Can the de Ritis Ratio (AST/ALT) Be Used to Predict Colon Cancer Stages?

Purpose: The De Ritis ratio (Aspartate transaminase/alanine transaminase) is a critical prognostic factor for some kinds of malignant tumors. Nevertheless, the De Ritis ratio’s prognostic value in preoperative colon cancer staging is unclear. The purpose of this research was to determine the De Ritis ratio and its prognostic significance for colon cancer. Materials and Methods: The clinicopathological data of 271 individuals with malign colon cancer were analyzed retrospectively at a single center from January 2010 to January 2018. The relationship between the De Ritis coefficient and clinicopathological findings in patients was evaluated before treatment. To compare the groups, the Mann-Whitney U test and the Kruskal Wallis test were performed. Results: The results indicated that there were no statistically significant differences between the groups in terms of pre-treatment De Ritis ratio assessment as a staging, localization, tumor diameter, lymph node metastasis, age, and overall survival. However, differences in T staging between groups of male participants were shown to be statistically significant. Conclusions: The De Ritis ratio evaluation before treatment was not found as an independent variable prognostic factor for the diagnosis and staging of colon cancer. However, future studies may demonstrate the significance of the De Ritis ratio with more participants

Reducing the environmental impact of surgery on a global scale: systematic review and co-prioritization with healthcare workers in 132 countries

Abstract Background Healthcare cannot achieve net-zero carbon without addressing operating theatres. The aim of this study was to prioritize feasible interventions to reduce the environmental impact of operating theatres. Methods This study adopted a four-phase Delphi consensus co-prioritization methodology. In phase 1, a systematic review of published interventions and global consultation of perioperative healthcare professionals were used to longlist interventions. In phase 2, iterative thematic analysis consolidated comparable interventions into a shortlist. In phase 3, the shortlist was co-prioritized based on patient and clinician views on acceptability, feasibility, and safety. In phase 4, ranked lists of interventions were presented by their relevance to high-income countries and low–middle-income countries. Results In phase 1, 43 interventions were identified, which had low uptake in practice according to 3042 professionals globally. In phase 2, a shortlist of 15 intervention domains was generated. In phase 3, interventions were deemed acceptable for more than 90 per cent of patients except for reducing general anaesthesia (84 per cent) and re-sterilization of ‘single-use’ consumables (86 per cent). In phase 4, the top three shortlisted interventions for high-income countries were: introducing recycling; reducing use of anaesthetic gases; and appropriate clinical waste processing. In phase 4, the top three shortlisted interventions for low–middle-income countries were: introducing reusable surgical devices; reducing use of consumables; and reducing the use of general anaesthesia. Conclusion This is a step toward environmentally sustainable operating environments with actionable interventions applicable to both high– and low–middle–income countries

Ectopic Liver Tissue on the Gallbladder: An Incidental Mass in Laparoscopy

WOS: 000369542900013PubMed: 26702754Ectopic liver is a rare developmental abnormality. It is often asymptomatic and could be determined during the surgery. Although it be detected in different areas of the body either below or above of the diaphragm, ectopic liver is usually found on the wall of the gallbladder. The importance of the ectopic liver came from the elevated risk of development of hepatocellulary carcinoma from ectopic tissue. Ectopic liver tissue could also mimic malign masses in radiographic studies. Ultrasound-guided percutaneous biopsies could be helpful for preoperative diagnosis. Recently, widespread usage of laparoscopic techniques caused an increase on the description of ectopic liver tissues located on the gallbladder, Due to the potential risk of developing malignancy the resection of the mass should be the preferred approach for an incidentally or intraoperatively diagnosed ectopic liver tissue

Effect of ankaferd blood stopper in experimental peritoneal adhesion model

Aydin, Oktay/0000-0001-5728-0128WOS: 000373862000005PubMed: 27073792Purpose: Ankaferd Blood Stopper (ABS) is an herbal extract attained from 5 different plants. It has the therapeutic, potential to be used for the management of external hemorrhage and controlling gastrointestinal bleedings. To date, the safety of ABS for intraperitoneal usage is not clear. In this study, we investigated the effectiveness and safety of using intraperitoneal ABS in an experimental peritoneal adhesion Model. Methods: Twenty-four male Wistar Albino rats were used in the study. The rats were randomly divided into 3 groups: saline, ABS, and control. On the 10th day, all rats were euthanized. The adhesions were evaluated by Nair's macroscopic adhesion classification, and pathologically evaluated with Zuhlke's microscopic adhesion classification. Results: A macroscopic and microscopic comparison between the ABS and saline groups did not show any differences but both the ABS and saline groups were superior when compared to the control group. Conclusion: ABS was found equally effective with saline on the abdominal adhesions and to no effect on postoperative adhesion formation

The effects of scalpel, harmonic scalpel and monopolar electrocautery on the healing of colonic anastomosis after colonic resection

WOS: 000376950400004PubMed: 27274507Purpose: In our study, the effects of harmonic scalpel, scalpel, and monopolar electrocautery usage on the health and healing of colon anastomosis after resection was investigated. Methods: In this study, 120 female albino Wistar rats were divided into 3 groups each containing 40 rats. Group A, resection with scalpel; group B, resection with monopolar electrocautery; group C, resection with harmonic scalpel. The groups were divided into 4 subgroups consisting of 10 rats and analysed in the postoperative 1st, 3rd, 5th, and 7th days. Anastomotic bursting pressures, hydroxyproline levels and histopathological parameters were surrogate parameters for evaluating wound healing. Results: The tissue hydroxyproline levels did not show any significant difference between the groups and subgroups. The mean bursting pressure of group A on the 5th day was significantly higher than groups B and C (P < 0.001). When the fibroblast and fibrosis scores were evaluated, scores of group C on the 5th day were significantly higher than the other groups, but the results of bursting pressures and biochemical parameters did not support the fibroblast and fibrosis scores. There were not any significant differences between the groups in other histopathologic parameters. Conclusion: The use of monopolar electrocautery needs more attention since the device causes tissue destruction. The obliterating effect of harmonic scalpel on luminal organs is an important problem, especially if an anastomosis is planned. Despite the disadvantages of scalpel, its efficacy on early wound healing is better than the other devices

Erdosteine ameliorates the harmful effects of ischemia-reperfusion injury on the liver of rats

<div><p>Abstract Purpose: To investigate the potential protective effects of erdosteine against the harmful effects of ischemia-reperfusion injury on the liver in an experimental rat model. Methods: Forty rats were divided into 4 groups. In the sham group, only the hepatic pedicle was mobilized. No other manipulation or treatment was performed. In the other groups, ischemia was achieved by clamping the hepatic pedicle for 60 min. After that, 90 min reperfusion was provided. In the control group, no treatment was given. In the perioperative treatment group, 100 mg/kg erdosteine was administered 2 hours before ischemia induction. In the preoperative treatment group, 100 mg/kg/day erdosteine was administered daily for ten days before the operation. At the end of the procedures, blood and liver samples were obtained for biochemical and histopathological assessment. Results: Treatment with erdosteine ameliorated the histopathological abnormalities when compared with the control group. Furthermore, this treatment significantly decreased the serum liver function test values. It was also found that erdosteine ameliorated the oxidative stress parameters in both the perioperative and preoperative treatment groups. Conclusion: The current study is the first to have shown the favorable effects of erdosteine on the harmful effects of experimental hepatic ischemia-reperfusion injury.</p></div