Visceral obesity is an important factor that increases the risk of complications after colorectal cancer surgery. As calculating visceral fat is difficult and time-consuming, more practical fat measurements that are not time-consuming have been introduced. This study aimed to investigate the effects of perirenal fat thickness on postoperative complications and prognosis in patients undergoing surgery for colorectal cancer. Perirenal fat thickness was measured from the dorsal aspect of the left kidney on preoperative computerized tomography of patients who underwent surgery for colorectal cancer. The effects of perirenal fat thickness on postoperative complications were investigated. Diagnostic test performance was examined using the Roc Curve test to determine the cutoff value for the perirenal fat thickness values according to the complication findings of the patients. The cutoff value of perirenal fat thickness was found to be above 25.1, according to the presence of complications in the patients. Those with a perirenal fat thickness greater than 25.1 mm were considered to have high perirenal fat thickness values, and those with a low perirenal fat thickness value were considered low. Multivariate analysis revealed that increased perirenal fat thickness is an independent risk factor for postoperative complications. We believe that perirenal fat thickness measurement, as an indicator of visceral fat volume, can be used to identify patients at high risk of developing complications after colorectal cancer surgery. This may change the disease management and affect the patient information process.

Background and Objectives: Mucinous adenocarcinoma (MAC) and mucinous components (MCP) in colorectal cancers (CRC) have shown conflicting results regarding their prognostic impact. This study aims to evaluate survival differences between MAC, MCP, and non-mucinous adenocarcinoma (nMAC) in stage II and III CRC patients. Materials and Methods: 224 CRC patients who underwent surgery between 2013 and 2021 were analyzed retrospectively. Patients were classified as nMAC, MCP, or MAC based on the percentage of extracellular mucin. Those who received neoadjuvant therapy, had stage I or IV TNM disease, and emergency cases were excluded. Survival analysis was performed using Kaplan–Meier curves and Cox regression models. Results: MAC patients showed worse survival outcomes compared to nMAC (p = 0.025). No difference in survival was found between MCP and nMAC (p = 0.055). Multivariate analysis identified MAC (OR: 2.814; p = 0.014) and perineural invasion (PNI) (OR: 2.283; p = 0.008) as independent factors associated with worse survival. Kaplan–Meier analysis revealed MAC’s worse prognosis than nMAC (p = 0.027). Conclusions: MAC was shown to have a worse prognosis than nMAC in stage II and III CRC patients, while MCP survival rates were similar with nMAC. These findings suggest that MAC requires more careful treatment approaches, while MCP and nMAC have better survival rates. Further studies focusing on molecular and genetic profiles are needed to better understand these outcomes.

Alterations in the biological activity of the molecules under stress conditions have not been documented as widely in the literature yet. This study was designed to reveal the functional impacts of various oxidation conditions on a model mAb, a commercial anti-VEGF IgG molecule. The responses to antigen binding, cell proliferation, FcRn receptors, and C1q binding, which rarely appear in the current literature, were investigated. The authors report peptide mapping data, post-translational modification (PTM) analysis, cell proliferation performance, and antigen (VEGF), C1q, and FcRn binding activities of the mAb under various stress conditions. The oxidation-prone site of the mAb was determined as Met252 in the DTLMISR peptide. The VEGF binding activity and anti-cell proliferation activity of the mAbs did not alter, while C1q and FcRn binding capacity significantly decreased under oxidative stress conditions. The full report is vital for many scientific and industrial processes about mAbs. The authors recommend performing functional analyses in addition to the structural studies while investigating the impacts of stress factors on therapeutic mAbs.

