MEDICINE AND SURGERY DEGREE (MD), PHD. GENERAL SURGEON
RESEARCH, TEACHING, or OTHER INTERESTS
Surgery, Gastroenterology
40
Scopus Publications
Scopus Publications
Restorative Surgery in Adult Short Bowel Syndrome: Outcomes from a Single-Center Experience with an Illustrative Complex Case Federica Galiandro, Carmen Nesci, Giulio Perrone, Franco Sacchetti, Angelo Eugenio Potenza, Dario Pastena, Sara Ennas, Marco Pizzoferrato, Franco Scaldaferri, Alfredo Papa, Luigi Sofo, Paola Caprino Journal of Clinical Medicine, 2026 Background: Short bowel syndrome (SBS) is a severe form of intestinal failure often associated with high output jejunostomy, fluid and electrolyte imbalance, and long-term dependence on parenteral nutrition (PN). In patients with type I SBS, restorative surgery may reduce PN dependence and enable conversion to type II or III SBS through restoration of intestinal continuity. Methods: We report our single-center experience. Between 2018 and 2025, nine adult patients with chronic type I SBS and high-output jejunostomy underwent restorative surgery within a multidisciplinary intestinal rehabilitation program. All patients were PN-dependent preoperatively, and two had intestinal failure-associated liver disease (IFALD). Surgical strategies were individualized according to residual anatomy and focused on restoration of intestinal continuity, without bowel lengthening procedures. Clinical outcomes were descriptively analyzed. Results: Intestinal continuity was successfully restored in all patients, resulting in conversion from type I to type II or III SBS. A clinically relevant improvement in intestinal function was observed in all cases, although follow-up duration was heterogeneous (range 3–60 months), with some patients still in early postoperative follow-up. Complete enteral autonomy was achieved in 3/9 patients (33%), while 6/9 patients (67%) experienced a reduction in PN requirements, including partial or nocturnal supplementation. Five of nine patients developed postoperative complications: one required reoperation and one endoscopic treatment for anastomotic bleeding. No 90-day postoperative mortality was recorded. Conclusions: In adult patients with type I SBS, restorative surgery enables anatomical and functional conversion to type II or III SBS. When performed within specialized multidisciplinary programs and guided by careful management of hostile abdomen, this approach may result in functional improvement and reduced PN dependence, although outcomes remain heterogeneous.
Use of Intraoperative Ultrasonography of the Small Bowel to Reduce Histologically Positive Margins in Crohn’s Disease Surgery: A Pilot Study Franco Sacchetti, Fabrizio Pizzolante, Mauro Giambusso, Carmen Nesci, Diana Giannarelli, Federica Galiandro, Daniela Pugliese, Franco Scaldaferri, Maria C. Giustiniani, Domenico Balzano, Paola Caprino, Angelo E. Potenza, Laura M. Minordi, Luigi Sofo Journal of Clinical Medicine, 2025 Background/Objectives: The histological involvement of surgical resection margins in Crohn’s disease (CD) is an important risk factor for postoperative recurrence. The aim of this study was to evaluate the usefulness of intraoperative ultrasonography (IOUS) of the small bowel to best identify the surgical site of resection and reduce the rate of the histological involvement of margins. Methods: Consecutive patients who underwent ileocolic surgery for CD were prospectively enrolled (IOUS group) and underwent IOUS to fix the resection site. A control historical group of patients undergoing the same surgical procedures was considered and a 1:1 propensity score matching for location of disease and repeated surgery was performed. The primary endpoint was the histological involvement of resection margins. The secondary endpoint was to assess the feasibility of the method. Results: Twenty-seven patients were enrolled in the IOUS group and twenty-seven were enrolled in the non-IOUS group. The two groups were homogeneous in terms of gender, age, smoking, BMI, behavior of disease, and surgical technique. The IOUS group presented a lower rate of histological positive margins (18.5% vs. 48.1%; p = 0.021). No significant differences were found in terms of mean duration of surgery (IOUS: 254.2 min vs. non-IOUS: 225 min [SD = 49.3–77.8]; p = 0.11) or in terms of mean length of surgical specimen (IOUS: 24.1 cm vs. non-IOUS: 34.1 cm [SD = 13.5–23.1]; p = 0.058). Conclusions: IOUS of the small bowel appears to be a useful tool to obtain a lower rate of histologically positive margins with a comparable duration of surgery and no significant difference in the intestinal specimen length.
