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Isoperistaltic vs antiperistaltic anastomosis after right hemicolectomy:A comprehensive review

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World Journal of Clinical Cases 2023年第8期11卷 1694-1701页

作者： dimitrios Symeonidis Kostas-Sotirios Karakantas Labrini Kissa Athina A Samara Effrosyni Bompou Konstantinos Tepetes Georgios tzovaras Department of Surgery University Hospital of LarissaLarissa 41110Greece

To optimize the efficiency of ileocolic anastomosis following right hemicolectomy,several variations of the surgical technique have been *** include performing the anastomosis intra-or extracorporeally or performing a stapled or hand-sewn *** the least studied is the configuration of the two stumps(i.e.,isoperistaltic or antiperistaltic)in the case of a side-to-side *** purpose of the present study is to compare the isoperistaltic and antiperistaltic side-to-side anastomotic configuration after right hemicolectomy by reviewing the relevant ***-quality literature is scarce,with only three studies directly comparing the two alternatives,and no study has revealed any significant differences in the incidence of anastomosis-related complications such as leakage,stenosis,or ***,there may be a trend towards an earlier recovery of intestinal function following antiperistaltic ***,existing data do not identify a certain anastomotic configuration(i.e.,isoperistaltic or antiperistaltic)as superior over the ***,the most appropriate approach is to master both anastomotic techniques and select between the two configurations based on each individual case scenario.

关键词： Isoperistaltic side-to-side anastomosis Antiperistaltic side-to-side anastomosis Ileocolic anastomosis Right hemicolectomy Scenario

Topographic and climatic effects on Pinus halepensis s.l. growth at its drought tolerance margins under climatic change

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Journal of Forestry Research 2024年第6期35卷 29-48页

作者： dimitrios Sarris dimitrios Christodoulakis KES Research Centre 1055 NicosiaCyprus KES College 1055 NicosiaCyprus Department of Biology University of Patras26500 PatrasGreece

Under global warming,drought will reduce productivity of Pinus halepensis s.l.(subspecies halepensis and brutia)and cause a retreat from its rear edge distribu-tion(latitudinal/elevational)in the *** test whether topography can influence this scenario,we studied for approximately 40 years the growth of six natural pine stands in water-limited habitats on the islands of Zakinthos and Samos(eastern Mediterranean Greece),and determined the critical moisture sources that drove pine ***-nant pines were selected with no permanent water sources under contrasting moisture conditions created by topogra-phy(“wet”-gulley/valley vs.“dry”-upslope habitats).The responses of *** *** drought under a moderate and a worst case scenario were tested,projected under global warming(approx.-25%and 40%in annual precipitation compared to 1961–1990 average).Our results show that“wet”habitat pines had higher productivity under normal to wet ***,the more precipitation declined,“wet”habitat tree growth was reduced at a significantly faster rate,but also showed a faster recovery,once rainfall ***,Pinus halepensis *** in gullies/valleys,may be more drought resilient and less likely to retreat towards higher elevation/latitudes under global warm-ing,compared to pines on dry upslope *** moderate drought,both ecosystems relied on deeper moisture pools supplied by rainfall of the previous 3–6 years(including the year of growth).However,valley/gully habitat pines on significantly deeper soils(and probably on deeper heavily weathered bedrock),appeared to utilize surface moisture from winter/spring rainfall more efficiently for survival and ***,deep soils may provide the key“buffer”for pine survival in such ecosystems that could act as potential refugia for *** *** climate change.

关键词： Tree rings Refugia Rooting depth Soil depth Mediterranean

Carcinosarcoma of the breast:Facing the challenge of a rare nosologic entity

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World Journal of Clinical Cases 2025年第2期13卷 14-20页

作者： Aikaterini Mastoraki Maria Tsamopoulou Foivos-Konstantinos Stamatis Alexios Strimpakos Ero Mouchtouri Christiana Panagi Evgenia Mela Sotiria Mastoraki Aristotelis Kechagias dimitrios Schizas Department of Surgery National and Kapodistrian University of AthensLaikon General HospitalAthens 11527Greece Department of Surgery National and Kapodistrian University of AthensAthens 11527Greece Department of Medical Oncology Hygeia HospitalAthens 15123Greece Department of Radiology Henry Dunant Hospital CenterAthens 11526Greece Department of Surgery Athens Metropolitan HospitalAthens 15562Greece

