Nicola Rocco

University of Naples Federico II | UNINA · Department of Clinical Medicine and Surgery

Inguinal hernia is a very common disease that mainly affects men in young and middle age and it's reparation is the most frequent operation in general surgery. Hernias present as bulges in the groin area that can become more prominent when coughing, straining, standing up and in all situation where the abdominal pressure grow. If uncomplicated they...

Diverse and contradictory approaches have been suggested for the management of non-palpable thyroid nodules. The aim of our study was to evaluate the indications and limits of ultrasound-guided fine-needle aspiration cytology (US-FNAC) in non-palpable infracentimetric thyroid nodules. From September 2003 to December 2004 we observed 325 patients wi...

A breast unit is a multidisciplinary center specialized in the management of women with breast diseases, including breast cancer (BC). It represents a care path, passing from screening activities to diagnostic investigations, from surgery to the definition of the therapeutic strategy, from psychophysical rehabilitation to long-term checks (follow-u...

In the modern era of multidisciplinary breast cancer management, breast conserving surgery has been established as the standard of care for early-stage disease when feasible to achieve oncological adequate margins and maintain the breast aesthetic. Despite advances in oncoplastic techniques and the increasing use of neoadjuvant systemic therapies t...

The lymphatic system represents a part of the immune system, and it is constituted by a network of lymphatic vessels, lymph nodes (LNs), lymphatic organs and tissues. Tumoural cells are carried in the lymphatic system and trapped in the LNs, commonly metastatic sites. In the late 1800s, Sappey was the first to describe breast lymphatic drainage, de...

Background Nipple-sparing mastectomies (NSM) and implant-based breast reconstructions (IBR) have evolved from two-stage reconstructions with tissue expansion (TE) and implant exchange, to direct-to-implant (DTI). In this study, we tested safety and efficacy of Polyurethane based implants according to standard assessment tools. Objectives This stud...

This study reports on feasibility and applicability of totally autologous primary breast reconstructions based on TDAP flaps using a standard set of internationally approved reporting scales. We reviewed 15 cases in patients with a good donor area in the back not suitable for implant or free flaps reconstructions. Complications according to Clavien...

Background: Volume replacement using chest wall perforator flaps (CWPFs) is a promising technique to reduce mastectomy rates without sacrificing function or aesthetics. Owing to limited availability of the technique, only a minority of patients currently have access to CWPF procedures. Methods: An international web-based survey was disseminated...

Importance: Improvement in clinical understanding of the priorities of patients with breast cancer (BC) regarding postoperative aesthetic outcomes (AOs) is needed. Objective: To assess expert panel and computerized evaluation modalities against patient-reported outcome measures (PROMs), the gold standard of AO assessment, in patients after surgi...

b> Introduction: Books and papers are the most relevant source of theoretical knowledge for medical education. New technologies of artificial intelligence can be designed to assist in selected educational tasks, such as reading a corpus made up of multiple documents and extracting relevant information in a quantitative way. Methods: Thirty experts...

A systematic review and meta-analysis of 30 population-based studies rom 2010-2021 comparing survival after BCS and mastectomy. The searches ere conducted in the PubMed, Embase and Cochrane databases.

Introduction The educational and professional life of everyone have been affected significantly by the COVID -19 pandemic. Many courses and meetings traditionally structured and organized as face-to-face events have been transformed in virtual events. Methods We report on the experience of G.Re.T.A. Fondazione in organizing international conference...

Background:. Acellular dermal matrices (ADMs) entered the market in the early 2000s and their use has increased thereafter. Several retrospective cohort studies and single surgeon series reported benefits with the use of ADMs. However, robust evidence supporting these advantages is lacking. There is the need to define the role for ADMs in implant-b...

Background Decisions in healthcare usually rely on the goodness and completeness of data that could be coupled with heuristics to improve the decision process itself. However, this is often an incomplete process. Structured interviews denominated Delphi surveys investigate experts' opinions and solve by consensus complex matters like those underlyi...

Introduction Multifocal and multicentric breast cancers (MFMCBCs) have traditionally been considered a contraindication to breast-conserving surgery (BCS) because of concerns about locoregional control¹. The most common definition of MFMCBC is anatomical, based on the presence of cancer foci either in a single breast quadrant (multifocal) or in mor...

A scientific and rigorous approach towards breast augmentation is mandatory to reduce complication rates and to obtain high patient satisfaction level.

Oncoplastic breast conserving surgery (BCS) techniques for the treatment of breast cancer have been developed for patients with challenging primary tumour location and/or size in relation to the shape and/or size of the breast. The aims are to provide better results in terms of cosmetic outcomes when compared with standard BCS, potentially improvin...

The authors reviewed the available evidence on revision surgery following implant-based breast surgery with the aim of investigating whether any difference in the surgical approach should be proposed if the patient has a textured device. They included in their review 31 studies presenting different approaches for revision surgery following implant-...

