Browsing by Author "Kus, Murat"

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THE CHANGE OF FRONTAL QRS-T ANGLE AFTER RENAL TRANSPLANTATION IN DIALYSIS PATIENTS
(2020) Acibuca, Aynur; Yilmaz, Mustafa; Okar, Sefa; Kus, Murat; Caliskan, Kenan; Torer, Nihan; Torun, Dilek; Moray, Gokhan; Muderrisoglu, Haldun; Haberal, Mehmet A.
Comparison of the Early Term Complications and Patency Rates of the Standard (Parachute) and Diamond-Shaped End-To-Side Anastomosis Techniques in Arteriovenous Fistulas Created for Hemodialysis
(2018) Yabanoglu, Hakan; Kus, Murat; Arer, Ilker Murat; Bali, Cagla; Avci, Tevfik; Akdur, Aydincan; Caliskan, Kenan; https://orcid.org/0000-0002-1161-3369; https://orcid.org/0000-0001-6529-7579; https://orcid.org/0000-0003-2615-1918; https://orcid.org/0000-0001-5225-959X; https://orcid.org/0000-0002-8726-3369; https://orcid.org/0000-0002-8767-5021; 30060787; AAJ-7865-2021; AAJ-7870-2021; AAI-8790-2021; AAF-1698-2021; AAA-3068-2021; AAJ-7201-2021
Objective: To compare the early-term patency and complication rates of the end-to-side anastomosis techniques parachute and diamond-shaped techniques in arteriovenous fistulas. Study Design: Prospective randomised study. Place and Duration of Study: Department of General Surgery, Adana Baskent University Application and Research Hospital, Adana, Turkey, between October 2014 and January 2015. Methodology: Patients with end stage renal disease who underwent arteriovenous fistula creation for hemodialysis were grouped into two according to the anastomosis technique performed. Group 1 was composed of the patients undergoing the standard parachute technique and Group 2 consisted of the patients operated with the diamond-shaped anastomosis technique. The two groups were compared with each other with respect to clinical and demographic data, operative and postoperative variables, and complication and patency rates. Results: A total of 56 patients underwent arteriovenous fistula creation. The overall complication rate was 12.5%. The early-term patency rate was higher in the diamond-shaped anastomosis technique than the standard parachute end-to-side anastomosis technique. Effective dialysis was established after 4 weeks in 48 (85.7%) patients in the overall study group, 23 (82.1%) in Group 1, and 25 (89.2%) in Group 2. However, there was no significant difference between both the techniques with respect to effectiveness of dialysis. Conclusion: Both end-to-side anastomosis techniques have their own advantages and disadvantages. Using a patient-specific suitable technique rather than a standard technique would be more appropriate in arteriovenous fistulas formation.
Corner-Saving Renal Artery Anastomosis for Renal Transplantation
(2018) Akdur, Aydincan; Kus, Murat; Moray, Gokhan; Yildirim, Sedat; Karakayali, Feza Yarbug; Caliskan, Kenan; Haberal, Mehmet; 0000-0002-8726-3369; 0000-0001-6529-7579; 0000-0003-2498-7287; 0000-0002-5735-4315; 0000-0002-1874-947X; 0000-0002-8767-5021; 0000-0002-3462-7632; AAA-3068-2021; AAJ-7870-2021; AAE-1041-2021; AAF-4610-2019; AAB-3888-2021; AAJ-7201-2021; AAJ-8097-2021
Effectiveness of Simultaneous Umbilical Hernia Primary Repair with Laparoscopic Cholecystectomy
(2023) Gundogdu, Ramazan; Erkan, Serkan; Kus, Murat; Aytac, Huseyin Ozgur; Yabanoglu, Hakan; 37829743
OBJECTIVE: Umbilical hernia repair can be easily performed simultaneously with laparoscopic cholecystectomy. The use of mesh is recommended for hernias larger than 1 cm. In this study, patients with primary repair of umbilical hernia simultaneously with laparoscopic cholecystectomy were evaluated. It aimed to present the effectiveness of this method and the effect of body mass index (BMI) on treatment results.METHODS: The records of patients who underwent primary repair of umbilical hernia simultaneously with laparoscopic cholecystectomy between 2014 and 2021 were reviewed retrospectively. Patients' age, gender, BMI, length of hospital stay, recurrence and reoperation information, and follow-up times were analyzed. The patients were examined in three groups according to their BMI, and the effect of BMI on treatment was investigated.RESULTS: patients were included in the study. Median values of the patients for age, BMI, hospitalization, and follow-up were 63 (28-94), 31 (20-51) kg/m2, 1 (1-25) days, and 23 (0.6-76) months, respectively. Recurrence was detected in 8 patients. BMI was <25 in one patient with recurrence and >30 in 5 patients. There was no significant correlation between length of stay, number of relapse and reoperation, and BMI (p>0.05).CONCLUSION: In our study, the recurrence rate was found to be higher than the studies reported with the use of mesh, and most of the patients with recurrence are obese, although it is not statistically significant. If the recurrence rate is acceptable, we believe that repair with primary suture is feasible in umbilical hernia.
