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Pancreatic Neoplasms: HELP
Articles by Nicola Avenia
Based on 6 articles published since 2010
(Why 6 articles?)
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Between 2010 and 2020, Nicola Avenia wrote the following 6 articles about Pancreatic Neoplasms.
 
+ Citations + Abstracts
1 Article Laparoscopic distal pancreatectomy in elderly patients: is it safe? 2017

Aprea, Giovanni / De Rosa, Davide / Milone, Marco / Rocca, Aldo / Bianco, Tommaso / Massa, Guido / Compagna, Rita / Johnson, Louis Banka / Sanguinetti, Alessandro / Polistena, Andrea / Avenia, Nicola / Amato, Bruno. ·Division of General Surgery, Department of Clinical Medicine and Surgery, School of Medicine, University of Naples Federico II, via S. Pansini, 5, 80131, Naples, Italy. · Division of General Surgery, Department of Surgical Sciences and Nephrology, School of Medicine, University of Naples Federico II, Naples, Italy. · Division of General Surgery, Department of Clinical Medicine and Surgery, School of Medicine, University of Naples Federico II, via S. Pansini, 5, 80131, Naples, Italy. aldorocca@hotmail.it. · Division of Colorectal Surgery, Department of Clinical Sciences, Pelvic Floor Centre, Malmö University Hospital, Lund University, Lund, Sweden. · General Surgery and Surgical Specialties Unit, Medical School, S. Maria University Hospital, University of Perugia, Terni, Italy. ·Aging Clin Exp Res · Pubmed #27878555.

ABSTRACT: BACKGROUND: Laparoscopic distal pancreatectomy (LDP) appears to be safe and effective as open distal pancreatectomy (ODP) for benign or borderline malignant lesion. However, studies comparing LDP with ODP in elderly patients are limited. The purpose of this study is to compare the clinical outcomes of these two several approaches in elderly patients. METHODS: A retrospective analysis was carried out by comparing laparoscopic (n = 7) and open (n = 15) distal pancreatectomy in elderly patients performed at the University of Naples "Federico II" and University of Perugia between January 2012 and December 2015. Demographic data, operative and postoperative outcomes were analyzed. RESULTS: Demographic and tumor characteristics of laparoscopic and ODP were similar. There were also no significant differences in operating room time. Patients undergoing LDP had lower blood loss, first flatus time, diet start time and postoperative hospital stay. There were no significant differences in complication rates or 90-day mortality. DISCUSSION: LDP is safe and feasible as ODP in selected elderly patients.

2 Article Pancreatic stump closure after pancreatoduodenectomy in elderly patients: a retrospective clinical study. 2017

Mauriello, Claudio / Polistena, Andrea / Gambardella, Claudio / Tartaglia, Ernesto / Orditura, Michele / De Vita, Ferdinando / Santini, Luigi / Avenia, Nicola / Conzo, Giovanni. ·Division of General and Oncologic Surgery, Department of Anesthesiologic, Surgical and Emergency Sciences, School of Medicine, Second University of Naples, Via Sergio Pansini 5, 80131, Naples, Italy. · Medical School, General Surgery and Surgical Specialties Unit, S. Maria University Hospital, University of Perugia, Terni, Italy. · Division of Medical Oncology, Department of Internal and Experimental Medicine "F. Magrassi", School of Medicine, Second University of Naples, Via Sergio Pansini 5, 80131, Naples, Italy. · Division of General and Oncologic Surgery, Department of Anesthesiologic, Surgical and Emergency Sciences, School of Medicine, Second University of Naples, Via Sergio Pansini 5, 80131, Naples, Italy. giovanni.conzo@unina2.it. ·Aging Clin Exp Res · Pubmed #27837458.

