LUCIA ILARIA SGARAMELLA

Dottoressa di ricerca

ciclo: XXXV


supervisore: Prof. Vito D'Andrea

Titolo della tesi: Utilizzo della risonanza magnetica e della mammografia nelle pazienti candidate a mastectomia nipple o skin sparing. Valutazione degli Outcomes chirurgici precoci

Ischemic complications in patients submitted to nipple or skin sparing mastectomy can be severe surgical sequelae that negatively impact the reconstruction causing temporary flap complication up to total loss of the implant. The risk factors for ischemic complications include patient and surgical risk factors. Among these the importance of flap thickness and the role of superficial vascularization in the subcutaneous tissue and in the dermal matrix remain poorly studied. The aim of the study is to evaluate the incidence of skin flap thickness in predicting ischemic complications and how these can be avoided with a correct preoperative study given by the integration of MRI and mammography data. A prospectively maintained institutional database from January 2018 to August 2022 was retrospectively reviewed. All patients with preoperative MRI availability who underwent skin or nipple sparing mastectomy were included in the study. For each patient, an external reviewer blindly calculated the thickness of the flaps from skin to gland on preoperative MRI and breast volume by mammography examination using PACS software. Demographics and outcomes were stratified by those with and without ischemic complications. Of 568 patients submitted to breast surgery, 28 surgical interventions were analyzed of which 20 for unilateral mastectomy and 8 interventions for bilateral mastectomy the latter equal to 16 glands operated with reconstruction, for a total of 36 operated glands. Three cases (8,33%) of ischemic complications were reported: 2 cases (66,67%) of nipple necrosis and 1 case (33,33%) of flap necrosis. All risk factors were analyzed and assessed in relation to ischemic complications. At univariable analysis a correlation with ischemic complications and a history of heart disease (p * 0.008) and with a preoperative thickness on MRI< 8 mm (p * 0.045) were identified. At multivariable analysis the preoperative thickness > 8 mm was an independent predictor inversely correlated with generic ischemic complications (p * 0.037) with strength of association equal to an 18-fold higher frequency of ischemic events (OR 18.1) in patients with flap thickness less than 8 mm. Thickness is a key predictor for assessing the risk of general ischemic complications in patients who are candidates for skin or nipple sparing mastectomy with one- or two-stage reconstructions. The presence of additional factors including heart disease, previous breast surgery or previous chest radiotherapy are certainly worthy of further study and should be the subject of further studies.

