Three-dimensional minimally invasive video-assisted thyroidectomy: preliminary report

Three-dimensional (3D) minimally invasive video-assisted thyroidectomy (MIVAT) was carried out with a 4-mm, 3D 0-degree stereoscopic endoscope. The procedure was applied on 3 patients who underwent total thyroidectomy and data were prospectively collected. Operative time for total thyroidectomy ranged from 72 to 90 minutes. Neither intra-nor post-operative complications were reported during the study. The surgical team noticed a good perception of depth and easy recognising of anatomic structures, especially concerning the upper and lower vascular pedicle, the parathyroids, the superior and inferior laryngeal nerves. Preliminary impression emerging from this study seems to suggest that 3D MIVAT is safe and effective. Future studies with larger case series are required to determine the role of this procedure

Raja asterias population assessment in FAO GFCM GSA17 area

Population structure and distribution of the starry ray, Raja asterias, were described based on data collected during yearly rapido trawl surveys (SoleMon), between 2005 and 2014 in the Northern and Central Adriatic Sea. A total of 306 individuals were caught, sex ratio was 1.04:1 in favor of males and length-weight relationships were obtained for the whole sample. Following the MEDITS scale, maturity was estimated, observing a higher number of immature individuals. Relative abundance significantly increased during the recent period with the highest values recorded at 5-30 m depths. Such increase could be related to the response of R. asterias to climatic change or to the decrease  in fishing pressure in the area. Clear spatial segregation of individuals depending on their life stage was observed, with immature individuals inhabiting the coastal areas and adults more abundant at depths greater than 40 m. The comparison of the result of the present study with MEDITS survey outcomes in terms of  distribution patterns, persistence areas of adults and juveniles and abundances indices, evidences that SoleMon survey seems to be more suitable in defining such features of the stock, likely due to the greater catchability of the rapido trawl in respect to the MEDITS trawl net. However, further investigations are needed to identify factors affecting the increasing abundance of this species, and develop an action plan for spatial management of fishing activities

Raja asterias population assessment in FAO GFCM GSA17 area

Population structure and distribution of the starry ray, Raja asterias, were described based on data collected during yearly rapido trawl surveys (SoleMon), between 2005 and 2014 in the Northern and Central Adriatic Sea. A total of 306 individuals were caught, sex ratio was 1.04:1 in favor of males and length-weight relationships were obtained for the whole sample. Following the MEDITS scale, maturity was estimated, observing a higher number of immature individuals. Relative abundance significantly increased during the recent period with the highest values recorded at 5-30 m depths. Such increase could be related to the response of R. asterias to climatic change or to the decrease  in fishing pressure in the area. Clear spatial segregation of individuals depending on their life stage was observed, with immature individuals inhabiting the coastal areas and adults more abundant at depths greater than 40 m. The comparison of the result of the present study with MEDITS survey outcomes in terms of  distribution patterns, persistence areas of adults and juveniles and abundances indices, evidences that SoleMon survey seems to be more suitable in defining such features of the stock, likely due to the greater catchability of the rapido trawl in respect to the MEDITS trawl net. However, further investigations are needed to identify factors affecting the increasing abundance of this species, and develop an action plan for spatial management of fishing activities

Lembo miofasciale di vasto laterale nella ricostruzione della lingua

Nell'ultimo decennio il lembo antero-laterale di coscia (ALT) è diventato il lembo libero più utilizzato nella ricostruzione della lingua, dal momento che esso è caratterizzato da bassa morbidità a livello del sito donatore e da migliori risultati estetici. Tuttavia, l'ALT fascio-cutaneo può essere insufficiente nella ricostruzione nei difetti maggiori (es. glossectomia totale) mentre la sua variante muscolo-cutanea (che include il muscolo vasto laterale)' può essere troppo voluminosa. Scopo dello studio è quello di descrivere la nostra esperienza preliminare nella ricostruzione della lingua utilizzando il lembo libero mio-fasciale di vasto laterale che potrebbe a nostro parere offrire notevoli vantaggi nella ricostruzione testa-collo come: possibilità di confezionare un lembo voluminoso quando necessario, ottimi risultati funzionali, obliterazione di spazi morti con prevenzione dello sviluppo di fistola e infezione con minima morbidità a livello del sito donatore

Poorly differentiated neuroendocrine larynx carcinoma: Clinical features and mirnas signature—a new goal for early diagnosis and therapy?

