Georgios D. Lianos

University of Ioannina | UOI · Division of Surgery

Introduction: Endoscopic procedures are expanding and have been evolving in recent years, increasing their volume along with the development of new devices. This is due to the low morbidity and complication rate, the reversibility of the procedures, and the positive impact on patients. Among the endoscopic procedures gaining interest is sleeve gast...

Background: Paediatric Traumatic Brain Injury (TBI) has received less research attention compared to TBI in adults, despite its potential morbidity in all ages. Our aim was to determine whether neutrophil to lymphocyte ratio (NLR), platelet to lymphocyte ratio (PLR) and glucose levels at admission can reliably predict the need for imaging in child...

We retrospectively reviewed the medical records of 109 patients who underwent curative laparoscopic or open resection for different types of gastrointestinal stromal tumors (GIST). Only primary GIST patients who did not receive preoperative chemotherapy or oral imatinib treatment were included in the analysis. We divided the patients into 2 groups...

Gastric diverticula are uncommon anatomic abnormalities that are usually asymptomatic or found incidentally in upper gastrointestinal radiographs with contrast or endoscopy. Gastric diverticula usually arise from the wall of the gastric fundus. Their preoperative study or intraoperative finding is of great importance in patients with obesity who ar...

Background The SARS-CoV-2 pandemic is still ongoing and a major challenge for health care services worldwide. In the first WSES COVID-19 emergency surgery survey , a strong negative impact on emergency surgery (ES) had been described already early in the pandemic situation. However, the knowledge is limited about current effects of the pandemic on...

During first outburst of COVID‐19, several strategies had been applied for surgical oncology patients to minimize COVID‐19 transmission. COVID‐19 infection seemed to compromise survival and major complication rates of surgical oncology patients. However, survival, tumor progression and recurrence rates of surgical oncology patients were associated...

Cell-cycle analysis has shown the presence of aneuploidy to be associated with poor prognosis. We developed an innovative rapid cell-cycle analysis protocol (the Ioannina protocol) that permitted the intraoperative identification of neoplastic cells in a plethora of malignancies. Herein, we aimed to investigate the potential role of cell-cycle anal...

Purpose of the Review The aim of the review is to present an updated overview on the pathologic aspects and the surgical approach to small bowel neuroendocrine tumors, focusing on the following debated issues: role of laparoscopic surgery, lymph node dissection, prophylactic cholecystectomy, mesenteric fibrosis, and surgery of distant metastases....

Purpose: The occurrence of coagulopathy in patients with traumatic brain injury (TBI) is related to severe complications. The authors performed the first systematic review to investigate whether biomarkers can predict the occurrence of hypocoagulopathy or progressive hemorrhagic injury in patients with TBI. Methods: The authors included studies tha...

Following the publication of the original article [1], the author name “Dragos Serban” under The WSES COVID-19 emergency surgery survey collaboration group was incorrectly written as “Dragos Seban” instead of “Dragos Serban”. The original article has been corrected.

This study aims to assess the role of Color Duplex Ultrasound with or without contrast media for surveillance following endovascular aortic aneurysm repair (EVAR). A systematic search of the literature published until April 2022 was performed according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Th...

Background: Flow Cytometry is an analytical technique for the precise quantification of cellular phenotype. Intraoperative Flow Cytometry (iFC) utilizes flow cytometry for DNA content/ploidy and cell cycle distribution analysis during surgery for cancer cell characterization and evaluation of tumor margins. Various types of cancers, including intr...

The development of fibrostenotic intestinal disease occurs in approximately one-third of patients with Crohn’s disease and is associated with increased morbidity. Despite introducing new biologic agents, stricturing Crohn’s disease remains a significant clinical challenge. Medical treatment is considered the first-line treatment for inflammatory st...

Hepatocellular carcinoma (HCC) is the most common primary liver malignancy. It is principally associated with liver cirrhosis and chronic liver disease. The major risk factors for the development of HCC include viral infections (HBV, HCV), alcoholic liver disease (ALD,) and non- alcoholic fatty liver disease (NAFLD). The optimal treatment choice is...

