Adhesion-preventing properties of 4% icodextrin and canola oil: a comparative experimental study

OBJECTIVE: Postsurgical abdominal adhesions are common, serious postoperative complications. The present study compared the usefulness of 4% icodextrin and canola oil in preventing postoperative peritoneal adhesions. METHODS: Twenty-four Wistar albino rats were divided into three groups. Following a laparotomy, a serosal abrasion was made by brushing the cecum, and 3 mL of 0.9% NaCl, 4% icodextrin, or 3 mL of canola oil were intraperitoneally administered for the control, icodextrin, and canola oil groups, respectively. The abdomen was then closed. All of the rats were sacrificed at day 10. Macroscopic, histopathological, and biochemical evaluations were performed. The results were statistically analyzed using Kruskal-Wallis and ANOVA tests. RESULTS: Macroscopic analyses revealed that both canola oil and 4% icodextrin reduced adhesion formation, but the difference was not statistically significant (p = 0.17). The histopathological examinations revealed no significant differences in terms of giant cell, lymphocyte/plasmocyte, neutrophil, ICAM1, or PECAM1 scores. However, both canola oil and 4% icodextrin significantly reduced fibrosis (p = 0.025). In the canola oil group, the histiocytic reactions were significantly increased (p = 0.001), and the hydroxyproline levels were significantly lower than those in the other groups (p = 0.034). CONCLUSIONS: In the present study, canola oil was determined to be superior to 4% icodextrin in lowering hydroxyproline levels and increasing histiocytic reactions. Considering these results, we believe that canola oil is a promising agent for preventing adhesion formation

Persistent High Postoperative Carcinoembryonic Antigen in Colorectal Cancer Patients- Is it Important?

INTRODUCTION: Evaluation of pre- and postoperative serum CEA levels together has seldom been assessed for the prognosis of colorectal cancer (CRC). OBJECTIVE: To concurrently evaluate pre- and postoperative CEA as factors of relapse and survival. METHODS: The study consisted of 114 patients who had undergone surgery from February 2002 to June 2006 for CRC. All patients were classified into four groups according to their pre- and postoperative CEA levels. Data obtained for clinicopathologic parameters, lymph node metastasis, stage, recurrence, and CEA levels were analyzed to determine their association with survival. Multivariate analysis by the Cox proportional hazard regression model was performed to identify the independent prognostic factors associated with survival. RESULTS: Postoperative serum CEA levels remained high in Group 3 (n = 32). Nineteen patients (59.3%) demonstrated a detectable cause for persistent high CEA levels, while the reasons for those in the other thirteen patients (40.6%) remained obscure. Abnormal preoperative CEA levels significantly correlated with the depth of tumor invasion, lymph node metastasis, TNM stage, and recurrence (p < 0.05). Abnormal postoperative CEA levels were significantly related to the depth of tumor invasion, TNM stage, and postoperative relapse (p<0.05). Patients in Group 3 demonstrated the worst survival rate. Abnormal postoperative CEA levels, lymph node metastasis, and location of the tumor were independent prognostic factors for survival. CONCLUSION: The survival of patients with high postoperative CEA levels due to unknown reasons may be extended if they are exhaustively tested with sensitive diagnostic methods and treated at an early stage

A Rare Causing of Difficulty in Defecation: Rectal Schwannoma

Objective: Schwannomas are mainly benign, non-epithelial tumors originating in the Schwann cells, which form nerve sheaths. Schwannomas account for about 2-8% of all gastrointestinal mesenchymal tumors, encountered more frequently in the stomach and the small intestine. Schwannomas of the colon and rectum are extremely rare. Case Presentation: In this report, we present a thirty-nine-year-old woman admitted for complaints of rectal fullness and difficulty in defecation. At her rectal examination, a polypoid tumor 22x27x27mm in size was found filling the lumen of the rectum; it was well defined, with a homogeneous nature and benign appearance. Complete excision of the tumor was achieved by a transanal surgical approach. Histolopathological and immunohistochemical diagnosis of the tumor reported a rectal schwannoma. There has been no tumor recurrence at 18 months after surgical excision. Conclusion: A schwannoma of the rectum is rare; a benign tumor can usually be separated from GISTs with immunohistochemical staining, and it carries a good prognosis with local excision, which is the procedure of choice. [Arch Clin Exp Surg 2014; 3(1.000): 59-63

Anti-adhesive effects of argan oil on postoperative peritoneal adhesions

The aim of this study is to reveal effect of Argan oil on postoperative peritoneal adhesion. Twenty-four Wistar albino rats were divided into three groups. After laparotomy was carried out intraperitoneally, 0,9% NaCl and 3 ml Argan Oil applied to saline and Argan oil groups, respectively. Four subjects in each groups were sacrificed at postoperative day 3 and 7. Macroscopic adhesions and microscopic cellular reactions, such as giant cell, lymphocyte/plasmocyte, neutrophil and histiocyte, were assessed and hydroxyproline levels were measured in all three groups. Adhesion and fibrosis scores were lower both 3rd and 7th days in Argan oil, but only lower fibrosis scores were statistically significant (p [Med-Science 2018; 7(3.000): 557-60

