Esophagopericardial fistula as a rare complication after total gastrectomy for cancer

<p>Abstract</p> <p>Background</p> <p>Esophagopericardial fistula is a rare but life-threatening complication of benign, malignant or traumatic esophageal disease. It is most commonly associated with benign etiology and carries a high mortality rate which increases with delay in diagnosis.</p> <p>Case presentation</p> <p>We present a case of an esophagopericardial fistula as a rare complication in a 53-year-old male patient, 7 months after total gastrectomy for an adenocarcinoma of the esophagogastric junction.</p> <p>Conclusion</p> <p>The prognosis of esophagopericardial fistula is poor, especially when it is associated with malignancy.</p

Two Cases of Primary Splenic Hydatid Cyst in Greece

Cystic disease of the spleen is an uncommon entity in general population. Most cases result from parasitic infection by Echinococcus granulosus, a form called splenic hydatid disease (SHD), with a reported frequency of 0.5-6.0% within abdominal hydatidosis. On the contrary, an isolated splenic involvement of hydatid disease is very uncommon even in endemic regions. Two cases of primary SHD managed with open and laparoscopic radical surgery in our department are reported herein. Primary SHD is a rare entity with non-specific symptoms underlying clinical suspicion by the physician for prompt diagnosis. Surgical treatment is the mainstay therapy, while laparoscopic approach when feasible is safe, offering the advantages of laparoscopic surgery

Association between biliary complications and technique of hilar division (extrahepatic vs. intrahepatic) in major liver resections

BACKGROUND: Division of major vascular and biliary structures during major hepatectomies can be carried out either extrahepatically at the porta hepatic or intrahepatically during the parenchymal transection. In this retrospective study we test the hypothesis that the intrahepatic technique is associated with less early biliary complications. METHODS: 150 patients who underwent major hepatectomies were retrospectively allocated into an intrahepatic group (n = 100) and an extrahepatic group (n = 50) based on the technique of hilar division. The two groups were operated by two different surgical teams, each one favoring one of the two approaches for hilar dissection. Operative data (warm ischemic time, operative time, blood loss), biliary complications, morbidity and mortality rates were analyzed. RESULTS: In extrahepatic patients, operative time was longer (245 ± 50 vs 214 ± 38 min, p < 0.05) while the overall complication rate (55% vs 52%), hospital stay (13 ± 7 vs 12 ± 4 days), bile leak rate (22% vs 20%) and mortality (2% vs 2%) were similar compared to intrahepatic patients. However, most (57%) bile leaks in extrahepatic patients were grade II (leaks that required non-operative interventional treatment, while most (70%) leaks in the intrahepatic group were grade I (leaks that resolved and presented two injuries (4%) of the remaining bile ducts (p < 0.05). CONCLUSION: Intrahepatic hilar division is as safe as extrahepatic hilar division in terms of intraoperative blood requirements, morbidity and mortality. The extrahepatic technique is associated with more severe bile leaks and biliary injuries

ERATOSTHENES: Excellence Research Centre for Earth Surveillance and Space-Based Monitoring of the Environment through the EXCELSIOR Horizon 2020 Teaming Project

Geophysical Research Abstracts, 2018, Volume 20, EGU2018-7390The aim of this paper is to present our vision to upgrade the existing ERATOSTHENES Research Centre (ERC) established within the Cyprus University of Technology (CUT) into a sustainable, viable and autonomous Centre of Excellence (CoE) for Earth Surveillance and Space-Based Monitoring of the Environment, which will provide the highest quality of related services on the National, European and International levels. EXCELSIOR is a Horizon 2020 Teaming project which addresses a specific challenge defined by the work program, namely, the reduction of substantial disparities in the European Union by supporting research and innovation activities and systems in low performing countries. It also aims at establishing long-term and strategic partnerships between the Teaming partners, thus reducing internal research and innovation disparities within European Research and Innovation landscape. The proposed CoE envisions the upgrading of the existing ERC into an inspiring environment for conducting basic and applied research and innovation in the areas of the integrated use of remote sensing and space-based techniques for monitoring the environment. Environment has been recognized by the Smart Specialization Strategy of Cyprus as the first horizontal priority for future growth of the island. The foreseen upgrade will regard the expansion of this vision to systematic monitoring of the environment using Earth Observation, space and ground based integrated technologies. Such an approach will lead to the systematic monitoring of the the Environment. Five partners have united to upgrade the existing ERC into a CoE, with the common vision to become a world-class innovation, research and education centre, actively contributing to the European Research Area (ERA). More specifically, the Teaming project is a team effort between the Cyprus University of Technology (CUT, acting as the coordinator), the German Aerospace Centre (DLR), the National Observatory of Athens (NOA), the German Leibniz Institute for Tropospheric Research (TROPOS) and the Cyprus Department of Electronic Communications of the Ministry of Transport, Communications and Works (DEC-MTCW)

