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  1. Article ; Online: Re-Operative Laparoscopic Colorectal Surgery

    Constantine Halkias / Athanasios Zoikas / Zoe Garoufalia / Michalis K. Konstantinidis / Argyrios Ioannidis / Steven Wexner

    Journal of Clinical Medicine, Vol 10, Iss 1447, p

    A Systematic Review

    2021  Volume 1447

    Abstract: Introduction: Re-operative laparoscopic colorectal surgery is becoming increasingly common. It can be a challenging procedure, but its benefits can outweigh the associated risks. Methods: A systematic review of the literature reporting re-operative ... ...

    Abstract Introduction: Re-operative laparoscopic colorectal surgery is becoming increasingly common. It can be a challenging procedure, but its benefits can outweigh the associated risks. Methods: A systematic review of the literature reporting re-operative laparoscopic surgery was carried out. Retrospective and prospective cohort studies and case series were included, with case reports being excluded. Results: Seventeen articles dated from 2007 to 2020 were included in the systematic review. In total, 1555 patients were identified. Five hundred and seventy-four of them had a laparoscopic procedure and 981 an open re-operation. One hundred and eighty-three women had a laparoscopic operation. The median age ranged from to 44.9 years to 68.7 years. In seven studies, the indication of the index operation was malignancy, one study regarded re-laparoscopy for excision of lateral pelvic lymph nodes, and one study looked at redo surgery of ileal J pouch anal anastomosis. There were 16 mortalities in the laparoscopic arm (2.78%) and 93 (9.4%) in the open surgery arm. One hundred and thirty-seven morbidities were recorded in the open arm and 102 in the laparoscopic arm. Thirty-nine conversions to open occurred. The median length of stay ranged from 5.8 days to 19 days in laparoscopy and 9.7 to 34 days in the open surgery arm. Conclusions: Re-operative laparoscopic colorectal surgery is safe when performed by experienced hands. The management of complications, recurrence of malignancy, and lateral pelvic floor dissection can be safely performed. The complication rate is low, with conversion to open procedures being relatively uncommon.
    Keywords re-laparoscopy ; re-intervention ; colorectal surgery ; Medicine ; R
    Subject code 616
    Language English
    Publishing date 2021-04-01T00:00:00Z
    Publisher MDPI AG
    Document type Article ; Online
    Database BASE - Bielefeld Academic Search Engine (life sciences selection)

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  2. Article ; Online: Causes, Management and Treatment of Delayed Arterial Hemorrhage after Pancreato-Duodenectomy. A Review Study

    Konstantinos Alexiou / Argyrios Ioannidis / Ioannis Drikos / Nikolaos Economou

    JOP Journal of the Pancreas, Vol 16, Iss 6, Pp 533-

    2015  Volume 539

    Abstract: In recent years, even if the associated with pancreaticoduodenectomy mortality has been reduced still remains high. Delayed arterial hemorrhage after pancretoduodenectomy is defined as bleeding 5 or more days postoperatively. Pancreatic fistula and ... ...

    Abstract In recent years, even if the associated with pancreaticoduodenectomy mortality has been reduced still remains high. Delayed arterial hemorrhage after pancretoduodenectomy is defined as bleeding 5 or more days postoperatively. Pancreatic fistula and pseudoaneyrysm are the most common complications following pancreaticoduodenectomy and are present in most cases of delayed arterial hemorrhage. Most patients presented to ER with episodes of melena and hematemesis. Upper abdominal control by computer tomography, selective angiography of the celiac trunk and the evaluation of superior mesenteric artery set the diagnosis of pseudoaneurysm of the gastroduodenal of arterial stump. Delayed hemorrhage has more complex pathophysiology and requires a multiple management approaches. In this paper, we review the related to postoperative hemorrhage articles after major pancreatic surgery. Initial management, both diagnostic and therapeutic, should be done by angiographic control and trans-catheter embolization. In case of hemodynamic instability or in cases when angiographic embolism is unsuccessful reoperation is the proper treatment.
    Keywords Pancretoduodenectomy ; Complications ; Postoperative Hemorrhage ; Diseases of the digestive system. Gastroenterology ; RC799-869 ; Specialties of internal medicine ; RC581-951 ; Internal medicine ; RC31-1245 ; Medicine ; R
    Subject code 610
    Language English
    Publishing date 2015-11-01T00:00:00Z
    Publisher E S Burioni Ricerche Bibliografiche
    Document type Article ; Online
    Database BASE - Bielefeld Academic Search Engine (life sciences selection)

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  3. Article ; Online: A prospective randomised trial of isolated pathogens of surgical site infections (SSI)

    Konstantinos Alexiou / Ioannis Drikos / Maria Terzopoulou / Nikolaos Sikalias / Argyrios Ioannidis / Nikolaos Economou

    Annals of Medicine and Surgery, Vol 21, Iss C, Pp 25-

    2017  Volume 29

    Abstract: Background: Every surgical wound is colonized by bacteria, but only a small percentage displays symptoms of infection. The distribution of pathogens isolated in surgical site infections has not significantly changed over the last decades. Staph. Aureus, ... ...