Clinical, Radiological, and Surgical Risk Factors for Endoscopic Anastomotic Recurrence Following Surgery in Crohn’s Disease Laura Maria Minordi, Franco Sacchetti, Domenico Balzano, Rossella Maresca, Francesca Bice D’Angelo, Luigi Larosa, Davide Carano, Lucrezia Laterza, Daniela Pugliese, Paola Caprino, Angelo Eugenio Potenza, Franco Scaldaferri, Luigi Sofo, Evis Sala Journal of Clinical Medicine, 2024 Objective: This study investigated the radiological, clinical, and surgical factors linked to the risk of endoscopic recurrence following ileocolic resection for Crohn’s disease. Materials and Methods: We conducted a retrospective analysis of data from all patients who underwent primary ileocecal resection for Crohn’s disease in a single colorectal unit between 2004 and 2020. We analyzed the potential risk factors subdivided by the clinical, radiological, and surgical factors associated with morphological recurrence, as detected by endoscopy within 2 years after surgery. Cox regression was employed to ascertain the risk factors associated with such recurrence. Results: In total, 63 patients were included, and 24 (38%) had endoscopic recurrence. The age of the patient at the time of surgery was identified as a significant clinical factor associated with the risk of recurrence (HR: 1.04; p = 0.003), indicating that the probability of recurrence increases by 1% as the surgical age increases each year. The radiological factors associated with an increased risk of recurrence included localization in the distal ileum (HR: 3.526; p = 0.015), the number of pathological small-bowel segments affected by the disease (HR: 1.15; p = 0.004), and the total length of the pathological intestinal segment (HR: 1.002; p = 0.014). The presence of granulomas (HR: 6.003; p = 0.004) and the length of the resected bowel (HR: 1.01; p = 0.003) were surgical factors associated with a higher risk of recurrence. Conclusions: This study delineated several clinical, radiological, and surgical factors that serve as predictors for the endoscopic recurrence of Crohn’s disease after surgery.
Effectiveness of autologous emulsified stromal vascular fraction tissue injection for the treatment of complex perianal fistulas in inflammatory bowel diseases patients: a pilot study Angelo Eugenio Potenza, Dania Nachira, Franco Sacchetti, Angelo Trivisonno, Daniela Pugliese, Ivo Boškoski, Giuseppe Caudullo, Laura Maria Minordi, Luigi Larosa, Paola Caprino, Franco Scaldaferri, Luigi Sofo, Venanzio Porziella Therapeutic Advances in Gastroenterology, 2024 Complex fistulizing perianal disease is a disabling manifestation of inflammatory bowel disease (IBD), seriously compromising patients ‘quality of life’. The success rate of available treatments is quite low, and nearly half of the patients will develop chronically active fistulas or experience fistula recurrence. Mesenchymal stem cell therapy has shown interesting results, but the complexity and the cost of production limit its widespread use. This study aims to report the results of the innovative use of autologous emulsified adipose-derived stromal vascular fraction tissue for treating complex fistulizing perianal disease. From March 2021 to March 2022, 10 patients underwent a two-step procedure: (1) examination under anaesthesia, with loose seton drainage and 4 weeks later and (2) curettage of the fistulous tract, internal fistula closure and an injection of autologous emulsified adipose-derived stromal vascular fraction tissue harvested from the subcutaneous layer of the patient’s hip. Clinical and radiological (through magnetic resonance imaging) healing were assessed at 6 months. We included five patients affected by Crohn’s disease, three by ulcerative colitis and two by indeterminate colitis. All patients were on concomitant biological therapy (50% on Infliximab). One patient required a re-treatment for a relapse and two different fistulas were separately treated in another one. Out of 12 total procedures performed, clinical healing was achieved in 10 cases (83%), while radiological healing in 6 patients (50%). No adverse events were recorded. Autologous emulsified adipose-derived stromal vascular fraction tissue can represent an effective, safe and cheap add-on therapy for patients with complex perianal fistulas in IBDs.
