Browsing by Author "Ezer, Ali"
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Item Advancement of House Flap in Treatment of Perianal Basal Cell Carcinoma(2017) Ezer, Ali; 0000-0002-3834-9924; 29056139; AAJ-8558-2021Item Anorectal Malformation in an Adult Associated with Chronic Renal Failure: A Case Report(2017) Ezer, Ali; Ezer, Semire S.; Parlakgumus, Alper; 0000-0002-3834-9924; 0000-0002-9597-3264; AAJ-8558-2021; AAJ-9529-2021Few adult cases suffering from anorectal malformation have been concerned in literature; therefore, little is known about the best approach for managing this matter in adults. Our case is a 24 years old female patient admitted to our center with recurrent urinary tract infections and fecal incontinence. She was in hemodialysis program for 1 year due to chronic renal failure. During clinical examination, rectovestibular fistula was detected. Initially, sigmoid loop colostomy was formed. After 10 days, posterior sagittal anorectoplasty (PSARP) was applied and after 3 months, closure of the colostomy was practiced. Total continence reconstruction was achieved. 8 months after all these processes, kidney transplant from our patient's mother was performed and the patient was back to her normal life. After 18 months, Arteriovenous fistula for hemodialysis was closed. By means of PSARP, satisfactory results were reached in adults with delayed anorectal malformation.Item Breast columnar alteration with prominent apical snouts and secretions(2018) Ezer, Ali; Parlakgumus, AlperItem Combination of mesh repair techniques for the primary form of acquired petit hernia(2018) Ezer, Ali; Parlakgumus, AlperItem Delayed Reconstruction of a Traumatic Cloaca Following Obstetric Anal Sphincter Rupture(2017) Ezer, Ali; Parlakgumus, Alper; 0000-0002-3834-9924; 28969732; AAJ-8558-2021Permanent communication between the rectum and the vagina along with full thickness of anal sphincter faults can be a result of an unsuccessful primary repair of fourth degree obstetric trauma. This results into complete fecal incontinence and impaired quality of life. Anterior overlapping sphincteroplasty can be chosen as a method of treatment for fecal incontinence due to obstetric injuries. However, large perineal body reconstructions are generally pretty challenging tasks for surgeons. What we will describe here for the repair of a traumatic cloaca, occurred 23 years ago during vaginal delivery, is the use of a transpositional flap following overlapping sphincteroplasty. Anatomic recovery and fecal continence restoration have been accomplished completely by a follow-up of 24 months.Item The Effect of Subcutaneous Suction Drains on Surgical Site Infection in Open Abdominal Surgery. A Prospective Randomized Study(2016) Arer, Ilker Murat; Yabanoglu, Hakan; Aytac, Huseyin Ozgur; Ezer, Ali; https://orcid.org/0000-0002-1161-3369; https://orcid.org/0000-0002-3583-9282; https://orcid.org/0000-0002-3834-9924; 27025777; AAJ-7865-2021; AAJ-7913-2021; AAJ-8558-2021AIM: Surgical site infection (SSI) is a major problem associated with open abdominal surgery and related to increased morbidity and mortality rates, healthcare costs and also incisional hernia. A negative pressure subcutaneous drain reduces dead space in subcutaneous tissue by preventing accumulation of fluid. The aim of current study was to establish the efficacy of a subcutaneous drainage system for preventing SSI after open abdominal clean-contaminated surgery. MATERIAL AND METHODS: A total of 62 patients underwent abdominal surgery, between November 2014 and March 2015, were enrolled. 48 eligible patients, were randomized into subcutaneous drainage (DG) and no drainage group (NDG). Antibiotic prophylaxis was appiled to each patient. The diagnosis of superficial SSI was made according to the Centers for Disease Control and Prevention's (CDC) definition. RESULTS: The mean age of patients was 48.77 +/- 12.62 years with a male-female ratio of 21:27. No statistical difference between groups was observed for age, sex, comorbidity, incision type, hemoglobin level, blood loss, hospital stay and operation time (P>0.05). 