Pogliani Dott. Luca
Pubblicazioni su PubMed
-
Management of COVID-19-related post-intubation tracheal stenosis.
Front Surg2023 ;10():1129803. doi: 1129803.
Conforti Serena, Licchetta Gloria, Reda Marco, Astaneh Arash, Pogliani Luca, Fieschi Stefano, Rinaldo Alessandro, Torre Massimo
Abstract
INTRODUCTION:
The Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) pandemic has affected Italy since the beginning of 2020. Endotracheal intubation, prolonged mechanical ventilation, and tracheostomy are frequently required in patients with severe COVID-19. Tracheal stenosis is a potentially severe condition that can occur as a complication after intubation. The aim of this study was to evaluate the utility and safety of endoscopic and surgical techniques in the treatment of tracheal stenosis related to COVID-19.
MATERIALS AND METHODS:
Between June 2020 and May 2022, consecutive patients with tracheal stenosis who were admitted to our surgical department were considered eligible for participation in the study.
RESULTS:
A total of 13 patients were included in the study. They consisted of nine women (69%) and four men (31%) with a median age of 57.2 years. We included seven patients with post-tracheostomy tracheal stenosis. Bronchoscopy was performed to identify the type, location, and severity of the stenosis. All patients underwent bronchoscopic dilation and surveillance bronchoscopy at 7 and 30 days after the procedure. We repeated endoscopic treatment in eight patients. Three patients underwent tracheal resection anastomosis. Final follow-up bronchoscopy demonstrated no residual stenosis.
CONCLUSIONS:
The incidence of and risk factors associated with tracheal stenosis in critically ill patients with COVID-19 are currently unknown. Our experience confirms the efficacy and safety of endoscopic management followed by surgical procedures in cases of relapsed tracheal stenosis.
© 2023 Conforti, Licchetta, Reda, Astaneh, Pogliani, Fieschi, Rinaldo and Torre.
Guarda su PubMed
-
Prognostic factors for survival in patients with lung metastases from gynaecological tract cancers.
Interact Cardiovasc Thorac Surg2022 Jan;34(1):66-73. doi: 10.1093/icvts/ivab216.
Chiappetta Marco, Gallotta Valerio, Pogliani Luca, Zanfrini Edoardo, Fagotti Anna, Ferrandina Gabriella, Fanfani Francesco, Nachira Dania, Meacci Elisa, Congedo Maria Teresa, Lococo Filippo, Giudice Maria Teresa, Scambia Giovanni, Margaritora Stefano
Abstract
OBJECTIVES:
Lung metastases from gynaecological tract cancers are rare, and prognostic factors are still undefined. The goal of this study was to analyse prognostic factors for survival in this group of patients.
METHODS:
Data of patients with lung metastases from gynaecological tract cancers who underwent surgical resections from 1 January 2005 to 31 May 2019 were reviewed retrospectively. All patients were treated surgically if the primitive tumour was under control and the lung was the only organ involved. Clinical and pathological data associated with metastatic patterns and previous treatment types were correlated with overall survival (OS) and disease-free survival using Kaplan-Meier curves, whereas the log-rank test was used to assess differences between subgroups.
RESULTS:
The analysis was conducted on 55 patients. OS was 65% at 5?years. With univariable analysis, age >45?years (P?=?0.022) and the absence of pleural infiltration (P?=?0.001) were determined to be favourable prognostic factors. The 5-year OS was 69.9% versus 53.3% in patients with pleural involvement. Multivariable analysis confirmed the absence of pleural infiltration as a favourable independent prognostic factor; the hazard ratio was 0.06; the 95% confidence interval was 0.00-0.23 (P?=?0.011).At univariable analysis, the absence of pleural infiltration was determined to be a favourable prognostic factor (P?=?0.034) for disease-free survival. The numbers and dimensions of the metastases did not influence survival in these patients.In uterine cancers of endometrial or cervical origin, the presence of pleural infiltration (P?=?0.001), lymph node involvement (P?=?0.001) and young age (P?=?0.044) were considered unfavourable prognostic factors for OS.
CONCLUSIONS:
Surgical treatment in technically resectable gynaecological tract metastases may represent an important option. Pleural infiltration and lymph node metastases seem to be adverse prognostic factors.
© The Author(s) 2021. Published by Oxford University Press on behalf of the European Association for Cardio-Thoracic Surgery. All rights reserved.
Guarda su PubMed
-
Masaoka-Koga and TNM Staging System in Thymic Epithelial Tumors: Prognostic Comparison and the Role of the Number of Involved Structures.
