Browsing by Author "Oner, Muzaffer Onder"

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Comparison of Milligan Morgan Hemorrhoidectomy and Direct Current Electrotherapy for the Treatment of Hemorrhoidal Disease
(Discovery Publication, 2018) Bartin, Mehmet Kadir; Tekeli, Arzu Esen; Eker, Esra; Oner, Muzaffer Onder
Background: It is aimed to compare Milligan Morgan hemorrhoidectomy and direct current electrotherapy for the treatment of grade 2 and grade 3 internal hemorrhoids. Material and Methods: Patients with symptomatic grade 2 or 3 internal hemorrhoids which is refractory to medical treatment were enrolled in this retrospective study. In the galvanization group, hemorrhoidal columns were coagulated using electrotherapy by a 2mA to 16mA current probe. And the Milligan Morgan hemorrhoidectomy was applied routinely as an open surgical procedure. Operative time, postoperative pain, hospitalization duration, clinical stage was measured. Patients were followed up for 3 months for healing, late complications and the recurrence. Results: The operative time and the hospitalization duration were significantly more in Milligan Morgan group (p<0.05). The relapse occurred in 3 patients in Milligan Morgan group and in 1 patient in galvanization group. The relaps rate was statistically less in galvanization group (p<0.05). Postoperative pain scores were similar in two groups at seventh day of the surgery (p=0.326). But at the first and third day of surgery the VAS values were higher in Milligan Morgan group (p=0.032). Conclusion: Hemorrhoidal coagulation with galvanic electrotherapy reduces the operation time and hospitalization duration. Also the relaps rate and the postoperative pain which is scored by the VAS values are less in this procedure according to the Milligan Morgan open surgery. However the late complications and late postoperative pain violence may be equivalent between these two surgery types.
The Effects of Thyroid Gland Volume and Weight on Surgical Approach Selection and Anesthesia Management in Retrosternal Goiter
(Zamensalamati Publ Co, 2022) Bartm, Mehmet Kadir; Tekeli, Arzu Esen; Okut, Gokalp; Eker, Esra; Oner, Muzaffer Onder
Background: Retrosternal goiter surgery is a technically challenging procedure. Selecting the appropriate surgical approach is critical in preventing surgical and anesthesia complications. Objectives: This retrospective clinical study aimed to investigate the role of thyroid volume and weight in the development of retrosternal goiter and the importance of special anesthesia management in patients with retrosternal goiter, which is a potentially difficult airway candidate. Methods: Retrosternal goiter was detected in 125 patients through ultrasonography. Patients were divided into cervical surgery (CA) and sternotomy (ECA) groups. Volumetric measurements were performed ultrasonographically. Patients' demographics, preoperative thyroid ultrasonography features, American Society of Anesthesiologists (ASA) classifications, Mallampati classifications, intubation characteristics, perioperative and postoperative patient data, and postoperative thyroid specimen weights were recorded. Results: A total of 106 patients (32 male and 74 female) were operated on for bilateral total thyroidectomy. Total thyroidectomy was performed with CA in 98 (92.5%) patients and with ECA in 8 (7.5%) patients. Malignancy was detected in 4 (3%) of 106 operated cases. All of the malignant cases were seen in patients with a cervical approach. When the volumetric measurements of both groups were compared, the volume values were significantly higher in the ECA group (P=0.032). 67 patients were ASA I and 39 patients were ASA II. 64 patients were defined as Mallampati Class I, 36 patients as Mallampati Class II, and 6 patients as Mallampati Class III. Intubation was performed on the third attempt for 5 patients and 8 patients with Mallampati I and Mallampati II, respectively. The rate of difficult intubation was statistically significant in the ECA group (P=0.019). Conclusion: Predicting ECA requirement in the preoperative period is closely related to the preoperative volumetric analysis of the thyroid gland with three-dimensional ultrasonography. In addition, since anesthesia management is difficult in patients who need ECA, volumetric analysis has become even more critical.
The Efficacy of Transversus Abdominis Plane Block for Postoperative Analgesia in Laparoscopic Cholecystectomy Cases: a Retrospective Evaluation of 515 Patients
(Sage Publications Ltd, 2020) Tekeli, Arzu Esen; Eker, Esra; Bartin, Mehmet Kadir; Oner, Muzaffer Onder
Objective To compare patients that received intravenous (i.v.) analgesics with those that received transversus abdominis plane (TAP) block for pain relief after laparoscopic cholecystectomy. Methods This retrospective study enrolled patients that had undergone laparoscopic cholecystectomy and divided them into two groups: the i.v. analgesic group (controls; group A) and the TAP block group (group T). Data retrieved from the medical records included postoperative visual analogue scale (VAS) pain scores, duration of intensive care unit (ICU) stay, total hospital stay, additional analgesic requirements and the occurrence of nausea and vomiting. Results A total of 515 patients were included (group A,n = 247; group T,n = 268). Postoperative VAS pain scores at 0, 2, 4 and 6 h and the need for additional analgesics were significantly lower in group T than in group A. Postoperative VAS pain scores at 12 and 24 h were significantly higher in group T than in group A. Postoperative nausea and vomiting were significantly lower in group T than in group A. The rate of ICU admission in group T was significantly lower than in group A. Conclusions Effective postoperative analgesia can be achieved with TAP block and undesirable effects can be reduced.
Evaluation of the Open and Laparoscopic Appendectomy Operations With Respect To Their Effect on Serum Il-6 Levels
(Turkish Assoc Trauma Emergency Surgery, 2016) Bartin, Mehmet Kadir; Kemik, Ozgur; Caparlar, Mehmet Ali; Bostanci, Mustafa Taner; Oner, Muzaffer Onder
BACKGROUND: Postoperative serum inflammatory cytokine levels are thought to reflect the magnitude of surgical stress. Cytokine interleukin-6 (IL-6) is an early marker of systemic inflammatory response and tissue damage. This study evaluated levels of IL-6 after open and laparoscopic appendectomy to compare the degree of surgical stress associated with these procedures. METHODS: IL-6 levels were measured pre- and postoperatively in the plasma of 200 consecutive patients with a diagnosis of acute appendicitis. After preoperative randomization, 100 patients underwent open appendectomy, and 100 patients underwent laparoscopic appendectomy. RESULTS: Preoperative concentrations of IL-6 were 65.22 +/- 4.76 pg/mL in the open appendectomy group and 65.73 +/- 6.34 pg/mL in the laparoscopic appendectomy group (p=0.752). Postoperative levels were 105.28 +/- 16.14 pg/mL and 76.11 +/- 16.18 pg/mL, respectively (p<0.05). CONCLUSION: Lower postoperative serum IL-6 levels suggest that laparoscopic surgery is associated with lower degree of surgical stress. Laparoscopic appendectomy has significant advantage over open appendectomy due to more rapid postoperative recovery.