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Mulita F, Leivaditis V, Dimopoulos P, Ibra A, Iliopoulos F, Tasios K, Pitros C, Kaplanis C, Peteinaris A, Bouchagier K, Papadoulas S, Pitiakoudis M. Correlation between gynecological tumors and atherosclerotic diseases. Arch Med Sci Atheroscler Dis 2023; 8:e118-e122. [PMID: 38283923 PMCID: PMC10811538 DOI: 10.5114/amsad/176655] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/24/2023] [Accepted: 12/08/2023] [Indexed: 01/30/2024] Open
Abstract
Gynecological cancer is among the leading causes of cancer-related mortality worldwide, with malignancies of the ovary, uterus, fallopian tube, cervix, vagina, and vulva making up 10-18% of all cancers diagnosed in women globally. Gynecological cancer and atherosclerosis are two of the most frequent medical entities that afflict women worldwide; thus the possible correlations between them ought to be explored. Vulvar, cervical, vaginal, endometrial, and ovarian cancers have been found to have common points with atherosclerosis regarding their pathogenesis and predisposing factors. Obesity and metabolic syndrome, HPV infection, vitamin D deficiency, and increased telomere length constitute common ground between these two afflictions, which this article aims to analyze.
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Affiliation(s)
- Francesk Mulita
- Department of Surgery, General University Hospital of Patras, Patras, Greece
| | - Vasileios Leivaditis
- Department of Cardiothoracic and Vascular Surgery, Westpfalz-Klinikum, Kaiserslautern, Germany
| | - Platon Dimopoulos
- Department of Radiology, General University Hospital of Patras, Patras, Greece
| | - Artemis Ibra
- Department of Surgery, General University Hospital of Patras, Patras, Greece
| | - Fotios Iliopoulos
- Department of Gynecology, General University Hospital of Patras, Patras, Greece
| | - Konstantinos Tasios
- Department of Surgery, General University Hospital of Patras, Patras, Greece
| | - Christos Pitros
- Department of Vascular Surgery, General University Hospital of Patras, Patras, Greece
| | | | - Angelis Peteinaris
- Department of Urology, General University Hospital of Patras, Patras, Greece
| | | | - Spyros Papadoulas
- Department of Vascular Surgery, General University Hospital of Patras, Patras, Greece
| | - Michail Pitiakoudis
- Second Department of Surgery, University General Hospital of Alexandroupolis, Democritus University of Thrace Medical School, Alexandroupolis, Greece
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Mulita F, Theofanis G, Verras GI, Liolis E, Papanikos V, Tchabashvili L, Tasios K, Iliopoulos F, Tsilivigkos C, Kehagias D, Kaplanis C, Antzoulas A, Samaras A, Drakos N, Panagiotopoulos I, Leivaditis V, Filis D, Maroulis I, Bouchagier K, Michalaki M. Comparison of postoperative bleeding using harmonic scalpel and LigaSure in thyroid surgery: a 15-year single-centre retrospective study. Med Glas (Zenica) 2023; 20. [PMID: 37585298 DOI: 10.17392/1629-23] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Received: 03/11/2023] [Revised: 05/24/2023] [Accepted: 05/30/2023] [Indexed: 08/18/2023]
Abstract
Aim Thyroidectomy is the most common operation in the field of endocrine surgery. The aim of this study was to compare the use of LigaSure vessel (LS) and harmonic scalpel (HS) in 1653 total thyroidectomies between January 2008 and March of 2023, with regards to analysis of surgical bleeding complications duration the hospital stay and operative surgical time. Methods It is a retrospective analysis of a prospectively maintained database. Patients have been categorized into two groups: Group A included 718 patients from January 2008 to May 2013 when LS was used, and the Group B included 935 patients from June 2013 to March 2023 when HS was used. Results From the total of 14 postoperative bleeding cases that occurred in patients of Group A, only in 4 of them it was necessary to have a reoperation. The other 10 cases involved minor haemorrhages, while from the total of 6 postoperative bleeding cases that happened to patients of Group B, there were 4 cases that needed a reoperation (p-value >0.05) and 2 patients with minor haemorrhages. The postoperative evaluation of minor bleedings revealed statistically significant differences between the two groups (p-value < 0.05). The average hospital stay was similar in the two groups. Conclusion Both devices exhibit identical safety profiles in thyroidectomies specifically regarding major bleeding complications that require reoperation. Additionally, HS was found to be more effective at achieving haemostasis, especially in the subgroup of patients with thyroid carcinoma. The results of the present study may be useful for high-volume centres performing numerous thyroidectomies every day.