Cancers (Basel)2021 Oct;13(21):. doi: 5254.
Chiappetta Marco, Lococo Filippo, Pogliani Luca, Sperduti Isabella, Tabacco Diomira, Bria Emilio, D'Argento Ettore, Massaccesi Mariangela, Boldrini Luca, Meacci Elisa, Porziella Venanzio, Nachira Dania, Congedo Maria Teresa, Margaritora Stefano
Abstract
BACKGROUND:
The aim of this study was to evaluate the Masaoka-Koga and the tumor node metastases (TNM) staging system in thymic epithelial tumors (TET) considering possible improvements.
METHODS:
We reviewed the data of 379 patients who underwent surgical resection for TET from 1 January 1985 to 1 January 2018, collecting and classifying the pathological report according to the Masaoka-Koga and the TMN system. The number of involved organs was also considered as a possible prognostic factor and integrated in the two staging systems to verify its impact.
RESULTS:
Considering the Masaoka-Koga system, 5- and 10-year overall survival (5-10YOS) was 96.4% and 88.9% in stage I, 95% and 89.5% in stage II and 85.4% and 72.8% in stage III ( 0.01), with overlapping in stage I and stage II curves. Considering the TNM system, 5-10YOS was 95.5% and 88.8% in T1, 84.8% and 70.7% in T2 and 88% and 76.3% in T3 ( 0.02), with overlapping T2-T3 curves. Including the number of involved structures, in Masaoka-Koga stage III, patients with singular involved organs had a 100% and 76.6% vs. 87.7% 5-10YOS, which was 76.6% in patients with multiple organ infiltration. Considering the TNM, T3 patients with singular involved structures presented a 5-10YOS of 100% vs. 62.5% and 37.5% in patients with multiple organ involvement ( 0.07).
CONCLUSION:
The two staging systems present limitations due to overlapping curves in early Masaoka-Koga stages and in advanced T stages for TNM. The addition of the number of involved organs seems to be a promising factor for the prognosis stratification in these patients.
Guarda su PubMed
-
Thulium cyber laser-assisted uniportal thoracoscopic resection of a pulmonary metastasis from colorectal cancer.
Minerva Chir2020 Dec;75(6):475-477. doi: 10.23736/S0026-4733.20.08416-3.
Lococo Filippo, Iaffaldano Amedeo, Zanfrini Edoardo, Pogliani Luca, Tabacco Diomira, Sassorossi Carolina, Mazzarella Ciro, Margaritora Stefano
Guarda su PubMed
-
Factors Affecting Long-Term Survival in Locally Advanced NSCLC Patients With Pathologic Complete Response After Induction Therapy Followed by Surgical Resection.
Clin Lung Cancer2021 Jul;22(4):e542-e543. doi: 10.1016/j.cllc.2020.06.023.
Sassorossi Carolina, Lococo Filippo, Pogliani Luca, Tabacco Diomira, Iaffaldano Amedeo, Zanfrini Edoardo, Nachira Dania, Margaritora Stefano
Guarda su PubMed
-
Uniportal VATS approach to sub-lobar anatomic resections: literature review and personal experience.
J Thorac Dis2020 Jun;12(6):3376-3389. doi: 10.21037/jtd.2020.01.12.
Meacci Elisa, Nachira Dania, Zanfrini Edoardo, Triumbari Elizabeth Katherine Anna, Iaffaldano Amedeo Giuseppe, Congedo Maria Teresa, Petracca Ciavarella Leonardo, Pogliani Luca, Chiappetta Marco, Porziella Venanzio, Gonzalez-Rivas Diego, Vita Maria Letizia, Margaritora Stefano
Abstract
Surgical scientific literature contains relatively little information regarding the surgical outcomes of anatomic sublobar resections performed with the uniportal video-assisted thoracoscopic surgery (U-VATS) technique. This paper attempts to evaluate the role of U-VATS segmentectomies in the landscape of a minimally invasive approach to the treatment of early stage non small cell lung cancer (NSCLC).
2020 Journal of Thoracic Disease. All rights reserved.
Guarda su PubMed
-
Surgical treatment of primary spontaneous pneumothorax: what is better to do?
J Thorac Dis2020 Apr;12(4):1274-1276. doi: 10.21037/jtd.2020.03.40.
