检索结果-南通市图书馆

Atypical anastomotic malignancies of small bowel after subtotal gastrectomy with BillorthⅡgastroenterostomy for peptic ulcer:Report of three cases and review of the literature

引用

World Journal of Gastrointestinal Oncology 2018年第7期10卷 194-201页

作者： Efstathios Kotidis Orestis Ioannidis Manousos George Pramateftakis konstantinos Christou Ioannis Kanellos konstantinos tsalis Fourth Surgical Department Medical SchoolAristotle University of ThessalonikiThessaloniki 57010Greece

AIM To present patients who developed small-bowel malignancy at the level of the gastrointestinal anastomosis decades after a subtotal gastrectomy for ulcer,to review relevant literature,and to attempt to interpret the reasons those cancers developed to these postsurgical non-gastric sights.METHODS For the current retrospective study and review of literature,the surgical and histopathological records dated from January 1,1993 to December 31,2017 of our department were examined,searching for patients who have undergone surgical treatment of small-bowel malignancy to identify those who have undergone subtotal gastrectomy for benign peptic ulcer.A systematic literature search was also conducted using Pub Med,EMBASE,and Cochrane Library to identify similar cases.RESULTS We identified three patients who had developed smallintestine malignancy at the level of the gastrointestinal anastomosis decades after a subtotal gastrectomy with Billroth Ⅱ gastroenterostomy for benign peptic ulcertwo patients with adenocarcinoma originated in the Braun anastomosis and one patient with lymphoma of the efferent loop.All three patients were submitted to surgical resection of the tumor with Roux-en-Y reconstruction of the digestive tract.In the literature review,we only found one case of primary small-intestinal cancer that originated in the efferent loop after Billroth Ⅱ gastrectomy because of duodenal ulcer but none reporting Braun anastomosis adenocarcinoma following partial gastrectomy for benign disease.We also did not find any case of efferent loop lymphoma following gastrectomy.CONCLUSION Anastomotic gastric cancer following distal gastrectomy for peptic ulcer is a well-established clinical entity.However,malignancies of the afferent or efferent loop of the gastrointestinal anastomosis are extremely uncommon.The substantial diversion of the potent carcinogenic pancreaticobiliary secretions through the Braun anastomosis and the stomach hypochlorhydria,allowing the formation of carcinogenic factors from food,are the two most promi

关键词： Anastomotic cancer Efferent loop Braun anastomosis Adenocarcinoma Anaplastic large cell lymphoma

来源：

维普期刊数据库评论

在线全文

维普期刊数据库

学校读者我要写书评

暂无评论

Midgut neuroendocrine tumor presenting with acute intestinal ischemia

引用

World Journal of Gastroenterology 2017年第45期23卷 8090-8096页

作者： Ioannis Mantzoros Natalia Antigoni Savvala Orestis Ioannidis Styliani Parpoudi Lydia Loutzidou Despoina Kyriakidou Angeliki Cheva Vasileios Intzos konstantinos tsalis Fourth Surgical Department Faculty of Health ScienceSchool of MedicineAristotle Uni-versity of Thessaloniki“G.Papanikolaou”General Hospital Department of Pathology General Hospital“G.Papanikolaou” Department of Radiology General Hospital“G.Papanikolaou”

Neuroendocrine tumors represent a heterogeneous group of neoplasms that arise from neuroendocrine cells and secrete various peptides and bioamines. While gastrointestinal neuroendocrine tumors,commonly called carcinoids,account for about 2/3 of all neuroendocrine tumors,they are relatively rare. Small intestine neuroendocrine tumors originate from intestinal enterochromaffin cells and represent about 1/4 of small intestine neoplasms. They can be asymptomatic or cause nonspecific symptoms,which usually leads to a delayed diagnosis. Imaging modalities can aid diagnosis and surgery remains the mainstay of treatment. We present a case of a jejunal neuroendocrine tumor that caused nonspecific symptoms for about 1 year before manifesting with acute mesenteric ischemia. Abdominal X-rays revealed pneumatosis intestinalis and an abdominal ultrasound and computed tomography confirmed the diagnosis. The patient was submitted to segmental enterectomy. Histopathological study demonstrated a neuroendocrine tumor with perineural and arterial infiltration and lymph node metastasis. The postoperative course was uneventful and the patient denied any adjuvant treatment.

