Abstract:
AIM:The authors seek to assess whether the lymph node ratio (the ratio of positive nodes divided by the total number of retrieved nodes) could predict the risk of metachronous liver metastases. MATERIAL AND METHODS:A homogeneous group of 280 patients, followed-up for at least 5 years, was evaluated. In order to highlight the groups with the highest risk of metachronous liver metastases, patients were divided into four quartiles groups in relation to the LNR. RESULTS:The number of lymph nodes sampled in group "stage I" was significantly lower. Even if statistical significance between the global LNR and the development of liver metastases has not been reached, the subdivision into quartiles has made it possible to highlight that in the more advanced ratio groups, a higher incidence of metachronous liver metastases (p <0.028) was registered and was a different distribution of patients with or without liver metastasis in function of quartiles (P =0.01). DISCUSSION:The LNR has enabled us to prognosticate patients who are at greater risk of developing metachronous liver metastases. The lower lymph node sampling in the patients with less advanced staging (I) and in patients with nodenegative cancer (I+II) who developed liver metastases, leads us to believe that some patients have been understaged. CONCLUSION:We believe that the LNR, especially in cases of adequate lymph node sampling, is a useful gauge to better sub-stratify "node-positive" patients. KEY WORDS:Colorectal cancer, Liver metastases, Lymph node ratio. OBIETTIVO:L’obiettivo di campionare almeno 12 linfonodi per una corretta stadiazione di una neoplasia colorettale non sempre è raggiunto e ciò è legato sia a variabili modificabili come il chirurgo o il patologo, sia a variabili immodificabili legate al paziente o alla malattia neoplastica. La ratio linfonodale (LNR), cioè il rapporto tra il numero dei linfonodi metastatici ed il numero totale dei linfonodi, permetterebbe una migliore selezione prognostica dei pazienti. Gli autori hanno voluto valutare se la suddivisione dei pazienti in base alla LNR possa predire il rischio di sviluppare metastasi epatiche metacrone da cancro colorettale. MATERIALI E METODI:È stato valutato retrospettivamente un gruppo omogeneo di 280 pazienti seguiti in follow- up per almeno 5 anni. Allo scopo di evidenziare i gruppi a maggior rischio di metastasi epatiche metacrone i soggetti sono stati suddivisi in 4 quartili in relazione alla LNR. RISULTATI: il numero dei linfonodi campionati nel gruppo allo stadio I è stato inferiore in modo statisticamente significativo rispetto ai gruppi II (p=0.011) e III (p<0.007), mentre non abbiamo registrato differenze statisticamente significative tra i gruppi II e III. Per quanto non sia stata raggiunta la significatività statistica tra la LNR globale e lo sviluppo di metastasi epatiche, la suddivisione in quartili ha permesso di evidenziare che in quelli più avanzati (LNR3 + LNR4) veniva registrata una maggiore incidenza di metastasi epatiche metacrone (70% vs 30%; p<0.028) e che esiste una differente distribuzione dei pazienti con o senza metastasi epatiche in funzione dei quartili (P< 0.01). DISCUSSIONE:Alla luce dei dati riportati la LNR permette di prognosticare i pazienti a maggior rischio di sviluppare metastasi epatiche metacrone. Il minor campionamento linfonodale, registrato nei pazienti con stadiazione meno avanzata (BI) e nei pazienti nodes-negative (BI+BII) che hanno sviluppato metastasi epatiche, ci induce a ritenere che alcuni pazienti agli stadi meno avanzati siano stati verosimilmente sottostadiati. CONCLUSIONE:Riteniamo che la LNR, soprattutto in caso di adeguato campionamento linfonodale, possa essere utile per meglio sub-stratificare i pazienti in senso prognostico in generale ed in relazione allo sviluppo di metastasi epatiche metacrone in senso più specifico. Riteniamo che ulteriori studi siano necessari allo scopo di poter stabilire quale sia quel cut-off della LNR che permetta di meglio discriminare sul rischio di ripresa di malattia.
