The healing effects of the topical mesenchymal stem cells application on colonic anastomosis subjected to ischemia reperfusion injury

Intestinal ischemia reperfusion injury (IRI) is a challenging problem and it adversely affects the healing of colonic anastomosis. Our experimental study aimed to investigate the role of mesenchymal stem cells (MSC) administration in the healing of colonic anastomosis. A total of 33 rats were grouped as Control, IRI and MSC treatment groups. Three rats were reserved for obtaining MSCs. Colonic resection and anastomosis procedure was performed in all groups. Anastomotic line was wrapped with MSCs impregnated spongostan after colonic anastomosis in the rats of the MSC treatment group. All rats were sacrificed and anastomotic line were sampled for examination on the post operative seventh day. Tissue hydroxyproline (HP) levels and anastomotic bursting pressures were statistically compared. Anastomotic bursting pressures were found to be significantly high in MSC treatment group rats. The lowest anastomotic bursting pressure was detected in IRI group rats. Hydroxyproline content of the anastomotic sites were also found to be significantly higher in the rats of the MSC treatment group when compared with the IRI group rats. Our study showed that the detrimental effects of IRI on the healing process of colonic anastomosis in an experimental model may be alleviated with the treatment of MSCs. © 2021, Veteriner Fakultesi Dergisi. All rights reserved

Effects of Different Anesthetic Techniques on Serum Leptin, C-reactive Protein, and Cortisol Concentrations in Anorectal Surgery

Aim: To compare the effects of intratracheal general anesthesia (ITGA) and regional (saddle block) anesthesia on leptin, C-reactive protein (CRP), and cortisol blood concentrations during anorectal surgery. Methods: Fifty-eight patients suffering from hemorrhoidal disease, pilonidal sinus, anal fissure, or anal fistula were included the study. Patients were randomly assigned into one of the two groups (n = 29). Patients in one group received ITGA. After thiopental and fentanyl induction, vecuronium was used as a muscle relaxant. Anesthesia was maintained with sevoflurane. In the other group we applied saddle block, injecting hyperbaric bupivacaine into the subarachnoid space, through the L3-L4 intervertebral space, in the sitting position. Blood samples were collected for leptin, CRP, and cortisol analysis before the induction of anesthesia at 3 and 24 hours postoperatively. Results: Preoperative leptin, CRP, and cortisol concentrations were comparable between the groups. There was no significant difference in postoperative levels of leptin and CRP in both groups. Although not significant, leptin and CRP concentrations were lower in the saddle block group at three hours postoperatively (mean ± SD, 6.95 ± 8.59 and 6.02 ± 12.25, respectively) than in the ITGA group (mean ± SD, 9.04 ± 9.89 and 8.40 ± 15.75, respectively). During early postoperative period, cortisol increased slightly in the ITGA group and remained at similar level in the saddle block group, but later decreased in both groups. Cortisol levels in the saddle block group were significantly lower than in the ITGA group at 3 hours postoperatively (343.7 ± 329.6 vs 611.4 ± 569.8; P = 0.034). Conclusion: Saddle block, a regional anesthetic technique, may attenuate stress response in patients undergoing anorectal surgery, by blocking afferent neural input during early postoperative perio

Effects of Different Anesthetic Techniques on Serum Leptin, C-reactive Protein, and Cortisol Concentrations in Anorectal Surgery

Aim: To compare the effects of intratracheal general anesthesia (ITGA) and regional (saddle block) anesthesia on leptin, C-reactive protein (CRP), and cortisol blood concentrations during anorectal surgery. Methods: Fifty-eight patients suffering from hemorrhoidal disease, pilonidal sinus, anal fissure, or anal fistula were included the study. Patients were randomly assigned into one of the two groups (n = 29). Patients in one group received ITGA. After thiopental and fentanyl induction, vecuronium was used as a muscle relaxant. Anesthesia was maintained with sevoflurane. In the other group we applied saddle block, injecting hyperbaric bupivacaine into the subarachnoid space, through the L3-L4 intervertebral space, in the sitting position. Blood samples were collected for leptin, CRP, and cortisol analysis before the induction of anesthesia at 3 and 24 hours postoperatively. Results: Preoperative leptin, CRP, and cortisol concentrations were comparable between the groups. There was no significant difference in postoperative levels of leptin and CRP in both groups. Although not significant, leptin and CRP concentrations were lower in the saddle block group at three hours postoperatively (mean ± SD, 6.95 ± 8.59 and 6.02 ± 12.25, respectively) than in the ITGA group (mean ± SD, 9.04 ± 9.89 and 8.40 ± 15.75, respectively). During early postoperative period, cortisol increased slightly in the ITGA group and remained at similar level in the saddle block group, but later decreased in both groups. Cortisol levels in the saddle block group were significantly lower than in the ITGA group at 3 hours postoperatively (343.7 ± 329.6 vs 611.4 ± 569.8; P = 0.034). Conclusion: Saddle block, a regional anesthetic technique, may attenuate stress response in patients undergoing anorectal surgery, by blocking afferent neural input during early postoperative perio

