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| 1 | Improvement of gastric emptying by enhanced recovery after pancreaticoduodenectomy显示文摘BACKGROUND: Enhanced recovery after surgery(ERAS) has improved postoperative outcomes particularly in colorectal surgery. This study aimed to assess compliance with an ERAS protocol and evaluate its effect on postoperative outcomes in patients undergoing pancreaticoduodenectomy. METHODS: Fifty patients who had received conventional peri operative management from 2005 to 2009(conventional group)were compared with 75 patients who had received perioperative care with an ERAS protocol(fast-track group) from 2010 to2014. Mortality, complications, readmissions and length of hospital stay were evaluated and compared in the groups.RESULTS: Compliance with each element of the ERAS pro tocol ranged from 74.7% to 100%. Uneventful patients had a significant higher adherence to the ERAS protocol(87.5% vs40.7%; P<0.001). There were no significant differences in de mographics and perioperative characteristics between the two groups. Patients in the fast-track group had a shorter time to remove the nasogastric tube, start liquid diet and solid food pass flatus and stools, and remove drains. No difference was found in mortality, relaparotomy, readmission rates and over all morbidity. However, delayed gastric emptying and length of hospital stay were significantly reduced in the fast-track group. The independent effect of the ERAS protocol in reduc ing delayed gastric emptying and length of hospital stay was confirmed by multivariate analysis.CONCLUSION: ERAS pathway was feasible and safe in improving gastric emptying, yielding an earlier postoperative recovery, and reducing the length of hospital stay. | Efstratios Zouros Theodoros Liakakos Anastasios Machairas Paulos Patapis Christos Agalianos Christos Dervenis | 2016 | Hepatobiliary & Pancreatic Diseases International2016，15，2： | 16 |
| 2 | TYMS/KRAS/BRAF molecular profiling predicts survival following adjuvant chemotherapy in colorectal cancer显示文摘BACKGROUND Patients with stage II-III colorectal cancer (CRC) treated with adjuvant chemotherapy, gain a 25% survival benefit. In the context of personalized medicine, there is a need to identify patients with CRC who may benefit from adjuvant chemotherapy. Molecular profiling could guide treatment decisions in these patients. Thymidylate synthase (TYMS) gene polymorphisms, KRAS and BRAF could be included in the molecular profile under consideration. AIM To investigate the association of TYMS gene polymorphisms, KRAS and BRAF mutations with survival of CRC patients treated with chemotherapy.METHODS A retrospective study studied formalin-fixed paraffin-embedded tissues (FFPEs) of consecutive patients treated with adjuvant chemotherapy during January/2005-January/2007. FFPEs were analysed with PCR for the detection of TYMS polymorphisms, mutated KRAS (mKRAS) and BRAF (mBRAF). Patients were classified into three groups (high, medium and low risk) according to 5’UTR TYMS polymorphisms Similarly, based on 3’UTR polymorphism ins/loss of heterozygosity (LOH) patients were allocated into two groups (high and low risk of relapse, respectively). Cox regression models examined the associated 5- year survival outcomes. RESULTS One hundred and thirty patients with early stage CRC (stage I-II: 55 patients;stage III 75 patients;colon: 70 patients;rectal: 60 patients) were treated with surgery and chemotherapy. The 5-year disease free survival and overall survival rate was 61.6% and 73.9% respectively. 