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| 1 | Laparoscopic surgery for rectal cancer:The state of the art显示文摘At present time,there is evidence from randomized controlled studies of the success of laparoscopic resection for the treatment of colon cancer with reported smaller incisions,lower morbidity rate and earlier recovery compared to open surgery.Technical limitations and a steep learning curve have limited the wide application of miniinvasive surgery for rectal cancer.The present article discusses the current status of laparoscopic resection for rectal cancer.A review of the more recent retrospective,prospective and randomized controlled trial(RCT) data on laparoscopic resection of rectal cancer including the role of trans-anal endoscopic microsurgery and robotics was performed.A particular emphasis was dedicated to mid and low rectal cancers.Few prospective and RCT trials specif ically addressing laparoscopic rectal cancer resection are currently available in the literature.Improved short-term outcomes in term of lesser intraoperative blood loss,reduced analgesic requirements and a shorter hospital stay have been demonstrated.Concerns have recently been raised in the largest RCT trial of the oncological adequacy of laparoscopy in terms of increased rate of circumferential margin.This data however was not conf irmed by other prospective comparative studies.Moreover,a similar local recurrence rate has been reported in RCT and comparative series.Similar f indings of overall and disease free survival have been reported but the follow-up time period is too short in all these studies and the few RCT trials currently available do not draw any def initive conclusions.On the basis of available data in the literature,the mini-invasive approach to rectal cancer surgery has some short-term advantages and does not seem to confer any disadvantage in term of local recurrence.With respect to longterm survival,a definitive answer cannot be given at present time as the results of RCT trials focused on long-term survival currently ongoing are still to fully clarify this issue. | Carlo Staudacher Andrea Vignali | 2010 | World Journal of Gastrointestinal Surgery2010，2，9： | 16 |
| 2 | Long-term outcomes after laparoscopic colectomy显示文摘AIM:To evaluate long-term outcomes in a large series of patients who randomly received laparoscopic or open colorectal resection.METHODS:From February 2000 to December 2004,six hundred sixty-two patients with colorectal disease were randomly assigned to laparoscopic(LPS,n = 330) or open(n = 332) colorectal resection.All patients were analyzed on an intention-to-treat basis.Long-term follow-up was carried out every 6 mo by office visits.In 526 cancer patients five-year overall and disease-free survival were evaluated.Median oncologic follow-up was 96 mo.RESULTS:Eight(4.2%) LPS group patients needed conversion to open surgery.Overall long-term morbidity rate was 7.6%(25/330) in the LPS vs 11.1%(37/332) in the open group(P = 0.17).In cancer patients,fiveyear overall survival was 68.6% in the LPS group and 64.0% in the Open group(P = 0.27).Excluding stage Ⅳ patients,five-year local and distant recurrence rates were 32.5% in the LPS group and 36.8% in the Open group(P = 0.36).Further,no difference in recurrence rate was found when patients were stratified according to cancer stage.CONCLUSION:LPS colorectal resection was associated with a slightly lower incidence of long-term complications than open surgery.No difference between groups was found in overall and disease-free survival rates. | Marco Braga Nicolò Pecorelli Matteo Frasson Andrea Vignali Walter Zuliani Valerio Di Carlo | 2011 | World Journal of Gastrointestinal Oncology2011，3，3： | 8 |
| 3 | Clinical impact of selective transarterial chemoembolization on hepatocellular carcinoma:A cohort study显示文摘AIM:To prospectively evaluate the short and long term clinical impact of selective transarterial chemoembolization (TACE) on liver function in patients with hepatocellular carcinoma (HCC).To assess side effects in relation to treatments.To analyze the overall survival and HCC progression free survival probability. METHODS:One hundred and seventeen cirrhotic patients with HCC were enrolled.Baseline liver function included Child-Pugh score and serum levels of alanineaminotransferase (ALT),prothrombin time(PT)and bilirubin.According to Cancer Liver Italian Program (CLIP) and Barcelona Clinic Liver Cancer (BCLC) staging systems,71 patients were eligible for TACE; 32 had previously received treatment for HCC.No significant differences in liver function were observed between previously treated and not treated patients. TACE was performed by selective catheterization of the arteries nourishing the lesions.While hospitalized, patient sunder went clinical,hematologicand ultrasonographic assessments.One month after TACE a CT scan was performed to assess tumor response. A second TACE was performed'on demand'.Liver function tests were checked in all patients every four months.RESULTS:After first TACE,the mean Child-Pugh score increased from a mean baseline 5.62±1.12 to 6.11±1.57 at discharge time (P<0.0001),decreasing after four months to 5.81±0.73 (not significant).ALT,PT and bilirubin significantly (P<0.0001)increased 24 h after TACE and progressively decreased until discharge. After the second TACE,variations in Child-Pugh score,ALT,PT and bilirubin were comparable to that described after the first TACE.No major complications were observed.The mean follow-up was 14.7±6.3 mo (median:16 