Browsing by Author "Dilek, ON"

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The Effect of Co2 Insufflation Rate on the Postlaparoscopic Shoulder Pain
(Mary Ann Liebert inc Publ, 1998) Berberoglu, M; Dilek, ON; Ercan, F; Kati, I; Ozmen, M
Shoulder pain (SP) is frequently mentioned in recent literature following laparoscopic operations. In the literature, many causes have been declared to explain shoulder pain after CO2 insufflation, such as direct peritoneal irritation of the CO2 gas, excessive traction of the triangular ligament, and overstretching of the diaphragmatic muscle fibers due to the high rate of insufflation, This study was planned as multicentric, and 76 patients, aged between 35 to 45, were entered into the study. They were all selected by a randomized sampling method, with equal numbers of men and women, to achieve true evaluation. The low flowrate (LFR) group was insufflated with 2.5 L/min and the high flow-rate (HFR) group with 7.5 L/min. All cases were evaluated by subjective pain classification on postoperative day 3. According to the subjective pain scale method, shoulder pain average was 23.9 +/- 3.1 in the LFR group and 55.4 +/- 6.5 in the HFR group. The difference between these groups was significant (p > 0.01), There is no significant difference for the operation time (LFR%: 64 +/- 15 minutes, HFR: 61 +/- 20 minutes, p > 0.05), Our results suggest that there is a significant statistical relation between the postoperative shoulder pain levels and increased insufflation rates. For this reason, low insufflation rate significantly reduces the shoulder pain but does not increase the operation time. Therefore, a low insufflation rate should be applied in all cases for patients' comfort and safety.
The Effect of Lymphatic Blockage on the Amount of Endotoxin in Portal Circulation, Nitric Oxide Synthesis, and the Liver in Dogs With Peritonitis
(Springer verlag, 1999) Güler, O; Ugras, S; Aydin, M; Dilek, FH; Dilek, ON; Karaayvaz, M
This study was performed to investigate the effect of lymphatic blockage on the amount of endotoxin in portal venous blood, nitric oxide synthesis, the release of aspartate aminotransferase (AST) from the liver, hepatic damage, and survival in an experimental model of dogs with peritonitis, The dogs were divided into a control group (group 1), an unligated thoracic duct peritonitis group (group 2), and a ligated thoracic duct peritonitis group (group 3), Peritoneal fluid and blood from the portal vein and femoral artery were taken for peritoneal culture, endotoxin, and AST assay, respectively, and liver biopsies were performed to assess for hepatic damage and for nitric oxide assay, There was a higher bacteria count in the peritoneal fluid from group 3 than in that from group 2 (P < 0.0001), Bacteria grew in all of the blood cultures from the group 2 animals, but growth was seen only in blood cultures from four of the group 3 animals. The levels of endotoxin, nitrite, and AST levels in group 3 were significantly increased in comparison with those in group 2 (P < 0.0001), Extensive hepatocellular necrosis,vith hemorrhage was observed in the livers of the group 3 animals, and all of them died,within 48 h, The results of this study suggest that the blockage of lymph flow has a negative effect on liver and survival in dogs with peritonitis, and that hepatic damage is directly related to the amount of endotoxin to which the liver is exposed,
Free Hydatid Cyst Only Covered With Germinative Membrane Disrupted From Fibrotic Capsule in the Peritoneal Cavity: a Case Report
(Assoc Soc Scientifique Med Belges, 1998) Arslan, H; Sakarya, ME; Bozkurt, M; Dilek, FH; Yilmaz, Y; Dilek, ON; Er, R
Echinococcosis, an endemic disease on the Asian continent, is caused by ecinococcus granulosus and rarely ecinococcus alveolaris. Although it occurs frequently in the liver and the lung, it can be localized in all tissues and organs. The purpose of this study is to report a rare localization and the complication of hydatid cyst in the pelvis : it pushed forward and upward the urine bladder and there was bilateral hydroureteronephrosis causing uraemia because of outflow obstruction. To our knowledge, a similar case has not been published before in English literature.