Factors affecting mortality in rectus sheath hematoma: A retrospective study
(2018) Arer, Ilker Murat; Akkapulu, Nezih; Hargura, Abdirahman Sakulen; Kus, Murat; Yabanoglu, Hakan; Aytac, Huseyin Ozgur; 0000-0002-3583-9282; 0000-0001-7392-961X; 0000-0002-1161-3369; 0000-0001-6529-7579; AAJ-7913-2021; AAM-8548-2021; AAJ-7865-2021; AAJ-7870-2021
Aim: Rectus sheath hematoma is a rare clinical condition. Because it could mimic various intra-abdominal pathologies suspicious approach and attention is needed for proper diagnosis and management of rectus sheath hematoma. The aim of this study is a review of factors affecting mortality in patients with rectus sheath hematoma besides clinical features, diagnosis modalities, treatment periods and results of patients with rectus sheath hematoma. Material and Method: Twenty-three patients with rectus sheath hematoma from January 2012 to March 2017 in a tertiary care center were included in the study. Patients' files were reviewed retrospectively. Reviewed variables were demographic and clinical features, symptom and findings, co-morbidities, medications, laboratory findings, diagnostic modalities, APACHE II scores, treatment approaches, transfused blood products and length of hospital stay. Results: Fifteen (65.2%) of the patients were women, and 8 (34.8%) of the patients were men. The mean age was 61.9 +/- 13.5. Seventeen (74%) of the patients had abdominal pain. Twenty (87%) of the patients had anticoagulant and antiplatelet therapy. The mean hematoma diameter was 6.3 +/- 3.6 cm. The mean APACHE II score for the patients was 13.1 +/- 7.3. One patient had undergone surgery. There was mortality in 3 (13%) of the patients. The median length of stay in hospital was 5 (5) days. Discussion: The diagnosis of rectus sheath hematoma should be kept in mind while assessing old female patients and patients on anticoagulants with a complaint of abdominal pain. In our study, we identify risk factors such as higher APACHE - II scores, the presence of a transient ischemic attack, need for transfusion of more units of packed erythrocytes and more extended hospital stay as factors associated with mortality.
