Browsing by Author "Aras, Abbas"

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Biliyer Obstrüksiyon Nedenleri ve Uygulanan Tedaviler: 139 Olguluk Seri
(2000) Kisli, Erol; Güler, Osman; Aydın, Metin; Çıkman, Öztekin; Aras, Abbas
Kliniğimizde obstrüktif ikter tanısı ile yatan 139 hasta etyoloji ve uygulanan tedavi açısından retrospektif olarak incelendi. Hastaların 62'si erkek (%44.6), 77'si kadındı (%55.4) ve ortalama yaş 48 (17-87) olarak bulundu. 99 hastada (%71.2) benign, 40 hastada (%28.8) malign nedene bağlı obstrüktif ikter tespit edildi. Tedavi olarak ERCP ile sfinkterotomi ve koledoktan taş ekstirpasyonu, bilio enterik drenaj (koledokoduodenostomi, koledokojejunostomi, hepatikojejunostomi, transduodenal sfinkterotomi, kolesistojejunostomi), eksternal bilier drenaj, whipple ameliyatı uygulanmıştır.
Çocuk, Erişkin ve Yaşlı Populasyonda Akut Apandisitin Klinik Özelliklerinin Karşılaştırılması
(2000) Barut, İbrahim; Kotan, Çetin; Sönmez, Reşit; Aras, Abbas; Bilici, Salim; Köseoğlu, Burhan
Akut apandisit, özellikle erken çocukluk çağı ve yaşlı populasyonda yüksek perforasyon oranı nedeni ile morbidite ve mortalite nedeni olabilmektedir. Çalışmamızda Genel Cerrahi ve Çocuk Cerrahisi Kliniklerinde ameliyat edilen akut apandisitli olgular, perforasyon, postoperatif komplikasyon, mortalite oranları ve hastanede yatış süreleri açısından karşılaştırıldı. Çalışma periyodunda çocuk cerrahisi kliniğinde ameliyat edilen 84 ve genel cerrahi kliniğinde ameliyat edilen 176 olgu retrospektif olarak incelendi. Onbeş yaş altı grupta perforasyon oranı % 50, 16 yaş üstü grupta ise % 41.5 olarak bulundu. Perforasyon oranı açısından gruplar arasında anlamlı farklılık yoktu. Yaş gruplarına göre perforasyon oranları incelendiğinde 0-4 yaş grubunda % 86, 60 yaş üstü grupta ise % 83 perforasyon oranı bulundu. Pediatrik gruptaki olgularda yedi günden uzun süren adinamik ileus, mekanik intestinal obstrüksiyon, intraabdominal apse ve sepsis komplikasyonları erişkin gruba göre anlamlı olarak yüksek bulundu. Erişkin grupta ise akciğer komplikasyonları anlamlı olarak daha yüksek bulundu. Pediatrik grupta mortalite oranı (% 2.7) erişkin gruba göre (% 0.77) anlamlı olarak daha yüksek bulundu. Hastanede yatış süresi 0-4 ve 60 yaş üstü gruplarında diğer alt gruplara göre anlamlı olarak daha yüksek bulundu.
Colon Cancer Presented With Sigmoid Volvulus: a Case Report
(Elsevier Sci Ltd, 2015) Aras, Abbas; Kiziltan, Remzi; Batur, Abdussamet; Celik, Sebahattin; Yilmaz, Ozkan; Kotan, Cetin
Introduction: Sigmoid volvulus is the most prevalent type of colonic volvulus. Colon cancer is seen less where sigmoid volvulus is common, so it is rare to see that colon cancer is synchronous with sigmoid volvulus. PRESENTATION OF CASE: We would like to present a case of sigmoid volvulus caused by colon cancer in a male patient aged 80 who was referred to the hospital with toxaemic shock presentation. DISCUSSION: Sigmoid cancer can be presented as sigmoid volvulus to the emergency department. In intestinal obstruction early diagnosis is of crucial importance. Computarized tomography is a diagnosis tool that should be preferred both in the diagnosis of obstruction and in detecting its cause, localisation, degree and complications. CONCLUSION: When surgery is performed due to the urgent colonic obstruction in colonic volvulus diagnosed patients, a colon tumour should be considered in the same column loops or in the distal colon. We believe that CT is the method that should be preferred in large-bowel obstruction suspected patients. (C) 2015 The Authors. Published by Elsevier Ltd.