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Affiliation(s)
- Francesk Mulita
- Department of General Surgery, University General Hospital of Patras, Greece
| | - George Theofanis
- Department of General Surgery, University General Hospital of Patras, Greece
| | | | - Elias Liolis
- Department of Oncology, University General Hospital of Patras, Greece
| | - Vasileios Papanikos
- Department of Otorhinolaryngology, University General Hospital of Patras, Greece
| | - Levan Tchabashvili
- Department of General Surgery, University General Hospital of Patras, Greece
| | - Konstantinos Tasios
- Department of General Surgery, University General Hospital of Patras, Greece
| | - Fotios Iliopoulos
- Department of General Surgery, University General Hospital of Patras, Greece
| | | | - Dimitrios Kehagias
- Department of General Surgery, University General Hospital of Patras, Greece
| | | | - Andreas Antzoulas
- Department of General Surgery, University General Hospital of Patras, Greece
| | - Angelos Samaras
- Department of General Surgery, University General Hospital of Patras, Greece
| | - Nikolas Drakos
- Department of General Surgery, University General Hospital of Patras, Greece
| | | | - Vasileios Leivaditis
- Department of Cardiothoracic Surgery, University General Hospital of Patras, Greece
| | - Dimitrios Filis
- Department of General Surgery, University General Hospital of Patras, Greece
| | - Ioannis Maroulis
- Department of General Surgery, University General Hospital of Patras, Greece
| | | | - Marina Michalaki
- Department of Endocrinology, University General Hospital of Patras, Greece
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Verras GI, Mulita F, Pouwels S, Parmar C, Drakos N, Bouchagier K, Kaplanis C, Skroubis G. Outcomes at 10-Year Follow-Up after Roux-en-Y Gastric Bypass, Biliopancreatic Diversion, and Sleeve Gastrectomy. J Clin Med 2023; 12:4973. [PMID: 37568375 PMCID: PMC10419540 DOI: 10.3390/jcm12154973] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2023] [Revised: 07/04/2023] [Accepted: 07/19/2023] [Indexed: 08/13/2023] Open
Abstract
INTRODUCTION Morbid obesity is a well-defined chronic disease, the incidence of which is constantly rising. Surgical treatment of morbid obesity has produced superior outcomes compared to conventional weight loss measures. Currently, there is a gap in the literature regarding long-term outcomes. Our single-institution, retrospective cohort study aims to evaluate weight loss outcomes, comorbidity reduction, and adverse effects at 10 years following Roux-en-Y Gastric Bypass (RYGB), Biliopancreatic Diversion (BPD), and Sleeve Gastrectomy (SG). MATERIALS AND METHODS We included all consecutive patients with 10-year follow-up records operated on within our institution. The comparison was carried out on the average percentage of weight and BMI loss. Nausea and vomiting were evaluated through self-reporting Likert scales. Diabetes resolution and nutritional deficiencies were also evaluated. RESULTS A total of 490 patients from 1995 up to 2011 were included in our study. Of these, 322 underwent RYGB, 58 underwent long-limb BPD, 34 underwent laparoscopic RYGB with fundus excision, 47 underwent laparoscopic SG, and 29 underwent laparoscopic RYGB as a revision of prior SG. RYGB and BPD were significantly associated with higher percentages of weight loss (37.6% and 37.5%), but were not found to be independent predictors of weight loss. Nausea and vomiting were associated with SG and laparoscopic RYGB with fundus excision, more so than the other operations. No differences were observed regarding diabetes resolution and nutritional deficiencies. CONCLUSIONS Longer follow-up reports are important for the comparison of outcomes between different types of bariatric operations. BPD and RYGB resulted in superior weight loss, with no observed differences in diabetes resolution and adverse outcomes.
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Affiliation(s)
- Georgios-Ioannis Verras
- Department of Surgery, General University Hospital of Patras, 26504 Patras, Greece; (N.D.); (K.B.); (C.K.) (G.S.)
| | - Francesk Mulita
- Department of Surgery, General University Hospital of Patras, 26504 Patras, Greece; (N.D.); (K.B.); (C.K.) (G.S.)
| | - Sjaak Pouwels
- Department of General, Abdominal and Minimally Invasive Surgery, Helios Klinikum, 47805 Krefeld, Germany;
- Department of Intensive Care Medicine, Elisabeth-Tweesteden Hospital, 5022 Tiburg, The Netherlands
| | - Chetan Parmar
- The Wittington Hospital NHS Trust, London N19 5NF, UK;
| | - Nikolas Drakos
- Department of Surgery, General University Hospital of Patras, 26504 Patras, Greece; (N.D.); (K.B.); (C.K.) (G.S.)
| | - Konstantinos Bouchagier
- Department of Surgery, General University Hospital of Patras, 26504 Patras, Greece; (N.D.); (K.B.); (C.K.) (G.S.)
| | - Charalampos Kaplanis
- Department of Surgery, General University Hospital of Patras, 26504 Patras, Greece; (N.D.); (K.B.); (C.K.) (G.S.)
| | - George Skroubis
- Department of Surgery, General University Hospital of Patras, 26504 Patras, Greece; (N.D.); (K.B.); (C.K.) (G.S.)
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Bousis D, Verras GI, Bouchagier K, Antzoulas A, Panagiotopoulos I, Katinioti A, Kehagias D, Kaplanis C, Kotis K, Anagnostopoulos CN, Mulita F. The role of deep learning in diagnosing colorectal cancer. Prz Gastroenterol 2023; 18:266-273. [PMID: 37937113 PMCID: PMC10626379 DOI: 10.5114/pg.2023.129494] [Citation(s) in RCA: 7] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 01/15/2023] [Accepted: 02/24/2023] [Indexed: 11/09/2023]
Abstract
Colon cancer is a major public health issue, affecting a growing number of individuals worldwide. Proper and early diagnosis of colon cancer is the necessary first step toward effective treatment and/or prevention of future disease relapse. Artificial intelligence and its subtypes, deep learning in particular, tend nowadays to have an expanding role in all fields of medicine, and diagnosing colon cancer is no exception. This report aims to summarize the entire application spectrum of deep learning in all diagnostic tests regarding colon cancer, from endoscopy and histologic examination to medical imaging and screening serologic tests.
