Federico Famiglietti

Università degli Studi di Torino, Torino, Piedmont, Italy

Are you Federico Famiglietti?

Claim your profile

Publications (18)57.64 Total impact

  • M. Toppino · G. Bonnet · S. Volpatto · F. Famiglietti · M. Morino

    No preview · Conference Paper · Jul 2014
  • A. Arezzo · N. Vettoretto · F. Famiglietti · L. Moja · M. Morino

    No preview · Article · Feb 2014
  • Mario Morino · Federico Famiglietti · Claudio Giaccone · Fabrizio Rebecchi
    [Show abstract] [Hide abstract]
    ABSTRACT: Since its first description in 1991, laparoscopic Heller myotomy has been associated with better short-term outcomes and shorter recovery time, compared to open operation and it is now generally accepted as the procedure of choice for achalasia. Despite the well-known short-term benefits of laparoscopy, esophageal perforation still occurs. Robotic technology has recently been introduced into laparoscopic clinical practice with the aim of improving surgical performance and excellent results have been described with robotically assisted Heller myotomy in patients with achalasia. The 3-D visualization, the very steady operative view and, above all, the articulated arms of the da Vinci Robotic Surgical System allow the surgeon to visualize and divide each individual muscolar fiber, easily identifying the submucosal plane at the GE junction. However, no high-quality studies are available in literature. Moreover, from an economic point of wiew, the use of the robotic technology may increase both the costs and the volume of surgeries performed. Achalasia, Robotically assisted myotomy.
    No preview · Article · Oct 2013
  • Source
    Alberto Arezzo · Gitana Scozzari · Federico Famiglietti · Roberto Passera · Mario Morino
    [Show abstract] [Hide abstract]
    ABSTRACT: Background: Single-incision laparoscopic cholecystectomy (SILC) is gaining popularity. It is not evident whether the benefits of this procedure overcome the potential increased risk. We performed a systematic review and meta-analysis to compare SILC with conventional multi-incision laparoscopic cholecystectomy (MILC). Methods: Data from randomized, controlled trials published up to December 2011 and comparing SILC versus MILC were extracted. The primary end point was overall morbidity. A fixed-effect model was applied to summarize the study outcomes in the meta-analysis, and a random-effect model was used in the sensitivity analysis. The outcome measures were relative risk (RR) and mean difference (MD); a RR of <1.0 or a negative MD indicated a more favorable outcome after SILC. Publication bias was assessed by a funnel plot, and heterogeneity was tested by the I (2) measure and subgroup analyses. Results: A total of 12 trials (996 patients) were included. Mortality was nil in both treatment groups; the overall RR for morbidity was 1.36 (p = 0.098). The mean operating time was 47.2 min for MILC and 58.1 min for SILC (MD 9.47 min; p < 0.001). The visual analog scale pain score at 24 h after surgery was 2.96 in MILC and 2.34 in SILC (MD -0.64; p = 0.058), but sensitivity analysis of the four studies deemed at low risk of bias for pain assessment, according to blinding and postoperative analgesic protocols, showed significance at -0.43 points (95 % confidence interval -0.87 to 0.00; p = 0.049). Cosmetic outcome scored better in the SILC group, with its standardized MD being equal to 1.16 (95 % confidence interval 0.57 to 1.75; p < 0.001). Conclusions: In selected patients, SILC has similar overall morbidity compared with MILC; further, it results in better cosmetic satisfaction and reduced postoperative pain despite longer operative time.
    Full-text · Article · Jan 2013 · Surgical Endoscopy
  • Mario Morino · Federico Famiglietti
    [Show abstract] [Hide abstract]
    ABSTRACT: Minimally invasive combined colorectal and liver resection is indicated for both benign (diverticular disease, colonic adenoma unsuitable for endoscopic resection, benign liver lesions) and malignant (primary colorectal cancer, hepatocellular carcinoma or HCC, colorectal liver metastases) etiologies. However, whereas reports for benign diseases are sporadic [1], most of the studies published show results of the combined minimally invasive approach to primary colorectal cancer (CRC) with synchronous liver metastases (SLM) [2–7].
    No preview · Chapter · Jan 2013
  • Source
    Alberto Arezzo · Nereo Vettoretto · Federico Famiglietti · Lorenzo Moja · Mario Morino
    [Show abstract] [Hide abstract]
    ABSTRACT: Background: The ideal management of cholelithiasis and common bile duct stones still is controversial. Although the two-stage sequential approach remains the prevalent management, several trials have concluded that the so-called laparoendoscopic rendezvous (LERV) technique offers some advantages, such as a reduced risk of post-ERCP (endoscopic retrograde cholangiopancreatography) pancreatitis. This study aimed to compare the single-stage LERV technique with the two-stage endoscopic sphincterotomy followed by laparoscopic cholecystectomy. Methods: A search for randomized controlled trials (RCTs) comparing LERV and the two-stage sequential approach was conducted. The outcomes considered were overall complications and pancreatitis. Medline, EMBASE, and the Cochrane Central Register of Controlled Trials (CENTRAL) were searched from 1998 to July 2012. Odds ratios (ORs) were extracted and pooled using a fixed or random-effect model depending on I (2) used as a heterogeneity measure. Results: Four RCTs, including a total of 430 patients, met the inclusion criteria. The incidence of overall complications was lower in the LERV group (11.2 %) than in the two-stage intervention group (18.1 %) (OR, 0.56; 95 % confidence interval [CI], 0.32-0.99; P = 0.04; I (2) = 45 %). The findings showed that LERV was associated with less clinical pancreatitis (2.4 %) than the two-stage technique (8.4 %) (OR, 0.33; 95 % CI, 0.12-0.91; P = 0.03; I (2) = 33 %). Conclusions: Despite the limitation of a small number of studies completed, the evidence of RCTs shows that LERV is superior to two-stage treatment due to a reduction in overall complications, particularly pancreatitis.
    Full-text · Article · Oct 2012 · Surgical Endoscopy

