We believe that antibiotic prophylaxis is necessary in patients scheduled for Karydakis flap repair. In our study, TCS tended to be associated with a lower rate of infection, but this trend did not achieve statistical significance. Anaerobic micro-organisms dominated the infective isolates.
During laparoscopy, the main problems of patients who have undergone previous abdominoplasty are inadequate pneumoperitoneum secondary to fibrosis and reconstructed anatomic landmarks for trocar placement. In this study, we present our laparoscopic bariatric experience in two patients with previous abdominoplasty. The procedures were a laparoscopic sleeve gastrectomy and a robotic Roux-en-Y gastric bypass. Both operations were done successfully by an abdominal wall traction technique, cutting fibrotic tissue and choosing new landmarks. We conclude that after abdominoplasty bariatric surgery can be performed safely either using conventional laparoscopic technique or robotically.
Pneumatosis cystoides intestinalis (PCI) is a rare disease. It was first described by Du Vernoy in 1793 during a cadaver dissection. Air-filled bubble-like lesions are located in the submucosa or the subserosa of the digestive tract. A 55-year-old Turkish male presented to the emergency department with complaints of recurrent abdominal pain and vomiting. Free air was detected in abdominal x-ray and abdominal computed tomography (CT). In exploration, a grape-like lesion consisting of hundreds of cysts was detected on the surface of the small intestine. Bowel resection was performed successfully. The surgical findings and pathological result confirmed the diagnosis of pneumatosis cystoides intestinalis. Keywords: Pneumatosis cystoides intestinalis, abdominal pain, acute abdomen INTRODUCTION Pneumatosis cystoides intestinalis (PCI) is a rare clinical pathology characterized by submucosal and/or subserosal collections of free gas, forming cystic lesions within the gastrointestinal tract and related peritoneal attachments (1). Air-filled bubble-like lesions are located in the submucosa or the subserosa of the digestive tract and usually range from 0.5 to 2.0 centimeters in size. Although PCI is most commonly seen in the intestine, it can be detected in all parts of the gastrointestinal tract. The incidence of PCI was reported to be 0.03% in the general population (2). The diagnosis of PCI can be a challenging event. We are presenting a patient who was admitted to the emergency department with abdominal pain for 3 days. He was operated on with a preoperative diagnosis of hollow viscous perforation. The surgical findings and pathological results confirmed the diagnosis of PCI.
BackgroundSplenectomy after combined colosplenic trauma or iatrogenic splenic injury during colorectal surgery associates with worse short- and long-term outcomes, including reduced survival in patients with colorectal cancer. Splenic autotransplantation may improve the outcomes of such patients. Omental splenic transplantation is the standard procedure but may be difficult when performing laparoscopic colorectal surgery or when total or subtotal omentectomy is required. This animal model study was performed to evaluate the impact of splenic autotransplantation to the groin area on colonic wound healing.MethodsThirty rats were divided into three groups of ten animals. One group underwent colon anastomosis and sham splenectomy, the second underwent colon anastomosis and splenectomy, and the third underwent colon anastomosis, splenectomy, and intramuscular autotransplantation of the spleen. On postoperative day 7, anastomotic healing was evaluated by measuring bursting pressure and hydroxyproline levels. The third group was subjected to scintigraphy before sacrifice to assess whether the transplant was functional.ResultsThe mortality rates of the sham, splenectomized, and transplanted animals were 0 %, 30 %, and 20 %, respectively: the splenectomized animals had significantly lower mean bursting pressures than the other two groups (p = 0.002). The mean hydroxyproline levels of the three groups were 467.4, 335.3, and 412.7 mg hydroxyproline/g protein, respectively (p = 0.0856). Nine of the ten transplanted animals (90 %) had splenic activity on scintigraphy.ConclusionsSplenectomy impaired the healing of the colonic anastomosis. This effect was largely reversed by splenic autotransplantation. Intramuscular autotransplantation to the groin area appears to be feasible and effective.
Objective: The effect of the specialty of physicians who perform endoscopy on preoperative wait-time of colorectal cancer patients was evaluated. Material and Methods:Data from 86 patients who have been operated with a diagnosis of colorectal cancer from January 2011-February 2013 regarding age, sex, tumor location, colonoscopy date, surgery date, the expertise and institution of the endoscopist were retrospectively examined. The time between colonoscopy and surgery was accepted as the pre-operative wait time (PWT). Results:Out of 86 patients, 24 (27.9%) colonoscopies were performed by general surgeons (GS), and 62 (72.1%) by gastroenterologists (GE). When patients who underwent colonoscopy in other centers were extracted, the PWT for our center was 20.4±10.8 days. When grouped according to specialties, the PWT of patients who had their colonoscopy performed by GS was significantly shorter than patients who underwent colonoscopy by GE at the same center (p<0.05). Patient's age, sex and location of the tumor had no effect on PWT (p>0.05). Conclusion:The preparation time for surgery in colorectal cancer patients is influenced by the specialty of the physician performing the procedure. In order to standardize this period, a common flow diagram after endoscopy should be established for patients with suspected malignancy.
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