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1.
Surgeon ; 2024 Jul 08.
Article in English | MEDLINE | ID: mdl-38981842

ABSTRACT

BACKGROUND: Postoperative pneumonia is one of the most observed hospital-acquired infections and increases the postoperative mortality rate. Further, it drives the healthcare systems under a severe financial burden. Preventing postoperative pneumonia is an incredibly challenging issue for clinicians. Since immunosuppression therapy, the patients who had kidney transplants are more vulnerable to postoperative infections. There is no data in the scientific literature focusing on the effects of preoperative oral care with chlorhexidine antiseptic solutions on postoperative pneumonia in kidney transplantation surgery cases. In the present research, we studied this topic. METHODS: A prospective, randomized clinical trial was conducted at our institution between August 2020 and August 2022. Group A: Received 0.12 % chlorhexidine oral rinse preoperatively; Group B: Not received 0.12 % chlorhexidine oral rinse preoperatively. We analyzed the differences between the two trial groups using a chi-square or t-test. The Mann-Whitney U test was used for the categorical data. RESULTS: Nine patients (17.6 %) were diagnosed with postoperative pneumonia in Group A and fourteen (25.9 %) in Group B (p < 0.05). Hospitalization time of Group B was prolonged (p < 0.05). In multivariate analysis, significant risk factors associated with postoperative pneumonia were advanced age, diabetes mellitus, smoking, delayed graft function and not gargling with 0.12 % chlorhexidine (p < 0.05). CONCLUSIONS: To reduce postoperative pneumonia risk in patients undergoing kidney transplantation surgery, an oral health protocol including 0.12 % chlorhexidine mouth rinse seems beneficial.

2.
Cureus ; 14(11): e31071, 2022 Nov.
Article in English | MEDLINE | ID: mdl-36475195

ABSTRACT

Introduction The aim of this work was to treat patients with leaky gut syndrome (LGS) and gastrointestinal flora loss in a simple, inexpensive, permanent and effective way without the need for further treatment. Methods A total gastrointestinal flora transplantation (TGFT) procedure is performed by simultaneously transferring the "flora" taken from approximately 30 different anatomical sites, from the mouth to the anus, of healthy donors to the corresponding anatomical site of the patient using the endoscopic lavage method. Results Of the patients, 25 (44.6%) were female and 31 (55.4%) were male, totaling 56 (100%). The mean age was 32.88±15.78 years. Among the 56 patients enrolled in the study, TGFT had no efficacy in one patient, five patients underwent repeat TGFT during a mean follow-up period of 23.73±16.74 months, and the treatment was permanent in 50 patients; our success rate during the follow-up period was 89.3%. Conclusion In LGS, TGFT should be the gold standard treatment.

3.
Transplant Proc ; 54(6): 1417-1423, 2022.
Article in English | MEDLINE | ID: mdl-34986975

ABSTRACT

BACKGROUND: Uncertainty raises questions in kidney transplant during the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) pandemic regarding the recipient, the donor, and health care professionals. The pandemic not only has disrupted kidney transplanted patients but also has influenced transplant systems, donation chains, and timely and safe transplant surgeries. In the present study, we aimed to explore the global effects of the SARS-CoV-2 pandemic on kidney transplant. METHODS: We collected transplantation statistics and SARS-CoV-2 pandemic data from the World Health Organization website on June 15, 2021. Spearman correlation analysis was applied to assess the strength of a monotonic relationship among quantitative variables. We also demonstrated the clinical characteristics of our kidney recipients with SARS-CoV-2 infection. RESULTS: Comparison of the mean of global kidney transplantation statistics between 2010 and 2019 with 2020 statistics showed a significant decrease in kidney transplant from living donors (P < .001). From the beginning of the pandemic to June 15, 2021, 1 of the 43 kidney transplant patients we treated in our clinic died of SARS-CoV-2 infection after discharge. Two of the patients we transplanted and saw in follow-up before the pandemic died of SARS-CoV-2 infection. CONCLUSION: While the overall kidney transplant numbers have increased in the year to date, kidney transplants decreased drastically at the onset of the pandemic.


