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1. Prophylactic Administration of Alpha Blocker for the Prevention of Urinary Retention in Males Undergoing Inguinal Hernia Repair Under Spinal Anesthesia: Interim Analysis of a Randomized Controlled Trial

Author

Konstantinos Perivoliotis, Georgios D Koukoulis, Konstantinos Bouliaris, and Konstantinos Tepetes

Subjects
urinary retention, Urinary retention, business.industry, Visual analogue scale, General Engineering, Perioperative, medicine.disease, Interim analysis, law.invention, alpha-blockers, Inguinal hernia, Randomized controlled trial, law, Tamsulosin, General Surgery, Anesthesia, tamsulosin, medicine, International Prostate Symptom Score, medicine.symptom, business, spinal anesthesia, inguinal hernia repair, medicine.drug
Abstract

Introduction This randomized controlled study aims to investigate the prophylactic effect of tamsulosin on the development of postoperative urinary retention (POUR) in men undergoing elective open inguinal hernia (IH) repair under spinal anesthesia. The study also focused on potentially predisposing factors for POUR. Methods 100 eligible patients were randomized into two groups. Patients in the experimental group were given two doses of tamsulosin 0.4 mg orally 24 hours and 6 hours before surgery. In the control group, two doses of placebo were administered, in the same manner as the study group. The following parameters were also recorded: the International Prostate Symptom Score (IPSS) questionnaire scores, the presence of scrotal hernia, operation duration, perioperative administration of IV opioids and/or atropine, postoperative pain, and preoperative anxiety. Results Overall, the incidence of POUR was 37% (37/100) with no difference between the two groups. Among patients receiving tamsulosin, 39.2% (20/51) developed POUR, compared to 34.7% (17/49) in the control group. Preoperative patients' high anxiety visual analog scale (VAS) score (>51mm) (P=0.007) and the intraoperative use of atropine (P=0.02) were detected as risk factors for POUR. Conclusion This interim analysis of our prospective randomized trial showed no benefit from the prophylactic use of tamsulosin in preventing POUR after IH repair under spinal anesthesia. This type of anesthesia was also correlated with an overall high incidence of POUR. Preoperative anxiety and administration of atropine were identified as statistically significant factors for POUR. In patients with preoperative high anxiety, VAS score a different type of anesthesia may be used.

Published
2021
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2. Adhesion Prevention to Polypropylene Meshes Using Combined Icodextrin Four Percent and Dimetindene Maleate

Author

Konstantinos Tepetes, Georgios Koukoulis, Konstantinos Bouliaris, Stella Tzika, E. K. Asprodini, Christina Befani, Alexandros Diamantis, and Panagiotis Liakos

Subjects
medicine.medical_specialty, Urology, Adhesion (medicine), Tissue Adhesions, Polypropylenes, Protective Agents, Injections, Intramuscular, Icodextrin, Random Allocation, 03 medical and health sciences, Hydroxyproline, chemistry.chemical_compound, Postoperative Complications, 0302 clinical medicine, Peritoneum, Animals, Dimethindene, Medicine, Adhesion prevention, Polypropylene, business.industry, Surgical Mesh, medicine.disease, Treatment Outcome, medicine.anatomical_structure, chemistry, 030220 oncology & carcinogenesis, Injections, Intravenous, Drug Therapy, Combination, Female, 030211 gastroenterology & hepatology, Surgery, Histopathology, Rabbits, Dimetindene maleate, business, Injections, Intraperitoneal
Abstract

Background The use of surgical meshes in ventral hernia repair has significantly reduced hernia recurrence rates. However, when placed intraperitoneally prosthetic materials can trigger the development of peritoneal adhesions. The present experimental study evaluated the combined icodextrin 4% and dimetindene maleate treatment in preventing peritoneal adhesion formation to polypropylene and titanium-coated polypropylene meshes. Materials and methods Sixty female white rabbits were divided into four groups. A 2 × 2 cm piece of mesh was fixed to intact peritoneum in all animals through a midline laparotomy. A lightweight polypropylene mesh was implanted in groups 1 and 2 and a titanium-coated polypropylene mesh in groups 3 and 4. Groups 2 and 4 were treated, intraoperatively, with intravenous dimetindene maleate (0.1 mg/kg) and intraperitoneal solution of icodextrin 4% (20 mL/kg) and for the next 6 d with dimetindene maleate intramuscularly. The observation period lasted 15 d. Adhesion scores, percentage of mesh affected surface, tissue hydroxyproline levels, and tissue histopathology were examined. Results All animals in group 1 and 57% of animals in group 3 presented postoperative adhesions. The combination of antiadhesives significantly reduced the extent and severity of adhesions as well as the hydroxyproline levels in groups 2 and 4 compared with groups 1 and 3. On microscopic evaluation, animals in group 1 exhibited higher inflammation scores compared with group 2, whereas animals in groups 2 and 4 had better mesotheliazation compared with groups 1 and 3. Conclusions The combined administration of icodextrin 4% and dimetindene maleate reduces the extent and severity of adhesions and may be successfully used to prevent adhesion formation after mesh intraperitoneal placement.

Published
2019
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3. Gastroenterology and liver disease during COVID-19 and in anticipation of post-COVID-19 era: Current practice and future directions

Author

Marios Karvouniaris, Panagiotis J. Vlachostergios, Evangelia Papapostolou, Panagiotis Papamichalis, Konstantinos Bouliaris, Apostolos Komnos, Katerina G Oikonomou, Maria Xanthoudaki, Apostolia-Lemonia Skoura, Asimina Valsamaki, Tilemachos Zafeiridis, and Michail Papamichalis

Subjects
medicine.medical_specialty, Telemedicine, business.industry, Transmission (medicine), SARS-CoV-2, Public health, COVID-19, Endoscopy, General Medicine, Disease, Review, Gastroenterology practice, medicine.disease, Liver disease, Health care, Anticipation (genetics), Pandemic, medicine, business, Intensive care medicine
Abstract

Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) has emerged as a major threat to global public health. The virus causes the clinical syndrome known as coronavirus disease 2019 (COVID-19), in which multiple organs can get affected. Apart from manifestations of the respiratory system, which predominate, its clinical presentation is frequently accompanied by symptoms of the gastro-intestinal (GI) tract and liver abnormalities. The correlation of symptoms and abnormalities with disease severity is discussed, leading to ambiguous results from international literature. Moreover, the disease infects patients with co-existing liver and GI disorders affecting both their health status and the availability of healthcare services provided to them. The risk of transmission of the disease during aerosol-generating procedures has changed the diagnostic approach and follow-up algorithms for liver and GI diseases. For the safety of both doctors and patients, telemedicine and distant evaluation have become everyday practice, whereas several routines and emergency visits at outpatient and emergency departments have been postponed or delayed. Vaccination against SARS-CoV-2 is underway, providing hope to humanity and the expectation that the post-COVID-19 era is near. This review aims to update knowledge about the manifestations of COVID-19 related to liver and GI diseases and the effect of the pandemic on the diagnostic and therapeutic procedures for these diseases with a special focus on how current practices have changed and what changes will possibly remain in the future.

