Publications (18)9.58 Total impact
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Article: Feasibility and Safety of Laparoscopic Hydatid Surgery: A Systematic Review.
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ABSTRACT: Background/Aims: Eccinococal disease is an important problem in regions such as Turkey, where tapeworms are endemic. Surgery is the main key to successful treatment. Among the various techniques, laparoscopy has recently come to be preferred over the commonly used open technique. The aim of this review was to evaluate the feasibility, safety and potential benefits of laparoscopic hydatid surgery. Methodology: Three independent investigators conducted comprehensive research using PubMed, MEDLINE, Embase and the Cochrane library. Language was restricted to English; reference lists were searched manually. Results: Tweny-two retrospective studies were selected for review, none of which were randomized controlled trials. It was found that the laparocopic approach was attempted in 666 patients. The overall conversion rate to laparotomy was 4% (27/666) with a recurrence rate of hydatid disease of 1.6% (11/666). Average length of hospital stay was 4.7 (1-30) days. Conclusions: Based on this meta-analsysis, evidence confirms that the laparoscopic surgical technique is feasable and safe. Good randomized controlled trials are lacking.Hepato-gastroenterology 08/2012; 60(122). · 0.66 Impact Factor -
Article: Multiple gunshot carotico-jugular fistulas.
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ABSTRACT: The development of post-traumatic fistula between the carotid artery and jugular vein is an extremely rare clinical condition. The authors present a 28-year-old patient, who sustained a gunshot injury to the right side of the neck 6 years ago, with undiagnosed contralateral carotico-jugular fistula.Case Reports 01/2012; 2012. -
Article: Single incision thoracoscopic sympathectomy for hyperhidrosis.
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ABSTRACT: Thoracal sympatectomy for hyperhidrosis and vasospastic vascular diseases is a rare method of surgical treatment. Three patients (1 male, 2 female; mean age 27.6; between 25 and 30) with palmar hyperhidrosis and/or axillary and dorsal hyperhidrosis who underwent single port thoracoscopic sympatectomy were analysed for age, sex, time of operation room, intraoperative and postoperative complications and length of hospital stay. Mean operating room time was 70 min (between 30 and 120 min). Mean length of hospital stay was 1 day. No postoperative complications were noted. Single incision laparoscopic surgery for hyperhidrosis is a safe method of treatment and an alternative to laparoscopy.Case Reports 01/2012; 2012. -
Article: The effect of progesterone in the prevention of the chemically induced experimental colitis in rats.
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ABSTRACT: To study the effects of progesterone on an experimental colitis model. Wistar albino rats were treated subcutaneously with 2mg/kg once a day during seven days Colitis was induced by intrarectal administration of 5mg trinitrobenzene sulfonic acid (TNBS). Disease activities, macroscopic and microscopic scores were evaluated. To determine the response provoked by progesterone we measured Colonic malondialdehyde (MDA), TNF alfa, IL-6 and Nitric oxide (NO) levels in addition to the MPO (Myeloperoxidase) and caspase-3 activities. Progesterone ameliorated significantly the macroscopic and microscopic scores. TNBS-induced colitis significantly increased the colonic MDA levels and caspase-3 activities in group 2 in comparison to the control group. The results of the study revealed a decline in MDA, NO, IL6 and TNF-α levels in the colon tissue and in blood due to progesterone therapy in group 3 when compared to the group 2, a significant improvement. Progesterone treatment was associated with decreased MDA, MPO, TNF alfa and caspase-3 activity. Progesterone therapy decreased oxidative damage in the colonic mucosa.Acta cirurgica brasileira / Sociedade Brasileira para Desenvolvimento Pesquisa em Cirurgia 01/2012; 27(1):23-9. · 0.48 Impact Factor -
Article: Iloprost reduces colonic injury in ischemic colitis in rats.
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ABSTRACT: Evaluate the effects of iloprost administration in the early period of ischemic colitis and the mechanism that how these effects develop. Thirty two Wistar albino female rats with an average weight of 220g were divided into four groups of eight rats. In group 1 the rats were given iloprost and sacrificed after 24 hours and in group 2 they were sacrificed after 24 hours without any iloprost. The rats in group 3 were administrated iloprost and sacrificed after 72 hours and in group 4 they were sacrificed at 72th hour without iloprost. The differences between the groups as tissue damage, vascularization or apoptosis were assessed statistically. Oxidative damage and apoptosis were less pronounced and vascularization was better developed in rats that were given iloprost and sacrificed at 24th hour later in contrast to the rats that were not treated with iloprost. But there was no statistical difference among the groups at 72th hour. Iloprost inhibited leucocyte infiltration, decreased proinflammatory cytokines and enhanced angiogenesis so that the oxidative stress and inflammatory response decreased resulting in lesser tissue damage.Acta cirurgica brasileira / Sociedade Brasileira para Desenvolvimento Pesquisa em Cirurgia 06/2011; 26(3):220-6. · 0.48 Impact Factor -
Article: Adrenomedulline improves ischemic left colonic anastomotic healing in an experimental rodent model.