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Affiliation(s)
- Dimitrios Bousis
- Department of Internal Medicine, General University Hospital of Patras, Patras, Greece
| | | | | | - Andreas Antzoulas
- Department of Surgery, General University Hospital of Patras, Patras, Greece
| | | | | | - Dimitrios Kehagias
- Department of Surgery, General University Hospital of Patras, Patras, Greece
| | | | - Konstantinos Kotis
- Intelligent Systems Lab, Department of Cultural Technology and Communication, University of the Aegean, Mytilene, Greece
| | | | - Francesk Mulita
- Department of Surgery, General University Hospital of Patras, Patras, Greece
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Verras GI, Mulita F, Bouchagier K, Dafnomili VD, Skroubis G, Perdikaris I, Tchabashvili L, Liolis E, Kaplanis C, Akinosoglou K, Velissaris D, Maroulis I. Development of a predictive model for surgical site infections in colorectal patients based on butyrylcholinesterase plasma levels. Eur J Surg Oncol 2023. [DOI: 10.1016/j.ejso.2022.11.082] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/19/2023] Open
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Verras GI, Filis D, Panagiotopoulos I, Liolis E, Kehagias D, Bousis D, Perdikaris I, Kaplanis C, Tchabashvili L, Mulita F. Perineal pseudocontinent colostomy: an alternative method to promote patients' satisfaction and safety? Prz Gastroenterol 2022; 18:216-218. [PMID: 37538280 PMCID: PMC10395054 DOI: 10.5114/pg.2022.116998] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 10/17/2021] [Accepted: 04/26/2022] [Indexed: 08/05/2023]
Affiliation(s)
| | - Dimitrios Filis
- Department of Surgery, “St. Andrew” General Hospital of Patras, Patras, Grecce
| | | | - Elias Liolis
- Department of Internal Medicine, General University Hospital of Patras, Patras, Grecce
| | - Dimitrios Kehagias
- Department of General Surgery, General University Hospital of Patras, Patras, Grecce
| | - Dimitrios Bousis
- Department of Internal Medicine, General University Hospital of Patras, Patras, Grecce
| | - Ioannis Perdikaris
- Department of General Surgery, General University Hospital of Patras, Patras, Grecce
| | - Charalampos Kaplanis
- Department of General Surgery, General University Hospital of Patras, Patras, Grecce
| | - Levan Tchabashvili
- Department of General Surgery, General University Hospital of Patras, Patras, Grecce
| | - Francesk Mulita
- Department of General Surgery, General University Hospital of Patras, Patras, Grecce
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Mulita F, Panagiotopoulos I, Verras G, Liolis E, Tchabashvili L, Paraskevas T, Iliopoulos F, Bousis D, Michailides C, Kaplanis C, Perdikaris I, Bouchagier K, Filis D, Velissaris D. Accidental ingestion of a dental bur in an 84‐year‐old male. Clin Case Rep 2022; 10:e05488. [PMID: 35280076 PMCID: PMC8898751 DOI: 10.1002/ccr3.5488] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2022] [Revised: 02/03/2022] [Accepted: 02/08/2022] [Indexed: 11/09/2022] Open
Affiliation(s)
- Francesk Mulita
- Department of General Surgery General University Hospital of Patras Patras Greece
| | | | | | - Elias Liolis
- Department of Internal Medicine General University Hospital of Patras Patras Greece
| | - Levan Tchabashvili
- Department of General Surgery General University Hospital of Patras Patras Greece
| | | | - Fotios Iliopoulos
- Department of General Surgery General University Hospital of Patras Patras Greece
| | - Dimitrios Bousis
- Department of Internal Medicine General University Hospital of Patras Patras Greece
| | - Christos Michailides
- Department of Internal Medicine General University Hospital of Patras Patras Greece
| | - Charalampos Kaplanis
- Department of General Surgery General University Hospital of Patras Patras Greece
| | - Ioannis Perdikaris
- Department of General Surgery General University Hospital of Patras Patras Greece
| | | | - Dimitrios Filis
- Department of Surgery "St. Andrew" General Hospital of Patras Patras Greece
| | - Dimitrios Velissaris
- Department of Internal Medicine General University Hospital of Patras Patras Greece
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Mulita F, Iliopoulos F, Tsilivigkos C, Tchabashvili L, Liolis E, Kaplanis C, Perdikaris I, Maroulis I. Cancer rate of Bethesda category II thyroid nodules. Med Glas (Zenica) 2022; 19. [PMID: 34734516 DOI: 10.17392/1413-21] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Received: 07/16/2021] [Revised: 08/16/2021] [Accepted: 09/22/2021] [Indexed: 02/07/2023]
Abstract
Aim Thyroid nodules are very common and may be found in more than 50% of the population. Fine-needle aspiration cytology (FNAC) of thyroid nodules is a very useful diagnostic tool with high sensitivity and predictive value for diagnosis. The Bethesda System for Reporting Thyroid Cytopathology (BSRTC) uses six categories for thyroid cytology reporting (I-nondiagnostic, IIbenign, III-atypia of undetermined significance (AUS)/ follicular lesion of undetermined significance (FLUS), IV-follicular neoplasm/suspicious for follicular neoplasm (SFN), V-suspicious for malignancy, and VI-malignant. Our objective was to determine the malignancy rate in Bethesda II nodules. Methods From June 2010 to May 2020 a retrospective analysis was performed among 1166 patients who underwent thyroid surgery for benign thyroid diseases in our institution. Thyroid cytopathological slides and Ultrasound (US) reports were reviewed and classified according to the BSRTC. Data collected included age, gender, cytological features, and histological type of thyroid cancer. Results During the study period, 44.77% (522/1166) of patients with an FNA categorized as Bethesda II underwent thyroid surgery. Incidental malignancy was found in 1.53% (8/522) cases of Bethesda II. The most common malignant tumour type was papillary thyroid carcinoma. Conclusion The current study demonstrates that incidental thyroid carcinoma can be diagnosed after thyroidectomy even in patients with an FNA categorized as Bethesda II.
