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Öğe Acute abdomen due to spilled gallstones: a diagnostic dilemma 10 years after laparoscopic cholecystectomy(Oxford University Press, 2020) Kafadar, Mehmet Tolga; Çetinkaya, İsmail; Aday, Ulaş; Başol, Ömer; Bilge, HüseyinLaparoscopic cholecystectomy (LC) carries a significant risk of gallbladder perforation and resulting scattering of bile stones into the abdominal cavity. The retrieval of the spilled stones is not always possible by laparoscopic technique. Most cases do not create long-term problems, although some cases may be complicated in future and create uncertainties regarding the correct diagnosis. Diagnosis can be difficult, and in most cases the patient may require open surgery for management of these complications. Herein, we report a case of acute abdomen due to spilled stones occurring 10 years after LC. In the first stage, definitive diagnosis could not be made with computed tomography examination. Finally, the patient was diagnosed with explorative laparotomyÖğe Cerrahi tedavi uygulanan varis-dışı ve malignite-dışı üst gastrointestinal sistem kanamalarında mortaliteyi etkileyen faktörler(Turkish Surgical Society, 2011) Önder, Akın; Kapan, Murat; Taşkesen, Fatih; Aliosmanoğlu, İbrahim; Arıkanoğlu, Zülfü; Gül, Mesut; Başol, Ömer; Aldemir, MustafaÖz:Giriş: Tedavi yöntemlerindeki ilerlemelere rağmen, üst gastrointestinal kanamaları hala ciddi bir sorundur. Bu çalışmada, endoskopik olarak durdurulamayan varis ve malignite dışı üst gastrointestinal sistem kanaması nedeniyle cerrahi uygulanan hastalarda mortaliteyi etkileyen risk faktörlerini araştırmayı amaçladık. Hastalar ve Yöntem: 1997–2010 yılları arasında endoskopik olarak durdurulamayan üst gastrointestinal sistem kanaması nedeniyle cerrahi uygulanan 74 hasta retrospektif olarak incelendi. Varis ve maligniteye bağlı kanamalar dışlandı. Bulgular: Hastaların 61'i (%82.4) erkek, 13'ü (%17.6) kadın olup, yaş ortalaması 51.8 yıldı. Başvuruda en sık şikayet melenaydı (%50). Hastaların 19'unda (%27.4) görülen kardiyovasküler hastalıklar en sık gözlenen yandaş hastalıktı. Şok bulguları 48 (%64.9) hastada görüldü. Endoskopik olarak 34 (%51.5) hastada saptanan en sık kanama şekli Forrest 1a idi. 56 (%75.7) hastada duodenal ülser saptandı. En sık uygulanan cerrahi prosedür bilateral trunkal vagotomi ve piloroplasti ile birlikte gastroduodenali arter ligasyonuydu (%70.3). Morbidite oranı %24.3 olup, akciğer komplikasyonu en sık görüleniydi. On beş (%20.3) hastada mortalite görüldü. Rockall skoru <5 olan hastalarda mortalite gözlenmezken, diğerlerinde mortalite oranı %25.4 idi. İleri yaş, erkek cinsiyet, yandaş hastalık, şok, hemoglobin değerinin düşük olması, kan transfüzyonu, Rockall skorunun yüksek olması mortalite üzerine etkili risk faktörler iydi. Sonuç: Gastroenterolog ile cerrah arasında yakın işbirliği ve erken cerrahinin varis ve malignite dışı yüksek riskli üst gastrointestinal sistem kanamalarının tedavisinde faydalı olacağını düşünmekteyiz.Öğe Comparison of local rosmarinic acid and topical dexpanthenol applications on wound healing in a rat experimental wound model(Via Medica, 2021) Küba, M. C.; Türkoǧlu, Ahmet; Oğuz, Abdullah; Tuncer, Cudi Mehmet; Kaya, Suheyla; Başol, Ömer; Bilge, Hüseyin; Tatlı, FarukBackground: The aim of the study was to compare the effects of rosmarinic acid and dexpanthenol in a rat experimental wound model. Materials and methods: Twenty-four Wistar albino rats weighing 200-250 g were randomly divided into three groups. After 2-cm full-thickness skin defects were created, the wounds were washed with sterile 0.9% NaCl solution. After washing, the control group was left untreated, the second group received 