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Dive into the research topics where Giovanna Rizzardi is active.

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Featured researches published by Giovanna Rizzardi.


European Journal of Cardio-Thoracic Surgery | 2008

A quarter of a century experience with sleeve lobectomy for non-small cell lung cancer.

Federico Rea; Giuseppe Marulli; Marco Schiavon; Andrea Zuin; Abdel-Mohsen Hamad; Giovanna Rizzardi; Egle Perissinotto; Francesco Sartori

OBJECTIVE Sleeve lobectomy represents an effective and widely accepted surgical therapy for non-small cell lung carcinoma (NSCLC). We sought to review our experience in terms of mortality, early and late morbidity, and long-term survival evaluating the technical progresses overtime. MATERIAL AND METHODS From 1980 to 2005, 199 patients underwent sleeve lobectomy. Pathology revealed 167 (83.9%) squamous carcinomas, 23 (11.6%) adenocarcinomas, 7 (3.5%) large cell and 2 (1%) adenosquamous carcinomas. In 39 (19.6%) patients a vascular procedure was associated. Nineteen (9.5%) patients had preoperative radiotherapy, 14 (7%) preoperative chemotherapy and 10 (5%) chemoradiotherapy. RESULTS Overall postoperative mortality was 4.5% (n=9) and morbidity was 17.9% (n=34). Preoperative radiotherapy was identified as a significant risk factor for perioperative mortality (OR: 5.34, 95% CI: 1.16-24.47; p=0.03) and early anastomotic complications (OR: 3.73, 95% CI: 1.01-13.68; p=0.04). Overall 5-year survival rate was 39.7% and stage-by-stage analysis did not reach a significant survival difference. With growing skills the number of procedures, associated angioplasty and difficult sleeves (such as sleeve bilobectomy) increased. Also in term of mortality, in the last 10 years we had 0.8% of mortality rate. CONCLUSIONS Sleeve lobectomy is a safe and effective therapy for selected patients with NSCLC. Vascular procedures and the use of induction chemotherapy did not increase mortality and morbidity; otherwise, the use of preoperative radiotherapy is not recommended. Overtime trend showed a significant lower mortality in the last period. This emphasises the importance of a learning curve and encourages the performance of this procedure in experienced centres.


Interactive Cardiovascular and Thoracic Surgery | 2007

Single-staged laryngotracheal resection and reconstruction for benign strictures in adults

Giuseppe Marulli; Giovanna Rizzardi; Luigi Bortolotti; Monica Loy; Cristiano Breda; Abdel-Mohsen Hamad; Francesco Sartori; Federico Rea

Laryngotracheal stenosis (LTS) is a challenging problem, and its management is complex. This study evaluated both short- and long-term outcomes following laryngotracheal resection and anastomosis. Between 1994 and 2006, 37 patients underwent surgery for LTS. The cause of stenosis was post-intubation or post-tracheostomy injury in 28 cases and idiopathic in nine. Pearsons technique was used for anterolateral cricotracheal resection (n=23), and Grillos technique of providing a posterior membranous tracheal flap was used in cases of circumferential stenosis (n=14). Since 1998, we have modified the techniques in 21 cases, using a continuous 4/0 polydioxanone suture for the posterior part of the anastomosis. No peri-operative mortality was recorded. Three (8.1%) patients developed major complications (two fistulae and one early stenosis) that required a second surgical look. We had 16 minor complications in 14 (37.8%) patients. The long-term results were excellent to satisfactory in 36 patients (97.3%) and unsatisfactory in one (2.7%). Single-staged laryngotracheal resection is a demanding operation, but can be performed successfully with acceptable morbidity in specialized centers. The continuous suture in the posterior part of the anastomosis simplifies the procedure without causing technique-related complications. In our experience, this procedure guaranteed excellent to satisfactory results in more than 90% of patients.


European Journal of Cardio-Thoracic Surgery | 2011

‘Six Sigma approach’ — an objective strategy in digital assessment of postoperative air leaks: a prospective randomised study

Luca Bertolaccini; Giovanna Rizzardi; Mary Jo Filice; Alberto Terzi

OBJECTIVE Until now, only way to report air leaks (ALs) has been with an analogue score in an inherently subjective manner. The Six Sigma quality improvement methodology is a data-driven approach applicable to evaluate the quality of the quantification method of repetitive procedures. We applied the Six Sigma concept to improve the process of AL evaluation. METHODS A digital device for AL measurement (Drentech PALM, Redax S.r.l., Mirandola (MO), Italy) was applied to 49 consecutive patients, who underwent pulmonary intervention, compared with a similar population with classical chest drainage. Data recorded were postoperative AL, chest-tube removal days, number of chest roentgenograms, hospital length of stay; device setup time, average time rating AL and patient satisfaction. Bivariable comparisons were made using the Mann-Whitney test, the χ² test and Fishers exact test. Analysis of quality was conducted using the Six Sigma methodology. RESULTS There were no significant differences regarding AL (p=0.075), although not statistically significant; there was a reduction of postoperative chest X-rays (four vs five) and of hospital length of stay (6.5 vs 7.1 days); and a marginally significant difference was found between chest-tube removal days (p=0.056). There were significant differences regarding device setup time (p=0.001), average time rating AL (p=0.001), inter-observer variability (p=0.001) and patient satisfaction (p=0.002). Six Sigma analyses revealed accurate assessment of AL. CONCLUSIONS Continuous digital measurement of AL reduces degree of variability of AL score, gives more assurance for tube removal, and reports AL without the apprehension of observer error. Efficiency and effectiveness improved with the use of a digital device. We have noted that the AL curves depict actually sealing of AL. The clinical importance of AL curves requires further study.


