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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 | Endoluminal Fundoplication (ELF) for GERD Using EsophyX: a 12-Month Follow-up in a Single-Center Experience显示文摘 | Alessandro Repici Uberto Fumagalli Alberto Malesci Roberta Barbera Camilla Gambaro Riccardo Rosati | 2010 | Journal of Gastrointestinal Surgery2010，，1： | 1 |
| 3 | Ghrelin and reproductive disorders显示文摘 | Andrea Repaci Alessandra Gambineri Uberto Pagotto Renato Pasquali | 2011 | Molecular and Cellular Endocrinology2011，，1： | 1 |
| 4 | Influence of Preservation Versus Division of Ilioinguinal, Iliohypogastric, and Genital Nerves During Open Mesh Herniorrhaphy: Prospective Multicentric Study of Chronic Pain显示文摘 | Sergio Alfieri Fabio Rotondi Andrea Di Giorgio Uberto Fumagalli Antonio Salzano Dario Di Miceli Marco Pericoli Ridolfini Antonio Sgagari Giovannibattista Doglietto | 2006 | Annals of Surgery2006，，4： | 1 |
| 5 | Endoluminal Fundoplication (ELF) for GERD Using EsophyX: a 12-Month Follow-up in a Single-Center Experience显示文摘 | Alessandro Repici Uberto Fumagalli Alberto Malesci Roberta Barbera Camilla Gambaro Riccardo Rosati | 2010 | Journal of Gastrointestinal Surgery2010，，： | 1 |
| 6 | Pharmacological inhibition of cannabinoid receptor 1 stimulates gastric release of nesfatin-1 via the mTOR pathway显示文摘AIM To determine whether Nucb2/nesfatin1 production is regulated by the cannabinoid system through the intracellular m TOR pathway in the stomach.METHODS Sprague Dawley rats were treated with vehicle, rimonabant, rapamycin or rapamycin+rimonabant. Gastric tissue obtained from the animals was used for biochemical assays: Nucb2 m RNA measurement by real time PCR, gastric Nucb2/nesfatin protein content by western blot, and gastric explants to obtain gastric secretomes. Nucb2/nesfatin levels were measured in gastric secretomes and plasma using enzyme-linked immunosorbent assay. RESULTS The inhibition of cannabinoid receptor 1(CB1) by the peripheral injection of an inverse agonist, namely rimonabant, decreases food intake and increases the gastric secretion and circulating levels of Nucb2/nesfatin-1. In addition, rimonabant treatment activates m TOR pathway in the stomach as showed by the increase in pm TOR/m TOR expression in gastric tissue obtained from rimonabant treated animals. These effects were confirmed by the use of a CB1 antagonist, AM281. When the intracellular pathway m TOR/S6 k was inactivated by chronic treatment with rapamycin, rimonabant treatment was no longer able to stimulate the gastric secretion of Nucb2/nesfatin-1.CONCLUSION The peripheral cannabinoid system regulates food intake through a mechanism that implies gastric production and release of Nucb2/Nesfatin-1, which is mediated by the m TOR/S6 k pathway. | Cintia Folgueira Silvia Barja-Fernandez Laura Prado Omar Al-Massadi Cecilia Castelao Veronica Pena-Leon Patricia Gonzalez-Saenz Javier Baltar Ivan Baamonde Rosaura Leis Carlos Dieguez Uberto Pagotto Felipe F Casanueva Sulay A Tovar Ruben Nogueiras Luisa M Seoane | 2017 | World Journal of Gastroenterology2017，23，35： | 1 |
| 7 | The short esophagus: Intraoperative assessment of esophageal length显示文摘 | Sandro Mattioli Maria Luisa Lugaresi Mario Costantini Alberto Del Genio Natale Di Martino Landino Fei Uberto Fumagalli Vincenzo Maffettone Luigi Monaco Mario Morino Fabrizio Rebecchi Riccardo Rosati Mauro Rossi Stefano Santi Vincenzo Trapani Giovanni Zani | 2008 | The Journal of Thoracic and Cardiovascular Surgery2008，，： | 1 |
| 8 | Plasma Adiponectin in Nonalcoholic Fatty Liver Is Related to Hepatic Insulin Resistance and Hepatic Fat Content, Not to Liver Disease Severity显示文摘 | Elisabetta Bugianesi Uberto Pagotto Rita Manini Ester Vanni Amalia Gastaldelli Rosaria de Iasio Elena Gentilcore Stefania Natale Maurizio Cassader Mario Rizzetto Renato Pasquali Giulio Marchesini | 2005 | The Journal of Clinical Endocrinology & Metabolism2005，，6： | 1 |
| 9 | 开放性网膜疝修补术中,采用保留或分离髂腹股沟神经、髂腹下神经和生殖神经方案间的影响:一项对慢性疼痛的前瞻性、多中心研究显示文摘目的:旨在评价在开放性网膜疝修补术中,通过采用不同的保留生殖股神经的生殖支、髂腹股沟神经、髂腹下神经的手术方案,是否能有效缓解慢性术后疼痛。背景:近年来,出于对其治疗和法律意义的关注,疝修补术后出现的慢性腹股沟疼痛日益引起人们的兴趣。然而,应采取何种治疗方案以保留3支腹股沟感觉神经仍存在许多争议。方法:一项由11家意大利研究中心参与多中心、前瞻性研究、募集了973例疝修补病例。要求所有手术医生报告是否每一根神经都被识别,并予以保留或分离。本研究的主要终点为评价6个月和1年时中重度慢性疼痛的情况。结果:6个月和1年随访时,分别有9.7%和4.1%的患者出现腹股沟疼痛。在6个月时,7.9%的患者为轻度疼痛,2.1%为中重度疼痛,而在1年时,3.6%的患者为轻度疼痛,0.5%的患者为中重度疼痛。单变量和多变量分析显示,并未发现与慢性疼痛存在显著相关的神经,随着未检测到的神经数量的增加,腹股沟疼痛的发生危险也随之增加。同样的,神经分离与慢性疼痛的发生明显相关。结论:目前的研究结果显示,在开放性腹股沟疝修补术中,分辨并保留神经可减少慢性失能性腹股沟疼痛,并且对于大多数6个月时出现慢性疼痛的患者,只有采取保守或内科治疗方法才能缓解其1年时的疼痛症状。 | Alfieri, Sergio Rotondi, Fabio Di Giorgio, Andrea Fumagalli, Uberto Salzano, Antonio Di Miceli, Dario Ridolfni, Marco Pericoli Sgagari, Antonio Doglietto, Giovannibattista Groin Pain Trial Group | 2007 | 医学信息(手术学分册)2007，20，8： | 0 |
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