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| 1 | Mesenteric ischemia:Pathogenesis and challengingdiagnostic and therapeutic modalities显示文摘Mesenteric ischemia(MI) is an uncommon medical condition with high mortality rates. ΜΙ includes inadequate blood supply, inflammatory injury and eventually necrosis of the bowel wall. The disease can be divided into acute and chronic MI(CMI), with the first being subdivided into four categories. Therefore, acute MI(AMI) can occur as a result of arterial embolism, arterial thrombosis, mesenteric venous thrombosis and nonocclusive causes. Bowel damage is in proportion to the mesenteric blood flow decrease and may vary from minimum lesions, due to reversible ischemia, to transmural injury, with subsequent necrosis and perforation. CMI is associated to diffuse atherosclerotic disease in more than 95% of cases, with all major mesenteric arteries presenting stenosis or occlusion. Because of a lack of specific signs or due to its sometime quiet presentation, this condition is frequently diagnosed only at an advanced stage. Computed tomography(CT) imaging and CT angiography contribute to differential diagnosis and management of AMI. Angiography is also the criterion standard for CMI, with mesenteric duplex ultrasonography and magnetic resonance angiography also being of great importance. Therapeutic approach of MI includes both medical and surgical treatment. Surgical procedures include restoration of the blood flow with arteriotomy, endarterectomy or anterograde bypass, while resection of necrotic bowel is always implemented. The aim of this review was to evaluate the results of surgical treatment for MI and to present the recent literature in order to provide an update on the current concepts of surgical management of the disease. Mesh words selected include MI, diagnostic approach and therapeutic management. | Aikaterini Mastoraki Sotiria Mastoraki Evgenia Tziava Stavroula Touloumi Nikolaos Krinos Nikolaos Danias Andreas Lazaris Nikolaos Arkadopoulos | 2016 | World Journal of Gastrointestinal Pathophysiology2016，7，1： | 23 |
| 2 | Inferior vena cava obstruction and collateral circulation as unusual manifestations of hepatobiliary cystadenocarcinoma显示文摘BACKGROUND: Hepatobiliary cystadenocarcinoma represents a rare epithelial malignant tumor derived from the intrahepatic bile duct. METHODS: A 71-year-old woman, who had undergone laparoscopic drainage of a cystic lesion of the right hepatic lobe, was misdiagnosed as having hepatic echinococcal disease, and received intracystic infusion of 95% ethanol four years ago. She was admitted to our hospital for further treatment. RESULTS: Physical examination revealed dilated superficial veins across the right abdominal wall. After mapping the direction of blood flow in these vessels, we assumed that this was a sign of inferior vena cava obstruction. Abdominal ultrasound, computed tomography, magnetic resonance imaging combined with magnetic resonance angiography showed a large cystic mass in the right upper quadrant and epigastrium, displacing the adjacent structures, adherent to the inferior vena cava, which was not patent, resulting in dilation of superficial epigastric veins. The patient underwent an exploratory laparotomy. Total excision of the huge mass measuring 16×15 cm was possible under selective vascular exclusion of the liver. Removal of the tumor resulted in immediate restoration of flow in the inferior vena cava. On the basis of the pathology and findings of immunohistochemical analysis, a hepatobiliary cystadenocarcinoma was diagnosed.CONCLUSIONS: In the present case, hepatobiliary cystadenocar-cinoma was accompanied by dilated superficial venous collaterals due to inferior vena cava obstruction. Selective vascular exclusion of the liver allowed a safe oncological resection of the tumor. | Nikolaos Arkadopoulos Anneza I Yiallourou Constantinos Palialexis Emmanouil Stamatakis Evi Kairi-Vassilatou Vassilis Smyrniotis | 2013 | Hepatobiliary & Pancreatic Diseases International2013，12，3： | 10 |
