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Syrnioti A, Koletsa T, Netta S, Gkoudina A, Paramythiotis D. Giant malignant phyllodes tumor with distant metastases: a case report and review of the literature. Hippokratia 2022; 26:41-45. [PMID: 37124283 PMCID: PMC10132391] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/02/2023]
Abstract
BACKGROUND Phyllodes tumors (PTs) represent a rare type of breast tumor and are classified into benign, borderline, and malignant. Giant PTs, meaning those sized more than ten cm, are even rarer, most commonly malignant, and usually have a dismal prognosis due to the high metastatic potential. CASE REPORT We report the case of a 55-year-old woman who underwent modified radical mastectomy and left axillary lymphadenectomy for a rapidly growing, giant, ulcerated mass of the left breast. Histopathologic examination revealed a malignant phyllodes tumor (MPT). Over one year after the initial surgery, the patient was found to have extensive thoracic and retroperitoneal metastases. CONCLUSION Although giant PTs are uncommon, clinical suspicion should be high in rapidly growing breast mass patients. A comprehensive review of all metastatic giant MPT cases reported in the English literature emphasizes the lack of consensus regarding appropriate treatment. In the case of metastatic foci, pathologists need to be aware of the previous history to make a definitive diagnosis. Also, a comparative histopathologic study of the primary and metastatic tumors is sometimes necessary. HIPPOKRATIA 2022, 26 (1):41-45.
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Affiliation(s)
- A Syrnioti
- Department of Pathology, School of Medicine, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - T Koletsa
- Department of Pathology, School of Medicine, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - S Netta
- First Propedeutic Department of Surgery, AHEPA University Hospital, School of Medicine, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - A Gkoudina
- First Propedeutic Department of Surgery, AHEPA University Hospital, School of Medicine, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - D Paramythiotis
- First Propedeutic Department of Surgery, AHEPA University Hospital, School of Medicine, Aristotle University of Thessaloniki, Thessaloniki, Greece
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Paramythiotis D, Goulas P, Moysidis M, Papavramidis T, Michalopoulos A. Bowel intussusception in adults: a report of three interesting cases and current trends for diagnosis and surgical management. Hippokratia 2019; 23:37-41. [PMID: 32256038 PMCID: PMC7124870] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/11/2023]
Abstract
BACKGROUND Bowel intussusception in adults remains a rare and constant diagnostic challenge for surgeons. It has an incidence of around 2-3 new cases per million per year, and its primary cause is benign or malignant neoplasms of the small bowel and colon. This report aims to outline the importance of high clinical suspicion regarding intussusception in adults presenting with abdominal pain in the emergency department. Case report: This is a retrospective review of three cases of adult ileocecal intussusception that were treated in a single surgical department in three years (2015-2018). All patients underwent right hemicolectomy in keeping with the principles of surgical oncology. Each patient had a different clinical presentation, while, in terms of the underlining pathology, the first had an adenocarcinoma of the ascending colon, the second an adenocarcinoma of the ileocecal valve, and the third one an inflammatory fibroid polyp of the ileocecal valve, also known as Vanek's tumor. CONCLUSION Large bowel intussusception in adults is quite an interesting entity, not only for its rarity but for its non-specific and atypical clinical presentation as well. High suspicion from the clinician's part and availability of a computed tomography scan is the key to diagnosis. It is not unusual for imaging modalities to be unable to identify the cause of the intussusception. Thus, surgery is always the preferred method of treatment, as, more often than not, a neoplasm of the small or the large bowel is the underlining pathology. HIPPOKRATIA 2019, 23(1): 37-41.
