[Traumatic intra-abdominal major vascular injuries]. / Travmatik karin içi büyük damar yaralanmalari.

The records of 47 patients who underwent surgery with traumatic intraabdominal vascular injury at 2. and 3. Surgical Clinics of Izmir Atatürk Training and Research Hospital between January 1990 and December 1999 were studied. The aim of this study was to investigate the prognostic factors affecting the mortality. Hemoglobin (p < 0.05), hematocrit (p < 0.05), Glasgow Coma Score (p = 0.01), blood pressure (p < 0.05), Revised Trauma Score (p = 0.01), prehospital time (p = 0.01) and associated organ injury (p < 0.05) were the significant factors affecting the mortality. Our overall mortality was 46.8% and morbidity 41%.

The effect of preoperative 5-fluorouracil on colonic healing: an experimental study.

BACKGROUND/AIMS: After curative resection for colorectal carcinoma there is a high recurrence rate and neoadjuvant chemotherapy may be useful in some patients. Very little is known about the effect of preoperative 5-fluorouracil on the healing of colon anastomosis. The aim of this study was to evaluate the effect of 5-fluorouracil on colonic healing when the time interval between the last injection and operation was shortened to 24 hours. METHODOLOGY: Thirty-six male Wistar rats with a median weight of 185 g (range: 165-200 g) were divided into three groups: 1) control group (n = 12); 2) sham group (n = 12) which received saline intraperitoneally, and 3) study group (n = 12) which received 5-fluorouracil intraperitoneally (20 mg/kg-1). All injections were given intraperitoneally for 5 days and the last dose was injected 24 hours before operation. RESULTS: The mortality rate (22.7%) and anastomotic complications (29.4%) were increased in the 5-fluorouracil group, compared with the control or saline groups (P < 0.05). The anastomotic bursting pressure in rats having 5-fluorouracil treatment (27 mm Hg) was significantly lower from both the control (55 mm Hg) and saline (84 mm Hg) groups on postoperative day 3 (P < 0.05). Both myeloperoxidase and hydroxyproline contents were also significantly lower than the other groups (P < 0.05). CONCLUSIONS: Colonic healing was impaired and mortality rate was increased when intraperitoneal 5-fluorouracil treatment was repeated until 24 hours before operation.

Unfiltered sulfur colloid and sentinel node biopsy for breast cancer: technical and kinetic considerations.

BACKGROUND: There are few clinical data on technical limitations and radiocolloid kinetics related to sentinel lymph node (SLN) biopsy for breast cancer. METHODS: In 70 clinical node-negative patients, unfiltered 99mTc sulfur-colloid was injected peritumorally and cutaneous hot spots were mapped with a gamma probe. SLN biopsy was performed followed by axillary lymph node dissection. Missed radioactive nodes (nodes not under hot spots) were removed from axillary lymph node dissection specimens and submitted separately. RESULTS: At least one hot spot was mapped in 69 patients (98%) and SLNs were retrieved in 62 (89%). No radiolabeled nodes were found in five (7%) and only nodes not under hot spots were retrieved in three patients (4%). Residual nodes not under hot spots were retrieved in 17 patients (24%) in whom at least one SLN specimen had been found. Diffuse radioactivity around the radiocolloid injection site impeded identification of all radiolabeled nodes during SLN biopsy, and was responsible for one of two false negatives (20 node-positive patients; false-negative rate 10%). Hot spot radioactivity, number of radiolabeled nodes, and nodal radioactivity did not change with time interval from radiocolloid injection to surgery (0.75-6.25 hours). CONCLUSIONS: Although SLN localization rate is high, intraparenchymal injection may predispose to failure of radiocolloid migration, failure to identify SLNs because of high radiation background, and false-negative outcomes. Alternative routes of radiocolloid administration should be explored.