Surgery, Gastroenterology and Oncology

Introduction: Esophagectomy has a crucial role in the treatment of esophageal cancer. Several different surgical techniques have been performed in order to achieve better post-surgical and oncological outcomes. In this systematic review and meta-analysis, we compare two procedures – Ivor Lewis and McKeown – regarding their impact on morbidity.

Methods: In March 2021, records from Pubmed, Scopus, Web of Science and ClinicalTrials.gov were retrieved. Eligible studies included articles evaluating morbidity outcomes of Ivor Lewis e....[more]

Purpose: Failure and recurrence are concerns in nonoperative management (NOM) for acute appendicitis (AA) and interval appendectomy (IA). The goal of the study was to identify predictors of failure and recurrence in patients with AA who underwent NOM.

Methods: A total of 348 adults with appendicitis were treated in our department from April 2016 to October 2021. Among these patients, 337 who did not undergo emergency surgery were divided into those for whom NOM was unsuccessful, leading to unplanned surgery (n=28) and tho....[more]

Background: Hepatocellular carcinoma (HCC) is a major type of liver tumor. It represents up to 90% of all liver malignancies. There are currently no reliable tumor markers or imaging technologies that can accurately diagnose early HCC. The use of circulating micro-RNAs (miRNAs or miR) as a potential tool for early detection of HCC has become an emerging area of study. Objectives: This study aimed to evaluate the role of miR-23b and miR-331 as biomarkers in HCC and chronic hepatitis C (CHC) patients.

Patients and Methods: This study include....[more]

Background and Aim: to compare the early outcome results of laparoscopic versus open management as laparoscopic management seems to have multiple attractions for surgeons with marked controversy.

Materials and Methods: All patients of Gastroduodenal perforation were included and randomized for laparoscopic or open repair. The data obtained from the diagnostic flowchart, operative details, postoperative morbidities, and mortalities were collected for statistical analysis.

Results: sixty-six patients were assigned to....[more]

Introduction: Spontaneous hemorrhage resulting from rupture of an adrenal artery is extremely rare. The exact pathophysiology of this phenomenon remains unclear in patients not assuming oral anticoagulant or antiplatelet therapies.

Case report: A 55-year-old male with no comorbidities was referred to our emergency department with worsening abdominal pain after iterate episodes of violent coughing. The abdominal CT scan revealed a large retroperitoneal hematoma resulting from the rupture of the superior adrenal artery with ac....[more]

Introduction: Different types of soft tissue tumors affect the gastrointestinal tract. Among them are leiomyomas, which are relatively uncommon. They are commonly asymptomatic masses and are discovered incidentally on radiological scans. Pathological examination of the tumors is the mainstay of the diagnosis. Surgery remains the cornerstone of management.

Case presentation: We present a 41-year-old female patient who was referred to our surgical department with a radiologically discovered pelviabdominal swelling, with vague ....[more]

Background: Appendiceal mucinous neoplasms are uncommon tumors that can occur in the appendix and cause various symptoms. Detecting these tumors can be challenging, and diagnostic imaging, such as ultrasonography and computed tomography (CT) scans, is critical in identifying them before surgery.

Case Report: A 47-year-old woman complained of experiencing pain and a heavy feeling in her lower abdomen. Imaging tests were conducted, which showed a sizable cystic swelling located in the left lower quadrant of the abdomen. The im....[more]

Cervical cancer is the fourth most common gynecological malignancy. It is a major health problem commonly affecting women in a young age. It is well known that the majority of cervical cancer cases are related to human papilloma virus. Therefore, in Europe the rate of cervical cancer is expected to decrease due to human papilloma virus vaccination (1-3). However, the discrepancy in cervical cancer cases is clearly seen between Eastern and Western European countries. Moreover, the estimated age-standardized incidence rate of cervical cancer is the highest in Bulgaria among all Euro....[more]

Introduction: Gastrointestinal stromal tumors frequently spread via hematogenous route to the liver or through peritoneal seeding in the abdominal cavity. Once metastization has occurred neither surgery alone nor systemic therapy can successfully accomplish persistent malignancy control. However, a grouping of both approaches may potentially achieve disease stabilization and significantly improve overall survival.

Case presentation: We describe the case of a 61-year-old male patient who had presented a large gastric GIST with tumor rupture....[more]