BACKGROUND: The effect of dexmedetomidine on regional splanchnic blood flow remain unclear. OBJECTIVES: We hypothesized, that there is no difference in regional rectal perianastomotic perfusion and oxygenation when using non-opioid dexmedetomidine-isoflurane anesthesia when compared to fentanyl-isoflurane anesthesia. METHODS: Ten female pigs were randomly divided into two groups (Dexmedetomidine, DEX, Fentanyl, FNT). Analgesia was provided by either dexmedetomidine (0.7-1.0 μg/kg/h) or fentanyl (6-10 μg/kg/h). The model of rectosigmoid resection in pigs was used. Two combined Laser Doppler flowmetry (LDF) and oxymetry probes were fixed on the antimesenterial site of the rectosigmoid, one orally and the second distally to resection zone. At the end of the experiment all animals were woken up and extubated. The healing of the anastomosis was controlled seven days after the operation. RESULTS: All experimental animals were hemodynamically stable throughout the experiment. No anastomotic leakage was detected. All animals survived until the seventh postoperative day. In the DEX group the median of the LDF signal on aboral site at the end of experiment was 35% (23-49%), in FNT group the median of the LDF signal was 19% (12-28%), which was statistically significantly lower (p < 0,05). CONCLUSIONS: This study has shown some protective effects of dexmedetomidine-isoflurane based anesthesia on perianastomotic microcirculation when compared to fentanyl-isoflurane based anesthesia.

• MeSH
• anastomóza chirurgická metody   MeSH
• anestezie metody   MeSH
• dexmedetomidin * farmakologie   MeSH
• fentanyl * farmakologie   MeSH
• kolorektální chirurgie metody   MeSH
• prasata MeSH
• zvířata MeSH
• Check Tag
• ženské pohlaví MeSH
• zvířata MeSH
• Publikační typ
• časopisecké články MeSH

Despite recent improvements in surgical technique, the morbidity of distal pancreatectomy remains high, with pancreatic fistula being the most significant postoperative complication. A systematic review of randomized controlled trials (RCTs) dealing with surgical techniques in distal pancreatectomy was carried out to summarize up-to-date knowledge on this topic. The Cochrane Central Registry of Controlled Trials, Embase, Web of Science, and Pubmed were searched for relevant articles published from 1990 to December 2013. Ten RCTs were identified and included in the systematic review, with a total of 1286 patients being randomized (samples ranging from 41 to 450). The reviewers were in agreement for application of the eligibility criteria for study selection. It was not possible to carry out meta-analysis of these studies because of the heterogeneity of surgical techniques and approaches, such as varying methods of pancreas transection, reinforcement of the stump with seromuscular patch or pancreaticoenteric anastomosis, sealing with fibrin sealants and pancreatic stent placement. Management of the pancreatic remnant after distal pancreatectomy is still a matter of debate. The results of this systematic review are possibly biased by methodological problems in some of the included studies. New well designed and carefully conducted RCTs must be performed to establish the optimal strategy for pancreatic remnant management after distal pancreatectomy.

• MeSH
• lidé MeSH
• pankreas chirurgie   MeSH
• pankreatektomie * MeSH
• randomizované kontrolované studie jako téma * MeSH
• Check Tag
• lidé MeSH
• Publikační typ
• časopisecké články MeSH
• metaanalýza MeSH
• práce podpořená grantem MeSH
• přehledy MeSH

BACKGROUND: Castleman disease is an uncommon lymphoproliferative disorder most frequently occurring in the mediastinum. Abdominal forms are less frequent, with pancreatic localization of the disease in particular being extremely rare. Only seventeen cases have been described in the world literature. METHOD: This report describes an interesting and unusual case of pancreatic Castleman disease treated with laparoscopic resection. RESULTS: A 48-year-old woman presented with epigastric pain. CT scan showed a well-encapsulated mass on the ventral border of the pancreas. Endosonography with fine needle aspiration biopsy was performed. Biopsy showed lymphoid elements and structures of a normal lymph node. The patient was treated with laparoscopic distal pancreatectomy. The pancreas was transected with a Ligasure device and the pancreatic stump was secured with a manual suture. One year after surgery the patient was complaint-free and showed no signs of recurrence of the disease. CONCLUSIONS: Laparoscopic distal pancreatectomy is a feasible and safe method for the treatment of lesions in the body and tail of the pancreas. Transection of the pancreas with a Ligasure device offers the advantages of low bleeding and low risk of pancreatic fistula.

