Linee Guida e Pubblicazioni

SICE è una società da sempre attenta alla produzione scientifica diretta ed indiretta: questo per permettere a tutti i professionisti del settore medico, siano essi nostri soci o meno, di potere avere un valido supporto nello svolgimento della propria quotidiana attività, attraverso la stesura di documenti scientifici che non rappresentino singoli particolarismi, ma che siano invece espressione di un’unica voce da parte della comunità chirurgica italiana ed internazionale.

Ciò ha portato alla produzione – seppure non si tratti di vere e proprie Linee Guida – di Documenti di Consenso, che potete trovare di seguito elencati.

Sono attualmente in corso da parte della SICE ulteriori produzioni scientifiche in collaborazione con altre Società italiane e straniere (fluorescenza, diverticolosi e diverticolite, chirurgia dell’obesità).

In caso di necessità di ulteriori approfondimenti, non esitare ad inviare una e.mail con la tua richiesta alla nostra Segreteria (, evidenziando in oggetto “Richiesta assistenza Linee Guida”.

La nostra conoscenza è a tua disposizione.

Hernia. 2018 Feb;22(1):183-198. doi: 10.1007/s10029-017-1697-5. Epub 2017 Nov 13.

European Hernia Society guidelines on prevention and treatment of parastomal

Antoniou SA(1), Agresta F(2), Garcia Alamino JM(3), Berger D(4), Berrevoet F(5),
Brandsma HT(6), Bury K(7), Conze J(8)(9)(10), Cuccurullo D(11), Dietz UA(12),
Fortelny RH(13), Frei-Lanter C(14), Hansson B(15), Helgstrand F(16), Hotouras
A(17), Jänes A(18), Kroese LF(19), Lambrecht JR(20), Kyle-Leinhase I(21),
López-Cano M(22), Maggiori L(23), Mandalà V(24), Miserez M(25), Montgomery A(26),
Morales-Conde S(27), Prudhomme M(28), Rautio T(29), Smart N(30), Śmietański
M(31)(32), Szczepkowski M(33)(34), Stabilini C(35), Muysoms FE(21).

Author information:
(1)Department of General Surgery, University Hospital of Herakion, Crete, Greece.
(2)Department of General Surgery, ULSS19 del Veneto, Adria, RO, Italy.
(3)Nuffield Department of Primary Care Health Sciences, University of Oxford,
Oxford, Oxfordshire, UK.
(4)Clinic of Abdominal, Thoracic and Pediatric Surgery, Klinikum
Mittelbaden/Balg, Baden-Baden, Germany.
(5)Department of General and HPB Surgery and Liver Transplantation, Ghent
University Hospital, Ghent, Belgium.
(6)Department of Colorectal Surgery, Western General Hospital, Edinburgh, UK.
(7)Department Cardiac and Vascular Surgery, Medical University of Gdańsk, Gdańsk,
(8)Herniacenter Dr. Muschaweck/Dr. Conze, Munich, Germany.
(9)Herniacenter Dr. Muschaweck/Dr. Conze, London, UK.
(10)Department of General, Visceral and Transplant Surgery, University Hospital,
RWTH Aachen University, Aachen, Germany.
(11)Department of General, Laparoscopic, and Robotic Surgery, Ospedale Monaldi,
Azienda Ospedaliera dei Colli, Naples, Italy.
(12)Department of General, Visceral, Vascular and Pediatric Surgery, University
Hospital of Wuerzburg, Wuerzburg, Germany.
(13)Certified Hernia Center, Department of General, Visceral and Oncological
Surgery, Wilhelminenspital, Vienna, Austria.
(14)Department of Surgery, Kantonsspital Winterthur, Winterthur, Switzerland.
(15)Department of Surgery, Canisius-Wilhelmina Hospital, Nijmegen, The
(16)Department of Surgery, Zealand University Hospital, Køge, Denmark.
(17)National Bowel Research Centre, The Royal London Hospital, London, United
(18)Department of Surgery, Sundsvall Hospital, Sundsvall, Sweden.
(19)Department of Surgery, Erasmus University Medical Center, Rotterdam,
(20)Surgical Department, Innlandet Hospital Trust, Gjøvik, Norway.
(21)Department of Surgery, Maria Middelares Hospital, Ghent, Belgium.
(22)Abdominal Wall Surgery Unit, Department of General Surgery, Hospital
Universitari Vall d’Hebron, Universitat Autònoma de Barcelona, Barcelona, Spain.
(23)Department of Colorectal Surgery, Beaujon Hospital, Assistance
publique-Hôpitaux de Paris, Université Paris VII, Clichy, France.
(24)Department of General Surgery, Buccheri La Ferla Hospital, Palermo, Italy.
(25)Department of Abdominal Surgery, University Hospitals Leuven, Leuven,
(26)Department of Surgery, Skåne University Hospital, Malmö, Sweden.
(27)University Hospital Virgen del Rocío, Sevilla, Spain.
(28)Digestive Surgery Department, CHU Nîmes, Nîmes, France.
(29)Department of Surgery, Division of Gastroenterology, Medical Research Center,
Oulu University Hospital, Oulu, Finland.
(30)Exeter Surgical Health Services Research Unit (HeSRU), Royal Devon and Exeter
Hospital, Exeter, UK.
(31)2nd Department of Radiology, Medical University of Gdansk, Gdańsk, Poland.
(32)Department of General Surgery and Hernia Centre, District Hospital in Puck,
Puck, Poland.
(33)Department of Rehabilitation, Józef Piłsudski University of Physical
Education in Warsaw, Warsaw, Poland.
(34)Clinical Department of General and Colorectal Surgery, Bielanski Hospital,
Warsaw, Poland.
(35)Department of Surgery, University of Genoa, Genoa, Italy.