mo).Only one patient died.No other patient experienced important long term worsening of clinical status.The overall survival probability at twenty-four months was 98.18%with a correspondent HCC progression free survival probability of 69%. CONCLUSION:Selectiv TAC Emayproduce significant,but transitory increases in ALT values, with no major impact on liver function and Child-Pugh score.Preservation of liver function is achievable also in patients previously treated with other therapeutic modalities and in patients undergoing multiple TACE cycles.Liver function can remain stable in the long-term, with optimal medium term survival.This result can be achieved through rigorous patient selection on the basis of tumour characteristics and clinical conditions. | Rodolfo Sacco Marco Bertini Pasquale Petruzzi Michele Bertoni Irene Bargellini Giampaolo Bresci Graziana Federici Luigi Gambardella Salvatore Metrangolo Giuseppe Parisi Antonio Romano Antonio Scaramuzzino Emanuele Tumino Alessandro Silvestri Emanuele Altomare Claudio Vignali Alfonso Capria | 2009 | World Journal of Gastroenterology2009，15，15： | 7 |
| 4 | Multidisciplinary treatment of rectal cancer in 2014: Where are we going?显示文摘In the present review we discuss the recent developments and future directions in the multimodal treatment of locally advanced rectal cancer, with respect to staging and re-staging modalities, to the current role of neoadjuvant chemo-radiation and to the conservative and more limited surgical approaches based on tumour response after neoadjuvant combined therapy. When initial tumor staging is considered a high accuracy has been reported for T pre-treatment staging, while preoperative lymph node mapping is still suboptimal. With respect to tumour re-staging, all the current available modalities still present a limited accuracy, in particular in defining a complete response. The role of short vs long-course radiotherapy regimens as well as the optimal time of surgery are still unclear and under investigation by means of ongoing randomized trials. Observational management or local excision following tumour complete response are promising alternatives to total mesorectal excision, but need further evaluation, and their use outside of a clinical trial is not recommended.The preoperative selection of patients who will benefit from neoadjuvant radiotherapy or not, as well as the proper identification of a clinical complete tumour response after combined treatment modalities,will influence the future directions in the treatment of locally advanced rectal cancer. | Andrea Vignali Paola De Nardi | 2014 | World Journal of Gastroenterology2014，20，32： | 5 |
| 5 | Laparoscopic Versus Open Colorectal Surgery: A Randomized Trial on Short-Term Outcome显示文摘 | Marco Braga Andrea Vignali Luca Gianotti Walter Zuliani Giovanni Radaelli Paola Gruarin Paolo Dellabona Valerio Di Carlo | 2002 | Annals of Surgery2002，，6： | 2 |
| 6 | Altered microperfusion at the rectal stump is predictive for rectal anastomotic leak显示文摘 | Andrea Vignali Luca Gianotti Marco Braga Giovanni Radaelli Leopoldo Malvezzi Valerio Di Carlo | 2000 | Diseases of the Colon & Rectum2000，，1： | 2 |
| 7 | Altered microperfusion at the rectal stump is predictive for rectal anastomotic leak显示文摘 | Andrea Vignali M.D. Luca Gianotti M.D. Ph.D. Dr. Marco Braga M.D. Giovanni Radaelli M.B. Leopoldo Malvezzi M.D. Valerio Di Carlo M.D | 2000 | Diseases of the Colon & Rectum2000，，1： | 2 |
| 8 | Factors associated with the occurrence of leaks in stapled rectal anastomoses: a review of 1014 patients显示文摘 | Vignali A Fazio VW Lavery IC | 1997 | J Am Coil Surg1997，185，2： | 1 |
| 9 | Factors associated with the occurrence of leaks in stapled rectal anastomoses: a review of 1,014 patients显示文摘 | Vignali A Fazio VW Lavery IC | 1997 | J Am Coll Surg1997，185，： | 1 |
| 10 | Immune and nutritional effects of early enteral nutrition after major abdominal operations显示文摘 | Braga M Vignali A Gianctti L | 1996 | Eur J Surg1996，162，2： | 1 |
| 11 | A protein interaction network of the malaria parasite Plasmodium falciparum显示文摘 | LaCount DJ Vignali M Chettier R | 2005 | Nature2005，438，： | 1 |
| 12 | Endometrioma excision and ovarian re- serve: A dangerous relation显示文摘 | Busacca M Vignali M | 2008 | J Minim Invasive Gynecool2008，16，： | 1 |
| 13 | Immune and nutlitionaeffects of early nutrition after major abdominal operations显示文摘 | Braga M Vignali A Gianotti L | 1996 | Eur J Surg1996，162，2： | 1 |
| 14 | Metabolic and functional results after laparoscopic colorectal surgery: a randomized, controlled trial 显示文摘 | Braga M Vignali A Zuliani W | 2002 | Dis Colon Rectum2002，45，8： | 1 |
| 15 | How regulatory T cells work 显示文摘 | Vignali DA Collison LW Workman CJ | 2008 | Nat Rev Immunol2008，8，7： | 1 |
| 16 | Vascular injuries after percutaneous renal procedures: treatment by transcatheter embolization显示文摘 | Vignali C Lonzi S Bargellini 1 | 2004 | Europe- an Radiology2004，14，4： | 1 |
| 17 | Interleukin -35 -odd one out or part of the family显示文摘 | Collison L W Vignali D A A | | 0，，： | 1 |
| 18 | IL-12 family cytokines: immunological playmakers 显示文摘 | Vignali DA Kuchroo VK | 2012 | Nat Immunol2012，13，8： | 1 |
| 19 | Laparoscopic resection in rectal cancer patients : outcome and cost-benefit analysis 显示文摘 | Braga M Frasson M Vignali A | 2007 | Dis Colon Rectum2007，50，4： | 1 |
| 20 | Immunonutrition in gastric cancer surgical patients显示文摘 | Marco Braga Luca Gianotti Andrea Vignali Valerio Di Carlo | 1998 | Nutrition1998，，11： | 1 |
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