Dr. Silvio Alen Canton, MD - University of Padova - MD

Dr. Silvio Alen Canton

MD

University of Padova

MD

PADOVA, Italy | Italy

Main Specialties: Surgery, Thoracic Surgery

Additional Specialties: General surgery. Thoracic surgery

ORCID logohttps://orcid.org/0000-0002-6085-0301

Dr. Silvio Alen Canton, MD - University of Padova - MD

Dr. Silvio Alen Canton

MD

Introduction

Dr Silvio Alen Canton, MD

- Specialties
General surgery, Thoracic surgery

- Primary Affiliation
University-Hospital of Padua, PADUA, Italy, Department of Surgery,
Oncology and Gatroenterology (DiSCOG)

- Full Member
Italian Society of Surgery (SIC)

- Research interests
Surgical Techniques. Meshes. Laparoscopic surgery. Ventral hernias (VH) laparoscopic
surgery. "Slim-Mesh" project

- Techniques devised
The new "Slim-Mesh" laparoscopic technique for VH treatment

- Lab
In 2009, in our Lab at Padua University-Hospital, Italy, I devised a new
sutureless laparoscopic technique which I called "Slim-Mesh", to treat
ventral hernias, including giant/massive types (those larger than 10/20
cm in size)

- Project
"Slim-Mesh"

Project goal: to reduce operative time, as well as intra- and
post-operative complications, with a new laparoscopic sutureless
technique which is called ‘‘Slim-Mesh’’ (SM). SM approach is used to treat
ventral hernias (VH), including giant/massive types (those larger than
10/20 cm in size).


- Educational videos playlist of SM on YouTube Channel: Alen Canton





Primary Affiliation: University of Padova - PADOVA, Italy , Italy

Specialties:

Additional Specialties:

Research Interests:

Education

Universita degli Studi di Trieste
Thoracic Surgery specialty
Università degli Studi di Padova Scuola di Medicina e Chirurgia
General Surgery specialty

Experience

Università degli Studi di Padova Scuola di Medicina e Chirurgia
University of Padua, MD
Department of Surgery, Oncology and Gatroenterology (DiSCOG), University of Padua, Padua, Italy

Publications

59Publications

38Reads

90Profile Views

2PubMed Central Citations

28TH INTERNATIONAL CONGRESS OF THE EUROPEAN ASSOCIATION FOR ENDOSCOPIC SURGERY (EAES), Krakòw, Poland, 24-27 June 2020 - Virtual Congress: ePoster Presentations with audio narration per sections. Topic: HERNIA-ADHESIONS - Abdominal wall hernia: 15 ePosters - EAES Academy, Canton S. A. 06/24/20, 293285, 190, ePOSTER 02

28TH INTERNATIONAL CONGRESS OF THE EUROPEAN ASSOCIATION FOR ENDOSCOPIC SURGERY (EAES)

Conference: 28TH INTERNATIONAL CONGRESS OF THE EUROPEAN ASSOCIATION FOR ENDOSCOPIC SURGERY (EAES). At: Krakòw, Poland, 24-27 June 2020 - Virtual Congress: ePoster Presentations with audio narration per sections. Topic: HERNIA-ADHESIONS - Abdominal wall hernia: 15 ePosters - EAES Academy, Author Dr. Canton, S. A., University of Padua, PADOVA, Italy (Presenting Author with audio narration per sections of the ePoster 293285, ref 190, No 02), Co-Author(s) Chief, Dr. Toniato, A., Veneto Institute of Oncology IOV-IRCCS, PADOVA, Italy, Prof. Pasquali, C., University of Padua, PADOVA, Italy.Title: “SLIM-MESH”: 10-YEAR FOLLOW-UP STUDY ON INTRAOPERATIVE/SHORT/MID-TERM OUTCOMES IN 67 OVERWEIGHT/OBESE/SUPEROBESE PATIENTS

View Article
June 2020

Primary mesenteric vein thrombosis: a case series

Journal of Surgical Case Reports, 2020;3, 1-3

Journal of Surgical Case Reports

Mesenteric vein thrombosis (MVT) is a rare condition, often misdiagnosed due to its vague and misleading clinical presentation. It can cause intestinal infarction, peritonitis, and consequently necessitate bowel resection. CT scanning with intravenous contrast enhancement is the gold standard for its diagnosis. Radiologists have an important role in defining the extent of thrombosis and identifying any signs of intestinal infarction influencing the decision whether or not to operate. In patients with no clinical signs of peritonitis or radiological evidence of intestinal infarction, the treatment can be exclusively medical, based on full anticoagulation (initially with low molecular weight heparin, followed by vitamin K antagonists or direct acting oral-anticoagulants). The duration of medical treatment depends on radiological evidence of resolution of thrombosis and the identification of pro-coagulant risk factors.

View Article
January 2020
2 Reads

"SLIM-MESH": athletic mother's diastasis recti abdominis

YouTube https://youtu.be/w6Ywy7KHJNg

"SLIM-MESH": athletic mother's diastasis recti abdominis"SLIM-MESH” (SM): a brand-new tacks or straps-only fixation technique (https://www.ncbi.nlm.nih.gov/pubmed/28791600) for the laparoscopic repair of diastasis recti abdominis and ventral hernias with a giant “Slim-Mesh”.This video shows a case of a symptomatic massive diastasis recti abdominis plus umbilical hernia in an athletic young mother who likes to jog up to 15 km every day. I tailor and roll up a very large prosthetic mesh (26 X 16 cm) on the operative bench according to the “Slim-Mesh” technique so that it becomes a giant ‘slim cigarette’. During the operation, I use 3 trocars on the right side for the giant “Slim-Mesh” introduction and fixation maneuvers. Operation carried out by Dr Silvio Alen Canton.

View Article
December 2019
6 Reads

"SLIM-MESH": MASSIVE DIASTASIS RECTI ABDOMINIS WITH UMBILICAL HERNIA

ACIT ASSOCIAZIONE CHIRURGICA ITALIANA TECNOLOGICA "29 CONGRESSO DI CHIRURGIA DELL' APPARATO DIGERENTE" - At Rome - Maximum Auditorium - laparoscopic.it

"SLIM-MESH": MASSIVE DIASTASIS RECTI ABDOMINIS WITH UMBILICAL HERNIA.Presenter: Canton Silvio Alen.Department of Surgery, Oncology and Gastroenterology (DiSCOG), University of Padua, Padova, Italy. This video shows the “Slim-Mesh” (SM) repair of a massive diastasis recti abdominis plus umbilical hernia in an athletic young woman using a single giant (26 x 16 cm.) SM. The SM technique involves the straightforward abdominal introduction, quick orientation, distension and fixation of a very/very large prosthetic mesh. This sutureless laparoscopic technique reduces operative time and the intra- and postoperative complications associated with transabdominal full-thickness stitches.

