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Öğe The effects of drainage on the rates of early wound complications and recurrences after Limberg flap reconstruction in patients with pilonidal disease(Springer, 2011) Kirkil, C.; Boyuk, A.; Bulbuller, N.; Aygen, E.; Karabulut, K.; Coskun, S.Background Cavity drainage has been used routinely in Limberg flap repair for pilonidal disease but there have been few controlled studies on the rationale for routine usage of drains. The aim of this study was to determine whether routine cavity drainage affects the rates of early wound complications and recurrences after rhomboid excision with Limberg flap repair for pilonidal disease. Methods Sixty patients with pilonidal disease in the sacrococcygeal region were randomized sequentially into 2 groups as drained or non-drained. All of them underwent rhomboid excision and Limberg flap reconstruction. The patients were followed up by physical examination at 2 and 4 weeks after the operation and every 6 months thereafter. Results Two patients in the drained group and 3 patients in the non-drained group were excluded from the study because of non-attendance at the follow-up physical examinations. The average length of hospital stay was 3.1 +/- A 0.9 and 3.3 +/- A 0.8 days in the drained and non-drained groups, respectively. There were 5 seromas, 2 wound dehiscences and 1 hematoma in the non-drained group, while 3 seromas and 2 wound dehiscences developed in the drained group. The complication rates of groups were similar (29.6% in the non-drained group vs. 17.8% in the drained group). Pilonidal disease recurred in 2 patients in the drained group who had wound dehiscence and in 3 patients in the non-drained group who had wound dehiscence or seroma. Conclusions Routine usage of drains for Limberg flap reconstruction in the sacrococcygeal region did not affect wound-related complications and recurrence rates.Öğe The effects of ellagic acid on the liver and remote organs' oxidative stress and structure after hepatic ischemia reperfusion injury caused by pringle maneuver in rats(Comenius Univ, 2012) Kapan, M.; Gumus, M.; Onder, A.; Firat, U.; Basarali, Kemal M.; Boyuk, A.; Aliosmanoglu, F.Introduction: We aimed to investigate the possible protective effects of ellagic acid (EA) on the liver and remote organs against the hepatic ischemia-reperfusion injury. Methods: Forty Wistar-Albino rats were divided into four groups each containing 10 rats. Group I with laparotomy only, Group II with laparatomy and ellagic acid application, Group III with hepatic ischemia-reperfusion and Group IV with hepatic ischemia-reperfusion and ellagic acid application. Hepatic ischemia was induced by pringle's manoeuvre for 30 minutes followed by 30 minutes reperfusion period. After induction of ischemia, EA was applied via oral gavage at a dose of 85 mg/kg. Blood samples were taken from the animals for biochemical analysis at 60th minute of the experiment in all groups. Simultaneously, liver, lung and kidney tissues were sampled for biochemical analyses and histopathological examinations. Results: The administration of EA reduced serum malonyldialdehid levels (p<0.05) and liver's oxidative stress index compared with the non-use EA groups (p<0.05). Although, ameliorated liver histopathological changes were seen in EA groups, these changes were not statistically significant (p>0.05). The use of EA did not exert significant protective effects against the effects of liver ischemia-reperfusion injury on the kidney and lung. Conclusion: In our experiments ellagic acid reduced the liver oxidative stress induced by ischemia-reperfusion injury. However, no significant histological improvement was found with EA. There were no significant protective effects on the remote organ injuries induced by ischemia-reperfusion (Tab. 3, Fig. 7, Ref. 37). Full Text in PDF www.elis.sk.Öğe The effects of pomegranate on bacterial translocation in rats with obstructive jaundice(Verduci Publisher, 2013) Gumus, M.; Tekin, R.; Firat, U.; Onder, A.; Kapan, M.; Boyuk, A.; Aldemir, M.BACKGROUND: Obstructive jaundice may promote bacterial overgrowth and altered intestinal barrier function, with resultant increased bacterial translocation. AIMS: This study aimed to evaluate potential effects of pomegranate on bacterial translocation after bile duct ligation in rats. MATERIALS AND METHODS: Wistar albino rats were randomized into four groups. Group 1 underwent sham operation; Group 2 underwent sham operation and simultaneous treatment with pomegranate; Group 3 underwent common bile duct ligation, and Group 4 underwent common bile duct ligation and simultaneous treatment with pomegranate. After 