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ABSTRACT: Leakage from colonic anastomosis is a major complication causing increased mortality and morbidity. Ischemia is a well-known cause of this event. This study was designed to investigate the effects of adrenomedullin on the healing of ischemic colon anastomosis in a rat model. Standardized left colon resection 3 cm above the peritoneal reflection and colonic anastomosis were performed in 40 Wistar rats that were divided into four groups. To mimic ischemia, the mesocolon was ligated 2 cm from either side of the anastomosis in all of the groups. The control groups (1 and 2) received no further treatment. The experimental groups (3 and 4) received adrenomedullin treatment. Adrenomedullin therapy was started in the perioperative period in group 3 and 4 rats (the therapeutic groups). Group 1 and group 3 rats were sacrificed on postoperative day 3. Group 2 and group 4 rats were sacrificed on postoperative day 7. After careful relaparotomy, bursting pressure, hydroxyproline, malondialdehyde, interleukin 6, nitric oxide, vascular endothelial growth factor, and tumor necrosis factor alpha levels were measured. Histopathological characteristics of the anastomosis were analyzed. The group 3 animals had a significantly higher bursting pressure than group 1 (p<0.05). Hydroxyproline levels in group 1 were significantly lower than in group 3 (p<0.05). The mean bursting pressure was significantly different between group 2 and group 4 (p<0.05). Hydroxyproline levels in groups 3 and 4 were significantly increased by adrenomedullin therapy relative to the control groups (p<0.05). When all groups were compared, malondialdehyde and nitric oxide were significantly lower in the control groups (p<0.05). When vascular endothelial growth factor levels were compared, no statistically significant difference between groups was observed. Interleukin 6 and tumor necrosis factor alpha were significantly decreased by adrenomedullin therapy (p<0.05). The healing parameters and inflammatory changes (e.g., granulocytic cell infiltration, necrosis, and exudate) were significantly different among all groups (p<0.05). Adrenomedullin had positive effects on histopathologic anastomotic healing in this experimental model of ischemic colon anastomosis.Clinics (São Paulo, Brazil) 01/2011; 66(10):1805-10. · 1.59 Impact Factor -
Article: Effects of glutamine and curcumin on bacterial translocation in jaundiced rats.
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ABSTRACT: To investigate the effect of curcumin on bacterial translocation and oxidative damage in an obstructive jaundice model and compare the results to glutamine, an agent known to be effective and clinically used. Twenty-four female Wistar-Albino rats, weighing 200-250 g, were randomly divided into three groups (8 in each group). After ligation of the common bile duct in all animals, Group I received oral normal saline, Group II received oral glutamine and Group III received oral curcumin for seven days. Blood samples via cardiac puncture, tissue samples (terminal ileum, liver and mesenteric lymph node) and peritoneal fluid were obtained from the animals at the time of death to investigate bacterial translocation and oxidative damage. We observed that both glutamine and curcumin reduced bacterial translocation in blood, hepatocellular damage, plasma cytokine levels, oxidative tissue damage and apoptosis significantly compared to the control group. Additionally, glutamine showed protective effects on ileal epithelium and reduced villus atrophy. On the basis of these findings, both curcumin and glutamine are thought to be effective in preventing or reducing bacterial translocation and oxidative damage in obstructive jaundice.World Journal of Gastroenterology 09/2010; 16(34):4313-20. · 2.47 Impact Factor -
Article: Esophageal stent migration can lead to intestinal obstruction.
