Francesco Guerra

Francesco Guerra
Azienda Usl Toscana Sud Est · Department of Surgery

MD

About

114
Publications
11,683
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768
Citations
Introduction
Francesco Guerra currently works at Azienda USL Toscana Sud Est. Francesco does research in Surgery, Oncology and Gastroenterology. Their current project is 'Robotic HPB Surgery'.
Additional affiliations
November 2017 - November 2021
Azienda Ospedaliera Marche Nord
Position
  • Medical Doctor
October 2016 - November 2017
Azienda Ospedaliero Universitaria Careggi
Position
  • Medical Doctor
Description
  • Division of Oncological and Robotic General Surgery
February 2016 - September 2016
Azienda Sanitaria Locale 3 Umbria
Azienda Sanitaria Locale 3 Umbria
Position
  • Staff Surgeon
Education
October 2005 - June 2006
Centre Hospitalier Universitaire - University of Nantes, France
Field of study
  • General Surgery, Organ Transplantation, Radiology
November 2002 - October 2008

Publications

Publications (114)
Article
Purpose Robotics has shown encouraging results for a number of technically demanding abdominal surgeries including pancreaticoduodenectomy, which has originally represented a relative contraindication to the application of the minimally-invasive technique. We aimed to investigate the perioperative, clinicopathologic, and oncological outcomes of rob...
Article
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.
Article
Full-text available
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...
Article
Introduction how best to manage patients with colorectal cancer and synchronous liver metastasis is still controversial, with specific concerns of increased risk of postoperative complications following combined resection. We aimed at analyzing the influence of combined liver resection on the risk of anastomotic leak (AL) following colorectal resec...
Article
Full-text available
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...
Article
The clinical benefit of extended prophylaxis for venous thromboembolism after laparoscopic surgery for cancer is unclear. The efficacy and safety of direct oral anticoagulants for this indication are unexplored. PROLAPS-II was a randomized, double-blind, placebo-controlled, investigator-initiated, superiority study aimed at assessing the efficacy a...
Article
Background: Isolated pancreatic metastasis from melanoma is extremely uncommon and accounts for approximately only 2% of visceral disseminations of melanoma.1-3 Interestingly, pancreatic localizations disproportionately derive from primary ocular melanoma.1,2 Despite the currently available evidence on this argument being scarce, the survival outc...
Article
Background The clinical benefit of extending prophylaxis for venous thromboembolism (VTE) beyond hospital discharge after laparoscopic surgery for cancer is unclear. The efficacy and safety of thromboprophylaxis with direct oral anticoagulants in cancer surgery is unexplored. Methods PROLAPS II is an investigator-initiated, prospective, randomized,...
Article
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.
Article
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Background: The laparoscopic approach in gastric cancer surgery is being increasingly adopted worldwide. However, studies focusing specifically on laparoscopic gastrectomy with D2 lymphadenectomy are still lacking in the literature. This retrospective study aimed to compare the short-term and long-term outcomes of laparoscopic versus open gastrect...
Article
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Background: Minimally invasive gastrectomy is currently considered a valid option to treat gastric cancer and is gaining increasing acceptance. Recent reports have suggested that the application of robots may confer some advantages over conventional laparoscopy, but the role of robotic surgery in clinical practice is still uncertain. We aimed to c...
Article
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...
Article
There is growing evidence supporting the use of minimally invasive resection in esophageal surgery, mainly due to reduced postoperative morbidity and faster recovery after surgery. In recent years, robot-assisted surgery has shown some potential benefits over conventional laparo-thoracoscopic esophagectomy. The purpose of this study is to report ou...
Article
The duodenum is traditionally reached and dissected by an anterior approach. Optimal exposure is achieved via complete hepatic flexure mobilization and kocherization of the duodenum and head of the pancreas, which can be technically challenging and time-consuming, especially in the setting of minimally invasive surgery. On the contrary, an inframes...
Article
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...
Article
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...
Article
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Background: Hyperthermic intraperitoneal chemotherapy (HIPEC) for peritoneal metastases (PM) is considered to be feasible, safe and to improve survival. Aim: To investigate whether an immune response is activated following HIPEC for PM. Methods: Six patients were enrolled in this study. Peripheral blood samples were obtained from each patient...
Article
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...
Article
A 47‐year old woman with a history of Crohn's disease (CD) was admitted to our hospital due to abdominal pain, vomiting and fever. She complained of passing small amounts of air in the urine during the last two weeks. Abdominal computed tomography and magnetic resonance‐enterography were performed, revealing the presence of a colovesical fistula, w...
Article
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...
Article
Background The aim of this study was to report on the application of a minimally invasive technique to the radical extirpation of primary and recurrent pilonidal disease. This technique does not require specific equipments, is ordinarily performed under local anesthesia on an outpatient basis, and provides optimal cosmetic results. Methods A total...
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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...
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Background: Total pancreatectomy is an obligatory surgical procedure in locally advanced or centrally located pancreatic neoplasms to achieve complete tumour clearance. Owing to sound understanding of tumour biology and evolution in intervention technique and improved postoperative care, nowadays the indications of total pancreatectomy have taken a...
Article
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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...
