Papers by Kalliopi Athanassiadi
Acromegaly caused by ectopic growth hormone-releasinghormone secretion
Growth Hormone & IGF Research, 2000
Alimentary Pharmacology and Therapeutics, 2006
Radiofrequency thermal ablation is the first therapeutic option in percutaneous treatment of hepa... more Radiofrequency thermal ablation is the first therapeutic option in percutaneous treatment of hepatocellular carcinoma but data on its long-term efficacy and safety are not conclusive. This study reports a prospective survey on radiofrequency thermal ablation in north-east Italy.
Prehabilitation in lung cancer surgery: A review and meta-analysis of RCT studies
Rehabilitation and chronic care
European Respiratory Journal, Sep 1, 2013
The Journal of Thoracic and Cardiovascular Surgery, Oct 1, 2004
ctopic secretion of growth hormone-releasing hormone (GHRH) is a rare cause of acromegaly. The mo... more ctopic secretion of growth hormone-releasing hormone (GHRH) is a rare cause of acromegaly. The most common tumors secreting GHRH are bronchial carcinoids and pancreatic islet cell tumors. Differential diagnosis of pituitary adenoma is necessary to avoid unnecessary pituitary surgery and damage to the pituitary gland. Rarely, that syndrome is secondary to a carcinoid bronchial tumor. We present a case of a synchronous GHRH-secreting bronchial carcinoid and a pituitary adenoma in a patient with acromegaly.
Management of residual pleural space and persistent airleak after major lung resection
OBJECTIVE: Residual space and persistent air leak is the most common complication after lung rese... more OBJECTIVE: Residual space and persistent air leak is the most common complication after lung resection, requiring additional treatment and hospital stay. The aim of this retrospective study is to assess the role of an anteriorly placed Pezzer catheter in order to treat prolonged alveolar air leakage and apical residual space after lung surgery. MATERIAL: During the last 7 years, out of 853 patients submitted to upper lobectomy/ bilobectomy for NSCLC, Lung Volume Reduction (LVR) for emphysema or reoperation, 79 (9.2%) experienced pleural space problems associated with prolonged air leak (>7days). Patients were divided into 2 groups: (A) with anterior Petzer catheter (n=52) and (B) (n=27) treated with reoperation or Heimlich valve, according to the surgeon9s preference. Duration of drainage, length of hospital stay and the need of additional interventions to treat the persistent postoperative alveolar leak were compared. RESULTS: No differences were found in the 2 groups concerning age, gender, type of resection, location (left/right). A significant reduction of the duration of drainage and of the length of the postoperative in-hospital stay was found in Group A compared to Group B. Obliteration of the pleural space was observed in all cases of Group A in a mean time of 2 days (range 1 to 4 days, while 4 patients of Group B were discharged with a residual pleural space. CONCLUSIONS: Our experience supports the use of an anterior Petzer catheter connected to water seal, whenever a space problem associated with prolonged air leak occurs. It reduces significantly the duration of the intrapleural drainages and the length of the in-hospital stay. The procedure is effective, safe, and easy to perform.
Interactive Cardiovascular and Thoracic Surgery, Aug 26, 2016
Pericardiodesis in pericardial tamponade
European Respiratory Journal, Sep 1, 2014
OBJECTIVE: The reported prevalence of pericardial diseases has changed and varied according to di... more OBJECTIVE: The reported prevalence of pericardial diseases has changed and varied according to diagnostic methods. In an autopsy series, it has been found in 2%-4% of the general population, in 7%-12% of cancer patients and, among these, in 19%-40% of patients dying of lung cancer. The goals of treatment may be simply to relieve symptoms and prevent recurrent effusion for a long-term symptomatic benefit, or to treat the local neoplastic disease with the aim of prolonging survival. We present our experience with pericardiodesis in 24 patients. MATERIAL: During the last 10 years 24 patients with tamponade or large pericardial effusion were admitted to our departments. Only in 7 cases (29%) there was a known history of neoplastic disease. The main symptom was dyspnea and the diagnostic tool of choice was echocardiogram. RESULTS: All but one patients were led to surgery, submitted to pericardial window and in undiagnosed cases an additional lung and pleural biopsy were performed. A soft foley catheter was introduced though the pericardial window as a pericardial drainage. Histology revealed in the majority of cases lung cancer, in 2 breast cancer (8.3%), in 5 cases (20.8%) inflammatory disease and only in one tuberculosis. In all cases but two pericardiodesis was performed through the foley catheter after instillation of xylocaine. In cases of neoplastic disease the agent of choice was bleocin, while in cases of inflammatory diseases tetracycline was instilled. The postoperative course was unevenful. No recurrences were observed in a follow up of 6.5 months. CONCLUSION: Pericardiodesis is an easy-to-perform and cost-effective method preventing from recurrences and offering even in end stage neoplastic disease a better quality of life.