Multiloculated omental cystic tumor hiding an angioleiomyoma: case report of a rare and atypical presentation and literature review Mauro Giambusso, Paola Caprino, Franco Sacchetti, Angelo Eugenio Potenza, Dario Pastena, Luigi Sofo Journal of Surgical Case Reports, 2023 Angioleiomyoma is a rare benign tumor arising from vascular smooth muscle and generally located in the subcutaneous tissue of the extremities. We reported a rare case of an intra-abdominal localization originating from the small omentum in which progressive growth detected on radiological follow-up indicated surgical excision. Histology documented a cavernous angioleiomuscular tumor with uncertain potential for malignancy. Although angioleiomyoma is described as a benign tumor, the uncertain behavior for malignancy of this case could have led to neoplastic degeneration. Early diagnosis followed by surgical excision of the neoplasia is crucial.
Risk factors and outcomes of restorative proctocolectomy with ileal pouch-anal anastomosis for ulcerative colitis. Retrospective study of 75 single center cases P. Caprino, M. Giambusso, F. Sacchetti, A. Potenza, D. Pastena, S. Panunzi, I. Piergentili, L. Sofo European Review for Medical and Pharmacological Sciences, 2023 OBJECTIVE Restorative proctocolectomy with ileal pouch-anal anastomosis (IPAA) is the surgical gold standard in patients with ulcerative colitis (UC). Results are generally satisfactory but there is a significant rate of patients who experience postoperative complications. The aims of our study were to identify the pre- and intraoperative risk factors and their correlation with the reported outcomes. PATIENTS AND METHODS A retrospective study was conducted on the medical records of all consecutive patients undergoing restorative proctocolectomy with IPAA for UC in our center from 2010 to 2021. Pre- and intraoperative factors were examined and correlated with pouchitis, endoscopic pouchitis, pouch failure, anastomotic leak, postoperative complications classified according to Clavien-Dindo score and stoma outlet obstruction. A univariate and multivariate statistical analysis was performed. RESULTS Out of 75 patients undergoing 3- or 2-stage IPAA surgery, the coexistence of extraintestinal clinical manifestations and preoperative topical rectal stump therapy for active proctitis were significantly associated with the occurrence of pouchitis (OR=4.4, p=0.03 and OR=7.6, p=0.01). Endoscopic pouchitis was found to be related to preoperative topical rectal therapy (OR=10.2, p=0.007), but not to extraintestinal manifestations of disease. Anastomotic leak was found to be significantly related to pouch failure (OR=22.7, p=0.007). Surgical indication for malignancy increased the risk for early complications (Clavien-Dindo >2) (OR=16.0, p=0.04). Young age was associated with the occurrence of outlet stoma obstruction in patients with recent IPAA surgery (OR=0.97, p=0.05). CONCLUSIONS Based on observed results, an appropriate preoperative patient assessment aimed at detecting specific risk factors is crucial to identify early or prevent worse outcomes in patients undergoing IPAA surgery.