Published
2021

4. Gastrointestinal Stromal Tumor (GIST) and Synchronous Intra-Abdominal Liposarcoma: A Report of Two Rare Cases and Literature Review

Author

Andreas-Marios Diamantis, Ioannis Baloyiannis, Konstantinos Bouliaris, Athina A Samara, Dimitrios Symeonidis, Alexandros Diamantis, Georgios Koukoulis, Maria Tolia, and Konstantinos Tepetes

Subjects
Male, medicine.medical_specialty, Gastrointestinal Stromal Tumors, Review Article, Liposarcoma, Adenocarcinoma, Stomach Neoplasms, medicine, Humans, Retroperitoneal liposarcoma, Retroperitoneal Neoplasms, Stromal tumor, neoplasms, RC254-282, R0 resection, Aged, Aged, 80 and over, GiST, business.industry, Stomach, Neoplasms. Tumors. Oncology. Including cancer and carcinogens, Middle Aged, medicine.disease, digestive system diseases, body regions, medicine.anatomical_structure, Oncology, Surgery, Female, Radiology, business, Gastric GIST
Abstract

Introduction. Gastrointestinal stromal tumors (GISTs) quite frequently occur synchronously with other malignancies, with most cases being adenocarcinomas. GISTs and liposarcomas are both of mesenchymal origin, and their coexistence is extremely rare. Methods. We conducted a review of the current literature regarding the synchronous occurrence of GISTs and intra-abdominal liposarcomas. An electronic search of the literature was undertaken using MEDLINE (database provider PubMed). Furthermore, we present the first described case of an 86-year-old male with a GIST and synchronous liposarcoma, both located in the stomach, as well as a 66-year-old male with a gastric GIST and concurrent retroperitoneal liposarcoma. Results. A total of 5 cases of synchronous GIST and intra-abdominal liposarcoma have been reported in the literature to date, with the most recent cases included in the present study. Conclusion. Further research is required to explain any possible correlation in the coexistence of these different neoplasms of the same origin. Meanwhile, R0 resection of both tumors remains the treatment of choice.

Published
2021

5. Prospective Observational Study on acute Appendicitis Worldwide (POSAW)

Author

Massimo Sartelli, Gian L. Baiocchi, Salomone Di Saverio, Francesco Ferrara, Francesco M. Labricciosa, Luca Ansaloni, Federico Coccolini, Deepak Vijayan, Ashraf Abbas, Hariscine K. Abongwa, John Agboola, Adamu Ahmed, Lali Akhmeteli, Nezih Akkapulu, Seckin Akkucuk, Fatih Altintoprak, Aurelia L. Andreiev, Dimitrios Anyfantakis, Boiko Atanasov, Miklosh Bala, Dimitrios Balalis, Oussama Baraket, Giovanni Bellanova, Marcelo Beltran, Renato Bessa Melo, Roberto Bini, Konstantinos Bouliaris, Daniele Brunelli, Adrian Castillo, Marco Catani, Asri Che Jusoh, Alain Chichom-Mefire, Gianfranco Cocorullo, Raul Coimbra, Elif Colak, Silvia Costa, Koray Das, Samir Delibegovic, Zaza Demetrashvili, Isidoro Di Carlo, Nadezda Kiseleva, Tamer El Zalabany, Mario Faro, Margarida Ferreira, Gustavo P. Fraga, Mahir Gachabayov, Wagih M. Ghnnam, Teresa Giménez Maurel, Georgios Gkiokas, Carlos A. Gomes, Ewen Griffiths, Ali Guner, Sanjay Gupta, Andreas Hecker, Elcio S. Hirano, Adrien Hodonou, Martin Hutan, Orestis Ioannidis, Arda Isik, Georgy Ivakhov, Sumita Jain, Mantas Jokubauskas, Aleksandar Karamarkovic, Saila Kauhanen, Robin Kaushik, Alfie Kavalakat, Jakub Kenig, Vladimir Khokha, Desmond Khor, Dennis Kim, Jae I. Kim, Victor Kong, Konstantinos Lasithiotakis, Pedro Leão, Miguel Leon, Andrey Litvin, Varut Lohsiriwat, Eudaldo López-Tomassetti Fernandez, Eftychios Lostoridis, James Maciel, Piotr Major, Ana Dimova, Dimitrios Manatakis, Athanasio Marinis, Aleix Martinez-Perez, Sanjay Marwah, Michael McFarlane, Cristian Mesina, Michał Pędziwiatr, Nickos Michalopoulos, Evangelos Misiakos, Ali Mohamedahmed, Radu Moldovanu, Giulia Montori, Raghuveer Mysore Narayana, Ionut Negoi, Ioannis Nikolopoulos, Giuseppe Novelli, Viktors Novikovs, Iyiade Olaoye, Abdelkarim Omari, Carlos A. Ordoñez, Mouaqit Ouadii, Zeynep Ozkan, Ajay Pal, Gian M. Palini, Lars I. Partecke, Francesco Pata, Gerson A. Pereira Júnior, Tadeja Pintar, Magdalena Pisarska, Cesar F. Ploneda-Valencia, Konstantinos Pouggouras, Vinod Prabhu, Padmakumar Ramakrishnapillai, Jean-Marc Regimbeau, Marianne Reitz, Daniel Rios-Cruz, Sten Saar, Boris Sakakushev, Charalampos Seretis, Alexander Sazhin, Vishal Shelat, Matej Skrovina, Dmitry Smirnov, Charalampos Spyropoulos, Marcin Strzałka, Peep Talving, Ricardo A. Teixeira Gonsaga, George Theobald, Gia Tomadze, Myftar Torba, Cristian Tranà, Jan Ulrych, Mustafa Y. Uzunoğlu, Alin Vasilescu, Savino Occhionorelli, Aurélien Venara, Andras Vereczkei, Nereo Vettoretto, Nutu Vlad, Maciej Walędziak, Tonguç U. Yilmaz, Kuo-Ching Yuan, Cui Yunfeng, Justas Zilinskas, Gérard Grelpois, Fausto Catena, Universidade do Minho, Sartelli, Massimo, Baiocchi, Gian L., Di Saverio, Salomone, Ferrara, Francesco, Labricciosa, Francesco M., Ansaloni, Luca, Coccolini, Federico, Vijayan, Deepak, Abbas, Ashraf, Abongwa, Hariscine K., Agboola, John, Ahmed, Adamu, Akhmeteli, Lali, Akkapulu, Nezih, Akkucuk, Seckin, Altintoprak, Fatih, Andreiev, Aurelia L., Anyfantakis, Dimitrio, Atanasov, Boiko, Bala, Miklosh, Balalis, Dimitrio, Baraket, Oussama, Bellanova, Giovanni, Beltran, Marcelo, Melo, Renato Bessa, Bini, Roberto, Bouliaris, Konstantino, Brunelli, Daniele, Castillo, Adrian, Catani, Marco, Che Jusoh, Asri, Chichom-Mefire, Alain, Cocorullo, Gianfranco, Coimbra, Raul, Colak, Elif, Costa, Silvia, Das, Koray, Delibegovic, Samir, Demetrashvili, Zaza, Di Carlo, Isidoro, Kiseleva, Nadezda, El Zalabany, Tamer, Faro, Mario, Ferreira, Margarida, Fraga, Gustavo P., Gachabayov, Mahir, Ghnnam, Wagih M., Giménez Maurel, Teresa, Gkiokas, Georgio, Gomes, Carlos A., Griffiths, Ewen, Guner, Ali, Gupta, Sanjay, Hecker, Andrea, Hirano, Elcio S., Hodonou, Adrien, Hutan, Martin, Ioannidis, Oresti, Isik, Arda, Ivakhov, Georgy, Jain, Sumita, Jokubauskas, Manta, Karamarkovic, Aleksandar, Kauhanen, Saila, Kaushik, Robin, Kavalakat, Alfie, Kenig, Jakub, Khokha, Vladimir, Khor, Desmond, Kim, Denni, Kim, Jae I., Kong, Victor, Lasithiotakis, Konstantino, Leão, Pedro, Leon, Miguel, Litvin, Andrey, Lohsiriwat, Varut, López-Tomassetti Fernandez, Eudaldo, Lostoridis, Eftychio, Maciel, Jame, Major, Piotr, Dimova, Ana, Manatakis, Dimitrio, Marinis, Athanasio, Martinez-Perez, Aleix, Marwah, Sanjay, McFarlane, Michael, Mesina, Cristian, Pȩdziwiatr, Michał, Michalopoulos, Nicko, Misiakos, Evangelo, Mohamedahmed, Ali, Moldovanu, Radu, Montori, Giulia, Mysore Narayana, Raghuveer, Negoi, Ionut, Nikolopoulos, Ioanni, Novelli, Giuseppe, Novikovs, Viktor, Olaoye, Iyiade, Omari, Abdelkarim, Ordoñez, Carlos A., Ouadii, Mouaqit, Ozkan, Zeynep, Pal, Ajay, Palini, Gian M., Partecke, Lars I., Pata, Francesco, Pereira Júnior, Gerson A., Pintar, Tadeja, Pisarska, Magdalena, Ploneda-Valencia, Cesar F., Pouggouras, Konstantino, Prabhu, Vinod, Ramakrishnapillai, Padmakumar, Regimbeau, Jean-Marc, Reitz, Marianne, Rios-Cruz, Daniel, Saar, Sten, Sakakushev, Bori, Seretis, Charalampo, Sazhin, Alexander, Shelat, Vishal, Skrovina, Matej, Smirnov, Dmitry, Spyropoulos, Charalampo, Strzałka, Marcin, Talving, Peep, Teixeira Gonsaga, Ricardo A., Theobald, George, Tomadze, Gia, Torba, Myftar, Tranà, Cristian, Ulrych, Jan, Uzunoğlu, Mustafa Y., Vasilescu, Alin, Occhionorelli, Savino, Venara, Aurélien, Vereczkei, Andra, Vettoretto, Nereo, Vlad, Nutu, Walȩdziak, Maciej, Yilmaz, Tonguç U., Yuan, Kuo-Ching, Yunfeng, Cui, Zilinskas, Justa, Grelpois, Gérard, and Catena, Fausto

