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Article: Diagnostic Modalities in Gastrointestinal Bleeding.

Feingold, Daniel L / Pappou, Emmanouil P / Lee-Kong, Steven A

2020 Volume 33, Issue 1, Page(s) 5–9

Abstract: A variety of diagnostic modalities is available to assist in the evaluation of patients presenting with acute gastrointestinal (GI) bleeding. This article reviews some older technologies like colonoscopy, nuclear scintigraphy, and conventional ... ...

Abstract	A variety of diagnostic modalities is available to assist in the evaluation of patients presenting with acute gastrointestinal (GI) bleeding. This article reviews some older technologies like colonoscopy, nuclear scintigraphy, and conventional angiography and will also review the newest additions to the lower GI bleeding diagnostic toolbox, which are video capsule endoscopy and computed tomography (CT) angiography. The management algorithm used at a given institution depends on the available expertise and resources.
Language	English
Publishing date	2020-01-07
Publishing country	United States
Document type	Journal Article ; Review
ZDB-ID	2048635-2
ISSN	1531-0043
ISSN	1531-0043
DOI	10.1055/s-0039-1693440
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Zs.A 3931: Show issues

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Article: The Failed J Pouch.

Pappou, Emmanouil P / Kiran, Ravi P

Clinics in colon and rectal surgery

2016 Volume 29, Issue 2, Page(s) 123–129

Abstract: The development and refinement of proctectomy with ileal pouch-anal anastomosis (IPAA) since its introduction in the 1970s has made it the optimal procedure of choice in patients with chronic ulcerative colitis and patients with familial adenomatous ... ...

Abstract	The development and refinement of proctectomy with ileal pouch-anal anastomosis (IPAA) since its introduction in the 1970s has made it the optimal procedure of choice in patients with chronic ulcerative colitis and patients with familial adenomatous polyposis. However, it is a procedure that can be associated with significant morbidity. Pouch failure due to infection, mechanical, or functional disability represents a challenge to both surgeon and patient. Practicing surgeons who deal with revisional pouch surgery face a variety of intraoperative, postoperative, and reoperative challenges. Success requires a strategy that includes critical planning, preparation, specialized surgical techniques, and experience to achieve long-term success, minimize the adverse consequences of IPAA-related complications, and ensure solutions and hope to patients.
Language	English
Publishing date	2016-05-31
Publishing country	United States
Document type	Journal Article ; Review
ZDB-ID	2048635-2
ISSN	1531-0043
ISSN	1531-0043
DOI	10.1055/s-0036-1580724
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Zs.A 3931: Show issues

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Article ; Online: Tumour deposits are independently associated with recurrence in colon cancer.

Hakki, Lynn / Khan, Asama / Do, Eric / Gonen, Mithat / Firat, Canan / Vakiani, Efsevia / Shia, Jinru / Widmar, Maria / Wei, Iris H / Smith, J Joshua / Pappou, Emmanouil P / Nash, Garrett M / Paty, Philip B / Garcia-Aguilar, Julio / Weiser, Martin R

Colorectal disease : the official journal of the Association of Coloproctology of Great Britain and Ireland

2024 Volume 26, Issue 3, Page(s) 459–465

Abstract: ... invasion (p < 0.05). The presence of tumour deposits (hazard ratio 2.48, 95% CI 1.49-4.10) and of lymph ...

Abstract	Aim: Tumour deposits are focal aggregates of cancer cells in pericolic fat and mesentery, distinct from vessels, nerves and lymphatics. Their presence upstages lymph node negative patients but is ignored in lymph node positive patients. We investigated the clinicopathological factors associated with tumour deposits and their impact on recurrence in lymph node positive and negative patients. Method: Clinicopathological variables were collected from the medical records of patients with Stage I-III colon cancer who underwent resection in 2017-2019. Pathology was reviewed by a gastrointestinal pathologist. Patients with rectal cancer, metastasis, and concurrent malignancy were excluded. Results: Tumour deposits were noted in 69 (9%) of 770 patients. They were associated with the presence of lymph node metastasis, advanced T category, poorly differentiated tumours, microsatellite stable subtype and lymphovascular and perineural invasion (p < 0.05). The presence of tumour deposits (hazard ratio 2.48, 95% CI 1.49-4.10) and of lymph node metastasis (hazard ratio 3.04, 95% CI 1.72-5.37) were independently associated with decreased time to recurrence. There was a weak correlation (0.27) between the number of tumour deposits and the number of positive lymph nodes. Conclusion: Tumour deposits are associated with more advanced disease and high-risk pathological features. The presence of tumour deposits and lymph node metastasis were found to be independent risk factors for decreased time to recurrence. A patient with both lymph node metastasis and tumour deposits is more than twice as likely to have recurrence compared with a patient with only lymph node metastasis. Tumour deposits independently predict recurrence and should not be ignored in lymph node positive patients.
MeSH term(s)	Humans ; Lymphatic Metastasis/pathology ; Extranodal Extension/pathology ; Prognosis ; Retrospective Studies ; Colonic Neoplasms/surgery ; Colonic Neoplasms/pathology ; Lymph Nodes/surgery ; Lymph Nodes/pathology ; Neoplasm Staging
Language	English
Publishing date	2024-01-23
Publishing country	England
Document type	Journal Article
ZDB-ID	1440017-0
ISSN	1463-1318 ; 1462-8910
ISSN (online)	1463-1318
ISSN	1462-8910
DOI	10.1111/codi.16873
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Zs.A 5799: Show issues

