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Article ; Online: Comparison of intracorporeal and extracorporeal anastomosis in laparoscopic right colectomy: an updated meta-analysis and trial sequential analysis.

Perivoliotis, Konstantinos / Tzovaras, George / Tepetes, Konstantinos / Baloyiannis, Ioannis

2024 Volume 76, Issue 2, Page(s) 375–396

Abstract: This meta-analysis was conducted to provide updated evidence regarding perioperative safety and efficacy, of IC and EC anastomosis in laparoscopic right colectomies. In this study, the Cochrane Handbook for Systematic Reviews of Interventions and the ... ...

Abstract	This meta-analysis was conducted to provide updated evidence regarding perioperative safety and efficacy, of IC and EC anastomosis in laparoscopic right colectomies. In this study, the Cochrane Handbook for Systematic Reviews of Interventions and the PRISMA guidelines were applied. The study protocol received a PROSPERO registration (CRD42020214596). A systematic literature search of the electronic scholar databases (Medline, Web of Science and Scopus) was performed. To reduce type I error, a trial sequential analysis (TSA) algorithm was introduced. The quality of evidence was evaluated based on the GRADE methodology. In total, 46 studies were included in this meta-analysis, Pooled comparisons and TSA confirmed that IC is superior in terms of incisional hernia (0.29; 95%CI: 0.19, 0.44), open conversion (0.45; 95%CI: 0.30, 0.67), reoperation (0.62; 95%CI: 0.46, 0.84]), LOS (- 0.76; 95%CI: - 1.03, - 0.49), blood loss (- 11.50; 95%CI: - 18.42, - 4.58), and cosmesis (- 1.71; 95%CI: - 2.01, - 1.42). Postoperative pain and return of bowel function were, also, shortened when the anastomosis was fashioned intracorporeally. The grading of most evidence ranged from 'low' to 'high'. Due to the discrepancy in the results of RCTs and non-RCTs, and the proportionally smaller sample size of the former, further randomized trials are required to increase the evidence of this comparison.
MeSH term(s)	Humans ; Laparoscopy/methods ; Colectomy/methods ; Anastomosis, Surgical/methods ; Incisional Hernia ; Pain, Postoperative ; Treatment Outcome
Language	English
Publishing date	2024-01-12
Publishing country	Italy
Document type	Meta-Analysis ; Journal Article ; Review
ZDB-ID	2572692-4
ISSN	2038-3312 ; 2038-131X
ISSN (online)	2038-3312
ISSN	2038-131X
DOI	10.1007/s13304-023-01737-8
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Article: Billroth II anastomosis combined with brown anastomosis reduce reflux gastritis in gastric cancer patients.

Christodoulidis, Grigorios / Kouliou, Marina Nektaria / Koumarelas, Konstantinos Eleftherios / Argyriou, Konstantinos / Karali, Garyfallia Apostolia / Tepetes, Konstantinos

World journal of methodology

2024 Volume 14, Issue 1, Page(s) 89709

Abstract: Background: The surgeon performing a distal gastrectomy, has an arsenal of reconstruction techniques at his disposal, Billroth II among them. Braun anastomosis performed during a Billroth II procedure has shown evidence of superiority over typical ... ...

Abstract	Background: The surgeon performing a distal gastrectomy, has an arsenal of reconstruction techniques at his disposal, Billroth II among them. Braun anastomosis performed during a Billroth II procedure has shown evidence of superiority over typical Billroth II, in terms of survival, with no impact on postoperative morbidity and mortality. Aim: To compare Billroth II Methods: Patients who underwent distal gastrectomy during 2002-2021, were separated into two groups, depending on the surgical technique used (Billroth II: 74 patients and Billroth II and Braun: 28 patients). The daily output of the nasogastric tube (NGT), the postoperative day that NGT was removed and the day the patient started per os feeding were recorded. Postoperative complications were at the same time noted. Data were then statistically analyzed. Results: There was difference in the mean NGT removal day and the mean start feeding day. Mean total postoperative NGT output was lower in Braun group (399.17 mL Conclusion: There was evidence of superiority of Billroth II and Braun
Language	English
Publishing date	2024-03-20
Publishing country	United States
Document type	Journal Article
ISSN	2222-0682
ISSN	2222-0682
DOI	10.5662/wjm.v14.i1.89709
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Article ; Online: Systemic immune response after open tension-free inguinal hernia repair under different anesthetic alternatives: a prospective comparative study.

