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Cystic echinococcosis (CE) is a parasitic disease caused by the larval stages of Echinococcus and is considered a neglected disease of public health worldwide. CE primarily affects the liver and demonstrates distinctive radiological findings in computed tomography (CT) and ultrasonography (US). Surgery is considered the mainstay of CE treatment. The patient was a 17-year-old man admitted to the Emergency Department of Shahid Faghihi Hospital affiliated with Shiraz University of Medical Sciences with dull right upper quadrant abdominal pain, loss of appetite, abdominal distention, and fullness. An abdominal CT scan revealed a giant hepatic cyst measuring about 24x20x15 cm in the right hepatic lobe (RHL) with a pressure effect on the right kidney, pancreas, and bowel loops. Semi-chevron incision was done and the patient underwent partial precystectomy with capitonnage and omentoplasty. The surgical outcome was uneventful and the patient was discharged on the eighth day after the surgery with the oral Albendazole. Reviewing the literature, our case was the 5th rank according to the size of the recorded published cases. The most common countries where the largest liver hydatid cysts were reported were Greece and Turkey. The most common surgery was the open surgery and the most common incisions were Kocher and then Chevron incisions. When dealing with a huge liver cyst, a high index of suspicion for echinococcal etiology becomes important in endemic areas such as Iran. The choice of treatment for giant hepatic cysts substantially seems to be radical surgery by surgical ablation in general to mitigate the mortality and morbidity rate, because they are at risk of rupture, anaphylaxis, and so forth. (The abstract is too long for a case report [260 words], it should be around 100 words. The part I highlighted can be deleted.) [ABSTRACT FROM AUTHOR]

Marine-derived bisindoles exhibit structural diversity and exert anti-cancer influence through multiple mechanisms. Comprehensive research has shown that the development success rate of drugs derived from marine natural products is four times higher than that of other natural derivatives. Currently, there are 20 marine-derived drugs used in clinical practice, with 11 of them demonstrating anti-tumor effects. This article provides a thorough review of recent advancements in anti-tumor exploration involving 167 natural marine bisindole products and their derivatives. Not only has enzastaurin entered clinical practice, but there is also a successfully marketed marine-derived bisindole compound called midostaurin that is used for the treatment of acute myeloid leukemia. In summary, investigations into the biological activity and clinical progress of marine-derived bisindoles have revealed their remarkable selectivity, minimal toxicity, and efficacy against various cancer cells. Consequently, they exhibit immense potential in the field of anti-tumor drug development, especially in the field of anti-tumor drug resistance. In the future, these compounds may serve as promising leads in the discovery and development of novel cancer therapeutics. [ABSTRACT FROM AUTHOR]

Cancer is the second leading cause of the death worldwide. As per the reports published by WHO, the cases of cancer in the world will increase to 22 million by 2030. Many resources are investigated all around the world for developing preventive, diagnostic and therapeutic strategies for cancer. Malignant cells display metabolic changes because of genetic and epigenetic alterations as compared to normal cell. Heterocycles are the key structural feature of many anti-cancer drugs present in the market. Between 2010 to 2015, FDA approved anticancer drugs also contain heterocyclic rings in their structures. Their presence in anti-cancer drugs can be credited to their being extremely common in nature, with enormous cellular processes and mechanisms. This review throws light on several heterocyclic compounds containing nitrogen, sulphur and oxygen in their rings, possessing anticancer activity on different cell lines. A compiled data of heterocyclic rings will help in providing a new way towards future development of new compound for treatment of cancer. [ABSTRACT FROM AUTHOR]