5’UTR polymorphisms of intermediate TYMS polymorphisms (2RG/3RG, 2RG/LOH, 3RC/LOH) were associated with lower risk for relapse [hazard ratio (HR) 0.320, P = 0.02 and HR 0.343, P = 0.013 respectively] and death (HR 0.368, P = 0.031 and HR 0.394, P = 0.029 respectively). The 3’UTR polymorphism ins/LOH was independently associated with increased risk for disease recurrence (P = 0.001) and death (P = 0.005). mBRAF (3.8% of patients) was associated with increased risk of death (HR 4.500, P = 0.022) whereas mKRAS (39% of patients) not. CONCLUSION Prospective validating studies are required to confirm whether 2RG/3RG, 2RG/LOH, 3RC/LOH, absence of ins/LOH and wild type BRAF may indicate patients at lower risk of relapse following adjuvant chemotherapy. | Anastasios Ntavatzikos Aris Spathis Paul Patapis Nikolaos Machairas Georgia Vourli George Peros Iordanis Papadopoulos Ioannis Panayiotides Anna Koumarianou | 2019 | World Journal of Gastrointestinal Oncology2019，11，7： | 5 |
| 3 | Integrating TYMS, KRAS and BRAF testing in patients with metastatic colorectal cancer显示文摘AIM To investigate the impact of thymidylate synthase(TYMS), KRAS and BRAF in the survival of metastatic colorectal cancer(m CRC) patients treated with chemotherapy. METHODS Clinical data were collected retrospectively from records of consecutive patients with m CRC treated with fluoropyrimidine-based chemotherapy from 1/2005 to 1/2007. Formalin-fixed paraffin-embedded tissues were retrieved for analysis. TYMS genotypes were identified with restriction fragment analysis PCR, while KRAS and BRAF mutation status was evaluated using real-time PCR assays. TYMS gene polymorphisms of each of the 3' untranslated region(UTR) and 5'UTR were classified into three groups according to the probability they have for high, medium and low TYMS expression(and similar levels of risk) based on evidence from previous studies. Univariate and multivariate survival analyses were performed.RESULTS The analysis recovered 89 patients with m CRC(46.1% de novo metastatic disease and 53.9% relapsed). Of these, 46 patients(51.7%) had colon cancer and 43(48.3%) rectal cancer as primary. All patients were treated with fluoropyrimidine-based chemotherapy(5FU or capecitabine) as single-agent or in combination with irinotecan or/and oxaliplatin or/and bevacizumab. With a median follow-up time of 14.8 mo(range 0-119.8), 85 patients(95.5%) experienced disease progression, and 63 deaths(70.8%) were recorded. The 3-year and 5-year OS rate was 25.4% and 7.7% while the 3-year progression-free survival rate was 7.1%. Multivariate analysis of TYMS polymorphisms, KRAS and BRAF with clinicopathological parameters indicated that TYMS 3'UTR polymorphisms are associated with risk for disease progression and death(P < 0.05 and P < 0.03 respectively). When compared to tumors without any del allele(genotypes ins/ins and ins/loss of heterozygosity(LOH) linked with high TYMS expression) tumors with del/del genotype(low expression group) and tumors with ins/del or del/LOH(intermediate expression group) have lower risk for disease progression(HR = 0.432, 95%CI: 0.198-0.946, P < 0.04 and HR = 0.513, 95%CI: 0.287-0.919, P < 0.03 respectively) and death(HR = 0.366, 95%CI: 0.162-0.827, P < 0.02 and HR = 0.559, 95%CI: 0.309-1.113, P < 0.06 respectively). Additionally,KRAS mutation was associated independently with the risk of disease progression(HR = 1.600, 95%CI: 1.011-2.531, P < 0.05). The addition of irinotecan in 1st line chemotherapy was associated independently with lower risk for disease progression and death(HR = 0.600, 95%CI: 0.372-0.969, P < 0.04 and HR = 0.352, 95%CI: 0.164-0.757, P < 0.01 respectively).CONCLUSION The TYMS genotypes ins/ins and ins/LOH associate with worst prognosis in m CRC patients under fluoropyrimidine-based chemotherapy. Large prospective studies are needed for validation of our findings. | Anastasios Ntavatzikos Aris Spathis Paul Patapis Nikolaos Machairas George Peros Stefanos Konstantoudakis Danai Leventakou Ioannis G Panayiotides Petros Karakitsos Anna Koumarianou | 2017 | World Journal of Gastroenterology2017，23，32： | 4 |
