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Subasi O, Ercan M, Aziret M, Biricik A, Kahraman YS, Altıntoprak F, Celebi F, Karaman K. Effects of preoperative biliary drainage methods and time to postoperative complications after biliary drainage in periampullary tumors. Ann Ital Chir 2022; 93:403-409. [PMID: 35758240] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/15/2023]
Abstract
OBJECTIVE To compare postoperative morbidity and mortality results in patients with and without endoscopic and percutaneous transhepatic biliary drainage due to obstructive jaundice caused by a periampullary tumor and to examine the effect of intervals until surgery on postoperative morbidity and mortality in patients who underwent preoperative biliary drainage (BD). METHODS Patients were divided into 3 groups according to their BD status. Group1, no biliary drainage (NBD), Group2, Endoscopic biliary drainage (EBD), Group3, Percutaneous transhepatic biliary drainage (PBD). Patients who underwent biliary drainage before pancreaticoduodenectomy (PD) were divided into 3 intervals according to the time interval between drainage and surgery: Short interval; patients undergoing surgery in 21 days and <, Medium interval; between 22-42 days, Long interval; 43 days and >. Groups and intervals were compared in terms of postoperative morbidity and mortality. RESULTS Of the 122 patients who underwent PD, 76 (62.3%) were male, and 46 (37.7%) were female. Within these patients, 47 (38.52%) had NPD, 42 (34.42%) had EBD, and 33 (27.05%) had PBD. The rate of postoperative Grade B and C fistula was higher in the groups that underwent preoperative drainage compared to the group without preoperative drainage (p = 0.007). CONCLUSION It was determined that the postoperative complication rate was lower in patients who did not undergo BD compared to patients who underwent biliary drainage. Besides, the endoscopic drainage method was observed to be associated with fewer complications than the percutaneous transhepatic drainage method. KEY WORDS Preoperative biliary drainage, Pancreaticoduodenectomy, Periampullary tumors, Post procedure complication, Timing.
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Aziret M, Subasi O, Bilir C, Tozlu M, Altıntoprak F, Karaman K, Ercan M, Celebi F. Morbidity and long-term results in patients with wild and mutant type Kirsten rat sarcoma viral oncogene homolog (KRAS) mutations undergoing colorectal cancer surgery. Ann Ital Chir 2022; 92:65-77. [PMID: 35342104] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/14/2023]
Abstract
BACKGROUND In colorectal cancer (CRC), the mutation of the K(N)RAS gene has a significant impact on the clinical course, and is associated with a negative prognosis. We aim to present the morbidity and long-term results in patients with wild/mut-K(N)RAS, undergoing CRC surgery. METHODS A total of 116 patients who underwent surgery for colorectal cancers with wild/mut-K(N)RAS were included in this retrospective study. The patients were divided into two groups: wild-K(N)RAS patients (Group 1) and mutant- K(N)RAS patients (Group 2). Results were evaluated for clinical, operative, morbidity and long-term survival outcomes. MATERIALS AND METHODS The highest surgical site infection (SSI) rate (OR=140.339)(4.303-4581.307)(P=0.005) was seen in patients given Bevacizumab during neoadjuvant treatment. Meanwhile, the SSI site infection rate was at its lowest in cases where minimally invasive surgery was preferred (OR=0.062)(0.006-0.628)(P=0.019). In addition, the overall median survival rate for the total cohort was 38±3.1 (31-44) months. Multivariate analysis showed that CEA (>5ng/mL)(HR 2.94)(1.337-6.492))(P=0.007); tumor stage (P=0.034), T(T4) stage (HR 1.91)(1.605-252.6)(P=0.02); metastasectomy/ablation (HR 0.19)(0.077-0.520)(P=0.001); the number of removed metastatic lymph nodes (HR 1.08)(1.010-1.155)(P=0.025); tumor implant or nodule (HR 2.71)(1.102-6.706)(P=0.03); curative resection (HR 2.40)(0.878-6.580)(P=0.042) to be factors affecting the overall survival rate. CONCLUSION Treatment with Bevacizumab during the neoadjuvant period in mut-K(N)RAS cases, surgical technique and complications of Grade 3 or higher are risk factors for SSI on morbidity in patients with mut/wild-K(N)RAS undergoing colorectal cancer surgery. Moreover, CEA (>5ng/mL), tumor stage, T stage, metastasectomy/ablation, the number of removed metastatic lymph nodes, tumor implant/nodule and curative resection are risk factors on the overall survival rate. KEY WORDS Bevacizumab, Colorectal cancer, K(N)RAS mutation, Morbidity, Mortality.
