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| 1 | Acute mechanical bowel obstruction: Clinical presentation, etiology, management and outcome显示文摘AIM: To identify and analyze the clinical presentation, management and outcome of patients with acute mechanical bowel obstruction along with the etiology of obstruction and the incidence and causes of bowel ischemia, necrosis, and perforation. METHODS: This is a prospective observational study of all adult patients admitted with acute mechanical bowel obstruction between 2001 and 2002. RESULTS: Of the 150 consecutive patients included in the study, 114 (76%) presented with small bowel and 36 (24%) with large bowel obstruction. Absence of passage of flatus (90%) and/or feces (80.6%) and abdominal distension (65.3%) were the most common symptoms and physical finding, respectively. Adhesions (64.8%), incarcerated hernias (14.8%), and large bowel cancer (13.4%) were the most frequent causes of obstruction. Eighty-eight patients (58.7%) were treated conservatively and 62 (41.3%) were operated (29 on the first day). Bowel ischemia was found in 21 cases (14%), necrosis in 14 (9.3%), and perforation in 8 (5.3%). Hernias, large bowel cancer, and adhesions were the most frequent causes of bowel ischemia (57.2%, 19.1%, 14.3%), necrosis (42.8%, 21.4%, 21.4%), and perforation (50%, 25%, 25%). A significantly higher risk of strangulation was noticed in incarcerated hernias than all the other obstruction causes. CONCLUSION: Absence of passage of flatus and/or feces and abdominal distension are the most common symptoms and physical finding of patients with acute mechanical bowel obstruction, respectively. Adhesions, hernias, and large bowel cancer are the most commoncauses of obstruction, as well as of bowel ischemia, necrosis, and perforation. Although an important proportion of these patients can be nonoperatively treated, a substantial portion requires immediate operation. Great caution should be taken for the treatment of these patients since the incidence of bowel ischemia, necrosis, and perforation is significantly high. | Haridimos Markogiannakis Evangelos Messaris Dimitrios Dardamanis Nikolaos Pararas Dimitrios Tzertzemelis Panagiotis Giannopoulos Andreas Larentzakis Emmanuel Lagoudianakis Andreas Manouras Ioannis Bramis | 2007 | World Journal of Gastroenterology2007，13，3： | 7 |
| 2 | Risk factors and implications of anastomotic complications after surgery for Crohn's disease显示文摘Anastomotic complications occur more frequently in patients with Crohn's disease leading to postoperative intra-abdominal septic complications(IASC). Patients with IASC often require re-operation or drainage to controlthe sepsis and have an increased frequency of disease recurrence. The aim of this article was to examine the factors affecting postoperative IASC in Crohn's disease after anastomoses, since some risk factors remain controversial. Studies investigating IASC in Crohn's operations were included, and all risk factors associated with IASC were evaluated: nutritional status, presence of abdominal sepsis, medication use, Crohn's disease type, duration of disease, prior operations for Crohn's, anastomotic technique, extent of resection, operative timing, operative length, and perioperative bleeding. In this review, the factors associated with an increased risk of IASC are preoperative weight loss, abdominal abscess present at time of surgery, prior operation, and steroid use. To prevent IASC in Crohn's patients, preoperative optimization with nutritional supplementation or drainage of abscess should be performed, or a diverting stoma should be considered for patients with multiple risk factors. | Kristen T Crowell Evangelos Messaris | 2015 | World Journal of Gastrointestinal Surgery2015，7，10： | 6 |
| 3 | Update on medical and surgical options for patients with acute severe ulcerative colitis: what is new?