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Öğe Granülomatöz mastit etiyolojisinde corynebacterium bir etken midir?(Dicle Üniversitesi, Tıp Fakültesi, 2021) Yaman, Gizem; Girgin, SadullahGİRİŞ VE AMAÇ Granülomatöz mastit (GM), memenin nadir görülen, benign, kronik inflamatuar bir hastalığıdır. Etiyolojisi tam aydınlatılamamış olup, klinik olarak meme kanserini taklit eden memenin nekrotizan granülomatöz lobuliti ile karakterizedir. Basit mastit toplumda daha sık görüldüğü ve yeterli deneyime sahip olmayan hekimler tarafından basit mastit tanısı konularak medikal tedaviye başlandığı için, GM tanısı konulmadan önce, hastaların uzun süreli hastalık dönemi mevcuttur. Bu çalışmada; idiyopatik granülomatöz mastit tanısı almış hastaların doku örneklerinin mikroskopik incelenmesi ile, etiyolojide rol aldığı düşünülen Corynebacterium suşlarının varlığının araştırılması amaçlandı. MATERYAL VE METOD Bu retrospektif çalışmada, Aralık 2018 - Eylül 2020 tarihleri arasında, Dicle Üniversitesi Tıp Fakültesi Genel Cerrahi Anabilim Dalı Poliklinik'inde tanısal amaçlı yapılmış olan 201 meme tru-cut biyopsi materyallerinin sonuçları retrospektif olarak incelendi. Histopatolojik olarak GM tanısı konulmuş, iletişim verilerine ulaşılan 41 hastanın kayıtları ayrıntılı olarak incelendi. GM tanısı alan hastaların doku örneklerinden hazırlanan preparatlar Gram yöntemiyle boyanarak incelendi. Uygun besiyeri eklenerek yapılan mikroskobik incelemede, Corynebacterium suşlarının varlığı araştırıldı. BULGULAR Histopatoloji sonucu GM olan 41 kadın hastanın kayıtları incelendi. Yaş ortalaması 35.7, yaş aralığı 20-58 idi. Çalışma sonucunda; bir hastanın (%2.4) doku örneğinin mikrobiyolojik incelemesi sonucunda etken mikroorganizma olarak Corynebacterium amycolatum tanımlandı. SONUÇ GM etiyolojisinde Corynebacterium'un etken olmadığını düşünmekteyiz. Etiyolojiyi aydınlatmak için geniş vaka serileri ile daha fazla çalışmaya ihtiyaç duyulmaktadır.Öğe Laparoscopic splenectomy: Clip ligation or en-bloc stapling?(Bilimsel Tip Yayinevi, 2019) Türkoǧlu, Ahmet; Oǧuz, Abdullah; Yaman, Gizem; Gül, Mesut; Ülger, Burak VeliObjective: Various techniques are used in the management of splenic hilum during laparoscopic splenectomy. Among them, the most used ones are polymer clips, en-bloc stapling and ultrasonic devices. To the best of our knowledge, there is no study in the literature comparing the results of clip and stapler techniques. This study was aimed to compare our results of clip ligation and en-bloc stapling of the splenic hilum. Material and Methods: The records of 67 patients undergoing laparoscopic splenectomy between December 2012 and October 2017 were reviewed. Patients were divided into two groups according to surgical method (stapler group: 26 patients and clip group: 41 patients). Patient age, sex, diagnosis, surgical technique, operation time, spleen dimensions, perioperative complications, postoperative hospital stay, blood transfusions, postoperative thrombocyte and hemoglobin levels were recorded. Results: Operating time was median 115 min (75-230) in the stapler group and 120 min (60-210) in the clip group, and there was no significant difference between the groups (p= 0.2593). There were no significant difference between the groups in terms of the postoperative complications (p= 0.59). Postoperative hospital stay was median 3.5 (2-8) days in the stapler group and 3 (2-6) days in the clip group with no significant difference (p= 0.0733). Conclusion: Clip ligation and en-bloc stapling techniques have no superiority over each other. Our results also showed that both techniques are safe and feasible. We suggest opting for the method according to the surgeon’s experience and hospital facilities.Öğe Perineal and abdominal approaches in the surgical treatment of rectal prolapse: Our 10-year clinical experience(İstanbul Bağcılar Eğitim ve Araştırma Hastanesi, 2021) Başol, Ömer; Bilge, Hüseyin; Akpulat, Faik Veysel; Yaman, Gizem; Oğuz, AbdullahObjective: Rectal prolapse is a rare condition characterized by protrusion of the rectum with all its layers from the anus. It is a disease that causes social and functional problems. In this study, it was aimed to investigate the abdominal and perineal approaches together with postoperative early and late results in our patients who underwent surgical treatment for rectal prolapse. Method: The records of 39 patients who were operated on with the diagnosis of rectal prolapse between 2010 and 2020 in the Department of General Surgery, Dicle University Faculty of Medicine were evaluated retrospectively. Demographic and physical examination findings of the patients, surgical methods applied, early and late postoperative complications, recurrence and mortality rates were recorded. Results: The most common complaints on admission to the hospital were gas control disorder, difficulty in defecating and getting wet with mucus. On physical examination, stage 1 rectal