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Affiliation(s)
- D Paramythiotis
- 1 Propaedeutic Surgical Department, AHEPA University General Hospital of Thessaloniki, Thessaloniki, Greece
| | - P Goulas
- 1 Propaedeutic Surgical Department, AHEPA University General Hospital of Thessaloniki, Thessaloniki, Greece
| | - M Moysidis
- 1 Propaedeutic Surgical Department, AHEPA University General Hospital of Thessaloniki, Thessaloniki, Greece
| | - T Papavramidis
- 1 Propaedeutic Surgical Department, AHEPA University General Hospital of Thessaloniki, Thessaloniki, Greece
| | - A Michalopoulos
- 1 Propaedeutic Surgical Department, AHEPA University General Hospital of Thessaloniki, Thessaloniki, Greece
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Drevelegkas K, Bangeas P, Paramythiotis D, Andrews T, Zakeri S. Metastatic spread of cutaneous melanoma to the sigmoid colon: a rare but important consideration. Hippokratia 2017; 21:194-196. [PMID: 30944511 PMCID: PMC6441346] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/09/2023]
Abstract
BACKGROUND Cutaneous melanoma is known for its aggressive tendency for metastasis, most commonly to lymph nodes, lung, liver, and brain. CASE REPORT We present the case of an 80-year-old male, with a history of cutaneous melanoma, found to have biopsy-proven metastatic melanoma deposits in the sigmoid colon. This rare case was initially thought to be a walled-off perforation secondary to diverticulitis. Although, computed tomography, showed features more strongly suggestive of malignancy. We propose early consideration of bowel metastasis in patients with a history of cutaneous melanoma presenting with lower gastrointestinal symptoms. CONCLUSION Once malignancy is included in the differential for any inflammatory type bowel lesion, arranging endoscopy and biopsy is essential to confirm the diagnosis and guide management. Multidisciplinary team discussion is recommended to determine the most appropriate treatment strategy - radical versus palliative, which must always consider the patient's performance status alongside cancer staging. HIPPOKRATIA 2017, 21(4): 194-196.
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Affiliation(s)
- K Drevelegkas
- Radiology Department Royal Liverpool University Hospital, UK
| | - P Bangeas
- 1 Propedeutic Surgical Department, A.H.E.P.A. University Hospital, Aristotle University of Thessaloniki, Greece
| | - D Paramythiotis
- 1 Propedeutic Surgical Department, A.H.E.P.A. University Hospital, Aristotle University of Thessaloniki, Greece
| | - T Andrews
- Histopathology Department, Royal Liverpool University Hospital, UK
| | - S Zakeri
- Radiology Department Royal Liverpool University Hospital, UK
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Paramythiotis D, Bangeas P, Karakatsanis A, Karayannopoulou G, Michalopoulos A. Anal canal gastrointestinal stromal tumors - report of a rare case and review of the literature. Hippokratia 2016; 20:313-316. [PMID: 29416307 PMCID: PMC5788233] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/08/2023]
Abstract
BACKGROUND Gastrointestinal stromal tumors (GISTs) are considered as rare gastrointestinal tumors, and their location in the anal track is exceptionally unusual. We describe the case of a 28-year-old man with anal GIST, and a review of the cases that have been reported so far in the literature. CASE REPORT The patient was referred for treatment of a gradually enlarging perianal mass. Clinical examination and imaging including orthosigmoidoscopy, transanal ultrasound, and magnetic resonance imaging (MRI) revealed a mass sized 7.5 cm in greatest diameter, in relation with the sphincters, which was excised under general anesthesia. His postoperative course was uneventful and he was discharged on the fourth postoperative day. Pathologic examination revealed characteristics of anal GISTs and further treatment with tyrosine kinase inhibitors was planned. CONCLUSION Anal GISTs usually present with rectal bleeding and pain, and only sixteen cases have been reported in the literature. MRI is the radiologic examination of choice, while optimal treatment is considered surgery in combination with adjuvant therapy. Long-term follow-up is necessary. Hippokratia 2016, 20(4): 313-316.
