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Öğe Acute biliary pancreatitis in cholecystectomised patients(Aves, 2012) Gul, Mesut; Aliosmanoglu, Ibrahim; Turkoglu, Ahmet; Ucmak, Feyzullah; Ulger, Burak Vel; Oguz, Abdullah; Uslukaya, OmerPurpose: This study aimed to investigate the treatments of patients with acute biliary pancreatitis after cholecystectomy. Materials and Methods: Twenty-two patients who were diagnosed with acute biliary pancreatitis and underwent cholecystectomy were analysed retrospectively. The patients' demographic characteristics, severity of disease, elapsed time since cholecystectomy, whether endoscopic retrograde cholangiopancreatography and endoscopic sphincterotomy were performed, surgical intervention, duration of hospital stay, and mortality were recorded. Results: The average age of the 22 patients was 60.14 +/- 16.4 (2186), and the female to male ratio was 14:8. The average elapsed time since cholecystectomy was 81.7 (6-240) months. In 18 patients, stones and mud were detected in the choledoch duct with endoscopic retrograde cholangiopancreatography, with no factors identified in 4 patients. While 14 of these 18 patients were treated successfully with stone extraction and endoscopic sphincterotomy, endoscopic retrograde cholangiopancreatography did not succeed in 4 patients. In 3 of 4 patients, in whom stones were detected but failed to be extracted, choledoch duct exploration was carried out with open surgery. Mortality developed in one patient. Average hospital stay, with the exception of the deceased patient, was 8.5 +/- 3.5 days. Conclusion: Some choledoch duct stones can remain asymptomatic for an extended period after cholecystectomy. However, some cause acute pancreatitis ending in mortality after several months or even years. Endoscopic retrograde cholangiopancreatography and endoscopic sphincterotomy are the standard methods of treatment. Patients in whom endoscopic retrograde cholangiopancreatography and endoscopic sphincterotomy have failed, can be treated with choledoch duct exploration with open surgery and laparoscopic surgery.Öğe Can Mean Platelet Volume be a New Risk Factor in Portal Venous Thrombosis?(Sage Publications Inc, 2013) Aliosmanoglu, Ibrahim; Gul, Mesut; Oguz, Abdullah; Basol, Omer; Uslukaya, Omer; Keles, CelalettinBackground: The aim of this study was to discuss the possibility of mean platelet volume (MPV) being a new risk factor in the etiology of portal venous thrombosis (PVT). Methods: Study participants were categorized into 2 different groups: group I, control group (n = 35) and group II, PVT group (n = 34). Demographic data and MPV values were recorded retrospectively. Results: No differences were determined between the 2 groups regarding hypertension, diabetes mellitus, and smoking (P > .05). The average hemoglobin levels were 10.8 +/- 2.1 in group II and 14.0 +/- 1.7 in group I (P < .001). Although the MPV levels of group II patients were 8.2 +/- 0.52, the average level in group I was determined as 7.8 +/- 0.62 (P = .012). In the performed receiver-operating characteristic (ROC) analysis, the cutoff value for patients with PVT for MPV was determined as 7.9 (area under curve: 0.674), sensitivity as 70.6%, and specificity as 65.7% (P = .013). Conclusion: The current study shows that MPV is significantly higher in patients with PVT than in the control group.Öğe Comparison of Early Clinical and Long-Term Oncological Outcomes of Laparoscopic Versus Converted Rectal Cancer Resection: A Retrospective Cohort Study(Springernature, 2024) Aday, Ulas; Akbas, Abdulkadir; Bayrak, Ferdi; Sekho, Zehra; Kozgun, Azat; Sevmis, Murat; Oguz, AbdullahAim The effects of conversion to open surgery during laparoscopic resection in rectal cancer on perioperative clinical and long-term oncological outcomes are still controversial. This study aimed to evaluate and compare the impact of conversion to laparoscopic resection for rectal cancer on perioperative and long-term oncological outcomes. Material and methods Between January 2019 and December 2023, 84 consecutive patients who underwent curative surgery for rectal cancer at a single academic center were evaluated retrospectively. Patients were classified and compared as the laparoscopic (LAP-G) and converted (CONV-G) groups. Perioperative, pathological, and long-term oncological outcomes were compared. Results Of the 84 consecutive patients included, 18 were converted to open surgery, leading to a 21.4% conversion rate. Intraoperative blood loss was higher in CONV-G (180 ml vs. 80 ml, p<0.001), but early clinical outcomes were similar in both groups. The median follow-up period was 23.5 (range 3-65) and 30.5 (range 6-61) months in the LAP-G and CONV-G, respectively, and recurrence occurred in 11 (16.7%) and 3 (16.6%) patients, respectively. Three-year overall survival was 96.9% and 89.4% (p=0.609) and 3-year disease-free survival was 92.4% and 83.3% (p=0.881) in LAP-G and CONV-G, respectively, and the results were similar. Conclusion Conversion from laparoscopic rectal resection to open surgery does not have a significant negative impact on morbidity and long-term oncological outcomes.Öğe The effects of sulforaphane on the liver and remote organ damage in hepatic ischemia-reperfusion model formed with pringle maneuver in rats(Elsevier, 2015) Oguz, Abdullah; Kapan, Murat; Kaplan, Ibrahim; Alabalik, Ulas; Ulger, Burak Veli; Uslukaya, Omer; Turkoglu, AhmetBackground: The purpose of this study was to investigate the effect of Sulforaphane on ischemia/ reperfusion (IR) injury of the liver and distant organs resulting from liver blood flow arrest. Materials and methods: Fourty Wistar rats were assigned into four groups, each included 10 rats were used. Group I as only laparatomy, Group II laparatomy and Sulforaphane application, Group III hepatic IR; and Group IV as hepatic IR and Sulforaphane application group. Animals were subjected to liver ischemia for 30 min and then reperfusion is started. 5 mg/kg Sulforaphane was applied via oral lavage 15 minutes before initiating the experimental study. 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: The administration of sulforaphane significantly reduced the serum TOA and liver TOA levels, increased the serum TAC and liver TAC levels and also decreased The OSI and liver OSI levels. In the histopathologic examination, the injury was reduced by the administration of sulforaphane. Administration of sulforaphane did not lead to any significant changes in any parameter including histopathological parameters in both the kidney and the lung. Conclusions: Sulforaphane reduced the liver oxidative stress from I/R injury. A histological injury in liver was reduced by sulforaphane administration. However, there were no significant effects of sulforaphane on the remote organ injuries induced by IR. (C) 2015 IJS Publishing Group Limited. Published by Elsevier Ltd. All rights reserved.Öğe Evaluation of predisposing factors, diagnostic and treatment methods in patients with translocation of intrauterine devices(Wiley, 2015) Agacayak, Elif; Tunc, Senem Yaman; Icen, Mehmet Sait; Oguz, Abdullah; Ozler, Ali; Turgut, Abdulkadr; Basaranoglu, SerdarAimThe purpose of this study was to evaluate the diagnostic methods, predisposing risk factors and surgical treatment options in patients with translocation of intrauterine devices (IUD). Material and MethodsDiagnosis, predisposing factors and treatment of 34 patients with translocation of IUD was evaluated in this retrospective study. ResultsComplaints of pain during insertion and history of cesarean section were present in 70.5% and 58.8% of patients, respectively. IUD-related complications were detected in 52.8% of patients. Transvaginal ultrasonography was used to detect translocation of IUD in 55.8% of cases. Laparoscopy was performed in 55.8% of patients. ConclusionThere were high rates of history of cesarean section, insertion in the puerperal period and insertion by midwives in patients with translocated IUD. These may be predisposing factors for IUD translocation. The clinician who inserts the IUD should be experienced in this area and obtain sufficient information from the pelvic examination prior to insertion of the device. Gynecological examination should be conducted for a proper diagnosis of translocation of IUD. In the event that the IUD string is not visible in the gynecological examination, transvaginal ultrasonography should be performed. If the IUD is still not visible, then abdominal radiography should be performed. As soon as diagnosis of translocation of IUD has been established, surgical treatment should be planned. First treatment of choice should be laparoscopy.