  • No preview · Article · Sep 2012 · European Journal of Surgical Oncology
  • Source
    [Show abstract] [Hide abstract]
    ABSTRACT: Background: Peritoneal perforation (PP) is frequently reported as a complication of transanal endoscopic microsurgery (TEM). Nevertheless, these concerns have only rarely been addressed in the literature, with no mention of the long-term oncologic consequences of PP. Methods: A prospective database was analyzed with the intent to evaluate the influence of PP on the short- and long-term outcomes for patients undergoing TEM. Results: Peritoneal perforation occurred in 28 (5.8%) of 481 patients who underwent TEM for a rectal neoplasm. The conversion rate to abdominal surgery was 10.7% (3/28). All the conversions occurred during the first 100 TEM procedures (3/100 vs 0/381; p = 0.007). The postoperative morbidity rate was 3.6% (1/28), and the 30-day mortality was nil. Compared with the group of patients who had no peritoneal perforation, the PP group showed a significantly longer operating time (120 vs 60 min; p < 0.001) and a significantly longer hospital stay (6 vs 4 days; p = 0.003). Nevertheless, the global morbidity rate and the type of complications according to Dindo's classification were similar. In the multivariate analysis, the only independent predictor of PP was tumor distance from the anal verge (p = 0.010). During a median follow-up period of 48 months (range, 12-150 months), no liver or peritoneal metastases were detected in 13 patients with rectal cancer. Conclusions: Peritoneal perforation does not seem to affect short-term or oncologic outcomes for patients submitted to TEM with full-thickness resection for upper rectum neoplasms. The use of TEM to resect rectal lesions involving the intraperitoneal rectum may therefore represent an intermediate step toward the development of transrectal natural orifice translumenal endoscopic surgery (NOTES) techniques.
    Full-text · Article · Jun 2012 · Surgical Endoscopy
  • Source
    [Show abstract] [Hide abstract]
    ABSTRACT: Transanal endoscopic microsurgery (TEM) has revolutionized the technique and outcome of transanal surgery, becoming the standard of treatment for large sessile rectal adenomas. Nevertheless, only a few studies have evaluated the risk factors for local recurrence in order to recommend a "tailored" approach. The aim of this study was to identify predictor variables for recurrence after TEM to treat rectal adenoma. This study is a retrospective analysis of a prospective database of patients treated for large sessile rectal adenomas by TEM at our institution, with a minimum follow-up of 12 months. Age, gender, tumor diameter, distance from the anal verge, degree of dysplasia, histology, and margin involvement were investigated. Between January 1993 and July 2010, 293 patients with a rectal adenoma ≥3 cm underwent TEM. Postoperative morbidity rate was 7.2 % (21/293) and there was no 30-day mortality. Over a median follow-up period of 110 (range = 12-216) months, 13 patients (5.6 %) were diagnosed with local recurrence. The median time to recurrence was 10 (range = 4-33) months, with 76.9 % of recurrences detected within 12 months after TEM. At univariate analysis, tumor diameter (p = 0.007), and positive margins (p < 0.001) were shown to be significant risk factors, while multivariate analysis indicated the presence of positive margins as the only independent predictor of recurrence (p = 0.003). TEM provides excellent oncological outcomes in the treatment of large sessile benign rectal lesions, assuring a minimal risk of resection margin infiltration at pathology examination, which represents the only risk factor for recurrence.
    Full-text · Article · Apr 2012 · Surgical Endoscopy
  • Alberto Arezzo · Federico Famiglietti · Mario Morino · Roberto Passera

