Browsing by Author "Kisli, Erol"

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Acute Pancreatitis, Bacterial Translocation, and Different Octreotide Regimens: an Experimental Study
(Springer, 2009) Gueler, Osman; Akturan, Saadet; Kisli, Erol; Dolapci, Istar; Caydere, Muzaffer; Akova, Atilla
To determine the effect of octreotide, octreotide with zinc, levamisole, and misoprostol on the bacterial translocation that develops in rats with acute pancreatitis (AP). A total of 36 rats were divided into six groups, each consisting of six rats. Only laparotomy was performed on the first group. Acute pancreatitis was performed on the second group. Octreotide was given to the third, fourth, fifth, and sixth groups. Octreotide, octreotide with zinc, levamisole, and misoprostol were given to groups III, IV, V, VI, respectively. Rats were euthanized 48 h after the occurrence of AP. Blood and mesenteric lymph node samples were collected for polymerase chain reaction (PCR). Pancreatic tissue and terminal ileum were obtained for histopathological examinations. The severity of pancreatitis and mucosal damage of the terminal ileum was higher in group II than groups I, III, IV, V, and VI, histopathologically (P < 0.05). There wasn't a significant difference with respect to OA with Zn or L or M and OA group (P > 0.05). A significant difference was found in PCR positivity in blood and mesenteric lymph node between groups I and II (P < 0.05). In AP, administering octreotide alone significantly prevented the bacterial translocation by preventing mucosal damage. The zinc, levamisole, or misoprostol with octreotide did not influence the results.
Adhesiv İnce Bağırsak Obstrüksiyonlarının Görülme Sıklığı
(2004) Güler, Osman; Söylemez, Ömer; Kisli, Erol; Kotan, Çetin; Başer, Murat; Aydın, Metin
Amaç: Abdominal cerrahi sonrası adhezyonlara bağlı gelişen ince barsak obstrüksiyon (İBO) sıklığını incelemektir. Metod: Kasım 1994 - Nisan 2000 arasında kliniğimizde abdominal cerrahi yapılan 2173 hastanın dosyaları retrospektif oiarak incelendi. Bulgular: Abdominal cerrahi yapılan 2173 olgunun 76'sında etyolojik sebep daha önce herhangi bir nedenle geçirmiş oldukları abdominal operasyona ikincil olarak gelişen adhezyonlardı.Buolguların 66'sına bridektomive 10'una ise bridcktonıi ile birlikte ilave cerrahi yapıldı- Rektosigmoid operasyonu yapılan olguların %13.86'ı, kolon operasyonu yapılanların %12.19'u, kolon dışı barsak operasyonu yapılanların %3.94'ü, diğer abdominal bölge operasyonu yapılanların %2.25'i ve apendektomi yapılanların %1.5'i adhezyonlara bağlı gelişen İBO'u nedeni ile ikinci kez öpere edildiler. Sonuç: Kliniğimizde İBO'Jarının en sık sebebi geçirilmiş operasyonlara bağlı gelişen adhezyonlar idi. Poştoperatif adhezyonların en sık sebebi ise geçirilmiş kolorektal operasyonlar idi.
Akut Apandisit Tanısında Peritoneal Aspirasyon Sitolojisinin Yeri
(2003) Özgören, Ersin; Aydın, Metin; Arslantürk, Hasan; Kisli, Erol; Bayram, İrfan; Güler, Osman
Amaç: Peritoneal aspirasyon sitolojisinin (PAS) akut apandisit tanısındaki etkinliğini araştırmaktır Gereç ve yöntem: Apendektomi uygulanan 50 olguya operasyon öncesi PAS yapıldı. Sitoloji, histopatolojik inceleme bulguları ile karşılaştırıldı. Bulgular: Klinik tanıya bağlı negatif apendektomi oranı %20 dir. PAS 32 olguda pozitif, 18 olguda negatif sonuçlandı. PAS 1+) 32 hastanın 30 (%93.75)'unda histopatolojik olarak akut apandisit, PAS (-) 18 olgunun 8 (%44.4)'inde normal apendiks saptandı. Yalancı pozitiflik %6.2, yalancı negatiflik %55.6 idi. PAS'ın duyarlılığı, özgüllüğü, pozitif öngörü ve negatif öngörü değerleri sırasıyla %,75, %80, %93.8, %44.4 ve doğruluk %76 olarak hesaplandı. Sonuç: PAS (+) sonuçlar akut apandisit tanısını güçlendirmekle birlikte, PAS (-) sonuçlar akut apandisit tanısını ekarte ettirmez.
