Alexandros Diamantis

Il caso Sonia Kalogeropoulou nell’arte greca della seconda metà del Novecento [The Case of Sonia Kalogeropoulou in the Greek Art of the Second Half of the Twentieth Century]. Gli avvenimenti artistici greci del secolo scorso vanno collocati nel quadro di un modernismo periferico. Nel secondo dopoguerra la pittura figurativa rimase una pratica piuttosto diffusa in Grecia, nonostante l’affermazione parallela dell’astrattismo e di nuovi linguaggi visivi. Numerosi artisti adottarono diversi modi di figurazione espressionista, nonché un modernismo evocativo dell’ideale della tradizione culturale nazionale. Tra gli anni Settanta e Ottanta emerse una tendenza riconducibile all’espressionismo gestuale, in parallelo al Neoespressionismo internazionale dell’epoca. Tali tendenze si riscontrano nell’arte di Sonia Kalogeropoulou (1945-2003), pittrice e poetessa attiva tra la fine degli anni Settanta e la fine degli anni Ottanta. Il suo fu un cammino artistico piuttosto discontinuo e segnato da esperienze personali dolorose. Proveniente da un ambiente familiare colto e ben inserito nel mondo artistico-culturale dell’epoca, Sonia ha prodotto numerosi dipinti e disegni di stile espressionista. Ricorrendo ad elementi figurativi tradizionali e moderni, l’artista ha trattato soprattutto il tema della condizione umana, mediante la rappresentazioni di figure per lo più malinconiche e sofferenti. Il suo caso, per quanto peculiare, apre interessanti prospettive di ricerca per l’arte e la cultura di un periodo recente e poco studiato come quello della prima fase della Terza Repubblica Ellenica, dal 1974 fino alla svolta internazionale del 1989.

Background: In the present study, we aimed to investigate the association between (EORTC) QLQ-C30 scores and both preoperative somatometric parameters and postoperative outcomes in elderly patients undergoing elective surgery for resectable colorectal cancer. Methods: The 118 elderly consecutive patients who underwent colorectal surgery for cancer in a single university’s surgical department between 01/2018 and 12/2018 were prospectively enrolled in the present study. All patients with an age > 65 years, diagnosed with resectable colorectal cancer, without metastatic disease, that underwent elective surgery were included prospectively in the present study. Results: Regarding patients’ characteristics, a negative correlation between preoperative QLQ (pQLQ) score and age (p = 0.001) and a positive correlation between body mass index (BMI) and pQLQ score (p = 0.048) were observed. Furthermore, there was a statistically significant difference (p = 0.004) in the mean pQLQ score between patients with rectal or colon cancer. Moreover, assessing pQLQ score was a useful tool in terms of postoperative recovery. Negative correlations between the pQLQ score and time (days) of beginning oral feeding (p < 0.001) and length of hospital stay (p = 0.004) were found. The pQLQ score was statistically significantly lower (p = 0.005) in patients who had any postoperative complication; however, there was no difference in patients with major complications. Conclusions: Advanced age, colon cancer and decreased BMI were negatively associated with preoperative QLQ. The assessment of pQLQ in elderly patients with colorectal cancer can be a useful predictive tool for postoperative complications, length of hospital stay and postoperative rehabilitation.

We aim to review the available literature on patients with esophageal cancer treated with robot-assisted (RAME) or video-assisted McKeown’s esophagectomy (VAME), to compare the efficacy and safety of the two approaches. Original research studies that evaluated perioperative and oncologic outcomes of RAME versus VAME were identified, from January 1990 to July 2022. The 90-day mortality, the R0 resection rate, the dissected lymph nodes, the perioperative parameters, and the complications were calculated according to a fixed and a random effect model. The Q statistics and I² statistic were used to test for heterogeneity among the studies. Seven studies were included, incorporating a total of 1617 patients treated with RAME or VAME. The 90-day mortality was similar between the two groups. No difference was found regarding the R0 resection rate and the number of dissected lymph nodes. In addition, the perioperative parameters, along with the total complications were similar between RAME and VAME. Nonetheless, the incidence of postoperative pneumonia was higher in the VAME group (OR:0.67 [95% CI: 0.49, 0.93]; p = 0.02). Finally, our outcomes were further validated by sensitivity analysis including only studies performing propensity score-matched analysis. Our meta-analysis showed that RAME was equivalent to VAME in terms of safety, feasibility, and oncologic adequacy. These results should be interpreted with caution due to the small number of included studies. New Randomized Controlled trials, that are currently active, will provide further evidence with greater clarity to assess the effectiveness and safety of RAME for esophageal cancer.