The Diagnosis of Acute Appendicitis in Pregnant Versus Non-Pregnant Women: a Comparative Study
(Assoc Medica Brasileira, 2016) Aras, Abbas; Karaman, Erbil; Peksen, Caghan; Kiziltan, Remzi; Kotan, Mehmet Cetin
Objective: To investigate whether the diagnosis of acute appendicitis is affected by pregnancy or not. Method: A retrospective study with the analysis of the medical records of all women suspected of having appendicitis who underwent appendectomy at our hospital between June 2010 and March 2015 were reviewed. The patients were divided into two groups according to whether they were pregnant or not during the surgery: group I, pregnant women, and group II, non-pregnant women. Results: During the study period, 38 pregnant women and 169 non-pregnant women underwent appendectomy. The time from admission to the operation was not statistically different (2.17 +/- 1.47 days in group I vs. 1.98 +/- 1.66 day in group II; p=0.288). The pregnant group had longer hospital stay than the nonpregnant group (p=0.04). Ultrasonography (USG) was used as the first diagnostic modality in 36/38 patients in group I and 161/169 in group II. The non-visualized appendix on ultrasound was seen in 17 patients in group I and 51 patients in group II, which was not statistically different. Sensitivity and specificity of USG in diagnosis of acute appendicitis were 61.29 and 80.00% in group I, and 93.0 and 31.6% in group II, respectively. Conclusion: Although the diagnosis of appendicitis in pregnant women is not delayed, careful assessment of these patients suspected of having appendicitis should be encouraged when USG examination is normal or nondiagnostic.
The Effect of Ozonated Water and Ozone Application on Intraperitoneal Infection in Rats With Fecal Peritonitis: an Experimental Study
(2024) Uçak, Müjdat; Aras, Abbas; Parlak, Mehmet; Çibuk, Salih
Uçak, M. Fekal Peritonitli Ratlarda Ozonlu Su ve Ozon Uygulamasının İntraperitoneal Enfeksiyon Üzerine Etkisi: Bir Deneysel Çalışma. Van Yüzüncü Yıl Üniversitesi, Tıp Fakültesi, Genel Cerrahi Anabilim Dalı, Uzmanlık Tezi, Van, 2024. Fekal peritonit, gastrointestinal sistem perforasyonları sonucu geliĢen ciddi bir enfeksiyon türüdür ve yüksek mortalite oranına sahiptir. Ozon tedavisi, antimikrobiyal, antienflamatuar ve antioksidan etkileri nedeniyle enfeksiyonların tedavisinde yardımcı bir tedavi yöntemi olarak araĢtırılmaktadır. Bu çalıĢmanın amacı, fekal peritonit oluĢturulan ratlarda ozonlu su ve ozon uygulamasının intraperitoneal enfeksiyon tedavisi üzerine etkisini araĢtırmaktır. ÇalıĢmada 40 adet Wistar albino rat kullanılmıĢ ve kontrol, antibiyotik, antibiyotik+ozonlu su, ozonlu su ve ozon olmak üzere 5 grup oluĢturuldu. Fekal peritonit, çekal içerik enjeksiyonu ile oluĢturuldu. Gruplara özgü tedaviler 7 gün boyunca uygulandı. Deney süresince ratlar gözlemlendi, 24. saatte ve 7. günde kan ve peritoneal örnekler alınarak hematolojik, mikrobiyolojik ve histopatolojik analizler yapıldı. Analiz sonucunda elde edilen verilerle Mann Whitney U testi, Kruskal Wallis H Testi ve Pearson Ki-kare testi gerçekleĢtirildi. Hematolojik bulgulara göre, ozonlu su grubunda MCH değeri antibiyotik ve ozon gruplarından anlamlı olarak daha yüksek bulundu. Antibiyotik grubunda MCHC değeri diğer tüm gruplardan anlamlı olarak daha düĢük saptandı. Ozon grubunda lenfosit sayısı ozonlu su ve antibiyotik gruplarına göre anlamlı olarak daha yüksek bulundu. Mikrobiyolojik bulgularda gruplar arasında anlamlı fark gözlenmedi. Histopatolojik bulgulara göre kontrol grubunda enflamasyon skorları tedavi gruplarından anlamlı olarak daha yüksek bulundu. Sonuç olarak, ozon ve ozonlu su tedavilerinin peritonit modelinde olumlu etkileri olduğu gösterildi. Ozon tedavisi immün sistemi uyararak ve enflamasyonu azaltarak, ozonlu su ise eritrosit fonksiyonlarını destekleyerek enfeksiyona karĢı koruyucu etki gösterebilir. Gelecek çalıĢmalarda daha geniĢ örneklemlerle, daha uzun tedavi protokolleriyle ve daha kapsamlı enfeksiyon göstergeleriyle ozon ve ozonlu su tedavilerinin etkinliğinin araĢtırılması faydalı olacaktır.
