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Kontzoglou K, Stamatakos M, Polyzou E, Levidou G, Iannescu R, Safioleas M. Dermatofibrosarcoma: a rare form of soft tissue. Management and review of the literature. Chirurgia (Bucur) 2011; 106:653-656. [PMID: 22165066] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/31/2023]
Abstract
Dermatofibrosarcoma protuberans (DFSP) is an uncommon soft tissue tumor of cutaneous origin of intermediate grade malignant potential. The incidence of DFSP is 0.1% of all cancers and 1% of all soft tissue sarcomas. We present the case of a 65years old female with a palpable, painful mass on the right thigh. A surgical excision of the lesion was done and the histopathology, as well as the immunohistochemical analysis with CD-34, confirmed the diagnosis of DFSP. Two years later, the patient is free of disease and no local recurrences or metastases have been found. Wide radical excision is the preferred surgical method for therapy of DFSP without distant metastasis. Furthermore, DFSP resists to conventional chemotherapy and radiation therapy, while, in cases of metastasis, therapy depends on cytogenesis and molecular biology of the tumor, so new therapeutic strategies are under research.
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Affiliation(s)
- K Kontzoglou
- 2nd Department of Propedeutic Surgery, University of Athens, School of Medicine, Laikon, General Hospital, Athens, Greece
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Stamatakos M, Kontzoglou K, Sargedi C, Tsaknaki S, Iannescu R, Safioleas C, Kaitanidi V, Safioleas M. Gastrointestinal carcinoid tumors: diagnosis and treatment. Chirurgia (Bucur) 2010; 105:759-766. [PMID: 21351698] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/30/2023]
Abstract
Carcinoid tumors are malignancies originating from neuroendocrine cells, most commonly encountered in the gastrointestinal tract, in a rate of 64%, with the majority affecting the ileum. Certain genetic syndromes sometimes include carcinoid tumors in their phenotype. These malignancies may be rather asymptomatic, although occasionally they behave aggressively. They are typically diagnosed due to the effects of a locally advanced disease, or when producing symptoms because of hormone secretion (carcinoid syndrome). A better understanding of their molecular biology and behavior is demanded so that these tumors to be diagnosed precociously and managed effectively.
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Affiliation(s)
- M Stamatakos
- 4th Department of Surgery, University of Athens, School of Medicine, Attikon General Hospital, Athens, Greece.
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Stamatakos M, Safioleas C, Tsaknaki S, Safioleas P, Iannescu R, Safioleas M. Insulinoma: a rare neuroendocrine pancreatic tumor. Chirurgia (Bucur) 2009; 104:669-673. [PMID: 20187464] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/28/2023]
Abstract
Insulinomas are functional endocrine tumors originating from the pancreatic b-cells. In 1902 Nicholls described the first adenoma of pancreatic islets, while the first insulinoma was described in 1927 in Mayo Clinic, which was dissected two years later in 1929 in Toronto. The first enucleation of insulinoma took place in a St. Jouis hospital in 1931, and after four years, in 1935, Whipple described the classic diagnostic triad: symptoms of fasting hypoglycemia or fatigue, blood glucose levels under 50 mg/dl and disappearance of symptoms after glucose administration.
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Affiliation(s)
- M Stamatakos
- 4h Department of Surgery, University of Athens, School of Medicine, Attikon General Hospital, Athens, Greece.
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Stamatakos M, Stefanaki C, Tsaknaki S, Safioleas P, Iannescu R, Safioleas M. Primary adenocarcinoma of the appendix: an update. Chirurgia (Bucur) 2009; 104:389-392. [PMID: 19886044] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/28/2023]
Abstract
Adenocarcinoid arising in the vermiform appendix is a rarity. The diagnosis of appendiceal adenocarcinoma has never been made preoperatively and is frequently an incidental finding at the time of operation for unrelated conditions. Because of the rarity of the disease, its natural history is poorly understood. Benefits from adjuvant radiation, chemotherapy, or a combination have not been reported. Most studies emphasize survival outcome based on surgical technique. There are few data and, consequently, much debate on the appropriate management of these lesions. The aim of this article is to review this entity and to assess and report new data, through a study of the literature.
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Affiliation(s)
- M Stamatakos
- 4th Surgical Department of Surgery, University of Athens, School of Medicine, Attikon General Hospital, Athens, Greece.
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Stamatakos M, Zervas A, Sargeti C, Tsaknaki S, Iannescu R, Safioleas P, Safioleas M. Hydatid disease of the urinary tract: an update. Chirurgia (Bucur) 2008; 103:621-627. [PMID: 19274905] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/27/2023]
Abstract
Hydatid disease constitutes an endemic zoonosis caused by different species of the cestode Echinococcus. The main organs affected are the liver and the lungs. Echinococcosis of the urinary tract is an extremely rare medical condition, met in 2-4% of cases. This pathologic entity has to be included in the differential diagnosis of occupying lesions of the urinary tract at any age, especially among patients in endemic areas. Meticulous laboratory and imaging control when taking into consideration the suspicion for the disease, can guarantee an accurate diagnosis and successful outcome.
