Nikolaos Sapidis

Aristotle University of Thessaloniki, SalonĂ­ki, Central Macedonia, Greece

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Publications (9)11.27 Total impact

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    ABSTRACT: AIM: The purpose of our study is to present the results of the handsewn single-layer interrupted extramucosal anastomosis following colon cancer. PATIENTS AND METHODS: In the period between 1989 and 2009, 276 intestinal anastomoses were fashioned following colon resection using single-layer interrupted extramucosal 3/0 Vicryl. RESULTS: The mean hospital stay was 8.2 days. Twenty-three patients had postoperative complications, and the total morbidity was 8.3%. Seven anastomotic leakages occurred (2.5%). The mortality rate was 2.5%. CONCLUSION: The single-layer anastomosis with interrupted extramucosal sutures after colon resection is safe and effective. PMID: 20683752 [PubMed - indexed for MEDLINE]
    Techniques in Coloproctology 01/2010; 14(1):s57-s59. · 1.54 Impact Factor
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    ABSTRACT: Laparoscopic cholecystectomy is the procedure of choice for the treatment of symptomatic gallstone disease. Some of the associated complications are rare, but often serious. The purpose of this study is to present our data about the type and the incidence of these complications and our experience in their management, in a district hospital, during the last 8 years. A retrospective study was performed on 1009 patients, 229 males and 780 females, with age ranging from 19 to 84 years, who underwent laparoscopic cholecystectomy for symptomatic gallstone disease, during the period from January 2000 to January 2008. The procedure was performed urgently due to acute cholecystitis in 78 patients (7.73%). Complications occurred in 96 (9.51%) patients. Bile leakage occurred in 15 patients (1.49%). One patient (0.10%) had a major bile duct injury (common bile duct transection). Bleeding occurred in 9 patients (0.89%), wound infection in 14 patients (1.39%), abdominal wall hematomas in 3 patients (0.30%), omental hematoma in 3 patients (0.30%), port site hernias in 3 patients (0.30%), subphrenic abscess in 1 patient (0.10%), subcapsular liver hematoma in 1 patient (0.10%), bowel injury in 5 patients (0.51%), postoperative acute pancreatitis in 4 patients (0.40%), respiratory and cardiovascular complications in 11 patients 1.09%). Finally in 14 patients (1.39%), the gallbladder was unintentionally opened during laparoscopic procedure and spillage of gallstones occurred into the peritoneal cavity. All patients had satisfactory results and no death occurred. We conclude that laparoscopic cholecystectomy is a safe procedure, although it is associated with some serious complications. The most usual complication during laparoscopic cholecystectomy is bile leakage, which remains a significant cause of morbidity. Early identification and management of these complications will minimize a potentially devastating outcome.
    Surgical laparoscopy, endoscopy & percutaneous techniques 12/2009; 19(6):449-58. · 0.88 Impact Factor
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    ABSTRACT: The aim of this experimental study was to investigate the contribution of insulin-like growth factor I (IGF)-I in the colonic healing process when injected intraperitoneally after colon resection. Forty male Wistar rats were used. Rats in the control group were injected with 3 mL of a solution of 0.9% NaCl intraperitoneally after the operation and on postoperative day 2, 4, and 6. Rats in the IGF-I group received recombinant human IGF-I in a dose of 2 mg/kg body weight intraperitoneally, immediately after the colonic anastomosis was performed and on postoperative day 2, 4, and 6. All rats were killed on postoperative day 7. The hydroxyproline tissue content was significantly higher in the IGF-1 group than in the control group. The bursting pressures were also significantly higher in IGF-1 group than in the control group. The weight change between the groups differed significantly; in the control group the average weight decreased about 5% postoperatively, while in the IGF-1 group the average weight increased about 6%. The average inflammatory cell infiltration score was significantly higher in the control group. Neoagiogenesis did not differ significantly between the two groups. The fibroblast activity differed significantly between the two groups, as the control group had significantly less fibroblasts compared to the IGF-1 group. In conclusion, IGF-I when given intraperitoneally stimulates the healing of colonic anastomoses in the rats. Further studies are required in order to determine whether this effect is dose related.
    Journal of Investigative Surgery 07/2009; 20(1):9-14. · 1.32 Impact Factor
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    ABSTRACT: A rare case of Mirizzi syndrome with atypical presentation is reported. An 81-year-old woman with a known history of cholelithiasis presented with epigastric discomfort and indigestion. Imaging investigations revealed Mirizzi syndrome, while a cholecystobiliary fistula at the junction of the hepatic ducts was recognized intraoperatively and treated successfully with cholecystectomy and Roux-en-Y hepaticojejunostomy. During two years' follow-up the patient remains free of biliary symptoms. Diagnosis of Mirizzi syndrome requires a high degree of clinical suspicion, especially in cases without obstructive jaundice. A fistula at the level of the confluence of the hepatic ducts is a rare topographic variant of the syndrome that may need a totally different surgical approach.
    Medical science monitor: international medical journal of experimental and clinical research 03/2009; 15(3):CS54-7. · 1.22 Impact Factor
