George Sambalis | National & Kapodistrian University of Athens (original) (raw)

Uploads

Papers by George Sambalis

Research paper thumbnail of A Decade of Laparoscopic Appendectomy: Presentation of 1026 Patients with Suspected Appendicitis Treated in a Single Surgical Department

Journal of Laparoendoscopic Advanced Surgical Techniques, Mar 28, 2008

The laparoscopic approach for suspected appendicitis is increasingly gaining acceptance. Neverthe... more The laparoscopic approach for suspected appendicitis is increasingly gaining acceptance. Nevertheless, the discussion on its safety, efficacy, indications, and diagnostic accuracy remains open. During the decade 1993-2003, 1026 patients with suspected appendicitis were approached by laparoscopy. Sixty-three patients (6.1%) had chronic recurrent symptoms. Data were collected retrospectively and analyzed. There were 587 female and 439 male patients. Fertile women were compared to all other patients with respect to the diagnostic accuracy of laparoscopy. Conversion rate was 0.55%. Median operating time was 26 minutes. Overall complication rate was 5.7%, consisting mostly of minor complications. There were no major intraoperative complications. Wound infections and intra-abdominal abscesses were reviewed separately and were 1.1% and 0%, respectively. Diagnosis could be established via laparoscopy in 89% of all patients, 85.4% of fertile women, and 93.1% of patients except fertile women. A median of 4 minor analgesics and 2 narcotics were required after surgery. The median time until bowel movements, intake of solid food, and the median length of hospital stay were 24, 48, and 30 hours, respectively. Patients returned to normal activity after a median of 7 days. There was no mortality. There was 1 reoperation. Follow-up lasted 4 weeks. Laparoscopic appendectomy is a well-justified procedure in the treatment of acute and chronic appendicitis. If there is enough experience, patients can profit from a higher diagnostic accuracy, quicker return of bowel habits, less postoperative pain, shorter hospital stay, and a faster return to normal activities than is reported for the open procedure. Especially, fertile women can profit from these advantages. This abstract has been presented as a poster in the SAGES Conference 2004.

Research paper thumbnail of Ectopic thyroid tissue in the lower neck with a coexisting normally located multinodular goiter. Brief literature review

HORMONES, 2005

Ectopic thyroid tissue in the lower neck with a coexisting normally located multinodular goiter i... more Ectopic thyroid tissue in the lower neck with a coexisting normally located multinodular goiter is a rare entity. We present a 27-year old asymptomatic woman with a recent history of a painless mass in the left side of her lower neck. Thyroid function tests were normal. An ultrasound of her neck showed a multinodular goiter and a 3.4 cm solid mass in the left lower cervical area. These findings were confirmed by an MRI scan of her neck. The Tc99m Pertechnetate scan showed the presence of a functioning area under the left lobe of the thyroid gland. The patient underwent surgery. The cervical mass was identified as a structure separate from the left lobe of the thyroid, without any attachments to the body of the gland and was uniformly resected. A subtotal thyroidectomy was also performed. The histology revealed that the separate structure represented ectopic thyroid tissue. The patient had an uneventful postoperative recovery, subsequent to which she was euthyroid and had normal calcium levels.

Research paper thumbnail of Laparoscopic Band Plication for the Treatment of Morbid Obesity

Laparoscopic Surgery, 1999

Research paper thumbnail of Cystic Lymphangioma of the Small Bowel in a Woman at 15 Weeks?? Gestation

Surgical Laparoscopy, Endoscopy & Percutaneous Techniques, 2005

Lymphangiomas are uncommon benign tumors, usually encountered early in childhood. Here is describ... more Lymphangiomas are uncommon benign tumors, usually encountered early in childhood. Here is described the case of a pregnant woman at 15 weeks' gestation with a symptomatic ileal small bowel lymphangioma that was approached laparoscopically. A limited number of laparoscopically managed cases of abdominal lymphangiomas have been reported. This is the first reported laparoscopically assisted resection of a small bowel cystic lymphangioma during pregnancy.