Background and Objectives: Hydatid disease (HD) remains a significant public health issue causing morbidity and mortality in many Mediterranean countries. Material and Methods: The present cohort study included 50 consecutive patients with liver hydatid disease who underwent surgery in a tertiary University Hospital. A total of 18 patients (36%) had a case of complicated HD, including simple communication of the cyst with the biliary tree (6 cases), rupture of the cyst into the biliary tree (6 cases), presence of a bronco-biliary fistula (2 cases), rupture of the cyst in the peritoneal cavity (2 cases), and rupture of the cyst and formation of a hepatic abscess (2 cases). Endoscopic retrograde cholangiopancreatography (ERCP) was pre-operatively performed on six patients. Results: The main clinical symptom presented was right upper quadrant pain in 16 patients (88%), which was associated with high fever (>39 °C) in 14 patients (78%). C-reactive protein (CRP) was the primary indicator of a complicated HD (p = 0.003); however, it was only elevated in 67% of cases. CRP was a more sensitive indicator of a rupture in the biliary tree cyst (p = 0.02). Computer tomography (CT) detected more cases (44%) of a complicated HD than ultrasonography (US) (25%); however, the difference was not statistically significant. Conclusions: For prevention and control of HD, a high suspicion of the disease leading to early referral to specialized centers, mainly in endemic areas, is required. Prior to surgical or percutaneous intervention, a combination of imaging and laboratory findings are essential in diagnosing a complicated case and avoiding unnecessary interventions.

Introduction. Gastrointestinal stromal tumors (GISTs) quite frequently occur synchronously with other malignancies, with most cases being adenocarcinomas. GISTs and liposarcomas are both of mesenchymal origin, and their coexistence is extremely rare. Methods. We conducted a review of the current literature regarding the synchronous occurrence of GISTs and intra-abdominal liposarcomas. An electronic search of the literature was undertaken using MEDLINE (database provider PubMed). Furthermore, we present the first described case of an 86-year-old male with a GIST and synchronous liposarcoma, both located in the stomach, as well as a 66-year-old male with a gastric GIST and concurrent retroperitoneal liposarcoma. Results. A total of 5 cases of synchronous GIST and intra-abdominal liposarcoma have been reported in the literature to date, with the most recent cases included in the present study. Conclusion. Further research is required to explain any possible correlation in the coexistence of these different neoplasms of the same origin. Meanwhile, R0 resection of both tumors remains the treatment of choice.

Gallstones may pass into the gastrointestinal tract spontaneously through the ampulla of Vater or through a biliary-enteric fistula. This report describes an extremely rare case of a patient vomiting a gallstone without the presence of a fistula between the gallbladder and the gastrointestinal tract. Furthermore, no imaging findings of gallstones disease appeared. The patient has been treated conservatively and all symptoms subsided. The patient remains asymptomatic 3 months after treatment and an elective laparoscopic cholecystectomy was arranged. Including this reported case, only three cases have been described in the literature worldwide. However, our case is the only one characterized by retrograde flow of the gallstones into the stomach without symptoms of bowel obstruction or other underlying pathologies.

Purpose: The current systematic review and meta-analysis aimed to compare Laparoscopic Distal Pancreatectomy (LPD) with Robotic Distal Pancreatectomy (RDP) in terms of length of hospital stay (LOS), perioperative, postoperative and economic parameters. Methods: A systematic review of the literature was undertaken and data from studies fulfilling the predetermined inclusion criteria were extracted. Meta-analyses were performed to combine the results of various studies in the forms of Weighted Mean Difference (WMD), Odds Ratio (OR) and Risk Difference (RD), as appropriate. Results: A significantly lower LOS (WMD:0.75, 95%CI:0.171.33) and longer operative duration (WMD:-28.29, 95%CI:49.98--6.6) for the RDP group was found. The rate of open conversion was higher in the LDP group (OR:2.38, 95%CI:1.75-3.22), while the rate of spleen preservation was lower (OR:0.49, 95%CI:0.31-0.79). No significant differ ence was noted in the intraoperative blood loss (WMD:34, 95%CI:-10.28-78.29), postoperative blood transfusion (OR:0.99, 95%CI:0.66-1.49) and overall morbidity analyses (OR:1.08, 95%CI:0.88-1.32). A significantly higher yield of lymph nodes was achieved in the RDP group (WMD:-2.09, 95%CI:-4.17--0.01), while no differences were found when positive resection margins (RD:0.02, 95%CI:-0.02-0.07) and specimen length (WMD:0.08, 95%CI:0.42-0.58) were considered. Finally, RDP was associated with significantly higher operative (WMD:-2733.42, 95%CI:-4189.77--1277.08) and total (WMD:-3799.68, 95%CI:-4438.39--3160.98) costs. Conclusion: RDP seems to be a viable option for both benign and malignant pancreatic disorders, although there are concerns regarding economic parameters. Large randomized controlled trials will shed more light on the subject.

Background: There is no clear evidence on whether radiotherapy (RT) improves treatment result in patients with retroperitoneal sarcomas (RPS). Methods: A systematic literature search was performed using PubMed, Scopus and CENTRAL databases. Data were retrieved from published comparatives studies in patients with RPS undergoing surgery alone or RT plus surgery. The primary endpoints were the 5-year OS and the median OS. The secondary endpoints were the recurrence-free survival (RFS) and the R0-resection rate. Continuous outcomes were calculated by means of weighted mean difference (WMD). Results: Ten out of 374 articles were analyzed. The median OS and the 5-year survival were significantly increased in patients treated with RT and surgery, compared to patients treated with surgery alone ( p < 0.00001, p < 0.001). Median RFS was significantly increased in patients treated with either preoperative ( p < 0.001) or postoperative ( p = 0.001) RT compared to patients that underwent surgery alone. Finally, median R0-resection rate was similar between the two groups ( p = 0.56). Conclusion: RT along with radical surgery could be the standard of care in at least a subgroup of patients with RPS.