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Akin E, Altintoprak F, Firat N, Dheir H, Bas E, Demirci T, Kamburoglu B, Celebi F. Is Laparoscopic Technique Suitable for Initial Experience in Live Donor Nephrectomy? Results of The First 51 Cases. ELECTRONIC JOURNAL OF GENERAL MEDICINE 2021. [DOI: 10.29333/ejgm/11313] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
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Isik A, Firat D, Yilmaz I, Peker K, Idiz O, Yilmaz B, Demiryilmaz I, Celebi F. A survey of current approaches to thyroid nodules and thyroid operations. Int J Surg 2018; 54:100-104. [PMID: 29709542 DOI: 10.1016/j.ijsu.2018.04.037] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2018] [Accepted: 04/19/2018] [Indexed: 01/15/2023]
Abstract
INTRODUCTION Thyroid nodules are commonly seen. Our aim is to learn the behaviors and operational attitudes of surgeons approaching the thyroid nodules. In a literature search, our study is the first and only study performed merely on surgeons. MATERIALS- METODS This cross-sectional study was done between June 2014-January 2015. The questionnaire consists of 25 questions. Initially, general questions consisting of demographic findings were asked. In step 2, questions consisting of the index case and case variants were asked. Results were compared with American Thyroid Association, European Thyroid Association guidelines, and Australia survey results. In the last step, questions about thyroid operations were asked. RESULTS A total of 301 surgeons responded to the survey. The response rate was approximately 20%. Thirty nine were female and 262 were male. For the question that asks the diameter of the thyroid nodule that will require a thyroid fine needle aspiration biopsy (TFNAB), 47.5% of the surgeons will require a TFNAB for 1-2 cm solid nodules. 40.15% of the surgeons required a TFNAB regardless of size. 46.1% of the surgeons who required a TFNAB between 1 and 2 cm solid nodules also required scintigraphy at diagnosis of suppressed TSH case variant. CONCLUSION In this survey, we identified differences from up-to-date guidelines about approaching thyroid nodules and perioperative thyroid surgery. From our perspective, surgeons need updated training requirements. This can be done with updated seminars across the country. Thereby approaches may become standard and consequently patients may have qualified services.
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Isik A, Soyturk M, Süleyman S, Firat D, Peker K, Yilmaz İ, Celebi F. Correlation of Bowel Wall Thickening Seen Using Computerized Tomography With Colonoscopies: A Preliminary Study. Surg Laparosc Endosc Percutan Tech 2017; 27:154-157. [PMID: 28291060 DOI: 10.1097/sle.0000000000000389] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
PURPOSE Bowel wall thickening (BWT) is a common finding in abdominal computerized tomography imaging (CTi). The purpose of the present study was a prospective assessment and management of patients who have BWT in abdominal CTi. MATERIALS AND METHODS This study was conducted between January 2012 and July 2014 at Erzincan University Hospital, Turkey, with 64 patients who were admitted to the emergency and general surgery department. All of the patients had received colonoscopies due to BWT seen in abdominal CTi. RESULTS Twenty-three (36%) female and 41 (64%) male patients were included in the study. The mean age was 56.2 years (range, 14 to 84 y). The positive predictive value of CTi for BWT was 87.5%. The positive predictive value of a CTi diagnosis of the disease according to a radiologist's report was 78.1%. Common pathologies detected by colonoscopy included neoplasia and inflammatory bowel disease. CONCLUSIONS Diagnosis of BWT by abdominal CTi reveals pathologies in many cases. Colonoscopies will be helpful in the differential diagnosis.