Subjects
Male, Medicina Básica [Ciências Médicas], Computed tomography, 030230 surgery, 0302 clinical medicine, Antibiotics, Diagnosis, Appendiciti, Prospective Studies, Laparoscopy, Prospective cohort study, Tomography, medicine.diagnostic_test, Acute appendicitis, Management, Surgery, Emergency Medicine, Acute Disease, Adult, Appendectomy, Appendicitis, Chi-Square Distribution, Female, Hospitalization, Humans, Length of Stay, Logistic Models, Tomography, X-Ray Computed, Treatment Outcome, Mortality rate, lcsh:Medical emergencies. Critical care. Intensive care. First aid, Apendicite, 3. Good health, X-Ray Computed, 030220 oncology & carcinogenesis, Ciências Médicas::Medicina Básica, Diagnosi, Human, Research Article, medicine.medical_specialty, Logistic Model, lcsh:Surgery, NO, 03 medical and health sciences, medicine, business.industry, General surgery, Antibiotic, lcsh:RD1-811, lcsh:RC86-88.9, medicine.disease, Prospective Studie, Observational study, Acute appendiciti, business, Chi-squared distribution
Abstract

Acute appendicitis (AA) is the most common surgical disease, and appendectomy is the treatment of choice in the majority of cases. A correct diagnosis is key for decreasing the negative appendectomy rate. The management can become difficult in case of complicated appendicitis. The aim of this study is to describe the worldwide clinical and diagnostic work-up and management of AA in surgical departments., info:eu-repo/semantics/publishedVersion

Published
2018
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6. Predictors of Need for Critical Care Support, Adverse Events, and Outcome after Stroke Thrombolysis

Author

Vasiliki Zisopoulou, Ioannis Staikos, Georgios Hadjigeorgiou, Dimitris Babalis, Apostolos Komnos, Tilemachos Zafeiridis, Konstantinos Bouliaris, Panagiotis Papamichalis, Apostolia-Lemonia Skoura, Spyridon Karagiannis, Achilleas Chovas, Efthimios Dardiotis, Dimitrios Papadopoulos, Michail Papamichalis, and Georgios Paraforos

Subjects
Male, Time Factors, medicine.medical_treatment, Comorbidity, 030204 cardiovascular system & hematology, law.invention, Disability Evaluation, 0302 clinical medicine, Recurrence, Risk Factors, law, Medicine, Thrombolytic Therapy, Hospital Mortality, Simplified Acute Physiology Score, Infusions, Intravenous, Stroke, APACHE, Rehabilitation, Age Factors, Thrombolysis, Middle Aged, Intensive care unit, Intensive Care Units, Treatment Outcome, SAPS II, Female, Cardiology and Cardiovascular Medicine, Intracranial Hemorrhages, medicine.medical_specialty, Critical Care, Hyperlipidemias, 03 medical and health sciences, Fibrinolytic Agents, Humans, Intensive care medicine, Adverse effect, Aged, business.industry, Neurointensive care, Recovery of Function, medicine.disease, Advanced life support, Life Support Care, Emergency medicine, Surgery, Neurology (clinical), business, 030217 neurology & neurosurgery
Abstract

Background Results from trials and international registries exhibit heterogeneity regarding safety, efficacy, markers of prognosis, and markers of the need for critical care support after intravenous thrombolysis (IVT) for strokes. The purpose of our study was to indentify such markers after performance of comparisons among patients who received thrombolysis in our intensive care unit. Materials and Methods Our study included 124 patients who received IVT in accordance with international criteria. Outcome measures of univariate and regression analyses resulted from comparisons between groups of patients with or without the need for critical care support (advanced life support and neurocritical care interventions), groups of patients developing or not developing primary adverse events (symptomatic intracranial hemorrhage [SICH] and/or Death and/or Serious systemic bleeding and/or New stroke) and groups of patients with different main outcome variables (mortality, functional independence at 3 months). Results Our results suggested that higher severity scores (Simplified Acute Physiology Score II, National Institutes of Health Stroke Scale) correlated with the need for critical care support, primary adverse events, and main outcome variables, whereas older age was significantly associated with fewer adverse events. Hyperlipidemia, symptom-to-needle time, and vascular disease were associated with functional capacity at 3 months, whereas diabetes mellitus and vascular disease correlated with the need for critical care support. Conclusion Patients' age, hyperlipidemia, presence of vascular disease, Simplified Acute Physiology Score II (a novel marker), and National Institutes of Health Stroke Scale at 2 hours and at 7 days are independent predictors of the need for critical care support, adverse events, and clinical outcomes after thrombolysis.

Published
2018
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7. WSES Guidelines for the management of acute left sided colonic diverticulitis in the emergency setting

Author

Ernest E. Moore, Frederick A. Moore, Walter L. Biffl, Gerson Alves Pereira Júnior, Isidoro Di Carlo, Aleksandar Karamarkovic, Daniel Rios-Cruz, Elif Colak, Miran Rems, Goran Augustin, Ewen A. Griffiths, Giovanni Bellanova, Ionut Negoi, Miklosh Bala, Rao R. Ivatury, Federico Coccolini, Osvaldo Chiara, Jan Ulrych, Andreas Hecker, Mario Paulo Faro, Kenji Inaba, Rifat Latifi, Andrew B. Peitzman, Boris Sakakushev, Dieter G. Weber, Arda Isik, Ari Leppäniemi, Ofir Ben-Ishay, Yunfeng Cui, Carlos Augusto Gomes, Gustavo Pereira Fraga, Michael McFarlane, Sanoop K. Zachariah, Salomone Di Saverio, Yoram Kluger, Ronald V. Maier, Zaza Demetrashvili, Arianna Birindelli, Renato Bessa Melo, Carlos A. Ordoñez, Mahir Gachabayov, Georgios Gkiokas, Raul Coimbra, Massimo Sartelli, Vishal G Shelat, Norio Sato, Rodolfo Soto, Fausto Catena, Sanjay Marwah, András Vereczkei, Jeffry L. Kashuk, Fikri M. Abu-Zidan, Kenneth Y.Y. Kok, Konstantinos Bouliaris, and Luca Ansaloni

Subjects
Perforated diverticulitis, medicine.medical_specialty, Acute diverticulitis, medicine.diagnostic_test, business.industry, General surgery, Consensus conference, Computed tomography, Diagnostic accuracy, Review, 030230 surgery, Diverticulitis, medicine.disease, Left sided, 3. Good health, Surgery, 03 medical and health sciences, 0302 clinical medicine, Emergency surgery, Emergency Medicine, Medicine, 030211 gastroenterology & hepatology, business
Abstract

Acute left sided colonic diverticulitis is one of the most common clinical conditions encountered by surgeons in acute setting. A World Society of Emergency Surgery (WSES) Consensus Conference on acute diverticulitis was held during the 3rd World Congress of the WSES in Jerusalem, Israel, on July 7th, 2015. During this consensus conference the guidelines for the management of acute left sided colonic diverticulitis in the emergency setting were presented and discussed. This document represents the executive summary of the final guidelines approved by the consensus conference.

