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Can we talk about “futile surgery” for the upfront treatment of the perihilar cholangiocarcinoma?

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Hepatobiliary Surgery and Nutrition 2024年第4期13卷 672-674页

作者： Maria Conticchio David Fuks stylianos Tzedakis Unit of Hepatobiliairy and Pancreatic Surgery Ente Ecclesiastico F.MiulliAcquaviva delle FontiBariItaly Unit of Hepatobiliary Digestive and Endocrine SurgeryCochin HospitalUniversitéParis CitéParisFrance

In this work(1),Ratti et *** to identify a subgroup of patients with perihilar cholangiocarcinoma(PHC)for whom the benefit of surgery could be compromised by morbidity,mortality and the risk of early tumor *** for this study come from a multi-institutional database that includes consecutive patients undergoing elective surgery for PHC in 27 Western centers(with experience of more than 15 major liver resections per year)starting in January *** from 2,271 patients were analyzed *** there is neither international consensus on preoperative management nor standardization of surgical technique,the indications for resection were validated at a local multidisciplinary consultation *** optimization was standardized with endoscopic or percutaneous biliary drainage to treat jaundice and the performance of portal embolization was proposed in the event of insufficient volume of the future remaining liver.

关键词： Perihilar cholangiocarcinoma(PHC) upfront surgery predictive risk score

Early cholecystectomy cannot be regarded as a mortality risk factor in moderate and severe acute biliary pancreatitis

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Hepatobiliary Surgery and Nutrition 2024年第1期13卷 109-111页

作者： Bader Al Taweel stylianos Tzedakis Fabrizio Panaro Digestive Surgery and Transplantation Montpellier University HospitalUniversity of MontpellierMontpellierFrance Chirurgie Digestive APHP Paris ParisFrance

We read with great interest the article by Di Martino et al.(1)on the timing of cholecystectomy after moderately severe and severe acute biliary pancreatitis(ABP).In this retrospective study,the authors analyzed data from the MANCTRA-1 *** 5,304 patients,3,696 met the inclusion criteria(cholecystectomy performed and stage of pancreatitis known)and were included in the *** aim of this study was to assess the impact of early cholecystectomy(EC)on morbidity and mortality in ABP,particularly in moderately severe and severe forms according to the modified Atlanta classification(2).EC was defined as removal of the gallbladder within 14 days of admission,and was compared with delayed cholecystectomy(DC).

关键词： Cholecystectomy severe pancreatitis morbidity mortality

Transcranial direct current stimulation efficacy in trigeminal neuralgia

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World Journal of Clinical Cases 2024年第5期12卷 1036-1038页

作者： Theodoros Fasilis stylianos Gatzonis Panayiotis Patrikelis Stefanos Korfias Athanasia Alexoudi 1^(st) Department of Neurosurgery National and Kapodistrian University of AthensAthens 10676Greece Department of Neurology Neurological Institute of AthensAthens 10676Greece

Trigeminal neuralgia is a severe,disabling pain and its deafferentation remains a challenge for health *** direct current stimulation is a non-invasive stimulation technique which finds new utility in managing ***-fore,the introduction of alternative,non-invasive,safe,and effective methods should be considered in treating patients with trigeminal neuralgia unresponsive to conventional treatment.

关键词： Trigeminal neuralgia Patient-controlled intravenous analgesia Neuromodulation Transcranial direct current stimulation

Total hip replacement using MINIMA^(■)short stem:A short-term follow-up study

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World Journal of Orthopedics 2020年第4期11卷 232-242页

作者： Georgios I Drosos stylianos tottas Ioannis Kougioumtzis Konstantinos Tilkeridis Christos Chatzipapas Athanasios Ververidis Orthopaedic Department Democritus University of ThraceUniversity General Hospital of AlexandroupolisAlexandroupolis 68100Greece

BACKGROUND Total hip replacement has become one of the most successful orthopaedic *** length of the femoral stem constitutes one of the most important geometrical and mechanical features of the *** different implants are currently available but data are limited concerning the clinical results for some of these *** To report the short-term clinical and radiological results of a novel squared section,tapered design–with four conicity-short stem in total hip *** This is a retrospective study of a prospectively collected data using of MINIMA?short stem in 61 consecutive patients with at least 1 year *** collected data included patients’demographics,type of arthritis,bone morphology,perioperative data,clinical results using Harris Hip Score,EuroQol(EQ-5D),pain score and satisfaction rate,complications and radiological *** Total 61 patients were included in our study with a mean age of 56 years of age(range 25-73 years).The majority of them(68.6%)were women,thirty seven patients(56.9%)were less than 60 years of age and almost half of patients(45.1%)suffered from secondary osteoarthritis(hip dysplasia,osteonecrosis,etc.).The mean time of follow-up examination was 33.4 mo(2.8 years)with a range of 12-57 months(1-4.8 years).In 35 patients(56.9%)the follow-up examination was more than 3 *** major complications such as revision,periprosthetic fracture,dislocation or infection were ***-admission 90 d postoperatively or laterwas deemed unnecessary for any reason regarding the ***,the mean pain score,mean Harris hip score,and mean EQ-5D were improved from 6.3,58.7 and 77.3 preoperatively to 0.1,95.1,and 79.8 *** Satisfaction rate at the final follow-up was 9.9(SD 0.3,range 8.0-10.0).All stems were classified as stable bone ingrowth and no radiolucent lineswere revealed in any of the modified Gruens’zone at the postoperative *** subsidence was within ac