As part of our ongoing efforts to produce promising cytotoxic agents, the novel compounds, 5-(4-(diethylamino)-2-((1-substitutedphenyl-1H-1,2,3-triazol-4-yl)methoxy)phenyl)-1,3,4-thiadiazol-2-yl)pyrrolidine-2,5-dione derivatives (9a-l) were developed, synthesized, and characterized using several analytical techniques, including 1H NMR, 13C NMR, and LC-MS. New series of 1,2,3-triazole and thiadiazole molecular hybrids synthesized were evaluated for their anti-cancer activity against human esophageal carcinoma cell line KYSE-450 and human pancreatic carcinoma cell line MIA PaCa-2 cells. According to cytotoxic evaluation data, compounds 9b, 9i, 9j, and 9l exhibited potential cytotoxic activity against KYSE-450 and MIAPaCa-2 cells. Compound 9j had more significant anti-cancer potential than the standard employed across all compounds evaluated. The remaining compounds exhibited moderate to weak anti-proliferative potential. In-vitro kinase inhibition of compound 9j was significantly more effective against ARK-A and ERK2 enzymes, indicating its dual inhibition potential. Docking analysis showed that 9k, 9j, and 9i have substantial docking scores with the ARK-A receptor, indicating the presence of strong binding affinities. Significant binding interactions between molecules 9j and 9h and the ERK2 receptor suggest an inhibitory effect. Hence the compounds are promising dual inhibitors of ARK-A/ERK2. [ABSTRACT FROM AUTHOR]

Thiazoles and thiazolidines are widespread occurring in natural products. They act as a viaduct between medicinal and organic chemistry. The presence of sulfur elevates their pharmacological activities whereas the presence of nitrogen makes it an active moiety for the development of scaffolds in a drug discovery process. Therefore, both of these compounds can be utilized as a vehicle for the synthesis of beneficial organic amalgamation. Thiazole exhibits high curative properties which enabled researchers to focus on composing various attempts to integrate and investigate novel structural precursors, which are more effective. On the other hand, thiazolidine and its derivatives are used in scrutinizing drug designs for the development of multifunctional drugs and modifying their activity. Both the nucleus and their derivative are blended in the evolution of drugs that display selective inhibition of both types of cyclooxygenases as well as lipoxygenase enzymes. In the present review, different recent synthetic routes of this important class are presented which show anti-inflammatory activities and enhanced potential in the inhibition of COX enzymes. [ABSTRACT FROM AUTHOR]

A new series of nortopsentin analogs, in which the central imidazole ring of the natural lead was replaced by a 1,3,4-oxadiazole or 1,3,4-thiadiazole moiety, was efficiently synthesized. The antiproliferative activity of all synthesized derivatives was evaluated against five pancreatic ductal adenocarcinoma (PDAC) cell lines, a primary culture and a gemcitabine-resistant variant. The five more potent compounds elicited EC50 values in the submicromolar–micromolar range, associated with a significant reduction in cell migration. Moreover, flow cytometric analysis after propidium iodide staining revealed an increase in the G2-M and a decrease in G1-phase, indicating cell cycle arrest, while a specific ELISA demonstrated the inhibition of CDK1 activity, a crucial regulator of cell cycle progression and cancer cell proliferation. [ABSTRACT FROM AUTHOR]

Cancer accounts for ten million dies in each year. There are ample number of Food and Drug Administration (FDA) approved drugs for this disease. Due to severe side effects and multiple drug resistance, the current drug therapies become ineffective. So, the newer chemical moieties/entities with less toxic are necessary for the development. The nitrogen bearing heterocycle indole scaffold is considered one of the most privileged pharmacophores in heterocyclic compounds. New indole-based drug may serve as an effective for the development of new drug against this disease. This review amalgamates the current advances on indole based molecular frameworks and their unique anticancer relevance as reported over the last two decades. It highlights an inclination in the use of indole-based drug crafting and subsequent emergence of several potent drug against a range of cancer diseases in the clinical and pre-clinical stages of development. [ABSTRACT FROM AUTHOR]

