Surgery, Gastroenterology and Oncology
Vol. 29, No. 2, Jun 2024
Predictive Factors for Mortality and Infection Surveillance in Romanian Candidates for Liver Transplantation
Mihaela Ghioca, Carmen Ester, Speranta Iacob, Razvan Cerban, Corina Pietrareanu, Irinel Popescu, Simona Ruta, Camelia Grancea, Cristian Gheorghe, Liliana Gheorghe
Article DOI: 10.21614/sgo-688
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Introduction: Infections in cirrhotic patients represent an important cause of decompensation, with an increased risk of sepsis and death and the most frequently incriminated infections are spontaneous bacterial peritonitis, urinary tract infections and pneumonia.

Materials and Methods: In a single – center retrospective cohort study, we analyzed data from 155 patients included on the waiting list for liver transplantation, such as biochemical parameters – serum C reactive protein and procalcitonin values, prognostic scores for....[more]

Impact of Psoas Muscle Wasting Among Cirrhotic Patients Awaiting Liver Transplantation: Predictor of Mortality and Transplant Select....
Corina Pietrareanu, Speranta Maria Iacob, Carmen Cristina Ester, Mihaela Corina Ghioca, Liliana Simona Gheorghe
Article DOI: 10.21614/sgo-686
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Introduction: In this study were included patients with liver cirrhosis waiting for liver transplantation. The study aims were to assess the prevalence and predictors of decreased muscle mass which is a frequent finding in liver cirrhosis associated with a poor prognosis.

Material and Method: The study included 133 patients with liver cirrhosis, who were splited into two groups, low and high, based on their psoas muscle index (PMI). The PMI was calculated using the area of the psoas muscle measured on CT or MRI images andmore]

Plateletcrit and Mean Platelet Volume in the Evaluation of Liver Cirrhosis and Nonalcoholic Fatty Liver Disease in Egyptian Patients
Abdel-Naser Abdel-Atty Gadallah, Elsayed Ibrahim Elshayeb, Belal Abd El-Mohsen Montaser, Ghada Ahmed Abdel-Fattah Shaheen, Ahmed Ezz El-Arab Abd El-Alim Mostafa
Article DOI: 10.21614/sgo-643
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Background: Non-alcoholic fatty liver disease (NAFLD) and cirrhosis represent significant global health concerns, often diagnosed through invasive methods like liver biopsy. Identifying non-invasive biomarkers for these conditions could greatly enhance early detection and management. Objective: To evaluate the relationship between Procalcitonin (PCT) and Mean Platelet Volume (MPV) levels and hepatic steatosis in patients with NAFLD and cirrhosis.


Methods: a case-control study included 133 participants divided into N....[more]

Predictors of Long-Term Clinical Response in Complex Perianal Fistulizing Crohn's Disease - A Retrospective Study
Ana Cristina Silva, Ezequiel Silva, Pedro Brandão, Mónica Sampaio, Andreia Teixeira, Paula Lago, Marisa Domingues Santos
Article DOI: 10.21614/sgo-678
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Background: Treatment of complex perianal fistula (cPF) in Crohn’s Disease (CD) constitutes a major challenge for gastroenterologists and surgeons. The aim of this study is to review the experience of a tertiary reference centre and identify prognostic factors related to non-response to treatment.


Methods: Retrospective cohort study of adult patients with CD operated on for cPF, in a

tertiary reference centre, from January 2015 to June 2023 and followed up until December 2023. Characteristics of ....[more]

Role of Indocyanine Green in Diagnostic Staging Laparoscopy in Intra-Abdominal Malignancy
Mohamed Hassan Sobeih Badreldeen, Ahmed Fahmy Omar, Tarek Osama Hegazy, M Emad Esmat, MM Essawy, Mohammed S Hedaya, Lamiaa Rafaat El sayed, Mahmoud Mohamed Rady, Mohamed Abdo
Article DOI: 10.21614/sgo-677
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Background: Patients with abdominal cancers may present with advanced disease either locally or metastatic and so, accurate staging help in selection of the appropriate treatment plan (curative or palliative). Up to 50% of patients diagnosed with colorectal cancers (CRC) and 40% of patients diagnosed with pancreatic cancers will have  metastatic hepatic lesions during the course of the disease, where 7% of patents with CRC and 14% of patients with advanced gastric cancers will develop peritoneal metastases. Despite advances in pre-operative imaging used for d....[more]