journal_name
Ann Ital Chirjournal_title
Annali italiani di chirurgiaauthors
Li Destri G,La Greca G,Pesce A,Conti E,Puleo S,Portale TR,Scilletta R,Piazza Msubject
Has Abstractpub_date
2019-01-01 00:00:00pages
275-280eissn
0003-469Xissn
2239-253Xpii
S0003469X19030227journal_volume
90pub_type
杂志文章abstract:BACKGROUND:An increase in intra-abdominal pressure causes a decrease in the splanchnic blood flow and the intramucosal pH of the bowel, as well as increasing the risk of ischemia in the colon. The aim of the present study is to evaluate the effect of hyperbaric oxygen therapy (HBOT) on the ischemia caused by laparoscop...
journal_title:Annali italiani di chirurgia
pub_type: 杂志文章
doi:
更新日期:2016-01-01 00:00:00
abstract:INTRODUCTION:Coverage of soft tissue defects in the lower leg is often made by use of free flap, also because of the improving of anaesthesiology techniques in the last decades. However, there are disadvantages in the use of free flaps like the need for a remote donor site, increased operative time, use of a major vess...
journal_title:Annali italiani di chirurgia
pub_type: 杂志文章
doi:
更新日期:2007-07-01 00:00:00
abstract::The presence of lesions on the retroperitoneum generally worsens the prognosis in traumatic pathology; it implies more attention and skills from both the medical and surgical aspect. All type of trauma, blunt or open, may involve retroperitoneal structures and organs; specifically there may be lesions on the great ves...
journal_title:Annali italiani di chirurgia
pub_type: 杂志文章,评审
doi:
更新日期:2000-07-01 00:00:00
abstract::Anal stenosis is a fibrous narrowing of the anal channel. It develops, in most cases, in the aftermath of proctologic surgical procedures with extensive anoderm excision or in the presence of chronic anal inflammation in patients with Crohn Disease. However rare, this condition is thoroughly debilitating for the patie...
journal_title:Annali italiani di chirurgia
pub_type: 杂志文章,评审
doi:
更新日期:2018-01-01 00:00:00
abstract::Dear Editor, We read with great interest the paper entitled "Laparoscopic organ-preserving gastric resection improves the quality of life in stromal tumor patients: an observational study with 23 patients" written by Ozcan et al. in Ann Ital Chir. 2018 Oct 23;7 1. We agree with the Authors that preserving the stomach ...
journal_title:Annali italiani di chirurgia
pub_type: 评论,信件
doi:
更新日期:2019-01-01 00:00:00
abstract::Hepatocellular carcinoma (HCC) is one of the leading cancer in the world, susceptible to potentially curative liver resection (LR) in selected cases. Centrally located HCC (CL-HCC) are sited in central liver segments and may require complex LR because of their relationship to major vascular and biliary structures and ...
journal_title:Annali italiani di chirurgia
pub_type: 杂志文章
doi:
更新日期:2018-01-01 00:00:00
abstract::Colo-rectal endometriosis represents a rare pathological event. Exceptionally, a malignant colo-rectal endometrioid carcinoma arising from endometriosis has been reported. In the present case, we describe a 32 year-old woman with clinical and radiological signs of large bowel sub-occlusive syndrome. Histologically, a ...
journal_title:Annali italiani di chirurgia
pub_type: 杂志文章
doi:
更新日期:2000-05-01 00:00:00
abstract:AIM:Research of a starting point to debate about the possibility of identifying a unique sign of previous DVT. MATERIAL OF STUDY:A retrospective study involving 202 outpatients with venous insufficiency of the lower limbs (CEAP classes C 4/6), classified according to the affected venous district. Patients positive for...
journal_title:Annali italiani di chirurgia
pub_type: 杂志文章
doi:
更新日期:2015-01-01 00:00:00
abstract::Hemosuccus pancreaticus is a rare clinical condition, defined as a bleeding from an artery around the pancreas or a lesion on the pancreas, to the pancreatic duct. The intensity of bleeding can vary from occult bleeding to life threatening massive acute bleeding. In this article, we aimed to present a 68-year-old man ...
journal_title:Annali italiani di chirurgia
pub_type: 杂志文章,评审
doi:
更新日期:2020-01-01 00:00:00
abstract:OBJECTIVE:Cervical radiation for head and neck cancer has been associated with an increased incidence of carotid arterial stenosis. Modern radiation therapy delivers higher doses with increasing long-term survival. In our study 50 patients with head and neck malignancies treated with radiotherapy are analized with colo...