Thoracic and Cardiovascular Surgeon | 2008

Sleeve resections and bronchoplastic procedures in typical central carcinoid tumours.

Giovanna Rizzardi; Giuseppe Marulli; Luigi Bortolotti; Fiorella Calabrese; Francesco Sartori; Federico Rea

BACKGROUND Typical carcinoids are low grade malignant neuroendocrine neoplasms, mostly located centrally in the tracheobronchial tree. The aim of our study was to analyse the long-term survival and surgical treatment outcome in patients submitted to parenchyma-sparing resections for typical central carcinoid tumours. METHODS We retrospectively reviewed the data of 70 patients who underwent sleeve resections or bronchoplastic procedures. We performed 21 sleeve lobectomies, 9 sleeve resections of the main bronchus, 25 bronchoplasties associated with lung resections and 15 isolated wedge bronchoplasties. Nine patients (12.8%) had nodal metastases. RESULTS There was no operative mortality; postoperative complications occurred in one patient (1.4%) who presented an empyema. At long-term follow-up evaluation, we were able to report good results: all patients were alive and nobody manifested recurrence; one patient had a late cicatricial bronchial stenosis, which was treated with laser therapy. CONCLUSIONS This series of central typical bronchial carcinoids, treated with sleeve or bronchoplastic resection, demonstrated an excellent outcome. Our results suggest that, in experienced and skilled hands, conservative procedures must be considered the treatment of choice for the management of these tumours.


Tropical Doctor | 2007

Breast tuberculosis mimicking other diseases.

Gian Franco Morino; Giovanna Rizzardi; Federico Gobbi; Marco Baldan

Breast tuberculosis can confuse the clinician by its close resemblance to carcinoma or non-specific abscess, with obvious negative therapeutical implications. We present two cases, one mimicking a breast malignancy and the other being confused with non-specific abscess, to illustrate the misdiagnosis risks and diagnostic challenges.


Interactive Cardiovascular and Thoracic Surgery | 2009

Paraneoplastic extra limbic encephalitis associated with thymoma.

Giovanna Rizzardi; Andrea Campione; Paolo Scanagatta; Alberto Terzi

We report the case of a 55-year-old woman with thymoma diagnosed after finding of extra limbic encephalitis. She presented neurologic symptoms as seizure and aphasia; magnetic resonance imaging (MRI) of the brain showed multiple lesions located in insular, parietal and temporal lobes (in cortical and sub-cortical area). Brain biopsies confirmed the diagnosis of encephalitis and CT-scan of the thorax showed an anterior mediastinal mass suspected for thymoma. The patient was submitted to thymectomy through a median sternotomy and we assisted to secondary reduction of cerebral lesions and total remission of symptoms.


European Journal of Cardio-Thoracic Surgery | 2008

Persistent chylothorax in lymphangioleiomyomatosis treated by intrapleural instillation of povidone

Giovanna Rizzardi; Monica Loy; Giuseppe Marulli; Federico Rea

Lymphangioleiomyomatosis (LAM) is a rare, idiopathic disease affecting young women often complicated by refractory and difficult to manage chylothorax. We report one case of a patient who received a bilateral lung transplantation for LAM presenting a refractory chylothorax. The instillation of povidone iodine in the pleural space was effective in inducing pleurodesis.


Journal of Heart and Lung Transplantation | 2008

A word of caution for patients undergoing lung transplantation with associated mitral regurgitation.

Abdel-Mohsen Hamad; Giovanna Rizzardi; T. Bottio; Gino Gerosa; Federico Rea

1. Kamalakkannan G, Petrilli CM, George I, et al. Clenbuterol increases lean muscle mass but not endurance in patients with chronic heart failure. J Heart Lung Transplant 2008;27:457–61. 2. Harrington D, Chua TP, Coats AJ. The effect of salbutamol on skeletal muscle in chronic heart failure. Int J Cardiol 2000;73: 257–65. 3. Deligiannis A, Björnstad H, Carre F, et al. ESC study group of sports cardiology position paper on adverse cardiovascular effects of doping in athletes. Eur J Cardiovasc Prev Rehabil 2006;13:687–94.


Tropical Doctor | 2006

Autotransfusion from haemothorax after penetrating chest trauma: a simple, life-saving procedure

Marco Baldan; Chris Paul Giannou; Giovanna Rizzardi; Francois Irmay; Valery Sasin

tion, prevalence of which is high in Nigeria, and will prefer their own blood. Autologous blood transfusion was commenced for these reasons. Parker-Williams notes that anyone between the age of 16 and 70 years is acceptable but that fit children and older people are not excluded. The youngest of our patients was an 11-year-old boy and the oldest man was 66 years. Monk and Goodnough have observed autologous blood transfusion to be cheaper than homologous blood. We observe in this study that a predonated unit of blood costs N3600 (


The Annals of Thoracic Surgery | 2009

Multiple-running suture technique for bronchial anastomosis in difficult sleeve resection.

Abdel-Mohsen Hamad; Giuseppe Marulli; Giovanna Rizzardi; Marco Schiavon; Andrea Zuin; Cristiano Breda; Federico Rea

28) in our centre with the cost of screening for hepatitis B and HIV, and cross matching. Rare blood groups like rhesus negative blood tend to cost about N9000 (

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Paolo Scanagatta

European Institute of Oncology

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