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Demir H, Karaman K, Ercan M, Kocer HB, Celebi F. Comparison of two procedures for symptomatic hemorrhoidal disease: Ligation under Vision and Ferguson Hemorrhoidectomy - a retrospective cohort study. Pak J Med Sci 2017; 33:90-95. [PMID: 28367179 PMCID: PMC5368337 DOI: 10.12669/pjms.331.11266] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
OBJECTIVE To compare Ligation under Vision (LUV) with Ferguson Hemorrhoidectomy (FH) in patients with Grade II, III and IV hemorrhoidal diseases according to their postoperative outcomes. METHODS Between July 2008 and August 2014, 155 patients underwent FH and 120 patients LUV, in Sakarya University Teaching and Research Hospital. Our retrospective analysis focuses on postoperative complications, postoperative pain and rate of recurrence. In LUV procedure, submucosal tissue of the hemorrhoidal pile base was transfixed using absorbable sutures under direct vision through anoscope in the Jackknife position. RESULTS In a mean postoperative follow-up period of 51.76+/-22.3 months; ectropion, anal fissure, and anal incontinence were the most frequent complications. The overall complication rate was significantly less after LUV than FH, (6.7% vs. 14.2%, P=0.047). The complication rate and need for a second or third surgery did not significantly differ between the two procedures with the increase in affected quadrants (P>0.05). The visual analog scale (VAS) at 24 hours was similar in both groups (P=0.267). CONCLUSIONS LUV is a safe, and practical procedure with similar outcomes compared to FH. LUV may be a better choice than excisional hemorrhoidectomies when three or four quadrants of the anal canal are involved with hemorrhoids as this reduces mucosal defect related possible complications such as ectropion and anal stenosis.
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Basoglu M, Yildirgan M, Yilmaz I, Balik A, Celebi F, Atamanalp S, Polat K, Oren D. Late Complications of Incisional Hernias Following Prosthetic Mesh Repair. Acta Chir Belg 2016. [DOI: 10.1080/00015458.2004.11679586] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
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Ordu C, Alço G, Pilanc K, Ilgün S, Sarsenov D, Celebi F, IyigüNun Erdoğan Z, Ağaçayak F, Demir G, Eralp Y, Tecimer C, Ozmen V. 1967 Does adjuvant chemotherapy induced amenorrhea effect survival in operated premenopausal breast cancer patients? Eur J Cancer 2015. [DOI: 10.1016/s0959-8049(16)30915-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
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Celik A, Altinel Y, Gur E, Ercetin C, Yigitbas H, Gulcicek H, Yavuz E, Muhammedoglu A, Celebi F. 911 The effectiveness of the oncoplastic surgery and a breast cancer ratio in the treatment of idiopathic granulomatous mastitis. Eur J Cancer 2015. [DOI: 10.1016/s0959-8049(16)30418-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Pilanci K, Alco G, Ordu C, Celebi F, Sarsenov D, Iyigun ZE, Agacayak F, Ilgun S, Ozmen V. P115 Does trastuzumab increase ONJ development due to zoledronic acid treatment in breast cancer? Breast 2015. [DOI: 10.1016/s0960-9776(15)70157-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022] Open
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Arslan Y, Altintoprak F, Serin KR, Kivilcim T, Yalkin O, Ozkan OV, Celebi F. Rare entity: Ectopic liver tissue in the wall of the gallbladder - A case report. World J Clin Cases 2014; 2:924-926. [PMID: 25516872 PMCID: PMC4266845 DOI: 10.12998/wjcc.v2.i12.924] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/02/2014] [Revised: 08/30/2014] [Accepted: 09/24/2014] [Indexed: 02/05/2023] Open
Abstract
Ectopic liver tissue (ELT) is a rare condition, which is usually not diagnosed preoperatively, but coincidentally during abdominal surgery. While the location of ELT can vary, it is usually localized on the gallbladder wall or in close proximity. ELT is associated with various complications, a major complication being extrahepatic hepatocellular carcinoma. A 59-year-old female underwent elective surgery for chronic cholecystitis with stones. During laparoscopic exploration, a 2-cm-diameter ELT was detected in the anterior gallbladder wall and a laparoscopic cholecystectomy was performed. The case is presented due to the rare nature of ELT and as a reminder of ELT-related complications.
