Publications
231 results found
Pellino G, Simillis C, Kontovounisios C, et al., 2017, Colorectal cancer diagnosed during pregnancy: systematic review and treatment pathways, EUROPEAN JOURNAL OF GASTROENTEROLOGY & HEPATOLOGY, Vol: 29, Pages: 743-753, ISSN: 0954-691X
Johnson N, Pellino G, Simillis C, et al., 2017, Discrepancies between NCCN and ESMO guidelines in the management of anal cancer: a qualitative review, Updates in Surgery, Vol: 69, Pages: 345-349, ISSN: 2038-131X
There is an ever-growing need, with the ongoing developments in research and the progress towards patient centered care, to delineate standardized protocols of management of anal cancer. However, guidelines from different societies show some degree of disagreement. This is a systematic review of the literature to identify similarities and discrepancies between the guidelines for the management of anal cancer drafted by the European Society for Medical Oncology (ESMO) and by the National Comprehensive Cancer Network (NCCN). We found essentially similar management for investigation, diagnosis, chemotherapy regimens, and radiotherapy doses in both ESMO and NCCN recommendations in the management of anal cancer. There were few differences, which included the levels of evidence and grades of recommendations, the delineation of radiotherapy fields, and the treatment of the elderly and personalized medicine based on genetics. The follow-up regime is also marginally different in the first 2 years. Even if the observed differences may be justified by a different implementation of evidence-based medicine among different countries for particular management modalities of anal cancer, we identified the grey areas which need further study. In addition, these facets should be assessed more carefully when planning future guidelines.
Kontovounisios C, Qiu S, Rasheed S, et al., 2017, The role of neurotensin as a novel biomarker in the endoscopic screening of high-risk population for developing colorectal neoplasia, Updates in Surgery, ISSN: 2038-131X
Colorectal cancer screening programs aim at early detection of cancer to reduce incidence rates and mortality. The objective of this study is to identify the role of neurotensin in the endoscopic screening of high-risk population for developing colorectal neoplasia. Blood samples from patients referred for urgent colonoscopy to investigate symptoms suspicious of colorectal cancer were collected. Blood neurotensin levels were measured using enzyme-linked immunosorbent assay. Colonoscopy findings were used as reference for determining the diagnostic accuracy of blood neurotensin. The study comprised 26 patients in total: 12 healthy and 14 with colon pathology (13 high-grade dysplasia adenomatous polyps, 1 adenocarcinoma). There were no statistically significant differences in the clinical and biochemical parameters between colon pathology and healthy group except neurotensin levels. Pathology in colon was associated with 3.7-fold increase in NT levels. In multivariate analysis, patients with pathology in colon have increased serum neurotensin levels compared to controls adjusted for age, gender, BMI and co-morbidities. The value of 12.93 pg/ml is associated with 87.5% sensitivity and 91.7% specificity for discriminating the colon pathology from normal colonic epithelium (p = 0.001). Neurotensin plasma values differentiate healthy people from patients suffering from colonic pathologies such as adenomatous polyps and cancer. The use of neurotensin as a potential endoscopic screening tool for identifying high-risk population for developing colorectal cancer is promising, but much has to be done before it is validated in larger scale prospective studies.
