
Salomone Di SaverioCambridge University Hospitals NHS Foundation Trust · Department of Surgery (Addenbrooke)
Salomone Di Saverio
M.D. FACS FRCS (Eng)
About
751
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Introduction
Consultant Surgeon, performing elective General Surgery Procedures and Team Leader Consultant in Acute Care-Trauma Surgery.
Previous Clinical Head for Laparoscopy in Trauma Surgery in the Trauma Surgery Unit, Maggiore Hospital Bologna.
Now Consultant Colorectal in Cambridge UK.
Performed more than 6000 major surgical procedures, mainly as first operator,more than 2500 Laparoscopic & surgical oncology for gastric and colon and rectal cancer.
Described & published several original or innovative surgical techniques in both open and laparoscopic surgery.
Additional affiliations
January 2007 - August 2007
January 2018 - present
December 2009 - present
Publications
Publications (751)
Background
Ideal surgical treatment for acute duodenal injuries should offer a definitive treatment, with low morbidity and mortality. It should be simple and easily reproducible by acute care surgeons in an emergency. Duodenal injury, due to major perforated or bleeding peptic ulcers or iatrogenic/traumatic perforation, represents a surgical chal...
Laparoscopy is increasingly being used for trauma patients. This study demonstrates how this technique is safe and feasible in selected patients for both diagnostic and therapeutic purposes. However, these results need to be correlated with the level of the center and the expertise of the surgeon.
Indications, procedures and techniques are provided...
This video very well details and discusses the difficulties of laparoscopic suturing for intracorporeal anastomoses in colorectal surgery. It proposes a nice modification in order to better align sutures and better offset the limitations of rigid laparoscopic instrumentation. It is associated with a text under submission for publication in the jour...
A 59-year-old hemodynamically stable female is admitted following a domestic fall with blunt left sided thoraco-abdominal trauma. She lived alone and had multiple comorbidities including hepatitis C virus positive splenomegaly, chronic psychosis with a history of opioid and alcohol abuse. A CT-scan of thorax and abdomen with IV contrast showed left...
A 73 years-old gentleman presented to ED complaining of colicky abdominal pain and subacute bowel obstruction with nausea and unable to pass stools for a couple of days. Abdomen was distended, painful at deep palpation, with no guarding. AXR showed colonic distension of the right and proximal transverse colon. Left colonic section was not visible.
Purpose
Acute appendicitis (AA) is the leading cause of acute abdomen worldwide, with an incidence of 90–100 cases per 100,000 individuals annually and a lifetime risk of 7–12%. Despite its prevalence, historical accounts of AA are limited, particularly when compared to conditions like haemorrhoids, likely due to the appendix’s internal location. T...
Groove pancreatitis (GP) is a chronic segmental pancreatitis which leads to altered pancreatic secretions and pancreatitis. The exact pathogenesis of GP has not been clearly identified to date but heavy smoking and chronic alcohol consumption seem to be the main factors involved. The resulting chronic pancreatitis (CP) is a debilitating disease cau...
Background
The current standard of care for mild acute biliary pancreatitis (MABP) involves early laparoscopic cholecystectomy (ELC) to reduce the risk of recurrence. The MANCTRA-1 project revealed a knowledge-to-action gap and higher recurrence rates in patients admitted to medical wards, attributable to fewer ELCs being performed. The project est...
Background
Rib fractures are one of the most common traumatic injuries and may result in significant morbidity and mortality. Despite growing evidence, technological advances and increasing acceptance, surgical stabilization of rib fractures (SSRF) remains not uniformly considered in trauma centers. Indications, contraindications, appropriate timin...
Commentary on the article written and published by Peng et al , investigating the role of endoscopic ultrasound (EUS)-guided biliary drainage for palliation of malignant biliary obstruction after failed endoscopic retrograde cholangiopancreatography (ERCP). For 40 years endoscopic biliary drainage was synonymous with ERCP, and EUS was used mainly f...