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ABSTRACT: Self-expanding metallic stents are the devices of choice in the treatment of malign or benign strictures of the esophagus. Stent migration is a well-known complication of this procedure. We report a case of intestinal obstruction caused by esophageal stent migration, in which surgical intervention was used. A 65-year-old woman, who had a medical history of gastric cancer operations and esophageal stent applications, was admitted to our emergency department with a 48-hour history of abdominal pain, nausea and vomiting. An emergency laparotomy was performed and the migrated stent causing intestinal obstruction was removed. The patient recovered without incident and was discharged on postoperative day 3. This case illustrates that esophageal stent migration has to be considered as a potential life-threatening complication.North American journal of medical sciences. 07/2009; 1(2):63-5. -
Article: Agenesis of the gallbladder as a rare misdiagnosis
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ABSTRACT: Anatomic anomalies of the biliary tract are not uncommon, but gallbladder and cystic duct agenesis is rare, with an incidence of 0.01% to 0.04% and a frequency of 0.016% at autopsy. It is usually asymptomatic and discovered incidentally. Although this congenital anomaly is infrequent, it may be encountered in clinical practice; thus, the surgeon should be aware of the associated problems. A correct preoperative diagnosis of this congenital anomaly is difficult to establish because of the nonspecific nature of the symptoms and the relative inaccuracy of the currently available diagnostic tests. Here we report a patient with a preoperative false diagnosis of cholelithiasis that was found on laparoscopy and open surgery to be agenesis of the gallbladder.Central European Journal of Medicine 02/2009; 4(1):128-130. · 0.31 Impact Factor -
Article: Diagnostic problems with parasitic and non-parasitic splenic cysts.
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ABSTRACT: The splenic cysts constitute a very rare clinical entity. They may occur secondary to trauma or even being more seldom due to parasitic infestations, mainly caused by ecchinocccus granulosus. Literature lacks a defined concencus including the treatment plans and follow up strategies, nor long term results of the patients. In the current study, we aimed to evaluate the diagnosis, management of patients with parasitic and non-parasitic splenic cysts together with their long term follow up progresses. Twenty-four patients with splenic cysts have undergone surgery in our department over the last 9 years. Data from eighteen of the twenty-four patients were collected prospectively, while data from six were retrospectively collected. All patients were assessed in terms of age, gender, hospital stay, preoperative diagnosis, additional disease, serology, ultrasonography, computed tomography (CT), cyst recurrences and treatment. In this study, the majority of patients presented with abdominal discomfort and palpable swelling in the left hypochondrium. All patients were operated on electively. The patients included 14 female and 10 male patients, with a mean age of 44.77 years (range 20-62). Splenic hydatid cysts were present in 16 patients, one of whom also had liver hydatid cysts (6.25%). Four other patients were operated on for a simple cyst (16%) two patients for an epithelial cyst, and the last two for splenic lymphangioma. Of the 16 patients diagnosed as having splenic hydatit cysts, 11 (68.7%) were correctly diagnosed. Only two of these patients were administered benzimidazole therapy pre-operatively because of the risk of multicystic disease The mean follow-up period was 64 months (6-108). There were no recurrences of splenic cysts. Surgeons should keep in mind the possibility of a parasitic cyst when no definitive alternative diagnosis can be made. In the treatment of splenic hydatidosis, benzimidazole therapy is not necessary, although it is crucial to perform splenectomy without rupturing and spilling the cysts.BMC Surgery 02/2009; 9:9. · 1.33 Impact Factor -
Article: The effect of hyaluronic acid carboxymethyl cellulose on the healing of colonic anastomosis in rats.
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ABSTRACT: This study demonstrates the effect of hyaluronic acid-carboxymethylcellulose on the healing of colonic anastomosis. 30 female Wistar-Albino rats were divided into three groups; control group 1 (n=10), treated with hyaluronic acid-carboxymethylcellulose, group 2 (n=8) treated with HBO and group 3 with hyaluronic acid-carboxymethylcellulose and HBO. Bursting pressure and rupture strength were significantly higher in the group 3 compared to other two groups (p<0.05). The severity of necrosis, granulation, neovascularisation and epithelization among groups did not show any significant difference (p>0.05). But the evaluation of inflammation showed a statistical significance (p<0.001) such as as granulation (p<0.05). This study did not detect the negative affect of seprafilm on wound healing. Combined treatment with seprafilm and HBO has a favorable therapeutic effect on the healing of ischemic colonic anastomosis (Tab. 4, Fig. 3, Ref. 15). Full Text (Free, PDF) www.bmj.sk.Bratislavske lekarske listy 01/2009; 110(4):210-4. · 0.40 Impact Factor -
Article: The comparison of preperitoneal and Lichtenstein repair for incarcerated groin hernias: a randomised controlled trial.
