Browsing by Author "Kotan, Ç"

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Bronchobiliary Fistula Due To Hydatid Disease of the Liver
(Acta Medical Belgica, 2002) Uzun, K; Özbay, B; Etlik, Ö; Kotan, Ç; Gencer, M; Sakarya, ME
As a complication of hydatid cyst disease of the liver, bronchobiliary fistula is a rare condition and manifests as bilioptysis. We report the case of a 34 year-old man with echinococcosis of the liver who developed a bronchobiliary fistula which manifested as chronic cough and bile stained sputum. A chest X-ray showed an unilateral infiltrate in the costodiaphragmatic angle. Bronchoscopy revealed bile filling the right basal bronchi. Magnetic resonance cystography revealed that the hepatic bile ducts communicated with the right basal pleural space. Percutaneous transhepatic drainage was applied. When the patient was reevaluated, the hydatid cyst had eroded into the pleural space, and a pleural effusion had developed. The condition of the patient deteriorated. Hence, surgical therapy was performed. After surgery, the condition of the patient improved. He was discharged from the hospital in good condition.
Coexistent Thyroid Pathologies and High Rate of Papillary Cancer in Patients With Primary Hyperparathyroidism
(Acta Medical Belgica, 2004) Kösem, M; Algün, E; Kotan, Ç; Harman, M; Öztürk, M
Thyroid carcinoma and benign thyroid diseases associated with primary hyperparathyroidism (PHPT) may cause difficulties in the diagnosis, localization and therapy of PHPT. In this study, we analysed coexistent thyroid pathologies in 51 patients who underwent neck exploration with a diagnosis of PHPT between 1999-2002. Five hundred thirteen patients who underwent thyroidectomy for nodular thyroid disease without a parathyroid pathology in histopathological examination served as controls. In patients with PHPT there were 43 cases (84.3%) of coexistent thyroid pathology. Nine patients (17.6%) had coexistent papillary thyroid cancer. Nine patients (17.6%) had lymphocytic thyroiditis, two (3.9%) had benign thyroid adenoma and 24 (47%) had nodular hyperplasia. In one patient (2%), there was intrathyroidal metastasis from a parathyroid cancer. One patient had coexistent lymphocytic thyroiditis and multi-focal papillary cancer. One of the two cases with thyroid adenomas was Hurthle cell type. In the control group only 28 patients (5.5%) had thyroid malignancy (27 papillary cancer and one follicular cancer). In conclusion, the coexistent thyroid pathologies are highly prevalent in patients with PHPT and pre- and intra-operative thyroid examination should be performed to avoid overlooking important thyroid pathologies.
Effects of Methylene Blue, Indigo Carmine Solution and Autologous Erythrocyte Suspension on Formation of Adhesions After Injection Into Rats
(Journals of Reproduction Fertility Ltd, 2000) Gül, A; Kotan, Ç; Dilek, I; Gül, T; Tas, A; Berktas, M
The aim of this study was to determine whether autologous erythrocyte suspension can be used as a dye for evaluation of tubal patency and whether it has any advantages over methylene blue or indigo carmine solutions. Reproductively healthy female nulliparous Wistar Albino rats (n = 30), aged 6 months, mass 165-195 g, were assigned randomly to three groups. Rats received a 1 mi i.p. injection of 5% (w/v) methylene blue solution (methylene blue group: n = 10), 5% (w/v) indigo carmine solution (indigo carmine group: n = 10) or 5% (v/v) fresh autologous erythrocyte suspension (autologous erythrocyte group: n=10). At 4 weeks after injection, a small sterile opening was made in the peritoneal cavity of each rat. The cavity was rinsed once with TCM-199 to collect macrophages. The rinsed peritoneal contents were cultured overnight to evaluate macrophage activation. The peritoneal opening was expanded for evaluation of adhesion formation. Only one rat from the autologous erythrocyte group had intra-peritoneal adhesions (score 2), whereas all rats in the methylene blue group (score 1: n = 1; score 2: n = 4; score 3: n = 4; and score 4: n = 1) and seven rats in the indigo carmine group (score 1: it = 1; score 2: n = 2; score 3: n = 3; and score 4: n = 1) had intra-abdominal adhesions. Macrophage activity was observed in the cultured peritoneal contents collected from the methylene blue and indigo carmine groups but not from the autologous erythrocyte group. Adhesion formation could be due to macrophage activation caused by methylene blue and indigo carmine solutions. These results indicate that tubal patency can be observed by laparoscopy using autologous erythrocyte suspension The results of this study are believed to be the first to indicate that a patient's own erythrocyte suspension could be used during observation of tubal patency by laparoscopy. However, further studies are required.
