Ferdinando Agresta - Academia.edu (original) (raw)
Papers by Ferdinando Agresta
The authors adopted the following methodology for literature search
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Colorectal disease : the official journal of the Association of Coloproctology of Great Britain and Ireland, Sep 1, 2018
The optimal bowel preparation strategy to minimise the risk of anastomotic leak is yet to be dete... more The optimal bowel preparation strategy to minimise the risk of anastomotic leak is yet to be determined. This study aimed to determine whether oral antibiotics combined with mechanical bowel preparation (MBP+Abx) was associated with a reduced risk of anastomotic leak when compared to mechanical bowel preparation alone (MBP) or no bowel preparation (NBP). A pre-planned analysis of the European Society of Coloproctology (ESCP) 2017 Left Sided Colorectal Resection audit was performed. Patients undergoing elective left sided colonic or rectal resection with primary anastomosis between 1 January 2017 and 15 March 2017 by any operative approach were included. The primary outcome measure was anastomotic leak. Of 3676 patients across 343 centres in 47 countries, 618 (16.8%) received MBP+ABx, 1945 MBP (52.9%) and 1099 patients NBP (29.9%). Patients undergoing MBP+ABx had the lowest overall rate of anastomotic leak (6.1%, 9.2%, 8.7% respectively) in unadjusted analysis. After case-mix adjustm...
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British Journal of Surgery
Introduction Umbilical Hernia is a common ventral hernia in the adult population. The classical a... more Introduction Umbilical Hernia is a common ventral hernia in the adult population. The classical approach was represented by open repair, but in recent years laparoscopic treatment is increasingly adopted and it can present some intraoperative and post-operative advantages. Materials and methods We prospectively analyzed a case series of 50 laparoscopic primary and incisional umbilical hernia repairs performed between January 1st, 2020, and December 31st, 2021. We collected data concerning age, sex, hernia defect size, operative time, and complications according to Clavien-DindoClassification, recurrence at 6 months, and 1-year follow-up. Results We performed laparoscopic umbilical hernia repairs in 50 patients (32males,18females);mean age52.1year-old(range30–82y.o.).Mean defect size was4.5cm(3–6.8cm).All procedures were performed under general anesthesia and with 5mm trocars and optic and under pneumoperitoneum pressure set until 10 mmHg as the maximum value. In all cases we applied...
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Colorectal disease : the official journal of the Association of Coloproctology of Great Britain and Ireland, Sep 1, 2018
Laparoscopy has now been implemented as a standard of care for elective colonic resection around ... more Laparoscopy has now been implemented as a standard of care for elective colonic resection around the world. During the adoption period, studies showed that conversion may be detrimental to patients, with poorer outcomes than both laparoscopic completed or planned open surgery. The primary aim of this study was to determine whether laparoscopic conversion was associated with a higher major complication rate than planned open surgery in contemporary, international practice. Combined analysis of the European Society of Coloproctology 2017 and 2015 audits. Patients were included if they underwent elective resection of a colonic segment from the caecum to the rectosigmoid junction with primary anastomosis. The primary outcome measure was the 30-day major complication rate, defined as Clavien-Dindo grade III-V. Of 3980 patients, 64% (2561/3980) underwent laparoscopic surgery and a laparoscopic conversion rate of 14% (359/2561). The major complication rate was highest after open surgery (l...
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Annali italiani di chirurgia, 2016
Intestinal obstructions/pseudo-obstruction of the small/large bowel are frequent conditions but t... more Intestinal obstructions/pseudo-obstruction of the small/large bowel are frequent conditions but their management could be challenging. Moreover, a general agreement in this field is currently lacking, thus SICUT Society designed a consensus study aimed to define their optimal workout. The Delphi methodology was used to reach consensus among 47 Italian surgical experts in two study rounds. Consensus was defined as an agreement of 75.0% or greater. Four main topic areas included nosology, diagnosis, management and treatment. A bowel obstruction was defined as an obstacle to the progression of intestinal contents and fluids generally beginning with a sudden onset. The panel identified four major criteria of diagnosis including absence of flatus, presence of >3.5 cm ileal levels or >6 cm colon dilatation and abdominal distension. Panel also recommended a surgical admission, a multidisciplinary approach, and a gastrografin swallow for patients presenting occlusions. Criteria for im...