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ABSTRACT: Lichtenstein hernioplasty can be performed successfully as an emergency operation for incarcerated inguinal hernia. The aim of the study was to compare the short-term and long-term outcomes of the preperitoneal mesh with the Lichtenstein mesh technique in strangula groin hernia. Forty consecutive patients with strangulated inguinal hernia were randomized (according to a random table) to undergo either a preperitoneal or a Lichtenstein repair under general anesthesia. Early outcome measures were age, gender, duration of surgery, operating time (min), side of hernia, other pathology, contents of hernia sac, the ratio of the bowel resection, required laparatomy, complete release of the intestinal loop and postoperative complications, time to return to work, driving and full activity. Long-term outcome measures were recurrence. A Student's t-test and Chi-square analysis were used for statistical analysis. They were randomly allocated to undergo either a preperitoneal mesh repair (n=19) or a tension-free mesh repair Lichtenstein (n=21). There were no persistent complications. Mean duration of surgery in the preperitoneal group was 54 min (SD - 11) versus 50 min in the Lichtenstein group (SD - 8). There was no significant difference with regards to age, race, gender, or comorbidities between the 2 groups. Four of the 21 patients (10.5%) who required an additional incision developed some type of complication. This circumstance was found to have significant influence on morbidity (P=0.003) but not on mortality. The median follow-up for the study was 24 months. Patients were seen 1 to 2 weeks after surgery. In conclusion we recommend preperitoneal repair in strangulated hernia instead of Lichtenstein repair. The use of preperitoneal hernia repair for strangulated inguinal hernia is safe, and any need for laparatomy if bowel resection is necessary.International journal of surgery (London, England) 07/2008; 6(3):189-92. -
Article: Ascaris as a leading point for small-bowel intussusception in an adult: a rare cause of intussusception.
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ABSTRACT: Adult intussusception represents 1% of patients with bowel obstructions and requires a surgical approach. Malignancy is associated with 31% of small bowel intussusception and 70% of large bowel intussusception. Intestinal intussusception caused by ascaris, however, is very uncommon. This report describes our experience of this rare cause of intussusception and its clinical findings.The American journal of emergency medicine 04/2008; 26(3):381.e3-4. · 1.54 Impact Factor -
Article: Cecal diverticulitis mimicking acute Appendicitis: a report of 4 cases.
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ABSTRACT: Diverticulum of the cecum is a rare, benign, generally asymptomatic lesion that manifests itself only following inflammatory or hemorrhagic complications. Most patients with inflammation of a solitary diverticulum of the cecum present with abdominal pain that is indistinguishable from acute appendicitis. The optimal management of this condition is still controversial, ranging from conservative antibiotic treatment to aggressive resection. We describe four cases that presented with symptoms suggestive of appendicitis, but were found at operation to have an inflamed solitary diverticulum.World Journal of Emergency Surgery 02/2008; 3:16. -
Article: Cecal diverticulitis mimicking acute Appendicitis: a report of 4 cases
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ABSTRACT: Abstract Diverticulum of the cecum is a rare, benign, generally asymptomatic lesion that manifests itself only following inflammatory or hemorrhagic complications. Most patients with inflammation of a solitary diverticulum of the cecum present with abdominal pain that is indistinguishable from acute appendicitis. The optimal management of this condition is still controversial, ranging from conservative antibiotic treatment to aggressive resection. We describe four cases that presented with symptoms suggestive of appendicitis, but were found at operation to have an inflamed solitary diverticulum.World Journal of Emergency Surgery. 01/2008; -
Article: Cholecystitis caused by hemocholecyst: An unusual complication of Hemophilia A
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ABSTRACT: Hemocholecyst is a rare disorder that has been reported in patients with gallstones. Previous reports describe cholecystitis resulting from hemocholecyst after iatrogenic trauma. We report the first case of acute cholecystitis secondary to hemocholecyst in a patient with Hemophilia A.Central European Journal of Medicine 11/2007; 2(4):539-542. · 0.31 Impact Factor -
Article: Coughing may lead to spontaneous chylothorax and chylous ascites.
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ABSTRACT: Chylous ascites is a rare form of ascites resulting from the accumulation of lymph in the abdominal cavity. It is due to an interruption in the lymphatic system. Surgical management is indicated in cases of recurrence or failure after conservative treatment. We report a case of spontaneous chylous peritonitis after chylothorax, which is a rare clinical event. The primary reason was unclear and the outcome of medical and surgical treatment was successful.Case Reports in Gastroenterology 01/2007; 1(1):178-83. -
Article: Safra Kesesi Malign Melanomu: Olgu Sunumu
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ABSTRACT: Malign melanoma of gall bladder: Case report Malign melanom is a disease affecting many organs but rarely seen in gallbladder. Distinction of isolated tumors from primary gallbladder tumors or metastatic disease can not be made in most cases. Mainly the complaints of acute cholecystitis appears. Mostly this clinical condition is not doubted when the primary tumor is not found. In cases with poor prognosis , very few patients benefit from surgery. The role of surgery is limited in malign melanoma of gallbladder because of low experience. Different surgical procedures should be applied to primary gallbladder melanoma and metastatic disease. Patients should be evaluated in a multidisciplinary manner with new therapeutic methods. We report here on an unusual case of gallbladder melanoma that was diagnosed by pathological examination in 46-year-old