Symeonidis, D / Diamantis, A / Baloyiannis, I / Tzovaras, G / Tepetes, K

Il Giornale di chirurgia

2020 Volume 41, Issue 1, Page(s) 103–109

Abstract: Purpose: The purpose of the present study was a comparison of the systemic inflammatory response intensity through the estimation of C- reactive protein and albumin levels before and after open tension free inguinal hernia repair performed under ... ...

Abstract	Purpose: The purpose of the present study was a comparison of the systemic inflammatory response intensity through the estimation of C- reactive protein and albumin levels before and after open tension free inguinal hernia repair performed under different anesthetic alternatives. Patients and methods: Totally, 125 inguinal hernia patients scheduled for unilateral primary open tension free inguinal repair unRomader local (50 patients), spinal (50 patients) and general anesthesia (25 patients) have been included in this prospective study. Results: The group of local anesthesia was associated with the higher postoperative serum levels of albumin compared to the group of general anesthesia (P 0.013). Local anesthesia was also associated with higher postoperative serum albumin levels compared to regional anesthesia but however the difference was not statistically significant (P 0.282). The group of local anesthesia was also associated with the lower postoperative levels of CRP compared to the regional (P 0.0094) and general anesthesia (P 0.0009) groups. Conclusion: Local anesthesia proved superior to regional or general anesthesia for open tension free inguinal hernia repair in the given patient sample from the standpoint of the inflammatory and acute phase response.
MeSH term(s)	Anesthesia/methods ; Anesthesia, General ; Anesthesia, Local ; Anesthesia, Spinal ; C-Reactive Protein/analysis ; Hernia, Inguinal/blood ; Hernia, Inguinal/immunology ; Hernia, Inguinal/surgery ; Herniorrhaphy/methods ; Herniorrhaphy/statistics & numerical data ; Humans ; Prospective Studies ; Serum Albumin/analysis ; Systemic Inflammatory Response Syndrome/immunology
Chemical Substances	Serum Albumin ; C-Reactive Protein (9007-41-4)
Language	English
Publishing date	2020-02-10
Publishing country	Italy
Document type	Comparative Study ; Journal Article
ZDB-ID	605974-0
ISSN	1971-145X ; 0391-9005
ISSN (online)	1971-145X
ISSN	0391-9005
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Article: BILE: A Literature Review Based Novel Clinical Classification and Treatment Algorithm of Iatrogenic Bile Duct Injuries.

Symeonidis, Dimitrios / Tepetes, Konstantinos / Tzovaras, George / Samara, Athina A / Zacharoulis, Dimitrios

Journal of clinical medicine

2023 Volume 12, Issue 11

Abstract: Purposes: The management of patients with iatrogenic bile duct injuries (IBDI) is a challenging field, often with dismal medico legal projections. Attempts to classify IBDI have been made repeatedly and the final results were either analytical and ... ...

Abstract	Purposes: The management of patients with iatrogenic bile duct injuries (IBDI) is a challenging field, often with dismal medico legal projections. Attempts to classify IBDI have been made repeatedly and the final results were either analytical and extensive but not useful in everyday clinical practice systems, or simple and user friendly but with limited clinical correspondence approaches. The purpose of the present review is to propose a novel, clinical classification system of IBDI by reviewing the relevant literature. Methods: A systematic literature review was conducted by performing bibliographic searches in the available electronic databases, including PubMed, Scopus, and the Cochrane Library. Results: Based on the literature results, we propose a five (5) stage (A, B, C, D and E) classification system for IBDI (BILE Classification). Each stage is correlated with the recommended and most appropriate treatment. Although the proposed classification scheme is clinically oriented, the anatomical correspondence of each IBDI stage has been incorporated as well, using the Strasberg classification. Conclusions: BILE classification represents a novel, simple, and dynamic in nature classification system of IBDI. The proposed classification focuses on the clinical consequences of IBDI and provides an action map that can appropriately guide the treatment plan.
Language	English
Publishing date	2023-05-31
Publishing country	Switzerland
Document type	Journal Article ; Review
ZDB-ID	2662592-1
ISSN	2077-0383
ISSN	2077-0383
DOI	10.3390/jcm12113786
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Article: Techniques and Current Role of Sentinel Lymph Node (SLN) Concept in Gastric Cancer Surgery.

