Renato Seracchioli - Academia.edu (original) (raw)

Papers by Renato Seracchioli

Australian and New Zealand Journal of Obstetrics and Gynaecology, 2015

5-12% of deep infiltrating endometriosis involves the digestive tract, especially the distal sigm... more 5-12% of deep infiltrating endometriosis involves the digestive tract, especially the distal sigmoid colon and rectum. Bowel endometriosis surgery may be associated with neurological complications. The aim of this study was to objectively evaluate whether excision of rectosigmoid deep infiltrating endometriosis by shaving technique alters intestinal and defecatory function at 6-months post-surgery. Nineteen women were enrolled in our tertiary care university hospital. They were affected by rectosigmoid endometriosis and underwent laparoscopic shaving excision of the nodule. Anorectal manometry was performed prior to and after surgery. The parameters studied were resting pressure, maximum squeezing pressure, pushing, rectoanal inhibitory reflex and rectal sensibility. The women completed a defecatory function questionnaire and ranked pain symptoms using a visual analogue scale. After surgery, no alteration of rectoanal inhibitory reflex was found. The tone of the internal anal sphincter was not significantly different before and after surgery. The defecatory function questionnaire revealed a significant improvement in constipation, urgency, bowel movements and anal eczema. No cases of incontinence were described. This report of the objective assessment of neurological intestinal alterations after rectal shaving of endometriotic nodules suggests the laparoscopic shaving technique preserves intestinal neurological activity.

Minerva ginecologica

The aim of this study was to investigate the feasibility and safety of laparoscopic staging of ov... more The aim of this study was to investigate the feasibility and safety of laparoscopic staging of overweight women with endometrial cancer and to compare the surgical outcomes among these patients with those managed by laparotomy. This was a retrospective analysis (Canadian Task-force Classification II-3). We reviewed operative and hospital records of 70 patients with a body mass index >25 kg/m2 who underwent surgical treatment for endometrial cancer between 2001 and 2008. Thirty-five patients treated laparoscopically were compared to an equivalent group of patients treated by laparotomy. Operative and postoperative variables were afterwards assessed. Women in laparoscopic group had a significantly lower blood loss (median, 25th-75th percentiles: 1.2, 0.8-2.0 in laparoscopic versus 1.8, 1.0-2.8 in laparotomic group, P<0.05). No differences between both group in terms of operative time (median, 25th-75th percentiles: 165 min, 130-183 in laparoscopic versus 135 min, 110-170 in lapa...

Journal of Minimally Invasive Gynecology, 2015

To evaluate the impact of obesity on the outcomes of surgical treatment for endometrial cancer (E... more To evaluate the impact of obesity on the outcomes of surgical treatment for endometrial cancer (EC) in general and comparing laparoscopic vs. open abdominal approach. Retrospective case-control study DESIGN: Classification: Canadian Task Force II-1 SETTING: Obstetrics and Gynecology Department, University of Insubria, Varese; Catholic University of the Sacred Heart, Rome, Italy; International School of Surgical Anatomy, Sacred Heart Hospital, Negrar; Sant&amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;#39;Orsola-Malpighi Hospital, Bologna (Italy). Data of consecutive patients who underwent surgery for EC in four centers were reviewed. Univariate and multivariable analysis were performed. Adjustment for potential selection bias in surgical approach was made using propensity score (PS) matching. Laparoscopic or open surgical treatment for endometrial cancer. A total of 1,266 patients were included: 764 by laparoscopy and 502 by open surgery. Three-hundred-ninety-one (30.9%) patients were obese: 238 (18.8%), 89 (7%), and 64 (5.1%) women were obese class I, II and III, respectively. The total number of complications, risk of wound complications, and venous thromboembolic events were higher among obese vs. non-obese women. Blood transfusions, incidence/severity of post-operative complications, and post-operative hospital stay were significantly higher in the open surgery group compared to laparoscopy, irrespectively of obesity. These differences remained significant both after multivariable and PS-matched analysis. The percentage of patients who received lymphadenectomy declined significantly for BMI&amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;gt;40 both for laparoscopy and open surgery. Conversions from initially-intended minimally-invasive approach to open surgery were between 1.1% and 2.2% for women with BMI&amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;lt;40, but they increased when BMI was &amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;gt;40 (8.6%; p=.05). PS analysis showed that obese women in the laparoscopic group had a lower complication rate, shorter hospital stay, and higher likelihood of receiving lymphadenectomy. Laparoscopy for EC retains its advantages over open surgery, even in obese patients. However, operating an obese subject, can be challenging per se, regardless of the surgical approach, especially in case of morbid adiposity.

