Social Media Networking in Medicine and Surgery
(Source: Hellenic Journal of Surgery)
Source: Hellenic Journal of Surgery - July 1, 2019 Category: Surgery Source Type: research

Framing the Preoperative Assessment of the Oncogeriatric Patient. The Surgeon ’s Point of View
AbstractElderly cancer patients constitute a steadily rising population and present a challenge for their physicians, who are confronted not only with medical questions, but also with ethical and social dilemmas. Oncogeriatric patients are underrepresented or excluded from clinical trials, especially in the field of surgery, resulting in a lack of evidencebased knowledge regarding their preoperative evaluation, treatment and follow-up. We therefore outline here a framework for the decision-making process, based on recognition of the problem, clarification of the relevant terms, and delineation of the challenges that need t...
Source: Hellenic Journal of Surgery - July 1, 2019 Category: Surgery Source Type: research

The Stage of Colorectal Cancer in Surgical Patients in Greece
Conclusions: The demographic and clinical characteristics of the patients in this series were in agreement with the current bibliographical evidence. Further interpretation of the results highlights the need for increased participation in screening programs, the creation of specialized cancer centers of excellence and the establishment of a national cancer database, in order to improve the early diagnosis and treatment of CRC. (Source: Hellenic Journal of Surgery)
Source: Hellenic Journal of Surgery - July 1, 2019 Category: Surgery Source Type: research

Parasitic Pelvic and Infradiaphragmatic Leiomyomatosis Following Laparoscopic Myomectomy
Discussion: Parasitic leiomyomatosis is a rare entity first described in 1909. Reports of its incidence have increased since the advent of laparoscopic surgery for the treatment of uterine fibroids and there appears to be an association with the use of power morcellators for fragmentation of large myomas, which may promote seeding. Parasitic myoma cells display increased expression of estrogen and progesterone receptors, and increased angiogenetic capacities compared with their uterine counterparts. Further studies are required to ascertain whether power morcellators play a key role in myoma dissemination, and to evaluate ...
Source: Hellenic Journal of Surgery - July 1, 2019 Category: Surgery Source Type: research

Which Needle in which Trocar? A Mathematical-Theoretical Approach
Conclusions: Introduction of needles into the abdomen through laparoscopic trocars poses the risk of needle distortion or trocar dysfunction. In order to avoid these complications, the type and length of the needle to be introduced should be compatible with the diameter of the trocar. (Source: Hellenic Journal of Surgery)
Source: Hellenic Journal of Surgery - July 1, 2019 Category: Surgery Source Type: research

Neck Cannulation for Extracorporeal Membrane Oxygenation Support in a 2-Year-Old Child with Acute Myocarditis
AbstractThe first case in Greece is described of peripheral extracorporeal membrane oxygenation (ECMO) support via neck cannulation in a 2-year-old boy. The advantages and technical details of this method are explained. (Source: Hellenic Journal of Surgery)
Source: Hellenic Journal of Surgery - July 1, 2019 Category: Surgery Source Type: research

Post Gastrectomy Phytobezoar Causing Intestinal Obstruction
We report the case of a 60-year-old male with diabetes mellitus (DM), who presented 6 months post distal gastrectomy with small bowel obstruction, due to migration of phytobezoars into the jejunum. He underwent exploratory laparotomy and enterotomy, with the removal of multiple phytobezoars. (Source: Hellenic Journal of Surgery)
Source: Hellenic Journal of Surgery - July 1, 2019 Category: Surgery Source Type: research

The Effect of 30-minute Ischemia on the Levels of IL6, TNF α, NO, Glutathione and Lactic Acid in the Hepatic Tissue of Rats with Hepatic Steatosis
ConclusionRats with steatotic livers undergoing 30-minute ischemia and reperfusion show significant elevation of TNF α and LA and reduction in IL6, GSH and NO in liver tissue, with poor survival after surgery, compared to non-steatotic rats. These findings suggest that steatotic livers are more susceptible to ischemia-reperfusion injury than lean livers. (Source: Hellenic Journal of Surgery)
Source: Hellenic Journal of Surgery - March 1, 2019 Category: Surgery Source Type: research