Symeonidis, Dimitrios / Tepetes, Konstantinos

Frontiers in surgery

2019 Volume 5, Page(s) 77

Abstract: Gastric cancer patients represent a rather divergent patient group and in certain carefully selected cases of early forms of gastric cancer the D2 gastrectomy could be considered a more radical procedure than the biological and oncological ... ...

Abstract	Gastric cancer patients represent a rather divergent patient group and in certain carefully selected cases of early forms of gastric cancer the D2 gastrectomy could be considered a more radical procedure than the biological and oncological characteristics of the primary tumor on the gastric wall would require. As any unnecessary dissection increases morbidity without always respective survival benefits, an approach that could accurately predict and actually dictate the exact extent of lymph node dissection would be ideal. It is more than logical the assumption that the standard D2 lymphadenectomy could represent an overtreatment in distinct patients groups such as patients with early gastric cancer with favorable pathological characteristics and clinically negative nodes not suitable for endoscopic treatment because this early stage disease shows limited lymph node metastasis incidence and excellent overall survival. Considering that the D2 gastrectomy has a negative impact on the quality of life of gastric cancer patients due to the post-gastrectomy functional results, a concept of a more targeted lymph node dissection, when appropriate, is certainly appealing. It is yet to be proven whether sentinel lymph node navigation surgery can fulfill such expectations providing the appropriate balance between morbidity and oncological safety in selected gastric cancer patients.
Language	English
Publishing date	2019-01-22
Publishing country	Switzerland
Document type	Journal Article ; Review
ZDB-ID	2773823-1
ISSN	2296-875X
ISSN	2296-875X
DOI	10.3389/fsurg.2018.00077
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Article: From Classic Whipple to Pylorus Preserving Pancreaticoduodenectomy and Ultimately to Pylorus Resecting - Stomach Preserving Pancreaticoduodenectomy: A Review.

Symeonidis, Dimitrios / Zacharoulis, Dimitrios / Kissa, Labrini / Samara, Athina A / Petsa, Eleana / Tepetes, Konstantinos

Chirurgia (Bucharest, Romania : 1990)

2023 Volume 118, Issue 4, Page(s) 335–347

Abstract: Pancreaticoduodenectomy is the procedure of choice for benign or malignant tumors of the periampullary region. The preservation of the pylorus has been established as the mostly utilized approach during pancreaticoduodenectomy among the majority of ... ...

Abstract	Pancreaticoduodenectomy is the procedure of choice for benign or malignant tumors of the periampullary region. The preservation of the pylorus has been established as the mostly utilized approach during pancreaticoduodenectomy among the majority of specialized, in the surgical treatment of pancreatic cancer, centers worldwide. The factors that influenced this predilection are the shorter operation times, the less intraoperative blood loss, the decreased technical difficulty, and the quite similar short- and long-term outcomes compared to the classic Whipple. However, there is a notable trend in the literature highlighting the increased incidence of delayed gastric emptying following pylorus preserving pancreaticoduodenectomy. Among other factors, pylorus dysfunction attributable to the surgical maneuvers has been implemented in the etiology of this complication. In an attempt to overcome this limitation of the pylorus preserving pancreaticoduodenectomy, pylorus resecting pancreaticoduodenectomy with the preservation of the stomach was proposed. In theory, pylorus resecting pancreaticoduodenectomy could maintain the advantages of organ sparing surgery, but at the same time guarantee a more seamless gastric emptying. Only three RCTs, to date, aimed to evaluate the approach with only one reporting results in favor of the pylorus resecting pancreaticoduodenectomy in regard to the incidence of delayed gastric emptying. Further well-designed prospective randomized studies are needed for an accurate assessment of the true role of each of these surgical alternatives on the treatment of pancreatic cancer.
MeSH term(s)	Humans ; Pancreaticoduodenectomy ; Pylorus/surgery ; Gastroparesis/etiology ; Gastroparesis/prevention & control ; Prospective Studies ; Treatment Outcome ; Pancreatic Neoplasms/surgery ; Pancreatic Neoplasms
Language	English
Publishing date	2023-09-12
Publishing country	Romania
Document type	Review ; Journal Article
ZDB-ID	419244-8
ISSN	1842-368X ; 1221-9118 ; 0009-4730 ; 0377-5003
ISSN (online)	1842-368X
ISSN	1221-9118 ; 0009-4730 ; 0377-5003
DOI	10.21614/chirurgia.2023.v.118.i.4.p.335
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Article ; Online: Comparison of Selected Older and Younger Patients Regarding Optimal Surgical Treatment of Colorectal Cancer: A Prospective Cohort Study.

