A feasibility study for the provision of electronic healthcare tools and services in areas of Greece, Cyprus and Italy.

Background: Through this paper, we present the initial steps for the creation of an integrated platform for the provision of a series of eHealth tools and services to both citizens and travelers in isolated areas of the southeast Mediterranean, and on board ships travelling across it. The platform was created through an INTERREG IIIB ARCHIMED project called INTERMED.

Methods: The support of primary healthcare, home care and the continuous education of physicians are the three major issues that the proposed platform is trying to facilitate.

Totally laparoscopic gastrectomy for gastric cancer: meta-analysis of short-term outcomes.

Introduction: We present a review of the literature, together with a meta-analysis of short-term outcomes of totally laparoscopic gastrectomy (TLG) compared with open gastrectomy (OG).

Material & Methods: We carried out a search in the Pubmed and Cochrane databases from September 2003 to May 2009. Controlled studies on early outcomes were included, both prospective and retrospective, randomized and non-randomized.

Contrast-induced nephropathy after percutaneous coronary intervention in simple lesions: risk factors and incidence are affected by the definition utilized.

Aim: To compare the incidence, and risk factors, in-hospital and at the 18-month prognosis of contrast-induced nephropathy (CIN) according to the definition utilized: as an increase in serum creatinine (Scr) ≥ 0.5 mg/dL (CIN 1) or as an increase in Scr ≥ 25% above baseline values (CIN 2).

Methods And Results: We prospectively evaluated CIN according to two different definitions in 150 patients who underwent percutaneous coronary intervention (PCI) in simple lesions employing a low-medium dose of contrast media.

Chest pain due to late huge coronary pseudoaneurysm following stent implantation.

A 50-year-old man was referred to our hospital because of persistent atypical chest pain. His past medical history was remarkable for a non ST elevation myocardial infarction, treated five months previously with PCI on the right coronary artery. Two months later, for chest pain, he underwent coronary angiography that showed a right coronary artery with slight ectasia near the stent.

Single port laparoscopically assisted hysterectomy with the TriPort system. A case report and review of the literature.

Aim: We report our recent experience with the TriPort system (trademark of Advanced Surgical Concepts, Wicklow, Ireland) to perform a laparoscopically assisted hysterectomy via a single periumbilical incision.

Case Report: A 48-year-old multiparous woman was referred to us on March 2009 because of menometrorrhagia and uterine fibroids.

Results: The procedure was performed without intraoperative complications.

Single incision laparoscopic anterior resection for cancer using a "QuadiPort access system".

Background: Single incision laparoscopic surgery (SILS) is developing rapidly and different devices are already available. However there is limited data in the literature about single port laparoscopic colorectal surgery.

Aims: We report the first case of a single incision laparoscopic anterior resection for cancer using the device "QuadiPort Access System.

Laparascopic colon resection for cancer: evidence based results.

About 90-92% of patients with carcinoma of the colon are treated surgically. For other surgeons, laparoscopic surgery for the treatment of malignancies remains controversial because of concerns about the adequacy of lymphadenectomy, the extent of resection, early findings of port-site metastasis and the lack of data on long-term results. In our experience, there are no differences between the laparoscopic and laparotomic techniques, and only advantages if the laparoscopic technique is use correctly.

Laparoscopic ureteroneocystostomy and vesicopsoas hitch for infiltrative ureteral endometriosis.

The aim of the study was to assess the safety and efficacy of laparoscopic treatment of distal infiltrative ureteral endometriosis with segmental ureteral resection, ureteroneocystostomy, and vesicopsoas hitch. We performed a retrospective analysis of perioperative data and looked at follow-up outcomes of patients with deep endometriosis with ureteral involvement treated by laparoscopic vesicopsoas hitch. Six patients were treated for left ureteral endometriosis in the study period.

How should I treat concomitant post-endarterectomy carotid pseudoaneurysm and contralateral symptomatic stenosis?

Background: A 74-year-old male patient complaining of crescendo TIAs, hypertension and hyperlipidaemia.

Investigation: Duplex ultrasound scan MR angiography.

Diagnosis: Pseudoaneurysm stemming from the ICA.

Carotid artery stenting with contralateral carotid occlusion in a rare aortic arch configuration.

We present the case of a 47-year-old man admitted to our department with an episode of aphasia. Duplex scan showed an occluded right internal carotid artery and severe left internal carotid artery stenosis. Contrast-enhanced computer tomography demonstrated a common trunk for both common carotid arteries anterior to the trachea and aberrant right subclavian artery posterior to the esophagus.

Hybrid endograft solution for complex iliac anatomy: Zenith body and Excluder limbs.

The purpose of this study was to evaluate single-center results with selective use of Gore Excluder limbs (W.L. Gore & Associates, Flagstaff, AZ) in a Cook Zenith body (Cook Inc, Bloomington, IN) for elective endovascular abdominal aortic aneurysm (AAA) repair.

Retroaortic left renal vein and inflammatory abdominal aortic aneurysm.

The aim of this study was to report successful surgical management of an inflammatory abdominal aortic aneurysm associated with a retroaortic left renal vein. The patient, a 78-year-old man, presented with diffuse abdominal pain, fever, and constipation. Contrast-enhanced computed tomography showed soft tissue surrounding the aneurysm and a left renal vein behind the aorta.

Side-to-side esophagojejunostomy during totally laparoscopic total gastrectomy for malignant disease: a multicenter study.

Background: Esophagojejunostomy (EJS) represents the most difficult steps during totally laparoscopic total gastrectomy (TLTG). Over the past few years, several techniques have been developed. This study aimed to evaluate the feasibility and surgical outcomes of the laparoscopic intracorporeal side-to-side EJS during TLTG used to treat malignant disease of the stomach.