Carcinosarcoma(CS),also known as metaplastic breast carcinoma with mesenchymal differentiation,is one of the five distinct subtypes of metaplastic breast *** is considered as a mixed,biphasic neoplasm consisting of a carcinomatous component combined with a malignant nonepithelial element of mesenchymal origin without an intermediate transition *** cellular origin of this neoplasm remains controversial,most researchers declare that neoplastic cells derive from a cellular structure with potential biphasic *** recent research on the therapeutic strategies against CS neoplastic disorders,surgical resection appears the only potentially curative *** CS metastasize by the lymphatic route,axillary assessment with sentinel lymph node biopsy and/or axillary lymph node dissection is always ***,the tumor also presents a hematogenous metastatic pattern including pleural,pulmonary,liver,brain and less commonly bone ***,surgical removal of breast CS does not necessarily ensure patient’s long-term ***,alternative therapies,such as radio-and chemotherapy proved insufficient and 5-year survival rate is ***,there is evidence that following surgery,the combination of radio and chemotherapy is associated with a better prognosis than either treatment *** aim of this review is to evaluate the results of surgical treatment for breast CS with special reference to the extent of its histological *** features,histogenesis,morphological and immunochemical findings are discussed,while the role of current diagnostic and therapeutic management of this aggressive neoplasm is emphasized.

关键词： Carcinosarcoma Breast Diagnostic approach Therapeutic management Prognostic parameters

Smoothing Non-Stationary Time Series Using the Discrete Cosine Transform

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Journal of Systems Science & Complexity 2016年第2期29卷 382-404页

作者： THOMAKOS dimitrios Department of Economics University of PeloponneseGreece22100 & Rimini Center for Economic Analysis

This paper considers the problem of smoothing a non-stationary time series(having either deterministic and/or stochastic trends) using the discrete cosine transform(DCT).The DCT is a powerful tool which has found fruitful applications in filtering and smoothing as it can closely approximate the optimal Karhunen-Loeve transform(KLT).In fact,it is known that it almost corresponds to the KLT for first-order autoregressive processes with a root close to unity:This is the case with most economic and financial time series.A number of new results are derived in the paper:(a) The explicit form of the linear smoother based on the DCT,which is found to have time-varying weights and that uses all observations;(b) the extrapolation of the DCT-smoothed series;(c) the form of the average frequency response function,which is shown to approximate the frequency response of the ideal low pass filter;(d) the asymptotic distribution of the DCT coefficients under the assumptions of deterministic or stochastic trends;(e) two news method for selecting an appropriate degree of smoothing,in general and under the assumptions in(d).These findings are applied and illustrated using several real world economic and financial time *** results indicate that the DCT-based smoother that is proposed can find many useful applications in economic and financial time series.

关键词： Discrete cosine transform non-stationary time series order selection singular spectrumanalysis smoothing trend extraction unit root.

Pancreatic duct guidewire placement for biliary cannulation in a single-session therapeutic ERCP

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World Journal of Gastroenterology 2011年第15期17卷 1989-1995页

作者： dimitrios Xinopoulos Stefanos P Bassioukas dimitrios Kypreos dimitrios Korkolis Andreas Scorilas Konstantinos Mavridis dimitrios Dimitroulopoulos Emmanouil Paraskevas Gastroenterology Unit Hellenic Anticancer Institute "Saint Savvas"Hospital of Athens 171 Alexandras Avenue GR 11522 Greece First Surgical Department Hellenic Antican-cer Institute "Saint Savvas" Hospital of Athens 171 AlexandrasAvenue GR 11522 Greece Department of Biochemistry and Molecular Biology University of Athens University Campus Ilissia GR 15701 Greece