5% dexpanthenol cream, and the third group received 10% rosmarinic acid cream. Before excision, the skin was evaluated macroscopically by measuring the reduction in wound size; after excision, histological examination (epithelisation, inflammation, fibrosis, granulation) was performed. Results: Macroscopic comparison of the wound sizes showed that group 3 showed a statistically significant difference in wound size reduction compared to the other two groups. Histopathological examination showed that there was no statistically significant difference between the groups. We found that the rosmarinic acid group had greater wound size reduction than the other two groups. However, epithelialisation was detected in fewer cases. Conclusions: We believe that rosmarinic acid can be used as a topical cream for wound healing, as it leads to significant reduction in wound size, resulting in fewer scars.Öğe Comparison of the results of sleeve gastrectomy, gastric pilication and liragulitide in obese rats(2023) Bilge, Hüseyin; Başol, Ömer; Yıldızhan, Eda; Ülger, Burak Veli; Temiz, Hakan; Akkuş, Murat; Yıldızhan, I.Obesity, which is generally seen in adults, is a serious health problem. Diseases caused by obesity are among the leading causes of death worldwide. Liraglutide (LG) is an analogue of glucagon-like peptide-1, which slows gastrointestinal motility, resulting in decreased food consumption. Gastric plication (GP) and sleeve gastrectomy (SG) is the reduction of stomach volume by surgical means. We examined and compared the body mass index (BMI) changes, metabolic changes and changes in gastric histology in obese rats after LG injection with surgical methods such as SG and GP. In this research, 35 Wistar Albino female rats were used. Rats were divided into 5 groups with 7 rats in each group. Group (G) 1: The control group, fed with a normal calorie diet for 8 weeks. G 2: Sham group, G 3: SG group, G 4: GP group and G 5: LG group, fed with high-calorie feed for 4 weeks. At the end of the 4th week, the study was terminated by making appropriate interventions for the groups. When the blood glucose (BG) levels measured at the beginning, 4th week and 8th week of the experiment were evaluated, it was monitored that the BG level at the 8th week was the lowest in the LG group (p<0.05). It was observed that the preop Ghrelin and Leptin levels of the LG group were lower than those of the SG and GP groups (p<0.05). As a consequence of our metabolic investigations, we observed that the use of LG is at least as effective as SG.Öğe Comparison of topical sucralfate with dexpanthenol in rat wound model(Wiley, 2022) Yıldızhan, Eda; Ülger, Burak Veli; Akkuş, Murat; Akıncı, Dilara; Başol, ÖmerWound healing is a dynamic process initiated in response to injury. There are many factors that have detrimental effects on the wound healing process. Numerous studies have been conducted for improving wound healing processes. Dexpanthenol is widely used to accelerate wound healing. Sucralfate is used for the treatment of peptic ulcers. We aimed to compare the efficacy of topical Dexpanthenol and Sucralfate in an experimental wound model in rats via histopathological examinations and immune histochemical determinations, as well, to evaluate their effects on EGF levels. Three different groups were formed: the Control Group, the Dexpanthenol Group and the Sucralfate Group. Full-thickness skin wounds were created on the back of each rat and isotonic saline was applied to the wounds of the rats in the control group, Bepanthol(R) cream was applied in Dexpanthenol Group and 10% Sucralfate cream was applied in Sucralfate Group, once a day. On the 7th, 14th and 21st days the wounds were measured and seven