Research paper thumbnail of Laparoscopic Resection of Presacral Schwannomas

Surgical Laparoscopy, Endoscopy & Percutaneous Techniques, 2005

Presacral tumors are particularly rare in the adult. Schwannomas are neurogenic neoplasms, rarely... more Presacral tumors are particularly rare in the adult. Schwannomas are neurogenic neoplasms, rarely occurring in the retroperitoneum and the pelvis. Presented herein are the cases of 2 female patients with chronic pelvic pain who were discovered to have presacral schwannomas and were managed laparoscopically. Laparoscopy is a safe and efficient option in approaching benign pelvic tumors and might offer the advantage of better visualization of structures due to the magnification of laparoscopic view, especially in narrow anatomic spaces.

Research paper thumbnail of A Decade of Laparoscopic Appendectomy: Presentation of 1026 Patients with Suspected Appendicitis Treated in a Single Surgical Department

Journal of Laparoendoscopic & Advanced Surgical Techniques, 2008

The laparoscopic approach for suspected appendicitis is increasingly gaining acceptance. Neverthe... more The laparoscopic approach for suspected appendicitis is increasingly gaining acceptance. Nevertheless, the discussion on its safety, efficacy, indications, and diagnostic accuracy remains open. During the decade 1993-2003, 1026 patients with suspected appendicitis were approached by laparoscopy. Sixty-three patients (6.1%) had chronic recurrent symptoms. Data were collected retrospectively and analyzed. There were 587 female and 439 male patients. Fertile women were compared to all other patients with respect to the diagnostic accuracy of laparoscopy. Conversion rate was 0.55%. Median operating time was 26 minutes. Overall complication rate was 5.7%, consisting mostly of minor complications. There were no major intraoperative complications. Wound infections and intra-abdominal abscesses were reviewed separately and were 1.1% and 0%, respectively. Diagnosis could be established via laparoscopy in 89% of all patients, 85.4% of fertile women, and 93.1% of patients except fertile women. A median of 4 minor analgesics and 2 narcotics were required after surgery. The median time until bowel movements, intake of solid food, and the median length of hospital stay were 24, 48, and 30 hours, respectively. Patients returned to normal activity after a median of 7 days. There was no mortality. There was 1 reoperation. Follow-up lasted 4 weeks. Laparoscopic appendectomy is a well-justified procedure in the treatment of acute and chronic appendicitis. If there is enough experience, patients can profit from a higher diagnostic accuracy, quicker return of bowel habits, less postoperative pain, shorter hospital stay, and a faster return to normal activities than is reported for the open procedure. Especially, fertile women can profit from these advantages. This abstract has been presented as a poster in the SAGES Conference 2004.

Research paper thumbnail of Laparoscopic-Assisted Small Bowel Resection of a Leiomyoma Causing Recurrent Obscure Gastrointestinal Bleeding

Journal of Laparoendoscopic & Advanced Surgical Techniques, 2005

A 62-year-old man experienced recurrent painless episodes of melenas and undiagnosed chronic anem... more A 62-year-old man experienced recurrent painless episodes of melenas and undiagnosed chronic anemia for 4 years. Despite extensive radiologic and endoscopic work-up, the origin of the bleeding could not be identified. At his last admission, visceral angiography revealed an area of hypervascularity at the initial portion of the jejunum, containing irregular, corkscrew vessels coming from the first jejunal branch of the superior mesenteric artery. Under general endotracheal anesthesia, a 10-mm trocar for the 30 degree laparoscope was inserted subumbilically using the open Hasson technique. Two 5-mm trocars were also used suprapubically and at the left iliac fossa. A 2.5 cm diameter, smooth, hypervascular tumor was easily visualized on the jejunal wall 10 cm from the ligament of Treitz. The small bowel segment was laparoscopically mobilized and brought through the subumbilical trocar site, which was extended 1 cm. A limited small bowel resection and a stapled anastomosis were easily performed extracorporeally. Histopathologic examination diagnosed a benign gastrointestinal tumor (gastrointestinal stromal tumor, leiomyoma). The patient was discharged on postoperative day 2. Laparoscopic identification and mobilization allows a loop of small bowel to be exteriorized through a small incision; the anastomosis can be safely performed extracorporeally. The advantages of rapid postoperative recovery and reduced pain are evident.

