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Background/Objectives: Ulcerative colitis (UC) is a chronic inflammatory bowel disease with limited effective treatments, prompting the need for investigation of novel therapeutic approaches. Eicosapentaenoic acid (EPA) and gamma-linolenic acid (GLA) have demonstrated potential anti-inflammatory properties, but their combined effects on UC have not been thoroughly investigated. This study aimed to evaluate the effect of the combined administration of EPA and GLA on clinical and histopathologic features of experimental UC models. Methods: Thirty-six male Wistar rats were randomized in three groups (DSS group, Ensure Plus group, and Oxepa group), with twelve rats in each group. Experimental colitis was induced by administrating dextran sulfate sodium (DSS) 8%. The DSS group received tap water, the Ensure Plus group was given a high caloric diet, and the Oxepa group received a special diet containing high levels of EPA and GLA. Disease activity index (DAI) and microscopic activity index (MAI) were measured. Inflammatory markers were calculated both in blood and large intestine, liver, spleen, and lung tissue samples. Neutrophil and macrophage populations were assessed with immunohistochemistry. Results: No significant differences in the DAI index were found between the groups, but the MAI revealed statistically significant differences (p < 0.001). While no significant differences were observed in tumor necrosis factor-alpha (TNF-α) levels, interleukin-17 (IL-17) levels in the large intestine showed statistically significant differences (p = 0.05), with the Ensure Plus and Oxepa groups displaying lower levels compared to the DSS group (p = 0.021 and p = 0.043, respectively). Significant differences in neutrophil infiltration were found in both the large intestine (p < 0.001) and lungs (p = 0.002), with the Oxepa group showing fewer cells. Similarly, significant differences in macrophage infiltration were observed in the large intestine (p = 0.038) and spleen (p < 0.001), with the Oxepa group having lower macrophage counts. Conclusions: In conclusion, the combination of EPA and GLA demonstrates local anti-inflammatory effects and improves the histopathological outcomes in UC. [ABSTRACT FROM AUTHOR]

Background: Rectal prolapse (RP) predominantly affects women over the age of 50 and presents as mucosal, internal, or full thickness prolapse. Strangulated rectal prolapse requires immediate medical intervention, and surgical treatment options include both abdominal and perineal approaches. We aim to present a case series of perineal rectosigmoidectomy performed urgently due to strangulation and argue that Altemeier's procedure is the preferred method for treating strangulated rectal prolapse. Methods: Perineal rectosigmoidectomy, particularly Altemeier's procedure, is effective for incarcerated cases. Altemeier's procedure with diverting ileostomy was used in all three patients. Results: All patients were successfully treated, with no recurrence of prolapse and stool incontinence. Conclusions: Altemeier's procedure is ideal for the treatment of strangulated rectal prolapse. [ABSTRACT FROM AUTHOR]

Mesh-augmented hernia repair is the gold standard in abdominal wall and hiatal/diaphragmatic hernia management and ranks among the most common procedures performed by general surgeons. However, it is associated with a series of drawbacks, including recurrence, mesh infection, and adhesion formation. To address these weaknesses, numerous biomaterials have been investigated for mesh coating. Platelet-rich plasma (PRP) is an autologous agent that promotes tissue healing through numerous cytokines and growth factors. In addition, many reports highlight its contribution to better integration of different types of coated meshes, compared to conventional uncoated meshes. The use of PRP-coated meshes for hernia repair has been reported in the literature, but a review of technical aspects and outcomes is missing. The aim of this comprehensive review is to report the experimental studies investigating the synergistic use of PRP and mesh implants in hernia animal models. A comprehensive literature search was conducted across PubMed/Medline, Web of Science, and Scopus without chronological constraints. In total, fourteen experimental and three clinical studies have been included. Among experimental trials, synthetic, biologic, and composite meshes were used in four, nine, and one study, respectively. In synthetic meshes, PRP-coating leads to increased antioxidant levels and collaged deposition, reduced oxidative stress, and improved inflammatory response, while studies on biological meshes revealed increased neovascularization and tissue integration, reduced inflammation, adhesion severity, and mechanical failure rates. Finally, PRP-coating of composite meshes results in reduced adhesions and improved mechanical strength. Despite the abundance of preclinical data, there is a scarcity of clinical studies, mainly due to the absence of an established protocol regarding PRP preparation and application. To this point in time, PRP has been used as a coating agent for the repair of abdominal and diaphragmatic hernias, as well as for mesh fixation. Clinical application of conclusions drawn from experimental studies may lead to improved results in hernia repair. [ABSTRACT FROM AUTHOR]

