Gaetano Gallo

• MD PhD FASCRS FEBS (Coloproctology)
• Assistant Professor - RTDB at Sapienza University of Rome

Background Primary hyperparathyroidism is a common endocrine disorder necessitating surgical intervention for definitive treatment. Measurement of intraoperative parathyroid hormone (ioPTH) has revolutionized surgical management, but interpreting the results remains a subject of debate. This retrospective study, evaluated the efficacy of the Miami...

Background The diverse range of therapeutic options for hemorrhoidal disease (HD) highlights the need for precise classification systems to guide treatment. Although the Goligher classification remains the most widely used, it has been criticized for its simplicity and limited ability to capture symptom severity or guide treatment decisions. This s...

Polidocanol foam sclerotherapy has gained increasing attention as a minimally invasive treatment for hemorrhoidal disease (HD). However, significant variability exists in its clinical application regarding patient selection, procedural techniques, and postoperative management. This study aimed to assess real-world practice patterns among internatio...

Introduction Recurrent hiatal hernia (HH) is a significant challenge in surgical practice, with recurrence rates reported to range between 25% and 42%. This condition often requires redo surgeries, which are technically demanding and complex. While advancements in surgical techniques have improved outcomes, the optimal strategy for the surgical man...

Background Patients with ileocolic Crohn’s disease often require surgery that can result in temporary stoma formation. Stomas are associated with a morbidity and can negatively impact quality of life. This study aimed to investigate the short-term (6-month) and mid-term (18-month) outcomes of intended temporary stomas in patients with Crohn’s disea...

Hemorrhoidal disease (HD) is a prevalent condition that often requires surgical intervention in advanced stages. This study evaluates the short-term outcomes of Skin-Sparing Hemorrhoidectomy and Pexy (SHAPE), a novel hybrid technique that integrates the excisional approach of closed hemorrhoidectomy with the tissue-sparing and fixation benefits of...

Purpose Hemorrhoidectomy remains the gold-standard treatment for advanced hemorrhoidal disease, but long-term outcomes vary depending on the surgical technique and assessment method. This study aims to show the long-term results achieved using a combination of transperineal ultrasound (TPUS) and endoscopy in patients who underwent Milligan-Morgan h...

Introduction Ventral mesh rectopexy (VMR) has gained popularity as a surgical solution for rectal prolapse. However, significant variability exists in patient selection criteria, preoperative evaluation, and reporting standards. This scoping review analyzes indications for robotic VMR (RVMR) and highlights areas requiring further standardization....

Debate about the psychological background and the impact on self-perception and social integration of cosmetic surgery and minimally invasive cosmetic procedures (MICPs), such as botulinum toxin (BoNT) and facial filler injections is still ongoing. The aim of the present study was to assess the psychological background and the impact on self-percep...

Background After the failure of conservative therapy, the most effective surgical treatment for chronic anal fissures (CAFs) is lateral internal sphincterotomy. However, the choice of the procedure must be always evaluated carefully due to the risk of long-term anal continence impairment. The aim of the present study is to report the outcomes of fi...

Background: Almost 30% of patients with rectal cancer (RC) who submit to comprehensive treatment experience relapse. Surveillance plays a leading role in early detection. The landmark approach provides a more flexible and dynamic framework for survival prediction. Objective: This large retrospective study aims to develop a machine learning algorith...

Purpose Small bowel obstructions represent a major cause of hospitalization, morbidity and mortality in surgical emergency departments. The Gastrografin protocol could be an effective tool in facilitating its evaluation and treatment. Methods A prospective observational study was conducted on patients admitted to the emergency department with a di...

Background Early detection of colorectal cancer (CRC) significantly improves its management and patients’ survival. Circular RNAs (circRNAs) are peculiar covalently closed transcripts involved in gene expression modulation whose dysregulation has been extensively reported in CRC cells. However, little is known about their alterations in the early p...

Over the past two decades, minimally invasive approaches in rectal surgery have changed the landscape of surgical interventions, impacting both malignant and benign pathologies. The dynamic nature of rectal cancer treatment owes much to innovations in surgical techniques, reflected in the expanding literature on available treatment modalities. Loca...

Background: Generative Artificial Intelligence (GAI) tools are increasingly used in research. At present, there is no standardised approach to reporting GAI use. We aimed to produce guidance to support authors in the use of GAI in scientific writing. Methods: A steering group of academic surgeons with experience in GAI developed draft statements f...