Gynecological Endocrinology

Transforming growth factor-beta 1 (TGF-beta 1) is a polypeptide involved in a variety of importan... more Transforming growth factor-beta 1 (TGF-beta 1) is a polypeptide involved in a variety of important physiological and pathophysiological processes such as the implantation of the embryo into the endometrium. Many factors seem to be related to this event. TGF-beta 1 is involved in many mechanisms both in endometrial and in embryonic tissues: it induces proliferation and differentiation, it regulates proteolytic activity and it modulates the maternal immune response. This study evaluated the presence of TGF-beta 1 in the endometrium during normal menstrual cycles and in the uterine fluids during induction of ovulation in the framework of an in vitro fertilization program. Immunohistochemistry was used to identify TGF-beta 1 in the endometrium and immunodot-blot to quantitate TGF-beta 1 in the uterine cavity fluid. The study shows that TGF-beta 1 is present in the endometrial tissue and its secretion is modulated during the menstrual cycle, as demonstrated immunohistochemically; its pro...

Journal of assisted reproduction and genetics, 1999

Journal of Obstetrics and Gynaecology Research, 2015

Herein is described the diagnosis, clinical management and laparoscopic removal of a rapid growin... more Herein is described the diagnosis, clinical management and laparoscopic removal of a rapid growing retro-uterine mass in a pregnant woman. After laparoscopic removal of the pelvic mass, diagnosis of peritoneal endometriotic cyst was made on histology. The patient was asymptomatic and no history of endometriosis was reported. The laparoscopic management of the peritoneal mass was safe and effective and to our knowledge this is the first case report describing a decidualized endometriotic lesion in the absence of a pre-pregnancy endometriosis diagnosis.

Objectives: To evaluate the accuracy of transvaginal sonography (TVS) in the diagnosis of deep in... more Objectives: To evaluate the accuracy of transvaginal sonography (TVS) in the diagnosis of deep infiltrating endometriosis of the posterior compartment (rectovaginal septum, uterosacral ligaments, rectosigmoid colon, vagina). Materials and Methods: 381 patients who were operated on between January 2002 and December 2005 for suspected pelvic endometriosis were recruited prospectively. Clinical, surgical and histopathologic data was collected, as well as preoperative

The journal of family planning and reproductive health care / Faculty of Family Planning & Reproductive Health Care, Royal College of Obstetricians & Gynaecologists, Jan 16, 2015

Endometriosis is a chronic and progressive condition of women of reproductive age. It is strongly... more Endometriosis is a chronic and progressive condition of women of reproductive age. It is strongly associated with significant impairment of sexual function. To objectively evaluate the impact of laparoscopic excision of endometriosis on sexual function in patients with deep infiltrating endometriosis (DIE) compared to healthy women. Prospective study, including 250 patients with a diagnosis of DIE scheduled for laparoscopic surgery and 250 healthy women. A sexual activity questionnaire, SHOW-Q (Sexual Health Outcomes in Women Questionnaire), was used to collect data pertaining to women's satisfaction, orgasm, desire and pelvic problem interference with sexual function. Women with DIE underwent complete excision of endometriotic lesions. All participants were asked to complete the SHOW-Q questionnaire before and after surgery. SHOW-Q scores in the endometriosis group before and 6 months after surgery were compared with the healthy group scores. A significant improvement was found...

Journal of minimally invasive gynecology, Jan 17, 2015

European journal of obstetrics, gynecology, and reproductive biology, 2014

Minimally invasive surgery, 2014

Objective. The aim of the study is to evaluate adenomyosis in patients undergoing surgery for dif... more Objective. The aim of the study is to evaluate adenomyosis in patients undergoing surgery for different type of endometriosis. It is an observational study including women with preoperative ultrasound diagnosis of adenomyosis. Demographic data and symptoms were recorded (age, body mass index, parity, history of previous surgery, dysmenorrhea, dyspareunia, dyschezia, dysuria, and abnormal uterine bleeding). Moreover a particular endometrial shape "question mark sign" linked to the presence of adenomyosis was assessed. Results. From 217 patients with ultrasound diagnosis of adenomyosis, we found 73 with ovarian histological confirmation of endometriosis, 92 with deep infiltrating endometriosis, and 52 patients who underwent surgery for infertility. Women with adenomyosis alone represented the oldest group of patients (37.8 ± 5.18 years, P = 0.02). Deep endometriosis patients were nulliparous more frequently (P < 0.0001), had history of previous surgery (P = 0.004), and co...

International journal of fertility & sterility, 2014

Fertility can be preserved after conservative cervical surgery. We report on a 29-year-old woman ... more Fertility can be preserved after conservative cervical surgery. We report on a 29-year-old woman who was obese, para 0, and diagnosed with cervical insufficiency at the first trimester of current pregnancy due to a previous trachelectomy. She underwent laparoscopic transabdominal cervical cerclage (LTCC) for cervical cancer. The surgery was successful and she was discharged two days later. The patient underwent a caesarean section at 38 weeks of gestation. Laparoscopic surgery is a minimally invasive approach associated with less pain and faster recovery, feasible even in obese women.