| 4 | Abscesses of the spleen:Report of three cases显示文摘Abscess of the spleen is a rare discovery, with about 600 cases in the international literature so far. Although it may have various causes, it is most usually associated with trauma and infections of the spleen. The latter are more common in the presence of a different primary site of infection, especially endocarditis or in cases of ischemic infarcts that are secondarily infected. Moreover, immunosuppression is a major risk factor. Clinical examination usually reveals a combination of fever, left-upper-quadrant abdominal pain and vomiting. Laboratory findings are not constant. Imaging is a necessary tool for establishing the diagnosis, with a choice between ultrasound and computed tomography. Treatment includes conservative measures, and surgical intervention. In children and in cases of solitary abscesses with a thick wall, percutaneous catheter drainage may be attempted. Otherwise, splenectomy is the preferred approach in most centers. Here, we present three cases of splenic abscess. In all three, splenectomy was performed, followed by rapid clinical improvement. These cases emphasize that current understanding of spleen abscess etiology is still limited, and a study for additional risk factors may be necessary. | Constantin Fotiadis Giagkos Lavranos Pavlos Patapis Gabriel Karatzas | 2008 | World Journal of Gastroenterology2008，14，19： | 3 |
| 5 | Sur- gical treatment of perianal abscess and fistula-in-ano in childhood, with emphasis in children older than 2 years 显示文摘 | Charalampopoulos A Zavras N Kapetanakis El Kopanakis K Misiakos E Patapis P Martikos G Machairas A | 2012 | J Pediatr Surg2012，47，11： | 1 |
| 6 | Acoustic charac- terization and microstructure of high zirconia elect refused refractories显示文摘 | Patapy C Gault C Huger M | 2009 | Journal of the European Ce- ramic Society2009，，29： | 1 |
| 7 | Tumors of the sacrum显示文摘 | Mavrogenis AF Patapis P Kostopanagiotou G | 2009 | Orthopedics2009，32，5： | 1 |
| 8 | Tumors of the sacrum显示文摘 | Mavrogenis AF Patapis P Kostopanagiotou G | 2009 | Orthopedics2009，32，5： | 1 |
| 9 | Genetic polymorphisms of inflammatory response gene TNF-α and its influence on sporadic pancreatic neuroendocrine tumors predisposition risk显示文摘 | Dimitrios Karakaxas Maria Gazouli Ahmet Coker Christos Agalianos Ioannis S. Papanikolaou Pavlos Patapis Theodoros Liakakos Christos Dervenis | 2014 | Medical Oncology2014，，： | 1 |
| 10 | Expectations and challenges of laparoscopic total gastrectomy显示文摘 | Liakakos T Patapis P Misiakos E | 2009 | Surg Endose2009，23，8： | 1 |
| 11 | Fluctuation conductivity behavior in thin films of YBaCuO indicates s-wave pairing 显示文摘 | Patapis S K Kruchinin S P | 1997 | Physica C1997，，282287： | 1 |
| 12 | Outcome of graft function and pregnancy following liver transplantation显示文摘 | Patapis P Irani S Mirza DF | 1997 | Transplant Proc1997，29，12： | 1 |
| 13 | Acoustic Characterization and Microstructure of High Zirconia Eleetrofused Refractories 显示文摘 | Patapy C Gauh C Huger M | 2009 | Journal of the European Ceramic Society2009，29，16： | 1 |
| 14 | Potential benefits of pro and prebiotics on intestinal mucosal immunity and intestinal barrier in short bowel syndrome显示文摘 | Stoidis CN Misiakos EP Patapis P | | 0，，： | 1 |
| 15 | Expectations and chal- lenges of laparoscopic total gastrectomy显示文摘 | Liakakos T Patapis P Misiakos E | 2009 | Surg Endosc2009，23，： | 1 |
| 16 | Current concepts in the management of necrotizing fasciitis显示文摘 | Misiakos EP Bagias G Patapis P | 2014 | Front Surg2014，1，： | 1 |
| 17 | Current concepts in the management of necrotizing fasciitis显示文摘 | Misiakos EP Bagias G Patapis P | 2014 | Front Surg2014，1，： | 1 |
| 18 | Prosthetic repair of incisional hernia combined with elective bowel operation显示文摘 | A. Machairas T. Liakakos P. Patapis C. Petropoulos D. Tsapralis E.P. Misiakos | 2008 | The Surgeon2008，，5： | 1 |
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