Subject(s)
COVID-19 , Kidney Transplantation , COVID-19/epidemiology , Humans , Kidney Transplantation/adverse effects , Living Donors , SARS-CoV-2 , Transplant Recipients , World Health Organization
4.
Turk J Surg ; 38(3): 302-305, 2022 Sep.
Article in English | MEDLINE | ID: mdl-36846065

ABSTRACT

Splanchnic artery aneurysms are rare vascular lesions with a high risk of rupture regardless of their size. Symptoms may vary from simple abdominal pain or vomiting to morbid conditions like haemorrhagic shock; however, most aneurysms are asymptomatic and difficult to diagnose. In this study, it was aimed to present the case of a 56-year-old female with a ruptured pancreaticoduodenal artery aneurysm treated by coil embolization.

5.
Sisli Etfal Hastan Tip Bul ; 55(1): 62-67, 2021.
Article in English | MEDLINE | ID: mdl-33935537

ABSTRACT

OBJECTIVES: We aimed to compare the once-daily and twice-daily formulation of tacrolimus concerning the efficiency and effects on graft function in de novo kidney transplant patients. METHODS: Twenty once-daily (TAC-OD) and twenty twice-daily (TAC-BID) tacrolimus administrated de novo kidney recipients who had received initial immunosuppressive therapy according to protocols at our institution (0.2 mg/kg of tacrolimus combined with 1000 milligrams of steroid taper plus 720 mg of mycophenolate and with 2.5mg/kg anti-thymocyte globulin) assessed concerning demographics, drug doses and blood concentration, and graft function. RESULTS: The mean tacrolimus blood concentration measurements were higher in the TAC-OD group in the first sixty days after transplantation, and the TAC-OD group showed more blood concentration overshoots/fluctuations in the first 30 days of the treatment. The initial drug dose was significantly higher in the TAC-OD group than the TAC-BID group (p=0.04). There was no meaningful difference among groups according to graft function (creatinine measurements) (p>0.05). CONCLUSION: Between de novo kidney recipients, the new TAC-OD formulation presents a similar short-term efficacy profile as TAC-BID. However, a higher daily dosage of TAC-OD is needed to achieve similar blood concentrations in the early postoperative period.

6.
Bariatr Surg Pract Patient Care ; 16(1): 61-67, 2021 Mar 01.
Article in English | MEDLINE | ID: mdl-33763312

ABSTRACT

Objective: To prospectively evaluate the postoperative morbidity, mortality, and weight loss evolution of patients who underwent a bariatric procedure during 1 year of follow-up. Methods: Since July 2016, a total of 101 patients' data have been prospectively registered in a database. Comorbidities, operating time, hospital stay, early and late complications rate, and weight loss evolution after 1 year of follow-up were recorded. Results: The mean age was 38.41 ± 11.05 years with a mean body mass index (BMI) of 49.02 ± 5.89 kg/m2 (range 38-67). Laparoscopic sleeve gastrectomy (LSG) was performed in 93 patients (92.07%) and Roux-en-Y gastric bypass (RNYGB) in 8 patients (7.92%). Thirty-day morbidity rate was 7.92% (8/101). Within a mean 9.32 ± 2.25 (range 1-19) months follow-up time, mean percent of the excess of weight loss of 1st, 6th, and 12th months were 22.7 ± 6.1, 67.2 ± 11.2, and 81.4 ± 10.5, respectively. Diabetes (n = 38, 37.6%), hypertension (n = 13, 12.9%), and obstructive sleep apnea (n = 5, 4.9%) were resolved in 76%, 68.4%, and 100% of the patients, respectively (p < 0.001). Conclusions: LSG and RNYGB are safe and highly effective, particularly in patients with a BMI >50 kg/m2. Both techniques have been presented with better clinical outcomes regarding significant comorbidity resolution in the early evolution of weight loss.