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Uzunoglu Y, Altintoprak F, Yalkin O, Gunduz Y, Cakmak G, Ozkan OV, Celebi F. Rare etiology of mechanical intestinal obstruction: Abdominal cocoon syndrome. World J Clin Cases 2014; 2:728-731. [PMID: 25405199 PMCID: PMC4233426 DOI: 10.12998/wjcc.v2.i11.728] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/06/2014] [Revised: 07/07/2014] [Accepted: 08/31/2014] [Indexed: 02/05/2023] Open
Abstract
Abdominal cocoon syndrome is a rare cause of intestinal obstruction with unknown etiology. Diagnosis of this syndrome, which can be summarized as the small intestine being surrounded by a fibrous capsule not containing the mesothelium, is difficult in the preoperative period. A 47-year-old male patient was referred to the emergency department with complaints of abdominal pain, nausea, and vomiting for two days. The abdominal computed tomography examination detected dilated small intestinal loops containing air-fluid levels clustered in the left upper quadrant of the abdomen and surrounded by a thick, saclike, contrast-enhanced membrane. During exploratory surgery, a capsular structure was identified in the upper left quadrant with a regular surface that was solid-fibrous in nature. Abdominal cocoon syndrome is a rarely seen condition, for which the preoperative diagnosis is difficult. The combination of physical examination and radiological signs, and the knowledge of “recurrent characteristics of the complaints” that can be learned by a careful history, may be helpful in diagnosis.
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Gunduz Y, Altintoprak F, Tatli Ayhan L, Kivilcim T, Celebi F. Effect of topical steroid treatment on idiopathic granulomatous mastitis: clinical and radiologic evaluation. Breast J 2014; 20:586-91. [PMID: 25228089 DOI: 10.1111/tbj.12335] [Citation(s) in RCA: 36] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
Idiopathic granulomatous mastitis (IGM) is a rare inflammatory, noncaseating, chronic granulomatous benign disease. The etiology of IGM is still unknown. It is postulated to be an autoimmune localized response. The use of a course of oral steroids provides an important regression of breast mass and skin lesions. Topical corticosteroids are used to treat many skin diseases, but no study is available on the sole use of topical steroids for treating IGM. Eleven women with IGM were treated with topical steroid and evaluated using mammography, ultrasonography, and dynamic MRI. At the end of the 12th week, patients were clinically and radiologically evaluated for the regression of breast and skin lesions. Pre- and post-treatment time-intensity curve patterns (TICs) were also compared. During the topical steroid treatment, the inflammation signs in the affected breast had markedly disappeared, the fistulas had become inactive, and the fistula orifices and/or skin erosions had closed in nine patients. The median follow-up period was 17 months (range: 12-48 months). Recurrence was observed in two patients (2/11) at 5 and 8 months, which were treated again topically. The inflammatory findings of the breast skin completely resolved after 8 weeks of treatment, and no side effects or steroid-related complications occurred. In the pretreatment period, TICs from enhancing areas showed a Type 1 pattern in three cases, a Type 2 pattern in five cases, and a Type 3 pattern in three cases. After topical steroid treatment, TIC was not changed only in one patient (Type 2). Type 1 patterns were determined in seven cases and Type 2 patterns in two cases. In addition, in two patients, TICs were not determined due to complete healing. Our MRI findings showed that topical steroid therapy may be useful because it affects mammary parenchyma as well as mammary skin. Further studies with a greater number of patients are needed to determine the topical steroid therapy dosing and duration, and to better understand the efficacy for treating IGM.
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Demiryilmaz I, Yilmaz I, Peker K, Celebi F, Cimen O, Isik A, Bicer S, Firat D. Application of fasciocutaneous V-Y advancement flap in primary and recurrent sacrococcygeal pilonidal sinus disease. Med Sci Monit 2014; 20:1263-6. [PMID: 25042095 PMCID: PMC4114698 DOI: 10.12659/msm.890752] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022] Open
Abstract
BACKGROUND Pilonidal sinus disease is a common disease of young adults, which most frequently occurs in the sacrococcygeal region on the skin's midline. Various procedures, ranging from simple incision and curettage to complex flaps for natal cleft obliteration, have been described in the literature. MATERIAL/METHODS We aimed to present the dermographic characters, post-operative complications, length of stay in hospital, time of return to daily activities, and recurrence rates of the patients in which we applied sinus excision and fasciocutaneous V-Y advancement flap due to primary complicated or recurrent sacrococcygeal pilonidal sinus disease. RESULTS Patients with primary complicated and recurrent pilonidal sinus received a fasciocutaneous V-Y advancement flap in the general surgery service of our hospital. Eleven patients had recurrent disease. Thirty-seven patients received a unilateral V-Y flap and 8 patients received a bilateral V-Y flap. None of the patients had post-operative flap necrosis or wound opening. Two of the patients had a self-draining simple seroma and 3 of the patients had delayed wound healing in the perianal region of the incision, which was treated with dressing. The mean time required to return to daily activities was 7 days, and return to work took 17 days. In the mean 25-month follow-ups of the patients, no recurrences were detected. CONCLUSIONS We think that fasciocutaneous V-Y advancement flap is an easily learned and practicable method that reduces the recurrences in the patients with primary complicated and recurrent pilonidal sinus, length of stay in hospital, and time to return to daily activities and work in the post-operative period.