Effect of Thymoquinone on the Healing of Left Colon Anastomosis: an Experimental Study
(Springer international Publishing Ag, 2016) Kiziltan, Remzi; Yilmaz, Ozkan; Celik, Sebahattin; Yildirm, Serkan; Alp, Hamit Hakan; Aras, Abbas; Kotan, Cetin
Aim: To evaluate the effect of thymoquinone on the healing of experimental left colon anastomosis in rats. Methods: Forty Wistar albino rats weighing 250-300 g were randomly divided into four groups (10 rats/group). Group 1 (control group) rats were not administered Thymoquinone (TQ) for 3 days after the operation. Group 2 was administered daily TQ for 3 days starting from the first day after the operation. Group 3 was not administered TQ for 7 days after the operation. Group 4 was administered daily TQ for 7 days starting from the first day after the operation. Thymoquinone was administered as a single dose oral gavage through a 4F feeding catheter per each day. The bursting strength of the anastomosis was measured on 3rd and 7th postoperative days (POD) and resection was performed. Subsequently, the hydroxyproline level in the resected tissue was measured and a histological evaluation was performed. Results: The bursting pressures of the anastomoses were measured to be statistically significantly greater on 7th POD in TQ administered groups compared to those without TQ administration. Tissues were stained with Masson's trichrome dye in order to evaluate the amount of fibrous tissue reaction for histopathological examination; there was no significant difference in the amount of fibrous tissue between groups 1 and 2, while a very marked increase in the fibrous tissue was detected in groups 3 and 4. Mean tissue hydroxyproline levels of the groups 3 and 4 on 7th POD were 1.30 and 2.72 mu g/g-protein, respectively. The difference between the groups was statistically significant (p = 0.001). Conclusions: TQ significantly increased the bursting pressure of the anastomosis, tissue hydroxyproline level, and fibrous tissue production.
Effect of X-Ray Exposure on Oxidative Stress in Liver and Kidney in Rats in Early Life: an Experimental Study
(Kafkas Univ, Veteriner Fakultesi Dergisi, 2025) Cibuk, Salih; Aras, Abbas
The aim of this study was to investigate the levels of oxidative stress and antioxidants in the liver and kidney tissue of baby rats exposed to whole-body x-ray by creating a newborn rat model. In this study, 60 baby rats obtained from 15 pregnant rats were used. Pregnant rats were randomly divided into five groups. The control group (Group I) was not subjected to X-ray. The 2(nd) and 3(rd) groups were subjected to both intrauterine and postnatal X-ray, and the 4(th) and 5(th) groups were subjected to only postnatal X-ray. At the end of the 4-week study period, oxidative stress markers were studied in the liver and kidney tissue. In all groups that received X-ray, an increase in the amounts of malondialdehyde (MDA) and advanced oxidation protein products (AOPP), a decrease in the amount of glutathione (GSH) and catalase (CAT) activity were detected in liver tissues (P<0.05), and an increase in the activities of MDA, AOPP and CAT, and a decrease in the amount of GSH were detected in kidney tissues (P<0.05). These findings indicate that X-ray exposure in early life disrupts the antioxidant defense system by inducing oxidative stress in liver and kidney tissues, highlighting the necessity of minimizing unnecessary radiation exposure in clinical practice.