8.
J Relig Health ; 60(2): 774-786, 2021 Apr.
Article in English | MEDLINE | ID: mdl-33415604

ABSTRACT

About one-fourth of the world population belongs to the religion of Islam, and a significant number of people in the Muslim society, including health professionals, are dedicated themselves to the holy book Qur'an but unclear about the religious teachings on organ donation and transplantation. These people are dependent on religious rulings declared by ecclesiastical authorities (scholars and imams). In this study, we aimed to question the attitude of Islamic nations on organ donation and transplantation. Secondly, we endeavored to investigate how the Islamic perspective on these issues influences scientific productivity about the subject of brain death, which is undeviatingly related to organ transplantation. The term "brain death" was searched in Thomson Reuters, Web of Science search engine, only including Muslim countries. All of the data obtained were subjected to bibliometric analysis. We also compared the transplantation statistics of Global Observatory on Donation and Transplantation Organization with the development statistics of the United Nations (UN). The two leading Muslim countries in terms of scientific productivity about brain death are Turkey and Iran. Transplantation proceedings is the leading scientific journal on this subject. These two countries have outperformed other Islamic countries in terms of organ donation and transplantation statistics. We also revealed that the human development index and education index of the UN have a positive correlation with the number of deceased transplantation, which is directly related to the number of brain-death-diagnosed cases (r 0.696, p < 0.05 and r 0.771, p < 0.05, respectively). Additionally, we found a positive correlation between expenditure on research and development data of the UN with the number of total transplantations performed and the number of scientific articles on brain death (r 0.889, p 0.01 and r 0.634, p < 0.05, respectively). There is not a consensus about brain death and organ transplantation in Islamic nations, and the majority of these countries have various hindrances about organ donation and transplantation. The legal authorities, health professionals, religious rulers, and media should spend every effort to educate the people on organ donation and transplantation. And, policymakers of Islamic nations should allocate extra funds for education and scientific activities to break down negative views on organ donation and transplantation.


Subject(s)
Organ Transplantation , Tissue and Organ Procurement , Brain Death , Humans , Iran , Islam , Turkey , United Nations
9.
Transplant Proc ; 52(10): 2916-2922, 2020 Dec.
Article in English | MEDLINE | ID: mdl-32660750

ABSTRACT

BACKGROUND: For health professionals, recognizing and diagnosing brain death is vital for the development of organ transplantation. However, cadaveric organ donation rates remain insufficient, and this problem has become one of the most serious obstacles in the treatment of end-organ failure. OBJECTIVES: This study examines the attitude and knowledge level of clinicians who practice in intensive care units (ICUs) concerning the determination of brain death and describes the hindrances in diagnosing brain death. MATERIALS AND METHODS: A survey study was designed with 26 questions, including questions regarding the determination of characteristics of respondents' trainings, practicing preferences, and their knowledge and approach toward brain death diagnosis. Clinicians practicing in ICUs in Turkey were invited to the survey. RESULTS: A total of 244 surveys were fully completed. Physicians working at the university hospitals or university-affiliated hospitals answered the basic knowledge questions about brain death more accurately (P < .001). Also, physicians employed in university or university-affiliated hospitals feel more capable in diagnosing brain death (P = .002) and are more willing to receive education on the brain death issue (P < .001). CONCLUSION: There is a gap separating the practices suggested in guidelines and the daily practice of ICU clinicians working in state hospitals or private institutions. Academic organizations producing and leading the education curricula may assist in informing ICU clinicians who should be trained.


Subject(s)
Attitude of Health Personnel , Brain Death/diagnosis , Health Knowledge, Attitudes, Practice , Physicians/psychology , Tissue and Organ Procurement/methods , Female , Humans , Intensive Care Units , Internet , Motivation , Surveys and Questionnaires , Turkey
10.
Turk J Surg ; 36(1): 9-14, 2020 Mar.
Article in English | MEDLINE | ID: mdl-32637870

