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All Topic Review Biography
Topic Review
Sphingosine 1-Phosphate Modulation in Inflammatory Bowel Diseases
Inflammatory bowel diseases (IBDs), including ulcerative colitis (UC) and Crohn’s disease (CD), are chronic, disabling conditions affecting the gastrointestinal tract and characterized by an abnormal immune response to intestinal microflora in genetically susceptible individuals. For their progressive behavior, the recommended management involves optimal and early treatment, in order to prevent complications such as corticosteroids’ need, hospitalization, surgery and disability and dysplasia/cancer. Most S1P modulators are reported to be safe and effective in the treatment of both UC and CD. High and satisfactory rates of clinical remission as well as endoscopic improvement and remission can be achieved with these molecules. Safety alarms remain rather low, although the S1P binding to two of its G protein-coupled receptors, 2 and 3 (S1PR2 and S1PR3), may be associated with cardiovascular risks.
  • 391
  • 08 Aug 2022
Topic Review
Spontaneous Bacterial Peritonitis in Decompensated Liver Cirrhosis
Spontaneous bacterial peritonitis (SBP) is defined as a bacterial infection of the ascitic fluid without a surgically treatable intra-abdominal infection source. SBP is a common, severe complication in cirrhosis patients with ascites, and if left untreated, in-hospital mortality may exceed 90%. However, the incidence of SBP has been lowered to approx. 20% through early diagnosis and antibiotic therapy. There are three types of SBP. Bacterial translocation from the gastrointestinal tract is the most common source of SBP. Distinguishing SBP from secondary bacterial peritonitis is essential because the conditions require different therapeutic strategies. The standard treatment for SBP is prompt broad-spectrum antibiotic administration and should be tailored according to community-acquired SBP, healthcare-associated or nosocomial SBP infections, and local resistance profile. Albumin supplementation, especially in patients with renal impairment, is also beneficial. Selective intestinal decontamination is associated with a reduced risk of bacterial infection and mortality in the high-risk group.
  • 519
  • 01 Dec 2022
Topic Review
Surgical Management of Gastroesophageal Junction Adenocarcinoma
Gastroesophageal (GE) junction adenocarcinoma is an aggressive malignancy of growing incidence and is associated with public health issues such as obesity and GERD. Management has evolved over the last two decades to incorporate a multidisciplinary approach, including endoscopic intervention, neoadjuvant chemotherapy/chemoradiation, and open or minimally invasive surgical approaches. Surgical approaches include esophagectomy, total gastrectomy, and, more recently, proximal gastrectomy. 
  • 182
  • 21 Feb 2024
Topic Review
Surgical Management of Pancreatic Neuroendocrine Tumours (pNETs)
Pancreatic neuroendocrine tumours (pNETs) are a group of rare neoplasms with an incidence of 1–2/100,000 inhabitants/year. They represent 2% of all pancreatic neoplasms and are characterized by a great heterogeneity according to their genetic or sporadic origin, their functional or non-functional character, their degree of locoregional or systemic invasion and their single or multiple localization. The reference curative treatment is surgical resection of the pancreatic tumor in specialized high-volume centres, after a multidisciplinary discussion involving surgeons, oncologists, radiologists and pathologists.
  • 608
  • 14 Jan 2022
Topic Review
Surgical Options for PSM from Colorectal Carcinoma
Peritoneal dissemination is proven to worsen the prognosis of these patients. Cytoreductive surgery (CRS), along with systemic chemotherapy, have been shown to constitute a survival benefit in selected patients with PSM. Furthermore, the association of CRS with hyperthermic intraperitoneal chemotherapy (HIPEC) seems to significantly improve the prognosis of patients with certain types of digestive malignancies associated with PSM. 
  • 280
  • 17 May 2023
Topic Review
Surgical Strategies for Recurrent Hepatocellular Carcinoma after Resection
Among primary liver cancers, hepatocellular carcinoma (HCC) is the most common. Surgical resection and liver transplantation both represent potentially curative treatments not only in the case of the first occurrence, but also in those cases of disease recurrence if a proper selection of patients is performed ahead. Incidentally, the type and the time of relapse carry important weight on patient prognosis and overall survival. For these cases, proper management has still not been exactly defined.
  • 565
  • 11 Feb 2023
Topic Review
Surgical Techniques for Rectal Prolapse
Complete rectal prolapse or rectal procidentia is a debilitating disease that presents with fecal incontinence, constipation, and rectal discharge. Definitive surgical techniques described for this disease include perineal procedures such as mucosectomy and rectosigmoidectomy, and abdominal procedures such as rectopexy with or without mesh and concomitant resection. The debate over these techniques regarding the lowest recurrence and morbidity rates, and the best functional outcomes for constipation or incontinence, has been going on for decades. The heterogeneity of available studies does not allow us to draw firm conclusions. 
  • 440
  • 02 Aug 2021
Topic Review
Surveillance and Diagnosis of NAFLD-Related Hepatocellular Carcinoma
With the significant achievements in eradicating the hepatitis C virus by direct-acting antiviral agents and the rising epidemic of obesity, diabetes mellitus, and metabolic syndrome, there is a paradigm shift in the leading cause of liver cirrhosis and cancer to nonalcoholic fatty liver disease (NAFLD). Data highlight the rapidly rising incidence of NAFLD-related hepatocellular carcinoma (HCC) worldwide and expose the unseen part of the iceberg. NAFLD-related HCC has some characteristic features that distinguish it from other etiologies such as HBV and HCV, which makes its diagnosis and management more complicated. 
  • 226
  • 25 Sep 2023
Topic Review
Sweeteners and Gut Microbiome
Worldwide, the demand for natural and synthetic sweeteners in the food industry as an alternative to refined sugar is increasing. This has prompted more research to be conducted to estimate its safety and effects on health. The gut microbiome is critical in metabolizing selected sweeteners which might affect overall health. Recently, more studies have evaluated the relationship between sweeteners and the gut microbiome.
  • 421
  • 19 Oct 2023
Topic Review
Synbiotics in Inflammatory Bowel Diseases
Inflammatory bowel disease (IBD) is a group of chronic relapsing gastrointestinal disorders that are characterized by inflammation of the gastrointestinal tract. The involvement of three distinct recurrent inflammatory features that sustains the chronic inflammation in IBD have been clearly identified that includes, disturbances in the gut microbiota, dysregulated immune response and altered colonic epithelial integrity. Dietary components such as prebiotic dietary fibres (DF) and probiotics due to their potential in modulating immune functions and influencing microbiota are promising strategies in the context of IBD. In this entry, we review the recent evidence from in-vivo studies to support the application of synergistic synbiotic carrying whole-plant complex prebiotic fibre and probiotic in resolving in the inflammatory cycle in IBD.
  • 512
  • 16 Apr 2021
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