George Pappas-Gogos | University of Ioannina/Greece (original) (raw)

Papers by George Pappas-Gogos

Journal of surgical case reports, Mar 1, 2022

Gastric metastasis from breast cancer occurs infrequently and causes non-specific symptoms, usual... more Gastric metastasis from breast cancer occurs infrequently and causes non-specific symptoms, usually attributed to the underlying disease. Furthermore, endoscopic findings are almost identical to primary gastric cancer, making the immunohistochemical examination of biopsies necessary for diagnosis. We present the case of a 64-year-old woman who was diagnosed with lobular breast cancer 3 years ago and received chemotherapy with evidence of remission. The patient presented with dyspepsia and progressive dysphagia for the last 6 months, not responsive to PPI treatment. Upper endoscopy revealed partial occlusion of the cardio-esophageal junction and thickened gastric folds resembling linitis plastica. However, immunohistochemical analysis of endoscopic biopsies showed infiltration of gastric mucosa by lobular breast cancer cells, making the diagnosis of gastric metastasis. Therefore, clinicians' awareness of possible gastric metastasis is warranted in patients with a history of advanced breast cancer and severe gastric symptoms.

Journal of Clinical Medicine, Apr 23, 2022

This article is an open access article distributed under the terms and conditions of the Creative... more This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY

Techniques in Coloproctology, 2008

Background Worldwide, the annual mortality from CRC is estimated to be 500.000. The incidence and... more Background Worldwide, the annual mortality from CRC is estimated to be 500.000. The incidence and mortality of CRC increase with age especially after 60 years of age. In Sudan there are no present population-based cancer registries that can provide database for epidemiological studies on CRC and its risk factors, for an effective implementation of the suitable screening programs. Methods A retrospective hospital-based study was conducted on all CRC patients who attended Soba University Hospital (SUH) between January 2004 and December 2007 to describe the pattern of CRC according to age, race, gender and sub-site location of the tumor. We considered that SUH is one of the largest central hospitals in Sudan that has integrated gastrointestinal and endoscopy units and receives patients from different sources of referral. Results During the study period, 202 patients with CRC attended both hospital clinical wards and endoscopy units between the ages of 10-90 years. Age was found to be independently significantly associated with both proximal and distal CRC (p=0.01). Gender and race were found to be insignificantly associated with both proximal and distal CRC (p=0.839 and 0.522 respectively). Fifty-two percent of patients were found to be of 50 years of age and below. The mean age for CRC was found to be 50 years. Almost 70% of the patients were found to have distal CRC and about 85% of them were having rectal cancer. Conclusions Fifty-two percent of the patients were found to be of 50 years of age and below with predominance of distal CRC among all patients. This gives a clue that screening with flexible sigmoidoscopy starting at the age of 40 can be of an appreciated secondary preventive value.

Current Oncology, Mar 7, 2023

Pathogens, Feb 11, 2023

Current Oncology, Apr 25, 2023

Journal of Trauma and Acute Care Surgery

BACKGROUND Accurate preoperative risk assessment in emergency laparotomy (EL) is valuable for inf... more BACKGROUND Accurate preoperative risk assessment in emergency laparotomy (EL) is valuable for informed decision making and rational use of resources. Available risk prediction tools have not been validated adequately across diverse health care settings. Herein, we report a comparative external validation of four widely cited prognostic models. METHODS A multicenter cohort was prospectively composed of consecutive patients undergoing EL in 11 Greek hospitals from January 2020 to May 2021 using the National Emergency Laparotomy Audit (NELA) inclusion criteria. Thirty-day mortality risk predictions were calculated using the American College of Surgeons National Surgical Quality Improvement Program (ACS-NSQIP), NELA, Portsmouth Physiological and Operative Severity Score for the Enumeration of Mortality and Morbidity (P-POSSUM), and Predictive Optimal Trees in Emergency Surgery Risk tools. Surgeons' assessment of postoperative mortality using predefined cutoffs was recorded, and a su...

