6 research outputs found
An unusual approach for the treatment of oesophageal perforation: Laparoscopic-endoscopic cooperative surgery
Boerhaave syndrome describes a transmural oesophageal rupture that develops following a spontaneous, sudden intraluminal pressure increase (i.e. vomiting, cough). It has a high rate of mortality and morbidity because of its proximity to the mediastinum and pleura. Perforation localisation and treatment initiation time affect the morbidity and mortality. In this article, we aim to present our successful laparoscopic-endoscopic cooperative surgery in a 59-year-old female who was referred to our clinic with a diagnosis of spontaneous lower oesophageal perforation. Laparoscopy and a simultaneous oesophageal stent application may be assumed as an effective alternative to conventional surgical approaches in cases of spontaneous lower oesophageal perforation
Effect of Intraoperative PEEP Application on Colonic Anastomoses Healing: An Experimental Animal Study
This study aimed to assess the effect of intraoperative positive
end-expiratory pressure (PEEP) intervention on the healing of colonic
anastomoses in rabbits. A total of 32 New Zealand type male rabbits were
divided into 2 groups of 16 animals each. Following ventilation with
tracheostomy, colonic resection and anastomosis were performed in both
groups. Although 10 cm of H2O PEEP level was applied in group 1 (PEEP),
group 2 {[}zero end-expiratory pressure (ZEEP)] was ventilated without
PEEP throughout the surgery. Half of both the PEEP and ZEEP group
animals were killed on the third postoperative day, whereas the
remaining half were killed on the seventh. Anastomotic bursting
pressures, the tissue concentrations in hydroxyproline, and histologic
assessments were performed. Intraoperative oxygen saturation and
postoperative arterial blood gas parameters were also compared. On the
first postoperative day, both arterial oxygen tension (PO2) and oxygen
saturation (SO2) in the PEEP group were significantly higher than in the
ZEEP group. On the seventh postoperative day, the bursting pressures of
the anastomoses were significantly higher in the PEEP group; however,
the hydroxyproline content was significantly lower in the PEEP group
than in the ZEEP group. At day 7, the PEEP group was significantly
associated with increased neoangiogenesis compared with the ZEEP group.
The anastomotic healing process is positively influenced by the
intraoperative PEEP application