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Dive into the research topics where Matteo Frasson is active.

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Featured researches published by Matteo Frasson.


Techniques in Coloproctology | 2018

Application of three-dimensional printing in laparoscopic dissection to facilitate D3-lymphadenectomy for right colon cancer

Alvaro Garcia-Granero; L. Sánchez-Guillén; Delfina Fletcher-Sanfeliu; B. Flor-Lorente; Matteo Frasson; J. Sancho Muriel; E. Alvarez Serrado; Gianluca Pellino; I. Grifo Albalat; F. Giner; M. J. Roca Estelles; P. Esclapez Valero; Eduardo García-Granero

Complete mesocolic excision (CME) has been recently popularized in an attempt to reduce local recurrences following curative right colon cancer surgery. CME combines the concept of total mesorectal excision, which currently represents the gold standard for rectal cancer surgery, with central ligation and removal of apical nodes (D3-lymphadenectomy), routinely recommended in Japanese guidelines for T3/T4 tumours irrespective of N status and in selected T2 patients [1, 2]. Dissection of the gastrocolic trunk of Henle (GCTH) and that of the surgical trunk of Gillot (STG) are crucial steps to achieve a proper D3-lymphadenectomy. Anatomical location, vascular variability and fragility of vessels in this area increase the risk of intraoperative bleeding from the superior mesenteric vein, which might be responsible for conversion during laparoscopic surgery. Preoperative vascular imaging studies can reduce bleeding and complications in laparoscopic surgery [1]. The role of preoperative three-dimensional (3D) printing in colorectal surgery needs to be assessed. We describe the application of 3D-printing in planning laparoscopic dissection of the GCTH and STG during D3-lymphadenectomy.


Liver Transplantation | 2017

Efficacy of hydrodynamic interleukin 10 gene transfer in human liver segments with interest in transplantation.

Luis Sendra Gisbert; Antonio Miguel Matas; Luis Sabater Ortí; María José Herrero; Laura Sabater Olivas; Eva Montalvá Orón; Matteo Frasson; Rafael López; Rafael López-Andújar; Eduardo García‐Granero Ximénez; Salvador Francisco Aliño Pellicer

Different diseases lead, during their advanced stages, to chronic or acute liver failure, whose unique treatment consists in organ transplantation. The success of intervention is limited by host immune response and graft rejection. The use of immunosuppressant drugs generally improve organ transplantation, but they cannot completely solve the problem. Also, their management is delicate, especially during the early stages of treatment. Thus, new tools to set an efficient modulation of immune response are required. The local expression of interleukin (IL) 10 protein in transplanted livers mediated by hydrodynamic gene transfer could improve the organ acceptance by the host because it presents the natural ability to modulate the immune response at different levels. In the organ transplantation scenario, IL10 has already demonstrated positive effects on graft tolerance. Hydrodynamic gene transfer has been proven to be safe and therapeutically efficient in animal models and could be easily moved to the clinic. In the present work, we evaluated efficacy of human IL10 gene transfer in human liver segments and the tissue natural barriers for gene entry into the cell, employing gold nanoparticles. In conclusion, the present work shows for the first time that hydrodynamic IL10 gene transfer to human liver segments ex vivo efficiently delivers a human gene into the cells. Indexes of tissue protein expression achieved could mediate local pharmacological effects with interest in controlling the immune response triggered after liver transplantation. On the other hand, the ultrastructural study suggests that the solubilized plasmid could access the hepatocyte in a passive manner mediated by the hydric flow and that an active mechanism of transportation could facilitate its entry into the nucleus. Liver Transplantation 23:50–62 2017 AASLD.