Evaluation of Effectiveness of Neutral-Ph Superoxidized Solution (Nsos) With Peritoneal Lavage in Rat Fecal Peritonitis Model: an Experimental Study
(Kafkas Univ, veteriner Fakultesi dergisi, 2024) Aras, Abbas; Karaman, Erbil; Seckin, Hamdullah; Cibuk, Salih
This experimental study aimed to evaluate the effectiveness of NSOS (Neutral-pH superoxidized solution) with peritoneal lavage in rat fecal peritonitis models. Forty Wistar rats weighing between 250-300 g were used for the study. All rats were inducted for fecal peritonitis formation. The rats were divided into five groups as follows; Group 0: control, no intervention. Group 1: Application of 10 mg/kg NSOS into the peritoneal cavity after 6 h of induction of peritonitis. Group 2: 10 mg/kg NSOS application and repeated at 24 and 48 h. Group 3: NSOS + Antibiotic treatment (Seftriakson 30 mg/kg/ day IM 2x1 + metronidazol 15 mg/kg/day IM 2x1). Group 4: Only antibiotic treatment (Seftriakson 30 mg/kg/day IM 2x1 + metronidazol 15 mg/kg/day IM 2x1). The animals were examined for peritoneal and thoracal abscess formation, adherences, and any abnormality with inspection after sacrificing on the 7th day. The peritoneal lavage fluid culture for microbiological analysis and blood samples were taken for blood cultures, biochemical and infectious parameters of WBC, CRP, TNF- alpha, IL-6, IL-1 beta, and IL-10. Peritonitis was developed in all rats at the end of follow-up. No death was observed in rats on the seventh day of the experiment. Group 3 (NSOS + Antibiotic treatment) showed the most significant improvement in the infection of peritoneal fluid. NSOS and antibiotic together (Group 3) were found to be more effective against Klebsiella than Enterococcus sp. The blood cultures showed a significant reduction in all groups. The infectious parameters including IL-6, IL-1 beta, and IL-10 showed no significant difference in the first week of treatment between all groups. Only TNF- alpha was observed significantly lower in group 3 when compared to the other groups (P=0.001). Peritoneal lavage with neutral pH-superoxidized water plus an antibiotic regimen is the most effective treatment in the rat fecal peritonitis model. Further studies including human subjects are needed to investigate its effectiveness and validity
The Factors That Effect the Histopathological Results of Specimen in Completion Thyroidectomy
(2020) Karayıl, Ali Riza; Aras, Abbas
Tiroid kanserleri endokrin kanserleri içinde en sık görülen malignitelerdir. Tiroid kanserlerinin tedavisinde tiroidektomi önemli bir yer tutmaktadır. Ameliyat öncesi klinik değerlendirme, radyolojik görüntüleme, moleküler ve biyokimyasal testlere rağmen tiroid kanserlerinin bir kısmına ancak histopatolojik inceleme ile tanı konulabilmektedir. Tiroid cerrahisindeki ilerlemelere, kullanılan inovatif cerrahi enstrümanlara ve tiroid cerrahisinde uzmanlaşmış cerrahlara rağmen tiroidektomi sonrası ciddi komplikasyonlar görülebilmektedir. Bu komplikasyonları azaltmak için günümüzde, total tiroidektomiden, daha konservatif bir cerrahi yaklaşım olan hemitiroidektomi yönünde bir eğilim mevcuttur. Hemitiroidektomi sonrası hangi hastalara tamamlayıcı tiroidektomi yapılması gerektiği hususunda ise tartışmalar devam etmektedir. Çalışmamızda hemitiroidektomi sonrası tamamlayıcı tiroidektomi yapılmış 60 hasta ile aynı dönem içerisinde total tiroidektomi uygulanmış gruptan seçilen 60 ardışık hastanın(TİİAB: BETHESDA-3,4 veya 5) verileri karşılaştırıldı. Bu çalışmada; 01.01.2014-01.10.2019 tarihleri arasında kliniğimizce 1619 hastaya tiroid cerrahisi yapılmış olduğu belirlendi. Bu hastalardan 1191'ine ''Total tiroidektomi'', 321 hastaya ''Hemitiroidektomi'', 60 hastaya ise hemitiroidektomi patoloji