Obstetrics and gynecology international, 2010

Endometrial cancer is the most common gynaecological malignancy and its incidence is increasing. ... more Endometrial cancer is the most common gynaecological malignancy and its incidence is increasing. In 1998, international federation of gynaecologists and obstetricians (FIGO) required a change from clinical to surgical staging in endometrial cancer, introducing pelvic and paraaortic lymphadenectomy. This staging requirement raised controversies around the importance of determining nodal status and impact of lymphadenectomy on outcomes. There is agreement about the prognostic value of lymphadenectomy, but its extent, therapeutic value, and benefits in terms of survival are still matter of debate, especially in early stages. Accurate preoperative risk stratification can guide to the appropriate type of surgery by selecting patients who benefit of lymphadenectomy. However, available preoperative and intraoperative investigations are not highly accurate methods to detect lymph nodes and a complete surgical staging remains the most precise method to evaluate extrauterine spread of the dis...

Anticancer research

Loco-regional recurrences after laparotomic surgery for early endometrial carcinoma have an incid... more Loco-regional recurrences after laparotomic surgery for early endometrial carcinoma have an incidence of 3-8%. This study examined the pattern of recurrences and survival after full laparoscopic hysterectomy. Between January 1997 and December 2002, 113 consecutive patients with pre-operative Stage I endometrial cancer, self-referred to two different surgical teams, were treated by the laparoscopic approach by one team and by the laparotomic approach by the other team. Nineteen patients were treated by total laparoscopic hysterectomy (TLH) by the endoscopic group, and 94 were treated by total abdominal hysterectomy (TAH) by the oncologic group. Sixteen patients (84.2%) in the laparoscopic group and 79 patients (84.0%) in the laparotomic group had Stage I disease. The mean age and mean weight did not differ in the two groups. With a mean follow-up of 52.2 months for the TLH group and 43.6 months for the TAH group, one recurrence (5.3%) was observed in the former group and 9 recurrence...

The Journal of the American Association of Gynecologic Laparoscopists, 2004

To evaluate the efficacy of conservative laparoscopic treatment of genital prolapse in women of r... more To evaluate the efficacy of conservative laparoscopic treatment of genital prolapse in women of reproductive age. Retrospective analysis (Canadian Task Force classification II-2). University hospital, Center of Reconstrutive Pelivc Endosurgery, Reproductive Medical Unit, S. Orsola Hospital, Bologna, Italy. Fifteen women of reproductive age with genital prolapse. Interventions. Conservative laparoscopic surgical correction of genital prolapse. Apical prolapse was corrected by sacral colpohysteropexy. Burch colposuspension was always included to treat evident or latent stress urinary incontinence. Anterior compartment defects were treated by laparoscopic paravaginal repair and by the interposition of an intervesicouterine prosthesis. Posterior compartment defects were corrected by a prosthetic reconstruction of the rectovaginal support structure. All patients underwent surgery between January 1998 and December 2000. They were prospectively evaluated for a minimum of 24 months of follo...

Human reproduction (Oxford, England), 1993

This study describes the technique and results of a new approach for the hysteroscopic catheteriz... more This study describes the technique and results of a new approach for the hysteroscopic catheterization of the Fallopian tube in order to transfer gametes (hysteroscopic GIFT). Ovarian stimulation was started on 51 patients. Three cycles were cancelled because of a failure of ovarian response. Forty-eight patients underwent hysteroscopic GIFT utilizing a technique completely different, easier, faster and more precise than that previously reported. Fourteen pregnancies were achieved (29.2%) of which five are ongoing, six patients have delivered and three have aborted. No ectopic pregnancies were observed.

Fertility and sterility, 1994

To compare the effects of depot and standard release form of triptoreline in superovulation induc... more To compare the effects of depot and standard release form of triptoreline in superovulation induction in IVF programs. One hundred ninety-six patients undergoing IVF were randomized between two treatment groups. Pituitary desensitization was obtained in group 1 (102 patients) with a single IM injection of 3.75 mg D-Trp-6-luteinizing hormone-releasing hormone (LH-RH) and, in group 2 (94 patients), with daily SC administration of 0.1 mg D-Trp-6-LH-RH. In a subgroup of 11 patients, a series of GnRH tests was performed to investigate pituitary desensitization and, in another subgroup of 12 patients, a study of luteal phase steroid profile was performed. In an additional 23 patients, a series of GnRH tests were performed to investigate pituitary desensitization during the late follicular and midluteal phases. No differences were found in the time necessary to reach desensitization (11.3 +/- 1.03 versus 11.3 +/- 1.45 days; mean +/- SEM), whereas resumption of pituitary activity takes plac...

Human reproduction (Oxford, England), 1991

Direct intraperitoneal insemination (DIPI) and superovulation are simple procedures which may tog... more Direct intraperitoneal insemination (DIPI) and superovulation are simple procedures which may together represent a good alternative to gamete intra-Fallopian transfer (GIFT) in infertile women with patent Fallopian tubes. In the present study, pregnancy occurred in 25 of 96 couples (26%) and six (24%) of these aborted. The pregnancy rate for all cycles was 19.6% and multiple pregnancies were found in six of 25 (24%) patients. We observed no ectopic pregnancy. The combination of these techniques is concluded to be useful in achieving pregnancy in infertile women with patient Fallopian tubes.