Breast conserving surgery (BCS) plus radiation therapy (RT) or mastectomy have shown comparable oncological outcomes in early-stage breast cancer and are considered standard of care treatments. Postmastectomy radiation therapy (PMRT) targeted to both the chest wall and regional lymph nodes is recommended in high-risk patients. Oncoplastic breast co...

Breast Implant Associated-Anaplastic Large Cell Lymphoma (BIA-ALCL) is a distinctive type of T-cell lymphoma arising around breast implants. We performed a review of the existing literature with the aim of providing an evidence-based overview of the available data on BIA-ALCL with a standardized evaluation of the quality of the studies and investig...

Growing numbers of asymptomatic women who become aware of carrying a breast cancer gene mutation (BRCA) mutation are choosing to undergo risk-reducing bilateral mastectomies with immediate breast reconstruction. We reviewed the literature with the aim of assessing the oncological safety of nipple-sparing mastectomy (NSM) as a risk-reduction procedu...

Introduction The potential advantages of oncoplastic breast conserving surgery (BCS) have not been validated in robust studies that constitute high levels of evidence, despite oncoplastic techniques being widely adopted around the globe. There is hence the need to define the precise role of oncoplastic BCS in the treatment of early breast cancer, w...

Objectives: This is a protocol for a Cochrane Review (intervention). The objectives are as follows:. To assess the effects of implants versus autologous tissue flaps for breast reconstruction following mastectomy for breast cancer treatment or risk reduction, on women’s level of satisfaction, and quality of life, and surgical short- and long-term c...

It has been widely reported that breast reconstruction improves the quality of life of women who undergo mastectomy for breast cancer. This approach provides many psychological advantages. Today, different techniques are available for the breast oncoplastic surgeon that involve the use of breast implants and autologous tissues, also offering inte...

Since its introduction nearly 30 years ago, sentinel lymph node biopsy (SLNB) has become the standard technique to stage the axilla for the great majority of patients with early breast cancer. While the accuracy of SLNB in clinically node-negative patients who undergo neoadjuvant chemotherapy (NAC) is similar to the upfront surgery setting, modific...

Background: Conflicting evidence challenges clinical decision-making when breast reconstruction is considered in the context of radiotherapy. Current literature was evaluated and key statements on topical issues were generated and discussed by an expert panel at the International Oncoplastic Breast Surgery Meeting in Milan 2017. Methods: Studies on...

Introduction The rapid spread of COVID‐19 across the globe is forcing surgical oncologists to change their daily practice. We sought to evaluate how breast surgeons are adapting their surgical activity to limit viral spread and spare hospital resources. Methods A panel of 12 breast surgeons from the most affected regions of the world convened a vi...

Oncoplastic breast surgery encompasses both displacement and replacement techniques following breast-conserving surgery and conservative mastectomies 3 (i.e., skin sparing (SSM) and nipple-areola complex-sparing mastectomies (NSM)) followed by breast reconstruction. In this chapter, we will offer an overview on complications following oncoplastic b...

A generalized lack of evidence is associated to mastectomies and reconstructions with dermal flaps. However these technique may warrant good cosmetic results in women with macromastia who can benefit from contralateral adjustment with symmetrical scarring. When performing DTI (direct to implant) breast reconstructions, the complication rates may be...

The aesthetic results of standard breast-conserving surgery (BCS) are not always acceptable, depending on several factors, in particular the location and size of the tumor to be excised and the breast size. The impact of radiation therapy after breast-conserving surgery (BCS) on residual breast tissues makes the surgical correction of deformities r...

Background: Therapeutic mammaplasty (TM) may be an alternative to mastectomy, but few well designed studies have evaluated the success of this approach or compared the short-term outcomes of TM with mastectomy with or without immediate breast reconstruction (IBR). Data from the national iBRA-2 and TeaM studies were combined to compare the safety a...

Surgical treatment of breast cancer has changed during the last few decades. Long-term evaluation of several studies performed worldwide have confirmed that conservative surgery (CS) and radical mastectomy have similar survival rates. Due to CS being the gold standard for treatment for most women with breast cancer, advances in materials, mastectom...

Background: Autologous fat grafting has broad applications in reconstructive and aesthetic breast surgery as a natural filler and for its regenerative purposes. Despite the widespread use of fat grafting, there remains no shared consensus on what constitutes the optimal fat grafting technique and its oncological safety. For this reason, the author...

Background Digital mammography clearly distinguishes gland tissue density from the overlying nonglandular breast tissue coverage, which corresponds to the existing tissue between the skin and the superficial layer of the fascia superficialis surrounding the gland (i.e., dermis and subcutaneous fat). Preoperative digital imaging can determine the th...

Background: Conflicting evidence challenges clinical decision-making when breast reconstruction is considered in the context of radiotherapy. Current literature was evaluated and key statements on topical issues were generated and discussed by an expert panel at the International Oncoplastic Breast Surgery Meeting in Milan 2017. Methods: Studies...

