The association of elevated mean platelet volume with the outcome of acute mesenteric ischemia.

Mesenteric ischemia is a life-threatening vascular emergency with high mortality rates. Mean platelet volume (MPV) has been shown to be closely related to platelet activation. We investigated whether MPV was associated with outcome of acute mesenteric ischemia (AMI). Sixty-one patients who were operated for AMI were retrospectively evaluated. Patients were divided into two groups: survivors and nonsurvivors, according to the outcome, and the two groups were compared in terms of MPV levels and other prognostic factors. Urea, creatinine, alkaline phosphatase, amylase, gamma-glutamyl transferase and MPV levels were significantly higher in nonsurvivors, when compared to that of survivors. In addition, hypertension, atherosclerotic heart diseases and rhythm disorders were statistically significant risk factors for mortality. AMI is an uncommon but highly lethal surgical emergency. Our results indicate that an elevated MPV is associated with a worse outcome in patients with AMI.

Prospective evaluation of crural repair with and without double-sided mesh reinforcement.

BACKGROUND: Laparoscopic Nissen fundoplication is gold standard treatment for gastroesophageal reflux disease. We examined the results of laparoscopic Nissen fundoplication with or without double-sided polypropylene mesh. PATIENTS AND METHODS: Sixty patients were prospectively evaluated. Primer cruroraphy and primer cruroraphy with mesh were performed in 31 and 29 patients, respectively. The Gastrointestinal Quality of Life Index (GIQLI) was used for assessment of the patient satisfaction preoperatively and postoperatively at 12 months. RESULTS: Sixty patients were included in the study, with a mean age of 42 years. There was no difference between the 2 groups with respect to age, sex, and duration of symptoms. GIQLI showed an equal improvement, and there were no differences in the quality of life in both the groups. All patients' endoscopic findings were normal at first year. CONCLUSIONS: Laparoscopic Nissen fundoplication appears to prevent reflux and its symptoms and create better quality of life. Double-sided polypropylene mesh for repair may result in better quality of life.