Ramage L, Yen C, Qiu S, et al., 2017, Functional and quality of life outcomes following obstetric anal sphincter injury (OASI): does the grade of injury affect outcomes?, International Urogynecology Journal, Vol: 28, Pages: 1709-1717, ISSN: 1433-3023
INTRODUCTION AND HYPOTHESIS: The aim of this study was to compare functional and quality of life data in patients with increasing grades of obstetric anal sphincter injury (OASI) presenting to a tertiary colorectal pelvic floor clinic within 24 months of delivery. METHODS: Prospective data were collected from the patients for the period 2009-2016 and included data on functional outcomes and motor anorectal manometry parameters. The instruments used for the evaluation of functional outcomes were the Birmingham Bowel and Urinary Symptoms Questionnaire, the Wexner Incontinence Score, Short Form 36, and the Pelvic Organ Prolapse/Urinary Incontinence Sexual Questionnaire. OASI grade of injury was based on the postdelivery endoanal ultrasound scan. Data from patients with a grade 3a, 3b, 3c or 4 OASI were compared using one-way ANOVA for parametric data and the Kruskal-Wallis test for nonparametric data overall and for separate time periods (3-6 months, 6-12 months, 12-24 months). RESULTS: Functional patient data were available in 177 patients: 29 with grade 3a, 55 with grade 3b, 77 with grade 3c and 16 with grade 4 OASI. There was no discernible trend in worsening function with increasing severity of OASI overall, nor for the specified time periods of 3-6 months 58 patients), 6-12 months (85 patients) or 12-24 months (18 patients). CONCLUSIONS: Our series demonstrated no significant differences in functional outcomes or quality of life in patients with different OASI grades. Longer-term follow-up is required to ascertain any later functional differences which may become apparent with time.
Baird D, Denost Q, Simillis C, et al., 2017, The role of adjuvant chemotherapy on survival and recurrence after curative rectal cancer surgery on patients who are histologically node negative after neoadjuvant chemoradiotherapy., Colorectal Disease, Vol: 19, Pages: 980-986, ISSN: 1463-1318
AIM: The aim of this study is to evaluate whether adjuvant chemotherapy will affect recurrence rates, disease free and overall survival in patients with rectal adenocarcinoma who were staged with MRI node positive disease (mrN+) preoperatively and underwent neoadjuvant chemoradiotherapy with curative rectal cancer surgery and their pathological staging was negative for nodal disease (ypN0). There is no consensus on the role of adjuvant chemotherapy in these patients. METHOD: Patients who received neoadjuvant chemoradiotherapy and underwent curative rectal cancer surgery for rectal adenocarcinoma staged as [mrTxN+M0] on MRI staging and on pathological staging were found to be [ypTxN0M0] were retrospectively identified from 01/2008-12/2012 from two tertiary referral centers (Royal Marsden Hospital and Saint-Andre Hospital). RESULTS: 163 patients were recruited and after propensity matching at a ratio of 2:1 n=80 patients were divided into adjuvant (n=28) and no adjuvant treatment (n=52) respectively. A comparison of adjuvant chemotherapy vs no adjuvant therapy showed that the mean overall survival was 2.67 vs 3.60 years (p=0.42), disease free survival was 2.27 vs 3.32 years (p=0.14). CONCLUSION: This study found no significant difference in survival or disease recurrence between patients who received adjuvant chemotherapy and patients who did not. There is no clear evidence to support or dismiss the use of adjuvant chemotherapy for patients who have been node positive on pre-operative MRI and node negative on histopathological staging. Further multicenter prospective randomised trials are needed to identify the appropriate treatment regime for this group of patients.
Yen C, Simillis C, Choudhry M, et al., 2017, A comparative study of short-term outcomes of colorectal cancer surgery in the elderly population., Acta Chirurgica Belgica, Vol: 117, Pages: 303-307, ISSN: 0001-5458
BACKGROUND: Colorectal Cancer (CRC) is a disease of the elderly, and with an ageing population, oncological surgical procedures for CRC in the elderly is expected to increase. However, the balance between surgical benefits and risks associated with age and comorbidities in elderly patients is obscure. MATERIALS AND METHODS: A retrospective database of consecutive patients who received CRC surgery was used to compare short-term surgical and oncological outcomes between patients aged ≥75 and <75 years old undergoing CRC resection. RESULTS: There were 54 patients (63.5%) in the <75 group and 31 patients (36.5%) in the ≥75 group. Overall, there were no differences between the <75 and ≥75 groups in postoperative HDU/ITU stay, median hospital LOS or 30-day mortality rates. Patients ≥75 had a higher preoperative performance status (25.9% versus 71.0%, p < .001), but no difference in ASA Grade and referral pattern, proportion of emergency operations, cancer staging, resection margins, achievement of curative resection or median lymph node yield. There was a significantly higher use of adjuvant chemotherapy in the <75 age group (48.1% versus 25.8%, p = .043). CONCLUSIONS: With adequate patient selection, CRC resection in elderly patients is not associated with higher postoperative mortality or worse short-term oncological benefits.