The Effects of Different Concentrations of Epinephrine Adjuvant to Levobupivacaine on Wound Healing

Objective: Local anesthetics (LAs) and epinephrine are often combined for infiltration of surgical sites for their wide-range effects. The aim of our study is to investigate the effects of different concentrations of epinephrine added to levobupivacaine on wound healing. Methods: Forty female albino Wistar rats were divided into four groups. 3 ml of 3,75mg/ml levobupivacaine was applicated for all groups. In the control group (C) (n=10), 1ml isotonic saline was added, and in group A10 (10 and micro;g/ml) (n=10), 1ml 1/100,000 adrenaline; in group A5 (5 and micro;g/ml) (n=10), 1ml 1/200,000 adrenaline; and in group A2,5 (2,5 and micro;g/ml) (n=10), 1ml 1/400,000 adrenaline. Two minutes after the infiltration of the drug combination into subcutaneous tissue, 3cm longitudinal cutaneous-subcutaneous incisions were performed on the mid-dorsal line under sterile conditions. Incisions were sutured with 4/0 sharp prolen with six sutures. Postoperative 8th-day rats were sacrificed to evaluate wound healing. Tissue burst pressures (TBP) and tissue hydroxyproline levels (THP) were measured, and histopathological evaluation for a fibrotic index was performed. A One-Way ANOVA and Chi-square test were used for statistical analyses. Results: There was no statistically significant difference between groups according to TBP and THP levels (p=0.4, p=0.201 respectively). Fibrotic index values were significantly higher in epinephrine groups (p=0,001), and were highest in A2,5. Conclusions: Epinephrine added to levobupivacaine in low concentrations accelerates wound healing in the early phase by stimulating fibrosis, and has no adverse effects on surgical sites. Long-term studies are needed for late effects of epinephrine adjuvant levobupivacaine. [Arch Clin Exp Surg 2013; 2(2.000): 92-96

Coexistence of Colon Cancer and Diverticilutis Complicated with Diverticular Abscess

Coexistence of a diverticular abscess and colorectal cancer is an extremely rare phenomenon. The clinical presentation and the extension of a diverticular abscess could cause mis-staging of colon cancer. We are presenting an overstaged colon cancer due to a diverticular abscess penetrating into the abdominal wall. A 65-year-old male patient with a history of an enlarging mass in the left lower quadrant of the abdomen was admitted to our service. Diagnostic studies revealed a sigmoid tumor communicating with an abdominal wall mass. The patient was clinically staged as T4 N1. Exploration revealed a diverticular abscess penetrating into the abdominal wall and a sigmoid tumor. Histopathological examination reported an intermediately differentiated T3 N0 adenocarcinoma of the sigmoid colon. After an uneventful postoperative recovery, the patient was referred to chemotherapy. [Arch Clin Exp Surg 2015; 4(4.000): 231-233

The Efficacy of Probiotic (Lactobacillus rhamnosus GG) and 5-ASA (Aminosalicylic Acid) in the Treatment of Experimental Radiation Proctitis in Rats

The aims of the study are to demonstrate the effect of probiotic use on the healing of radiation proctitis (RP) and evaluate the efficiency of fecal biomarkers at follow-up of the treatment. Thirty-two male/female rats were randomly separated into four groups of eight rats. The first group (control) was not radiated. RP was created by 17.5 Gy single dose rectal irradiation. The second group (RP) was subjected to RP, but not treated. The third group (RP+ASA) was treated with 5-aminosalicylic acid (5-ASA) 250 mg/kg daily by gastric lavage for 14 days after the irradiation, and the forth group (RP+LGG) was treated with Lactobacillus GG (LGG) 25x100 million CFU daily. Feces samples were taken at the 7th and 14th day of the treatment for fecal biomarkers. Rectums of the rats were resected at the 14th day by laparotomy. Samples were evaluated both macroscopically and microscopically. RP was achieved both macroscopically and microscopically. Weight loss of RP group is statistically significant (p<0.005) than other groups. The healing ratio of RP+ASA and RP+LGG groups was significantly better than the RP group (p<0.005) both macroscopically and microscopically. But there was no significant difference between ASA and LGG groups. Biochemically, fecal calprotectin was found to be more effective than fecal myeloperoxidase and fecal lactoferrin to show the efficacy of treatment of radiation proctitis. The results of our study demonstrate that probiotic is as effective as 5-aminosalicylic in the treatment of radiation proctitis, and fecal calprotectin is a useful biomarker in determining the response to the treatment