8 days, the samples of systemic blood, liver, spleen and mesenteric lymph nodes (MLNs) were obtained under sterile conditions for microbiological culture. The segments of the ileum were removed for histopathological examination. RESULTS: Bacterial translocation significantly decreased in Group 4 compared to Group 3 (p = 0.007). The bacterial counts (Colony forming unit: CFU/g) of Group 3 were significantly higher than those of Groups 1, 2 and 4 (p < 0.05). The mean ileal villus heights in the Groups 1, 2, 3 and 4 were 480.5 +/- 20.5 mu m, 494.7 +/- 17.3 mu m, 356.3 +/- 25.7 mu m and 420.7 +/- 23.7 mu m, respectively. The mean villus height in Group 4 was higher than that of Group 3 (p = 0.010). CONCLUSIONS: Pomegranate has significant protective effects on intestinal mucosa barrier in obstructive jaundice and reduces bacterial translocation.Öğe Plasma homocysteine and liver tissue S-adenosylmethionine, S-adenosylhomocysteine status in vitamin B6-deficient rats(Verduci Publisher, 2015) Taysi, S.; Keles, M. S.; Gumustekin, K.; Akyuz, M.; Boyuk, A.; Cikman, O.; Bakan, N.OBJECTIVE: The aim of this study was to evaluate plasma homocysteine (Hcy), malondialdehyde (MDA), glutathione (GSH) levels, glutathione peroxidase (GSH-Px) and glutathione-S-transferase (GST) activities and liver tissue S-adenosylmethionine (SAM) and S-adenosylhomocysteine (SAH) levels in control and vitamin B6-deficient rats. MATERIALS AND METHODS: Thirty-two male rats with a weight of 65-75 g were used for the experiment. The rats were divided into control (n = 16) and vitamin B6-deficient groups. At the end of the experiment, the animals were anesthetized with ketamine-HCl (Ketalar, 20 mg/kg, i.p.), and the blood was collected by cardiac puncture after thoracotomy. Plasma Hcy, pyridoxal phosphate (PLP), liver SAM, SAH levels measured by an isocratic system with high performance liquid chromatography. Plasma GSHPx, GST activities and GSH, MDA levels were carried out using a spectrophotometer. RESULTS: Plasma Hcy, MDA, liver tissue SAH levels were significantly increased, whereas plasma GSH, PLP, liver tissue SAM levels, plasma GST, GSH-Px activities and SAM/SAH ratio were decreased compared to those of control group. CONCLUSIONS: Vitamin B-6 deficiency causes an increase in plasma homocysteine levels. Thus, we think that vitamin B-6 supplementation could be used for therapeutic purposes in hyperhomocysteinemia condition.Öğe Sigmoid volvulus treated by resection and primary anastomosis: urgent and elective conditions as risk factors for postoperative morbidity and mortality(Springer Heidelberg, 2012) Kapan, M.; Onder, A.; Arikanoglu, Z.; Boyuk, A.; Taskesen, F.; Gul, M.; Keles, C.Sigmoid volvulus is a major cause of intestinal obstruction. The aim of this study is to analyze urgent and elective conditions as risk factors for morbidity and mortality regarding sigmoid colon resection and primary anastomosis in patients with sigmoid volvulus. This retrospective study included 63 patients diagnosed with sigmoid volvulus, who underwent sigmoid colon resection plus primary anastomosis under urgent or elective conditions between January 1994 and December 2010. Sigmoid colon resection plus anastomosis was performed in 63 patients; 31 (49.2 %) under urgent conditions, while 32 (50.8 %) were performed electively. The mean age of the patients was 65.2 +/- A 15.2 (18-95) years. The patients consisted of 50 (79.4 %) men and 13 (20.6 %) women. There were no statistical significances between groups in terms of age, gender, associated diseases, and hospital stay. Postoperative morbidity occurred in 30.2 % of patients. The morbidity rates for the urgent group and the elective group were 35.5 and 25.0 %, respectively (p = 0.419). Wound infection, pneumonia, and evisceration were the most common postoperative complications. Wound infection was higher in the urgent group (p = 0.026). In terms of other complications, the groups were similar. Total mortality occurred in 19.4 % of the urgent group and 15.6 % of the elective group (p = 0.750). Sigmoid colon resection plus primary anastomosis-related morbidity and mortality rates were similar in patients who were operated on under urgent and elective conditions, and who maintained good general condition.