View Article
November 2019
6 Reads

"SLIM-MESH": RISULTATI INTRA/POSTOPERATORI A MEDIO TERMINE SU 67 PAZIENTI SOVRAPPESO/OBESI/SUPEROBESI

Conference Paper: NATIONAL CONGRESS OF THE ITALIAN SURGERY SOCIETY - At: Bologna, Culture Palace, Italy

Topic: Abdominal Wall Laparoscopic Surgery. Oral Presentations: 01-17. Oral presentation 03: “SLIM-MESH”: RISULTATI INTRA/POSTOPERATORI A MEDIO TERMINE SU 67 PAZIENTI SOVRAPPESO/OBESI/SUPEROBESI. Author Dr. Canton, S.A. University of Padua, Padova, Italy (Presenting Author). Co-author(s): Dr.Toniato, Antonio, Veneto Institute of Oncology IOV – IRCCS, Italy; Dr. Zangrandi, Fabio, University of Padua; Prof. Pasquali, Claudio, University of Padua, Padova, Italy. OBIETTIVI Con lo scopo di ridurre il tempo chirurgico (t.c.) e le complicanzeintra (i.)/postoperatorie (p.) abbiamo operato con la tecnica laparoscopica “Slim-Mesh” (SM) senza punti transparietali di fissaggio un gruppo di pazienti sovrappeso (S, BMI 25-29.9), obesi (O, BMI 30-49.9 e superobesi BMI 50-59.9) affetti da ernia della parete addominale (EPA) e abbiamo analizzato i risultati i./p. a medio termine.MATERIALI E METODI Da settembre 2009 a novembre 2018, 67 pazienti S/O (O di classe I, II, III con BMI rispettivamente compreso tra 30-34.9, 35-39.9, 40-49.9 e super O) affetti da EPA sono stati sottoposti a riparazione chirurgica con la tecnica sutureless SM presso il nostro Dipartimento. La tecnica SM prevede 4 fasi chirurgiche: 1ª) primo step laparoscopico: esplorazione del cavo addominale, misurazione dell’overlap di SM e successiva marcatura dei 4 punti cardinali peritoneali con misurazione dell’area di applicazione peritoneale (interna) di SM (SMAA); 2ª) marcatura cutanea dei corrispettivi 4 punti cardinali cutanei e misurazione della SMAA cutanea (esterna); 3ª) allestimento a banco di SM; 4ª) ultimo step laparoscopico: introduzione e fissaggio parietale di SM. I dati relativi alla nostra casistica sono stati raccolti prospetticamente nel 65% e retrospettivamente nel 35% dei casi. Ultimo follow-up (f. u.) maggio 2019.                                                                                                                                   RISULTATI Il nostro studio ha compreso 36 pazienti maschi e 31 femmine con età media complessiva di 59 anni. Ventotto pazienti erano S, 28 erano O di classe I e 11 erano O di classe II/III/super O.L’EPA è risultata compresa tra 3-10 cm (piccola-media), 10-20 cm (gigante) e ≥ 20 cm (massiva senza perdita di diritto di domicilio) rispettivamente in 45, 17 e 5 casi. Nei 28 pazienti S, nei 28 O di classe I e negli 11 O di classe II/III/super O il t. c. medio è stato rispettivamente di 95, 103 e 103 minuti.Nel 28.3% dei casi la misura i. dell’EPA è risultata maggiore di quella preoperatoria ein 16.4% dei casi la laparoscopia ha evidenziato la presenza di EPA aggiuntive e misconosciute all’ecografia e/o TC. Nel 87% dei casi è stata impiegata la rete protesica composita Proceedᵀᴹ e come dispositivo di fissaggio di SM sono state applicate le graffe assorbibili SecureStrapᵀᴹ nel 85% dei casi.Nel nostro studio la durata media di degenza è stata di 2.6 giorni. Il tempo medio di f. u. è stato di 3 anni (range: 6-114 mesi). Le complicanze p. tardive sono state rappresentate da 1 caso di dolore addominale transitorio, 3 recidive erniarie e 1 caso di trocar site ernia.                                                                                                                        CONCLUSIONI La tecnica sutureless SM anche nei pazienti S/O ha alcuni vantaggi tra cui la riduzione del t. c. e del ricovero ospedaliero e delle complicanze i./p. tra cui il dolore cronico (0%) e la recidiva erniaria (4.4%).

View Article
October 2019
6 Reads

27th International Congress of the European Association For Endoscopic Surgery (EAES), Sevilla, Spain, 12-14 June 2019

Surg Endosc (2019). https://doi.org/10.007/s00464-019-07109-x Print ISSN 0930-2794. Online ISSN 1432-2218

Surgical Endoscopy

Surgical Endoscopy October 2019: DOI:10.1007/s00464-019-07109-x. Print ISSN: 0930-2794. Online ISSN: 1432-2218. PP: 485-781. ORAL PRESENTATION 0086: "SLIM-MESH": SHORT/MID-TERM OUTCOMES IN 27 CASES OF GIANT/MASSIVE VENTRAL HERNIA Author Dr. Canton, S.A., University of Padua, Padova, Italy (Presenting Author of Oral Presentation 0086). Co-Author(s) Dr. Pianalto, Saverio, Donato, University of Padua, PADOVA, Italy, Prof. Pasquali, Claudio, University of Padua, PADOVA, Italy. Topic HERNIA-ADHESIONS. Oral Presentations 0085-V265.

View Article
October 2019

Impact Factor 3.110

3 Reads

27th International Congress of the European Association For Endoscopic Surgery (EAES), Sevilla, Spain, 12-14 June 2019

Surg Endosc (2019). https://doi.org/10.007/s00464-019-07109-x Print ISSN 0930-2794. Online ISSN 1432-2218

Surgical Endoscopy

Surgical Endoscopy October 2019: DOI:10.1007/s00464-019-07109-x. Print ISSN: 0930-2794. Online ISSN: 1432-2218. PP: 485-781. POSTER PRESENTATION 005: SLIM-MESH TECHNIQUE Author Dr. Canton, S.A., University of Padua, Padova, Italy (Presenting Author of Poster 005). Topic AMAZING TECHNOLOGIES. Poster Presentations 005-054.

View Article
October 2019

Impact Factor 3.110

2 Reads

27TH INTERNATIONAL CONGRESS OF THE EUROPEAN ASSOCIATION FOR ENDOSCOPIC SURGERY (EAES), Sevilla, Spain, 12-14 June 2019: Oral Presentations. Topic: HERNIA-ADHESIONS. Oral Presentations: 0085-V265. Session: S13 - What's new in hernia surgery? - ORAL PRESENTATION 086

Surgical Endoscopy

Conference: 27th INTERNATIONAL CONGRESS OF THE EUROPEAN ASSOCIATION FOR ENDOSCOPIC SURGERY (EAES). At: SEVILLA, Barcelo' Convention Center, Spain, 12-14 June 2019.WWW.EAES.EU. Topic: HERNIA-ADHESIONS. Oral Presentations: 0086-V265. Session: S13 - What's new in hernia surgery? - Oral presentation 0086: Author Dr. Canton, S. A., University of Padua, Padova, Italy (Presenting Author), Co-Author(s) Dr. Pianalto, S. D., University of Padua, Padova, Italy, Co-Author(s) Prof. Pasquali, C., University of PADOVA, Padova, Italy. Title: "SLIM-MESH": SHORT/MIDTERM OUTCOMES IN 27 CASES OF GIANT/MASSIVE VENTRAL HERNIA. PATHWAY: Hernia. 

