Aims: Prosthetic graft infection frequently requires graft replacement. Among other options, a bi... more Aims: Prosthetic graft infection frequently requires graft replacement. Among other options, a biological graft could serve as an alternative choice. Decellularization reduces tissue immunogenicity. Our aim was to determine an efficient decellularization method and to evaluate the decellularized porcine biografts’ adaptability. Methods: Four different protocols were implemented to decellularize porcine aortic segments (n = 4). Cell removal effectiveness and matrix structure preservation were histologically examined. Mechanical tests were performed. Decellularized porcine grafts were interpositioned in a porcine aorta. After a 6-month period, implanted samples were removed and evaluated using light and electron microscopy. Results: Histological results showed complete removal of cells and preserved connective tissue fiber structure following decellularization, using sodium dodecyl sulfate and sodium azide. Pressure tests demonstrated similar compliance to fresh vessels. In 9 out of 10 cases, pigs survived the follow-up period. Graft rejection, intimal hyperplasia, reocclusion and/or aneurysm formation were not observed. Presence of host cells and neoendothelialization were microscopically confirmed. Conclusions: This decellularization protocol enables a cost-effective preparation of biological grafts featuring reduced immunogenicity. The implanted grafts did not degenerate during the 6-month follow-up period, the lack of graft rejection suggests acceptable immunological tolerance, while recipient cells migrate into, proliferate and differentiate, thus creating the possibility for further use as an optional vascular graft.
Journal of Thermal Analysis and Calorimetry, Mar 1, 2009
Massive bleeding from esophagus varices presents a life threatening complication of portal hypert... more Massive bleeding from esophagus varices presents a life threatening complication of portal hypertension. No effective method of treatment is available until now, that would guarantee high grade of patient wellness during the conditioning and investigation phase until the definitive treatment could be introduced. The aim of this study was to evaluate the tissue response to esophagus stents - designed for
Bevezetés és célkitűzés: Az akut Stanford B típusú aortadissectio (ATBAD) egy potenciálisan élete... more Bevezetés és célkitűzés: Az akut Stanford B típusú aortadissectio (ATBAD) egy potenciálisan életet veszélyeztető kórkép, melynek adekvát ellátása kritikus lehet a beteg túlélése szempontjából. A jelen vizsgálat célja az ATBAD ellátásával kapcsolatosan végzett konzervatív, nyitott vagy endovascularis terápiás modalitások rövid és hosszú távú eredményeinek összehasonlítása. Módszer: Retrospektív, multicentrikus kohorszvizsgálatunk során a 2011. 01. 01. és 2020. 12. 31. között akut és szubakut TBAD-val kezelt betegeket vizsgáltuk. A terápia módja szerint a konzervatívan, nyitott műtéttel kezelt és a thoracalis endovascularis aortasztentgraft-implantáción (TEVAR) átesett betegek eredményeit hasonlítottuk össze. Regisztráltuk a posztoperatív 30 napban történt halálozást, major szövődményeket, valamint az utánkövetés során való reoperáció szükségességét és a túlélést. Eredmények: A vizsgálatba 188 beteget vontunk be (69,7% férfi, átlagéletkor: 57 ± 12,2 év). A betegek 88,8%-a szenvedett magasvérnyomás-betegségben. A posztoperatív 30 napban a nyitott műtéten átesett betegek között magasabb arányban fordult elő halálozás, mint a TEVAR-on átesett betegek között (26% és 16,7%, p = 0,12). A nyitott műtéten és a TEVAR-on átesett betegek között hasonlóan magas arányban fordult elő posztoperatív lélegeztetést igénylő tüdőszövődmény (22,6% és 19,4%), valamint műtétet igénylő vascularis szövődmény (25,9% és 16,7%). A konzervatívan kezelt csoportban 3 esetben volt szükséges a dissectióval kapcsolatos műtét végzése 30 napon belül (renalis sztentimplantáció: n = 2, TEVAR: n = 1). A medián utánkövetési idő 41 (IQR, 73,5) hónap volt. Utánkövetésünk alatt a reoperációk tekintetében nem volt szignifikáns különbség a három csoport között (p = 0,428). A 6 éves túlélés a nyitott műtéten átesett betegek között szignifikánsan alacsonyabb volt, mint a másik két vizsgált betegcsoportban (54,8% vs. 79,3% és 75%, p = 0,017). Következtetés: Amennyiben ATBAD esetén műtét indikált, TEVAR végzése előnyösebb a nyitott műtéthez képest mind a rövid, mind a hosszú távú eredmények tekintetében. A nem komplikált esetekben folytatott konzervatív te rápia hosszú távú eredményei nem mutatnak szignifikáns különbséget a TEVAR eredményeihez képest.
