Browsing by Author "Parlakgumus, Alper"

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Abdominal CT Findings in Patients with Primary Lymphoma Causing Small Bowel Obstruction
(2017) Karadeli, Elif; Erbay, Gurcan; Parlakgumus, Alper; Yabanoglu, Hakan; 0000-0002-0352-8818; 0000-0002-1706-8680; 0000-0002-1161-3369; 29132484; AAK-5399-2021; AAK-5370-2021; AAJ-7865-2021
The purpose of this study was to investigate retrospectively CT findings in patients with primary lymphoma causing small bowel obstruction. CT scans of 11 patients with small bowel lymphoma were separately analysed in terms of affected section of the small bowel, focality, wall thickness, pattern and degree of contrast enhancement, lymphadenopathy, organ involvement, perforation, and the presence of intraabdominal fluid. Eight patients had diffuse large B-cell lymphoma, and one patient each had marginal zone lymphoma of mucosa-associated lymphoid tissue (MALT), T-cell lymphoma, and anaplastic T-cell lymphoma. Affected sections of the bowels involved were jejunum (n=5, 45.4%), ileum (n=2, 18.1%), and one case (9%) each of distal ileum, distal jejunum, distal jejunum and ileum, and distal jejunum and colon. Primary gastrointestinal (GI) lymphoma is an uncommon disease, that may lead to small bowel obstruction sometimes.
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-9529-2021
Few 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.
Atorvastatin for Ovarian Torsion: Effects on Follicle Counts, AMH, and VEGF Expression
(2014) Parlakgumus, H. Ayse; Bolat, Filiz Aka; Kilicdag, Esra Bulgan; Simsek, Erhan; Parlakgumus, Alper; https://orcid.org/0000-0003-2031-7374; https://orcid.org/0000-0002-0942-9108; 24507756; HJZ-1654-2023; AAK-8872-2021
Objective(s): To determine if atorvastatin protects ovarian follicles against ischemia reperfusion (I/R) injury and to determine how anti-Mullerian hormone (AMH) and vascular endothelial growth factor-A (VEGF-A) expression is altered. Study design: This experimental study was conducted at the Baskent University Animal Research Laboratory. Forty-four rats were arbitrarily assigned into four groups of 11 rats each. The control group underwent a laparotomy. The atorvastatin group received atorvastatin (10 mg/kg/day), by oral gavage 7 days before and 7 days after the sham operation. The torsion group had bilateral torsion and detorsion of the ovaries. The atorvastatin + torsion group received atorvastatin (10 mg/kg/day) 7 days before and 7 days after the torsion/detorsion operation. At day 7, the animals were euthanized and their ovaries were removed. Ovarian follicles were counted, and AMH and VEGF-A expression was determined. The Kruskal-Wallis, chi(2), or Fisher's exact test were used when appropriate. Results: Primordial follicles (p = 0.001), VEGF-A expression (p = 0.018) and vascularization (p = 0.02) were significantly higher in the atorvastatin group compared to controls. Primordial (p = 0.002), primary (p = 0.001), and secondary follicles (p = 0.001), AMH expression (p = 0.001), and vascularization (p = 0.001) were lower in the torsion group compared with the control group. Primordial follicles (p = 0.001), AMH (p = 0.001) and VEGFA expression (p = 0.001), and vascularization (p = 0.001) were significantly higher in the atorvastatin + torsion group compared to the torsion group. Conclusion(s): Atorvastatin increased the primordial follicle pool and vascularization and protected primordial follicles and vascular structures against I/R injury. (C) 2014 Elsevier Ireland Ltd. All rights reserved.
Breast columnar alteration with prominent apical snouts and secretions
(2018) Ezer, Ali; Parlakgumus, Alper
Combination of mesh repair techniques for the primary form of acquired petit hernia
(2018) Ezer, Ali; Parlakgumus, Alper
Delayed Reconstruction of a Traumatic Cloaca Following Obstetric Anal Sphincter Rupture
(2017) Ezer, Ali; Parlakgumus, Alper; 0000-0002-3834-9924; 28969732; AAJ-8558-2021
Permanent 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.
Diagnosis and Management of Retained Foreign Objects
(2015) Yildirim, Tulin; Parlakgumus, Alper; Yildirim, Sedat; 0000-0001-7788-9416; 0000-0002-5735-4315; 26008665; AAQ-7559-2021; AAF-4610-2019
Retained surgical foreign objects (RFO) include surgical sponges, instruments, tools or devices that are left behind following a surgical procedure unintentionally. It can cause serious morbidity as well as even mortality. It is frequently misdiagnosed. It should be considered in the differential diagnosis of any postoperative case with unresolved or unusual problems. Risk factors for RFOs include emergency procedures, unplanned change in operation, and body mass index and are clarified as being more frequent approximately 1 in 700 emergent cases. Although human errors cannot be completely prevented, medical training and consistency to rules seem to reduce the incidence to a minimum. It is a legal issue and potentially dangerous medical error. The definition, types, incidence, risk factors, complications and prevention strategies from RFOs are reviewed, from the comprehensive series until the year 2014.