Akut Karnın Nadir Bir Nedeni Olarak Gezici Dalak Torsiyonu: Olgu Sunumu
(2007) Kisli, Erol; Kotan, Çetin; Karaayvaz, Muammer; Kızıltan, Remzi; Lobut, Nuriye
Dalak diyaframın sol tarafında peritoneal bağlarla oldukça iyi fikse olmuş bir organdır. Henüz bilinmeyen patolojisi ile gezici dalak oldukça nadir görülen bir klinik durumdur. Gezici dalak en sık alt karı n veya pelvise yerleşir. şüphelenilmezse tanı koyabilmek zordur. Sıklıkla dalak alt karında palpe edilebilir. Nadir olgularda splenik vasküler pedikül torsiyona uğradığında semptomatik olabilir ve splenektomi yapılmalıdır. Bu yazıda, akut karna yol açmış gezici dalak torsiyonu nedeniyle splenektomi yaptığımız olgu literatür eşliğinde değerlendirilmiştir.
Batın Ön Duvarında Ekinokok Kisti: Olgu Sunumu
(2000) Sönmez, Reşit; Aydın, Metin; Güler, Osman; Arslantürk, Hasan; Ünal, Özkan; Kisli, Erol
Echinococcus granulsus parazitinin neden olduğu hastalık en sık olarak karaciğerde görülmektedir. Sistemik dolaşıma geçen parazit yumurtaları teorik olarak vücudun herhangi bir yerinde yerleşebilmesine rağmen batın duvarına yerleşim oldukça nadirdir. Bu yazıda batın duvarında saptanan bir ekinokok kisti olgusu sunulmaktadır.
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.
The Diagnostic Value of Diffusion-Weighted Magnetic Resonance Imaging in Soft Tissue Abscesses
(Elsevier Ireland Ltd, 2011) Unal, Ozkan; Koparan, Halil Ibrahim; Avcu, Serhat; Kalender, Ali Murat; Kisli, Erol
Purpose: To study the diagnostic value of diffusion-weighted imaging (DWI) in soft tissue abscesses. Materials and methods: Fifty patients were included in this study who were thought to have soft tissue abscess or cystic lesion as a result of clinical and radiological examinations. Localisations of the lesions were: 1 periorbital, 3 breast, 14 intraabdominal, and 32 intramuscular lesions. After other radiological examinations, DWI was performed. The signal intensity values of the lesions were evaluated qualitatively according to the hyperintensity on b-1000 DWI, using 1.5 T MR system. All of the lesions were aspirated after DWI, and detection of pus in the aspiration material was accepted as gold standard for the diagnosis of abscess. Results: In 38 of the 50 patients, hyperintensity was obtained on diffusion-weighted images. False-positive results were maintained in 2 of these patients, and true-positive results were maintained in 36 of them. In 11 of the 50 patients, hypointensity was visualised on diffusion-weighted images. False-negative results were maintained in 3 of these patients, and true-negative results were maintained in 8 of them. An abscess which was seen on post-contrast conventional MRI could not be seen on DWI, and this was regarded as false-negative. Conclusion: The sensitivity and specificity of diffusion-weighted images for detecting soft tissue abscesses were found to be 92% and 80%, respectively. DWI has a high diagnostic value in soft tissue abscesses, and is an important imaging modality that may be used for the differentiation of cysts and abscesses. (C) 2009 Elsevier Ireland Ltd. All rights reserved.