Öğe An extremely rare clinical condition: isolated post-traumatic diaphragmatic injuries(Termedia Publishing House Ltd, 2012) Taskesen, Fatih; Arikanoglu, Zulfu; Onder, Akin; Gul, Mesut; Aliosmanoglu, Ibrahim; Oguz, Abdullah; Celik, FeyziAim: Isolated post-traumatic diaphragmatic injuries are observed less commonly, and the preoperative diagnosis is difficult to make. Material and methods: Thirteen patients with post-traumatic isolated diaphragmatic injury were treated in our department between January 2005 and June 2011. Age, sex, the cause, the location, the size of rupture, the severity of organ injury, the surgical materials used for repair, the associated morbidity and mortality, and the duration of hospitalization were all evaluated. Results: There were 12 male patients (92.3%) and 1 female patient (7.7%) with an overall mean age of 28.76 years (range: 15-55 years). Blunt trauma was responsible for the injuries in 4 patients (30.8%), while 9 patients (69.2%) had penetrating injuries. The diagnosis was established preoperatively in all patients (100%) via a plain chest X-ray and/or a computed tomography (CT) scan. The location of rupture was on the left side of the diaphragm in 12 patients (92.3%) and on the right side in 1 (7.7%). Isolated post-traumatic diaphragmatic rupture was repaired with interrupted nonabsorbable sutures or polypropylene mesh. Postoperative complications were observed in 2 patients (15.3%). Mortality did not occur in any of our patients. Conclusions: A meticulous physical examination and obtaining a chest X-ray should be the first steps to be taken in patients with suspicious isolated post-traumatic diaphragmatic rupture. In case of uncertainty in diagnosis, advanced modalities such as CT, ultrasonography, and magnetic resonance imaging should be utilized.Öğe Factors Affecting the Postsurgical Length of Hospital Stay in Patients with Breast Cancer(Aves, 2015) Gumus, Metehan; Satici, Omer; Ulger, Burak Veli; Oguz, Abdullah; Taskesen, Fatih; Girgin, SadullahObjective: Breast cancer is the most common malignancy and the most common cause of mortality in women worldwide. In addition to the increasing incidence of breast cancer, the length of hospital stay (LOS) after breast cancer surgery has been decreasing. Because LOS is key in determining hospital usage, the decrease in the use of hospital facilities may have implications on healthcare planning. The purpose of this study was to evaluate the factors affecting postoperative LOS in patients with breast cancer. Materials and Methods: Seventy-six in patients with breast cancer, who had been treated between July 2013 and December 2014 in the General Surgery Clinic of Dicle University, were included in the study. The demographic characteristics of the patients, treatment methods, histopathological features of the tumor, concomitant diseases, whether they underwent neoadjuvant chemotherapy or not, and the length of drain remaining time were retrospectively recorded. Results: There was a correlation between drain remaining time, totally removed lymph node, the number of metastatic lymph node, and LOS. LOS of patients treated with neoadjuvant chemotherapy was longer. The patients who underwent breast-conserving surgery had a shorter LOS. Linear regression analysis revealed that the drain remaining time and the number of metastatic lymph nodes were independent risk factors for LOS. Conclusion: Consideration should be given to cancer screening to diagnose the patients before lymph node metastasis occurs. In addition, drains should be avoided unless required and, if used, they should be removed as early as possible for shortening LOS.