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Minimally invasive pelvic exenteration for primary or recurrent locally advanced rectal cancer:A glimpse into the future

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World Journal of Gastrointestinal Surgery 2024年第7期16卷 1960-1964页

作者： Dimitrios Kehagias Charalampos Lampropoulos ioannis Kehagias Department of General Surgery General University Hospital of PatrasPatras 26504Greece Intensive Care Unit Saint Andrew’s General HospitalPatras 26335Greece Division of Bariatric and Metabolic Surgery Department of SurgeryUniversity of PatrasPatras 26504Greece

Surgeons have grappled with the treatment of recurrent and T4b locally advanced rectal cancer(LARC)for many *** main objectives are to increase the overall survival and quality of life of the patients and to mitigate postoperative ***,pelvic exenteration(PE)with or without neoadjuvant treatment is a curative treatment when negative resection margins are *** traditional open approach has been favored by many ***,the technological advancements in minimally invasive surgery have radically changed the surgical *** studies have demonstrated promising results in postoperative complications and oncological outcomes after robotic or laparoscopic PE.A recent retrospective study entitled“Feasibility and safety of minimally invasive multivisceral resection for T4b rectal cancer:A 9-year review”was published in the World Journal of Gastrointestinal *** we read this article with great interest,we decided to delve into the latest data regarding the benefits and risks of minimally invasive PE for ***,the small number of suitable patients,limited surgeon experience,and steep learning curve are hindering the establishment of minimally invasive PE.

关键词： Locally advanced rectal cancer Pelvic exenteration Multivisceral resection Minimally invasive surgical procedures Robotic surgical procedures

New trends in diagnosis and management of gallbladder carcinoma

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World Journal of Gastrointestinal Oncology 2024年第1期16卷 13-29页

作者： Efstathios T Pavlidis ioannis N Galanis Theodoros E Pavlidis ^(nd)Propedeutic Department of Surgery Hippokration General HospitalSchool of MedicineAristotle University of ThessalonikiThessaloniki 54642Greece

Gallbladder(GB)carcinoma,although relatively rare,is the most common biliary tree cholangiocarcinoma with aggressiveness and poor *** is closely associated with cholelithiasis and long-standing large(>3 cm)gallstones in up to 90%of *** other main predisposing factors for GB carcinoma include molecular factors such as mutated genes,GB wall calcification(porcelain)or mainly mucosal microcalcifications,and GB polyps≥1 cm in *** is made by ultrasound,computed tomography(CT),and,more precisely,magnetic resonance imaging(MRI).Preoperative staging is of great importance in decisionmaking regarding therapeutic *** staging is based on MRI findings,the leading technique for liver metastasis imaging,enhanced three-phase CT angiography,or magnetic resonance angiography for major vessel *** is also necessary to use positron emission tomography(PET)-CT or ^(18)F-FDG PET-MRI to more accurately detect metastases and any other occult deposits with active metabolic *** laparoscopy may detect dissemination not otherwise found in 20%-28.6%of *** treatment is needed,including surgical resection,targeted therapy by biological agents according to molecular testing gene mapping,chemotherapy,radiation therapy,and *** is of great importance to understand the updated guidelines and current treatment *** extent of surgical intervention depends on the disease stage,ranging from simple cholecystectomy(T1a)to extended resections and including extended cholecystectomy(T1b),with wide lymph node resection in every case or IV-V segmentectomy(T2),hepatic trisegmentectomy or major hepatectomy accompanied by hepaticojejunostomy Roux-Y,and adjacent organ resection if necessary(T3).Laparoscopic or robotic surgery shows fewer postoperative complications and equivalent oncological outcomes when compared to open surgery,but much attention must be paid to avoiding *** addition to surgery,novel targe

关键词： Biliary tract neoplasms Extrahepatic cholangiocarcinoma Gallbladder carcinoma Gallbladder diseases Biliary tree diseases Gastrointestinal malignancies

Current considerations on intraductal papillary neoplasms of the bile duct and pancreatic duct

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World Journal of Gastroenterology 2024年第10期30卷 1461-1465页

作者： Efstathios T Pavlidis ioannis N Galanis Theodoros E Pavlidis 2^(nd) Propedeutic Department of Surgery Hippokration General HospitalSchool of MedicineAristotle University of ThessalonikiThessaloniki 54642Greece

Pancreatobiliary intraductal papillary neoplasms(IPNs)represent precursors of pancreatic cancer or bile duct cholangiocarcinoma that can be detected and *** advances in diagnostic methods,identifying these premalignant lesions is still challenging for treatment *** imaging,biomarkers and molecular tests for genomic alterations can be used for diagnosis and *** intervention in combination with new chemotherapeutic agents is considered the optimal treatment for malignant *** balance between the risk of malignancy and any risk of resection guides management policy;therefore,treatment should be individualized based on a meticulous preoperative assessment of high-risk *** of the bile duct is more aggressive;thus,early diagnosis and surgery are *** conservative management of low-risk pancreatic branch-duct lesions is safe and effective.