Liver Transplant and Reexpansion Pulmonary Edema: A Case Report
(2018) Kara, Sibel; Sen, Nazan; Akcay, Sule; Moray, Gokhan; Kus, Murat; Haberal, Mehmet; 0000-0002-4171-7484; 0000-0002-8360-6459; 0000-0003-2498-7287; 0000-0001-6529-7579; 0000-0002-3462-7632; 29528016; AAI-8069-2021; AAI-8947-2021; AAB-5175-2021; AAE-1041-2021; AAJ-7870-2021; AAJ-8097-2021
Hydrothorax occurs frequently in patients with end-stage liver disease and usually requires drainage of pulmonary effusion during the hepatectomy phase of liver transplant. Reexpansion pulmonary edema is a rare but potentially fatal complication seen after rapid reexpansion of the collapsed lung following thoracentesis of pleural fluid or tube drainage of pneumothorax. This condition, which manifests with various degrees of clinical severity, is rarely reported following liver transplantation. Herein, we present a 62-year-old male patient who developed reexpansion pulmonary edema after drainage of massive pleural effusion, which caused a total collapse in the right hemithorax during liver transplant. Six hours after pleural fluid drainage, the patient developed a nonproductive cough, mild tachypnea, shortness of breath, and low oxygen saturation (88%). His chest radiograph showed diffuse heterogeneous opacities in the right hemithorax. Computed tomography of the thorax revealed consolidations containing air bronchograms and ground glass opacities in the parenchyma of the right lung; these findings did not extend to the periphery and were observed less frequently in the inferoposterior left lung. These symptoms and radiologic findings were diagnosed as reexpansion pulmonary edema. Complete clinical and radiologic improvements were achieved within 72 hours of mechanical ventilatory support.
Male Breast Cancer: Clinicopathological, Immunohistochemical and Radiological Study
(2020) Hasbay, Bermal; Bolat, Filiz Aka; Aytac, Huseyin Ozgur; Kus, Murat; Pourbagher, Aysin; 0000-0001-6529-7579; 0000-0002-3583-9282; 32525214; AAJ-7870-2021; AAJ-7913-2021
Objective: To evaluate the pathological and radiological features, immunohistochemical profile and treatment methods of primary male breast carcinoma cases diagnosed at our center. Material and Method: The pathology archive between 2006 and 2019 was reviewed and the data of 27 male patients diagnosed as primary breast cancer were retrospectively evaluated. Results: The age of the patients ranged between 40-86 years. The left breast was involved in 17 patients. The mean tumor diameter was 2.35 +/- 1.09 cm. Of the 27 cases, 8 were dead and 19 were alive. The mean follow-up duration was 37.45 +/- 24.84 months. The mean estimated life expectancy was 65 +/- 14.7 months. The most common complaint was a swelling in the breast. The time interval between the onset of complaints and admittance to hospital ranged from three months to two years. The most common histopathological diagnosis was invasive carcinoma - no special type. The most common surgical procedure was mastectomy with lymph node dissection. Nine patients had metastatic lymph nodes. In terms of the hormone profiles, 24 were Estrogen receptor positive, 21 were Progesterone receptor positive and six were Her2/neu positive. Three patients had triple-negative tumors. Conclusion: Male breast carcinoma is a rare disease but its frequency has been increasing recently. As breast cancer is more commonly attributed to women, the diagnosis is usually delayed until later stages in males. Public awareness should therefore be increased and breast cancer should be considered in the differential diagnosis especially in the presence of breast swelling and complaints related to the breast skin so that the appropriate biopsy can be obtained without delay.
Management and Clinical Outcomes of latrogenic Injury Secondary to Endoscopic Retrograde Cholangiopancreatography
(2020) Sari, Ramazan; Yabanoglu, Hakan; Kus, Murat; Arer, Ilker Murat; 0000-0002-1161-3369; 0000-0001-6529-7579; 0000-0003-3492-9953; AAG-1897-2021; AAJ-7865-2021; AAJ-7870-2021
Introduction: Perforation secondary to endoscopic retrograde cholangiopancreatography (ERCP) is a rare complication but a problematic one because of associated morbidity and mortality. In our study, we aimed to define correct timing for surgery, to analyze and present our results on suitable methods that can be used in the surgical management of perforation secondary to ERCP done for various indications. Methods: The data were collected from 19 patients who underwent surgery for perforation secondary to ERCP. We retrospectively analyzed clinical and demographic characteristics with the treatment outcomes of these patients. Results: The mean age of the patients was 57 years (range: 16-92). The ERCP procedure was for therapeutic purposes in all the patients. Perforation mostly occurred during sphincterectomy, as was seen in 12 patients (63%). The patients underwent surgical intervention at a mean of 42.5 hours (range: 3-192) after perforation. Postoperative mortality occurred in seven patients (36.8%). The mean hospitalization period was 16.5 days (range: 11-49). Conclusion: Duodenal perforation is an ERCP-related complication that carries high mortality and morbidity risks, even in experienced tertiary centers. When perforation is suspected, these patients should immediately be referred to experienced centers/units for further management. Careful scrutiny of clinical and radiological findings is critical in choosing the appropriate surgical intervention.
