Aberrant anatomy in the context of the critical view of safety.

Background: The protective impact of the Critical View of Safety (CVS) approach on the vasculo-biliary injuries during laparoscopic cholecystectomy (LC) depends largely upon the understanding of the normal and variant anatomy. Structures exposed during the acquisition of the CVS can deviate from the typical dual configuration of the cystic duct and artery (gallbladder pedicle) representing either a third (supernumerary) or atypical in course (heterotopic) element. The aim of this study was to determine the identity and the frequency of these anatomical elements and to propose anatomic schemata that can guide the achievement of CVS by surgeons.

Primary extrarenal papillary type II renal cell carcinoma presenting as a pelvic mass: a case report and review of the literature.

We report a case of a 57 years old woman with a solitary mass located in the pelvis diagnosed as an extrarenal papillary renal cell carcinoma, in the absence of a primary renal cancer. The diagnosis was based on cytomorphological features and further confirmed by immunochemistry findings following surgical excision. The hypothesis of a tumor developing in a supernumerary or ectopic kidney was excluded, since no normal renal tissue could be identified in the specimen and in the preoperative computed tomography and MRI images.

Large cystic lymphangioma of the pancreas: unusual finding with differential diagnosis and therapeutic considerations.

Lymphangiomas are rare benign tumours of lymphatic vascular origin. They are more common in the paediatric population and manifest mainly in the neck and axillary region. Retroperitoneal lymphangiomas are <1% and pancreatic origin is even rarer.

Primary adrenal Ewing sarcoma: A systematic review of the literature.

Background: Ewing sarcoma (ES) is a malignant neoplasm of neuroectodermal origin and is commonly observed in children and young adults. The musculoskeletal system is the main body system impacted and ES is rarely seen in the visceral organs particularly the adrenal gland.

Aim: To present a comprehensive review of primary adrenal ES, with emphasis on diagnosis, therapy and oncological outcomes.

Giant teratoma of the pancreas expanding to the mediastinum: Rare tumor and literature review.

Pancreatic mature cystic teratomas are very rare with limited cases found in the literature. These lesions raise a diagnostic challenge and complicate the surgical approach not only because of their anatomic position but also because of their ever-growing size. An elusive diagnosis, usually leads to the operative theatre where surgical resection takes place.

Critical View of Safety in Laparoscopic Cholecystectomy: A Systematic Review of Current Evidence and Future Perspectives.

Background: The Critical View of Safety (CVS) has been increasingly recognised as the standard method for identification of the cystic structures, to prevent vasculobiliary injuries during laparoscopic cholecystectomy, however, its adoption has been anything but universal. A significant proportion of surgeons has a poor understanding of the three requirements. To bridge this gap between theory and practice, we aimed to summarise the available evidence on CVS, emphasising on current debates and future perspectives.

Individualized Approach in the Surgical Management of Hepatocellular Carcinoma: Results from a Greek Multicentre Study.

Hepatocellular carcinoma (HCC) is the most common primary liver cancer and the third leading cause of death worldwide. The management of HCC is complex, with surgical treatment providing long-term survival in eligible patients. This study aims to present the experience of aggressive surgical management of HCC in Greece.

Serum Concentration of Selected Angiogenesis-Related Molecules Differs among Molecular Subtypes, Body Mass Index and Menopausal Status in Breast Cancer Patients.

Background: Angiogenesis is a hallmark of breast cancer (BC) and is mediated by the vascular endothelial growth factor (VEGF) signaling axis. It is regulated by different proangiogenic factors, including platelet-derived growth factor-CC (PDGF-CC) and heparin-binding EGF-like growth factor (HB-EGF), as well as co-receptors, such as neuropilin-1, which could have prognostic implications in BC patients.

Patients And Methods: We assessed the serum levels of VEGF, HB-EGF, PDGF-CC and neuropilin-1 in 205 patients with early BC (invasive, = 187; in situ, = 18) and in 31 healthy donors (HD) and investigated the potential associations with clinical and histopathological parameters.

The effect of anastomotic leak on postoperative pelvic function and quality of life in rectal cancer patients.

