Liver Transplantation in Patients With Complete Portal Vein Thrombosis: Renoportal or Varicoportal Anastomosis Using Cryopreserved Vein Grafts.

BACKGROUND: Despite technical developments in transplantation surgery, complete portal vein thrombosis still remains a challenge for restoration of adequate portal vein inflow. Renoportal or varicoportal anastomosis provides an effective alternative solution for patients with complete portal vein thrombosis. This study describes our experience with renoportal and varicoportal anastomosis during liver transplantation. PATIENTS AND METHODS: Between January 2014 and May 2016, 5 patients with complete portal vein thrombosis underwent extra-anatomic portal anastomosis. In 3 cases, varicoportal anastomosis was performed and for the others, end-to-end renoportal anastomosis. We used iliac cryopreserved vein grafts to restore portal anastomosis in 3 cases. Epidemiology, risk factors, surgical techniques, complications, and outcomes of these procedures were evaluated over short- and long-term follow-ups. RESULTS: The follow-up time is 3 years for our first renoportal case, which was performed in a cadaveric liver transplantation; it was also first nationwide case. The other renoportal anastomosis was practiced in a living donor liver transplantation and the follow-up time is 8 months. The patient and graft survival rates were 100% at the last follow-up. The follow-up times are 10.9 and 4 months for the patients with varicoportal anastomosis. One of these patients died due to recurrence of hepatocellular carcinoma. The other two patients are alive with good graft functions. CONCLUSION: Our experience suggests that reno-varicoportal anastomosis is a useful technique for patients with complete portal vein thrombosis and cryopreserved grafts may be safely used.

Endoscopic Removal of Duodenal Perforating Fishbone - A Case Report.

BACKGROUND: Accidental ingestion of foreign bodies is common in clinical practice. While perforation of the ileum and jejunum due to the ingested foreign body is common, duodenal perforation is rare. In this report, our experience with this rare entity is shared. CASE REPORT: Here we present a 31-year-old patient with gastrointestinal tract perforation at the second part of the duodenum due to an ingested fishbone. The patient was admitted to the emergency room with abdominal pain. Right upper quadrant tenderness was detected at physical examination, and leukocytosis on the laboratory test results. Ultra-sonography was not diagnostic, however, computerized tomo-graphy showed an ingested foreign body in the second part of the duodenum. A fishbone perforating the duodenum was retrieved by endoscopy. The patient was managed non-operatively, and discharged without any problems on the third day after endoscopy. CONCLUSION: Endoscopic removal and non-operative management may be feasible in carefully selected patients with duodenal perforated fishbone ingestion.

Oncostatin-M as a novel biomarker in colon cancer patients and its association with clinicopathologic variables.

OBJECTIVE: The aim of this study was to evaluate preoperative serum oncostatin M (OSM) concentration as a diagnostic marker in colon cancer patients and its association with clinicopathologic variables. PATIENTS AND METHODS: Preoperative serum OSM concentrations were measured in 100 colon cancer patients and 70 healthy volunteers by enzyme-linked immunosorbent assay (ELISA). RESULTS: Serum OSM concentrations were significantly higher in colon cancer patients than in controls (p < 0.001). Serum OSM concentrations increased significantly with higher T stage (p < 0.001) and were significantly higher in patients with increased tumor burden, lymphovascular involvement, and lymph node and distant metastasis (p < 0.001 for each). CONCLUSIONS: To our knowledge, this is the first report showing that elevated OSM concentration was associated with colon cancer and its clinicopathologic variables, including invasion and metastasis. These findings indicate that serum OSM may serve as a novel biomarker in the diagnosis of colon cancer.

The role of preoperative serum levels for Dickkopf-related protein 1 as a potential marker of tumor invasion in patients with stage II and III colon cancer.

OBJECTIVES: To determine and correlate preoperative serum levels of CEA and Dickkopf-related protein 1 (DKK-1) in stage II and III colon cancer and so identify the patients at high risk for early relapse. PATIENTS AND METHODS: A total of 100 patients with stage II (n = 50; median age: 53 years, 31 males) and III (n = 50; median age: 57 years, 32 males) colon cancer and 50 controls (median age: 53.9 years, 25 males) were included. Serum levels for CEA and DKK-1 were recorded in each subject. RESULTS: Mean (SD) levels for serum CEA and DKK-1 were significantly higher in stage III patients than in stage II patients and controls (p < 0.001 for each). There was a significant correlation between serum levels of CEA and DKK-1 in stage II (r = 0.71, p < 0.001) stage III (r = 0.62, p < 0.001) patients. CONCLUSIONS: Preoperative serum levels for DKK-1 seem to be a potential marker in prediction of tumor invasion and relapse in stage II-III colon cancer.