Published
2016
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8. Lymph node ratio as a prognostic factor in gastric cancer patients following D1 resection. Comparison with the current TNM staging system

Author

Grigorios Christodoulidis, G. Rachiotis, Efstathia Polychronopoulou, Konstantinos Tepetes, Konstantinos Bouliaris, and Alexandros Diamantis

Subjects
Adult, Male, medicine.medical_specialty, Left gastric artery, medicine.medical_treatment, 030230 surgery, TNM staging system, Adenocarcinoma, Gastroenterology, 03 medical and health sciences, 0302 clinical medicine, Stomach Neoplasms, Internal medicine, medicine.artery, medicine, Humans, Lymph node, Aged, Neoplasm Staging, Retrospective Studies, Aged, 80 and over, Univariate analysis, business.industry, Cancer, Retrospective cohort study, General Medicine, Middle Aged, medicine.disease, Prognosis, Surgery, Survival Rate, medicine.anatomical_structure, Oncology, 030220 oncology & carcinogenesis, Lymphatic Metastasis, Lymph Node Excision, Gastrectomy, Lymphadenectomy, Female, Lymph Nodes, business
Abstract

Introduction Nodal ratio (NR) has been demonstrated to be an independent prognostic factor in patients with gastric cancer. We evaluated the prognostic role of NR comparing it with the current TNM (2010) classification in gastric cancer patients treated with curative (R0) D1 resection. Materials and methods We retrospectively reviewed 110 patients who underwent R0 resection for gastric cancer at University Hospital of Larissa between 2002 and 2011. All patients had a D1 lymphadenectomy plus the nodes along the left gastric artery. Factors affecting survival as well as correlations between the N status, NR status and resected nodes were investigated. Results In univariate analysis the N and NR status but not the numbers of retrieved nodes were significant prognostic factors. Inside N1 and N2 categories, patients with different NR groups were present and survival of some of these subpopulations was statistically different at long-rank test. There was a correlation between the nodes retrieved and N status but not with the NR category. In multivariate analysis both N status (HR = 1.45; 95% C.I. = 1.19–1.89) and NR (HR = 4.53; 95% C.I. = 1.86–11.03) found to be independent prognostic factors of survival. Conclusion Prognostic significance of N status and NR status was comparable. Unlike N status, NR is independent by the number of resected nodes, and therefore it is particularly useful in case of conventional lymphadenectomy.

Published
2016

9. Damage Control Surgery for Hepatocellular Cancer Rupture in an Elderly Patient: Survival and Quality of Life

Author

Grigorios Christodoulidis, Dimitrios Symeonidis, Alexandros Diamantis, Konstantinos Bouliaris, and Konstantinos Tepetes

Subjects
Damage control, medicine.medical_specialty, business.industry, Arterial Embolization, Mortality rate, lcsh:Medical emergencies. Critical care. Intensive care. First aid, Case Report, General Medicine, lcsh:RC86-88.9, medicine.disease, Surgery, Damage control surgery, Hepatocellular carcinoma, Medicine, Liver function, Hemoperitoneum, medicine.symptom, business, Complication
Abstract

Spontaneous rupture of hepatocellular carcinoma (HCC) is a rare emergency condition with high mortality rate. Successful management depends on patients’ hemodynamic condition upon presentation and comorbidities, correct diagnosis, HCC status, liver function, and future liver remnant, as well as available sources. There is still a debate in the literature concerning the best approach in this devastating complication. Nevertheless, the primary goal should be a definitive bleeding arrest. In most cases, patients with spontaneous rupture of HCC present with hemodynamic instability, due to hemoperitoneum, necessitating an emergency treatment modality. In such cases, transcatheter arterial embolization (TAE) should be the treatment of choice. Emergency liver resection is an option when TAE fails or in cases with preserved liver function and limited tumors. Otherwise, damage control strategies, as in liver trauma, are a reasonable alternative. We report a case of an elderly patient with hemoperitoneum and hypovolemic shock from spontaneous rupture of undiagnosed HCC, who was treated successfully by emergency surgery and damage control approach.

Published
2015

10. Global validation of the WSES Sepsis Severity Score for patients with complicated intra-abdominal infections : a prospective multicentre study (WISS Study)