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Affiliation(s)
- D Paramythiotis
- 1 Propedeutic Surgical Department, A.H.E.P.A. University Hospital, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - P Bangeas
- 1 Propedeutic Surgical Department, A.H.E.P.A. University Hospital, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - A Karakatsanis
- 1 Propedeutic Surgical Department, A.H.E.P.A. University Hospital, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - G Karayannopoulou
- Pathology Department, Faculty of Medicine, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - A Michalopoulos
- 1 Propedeutic Surgical Department, A.H.E.P.A. University Hospital, Aristotle University of Thessaloniki, Thessaloniki, Greece
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Paramythiotis D, Stavrou G, Panagiotou D, Petrakis G, Michalopoulos A. Dermatofibrosarcoma protuberans: a case report and review of the literature. Hippokratia 2016; 20:80-83. [PMID: 27895450 PMCID: PMC5074405] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/06/2023]
Abstract
BACKGROUND Dermatofibrosarcoma protuberans (DFSP) represents less than 0.1% of all tumors, but it is considered the most common skin sarcoma. Wide local excision (=5 cm) has been largely replaced by Mohs micrographic surgery; however, recurrence is not rare. Description of the case: A 35-year-old man presented with a large tumor on the upper side of his back and underwent local excision with the possible preoperative diagnosis of lipoma. Upon histological examination, the diagnosis of DFSP was made, and the patient underwent wide local excision with skin flap reconstruction and was referred for adjuvant radiotherapy.On twenty months follow-up, no recurrence has been observed. CONCLUSION DFSP is the most common cutaneous sarcoma. It originates in the dermis and tends to infiltrate underlying structures, including muscles, tendons, fascia and bone. In our case, the tumor was confined to the skin and subcutaneous tissue, however, our patient underwent adjuvant radiotherapy to avoid a possible relapse that would infiltrate deeper structures. Long-term follow-up is strongly recommended. Hippokratia 2016, 20(1): 80-83.
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Affiliation(s)
- D Paramythiotis
- 1st Propedeutic Surgical Department, AHEPA University Hospital, Medical School, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - G Stavrou
- 1st Propedeutic Surgical Department, AHEPA University Hospital, Medical School, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - D Panagiotou
- 1st Propedeutic Surgical Department, AHEPA University Hospital, Medical School, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - G Petrakis
- Department of Pathology, Medical School, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - A Michalopoulos
- 1st Propedeutic Surgical Department, AHEPA University Hospital, Medical School, Aristotle University of Thessaloniki, Thessaloniki, Greece
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Papadopoulos VN, Michalopoulos A, Apostolidis S, Paramythiotis D, Ioannidis A, Mekras A, Panidis S, Stavrou G, Basdanis G. Surgical management of colorectal injuries: colostomy or primary repair? Tech Coloproctol 2011; 15 Suppl 1:S63-6. [DOI: 10.1007/s10151-011-0734-0] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
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Michalopoulos A, Papadopoulos V, Paramythiotis D, Papavramidis T, Douros V, Netta S, Mekras A, Apostolidis S. Colonic cancer in a patient with intestinal malrotation: a case report. Tech Coloproctol 2011; 14 Suppl 1:S65-6. [PMID: 20683743 DOI: 10.1007/s10151-010-0632-x] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
We present a case of a 76-year-old patient with intestinal malrotation, with incomplete rotation of the small intestine and abnormal positioning of the duodenum and superior mesenteric vessels over the transverse colon. Furthermore, the patient suffered of a concomitant cancer of the ascending colon.
