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    Sigmoid colon torsion: mortality and relevant risk factors.
    (2013) Onder A.; Kapan M.; Arikanoglu Z.; Palanci Y.; Gumus M.; Aliosmanoglu I.; Aldemir M.
    Sigmoid volvulus is an important acute intestinal obstruction, leading to high mortality and requiring urgent operation. The purpose of this study is to analyze risk factors for mortality in patients that were operated on due to sigmoid volvulus at our Department. The retrospective study included 158 patients, who were operated on due to sigmoid volvulus between January 1994-December 2010, in terms of age, gender, complaints at admission, physical signs, period of symptoms before admission, associated diseases, laboratory and radiological parameters, hospital stay, morbidity, and mortality. The study consisted of 135 men (85.4%) and 23 women (14.6%), with a mean age of 62.54 years. Cardiovascular disease and respiratory disease were present in 34 (21.5%) and 42 (26.6%) patients, respectively. Urgent operation was undertaken in 125, while 33 received elective surgery. Abdominal distension and pain was evident in all the patients. Generalized tenderness was detected in 58.2%, while 70.9% had hyperactive bowel sound with tympanism. Plain radiograph revealed an impression of "omega ans" in all patients, while free air was detected in 11.4% of them. Risk factors for mortality included age (p = 0.008), delayed admission (p = 0.001), cardiovascular and respiratory diseases (p = 0.001), fluid-electrolyte imbalance (p =0.001), presence of necrosis (p = 0.001), and major contamination (p = 0.001). Wound infection and intraabdominal abscess were more common in patients that developed mortality (p = 0.001 and p = 0.002). Complications like wound infection and intraabdominal abscess are more frequent in the patients with the risk of mortality. Delayed admission results in higher risk of mortality. Mortality rates can be reduced by early admission, preoperative intensive resuscitation, suitable antibiotics, and emergent and viable surgery.  
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    Trocar-site hernias after laparoscopic cholecystectomy
    (Duzce University Medical School, 2011) Kapan M.; Önder A.; Gümüş M.; Böyük A.; Girgin S.
    Introduction: Trocar-site hernia (TH) development after laparoscopic cholecystectomy (LC) is a rare complication. In this study, we aimed to investigate the TH after LC in the light of current literature. Methods: Between January 2007 and June 2010, the records of the patients with TH in 515 patients performed LC analyzed retrospectively in terms of age, sex, location, size, performed previous operation and risk factors. Results: TH was determined in 3 (0.58%) patients among patients underwent LC. The average age was 49.67±5.77 and all of them were women. The 10-mm trocars entry site related to TH appeared at umbilical region for 2 patients and at epigastric region for patient. The average time from LC to TH formation was 18.33±10.97 months. The diameter of the hernia defects were 1.33±0.29 cm. The average of body mass index was 30.3 ± 3.1. During the LC, 2 cm in diameter gallstone in 1 patient and multiple gallstones smaller than 1 cm in the others were detected. Wound infection at the umbilical trocar region in one patient was detected after LC. Conclusion: Although the risk of TH after LC is rare, 10 mm or larger diameter trocar sites should be sutured especially in the patients including risk factors. © 2011 Düzce Medical Journal.