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Hepatobiliary & Pancreatic Diseases International 2018年第1期17卷 91-92页

作者： antonios athanasiou eleftherios spartalis mairead hennessy michael spartalis demetrios moris christos damaskos emmanouil pikoulis department of upper gastrointestinal surgery university hospitals birmingham nhs foundation trustBirmingham UK laboratory of experimental surgery and surgical research university of athens medical schoolAg. Thoma 15B Athens 11527 Greece department of surgery wexford general hospitalIreland department of surgery duke universityDurham NC USA first surgery department laikon general hospital national and kapodistrian university of athensGreece

To the editor:We read with great interest the article entitled "Comparative study of the effects of terlipressin versus splenectomy on liver regeneration after partial hepatectomy in rats" by Ulmer et al.[1].The aim o... 详细信息

关键词： Effects of terlipressin versus splenectomy on liver regeneration after partial hepatectomy in rats What we know so far

Colonoscopy attachments for the detection of precancerous lesions during colonoscopy:A review of the literature

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World Journal of Gastroenterology 2018年第37期24卷 4243-4253页

作者： Paraskevas Gkolfakis Georgios Tziatzios eleftherios spartalis Ioannis S Papanikolaou Konstantinos Triantafyllou Hepatogastroenterology Unit Second Department of Internal Medicine-PropaedeuticResearch Institute and Diabetes CenterMedical SchoolNational and Kapodistrian University of Athens''Attikon”University General HospitalAthens 12462Greece Laboratory of Experimental Surgery and Surgical Research National and Kapodistrian University of AthensAthens 12462Greece

Although colonoscopy has been proven effective in reducing the incidence of colorectal cancer through the detection and removal of precancerous lesions, it remains an imperfect examination, as it can fail in detecting up to almost one fourth of existing adenomas. Among reasons accounting for such failures, is the inability to meticulously visualize the colonic mucosa located either proximal to haustral folds or anatomic curves, including the hepatic and splenic flexures. In order to overcome these limitations, various colonoscope attachments aiming to improve mucosal visualization have been developed. All of them-transparent cap, Endocuff, Endocuff Vision and Endorings-are simply mounted onto the distal tip of the scope. In this review article, we introduce the rationale of their development, present their mode of action and discuss in detail the effect of their implementation in the detection of lesions during colonoscopy.

关键词： Adenoma detection rate Adenoma miss rate Colonoscopy Cup Endocuff Endocuff Vision Endorings

Robotic-assisted microsurgery in andrology: a systematic review

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Asian Journal of Andrology 2023年第4期25卷 454-461页

作者： Konstantinos Douroumis eleftherios spartalis Konstantinos Stravodimos Panagiotis K Levis Gerasimos Tsourouflis Dimitrios Dimitroulis Nikolaos I Nikiteas Hellenic Minimally Invasive and Robotic Surgery(MIRS)Study Group National and Kapodistrian University of AthensMedical SchoolAgiou Thoma 15bGoudiAthens 11527Greece First Department of Urology National and Kapodistrian University of AthensMedical SchoolAgiou Thoma 17GoudiAthens 11527Greece Second Department of Propaedeutic Surgery National and Kapodistrian University of AthensMedical SchoolAgiou Thoma 17GoudiAthens 11527Greece

Robot-assisted surgery is the gold standard of treatment in many fields of urology. In this systematic review, we aim to reportits usage in andrology and to evaluate any advantages. A systematic search of the PubMed and Cochrane Library databases wasconducted to identify articles referring to robotic-assisted microsurgery in andrology. The search strategy was in line with thePreferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines and the Cochrane Handbook. Thearticles were then reviewed by two authors. A qualitative analysis of the articles that met the inclusion criteria was ***-one articles that met the inclusion criteria were reviewed. The first results for robot-assisted vasovasostomy (RAVV) areencouraging as excellent patency rates, short operative times, and learning curves were achieved. Interestingly, patency rates weregreater in some case series for RAVV than for microsurgical vasovasostomy, with a statistically significant difference. In addition,robot has been shown to be of great use in bypassing fibrotic changes in cases of iatrogenic vasal injuries, difficulties encounteredwith traditional microsurgery. In addition, the feasibility of robot-assisted microsurgery has been proven for varicocelectomy andmicrosurgical denervation of the spermatic cord, with acceptable improvement in sperm parameters and pain, respectively. Thecurrent evidence suggests that there are potential advantages of the use of robots in andrology. However, for robotic surgery tobecome incorporated into the daily use of the andrologists, large, multicenter randomized trials are needed. As robotics systemsare becoming standard in urology practice, it is reasonable for one to believe that they will also find their place in andrology.