Transgastric and Reverse Sleeve Resection of Gastric Submucosal Tumors: Analysis of 7 Cases
ConclusionsTransgastric CELS and reverse sleeve gastrectomy can be performed safely for gastric submucosal lesions located in the esophagogastric junction and lesser curvature. (Source: Hellenic Journal of Surgery)
Source: Hellenic Journal of Surgery - March 1, 2019 Category: Surgery Source Type: research

Internal Drainage of Infected Pancreatic Necrosis: A Fail-Safe Alternative to Percutaneous Catheter Drainage
ConclusionInternal drainage into the stomach in IPN is a feasible and relatively safe procedure when indicated. It is more effective in avoiding repeated surgical procedures when compared to external drainage. (Source: Hellenic Journal of Surgery)
Source: Hellenic Journal of Surgery - March 1, 2019 Category: Surgery Source Type: research

Xanthogranulomatous Cholecystitis Masquerading as Gallbladder Cancer: Case Series and Literature Review
ConclusionDifferentiation of XGC from gallbladder carcinoma is difficult, and a definitive diagnosis necessitates histopathological examination. An accurate preoperative diagnosis requires an integrated review of the clinical and characteristic radiological features, the presence of which may help to avoid radical resection and avoidable morbidity in selected cases. Knowledge of the entity, a high degree of suspicion and involvement of an expert surgeon should provide the optimal management. An incorrect diagnosis may lead to inappropriate surgery - either over-treating it by performing a radical cholecystectomy for XGC or...
Source: Hellenic Journal of Surgery - March 1, 2019 Category: Surgery Source Type: research

Evaluation of Laparoscopic Total Extraperitoneal Repair of Inguinal Hernia Under Regional Anesthesia: A Prospective Case Series
ConclusionTEP hernioplasty is a feasible and safe procedure which can be performed under regional anesthesia and on patients who are at high risk or unfit for GA as well as in patients with no other problems. (Source: Hellenic Journal of Surgery)
Source: Hellenic Journal of Surgery - March 1, 2019 Category: Surgery Source Type: research

Laparoscopic Repair of Lumbar Hernia: A Case Report and Mini Review
ConclusionLumbar hernia is a rare abdominal wall defect, which is usually secondary to trauma or previous surgery. A thorough history and clinical examination, along with abdominal CT, will provide accurate confirmation of the diagnosis. CT should always be included in the investigation prior to surgery, even in uncomplicated cases. The relevant literature is limited, but confirms that laparoscopic repair with mesh is the treatment of choice, especially when the hernia is symptomatic. (Source: Hellenic Journal of Surgery)
Source: Hellenic Journal of Surgery - March 1, 2019 Category: Surgery Source Type: research

Comparison of Open Versus Closed Lateral Internal Sphincterotomy in the Management of Chronic Anal Fissure
ConclusionsClosed lateral anal sphincterotomy is the treatment of choice for CAF. It can be performed effectively and safely, with a low rate of complications and a reduced cost burden. (Source: Hellenic Journal of Surgery)
Source: Hellenic Journal of Surgery - March 1, 2019 Category: Surgery Source Type: research

Neoadjuvant Chemotherapy for Male Breast Cancer - “Pushing the Boundaries”
We report the case of a 67-year-old male with Grade III invasive ductal carcinoma and lymph node metastasis who underwent neoadjuvant chemotherapy prior to surgical treatment. In addition, we discuss the current rationale and evidence behind neoadjuvant chemotherapy for breast cancer, and the justification for providing this treatment in male breast cancer.Due to the rarity of male breast cancer, it is difficult to determine its optimal management, but it would appear reasonable to extrapolate from studies on the management of female breast cancer. (Source: Hellenic Journal of Surgery)
Source: Hellenic Journal of Surgery - March 1, 2019 Category: Surgery Source Type: research

Surgery at the End of Life. Is it Necessary?
(Source: Hellenic Journal of Surgery)
Source: Hellenic Journal of Surgery - March 1, 2019 Category: Surgery Source Type: research

Diffuse Large B-cell Lymphoma of the Ileum in a 41-year-old Greek Male with Undiagnosed HIV Infection Presenting with Iliac Fossa Pain
In conclusionAll patients with lymphoma should be investigated for underlying immunosuppression, especially in the case of extranodal localization of the disease. (Source: Hellenic Journal of Surgery)
Source: Hellenic Journal of Surgery - March 1, 2019 Category: Surgery Source Type: research