rats from each group were sacrificed and the wounds were excised for histopathological examination. Sucralfate increased wound healing rates by increasing neovascularization, fibroblast activation, reepithelialization and collagen density, as well as dexpanthenol. Our study revealed that the dexpanthenol and sucralfate groups were better than the control group in terms of their effects on wound healing, however there was no statistically significant difference among these two groups. Sucralfate improves EGF expression in skin wounds and has positive results on skin wound healing comparable to dexpanthenol.Öğe The effective factors on morbidity due to penetrating small intestine injuries(2012) Böyük, Abdullah; Girgin, Sadullah; Önder, Akın; Gümüş, Metehan; Kapan, Murat; Gül, Mesut; Başol, ÖmerAmaç: Bu çalışmada penetran travmaya bağırsak ince bağırsak yaralanmalarında morbidite üzerine etkili faktörlerin araştırılması amaçlandı. Gereç ve Yöntemler: Ocak 2006-Aralık 2010 tarihleri arasında penetran ince bağırsak yaralanmasına bağlı cerrahi uygulanan 114 hasta retrospektif olarak incelendi. Bulgular: Hastaların 96’sı (%84.2) erkek, 18’i (%15.8) kadın idi. Hastaların ortalama yaşları 32.8±12.3 (15-77) yıldı. En sık etiyolojik neden ateşli silah yaralanmasıydı (%66.7). Hastaların 51’inde (%44.7) izole ince bağırsak yaralanması, 63’ünde (%55.3) ince bağırsakla beraber intraabdominal yandaş organ yaralanması mevcuttu. Yandaş organ olarak en sık kolon yaralanmasının (%66.7) ettiği belirlendi. Hastalara en sık olarak 68’ine (%59.7) primer sutür uygulandı. Hastaların 30’unda (%26.3) morbidite gelişti. En sık görülen komplikasyon yara yeri enfeksiyonuydu. Yandaş organ yaralanmalarının eşlik ettiği ince bağırsak yaralanmalarında morbidite anlamlı olarak artmaktaydı (p=0.006). Kolon yaralanması (p=0.002) mevcut olanlar ile peritonit bulguları (p=0.048) nedeniyle opere edilen hastalarda morbidite anlamlı olarak daha yüksekti. Mortalite gelişimi üzerine kan tranfüzyon miktarı etkiliydi (p<0.001). Hastaların ortalama yatış süreleri 6.9±2.9 (1-21) gün olup, morbidite gelişen grupta anlamlı olarak uzundu. (p=0.002). Mortalite hastalarımızın 6’sında ilk 24 saat içinde hemorajiye ve 1’inde anastomoz kaçağına bağlı sepsis nedeniyle görüldü. Sonuç: İnce bağırsak yaralanmalarında özellikle kolon ve beraberinde intraabdominal diğer organ yaralanmalarının eşlik etmesi postoperatif morbidite anlamlı olarak arttırmaktadır. (JAEM 2012; 11: 204-7)Öğe Median arcuate ligament (Dunbar) syndrome: Laparoscopic management and clinical outcomes of a single centre(Wolters Kluwer Medknow Publications, 2021) Kafadar, Mehmet Tolga; Oğuz, Abdullah; Aday, Ulaş; Bilge, Hüseyin; Başol, ÖmerBackground: Median arcuate ligament syndrome (MALS) is a condition characterised by chronic abdominal symptoms associated with median arcuate ligament (MAL) compression of the coeliac artery. Aim: In this observational study, we aimed to evaluate the outcomes of laparoscopic treatment in patients with MALS. Materials and Methods: The data of ten patients with MALS who were subjected to laparoscopic sectioning of the MAL were retrospectively reviewed. The following data were evaluated: age, gender, clinical and diagnostic test findings, American Society of Anaesthesiologists score, operative findings and complications and mortality, hospital stay duration and hospital readmission. The diagnosis of MALS was established by computed tomography (CT) angiography. Results: Six (60%) of ten patients with MALS were female and four (40%) were male. The mean age was 42.4 +/- 12.3. The main symptoms were epigastric pain (100%) and weight loss (60%). CT angiography showed high-grade stenosis of the anterior wall of the