A Novel Specimen Retrieval Bag Using Camera Cover in Elective Laparoscopic Cholecystectomy: A Prospective Cross-Sectional Cohort Study
(2020) Arer, Ilker M.; Kus, Murat; Yabanoglu, Hakan; Turk, Emin; Birol, Selim; 0000-0002-1161-3369; 0000-0001-6529-7579; 0000-0003-4766-3373; 0000-0003-0268-8999; 32762623; AAJ-7865-2021; AAJ-7870-2021; AAJ-5609-2021; AAK-2011-2021
Outcomes of Total Parathyroidectomy with Autotransplantation versus Subtotal Parathyroidectomy Techniques for Secondary Hyperparathyroidism in Chronic Renal Failure
(2020) Sari, Ramazan; Yabanoglu, Hakan; Hargura, Abdirahman Sakulen; Kus, Murat; Arer, Ilker Murat; 0000-0001-6529-7579; 0000-0002-1161-3369; 0000-0003-3492-9953; 0000-0003-0268-8999; 31931926; AAJ-7870-2021; AAG-1897-2021; AAJ-7865-2021; AAK-2011-2021
Objective: To compare the safety and the effectiveness of total parathyroidectomy with autotransplantation versus subtotal parathyroidectomy for refractory secondary hyperparathyroidism in patients with chronic kidney disease. Study Design: A comparative study. Place and Duration of Study: Baskent University, Adana Medical and Research Center, Adana, Turkey, from January 2012 to November 2018. Methodology: Patients operated upon for refractory secondary hyperparathyroidism by the general surgery team were inducted. Overall, 25 (40%) patients underwent total parathyroidectomy with autotransplantation (Group 1), whereas 37 (60%) patients underwent subtotal parathyroidectomy (Group 2). Patient files were retrospectively analysed for recurrence or persistence of hyperparathyroidism. Results: A total of 62 patients, 32 (52%) of whom were females, with a mean age of 41.4 +/- 15.8 years for group 1; and 30 patients were males with a mean age of 43.1 +/- 16.7 years for group 2 were assessed in this study. The presenting complaints were bone pains and malaise supported by laboratory values that showed consistently elevated parathyroid hormone levels (>200 pg/ml). In the postoperative follow-up, 29 patients (46.8%) had transient hypocalcemia, while 3 (5%) had persistent hypoparathyroidism. In Group 1, one (4%) patient had a recurrence, while 4 (16%) patients had persistent hyperparathyroidism. In contrast, two (5.6%) patients in Group 2 had recurrence, whereas 8 (22%) patients had persistent hyperparathyroidism. Conclusion: Both surgical options can be safely utilised in the management of refarctory secondary hyperparathyroidism. Moreover, regardless of the procedure used, all the parathyroid glands must be explored. However, due to high morbidity and failure rates of subsequent surgeries, the surgeon should be keen and thorough in the initial procedure.
