Postoperative complications associated with anterior cervical discectomy and three years follow-up.

INTRODUCTION: Anterior cervical discectomy (ACD) is used in the surgical treatment of cervical degenerative disc disease (DDD). Besides the low incidence of postoperative complications, they can affect the postoperative course for patients. MATERIAL AND METHODS: From January 2015 to December 2019, 789 cervical DDD patients with ACD were investigated. This study aims to identify the risk factors for postoperative complications and evaluate the quality of life for ACD patients using the Visual Analog Pain Scale (VAS) and Neck Disability Index (NDI). RESULTS: Among the 789 cervical patients, postoperative complications were identified in 88 patients. In analyzing independently risk factors for postoperative complications, we don't record the male gender, age, number of treated segments, diabetes mellitus, and hypertension with significant risk. A BMI higher than 23.5, a longer surgery of more than 82.5 min, and blood loss of more than 95 ml were found as independent risk factors for postoperative complications. The three-year follow-up quality of life was evaluated in 565 because of the loss of 224 patients. We found improved quality of life in the whole group of patients. Moreover, we have not confirmed significant differences in groups of patients, with and without postoperative complications. CONCLUSION: The result of our study documented a low incidence of postoperative complications after ACD. We identified high BMI level, increased blood loss, and prolonged operation time as independent risk factors for the increased incidence of postoperative complications. Moreover, we demonstrated that postoperative complications do not significantly influence the patient's quality of life (Tab. 5, Ref. 32).

Regulation of transforming growth factor-ß signaling as a therapeutic approach to treating colorectal cancer.

According to data from 2020, Slovakia has long been among the top five countries with the highest incidence rate of colorectal cancer (CRC) worldwide, and the rate is continuing to rise every year. In approximately 80% of CRC cases, allelic loss (loss of heterozygosity, LOH) occurs in the long arm of chromosome 18q. The most important genes that can be silenced by 18q LOH or mutations are small mothers against decapentaplegic homolog (SMAD) 2 and SMAD4, which are intracellular mediators of transforming growth factor (TGF)-ß superfamily signals. TGF-ß plays an important role in the pro-oncogenic processes, including such properties as invasion, epithelial-mesenchymal transition (commonly known as EMT), promotion of angiogenesis, and immunomodulatory effects. Several recent studies have reported that activation of TGF-ß signaling is related to drug resistance in CRC. Because the mechanisms of drug resistance are different between patients in different stages of CRC, personalized treatment is more effective. Therefore, knowledge of the activation and inhibition of factors that affect the TGF-ß signaling pathway is very important.