proximal coeliac trunk and post-stenotic dilation caused by extrinsic compression of the MAL. Surgical procedure was uneventful in all patients. Operating time was 155.5 min (120-200) and intra-operative blood loss was 150 ml (100-250). Length of stay was 3.1 day (2-9), with no mortality. The post-operative complications developed in two female patients. One of them developed ileus and the other patient developed pulmonary thromboembolism. At 6-month follow-up, all patients were asymptomatic. Conclusion: Laparoscopic decompression is an effective treatment for MALS and can provide symptomatic relief. This method may be the preferred modality of treatment in view of its lack of morbidity and good results.Öğe Perineal and abdominal approaches in the surgical treatment of rectal prolapse: Our 10-year clinical experience(İstanbul Bağcılar Eğitim ve Araştırma Hastanesi, 2021) Başol, Ömer; Bilge, Hüseyin; Akpulat, Faik Veysel; Yaman, Gizem; Oğuz, AbdullahObjective: Rectal prolapse is a rare condition characterized by protrusion of the rectum with all its layers from the anus. It is a disease that causes social and functional problems. In this study, it was aimed to investigate the abdominal and perineal approaches together with postoperative early and late results in our patients who underwent surgical treatment for rectal prolapse. Method: The records of 39 patients who were operated on with the diagnosis of rectal prolapse between 2010 and 2020 in the Department of General Surgery, Dicle University Faculty of Medicine were evaluated retrospectively. Demographic and physical examination findings of the patients, surgical methods applied, early and late postoperative complications, recurrence and mortality rates were recorded. Results: The most common complaints on admission to the hospital were gas control disorder, difficulty in defecating and getting wet with mucus. On physical examination, stage 1 rectal prolapse was found in 12.8% of the patients, and full-thickness prolapse was found in the other patients. The mean age of 39 patients included in the study was 36 (14- 88) years. Of the patients included in the study, 14 (35.9%) were female and 25 (64.1%) were male. Surgery was performed with an abdominal and perineal approach in 53.8% of the patients, while laparoscopy was performed in 46.2%. The most frequently used abdominal surgical technique was Notaras (35.8%). The most common perineal approach technique was Altemeier (5.1%). Patients who underwent the perineal approach were older and had a shorter hospital stay, and it was often performed under regional anesthesia. Complications developed in the early postoperative period in 10.4% of the patients. The median hospital stay was 5 days (2-19) and the follow-up period was 13 months (9-19). Postoperative mortality did not occur in any of the patients. Hospital stay was significantly shorter in patients who underwent laparoscopic surgery. There was no statistical difference in terms of early postoperative complications and recurrence. Conclusion: Although more than a hundred surgical procedures have been described to date for the treatment of rectal prolapse, the ideal treatment method is still unclear. In terms of surgical treatment, the results of abdominal or perineal approaches to be applied are similar, considering the risk factors, patient findings and surgeon’s experience.