Diego Coletta

• PhD
• Medical Doctor , General Surgeon at San Salvatore Hospital-AST Pesaro-Urbino

Purpose Bile duct injury (BDI) during laparoscopic cholecystectomy (LC) is a dreaded complication. Artificial intelligence (AI) has recently been introduced in surgery. This systematic review aims to investigate whether AI can guide surgeons in identifying anatomical structures to facilitate safer dissection during LC. Methods Following PROSPERO r...

Adrenalectomies are growing worldwide because of the frequent diagnosis of incidentaloma and the use of minimally invasive surgery (MIS). The factors used to identify a malignant lesion and the best surgical technique are uncertain. In this context, the definition of high-volume center and expert surgeon is under debate. The Italian Society of Endo...

Gallbladder cancer (GBC) is an aggressive malignancy with poor prognosis. Due to the generally asymptomatic course of the disease in its early stages, patients are most often diagnosed incidentally (iGBC), following cholecystectomy for presumed benign disease. Thorough staging to predict oncologic and technical resectability is mandatory. Robotic s...

There are many options for the surgical management of complicated diverticulitis, and standards vary widely despite international practice recommendations. We conducted a survey to capture the variation in practice across Europe. An online questionnaire was distributed to fellow and surgeon members of the European Association of Endoscopic Surgery...

BACKGROUND The double-stapled technique is the most common method of colorectal anastomosis in minimally invasive surgery. Several modifications to the conventional technique have been described aiming to reduce the intersection between the stapled lines, as the resulting lateral dog-ears are considered as possible risk factors for anastomotic leak...

Fluorescence imaging is a real-time intraoperative navigation modality to enhance surgical vision and it can guide emergency surgeons while performing difficult, high-risk surgical procedures. The aim of this study is to assess current knowledge, attitudes, and practices of emergency surgeons in the use of indocyanine green (ICG) in emergency setti...

Fluorescence imaging is a real-time intraoperative navigation modality to enhance surgical vision and it can guide emergency surgeons while performing difficult, high-risk surgical procedures. The aim of this study is to assess current knowledge, attitudes, and practices of emergency surgeons in the use of indocyanine green (ICG) in emergency setti...

Laparoscopic appendectomy represents the gold standard of surgical treatment for acute appendix disease. Robot-assisted surgery is rarely indicated to perform appendectomy as a single procedure due to high costs and no advantage in terms of pain and length of stay, over the pure laparoscopic technique. There are no studies reporting a description o...

Introduction A textbook outcome patient is one in which the operative course passes uneventful, without complications, readmission or mortality. There is a lack of publications in terms of TO on acute cholecystitis. Objetive The objective of this study is to analyze the achievement of TO in patients with urgent early cholecystectomy (UEC) for Acut...

Currently, groin hernia repair is mostly performed with application of mesh prostheses fixed with or without suture. However, views on safety and efficacy of different surgical approaches are still partly discordant. In this multicentre retrospective study, three sutureless procedures, i.e., mesh fixation with glue, application of self-gripping mes...

Situs viscerum inversus (SVI) is a very rare condition in that abdominal and thoracic organs are located reversed. Abdominal aortic aneurysm (AAA) is a life-threatening pathology due to progressive aortic enlargement until the rupture. The association between SVI and AAA is very infrequent. The aim of this study is to identify the surgical procedur...

The definition of Early Cholecystectomy (EC) is still debatable. This paper aims to find whether the timing of EC affects outcomes. The article reports a multicentric prospective observational study including patients with acute calculous cholecystitis (ACC) who had cholecystectomy within ten days from the onset of symptoms. Kruskall-Wallis test, F...

Background: Accurate preoperative workup is crucial to identify patients with intrahepatic cholangiocarcinoma (IHC) who would have truly benefit from liver resection, avoiding it in patients with advanced disease or distant metastases. Staging laparoscopy (SL) may prevent unnecessary laparotomies in those patients with otherwise resectable disease,...

The definition of Early Cholecystectomy (EC) is still debatable. This paper aims to find whether the timing of EC affects outcomes. This is a multicentric prospective observational study including patients with acute calculous cholecystitis (ACC) who had cholecystectomy within ten days from the onset of symptoms. Kruskall-Wallis test, Fisher’s Exac...

Background: Over the last decade, there has been growing diffusion of minimally invasive surgery in the setting of abdominal emergencies. However, right-colon diverticulitis is still mainly approached by conventional celiotomy. Materials and methods: A video vignette is presented showing the details of an emergent laparoscopic right colectomy as...

Background Pancreatic solid pseudopapillary tumors (SPTs) are rare clinical entity, with low malignancy and still unclear pathogenesis. They account for less than 2% of exocrine pancreatic neoplasms. This study aimed to perform a systematic review of the main clinical, surgical and oncological characteristics of pancreatic SPTs. Data sources MEDLI...

