Continent gastrostomy.
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Anesthesia, Local↗
Biomedical subjects
N Kelessis
Publications and source records attributed to N Kelessis.
Competent gastrostomy for patients with head and neck cancer.
This study was performed to evaluate the efficiency and patient satisfaction with a modified Janeway gastrostomy for patients with head and neck cancer and cancer of the upper GI tract and involved 24 consecutive patients with serious malnutrition caused by advanced cancer of these sites. All underwent surgery during which a tube was constructed from the anterior gastric wall with the aid of GIA-75 automatic stapler. The operation was performed under local anaesthesia, with a senior anaesthesiologist, who sedated the patients, in attendance. The operation was successful in all cases. No postoperative mortality could be attributed to the operation. The complications were minor. The patient's close relatives were able to feed them intermittently with home-made formula made according to the instructions of our dietician. No late complications were recorded. Overall, the patients were satisfied with his technique for managing their feeding problem. The modified Janeway gastrostomy is an easy and safe operative procedure; it is an effective way of managing patients with malnutrition as a result of cancer of the head and neck or of the upper GI tract.
Aged↗
Pre-operative evaluation of parotid tumours by fine needle biopsy.
AIMS: Although fine needle biopsy (FNB) is a well established diagnostic technique there continues to be controversy concerning its use in the pre-operative assessment of intraparotid masses. The purpose of this study was to evaluate the diagnostic accuracy, specificity and sensitivity of FNB in parotid tumours and consequently to asses its clinical value. METHODS: Over a 6-year period, 129 consecutive patients with parotid masses underwent pre-operative FNB evaluation and in 121 of these cases the cytological diagnosis was confirmed. RESULTS: Out of the 86 cases cytologically diagnosed as benign, two false negative results were obtained by FNB, whereas out of the 38 cytological diagnoses of malignant tumours one case was found histologically to be Warthin's tumour. In the FNB results of the two cases suspicious for malignancy, one was confirmed histologically as malignant. Three cases of FNB with inadequate material were found to be benign lesions. In this trail, the diagnostic accuracy of FNB was 96.7%, the specificity, 97.6% and the sensitivity, 95%. CONCLUSIONS: Our results show that FNB is a valuable examination technique in the pre-operative evaluation of parotid masses.
Adult↗
The prognostic significance of breast tumour microcalcifications.
The prognostic significance of breast tumour microcalcifications has shown, so far, contradictory results. We compared two groups of breast cancer patients: in the first group, the patients showed mammographic and histological microcalcifications, whereas the second group did not. The prognostic indices for both groups included the size of the primary tumour, the number of positive axillary nodes, the histological type, the grade, the hormone-receptor status and the menopausal status. An increased number of cases with both oestrogen and progesterone receptor-positive tumours was found in the group with microcalcifications, which is a favorable prognostic sign for these patients. For the remaining prognostic indices there was no difference between the two groups.
Breast Neoplasms↗
Colorectal cancer trends by anatomic sides, age and staging. A twenty-year study of 1412 Greek cases.
The purpose of this study was to investigate whether Greek patients, suffering from colorectal adenocarcinoma, showed the same changes in the side distribution, as has been observed in the patients of many western countries. We retrospectively analysed 1412 consecutive cases of colorectal adenocarcinoma admitted to our institute over in a twenty-year period. The side distribution, the staging and the grade were evaluated in correlation with the age. We found that the number of patients with colorectal adenocarcinoma has steadily increased. The right-sided colonic carcinomas remained stable over the years in the total number of cases, however, for the elderly patients (age > 65 years), there was trend of gradual but steady increase in the incidence. We did not observe any evidence of earlier diagnosis in recent years. We conclude that a delayed but similar trend in the incidence and distribution of colorectal adenocarcinoma is present in Greek patients. The maintenance of the traditional dietary habits could change the pattern.
Adenocarcinoma↗