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Affiliation(s)
- Francesk Mulita
- Department of General Surgery, University General Hospital of Patras, Greece
| | - Fotios Iliopoulos
- Department of General Surgery, University General Hospital of Patras, Greece
| | | | - Levan Tchabashvili
- Department of General Surgery, University General Hospital of Patras, Greece
| | - Elias Liolis
- Department of Internal Medicine, University General Hospital of Patras, Greece
| | | | - Ioannis Perdikaris
- Department of General Surgery, University General Hospital of Patras, Greece
| | - Ioannis Maroulis
- Department of General Surgery, University General Hospital of Patras, Greece
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Kaplanis C, Mulita F, Drakos N, Ambalov E, Germanos S, Maroulis I, Benetatos N. A rare case of primary squamous cell carcinoma of the liver presenting with paraneoplastic syndrome. Eur J Surg Oncol 2022. [DOI: 10.1016/j.ejso.2021.12.240] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022] Open
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Mulita F, Liolis E, Tchabashvili L, Verras GI, Plachouri KM, Kaplanis C, Iliopoulos F, Germanos S, Maroulis I, Benetatos N. Mild-term outcomes in the treatment of retroperitoneal sarcomas: a 12-year single-institution experience. Eur J Surg Oncol 2022. [DOI: 10.1016/j.ejso.2021.11.052] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022] Open
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Mulita F, Liolis E, Akinosoglou K, Tchabashvili L, Maroulis I, Kaplanis C, Vailas M, Panos G. Postoperative sepsis after colorectal surgery: a prospective single-center observational study and review of the literature. Prz Gastroenterol 2022; 17:47-51. [PMID: 35371356 PMCID: PMC8942007 DOI: 10.5114/pg.2021.106083] [Citation(s) in RCA: 26] [Impact Index Per Article: 13.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 03/09/2021] [Accepted: 04/12/2021] [Indexed: 02/07/2023]
Abstract
INTRODUCTION Postoperative sepsis represents a significant problem in colorectal surgery patients. AIM To identify the etiology as well as the risk factors associated with the development of postoperative sepsis, based on prospective data of patients undergoing colorectal surgery at a single large-volume institution. MATERIAL AND METHODS Between November 2019 and February 2021, 141 patients underwent an elective operation for colorectal cancer at a tertiary hospital center. The following variables were recorded for each patient: age, gender, American Society of Anesthesiologists Classification (ASA class), duration of surgery, surgical approach, comorbidities (diabetes, cardiovascular disease, respiratory disease). Univariate analysis was performed using χ2 tests for categorical variables. RESULTS A total of 69 males and 72 females were enrolled. Postoperative sepsis was diagnosed in 18 (12.77%) cases, with anastomotic leakage being the most frequent cause (3.55%). There was no statistically significant difference in the presence of sepsis among patients when gender, surgical approach, duration of surgery, and respiratory disease were taken into account. Sixty-nine patients were > 65 years old, with sepsis being statistically significant in this group (p = 0.034). Furthermore, patients with ASA class ≤ 2 developed postoperative sepsis less frequently than patients with advanced ASA scores (p = 0.008). Diabetes and cardiovascular disease also reach statistical significance; sepsis was more frequent in this group of patients (p = 0.013 and p = 0.009, respectively). CONCLUSIONS Following colorectal cancer procedures, postoperative sepsis was significantly more common among patients over 65 years old, ASA score > 2, and also with associated comorbidities such as diabetes and cardiovascular disease.
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Affiliation(s)
- Francesk Mulita
- Department of General Surgery, General University Hospital, Patras, Greece
- Address for correspondence: Dr. Francesk Mulita, Department of General Surgery, General University Hospital, Patras, Greece, e-mail:
| | - Elias Liolis
- Department of Internal Medicine, Division of Oncology, General University Hospital, Patras, Greece
| | - Karolina Akinosoglou
- Department of Internal Medicine and Infectious Diseases, General University Hospital, Patras, Greece
| | - Levan Tchabashvili
- Department of General Surgery, General University Hospital, Patras, Greece
| | - Ioannis Maroulis
- Department of General Surgery, General University Hospital, Patras, Greece
| | | | - Michail Vailas
- Department of General Surgery, General University Hospital, Patras, Greece
| | - George Panos
- Department of Internal Medicine and Infectious Diseases, General University Hospital, Patras, Greece
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Mulita F, Verras GI, Liolis E, Tchabashvili L, Parchas N, Tsilivigkos C, Iliopoulos F, Kaplanis C, Perdikaris I, Maroulis I. Analgesic effect of paracetamol monotherapy versus the combination of paracetamol/parecoxib in patients undergoing thyroid cancer surgery. Eur J Surg Oncol 2022. [DOI: 10.1016/j.ejso.2021.11.053] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022] Open
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13
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Mulita F, Verras GI, Iliopoulos F, Kaplanis C, Liolis E, Tchabashvili L, Tsilivigkos C, Perdikaris I, Sgourou A, Papachatzopoulou A, Maroulis I. Analgesic effect of paracetamol monotherapy vs. the combination of paracetamol/parecoxib vs. the combination of pethidine/paracetamol in patients undergoing thyroidectomy. Prz Menopauzalny 2021; 20:226-230. [PMID: 35069077 PMCID: PMC8764955 DOI: 10.5114/pm.2021.110955] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/31/2021] [Accepted: 06/19/2021] [Indexed: 02/07/2023]
Abstract
INTRODUCTION The purpose of this study was to investigate the analgesic effect of 3 different regimens of combination analgesics administered to patients undergoing thyroidectomy. MATERIAL AND METHODS A total of 152 patients undergoing total or subtotal thyroidectomy were enrolled. Patients allocated to group A received a combination of intravenous (IV) paracetamol and intramuscular (IM) pethidine, patients in group B received a combination of IV paracetamol and IV parecoxib, while patients in group C received IV paracetamol monotherapy. RESULTS The analgesic regimens of groups A and B were found to be of equivalent efficacy (p-value = 1.000). In contrast, patients in group C (paracetamol monotherapy) had higher numerical rating scale scores, compared to both patients in groups A (p-value < 0.001) and B (p-value < 0.001). CONCLUSIONS The combinations of IV paracetamol with either IM pethidine or IV parecoxib are superior to IV paracetamol monotherapy in achieving pain control in patients undergoing thyroid surgery.
