RESUMEN
AIM: We aimed to assess the factors which may affect the quality of life (QoL) of the patients who underwent curative gastrectomy for gastric cancer. SUBJECTS AND METHODS: Patients with gastric cancer, who underwent gastrectomy with curative intent at Department of Gastrointestinal Surgery, Kartal Training and Research Hospital from January 2013 to December 2015, were retrospectively reviewed. Gastrointestinal Quality of Life Index was utilized for this research. The clinical factors that might affect QoL after gastrectomy were selected. They were demographic data (age and gender), the American Society of Anesthesiologists classification, body mass index (BMI), operative variables (level and type of resection, type of dissection [D1, D2], type of reconstruction, and additional organ resections), postoperative appetite level, type of oncological treatment, and pathological stages. One hundred and eighteen patients were included in this study. RESULTS: Eighty-seven (73.7%) of them were male and mean age was 59.4 ± 10.2 (36-74). Mean follow-up period was 25.7 ± 11.3 (6-42) months. According to multivariate analysis, advanced stage, neoadjuvant therapy, lower BMI, poor appetite, and shorter follow-up were independently associated with poorer cumulative scores. CONCLUSIONS: Advanced stage, application of neoadjuvant therapy, low BMI level, and poor postoperative appetite may deteriorate the postoperative QoL of the patients with gastric cancer.
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Gastrectomía , Calidad de Vida , Neoplasias Gástricas/patología , Neoplasias Gástricas/cirugía , Anciano , Anorexia/etiología , Índice de Masa Corporal , Femenino , Estudios de Seguimiento , Gastrectomía/efectos adversos , Humanos , Masculino , Persona de Mediana Edad , Terapia Neoadyuvante , Estadificación de Neoplasias , Periodo Posoperatorio , Estudios Retrospectivos , Neoplasias Gástricas/terapia , Factores de Tiempo , Pérdida de PesoRESUMEN
AIM: In this study, we aimed to evaluate the clinical characteristics and outcomes of the patients with anal melanoma (AM), who underwent surgical treatment. MATERIALS AND METHODS: This study was conducted in Kartal Training and Research Hospital between January 2010 and December 2017. All patients, who underwent surgical resection with a diagnosis of AM, were enrolled. RESULTS: A total of 10 patients were examined, 8 of them were females, and their average age was 69.2 years (range, 47-85 years). Abdominoperineal resection (APR) was performed in five (50%) patients, and local excision (LE) was performed in other five (50%) patients. Three patients (30%) had stage I disease, two (20%) had stage II disease, and five (50%) had stage III disease. All five patients in APR group had stage III disease. In the comparison of the survival period after surgery, the mean survival period of the APR group was 6.2 months (range, 1-16 months) while that of the LE group was 19.6 months (range, 7-43 months). CONCLUSION: LE with adjuvant radiation seems to offer good locoregional control without reducing the survival and may be an option of treatment for patients with small, superficial AM. However, APR should be offered for patients with locally advanced disease or as a salvage following recurrence.
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Neoplasias del Ano/cirugía , Melanoma/cirugía , Proctectomía/métodos , Adulto , Anciano , Anciano de 80 o más Años , Femenino , Humanos , Masculino , Persona de Mediana Edad , Neoplasias del Recto , Resultado del TratamientoRESUMEN
AIM: The aim of this study was to determine the effects of mycophenolate mofetil (MMF) on acute pancreatitis with evaluation of biochemical and histopathological findings. MATERIALS AND METHODS: Cerulein was administered to induce acute pancreatitis in rats. Three groups of 10 rats each were formed. Animals in group 1 received physiologic saline solution. In group 2 animals received MMF at a dose of 14 mg/kg and group 3 had double doses of MMF. Alanine aminostransferase, aspartate aminotransferase (AST), amylase and bilirubin levels were assessed. Pancreatic tissues were evaluated under light microscopy for the presence of edema, acinar necrosis, hemorrhage, inflammation and perivascular infiltration. RESULTS: Amylase, serum AST, edema and inflammatory infiltration levels differed between groups (amylase: p = 0.0001, serum AST: p = 0.001, edema: p = 0.0001 and inflammatory infiltration: p = 0.002), group 1 showing the highest amylase, serum AST and edema levels. The lowest levels of edema were found in group 3. CONCLUSION: In an experimental pancreatitis model in rats, MMF proved to exert a beneficial effect on biochemical and histopathological parameters.
