Piroglu, Isilay; Tulgar, Serkan; Thomas, David Terence; Cakiroglu, Basri; Piroglu, Mustafa Devrim; Bozkurt, Yasin; Gergerli, Ruken; Ates, Nagihan Gozde

Background: Mechanical bowel preparation before colorectal surgery is commonly performed, but its benefits are controversial. The aim of this study was to compare the effects of mechanical bowel preparation on healing of colonic anastomosis and tissue strength. Material/Methods: After institutional review board approval, 20 adult Wistar albino rats were randomly divided into 2 groups of 10 animals each. Mechanical bowel preparation including sodium phosphate was performed on the experimental group via a feeding tube, whereas no bowel preparation procedures were performed on the control group. Transverse colon resection and anastomosis were performed on all rats under general anaesthesia. On postoperative day 5, re-laparotomy was performed and the anastomotic areas were resected. Animals were killed, after which bursting pressure and tissue hydroxyproline concentrations were measured, histopathological examination was performed, and we evaluated and compared the results. Results: There were no differences between control and experimental groups in bursting pressure, tissue hydroxyproline concentrations, or histopathological examination results (P>0.05). Conclusions: Our study demonstrated no significant difference between bursting pressures, tissue hydroxyproline levels, or modified wound healing score at postoperative day 5 between rats undergoing and not undergoing mechanical bowel preparation. Mechanical bowel preparation is not essential for healing or strength of colonic anastomosis in rats.

Tulgar, Serkan; Cakiroglu, Basri; Cevik, Banu Eler; Karakilic, Evvah; Ates, Nagihan Gozde; Gergerli, Ruken; Ozdemir, Erman

Introduction: Acute Renal Injury (ARI) is a constant problem for patients in intensive care and Continuous Renal Replacement Therapy (CRRT) is an ever-more important part of acute renal injury (ARI) treatment. Various criteria have been used for the diagnosis and classification of acute renal failure, including RIFLE (Risk-Injury-Failure-Loss-End stage), AKIN (Acute Kidney Injury Network) and most recently KDIGO (Kidney Disease: Improving Global Outcomes). Many studies have only evaluated urinary output or serum creatinine when categorizing ARI. Our aim was to determine the predictors of mortality in intensive care patients treated with CRRT and to compare mortality with ARI level as determined by KDIGO-Serum Creatinine (KDIGO-SCr) and KDIGO-urinary output (KDIGO-UO) Materials and methods: This retrospective study was performed on intensive care patients receiving CRRT at our institute between January 2010-December 2011. Patient files were reviewed and demographic data, hospitalization time, laboratory findings, CRRT commencement and ARI levels were noted. Results: Seventy patients were included in the study. Mortality was found to be associated with patients' age, Glascow Coma Scale (GCS) score, Acute Physiology and Chronic Health Evaluation (APACHE) II score and adjusted predicted death rate. (p<0,01). Receiver Operating Curve (ROC) area under the curve was statistically significant for determination of mortality using KDIGO-SCR (p<0.01) although the same was not true for KDIGO-UO (p>0.05). Conclusions: We believe that RIFLE, AKIN, KDIGO criteria are each good predictors of mortality. In the case of KDIGO criteria, based solely on serum creatinine or urinary output, KDIGO-SCr was found to be a better predictor of mortality when compared to KDIGO-UO.