Introduction: Cerebral hyperperfusion syndrome is a rare, hardly known condition, which can resul... more Introduction: Cerebral hyperperfusion syndrome is a rare, hardly known condition, which can result in serious complications either after surgical or endovascular revascularization. Recognition of the typical triad (headache, seizure, focal neurological deficit) and the prompt radiological diagnosis (sonography, computed tmography) are crucial to achieve a favourable outcome. Aim: The aim of the authors was to select the endangered group and set up an effective therapeutic protocol based their own expereince in combination with relevant literature data. Method: From the beginning of 2010 up to now three cases with these symptoms pursuant to the criteria of cerebral hyperperfusion syndrome have been recognized by the authors. Results: Each of the three patients were treated by similar principles on intensive care unit, but the applied therapy resulted in complete remission in one patient only. Conclusions: At present there is no efficient diagnostic way to screen the endangered group,...
In this article we present a relatively rare vascular surgical complication and an uncommon treat... more In this article we present a relatively rare vascular surgical complication and an uncommon treatment of it. In this case we used an aorto-bifemoral bypass on a patient with Leriche syndrome. The implanted Y-graft got infected and we were forced to remove it. Having inserted the abdominal aortic graft, an axillobifemoral bypass was also applied to secure the circulation of the lower limbs. However, the graft occluded later on, and 37 months after the inital surgery a rather large pseudoaneurysm developed at the origin of the graft in the right subclavian artery. Another surgical intervention was indicated to prevent embolisation, rupture and compression. Instead of the conventional surgical method (resection, interposition) we did an endovascular procedure. We removed the false aneurysm by inserting a covered stent, using catheter technique, into the right brachial artery and therefore prevented the previously mentioned complications. This minimal invasive method is very useful for ...
Szakmai beszámoló "Az akut izületi vérömleny patomechanizmusának vizsgálata" című kutatási progra... more Szakmai beszámoló "Az akut izületi vérömleny patomechanizmusának vizsgálata" című kutatási program zárójelentéséhez (OTKA-azonosító: F 46504) Témavezető: Dr Borsiczky Balázs A 2004-ben megkezdett projekt végrehajtása során in vitro, in vivo állatkísérletek, és
It is well known that conventional coronary revascularization is associated with a pronounced sys... more It is well known that conventional coronary revascularization is associated with a pronounced systemic inflammatory response due to the application of cardiopulmonary bypass (CPB). To compare the effects of coronary artery bypass grafting (CABG) with (on-pump) or without (off-pump) extra-corporeal circulation observing certain inflammatory response parameters. TWENTY PATIENTS UNDERGOING CABG WITH (CPB GROUP: 10 patients) or without (off-pump coronary artery bypass grafting [OPCAB] group: 10 patients) CPB were enrolled in this prospective, randomized study. Blood samples were collected three times during the operation and on postoperative days 1, 2, 3 and 7. The plasma level of proinflammatory cytokine tumor necrosis factor (TNF)-alpha was measured by enzyme-linked immunosorbent assay method following stimulation, and the expression of adhesion molecules (CD11, CD18) of leukocytes were determined by flow cytometry. Furthermore, white blood cell (WBC) and neutrophil count were carried...