Aim: The aim of this review was to collect all available literature data analysing the effects of the anastomotic leak (AL) on post-sphincter preserving rectal cancer surgery bowel and urogenital function as well as to quality of life (QoL) dimensions.

Methods: A literature search of the PubMed and Embase electronic databases was conducted by two independent investigators and all studies using either functional parameters or QoL as a primary or secondary endpoint after a rectal cancer surgery AL were included.

Results: Amongst the 13 identified studies focusing on the post-AL neorecto-anal function, 3 case-matched studies,3 comparative studies and 1 population-based study supported the deleterious effects of the AL on bowel function, with disturbances of the types of high bowel movement frequency, urgency and increased incontinent episodes to predominate.

Are YouTube Videos a Reliable Training Method for Safe Laparoscopic Cholecystectomy? A Simulated Decision-Making Exercise to Assess the Critical View of Safety.

 The present study assesses the educational value of laparoscopic cholecystectomy videos on YouTube regarding the correct application of the critical view of safety (CVS), and evaluates… surgical trainees' perceptions of the CVS criteria in a simulated, operative decision-making exercise.  YouTube was systematically searched for laparoscopic cholecystectomy videos, explicitly reporting a satisfactory CVS. The top 30 most popular videos, by number of views, were identified and scored on the 6-point scale by three experienced consultants.

Splenosis mimicking gastric obstructive tumor: Diagnostic workup and surgical excision.

Splenosis is a condition that occurs after splenic rupture. A 29-year-old male patient with a history of splenectomy was admitted due to multiple vomiting episodes. The diagnostic workup was unable to differentiate between gastric GIST and splenosis.

Morphology of the sulcus of the caudate process (Rouviere's sulcus) in a Greek population and a systematic review with meta-analysis.

The purpose of this study was to determine the prevalence and to investigate the morphology of the sulcus of the caudate process in a Greek population, along with a systematic review and meta-analysis of the literature. Overall, 103 consecutive patients undergoing laparoscopic cholecystectomy were included in the analysis. The sulcus was present in 91% and three morphological variants were identified (groove 69%, slit 21% and scar 10%).

Colorectal cancer metastases to the thyroid gland-a systematic review : Colorectal cancer thyroid metastases.

Background: Despite its rich vasculature, the thyroid gland is a rare site of metastatic disease. We present a systematic review of colorectal cancer (CRC) thyroid metastases, with emphasis on diagnosis, therapeutic management, and oncological outcomes.

Methods: A systematic review of the English literature (1990 to 2019) was performed, using the PubMed, Embase, and Google Scholar bibliographic databases.

Effects of the Enhanced Recovery Program on the Recovery and Stress Response in Patients With Cancer Undergoing Pancreatoduodenectomy.

Aim the study was the comparison of enhanced recovery after surgery (ERAS) versus conventional care (CON) protocols in patients undergoing pancreatoduodenectomy with regard to pain intensity, emotional response (optimism/sadness/stress), and stress biomarker levels (adrenocorticotropopic hormone, cortisol). We conducted a prospective two-group randomized controlled study with repeated measures in 85 patients with cancer pancreatoduodenectomy. In the ERAS group (N = 44), the ERAS protocol was followed, compared with the CON group (N = 41).

Factors Affecting Stress Levels in Hospitalized Patients after Implementation of Fast-Track Protocol in Hepatopancreatobiliary Surgery.

Objective: The objective was to explore factors affecting stress levels in hospitalized patients after implementation of fast-track (FT) protocol in hepatopancreatobiliary surgery.

Methods: This was a prospective cross-sectional study, where 90 patients were included. Exploration of environmental postoperative stress levels was conducted by serum adrenocorticotropic hormone and cortisol levels, the Intensive Care Unit Environmental Stressor Scale, and three self-reported Numeric Analog Scale questions, with regard to emotional/stress level, specifically "How sad do you feel right now?" "How stressed do you feel right now?" and "How optimistic do you feel right now, about the future?" at 3 time points: (T) Before surgery, (T) the day of surgery, and (T) the 3 postoperative day.

