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Article: Laparoscopic bilateral inguinal hernia repair: Should it be the preferred technique?

Doudakmanis, Christos / Kolla, Christina / Bouliaris, Konstantinos / Efthimiou, Matthaios / Koukoulis, Georgios D

World journal of methodology

2022 Volume 12, Issue 4, Page(s) 193–199

Abstract: Inguinal hernias are amongst the most common conditions requiring general surgical intervention. For decades, the preferred approach was the open repair. As laparoscopy became more popular and available and more surgeons became familiarized with this ... ...

Abstract	Inguinal hernias are amongst the most common conditions requiring general surgical intervention. For decades, the preferred approach was the open repair. As laparoscopy became more popular and available and more surgeons became familiarized with this modality, laparoscopic inguinal hernia repair became an alternative. The aim of this study is to assess the effectiveness of laparoscopic inguinal repair, with a focus on bilateral inguinal hernias. Initial reports have shown promising clinical outcomes compared to those of conventional repair of bilateral hernias. However, there are only a few studies concerning laparoscopic repair of bilateral hernias. It is yet to be proven that laparoscopy is the "gold standard" in the treatment of bilateral inguinal hernias. So far, the choice of an inguinal hernia repair technique has been up to each surgeon, depending on their expertise and available resources after taking into consideration each patient's needs.
Language	English
Publishing date	2022-07-20
Publishing country	United States
Document type	Journal Article ; Review
ISSN	2222-0682
ISSN	2222-0682
DOI	10.5662/wjm.v12.i4.193
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Article: Palliative Treatment of Bowel Obstruction With Colostomy Under Local Anesthesia in Frail Patients: A Single-Site Experience.

Doudakmanis, Christos / Baxevanidou, Kyriaki / Chatzikomnitsa, Paraskevi / Kolla, Christina / Bouliaris, Konstantinos / Giaglaras, Anargiros / Efthimiou, Matthaios / Koukoulis, Georgios D

Cureus

2023 Volume 15, Issue 9, Page(s) e45698

Abstract: Introduction: Attendance of patients to the emergency department due to acute large bowel obstruction is a common phenomenon. Most of these patients are elderly, critically ill, and with high comorbidity. The literature suggests that more than 50% of ... ...

Abstract	Introduction: Attendance of patients to the emergency department due to acute large bowel obstruction is a common phenomenon. Most of these patients are elderly, critically ill, and with high comorbidity. The literature suggests that more than 50% of these cases are due to colon cancer. Since this condition is considered to be an emergency, immediate intervention and response is imperative. Purpose: The aim of the present study is to present our surgical technique of colostomy formation under local anesthesia in selected critically ill patients, with increased perioperative risk and acute large bowel obstruction. Materials and methods: This is a retrospective study of 24 patients, with obstipation, who underwent emergency colostomy under local anesthesia, during the period from 2014 to 2021. Results: The mean age of the patients was 77 years. The vast majority of patients had an American Society of Anesthesiologists (ASA) score of ≥3 and a Charlson score of ≥7. The most common colostomy was transverse colostomy (21/24 patients). The patients' hospitalization ranged from four to 42 days. Only one patient died. All colostomies functioned properly in the immediate postoperative period. Only one patient required postoperative admission to the ICU. Conclusions: Colostomy under local anesthesia in critically ill, elderly patients is an alternative option for the treatment of ileus.
Language	English
Publishing date	2023-09-21
Publishing country	United States
Document type	Journal Article
ZDB-ID	2747273-5
ISSN	2168-8184
ISSN	2168-8184
DOI	10.7759/cureus.45698
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Article: Bacterial translocation in patients undergoing major gastrointestinal surgery and its role in postoperative sepsis.

Doudakmanis, Christos / Bouliaris, Konstantinos / Kolla, Christina / Efthimiou, Matthaios / Koukoulis, Georgios D

World journal of gastrointestinal pathophysiology

2021 Volume 12, Issue 6, Page(s) 106–114

Abstract: Bacteria of the human intestinal microflora have a dual role. They promote digestion and are part of a defense mechanism against pathogens. These bacteria could become potential pathogens under certain circumstances. The term "bacterial translocation" ... ...

