Sofronis Loizides

American Medical Center

Introduction Reporting of pelvic exenteration specimens for locally recurrent rectal cancer (LRRC) can be challenging for structured pathological analysis and currently, there is a lack of specific guidelines. The aim of this study was to assess the quality of pathology reporting in a cohort of patients who underwent pelvic exenteration for LRRC in...

Introduction Re‐operative pelvic surgery is rarely hostile and unsafe. Kraske’s procedure has historically been used to approach the mid‐rectum and to resect retrorectal tumors. However, it provides limited access to the pelvis and is best in the “virgin” pelvis. We have encountered a select group of patients who required completion proctectomy or...

Ischiorectal fossa tumours are rare, heterogenous, and can be malignant. The approach to excision of ischiorectal fossa tumours is dependent on the size of the tumour, its association with surrounding structures, and the histopathology. The most common operative approach is local excision via a perineal or posterior approach. We have developed a no...

Re-operative pelvic surgery is rarely hostile and unsafe. The posterior trans-sacral approach (Kraske’s procedure) has historically been used to approach the mid-rectum and to resect retrorectal tumours as it provides excellent access to the pre-sacral space. However, this manoeuvre provides limited access to the pelvis and is best in the “virgin”...

Background: The World Health Organization (WHO) Surgical Safety Checklist has fostered safe practice for 10 years, yet its place in emergency surgery has not been assessed on a global scale. The aim of this study was to evaluate reported checklist use in emergency settings and examine the relationship with perioperative mortality in patients who ha...

Background Surgical mortality data are collected routinely in high-income countries, yet virtually no low- or middle-income countries have outcome surveillance in place. The aim was prospectively to collect worldwide mortality data following emergency abdominal surgery, comparing findings across countries with a low, middle or high Human Developmen...

Pseudoaneurysm of the cystic artery is very rare. In the majority of cases it has been reported as a post-operative complication of laparoscopic cholecystectomy, however it has also been associated with the presence of acute cholecystitis or pancreatitis. When these pseudoaneurysms rupture they can lead to intraperitoneal bleeding, haemobilia and u...

Bouveret syndrome is a proximal form of gallstone ileus where a large gallstone lodges in the pylorus or proximal duodenum, having passed through a bilioenteric fistula that has formed secondary to previous cholecystitis. We describe the laparoscopic extraction of a giant 'Bouveret' gallstone from the duodenum of an elderly man with morbid obesity....

Doctors in the United Kingdom are expected to choose a broad career path after approximately 16 months of finishing medical school. We aim to investigate how much surgical exposure foundation-year (FY)1 doctors would have by the end of their first year after finishing medical school and whether this is sufficient to make an informed decision on a c...

Aims: In the rapidly advancing world of laparoendoscopic surgery, surgeons are faced with new devices all of which are aimed towards a single access. Various single-access devices are available on the market. Our study aimed to compare the performance of experienced laparoscopic surgeons on validated laparoscopic tasks using five devices within a s...

Preoperative fasting is recognised as an important factor in perioperative patient care. Implementation of guidelines on preoperative fasting remains sub-optimal. We audited perioperative fasting in a district general hospital, implemented changes to the preoperative information leaflet and improved fasting practices. The manner in which informatio...

While laparoscopic cholecystectomy is generally considered to be less painful than open surgery, pain is one of the important reasons for delayed discharge after day surgery resulting in overnight stay following laparoscopic cholecystectomy. The safety and effectiveness of local anaesthetic wound infiltration in people undergoing laparoscopic chole...

Premature coronary disease is an important emerging paradigm affecting contemporary HIV patients. Through immune reconstruction HIV causes multisystem pathology. Recent advances in the treatment of AIDS, mainly highly active retroviral therapy (HAART), have transformed this previously terminal illness to a chronic disease. However, an interplay bet...

Open inguinal Hernia repair is one of the most commonly performed operative procedure. Despite this, hernia repair can cause considerable morbidity and rarely mortality. Some of these complications such as chronic pain and testicular complications can be easily disregarded, thereby leading to medico-legal claims being made. As a result, the quality...

Background Medico-legal societies and the General Medical Council have been urging a greater use of chaperones during intimate examinations. However, research into the use of chaperones has been limited only to general practice. The objectives of this national survey were to find out: (1) whether formal chaperone policy exists in accident and emerg...

Primary repair of large hiatal hernia is associated with a high recurrence rate. The use of mesh may reduce this recurrence rate. The indication for mesh use, the type of mesh to use, and the placement technique are controversial. A survey of surgeon practice was undertaken to obtain a better understanding of the controversies surrounding this clin...

We describe two unusual cases; both patients wish to continue using the Gynefix despite experiencing difficulty with the device. In case A, the marker string of the Gynefix(R) perforated the full thickness of the cervix and was visualized on the left lateral aspect of the cervix. Three months later the string had moved again and could no longer be...

This study aims to review and assess the safety of carrying out transurethral resection of prostate (TURP) and transurethral resection of bladder tumour (TURBT) simultaneously, in men who require TURP for bladder outflow obstruction and are incidentally found to have a transitional cell carcinoma of the bladder. A detailed Medline search between 19...

Transrectal ultrasonography and prostate biopsies have become a common urological procedure. There is strong published evidence to support the use of a prophylactic antimicrobial cover during the procedure but there is no consensus on the actual antibiotic protocol. Reported here is the first case of septic arthritis of the acromioclavicular joint...