Effect of Dexmedetomidine Iv on the Duration of Spinal Anesthesia With Prilocaine: a Double-Blind, Prospective Study in Adult Surgical Patients
(Elsevier Science inc, 2007) Tekin, Murat; Kati, Ismail; Tomak, Yakup; Kisli, Erol
Background: The duration of spinal anesthesia with prilocaine has been poorly documented and no English-language study has been published regarding the effects of dexmedetomidine on the duration of anesthesia with spinal prilocaine. Objective: The aim of this study was to assess the effects of dexmedetomidine IV on the duration of action of prilocaine and its associated adverse events (AEs) in spinal anesthesia. Methods: In this double-blind, prospective study, patients classified as American Society of Anesthesiologists grade I to 11 who were to undergo lower abdominal, anorectal, or extremity surgery with a spinal anesthetic were assigned to I of 2 groups. All patients were administered prilocaine 2% for spinal anesthesia. Within 10 minutes after spinal anesthesia was initiated, group I received a loading dose of dexmedetomidine 1 mu g/kg IV, followed by a maintenance dose of 0.4 mu g/kg - h for 50 minutes; group 2 (control) received the same amount of physiologic saline in the same time frame. Mean arterial pressure (MAP), heart rate (HR), duration of sensory and motor blockade, and sedation scores were tracked. Patients were observed for 4.5 hours after surgery, with follow-ups occurring up to 96 hours after surgery. Results: Eighty-three patients were assessed for study inclusion, 23 of whom were excluded. Sixty patients (42 men, 18 women; mean [SD] age, 40.56 [16.861 years) were included in the study. MAP was similar in the 2 groups throughout the study. Mean (SD) HR was significantly lower in group I compared with group 2 at 20 minutes (70.43 [19.28] vs 77.63 [18.14] beats per minute, respectively; P = 0.02). The mean (SD) duration of the persistence of sensory anesthesia (ie, the time required for the maximal level of anesthesia to regress 2 dermatomes) was significantly longer in group I compared with group 2 (148.33 [21.18] vs 122.83 [18.73] minutes; P < 0.001). The mean (SD) time to complete abolishment of motor blockade was also significantly longer in group I than in group 2 (215.16 [25.10] vs; 190.83 [18.57] minutes; P < 0.001). The average sedation score in group I was significantly higher than in group 2 (P < 0.001) during anesthesia. Significantly more patients in group I required atropine than those in group 2 (9 vs 2 patients; P < 0.001) to treat bradycardia. There was no significant between-group difference in the number of patients who received ephedrine to treat hypotension. One patient in each group reported waist and back pain; 2 patients in each group reported nausea. Shivering occurred in 0 and 5 patients in groups I and 2, respectively; the between-group difference in AEs was not statistically significant. Paresthesia, postdural puncture headache, allergic reactions, total spinal anesthesia, urinary retention, or vomiting-AEs commonly associated with spinal anesthesia-were not observed or reported by either group. Conclusions: The results of this study suggest that dexmedetomidine IV significantly prolonged the duration of spinal anesthesia and provided a significantly higher level of sedation compared to placebo in this group of adult surgical patients. The treatment was generally well tolerated in all patients.
Effect of Ginkgo Biloba Extract (Egb 761) on the Healing of Left Colonic Anastomoses in Rat
(Wiley, 2007) Kisli, Erol; Ozdemir, Huelya; Kosem, Mustafa; Surer, Hatice; Ciftci, Ali; Kanter, Mehmet
Background The aim of this study was to assess the effect of Ginkgo biloba extract (EGb 761) on healing of experimental colonic anastomoses in a rat model. Methods Rats were divided into four groups: postoperative day (POD) 3 untreated control group, POD 3 EGb 761 group, POD 7 untreated control group, and POD 7 EGb 761 group. In the oral EGb 761 groups, the agent was given at 9.6 mg daily per orogastric route using a 4-F fine feeding catheter. We measured bursting pressures and hydroxyproline content and histologically examined the resected anastomoses on POD 3 and POD 7. Results The bursting pressures increased more in the EGb 761 group than in the untreated control group on POD 3, but this difference was not statistically significant. Hydroxyproline content was higher in the EGb 761 group than in the untreated control group on POD 3, and this difference was statistically significant. Anastomosis bursting pressure values and hydroxyproline contents were significantly higher in the EGb 761 group than in the untreated control group on POD 7. Histological examination showed greater fibroblastic activity in the EGb 761 group than in the untreated control group on POD 3. There was no significant difference in anastomotic polimorphonuclear leukocyte, mononuclear cells and blood vessel neodevelopment between the POD 3 groups, but there was significant difference in fibroblastic activity and blood vessel neodevelopment between the POD 7 groups. Conclusions These results showed us that EGb 761 administration resulted in enhanced stability of colonic anastomoses during the first postoperative week.