We present a case of a 44-year-old male with chronic hepatitis B that visited the Emergency Department due to epigastric pain after a liver biopsy. The ultrasonography revealed signs of bleeding in the bile ducts. and angiography visualized an arterioportal fistula. Selective right hepatic artery branch embolization was performed, and the bleeding was controlled. Although, the clinical picture was initially improved, the patient presented later with acute abdomen, obstructive jaundice and fever. The patient underwent cholecystectomy with bile duct exploration and placement of a Kehr's T tube in the common bile duct. The postoperative course was uneventful. We also review the relevant literature concerning arterioportal fistula manifested as hemobilia as well as acute cholecystitis occurring after hemobilia. [ABSTRACT FROM AUTHOR]

Copyright of Cirugía y Cirujanos is the property of Publicidad Permanyer SLU and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Cirugía y Cirujanos is the property of Publicidad Permanyer SLU and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Objectives: Complex abdominal wall reconstruction cases constitute a challenging issue, with high morbidity and mortality rates. Materials and methods: A young trauma patient presented abdominal dehiscence after multiple laparotomies. The fascial defect was managed with the use of a biological mesh, while initially primary wound closure was attempted. Due to cutaneous dehiscence, the use of negative pressure wound therapy was decided. Results: Granulation tissue formation was noticed on the eighth day while complete wound closure was achieved after 57 days. Conclusions: In conclusion, the combined use of biological mesh and negative pressure wound therapy is feasible in the management of complicated abdominal defects. [ABSTRACT FROM AUTHOR]

Objective: The aim of the present study was to evaluate the changes caused by intravenous administration of regulatory peptides, bombesin (BBS) and neurotensin (NT), on gastric secretion, serum gastrin, and plasma levels of bombesin-1ike immunoreactivity (BLI) and neurotensin. Materials and methods: Fourteen dogs underwent an upper gastrointestinal tract operation and a Pavlov pouch for the concentration of gastric fluids was formed. The experimental animals were divided into two groups. Peptides were given one month after the second operation and after fasting for 12 hours. In group A, the effects of BBS were studied after a rapid 1 µg/kg body weight dose and a slow 30΄ 0.5 μg/kg body weight dose administration intravenously. Correspondingly to group B the effects of NT were studied in the same way. Results: The rapid intravenous infusion of BBS caused a very significant increase in gastrin levels, BLI in plasma, volume and HCl of the gastric fluids. The same results, plus a significant decrease in gastric pH, were observed following slow intravenous infusion of BBS. Concerning the NT, rapid administration caused a significant decrease in the volume of gastric fluids. Slow NT administration of caused a significant reduction in gastric fluid volume and in HCl. On the contrary, pH was significantly increased. Conclusion: Bombesin increases plasma gastrin levels and HCl secretion. Neurotensin administration causes a decrease in HCl secretion without affecting gastrin levels in plasma. [ABSTRACT FROM AUTHOR]

Background: Growth hormone (GH) plays a crucial role in wound healing and tissue repair in postoperative patients. In particular, colonic anastomosis healing following colorectal surgery is impaired by numerous chemotherapy agents., Aim: To investigate whether GH can improve the healing of a colonic anastomosis following the adverse effects of intraperitoneal administration of 5-fluorouracil (5-FU), bleomycin and cisplatin., Methods: Eighty Wistar rats underwent laparotomy and a 1 cm-resection of the transverse colon, followed by an end-to-end anastomosis under general anesthesia. The rats were blindly allocated into four equal groups and administered a different daily intraperitoneal therapeutic regimen for 6 days. The control group (A) received normal saline. Group B received chemotherapy with 5-FU (20 mg/kg), bleomycin (4 mg/kg) and cisplatin (0.7 mg/kg). Group C received GH (2 mg/kg), and group D received the aforementioned combination chemotherapy and GH, as described. The rats were sacrificed on the 7 th postoperative day and the anastomoses were macroscopically and microscopically examined. Body weight, bursting pressure, hydroxyproline levels and inflammation markers were measured., Results: All rats survived until the day of sacrifice, with no infections or other complications. A decrease in the body weight of group D rats was observed, not statistically significant compared to group A ( P = 1), but significantly different to groups C ( P = 0.001) and B ( P < 0.01). Anastomotic dehiscence rate was not statistically different between the groups. Bursting pressure was not significantly different between groups A and D ( P = 1.0), whereas group B had a significantly lower bursting pressure compared to group D ( P < 0.001). All groups had significantly more adhesions than group A. Hydroxyproline, as a measurement of collagen deposition, was significantly higher in group D compared to group B ( P < 0.05), and higher, but not statistically significant, compared to group A. Significant changes in group D were recorded, compared to group A regarding inflammation (3.450 vs 2.900, P = 0.016) and fibroblast activity (2.75 vs 3.25, P = 0.021). Neoangiogenesis and collagen deposition were not significantly different between groups A and D. Collagen deposition was significantly increased in group D compared to group B ( P < 0.001)., Conclusion: Intraperitoneal administration of chemotherapy has an adverse effect on the healing process of colonic anastomosis. However, GH can inhibit the deleterious effect of administered chemotherapy agents and induce colonic healing in rats., Competing Interests: Conflict-of-interest statement: The authors declare no conflict of interest., (©The Author(s) 2024. Published by Baishideng Publishing Group Inc. All rights reserved.)