Chronic anal fissures (CAFs) are the second most common anorectal disease. Non-surgical treatment includes several options with controversial efficacy. The aim of this study was to evaluate the efficacy and safety of a new ointment based on methylene blue in addition to glyceryl trinitrate. A phase II randomized single-centre triple-blinded study w...

Background Hemorrhoidal disease (HD) is associated with substantial economic burden and negative effects on health-related quality of life (HRQoL). The aCute HaemORrhoids treatment with MESoglycan (CHORMES) study aims to evaluate the effects of orally administered mesoglycan, a natural preparation of glycosaminoglycans with antithrombotic and profi...

Background: There is widespread concern that treatment with biologics agents may be associated

Minimally invasive surgery for the treatment of colon and rectal cancer has gained popularity due to its association with reduced postoperative pain, shorter hospital stays, and quicker recovery. The Da Vinci Single-Port (SP) System combines single-port laparoscopy with robotic assistance. This scoping review aims to evaluate the safety and short-t...

Introduction Anal fissure (AF) poses a common challenge in clinical practice, prompting various treatment approaches. This multicenter study, conducted by the Italian Society of Colorectal Surgery, aimed to assess treatment trends in AF over a 10 year period. Methods A survey of proctologists and retrospective analysis of patient records were cond...

Background Hemorrhoidal disease (HD) significantly impacts patients’ quality of life. This study aimed to evaluate the effectiveness of preoperative treatment with the micronized purified flavonoid fraction (MPFF) and a sucralfate-based rectal ointment in managing HD symptoms and reducing interventions. Methods A prospective quasi-experimental stu...

Background: The aim of this study was to evaluate the incidence of fecal incontinence (FI) in patients attending colorectal clinics in a global setting, treatment choices and accessibility to diagnostic and treatment tools. Methods: An international, multi-center snapshot audit was performed in an 8-week period between January 9, 2023 and March 28,...

Diagnostic performance of molecular markers in surrogate tissues like stool may be affected by colorectal cancer (CRC) morphological heterogeneity. The mucinous histotype represents a subgroup of CRC with a peculiar molecular program and unfavorable disease progression. However, the percentage of mucinous morphology necessary to define this subtype...

The diagnostic performance of molecular markers in surrogate tissues like stool may be affected by colorectal cancer (CRC) morphological heterogeneity. The mucinous histotype represents a subgroup of CRC with a peculiar molecular program and unfavorable disease progression. However, the percentage of mucinous morphology necessary to define this sub...

BACKGROUND: Colorectal (CRC) cancer is becoming a disease of the elderly. Ageing is the most significant risk factor for presenting CrC. early diagnosis of CrC and management is the best way in achieving good outcomes and longer survival but patients aged ≥75 years are usually not screened for CRC. This group of patients is often required to be man...

To describe patients with anal fissure (AF) and their management in primary care. Retrospective study using the Italian Longitudinal Patient Database on 18 + years old subjects with AF records during ‘July 2016–June 2021’ (selection period). Index Date (ID) was the first AF record during selection period. Sub-cohorts were defined by presence/absenc...

Background Timely and safe elective health care facilitates return to normal activities for patients and prevents emergency admissions. Surgery is a cornerstone of elective care and relies on complex pathways. This study aimed to take a whole-system approach to evaluating access to and quality of elective health care globally, using inguinal hernia...

BACKGROUND (MAIN AIM): Chronic anal fissures (CAFs) are the second most common anorectal disease. Non-surgical treatment includes several options with controversial efficacy. The aim of this study was to evaluate the efficacy and safety of a new ointment based on methylene blue in addition to glyceryl trinitrate. METHODS: A phase II randomized sing...

Background/aim: The integration of AI and natural language processing technologies, such as ChatGPT, into surgical practice has shown promising potential in enhancing various aspects of abdominopelvic surgical procedures. This systematic review aims to comprehensively evaluate the current state of research on the applications and impact of artific...

Oligomeric alpha-synuclein (α-syn) in saliva and phosphorylated α-syn deposits in the skin have emerged as promising diagnostic biomarkers for Parkinson’s disease (PD). This study aimed to assess and compare the diagnostic value of these biomarkers in discriminating between 38 PD patients and 24 healthy subjects (HSs) using easily accessible biolog...