Author

Elif Colak, Iyiade Olaoye, Raghuveer Mn, Tugan Tezcaner, David W da Costa, Varut Lohsiriwat, Vinod V. Prabhu, Tadeja Pintar, Fausto Catena, Raul Coimbra, Daniel Rios-Cruz, Zaza Demetrashvili, Dimitrios Anyfantakis, Isidoro Di Carlo, John Agboola, Konstantinos Pouggouras, Charalampos Spyropoulos, AA Munyika, Sanjay Marwah, Stefano Rausei, Giovanni Bellanova, Francesco Pata, András Vereczkei, Piotr Major, Nereo Vettoretto, Ari Leppäniemi, Ramakrishnapillai Padmakumar, Geanina Loredana Curca, Oussama Baraket, Marco Catani, Massimo Sartelli, Miguel Leon, Konstantinos Bouliaris, Maria Luisa Sánchez de Molina, Eftychios Lostoridis, Gianfranco Cocorullo, Bandar Alharthi, Ionut Negoi, Zygimantas Kuliesius, Sanjay Gupta, Maurice Zida, Terry Curry, Savas Bayrak, Frederic Branger, Pedro Leão, Teresa Giménez Maurel, Saleh Abdel Kader, Cristian Mesina, Marcelo A. Beltrán, Eudaldo López-Tomassetti Fernandez, Carlos A. Ordoñez, Martin Hutan, Jakub Kenig, Avidyl Krasniqi, Sumita A Jain, Tonguç Utku Yılmaz, Miran Rems, Dmitry Smirnov, Gabrielle H. van Ramshorst, Robin Kaushik, Renato Bessa Melo, Mario Paulo Faro, Ouadii Mouaqit, Asri Che Jusoh, Adamu Amhed, Abdelkarim H. Omari, Jaan Tepp, Ali Guner, Miklosh Bala, Charampolos Seretis, Alain Chichom-Mefire, Nadezda Drozdova, Matej Skrovina, Saila Kauhanen, Aurélien Venara, Aintzane Lizarazu Pérez, Kuo-Ching Yuan, Adesina Ajibade, Silvia Figueiredo Costa, Yoshimitsu Izawa, Mahir Gachabayov, Michael McFarlane, Ricardo Alessandro Teixeira Gonsaga, Ashok Kshirsagar, Jae Gil Lee, Gustavo Pereira Fraga, Koray Das, Jan Ulrych, Tamer El Zalabany, Luca Ansaloni, Victor Y. Kong, Matti Tolonen, Jorge Pereira, Nick Michalopoulos, Georgios Gkiokas, Arda Isik, Orestis Ioannidis, Aleix Martínez-Pérez, Seckin Akkucuk, Giovanni Sinibaldi, Gabriela Elisa Nita, Jae Il Kim, Yunfeng Cui, Federico Coccolini, Ewen A. Griffiths, Roberto Bini, Salomone Di Saverio, Mushira Enani, Boris Sakakushev, Mustafa Yener Uzunoglu, Asrhaf Abbas, Fikri M. Abu-Zidan, David van Dellen, Sandra Gutierrez, Samir Delibegovic, Ioannis Nikolopoulos, Daniele Brunelli, Vishal G Shelat, Ferdinando Agresta, Gerson Alves Pereira Júnior, Goran Augustin, Mantas Jokubauskas, Zeynep Özkan, Sanoop K. Zachariah, Nutu Vlad, Romeo Lages Simões, Konstantinos Lasithiotakis, Giorgio Vasquez, Matthew Boal, Daniele Marrelli, Sanjay Kumar Yadav, Paola Rodriguez Ossa, Vladimir Khokha, Carlos Augusto Gomes, Justas Zilinskas, Gianluca Guercioni, Renol M. Koshy, Gian Luca Baiocchi, Athanasios Marinis, Aleksandar Karamarkovic, Radu Moldovanu, Andrey V. Borodach, Myftar Torba, II kirurgian klinikka, Clinicum, [et al.], Universidade do Minho, Sartelli, M., Abu Zidan, F., Catena, F., Griffiths, E., Di Saverio, S., Coimbra, R., Ordoñez, C., Leppaniemi, A., Fraga, G., Coccolini, F., Agresta, F., Abbas, A., Abdel Kader, S., Agboola, J., Amhed, A., Ajibade, A., Akkucuk, S., Alharthi, B., Anyfantakis, D., Augustin, G., Baiocchi, G., Bala, M., Baraket, O., Bayrak, S., Bellanova, G., Beltràn, M., Bini, R., Boal, M., Borodach, A., Bouliaris, K., Branger, F., Brunelli, D., Catani, M., Che Jusoh, A., Chichom Mefire, A., Cocorullo, G., Colak, E., Costa, D., Costa, S., Cui, Y., Curca, G., Curry, T., Das, K., Delibegovic, S., Demetrashvili, Z., Di Carlo, I., Drozdova, N., El Zalabany, T., Enani, M., Faro, M., Gachabayov, M., Giménez Maurel, T., Gkiokas, G., Gomes, C., Gonsaga, R., Guercioni, G., Guner, A., Gupta, S., Gutierrez, S., Hutan, M., Ioannidis, O., Isik, A., Izawa, Y., Jain, S., Jokubauskas, M., Karamarkovic, A., Kauhanen, S., Kaushik, R., Kenig, J., Khokha, V., Kim, J., Kong, V., Koshy, R., Krasniqi, A., Kshirsagar, A., Kuliesius, Z., Lasithiotakis, K., Leão, P., Lee, J., Leon, M., Lizarazu Pérez, A., Lohsiriwat, V., López Tomassetti Fernandez, E., Lostoridis, E., Mn, R., Major, P., Marinis, A., Marrelli, D., Martinez Perez, A., Marwah, S., Mcfarlane, M., Melo, R., Mesina, C., Michalopoulos, N., Moldovanu, R., Mouaqit, O., Munyika, A., Negoi, I., Nikolopoulos, I., Nita, G., Olaoye, I., Omari, A., Ossa, P., Ozkan, Z., Padmakumar, R., Pata, F., Pereira Junior, G., Pereira, J., Pintar, T., Pouggouras, K., Prabhu, V., Rausei, S., Rems, M., Rios Cruz, D., Sakakushev, B., Sánchez de Molina, M., Seretis, C., Shelat, V., Simões, R., Sinibaldi, G., Skrovina, M., Smirnov, D., Spyropoulos, C., Tepp, J., Tezcaner, T., Tolonen, M., Torba, M., Ulrych, J., Uzunoglu, M., van Dellen, D., van Ramshorst, G., Vasquez, G., Venara, A., Vereczkei, A., Vettoretto, N., Vlad, N., Yadav, S., Yilmaz, T., Yuan, K., Zachariah, S., Zida, M., Zilinskas, J., and Ansaloni, L.

Subjects
medicine.medical_specialty, Infections, Intra-abdominal, Sepsis, Septic shock, Ciências da Saúde [Ciências Médicas], Surgery, Emergency Medicine, Ciências Médicas::Ciências da Saúde, Sepsi, medicine.medical_treatment, macromolecular substances, 030230 surgery, GUIDELINES, Likelihood ratios in diagnostic testing, PERITONITIS, 03 medical and health sciences, PROGNOSTIC-FACTORS, 0302 clinical medicine, Internal medicine, Medicine and Health Sciences, MANAGEMENT, medicine, Intra-abdominal Sepsis, Univariate analysis, Science & Technology, COLONIC PERFORATION, Receiver operating characteristic, business.industry, Abdominal Infection, Immunosuppression, 3126 Surgery, anesthesiology, intensive care, radiology, medicine.disease, 3. Good health, 030220 oncology & carcinogenesis, Infections, Intra-abdominal Sepsis, Observational study, Infection, business, SYSTEM, Research Article
Abstract

BACKGROUND: To validate a new practical Sepsis Severity Score for patients with complicated intra-abdominal infections (cIAIs) including the clinical conditions at the admission (severe sepsis/septic shock), the origin of the cIAIs, the delay in source control, the setting of acquisition and any risk factors such as age and immunosuppression. ----- METHODS: The WISS study (WSES cIAIs Score Study) is a multicenter observational study underwent in 132 medical institutions worldwide during a four-month study period (October 2014-February 2015). Four thousand five hundred thirty-three patients with a mean age of 51.2 years (range 18-99) were enrolled in the WISS study. ----- RESULTS: Univariate analysis has shown that all factors that were previously included in the WSES Sepsis Severity Score were highly statistically significant between those who died and those who survived (p

Published
2015

11. Vertebral erosion: a rare complication of tracheostomy tube

Author

Spyridon Karagiannis, Tilemachos Zafeiridis, Evangelos Alexiou, and Konstantinos Bouliaris

Subjects
Male, Thorax, medicine.medical_specialty, Critical Care and Intensive Care Medicine, Thoracic Vertebrae, Young Adult, Tracheostomy, X ray computed, medicine, Humans, Tracheostomy tube, business.industry, Osteomyelitis, medicine.disease, Magnetic Resonance Imaging, Respiration, Artificial, Surgery, Equipment failure, medicine.anatomical_structure, Tomography x ray computed, Thoracic vertebrae, Equipment Failure, Spinal Diseases, Radiology, Tomography, X-Ray Computed, Complication, business
Published
2016
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12. Hemorrhagic Shock as a Sequela of Splenic Rupture in a Patient with Infectious Mononucleosis: Focus on the Potential Role of Salicylates

Author

Dimos Karangelis, Anargyros Giaglaras, Konstantinos Spanos, Michael Fanariotis, Konstantinos Bouliaris, and Marios E. Daskalopoulos

Subjects
medicine.medical_specialty, Mononucleosis, business.industry, medicine.medical_treatment, lcsh:R, lcsh:Medicine, Splenic Ruptures, Spleen, Sequela, Case Report, General Medicine, medicine.disease, Surgery, medicine.anatomical_structure, Acute abdomen, Hemorrhagic complication, Laparotomy, Hemorrhagic shock, medicine, medicine.symptom, business
Abstract

Despite the fact that the vast majority of splenic ruptures are traumatic, infectious mononucleosis has been incriminated as a major predisposing factor that affects the integrity of the spleen, thus causing atraumatic ruptures and life-threatening hemorrhages. Herein we present a case of a 23-year-old Caucasian male who underwent an emergency laparotomy for acute abdomen and hemorrhagic shock, caused by spontaneous splenic rupture secondary to infectious mononucleosis. The potential role of salicylates in the development of a hemorrhagic complication in a patient with infectious mononucleosis is discussed.

