No abstract

The laparoscopic approach appears to be as effective as open repairs in the treatment of ventral hernias. Advanced surgical skill, laparoscopic experience and high technology are mandatory factors for successful ventral hernia repair.

Although there were some procedures performed with single incision technique like cholecystectomy, prostatectomy, and partial nephrectomy, as far as we are concerned this is the first report about laparoscopic splenectomy performed with single incision surgery technique.

Context: Although some endocrine surgeons administer Lugol solution to decrease thyroid gland vascularity, there is still not an agreement on its effectiveness. Objective:The aims of this clinical trial are to evaluate thyroid blood flow and microvessel density in patients with Graves' disease who received Lugol solution treatment preoperatively.Design: This was a prospective clinical trial. Setting:This clinical trial took place at a tertiary referral center. Method:Thirty-six patients were randomly assigned to receive either preoperative treatment with Lugol solution (group 1, n ϭ 17) or no preoperative treatment with Lugol solution (group 2, n ϭ 19). Main Outcome Measures:Blood flow through the thyroid arteries of patients with Graves' disease was measured by color flow Doppler ultrasonography. The microvessel density (MVD) was assessed by immunohistochemical and Western blot analysis of the level of expression of CD-34 in thyroid tissue. The weight and blood loss of the thyroid gland were measured in all patients. Results:The mean blood flow, MVD, CD-34 expression, and blood loss in group 1 patients were significantly lower than those in group 2 patients. There was a negative correlation between Lugol solution treatment and blood flow (r s ϭ Ϫ0.629; P ϭ 0.0001), blood loss (r s ϭ Ϫ0.621; P ϭ 0.0001), MVD (r s ϭ Ϫ0.865; P ϭ 0.0001), and CD-34 expression (r s ϭ Ϫ0.865; P ϭ 0.0001). According to logistic regression analysis, Lugol solution treatment resulted in a 9.33-fold decreased rate of intraoperative blood loss. Conclusion

These findings indicate that the increased incidence of cardiovascular risk factors commonly observed in classical CS, is also present in SCS. Unilateral adrenalectomy does not always lead to significant improvements in cardiovascular risk profile in SCS.