    No preview · Article · Mar 2012 · Annals of surgery
  • M. Morino · M.E. Allaix · F. Famiglietti · A. Arezzo

    No preview · Article · Mar 2012 · Digestive and Liver Disease
  • Source

    Full-text · Article · Feb 2012 · Colorectal Disease
  • M Morino · M Verra · F Famiglietti · A Arezzo
    [Show abstract] [Hide abstract]
    ABSTRACT: Surgical techniques and technologies are rapidly evolving. In the field of colorectal surgery the transanal video-assisted approach was introduced by Buess, 30 years ago, with transanal endoscopic microsurgery (TEM). In more recent years different techniques and technologies have been proposed, including natural orifice specimen extraction (NOSE), natural orifice transluminal endoscopic surgery (NOTES) and single-access surgery. Furthermore, a better understanding of the prognostic and risk factors of rectal cancer has allowed TEM to expand its indications to local resection of selected tumours, and more recently there have been proposals for sentinel node biopsy in colon and rectal cancer.
    No preview · Article · Nov 2011 · Colorectal Disease
  • G. Scozzari · M. Toppino · G. Bonnet · F. Famiglietti · M. Morino

    No preview · Conference Paper · Aug 2011
  • Alberto Arezzo · Federico Famiglietti · Domenica Garabello · Mario Morino

