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    Effects of TVE application during 70% hepatectomy on regeneration capacity of rats
    (Academic Press Inc Elsevier Science, 2005) Topaloğlu, Serdar; İzci, Erdal; Özel, Hakan; Topaloğlu, Eda; Avşar, Fatih M.; Saygun, Oral; Hengirmen, Süleyman
    Background For adequate control of excess bleeding during liver resection, total vascular exclusion (TVE) is preferred by surgeons, especially when the tumor is located in the posterior liver lobes or near the cava. To the authors' knowledge, the effects of TVE technique on the postoperative liver regeneration process have not thus far been evaluated yet in the literature. This study was planned to compare the effects of liver resections performed either with portal pedicle clamping or with TVE on the regeneration process. Materials and methods. Seventy percent hepatectomy was performed with portal pedicle clamping (n = 10, Group A) or with TVE (n = 10, Group B) in rats. At 48 h after resection, sampling was performed for the measurement of serum transaminase, alkaline phosphatase (ALP), tissue malondialdehyde (AIDA), and glutathione (GSH) levels. Liver regeneration rate, proliferating cell nuclear antigen (PCNA) labeling, and mitotic indices were also evaluated. Results. Liver injury determinants (serum transaminases, ALP, and tissue MDA levels) were found significantly higher in group B than in group A. Liver regeneration rate, liver GSH levels, PCNA labeling index, and mitotic index were significantly lower in group B than in group A. Conclusions. The injury during TVE seems to be greater than during resection with portal pedicle clamping. The negative effect of this oxidative damage may influence the regenerative capacity of the remnant liver tissue. (c) 2004 Elsevier Inc. All rights reserved.
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    Evaluation of liver damage after application of TVE in the rat model
    (Elsevier Science Inc, 2005) Darılmaz, Gökhan; Topaloğlu, Serdar; Topaloglu, E; Özel, Helin; Saygun, Oral; Avşar, Fatih Mehmet; Hengirmen, Süleyman
    Introduction. The aim of this study was to investigate the effects of total vascular exclusion (TVE) on the liver during the early period of reperfusion. Materials and methods. Forty Wistar-Albino rats were divided into four groups. Portal pedicle clamping (groups 1 and 2) or TVE (groups 3 and 4) were applied for 10 minutes. Samples were collected at the time of clamp release (groups 1 and 3) and at 30 minutes of reperfusion (groups 2 and 4). We examined oxidative injury to and histopathology of the liver. Results. Oxidative stress was more prominent with TVE application. Significant alterations were shown in hepatic superoxide dismutase, catalase, glutathione, and glutathione S-transferase levels. The levels of malondialdehyde and myeloperoxidase were not altered significantly. Conclusion. Inflow-outflow occlusion of the liver causes more oxidative stress compared with inflow occlusion.
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    The results of surgical treatment in the elderly acute abdomen patients
    (1999) Ağalar, Fatih; Özdoğan, Mehmet; Daphan, Çağatay Erden; Topaloğlu, Serdar; Sayek, İskender
    The aim of this study was to evaluate the factors affecting the outcome of geriatric patients presenting with acute abdomen. Eighty patients who underwent surgery with the diagnosis of acute abdomen were analysed retrospectively. The effects of age, sex, American Society of Anaesthesiology (ASA) class, preexisting disease, admission time after the onset of the symptoms, followup interval before the operation on morbidity, mortality and length of hospital stay were evaluated. Male/female ratio was 1.3, mean age was 72.4. Main causes were biliary system disease (38.8%), intestinal obstruction (31.3%), peptic ulcer perforation (12.5%) and acute appendicitis (8.7%). Median ASA class was 3 and 76.3% of the patients had at least one preexisting disease. ASA class was significantly effective on mortality and complication rate. Shock at the admission, malignity, male sex, mechanical ventilation and transfusion were the factors that have statistically significant effect on mortality. 58.8% of the patients had complications. Complications were significantly related to mortality, prolonged intensive care unit (ICU) stay and hospital stay. Male sex, ASA class, malign diseases, peptic ulcer perforation, colonic obstruction, shock, mechanical ventilation and blood transfusion were the factors affecting mortality in the elderly. Preexisting diseases other than malignity, period between the onset of symptoms and admission, follow-up time and operation time did not influence mortality. Complications and ASA classification were associated with a prolonged ICU and hospital stay.