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Article ; Online: Robotic colonic resection.

Pappou, Emmanouil P / Weiser, Martin R

Journal of surgical oncology

2015 Volume 112, Issue 3, Page(s) 315–320

Abstract: Innovative robotic technologies are aiming to help surgeons overcome the limits of conventional laparoscopic surgery. Recent studies have shown that robotic colorectal surgery is safe and provides favorable results in comparison to conventional ... ...

Abstract	Innovative robotic technologies are aiming to help surgeons overcome the limits of conventional laparoscopic surgery. Recent studies have shown that robotic colorectal surgery is safe and provides favorable results in comparison to conventional laparoscopic techniques. Further studies and long-term follow-up are required to assess the outcomes and potential benefits of robotic colon surgery over laparoscopic surgery.
MeSH term(s)	Colectomy/methods ; Colon/surgery ; Humans ; Laparoscopy/methods ; Robotic Surgical Procedures/methods ; Treatment Outcome
Language	English
Publishing date	2015-09
Publishing country	United States
Document type	Journal Article ; Review
ZDB-ID	82063-5
ISSN	1096-9098 ; 0022-4790
ISSN (online)	1096-9098
ISSN	0022-4790
DOI	10.1002/jso.23953
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Zs.A 706: Show issues

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Article ; Online: Correction to: Anal canal squamous cell cancer: are surgical alternatives to chemoradiation just as effective?

Suradkar, Kunal / Pappou, Emmanouil P / Lee-Kong, Steven A / Feingold, Daniel L / Kiran, Ravi P

International journal of colorectal disease

2018 Volume 33, Issue 5, Page(s) 659

Abstract: ... This is now presented correctly in this article as "Emmanouil P. Pappou." ... One of the author's middle name of this article was incorrectly published as "Emmanouil E. Pappou ...

Abstract	One of the author's middle name of this article was incorrectly published as "Emmanouil E. Pappou." This is now presented correctly in this article as "Emmanouil P. Pappou."
Language	English
Publishing date	2018-02-02
Publishing country	Germany
Document type	Journal Article ; Published Erratum
ZDB-ID	84975-3
ISSN	1432-1262 ; 0179-1958
ISSN (online)	1432-1262
ISSN	0179-1958
DOI	10.1007/s00384-018-3000-3
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Zs.A 2121: Show issues

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Article: Retroileal colorectal anastomosis after left-sided or transverse colectomy for advanced serous carcinoma of the ovary or uterus.

Moukarzel, Lea A / Casanova, Joao / Filipe Cunha, José / Paty, Philip B / Pappou, Emmanouil P / Jewell, Elizabeth / Chi, Dennis S

Gynecologic oncology reports

2021 Volume 37, Page(s) 100834

Abstract: The ability to achieve complete or optimal cytoreduction in advanced or recurrent ovarian and uterine cancer is a well-established prognostic factor. Colonic resections are commonly required to achieve minimal or no residual disease. When multiple ... ...

Abstract	The ability to achieve complete or optimal cytoreduction in advanced or recurrent ovarian and uterine cancer is a well-established prognostic factor. Colonic resections are commonly required to achieve minimal or no residual disease. When multiple colonic resections are required there is a corresponding difficulty in obtaining sufficient colonic mobility to create tension-free anastomoses for restoration of gastrointestinal continuity; specifically, when a left hemicolectomy or a transverse colectomy is required in addition to a rectosigmoid resection, it may be difficult to achieve a tension-free colorectal anastomosis. We describe the use of retroileal routing of the colon to address this scenario in the context of gynecologic cancer debulking surgery. We report four cases in which the surgeon encountered limited colonic mobility after performing either a left hemicolectomy or a transverse colonic resection in addition to a rectosigmoid resection. In using a retroileal path to perform the colorectal anastomosis, we were able to achieve well-perfused and tension-free anastomoses. Complete gross resection was achieved in all four cases, with acceptable rates of perioperative complications.
Language	English
Publishing date	2021-07-21
Publishing country	Netherlands
Document type	Case Reports
ZDB-ID	2818505-5
ISSN	2352-5789
ISSN	2352-5789
DOI	10.1016/j.gore.2021.100834
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Article ; Online: Association of Lateral Pelvic Lymph Nodes with Disease Recurrence and Organ Preservation in Patients with Distal Rectal Adenocarcinoma Treated with Total Neoadjuvant Therapy.