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June 2019
4 Reads

27TH INTERNATIONAL CONGRESS OF THE EUROPEAN ASSOCIATION FOR ENDOSCOPIC SURGERY (EAES), Sevilla, Spain, 12-14 June 2019: Poster Presentations. Topic: AMAZING TECHNOLOGIES. Posters: P001-P054. POSTER 005

Surgical Endoscopy

Conference: 27th INTERNATIONAL CONGRESS OF THE EUROPEAN ASSOCIATION FOR ENDOSCOPIC SURGERY (EAES). At: SEVILLA, Barcelo' Convention Center, Spain, 12-14 June 2019.WWW.EAES.EU. Topic: AMAZING TECHNOLOGIES. Posters: P001-P054. Poster 005: Author Dr. Canton, S.A., University of Padova, Italy (Presenting Author of Poster 005). TITLE: SLIM-MESH TECHNIQUE. PATWAY: Innovative surgeon.

View Article
June 2019
1 Read

"SLIM-MESH": right subcostal ventral hernia

You Tube https://www.youtube.com/watch?v=s1eXNHQ6Byw

“SLIM-MESH” (SM): a sutureless technique (https://link.springer.com/article/10....) for the laparoscopic repair of a ventral hernia with a “Slim-Mesh”.This video shows a rare case of a symptomatic subcostal incisional hernia of the abdominal wall in the right hypochondria repaired with “Slim-Mesh”. Being careful not to injure the liver and the intercostal artery and nerve, I carry out adhesiolysis to expose the hernia defect. I then tailor and roll up a prosthetic mesh on the operative bench according to the “Slim-Mesh” technique (https://www.ncbi.nlm.nih.gov/pubmed/2...) so that it becomes a ‘slim cigarette’. The operation is carried out by Dr Silvio Alen Canton.

View Article
June 2019
4 Reads

"SLIM-MESH": double ventral hernia

You Tube https://www.youtube.com/watch?v=0xaEvGk1Cbl

“SLIM-MESH” (SM): a brand-new sutureless fixation technique (https://link.springer.com/article/10....) for the laparoscopic repair of ventral hernias with a giant “Slim-Mesh” (20 x 17 cm).This video shows a case of a symptomatic incarcerated umbilical hernia and an incisional midline hernia of the linea alba repaired with the “Slim-Mesh” technique. I use a single giant “Slim-Mesh” to treat the double hernia. I tailor and roll up a large prosthetic mesh on the operative bench according to the “Slim-Mesh” technique (https://www.ncbi.nlm.nih.gov/pubmed/2...) so that it becomes a giant “slim cigarette”. Operation carried out by Dr Silvio Alen Canton.

View Article
December 2018
4 Reads

"SLIM-MESH": double abdominal wall hernia repaired with a single giant "SLIM-MESH"

ACIT ASSOCIAZIONE CHIRURGICA ITALIANA TECNOLOGICA "29 CONGRESSO DI CHIRURGIA DELL' APPARATO DIGERENTE" - At Rome - Maximum Auditorium - laparoscopic.it

Presenter: Dr Canton, Silvio Alen, Department of Surgery, Oncology and Gastroenterology (DiSCOG), University of Padua, Padova, Italy. This video shows the “Slim-Mesh” (SM) laparoscopic repair of a double abdominal wall hernia using a single giant. SM without transabdominal full-thickness stitches. The SM technique involves the straightforward abdominal introduction, quick orientation, distension and fixation of a giant prosthetic mesh. This new technique reduces intra- and postoperative complications associated with transabdominal fixation sutures.

View Article
November 2018
19 Reads

"SLIM-MESH" TECHNIQUE: RISULTATI A BREVE-MEDIO TERMINE SU 22 CASI DI ERNIA GIGANTE E MASSIVA DELLA PARETE ADDOMINALE

Italian Surgery Society (SIC) ABSTRACT BOOK. Topic: Abdominal Wall Laparoscopic Surgery. Oral Presentation: 02

Obiettivi: L’obiettivo di questo studio è di analizzare i risultati a breve-medio termine della nuova tecnica laparoscopica “Slim-Mesh” (SM) nel trattamento delle ernie giganti (EG, maggiori 10 cm e minori 20 cm) e massive (EM, maggiori o = 20 cm) della parete addominale senza l’uso di punti di fissaggio transparietali. Materiali e metodi: Da settembre 2009 ad aprile 2018, 22 pazienti portatori di EG/EM sono stati sottoposti a riparazione chirurgica con tecnica SM presso il nostro Dipartimento. I dati relativi alla nostra casistica sono stati raccolti prospetticamente nel 59% e retrospettivamente nel 41% dei casi. Rsultati: Il 68.2% dei pazienti erano maschi e l’età media della nostra casistica era di 64 anni (range:42-82 anni). Le EG e le EM sono state documentate intraoperatoriamente rispettivamente in 17 e 5 casi. Nei 22 pazienti totali, nei 17 pazienti con EG e nei 5 affetti da EM, il tempo chirurgico medio è stato rispettivamente di 128 minuti (range:70-240 minuti), 116.8 minuti (range:70-155 minuti) e 169 minuti (range:105-240 minuti). In 11 (50%) pazienti la misura intraoperatoria dell’ernia è risultata maggiore di quella preoperatoria, di cui 7 (63.6%) e 4 (36.4%) erano affetti rispettivamente da laparocele ed ernia ventrale. In 7 (31.8%) casi la laparoscopia ha evidenziato la presenza di ernie aggiuntive della parete addominale e misconosciute all’ecografia e/o TC. Nel 95.5% dei casi è stata impiegata una rete protesica composita Proceed grande anche fino a 30 cm, nel rimanente 4.5% dei casi è stata usata una mesh non composita B BRAUN Omyra®. Nella maggioranza (72.7%) dei casi come dispositivo di fissaggio abbiamo impiegato le graffe assorbibili SecureStrap. Nel nostro studio la durata media di degenza è stata di 3 giorni. Il tempo medio di follow-up è stato di 34 mesi (range:1-103 mesi). Non ci sono state complicanze postoperatorie precoci nè tardive. Conclusioni: La tecnica SM per il trattamento delle EG/EM rende agevole la manipolazione intraddominale di una mesh gigante o enorme. Nella nostra esperienza, come nel caso del trattamento delle ernie piccole e medie della parete addominale, SM si è dimostrata una metodica altrettanto semplice, veloce ed economica anche nella riparazione di EG/EM.