Pancreatic ductal adenocarcinoma (PDAC) is one of the main aggressive types of cancer, characterized by late prognosis and drug resistance. Among the main factors sustaining PDAC progression, the alteration of cell metabolism has emerged to have a key role in PDAC cell proliferation, invasion, and resistance to standard chemotherapeutic agents. Taking into account all these factors and the urgency in evaluating novel options to treat PDAC, in the present work we reported the synthesis of a new series of indolyl-7-azaindolyl triazine compounds inspired by marine bis-indolyl alkaloids. We first assessed the ability of the new triazine compounds to inhibit the enzymatic activity of pyruvate dehydrogenase kinases (PDKs). The results showed that most of derivatives totally inhibit PDK1 and PDK4. Molecular docking analysis was executed to predict the possible binding mode of these derivatives using ligand-based homology modeling technique. Evaluation of the capability of new triazines to inhibit the cell growth in 2D and 3D KRAS-wild-type (BxPC-3) and KRAS-mutant (PSN-1) PDAC cell line, was carried out. The results showed the capacity of the new derivatives to reduce cell growth with a major selectivity against KRAS-mutant PDAC PSN-1 on both cell models. These data demonstrated that the new triazine derivatives target PDK1 enzymatic activity and exhibit cytotoxic effects on 2D and 3D PDAC cell models, thus encouraging further structure manipulation for analogs development against PDAC. [ABSTRACT FROM AUTHOR]

Introduction: Hepatocellular carcinoma (HCC) accounts for nearly 90% of primary liver cancers, with estimates of over 1 million people affected by 2025. We aimed to explore the impacting role of an iterative surgical treatment approach in a cohort of HCC patients within the Milan criteria, associated with clinical risk factors for tumor recurrence (RHCC) after liver transplant (LT) and loco-regional therapies (LRT), as well as liver resection (LR) and/or microwave thermal ablation (MWTA). Methods: We retrospectively analyzed our experience performed during an 8-year period between January 2013 and December 2021 in patients treated for HCC, focusing on describing the impact on preoperative end-stage liver disease severity, oncologic staging, tumor characteristics, and surgical treatments. The Cox model was used to evaluate variables that could predict relapse risks. Relapse risk curves were calculated according to the Kaplan-Meier method, and the log-rank test was used to compare them. Results: There were 557 HCC patients treated with a first-line approach of LR and/or LRTs (n = 335) or LT (n = 222). The median age at initial transplantation was 59 versus 68 for those whose first surgical approach was LR and/or LRT. In univariate analysis with the Cox model, nodule size was the single predictor of recurrence of HCC in the posttreatment setting (HR: 1.61, 95% CI: 1.05-2.47, p = 0.030). For the LRT group, we have enlightened the following clinical characteristics as significantly associated with RHCC: hepatitis B virus infection (which has a protective role with HR: 0.34, 95% CI: 0.13-0.94, p = 0.038), number of HCC nodules (HR: 1.54, 95% CI: 1.22-1.94, p < 0.001), size of the largest nodule (HR: 1.06, 95% CI: 1.01-1.12, p = 0.023), serum bilirubin (HR: 1.57, 95% CI: 1.03-2.40, p = 0.038), and international normalized ratio (HR: 16.40, 95% CI: 2.30-118.0, p = 0.006). Among the overall 111 patients with RHCC in the LRT group, 33 were iteratively treated with further curative treatment (12 were treated with LR, two with MWTA, three with a combined LR-MWTA treatment, and 16 underwent LT). Only one of 18 recurrent patients previously treated with LT underwent LR. For these RHCC patients, multivariable analysis showed the protective roles of LT for primary RHCC after IDLS (HR: 0.06, 95% CI: 0.01-0.36, p = 0.002), of the time relapsed between the first and second IDLS treatments (HR: 0.97, 95% CI: 0.94-0.99, p = 0.044), and the impact of previous minimally invasive treatment (HR: 0.28, 95% CI: 0.08-1.00, p = 0.051). Conclusion: The coexistence of RHCC with underlying cirrhosis increases the complexity of assessing the net health benefit of ILDS before LT. Minimally invasive surgical therapies and time to HCC relapse should be considered an outcome in randomized clinical trials because they have a relevant impact on tumor-free survival. [ABSTRACT FROM AUTHOR]