Herniography and Ultrasonography - a Prospective Study Comparing the Effectiveness of Laparoscopic Hernia Repair With Extraperitoneal Balloon Dissection
(Springer verlag, 1997) Dilek, ON; Bozkurt, M; Arslan, H; Kisli, E; Poyraz, N; Berberoglu, M
Background: This study was designed to assess differences between pre- and postoperative herniography and ultrasonography in inguinal hernia performed laparoscopically with balloon dissection and mesh without suture, Methods: Pre- and postoperative herniographic and ultrasonographic findings were analyzed in ten consecutive patients, Postoperative ultrasonography was performed on the 3rd and 7th days and herniography was performed on the 7th day, Results: Following the operation both the herniography and ultrasonography were almost normalized to a great extent in nine patients, Overall, minimal impaired continence was recorded by herniography in one patient. Also, we detected nonspecific soft-tissue thickening at the operation site in ultrasonographic examination in four patients, Conclusions: As for inguinal hernias, compared with other operative modalities of treatment, laparoscopic hernia repair with extraperitoneal balloon dissection and mesh without suture is a highly successful procedure and its minimal morbidity is well accepted by the patient.
Multicentric Tumor of the Esophagus and Its Clinical Significance; Case Report and Review of the Literature
(Acta Medical Belgica, 2001) Dilek, FH; Yalcinkaya, I; Dilek, ON; Akpolat, N
Simultaneous occurrence of the esophageal tumor at multiple sites in a single patient is unusual. Here in, we described a patient had three separate turnoral nodules with ulceration of the esophagus. Thorax CT scan, X-ray and endoscopy revealed the only two tumoral lesion at the lower esophagus. But, the other tumoral lesion at the upper part of the esophagus was detected at operation and histopathologic examination. The aspect of treatment was changed according to this new condition during the operation. We discussed the multicentric tumoral lesions of the esophagus in view of the literature.
Primary Leiomyosarcoma of the Breast
(Springer verlag, 1997) Ugras, S; Dilek, ON; Karaayvaz, M; Dilek, H; Peker, O; Barut, I
Sarcomas of the breast are rare, accounting for about 1% of all malignant breast tumors. Leiomyosarcoma of the breast was an almost unknown tumor until some 20 years ago, and the few previously published cases lacked detailed information. Only 11 well-documented cases of leiomyosarcoma of the breast had been reported in the literature up to February 1992. The clinical features, diagnosis, therapy, and prognosis are discussed here in the light of the previously published literature.
Protection of Intestinal Anastomoses in Septic Environment With Peritoneal Graft and Polyglycolic Acid Mesh: an Experimental Study
(Assoc Soc Scientifique Med Belges, 1996) Dilek, ON; Bakir, B; Dilek, FH; Demirel, H; Yigit, MF
We carried out an experimental study in dogs to evaluate the outcome of large bowel anastomosis with 6 stitches (Group C, n:6) in a septic environment with protection by a polyglycolic acid (PGA) mesh (Group M, n:12) or peritoneal graft (Group P, n:12). Thirty dogs were used to compare the techniques. Two dogs in each group were re-operated after 3, 5, 7, 14, 28 and 90 days. They were evaluated for adhesion formation, lumen diameter (anastomotic index), clinical features, histologic appearance and quality of healing at the anastomotic sites. All dogs in group P and group M survived, whereas 2 dogs in the control group died of anastomotic leakage and 3 dogs were re-operated for anastomotic leakage and peritonitis. In group M, one dog was reoperated because of the anastomotic leakage and two dogs were reoperated because of the anastomotic stenosis. Also, 4 anastomoses showed evidence of moderate stenosis. In group P, three anastomoses were graded as minimal stenosis. Histopathologic evaluation showed more complete epithelization, less inflammation, and less adhesion in group P than group M. We could not find any study in the literature that described and compared both techniques. We report here the results of such a study.