A vekonybel transzplantalhatosagat fokozott immunogenitasa mellett az neheziti, hogy az egyik leg... more A vekonybel transzplantalhatosagat fokozott immunogenitasa mellett az neheziti, hogy az egyik legerzekenyebb szovet az ischemias/reperfuzios (I/R) karosodasokra. Az immunologiai problemakat kizarva kiserletes vekonybel autotranszplantacios modellekben az I/R karosodast vizsgaltuk. A karosodas csokkentesere, kivedesere az ischemias prekondicionalas (IPC) hatasat vizsgaltuk. IPC-t vegeztunk kulonboző ciklusokkal a vekonybel transzplantacio előtt. Kimutattuk, hogy az IPC mindket formaja fokozta a szovet ischemias toleranciajat valamennyi prekondicionalt csoportban. A prekondicionalas kivaltotta, az intracellularisan jelen levő transcripcios faktor, a nuklearis factor kappa B (NF-kB) aktivaciojat. Az aktivitas valtozas bifazisos jellegű volt mind a citoplazmalis, mind a nuklearis NF-kB eseten. Az altalunk alkalmazott legrovidebb IPC ciklus (1 perc ischemia + 1 perc reperfuzio) aktivalta a prekondicionalasi kaszkadot. Ez alatamasztja, hogy a belsejtekben is a "minden vagy semmi"...
The aim of this study was to assess the efficacy of a hyaluronic acid derivate gel in reducing ad... more The aim of this study was to assess the efficacy of a hyaluronic acid derivate gel in reducing adhesions in pigs undergoing laparoscopic abdominal cavity surgery. 20 domestic female pigs underwent laparoscopy in general anesthesia. 4 defined serosal defects have been made (hepatoduodenal ligament, parietal, anterior stomach wall and jejunal mesentery). The defects have been covered with 20 mL Hyalobarrier Gel in 10 randomly selected pigs. 2 weeks postoperatively the pigs got reoperated for evaluation of potential adhesions. 17 pigs remained for evaluation. 2 pigs died during introduction of anesthesia, one at the end of the operation. None of the pigs died due to a reaction to the gel. We found adhesions in 33% of the gel group (n=3 out of 9) and in 87.5% in the group without gel (7 out of 8): p < 0.05. Most of the adhesions have been found at the parietal defect (7 out of 17 at all). The hyaluronic acid gel was highly efficacious and reduced the number and extent of adhesions th...
The authors aimed to study of oxidative stress and thrombocyte function in the perioperative inte... more The authors aimed to study of oxidative stress and thrombocyte function in the perioperative interval following the revascularization surgery of lower limb. The prospective randomised study involved 10 patients whose surgical interventions were indicated by lower limb embolism, thrombosis or abdominal aorta aneurysm, and 10 healthy volunteers were also involved in the study. Peripheral blood samples were collected before, and after the surgery (2, 24 hours and one week). The maximal free radical production and lag time of the free radical production of activated leukocytes were measured, and leukocyte adhesion molecules (CD11a and CD18) signing leucocyte activation were determined as well. Endogenous antioxidant defence status, reduced glutathione (GSH), total thiol-groups (-SH), SOD activity and thrombocyte function were investigated in platelet rich plasma and in whole blood. White blood cell count and free radical production was significantly higher in patients group before surge...
Treatment for long segment circular defects of the trachea still represent a challenge. Short-seg... more Treatment for long segment circular defects of the trachea still represent a challenge. Short-segment lesions can be treated with primary reconstruction. Segmental grafting is necessary if primary reconstruction is impossible. We investigated the use of politetrafluoroethylene (PTFE) grafts for tracheal grafting. Forty-nine adult New Zealand white rabbits were divided in 7 groups in which we compared the effects of continuous and interrupted suture techniques, and various positioning of the graft. Length of survival, changes in intraoperative tracheal microcirculation were measured, microscopic alterations of the trachea, and the anastomosis were studied. Continuous sutures significantly decreased local microcirculation. Using interrupted sutures this effect was not seen. The frequent development of granulation tissue was reduced by using internal telescopic anastomosis. We found that PTFE graft with internal telescopic anastomosis using interrupted sutures is superior to all other ...
