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| 1 | Laparoscopic rectal cancer surgery: Where do we stand?显示文摘Large comparative studies and multiple prospective randomized control trials (RCTs) have reported equivalence in short and long-term outcomes between the open and laparoscopic approaches for the surgical treatment of colon cancer which has heralded widespread acceptance for laparoscopic resection of colon cancer. In contrast, laparoscopic total mesorectal excision (TME) for the treatment of rectal cancer has been welcomed with significantly less enthusiasm. While it is likely that patients with rectal cancer will experience the same benefits of early recovery and decreased postoperative pain from the laparoscopic approach, whether the same oncologic clearance, specifically an adequate TME can be obtained is of concern. The aim of the current study is to review the current level of evidence in the literature on laparoscopic rectal cancer surgery with regard to short-term and long-term oncologic outcomes. The data from 8 RCTs, 3 metaanalyses, and 2 Cochrane Database of Systematic Reviews was reviewed. Current data suggests that laparoscopic rectal cancer resection may benefit patients with reduced blood loss, earlier return of bowel function, and shorter hospital length of stay. Concerns that laparoscopic rectal cancer surgery compromises short-term oncologic outcomes including number of lymph nodes retrieved and circumferential resection margin and jeopardizes long-term oncologic outcomes has not conclusively been refuted by the available literature. Laparoscopic rectal cancer resection is feasible but whether or not it compromises short-term or long-term results still needs to be further studied. | Mukta K Krane Alessandro Fichera | 2012 | World Journal of Gastroenterology2012，18，46： | 11 |
| 2 | Surgical treatment of ulcerative colitis:Ileorectal vs ileal pouch-anal anastomosis显示文摘Total proctocolectomy with ileal pouch-anal anastomosis(IPAA) is the current gold standard in the surgical treatment of ulcerative colitis(UC) refractory to medical management. A procedure of significant magnitude carries its own risks including anastomotic failure, pelvic sepsis and a low rate of neoplastic degeneration overtime. Recent studies have shown that total colectomy with ileorectal anastomosis(IRA) has been associated with good long-term functional results in a selected group of UC patients amenable to undergo a strict surveillance for the relatively high risk of cancer in the rectum. This manuscript will review and compare the most recent literature on IRA and IPAA as it pertains to postoperative morbidity and mortality, failure rates, functional outcomes and cancer risk. | Daniele Scoglio Usama Ahmed Ali Alessandro Fichera | 2014 | World Journal of Gastroenterology2014，20，37： | 9 |
| 3 | Surgical treatment of ulcerative colitis in the biologic therapy era显示文摘Recently introduced in the treatment algorithms and guidelines for the treatment of ulcerative colitis,biological therapy is an effective treatment option for patients with an acute severe flare not responsive to conventional treatments and for patients with steroid dependent disease.The reduction in hospitalization and surgical intervention for patients affected by ulcerative colitis after the introduction of biologic treatment remains to be proven.Furthermore,these agents seem to be associated with increase in cost of treatment and risk for serious postoperative complications.Restorative proctocolectomy with ileal pouch-anal anastomosis is the surgical treatment of choice in ulcerative colitis