    Abstract Background: Every surgical wound is colonized by bacteria, but only a small percentage displays symptoms of infection. The distribution of pathogens isolated in surgical site infections has not significantly changed over the last decades. Staph. Aureus, Coag(-) Staphylococci, Enterococcus spp and E. Coli are the main strains appearing. In addition, a continuously rising proportion of surgical site infections caused by resistant bacterial species (MRSA, C. Albicans) has been reported. Methods: This prospective and randomized clinical study was performed in the 1st Surgical Clinic of Sismanoglion General Hospital of Athens, from February 2009 to February 2015. Patients undergoing elective surgery in the upper or lower digestive system were randomized to receive antimicrobial treatment as chemoprophylaxis. Each patient filled a special monitoring form, recording epidemiological data, surgery related information, surgical site infections (deep and superficial), as well as postoperative morbidity (urinary and respiratory infections included). The monitoring of patients was carried by multiple visits on a daily basis during their hospitalization and continued after they were discharged via phone to postoperative day 30. Results: Our overall SSI incidence was 4,3% (31patients out of a whole of 715 patients). Specifically, the incidence of SSIs for scheduled surgery of the upper GI tract was 2,2% (11 out of 500 patients) and for the lower GI tract was 9,3% (20 out of 215 patients). Seven main pathogens were isolated from patients with SSIs: Escherichia coli, Klebsiella pneumoniae, Enterobacter cloacae, Pseudomonas aeruginosa, Bacteroides fragilis, Staphylococcus aureus and Enterococcus faecalis. Their growth rates were respectively: S. Aureus (17,3%), E. faecalis (19,5%), P. aeruginosa (10,5%), B. Fragilis (13,4%) E. coli (20,4%), Enterobacter cloacae (9,1%) and K. Pneumoniae (9,8%). In addition, all the SSIs were found to be multimicrobial. Several studies have already revealed that patient characteristics and coexisting morbidities such as obesity, smoking, heart or renal failure, pre-existing localized infections and patients' age (especially if age exceeds 65) seem to be independent prognostic factors for surgical field infections. Additionally, classification of the surgical wound, surgical operation complexity, preoperative hospitalization, prolongation of surgical time and need for transfusions have been proved to differentiate the incidence of SSIs. Conclusions: In conclusion, surgical site infections are important complications affecting the healthcare services, the cost of hospitalization and the patient himself. Future thorough studies are expected to reveal much more data, regarding predisposing and precautionary patient and hospital characteristics.
    Keywords Surgical site infections (SSI) ; Healthcare associated infections (HAIs) ; Wound care ; Infection control ; Medicine (General) ; R5-920
    Subject code 616 ; 610
    Language English
    Publishing date 2017-09-01T00:00:00Z
    Publisher Elsevier
    Document type Article ; Online
    Database BASE - Bielefeld Academic Search Engine (life sciences selection)

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  4. Article ; Online: Management of Delayed Arterial Hemorrhage After Pancreato-Duodenectomy. A Case Report Study

    Konstantinos Alexiou / Ioannis Drikos / Argyrios Ioannidis / Nikolaos Sikalias / Nikolaos Economou / Eleftheria Konstantinidou

    JOP Journal of the Pancreas, Vol 16, Iss 4, Pp 373-

    2015  Volume 376

    Abstract: Context Delayed arterial hemorrhage after pancreatoduodenectomy is defined as bleeding 5 or more days postoperatively. Objective We present the management of delayed hemorrhage after PD, due to gastro-duodenal arterial stump aneurysm. Case report A sixty- ...

