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  • 1
    Language: English
    In: Gastroenterology, May 2010, Vol.138(5), pp.1667, 2025
    Keywords: Alphapapillomavirus -- Isolation & Purification ; Anus Diseases -- Virology ; Anus Neoplasms -- Virology ; Carcinoma, Squamous Cell -- Virology ; Condylomata Acuminata -- Virology ; Hypercalcemia -- Virology ; Papillomavirus Infections -- Virology ; Paraneoplastic Syndromes -- Virology
    E-ISSN: 1528-0012
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  • 2
    Language: English
    In: Gastroenterology, 2011, Vol.141(6), pp.e1-e2
    Keywords: Medicine
    ISSN: 0016-5085
    E-ISSN: 1528-0012
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  • 3
    Language: English
    In: Gastroenterology, 2010, Vol.139(4), pp.e5-e7
    Keywords: Medicine
    ISSN: 0016-5085
    E-ISSN: 1528-0012
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  • 4
    Language: English
    In: Digestive Diseases and Sciences, 2010, Vol.55(11), pp.3031-3040
    Description: Byline: George Sgourakis (1,2), Ines Gockel (1), Arnold Radtke (1), Thomas J. Musholt (1), Stephan Timm (1), Andreas Rink (1), Achilleas Tsiamis (3), Constantine Karaliotas (2), Hauke Lang (1) Keywords: Minimally invasive esophagectomy; Open esophagectomy; Meta-analysis; Evidence based medicine; Publication bias; Barrett's esophagus Abstract: Background A meta-analysis of the current literature was performed to compare the perioperative outcome measures and oncological impact between minimally invasive and open esophagectomy. Methods Using the electronic databases Medline, Embase, Pubmed and the Cochrane Library, we performed a meta-analysis pooling the effects of outcomes of 1,008 patients enrolled into eight comparative studies, using classic and modern meta-analytic methods. Results Two comparisons were considered for this systematic review: (I) open thoracotomy vs. VATS/laparoscopy esophagectomy and (II) open thoracotomy vs. VATS esophagectomy. In comparison I: both procedures report equally comparable outcomes (removed lymph nodes, 30-day mortality, 3-year survival) with the exception of overall morbidity (P = 0.038 in favor of the MIE arm) and anastomotic stricture (P 〈 0.001 in favor of the open thoracotomy arm). In comparison II: No differences were noted between treatment arms concerning postoperative outcomes and survival. Conclusions In summary, both arms were comparable with regard to perioperative results and prognosis. Further prospective comparative or randomized-controlled trials focusing on the oncological impact of MIE are needed. Author Affiliation: (1) Department of General and Abdominal Surgery, Johannes Gutenberg University Hospital, Mainz, Germany (2) 2nd Surgical Department and Surgical Oncology Unit, Korgialenio--Benakio Red Cross Hospital, 11 Mantzarou St., Neo Psychiko, 15451, Athens, Greece (3) Department of Colorectal and Laparoscopic Surgery, James Paget University Hospital, Norfolk, UK Article History: Registration Date: 03/02/2010 Received Date: 15/11/2009 Accepted Date: 03/02/2010 Online Date: 26/02/2010
    Keywords: Minimally invasive esophagectomy ; Open esophagectomy ; Meta-analysis ; Evidence based medicine ; Publication bias ; Barrett’s esophagus
    ISSN: 0163-2116
    E-ISSN: 1573-2568
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  • 5
    In: The Journal of Trauma: Injury, Infection, and Critical Care, 2011, Vol.71(6), pp.E123-E127
    Description: BACKGROUND:: The purpose of this study was to identify which age-related groups of hemodynamically stable blunt trauma patients will present a positive cost-to-benefit ratio, in regard to the screening of incidental findings on Focused Assessment with Sonography for Trauma (FAST). METHODS:: We conducted a prospective study using retrospective data taken from the trauma registry of 6,041 consecutive hemodynamically stable blunt trauma patients who underwent FAST at our Level I urban trauma hospital during the year 2009. A receiver operating characteristic curve was used to determine whether age level is useful in detecting organ-/system-specific incidental findings in trauma patients undergoing FAST and to establish the required diagnostic cutoff value of this selected test. A cost-benefit analysis was then performed for the age-specific cutoff values of each organ/system evaluated by FAST. RESULTS:: We found 522 incidental findings in 468 patients (7.8%). Further diagnostic workup was instructed in 35% (168 of 468) of patients with incidental findings. The cost-benefit analysis for the age-specific cutoff values found in the receiver operating characteristic curve analysis showed that the project of screening for incidental findings on FAST was viable only when the ultrasound operator additionally searches the liver/biliary tree (≥43 years) and the kidneys (≥56 years). CONCLUSIONS:: A systematic examination of the liver and biliary tree and both kidneys of specific age groups during FAST screening of hemodynamically stable blunt trauma patients may disclose a potentially unknown pathology with a positive cost-to-benefit ratio.