Cirugia Espanola | 2017

Stents metálicos autoexpandibles como puente a la cirugía en el tratamiento del cáncer de colon izquierdo en oclusión. Análisis coste-beneficio y resultados oncológicos

Blas Flor-Lorente; Gloria Báguena; Matteo Frasson; Alvaro Garcia-Granero; A. Cervantes; Vicente Sanchiz; Andres Pena; Alejandro Espí; Pedro Esclapez; Eduardo García-Granero

INTRODUCTIONnThe use of a self-expanding metallic stent as a bridge to surgery in acute malignant left colonic obstruction has been suggested as an alternative treatment to emergency surgery. The aim of the present study was to compare the morbi-mortality, cost-benefit and long-term oncological outcomes of both therapeutic options.nnnMETHODSnThis is a prospective, comparative, controlled, non-randomized study (2005-2010) performed in a specialized unit. The study included 82 patients with left colon cancer obstruction treated by stent as a bridge to surgery (n=27) or emergency surgery (n=55) operated with local curative intention. The main outcome measures (postoperative morbi-mortaliy, cost-benefit, stoma rate and long-term oncological outcomes) were compared based on an intention-to-treat analysis.nnnRESULTSnThere were no significant statistical differences between the two groups in terms of preoperative data and tumor characteristics. The technically successful stenting rate was 88.9% (11.1% perforation during stent placement) and clinical success was 81.4%. No difference was observed in postoperative morbi-mortality rates. The primary anastomosis rate was higher in the bridge to surgery group compared to the emergency surgery group (77.8% vs. 56.4%; P=.05). The mean costs in the emergency surgery group resulted to be €1,391.9 more expensive per patient than in the bridge to surgery group. There was no significant statistical difference in oncological long-term outcomes.nnnCONCLUSIONSnThe use of self-expanding metalllic stents as a bridge to surgery is a safe option in the urgent treatment of obstructive left colon cancer, with similar short and long-term results compared to direct surgery, inferior mean costs and a higher rate of primary anastomosis.


Techniques in Coloproctology | 2017

Importance of the Moskowitz artery in the laparoscopic medial approach to splenic flexure mobilization: a cadaveric study

Alvaro Garcia-Granero; L. Sánchez-Guillén; O. Carreño; J. Sancho Muriel; E. Alvarez Sarrado; D. Fletcher Sanfeliu; B. Flor Lorente; Matteo Frasson; F. Martinez Soriano; Eduardo García-Granero

AbstractBackgroundnThe medial approach in laparoscopic splenic flexure mobilization is based on the entrance to the lesser sac just above the ventral edge of the pancreas (VEOP). The artery of Moskowitz runs through the base of the mesocolon, just above the VEOP. The aim of this study was to assess the incidence of the artery of Moskowitz, its route and its distance from the VEOP.MethodsWe performed a cadaveric study on 27 human cadavers. The vascular arcades of the splenic flexure were dissected, the number of vascular arches, and the origin and localization of its terminal anastomosis were recorded. The splenic flexure avascular space (SFAS) was defined as the avascular zone in the mesocolon delimited by the VEOP, middle colic artery, ascending branch of the left colic artery and the vascular arch of the splenic flexure nearest to the VEOP and was quantified as the distance between the VEOP and the most proximal archResultsThe artery of Drummond was identified in 100% of the cadavers. In 5 of 27 (18%) Riolan’s arch was present, and in 3 of 27 (11%) the Moskowitz artery was found. The mean distance from the VEOP to the artery of Moskowitz was 0.3xa0cm (SD 0.04). This vascular arch travelled from the origin of the middle colic artery to the distal third of the ascending branch of the left colic artery. The SFAS was greater (pxa0=xa00.001) in cadavers that only presented the artery of Drummond (mean 6.8xa0cm; SD 1.25) than in those with Riolan’s arch (mean 4.5xa0cm; SD 0.5)ConclusionsIn the medial approach for laparoscopic mobilization of the splenic flexure, when only one of the arches is present, the avascular area is an extensive and secure territory. If the artery of Moskowitz is present, the area is nonexistent and this would contraindicate the approach due to risk of iatrogenic bleeding. A radiological preoperatory study could be essential for accurate and safe surgery in this area.