Laryngeal neuroendocrine carcinomas (LNECs) are rare and highly heterogeneous malignancies presenting a wide range of pathological and clinical manifestations. Herein, we retrospectively characterize ten patients diagnosticated with LNEC, five of which were defined as well‐moderately differentiated neuroendocrine carcinomas, and five that were defined as poorly differentiated neuroendocrine carcinomas, according to the latest WHO classification. Clinical features were analyzed and compared between the two subgroups together with a microRNA study which evidenced a peculiar signature likely related to poorly differentiated larynx neuroendocrine carcinomas. These findings may offer new useful insights for clinicians to improve diagnosis efficiency, therapy response, and patients’ outcome for this aggressive neoplasm

Multicentric prospective study on the prevalence of sublevel IIB metastases in head and neck cancer

Objective: To evaluate the prevalence of sublevel IIB lymph node (LN) metastases for head and neck primary tumors in a large cohort of patients. Design: Prospective study. Setting: One referral university hospital and 2 national institutes of oncology. Patients: Between 2003 and 2005, 297 patients (male to female ratio, 3.5:1; mean age, 58.8 years [range, 18-89 years]) affected by head and neck cancer were treated by surgery on the primary tumor and/or the neck. Primary site distribution included the following: oral cavity in 111 patients, larynx in 92, oropharynx in 32, thyroid gland in 22, skin of the lateral face or scalp in 16, hypopharynx in 11, unknown primary in 7, and parotid gland in 6. Sublevel IIB was evaluated for the number of LNs and pathologic N (pN) status. Interventions: All patients underwent unilateral or bilateral neck dissection (ND) with therapeutic or elective intent according to the primary site and clinical T (cT) and clinical N (cN) status. Sublevel IIB was selectively dissected at the beginning of ND, labeled, and processed independently. Main Outcome Measures: The distribution of metastases among the different levels was analyzed. The influence of several factors (institution in which the surgical procedure was performed, sex of the patient, site of primary, histotype, pathologic T [pT] status, cN status, lower level involved in the neck together with sublevel IIB, association with sublevel IIA metastasis, ipsilateral number of involved levels, and previous surgical treatment limited on the primary site) on the prevalence of sublevel IIB metastasis was statistically evaluated by the Pearson \u3c72 test or Fisher exact test. Results: A total of 443 NDs were performed (unilateral in 151 patients and bilateral in 146). Among the patients, the tumors were staged cN0/pN0 in 27%,cN+/pN+ in 50%, cN+/pN0 in 7%, and cN0/pN+ in 16%. The mean number of LNs collected at sublevel IIB was 5.4 (range, 0-24). The overall prevalence of sublevel IIB metastases was 5.6% (26 neck sides). Tumor histologic type in the sublevel IIB+ population was squamous cell carcinoma in 80%, papillary carcinoma in 8%, melanoma in 8%, and adenocarcinoma in 4%. The \u3c72 test showed a significantly higher risk for LN metastases at sublevel IIB in patients affected by parotid gland primary tumors (33%), tumors of the skin or scalp (25%), unknown primary tumors (14%), and cancers of the oral cavity (10%) (P=.02) and in those clinically staged as cN+ (P<.001). Conclusions: Sublevel IIB dissection is strongly recommended for all patients with cN+ tumors and in those affected by tumor of the parotid gland, skin, and scalp scheduled for elective ND. Patients affected by laryngeal cancer scheduled for elective ND can be considered the ideal candidates for preservation of sublevel IIB. However, whether this policy could be associated with a better functional outcome remains to be demonstrated by prospective studies on a large series of patients

Acinic cell carcinoma of the parotid gland: Timeo Danaos et dona ferentes? A multicenter retrospective analysis focusing on survival outcome

Objectives: To analyze the demographic data, surgical and adjuvant treatment data and the survival outcomes in adult patients affected by acinic cell carcinoma of the parotid gland (AciCC). Methods: A retrospective multicenter analysis of patients treated for AciCC of the parotid gland from 2000 to 2021 was performed. Exclusion criteria were pediatric (0–18&nbsp;years) patients, the absence of follow-up and patients with secondary metastatic disease to the parotid gland. Multivariable logistic regression was used to determine factors associated with survival. Results: The study included 81 adult patients with AciCC of the parotid gland. The median age was 46.3&nbsp;years (SD 15.81, range 19–84&nbsp;years), with a gender female prevalence (F = 48, M = 33). The mean follow-up was 77.7&nbsp;months (min 4–max 361, SD 72.46). The 5&nbsp;years overall survival (OS) was 97.5%. The 5&nbsp;years disease-free survival (DFS) was 60%. No statistical differences have been found in prognosis for age (&lt; 65 or ≥ 65&nbsp;years), sex, surgery type (superficial vs profound parotid surgery), radicality (R0 vs R1 + Rclose), neck dissection, early pathologic T and N stages and adjuvant therapy (p &gt; 0.05). Conclusion: This study did not find prognostic factor for poorest outcome. In contrast with the existing literature, our results showed how also high-grade tumours cannot be considered predictive of recurrence or aggressive behaviour