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Affiliation(s)
- A Michalopoulos
- 1st Propedeutic Surgical Clinic, AHEPA Hospital, Medical School, Aristotle University of Thessaloniki, T.Ikonimidi 21, Kalamaria, 551 31 Thessaloniki, Greece
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Netta S, Michalopoulos A, Apostolidis S, Paramythiotis D, Papavramidis T, Papadopoulos V, Tziris N. Enhancement of colonic anastomotic strength in rats by short-chain fatty acids. Tech Coloproctol 2011; 14 Suppl 1:S53-5. [PMID: 20683753 DOI: 10.1007/s10151-010-0611-2] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
BACKGROUND The present study is aiming at elucidating the effect of intraoperative lavage with short-chain fatty acids (SCFAs) on colonic anastomosis in rats. METHODS Forty male Wistar rats were randomized into four groups (10 rats each). After resection of a segment of transverse colon, an end-to-end anastomosis was performed. In the 1st group, no intraoperative large bowel lavage was performed; in the 2nd, a lavage with normal saline solution; in the 3rd, the animals received a diet rich in SCFAs pre- and postoperatively, and a lavage with normal saline was performed; and in the 4th group, an intraoperative lavage with SCFAs was carried out. On the 4th postoperative day, the animals were sacrificed. Septic complications, adhesions and anastomoses were graded macroscopically and histologically, and bursting pressure of the anastomoses, CRP, IL-6 and TNF-a was measured. RESULTS Fewer septic complications (abscesses and minimal ruptures) and adhesions were observed in the 4th group with the intraoperative lavage with SCFAs. The bursting pressure also, in the same group, was higher (73.3 mmHg), followed by the 1st group (67.1 mmHg). CONCLUSION Intraoperative lavage with SCFAs increases the bursting pressure of colonic anastomoses, while lavage with saline solution decreases it, in comparison to the group without lavage.
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Affiliation(s)
- S Netta
- 1st Propedeutic Surgical Department, AHEPA University Hospital, Medical School, Aristotle University of Thessaloniki, T.Ikonimidi 21, 551 31 Kalamaria, Thessaloniki, Greece
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Papavramidis TS, Potsi S, Paramythiotis D, Michalopoulos A, Papadopoulos VN, Douros V, Pantoleon A, Foutzila-Kalogera A, Ekonomou I, Harlaftis N. Gallstone obstructive ileus 3 years post-cholecystectomy to a patient with an old ileoileal anastomosis. J Korean Med Sci 2009; 24:1216-9. [PMID: 19949687 PMCID: PMC2775879 DOI: 10.3346/jkms.2009.24.6.1216] [Citation(s) in RCA: 14] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/22/2007] [Accepted: 06/22/2008] [Indexed: 12/25/2022] Open
Abstract
The present case is one of gallstone obstructive ileus due to gallstones 3 yr after laparoscopic cholecystectomy. It is interesting because of the sex of the patient, the fact that ileus occurred 3 yr after cholecystectomy and that the localization of the obstruction was an old side-to-side ileoileal anastomosis due to a diverticulectomy following intussusception of Meckels' diverticulum at the age of 3.
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Affiliation(s)
- T S Papavramidis
- 1st Propedeutic Surgical Clinic, Aristotle University of Thessaloniki, A.H.E.P.A. University Hospital, Thessaloniki, Greece.
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Apostolidis S, Papavramidis T, Michalopoulos A, Papadopoulos V, Paramythiotis D, Harlaftis N. Groin swelling, the anatomic way out of abdominal haematomas: a case report and explicative literature review. Acta Chir Belg 2008; 108:251-3. [PMID: 18557154 DOI: 10.1080/00015458.2008.11680214] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
This case report concerns a previously healthy thirty-five-year-old female with complaints of inguinal hernia that ultimately proved to be a retroperitoneal haematoma. The patient suffered from a car accident 5 months before admission and was hospitalized. During her prior hospitalization, explorative laparotomy revealed a haematoma of the mesentery. The haematoma was treated conservatively, with fluid resuscitation and rest. During her second admission, MRI of the inguinal region revealed localized haematoma. During inguinal exploration, a fluid-filled bluish indirect hernia sac was identified and found to be contoured by free-flowing, non-clotting blood. The postoperative course was uneventful, and the patient was discharged six days following surgery.