Aim: Traumatic brain injury (TBI) is a public health issue of increasing incidence. Coagulopathy after TBI is a frequent event, associated with a poor prognosis, and biomarkers that could predict coagulopathy occurrence are needed. The neutrophil-to-lymphocyte ratio (NLR) is useful as a cost-effective biomarker to assess prognosis and the need for...

Liver resection is the main treatment for primary and metastatic liver tumors in order to achieve long-term survival with good quality of life. The ultimate goal of surgical oncology is to achieve complete tumor removal with adequate clear surgical margins. Flow cytometry is a powerful analytical technique with applications such as phenotypic analy...

Curcumin is a polyphenol extracted from the rhizomes of the turmeric plant, Curcuma longa which has anti-inflammatory, and anticancer properties. Chronic inflammation is associated with the development of cancer. Curcumin acts on the regulation of various immune modulators, including cytokines, cyclooxygenase-2 (COX-2), and reactive oxygen species...

Background: This is the first Western study presenting short-term results on patients older than 80 years affected by gastric cancer and treated with laparoscopic distal gastrectomy. Methods: A multicentre prospective database on patients suffering from distal gastric cancer with age of ≥ 80 undergone to distal gastrectomy was analysed retrospec...

Objective: Head and neck squamous cell carcinoma (HNSCC) has been reasonably linked to smoking and / or alcohol consumption. The purpose of our study was to investigate the possible correlation of HPV infection with papillary, precancerous and cancerous laryngeal lesions. Methods: Biopsy material was obtained from larynx of patients with papillary,...

Surgery represents the only method for potentially curative intent for gastric cancer (GC) [...].

Aim To compare anatomical with numerical criterion to measure the quality of lymphadenectomy for gastric cancer. Patients and Methods We analyzed 447 gastric cancer patients with resectable tumor stage (R0 resection) with at least 16 examined lymph nodes. Results Of 447 patients, 82.6% underwent D2 lymphadenectomy for a median of total examined l...

Introduction The indisputable increase in non-Alcoholic Fatty Liver Disease (NAFLD) prevalence, has consequently led to an increase in Hepatocellular Carcinoma (HCC) and liver-related mortality worldwide. Twenty-five percent of the general population present with various degrees of steatosis and most of them are unaware of their disease until its p...

Aim: Traumatic brain injury (TBI) is a serious health concern. We set out to investigate the role of neutrophil-to-lymphocytes ratio (NLR) at admission for predicting the need for computed tomography (CT) in mild-TBI. Materials & methods: A retrospective study of adult patients who presented with mild-TBI Results: One hundred and thirty patients me...

Neoadjuvant therapy for locally advanced gastric cancer is a treatment option well recognized in international guidelines. However, neither completed randomized trials nor ongoing studies (will) offer definitive answers about the efficacy of neoadjuvant therapy. With extensive experience confirming the safety and some efficacy for this approach mos...

Background: There is a broad spectrum of infections that may occur in IBD. The aim of the present study was to explore infections in IBD patients monitored for the past 30 years. Materials and Methods: A total of 527 IBD patients of the University Gastroenterology Dept. and the associated Gastroenterology Outpatient Clinic were scrutinized between...

Background Early gastric cancer (EGC) is more common nowadays and is related a to low percentage of lymph node metastasis. For this reason, there is enormous interest to implicate minimally invasive approaches. Recently, special efforts have been made towards a potential intraoperative (real-time) lymph node metastasis (LNM) assessment, as nodal di...

Background To evaluate the impact of extended surgical treatment performed by a team of gynecologists and general surgeons on postoperative morbidity and survival of patients with advanced ovarian cancer. Methods We collected data of 156 patients with advanced ovarian cancer stage IIb-III-IV according to International Federation of Gynecology and...