Letter from the Editor
(Source: Hellenic Journal of Surgery)
Source: Hellenic Journal of Surgery - March 1, 2019 Category: Surgery Source Type: research

A New Surgical Approach to the Treatment of Renovascular Hypertension by Intervention on the Renal Vein. An Experimental Study
ConclusionDeviation into the portal system of the renal venous blood from the kidney affected by renal artery stenosis can result in total degradation by the liver of the high amounts of renin generated by the RAAS and ameliorate renovascular hypertension. This surgical strategy could be of benefit to individuals with fibromuscular or atheromatous lesions in the distal region of the renal artery or its branches, which are not amenable to balloon angioplasty or surgical revascularization. (Source: Hellenic Journal of Surgery)
Source: Hellenic Journal of Surgery - January 1, 2019 Category: Surgery Source Type: research

Rectal Perforation during Computed Tomographic Colonography: Case Report and Literature Review
ConclusionAlthough rare, bowel perforation may occur during CTC. Awareness of this complication will lead to prompt diagnosis and timely management. (Source: Hellenic Journal of Surgery)
Source: Hellenic Journal of Surgery - January 1, 2019 Category: Surgery Source Type: research

Neoadjuvant Treatment of Locally Advanced Soft Tissue Sarcoma of the Extremities to Avoid Amputation. Isolated Limb Perfusion is a Valid Option
AbstractThe goals of treatment for soft tissue sarcoma (STS) of the extremities are local tumor control, preservation of limb function and reduction of the risk of distant metastasis. The standard treatment for STS of the limbs is wide local excision with histologically negative margins and, in the majority of cases, adjuvant radiotherapy. In the case of locally advanced tumors, this might not be feasible, especially when the tumor is located at the periphery of the limb, or tumor infiltration, encasement or fixation of motor nerves, major vessels or bones has occurred, in which case, amputation may be necessary. The aim o...
Source: Hellenic Journal of Surgery - January 1, 2019 Category: Surgery Source Type: research

Non — Technical Skills for Surgeons
(Source: Hellenic Journal of Surgery)
Source: Hellenic Journal of Surgery - January 1, 2019 Category: Surgery Source Type: research

Small Bowel Obstruction Due to Phytobezoars: Report of Four Cases and Literature Review
AbstractBezoars are concretions of indigestible foreign materials that develop within the gastrointestinal (GI) tract. A variety of materials received orally may form these masses. According to their composition, bezoars are classified as phytobezoars, which are the most frequent, trichobezoars, pharmacobezoars, lactobezoars, and other more rare entities. They are formed most frequently in the stomach and they may trigger serious symptoms, including dysphagia, abdominal pain, hematemesis, and intestinal obstruction or perforation. Contrast-enhanced computerized tomography (CT), in conjunction with GI endoscopy, has contrib...
Source: Hellenic Journal of Surgery - January 1, 2019 Category: Surgery Source Type: research

“Jeep Disease” and Optimal Treatment Strategy for Sacrococcygeal Pilonidal Sinus in a High Volume Tertiary Military Medical Center
AbstractAim-BackgroundSacrococcygeal pilonidal sinus (SPS), a well-known “army” disease, is a relatively common condition affecting mostly males. Several factors have been described as contributing to the etiology of SPS, including irritation from trauma, obesity, a sedentary lifestyle, and intense hair growth in the intergluteal region.MethodsOver a period of 7 years (2010 –2017), 1,100 patients with SPS underwent surgery using different surgical methods, the efficacy of which was evaluated by recording complications and recurrences and duration of hospitalization. The methods used were the semi-closed m...
Source: Hellenic Journal of Surgery - January 1, 2019 Category: Surgery Source Type: research

Castleman ’s Disease: A Unicentric Case of Abdominal Origin and Literature Review
ConclusionAlthough further research is required to identify the exact etiology of the disease, the HV variant of CD, which is the most common, can be effectively treated with surgical resection. The plasma cell type of CD is a more serious condition and the high risk associated with misdiagnosis and delay in its treatment renders high clinical suspicion and early identification of this variant of the utmost importance. (Source: Hellenic Journal of Surgery)
Source: Hellenic Journal of Surgery - January 1, 2019 Category: Surgery Source Type: research