Published
2012

13. Complicated intra-abdominal infections in Europe: a comprehensive review of the CIAO study

Author

Salvador Navarro, Giorgio Giraudo, Harry van Goor, Sergio Aloia, Saila Kauhanen, Luca Ansaloni, Miran Rems, Cyrille Huchon, Rodolfo Scibé, Stefano Rausei, Ihor Herych, Damien Massalou, Ferdinando Agresta, Gianluca Guercioni, Fausto Catena, Cristian Mesina, Olivier Pittet, Ionut Negoi, Konstantinos Bouliaris, Cristian Tranà, Elia Poiasina, András Vereczkei, Marco Catani, Jorge Pereira, Mario Dente, Vladimir Khokha, Zoran Krivokapic, Alessandro Ferrero, Daniele Marrelli, Federico Coccolini, Pietro Coletta, Athanasios Marinis, Radu Moldovanu, Dmitry Smirnov, Dimitrios Giakoustidis, Daniel Lazzareschi, Jelena Petrović, Matej Skrovina, Samipetteri Laine, Fabio Cesare Campanile, Ludwig Ney, Martin Hutan, P. Pletinckx, Michele Cucchi, Adam Dziki, Korhan Taviloğlu, Günter Weiss, Mirjami Uotila-Nieminen, Salomone Di Saverio, Pierluigi Viale, Davide Corbella, Avdyl Krasniqi, Dragoljub Zivanovic, Elio Jovine, Piotr Major, Nikola Vladov, Ari Leppäniemi, Nurkan Törer, Sergio Colizza, Carlo De Werra, Charalampos Seretis, Orestis Ioannidis, Nereo Vettoretto, Jaan Tepp, Eliane Angst, Konstantinos Lasithiotakis, Jakub Kenig, Massimo Sartelli, Goran Augustin, Giorgio Vasquez, Helen Tzerbinis, Tadeja Pintar, Miguel Leon, Renato Bessa Melo, Halil Alis, Rafael Díaz-Nieto, Roberto Bini, Boris Sakakushev, David van Dellen, Samir Delibegovic, [Sartelli,M, Lazzareschi,DV, Scibè,R] Department of Surgery, Macerata Hospital, Macerata, Italy. [Catena,F, Cucchi,M] Emergency Surgery, Maggiore Parma Hospital, Parma, Italy. [Ansaloni,L, Coccolini,F, Poiasina,E] Department of General Surgery, Ospedali Riuniti, Bergamo, Italy. [Leppaniemi,A] Department of Abdominal Surgery, University Hospital Meilahti, Helsinki, Finland. [Taviloglu,K] Department of Surgery, Sisli Florence Nigtingale Hospital, Istanbul, Turkey. [van Goor,H] Department of Surgery, Radboud University Nijmegen Medical Centre, Nijmegen, Netherlands. [Viale,P] Department of Internal Medicine Geriatrics and Nephrologic Diseases, Clinic of Infectious Diseases, St Orsola-Malpighi University Hospital, Bologna, Italy. [Corbela,D] Department of Anestesiology, Ospedali Riuniti, Bergamo, Italy. [de Werra,C, Aloia,S] General, Oncological, Geriatrical Surgery and advanced Technology, University Federico II, Naples, Italy. [Marrelli,D] Department of Human Pathology and Oncology, Policlinico le Scotte, University Hospital, Siena, Italy. [Colizza,S] Department of Surgery, Fatebenefratelli Isola Tiberina hospital, Rome, Italy. [Alis,H] Department of General Surgery, Bakirkoy Training Research Hospital, Istanbul, Turkey. [Torer,N] Department of General Surgery, Baskent University Faculty of Medicine, Adana, Turkey. [Navarro,S] Department of Surgery, Parc Tauli University Hospital, Barcelona, Spain. [Sakakushev,B] First General Surgery Clinic, University Hospital St. George/Chair of Surgical Propedeutics, Medical Faculty, Medical University Plovdiv, Plovdic, Bulgaria. [Massalou,D] Department of Emergency Surgery, University Hospital of Nice, University of Nice Sophia-Antipolis, Sophia-Antipolis, France. [Augustin,G] Department of Surgery, University Hospital Center, Zagreb, Croatia. [Catani,M] Emergency Department, Umberto I Hospital, 'La Sapienza' University of Rome, Rome, Italy. [Kauhanen,S] Department of Gastroenterological surgery Turku, University Central Hospital, Turku, Finland. [Pletinckx,P] Department of Surgery, AZ Maria Middelares, Ghent, Belgium. [Kenig,J] 3rd Department of Generał Surgery, Narutowicz Hospital, Krakow, Połand. [Di Saverio,S, Jovine,E] Department of Surgery, Maggiore Hospital, Bologna, Italy. [Guercioni,G] Department of Surgery, Mazzoni Hospital, Ascoli Piceno, Italy. [Skrovina,M] Department of Surgery Hospital and Oncological Centre Novy Jicin, Novy Jicin, Czech republic. [Díaz-Nieto,R] Department of General and Digestive Surgery, Hospital Universitario Virgen de la Victoria, Málaga, Spain. [Ferrero,A] Department of Surgery, Mauriziano Hospital, Torino, Italy. [Rausei,S] Department of Surgery (Chief Renzo Dionigi), University of Insubria, Ospedale di Circolo e Fondazione Macchi, Varese, Italy. [Laine,S] Department GI-surgery, Kuopio University Hospital, Kuopio, Finland. [Major,P] 2nd Department of Surgery, Jagiellonian University, Krakow, Poland. [Angst,E] Department of Visceral Surgery and Medicine, Inselspital Bern, University of Bern, Bern, Switzerland. [Pittet,O] Department of Visceral Surgery Centre Hospitalier Universitaire Vaudois, CHUV, Lausanne, Switzerland. [Herych,I] Department of General Surgery, Lviv Emergency Hospital, Lviv, Ukraine. [Agresta,F] Department of General Surgery, Ospedale Civile, Adria (RO), Italy. [Vettoretto,N] General and Vascular Surgery, M.Mellini Hospital, Chiari, Italy. [Tepp,J] First General Surgery, North Estonia Regional Hospital, Tallinn, Estonia. [Weiss,G] Intensive Care Klinikum, Magdeburg gGmbH, Magdeburg, Germany. [Vasquez,G] Department of Emergency Surgery Azienda Ospedaliero-Universitaria S.Anna, Ferrara, Italy. [Vladov,N] Department of Hepato-biliary and Pancreatic surgery and Transplantology, Military Medical Hospital, Sofia, Bulgaria. [Tranà,C] Department of Surgery, Ospedali Riuniti Umberto I-Lancisi-Salesi, Ancona, Italy. [Delivegovic,S] Department of surgery, University Clinic Center Tuzla, Tuzla, Bosnia and Herzegovina. [Dziki,A] Department of General and Colorectal Surgery, University Hospital, Central Veterans Hospital, Lodz, Poland. [Giraudo,G] Surgical Department Santa Croce e Carle hospital, Cuneo, Italy. [Pereira,J] Department of Surgery, São Teotónio Hospital, Viseu, Portugal. [Tzerbinis,H] Department of HPB and Liver Transplant Surgery, Royal Free Hospital, London, United Kingdom. [van Dellen,D] Department of Surgery, Manchester Royal Infirmare, Manchester, UK. [Hutan,M] IInd Surgical department of Medical faculty Comenius University, University Hospital Bratislava, st. Cyril and Methodius Hospital, Bratislava, Slovakia. [Vereczkei,A] Department of Surgery, Medical School University of Pécs, Pécs, Hungary. [Krasniqi,A] Department of Abdominal Surgery, University Clinical Centre of Kosovo, Prishtina, Kosovo. [Seretis,Ch] 2nd Department of Surgery, General Army Hospital of Athens, Athens, Greece. [Mesina,C] Second Surgical Clinic, Emergency Hospital of Craiova, Craiova, Roumanie. [Rems,M] Surgical Department, General hospital Jesenice, Jesenice, Slovenia. [Campanile,FC] Department of surgery, Andosilla Hospital, Civita Castellana, Italy. [Coletta,P] Department of Surgery, Jesi Hospital, Jesi, Italy. [Uotila-Nieminen,M] Department of Gastrointestinal Surgery, North Carelian Central Hospital, Joensuu, Finland. [Dente,M] Oncologic, Digestive and Emergency Surgery, Bocage Hospital, Dijon, France. [Bouliaris,K] Surgical Department General Hospital of Larissa, Larissa, Greece. [Lasithiotakis,K] Department of General Surgery, University Hospital of Heraklion, Heraklion, Greece. [KhoKha,V] Surgical Department, Mozyr, Belarus. [Zivanovic,D] Department of Pediatric surgery, Paediatric surgery and orthopaedic Clinic, Nis, Serbia. [Smirnov,D] General Surgery, Clinical Hospital at Chelyabinsk Station OJSC 'Russian Railroads', Chelyabinsk City, Russian Federation. [Marinis,A] First Department of Surgery, Tzanion General Hospital, Piraeus, Greece. [Negoi,I] Department of General Surgery, Emergency Hospital of Bucharest, Bucharest, Romania. [Ney,L] Deparment of Surgery, Downtown Campus, University Hospital of Munich, Munich, Germany. [Bini,R] General and emergency surgery, SG Bosco Hospital, Torino, Italy. [León,M] Department of General Surgery, Hospital La Paz, Madrid, Spain. [Huchon,C] Department of Gynecology and Obstetrics, CHI Poissy-St-Germain-En-Laye, France and University Versailles Saint-Quentin, Versailles, France. [Moldovanu,R] Chirurgie Viscerale, Digestive et Oncologique Hospital Prive, Arras les Bonnettes, Arras, France. [de Melo,RB] Department of General Surgery, Hospital São João Porto, Porto, Portugal. [Giakoustidis,D] Division of Transplantation, Department of Surgery, Medical School, Aristotle University of Thessaloniki, Hippokration General Hospital, Thessaloniki, Greece. [Ioannidis,O] 1st Surgical Department, General Regional Hospital 'George Papanikolaou', Thessaloniki, Greece. [Pintar,T] Department of Abdominal Surgery, umc Ljubljana, Ljubljana, Slovenia. [Krivokapic,Z, Petrovic,J] First Surgical clinic, Clinical Center of Serbia, School of Medicine, University of Belgrade 8, Belgrade, Serbia., and II kirurgian klinikka