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Antiinflamatorios no Esteroideos/uso terapéutico , Ácido Micofenólico/análogos & derivados , Pancreatitis/tratamiento farmacológico , Alanina Transaminasa/sangre , Amilasas/sangre , Animales , Antiinflamatorios no Esteroideos/administración & dosificación , Aspartato Aminotransferasas/sangre , Bilirrubina/sangre , Ceruletida/toxicidad , Femenino , Inmunosupresores/administración & dosificación , Inmunosupresores/uso terapéutico , Masculino , Ácido Micofenólico/administración & dosificación , Ácido Micofenólico/uso terapéutico , Pancreatitis/sangre , Pancreatitis/inducido químicamente , Pancreatitis/patología , Ratas , Ratas WistarRESUMEN
AIM: Postoperative intra-abdominal adhesion formation is a significant cause of morbidity. The aim of this study was to assess the effects of heparin and Seprafilm, which is considered the gold standard, on the prevention of intra-abdominal adhesions. METHOD: Four groups consisting of 25 rats each were formed. Cecal abrasion was performed in all animals. Group 1 was the control group with no treatment; in group 2, heparin was applied intraperitoneally; in group 3, Seprafilm was used underneath the abdominal wall, and group 4 animals were treated with both heparin and Seprafilm. Two weeks after the surgical procedure, animals were sacrificed and specimens were removed for the measurement of the grade of adhesions, according to the Mazuji classification. RESULTS: Formation of adhesions was prevented in the three study groups treated with heparin only, Seprafilm only and both heparin and Seprafilm (p < 0.001) compared with the control group. There was no statistical difference between the treatment groups. Autopsy results of the animals that died within the first week after the surgical procedure revealed intra-abdominal abscess formation and infections, which were considered as possible causes of death. CONCLUSION: Seprafilm seems to be more effective in the prevention of adhesions. In the combined application of Seprafilm and heparin, heparin showed no additive impact. Future studies are needed to detect the suitable dose and side effects of heparin for humans.
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Anticoagulantes/farmacología , Heparina/farmacología , Ácido Hialurónico/farmacología , Adherencias Tisulares/tratamiento farmacológico , Adherencias Tisulares/prevención & control , Abdomen/patología , Abdomen/cirugía , Pared Abdominal/patología , Animales , Ciego/patología , Quimioterapia Combinada , Inyecciones Intraperitoneales , Masculino , Ratones , Ratones Endogámicos BALB C , Ratas , Adherencias Tisulares/patologíaRESUMEN
BACKGROUND: The use of porcine extracorporeal liver perfusion (PECLP) to provide temporary hepatic support for patients in fulminant hepatic failure has been limited by the fact that individual perfusions can be sustained for only a few hours. Inadequate liver function and/or hemodynamic instability are the major contributing factors for early interruption of PECLP. Recent reports suggest that the choice of single (portal vein only) vs dual (portal vein and hepatic artery) vessel perfusion may influence the duration of perfusion. We hypothesize that PECLP with single vessel perfusion (SVP) is associated with worse liver function and greater hemodynamic instability than PECLP with dual vessel perfusion (DVP). MATERIALS AND METHODS: To eliminate the potentially confounding influences of liver failure and xenograft rejection, liver isografts procured from White-Landrace pig donors were perfused by either SVP or DVP via an extracorporeal circuit established with normal White-Landrace pig recipients. The function of perfused livers was evaluated by measuring production of bile and Factors V and VIII, clearance of ammonia and lactate, and extraction of O(2) at baseline and at 0, 1, 3, 6, 12, and 24 h after initiation of PECLP. The impact of PECLP on recipient hemodynamic status was assessed by monitoring BP, heart rate, urine output, O(2) saturation, etc. Among other parameters evaluated were serum albumin and total protein and hepatic release of IL-1beta and nitric oxide to assess their possible contributions to hemodynamic instability. RESULTS: DVP and SVP livers cleared ammonia and lactate similarly. Both approaches were associated with progressive hypoalbuminemia and hypoproteinemia. DVP livers produced more bile and Factor V and were associated with less recipient hypotension and IL-1beta and NO release than SVP livers. CONCLUSIONS: Livers with DVP function better than livers with SVP. The duration of PECLP can be limited by recipient hypotension, although this complication is less severe with DVP than with SVP.
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Circulación Extracorporea/métodos , Arteria Hepática , Hígado/irrigación sanguínea , Vena Porta , Amoníaco/metabolismo , Animales , Bilis/fisiología , Presión Sanguínea , Diuresis , Factor V/biosíntesis , Femenino , Frecuencia Cardíaca , Hemodinámica , Hipotensión/etiología , Ácido Láctico/metabolismo , Hígado/fisiología , Fallo Hepático/terapia , Oxígeno/sangre , Consumo de Oxígeno , Porcinos , Tromboplastina/biosíntesisRESUMEN
The search for a support system for liver failure has been intensified. Methods currently being tested include those based on artificial support, on biological approaches (including extracorporeal liver perfusion and transplanted hepatocytes) as well as hybrid devices that combine artificial aspects with biological systems. Each of these three areas is undergoing fast technological and conceptual development. Controlled clinical trials are also under way.
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Fallo Hepático/terapia , Hemoperfusión , Hepatocitos/trasplante , Humanos , Hígado Artificial , Perfusión , Diálisis RenalRESUMEN
The presence of free tumour cells at the mesothelial surface in patients with intraperitoneal colon cancer is an important prognostic factor and may alter the decision regarding adjuvant chemotherapy. In this prospective study of 72 patients we aimed to show the existence of malignant cells in the peritoneal cavity by scraping the serosa and by peritoneal lavage. Intraoperative peritoneal cytology was performed in 72 colon cancer patients who underwent curative surgery in our department between 1992 and 1995. Specimens were obtained by peritoneal lavage and by scraping the serosa overlying the major tumour mass and an area of normal serosa at least 10 cm from the primary site. Slides were stained with haemotoxylen-eosine stain. Statistical analysis was performed with chi-squared and Fisher's exact tests. In conclusion, peritoneal washing and serosal cytological study appeared to be a simple and reliable method to detect serosal involvement and the existence of malignant cells in the peritoneal cavity.