gastric cancer: Systematic review显示文摘AIM: To identify the most effective treatment of duodenalstump fistula(DSF) after gastrectomy for gastric cancer.METHODS: A systematic review of the literature was performed. Pub Med, EMBASE, Cochrane Library, CILEA Archive, BMJ Clinical Evidence and Up To Date databases were analyzed. Three hundred eighty-eight manuscripts were retrieved and analyzed and thirteen studies published between 1988 and 2014 were finally selected according to the inclusion criteria, for a total of 145 cases of DSF, which represented our group of study. Only patients with DSF after gastrectomy for malignancy were selected. Data about patients' characteristics, type of treatment, short and long-term outcomes were extracted and analyzed. RESULTS: In the 13 studies different types of treatment were proposed: conservative approach, surgical approach, percutaneous approach and endoscopic approach(3 cases). The overall mortality rate was 11.7% for the entire cohort. The more frequent complications were sepsis, abscesses, peritonitis, bleeding, pneumonia and multi-organ failure. Conservative approach was performed in 6 studies for a total of 79 patients, in patients with stable general condition, often associated with percutaneous approach. A complete resolution of the leakage was achieved in 92.3% of these patients, with a healing time ranging from 17 to 71 d. Surgical approach included duodenostomy, duodenojejunostomy, pancreatoduodenectomy and the use of rectus muscle flap. In-hospital stay of patients who underwent relaparotomy ranged from 1 to 1035 d. The percutaneous approach included drainage of abscesses or duodenostomy(32 cases) and percutaneous biliary diversion(13 cases). The median healing time in this group was 43 d. CONCLUSION: Conservative approach is the treatment of choice, eventually associated with percutaneus drainage. Surgical approach should be reserved for severe cases or when conservative approaches fail. | Paolo Aurello Dario Sirimarco Paolo Magistri NiccolòPetrucciani Giammauro Berardi Silvia Amato Marcello Gasparrini Francesco D’Angelo Giuseppe Nigri Giovanni Ramacciato | 2015 | World Journal of Gastroenterology2015，21，24： | 19 |
| 7 | Univariate and Multivariate Analysis of Prognostic Factors in the Surgical Treatment of Hilar Cholangiocarcinoma显示文摘 | Ramacciato Giovanni Nigri Giuseppe Bellagamba Riccardo Petrucciani Niccolò Ravaioli Matteo Cescon Matteo Del Gaudio Massimo Ercolani Giorgio Di Benedetto Fabrizio Cautero Nicola Quintini Cristiano Cucchetti Alessandro Lauro Augusto Miller Ch | 2010 | The American Surgeon2010，，11： | 1 |
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