Post-hepatectomy liver failure is a serious complication following liver resection and is associated with high morbidity and mortality. Platelets play a crucial role in liver regeneration due to their rich content of growth factors. However, the comparative effects of platelet-rich plasma (PRP) and concentrated growth factor (CGF) on liver regeneration remain unclear. This study aimed to evaluate and compare the effects of splenectomy (SPx), PRP, and CGF on liver regeneration and function following 70% hepatectomy in rats. Male Wistar rats were randomly divided into six groups: Control, Sham, Hepatectomy (PHx), Hepatectomy + SPx, Hepatectomy + PRP, and PHx + CGF. PRP and CGF were prepared using differential centrifugation and administered via the portal vein after hepatectomy. Liver regeneration was assessed histopathologically, immunohistochemically and biochemically on postoperative day (POD) 5. PRP treatment significantly increased Ki-67 expression, indicating enhanced hepatocyte proliferation. CGF promoted neovascularization and improved hepatocyte morphology but showed lower Ki-67 expression than PRP. SPx did not significantly enhance regeneration compared to PHx alone. Signal Transducer and Activator of Transcription 3 (STAT3) expression was highest in the PHx group, whereas the PRP and CGF groups exhibited moderate levels. PRP and CGF improved liver function biochemically, reducing bilirubin levels. Both PRP and CGF promote liver regeneration, albeit through distinct mechanisms: PRP primarily enhances cellular proliferation, whereas CGF facilitates vascularization and modulates the immune response. SPx did not confer additional benefits in this model. These findings suggest that PRP and CGF may have potential therapeutic applications in preventing post-hepatectomy liver failure.

Background/Objectives: Posterior vaginal wall prolapse (rectocele) significantly im-pairs bowel function and quality of life (QoL). This study evaluated the short-term functional, QoL, and safety outcomes of transvaginal Prolene mesh–augmented recto-cele repair and examined predictors of recurrence. Methods: A retrospective cohort of 120 women (mean age 49.5 ± 11.0 years) who underwent transvaginal mesh-augmented rectocele repair between January 2020 and July 2023 was analysed. Functional and QoL outcomes were assessed using the Constipation Scoring System (CSS), Obstructed Defecation Syndrome (ODS) score, Patient Assessment of Constipa-tion Quality of Life (PAC-QOL), and Visual Analogue Scale (VAS) for pelvic/rectal pain. Results All functional and QoL scores improved significantly at 12 months (all p < 0.001): CSS decreased from 9.5 ± 2.8 to 6.0 ± 3.1 (−36.8%), ODS from 22.3 ± 7.5 to 15.4 ± 5.2 (−30.9%), PAC-QOL from 58.6 ± 15.5 to 39.1 ± 18.2 (−33.3%), and VAS pain from 7.38 ± 1.73 to 4.61 ± 1.67 (−37.5%). The overall complication rate was 11.7%, with mesh exposure (5.0%), retraction (4.2%), and infection (1.7%). Multiparity (p = 0.004) and higher BMI (p = 0.011) were independently associated with recurrence. Conclusions: Transvaginal mesh–augmented rectocele repair provides substantial short-term im-provements in bowel function, pain, and QoL with an acceptable safety profile. Multi-parity and obesity are important predictors of recurrence, underscoring the need for individualized risk assessment and long-term follow-up.

SUMMARY OBJECTIVE: Median arcuate ligament syndrome is a rare pathology where the median arcuate ligament causes compression on the celiac trunk. Different techniques are utilized in the treatment of median arcuate ligament syndrome, and studies on a standard laparoscopic technique are limited. The aim of this study is to evaluate the surgical and clinical outcomes of patients who underwent laparoscopic "antegrade" release of median arcuate ligament in a single tertiary center. METHODS: This retrospective study includes nine adolescents/young adults who underwent laparoscopy for median arcuate ligament syndrome between 2016 and 2024. All laparoscopic procedures were performed with an antegrade approach. The patients’ demographic data, symptoms, radiologic imaging methods, operative technique, and postoperative outcomes were recorded. RESULTS: There were seven female and two male patients in our series. The median age at diagnosis was 17 (range: 15–26) years. The most common symptoms were postprandial abdominal pain (n=9), nausea and vomiting (n=8), and weight loss (n=7). Doppler ultrasonography and/or computed tomography angiography (n=9, 100%) were performed in all patients as preoperative diagnostic imaging. The mean operation time was 92 (range: 60–110) min. The mean oral intake time was 1.2 (range: 1–3) days. The mean hospitalization time was 3 (range: 2–5) days. There was no conversion to laparotomy. One patient had a recurrence during follow-up and underwent a secondary intervention. The mean follow-up time was 62.6 (3–88) months. CONCLUSION: Laparoscopic median arcuate ligament release with an antegrade approach is safe and feasible to perform and adequate in terms of symptom relief and celiac artery compression release in both adolescent and young adult groups.

Amaç: Bu sistematik derleme ve meta-analizin amacı, erişkin kadınlarda rektocele bağlı semptomların cerrahi tedavisinde kullanılan başlıca yöntemleri karşılaştırmak ve güncel literatür doğrultusunda etkinlik–güvenlik profillerini değerlendirmektir.Yöntem: PRISMA 2020 kılavuzuna uygun olarak 1998–2025 yılları arasında yayımlanmış çalışmalar tarandı. Dahil etme kriterleri erişkin kadın popülasyonu, rektocele için uygulanan cerrahi girişim, ≥12 ay takip ve ≥10 hasta içeren çalışma tasarımları idi. Toplam 45 çalışma (12 RCT, 33 gözlemsel) analiz edildi; 20 çalışma meta-analize dahil edildi. Temel sonuçlar anatomik başarı, obstrüktif defekasyon sendromu (ODS) düzelmesi, rekürrens ve reoperasyon oranları; ikincil sonuçlar ise meş komplikasyonları, disparoni, fekal inkontinans ve de novo konstipasyondu.Bulgular: Meta-analiz, transvajinal posterior kolporafinin transanal onarıma göre anlamlı derecede daha düşük rekürrens oranı sunduğunu göstermiştir (RR ≈ 0.25). Meş ile güçlendirilmiş posterior onarım, yerli doku tamirine göre belirgin bir avantaj sağlamamış; buna karşın meş erozyonu ve ağrı gibi komplikasyonlar %5–10 oranlarında görülmüştür. STARR, kısa dönemde ODS semptomlarını belirgin biçimde azaltmasına rağmen, uzun dönemde rekürrens ve yeniden müdahale gereksinimi %20–30 düzeyine ulaşmıştır. Laparoskopik ventral meş rektopeksi; ODS, intussusepsiyon ve çoklu kompartman prolapsusu olan hastalarda %80–95 iyileşme oranları ve düşük komplikasyon profili ile en güçlü seçeneklerden biri olarak öne çıkmıştır.Sonuç: Erişkin kadınlarda rektocele tedavisinde yerli doku posterior kolporafi çoğu hasta için birinci basamak cerrahi olmaya devam etmektedir. STARR seçilmiş ODS-dominant hastalarda etkili olmakla birlikte, uzun dönem başarısı sınırlıdır. Posterior kompartmanda meş kullanımı anlamlı fayda sağlamadığından önerilmemektedir. Ventral meş rektopeksi, karmaşık veya çoklu prolapsuslu hastalarda üstün fonksiyonel sonuçlar sunmaktadır. Tedavi kararı mutlaka bireyselleştirilmeli, anatomi–fonksiyon ilişkisi bütüncül olarak değerlendirilmelidir.