Aim: Haemorrhoidal disease (HD) is one of the most common anal disorders in the adult population. Despite that, treatment options differ among different countries and special- ists, even for the same grade of HD. The aim of this study is to evaluate the differences in patient demographics, surgeon preference for the treatment option, outcomes as we...

Injection sclerotherapy is an effective and safe treatment in selected cases. It might be used as the first treatment for I-III degree hemorrhoidal disease (HD), but also as a bridge therapy for more severe cases not amenable to invasive treatments. However, concerning the long-term recurrence rate, open excisional hemorrhoidectomy remains the gold...

Silicone implants are widely used in aesthetic and reconstructive breast surgery. Rupture of a breast implants is a well-known complication. Silicone leakage from a rupture or silicone bleeding can accumulate in lymphnodes because the silicone migrates through the lymphatics, and it can reach local or distant nodes. The systemic effects of silicone...

Digital surgery is the use of technology in order to share information, educate, and improve clinical outcomes. The outbreak of COVID-19 forced healthcare professionals to find new ways of taking care of patients, sharing therapeutical decisions, and maintaining research progress. Social media and networks played a pivotal role in the diffusion of...

Chronic venous disease (CVD) and hemorrhoidal disease (HD) are among the most common vascular diseases in the world, with CVD affecting 22–41% of the population in Europe and HD having a point prevalence of 11–39%. The burden is substantial in terms of the effect of symptoms on patients’ health-related quality of life (HRQoL) and direct/indirect me...

Background SARS-CoV-2 pandemic has had many significant impacts within the surgical realm, and surgeons have been obligated to reconsider almost every aspect of daily clinical practice. Methods This is a cross-sectional study reported in compliance with the CHERRIES guidelines and conducted through an online platform from June 14th to July 15th, 2...

Introduction Weight loss after bariatric surgery causes very important modifications to the patient's silhouette. Abdominal fat and skin excess reduction are associated with several complications. The most frequent are seroma and hematoma whereas major complications, such as pulmonary embolism, are less frequent. This study aimed to describe our te...

Background Acute severe ulcerative colitis (ASUC) is a serious, potentially life-threatening condition. Hospital admission and prompt medical therapy with intravenous steroids is crucial, but rescue medical therapy is frequently needed, and surgery is often required. Our aim was to assess the adherence to main diagnostic and management recommendati...

Background This systematic review and meta-analysis aimed to evaluate the safety and efficacy of sclerotherapy methods for hemorrhoidal disease (HD) over the past 40 years. Methods The review followed the 2020 Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA) guidelines. A comprehensive literature search was conducted, in...

EAGLE is an international study bringing together surgeons, anaesthetists and theatre teams around the world to share best practice. The common goal is to reduce the global anastomotic leak rate after right colectomy and ileocaecal resection. Feel free to join ESCP Safe-anastomosis programme.

Aim The primary aim of the European Society of Coloproctology (ESCP) Guideline Development Group (GDG) was to produce high‐quality, evidence‐based guidelines for the management of cryptoglandular anal fistula with input from a multidisciplinary group and using transparent, reproducible methodology. Methods Previously published methodology in guide...

Background: Anastomotic leak affects 8 per cent of patients after right colectomy with a 10-fold increased risk of postoperative death. The EAGLE study aimed to develop and test whether an international, standardized quality improvement intervention could reduce anastomotic leaks. Methods: The internationally intended protocol, iteratively co-devel...

There is no consensus regarding the definition of acute nonspecific abdominal pain (NSAP); however, it accounts for 5–10% of all admissions to the emergency department (ED). The underlying conditions of NSAP comprise a spectrum of undiagnosed conditions, both somatic and functional, but its diagnosis remains a “diagnosis of exclusion.” In general,...

Bowel ischemia is an umbrella term encompassing a wide range of diseases, ranging from self-limiting conditions, usually responding to conservative treatment, to surgical emergencies, associated with high mortality rates. In acute setting, according to anatomy, different pathogenesis, and clinical evolution, we can classify them in two main entitie...

Introduction Around 20% of population in western countries is under anticoagulant treatment. However, there is paucity of evidence about the treatment of HD in patients under anticoagulant/antiplatelet therapy, although both suspension and continuation in the perioperative period may increase the risk of severe complications. The aim of this pilot...

Objective: To develop and validate a prediction model (STOMA score) for 1-year stoma-free survival in patients with rectal cancer (RC) with anastomotic leakage (AL). Background: AL after RC resection often results in a permanent stoma. Methods: This international retrospective cohort study (TENTACLE-Rec-tum) encompassed 216 participating centres an...