Research paper thumbnail of A Decade of Laparoscopic Appendectomy: Presentation of 1026 Patients with Suspected Appendicitis Treated in a Single Surgical Department

Journal of Laparoendoscopic Advanced Surgical Techniques, Mar 28, 2008

The laparoscopic approach for suspected appendicitis is increasingly gaining acceptance. Neverthe... more The laparoscopic approach for suspected appendicitis is increasingly gaining acceptance. Nevertheless, the discussion on its safety, efficacy, indications, and diagnostic accuracy remains open. During the decade 1993-2003, 1026 patients with suspected appendicitis were approached by laparoscopy. Sixty-three patients (6.1%) had chronic recurrent symptoms. Data were collected retrospectively and analyzed. There were 587 female and 439 male patients. Fertile women were compared to all other patients with respect to the diagnostic accuracy of laparoscopy. Conversion rate was 0.55%. Median operating time was 26 minutes. Overall complication rate was 5.7%, consisting mostly of minor complications. There were no major intraoperative complications. Wound infections and intra-abdominal abscesses were reviewed separately and were 1.1% and 0%, respectively. Diagnosis could be established via laparoscopy in 89% of all patients, 85.4% of fertile women, and 93.1% of patients except fertile women. A median of 4 minor analgesics and 2 narcotics were required after surgery. The median time until bowel movements, intake of solid food, and the median length of hospital stay were 24, 48, and 30 hours, respectively. Patients returned to normal activity after a median of 7 days. There was no mortality. There was 1 reoperation. Follow-up lasted 4 weeks. Laparoscopic appendectomy is a well-justified procedure in the treatment of acute and chronic appendicitis. If there is enough experience, patients can profit from a higher diagnostic accuracy, quicker return of bowel habits, less postoperative pain, shorter hospital stay, and a faster return to normal activities than is reported for the open procedure. Especially, fertile women can profit from these advantages. This abstract has been presented as a poster in the SAGES Conference 2004.

Research paper thumbnail of Ectopic thyroid tissue in the lower neck with a coexisting normally located multinodular goiter. Brief literature review

HORMONES, 2005

Ectopic thyroid tissue in the lower neck with a coexisting normally located multinodular goiter i... more Ectopic thyroid tissue in the lower neck with a coexisting normally located multinodular goiter is a rare entity. We present a 27-year old asymptomatic woman with a recent history of a painless mass in the left side of her lower neck. Thyroid function tests were normal. An ultrasound of her neck showed a multinodular goiter and a 3.4 cm solid mass in the left lower cervical area. These findings were confirmed by an MRI scan of her neck. The Tc99m Pertechnetate scan showed the presence of a functioning area under the left lobe of the thyroid gland. The patient underwent surgery. The cervical mass was identified as a structure separate from the left lobe of the thyroid, without any attachments to the body of the gland and was uniformly resected. A subtotal thyroidectomy was also performed. The histology revealed that the separate structure represented ectopic thyroid tissue. The patient had an uneventful postoperative recovery, subsequent to which she was euthyroid and had normal calcium levels.

Research paper thumbnail of Laparoscopic Band Plication for the Treatment of Morbid Obesity

Laparoscopic Surgery, 1999

Research paper thumbnail of Cystic Lymphangioma of the Small Bowel in a Woman at 15 Weeks?? Gestation

Surgical Laparoscopy, Endoscopy & Percutaneous Techniques, 2005

Lymphangiomas are uncommon benign tumors, usually encountered early in childhood. Here is describ... more Lymphangiomas are uncommon benign tumors, usually encountered early in childhood. Here is described the case of a pregnant woman at 15 weeks' gestation with a symptomatic ileal small bowel lymphangioma that was approached laparoscopically. A limited number of laparoscopically managed cases of abdominal lymphangiomas have been reported. This is the first reported laparoscopically assisted resection of a small bowel cystic lymphangioma during pregnancy.