关键词： Total hip replacement Total hip arthroplasty Short-stem Hip prostheses Femoral components MINIMA^(■) stem

Prognostic nutritional index in predicting survival of patients with gastric or gastroesophageal junction adenocarcinoma: A systematic review

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World Journal of Gastrointestinal Oncology 2024年第2期16卷 514-526页

作者： stylianos Fiflis Grigorios Christodoulidis Menelaos Papakonstantinou Alexandros Giakoustidis Stergos Koukias Paraskevi Roussos Marina Nektaria Kouliou Konstantinos Eleftherios Koumarelas Dimitrios Giakoustidis First Department of Surgery General Hospital PapageorgiouThessaloniki 56429Greece Department of General Surgery University Hospital of LarissaLarissa 41110Greece

BACKGROUND Gastric cancer is the third most common cause of cancer related death *** with or without chemotherapy is the most common approach with curative intent;however,the prognosis is poor as mortality rates remain *** indexes have been proposed in the past few years in order to estimate the survival of patients undergoing *** preoperative nutritional status of gastric cancer patients has recently gained attention as a factor that could affect the postoperative course and various indexes have been *** aim of this systematic review was to assess the role of the prognostic nutritional index(PNI)in predicting the survival of patients with gastric or gastroesophageal adenocarcinoma who underwent gastrectomy with curative *** To investigate the role of PNI in predicting the survival of patients with gastric or gastroesophageal junction *** A thorough literature search of PubMed and the Cochrane library was performed for studies comparing the overall survival(OS)of patients with gastric or gastroesophageal cancer after surgical resection depending on the preoperative PNI *** PRISMA algorithm was used in the screening process and finally 16 studies were included in this systematic *** review protocol was registered in the International Prospective Register of Systematic Reviews(PRO) RESULTS Sixteen studies involving 14551 patients with gastric or esophagogastric junction adenocarcinoma undergoing open or laparoscopic or robotic gastrectomy with or without adjuvant chemotherapy were included in this systematic *** patients were divided into high-and low-PNI groups according to cut-off values that were set according to previous reports or by using receiver operating characteristic curve analysis in each individual *** 5-year OS of patients in the low-PNI groups ranged between 39%and 70.6%,while in the high-PNI groups,it ranged between 54.9%and 95.8%.In most of the included st

关键词： Prognostic nutritional index Gastric adenocarcinoma Gastroesophageal junction cancer Prognosis Overall survival

Near-infrared cholangiography with intragallbladder indocyanine green injection in minimally invasive cholecystectomy

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World Journal of Gastrointestinal Surgery 2024年第4期16卷 1017-1029页

作者： Savvas Symeonidis Ioannis Mantzoros Elissavet Anestiadou Orestis Ioannidis Panagiotis Christidis Stefanos Bitsianis Vasiliki Bisbinas Konstantinos Zapsalis Trigona Karastergiou Dimitra Athanasiou stylianos Apostolidis Stamatios Angelopoulos Fourth Department of Surgery Medical SchoolAristotle University of ThessalonikiThessaloniki 57010Greece ENT Department Royal Cornwall Hospitals NHS TrustCornwall TR13LJUnited Kingdom 1^(st)Propedeutic Surgical Department University Hospital of ThessalonikiAristotle University of ThessalonikiThessaloniki 54636Greece

Laparoscopic cholecystectomy(LC)remains one of the most commonly performed procedures in adult and paediatric *** the advances made in intraoperative biliary anatomy recognition,iatrogenic bile duct injuries during LC represent a fatal complication and consist an economic burden for healthcare systems.A series of methods have been proposed to prevent bile duct injury,among them the use of indocyanine green(ICG)*** most commonly reported method of ICG injection is the intravenous administration,while literature is lacking studies investigating the direct intragallbladder ICG *** narrative mini-review aims to assess the potential applications,usefulness,and limitations of intragallbladder ICG fluorescence in *** screened the available international literature to identify the reports of intragallbladder ICG fluorescence imaging in minimally invasive cholecystectomy,as well as special issues regarding its *** search retrieved four prospective cohort studies,three case-control studies,and one case *** the three case-control studies selected,intragallbladder near-infrared cholangiography(NIRC)was compared with standard LC under white light,with intravenous administration of ICG for NIRC and with standard intraoperative cholangiography(IOC).In total,133 patients reported in the literature have been administered intragallbladder ICG administration for biliary mapping during *** includes several reports of intragallbladder ICG administration,but a standardized technique has not been established *** data suggest that NIRC with intragallbladder ICG injection is a promising method to achieve biliary mapping,overwhelming limitations of IOC including intervention and radiation exposure,as well as the high hepatic parenchyma signal and time interval needed in intravenous ICG ***-based guidelines on the role of intragallbladder ICG fluorescence in LC require the assessment of furth