Transdiaphragmatic intercostal hernia, in which the abdominal contents of the hernia protrude through the diaphragm and the thoracic wall defect. is a very rare type of hernia with only a few cases having been reported in the literature. That type of hernia is usually manifested in male patients after trauma, penetrating or blunt. It is frequently presented with a palpable thoracic mass and pain. The indicated treatment is surgery. We present the case of a 60-year-old female admitted to the hospital after a car accident and suffered multiple rib fractures (6th, 7th, 8th right ribs / 7th, 8th, 9th left ribs), as well as flail thorax, hemothorax bilaterally, left subcutaneous emphysema and swelling of soft tissues of the right lateral thoracoabdominal wall. CT scan revealed herniation of hepatic parenchyma and intestinal loops into the thorax. The patient was treated surgically, and his postoperative course was uneventful. We also review the relevant literature concerning this transdiaphragmatic, intercostal hernia and identify 42 cases. Transdiaphragmatic intercostal hernia is a rare condition, usually manifested in male patients after trauma, penetrating or blunt. It is frequently presented with a palpable thoracic mass and pain. The indicated treatment is surgery., Competing Interests: Conflict of interests: The authors declare no competing financial interests or conflicts of interest., (Copyright © 2021, Ioannidis O. et al., Applied Systems and Discoveries Journals.)

Aim: Growth hormone is known to affect healing on the postoperative patient. The aim of the present experimental study was to evaluate the effect of systematic infusion of growth hormone on the healing of colonic anastomoses in rats., Methods: Fourty Albino-Wistar male rats were randomly divided into two groups, a control group (CONTROL) and a growth hormone (GH) group. In both groups, an end-to-end colonic anastomosis was performed after segmental resection. In the CONTROL group, 1 cc saline was administered subcutaneously in the experimental animals' necks in two equal doses daily until the sixth postoperative day. In the GH group, rats were administered a growth hormone solution (2 mg/kg b.w.) in an amount of 1 cc subcutaneously in their necks in two equal doses daily until the sixth postoperative day. Rats were sacrificed on the seventh postoperative day. Anastomoses were resected and macroscopically examined. Bursting pressures were calculated and histological features were graded and hydroxyproline was evaluated., Results: No deaths or wound infections were observed until the sacrifice. Bodyweight was significantly increased in the GH group until the seventh postoperative day (p = 0.005). Bursting pressures (p = 0.0025), adhesion formation (p=0.0019), hydroxyproline concentrations (p = 0.007) were significantly higher in the GH group than in the control group. Also GH lead to decreased inflammation (p < 0.001), but increased neoangiogenesis (p < 0.001), fibroblast activity (p = 0.001) and collagen deposition (p < 0.001)., Conclusion: Growth hormone, when applied systematically in rats with colonic anastomoses, promotes their healing in rats. Therefore, the application of growth hormone in colonic anastomoses leads to better outcomes., Key Words: Adhesion, Bursting pressure, Collagen, Hydroxyproline, Inflammation, Neoangiogenesis.