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Altintoprak F, Dikicier E, Sonmez O, Cakmak G, Gunduz Y, Arslan Y, Kivilcim T, Celebi F. Gastrointestinal Stromal Tumor: Single Center Experience. Ann Oncol 2013. [DOI: 10.1093/annonc/mdt203.152] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
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Altintoprak F, Arslan Y, Dikicier E, Kahyaoglu Z, Kivilcim T, Cakmak G, Demir H, Celebi F. Carcinoid Tumors: Retrospective Review of 1490 Consecutive Appendectomies. Ann Oncol 2013. [DOI: 10.1093/annonc/mdt203.35] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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Oztürk G, Aydınlı B, Celebi F, Gürsan N. Gastric perforation caused by Strongyloides stercoralis: a case report. ULUS TRAVMA ACIL CER 2011; 17:90-92. [PMID: 21341143] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/30/2023]
Abstract
Strongyloidiasis is a parasitosis caused by the female nematode of the Strongyloides stercoralis. S. stercoralis causes a chronic infection that is asymptomatic in 50% of chronically infected patients, and it can also affect the stomach. Gastric involvement causes symptoms mostly mimicking gastritis. We report herein a case of gastric perforation in a 37-year-old woman, which was thought to be caused by S. stercoralis.
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Simsek Celik A, Erdem H, Guzey D, Celebi F, Birol S, Erozgen F, Kaplan R. Fournier's gangrene: series of twenty patients. ACTA ACUST UNITED AC 2010; 46:82-6. [PMID: 21196741 DOI: 10.1159/000322616] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2010] [Accepted: 11/08/2010] [Indexed: 11/19/2022]
Abstract
BACKGROUND AND PURPOSE Fournier's gangrene (FG) is a rare, rapidly progressive, fulminant form of necrotizing fasciitis of the genital, perianal and perineal regions. Our aim is to investigate the clinical signs, symptoms and factors which affect the clinical results of patients with FG in our clinic. PATIENTS AND METHODS 20 patients having FG were admitted to our department during the past 6-year period. Age, gender, diabetes mellitus (DM), duration of symptoms, FG severity index score (FGSIS), colostomy, hospitalization time and number of debridements were investigated for their effects. RESULTS 13 of our patients were male, 7 of them were female. The mean age was 52.2 years (range: 30-80 years). 85% of our patients had DM as a predisposing factor. The mean hospitalization time was 19.7 days (range: 6-45 days), and overall mortality was 20% (4 patients). Age and FGSIS have been found to be statistically significant factors among the parameters studied. DISCUSSION FG is still an important disease with high mortality rates in spite of the developments in intensive care units and new-generation antibiotics. In conclusion, we have found that the age and FGSIS of the patient are the most important effecting factors.
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Gümüş M, Celebi F, Böyük A, Gürsan N, Akçay F. Dehydroepiandrosterone ameliorates hepatocellular damage in obstructive jaundice. Cell Biochem Funct 2010; 28:515-20. [PMID: 20803708 DOI: 10.1002/cbf.1686] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
We aimed to investigate the ameliorating effect of dehydroepiandrosterone (DHEA) on the potential hepatocellular damage in experimental obstructive jaundice. Twenty-four male rabbits in the study were randomly allocated into three groups. In the sham group, the choledochal canal was identified and explored. In the obstructive jaundice and treatment groups, the choledochal canal was ligated. Placebo and DHEA were administered to the obstructive jaundice and treatment groups, respectively. Blood samples were obtained at baseline, and both blood samples and liver tissue samples were obtained by re-laparotomy performed on day 8. Biochemical parameters were measured in blood samples, and liver samples were histopathologically evaluated. Alanine aminotransferase (ALT), aspartate aminotransferase (AST), gamma glutamyl transferase (GGT), alkaline phosphatase (ALP) and bilirubin levels were lower in the treatment group than in obstructive jaundice. Mononuclear inflammation in the portal region and hepatocyte degeneration were milder in the treatment group compared to obstructive jaundice group. Fibrosis and necrosis were also recovered by the DHEA treatment.In conclusion, these findings suggested that DHEA may reduce the obstructive jaundice-induced hepatocellular damage.