关键词：小肠良性肿瘤 Enterochromaffin 房间空肠 Enterectomy Pneumatosis intestinalis

来源：

维普期刊数据库评论

在线全文

维普期刊数据库

学校读者我要写书评

暂无评论

Metalloproteinase expression after desflurane preconditioning in hepatectomies:A randomized clinical trial

引用

World Journal of Hepatology 2020年第11期12卷 1098-1114页

作者： Eleni Koraki Ioannis Mantzoros Christos Chatzakis Anna Gkiouliava Angeliki Cheva Athina Lavrentieva Freideriki Sifaki Helena Argiriadou Isaak Kesisoglou konstantinos Galanos-Demiris Stefanos Bitsianis konstantinos tsalis Department of Anaesthesiology “G Papanikolaou”General HospitalThessaloniki 57010Greece Fourth Department of Surgery Medical SchoolAristotle University of ThessalonikiThessaloniki 57010Greece Department of Pathology Medical SchoolAristotle University of ThessalonikiThessaloniki 54636Greece First Department of Intensive Care Unit "G Papanikolaou"General HospitalThessaloniki 57010Greece Department of Anaesthesiology and Intensive Care Unit Aristotle University of ThessalonikiAHEPA University HospitalThessaloniki 54636Greece Third Department of Surgery Aristotle University of ThessalonikiAHEPA University HospitalThessaloniki 54636Greece

BACKGROUND Hepatectomy with inflow occlusion results in ischemia-reperfusion injury;however,pharmacological preconditioning can prevent such injury and optimize the postoperative recovery of hepatectomized patients.The normal inflammatory response after a hepatectomy involves increased expression of metalloproteinases,which may signal pathologic hepatic tissue reformation.AIM To investigate the effect of desflurane preconditioning on these inflammatory indices in patients with inflow occlusion undergoing hepatectomy.METHODS This is a single-center,prospective,randomized controlled trial conducted at the 4th Department of Surgery of the Medical School of Aristotle University of Thessaloniki,between August 2016 and December 2017.Forty-six patients were randomized to either the desflurane treatment group for pharmacological preconditioning(by replacement of propofol with desflurane,administered 30 min before induction of ischemia)or the control group for standard intravenous propofol.The primary endpoint of expression levels of matrix metalloproteinases and their inhibitors was determined preoperatively and at 30 min posthepatic reperfusion.The secondary endpoints of neutrophil infiltration,coagulation profile,activity of antithrombin III(AT III),protein C(PC),protein S and biochemical markers of liver function were determined for 5 d postoperatively and compared between the groups.RESULTS The desflurane treatment group showed significantly increased levels of tissue inhibitor of metalloproteinases 1 and 2,significantly decreased levels of matrix metalloproteinases 2 and 9,decreased neutrophil infiltration,and less profound changes in the coagulation profile.During the 5-d postoperative period,all patients showed significantly decreased activity of AT III,PC and protein S(vs baseline values,P<0.05).The activity of AT III and PC differed significantly between the two groups from postoperative day 1 to postoperative day 5(P<0.05),showing a moderate drop in activity of AT III and PC in the desflurane treatment group an

关键词： Desflurane Preconditioning Hepatectomy Inflammation Metalloproteinases Reperfusion injury

来源：

维普期刊数据库评论

在线全文

维普期刊数据库

学校读者我要写书评

暂无评论

Effects of albumin/glutaraldehyde glue on healing of colonic anastomosis in rats

引用

World Journal of Gastroenterology 2017年第31期23卷 5680-5691页

作者： Kalliopi Despoudi Ioannis Mantzoros Orestis Ioannidis Aggeliki Cheva Nikolaos Antoniou Dimitrios Konstantaras Savvas Symeonidis Manousos George Pramateftakis Efstathios Kotidis Stamatis Angelopoulos konstantinos tsalis Fourth Surgical Department Medical SchoolAristotle University of Thessaloniki Department of Pathology General Hospital“G.Papanikolaou”57010 ThessalonikiGreece

AIM To evaluate the effect of local surgical adhesive glue(albumin/glutaraldehyde-Bioglue) on the healing of colonic anastomoses in rats.METHODS Forty Albino-Wistar male rats were randomly divided into two groups, with two subgroups of ten animals each. In the control group, an end-to-end colonic anastomosis was performed after segmental resection. In the Bioglue group, the anastomosis was protected with extraluminar application of adhesive glue containing albumin and glutaraldehyde. Half of the rats were sacrificed on the fourth and the rest on the eighth postoperative day. Anastomoses were resected and macroscopically examined. Bursting pressures were calculated and histological features were graded. Other parameters of healing, such as hydroxyproline and collagenase concentrations, were evaluated. The experimental data were summarized and computed from the results of a one-way ANOVA. Fisher's exact test was applied to compare percentages. RESULTS Bursting pressures, adhesion formation, inflammatory cell infiltration, and collagen deposition were significantly higher on the fourth postoperative day in the albumin/glutaraldehyde group than in the control group. Furthermore, albumin/glutaraldehyde significantly increased adhesion formation, inflammatory cell infiltration, neoangiogenesis, and collagen deposition on the eighth postoperative day. There was no difference in fibroblast activity or hydroxyproline and collagenase concentrations. CONCLUSION Albumin/glutaraldehyde, when applied on colonic anastomoses, promotes their healing in rats. Therefore, the application of protective local agents in colonic anastomoses leads to better outcomes.