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Affiliation(s)
- Francesk Mulita
- Department of Surgery, General University Hospital of Patras, Greece
- Corresponding author: Francesk Mulita, MD, Department of Surgery, General University Hospital of Patras, Greece, e-mail:
| | | | - Fotios Iliopoulos
- Department of Surgery, General University Hospital of Patras, Greece
| | | | - Elias Liolis
- Department of Internal Medicine, Division of Oncology, General University Hospital of Patras, Greece
| | | | | | | | - Argyro Sgourou
- Biology Laboratory, School of Science and Technology, Hellenic Open University, Patras, Greece
| | | | - Ioannis Maroulis
- Department of Surgery, General University Hospital of Patras, Greece
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Sotiropoulou M, Mulita F, Verras GI, Schizas D, Papalampros A, Tchabashvili L, Kaplanis C, Liolis E, Perdikaris I, Maroulis I, Vailas M. A novel tool for visualization and detection of pancreatic neuroendocrine tumours. A 'fluorescent' world is calling for exploration? Prz Menopauzalny 2021; 20:207-210. [PMID: 35069073 PMCID: PMC8764961 DOI: 10.5114/pm.2021.110834] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 09/02/2021] [Accepted: 09/10/2021] [Indexed: 02/07/2023]
Abstract
AIM OF THE STUDY Pancreatic neuroendocrine tumours (pNETs) are rare tumours with a propensity to metastasize. Physicians frequently face a huge clinical challenge during the localization of these lesions. The aim of this study is to investigate whether fluorescence-guided localization techniques with indocyanine green (ICG) can be utilized as a detection tool in pNETs, along with any other clinical implications of this technique. MATERIAL AND METHODS A thorough literature search in PubMed and Google Scholar, under the terms 'ICG OR Indocyanine OR Fluorescence AND Neuroendocrine' until 31 June 2021, regarding the utilization of indocyanine-fluorescence in localization of pancreatic neuroendocrine, was conducted by the authors, and the associated results are presented. RESULTS Indocyanine fluorescence imaging may facilitate the efforts of surgeons to identify occult pancreatic neuroendocrine lesions, assisting them in the identification of resection margins and delineation of the surgical anatomy when it is difficult to clarify. CONCLUSIONS Indocyanine-fluorescence imaging might play a pivotal role in pancreatic surgery in terms of localization for neuroendocrine tumours. However, further large-scale clinical studies are needed to assess the absolute indications and optimal use of this technique.
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Affiliation(s)
- Maria Sotiropoulou
- Department of Surgery, National and Kapodistrian University of Athens, Athens, Greece
| | - Francesk Mulita
- Department of Surgery, General University Hospital of Patras, Greece
- Corresponding author: Francesk Mulita, MD, General University Hospital of Patras, Greece, e-mail:
| | | | - Dimitrios Schizas
- Department of Surgery, National and Kapodistrian University of Athens, Athens, Greece
| | | | | | | | - Elias Liolis
- Department of Internal Medicine, Division of Oncology, General University Hospital of Patras, Greece
| | | | - Ioannis Maroulis
- Department of Surgery, General University Hospital of Patras, Greece
| | - Michail Vailas
- Department of Surgery, General University Hospital of Patras, Greece
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Mulita F, Lampropoulos C, Kehagias D, Verras GI, Tchabashvili L, Kaplanis C, Liolis E, Iliopoulos F, Perdikaris I, Kehagias I. Long-term nutritional deficiencies following sleeve gastrectomy: a 6-year single-centre retrospective study. Prz Menopauzalny 2021; 20:170-176. [PMID: 35069068 PMCID: PMC8764960 DOI: 10.5114/pm.2021.110954] [Citation(s) in RCA: 23] [Impact Index Per Article: 7.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/24/2021] [Accepted: 08/24/2021] [Indexed: 02/07/2023]
Abstract
INTRODUCTION Sleeve gastrectomy (SG) is associated with short-term nutritional deficiencies postoperatively. This study evaluates the long-term percentage of excess weight loss (% EWL), and nutritional deficiencies in a single-centre cohort undergoing SG as a primary procedure, with a 6-year follow-up. MATERIAL AND METHODS From January 2005 to December 2010 the records of 209 patients who underwent laparoscopic SG were retrieved from a computer database for analysis. Sixty out of the 209 paients completed follow-ups for 6 years. RESULTS Median % EWL at 1, 2, 3, 4, 5, and 6 years postoperatively was 80.9%, 79.1%, 73.8%, 71.8%, 71.5%, and 64.9%, respectively. Prior to surgery, 17.2% had anaemia. Deficiencies of iron, ferritin, folic acid, vitamin B12, magnesium, and phosphorus were 22%, 5.3%, 1.4%, 3.8%, 29.7%, and 5.3%, respectively. Six years post-surgery, deficiencies of haemoglobin, ferritin, and B12 worsened (36.7%, 43.3%, and 11.7%, p = 0.001, p < 0.001, p = 0.019, respectively), whereas there was no significant difference in deficiencies of iron, folic acid, magnesium, and phosphorus (25%, 1.7%, 20%, and 3%, p = 0.625, p = 0.896, p = 0.139, p = 0.539, respectively). There was elevated PTH before and 6 years after surgery (2.9% and 1.7%, p = 0.606). CONCLUSIONS This retrospective study shows that laparoscopic sleeve gastrectomy had a considerable effect on specific nutritional deficiencies in our patients at 6 years post-surgery. Knowledge of micronutrient deficiencies in these patients is beneficial for both prevention and management of nutritional complications associated with SG with the administration of oral nutritional supplementation according to the patient's needs.