Background: A preliminary analysis from the COVID-Advanced Gastrointestinal Cancer Surgical Treatment (AGICT) study showed that the rate of minimally invasive surgery (MIS) for elective and urgent procedures did not decrease during the pandemic year. In this article, we aimed to perform a subgroup analysis using data from the COVID-AGICT study to e...

Background: Even though the risk of postoperative venous thromboembolism (VTE) after liver resection is well recognized, the association between surgical approach and VTE risk is unknown. This study aims to compare VTE rates following open liver resection (OLR) and minimally invasive liver resection (MILR). Methods: MEDLINE, Web Of Sciences and...

Background: This Italian multicentric retrospective study aimed to investigate the possible changes in outcomes of patients undergoing surgery for gastrointestinal cancers during the COVID-19 pandemic. Method: Our primary endpoint was to determine whether the pandemic scenario increased the rate of patients with colorectal, gastroesophageal, and...

Background: In contrast to adults, the situation for pediatric trauma care from an international point of view and the global management of severely injured children remain rather unclear. The current study investigates structural management of pediatric trauma in centers of different trauma levels as well as experiences with pediatric trauma mana...

Purpose: The risk of postoperative venous thromboembolism (VTE) after liver resection is well recognized, however, the association between surgical approach and VTE risk remains unknown. The aim of this meta-analysis is to compare VTE rates following open (OLR) and minimally invasive (MILR) liver resection. Methods: On 22nd May 2022, MEDLINE, Web...

Background Less invasive alternatives than Early Cholecystectomy (EC) for Acute Calculous Cholecystitis (ACC) treatment have been spreading in recent years. We still lack a reliable tool to select high-risk patients who could benefit from these alternatives. Our study aimed to prospectively validate the Chole-Risk score in predicting postoperative...

Background Even though the risk of postoperative venous thromboembolism (VTE) after liver resection is well recognized, the association between surgical approach and VTE risk is unknown. This study aims to compare VTE rates following open liver resection (OLR) and minimally invasive liver resection (MILR). Methods MEDLINE, Web Of Sciences and EMBA...

Background The SARS-CoV-2 pandemic is still ongoing and a major challenge for health care services worldwide. In the first WSES COVID-19 emergency surgery survey , a strong negative impact on emergency surgery (ES) had been described already early in the pandemic situation. However, the knowledge is limited about current effects of the pandemic on...

Minimally invasive surgery (MIS) is a widespread approach in general surgery. Computer guiding software, such as the augmented reality (AR), the virtual reality (VR) and mixed reality (MR), has been proposed to help surgeons during MIS. This study aims to report these technologies' current knowledge and diffusion during surgical training in Italy....

Background Among patients with distant metastatic melanoma, the site of metastases is the most significant predictor of survival and visceral-nonpulmonary metastases hold the highest risk of poor outcomes. However, studies demonstrate that a significant percentage of patients may be considered candidates for resection with improved survival over no...

Following the publication of the original article [1], the author name “Dragos Serban” under The WSES COVID-19 emergency surgery survey collaboration group was incorrectly written as “Dragos Seban” instead of “Dragos Serban”. The original article has been corrected.

Background: Many surgeons routinely place intraperitoneal drains after elective colorectal surgery. However, enhanced recovery after surgery guidelines recommend against their routine use owing to a lack of clear clinical benefit. This study aimed to describe international variation in intraperitoneal drain placement and the safety of this practice...

During the corona virus disease 2019 (COVID-19) pandemic, most of the surgical procedures were performed for emergencies or oncologic reasons to the detriment of the remaining elective procedures for benign conditions. Ileostomy or colostomy creation are sequelae of oncologic or emergency colorectal surgery, but their closure does not fall within t...

Background Postoperative acute kidney injury (AKI) is a common complication of major gastrointestinal surgery with an impact on short- and long-term survival. No validated system for risk stratification exists for this patient group. This study aimed to validate externally a prognostic model for AKI after major gastrointestinal surgery in two multi...

PurposeMinimally invasive surgery has been universally accepted as a valid option for the treatment of diverticular disease, provided specific expertise is available. Over the last decade, there has been a growing interest in the application of robotic approaches for diverticular disease. We aimed at evaluating whether robotic colectomy may offer s...

Purpose Aim of this systematic review is to assess the changes in esophageal motility and acid exposure of the esophagus through esophageal manometry and 24-hours pH-monitoring before and after laparoscopic sleeve gastrectomy (LSG). Methods Articles in which all patients included underwent manometry and/or 24-hours pH-metry or both, before and aft...

We are very grateful for the opportunity to reply to Dr Mathew’s comments and to widen the discussion on this subject. More than 20 % of patients admitted as an emergency with small bowel obstruction (SBO) will require surgery, especially when there is risk of strangulation.