关键词： andrology male infertility robotic surgical procedures varicocele vasovasostomy

Indications,limitations and maneuvers to enable extended hepatectomy:Current trends

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World Journal of Gastroenterology 2014年第24期20卷 7887-7893页

作者： Dimitrios Dimitroulis Petros Tsaparas Serena Valsami Dimitrios Mantas eleftherios spartalis Charalampos Markakis Gregory Kouraklis Second Department of Propedeutic Surgery Athens University Medical School"Laiko" Hospital11527 AthensGreece Blood Transfusion Department Athens University Medical SchoolAreteion Hospital11527 AthensGreece

The liver is a solid organ with a wide variety of primary benign or malignant tumors as well as metastatic *** resection of these tumors remains the only curative *** limitations,however,do not allow the performance of these *** review evaluates the indications and limitations regarding these extended hepatic resections,as well as describing all the manipulations that increase the candidates for such operations.A thorough review of the literature was performed in order to define indications for extended hepatectomy,as well as to present all methods that contribute to increasing the volume of the future remnant *** role of portal vein ligation,portal vein embolization,two-stage hepatectomy,and in situ liver transection are evaluated in the setting of indications and *** hepatectomies are a necessity due to oncological *** methods developed in order to increase the volume of the remnant liver are safe and *** situ liver transection is a novel and revolutionary two-step procedure for extended hepatic *** clinical studies are required to estimate long-term results and the oncological basis of this technique.

关键词： Extended hepatectomy Portal vein ligation Remnant liver volume

Conduit necrosis following esophagectomy: An up-to-date literature review

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World Journal of Gastrointestinal Surgery 2019年第3期11卷 155-168页

作者： Antonios Athanasiou Mairead Hennessy eleftherios spartalis Benjamin H L Tan Ewen A Griffiths Department of Upper GI Bariatric and Minimally Invasive Surgery St.James' University Hospital Leeds Teaching Hospitals NHS Trust Department of Anaesthesia University Hospital of Waterford Laboratory of Experimental Surgery and Surgical Research University of Athens Medical School Department of Upper Gastrointestinal Surgery University Hospitals Birmingham NHS Foundation Trust

Esophageal conduit ischaemia and necrosis is an uncommon but devastating complication of esophagectomy and remains one of the most challenging issues in surgical practice. The incidence, time interval to develop symptoms, and clinical presentation are highly variable with no predictable pattern. Evidence comes from case reports and case series rather than randomized controlled *** describe the issues surrounding conduit necrosis affecting the stomach,jejunum and colon as an esophageal replacement and the advantages,disadvantages and challenges of each type of reconstruction. Diagnosis is challenging for the most experienced surgeon. Upper gastrointestinal endoscopy and computed tomography thorax with both oral and intravenous contrast is the gold standard. Management, either conservative or interventional is also a difficult decision. Management options include conservative treatment and more aggressive treatments such as stent insertion, surgical debridement and repair of the esophagus using jejunum, colon or a musculocutaneous flap. In spite of recent advances in surgical techniques, there is no reliable strategy to manage esophageal conduit necrosis. Our review covers the pathophysiology and clinical significance of esophageal necrosis while highlighting current techniques of prevention, diagnosis and treatment of this life-threatening condition.

关键词： Esophagectomy Esophageal cancers Esophagogastric anastomosis

Hepatocellular carcinoma in patients co-infected with hepatitis C virus and human immunodeficiency virus

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World Journal of Hepatology 2013年第6期5卷 323-327页

作者： Dimitrios Dimitroulis Serena Valsami eleftherios spartalis Emmanuel Pikoulis Gregory Kouraklis Second Department of Propedeutic Surgery Athens University Medical School "Laiko" Hospital Blood Transfusion Department Athens University Medical School Areteion Hospital

Hepatitis C virus (HCV) and human immunodeficiency virus (HIV) share a common route of transmission so that about one third of HIV infected individuals show HCV coinfection. Highly active antiretroviral therapy has offered a longer and better life to infected patients. While has removed AIDS-related diseases from the list of most common causes of death their place has been taken by complications of HCV infection, such as cirrhosis, end stage liver disease and hepatocellular carcinoma (HCC). HIV/HCV co-infection requires complex management, especially when HCC is present. Co-infected patients with HCC undergo the same therapeutic protocol as their mono-infected counterparts, but special issues such as interaction between regimens, withdrawal of therapy and choice of immunosuppressive agents, demand a careful approach by specialists. All these issues are analyzed in this minireview.

