Article
Hematology
Cecilia Becattini, Ugo Pace, Felice Pirozzi, Annibale Donini, Giampiero Avruscio, Fabio Rondelli, Michela Boncompagni, Damiano Chiari, Marco De Prizio, Adriana Visona, Raffaele De Luca, Francesco Guerra, Andrea Muratore, Giuseppe Portale, Marco Milone, Giampaolo Castagnoli, Marc Righini, Jacopo Martellucci, Roberto Persiani, Stefania Frasson, Francesco Dentali, Paolo Delrio, Mauro Campanini, Gualberto Gussoni, Maria Cristina Vedovati, Giancarlo Agnelli
Summary: Rivaroxaban is more effective than placebo in extended prevention of VTE after laparoscopic surgery for colorectal cancer without increasing the risk of major bleeding.
Editorial Material
Hematology
Gerald A. Soff
Summary: The study published in Blood presents the results of PROLAPS-II trial, which investigated the efficacy and safety of extended prophylaxis with rivaroxaban after laparoscopic surgery for colorectal cancer.
Article
Surgery
Takashi Harino, Shingo Noura, Atsushi Hamabe, Takayuki Ogino, Hiroshi Takeyama, Yozo Suzuki, Tsukasa Tanida, Naohiro Tomita, Keizo Dono
Summary: Discontinuation of aspirin in laparoscopic colorectal cancer surgery increases the risk of severe thrombotic complications. Although bleeding complications significantly increased in the group continuing aspirin, thrombotic complications were significantly more frequent in the group discontinuing aspirin.
SURGICAL ENDOSCOPY AND OTHER INTERVENTIONAL TECHNIQUES
(2022)
Article
Cardiac & Cardiovascular Systems
Charles Marc Samama, Nadia Rosencher, Silvy Laporte, Philippe Girard
Summary: The risk of venous thromboembolism is low to moderate in nonmajor orthopedic surgery, with inconclusive literature and new emerging data available. Global patient risk must be considered to determine the need for prophylaxis.
TRENDS IN CARDIOVASCULAR MEDICINE
(2021)
Article
Surgery
Masayoshi Yasui, Masataka Ikeda, Taishi Hata, Shu Okamura, Yasuhiro Miyake, Hideki Sakisaka, Hidekazu Takahashi, Norikatsu Miyoshi, Mamoru Uemura, Tsunekazu Mizushima, Hirofumi Yamamoto, Kohei Murata, Yuichiro Doki, Hidetoshi Eguchi
Summary: Postoperative venous thromboembolism (VTE) is a major postoperative complication of colorectal cancer surgery, and anticoagulant prophylaxis may be necessary for high-risk patients. Factors such as blood loss and tumor location can predict the onset of proximal DVT/PE in patients with colorectal cancer after laparoscopic surgery. It is important to carefully monitor patients with rectal cancer and those with excessive blood loss during colon cancer surgery for signs of VTE, particularly proximal DVT/PE.
Article
Surgery
Qi Wei, Zheng-Qiang Wei, Chang-Qing Jing, Yong-Xiang Li, Dong-Bing Zhou, Mou-Bin Lin, Xian-Li He, Fan Li, Qian Liu, Jian-Yong Zheng, Gui-Ying Wang, Shi-Liang Tu, Zhen-Jun Wang, Ang Li, Gang Xiao, Jing Zhuang, Lian Bai, He Huang, Yong Li, Wu Song, Zhong-Lin Liang, Zhan-Long Shen, Fan-Long Liu, Yong Dai, Xiao-Jun Zhou, Ming Dong, Hui Wang, Jian Qiu, Lei Zhou, Xin-Xiang Li, Zi-Qiang Wang, Hong Zhang, Quan Wang, Ming-Hui Pang, Hong-Bo Wei, Zhi-Qian Hu, Yi-Dan Yan, Yan Che, Zhi-Chun Gu, Hong-Wei Yao, Zhong-Tao Zhang, CRC VTE Investigators
Summary: This study investigated the incidence and prevention of VTE in Chinese patients after CRC surgery and identified risk factors for developing VTE. A new scoring system was proposed for clinical decision-making and care planning. It provides important guidance for VTE prevention in patients after CRC surgery.
INTERNATIONAL JOURNAL OF SURGERY
(2023)
Article
Surgery
Carlos Cordova-Cassia, Daniel Wong, Mary B. Cotter, Thomas E. Cataldo, Vitaliy Y. Poylin
Summary: The global use of extended enoxaparin prophylaxis for colorectal surgery patients is safe but does not reduce VTE rates compared to selective use. Patient non-adherence may play a significant role in this outcome.