AIM: To investigate the technical success and clinical complication rate of a cannulated pancreatic duct with guidewire for biliary access. METHODS: During a five-year study period, a total of 2843 patients were included in this retrospective analysis. Initial biliary cannulation method consisted of single-guidewire technique (SGT) for up to 5 attempts, followed by double-guidewire technique (DGT) when repeated unintentional pancreatic duct cannulation had taken place. Pre-cut papillotomy technique was reserved for when DGT had failed or no pancreatic duct cannulation had been previously achieved. Main outcome measurements were defined as biliary cannu-lation success and post-endoscopic retrograde cholangiopancreatography (ERCP) complication rate. RESULTS: SGT (92.3% success rate) was characterized by statistically significant enhanced patient outcome compared to either the DGT (43.8%, P < 0.001), pre-cut failed DGT (73%, P < 0.001) or pre-cut as first step method (80.6%, P = 0.002). Pre-cut as first step method offered a statistically significantly more favorable outcome compared to the DGT (P < 0.001). The incidence of post-ERCP pancreatitis did not differ in a statistically significant manner between either method (SGT: 5.3%, DGT: 6.1%, Pre-cut failed DGT: 7.9%, Pre-cut as first step: 7.5%) or with patients' gender. CONCLUSION: Although DGT success rate proved not to be superior to SGT or pre-cut papillotomy, it is considered highly satisfactory in terms of safety in order to avoid the risk of a pre-cut when biliary therapy is necessary in difficult-to-cannulate cases.

关键词： Endoscopic retrograde cholangiopancreatography Post-endoscopic retrograde cholangiopancreatography pancreatitis Pre-cut papillotomy Pancreatic duct

Timing of laparoscopic cholecystectomy for acute cholecystitis: A prospective non randomized study

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World Journal of Gastroenterology 2006年第34期12卷 5528-5531页

作者： George tzovaras Dimitris Zacharoulis Paraskevi Liakou Theodoros Theodoropoulos George Paroutoglou Constantine Hatzitheofilou Department of Surgery University of Thessaly School of Medicine University Hospital of Larissa Larissa 41335 Greece Department of Gastroenterology University Hospital of Larissa Larissa 41335 Greece

AIM： To study the timing of laparoscopic cholecystectomy for patients with acute cholecystitis. METHODS： Between January 2002 and December 2005, all American Society of Anesthesiologists classification （ASA） Ⅰ ,Ⅱ and Ⅲ patients with acute cholecystitis were treated laparoscopically during the urgent （index） admission. The patients were divided into three groups according to the timing of surgery：（1） within the first 3 d, （2） between 4 and 7 d and （3） beyond 7 d from the onset of symptoms. The impact of timing on the conversion rate, morbidity and postoperative hospital stay was studied. RESULTS： One hundred and twenty-nine patients underwent laparoscopic cholecystectomy for acute cholecystitis during the index admission. Thirty six were assigned to group 1, 58 to group 2, and 35 to group 3. The conversion rate and morbidity for the whole cohort of patients were 4.6% and 10.8%, respectively. There was no significant difference in the conversion rate, morbidity and postoperative hospital stay between the three groups.CONCLUSION： Laparoscopic cholecystectomy for acute cholecystitis during the index admission is safe, regardless of the time elapsed from the onset of symptoms. This policy can result in an overall shorter hospitalization.

关键词： Acute cholecystitis Laparoscopic cholecy stectomy Timing

Next-generation surgicalmeshes for drug delivery and tissue engineering applications:materials,design and emerging manufacturing technologies

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Bio-Design and Manufacturing 2021年第2期4卷 278-310页

作者： Francesca Corduas dimitrios A.Lamprou Elena Mancuso Nanotechnology and Integrated Bio-Engineering Centre(NIBEC) Ulster UniversityJordanstown CampusNewtownabbey BT370QBUK School of Pharmacy Queen’s University BelfastBelfast BT97BLUK