    Keywords: Health Care Costs ; Incidental Findings ; Ultrasonography, Doppler -- Economics ; Wounds, Nonpenetrating -- Diagnostic Imaging;
    ISSN: 0022-5282
    E-ISSN: 15298809
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  • 6
    Language: English
    In: The American Journal of Surgery, 2010, Vol.199(6), pp.776-781
    Description: The aim of this study was to compare the immediately postoperative and follow-up results of open and laparoscopic surgery of hepatic cysts in a tertiary hepatobiliary referral center. From March 1999 to February 2007, 59 patients underwent surgical treatment for nonparasitic liver cysts. Patients were assigned to the laparoscopic (n = 42) or open group (n = 17) for analysis. Three conversions to open procedures had to be performed in the laparoscopic group. One patient had to be reoperated because of a bile leakage in the laparoscopic group. Follow-up examination showed 2 recurrences in the laparoscopic and 3 in the open group. Three out of 17 patients in the open group had to be operated for incisional hernias. Time to previous activities was significantly shorter after laparoscopy. Laparoscopic treatment of symptomatic nonparasitic liver cysts is superior concerning short- and long-term results in a vast majority of cases.
    Keywords: Liver Cysts ; Laparoscopy ; Open Treatment ; Follow-Up ; Recurrence
    ISSN: 0002-9610
    E-ISSN: 1879-1883
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  • 7
    Language: English
    In: The American Journal of Surgery, 2010, Vol.200(2), pp.291-297
    Description: The objective of this study was to examine the outcomes of comparisons between laparoscopic and open mesh repairs in the setting of recurrent inguinal hernia. The electronic databases MEDLINE, Embase, Pubmed, and the Cochrane Library were used to search for articles from 1990 to 2008. The present meta-analysis pooled the effects of outcomes of a total of 1,542 patients enrolled into 5 randomized controlled trials and 7 comparative studies, using classic and modern meta-analytic methods. Significantly fewer cases of hematoma/seroma formation were observed in the laparoscopic group in comparison with the Lichtenstein group (odds ratio, .38; .15–.96; = .04). A matter of great importance is the higher relative risk of overall recurrence in the transabdominal preperitoneal group compared with the totally extraperitoneal group (relative risk, 3.25; 1.32–7.9; = .01). Laparoscopic versus open mesh repair for recurrent inguinal hernia was equivalent in most of the analyzed outcomes.
    Keywords: Meta-Analysis ; Evidence Based ; Publication Bias ; Recurrent Inguinal Hernia ; Totally Extraperitoneal ; Transabdominal Preperitoneal ; OPM ; Open Preperitoneal Mesh ; Stoppa ; Giant Prosthetic Reinforcement of the Visceral Sac ; Lichtenstein Procedure
    ISSN: 0002-9610
    E-ISSN: 1879-1883
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  • 8
    Language: English
    In: Surgery, February 2013, Vol.153(2), pp.189-199
    Description: In adult live donor liver transplantation, postoperative venous congestion of graft and remnant livers can lead to life-threatening complications. The purpose of this study was to evaluate the safety and benefits of our 3-dimensional, computed tomographic, computer-assisted donor hepatectomy using the “carving” partitioning technique. Eighty-three consecutive adult live donor liver transplantations were performed based on data obtained from individualized preoperative 3-dimensional, computed tomographic reconstructions and virtual graft hepatectomies. There were 71 right and 12 left grafts. Small grafts (graft volume body weight ratio, 〈1.0) were used in 20 cases. We observed no clinically important differences in postoperative function between right and left grafts. Four recipients developed lethal small-for-size syndrome. Reversible small-for-size syndrome was observed in a right graft recipient and in 2 right graft donors. Preoperative 3-dimensional, computed tomographic, computer-assisted planning using virtual liver partitioning allowed for: (1) an individualized carving technique based on specific donor anatomic characteristics, (2) donor safety based on individualized patterns of venous outflow, and (3) optimized drainage of the medial area of the graft based on the preferential inclusion of the middle hepatic vein.