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Affiliation(s)
- S. Apostolidis
- 1st Propedeutic Surgical Department,A.H.E.P.A University Hospital,Aristotle’s University of Thessaloniki, Thessaloniki, Greece
| | - T.S. Papavramidis
- 1st Propedeutic Surgical Department,A.H.E.P.A University Hospital,Aristotle’s University of Thessaloniki, Thessaloniki, Greece
| | - A. Michalopoulos
- 1st Propedeutic Surgical Department,A.H.E.P.A University Hospital,Aristotle’s University of Thessaloniki, Thessaloniki, Greece
| | - V.N. Papadopoulos
- 1st Propedeutic Surgical Department,A.H.E.P.A University Hospital,Aristotle’s University of Thessaloniki, Thessaloniki, Greece
| | - D. Paramythiotis
- 1st Propedeutic Surgical Department,A.H.E.P.A University Hospital,Aristotle’s University of Thessaloniki, Thessaloniki, Greece
| | - N. Harlaftis
- 1st Propedeutic Surgical Department,A.H.E.P.A University Hospital,Aristotle’s University of Thessaloniki, Thessaloniki, Greece
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Paramythiotis D, Papadopoulos VN, Michalopoulos A, Papavramidis TS, Berovalis P, Harlaftis N. Acute pneumomediastinum secondary to hydrogen peroxide therapy of upper right limb wound. Eur Surg 2007. [DOI: 10.1007/s10353-007-0372-y] [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: 11/24/2022]
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Michalopoulos A, Papadopoulos V, Apostolidis S, Papavramidis T, Paramythiotis D, Berovalis P. A rare case of pancreatic pseudocyst masquerading as hydrocele. Acta Gastroenterol Belg 2006; 69:424. [PMID: 17343088] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 05/14/2023]
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Apostolidis SA, Michalopoulos AA, Papadopoulos VN, Paramythiotis D, Zatagias A, Gigis P, Harlaftis N. Effect of ranitidine on healing of normal and transfusion-suppressed experimental anastomoses. Tech Coloproctol 2005; 8 Suppl 1:s104-7. [PMID: 15655589 DOI: 10.1007/s10151-004-0126-9] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
BACKGROUND Histamine has been shown to participate in immune response. Wound healing is a process of immune system. This experimental study was done to find the effect of histamine2 receptor antagonist ranitidine on the healing process of intestinal anastomosis in rats. METHODS Eighty Wistar rats in four groups of 20 each underwent colon resection and anastomosis. They were given 2 ml saline or blood, twice daily 0.4 ml saline or 0.4 ml saline containing 0.7 mg ranitidine. The animals were killed 3 or 7 days postoperatively and the anastomotic strength assessed by bursting pressure. RESULTS The ranitidine group developed fewer anastomotic abscesses (p<0.001). Anastomotic strength was significantly reduced either on day 3 or 7 in animals given blood transfusions (p<0.04, p<0.001), whereas in animals given ranitidine this effect was partially reversed. CONCLUSIONS These data indicate that ranitidine has no influence in anastomotic bursting pressure, but has a lower incidence of septic complications.
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Affiliation(s)
- S A Apostolidis
- Laboratory of Anatomy, Aristotle University, Thessaloniki, Greece
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Papadopoulos V, Michalopoulos A, Basdanis G, Papapolychroniadis K, Paramythiotis D, Fotiadis P, Berovalis P, Harlaftis N. Synchronous and metachronous colorectal carcinoma. Tech Coloproctol 2005; 8 Suppl 1:s97-s100. [PMID: 15655657 DOI: 10.1007/s10151-004-0124-y] [Citation(s) in RCA: 33] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Abstract
BACKGROUND Synchronous and metachronous colorectal carcinoma have an incidence of 2-10%. The purpose of the study was to evaluate the clinical characteristics, the accuracy of diagnostic examinations and the survival of these patients. METHODS From 1970 to 1999, 1160 patients with colorectal cancer were admitted to our Department. During follow-up examination 50 patients (4.3%) were found to present with multiple primary colon cancers. Fifty-two per cent were synchronous and 48% metachronous tumours. RESULTS The overall 5-year survival of the patients was 45.87%. Mortality was 10% for multiple primaries, while in patients with single cancer was 4.1%. The overall 5-year survival of the patients with multiple primaries tumours was 46.67%. CONCLUSIONS Patients with colorectal cancer must be fully studied endoscopically. There has been an improvement in survival in recent years due to better surgical techniques, the introduction of more sophisticated examination methods and the meticulous follow-up of patients at risk.