Diagnosis and Treatment of Sporadic and Familial Adenomatous Polyposis (FAP) - Associated Desmoid Tumors: Literature Review
AbstractDesmoid tumors account for 3% of all soft tissue tumors and 0.03% of all neoplasms. In some cases, they appear as part of various syndromes, such as familial adenomatous polyposis (FAP). Desmoids are associated with CTNNB1and APC mutations, which exclude each other. Desmoid tumors appear as slowly growing masses that often do not cause symptoms. The natural course of desmoids varies and is unpredictable. Most patients feel relieved by the benign diagnosis and underestimate the aggressive behavior of the disease.Various imaging techniques have been used for diagnosis and monitoring of desmoids, including ultrasound ...
Source: Hellenic Journal of Surgery - November 1, 2018 Category: Surgery Source Type: research

Laparoscopic Reversal of Hartmann ’s Procedure: Report of Two Cases and Literature Review
AbstractReversal of Hartmann ’s procedure is considered a major surgical operation, associated with a significant morbidity and mortality.We reviewed current literature to demonstrate whether laparoscopic reversal of a Hartmann ’s procedure is safe and feasible, and report here two consecutive cases of Hartmann’s reversal performed laparoscopically (Source: Hellenic Journal of Surgery)
Source: Hellenic Journal of Surgery - November 1, 2018 Category: Surgery Source Type: research

Resection of Pulmonary Metastases in Osteosarcoma. Is it Justified?
AbstractOsteosarcoma shows a high propensity to metastasize to the lung. Pulmonary metastases occur in approximately 40% of patients with osteosarcoma during the course of their disease, and the lung is the only site of metastatic disease in the majority of these cases. Chemotherapy continues to be the standard treatment for metastatic sarcoma, but when it is the only treatment modality, it still results in poor survival rates. In order to improve the outcome, a combination of chemotherapy followed by surgical resection of the metastases has been advocated for selected cases. Substantial evidence documents the potential be...
Source: Hellenic Journal of Surgery - November 1, 2018 Category: Surgery Source Type: research

The History of Lymphatic Anatomy and the Contribution of Frederik Ruysch
AbstractDiscovery of the lymphatic system is documented in numerous sources and can be attributed to a variety of persons. Like many other important developments in medicine, the recognition of the lymphatic system starts with Hippocrates (ca. 460 –370 BC), who described a disease course consistent with metastasis to lymph nodes. Until the 17th century, knowledge about the anatomy and pathophysiology of the lymphatic system was limited, probably because of the difficulty of visualizing lymph vessels in animals and humans. Frederik Ruysch (1638-1731), a “praelector anatomiae” of the Amsterdam Guild of Surg...
Source: Hellenic Journal of Surgery - November 1, 2018 Category: Surgery Source Type: research

The Role of Revascularization of the Profunda Femoris Artery in Vasculogenic Impotence
ConclusionIn patients with Leriche ’s syndrome, revascularization of the profunda femoris artery (profundoplasty) ameliorates vasculogenic impotence through the improvement of the pelvic blood flow via the collateral circulation. (Source: Hellenic Journal of Surgery)
Source: Hellenic Journal of Surgery - November 1, 2018 Category: Surgery Source Type: research

A Novel Modified Model for Induction of Intestinal Adenomas in Female Mice
ConclusionThis modification of the widely used AOM/DSS protocol for induction of colonic carcinoma may constitute a novel approach for investigating colitis-related colonic adenomas. (Source: Hellenic Journal of Surgery)
Source: Hellenic Journal of Surgery - November 1, 2018 Category: Surgery Source Type: research

Situational Awareness in Surgery
(Source: Hellenic Journal of Surgery)
Source: Hellenic Journal of Surgery - November 1, 2018 Category: Surgery Source Type: research

From the “Artist of Death” to the “Artist of Lymphatic Mapping”
(Source: Hellenic Journal of Surgery)
Source: Hellenic Journal of Surgery - November 1, 2018 Category: Surgery Source Type: research

Novel Technique for Defogging and Cleaning the Laparoscope Lens uring Minimally Invasive Surgery
ConclusionThe use of a syringe and cheap plastic sheath can allow application of antifog solution to the laparoscope lens without removing it from the body cavity, overcoming the main issues associated with maintaining lens clarity during laparoscopic surgery. (Source: Hellenic Journal of Surgery)
Source: Hellenic Journal of Surgery - November 1, 2018 Category: Surgery Source Type: research

