Browsing by Author "Ersoz, Siyar"

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    Acute Appendicitis During Coronavirus Disease 2019 in Turkiye: Changes in Clinical Approach, Treatment, and Diagnosis Modalities: A Retrospective and Cohort Study
    (2022) Ersoz, Siyar; Bozkurt, Mehmet Abdussamet; Kulle, Cemil Burak; Elhan, Atilla Halil; Gulcu, Baris; Tarim, Ismail Alper; Bozbiyik, Osman; Yasar, Necdet Fatih; Atalay, Vafi; Yonder, Huseyin; Yalav, Orcun; Kuzu, Mehmet Ayha; Karakayali, Feza Yarbug; 36453790
    BACKGROUND: The novel coronavirus disease 2019 (COVID-19) has resulted in major changes in health-care systems and emergency surgical interventions. Here, we examined patients with acute appendicitis who presented to emergency departments and compared diagnosis, treatment, and post-treatment processes before and during the pandemic period and investigated how the pandemic affected management of acute appendicitis. METHODS: A national, multicenter, and cohort study model was designed that included patients older than 18 years of age diagnosed with acute appendicitis clinically and/or radiologically, with patients compared before (pre-pandemic period: January 1-April 30, 2019) and after (pandemic period: January 1-April 30, 2020) the pandemic. Our investigation included comparisons of pre-operative imaging methods, presence of plastron appendicitis/abscess, conservative/surgical approach, type of anesthesia given, laparoscopic/ open surgical approach, bowel resection rates, drain insertion rates, and presence of post-operative complications RESULTS: For the two study groups, 8972 patients from 69 centers were examined, with 4582 patients operated in the pre-pandemic period and 4234 patients operated in the pandemic period. During the pandemic period, 63.6% of patients underwent open surgery, whereas 34.4% had laparoscopic surgery. Although 60 patients (1.3%) requested non-operative follow-up in the pre-pandemic period, 94 patients (2.2%) requested this in the pandemic period. When conditions of patients were evaluated regardless of their own wishes, 114 patients (2.4%) before and 163 patients (3.8%) during the pandemic received non-operative follow-up. CONCLUSION: Our study did not show the direct correlation between the application of COVID-19-related restrictions and the severity of acute appendicitis. Although non-operative management rates have been increased during the COVID-19 period, the incidences of both complicated and the uncomplicated appendicitis were similar during the COVID-19 crisis period. Given this information non-operative management can be employed for patients diagnosed with appendicitis.
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    Management and Outcomes of Major Pelvic Hemorrhage in Complex Abdomino-Pelvic Surgery
    (2023) Aytac, Erman; Sokmen, Selman; Ozturk, Ersin; Rencuzogullari, Ahmet; Sungurtekin, Ugur; Akyol, Cihangir; Demirbas, Sezai; Leventoglu, Sezai; Karakayali, Feza; Korkut, Mustafa Ali; Oncel, Mustafa; Gulcu, Baris; Canda, Aras Emre; Eray, Ismail Cem; Ozgen, Utku; Ersoz, Siyar; Ozer, Tahir; Ozerhan, Ismail Hakki; Bozbiyik, Osman; Haksal, Mustafa; Oral, Berke Mustafa; 0000-0002-6481-1473; 37816336; HKO-5077-2023
    Introduction: Hemorrhage is a challenging complication of pelvic surgery. This study aimed to analyze the causes, management and factors associated with morbidity in patients experiencing major pelvic hemorrhage during complex abdomino-pelvic surgery.Methods: Patients who had major intraoperative pelvic hemorrhage during complex abdomino-pelvic surgery at 11 tertiary referral centers between 1997-2017 were included. Patient characteristics, management strategies to control bleeding, short and long term postoperative outcomes were evaluated retrospectively.Results: There were 120 patients with a mean age of 56.6 +/- 2.4 years and a mean BMI of 28.3 +/- 1 kg/m(2). While 104 (95%) of the patients were operated for malignancy, 16(5%) of the patients had surgery for a benign disease. The most common bleeding site was the presacral venous plexus 90(75%). Major pelvic hemorrhage was managed simultaneously in 114(95 %) patients. Electrocauterization 27(23%), pelvic packing 26(22%), suturing 7(6%), thumbtacks application 7(6%), muscle welding 4(4%), use of energy devices 2(2%) and topical hemostatic agents 2(2%) were the management tools. Combined techniques were used in 43(36%) patients. Short-term morbidity and mortality rates were 48(40%) and 2(2%), respectively. High preoperative CRP levels(p=0.04), history of preoperative radiotherapy (p=0.04), longer bleeding time (p=0.006) and increased blood transfusion (p=0.005) were the factors associated with postoperative morbidity.Discussion/Conclusion: Postoperative morbidity related to major pelvic hemorrhage can be reduced by optimizing the risk factors. Prehabilitation prior to surgery to moderate inflammatory status and prompt action with proper technique to control major pelvic hemorrhage can prevent excessive blood loss in complex abdomino-pelvic surgery.