Aggelakopoulou, Chrysa / Perivoliotis, Konstantinos / Stergiannis, Pantelis / Intas, George / Mouzakis, George / Tepetes, Konstantinos

Cancer diagnosis & prognosis

2023 Volume 3, Issue 4, Page(s) 504–513

Abstract: Background/aim: Current evidence regarding the optimal management of older colorectal cancer patients, is conflicting. Functional deficits impact long-term survival prognosis, while frailty often results to optimal treatment postponement. Thus, the ... ...

Abstract	Background/aim: Current evidence regarding the optimal management of older colorectal cancer patients, is conflicting. Functional deficits impact long-term survival prognosis, while frailty often results to optimal treatment postponement. Thus, the characteristics of this subgroup combined with treatment deviations further perplex optimal oncological management. The study aim was to compare survival and optimal surgery rates between older and younger colorectal cancer patients. Patients and methods: This study was designed as a prospective cohort. All adult (³18 years) colorectal cancer patients operated, during the 2016-2020 period, in the Department of Surgery, University Hospital of Larissa, were considered as eligible. The primary endpoint of the study was the difference in terms of the overall survival between older (>70 year) and younger (<70 years) colorectal cancer patients. Results: Overall, 166 patients (60 younger and 106 older) were enrolled. Although the older subgroup displayed a higher rate (p=0.007) of ASA II and ASA III patients, mean CCI scores were comparable (p=0.384). The two subgroups were similar in terms of performed operations (p=0.140). No delay in surgery was noted. Most operations were performed using an open approach (open: 57.8% vs. laparoscopic: 42.2%), under an elective status (elective: 91% vs. emergency: 1.8%). There was no difference in terms of overall complications rate (p=0.859). Overall survival was similar (p=0.227) between the older and younger subgroups (25.68 vs. 28.48 months). Conclusion: Older operated patients did not differ from their younger counterparts with regard to their overall survival. Due to several study limitations, further trials are required to confirm these findings.
Language	English
Publishing date	2023-07-03
Publishing country	Greece
Document type	Journal Article
ISSN	2732-7787
ISSN (online)	2732-7787
DOI	10.21873/cdp.10247
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Article: Central Pancreatectomy: Balancing between the Favorable Functional Results and the Increased Associated Morbidity.

Symeonidis, Dimitrios / Paraskeva, Ismini / Samara, Athina A / Kissa, Labrini / Valaroutsos, Alexandros / Petsa, Eleana / Tepetes, Konstantinos

Surgery journal (New York, N.Y.)

2024 Volume 10, Issue 1, Page(s) e20–e24

Abstract: ... ...

Abstract	Introduction
Language	English
Publishing date	2024-03-14
Publishing country	United States
Document type	Case Reports
ZDB-ID	2864275-2
ISSN	2378-5136 ; 2378-5128
ISSN (online)	2378-5136
ISSN	2378-5128
DOI	10.1055/s-0044-1782655
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Article ; Online: Microvessel Density (MVD) in Patients with Osteosarcoma: A Systematic Review and Meta-Analysis.