Optimizing Closed Incision Negative Pressure Wound Therapy in Emergency Laparotomy (OPTIWOUND): A Multi-arm Randomized Prospective T....
Marcelo J Costa, Marta F Martins, Rita R Lages, Álvaro L Gonçalves, Isabel S Armas, Joana I Almeida, Maria J Dantas, Vítor N Lopes
Article DOI: 10.21614/sgo-684
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Objective: To evaluate the effectiveness among two incisional negative pressure wound

therapy (iNPWT) devices (Prevena™ and PICO™) and compare them with conventional dressings in preventing surgical site occurrences (SSOs), particularly surgical site infections (SSIs), in patients undergoing emergency laparotomies. Summary Background data: Surgical site occurrences (SSOs), particularly infections, are prevalent post-surgery complications, increasing morbidity and healthcare costs. The prophylactic use of advanced wound dressings ....[more]

Neuroendocrine Neoplasms of the Colon and Rectum
Vasil Bozhkov, Plamen Chernopolsky, Rossen Madjov
Article DOI: 10.21614/sgo-670
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Introduction: Neuroendocrine neoplasms (NENs) originate from neuroendocrine cells

diffusing throughout the body. They are a heterogeneous group of tumors with neuro-endocrine function and malignant potential. They manifest themselves in various and

complex clinical manifestation and localization, mostly affecting the GIT(gastrointestinal tract), the pancreas (GEP) and the bronchopulmonary system. The incidence of colon and rectum NEN (r-NEN) tumors has increased significantly over the last decade, partly as a result of improved diagnostic methods. ....[more]

Sensitivity and Specificity of Colposcopic Examination in the Diagnosis of HSIL in the LLETZ Histological Specimen
Yonka Ivanova, Yavor Kornovski, Stoyan Kostov, Stanislav Slavchev, Angel Yordanov, Dimitar Metodiev
Article DOI: 10.21614/sgo-667
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Introduction/Background: Colposcopy-directed targeted biopsy has been established as a proven technique for identifying cervical precancerous lesions. The qualifications of the colposcopist significantly impact the subjective evaluation of the affected cervical areaduring colposcopy. The Large Loop Excision of the Transformation Zone (LLETZ) procedure is the most commonly used excisional method for treating cervical precancerous lesions. The present study aimed to investigate the correlation between colposcopic (colposcopic impression) and histological diagnosis f....[more]

The Act of Hysteroscopy in Detecting Endometrial Cancer, National Cancer Institute Experience, Egypt
Amr Kamal Younis, Mohamed Abd Al Fatah El Zohiery, Rasha Allam, Adel Hosney Ahmed
Article DOI: 10.21614/sgo-669
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Objectives: to assess the diagnostic role of the hysteroscopy in endometrial cancer

detection compared to pathology as a gold standard.


Methodology: This is a descriptive diagnostic accuracy study, including 136 women

attending to National Cancer Institute, Cairo University outpatient clinic and presenting with post-menopausal bleeding or any ultrasound diagnosed endometrial mass, in the 2 year interval from July 2021 till July 2023. Ultrasound, Hysteroscopy and hysteroscopic guided biopsy were....[more]

The Role of CD47 in Gynecological Oncology
Angel Yordanov, Eva Tsoneva, Stoyan Kostov, Konstantina Karakadieva, Ihsan Hasan
REVIEW, Jun 2024
Article DOI: 10.21614/sgo-665
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Cancer is a disease with major societal impact with 18.1 million cases reported globally in 2020. About 16% of all oncological disorders are malignant gynaecological tumours, the most common types being cervical, endometrial and ovarian cancer. The classic methods of treating these diseases are surgery, radiotherapy chemotherapy and different combinations of them, and they are directed against the tumor cell itself. This necessitates the searchfor more and more new and effective therapeutic approaches. Advances in genomic and molecular techniques have led to the introduction of pe....[more]

Novel Technique for The Placement of Omental Patch During Repair of Perforated Duodenal Ulcer. A Retrospective Study of Prospectivel....
Oday G Al-Asadi, Qais K Baqir, Issam M Alnajjar
Surgical Technique, Jun 2024
Article DOI: 10.21614/sgo-663
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Objective: To present a novel technique for the placement of omental patch aiming to prevent post-operative leak in order to decrease post-operative morbidity, prolonged hospitalisation and mortality.

