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    The effective risk factors on mortality in patients undergoing damage control surgery
    (Verduci Publisher, 2013) Kapan, M.; Onder, A.; Oguz, A.; Taskesen, F.; Aliosmanoglu, I.; Gul, M.; Tacyildiz, I.
    BACKGROUND: Damage control surgery is a life-saving procedure used in fatal injuries. Morbidity and mortality rate are high in these patients due to massive trauma. The aim of this study was to analyze the risk factors associated with mortality in abdominal traumas that underwent damage control surgery. PATIENTS AND METHODS: The retrospective study included 24 patients that underwent damage control surgery between January 2004 and September 2010. Age, gender, type of injury, period of time before admission, hemodynamic parameters, associated organ injury, injury severity score, surgical procedures performed, length of hospital stay, and complication and mortality rates were recorded. RESULTS: The study included 16 (66.7%) men and 8 (33.3%) women, with a mean age of 32.3 years. Median period of time before admission was 30.83 minutes. All the patients were present with hypothermia and acidosis at admission, while only 5 of them were hemodynamically stable. Mean 6.75 units of blood were transfused in all of them. Common etiological factors included gunshot (50%) and motor vehicle accident (25%). Hepatic injury (83.3%) was the most common organ injury. Mean injury severity score (ISS) was 28.88. Damage control surgery was performed in all the patients. Skin-only closure was applied in 17 (70.8%), while 7 (29.2%) patients received Bogota bag application. Definitive surgery was achieved through de-packing over 36-48 hours in average. Total mortality occurred in 11 (45.8%) patients. Period of time before admission, core temperature at admission, pH levels and amount of blood transfusion were statistically different in the mortality group. A total of 16 complications occurred in 10 patients. Among these, intraabdominal abscess (46.2%) was the most common. CONCLUSION: Hypothermia (< 35 degrees C), acidosis (pH < 7.2), instability related to systolic blood pressure, massive blood transfusion, and delayed admission are predictive factors for mortality.
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    The effects of curcumin on the liver and remote organs after hepatic ischemia reperfusion injury formed with Pringle manoeuvre in rats
    (Verduci Publisher, 2013) Oguz, A.; Kapan, M.; Onder, A.; Kilic, E.; Gumus, M.; Basarali, M. K.; Firat, U.
    BACKGROUND: We aimed to investigate the effects of curcumin on ischemia/reperfusion (IR) injury of the liver and distant organs resulting from liver blood flow arrest. MATERIALS AND METHODS: Totally 40 rats, divided into four groups, each included 10 rats were used. Group I as only laparatomy, Group II laparatomy and curcumin application, Group III hepatic IR; and Group IV as hepatic IR and curcumin application group. Ischemia was generated by hepatoduedonal ligament clamping for 30 minutes and then reperfusion is started. Curcumin capsules were opened and appropriate dose had been created within weighing scales. After calculations, the powder was diluted with saline. Fifteen minutes before the ischemia, curcumin was applied via oral gavage. Blood samples were taken from the animals for biochemical analysis at 60th minutes of the experiment in the first and second groups; 30 minutes after beginning reperfusion in the third and forth groups. Simultaneously, liver, lung and kidney tissues were sampled for biochemical and histopathological examinations. RESULTS: Plasma malondialdehyde levels were found to be higher (p < 0.001), but total antioxidant activity values were not different in IR group compared with IR + curcumin group (p > 0.05). Biochemical and histopathological evaluation of tissue samples revealed that there were no differences in total antioxidant activity, total oxidant activity and histopathologic scores in IR + curcumin group compared with values of IR group (p > 0.05). CONCLUSIONS: Curcumin did not reduce the effects of hepatic ischemia reperfusion injury on the liver and distant organs including kidneys and lungs significantly.
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    Factors affecting morbidity and mortality in pancreatic injuries
    (Springer Heidelberg, 2016) Bozdag, Z.; Kapan, M.; Ulger, B. V.; Turkoglu, A.; Uslukaya, O.; Oguz, A.; Aldemir, M.
    Difficulties in the detection of pancreatic damage result in morbidity and mortality in cases of pancreatic trauma. This study was performed to determine factors affecting morbidity and mortality in pancreatic trauma. The records of 33 patients who underwent surgery for pancreatic trauma between January 2004 and December 2013 were analyzed retrospectively. The types of injury were penetrating injury and blunt abdominal trauma in 75.8 and 24.2 % of all cases, respectively. Injuries were classified as stage 1 in 6 cases (18.2 %), stage 2 in 18 cases (54.5 %), stage 3 in 5 cases (15.2 %), and stage 4 in 4 cases (12.1 %). The average injury severity scale (ISS) value was 25.70 +/- A 9:33. Six patients (18.2 %) had isolated pancreatic injury, 27 (81.2 %) had additional intraabdominal organ injuries and 10 patients (30.3 %) had extraabdominal organ injuries. The mean length of hospital stay was 13.24 +/- A 9 days. Various complications were observed in eight patients (24.2 %) and mortality occurred in three (9.1 %). Complications were more frequent in patients with high pancreatic damage scores (p = 0.024), additional organ injuries (p = 0.05), and blunt trauma (p = 0.026). Pancreatic injury score was associated with morbidity, while the presence of major vascular injury was associated with mortality. Complications were significantly more common in injuries with higher pancreatic damage scores, additional organ injuries, and blunt abdominal trauma. Pancreatic injury score was associated with morbidity, while the presence of major vascular injury was associated with mortality.
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    Laparoscopic salvage for malfunctioning of peritoneal dialysis catheters
    (Edizioni Minerva Medica, 2012) Taskesen, F.; Arikanoglu, Z.; Uslukaya, O.; Aliosmanoglu, I.; Oguz, A.; Guzel, A.; Tas, I.
    Aim. The aim of this study was to emphasize the efficacy of the laparoscopic surgical method performed for elimination of catheter-induced mechanical complications developing in CAPD patients. Methods. Medical records of 31 patients who had undergone CAPD catheter implantation at the Dicle University Medical Faculty Hemodialysis Unit between January 2001 and June 2012 were examined retrospectively. Double-felted spiral Tenckhoff catheters were used in all patients for peritoneal access. Results. We performed a retrospective review of 31 patients who, over an 11-year period, underwent revision of a peritoneal dialysis catheter using laparoscopy. Chronic renal failure requiring dialysis occurred in 31 patients (12 males and 19 female). Ages ranged from 13 to 77 years (mean age 35.8 years). Conclusion. As a conclusion, CAPD is currently a choice to be frequently used in patients with ESRD. In the treatment of CAPD-associated mechanical catheter complications laparoscopic method may be preferred because of patient comfort, short hospital stay, and lesser postoperative complications.