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Preventive, Diagnostic and Therapeutic Strategies for Abdominal Surgery Complications (Second...
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Preventive, Diagnostic and Therapeutic Strategies for Abdominal Surgery Complications (Second Edition)

A special issue of Journal of Clinical Medicine (ISSN 2077-0383). This special issue belongs to the section "General Surgery".

Deadline for manuscript submissions: 31 May 2025 | Viewed by 3101

Special Issue Editor

Dr. Orestis Ioannidis

E-Mail Website1 Website2
Guest Editor
4th Department of Surgery, Medical School, Aristotle University of Thessaloniki, Thessaloniki, Greece
Interests: acute care surgery; surgical infections; nutrition; negative-pressure wound therapy/vacuum-assisted closure (NPWT/VAC); enhanced recovery after surgery (ERAS); open abdomen; vascular access; minimally invasive surgery
Special Issues, Collections and Topics in MDPI journals

Special Issue Information

Dear Colleagues,

Surgery is indicated to cure or palliate numerous physical ailments, with millions of operations being performed each year worldwide. While the overall risk of complications is low because of the presence of trained and skilled surgeons and the adaptation of good surgical techniques, complications can still occur even with the most experienced of surgeons or in the simplest of cases. Surgery can be complicated by adverse effects that can affect daily living by impairing one’s quality of life, due to increases in the cost of health systems caused by longer hospitalization times, and even increases in mortality rates and decreases in life expectancy. Complications can be more or less severe; can resolve spontaneously or require medical, interventional or surgical treatment; and can be specific to the operation performed. However, all of them are significant for the patient and are usually the most difficult part of their management. Prompt and early diagnosis of complications and adequate and proper treatment are the cornerstones in their successful management.

After the success of the first edition (https://www.mdpi.com/journal/jcm/special_issues/H71J35SJP2), a second edition of that Special Issue is in production. It will continue focusing on preventive, diagnostic, and therapeutic strategies for abdominal surgery complications.

Dr. Orestis Ioannidis
Guest Editor

Manuscript Submission Information

Manuscripts should be submitted online at www.mdpi.com by registering and logging in to this website. Once you are registered, click here to go to the submission form. Manuscripts can be submitted until the deadline. All submissions that pass pre-check are peer-reviewed. Accepted papers will be published continuously in the journal (as soon as accepted) and will be listed together on the special issue website. Research articles, review articles as well as short communications are invited. For planned papers, a title and short abstract (about 100 words) can be sent to the Editorial Office for announcement on this website.

Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are thoroughly refereed through a single-blind peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. Journal of Clinical Medicine is an international peer-reviewed open access semimonthly journal published by MDPI.

Please visit the Instructions for Authors page before submitting a manuscript. The Article Processing Charge (APC) for publication in this open access journal is 2600 CHF (Swiss Francs). Submitted papers should be well formatted and use good English. Authors may use MDPI's English editing service prior to publication or during author revisions.

Keywords

  • complications
  • diagnosis
  • treatment
  • management
  • morbidity
  • abdomen
  • abdominal surgery
  • outcome
  • postoperative

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Related Special Issue

Published Papers (3 papers)