关键词： Minimally invasive cholecystectomy Laparoscopic cholecystectomy Biliary tract mapping Indocyanine green Near-infrared fluorescent cholangiography Intracystic indocyanine green Intragallbladder indocyanine green Bile duct injury

BIM for the Underground-An enabler of trenchless construction

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Underground Space 2020年第4期5卷 354-361页

作者： David Chapman stylianos Providakis Christopher Rogers Department of Civil Engineering University of BirminghamBirmingham B152TTUK

The subsurface space in urban areas is an important ***,the information available on this environment is relatively poor compared to above ground *** paper proposes a Building Information Model(BIM)for underground applications as means to address this information *** creation and progressive update of BIM for a constructed artefact ensures that data on the structures is available and can be used throughout its lifetime.A BIM for underground applications integrates data on surface structures,such as buildings,and subsurface infrastructures,such as pipes,along with details of the surrounding ground,the associated soil and rock properties and groundwater regime into a single *** approach is demonstrated by applying it to trenchless construction operations,including a microtunnelling project for a new *** data from this extended BIM concept can be interactively used with analysis packages to conduct risk assessments for new construction *** also shows how BIM for the Underground can be used throughout the planning,construction and post-construction stages of a project,and,importantly,how this information can be available for future projects.

关键词： Trenchless BIM Underground Pipe jacking Microtunnelling Horizontal directional drilling

Is there a changing trend in surgical management of gastroesophageal reflux disease in children?

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World Journal of Gastroenterology 2007年第33期13卷 4417-4422页

作者： Mahmud Saedon Stavros Gourgiotis stylianos Germanos Department of General Surgery Leighton Hospital Cheshire CW1 4QJ United Kingdom Second Surgical Department 401 GeneraArmy Hospital of Athens Greece Nuffield Department of Surgery John Radcliffe Hospital Oxford OX3 9DU United Kingdom

Gastroesophageal reflux disease (GORD) is a pathological process in infants manifesting as poor weight gain, signs of esophagitis, persistent respiratory symptoms and changes in neurobehaviour. It is currently estimated that approximately one in every 350 children will experience severe symptomatic gastroesophageal reflux necessitating surgical treatment. Surgery for GORD is currently one of the common major operations performed in infants and children. Most of the studies found favour laparoscopic approach which has surpassed open antireflux surgery as the gold standard of surgical management for ***, it must be interpreted with caution due to the limitation of the studies, especially the small number of subject included in these studies. This review reports the changing trends in the surgical treatment of GORD inchildren.

关键词： Children Gastroesophageal reflux Antireflux surgery Laparoscopic fundoplication

Recycled oceanic crust as a source for tonalite intrusions in the mantle section of the Khor Fakkan block, Semail ophiolite(UAE)

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Geoscience Frontiers 2019年第3期10卷 1187-1210页

作者： Hosung Joun Sotirios Kokkalas stylianos Tombros Department of Earth Sciences Khalifa University Department of Geology University of Patras

Several types of felsic granitoid rocks have been recognized, intrusive in both the mantle and the crustal sequence of the Semail ophiolite. Several models have been proposed for the source of this suite of tonalites, granodiorites, trondhjemites intrusions, however their genesis is still not clearly *** sampled Dadnah tonalites that intruded in the mantle section of the Semail ophiolite display arctype geochemical characteristics, are high siliceous, low-potassic, metaluminous to weakly peraluminous, enriched in LILE, show positive peaks for Ba, Pb, Eu, negative troughs for U, Ti and occur with low δ^(18)O_(H_2 O), moderate ε_(Sr) and negative eNd values. They have crystallized at temperatures that range from～550 ℃ to ～720 ℃ and pressure ranging from 4.4 kbar to 6.5 kbar. The isotopic ages from our tonalite samples range between 98.6 Ma and 94.9 Ma, slightly older and overlapping with the age of the metamorphic sole. Our field observations, mineralogical, petrological, geochemical, isotopic and melt inclusion data suggest that the Dadnah tonalites formed by partial melting(～10%-15% continuous or ～12% batch partial melting), accumulation of plagioclase, fractional crystallization(～55%-57%), and interaction with their host harzburgites. These tonalites were the end result of partial melting and subsequent contamination and mixing of ～4% oceanic sediments with ～96% oceanic lithosphere from the subducted slab. This MORB-type slab melt composed from ～97% recycled oceanic crust and ～3% of the overlying *** suggest that a possible protolith for these tonalites was the basaltic lavas from the subducted oceanic slab that melted during the initial stages of the supra-subduction zone(SSZ), which was forming synchronously to the spreading ridge axis. The tonalite melts mildly modified due to low degree of mixing and interaction with the overlying lithospheric mantle. Subsequently, the Dadnah tonalites emplaced at the upper part of the mantle sequence of the Se

关键词： Tonalites Felsic granitoids Recycled oceanic crust Source contribution Partial melting Melt inclusions