journal_title:Annali italiani di chirurgia
pub_type: 杂志文章
doi:
更新日期:2014-11-01 00:00:00
abstract::We hereby report a case of use of biological mesh to repair one large, contaminated abdominal wall defect due to a sigmoid tumour presented as an abscess infiltrating the abdominal wall. Our patient was a 48-year-old woman. Her medical history was negative for any previous disease or surgical procedure. Because of the...
journal_title:Annali italiani di chirurgia
pub_type: 杂志文章
doi:
更新日期:2012-03-01 00:00:00
abstract::Ganglioneuroblastoma, nodular (GNBn) is a subtype of neuroblastic tumors. This is a rare malignancy typically affecting young children. Few cases are reported in adolescents and adults. The prognosis is related to the surgical excision radicality. Hereby we present a case of a young male patient age 13 from the Horn ...
journal_title:Annali italiani di chirurgia
pub_type: 杂志文章
doi:
更新日期:2012-11-01 00:00:00
abstract:AIM:The aim of our study was to determine how many and what subtypes of breast cancer could be treated with breast-conserving surgery after NACT. Another outcome was to determine the applicability of MD Anderson Cancer Center nomogram to predict it. MATERIAL OF STUDY:We reviewed the histological examinations of 86 per...
journal_title:Annali italiani di chirurgia
pub_type: 杂志文章
doi:
更新日期:2018-01-01 00:00:00
abstract:BACKGROUND:Cervical carotid dissection is more common in extracranical vessel: internal carotid artery dissection (ICAD) is typical, vertebral artery dissection is uncommon, common carotid artery dissection (CCAD) is rare and even a more rare cause of ischemic stroke. Cervical artery dissections account up to 20-25% of...
journal_title:Annali italiani di chirurgia
pub_type: 杂志文章
doi:
更新日期:2014-09-18 00:00:00
abstract:OBJECTIVES:The objective of our study was to determine the predictive factors of their occurrence during conservative surgical treatment of the hepatic hydatid cyst (HHC). PATIENTS AND METHODS:We carried out a retrospective review of patients who had undergone conservative surgical treatment of the HHC during 6 years....
journal_title:Annali italiani di chirurgia
pub_type: 杂志文章
doi:
更新日期:2019-01-01 00:00:00
abstract::Venous leg ulcer is the most frequent cause of trophic lesions of the limbs in patients with chronic venous insufficiency. Appropriate management of cutaneous vascular lesions is based on systemic, vascular and local assessment. The Authors used a protease-modulating matrix in 126 patients suffering from venous leg ul...
journal_title:Annali italiani di chirurgia
pub_type: 杂志文章
doi:
更新日期:2009-09-01 00:00:00
abstract::After having examined different methods as to continence colostomy, the authors introduce their own control system for the stoma. The study was carried out on 6 colostomized patients. Preliminary, the intraluminal pressure in closed colostomy was recorded. Pressure waves, largely varying from patient to patient, were ...
journal_title:Annali italiani di chirurgia
pub_type: 杂志文章
doi:
更新日期:1990-01-01 00:00:00
abstract::A 76 year-old female patient with a long-time history of nonspecific abdominal pain admitted to our hospital. Imaging studies showed 5 cm liver hydatid cyst between segments 2 and 3. She was recommended surgery and was informed about the details of single incision laparoscopic surgery (SILS). We performed single-incis...
journal_title:Annali italiani di chirurgia
pub_type: 杂志文章
doi:
更新日期:2013-07-01 00:00:00
abstract::Gas within the wall of the stomach (emphysematous gastritis) is a rare condition associated with systemic toxicity and very often mortal end. The etiology includes firstly infections with gas-foaming organisms, other predisposing causes are the ingestion of corrosive substances, alcohol abuse and immunosuppression. Bu...
journal_title:Annali italiani di chirurgia
pub_type: 杂志文章
doi:
更新日期:2005-05-01 00:00:00
abstract::Carotid restenosis is defined as a new > 50% diameter-reducing lesion present in sites of previous surgery. The clinical aspects of this complication are strongly connected with their anatomopathologic evolution: fibromuscular hyperplasia in early recurrent disease, atherosclerotic degeneration in the later lesions. R...