Laparoscopic Cholecystectomy in a Patient with Situs Inversus
We report one such case outlining how the diagnosis was made and describing the pitfalls encountered during surgery and how they were overcome. (Source: Hellenic Journal of Surgery)
Source: Hellenic Journal of Surgery - November 1, 2018 Category: Surgery Source Type: research

The Prevalence of Malnutrition in Oncology Patients in a Greek General Hospital. Evaluation Using Anthropometric and Laboratory Measurements
ConclusionsThe problem of malnutrition among Greek oncology patients appears to be significant and there is a need for further efforts in its detection and management. (Source: Hellenic Journal of Surgery)
Source: Hellenic Journal of Surgery - September 1, 2018 Category: Surgery Source Type: research

Initial Experience with a New Technique of Binding Pancreaticogastrostomy: A Prospective Study
ConclusionThe technique of binding PG is simple, safe, easy to perform, and less traumatic to the pancreatic stump, with fewer complications, and it can be performed without significant adverse outcome, irrespective of pancreatic stump texture or pancreatic duct diameter. (Source: Hellenic Journal of Surgery)
Source: Hellenic Journal of Surgery - September 1, 2018 Category: Surgery Source Type: research

Anatomy Lessons by the Amsterdam Guild of Surgeons. Medical Education and Art
AbstractThe Amsterdam Guild of Surgeons organized lessons in anatomy as part of the education of surgical trainees and surgeons. Appreciating that the acquisition of correct anatomical knowledge by regular perceptive education during dissection of the human body was essential for surgeons, in 1555 Philip II, King of Spain and Holland, gave his permission to the Amsterdam Guild of Surgeons to perform anatomical dissections on bodies of deceased humans. The anatomy instructors, called “praelectores anatomiae”, who were always academically educated medical doctors, were appointed by the guild for the teaching of a...
Source: Hellenic Journal of Surgery - September 1, 2018 Category: Surgery Source Type: research

Pilot Trial Evaluating Mid-Regional Pro-Atrial Natriuretic Peptide as a Marker of Sepsis after Abdominal Surgery
The objective of this pilot study was to evaluate the potential of MR pro-ANP in the diagnosis of postoperative sepsis.MethodsWe enrolled 18 patients with postoperative sepsis, 19 patients who underwent major abdominal surgery without sepsis and 9 healthy individuals as control subjects. MR pro-ANP, interleukin-6 (IL-6) and procalcitonin (PCT) were measured on the day of inclusion in the study, and at days 3, 7 and 10.ResultsThe mean levels of MR pro-ANP were significantly higher in patients with postoperative sepsis than in patients without sepsis (two-way ANOVA p
Source: Hellenic Journal of Surgery - September 1, 2018 Category: Surgery Source Type: research

Hyperhomocysteinemia and Peripheral Arterial Disease in Patients Undergoing Hemodialysis
This study compared groups of patients with different duration of hemodialysis, with a view to determining the association of clinical presentation of peripheral arterial disease (PAD) with age and duration of hemodialysis.Material-MethodStudy was made of 150 adult patients with CRF undergoing dialysis. Regardless of medication, the inclusion criteria were: blood pressure
Source: Hellenic Journal of Surgery - September 1, 2018 Category: Surgery Source Type: research

Current Concepts in Laparoscopic Liver Surgery
AbstractLaparoscopic liver surgery is currently acknowledged to be a safe and effective approach for the treatment of a variety of benign and malignant hepatic lesions. Its wider adoption was delayed by lack of experience, unavailability of suitable laparoscopic equipment, fear of uncontrollable intraoperative adverse events and the perceived oncological inadequacy of the approach. Over the years all these obstacles were overcome, and increasing numbers of studies documented the safety and efficacy of the procedure, with beneficial short-term results and long-term outcome comparable with that of the traditional open approa...
Source: Hellenic Journal of Surgery - September 1, 2018 Category: Surgery Source Type: research