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Başoğlu M, Öztürk G, Aydınlı B, Yıldırgan Mİ, Atamanalp SS, Celebi F. Benign nodular goiter causing upper airway obstruction. Eurasian J Med 2009; 41:75-79. [PMID: 25610072 PMCID: PMC4261473] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/04/2023] Open
Abstract
OBJECTIVE Benign nodular goiter (BNG) can cause narrowing of the upper airway. In some rare cases, obstruction of the upper airway also occurs. The following paper reports our experiences with regard to BNG patients who experienced obstruction of the upper airway. MATERIALS AND METHODS We retrospectively investigated the records of 13 patients with acute airway obstruction due to BNG who were admitted to the General Surgery Department of Ataturk University Medical School between January 2000 and December 2007. RESULTS Thirteen patients with airway obstruction secondary to BNG were hospitalized during this period. There were two males and 11 females, and the mean age was 58.5 years (range 37-74 years). For all patients, the primary symptom upon admission was defined as respiratory distress; all patients had varying degrees of respiratory distress upon admission. Three of the patients underwent emergent endotracheal intubation in the emergency room. A preoperative radiological evaluation was performed with thyroid ultrasonography (US) and computed tomography (CT). There were retrosternal or substernal components of the BNG in nine patients. Twelve patients underwent operations, while one patient with mild respiratory distress elected not to be operated on. Ten patients underwent total thyroidectomies, while two patients underwent near-total thyroidectomies. One patient with retrosternal goiter also underwent a median sternotomy. Three patients received a tracheostomy after the operation. Suction drains were utilized in all operations. During the post-operative period, two patients suffered from voice impairment, and seven patients experienced hypocalcemia. Two patients died. Pathological examination of the thyroidectomy tissue revealed BNG in all cases. In addition, two patients had micropapillary carcinomas. CONCLUSION Although BNG causing upper airway obstruction is rare, it is an important clinical entity because of the need for emergent operation, the increased rate of complications, and high mortality.
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Oztürk G, Aydinli B, Atamanalp SS, Celebi F, Acemoğlu H, Dönmez R. Blunt colonic injury: a 64-case series. ULUS TRAVMA ACIL CER 2009; 15:347-352. [PMID: 19669963] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/28/2023]
Abstract
BACKGROUND Blunt colonic injuries are rare but can complicate the management of the blunt trauma patient and worsen the outcome. We analyzed in this study the colonic injuries caused by blunt abdominal trauma. METHODS The records of 64 patients (60 male, 4 female; mean age 39.3 years; range 16 to 69 years) were investigated retrospectively. The records were reviewed for clinical presentation, investigations, diagnostic methods, associated injuries, time from injury to operation, site of colon injury, operative management, morbidity, and mortality. RESULTS One-stage operation was performed in 53 cases (82.8%) and two-stage operation in 11 cases (17.2%). The treatment chosen was strongly related with the degree of fecal contamination and grade of colonic injury (p<0.01). The overall incidence of colonic injury-related abdominal complications was 26.5% (17 cases). There were six non-colon-related and one colon-related mortalities. Shock at presentation, severe fecal contamination, colon injury scale (CIS) grade, and associated injuries were related with complications and mortality. CONCLUSION We conclude that in patients with shock at presentation, severe fecal contamination and higher CIS grade, two-staged operation is appropriate.
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Öztürk G, Aydinli B, Selcuk Atamanalp S, Celebi F, Ilhan Yildirgan M, Donmez R. Penetrating colon injury: experience of a single centre. Acta Chir Belg 2009; 109:185-90. [PMID: 19499679 DOI: 10.1080/00015458.2009.11680403] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
OBJECTIVE Penetrating colonic injuries are amongst the most discussed intra-abdominal injuries because of the complexity of their management and the severe complications. Penetrating colonic injuries can be managed by either primary repair or diversion. There is a debate over which procedure has to be used under which circumstances. In this retrospective study we analyzed our experience to contribute to the answer. PATIENTS AND METHODS The records of patients with penetrating colonic injury between January 1995 and December 2006 at the General Surgery Department of Atatürk University School of Medicine, were reviewed retrospectively. RESULTS One hundred and forty-one patients were included in the study. Ten patients did not need any surgical treatment. Seventy-nine patients (56%) were treated without formation of a stoma and fifty-two patients (36.8%) with formation of a stoma. The overall complication rate was 50.3% (71 patients). The rate of septic complications was 33.3%. CONCLUSION There is an ongoing debate whether formation of a stoma is indicated in penetrating colonic injury or not. Our clinical experience showed that severe faecal contamination, shock at presentation, and high CIS grades are associated with increased postoperative complications and mortality. Therefore the treatment of penetrating colonic injury in the presence of these risk factors should be stoma formation rather than primary repair.
