27 research outputs found
Robotic surgery for rectosigmoid junction tumor with ovarian metastases
Isolated ovarian metastases from colorectal cancer (CRC) are rare
disease presenting in approximately 3\% of all patients undergoing
colorectal resection. Most reports describe an open approach to the
disease, but we report a case isolated ovarian metastases from CRC
managed completely by robotic technique. A 54-year-old female, with a
family history of CRC, was admitted for rectosigmoid junction cancer.
Computed tomography scan demonstrated in rectosigmoid tumor and pelvic
mass, presumed as teratoma. Robotic surgery discovered a 10-cm
encapsulated tumor, attached to the left ovary, with no macroscopic
peritoneal involvement. The pathologic diagnosis of the resected pelvic
mass, ovarian metastases from CRC. Robotic anterior resection was
performed. Operative time was lasted 165 min, considering 25 min for
robotic system set up. This is the first report to describe
robot-assisted anterior resection and oophorectomy in patient with
isolated ovarian metastases from rectosigmoid junction cancer
Robotic Versus Laparoscopic Resection for Mid and Low Rectal Cancers.
The current study was conducted to determine whether robotic low anterior resection (RLAR) has real benefit over laparoscopic low anterior resection (LLAR) in terms of surgical and early oncologic outcomes
Laparoscopic versus Open Surgery for Colorectal Cancer: A Retrospective Analysis of 163 Patients in a Single Institution
Background. The present study aimed to compare the clinical outcomes of laparoscopic versus open surgery for colorectal cancers.
Materials and Methods. The medical records from a total of 163 patients who underwent surgery for colorectal cancers were retrospectively
analyzed. Patient’s demographic data, operative details and postoperative early outcomes, outpatient follow-up, pathologic results,
and stages of the cancer were reviewed from the database. Results. The patients who underwent laparoscopic
surgery showed significant advantages due to the minimally invasive nature of the surgery compared with those who underwent open
surgery, namely, less blood loss, faster postoperative recovery, and shorter postoperative hospital stay (P0.05). Open surgery resulted in more incisional infections and postoperative ileus compared with laparoscopic surgery (P<0.05). There were no differences in the pathologic parameters between two groups (P<0.05). Conclusions. These findings indicated that laparoscopic surgery for colorectal cancer had the clear advantages of a minimally invasive surgery and relative disadvantage with longer surgery time and exhibited similar pathologic parameters compared with open surgery
Administration of Ginkgo biloba Extract (EGb761) Alone and in Combination with FK506 Promotes Liver Regeneration in a Rat Model of Partial Hepatectomy
Background: Free radical damage is known to occur during liver regeneration. The Ginkgo biloba extract EGb761 has antioxidant properties due to its ability to scavenge free radicals. FK506 has been widely used as an immunosuppressant that stimulates hepatocyte proliferation following partial hepatectomy
Portosystemic shunt prevents apoptosis in rat intestinal mucosa caused by total hepatic ischemia
Background: Prolonged splanchnic congestion due to total hepatic ischemia (THI) has been shown to induce damage to the intestinal mucosa. The present study was conducted to examine whether the protective effect of portosystemic shunt (PSS) can be seen on apoptosis of intestinal mucosa in a rat model of THI. Methods: Adult male Wistar rats were divided into the following 3 groups: control group; the THI group underwent THI for 30 min, and the PSS group was subjected to THI for 30 min with PSS. Rats were killed after 1, 2, and 6 h of reperfusion. For each time point, levels of serum liver enzymes, intestinal morphology, malondialdehyde (MDA) contents and DNA fragmentation in intestinal tissue were determined. In addition, the 7-day survival rate was measured. Results: The 7-day survival rate of THI group remained at 50%, whereas that of PSS group was significantly higher at 90% (p < 0.01). Serum AST and ALT levels