关键词： Biliary tree diseases Pancreatic cystic neoplasms Biliary tract neoplasms Extrahepatic cholangiocarcinoma Pancreatic adenocarcinoma

Current considerations for the surgical management of gallbladder adenomas

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World Journal of Gastrointestinal Surgery 2024年第6期16卷 1507-1512页

作者： Efstathios T Pavlidis ioannis N Galanis Theodoros E Pavlidis The Second Department of Propaedeutic Surgery Hippokration General HospitalSchool of MedicineAristotle University of ThessalonikiThessaloniki 54642Greece

Gallbladder adenomas are rare lesions(0.5%)associated with potential malignant transformation,particularly with gallbladder adenomas that are≥1 cm in *** detection and management are crucial for preventing lethal carcinoma *** polyps can often be distinguished from the more often nonneo-plastic cholesterol pseudopolyps(5%-10%),which are *** is the first-line tool for initial diagnosis and follow-up when *** question is whether cholecystectomy is always necessary for all *** manage-ment of gallbladder adenomas is determined according to the size of the tumor,the growth rate of the tumor,the patient’s symptoms and whether risk factors for malignancy are ***≥1 cm in size,an age>50 years and a familial history of gallbladder carcinoma are indications for immediate laparoscopic ***,ultrasound follow-up is *** adenomas 6-9 mm in size,the absence of≥2 mm growth at 6 months,one year,and two years,as well as an adenoma sized<5 mm without existing risk factors indicates that no further surveillance is ***,it would be preferable to individualize the management in doubtful *** interventional modalities for preserving the gallbladder need further evaluation,especially to determine the long-term outcomes.

关键词： Biliary diseases True neoplastic polyps Gallbladder adenomas Benign bi-liary tumors Gallbladder polyps Extrahepatic biliary neoplasms

Slope stability of reclaimed coal mines through a new water filling index

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Journal of Rock Mechanics and Geotechnical Engineering 2024年第3期16卷 828-839页

作者： Antonios Mikroutsikos Alexandros I.Theocharis Nikolaos C.Koukouzas ioannis E.Zevgolis Chemical Process&Energy Resources Institute Centre for Research&Technology HellasAthensGreece School of Mining and Metallurgical Engineering National Technical University of AthensAthensGreece

A common reclamation practice for closed coal surface mines is filling them with water to form pit *** creation and sustainability of these lakes are significantly affected by the stability of the corresponding *** present study provides a general framework for analyzing the water filling’s effect on slope stability based on a new water filling index,which can indirectly consider the factors affecting the process and efficiently quantify the filling speed’s *** assumptions of the proposed approach are thoroughly discussed,and the range of the water filling index is ***,the safety factor is calculated using the finite element method with the shear strength reduction technique during the filling process for various conditions(soil properties,slope geometry,hydraulic conditions,and water filling speed).Results are presented as normalized stability charts for practical *** the water filling,the stability gradually decreases until the reservoir reaches a critical level of 10%e40%of the total height;it then increases to even more stable conditions than the initial ***,the present analysis allows for the preliminary stability evaluation of a coal mine during the formation of a pit lake and the appropriate quantification of the water filling’s effect.

关键词： Post-coal era Open-pit flooding Stability charts Critical level

Assistive techniques and their added value for tremor classification in multiple sclerosis

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Neural Regeneration Research 2024年第5期19卷 977-978页

作者： Nabin Koirala Abdulnasir Hossen ioannis U.Isaias Jens Volkmann Muthuraman Muthuraman Child Study Center School of MedicineYale UniversityNew HavenCTUSA Department of Electrical&Computer Engineering Sultan Qaboos UniversityAl-KhodMuscatOman Neural Engineering with Signal Analytics and Artificial Intelligence Department of NeurologyUniversity Hospital of WürzburgWürzburgGermany Centro Parkinson e Parkinsonism Azienda Socio Sanitaria Territoriale G.Pini-CTO20126 MilanItaly