Öğe Factors effecting mortality in abdominal major vascular injuries(Drunpp-Sarajevo, 2012) Gul, Mesut; Aliosmanoglu, Ibrahim; Oguz, Abdullah; Ulger, Burak Veli; Turkoglu, AhmetBackground and Aim: Despite recent advancements of medical facilities and improvements in surgical techniques, traumatic abdominal major vascular injuries still has high morbidity and mortality rates. Our objective in this study is to investigate the factors effecting mortality in patients who had surgery due to abdominal major vascular injury. Methods: Seventeen patients who had emergent surgery for abdominal major vascular injury were analyzed retrospectively. Age, gender, cause of injury, existence of additional organ injuries, vascular repair technique, blood replacement, mortality and duration of hospital stay are evaluated. Results: The study group consisted of 16 male and 1 female patients. Average age was 28.4 +/- 8.3. Cause of injury was firearms for 15 patients (88.2 %), cutter for 1 patient (5.9 %) and traffic accident in vehicle for 1 patient (5.9 %). Iliac veins, iliac arteries and vena cava inferior were the most injured vessels. Elapsed time between injury and operation was 140.0 +/- 18.2 minutes for patients who have died, 97.3 +/- 16.1 minutes for the other patients (p=0.003). For patients who had additional organ injury accompanying vessel injury, mortality rate was higher (p=0.028). Four patients have died (23,5 %). Conclusion: Successful surgical results in abdominal vascular injuries depend on well knowledge of abdominal vascular anatomy, experience in vascular repair techniques, less additional organ injury and surgical intervention without delay.Öğe Fasciola hepatica infection at a University Clinic in Turkey(J Infection Developing Countries, 2014) Ulger, Burak Veli; Kapan, Murat; Boyuk, Abdullah; Uslukaya, Omer; Oguz, Abdullah; Bozdag, Zubeyir; Girgin, SadullahIntroduction: We aimed to analyze the approaches to the diagnosis and treatment of patients with fascioliasis in light of current literature. Methodology: Thirty-nine patients with fascioliasis admitted to the Surgery Clinic of Dicle Medical Faculty (Turkey) were included in this study. The demographic, clinical, diagnostic, treatment and outcome data were analyzed retrospectively. Results: Abdominal pain (n = 37; 95%) and eosinophilia (n = 31; 79%) were the most common findings. Twenty-seven patients were diagnosed by clinical and radiological findings. Patients were treated with triclabendazole. Thirty-six (92.4%) of the patients improved after medical treatment. Conclusions: The presence of typical clinical, laboratory and radiological findings is sufficient for diagnosis. Triclabendazole administration is often an effective treatment, with improvements occurring over the course of a few months.Öğe Fournier's Gangrene: A Summary of 10 Years of Clinical Experience(Int College Of Surgeons, 2015) Oguz, Abdullah; Gumus, Metehan; Turkoglu, Ahmet; Bozdag, Zubeyir; Ulger, Burak Veli; Agacayak, Elif; Boyuk, AbdullahWe aimed to present our clinical experience with FG treatment. Fournier's gangrene (FG) is a rare but serious disease characterized by progressive necrosis in the genitourinary and perineal region. The retrospective study included 43 patients. Patients were divided into 2 groups as survivors and nonsurvivors. Included in the analysis were data pertaining to demographics, predisposing factors, comorbidities, results of bacteriologic analyses, number of debridements, duration of treatment, FG Severity Index (FGSI) score, fecal diversion methods (trephine ostomy or Flexi-Seal Fecal Management System-FMS), and dressing methods (wet or negative aspiration system). In the nonsurvivor group, urea, WBC, and age were significantly higher, whereas albumin, hematocrit, platelet count, and length of hospital stay (LOHS) were significantly lower compared to the survivor group. Mean FGSI was lower in survivors in comparison with nonsurvivors (5.00 +/- 1.86 and 10.00 +/- 1.27, respectively; P < 0.001). We conclude that FGSI is an important predictor in the prognosis of FG. Vacuum-assisted closure (VAC) should be performed in compliant patients in order to enhance patient comfort by reducing pain and the number of dressings. Fecal diversion should be performed as needed, preferably by using FMS. The trephine ostomy should be the method of choice in cases where an ostomy is necessary.Öğe Gangrenous Cholecystitis: Mortality and Risk Factors(Int College Of Surgeons, 2015) Onder, Akin; Kapan, Murat; Ulger, Burak Veli; Oguz, Abdullah; Turkoglu, Ahmet; Uslukaya, OmerAs a serious complication of cholelithiasis, gangrenous cholecystitis presents greater mortality than noncomplicated cholecystitis. The aim of this study was to specify the risk factors on mortality. 