Pellino G, Ramage L, Simillis C, et al., 2017, Evaluation of sexual dysfunction in female patients presenting with faecal incontinence or defecation disorder, INTERNATIONAL JOURNAL OF COLORECTAL DISEASE, Vol: 32, Pages: 667-674, ISSN: 0179-1958
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- Citations: 7
Baird DLH, Simillis C, Kontovounisios C, et al., 2017, CLINICAL UPDATES Acute appendicitis, BMJ, Vol: 357, ISSN: 1756-1833
Acute appendicitis is the most common abdominal surgical emergency in the world, with around 50 000 and 300 000 acute appendicectomies performed annually in the UK and in the US respectively.12 However, its incidence is falling for unknown reasons.34This clinical update provides information on how patients may present and what investigations and treatments are available.
Qiu SY, Pellino G, Fiorentino F, et al., 2017, A review of the role of Neurotensin and its receptors in colorectal cancer, Gastroenterology Research and Practice, Vol: 2017, ISSN: 1687-630X
Neurotensin (NTS) is a physiologically occurring hormone which affects the function of the gastrointestinal (GI) tract. In recent years, NTS, acting through its cellular receptors (NTSR), has been implicated in the carcinogenesis of several cancers. In colorectal cancer (CRC), a significant body of evidence, from in vitro and in vivo studies, is available which elucidates the molecular biology of NTS/NTSR signalling and the resultant growth of CRC cells. There is growing clinical data from human studies which corroborate the role NTS/NTSR plays in the development of human CRC. Furthermore, blockade and modulation of the NTS/NTSR signalling pathways appears to reduce CRC growth in cell cultures and animal studies. Lastly, NTS/NTSR also shows potential of being utilized as a diagnostic biomarker for cancers as well as targets for functional imaging. We summarize the existing evidence and understanding of the role of NTS and its receptors in CRC.
Pellino G, Kontovounisios C, Tait D, et al., 2017, Squamous cell carcinoma of the anal transitional zone after ileal pouch surgery for ulcerative colitis: systematic review and treatment perspectives, Case Reports in Oncology, Vol: 10, Pages: 112-122, ISSN: 1662-6575
Background: Few cases of pouch-related cancers have been reported in ulcerative colitis (UC), and squamous cell carcinoma (SCC) is very rare. Method: A systematic review of the literature was performed to identify all unequivocal cases of pouch-related SCC in UC patients. Results: Eight cases of SCC developing after ileal pouch-anal anastomosis (IPAA) have been observed since 1978. Two arose from the pouch mucosa and 6 from below. The pooled cumulative incidence of SCC is below 0.06% after IPAA. Many patients had neoplasia on the preoperative specimen, but squamous metaplasia of the pouch or anorectal mucosa may have an important role in SCC. These patients are rarely offered chemoradiation therapy and the outcome is poor. Selected patients with SCC located close to the pouch outlet can be treated with chemoradiation prior to consideration of surgery and salvage their pouch. A chemoradiation regimen is suggested to avoid pouch excision in these patients. Conclusions: SCC is rare after pouch surgery but associated with extremely poor survival. Very low SCC can be managed with chemoradiation treatment, preserving the pouch and avoiding surgery, even in older patients. The role of pouch metaplasia, surveillance frequency, and treatment modalities after IPAA need further studying.