Background and Aims: Recently, extensive research is performed in order new prognostic factors for gastric cancer to be identified. The prognostic value of perineural invasion for gastric cancer remains controversial. Aim of this study was the evaluation of the prognostic role of perineural invasion in patients with gastric cancer. Material and Met...

Empyema of acalculous gallbladder in the setting of salmonellosis represents an extremely rare and life-threatening clinical condition in adults. In this unique case report, we deal with a previously healthy patient who developed acalculous cholecystitis and empyema due to infection by Salmonella . He underwent explorative laparotomy in emergency s...

Traumatic brain injury has been associated with increased blood glucose levels. In the present study, we set out to investigate if blood glucose level in mild head trauma could predict the need for CT. One hundred fifty-nine patients with minor TBI (GCS 13-15) and a mean age of 44.8±23.8 years were included in the study. The most common mechanism o...

Inflammatory bowel disease (IBD) consists of two disorders: Crohn's disease (CD) and ulcerative colitis (UC). Over the past few decades, a great body of knowledge has accumulated regarding the pathogenesis of IBD, and effective pharmaceutical agents, such as inhibitors of tumor necrosis factor (anti-TNF), have been introduced. Although these agents...

Purpose: Lung cancer is among the leading causes of cancer-related cases and cancer-associated deaths. Tumor cells frequently acquire chemoresistance and, due to that, new therapies are always needed in the fight against cancer. Pharmaceutical plants continue to offer novel compounds as anticancer therapies. Methods: We studied the action of N-p...

Background: Patients with multiple severe systemic diseases present a high rate of complications after abdominal surgery under general anesthesia especially in emergency setting. Herein, we deal with two cases of high-risk patients who underwent colectomy in emergency setting at our Department under continuous spinal anesthesia as a primary method...

Background: Gastric cancer is reported to be the fourth most common cancer and the second leading cause of cancer-related death worldwide. Minimally invasive surgical treatment for gastric cancer is a very challenging approach which offers undoubtedly important advantages. Materials and methods: There is intense debate concerning the minimally i...

Superior vena cava syndrome (SVCS) represents undoubtedly a rare life-threatening condition. Herein, we present a rare case of a 69-year-old woman, with a history of hepatic flexure tumor and an indwelling central venous port, presenting with acute signs and symptoms of SVCS due to thrombosis of the catheter. The patient was treated with intravenou...

Introduction: The aim of this study is to compare short-term outcomes of right versus left colectomies performed as a form of cancer treatment. Materials and methods: This study includes 305 consecutive patients with adenocarcinoma treated by laparoscopic or open colectomy. Right colectomy has been compared with left colectomy. The study endpoin...

Background. Mucocutaneous separation is reported as the detachment of the stoma from the skin, usually arises as an early complication and potentially can lead to infection, peritonitis and stomal stenosis. Case Presentation. Herein, we report a unique case of reconstruction with rotation skin flap of postoperative mucocutaneous separation after Ha...

Background/Purpose: In colon cancer (CC) patients preoperative (pre-op) levels of VEGF-A165 (VEGF) is a strong predictor for disease recurrence. Elevated postoperative (post-op) VEGF levels could have undesirable effects by enhancing tumor growth and metastasis formation. It has been suggested that thromboprophylaxis with a Low Molecular Weight Hep...

Background Pancreatic resection for cancer represents a real challenge for every surgeon. Recent improvements in laparoscopic experience, minimally invasive surgical techniques and instruments make now the minimally invasive approach a real “triumph.” There is no doubt that minimally invasive surgery has replaced with great success conventional sur...

Despite dramatic advances in cancer research setting, breast cancer remains a major health problem and represents currently a top biomedical research priority. Worldwide, breast cancer is the most common cancer affecting women, and its incidence and mortality rates are expected to increase significantly the next years. Recently the researchers’ int...

Difluoromethylornithine (DFMO; eflornithine) is an irreversible suicide inhibitor of the enzyme ornithine decarboxylase which is involved in polyamine synthesis. Polyamines are important for cell survival, thus DFMO was studied as an anticancer agent and as a chemoprevention agent. DFMO exhibited mainly cytostatic activity and had single agent effi...

