Browsing by Author "Krivokapic, Z. (55503352000)"

Aim: The purpose of this study was to investigate the safety and feasibility of autologous adipose-derived regenerative cells (ADRC) in the treatment of chronic anal fissure. Method: A prospective pilot study was conducted in six patients with chronic anal fissures at the First Surgical Clinic, Clinical Center of Serbia and at the BelPrime Clinic, Belgrade, Serbia. All patients were candidates for surgical treatment. The average duration of symptoms was 24 months. Pain assessment was quantified using a visual analogue scale and bowel continence was assessed using the Wexner incontinence score. Both were assessed before treatment and during each postoperative outpatient visit. Liposuction was performed under local or general anaesthesia. Extraction of ADRC was achieved with a closed automated medical device. The fat and ADRC were injected subcutaneously into the edge of the fissure. The rest of the pellet was infiltrated into the internal anal sphincter. The study has been registered at ClinicalTrials.gov (NCT02628522). Results: Complete healing of the anal fissure and the disappearance of symptoms was achieved in all patients. The average time to complete pain cessation was 33.7 ± 15.0 days. All fissures healed after 3 months and remained healed 12 months after the procedure. There were no complications related to the procedure. Conclusion: The application of ADRC may be an alternative to lateral sphincterotomy and a reliable procedure which avoids faecal incontinence. Colorectal Disease © 2016 The Association of Coloproctology of Great Britain and Ireland

An experimental study was carried out to evaluate the protective role of an endoluminal prosthesis on high risk colo-colonic anastomoses. One hundred and fifty rats were divided into two groups: Group E with endoluminal latex prosthesis and Group C without. Bursting pressure and collagen concentration in the perianastomotic tissue were tested, respectively, on the 4th, 7th and 12th, and 4th, 7th, 12th, 18th and 38th post-operative days. Bursting pressure was significantly higher in Group E on the 4th postoperative day. There was no significant difference in the anastomotic collagen concentration between the two groups. The presence of the prosthesis did not produce any macroscopic or microscopic evidence of impaired healing or stricture at the suture line. Death due to anastomotic dehiscence occurred in 11/75 (15%) in Group C and in 1/75 (1.3%) in Group E (p<0.010). Endoluminal prosthesis appears to have a protective effect on anastomotic healing. The mechanism is probably due to mechanical protection and not to differences in collegen concentration. © 1991 Springer-Verlag.

Matrix metalloproteinases (MMPs) are involved in tumour invasion and metastasis of colorectal carcinoma. Oxidative stress represents one of the possible mechanisms that activate inactive MMPs. Oxidative stress increases lipid peroxidation, which causes impaired membrane permeability and leakage of lactate dehydrogenase (LDH) and malate dehydrogenase (MDH) into circulation. Our aim was to assess the activity of MMP-2 and MMP-9 and its relation to the parameters of oxidative stress and membrane damage markers in patients with different TNM (tumour, lymph nodes, metastasis) stages of colorectal carcinoma. MMP-2 and -9 activities were evaluated by gelatin zymography. Oxidative stress was examined by quantifying serum malondialdehyde (MDA) concentration. LDH and MDH activities were determined spectrophotometrically. The activities of MMP-2 and -9 were significantly higher in the sera of colorectal carcinoma patients when compared to healthy subjects. There was a stage-dependent increase in relative MMP-2 activity compared to the overall serum gelatinolytic activity. The activity of MMP-9 was the highest in TNM III. The MDA concentration and the LDH and MDH activities were significantly higher in colorectal carcinoma patients than in controls, while LDH and MDH activities were stage dependent. There was significant correlation between serum MMP-2 and LDH activity in TNM II, III and IV patients. A stage-dependent increase of LDH and MDH activity was observed. We highlight here that MMP-9 could be a 100% sensitive marker of TNM stage III of colorectal carcinogenesis. In this study it was shown for the first time that gelatinolytic activity in colorectal carcinoma is associated with redox imbalance. © 2017 Charles University. All rights reserved.