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    Öğe
    The factors affecting mortality in complicated emergency cases who were transferred to our center after being operated on
    (2002) Akgun Y.; Yilmaz G.
    BACKGROUND: To find out the deficiencies related to education and experience of surgeons about the surgical treatment of emergency patients, and to investigate their effects on mortality. METHODS: The records of 214 patients, who were transferred to our department after being operated with the diagnosis of abdominal trauma or acute abdomen in last 7 years, were reviewed. RESULTS: Total mortality rate was 34.1%.1t was seen that 14.5% in patients who underwent efficient surgical treatment and 42.1 % in patients whose treatment was inefficient. CONCLUSION: In centre when intensive care unit does not exist, immediately transportation of emergency operated patients with high risk will decrease morbidity and mortality rates. Participation of the surgeons who deal with emergency surgery to the post graduating courses adapting their experiences to the current improvements has also importance. Key words: Abdominal trauma, acute abdomen, postoperatively transported patients, mortality, surgery training.
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    Öğe
    Intestinal and peritoneal tuberculosis: Changing trends over 10 years and a review of 80 patients
    (2005) Akgun Y.
    Background: To establish the efficiency of minimally invasive procedures in the diagnosis and management of abdominal (intestinal and peritoneal) tuberculosis (AT), I retrospectively and then prospectively evaluated clinical, physical and laboratory findings in patients with AT at a university general-surgery clinic. Diagnostic and therapeutic options were also considered. Methods: Data from the case records of 43 patients diagnosed with AT via laparotomy were collected and analyzed. On the basis of findings from that early analysis, a further 37 patients were studied prospectively. In the latter group, percutaneous aspiration, endoscopy and laparoscopy were used for diagnosis, except in cases with acute abdominal findings or failure of these diagnostic procedures. Morbidity and mortality rates and mean hospitalization time were evaluated for both groups. Results: In the early group of 43 patients, the morbidity rate was 30%; mortality, 12%; and median hospital stay, 18.3 days (standard deviation [SD] 6.2 d). The diagnosis was confirmed by laparotomy in 18 patients in the prospective group: laparoscopy or endoscopy in 10 and percutaneous drainage of an intra-abdominal abscess in 9. Changes in our approach to diagnostic procedures in the prospective group led to decreased morbidity (11%), mortality (0) and median hospital stay (9.3 [SD 4.7] d). Conclusions: Minimally invasive procedures such as laparoscopic, endoscopic and percutaneous biopsy should be used for diagnosis of IPTB as a first step in diagnosis. Laparotomy should be performed only when complications develop or diagnosis remains unclear in spite of these diagnostic modalities. © 2005 CMA Media Inc.