关键词： Hepatocellular carcinoma Hepatitis C virus, Human immunodeficiency virus Co-infection

Concept of histone deacetylases in cancer:Reflections on esophageal carcinogenesis and treatment

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World Journal of Gastroenterology 2018年第41期24卷 4635-4642页

作者： Dimitrios Schizas Aikaterini Mastoraki Leon Naar eleftherios spartalis Diamantis I Tsilimigras Georgia-Sofia Karachaliou George Bagias Dimitrios Moris 1^st Department of Surgery Laikon General HospitalNational and Kapodistrian University of AthensAthens 11527Greece 4^th Department of Surgery Attikon University HospitalNational and Kapodistrian University of AthensAthens 12462Greece Laboratory of Experimental Surgery and Surgical Research National and Kapodistrian University of AthensAthens 11527Greece Department of General Visceral and Transplant SurgeryUniversity Hospital EssenEssen 45141Germany Department of Surgery Duke University Medical CenterDurhamNC 27710United States

Esophageal cancer (EC) presents a high mortality rate, mainly due to its aggressive nature. Squamous cell carcinoma is the most common histological type world-wide, though, a continuous increase in esophageal adenocarcinomas has been noted in the past decades. Common risk factors associated with EC include smoking, alcohol consumption, gastroesophageal reflux disease, Barrett's esophagus and obesity. In an effort to overcome chemotherapy resistance in oncology, it was discovered that histone acetylation/deacetylation equilibrium is altered in carcinogenesis, leading to changes in chromatin structure and altering expression of genes important in the cell cycle, differentiation and apoptosis. Based on this knowledge, histone acetylation was addressed as a potential novel chemotherapy drug target to repress cancer cell proliferation. There are four classes of histone deacetylases (HDACs) inhibitors with a variety of different mechanisms of actions that render them possible anticancer drugs. They arrest the cell cycle, inhibit differentiation and angiogenesis and induce apoptosis. They do not necessarily act on histone proteins, since they can also exert indirect anti-cancer effects, by modifying various cellular *** addition,HDACs have also been associated with increased chemotherapy *** on the literature,HDACs have been associated with EC,with surveys revealing that increased expression of certain HDACs correlates with advanced TNM stages,tumor grade,metastatic potential and decreased 5-year overall and disease-free *** aim of this survey is to elucidate the molecular identity and mechanism of action of HDAC inhibitors as well as verify their potential utility as anti-cancer agents in esophageal cancer.

关键词： Esophageal cancer Histone deacatylases Inhibitors Drugs

Inherited arrhythmias and gene therapy: Are there any ethical considerations to take into account?

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World Journal of Cardiology 2023年第12期15卷 623-626页

作者： Michael spartalis eleftherios spartalis Gerasimos Siasos 3rd Department of Cardiology National and Kapodistrian University of AthensAthens 11527Greece Laboratory of Experimental Surgery and Surgical Research Medical SchoolNational and Kapodistrian University of AthensAthens 11527Greece

Interventional electrophysiology represents a relatively recent subspecialty within the field of *** the past half-century,there has been significant advan-cement in the development and implementation of innovative ablation treatments and ***,the treatment of arrhythmias continues to be *** arrhythmias,such as ventricular tachycardia and atrial fibrillation,pose significant challenges in terms of therapeutic efficacy,whether through interventional procedures or the administration of antiarrhythmic ***-logists are engaged in ongoing research to explore innovative methodologies,such as genome editing,with the purpose of effectively managing arrhythmias and meeting the growing needs of patients afflicted with rhythm *** field of genome editing has significant promise and has the potential to serve as a highly effective personalized therapy for rhythm disorders in ***,several ethical issues must be considered.