prolapse was found in 12.8% of the patients, and full-thickness prolapse was found in the other patients. The mean age of 39 patients included in the study was 36 (14- 88) years. Of the patients included in the study, 14 (35.9%) were female and 25 (64.1%) were male. Surgery was performed with an abdominal and perineal approach in 53.8% of the patients, while laparoscopy was performed in 46.2%. The most frequently used abdominal surgical technique was Notaras (35.8%). The most common perineal approach technique was Altemeier (5.1%). Patients who underwent the perineal approach were older and had a shorter hospital stay, and it was often performed under regional anesthesia. Complications developed in the early postoperative period in 10.4% of the patients. The median hospital stay was 5 days (2-19) and the follow-up period was 13 months (9-19). Postoperative mortality did not occur in any of the patients. Hospital stay was significantly shorter in patients who underwent laparoscopic surgery. There was no statistical difference in terms of early postoperative complications and recurrence. Conclusion: Although more than a hundred surgical procedures have been described to date for the treatment of rectal prolapse, the ideal treatment method is still unclear. In terms of surgical treatment, the results of abdominal or perineal approaches to be applied are similar, considering the risk factors, patient findings and surgeon’s experience.Öğe Rectus Sheath Hematoma-a Hitherto Less Described Entity(Springer India, 2021) Basol, Omer; Bilge, Huseyin; Kirsan, Mehmet Ali; Yaman, GizemRectus sheath hematoma is a rare condition that is manifested by abdominal wall pain and stiffness in the abdominal wall. It is usually a result of the rupture of the epigastric vessels or rectus muscle into the lower part of the umbilical region. Surgical intervention is rarely required due to diagnosis and uncontrollable growth. Twenty-two patients who were diagnosed and followed up with rectus sheath hematoma between January 2010 and January 2020 in Dicle University Medical Faculty, Clinic of General Surgery, were retrospectively reviewed for demographic features, clinical and radiological findings, and length of hospital stay. The most common complaints of patients with rectus sheath hematoma were abdominal wall pain, swelling, ecchymosis, and mass on the abdominal wall. The average age of the patients was 63 (22-78) years. Twenty of the patients were women and 2 of them were men. None of the patients had a history of trauma, and all were using anticoagulant drugs. In radiological imaging, types of rectus sheath hematoma were type 1 in twelve patients, type 2 in seven, and type 3 in three. Firstly, anticoagulant medications used by patients were discontinued. Then, all patients, except two who were undertaken surgery, were treated conservatively. The reason for the surgery was rapid and widespread growth of hematoma. The average length of hospital stay was 7 (6-13) days. At the end of the first month after diagnosis and treatment, computed tomography revealed that the mass disappeared in patients with type 1 rectus sheath hematoma, while the other patients had a marked reduction in mass size. In patients with an abdominal wall pain, anemia, a mass/ecchymosis on anterior abdominal wall, and history of anticoagulant medication, rectus sheath hematoma should be considered in the differential diagnosis. Early diagnosis of rectus sheath hematoma ensures the prevention of unnecessary surgical interventions and determines the success of conservative treatment.Öğe The Role of Corynebacterium in The Etiology of Granulomatous Mastitis(Merthan TUNAY, 2023) Yaman, Gizem; Girgin, Sadullah; Akpolat, Nezahat; Uzuner, Nurullah; Yildizhan, EdaIntroduction: Granulomatous mastitis (GM) is a rare, benign, chronic inflammatory illness of the breast. It is characterized by necrotizing granulomatous lobulitis of the breast that clinically mimics breast cancer. The aim of this study was to examine the existence of Corynebacterium strains thought to be covered in the etiology of idiopathic granulomatous mastitis. Material and Methods: In this study, we retrospectively analyzed the results of 201 breast tru-cut biopsies carry out for diagnostic purposes in the Department of General Surgery. The tissue samples of 41 patients with histopathologically diagnosed GM were examined by Gram staining. The existence of Corynebacterium kinds was investigated microscopically by adding appropriate medium. Results: The mean age of 41 female patients with GM was 35. 7 years and the age range was 20-58 years. At the end of the study, Corynebacterium amycolatum was defined as the causative microorganism as a consequence of microbiologic examination of the tissue sample of one patient (2.4%). Conclusion: We consider that Corynebacterium is not the etiologic agent of GM. Additionally studies with large case series are needed to explain the etiology.