The worldwide impact of cancer is further compounded by the constraints of current anticancer medications, which frequently exhibit a lack of selectivity, raise safety apprehensions, result in significant adverse reactions, and encounter resistance mechanisms. The current situation highlights the pressing need to develop novel and more precise anticancer agents that prioritize safety and target specificity. Remarkably, more than 85% of drugs with physiological activity contain heterocyclic structures or at least one heteroatom. Nitrogen-containing heterocycles hold a significant position among these compounds, emerging as the most prevalent framework within the realm of heterocyclic chemistry. This article explores the medicinal chemistry behind these molecules, highlighting their potential as game-changing possibilities for anticancer medication development. The analysis highlights the inherent structural variety in nitrogen-containing heterocycles, revealing their potential to be customized for creating personalized anticancer medications. It also emphasizes the importance of computational techniques and studies on the relationships between structure and activity, providing a road map for rational medication design and optimization. Nitrogen- containing heterocycles are a promising new area of study in the fight against cancer, and this review summarises the state of the field so far. By utilizing their inherent characteristics and exploiting cooperative scientific investigations, these heterocyclic substances exhibit potential at the forefront of pioneering therapeutic approaches in combating the multifaceted obstacles posed by cancer., (Copyright© Bentham Science Publishers; For any queries, please email at epub@benthamscience.net.)

Despite significant advances in understanding cancer pathogenesis, it continues to be one of the leading causes of death. Thus, there is an urgent need for the development of novel, more effective anticancer therapeutics. In recent years, small molecules containing five-member heterocyclic moieties have become the subject of considerable growing interest for designing new anticancer agents. An example is the 1,3,4-thiadiazole, a versatile scaffold widely studied in medicinal chemistry. The mesoionic character of the ring allows 1,3,4-thiadiazole-containing derivatives to cross the cellular membrane and interact strongly with biological targets leading to the possibility of low toxicity and high selectivity. This review attempts to collect the recent updates of synthetic methodology, structural activity relationship (SAR), and anticancer properties of 1,3,4-thiadiazole embedded derivatives, which can be considered potential anticancer agents. [ABSTRACT FROM AUTHOR]

Background: Circular RNAs have been emerging as biomarkers in diagnosis and prognosis of pancreatic ductal adenocarcinoma (PDAC). The hsa_circ_0013912 (circ_0013912) has been retrieved to be upregulated in PDAC. Here, we further investigated its role in PDAC cells, as well as its mechanism via serving as competing endogenous RNA (ceRNA) for miRNA (miR)-7-5p, which is abundant in pancreas and suppresses the development of PDAC. Materials and Methods: The clinical human tissues were harvested from Gene Expression Omnibus (GEO) database and PDAC patients, and expression of circ_0013912 and miR-7-5p was detected by real-time quantitative PCR. The interaction between both was confirmed by dual-luciferase reporter assay, RNA immunoprecipitation and biotin-miRNA pull-down assay. Functional experiments were performed using Cell Counting Kit-8 assay, colony formation assay, fluorescence-activated cell separation method, caspase 3 activity assay kit, Western blotting, transwell assays, and xenograft tumor model. Results: circ_0013912 was upregulated in PDAC tumors and cells; besides, circ_0013912 upregulation was associated with TNM stage and lymph node metastasis. Silencing circ_0013912 inhibited cell viability, colony formation ability, cell cycle entrance, migration and invasion, but facilitated apoptosis rate and caspase 3 activity in PANC-1 and AsPC-1 cells, accompanied with decreased c-myc, cyclin D1 and vimentin, and increased E-cadherin. Furthermore, miR-7-5p was a target of circ_0013912. Blocking miR-7-5p could promote cell growth, migration and invasion of PANC-1 and AsPC-1 cells with circ_0013912 silencing or not. Tumor growth was also restrained by circ_0013912 downregulation. Conclusion: Circ_0013912 knockdown could suppress cell growth and metastasis of PDAC cells via sponging miR-7-5p. [ABSTRACT FROM AUTHOR]