    Abstract Context Delayed arterial hemorrhage after pancreatoduodenectomy is defined as bleeding 5 or more days postoperatively. Objective We present the management of delayed hemorrhage after PD, due to gastro-duodenal arterial stump aneurysm. Case report A sixty-nineyear- old man suffering from pancreatic head carcinoma underwent pancreatoduodenectomy. On the 12th postoperative day he developed melena. Endoscopic evaluation revealed occult bleeding coming from the afferent limb of the gastro-jejunal anastomosis. The patient was treated conservatively. On the 15th postoperative day the patient presented a new episode of melena and hematemesis. Upper abdominal series control by computer tomography, selective angiography of the celiac trunk and superior mesenteric artery set the diagnosis of a pseudoaneurysm of the gastro-duodenal arterial stump. The patient was managed by trans-catheter arterial embolization and complete hemostasis was achieved. Conclusion Delayed intraluminal hemorrhage after pancreatoduodenectomy may be caused after pseudoaneurysm due to some visceral arterial stem erosion. Initial management, both diagnostic and therapeutic, should be the angiographic control and trans-catheter embolization of the bleeding vessel. In case of hemodynamic instability or when angiographic embolism is unsuccessful reoperation is the proper treatment.
    Keywords Adenocarcinoma ; Pancreatoduodenectomy ; Diseases of the digestive system. Gastroenterology ; RC799-869 ; Specialties of internal medicine ; RC581-951 ; Internal medicine ; RC31-1245 ; Medicine ; R
    Language English
    Publishing date 2015-07-01T00:00:00Z
    Publisher E S Burioni Ricerche Bibliografiche
    Document type Article ; Online
    Database BASE - Bielefeld Academic Search Engine (life sciences selection)

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  5. Article ; Online: Adenocarcinoma of the Appendix in Young Men with Acute Appendicitis

    K. Alexiou / Argyrios Ioannidis / I. Drikos / I. Karanikas / A. Fotopoulos / M. Chorti / N. Economou

    Surgical Science , Vol 05, Iss 05, Pp 206-

    2014  Volume 209

    Abstract: Intoduction: The adenocarcinomas of the appendix are rare tumors of the gastrointestinal truct that often reveal no clear clinical symptoms and are not diagnosed in time. In this study, we analyze a rare case of an incidentally discovered adenocarcinoma ... ...

    Abstract Intoduction: The adenocarcinomas of the appendix are rare tumors of the gastrointestinal truct that often reveal no clear clinical symptoms and are not diagnosed in time. In this study, we analyze a rare case of an incidentally discovered adenocarcinoma of the appendix after appendicectomy. Case presentation: A Greek male patient of 37 years old patient presented to our hospital with signs of acute appendicitis and peritonitis. He underwent appendicectomy as therapeutic treatment. Post operational histological examination revealed in situ carcinoma of the appendix without high hematological tumor markers or visible metastasis in CT scan analysis. We decided to proceed to right hemicolectomy. The patient was discharged without complications and without displaying other symptoms in a monitoring interval of two months after surgery. Conclusion: Adenocarcinomas of the appendix are generally difficult to detect in the early stage leading to significant morbidity and mortality rates. Therefore, it is necessary to execute a very careful histopathological examination and perform a detailed intraperitoneal cleaning during operation, so that any indications of appendix adenocarcinomas in cases of appendectomy won’t be missed or misjudged.
    Keywords Acute Appendicitis ; Appendix Adenocarcinoma ; Right Hemicolectomy ; Surgery ; RD1-811 ; Medicine ; R
    Subject code 410
    Language English
    Publishing date 2014-05-01T00:00:00Z
    Publisher Scientific Research Publishing
    Document type Article ; Online
    Database BASE - Bielefeld Academic Search Engine (life sciences selection)

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  6. Article ; Online: Gallstone Ileus

    Konstantinos Alexiou / Argyrios Ioannidis / Nikolaos Sikalias / Eleftheria Konstantinidou / Athanasios Fotopoulos / Ioannis Karanikas / Nikolaos Economou

    Surgical Science , Vol 05, Iss 01, Pp 10-

    A Case Report and Our Clinic’s Experience

    2014  Volume 14

    Abstract: We present a 72 - year - old female patient complaining of pain and distention of the abdomen, nausea and vomiting. No history of previous abdominal surgery, hernias or biliary disease was present. Plain abdominal x-rays showed small bowel obstruction. ... ...

    Abstract We present a 72 - year - old female patient complaining of pain and distention of the abdomen, nausea and vomiting. No history of previous abdominal surgery, hernias or biliary disease was present. Plain abdominal x-rays showed small bowel obstruction. This mechanical obstruction of the gastrointestinal truct was caused by a gallstone in the terminal ileum.
    Keywords Gallstone Ileus ; Surgery ; RD1-811 ; Medicine ; R
    Language English
    Publishing date 2014-01-01T00:00:00Z
    Publisher Scientific Research Publishing
    Document type Article ; Online
    Database BASE - Bielefeld Academic Search Engine (life sciences selection)

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