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October 2018
7 Reads

26th International Congress of the European Association for Endoscopic Surgery (EAES), London, United Kingdom, 30 May-1 June 2018: Poster Presentations. Topic: Abdominal Cavity and Abdominal Wall. Posters: P001-P132. POSTER 003

Surgical Endoscopy

Conference: 26th International Congress of the European Association for Endoscopic Surgery (EAES). At: LONDON, Excel, United Kingdom, 30 May-1June 2018. Surgical Endoscopy April 2018 DOI: 10.1007/s00464-018-6181-5. Print ISSN: 0930-2794. Online ISSN: 1432-2218. PP: 1-132. Topic: Abdominal Cavity and Abdominal Wall. Posters: P001-132. Poster 003: Author Dr. Canton, S. A., University of Padua, Padova, Italy (Presenting Author of Poster 003). Co-Author(s) Prof. Pasquali, Claudio, University of Padua, PADOVA, Italy. Title: "SLIM-MESH": A NEW LAPAROSCOPIC TECHNIQUE FOR THE TREATMENT OF ABDOMINAL WALL HERNIAS. THE FIRST MID-TERM RESULTS 

View Article
April 2018

Impact Factor 3.110

3 Reads

26th International Congress of the European Association for Endoscopic Surgery (EAES), London, United Kingdom, 30 May-1 June 2018: Poster Presentations

Surg Endosc (2018). https://doi.org/10.007/s00464-018-6181-S Print ISSN 0930-2794. Online ISSN 1432-2218

Surgical Endoscopy

Surgical Endoscopy April 2018 DOI: 10.1007/s00464-018-6181-S. Print ISSN: 0930-2794. Online ISSN: 1432-2218. PP: 1-132. 

View Article
April 2018

Impact Factor 3.110

5 Reads

"SLIM-MESH": triple ventral hernia in an obese patient (BMI 43 kg/m2) repaired with 3 SM

You Tube https://www.youtube.com/watch?v=kB2JxbErP58

"SLIM-MESH" (SM): a brand-new tacks or straps-only fixation technique for the laparoscopic repair of ventral hernias with a “Slim-Mesh”.This video shows a case of a triple small-size ventral hernia in an obese patient (BMI 43 Kg/m²). The first operation is on a small size umbilical hernia, the second and the third operations are on a small incisional hernia of the right and left hypocondria respectively. I roll up three circular prosthetic meshes on the operative bench according to the “Slim-Mesh” technique (https://www.research.unipd.it/handle/..., https://www.ncbi.nlm.nih.gov/pubmed/2...https://www.ncbi.nlm.nih.gov/pubmed/2...) so that they become three “slim cigarettes”. Operation carried out by Dr Silvio Alen Canton.

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March 2018
5 Reads

“SLIM-MESH”: A NEW LAPAROSCOPIC TECHNIQUE FOR GIANT ABDOMINAL WALL HERNIA REPAIR WITHOUT TRANSABDOMINAL FIXATION SUTURES

ACIT ASSOCIAZIONE CHIRURGICA ITALIANA TECNOLOGICA "29 CONGRESSO DI CHIRURGIA DELL' APPARATO DIGERENTE" - At Rome - Maximum Auditorium - laparoscopic.it

Presenter: Dr Canton, Silvio Alen, Department of Surgery, Oncology and Gastroenterology (DiSCOG), University of Padua, Padova, Italy. This video shows the “Slim-Mesh” (SM) laparoscopic repair of a giant incisional hernia of the abdominal wall front. During the SM operation, I roll a large prosthetic mesh (20X17 cm) on the operative bench and fix it with multiple sets of stitches so that it becomes a giant “slim cigarette”. Then the SM is easily introduced intraperitoneally. The giant SM is anchored onto the abdominal wall without transabdominal fixation sutures in according to the SM technique modulating the proper tension-free of the mesh.

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November 2017
8 Reads

TECNICA "SLIM-MESH" PER IL TRATTAMENTO LAPAROSCOPICO DELLE ERNIE DELLA PARETE ADDOMINALE: PRIMI RISULTATI A MEDIO TERMINE

ATTI 119° CONGRESSO DELLA SOCIETA' ITALIANA DI CHIRURGIA (SIC)

OBIETTIVI L’obiettivo di questo studio è di valutare i risultati a breve-medio termine della nuova tecnica laparoscopica “Slim-Mesh” nel trattamento delle ernie della parete addominale (EPA) senza l’uso di punti di fissaggio transparietali. MATERIALI E METODI Da settembre 2009 ad aprile 2017, 52 pazienti portatori di EPA sono stati sottoposti a trattamento chirurgico con tecnica “Slim-Mesh” presso il nostro Dipartimento. I dati relativi alla nostra casistica sono stati raccolti retrospettivamente nel 63% dei casi o prospetticamente (37%). RISULTATI Il 52% dei pazienti erano femmine e l’età media della nostra casistica era di 58 anni (range: 31-82 anni). Il valore medio dell’indice di massa corporea (BMI) era di 28, la misura intraoperatoria del difetto erniario era inferiore a 10 cm e maggiore di 10 cm fino a 24 cm rispettivamente in 39 e 13 casi. Nei 39 pazienti con EPA < 10 cm il tempo chirurgico medio è stato di 86 minuti (range: 55-150 minuti) e 138 minuti (range: 215-90 minuti) nei 13 pazienti con EPA giganti o enormi (rispettivamente > 10 cm o > 20 cm). In 21.1% dei casi la misura intraoperatoria dell’ernia è risultata maggiore di quella preoperatoria e nel 15.3% dei casi la laparoscopia ha evidenziato la presenza di EPA aggiuntive e misconosciute all’esame obiettivo, ecografia e/o TC della parete addominale. Nel 88% dei casi è stata utilizzata una rete protesica composita grande anche fino a 30 cm. Nel nostro studio c’è stata una (1.9%) complicanza intraoperatoria rappresentata da bradicardia che non ha richiesto la conversione laparotomica. Una paziente ha accusato dolore addominale a domicilio in settima giornata postoperatoria per cui è stata ricoverata e sottoposta a laparoscopia esplorativa che non ha evidenziato complicazioni precoci correlate all’intervento chirurgico “Slim-Mesh”. La durata media di degenza è stata di tre giorni. Il tempo medio di follow-up è stato di trenta mesi (range: 1-89 mesi). Le complicanze postoperatorie tardive sono state tre (5.7%) recidive di EPA ed un caso di laparocele da trocar, tutti i quattro pazienti sono stati rioperati. CONCLUSIONI Questa nuova tecnica laparoscopica per il trattamento delle EPA rende agevole la manipolazione intraddominale ed il fissaggio perimetrale di una rete protesica senza l’uso di punti transparietali di fissaggio. Nella nostra esperienza “Slim-Mesh” è una metodica veloce, sicura, economica e semplice anche nel trattamento delle EPA giganti ed enormi S.I.C. VIALE TIZIANO, 19 - 00196 ROMA

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October 2017
11 Reads

"SLIM-MESH": super giant (30x15cm) SM for the repair of a massive pseudohernia of the abdominal wall

You Tube https://www.youtube.com/watch?v=sV7XpCuwbRw

“SLIM-MESH” (SM): a brand-new tacks or straps-only fixation technique (https://www.ncbi.nlm.nih.gov/pubmed/2...) for the laparoscopic repair of abdominal wall hernias.This video shows the “Slim-Mesh” repair of a symptomatic super giant pseudohernia of the abdominal wall front due to atrophy and diastasis recti abdominis in an obese patient. The operation involves tailoring and rolling up a massive (30 X 15 cm) prosthetic mesh on the operative bench according to the “Slim-Mesh” technique so that it becomes a super giant slim cigarette. Operation carried out by Dr Silvio Alen Canton.

