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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 Anti-inflammatory and anti-oxidant role of ursolic acid in cerulein-induced acute pancreatitis in rats(Acad Nacional Medicina Mexico, 2023) Turkoglu, Ahmet; Ibiloglu, Ibrahim; Kaplan, Ibrahim; Arslan, Serkan; Halil-Ocal, Ibrahim; Gumus, MetehanBackground: Ursolic acid (UA) is found in many plants, and has been reported to have anti-protease, antioxidant, anti-inflammatory, antimicrobial, nephroprotective, hepatoprotective, and cardioprotective effects. Objective: The purpose of this study was to investigate the effects of ursolic acid in cerulein-induced acute pancreatitis (AP). Materials and methods: Thirty-two Wistar albino rats were randomly assigned to 4 equal groups: Sham, acute pancreatitis, treatment, and ursolic acid group. Results: Serum amylase levels in the AP and treatment groups were significantly higher than in the others (p < 0.05). In addition, serum IL-113, IL-6, and TNF-& alpha; levels were significantly higher in the AP group in comparison with the treatment group. Although pancreatic tissue total oxidant activity in the AP and treatment groups was similar, pancreatic tissue total antioxidant capacity was significantly higher in the treatment group than in the AP group. Conclusions: Damage to the pancreas and remote organs in AP was observed to be reduced by UA. In addition, oxidative stress was observed to be decreased by the effect of UA.Öğe The antioxidant effects of pomegranate extract on local and remote organs in a mesenteric ischemia and reperfusion model(Taylor & Francis Ltd, 2016) Kilic, Elif; Turkoglu, Ahmet; Keles, Aysenur; Ekinci, Aysun; Kesgin, Siddika; Gumus, MetehanObjectives: We investigated whether pomegranate extract plays a protective antioxidant role against mesenteric ischemia-reperfusion injury (IR), which can lead to a systemic response and damage distant organs, such as the lung, liver, and kidney. Methods: Forty female Wistar-Albino rats were separated into four groups: laparotomy, laparotomy + PG, mesenteric IR, and mesenteric IR and pomegranate (IR + PG). In the laparotomy + PG and IR + PG groups, pomegranate (225 mg/kg) was given by oral gavage at the beginning of the study. Ischemia was induced for 30 minutes, and reperfusion was subsequently allowed for 60 minutes in the IR and IR + PG groups. The malondialdehyde (MDA) and total antioxidant activity (AOA) levels were evaluated in blood samples. Additionally, all tissues were removed for the measurement of AOA and total oxidant status as well as for subsequent histopathological evaluation. The oxidative stress index was calculated. Results: Histopathological changes in all organs were significantly higher in the IR group and significantly lower in the IR + PG group vs. the other groups. Serum MDA levels were significantly lower in the IR + PG group than in the IR group. No significant difference was found in AOA levels of the groups. Discussion: These data may explain the positive protective effects of pomegranate based on the histopathologic findings in ischemic conditions in an intestinal IR injury model.Öğe Caffeic acid phenethyl ester prevents fluoxetine-induced hepatotoxicity in rats(Wiley-Blackwell, 2015) Yilmaz, Ahmet; Elbey, Bilal; Yazgan, Umit Can; Turkoglu, Ahmet[Abstract Not Available]Öğe Comparing the effects of nebivolol and dexpanthenol on wound healing: an experimental study(Wiley, 2016) Ulger, Burak V.; Kapan, Murat; Uslukaya, Omer; Bozdag, Zubeyir; Turkoglu, Ahmet; Alabalik, Ulas; Onder, AkinWound healing is a dynamic, interactive process that is initiated in response to injury. A number of investigations and clinical studies have been performed to determine new approaches for the improvement ofwound healing. The aim of this studywas to compare the effects of dexpanthenol, a molecule that is widely used for improvingwound healing, and nebivolol, a molecule that increases nitric oxide release, on wound healing. A total of 30 rats were divided into three equal groups (n = 10). A linear 2 cm incision was made in the rats' skin. No treatment was administered in the first (control) group. Dexpanthenol cream was administered to the rats in the second group and 5% nebivolol cream was administered to the rats in the third group. The wound areas of all of the rats were measured on certain days. On the 21st day, all wounds were excised and histologically evaluated. The wound healing rates of the dexpanthenol and nebivolol groups were higher than those of the control group (P < 0.05). However, the wound healing rates of the dexpanthenol and nebivolol groups were not significantly different. Nebivolol and dexpanthenol have comparable effects on wound healing.