Primary peripheral neuroectodermal tumor (PNET) of the adrenal gland: a rare entity.

Purpose: Ewing Sarcoma/Primitive Neuroectodermal Tumor (ES/PNET) is a malignant small round cell tumor belonging to the Ewing Sarcoma Family of Tumors. It occurs more commonly in children and young adults. Its localization in the adrenal gland is extremely rare.

Cross-Correlation Among Visual Analog, Observational, and Behavioral Pain Scales of Oncological Patients Undergoing Major Abdominal Surgery.

Purpose: To determine the perception of postoperative pain intensity between nurses and oncology patients undergoing major abdominal surgery.

Design: A prospective cross-correlation study with 173 oncology patients undergoing major abdominal surgery, such as hepatectomy or pancreatectomy.

Methods: Postoperative pain intensity was evaluated by clinical pain assessment tools such as critical-care pain observation tool (CPOT) and behavioral pain scale (BPS) recorded by the researcher, whereas the visual analog scale was completed by patients.

A well differentiated neuroendocrine tumor of the jejunum with peritoneal carcinomatosis: A case report.

Neuroendocrine tumors (NETs), belong to a group of neoplasms that arise from neuroendocrine cells and express markers such as synaptophysin and chromogranin A. The digestive system (DS) is the most common site of NET development. The World Health Organization classification divides NETs into low grade (G1-G2) tumors (NETs) and high grade carcinomas [neuroendocrine carcinomas (NECs)], based on mitotic index and histological criteria.

Diagnostic Accuracy of Preoperative Neutrophil-to-Lymphocyte and Platelet-to-Lymphocyte Ratios in Detecting Occult Papillary Thyroid Microcarcinomas in Benign Multinodular Goitres.

Objective: To investigate the diagnostic accuracy of neutrophil-to-lymphocyte (NLR) and platelet-to-lymphocyte (PLR) ratios in detecting occult papillary thyroid microcarcinomas in benign, multinodular goitres.

Methods: 397 total thyroidectomy patients were identified from the institutional thyroid surgery database between 2007 and 2016 (94 males, 303 females, mean age 53 ± 14.5 years).

Fast-Track Recovery Program After Major Liver Resection: A Randomized Prospective Study.

The objective of this study was to compare fast-track (FT) recovery protocol with the conventional one in patients treated with major liver resection by evaluating perioperative morbidity, length of hospitalization, and readmission rate. Sixty-two patients suffering from malignant liver tumors were surgically treated from May 2012 to April 2014. After randomization, they were prospectively divided into two groups: Group A patients (n = 32) followed FT recovery protocol and Group B patients (n = 30) were treated with the conventional (CON) protocol.

Association of Baseline Neutrophil-to-Lymphocyte Ratio with Clinicopathological Characteristics of Papillary Thyroid Carcinoma.

Objective: To investigate the potential association of neutrophil-to-lymphocyte ratio (NLR), a surrogate systemic inflammatory biomarker, with clinical and pathological characteristics of papillary thyroid cancers.

Methods: 205 patients with papillary carcinoma were identified from the institutional thyroid cancer database between 2006 and 2015 (55 males, 150 females, mean age 51.2 ± 14.

Comparative Evaluation of Pain, Stress, Neuropeptide Y, ACTH, and Cortisol Levels Between a Conventional Postoperative Care Protocol and a Fast-Track Recovery Program in Patients Undergoing Major Abdominal Surgery.

Background: Fast-track (FT) postoperative protocol in oncological patients after major abdominal surgery reduces complications and length of postoperative stay compared to the conventional (CON) protocol. However, stress and pain responses have not been compared between the two protocols.

Objectives: To compare stress, pain, and related neuropeptidic responses (adrenocorticotropic hormone [ACTH], cortisol, and neuropeptide Y [NPY]) between FT and CON protocols.

Incidental Parathyroidectomy during Total Thyroidectomy: Risk Factors and Consequences.

Objective. To evaluate the incidence of accidental parathyroidectomy in our series of total thyroidectomies, to investigate its clinical and biochemical consequences, and to identify potential risk factors. Methods.