Effects of Spinal Anesthesia and Laryngeal Mask Anesthesia on Mood States During Hemorrhoidectomy
(Health Communications inc, 2007) Kisli, Erol; Agargun, M. Yucel; Tekin, Murat; Selvi, Yavuz; Karaayvaz, Muammer
The present study was undertaken to compare the effects of laryngeal mask anesthesia (LMA) and spinal anesthesia on mood states in patients undergoing hemorrhoidectomy. A total of 46 patients who underwent hemorrhoidectomy for grade III and IV hemorrhoids were included in this study. LMA with fentanyl plus propofol was given to 23 patients, and spinal anesthesia with bupivacaine was administered to 23 patients. Mood changes were assessed preoperatively and 2 h postoperatively with the Profile of Mood States (POMS), which consists of 65 questions that are designed to measure 6 identifiable mood states (tension, depression, anger, vigor, fatigue, and confusion). No significant differences were noted between the 2 groups in terms of baseline POMS global and subscale scores, except for scores regarding vigor. No significant mood changes were observed after hemorrhoidectomy in patients who were given LMA; however, an increase in total POMS score was reported in patients given spinal anesthesia. These findings suggest that mood score is affected by spinal anesthesia but not by LMA in patients who are about to undergo hemorrhoidectomy.
Foeniculum Vulgare Miller ( Rezene ) Uçucu Yağının Karbon Tetraklorürle Oluşturulmuş Karaciğer Fibrozu Üzerine Koruyucu Etkisinin Sıçanlar Üzerindeki Araştırılması
(2003) Tuncer, İlyas; Kisli, Erol; Uğraş, Serdar; Bayram, İrfan; Tunçtürk, Murat; Özbek, Hanefi
Amaç: Foeniculum vulgare Miller (rezene) uçucu yağının (RUY) sıçanlarda karbon tetraklorürle oluşturulmuş karaciğer fibrozu modelinde karaciğeri koruyucu etkisinin araştırılması. Yöntem: Yirmi dört adet albino sıçan, herbirinde sekizer adet olmak üzere üç çalışma grubuna ayrıldı. Çalışma süresince tüm gruplara haftada üç kez olmak üzere toplam 20 doz uygulama yapıldı. I. gruba (SF) intraperitoneal (i.p.) yolla 0.2 ml serum fizyolojik, II. gruba (CCL)) i.p. yolla 1.5 ml/kg CCI4-zeytin yağı (1:7) ve III. gruba (RUY) i.p. yolla 1.5 ml/kg CCl4-zeytin yağı (1:7) + p.o yolla 0.4 ml/kg RUY uygulandı. Çalışmanın sonunda intrakardiyak girişimle kan alınarak serum aspartate aminotransferase (AST), alanine aminotransferase (ALT) ve bilirubin düzeyleri ölçüldü. Her uygulamadan önce ve çalışmanın bitiminde hayvanların vücut ağırlıkları ölçülerek kaydedildi. Sıçanlar sakrifiye edilerek karaciğerleri çıkarıldı. Bulgular: Serum bilirubin düzeyleri tüm gruplar arasında anlamlı bir farklılık göstermedi. Serum AST ve ALT düzeyleri yönünden RUY ile CCl4 grubu arasında herhangi bir farklılık görülmezken (p>0.05) bu parametreler RUY ve CCl4 grubunda S-F grubuna göre oldukça anlamlı derecede yüksekti (p<0.01). Vücut ağırlığının seyri yönünden CCl4 grubunda gittikçe artan bir ağırlık artışı varken, SF grubunda bir miktar ağırlık artışı, RUY grubunda ise vücût ağırlığında bir miktar azalma gözlendi. Vücut ağırlıkları arasındaki bu farklılıklar tüm gruplar arasında anlamlı derecedeydi. Histopatolojik incelemelerde RUY'nın karaciğer üzerine koruyucu bir etkisi gözlenmedi. Sonuç: Ağızdan RUY uygulamasının deneysel karaciğer fibrozu üzerinde koruyucu bir etki gerçekleştiremediği sonucuna varıldı.