Early and late outcomes of a series of 255 patients with Crohn’s disease who underwent resection: 10 years of experience at a single referral center Franco Sacchetti, Paola Caprino, Angelo Eugenio Potenza, Dario Pastena, Stefano Presacco, Luigi Sofo Updates in Surgery, 2022 Patients with Crohn's disease experience an increased risk of postoperative complications and disease recurrence. The aim of this study was to investigate the role of the risk factors in determining these outcomes and whether preoperative removal of some of these risk factors would optimize the results. We conducted a retrospective study analyzing a consecutive series of 255 patients who underwent surgical resection for Crohn's disease between 2010 and 2020. We considered short- and long-term endpoints, such as postoperative complications categorized according to the Clavien–Dindo classification and the appearance of surgical and endoscopic postoperative recurrence. Univariable and multivariable analyses showed that multiple and extensive localizations increased the incidence of postoperative complications (OR = 2.19; 95% CI 1.05–4.5; p = 0.035 and OR = 1.015; 95% CI 1.003–1.028; p = 0.017 for each cm of resected segment, respectively). Regarding theoretically modifiable factors, preoperative hypoalbuminemia (for each g/L reduction) increased the risk of complications with an OR = 1.1; 95% CI 1.02–1.12; p = 0.003. Preoperative steroid therapy exerted a similar effect, with an OR = 2.6; 95% CI 1.1–5.9; p = 0.018. Modifying these last two risk factors by improving the nutritional status or discontinuing steroid therapy significantly reduced complications.Microscopic positivity of the resection margins was a risk factor for surgical recurrence (OR = 8.7; 95% CI 1.9–40; p = 0.05). Based on the results of the present study, surgeons must examine modifiable risk factors, and careful preoperative tailored management may reduce postoperative complications and disease recurrence.
Malakoplakia of the appendix in a young healthy adult: a case report and literature review Dario Pastena, Mauro Giambusso, Federica Castri, Angelo Eugenio Potenza, Paola Caprino, Franco Sacchetti, Luigi Sofo Journal of Surgical Case Reports, 2022 Malakoplakia is a rare entity on inflammatory base that mostly occurs in immunocompromised individuals which is thought to be secondary to a bactericidal defect in macrophages. The genitourinary tract is typically affected. The appendix is a very rare localization. We report a case of malakoplakia in the appendix of a young healthy patient with a recent history of abdominal pain associated with diarrhea and nausea. The colonscopy and CT scan showed an extramucosal bumping mass pressing on the cecum and covered by normal mucosa. The patient underwent to laparoscopic appendectomy. The histology showed a malakoplakia of the appendix. Gastrointestinal localization of malakoplakia is often associated with preexisting diseases, which are probably responsible for an immune disorder underlying the etiopathogenesis of the disease. However, in our case, the patient had no comorbidities. Probably, a clinically unknown immune predisposition plays an important role. Further studies are needed to clarify this nexus.
The impact of COVID-19 pandemic on IBD surgery: a single center experience D. Pastena, M. Giambusso, A. Potenza, P. Caprino, F. Sacchetti, A. Armuzzi, L. Sofo European Review for Medical and Pharmacological Sciences, 2022 OBJECTIVE The spread of COVID-19 pandemic forced the national healthcare system to reorganize almost all surgical services, in order to maintain an adequate therapeutic offer. At General Surgery department of Fondazione Policlinico Gemelli in Rome, surgical procedures were progressively reduced to provide beds and personnel for COVID-19. The aim of our study was to analyze the effect of one year of COVID-19 pandemic on Inflammatory Bowel Disease (IBD) surgery in a cohort of patients and evaluate post-operative short-term complications. PATIENTS AND METHODS Our team retrospectively analyzed the records of IBD patients who were referred to an IBD-related resective surgery from January 2020 to December 2020. These patients were compared to a comparable group of IBD patients who were operated from January 2019 to December 2019. RESULTS A total of 160 patients were included in the study. Median age was 44 (range 15-77). Patients were referred for Ulcerative colitis (23.1%) and Crohn's disease (76.9%). Eighty-three patients underwent surgery from January 2020 to December 2020, which constitutes a 4.6% increase in the number of patients compared to the same period in 2019. Median post-operative hospital stay increased (7 days in 2019 vs. 6 days in 2020). Laparoscopic was the most frequently performed procedure during both periods (49% in 2019 and 59% in 2020). Complication rates, reported as Clavien-Dindo score 3 or 4, slightly decreased in 2020 (6.5 in 2019 vs. 4.8 in 2020). PCR test for detection of COVID-19 infection was conducted in all the patients before the hospitalization. Two patients out of 70 were tested positive for COVID-19 and their surgeries were rescheduled. CONCLUSIONS There was no significant reduction in IBD resective surgeries at our center in 2020, nor a deterioration of the outcomes. A reduction of other elective surgical procedures had to be carried out and adequate protective measures for both patients and healthcare workers were established.