关键词：粘附爆炸压力 Bioglue Albumin/glutaraldehyde 骨胶原结肠的吻合

来源：

维普期刊数据库评论

在线全文

维普期刊数据库

学校读者我要写书评

暂无评论

Primary hepatic gastrinoma:Report of a case and review of literature

引用

World Journal of Gastrointestinal Pathophysiology 2011年第2期2卷 26-30页

作者： konstantinos tsalis Georgios Vrakas Stergios Vradelis Abraham Dimoulas Maria Pilavaki StilianiPa paemmanouil Anastasia Micheli Charalampos Lazarides Georgios Kartalis Fourth Surgical Department Aristotle University Firs Department of Internal Medicine Democritus University of Thrace Radiology Department ‘G.Papanikolaou’Hospital Pathology Department ‘G.Papaniko-laou’Hospital

Primary hepatic gastrinoma is a very rare ectopic gastrinoma with less than 20 cases reported worldwide. We report the case of a patient with hypergastrinemia who was subjected to exhaustive preoperative and intraoperative imaging and also careful surgical exploration of the duodenum and pancreas which failed initially to identify the primary tumour. Eventually the patient was subjected to left liver lobectomy,as a small palpable lesion was noted intraoperatively. The diagnosis of gastrinoma requires a high index of clinical suspicion and the flawless cooperation of many specialties.

关键词： Primary hepatic gastrinoma Zollinger-Ellison syndrome

来源：

维普期刊数据库评论

在线全文

维普期刊数据库

学校读者我要写书评

暂无评论

Management of afferent loop obstruction: Reoperation or endoscopic and percutaneous interventions?

引用

World Journal of Gastrointestinal Surgery 2015年第9期7卷 190-195页

作者： konstantinos Blouhos konstantinos Andreas Boulas konstantinos tsalis Anestis Hatzigeorgiadis Department of General Surgery General Hospital of Drama D’ Surgical Department "G.Papanikolaou" HospitalMedical SchoolAristotle University of Thessaloniki

Afferent loop obstruction is a purely mechanical complication that infrequently occurs following construction of a gastrojejunostomy. The operations most commonly associated with this complication are gastrectomy with Billroth Ⅱ or Roux-en-Y reconstruction, and pancreaticoduodenectomy with conventional loop or Roux-en-Y reconstruction. Etiology of afferent loop obstruction includes:(1) entrapment, compression and kinking by postoperative adhesions;(2) internal herniation, volvulus and intussusception;(3) stenosis due to ulceration at the gastrojejunostomy site and radiation enteritis of the afferent loop;(4) cancer recurrence; and(5) enteroliths, bezoars and foreign bodies. Acute afferent loop obstruction is associated with complete obstruction of the afferent loop and represents a surgical emergency, whereas chronic afferent loop obstruction is associated with partial obstruction. Abdominal multiple detector computed tomography is the diagnostic study of choice. CT appearance of the obstructed afferent loop consists of a C-shaped, fluidfilled tubular mass located in the midline between the abdominal aorta and the superior mesenteric artery with valvulae conniventes projecting into the lumen. The cornerstone of treatment is surgery. Surgery includes:(1) adhesiolysis and reconstruction for benign causes; and(2) by-pass or excision and reconstruction for malignant causes. However, endoscopic enteral stenting, transhepatic percutaneous enteral stenting and direct percutaneous tube enterostomy have the principal role in management of malignant and radiation-induced obstruction. Nevertheless, considerable limitations exist as a former Roux-en-Y reconstruction limits endoscopic access to the afferent loop and percutaneous approaches for enteral stenting and tube enterostomy have only been reported in the literature as isolated cases.

关键词： Afferent loop Obstruction Reoperation Endoscopy En

来源：

维普期刊数据库评论

在线全文

维普期刊数据库

学校读者我要写书评

暂无评论

欢迎您,

建议与咨询留下您的常用邮箱和电话号码，以便我们向您反馈解决方案和替代方法

时间限定

文献类型

馆藏选择

核心期刊

语言

文献类型

帮助

文字说明：

检索规则说明：

检索范例：

分类表

所选分类

限定检索结果

文献类型

馆藏范围

日期分布

学科分类号

主题

机构

作者

语言

在线全文

在线全文

在线全文

在线全文

在线全文

在线全文

请选择保存的检索档案：

请选择收藏分类：

通借通还

欢迎您,

建议与咨询 留下您的常用邮箱和电话号码，以便我们向您反馈解决方案和替代方法

时间限定

文献类型

馆藏选择

核心期刊

语言

文献类型

帮助

文字说明：

检索规则说明：

检索范例：

分类表

所选分类

限定检索结果

文献类型

馆藏范围

日期分布

学科分类号

主题

机构

作者

语言

在线全文

在线全文

在线全文

在线全文

在线全文

在线全文

请选择保存的检索档案： 新增检索档案 确定 取消

请选择收藏分类： 新增自定义分类 确定 取消

通借通还

建议与咨询留下您的常用邮箱和电话号码，以便我们向您反馈解决方案和替代方法

请选择保存的检索档案：

请选择收藏分类：