Article
Aim Robotic surgery is thought to have a role in widening the application of minimally invasive liver surgery. Nonetheless, data concerning surgical results for liver malignancies are presently still lacking. We aimed to evaluate the surgical and oncological outcomes of ultrasound guided robotic liver resections for hepatic malignancies. Methods A...
Article
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...
Article
Background Current evidence supporting robotics to perform minimally invasive liver resection is based on single center case series reporting surgical outcomes in heterogeneous groups of patients. On the contrary, relatively scarce data specifically focusing on secondary hepatic malignancies is available. The objective of this study is to assess sh...
Article
Background: The laparoscopic methods for major abdominal surgery are gaining increasing acceptance worldwide. Despite its relatively recent introduction in clinical practice, robotics has been accepted as an effective option to perform high-demanding procedures such as those required in hepatobiliary surgery. Some potential advantages over convent...
Article
Background: Pancreatic neuroendocrine tumors (PanNETs) are relatively rare neoplasms with a low to mild malignant potential. They can be further divided into functioning and nonfunctioning, according to their secretive activity. Surgery is an optimal approach, but the classic open approach is challenging, with some patients having long hospitaliza...
Article
Résumé Introduction Plusieurs études ont suggéré la faisabilité de la chirurgie robotique (CR) dans des indications techniquement difficiles telles que la duodénopancréatectomie céphalique (DPC), initialement considérée comme une contre-indication relative à la chirurgie mini-invasive. Le but de cette étude était d’analyser les résultats périopéra...
Article
Robotic surgery has been proposed over the last decade as a valid option to treat gastrointestinal malignancies in a minimally invasive method, yielding encouraging results. The authors examine the outcomes of a consecutive series of patients with stromal gastrointestinal neoplasms who were operated on using a totally robotic technique. There were...
Article
Full-text available
Background: Recent reports have suggested that the use of the robot might reduce the rate of pancreatic complications following minimally invasive radical gastrectomy. Methods: By meta-analyzing the available literature, we aimed to elucidate possible differences between conventional laparoscopic and robotic radical gastrectomy on pancreatic mor...
Article
Parenchymal sparing procedures are gaining interest in pancreatic surgery and recent studies have reported that minimally invasive pancreatic enucleation may be associated with enhanced outcomes when compared with traditional surgery. By meta‐analyzing the available data from the literature, minimally invasive surgery is not at higher risk of pancr...
Article
Background: Over recent decades, minimally invasive esophagectomy has gained popularity and is increasingly performed worldwide. The aim of this work was to investigate the perioperative, clinicopathologic, and oncological outcomes of robot-assisted esophagectomy on a consecutive series of totally robotic procedures. Methods: All patients receiv...
Article
Background: Liver resection may be complicated by unpredictable intraoperative bleeding. Pringle's maneuver was the first attempt to control bleeding,but the main problem is the duration of ischemia. Robotic surgery thanks to the magnified view,three-dimensional visualization associated and fine movement allow to perform good parenchymal dissectio...
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Full-text available
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...
Article
Full-text available
Background: Postoperative pancreas-related complications are quite uncommon but potentially life-threatening occurrences that may occasionally complicate the postoperative course of gastrectomy. A number of reports have described such conditions after both standard open and minimally invasive surgery. Our study has the purpose to systematically de...
Article
Full-text available
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...
Chapter
Pelvic floor and lower gastrointestinal tract complications as a consequence of vaginal childbirth are issues that have a great impact on women’s well-being. They are also of great social and economic importance, even if the role of childbirth on pelvic and anorectal disorders is still an area of debate. Levator ani and anal sphincter injuries are...
Article
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...
Article
Minimally invasive surgical approaches in transplantation are gaining increasing interest, and many centers are reporting their, mainly laparoscopic, experiences. Robotic surgery (RS) has some hypothetical advantages over traditional laparoscopy, and has been successfully applied, although infrequently to organ transplantation. Our goal was to revi...
Article
Background: Pilonidal disease is a quite common chronic inflammatory disease that causes discomfort, embarrassment and absence from work or school. In line with its acquired pathogenesis, a number of surgical alternatives to conventional en bloc excision have been proposed over the last decades, yielding encouraging results. We reviewed our experi...
Article
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...
Chapter
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...
Article
Background Laparoscopic gastrectomy for cancer is commonly considered a challenging procedure. The technical drawbacks of laparoscopy have been addressed by robotic technology, which can facilitate demanding reconstructions and fine dissection. These features confer potential advantages in the execution of lymphadenectomy. Objectives Here, we illus...
Article
Background Laparoscopic gastrectomy for cancer is commonly considered a challenging procedure. The technical drawbacks of laparoscopy have been addressed by robotic technology, which can facilitate demanding reconstructions and fine dissection. These features confer potential advantages in the execution of lymphadenectomy. Objectives Here, we illus...
Article
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...
Article
Although late complications caused by laparoscopic cholecystectomy are uncommon, a number of different and potentially severe conditions can develop years after the procedure. Herein we report the case of a woman who presented with fever and abdominal pain eleven years following surgery. Possible sequelae due intraoperative complication at the time...