107 consecutive patients who underwent surgery due to gangrenous cholecystitis between January 1997 and October 2011 were investigated retrospectively. The study included 60 (56.1%) females and 47 (43.9%) males, with a mean age of 60.7 6 16.4 (21-88) years. Cardiovascular diseases were the most frequently accompanying medical issues (24.3%). Thirty-six complications (33.6%) developed in 29 patients, and surgical site infection was proven as the most common. Longer delay time prior to hospital admission, low white blood cell count, presence of diabetes mellitus, higher blood levels of aspartate aminotransferase, alanine aminotransferase, alkaline phosphatase and total bilirubin, pericholecystic fluid in abdominal ultrasonography, and conversion from laparoscopic surgery to open surgery were identified as risk factors affecting mortality (P < 0.001, P = 0.001, P = 0.044, P = 0.005, P = 0.049, P = 0.009, P = 0.022, P = 0.011, and P = 0.004, respectively). Longer delay time prior to hospital admission and low white blood cell count were determined as independent risk factors affecting mortality.Öğe Improvement of minimally invasive parathyroidectomy outcomes by real time ultrasonography performed by a surgeon and radiologist team(Soc Romana Ultrasonografe Medicina Biologie-Srumb, 2015) Uslukaya, Omer; Gumus, Metehan; Tasdemir, Bekir; Goya, Cemil; Kilinc, Faruk; Oguz, Abdullah; Turkoglu, AhmetAims: Minimally invasive parathyroidectomy (MIP) has become the first line of treatment for primary hyperparathyroidism caused by solitary parathyroid adenoma. In order to increase the sensitivity of high-resolution ultrasonography (hUS), surgeon performed ultrasonography (SUS) has been increasingly used preoperatively. However, a radiologist and surgeon performing ultrasonography (RSUS) has not been a usual practice. In this study, we aimed to evaluate the clinical contribution of RSUS on MIP. Material and methods: From 2012 to 2014, a total of 30 consecutive patients (4 male, 26 female, mean age 48.87 +/- 14.52 years) with solitary parathyroid adenoma, were included in the study. All patients underwent preoperative hUS and Technetium-99m sestamibi scintigraphy. In patients, demographic characteristics, diagnostic tools used, levels of biochemical parameters, duration of operation, and length of hospital stay were recorded. Results: Adenomas were successfully localized by US in all patients and the surgical approach was determined according to this localization. Parathyroidectomy with MIP was successfully performed under local anesthesia in all patients. Mean operation time was 19.87 +/- 3.35 min. Postoperative PTH and calcium values were significantly decreased. All patients were discharged from the hospital in the same day. None of the patients had complications such as recurrent laryngeal nerve injury, hematoma, or injury to nearby organs. None of the patients had drains placed. Conclusions: Adenoma is well localized by US and thus, MIP can be completed under local anesthesia. US provides a very important clinical contribution to the success of MIP. In addition to these, RSUS helps in determining the location of the incision and the shortest way to achieve the lesion; therefore, it provides a small incision and shortens duration of the operation with a minimal dissection.Öğe Investigation of the effects of sildenafil on liver and remote organ in hepatic ischemia-reperfusion damage(Wolters Kluwer Medknow Publications, 2020) Cetin, Erman; Oguz, Abdullah; Basol, Omer; Bilge, HuseyinIntroduction The aim of this study was to demonstrate whether sildenafil is effective in minimizing and/or eliminating hepatic ischemia/reperfusion injury effects. For this purpose, the authors experimentally performed biochemical and histopathological examinations of the included rats using the hepatic ischemia/reperfusion model. Materials and methods The authors used 40 animals, with 10 rats in each group, in this study. Ischemia was applied 30-45min with the hepatoduodenal ligament clamping, and then reperfusion is started. The rats were grouped as follows: the first group, only laparotomy; the second group, laparotomy and sildenafil; the third group, hepatic ischemia-reperfusion; and the fourth group, hepatic ischemia-reperfusion and sildenafil. During experimental studies, sildenafil capsules were opened, and appropriate dose required for animals had been created with the weighing scales. Then, the powder was diluted with saline. The authors gave sildenafil through oral gavage 15 minutes before the ischemia. 