Abstract	Bacteria of the human intestinal microflora have a dual role. They promote digestion and are part of a defense mechanism against pathogens. These bacteria could become potential pathogens under certain circumstances. The term "bacterial translocation" describes the passage of bacteria of the gastrointestinal tract through the intestinal mucosa barrier to mesenteric lymph nodes and other organs. In some cases, the passage of bacteria and endotoxins could result in blood stream infections and in multiple organ failure. Open elective abdominal surgery more frequently results in malfunction of the intestinal barrier and subsequent bacterial translocation and blood stream infections than laparoscopic surgery. Postoperative sepsis is a common finding in patients who have undergone non-elective abdominal surgeries, including trauma patients treated with laparotomy. Postoperative sepsis is an emerging issue, as it changes the treatment plan in surgical patients and prolongs hospital stay. The association between bacterial translocation and postoperative sepsis could provide novel treatment options.
Language	English
Publishing date	2021-11-28
Publishing country	United States
Document type	Editorial
ZDB-ID	2583474-5
ISSN	2150-5330
ISSN	2150-5330
DOI	10.4291/wjgp.v12.i6.106
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Article: Manual Reduction of Incarcerated Abdominal Wall Hernias. A Feasible Option during COVID-19 Pandemic: A Prospective Study.

Bouliaris, Konstantinos / Efthimiou, Matthaios / Chatzikomnitsa, Paraskevi / Kolla, Christina / Doudakmanis, Christos / Zervas, Konstantinos / Giaglaras, Anargiros / Koukoulis, Georgios D

Surgery journal (New York, N.Y.)

2022 Volume 8, Issue 1, Page(s) e46–e51

Abstract: ... ...

Abstract	Background
Language	English
Publishing date	2022-02-01
Publishing country	United States
Document type	Journal Article
ZDB-ID	2864275-2
ISSN	2378-5136 ; 2378-5128
ISSN (online)	2378-5136
ISSN	2378-5128
DOI	10.1055/s-0041-1742178
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Article: Manual Reduction of Incarcerated Abdominal Wall Hernias. A Feasible Option during COVID-19 Pandemic: A Prospective Study

Bouliaris, Konstantinos / Efthimiou, Matthaios / Chatzikomnitsa, Paraskevi / Kolla, Christina / Doudakmanis, Christos / Zervas, Konstantinos / Giaglaras, Anargiros / Koukoulis, Georgios D.

The Surgery Journal

2022 Volume 08, Issue 01, Page(s) e46–e51

Abstract: Background: Incarcerated hernia is a common surgical emergency with considerable morbidity or even mortality. Manual reduction (taxis) and elective surgery could be an alternative management approach. This study examines the role of taxis with the ... ...