Background
Patients with acute cholecystitis (AC) presenting with unfavorable systemic or local conditions are often managed with percutaneous cholecystostomy (PC) as a temporary measure. The clinical outcomes of interval cholecystectomy following PC remain unclear. The aim of the study was to identify the association between the timing of cholecys...
The workload of general surgeons is multifaceted, encompassing not only surgical procedures but also a myriad of other responsibilities.
Aim
Solitary rectal ulcer syndrome (SRUS) is a benign and poorly understood disorder with complex management. Typical symptoms include straining during defaecation, rectal bleeding, tenesmus, mucoid secretion, anal pain and a sense of incomplete evacuation. Diagnosis is based on characteristic clinical symptoms and endoscopic/histological findings....
The Nurse Navigator is a highly specialized nurse with technical and non-technical skills that offers individualized assistance to cancer patients, their family and caregivers to overcome health system barriers and facilitate access to care. This role was introduced in the General Surgery Unit of the Madonna del Soccorso Hospital in San Benedetto d...
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...
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...
Background
The trauma mortality rate is higher in the elderly compared with younger patients. Ageing is associated with physiological changes in multiple systems and correlated with frailty. Frailty is a risk factor for mortality in elderly trauma patients. We aim to provide evidence-based guidelines for the management of geriatric trauma patients...
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...
The workload of general surgeons is multifaceted, encompassing not only surgical procedures but also a myriad of other responsibilities.
Primary segmental omental torsion (PSOT) is a very rare cause of acute abdominal pain, and it may often imitate the clinical picture of acute appendicitis. In instances of acute abdominal pain without anorexia, nausea, and vomiting, omental torsion should be included in the differential diagnosis. Any misdiagnosis may lead to major complications su...
Background
This multicentre case–control study aimed to identify risk factors associated with non-operative treatment failure for patients with CT scan Hinchey Ib-IIb and WSES Ib-IIa diverticular abscesses.
Methods
This study included a cohort of adult patients experiencing their first episode of CT-diagnosed diverticular abscess, all of whom unde...
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...
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...
Background. The role of the Nurse Navigator was developed in order to address the health disparities created by the social determinants of health, , being an expert, specialized and trained nurse who takes charge of the patient diagnosed with cancer and accompanies him throughout the treatment process, helping him to extricate himself from the laby...
Percutaneous cholecystostomy (PC) is often preferred over early cholecystectomy (EC) for elderly patients presenting with acute cholecystitis (AC). However, there is a lack of solid data on this issue. Following the PRISMA guidelines, we searched the Medline and Web of Science databases for reports published before December 2022. Studies that asses...
To determine if preoperative-intraoperative factors such as age, comorbidities, American Society of Anesthesiologists (ASA) classification, body mass index (BMI), and severity of peritonitis affect the rate of morbidity and mortality in patients undergoing a primary anastomosis (PA) or Hartmann Procedure (HP) for perforated diverticulitis. This is...
Background Despite advances and improvements in the management of surgical patients, emergency and trauma surgery is associated with high morbidity and mortality. This may be due in part to delays in definitive surgical management in the operating room (OR). There is a lack of studies focused on OR prioritization and resource allocation in emergenc...
Background Despite advances and improvements in the management of surgical patients, emergency and trauma surgery is associated with high morbidity and mortality. This may be due in part to delays in definitive surgical management in the operating room (OR). There is a lack of studies focused on OR prioritization and resource allocation in emergenc...
Despite advances and improvements in the management of surgical patients, emergency and trauma surgery is associated with high morbidity and mortality. This may be due in part to delays in definitive surgical management in the operating room (OR). There is a lack of studies focused on OR prioritization and resource allocation in emergency surgery....
Background Despite advances and improvements in the management of surgical patients, emergency and trauma surgery is associated with high morbidity and mortality. This may be due in part to delays in definitive surgical management in the operating room (OR). There is a lack of studies focused on OR prioritization and resource allocation in emergenc...
Background
Laparoscopy is widely adopted across nearly all surgical subspecialties in the elective setting. Initially finding indication in minor abdominal emergencies, it has gradually become the standard approach in the majority of elective general surgery procedures. Despite many technological advances and increasing acceptance, the laparoscopic...