Objective: Pancreaticoduodenectomy has been established as the treatment of choice for the management of benign and malignant lesions of the pancreatic head, and pancreaticojejunal or pancreaticogastric anastomosis seems to be the safer choice for the management of the pancreatic duct. However, in certain seldom, but still existing circumstances, pancreatic duct ligation or occlusion with a chemical substance is a valuable and viable alternative. The aim of the current study is to compare these two methods of occlusion of the pancreatic duct regarding the endocrine and exocrine function of the pancreas and its histopathology., Materials and Methods: 18 health mixed breed dog of both sexes were randomized in two groups: group A, in which the pancreatic duct was ligated and group B, in which the pancreatic duct was occluded with prolamine., Results: None of the animals presented postoperatively steatorrhea and significant body weight changes. Peripancreatic inflammation at sacrifice, inflammatory cell infiltration and edema of the pancreas on the 15th postoperative day and 30th postoperative day were milder after occlusion with prolamine than after ligation. Ligation of pancreatic duct lead to significantly greater hyperamylasemia than prolamine occlusion every day until the 15th. Mild hyperglycemia presented from the first to the fourth day in both groups, which was associated with a significant drop in insulin. Glucagon remained within the normal values at all times during the experiment. None of glucose, insulin and glucagon differed between groups., Conclusion: Prolamine occlusion of the pancreatic duct causes milder hyperamylasemia and less extensive inflammation both macroscopically and microscopically than ligation., Key Words: Pancreas, Pancreaticoduodenectomy, Hyperamylasemia.

Purpose: Chemotherapeutic factors are known to affect healing on the postoperative patient. The aim of the present experimental study was to evaluate the effect of intraperitoneal infusion of 5-fluorouracil, bleomycin and cisplatin on the healing of colonic anastomoses in rats., Methods: Forty Albino-Wistar male rats were randomly divided into two groups, a control and a chemotherapy (CT) group. In both, an end-to-end colonic anastomosis was performed. collagen, In the control group, 2cc saline was administered intraperitoneally during the operation and daily postoperatively until the sacrifice. In the CT group, rats were administered a solution of 5-fluorouracil (20mg/kg b.w.), bleomycin (4mg/kg b.w.) and cisplatin (0.7 mg/kg b.w.) in an amount of 2cc intraperitoneal intraoperatively and afterwards daily postoperatively until the seventh postoperative day when they were sacrificed. At sacrifice, adhesion presence was calculated and the anastomoses were resected and macroscopically examined. Bursting pressures were calculated and histological features were graded. Hydroxyproline concentrations were evaluated., Results: No deaths or wound infections were observed until sacrifice. Bodyweight was significantly decreased in the CT group (p=0.005). Bursting pressures (p=0.001) were significantly lower in the chemotherapy group, whereas adhesions were significantly increased (p=0.001). Hydroxyproline concentrations were not significantly different (p=0.401). All histological parameters appeared significantly decreased in the CT group: inflammation (p<0.008), neoangiogenesis (p<0.001), and fibroblast activity (p=0.001) and collagen deposition (p<0.001)., Conclusion: The use of chemotherapeutic agents had negative effects on the healing process of colonic anastomosis in rats. The decreased inflammatory response depicts in more frequent anastomotic dehiscence, ruptures and bodyweight loss postoperatively., Key Words: Adhesion, Bursting pressure, Collagen, Hydroxyproline, Inflammation, Neoangiogenesis.

Objective: The aim of the current study was to evaluate the effect of ischemia-reperfusion injury on the liver's function and morphology during the establishment and progress of obstructive jaundice., Material and Methods: 80 Wistar rats were used for the purposes of the study and were allocated in four groups: JAUNDICE (obstructive jaundice), JAUN-ISC (obstructive jaundice and ischemia reperfusion), CONTROL (laparotomy) and ISCHEMIA (ischemia reperfusion)., Results: Obstructive jaundice, and ischemia-reperfusion injury following obstructive jaundice led to increased mortality, while no mortality was noticed in the control and ischemia groups. In the JAUN-ISC group, SGOT was significantly increased on the 10th day and SGPT was significantly increased on the 1st day compared to JAUNDICE group. Moreover, in the JAUN-ISC group, sinusoid dilation was significantly increased on the 5th and 10th days and neutrophil infiltration was significantly increased on the 10th day compared to the JAUNDICE group., Conclusions: A mild ischemia-reperfusion injury that in the normal liver led only to slight increase of hepatic neutrophil infiltration in the presence of obstructive jaundice led to increased hepatic biochemical markers (SGOT, SGPT) and increased hepatic sinusoid dilatation and enhanced neutrophil infiltration., Key Words: Dilatation of sinusoids, Granulocytes infiltration, Oxaloxate, Pyruvate transaminase, Transaminase reperfusion.

