Intra-abdominal use of taurolidine or heparin as alternative products to an antiadhesive barrier (Seprafilm) in adhesion prevention: an experimental study on mice.

PURPOSE: Seprafilm (Genzyme Biosurgery, Cambridge, MA) remains a widely used product in postoperative adhesion prevention. This study was designed to compare the antiadhesive effects of taurolidine, heparin, and Seprafilm in a murine cecal abrasion model. METHODS: Sixty male Balb/c mice underwent a cecal abrasion procedure and were randomized into four groups (n = 15 in each). Groups T, H, and S animals intraperitoneally received taurolidine, heparin, and Seprafilm, respectively, and Group C animals were reserved as control. Animals were killed on Day 21, and the severity of adhesions was evaluated with a scoring system ranging between 0 to 5. In addition, the localizations of the adhesions were questioned. RESULTS: Five (1 in Group S and 4 in Group H) animals died before they were killed. The deaths were related to intra-abdominal bleeding, and mortality rate was significantly higher in Group H than those in other groups (P < 0.05 for each comparison). The severity of adhesions was significantly less in the study groups than Group C, and in Group H than Groups T and S (P < 0.05 for each comparison). In addition, adhesions located cecum over itself were significantly less in the study groups than the control group, and those between small bowel and cecum were significantly lower in Groups T and S than the control group (P < 0.05 for each comparison). CONCLUSIONS: All products are effective in adhesion prevention. Heparin use provides the best results but may be associated with a higher mortality rate related to intra-abdominal bleeding. Taurolidine may be an alternative product to Seprafilm , but further studies are required.

A patient with metachronous gastric, colonic, and thyroid cancers: a case report.

In this paper, we discuss a 62-year-old woman who, in the course of 7 years (1994-2001), developed three cancers: adenocarcinoma of the stomach, adenocarcinoma of the cecum, and insular thyroid carcinoma, which metastasized to the retroperitoneal lymph nodes and liver. The patient died from complications related to the metastases. The results of basic genetic tests were normal. To the best of our knowledge, no other patient with the combination of these three cancers has been reported in the literature. Although patients with multiple cancers are not common, it is nonetheless important for clinicians to consider the possibility of second and third cancers in patients who were treated for a primary malignant tumor.