Tremor occurs in about half of multiple sclerosis(MS)*** tremor has a broad frequency range of 2.5-7 Hz,with a higher prevalence of postural tremor(44%)compared to intentional tremor(6%)(Alusi et al.,2001).Tremor may affect the upper and lower extremities,head,and trunk,and may even affect the vocal cords in isolated cases of palatal *** tremor is classically attributed to lesions of the brain stem,cerebellum,or cerebellar peduncles,and tremor intensity has been shown to correlate with the number of lesions or their functional ***,recent work has demonstrated that inflammatory damage to the cerebello-thalamic and cortico-thalamic pathways might also play an important role in causing tremor,as it co-occurs with other signs and symptoms of MS such as dysarthria,dysmetria,dysdiadochokinesia,and dystonia(Alusi et al.,2001).

关键词： tremor sclerosis

Multifunctional HDPE/Cu biocidal nanocomposites for MEX additive manufactured parts: Perspectives for the defense industry

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Defence Technology（防务技术） 2024年第8期38卷 16-32页

作者： Nectarios Vidakis Nikolaos Michailidis Markos Petousis Nektarios K.Nasikas Vassilios Saltas Vassilis Papadakis Nikolaos Mountakis Apostolos Argyros Mariza Spiridaki ioannis Valsamos Department of Mechanical Engineering Hellenic Mediterranean UniversityHeraklion 71410Greece Physical Metallurgy Laboratory Mechanical Engineering DepartmentSchool of EngineeringAristotle University of ThessalonikiThessaloniki 54124Greece Centre for Research&Development of Advanced Materials(CERDAM) Center for Interdisciplinary Research and InnovationBalkan CentreThessaloniki 57001Greece Division of Mathematics and Engineering Sciences Department of Military SciencesHellenic Army AcademyVari GR16673AtticaGreece Department of Electronic Engineering Hellenic Mediterranean UniversityChania 73133Greece Department of Industrial Design and Production Engineering University of West AtticaAthens 12244Greece Institute of Electronic Structure and Laser Foundation for Research and Technology-HellasHeraklion 70013Greece

In this study, we investigated the performance improvement caused by the addition of copper(Cu)nanoparticles to high-density polyethylene(HDPE) matrix material. Composite materials, with filler percentages of 0.0, 2.0, 4.0, 6.0, 8.0, and 10.0 wt% were synthesized through the material extrusion(MEX)3D printing technique. The synthesized nanocomposite filaments were utilized for the manufacturing of specimens suitable for the experimental procedure that followed. Hence, we were able to systematically investigate their tensile, flexural, impact, and microhardness properties through various mechanical tests that were conducted according to the corresponding standards. Broadband Dielectric Spectroscopy was used to investigate the electrical/dielectric properties of the composites. Moreover, by employing means of Raman spectroscopy and thermogravimetric analysis(TGA) we were also able to further investigate their vibrational, structural, and thermal properties. Concomitantly, means of scanning electron microscopy(SEM), as well as atomic force microscopy(AFM), were used for the examination of the morphological and structural characteristics of the synthesized specimens, while energy-dispersive Xray spectroscopy(EDS) was also performed in order to receive a more detailed picture on the structural characteristics of the various synthesized composites. The corresponding nanomaterials were also assessed for their antibacterial properties regarding Staphylococcus aureus(S. aureus) and Escherichia coli(E. coli) with the assistance of a method named screening agar well diffusion. The results showed that the mechanical properties of HDPE benefited from the utilization of Cu as a filler, as they showed a notable improvement. The specimen of HDPE/Cu 4.0 wt% was the one that presented the highest levels of reinforcement in four out of the seven tested mechanical properties(for example, it exhibited a 36.7%improvement in the flexural strength, compared to the pure matrix). At the same

关键词： High-density polyethylene(HDPE) Copper(Cu) Material extrusion(MEX) Mechanical performance Electrical properties Antibacterial Defense and security

Effect of growth hormone on colonic anastomosis after intraperitoneal administration of 5-fluorouracil, bleomycin and cisplatin: An experimental study

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World Journal of Gastrointestinal Surgery 2024年第8期16卷 2679-2688页