Prophylactic Oral Calcium Supplementation Therapy to Prevent Early Post Thyroidectomy Hypocalcemia and Evaluation of Postoperative Parathyroid Hormone Levels to Detect Hypocalcemia: A Prospective Randomized Study
(2017) Arer, Ilker Murat; Kus, Murat; Akkapulu, Nezih; Aytac, Huseyin Ozgur; Yabanoglu, Hakan; Caliskan, Kenan; Tarim, Mehmet Akin; 0000-0001-7392-961X; 0000-0003-0268-8999; 0000-0002-3583-9282; 0000-0001-6529-7579; 0000-0002-1161-3369; 0000-0002-8767-5021; 28039060; AAM-8548-2021; AAK-2011-2021; AAJ-7913-2021; AAJ-7870-2021; AAJ-7865-2021; AAJ-7201-2021
Background: Postoperative hypocalcemia is the most common complication after total thyroidectomy. Postoperative parathyroid hormone (PTH) measurement is one of the methods to detect or prevent postoperative hypocalcemia. Prophylactic oral calcium supplementation is another method to prevent early postoperative hypocalcemia. The aim of this study is to detect the accurate timing of PTH and evaluate efficacy of routine oral calcium supplementation for postoperative hypocalcemia. Methods: A total of 106 patients were performed total thyroidectomy. Rotuine oral calcium supplementation was given to group 1 and no treatment to group 2 according to randomization. Serum calcium and PTH level of patients in group 2 at postoperative 6, 12 and 24 h and patients in both groups at postoperative day 7 were evaluated. Patients were compared according to age, sex, operation findings, serum calcium and PTH levels and symptomatic hypocalcemia. Results: Half of the patients (50%) were in group 1. Most of the patients were female (83%). The most common etiology of thyroid disease was multinodular goiter (64.1%). Oral calcium supplementation was given to 18 (33.9%) patients in group 2. Symptomatic hypocalcemia for group 1 and 2 was found to be 1.9 and 33.9% respectively (p < 0.05). No statistical difference can be observed regarding the timing of serum biomarkers. Conclusion: Serum PTH levels at postoperative 12 and 24 h can predict early post-thyroidectomy hypocalcemia. Prophylactic oral calcium supplementation therapy can prevent early post-thyroidectomy hypocalcemia with advantages of being cost effective and safe. (C) 2016 IJS Publishing Group Ltd.
Relationship Between Perioperative Factors and Splenic Artery Steal Syndrome After Orthotopic Liver Transplant: A Retrospective Clinical Study
(2023) Kuscu, Ozlem Ozkan; Kus, Murat; Incekas, Caner; Ozmete, Ozlem; Ergenoglu, Pinar; Yildirim, Sedat; Torgay, Adnan; Haberal, Mehmet; 37885290
Objectives: After orthotopic liver transplant, ischemia of biliary tract and graft loss may occur due to impaired hepatic arterial blood flow. This situation with hypersplenism and impaired hepatic arterial blood flow is defined as splenic artery steal syndrome. The aim of this study was to investigate the relationship between perioperative factors and splenic artery steal syndrome in orthotopic liver transplant patients. Materials and Methods: Forty-five patients who underwent orthotopic liver transplant between 2014 and 2022 were included in the study. The data for the patients were obtained from the hospital database, including the intraoperative anesthesiology and postoperative intensive care records. Results: Eleven patients were diagnosed with splenic artery steal syndrome. Patients with splenic artery steal syndrome had higher need for intraoperative vasopressor agents (P = .016) and exhibited lower intraoperative urine output (P = .031). In the postoperative intensive care follow-up, patients with splenic artery steal syndrome had higher levels of C-reactive protein during the first 48 hours (P = .030). Conclusions: Intraoperative administration of vasopressor drugs, low urine output, and early postoperative high C-reactive protein levels were associated with the development of splenic artery steal syndrome in patients undergoing orthotopic liver transplant. Future studies should focus on investigation of biomarkers associated systemic hypoperfusion that may contribute to the development of splenic artery steal syndrome.
