A comparison in an experimental rat model of the effects on adhesion formation of different hemostatic methods used in abdominopelvic surgery

Objectives: To evaluate the effects of different hemostasis methods used in abdominal surgery on the development of abdominal adhesion.  Material and methods: A total of 48 Wistar albino female rats were separated into six groups; Group 1 — Control group, Group 2 — Hemorrhage group, Group 3 — Electrocoautery group, Group 4 — Gel Spon-P®, Group 5 — PAHACEL®, and Group 6 — Ankaferd-Blood Stopper®. Adhesions that developed were scored according to the Knightly classification and the prevalence of adhesions according to the Linsky classification. The total adhesion score was calculated as the total of the severity and prevalence scores.  Results: The lowest total adhesion values were determined in Group 1 (control) and the highest adhesion values were in Group 2 (hemorrhage) group in terms of all parameters. The adhesion values in Group 3, where the rats were administered hemostasis with electrocautery were similar to those of Group 2 (hemorrhage). When the alternative methods were evaluated, the lowest adhesion scores were in Group 6 (Ankaferd-Blood Stopper®).  Conclusions: In cases of minor pelvic or abdominal bleeding, not providing hemostasis or applying hemostasis with electrocautery can increase the development of intra-abdominal adhesions. The use of alternative hemostatic materials instead of electrocautery for hemostasis may reduce the formation of adhesions

Preeklampsi Hastalarının Değerlendirilmesi – 3 Yıllık Veri: Araştırma Makalesi

Introduction: Preeclampsia is the most important cause of maternal, fetal, and neonatal morbidity and mortality worldwide, affecting approximately 4% of all pregnancies. Objective: Patients admitted to our clinic and diagnosed with non-severe preeclampsia, severe preeclampsia, HELLP syndrome, and eclampsia were retrospectively examined, and the demographic, clinical, and laboratory data obtained from these patients were compared with the diagnostic groups. Method: A total of 156 patients, including 63 with non-severe preeclampsia, 84 with severe preeclampsia, 6 with HELLP syndrome, and 3 with eclampsia, who were followed up and treated in our center, were evaluated. Patient characteristics were classified by comparing the groups regarding delivery methods, demographic characteristics, and clinical and laboratory parameters. Results: In terms of maternal complications, peripartum hemorrhage and placental abruption were more common in the eclampsia and severe preeclampsia groups. At the same time, DIC was more common in the patient group diagnosed with HELLP syndrome, and these results were found to be statistically significant (p<0.05). When demographic, clinical, and laboratory data were compared with whether maternal complications developed, the rate of maternal complications was found to be significantly higher in patients with elevated AST and ALT. No maternal mortality occurred in any of the patient groups. Conclusion: The higher rate of maternal complications in patients with elevated AST and ALT suggested that follow-up of this patient group in the intensive care unit will be beneficial in reducing maternal morbidity and mortality.Giriş: Preeklampsi tüm gebeliklerin yaklaşık %4'ünü etkileyen, dünya çapında anne, fetus ve neonatal morbidite ve mortalitenin en önemli nedenidir. Amaç: Kliniğimize başvuran ve gebeliğin hipertansif bozuklukları arasında yer alan, şiddetli özellik göstermeyen preeklampsi, şiddetli özellik gösteren preeklampsi, HELLP sendromu ve eklampsi tanısı alan hastaları retrospektif olarak incelenerek bu hastalardan elde edilen demografik, klinik ve laboratuvar verilerinin tanı grupları ile karşılaştırması yapılmıştır. Metod: Merkezimizde takip ve tedavisi yapılan 63 şiddetli özellik göstermeyen preeklampsili, 84 şiddetli özellik gösteren preeklampsili, 6 HELLP sendromlu, 3 eklampsili olmak üzere toplam 156 hasta değerlendirildi. Doğum şekilleri, demografik özellikleri, klinik ve laboratuvar parametreleri açısından gruplar arasında karşılaştırma yapılarak hasta özellikleri sınıflandırıldı. Bulgular: Maternal komplikasyonlar açısından peripartum hemoraji ve plasenta dekolmanı, eklampsi ve şiddetli özellik gösteren preeklampsi grubunda daha sık görülürken, DİC, HELLP sendromu tanılı hasta grubunda daha sıktı ve bu sonuçlar da istatistiksel olarak anlamlı bulundu (p<0,05). Maternal komplikasyon gelişip gelişmediği ile demografik, klinik ve laboratuvar verileri kıyaslandığında, AST ve ALT yüksekliği olan hastalarda maternal komplikasyon gelişme oranı anlamlı derecede yüksek bulundu. Hasta gruplarının hiçbirinde maternal mortalite gelişmedi. Sonuç: AST ve ALT yüksekliği olan hastalarda maternal komplikasyon gelişme oranının daha yüksek bulunması, bu hasta grubunun yoğun bakım ünitesinde takibinin, maternal morbidite ve mortaliteyi azaltmak açısından faydalı olacağını düşündürmektedir