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Updates in Surgery
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Updates in Surgery, 2020
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Chirurgia italiana
Laparoscopic hernia repair has already become as accepted a technique as the conventional ones an... more Laparoscopic hernia repair has already become as accepted a technique as the conventional ones and is routinely used in those centres where this kind of surgery is normally performed. The two most commonly used laparoscopic techniques (transabdominal and total extraperitoneal) have been shown to produce good results in terms of post-operative course and recurrence rates, but still present the disadvantages of high cost and the need for general anaesthesia. We report here a retrospective analysis of our early experience with laparoscopic treatment of inguino-crural hernias. The positive results achieved (no cases of conversion to an open technique; no recurrences to date; 4.7% major morbidity) allow us to consider this approach a valid alternative to the traditional ones in selected, well-informed patients.
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Acute calculus cholecystitis is a very common disease with several area of uncertainty. The World... more Acute calculus cholecystitis is a very common disease with several area of uncertainty. The World Society of Emergency Surgery developed extensive guidelines in order to cover grey areas. The diagnostic criteria, the antimicrobial therapy, the evaluation of associated common bile duct stones, the identification of “high risk” patients, the surgical timing, the type of surgery, and the alternatives to surgery are discussed. Moreover the algorithm is proposed: as soon as diagnosis is made and after the evaluation of choledocholitiasis risk, laparoscopic cholecystectomy should be offered to all patients exception of those with high risk of morbidity or mortality. These Guidelines must be considered as an adjunctive tool for decision but they are not substitute of the clinical judgement for the individual patient.
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Surgical Endoscopy, 2017
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Pancreatology
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Hernia, 2017
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Emergency laparoscopic surgery in the elderly and frail patient, 2021
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Emergency laparoscopic surgery in the elderly and frail patient, 2021
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Journal of Peritoneum (and other serosal surfaces), 2016
Unlike other surgical fields, such as cardiac surgery, where many trials have been made about saf... more Unlike other surgical fields, such as cardiac surgery, where many trials have been made about safety, feasibility and outcome of surgical procedures in the elderly, there is lack of literature about emergency abdominal surgery in very old patients, especially in people over 90 years of age. The available data reported survival of about 50% one year after the operation. The aim of the study is to determine the survival rate two years after emergency abdominal surgery in a nonagenarian population and to identify any demographic and surgical parameters that could predict a poor outcome in this type of patient. The study was a retrospective multicenter trial. Patient inclusion criteria were: age 90 years old or older, urgent abdominal surgery. The medical charts reviewed and data collected were: gender, age, the American Society of Anesthesiologists (ASA) score and comorbidities, diagnosis, time elapsed between arrival to the Emergency Room and admission to the Operatory Room, surgical ...
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Emergency Laparoscopy, 2016
Due to the steady increase in the elderly population, the issue of frail patients with acute abdo... more Due to the steady increase in the elderly population, the issue of frail patients with acute abdomen management is ever more actual. Many questions remain unsolved, concerning both the indication to surgery and the type of surgical approach, open or laparoscopic. This chapter describes the specific problems of the elderly patient, providing to the emergency surgeon, who has to take a quick and often lonely therapeutic choice, a survey of the literature upon which to base a rational approach to treating frail patients with acute abdomen. Some diseases, such as cholecystitis, appendicitis, and complicated Hinchey stage 3 diverticulitis, can be treated with laparoscopic approach, if the answer to a series of 11 questions is always “yes.”