PurposeThe objective of this study was to investigate the risk of conversion associated with conventional laparoscopic surgery (LAP) versus robot-assisted surgery (ROB) in patients undergoing abdominal oncological surgery. Possible differences between ROB and LAP on postoperative overall and major morbidity, operative time, and length of hospitaliz...

Aim Although there is growing evidence supporting the feasibility of a minimally invasive approach for acute small bowel obstruction, inability to adequately evaluate compromised bowel segments has been cited as a main limitation. We report a novel application of extemporaneous ICG fluorescence to assess bowel viability where there is a concern for...

Background Major hepatectomy is still regarded as a technically demanding procedure for which minimally invasive surgery remains limited to selected cases in experienced centers and robotic platforms may provide some advantages over conventional laparoscopy in this setting. We aimed to combine and meta‐analyze the available literature upon this top...

Primary leiomyoma of the liver (PLL) is a rare benign tumor occurring in immunosuppressed people. From 1926 less than fifty cases are reported in the scientific literature and about half are in immunocompetent patients. Etiology of this kind of lesion is not yet well known. We report a case of primary hepatic leiomyoma in a 60-year-old immunocompet...

Background: Surgery, with the aid of chemotherapy and radiotherapy, is the only curative chance for gastric cancer. Unfortunately, gastric cancer had an elevated recurrence rate, primarily locally. Mesogastrium excision (MGE) during D2 lymphadenectomy has the aim to remove all possible contaminated tissue around the stomach. Methods: PubMed, EMBAS...

BACKGROUND Patient-reported outcomes associated with different bowel reconstruction techniques following anterior resection for rectal cancer are still a matter of debate. OBJECTIVE This study aimed to assess quality of life and bowel function in patients who underwent colonic J-pouch or straight colorectal anastomosis reconstruction after low ant...

Aim: Aspiration is a common cause of pneumonia in patients with postoperative ileus. Insertion of a nasogastric tube (NGT) is often performed, but this can be distressing. The aim of this study was to determine whether the timing of NGT insertion after surgery (before versus after vomiting) was associated with reduced rates of pneumonia in patients...

Background: Our systematic review and meta-analysis examine the impact of minilaparoscopic cholecystectomy (MLC) versus conventional laparoscopic cholecystectomy (CLC). Some authors previously compared these surgical approaches without reaching any clear conclusion, since then, further trials have been performed, but an update was needed. Material...

Background Midline laparotomy is an unavoidable approach to many surgical procedures. Many surgeons prescript the use of postoperative abdominal binder during the first mobilization after surgery. The use and the cost effective of this device is still debated by many surgeons. Methods PubMed, EMBASE and the CENTRAL were systematically searched for...

Background: Laparoscopic surgery is a choice of treatment for liver diseases; it can decrease postoperative morbidity and length of hospital stay (LOS). Hepatocellular carcinoma (HCC) in patients with cirrhosis and portal hypertension may benefit from minimally invasive liver resections (MILRs) instead of open liver resections (OLRs). Whether minim...

In our study, we investigated the role of CD39 on tumor‐infiltrating CD8⁺ T lymphocytes (CD8⁺ TILs) in colorectal, head and neck and pancreatic cancers. Partially confirming recent observations correlating the CD39 expression with T‐cell exhaustion, we demonstrated a divergent functional activity in CD39⁺CD8⁺ TILs. On the one hand, CD39⁺CD8⁺ TILs (...

There are demonstrations that the prognosis of patients with isolated pulmonary dissemination of pancreatic cancer is more favorable than that of patients with other patterns of disease progression. The aim of this systematic review with meta-analysis was to evaluate the oncological outcomes of pulmonary vs. non-pulmonary metastasis of patients wit...

Background splenic artery aneurysms (SAAs) are the most frequent visceral aneurysms, with a life-threatening risk in case of rupture. Our systematic review investigated the features of minimally invasive surgical approaches in vascular surgery for SAAs: robotic and laparoscopy. Methods PubMed, EMBASE and the Web of Science (WOS) were systematicall...

Background: Recently, the minimally invasive surgical approach has been available for performing liver resections (LRs) with laparoscopic and robotic techniques. The robotic approach for LRs seems to overcome several laparoscopic limitations, which is a valid alternative when performed in high volume and specialized centers. Laparoscopic difficulty...

Background: over the last years there has been a growing interest toward the application of minimally invasive surgery in the management of cholecystectomy-related injury to the biliary tract. The aim of this analysis is to identify and combine the available evidence on the argument, with particular reference to major injuries to the main bile duc...

Background: Appendicitis is the most common general surgical emergency worldwide, but its diagnosis remains challenging. The aim of this study was to determine whether existing risk prediction models can reliably identify patients presenting to hospital in the UK with acute right iliac fossa (RIF) pain who are at low risk of appendicitis. Methods...