作者： ioannis Lambrou ioannis Mantzoros Orestis Ioannidis Dimitrios Tatsis Elissavet Anestiadou Vasiliki Bisbinas Manousos-Georgios Pramateftakis Efstathios Kotidis Barbara Driagka Ourania Kerasidou Savvas Symeonidis Stefanos Bitsianis Freideriki Sifaki Konstantinos Angelopoulos Haralabos Demetriades Stamatios Angelopoulos Fourth Department of Surgery Medical SchoolAristotle University of ThessalonikiThessaloniki 57010Greece Department of ENT Royal Cornwall Hospitals NHS TrustCornwall TR13LJUnited Kingdom

BACKGROUND Growth hormone(GH)plays a crucial role in wound healing and tissue repair in postoperative *** particular,colonic anastomosis healing following colorectal surgery is impaired by numerous chemotherapy *** To investigate whether GH can improve the healing of a colonic anastomosis following the adverse effects of intraperitoneal administration of 5-fluorouracil(5-FU),bleomycin and *** Eighty Wistar rats underwent laparotomy and a 1 cm-resection of the transverse colon,followed by an end-to-end anastomosis under general *** rats were blindly allocated into four equal groups and administered a different daily intraperitoneal therapeutic regimen for 6 *** control group(A)received normal *** B received chemotherapy with 5-FU(20 mg/kg),bleomycin(4 mg/kg)and cisplatin(0.7 mg/kg).Group C received GH(2 mg/kg),and group D received the aforementioned combination chemotherapy and GH,as *** rats were sacrificed on the 7th postoperative day and the anastomoses were macroscopically and microscop-ically *** weight,bursting pressure,hydroxyproline levels and inflammation markers were *** All rats survived until the day of sacrifice,with no infections or other complications.A decrease in the body weight of group D rats was observed,not statistically significant compared to group A(P=1),but significantly different to groups C(P=0.001)and B(P<0.01).Anastomotic dehiscence rate was not statistically different between the *** pressure was not significantly different between groups A and D(P=1.0),whereas group B had a significantly lower bursting pressure compared to group D(P<0.001).All groups had significantly more adhesions than group ***,as a measurement of collagen deposition,was significantly higher in group D compared to group B(P<0.05),and higher,but not statistically significant,compared to group *** changes in group D were recorded,compared to group A

关键词： Growth hormone Colonic anastomosis Adhesion Bursting pressure Collagen Hydroxyproline Inflammation Neoangiogenesis Chemotherapy

Critical considerations for the management of acute abdomen in transplant patients

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World Journal of Transplantation 2024年第2期14卷 8-12页

作者： Efstathios T Pavlidis Georgios Katsanos Athanasios Kofinas Georgios Tsoulfas ioannis N Galanis Theodoros E Pavlidis The 2^(nd)Department of Propaedeutic Surgery Hippokration General HospitalSchool of MedicineAristotle University of ThessalonikiThessaloniki 54642Greece Department of Transplantation Surgery Center for Research and Innovation in Solid Organ TransplantationAristotle University of ThessalonikiSchool of MedicineThessaloniki 54642Greece

The number of solid organ transplantations performed annually is increasing and are increasing in the following order:Kidney,liver,heart,lung,pancreas,small bowel,and uterine ***,the outcomes of transplants are impro-ving(organ survival>90%after the 1st year).Therefore,there is a high probability that a general surgeon will be faced with the management of a transplant patient with acute *** problems in immunocompromised patients may not only include graft-related problems but also nongraft-related *** perioperative regulation of immunosuppression,the treatment of accompanying problems of immunosuppression,the administration of cortisol and,above all,the realization of a rapidly deteriorating situation and the accurate evaluation and interpretation of clinical manifestations are particularly important in these *** perioperative assessment and preparation includes evaluation of the patient’s cardiovascular system and determining if the patient has hypertension or suppression of the hypothalamic-pituitary-adrenal axis,or if the patient has had any coagulation mechanism abnormalities or thromboembolic *** in transplant patients is associated with the use of calci-neurin inhibitors,corticosteroids,and antiproliferation *** times,the clinical picture is atypical,resulting in delays in diagnosis and treatment and leading to increased morbidity and *** computed tomo-graphy is of utmost importance for early diagnosis and *** recipients are prone to infections,especially specific infections caused by cytomegalovirus and Clostridium difficile,and they are predisposed to intraop-erative or postoperative complications that require great care and *** is necessary to follow evidence-based therapeutic ***,it is required that the clinician choose the correct therapeutic plan for the patient(conservative,emergency open surgery or minimally invasive s

关键词： Acute abdomen Abdominal emergency surgery Transplantation Immunocompromised patients Immuno-suppression Posttransplantation surgery