60min after starting the experiment in 1-2 groups and 30min after beginning reperfusion in 3-4 groups (60min after beginning the experiment in all groups), blood was taken from the animals for biochemical analysis, and the animals were sacrificed. Simultaneously liver, lung, and kidney tissues were removed for biochemical and histopathological examination. Results Based on plasma evaluation, total antioxidant status was lower (P=0.0274) in ischemia/reperfusion group compared with ischemia/reperfusion+sildenafil group. However, there was no difference between the groups regarding total oxidant status values (P=0.0274). When comparing total antioxidant status and oxidative stress index in liver tissue, a statistically significant difference was observed between groups (P=0.012766 and P=0.004081), but on comparing histopathological scores, there was no difference between groups (P=0.1244). Conclusion Sildenafil partly reduced the effects of hepatic ischemia-reperfusion injury on the liver and distant organs, although this difference was not statistically significant.Öğe Is Ostomy Still Mandatory in Rectal Injuries?(Int College Of Surgeons, 2013) Ulger, Burak Veli; Turkoglu, Ahmet; Oguz, Abdullah; Uslukaya, Omer; Aliosmanoglu, Ibrahim; Gul, MesutThe aim of this study was to compare the outcomes of the treatment methods of ostomy and primary repair in rectal injuries. A total of 63 patients with rectal injury who had been treated at Dicle University Hospital between 2000 and 2011 were retrospectively reviewed. To determine the outcomes of the treatment methods, the patients were divided into 2 groups (ostomy group: patients who underwent ostomy plus primary repair; repair group: patients who only underwent primary repair) and compared. The patients included 51 men and 12 women. A total of 44 patients underwent ostomy, whereas 19 patients underwent primary repair. No morbidity was detected in either group with grade II intraperitoneal rectal injury. The outcomes of the patients with grade II intraperitoneal and extraperitoneal rectal injury were similar. In the treatment of patients with low-grade rectal injuries, primary repair can be preferred to ostomy.Öğe Mean Platelet Volume: Is It a Predictive Parameter in Diagnosis of Acute Mesenteric Ischemia?(Int College Of Surgeons, 2015) Turkoglu, Ahmet; Gul, Mesut; Oguz, Abdullah; Bozdag, Zubeyir; Ulger, Burak Veli; Yilmaz, Ahmet; Aldemir, MustafaOur objective for this study was to discuss the usability of mean platelet volume, which is associated with numerous vascular pathologies, in the early diagnosis of acute mesenteric ischemia. Acute mesenteric ischemia is an uncommon, life-threatening clinical condition mostly seen in the elderly. Early diagnosis of acute mesenteric ischemia and correction of blood circulation before necrosis occurs are important factors affecting prognosis. A total of 95 patients who underwent emergency surgery for acute mesenteric ischemia and 90 healthy volunteers as control group were included in this study. Age, gender, hemoglobin values, white blood cell counts, mean platelet volume, and platelet counts are recorded for evaluation. The mean platelet volume values were significantly higher in patients with acute mesenteric ischemia than in the controls (9.4 +/- 1.1 fL and 7.4 +/- 1.4 fL, respectively; P < 0.001). Receiver-operating characteristic analysis demonstrated a cutoff value of mean platelet volume as 8.1 fL (area under the curve, 0.862), a sensitivity of 83.2%, and a specificity of 80%. As a result, in the patients who are admitted to the hospital with acute nonspecific abdominal pain and suspected of having acute mesenteric ischemia, high mean platelet volume values in routine hemograms support the diagnosis of acute mesenteric ischemia.