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Biomedical subjects

Tayfun Karahasanoglu

Publications and source records attributed to Tayfun Karahasanoglu.

8 recordsLinked to original sources

Mesh fixation devices and formation of intraperitoneal adhesions.

PURPOSE: To investigate the effect of mesh fixation devices on the formation of intra-abdominal adhesions. MATERIALS AND METHODS: Fourteen New Zealand rabbits were used. In seven animals, nickel-titanium (nitinol) anchors (group 1) and titanium tacks (group 2) were applied by laparoscopy on the right and left sides of the abdomen, respectively. In the remaining seven rabbits, the same devices were applied on prosthetic meshes (groups 3 and 4, respectively). On day 30, the rabbits were sacrificed and macroscopic adhesion scoring was performed. All the specimens were assessed by scanning electron microscopy (SEM). RESULTS: All parameters of adhesion except extension were significantly higher in group 4 than group 3 (P < 0.05). Comparisons of group 1 vs. group 2 were not statistically significant (P > 0.05). All the comparisons between a nonmesh group and a mesh group resulted in significant differences. SEM results revealed that the mesothelial cell layer and connective tissue intensively covered the tacks in group 2 whereas no similar findings were observed in group 1. Comparable appearances were encountered in groups 3 and 4. CONCLUSION: The nitinol anchor is associated with an acceptable level of adhesion formation and its intraperitoneal use can be considered safe in this regard.

Animals↗

Oxidative stress and nitric oxide in rats with alcohol-induced acute pancreatitis.

AIM: Oxygen free radical mediated tissue damage is well established in pathogenesis of acute pancreatitis (AP). Whether nitric oxide (NO) plays a deleterious or a protective role is unknown. In alcohol-induced AP, we studied NO, lipooxidative damage and glutathione in pancreas, lung and circulation. METHODS: AP was induced in rats (n = 25) by injection of ethyl alcohol into the common biliary duct. A sham laparatomy was performed in controls (n = 15). After 24 h the animals were killed, blood and tissue sampling were done. RESULTS: Histopathologic evidence confirmed the development of AP. Marked changes were observed in the pulmonary tissue. Compared with controls, the AP group displayed higher values for NO metabolites in pancreas and lungs, and thiobarbituric acid reactive substances in circulation. Glutathione was lower in pancreas and in circulation. Glutathione and NO were positively correlated in pancreas and lungs of controls but negatively correlated in circulation of experimental group. In the experimental group, plasma thiobarbituric acid reactive substances were negatively correlated with pancreas thiobarbituric acid reactive substances but positively correlated with pancreas NO. CONCLUSION: NO increases in both pancreas and lungs in AP and NO contributes to the pathogenesis of AP under oxidative stress.

Acute Disease↗

Spiral tacks may contribute to intra-abdominal adhesion formation.

PURPOSE: With the inception of laparoscopic ventral hernia repair came a novel device not used in conventional hernia repair; the spiral tack. We conducted an experimental study on pigs to determine whether spiral tacks contribute to adhesion formation. METHODS: Using a standard laparoscopic technique in pigs, pieces of polypropylene mesh were fixed to the fascia on the upper abdominal wall, with polypropylene sutures on a randomly chosen side (side 1), and with 5-mm spiral tacks on the opposite side (side 2). The extent, type, and tenacity of the adhesions were assessed on postoperative days (PODs) 30 and 90. RESULTS: The mesh fixed to the abdominal wall with spiral tacks tended to increase the extent, type, and tenacity of adhesions more than the mesh fixed with polypropylene sutures (P < 0.05). CONCLUSIONS: Spiral tacks contributed to the formation of adhesions more than polypropylene mesh did. Although this was a small-scale animal study, our findings suggest that the effect of spiral tacks used in laparoscopic ventral hernia repair should be assessed and the consequences monitored more closely.

Abdomen↗

Laparoscopic removal of a retained surgical instrument.

We report the case of a patient who underwent laparoscopic removal of a retained surgical spatula two months after a total abdominal hysterectomy and bilateral salpingo-oophorectomy for endometrial carcinoma. The foreign body was detected on a routine radiograph while the patient was been prepared for radiotherapy. Laparoscopy allowed us to explore the entire abdominal cavity for any potential complications of the retained instrument, and the procedure was completed successfully. This case demonstrates the feasibility of using a minimally invasive technique in the removal of a retained foreign body.