International Journal of Colorectal Disease | 2018

How to reduce the superior mesenteric vein bleeding risk during laparoscopic right hemicolectomy

Alvaro Garcia-Granero; L. Sánchez-Guillén; Matteo Frasson; Jorge Sancho Muriel; Eduardo Alvarez Sarrado; Delfina Fletcher-Sanfeliu; Blas Flor Lorente; Jose Pamies; Javier Corral Rubio; Alfonso A. Valverde Navarro; Francisco Martinez Soriano; Eduardo García-Granero

PurposeThe superior right colic vein (SRCV) has been proposed as the main cause of superior mesenteric vein bleeding by avulsion during laparoscopic right hemicolectomy. Our objective is to identify the main vessel causing transverse mesocolic tension during the extraction of the surgical specimen or extracorporeal anastomosis and to perform an anatomical description of the SRCV.MethodsIn this cadaveric study, we performed a simulation of right hemicolectomy and anatomical description of the surgical area of the gastrocolic trunk of Henle (SAGCTH), the gastrocolic trunk of Henle (GCTH), and SRCV. The length of the exteriorization of the anastomotic transverse colon (ATC) was measured before and after sectioning the vascular vessel causing the exteriorization tension.ResultsFive fresh cadavers and 12 formalin were dissected. In 100% of the specimens, the SRCV was present and drained in 95% into the GCTH and in 5% directly into the superior mesenteric vein (SMV). In 100% of the specimens, the SRCV caused the tension when extracting the ATC. The mean length of exteriorization of the ATC before and after SRCV section was 7.2 and 10.4xa0cm in formalin cadavers, meaning a 44% of increment in the length of exteriorization. In fresh cadavers, the mean length of exteriorization increased to 2.7xa0cm, meaning a 28% of the initial length of exteriorization.ConclusionsThe SRCV is the main cause of tension in the extraction of the surgical specimen after right hemicolectomy. Its high tie increases the length of the ATC exteriorization, in about 3xa0cm, and could reduce the risk of SMV bleeding during laparoscopic right hemicolectomy and facilitate an extracorporeal anastomosis free of tension.


Colorectal Disease | 2017

Inferior mesenteric vein as initial landmark for laparoscopic medial to lateral dissection of descending colon - video vignette

Alvaro Garcia-Granero; Gabriela Wagner Tustanowski; L. Sánchez-Guillén; Delfina Fletcher Sanfeliu; Matteo Frasson; Blas Flor Lorente; Francisco Martinez-Soriano

The root of the inferior mesenteric artery is an important area where autonomic nerves are close by, the dissection can be hard and laborious in order to avoid nerve damage; and the separation of mesocolon and retroperitoneum in this area can sometimes be difficult. The inferior mesenteric vein dissection is an alternative option as the first step during medial to lateral approach of laparoscopic left mesocolon mobilisation, as we have shown in this video based on two real cases and two anatomical cadaveric dissection. n nThis article is protected by copyright. All rights reserved.


Techniques in Coloproctology | 2018

Preoperative surgical planning based on cadaver simulation and 3D imaging for a retrorectal tumour: description and video demonstration

Gianluca Pellino; Alvaro Garcia-Granero; D. Fletcher-Sanfeliu; M. Navasquillo-Tamarit; Matteo Frasson; D. García-Calderon; M. García-Gausi; A. A. Valverde-Navarro; J. Garcia-Armengol; J. V. Roig-Vila; Eduardo García-Granero

Retrorectal or presacral tumours include rare lesions growing into the retrorectal space. A recent systematic review with 82 patients found that these tumours are more frequent in women, mostly occurring around 40 years of age. In up to 95% of reported cases the mass was benign, schwannoma accounting for 33% of them [1]. Indications for surgery include compression of surrounding structures, symptoms, and features suspicious of malignancy or malignant transformation. According to tumour and patient features, different surgical approaches have been proposed. Minimally invasive surgery can be safely performed [1, 2], but no criteria have been agreed upon for selecting patients suitable for such an approach. It has been reported that there are no differences in the median size of the tumours between those removed by open vs minimally invasive surgery. However, solid or very large masses and a narrow pelvis could preclude minimally invasive approaches [1]. We describe our approach to retrorectal tumours, based on three-dimensional (3D) imaging reconstruction combined with preoperative strategy planning with a cadaver simulation.