Subjects
Infecciones Intraabdominales, Analytical, Diagnostic and Therapeutic Techniques and Equipment::Surgical Procedures, Operative::Digestive System Surgical Procedures [Medical Subject Headings], Diseases::Bacterial Infections and Mycoses::Infection::Cross Infection [Medical Subject Headings], Phenomena and Processes::Microbiological Phenomena::Drug Resistance, Microbial [Medical Subject Headings], 030230 surgery, Analytical, Diagnostic and Therapeutic Techniques and Equipment::Therapeutics::Drainage [Medical Subject Headings], Abceso Abdominal, Organisms::Eukaryota::Animals::Chordata::Vertebrates::Mammals::Primates::Haplorhini::Catarrhini::Hominidae::Humans [Medical Subject Headings], Analytical, Diagnostic and Therapeutic Techniques and Equipment::Surgical Procedures, Operative::Reoperation [Medical Subject Headings], 0302 clinical medicine, Epidemiology, Farmacoresistencia Microbiana, Medicine, Diseases::Bacterial Infections and Mycoses::Infection::Sepsis [Medical Subject Headings], PRIMARY ANASTOMOSIS, Publication Characteristics::Study Characteristics::Multicenter Study [Medical Subject Headings], Adulto, Mortality rate, lcsh:Medical emergencies. Critical care. Intensive care. First aid, Diverticulitis, 3. Good health, Humanos, Procedimientos Quirúrgicos del Sistema Digestivo, 030220 oncology & carcinogenesis, Emergency Medicine, Diseases::Digestive System Diseases::Peritoneal Diseases::Peritonitis [Medical Subject Headings], Reoperación, Diseases::Pathological Conditions, Signs and Symptoms::Pathologic Processes::Disease Attributes::Critical Illness [Medical Subject Headings], Research Article, medicine.medical_specialty, Perforation (oil well), education, Infección Hospitalaria, lcsh:Surgery, APPENDECTOMY, Enfermedad Crítica, Diseases::Bacterial Infections and Mycoses::Infection::Suppuration::Abscess::Abdominal Abscess [Medical Subject Headings], Sepsis, 03 medical and health sciences, Internal medicine, HARTMANNS PROCEDURE, MANAGEMENT, Named Groups::Persons::Age Groups::Adult [Medical Subject Headings], Estudio Multicéntrico, Diseases::Bacterial Infections and Mycoses::Infection::Intraabdominal Infections [Medical Subject Headings], business.industry, Septic shock, Abdominal Infection, lcsh:RD1-811, lcsh:RC86-88.9, medicine.disease, 3126 Surgery, anesthesiology, intensive care, radiology, PRIMARY RESECTION, Emergency medicine, Observational study, Surgery, business, DIVERTICULITIS
Abstract

The CIAO Study (“Complicated Intra-Abdominal infection Observational” Study) is a multicenter investigation performed in 68 medical institutions throughout Europe over the course of a 6-month observational period (January-June 2012). Patients with either community-acquired or healthcare-associated complicated intra-abdominal infections (IAIs) were included in the study. 2,152 patients with a mean age of 53.8 years (range: 4–98 years) were enrolled in the study. 46.3% of the patients were women and 53.7% were men. Intraperitoneal specimens were collected from 62.2% of the enrolled patients, and from these samples, a variety of microorganisms were collectively identified. The overall mortality rate was 7.5% (163/2.152). According to multivariate analysis of the compiled data, several criteria were found to be independent variables predictive of patient mortality, including patient age, the presence of an intestinal non-appendicular source of infection (colonic non-diverticular perforation, complicated diverticulitis, small bowel perforation), a delayed initial intervention (a delay exceeding 24 hours), sepsis and septic shock in the immediate post-operative period, and ICU admission. Given the sweeping geographical distribution of the participating medical centers, the CIAO Study gives an accurate description of the epidemiological, clinical, microbiological, and treatment profiles of complicated intra-abdominal infections (IAIs) throughout Europe.

Published
2012
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14. Ileosigmoid fistula and delayed ileal obstruction secondary to blunt abdominal trauma: a case report

Author

Dimos Karangelis, Evangelos Alexiou, Anargyros Giaglaras, Stylianos Germanos, Konstantinos Spanos, and Konstantinos Bouliaris

Subjects
Medicine(all), medicine.medical_specialty, Pediatrics, business.industry, Fistula, lcsh:R, lcsh:Medicine, Case Report, General Medicine, medicine.disease, Surgery, Bowel obstruction, Road traffic accident, Blunt, Abdominal trauma, Medicine, Ileal Obstruction, Surgical emergency, business, Ileal stricture
Abstract

Introduction Abdominal trauma is a source of significant mortality and morbidity. Bowel injury as a result of blunt abdominal trauma is usually evident within hours or days of the accident. Case presentation A 38-year-old Caucasian Greek man presented with a subtle and delayed small bowel obstruction caused by a post-traumatic ileosigmoid fistula and ileal stricture four months after a road traffic accident. Conclusion Delayed occurrence of post-traumatic small bowel stricture and ileosigmoid fistula is an uncommon surgical emergency. General surgeons as well as emergency physicians should bear this manifestation in mind should a patient return to the hospital several weeks or even years after blunt abdominal trauma with symptoms or signs of bowel obstruction.