Biomarkers in Medicine, 2020

The development and validation of screening, prognostic and predictive biomarkers represents an e... more The development and validation of screening, prognostic and predictive biomarkers represents an exciting strategy to improve early diagnosis and more effective therapies "

Frontiers in Oncology

Intestinal metaplasia of the stomach (IM) is considered a pre-cancerous lesion and is a potential... more Intestinal metaplasia of the stomach (IM) is considered a pre-cancerous lesion and is a potential precursor to adenocarcinoma. Metabolic syndrome (MetS) has been associated with lesions to the gastrointestinal tract such as the risk of developing Barett esophagus. Vascular endothelial growth factor and leptin have been associated with either gastrointestinal tract carcinogenesis or MetS. In this context, this study was designed to analyze plasma levels of VEGF and leptin in patients with IM and MetS. Four groups of 137 participants (a control group and three patient groups, IM, MetS and IM- MetS) were created. Inclusion criteria for the presence of IM were endoscopic findings and histological confirmation, while for MetS the ATP III and IDF guidelines. Levels of plasma vascular endothelial growth factor (VEGF) and leptin (Leptin) were determined. VEGF levels were increased in IM (IM vs Control, p=0,011) and IM-MetS groups (IM-MetS vs Control, p <0.001 and IM-MetS vs MetS, p=0.001...

World Journal of Surgery

Background Emergency laparotomy (EL) is accompanied by high post-operative morbidity and mortalit... more Background Emergency laparotomy (EL) is accompanied by high post-operative morbidity and mortality which varies significantly between countries and populations. The aim of this study is to report outcomes of emergency laparotomy in Greece and to compare them with the results of the National Emergency Laparotomy Audit (NELA). Methods This is a multicentre prospective cohort study undertaken between 01.2019 and 05.2020 including consecutive patients subjected to EL in 11 Greek hospitals. EL was defined according to NELA criteria. Demographics, clinical variables, and post-operative outcomes were prospectively registered in an online database. Multivariable logistic regression analysis was used to identify independent predictors of post-operative mortality. Results There were 633 patients, 53.9% males, ASA class III/IV 43.6%, older than 65 years 58.6%. The most common operations were small bowel resection (20.5%), peptic ulcer repair (12.0%), adhesiolysis (11.8%) and Hartmann’s procedu...

Journal of Surgical Case Reports, 2022

Intussusception in adults is rare, and the clinical symptoms of intussusception are subtle, makin... more Intussusception in adults is rare, and the clinical symptoms of intussusception are subtle, making the diagnosis quite challenging. Gastrointestinal lipomas are rare benign tumors and are essentially adipose growths, most frequently found within the small intestine wall or mesentery. Limited up-to-date evidence exists regarding such lipomas. Intussusception due to a gastrointestinal lipoma constitutes an infrequent clinical entity, and the diagnosis of duodenal lipoma mainly depends on endoscopy examination, supplemented by computed tomography and magnetic resonance imaging. The present report describes a case of jejunal intussusception in an adult with a history of intermittent colicky abdominal pain located in the left upper quadrant over the last month. Contrast-enhanced computed tomography of the abdomen showed the typical target sign of a small intestinal intussusception along the left upper quadrant and a well-defined, low-density tumor in the intussusception. Exploratory lapa...

Annals of Translational Medicine, 2020

High-grade serous ovarian carcinoma (HGSOC) is a leading cause of mortality among women worldwide... more High-grade serous ovarian carcinoma (HGSOC) is a leading cause of mortality among women worldwide. Currently, there is no clear consensus over the regime these patients should receive. The main two options are upfront debulking surgery with adjuvant chemotherapy or neoadjuvant chemotherapy followed by interval debulking surgery (IDS). The former approach is proposed to be accompanied by lower chemoresistance rates but could lead to severe surgical comorbidities and lower quality of life (QoL). Optimizing patient's selection for upfront debulking surgery might offer higher progression-free and overall survival rates. Further studies need to be conducted in order to elucidate the predictive factors, which are favorable for patients undergoing upfront debulking surgery in cases of high-grade serous ovarian cancer.