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Affiliation(s)
- Francesk Mulita
- Department of Surgery, General University Hospital of Patras, Greece
- Corresponding author: Francesk Mulita, Md, Department of Surgery, General University Hospital of Patras, Greece, e-mail:
| | | | | | | | | | | | - Elias Liolis
- Department of Internal Medicine, Division of Oncology, General University Hospital of Patras, Greece
| | - Fotios Iliopoulos
- Department of Surgery, General University Hospital of Patras, Greece
| | | | - Ioannis Kehagias
- Department of Surgery, General University Hospital of Patras, Greece
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16
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Plachouri K, Mulita F, Bousis D, Tchabashvili L, Liolis E, Kaplanis C, Perdikaris I, Iliopoulos F, Verras G, Tolias V, Georgiou S. Successful treatment of a keratoacanthoma in a young patient with the application of topical 5% imiquimod cream. Clin Case Rep 2021; 9:e04920. [PMID: 34765197 PMCID: PMC8572324 DOI: 10.1002/ccr3.4920] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2021] [Revised: 08/31/2021] [Accepted: 09/25/2021] [Indexed: 02/05/2023] Open
Abstract
Keratoacanthomas (KA) are epithelial tumors that present as rapidly evolving nodules with a central hyperkeratotic plug and occasionally show signs of spontaneous regression. A 21-year-old patient strongly refused the diagnostic biopsy and insisted on a nonsurgical treatment. He was successfully treated with imiquimod 5% cream.
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Affiliation(s)
| | - Francesk Mulita
- Department of General SurgeryGeneral University Hospital of PatrasPatrasGreece
| | - Dimitrios Bousis
- Department of Internal MedicineGeneral University Hospital of PatrasPatrasGreece
| | - Levan Tchabashvili
- Department of General SurgeryGeneral University Hospital of PatrasPatrasGreece
| | - Elias Liolis
- Department of Internal MedicineGeneral University Hospital of PatrasPatrasGreece
| | | | - Ioannis Perdikaris
- Department of General SurgeryGeneral University Hospital of PatrasPatrasGreece
| | - Fotios Iliopoulos
- Department of General SurgeryGeneral University Hospital of PatrasPatrasGreece
| | | | - Vasilios Tolias
- Department of DermatologyGeneral University Hospital of PatrasPatrasGreece
| | - Sophia Georgiou
- Department of DermatologyGeneral University Hospital of PatrasPatrasGreece
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17
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Mulita F, Tchabashvili L, Bousis D, Kehagias D, Kaplanis C, Liolis E, Perdikaris I, Iliopoulos F, Verras G, Bouchagier K. Gallstone ileus: A rare cause of small intestine obstruction. Clin Case Rep 2021; 9:e04924. [PMID: 34765198 PMCID: PMC8572328 DOI: 10.1002/ccr3.4924] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2021] [Revised: 10/07/2021] [Accepted: 09/23/2021] [Indexed: 02/05/2023] Open
Abstract
Gallstone ileus is a very rare cause of mechanical bowel obstruction with often-delayed presentation and nonspecific symptoms. Aerobilia is found in approximately 50% of patients with gallstone ileus.
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Affiliation(s)
- Francesk Mulita
- Department of General SurgeryGeneral University Hospital of PatrasPatrasGreece
| | - Levan Tchabashvili
- Department of General SurgeryGeneral University Hospital of PatrasPatrasGreece
| | - Dimitrios Bousis
- Department of Internal MedicineGeneral University Hospital of PatrasPatrasGreece
| | - Dimitrios Kehagias
- Department of General SurgeryGeneral University Hospital of PatrasPatrasGreece
| | | | - Elias Liolis
- Department of Internal MedicineGeneral University Hospital of PatrasPatrasGreece
| | - Ioannis Perdikaris
- Department of General SurgeryGeneral University Hospital of PatrasPatrasGreece
| | - Fotios Iliopoulos
- Department of General SurgeryGeneral University Hospital of PatrasPatrasGreece
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18
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Mulita F, Liolis E, Kehagias D, Tchabashvili L, Kaplanis C, Iliopoulos F, Perdikaris I, Kehagias I. An enormous pelvic tumor in a 46-year-old woman with an elevated serum CA 125 level, what lies beneath it? Investigation of uterine tumors in postmenopausal women. Prz Menopauzalny 2021; 20:154-157. [PMID: 34703417 PMCID: PMC8525254 DOI: 10.5114/pm.2021.109773] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/14/2021] [Accepted: 06/09/2021] [Indexed: 02/07/2023]
Abstract
Abdominal and pelvic pain with an associated pelvic mass is a very common emergency situation. There is always a management dilemma for most emergency physicians regarding these patients. A 46-year-old postmenopausal woman was admitted to our emergency department (ED) with complaints of massive abdominal distention. Abdominal and pelvis magnetic resonance imaging (MRI) was performed, which revealed a huge pelvic abdominal mass. All tumor markers were within normal limits. However, the ovarian cancer antigen (CA 125) level was elevated. As there was a strong suspicion of malignancy, the patient underwent total abdominal hysterectomy with bilateral salpingo-oophorectomy. Her final histopathology report was suggestive of uterine leiomyoma. Uterine leiomyomas are the most common benign uterine tumors in women. Surgical treatment is the gold standard, especially for older women with severe symptoms and no desire for future fertility. Although the combination of a pelvic tumor and a high-level of CA 125 arouses suspicion of gynecological malignancy, other benign conditions should always be considered in the differential diagnosis. There is limited evidence to support an association between elevated CA 125 levels and uterine fibroids so far. However, conditions such as the coexistence of adenomyosis and tumor size can affect the level of this marker in uterine fibroids.