BACKGROUND: International guidelines on the prevention and treatment of
parastomal hernias are lacking. The European Hernia Society therefore implemented
a Clinical Practice Guideline development project.
METHODS: The guidelines development group consisted of general, hernia and
colorectal surgeons, a biostatistician and a biologist, from 14 European
countries. These guidelines conformed to the AGREE II standards and the GRADE
methodology. The databases of MEDLINE, CINAHL, CENTRAL and the gray literature
through OpenGrey were searched. Quality assessment was performed using Scottish
Intercollegiate Guidelines Network checklists. The guidelines were presented at
the 38th European Hernia Society Congress and each key question was evaluated in
a consensus voting of congress participants.
RESULTS: End colostomy is associated with a higher incidence of parastomal
hernia, compared to other types of stomas. Clinical examination is necessary for
the diagnosis of parastomal hernia, whereas computed tomography scan or
ultrasonography may be performed in cases of diagnostic uncertainty. Currently
available classifications are not validated; however, we suggest the use of the
European Hernia Society classification for uniform research reporting. There is
insufficient evidence on the policy of watchful waiting, the route and location
of stoma construction, and the size of the aperture. The use of a prophylactic
synthetic non-absorbable mesh upon construction of an end colostomy is strongly

1. Surg Endosc. 2015 Sep;29(9):2463-84. doi: 10.1007/s00464-015-4293-8. Epub 2015 Jul 3.

Laparoscopic ventral/incisional hernia repair: updated Consensus Development
Conference based guidelines [corrected].

Silecchia G(1), Campanile FC, Sanchez L, Ceccarelli G, Antinori A, Ansaloni L,
Olmi S, Ferrari GC, Cuccurullo D, Baccari P, Agresta F, Vettoretto N, Piccoli M.

Author information:
(1)Division of General Surgery and Bariatric Centre of Excellence, Department of
Medico-Surgical Sciences and Biotechnology, Sapienza University of Rome, Via
Faggiana 1668, 04100, Latina, LT, Italy.

Erratum in
Surg Endosc. 2015 Sep;29(9):2485.