sonucu malign olduğu için 2.cerrahi olarak ''Tamamlayıcı tiroidektomi'' uygulanmıştı. Malignite şüphesi nedeniyle ilk cerrahisinde hemitiroidektomi yapılan hastaların %83,5'inin total tiroidektomi ve onun komplikasyonlarından korunduğunu belirledik. Total tiroidektomi yapılan hastaların tamamlayıcı tiroidektomi yapılan hastalara göre hastanede yatış sürelerinin daha uzun olduğu görüldü ve aradaki fark istatistiksel olarak anlamlı bulundu. Total tiroidektomi grubunda, cerrahi patolojisi malign hastaların %17,7'sinde karşı lobda da malignite olduğu görüldü. Hemitiroidektomi sonrası tamamlayıcı tiroidektomi yapılan hastaların %23,3'ünde maligniteye rastlandı. Tamamlayıcı tiroidektomi patoloji sonucunun benign veya malign olması durumunun postop hipokalsemi gelişme oranı üzerine anlamlı bir etkisinin olmadığı belirlendi. İstatistiksel anlamlı olarak, primer cerrahi sonrası 10-90.günler arasında tamamlayıcı tiroidektomi yapılmasının, 90.günden sonra yapılan cerrahiye göre daha yüksek oranda komplikasyona ve daha uzun süre hastanede yatışa neden olduğunu tespit ettik. Hemitiroidektomi yapılan hastalarda, patoloji tipinin, yaşın, tümör çapının ve serum TSH seviyesinin karşı lobda malignite görülmesi üzerine anlamlı ektisinin olmadığı görüldü. Bu çalışma ile hemitiroidektomi yapılan hastalarda karşı lobda malignite durumunu yüksek doğruluk oranıyla tahmin edecek belirteçleri araştırdık. Çalışmamız neticesinde, istatistiksel olarak anlamlı olmasa da tamamlayıcı tiroidektomi materyalinde malign histopatolojik sonuca etki eden faktörler olarak, erkek cinsiyet ile Papiller tiroid karsinomu(PTC) birlikteliği, 45 yaş üzerinde erkek cinsiyet, ilk cerrahi patolojide ilave risk faktörlerinin erkek cinsiyet ile birlikteliği, tamamlayıcı tiroidektominin sol tarafa uygulanması ve tiroglobulin(TG) düzeyinin 30ng/mL üzerinde olmasını tespit ettik. Yine çalışmamızın sonucunda tamamlayıcı tiroidektominin, total tiroidektomiden daha düşük komplikasyon oranına sahip olduğunu belirledik. Kesin endikasyon olmadıkça, hemitiroidektominin total tiroidektomiye tercih edilebileceğini ve hemitiroidektomi sonrası endikasyon varlığında tamamlayıcı tiroidektominin düşük morbidite ve güvenle yapılabileceğini düşünmekteyiz. Anahtar sözcükler; Total tiroidektomi, hemitiroidektomi, tamamlayıcı tiroidektomi, zamanlama, komplikasyon.
Ingested Intraabdominal Foreign Bodies That Require Surgical Intervention
(Turkish Assoc Trauma Emergency Surgery, 2016) Kiziltan, Remzi; Yilmaz, Ozkan; Aras, Abbas; Toktas, Osman; Batur, Abdulsamet; Agar, Fatma; Kotan, Cetin
BACKGROUND: The aim of the present study was to review cases that required surgical intervention to remove ingested foreign bodies. METHODS: Medical records of 7 patients who underwent surgical intervention at the Yuzuncu Yil University Department of General Surgery between 2009 and 2014 after ingesting foreign bodies were reviewed. RESULTS: Female: male ratio was 5:2; mean age was 25 (16-35). Four patients had swallowed pins, 1 patient had swallowed a sewing pin, 1 patient had swallowed a safety pin, and 1 patient had swallowed a wristwatch. The patient who had swallowed the wristwatch had psychiatric disorders. All other patients stated that they had swallowed the objects by accident. CONCLUSION: Most ingested foreign bodies pass smoothly through the gastrointestinal (GI) tract within a week, but those that migrate out of the lumen require surgical intervention due to complications including perforation, abscess, fistula, and peritonitis. Early diagnosis and intervention is crucial to reduce morbidity and mortality. It is believed that sharp and pointed objects that migrate outside of the lumen ought to be removed, lest they cause complications.