ABSTRACT: BACKGROUND: Pancreatic fistula (PF) after pancreatoduodenectomy (PD) represents the major source of morbidity. Derivative procedures are preferred by pancreatic surgeons, but the optimal management of remnant pancreatic stump remains controversial. AIMS: The purpose of this retrospective study is to evaluate the efficacy and safety of pancreatic stump closure in selected elderly patients (>65 years). METHODS: Clinical data of 44 PD undergone mechanical closure of the pancreatic stump performed between 2001 and 2014 in two department of general and oncologic surgery were retrospectively collected. Considering the age, patients were divided into two groups: 21 patients of less than 65 years (Group A) and 23 patients of more than 65 years (Group B). RESULTS: A soft pancreatic parenchyma with a not-dilated duct (diameter <3 mm) was reported in all the 44 patients. A grade-A PF, which did not required further treatments, developed in 20 cases (45.4%; 13 in group A and 7 in group B; p < 0.05), grade-B in 5 patients (11.4%; 3 in group A and 2 in group B; statistically not significant) and a grade-C PF was observed only in one patient (2.2%; 1 in group A and 0 in group B). DISCUSSION: In selected "high risk" elderly patients (>65 years) with soft pancreatic texture, the closure of the pancreatic stump can be a useful tool in the surgical armamentarium with the aim to reduce the incidence of age-related complications. CONCLUSIONS: Prospective randomized controlled trial to better evaluate PF risk factors is needed.

3 Article Distal pancreatectomy with splenic preservation: A short-term outcome analysis of the Warshaw technique. 2015

Boselli, Carlo / Barberini, Francesco / Listorti, Chiara / Castellani, Elisa / Renzi, Claudio / Corsi, Alessia / Grassi, Veronica / Cacurri, Alban / Desiderio, Jacopo / Trastulli, Stefano / Santoro, Alberto / Pironi, Daniele / Burattini, Federica / Cirocchi, Roberto / Avenia, Nicola / Noya, Giuseppe / Parisi, Amilcare. ·Department of General and Oncologic Surgery, University of Perugia, Perugia, Italy. Electronic address: carloboselli@yahoo.it. · Department of General and Oncologic Surgery, University of Perugia, Perugia, Italy. Electronic address: francescobarberini@hotmail.it. · Department of General and Oncologic Surgery, University of Perugia, Perugia, Italy. Electronic address: chiaralist@gmail.com. · Department of General and Oncologic Surgery, University of Perugia, Perugia, Italy. Electronic address: elisa.ecv@gmail.com. · Department of General and Oncologic Surgery, University of Perugia, Perugia, Italy. Electronic address: renzicla@virgilio.it. · Department of General and Oncologic Surgery, University of Perugia, Perugia, Italy. Electronic address: alessia.cor@libero.it. · Department of General and Oncologic Surgery, University of Perugia, Terni, Italy. Electronic address: veronicagrassi@hotmail.it. · Department of General and Oncologic Surgery, University of Perugia, Terni, Italy. Electronic address: albancacurri@gmail.com. · Department of General and Oncologic Surgery, University of Perugia, Terni, Italy. Electronic address: djdesi85@hotmail.it. · Department of General and Oncologic Surgery, University of Perugia, Terni, Italy. Electronic address: stefano.trastulli@hotmail.it. · Department of Surgical Sciences, Sapienza University of Rome, Italy. Electronic address: albert.santoro@tiscali.it. · Department of Surgical Sciences, Sapienza University of Rome, Italy. Electronic address: danielepironi@gmail.com. · Department of General and Oncologic Surgery, University of Perugia, Perugia, Italy. Electronic address: maria.burattini@unipg.it. · Department of General and Oncologic Surgery, University of Perugia, Terni, Italy. Electronic address: roberto.cirocchi@unipg.it. · Department of General Surgery, Saint Mary Hospital, University of Perugia, Terni, Italy. Electronic address: nicolaavenia@libero.it. · Department of General and Oncologic Surgery, University of Perugia, Perugia, Italy. Electronic address: giuseppe.noya@unipg.it. · Department of Digestive Surgery, St. Maria Hospital, Terni, Italy. Electronic address: amilcareparisi@virgilio.it. ·Int J Surg · Pubmed #26118603.

ABSTRACT: INTRODUCTION: Spleen-preserving left pancreatectomy (SPDP) with splenic vessels preservation (SVP) or without (Warshaw technique, WT) has been described with robotic, laparoscopy and open surgery. Nevertheless, significant data on medium- and long-term follow-up are still not available, since data in literature are scarce and the level of evidence is low. METHODS: In this retrospective study, we describe and compare short and medium term results of spleen-preserving distal pancreatectomy in eight patients. RESULTS: In WT group the duration and the intraoperative bleeding was superior than SVP group. The incidence of perigastric collateral vessels and presence of submucosal varices evidenced at CT scan was 66% in WT group, while only one case occurred in SVP group. DISCUSSION: The limit of laparoscopic approach is the fact that it needs advanced laparoscopic skills, which might result in intraoperative bleeding and splenectomy. The most of literature considered salvage WT intraoperatively performed in case of classical SVP and not only elective WT. The consequence is that there is no difference in immediate postoperative results (operative time, intraoperative bleeding, hospital stay) that are in favour of SVP because WT is performed only in case of failure in preserving the splenic vessels. In fact when this intervention is performed electively, the procedure time is reduced as well as the intraoperative bleeding. CONCLUSIONS: WT is safe and feasible, even if there are not definitive evidences that demonstrate it is superior to classic SVP. RCTs are needed to determine advantages and disadvantages of WT compared to the classic SVP.