Öğe Differential diagnosis of idiopathic granulomatous mastitis and breast cancer using acoustic radiation force impulse imaging(Springer Japan Kk, 2017) Teke, Memik; Teke, Fatma; Alan, Bircan; Turkoglu, Ahmet; Hamidi, Cihad; Goya, Cemil; Hattapoglu, SalihPurpose Differentiation of idiopathic granulomatous mastitis (IGM) from carcinoma with routine imaging methods, such as ultrasonography (US) and mammography, is difficult. Therefore, we evaluated the value of a newly developed noninvasive technique called acoustic radiation force impulse imaging in differentiating IGM versus malignant lesions in the breast. Methods Four hundred and eighty-six patients, who were referred to us with a presumptive diagnosis of a mass, underwent Virtual Touch tissue imaging (VTI; Siemens) and Virtual Touch tissue quantification (VTQ; Siemens) after conventional gray-scale US. US-guided percutaneous needle biopsy was then performed on 276 lesions with clinically and radiologically suspicious features. Malignant lesions (n = 122) and IGM (n = 48) were included in the final study group. Results There was a statistically significant difference in shear wave velocity marginal and internal values between the IGM and malignant lesions. The median marginal velocity for IGM and malignant lesions was 3.19 m/s (minimum-maximum 2.49-5.82) and 5.05 m/s (minimum-maximum 2.09-8.46), respectively (p < 0.001). The median internal velocity for IGM and malignant lesions was 2.76 m/s (minimum-maximum 1.14-4.12) and 4.79 m/s (minimum-maximum 2.12-8.02), respectively (p < 0.001). Conclusion The combination of VTI and VTQ as a complement to conventional US provides viscoelastic properties of tissues, and thus has the potential to increase the specificity of US.Öğe Effect of Intraperitoneal Curcumin Instillation on Postoperative Peritoneal Adhesions(Karger, 2015) Turkoglu, Ahmet; Gul, Mesut; Yuksel, Hatice Kurt; Alabalik, Ulas; Ulger, Burak Veli; Uslukaya, Omer; Avci, YahyaObjective: The aim of this study was to determine the effect of curcumin on adhesion formation in a rat cecum abrasion model. Materials and Methods: Thirty Wistar rats were randomized into three groups; the control group received saline, the curcumin group received 10 mg/kg of curcumin after cecal abrasion, and in the sham group the abdominal wall was closed without any abrasion to the cecum. On day 15, adhesions were assessed blindly using a standardized scale, and histopathological samples were taken and examined. Results: There were no incisional hernias or wound dehiscences in any animals of the three groups. A comparison of adhesion scores showed a significant difference between the curcumin (median = 1) and the control group (median = 2; p < 0.05). The grade of inflammation of the curcumin (median = 1) and the sham (median = 0) group was significantly lower than that of the control group (median = 3; p < 0.01 and p < 0.001, respectively). Hydroxyproline levels were significantly lower in the sham (48.3 +/- 11.8 mu g/mg) and the curcumin (63.8 +/- 13.9 mu g/mg) group compared to the control group (85.7 +/- 22.1 mu g/mg; p < 0.05). Conclusion: These data suggest that curcumin, administered intraperitoneally, was effective in the prevention of peritoneal adhesion formation. (C) 2014 S. Karger AG, BaselÖğe The effects of roflumilast on the pancreas and remote organs in a cerulein-induced experimental acute pancreatitis model in rats(Springer, 2016) Uslukaya, Omer; Turkoglu, Ahmet; Yazgan, Umit Can; Kaplan, Ibrahim; Ibiloglu, Ibrahim; Kapan, Murat; Gumus, MetehanSystemic damage in acute pancreatitis (AP) can be characterized by oxidative stress and the release of pro-inflammatory cytokines. Roflumilast has been shown to be a potent anti-inflammatory and antioxidant agent. In the present study, we aimed to investigate the effect of roflumilast in cerulein-induced AP. Thirty-two male rats were divided into four groups: group 1 (sham), group 2 (Roflumilast), group 3 (AP), and group 4 (AP + Roflumilast). AP was induced by injecting 4 x 75 mu g/kg of body weight at an interval of 1 h. Rats were killed after 12 h following the last cerulein administration. AP was confirmed by measuring the serum amylase level and inflammatory features. Morphological changes were observed in the pancreas. Amylase levels were higher in the AP and AP + Roflumilast groups than the sham and Roflumilast groups. The serum levels of TNF-alpha, IL-1 beta, and IL-6 increased in the AP group, whereas they decreased in the Roflumilast group. The total oxidant activity (TOA) was higher and the total antioxidant capacity (TAC) was lower in the AP group. The administration of roflumilast decreased the TOA and increased the TAC in comparison with the AP group (p < 0.05 for both). Roflumilast significantly decreases oxidative stress and inflammatory mediators in the plasma, pancreas, and lung in cerulein-induced AP rats.