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Research

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26 pages, 3850 KiB  
Article
The Effect of Albumin/Glutaraldehyde Glue (Bioglue) on Colonic Anastomosis Under Intestinal Obstruction: An Experimental Study in Rats
by Kalliopi Despoudi, Ioannis Mantzoros, Orestis Ioannidis, Elissavet Anestiadou, Savvas Symeonidis, Stefanos Bitsianis, Efstathios Kotidis, Manousos George Pramateftakis, Antonia Aikaterini Bourtzinakou, Eleni Salta-Poupnara, Konstantinos Angelopoulos, Barbara Driagka, Freiderikos Tserkezidis and Stamatios Angelopoulos
J. Clin. Med. 2025, 14(7), 2457; https://doi.org/10.3390/jcm14072457 - 3 Apr 2025
Viewed by 392
Abstract
Background/Objectives: Healing of colonic anastomoses is critical to surgical recovery, particularly under obstructive ileus conditions. Adhesive biological materials such as albumin/glutaraldehyde glue (Bioglue) show potential in enhancing anastomotic healing and minimizing complications. This study investigates the effect of Bioglue on colonic anastomoses [...] Read more.
Background/Objectives: Healing of colonic anastomoses is critical to surgical recovery, particularly under obstructive ileus conditions. Adhesive biological materials such as albumin/glutaraldehyde glue (Bioglue) show potential in enhancing anastomotic healing and minimizing complications. This study investigates the effect of Bioglue on colonic anastomoses healing under obstructive ileus conditions in rats. Methods: Eighty albino Wistar rats were divided into control, ileus, Bioglue, and ileus + Bioglue groups (n = 20 each). Subgroups (n = 10) were sacrificed on the 4th or 8th postoperative day. In the control and Bioglue groups, end-to-end anastomoses were performed after colonic resection. In the ileus and ileus + Bioglue groups, obstructive ileus was induced by colonic ligation, followed by resection and primary anastomosis. Bioglue was applied in the Bioglue and ileus + Bioglue groups. Assessments included bursting pressure, peritoneal adhesion and inflammation scores, and biochemical markers (fibroblast activity, neoangiogenesis, collagen deposition, hydroxyproline, and collagenase concentrations). Results: Bursting pressure and fibroblast activity were significantly higher in the ileus + Bioglue group compared to the ileus group on both postoperative days. Although anastomotic rupture occurred in the ileus and ileus + Bioglue groups, the incidence was not significantly different from the control and Bioglue groups. Ileus + Bioglue showed significantly higher adhesion scores, inflammatory infiltration, neoangiogenesis, and collagen deposition compared to the control and ileus groups. Hydroxyproline was significantly elevated in the ileus + Bioglue group on the 8th day. Collagenase I concentrations were higher in ileus + Bioglue but not significant. Conclusions: Bioglue application enhances colonic anastomotic healing under obstructive ileus conditions, improving mechanical strength and promoting tissue repair by the 4th and 8th postoperative days. These findings support its potential clinical application. Full article
(This article belongs to the Special Issue Preventive, Diagnostic and Therapeutic Strategies for Abdominal Surgery Complications (Second Edition))
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15 pages, 778 KiB  
Article
The Predictive Role of Preoperative Malnutrition Assessment in Postoperative Outcomes of Patients Undergoing Surgery Due to Gastrointestinal Cancer: A Cross-Sectional Observational Study
by Eva Karanikki, Maximos Frountzas, Irene Lidoriki, Alexandros Kozadinos, Adam Mylonakis, Iliana Tsikrikou, Maria Kyriakidou, Orsalia Toutouza, Efthimios Koniaris, George E. Theodoropoulos, Dimitrios Theodorou, Dimitrios Schizas and Konstantinos G. Toutouzas
J. Clin. Med. 2024, 13(23), 7479; https://doi.org/10.3390/jcm13237479 - 9 Dec 2024
Viewed by 1092
Abstract
Background: Malnutrition affects patients undergoing surgery for gastrointestinal cancers and contributes to poor postoperative outcomes, including increased complication rates, longer hospital stays, and higher mortality. Despite the availability of several malnutrition screening tools and prognostic scores, their effectiveness in predicting postoperative outcomes remains [...] Read more.
Background: Malnutrition affects patients undergoing surgery for gastrointestinal cancers and contributes to poor postoperative outcomes, including increased complication rates, longer hospital stays, and higher mortality. Despite the availability of several malnutrition screening tools and prognostic scores, their effectiveness in predicting postoperative outcomes remains unclear. This study aimed to compare the predictive accuracy of Patient-Generated Subjective Global Assessment (PG-SGA), Global Leadership Initiative on Malnutrition (GLIM), Geriatric Nutritional Risk Index (GNRI), and Controlling Nutritional Status (CONUT) score for postoperative outcomes in patients undergoing surgery for colorectal, hepato-pancreato-biliary and upper gastrointestinal cancers. Methods: A cross-sectional observational study from March 2022 to October 2023 was conducted in two university surgical departments, after registration on ClinicalTrials database (NCT05795374). Patient characteristics, preoperative nutritional status and postoperative outcomes were analyzed. Results: In total, 480 patients were enrolled. CONUT and GNRI demonstrated high specificity (over 90% and 80%, respectively) for predicting overall complications, major complications, prolonged hospital stay, mortality, and advanced disease stage across all cancer types. Notably, CONUT showed a specificity over 97% and GNRI over 89.7% for colorectal and upper gastrointestinal cancer patients, respectively, despite their lower sensitivity. On the contrary, PG-SGA and GLIM presented better sensitivity (up to 50%), but slightly lower specificity (up to 86.4%). Conclusions: CONUT and GNRI are valuable for ruling out non-at-risk patients for adverse postoperative outcomes, while PG-SGA and GLIM provide better sensitivity. A step-up approach—initial screening with PG-SGA and GLIM, followed by detailed evaluation with CONUT or GNRI— should be validated in future studies across diverse clinical settings. Full article
(This article belongs to the Special Issue Preventive, Diagnostic and Therapeutic Strategies for Abdominal Surgery Complications (Second Edition))
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Review

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17 pages, 531 KiB  
Review
The Impact of EndoVAC in Addressing Post-Esophagectomy Anastomotic Leak in Esophageal Cancer Management
by Stavros P. Papadakos, Alexandra Argyrou, Ioannis Katsaros, Vasileios Lekakis, Georgia Mpouga, Chrysovalantis Vergadis, Paraskevi Fytili, Andreas Koutsoumpas and Dimitrios Schizas
J. Clin. Med. 2024, 13(23), 7113; https://doi.org/10.3390/jcm13237113 - 25 Nov 2024
Viewed by 1302
Abstract
Anastomotic leakage (AL) remains a major complication after esophagectomy, especially in patients with esophagogastric cancers who have undergone neoadjuvant therapies, which can impair tissue healing. Endoscopic vacuum-assisted closure (EndoVAC) is an innovative approach aimed at managing AL by facilitating wound drainage, reducing infection, [...] Read more.
Anastomotic leakage (AL) remains a major complication after esophagectomy, especially in patients with esophagogastric cancers who have undergone neoadjuvant therapies, which can impair tissue healing. Endoscopic vacuum-assisted closure (EndoVAC) is an innovative approach aimed at managing AL by facilitating wound drainage, reducing infection, and promoting granulation tissue formation, thus supporting effective healing. This review explores the role and effectiveness of EndoVAC in treating AL post-esophagectomy in esophageal cancer patients. We present an overview of its physiological principles, including wound contraction, enhanced tissue perfusion, and optimized microenvironment, which collectively accelerate wound closure. In addition, we examine clinical outcomes from recent studies, which indicate that EndoVAC is associated with improved leak resolution rates and potentially shorter hospital stays compared to traditional methods. Overall, this review highlights EndoVAC as a promising tool for AL management and underscores the need for continued investigation to refine its protocols and broaden its accessibility. By optimizing EndoVACs use, multidisciplinary teams can improve patient outcomes and advance esophageal cancer care. Full article
(This article belongs to the Special Issue Preventive, Diagnostic and Therapeutic Strategies for Abdominal Surgery Complications (Second Edition))
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