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Biomedical subjects

L Kotsis

Publications and source records attributed to L Kotsis.

At least 37 records · Page 2Linked to original sources
PubMed1992

[Surgical management of mediastinal tumors based on experience with 1000 cases].

One thousand operated mediastinal tumours are analysed. Their characteristic features are discussed and some uncommon manifestations are presented. It is emphasized that in most cases (80-90%) the traditional simple X-ray methods can give a sufficient information for the diagnosis. On the other hand, vascular lesions, cervicomediastinal goiters, dumbbell neurinomas, lymphatic diseases and esophageal lesions should be detected carefully by especial diagnostic methods before surgery because of the different operative tactics and consequences. The diagnosis of the mediastinal neoplasm indicates surgery due to their compressive behaviour.

Adolescent↗
PubMed1990

[Adaptation of the esophagus, reconstructed using the colon, based on 135 cases of surgery in corrosive stenosis].

Late aspects of adaptation were studied on the basis of 135 esophagoplasty by means of isoperistaltic (except of 7 anisoperistaltic) transverse colon for corrosive strictures. Histochemically, the augmentation of neutral mucopolysaccharide, which increases mucosal resistance--was observed on the surface and in Lieberkühn glands of colonic mucosa. Mucosal absorption remains unmodified. Transit time is considerable longer, but without functional consequences. Radiokinematographically, characteristic, coordinated, multihaustral, propulsive movements of transverse colon were present, playing a secondary, but active role in the swallowing mechanism. In the authors opinion, the marked differences between the iso- and anisoperistaltic interposition modality, in point of view of gastro-colic reflux, is explained by these unmodified, more independent, motor activity of the bowel wall. Good long-term functional results were present in 92% of patients. In management of corrosive strictures, isoperistaltic transverse colon may be considered the graft of choice, both technically and functionally.

Burns, Chemical↗
PubMed1989

[Severe tracheal compression caused by achalasia].

A very rare complication of achalasia (cardiospasm) is presented. In the authors' case the esophagus of a 15-year old girl was dilated to a great extent and caused through the compression of the trachea upper respiratory obstruction. Following the surgical solution of the achalasia the respiratory complications ceased too. Attention is drawn to the possibility that esophagus diseases may play a significant role in the etiology of different pulmonary diseases.

Adolescent↗
PubMed1987

Bypass with transdiaphragmatic Roux loop in nonresectable malignant stricture of the lower oesophagus.

Bypass with a Roux-en-Y loop is proposed for palliation of nonresectable malignant obstruction in the distal oesophagus and cardia without peritoneal dissemination. Over a 15-year period, 51 transdiaphragmatic Roux-en-Y procedures with side-to-end oesophagojejunal anastomosis were performed. The 11.8% mortality was unrelated to anastomotic leakage. Gastrostomy should be avoided because of its nutritional and psychologic disadvantages. Other methods for surgical bypass are discussed and comparison is made with intubation. Wider indications for the Roux loop bypass are mentioned.

Cardia↗
PubMed1987

A new reflux-free surgical esophageal intubation technique.

Pull-through esophageal intubation with a composite, detachable prosthesis allows insertion of the tube only in the narrowing due to the tumor. Using this easy technique, which permits a convenient low, small 3 millimeter gastrotomy, the intra-abdominal contamination is reduced. The end of the tube does not pass across the cardia, so the patient is free from gastroesophageal reflux and its consequences.

Esophageal Stenosis↗
PubMed1983

Complications of oesophagoplasty with isoperistaltic transverse colon.

An analysis is presented of late results in 144 reconstructions of oesophagus with transplants (137 isoperistaltic, 7 anisoperistaltic) from transverse colon for correction of stricture, mainly after corrosive trauma. The grafts were interposed retrosternally in 126 cases and intrathoracically in 18. Delayed passage due to excessive size of the colon segment was managed in four cases by plication of the intra-abdominal part of the graft or by jejunal by-pass. 'Pseudo-diverticulum' at the proximal anastomosis occurred in five cases as a complication of the standard by-pass procedure. Correction was made by closure of the pouching oesophagus below the cervical anastomosis. Transformation to end-to-end anastomosis is also recommended. The incidence of gastrocolic reflux was low. In two of the four observed cases the cause was late pyloric stenosis. There was no case of peptic ulceration. For good late results of colo-oesophageal reconstruction, appropriate length and type of colon segment, suitable site of gastric implantation and isoperistalsis are of primary importance.