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September 2017
6 Reads

Laparoscopic repair of ventral/incisional hernias with the "Slim-Mesh" technique without transabdominal fixation sutures: preliminary report on short/midterm results

Updates Surg

This study details our experience with a new laparoscopic technique called “Slim-Mesh” without using transabdominal full-thickness stitches, to treat ventral and incisional hernias (V/IH). Since 2009–May 2015, 28 consecutive patients with V/IH were treated in our center, with this new SM technique. Fifty percent males were included in this retrospective study, averaging 59 years (range 31–81 years). Mean body mass index was 26 and VH size was <10 cm in 24 cases and in 4 cases was larger, up to 22 cm. Mean operative time in the 28 V/IH patients was 97 min (range 57–160 min) and in those with V/IH larger than 10 cm it was 135 min. In 14.2% of patients laparoscopy diagnosed others V/IH previously undetected by physical examination and CT-scan. In all patients a composite mesh was used, up to 30 cm in size. In this series we had one intraoperative complication (3.6%) with transient bradycardia, but no conversion occurred; no early postoperative complication was detected. Mean length of hospital stay was 3.0 days. Mean follow-up time was 40 months (range 13–78 months). Late surgical complications included one case (3.6%) of incisional hernia recurrence and one case of 10 mm trocar site incisional hernia. This new surgical technique for V/IH repair, makes easy the handling and fixation of the composite mesh without using transabdominal fixation sutures, and appears in our experience fast, and simple. Keywords Ventral/incisional hernia repair Slim-Mesh Transabdominal fixation sutures Operation time Hernia recurrence 

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August 2017
264 Reads

"SLIM-MESH": super obese (BMI 51) patient treated for double ventral hernia with a giant "Slim-Mesh"

You Tube https://www.youtube.com/watch?v=FCVgepXgLRw

"SLIM-MESH": a brand-new tacks or straps-only fixation technique (http://www.ncbi.nlm.nih.gov/pubmed/28...) for the laparoscopic repair of abdominal wall hernias.This video shows the repair of a double ventral hernia in a super obese (BMI 51 kg/m²) patient. The first is an incarcerated umbilical hernia and the second a paraumbilical hernia. The operation involves rolling up a giant prosthetic mesh on the operative bench and fixing it initially with a single stitch and after with multiple sets of stitches so that it becomes a giant slim cigarette. Operation carried out by Dr Silvio Alen Canton.

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May 2017
4 Reads

"SLIM-MESH": a new laparoscopic technique for giant abdominal wall hernia repair

You Tube https://www.youtube.com/watch?v=squBJ5nlP5s0

"SLIM-MESH": a brand-new tacks or straps-only fixation technique (https://www.ncbi.nlm.nih.gov/pubmed/2...) for the laparoscopic repair of giant abdominal wall hernias. The first operation is on a giant lumbar hernia and involves rolling up a large prosthetic mesh on the operative bench and fixing it initially with a single stitch and after with multiple sets of stitches so that it becomes a giant slim cigarette. The second is on a paraumbilical hernia. Operations carried out by Dr Silvio Alen Canton.

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February 2017
3 Reads

"SLIM-MESH": nuova tecnica di onfalo-laparoplastica videolaparoscopica

ACIT ASSOCIAZIONE CHIRURGICA ITALIANA TECNOLOGICA "29 CONGRESSO DI CHIRURGIA DELL' APPARATO DIGERENTE" - At Rome - Maximum Auditorium - laparoscopic.it

 “SLIM-MESH”: A NEW LAPAROSCOPIC TECHNIQUE FOR VENTRAL HERNIA REPAIR WITHOUT TRANSABDOMINAL FIXATION SUTURES Canton Silvio Alen ¹ Presenter: Canton Silvio Alen1- Department of Surgery, Oncology and Gastroenterology (DiSCOG), University of Padua, Italy This video shows the “Slim-Mesh” (SM) laparoscopic repair of a ventral hernia of the abdominal wall front. During the SM operation, I roll a prosthetic mesh on the operative bench and fix it with multiple sets of stitches so that it becomes a "slim cigarette”. Then the SM is easily introduced intraperitoneally. The SM is anchored onto the abdominal wall without transabdominal fixation sutures in according to the SM technique modulating the proper tension-free of the mesh.

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November 2016
9 Reads

"SLIM-MESH": UNA NUOVA TECNICA DI ONFALO-LAPAROPLASTICA VIDEOLAPAROSCOPICA SENZA PUNTI TRANSPARIETALI DI FISSAGGIO

Congresso Congiunto delle Società Scientifiche Italiane di Chirurgia. Sostenibilità, Innovazione, Contenzioso ed Etica. LE SFIDE DELLA CHIRURGIA. 25/29 settembre 2016 roma

SLIM-MESH: UNA NUOVA TECNICA DI ONFALO-LAPAROPLASTICA VIDEOLAPAROSCOPICA SENZA PUNTI TRANSPARIETALI DI FISSAGGIO

Canton Silvio Alen, Merigliano Stefano, Pasquali Claudio. Relatore: Canton Silvio Alen. Dipartimento di Scienze Chirurgiche, Oncologiche e Gastroenterologiche (DiSCOG), Università degli Studi di Padova. 

Con questa presentazione combinata slides-video vogliamo presentare la nuova tecnica chirurgica video-laparoscopica di laparoplastica senza l' uso di punti transparietali di fissaggio nominata slim mesh. Questa tecnica innovativa permette un' agevole introduzione intraddominale, un singolare orientamento, ancoraggio perimetrale e distensione di una rete protesica composita evitando l' uso di punti di orientamento e di fissaggio transparietali anche nel caso di utilizzo di grandi mesh. 

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September 2016
11 Reads

"SLIM-MESH": a new laparoscopic technique for the repair of abdominal wall hernias

You Tube https://www.youtube.com/watch?v=cd1fD4D_RAw

"SLIM-MESH": a brand new tacks or straps only fixation technique (https://www.ncbi.nlm.nih.gov/pubmed/2..) for the laparoscopic repair of abdominal wall hernias. This new approach involves rolling up a prosthetic mesh on the operative bench and fixing it with stitches so that it becomes a slim cigarette. Operation carried out by Dr. Silvio Alen Canton 

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September 2016
5 Reads

"Retrospective-prospective observational study on the short-to-long term intraoperative efficacy and safety of the "Slim-Mesh" technique in the treatment of abdominal wall hernias. Research Project no. 3902/AO/16.