ABSTRACT

OBJECTIVES: Setting up and advocating a thesis is mandatory at the end of the residency training program to become a specialist in general surgery according to the regulations on medical specialization in Turkey. Writing a thesis helps the resident to learn to ask structured questions, assembling the most accurate study design, managing the study process, collecting the results and building a conclusion with medical implications. In this descriptive study, we aimed to investigate the publication rates of the theses written in the field of general surgery and to assess the properties of the published theses. MATERIAL AND METHODS: We performed an online search on September 1, 2018, about the theses of general surgery residents on the website of National Thesis data center of Academic Educational Board in Turkey including theses of medical residents in university-affiliated hospitals and analyzed theses accomplished between 1998-2018. The publication status of the theses was assessed by the entry of author name, the title of the theses and keywords of the theses by using the search engines of PubMed, Google Scholar and Turkish Academic Network and Information Center Turkish Database (ULAKBIM). Data were presented in a descriptive form as absolute numbers and percentages. RESULTS: Between 1998-2018, 1996 theses were completed. 393 (20.5%) of these were published in a journal, and 288 (14.4%) were published in a journal indexed in SCI/SCIE. According to research methodologies, 79.2% of the experimental studies were published in SCI/SCIE indexed journals. CONCLUSION: Publication rates of the theses in the field of general surgery are low as they are in other specialties of medicine. This descriptive study might give an idea about the low scientific publication rates of general surgery theses. Further studies are needed to understand the underlying factors, which are responsible for this scant scientific performance.

11.
Sisli Etfal Hastan Tip Bul ; 54(1): 1-7, 2020.
Article in English | MEDLINE | ID: mdl-32377127

ABSTRACT

Gastric outlet obstruction that arises from gallstones impacted in the distal stomach or proximal duodenum after passing through a cholecystoduodenal, cholecystogastric or rarely choledocoduodenal fistula is called as Bouveret's syndrome and it accounts for approximately 1-3% of all the patients with gallstone ileus. Although treatment modalities, including stone removal or fragmentation with classical endoscopic devices, such as snares, and forceps or fragmentation of gallstones with new devices, such as electrohydraulic lithotripsy, laser, extracorporeal shockwave lithotripsy have been described. However, only 29% of the patients benefit from nonsurgical methods. Removal of the stone through a gastrotomy or enterotomy and performing cholecystectomy and fistula repair with a second operation is an approach recommended for older patients with comorbid diseases. In this paper, a case of Bouveret's syndrome was presented. The authors also aimed to review the diagnosis, management and treatment of this rare disease and to update the previous reviews.

12.
Obes Surg ; 30(9): 3472-3479, 2020 Sep.
Article in English | MEDLINE | ID: mdl-32306298

ABSTRACT

PURPOSE: Many studies evaluating the effect of intragastric botulinum toxin type A injection (IG-BTxA) for the treatment of obesity have been published. However, none of these studies combined this procedure with a calorie-restricting high-protein diet. Herein, we aimed to evaluate the effects of IG-BTxA application combined with a calorie-restricting high-protein diet. MATERIALS AND METHODS: This prospective cohort study is conducted with eighty-seven grade 2 obese patients treated between January 2019 and August 2019. Group 1: IG-BTxA + refused to consult the dietitian; group 2: IG-BTxA + get calorie-restricting high-protein diet; group 3: only get a calorie-restricting high-protein diet. Loss of weight, treatment adaptation (visual analog scale score), the status and changes of comorbid conditions, and changes in eating behaviors (Self-Regulation of Eating Behaviour Questionnaire score) were assessed. RESULTS: Loss of weight, treatment adaptation, and positive behavioral change in eating preferences were significantly higher in group 2 (p = 0.01; p = 0.001; p < 0.01, respectively). Additionally, the decrease in medication requirement for diabetes and hypertension was higher in group 2 (p < 0.05). CONCLUSION: IG-BTxA application before calorie-restricting high-protein diet facilitates adaptation to the new diet style and helps to lose weight faster in grade 2 obese patients. Also, more positive results were achieved in terms of controlling comorbid diseases.