Colon↗
PubMed1982

Demonstration of alpha 1-antitrypsin in paraffin sections of hepatoma and cirrhosis.

Alpha 1-antitrypsin has been examined in formalin-fixed, paraffin-embedded liver specimens from Greek patients with cirrhosis (35 cases) and hepatoma (55 cases) by peroxidase-antiperoxidase (PAP) method. Ring-like AAT globules were found in the non-neoplastic cells in 12% of the cases of hepatoma and in 11% of the cases of cirrhosis. Atypical globules were seen in neoplastic cells in 5.4% of the cases of hepatoma and in 17% of the cases of liver cirrhosis. A diffuse fine granular pattern of AAT distribution was present in 31% of the cases of hepatoma in the neoplastic cells and in 27% of those in the non-neoplastic cells. The relatively high incidence of ring-like AAT-globules, and of atypical globules in cases of hepatoma and cirrhosis is not in agreement with the extremely low gene frequency of Z allele in a Greek population of patients with cirrhosis and hepatoma. Thus, there is some doubt whether AAT-globules in the liver represent a histopathologic marker of genetically determined AAT deficiency. A relationship between AAT deposits and the degree of differentiation of hepatoma was noted in this series. AAT-positive cells were found in 55% of moderately differentiated, in 29% of highly differentiated and in 20% of poorly differentiated hepatomas.

Carcinoma, Hepatocellular↗
PubMed1982

Distribution of lysozyme, alpha 1-Antichymotrypsin and alpha 1-Antitrypsin in adenocarcinomas of the stomach and large intestine. An immunohistochemical study.

Lysozyme, alpha 1-Antichymotrypsin and alpha 1-Antitrypsin were demonstrated by an immunoperoxidase technique (PAP) in malignant cells of adenocarcinomas of the stomach but not of the large intestine. Lymph-node metastases showed identical immunoreactivity to that of the primary tumour. Neoplasms arising from the cardia, the body and the pyloric antrum of the stomach showed different immunostaining reactions. It seems that these differences partly reflect the distribution of lysozyme, alpha 1-Antichymotrypsin and alpha 1-Antitrypsin in the normal gastric mucosa. The usefulness of our findings in the identification of the primary tumour in cases of lymph node metastases of unknown origin, is also discussed.

Adenocarcinoma↗
PubMed1980

Treatment of perforated duodenal ulcer by vagotomy-associated antrectomy.

In the years between 1967 and 1978, Billroth I-type antrectomy and truncal vagotomy were performed in 44, and primary gastric resection in 19 cases of perforated duodenal ulcer. It was found that in the case of perforated ulcer causing extensive scarring, stenosis or penetration, antrectomy is not more complicated than pyloroplasty. In the absence of other local lesions and mainly in high-risk patients with cirrhosis, diabetes, chronic renal disease, tuberculosis, etc. excision of the perforated duodenal ulcer, pyloroplasty according to Finney and vagotomy were performed (48 operations), while in purulent peritonitis (8 patients) suturing only was applied. Bearing in mind the above aspects, the authors lost none of their patients. Final and similar results can be achieved with performed (in 48 cases), while in the case of purulent peritonitis only suturing was applied in 8 patients. None of the patients was lost. Similar results can be achieved with emergency antrectomy and vagotomy as under elective conditions. In the majority of cases the perforated duodenum can be operated upon in such a way which will abolish the perforation and ensure a final healing of the ulcer.

Duodenal Ulcer↗
PubMed1975

[Palliative treatment of nonresectable cardia tumors using esophago-jejunal bypass].

Transdiaphragmal internal bypass with Roux's loop is believed to be the best solution for non-resectable primary or secondary tumorous obstructions in the region of the cardia. Of 26 cases subjected to such an operation, 3 patients died. The indication of bypass operations must not be extended at the cost of palliative (and even less of radical) resections. On the contrary, in the surgery of gastric tumours these operations aim to improve operability. It is believed that internal palliative solutions might finally replace the external ones, since the former intervention offers definite nutritional and moral advantages.

Cardia↗