Hypertrophic Pyloric Stenosis Mr Findings
(Modestum Ltd, 2006) Arslan, Halil; Bay, Ali; Temizoz, Osman; Etlik, Omer; Koseeoglu, Burhan; Kisli, Erol
Infantile hypertrophic pyloric stenosis (IHPS) is a condition affecting young infants, in which the antropyloric portion of the stomach becomes abnormally thickened and manifests as obstruction to gastric emptying. The clinical diagnosis hinges on palpation of the thickened pylorus, or "olive." Abdominal palpation is accurate but not always successful, in such cases, radiologic examinations including US or MRI can be performed. US is the first choice of imaging modality. Unfortunately, in case of difficulty by the sonographic diagnosis of IHPS such as overlying bowel gas, MRI could be useful for the diagnosis.
Impaired Function of the Levator Ani Muscle in the Grand Multipara and Great Grand Multipara
(Tohoku Univ Medical Press, 2006) Kisli, Erol; Kisli, Mesude; Agargun, Havva; Altinokyigit, Filiz; Kamaci, Mansur; Ozman, Ekrem; Kotan, Cetin
Repeated deliveries might disturb the levator function and increase defecation disorders. In this prospective study, we determined the electric activity of the levator ani muscle (LAM) in nullipara, multipara, grand multipara, and great grand multipara (20 subjects for each group). Multiparity, grand multiparity, and great grand multiparity were defined as women having 2 - 5, 6 - 9, and 10 and over deliveries, respectively. The number of deliveries of multipara, grand multipara and great grand multipara were 4.05 +/- 1.14 (2 - 5), 7.55 +/- 1.23 (6 - 9) and 12.2 +/- 2.16 (10 - 17), respectively. All women were asked whether they had experienced constipation, fecal or urinary incontinence, and/or pelvic pain. All women were also evaluated for pelvic organ prolapse. Electromyography (EMG) of the LAM at rest and on contraction was recorded. EMG is an electrical recording of muscle activity. Constipation, incontinence and pelvic organ prolapse were encountered in multipara, grandmultipara and great grand multipara women. The LAM EMG at rest and on contraction in the nullipara was accepted as control. Both the resting and contractile activities of the LAM were as follows: nullipara > multipara > grand multipara > great grand multipara. These findings indicate that levator dysfunction and defecation disorders are increased with repeated deliveries because of pudendal and/or levator ani nerve injury and traumatic injury to the LAM occurred with the mechanical stresses of vaginal deliveries.
Kolorektal Kanserlerde Tedavi Yaklaşımlarımız
(2001) Güler, Osman; Aydın, Metin; Kisli, Erol; Başer, Murat; Özgören, Ersin; Şahin, Şevki; Aslantürk, Hasan
Kolorektal kanser insidansı Türkiye'de geniş bir coğrafi dağılım göstermektedir. Bir çok hasta ileri evrelerde saptanabilmekte ve çoğu zaman tek tip bir tedavi ile takip edilmektedir. Bu konuda kliniğimizin yaklaşımını ortaya koymak amacıyla,1994-2001 yılları arasında Y.Y.Ü Tıp Fakültesi Genel Cerrahi kliniğinde kolorektal kanser tedavi protokolüne alınmış 69 hastanın dosyaları retrospektif olarak tarandı. Seride rektal kanserli hastalar çoğunlukta idi (%30) bu hastaların 9'una abdomino-perineal rezeksiyon uygulandı, diğer hastalara tümör yerleşim yerlerine göre ve preoperatif evreleme göz önüne alınarak cerrahi rezeksiyonlar yapıldı. İnrezektabilite oranı %7 idi ve rektal kanserli hastalarda sfinkter korunabilme oranı %52 idi. Tüm kolorektal kanserli hastaların %96'sı adenokarsinomdu. Modifiye Aster -Çöller evrelemesinde evre B ve C olarak değerlendirildiler. Evre A'da hiç hasta yoktu. Ortalama takip süresi 48 ay olan hastaların bu süre içerisinde 28'inde nüks gelişti, (%40) ve 6 hasta (%0.08) uzak organ metastazlarına bağlı olarak kaybedildi. Ülkemizde kolorektal kanser hastalarının büyük bir kısmına ileri evrelerde tanı konulabilmektedir (1). Multimodalite tedavi protokollerinin uygulamaya konulması ve lokoregional ve sistemik kontrolün iyi bir biçimde sağlanabilmesi ile ileri dönemde tespit edilen hastalar içinde bir takım güçlüklerin üstesinden gelinebilir.