Intraperitoneal Infusion of Neutral-Ph Superoxidized Solution in Rats: Evaluation of Toxicity and Complications on Peritoneal Surface and Liver
(int Scientific information, inc, 2017) Aras, Abbas; Karaman, Erbil; Yildirim, Serkan; Yilmaz, Ozkan; Kiziltan, Remzi; Karaman, Kamuran
Background: Superoxidized water (SOW) is known to be a potent disinfectant. The aim of this study was to evaluate the toxicity and complications on the peritoneal surface and liver after infusion of pH-neutral SOW into the peritoneal cavity of rats. Material/Methods: Thirty Wistar-Albino rats weighing 250-300 g were randomly divided into 3 groups (10 rats/group). Group1 (control group) rats received single dose of 10 mg/kg saline solution intraperitoneally. Group 2 (single-dose group) rats received a single dose of 10 mg/kg pH-neutral SOW intraperitoneally. Group 3 (multiple-doses group) rats received multiple doses of 10 mg/kg pH-neutral SOW intraperitoneally on days 1, 3, and 5. All animals were killed at 1 week after infusion. Blood specimens were taken to the laboratory and macroscopic and microscopic examinations were performed on each rat. Results: All 30 rats survived after the infusion. The gross-macroscopic examinations revealed no pathologic findings in any of the 3 groups. The microscopic examination of peritoneum and liver showed no signs of toxicity or complications in any of the 3 groups. There were no statistically significant differences among the 3 groups with regards to the blood biochemistry, including hemoglobin, hematocrit, platelets, aspartate aminotransferase, alanine aminotransferase, urea, or creatinine levels (p>0.05). However, the leucocyte counts were lower in group 3 than in groups 1 and 2, but this was not statistically significant (p=0.189). Conclusions: Intraperitoneal infusion of pH-neutral SOW does not result in any significant toxicity or complications on the liver and peritoneal surface. However, multiple infusions lead to low leucocyte counts and future studies with longer follow-up times are needed.
Maternal and Fetal Outcomes After Laparoscopic Vs. Open Appendectomy in Pregnant Women: Data From Two Tertiary Referral Centers
(Studio K, 2016) Karaman, Erbil; Aras, Abbas; Cim, Numan; Kolusari, Ali; Kiziltan, Remzi; Celik, Sebahattin; Anule, Turgut
Objectives: Appendectomy is the most common cause of non-obstetric surgery in pregnant women. Our aim was to compare the clinical characteristics, pert-and post-operative data of pregnant women undergoing either laparoscopic appendectomy (LA) or open appendectomy (OA). Material and methods: This was a retrospective study of medical records of all pregnant women diagnosed and treated surgically for acute appendicitis at two referral centers of Yuzuncu Yil University Medical Faculty and Kafkas University Medical Faculty, from January 2010 to January 2015. Results: The study included 48 patients, divided to two groups (12 - LA and 36 - OA). There were no significant differences in demographic characteristics of the studied population, including age, BMI, gestational age at operation, gravidity, parity, and history of cesarean sections. A far as obstetric and fetal outcomes are concerned, no significant differences were found in terms of preterm delivery, fetal loss, delivery mode, birth weight, APGAR score, and maternal death between the two investigated groups. One perioperative complication of intra-abdominal abscess was noted in the OA group. However, the LA group had shorter hospital stay (3.25 +/- 2.45 vs. 4.28 +/- 3.31, p=0.004), earlier mobilization time (8.1 +/- 2.2 vs. 10.1 +/- 1.6, p=0.025), and shorter time to first flatus (2.3 +/- 0.3 vs. 4.0 +/- 1.6, p=0.032) as compared to the OA group. The OA group had statistically shorter operation time than the LA group (38.61 +/- 11.5 vs. 49.42 +/- 11.38, p=0.007). Conclusion: LA is related to shorter hospital stay, faster return to daily activities, and shorter time to first flatus. LA appears to be as safe and effective as OA in pregnant patients without increasing adverse perinatal outcomes.