Hepatic hydatid disease is located mainly in the right liver. It is usually solitary and asymptomatic; however, a large cyst may cause compression symptoms. We report a case of a huge echinococcal cyst located in segment IVb of the liver in a 39-year-old female, 17 x 11 cm in dimensions, causing persistent epigastric pain and discomfort. The diagnosis was made by a computed tomography (CT) scan, which showed the cystic mass with the characteristic daughter cysts and reactive caps (pericystic wall) consisting of fibrous connective tissue and calcifications. The patient underwent radical resection by total cysto-pericystectomy and had an uneventful postoperative course. Follow-up showed no recurrence in CT and normal liver function test. Total cysto-pericystectomy, as an alternative to hepatectomy, is the preferable choice of radical resection operation, nowadays, in the management of liver hydatid disease even in huge cysts. [ABSTRACT FROM AUTHOR]

Aim Hydatidosis is an endemic zoonosis that is prevalent in South America, specifically in Chile, Argentina and Uruguay. Liver hydatidosis (LH) is associated with morbidity and mortality due to evolutionary complications, as well as the risk of complications related to surgical procedures. The surgical treatment of LH can be divided into four phases: isolation of the surgical area, evacuation of the cyst, treatment of the complications of the cyst and treatment of the residual cavity. LH surgical procedures can be classified as conservative and radical. The aim of the present study was to present a general, evidence-based overview of some surgical aspects of interest in the treatment of LH. Patients and Methods An overview was conducted. Articles published between 1990 and 2015 and related to results of surgery in patients with LH were evaluated. PubMed, Web of Science, SciELO and Trip Database were reviewed, and the results of surgery in LH patients were evaluated. Results A total of 301 articles were retrieved, 46 of which met the selection criteria (3 systematic reviews, 2 controlled trials, 5 cohorts studies, 12 observational studies and 24 case series). The studies had a level of evidence of 1b, 2a, 2b, 3a and 4 of prognostic and therapy scenarios. Conclusions The articles found were few and heterogeneous, making meaningful conclusions difficult. Studies with better levels of evidence, methodological quality and population size are needed to make conclusions and recommendations. [ABSTRACT FROM AUTHOR]

Background and Aims In patients with hepatitis C virus ( HCV), recurrence of infection after liver transplant ( LT) is universal and associated with worst survival. We present the results of an Italian cohort to compare the 3-year outcome of HCV-Ab-positive and HCV-Ab-negative LT recipients and to assess the potential interaction between HCV-Ab sero-status and other risk factors for LT failure. Methods The study is a multicentre cohort including a sample of liver transplant centres. Participant's information was collected at the local level. The best functional form of variables was decided according to the objective methods based on information theory. Association between transplant failure and potential risk factors was assessed in univariate and multivariate Poisson regression model with random intercept. Results Between June 2007 and May 2009, 1164 LT recipients were enrolled in 16 Italian transplant centres, of them 275 (23.63%) experienced LT failure. Incidence rates of LT failure was 0.32 and 0.23 per 1000 person-days in HCV-Ab-positive and HCV-Ab-negative recipients respectively ( P = 0.003). Inferential models according to Akaike information criterion indicated that donor-recipient age difference and donor-recipient sex matching were more informative to predict LT failure than the age and the sex as separate variables. Multivariate analysis provided evidence that HCV-Ab sero-status, time after LT, donor-recipient age difference, donor-recipient sex matching and recipient's MELD score were significantly associated with LT failure. Moreover, the effect of HCV-Ab sero-status on LT failure was modified by the simultaneous action of time after LT and donor-recipient age difference. No interaction was found between recipient's HCV-Ab sero-status and either recipient's MELD or donor-recipient sex matching. Conclusion In view of the imminent introduction of new anti- HCV therapies, our study provides information to assess which LT recipients should be prioritized for receiving these highly effective, but expensive, new treatments. This is particularly relevant for those clinical settings where healthcare prioritization is endorsed by national authorities. [ABSTRACT FROM AUTHOR]

