SUMMARY OBJECTIVE: The aim of this study is to evaluate the early results of robotic surgery-assisted low anterior resection for rectal cancer and transvaginal specimen extraction, regarding the operative time, operative and early postoperative complications, hospital stay, and pathological reports in a series of 10 patients. METHODS: From November 2016 to October 2019, case series study on patients diagnosed with RC was included in this study. All robotic-assisted low anterior resection of the rectum, vaginal removal of the specimen, colorectal anastomosis, and loop ileostomies were performed using the Da Vinci XI system. RESULTS: The mean age of patient was 64.8 (58–72) years. Low anterior resection was performed to seven patients, and very low anterior resection was performed to three patients. Total mesorectal excision of the rectum, transvaginal specimen extraction, transanal anastomoses, and protective ileostomy were performed in all 10 patients. The mean operative time was 275±30.50 min, and estimated blood loss was 50±10.50 mL. No patient required conversion to conventional surgery. Negative circumferential resection, proximal, and distal margins were accomplished negative. Mean number of lymph nodes harvested was 20±5.5. According to the pathological reports, all were adenocarcinoma. T1 stage was 80.0%, and T2 stage was 20.0%. Lymph node metastasis accounted for 80.0%. CONCLUSIONS: To our literature search, this is the first study reporting the early outcomes of the novel robotic surgery-assisted low anterior resection for rectal cancer and transvaginal specimen extraction by using the Da Vinci Xi system. It can be performed safely and successfully in selected patients by providing an excellent cosmetic body image, which may be important for women.

RESUMO Objetivo: Avaliar a pressão intraocular (PIO) e vasos orbitários extraoculares com ultrassom Doppler colorido (UDC) e investigar os efeitos da obesidade sobre o fluxo sanguíneo retrobulbar. Métodos: Cinquenta e nove pacientes foram incluídos neste estudo prospectivo. Os pacientes foram divididos em dois grupos de acordo com o índice de massa corpo ral (IMC): Grupo 1 (31 pacientes obesos) e Grupo 2 (28 não obesos). As pressões intraoculares (PIOs) foram medidas com tonômetro de aplanação de Goldmann e o UDC foi utilizada para a avaliação de vasos retrobulbar. Resultados: As PIOs foram 18 ± 6,68 mmHg nos pacientes obesos e 13,71 ± 1,60 mmHg nos grupos controle (p<00,001). Quando os valores da artéria central da retina (ACR) foram comparados entre os grupos controle e obeso. O índice pulsátil (PI) foi marcadamente menor no grupo obeso (p<00,001). Quando os valores da artéria oftálmica (AO) dos grupos obesos e de controle foram comparados. Os valores de Velocidade do pico sistólico (PSV) (p<00,001) e velocidade diastólica final (EDV) (p=00,002) foram significativamente mais baixos no grupo obeso. Conclusão: Pacientes obesos têm maior PIO do que os pacientes não obesos. Os pacientes obesos têm diminuição nas velocidades de fluxo da AO. O aumento da PIO. Juntamente com a diminuição do fluxo sanguíneo retrobulbar, especialmente em indivíduos obesos, pode aumentar o risco de desenvolvimento de glaucoma.

ABSTRACT Purpose: To evaluate intraocular pressure (IOP) and extraocular orbital vessels with color Doppler ultrasound (CDU) and investigate the effects of obesity on retrobulbar blood flow. Methods: Fifty-nine patients were included in this prospective study. Patients were divided into two groups according to body mass index: Group 1 (31 obese patients) and Group 2 (28 non-obese patients). IOP was measured with a Goldmann applanation tonometer, and CDU was used to evaluate the retrobulbar vessels. Results: The mean IOP was 18 ± 6.68 mmHg in the obese group and 13.71 ± 1.60 mmHg in the control group (p<0.001). When the CDU values for the central retinal artery were compared between the groups, the pulsatility index was found to be significantly lower in the obese group than in the control group (p<0.001). When the CDU values for the ophthalmic artery (OA) were compared between the groups, the peak systolic velocity (p<0.001) and end-diastolic velocity (p=0.002) values were found to be significantly lower in the obese group than in the control group. Conclusions: Obese patients have a higher mean IOP and lower flow velocity than non-obese patients. Increased IOP together with decreased retrobulbar blood flow, particularly in obese individuals, may increase the risk of glaucoma development.