GNRH Agonists and Antagonists in Rescue for Cyclophosphamide-Induced Ovarian Damage: Friend or Foe?
(2015) Parlakgumus, Huriye A.; Kilicdag, Esra B.; Bolat, Filiz A.; Haydardedeoglu, Bulent; Parlakgumus, Alper; 0000-0002-0942-9108; 0000-0003-2031-7374; 25472738; AAK-8872-2021; HJZ-1654-2023
To find out if GnRH agonist (GnRHa) and GnRH antagonist (GnRHant) offer ovarian protection from cyclophosphamide (Cyc) and if AMH expression is affected. This experimental study was conducted in Baskent University Animal research laboratory and 66 virgin Wistar albino rats were assigned to six groups. The control group received intraperitoneal saline injection. The GnRHa group had a single dose of leuprolide acetate (1 mg/kg) 28 days prior to saline injection. The GnRHant group had a single dose of cetrorelix acetate (0.1 mg/kg) 1 h prior to saline injection. The Cyc group had a single intraperitoneal dose of Cyc (75 mg/kg). The GnRHa+Cyc group had a single dose of leuprolide acetate (1 mg/kg) 28 days prior to Cyc (75 mg/kg). The GnRHant+Cyc group had single dose of cetrorelix acetate (0.1 mg/kg) 1 h prior to Cyc (75 mg/kg). At day 35, the animals were euthanized, and their ovaries were removed. Primordial follicles were counted and AMH expression was determined. The Kruskal-Wallis, chi (2), or Fisher's exact test was used where appropriate. p < 0.05 was considered statistically significant. PMF count was reduced in GnRHant (p < 0.01) and Cyc (p < 0.01) groups. Cyc, GnRHa+Cyc and GnRHant+Cyc groups had similar numbers of PMF. AMH expression was reduced in Cyc, GnRHa+Cyc and GnRHant+Cyc groups (p < 0.01). Neither GnRHa nor GnRHant can offer protection against Cyc-induced damage. GnRHant itself reduces the number of primordial follicles.
High Dose Oral Furosemide with Salt Ingestion in the Treatment of Refractory Ascites of Liver Cirrhosis
(2016) Yakar, Tolga; Demir, Mehmet; Dogan, Ozlem; Parlakgumus, Alper; Ozer, Birol; Serin, Ender; 0000-0002-0138-6107; 27917812; GZH-1913-2022; AAM-7281-2021
Purpose: We aimed to evaluate and compare the efficacy and safety of high-dose furosemide+salt orally by comparing HSS+furosemide (i.v.) and repeated paracentesis in patients with RA. Methods: This was a prospective study of 78 cirrhotic patients with RA, randomized into three groups: Group A (n=25) i.v. furosemide (200-300 mg bid) and 3% hypotonic saline solution (HSS) (once or twice a day); Group B (n= 26) oral furosemide tablets (360-520 mg bid) and salt (2.5 g bid); and, Group C (n= 27) repeated large-volume-paracentesis (RLVP) with albumin infusion. Patients without hyperkalemia were administrated 100 mg of spironolactone/day. During the follow-up; INR, creatinine, and total bilirubin levels were measured to determine the change in MELD (model of end stage liver disease) score. Results: Hepatic encephalopathy (HE), severe episodes of spontaneous bacterial peritonitis (SBP) and pleural effusions (PE) occurred more frequently in Group C. Improvement in Child-Pugh and MELD score was better in Group A and B than Group C. In Group B, improvements were seen in the Child-Pugh and MELD score, reduction in body weight, duration and number of hospitalization. In Groups A and B, remarkable increases in diuresis were observed (706 +/- 116 to 2425 +/- 633 mL and 691 +/- 111 to 2405 +/- 772 mL) and serum sodium levels also improved. HE and SBP were occurred more often in group C (p< 0.002). Hospitalization decreased significantly in Group B (p< 0.001). There was no significant difference in survival among groups. Conclusion: High dose oral furosemide with salt ingestion may be an alternative, effective, safe and well-tolerated method of therapy for RA.