Published
2011

15. Synchronous perforation of a duodenal and gastric ulcer: a case report

Author

Anargyros Giaglaras, Dimos Karangelis, Konstantinos Bouliaris, Andony J Baddour, Christos Karathanos, and Georgios I Tagarakis

Subjects
Medicine(all), medicine.medical_specialty, business.industry, General surgery, Public health, lcsh:R, Perforation (oil well), lcsh:Medicine, Peritonitis, Case Report, General Medicine, medicine.disease, digestive system, Gastroenterology, digestive system diseases, Peptic Ulcer Perforation, Surgical oncology, Internal medicine, mental disorders, medicine, Risk of mortality, Surgical emergency, business
Abstract

Introduction Peritonitis due to peptic ulcer perforation is a surgical emergency with a high risk of mortality and morbidity. Case presentation We present a rare case of a 54-year-old Caucasian man who underwent an emergency laparotomy for peritonitis caused by perforation of two peptic ulcers. The first was located on the anterior wall of the duodenum and the second was posterior, pre-pyloric, close to the lesser curvature. Conclusion To the best of our knowledge, this is only the second report in the medical literature of a simultaneous perforation of two peptic ulcers; though rare, every surgeon performing open or laparoscopic repair of a perforated peptic ulcer should be aware of the possibility of simultaneous perforation.

Published
2010
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16. Complicated intra-abdominal infections in Europe: preliminary data from the first three months of the CIAO Study

Author

Roberto Bini, Boris Sakakushev, Martin Hutan, Samir Delibegovic, Piotr Major, Nikola Vladov, Ari Leppäniemi, Miran Rems, Harry van Goor, Konstantinos Bouliaris, Cristian Tranà, Miguel Leon, Marco Catani, Charalampos Seretis, Adam Dziki, Mario Dente, P. Pletinckx, Helen Tzerbinis, Damien Massalou, Daniele Marrelli, Konstantinos Lasithiotakis, Dimitrios Giakoustidis, Elia Poiasina, Pierluigi Viale, Goran Augustin, Carlo De Werra, Fabio Cesare Campanile, Ludwig Ney, Stefano Rausei, Saila Kauhanen, Fausto Catena, Gianluca Guercioni, Salvador Navarro, András Vereczkei, Dmitry Smirnov, Rodolfo Scibé, Halil Alis, Rafael Díaz-Nieto, Giorgio Giraudo, Olivier Pittet, Pietro Coletta, Luca Ansaloni, Orestis Ioannidis, Ionut Negoi, Radu Moldovanu, Vladimir Khokha, Avdyl Krasniqi, Giorgio Vasquez, Tadeja Pintar, Daniel Lazzareschi, Guenter Weiss, Ihor Gerych, Jaan Tepp, Michele Cucchi, Dragoljub Zivanovic, Jorge Pereira, Nereo Vettoretto, Cyrille Huchon, Matej Skrovina, Eliane Angst, Samipetteri Laine, Massimo Sartelli, Mirjami Uotila-Nieminen, Sergio Aloia, Salomone Di Saverio, Elio Jovine, Renato Bessa Melo, Ferdinando Agresta, Cristian Mesina, Nurkan Törer, Jakub Kenig, Athanasios Marinis, Sergio Colizza, Korhan Taviloğlu, and II kirurgian klinikka

Subjects
medicine.medical_specialty, surgical treatment, education, lcsh:Surgery, Peritonitis, Disease, APPENDECTOMY, 030230 surgery, Malignancy, community-acquired infections, 03 medical and health sciences, 0302 clinical medicine, Internal medicine, MANAGEMENT, medicine, risk factors, intra-abdominal infections, ANASTOMOSIS, business.industry, Septic shock, Abdominal Infection, Mortality rate, lcsh:Medical emergencies. Critical care. Intensive care. First aid, lcsh:RD1-811, lcsh:RC86-88.9, Diverticulitis, healthcare-associated infections, postoperative mortality, multicenter study, 3126 Surgery, anesthesiology, intensive care, radiology, medicine.disease, 3. Good health, PRIMARY RESECTION, 030220 oncology & carcinogenesis, Emergency medicine, Emergency Medicine, Surgery, Observational study, Evaluation of complex medical interventions Tissue engineering and pathology [NCEBP 2], DIVERTICULITIS, business, Research Article
Abstract

Contains fulltext : 110654.pdf (Publisher’s version ) (Open Access) ABSTRACT: The CIAO Study is a multicenter observational study currently underway in 66 European medical institutions over the course of a six-month study period (January-June 2012).This preliminary report overviews the findings of the first half of the study, which includes all data from the first three months of the six-month study period.Patients with either community-acquired or healthcare-associated complicated intra-abdominal infections (IAIs) were included in the study.912 patients with a mean age of 54.4 years (range 4-98) were enrolled in the study during the first three-month period. 47.7% of the patients were women and 52.3% were men. Among these patients, 83.3% were affected by community-acquired IAIs while the remaining 16.7% presented with healthcare-associated infections. Intraperitoneal specimens were collected from 64.2% of the enrolled patients, and from these samples, 825 microorganisms were collectively identified.The overall mortality rate was 6.4% (58/912). According to univariate statistical analysis of the data, critical clinical condition of the patient upon hospital admission (defined by severe sepsis and septic shock) as well as healthcare-associated infections, non-appendicular origin, generalized peritonitis, and serious comorbidities such as malignancy and severe cardiovascular disease were all significant risk factors for patient mortality.White Blood Cell counts (WBCs) greater than 12,000 or less than 4,000 and core body temperatures exceeding 38 degrees C or less than 36 degrees C by the third post-operative day were statistically significant indicators of patient mortality.

Published
2012
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17. A proposal for a CT driven classification of left colon acute diverticulitis

Author

Salomone Di Saverio, Fausto Catena, Zaza Demetrashvili, Fikri M. Abu-Zidan, Damien Massalou, Carlos Augusto Gomes, Federico Coccolini, Miran Rems, Charalampos Spyropoulos, András Vereczkei, Jae Il Kim, Offir Ben-Ishay, Goran Augustin, Yunfeng Cui, Rodolfo Soto, Darija Soldatenkova, Massimo Sartelli, Gerson Alves Pereira, Imtiaz Wani, Renato Bessa Melo, Norio Sato, Matej Skrovina, Jakub Kenig, Victor Y. Kong, Carlos A. Ordoñez, Daniel Rios-Cruz, Abdelkarim H. Omari, Sanoop K. Zachariah, Marco Catani, Dmitry Smirnov, Jaan Tepp, Koray Das, Zurabs Kecbaja, Ferdinando Agresta, Michael McFarlane, Ewen A. Griffiths, Frederick A. Moore, Roberto Bini, Boris Sakakushev, Emanuele Caproli, Miklosh Bala, Diego Piazza, Georgios Gkiokas, Isidoro Di Carlo, Varut Lohsiriwat, Mahir Gachabayov, Raul Coimbra, Ioannis Nikolopoulos, Sanjay Marwah, Helmut Alfredo Segovia Lohse, Jan Ulrych, Tadaja Pintar, Mario Paulo Faro, Ionut Negoi, Gian Luca Baiocchi, Athanasios Marinis, Aleksandar Karamarkovic, Ashraf Abbas, Konstantinos Bouliaris, Giovanni Bellanova, Cristian Tranà, F. Corcione, David Costa Navarro, Arda Isik, Kenneth Y.Y. Kok, Vishal G Shelat, Luca Ansaloni, Gabriele Anania, and Elif Colak

Subjects
medicine.medical_specialty, Acute diverticulitis, medicine.diagnostic_test, business.industry, Computed tomography, Review, Diverticulitis, medicine.disease, Surgery, NO, Left colon, medicine, Emergency Medicine, Radiology, Day to day, Ct imaging, business, Radiation treatment planning
Abstract

Computed tomography (CT) imaging is the most appropriate diagnostic tool to confirm suspected left colonic diverticulitis. However, the utility of CT imaging goes beyond accurate diagnosis of diverticulitis; the grade of severity on CT imaging may drive treatment planning of patients presenting with acute diverticulitis. The appropriate management of left colon acute diverticulitis remains still debated because of the vast spectrum of clinical presentations and different approaches to treatment proposed. The authors present a new simple classification system based on both CT scan results driving decisions making management of acute diverticulitis that may be universally accepted for day to day practice.

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