Denost Q, Kontovounisios C, Rasheed S, et al., 2017, Individualizing surgical treatment based on tumour response following neoadjuvant therapy in T4 primary rectal cancer, EJSO, Vol: 43, Pages: 92-99, ISSN: 0748-7983
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- Citations: 18
Choudhry M, Pellino G, Simillis C, et al., 2017, Prostatic abscesses. A case report and review of the literature on current treatment approaches, CENTRAL EUROPEAN JOURNAL OF UROLOGY, Vol: 70, Pages: 118-122, ISSN: 2080-4806
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- Citations: 2
Pellino G, Slesser AAP, Ojo D, et al., 2016, A simple and safe technique to decompress a large bowel obstruction, UPDATES IN SURGERY, Vol: 68, Pages: 425-+, ISSN: 2038-131X
Kontovounisios C, 2016, The impact of surgical clinical placements on medical student's career preferences, International Surgery Journal, Vol: 3, Pages: 2365-2366, ISSN: 2349-3305
Slesser AAP, Pellino G, Shariq O, et al., 2016, Compression versus hand-sewn and stapled anastomosis in colorectal surgery: a systematic review and meta-analysis of randomized controlled trials, TECHNIQUES IN COLOPROCTOLOGY, Vol: 20, Pages: 667-676, ISSN: 1123-6337
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- Citations: 21
Kaimakliotis P, Simillis C, Harbord M, et al., 2016, A Systematic Review Assessing Medical Treatment for Rectovaginal and Enterovesical Fistulae in Crohn's Disease, JOURNAL OF CLINICAL GASTROENTEROLOGY, Vol: 50, Pages: 714-721, ISSN: 0192-0790
Kontovounisios C, Tan E, Pawa N, et al., 2016, Selection process can improve the outcome in locally advanced and recurrent colorectal cancer: activity and results of a dedicated multidisciplinary colorectal cancer centre., Colorectal Disease, Vol: 19, Pages: 331-338, ISSN: 1463-1318
AIM: There is wide disparity in the care of patients with multi-visceral involvement of rectal cancer. The results of treatment of advanced and recurrent colorectal cancer are presented from a centre where a dedicated Multidisciplinary Team (MDT) is central to the management. METHOD: All consecutive MDT referrals between 2010 and 2014 were examined. Analysis was undertaken of the referral pathway, site, selection process, management decision, R0 resection rate, mortality / morbidity / Clavien-Dindo (CD) classification of morbidity, length of stay (LOS), and improvement of quality of life. RESULTS: There were 954 referrals. These included locally advanced primary rectal cancer (LAPRC b-TME) [39.0%], rectal recurrence (RR) [22.0%], locally advanced primary colon cancer (LAPCC T3c/d-T4) [21.1%], colon cancer recurrence (CR) 12.4%, locally advanced primary anal cancer (LAPAC-failure of CRT/ T3c/d-T4) [3.0%] and anal cancer recurrence (AR) [2.2%]. Among these patients 271 operations were performed, 212 primary and 59 for recurrence. These included 16 sacrectomies, 134 total pelvic exenterations) and 121 other multi-visceral exenterative procedures. An R0 resection (no microscopic margin involvement) was achieved in 94.4% and R1 (microscopic margin involvement) in 5.1%. In LAPRC b-TME the R0 rate was 96.1% and for RR it was 79%. The length of stay (LOS) varied from 13.3-19.9 days. RR operations had the highest morbidity (Clavien-Dindo [CD] 1-2 33.3%) and LAPRC operations had the highest rate of CD 3-4 complications (18.4%). Most (39.6%) of the referred patients were from other UK hospitals CONCLUSION: Advanced colorectal cancer can be successfully treated in a dedicated referral centre, achieving R0 resection in over 90% with low morbidity and mortality. Implementation of a standardised referral pathway is encouraged. This article is protected by copyright. All rights reserved.