Laparoscopic cholecystectomy (LC) represents the gold standard for the treatment of symptomatic chololithiasis. Numerous complications have been described during LC, the majority of them are mostly related with bile duct injuries. In this 'educational laparoscopic video' we deal with an unusual complication of LC, an iatrogenic right diaphragm inju...

Nowadays, laparoscopic cholecystectomy (LC) represents the gold standard of treatment for gallstone disease. However, complications during LC still occur, and conversion to open surgery is sometimes urgently required. It is reported that major hemorrhage during LC occurs in 0.1% to 1.9% of all cases, with 88% originating from the gallbladder bed. I...

Complete (R0) resection and regional lymph nodes (LNs) dissection represent undoubtedly the basic surgical tools for patients with gastric cancer. It is reported that the LN metastasis rate in patients with early gastric cancer (EGC) is approximately 15-20%. Therefore, the innovative clinical application of sentinel node navigation surgery (SNNS) f...

Aim: By identifying cancer driver genes involved in tumorigenesis, whole-exome sequencing (WES) analyses enable the development of robust biomarkers and novel therapeutic targets to reach precision oncology. Patients & methods: WES analyses were performed in matched gastric cancer-normal gastric tissues from two patients. We compared genes highl...

OBJECTIVE Congenital hydrocephalus (CH) is one of the most frequent CNS congenital malformations, representing an entity with serious pathological consequences. Although several studies have previously assessed child-related risk factors associated with CH development, there is a gap of knowledge on maternal environmental risk factors related to CH...

Kimmelstiel and Wilson originally described nodular glomerulosclerosis as the pathognomonic lesion of diabetic nephropathy. Nevertheless, nodular glomerulosclerosis pattern can rarely occur in non-diabetic patients. In such cases, the differential diagnosis includes membranoproliferative glomerulonephritis, light or heavy chain deposition disease,...

Background: Primary liver and biliary cancers are very aggressive tumors. Surgical treatment is the main option for cure or long term survival. The main purpose of this systematic review is to underline the indications for portal vein embolization (PVE), in patients with inadequate future liver remnant (FLR) and to analyze other parameters such as...

Neuroendocrine tumors (NETs) are rare and heterogeneous tumors and there is a paucity of randomized clinical trials evaluating the different therapeutic strategies. Over recent years, some important molecular aspects have been investigated and multiple targeted therapies are currently available. One of the most promising targets for the therapy of...

Laparoscopic hepatectomy, although constitutes a demanding surgical procedure, presents undoubtedly important advantages such as less post-operative pain, shorter post-operative hospital stay and substantially better cosmetic results. In this 'educational laparoscopic video' we deal with a 35 years-old young woman presented at our Department with r...

Background: Continuous intraoperative neuromonitoring (C-IONM) is a new technology and it is appropriate to analyze its safety. Methods: C-IONM was performed according to a standardized technique to control any adverse events and electrode positioning issues. Results: Four hundred vagal nerve dissections were analyzed considering vagal nerve d...

large retrospective clinical study describing the long-term experience of a single center in the surgical management of liver echinococcosis in an endemic area. 232 patients were operated for liver hydatid disease between 1978 and 2012. Seventy-three patients (Group A) underwent a radical procedure (total pericystectomy or hepatectomy), while 145 (...

Randomized trials and meta-analyses have established surgery, radiotherapy, chemotherapy and targeted therapy in the multidisciplinary treatment of gastric cancer. However, personalized prediction of both therapeutic resistance and recurrence or metastatic disease progression still remains a researcher's dream. In this editorial, we summarize stand...

Multimodal treatment of resectable gastric cancer has been standardized including R0–D2 gastrectomy and adjuvant treatment. For advanced gastric cancer, several molecular agents have been evaluated in well–conducted randomized studies. The most important is represented by trastuzumab, a monoclonal antibody, which has shown significant antitumor act...

