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    Comparison of the early complications of total and subtotal thyroidectomy in the multinodular goitre
    (Aves, 2011) Durgun, Cemalettin; Boyuk, Abdullah; Girgin, Sadullah; Kapan, Murat; Onder, Akin; Gumus, Metehan; Tacyildiz, Ibrahim Halil
    Purpose: In the recent years, total thyroidectomy is increasingly being accepted in the surgical treatment of benign multinodular goitre due to the high rate of recurrence after bilateral subtotal thyroidectomy. The aim of this study is to compare early postoperative complications of total and bilateral subtotal thyroidectomy in benign multinodular goitre. Materials and Methods: In our study, the findings of 419 patients operated due to multinodular goitre between January 2005 - December 2009 in Dicle University Medical School Department of General Surgery were retrospectively evaluated. Patients were divided into two groups as total thyroidectomy and bilateral subtotal thyroidectomy. Results: The mean age of patients was 41.72 +/- 12.55. 329 (78.5%) patients were women and 90 (21.5%) were men. A total of 263 (62.8%) patients underwent total and 156 (37.2%) patients bilateral subtotal thyroidectomy. Six (2.3%) of total thyroidectomy patients and 3 (1.9%) of bilateral subtotal thyroidectomy patients had recurrent laryngeal nerve injury. Bilateral subtotal thyroidectomy group revealed no permanent damage whereas in total thyroidectomy group one (0.4%) patient did. Hypocalcemia was observed in 40 (15.2%) patients in the total thyroidectomy group and in 27 (17.3%) patients in the bilateral subtotal thyroidectomy group. One (0.4%) patient in total thyroidectomy group suffered from permanent hypocalcemia whereas it wasn't observed in bilateral subtotal thyroidectomy group. Haematoma occurred in 3 (1.9%) patients treated with bilateral subtotal thyroidectomy and in 3 (1.1%) treated with total thyroidectomy, wound infection occured in one (0.6%) patient subjected to bilateral subtotal thyroidectomy and 3 (1.1%) patients treated with total thyroidectomy. Conclusion: In conclusion, our study supports total thyroidectomy for multinodular goitre involving both lobes as a safe technique with low complication rate.
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    Diverticulitis of Cecum Mimicking Plastron Appendicitis: A Diagnostic and Therapeutic Dilemma
    (Modestum Ltd, 2013) Arikanoglu, Zulfu; Taskesen, Fatih; Kapan, Murat; Gumus, Hatice; Tacyildiz, Ibrahim Halil
    Cecal diverticulitis is an unusual condition that presents clinically similar to appendicitis. Although it is usually asymptomatic, it may cause inflammation, bleeding, or perforation. The diagnosis is not always easy and in the majority of cases, the diagnosis is usually made at laparotomy. There have been various controversies in the literature regarding the optimal management of cecal diverticulitis. The aim of this study is a detailed description of this rare cause of acute abdomen. A 40-year-old female patient presenting with acute onset pain in the right lower abdominal quadrant, nausea and fever had mild leukocytosis. Abdominal ultrasonography and computed tomography revealed findings suggestive of plastron appendicitis. The diagnosis of cecal diverticulitis was established during the surgery. The patient underwent diverticulectomy and appendectomy operations. Cecal diverticulitis is rare clinical entity that should be considered in the differential diagnosis of emergency patients admitted with the complaint of pain in the right lower abdominal quadrant.
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    The evaluation of 250 patients with thoracoabdominal injuries
    (Turkish Assoc Trauma Emergency Surgery, 2008) Ciftci, Fatih; Girgin, Sadullah; Gedik, Ercan; Onat, Serdar; Tacyildiz, Ibrahim Halil; Keles, Celalettin
    BACKGROUND Prognostic factors affecting mortality and morbidity in thoracoabdominal injuries were evaluated. METHODS Two hundred and fifty patients (227 males, 23 females; mean age 30.1 +/- 5.11; range 15 to 71 years) who had been exposed to thoracoabdominal injuries and underwent laparotomy between June 1996 and November 2005 were investigated retrospectively. Patients were assessed according to age, sex, trauma-operation interval, shock, hospitalization period, number of injured organs, blood transfusion, timing of closed thorax drainage, thoracotomy, Abdominal Trauma Index, Injury Severity Score, Abbreviated Injury Score, Revised Trauma Score, and complications. RESULTS Mortality and morbidity ratios were 15.6% and 53.5%, respectively. The factors effective on mortality were trauma-operation interval >= 3 hours (p=0.03), presence of shock (p=0.03), increase in the rate of blood transfusion (p=0.001), injured organ number >= 3 (p=0.001), and not performing early-term closed thorax drainage (p=0.005). Trauma-operation interval <3 (p=0.02), increase in the rate of blood transfusion (p=0.02), injured organ number >= 3 (p=0.001), and not performing early-term closed thorax drainage (p=0.005) were the factors effective on morbidity. CONCLUSION It was determined that trauma-operation period >= 3 hours, number of injured organs >= 3, and increased number of blood transfusions increased both mortality and morbidity. However, presence of shock increased only mortality. On the other hand, application of closed thorax drainage within a reasonable time period was determined to decrease mortality and morbidity.