4 Article Retrospective analysis of short term outcomes after spleen-preserving distal pancreatectomy for sodid pseudopapillary tumours. 2015

Graziosi, Luigina / Marino, Elisabetta / Rivellini, Roberta / Ciaccio, Vincenzo / Cirocchi, Roberto / Sanguinetti, Alessandro / Hirota, Masahiko / Avenia, Nicola / Donini, Annibale. ·General and Emergency Surgery, Santa Maria della Misericordia Hospital, University of Perugia, Perugia. Electronic address: luiginagraziosi@yahoo.it. · General and Emergency Surgery, Santa Maria della Misericordia Hospital, University of Perugia, Perugia. Electronic address: elisabetta.marino1986@gmail.com. · General and Emergency Surgery, Santa Maria della Misericordia Hospital, University of Perugia, Perugia. Electronic address: roririvellini@gmail.com. · General and Emergency Surgery, Santa Maria della Misericordia Hospital, University of Perugia, Perugia. Electronic address: vincenzo.ciaccio@unipg.it. · Department of General and Oncologic Surgery, Santa Maria Hospital, University of Perugia, Terni. Electronic address: roberto.cirocchi@unipg.it. · Department of General Surgery, Santa Maria Hospital, University of Perugia, Terni. Electronic address: a.sanguinetti@aospterni.it. · Kumamoto Regional Medical Center, Japan. Electronic address: mhirota@krmc.or.jp. · Department of General Surgery, Santa Maria Hospital, University of Perugia, Terni. Electronic address: nicolaavenia@libero.it. · General and Emergency Surgery, Santa Maria della Misericordia Hospital, University of Perugia, Perugia. Electronic address: annibale.donini@unipg.it. ·Int J Surg · Pubmed #26118599.

ABSTRACT: Solid pseudopapillary pancreatic tumour (SPN) is a rare pancreatic tumour representing 0.1%-3% of all exocrine pancreatic tumours. Most SPN show benign and low-grade malignant behaviour; malignant degeneration is observed in 10-15% of the patients. More than 40% of SPN involve the tail of the pancreas leading to a minimal invasive distal pancreatectomy approach. In this report we present the case of a young 22 Caucasian woman suffering from SPN who successfully underwent laparoscopic spleen-preserving distal pancreatectomy. Postoperative course was uneventful. A CT scan control at six months was negative for recurrences. We have also made an analysis of all the laparoscopic treatment of SPN reported in English literature.

5 Article Can the measurement of amylase in drain after distal pancreatectomy predict post-operative pancreatic fistula? 2015

Cirocchi, Roberto / Graziosi, Luigina / Sanguinetti, Alessandro / Boselli, Carlo / Polistena, Andrea / Renzi, Claudio / Desiderio, Jacopo / Noya, Giuseppe / Parisi, Amilcare / Hirota, Masahiko / Donini, Annibale / Avenia, Nicola. ·Department of General and Oncologic Surgery, University of Perugia, Terni, Italy. Electronic address: roberto.cirocchi@unipg.it. · General and Emergency Surgery, Santa Maria della Misericordia Hospital, University of Perugia, Perugia, Italy. Electronic address: luiginagraziosi@yahoo.it. · Department of General Surgery, Saint Mary Hospital, University of Perugia, Terni, Italy. Electronic address: a.sanguinetti@aospterni.it. · Department of General and Oncologic Surgery, University of Perugia, Perugia, Italy. Electronic address: carloboselli@yahoo.it. · Department of General Surgery, Saint Mary Hospital, University of Perugia, Terni, Italy. Electronic address: apolis74@yahoo.it. · Department of General and Oncologic Surgery, University of Perugia, Perugia, Italy. Electronic address: renzicla@virgilio.it. · Department of General and Oncologic Surgery, University of Perugia, Terni, Italy. Electronic address: djdesi85@hotmail.it. · Department of General and Oncologic Surgery, University of Perugia, Perugia, Italy. Electronic address: giuseppe.noya@unipg.it. · Department of Digestive Surgery, St. Maria Hospital, Terni, Italy. Electronic address: amilcareparisi@virgilio.it. · Kumamoto Regional Medical Center, Japan. Electronic address: mhirota@krmc.or.jp. · General and Emergency Surgery, Santa Maria della Misericordia Hospital, University of Perugia, Perugia, Italy. Electronic address: annibale.donini@unipg.it. · Department of General Surgery, Saint Mary Hospital, University of Perugia, Terni, Italy. Electronic address: nicolaavenia@libero.it. ·Int J Surg · Pubmed #26117433.