Cold preservation prior to small-bowel transplantation can moderate tissue injury, although it is... more Cold preservation prior to small-bowel transplantation can moderate tissue injury, although it is unable to protect the bowel graft from acute reperfusion injury. One method to reduce oxidative stress is ischemic preconditioning (IPC). The limited data regarding IPC of the bowel encouraged us to investigate the key factor in this process, i.e., the activation of nuclear factor-kappa binding (NF-kB) in bowel tissue. The intestine was preconditioned by various cycles of IPC on rats. Activation of NF-kB was detected by a chemiluminescence-based ELISA method. Our findings showed that NF-kB level was elevated significantly 30 min after IPC. One hour following IPC, NF-kB decreased to control level; 2 h after IPC, the level significantly increased again. These changes were independent of the number of IPC cycles. Our experiments with various IPC cycles revealed that even a very short IPC cycle was able to activate the IPC cascade in small-bowel tissue.
Background. To examine the feasibility of a new, minimally invasive procedure for the devasculari... more Background. To examine the feasibility of a new, minimally invasive procedure for the devascularization of the proximal stomach and distal esophagus to prevent recurrent variceal bleeding in portal hypertension in a new animal model. Material and methods. Portal hypertension was created by laparoscopic clip ligation of the portal vein on 20 pigs. After 2 weeks the azygoportal disconnection procedure was performed with the LigaSure-ATLAS instrument. Results. There were 16 pigs out of 20 that survived both operations. Two died during introduction of anesthesia, one because of a cardiac arrest (second operation). One pig died resulting from necrosis of the gastric and esophageal wall. Autopsy (2 weeks later) showed that there was a complete arterial devascularization. At autopsy, none of the remaining 16 pigs had esophageal varices or necrosis of the stomach or esophagus. Conclusion. Laparoscopic azygoportal disconnection is a less invasive method for the prevention of rebleeding and seems to be safely performed with the LigaSure-ATLAS instrument.
Aims: Prosthetic graft infection frequently requires graft replacement. Among other options, a bi... more Aims: Prosthetic graft infection frequently requires graft replacement. Among other options, a biological graft could serve as an alternative choice. Decellularization reduces tissue immunogenicity. Our aim was to determine an efficient decellularization method and to evaluate the decellularized porcine biografts’ adaptability. Methods: Four different protocols were implemented to decellularize porcine aortic segments (n = 4). Cell removal effectiveness and matrix structure preservation were histologically examined. Mechanical tests were performed. Decellularized porcine grafts were interpositioned in a porcine aorta. After a 6-month period, implanted samples were removed and evaluated using light and electron microscopy. Results: Histological results showed complete removal of cells and preserved connective tissue fiber structure following decellularization, using sodium dodecyl sulfate and sodium azide. Pressure tests demonstrated similar compliance to fresh vessels. In 9 out of 10 cases, pigs survived the follow-up period. Graft rejection, intimal hyperplasia, reocclusion and/or aneurysm formation were not observed. Presence of host cells and neoendothelialization were microscopically confirmed. Conclusions: This decellularization protocol enables a cost-effective preparation of biological grafts featuring reduced immunogenicity. The implanted grafts did not degenerate during the 6-month follow-up period, the lack of graft rejection suggests acceptable immunological tolerance, while recipient cells migrate into, proliferate and differentiate, thus creating the possibility for further use as an optional vascular graft.