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 Evaluating mean platelet volume as a new indicator for confirming the diagnosis of necrotizing pancreatitis(Edizioni Luigi Pozzi, 2015) Erbis, Halil; Aliosmanoglu, Ibrahim; Turkoglu, Mehmet Akif; Ay, Enver; Turkoglu, Ahmet; Ulger, Burak VeilBACKGROUND: The aim of the present study is to discuss the possible role of mean platelet volume as a new predictor in the diagnosis of necrotizing pancreatitis. METHODS: Study subjects are arranged in three different groups: Group I; control group (n= 40), Group II; acute pan-creatitis (n= 40), Group III; necrotizing pancreatitis (n= 36). Demographic data and mean platelet volume values are recorded retrospectively. RESULTS: Mean platelet volume of patients in Group II was 7.9 +/- 0.53, while in Group III patients' it was 7.2 +/- 0.52 (p<0.001). When we compared the study groups with ROC analysis, results demonstrated that cut off value of necrotizing pancreatitis patients as 7,8 (area under curve: 0.857), sensitivity as 86.1% and specificity as 72.5%. CONCLUSION: The current study shows that mean platelet volume in necrotizing pancreatitis patients is significantly reduced compared to that of patients in the control and acute pancreatitis group.Öğe Evaluation of the incidence of haemorrhoidal disease in patients with ankylosing spondylitis(Springer London Ltd, 2015) Caglayan, Mehmet; Turkoglu, Ahmet; Oktayoglu, Pelin; Yildiz, Mehmet; Dagli, Abdullah Zubeyir; Boyuk, Abdullah; Em, SerdaHaemorrhoidal disease (HD) is one of the most common diseases encountered by the clinicians of general surgery. Chronic constipation, pushing during defecation and increased abdominal pressure play an important role in development of haemorrhoidal disease. Patients with ankylosing spondylitis (AS) frequently use the Valsalva manoeuvre in their daily lives, which may increase the abdominal pressure, leading to formation of haemorrhoids. The purpose of this study was to evaluate the incidence of haemorrhoidal disease in patients with AS. A total of 221 individuals were included in this study in three groups as follows: 72 patients with ankylosing spondylitis (AS), 75 patients with chronic low back pain (LBP) and 74 healthy control subjects. Patients were examined both physically and anoscopically, and their histories were taken. The incidence of HD was 45.8 % in patients with AS, 16 % in patients with chronic LBP and 9.5 % in healthy control subjects. The incidence of HD was significantly higher in patients with AS compared to the other groups. Patients with AS have a high incidence of HD, which should be taken into consideration by clinicians during routine examination of these patients.Öğe Factors affecting mortality in patients with splenic injuries(Edizioni Luigi Pozzi, 2018) Uslukaya, Omer; Bozdag, Zubeyir; Gumus, Metehan; Turkoglu, Ahmet; Boyuk, Abdullah; Yilmaz, Edip Erdal; Gunduz, ErcanAIM: Mortality in splenic injuries can create medico-legal problems. Though many studies exist regarding splenic injuries, there are not a sufficient number investigating the factors in splenic injuries influencing mortality. In this study, we aimed to investigate the factors affecting mortality in splenic injuries. MATERIALS AND METHODS: All 237 patients with splenic injury between 2005 to 2014 were retrospectively analyzed. The patients were divided into two groups, survivors and non-survivors. Age, gender, mechanism of injury, grade of splenic injury, pulse, respiratory rate, systolic blood pressure, hemoglobin levels, number of transfusions, surgical procedure, ISS, RTS and hospitalization period were recorded. Univariate and multivariate analysis were used to compare survivors and non-survivors. RESULTS: The average age of the patients was 32 and most (82.7%) were male. Mortality was observed in 18 patients (7.6%). Mortality was found significantly lower in patients who had isolated splenic injury (p=0.048). In univariate analyses, decreased RTS (p<0.001), increased number of blood transfusion (p<0.001), decreased hemoglobin level (p=0, 025) and increased ISS (p<0.001) were found significant in non-survivors. In multivariate analysis; number of transfusions, ISS and RTS were found as independent risk factors for mortality. CONCLUSIONS: We found high number of transfusions, high ISS and low RTS as independent risk factors for mortality in patients with splenic injury.