Purpose: LigaSure, a bipolar electronic vessel sealing system, has become popular in abdominal surgery but few clinical studies have been conducted to evaluate its effectiveness in radical gastrectomy for gastric cancer. Methods: In this multicenter, prospective, randomized controlled trial, patients with curative gastric cancer were randomly assigned to undergo gastrectomy either with LigaSure or a conventional technique. Results: Of the 160 patients enrolled, 80 were randomized to the LigaSure group and 78 to the conventional group. Patient characteristics were well balanced in the two groups. There were no significant differences between the LigaSure and conventional groups in blood loss (288 vs. 260 ml, respectively; P = 0.748) or operative time (223 and 225 min, respectively; P = 0.368); nor in the incidence of surgical complications or duration of postoperative hospital stay. In a subgroup analysis of patients who underwent gastrectomy that preserved the distal part of the greater omentum, the use of LigaSure significantly reduced blood loss (179 vs. 245 ml; P = 0.033), and the duration of the operation (195 vs. 221 min; P = 0.039). Conclusions: LigaSure did not contribute to reducing intraoperative blood loss, operative time, or other adverse surgical outcomes. The usefulness of the device may be limited to a specific part of the surgical procedure in open gastrectomy. [ABSTRACT FROM AUTHOR]

Aim: Both LigaSure (LS) and Harmonic Scalpel (HS) are new surgical technologies that have been used to secure hemostasis in various fields of surgery. There is little information in the literature about the use of LS and HS in thyroid surgery. The aim of this study was to report our experience with LS and HS in thyroid surgery. Materials and methods: In this nonrandomized retrospective study 326 consecutive patients who underwent primary thyroid surgery were reviewed. HS was used in 136 patients and LS was used in 126 patients. A conventional technique was used in 64 patients. he were 42 male patients (12.9%) and 284 female patients (87.1%); their ages varied between 19 and 72 years (mean 42.8 ± 12.4). Data regarding each patient's demographics, thyroid pathology, operation time, and complications were collected throughout the study. Results: he 3 study groups had similar demographics (age, female/male ratio) and thyroid pathology. Permanent hypocalcemia developed in 2 (1.6%) patients in the patient group operated on through LS, of which 1 was male and the other was female. In the HS group, postoperative hematoma developed in 2 (1.5%) patients. Conclusion: The results of this retrospective clinical study showed that LS and HS thyroidectomy can be a useful and fast alternative for conventional thyroidectomy. he main advantage of these devices is that they simplify the procedure and eliminate the need for clips and suture ligations while achieving efficient hemostasis. [ABSTRACT FROM AUTHOR]

Summary Optimization of donor-recipient match is one of the exciting challenges in liver transplantation. Using algorithms obtained by the Italian D-MELD study (5256 liver transplants, 21 Centers, 2002-2009 period), a web-based survival calculator was developed. The calculator is available online at the URL . The access is free. Registration and authentication are required. The website was developed using PHP scripting language on HTML platform and it is hosted by the web provider Aruba.it. For a given donor (expressed by donor age) and for three potential recipients (expressed by values of bilirubin, creatinine, INR, and by recipient age, HCV, HBV, portal thrombosis, re-transplant status), the website calculates the patient survival at 90 days, 1 year, 3 years, and allows the identification of possible unsustainable matches (i.e. donor-recipient matches with predicted patient survival less than 50% at 5 years). This innovative approach allows the selection of the best recipient for each referred donor, avoiding the allocation of a high-risk graft to a high-risk recipient. The use of the D-MELD.com website can help transplant surgeons, hepatologists, and transplant coordinators in everyday practice of matching donors and recipients, by selecting the more appropriate recipient among various candidates with different prognostic factors. [ABSTRACT FROM AUTHOR]