of the THI and PSS groups rapidly increased after reperfusion, reaching peak values at 2 h. MDA levels after 1 and 2 h of reperfusion in the THI group were significantly increased as compared with the control group p < 0.001). Increases in the percentage of fragmented DNA peaked 1 h after reperfusion in the THI group. PSS resulted in the reduction of DNA fragmentation and preserved the macroscopic and microscopic appearance of the intestinal mucosa. Conclusions: Splanchnic congestion due to portal occlusion increased apoptosis in the rat intestinal mucosa. PSS is very effective in counteracting the principal negative effects of total hepatic ischemia. Copyright (C) 2004 S. Karger AG, Basel
Role of granulocyte-macrophage colony-stimulating factor on apoptosis induced by ischemia-reperfusion in the intestinal epithelium
Background. To evaluate the effect of granulocyte-macrophage colony-stimulating factor (GM-CSF) on ischemia-reperfusion-induced apoptosis in the intestinal epithelium. Methods: In this study, 50 male Wistar albino rats were used. After midline laparotomy superior mesenteric artery (SMA) was identified only in the sham group, while 60 min of ischemia and 2 h of reperfusion were performed in the control group. In the treatment groups, after 15, 30 and 60 min of ischemia, respectively, 1 mug/kg GM-CSF was administered subcutaneously, followed by 2 h of reperfusion. Malondialdehyde (MDA), campothecin (CAM), an indicator of DNA fragmentation, and histopathology were evaluated in the intestinal mucosa. Results: Tissue MDA levels were found significantly high in all groups at various times of ischemia and 2 h of reperfusion compared with the sham group (p < 0.001). Administration of GM-CSF following 60 min of ischemia caused a significant increase in the MDA levels compared with the control group (6,430 +/- 725 vs. 4,174 +/- 565 nmol/g protein for jejunum. 7,576 +/- 618 vs. 4,938 +/- 809 nmol/g protein for ileum, p < 0.05). Intestinal ischemia and reperfusion resulted in a significant increase in tissue CAM levels (p < 0.05). The highest CAM value was found in the group in which 60 min of ischemia and 2 h of reperfusion were performed (50 +/- 3.2 ng/ml for jejunum, 52.8 +/- 2.7 ng/mg for ileum). Compared with the control group, GM-CSF administration following 1 h of ischemia aggravated the tissue injury. Conclusions: Apoptosis was induced in the small intestine by ischemia-reperfusion. GM-CSF increased the apoptosis of intestinal epithelial cells and exacerbated mucosal injury due to ischemia-reperfusion. Copyright (C) 2003 S. Karger AG, Basel
Administration of Ginkgo biloba Extract (EGb761) Alone and in Combination with FK506 Promotes Liver Regeneration in a Rat Model of Partial Hepatectomy
Background: Free radical damage is known to occur during liver
regeneration. The Ginkgo biloba extract EGb761 has antioxidant
properties due to its ability to scavenge free radicals. FK506 has been
widely used as an immunosuppressant that stimulates hepatocyte
proliferation following partial hepatectomy.
Aims: To explore whether EGb761 enhances liver regeneration after
hepatectomy in rats, we investigated the effects of EGb761 alone and in
combination with FK506 on the liver regenerative process.
Study Design: Animal experimentation.
Methods: A total of 75 Wistar albino rats weighing 340.08 +/- 11.66 g
were randomly divided into five experimental groups: sham, control,
FK506, EGb761, and FK506 + EGb761. According to the study groups, rats
were administered FK506 at a dose of 0.1 mg/kg/day and EGb761 at 25
mg/kg/day three times via the intraperitoneal route. Then, two-thirds
hepatectomy was performed according to the Higgins and Anderson
technique in all the rats. At postoperative 48 h, 53 surviving rats were
sacrificed. Serum and plasma samples were collected for analyzing
thymidine kinase and oxidative stress marker levels. The regenerated
liver was entirely resected, weighed, and sectioned. The mitotic index
was assessed using hematoxylin-eosin staining. The extent of liver
regeneration was calculated using the Child's formula. The data were
statistically analyzed using ANOVA, with a significance level of 5\%
(p<0.05).