Journal of Thermal Analysis and Calorimetry, Mar 1, 2009
Massive bleeding from esophagus varices presents a life threatening complication of portal hypert... more Massive bleeding from esophagus varices presents a life threatening complication of portal hypertension. No effective method of treatment is available until now, that would guarantee high grade of patient wellness during the conditioning and investigation phase until the definitive treatment could be introduced. The aim of this study was to evaluate the tissue response to esophagus stents - designed for
Bevezetés és célkitűzés: Az akut Stanford B típusú aortadissectio (ATBAD) egy potenciálisan élete... more Bevezetés és célkitűzés: Az akut Stanford B típusú aortadissectio (ATBAD) egy potenciálisan életet veszélyeztető kórkép, melynek adekvát ellátása kritikus lehet a beteg túlélése szempontjából. A jelen vizsgálat célja az ATBAD ellátásával kapcsolatosan végzett konzervatív, nyitott vagy endovascularis terápiás modalitások rövid és hosszú távú eredményeinek összehasonlítása. Módszer: Retrospektív, multicentrikus kohorszvizsgálatunk során a 2011. 01. 01. és 2020. 12. 31. között akut és szubakut TBAD-val kezelt betegeket vizsgáltuk. A terápia módja szerint a konzervatívan, nyitott műtéttel kezelt és a thoracalis endovascularis aortasztentgraft-implantáción (TEVAR) átesett betegek eredményeit hasonlítottuk össze. Regisztráltuk a posztoperatív 30 napban történt halálozást, major szövődményeket, valamint az utánkövetés során való reoperáció szükségességét és a túlélést. Eredmények: A vizsgálatba 188 beteget vontunk be (69,7% férfi, átlagéletkor: 57 ± 12,2 év). A betegek 88,8%-a szenvedett magasvérnyomás-betegségben. A posztoperatív 30 napban a nyitott műtéten átesett betegek között magasabb arányban fordult elő halálozás, mint a TEVAR-on átesett betegek között (26% és 16,7%, p = 0,12). A nyitott műtéten és a TEVAR-on átesett betegek között hasonlóan magas arányban fordult elő posztoperatív lélegeztetést igénylő tüdőszövődmény (22,6% és 19,4%), valamint műtétet igénylő vascularis szövődmény (25,9% és 16,7%). A konzervatívan kezelt csoportban 3 esetben volt szükséges a dissectióval kapcsolatos műtét végzése 30 napon belül (renalis sztentimplantáció: n = 2, TEVAR: n = 1). A medián utánkövetési idő 41 (IQR, 73,5) hónap volt. Utánkövetésünk alatt a reoperációk tekintetében nem volt szignifikáns különbség a három csoport között (p = 0,428). A 6 éves túlélés a nyitott műtéten átesett betegek között szignifikánsan alacsonyabb volt, mint a másik két vizsgált betegcsoportban (54,8% vs. 79,3% és 75%, p = 0,017). Következtetés: Amennyiben ATBAD esetén műtét indikált, TEVAR végzése előnyösebb a nyitott műtéthez képest mind a rövid, mind a hosszú távú eredmények tekintetében. A nem komplikált esetekben folytatott konzervatív te rápia hosszú távú eredményei nem mutatnak szignifikáns különbséget a TEVAR eredményeihez képest.
Introduction: Cerebral hyperperfusion syndrome is a rare, hardly known condition, which can resul... more Introduction: Cerebral hyperperfusion syndrome is a rare, hardly known condition, which can result in serious complications either after surgical or endovascular revascularization. Recognition of the typical triad (headache, seizure, focal neurological deficit) and the prompt radiological diagnosis (sonography, computed tmography) are crucial to achieve a favourable outcome. Aim: The aim of the authors was to select the endangered group and set up an effective therapeutic protocol based their own expereince in combination with relevant literature data. Method: From the beginning of 2010 up to now three cases with these symptoms pursuant to the criteria of cerebral hyperperfusion syndrome have been recognized by the authors. Results: Each of the three patients were treated by similar principles on intensive care unit, but the applied therapy resulted in complete remission in one patient only. Conclusions: At present there is no efficient diagnostic way to screen the endangered group,...
In this article we present a relatively rare vascular surgical complication and an uncommon treat... more In this article we present a relatively rare vascular surgical complication and an uncommon treatment of it. In this case we used an aorto-bifemoral bypass on a patient with Leriche syndrome. The implanted Y-graft got infected and we were forced to remove it. Having inserted the abdominal aortic graft, an axillobifemoral bypass was also applied to secure the circulation of the lower limbs. However, the graft occluded later on, and 37 months after the inital surgery a rather large pseudoaneurysm developed at the origin of the graft in the right subclavian artery. Another surgical intervention was indicated to prevent embolisation, rupture and compression. Instead of the conventional surgical method (resection, interposition) we did an endovascular procedure. We removed the false aneurysm by inserting a covered stent, using catheter technique, into the right brachial artery and therefore prevented the previously mentioned complications. This minimal invasive method is very useful for ...