Ureteroiliac artery fistula in a young woman with short bowel syndrome for radiation enteritis.

Ureteral-iliac artery fistula is a rare and potentially life-threatening complication, typically occurring after radiation therapy in already surgically treated cancer patients. This case report describes the diagnostic challenges and the successful management, with the positioning of an intra-arterial prosthesis, of a fistula between the internal iliac artery and the left ureter presenting as massive hematuria in a young woman with history of total colectomy and pelvic radiotherapy for rectal cancer and subsequent wide ileal resections and bilateral ureteral stent positioning for radiation enteritis. Ureteroiliac artery fistulas require a prompt diagnosis and intervention, to avoid life threatening clinical events.

Fenestrated stent grafting for short-necked and juxtarenal abdominal aortic aneurysm: an 8-year single-centre experience.

Objectives: To present an 8-year clinical experience in the endovascular treatment of short-necked and juxtarenal abdominal aortic aneurysm (AAA) with fenestrated stent grafts.

Methods: At our tertiary referral centre, all patients treated with fenestrated and branched stent grafts have been enrolled in an investigational device protocol database. Patients with short-necked or juxtarenal AAA managed with fenestrated endovascular aneurysm repair (F-EVAR) between November 2001 and April 2009 were retrospectively reviewed.

[Abdominal compartment syndrome (ACS) after abdominal aortic aneurysm (AAA) open repair].

Introduction: The Abdominal Compartment Syndrome (ACS) is a "condition in which increased tissue pressure in a confined anatomic space, causes decreased blood flow leading to ischaemia and organic dysfunction and may lead to permanent impairment of function".

Materials And Methods: Between June 2007 and June 2008 all patients recovered to our Institution for Abdominal Aortic Aneurysm (AAA) underwent intermittent intra-abdominal pressure monitoring using intra-vescical catheter. Pressure data were registered before abdominal incision, during intervention, at closure of abdominal wall and at 6, 12, 24 and 36 hours in post-operative course.

Anastomotic pseudoaneurysm complicating renal transplantation: treatment options.

Introduction: Anastomotic pseudoaneurysm following renal transplantation is uncommon. Indications for repair, treatment options and outcomes remain controversial.

Report: We present 6 renal transplant recipients with large anastomotic pseudoaneurysms.

Mortality of ruptured abdominal aortic aneurysm with selective use of endovascular repair.

The aim of this review was to examine the results over a seven-year period of treatment for ruptured abdominal aortic aneurysm (RAAA). From 2002 on, our tertiary referral centre offered both open and endovascular (EVAR) treatment modalities for RAAA. All patients with a proven RAAA who were admitted into our hospital were included.

Deep pelvic endometriosis (Adamyan IV stage): multidisciplinary laparoscopic treatments.

Background: Few small studies have confirmed the feasibility of laparoscopic colorectal resection for Deep Infiltrating Endometriosis (DIE), albeit with a wide range of complications.

Aim: The aim of this study is to evaluate retrospectively the feasibility and clinical outcome of laparoscopic segmental bowel resection for DIE.

Methods: We have retrospectively reviewed the data of patients undergoing laparoscopic rectosigmoidal resection for bowel endometriosis from January 2000 and June 2008.

External iliac artery pseudoaneurysm complicating renal transplantation.

Objectives: To assess the etiology, management and outcome of iliac pseudoaneurysms following renal transplantation.

Methods: Eleven patients who underwent repair between 1982 and 2007 were identified. Five (Group 1) presented pseudoaneurysm at the anastomosis of the donor renal and native iliac arteries, and six (Group 2) presented iliac pseudoaneurysm following transplant nephrectomy.

Long-term results of laparoscopic treatment for advanced rectal cancer.

Background: The management of advanced rectal cancer has changed into a multidisciplinary treatment model. Only limited randomized data are available for patients with rectal cancer treated laparoscopically.

Aim: We report a multimodal treatment of advanced rectal cancer: preoperative oncological treatment, use of endoscopic stent (for malignant obstruction), minimal invasive treatment.

Renewed endovascular repair for recurrent acute abdominal aortic aneurysm.

The aim of the study was to describe the successful endovascular management of a patient who was admitted urgently with a second episode of acute abdominal aortic aneurysm (AAA) 30 months after emergency endovascular abdominal aortic aneurysm repair (eEVAR) for a ruptured AAA. The patient, an 84 year-old male physician, presented with severe acute abdominal and back pain. Contrast-enhanced computer tomography scanning showed type III endoleak owing to complete disconnection of both graft limbs and the prosthetic main body.

Decreased paraoxonase-2 expression in human carotids during the progression of atherosclerosis.

Objective: Many gene products involved in oxidation and inflammation are implicated in the pathogenesis of atherosclerosis. We investigated paraoxonase 2 (PON2), 5-lipoxygenase (5-LO), and 5-LO activating protein (FLAP) expression and malondialdehyde (MDA) levels in carotid lesions to assess their involvement in plaque formation.

Methods And Results: We measured gene expression and MDA levels in atherosclerotic plaques from 59 patients undergoing carotid endarterectomy, and in plaque-adjacent tissue from 41/59 patients.

Endovascular versus open surgical repair of abdominal aortic aneurysm with concomitant malignancy.

Background: The management of patients with abdominal aortic aneurysm (AAA) and concurrent malignancy is controversial. This study retrospectively assessed the outcome of endovascular repair (EVAR) and open repair (OR) for the treatment of AAA in patients undergoing curative treatment for concomitant malignancies.

Methods: All patients who underwent surgery for a nonruptured infrarenal AAA of > or =5.