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 Factors that Affect Drain Indwelling Time after Breast Cancer Surgery(Aves, 2016) Uslukaya, Omer; Turkoglu, Ahmet; Gumus, Metehan; Bozdag, Zubeyir; Yilmaz, Ahmet; Gumus, Hatice; Kaya, SeyhmusObjective: The most common procedure to prevent seroma formation, a common complication after breast and axillary surgery, is to use prophylactic surgical drains. Ongoing discussions continue regarding the ideal time for removing drains after surgical procedures. In this study, we aimed to investigate factors that affect drain indwelling time (DIT). Materials and Methods: From 2014 to 2015, a total of 91 consecutive patients with breast cancer were included in the study. The demographic characteristics of the patients, treatment methods, histopathologic features of the tumor, size of removed breast tissue (BS), tumor size (TS), number of totally removed lymph nodes (TLN), and metastatic lymph nodes (MLN), whether they had neoadjuvant chemotherapy, and the DIT were retrospectively recorded from the hospital database. Results: The mean age of the patients was 48.9 years, and the mean DIT was 4.8 days. The mean size of breast removed was 17.3 cm and tumor size was 4.7 cm, and the mean number of metastatic lymph nodes was 3.3, and mean total number of lymph nodes was 14.1. Patients who had neoadjuvant chemotherahpy had longer DIT. There was a positive correlation between the BS, TS, TLN, MLN, length of hospital stay, and DIT. Linear regresion analysis revealed that the BS, TLN, and history of neoadjuvant chemotherahpy were independent risk factors for DIT. Conclusion: DIT primarily depends on BS, TLN, and history of neoadjuvant chemotherahpy. A policy for the management of removing drains to prevent seroma formation should thus be individualized.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 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 The Management and Outcomes of Male Breast Cancer(Aves, 2016) Uslukaya, Omer; Gumus, Metehan; Gumus, Hatice; Bozdag, Zubeyir; Turkoglu, AhmetObjective: Due to a lack of sufficient data, the treatment protocols for male breast cancer are usually the same as those used for female breast cancer. The aim of the current study was to present our clinical experience with male breast cancer. Materials and Methods: The records of 37 patients who were treated for male breast cancer in our hospital between 2004 and 2014 were reviewed retrospectively. The data of patients were recorded and analyzed. Results: The mean age of the patients was 63.03 +/- 12.36 years. Thirty-three patients (89.2%) had invasive ductal carcinoma, two (5.4%) had ductal carcinoma in situ, and two had invasive lobular carcinoma (5.4%). The most common molecular subtype was luminal A (17 cases, 45.9%). Twenty-nine patients with male breast cancer underwent mastectomy and two underwent breast conserving surgery. Axillary lymph node dissection was performed in 25 patients. The most common surgical procedure was modified radical mastectomy. Distant metastases were present in 17 (45.9%) patients. Overall, the 5-year survival was 60%. The 5-year survival was 100% for those with stage 0-I disease, 87% for stage II, and 42% for stage III. The 3-year survival was 14% for stage IV. Conclusion: Patients with male breast cancer presented at an older age, a later stage, and with earlier metastasis. Early metastasis and death increases with increasing stage. Poor prognosis correlates with late admission. Data from different centers should be compiled and reviewed in order to determine a specific treatment protocol for male breast cancer; each paper published reveals new data.Öğe Mean Platelet Volume/Platelet Count Ratio: A New Diagnostic Parameter for Necrosis in Adhesive Small Bowel Obstruction-A Retrospective Cohort Study(Int College Of Surgeons, 2015) Ulger, Burak Veli; Erbis, Halil; Turkoglu, Ahmet; Gumus, Metehan; Gul, Mesut; Arikanoglu, Zulfu; Bozdag, ZubeyirAbdominal adhesions are still one of the most common causes of intestinal obstruction. A major challenge in adhesive small bowel obstruction (SBO) management is to detect ischemia as early as possible to avoid necrosis and resection. Elevated mean platelet volume and decreased platelet count have been associated with worse disease course for various ischemic diseases in many clinical studies. The objective of the current study was to evaluate the predictive value of the mean platelet volume/platelet count ratio for patients with small bowel obstruction. Data for patients with adhesive small bowel obstruction, admitted to the general surgery department of Dicle University Hospital between November 2010 and March 2014, were reviewed retrospectively. Mean platelet volume (MPV)/platelet count (PC) ratio values, demographic data, vital signs, and laboratory blood test results of the patients were analyzed. Mean platelet volume/platelet count ratio was higher in bowel necrosis group, while there were no differences between the groups in terms of mean platelet volume values. Mean platelet volume and mean platelet volume/platelet count ratio was higher in patients who underwent surgical treatment. The cutoff value with the highest sensitivity and specificity for MPV/PC ratio was 0.02855 (sensitivity 68%, specificity 65%) for predicting bowel necrosis in patients with adhesive SBO. Mean platelet volume/platelet count ratio is associated with the failure of the conservative management and the presence of bowel necrosis in patients with adhesive small bowel obstruction.