Szakmai beszámoló "Az akut izületi vérömleny patomechanizmusának vizsgálata" című kutatási progra... more Szakmai beszámoló "Az akut izületi vérömleny patomechanizmusának vizsgálata" című kutatási program zárójelentéséhez (OTKA-azonosító: F 46504) Témavezető: Dr Borsiczky Balázs A 2004-ben megkezdett projekt végrehajtása során in vitro, in vivo állatkísérletek, és
It is well known that conventional coronary revascularization is associated with a pronounced sys... more It is well known that conventional coronary revascularization is associated with a pronounced systemic inflammatory response due to the application of cardiopulmonary bypass (CPB). To compare the effects of coronary artery bypass grafting (CABG) with (on-pump) or without (off-pump) extra-corporeal circulation observing certain inflammatory response parameters. TWENTY PATIENTS UNDERGOING CABG WITH (CPB GROUP: 10 patients) or without (off-pump coronary artery bypass grafting [OPCAB] group: 10 patients) CPB were enrolled in this prospective, randomized study. Blood samples were collected three times during the operation and on postoperative days 1, 2, 3 and 7. The plasma level of proinflammatory cytokine tumor necrosis factor (TNF)-alpha was measured by enzyme-linked immunosorbent assay method following stimulation, and the expression of adhesion molecules (CD11, CD18) of leukocytes were determined by flow cytometry. Furthermore, white blood cell (WBC) and neutrophil count were carried...
A vekonybel transzplantalhatosagat fokozott immunogenitasa mellett az neheziti, hogy az egyik leg... more A vekonybel transzplantalhatosagat fokozott immunogenitasa mellett az neheziti, hogy az egyik legerzekenyebb szovet az ischemias/reperfuzios (I/R) karosodasokra. Az immunologiai problemakat kizarva kiserletes vekonybel autotranszplantacios modellekben az I/R karosodast vizsgaltuk. A karosodas csokkentesere, kivedesere az ischemias prekondicionalas (IPC) hatasat vizsgaltuk. IPC-t vegeztunk kulonboző ciklusokkal a vekonybel transzplantacio előtt. Kimutattuk, hogy az IPC mindket formaja fokozta a szovet ischemias toleranciajat valamennyi prekondicionalt csoportban. A prekondicionalas kivaltotta, az intracellularisan jelen levő transcripcios faktor, a nuklearis factor kappa B (NF-kB) aktivaciojat. Az aktivitas valtozas bifazisos jellegű volt mind a citoplazmalis, mind a nuklearis NF-kB eseten. Az altalunk alkalmazott legrovidebb IPC ciklus (1 perc ischemia + 1 perc reperfuzio) aktivalta a prekondicionalasi kaszkadot. Ez alatamasztja, hogy a belsejtekben is a "minden vagy semmi"...
The aim of this study was to assess the efficacy of a hyaluronic acid derivate gel in reducing ad... more The aim of this study was to assess the efficacy of a hyaluronic acid derivate gel in reducing adhesions in pigs undergoing laparoscopic abdominal cavity surgery. 20 domestic female pigs underwent laparoscopy in general anesthesia. 4 defined serosal defects have been made (hepatoduodenal ligament, parietal, anterior stomach wall and jejunal mesentery). The defects have been covered with 20 mL Hyalobarrier Gel in 10 randomly selected pigs. 2 weeks postoperatively the pigs got reoperated for evaluation of potential adhesions. 17 pigs remained for evaluation. 2 pigs died during introduction of anesthesia, one at the end of the operation. None of the pigs died due to a reaction to the gel. We found adhesions in 33% of the gel group (n=3 out of 9) and in 87.5% in the group without gel (7 out of 8): p < 0.05. Most of the adhesions have been found at the parietal defect (7 out of 17 at all). The hyaluronic acid gel was highly efficacious and reduced the number and extent of adhesions th...
