Publications by authors named "Alberto Aiolfi"

Robotic surgery, as an increasingly widespread application in the treatment of gastric and colorectal cancer, still faces obvious discrepancies in recommendations, indications, and evidence strength across existing guidelines. This study systematically analyzed 31 relevant guidelines and consensus statements (retrieved from Chinese and English databases from January 2010 to May 2025) from two dimensions: feasibility (effectiveness, safety, etc.) and training quality control.

View Article and Find Full Text PDF

Educating and training young surgeons is a complex challenge that requires a structured pathway. Upper gastrointestinal (UGI) surgery is becoming a highly attractive subspecialty, yet it is not universally recognized. Currently, there are no standardized guidelines or curricula for UGI surgical training across Europe and a wide disparity among countries remains.

View Article and Find Full Text PDF

Background: The prognostic nutritional index (PNI) involves both the nutritional status and immune function as crucial factors linked to the prognosis of various gastrointestinal cancers. The relationship between the PNI and postoperative quality of life (QOL) in patients with esophageal cancer (EC) has not been examined. This study sought to examine the effects of the PNI on the postoperative patient-reported outcomes (PROs) of patients with esophageal squamous cell carcinoma (ESCC).

View Article and Find Full Text PDF

Background: Anastomotic leak (AL) is a serious complication after gastrectomy. It is associated with prolonged hospital stay, greater expenses, and increased risk for 90-day mortality. Currently, there is no consensus regarding the effect of AL on OS in patients with GC undergoing gastrectomy.

View Article and Find Full Text PDF

Background: The surgical approach to esophageal cancer is evolving. Open (OE) and hybrid esophagectomy (HE) have been standard treatments for years but minimally invasive (MIE) and robotic-assisted esophagectomy (RAMIE) have recently emerged with promising perspectives.

Purpose: Compare short-term outcomes among different techniques for transthoracic esophagectomy.

View Article and Find Full Text PDF

Background: Centralization of esophageal cancer surgery in high-volume centers has been shown to be associated with reduced mortality, length of stay, and improved surgical radicality. However, the effect of hospital volume on long-term survival is unclear. The purpose of this study was to evaluate the long-term survival effects of centralizing esophageal cancer surgery in high-volume centers.

View Article and Find Full Text PDF

Purpose: Giant sliding hiatal hernias (HH) are prevalent in the elderly population (EP) and often present with multiple comorbidities and a high surgical risk. Frailty has been increasingly recognized as a predictor of surgical outcomes in the EP. This study assessed the rate of recurrent sliding HH following mesh cruroplasty and laparoscopic Nissen fundoplication (LNF), and evaluated frailty as a potential risk factor of recurrence.

View Article and Find Full Text PDF

: The optimal surgical management of perforated gastric cancer (PGC) in emergency settings remains controversial. Urgent upfront one-stage gastrectomy (1SG) and two-stage gastrectomy (2SG) with damage-control surgery followed by elective gastrectomy have been proposed. The aim of the present systematic review is to compare short- and long-term outcomes between 1SG and 2SG in the treatment of PGC.

View Article and Find Full Text PDF

Purpose: Rectus Abdominis diastasis (RAD) is a prevalent condition, particularly in post-gravidic women, with functional and esthetic impact. This Delphi consensus, led by general surgeons, aimed to establish evidence-based recommendations for the diagnosis and management of RAD in post-gravidic women.

Methods: A Delphi process was conducted under the auspices of the Italian Society of Hernia and Abdominal Wall Surgery (ISHAWS), the national chapter of the European Hernia Society (EHS).

View Article and Find Full Text PDF

Background: Preventing postpartum haemorrhage remains a high priority worldwide. We aimed to provide all available evidence comparing maternal and neonatal outcomes of different prophylactic endovascular procedures in patients with abnormal placentation.

Methods: Pubmed, Embase and ClinicalTrials.

View Article and Find Full Text PDF

Background: Indocyanine green-guided (ICG-guided) lymphadenectomy during gastrectomy for cancer has been proposed to enhance the accuracy of lymphadenectomy. The impact of ICG-guided lymphadenectomy on patient survival remains debated.

Methods: The findings of the systematic review were reconstructed into an individual patient data (IDP) meta-analysis with restricted mean survival time difference (RMSTD).