Purpose: Gastric cancer is a common malignancy and its radical excision with an adequate lymph node resection provides an improved oncologic outcome. D2 lymphadenectomy in distal or total gastrectomy is considered a highly desirable technique for curable early or locally advanced gastric cancer. Many studies with high-level of evidence confirm the importance of the application of minimally invasive techniques in improving the short and long term outcomes of patients who undergo gastrectomy., Methods: A MEDLINE search was performed with the following keywords; "d2 gastrectomy open laparoscopic", "d2 gastrectomy open robotic" and "d2 gastrectomy laparoscopic robotic". The search was narrowed on randomized control trials (RCT)., Results: 6 studies in total are included in the study; 5 RCTs on open vs laparoscopic group and 1 RCT on open vs robotic group. There is currently no RCT comparing the laparoscopic vs robotic techniques., Conclusions: The superiority of laparoscopic gastrectomy towards the open technique is widely accepted, yet the proven acceptance of minimally invasive robotic techniques is still debated and not scientifically established. Technical challenges are the main point of discussion among the experts on the field, as well as the advantages of laparoscopic and robotic assisted gastrectomy over the conventional open. This review provides a comparison on technical aspects, the short and long term outcomes of open and minimally invasive gastrectomy with D2 lymphadenectomy in early and advanced gastric cancer.

Purpose: To present our experience in the treatment of patients with liver metastases from colorectal cancer., Methods: The surgical and histopathological records of our department dating from 1st January 1997 to 31 December 2016 were examined, searching for patients who have undergone surgical treatment of colorectal liver metastasis., Results: A total of 90 patients with colorectal liver metastases were treated in the last 20 years in our department. Their mean age was 65.28 years and 54 (60%) were male. The primary tumor was in the colon in 71 patients (78.9%) and in 19 (21.1%) patients in the rectum. Thirty-six (40%) patients presented with synchronous metastatic liver disease, from which 27 were subjected to simultaneous resection, 2 underwent a liver-first approach and 7 were subjected to resection of primary tumor first. Regarding the number of metastases 67 (74.4%) patients had single metastasis, 12 (13.3%) had 2 lesions, 4 (4.4%) had 3 lesions and 7 (7.8%) had 4-8 lesions. In-hospital and 30-day mortality was 3.85%. Median survival was 41 months., Conclusion: Surgical resection is the treatment of choice for the management of liver metastasis from colorectal cancer and can be safely performed. Follow up of patients with colorectal cancer is imperative as metachronous metastasis presents in a significant percentage of patients with negative locoregional lymph nodes of the primary tumor. The order of resection doesn't seem to alter outcome in synchronous metastasis. Recurrence is common and re-resection if feasible is the only chance of cure.

Lipomas are benign, usually asymptomatic, tumours and pelvic lipomas are extremely rare. We describe the case of a giant pelvic lipoma causing obstructive uropathy to a 66-year-old morbidly obese female treated in the 4th Surgical Department of the Medical School of Aristotle University of Thessaloniki in General Hospital "G. Papanikolaou" in March 2016. The patient presented with a history of nocturia and frequent daytime urination for 1 year. Her medical history included diffuse lipomatosis. Computer tomography revealed a giant pelvic mass which lead to left side hydronephrosis, hydrouterer and a pear-shaped bladder, with the differential diagnosis including pelvic lipoma or liposarcoma. An ultrasound guided biopsy excluded the diagnosis of liposarcoma. The patient was submitted to laparoscopic resection of the pelvic lipoma, with complete remission of urinary symptoms. The key-point is to consider the possibility that the pelvic mass is a well-differentiated liposarcoma and to manage it adequately and thus, we recommend intact excision of the mass through a wound protector, and extreme caution to avoid any rupture of the capsule.

Massive localized lymphedema (MLL) is a rare benign soft tissue lesion that develops in morbidly obese patients, most commonly on the medial thigh (though other locations have also been described). The cause of MLL remains unknown, but the common denominator in all reported cases is obesity. The diagnosis of MLL is usually made based on clinical history and presentation but it is believed to be underdiagnosed due to a lack of awareness of this distinct entity. When left untreated, MLL can degenerate into angiosarcoma. This report describes a case of MLL of the right lower abdominal wall in an obese 61-year-old female (BMI = 42 kg/m(2)).