Öğe Pneumatosis cystoides intestinalis: Clinical experience in a single center(TIP ARASTIRMALARI DERNEGI, 2012) Önder, Akın; Kapan, Murat; Önder, Hakan; Taşkesen, Fatih; Gül, Mesut; Aliosmanoğlu, İbrahim; Başol, Ömer; Taş, İlhanThe purpose of the present study was to examine deeply the treatment strategies implemented in four patients diagnosed with pneumatosis cystodes intestinalis and their results. Medical records of four patients who had been treated at the diagnosis of pneumatosis cystoides intestinalis between January 2006 and November 2011 were investigated retrospectively. Three (75%) of the patients were male and 1 (25%) female, with the average age of 47.3±19.3 (21-66) years. Pain in abdomen was the first symptom complained by all four patients on admission. While the findings consistent with the peritonitis were revealed during physical examination in three of the cases, abdominal tenderness was detected in one patient. Of all the cases, 2 were accepted as the primary cases due to unknown etiology, while chronic obstructive pulmonary disease and peptic ulcer were held responsible in the etiology, thus assigning these cases in the secondary pneumatosis cystoides intestinalis group. Plain abdominal x-ray images acquired in all patients revealed subdiaphragmatic free gas collection; moreover, free fluid collection within the abdomen was recognized ultrasonographically in 3 patients. The diagnosis of pneumatosis cystoides intestinalis was established through abdominal computed tomography in the patient followed up under conservative treatment. Mortality and complications occurred in none of the patients. Should the physical examination findings associated with the peritonitis be obscured by subdiafragmatic free gas, such a patient may be erroneously followed up under conservative treatment. Implementation of a surgical strategy should not be deferred in case of acute abdomen.Öğe Prognostic significance of pretreatment serum lactate dehydrogenase-to-albumin ratio in gastric cancer(Termedia Publishing House Ltd., 2020) Aday, Ulaş; Tatlı, Faruk; Akpulat, Faik V.; İnan, Mazlum; Kafadar, Mehmet Tolga; Bilge, Hüseyin; Başol, Ömer; Oǧuz, AbdullahAim of the study: To investigate the prognostic role of lactate dehydrogenase-to-albumin ratio (LAR) in gastric cancer patients undergoing curative resection. Material and methods: A retrospective study was conducted including resectable gastric cancer patients. According to the time-dependent receiver operating characteristics (ROC) analysis, the optimal threshold for pretreatment LAR was 5.5. The Kaplan-Meier method, Cox regression univariate and multivariate analyses were used to analyze the prognostic factors for disease-free survival and overall survival (OS). Results: The study cohort consisted of 81 patients, mean age was 60.2 ±13.8 (range, 29-87) years and 55 (67.9%) were male. The median OS time was 34.8 and 45 months in patients with LAR ≥ 5.5 (n = 50) and LAR < 5.5 (n = 31), respectively. Kaplan-Meier curves showed that with the increase in LAR there was reduced survival, but it was not statistically significant (p = 0.278). Multivariate analyses revealed that the positive lymph node ratio above 20% was an independent predictor in resectable gastric cancer patients (OR = 6.281, 95% CI: 1.135-34.767, p = 0.035). Conclusions: With the increase in LAR survival in gastric cancer decreased, but it was not statistically significant. Studies involving a large patient series are needed.Öğe The prognostic significance of serum lactate dehydrogenase to albumin ratio in pancreatic ductal adenocarcinoma(Hacettepe University Faculty of Medicine, 2023) Bilge, Hüseyin; Başol, Ömer; Demir, Baran; Oğuz, AbdullahObjective: This study was performed to investigate the prognostic role of lactate dehydrogenase/albumin ratio (LAR) and pancreatic ductal adenocarcinoma (PDAC) with initial curable resection treatment. Materials and Methods: This retrospective study was conducted with the data of patients with resectable PDAC. The (ROC) analysis showed