İleus, bağırsak içeriğinin mekanik veya paralitik nedenlerle ilerleyememesi olarak tanımlanan ve akut karın ağrısının başlıca nedenlerinden olan kritik bir cerrahi tablodur. Mekanik ileusun en yaygın sebebi geçirilmiş cerrahi sonrası oluşan adezyonlar iken, bunu tümörler ve fıtıklar takip eder; vakaların %80'i ince bağırsak kaynaklıdır. Paralitik ileus ise fiziksel bir engel olmaksızın bağırsak hareketlerinin durmasıdır ve genellikle postoperatif dönemde ya da elektrolit bozuklukları gibi nedenlerle görülür. Hastalığın klinik belirtileri arasında karın ağrısı, kramplar, şişkinlik ve kusma yer alır; özellikle strangülasyon (boğulma) veya nekroz şüphesi olan durumlarda acil cerrahi müdahale hayati önem taşır. Tanı sürecinde fizik muayenenin yanı sıra direkt batın grafisi ve altın standart olarak kabul edilen bilgisayarlı tomografi (BT) kritik rol oynar. Tedavi yaklaşımı, sıvı-elektrolit desteği ve nazogastrik tüp ile dekompresyon gibi konservatif yöntemlerle başlasa da, tam tıkanıklık ve iskemi bulguları olan olgularda cerrahi tedavi kaçınılmazdır. Postoperatif süreçte bağırsak motilitesinin geri dönmesi için ilaç tedavileri de kullanılabilirken, tanı konulmamış vakaların tümör açısından titizlikle değerlendirilmesi gerekmektedir. Ileus is a critical surgical condition defined as the failure of intestinal contents to progress due to mechanical or paralytic reasons, and it is a leading cause of acute abdominal pain. While the most common cause of mechanical ileus is adhesions resulting from previous surgeries, followed by tumors and hernias, 80% of cases originate in the small intestine. Paralytic ileus involves the cessation of intestinal motility without a physical obstruction, typically observed during the postoperative period or due to factors like electrolyte imbalances. Clinical symptoms include abdominal pain, cramping, bloating, and vomiting; emergency surgical intervention is vital, especially in cases where strangulation or necrosis is suspected. In the diagnostic process, physical examination is supplemented by direct abdominal radiography and computed tomography (CT), which is considered the gold standard. Although the treatment approach begins with conservative methods such as fluid-electrolyte support and decompression via nasogastric tubes, surgical intervention is inevitable for cases with complete obstruction or signs of ischemia. While pharmacological treatments can be utilized to restore intestinal motility postoperatively, undiagnosed cases must be rigorously evaluated for potential tumors.

Stomalar, gastrointestinal veya üriner sistemin karın duvarına ağızlaştırılmasıyla oluşturulan ve dışkı sapması veya dekompresyon sağlayan cerrahi açıklıklardır. Bu işlem, kolorektal kanserler, inflamatuar bağırsak hastalıkları, travmalar ve doğumsal anomaliler gibi çeşitli endikasyonlarla geçici veya kalıcı olarak uygulanabilir. Başarılı bir stoma yönetimi için ameliyat öncesi yer seçimi kritik öneme sahiptir; ideal konumun rektus kası içinden geçmesi, hastanın görüş alanında olması ve kemik çıkıntılarından uzak düz bir alanda bulunması gerekir. Stomalar, kullanılan bağırsak segmentine göre ileostomi veya kolostomi olarak, cerrahi teknik açısından ise uç veya loop şeklinde sınıflandırılır. İleostomilerde içerik daha sıvı ve tahriş ediciyken, kolostomilerde daha katı bir çıktı gözlenir. Cerrahi sonrası dönemde iskemi, nekroz, prolapsus, darlık ve parastomal herni gibi komplikasyonlar gelişebileceğinden, titiz cerrahi teknik ve düzenli stoma bakımı esastır. Günümüzde laparoskopik yöntemler açık cerrahiye güvenli bir alternatif sunarken, stoma bakımı ve uygun cihaz kullanımı hastaların yaşam kalitesini artırmada kilit rol oynar. Stomas are surgical openings created by anastomosing a part of the gastrointestinal or urinary system to the abdominal wall to provide fecal diversion or decompression. This procedure can be performed temporarily or permanently for various indications such as colorectal cancers, inflammatory bowel diseases, traumas, and congenital anomalies. For successful stoma management, preoperative site selection is critical; the ideal location should pass through the rectus muscle, be within the patient's field of vision, and be located on a flat area away from bony prominences. Stomas are classified as ileostomy or colostomy according to the intestinal segment used, and as end or loop stomas in terms of surgical technique. While the content is more liquid and irritating in ileostomies, a more solid output is observed in colostomies. Since complications such as ischemia, necrosis, prolapse, stenosis, and parastomal hernia may develop in the postoperative period, meticulous surgical technique and regular stoma care are essential. Today, laparoscopic methods offer a safe alternative to open surgery, while stoma care and the use of appropriate devices play a key role in improving the quality of life of patients.