    No preview · Article · Nov 2010 · Clinical gastroenterology and hepatology: the official clinical practice journal of the American Gastroenterological Association
  • Gitana Scozzari · Mauro Toppino · Federico Famiglietti · Gisella Bonnet · Mario Morino
    [Show abstract] [Hide abstract]
    ABSTRACT: To evaluate the long-term results of laparoscopic vertical banded gastroplasty (VBG) for morbid obesity. Laparoscopic VBG, a safe and straightforward bariatric procedure characterized by good short-term results, has been progressively replaced by other more complex procedures on the basis of a presumed high rate of long-term failure. Nevertheless, some authors have recently reported long-term efficacy in selected patients. All patients who underwent laparoscopic VBG were included in a prospective database. Patients reaching 10-year follow-up received a complete evaluation including clinical, endoscopic, and biochemical examinations. Between January 1996 and March 1999, 266 morbidly obese patients underwent bariatric procedures. Among them, 213 were selected for laparoscopic VBG; exclusion criteria were as follows: contraindications to pneumoperitoneum, gastroesophageal reflux disease, and psychological contraindications to restrictive procedures. Mean age, preoperative weight, and body mass index were 36.9 years, 123.6 kg, and 45.4 kg/m, respectively. Intraoperative complication rate and conversion rate were 0.9% and 0.9%, respectively. Early postoperative complication rate was 4.2% and early reoperation rate was 0.5%. Mean hospital length of stay was 6.3 days. Mortality was nil. The 10-year follow-up rate was 70.4% (150 patients). Late postoperative complication rate was 14.7%, and 10-year revisional surgery rate was 10.0%. The excess weight loss percentages at 3, 5, and 10 years were 65.0%, 59.9%, and 59.8%, respectively. The resolution and/or improvement rate for comorbidity were 47.5% for hypertension, 55.6% for diabetes, 75% for sleep apnea, and 47.4% for arthritis. Mean Moorehead-Ardelt Quality of Life Questionnaire and BAROS values were 1.4 and 3.8, respectively. The present study demonstrates that laparoscopic VBG in carefully selected patients leads to long-term results comparable with more complex and invasive procedures. Given the low postoperative morbidity for laparoscopic VBG, its present clinical role should be, in our opinion, reevaluated.
    No preview · Article · Nov 2010 · Annals of surgery
  • Source
    [Show abstract] [Hide abstract]
    ABSTRACT: We report the case of a 68-year-old female patient affected by rectal cancer and a synchronous metastatic lesion measuring 8 cm in diameter in the left hepatic lobe. After a laparoscopic ultrasonography exploration of the liver to detect possible occult metastases, a simultaneous colorectal resection and a left hepatic lobectomy including a partial resection of segment IV were performed. Five ports were used for the entire procedure. The resected specimens were extracted through a Pfannenstiel incision. The procedure was completed laparoscopically. Total operative time was 455 minutes with negligible intraoperative blood loss. The postoperative hospital stay was 12 days. At 4-month follow-up, the patient recovered completely. A computed tomography scan performed at this time showed no signs of recurrent disease. This report confirms the feasibility of the laparoscopic approach to simultaneous hepatic and colorectal resections in stage IV rectal cancer. The known advantages of the miniinvasive approach could make such complex procedures more endurable.
    Full-text · Article · Jul 2010 · JSLS: Journal of the Society of Laparoendoscopic Surgeons / Society of Laparoendoscopic Surgeons
  • [Show abstract] [Hide abstract]
    ABSTRACT: Simultaneous pancreas-kidney transplantation (SPKT) is now an accepted therapy for patients with insulin-dependent diabetes mellitus. However, SPKT has an high rate of morbidity and mortality, mainly for infection. From October 1986 to June 2008, in our center 54 patients (18 female; 36 male) affected by diabetes and end-stage renal disease underwent SPKT. The mean duration of diabetes mellitus was 25 +/- 4 years. Only 4 patients had not been treated by dialysis before SPKT. Three operative techniques were used: duct injection (n = 5), bladder diversion (n = 14), and enteric diversion (n = 39). The kidneys were always placed into the left retroperitoneal space. The pancreas was placed extraperitoneally in 5 patients. Thirty-four recipients are alive, including 30 with function of both grafts. Six patients died during the first year after transplantation. Infectious complications were the main cause of death in 3 subjects whereas 98 infections were diagnosed in 51 patients. All patients were treated with immunosuppressive agents: steroids associated with calcineurin inhibitors and mycophenolic acid, or azathioprine. Antibody induction was used in 41 patients with anti-interleukin-2 monoclonal antibody or antithymocyte globulin. We detected 41 episodes of cytomegalovirus infection: systemic (n = 38), bladder (n = 2), and duodenal (n = 1). The 51 bacterial infections were systemic: (n = 10); urinary tract: (n = 22); pulmonary (n = 11); wound (n = 5); intestinal (n = 3). The 5 fungal infections were gastrointestinal tract (n = 3); and arteritis (n = 2). Some patients experienced more than 1 type of infection. The predominant etiology of the systemic infections was bacterial. In conclusion, infectious complications were the main causes of morbidity after SPKT. An early diagnosis of infection, particularly fungal complications, is essential. We recommend administration of broad-spectrum prophylactic antibiotics, antifungals, and antiviral agents.
    No preview · Article · Jun 2009 · Transplantation Proceedings

Publication Stats

130 Citations
57.64 Total Impact Points


  • 2010-2013
    • Università degli Studi di Torino
      • Dipartimento di Scienze Cliniche e Biologiche
      Torino, Piedmont, Italy
    • Università degli Studi di Genova
      Genova, Liguria, Italy
  • 2009
    • Azienda Ospedaliera Universitaria San Martino di Genova
      Genova, Liguria, Italy