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Livia Palmieri

Sapienza University of Rome Italy

• Master’s Degree in Medicine and Surgery at University of Bari "Aldo Moro" (July 2015); • Specialization in General Surgery cum laude, at Sapienza University of Rome (November 2021); • PhD in “EXPERIMENTAL AND CLINICAL HEPATO-GASTROENTEROLOGY”, Physiopathology Surgery curriculum, at Sapienza University of Rome; • One-year research grant at “Chirurgia Bariatrica e mini-invasiva”, Dipartimento di Chirurgia Generale e Specialistica “Paride Stefanini, Policlinico Umberto I, Sapienza University of Rome (May 2022 - October 2022); • Physician Consultant, MD, UOC Chirurgia Endocrina e Metabolica, Policlinico Universitario Fondazione Agostino Gemelli IRCCS, Rome (October 2022 - June 2023); • Author or co-author of numerous scientific publications published in national and international journals; • Participation as speaker or faculty in numerous national and international conferences; • Member of numerous scientific societies; • Winner of grants for various national and international research projects in the field of General Surgery; • Clinical and research activity in General, Laparoscopic, Bariatric and Endocrine Surgery; • Physician Consultant, MD, UOC Chirurgia generale e specialità chirurgiche - Chirurgia Endocrina, Azienda Ospedaliera Santa Maria Terni (July 2023 – today)

1chapters authored

Chapters authored

Local Excision for the Management of Early Rectal Cancer

By Silvia Quaresima, Livia Palmieri, Andrea Balla, Salomone di Saverio and Alessandro M. Paganini

Transanal endoscopic microsurgery (TEM) is a minimally invasive technique introduced in the 1980s to overcome the technical difficulties in the management of low rectal tumors. The TEM system includes a dedicated rigid rectoscope and platform with a dedicated expensive instrumentation. The transanal minimally invasive surgery (TAMIS) technique was introduced to overcome these limitations. Transanal surgery consists of three main steps: exposure of the lesion, tumor excision, and defect closure. Traditional indications are benign adenomas and selected T1 rectal cancers. However, when combined with neoadjuvant chemoradiotherapy (n-CRT), the indications may be extended to patients with selected T2-T3 rectal cancers responsive to n-CRT. Intraoperative complications may be difficult to deal with, but peritoneal entry is adequately managed by endoluminal direct closure of the defect by expert surgeons. Concerning the indications for defect closure, there is no evidence of better results to prevent complications such as bleeding; the indication for defect closure should be evaluated according to multiple variables. The management of other complications is safe and does not affect TEM’s oncological and functional outcomes. Transanal excision of rectal tumor is a safe and effective alternative to conventional resection to avoid the low anterior resection syndrome, with comparable oncological results and with the advantages of an organ-sparing strategy for better patients’ QoL.

Part of the book: Current Concepts and Controversies in Laparoscopic Surgery

Related collaborators

Alessandro M. Paganini

Sapienza University of Rome , Italy

Andrea Balla

Marisa Domingues dos Santos

Centro Hospitalar Universitário de Santo António

Amit R. Sharma

Efstathios Kotidis

Aristotle University of Thessaloniki , Greece

Elissavet Anestiadou

Aristotle University of Thessaloniki , Greece

Dobromir Sotirov

MBAL “HYGIA”, Pazardzhik, Bulgaria

Antonio Marte

University of Campania "Luigi Vanvitelli" , Italy

Silvia Quaresima

Sapienza University of Rome , Italy

Salomone Di Saverio

Addenbrooke's Hospital , United Kingdom