Curative resection has to be the goal of surgical management in patients with gastric remnant cancer. Concerning clinician should be sceptical about a newly developing cancer in order to detect it in an early stage and enhance resectability.
To help predict ischemic events, the increasing use of the D-dimer assay in clinical practice could be extended to patients presenting with intestinal emergencies. An elevated D-dimer level on admission had a high sensitivity for identifying patients with intestinal ischemia, although it had a low specificity. Whether it is predictive or preventive for resection in strangulated intestinal hernia patients still remains a question.
Testicular blood flow is influenced during laparoscopic inguinal hernia surgery. Whether changes in flow parameters remain in the late postoperative period, and whether they have an impact on complications will be evaluated in further studies.
Summary
Congestion of the anterior sector may lead to graft failure in right lobe grafts. Selective drainage of the prominent segment 5 and/or 8 veins is proposed to overcome this problem. Different vascular conduits may be used during drainage of the anterior sector. In this study, we evaluated the efficiency of the vascular conduits. Between June 1999 and December 2005, 190 patients underwent living donor right lobe liver transplantation and reconstruction of segment 5 and/or 8 veins was performed in 48 patients (25.2%). Two groups were formed according to the types of vascular conduits. Cryopreserved cadaveric iliac artery (n = 28) and cryopreserved cadaveric iliac vein (n = 8) were used in group A. In group B, recipient saphenous vein (n = 6), recipient umbilical vein (n = 5) and recipient collateral omental vein (n = 1) were used for reconstruction. The graft‐recipient weight ratio, mean duration of anhepatic phase and MELD scores between two groups were not significantly different. All of the conduits were found to be patent just after reperfusion and in the early postoperative period by Doppler ultrasonography. In follow‐up period of 1 year, four (11%) patients died in group A, two patients (16%) in group B. One of these patients died because of sepsis started from the saphenous vein incision site. None of the patients dying in the two groups were lost due to venous outflow problems. This study proves the efficacy of drainage of segment 5 and/or 8 veins using cryopreserved cadaveric vascular conduits. Every effort should be employed to store cadaveric iliac vessels, otherwise, whole other additive surgical intervention to ensure vascular conduit may lead uninvited serious complication.
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