SURGICAL ENDOSCOPY AND OTHER INTERVENTIONAL TECHNIQUES
(2022)
Review
Orthopedics
Tao Li, Yinghao Li, Linmin Zhang, Long Pang, Xin Tang, Jing Zhu
Summary: This study summarized the incidence, risk factors, diagnosis methods, prophylaxis methods, and treatment of venous thromboembolism (VTE) following arthroscopic shoulder surgery. The incidence of VTE after arthroscopic shoulder surgeries is relatively low, and current evidence shows that chemical prophylaxis did not deliver significant benefits. CT/CTA and ultrasound were the mainstream diagnosis methods for PE and DVT, respectively. High-quality studies focusing on the prophylaxis and management of VTE population undergoing arthroscopic shoulder surgeries should be done in the future.
JOURNAL OF ORTHOPAEDIC SURGERY AND RESEARCH
(2023)
Article
Oncology
Hyung Jin Cho, In Kyu Lee, Yoon Suk Lee, Sang Seob Yun, Sun Cheol Park, Jang Yong Kim, Chul Seung Lee
Summary: This study evaluated the short- and long-term outcomes of a VTE prophylaxis program for minimally invasive colorectal cancer surgery with an ERAS protocol. The results showed a low incidence rate (0.5%) of symptomatic VTE in patients who participated in the prophylaxis program. Factors such as age, perioperative complications, and length of postoperative day were not associated with VTE onset, while TNM staging and Caprini score were significantly associated.
Review
Oncology
Pramod N. Kamalapathy, Adam Kline, Hannah Hollow, Kevin Raskin, Joseph H. Schwab, Santiago Lozano-Calderon
Summary: This study found that 4.36% of patients undergoing soft tissue sarcoma surgery developed venous thromboembolism (VTE), with significant risk factors including pre-operative and post-operative partial thromboplastin time (PTT), post-op chemotherapy, metastasis at diagnosis, additional surgery for metastasis or local recurrence, and tumor size larger than 10 cm. The use of prophylaxis medications increased the risk of wound complications and infection. Therefore, there is a need for further research to establish risk factors and guidelines for prophylactic treatment of VTE in patients undergoing soft tissue sarcoma surgery.
Article
Pediatrics
Hannah R. Spiegl, Jeremie H. Estepp, Chen Li, Sebastian Gil, Ankush Gosain, Andrew J. Murphy, Andrew M. Davidoff
Summary: The study aimed to assess the incidence of DVT in pediatric cancer patients undergoing select surgical procedures, with an overall incidence of post-operative DVT at 0.46%. Findings suggest that surgery does not significantly increase the risk of DVT in children with cancer, indicating routine pharmacologic prophylaxis may not be warranted.
JOURNAL OF PEDIATRIC SURGERY
(2021)
Article
Gastroenterology & Hepatology
Fenella K. S. Welsh, Caoimhe M. Walsh, Kandiah Chandrakumaran, Wasula S. Rathnaweera, Ashok Roy, Jane Needham, Adrian B. Cresswell, John H. McVey, Myrddin Rees
Summary: This study observed patients undergoing hepatectomy for colorectal metastases and found that there is a risk of thrombosis before the surgery, which is further increased by the hepatectomy. Based on the results, it is suggested that chemical thromboprophylaxis should be considered early in the patient pathway.
Article
Hematology
F. Abu Saadeh, Z. Marchocki, S. A. O'Toole, N. Ibrahim, N. Gleeson, L. A. Norris
Summary: The study found that extended prophylaxis did not significantly reduce VTE rates in gynaecological cancer patients post surgery. In many patients receiving a fixed LMWH dose, peak anti-Xa levels may be suboptimal.
THROMBOSIS RESEARCH
(2021)
Article
Surgery
Henry J. J. Stitzel, Jonathan J. J. Hue, Mohamedraed Elshami, Lauren McCaulley, Richard S. S. Hoehn, Luke D. D. Rothermel, John B. B. Ammori, Jeffrey M. M. Hardacre, Jordan M. M. Winter, Lee M. M. Ocuin
Summary: This study aimed to compare rates of venous thromboembolism (VTE) and postpancreatectomy hemorrhage (PPH) in patients with pancreatic or periampullary malignancy before and after the implementation of routine extended VTE prophylaxis. The results showed that extended VTE prophylaxis did not significantly affect the rates of postdischarge VTE and PPH. These findings suggest that extended VTE prophylaxis may not be necessary for all patients undergoing pancreatectomy.