Purpose: A new method for ensuring hemostasis during thyroid surgery has recently been introduced. This technique, electrothermal (LigaSure) and ultrasound blood vessel sealing, is still experimental. The aim of the present study was to evaluate the applications and efficacy of LigaSure by analyzing the duration of the surgery and the rate of complications of the surgical procedure. Methods: A total of 23 patients who underwent the LigaSure operation (n group) were analyzed in a prospective nonrandomized/partly randomized clinical study, and were compared with patients who underwent treatment using the conventional (ligature) surgical technique. Results: At our institutions, 187 patients were treated surgically for thyroid disease in 2006, and 23 of these patients were treated using LigaSure. The complication rate in the patients treated with LigaSure (n: 4.3%) was lower than those who received conventional ligature surgery. However, given the small number of patients, this difference was not statistically significant (retrospective group n: 10.7%; nonrandomized group n: 9.8%; and randomized group n: 9.1%). The length of surgery in the LigaSure group (n = 65 ± 3 min) was significantly shorter ( P < 0.001) compared with both nonrandomized (n = 71 ± 6 min) and randomized (n = 70 ± 4 min) patients who received a conventional ligature. Conclusions: The application of LigaSure using meticulous surgical technique provides a new option for a safe thyroidectomy. Moreover, the duration of the LigaSure procedure is significantly shorter, and there are fewer complications as compared with the classic surgical thyroidectomy technique. [ABSTRACT FROM AUTHOR]

In this paper, we have described a co-construction process model, in the context of a socio-technical framework, to support the collaborative engineering design. This paper has reviewed our previous work in building a co-construction model on the conceptual, logical, and analytical layers and then proposed an expanded Petri net representation that is developed toward a more comprehensive and operational co-construction model, which captures the key conceptual components of a collaborative engineering design process, describes the possible logic flow between these components, and analyzes their interaction in the design process. In this paper, we have also discussed a case study that was conducted in a real-life engineering design to validate our research. At the end of this paper, we emphasized the importance of this study and outlined the future directions of improving this study. [ABSTRACT FROM PUBLISHER]

The article presents abstracts related to surgery which include the reliability of computed tomography (CT) scan for diagnosing splenosis under conditions of emergency, case studies of angiodysplasia of the gastrointestinal tract, and the use of biliary decompression in the treatment of pancreatic cancer.

Abstract Purpose  LigaSure is a bipolar diathermy system, which achieves vessel sealing with reduced thermal spread. The device has been used successfully in abdominal operations and because of its features, it has been applied recently in thyroid surgery to minimize the risk of complications such as laryngeal nerve palsy and hypocalcemia, and also to reduce the operating time. Methods  Between June and December 2005, we performed total thyroidectomy for various disorders in 105 patients. We used the LigaSure diathermy system in 53 patients and traditional hemostatic procedures in the other 52. We evaluated the demographic features, histopathological diagnosis, operating times, and relevant postoperative complications. Results  The two study groups had similar demographic and histopathological features. The mean operating time ± SD was not significantly shorter in the LigaSure group than in the traditional group (104 ± 12.7 vs 110 ± 15.6 min). None of the patients in either group suffered hemorrhage, definitive hypocalcemia, or definitive laryngeal nerve palsy. Transient hypocalcemia and transient laryngeal nerve palsy developed in 7.54% and in 1.88%, respectively, of the patients in the LigaSure group, and in 7.69% and 1.92%, respectively, of the patients in the traditional group; these differences were not significant. Conclusions  LigaSure is a safe and effective method of hemostasis control, but it did not reduce the incidence of complications or operating times compared with traditional hemostatic procedures; moreover, the operative costs were higher. [ABSTRACT FROM AUTHOR]