显示文摘Acute severe ulcerative colitis(UC) is a highly morbid con dition that requires both medical and surgical managementhrough the collaboration of gastroenterologists and colorectal surgeons. First line treatment for patients presenting with acute severe UC consists of intravenous steroids, but those who do not respond require escalation of therapy or emergent colectomy. The mortality of emergent colectomy has declined significantly in recent decades, but due to the morbidity of this procedure, second line agents such as cyclosporine and infliximab have been used as salvage therapy in an attempt to avoid emergent surgery. Unfortunately, protracted medical therapy has led to patients presenting for surgery in a poorer state of health leading to poorer post-operative outcomes. In this era of multiple medical modalities available in the treatment of acute severe UC, physicians must consider the advantages and disadvantages of prolonged medical therapy in an attempt to avoid surgery. Colectomy remains a mainstay in the treatment of severe ulcerative colitis not responsive to corticosteroids and rescue therapy, and timely referral for surgery allows for improved post-operative outcomes with lower risk of sepsis and improved patient survival. Options for reconstructive surgery include three-stage ileal pouchanal anastomosis or a modified two-stage procedure that can be performed either open or laparoscopically. The numerous avenues of medical and surgical therapy have allowed for great advances in the treatment of patients with UC. In this era of options, it is important to maintain a global view, utilize biologic therapy when indicated, and then maintain an appropriate threshold for surgery. The purpose of this review is to summarize the growing number of medical and surgical options available in the treatment of acute, severe UC. | Rachel E Andrew Evangelos Messaris | 2016 | World Journal of Gastrointestinal Surgery2016，8，9： | 4 |
| 4 | Single-Site Laparoscopic Colorectal Surgery Provides Similar Clinical Outcomes Compared With Standard Laparoscopic Surgery : An Analysis of 626 Patients 显示文摘 | Sangster W Messaris E Berg AS | 2015 | Dis Colon Rectum2015，58，9： | 1 |
| 5 | Administra- tion of human protein C improves survival in an experi- mental model of sepsis显示文摘 | Messaris E Betrosian AP Memos N | 2010 | Crit Care Med2010，38，1： | 1 |
| 6 | Time-dependent mitochondrial- mediated programmed neuronal cell death prolongs survival in sepsis显示文摘 | Messaris E Memos N Chatzigianni E | 2004 | Crit Care Med2004，32，8： | 1 |
| 7 | Management of blunt hepatic and splenic trauma in a Greek level I trauma centre显示文摘 | Markogiannakis H Sanidas E Messaris E | 2006 | Acta Chir Belg2006，106，5： | 1 |
| 8 | Perioperative erythropoieetin adminstration in patients with gastrointestinal tract cancer显示文摘 | Kosmadakis N Messaris E Maris A | | Ann Surg0，237，3： | 1 |
| 9 | Time-dependent mitochondrial-mediated programmed neuronal cell death prolongs survival in sepsis显示文摘 | Messaris E Memos N Chatzigianni E | 2004 | Crit Care Med2004，32，8： | 1 |
| 10 | Time-dependent mitochondrial-mediated programmed neuronal cell death survival in sepsis显示文摘 | Messaris E Memos N Chatzigianni E | 2004 | Crit Care Med2004，32，8： | 1 |
| 11 | Apoptotic death of re- nal tubular cells inexperimental sepsis 显示文摘 | Messaris E Memos N Chatziqianni E at el | 2008 | Surq Infect2008，9，3： | 1 |
| 12 | Administration of human protein-C concentrate prevents apoptotic brain cell death after experimental sepsis显示文摘 | Nikolaos Memos Alex Betrosian Evangelos Messaris | 2009 | Brain Res2009，1264，： | 1 |
| 13 | Functional disso- ciation of apelin on receptor signaling and endocytosis: implications for the effects of apelin on arterial blood pres- sure显示文摘 | Messari SE Ituriozz X Fassot C | 2004 | Neurochem2004，90，6： | 1 |
| 14 | Morning cortisol as a risk factor for subsequent major depressive disorder in adult women 显示文摘 | Harris TO Borsanyi S Messari S | 2000 | BJP2000，177，： | 1 |
| 15 | Perioperative erythropoietin administration in patients with gastrointestinal tract cancer:prospective randomized double-blind study显示文摘 | Kosmadakis N Messaris E Maris A | 2003 | Ann Surg2003，237，3： | 1 |
| 16 | Time-dependent mitochondrial-medlated programmed neuronal cell death survival in sepsis显示文摘 | Messaris E Memos N Chatzigianni E | 2004 | Crit Care Med2004，32，8： | 1 |
| 17 | Apelin, a potent diuretic neuropeptide counteracting vasopressin actions through inhibition of vasopressin neuron activity and vasopressin release 显示文摘 | De Mota N Reaux- Le Goazigo A El Messari S | 2004 | Proc Natl Acad Sci USA2004，101，10： | 1 |
| 18 | Time-dependent mitochondrial-mediated programmed neuronal cell death prolongs survival in sepsis显示文摘 | Messaris E Memos N Chatzigianni E | 2004 | Crit Care Med2004，32，8： | 1 |
| 19 | Apoptotic death of renal tubular cells in experimental sepsis显示文摘 | MESSARIS E MEMOS N CHATZIQIANNI E at el | 2008 | Surq Infect(Larchmt)2008，9，3： | 1 |
| 20 | Time-dependent mitochondrial-mediated programmed neuronal cell death prolongs survival in sepsis显示文摘 | Messaris E Memos N Chatzigianni E | 2004 | Crit Care Med2004，32，8： | 1 |
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