Simillis C, Baird DL, Kontovounisios C, et al., 2016, A Systematic Review to Assess Resection Margin Status After Abdominoperineal Excision and Pelvic Exenteration for Rectal Cancer, Annals of Surgery, ISSN: 1528-1140
Objective: The aim of this study was to assess resection margin status and its impact on survival after abdominoperineal excision and pelvic exenteration for primary or recurrent rectal cancer.Summary of Background Data: Resection margin is important to guide therapy and to evaluate patient prognosis.Methods: A meta-analysis was performed to assess the impact of resection margin status on survival, and a regression analysis to analyze positive resection margin rates reported in the literature.Results: The analysis included 111 studies reporting on 19,607 participants after abdominoperineal excision, and 30 studies reporting on 1326 participants after pelvic exenteration. The positive resection margin rates for abdominoperineal excision were 14.7% and 24.0% for pelvic exenteration. The overall survival and disease-free survival rates were significantly worse for patients with positive compared with negative resection margins after abdominoperineal excision [hazard ratio (HR) 2.64, P < 0.01; HR 3.70, P < 0.01, respectively] and after pelvic exenteration (HR 2.23, P < 0.01; HR 2.93, P < 0.01, respectively). For patients undergoing abdominoperineal excision with positive resection margins, the reported tumor sites were 57% anterior, 15% posterior, 10% left or right lateral, 8% circumferential, 10% unspecified. A significant decrease in positive resection margin rates was identified over time for abdominoperineal excision. Although positive resection margin rates did not significantly change with the size of the study, some small size studies reported higher than expected positive resection margin rates.Conclusions: Resection margin status influences survival and a multidisciplinary approach in experienced centers may result in reduced positive resection margins. For advanced anterior rectal cancer, posterior pelvic exenteration instead of abdominoperineal excision may improve resection margins.
Alexander J, Gildea L, Balog J, et al., 2016, A novel methodology for in vivo endoscopic phenotyping of colorectal cancer based on real-time analysis of the mucosal lipidome: a prospective observational study of the iKnife, Surgical Endoscopy and Other Interventional Techniques, Vol: 31, Pages: 1361-1370, ISSN: 1432-2218
Background:This pilot study assessed the diagnostic accuracy of rapid evaporative ionization mass spectrometry (REIMS) in colorectal cancer (CRC) and colonic adenomas.Methods:Patients undergoing elective surgical resection for CRC were recruited at St. Mary’s Hospital London and The Royal Marsden Hospital, UK. Ex vivo analysis was performed using a standard electrosurgery handpiece with aspiration of the electrosurgical aerosol to a Xevo G2-S iKnife QTof mass spectrometer (Waters Corporation). Histological examination was performed for validation purposes. Multivariate analysis was performed using principal component analysis and linear discriminant analysis in Matlab 2015a (Mathworks, Natick, MA). A modified REIMS endoscopic snare was developed (Medwork) and used prospectively in five patients to assess its feasibility during hot snare polypectomy.Results:Twenty-eight patients were recruited (12 males, median age 71, range 35–89). REIMS was able to reliably distinguish between cancer and normal adjacent mucosa (NAM) (AUC 0.96) and between NAM and adenoma (AUC 0.99). It had an overall accuracy of 94.4 % for the detection of cancer versus adenoma and an adenoma sensitivity of 78.6 % and specificity of 97.3 % (AUC 0.99) versus cancer. Long-chain phosphatidylserines (e.g., PS 22:0) and bacterial phosphatidylglycerols were over-expressed on cancer samples, while NAM was defined by raised plasmalogens and triacylglycerols expression and adenomas demonstrated an over-expression of ceramides. REIMS was able to classify samples according to tumor differentiation, tumor budding, lymphovascular invasion, extramural vascular invasion and lymph node micrometastases (AUC’s 0.88, 0.87, 0.83, 0.81 and 0.81, respectively). During endoscopic deployment, colonoscopic REIMS was able to detect target lipid species such as ceramides during hot snare polypectomy.Conclusion:REIMS demonstrates high diagnostic accuracy for tumor type and for established histological featur