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Affiliation(s)
- M Stamatakos
- 2nd Department of Propaedeutic Surgery, University of Athens, School of Medicine, Laiko General Hospital, Athens, Greece.
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Safioleas M, Stamatakos M, Safioleas P, Diab A, Iannescu R, Safioleas C. Superficial parotidectomy under local anaesthesia. Chirurgia (Bucur) 2008; 103:453-454. [PMID: 18780619] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/26/2023]
Abstract
The modern tendency of surgery is to perform a constantly rising number of operations under local anaesthesia. Superficial parotidectomy under local anaesthesia has not been widely attempted. However only few reports show that this kind of procedure could be feasible. If this is the case, standard assessment of benign parotid tumors will change radically.
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Affiliation(s)
- M Safioleas
- 2nd Department of Propaedeutic Surgery, University of Athens, School of Medicine, Laiko General Hospital, Athens, Greece.
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Safioleas M, Stamatakos M, Spyrakos C, Safioleas P, Chatzikonstantinou C, Iannescu R, Safioleas C. Evaluation and surgical management of the gallstone ileus. A single center experience. Chirurgia (Bucur) 2008; 103:297-300. [PMID: 18717278] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/26/2023]
Abstract
Gallstone ileus representing 1-4% of all bowel obstructions cholelithiasis. Impaction of a gallstone in the human of the bowel is a surgical emergency. Relief of the obstruction is the treatment of choice, but controversy exists regarding the repair of the fistula and cholecystectomy. Our experience in the management of gallstone ileus is presented in the following article.
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Affiliation(s)
- M Safioleas
- 2nd Department of Propedeutic Surgery, University of Athens, School of Medicine, Laiko General Hospital, Athens, Greece
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Mouzopoulos G, Stamatakos M, Tzurbakis M, Batanis G, Michou E, Mouzopoulos D, Tsembeli A, Iannescu R, Safioleas M. Lower extremity infections by vibrio vulnificus. Chirurgia (Bucur) 2008; 103:201-203. [PMID: 18457099] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/26/2023]
Abstract
BACKGROUND Vibrio vulnificus is a Gram-negative pathogen which is found in seawater and shellfish during warm months and can cause local infections in healthy individuals or septicemia in patients with chronic liver disease. MATERIALS-METHODS Clinical and laboratory records of four complicated cases are presented, with a 4.2 mean year follow-up. RESULTS Three patients underwent urgent leg amputation because of of irreversible necrotic changes with septic complications and failure of incisional drainage to control the infection. Another one patient underwent only excision of necrotic soft tissue but he developed calcaneus osteomyelitis after three years of the initial fish bone injury. DISCUSSION Clinicians must maintain a high index of suspicion, especially in regions endemic for vibrio necrotising fasciitis and antibiotic prophylaxis must be given to swimmers before or during bathing.
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Safioleas M, Stamatakos M, Safioleas C, Iannescu R, Safioleas P, Mantas D. Adrenal rupture after blunt abdominal trauma. Chirurgia (Bucur) 2008; 103:107-109. [PMID: 18459507] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/26/2023]
Abstract
The case of a patient, victim of a car accident, with rupture of the left adrenal gland associated with splenic rupture and liver laceration is reported. Injury of the adrenal glands is most frequently caused by blunt abdominal trauma and is usually associated with injuries of other abdominal organs. Careful exploration of the upper retroperitoneal space where adrenals are located is considered necessary during laparotomy for severe blunt abdominal trauma. If adrenal lesion has been overlooked continuous hemorrhage may occur, which could be lethal if not promptly treated.
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Affiliation(s)
- M Safioleas
- 2nd Department of Propedeutic Surgery, University of Athens, School of Medicine, Laiko General Hospital, Athens, Greece
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Stamatakos M, Tsaknaki S, Iannescu R, Stathellis A, Safioleas P, Rompoti N, Safioleas M. Abdominal compartment syndrome: effects on organ function. Chirurgia (Bucur) 2007; 102:633-640. [PMID: 18323225] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/26/2023]
Abstract
Abdominal compartment syndrome (ACS) constitutes a critical clinical situation presenting a remarkable incidence being the causal factor of variable abdominal and extra-abdominal pathology, thus a rising issue of interest in intensive medical care over the past decade. Moreover, ACS as a condition potentially leading to Multiple Organ Failure (MOF), its better understanding could provide more effective management resulting to limitation of MOF incidence and mortality.
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Affiliation(s)
- M Stamatakos
- 2nd Department of Propaedeutic Surgery, University of Athens, School of Medicine, Laiko General Hospital, Athens, Greece.