Öğe Splenic injuries: factors affecting the outcome of non-operative management(Springer Heidelberg, 2012) Boyuk, A.; Gumus, M.; Onder, A.; Kapan, M.; Aliosmanoglu, I.; Taskesen, F.; Arikanoglu, Z.The aim of this study was to evaluate the outcome of non-operative management (NOM) in patients with splenic injuries and to determine the predictive factors of NOM failure. Two hundred and six patients with splenic injury were admitted between January 2005 and April 2011. Of the 206 patients with splenic injury, 47 patients met the inclusion criteria of NOM. The mechanism of injury, grade of splenic injury, other intra- and extra-abdominal injuries, systolic blood pressure on admission, hemoglobin levels, number of transfusions, Injury Severity Score (ISS), Glasgow Coma Scale score, and hospitalization period were recorded. The patients were divided into two groups: those with NOM and those in whom the failure of NOM led to laparotomy. The patients were monitored for vital signs, abdominal findings, and laboratory data. NOM was abandoned in cases of hemodynamic instability, ongoing bleeding, or development of peritonitis. Independent predictive factors of NOM failure were identified. The patients managed non-operatively were compared with the patients for whom NOM failed. NOM was successful in 40 of 47 patients. There were differences between the two groups for ISS, hemoglobin levels, need for blood transfusion, and the number of associated extra-abdominal injuries. The grade of splenic injury was determined to be an important and significant independent predictive factor for the success of NOM of splenic injuries. The grade of splenic injury is an important and significant independent predictor factor for the success of NOM. NOM is not recommended in patients with high-grade splenic injury.Öğe Surgical management of pyogenic liver abscess(Verduci Publisher, 2011) Onder, A.; Kapan, M.; Boyuk, A.; Gumus, M.; Tekbas, G.; Girgin, S.; Tacyildiz, I. H.Background and Aim: Although Pyogenic Liver Abscess (PLA) has lower mortality rate in recent years due to the broad spectrum antibiotic usage, developed imaging techniques and improved intensive care services, it is still a potentially fatal disease. The objective of this study is to examine the treatment methods and our case load with the current literature. Materials and Methods: Of 55 patients with PLA, between January 2000 and December 2009, records of 28 who received surgical drainage treatment have retrospectively been analysed. Results: Nineteen (67.9%) of the patients were male, while 9 (32.1%) were female. Average age was 41.07 (15-76). Seven (25%) had associated disease. The most common symptoms were fever and abdominal pain. Twenty three (82.1%) patients had single and 5 (17.9%) had multiple cavitary lesion. Nineteen (67.9%) patients had abscess on the right and 7 (25%) had on the left one, while 2 (7.1%) had on both lobes. All were treated surgically, because of 11 (39.3%) inappropriate localization for percutaneous treatment, 6 (21.5%) insufficient percutaneous drainage, 6 (21.5%) intraabdominal free rupture and 5 (17.7%) multiple cavitary lesion. We observed 5 pulmonary complications, 5 wound infections and 2 perihepatic collections. The average hospital stay was 11.2 days. We observed only two deaths (7.1%). Conclusions: Surgical treatment is the sole option for the patients with PLA who; (a) can't be treated by percutaneous drainage or had an unsuccessful one, (b) have multiple abscess cavity, (c) are thought to have perforated abscess, (d) have additional abdominal pathology requiring laparatomy.Öğe Unusual extraperitoneal rectal injuries: a retrospective study(Springer Heidelberg, 2012) Gumus, M.; Boyuk, A.; Kapan, M.; Onder, A.; Taskesen, F.; Aliosmanoglu, I.; Tufek, A.Rectal injuries, which are rarely encountered because of the anatomic characteristics, occur due to penetrating traumas. In the current study, we aimed to present experiences gleaned from our clinic concerning rarely encountered unusual rectal injuries, including those cases presented for the first time. Eleven patients who had been treated for unusual rectal injuries in the General Surgery Clinic of Dicle University between 2004 and 2011 were retrospectively reviewed. The reasons for rectal injuries included foreign bodies in four cases, sexual intercourse in three cases, iatrogenic injuries in two cases, electric shock in one case, and animal horns in one case. All cases had extraperitoneal rectal injuries and all injuries were grade 2 injuries, except for the electrical burn. Primary repair was adequate for the treatment of six patients. Four patients underwent primary repair and ostomy, whereas one of the patients underwent debridement and an ostomy. The patients recovered without complications, except for one patient with sphincter insufficiency. The results of the current study suggested that primary repair is adequate in the patients with low-energy injuries and early presentation, whereas an ostomy is required for those with late presentation and for those with high-energy and destructive injuries.
