ABSTRACT
PURPOSE: Hyperthermic intraperitoneal chemotherapy (HIPEC) is a novel treatment option for peritoneal surface malignancies. Due to cytotoxic effects of chemotherapeutic agents, anastomosis healing can be impaired and lead to leakage rates higher than conventional intestinal surgery. In this experimental study, we aimed to investigate the effects of platelet-rich plasma (PRP) on colonic anastomosis in rats that received HIPEC with oxaliplatin.METHODS: Thirty rats were divided into 3 groups. Group 1 was determined as control group and hyperthermic saline perfusion was performed after colon anastomosis. In group 2, colon anastomosis then hyperthermic oxaliplatin perfusion was performed. In the last group, the colonic anastomosis was enhanced by PRP gel and then hyperthermic oxaliplatin perfusion was performed. All the rats were reoperated on postoperative day 7 and anastomotic bursting pressure values were recorded. Tissue samples were taken for hydroxyproline assay and histopathological examination.RESULTS: Control group had higher anastomotic bursting pressure value than group 2 and group 3 (P < 0.001). There were significant differences in anastomotic bursting pressure between groups 2 and 3 (P < 0.001). Group 2 had significantly lower hydroxyproline levels than group 3 and control group (P < 0.001). Histopathological examination revealed that PRP application reduced inflammatory response.CONCLUSION: PRP application on colonic anastomosis improves anastomotic healing and can reduce anastomosis related complications and stoma creation; though further clinical studies are needed.
Subject(s)
Animals , Rats , Anastomotic Leak , Colon , Colonic Neoplasms , Drug Therapy , Fever , Hydroxyproline , Perfusion , Platelet-Rich PlasmaABSTRACT
Objective: To determine the potential utility of hematological parameters in the diagnosis of intra-abdominal hypertension [IAH]
Study Design: Cross-sectional descriptive study
Place and Duration of Study: Health Sciences University, Samsun Training and Research Hospital, Samsun, Turkey, from January 2016 to July 2017
Methodology: Forty-two patients who underwent transperitoneal laparoscopic urologic surgery were included. Blood samples were obtained during periods of pre-insufflation, insufflation, and desufflation to determine the effects of increased intraabdominal pressure [IAP] on hematological parameters, respectively
Results: Leukocyte and neutrophil median values changed with time [p<0.001]. The median pre-insufflation, insufflation, and desufflation values for leukocytes were 6.3 fL [4.2-7.8 fL], 7.2 fL [4.4-9.9 fL], and 8.1 fL [4.9-13.5 fL], respectively.In the pre-insufflation period, the median value for neutrophils was 3.7 x 10[3] MuL [2.0-6.2 x 10[3] MuL], increasing 5.1 x 10[3] MuL [2.1-9.7 x 10[3] MuL] during insufflation and 6.1 * 10[3] MuL [3.1-10.0 x 10[3] MuL] during desufflation. The median values obtained in pre-insufflation period were significantly lower than those recorded in the other periods. There was no difference between the median values obtained during insufflation and those obtained during desufflation. The mean platelet volume [MPV] values during pre-insufflation, insufflation, and desufflation were 8.2 fL [6.3-9.6 fL], 8.8 [6.2-10.3 fL], and 8.1 [6.6-10.6 fL], respectively. There was a statistically significant increase in MPV values during high IAP [p<0.001]
Conclusion: The rise in MPV during IAP rise indicated that this parameter may be used to detect IAH