A 62-year-old woman who had recently been treated for pelvic inflammatory disease presented with abdominal pain. On laparoscopy, adhesions between the anterosuperior hepatic surface and the abdominal wall were seen, a finding consistent with the Fitz-Hugh–Curtis syndrome.

Background: Ileus is common after elective colorectal surgery, and is associated with increased adverse events and prolonged hospital stay. The aim was to assess the role of non-steroidal anti-inflammatory drugs (NSAIDs) for reducing ileus after surgery. Methods: A prospective multicentre cohort study was delivered by an international, student-...

Purpose The role of subcutaneous prophylactic drainage in preventing postoperative abdominal wound complications is still controversial. We aimed to elucidate whether any difference in the incidence of surgical site infection (SSI) exists between patients with or without subcutaneous suction drain following clean-contaminated abdominal surgery. Me...

Although end colostomy closure following Hartmann’s procedure is a major surgery that is traditionally performed by conventional celiotomy, over the last decade there has been a growing interest toward the application of different minimally invasive techniques. We aimed at evaluating the relative outcomes of conventional surgery versus minimally in...

Background: The World Health Organization (WHO) Surgical Safety Checklist has fostered safe practice for 10 years, yet its place in emergency surgery has not been assessed on a global scale. The aim of this study was to evaluate reported checklist use in emergency settings and examine the relationship with perioperative mortality in patients who ha...

Background: Surgical site infection (SSI) is one of the most common infections associated with health care, but its importance as a global health priority is not fully understood. We quantified the burden of SSI after gastrointestinal surgery in countries in all parts of the world. Methods: This international, prospective, multicentre cohort stu...

Background: Anastomotic leakage is one of the most feared complications of rectal resections. The role of drains in limiting this occurrence or facilitating its early recognition is still poorly defined. We aimed to study whether the presence of prophylactic pelvic drains affects the surgical outcomes of patients undergoing rectal surgery with ext...

Haemorrhoids are a common problem in the general practice. The aim of this case report is to point out the diagnostic value of histopathologic evaluation of haemorrhoids specimens, in daily practice, after haemorrhoidectomy in all patients presenting with anorectal complaints, such as bleeding, pain or discomfort, which may suggest a neoplastic les...

Background: Anastomosis technique following right sided colonic resection is widely variable and may affect patient outcomes. This study aimed to assess the association between leak and anastomosis technique (stapled versus handsewn) METHODS: This was a prospective, multicentre, international audit including patients undergoing elective or emergen...

The anorectal canal has the important function of regulating defecation and the role of controlling fecal continence. To fulfill its function, it is necessary to integrate muscular and sensory components. Continence in normal conditions is maintained by the acute angle that the contraction of the pubo-rectal muscle creates at the recto-anal junctio...

Pelvic Organ Prolapse (POP) can be defined as a downward descent of female pelvic organs, including the bladder, uterus, post-hysterectomy vaginal cuff and the small or large bowel, resulting in protrusion of the vaginal walls, uterus, or both. The International Continence Society includes also rectal prolapses. POP development is multifactorial.

Aim The anastomosis technique used following right-sided colonic resection is widely variable and may affect patient outcome. This study aimed to assess the association between leak and anastomosis technique (stapled vs handsewn). Method This was a prospective, multicentre, international audit including patients undergoing elective or emergency rig...

Aim: Rectourethral fistula (RUF) is a rare complication of radical prostatectomy. We report a trans-perineal approach using a fibrin sealant haemostatic patch. Method: Five consecutive patients who developed RUF following radical prostatectomy had a direct transperineal repair with a haemostatic patch (TachoSil(®) ) and were assessed at a median...

Fecal incontinence surgery is still young, associated with elevated morbidity and with variable long-term outcomes (Findlay and Maxwell-Armstrong Int J Colorectal Dis 26: 265–273, 2011). Artificial bowel sphincter (ABS) is still considered an optional surgical treatment together after conservative and less-invasive surgical procedures failure. To d...

Endoscopic retrograde cholangiopancreatography (ERCP)-related perforations represent rare but often severe conditions. While lesions with intraperitoneal perforation have an almost imperative indication to surgery, whether or not to manage retroperitoneal perforations surgically is still an area of debate. The aim of the present work was to review...

Background:Several surgeries are available to treat pilonidal disease. Methods: We analysed the relative effects of conventional excision with primary midline closure compared with the cleft lift procedure on the clinical outcomes of recent published reports. Results: A total of 14 studies containing 2089 patients were included in the analysis. At...

Background: The injection of bulking agents into the anal canal has been reported to help patients with fecal incontinence. Although it has been advocated as a safe and effective option, substantial data concerning long-term efficacy are still lacking, and the resorption process of the implants has not yet been carefully studied. The aim of our st...