| 3 | Surgical approaches of resectable synchronous colorectal liver metastases:Timing considerations显示文摘AIM: To compare the safety and efficacy of simultaneous versus two stage resection of primary colorectal tumors and liver metastases. METHODS: From January 1996 to May 2004, 103 colorectal tumor patients presented with synchronous liver metastases. Twenty five underwent simultaneous colorectal and liver surgery and 78 underwent liver surgery 1-3 mo after primary colorectal tumor resection. Data were retrospectively analyzed to assess and compare the morbidity and mortality between the surgical strategies. The two groups were comparable regarding the age and sex distribution, the types of liver resection and stage of primary tumors, as well as the number and size of liver metastases. RESULTS: In two-stage procedures more transfusions were required (4 ± 1.5 vs 2 ± 1.8, pRBCs, P < 0.05). Chest infection was increased after the two-stage approach (26% vs 17%, P < 0.05). The two-stage procedure was also associated with longer hospitalization (20 ± 8 vs 12 ± 6 d, P < 0.05). Five year survival in both groups was similar (28% vs 31%). No hospital mortality occurred in our series. CONCLUSION: Synchronous colorectal liver metastases can be safely treated simultaneously with the primary tumor. Liver resection should be prioritized over colon resection. It is advisable that complex liver resections with marginal liver residual volume should be dealt with at a later stage. | Ioannis Vassiliou Nick Arkadopoulos Theodosios Theodosopoulos Georgios Fragulidis Athanasios Marinis Agathi Kondi-Paphiti Lazaros Samanides Andreas Polydorou Constantinos Gennatas Dionysios Voros Vassilios Smyrniotis | 2007 | World Journal of Gastroenterology2007，13，9： | 8 |
| 4 | Facing the challenge of venous thromboembolism prevention in patients undergoing major abdominal surgical procedures for gastrointestinal cancer显示文摘Venous thromboembolism(VTE)refers to a hypercoa-gulable state that remains an important and preven-table factor in the surgical treatment of malignancies.VTE includes two identical entities with regards to deep vein thrombosis and pulmonary embolism.The incidence of VTE after major abdominal interventions for gastro-intestinal,hepato-biliary and pancreatic neoplastic disor-ders is as high as 25%without prophylaxis.Prophylactic use of classic or low-molecular-weight heparin,anti-Xa factors,antithrombotic stocking,intermittent pneumatic compression devices and early mobilization have been described.Nevertheless,thromboprophylaxis is often dis-continued after discharge,although a serious risk may persist long after the initial triggering event,as the coagu-lation system remains active for at least 14 d post-opera-tively.The aim of this review is to evaluate the results of the current practice of VTE prevention in cancer patients undergoing major abdominal surgical operations,with special attention to adequately elucidated guidelinesand widely accepted protocols.In addition,the recent literature is presented in order to provide an update on the current concepts concerning the surgical manage-ment of the disease. | Aikaterini Mastoraki Sotiria Mastoraki Dimitrios Schizas Raphael Patras Nikolaos Krinos Ioannis S Papanikolaou Andreas Lazaris Theodore Liakakos Nikolaos Arkadopoulos | 2018 | World Journal of Gastrointestinal Oncology2018，10，10： | 7 |
| 5 | Recurrent aggressive mesenteric desmoid tumor successfully treated with sorafenib: A case report and literature review显示文摘BACKGROUND Desmoid tumors(DT) are locally advanced but histologically benign monoclonal neoplasms that can occur from any musculoaponeurotic structure. The aim of this report is to analyze a rare clinical case of an aggressive intra-abdominal DT successfully treated with sorafenib.CASE SUMMARY A 36-year-old man presented with increasing colicky abdominal pain and a selfpalpable mass in his left abdomen. Fourteen years earlier he was diagnosed with a large intra-abdominal tumor, which adhered to the left colonic flexure, part of the major gastric curvature and the spleen. Subsequent exploratory laparotomy revealed a voluminous mass in the epigastrium, arising