The Use of Radiofrequency Thermal Ablation Method in The Treatment of Hepatic Hydatid Cysts: Ex vivo Sheep Study

Objective: Hydatid disease is a disease caused by parasites belonging to the echinococcus family. This disease is often caused by Echinococcus granulosus and rarely by echinococcus alveolaris.The parasite may cause illness anywhere in the human body, mainly in liver. In this study, we aimed to destroy the hydatid cyst viability by Radiofrequency Thermal Ablation (RFTA) method which has been used in many areas in medicine. Methods: We used fresh sheep liver with hydatid cysts. Average diameter of cysts was 3.3 cm. The study was performed in 3 groups, each of which involved 20 cysts. After more than half of the cyst fluid was drained, ablation was performed. When the core temperature of the cyst exceeded 95°C, ablation procedure was continued for 3 minute in 1st group and for 4 minutes in 2nd group. Third group was the control group. And then, cyst fluid and germinative membrane were collected for microbiologic and pathologic assessment. Results: In 1st group, the cysts could not be destroyed at the desired level. In 2nd group, it was observed that 100% of the protoscolex died and 100% of the germinative membranes was degenerated. In control group, %13 of protoscolex died and %10 of germinative membranes wasdegenerated. Conclusion: We destroyed all the protoscolex and germinative membranes by using RFTA in 2nd group.

Effects of peritoneal lavage and dry cleaning on bacterial translocation in a model of peritonitis developed using cecal ligation and puncture.

BACKGROUND: Currently, all progress in diagnostic techniques, surgical techniques, antibiotherapy, and intensive care units is accompanied by a decrease in the mortality due to severe secondary peritonitis; however, the rate is still unacceptably high. To remove the source of peritonitis, a surgeon has several options, such as closure, exclusion, and resection, depending on the preference of the surgeon and the condition of the patient. The aim of this study is to determine the rates of bacterial translocation by comparing the dry cleaning method (gauze squeezed with saline) and peritoneal lavage method (cleaning with saline), which are among the peritoneal cleaning methods. METHODS: A total of 64 rats were studied as sham, control, dry cleaning, and saline cleaning groups. Only laparotomy was performed in the sham group, and cecal ligation puncture was performed in the control group. After ligation puncture operations in the other two groups, one of them was subjected to dry cleaning and the other to isotonic cleaning. The samples obtained from the liver, spleen, and mesothelium were sacrificed and cultured under aerobic and anaerobic environments. RESULTS: There was no significant difference in the anaerobic bacterial counts, although there was a significant difference in the results of the aerobic bacterial counts in liver, spleen, and mesothelium samples on comparing the dry cleaning and saline cleaning groups. CONCLUSION: According to our study, the cleaning of intraabdominal infections with dry gauze is more effective than the cleaning with physiological saline for the elimination of aerobic bacteria. There is no difference observed with respect to the anaerobic bacterial counts.

Comparison of Unilateral Fasciocutaneous V-Y Flap Technique with Cleft Lift Procedure in the Treatment of Recurrent Pilonidal Sinus Disease: A Retrospective Clinical Study.

BACKGROUND This study aimed to assess treatment outcomes of the cleft lift procedure and V-Y flap technique in the treatment of recurrent pilonidal sinus disease (PSD). MATERIAL AND METHODS A total of 51 patients who underwent cleft lift procedure and 43 patients who underwent fasciocutaneous V-Y flap technique were evaluated. The demographic characteristics, previous operations, duration of symptoms, perioperative complications, duration of operation and hospital stay, duration of draining of all patients, and recurrence of PSD were recorded. RESULTS The mean operation time was 35.61±5.254 min in the cleft lift group (CLG) and 57.42±7.327 min in the V-Y flap group (VYFG) (p=0.001). No wound dehiscence was found in the VYFG and 5 patients (9.8%) had wound dehiscence in the CLG (p=0.035). Draining time was 1.39±0.603 days in the CLG and 2.79±0.638 days in VYFG (p=0.001). The mean hospital stay was 1.75±0.523 days in the CLG and 3.77±1.02 days in the VYFG (p=0.001). Two patients (3.9%) in the CLG had recurrence and no recurrence was reported in the VYFG (p=0.189) in the given time interval. CONCLUSIONS Both methods in treatment of recurrent PSD can be preferred because of low complication and recurrence rates. Because no recurrence was found after the V-Y flap technique, it appears to be a preferable method despite some disadvantages.