Subject(s)
Botulinum Toxins, Type A , Diabetes Mellitus , Diet, High-Protein , Obesity, Morbid , Humans , Obesity, Morbid/surgery , Prospective Studies
13.
Urol J ; 17(4): 379-385, 2020 06 23.
Article in English | MEDLINE | ID: mdl-32207136

ABSTRACT

PURPOSE: Recent studies reported that the presence of metabolic syndrome is closely correlated with impaired kidney function after living donor nephrectomy. Since the measurement of body mass index cannot differentiate the amount of body adipose tissue from total body weight, body mass index is not a reliable parameter for determining metabolic syndrome. In the present study, we investigated the correlation between body adipose tissue and kidney function recovery following living donor nephrectomy. MATERIALS AND METHODS: The patients who underwent living kidney donor nephrectomy consequently from July 2016 through December 2017 were enrolled in the study. We preoperatively measured the visceral (VAdT), retroperitoneal (RPAdT), and subcutaneous (SCAdT) adipose tissue volume by a computed tomography scan. Body mass index, adipose tissue measurements, and postoperative estimated glomerular filtration rate (eGFR) were evaluated. RESULTS: The decrease between preoperative eGFR, and the first day, the first month and the sixth month eGFR after surgery were statistically significant (P = .001; P = .001; P = .001, respectively). The negative correlation between VAdT/SCAdT measurements and changes in eGFR at the first and the sixth postoperative month compared to preoperative eGFR were statistically significant (P = .049; P = .041, respectively). Additionally, RPAdT measurements and changes in eGFR at the first and the sixth postoperative month compared to preoperative eGFR (decreasing as RPAdT value increased) were statistically significant (P = .035; P = .026, respectively). CONCLUSION: According to a preoperative computed tomography scan, VAdT, RPAdT, and VAdT-to-SAdT ratio can predict impaired kidney function recovery. Furthermore, RPAdT measurement is a new variable to predict the impaired kidney function after living donor nephrectomy.


Subject(s)
Intra-Abdominal Fat/diagnostic imaging , Kidney/physiology , Nephrectomy , Subcutaneous Fat/diagnostic imaging , Tissue and Organ Harvesting , Tomography, X-Ray Computed , Adult , Aged , Correlation of Data , Female , Glomerular Filtration Rate , Humans , Kidney Diseases/diagnosis , Living Donors , Male , Middle Aged , Postoperative Complications/diagnosis , Recovery of Function , Retrospective Studies , Young Adult
14.
Ulus Travma Acil Cerrahi Derg ; 26(1): 144-147, 2020 Jan.
Article in English | MEDLINE | ID: mdl-31942736

ABSTRACT

Castleman's disease (CD) is a lymphoproliferative disorder and the occurrence of CD in the small bowel is rare. In this study, we present one case of CD causing mechanical intestinal obstruction due to involvement of terminal ileum. A 50-year-old man was admitted to the hospital with signs and symptoms of mechanical intestinal obstruction without history previous surgery. After examination and obtaining abdominal computed tomography, diagnosis of mechanical intestinal obstruction was reached and emergency surgery was performed with a median incision. On abdominal exploration a tumor like mass that also held distal small intestine mesentery, and ileocecal valve causing complet intestinal obstruction was observed. Ileocecal resection and ileocolonic anastomosis were performed. CD is a rare entity and should be kept in mind during the differential diagnosis of mechanical intestinal obstruction provided that wall thickening in terminal ileum mimicking mass, and accompanying enlargement mesenteric lymph nodes observed during preoperative investigations or intraoperative exploration.


Subject(s)
Castleman Disease , Ileal Diseases , Intestinal Obstruction , Diagnosis, Differential , Humans , Ileum/diagnostic imaging , Ileum/physiopathology , Ileum/surgery , Male , Middle Aged , Tomography, X-Ray Computed
15.
J Gastrointest Surg ; 24(2): 313-319, 2020 02.
Article in English | MEDLINE | ID: mdl-30788716