Surgical meshes have been employed in the management of a variety of pathological conditions including hernia,pelvic floor dysfunctions,periodontal guided bone regeneration,wound healing and more recently for breast plastic surgery after *** common pathologies affect a wide portion of the worldwide population;therefore,an effective and enhanced treatment is crucial to ameliorate patients’living conditions both from medical and aesthetic points of *** present,non-absorbable synthetic polymers are the most widely used class of biomaterials for the manufacturing of mesh implants for hernia,pelvic floor dysfunctions and guided bone regeneration,with polypropylene and poly tetrafluoroethylene being the most *** prostheses,such as surgical grafts,have been employed mainly for breast plastic surgery and wound healing *** the advantages of mesh implants to the treatment of these conditions,there are still many drawbacks,mainly related to the arising of a huge number of post-operative complications,among which infections are the most *** a mesh that could appropriately integrate with the native tissue,promote its healing and constructive remodelling,is the key aim of ongoing research in the area of surgical mesh *** this end,the adoption of new biomaterials including absorbable and natural polymers,the use of drugs and advanced manufacturing technologies,such as 3D printing and electrospinning,are under investigation to address the previously mentioned challenges and improve the outcomes of future clinical *** aim of this work is to review the key advantages and disadvantages related to the use of surgical meshes,the main issues characterizing each clinical procedure and the future directions in terms of both novel manufacturing technologies and latest regulatory considerations.

关键词： 3D printing Electrospinning Manufacturing technologies Biomaterials Drug delivery Surgical mesh implants

Gastrointestinal stromal tumor causing small bowel intussusception in a patient with Crohn’s disease

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World Journal of Gastroenterology 2009年第41期15卷 5224-5227页

作者： George E Theodoropoulos dimitrios Linardoutsos dimitrios Tsamis Paraskevas Stamopoulos dimitrios Giannopoulos Flora Zagouri Nikolaos V Michalopoulos First Department of Propaedeutic Surgery Hippocration University Hospital Department of Pathology Hippocration University Hospital Department of Clinical Therapeutics Alexandra Hospital

We report a case of jejunoileal intussusception in a 42-year-old patient with Crohn's disease caused by a gastrointestinal stromal tumor. The patient complained of vague diffuse abdominal pain for a period of 4 mo. Intussusception was suspected at computer tomography and magnetic resonance imaging scans. Segmental resection of the small intestine was performed. Pathological examination of the surgical specimen revealed a gastrointestinal stromal tumor as well as aphthous ulcerations and areas of inflammation, which were characteristic of Crohn's disease. This is the f irst report of small bowel intussusception due to a gastrointestinal stromal tumor coexisting with Crohn's disease.

关键词： Gastrointestinal stromal tumor Crohn's disease Intussusception

Role of surgery in colorectal liver metastases:Too early or too late?

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World Journal of Gastroenterology 2010年第28期16卷 3484-3490页

作者： dimitrios Dimitroulis Nikolaos Nikiteas Theodore Troupis dimitrios Patsouras Panayiotis Skandalakis Gregory Kouraklis Second Department of Propaedeutic Surgery School of MedicineUniversity of Athens"LAIKON" University Hospital14 Ag.Thoma Street11527 AthensGreece Department of Surgery and Transplantation 4 Sakelariou Street17455 AlimosAthensGreece Department of Anatomy School of MedicineUniversity of Athens75 Mikras Asias Street11527 AthensGreece

As colorectal cancer and colorectal liver metastases become a serious public health problem,new treatment modalities are needed in order to achieve better results. In the last decade there has been very important progress in oncology,with new and more effective chemotherapeutic agents administered alone or in combination improving the resectability rate in up to 40%of patients with colorectal liver *** in interventional radiology,in particular,with the use of portal vein embolization and radiofrequency thermal ablation are new strategies allowing major liver resections and treatment of small liver metastases or early ***,however,remains the gold standard strategy with intention to *** this review article we will describe the advanced role of surgery in the multidisciplinary approach to colorectal liver metastases,and the clinical problems the liver surgeon has to deal with,such as theresectability of the metastases,the presence of bilobar liver lesions and extrahepatic disease,the impact of chemotherapy in already resectable liver metastases,the problem of vanishing metastases after chemotherapy and the dilemma of staged or combined liver and colon operations and which organ first in the clinical scenario of synchronous colorectal liver metastases.

关键词： Metastases Liver metastases Colorectal cancer Surgery