Authors:
S.A. Canton

University-Hospital of Padua, PADUA, Italy. Research Project no. 3902/AO/16.

TITLE: Retrospective-prospective observational study on the short-long term intraoperative efficacy and safety of the “Slim-Mesh” technique in the treatment of abdominal wall hernias PROMOTER: Dr. Silvio Alen Canton PRINCIPAL INVESTIGATOR: Dr. Silvio Alen Canton OPERATIONAL UNIT: Department of Surgery, Oncology and Gastroenterology (DiSCOG) STUDY DESIGN: Monocentric retrospective-prospective observational Study/Register

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July 2016
8 Reads

NUOVA TECNICA DI DISPIEGAMENTO DELLA PROTESI

LAPAROCELI. Laparoscopy Live Surgery. Auditorium degli Ospedali Riuniti Padova Sud " Madre Teresa di Calcutta" Schiavonia, Monselice (PD)

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March 2016
8 Reads

Duodenum-preserving versus pylorus-preserving pancreatic head resection for benign and premalignant lesions.

J Hepatobiliary Pancreat Sci 2011 Jan;18(1):94-102

Department of Medical and Surgical Sciences, IV Surgical Clinic, University of Padova, Ospedale Giustinianeo, Via Giustiniani 2, 35128 Padua, Italy.

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http://dx.doi.org/10.1007/s00534-010-0317-xDOI Listing
January 2011
20 Reads
2 Citations
2.313 Impact Factor

Enucleation of Benign Tumors of the Pancreas. Thirty-Five Years Experience in a Single Center

JOP. J Pancreas (Online)

Context Tumor enucleation is a surgical procedure traditionally reserved to treat small benigrr tumors of the pancreas. Complication rate of this operation in small series of patients is reported to be high. Objective To evaluate complications of pancreatic tumor enucleation in a series of patients collected in 35 years in a single center. Methods From 08/1975 to 1212009,60 patients underwent enucleation for benign or uncertain behavior tumors of the pancreas. Five patients were excluded from the study because of an associated procedure of pancreatic resection. In 55 patients we retrospectively evaluated: age, sex, histotype, site, size, operative ultrasound, morbidity, mortality, length of hospital stay and postoperative complications. Results Fifly-five patients (24 males and 33 females) averaging 53 years (range: 0.2-86 years) were included in the study. Three cases had two surgical enucleations due to the onset of a new lesion 4 to I I years after the first operation. Overall 6 cases had a previous pancreatic operation; in three cases an additional surgical procedure on the GI tract was performed. Finally, the operative procedures were 58, one of which with a double enucleation. Mean size of the lesion was 2.0 cm (range: 0.5-15 cm), 53.4Yo nthe head of the pancreas. Fifty-two out of 59 (88.1%) were endocrine tumors; insulinomas were 36159 (61.0%). Operative ultrasound was performed in 37 cases (63.70/o). Mean hospital stay was 15.1 days (range: 654 days); in the last l0 years (2000-2009) median hospital stay was 9 days. Main surgical complications

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September 2010
14 Reads

The Need of a Severity Scoring System for Postoperative Pancreatic Fistulas

J Gastrointestinal Surg

To the Editors: Postoperative pancreatic fistulas (POPF) remain the major contributor to morbidity and mortality after pancreatic resection even in high volume centers. We read with great interest the article by Fryerman et al on the impact of grade C POPFs on surgical outcome after pancreatic resections. The application of the International Study Group on Pancreatic Fistula (ISGPF) classification to 483 patients who underwent pancreatic resection allowed the authors to confirm that the mortality due to POPF was confined to grade C POPFs (5/29). However, the authors stated that ISGPF classifications is susceptible to bias in treatment selection due to its post hoc character, and does not provide a guideline for the timely treatment of POPF in an individual patient. We recently reported a reoperation rate of 4.3% and a mortality rate of 0% for 70 POPFs diagnosed between 1993 and 2007.

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June 2010
8 Reads

Parenchyma-sparing resection for pancreatic neoplasms

Journal of Hepato-Biliary-Pancreatic Sciences

To the Editor, We read with great interest the article by Crippa et al. [1] published online on 29 October 2009 in the Journal of Hepatobiliary and Pancreatic Surgery. In recent years parenchyma-sparing resections have been increasingly performed for isolated, benign, borderline, or low-grade malignant lesions of the pancreas. Probably the increased confidence with the treatment of pancreatic fistulas, and the better knowledge of the natural history of pancreatic neoplasms, have encouraged surgeons to preserve as much pancreatic parenchyma as possible. Enucleation is the simplest and most parenchyma-sparing procedure. Intraoperative ultrasound (IOUS) can help in choosing the best procedure for the patient. The above authors reported a 26% increase in the enucleation rate, thanks to IOUS, in patients who were initially candidates for standard pancreatectomy. However, in spite of IOUS their reported fistula rate was quite high (38%), with a clinically significant fistula rate of 23%. This may have been due to the short distance (2–3 mm) from the main pancreatic duct accepted to consider the patient a candidate for enucleation and, most important, the lack of an ultrasonographic check of the main pancreatic duct after completing the procedure. After selecting patients with at least 4–5 mm distance between the tumor and the main pancreatic duct, and verifying by IOUS the morphology of the main pancreatic duct after the procedure, our fistula rate was 15% (5/33), with only one (3%) clinically significant pancreatic fistula [2].

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March 2010
12 Reads

[Thoracic outlet syndrome: clinical staging].

Chir Ital 2004 Jan-Feb;56(1):55-62

U.O. di Chirurgia Toracica, Ospedale Civile Umberto I, Mestre, Venezia.

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September 2004
18 Reads

Thoracic outlet syndrome: clinical staging

Chir Ital 2004 56(1):55-62

The clinical and instrumental manifestations of thoracic outlet syndrome are well known but the therapeutic choices frequently differ in relation to the physician’s experience. Thus, there is univocal opinion regarding the therapy of this complex syndrome. To solve this problem we have attempted to bring together the clinical and intrumental pictures in a single classification that includes the three fundamental aspects of the syndrome, namely nerve, artery and vein iniury (NAV). Our goal was to achieve a universally accetped therapy-oriented staging system, as is the case with the TNM system for malignant tumours. From 1984 to 2002, in our istitution 156 patients with thoracic outlet syndrome were evaluated. These were grouped in 4 stages depending on their NAV status. Subsequent therapy was in accordance with stage. Our results confirmed the accuracy of NAV. On the bases of our preliminary experience, the NAV staging system is useful for correct patient grouping. Now a prospective multicentre study is needed for universal scientific validation. Key words: thoracic outlet syndrome, cervical rib syndrome, brachial plexus, subclavian artery, subclavian vein. Chir Ital 2004; 1:55-62