Article
Anesthesiology
Megan Fiasconaro, Jashvant Poeran, Jiabin Liu, Lauren A. Wilson, Stavros G. Memtsoudis
Summary: There is currently no consensus on perioperative VTE prophylaxis for spine surgery patients. A study using national data found that aspirin and regular heparin were associated with increased odds of blood transfusion, but all three anticoagulants had similar incidence of VTE and hematoma. Consideration of subgroup-specific VTE risks may help identify patients who could benefit most from thromboprophylaxis.
CANADIAN JOURNAL OF ANESTHESIA-JOURNAL CANADIEN D ANESTHESIE
(2021)
Article
Surgery
Emanuele Damiano Luca Urso, Filippo Crimi, Giorgio Rivella, Francesco Celotto, Pietro Zucchetta, Laura Albertoni, Salvatore Pucciarelli, Quoc Riccardo Bao
Summary: This study reports a rare case of duodenal lesion in a 41-year-old female patient, which was evaluated for malignant potential and treatment planning using clinical staging and (18)FDG PET/MRI. Robotic transduodenal excision was performed based on the findings. The study suggests that accurate staging with (18)FDG PET/MRI can be very useful in the management of duodenal lesions with uncertain malignant potential.
Article
Pathology
Paola Parente, Umberto Malapelle, Valentina Angerilli, Mariangela Balistreri, Sara Lonardi, Salvatore Pucciarelli, Caterina De Luca, Francesco Pepe, Gianluca Russo, Elena Vigliar, Angela Danza, Fabio Scaramuzzi, Giancarlo Troncone, Paolo Graziano, Matteo Fassan
Summary: This study assessed the concordance rate of MMR/MSI status between primary mucinous adenocarcinoma (MA) and synchronous metastasis. The results showed high concordance rates using different evaluation methods. Therefore, integrating immunohistochemistry evaluation and molecular methods may be beneficial for molecular profiling of MA patients.
JOURNAL OF CLINICAL PATHOLOGY
(2023)
Article
Gastroenterology & Hepatology
Valentina Mari, Valentina Angerilli, Giada Munari, Marco Scarpa, Quoc Riccardo Bao, Salvatore Pucciarelli, Matteo Fassan, Gaya Spolverato
Summary: This review outlines the molecular pathways involved in peritoneal metastatic dissemination in gastric cancer, highlighting the lack of comprehensive understanding of the complex molecular landscape of this disease. The integration of molecular profiling and histological evaluation is recommended for risk prediction assessment of peritoneal dissemination.
DIGESTIVE DISEASES
(2023)
Article
Surgery
Maurizio Degiuli, Monica Ortenzi, Mariano Tomatis, Lucia Puca, Desiree Cianflocca, Daniela Rega, Annalisa Maroli, Ugo Elmore, Francesca Pecchini, Marco Milone, Roberta La Mendola, Erica Soligo, Simona Deidda, Domenico Spoletini, Diletta Cassini, Alessandra Aprile, Michela Mineccia, Herald Nikaj, Francesco Marchegiani, Fabio Maiello, Cristina Bombardini, Michele Zuolo, Michele Carlucci, Luca Ferraro, Armando Falato, Alberto Biondi, Roberto Persiani, Patrizia Marsanich, Daniele Fusario, Leonardo Solaini, Sara Pollesel, Gianluca Rizzo, Claudio Coco, Alberto Di Leo, Davide Cavaliere, Franco Roviello, Andrea Muratore, Domenico D'Ugo, Francesco Bianco, Paolo Pietro Bianchi, Paola De Nardi, Marco Rigamonti, Gabriele Anania, Claudio Belluco, Roberto Polastri, Salvatore Pucciarelli, Sergio Gentilli, Alessandro Ferrero, Stefano Scabini, Gianandrea Baldazzi, Massimo Carlini, Angelo Restivo, Silvio Testa, Dario Parini, Giovanni Domenico De Palma, Micaela Piccoli, Riccardo Rosati, Antonino Spinelli, Paolo Delrio, Felice Borghi, Marco Guerrieri, Rossella Reddavid
Summary: This study investigated the efficacy and short-term outcomes of minimally invasive (MI) and open treatment for splenic flexure cancer (SFC). The results showed that MI was noninferior to open procedure in terms of postoperative complications and pathological outcomes in SFC patients.