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The authors adopted the following methodology for literature search
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Colorectal disease : the official journal of the Association of Coloproctology of Great Britain and Ireland, Sep 1, 2018
The optimal bowel preparation strategy to minimise the risk of anastomotic leak is yet to be dete... more The optimal bowel preparation strategy to minimise the risk of anastomotic leak is yet to be determined. This study aimed to determine whether oral antibiotics combined with mechanical bowel preparation (MBP+Abx) was associated with a reduced risk of anastomotic leak when compared to mechanical bowel preparation alone (MBP) or no bowel preparation (NBP). A pre-planned analysis of the European Society of Coloproctology (ESCP) 2017 Left Sided Colorectal Resection audit was performed. Patients undergoing elective left sided colonic or rectal resection with primary anastomosis between 1 January 2017 and 15 March 2017 by any operative approach were included. The primary outcome measure was anastomotic leak. Of 3676 patients across 343 centres in 47 countries, 618 (16.8%) received MBP+ABx, 1945 MBP (52.9%) and 1099 patients NBP (29.9%). Patients undergoing MBP+ABx had the lowest overall rate of anastomotic leak (6.1%, 9.2%, 8.7% respectively) in unadjusted analysis. After case-mix adjustm...
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British Journal of Surgery
Introduction Umbilical Hernia is a common ventral hernia in the adult population. The classical a... more Introduction Umbilical Hernia is a common ventral hernia in the adult population. The classical approach was represented by open repair, but in recent years laparoscopic treatment is increasingly adopted and it can present some intraoperative and post-operative advantages. Materials and methods We prospectively analyzed a case series of 50 laparoscopic primary and incisional umbilical hernia repairs performed between January 1st, 2020, and December 31st, 2021. We collected data concerning age, sex, hernia defect size, operative time, and complications according to Clavien-DindoClassification, recurrence at 6 months, and 1-year follow-up. Results We performed laparoscopic umbilical hernia repairs in 50 patients (32males,18females);mean age52.1year-old(range30–82y.o.).Mean defect size was4.5cm(3–6.8cm).All procedures were performed under general anesthesia and with 5mm trocars and optic and under pneumoperitoneum pressure set until 10 mmHg as the maximum value. In all cases we applied...
Bookmarks Related papers MentionsView impact
Colorectal disease : the official journal of the Association of Coloproctology of Great Britain and Ireland, Sep 1, 2018
Laparoscopy has now been implemented as a standard of care for elective colonic resection around ... more Laparoscopy has now been implemented as a standard of care for elective colonic resection around the world. During the adoption period, studies showed that conversion may be detrimental to patients, with poorer outcomes than both laparoscopic completed or planned open surgery. The primary aim of this study was to determine whether laparoscopic conversion was associated with a higher major complication rate than planned open surgery in contemporary, international practice. Combined analysis of the European Society of Coloproctology 2017 and 2015 audits. Patients were included if they underwent elective resection of a colonic segment from the caecum to the rectosigmoid junction with primary anastomosis. The primary outcome measure was the 30-day major complication rate, defined as Clavien-Dindo grade III-V. Of 3980 patients, 64% (2561/3980) underwent laparoscopic surgery and a laparoscopic conversion rate of 14% (359/2561). The major complication rate was highest after open surgery (l...
Bookmarks Related papers MentionsView impact
Annali italiani di chirurgia, 2016
Intestinal obstructions/pseudo-obstruction of the small/large bowel are frequent conditions but t... more Intestinal obstructions/pseudo-obstruction of the small/large bowel are frequent conditions but their management could be challenging. Moreover, a general agreement in this field is currently lacking, thus SICUT Society designed a consensus study aimed to define their optimal workout. The Delphi methodology was used to reach consensus among 47 Italian surgical experts in two study rounds. Consensus was defined as an agreement of 75.0% or greater. Four main topic areas included nosology, diagnosis, management and treatment. A bowel obstruction was defined as an obstacle to the progression of intestinal contents and fluids generally beginning with a sudden onset. The panel identified four major criteria of diagnosis including absence of flatus, presence of >3.5 cm ileal levels or >6 cm colon dilatation and abdominal distension. Panel also recommended a surgical admission, a multidisciplinary approach, and a gastrografin swallow for patients presenting occlusions. Criteria for im...