The immune-pathogenesis of psoriatic arthritis represents a subject of intense research, as a still unknown factor can trigger the chronic inflammation that, upon a defective immune terrain, generates this auto-immune/auto-inflammatory condition. The pathogenesis complexity of psoriatic arthritis resides in the psoriatic synovitis milieu, where int...

Hydatid disease is caused by the tapeworm Echinococcus granulosus and it is an endemic parasitic disease of the Mediterranean countries. Although the liver is the most involved organ by this disease, hydatidosis can be found anywhere in the human body. Rare forms of location may pose diagnostic and therapeutic dilemmas. Herein we report our experie...

One of the most important trends in intraoperative neural monitoring (IONM) in thyroid surgery is currently the real-time monitoring of the vagus nerve (VN) in order to prevent recurrent laryngeal nerve (RLN) iatrogenic damages. Notably, continuous intraoperative neuromonitoring (C-IONM) seems to be superior to intermitted intraoperative neural mon...

The role of neoadjuvant (NAD) chemotherapy (CHT) in patients with locally advanced gastric cancer (LAGC) is validated. However, some important limitations emerged from the literature, including patient selection, quality of surgery, and pathologic response evaluation. Neoadjuvant CHT for LAGC has been evaluated with a focus on safety and efficacy o...

The transforming growth factor-β superfamily and its signaling downstream pathwayThe transforming growth factor-β (TGF-β) superfamily is a group of secreted polypeptide growth factors that can be categorized and divided into three main families: TGF-βs, BMPs and activins [1].These superfamily members are multifunctional signaling proteins that are...

The aim of this study was to assess the feasibility of the application of the new system (Emprint Microwave Ablation System, Covidien Boulder, CO, USA) and to identify its advantages. In particular the attention was focused to the spherical ablation zone obtained and its usefulness in terms of effectiveness. The new system is composed of: a 2450 MH...

Background: Abdominal wall retention sutures are widely used in every-day surgical practice, but their potential effect on intra-abdominal pressure (IAP) has not been studied. Methods: we conducted a non-randomized prospective, double-blind clinical trial that enrolled a total of 37 patients who un-derwent elective surgery for abdominal pathology....

Heat shock proteins (HSPs) are an evolutionary family of proteins that act as molecular chaperones. According to their size have been classified into the following families; HSP90, HSP70, HSP60, HSP40 and HSP27. They are preventing the formation of nonspecific protein aggregates and they are assisting proteins in the acquisition of their normal arc...

Heat shock proteins (HSPs) are an evolutionary family of proteins that act as molecular chaperones. According to their size they have been classified into the following families; HSP90, HSP70, HSP60, HSP40 and HSP27. They prevent the formation of nonspecific protein aggregates and they assist proteins in the acquisition of their normal architecture...

The external branch of the superior laryngeal nerve (EBSLN) is surgically relevant since its close anatomical proximity to the superior thyroid vessels. There is heterogeneity in the EBSLN anatomy and EBSLN damage produces changes in voice that are very heterogenous and difficult to diagnose. The reported prevalence of EBSLN injury widely ranges. E...

It is well known that blunt neck trauma, when compared to a penetrating injury in the same anatomical area, is very rare. We report a case of an 81-year-old Caucasian woman with a blunt life-threatening neck trauma due to a bully goat. Although rare, direct evaluation should always be done in these cases because any misinterpretation may result in...

Laryngeal nerve injuries are one the most critical complications during thyroid and parathyroid surgery. Iatrogenic damages to the recurrent laryngeal nerve (RLN) are relevant in terms of clinical implications, economic costs, and for malpractice litigation. In order to minimize potential neural damages, a standardized surgical technique is mandato...

Nowadays, our understanding of gastric cancer has been improved. The major hope is to increase the survival rates of this aggressive, enigmatic and heterogeneous disease, especially in Western population. Over the past decades, conventional surgery has been the cornerstone of treatment for non metastatic gastric cancer patients. Adequate gastrectom...