The effects of ventilation with high density oxygen on the strength of gastrointestinal anastomosis

PURPOSE: The aim of our study is to evaluate the effects of administration of perioperative supplemental oxygen on anastomoses. METHODS: Forty male Wistar albino rats were used in the study and randomized into 4 groups. Ischemia-reperfusion models were built in groups 3 and 4. Jejunojejunostomy was performed in all rats and assigned to an oxygen/nitrous oxide mixture with a fraction of inspired oxygen of 30% in groups 1 and 3 and 80% in groups 2 and 4. The measurements of perianastomotic tissue oxygen pressure, bursting pressure, level of hydroxyproline were evaluated and compared in all groups. RESULTS: The perianastomotic tissue oxygen pressures, bursting pressures and levels of hydroxyproline were identified as significantly high in groups 2 and 4, administered a fraction of inspired oxygen of 80%, compared to groups 1 and 3, administered a fraction of inspired oxygen of 30%. CONCLUSION: Perioperative supplemental oxygen contributes positively to the anastomotic healing.

Outcome of the patients with chronic mesh infection following open inguinal hernia repair / 대한외과학회지

PURPOSE: Hernia repairs are the most common elective abdominal wall procedures performed by general surgeons. The use of a mesh has become the standard for hernia repair surgery. Herein, we discuss a management strategy for chronic mesh infections following open inguinal hernia repair with onlay prosthetic mesh. METHODS: In this study, 15 patients with chronic mesh infections following open inguinal hernia repairs were included. The medical records of these patients were retrospectively reviewed and information regarding presentation, type of previous hernia repair, type of mesh, operative findings and bacteriological examination results were obtained. In all cases, the infected mesh was removed completely and the patients were treated with antibiotic regimens and local wound care. RESULTS: Fifteen mesh removals due to chronic infection were performed between January 2000 and March 2012. The mean interval of hernia repair to mesh removal was 49 months. All patients were followed up for a median period of 62 months (range, 16 to 115 months). In all patients, the infections were resolved successfully and none were persistent or recurrent. However, one patient developed recurrent hernia and one developed nerve injury. CONCLUSION: Chronic mesh infection following hernia repair mandates removal of the infected mesh, which rarely results in hernia recurrence.

Localization of Stricture in Crohn's Disease with Foley Catheter

No abstract available.

Multiple renal arteries challenge in laparoscopic donor nephrectomy: how far can we go? / 대한외과학회지

PURPOSE: Living donor kidneys with multiple arteries are routinely procured laparoscopically. We aim to present our experience with laparoscopic donor nephrectomy (LDN) and to compare the graft function and outcome between cases with single versus multiple arteries. METHODS: We compared the demographic data, operation time, warm ischemia time, rejection rate, and graft function between LDN kidneys with single artery and those with multiple arteries. RESULTS: Seventy-three cases with 1 renal artery (group LDN-1), 8 cases with 2 renal arteries (group LDN-2) and 5 cases with 3 or more renal arteries (group LDN-3) were included in the study. The mean operative time was significantly higher in groups LDN-2 (100.3 +/- 9.5 minutes) and LDN-3 (120.6 +/- 10.3 minutes) compared to group LDN-1 (75.7 +/- 10 minutes, P < 0.001). Similar results were detected with respect to the warm ischemia time. There were no statistically significant differences related to graft function and outcome among these groups. CONCLUSION: Multiple renal arteries present a special challenge in both donor nephrectomy and renal transplantation. However, laparoscopic procurement of a kidney with multiple renal arteries, regardless of the number, is reliable and has no significant impact on the graft outcome.

Clinically Positive Axillary Lymphadenopathy May Lead to False Diagnosis of Overstaged Breast Cancer in Patients with Sjogren's Syndrome: A Case Report / 한국유방암학회지

Sjogren's syndrome (SS) is an autoimmune disease that chronic inflammation and lymph node proliferation. Patients with SS carry a greater risk of developing lymphoproliferative malignancy. In addition to other organ cancers, breast cancer may also occur in these patients. Considering these, breast cancer in patients with SS can be misdiagnosed as being in an advanced stage particularly in the presence of axillary lymphadenopathy. Here, we report a rare case of a 45-year-old woman with SS who presented with a breast mass. Radiology showed a 4 cm solid lesion and conglomerates of axillary lymphadonepathy. A breast biopsy revealed ductal carcinoma in situ. A modified radical mastectomy was performed; however, no axillary metastases were detected. Clinicians should remain vigilant to the possibility that a false clinical impression of axillary metastasis may occur in such patients with breast cancer. Therefore, axillary node status should be verified first.

Splenic infarction as a complication of celiac artery thromboembolism: an unusual cause of abdominal pain / 대한외과학회지

Splenic infarction is a relatively uncommon diagnosis and this clinical presentation can mimic other causes of acute abdominal pain. Cardiologic and hematologic disorders are common reasons for this entity. There have been a few series and single case reports of splenic infarction published in peer-reviewed medical journals. We report a 53-year-old patient who had splenic infarction caused by celiac artery thromboembolism. The importance of this case, without any etiological predisposing factors, is that this kind of clinical situation should be considered in the differential diagnosis of abdominal pain.

Splenic infarction as a complication of celiac artery thromboembolism: an unusual cause of abdominal pain / 대한외과학회지

Splenic infarction is a relatively uncommon diagnosis and this clinical presentation can mimic other causes of acute abdominal pain. Cardiologic and hematologic disorders are common reasons for this entity. There have been a few series and single case reports of splenic infarction published in peer-reviewed medical journals. We report a 53-year-old patient who had splenic infarction caused by celiac artery thromboembolism. The importance of this case, without any etiological predisposing factors, is that this kind of clinical situation should be considered in the differential diagnosis of abdominal pain.

questionnaire study on the surgeon's preferences for inguinal hernia repair after a decade

During the 20th century, hernia repair trend changed several times. A very interesting competition has been going on between the opponents of Lichtenstein and laparoscopic repairs. We recently questioned the same issue by the same method to see if laparoscopic hernia repair found more opponents and preference rate in surgeons and physicians in Ankara, Turkey. In general 88.9% of the respondents preferred open repair, while only 11.1% chose laparoscopy. The majority of the participants who preferred an open repair stated that it was a better known technique to choice. Almost half considered local anaesthesia an advantage. Laparoscopic repair was mainly preferred for its advantages of less pain and early return to work. When three consecutive surveys among the same population in Ankara in 1997, 2001 and 2007 were compared the laparoscopic repair preference rates did not show a statistical difference [9.1%, 16.1% and 11.1% respectively]