patients.Surgery is traditionally recommended as salvage therapy when medical management fails,and,despite advances in medical therapy,colectomy rates remain unchanged between 20% and 30%.To overcome the reported increase in postoperative complications in patients on biologic therapies,several surgical strategies have been developed to maintain long-term pouch failure rate around 10%,as previously reported.Surgical staging along with the development of minimally invasive surgery are among the most promising advances in this field. | Alberto Biondi Marco Zoccali Stefano Costa Albert Troci Ettore Contessini-Avesani Alessandro Fichera | 2012 | World Journal of Gastroenterology2012，18，16： | 8 |
| 4 | Anal transition zone in the surgical management of ulcerative colitis显示文摘Preservation of the anal transition zone has long been a significant source of controversy in the surgical management of ulcerative colitis.The two techniques for restorative proctocolectomy and ileal pouch anal anastomosis(RPC IPAA) in common practice are a stapled anastomosis and a handsewn anastomosis;these techniques differ in the amount of remaining rectal mucosa and therefore the presence of the anal transition zone following surgery.Each technique has advantages and disadvantages in long-term functional outcomes,operative and postoperative complications,and risk of neoplasia.Therefore,we propose a selective approach to performing a stapled RPC IPAA based on the presence of dysplasia in the preoperative endoscopic evaluation. | Jennifer Holder-Murray Alessandro Fichera | 2009 | World Journal of Gastroenterology2009，15，7： | 5 |
| 5 | Inflammatory bowel disease surgery in the biologic era显示文摘Anti-tumour necrosis factor(TNF)-α therapy has revolutionized inflammatory bowel disease(IBD) treatment. Infliximab and adalimumab either as monotherapy or in combination with an immunomodulator are able to induce clinical and biological remission in patients with moderate and severe Crohn's disease(CD) and ulcerative colitis(UC). These new therapies have led to a shift in the goals of IBD management from just controlling clinical symptoms to preventing disease progression. However, despite these advances in medical therapy, surgery is still required in 30%-40% of patients with CD and 20%-30% of patients with UC at some point during their lifetime. While biologics certainly play a major role in the medical treatment of IBD, there is concern about the effects of these anti-TNF-α agents on postoperative complications and morbidity. The purpose of this article is to review the role of surgery in the treatment of IBD in the age of biologics and the impact of these medications on per-operative outcomes. In this manuscript we review the relationship between biologic agents and surgery in the treatment of IBD. We also discuss in detail the periopetative risks and complications. | Linda Ferrari Mukta K Krane Alessandro Fichera | 2016 | World Journal of Gastrointestinal Surgery2016，8，5： | 4 |
| 6 | Modern Rectal Cancer Multidisciplinary Treatment: The Role of Radiation and Surgery显示文摘 | Marco E. Allaix Alessandro Fichera | 2013 | Annals of Surgical Oncology2013，，9： | 4 |
