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    Intraperitoneal octenidindihydro-chloride-phenoxyethanol solution to prevent peritoneal adhesion formation in a rat peritonitis model
    (Wiley, 2007) Guezelsagqaltici, Nihat; Girgin, Sadullah; Gedik, Ercan; Bueyuekbayram, Hueseyin; Bac, Bilsel
    Background. Peritoneal adhesion is a common complication following abdominal surgery. Despite recent advances in diagnosis and treatment, it still presents a problem for the patients and surgeons. In the present study, we investigated the effects of octenidindihydro-chloride - phenoxyethanol (OCP) on peritoneal adhesions. Method. Rats were divided into four groups: Group 1 ( saline), Group 2 ( peritonitis plus saline), Group 3 ( OCP), and Group 4 ( peritonitis plus OCP). Peritonitis was induced in the rats of Groups 2 and 4. The abdominal cavities of the rats in Groups 1 and 2 were washed with saline, while those of the rats in Groups 3 and 4 were irrigated with 1: 10 OCP solution. Adhesion and fibrotic scores were determined by re-laparotomy after 21 days. Results. The adhesion scores in Groups 1 ( saline), 2 ( peritonitis plus saline), 3 (OCP) and 4 ( peritonitis plus OCP) were 3.30 +/- 0.94, 5.25 +/- 1.03, 1.12 +/- 0.83 and 0.28 +/- 0.48, respectively. Statistical analysis of adhesion scores revealed significant differences between groups, except between Groups 3 and 4 ( p = 0.265). Statistical analyses of grades of histopathological signs showed that Group 1 differed from Groups 2 and 4 ( p = 0.004, p = 0.003, respectively); Group 2 differed from Groups 3 and 4 ( p = 0.001, p = 0.001, respectively). On the other hand, differences between Group 3 and Groups 1 and 4 were not significant ( p = 0.06, p = 0.08, respectively). Conclusion. OCP decreased the peritoneal adhesion formation macroscopically and microscopically in the presence or absence of peritonitis. Peritoneal defects due to trauma are to be left open and OCP diluted 1: 1 should not be used intraperitoneally.
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    Management of duodenal injury: our experience and the value of tube duodenostomy
    (Turkish Assoc Trauma Emergency Surgery, 2009) Girgin, Sadullah; Gedik, Ercan; Yagmur, Yusuf; Uysal, Ersin; Bac, Bilsel
    BACKGROUND The aim of this study was to report our experience with duodenal injuries and determine if primary repair and/or tube duodenostomy are valid options for definitive operative repair of severe duodenal injuries. METHODS Sixty-seven patients who underwent surgery for duodenal injuries were evaluated. Management of duodenal injury was classified as primary repair and tube decompression. RESULTS Fifty-nine patients were injured by a penetrating mechanism, and eight were injured by blunt mechanism. The most common injury site was in the second portion of the duodenum. There were no significant differences between the two groups with respect to morbidity and mortality rate. In 35 patients without morbidity, the mean length of hospital stay was 18.53+/-1.85 days in the tube duodenostomy group and 11.45+/-1.92 days in the primary repair group, and the difference was statistically significant. In the 32 patients with morbidity, the mean length of hospital stay was 47.05+/-10.46 days in the tube duodenostomy group and 49.86+/-10.86 days in primary repair group, but there was no statistically significant difference between the groups. CONCLUSION Primary repair is suitable in the vast majority of duodenal injuries; tube duodenostomy increases the length of hospital stay and does not improve clinical outcome.
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    Patients with Benign Hematological Disease
    (Emergency Medicine Physicians Assoc Turkey, 2009) Girgin, Sadullah; Gedik, Ercan; Bac, Bilsel; Tacyildiz, Ibrahim Halil
    Background: Surgical diseases of the spleen are most hematological diseases especially in patients with a severe refractory medical treatment. In this study, 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 reviewed. Age, gender, type of hematological 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 idiopathic thrombocytopenic purpura (56.6%). The accessory spleens were encountered 26% patients during operation, and in six patients, who operated for anemia, were underwent cholesystectomy. Complication was occurred 9.56% and the most complication was atelectasia. A patient was died from postsplenectomic sepsis. Conclusion: Investigation of accessory spleens would not be missed to prevent the recurrences and in these patients anticoagulant prophylaxis never be forgotten besides vaccination, and antibiotic prophylaxis.
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    Pilonidal Sinus Disease: Risk Factors for Postoperative Complications and Recurrence
    (Int College Of Surgeons, 2012) Onder, Akin; Girgin, Sadullah; Kapan, Murat; Toker, Mehmet; Arikanoglu, Zulfu; Palanci, Yilmaz; Bac, Bilsel
    The aim of this study is to analyze the risk factors for complications and recurrence in pilonidal sinus disease. The prospective study consisted of 144 patients with pilonidal sinus disease who were operated on at Dicle University Medical Faculty, Department of General Surgery, between February 2008 and December 2010. Patients receiving the Limberg flap totaled 106 (73.6%), while 38 (26.4%) had primary closure. Postoperative complications developed in 42 subjects (29.2%), and recurrence occurred in 19 (13.2%). The Limberg flap method was statistically considered as a risk factor for postoperative complications (P = 0.039). Regarding recurrence, family tendency (P = 0.011), sinus number (P = 0.005), cavity diameter (P = 0.002), and primary closure (P = 0.001) were found to be risk factors. Postoperative complication rate is higher in the Limberg flap method than primary closure method. The risk of recurrence is related to family tendency, sinus number, cavity diameter and anesthesia type and is also higher in primary closure.
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    A Serious Medicolegal Problem After Surgery Gossypiboma
    (Lippincott Williams & Wilkins, 2012) Gumus, Metehan; Gumus, Hatice; Kapan, Murat; Onder, Akin; Tekbas, Guven; Bac, Bilsel
    After surgery, the most common foreign bodies retained in the abdominal cavity are the surgical sponges. The aim of the present study was to emphasize the importance of gossypiboma, which is a serious and medicolegal problem. The records of 12 patients with a confirmed diagnosis of gossypiboma after abdominal surgery at Dicle University Hospital were retrospectively reviewed between January 1994 and December 2009. Eight of the 12 patients were females, and 4 were males. Previously, 7 patients had been operated on electively, and 5 had undergone operations on an emergency basis. Abdominal ultrasonography clearly demonstrated gossypibomas in 5 patients, and computed tomography demonstrated a more precise image of retained surgical sponges in 3 patients. One patient died because of ventricular fibrillation; the other 11 patients were discharged in good health. To eliminate the risk of gossypibomas, all sponges should be counted at least twice (once preoperatively and once postoperatively); use of small sponges should be avoided during laparotomy, and only sponges with radiopaque markers should be used. The surgeon should explore the abdomen before closure. In cases in which the sponge count is uncertain, an abdominal x-ray should be performed before closure.