European Journal of Cardio-Thoracic Surgery, Jun 1, 2003
published a study on cavitary pulmonary lesions related to blunt thoracic trauma [1]. We congratu... more published a study on cavitary pulmonary lesions related to blunt thoracic trauma [1]. We congratulate the authors on presenting their 10-year experience with 12 cases of a rare, yet multi-faceted, clinical entity.
Autologous Blood Pleurodesis for Persistent Air Leak
Thoracic and Cardiovascular Surgeon, Dec 1, 2009
Air leak is a well-known problem, often leading to great discomfort and prolonged hospitalization... more Air leak is a well-known problem, often leading to great discomfort and prolonged hospitalization. Many methods have been proposed for the prevention or treatment of prolonged air leak, but none of them turned out to offer the perfect solution. The purpose of this study was to evaluate the results of blood pleurodesis in patients with persistent air leak. From February 2005 through March 2007, 20 patients (14 male and 6 female) ranging in age from 41 to 81 years underwent blood pleurodesis in our department due to persistent air leak (> 7 days). In the majority of patients the underlying disease was emphysema (n = 14). Lobectomy was performed in 10 cases, LVRS in 4 and 3 patients suffered from secondary pneumothorax. Autologous blood pleurodesis was performed at bedside. With apical chest tube placement and an expanded lung, 60 ml of blood was taken from the femoral vein and instilled into the thoracic cavity. Because of the high air leakage the drainage was not clamped but was positioned over the patient to prevent blood running out of the pleural space, but allowing air to be evacuated. Patients were asked to rotate in bed every 15 minutes over a period of 6 hours. The tube was removed 12 h after cessation of the air leak. In 14 patients (70 %) closure of the fistula was achieved in less than 12 hours, in 3 within 24 h, in 2 within 48 h, while one patient with LVRS and NSCLC needed reoperation. Only in 2 cases was a second instillation of blood performed. Over a 2- to 24-month follow-up period neither complications nor recurrences were observed. The injection of autologous blood into the pleural space through an existing chest tube is an easy-to-perform, painless and inexpensive method with a high success rate.
The Journal of Thoracic and Cardiovascular Surgery, Sep 1, 2003
Objective: Spontaneous pneumomediastinum usually occurs in young people without an apparent preci... more Objective: Spontaneous pneumomediastinum usually occurs in young people without an apparent precipitating factor or disease. Thoracic surgeons are involved in the diagnosis and management of this entity because of the potentially life-threatening conditions that either must be treated as an emergency or excluded, such as esophageal perforation or necrotizing mediastinitis. We present our modest experience in treating spontaneous pneumomediastinum. Between 1988 and 1998 we treated 22 cases of spontaneous pneumomediastinum in 18 male patients and 4 female patients, ranging in age between 12 and 32 years. All traumatic cases were excluded. Retrosternal chest pain was the main symptom the patients presented. In only 11 cases was subcutaneous emphysema present. Chest radiography was diagnostic in all our cases. Computed tomographic scan, when performed, confirmed the diagnosis. An esophagogram was essential to exclude an esophageal rupture. Last, a cardiologic examination especially focusing on pericarditis excluded cardiac disease. Results: Conservative treatment consisted of bed rest, oxygen therapy, and analgesics, which led to rapid resolution of the spontaneous pneumomediastinum. The mean hospital stay ranged between 3 and 10 days. In a follow-up of 3 to 12 years only 1 recurrence was observed. Spontaneous pneumomediastinum is usually an undiagnosed benign entity that responds very well to conservative treatment. It should be considered in the differential diagnosis of chest pain, especially in healthy adolescents and young adults. S pontaneous pneumomediastinum (SPM) is a rare, self-limited disorder that usually occurs in young adult men without an apparent precipitating factor or disease. Thoracic surgeons are involved in the diagnosis and management of this entity because of the potentially life-threatening conditions that either must be treated as an emergency or excluded. We present our modest experience in treating SPM.