Aortic graft-enteric fistula is an infrequent, severe, and late complication that sometimes follows aortic reconstructive surgery. In this case study, we describe the clinical course of a 62-year-old man with a previous leg amputation due to ischemia and gangrene, aortic bifemoral by-pass, and femoral thromboendarterectomy. In the past, the patient...
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,...
Despite the increasing trend in liver resections for non-colorectal non-neuroendocrine liver metastases (NCNNLM), the role of surgery for these liver malignancies is still debated. Registries are an essential, reliable tool for assessing epidemiology, diagnosis, and therapeutic approach in a single hub, especially when data are dispersive and incon...
Emergency Resuscitative Thoracotomy (ERT) is a lifesaving procedure in selected patients. Outcome mostly in blunt trauma is believed to be poor. The primary aim of this study was to determine the predictors of postoperative mortality following ERT. We retrospectively reviewed 34 patients ≥ 18 years who underwent ERT at San Camillo—Forlanini Hospita...
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...
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...
Purpose
Emergency treatment of acute diverticulitis remains a hazy field. Despite a number of clinical studies, randomized controlled trials (RCTs), guidelines and surgical societies recommendations, the most critical hot topics have yet to be addressed.
Methods
Literature research from 1963 until today was performed. Data regarding the principal...
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...
Iatrogenic urinary tract injury (IUTI) is a severe complication of emergency digestive surgery. It can lead to increased postoperative morbidity and mortality and have a long-term impact on the quality of life. The reported incidence of IUTIs varies greatly among the studies, ranging from 0.3 to 1.5%. Given the high volume of emergency digestive su...
Background
Sigmoid Volvulus is the consequence of the rotation of the superior mesosigmoid. Initial management in patients without signs of peritoneal irritation is endoscopic devolvulation with a flexible colonoscope. Laparoscopic sigmoidectomy with primary anastomosis after colonoscopy is a feasible procedure. It has shown reduction in morbidity...
Importance:
Considering the lack of equipoise regarding the timing of cholecystectomy in patients with moderately severe and severe acute biliary pancreatitis (ABP), it is critical to assess this issue.
Objective:
To assess the outcomes of early cholecystectomy (EC) in patients with moderately severe and severe ABP.
Design, settings, and partic...
Laparotomy incisions provide easy and rapid access to the peritoneal cavity in case of emergency surgery. Incisional Hernia (IH) is a late manifestation of the failure of abdominal wall closure and represents frequent complication of any abdominal incision: IHs can cause pain and discomfort to the patients but also clinical serious sequelae like bo...
Laparotomy incisions provide easy and rapid access to the peritoneal cavity in case of emergency surgery. Incisional hernia (IH) is a late manifestation of the failure of abdominal wall closure and represents frequent complication of any abdominal incision: IHs can cause pain and discomfort to the patients but also clinical serious sequelae like bo...
Background
Diaphragmatic hernia (DH) presenting acutely can be a potentially life-threatening condition. Its management continues to be debatable.
Methods
A bibliographic search using major databases was performed using the terms “emergency surgery” “diaphragmatic hernia,” “traumatic diaphragmatic rupture” and “congenital diaphragmatic hernia.” GR...
Intra-abdominal infections (IAI) are among the most common global healthcare challenges and they are usually precipitated by disruption to the gastrointestinal (GI) tract. Their successful management typically requires intensive resource utilization, and despite the best therapies, morbidity and mortality remain high. One of the main issues require...
Objective:
To generate an up-to-date bundle to manage acute biliary pancreatitis using an evidence-based, artificial intelligence (AI)-assisted GRADE method.
Summary background data:
A care bundle is a set of core elements of care that are distilled from the most solid evidence-based practice guidelines and recommendations.
Methods:
The resear...
We would like to thank our colleagues for their interest
in our work (1). They rightly mentioned that there is a
discrepancy in the evaluation of guidelines in recently
published paper (2). However, this topic is discussed
in detail in our manuscript and we make particular
reference to this in the discussion
Many countries are facing an aging population. As people live longer, surgeons face the prospect of operating on increasingly older patients. Traditional teaching is that with older age, these patients face an increased risk of mortality and morbidity, even to a level deemed too prohibitive for surgery. However, this is not always true. An active 9...