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Stamatakos M, Kontzoglou K, Tsaknaki S, Sargeti C, Iannescu R, Safioleas C, Safioleas M. Intrahepatic bile duct rupture of hydatid cyst: a severe complication for the patient. Chirurgia (Bucur) 2007; 102:257-62. [PMID: 17687852] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/16/2023]
Abstract
In most cases of echinococcal disease the liver is the mainly affected organ. The clinical manifestations are defined by the size and the localization of the hydatid cyst. The appearance of complications, such as purulence and rupture of the cyst, aggravate the patients' clinical condition. Intrabiliary rupture, although rare, carries severe health risks; timely diagnosis and appropriate management of this entity are vital for the patient's survival.
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Affiliation(s)
- M Stamatakos
- 2nd Department of Propedeutic Surgery, University of Athens, School of Medicine, Laiko General Hospital, Athens, Greece.
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Safioleas M, Stamatakos M, Iannescu R, Safioleas C, Kostakis A. The coexistence of carcinoma of the rectum and of ischiorectal abscess: what is the optimal therapeutic approach? Chirurgia (Bucur) 2007; 102:221-2. [PMID: 17615926] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/16/2023]
Abstract
This article deals with the dilemma of the surgeon to choose the optimal surgical procedure in case of coexistence of ischiorectal abscess and a rectal carcinoma. The case of a patient suffering from ischiorectal abscess in association with rectal carcinoma is reported.
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Affiliation(s)
- M Safioleas
- 2nd Department of Propedeutic Surgery, School of Medicine, Athens University, Greece
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Safioleas M, Stamatakos M, Rompoti N, Mouzopoulos G, Iannescu R, Salichou V, Skandalakis P. Complications of thyroid surgery. Chirurgia (Bucur) 2006; 101:571-81. [PMID: 17283832] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/13/2023]
Abstract
Thyroid surgery has a history of significant changes in the technique and the incidence of complications. Since then continuous developments in surgical techniques and better understanding of thyroid anatomy and pathology have increased the safety of thyroid surgery and reduced the incidence of complications. Nowadays, the rate of postoperative mortality is extremely low. Nevertheless, the incidence of postoperative complications varies in literature from 7.4% to 53% of the operations performed. The most common and potentially life-threatening complications in thyroid gland surgery are vocal cord palsy and hypocalcemia. Herein we discuss the common complications in thyroid gland surgery and their proper management.
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Affiliation(s)
- M Safioleas
- 2nd Department of Propedeutic Surgery, University of Athens, School of Medicine, Laiko General Hospital, Athens, Greece.
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Safioleas M, Stamatakos MK, Mouzopoulos GJ, Karampali E, Iannescu R, Chantzikonstantinou K, Kostakis A. Pancreatic abscess due to perforation of duodenal diverticulum. Chirurgia (Bucur) 2006; 101:523-4. [PMID: 17278646] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/13/2023]
Abstract
Duodenal diverticula are usually incidental findings, but some times could be complicated with inflammatory or pressures effects to pancreas tissue. We present a rare case of pancreatic abscess caused by a perforated diverticulum, arising from the distal end of the second part of the duodenum.
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Affiliation(s)
- M Safioleas
- 2nd Department of Propedeutic Surgery, School of Medicine, Athens University, Greece.
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Safioleas M, Stamatakos MK, Mouzopoulos GJ, Manti C, Iannescu R, Skandalakis P, Kostakis A. Changes of CPK and CPK-MB levels after open and laparoscopic cholecystectomy. Chirurgia (Bucur) 2006; 101:401-5. [PMID: 17059151] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/12/2023]
Abstract
According to the World Health Organization, an increased ratio (more than 6%) of CPK-MB to total CPK may indicate the diagnosis of an acute infarction. But false elevation of CPK and CPK-MB levels after noncardiac operation, because of soft tissue damage, may confuse the clinicians in detecting myocardial infarction in early postoperative period. In order to determine the usefulness of CPK-MB to total CPK ratio in detecting myocardial infarction after open and laparoscopic cholecystectomy, we measured the serum levels of these markers in 135 patients, immediately after the operation and for the next five days. Patients were divided into four groups according to type of surgical procedure, as follows: Group I: a right oblique subcostal (Kocher's) incision was performed in 29 patients, Group II: a right paramedian transrectal incision was performed in 52 patients, Group III: a vertical high midline incision was performed in 17 patients, Group IV: laparoscopic cholecystectomy was performed in 37 patients. Although we found increased levels of CPK and CPK-MB after all the types of cholecystectomy, but in any case the CPK-MB exceeded more than 6% of total serum CPK. Furthermore we noticed that the patients who underwent open cholecystectomy with right oblique subcostal incision had the most elevated CPK and CPK-MB levels comparing to the other types of cholecystectomy. In conclusion, tissue damage after elective cholecystectomy is minimal and CPK-MB to total CPK ratio is a secure marker in detection of myocardial infarction during early post-operation period, after cholecystectomy.
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Affiliation(s)
- M Safioleas
- 2nd Department of Propedeutic Surgery, School of Medicine, Athens University, Greece
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