The ERATOSTHENES Centre of Excellence (ECoE) as a digital innovation hub for Earth observation

The "EXCELSIOR" H2020 Widespread Teaming Phase 2 Project: ERATOSTHENES: EXcellence Research Centre for Earth SurveiLlance and Space-Based MonItoring Of the EnviRonment is supported from the European Union’s Horizon 2020 research and innovation programme under grant agreement No. 857510 for a 7 year project period to establish a Centre of Excellence in Cyprus. As well, the Government of the Republic of Cyprus is providing additional resources to support the establishment of the ERATOSTHENES Centre of Excellence (ECoE) in Cyprus. The ECoE seeks to fill the gap by assisting in the spaceborne Earth Observation activities in the Eastern Mediterranean and become a regional key player in the Earth Observation (EO) sector. There are distinct needs and opportunities that motivate the establishment of an Earth Observation Centre of Excellence in Cyprus, which are primarily related to the geostrategic location of the European Union member state of Cyprus to examine complex scientific problems and address user needs in the Eastern Mediterranean, Middle East and Northern Africa (EMMENA), as well as South-East Europe. An important objective of the ECoE is to be a Digital Innovation Hub and a Research Excellence Centre for EO in the EMMENA region, which will establish an ecosystem where state-of-the-art sensing technology, cutting-edge research, targeted education services, and entrepreneurship come together. It is based on the paradigm of Open Innovation 2.0 (OI2.0), which is founded on the Quadruple Helix Model, where Government, Industry, Academia and Society work together to drive change by taking full advantage of the cross-fertilization of ideas. The ECoE as a Digital Innovation Hub (DIH) adopts a two-axis model, where the vertical axis consists of three Thematic Clusters for sustained excellence in research of the ECoE in the domains of Atmosphere and Climate, Resilient Societies and Big Earth Data Management, while the horizontal axis is built around four functional areas, namely: Infrastructure, Research, Education, and Entrepreneurship. The ECoE will focus on five application areas, which include Climate Change Monitoring, Water Resource Management, Disaster Risk Reduction, Access to Energy and Big EO Data Analytics. This structure is expected to leverage the existing regional capacities and advance the excellence by creating new programs and research, thereby establishing the ECoE as a worldclass centre capable of enabling innovation and research competence in Earth Observation, actively participating in Europe, the EMMENA region and the global Earth Observation arena. The partners of the EXCELSIOR consortium include the Cyprus University of Technology as the Coordinator, the German Aerospace Center (DLR), the Leibniz Institute for Tropospheric Research (TROPOS), the National Observatory of Athens (NOA) and the Department of Electronic Communications, Deputy Ministry of Research, Innovation and Digital Policy

The impact of surgical delay on resectability of colorectal cancer: An international prospective cohort study

AIM: The SARS-CoV-2 pandemic has provided a unique opportunity to explore the impact of surgical delays on cancer resectability. This study aimed to compare resectability for colorectal cancer patients undergoing delayed versus non-delayed surgery. METHODS: This was an international prospective cohort study of consecutive colorectal cancer patients with a decision for curative surgery (January-April 2020). Surgical delay was defined as an operation taking place more than 4 weeks after treatment decision, in a patient who did not receive neoadjuvant therapy. A subgroup analysis explored the effects of delay in elective patients only. The impact of longer delays was explored in a sensitivity analysis. The primary outcome was complete resection, defined as curative resection with an R0 margin. RESULTS: Overall, 5453 patients from 304 hospitals in 47 countries were included, of whom 6.6% (358/5453) did not receive their planned operation. Of the 4304 operated patients without neoadjuvant therapy, 40.5% (1744/4304) were delayed beyond 4 weeks. Delayed patients were more likely to be older, men, more comorbid, have higher body mass index and have rectal cancer and early stage disease. Delayed patients had higher unadjusted rates of complete resection (93.7% vs. 91.9%, P = 0.032) and lower rates of emergency surgery (4.5% vs. 22.5%, P < 0.001). After adjustment, delay was not associated with a lower rate of complete resection (OR 1.18, 95% CI 0.90-1.55, P = 0.224), which was consistent in elective patients only (OR 0.94, 95% CI 0.69-1.27, P = 0.672). Longer delays were not associated with poorer outcomes. CONCLUSION: One in 15 colorectal cancer patients did not receive their planned operation during the first wave of COVID-19. Surgical delay did not appear to compromise resectability, raising the hypothesis that any reduction in long-term survival attributable to delays is likely to be due to micro-metastatic disease