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| 1 | Laparoscopic liver resection:Experience based guidelines显示文摘Laparoscopic liver resection(LLR) has been progressively developed along the past two decades. Despite initial skepticism, improved operative results made laparoscopic approach incorporated to surgical practice and operations increased in frequency and complexity. Evidence supporting LLR comes from case-series, comparative studies and meta-analysis. Despite lack of level 1 evidence, the body of literature is stronger and existing data confirms the safety, feasibility and benefits of laparoscopic approach when compared to open resection. Indications for LLR do not differ from those for open surgery. They include benign and malignant(both primary and metastatic) tumors and living donor liver harvesting. Currently, resection of lesions located on anterolateral segments and left lateral sectionectomy are performed systematically by laparoscopy in hepatobiliary specialized centers. Resection of lesions located on posterosuperior segments(1, 4a, 7, 8) and major liver resections were shown to be feasible but remain technically demanding procedures, which should be reserved to experienced surgeons. Hand-assisted and laparoscopy-assisted procedures appeared to increase the indications of minimally invasive liver surgery and are useful strategies applied to difficult and major resections. LLR proved to be safe for malignant lesions and offers some short-term advantages over open resection. Oncological results including resection margin status and long-term survival were not inferior to open resection. At present, surgical community expects high quality studies to base the already perceived better outcomes achieved by laparoscopy in major centers' practice. Continuous surgical training, as well as new technologies should augment the application of lap-aroscopic liver surgery. Future applicability of new technologies such as robot assistance and image-guided surgery is still under investigation. | fabricio ferreira coelho jaime arthur pirola kruger gilton marques fonseca raphael leonardo cunha araújo vagner birk jeismann marcos vinícius perini renato micelli lupinacci ivan cecconello paulo herman | 2016 | World Journal of Gastrointestinal Surgery2016，8，1： | 22 |
| 2 | Perioperative fluid management in major hepatic resection: an integrative review显示文摘BACKGROUND: Fluid intervention and vasoactive pharmacological support during hepatic resection depend on the preference of the attending clinician, institutional resources, and practice culture. Evidence-based recommendations to guide perioperative fluid management are currently limited. Therefore, we provide a contemporary clinical integrative overview of the fundamental principles underpinning fluid intervention and hemodynamic optimization for adult patients undergoing major hepatic resection. DATA SOURCES: A literature review was performed of MEDLINE, EMBASE and the Cochrane Central Registry of Controlled Trials using the terms 'surgery', 'anesthesia', 'starch', 'hydroxyethyl starch derivatives', 'albumin', 'gelatin', 'liver resection', 'hepatic resection', 'fluids', 'fluid therapy', 'crystalloid', 'colloid', 'saline', 'plasma-Lyte', 'plasmalyte', 'hartmann's', 'acetate', and 'lactate'. Search results for MEDLINE and EMBASE were additionally limited to studies on human populations that included adult age groups and publications in English. RESULTS: A total of 113 articles were included after appropriate inclusion criteria screening. Perioperative fluid management as it relates to various anesthetic and surgical techniques is discussed.CONCLUSIONS: Clinicians should have a fundamental understanding of the surgical phases of the resection, hemodynamic goals, and anesthesia challenges in attempts to individualize therapy to the patient's underlying pathophysiological condition. Therefore, an ideal approach for perioperative fluid therapy is always individualized. Planning and designing large-scale clinical trials are imperative to define the optimal type and amount of fluid for patients undergoing major hepatic resection. Further clinical trials evaluating different intraoperative goal-directed strategies are also eagerly awaited. | Osamu Yoshino Marcos Vinicius Perini Christopher Christophi Laurence Weinberg | 2017 | Hepatobiliary & Pancreatic Diseases International2017，16，5： | 5 |
