Scott G. Prushik

An FDA Approved Neurokinin-1 Receptor Antagonist is Effective in Reducing Intraabdominal Adhesions when Administered Intraperitoneally, But Not Orally

R Lim, J Morrill, S G Prushik, K L Reed, A C Gower, S E Leeman, A F Stucchi, J M Becker (2008) An FDA Approved Neurokinin-1 Receptor Antagonist is Effective in Reducing Intraabdominal Adhesions when Administered Intraperitoneally, But Not Orally. Journal of Gastrointestinal Surgery 12:1754–1761. DOI:10.1007/s11605-008-0634-4. This article was incorrectly published as a 2008 SSAT Plenary Presentation. The Discussion published with it does not belong with that article, but instead belongs to the article by Lim, et al (DOI:10.1007/s11605-008-0724-3) appearing in this issue. J Gastrointest Surg (2009) 13:43 DOI 10.1007/s11605-008-0767-5

Open adhesiolysis is more effective in reducing adhesion reformation than laparoscopic adhesiolysis in an experimental model

This study compared adhesion reformation after open and laparoscopic adhesiolysis in a rat model.

Parental intermittent claudication as risk factor for claudication in adults.

Little is known about the familial aggregation of intermittent claudication (IC). Our objective was to examine whether parental IC increased the risk of IC in adult offspring, independent of the established cardiovascular risk factors. We evaluated the Offspring Cohort Participants of the Framingham Heart Study who were ≥30 years old, cardiovascular disease free, and had both parents enrolled in the Framingham Heart Study (n = 2,970 unique participants, 53% women). Pooled proportional hazards regression analysis was used to examine whether the 12-year risk of incident IC in offspring participants was associated with parental IC, adjusting for age, gender, diabetes, smoking, systolic blood pressure, total cholesterol, high-density lipoprotein cholesterol, and antihypertensive and lipid treatment. Of the 909 person-examinations in the parental IC history group and 5,397 person-examinations in the no-parental IC history group, there were 101 incident IC events (29 with parental IC history and 72 without a parental IC history) during follow-up. The age- and gender-adjusted 12-year cumulative incidence rate per 1,000 person-years was 5.08 (95% confidence interval [CI] 2.74 to 7.33) and 2.34 (95% CI 1.46 to 3.19) in participants with and without a parental IC history. A parental history of IC significantly increased the risk of incident IC in the offspring (multivariable adjusted hazard ratio 1.81, 95% CI 1.14 to 2.88). The hazard ratio was unchanged, with an adjustment for the occurrence of cardiovascular disease (hazard ratio 1.83, 95% CI 1.15 to 2.91). In conclusion, IC in parents increases the risk of IC in adult offspring, independent of the established risk factors. These data suggest a genetic component of peripheral artery disease and support future research into genetic causes.

Giant Bilobed Hepatic Artery Aneurysm with Occlusion of the Celiac Axis: Repair Using a Bifurcated Graft

Hepatic artery aneurysms are uncommon, with fewer than 500 cases noted in the literature. Bilobed hepatic artery aneurysms are extremely rare, with no documented cases in the literature. Although often asymptomatic, these visceral aneurysms are at high risk of rupture. We present an interesting case report of a bilobed hepatic artery aneurysm with occlusion of the celiac axis in a 72-year-old woman. She was asymptomatic at the time of presentation, and diagnosis was made on computerized tomography scan. She was not a candidate for endovascular repair due to the anatomy of the aneurysm and a chronically occluded celiac artery origin. Surgical repair using a bifurcated graft with ligation of the gastroduodenal artery was performed.

Authors' reply: Open adhesiolysis is more effective in reducing adhesion reformation than laparoscopic adhesiolysis in an experimental model (Br J Surg 2010; 97: 420–427)

Sir We read with interest this report of a large experience with portal vein embolization (PVE) before liver resection for colorectal hepatic metastases. The key to extrapolation of the message of these data lies in the authors’ definition of the term ‘initially unresectable’ liver metastases. In their study, with an inclusion period spanning 16 years, there is likely to have been some variation in interpretation of this term, based not least on the increasing choice and sophistication of imaging modalities with time. Given that 100 per cent of patients who underwent PVE had initially unresectable disease (78 per cent bilobar), it would be useful to know whether adjunctive staging modalities such as [18F]fluorodeoxyglucose positron emission tomography (PET) were used in the later patients in this series1. If so, does the use of PET reduce the number of patients coming to PVE by demonstrating extrahepatic disease in individuals with bilobar disease? The demonstration of equivalent survival curves in patients coming to resection after PVE is encouraging but the number of patients at risk 2 years after PVE is small at 14. Although these findings support the current concept of modification of the future remnant liver before hepatic resection for extensive colorectal hepatic metastases2, more tightly defined prospective comparative data are required to precisely assess the benefit and role of PVE. S. Jamdar, S. Jegatheeswaran, A. Bandara, A. J. Sheen and A. K. Siriwardena Regional Hepatobiliary Unit, Manchester Royal Infirmary, Manchester M13 9WL, UK (e-mail: Ajith.Siriwardena@cmft.nhs.uk) DOI: 10.1002/bjs.7138