Colorectal Disease | 2018

Surgical anatomy of the deep postanal space and the re-modified Hanley procedure - a video vignette

J. Sancho-Muriel; Alvaro Garcia-Granero; D. Fletcher-Sanfeliu; E. Alvarez-Sarrado; L. Sánchez-Guillén; Gianluca Pellino; M. Millán; A. A. Valverde-Navarro; Francisco Martinez-Soriano; Matteo Frasson; Eduardo García-Granero

Deep postanal abscess (DPA) comprises less than 15% of all types of anorectal abscess (1). The deep postanal space communicates on either side with the ischioanal fossa providing a pathway for abscess extension. A horseshoe extension with bilateral involvement of both ischioanal fossae secondary to a trans-sphincteric fistula is the most severe manifestation of this condition(2). This article is protected by copyright. All rights reserved.


Colorectal Disease | 2018

Surgical anatomy of D3 lymphadenectomy in right colon cancer, gastrocolic trunk of Henle and surgical trunk of Gillot - a video vignette

Alvaro Garcia-Granero; L. Sánchez-Guillén; D. Fletcher-Sanfeliu; J. Sancho-Muriel; E. Alvarez-Sarrado; Gianluca Pellino; J. J. Delgado-Moraleda; L. Sabater Ortí; A. A. Valverde-Navarro; Matteo Frasson

Complete mesocolon excision (CME) and D3 lymphadenectomy(D3-L) necessitate a high tie of mesenteric vessels (1,2). D3-L highlights lymph nodes dissection of Surgical Trunk of Gillot (STG) and Gastrocolic Trunk of Henle (GCTH) areas (3). Laparoscopic dissection of these areas is associated with intraoperative bleeding, which may culminate in a fatal outcome(4). The STG is the adipose tissue between the ileocolic vein and the GCTH. GCTH is a venous trunk consisting of the right gastroepiploic vein, anterior superior pancreatic-duodenal vein and the superior right colic vein (5). This article is protected by copyright. All rights reserved.


Colorectal Disease | 2018

Anatomical strategy for complete laparoscopic mesocolic excision for splenic flexure colonic cancer - a video vignette

Alvaro Garcia-Granero; O. Carreño; J. Sancho-Muriel; E. Alvarez-Sarrado; D. Fletcher-Sanfeliu; L. Sánchez-Guillén; Gianluca Pellino; C. García-Amador; J. Pamies; A. A. Valverde-Navarro; Francisco Martinez-Soriano; Matteo Frasson

A laparoscopic approach to complete mesocolic excision (CME) for splenic flexure colonic tumors (SFCT) is less frequently performed as it presents a higher degree of difficulty tan other colonic resections and is accompanied by associated intraoperative complications (1). Furthermore the variation of lymphovascular structures has hindered standardisation of surgery for SFCT (2). Using both cadaveric simulation and video examples from a resected T4 adenocarcinoma, the key technical points for a laparoscopic complete mesocolic excision for a SFCT are demonstrated. This article is protected by copyright. All rights reserved.

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Eduardo García-Granero

Instituto Politécnico Nacional

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Alvaro Garcia-Granero

Instituto Politécnico Nacional

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L. Sánchez-Guillén

Instituto Politécnico Nacional

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Gianluca Pellino

Instituto Politécnico Nacional

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E. Alvarez-Sarrado

Instituto Politécnico Nacional

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J. Sancho-Muriel

Instituto Politécnico Nacional

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Blas Flor Lorente

Instituto Politécnico Nacional

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Blas Flor-Lorente

Instituto Politécnico Nacional

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