Produzione scientifica

  • 11573/1346526 - 2019 - A Novel Technique of Digestive Anastomosis Reinforcement Using Bovine Pericardium Patch (01a Articolo in rivista)
    SGARAMELLA, LUCIA ILARIA; FALCO, EMILIO; CECCARELLI, GRAZIANO; TESTINI, MARIO
  • 11573/1350065 - 2019 - Current concepts in parathyroid carcinoma. A single Centre experience (01a Articolo in rivista)
    FERRARO, VALENTINA; SGARAMELLA, LUCIA ILARIA
  • 11573/1495903 - 2020 - Severe anemia in a patient with vulvar melanoma (01m Editorial/Introduzione in rivista)
    SGARAMELLA, LUCIA ILARIA; TESTINI, MARIO
  • 11573/1496162 - 2021 - Effect of thyroidectomy on circulating angiogenic cytokines in papillary thyroid carcinoma and benign goiter: Potential for new biomarkers? (01a Articolo in rivista)
    FERRARO, VALENTINA; SGARAMELLA, LUCIA ILARIA; TESTINI, MARIO
  • 11573/1495910 - 2020 - Open necrosectomy is feasible as a last resort in selected cases with infected pancreatic necrosis: a case series and systematic literature review (01g Articolo di rassegna (Review))
    SGARAMELLA, LUCIA ILARIA; TESTINI, MARIO
  • 11573/1496164 - 2020 - A combined open and laparoscopic technique for the treatment of umbilical hernia. Retrospective review of a consecutive series of patients (01g Articolo di rassegna (Review))
    SGARAMELLA, LUCIA ILARIA; CAVALLARO, GIUSEPPE; TESTINI, MARIO
  • 11573/1349721 - 2018 - Parathyroid carcinoma in multiple endocrine neoplasm type 1 syndrome: case report and systematic literature review (01g Articolo di rassegna (Review))
    SGARAMELLA, LUCIA ILARIA; FERRARO, VALENTINA; TESTINI, MARIO
  • 11573/1495908 - 2020 - The critical view of safety during laparoscopic cholecystectomy: Strasberg Yes or No? An Italian Multicentre study (01a Articolo in rivista)
    SGARAMELLA, LUCIA ILARIA; CECCARELLI, GRAZIANO; TESTINI, MARIO; CONZO, GIOVANNI; FERRARO, VALENTINA; FONTANA, MARIO TOMMASO; GENNAI, ANDREA; TOLONE, STEFANO
  • 11573/1496768 - 2017 - Management of Mirizzi syndrome in emergency (01a Articolo in rivista)
    TESTINI, MARIO; SGARAMELLA, LUCIA ILARIA
  • 11573/1496772 - 2017 - Patologia litiasica della colecisti e delle vie biliari. Testo di “Chirurgia Generale” a cura di Minni F. Edizioni CEA. Zanichelli 2019. (02a Capitolo o Articolo)
    SGARAMELLA, LUCIA ILARIA; FERRARO, VALENTINA; TESTINI, MARIO
  • 11573/1561222 - 2021 - The THYCOVIT (Thyroid Surgery during COVID-19 pandemic in Italy) study: results from a nationwide, multicentric, case-controlled study (01a Articolo in rivista)
    BASILI, GIORGIA; BONONI, MARCO; CAVALLARO, GIUSEPPE; CONZO, GIOVANNI; IACOBONE, MARCO; TESTINI, MARIO; ANEDDA, GLORIA; CANGIANO, ALESSIO GIOVANNI; CAPPELLACCI, FRANCESCA; CHIAPPINI, AMBRA; CROCETTI, DANIELE; GIUDICI, FEDERICO; LUCCHINI, RENATO; MARCELLINARO, ROSA; MENDITTO, ROSA; OSSOLA, PAOLO; PIETRASANTA, DARIO; POLISTENA, ANDREA; SCALISE, ELENA; SGARAMELLA, LUCIA ILARIA; SPINELLI, SILVIA; SPOLETINI, DOMENICO; VIVIANI, EMANUELE
  • 11573/1561231 - 2021 - Impact of the COVID-19 pandemic on surgery for thyroid cancer in Italy: nationwide retrospective study (01f Lettera, Nota)
    BASILI, GIORGIA; BONONI, MARCO; CAVALLARO, GIUSEPPE; CONZO, GIOVANNI; IACOBONE, MARCO; TESTINI, MARIO; ANEDDA, GLORIA; CANGIANO, ALESSIO GIOVANNI; CAPPELLACCI, FRANCESCA; CHIAPPINI, AMBRA; CROCETTI, DANIELE; DE MANZINI, NICOLO'; GIUDICI, FEDERICO; LUCCHINI, RENATO; MARCELLINARO, ROSA; MENDITTO, ROSA; OSSOLA, PAOLO; PIETRASANTA, DARIO; POLISTENA, ANDREA; SCALISE, ELENA; SGARAMELLA, LUCIA ILARIA; SPINELLI, SILVIA; SPOLETINI, DOMENICO; VIVIANI, EMANUELE
  • 11573/1619661 - 2021 - Rare gastrointestinal metastases from primary lung cancer. Two case reports of patients managed with emergency surgery (01a Articolo in rivista)
    SGARAMELLA, LUCIA ILARIA; TESTINI, MARIO
  • 11573/1619652 - 2021 - Prognostic and therapeutic role of angiogenic microenvironment in thyroid cancer (01a Articolo in rivista)
    SGARAMELLA, LUCIA ILARIA; TESTINI, MARIO
  • 11573/1620340 - 2021 - Introducing routine intraoperative nerve monitoring in a high-volume endocrine surgery centre: a health technology assessment (01a Articolo in rivista)
    SGARAMELLA, LUCIA ILARIA; TESTINI, MARIO
  • 11573/1619648 - 2021 - The value of intraoperative ultrasound in selective lateral cervical neck lymphadenectomy for papillary thyroid cancer: a prospective pilot study (01a Articolo in rivista)
    SGARAMELLA, LUCIA ILARIA; TESTINI, MARIO
  • 11573/1668483 - 2022 - Intraabdominal sporadic desmoid tumors and inflammation: an updated literature review and presentation and insights on pathogenesis of synchronous sporadic mesenteric desmoid tumors occurring after surgery for necrotizing pancreatitis (01a Articolo in rivista)
    SGARAMELLA, LUCIA ILARIA; RESTA, NICOLETTA; TESTINI, MARIO
  • 11573/1668480 - 2023 - Utilizzo della risonanza magnetica e della mammografia nelle pazienti candidate a mastectomia nipple o skin sparing. Valutazione degli Outcomes chirurgici precoci (07a Tesi di Dottorato)
    SGARAMELLA, LUCIA ILARIA
  • 11573/1668482 - 2022 - Risk factors for difficult thyroidectomy and postoperative morbidity do not match: retrospective study from an endocrine surgery academic referral centre (01a Articolo in rivista)
    SGARAMELLA, LUCIA ILARIA; TESTINI, MARIO
  • 11573/1668484 - 2022 - Effect of Antibiotic Prophylaxis on Surgical Site Infection in Thyroid and Parathyroid Surgery: A Systematic Review and Meta-Analysis (01a Articolo in rivista)
    POLISTENA, ANDREA; AVENIA, STEFANO; CAVALLARO, GIUSEPPE; SGARAMELLA, LUCIA ILARIA; TESTINI, MARIO
  • 11573/1668481 - 2023 - Mastectomy with one-stage or two-stage reconstruction in breast cancer: analysis of early outcomes and patient's satisfaction (01a Articolo in rivista)
    MARUCCIA, MICHELE; SGARAMELLA, LUCIA ILARIA; LO GIUDICE, GIUSEPPE; TESTINI, MARIO

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