We aim to offer a complete view on the actual knowledge about NAFLD and NASH, by an extensive review of the literature.

Minimally invasive surgery has gained a major role in the current management of colorectal disease since the introduction of laparoscopy in the early 1990s for colorectal procedures. The laparoscopic approach, in fact, is not exempt from the risk of intraoperative complications, some of which can occur outside the field of view. Aim of this chapter is to review the different types of complications that can happen during left colectomy, analyzing the causes, how to prevent them and what to do in case they occur.

A literature search was carried out using the MEDLINE and PubMed databases for studies published between January 1980 and October 2020. The following terms were used for the search complications, risk factors, colorectal surgery, colorectal resection, laparoscopy, left colectomy, intraoperative complications, splenic injury, intraoperative bleeding.

From our literature search we identified twenty-four studies, including two systematic reviews and metanalyses, that were the most pertinent to the subject.

Many different complications can occur during laparoscopic left colectomy. Maintaining control of the situation is important to provide a prompt solution to the occurred injury. Increasing the reporting rate of complications may help, in the future, to analyze the causes and improve management strategies, keeping in mind that the only surgeon who does not have complications is the one who does not operate.

Many different complications can occur during laparoscopic left colectomy. Maintaining control of the situation is important to provide a prompt solution to the occurred injury. Increasing the reporting rate of complications may help, in the future, to analyze the causes and improve management strategies, keeping in mind that the only surgeon who does not have complications is the one who does not operate.

Aim is to report our experience in the management of complications after laparoscopic left hemicolectomy (LLH) after the incorporation in our clinical practice of intraoperative indocyanine green (ICG) fluorescence angiography (FA).

In our last period after incorporation of ICG-FA, 277 unselected consecutive patients underwent laparoscopic colorectal surgery with this technology. Ropsacitinib Ninety-seven (35%) right hemicolectomy, 19 segmental resection of the splenic flexure (6.9%), 54 anterior resection of the rectum (19.5%) and 107 LLH (38.6%) were performed. Complications were graded according to Clavien-Dindo classification, and anastomotic leakages (AL) were graded according to Clavien-Dindo classification and to International Study Group of Rectal Cancer (ISGRC) classification.

Eight surgical and one medical complications (8.4%) were observed. Two AL occurred (1.9%). One drained spontaneously by drainage placed intraoperatively (Clavien-Dindo I, ISGRC A) and one treated by laparoscopic peritoneal lavage, lea of these patients proved to be safe and effective due to in all cases the complication has been resolved. Further studies are required to standardize the management of these patients.

During the last decade, numerous therapeutic regimes were assessed to improve the outcome of patients with esophageal carcinoma. We analyzed the impact of therapy alterations, including the establishment of a standardized clinical pathway and the introduction of an interdisciplinary tumor conference on the outcome of patients undergoing esophagectomy because of esophageal cancer.

Three hundred one patients were included (204 adenocarcinoma and 97 squamous cell carcinoma) who underwent an esophagectomy between 2006 and 2015. Patients were divided into 3 groups interval A (2006-2008), interval B (2009-2011) and interval C (2012-2015) and evaluated separately focusing on therapy management and patients’ outcome.

Over the time periods, the incidence of tumor entity of adenocarcinoma increased from 61% to 76.2% (P=0.059). Patients with an initial tumor stage uT1 increased significantly from 4% to 15.9% over the intervals (P=0.002), while positive nodal involvement remained comparable (P=0.237). Patients in t cancer has changed over the last decade. Continuous further developments of the therapy regimes are needed to meet the requirements of reducing perioperative mortality and extending survival time.Some of the ethically most sensitive issues in radiation protection arise at imaging of pregnant-and potentially pregnant-patients and of newborn. This article reviews the current literature and recommendations on imaging during pregnancy and breastfeeding. Risks related to alternative non-ionizing radiation methods are also considered. With few exceptions, exposure of the fetus through radiography, computed tomography (CT) and nuclear medicine imaging can be limited to safe levels, although studies such as abdominal-pelvic CT cannot avoid significant exposure to fetuses. Eight to 10 weeks post-conception, the fetus has a thyroid which starts to concentrate iodide having crossed the placenta barrier resulting in unacceptably high doses to the fetal thyroid after administration of 131I- and even 123I-iodide and other radiopharmaceuticals with a high content of free radioiodine. Many radiopharmaceuticals are excreted through breast milk. Breastfeeding interruption recommendations should be followed to keep the effective dose to the infant below 1 mSv.Emergent scientific evidence indicates the central role of cancer-associated fibroblasts in determining whether the microenvironment of cancer works as friend or foe of the host; however, there is no unified histological evaluation framework of fibrotic stroma in colorectal cancers. Myxoid stroma and keloid-like collagen are site-specific histopathological features generated by cancer-associated fibroblasts, which appear exclusively in the tumor front during desmoplastic reaction. On the basis of these two stromal components, desmoplastic reaction is categorized into three patterns-immature, intermediate and mature-using hematoxylin and eosin staining. In January 2020, a prospective randomized clinical trial, JCOG1805, to elucidate the value of adjuvant chemotherapy in stage II colorectal cancer patients with pathological risk factors of recurrence was launched in Japan, in which intermediate/immature desmoplastic reaction is one of the four risk factors selected as inclusion criteria. This paper covers the diagnostic criteria for the desmoplastic reaction classification being used in the JCOG1805 study.