Authors:L. Benkő, J. Danis, R. Hubmann, G. Kasza, Éva Gömöri, Erzsébet Rőth, and D. Lőrinczy
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 manage acute variceal bleeding - in animal experiment.
Self-expandable nitinol stents were introduced into the esophagus of six porcines. Another twelve porcines were undergone
the same procedure, using the new biodegradable stents made of PDO (polydioxanon). Histological investigations of the stented
esophagus segments were observed after 2 and 4 weeks at the first 12 animals. To monitor the time of stent degradation, histology
were performed 7 and 12 weeks after the implantation in the biodegradable group (3–3 animals). Differential scanning calorimetric
examination was performed in all esophagus samples.
Focal erosion of the esophagus segments was more explicit in the nitinol group at the histology. On the 7th week all of the biodegradable stent were in the stomach and on the 12th week these were completely solved. DSC examination showed significant alterations in the structure of the esophagus in both
stented group compared to the healthy control.
This experiment showed that the new self-expandable stents are safety and suitable procedure without deterioration of the
esophageal wall. According to our DSC results the thermal denaturation of intact esophagus, its mucosa and muscle fragments
revealed significant differences compared to healthy sample in favour the new biodegradable stent. Safety and efficiency in
the experimental model had encouraged us to apply this method successfully patients with bleeding esophagus varices. The long
term goal is to show that stent placement could be an effective way of decreasing or stabilising the acute bleeding from ruptured
esophagus varices in cirrhotic patients.
Authors:R. Izadpanah, Á. Dán, Mária Benkő, M. Rusvai, L. Fodor, and B. Harrach
One of the plasmids present in a Haemophilus somnus strain isolated from nasal discharge of a cattle with respiratory disease was purified and cloned for DNA sequencing. The plasmid was found to be 1065 base pairs long with 39.2% G+C content, and showed no homology to any DNA sequenced so far. It has no capacity to code any protein longer than 43 residues. It is not clear yet if this plasmid codes Haemophilus somnus specific factors.
Authors:Z. Szántó, L. Benkő, B. Gasz, G. Jancsó, Ö. P. Horváth, and E. Rőth
Resection and subsequent end-to-end anastomosis of the windpipe is a tried-and-tested acceptable method for the surgical treatment
of segmental defects. There are a variety of different techniques for tracheal end-to-end anastomosis, but controversial reports
highlight the fact that the suturing technique of the anastomosis is still subject of debate. We aimed to show the postoperative
effects of the continuous and simple interrupted suturing technique respectively on the tracheal cartilage using differential
scanning calorimetry. Transsection and subsequent reanastomosis of the cervical trachea was performed in 14 adult beagle dogs.
The trachea was anastomized with continuous or simple interrupted sutures respectively depict no change in microcirculation
after the resection of the trachea, but significant decrease following the completion the anastomosis with continuous sutures.
Conventional histological analysis did not show any marked postoperative change in the tracheal cartilage but our DSC scans
clearly demonstrated the differences between the intact cartilages and the ones involved in the anastomosis.
Authors:Peter Lukovich, A. Zsirka-Klein, T. Vanca, L. Szpaszkij, and P. Benkő
The technical background of pure Natural Orifice Translumenal Endoscopic Surgery (NOTES) surgery has not been created yet, but ever more reports are being published on hybrid NOTES surgery and single-port surgical interventions, which have appeared as a result of device development inspired by NOTES. Surgery carried out through single ports only differ from pure NOTES in respect of the access orifice, which makes learning this technique extremely important for anyone whishing to implement a surgical intervention through a natural orifice. Numerous publications have appeared by now on the single port or hybrid NOTES surgery of various organs (gall bladder, kidney, large bowel). Based on these, most surgery is safely feasible through one port as well, but the surgery takes longer and it is not significantly less painful than a “traditional” laparoscopic intervention. Long-term results are still missing, primarily in what concerns the frequency of infections and post-operative hernia. We have received an answer to part of the dilemmas formulated in the White Paper. Besides specially bent laparoscopic devices robot technology and devices controlled by extracorporal magnets may both be a solution to the problem of triangulation. The transvaginal and transgastric paths do not seem to cause significant risks from the viewpoint of infections, but the closing of viscerotomy in the case of the stomach is far from being solved. In respect of learning and practicing new surgical techniques no method exists at the moment that could be considered the “gold standard”. Besides the earlier questions there are new ones as well awaiting partial solutions (e.g. necessity of drain following a NOTES surgery, oncologic principles).
Authors:L. Benkő, J. Danis, M. Czompo, R. Hubmann, A. Ferencz, G. Jancsó, Z. Szántó, A. Zólyomi, F. Könczöl, Á. Bellyei, E. Rőth, and D. Lőrinczy
Massive bleeding from oesophagus varices presents
a life threatening complication of liver cirrhosis. 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 fact that we have not found any report in the
literature about self-expandable metal stents (SEMS) application in acute
variceal bleeding had encouraged us to use stents usually used for oesophageal
malignancy and furthermore develop a special stent for this individual indication.
The aim of this study
was to evaluate the tissue response to oesophagus stent designed for stop
acute variceal bleeding in animal experiment in compare with another stent
used for iatrogenic treatment of different strictures of the oesophagus. Tissue
oxygen saturation (StO2) measurement was performed
before and after the implantation of the stents. Macroscopic and histological
investigations of the stented oesophagus segments were observed after 10 days.
calorimeter (DSC) is a well-established method for the demonstration of thermal
consequences of local and global conformational changes in biological systems,
but it has never been used for the investigation of the oesophagus. According
to our results the thermal denaturation of intact oesophagus, its mucosa and
muscle fragments revealed significant differences compared to healthy sample
in favour of the new stent.