Day 1 :
Keynote Forum
Carlo Staudacher
Vita-Salute San Raffaele University, Italy
Keynote: Multivisceral resection in digestive tract surgery
Time : 09:30
Biography:
Carlo Staudacher has obtained degree in Medicine at the University of Milan, Italy. He was the Director of the Department of Surgery of San Raffaele Hospital in Milan and Full Professor of Surgery at Vita-Salute San Raffaele University, Italy.
Abstract:
In patients with apparent locally advanced digestive tract cancer Multivisceral Resection (MVR) offers the possibility of cure. The results reported in the literature were analyzed in this study. In locally advanced gastric cancer patients the prognosis is very poor and the role of MVR is still debated. Many studies reported high rate of morbidity and mortality and no significant increase of survival rate. An Italian multicentre observational study, including 2208 patients, demonstrated that multivisceral resection of advanced gastric cancer have an acceptable morbidity and mortality rate when a complete resection can be performed and when there is limited lymph node metastasis. When a colon cancer has adhesions with other organs, it is not possible to state for sure if there is a cancer infiltration or only an inflammatory reaction. The dissection of the adhesions exposes to high probability to disseminate cancer cells in surgical field and reduce survival time of patient. Because of that in these cases a MVR should be performed. In locally advanced rectal cancers (cT4) an actual invasion may be observed in 30-50% of cases. A MVR should be performed in order to obtain R0 circumferential margin and to preserve the integrity of the mesorectal fascia. In locally advanced rectal cancers MVR do not alter the rates of sphincter saving, morbidity and mortality when is performed in a high-volume hospital but significantly decreases pelvic relapse.
Keynote Forum
Ergun Demirso
Kolan International Hospital, Turkey
Keynote: Surgical treatment of atrial fibrillation: Today’s questions and answers
Biography:
Dr. Demirsoy, has completed his PhD from Karadeniz Technical University and postdoctoral studies from Istanbul University, School of Medicine. He is the director of Cardiovascular Surgery at International Sisli Kolan Hospital, Istanbul - Turkey. He has published more than 38 papers in reputed journals and has been serving as an board member and cardiac councilor of European Society of Cardiovascular Surgeons (ESCVS).
Abstract:
Atrial Fibrillation (AF) is the most common cardiac arrhythmia, characterized by chaotic electrical activity and the lack of coordinated contractions in the atria. AF can cause significant morbidity and mortality including stroke and heart failure. The goal of AF therapy is to achieve a return to permanent sinus rhythm. Medical treatment is accompanied with serious drug side effects and often fails to completely preclude complications of AF. Classic cut and sew procedure Cox-Maze did not gain widespread acceptance due to complexity and technical difficulty. There are alternative techniques using various energy sources in an effort to make Cox-Maze procedure technically simpler and faster to perform. The main idea is to create lines of intra-atrial conduction block that will stop macro-reentrant electrical circuits in the atria, isolate the trigger or triggers for AF originating near the pulmonary vein orifices or accomplish both and allow the atria to resume a sinus rhythm. Radiofrequency, cryotherapy and ultrasound waves are the most common sources of energy employed in clinical use of treatment of AF. These energy sources rely on energy sources to create long, continuous, linear lesions that block conduction. They differ mainly in the way by which they transfer energy to the tissue and how deep that energy is conducted into the tissue. There are some important questions we have to answer when we are considering to treat a patient with AF, they are: Which patients benefit most? How much important does the preoperative AF triggers localization? Should we consider hybrid procedures? What is the optimal ablation approach? What are the choices of the lesion set? Which energy source alternative should we use? In future; answering these questions and better understanding of AF will bring successful ablation modalities to AF patients.
Keynote Forum
Baris Cankaya
Marmara University Pendik Training Hospital, Turkey
Keynote: Anesthesia and cancer: Making decision for the patient with during anesthesia
Biography:
Baris Canaya is an Anesthesiologist at Marmara University Pendik Training Hospital in Istanbul, Turkey. He has deep interest for resuscitation, acute critical illness, trauma anesthesia, pediatric congenital cardiovascular anesthesia and perioperative patient safety.
Abstract:
Cancer is a leading health problem worldwide. Anesthesiology and the oncology are two disciplines caring for the patients. Performing anesthesia for the oncologic patient evolves as our knowledge about the cancer cells is growing rapidly. The effect of the anesthetic drug on development of the cancer cell and its sequences on the patient are new controversies. Anesthesia can affect cancer recurrence in cancer patients, due to immunosuppression, stimulation of angiogenesis and dissemination of residual cancer cells. Anesthetic decision affects long-term cancer outcomes. It has been advised that some techniques help reducing cancer recurrence risk. These are regional anesthesia, adjuvants for reducing anesthetic dose, and TIVA against inhalational anesthetics. Anesthetic drugs also interact with chemotherapy drugs. The patient may experience pulmonary edema, cardiac arrhythmias, coagulopathy, and peripheral neuropathy perioperatively. Immunomodulation is an important mechanism during cancer development. Opiods, blood transfusions effects immunomodulation. Anesthesia for the patient with cancer undergoing an oncologic surgery or a non-oncologic surgery will require critical decisions perioperatively. Clinical trials will help us to know about the influence of anesthesia on the cancer patients.