Matrix Metalloproteinases in Pathogenesis of Hemorrhoidal Disease
(Southeastern Surgical Congress, 2013) Kisli, Erol; Kemik, Ahu; Sumer, Aziz; Kemik, Ozgur
The aim of this study is to investigate the accuracy of serum matrix metalloproteinase (MMP) levels in an effort to find a reliable factor that may play an important role in pathogenesis of hemorrhoidal disease. Twenty control subjects and 21 Grade I, 19 Grade II, 20 Grade III, and 21 Grade IV patients with internal hemorrhoid were included in this prospective study. The mean ages of control subjects were 47.65 +/- 6.71 standard deviation (SD) years (range, 37 to 60 years). The mean age of internal Grade I, Grade II, Grade III, and Grade IV patients with internal hemorrhoid were 48.85 +/- 6.44, 47.20 +/- 6.75, 44.90 +/- 6.13, and 42.95 +/- 3.49 SD years (ranges, 38 to 58, 38 to 60, 34 to 55, and 38 to 50 years), respectively. Ten milliliters of blood was taken from all subjects. Enzymelinked immunosorbent assay (ELISA) for MMP-1, -2, -7, and -9 levels were performed using an ELISA kit (R&D Systems) following the manufacturer's instructions. There was an important difference between Grade I and Grade II groups in the serum levels of MMP-9 (P <0.01). Patients with Grade III hemorrhoidal disease had significantly higher serum levels of all MMP than patients with Grade I and Grade II hemorrhoidal disease (P < 0.001). Also, patients with Grade 4 hemorrhoidal disease had higher serum levels of MMP-7 and -9 according to Grade I, II, and III groups (P < 0.01, 0.001). High serum levels of MMP are present in patients with hemorrhoids, suggesting the possible mechanism in the pathogenesis of hemorrhoids.
Outcome of Surgical Treatment of Intestinal Perforation in Typhoid Fever
(Baishideng Publishing Group inc, 2010) Sumer, Aziz; Kemik, Ozgur; Dulger, Ahmet Cumhur; Olmez, Aydemir; Hasirci, Ismail; Kisli, Erol; Kotan, Cetin
AIM: To represent our clinical experience in the treatment of intestinal perforation arising from typhoid fever. METHODS: The records of 22 surgically-treated patients with typhoid intestinal perforation were evaluated retrospectively. RESULTS: There were 18 males and 4 females, mean age 37 years (range, 8-64 years). Presenting symptoms were fever, abdominal pain, diarrhea or constipation. Sixteen cases were subjected to segmental resection and end-to-end anastomosis, while 3 cases received 2-layered primary repair following debridement, one case with multiple perforations received 2-layered primary repair and end ileostomy, one case received segmental resection and end-to-end anastomosis followed by an end ileostomy, and one case received segmental resection and end ileostomy with mucous fistula operation. Postoperative morbidity was seen in 5 cases and mortality was found in one case. CONCLUSION: Intestinal perforation resulting from Salmonella typhi is an important health problem in Eastern and Southeastern Turkey. In management of this illness, early and appropriate surgical intervention is vital. (C) 2010 Baishideng. All rights reserved.
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.