BACKGROUND: The Executive board of the Italian Society for Endoscopic Surgery
(SICE) promoted an update of the first evidence-based Italian Consensus
Conference Guidelines 2010 because a large amount of literature has been
published in the last 4 years about the topics examined and new relevant issues.
METHODS: The scientific committee selected the topics to be addressed:
indications to surgical treatment including special conditions (obesity,
cirrhosis, diastasis recti abdominis, acute presentation); safety and outcome of
intraperitoneal meshes (synthetic and biologic); fixing devices
(absorbable/non-absorbable); abdominal border and parastomal hernia;
intraoperative and perioperative complications; and recurrent ventral/incisional
hernia. All the recommendations are the result of a careful and complete
literature review examined with autonomous judgment by the entire panel. The
process was supervised by experts in methodology and epidemiology from the most
qualified Italian institution. Two external reviewers were designed by the EAES
and EHS to guarantee the most objective, transparent, and reliable work. The
Oxford hierarchy (OCEBM Levels of Evidence Working Group*. “The Oxford 2011
Levels of Evidence”) was used by the panel to grade clinical outcomes according
to levels of evidence. The recommendations were based on the grading system
suggested by the GRADE working group.
RESULTS AND CONCLUSIONS: The availability of recent level 1 evidence (a
meta-analysis of 10 RCTs) allowed to recommend that not only laparoscopic repair
is an acceptable alternative to the open repair, but also it is advantageous in
terms of shorter hospital stay and wound infection rate. This conclusion appears
to be extremely relevant in a clinical setting. Indications about specific
conditions could also be issued: laparoscopy is recommended for the treatment of
recurrent ventral hernias and obese patients, while it is a potential option for
compensated cirrhotic and childbearing-age female patients. Many relevant and
controversial topics were thoroughly examined by this consensus conference for
the first time. Among them are the issue of safety of the intraperitoneal mesh
placement, traditionally considered a major drawback of the laparoscopic
technique, the role for the biologic meshes, and various aspects of the
laparoscopic approach for particular locations of the defect such as the
abdominal border or parastomal hernias.

DOI: 10.1007/s00464-015-4293-8
PMID: 26139480 [Indexed for MEDLINE]

Langenbecks Arch Surg. 2015 May;400(4):429-53. doi: 10.1007/s00423-015-1300-4.
Epub 2015 Apr 8.

Laparoscopic cholecystectomy: consensus conference-based guidelines.

Agresta F(1), Campanile FC, Vettoretto N, Silecchia G, Bergamini C, Maida P,
Lombari P, Narilli P, Marchi D, Carrara A, Esposito MG, Fiume S, Miranda G,
Barlera S, Davoli M; Italian Surgical Societies Working Group.

Collaborators: Ricciardelli L, Belli F, Brandara F, Cantore F, Capizzi D,
Carlomagno N, Carrara A, Ciccorti L, Cillara N, Esposito MG, Feroci F, Fiume S,
Gilio F, Guercioni G, Indiani D, Lazzaro L, Luridiana G, Mannino L, Maglione V,
Masci E, Miranda G, Motter M, Nigro F, Perna F, Piccolo D, Prando D, Rizzuto A,
Sallustio P, Serventi F, Vadalà S, Virzì C, Rasi M, Arru A, Mutignani M,
Scaglione M, Scaramuzza G.

Author information:
(1)Department of Surgery, Presidio Ospedaliero di Adria (RO), Adria, RO, Italy,

INTRODUCTION: Laparoscopic cholecystectomy (LC) is the gold standard technique
for gallbladder diseases in both acute and elective surgery. Nevertheless,
reports from national surveys still seem to represent some doubts regarding its
diffusion. There is neither a wide consensus on its indications nor on its
possible related morbidity. On the other hand, more than 25 years have passed
since the introduction of LC, and we have all witnessed the exponential growth of
knowledge, skill and technology that has followed it. In 1995, the EAES published
its consensus statement on laparoscopic cholecystectomy in which seven main
questions were answered, according to the available evidence. During the
following 20 years, there have been several additional guidelines on LC, mainly
focused on some particular aspect, such as emergency or concomitant biliary tract
METHODS: In 2012, several Italian surgical societies decided to revisit the
clinical recommendations for the role of laparoscopy in the treatment of
gallbladder diseases in adults, to update and supplement the existing guidelines
with recommendations that reflect what is known and what constitutes good
practice concerning LC.