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Celebi F, Ozturk G, Kizilkaya M. The effects of combined use of glutamine and growth hormone on the bacterial translocation associated with obstructive jaundice. Saudi Med J 2008; 29:989-993. [PMID: 18626527] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/26/2023] Open
Abstract
OBJECTIVE To investigate the effects of combined use of glutamine and growth hormone on bacterial translocation. METHODS The study was performed at the laboratories of the Department of Physiology at Ataturk University Medical School, Erzurum, Turkey between June and September 2007. Forty rats divided into 5 groups of 8, were included in the study. In the study groups, the common bile duct was ligated to obtain obstructive jaundice. The rats in the control group CG were given sodium chloride, in the glutamine group GLG they were given glutamine, in the growth hormone group GHG, growth hormone, and in the glutamine + growth hormone group GLGHG glutamine + growth hormone at equal doses by the same methods. Blood, spleen, liver, lymph node, and cecal content samples were obtained. Total bilirubin TB, alkaline phosphates ALP, and gamma glutamine transferase GGT activities were evaluated. RESULTS In the CG, cecal contents were higher than in the GLG, and cecal contents and BT were higher than in the GHG and the GLGHG. The BT rate was the lowest in the GLGHG, with a borderline difference with the values of the GLG and GHG. CONCLUSION We found that in preventing BT, combined use of glutamine, and growth hormone was more effective than using each of these agents alone.
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Inceboz T, Korkmaz M, Celebi F, Uner A. The first report in Turkey of in vivo cultivation in Rattus norvegicus of Echinococcus multilocularis human strain. TURKIYE PARAZITOLOJII DERGISI 2007; 31:194-196. [PMID: 17918057] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/25/2023]
Abstract
The adult form of the small cestode Echinococcus multilocularis is found in carnivorous animals, especially in the fox. This cestode, which is found in the northern hemisphere in the world, is the cause of a generally fatal disease in humans, known as alveolar echinococcosis (AE). The metacestodes of Echinococcus multilocularis can be experimentally developed in the Meriones unguiculatus species of rodents, and it is possible to use these metacestodes for numerous purposes, primarily for supplying the antigens required for serological diagnosis of the disease. It is with this aim that in this study for the first time in Turkey, Echinococcus multilocularis metacestodes were developed using different kind of rodent, Rattus norvegicus, and an indigenous strain was isolated using the surgical material of a patient diagnosed with alveolar echinococcosis.
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Gulaboglu M, Yildiz L, Gul M, Celebi F, Peker K. Blood and urine iodine levels in patients with gastric cancer. Biol Trace Elem Res 2006; 113:261-71. [PMID: 17194926 DOI: 10.1385/bter:113:3:261] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/27/2005] [Revised: 02/16/2006] [Accepted: 02/28/2006] [Indexed: 11/11/2022]
Abstract
In this study, we aimed to investigate whether there is any relationship between gastric cancer and iodine concentrations in blood and urine in the northeast Anatolia region, where iodine deficiency is common. A total of 56 patients, diagnosed as gastric cancer and 25 healthy volunteers were included in the study. The methods used were based on the Sandell-Kolthoff reaction. The urine iodine concentration (UIC) and serum protein-bound iodine (PBI) levels were higher in patients with gastric cancer compared with healthy control subjects. The UIC in stage IV was higher than all other stages and the control group. The UIC was higher in stages III and IV compared with stages I and II. However, serum PBI levels in stage III were higher compared with stages I and II and also control group. The serum PBI level in stage IV was higher than stage II and the control group. In the patient and control groups, there were no significant differences in serum PBI and UIC with regard to age or sex. Our results suggested that urinary and blood iodine concentration might be a useful marker for following the disease.
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