Modified Lichtenstein Procedure for Repair of Direct or Indirect Inguinal Hernia by Triangulation of the Inguinal Canal
AbstractA modified Lichtenstein hernioplasty procedure was performed, by triangulating the inguinal canal, for indirect or direct inguinal hernia. A series of 276 patients is reported, who underwent a modified Lichtenstein procedure for surgical repair of the indirect or direct inguinal hernia, 32 of which were recurrent hernias. Because of the presence of bilateral hernia in 28 of the cases, the total number of modified Lichtenstein procedures performed was 304. The Lichtenstein hernioplasty procedure was modified by placement of the polypropylene mesh between the Poupart's ligament and the intersection line of the aponeu...
Source: Hellenic Journal of Surgery - September 1, 2018 Category: Surgery Source Type: research

Adult Ileocolic Intussusception Caused by a Submural Ileal Lipoma
ConclusionIleocecal intussusception in adults due to submural lipoma is a rare condition. Because of its nonspecific clinical findings, CT scan is the imaging modality of choice for confirmation of the diagnosis. Surgical treatment is mandatory, via laparotomy, or in selected cases, laparoscopically. (Source: Hellenic Journal of Surgery)
Source: Hellenic Journal of Surgery - September 1, 2018 Category: Surgery Source Type: research

The Surgical Personality and its Quality Components
(Source: Hellenic Journal of Surgery)
Source: Hellenic Journal of Surgery - September 1, 2018 Category: Surgery Source Type: research

Νεκρολογία: Γιάννης Παπαδημητρίου
(Source: Hellenic Journal of Surgery)
Source: Hellenic Journal of Surgery - September 1, 2018 Category: Surgery Source Type: research

Laparoscopic Liver Surgery: A Marriage of Technology and Surgical Technique
(Source: Hellenic Journal of Surgery)
Source: Hellenic Journal of Surgery - September 1, 2018 Category: Surgery Source Type: research

Management of Complicated Hydatid Cyst in Pregnancy. A Multicenter Study
ConclusionsComplicated hydatid cyst in pregnancy is a serious condition which can be life-threatening for the mother and the fetus. The treatment is surgical, and patient management requires close collaboration between the surgeon, the anesthesiologist and the obstetrician-gynecologist. (Source: Hellenic Journal of Surgery)
Source: Hellenic Journal of Surgery - July 1, 2018 Category: Surgery Source Type: research

Evidence-Based Management of Acute Malignant Colorectal Obstruction: Diverting Colostomy as a Bridge to Elective Surgery is a Valid Alternative
AbstractColorectal cancer presents relatively often as acute bowel obstruction, which requires immediate intervention. Operative morbidity and mortality are increased by deterioration of the patient and the commonly poor condition of the proximal bowel. The optimal curative approach for obstructing colorectal carcinoma continues to be a topic of discussion and is the subject of this literature review. The pros and cons of the various strategies based on data provided by clinical studies are discussed. Primary decompression of the bowel with a colostomy or stent and delayed colectomy has the advantage of providing time for ...
Source: Hellenic Journal of Surgery - July 1, 2018 Category: Surgery Source Type: research

The Amsterdam Guild of Surgeons and the Training of Surgeons in the Early Modern Period
AbstractTraining, examination and quality standards of surgeons are topics of interest for the present international surgical community. In this review, surgical training and examination are discussed from the historical perspective on the basis of the regulations of the Amsterdam Guild of Surgeons (1461-1736). In Amsterdam, in that period, surgeons usually underwent a 5-year training in a master-mate relationship under the guidance of a master surgeon in a “surgeon's store”. The trainee was expected to acquire additional knowledge from weekly anatomy lessons on the body of a deceased person, given by the &ldqu...
Source: Hellenic Journal of Surgery - July 1, 2018 Category: Surgery Source Type: research

Acute Intrathoracic Stomach: Complicated Paraesophageal Hernia associated with Distal Gastrointestinal Obstruction. Report of Two Cases and Review
ConclusionsObstructive conditions distal to large PEHs may cause life-threatening complications in the contents of the hernial sac. In patients who are in unstable condition, with complicated large PEH or UDS with gastric compromise, emergency open surgery is required for reduction and resection of the necrotic parts of the stomach and possibly other organs. In other patients, who respond well to resuscitation after endoscopic gastric decompression, semi-urgent or early elective repair may be programmed. (Source: Hellenic Journal of Surgery)
Source: Hellenic Journal of Surgery - July 1, 2018 Category: Surgery Source Type: research