DIVERTICULOSIS COLI IN TURKISH POPULATION: SINGLE CENTER DATA

H. CETİNKAYA, O. KESKİN, M. BEKTAS, A. TUZUN, G. KABACAM, G. SEVEN, M. YAKUT,

H. ANİKTAR, S. AGAYEVA, E. DOGRU, M. TORUNER, I. SOYKAN,

A. R. BEYLER, K. BAHAR

Ankara University, Ankara, TURKEY

Introduction: Diverticulosis of colon is an acquired condition that results from herniation of the mucosa through defects in the muscle layer. Diverticular disease of the colon is common especially in Western countries. In developed countries, studies showed that prevalence of diverticula was about 30% in those aged over 50 and 50% in those aged over 70. Prevalence of diverticulosis is linearly and directly corralated with increasing age. Recent studies also show no difference in the gender distribution of diverticular diseases. Diverticulosis in Western countries is predominantly left-sided and diverticulosis is usually right-sided in Asian countries.

Material and methods: Data from patients undergoing colonoscopy for various reasons in our clinic was evaluated. Reports of all colonoscopies in the last 4 years were taken into consideration. Patients with inadequate cleaning of colon were excluded from evaluation. Emergent colonoscopies were also excluded.

Results: Total number of colonoscopies evaluated was 5211. Mean age of patients was 49 in males and 45 in females. 51% of patients was male and 49% was female. 330 patients (183 M,147 F) had diverticulosis (6.63%). Mean age of patients with diverticulosis was 64.5 (29-95, medyan:65). Frequency of divertikulosis was 1%, 2.8%, 5.8%, 6.9%, 12.5% in patients <40 years old, 40-50, 51-60, 61-70 and >70 years old respectively. 64% of patients have left-sided diverticulosis, 19.5% of patients have right-sided and 16.5% of patients have full colon diverticulosis.

Conclusion: In our Turkish population, frequency of diverticulosis was found as 6.63%. This percentage is lower than Western countries. In Western countries studies showed that no gender difference in diverticulosis patients but there is male predominance in our population. Frequency of diverticulosis was detected as 1-4% in previous studies in Turkish population. Diverticulosis coli is increasing in Turkish population because Western type nutrition and obesity is increasing in Turkish population. As the frequency of diverticulosis increases, complications related with diverticulosis (bleeding and diverticulitis) will also increase.

THE FUNCTIONAL STATE OF CENTRAL HEMODYNAMICS DURING LAPAROSCOPIC APPENDECTOMY IN PREGNANT WOMEN

S.M. CHUDNIKH, E.S. ALIYEV

Moscow State Medical-Stomatological University, Moscow, RUSSIA

The stability of indices of central hemodynamics is one of important criteria reflecting the efficacy of laparoscopic operations generally and particularly in pregnant women.

Aim of the study: To investigate the functional state of central hemodynamics during laparoscopic appendectomy (LA) in pregnant women.

Material and methods: The study is based on evaluation of efficacy of diagnosis and treatment of acute appendicitis in 13 pregnant women by means of endovideosurgical technique taking into account the functional state of central hemodynamics. Diagnostic laparoscopy was applied to 5 pregnant women in I trimester, 7 in II trimester, and 1 in III trimester. The intraabdominal pressure was managed by gas insufflation individually according to the duration of gestation and varied from 8-9 mmHg to 10-12 mmHg. The criteria for evaluation of functional state of central hemodynamics were systolic pressure (SP), diastolic pressure (DP), heart rate (HR), minute volume of blood circulation (MVBC), stroke volume (SV), cardiac index (CI), factor of respiratory change (FRC), vegetative index (VI), and peripheral vascular resistance (PVR).

Results: After the gas insufflation into abdominal cavity the only significant change was 8% increase of mean DP in comparison with the state after the start of anesthesia. There have been no significant changes of heart productivity (SV, MVBC, CI) as well as state of vascular tonus (PVR) noted during LA execution (from insufflation to desufflation). The creation of carboperitoneum during LA was accompanied by decrease of VI to 10.6 standard units (p<0.05). By the end of operation before the decompression of abdominal cavity no significant change of VI was noted. The change of FRC after the start of anesthesia and creation of carboperitoneum for LA was characterized by increase of its mean value (p<0.05) in response to the abdominal compression. It proves the significant negative effect of respiratory ventilation to the state of central hemodynamics under increased insufflating pressure.

Conclusion: The changes of central hemodynamics in LA in pregnant women are based on specific effect of intraabdominal pressure. The maintenance of intraabdominal pressure at 8-9 mmHg allows the minimization of negative effect of this aggressive factor and maximally approximates the functional state of central hemodynamics to the physiological rate in pregnant women.

Date: 2014-12-28; view: 1005