Perivoliotis, Konstantinos / Ntellas, Panagiotis / Dadouli, Katerina / Samara, Athina A / Sotiriou, Sotirios / Ioannou, Maria / Tepetes, Konstantinos

Cancer investigation

2024 Volume 42, Issue 1, Page(s) 104–114

Abstract: A meta-analysis was designed and conducted to estimate the effect of tumoral microvessel density (MVD) on the survival of patients with osteosarcoma. There was no difference between high and low MVD regarding the overall (OS) and disease-free (DFS) ... ...

Abstract	A meta-analysis was designed and conducted to estimate the effect of tumoral microvessel density (MVD) on the survival of patients with osteosarcoma. There was no difference between high and low MVD regarding the overall (OS) and disease-free (DFS) survival. Low MVD tumors displayed a lower DFS at the third year of follow-up. Although primary metastases did not affect the mean MVD measurements, tumors with a good chemotherapy response had a higher MVD value. Although no significant differences between tumoral MVD, OS and DFS were found, good adjuvant therapy responders had a significant higher vascularization pattern.
MeSH term(s)	Humans ; Microvascular Density ; Osteosarcoma/drug therapy ; Neovascularization, Pathologic ; Combined Modality Therapy ; Bone Neoplasms/therapy ; Prognosis ; Disease-Free Survival
Language	English
Publishing date	2024-02-12
Publishing country	England
Document type	Meta-Analysis ; Systematic Review ; Journal Article ; Review
ZDB-ID	604942-4
ISSN	1532-4192 ; 0735-7907
ISSN (online)	1532-4192
ISSN	0735-7907
DOI	10.1080/07357907.2024.2311266
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Article ; Online: Comparison of ointment-based agents after excisional procedures for hemorrhoidal disease: a network meta-analysis of randomized controlled trials.

Perivoliotis, Konstantinos / Chatzinikolaou, Charito / Symeonidis, Dimitrios / Tepetes, Konstantinos / Baloyiannis, Ioannis / Tzovaras, George

Langenbeck's archives of surgery

2023 Volume 408, Issue 1, Page(s) 401

Abstract: Introduction: Efficient postoperative pain control is important after hemorrhoidal surgery. Although several locally applied medications have been used, current evidence regarding the optimal strategy is still conflicting. This network meta-analysis ... ...

Abstract	Introduction: Efficient postoperative pain control is important after hemorrhoidal surgery. Although several locally applied medications have been used, current evidence regarding the optimal strategy is still conflicting. This network meta-analysis assessed analgesic efficacy and safety of the various topical medications in patients submitted to excisional procedures for hemorrhoids. Methods: The present study followed the Cochrane Handbook for Systematic Reviews of Interventions and the PRISMA guidelines. The last systematic literature screening was performed at 15 June 2023. Comparisons were based on a random effects multivariate network meta-analysis under a Bayesian framework. Results: Overall, 26 RCTs and 2132 patients were included. Regarding postoperative pain, EMLA cream (surface under the cumulative ranking curve (SUCRA) 80.3%) had the highest ranking at 12-h endpoint, while aloe vera cream (SUCRA 82.36%) scored first at 24 h. Metronidazole ointments had the highest scores at 7 and 14 days postoperatively. Aloe vera had the best analgesic profile (24-h SUCRA 84.8% and 48-h SUCRA 80.6%) during defecation. Lidocaine (SUCRA 87.9%) displayed the best performance regarding overall morbidity rates. Conclusions: Due to the inconclusive results and several study limitations, further RCTs are required.
MeSH term(s)	Humans ; Hemorrhoids/surgery ; Ointments/therapeutic use ; Network Meta-Analysis ; Bayes Theorem ; Randomized Controlled Trials as Topic ; Pain, Postoperative ; Analgesics/therapeutic use
Chemical Substances	Ointments ; Analgesics
Language	English
Publishing date	2023-10-14
Publishing country	Germany
Document type	Meta-Analysis ; Journal Article
ZDB-ID	1423681-3
ISSN	1435-2451 ; 1435-2443
ISSN (online)	1435-2451
ISSN	1435-2443
DOI	10.1007/s00423-023-03128-4
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