ABSTRACT

OBJECTIVE: A restrictive diet applied before bariatric surgery can be required to reduce the liver volume or as a necessity imposed by insurance companies. However, the benefits of preoperative weight loss remain controversial. The present study aimed to investigate the perioperative and postoperative outcomes of a restrictive diet applied before laparoscopic sleeve gastrectomy. MATERIALS AND METHODS: The data of 128 patients who received surgery in 2015 and 2016 were retrospectively analyzed. All patients were advised to follow a 4-week low-calorie (1000 cal) restrictive diet. Nevertheless, approximately 50% of patients did not accept the diet plan. We divided the patients into two groups as dieters (group 1) and non-dieters (group 2). RESULTS: In group 1, changes in after-diet BMI and liver size were statistically significant (p < 0.001). In group 2, mean operation duration, mean hospitalization duration values, mean BMI values, and mean body weight at postoperative 1, 3, 6, and 12 months were statistically significantly higher than in group 1. No statistically significant difference was found between early complication rates of the groups (p = 0.844). CONCLUSION: Low-calorie restrictive diet applied before laparoscopic sleeve gastrectomy has reduced liver volume and shortens surgery and hospitalization time but does not have any significance concerning early complications and weight loss after operation in 1 year. Also, non-adherence of the bariatric surgery candidate patients to the diet seems to be a challenge.


Subject(s)
Caloric Restriction/methods , Gastrectomy/methods , Laparoscopy/methods , Obesity, Morbid/surgery , Weight Loss/physiology , Adolescent , Adult , Female , Humans , Male , Middle Aged , Obesity, Morbid/diet therapy , Perioperative Period , Postoperative Period , Retrospective Studies , Treatment Outcome , Young Adult
16.
Wounds ; 31(11): 292-296, 2019 Nov.
Article in English | MEDLINE | ID: mdl-31747369

ABSTRACT

INTRODUCTION: Sacrococcygeal pilonidal sinus disease generally affects young people and impacts their quality of life. Few published studies assessing the characteristics of the disease in the adolescent population exist. OBJECTIVE: In this paper, the authors aim to evaluate the effects of bathing habits on wound complications in adolescent patients following Karydakis flap surgery for sacrococcygeal pilonidal sinus. MATERIALS AND METHODS: The medical records of 79 adolescent patients who underwent sacrococcygeal pilonidal sinus surgery between January 2014 and December 2017 at the Surgery Clinic of Malatya State Hospital (Malatya, Turkey) were evaluated retrospectively. Following exclusion, 67 patients were evaluated for demographics, body mass index (BMI), previous abscess formation, bathing frequency, number of sinus pits, and postoperative wound infection and dehiscence. The total follow-up time for the 67 patients was 90 days. RESULTS: The BMIs of patients with previous abscess formation were significantly higher (P = .029). In the cases with abscess, the number of pilonidal sinus pits was significantly higher (P = .039) There was a statistically significant difference between postoperative complication rates according to the number of baths per week. Wound infection rates were found to be higher in patients who bathed more than twice weekly during the 28 days after surgery (P = .005). No statistical significance was observed in complication rates from days 28 to 90 after the surgery between those who bathed twice weekly and more than twice weekly (P > .05). CONCLUSIONS: Postoperative wound complications in adolescent patients treated with Karydakis flap surgery for sacrococcygeal pilonidal sinus are more frequent in those who bathe more than twice weekly during the first 28 days postoperatively.


Subject(s)
Abscess/pathology , Baths/adverse effects , Pilonidal Sinus/surgery , Postoperative Complications/pathology , Sacrococcygeal Region/surgery , Surgical Flaps/pathology , Wound Healing/physiology , Abscess/etiology , Abscess/microbiology , Adolescent , Female , Humans , Male , Pilonidal Sinus/microbiology , Pilonidal Sinus/physiopathology , Postoperative Complications/microbiology , Plastic Surgery Procedures/methods , Retrospective Studies , Sacrococcygeal Region/microbiology , Sacrococcygeal Region/physiopathology , Self Care , Surgical Flaps/blood supply , Surgical Flaps/microbiology , Treatment Outcome , Turkey
17.
J Coll Physicians Surg Pak ; 29(12): S123-S125, 2019 Dec.
Article in English | MEDLINE | ID: mdl-31779764

