Laparoscopic management of hydatid cyst of the liver.

BACKGROUND: Hydatid liver disease management has evolved from traditional operative approaches to the increasing application of laparoscopic treatments. We aimed to prospectively assess the early outcomes of laparoscopic treatment at our institution. PATIENTS AND METHODS: Forty-four patients with hydatid disease of liver were screened with ultrasonography and computed tomography of the abdomen to exclude Gharbi type V cysts. The distribution of cyst sizes was: 1-4 cm, 10; 5-10 cm, 24; 10-15 cm, 8; > 15 cm, 2 patients. The following laparoscopy therapies were performed: 30 patients had cystectomy alone, 14 patients had partial pericystectomy. Pericystectomy was performed using a hook and harmonic tissue sealers with the resection made through normal liver tissue. RESULTS: Three patients were converted to open surgery. Seven patients had biliary leakage through their cystic cavity drains. Five stopped spontaneously by the 7th postoperative day and 2 responded to ERCP sphincterotomy. There were no deaths and no recurrence of disease noted by 6 months. CONCLUSION: In selected patients with hepatic hydatid disease, a laparoscopic treatment is feasible and safe with low conversion rate and short term recurrences.

Outmoded attitudes toward organ donation among Turkish health care professionals.

AIM: Our goal was to investigate the attitudes toward and information regarding organ donation possessed by assistant and intern doctors and nurses. METHOD: A total of 70.4% of assistant doctors, 52.9% of nurses, and 94.3% of interns participated in this descriptive study. Participants were interviewed fact-to-face to ask questions investigating profession; gender; age; whether they had donated organs; if so, which organ(s); if not, which organ(s) they would consider donating; if they would not consider such donation the reason why; whether they would donated another person's organs in the event of the death of a relative; and what their thoughts would be if they themselves required an organ transplant. RESULTS: Ten (2.2%) individuals had donated organs by applying to an official health institution. Of those participants who had not yet donated organs, the main reason cited for this were lack of information regarding the donation process (28.7%), concerns about the sale of organs (22.1%), and Islamic religious beliefs (21.6%). In the event that they themselves required an organ transplant, 59.8% replied that they "would wish an organ transplant to be performed," and 57.6% of those asked whether they would donate the organs of a deceased relative replied that they would not. CONCLUSIONS: The low level of donation among health care professionals, who should be in the forefront of organ transplantation, and the predominance of ethical and religious reasons for not donating, are incompatible with the present state of medicine.

Formation and location of the sural nerve in the newborn.

In this study, the location and formation of the sural nerve were examined in 40 legs of new-born cadavers. The sural nerve was formed by the peroneal communicating branch from the common peroneal nerve joining the medial sural cutaneous nerve in 27 of 40 legs (67.5%). It was formed by the peroneal communicating branch from the lateral sural cutaneous nerve joining the medial sural cutaneous nerve in 4 (10%). It was formed by the peroneal communicating branch from the common peroneal nerve and fibers from the posterior femoral cutaneous nerve joining the medial sural cutaneous nerve in 2 (5%). In 5 of 40 legs (12.5%), the medial sural cutaneous nerve was in the place of the sural nerve without joining any other nerve. In one case (5%), the sural nerve was not formed bilaterally.

An accessory flexor digitorum longus muscle with high division of the tibial nerve.

An accessory flexor digitorum longus muscle associated with a high division of the tibial nerve was encountered during routine dissection in the right leg of a newborn cadaver. The tibial nerve divided into its two terminal branches at a higher level than normal with a small branch from the tibial nerve contributing to one of the terminal branches. In addition, an accessory flexor digitorum longus muscle was observed to pass between the terminal branches of the tibial nerve.