The effect of Bosentan on healing of colonic anastomosis

BACKGROUND: Ischemia is the most important factor compromises wound healing in colonic anastomosis. Mesenteric vessels are ligated at first while performing colonic resection and following anastomosis. Therefore blood supply of the related segments of colon temporarily interrupted and ischemia can easily occur. This study was carried out to explore whether Bosentan, an endothelin-receptor antagonist, can eliminate vasoconstruction, increase blood flow in the splanchnic area and anastomotic region and therefore possibly facilitate wound healing and prevent intra-abdominal adhesion formation. METODS: Study is conducted on 30 female Wistar-Albino rats weighing 180–240 gr. Rats were allocated into three groups. Group 1 (n = 10) recevied full-thickness resection of the left colon and end-to-end anastomosis. In Groups 2 (n = 10) and 3 (n = 10), vessels of 2–3 cm segment of the left colon were ligated, indications of necrosis of that segment were expected, followed by resection and end-to-end anastomosis. Two milliliter of saline and 5 mg/kg Bosentan was given intraperitoneally in Group 2 and 3, respectively. On postoperativ day 6, intra-abdominal adhesions were scored. Healing of anastomosis, anastomotic bursting pressures, tissue hydroxyproline levels and histopatologically healing scores were assessed. RESULTS: Macroscopic adhesion score in Group 3 was lower than the remained groups (p < 0.05). Tissue hydroxyproline levels were significantly higher in Group 3 compared to the Groups 1 and 2 (p < 0.001). Mean anastomotic bursting pressures were 200 mmHg, 164 mmHg and 240 mmHg in Groups 1, 2 an 3, respectively (p < 0.05 between Groups 1 and 3; p < 0.001 between Groups 2 and 3). Histopathologically, healing scores of Group 1 were significantly higher than the other groups (p < 0.05 group 1–3, group 2–3). CONCLUSION: Bosentan increases anastomotic healing of ischemic colonic anastomosis and decreases intra-abdominal adhesion formation

The Effect of Antivascular Endothelial Growth Factor on the Development of Adhesion Formation in Laparotomized Rats: Experimental Study

Aims. This study determined the effects of a single dose of bevacizumab, an antiangiogenic recombinant monoclonal antibody that specifically targets vascular endothelial growth factor (VEGF), on adhesion formation in the rat cecal abrasion model. Methodology. Thirty female Wistar albino rats (200–224 g) were divided into three groups. All rats underwent laparotomy at which time cecal wall abrasion and abdominal wall injuries were induced. Group I (control) underwent only the abrasion procedure; Groups II and III received saline or bevacizumab intraperitoneally, respectively, following the abrasion. The rats were killed on postoperative day 7, and the severity of adhesions was evaluated, together with histopathological fibrosis parameters and immunohistochemical staining to identify the VEGF receptor. Results. The mean adhesion severity score in Groups I–III was 2.5 ± 0.52, 2.4 ± 0.69, and 0.7 ± 0.82, respectively; the score in Group III was significantly lower than that in Groups I (P < 0.001) and II (P < 0.001). In the histopathological evaluation, the mean fibrosis score in Group III was significantly lower that the scores in Groups I (P < 0.001) and II (P < 0.001). VEGF staining of the adhesion areas in Group III was significantly lower than that in Groups I (P < 0.001) and II (P < 0.001). Conclusion. Bevacizumab decreases adhesion formation following laparotomy in rats by blocking VEGF receptor occupancy

Effects of endobag usage on port site infections in acute cholecystitis

Objectives: To find out the usage of endo-bag technique whether has an effect on port site infection in which the gallbladder is removed out within the patients of laparoscopic cholecystectomy for acute cholecystitis.Materials and methods: A total of 30 cases with acute cholecystitis underwent laparoscopic cholecystectomy by the same surgeon in Fırat University Medical School Hospital were evaluated. Endobag was used in 15 patients and 15 patients were included as control group. All the patients were observed in terms of port site infection after removal of gallbladder in postoperative period.Results: There were no wound infection in which endobag was used, but 3 patients of the control group had port site infection.Conclusion: There were no significant effect of using endo-bag among acute cholcystitis patients underwent laparoscopic chelcystectomy on the port site infection which gall bladder is removed ou

Management of anesthesia in unspecified extra-adrenal pheochromocytoma patient who used beta-blocker

An operation was planned for a female patient aged 59 for intra-abdominal mass. The patient was using nebivolol for hypertension. Blood pressure (BP) of the patient was raised to 200/130 mmHg during anesthesia induction. BP was gradually reduced by remifentanil infusion. Following the manipulation of the mass, BP began to increase (225/160 mmHg), thus nitroglycerin and followed nitroprusside infusion was started. Propofol (200 + 200 mg) and furosemide (20 mg) were administered intravenously. BP suddenly dropped (90/60 mmHg) following the removal of the mass, nitroglycerine, and nitroprusside infusions were stopped; remifentanil dose was decreased and fluid was quickly infused. The patient was uneventually recovered. Vanilmandelic acid level was higher in the patient and pheochromocytoma was considered