journal_title:Annali italiani di chirurgia
pub_type: 杂志文章
doi:
更新日期:1997-07-01 00:00:00
abstract::We report the fourth worldwide case of pure primary squamous cell carcinoma of the breast presenting as an abscess. An inflammatory breast lesion in postmenopausal woman must be suspected as a malignant one and drainage of the abscess has to be followed by an accurate excision. The finding of a pure squamous cell carc...
journal_title:Annali italiani di chirurgia
pub_type: 杂志文章,评审
doi:
更新日期:2004-03-01 00:00:00
abstract::The authors report their experience about the clinical significance of the invasion of veins (BVI) in 68 patients with colorectal carcinoma, submitted to potentially curative surgery in the period 1980-1988. Every patient was screened for BVI. The tumoral spreading was differentiated into endovascular and perivascular...
journal_title:Annali italiani di chirurgia
pub_type: 杂志文章
doi:
更新日期:1992-01-01 00:00:00
abstract:AIM:Endometriosis is not a well-known disease and sometimes its rare onset is a pathogenetic, diagnostic and therapeutic problem. The Canal of Nuck is an embryonal rest of the parietal peritoneum that accompanies the round ligament through the inguinal canal. The perviousness of the canal of Nuck could explain the path...
journal_title:Annali italiani di chirurgia
pub_type: 杂志文章
doi:
更新日期:2014-12-29 00:00:00
abstract:OBJECTIVE:Esophageal anastomotic leaks are associated with significant morbidity and mortality. The purpose of this study was to retrospectively assess the role of the anastomotic positioning (thoracic or cervical) on the incindence of the anastomotic leak and its severity. METHODS:In the period 2002-07, we have perfo...
journal_title:Annali italiani di chirurgia
pub_type: 杂志文章
doi:
更新日期:2013-03-01 00:00:00
abstract::The authors take in consideration the sensitivity of imaging methods in localization of adenomas and hyperplastic glands in primary and secondary hyperparathyroidism. Advantages and limits of Ultrasound, Computed Tomography, Magnetic Resonance Imaging and Dual Isotope Subtraction Scintigraphy are considered, specifyin...
journal_title:Annali italiani di chirurgia
pub_type: 杂志文章,评审
doi:
更新日期:1993-07-01 00:00:00
abstract:INTRODUCTION:In this study we retrospectively reviewed data on 311 consecutive elective cholecystectomies, performed for benign disease (cholelithiasis, cholecystitis) in our institution in the last six years, in order to determine the frequency of unexpected gallbladder pre-neoplastic and neoplastic lesions and analys...
journal_title:Annali italiani di chirurgia
pub_type: 杂志文章,评审
doi:
更新日期:2013-05-01 00:00:00
abstract:AIM:Retrospective review of aorto-iliac infections in a single vascular surgery center. METHODS:From a retrospective review of their experience in the last 20 years, the Authors analyze a series of 12 cases of aorto-iliac infection. Prognostic factors, surgical options and results are discussed and compared with the l...
journal_title:Annali italiani di chirurgia
pub_type: 杂志文章
doi:
更新日期:2011-11-01 00:00:00
abstract::In order to highlight the occult pathology of the thyroid in the aged, the authors examined all the glands withdrawn from 507 consecutive autopsies on subjects of 67.10 years of median age. In 10 tables there are weight and measurements of the thyroids, macro and microscopic details and pathologic appearances. Adenoma...
journal_title:Annali italiani di chirurgia
pub_type: 杂志文章
doi:
更新日期:1992-11-01 00:00:00
abstract:AIM:Trans-Abdominal Preperitoneal Patch (TAPP) repairs for Recurrent Hernia (RH) is a technically demanding procedure. It has to be performed only by surgeons with extensive experience in the laparoscopic approach. The purpose of this study is to evaluate the surgical safety and the efficacy of TAPP for RH performed in...
journal_title:Annali italiani di chirurgia
pub_type: 杂志文章
doi:
更新日期:2017-01-01 00:00:00
abstract::Columnar epithelial metaplasia of the distal esophagus (i.e. barrett's esophagus) is an acquired condition showing a prevalence of 4%. It is probably due to abnormal reparative processes of the esophageal squamous epithelium after gastroesophageal reflux damage. "Mixed" (both acid and biliary) reflux seems more releva...
journal_title:Annali italiani di chirurgia
pub_type: 杂志文章,评审
doi:
更新日期:1995-09-01 00:00:00