关键词： Arrhythmia Sudden cardiac death Genome editing Long QT Channelo-pathies Mutation

Acute esophageal necrosis: A systematic review and pooled analysis

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World Journal of Gastrointestinal Surgery 2020年第3期12卷 104-115页

作者： Dimitrios Schizas Nikoletta A Theochari Konstantinos S Mylonas Prodromos Kanavidis eleftherios spartalis Stamatina Triantafyllou Konstantinos P Economopoulos Dimitrios Theodorou Theodore Liakakos First Department of Surgery National and Kapodistrian University of AthensLaikon General HospitalAthens 11527Greece Department of Medicine Surgery Working GroupSociety of Junior DoctorsAthens 15122Greece Laboratory of Experimental Surgery and Surgical Research N.S.Christeas National and Kapodistrian University of AthensAthens 11527Greece First Propedeutic Department of Surgery National and Kapodistrian University of AthensHippocration General HospitalAthens 11527Greece Department of Surgery Duke University Medical CenterDurhamNC 27708United States

BACKGROUND Acute esophageal necrosis(AEN)is a rare entity with multifactorial etiology,usually presenting with signs of upper gastrointestinal *** To systematically review all available data on demographics,clinical features,outcomes and management of this medical *** A systematic literature search was performed with respect to the PRISMA statement(end-of-search date:October 24,2018).Data on the study design,interventions,participants and outcomes were extracted by two independent *** Seventy-nine studies were included in this ***,114 patients with AEN were identified,of whom 83 were males and 31 *** patient age was 62.1±*** most common presenting symptoms were melena,hematemesis or other manifestations of gastric bleeding(85%).The lower esophagus was most commonly involved(92.9%).The most widely implemented treatment modality was conservative treatment(75.4%),while surgical or endoscopic intervention was required in 24.6%of the *** overall followup was 66.2±101.8 *** 29.9%of patients died either during the initial hospital stay or during the follow-up *** symptoms on presentation[Odds ratio 3.50(1.09-11.30),P=0.03]and need for surgical or endoscopic treatment[surgical:Odds ratio 1.25(1.03-1.51),P=0.02;endoscopic:Odds ratio 1.4(1.17-1.66),P<0.01]were associated with increased odds of complications.A sub-analysis separating early versus late cases(after 2006)revealed a significantly increased frequency of surgical or endoscopic intervention(9.7%vs 30.1%respectively,P=0.04)CONCLUSION AEN is a rare condition with controversial pathogenesis and unclear optimal *** the frequency of surgical and endoscopic intervention has increased in recent years,outcomes have remained the ***,further research work is needed to better understand how to best treat this potentially lethal disease.

关键词： Acute esophageal necrosis Black esophagus Acute necrotizing esophagitis

From diagnosis to treatment of hepatocellular carcinoma: An epidemic problem for both developed and developing world

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World Journal of Gastroenterology 2017年第29期23卷 5282-5294页

作者： Dimitrios Dimitroulis Christos Damaskos Serena Valsami Spyridon Davakis Nikolaos Garmpis eleftherios spartalis Antonios Athanasiou Demetrios Moris Stratigoula Sakellariou Stylianos Kykalos Gerasimos Tsourouflis Anna Garmpi Ioanna Delladetsima Konstantinos Kontzoglou Gregory Kouraklis Second Department of Propedeutic Surgery Laiko General Hospital Medical School National and Kapodistrian University of Athens Blood Transfusion Department Aretaieion Hospital Medical School National and Kapodistrian Athens University First Department of Surgery Laiko General Hospital Medical School National and Kapodistrian University of Athens N.S. Christeas Laboratory of Experimental Surgery and Surgical Research Medical School National and Kapodistrian University of Athens Department of Surgery Mercy University Hospital Lerner Research Institute Cleveland Clinic Foundation First Department of Pathology Medical School National and Kapodistrian University of Athens Internal Medicine Department Laiko General Hospital University of Athens Medical School

Hepatocellular carcinoma(HCC) is the most frequent primary liver malignancy and the third cause of cancer-related death in the Western Countries. The well-established causes of HCC are chronic liver infections such as hepatitis B virus or chronic hepatitis C virus, nonalcoholic fatty liver disease, consumption of aflatoxins and tobacco smocking. Clinical presentation varies widely; patients can be asymptomatic while symptomatology extends from right upper abdominal quadrant paint and weight loss to obstructive jaundice and lethargy. Imaging is the first key and one of the most important aspects at all stages of diagnosis, therapy and follow-up of patients with HCC. The Barcelona Clinic Liver Cancer Staging System remains the most widely classification system used for HCC management guidelines. Up until now, HCC remains a challenge to early diagnose, and treat effectively; treating management is focused on hepatic resection, orthotopic liver transplantation, ablative therapies, chemoembolization and systemic therapies with cytotocix drugs, and targeted agents. This review article describes the current evidence on epidemiology, symptomatology, diagnosis and treatment of hepatocellular carcinoma.

关键词： Hepatocellular Cancer Epidemiology Treatment Diagnosis Staging Transplantation