Athanasia Mitsala

Dr. Athanasia Mitsala

Second Department of Surgery, Democritus University of Thrace, Komotiní, Anatolikí Makedonía kai Thráki, Greece

Research Focus & Metrics

Academic Career Length

5Years (2022-Present)

(Calculated once Scilit publication data is synced: current year − year of first publication + 1)

Representative Publications

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7 March 2023 in Current Oncology
Verified
Journal Article
Open access
PDF file
CTChristos Tsalikidis
Christos Tsalikidis
AMAthanasia Mitsala
Athanasia Mitsala
VMVasileios I. Mentonis
Vasileios I. Mentonis
KRKonstantinos Romanidis
Konstantinos Romanidis
GPGeorgios Pappas-Gogos
Georgios Pappas-Gogos
MPMichail Pitiakoudis
Michail Pitiakoudis
Anastomotic leakage (AL) remains one of the most severe complications following colorectal cancer (CRC) surgery. Indeed, leaks that may occur after any type of intestinal anastomosis are commonly associated with a higher reoperation rate and an increased risk of postoperative morbidity and mortality. At first, our review aims to identify specific preoperative, intraoperative and perioperative factors that eventually lead to the development of anastomotic dehiscence based on the current literature. We will also investigate the role of several biomarkers in predicting the presence of ALs following colorectal surgery. Despite significant improvements in perioperative care, advances in surgical techniques, and a high index of suspicion of this complication, the incidence of AL remained stable during the last decades. Thus, gaining a better knowledge of the risk factors that influence the AL rates may help identify high-risk surgical patients requiring more intensive perioperative surveillance. Furthermore, prompt diagnosis of this severe complication may help improve patient survival. To date, several studies have identified predictive biomarkers of ALs, which are most commonly associated with the inflammatory response to colorectal surgery. Interestingly, early diagnosis and evaluation of the severity of this complication may offer a significant opportunity to guide clinical judgement and decision-making.

13 May 2024 in Medicina
Verified
Journal Article
Open access
PDF file
VLVasileios Leivaditis
Vasileios Leivaditis
KSKONSTANTINOS ANTONIOS SKEVIS
KONSTANTINOS ANTONIOS SKEVIS
Francesk MulitaFrancesk Mulita
Francesk Mulita
CTChristos Tsalikidis
Christos Tsalikidis
AMAthanasia Mitsala
Athanasia Mitsala
Efstratios N KoletsisEfstratios N Koletsis
Efstratios N Koletsis
Background: Postoperative air leak (PAL) is a frequent and potentially serious complication following thoracic surgery, characterized by the persistent escape of air from the lung into the pleural space. It is associated with extended hospitalizations, increased morbidity, and elevated healthcare costs. Understanding the mechanisms, risk factors, and effective management strategies for PAL is crucial in improving surgical outcomes. Aim: This review seeks to synthesize all known data concerning PAL, including its etiology, risk factors, diagnostic approaches, and the range of available treatments from conservative measures to surgical interventions, with a special focus on the use of autologous plasma. Materials and Methods: A comprehensive literature search of databases such as PubMed, Cochrane Library, and Google Scholar was conducted for studies and reviews published on PAL following thoracic surgery. The selection criteria aimed to include articles that provided insights into the incidence, mechanisms, risk assessment, diagnostic methods, and treatment options for PAL. Special attention was given to studies detailing the use of autologous plasma in managing this complication. Results: PAL is influenced by a variety of patient-related, surgical, and perioperative factors. Diagnosis primarily relies on clinical observation and imaging, with severity assessments guiding management decisions. Conservative treatments, including chest tube management and physiotherapy, serve as the initial approach, while persistent leaks may necessitate surgical intervention. Autologous plasma has emerged as a promising treatment, offering a novel mechanism for enhancing pleural healing and reducing air leak duration, although evidence is still evolving. Conclusions: Effective management of PAL requires a multifaceted approach tailored to the individual patient’s needs and the specifics of their condition. Beyond the traditional treatment approaches, innovative treatment modalities offer the potential to improve outcomes for patients experiencing PAL after thoracic surgery. Further research is needed to optimize treatment protocols and integrate new therapies into clinical practice.

25 June 2022 in Current Oncology
Verified
Journal Article
Open access
PDF file
AMAthanasia Mitsala
Athanasia Mitsala
CTChristos Tsalikidis
Christos Tsalikidis
KRKonstantinos Romanidis
Konstantinos Romanidis
MPMichail Pitiakoudis
Michail Pitiakoudis
Non-alcoholic fatty liver disease (NAFLD) is now considered the main driver and leading cause of chronic liver disease globally. The umbrella term NAFLD describes a range of liver conditions closely related to insulin resistance, metabolic syndrome, diabetes mellitus, obesity, and dyslipidemia. At the same time, several malignancies, including hepatocellular carcinoma and colorectal cancer, are considered to be common causes of death among patients with NAFLD. At first, our review herein aims to investigate the role of NAFLD in developing colorectal neoplasms and adenomatous polyps based on the current literature. We will also explore the connection and the missing links between NAFLD and extrahepatic cancers. Interestingly, any relationship between NAFLD and extrahepatic malignancies could be attributable to several shared metabolic risk factors. Overall, obesity, insulin resistance, metabolic syndrome, and related disorders may increase the risk of developing cancer. Therefore, early diagnosis of NAFLD is essential for preventing the progression of the disease and avoiding its severe complications. In addition, cancer screening and early detection in these patients may improve survival and reduce any delays in treatment.