DOI: 10.1007/s00423-015-1300-4
PMID: 25850631 [Indexed for MEDLINE]

Int J Colorectal Dis. 2014 Jul;29(7):863-75. doi: 10.1007/s00384-014-1887-x. Epub
2014 May 13.

Clinical competence in the surgery of rectal cancer: the Italian Consensus

Piccoli M, Agresta F, Trapani V, Nigro C, Pende V, Campanile FC, Vettoretto N,
Belluco E, Bianchi PP, Cavaliere D, Ferulano G, La Torre F, Lirici MM, Rea R,
Ricco G, Orsenigo E, Barlera S, Lettieri E, Romano GM; Italian Surgical Societies
Working Group.

Collaborators: Sartori CA, Mele A, Casciola L, Corcione F, D’Annibale A, De
Manzini N, Doglietto GB, Leo E, Lezoche E, Marino I, Melotti G, Morino M,
Presenti L, Prete F, Pugliese R, Romano GM, Santoro E, Spinoglio G, Trompetto M.

Author information:
(1)Department of General and Emergency Surgery, NOCSAE, Modena, Italy.

Erratum in
Int J Colorectal Dis. 2014 Aug;29(8):1029. multiple author names corrected.

BACKGROUND AND AIM: The literature continues to emphasize the advantages of
treating patients in “high volume” units by “expert” surgeons, but there is no
agreed definition of what is meant by either term. In September 2012, a Consensus
Conference on Clinical Competence was organized in Rome as part of the meeting of
the National Congress of Italian Surgery (I Congresso Nazionale della Chirurgia
Italiana: Unità e valore della chirurgia italiana). The aims were to provide a
definition of “expert surgeon” and “high-volume facility” in rectal cancer
surgery and to assess their influence on patient outcome.
METHOD: An Organizing Committee (OC), a Scientific Committee (SC), a Group of
Experts (E) and a Panel/Jury (P) were set up for the conduct of the Consensus
Conference. Review of the literature focused on three main questions including
training, “measuring” of quality and to what extent hospital and surgeon volume
affects sphincter-preserving procedures, local recurrence, 30-day morbidity and
mortality, survival, function, choice of laparoscopic approach and the choice of
transanal endoscopic microsurgery (TEM).
RESULTS AND CONCLUSION: The difficulties encountered in defining competence in
rectal surgery arise from the great heterogeneity of the parameters described in
the literature to quantify it. Acquisition of data is difficult as many articles
were published many years ago. Even with a focus on surgeon and hospital volume,
it is difficult to define their role owing to the variability and the quality of
the relevant studies.

DOI: 10.1007/s00384-014-1887-x
PMID: 24820678 [Indexed for MEDLINE]

Hernia. 2013 Oct;17(5):557-66. doi: 10.1007/s10029-013-1055-1. Epub 2013 Feb 12.

Laparoscopic ventral incisional hernia repair: evidence-based guidelines of the
first Italian Consensus Conference.

Cuccurullo D(1), Piccoli M, Agresta F, Magnone S, Corcione F, Stancanelli V, Melotti G.

Author information:
(1)Department of Surgery, Monaldi Hospital, Naples, Italy.