Retrospective Analysis of Patients with Synchronous Primary Breast and Thyroid Carcinoma
(2018) Arer, Ilker Murat; Yabanoglu, Hakan; Kus, Murat; Aldur, Aydincan; Avci, Tevfik; 0000-0002-8726-3369; 0000-0002-1161-3369; 0000-0001-5225-959X; 0000-0001-6529-7579; 29774315; AAA-3068-2021; AAJ-7865-2021; AAF-1698-2021; AAJ-7870-2021
Objective: Breast and thyroid cancers are commonly encountered malignancies. Increased risk of breast cancer in follow-up period of thyroid cancer or vice versa has been reported. However, they have some associations, synchronous presentation of these tumors is rare. We presented 12 patients diagnosed as breast and thyroid cancer and treated at the same time. Materials and Methods: Mastectomy and thyroidectomy were performed in 19 patients at the same time. 7 patients were excluded because of benign thyroid pathology. Therefore 12 patients who had diagnosis of synchronous breast and thyroid cancer were included. Data regarding clinical, pathological, treatment and prognostic factors was retrospectively analyzed. Results: Total thyroidectomy was performed in all patients. The mean age of patients was 54 years (min. 44-max. 70). Only one patient was male. Thyroid pathology was detected preoperatively by FDG PET-CT scan in 11 patients. Breast reconstruction was performed in three patients. The most commonly seen thyroid malignancy was papillary thyroid carcinoma. Postoperative complication rate was 33.3%. Adjuvant chemotherapy was given in 11 patients whereas one patient received adjuvant radiotherapy. Conclusion: Although synchronous presentation of breast and thyroid cancer is rare, surgical treatment of both of these tumors can be safely performed at the same time. Association of these tumors should be evaluated by large scaled studies.
Subcapsular Hydatid Cyst of the Liver
(2017) Kus, Murat; Arer, Ilker Murat; Akkapulu, Nezih; Yabanoglu, Hakan; 0000-0001-6529-7579; 0000-0001-7392-961X; 0000-0002-1161-3369; AAJ-7870-2021; AAM-8548-2021; AAJ-7865-2021
Hydatid cyst disease is an important health problem in Turkey. The disease localized in liver in most of the cases, but also be exits everywhere in the body. One of the rare complications of liver's hydatid cyst is subcapsular perforation. We present a 53 year male patient with subcapsular perforation of liver hydatid cyst
Total Versus Subtotal Gastrectomy for Signet Ring Cell Carcinoma of the Stomach
(2017) Arer, Ilker Murat; Yabanoglu, Hakan; Akdur, Aydincan; Akkapulu, Nezih; Kus, Murat; 0000-0002-1161-3369; 0000-0002-8726-3369; 0000-0001-7392-961X; 0000-0001-6529-7579; 29056122; AAJ-7865-2021; AAA-3068-2021; AAM-8548-2021; AAJ-7870-2021
Objective: To determine the adequate surgery type for the treatment of signet ring cell of stomach in terms of postoperative complications and survival. Study Design: Comparative analytical study. Place and Duration of Study: Baskent University Adana Teaching and Research Center, Adana, Turkey, between 2006 and 2015. Methodology: A total of 46 patients with the diagnosis of gastric signet ring cell, who underwent total or subtotal gastrectomy, were enrolled in this study. Patients were compared according to age, gender, tumor location, TNM stage, survival and mortality rates, operation time, complication and recurrence. Comparisons between groups were performed by using Mann-Whitney U-test for the data not normally distributed. The categorical data were analyzed by using the Chi-square test or Fisher's exact test, where applicable. Kaplan-Meier test was used for survival curve and Long-rank test was used for survival differences between groups. Values of p < 0.05 were considered statistically for all tests. Results: Of the 46 patients, 29 (63.0%) were male. The mean age was 56.6 +/- 13.2 years. The median tumor size was 5.0 cm (IQR: 3.0-6.6). Twenty-six (56.5%) patients were in total gastrectomy, whereas 20 (43.5%) were in subtotal gastrectomy group. Five-year cumulative survival rate was 0.487. Five-year overall survival rate for early and advanced signet ring cell carcinoma was 0.830 and 0.164, respectively (p<0.001). Five-year overall survival rate for total and subtotal gastrectomy groups were 0.422 and 0.582, respectively (P=0.417). Complications were observed in 17.4% (n=8) of all 46 patients. Conclusion: Subtotal gastrectomy can be performed safely for patients with gastric signet ring cell carcinoma and is equal to total gastrectomy with respect to prognosis and complication rates.