    Keywords: Universities And Colleges -- Methods ; Liver Transplantation -- Methods;
    ISSN: 0039-6060
    E-ISSN: 1532-7361
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  • 9
    In: Annals of Surgery, 2010, Vol.251(4), pp.632-639
    Description: OBJECTIVES:: To evaluate differences in outcomes of breast cancer patients undergoing either conventional mastectomy without reconstruction (NSSM) or skin-sparing mastectomy (SSM) with immediate reconstruction. DATA SOURCES:: All comparative studies published between 1997 and 2009 were used to evaluate local recurrence and distant relapse in the 2 study groups. REVIEW METHODS:: Meta-analytical models were used to evaluate the study outcomes. Sensitivity analysis, was carried out to evaluate the robustness of the pooled estimates and assess the between-study heterogeneity. RESULTS:: Nine studies, comprising of 3739 patients (1104 SSM and 2635 NSSM) were included in the analysis. There were no significant differences in the disease stage or the proportion of invasive cancers between groups (73.9% vs. 83.8%, P = 0.65). There was no significant difference in local recurrence between the SSM versus NSSM groups (7 studies, 3436 patients, 6.2% vs. 4.0%, odds ratio = 1.25, 95% CI: 0.81–1.94) and there was no significant heterogeneity between the studies. The SSM group had a lower proportion of distant relapses compared with the NSSM group (5 studies, 2122 patients, 10.0% vs. 12.7%, odds ratio = 0.67, 95% CI: 0.48–0.94) but this should be interpreted with caution since the grade of the tumors was not adequately reported in the studies considered. CONCLUSIONS:: Our results suggest that in breast cancer patients, SSM was not significantly different from NSSM, in terms of rates of local recurrence. As no randomized control trial has addressed this question to date, the present meta-analysis reports the best evidence on the subject.
    Keywords: Breast Neoplasms–Pathology ; Female–Surgery ; Humans–Methods ; Mammaplasty–Methods ; Mastectomy–Methods ; Neoplasm Metastasis–Methods ; Neoplasm Recurrence, Local–Methods ; Abridged;
    ISSN: 0003-4932
    E-ISSN: 15281140
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  • 10
    In: Annals of Surgery, 2002, Vol.236(6), pp.806-813
    Description: PURPOSE: To evaluate in a prospective randomized study the long-term results of adjuvant locoregional chemoimmunotherapy in a number of patients with stage III pancreatic duct cancer who underwent pancreatic resection between November 1993 and October 2000. METHODS: One hundred twenty-eight patients were divided into three groups. Group A (n = 40) patients had surgical resection alone. Group B (n = 45) patients had, using a side arterial branch of the jejunal artery, an arterial catheter advanced under fluoroscopic control into the superior mesenteric artery. Group B patients also received adjuvant chemotherapy. Group C (n = 43) patients had the same kind of arterial catheter and received as an adjuvant treatment locoregional chemoimmunotherapy. During the initial surgical exploration, all patients underwent pancreatic resection. Pancreatic resection involved a standard technique of extended duodenopancreatectomy with regional lymphadenectomy and was carried out in all patients by the first author. At the end of intervention, all patients were randomly assigned to the above-mentioned groups. Randomization was based mainly on histologic evidence of the stage of the disease. RESULTS: The 2- and 5-year survival rates were 29% and 0% for group A, 52% and 10% for group B, and 65% and 18% for group C. The respective percentages for disease-free survival were 20% and 0% for group A, 35% and 7% for group B, and 58% and 11% for group C. Since statistical differences among groups were observed from the second and third years, the study was interrupted early for ethical reasons. CONCLUSIONS: When applied regionally, combined chemoimmunotherapy is simple, safe, and effective. This type of therapy offers substantial advantages in terms of prolonging overall survival and improving disease-free survival compared to surgical resection alone or to surgical resection and adjuvant regional chemotherapy.
    Keywords: Adenocarcinoma–Mortality ; Adult–Pathology ; Aged–Surgery ; Aged, 80 and Over–Therapy ; Antineoplastic Combined Chemotherapy Protocols–Administration & Dosage ; Biopsy, Needle–Methods ; Chemotherapy, Adjuvant–Methods ; Chemotherapy, Cancer, Regional Perfusion–Mortality ; Combined Modality Therapy–Pathology ; Disease-Free Survival–Surgery ; Female–Therapy ; Humans–Therapy ; Immunotherapy–Therapy ; Male–Therapy ; Middle Aged–Therapy ; Neoplasm Staging–Therapy ; Odds Ratio–Therapy ; Pancreatectomy–Therapy ; Pancreatic Neoplasms–Therapy ; Probability–Therapy ; Prognosis–Therapy ; Proportional Hazards Models–Therapy ; Prospective Studies–Therapy ; Survival Analysis–Therapy ; Treatment Outcome–Therapy ; Abridged;
    ISSN: 0003-4932
    E-ISSN: 15281140
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