| 7 | Diverting colostomy is an effective and reversible option for severe hemorrhagic radiation proctopathy显示文摘A total of 738 continual CRP patients were screened.After exclusion,14 patients in the colostomy group and 25 in the conservative group were included in the final analysis.Preoperative Hb was only 63 g/L±17.8 g/L in the colostomy group compared to 88.2 g/L±19.3 g/L(P<0.001)in the conservative group.All 14 patients in the former group achieved complete remission of bleeding,and the colostomy was successfully reversed in 13 of 14(93%),excepting one very old patient.The median duration of stoma was 16(range:9-53)mo.The Hb level increased gradually from 75 g/L at 3 mo,99 g/L at 6 mo,and 107 g/L at 9 mo to 111 g/L at 1 year and 117 g/L at 2 years after the stoma,but no bleeding cessation or significant increase in Hb levels was observed in the conservative group.Endoscopic telangiectasia and bleeding were greatly improved.Endoultrasound showed decreased vascularity,and magnetic resonance imaging revealed an increasing presarcal space and thickened rectal wall.Anorectal functions and quality of life were significantly improved after stoma reversal,when compared to those before stoma creation.CONCLUSION Diverting colostomy is a very effective method in the remission of refractory hemorrhagic CRP.Stoma can be reversed,and anorectal functions can be recovered after reversal. | Zi-Xu Yuan Qi-Yuan Qin Miao-Miao Zhu Qing-Hua Zhong Alessandro Fichera Hui Wang Huai-Ming Wang Xiao-Yan Huang Wu-Teng Cao Ye-Biao Zhao Lei Wang Teng-Hui Ma | 2020 | World Journal of Gastroenterology2020，26，8： | 3 |
| 8 | 直肠癌新辅助放化疗和病理完全缓解显示文摘在过去几十年里,直肠癌的治疗已有了很大的进展,其中最为显著的要属20世纪90年代全直肠系膜切除术(TME)的问世和新辅助放化疗(CRT)的应用。临床Ⅰ级证据显示,新辅助放化疗(CRT)可使局部复发率降至6%以下,CRT也就此成为了目前直肠癌的标准治疗模式。CRT可使肿瘤降期,其中15%–27%的患者可以获得病理完全缓解(pCR),意味着CRT后在组织学标本中无任何肿瘤残留。CRT后获得pCR的患者预后良好,局部复发和远处转移风险下降,生存时间延长。因此,积极保留括约肌或保留器官的手术方式如局部切除术在直肠癌治疗中得以更多的应用,甚至非手术治疗也成为可能。尽管多学科综合治疗可使局部进展期直肠癌的局部复发率稳定在5%–6%,但其远处转移率却仍然高达25%以上,这也是患者的主要死因。因此,最近一些研究采用新辅助全量系统化疗以早期治疗远处微转移灶,从而提高肿瘤的系统控制率,仅对化疗无应答者或低位直肠癌(距肛缘不足5 cm)进行术前放疗。 | Linda Ferrari Alessandro Fichera | 2015 | Gastroenterology Report2015，3，4： | 2 |
| 9 | Robotic-Assisted Proctectomy for Inflammatory Bowel Disease: A Case-Matched Comparison of Laparoscopic and Robotic Technique显示文摘 | Aaron T. Miller Julia R. Berian Michele Rubin Roger D. Hurst Alessandro Fichera Konstantin Umanskiy | 2012 | Journal of Gastrointestinal Surgery2012，，： | 1 |
| 10 | Laparoscopic Restorative Proctocolectomy with Ileal Pouch Anal Anastomosis: A Comparative Observational Study on Long-term Functional Results显示文摘 | Alessandro Fichera Mark T. Silvestri Roger D. Hurst Michele A. Rubin Fabrizio Michelassi | 2009 | Journal of Gastrointestinal Surgery2009，，： | 1 |
| 11 | Antimesenteric Functional End-to-End Handsewn (Kono-S) Anastomosis显示文摘 | Alessandro Fichera Marco Zoccali Toru Kono | 2012 | Journal of Gastrointestinal Surgery2012，，7： | 1 |
| 12 | A Vitamin D Analogue Inhibits Colonic Carcinogenesis in the AOM/DSS Model显示文摘 | Alessandro Fichera Nathaniel Little Urszula Dougherty Reba Mustafi Sonia Cerda Yan Chun Li Jorge Delgado Amrita Arora Lucas K. Campbell Loren Joseph John Hart Amy Noffsinger Marc Bissonnette | 2007 | Journal of Surgical Research2007，，2： | 1 |
| 13 | Health related quality of life in inflammatory bowel disease: The impact of surgical therapy显示文摘Over the past 30 years, health related quality of life (HRQOL) has developed into a scientific index of subjective health status. Measurement of HRQOL is now clearly a mandatory component in evaluating interventions and management of medical and surgical diseases. In designing comprehensive and meaningful clinical studies particular attention ought to be made of measures of HRQOL. This is clearly very important in inflammatory bowel disease. Both ulcerative colitis (UC) and Crohn’s disease (CD) have a major impact on HRQOL. The chronic and unrelenting nature of these diseases, the often early age of onset, and the impact on social and sexual aspects of life significantly change patient’s perception, body image and quality of life. This manuscript is an overview of the available published data on HRQOL in UC and CD patients focusing on the impact of surgical therapy. While these two diseases may have some similarities in their management, clearly their impact on quality of life and the effects of are significantly different. Hence we are presenting the data separately. | Konstantin Umanskiy Alessandro Fichera | 2010 | World Journal of Gastroenterology2010，16，40： | 1 |