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Affiliation(s)
- Francesk Mulita
- Corresponding author: Dr. Francesk Mulita, Department of Surgery, General University Hospital of Patras, Rio, Greece , e-mail:
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19
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Mulita F, Verras G, Liolis E, Tchabashvili L, Kehagias D, Kaplanis C, Perdikaris I, Kehagias I. Recurrent retroperitoneal liposarcoma: A case report and literature review. Clin Case Rep 2021; 9:e04717. [PMID: 34484756 PMCID: PMC8405415 DOI: 10.1002/ccr3.4717] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2021] [Revised: 07/10/2021] [Accepted: 07/30/2021] [Indexed: 02/05/2023] Open
Abstract
Retroperitoneal liposarcoma frequently recurs within 2 years of the initial surgical resection. For the early detection of recurrent retroperitoneal liposarcomas, a shorter follow-up interval with CT or MRI would be helpful.
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Affiliation(s)
- Francesk Mulita
- Department of General SurgeryGeneral University Hospital of PatrasPatrasGreece
| | | | - Elias Liolis
- Department of Internal MedicineGeneral University Hospital of PatrasPatrasGreece
| | - Levan Tchabashvili
- Department of General SurgeryGeneral University Hospital of PatrasPatrasGreece
| | - Dimitrios Kehagias
- Department of General SurgeryGeneral University Hospital of PatrasPatrasGreece
| | | | - Ioannis Perdikaris
- Department of General SurgeryGeneral University Hospital of PatrasPatrasGreece
| | - Ioannis Kehagias
- Department of General SurgeryGeneral University Hospital of PatrasPatrasGreece
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20
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Panos G, Mulita F, Akinosoglou K, Liolis E, Kaplanis C, Tchabashvili L, Vailas M, Maroulis I. Risk of surgical site infections after colorectal surgery and the most frequent pathogens isolated: a prospective single-centre observational study. Med Glas (Zenica) 2021; 18:438-443. [PMID: 34080408 DOI: 10.17392/1348-21] [Citation(s) in RCA: 20] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Received: 01/27/2021] [Revised: 02/05/2021] [Accepted: 03/18/2021] [Indexed: 02/07/2023]
Abstract
Aim To identify risk factors for developing surgical site infections (SSIs) based on a prospective study of patients undergoing colorectal surgery. Methods Between November 2019 and January 2021, 133 patients underwent elective operation for colorectal cancer in our institution. The following variables were recorded for each patient: age, gender, body mass index (BMI), American Society of Anesthesiologists Classification (ASA class), duration of surgery, wound classification, skin preparation regimens, surgical approach, comorbidities (hypertension, diabetes, cardiovascular disease, respiratory disease, chronic steroid use), and pathogens responsible for surgical site infection. Univariate analysis was performed using χ2 tests for categorical variables. Results A total of 65 males and 68 females were enrolled. Postoperative SSI was diagnosed in 29 (21.8%) cases. Fifty five patients were >70 years old, and SSIs were significantly more frequent in this group (p=0.033). There were 92 patients with BMI <30kg/m2 and 87 with ASA class ≤2; SSIs occurred significantly less frequently in these patients (p=0.021 and p=0.028, respectively). Open surgery was performed in 113 patients; 35 (out of 113; 31%) wound infections were classified as contaminated or dirty, and SSI occurred more often in these two groups (p=0.048 and p=0.037, respectively). Nineteen patients had diabetes and 36 used steroids continuously; SSI was significantly more frequent in these patients (p=0.021 and p=0.049, respectively). Conclusion Following colorectal cancer procedures SSIs were significantly more common among patients over 70 years old, BMI≥30kg/m2 , ASA score>2, with diabetes and chronic steroid use, undergoing open, dirty or contaminated surgery. Escherichia coli and Enterococcus spp. were the two most common pathogens isolated.
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Affiliation(s)
- George Panos
- Department of Internal Medicine and Infectious Diseases, University General Hospital, Patras, Greece
| | - Francesk Mulita
- Department of General Surgery, University General Hospital, Patras, Greece
| | - Karolina Akinosoglou
- Department of Internal Medicine and Infectious Diseases, University General Hospital, Patras, Greece
| | - Elias Liolis
- Department of Internal Medicine, Division of Oncology, University General Hospital, Patras, Greece
| | | | - Levan Tchabashvili
- Department of General Surgery, University General Hospital, Patras, Greece
| | - Michail Vailas
- Department of General Surgery, University General Hospital, Patras, Greece
| | - Ioannis Maroulis
- Department of General Surgery, University General Hospital, Patras, Greece
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21
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Vailas M, Benetatos N, Maroulis I, Kaplanis C, Drakos N, Mulita F, Sotiropoulou M, Germanos S. A gelatinous veil inside the abdomen of a pancreatic cancer patient. What lies beneath it? Clin Case Rep 2021; 9:e04353. [PMID: 34136253 PMCID: PMC8190690 DOI: 10.1002/ccr3.4353] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2021] [Accepted: 04/28/2021] [Indexed: 02/05/2023] Open
Abstract
Chylous ascites following pancreatic surgery results from surgical damage to the cisterna chyli or tributaries, with an incidence in pancreatic surgery of 1.8%-11%. Usually, conservative treatment is effective.