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January 2004
8 Reads

Pleurodesi con tenda pleurica nello PNT spontaneo

CHIRURGIA GENERALE-General Surgery

Unanimamente riconosciuti sono i capisaldi del trattamento chirurgico dello pneumotorace (PNT) spontaneo: controllo della fuga aerea; ripristino della negatività intrapleurica; riespansione del polmone e soprattutto suo accollamento aereostatico alla parete, principale prevenzione delle recidive. Non vi è invece consenso univoco nella metodica di adesione piu' affidabile. Tanto la cruentazione delle sierose (pleurodesi), quanto la fusione diretta del polmone alla parete pleurica (pleurectomia) presentano limiti non trascurabili, l' una per la variabilità dei risultati, l' altra per gli effetti collaterali. Negli anni '50 Miscali (1) ha dimostrato che l' apposizione sulla superficie del pomone di un ampio lembo di pleura parietale scollata (tenda pleurica) è in grado di ottenere una valida obliterazione. L' efficacia adesivo-aereostatica della tenda è stata di recente riconfermata dopo riduzione polmonare per enfisema (2) e lobectomia (3,4), registrandosi un accollamento del polmone solido e permanente al pari della pleurectomia, nel contempo rispettando i piani anatomici come la pleurodesi. Rappresentando quindi la tenda pleurica un potenziale miglioramento delle metodiche tradizionali, soprattutto negli individui giovani, se abbiamo valutato applicabilità e risultati nel trattamento chirurgico dello PNT spontaneo c.d. primitivo.

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June 2002
10 Reads

La stapled lobectomy in traumatologia

ANNALI ITALIANI DI CHIRURGIA

Il 65% dei pazienti con trauma toracico presenta lesioni al torace da sole o associate , spesso emorragie da lacerazioni polmonari; risulta critico per la sopravvivenza (golden hour) controllare rapidamente (damage control) il sanguinamento, riducendo al minimo il rischio di innesco di ipotermia-acidosi-coagulopatia, irreversibilmente auto-alimentantesi. In quest'ottica l'intervento proposto da Lewis (1) di resezione polmonare con sutura simultanea meccanica delle strutture vascolari e bronchiali appare capace di ridurre considerevolmente i tempi chirurgici (2). Tra ottobre 1997 e luglio 2001 abbiamo eseguito 15 resezioni polmonari secondo Lewis. In 5 di questi pazienti l'indicazione è consistita in gravi lacerazioni non altrimenti dominabili: 4 da trauma chiuso e 1 da proiettile, con età tra 22 e 23 anni. Sono state effettuate 3 lobectomie inferiori, una superiore, una pneumonectomia destra. In tutti i casi il moncone bronchiale non è stato protetto; il tempo chirurgico medio è risultato 15 + 5 minuti; in un caso è stato necessario un reintervento programmato dopo packing toracico associato. Essenziale l'agevole reperimento degli elementi ilari al fine di non ricadere nella antica e abbandonata tecnica di "legatura in massa", ma invece consentirne lo stapling complanare individuale pur se simultaneo. Non abbiamo registrato nessun decesso né complicanze legate alla tecnica, in particolare sanguinamento o fistola bronchiale; un paziente è deceduto in 30° giornata per complicanze non legate alla patologia toracica. Il drenaggio è stato rimosso in 6° + 2 gg. (a scopo prudenziale piu' a lungo che di norma per escludere perdite aeree e/o emorragie tardive). Il follow-up varia da 6 mesi a 4 anni e nei 4 pazienti sopravissuti non si sono rilevati reliquati legati alla metodica resettiva. Riteniamo che la tecnica di Lewis, sia quando applicabile, affidabile anche in emergenza in termini di riduzione del tempo chirurgico e quindi della prognosi del traumatizzato toracico, senza incremento di complicanze rispetto all'intevento exeretico tradizionale.

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November 2001
9 Reads

Packing e reintervento programmato per trauma toracico

ANNALI ITALIANI DI CHIRURGIA

Il 65% dei traumi severi coinvolge il torace e, dato il miglioramento della rete di soccorso, un crescente numero di gravi toracolesi giunge ancora vivo in Ospedale: il 40% di questi richiede una correzione chirurgica efficace e rapida. Conseguentemente, anche in traumatologia toracica si va estendendo il principio di damage control, ben consolidato nei traumi maggiori dell' addome, inclusa la strategia del trattamento chirurgico definitivo differito (1), limitandosi nel primo approccio a controllare le lesioni/emorragie minaccianti la vita. Una di queste misure prevede il tamponamento temporaneo di varie e molteplici fonti emorragiche anche in torace (2) mediante packing, diffusamente impiegato per lesioni dei parenchimi addominali. In un caso occorso alla nostra osservazione di trauma chiuso da schiacciamento del torace con lacerazioni polmonari bilaterali, emotorace bilaterale, necessità di massaggio cardiaco e clamp provvisorio dell' aorta discendente, si è risolta la situazione acuta mediante incisione clam-shell, esecuzione delle manovre rianimatorie, lobectomia stapled del lobo inferiore destro e, essendosi iniziato il circolo catastrofico ipotermia-ipocoagulazione-acidosi, provvedendo alle molteplici lacerazioni dei vasi costali mediante packing endo-toracico e chiusura lassa e temporanea della incisione bi-toracotomica trans-sternale. Dopo 48 ore si è proceduto a de-packing con successivo e duraturo buon esito ed in particolare con stabile guarigione dei fatti viscerali e parietali. In conclusione, il caso da noi descritto conferma l' efficacia della strategia del reintervento programmato anche in determinati gravi traumi del torace così come già attuato in traumatologia non toracica.

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November 2001
10 Reads

Relationship between objective and subjective evaluation of an ambulatory treatment: sclerotherapy of haemorrhoids

Ambulatory Surgery

Injection slerotherapy remains a universally popular method for the treatment of first and second degree haemorrhoids in the outpatient clinic. The ultimate judgement regarding the procedure must be made by physician as well as by the patient. The aim fo this study was to investigate the patient's point of view and to compare the findings with the clinica objective data.

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April 1999
9 Reads

Transanal excision of rectal carcinoma

Abstract The role of local excision (LE) in the treatment of carcinoma of the lower rectum has to be defined yet. The aim of this study was to clarify the indications for LE in carcinoma of the lower rectum by making a retrospective evaluation of 22 patients (14 males, 8 females; mean age 68 years, range 33-89) who from 1983 to 1994 underwent this procedure for invasive rectal carcinoma at our Institute. Patients were subdivided into two groups. Group A (low risk) consisted of 19 patients with well o moderately differentiated (G1 or G2) carcinoma, confined to the rectal wall (T1-2), without nodal or vascular involvement; four patients underwent radical surgery after LE, and seven of the remaining 15 were given adjuvant radiotherapy. Group B (high risk) consisted of three patients with poorly differentiated carcinoma (G3) and/or invasion beyond the rectal wall (T3-4) and/or nodal or vascular involvement; only one patient had radiotherapy. One patient died postoperatively from pulmonary embolism (group A) and only one major complication occurred, requiring reoperation (group B). Three patients were excluded from the follow-up (FU). In the 19 evaluable patients (17 group A and 2 group B) median FU was 53 months (range 5-135 months). Four patients (2 group A and 2 group B) had local recurrences. The only two cancer correlated deaths occurred in group B patients. The two group A patients with recurrences underwent radical surgery and are now alive and (2 and 8 years later) disease free. Although our series was small and the study retrospective, our findings suggest that for most T3 carcinomas LE is contraindicated, while for T1-2 carcinomas the selection criteria must be rigorous and the use of adjuvant radiotherapy should be considered particularly for patients with T2 carcinomas. 