Background: The combination of breast conserving surgery (BCS) with plastic surgery techniques has provided a useful surgical tool matching the radicality of the oncological excision with the preservation of breast cosmesis. Even though BCS represents a good option for surgical treatment of tumors located in these quadrants, wide excisions often n...

Background: Immediate breast reconstruction (IBR) is routinely offered to improve quality-of-life for women requiring mastectomy, but there are concerns that more complex surgery may delay adjuvant oncological treatments and compromise long-term outcomes. High-quality evidence is lacking. The iBRA-2 study aimed to investigate the impact of IBR on...

Background The combination of breast conserving surgery (BCS) together with plastic surgery techniques (oncoplastic breast surgery) is a useful surgical tool matching the radical oncological excision while preserving breast cosmesis. Upper-inner quadrant resections represent a challenge for breast surgeons. The aim of this study was to identify a r...

Ductal carcinoma in situ (DCIS) has been the subject of much controversy since the advent of population based breast screening programmes. An increasing number of asymptomatic women are being diagnosed with this condition and there is uncertainty over the best treatment algorithm for this condition if treatment is to be considered at all. Different...

Axillary surgery in breast cancer patients has shifted from more extensive to minimalist approaches with re-evaluation of the risks versus benefits of available treatment options which are increasingly tailored to individual patient characteristics.A radical axillary node dissection is rarely indicated nowadays due to several factors including scre...

Background Breast shape is defined utilizing mainly qualitative assessment (full, flat, ptotic) or estimates, such as volume or distances between reference points, that cannot describe it reliably. Objectives We will quantitatively describe breast shape with two parameters derived from a statistical methodology denominated principal component anal...

Advances in reconstructive breast surgery with new materials and techniques now allow us to offer patients the best possible cosmetic results without the risks associated with oncological control of the disease. These advances, in both oncological and plastic surgery, have led to a new field, oncoplastic breast surgery, which enables us to undertak...

Background: Augmented reality (AR) enables the superimposition of virtual reality reconstructions onto clinical images of a real patient, in real time. This allows visualization of internal structures through overlying tissues, thereby providing a virtual transparency vision of surgical anatomy. AR has been applied to neurosurgery, which utilizes...

We present a new reconstructive system encompassing prostheses and fat grafting as integrated tools to improve the final reconstructive outcome. Fat grafting in our view is a pre-operatively planned part of the reconstruction. The final volume we achieve will be made up of fat and implants in a variable percentage according to patient's body contou...

Indications for post mastectomy radiotherapy are widening to a larger group of mastectomy patients and breast reconstruction rates following mastectomy are rising all over the world, this leading breast surgeons to face breast reconstruction in a growing number of patients who will undergo radiotherapy Increased morbidity is associated with al form...

The evolution of breast reconstructive surgery keeps pace with the evolution of breast oncologic surgery. The reconstructive choice should always balance the optimal local control of disease and the best cosmetic result, reflecting an informed decision that is shared with the patient, who is always at the center of the decision-making process. Impl...

Introduction: The introduction of acellular dermal matrices (ADMs) contributed to the growing diffusion of direct-to-implant breast reconstruction (DTI-BR) following mastectomy for breast cancer. According to specific legislations, European specialists could not benefit from the use of human-derived ADMs, even though most evidence in the literatur...

Breast implant-associated anaplastic large cell lymphoma (BIA-ALCL) is an uncommon neoplasia occurring in women with either cosmetic or reconstructive breast implants. The actual knowledge about BIA-ALCL deriving from the literature presents several limits, and it remains difficult to make inferences about BIA-ALCL epidemiology, cause, and pathogen...

Background: Capsular contracture represents the most frequent complication after implant-based breast reconstruction. An experimental study on mice demonstrated that capsule formation around breast implants is considerably diminished after topical application of mitomycin C. The authors conducted a randomized controlled clinical trial investigatin...

No high-level evidences about the best technique or the best implant to use for obtaining the best outcomes in aesthetic breast augmentation, with low complications and re-interventions rates exist from available literature. In this paper we present the actual best evidence about the etiopathogenesis of main complications in aesthetic breast augmen...

Background: Many techniques have been described for mastopexy, with several types of skin incisions and parenchymal rearrangements. We present a parenchymal rearrangement technique allowing better upper pole fullness and nipple-areola-complex (NAC) projection when performing a mastopexy, with a combination of a superior pedicle for the NAC and an i...

Breast augmentation is the most commonly performed surgical procedure in aesthetic plastic surgery. Accurate pre-operative planning is crucial to obtain the best outcomes. We present our planning method deriving from a more than 30-year experience in aesthetic breast surgery, matching together patients tissues’ characteristics and patients’ wishes....

Breast implant-associated anaplastic large cell lymphoma (BI-ALCL) is a distinct type of T-cell lymphoma arising around breast implants. The United States FDA recently updated the 2011 safety communication, warning that women with breast implants may have a very low risk of developing ALCL adjacent to a breast implant. According to the World Health...

Patients undergoing mastectomy for breast cancer have nowadays many options for breast reconstruction, that will help in re-establishing patient's self confidence in her own body image.