Reinforcement of the suture line with an ePTFE graft attached with histoacryl glue in duodenal trauma

PubMed: 16630421Background: Most duodenal injuries are managed with primary repair, but the degree of duodenal-wall injury may threaten the integrity of the primary repair. Therefore, we evaluated whether the primary repair site could be reinforced with histoacryl glue (HAG) or HAG with an expanded polytetrafluoroethylene (ePTFE) mesh. Methods: Grade 3 duodenal injury in the second portion of the rat duodenum was chosen as a standard trauma model. Thirty-three male rats were divided into sham (n = 3), 2-layer primary repair (n = 10), 1-layer primary repair plus HAG application (n = 10) and ePTFE attached with HAG over the 1-layer primary repair site (n = 10) groups. Ten-day survival, adhesion grades and histological assessment were taken as outcome measures. Results: A significant survival advantage was identified in the group that had an ePTFE graft attached with HAG over a 1-layer repair when compared with the group that had a 2-layer primary repair. Adhesion grades were found to be particularly increased in the group that had an ePTFE graft attached with HAG over the primary repair site, moderately increased in the primary repair plus HAG application group and lower in the 2-layer primary repair group. ePTFE graft application was found to be beneficial to coverage of the HAG-dependent empty spaces in the serosal layer. Conclusions: A primary repair site after duodenal trauma or a difficult duodenal stump can be reinforced with the application of HAG or ePTFE graft implantation with HAG. © 2006 CMA Media Inc

Effects of TVE application during 70% hepatectomy on regeneration capacity of rats

WOS: 000227650100022PubMed: 15734492Background For adequate control of excess bleeding during liver resection, total vascular exclusion (TVE) is preferred by surgeons, especially when the tumor is located in the posterior liver lobes or near the cava. To the authors' knowledge, the effects of TVE technique on the postoperative liver regeneration process have not thus far been evaluated yet in the literature. This study was planned to compare the effects of liver resections performed either with portal pedicle clamping or with TVE on the regeneration process. Materials and methods. Seventy percent hepatectomy was performed with portal pedicle clamping (n = 10, Group A) or with TVE (n = 10, Group B) in rats. At 48 h after resection, sampling was performed for the measurement of serum transaminase, alkaline phosphatase (ALP), tissue malondialdehyde (AIDA), and glutathione (GSH) levels. Liver regeneration rate, proliferating cell nuclear antigen (PCNA) labeling, and mitotic indices were also evaluated. Results. Liver injury determinants (serum transaminases, ALP, and tissue MDA levels) were found significantly higher in group B than in group A. Liver regeneration rate, liver GSH levels, PCNA labeling index, and mitotic index were significantly lower in group B than in group A. Conclusions. The injury during TVE seems to be greater than during resection with portal pedicle clamping. The negative effect of this oxidative damage may influence the regenerative capacity of the remnant liver tissue. (c) 2004 Elsevier Inc. All rights reserved

Retrorectal benign cystic teratoma misdiagnosed with high lying pararectal abscess.

PubMed: 15244193A case of presacral teratoma with abscess formation is presented in this report. Teratomas, like the chordomas and dermoids, constitute the largest group of retrorectal tumors. Their presentation has varied. Dependent to unique localization, cystic teratoma complicated with abscess formation are misdiagnosed as high lying pararectal abscesses. Both diagnostic and therapeutic difficulties were evaluated with literature review

Evaluation of liver damage after application of TVE in the rat model

WOS: 000234412900103PubMed: 16387167Introduction. The aim of this study was to investigate the effects of total vascular exclusion (TVE) on the liver during the early period of reperfusion. Materials and methods. Forty Wistar-Albino rats were divided into four groups. Portal pedicle clamping (groups 1 and 2) or TVE (groups 3 and 4) were applied for 10 minutes. Samples were collected at the time of clamp release (groups 1 and 3) and at 30 minutes of reperfusion (groups 2 and 4). We examined oxidative injury to and histopathology of the liver. Results. Oxidative stress was more prominent with TVE application. Significant alterations were shown in hepatic superoxide dismutase, catalase, glutathione, and glutathione S-transferase levels. The levels of malondialdehyde and myeloperoxidase were not altered significantly. Conclusion. Inflow-outflow occlusion of the liver causes more oxidative stress compared with inflow occlusion

Heterogeneity of damage between segments of rat liver after inflow-outflow obstruction

WOS: 000242294500084PubMed: 17112903Background. Total vascular exclusion (TVE) causes warm liver ischernia. The complete explanation of the events during inflow and outflow obstruction of the liver during selective TVE has not yet been studied. The aim of this study was to investigate the liver injury caused by inflow-outflow obstruction in the rat liver. Materials and methods. Forty Wistar-Albino rats were divided into four groups. Liver inflow occlusion (groups A and C) or inflow-outflow occlusion (groups B and D) was applied for 30 minutes. Samples were collected at the end of the ischemia period. We examined oxidative injury in the liver tissue and liver histopathology. Results. Oxidative stress and histopathologic alterations were more prominent with TVE application. Significant alterations were shown in hepatic superoxide dismutase, glutathione, and glutathione S-transferase levels. Central segments of the rat liver were affected significantly from inflow occlusion, whereas dome segments were significantly damaged from inflow-outflow occlusion. Conclusions. Inflow-outflow occlusion of the liver caused more tissue damage compared with inflow occlusion. The pattern of distribution of the damage due to TVE seemed different from other well-known ischemia-reperfusion injuries