Öğe New hormones to predict the severity of gallstone-induced acute pancreatitis(Aves, 2014) Ulger, Burak Veli; Gul, Mesut; Uslukaya, Omer; Oguz, Abdullah; Bozdag, Zubeyir; Yuksel, Hatice; Boyuk, AbdullahBackground/Aims: Levels of the hormones ghrelin and leptin in rat models of acute pancreatitis (AP) have been investigated in several experimental studies. However, there are very few clinical studies addressing the connection between hormone levels and AP. A few recent studies investigating the changes in ghrelin and leptin levels in patients with AP have been reported; however, our study is the first clinical study to investigate the change of nesfatin-1 levels in patients with gallstone-induced AP. Materials and Methods: Forty patients were enrolled in this study, eight of which presented with severe AP. Two blood samples were obtained from each study patient. The first blood samples were obtained at patient admission to the hospital and the second was obtained at patient discharge. All samples were collected after at least 6 h of fasting. Plasma nesfatin-1, leptin, and ghrelin levels were measured. Results: In all 40 patients, nesfatin-1 and leptin levels were higher at admission and had decreased at discharge. In contrast, the ghrelin levels at discharge were significantly higher than those at admission. Only the changes in these hormones in the mild AP group were significant. Conclusion: Levels of these hormones were altered during the course of gallstone-induced AP. These changes might be associated with the clinical outcomes of the disease. To clarify whether the magnitude of the change in hormone levels at AP onset can be used as a biomarkers to predict the severity of the disease requires further investigation.Öğe Protective Effect of Sildenafil on the Heart in Hepatic Ischemia/Reperfusion Injury(Sci Printers & Publ Inc, 2021) Ekinci, Aysun; Oguz, Abdullah; Asir, Firat; Ekinci, Cenap; Dursun, RecepOBJECTIVE: To investigate the effect of sildenafil on reducing the impact of hepatic ischemia/reperfusion (HIR) injury established by Pringle maneuver on the heart of rats. STUDY DESIGN: Forty Wistar albino rats were divided into 4 groups: Sham (laparotomy only), Control (laparotomy following sildenafil application), IR (ischemia/reperfusion injured by HIR), and IR+ SIL (injured by HIR following sildenafil application). Ischemia was developed by clamping the hepatoduodenal ligament for 30 minutes; then reperfusion was applied for 30 minutes. Sildenafil (single dose of 50 mg/kg) was administered by oral gavage for 15 minutes before ischemia. Blood samples of rats were collected from Sham and Control groups at 60 minutes and from IR and IR+ SIL groups at 30 minutes after initiation of reperfusion for biochemical analysis. Meanwhile, heart tissues were sampled for biochemical analysis. Malondialdehyde (MDA) and total antioxidant capacity (TAC) in serum samples and TAC, total oxidative capacity (TOC), and oxidative stress index in heart tissues were examined biochemically. RESULTS: Serum MDA levels were elevated significantly in the IR and IR+ SIL groups as compared to the sham group. Sildenafil treatment inhibited MDA increase considerably in the IR+ SIL group as compared to the IR group. Serum TAC levels were elevated significantly in the sildenafil and control groups (compared with sham groups) and in the IR+ SIL group (compared with the IR group). TAC levels detected in heart tissue increased significantly in the IR group as compared to the sham group; however, sildenafil treatment had no effect on this increase. CONCLUSION: Heart tissue was affected by HIR. It was revealed that sildenafil treatment may prevent the oxidative stress via increasing serum TAC levels in both control and IR+ SIL groups.Öğe A Rare Finding During a Common Procedure: Xanthogranulomatous Cholecystitis(Int College Of Surgeons, 2014) Taskesen, Fatih; Arikanoglu, Zulfu; Uslukaya, Omer; Oguz, Abdullah; Aliosmanoglu, Ibrahim; Dusak, Abdurrahim; Turkcu, GulXanthogranulomatous cholecystitis is a rare variant of chronic cholecystitis characterized by severe proliferative fibrosis and accumulation of lipid-laden macrophages in regions of destructive inflammation. Xanthogranulomatous cholecystitis clinically and radiologically mimics early-stage gallbladder cancer, with wall thickening on computed tomography. The study included 14 xanthogranulomatous cholecystitis patients that were identified following retrospective analysis of the records of 1248 patients that underwent cholecystectomy between 2005 