Results: Rats who received EGb761 showed significantly higher levels of
liver regeneration than those who received FK506 or FK506 + EGb761
(p<0.01). Thymidine kinase level and mitotic index were significantly
higher in the EGb761 (p<0.005) and FK506 (p<0.05) groups than in the
control and sham groups. In addition, the liver regeneration percentage
was significantly higher in the EGb761 group than in the FK506 group
(p<0.01). Myeloperoxidase and malondialdehyde levels were significantly
correlated between the EGb761 and FK506 groups, even at lower levels in
the EGb761 group (p<0.001).
Conclusion: EGb761, which is an antioxidant, reduces liver damage and
stimulates liver regeneration following partial hepatectomy in rats
through its anti-inflammatory and antioxidative effects
A Novel Technique for Duodenal Resection and Primary Anastomosis With Robotic Assistance and OrVil
Background and Objectives: Benign duodenal neoplasm is a rare
occurrence. Minimally invasive tumor resection and anastomosis formation
with an OrVil catheter is a novel approach to treating this disease. In
this article, we present a new technique for duodenojejunal anastomosis.
This technique was applied in 4 patients with benign distal duodenal
tumors who were treated with minimally invasive surgery with robotic
assistance.
Methods: In 4 patients, after the removal of distal duodenal masses with
a robotic technique, an orifice in the duodenum was opened to allow for
the passage of a guidewire. The guidewire was removed from the orifice
by holding it with forceps during an upper endoscopy. An OrVil catheter
was sutured to the guidewire outside to allow 2 catheters to proceed
consecutively. After the removal of the anvil, an end-lateral
duodenojejunostomy was performed with a circular stapler.
Results: The patients included 3 men and 1 woman (average age, 56). The
durations of the operations were 215, 175, 180, and 185 minutes. No
complications were observed in any of the patients during the
postoperative period. The patients began oral intake on the fifth day of
the postoperative period, and they were discharged on the sixth
postoperative day. Histopathologic analyses indicated that the removed
tumors were adenomas in 2 patients and gastrointestinal stromal tumors
(GISTs) in 2 patients. Clear surgical margins were observed in all of
the patients.
Conclusion: The placement of an OrVil catheter for anastomosis in benign
neoplasms with distal duodenum localization and the subsequent
achievement of duodenojejunal anastomosis with a circular stapler
constitute a novel treatment approach
Sevoflurane exerts brain-protective effects against sepsis-associated encephalopathy and memory impairment through caspase 3/9 and Bax/Bcl signaling pathway in a rat model of sepsis
Objective We compared the effects of sevoflurane and isoflurane on
systemic inflammation, sepsis-associated encephalopathy, and memory
impairment in a rat sepsis model of cecal ligation and puncture
(CLP)-induced polymicrobial peritonitis.
Methods Twenty-four rats were assigned to sham, CLP, CLP+sevoflurane,
and CLP+isoflurane groups. At 72 hours after CLP, the rats underwent
behavior tests. Serum cytokines were evaluated. Brain tissue samples
were collected for determination of glutathione peroxidase (GPX),
superoxide dismutase (SOD), and catalase; the wet/dry weight ratio;
myeloperoxidase (MPO) and malondialdehyde (MDA); apoptotic gene release;
and histologic examinations.
Results The MPO level, wet/dry weight ratio, and histopathology scores
were lower and the Bcl2a1 and Bcl2l2 expressions were upregulated in
both the CLP+sevoflurane and CLP+isoflurane groups compared with the CLP
group. The interleukin-6, interleukin-1, MDA, and caspase 3, 8, and 9
levels were lower; the GPX, SOD, Bax, Bcl2, and Bclx levels were higher;
and non-associative and aversive memory were improved in the
CLP+sevoflurane group compared with the CLP+isoflurane group.
Conclusion Sevoflurane decreased apoptosis and oxidative injury and
improved memory in this experimental rat model of CLP. Sevoflurane
sedation may protect against brain injury and memory impairment in
septic patients