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Affiliation(s)
- V Papadopoulos
- 1st Propedeutic Surgical Clinic, Aristotle's University, AHEPA Hospital, Thessaloniki, Greece.
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Papadopoulos VN, Michalopoulos A, Netta S, Basdanis G, Paramythiotis D, Zatagias A, Berovalis P, Harlaftis N. Prognostic significance of mucinous component in colorectal carcinoma. Tech Coloproctol 2005; 8 Suppl 1:s123-5. [PMID: 15655594 DOI: 10.1007/s10151-004-0131-z] [Citation(s) in RCA: 55] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
BACKGROUND Many factors influence survival in colorectal cancer patients, one of them is the mucinous component of the tumour. Mucinous adenocarcinoma is characterized by the extracellular mucin of more than 50% of the tumour volume. METHODS From 1970 to 1999, 1160 patients were admitted to our clinic for colorectal cancer. They were divided into four groups according to mucinous character of the tumour, in two time periods of 15 years. RESULTS There was an increase in the incidence of mucinous tumours from 20.8 to 30.5% in the second period. These tumours were more advanced (Dukes' C) and especially right sided (34.5% vs. 17.9%). Five-year survival was increased during the second period but was of a lesser degree in the mucinous group (51.5% vs. 65.5%). CONCLUSIONS Colorectal mucinous carcinomas present at a more advanced stage, predominantly in men, with higher right colon location rate, and a worse overall 5-year survival rate than the non-mucinous colorectal cancers.
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Affiliation(s)
- V N Papadopoulos
- 1st Propedeutic Surgical Clinic, Aristotle's University of Thessaloniki, AHEPA Hospital, Thessaloniki, Greece.
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Kotzampassi K, Paramythiotis D, Voudouris A, Mioglou E, Iakovidou Z, Eleftheriadis E. Crit Care 2005; 9:P361. [DOI: 10.1186/cc3424] [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: 11/10/2022] Open
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Kotzampassi K, Paramythiotis D, Tsiakitzis K, Kourounakis A, Tzitzikas J, Metaxas G, Kourounakis P, Harlaftis N, Eleftheriadis E. The impact of α-tocopherol on radiation-induced liver injury. Nutr Res 2003. [DOI: 10.1016/s0271-5317(02)00488-8] [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: 11/24/2022]
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Abstract
BACKGROUND The pathogenesis of chronic pancreatitis (CP) remains poorly understood. Recently, molecular biology has identified the genetic background for many patients with hereditary CP. In addition, a number of studies have focused on the detection of proto-oncogenes and tumour suppressor gene mutations in the pathogenesis of CP. So far, the use of these mutations (with the exception of mutations causing hereditary CP), as diagnostic and prognostic markers is still controversial. DISCUSSION It is well known that the risk of pancreatic cancer in patients with CP, especially the hereditary form, is high. At present, there is insufficient evidence to show a clear relationship between the development of pancreatic cancer and certain mutations. New biotechnological methods, such as DNA array expression analysis, expand our knowledge of the molecular pathogenesis of this disease and may help to develop specific diagnostic, prognostic and therapeutic tools. However, until long-term studies examine the safety and efficacy of certain genetic markers, long-term follow-up of patients with CP who harbour mutations is needed.