PURPOSE: To investigate the effect of medical ozone treatment on the experimental acute distal colitis in rats. METHODS: Eighteen rats were randomly distributed into three equal groups; control, acute distal colitis (ADC) without and with medical ozone treatment. Rats in the control group were taken saline. ADC was performed by rectal way with 4% acetic acid in groups 2 and 3, and the group 3 was treated with medical ozone for three weeks both rectally and intraperitoneally. At the twenty second day the distal colons samples were obtained for malondialdehyde and myeloperoxidase, blood samples were obtained to measure the levels of TNF-α and IL-1β levels. Histolopatological examination was evaluated with Ki-67, IL-1β and VEGF immunostaining densities. RESULTS: There was significant increase in tissue MDA, MPO activity, TNF-α and IL-1β after ozone administration. There was also a significant difference at immunostaining densities of histopathological examination. CONCLUSIONS: Medical ozone treatment ameliorated the experimental acute distal colitis induced by acetic acid in rats. Its possible effect is by means of decreasing inflammation, edema, and affecting the proliferation and the vascularization.

ABSTRACT PURPOSE: To determine the effect of grape-seed extract against ischemia/reperfusion injury in cholestatic liver. METHODS: Eighteen Wistar albino rats were divided into three groups. In control and study groups, cholestasis was provided by bile duct ligation. Seven days later, the rats were subjected to 30 min hepatic ischemia, followed by 60 min of reperfusion. Oral administration of 50 mg/kg/day grape-seed extract was started 15 days before bile duct ligation and continued to the second operation in the study group. Serum, plasma and liver samples were taken. Laboratory analysis, tissue gluthation, malondialdehyde, myeloperoxidase levels and histopathological examination were performed. RESULTS: Significant decrease in liver gluthation level and significant increase in malondialdehyde level and myeloperoxidase activity were observed after ischemia/reperfusion in cholestatic rats. Serum and plasma levels for laboratory analysis were also significantly higher in cholestatic I/R group. Hepatic necrosis and fibrosis were detected in histopathological examination. Oral grape-seed extract administiration reversed all these parameters and histopathological findings except serum bilirubin levels. CONCLUSION: Oral grape-seed extract treatment can improve liver functions and attenuate the inflammation and oxidative stress in cholestatic ischemia/reperfusion injury.

PURPOSE: To investigate the effects of medical ozone theraphy on the colon anastomosis of peritonitis model in rats. METHODS: Eighteen rats were randomly assigned into three equal groups; control, cecal punctuation and colon anastomosis and ozone theraphy. Sepsis was performed with a cecal punctuation in groups 2 and 3. The medical ozone theraphy was administered intraperitonealy for three weeks in group 3 while the other rats received saline injection. At the twenty second day serum were obtained for TNF-α and IL-1β, the colonic burst pressures were measured and colonic tissue samples were obtained for MDA and MPO levels. Histolopatological examination was evaluated with H&E stain, and Ki-67, IL-1β and the VEGF immunostaining densities were also compared. RESULTS: Intraperitoneal ozone administration reversed TNF-α, IL-1β, MDA and MPO levels and the colonic burst pressures. There was also a significant difference at immunostaining densities of histopathological examination. CONCLUSION: Medical ozone therapy may contribute to tissue healing by affecting the proliferation and the vascularization thus has benefits on colonic anastomosis at peritonitis in rats.

PURPOSE: To determine the antioxidant and anti-inflammatory effects of alfa lipoic acid (ALA) on the liver injury induced by methotrexate (MTX) in rats.METHODS:Thirty two rats were randomly assigned into four equal groups; control, ALA, MTX and MTX with ALA groups. Liver injury was performed with a single dose of MTX (20 mg/kg) to groups 3 and 4. The ALA was administered intraperitonealy for five days in groups 2 and 4. The other rats received saline injection. At the sixth day the rats decapitated, blood and liver tissue samples were removed for TNF-α, IL-1β, malondialdehyde, glutathione, myeloperoxidase and sodium potassium-adenosine triphosphatase levels measurement and histological examination.RESULTS: MTX administration caused a significant decrease in tissue GSH, and tissue Na+, K+ ATPase activity and which was accompanied with significant increases in tissue MDA and MPO activity. Moreover the pro-inflammatory cytokines (TNF-α, IL- β) were significantly increased in the MTX group. On the other hand, ALA treatment reversed all these biochemical indices as well as histopathological alterations induced by MTX.CONCLUSION:Alfa lipoic acid ameliorates methotrexate induced oxidative damage of liver in rats with its anti-inflammatory and antioxidant effects.