SURGICAL ENDOSCOPY AND OTHER INTERVENTIONAL TECHNIQUES
(2023)
Article
Gastroenterology & Hepatology
Simona Deidda, Gaya Spolverato, Giulia Capelli, Riccardo Quoc Bao, Lorenzo Bettoni, Filippo Crimi, Luigi Zorcolo, Salvatore Pucciarelli, Angelo Restivo
Summary: This study retrospectively reviewed the clinical restaging of rectal cancer after neoadjuvant therapy, and found limitations in accurately detecting the complete pathological response to treatment. Current clinical assessments need to be revised to account for indications for rectal preservation after neoadjuvant chemoradiotherapy.
DISEASES OF THE COLON & RECTUM
(2023)
Article
Medicine, General & Internal
Maria Cristina Vedovati, Mara Graziani, Giancarlo Agnelli, Cecilia Becattini
Summary: This study aimed to evaluate the efficacy and safety of standard or higher heparin regimens for the prevention of venous thromboembolism (VTE) in hospitalized patients with COVID-19. The study found that high-dose heparin prophylaxis reduces the risk of VTE but increases the risk of major bleeding (MB). High-dose heparin did not show clinical benefit in the ICU setting but may have some benefit in the non-ICU setting.
INTERNAL AND EMERGENCY MEDICINE
(2023)
Review
Oncology
Quoc Riccardo Bao, Stefania Ferrari, Giulia Capelli, Cesare Ruffolo, Marco Scarpa, Amedea Agnes, Giuditta Chiloiro, Elisa Palazzari, Emanuele Damiano Luca Urso, Salvatore Pucciarelli, Gaya Spolverato
Summary: With the increasing rate of complete response after neoadjuvant treatment for locally advanced rectal cancer, there has been growing interest in rectal-sparing approaches such as local excision and Watch and Wait. This study aimed to systematically review the literature and compare these approaches in terms of rectum-preservation rate, local control, and distant recurrences. The findings showed no significant differences between Watch and Wait and local excision in these outcomes. Rating: 7/10
Letter
Hematology
Michela Giustozzi, Cecilia Becattini, Fausto Roila, Giancarlo Agnelli, Mario Mandala
Article
Medicine, General & Internal
Maria Cristina Vedovati, Michela Giustozzi, Andres Munoz, Laurent Bertoletti, Alexander T. Cohen, Frederikus A. Klok, Jean M. Connors, Rupert Bauersachs, Benjamin Brenner, Mauro Campanini, Cecilia Becattini, Giancarlo Agnelli
Summary: Patients with cancer-associated venous thromboembolism (VTE) face high risks of recurrence and treatment-emergent bleeding, but factors associated with these risks are not well-defined. This study analyzed patients included in the Caravaggio study to identify risk factors for recurrent VTE and major bleeding in cancer-associated VTE. Independent risk factors for recurrent VTE included deep vein thrombosis as the initial event, ECOG status of 1 or more, pancreatic or hepatobiliary cancer site, concomitant anti-cancer treatment, and creatinine clearance. Independent risk factors for major bleeding included ECOG status of 2, genitourinary or upper gastrointestinal cancer site, and non-resected luminal gastrointestinal cancer. Understanding these predictors can help optimize anticoagulant treatment in cancer-associated VTE patients.
EUROPEAN JOURNAL OF INTERNAL MEDICINE
(2023)
Article
Gastroenterology & Hepatology
Quoc Riccardo Bao, Isabella Frigerio, Marzia Tripepi, Stefano Marletta, Guido Martignoni, Alessandro Giardino, Paolo Regi, Filippo Scopelliti, Valentina Allegrini, Roberto Girelli, Salvatore Pucciarelli, Gaya Spolverato, Giovanni Butturini
Summary: This study aimed to evaluate the impact of major pathological response on overall survival in patients with borderline resectable and locally advanced pancreatic ductal adenocarcinoma following neoadjuvant treatment, and to identify predictors of major pathological response. The study included 200 patients who underwent surgical resection after neoadjuvant treatment. The results showed that patients with major pathological response had higher overall survival rates compared to those without major pathological response. CA19-9 normalization and radiological post-treatment tumor size were found to be independent predictors of major pathological response.