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Affiliation(s)
- D Paramythiotis
- Department of General Surgery, University of HeidelbergHeidelbergGermany
| | - J Kleeff
- Department of General Surgery, University of HeidelbergHeidelbergGermany
| | - J Schmidt
- Department of General Surgery, University of HeidelbergHeidelbergGermany
| | - Mw Büchler
- Department of General Surgery, University of HeidelbergHeidelbergGermany
| | - H Friess
- Department of General Surgery, University of HeidelbergHeidelbergGermany
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Kotzampassi K, Paramythiotis D, Eleftheriadis E. Deterioration of visceral perfusion caused by intra-abdominal hypertension in pigs ventilated with positive end-expiratory pressure. Surg Today 2001; 30:987-92. [PMID: 11110392 DOI: 10.1007/s005950070018] [Citation(s) in RCA: 30] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
Experimental studies and clinical experience suggest that the combination of positive end-expiratory pressure (PEEP) ventilation and intra-abdominal hypertension might alter splanchnic hemodynamics to a significantly greater degree than the effect of either of them alone. Therefore, we assessed the intestinal and hepatic hemodynamics in two steps of PEEP ventilation, adding tense pneumoperitoneum in a pig model. The hepatic artery, portal vein, and superior mesenteric artery blood flow, as well as the hepatic and intestinal mucosal microcirculation, and the hepatic pO2 and intestinal mucosal pH, were assessed before, then with 5 cmH2O and 10 cmH2O PEEP alone, and in combination with a 12-mmHg pneumoperitoneum, in ten domestic pigs. Statistical analysis of the hepatic and intestinal measurements revealed a significant decrease (P = 0.001) in all parameters in relation to the baseline, during the 5-cmH2O and 10-mmH2O PEEP ventilation period. The addition of 12 mmHg intra-abdominal pressure led to an extreme deterioration in all parameters (P = 0.001), in relation to both the baseline and the 10-cmH2O PEEP measurement. These findings demonstrate that PEEP and intra-abdominal hypertension act cumulatively on the abdominal viscera, producing conditions of extremely low hypoperfusion and ischemia.
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Affiliation(s)
- K Kotzampassi
- Department of Surgery, University of Thessaloniki, Medical School, Greece
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Eleftheriadis E, Kotzampassi K, Vafiadis M, Paramythiotis D. 24-hr measurement of gastric mucosal perfusion in conscious humans. Hepatogastroenterology 1998; 45:2453-7. [PMID: 9951943] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/10/2023]
Abstract
BACKGROUND/AIMS Gastric mucosal blood flow estimation in humans is obtained through an endoscope and the time of measurement lasts only a few minutes. Thinking that long-term monitoring of mucosal perfusion would be a significant contribution to the study of gastric physiology, we registered gastric mucosal blood flow continuously for 24 hours, using single fiber laser-Doppler technology. METHODOLOGY The study was undertaken in 16 healthy subjects (8 of them had their gastric acidity inhibited with a proton pump inhibitor) and in 8 patients with an endoscopically proven, active duodenal ulcer. A 140 cm-long single fiber laser-Doppler microprobe was positioned through a gastrointestinal tube in the middle of the gastric corpus and the mucosal microcirculation was monitored from 14.00 h until 13.59 h the following day. Data were stored and processed to evaluate the probable circadian rhythms, using maximum entropy spectrum analysis. RESULTS We found that the daily variations of gastric mucosal perfusion follow a circadian rhythm. The respective patterns with maximum and minimum values were: healthy controls, maximum at 02.00, 10.00, 18.00 h and minimum at 5.30, 14.00 and 22.00 h. Healthy controls treated by a proton pump inhibitor, maximum at 02.00, 07.00, 18.00 h and minimum at 04.00, 12.00 and 22.00 h. Ulcer patients, maximum 07.00 and 21.00 h and minimum at 17.00 and 24.00 h. CONCLUSIONS It is concluded that long-term measurement of gastric mucosal blood flow in conscious humans is feasible and that this factor of gastric physiology follows a concrete circadian rhythm, which is not particularly influenced by acid inhibition, but is completely distorted in ulcer patients.
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