ABSTRACT

Vascular leiomyomas with bizarre nuclei are rare. Differentiation of these tumors from malignant lesions is essential to avoid unnecessary dissection and organ loss in surgery. Herein, we present a 39-year Kosovo woman with a bizarre leiomyoma arising from the portal vein. The patient presented to the general surgery clinic with a one-year history of abdominal pain, vomiting and back ache. No abnormality was observed on physical examination. On computed tomography, a 42x35 mm, cystic-solid mass in the pancreatic neck, wrapping the superior mesenteric vein for 360-degrees and the superior mesenteric artery for 180-degrees, was found. In contrast to preoperative findings, a 5x4 cm mass located behind the portal vein and reaching portal vein-superior mesenteric vein junction posteriorly was seen perioperatively. There was no relationship between the mass and the superior mesenteric artery. The tumor was excised with the posterior wall of the junction of the portal vein and the superior mesenteric vein. The end-to-end vascular anastomosis was performed between the portal vein and the superior mesenteric vein. After finishing distal pancreatectomy, the operation was accomplished without any complication. The patient was discharged on 10th day of the operation without any problem. In conclusion, vascular bizarre leiomyomas are rare tumors. It is impossible to diagnose these correctly before surgery. Perioperative use of pathological examination as a frozen section can be helpful to avoid unnecessary surgical procedures.


Subject(s)
Leiomyoma/diagnosis , Portal Vein , Vascular Neoplasms/diagnosis , Adult , Anastomosis, Surgical/methods , Diagnosis, Differential , Female , Humans , Leiomyoma/surgery , Tomography, X-Ray Computed , Vascular Neoplasms/surgery , Vascular Surgical Procedures/methods
18.
Ulus Travma Acil Cerrahi Derg ; 25(4): 324-330, 2019 Jul.
Article in English | MEDLINE | ID: mdl-31297772

ABSTRACT

BACKGROUND: Oils from marine organisms have a different fatty acid composition. Fish oil (FO) has a high content of eicosapentaenoic and docosahexaenoic acids esterified to triacylglycerols; while in krill oil (KO), fatty acids are primarily esterified to phospholipids. This study aimed to compare the efficacy of two different, marine-derived omega-3 fatty acid sources in the wound healing of colon anastomoses rat model. METHODS: For the study, we used 42 male Wistar albino rats. The rats were divided into six groups with seven rats in each group-CO3: left colonic anastomosis (control group), sacrificed on the third day; KO3: left colonic anastomosis + oral KO, sacrificed on the third day; FO3: left colonic anastomosis + oral FO, sacrificed on the third day; CO7: left colonic anastomosis (control group), sacrificed on the seventh day; KO7: left colonic anastomosis + oral KO, sacrificed on the seventh day; FO7: left colonic anastomosis + oral FO, sacrificed on the seventh day. Peritoneal adhesions, anastomotic bursting pressures, hydroxyproline levels, and histological examination of the anastomotic tissue were evaluated. RESULTS: On day 7, bursting pressure and hydroxyproline measurements of the KO group was significantly higher than the FO group (p=0.012; p=0.002, respectively). Also, on day 7, a statistically significant difference was observed between the groups according to inflammatory cell infiltration, fibroblast activity, neoangiogenesis, and collagen deposition in favor of the KO group (p=0.023; p=0.028; p=0.016; p=0.012, respectively). CONCLUSION: Both KO and FO supplementation in patients before colorectal surgery may reduce some risk of anastomotic leakage; and KO might be a better alternative and excellent omega-3 source.


Subject(s)
Colon/surgery , Euphausiacea/chemistry , Fatty Acids, Omega-3/therapeutic use , Fish Oils/chemistry , Wound Healing/drug effects , Anastomosis, Surgical/adverse effects , Anastomotic Leak/drug therapy , Anastomotic Leak/pathology , Animals , Colectomy/adverse effects , Colon/pathology , Fatty Acids, Omega-3/pharmacology , Humans , Hydroxyproline/analysis , Male , Pressure , Random Allocation , Rats , Rats, Wistar , Surgical Wound/drug therapy
19.
Ann Ital Chir ; 90: 574-579, 2019.
Article in English | MEDLINE | ID: mdl-31354153

