Evaluating the effect of infliximab on the healing of left colonic anastomosis in the presence of intra-abdominal sepsis.

BACKGROUND AND STUDY AIMS: Infliximab (IFX) is a chimeric anti-TNF-α body which is effectively used in the treatment of inflammatory bowel diseases and a variety of autoimmune diseases. The effect of IFX on the healing of intestinal anastomosis has been evaluated in several studies, however with conflicting results. Furthermore, the effect of IFX on colonic anastomosis in sepsis has not been evaluated to date. In this study, we aimed to investigate whether IFX has an adverse effect on the healing process of colonic anastomosis either under normal or septic condition. MATERIAL AND METHOD: The efficiency of IFX was assessed with respect to anastomotic bursting pressure (ABP), tissue hydroxyproline levels (THL) and histopathological examination of left colonic anastomosis in 40 male rats. The rats were randomly allocated into four groups of 10 rats each as control (C), septic control (SC), control IFX (C-IFX) and septic IFX (S-IFX). RESULTS: The anastomotic bursting pressure was measured at 182±19.1, 158±15.4, 161±26.8 and 100±10.3mm/Hg, in C, SC, C-IFX and S-IFX; respectively. IFX administration did not influence the anastomotic strength under normal condition whereas in sepsis significantly induced the reduction of APB. The mean THL was almost similar in both control groups (p=0.87), whilst IFX reduced the level of TH in sepsis comparing with control groups (p=0.01). IFX significantly impaired immune response in sepsis resulting in poor anastomotic healing in S-IFX group. CONCLUSION: Our study demonstrated that IFX had no detrimental effect on the healing of colonic anastomosis under normal condition whilst significantly impaired the healing process in sepsis.

The Effect of Platelet-Rich-Plasma on the Healing of Left Colonic Anastomosis in a Rat Model of Intra-Abdominal Sepsis.

OBJECTIVE: The aim of this study was to investigate the effect of platelet-rich plasma (PRP) on the healing of colonic anastomosis in the presence of sepsis. MATERIALS AND METHOD: Fifty Wistar-albino male rats were used. Ten healthy rats were euthanized to prepare PRP, the rest were subjected to colonic anastomosis and randomly allocated into four groups of 10 rats each as anastomosis without PRP (C), without PRP in sepsis (SC), anastomosis with PRP (C-PRP), and with PRP in sepsis (S-PRP). Sepsis was induced by cecal ligation and puncture procedure. All animals were euthanized on postoperative day 7. The body weight change, anastomotic bursting pressure (ABP), tissue hydroxyproline (TH) and histopathological examination of each group were analyzed by using one-way analysis of variance (ANOWA) and Tukey's HSD post-hoc test to assess the differences between the groups. RESULTS: There was no statistical difference among the groups in terms of body weight changes. The ABP was measured at a mean value of 179.5 ± 10.3, 129.3 ± 14.2, 209 ± 14.4, and 167.5 ± 7.5 mm-Hg, in group C, SC, C-PRP, and S-PRP, respectively. The ABP and TH of C-PRP group was significantly higher than three groups (p < .05, for each comparison). In sepsis, PRP significantly raised the mean ABP and TH levels up to the levels of C group. Tissue regeneration was significant with increased collagen formation in C-PRP group than the other groups (p < .05). The healing effect of PRP in the presence of sepsis was significant than S-group (p < .05), while similar to C group (p = .181). CONCLUSION: PRP application to colonic anastomosis promotes the healing process in rats with intra-abdominal sepsis.

A spinal dermoid cyst with spontaneous rupture into the syrinx cavity: a case report.

Dermoid cysts are rare benign congenital tumors comprising 1.1 % of the spinal tumors, with lumbosacral region and cauda equina being the common sites. Many cranial cases with spillage of cyst contents into the subarachnoid space have been reported. We report an extremely unusual case of symptomatic spinal dermoid cyst that ruptured into the syrinx cavity. The gold standard treatment is complete resection of both cyst wall and content in dermoid cysts. However, there is no consensus for the treatment of the syrinx cavity. Observation of similar cases would give us more information about treatment options and the progression of these lesions.

Dermatofibrosarcoma protuberans: A case report of a rare, bulky tumor that was managed with surgical therapy.

We report a case of this rare tumor and describe the surgical approach that we adopted and the clinical outcome; we also report his condition at 24 months' follow-up. Although treatment was with radical surgery, sufficient shoulder function could be obtained in our patient. We also describe the interesting MR findings of this tumor which correlated well with the histopathologic findings.