and 2011. Mean age of the 5 male and 9 female patients was 56.7 years. All 14 patients had gallbladder stones; 10 had a history of acute cholecystitis, 1 had cholangitis, and 2 presented with obstructive jaundice. A right-upper quadrant mass was palpable in 2 patients. All patients underwent cholecystectomy. Open surgery was planned and performed in 6 of the 14 patients, and laparoscopic cholecystectomy was planned in 8 patients, but was converted to open surgery in 1 case. In total, 1 patient developed wound infection, 1 patient had postoperative pneumonia, and 1 patient developed intraabdominal hematoma. None of the patients in the series died. Xanthogranulomatous cholecystitis is difficult to diagnose, both preoperatively and intraoperatively, and definitive diagnosis depends exclusively on pathological examination. Xanthogranulomatous cholecystitis should be a consideration in all difficult cholecystectomy cases.Öğe The Reliability of Fine-Needle Aspiration Biopsy in Terms of Malignancy in Patients With Hashimoto Thyroiditis(Int College Of Surgeons, 2015) Kapan, Murat; Onder, Akin; Girgin, Sadullah; Ulger, Burak Veli; Firat, Ugur; Uslukaya, Omer; Oguz, AbdullahThe aim of this study was to analyze the presence of malignancy in patients with Hashimoto's thyroiditis and to investigate the reliability of preoperative fine-needle aspiration biopsy (FNAB). The retrospective study included 44 patients who were operated on for nodular goiter between December 2010 and October 2011. The patients underwent thyroidectomy following a cytologic analysis plus FNAB. Hashimoto's thyroiditis was confirmed on histopathology in all patients. FNAB results were defined as benign in 14 (31.8%), suspicion for malignancy in 17 (38.6%), malignant in 9 (20.5%), and inadequate in 4 (9.1%). Following the thyroidectomy, presence of papillary thyroid carcinoma and follicular variant of papillary thyroid carcinoma were detected in 10 patients (22.7%) and 1 (2.3%) patient, respectively. The FNAB results were interpreted in terms of malignancy, which revealed the sensitivity as 80%; specificity, 40%; false positives, 69.2%; false negatives, 14.3%; positive predictive value, 31.8%; negative predictive value, 85.7%; and diagnostic accuracy, 50%. The coexistence of Hashimoto's thyroiditis with papillary thyroid carcinoma is quite common. The FNAB results for such cases are hard to evaluate, and they are likely to increase the number of false positives.Öğe Retrorectal Tumors in Adults: A 10-Year Retrospective Study(Int College Of Surgeons, 2015) Oguz, Abdullah; Boyuk, Abdullah; Turkoglu, Ahmet; Goya, Cemil; Alabalik, Ulas; Teke, Fatma; Budak, HidirDue to the rarity and large diversity of the primary retrorectal tumors (RTs), the diagnoses are often difficult and they can be misdiagnosed. We present our experience in light of scarce information available on the clinical manifestations of RTs. The retrospective study included 17 patients diagnosed as RTs between January 2004 and January 2014. Demographic characteristics, length of symptoms, clinical findings, diagnostic methods, evaluations on the treatment procedures and postoperative periods, pathology, complications, and length of hospital stay were recorded. A mean of 1.7 of patients were diagnosed with RTs annually in our hospital. Patients comprised 12 females and 5 males. Pain and discomfort were the most common symptoms at presentation. All the lesions were evaluated by using magnetic resonance imaging (MRI) and computed tomography (CT), and all the patients were treated operatively. Based on the preoperative MRI or CT findings, an anterior approach was performed in 7 patients, a posterior approach in 6 patients, and combined approach in 4 patients. Mean size of tumors was 9.2 +/- 4.3 cm. Epidermoid cyst (n = 8) was the most common tumor. Except for 1 case of liposarcoma, 16 tumors were confirmed to be of benign nature in histologic examination. Mean length of hospital stay 12.4 +/- 6.8 days. Retrorectal tumors are heterogeneous and lead to diagnostic difficulties. A high index of clinical suspicion is needed for diagnosis. Preoperative imaging may be helpful in determining the course of treatment. Total excision of a retrorectal tumor may alleviate pressure symptoms and confirm the diagnosis.