2 (8.7%) patients in DG and 8 (32%) patients in NDG had incisional SSI but no statistical difference was observed (P>0.05). CONCLUSION: SSI appear to be reduced with subcutaneous suction drains in open abdominal surgery however prospective randomized larger scaled studies should be performed on this topic.Item Importance of Laparoscopy in Predicting Complete Cytoreduction at Advanced Stage Ovarian Cancer(2022) Durdag, Gulsen Dogan; Alemdaroglu, Songul; Baran, Safak Yilmaz; Serbetcioglu, Gonca Coban; Ozmete, Ozlem; Ezer, Ali; Celik, Husnu; https://orcid.org/0000-0003-4335-6659Purpose Laparoscopy has been used in evaluation of ovarian cancer to assess the extent and surgical resectability of the disease, and to avoid futile laparotomy, where primary cytoreduction is not suitable. Aim of this study is to investigate the contribution of laparoscopy in predicting 'no gross residue' in advanced stage ovarian cancer. Methods Data of advanced stage ovarian cancer patients, who underwent diagnostic laparoscopy for prediction of complete cytoreduction due to an alternative model, are analyzed retrospectively. Accordingly, in the absence of obvious mesenteric retraction or extensive tumoral implants on small intestine in laparoscopic assessment, cases were deemed surgically resectable, and the operation was continued with laparotomy to achieve complete cytoreduction. Clinical features of the patients, surgical details, complete and optimal cytoreduction rates, and perioperative complications were evaluated. Results Out of 243 patients with advanced stage ovarian/tubal/peritoneal cancer, laparoscopy was performed at 93 patients, 77 of whom underwent primary cytoreduction subsequently. Complete cytoreduction (no gross residue) and optimal cytoreduction (< 1 cm residual tumor) rates were 75.3 and 100%, respectively. None of the patients had suboptimal surgery. Morbidity and mortality rates were acceptable. Conclusion Laparoscopic evaluation prior to cytoreductive surgery can highly contribute to prediction of complete or optimal cytoreduction in suitable patients. However, experience and skills of the surgeon, as well as technical equipment of the center, may affect surgery; therefore, the model to predict residual tumor should be individualized according to the set up and the surgical team of each center.Item A lesion mixed with gallbladder neoplasm: adenomyomatosis(2018) Ezer, Ali; Parlakgumus, AlperItem LIFT Technique for Simple Rectovaginal Fistula(2017) Parlakgumus, Alper; Ezer, Ali; 0000-0002-3834-9924; 29185412; AAJ-8558-2021Item Long-term results of retromuscular hernia repair: a single center experience(2017) Arer, Ilker Murat; Yabanoglu, Hakan; Aytac, Huseyin Ozgur; Ezer, Ali; Caliskan, Kenan; 0000-0002-3583-9282; 0000-0002-1161-3369; 0000-0002-3834-9924; 0000-0002-8767-5021; 0000-0003-0268-8999; 28904662; AAJ-7865-2021; AAJ-7913-2021; AAJ-8558-2021; AAJ-7201-2021; AAK-2011-2021Introduction: Incisional hernia (IH) is one of the most frequent postoperative complications after abdominal surgery. There are multiple surgical techniques described for IH repair. The aim of the study is to evaluate the effect of primary fascial closure on long-term results in retromuscular hernia repair (RHR) for incisional hernias. Methods: A total of 132 patients underwent RHR for IH were included in our study. 109 patients were evaluated in 2009 and 55 patients in 2015 for short and long-term results. Results: Among 132 patients perfromed RHR, fascia was closed in 107 (81%) and left open in 25 (19%) patients. The mean age of patients was 57.9 +/- 11.8 years. Average mesh area was 439.8 +/- 194.6 cm(2), hernia area was 112 +/- 77.5 cm(2) and open area after repair was 40.8 +/- 43.3 cm(2). Mean follow-up of 104 patients regarding postoperative complications evaluated in 2009 was 30.7 +/- 14.1 months. Recurrent IH was observed in 6 (4.5%) patients according to data collected in 2009. Long-term results were; mean follow-up period was 91 +/- 20.2 months (20-112 months) and recurrent IH was observed in 4 (7.3%) patients. Conclusion: Retromuscular repair for incisional hernia regardless of the fascial closure gives high patient satisfaction, less recurrence rates and complications in long-term follow-up.Item A Novel Technique for Detection and