Biomedical subjects

G Savanis

Publications and source records attributed to G Savanis.

6 recordsLinked to original sources

PubMed2003

A new tension-free technique for the repair of umbilical hernia, using the Prolene Hernia System--early results from 48 cases.

Tension-free repair using the Prolene Hernia System (PHS) has been widely adopted for inguinal hernias with excellent results. In our department, a new technique for umbilical hernia repair, using the PHS, has been developed. Between 2000 and 2002, 48 patients underwent tension-free umbilical hernia repair, using the PHS. There were 20 male and 28 female patients, with a mean age of 54 years. The preperitoneal space was dissected to accumulate the underlay patch of the PHS. The onlay patch was placed on the anterior rectus sheath and the connector in the umbilical ring. The median operating time was 35 min (range, 28-40). Postoperative pain was minimal, and there were no complications associated with the mesh, except a seroma, which required needle aspiration. There were no recurrences after a median follow-up of 13 months (1-24). Our early results indicate that the described tension-free technique could become the standard treatment for umbilical hernia repair, but long-term results are required to establish the efficacy of the procedure.

Adult↗

PubMed2003

Randomized comparison between different insufflation pressures for laparoscopic cholecystectomy.

Laparoscopy using carbon dioxide insufflation induces adverse effects in both the cardiovascular and the respiratory function. The use of low pressure pneumoperitoneum has been shown to reduce adverse hemodynamic effects. However, its effect on tissue trauma and postoperative pain and recovery remains controversial. The aim of this study was to compare tissue trauma, postoperative pain, and recovery in two groups of patients undergoing laparoscopic cholecystectomy, one at insufflation pressure of 8 (LC8) and the other at 15 mm Hg (LC15). Forty patients were randomized, 20 in each group. The characteristics of the patients were similar in the two groups. The procedure was completed in all patients in the LC15 group, but in 2 patients in the LC8 group the pressure was increased to 15 mm Hg to complete the operation. There were no significant differences in postoperative pain scores, analgesic consumption, and the incidence of nausea, vomiting, and shoulder pain between the two groups. C-reactive protein concentrations and white blood cell count rose significantly after surgery, but the increase was similar in the two groups. The median duration of surgery was similar, 23 minutes (range 15-65) in the LC8 group and 25 minutes (range 15-80) in the LC15 group. Using our technique of laparoscopic cholecystectomy, there were no advantages to tissue damage, postoperative pain, and recovery when a low pressure pneumoperitoneum was used.

Acute-Phase Reaction↗

PubMed1993

Technical considerations and results of a "new" method of reconstruction of alimentary continuity after duodenopancreatectomy.

A total of (152) patients who consecutively underwent extended pancreaticoduodenectomy between 1983 and August 1992 had reconstruction of alimentary continuity, using two independent jejunal loops. One for the fashioning of a pancreatic and biliary anastomosis and the other for creating the gastric anastomosis. From the results of this study it has been shown that the present technique is contributing to low mortality, early morbidity and a satisfactory quality of post-operative life in long-term survivors. Four patients died during the first 30 days after surgery, and only 25% of those with confirmed pancreaticojejunal anastomotic leakages required early reoperation. Moreover, no patient developed marginal ulceration, or reflux gastritis, or dumping, while the incidence of steatorrhea and diabetes mellitus remained low. Additionally, the present technique makes locoregional radical surgery possible and we thus believe that it merits consideration with respect to the choice of method of reconstruction of alimentary continuity after extended pancreaticoduodenectomy. The present technique has been proved to be safe, simple and effective in fulfilling current demands on resectional pancreatic surgery, particularly in the case of pancreatic malignancies, and can therefore be recommended.

Adult↗

PubMed1993

Induced in vivo targeted transarterial and transvenous immunostimulation in patients with unresectable pancreatic carcinoma.

On the basis of the preliminary results of this study, in vivo dual immunostimulation in patients with advanced pancreatic cancer appears to be a promising therapeutic alternative. A surgical technique is presented in which the spleen of the patient is used as the target organ for in vivo lymphokine activated killer cell generation. Additionally, applying locoregional transvenous administration of gamma-INF and IL2 in the area of the tumor, tumor infiltrating lymphocytes (TIL) area activated, thus completing the system of dual in vivo immunostimulation.

Aged↗

PubMed1992

A new look in the management of unresectable primary hepatocellular carcinoma.

From January 1992 to October 1992, nine patients with unresectable primary hepatocellular carcinoma were treated either by liver resection combined with transarterial on-target chemotherapy (n = 4) or by transarterial on-target chemotherapy alone (n = 5). All nine patients were seen with diffuse spread of their disease and were considered as refractory to surgical treatment. The patients who had liver resection combined with alcohol transtumoral injection of the residual tumor in the liver remnant and transarterial lipiodol on-target chemotherapy, responded well and were seen postoperatively with a significant decrease in size of their residual tumor, which was found histologically to have advanced necrotic changes. Similarly, the remaining patients, who had only alcohol injection and frequent administration of on-target chemotherapy, were seen with necrosis of their tumor and with decrease in its size. The fetoprotein serum levels were decreased in all patients. None of the patients showed systemic effects from the use of chemotherapy, nor did they demonstrate any hepatotoxic side effects.

Aged↗

PubMedDate not supplied

Transarterial locoregional immunostimulation and chemotherapy in patients with unresectable secondary liver tumours.

Ten patients with unresectable liver secondaries from colorectal carcinoma were included in this study. All patients were treated with combined locoregional transarterial targeting immunostimulation and chemotherapy. After abdominal surgery for the introduction of an arterial catheter into the hepatic artery via the gastroduodenal artery, all patients survived the operation and their response to the treatment was satisfactory. At present, seven patients are alive with a survival ranging from 6 to 19 months (mean survival 12 months). Three patients died from their disease after 12, 8 and 7 months respectively. We were able to demonstrate significant tumour necrosis in all patients, even after the first series of combined immunotherapy and chemotherapy. It is concluded that locoregional transarterial targeting immunostimulation and chemotherapy is a promising alternative for patients with unresectable liver secondaries. Further studies are warranted to elucidate the impact of this new treatment modality on overall survival.

Aged↗