that the optimal sill value for pretreatment LAR was 91.43 and this threshold value was used in other analyses. Univariate and multivariate analyses were performed to determine the prognostic factors for overall survival (OS). Results: Our study consisted of 70 patients with a mean age of 59.5±13.2 years and 37 (52,9%) women. OS was 50 months in LAR <91.43 (n = 32) patients and 27,7 months in LAR≥91.43 (n=38) patients, respectively. Kaplan–Meier curves showed that LAR≥91.43 was significantly associated with worse OS (p=0.029). Multivariate analyses proved that LAR was an independent predictor in resectable PDAC patients (p=0.017). Conclusion: Our results showed that a high pre-treatment LAR level was a unfavorable prognosticator in PDAC patients undergoing curative resection. LAR has the potential to be a prognostic biomarker in clinical practice.Öğe Protective effect of taxifolin in the prevention of cardiac tissue damage in liver ischemia and reperfusion injury: Experimental study(Merthan Tunay, 2023) Bilge, Hüseyin; Yıldızhan, İbrahim; Ülger, Burak Veli; Aday, Ulaş; Başol, Ömer; Çiçekçi, Kadriye; Yıldızhan, EdaAim: Liver ischemia and reperfusion (I/R) is a serious, irreversible health problem in clinical practice. Taxifolin (Tax) is an easy to obtain and use agent found in maritime pine bark, Douglas fir bark and Siberian larch wood. In this study, we examined the protective efficacy of Taxifolin in the correction of cardiac tissue damage that may develop in liver I/R damage. Methods: In our study, a total of 28 Wistar Albino rats, 8-10 weeks old, weighing 250-300 grams, were used. Group 1 (n=7): control group, Group 2 (n=7): Tax group with 50 mg/kg dose orally for 3 weeks, Group 3 (n=7): Liver I/R group for 30 minutes ischemia and 120 minutes of reperfusion were performed. Group 4 (n=7): Tax+Liver I/R group. Results: In our study, MDA analysis was performed to evaluate oxidative stress. In the statistical analysis of MDA values, we observed that there was a statistically significant difference between the serum MDA values of the Tax group and the Tax+Liver I/R group, and the MDA level of the Tax group was lower (p<0.05). In myocyte damage scoring, we observed that the liver I/R group had the highest damage score, while the damage score of the Tax+Liver I/R group was significantly lower than the I/R group (p<0.05). Conclusion: As a result of our study, we observed that there was an increase in serum MDA levels as a result of liver I/R and histopathological changes occurred in the heart tissue. However, Taxifolin has been successful in ameliorating this situation.Öğe Relaparatomilerde mortaliteye etkili prediktif faktörler(2015) Başol, ÖmerAmaç: Relaparatomilerde mortaliteye etkili prediktif faktörleri incelemektir. Materyal metod: Dicle Üniversitesi Tıp Fakültesi Hastanesi Genel Cerrahi Kliniğinde Ocak 2000-Aralık 2011 tarihleri arasında abdominal cerrahi geçiren ve relaparatomi yapılan 236 hastanın dosyaları hastane arşivlerinden tarandı. Hastalarda incelenen parametreler; yaş, cinsiyet, mevcut sistemik hastalıklar, ilk operasyonda hangi sisteme yönelik cerrahi yapıldığı, hangi şartlarda gerçekleştirildiği (acil/elektif), ilk operasyondan itibaren hastaya kan transfüzyonu yapılıp-yapılmadığı ve ilk operasyon ile relaparatomi arasında geçen süre, ilk operasyon zamanı (gece/gündüz), hastanede kalış süresi, yoğun bakımda kalış süresi, Preoperatif Albumin, Platelet, Lökosit, Hemoglobin değerleri, Ortalama Trombosit Hacmi (MPV) değeri, Glasgow koma skoru, şok varlığı idi. Bulgular: Relaparatomi yapılan 236 hastanın 165’i (%69.9) erkek iken, 71’i (%30.1) kadın idi. Yaş ortalaması 55.5±17.22 (15-89) idi. 231 (%97.8) hastaya erken dönemde (ilk operasyondan