Surgery, Gastroenterology and Oncology

Read article I share the belief that the IASGO philosophy - "health for all and medicine without frontiers" - can be achieved and implemented through training and dissemination of state-of-the-art medical knowledge and practices. In this spirit, the General Surgery Department of the Braga Hospital organized the first IASGO Continuing Medical Education (CME) Course in Portugal between the 28th and 31st of October 2019. Drs. Dan G. Duda and Sonia Vilaca have joined me as Course Directors.
The Braga Course curriculum included timely and largely controversial topics such as bariatric surgery, l....[more]

Read article The curative approach to advanced gastric cancer treatment is surgical resection. But the risk of relapse after resection in this disease remains high. To address this, multiple perioperative local and systemic therapies have been tested in patients with operable gastric adenocarcinomas over the last two decades.
However, while the roles of neoadjuvant and adjuvant therapies have been evolving over the last two decades, many unanswered questions remain.
Here, we first discuss the scientific rationale for these interventions. Next, we review the current progress, and offer a....[more]

Read article Nowadays gastric cancer is still considered a fatal disease, in spite of the declined incidence and mortality due to the advances in treatment, postoperative care, and multimodality therapy.
It was made a systematic research of literature published regarding gastric cancer and lymphadenectomy in locally advanced ones. Surgical resection with appropriate lymphadenectomy is still the best chance for long-term survival for patients with gastric cancer. Lymph node status is a major determinant of disease recurrence after patients undergo curative surgery.
When performed in cen....[more]

Read article Pancreatic intraductal papillary mucinous neoplasms (IPMN) are one of the precursors lesions of pancreatic adenocarcinoma. They have only been individualized as a specific disease in the mid 80's and were first recognized by the World Health Organization in 1996. Since then, significant progress has been made in the diagnosis, understanding of the natural history and management of this frequent pancreatic neoplasm.
Nevertheless, there are still numerous unanswered questions that make difficult patients management.

Read article Intraductal papillary mucinous neoplasm (IPMN) of the pancreas are pre neoplastic lesions defined by the World Health Organization as a grossly visible intraductal epithelial neoplasm that arises in the pancreatic ductal system, composed of mucin producing cells.
The predisposing factor for their development as well as genetics are still largely unknown. Pathologists have a pivotal role in IPMN management since features like IPMN subtype, degree of atypia, margins status and presence or absence of an invasive component imply different patient management.
In this article, ....[more]

Read article Colorectal cancer (CRC) is one of the most common cancers in the world and a leading cause of death. The liver is the dominant metastatic site for patients with CRC, and approximately 50% of patients develop CRC liver metastases (CRCLM) during the course of their disease. Surgical resection, when combined with chemotherapy, can achieve 5-year overall survival (OS) rates of up to 40-60% for patients with CRCLM.
Despite excellent results, recurrence-free survival rates remain low as many surviving patients eventually experience recurrence. Appropriate patient selection is the key....[more]

Read article Introduction: Acute kidney injury (AKI) following liver transplantation (LT) is a frequent complication and is associated with increased morbidity and mortality. Aim: To investigate whether the levels of serum NGAL are able to predict early occurrence (within the first 48 hours) of the post-LT renal dysfunction.

Methods: The study was conducted on 50 recipients transplanted at the Fundeni Clinical Institute between May 2016 and June 2017. Serum NGAL and serum creatinine (sCr) were analyzed before LT, as well as 4 and 24 hours after graft reperfusion. In defining....[more]

Read article Aim: The diagnosis of multicentric papillary microcarcinomas of the thyroid gland is often overlooked by preoperative diagnostic methods because of their small size, and the diagnosis is made by histopathological examination of the specimen after surgery.Appropriate surgical treatment should be performed to protect the patient from the risk of secondary surgery.The aim of this study is to determine multicentricity in patients with papillary microcarcinoma of the thyroid and the surgical treatment method that should be applied to these patients.

Materials Methods:....[more]

Read article Background: Hepatectomy is the potentially curative treatment for liver tumors. The most critical postoperative complication of extensive liver resection is post-hepatectomy liver failure (PHLF) due to insufficient future liver remnant (FLR). The ALPPS (Associating Liver Partition and Portal vein Ligation for Staged hepatectomy) effectively increases the resectability of inoperable liver tumors by achieving a rapid and an effective hypertrophy of the FLR, which lowers postoperative liver failure risk. However, this technique still carries on with high morbidity and mortality r....[more]