Nachira Dania, Meacci Elisa, Congedo Maria Teresa, Pogliani Luca, Chiappetta Marco, Vita Maria Letizia, Margaritora Stefano
Guarda su PubMed
-
Chest ultrasound in post-operative management: the needed to rethink our perspective?
J Thorac Dis2019 Sep;11(Suppl 15):S2039-S2040. doi: 10.21037/jtd.2019.08.75.
Chiappetta Marco, Pogliani Luca, Nachira Dania, Vita Maria Letizia, Margaritora Stefano
Guarda su PubMed
-
A 46-Year-Old Woman With an Uncommon Case of Massive Pneumothorax.
Chest2019 Feb;155(2):e25-e28. doi: 10.1016/j.chest.2018.10.051.
Chiappetta Marco, Ferretti Gian Maria, Pogliani Luca, Zanfrini Edoardo, Iaffaldano Amedeo, Nachira Dania, Margaritora Stefano
Abstract
A 46-year-old woman arrived at our ED for the worsening of a thoracic pain localized in the left interscapulo-vertebral region that she had been commenting on for the past few days. Anamnestic data were collected; vital parameters, blood tests, and ECG were normal.
Copyright © 2018 American College of Chest Physicians. Published by Elsevier Inc. All rights reserved.
Guarda su PubMed
-
Initial experience with uniportal video-assisted thoracic surgery esophagectomy.
J Thorac Dis2018 Nov;10(Suppl 31):S3686-S3695. doi: 10.21037/jtd.2018.04.17.
Nachira Dania, Meacci Elisa, Mastromarino Maria Giovanna, Pogliani Luca, Zanfrini Edoardo, Iaffaldano Amedeo, Petracca-Ciavarella Leonardo, Chiappetta Marco, Congedo Maria Teresa, Vita Maria Letizia, Porziella Venanzio, Margaritora Stefano
Abstract
BACKGROUND:
Multiportal thoracoscopic approach is already a well standardized procedure for minimally invasive esophagectomy (MIE); conversely very few reports have been published about uniportal video-assisted thoracic surgery (VATS) technique till now. We present our preliminary experience with uniportal VATS esophagectomy, evaluating short-term outcomes as perioperative mortality, complications, oncological radicality, postoperative pain and cosmetic results.
METHODS:
From December 2016 to November 2017, the prospectively collected clinical data of 12 patients, who underwent uniportal VATS esophagectomy and reconstruction with a stomach conduit, according to McKeown technique, were reviewed and outcomes evaluated.
RESULTS:
The mean age of population was 60.67±8.61 years. Ten (83.3%) patients were males. The main histological type was a squamous cell carcinoma in six patients (50%). No patient had a local recurrence. After 4.33±3.31 months 10 patients (83.3%) were alive with no evidence of disease; 2 (16.7%) patients died of other causes. Two (16.7%) patients developed an anastomotic leak (treated conservatively) and one (8.3%) patient a chylothorax (which required a surgical treatment). The mean operative time of uniportal VATS esophagectomy was 104.67±20.66 min. Mean number of thoracic nodes removed was 10.44±3.94. Post-operative hospitalization was 15.73±14.29 days (median of 9 days). The mean level of pain was 1.92±0.90 in first postoperative day with a duration of 2.25±1.54 days. Cosmetic result was 2.42±0.79 on a 3-point scale.
CONCLUSIONS:
Uniportal VATS esophagectomy seems to be a safe, feasible and effective alternative to multiportal VATS in terms of operative time, postoperative mortality, hospital stay and oncological outcomes. Less postoperative pain and better cosmetic results seem to be some advantages in favor of Uniportal VATS, however further studies with longer follow-up are claimed.
Guarda su PubMed
-
Polyarteritis nodosa and acute abdomen: A role for laparoscopy?
Int J Surg Case Rep2015 ;17():161-3. doi: 10.1016/j.ijscr.2015.11.007.
Asti Emanuele, Pogliani Luca, Tritella Stefania, Bonavina Luigi
Abstract
Mesenteric vasculitis secondary to polyarteritis nodosa represents an atypical but potentially life-threatening cause of bowel ischemia and acute abdomen. The patient presented with severe abdominal pain of recent onset, pitting edema of the legs, renal failure and bowel wall thickening suggestive of mesenteric ischemia on CT scan. Early laparoscopy allowed to rule out proximal bowel necrosis and resection was avoided. The patient was successfully managed with corticosteroid therapy and repeated hemodialysis sessions.
Copyright © 2015 The Authors. Published by Elsevier Ltd.. All rights reserved.
Guarda su PubMed