Multiple Inflammatory Myofibroblastic Tumors Involving Lung and Mediastinum: A Rare Clinical Entity
Thoracic and Cardiovascular Surgeon, Aug 25, 2009
Inflammatory myofibroblastic tumors (IMT) are a rare clinical entity. We retrospectively reviewed... more Inflammatory myofibroblastic tumors (IMT) are a rare clinical entity. We retrospectively reviewed the clinicopathological characteristics and prognosis for all patients with surgically resected IMTs of the lung at our institution. From January 1995 through February 2007, 16 patients, 9 men and 7 women ranging in age from 18 to 64 years with a median age of 46 years, were admitted to our hospital for IMT of the lung, mediastinum and thoracic outlet. Nine of them (56.3 %) had a history of pneumonia, while in the rest it was documented as an incidental finding on chest X-ray. Five of our patients (31.3 %) were under immunosuppressive therapy. CT scan was the diagnostic tool routinely used and PET performed turned out to be positive in 5 cases. Wedge resection was performed in the majority of cases along with 2 lobectomies and 2 segmentectomies. The resected lesions were studied histologically and immunohistochemically. There were no operative deaths. Follow-up was complete in all patients and ranged from 9 months to 135 months. No recurrence was observed. Overall 5-year survival was 93.8 %. Fifteen patients are still alive and the cause of death in one case was not related to the pseudotumor. Cox regression analysis was performed for different factors such as age, sex, previous pneumonia and immunosuppression. None of them was found to play a role in the development of an IMT. The type of intervention also did not seem to affect the prognosis in our series. IMTs are a rare clinical entity. An accurate preoperative diagnosis is difficult and complete resection remains the treatment of choice and leads to an excellent survival.
Infections of the Mediastinum
Thoracic Surgery Clinics, Feb 1, 2009
Infections of the mediastinum (ie, mediastinitis) are serious, are associated with high morbidity... more Infections of the mediastinum (ie, mediastinitis) are serious, are associated with high morbidity and mortality, and may result from adjacent disease with direct extension, hematogenous spread, or direct introduction into the mediastinal space. The organs and tissues involved determine the manifestations and approach to treatment of these infections. The most common ones are those secondary to perforation of the esophagus or penetrating trauma, and those that extend from an adjacent infection. Today, the most common cause of mediastinitis is direct invasion of the mediastinum after surgical intervention. Cases of mediastinitis can be classified as either acute or chronic. Two broad categories of acute mediastinitis are acute necrotizing mediastinitis and poststernotomy mediastinitis. Chronic mediastinitis has been arbitrarily subdivided into two categories: (1) granulomatous mediastinitis, and (2) fibrosing or sclerosing mediastinitis. However, these likely represent a continuum of chronic infection. In cases of acute mediastinitis, treatment should always be directed toward the primary pathology and the clinical presentation. In chronic cases, surgical treatment is only palliative.
The successful use of Pezzer Catheter in Covid-19 patients
Omental Transposition: The Final Solution for Major Sternal Wound Infection
Asian Cardiovascular and Thoracic Annals, Jun 1, 2007
Sternal osteomyelitis after median sternotomy for cardiac surgery is associated with considerable... more Sternal osteomyelitis after median sternotomy for cardiac surgery is associated with considerable morbidity and mortality. The ideal reconstruction after sternal debridement is still debated. From 2000 to 2004, we treated 15 patients for sternal osteomyelitis (type IIIB, IVA, IVB) after median sternotomy for cardiac surgery. Total or partial resection of the sternum and extensive debridement were performed in all cases. The defect was covered by omental transposition. In 11 cases, a single-stage operation took place, and a two-stage procedure was employed in 4. All patients had antibiotics postoperatively. There were 3 (20%) deaths due to cardiac failure. Hospital stay ranged from 21 to 45 days. Transient paradoxical movement of the anterior chest wall disappeared within one month. No recurrence was observed during 6 to 24 months of follow-up. Radical debridement along with omental flap transposition provides definitive control of the infection in cases of failure of other semi-conservative or surgical interventions. Prognosis depends on the general condition of the patient.
European Journal of Cardio-Thoracic Surgery, Sep 1, 2007
The Journal of Thoracic and Cardiovascular Surgery, Aug 1, 2006
Elastofibroma: A rare neoplasm of the chest wall
Lung herniation as a complication of minimally thoracic surgery
Lung Cancer with Huge Intratumoral Lung Abscess
Chest, Jun 1, 2019
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Papers by Kalliopi Athanassiadi