Σκοπός: Ο ορθοκολικός καρκίνος, καθώς και η χειρουργικές επεμβάσεις που αφορούν στο παχύ έντερο κ... more Σκοπός: Ο ορθοκολικός καρκίνος, καθώς και η χειρουργικές επεμβάσεις που αφορούν στο παχύ έντερο και στο ορθό σχετίζονται με αυξημένο οξειδωτικό στρες μέσω διαφορετικών μηχανισμών. Στην παρούσα μελέτη, αξιολογήθηκαν και συγκρίθηκαν τα επίπεδα διαφορετικών δεικτών οξειδωτικού στρες σε ασθενείς με ορθοκολικό καρκίνο που υποβλήθηκαν σε χειρουργική επέμβαση με λαπαροσκοπική ή ανοιχτή προσπέλαση.Υλικό/Μέθοδοι: Εξήντα ασθενείς με καρκίνο του παχέος εντέρου τυχαιοποιήθηκαν σε δύο ομάδες, την ομάδα της λαπαροσκοπικής (ΑΠ) και την ομάδα της ανοικτής προσπέλασης (ΑΠ). Η λιπιδιακή υπεροξείδωση, η οξείδωση των πρωτεϊνών, η οξείδωση του RNA και οι βλάβες από δραστικές μορφές αζώτου διερευνήθηκαν μέσω προσδιορισμού των 8-ισοπροστανίων (8-epiPGF2a), των καρβονυλίων (PC), της 8-υδροξυγουανοσίνης (8-OHG) και της 3-νιτροτυροσίνης (3-ΝΤ) αντίστοιχα, στο πλάσμα των ασθενών. Σκοπός ήταν η ανάλυση και η σύγκριση των επιπέδων των δεικτών του οξειδωτικού στρες σε διαφορετικές χρονικές περιόδους και μεταξύ τ...

The American Surgeon, 2007

Unresectable obstructing rectal cancer with synchronous hepatic metastases is usually a fatal dis... more Unresectable obstructing rectal cancer with synchronous hepatic metastases is usually a fatal disease. This prospective study was scheduled to treat this difficult condition using a multimodal curative strategy combined with a two-stage surgical treatment. Patients with T4N2 or N3M1 rectal cancer and hepatic metastases underwent a two-stage surgical treatment; in the first stage, a decompressing colostomy plus radiofrequency ablation (RFA) in liver metastases. In the second stage, a colectomy was done with stoma closing and resection of superficial necrotic hepatic tumors, plus repetition of RFA in recurrent or new hepatic tumors. Four patients were included, with 1 to 8 (total 20) hepatic metastases, each <5 cm in diameter. In the first stage, two patients were operated on by open approach and two laparoscopically. All hepatic tumors were treated by RFA to produce at least a 1-cm tumor-free margin. After chemoradiation of the rectal tumor, the second stage of surgical treatment ...

Gastroenterology research, 2018

Double pylorus is a rare endoscopic finding that has been reported in 0.001% to 0.4% of upper gas... more Double pylorus is a rare endoscopic finding that has been reported in 0.001% to 0.4% of upper gastrointestinal endoscopies and can be either congenital or acquired. Acquired double pylorus is usually an uncommon complication of peptic ulcer that erodes and creates a fistula between the duodenal bulb and the prepyloric antrum. We describe a case of a 67-year-old man who experienced mild epigastric pain and dyspepsia over the last 6 months. The patient periodically took nonsteroidal anti-inflammatory drugs (NSAIDs) due to joint pain. Esophagogastroduodenoscopy revealed gastritis and a double pylorus. An accessory channel connected the lesser curvature of the prepyloric antrum to the duodenal bulb and the endoscope was able to be passed through both of the ducts. The Helicobacter pylori quick test proved positive. Two years later, a follow-up endoscopy showed that fistula fused with normal pylorus and there was a single large opening.

International journal of surgery case reports, 2018

De Garengeot hernia is defined as femoral hernia containing appendix. An acute appendicitis in a ... more De Garengeot hernia is defined as femoral hernia containing appendix. An acute appendicitis in a femoral hernia is a extremely unusual surgical finding and occurs in 0.08%-0.013% of all cases. We report the case of an elderly woman, who presented with a typical clinical image of incarcerated femoral hernia and underwent open surgery. An infrainguinal incision was performed and after the dissection of hernia sac, an acute appendicitis within femoral hernia was revealed. Subsequently, appendectomy and hernioplasty were performed. Acute appendicitis within femoral hernia should be included in differential diagnosis of patients presenting with clinical signs of an incarcerated femoral hernia and prompt surgical treatment is essential in order to avoid severe complications.