16 August 2024 in Diagnostics
Verified
Journal Article
Open access
PDF file
KSKONSTANTINOS STEFANIDIS
KONSTANTINOS STEFANIDIS
GYGibran Yusuf
Gibran Yusuf
Francesk MulitaFrancesk Mulita
Francesk Mulita
CTChristos Tsalikidis
Christos Tsalikidis
AMAthanasia Mitsala
Athanasia Mitsala
MDMarios Platon Dimopoulos
Marios Platon Dimopoulos
Extraosseous plasmacytomas (EPs) are rare neoplasms originating from plasma cells, often associated with multiple myeloma. EPs are classified into three subtypes: extramedullary myeloma, solitary extramedullary plasmacytoma (SEP), and multiple solitary plasmacytomas. They can manifest in various anatomical sites, including the lung, mediastinum, breast, liver, pancreas, stomach, mesentery, kidney, small and large bowel, testis, and soft tissue. Despite their rarity, EPs present a diagnostic challenge due to their non-specific imaging appearances, which can mimic other neoplastic and inflammatory conditions. This review aims to describe the radiographic features of EPs in the chest, abdomen, and pelvis based on a thorough analysis of the existing literature. While imaging plays a crucial role in the detection and characterization of EPs, histological confirmation is necessary to differentiate them from other neoplastic entities. The review underscores the importance of considering EPs in the differential diagnosis, particularly in patients with a history of multiple myeloma. Understanding the imaging characteristics of EPs is essential for accurate diagnosis and appropriate management. Early imaging is crucial in these patients to exclude the possibility of EP, as timely diagnosis can significantly impact patient outcomes.

18 September 2023 in Journal of Clinical Medicine
Verified
Journal Article
Open access
PDF file
CTChristos Tsalikidis
Christos Tsalikidis
AMAthanasia Mitsala
Athanasia Mitsala
GPGeorgios Pappas-Gogos
Georgios Pappas-Gogos
KRKonstantinos Romanidis
Konstantinos Romanidis
ATAlexandra K. Tsaroucha
Alexandra K. Tsaroucha
MPMichail Pitiakoudis
Michail Pitiakoudis
Focal nodular hyperplasia (FNH) is the second most common benign hepatic tumor and can rarely present as an exophytic solitary mass attached to the liver by a stalk. Most FNH cases are usually detected as incidental findings during surgery, imaging or physical examination and have a high female predominance. However, the pedunculated forms of FNH are particularly rare and commonly associated with severe complications and diagnostic challenges. Hence, our study aims to provide a comprehensive summary of the available data on the pedunculated FNH cases among adults and children. Furthermore, we will highlight the role of different therapeutic options in treating this clinical entity. The use of imaging techniques is considered a significant addition to the diagnostic toolbox. Regarding the optimal treatment strategy, the main indications for surgery were the presence of symptoms, diagnostic uncertainty and increased risk of complications, based on the current literature. Herein, we also propose a management algorithm for patients with suspected FNH lesions. Therefore, a high index of suspicion and awareness of this pathology and its life-threatening complications, as an uncommon etiology of acute abdomen, is of utmost importance in order to achieve better clinical outcomes.

16 November 2024 in Journal of Clinical Medicine
Verified
Journal Article
Open access
PDF file
SDSpyridon Davakis
Spyridon Davakis
DZDimitrios C Ziogas
Dimitrios C Ziogas
PPPavlos Papadakis
Pavlos Papadakis
SSStratigoula Sakellariou
Stratigoula Sakellariou
AMAthanasia Mitsala
Athanasia Mitsala
ACAlexandros Charalabopoulos
Alexandros Charalabopoulos
Background/Objectives: Esophagectomy is the mainstay of treatment in esophageal cancer. Minimally invasive esophagectomy (MIE) remains a challenging procedure and has been associated with a high rate of complications and mortality. Routine lymphadenectomy includes two-field lymphadenectomy for distal-esophageal or gastroesophageal junction Siewert I–II tumors. Superior mediastinal lymphadenectomy (SML) refers to an extended two-field lymphadenectomy or total mediastinal lymphadenectomy during MIE for cancer. The exact benefits of SML have been the subject of prolonged debate, with no conclusive evidence indicating improved clinical and oncological results. Herein, we aim to present our surgical technique of thoracoscopic SML during MIE in the prone position, with short-term clinical and oncological outcomes. Methods: About 150 consecutive patients underwent totally MIE within 3 years period (2016–2019). SML included right-paratracheal nodes and nodes along the right-recurrent laryngeal nerve throughout its mediastinal route in cases of extended two-field lymphadenectomy, as well as left-paratracheal nodes and nodes along the left recurrent laryngeal nerve during total mediastinal lymphadenectomy. Eligible patients underwent SML during two-stage or three-stage MIE. Results: Twenty consecutive patients underwent SML during the study period. The 30- and 90-day mortality rates were 0. Pulmonary complications were observed in 16.5% of the patients. There was 1 right recurrent laryngeal nerve palsy noted. The median length of stay was 9 days. The median number of resected lymph nodes was 45, with the median SML nodes count being 8. The median follow-up was 24 months. Conclusions: SML during prone position thoracoscopy for esophageal cancer is safe and feasible, although technically demanding. Minimally invasive esophagectomy with SML may offer meaningful benefits in oncological outcomes without introducing additional significant morbidity. Further comparative studies are needed to better elucidate our results.