Article
Pathology
Federica Zannier, Valentina Angerilli, Gaya Spolverato, Stefano Brignola, Daniele Sandona, Mariangela Balistreri, Marianna Sabbadin, Sara Lonardi, Francesca Bergamo, Claudia Mescoli, Marco Scarpa, Quoc Riccardo Bao, Angelo Paolo Dei Tos, Salvatore Pucciarelli, Emanuele L. D. Urso, Matteo Fassan
Summary: This study aimed to compare the pathological and clinical characteristics of MMR-deficient (MMRd) tumors and MMR proficient (MMRp) cases, with a particular focus on the relationship between these molecular subgroups and lymph node ratio (LNR). The study found significant differences between MMRd and MMRp tumors in terms of sex, age, size, growth pattern, inflammatory infiltrate, perineural invasion, stage, grade, and LNR. In conclusion, MMRd tumors are a distinct molecular subtype of colorectal cancer characterized by a significantly lower LNR, further supporting the prognostic impact of MMRd status in early-stage CRC.
PATHOLOGY RESEARCH AND PRACTICE
(2023)
Article
Surgery
Imerio Angriman, Silvia Degasperi, Claudia Mescoli, Carmelo Lacognata, Claudia Armellin, Antonino Caruso, Federico Scognamiglio, Matteo Fassan, Renata D'Inca, Edoardo Savarino, Fabiana Zingone, Gaya Spolverato, Salvatore Pucciarelli, Romeo Bardini, Cesare Ruffolo, Marco Scarpa
Summary: This retrospective study analyzed the intestinal and systemic inflammation after surgery in Crohn's disease patients with strictures where the diseased bowel was left behind. The results showed that the intestinal inflammatory activity decreased even with the preservation of the diseased bowel, but the presence of the diseased bowel increased the risk of reoperation.
Article
Nutrition & Dietetics
Alice Zaramella, Diletta Arcidiacono, Daniele Nucci, Federico Fabris, Clara Benna, Salvatore Pucciarelli, Matteo Fassan, Alberto Fantin, Valli De Re, Renato Cannizzaro, Stefano Realdon
Summary: Esophageal adenocarcinoma (EAC) is a consequence of long-term gastroesophageal reflux, which leads to inflammation and could cause Barrett's esophagus (BE), the main risk factor for EAC development. The study aims to explore the esophageal microbial profile in patients with different stages of BE and EAC, and develop a score to predict cancer risk.
Review
Cardiac & Cardiovascular Systems
Marco Zuin, Cecilia Becattini, Gregory Piazza
Summary: The present article aims to identify the current unmet needs related to the early identification of intermediate-high risk PE patients at higher risk of clinical deterioration and mortality during the early hours after the acute cardiovascular event and suggest some potential strategies to further explore gaps in the literature.
EUROPEAN HEART JOURNAL-ACUTE CARDIOVASCULAR CARE
(2023)
Article
Surgery
Gaya Spolverato, Matteo Fassan, Melania Scarpa, Astghik Stepanyan, Ottavia De Simoni, Federico Scognamiglio, Valentina Chiminazzo, Clarissa De Nardi, Giulia Tamponi, Silvia Negro, Imerio Angriman, Andromachi Kotsafti, Cesare Ruffolo, Chiara Vignotto, Maurizio Zizzo, Francesco Marchegiani, Luca Facci, Francesca Bergamo, Stefano Brignola, Gianluca Businello, Vincenza Guzzardo, Luca Dal Santo, Roberta Salmaso, Carlotta Ceccon, Marco Massani, Anna Pozza, Ivana Cataldo, Tommaso Stecca, Angelo Paolo Dei Tos, Vittorina Zagonel, Pierluigi Pilati, Boris Franzato, Antonio Scapinello, Giovanni Pirozzolo, Alfonso Recordare, Roberto Merenda, Giovanni Bordignon, Licia Laurino, Silvio Guerriero, Chiara Romiti, Giuseppe Portale, Chiara Cipollari, Salvatore Candioli, Laura Gavagna, Giulia Pozza, Mario Godina, Isabella Mondi, Giulia Noaro, Monica Ortenzi, Mario Guerrieri, Giovanni Tagliente, Monica Tomassi, Umberto Tedeschi, Andrea Porzionato, Marco Agostini, Isacco Maretto, Quoc Riccardo Bao, Francesco Cavallin, Barbara Di Camillo, Romeo Bardini, Ignazio Castagliuolo, Salvatore Pucciarelli, Marco Scarpa
Summary: The study found that early-onset rectal cancer is rarely associated with common hereditary syndromes. The tumor microenvironment is characterized by a high frequency of mutations impairing the local immune surveillance mechanisms and low expression of immune editing-related genes. A constitutively low number of CD4 T cells associated with a high number of T regulators indicates an imbalance in the immune surveillance mechanisms.
BRITISH JOURNAL OF SURGERY
(2023)