from the posterior surface of the stomach and invading the superior mesenteric vessels, transverse mesocolon and the small bowel mesentery. As the tumor was unresectable, a jejunojejunal bypass was performed. Traditional therapeutic interventions proved insufficient, and the patient was started on sorafenib with a subsequent fulldisease response.CONCLUSIONDT's pathogenesis has been associated with mutations in the adenomatous polyposis coli(APC) gene or beta-catenin gene CTNNB1, sex steroids or previous surgical trauma. Local treatment modalities, such as surgery or radiotherapy, are implemented in aggressively progressing or symptomatic patients. Sorafenib is a hopeful therapeutic option against DTs, while several pharmacological agents have been successfully used. | Aikaterini Mastoraki Dimitrios Schizas Chrysovalantis Vergadis Leon Naar Alexios Strimpakos Michail G Vailas Natasha Hasemaki George Agrogiannis Theodore Liakakos Nikolaos Arkadopoulos | 2019 | World Journal of Clinical Oncology2019，10，4： | 4 |
| 6 | Global Consequences of Liver Ischemia/Reperfusion Injury显示文摘 | Constantinos Nastos Konstantinos Kalimeris Nikolaos Papoutsidakis Marios-Konstantinos Tasoulis Panagis M. Lykoudis Kassiani Theodoraki Despoina Nastou Vassilios Smyrniotis Nikolaos Arkadopoulos Mengzhou Xue | 2014 | Oxidative Medicine and Cellular Longevity2014，，： | 3 |
| 7 | Management of primary retroperitoneal synovial sarcoma: A case report and review of literature显示文摘BACKGROUND Synovial sarcoma(SS) is a rare type of soft tissue sarcoma that is usually developed from areas where synovial tissue exists, especially at the extremities.Nevertheless, several cases of retroperitoneal SS(RSS) have been described. We herein report a case of RSS presented in our institution.CASE SUMMARY A 69-year-old female patient was admitted with a large, palpable, firm mass in the right abdominal space SS. Computerized tomography scan depicted a concentric, sharply marinated retro-peritoneal lesion which was displacing the right kidney and the lower edge of the liver. Subsequently, the patient underwent surgical excision of the mass with additional right nephrectomy and resection of the right adrenal gland and a part of the diaphragm. The final histological diagnosis of the tumour was grade II monophasic RSS.CONCLUSION RSS is encountered in the biphasic type, the monophasic fibrous, and the monophasic epithelial category as well. Relevant clinical manifestations are not always documented at early stages. Therefore, the final diagnosis is posed after complete histological examination taking into consideration the results of immunochemistry and genetic analysis. Therapeutic approach happens often late when metastases at the lungs and the liver are apparent. Thus, 5-year survival rates remain low. | Aikaterini Mastoraki Dimitrios Schizas Ioannis S Papanikolaou George Bagias Nikolaos Machairas George Agrogiannis Theodore Liakakos Nikolaos Arkadopoulos | 2019 | World Journal of Gastrointestinal Surgery2019，11，1： | 2 |
| 8 | Ischemic Preconditioning Confers Antiapoptotic Protection During Major Hepatectomies Performed Under Combined Inflow and Outflow Exclusion of the Liver. A Randomized Clinical Trial显示文摘 | Nikolaos Arkadopoulos Georgia Kostopanagiotou Kassiani Theodoraki Charalambos Farantos Theodosios Theodosopoulos Vaia Stafyla John Vassiliou Dionyssios Voros Agathi Pafiti Vassilios Smyrniotis | 2009 | World Journal of Surgery2009，，9： | 2 |
| 9 | Vascular Control during Hepatectomy: Review of Methods and Results显示文摘 | Vassilios Smyrniotis MD PhD Charalampos Farantos MD Georgia Kostopanagiotou MD PhD Nikolaos Arkadopoulos MD PhD | 2005 | World Journal of Surgery2005，，11： | 2 |
| 10 | Use of iron chelation for the control of brain edema in experimental ischemic liver failure显示文摘 | Arkadopoulos N Vlahakos D Kostopanagiotou G | 2005 | Alimentary Tract2005，201，3： | 1 |
| 11 | Des-ferrioxamine attenuates minor lung injury following surgical acuteliver failure显示文摘 | Kostopanagiotou GG Kalimeris KA Arkadopoulos NP | 2009 | Eur Respir J2009，33，6： | 1 |