Non-rekürren Laringeal Sinir: Olgu Sunumu
(2001) Arslantürk, Hasan; Kotan, Çetin; Aras, Abbas
Özet: Tiroidektominin en önemli komplikasyonlarından biri rekürren laringeal sinir (İnferior laringeal sinir) yaralanmasıdır. Rekürren sinirin anatomik seyri varyasyonlar göstermektedir. Nadiren inferior laringeal sinir non-rekurren olabilir. Sinirin anatomik seyrindeki farklılıklar nedeni ile, yaralanma olasılığını azaltmak için sinirin görülüp korunması önerilmektedir. Bu olgu sunumunda, benign tiroid patolojisi nedeni ile tiroidektomi yaptığımız bir olguda sinir eksplorasyonu esnasında saptadığımız, inferior laringeal sinirin non-reküren anomalisi sunulmuştur.
Özofagus Kanserinin Cerrahi Tedavisinde Deneyimimiz: 57 Olgunun Analizi
(2001) Sönmez, Reşit; Kisli, Erol; Kotan, Çetin; Aras, Abbas; Arslantürk, Hasan; Aslan, Murat; Söylemez, Ömer
Amaç: Özofagus kanseri Van bölgesinde sık görülen gastrointestinal malignitelerden biridir. Bu çalışmada YYÜ Tıp Fakültesi Genel Cerrahi Ana Bilim Dalında ameliyat ettiğimiz özofagus kanserli olgular irdelendi. Metod: 1994- 2000 yılları arasında kliniğimizde 57 özofagus kanseri olgusu ameliyat edildi. Bulgular: Tümör 3 olguda servikal, 21olguda intratorasik ve 33 olguda ise distal özofagusa lokalize idi. Rezektabilite oranı % 91 olarak bulundu ve 52 olguya değişik cerrahi teknikler ile özofajektomi yapıldı. İntratorasik tümörlerde en sık uygulanan ameliyat tekniği % 43 oranı ile, laparotomi, sağ torakotomi ve servikal özofagogastrostomi, distal tümörlerde ise en sık uygulanan ameliyat tekniği % 36 oranı ile, laparotomi, sağ torakotomi, proksimal gastrektomi, distal özofajektomi ve intratorasik özofagogastrostomi olmuştur. Anastomoz 21 (%40.3) olguda sirküler stapler ile yapılmış, 31 olguda ise elle yapılmıştır. Stapler kullanılan olgularda anastomoz kaçağı oluşmamış, ancak elle anastomoz yapılan 4 olguda (% 7.7) anastomoz kaçağı oluşmuştur. Ameliyat sonrası toplam komplikasyon oranı % 56, hastane mortalitesi ise % 10.5 olarak bulunmuştur. Sonuç: Özofagus kanserinin cerrahi tedavisinde farklı cerrahi teknikler, tümör lokalizasyonu ve cerrahın tercihine bağlı olarak tercih edilebilir.