Noncurative Total Gastrectomy and Oesophagogastrectomy in the Treatment of Advanced Gastric Carcinoma in a Country With High Incidence
(Taylor & Francis Ltd, 2005) Kotan, Ç; Kisli, E; Sönmez, R; Cikman, O; Arslan, M; Arslanturk, H; Baser, M
The role of extensive resectional surgery, including total gastrectomy for the palliation of advanced gastric cancer is controversial. This study shows operative results with complications and mortality occurring after total gastrectomy in patients with advanced stage gastric carcinoma. The study included 83 (48 males and 35 females, median age was 54.6 +/- 11.4 years) patients who underwent palliative total gastrectomy or oesophagogastrectomy (distal oesophagectomy in continuity with total gastrectomy). The reason for nonradical treatment was a too locally advanced disease. There was no case of carcinoma without serosal extension. Only five patients were free of histological lymph node metastases. A total of 72 (86.7%) early postoperative complications, including 17 self-limited wound complications, and 21 pulmonary complications were noted. Dehiscence of the oesophagojejunal anastomosis was noted in 7 patients, 3 of whom subsequently died. A total of 8 (9.6%) patients died in the postoperative period. The mean survival period was 12.8 +/- 0.8 months for all patients. It was 18.16 +/- 2.04 months in stage IIIA patients, 13.37 +/- 0.79 months in stage IIIB, and 7.51 +/- 0.97 months in stage IV patients. Total gastrectomy is a relatively safe procedure even when performing as a palliative procedure, with acceptable mortality and low lethal complication rate, and should be considered an alternative option in palliative treatment of advanced gastric cancer.
Repair of Large Incisional Hernias With Multiple Small Relaxing Incisions Technique
(Assoc Soc Scientifique Med Belges, 2000) Kotan, Ç; Gül, A
We report our results in repairing wide incisional hernial defects without using any prosthetic synthetic material, but expanding rectus sheaths by multiple small, 8 to 10 mm, relaxing incisions. In this way, hernial defect becomes smaller and fascial flaps are sutured to each other in an overlapping manner. These relaxing incisions are filled with collagenous connective tissue, and consequently do not cause any abdominal wall weakness. This procedure was performed on 32 patients with hernial defect of 4 x 4 cm to 15 x 15 cm. Mean hospital stay was 6, 8 days. In the follow-up period ranging from 5 to 42 months, no patient presented reccurence of the hernia. Rectus diastasis occurred in one patient who had been operated five times previously. Wound complication such as infection, seroma, haematoma developed in 9 of the patients, and were successfully treated by wound drainage and administration of appropriate antibiotic therapy. The findings of this study led us to conclude that the technique can be used in the repair of incisional hernias as an alternative technique.
Simultaneous Occurrence of Papillary Intrafollicular and Microcarcinomas With Bilateral Medullary Microcarcinoma of the Thyroid in a Patient With Multiple Endocrine Neoplasia Type 2a
(Springer-verlag, 2002) Kösem, M; Kotan, Ç; Algün, E; Topal, C
We report the case of a simultaneous occurrence of papillary intrafollicular and microcarcinomas with bilateral medullary microcarcinoma of the thyroid in a patient with multiple endocrine neoplasia type 2A. The concurrent presence of two thyroid carcinomas is rare. The simultaneous occurrence of two different tumors in the same thyroid each being multifocal and smaller than 1 cm in diameter has not been previously reported in the literature. Furthermore, we define the first case of intrafollicular papillary thyroid carcinoma (carcinoma in situ).
Transverse Uterine Incision Non-Closure Versus Closure
(Elsevier Science Bv, 2000) Gül, A; Kotan, Ç; Ugras, S; Alan, M; Gül, T
This study was conducted to test the hypothesis that non-closure of all layers of the uterus during low transverse cesarean section is not associated with increased intra-operative or immediate and late postoperative complication. Eleven pregnant dogs underwent cesarean section for the evaluation of non-closure and closure of all layers of the uterus on immediate or early and late postoperative complication and the effect of suture in tissue. Statistical analysis was performed using Student's t-test for continuous variables and analysis for qualitative variables. Significance was defined as P < 0.05. The ranges of wound infection, other morbidity, and mortality were similar between the groups. The average operating time was significantly less for the non-closure group (71.00 +/- 7.11 min) than for the closure group (92.00 +/- 6.12 min; P < 0.005). Adhesion was significantly less (P < 0.001) for the non-closure group than for the closure group. The ranges of myometrial necrosis (5/5: 100% versus 0/5: 00%; P < 0.001) and fibrosis (2/5. 40% versus 0/5: 00%; P < 0.01) were significantly higher for the closure group than for the open group. It was found that non-closure of all layers of the uterus at low transverse cesarean incision had no adverse effect on immediate and late postoperative complication in dogs. Our data show that non-closure of all layers of the uterus at low transverse cesarean incision results in significantly less muscular necrosis and fibrosis than in the closure group. We suggest that non-closure and/or at least non-vigorous locking bur very simple closure of all layers of the uterus at low transverse cesarean incision may be preferential in appropriate cases. (C) 2000 Elsevier Science Ireland Ltd. All rights reserved.