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    Independent risk factors of morbidity in penetrating colon injuries
    (Turkish Assoc Trauma Emergency Surgery, 2009) Girgin, Sadullah; Gedik, Ercan; Uysal, Ersin; Tacyildiz, Ibrahim Halil
    BACKGROUND The present study explored the factors effective on colon-related morbidity in patients with penetrating injury of the colon. METHODS The medical records of 196 patients were reviewed for variables including age, gender, factor of trauma, time between injury and operation, shock, duration of operation, Penetrating Abdominal Trauma Index (PATI), Injury Severity Score (ISS), site of colon injury, Colon Injury Score, fecal contamination, number of associated intra- and extraabdominal organ injuries, units of transfused blood within the first 24 hours, and type of surgery. In order to determine the independent risk factors, multivariate logistic regression analysis was performed. RESULTS Gunshot wounds, interval between injury and operation >= 6 hours, shock, duration of the operation >= 6 hours, PATI >= 25, ISS >= 20, Colon Injury Score >= grade 3, major fecal contamination, number of associated intraabdominal organ injuries >2, number of associated extraabdominal organ injuries >2, multiple blood transfusions, and diversion were significantly associated with morbidity. Multivariate logistic regression analysis showed diversion and transfusion of >= 4 units in the first 24 hours as independent risk factors affecting colon-related morbidity. CONCLUSION Diversion and transfusion of >= 4 units in the first 24 hours were determined to be independent risk factors for colon-related morbidity.
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    Intussusception in adults
    (Turkish Assoc Trauma Emergency Surgery, 2009) Korkmaz, Oezguer; Yilmaz, Hatice Guelsen; Tacyildiz, Ibrahim Halil; Akgun, Yilmaz
    BACKGROUND Adult intussusception is an unusual entity, and its etiology differs from that in pediatric patients. The purpose of this study was to determine the causes and management of intussusception in adults. METHODS A retrospective review of patients with a diagnosis of gastrointestinal intussusception between 1986 and 2006 was conducted. All patients under the age of 18 and cases with rectal, ostomy, or gastroenterostomy prolapse were excluded. RESULTS There were 28 cases of adult intussusception. Mean age was 38.6 +/- 16.7 years. A preoperative diagnosis of intussusception was made in 53.5% of the cases. There were 23 enteric, three colonic and two ileocolic intussusceptions. A lead point was identified in 25 patients (89.3%). Invagination was due to benign causes in 19 patients, malignant causes in six patients and idiopathic in three patients. Complication was seen in three (10.3%) cases. CONCLUSION In this series, the mean age of the patients was younger than in the literature. Since intussusception was due to small bowel pathologies, the proportion of benign/malignant lesions favored benign lesions. Although it is encountered rarely in adults, physicians should be aware of invagination and consider it in each case of acute abdomen because of the wide spectrum of the clinical settings.
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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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    SCHWANNOMA OF THE BREAST: REPORT OF A CASE
    (Aves, 2007) Korkmaz, Ozgur; Yilmaz, Hatice Gulsen; Ozekinci, Selver; Tacyildiz, Ibrahim Halil; Akgun, Yilmaz
    Schwannoma is a slow-growing tumor that frequently occurs in the extremities, the trunk and the head region. We report a case of benign schwannoma of the breast in a 76-year-old woman. The palpable mass was localized in the upper outer quadrant of the right breast. Complete excision of the mass was done and pathology revealed a schwannoma.