Relationship Between Mthfr Gene Polymorphisms and Gastrointestinal Tumors Development: Perspective From Eastern Part of Turkey
(Taylor & Francis inc, 2022) Oksuz, Ersoy; Gorgisen, Gokhan; Oto, Gokhan; Ozdemir, Hulya; Aras, Abbas; Oksuz, Murat; Demirkol, Muhammet Hamdi
Background Gastric and esophageal cancers are 2 of the most prevalent cancer types worldwide. Polymorphisms in the genes that code the methylenetetrahydrofolate reductase (MTHFR) enzyme increase the formation of both cancer types. In this study, it was aimed to research the relationship between the existence of MTHFR C677T and A1298C polymorphisms in patients with gastric and esophageal cancer and the lifespans of patients. Methods and Materials This prospective study was performed at Van Yuzuncu Yil University. Included in the study were 30 patients with esophageal tumors, 70 patients with gastric tumors, and 61 healthy volunteers. From each of the patients, 5 mL of blood was drawn. DNA was isolated via kits with spin-column technology. Results It was concluded that the risk of developing gastric cancer was 4.13 times higher in individuals who had the AC genotype of the A1298C polymorphism when compared to those who had the AA genotype, while the risk was 2.91 times higher in individuals who had the CC genotype when compared to those who had the AA genotype (P = 0.001, P = 0.027). Carriers of the AC genotype of the A1298C polymorphism had 2.89 times higher risk of developing esophageal cancer when compared to those who had the AA genotype (P = 0.033). It was determined that individuals who had the 1298 CC genotype were not at higher risk of developing esophageal cancer when compared to those with the AA genotype (P = 0.863). It was concluded that individuals who had the TT genotype of the C677T polymorphism were not at higher risk of developing gastric and esophageal cancers when compared to those who had the 677CC genotype (P > 0.05). There was no difference in terms of the life spans of the patients with regards to the genotypes (P > 0.05). Conclusion The results showed that the A1298C polymorphism on the MTHFR gene can be a risk factor for gastric and esophageal cancer in eastern Turkey. These polymorphisms may have no effect on the life spans of the patients.
Successful Treatment of a Large Pelvic Abscess Using Intraluminal Vac: a Case Report
(Premchand Shantidevi Research Foundation, 2016) Aras, Abbas; Celik, Sebahattin; Kiziltan, Remzi; Yilmaz, Ozkan; Kotan, Cetin
The most feared complication of the surgical treatment of rectal cancer is anastomotic leakage, which is related to high rates of mortality and morbidity. Here, we present a patient who could not be treated with surgical drainage but treated by intraluminal Vacuum Associated Closure (VAC). A 34-year-old male patient was treated for rectal cancer by low anterior resection, colorectal anastomosis, and diverting ileostomy following neoadjuvant CRT. The patient reported with a postoperative anastomotic disruption and a large pelvic abscess. Due to the continuation of foul-smell drainage inspite of perianal incision and drainage, intraluminal VAC was applied and the pelvic abscess and the foul-smell were successfully treated. The presence of an adequate anal sphincter tonus is a disadvantage in anastomotic leakage, since it prevents the emptying of the intestinal content and also precludes the drainage of the pelvic abscess. The endoluminal application of VAC, similar to the results of application of VAC in open wounds, has been demonstrated to decrease fibrin and necrotic tissue in the pelvic cavity and increase granulation tissue. VAC, which has long been used in the treatment of open wounds, is a promising method in the treatment of large pelvic abscesses due to anastomotic leakage following rectum resection.
Yüzüncü Yıl Üniversitesi Tıp Fakültesi Genel Cerrahi Anabilim Dalında Ameliyat Edilen Mide Kanserli Hastalarda Proksimal Mide Kanseri Sıklığı
(2000) Sönmez, Reşit; Çıkman, Öztekin; Barut, İbrahim; Özgören, Ersin; Kotan, Çetin; Aras, Abbas
Son yıllarda mide kanseri insidensindeki düşme eğilimine rağmen, proksimal lokalizasyonlu mide kanserlerinde artış olduğu bildirilmektedir. Distal özofagus adenokarsinomu ile birlikte, mide kanserinden ayrı bir klinik durum olarak kabul edilen proksimal mide kanserlerinin daha kötü prognoza sahip olduğu bildirilmektedir. Gastrointestinal kanserler, özellikle mide ve özofagus kanserleri Van bölgesinde sık görülen, önemli bir mortalite nedenidir. Bu retrospektif çalışmanın amacı Ekim 1994- Temmuz 1999 tarihleri arasında Van Tıp Fakültesi Genel Cerrahi Kliniğinde ameliyat edilen 113 mide kanserli olguda proksimal lokalizasyonlu mide kanseri sıklığını araştırmaktır. Mide kanseri tanısı ile ameliyat ettiğimiz, incelenen, 113 olguda proksimal mide kanseri sıklığı % 38.9 olarak bulundu.