• MeSH
• biopsie tenkou jehlou pod endosonografickou kontrolou MeSH
• hyperplazie velkých lymfatických uzlin diagnóza   chirurgie   MeSH
• laparoskopie * MeSH
• lidé středního věku MeSH
• lidé MeSH
• nemoci slinivky břišní diagnóza   chirurgie   MeSH
• pankreatektomie metody   MeSH
• počítačová rentgenová tomografie MeSH
• šicí techniky MeSH
• výsledek terapie MeSH
• Check Tag
• lidé středního věku MeSH
• lidé MeSH
• ženské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH
• kazuistiky MeSH
• práce podpořená grantem MeSH

The major postoperative complication after open and laparoscopic distal pancreatectomy is pancreatic fistula. Different operative techniques have been tested to minimize this unpleasant complication. We evaluated a new technique for pancreatic stump reinforcement with synthetic glue after laparoscopic distal pancreatectomy. Ten female domestic pigs were divided into 2 groups; in group A (n=5), the pancreas was transected using an EndoGIA stapler, whereas in group B (n=5), the pancreas was transected using a Ligasure device and the pancreatic stump was reinforced with a hydrogel sealant. The clinical postoperative course was uneventful in all the cases. No differences were observed in pancreatic remnant healing between the groups, and only minor microscopic alterations of the healing process were found in the groups. The technique using Ligasure transection reinforced by the hydrogel sealant seems to be comparable with the standard transection technique using the stapler.

• MeSH
• chirurgické staplery MeSH
• hojení ran fyziologie   MeSH
• laparoskopie MeSH
• ligace MeSH
• pankreas fyziologie   chirurgie   MeSH
• pankreatektomie metody   MeSH
• PEG-DMA hydrogel terapeutické užití   MeSH
• prasata MeSH
• zvířata MeSH
• Check Tag
• ženské pohlaví MeSH
• zvířata MeSH
• Publikační typ
• časopisecké články MeSH
• práce podpořená grantem MeSH
• srovnávací studie MeSH

BACKGROUND: We explored the potential of two cyanoacrylate tissue adhesives for constructing colonic anastomoses. METHOD: The study involved 12 female domestic pigs. The animals were divided into two equal groups. In both groups, the sigmoid colon was transected. An intestinal anastomosis was constructed with a modified circular stapler (all staples were withdrawn) and cyanoacrylate tissue adhesives. Glubran 2 was used in group A and Dermabond was applied in group B. Fourteen days after the first operation, a follow-up surgery was performed in both groups. The glued section of the colon was resected, processed with the standard paraffin technique and stained with haematoxylin-eosin. The finished specimens were examined under light microscopy. Assessments were made for the presence of fibroblasts, neutrophils, giant polynuclear cells, neovascularisation and collagen deposits. Adhesions, anastomotic dehiscence, peri-anastomotic inflammation and intestinal healing were assessed peri-operatively. RESULTS: All anastomoses in group A healed with no signs of pathology. In group B, fibrotic adhesions and stenoses tended to occur in areas surrounding the anastomoses. Histological examinations confirmed increased fibrosis. CONCLUSION: The tissue adhesive Glubran 2 appears to be (under experimental conditions) a promising synthetic adhesive for colonic anastomosis construction; conversely, the tissue adhesive Dermabond was unsuitable for suture-free anastomosis construction.

• MeSH
• adheze tkání MeSH
• anastomóza chirurgická metody   MeSH
• colon sigmoideum patologie   chirurgie   MeSH
• dehiscence operační rány MeSH
• hojení ran MeSH
• kyanoakryláty MeSH
• prasata MeSH
• tkáňová adheziva MeSH
• zánět MeSH
• zvířata MeSH
• Check Tag
• ženské pohlaví MeSH
• zvířata MeSH
• Publikační typ
• časopisecké články MeSH
• práce podpořená grantem MeSH
• srovnávací studie MeSH

• MeSH
• chirurgie operační MeSH
• kongresy jako téma MeSH

• MeSH
• chirurgie operační MeSH
• kongresy jako téma MeSH

• MeSH
• chirurgie operační MeSH
• infekce v ráně prevence a kontrola   terapie   MeSH
• laparoskopie metody   MeSH
• pankreatektomie metody   MeSH
• výzkumný projekt MeSH

• Publikační typ
• abstrakt z konference MeSH

• MeSH
• ablace metody   MeSH
• hepatektomie * metody   škodlivé účinky   MeSH
• játra chirurgie   patologie   MeSH
• kolorektální nádory chirurgie   komplikace   MeSH
• laparoskopie metody   MeSH
• lidé MeSH
• ligace metody   MeSH
• metastázy nádorů terapie   MeSH
• miniinvazivní chirurgické výkony metody   MeSH
• nádory jater * chirurgie   sekundární   MeSH
• radiofrekvenční ablace metody   MeSH
• recidiva MeSH
• terapeutická embolizace metody   MeSH
• Check Tag
• lidé MeSH