Limberg flap repair for pilonidal sinus disease

WOS: 000188739300015PubMed: 15043295PURPOSE: There are many methods described for the treatment of sacrococcygeal pilonidal sinus disease, and none of them has been accepted as an optimal modality. Plastic procedures have some advantages, such as short duration of hospitalization, quick healing time, low risk of wound infection, and lower recurrence rates. Our choice is Limberg flap repair; we present here our experience with this procedure. METHODS: From August 1998 to July 2000, 147 male patients were treated with Limberg flap repair under regional anesthesia in a soldier's hospital. RESULTS: No major anesthetic complication or wound infection developed. Three patients (2 percent) had a seroma (with negative culture) and six patients (4.1 percent) had partial wound detachment. Patients returned to full activity on the 10th to 25th postoperative day (mean, 18.8). Patients were followed from 1 to 40 (mean; 13.1) months. Seven patients (4.8 percent) had a recurrence. CONCLUSION: The Limberg flap procedure is an easy and effective technique. Patient comfort, quick healing time, early return to full activity, and low complication and recurrence rates are the important advantages of this procedure

A comparison of four intravenous sedation techniques and Bispectral Index monitoring in sinonasal surgery

WOS: 000182279400004PubMed: 12712779This study was performed to investigate the quality of different intravenous sedation techniques, and the correlation between the Bispectral Index (BIS) values and the Observer's Assessment of Alertness/Sedation (OAA/S) scores. Eighty patients undergoing sinonasal surgery were randomly assigned to one of four groups. Group MF received midazolam and fentanyl, group PF received propofol and fentanyl, group MR received midazolam and remifentanil, and group PR received propofol and remifentanil. Heart rate and mean arterial pressuure values were not different among the groups. SpO(2) decreased only after intravenous medication in groups MF and MR (P<0.017). Emesis was less common with propofol. A positive relationship existed between the BIS values and OAA/S scores during the operation in all groups and the strongest correlation was observed in group PR (r=0.565 and P<0.001). In conclusion, these four intravenous sedation techniques did not change mean arterial pressure, heart rate or SpO(2) clinically and produced a similar level of light sedation. The BIS was useful for monitoring of sedation during sinonasal surgery under local anaesthesia with intravenous sedation

The effect of peritoneal wrapping on colonic anastomosis healing in rats with impaired wound healing due to superior mesenteric artery occlusion

45th Congress of the European-Society-for-Surgical-Research -- JUN 09-12, 2010 -- Geneva, SWITZERLANDWOS: 000281136400435…European Soc Surg Re

Akut karinla basvu?ran geri?atri?k hastalarda cerrahi? tedavi? ve sonuçlari

The aim of this study was to evaluate the factors affecting the outcome of geriatric patients presenting with acute abdomen. Eighty patients who underwent surgery with the diagnosis of acute abdomen were analysed retrospectively. The effects of age, sex, American Society of Anaesthesiology (ASA) class, preexisting disease, admission time after the onset of the symptoms, followup interval before the operation on morbidity, mortality and length of hospital stay were evaluated. Male/female ratio was 1.3, mean age was 72.4. Main causes were biliary system disease (38.8%), intestinal obstruction (31.3%), peptic ulcer perforation (12.5%) and acute appendicitis (8.7%). Median ASA class was 3 and 76.3% of the patients had at least one preexisting disease. ASA class was significantly effective on mortality and complication rate. Shock at the admission, malignity, male sex, mechanical ventilation and transfusion were the factors that have statistically significant effect on mortality. 58.8% of the patients had complications. Complications were significantly related to mortality, prolonged intensive care unit (ICU) stay and hospital stay. Male sex, ASA class, malign diseases, peptic ulcer perforation, colonic obstruction, shock, mechanical ventilation and blood transfusion were the factors affecting mortality in the elderly. Preexisting diseases other than malignity, period between the onset of symptoms and admission, follow-up time and operation time did not influence mortality. Complications and ASA classification were associated with a prolonged ICU and hospital stay

The effects of anesthetic techniques on acute phase response at delivery (anesthesia and acute phase response)

WOS: 000180795300012PubMed: 12554063Objectives: To investigate the effects of anesthetic techniques and delivery types on stress response during uncomplicated delivery. Design and methods: Forty pregnant women at term were divided into four groups. Group-I, cesarean section with general anesthesia; Group-II, section with spinal anesthesia; Group-III, section with epidural anesthesia; and Group-IV, vaginal delivery with epidural analgesia. C-reactive protein and albumin were measured on hospital admission, immediately after delivery and 24 h later. Results: Albumin and CRP levels decreased significantly in Group-II and Group-III, just after delivery. CRP increased significantly in all groups at the 24(th) hour of delivery. The effect of hemodilution on CRP and Albumin, due to volum loading, during spinal and epidural anesthesia disappeared after 24 h. Conclusion: We found no influence of anesthetic techniques on acute phase response except hemodilution effect. In the view of delivery types, vaginal delivery caused less stress response than section. (C) 2003 The Canadian Society of Clinical Chemists. All rights reserved