| 12 | Protective Effect of NAC Preconditioning Against Ischemia-Reperfusion Injury in Piglet Small Bowel Transplantation: Effects on Plasma TNF, IL-8, Hyaluronic Acid, and NO显示文摘 | Georgia Kostopanagiotou Efthimios D. Avgerinos Efthimia Markidou Panagiotis Voiniadis Constantinos Chondros Kassiani Theodoraki Vassilios Smyrniotis Nikolaos Arkadopoulos | 2011 | Journal of Surgical Research2011，，2： | 1 |
| 13 | Does internal stenting of the pancreaticojejunostomy improve outcomes after pancreatoduode- nectomy? A prospective study 显示文摘 | Smyrniotis V Arkadopoulos N Kyriazi MA | 2010 | Langenbecks Arch Surg2010，395，3： | 1 |
| 14 | Adjuvant chemotherapy and acute toxicity in hypofractionated radiotherapy for early breast cancer显示文摘AIM: To evaluate the effect of chemotherapy to the acute toxicity of a hypofractionated radiotherapy(HFRT) schedule for breast cancer. METHODS: We retrospectively analyzed 116 breast cancer patients with T1, 2N0 Mx. The patients received3-D conformal radiotherapy with a total physical dose of 50.54 Gy or 53.2 Gy in 19 or 20 fractions according to stage, over 23-24 d. The last three to four fractions were delivered as a sequential tumor boost. All patients were monitored for acute skin toxicity according to the European Organization for Research and Treatment of Cancer/Radiation Therapy Oncology Group criteria. The maximum monitored value was taken as the final grading score. Multivariate analysis was performed for the contribution of age, chemotherapy and 19 vs 20 fractions to the radiation acute skin toxicity.RESULTS: The acute radiation induced skin toxicity was as following: grade Ⅰ 27.6%, grade Ⅱ 7.8% and grade Ⅲ 2.6%. No significant correlation was noted between toxicity grading and chemotherapy(P = 0.154, χ2 test). The mean values of acute toxicity score in terms of chemotherapy or not, were 0.64 and 0.46 respectively(P = 0.109, Mann Whitney test). No significant correlation was also noted between acute skin toxicity and radiotherapy fractions(P = 0.47, χ2test). According to univariate analysis, only chemotherapy contributed significantly to the development of acute skin toxicity but with a critical value of P = 0.05. However, in multivariate analysis, chemotherapy lost its statistical significance. None of the patients during the 2-years of follow-up presented any locoregional relapse.CONCLUSION: There is no clear evidence that chemotherapy has an impact to acute skin toxicity after an HFRT schedule. A randomized trial is needed for definite conclusions. | Vassilis Kouloulias Anna Zygogianni Efrosini Kypraiou John Georgakopoulos Zoi Thrapsanioti Ivelina Beli Eftychia Mosa Amanta Psyrri Christos Antypas Christina Armbilia Maria Tolia Kalliopi Platoni Christos Papadimitriou Nikolaos Arkadopoulos Costas Gennatas George Zografos George Kyrgias Maria Dilvoi George Patatoucas Nikolaos Kelekis John Kouvaris | 2014 | World Journal of Clinical Cases2014，2，11： | 1 |
| 15 | Pathways andtargets in hepatocellular carcinoma显示文摘 | Psyrri A Arkadopoulos N Vassilakopoulou M | 2012 | Expert Rev Antieancer Ther2012，12，10： | 1 |
| 16 | Does internal stenting of the pancreaticojejunostomy improve outcomes after pancreatoduodenectomy? A prospective study显示文摘 | Smyrniotis V Arkadopoulos N Kyriazi MA | | 0，，03： | 1 |
| 17 | Small liver remnants are more vulnerable to ischemia/reperfusion injury after extended hepatectomies: a case-control study显示文摘 | Theodoraki K Arkadopoulos N Nastos C | 2012 | World J Surg2012，36，12： | 1 |
| 18 | Clinical use of a bioartificial liver in the treatment of acetaminopheninduced fulminant hepatic failure显示文摘 | DETRY O ARKADOPOULOS N TING P | 1999 | Am Surg1999，65，10： | 1 |
| 19 | Central hepatectomy under sequential hemihepatic control显示文摘 | Nikolaos Arkadopoulos Maria A. Kyriazi Kassiani Theodoraki Pantelis Vassiliou Apostolos Perelas Ioannis Vassiliou Vassilios Smyrniotis | 2012 | Langenbeck’s Archives of Surgery2012，，8： | 1 |
| 20 | Development of a porcine model of post-hepatectomy liver failure显示文摘 | Arkadopoulos N Defterevos G Nastos C | 2011 | Journal of Surgical Research2011，170，2： | 1 |
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