Sürdürülebilir Kalkınma Amaçları
Yayınlar
- MakaleAçık Erişim2014Stereotactic Excision of Additional Lesions Detected with Intraoperative Ultrasound Examination During Radiofrequency Dissecting Sealar (Habib®) Assisted Hepatic Metastasectomy: Report of 4 Cases
Altuntas, Yunus E.; Unel, Sacide; Gezen, Fazli C.; Aksakal, Nihat; Civil, Osman; Vural, Selahattin; Ozates, Mustafa; Oncel, Mustafa
Intraoperative ultrasound has been using to achieve a proper resection strategy in patients undergoing a hepatic colorectal metastasectomy. This study aims to describe and reveal the place of stereotactic metastasectomy in nonpalpable colorectal liver metastases (CLM). A chart review was initiated for all patients underwent resection for CLM between 2006 and 2011. The data concerning perioperative data and intraoperative strategy were abstracted. Among the 58 patients, who underwent a resection for CLM, 4 (6.9 %) (all men, median age 65.5, range 49-72, years) necessitated a stereotactic metastasectomy. Preoperative evaluations showed 1 (n = 1), 2 (n = 2), or 3 (n = 1) lesions, and intraoperative ultrasound (IUS) found an additional lesion in a case. Stereotactic marking was performed for nonpalpable lesions located in segments IVA, II, and VI and at the junction of segments V and VI. The margins were negative for all lesions both resected with conventional and stereotactic techniques. The examinations of the stereotactic resection materials revealed metastatic adenocarcinoma (patients n = 2), focal nodular hyperplasia (n = 1), and abnormal benign liver histology probably induced by chemotherapy (n = 1). The median (range) operation and hospitalization periods were 217.5 (150-310) minutes and 5.5 (2-9) days. No complications were observed except biliary fistula in a case, which spontaneously disappeared within 2 weeks. A patient died due to systemic disease including hepatic metastases 33 months after the liver surgery. Stereotactic metastasectomy may be feasible for the removal of nonpalpable CLM. Further evaluations are necessitated to understand the accurate place of this novel technique.
- MakaleAçık Erişim2011Heparin for adhesion prevention: Comparison of three different dosages with Seprafilm in a murine model
Kement, Metin; Censur, Zafer; Oncel, Mustafa; Buyukokuroglu, Mehmet E.; Gezen, Fazli C.
Background: This study aimed to assess the safety and effectiveness of different dosages of heparin for adhesion prevention by comparing with Seprafilm®, in a murine model. Materials and methods: Seventy five Balb/c mice were randomized into five groups. Group C were reserved as controls, and 62.5 IU, 125 IU, 250 IU of heparin, and Seprafilm® were intraperitoneally applied in studied groups. The severity and locations of adhesions were assessed after the sacrification on day 14. The cause of death was investigated to evaluate the side effects of the drugs. Results: The death of 2 subjects due to peritonitis (1 in Group C, 1 in Group H62.5) left 14 subjects in Group C and Group H62.5 (P ≥ 0.05), and no hemorrhage related death was observed. The use of the products significantly reduced the severity score of adhesion and the number of animals, had adhesions in different locations of the abdominal cavity, when the results were compared with the control group (P < 0.05 for all comparisons). Higher dosages of heparin seemed to be more effective. The results in group S, groups H250 and H125 were quite similar. Conclusions: Relatively high doses (125 IU and 250 IU) of intra-abdominal heparin may be comparable in safety and effectiveness to Seprafilm® in adhesion prevention in mice.