Surgery, Gastroenterology and Oncology

Background: The early detection of colorectal anastomotic leakage (CAL) remains challenging despite advancements in diagnostic methods. Reliable markers are needed to reduce patient morbidity and mortality. Cytokines in drain fluid and systemic cytokine levels have shown potential as predictive markers for CAL, but more robust evidence is required. This systematic review and meta-analysis aimed to evaluate the importance of peritoneal and serum or plasma interleukin-6 (IL-6) levels in the early detection of CAL after colorectal surgery in colorectal cancer patient....[more]

Purpose: Patients with Cowden syndrome (CS) have an increased lifetime risk of developing cancers, particularly breast, uterus, thyroid, colon and renal cell cancer. CS is associated with a germline mutation of PTEN, a gene that plays an important role in carcinogenesis. This review hypothesized that inactivation of PTEN could have dramatic consequences on response of treatments in patients with Cowden Syndrome.

Methods: This systematic review has been reported in line with PRISMA and AMSTAR, we investigated to deficit of PTEN and the resp....[more]

Background: Alcohol consumption is increasing worldwide, as being the most popular drug used for recreational purposes. Excessive consumption leads to irreversible liver damage, and since 2015 alcoholic cirrhosis has become the main indication of liver transplantation (LT).

Methods: Our aim was to create the epidemiological profile, of the cirrhotic patient who consumes alcohol and is considered a candidate for LT. Evaluation of alcohol consumption by applying three screening questionnaires: CAGE, AUDIT-C and FAST. Survival rates and LT ev....[more]

Objective: Patients with acute diverticulitis (AD) have an increased risk of underlying colorectal cancer (CRC), however those with uncomplicated AD may have the same underlying population risk. Despite evidence suggesting these patients may not require further endoscopy, published guidelines still recommended Colonoscopy as standard post-diverticulitis management. A practical approach to the definition of bowel wall thickening may improve negative predictability, a potential impediment to omitting colonoscopic followup.

Material and Methods: A 2-year (July 2....[more]

Introduction: The functional laparoscopic gastric bypass with fundectomy and gastric remnant exploration (LRYGBfse) has been described in attempt to overcome the intrinsic limitations of the LRYGB with promising results. However, the detailed learning curve related to this innovative procedure has not been assessed.

Materials and Methods: Retrospective multicenter study from December 2010 to January 2015. Data were prospectively collected from one surgeon experienced in laparoscopic surgery. The cumulative summation methodology (CUSUM) was....[more]

Background: Patient reported outcomes are valuable components in the assessment of results of treatment for peripheral arterial disease (PAD). The aim of the study was to translate the six item Vascular Quality of Life Questionnaire (VascuQoL-6) survey into Romanian, and to validate the psychometric performance of the questionnaire in a representative cohort of patients with lower extremity arterial disease.

Material and Methods: Translation of the VascuQoL-6 questionnaire was performed following accepted methodology. The overall validatio....[more]

Introduction: Pediatric sacrococcygeal teratoma (SCT), yet a rare tumor, is a common solid tumor among neonates. Although overall survival is excellent, tumor recurrence may compromise the outcomes.Objectives: The aim of this study is to determine overall survival rate, tumor recurrence rate, and associated factors for recurrence.

Materials and Methods: A retrospective chart review of patients admitted to Siriraj Hospital with SCT (2000-2018) was performed. Data were collected and analyzed for the association with outcomes, including survi....[more]

Background: Choledocholithiasis occurs in 8–20% of patients with gallbladder stones. All patients with symptomatic gallbladder stone disease should be assessed for synchronous choledocholithiasis. When synchronous to symptomatic gallbladder stones disease, indication for treating both is clear. The most common treatment options are single-stage approach (SSA) with laparoscopic cholecystectomy and common bile duct (CBD) exploration or two-stage approach (TSA) combining pre- or post-operative ERCP (endoscopic retrograde cholangio-pancreatography) and laparosco....[more]

Pancreatic glucagonoma is a well-known rare subtype of pancreatic neuroendocrine tumors (PNETs). Most cases of pancreatic glucagonoma are associated with symptoms such as skin rash and necrotizing migratory erythema; however, some cases are asymptomatic. Complete tumor resection has an important impact on the long-term prognosis of patients with primary PNETs. The 2019 edition of the Japanese Guidelines for Neuroendocrine Tumors recommends recurrent lesions of pancreatic and gastrointestinal NETs to be treated multimodally, including resection if the lesions are curatively resecta....[more]

Introduction: Synchronous esophageal and lung cancer is an uncommon entity with few descriptions in the literature. It poses a relevant challenge to health care providers regarding its management and surgical approach.

Case report: We present the case of a 73-year-old male diagnosed with lung squamous-cell carcinoma after admission for a history of productive cough and episodic hemoptysis. An esophageal squamous-cell carcinoma was diagnosed. Both tumors were histologically different. A surgical procedure was conducted with concomitant esop....[more]

Left isomerism (IS), also known as polysplenic syndrome, is part of the category of heterotaxic syndromes. Heterotaxic syndrome is a general term that describes the abnormal positioning of the viscera in the chest and abdomen. Signs of polysplenic syndrome include: bilobed lungs, liver located on the median line, but also intestinal malrotation. The prevalence of this condition is 1.4 patients per 10,000 children. The clinical aspect is closely correlated with the specific pathology of polysplenism. Apparently, incidental signs and symptoms are encountered, unexplained and unassoc....[more]

Case Report: We present a clinical case of a woman, 59 years old, with a history of papillary thyroid carcinoma with cervical metastases, asymptomatic. During the follow-up of the carcinoma, a large lipomato....[more]