| 3 | Utility of endoscopic ultrasound, cytology and fluid carcinoembryonic antigen and CA 19-9 levels in pancreatic cystic lesions显示文摘AIM: To assess the diagnostic accuracy of endoscopic ultrasound (EUS), fluid tumor markers and cytology in distinguishing benign from (pre)malignant pancreatic cystic lesions. METHODS: 46 consecutive patients, referred to a gastroenterologist and surgeon for a symptomatic or incidental pancreatic cyst, were reviewed. EUS, cytology, and carcinoembryonic antigen (CEA) and carbohydrate antigen (CA 19-9) levels were compared with the final diagnosis, based on surgical pathology and/or imaging follow-up of at least 12 mo. Cysts were classified as benign (pseudocyst, serous cystadenoma) or malignant/ pre-malignant (mucinous cystic neoplasm). Receiver- operator characteristics (ROC) curve analysis was performed. RESULTS: The mean age was 56 years; 29% were male and median cyst diameter was 3 cm. Final outcome was obtained in 41 (89%) patients. Twenty-three (56%) of these 41 had surgical pathology. Twenty-three (56%) had benign lesions and 18 (44%) had malignant/pre- malignant lesions. Sensitivity, specificity and positive and negative predictive value of EUS alone to distinguish benign from malignant/premalignant pancreatic cystic lesions were 50%, 56%, 36% and 54% and for cytology were 71%, 96%, 92% and 85%, respectively. The corresponding values for the ROC-derived ideal cutoffswere 75%, 90%, 75%, 90% for CA 19-9 (> 37 U/mL) and 70%, 85%, 79% and 78% for CEA (> 3.1 ng/mL). Subgroup analysis of those with surgical pathology yielded almost identical performance and cutoffs. CONCLUSION: Cytology and cyst fluid tumor marker analysis is a very useful tool in distinguishing benign from (pre)malignant pancreatic cystic lesions. | Abdulrahman M Aljebreen Joseph Romagnuolo Rafael Perini Francis Sutherland | 2007 | World Journal of Gastroenterology2007，13，29： | 5 |
| 4 | From minimal to maximal surgery in the treatment of hepatocarcinoma:A review显示文摘Hepatocellular carcinoma represents one of the most challenging frontiers in liver surgery. Surgeons have to face a broad spectrum of aspects,from the underlying liver disease to the new surgical techniques. Safe liver resection can be performed in patients with portal hypertension and well-compensated liver function witha 5-year survival rate of 50%,offering good longterms results in selected patients. With the advances in laparoscopic surgery,major liver resections can be performed with minimal harm,avoiding the wound and leak complications related to the laparotomies. Studies have shown that oncological margins are the same as in open surgery. In patients submitted to liver resection(either laparoscopic or open) who experience recurrence,re-resection or salvage liver transplantation has been showing to be an alternative approach in well selected cases. The decision making approach to the cirrhotic patient is becoming more complex and should involve hepatologists,liver surgeons,radiologists and oncologists. Better understanding of the different risk factors for recurrence and survival should be aimed in these multidisciplinary discussions. We here in discuss the hot topics related to surgical risk factors regarding the surgical treatment of hepatocellular carcinoma: anatomical resection,margin status,macrovascular tumor invasion,the place of laparoscopy,salvage liver transplantation and liver transplantation. | Marcos Vinicius Perini Graham Starkey Michael A Fink Ramesh Bhandari Vijayaragavan Muralidharan Robert Jones Christopher Christophi | 2015 | World Journal of Hepatology2015，7，1： | 4 |