sonraki ilk 21 gün içerisinde) relaparatomi yapılmışken, 5 (%2.2) hastaya geç dönemde (21. günden sonra) relaparatomi yapıldı. Relaparatomi yapılan hastaların ortalama mortalite oranı %15.25 (36/236) idi. Erken dönemde relaparatomi yapılan hastalarda mortalite oranı %13.8 (32/231) iken, geç dönemde relaparatomi yapılan hastalarda mortalite %80.0 (4/5) idi. Relaparatomi yapılan 50 yaş üstü 24 hastada mortalite oranı %66.6 (24/36) iken, 50 yaş altındaki 12 hastada mortalite oranı %6.0 (12/200) idi. APACHE II skorunun 20’ nin üzerinde olması, MPV değerinin yüksek oluşu, şok varlığı, ilk operasyon zamanı, relaparatomi sayısı, kan transfüzyonu ve ilk operasyon süresi mortalite üzerine etkili prediktif faktörler olarak belirlendi. Sonuç: Relaparatomilerde karar verme, zamanlama, perioperatif hazırlık, relaparatomi sayısı, kan transfüzyonu ve ilk operasyon süresi mortaliteye etkisi açısından önemlidir. Anahtar kelimeler: Relaparatomi, mortalite.Öğe Tek lobda lokalize adenoma bağlı sekonder hiperparatiroidizmde sedasyon ve lokal anestezi ile paratiroidektomi(2012) Kapan, Murat; Önder, Akın; Aliosmanoğlu, İbrahim; Arıkanoğlu, Zülfü; Başol, Ömer; Gül, Mesut; Girgin, SadullahAmaç: Son dönem böbrek yetmezliğine bağlı gelişen sekonder hiperparatiroidizm ciddi bir komplikasyondur. Bu çalışmada tek lobda lokalize sekonder hiperparatiroidizmli hastalarda sedasyon ve lokal anestezi altında paratiroidektomi yönteminin teknik detaylarının, patolojik ve takip sonuçlarının değerlendirilmesi amaçlandı. Gereç ve yöntem: 2007 2011 tarihleri arasında lokal anestezi ve sedasyon altında paratiroidektomi uygulanan sekonder hiperparatiroidizm tanılı 10 hasta retrospektif incelendi. Bulgular: Hastaların 7 (%70)si kadın ve 3 (%30)'ü erkek olup, yaş ortalaması 48.5±10.8 (30-62) yıl idi. Sekonder hiperparatiroidizme yol açan patolojiler tek lobda lokalize idi. Hastaların %40ında sık lokalizasyon sağ alt lobdaydı. Hastalarda en sık klinik bulgu kas güçsüzlüğü idi (%90 oranında). Preoperatif dönemde parathormon, kalsiyum, fosfor ve alkalen fosfataz değerleri yüksek idi. Postoperatif 24. saatte laboratuar tetkiklerinde bir hasta hariç paratiroid hormonu arzu edilen değerlere geldi. Hastaların 7sinde (%70) ameliyat sonrası dönemde hipokalsemi gelişti. Preoperatif dönemde boyun ultrasonografi ve paratiroid sintigrafi ile paratiroid patolojisini saptama oranı %100 idi. Hastaların ortalama ameliyat süresi 25.3 ±12.5 (15-39) dakika ve hastanede ortalama yatış süreleri 1.1 ±0.3 (1-2) gün idi. Postoperatif dönemde bir hastada hemorajiye bağlı hematom gelişti ve hematom drene edildi. Hiçbir hastada postoperatif dönemde rekürrens sinir zedelenmesi gözlenmedi. Hastalar medyan 17 (4-48) ay takip edildi. Bu süre zarfında hastaların 2sinde (%20) nüks gelişti. Sonuç: Tek lobda lokalize sekonder paratiroid adenomlarının tedavisinde sedasyon ve lokal anestezi altında paratiroidektomi; güvenli, nispeten az travmatik, hastanede kalış süresini kısaltan ve bu nedenlerle uygulanabilir bir girişimdir.Öğe Üremik koagülopatiye bağlı spontan dalak rüptürü(2012) Kapan, Murat; Girdin, Sadullah; Önder, Akın; Tekbaş, Güven; Başol, ÖmerÜremik koagülopatili hastalarda spontan dalak rüptürünadir karşılaşılan, önemli bir klinik antitedir. Travmaöyküsü olmadığından, hastalık göz ardı edilebilir veyatanısı gecikebilir. Bu çalışmada sol üst karın ağrısı, hal sizlik ve idrar miktarında azalma şikâyetleriyle nefrolojikliniğine başvuran ve üremi tanısıyla hastaneye yatırılan77 yaşında erkek hasta sunulmuştur. Gözlem altınday ken karın ağrısının devam etmesi nedeniyle abdominalultrasonografi çekildi ve dalakta hematom tespit edildi.Kliniğimize sevk edilen hastaya konservatif tedavi uygu landı ve 10. gün şifa ile taburcu edildi.