Suturing of Biliary Fistula in a Giant Hydatid Cyst: Video-assisted Biliary Fistula Suturing in Hydatid Cyst(2016) Ezer, Ali; Parlakgumus, Alper; 0000-0002-3834-9924; 28666492; AAJ-8558-2021Hydatid disease remains an important health problem in endemic areas; and by the way of travel and immigration, it can also be encountered in non-endemic areas. The most common cases with complications following hydatid liver surgeries are biliary fistulas with a frequency of 14.6 - 27.5%. Postoperative biliary leakage is generally due to unnoticed biliary tract communications. It is technically difficult to determine and suture the biliary fistulas, particulary for deep located ones with giant cavities for patients with high body mass index. We report a novel technique via video-assisted suturing of potentially unnoticeable biliocystic fistula in open surgery for patients with hydatid disease.Item Polymeric Clips for Stump Closure in Laparoscopic Appendectomy(2017) Parlakgumus, Alper; Ezer, Ali; 0000-0002-3834-9924; 29056133; AAJ-8558-2021Many different techniques are used to perform laparoscopic appendectomy in terms of locations of trocars and closure of the appendiceal stump. They include mechanical endostaplers, endoligature, metal clips, bipolar endocoagulation, polymeric clips and intracorporeal sutures. The method of choice for appendiceal stump closure should be inexpensive and easy to perform. Non-absorbable polymer clips is an acceptable option for this purpose. Polymeric clips provide considerable cost savings as compared with endoscopic staplers, and are easy to apply in comparison to suture ligature techniques. In this study, we aimed to investigate outcomes of appendectomy carried out by using polymeric clips in 123 patients without any intraabdominal collection of pus or abscess. As such, the authors found polymeric clips to be safe, cheap and effective for stump closure in laparoscopic appendectomy.Item Primary Axillary Hydatid Cyst: An Extremely Rare Manifestation of Hydatid Disease(2017) Ezer, Ali; Parlakgumus, Alper; 0000-0002-3834-9924; 28406785; AAJ-8558-2021Item A Rare Cause of Acute Appendicitis: Migration of an Intrauterine Device(2017) Parlakgumus, Alper; Parlakgumus, Huriye Ayse; Ezer, Ali; 0000-0002-3834-9924; 28599702; AAJ-8558-2021Item A Rare Cause of Gastrointestinal Bleeding: Jejunal Diverticulosis(2016) Parlakgumus, Alper; Ezer, Ali; Tarim, Akin; 0000-0002-3834-9924; 27806823; AAJ-8558-2021Item Safra kesesi ameliyatı sonrası cerrahi müdahale gerektiren ciddi komplikasyonlar ve yaklaşımlar(Ulusal Cerrahi Dergisi ,25 (2) ,62-67, 2009) Törer, Nurkan; Nursal, Tarık Zafer; Çalışkan, Kenan; Ezer, Ali; Çolakoğlu, Tamer; Karakayalı, Hamdi; Haberal, MehmetKolosistektomi sonrası görülen ciddi komplikasyonlarla ilgili kliniğimizin deneyimlerini paylaşmak ve önemli gördüğümüz noktaları belirtmek. Gereç-Yöntem: Mayıs 1999 - Kasım 2007 tarihleri arasında kolesistektomi sonrası ciddi sorun gelişen ve hastanemizde ameliyat edilen hastaların dosyaları incelendi. Kolesistektominin tipi, başvuru süresi, başvuru anındaki bulguları, yaralanma tipi, başvurudan ameliyata kadar geçen süre, ameliyat sonrası sonuçları kaydedildi. Bulgular: Yirmi iki hastanın yaş ortancası 50 (27 - 73), kadın/erkek oranı 1,2 idi. Dokuz hastada laparoskopik kolesistektomi (LK), sekiz hastada açık kolesistektomi (AK), üç hastada laparoskopik başlanıp AK, iki hastada kolesistektomi sonrası benign biliyer darlık nedeniyle bilioenterostomi yapılmıştı. Amsterdam sınıflamasına göre hastaların yedisi Tip-B, onbiri Tip-C, üçü Tip-D yaralanma, biri damar yaralanmasıydı Tip-B yaralanma, LK veya laparoskopik başlanıp açığa geçilen olgularda gözlenirken, AK yapılanlarda hiç görülmedi. AK yapılanlardaki hakim yaralanma ise Tip-C idi (n=6/8) (p=0,029). Mortalite bir, ciddi komplikasyon yedi, uzun dönemde sorun iki hastada gözlendi. Komplikasyon gelişme oranları; Tip-D yaralanmalarda 3 hastadan ikisinde (p=0,167), erken dönemde başvuran (10 günden önce) hastalarda (5/9 - 2/13 p=0,046), erken müdahale yapılan (10 günden önce) hastalarda daha yüksekti (6/13 - 1/9 p=0,069). Uzun dönemde sorun yaşama oranı erken müdahale yapılan hastalarda (2/12 - 0/9 p=0,178) daha fazlaydı. Sonuç: