Effect of a new cross-linked hyaluronan gel on the staple line after sleeve gastrectomy in a rat model.

PURPOSE: To evaluate the effect of a new cross-linked hyaluronan (NCHA) gel on healing of the staple line in an experimental sleeve gastrectomy. METHODS: Eighteen rats were randomly divided into three groups. The control group (n = 6) received no medication. In the saline group (n = 6) and NCHA gel group (n = 6), saline and NCHA gel were respectively administered onto the staple line and intraperitoneally into the abdominal cavity after the standard stapling procedure. RESULTS: The fibroblast activity and collagen deposition were significantly higher in the NCHA gel group than in the control group (p = 0.00, p = 0.017) and saline group (p = 0.004, p = 0.015). The tissue hydroxyproline protein level was significantly higher in the NCHA gel group than in the control group (p = 0.041). Adhesion formation was significantly lower in the NCHA gel group than in the control and saline groups (p = 0.015, p = 0.041). CONCLUSIONS: New cross-linked hyaluronan gel could be an effective approach to improve staple line wound healing and prevent potential leakage after sleeve gastrectomy. Moreover, NCHA gel helps to prevent adhesion formation without compromising healing of the staple line.

Appendix mucocele mimicking a complex ovarian cyst.

Appendiceal mucocele is a rare entity which is characterized by cystic dilatation due to abnormal accumulation of mucus in the lumen of the appendix. Patients are often diagnosed incidentally by abdominal screening or abdominal surgery for other causes. Pain in the right lower quadrant of the abdomen, which may present as acute or chronic appendicitis, is the most common symptom of appendix mucocele, when the patient is symptomatic. This study describes the case of a 26-year-old female for whom surgical intervention for a complex ovarian cyst was planned, but who instead underwent laparoscopic appendectomy because appendiceal mucocele was determined during laparoscopic exploration.

The effects of luteolin on the intestinal ischemia/reperfusion injury in mice.

The purpose of this study is to investigate the potential protective effect of the flavonoid Luteolin on ischemia-reperfusion (IR) injury in mouse intestine, which has not previously been studied. Twenty-four female C57BL/6 mice were randomly assigned to four groups, each consisting of 6 mice: a sham group (laparotomy, but no IR injury), a sham + Luteolin group (no IR, and Luteolin was administered intraperitoneally 30 min after laparotomy), IR group (30 min occlusion of the superior mesenteric artery (SMA) then 2 hr' reperfusion), IR + Luteolin (30 min occlusion of the SMA then 2 hr' reperfusion; Luteolin was administered intraperitoneally before reperfusion). Intestine tissues were harvested from the mice for histopathological and biochemical analysis. Total oxidant status (TOS) and total antioxidant capacity (TAC) of the intestinal tissues were measured using Erel's method. Oxidative stress index (OSI) was calculated using the TOS/TAC ratio. Intestinal histological changes were significantly decreased in the IR + Luteolin group compared with the IR group (p = .037). TOS tissue levels were also significantly decreased in the IR + Luteolin group compared with the IR group (p = .005). TAC levels did not increase significantly in the IR treatment group and were not affected by Luteolin treatment (p > .05). The results of this study show that Luteolin administration provides considerable protection against IR injury in the mouse intestine.

Comparison of Z-plasty, limberg flap, and asymmetric modified Limberg flap techniques for the pilonidal sinus treatment: review of literature.

BACKGROUND AND AIMS: The aim of this study is to analyze and compare the early complications and recurrent results of Z-plasty, Limberg flap, and asymmetric modified Limberg flap both demographically and clinically. MATERIALS AND METHODS: Between March 2009 and February 2010, a total of 45 patients with pilonidal sinus were enrolled in this study. 10 of 45 patients (22.2%) required Z-plasty; 24 patients (53.3%) had surgery with Limberg flap closure, and 11 patients (24.4%) had asymmetric modified Limberg flap. RESULTS: A total of 45 patients were included in the study (mean age: 23.36 > +/- 3.4 (range, 20-33) years). When we compared duration of operation and the length of stay in hospital, no statistically significant findings were detected (p = 0.595 and p = 0.23, respectively). The mean follow-up was 22.4 (range, 18-24) months. Recurrence was not seen in any of the patients. CONCLUSIONS: Our results were similar: the comparison of the three techniques revealed no significant differences regarding early complications and recurrence.