Research paper thumbnail of Laparoscopic Resection of Presacral Schwannomas

Surgical Laparoscopy, Endoscopy & Percutaneous Techniques, 2005

Presacral tumors are particularly rare in the adult. Schwannomas are neurogenic neoplasms, rarely... more Presacral tumors are particularly rare in the adult. Schwannomas are neurogenic neoplasms, rarely occurring in the retroperitoneum and the pelvis. Presented herein are the cases of 2 female patients with chronic pelvic pain who were discovered to have presacral schwannomas and were managed laparoscopically. Laparoscopy is a safe and efficient option in approaching benign pelvic tumors and might offer the advantage of better visualization of structures due to the magnification of laparoscopic view, especially in narrow anatomic spaces.

Research paper thumbnail of A Decade of Laparoscopic Appendectomy: Presentation of 1026 Patients with Suspected Appendicitis Treated in a Single Surgical Department

Journal of Laparoendoscopic & Advanced Surgical Techniques, 2008

The laparoscopic approach for suspected appendicitis is increasingly gaining acceptance. Neverthe... more The laparoscopic approach for suspected appendicitis is increasingly gaining acceptance. Nevertheless, the discussion on its safety, efficacy, indications, and diagnostic accuracy remains open. During the decade 1993-2003, 1026 patients with suspected appendicitis were approached by laparoscopy. Sixty-three patients (6.1%) had chronic recurrent symptoms. Data were collected retrospectively and analyzed. There were 587 female and 439 male patients. Fertile women were compared to all other patients with respect to the diagnostic accuracy of laparoscopy. Conversion rate was 0.55%. Median operating time was 26 minutes. Overall complication rate was 5.7%, consisting mostly of minor complications. There were no major intraoperative complications. Wound infections and intra-abdominal abscesses were reviewed separately and were 1.1% and 0%, respectively. Diagnosis could be established via laparoscopy in 89% of all patients, 85.4% of fertile women, and 93.1% of patients except fertile women. A median of 4 minor analgesics and 2 narcotics were required after surgery. The median time until bowel movements, intake of solid food, and the median length of hospital stay were 24, 48, and 30 hours, respectively. Patients returned to normal activity after a median of 7 days. There was no mortality. There was 1 reoperation. Follow-up lasted 4 weeks. Laparoscopic appendectomy is a well-justified procedure in the treatment of acute and chronic appendicitis. If there is enough experience, patients can profit from a higher diagnostic accuracy, quicker return of bowel habits, less postoperative pain, shorter hospital stay, and a faster return to normal activities than is reported for the open procedure. Especially, fertile women can profit from these advantages. This abstract has been presented as a poster in the SAGES Conference 2004.

Research paper thumbnail of Laparoscopic-Assisted Small Bowel Resection of a Leiomyoma Causing Recurrent Obscure Gastrointestinal Bleeding

Journal of Laparoendoscopic & Advanced Surgical Techniques, 2005

A 62-year-old man experienced recurrent painless episodes of melenas and undiagnosed chronic anem... more A 62-year-old man experienced recurrent painless episodes of melenas and undiagnosed chronic anemia for 4 years. Despite extensive radiologic and endoscopic work-up, the origin of the bleeding could not be identified. At his last admission, visceral angiography revealed an area of hypervascularity at the initial portion of the jejunum, containing irregular, corkscrew vessels coming from the first jejunal branch of the superior mesenteric artery. Under general endotracheal anesthesia, a 10-mm trocar for the 30 degree laparoscope was inserted subumbilically using the open Hasson technique. Two 5-mm trocars were also used suprapubically and at the left iliac fossa. A 2.5 cm diameter, smooth, hypervascular tumor was easily visualized on the jejunal wall 10 cm from the ligament of Treitz. The small bowel segment was laparoscopically mobilized and brought through the subumbilical trocar site, which was extended 1 cm. A limited small bowel resection and a stapled anastomosis were easily performed extracorporeally. Histopathologic examination diagnosed a benign gastrointestinal tumor (gastrointestinal stromal tumor, leiomyoma). The patient was discharged on postoperative day 2. Laparoscopic identification and mobilization allows a loop of small bowel to be exteriorized through a small incision; the anastomosis can be safely performed extracorporeally. The advantages of rapid postoperative recovery and reduced pain are evident.