Bookmarks Related papers MentionsView impact
Updates in Surgery
Bookmarks Related papers MentionsView impact
Updates in Surgery, 2020
Bookmarks Related papers MentionsView impact
Chirurgia italiana
Laparoscopic hernia repair has already become as accepted a technique as the conventional ones an... more Laparoscopic hernia repair has already become as accepted a technique as the conventional ones and is routinely used in those centres where this kind of surgery is normally performed. The two most commonly used laparoscopic techniques (transabdominal and total extraperitoneal) have been shown to produce good results in terms of post-operative course and recurrence rates, but still present the disadvantages of high cost and the need for general anaesthesia. We report here a retrospective analysis of our early experience with laparoscopic treatment of inguino-crural hernias. The positive results achieved (no cases of conversion to an open technique; no recurrences to date; 4.7% major morbidity) allow us to consider this approach a valid alternative to the traditional ones in selected, well-informed patients.
Bookmarks Related papers MentionsView impact
Acute calculus cholecystitis is a very common disease with several area of uncertainty. The World... more Acute calculus cholecystitis is a very common disease with several area of uncertainty. The World Society of Emergency Surgery developed extensive guidelines in order to cover grey areas. The diagnostic criteria, the antimicrobial therapy, the evaluation of associated common bile duct stones, the identification of “high risk” patients, the surgical timing, the type of surgery, and the alternatives to surgery are discussed. Moreover the algorithm is proposed: as soon as diagnosis is made and after the evaluation of choledocholitiasis risk, laparoscopic cholecystectomy should be offered to all patients exception of those with high risk of morbidity or mortality. These Guidelines must be considered as an adjunctive tool for decision but they are not substitute of the clinical judgement for the individual patient.
Bookmarks Related papers MentionsView impact
Surgical Endoscopy, 2017
Bookmarks Related papers MentionsView impact
Pancreatology
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Hernia, 2017
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Emergency laparoscopic surgery in the elderly and frail patient, 2021
Bookmarks Related papers MentionsView impact
Bookmarks Related papers MentionsView impact
Emergency laparoscopic surgery in the elderly and frail patient, 2021
Bookmarks Related papers MentionsView impact
Bookmarks Related papers MentionsView impact
Bookmarks Related papers MentionsView impact
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Journal of Peritoneum (and other serosal surfaces), 2016
Unlike other surgical fields, such as cardiac surgery, where many trials have been made about saf... more Unlike other surgical fields, such as cardiac surgery, where many trials have been made about safety, feasibility and outcome of surgical procedures in the elderly, there is lack of literature about emergency abdominal surgery in very old patients, especially in people over 90 years of age. The available data reported survival of about 50% one year after the operation. The aim of the study is to determine the survival rate two years after emergency abdominal surgery in a nonagenarian population and to identify any demographic and surgical parameters that could predict a poor outcome in this type of patient. The study was a retrospective multicenter trial. Patient inclusion criteria were: age 90 years old or older, urgent abdominal surgery. The medical charts reviewed and data collected were: gender, age, the American Society of Anesthesiologists (ASA) score and comorbidities, diagnosis, time elapsed between arrival to the Emergency Room and admission to the Operatory Room, surgical ...
Bookmarks Related papers MentionsView impact
Emergency Laparoscopy, 2016
Due to the steady increase in the elderly population, the issue of frail patients with acute abdo... more Due to the steady increase in the elderly population, the issue of frail patients with acute abdomen management is ever more actual. Many questions remain unsolved, concerning both the indication to surgery and the type of surgical approach, open or laparoscopic. This chapter describes the specific problems of the elderly patient, providing to the emergency surgeon, who has to take a quick and often lonely therapeutic choice, a survey of the literature upon which to base a rational approach to treating frail patients with acute abdomen. Some diseases, such as cholecystitis, appendicitis, and complicated Hinchey stage 3 diverticulitis, can be treated with laparoscopic approach, if the answer to a series of 11 questions is always “yes.”
Bookmarks Related papers MentionsView impact