AK ile safra yolu darlıkları, LK ile safra kaçaklarının daha sık meydana geldiği görüldü. We aim to share our experience on major complications of cholecystectomy. Methods: Records of patients operated for major cholecystectomy complications between May 1999 - November 2007 were analyzed. Type of cholecystectomy, clinical complaint, type of injury, period from first operation to referral and referral to corrective surgery, postoperative complications and long-term outcome were recorded. Results: Median age of 22 patients was 50 (27 - 73), female/male ratio was 1.2. Type of cholecystectomy was laparoscopic cholecystectomy (LC) (n=9), open cholecystectomy (OC) (n=8), bilioenterostomy (due to post-cholecystectomy benign biliary stricture) (n=2), conversion to open cholecystectomy (COC) (n=3). Detected type of injury was; Type-B (n=7), Type-C (n=11), Type-D (n=3) and unclassified (n=1) according to Amsterdam classification. All of the Type-B injuries were observed in four LC and three COC patients and none of the OC patients. However, in the OC group, most frequent type of injury was Type-C (n=6/8) (p=0.029). One patient died, 7 patients had complication, and two patients had recurrent biliary problems. Complication rate was more frequent for; Type-D injury (2/3 p=0.167), patients with early (<10 days) presentation (5/9 - 2/13) (p=0.046) and patients with early (<10 days) surgical intervention (6/13 - 1/9) (p=0.069). Experiencing recurrent problem rate was more frequent for the patients with early surgical intervention (2/12 - 0/9) (p=0.178). Conclusion: Most frequent complication of OC was biliary strictures and that of LC was bile leakage.Item Solitary Cecal Diverticulitis Mimicking Cecal Carcinoma(2018) Ezer, Ali; Parlakgumus, Alper; https://orcid.org/0000-0002-3834-9924; 29866226; AAJ-8558-2021Cecal diverticulum is a rare clinical condition which may present as acute abdomen through diverticulitis and perforation of diverticulitis. Surgical treatment of cecal diverticulitis has been controversial, with studies recommending options ranging from conservative management with antibiotics alone to aggressive resection. Two cases, one of which was pre-diagnosed with cecal tumor perforation and the other with cecal tumor leading to intestinal obstruction, were urgently operated. To both patients, right hemicolectomy was applied. Pathologic evaluation revealed cecal diverticulitis in both patients. Right hemicolectomy is principally reserved for patients experiencing perforation of the diverticulum and extensive inflammatory reaction.Item Ultrasound Elastography and Magnetic Resonance Imaging Findings of Breast Angiosarcoma Mimicking a Benign Lesion by Elastography: A Case Report(2017) Aslan, Hulya; Pourbagher, Aysin; Ezer, Ali; Bolat, Fİliz Aka; Yabanoglu, Hakan; 0000-0002-7138-246X; 0000-0002-1161-3369; 0000-0002-3834-9924; 0000-0003-0268-8999; AAK-9104-2021; AAJ-7865-2021; AAJ-8558-2021; AAK-2011-2021Introduction: Primary and secondary angiosarcomas of the breast are rare neoplasms. Radiologically, magnetic resonance imaging, mammography, and ultrasound (US) findings of angiosarcomas have been reported previously. However, ultrasound (US) elastography findings of angiosarcoma have not been reported yet. Currently, US elastography should be used commonly to decide biopsy or short-term follow-up of breast lesions. Case Presentation: A 39-year-old female from Adana, Turkey, was admitted to Dr.Turgut Noyan Adana Teaching and Medical Research Center at the breast center of Baskent University, with a palpable right breast mass, which had been enlarging for one year in 2015. Our breast center is a tertiary referral center. B-mode US and US elastography findings suggested that the lesion was benign; however, magnetic resonance imaging showed a mass enhancing intensely at early phases with rapid wash out. The final diagnosis of the mastectomy specimen confirmed low-grade angiosarcoma. If the recommendation would have been based on the elastography findings, it would have been catastrophic because angiosarcomas tend to rapidly increase in size. Conclusions: B-mode US and elastography findings of breast angiosarcoma may mimic benign lesions.