Summary Background Data: Peptic ulcer perforation is a common life-threatening emergency and requires urgent surgical solution. Graham patch and modified Graham patch are the two most widely used techniques for omental patch repair. However, the post-operative leak rate following these techniques could be between 3.33% and 6.7%.



Endoscopic Resection of Large Gastric Polyp in a Patient with Peutz-Jeghers Syndrome: A Case Report
María Fernanda Vega Robles, Oscar Roberto Verdugo Heredia, Mariana González Villegas, Garcia Torres Cosme Damián
Images in Clinical Medicine, Jun 2024
Article DOI: 10.21614/sgo-681
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Gastric polyps (GPs) are luminal lesions protruding from the mucosa and are incidentally

discovered in approximately 2% of esophagogastroduodenoscopies (EGDs). Most patients are asymptomatic and rarely develop complications such as bleeding or gastric obstruction. Peutz-Jeghers syndrome is a low-incidence polyposis characterized by the combination of mucocutaneous pigmented lesions and hamartomatous gastrointestinal polyps. Herein, we present a case of a 24-year-old female patient with Peutz-Jeghers syndrome who underwent endoscopic resection of a large gast....[more]

Meckel's Diverticulum: A Rare Cause of Small Bowel Obstruction in Adults
Carolina Coutinho, Sara Castanheira Rodrigues, Vitorino Garrido, Elisabete Barbosa
Article DOI: 10.21614/sgo-644
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Small bowel obstruction (SBO) is a common cause of hospital admission. Adhesions are the most frequent etiology, usually associated with past abdominal surgery. Meckel’s diverticulum is a rare cause of small bowel obstruction in the adults. We present a case of a 76 years-old male patient presenting at the emergency department with complaints of abdominal pain, vomiting and constipation. Abdomino-pelvic computed tomography scan showed signs of small bowel obstruction. Patient was proposed for surgery and was submitted to an exploratory laparotomy. Small bowel obstruction was....[more]

A Hostile Abdomen: A Case Report
Mariana González-Villegas, Lucia Villegas-Coronado, Jorge Eduardo Flores-Godínez, María Fernanda Vega-Robles, Kimberly Oney Bojorquez-Osuna
Article DOI: 10.21614/sgo-676
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Introduction: A hostile abdomen presents a challenging surgical scenario characterized by scarring, fibrosis, and adhesions within the abdominal cavity, complicating surgical intervention and increasing the risk of complications. This condition arises from multiple factors, including previous abdominal surgeries, trauma, or chronic inflammatory diseases.


Case report: In this case, a 24-year-old female patient initially presented with fever and abdominal discomfort, later developing severe abdominal pain and vomiting. Despite....[more]

Unicentric Castelman Disease: A Rare Indication for Major Hepatectomy
Horea Bocse, Caius Breazu, Cristina Pojoga, Ioana Iancu, Sandu Branzilă, Adrian Bartoş
Article DOI: 10.21614/sgo-659
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This report presents a rare case of Unicentric Castleman Disease (UCD) necessitating a major hepatectomy in a 53-year-old Caucasian male with an anomalous hepatic mass. Despite the non-specific findings on MRI and CT scans, the use of intraoperative ultrasonography revealed critical tumor proximity to the left hepatic artery, guiding the decision for a left hepatectomy. Post-surgical histopathological analyses confirmed the UCD diagnosis, emphasizing its rarity in hepatic contexts. The case underlines the importance of combined imaging modalities, especially intraoperative assessm....[more]

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