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Affiliation(s)
- Michail Vailas
- Department of SurgeryUniversity of PatrasUniversity Hospital of PatrasPatraGreece
| | - Nikolaos Benetatos
- Department of SurgeryUniversity of PatrasUniversity Hospital of PatrasPatraGreece
| | - Ioannis Maroulis
- Department of SurgeryUniversity of PatrasUniversity Hospital of PatrasPatraGreece
| | - Charalampos Kaplanis
- Department of SurgeryUniversity of PatrasUniversity Hospital of PatrasPatraGreece
| | - Nikolaos Drakos
- Department of SurgeryUniversity of PatrasUniversity Hospital of PatrasPatraGreece
| | - Francesk Mulita
- Department of SurgeryUniversity of PatrasUniversity Hospital of PatrasPatraGreece
| | | | - Stylianos Germanos
- Department of SurgeryUniversity of PatrasUniversity Hospital of PatrasPatraGreece
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22
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Mulita F, Tchabashvili L, Liolis E, Tasios K, Iliopoulos F, Kaplanis C, Parchas N, Plachouri K. Green nail syndrome caused by Citrobacter braakii. Clin Case Rep 2021; 9:e04203. [PMID: 34084511 PMCID: PMC8142313 DOI: 10.1002/ccr3.4203] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2021] [Accepted: 04/10/2021] [Indexed: 02/05/2023] Open
Abstract
A 34-year-old woman presented due to progressive painful swelling around the nail of the right index finger. Onychectomy and drainage of the abscess of the affected finger were performed as the inflammation was progressive despite the previous antibiotic therapy. The microbiological culture revealed a ciprofloxacin-susceptible Citrobacter braakii.
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Affiliation(s)
- Francesk Mulita
- Department of General SurgeryGeneral University Hospital of PatrasPatrasGreece
| | - Levan Tchabashvili
- Department of General SurgeryGeneral University Hospital of PatrasPatrasGreece
| | - Elias Liolis
- Department of Internal MedicineGeneral University Hospital of PatrasPatrasGreece
| | - Konstantinos Tasios
- Department of General SurgeryGeneral University Hospital of PatrasPatrasGreece
| | - Fotios Iliopoulos
- Department of General SurgeryGeneral University Hospital of PatrasPatrasGreece
| | | | - Nikolaos Parchas
- Department of OrthopedicsGeneral University Hospital of PatrasPatrasGreece
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23
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Kakkos SK, Zampakis P, Lampropoulos GC, Paridis L, Kaplanis C, Bantouna D, Nikolakopoulos KM, Papageorgopoulou CP, Kalogeropoulou C, Tsolakis IA. Successful Resection of a Large Carotid Body Tumor Masquerading Complete Encasement of the Internal Carotid Artery on Preoperative Imaging. Vasc Endovascular Surg 2018; 52:304-308. [PMID: 29495959 DOI: 10.1177/1538574418761722] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
A 41-year-old woman presented with a large painful and tender mass of the left side of her neck located just below the angle of the mandible. She was also complaining of frequent attacks of symptoms ranging from dizziness upon resuming the erect position to frank syncope. Color-coded duplex showed a large well-vascularized vascular mass at the level of the carotid bifurcation, suggesting the diagnosis of a carotid body tumor (CBT). A computerized tomographic angiography confirmed the diagnosis of a CBT, which measured 5.7 cm in its craniocaudal axis. The tumor appeared to encase the internal carotid artery (ICA) at the level of its origin, indicating the presence of a Shamblin group 3 tumor. During surgery, the CBT seemingly encased the ICA; however, it was successfully taken off the ICA, by establishing an adventitial dissection place, obviating the need for arterial resection and replacement. A brief intraoperative episode of cardiac arrest was successfully managed. Postoperative course was uneventful, and all symptoms were cured. Pathology confirmed the clinical diagnosis and did not show malignancy. In conclusion, meticulous surgical techniques can spare the ICA from removal or inadvertent injury during CBT surgery and reduce the morbidity often associated with the resection of large or advanced tumors but also cure atypical patient symptoms.
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Affiliation(s)
- Stavros K Kakkos
- 1 Department of Vascular Surgery, University of Patras Medical School, Patras, Greece
| | - Peter Zampakis
- 2 Clinical Laboratory of Radiology, University of Patras Medical School, Patras, Greece
| | - George C Lampropoulos
- 1 Department of Vascular Surgery, University of Patras Medical School, Patras, Greece
| | - Leonidas Paridis
- 3 Department of Anesthesiology and Intensive Care, University of Patras Medical School, Patras, Greece
| | - Charalampos Kaplanis
- 1 Department of Vascular Surgery, University of Patras Medical School, Patras, Greece
| | - Dimitra Bantouna
- 4 Clinical Laboratory of Pathology, University of Patras Medical School, Patras, Greece
| | | | | | | | - Ioannis A Tsolakis
- 1 Department of Vascular Surgery, University of Patras Medical School, Patras, Greece
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