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Öğe Factors affecting morbidity and mortality in gangrenous cholecystitis(Acta Medical Belgica, 2006) Girgin, S.; Gedik, E.; Tacyildiz, I. H.; Akguen, Y.; Bac, B.; Uysal, E.Introduction : Gangrenous cholecystitis is a serious complication of acute cholecystitis. Male gender, older age, leukocytosis, cardio-vascular diseases and diabetes were reported as factors that increase the risk of gangrenous cholecystitis. The aim our study was to determine variables affecting morbidity and mortality as well as to define the independent risk factors in Gangrenous Cholecystitis. Methods : Fifty three patients who had been treated for Gangrenous Cholecystitis were reviewed. The variables are defined as follows : age, gender, systemic diseases, Mannheim Peritonitis index, aspartate aminotransferase, alanine aminotransferase, white blood cell count and type of surgery. In order to determine the independent risk factors that might affect morbidity and mortality in Gangrenous Cholecystitis, we made use of multivariate logistic regression analysis. Results : The independent risk factors affecting on morbidity were age (P = 0.037), existing systemic disease (P 0.047) and >= 29 Mannheim Peritonitis index (P = 0.008), and the independent risk factors affecting on mortality were age (P = 0.046), white blood cell count (P = 0.035). Pre-operative and post-operative third day aspartate aminotransferase and alanine aminotransferase average values were compared, there was a significant difference (P < 0.0001, P < 0.0001 respectively). Conclusions : We found that older age, >= 29 Mannheim Peritonitis index and existence of systemic diseases were independent risk factors affecting morbidity. Older age and lower of white blood cell count were independent risk factors affecting mortality. We believe that further comprehensive studies, involving prospective, multi-center and a large number of patients, are needed.Öğe The Independent Risk Factors of Mortality and Morbidity from upper Gastrointestinal System Haemorrhages after Surgery(Acta Medical Belgica, 2009) Kafadar, T.; Gedik, E.; Girgin, S.; Tacyildiz, I. H.; Bac, B.Background : The aim this study was to determine the variables influencing the morbidity and mortality of operated patients with upper gastrointestinal haemorrhage (UGIH) and to define the independent risk factors. Patients and methods : The medical records of 62 patients with upper gastrointestinal haemorrhage who underwent operation were reviewed for variables including age, gender, shock, association with co-morbidity, pulse rate, haemoglobin levels, white blood cell count. serum urea, creatinine, sodium and potassium level. time of operation, blood transfusion unit, Rock all risk score and the length of hospital stay. In order to determine the independent risk factors related to mortality and morbidity, we carried out logistic regression analysis. Results : Morbidity and mortality rates were 35.4% (22 patients) and 29 1% (18 patients), respectively. The independent risk factors affecting morbidity were. serum albumin level and Rockall score >= 5. and the independent risk factors affecting mortality were advanced age. and high Rockall score. Conclusion : To decrease the postoperative morbidity and mortality rates in patients with UGIH requiring surgery, their pre-operative risk factors should be demonstrated. We believe that the establishment of interventional indication on time and the evaluation of the intra-operative surgical region and technique in combination with the patient- and disease-related factors would help reduce morbidity and mortality rates.Öğe Our Clinical Outcome: Patients With Benign Hematological Disease(Emergency Medicine Physicians Assoc Turkey, 2008) Girgin, S.; Gedik, E.; Bac, B.; Tacyildiz, H. I.Background: Surgical diseases of the spleen are most hematological diseases especially in patients with a severe refractory medical treatment. In this tstudy, we assessed our clinical experience patients with benign hematological disease clinical outcome of the disease processes requiring splenectomy. Materials-Methods: A retrospective review of the 115 patients who had undergone splenectomy for hematological diseases was reveiwed. Age, gender, type of hematolojik disease, presence of accessory spleens and location, duration operation, Number of unit blood transfusion, length of hospital stay, long-term outcomes, morbidity and mortality were evaluated. Results: The mean age was 41.08 +/- 17.90 and, there were 67.8% female patients and 32.2% male patients. The most benign hematological disease which requiring splenectomy was idiopatic thrombocytopenic purpura (56.6%). The accessory spleens were encountered 26% patients during opration, and in six patients, who operated for anemia, were underwent cholesystectomy. Complicatoin was occured 9.56% and the most complication was atelectasia. A patient was dieded from postsplenectomic sepsis. Conclusion: Investigation of accessory spleens would not be missed to prevent the recurrences and in these patients anticoagulan profilaxy never be forgotten besides vaccination, and antibiotic profilaxyÖğe A review of Morgagni and Bochdalek hernias in adults(Via Medica, 2011) Gedik, E.; Tuncer, M. C.; Onat, S.; Avci, A.; Tacyildiz, I.; Bac, B.The incidence of Bochdalek and Morgagni hernias among adults is very rare. The purpose of this study was to determine retrospectively the prevalence and characteristics of adult Bochdalek and Morgagni hernias in a decade. Consequently, we demonstrated 12 patients with Bochdalek and 8 patients with Morgagni hernias. We presented plain radiography, operation images, and computed tomography findings of an adult patient with symptoms due to Bochdalek and Morgagni hernias. In surgical repair, the Morgagni hernia is best approached via laparotomy, and the Bochdalek hernia can be treated through thoracotomy or laparotomy. (Folia Morphol 2011; 70, 1: 5-12)