ABSTRACT

OBJECTIVE: Pilonidal sinus is one of the common diseases, although there is still no gold standard of treatment available. The aim of this study was to reduce the residual dead-space volume with a modification following the standard Karydakis procedure. METHODS: A total of 100 patients were included in a randomised controlled trial, who were divided into two groups. Each group included 50 patients, and the patients in Group-1 were treated with the new technique, whereas in Group- 2, the standard Karydakis technique was performed. In the new technique, following total sinus excision, an advancement tissue flap was performed using additional skin excision, in order to reduce the dead-space volume. RESULTS: There was no significant difference in terms of sex, age, and sinus volume. Operation time was longer in first group (p=0,002). Seroma formation rate was higher in the secound group (p=0.036). There was no significant difference in terms of soft tissue infection (p=0.339) and wound dehiscence (p=0.218). The mean follow-up period was 30 months and no recurrence was observed in both groups. CONCLUSIONS: The results of the study suggest that this technique may be considered as an alternative surgical method in pilonidal sinus surgery. KEY WORDS: Dead, Karydakis flap-space volume, Sacrococcygeal pilonidal sinus, Seroma, Skin excision.


Subject(s)
Pilonidal Sinus/surgery , Adult , Dermatologic Surgical Procedures , Female , Follow-Up Studies , Humans , Length of Stay/statistics & numerical data , Male , Postoperative Complications/epidemiology , Postoperative Complications/etiology , Recurrence , Seroma/epidemiology , Seroma/etiology , Seroma/prevention & control , Soft Tissue Infections/epidemiology , Soft Tissue Infections/etiology , Surgical Flaps , Surgical Wound Dehiscence/epidemiology , Surgical Wound Dehiscence/etiology , Young Adult
20.
Obes Surg ; 29(11): 3560-3568, 2019 11.
Article in English | MEDLINE | ID: mdl-31187460

ABSTRACT

BACKGROUND: The staple line leakage is a dangerous complication of sleeve gastrectomy. Various strategies have been tried to reduce the leakage risk. The amniotic membrane (AmM) is the inner layer of the placental membranes and has anti-inflammatory, anti-fibrosis, and anti-scarring effects, and it also has lower immune characteristics which are another essential characteristic of AmM concerning its utility for grafting. In this study, we aimed to investigate the impact of AmM on the staple line healing process of sleeve gastrectomy model in rats. MATERIALS AND METHODS: We used twenty-eight Long-Evans rats in this study. Sleeve gastrectomy was performed with tristapler. Fourteen rats served as controls, AmM was applied staple line of the other fourteen. Fourteen animals were sacrificed (seven from the AmM applied group and the other seven from the control group) on the third postoperative day. And, the other fourteen animals were sacrificed (seven from the AmM applied group and seven from the control group) on the seventh postoperative day. The tissue around the staple line was evaluated microscopically and macroscopically, bursting pressures and hydroxyproline levels were also measured. RESULTS: The bursting pressure and hydroxyproline measurements of the AmM applied group was significantly higher on the seventh postoperative day (p = 0.015, p = 0.012) Fibroblast activity and neoangiogenesis of the AmM applied group was also significantly higher on the seventh postoperative day (p = 0.004, p = 0.002). CONCLUSION: This study showed that covering of staple line of sleeve gastrectomy model in rats significantly provided higher bursting pressures and increased hydroxyproline levels, fibroblast activity, and neoangiogenesis which may potentially lead a better staple line healing. We think further investigations are needed on this issue.


Subject(s)
Abdominal Wound Closure Techniques , Amnion/physiology , Anastomosis, Surgical/methods , Gastrectomy/methods , Obesity, Morbid/surgery , Surgical Stapling , Wound Healing/physiology , Adult , Amnion/transplantation , Anastomotic Leak/prevention & control , Animals , Female , Gastrectomy/adverse effects , Humans , Laparoscopy/adverse effects , Laparoscopy/methods , Obesity, Morbid/pathology , Postoperative Period , Pregnancy , Rats , Rats, Long-Evans , Surgical Stapling/adverse effects , Sutures
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