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Peritoneal invasion is more common and has a worse prognosis in gastric cancer than most of other intestinal cancers. Advanced gastric cancers have a poor course in terms of the development of peritoneal carcinomatosis and prognosis, even if the curative resection has been performed. Patients usually die within the first 2 years of the postoperative period mainly due to peritoneal metastasis. It is, therefore, essential to eradicate intraperitoneal free cancer cells to prevent peritoneal recurrences. A standard therapy has not been developed yet for patients with gastric cancer with a positive peritoneal cytology or a gross peritoneal metastasis. Curative resection following neoadjuvant chemotherapy, postoperative oral S-1 chemotherapy, intraoperative intraperitoneal chemotherapy (IPC), and extensive intraoperative peritoneal lavage (EIPL)−IPC are recommended as therapeutic approaches. Although there is a limited number of studies on EIPL, which is a promising and exciting method in this patient population, unexpected results of survival have been demonstrated. We consider that the results of ongoing and further studies would lead to an extensive use of EIPL, which is a simple and easy method which can be applied anywhere and anytime, in patients with advanced gastic cancer and/or peritoneal cytology positive but peritoneal metastasis negative (CY+/P0) gastric cancer. [ABSTRACT FROM PUBLISHER]

Objective: To compare sugammadex with neostigmine / atropine combination for reversal of neuromuscular blocker agents in terms of postoperative gastrointestinal motility in patients who underwent laparoscopic cholecystectomy., Study Design: Experimental study. Place and Duration of the Study: University of Health Sciences, Izmir Bozyaka Training and Research Hospital, Izmir, Turkiye, between December 2020 and June 2021., Methodology: Seventy-two patients undergoing laparoscopic cholecystectomy were included. At the end of the surgery, patients were antagonised for neuromuscular blockers either by atropine / neostigmine or sugammadex by an anaesthesiologist who was not involved in the study. Total anaesthesia time, pneumoperitoneum time, surgery time, number of postoperative opioid dose requirements and total opioid dose administered, number of medication requirements for postoperative nausea and vomiting, postoperative hospital stay, and first gas and stool output time of all the cases were evaluated by the researcher who was unaware of the medicines used for antagonisation., Results: There were no statistically significant differences between the two groups in terms of their effects on postoperative gastrointestinal motility (first gas and stool output time), duration of anaesthesia, duration of surgery, duration of pneumoperitoneum, the number of postoperative opioid dose requirements, the number of drug requirements for postoperative nausea / vomiting, and the postoperative hospitalisation duration of the cases., Conclusion: Effects of reversal agents on postoperative gastrointestinal motility are still debated. Studies on this subject in the literature are both limited in number and have been conducted with different medicine combinations in a wide variety of patient populations. The authors thought that further prospective randomised studies are needed to interpret this effect more clearly., Key Words: Sugammadex, Neostigmine / atropine, Gastrointestinal motility, Laparoscopic cholecystectomy.

Background: In acute obstructive left-sided colorectal cancers (AOLCRC), damage to the colon wall may occur as a result of distension of the colon segments proximal to the tumor. In this study, we aimed to evaluate the relationship between the ratio of dilated colon diameter (CD) to lumbar vertebral corpus diameter on preoperative abdominal computed tomography (CT) scan in patients undergoing Hartmann's Procedure (HP) and post-operative complications., Methods: The tumor group consisted of 49 patients who underwent HP for AOLCRC under emergency conditions. The control group consisted of 49 age-and gender-matched individuals (compatible with tumor group) that had an abdominal CT due to pathologies outside the gastrointestinal tract and without a history of abdominal surgery. In both group, the ratios of the CD to the diameter of the first lumbar vertebra corpus (L1-VD) measured on axial CT images of each patient. These ratios were compared between groups. In the tumor group, the relationship between post-operative complications (Clavien-Dindo classification-major (grade ≥III), minor (grade

To date, there was no controlled-study regarding awareness and knowledge of colorectal cancer in the Turkish population. We therefore designed a questionnaire consisting of items related to socio-demographic parameters, medical and family history and questions of awareness and knowledge about colorectal cancer for use in a descriptive cross-sectional study. An interviewer-administered technique was applied and 450 subjects were interviewed in the outpatient clinics at Near East University Hospital. Among all subjects, 337 were found to be eligible for the study group. Exclusion criteria were age below 18 years, any cancer history, family history of colorectal cancer, current colorectal problems, history of any diagnostic or therapeutic interventions for colorectal diseases.All participants stated that they heard about colorectal cancer. When asked about the lifetime risk of colorectal carcinoma, only 25.4% of women and 37.9% of men estimated correctly. Univariate analysis revealed that the total awareness score was significantly correlated with age, marital status, parenthood and fecal occult blood testing history. On multivariate analysis of independent predictors for awareness of colorectal cancer were found to be history of fecal occult blood testing, age and marital status were found to be the most important determinants. As a conclusion, opportunistic screening with fecal occult blood test by physicians from non-gastrointestinal specialties not only helps to reduce the mortality but also increases the awareness of colorectal cancer.

Background/aims: Until recently chronic hepatitis B virus (HBV) infection was considered a formal contraindication for liver transplantation, since recurrence of infection without prophylaxis occurs in 75%-90% of the patients. However, the introduction of hepatitis B immunoglobulin (HBIg) plus lamivudine has reduced the reinfection rates of the grafts less than 10%. The purpose of this study is to report our experience in a single transplant center and contribute to arguments about prophylaxis in areas where the prevalence of HBV is high., Methodology: From July 2004 to September 2008, 50 living donor liver recipients with HBV were included in our study. Preoperative HBV-DNA was positive in 25 patients and negative in the remaining 25. HBIg was first administered during the unhepatic phase of surgery as intravenous (i.v.) bolus and repeated in daily doses as intramusculary (IM) until seroconversion was achieved. Two different low dose HBIg protocols were used for HBV-DNA negative patients. First 15 patients transplanted until January 2006 received 1200 IU HBIg during the operation. From 2006 onwards, 10 patients who were transplanted received 2000 IU HBIg. HBV-DNA positive patients received 5000 IU HBIg during surgery. Until postoperative anti-HBs levels were above 100 mIU/mL and seroconversion was achieved; patients received maintenance doses of HBIg as detailed below: patients with negative preoperative HBV-DNA who received 1200 HBIg preoperative dose received 300 IU/day, those who received 2000 IU had 500 IU/day, those with DNA positivity had 1000 IU/day of maintenance HBIg. Lamivudine was given to all recipients begining on postoperative day 1., Results: Three of 15 patients who were HBV-DNA negative and who received 1200 IU HBIg intraoperatively developed HBV reinfections. The following 10 DNA negative patients who received 2000 IU of HBIg prophylaxis during the operation and those 25 patients who were DNA positive and received 5000 IU HBIg did not have any HBV reinfections., Conclusions: Higher doses of HBIg plus lamivudine therapy is a very effective prophylactic regimen for recipients with pre-operative HBV-DNA positivity in preventing a recurrent HBV infection. For preoperative HBV-DNA negative patients, low doses of HBIg plus lamivudine therapy is a feasable prophylactic option when ease of use, cost and low incidence of side effects are taken into consideration. However, it is still a controversial issue how much the required lowest dose should be and at the same time safe for prophylaxis.