Harris CA, Solomon MJ, Heriot AG, et al., 2016, The outcomes and patterns of treatment failure after surgery for locally recurrent rectal cancer, Annals of Surgery, Vol: 264, Pages: 323-329, ISSN: 0003-4932
Objective: To assess the outcomes and patterns of treatment failure of patients who underwent pelvic exenteration surgery for recurrent rectal cancer.Background: Despite advances in the management of rectal cancer, local recurrence still occurs. For appropriately selected patients, pelvic exenteration surgery can achieve long-term disease control.Methods: Prospectively maintained databases of 5 high volume institutions for pelvic exenteration surgery were reviewed and data combined. We assessed the combined endpoints of overall 5-year survival, cancer-specific 5-year mortality, local recurrence, and the development of metastatic disease.Results: Five hundred thirty-three patients who had undergone surgery for locally recurrent rectal cancer were identified. Five-year cancer-specific survival for patients with a complete (R0) resection is 44%, which was achieved in 59% of patients. For those with R1 and R2 resections, the 5-year survival was 26% and 10%, respectively. Radical resection required sacrectomy in 170 patients (32%), and total cystectomy in 105 patients (20%). Treatment failure included local recurrence alone in 75 patients (14%) and systemic metastases with or without local recurrence in 226 patients (42%). Chemoradiotherapy before exenteration was associated with a significant (P < 0.05) improvement in overall 5-year cancer-specific survival for those patients with an R0 resection. Postoperative chemotherapy did not alter outcomes.Conclusions: R0 resection of the pelvic recurrence is the most significant factor affecting overall and disease-free survival. The surgery is complex and often highly morbid, and where possible patients should be given perioperative chemoradiotherapy. Further investigations are required to determine the role of adjuvant chemotherapy.
Kontovounisios C, Tekkis P, Tan E, et al., 2016, Adoption and success rates of perineal procedures for fistula-in-ano: a systematic review, Colorectal Disease, Vol: 18, Pages: 441-458, ISSN: 1463-1318
AIM: Several sphincter-preserving techniques have been described with extremely encouraging initial reports. However, more recent studies have failed to confirm the positive early results. We evaluate the adoption and success rates of advancement flap procedures (AFP), fibrin glue sealant (FGS), anal collagen plug (ACP) and ligation of intersphincteric fistula tract (LIFT) procedures based on their evolution in time for the management of anal fistula. METHOD: A PubMed search from 1992 to 2015. An assessment of adoption, duration of study and success rate was undertaken. RESULTS: We found 133 studies (5604 patients): AFP (40 studies, 2333 patients), FGS (31 studies, 871 patients), LIFT (19 studies, 759 patients), ACP (43 studies, 1641 patients). Success rates ranged from 0% to 100%. Study duration was significantly associated with success rates in AFP (P = 0.01) and FGS (P = 0.02) but not in LIFT or ACP. The duration of use of individual procedures since first publication was associated with success rate only in AFP (P = 0.027). There were no statistically significant differences in success rates relative to the number of the patients included in each study. CONCLUSION: Success and adoption rates tend to decrease with time. Differences in patient selection, duration of follow-up, length of availability of the individual procedure and heterogeneity of treatment protocols contribute to the diverse results in the literature. Differences in success rates over time were evident, suggesting that both international trials and global best practice consensus are desirable. Further prospective randomized controlled trials with homogeneity and clear objective parameters would be needed to substantiate these findings.