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January 1997
9 Reads

FACTORS ASSOCIATED WITH POSTOPERATIVE HOSPITAL STAY IN PATIENTS RESECTED FOR COLORECTAL CANCER

Italian Journal of Coloproctology, January 1997, vol.16

PURPOSE OF THIS STUDY: The large number of colorectal cancer patients admitted to departments of general surgery has a great ingluence on the overall cost of hospitalisation, which is highly correlated with lenght of hospital stay. The aim of our study was therefore to identify factors affecting the lenght of stay following colorectal resection. PATIENT AND METHODS: The study population consisted of 151 consecutive patients who, from January 1994 through December 1995, undervent colorectal resection for primary tumors at Surgical Clinic II, Padua University. The patients' characteristics, procedures performed, and morbiditiy and mortality rates prospectively recorded were avaluated. RESULTS: At survival curve analysis, several parameters were found to be significantly correlated to prolonged postoperative stay. However, at multivariate Cox model analysis, significant correlation was found between lenght of stay and the following variables only: reoperation within 30 days for primary surgery complications (p=0.0282); non-infectious urinary complications (p=0.0091); anastomotic leaks (p=0.0005); respiratory complications (p=0.0173); intraoperative blood loss (p=0.0012). COMMENT: Our findings suggest that general morbidity does not necessarily lead to prolonged hospitalization, but some surgical complications do. Postoperative hospital stay could be reduced by preventing these surgical complications, minimising their conseguences, and also by increasing the availability of improved low-cost homecare assistance.

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January 1997
11 Reads

TUBERCOLAR PERIPANCREATIC LYMPH-ADENOPATHY MIMICKING A PANCREATIC HEAD TUMOUR. A CASE REPORT

The Italian Journal of Gastroenterology

TB peripancreatic lymph-nodes involvement is rare, although pancreatic TB has been occasionally reported in non-endemic areas, in association with acute miliary TB disease in subjects with AIDS. Symptoms may include fever, abbominal pain, jaundice and boddy weight loss. We report an unusual presentation where the discrepancy between the radiolic features resembling a pancreatic tumor and scarcity of symptoms induced esploration with unexpected finding. We observed a 67 -year-old woman who was referred to our Department for a pancreatic head mass suspected to be a neplasm. Two months before she was admitted in another hospital after three episodes of sudden fever without jaundice or pain, and after a CT scan she was discharged with a diagnosis of locally advanced pancreatic head cancer and gallbladder stones. When the patient was referred to our Department routine laboratory tests were all in the normal range including serum amylase, lypase, ALP, bilirubin and also CEA and CA19-9. The patient was asymptomatic. The CT-scan also showed a 3 cm mass enlarging the head of the pancreas on the posterior aspect, with few hypodense (hyperintense to MRI) areas within the mass. The mass was hypervascolar at arteriography. These features suggested a diagnosis of a rare variety of pancreatic neoplasm (sarcoma or cystoadenocarcinoma). In February 1995, the patient undervent surgery and a large mass (6 x 4 x 3 cm) adherent to the posterior wall of the duodenum, pancreas and main bile duct, and also to the portal vein and hepatic artery, was found. The mass was excised and a cholecystectomy and liver biopsy were performed. Histology showed a TB lymph-node ande evidence in the liver biopsy of epitheliod - giant cells in the portal spaces. The postoperative course was uneventful and the patient was treated with anti TB therapy for 9 months. She is alive and well 18 months after surgery.

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December 1996
15 Reads

RECURRENCE AFTER RESECTION FOR DUCTAL ADENOCARCINOMA OF THE PANCREAS

HPB SURGERY a World Journal of Hepatic, Pancreatic and Biliary Surgery

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June 1995
9 Reads

Percutaneous CT-guided fine needle aspiration cytology in the differential diagnosis of pancreatic lesions.

Ital J Gastroenterol

Cytologic results were retrospectively evaluated in 83 patients who underwent CT-guided fine-needle aspiration of pancreatic lesions during a 5-year period. Sixty seven patients had malignant disease and 16 benign disease. The sensitivity, specificity, positive and negative predictive values, and diagnostic efficiency of fine-needle aspiration (FNA) cytology in detecting malignancy were 91%, 100%, 100%, 73%, and 93%, respectively. In solid pancreatic masses the sensitivity of FNA cytology rose to 98%, while in cystic pancreatic masses sensitivity fell to 62%. In 18 patients with cystic lesions (12 benign and 6 malignant), the cystic fluid was analyzed for amylase, CEA and CA 19-9 content. Amylase levels were high in pseudocysts and in 4/6 malignant cysts. CEA levels were low in benign cysts, and high in all malignant cysts. CA 19-9 levels were high in one pseudocyst and in all malignant cysts. Tumour marker content analysis enhanced the sensitivity of the cytologic diagnosis of malignant cysts to 92%. FNA cytology is a simple and highly accurate method in the differential diagnosis of solid pancreatic lesions. In cystic lesions, tumour marker fluid content determination increases the sensitivity of FNA cytology.

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April 1994
10 Reads

Prevenzione con omeprazolo della recidiva di ulcera peptica: validità di un trattamento con 20 mg a gioni alterni.

Recenti Progressi in Medicina

Prevention of peptic ulcer relapse: effectiveness of a treatment with omeprazole 20 mg every second day. . Omeprazole, 20 mg every second day, in prevention of duodenal ulcer relapse has been tested. 15 patients with peptic ulcer, which was endoscopically proved and then healed, underwent the treatment. No matter of ulcer original seat as well as antiacid drug, previously employed, recurrences were not seen after 6 months period, while clinical symptoms and possible adverse reactions appeared to be very slight. The proposed regimen of omeprazole seems to be cost-saving and woth proving.

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January 1993
9 Reads

Top co-authors

Giorgio Stevanato
Giorgio Stevanato

Azienda Ospedaliera Universitaria Integrata

1
Vittore Pagan
Vittore Pagan

Umberto I General Hospital

1
Antonio Zaccaria
Antonio Zaccaria

Umberto I General Hospital

1
Paolo Fontana
Paolo Fontana

Federico II University

1
Cosimo Sperti
Cosimo Sperti

University of Padua

1
Alessandro Busetto
Alessandro Busetto

Umberto I General Hospital

1
Sergio Pedrazzoli
Sergio Pedrazzoli

IV Surgical Clinic

1