| 5 | Changes in foliar carbon isotope composition and seasonal stomatal conductance reveal adaptive traits in Mediterranean coppices affected by drought显示文摘We estimated water-use efficiency and potential photosynthetic assimilation of Holm oak(Quercus ilex L.) on slopes of NW and SW aspects in a replicated field test examining the effects of intensifying drought in two Mediterranean coppice forests. We used standard techniques for quantifying gas exchange and carbon isotopes in leaves and analyzed total chlorophyll, carotenoids and nitrogen in leaves collected from Mediterranean forests managed under the coppice system. We postulated that responses to drought of coppiced trees would lead to differential responses in physiological traits and that these traits could be used by foresters to adapt to predicted warming and drying in the Mediterranean area. We observed physiological responses of the coppiced trees that suggested acclimation in photosynthetic potential and water-use efficiency:(1) a significant reduction in stomatal conductance(p<0.01) wasrecorded as the drought increased at the SW site;(2) foliar δ13C increased as drought increased at the SW site(p<0.01);(3) variations in levels of carotenoids and foliar nitrogen, and differences in foliar morphology were recorded, and were tentatively attributed to variation in photosynthetic assimilation between sites. These findings increase knowledge of the capacity for acclimation of managed forests in the Mediterranean region of Europe. | Giovanni Di Matteo Luigi Perini Paolo Atzori Paolo De Angelis Tiziano Mei Giada Bertini Gianfranco Fabbio Giuseppe Scarascia Mugnozza | 2014 | Journal of Forestry Research2014，25，4： | 2 |
| 6 | Pharmacogenetics of warfarin:develop-ment of a dosing algorithm for brazilian patients显示文摘 | Perini JA Struchiner CJ Silva-Assun??o E | 2008 | Clin Pharmacol Ther2008，84，6： | 1 |
| 7 | Temporal profile of serum anti-inflammatory and pro-inflammatory interleukins in acute ischemic stroke patients显示文摘 | Perini F Morra M Alecci M | 2001 | Neurol Sci2001，22，4： | 1 |
| 8 | Tropos: An Agent-Oriented Software Development Methodology显示文摘 | Paolo Bresciani Anna Perini Paolo Giorgini Fausto Giunchiglia John Mylopoulos | 2004 | Autonomous Agents and Multi - Agent Systems2004，，3： | 1 |
| 9 | Expressing the human genome显示文摘 | PERINI G GREEN M R | 2001 | Nature2001，409，： | 1 |
| 10 | Goal oriented testing for Multi-Agent Systems显示文摘 | Nguyen C D Perini A Tonella P | 2010 | International Journal of Agent Orien ted Software Engineering2010，4，1： | 1 |
| 11 | Adolescent girls with polycystic ovary syndrome showing dit'ferent phenotypes have a different metabolic profile associated with increasing androgen levels显示文摘 | Fruzzetti F Perini D Lazzarini V | 2009 | Fertil Steril2009，92，： | 1 |
| 12 | Hepatocellular adenoma:an excellent indication for laparoscopic liver resection显示文摘 | Herman P Coelho FF Perini MV | 2012 | HPB (Oxford)2012，14，6： | 1 |
| 13 | Human airway mucin glycosyla- tion: a combinatory of carbohydrate determinants which vary in cystic fibrosis显示文摘 | Lamblin G Degroote S Perini JM | 2001 | Glycoconj J2001，18，9： | 1 |
| 14 | Use of intraoperative epiaortic ultrasonography to delineate aortic atheroma显示文摘 | BOLOTIN G DOMANY Y DE PERINI L | 2005 | Chest2005，127，1： | 1 |
| 15 | Temporal profile of serumm antiinflammatory and pro-inflammatory interleukins in acute ischemic stroke patients显示文摘 | Perini F Morra M Alecci M | 2001 | Neurol Sci2001，22，： | 1 |
| 16 | Phase 1 and pharmacodynamic trial of everolimus in combination with cetux- imab in patients with advanced cancer显示文摘 | CIUNCI CA PERINI RF AVADHANI AN | 2014 | Cancer2014，120，1： | 1 |
| 17 | Elevated plasma homocystcine in acute stroke was not associated with severity and outcome: stronger association with small artery disease显示文摘 | Perini F Galloni E Bolgan I | 2005 | Neurol Sci2005，26，5： | 1 |
| 18 | Potential isotopic and chemical markers for charactcrising organic fruits 显示文摘 | Camin F Perini M Bontcmpo L Fabroni S Faedl W Magnani S Baruzzi G Bonoli M Tabilio M R Musmeei S | 2011 | Food Chemistry2011，125，： | 1 |
| 19 | Outcomes of chol- ecystectomy for treatment of acute cholecystitis in octogenarians 显示文摘 | Nikfarjam M Yeo D Perini M | 2013 | ANZ J Surg2013，，： | 1 |
| 20 | Acute cerebral infarction in watershed distribution in a patient with hypereasinophilic syndrome 显示文摘 | Perini GF Kassab C Bley C | 2009 | Arq Neuropsiquiatr2009，67，2： | 1 |
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