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Risk of colorectal neoplasm in patients with acromegaly: A meta-analysis

World Journal of Gastroenterology 2008年第22期14卷 3484-3489页

作者： Theodoros Rokkas Dimitrios Pistiolas Panos Sechopoulos georgios Margantinis georgios koukoulis Gastroenterology Clinic Henry Dunant Hospital 107 Messogion Ave. Athens 11526 Greece

AIM: To examine the risk of colorectal neoplasm in acromegalic patients by meta-analyzing all relevant controlled studies. METHODS: Extensive English language medical literature searches for human studies, up to December 2007, were performed using suitable keywords. Pooled estimates [odds ratio (OR) with 95% confidence intervals (CI)] were obtained using either the fixed or random-effects model as appropriate. Heterogeneity between studies was evaluated with the Cochran Q test whereas the likelihood of publication bias was assessed by constructing funnel plots. Their symmetry was estimated by the adjusted rank correlation test. RESULTS: For hyperplastic polyps the pooled ORs with 95% CI were 3.557 (2.587-4.891) by fixed effects model and 3.703 (2.565-5.347) by random effects model. The Z test values for overall effect were 7.81 and 6.984, respectively (P < 0.0001). For colon adenomas the pooled ORs with 95% CI were 2.486 (1.908-3.238) (fixed effects model) and 2.537 (1.914-3.364) (random effects model). The Z test values were 6.747 and 6.472, respectively (P < 0.0001). For colon cancer the pooled OR with 95% CI was identical for both fixed and random effects model (OR, 4.351; 95% CI, 1.533-12.354; Z = 2.762, P = 0.006]. There was no significant heterogeneity and no publication bias in all the above meta-analyses. CONCLUSION: Acromegaly is associated with an increased risk of colorectal neoplasm.

关键词： Acromegaly Colon cancer Colon polyps Colon neoplasia Meta-analysis

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Laparoscopic bilateral inguinal hernia repair: Should it be the preferred technique?

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World Journal of Methodology 2022年第4期12卷 193-199页

作者： Christos Doudakmanis Christina Kolla Konstantinos Bouliaris Matthaios Efthimiou georgios D koukoulis Department of General Surgery General Hospital of LarissaLarissa 41221Greece

Inguinal hernias are amongst the most common conditions requiring general surgical *** decades,the preferred approach was the open *** laparoscopy became more popular and available and more surgeons became familiarized with this modality,laparoscopic inguinal hernia repair became an *** aim of this study is to assess the effectiveness of laparoscopic inguinal repair,with a focus on bilateral inguinal *** reports have shown promising clinical outcomes compared to those of conventional repair of bilateral ***,there are only a few studies concerning laparoscopic repair of bilateral *** is yet to be proven that laparoscopy is the“gold standard”in the treatment of bilateral inguinal *** far,the choice of an inguinal hernia repair technique has been up to each surgeon,depending on their expertise and available resources after taking into consideration each patient’s needs.

关键词： Bilateral inguinal hernia Laparoscopic repair Open repair:Gold standard Chronic pain Recurrence

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Bacterial translocation in patients undergoing major gastrointestinal surgery and its role in postoperative sepsis

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World Journal of Gastrointestinal Pathophysiology 2021年第6期12卷 106-114页

作者： Christos Doudakmanis Konstantinos Bouliaris Christina Kolla Matthaios Efthimiou georgios D koukoulis Department of General Surgery General Hospital of LarissaLarisa 41221Greece

Bacteria of the human intestinal microflora have a dual *** promote digestion and are part of a defense mechanism against *** bacteria could become potential pathogens under certain *** term“bacterial translocation”describes the passage of bacteria of the gastrointestinal tract through the intestinal mucosa barrier to mesenteric lymph nodes and other *** some cases,the passage of bacteria and endotoxins could result in blood stream infections and in multiple organ *** elective abdominal surgery more frequently results in malfunction of the intestinal barrier and subsequent bacterial translocation and blood stream infections than laparoscopic *** sepsis is a common finding in patients who have undergone non-elective abdominal surgeries,including trauma patients treated with *** sepsis is an emerging issue,as it changes the treatment plan in surgical patients and prolongs hospital *** association between bacterial translocation and postoperative sepsis could provide novel treatment options.

关键词： Bacterial translocation Major gastrointestinal surgery Postoperative sepsis Intestinal permeability Microbiota

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Impact of antiplatelet treatment on colorectal cancer staging characteristics

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World Journal of Gastrointestinal Endoscopy 2012年第9期4卷 409-413页

作者： Dimitrios Symeonidis georgios koukoulis Grigorios Christodoulidis Ioannis Mamaloudis Ioannis Chatzinikolaou Konstantinos Tepetes Department of General Surgery University Hospital of LarissaMezourlo 41110LarissaGreece

AIM: To evaluate whether antiplatelet medication leads to an earlier stage colorectal cancer (CRC) diagnosis. METHODS: From January 2002 until March 2010, patients that presented to our institution with the initial diagnosis of CRC and were submitted to an open curative CRC resection or a palliative procedure were retrospectively reviewed. Exclusion criteria were the use of antithrombotic medication, i.e., coumarins, and appendiceal malignancies. Data acquired from medical files included age, gender, past medical history, antithrombotic treatment received prior to endoscopic diagnosis, preoperative imaging staging, location of the tumor, surgical and final histopathological report. Patients that did not receive any antithrombotic medication prior to the endoscopic diagnosis comprised the control group of the study, while patients that were on antiplatelet medication comprised the antiplatelet group. Primary end point was a comparison of CRC stage in the two groups of the study. CRC presenting symptoms and the incidence of each cancer stage in the two groups were also evaluated. RESULTS: A total of 387 patients with the diagnosis of CRC were submitted to our department for further surgical treatment. Ninety-eight patients (25.32%), with a median age of 71 years (range 52-91 years), were included in the antiplatelet group, while 289 (74.67%) patients, with a median age of 67 years (range 41-90 years), were not in any thrombosis prophylaxis medication (control group). Thirty-one patients were treated with some kind of palliative procedure, either endoscopic, such as endoscopic stent placement, or surgical, such as de-compressive colostomy or deviation. Coronary disease (77.55% - 76 patients), stroke recurrence prevention (14.28% - 14 patients) and peripheral arterial disease (8.16% - 8 patients) were the indications for the administration of antiplatelet treatment (aspirin, clopidogrel, ticlopidine or dipyridamole) in the antiplatelet group. All patients on aspirin tre

关键词： Colorectal cancer Antiplatelets Cancer stage Abdominal surgery Colonoscopy

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