Abstract	Background: Incarcerated hernia is a common surgical emergency with considerable morbidity or even mortality. Manual reduction (taxis) and elective surgery could be an alternative management approach. This study examines the role of taxis with the adjuvant use of the visual analogue scale (VAS) score in treating incarcerated hernias and thereby decreasing the emergency surgery rate, especially during the novel coronavirus disease 2019 (COVID-19) pandemic. Methods: All adult patients admitted to the emergency department of our hospital with incarcerated hernias of anterior abdominal wall were prospectively submitted to hernia manual reduction. The VAS score was used as an adjuvant tool for monitoring the success of this maneuver. Patients with successful taxis and low VAS score were hospitalized for a 24-hour period of observation. On their discharge, they were scheduled for an elective hernia repair. Patients with unsuccessful taxis or with less than a 50% reduction in VAS score after successful taxis were submitted to emergency surgical repair. Age, sex, type of hernias, time until taxis, VAS scores before and after taxis, length of hospital stay, and adverse events for both groups were recorded. Results: Between September 2018 and September 2020, 86 patients with incarcerated hernias were included. The types of hernias were incisional in 8 patients, umbilical in 15 patients, inguinal in 56 patients, and femoral in 7 patients. Taxis was successful in 66% of patients with a mean reduction in VAS score from 83 to 17 mm. Following successful taxis, patients were hospitalized for a 24-hour period of observation. No taxis-related complications were observed. Fifty-two patients were safely discharged from hospital and scheduled for an elective repair during the first month. Thirty-four patients were operated emergently. Five patients had successful taxis but with a reduction of posttaxis VAS score less than 50% (a mean reduction from 86 to 62 mm), while taxis failed in twenty-nine patients. Patients with emergency surgery had longer time until reduction and longer stay of hospitalization. In this group, two patients required admission to the intensive care unit while one patient died. Conclusion: In this protocolized approach, taxis is a safe and feasible option for most patients with incarcerated hernias. It should be kept in our armament, especially in times when emergency surgery capabilities are under strain like the ongoing COVID-19 pandemic.
Keywords	hernia ; visual analog pain score ; coronavirus ; manual reduction ; taxis
Language	English
Publishing date	2022-01-01
Publisher	Thieme Medical Publishers, Inc.
Publishing place	Stuttgart ; New York
Document type	Article
ZDB-ID	2864275-2
ISSN	2378-5136 ; 2378-5128
ISSN (online)	2378-5136
ISSN	2378-5128
DOI	10.1055/s-0041-1742178
Database	Thieme publisher's database

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Article: Haemangiopericytoma of the greater omentum: a rare tumour requiring long-term follow-up.

Vasdeki, Dionysia / Bompou, Effrosyni / Diamantis, Alexandros / Anagnostou, Athanasios / Tepetes, Konstantinos / Efthimiou, Matthaios

Journal of surgical case reports

2018 Volume 2018, Issue 5, Page(s) rjy087

Abstract: Haemangiopericytomas (HPC) are highly vascularized tumours located in any part of the body where capillaries can be found. Since 2002, they have been re-classified under the umbrella 'extrapleural Solitary Fibrous Tumour (SFT)' and the term HPC is ... ...

Abstract	Haemangiopericytomas (HPC) are highly vascularized tumours located in any part of the body where capillaries can be found. Since 2002, they have been re-classified under the umbrella 'extrapleural Solitary Fibrous Tumour (SFT)' and the term HPC is nowadays used to describe a growth pattern rather than a clinical entity. Their biological behaviour varies and they require a long-term follow-up since they may recur or metastasise several years after successful treatment. We present the case of a gentleman with HPC of the greater omentum initially appeared in 1998. HPC rarely develops in the greater omentum and only 20 cases have been described in the literature till today. Despite complete excision the mass re-appeared in 2011 and 2017, 13 and 19 years after initial treatment. Surgical management included en bloc excision of three lesions along with greater omentum. No further treatment was required.
Language	English
Publishing date	2018-05-14
Publishing country	England
Document type	Case Reports
ISSN	2042-8812
ISSN	2042-8812
DOI	10.1093/jscr/rjy087
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Article: Combined study on clastogenic, aneugenic and apoptotic properties of doxorubicin in human cells in vitro.

Chondrou, Vasiliki / Trochoutsou, Katerina / Panayides, Andreas / Efthimiou, Maria / Stephanou, Georgia / Demopoulos, Nikos A

Journal of biological research (Thessalonike, Greece)

2018 Volume 25, Page(s) 17

Abstract: Background: Doxorubicin is a widely used anticancer drug due to its broad spectrum of antitumor activity. Various mechanisms have been proposed for its cytostatic activity, including DNA intercalation, topoisomerase II inhibition, generation of free ... ...