View Article and Find Full Text PDF

Background: The surgical treatment for esophageal achalasia has evolved over the years, with laparoscopic Heller myotomy (LHM) and partial fundoplication becoming widely used worldwide. More recently, an increased interest in the robotic Heller myotomy (RHM) has arisen.

Purpose: Compare short-term and functional outcomes of RHM vs.

View Article and Find Full Text PDF

Purpose: Anastomotic leakage (AL) is one of the most important complications that occurs after upper gastrointestinal surgery, registering rates of 20-30% after esophagectomy. The role of systemic inflammatory biomarkers to predict anastomotic leaks is controversial and needs systematization.

Methods: A systematic review based on the PRISMA guidelines criteria was performed.

View Article and Find Full Text PDF

Patients with esophageal cancer and concomitant liver cirrhosis (LC) pose a surgical challenge because of the increased risk of postoperative complications and mortality. Purpose of this study was to review the existing literature and estimate perioperative short-term outcomes of esophagectomy in this patient population. Systematic review and meta-analysis.

View Article and Find Full Text PDF

Background: Minimally invasive distal gastrectomy (MIDG) has been shown to be associated with improved short-term outcomes compared to open distal gastrectomy (ODG) in patients with locally advanced gastric cancer (LAGC). The impact of MIDG on long-term patient survival remains debated. Aim was to compare the MIDG vs.

View Article and Find Full Text PDF

Background: Minimally invasive distal gastrectomy (MIDG) has been shown to improve short-term outcomes compared with open distal gastrectomy (ODG) in patients with early (EGC) and locally advanced gastric cancer (LAGC). The impact of MIDG on patient survival remains debated. This study aimed to compare the effect of MIDG versus ODG on long-term survival.

View Article and Find Full Text PDF
Article Synopsis
  • Total gastrectomy (TG) is the main treatment for gastric cancer, and while open TG (OTG) is the traditional method, newer techniques like laparoscopic and robotic surgeries are showing promising results.
  • A systematic review and network meta-analysis of 68 studies with nearly 45,000 patients were conducted to compare the short-term outcomes of these different surgical techniques.
  • Results suggest that minimally invasive methods like totally laparoscopic TG (TLTG) and robotic TG (RTG) have lower overall complications and better functional outcomes despite longer surgery times compared to OTG.
View Article and Find Full Text PDF

This systematic review aims to evaluate the current evidence regarding safety and efficacy of magnetic sphincter augmentation (MSA) for the treatment of gastroesophageal reflux disease (GERD) after laparoscopic sleeve gastrectomy (LSG). Conversion to Roux-en-Y gastric bypass (RYGB) carries the risk of surgical and metabolic complications and may be contraindicated in patients with normalized or near-normalized body mass index. The LINX™ procedure aims to restore LES competency and to repair the crura.

View Article and Find Full Text PDF
Article Synopsis
  • Gastroesophageal reflux disease (GERD) is a common but progressive condition that can lead to serious complications, and about 40% of patients don’t respond to proton pump inhibitors as treatment.
  • The 360° Nissen fundoplication has been the standard surgical treatment for GERD for 70 years, but partial fundoplications like Toupet and Dor have developed as alternatives to reduce side effects such as dysphagia.
  • Laparoscopic antireflux surgery is deemed safe and effective, highlighting the need for tailored approaches in clinics that provide comprehensive care for individual GERD cases.
View Article and Find Full Text PDF

The optimal treatment for paraesophageal hiatus hernia (PEH) is controversial. While crural buttressing with mesh shows promises in reducing recurrences, the decision to use mesh during minimally invasive PEH repair is largely subjective. Due to these uncertainties, we conducted a survey to examine current clinical practices among surgeons and to assess which are the most important determinants in the decision-making process for mesh placement.

View Article and Find Full Text PDF

Purpose: Anastomotic leak (AL) remains the most important complication after left-sided colic anastomoses and technical complications during anastomotic construction are responsible of higher leakage incidence. Powered circular stapler (PCS) in colorectal surgery has been introduced in order to reduce technical errors and post-operative complications due to the manual circular stapler (MCS).

Methods: A systematic review and meta-analysis were performed.

View Article and Find Full Text PDF