  • Techniques in Coloproctology 10/2008; 12(3):267-71. · 1.54 Impact Factor
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    ABSTRACT: The aim of this retrospective study was to evaluate the outcome of laparoscopic cholecystectomies (LCs) performed in our Academic Surgical Unit, and the impact of our policy not to perform intraoperative cholangiograms (IOCs) on the incidence of bile duct injuries (BDIs). Data was collected for the time period from 1992 (when the laparoscopic procedure was first introduced in our Unit) until 2005. During this time, 1851 patients underwent an LC. Patients with a history of jaundice, ultasonographic bile duct dilatation, bile duct stones, or deranged liver function tests were referred initially for an endoscopic retrograde cholangiopancreatography procedure. An IOC was not performed on any patient. The conversion rate was 23.9% among the patients with acute cholecystitis and 1.6% among the patients with a noninflamed gallbladder. This difference was statistically significant. The morbidity reached 1.1%, as minor or major complications were present in 22 of 1851 patients. Complications consisted of BDI in 7 patients (0.37%). Six patients presented with minor BDI. Two of the BDIs occurred among the group of patients with acute cholecystitis, whereas the remaining 5 occurred in the group of patients with a noninflamed gallbladder. This distribution was not statistically significant. The low BDI rate in our series allowed us to recommend an LC procedure without an IOC. Performing a cholangiogram either routinely or selectively is not wrong. However, adherence to a meticulous hemostatic technique, thorough knowledge of the anatomy, and a low threshold for conversion may also enable satisfactory results to be achieved.
    Journal of Laparoendoscopic & Advanced Surgical Techniques 11/2007; 17(5):620-5. · 1.07 Impact Factor
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    ABSTRACT: Although local excision (ampullectomy) was first described by Halsted in 1899, its adequacy as an alternative surgical treatment for the ampullary tumors is still a matter of debate. The aim of this study was to evaluate the results of ampullectomy as a curative treatment for benign and malignant tumors arising from the ampulla, in a 14-year single-institution experience. From 1990 to 2004, a total of 20 patients of adenocarcinoma (12) or adenoma (8) of the ampulla of Vater underwent local excision. Clinical data were collected and morbidity, mortality, as well as long-term survival were evaluated. The usefulness of several pre or intraoperative diagnostic methods was also recorded. Median follow-up was 85 (range 6-180) months. The combination of endoscopic preoperative biopsies and intraoperative frozen section examination adequately diagnosed ampullary tumors in all cases. The postoperative morbidity and mortality were 0%, whereas the 3 and 5-year survival rates for the patients with adenocarcinoma was 75 % and 33.3 % respectively. All the patients with adenoma are still alive without any sign of recurrence. In our series, local excision was a safe option, associated with satisfactory long-term survival rates in patients with benign lesions and in those with small(<2 cm), pT1, well differentiated ampullary tumours without nodal involvement.
    World Journal of Surgical Oncology 01/2006; 4:14. · 1.09 Impact Factor
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    ABSTRACT: Metastases from hepatocellular carcinoma (HCC) can be found in the lung and adrenal gland. We report case of a patient who presented with adrenal metastasis as the first clinical manifestation of HCC. A patient was referred for surgical treatment for a tumor in retro-peritoneal space. The computerized tomography (CT) scan revealed a mass originating from the left adrenal gland. The patient underwent left adrenalectomy and the exploration of abdominal cavity did not reveal any other palpable lesions. Histologically, the resected lesion was a poorly differentiated metastatic tumor from HCC. Seven months later patient was readmitted complaining of cachexia, icterus, and significant weight loss. CT scan revealed hyperdense lesions of the liver. HCC may have atypical presentations like in present case. Fine needle aspiration/tru-cut biopsy might be useful in the investigation of an accidentally discovered adrenal mass regardless of the size and can lead to the detection of a primary tumor.
    World Journal of Surgical Oncology 08/2005; 3:50. · 1.09 Impact Factor
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    ABSTRACT: The aim of this study was to define the survival rates in patients with rectal carcinoma treated with curative resections. Between 1993 and 1998, 54 patients with rectal cancer underwent curative resection by conventional technique. Tumour location, TNM staging and tumour differentiation were evaluated. Among the 54 patients, 14 underwent high anterior resection, 28 low anterior resection, 7 abdominoperineal resection and 5 underwent local excision. Survival rates were calculated using the Kaplan-Meier method and long-range analysis. Five-year survival was 70.4%. The survival rate statistically significantly decreased with increasing TNM tumour stage (p=0.009). Patients with poor differentiation of the tumour had the lowest 5-year survival (33%) compared to patients with moderate (72%) and good (78%) tumour differentiation. Sex and age did not affect survival. Location of the tumour in the distal end of the rectum and mucinous characteristics are poor prognostic factors affecting survival. Curative resection combined with chemoradiotherapy, whenever necessary, is accompanied with acceptable 5-year survival rates.
    Techniques in Coloproctology 12/2004; 8 Suppl 1:s167-9. · 1.54 Impact Factor