ABSTRACT: INTRODUCTION: The most frequent reason for performing a distal pancreatectomy is the presence of cystic or neuroendocrine tumors, in which the distal pancreatic stump is often soft and non fibrotic. This parenchymal consistence represents the main risk factor for post-operative pancreatic fistula. In order to identify the fistula and assessing its severity postoperative monitoring of amylase from intraperitoneal drains is important. METHODS: From a retrospective multicentric database analysis were included 33 patients who underwent distal pancreatectomy for pancreatic neoplastic disease. RESULTS: Postoperative pancreatic fistula occurred in four cases. One patient had a ductal adenocarcinoma, two presented with pancreatic endocrine neoplasms and the last one had an intraductal papillary mucinous neoplasia. Two patients underwent open, the other two laparoscopic distal pancreatectomy. DISCUSSION: Postoperative pancreatic fistulas after distal pancreatectomy worsen the quality of life, prolong the post-operative stay and delay further adjuvant therapy. In patients who underwent distal pancreatectomy literature exposed some advantages deriving from the placement of abdominal drainages only in selected cases and from their early removal. Patients presenting a high risk of pancreatic fistula had higher amylase levels of drainage fluid in the first postoperative day. CONCLUSION: POPF is the most frequently complication after pancreatectomy. In our analysis DFA1>5000 can be considered as a predictive factor for pancreatic fistula. For this reason, the systematic measurement of amylase in drain fluid in first-postoperative day can be considered a good clinical practice.

6 Article Pancreatico-jejunal anastomosis with invaginating jenunal "J"-loop. Preliminary report of a new technique. 2014

Bugiantella, Walter / Rondelli, Fabio / Mariani, Lorenzo / Longaroni, Maurizio / Federici, Maria Teresa / Avenia, Nicola / Mariani, Enrico. ·"San Matteo degli Infermi" Hospital, AUSL Umbria 2, Via Loreto, 06049 Spoleto, Italy; University of Perugia, PhD School in Biotechnologies, Italy. Electronic address: walterbugiantella@alice.it. · University of Perugia, Department of Surgical and Biomedical Sciences, Via G. Dottori, 06100 Perugia, Italy; "San Giovanni" Bellinzona e Valli Regional Hospital, 6500 Bellinzona, Switzerland. · General Surgery, "San Giovanni Battista Hopsital", AUSL Umbria 2, Via M. Arcamone, 06034 Foligno, Italy. · University of Perugia, Department of Surgical and Biomedical Sciences, Via G. Dottori, 06100 Perugia, Italy; General and Specialized Surgery, "Santa Maria" Hospital, Via T. Di Joannuccio, 05100 Terni, Italy. ·Int J Surg · Pubmed #24879342.

ABSTRACT: INTRODUCTION: The pancreatic anastomosis is the most demanding step after pancreaticoduodenectomy (PD) and the pancreatic fistula (PF) is the most dreaded complication. Many techniques have been investigated to assess the best way to deal with the pancreatic stump after PD and none of these has shown to be superior in terms of statistically significant reduction of PF rate. We report the preliminary experience of a new technique of pancreaticojejunostomy (PJ). METHODS: Fifteen patients underwent PD for neoplasms with end-to-side PJ with dunking jejunal "J"-loop, between July 2011 and March 2014. The data about their post-operative outcomes were analyzed. RESULTS: There were no intra-operative neither post-operative deaths. One patient had a grade A PF (6.7%). Total post-operative complications occurred in 6 patients (40%), major post-operative complications occurred in 3 patients (20%). CONCLUSION: The new "sandwich" technique for dunking PJ after PD that we describe proved to be easy to perform and sure. It appears to be suitable for a dunking PJ when the diameter of the jejunum is too small than this of the pancreatic stump.