Objective: To develop and validate a prediction model (STOMA score) for 1-year stoma-free survival in patients with rectal cancer (RC) with anastomotic leakage (AL). Background: AL after RC resection often results in a permanent stoma. Methods: This international retrospective cohort study (TENTACLE-Rec-tum) encompassed 216 participating centres an...

Background The optimal treatment of anastomotic leak after rectal cancer resection is unclear. This worldwide cohort study aimed to provide an overview of four treatment strategies applied. Methods Patients from 216 centres and 45 countries with anastomotic leak after rectal cancer resection between 2014 and 2018 were included. Treatment was categ...

The best nonoperative or operative anal fissure (AF) treatment is not yet established, and several options have been proposed. Aim is to report the surgeons’ practice for the AF treatment. Thirty-four multiple-choice questions were developed. Seven questions were about to participants’ demographics and, 27 questions about their clinical practice. B...

Aim Pilonidal disease (PD) is a common debilitating condition frequently seen in surgical practice. Several available treatments carry different benefit/risk balances. The aim of this study was to snapshot the current management of PD across European countries. Method Members affiliated to the European Society of Coloproctology were invited to joi...

Appendiceal adenocarcinoma was first described by Berger in 1882 [1], whereas a tumor arising from neuroendocrine cells [neuroendocrine tumors (NETs)] was reported by Masson in 1928 [2]. Primary appendiceal tumors (ATs) are rare entities, occurring in <2% of all appendectomies, with an age-adjusted incidence of 0.12 cases per million people per yea...

BACKGROUND: The CovidSurg-Cancer Consortium aimed to explore the impact of COVID-19 in surgical patients and services for solid cancers at the start of the pandemic. The CovidSurg-Gynecologic Oncology Cancer subgroup was particularly concerned about the magnitude of adverse outcomes caused by the disrupted surgical gynecologic cancer care during th...

AIM: Intraperitoneal drains are often placed during emergency colorectal surgery. However, there is a lack of evidence supporting their use. This study aimed to describe the efficacy and safety of intraperitoneal drain placement after emergency colorectal surgery. METHOD: COMPlicAted intra-abdominal collectionS after colorectal Surgery (COMPASS...

Aim: Complex anal fistula represents a burden for patients, and its management is a challenge for surgeons. Video-assisted anal fistula treatment (VAAFT) is one sphincter-sparing technique. However, data on its long-term effectiveness are scant. We aimed to explore the outcomes of VAAFT in a retrospective cohort of patients referred to a tertiary...

Background/aim: Gastric cancer surgery is still characterised by high morbidity and mortality. However, in 2018 an online platform, GASTRODATA has been proposed in Europe to standardize the recording of gastric surgery complications. The aim of the study was to present a single center experience regarding incidence and grading of acute postoperati...

Background: In the last decades, several surgical approaches have been proposed to treat hemorrhoids. Objective: This multicenter study aims to compare transanal hemorrhoidal artery ligation and conventional excisional hemorrhoidectomy for grade III hemorrhoidal disease. Design: Multicenter retrospective study. Settings: Any center belonging...

Purpose: The aim of this study was to evaluate the 5-year recurrence rate of pilonidal sinus disease (PSD) after endoscopic sinusectomy and identify risk factors for recurrence. Methods: All consecutive patients from September 2011 through December 2017 who underwent endoscopic sinusectomy at seven referral centres for pilonidal sinus treatment...

COVID-19 negatively affected surgical activity, but the potential benefits resulting from adopted measures remain unclear. The aim of this study was to evaluate the change in surgical activity and potential benefit from COVID-19 measures in perspective of Italian surgeons on behalf of SPIGC. A nationwide online survey on surgical practice before, d...

Aim To describe the currently available evidence regarding the efficacy and safety of preoperative tumor marking using indocyanine green (ICG) prior to laparoscopic or robotic colorectal resections. Methods A systematic search for relevant studies was conducted using the following databases: Embase (OVID), MEDLINE® (OVID), APA PsycInfo (OVID), Glo...

Complex anal fistulas (CAF) present a challenge in achieving healing while preserving anal sphincter function. This study aims to introduce a novel staged approach for CAF treatment, combining video-assisted anal fistula treatment (VAAFT), seton placement, and other staged approaches. Consecutive patients with CAF underwent the staged approach invo...

