Background Anastomotic leak (AL) is one of the most important postoperative complications after hemicolectomy with stapled anastomosis. This study aimed to evaluate the association of preoperative vitamin D3 with early anastomotic leakage after right colon cancer surgery with stapled anastomosis. Method In this prospective cohort study, 535 patients who underwent right colon cancer surgery (right hemicolectomy) with stapled anastomosis were enrolled. A subset of 315 patients was included in the study after meeting the inclusion criteria. Preoperative vitamin D level was measured and analyzed for association with early AL using univariable and multivariable logistic regression analyses. Result This study included 315 cases; among them, 18 (5.71%) patients developed early AL. Vitamin D3 was significantly higher among patients without early AL ( P < .001). Low vitamin D3 status was reported among 111 patients (35.2%) and 204 (64.8%) of patients did not have low vitamin D3 status (sufficient level = 30-100 ng/mL). Sufficient vitamin D3 levels before right colon cancer surgery with stapled anastomosis was associated inversely with early AL (crude OR = .89, 95% CI = .85-.94, P < .001 and adjusted OR = .89, 95% CI = .82-.98, P = .02). Conclusion The vitamin D3 level has a protective association with early AL. As a result, low vitamin D3 status may be a risk factor for early AL development, suggesting that it can be one of the predictors of early AL occurrence.
<b> Introduction:</b> Anastomotic leak after colorectal surgery is a serious complication that causes significant postoperative morbidity and mortality. </br></br> <b>Aim:</b> This study aimed to investigate the predictive value of increased postoperative carcinoembryonic antigen (CEA) in early intestinal anastomosis leakage in patients who underwent right hemicolectomy surgery.</br></br> <b>Material and methods:</b> In this prospective study, 535 patients who underwent right colon cancer surgery with stapled anastomosis were enrolled. A subset of 315 patients was included in the study after meeting the inclusion criteria. Preoperatively, their serum CEA levels were measured, and on postoperative days 3 and 6, the levels were measured again.</br></br> <b>Results:</b> Early AL occurred in 18 patients (5.71%). The mean ± SD age of patients was 65.06 ± 11.69 years. Increased CEA level was associated with increased odds of intestinal AL among the patients after three and six days of surgery (OR after three days = 1.3; 95%CI = 1.1–1.5, OR after six days = 1.7 95%CI = 1.14–2.5). The mean CEA level significantly increased among patients with anastomose leakage (P-value < 0.001). </br></br> <b>Conclusion:</b> The results showed that increasing CEA levels can be used as one of the non-invasive markers in detecting early AL in patients with right colon cancer surgery.
Background: Pilonidal sinus disease is a common infectious process that occurs on the natal cleft and sacrococcygeal part. The treatment of pilonidal sinus disease remains challenging and despite the existence of many non-surgical and surgical methods, there is no consensus for the best treatment for this disease. Objective: The goal of this study is to investigate the outcomes of pilonidal sinus surgery by three methods of semi-open, primary repair, and elliptical rotational flap. Methodology This prospective randomized study was conducted on patients suffering from primary pilonidal sinus. The patients were randomly assigned to one of the three groups based on surgical technique, were followed according to a checklist within the first, second and fourth weeks, as well as third and sixth months after surgery. Follow up was done in terms of recurrence, surgical complications, post-operative pain, and duration of hospitalization. Results: One hundred forty-six patients completed the study, including 21 women and 125 men. The mean age of patients was 26.56 ± 5 years. There was only one case of recurrence and the rate of post-operative haematoma and infection were not significant between groups, while the rate of itching problem was significantly different (P-value = .001). The highest degree of itching, haematoma and infection were in the semi-open, rotational flap and primary repair group, respectively. The mean duration of pain relief and time of hospitalization were 25.73 ± 11.36 hours and 4.41 ± 1.56 days, respectively, which were significantly different between groups. The longest mean duration of pain relief and hospitalization were in primary repair and semi-open group, respectively. Conclusions: Elliptical rotational flap is preferred to the other two methods due to less pain, lower recurrence rate after surgery and early return of patients to the economic cycle.
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