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3. Christakis C, Christakis E, Karanikas M. Creation of a permanent colostomy with the use of an

intraluminal stapler device. Surg Technol Int. 2005;14:171-5. PMID: 16525970 [PubMed]
[Scopus]

Abstract: We present our experience with the use of the intraluminal stapler device for the

purpose of creating of a permanent dermal colostomy in patients requiring acute emergency
operations and for regularly scheduled procedures. The advantages of this method for

surgeons who use stapling devices are controlled safety of the colostomy, reduced operation
time, and the creation of a stable diameter of the colostomy. Furthermore, this method can be
used in patients where a secondary operation is needed due to shrinkage or stricture of the

primary colostomy during the first operation. This method has now been used in our clinic for

five years with excellent results. All patients, including those having procedures related to
colon cancer, are placed on a follow up protocol for three years and are closely monitored.
This protocol has allowed us to closely follow these patients and any related complications

such as stricture, stenosis, prolapse, in situ hernia, and ecstomosis.

4. Efremidou El, Liratzopoulos N, Papageorgiou MS, Karanikas M, Pavlidou E, Romanids K,

Manolas KJ. Peptic ulcer perforation as the first manifestation of previously unknown primary
hyperparathyroidism. Case Rep Gastroenterol. 2007 Jun 22;1(1):21-6.DOI:
10.1159/000104224 PMID: 21487467 [PubMed]

Abstract: A patient admitted for acute abdomen was incidentally found with elevated serum

calcium level. In surgery, under conservative treatment of the hypercalcemia, a perforated
duodenal ulcer was found and simple closure was performed. Postoperatively, calcium level

continued to rise, parathyroid hormone was elevated and ultrasonographic examination
showed a lesion in the right anterior neck, while serum gastrin level was normal, thus

documenting the diagnosis of primary hyperparathyroidism. Conservative treatment had no
effect on calcium level and the patient was subjected to emergency neck exploration, where a

large parathyroid adenoma was removed. After surgery, calcium and PTH levels were
normalized and the patient was discharged on the 5th postoperative day. Peptic ulcer and its

complications are usual manifestations of primary hyperparathyroidism, with or without
increased gastrin level. On the other hand, cases of a perforation of peptic ulcer as the first

clinical manifestation of primary hyperparathyroidism are extremely rare.

5. Kakagia DD, Kazakos KJ, Xarchas KC, Karanikas M, Georgiadis GS, Tripsianis G, Manolas C.
Synergistic action of protease-modulating matrix and autologous growth factors in healing of

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