Objective: This study aimed to develop and validate a prediction model (STOMA-score) for one-year stoma-free survival in rectal cancer (RC) patients with anastomotic leakage (AL). Background: AL after RC resection often results in a permanent stoma. Methods: This international retrospective cohort study (TENTACLE-Rectum) encompassed 216 partic...

Background: This study assessed the potential cost-effectiveness of high (80-100%) vs low (21-35%) fraction of inspired oxygen (FiO2) at preventing surgical site infections (SSIs) after abdominal surgery in Nigeria, India, and South Africa. Methods: Decision-analytic models were constructed using best available evidence sourced from unbundled da...

Background: Growing interest has been recently reported in the potential detrimental role of donor gamma-glutamyl transferase (GGT) peak at the time of organ procurement regarding the risk of poor outcomes after liver transplantation (LT). However, the literature on this topic is scarce and controversial data exist on the mechanisms justifying suc...

Importance: Postoperative urinary retention (POUR) is a well-recognized complication of inguinal hernia repair (IHR). A variable incidence of POUR has previously been reported in this context, and contradictory evidence surrounds potential risk factors. Objective: To ascertain the incidence of, explore risk factors for, and determine the health...

Objective To compare perioperative and oncologic surgical outcomes during laparoscopic partial nephrectomy (LPN) performed by standard carbon dioxide insufflation, with those from surgeries in which the AirSeal® intelligent insufflation system was used for renal tumors. Materials and methods A total of 27 patients with renal tumor were identified,...

Acute appendicitis (AA) is one of the most common causes of lower abdominal pain and admissions to the emergency department. Ninety percent of AA occurs in children and young adults. However, recent statistics have shown that AA accounts for 15% of all emergency room visits for acute abdominal pain in patients over 60 years of age. AA is burdened b...

Aim: Faecal incontinence (FI) is a common problem, affecting about 9% of Western populations. However, only a few patients seek consultation and the number of such patients reaching hospital care is unknown. Current treatment pathways are poorly evidence based and are thought to vary greatly between different countries. This audit will study the i...

Background & aims: Fecal tests currently used for colorectal cancer (CRC) screening show limited accuracy in detecting early tumors or precancerous lesions. In this respect, we comprehensively evaluated stool microRNA (miRNA) profiles as biomarkers for non-invasive CRC diagnosis. Methods: A total of 1,273 small RNA sequencing experiments were pe...

Anal diseases are very common and, in most of the cases, require surgery of minor or medium complexity, and, therefore, are among the most accessible diseases for surgeons in training. Aim of this study is to investigate the status of the training in proctology in Italy. A 31-items questionnaire was administered to residents and young specialists (...

Aim: Chronic anal fissure (CAF) is an extremely frequent finding in clinical practice. Several topical agents have been proposed for its treatment with the common goal of increasing anodermal blood flow to promote healing. The aim of this study was to compare the efficacy and safety of a Propionibacterium extract gel (PeG) and 0.4% glyceryl trinit...

Purpose: The standard treatment for chronic anal fissures that have failed non-operative management is lateral internal sphincterotomy. Surgery can cause de novo incontinence. Fissurectomy has been proposed as a sphincter/saving procedure, especially in the presence of a deep posterior pouch with or without a crypt infection. This study investigat...

Basosquamous cell carcinoma (BSCC) is a rare malignancy usually arising on sun-exposed areas of the skin. BSCC is described as a rare variant of Basal cell carcinoma (BCC) which shows clinical and microscopic features of both BCC and of Squamous cell carcinoma (SCC). We report the case of a 70-year-old male with a cutaneous lesion of the nipple-are...

Aim: The burden of abdominal wound failure can be profound. Recent clinical guidelines have highlighted the heterogeneity of laparotomy closure techniques. The aim of this study was to investigate current midline closure techniques and practices for prevention of surgical site infection (SSI). Method: An online survey was distributed in 2021 among...

Background Acute severe ulcerative colitis (ASUC) is a potentially life-threatening condition, requiring immediate hospitalization. Delayed colectomy is associated with increased risk of post-operative complications. This study aimed to identify early predictors of failure to medical treatment and need for colectomy in patients with ASUC. Methods...

Aim Aspiration is a common cause of pneumonia in patients with postoperative ileus. Insertion of a nasogas-tric 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 (be-fore versus after vomiting) was associated with reduced rates of pneumonia in patient...