Beets, Nathalie R A / Verheij, Floris S / Williams, Hannah / Omer, Dana M / Lin, Sabrina T / Qin, Li-Xuan / Beets, Geerard L / Beets-Tan, Regina G H / Wei, Iris H / Widmar, Maria / Pappou, Emmanouil P / Weiser, Martin R / Nash, Garrett M / Smith, J Joshua / Paty, Philip B / Miranda, Joao / Kim, Tae-Hyung / Gollub, Marc J / Garcia-Aguilar, Julio

Annals of surgery

2024

Abstract: ... P=0.013). We found no significant differences in rates of local recurrence or metastasis between ...

Abstract	Objective: Assess the significance of enlarged lateral lymph nodes (LLN) for disease recurrence, metastasis, and organ preservation in patients with rectal cancer. Background: Optimal treatment of rectal adenocarcinoma involving LLN is subject to debate. Methods: A post hoc analysis of the OPRA trial, a multicenter study of patients with rectal cancer treated with total neoadjuvant therapy (TNT) followed by total mesorectal excision or watch-and-wait management. We analyzed the association of visible LLN (LLN+), LLN≥7 mm (short axis) on baseline MRI, and LLN≥4 mm on restaging MRI with recurrence, metastasis, and rectum preservation. Results: At baseline, 57 out of 324 (18%) patients had LLN+. In 30 (53%) of 57 patients with LLN+ on baseline MRI, the LLN disappeared after TNT. Disease recurrence in LLN was rare (3.5% of patients with LLN+ and 0.4% of patients with LLN-). All patients with recurrence in LLN also had distant metastasis. The rate of organ preservation was significantly lower in patients with LLN≥4 mm on restaging MRI (P=0.013). We found no significant differences in rates of local recurrence or metastasis between patients with LLN+ vs. LLN- and in patients with LLN≥7 vs.<7 mm on baseline MRI. LLN dissection was performed in 3 patients; 2 of them died of distant metastasis. Conclusions: LLN involvement is not associated with disease recurrence or metastasis, but persistence of LLN≥4 mm after TNT is negatively associated with rectum preservation in patients with locally advanced rectal cancer treated with TNT. Dissection of lateral nodes likely benefits few patients.
Language	English
Publishing date	2024-04-22
Publishing country	United States
Document type	Journal Article
ZDB-ID	340-2
ISSN	1528-1140 ; 0003-4932
ISSN (online)	1528-1140
ISSN	0003-4932
DOI	10.1097/SLA.0000000000006305
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Article ; Online: Erratum to: Comparing outcomes of robotic versus open mesorectal excision for rectal cancer.

Jimenez-Rodriguez, Rosa M / Flynn, Jessica / Patil, Sujata / Widmar, Maria / Quezada-Diaz, Felipe / Lynn, Patricio / Strombom, Paul / Temple, Larissa / Smith, J Joshua / Wei, Iris H / Pappou, Emmanouil P / Guillem, Jose G / Paty, Philip B / Nash, Garrett M / Weiser, Martin R / Garcia-Aguilar, Julio

BJS open

2022 Volume 6, Issue 1

Language	English
Publishing date	2022-02-10
Publishing country	England
Document type	Published Erratum
ISSN	2474-9842
ISSN (online)	2474-9842
DOI	10.1093/bjsopen/zrac021
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Article ; Online: Comparison of short-term outcomes and survival between minimally invasive colectomy and open colectomy in patients 80 years of age and older.

Thompson, Hannah M / Williams, Hannah / Omer, Dana M / Yuval, Jonathan B / Verheij, Floris S / Fiasconaro, Megan / Widmar, Maria / Wei, Iris H / Pappou, Emmanouil P / Smith, J Joshua / Nash, Garrett M / Weiser, Martin R / Paty, Philip B / Shahrokni, Armin / Garcia-Aguilar, Julio

Journal of robotic surgery

2023 Volume 17, Issue 4, Page(s) 1857–1865

Abstract: ... a robotic colectomy had a shorter median length of hospital stay (5 versus 6 days; p < 0.001) and underwent ... fewer conversions to open surgery (3% versus 17%; p = 0.002) compared to the laparoscopic cohort ...

