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Sulu B.,Kafkas University | Yildiz B.D.,Ankara Numune Teaching Hospital | Ilingi E.D.,Kafkas University | Gunerhan Y.,Kafkas University | And 4 more authors.
Advances in Clinical and Experimental Medicine | Year: 2015

Background: Classical laparoscopic cholecystectomy involves four ports while most novel 'single port' technique only requires one incision on the abdominal wall. This technique is thought to decrease surgical trauma and improve cosmesis although there are reports pointing out that classical laparoscopic cholecystectomy is also feasible in terms of cosmesis. Objectives. In this study we tried to determine if there are certain advantages in quality of life after single port surgery which would justify its utilization instead of classical laparoscopic cholecystectomy. Material and Methods: This is a prospective randomized study which enrolled 30 patients randomized either into classical laparoscopic cholecystectomy or single port surgery. The primary endpoint was patient satisfaction after surgery. This was assessed with short form 36 and gastrointestinal quality of life index (first preoperatively and then 3 months postoperatively) and a visual analogue scale on the first and seventh days. Results: There was not a statistically significant difference between groups in the emotional role, social functions, mental health, vitality and general health subscales of short form 36. At the end of 12 weeks, both groups demonstrated increases in the gastrointestinal and social subscales of the gastrointestinal quality of life index. There was not a statistically significant difference between groups when the visual analogue scale scores on first and seventh days were compared. Conclusions: The equal length of hospitalization, patient quality of life and pain perception and the longer operative times, high likelihood of incisional hernia and surgical site infection call into question the utilization of single port surgery, as it does not seem to confer an advantage over classical laparoscopic cholecystectomy © Copyright by Wroclaw Medical University.

Sulu B.,Kafkas University | Yildiz B.,Ankara Numune Teaching Hospital
Hong Kong Journal of Emergency Medicine | Year: 2013

Introduction: Patients with acute abdominal pain are sometimes held under long-term observation because of failure to make a certain diagnosis. This study investigates the effectiveness of utilising laboratory and clinical variables to choose between surgical and medical treatment to reduce costs and speed up the evaluation period. Methods: In a university hospital setting, 165 patients with abdominal pain who had undergone surgical (n=115) or nonsurgical (n=50) treatment after observation were prospectively analysed. Upon presentation body temperature, white blood cell count, neutrophil count, seroreactive protein, and malonyl dialdehyde levels were determined. The area under the ROC curve and logistic regression analyses were performed. Surgical probability formula was prepared by using parameters. Results: Body temperature, white cell count, neutrophil count, C-reactive protein were higher in the surgical group (p=0.0001). Sensitivity of C-reactive protein was higher in determining patients who required surgical treatment. Multivariate analysis showed that above mentioned variables (except neutrophil count) along with malonyl dialdehyde levels were effective in determining optimal treatment strategy. Conclusions: It is possible to identify patients who need to undergo surgery by implementation of a 'probability of surgery' model using certain laboratory values from blood samples obtained from patients with abdominal pain and unknown diagnosis, upon presentation in the emergency room.

Bostanolu A.,Ankara Numune Teaching Hospital | Oru T.,Medicalpark Istanbul Gotepe Hospital | Yildiz B.D.,Ankara Numune Teaching Hospital | Isik S.,Ordu University | And 3 more authors.
Turkish Journal of Gastroenterology | Year: 2014

Background/Aims: The effects of short-bowel syndrome on liver function and liver morphology independent of parenteral nutrition have not been thoroughly investigated. Our aim was to investigate the effects of massive bowel resection on hepatocyte apoptosis and liver function in rats. bMaterials and Methods: A total of 37 female Sprague-Dawley rats were randomly assigned to five groups: Control b(no procedure); Sham 1 [laparotomy (LT)/enterotomy (ET); evaluated on postoperative day (POD) 1]; Sham 2 (LT/ET; bevaluated on POD7; Group 1 (80% bowel resection after LT/ET; POD1); and Group 2 (80% bowel resection; POD7). bBlood samples were obtained for measuring aspartate aminotransferase, alanine aminotransferase, and lactate dehydrogenase levels. For assessing hepatocyte apoptosis, liver tissue samples from the median lobe were obtained and used for a terminal deoxynucleotidyl transferase deoxyuridine triphosphate nick-end labeling assay. bResults: Aspartate aminotransferase, alanine aminotransferase, and lactate dehydrogenase levels showed statistically significant differences among the five groups. Apoptotic hepatocyte counts there were statistically significant differences among groups for counts made in 20 consecutive high-power fields. However, liver sinusoidal cell apoptosis rates among groups showed statistically significant differences for counts made in 20 consecutive highpower fields, particularly on POD7 in rats undergoing massive bowel resection. bConclusion: Parenteral nutrition is not the only factor involved in liver dysfunction after massive bowel resection. bMassive bowel resection alone can cause liver abnormalities. Rats undergoing massive small intestinal resection show significant temporal increases in liver sinusoidal cell apoptosis rates. © Copyright 2014 by The Turkish Society of Gastroenterology.

Yildiz B.D.,Ankara Numune Teaching Hospital
ASAIO Journal | Year: 2014

Thousands of patients with renal disease are on waiting lists for kidney transplant. Survival and quality of life on hemodialysis are much lower than that after renal transplantation. Renal allografts are extremely valuable and worth saving at all costs. Many complications can be seen after organ transplants on short and long term as rejection, vascular compromise, and infection. There are various reports on partial nephrectomy after renal transplant secondary to de novo masses in the renal allograft. Here, we present a case where we used radiofrequency bipolar sealer for partial nephrectomy for necrotic abscess of the renal allograft. We successfully saved the allograft with partial nephrectomy despite parenchymal infection and necrosis. © 2014 by the American Society for Artificial Internal.

Akturk O.M.,Ankara Numune Teaching Hospital | Kayloglu S.I.,Ankara Numune Teaching Hospital | Aydogan I.,Ankara Numune Teaching Hospital | Dinc T.,Ankara Numune Teaching Hospital | And 4 more authors.
Indian Journal of Surgery | Year: 2015

Rectus sheath hematoma is a clinical entity characterized by the presence of blood within rectus abdominis muscle sheath. The aim of this study was to analyze clinical characteristics, diagnostic approach, treatment strategy, and outcomes of patients with rectus sheath hematoma. Patients diagnosed and treated for spontaneous rectus sheath hematoma between March 2010 and March 2014 were included in the study. A total of 10 patients were diagnosed as spontaneous rectus sheath hematoma. The mean age was 66.5 ± 16.9 years, and the mean hospital stay was 4.4 ± 1.8 days. There was no mortality. Six patients were using anticoagulant or antiplatelet agents. Eight patients recovered after conservative treatment. Two patients underwent surgery. Spontaneous rectus sheath hematoma is associated with anticoagulant therapy. Cases with abdominal pain and a non-pulsatile abdominal mass particularly in elderly women should be kept in mind. Treatment is mostly based on supportive care to preserve hemodynamic stability. © 2015, Association of Surgeons of India.

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