Abdomen↗

Adult intussusception due to inverted Meckel's diverticulum: laparoscopic approach.

Nowadays, laparoscopy appears to be an attractive alternative to conventional surgery in the management of small bowel obstruction. Adult intussusception is an unusual cause of intestinal obstruction, and a wide range of pathologic conditions can result with intussusception. In this report, we present a very rare case of intussusception secondary to inverted Meckel's diverticulum in an adult who underwent laparoscopic surgery. The diagnostic modalities and surgical management of intussusception are discussed.

Adult↗

Laparoscopically treated liver hydatid cysts.

HYPOTHESIS: Laparoscopy is effective and reliable in treating hepatic hydatid disease. DESIGN: Case series of patients with hepatic hydatid disease who underwent laparoscopic treatment within 7 years. SETTING: Department of General Surgery, Cerrahpasa Medical School, University of Istanbul, Istanbul, Turkey. PATIENTS: Forty-eight patients with hydatid disease who met our criteria for laparoscopic surgery and were aged 17 years or older. INTERVENTIONS: Cystotomy and partial cystectomy with drainage were performed in 33 patients. Omentoplasty was simultaneously performed in 15 patients to obliterate the cystic cavity. MAIN OUTCOME MEASURES: Clinicopathologic features, morbidity, mortality, operative time, length of hospital stay, conversion to laparotomy, and recurrences were reviewed retrospectively. RESULTS: The mean operative time was 82 minutes (range, 45-170 minutes). The conversion rate to open surgery was 4%. The mean postoperative length of hospital stay was 4.2 days. Morbidity was 6% (3 patients). There was no mortality. The mean follow-up was 34.2 months. No recurrences were observed during this period. CONCLUSIONS: Laparoscopic hepatic hydatid surgery is a safe and effective method in selected patients. Further studies should be encouraged in this field because there is no universally accepted standard technique.

Adolescent↗

Total laparoscopic cystogastrostomy for the treatment of pancreatic pseudocyst.

Laparoscopic surgery may be performed for the treatment of pancreatic pseudocyst when decompression is indicated. Most of reported laparoscopic procedures are performed by inserting trocars via the anterior gastric wall and operating intraluminally with gastric insufflation and endoscopic guidance. We report a patient who was treated successfully with laparoscopic stapled cystogastrostomy and discuss the feasibility and features of such a technique performed with a totally abdominal approach.

Decompression, Surgical↗

Pentoxifylline in the treatment of radiation-related pelvic insufficiency fractures of bone.

The reported incidence of bone complications after radiation therapy is quite low. The most commonly seen bone complication is insufficiency fractures of the pubis and sacrum. Treatment of insufficiency fractures consists of conservative care, and mineral replacement may be useful. The resolution of symptoms takes at least one year with these treatments. Vascular damage has an important role in the etiology of late radiation injury in normal tissues. Progressive ischemic changes further weaken the bone structure, which can cause fractures, and healing is also delayed. Pentoxifylline is a methylxanthine derivative that is shown to increase tissue blood flow. Here, we present a 63-year-old male patient with pelvic insufficiency fractures due to postoperative pelvic irradiation for rectal adenocarcinoma. The patient received pelvic radiotherapy to a total dose of 50.4 Gy with concomitant 5-FU. Six months after the completion of radiotherapy, the patient presented with severe pelvic pain. Pelvic magnetic resonance imaging (MRI) demonstrated abnormal signal intensity with insufficiency fractures at the sacrum and bone marrow edema near the fractures, but not an abnormal intensity that revealed bone metastases. Neither distant nor locoregional recurrence was observed at his work-up. The final diagnosis was insufficiency fractures of the pelvic bones owing to irradiation, and pentoxifylline (400 mg, 3 times daily, peroral, 1,200 mg/day) was used for eight months as treatment. Dramatic clinical improvement was obtained in six months, and objective healing was revealed with MRI. We concluded that pentoxifylline is a cost-effective drug with minimal adverse effects in treating radiation damage of bone.

Bone and Bones↗