Lower gastrointestinal (GI) bleeding occurs from lesions distal to the ligament of Treitz and poses a huge burden on healthcare systems worldwide. It results in significant morbidity, but its mortality is low and usually in patients with advanced age and multiple co-morbidities. Initial assessment should focus on history, examination, assessment of...
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...
Background
This study aimed to compare the short- and long-term outcomes of robotic (RRC-IA) versus laparoscopic (LRC-IA) right colectomy with intracorporeal anastomosis using a propensity score matching (PSM) analysis based on a large European multicentric cohort of patients with nonmetastatic right colon cancer.Methods
Elective curative-intent RR...
Background:
The treatment of the primary tumour in colorectal cancer with unresectable liver and/or lung metastases but no peritoneal carcinomatosis is still a matter of debate. In the absence of clear evidence and guidelines, our survey was aimed at obtaining a snapshot of the current attitudes and the rationales for the choice of offering resect...
Sigmoid volvulus is a common surgical emergency, especially in elderly patients. Patients can present with a wide range of clinical states: from asymptomatic, to frank peritonitis secondary to colonic perforation. These patients generally need urgent treatment, be it endoscopic decompression of the colon or an upfront colectomy. The World Society o...
Background
Severe complicated intra-abdominal sepsis (SCIAS) has an increasing incidence with mortality rates over 80% in some settings. Mortality typically results from disruption of the gastrointestinal tract, progressive and self-perpetuating bio-mediator generation, systemic inflammation, and multiple organ failure. A further therapeutic option...
Purpose
Hemorrhoidal disease (HD) is a common condition, and several surgical techniques have been proposed to date without being able to achieve definitive consensus on their use and indications. Laser hemorrhoidoplasty (LHP) is a minimally invasive procedure for HD treatment determining the shrinkage of the hemorrhoidal piles by diode laser limit...
Background:
There are no specific recommendations regarding optimal management of this group of patients. The WSES suggested a non-operative strategy with antibiotic therapy, but this was a weak recommendation. This study aims to identify the optimal management of patients with acute diverticulitis (AD) presenting with pericolic free air with or w...
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...
The identification of high-risk patients in the early stages of infected pancreatic necrosis (IPN) is critical, because it could help the clinicians to adopt more effective management strategies. We conducted a post hoc analysis of the MANCTRA-1 international study to assess the association between clinical risk factors and mortality among adult pa...
The greatest advantages of laparoscopy, when compared to open surgery, are already recognized: less post-operative pain, faster and better postoperative recovery, shorter hospital stay, earlier discharge, and earlier return to normal daily, activity, such as physical exercise, and cost of the hospital stay. Nevertheless, laparoscopy today represent...
Background: Haemorrhoids are a very common disease and many professional societies have produced
guidelines for their treatment. The aim of this study is to appraise the quality of the existing guidelines in the
management of haemorrhoids.
Methods: A systematic search of the literature was conducted in the EMBASE, Google Scholar, Cochrane
library,...
Background
This meta-analysis aims to compare morbidity, mortality, oncological safety, and survival outcomes after laparoscopic multi-visceral resection (MVR) of the locally advanced primary colorectal cancer (CRC) compared with open surgery.
Materials and methods
A systematic search of multiple electronic data sources was conducted, and all stud...
· Background: Severe complicated intra-abdominal sepsis (SCIAS) has an increasing incidence with mortality rates over 80% in some settings. Mortality typically results from disruption of the gastrointestinal tract, progressive and self-perpetuating bio-mediator generation, systemic inflammation, and multiple organ failure. A further therapeutic opt...
Dear Colleague,
The ACIE (Association of Italian Surgeons in Europe) is launching this 2-step survey to get a snapshot of the work conditions of the general surgeons worldwide during the on-call shift to detect differences, strengths and limitations among different national health systems. The baseline data obtained will help us to inform future im...