ABSTRACT
Objective: Management of splenic injury is a challenging surgical emergency. The spleen has important immunologic functions. Therefore, conservation of the spleen after trauma-whenever possible - is necessary. The present study was carried out to assess the efficacy of topical fibrin sealants [fibrin glue] in comparison with gelatin sponge [gelfoam] and oxidized regenerated cellulose [surgicel] in a rat spleen trauma model
Material and Methods: A standardized traumatic splenic injury was inflicted in male Sprague-Dawley albino albino rats. Animals were divided into four groups [10 rats per group]. Rats that were managed only with surgical gauze served as controls [group 1]. The rest of the animals were categorized as follows; gel foam [group2], surgicel [group 3] and fibrin glue [group 4]. The time necessary to achieve hemostasis was recorded for each rat. Spleens were removed 72 hours later to examine the histopathological parenchymal effects of the topical agents
Results: Complete hemostasis was achieved in all animals within minutes, but fibrin glue and gel foam were significantly superior compared to the control group [p < 0.05]. The surgicel didn't show statistical significance over the control group [p> 0.05]. Moreover, the fibrin glue was significantly better in achieving hemostasis compared to the gel foam [p < 0.05]. Histopathological findings showed that the gelfoam exhibited the most severe inflammatory reaction, while the surgicel caused a moderate inflammatory reaction. Fibrin glue constituted the least inflammatory parenchymal reaction
Conclusion: The present study illustrated that the use of fibrin sealants can be considered an efficient reliable method of attaining hemostasis after splenic injury. Larger prospective clinical studies are recommended
ABSTRACT
Twenty-seven patients with an age range of 36-71 years were included in this study. They were subjected to thorough clinical, radiological and biochemical assessment as well as serological testing for HCV, HBV and serum alpha fetoprotein [AFP] level. Serum vascular endothelial growth factor [VEGF] levels were measured by an enzymeournallinked immunosorbent assay kit. Samples from 15 healthy adults were obtained as controls for the assessment of serum VEGF levels. An immunohistochemical staining was done to study the tumor VEGF expression in the resected specimens. A histologic grade of tumor differentiation was also performed. Prognostic information was obtained by a close follow up every 2-3 months. The study demonstrated that serum VEGF level in HCC patients appears to reflect the disease potential activity for an aggressive behavior and can be used as a predictor of tumor recurrence