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Matteo Riva

Publications and source records attributed to Matteo Riva.

5 recordsLinked to original sources
PubMed2006

Intra- and peri-operative outcomes comparing radical retropubic and laparoscopic radical prostatectomy: results from a prospective, randomised, single-surgeon study.

OBJECTIVES: To prospectively compare intra- and peri-operative outcomes of open radical retropubic prostatectomy (RRP) and laparoscopic prostatectomy (LRP) by a single surgeon. PATIENTS AND METHODS: One-hundred-twenty, consecutive, age-matched patients diagnosed with clinically localized prostate cancer were eligible for surgery. Sixty patients underwent RRP and 60, LRP. Intra- and peri-operative parameters, pathologic findings and early complications were recorded. A validated visual analogue scale was used to assess pain in the recovery room, 3 h after the operation and on post-operative days 1, 2 and 3. A cystogram was performed on post-operative day 5. RESULTS: Operating time was significantly shorter in the RRP group versus the LRP group (mean+/-SD, 170+/-34. 2 vs 235+/-49.9 min, p<0.001). Blood loss was significantly less in the LRP group versus the RRP group (mean+/-SD, 853.3+/-485 vs 257.3+/-177 ml, p<0.001), but no patient in either group underwent early re-intervention for bleeding. The RRP group showed a trend for higher use of analgesia. A watertight anastomosis was shown at cystourethrography and the catheter removed in 86% and 66% of LRP and RRP patients, respectively. The overall percentage of post-operative complications and positive margins were comparable. CONCLUSION: Laparoscopic prostatectomy is an attractive alternative to open prostatectomy, offering the advantages of reduced blood loss and safe early catheter removal. Furthermore, the laparoscopic procedure proved to be safe oncologically. Long-term follow-up is required to compare functional results in terms of continence and potency.

Aged↗
PubMed2006

Cost containment in laparoscopic radical nephrectomy: feasibility and advantages over open radical nephrectomy.

PURPOSE: To highlight the impact of the laparoscopic experience of the surgical team on achievement of satisfactory results with cost containment in performing laparoscopic radical nephrectomy (LRN). PATIENTS AND METHODS: We compared the cost components of 15 consecutive uncomplicated LRNs performed in 2001 (LRN01) with 15 consecutive uncomplicated laparoscopic radical nephrectomies performed in 2003 (LRN03) and with 15 consecutive uncomplicated procedures performed at our institution by the same surgical team in the year 1999 matched for patient age, tumor size, and disease stage. The groups were comparable in demographics. RESULTS: The operative times were 250, 225, and 195 minutes in the LRN01, LRN03, and open-surgery groups, respectively, while the lengths of postoperative stay were 3.8, 3.1, and 6.5 days. Operating room costs, excluding the disposable instruments, were 11.00 /min for the open surgery and 10.00 /min for laparoscopic nephrectomy, and the cost of the postoperative stay was 300 to 310 per day. The cost of disposable instruments was 952.18 for LRN01 and 146.37 for LRN03. The overall costs were 4155.00 for the open-surgery group, 4672.00 for LRN01, and 3336.37 for LRN03. CONCLUSIONS: Cost containment in laparoscopic nephrectomy is possible. A proper team learning curve and the employment of reliable reusable instruments is the key to reducing costs, making this procedure as economically advantageous as the equivalent open procedure.

Cost Control↗
PubMed2006

Ataxin-3 is subject to autolytic cleavage.

The protein ataxin-3 is responsible for spinocerebellar ataxia type 3, a neurodegenerative disease triggered when the length of a stretch of consecutive glutamines exceeds a critical threshold. Different physiologic roles have been suggested for this protein. More specifically, recent papers have shown that the highly conserved N-terminal Josephin domain of ataxin-3 binds ubiquitin and has ubiquitin hydrolase activity, thanks to a catalytic device specific to cysteine proteases. This article shows that the protein also has autoproteolytic activity, sustained by the same residues responsible for the ubiquitin hydrolase activity. The autolytic activity was abolished when these residues, i.e. Cys14 and His119, were replaced by noncatalytic ones. Furthermore, we found that pretreatment of the protein with tosyl l-phenylalanine chloromethyl ketone also abolished this activity, and that this site-specific reagent covalently bound His119, findings supported by MS experiments. MS also allowed us to establish that the attack was aspecific, as cleavage sites were observed at the carboxyl side of apolar, acidic and polar uncharged residues, clustered in the C-terminal, unstructured domain of the protein. In contrast, the Josephin domain was preserved from attack. We propose that the autolytic activity reported here may play a role in pathogenesis, as fragments carrying expanded polyglutamines are thought to be significantly more toxic than the whole protein.

Amino Acid Chloromethyl Ketones↗
PubMed2005

Nerve-sparing laparoscopic cystectomy.

Laparoscopic radical cystectomy has been included among the viable options for the surgical treatment of muscle-invasive bladder cancer. Even with the minimally invasive approach, it must be considered a major surgical intervention and, even in experienced hands, it can be associated with a significant percentage of complications with a negative impact on overall quality of life, especially in terms of continence and sexual potency. According to our Medline search, only two papers are available from the literature on laparoscopic and robotic versions of nerve- and seminal-sparing cystectomy and nerve-sparing cystectomy, performed respectively on three and 17 patients, showing the feasibility and preliminary results of those surgical procedures. Therefore, data seem encouraging, but further prospective studies are mandatory to correctly assess oncologic and functional results in terms of potency and continence maintenance related to these innovative techniques.

Carcinoma, Transitional Cell↗