| 14 | Single-incision laparoscopic total abdominal colectomy for refractory ulcerative colitis显示文摘 | Alessandro Fichera Marco Zoccali | 2012 | Surgical Endoscopy2012，，3： | 1 |
| 15 | 基于CT图像的深度学习算法在诊断结直肠癌同时性腹膜转移中的应用价值显示文摘目的对结直肠癌同时性腹膜转移患者进行精准诊断和分期依旧困难。本研究旨在利用人工智能的ResNet-3D算法构建一种矢量向量模型(SVM)分类器,来预测结直肠癌同时性腹膜转移。方法由放射科医生按原始格式,回顾性提取2017年1月至2018年5月期间,在中山大学附属第六医院经病理确诊的同时性腹膜转移或无腹膜转移的结直肠癌患者术前增强CT图像;从专业随访人员维护的结直肠癌数据库中,收集相应患者的临床病理参数和生存期资料。排除术后异时性腹膜转移、或肿瘤复发的患者以及无法获得增强CT扫描原始图像者。应用ITK-SNAP软件在结直肠癌同时性腹膜转移患者的术前增强CT扫描图像中勾画原发肿瘤,提取肿瘤邻近腹膜的特征,建立一种ResNet-3D+SVM分类器。再利用测试集对ResNet-3D+SVM分类器的效能进行评估,并与放射科医生常规CT的诊断水平进行对比。结果同时性结直肠癌腹膜转移患者74例和同期无腹膜转移的96例患者共计170例入组,被随机分为训练组(腹膜转移54例,非腹膜转移76例)和测试组(腹膜转移和非腹膜转移各20例)。通过深度学习构建的ResNet-3D算法只用了34 s就分析完了所有40例测试组患者的7837张测试图像。为了提高该模型对腹膜转移的诊断准确性,将ResNet-3D的人工智能(AI)模型与12个腹膜腹膜转移特征相结合,构建了SVM分类器(均P<0.05)。该分类器的腹膜转移诊断准确率为94.11%,曲线下面积(AUC)为0.922(0.912~0.944),灵敏度为93.75%,特异度为94.44%,阳性预测值为93.75%,阴性预测值为94.44%。其诊断能力明显优于常规增强CT(AUC:0.791)。结论基于深度学习算法构建的ResNet-3D+SVM分类器,在诊断结直肠癌同时性腹膜转移中显示出很大的潜能。 | 袁紫旭 徐挺洋 蔡建 赵业标 曹务腾 Fichera Alessandro 刘晓霞 姚建华 王辉 | 2021 | 中华胃肠外科杂志2021，24，3： | 1 |
| 16 | Bowel necrosis associated with esrly jejunal tube feeding a complication of postoperative enteral nutrition显示文摘 | Marcovalerio Melis Alessandro Fichera Mark K Ferguson | | 0，，07： | 1 |
| 17 | SJWK14081300000036显示文摘 | Vlad V. Simianu Amir L. Bastawrous Richard P. Billingham Ellen T. Farrokhi Alessandro Fichera Daniel O. Herzig Eric Johnson Scott R. Steele Richard C. Thirlby David R. Flum | 2014 | Annals of Surgery2014，，3： | 1 |
| 18 | Minimally invasive approaches for the treatment of inflammatory bowel disease显示文摘Despite significant improvements in medical management of inflammatory bowel disease, many of these patients still require surgery at some point in the course of their disease. Their young age and poor general conditions, worsened by the aggressive medical treatments, make minimally invasive approaches particularly enticing to this patient population. However, the typical inflammatory changes that characterize these diseases have hindered wide diffusion of laparoscopy in this setting, currently mostly pursued in high-volume referral centers, despite accumulating evidences in the literature supporting the benefits of minimally invasive surgery. The largest body of evidence currently available for terminal ileal Crohn's disease shows improved short term outcomes after laparoscopic surgery, with prolonged operative times. For Crohn's colitis, high quality evidence supporting laparoscopic surgery is lacking.Encouraging preliminary results have been obtained with the adoption of laparoscopic restorative total proctocolectomy for the treatment of ulcerative colitis. A consensus about patients' selection and the need for staging has not been reached yet. Despite the lack of conclusive evidence, a wave of enthusiasm is pushing towards less invasive strategies, to further minimize surgical trauma, with single incision laparoscopic surgery being the most realistic future development. | Marco Zoccali Alessandro Fichera | 2012 | World Journal of Gastroenterology2012，18，46： | 0 |
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