Prevention of Wrap Disruption After Antireflux Surgery: an Experimental Study
(Nobel Ilac, 2015) Ilce, Zekeriya; Ozaydin, Ismet; Iskender, Abdulkadir; Aydin, Metin; Kisli, Erol; Genccelep, Musa
Objective: The worst complication after a fundoplication is the disruption of the fundic wrap which is the main cause of recurrent gastro-esophageal reflux. The purpose of this experimental study is to seek for an alternative technique to prevent wrap-breakdown. Material and Method: The experiments were carried out on thirty canine subjects those were randomly allocated into 3 groups for performance of a Nissen procedure. Silk sutures were used for construction of the fundic wrap in Group I, silk sutures and fibrin glue were used in Group II and only fibrin glue was used in Group III for the same purpose. Operation durations were noted as minutes. The break-down force of the fundic wrap was measured and recorded. The results were recorded as kg and statistical examinations were performed by SPSS 13.0 statistical software program. The intergroup comparisons were performed with Kruskal-Wallis and Mann-Whitney U tests. p was significant at <0.05 Results: No post-operative complications were observed and all the animals survived until the post-operative 2nd month when they were euthanized and the wrap break-down forces were determined. The break-down force was 11.2 kg in Group I, 17.3 kg in Group II, and 11.5 kg in Group III. The difference between group I and II, with group III was statistically significant (p<0.05). But group I and III was not statistically significant (p>0.05). Operation times were 47.9 in Group I, 53.2 in Group II and 28.38 minutes in Group III. Operation times were significantly longer in Group II than in Group I and III (p<0.05), and significantly shorter in Group III than in Groups I and II (p<0.05). Conclusion: We believe that, application of the fibrin glue together with the conventional suturing technique in construction of the fundoplication may prevent wrap-breakdown after the Nissen antireflux procedure.
Primary Aortoduodenal Fistula Due To a Swallowed Sewing Needle: a Rare Cause of Gastrointestinal Bleeding
(Turkish Assoc Trauma Emergency Surgery, 2007) Baser, Murat; Arslanturk, Hasan; Kisli, Erol; Arslan, Murat; Ozturk, Tuncer; Uygan, Ismail; Kotan, Cetin
A primary fistula between the abdominal aorta and the duodenum is rare and usually fatal. Atherosclerosis remains the most common etiologic factor, accounting for more than two-thirds of the cases reported. Other etiologies include carcinoma, ulcers, radiation, aortitis and foreign bodies including sewing needle, cocktail stick, open safety pin and fishbone. We report a case of a 17 year-old girl who underwent surgical treatment because of severe upper gastrointestinal bleeding which was related to an aortoduodenal fistula caused by a swallowed sewing needle. At operation, a chronic aortoduodenal fistula that contained the sewing needle was found and repaired. This is the fourth case in the literature in which a needle was found to be associated with the development of an aortoenteric fistula.
Tek İnsizyondan Laparoskopik Kolesistektomi (TİLK). Üniversitemizdeki İlk Olgu
(2010) İliklerden, Ümit Haluk; Kemik, Özgür; Kisli, Erol; Ölmez, Aydemir; Barbaros, Umut; Hasırcı, İsmail; Sumer, Aziz
Laparoskopik cerrahi bir çok karın içi organ ameliyatlarında standart tedavi haline dönüşmektedir. Son dönmelerde insizyon morbiditesini azaltmak ve daha iyi kozmetik sonuç elde etmek amacı ile port sayıları azaltılmaktadır. Tek insizyondan laparoskopik cerrahi yeni bir uygulamadır. Biz burada üniversitemizde tek insizyondan laparoskopik kolesistektomi uygulanan hastayı sunmak istedik. 65 yaşında asemptomatik safra taşı bulunan olguya Temmuz 2010 tarihinde tek insizyondan laparoskopik kolesistektomi ameliyatı uygulandı. Hasta ameliyat sonrası 1. gün sorunsuz olarak taburcu edildi. Sonuç olarak; minimal invaziv cerrahi deneyimine sahip ellerde tek insizyondan laparoskopik cerrahi uygulanabilir bir tekniktir.