Hylan GF-20 and methyl-prednisolone’s effects on adhesion formation in rats underwent laparotomy

İstanbul Bilim Üniversitesi, Tıp Fakültesi.Amaç: Bu çalışmada Hylan GF-20 ve metil-prednizolonun laparotomi yapılan ratlarda yapışıklık oluşması üzerine etki gösterip göstermeyeceklerinin incelenmesi amaçlanmıştır. Gereç ve Yöntem: Kırk adet rat 4 gruba ayrılıp çekum ön duvarında 1 cm2'lik alanda steril gazlı bezle abrazyon oluşturuldu. Birinci gruptaki ratlara herhangi bir ilaç verilmez iken, 2. gruptakilere intraperitoneal 1 cc %4 Hylan GF-20 solüsyonu, 3. gruptakilere intraperitoneal 10 mg/kg metil prednizolon 4. gruptakilere intraperitoneal 1 cc %4 Hylan GF-20 solüsyonu + 10 mg/kg metil prednizolon verildi. Yedi gün sonra, grupları bilmeyen bir incelemeci tarafından daha önceki kesi hattı dışından tekrar laparotomi yapılarak kesi hattına ve çekuma olan yapışıklıklar değerlendirildi.Objective: In this study we aimed to investigate if Hylan GF-20 and methyl-prednisolone will effect upon the formation of adhesions in rats underwent laparotomy. Material and Method: Forty rats were divided into 4 groups and abrasion was created with sterile gauze at 1 cm2 area on the anterior wall of the cecum. In the first group, while the rats not given any drug, in the second group 1 cc of 4% solution of Hylan GF-20, in the third group 10 mg / kg methyl prednisolone and in the fourth group 1 cc %4 Hylan GF-20 solüsyonu +10 mg / kg methyl prednisolone 10 mg / kg methyl prednisolone were given intraperitoneally. Seven days later, adhesions with incision line and cecum were evaluated by an investigator blinded to group by doing again laparotomy outside earlier incision line

Prognostic factors in colorectal cancers

Objective: The aim of this study is to investigate retrospectively the impact of the various prognostic factors on survival in patients with colorectal cancer. Methods: The clinical records, pathology and operation reports of 126 patients in 154 patients operated for colorectal cancer General Surgery Clinic of Fırat University Hospital between 1994 and 2005 years. The effects of the prognostic factors on 2-years, 5-years and 10-years survival, overall survival (OS) and disease-free survival (DFS) were evaluated. The survival durations are presented as months. Results: The mean age was 57.5 ± 15.2. The median duration of follow-up was 44,5 month. The median OS was 60 months. The median DFS in stage I-III patients was 62 months. According to the univariate analysis, the factors found significant in both OS and DFS rates were the following; stage of the cancer, extent of bowel wall penetration, lymph nodes metastasis, distant metastasis, pathologic stage, surgical margin, pretreatment CEA levels and type of surgery. The age and histologic type of tumor were related to only OS. The following variables were independent prognostic factors for both OS and DFS as determined by multivariate analysis; stage of the cancer, extent of bowel wall penetration and distant metastasis. Conclusion: A large number of prognostic factors are available to help predict the outcome of patients with colorectal cancer after surgery. In order to predict survival more accurately, a scoring system can be created that involving not only prognostic factors determined by multivariate analysis, but also prognostic factors determined by univariate analysis

Effects of Copper, Zinc, and Vitamin Complex (Cernevit (R)) on Hepatic Healing in Rats Experimentally Subjected to Blunt Hepatic Trauma

WOS: 000371618600058PubMed ID: 27011508Solid organ injuries following blunt trauma are frequently encountered. The use of non-operative approach is gradually increasing. Thus, research on the methods that could enhance healing in solid organ injuries is in progress. Agents known to have antioxidant property were used after an experimentally induced blunt hepatic trauma. Thirty-two Wistar albino rats weighing 200 g were dropped from a height of 40 cm on to the right upper abdominal quadrant to produce a grade II-III hepatic injury. Rats were divided into control, Zn-administered, Cu-administered, and vitamin complex-administered groups, with eight rats in each. Aminotransferase (AST), alanine aminotransferase (ALT), and lactate dehydrogenase (LDH) levels were measured in the blood samples. The percentage of cells displaying Ki-67 nuclear staining was estimated. The sections were stained with hematoxylin and eosin and the degree of inflammation in the samples was semi-quantitatively assessed. Treatment with zinc, copper, and Cernevit (R) caused varying levels of decrease in AST, ALT, and LDH levels compared to the control group. Ki-67 positivity was significantly lower in group I compared with groups II and III (p=0.002). Ki-67 positivity was significantly higher in group II compared to the other groups (p<0.05). A marked improvement was observed in inflammation in group II. Copper and zinc treatment decreased inflammation as well as blood levels of AST and ALT, and enhanced the healing of traumatized hepatic tissue. However, Cernevit (R) reduced only the degree of inflammation