Abstract	Background: Doxorubicin is a widely used anticancer drug due to its broad spectrum of antitumor activity. Various mechanisms have been proposed for its cytostatic activity, including DNA intercalation, topoisomerase II inhibition, generation of free radicals and apoptosis. The present study aims to further clarify the cytostatic activity of doxorubicin by its specific effect on (a) DNA damage, (b) micronucleation and (c) apoptosis, using a combination of different methods and cell systems such as human lymphocytes and HL-60 human leukemic cells. DNA lesions were analyzed by the alkaline comet assay in combination with formamidopyrimidine (Fpg) and human 8-oxoguanine (hOGG1) repair enzymes. Micronucleation was investigated by the Cytokinesis-Block Micronucleus assay (CBMN) in combination with Fluorescence In Situ Hybridization analysis. Impairment on mitotic apparatus was investigated by double immunofluorescence of β- and γ-tubulin. Apoptotic cell frequency was determined by the CBMN cytome assay. Complementary to the above, caspase-3 level was investigated by Western blot. Results: It was found that doxorubicin generates DNA breakage induced by oxidative damage in DNA bases, which can be repaired by the Fpg and hOGG1 enzymes. Increased micronucleus frequency was identified mainly through chromosome breakage and, at a lesser extent, through chromosome delay. Analysis of mitotic spindle showed disturbance of chromosome orientation and centrosome duplication and/or separation, leading to aneuploidy. Enhanced frequency of apoptotic leukemic cells was also observed. Caspase-3 seems to be involved in the generation of apoptosis. Conclusions: The aforementioned findings derived from different treatment schedules, doses and time of exposure on primary versus transformed cells extend our knowledge about doxorubicin genotoxicity and contribute to the better understanding of the mechanisms by which doxorubicin induces genotoxic effects on human cells.
Language	English
Publishing date	2018-10-11
Publishing country	Greece
Document type	Journal Article
ZDB-ID	2186880-3
ISSN	2241-5793 ; 1790-045X
ISSN (online)	2241-5793
ISSN	1790-045X
DOI	10.1186/s40709-018-0089-z
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Article ; Online: Open inguinal hernia repair with the use of polyglycolic acid/trimethylene carbonate mesh: gross and pathologic assessment of the inguinal area at reoperation for recurrence.

Symeonidis, D / Efthimiou, M / Koukoulis, G / Mamaloudis, I / Ioannou, M / Tzovaras, G

Hernia : the journal of hernias and abdominal wall surgery

2013 Volume 17, Issue 6, Page(s) 791–794

Abstract: Purpose: Our group tried to test the hypothesis of using a totally absorbable material for open inguinal hernia repair. However, the increased incidence of recurrences alleviated our initial enthusiasm regarding the technique. The purpose of the present ...

Abstract	Purpose: Our group tried to test the hypothesis of using a totally absorbable material for open inguinal hernia repair. However, the increased incidence of recurrences alleviated our initial enthusiasm regarding the technique. The purpose of the present study was to attain both gross and microscopic data that could at least in part justify the hernia repair failure from a patient included in our initial pilot study and was re-operated for recurrence. Methods: A 65-year-old male patient was diagnosed clinically with a recurrence 24 months after open inguinal hernia repair with the use of polyglycolic acid/trimethylene carbonate mesh. The patient was operated for the recurrence upon our group on July 2012. The gross appearance of the inguinal area as well as the degree of chronic inflammation provoked by the used mesh as depicted by the pathologic analysis of specimens obtained intraoperatively were assessed. Results: An open tension-free repair with the use of a non-absorbable mesh under spinal anesthetic was undertaken. Intraoperatively, after the division of the external oblique aponeurosis, only minor fibrotic reaction was observed a finding that was additionally confirmed pathologically. Conclusion: Polyglycolic acid/trimethylene carbonate mesh used for inguinal hernia repair was associated with a minimal inflammatory host reaction in the inguinal area at 3 years verified both grossly and microscopically.
MeSH term(s)	Aged ; Dioxanes/adverse effects ; Foreign-Body Reaction/etiology ; Foreign-Body Reaction/pathology ; Foreign-Body Reaction/surgery ; Hernia, Inguinal/pathology ; Hernia, Inguinal/surgery ; Herniorrhaphy/instrumentation ; Herniorrhaphy/methods ; Humans ; Male ; Polyglycolic Acid/adverse effects ; Recurrence ; Reoperation ; Surgical Mesh/adverse effects
Chemical Substances	Dioxanes ; Polyglycolic Acid (26009-03-0) ; trimethylene carbonate (4316AQ174Q)
Language	English
Publishing date	2013-04-06
Publishing country	France
Document type	Case Reports ; Journal Article
ZDB-ID	1388125-5
ISSN	1248-9204 ; 1265-4906
ISSN (online)	1248-9204
ISSN	1265-4906
DOI	10.1007/s10029-013-1079-6
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Article ; Online: Open inguinal hernia repair with the use of polyglycolic acid/trimethylene carbonate absorbable mesh: a critical update of the long-term results.