Tekkis P, Tan E, Kontovounisios C, et al., 2015, Hand-sewn coloanal anastomosis for low rectal cancer: technique and long-term outcome, Colorectal Disease, Vol: 17, Pages: 1062-1070, ISSN: 1463-1318
AimThis study compared the operative outcome and long-term survival of three types of hand-sewn coloanal anastomosis (CAA) for low rectal cancer.MethodPatients presenting with low rectal cancer at a single centre between 2006 and 2014 were classified into three types of hand-sewn CAA: type 1 (supra-anal tumours undergoing transabdominal division of the rectum with transanal mucosectomy); type 2 (juxta-anal tumours, undergoing partial intersphincteric resection); and type 3 (intra-anal tumours, undergoing near-total intersphincteric resection with transanal mesorectal excision).ResultsSeventy-one patients with low rectal cancer underwent CAA: 17 type 1; 39 type 2; and 15 type 3. The median age of patients was 61.6 years, with a male/female ratio of 2:1. Neoadjuvant therapy was given to 56 (79%) patients. R0 resection was achieved in 69 (97.2%) patients. Adverse events occurred in 25 (35.2%) of the 71 patients with a higher complication rate in type 1 vs type 2 vs type 3 (47.1% vs 38.5% vs 13.3%, respectively; P = 0.035). Anastomotic separation was identified in six (8.5%) patients and pelvic haematoma/seroma in five (7%); two (8.3%) female patients developed a recto–vaginal fistula. Ten (14.1%) patients were indefinitely diverted, with a trend towards higher long-term anastomotic failure in type 1 vs type 2 vs type 3 (17.6% vs 15.5% vs 6.7%). The type of anastomosis did not influence the overall or disease-free survival.ConclusionCAA is a safe technique in which anorectal continuity can be preserved either as a primary restorative option in elective cases of low rectal cancer or as a salvage procedure following a failed stapled anastomosis with a less successful outcome in the latter. CAA has acceptable morbidity with good long-term survival in carefully selected patients.
Kontovounisios C, 2015, The role of masterclasses in surgical oncology training: experience from a colorectal cancer surgery masterclass, International Journal of Colorectal Disease, Vol: 31, Pages: 1065-1066, ISSN: 1432-1262
Ramage L, Qiu S, Kontovounisios C, et al., 2015, A systematic review of sacral nerve stimulation for low anterior resection syndrome, COLORECTAL DISEASE, Vol: 17, Pages: 762-771, ISSN: 1462-8910
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Kontovounisios C, Kinross J, Tan E, et al., 2015, Complete mesocolic excision in colorectal cancer: a systematic review, COLORECTAL DISEASE, Vol: 17, Pages: 7-16, ISSN: 1462-8910
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- Citations: 74
Kontovounisios C, Baloyiannis Y, Kinross J, et al., 2014, Modified right colon inversion technique as a salvage procedure for colorectal or coloanal anastomosis, COLORECTAL DISEASE, Vol: 16, Pages: 971-975, ISSN: 1462-8910
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- Citations: 11
Sgourakis G, Papapanagiotou A, Kontovounisios C, et al., 2014, The combined use of serum neurotensin and IL-8 as screening markers for colorectal cancer, TUMOR BIOLOGY, Vol: 35, Pages: 5993-6002, ISSN: 1010-4283
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- Citations: 12
Sgourakis G, Papapanagiotou A, Kontovounisios C, et al., 2013, The value of plasma neurotensin and cytokine measurement for the detection of bowel ischaemia in clinically doubtful cases: A prospective study, EXPERIMENTAL BIOLOGY AND MEDICINE, Vol: 238, Pages: 874-880, ISSN: 1535-3702
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- Citations: 7
Lanitis S, Kontovounisios C, Zafeiriadou P, et al., 2013, Epidemiology and management of trauma patients in a Greek multispecialty hospital in the absence of a dedicated trauma center, EUROPEAN JOURNAL OF TRAUMA AND EMERGENCY SURGERY, Vol: 39, Pages: 369-374, ISSN: 1863-9933
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- Citations: 2
Lanitis S, Lazari P, Kontovounisios C, et al., 2013, The role of core biopsy in the preoperative classification of breast cancer according to prognostic factors, Hellenic Journal of Surgery, Vol: 85, Pages: 1-7, ISSN: 0018-0092
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