PURPOSE: The laparoscopic treatment of ventral incisional hernias is the object
of constant attention and is becoming increasingly widespread in the
international scientific-surgical community; however, there is ample debate on
its technical details and indications. In order to establish a common approach on
laparoscopic ventral incisional hernia repair, the first Italian Consensus
Conference was organized in Naples (Italy) on 14-15 January 2010.
METHODS: The format of the Consensus Conference was freely adapted from the
standards of the National Institute of Health and the Italian Health Institute.
The parties involved included the followings: a Promotional Committee, a
Scientific Committee, a group of Experts, the Jury Panel and a Scientific
RESULTS: Eleven statements, regarding three large chapters on the indications,
the technical details and the management of complications were drafted on the
basis of literature references collected by the Scientific Committee, documents
developed by the Experts, reports presented and discussed during the Consensus
Conference, and discussion among the members of the Jury.
CONCLUSIONS: The laparoscopic approach is safe and effective for defects larger
than 3 cm in diameter; old age, obesity, previous abdominal operations,
recurrence and strangulation are not absolute contraindications. Ensuring an
adequate overlap, careful adhesiolysis and correct fixing of the prosthesis are
among the technical details recommended. Complications and recurrences are
comparable to, and in some cases, less numerous than with the open approach.

DOI: 10.1007/s10029-013-1055-1
PMID: 23400528 [Indexed for MEDLINE]

Surg Endosc. 2012 Aug;26(8):2134-64. doi: 10.1007/s00464-012-2331-3. Epub 2012
Jun 27.

Laparoscopic approach to acute abdomen from the Consensus Development Conference
of the Società Italiana di Chirurgia Endoscopica e nuove tecnologie (SICE),
Associazione Chirurghi Ospedalieri Italiani (ACOI), Società Italiana di Chirurgia
(SIC), Società Italiana di Chirurgia d’Urgenza e del Trauma (SICUT), Società
Italiana di Chirurgia nell’Ospedalità Privata (SICOP), and the European
Association for Endoscopic Surgery (EAES).

Agresta F(1), Ansaloni L, Baiocchi GL, Bergamini C, Campanile FC, Carlucci M,
Cocorullo G, Corradi A, Franzato B, Lupo M, Mandalà V, Mirabella A, Pernazza G,
Piccoli M, Staudacher C, Vettoretto N, Zago M, Lettieri E, Levati A, Pietrini D,
Scaglione M, De Masi S, De Placido G, Francucci M, Rasi M, Fingerhut A, Uranüs S,
Garattini S.

Author information:
(1)Department of General Surgery, Presidio Ospedaliero di Adria, Piazza degli
Etruschi, 9, 45011 Adria, RO, Italy.

BACKGROUND: In January 2010, the SICE (Italian Society of Endoscopic Surgery),
under the auspices of the EAES, decided to revisit the clinical recommendations
for the role of laparoscopy in abdominal emergencies in adults, with the primary
intent being to update the 2006 EAES indications and supplement the existing
guidelines on specific diseases.
METHODS: Other Italian surgical societies were invited into the Consensus to form
a panel of 12 expert surgeons. In order to get a multidisciplinary panel, other
stakeholders involved in abdominal emergencies were invited along with a
patient’s association. In November 2010, the panel met in Rome to discuss each
chapter according to the Delphi method, producing key statements with a grade of
recommendations followed by commentary to explain the rationale and the level of
evidence behind the statements. Thereafter, the statements were presented to the
Annual Congress of the EAES in June 2011.
RESULTS: A thorough literature review was necessary to assess whether the
recommendations issued in 2006 are still current. In many cases new studies
allowed us to better clarify some issues (such as for diverticulitis, small bowel
obstruction, pancreatitis, hernias, trauma), to confirm the key role of
laparoscopy (such as for cholecystitis, gynecological disorders, nonspecific
abdominal pain, appendicitis), but occasionally previous strong recommendations
have to be challenged after review of recent research (such as for perforated
peptic ulcer).
CONCLUSIONS: Every surgeon has to develop his or her own approach, taking into
account the clinical situation, her/his proficiency (and the experience of the
team) with the various techniques, and the specific organizational setting in
which she/he is working. This guideline has been developed bearing in mind that
every surgeon could use the data reported to support her/his judgment.

DOI: 10.1007/s00464-012-2331-3
PMID: 22736283 [Indexed for MEDLINE]