Symeonidis, D / Efthimiou, M / Koukoulis, G / Athanasiou, E / Mamaloudis, I / Tzovaras, G

Hernia : the journal of hernias and abdominal wall surgery

2012 Volume 17, Issue 1, Page(s) 85–87

Abstract: Purpose: Our group evaluated on a pilot basis open inguinal hernia repair with the use of a fully absorbable mesh aiming to take mesh inguinal hernia repair one step forward. The purpose of the present study was to assess the long-term results of the ... ...

Abstract	Purpose: Our group evaluated on a pilot basis open inguinal hernia repair with the use of a fully absorbable mesh aiming to take mesh inguinal hernia repair one step forward. The purpose of the present study was to assess the long-term results of the proposed technique. Methods: Patients that were included in our previous report were followed up at 3 years after the initial operation. Results: Ten patients underwent open inguinal hernia repair with the use of an absorbable polyglycolic acid/trimethylene carbonate mesh. 3 years after the procedure, from the total of ten patients, two were lost to follow-up (20 %). Three patients (37.5 %), one with direct and two with indirect hernia, were diagnosed clinically with a recurrence at the follow-up of 3 years. Recurrences were developed nearly 2 years--median 24 months (range 18-30)--after the initial operation. Among patients without recurrence none complained about chronic pain, foreign body sensation or numbness. On the other hand, chronic pain was a constant complain in the recurrence patient group. Conclusions: The results of the 3-year follow-up in the given patient sample alleviate the initial enthusiasm regarding the use of an absorbable mesh for inguinal hernia repair as an attractive alternative and causes skepticism about the generalized use of the procedure in its certain form.
MeSH term(s)	Absorbable Implants/adverse effects ; Chronic Pain/etiology ; Dioxanes ; Follow-Up Studies ; Hernia, Inguinal/surgery ; Herniorrhaphy/adverse effects ; Humans ; Hypesthesia/etiology ; Polyglycolic Acid ; Recurrence ; Surgical Mesh/adverse effects ; Time Factors
Chemical Substances	Dioxanes ; Polyglycolic Acid (26009-03-0) ; trimethylene carbonate (4316AQ174Q)
Language	English
Publishing date	2012-11-09
Publishing country	France
Document type	Journal Article
ZDB-ID	1388125-5
ISSN	1248-9204 ; 1265-4906
ISSN (online)	1248-9204
ISSN	1265-4906
DOI	10.1007/s10029-012-1016-0
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Article: Thyroid abscess requiring emergency intervention.

Sioka, Eleni / Efthimiou, Matthaios / Skoulakis, Charalambos / Zacharoulis, Dimitrios

The Journal of emergency medicine

2012 Volume 43, Issue 6, Page(s) e455–6

MeSH term(s)	Abscess/surgery ; Adult ; Emergencies ; Humans ; Male ; Streptococcal Infections/surgery ; Streptococcus sanguis ; Thyroid Diseases/surgery
Language	English
Publishing date	2012-12
Publishing country	United States
Document type	Case Reports ; Journal Article
ZDB-ID	605559-x
ISSN	0736-4679
ISSN	0736-4679
DOI	10.1016/j.jemermed.2011.06.054
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