The authors aimed to study of oxidative stress and thrombocyte function in the perioperative inte... more The authors aimed to study of oxidative stress and thrombocyte function in the perioperative interval following the revascularization surgery of lower limb. The prospective randomised study involved 10 patients whose surgical interventions were indicated by lower limb embolism, thrombosis or abdominal aorta aneurysm, and 10 healthy volunteers were also involved in the study. Peripheral blood samples were collected before, and after the surgery (2, 24 hours and one week). The maximal free radical production and lag time of the free radical production of activated leukocytes were measured, and leukocyte adhesion molecules (CD11a and CD18) signing leucocyte activation were determined as well. Endogenous antioxidant defence status, reduced glutathione (GSH), total thiol-groups (-SH), SOD activity and thrombocyte function were investigated in platelet rich plasma and in whole blood. White blood cell count and free radical production was significantly higher in patients group before surge...
Treatment for long segment circular defects of the trachea still represent a challenge. Short-seg... more Treatment for long segment circular defects of the trachea still represent a challenge. Short-segment lesions can be treated with primary reconstruction. Segmental grafting is necessary if primary reconstruction is impossible. We investigated the use of politetrafluoroethylene (PTFE) grafts for tracheal grafting. Forty-nine adult New Zealand white rabbits were divided in 7 groups in which we compared the effects of continuous and interrupted suture techniques, and various positioning of the graft. Length of survival, changes in intraoperative tracheal microcirculation were measured, microscopic alterations of the trachea, and the anastomosis were studied. Continuous sutures significantly decreased local microcirculation. Using interrupted sutures this effect was not seen. The frequent development of granulation tissue was reduced by using internal telescopic anastomosis. We found that PTFE graft with internal telescopic anastomosis using interrupted sutures is superior to all other ...
Cold preservation prior to small-bowel transplantation can moderate tissue injury, although it is... more Cold preservation prior to small-bowel transplantation can moderate tissue injury, although it is unable to protect the bowel graft from acute reperfusion injury. One method to reduce oxidative stress is ischemic preconditioning (IPC). The limited data regarding IPC of the bowel encouraged us to investigate the key factor in this process, i.e., the activation of nuclear factor-kappa binding (NF-kB) in bowel tissue. The intestine was preconditioned by various cycles of IPC on rats. Activation of NF-kB was detected by a chemiluminescence-based ELISA method. Our findings showed that NF-kB level was elevated significantly 30 min after IPC. One hour following IPC, NF-kB decreased to control level; 2 h after IPC, the level significantly increased again. These changes were independent of the number of IPC cycles. Our experiments with various IPC cycles revealed that even a very short IPC cycle was able to activate the IPC cascade in small-bowel tissue.
Background. To examine the feasibility of a new, minimally invasive procedure for the devasculari... more Background. To examine the feasibility of a new, minimally invasive procedure for the devascularization of the proximal stomach and distal esophagus to prevent recurrent variceal bleeding in portal hypertension in a new animal model. Material and methods. Portal hypertension was created by laparoscopic clip ligation of the portal vein on 20 pigs. After 2 weeks the azygoportal disconnection procedure was performed with the LigaSure-ATLAS instrument. Results. There were 16 pigs out of 20 that survived both operations. Two died during introduction of anesthesia, one because of a cardiac arrest (second operation). One pig died resulting from necrosis of the gastric and esophageal wall. Autopsy (2 weeks later) showed that there was a complete arterial devascularization. At autopsy, none of the remaining 16 pigs had esophageal varices or necrosis of the stomach or esophagus. Conclusion. Laparoscopic azygoportal disconnection is a less invasive method for the prevention of rebleeding and seems to be safely performed with the LigaSure-ATLAS instrument.
Uploads
Papers by László Benko