Abstract	We investigated the short- and long-term outcomes of patients 80 years of age and older with colon cancer who underwent robotic colectomy versus laparoscopic colectomy. Data for patients treated at a comprehensive cancer center between January 2006 and November 2018 were collected retrospectively. Outcomes from minimally invasive laparoscopic or robotic colectomy were compared. Survival was analyzed by the Kaplan-Meier method with significance evaluated by the log-rank test. The laparoscopic (n = 104) and the robotic (n = 75) colectomy groups did not differ across baseline characteristics. Patients who underwent a robotic colectomy had a shorter median length of hospital stay (5 versus 6 days; p < 0.001) and underwent fewer conversions to open surgery (3% versus 17%; p = 0.002) compared to the laparoscopic cohort. The groups did not differ in postoperative complication rates, overall survival or disease-free survival. Elderly patients undergoing robotic colectomy for colon cancer have a shorter hospital stay and lower rates of conversion without compromise to oncologic outcomes.
MeSH term(s)	Humans ; Aged ; Robotic Surgical Procedures/methods ; Retrospective Studies ; Colonic Neoplasms/surgery ; Robotics ; Postoperative Complications/etiology ; Colectomy/methods ; Laparoscopy/methods ; Length of Stay ; Treatment Outcome
Language	English
Publishing date	2023-04-06
Publishing country	England
Document type	Letter
ZDB-ID	2268283-1
ISSN	1863-2491 ; 1863-2483
ISSN (online)	1863-2491
ISSN	1863-2483
DOI	10.1007/s11701-023-01575-1
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Article ; Online: Nonoperative management of the primary tumor in patients with unresectable stage IV colon cancer treated with systemic chemotherapy: Higher complication rates for left-sided colon tumors.

Verheij, Floris S / Yuval, Jonathan B / Kok, Niels F M / Lin, Sabrina T / Qin, Li-Xuan / Omer, Dana M / Thompson, Hannah M / Wei, Iris H / Widmar, Maria / Pappou, Emmanouil P / Weiser, Martin R / Nash, Garrett M / Smith, J Joshua / Paty, Philip B / Beets, Geerard L / Garcia-Aguilar, Julio

European journal of surgical oncology : the journal of the European Society of Surgical Oncology and the British Association of Surgical Oncology

2023 Volume 50, Issue 1, Page(s) 107294

Abstract: ... frequently in patients with left-sided tumors than in patients with right-sided tumors (29% vs 13%, P = 0.003 ... 89; P = 0.003) was significantly associated with primary tumor-related complications requiring ...

Abstract	Introduction: Treatment of the primary tumor in asymptomatic patients with unresectable colorectal metastases remains controversial. Methods: Data from patients with synchronous stage IV colon cancer and an untreated primary tumor who started treatment aimed at metastatic disease at a specialized cancer center between 2014 and 2018 were analyzed retrospectively. Main outcome was primary tumor-related complications comparing left-sided and right-sided colon cancer. A competing-risk regression model was used to identify predictors of complications. Results: Of 523 patients with metastatic colon cancer at presentation, 221 started treatment aimed at metastatic disease; these patients constituted the study cohort. The primary tumor was left-sided in 109 patients (49%) and right-sided in 112 patients (51%). In total, 46 patients (21%) developed a complication that required invasive intervention. Complications occurred more frequently in patients with left-sided tumors than in patients with right-sided tumors (29% vs 13%, P = 0.003). Eighteen patients (8%) underwent non-surgical intervention. Six patients (33%) failed non-surgical management and underwent surgery. Of 34 patients (15%) who underwent surgical intervention, 20 underwent an emergency colectomy and 14 underwent diversion with a permanent stoma. Overall, 10% of patients ended up with a permanent stoma. In competing-risk analysis, only left-sided primary tumor (hazard ratio 2.62; 95% CI 1.40-4.89; P = 0.003) was significantly associated with primary tumor-related complications requiring invasive intervention. Conclusions: Patients with asymptomatic metastatic left-sided tumors have a higher risk for primary tumor-related complications than patients with right-sided tumors. Close monitoring and early surgical rescue should be considered for patients with left-sided colon cancer who are managed nonoperatively.
MeSH term(s)	Humans ; Retrospective Studies ; Colonic Neoplasms/drug therapy ; Colonic Neoplasms/etiology ; Colectomy/adverse effects ; Surgical Stomas/pathology ; Colorectal Neoplasms/pathology
Language	English
Publishing date	2023-11-23
Publishing country	England
Document type	Journal Article
ZDB-ID	632519-1
ISSN	1532-2157 ; 0748-7983
ISSN (online)	1532-2157
ISSN	0748-7983
DOI	10.1016/j.ejso.2023.107294
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Zs.A 1149: Show issues			Location: Je nach Verfügbarkeit (siehe Angabe bei Bestand) bis Jg. 1994: Bestellungen von Artikeln über das Online-Bestellformular Jg. 1995 - 2021: Lesesall (1.OG) ab Jg. 2022: Lesesaal (EG)
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