Use of electrochemotherapy in a combined surgical treatment of local recurrence of rectal cancer Paola Caprino, Franco Sacchetti, Luca Tagliaferri, Maria Antonietta Gambacorta, Angelo Eugenio Potenza, Dario Pastena, Luigi Sofo Journal of Surgical Case Reports, 2021 Recurrence of rectal cancer (RRC) affects up to one-third of patients. The survival is strictly dependent on the possibility of performing surgery without microscopic tumor residues (R0). Electrochemotherapy (ECT) is based on the effect that electric pulsations have on increasing the permeability of the cell membrane to certain drugs. We propose the association of ECT to the surgical excision of perineal RRC in a 72-year-old male patient. Given the proximity between the recurrence and the urethra, it was decided to use ECT in order to clean any further neoplastic residues 10 mm from the surgical resection margin. Pelvic MRI at 4 and 7 months and clinical follow-up conducted for 9 months did not document disease recurrence. ECT combined with surgery can prove to be a valid choice in selected cases and could be the best treatment the patient is willing to accept.
Inflammatory bowel disease position statement of the Italian Society of Colorectal Surgery (SICCR): ulcerative colitis G. Pellino, D. S. Keller, G. M. Sampietro, M. Carvello, V. Celentano, C. Coco, F. Colombo, A. Geccherle, G. Luglio, M. Rottoli, M. Scarpa, G. Sciaudone, G. Sica, L. Sofo, R. Zinicola, S. Leone, S. Danese, A. Spinelli, G. Delaini, F. Selvaggi, Imerio Angriman, Paola Caprino, Francesca Di Candido, Mirko Di Ruscio, Silvio Laureti, Gilberto Poggioli, Gianluca Rizzo, Giulia Roda, Franco Sacchetti, Stefano Scaringi, Bruno Sensi, Angela Variola, Committee Gianluca Pellino, Deborah S. Keller, Gianluca M. Sampietro, Salvatore Leone, Silvio Danese, Antonino Spinelli, GianGaetano Delaini, Francesco Selvaggi, and Techniques in Coloproctology, 2020
Incidence and impact of variant celiacomesenteric vascularization and vascular stenosis on pancreatic surgery outcomes: Personal experience American Surgeon, 2018
Does CD10 expression individuate a GIST subgroup of patients? Minerva Chirurgica, 2014
Temporary medium arcuate ligament syndrome after pancreatoduodenectomy American Surgeon, 2013
Complications related to hyperthermia during hypertermic intraoperative intraperitoneal chemiotherapy (HIPEC) treatment. Do they exist? European Review for Medical and Pharmacological Sciences, 2012
A very advanced case of a T cell peritoneal lymphomatosis Annali Italiani Di Chirurgia, 2012
Capecitabine based postoperative accelerated chemoradiation of pancreatic carcinoma. A dose-escalation study Alessio G. Morganti, Vincenzo Picardi, Edy Ippolito, Mariangela Massaccesi, Gabriella Macchia, Francesco Deodato, Gian Carlo Mattiucci, Luciana Caravatta, Liberato Di Lullo, Gianfranco Giglio, Rosa Tambaro, Samantha Mignogna, Paola Caprino, Marcello Ingrosso, Luigi Sofo, Numa Cellini, Vincenzo Valentini Acta Oncologica, 2010
Acute abdomen for omental volvulus Paola Caprino, Francesco P. Prete, Sergio Alfieri, Giovanni Battista Doglietto American Journal of Surgery, 2004
A rare case of digestive tract hemorrhage of extraluminal origin after total gastrectomy Chirurgia Italiana, 2003
Avoiding early postoperative complications in liver surgery. A mutlivariate analysis of 254 patients consecutively observed Digestive and Liver Disease, 2001
Lymph node dissection in the treatment of gastric cancer Annali Italiani Di Chirurgia, 2001