A lesion mixed with gallbladder neoplasm: adenomyomatosis
(2018) Ezer, Ali; Parlakgumus, Alper
LIFT Technique for Simple Rectovaginal Fistula
(2017) Parlakgumus, Alper; Ezer, Ali; 0000-0002-3834-9924; 29185412; AAJ-8558-2021
MRI Findings of Borderline Retroperitoneal Serous Cystadenocarcinoma
(2019) Erbay, Gurcan; Karadeli, Elif; Parlakgumus, Alper; 30823957
Retroperitoneal serous cystadenocarcinoma is an extremely uncommon lesion. Here, we present MR imaging findings of a 40-year woman who was admitted to the hospital due to abdominal pain. The patient was evaluated with abdominal Computed Tomography (CT) and Magnetic Resonance Imaging (MRI). Abdominal CT revealed a 13x18 cm large retroperitoneal and cystic mass with polypoid projections. MRI was superior than CT in showing polypoid projections. Contrast enhanced MRI detected enhancement of thin septations and cyst appearance inner the cyst. Diffusion-weighted MRI showed restricted diffusion in the polypoid component with contrast enhancement. Therefore, we thought malignant lesion. The findings of contrast-enhanced CT and MRI were helpful in the diagnosis of those lesions. In addition, diffusion weighted MRI with multi parametric modalities played unlimited role in the assesment of the differential diagnosis.
Nasobiliary Drainage for Benign Recurrent Intrahepatic Cholestasis in Patients Refractory to Standard Therapy
(2016) Yakar, Tolga; Demir, Mehmet; Gokturk, Huseyin S.; Kanat, Ayse G. Unler; Parlakgumus, Alper; Ozer, Birol; Serin, Ender; 0000-0002-0138-6107; AAM-7281-2021
Purpose: Benign recurrent intrahepatic cholestasis (BRIC) is characterized by episodic cholestasis and pruritus without anatomical obstruction. The aim of this study was to evaluate the safety and efficacy of nasobiliary drainage (NBD) in patients with BRIC refractory to medical therapy and to determine whether the use of NBD prolongs the episode duration. Methods: This was a multicenter retrospective study consisting of 33 patients suffering from BRIC. All patients were administrated medical treatment and 16 patients who were refractory to standard medical therapies improved on treatment with temporary endoscopic NBD. Duration of treatment response and associated complications were analyzed. Results: Sixteen patients (43% females) underwent 25 NBD procedures. The median duration of NBD was 17 days. There were significant improvements in total and direct bilirubin and alanine aminotransferase, aspartate aminotransferase, alkaline phosphatase and gamma-glutamyl transpeptidase on the 3rd day of NBD. Longer clinical remission was monitored in the NBD group. Post-endoscopic retrograde cholangiopancreatography pancreatitis was observed in one of 16 cases. Conclusion: NBD effectively eliminates BRIC in all patients and improves biomarkers of cholestasis. It can be suggested that patients with attacks of BRIC can be treated with temporary endoscopic NBD; however, the results of this study should be confirmed by prospective studies in the future.
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-8558-2021
Hydatid 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.
Polymeric Clips for Stump Closure in Laparoscopic Appendectomy
(2017) Parlakgumus, Alper; Ezer, Ali; 0000-0002-3834-9924; 29056133; AAJ-8558-2021
Many 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.
Primary Axillary Hydatid Cyst: An Extremely Rare Manifestation of Hydatid Disease
(2017) Ezer, Ali; Parlakgumus, Alper; 0000-0002-3834-9924; 28406785; AAJ-8558-2021
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-8558-2021
A Rare Cause of Gastrointestinal Bleeding: Jejunal Diverticulosis
(2016) Parlakgumus, Alper; Ezer, Ali; Tarim, Akin; 0000-0002-3834-9924; 27806823; AAJ-8558-2021
Results of Surgery in General Surgical Patients Receiving Warfarin: Retrospective Analysis of 61 Patients
(2015) Belli, Sedat; Aytac, Huseyin Ozgur; Yabanoglu, Hakan; Karagulle, Erdal; Parlakgumus, Alper; Nursal, Tarik Zafer; Yildirim, Sedat; 25692422
The aim of this study is to investigate postoperative complications, mortality rates, and to determine the factors affecting mortality on the patients receiving warfarin therapy preoperatively, as well as comparing the results obtained from emergency and elective surgeries. Surgical outcomes of 61 patients on long-term oral anticoagulation with warfarin who underwent surgery in our center were retrospectively reviewed over an 8-year period. Thirty-three (54.1%) patients were female, with a mean age of 53 years. Mitral valve replacement (62.3%) was the most frequent indication for chronic anticoagulation therapy. Twelve out of 61 (19.2%) patients underwent emergency surgery; 59 (96.7%) operations were classified as major surgery. We did not observe any thromboembolic events on patients receiving our bridging therapy protocol. Cardiopulmonary dysfunction (CPD; 19.7%) and hemorrhage (16.4%) were the most encountered postoperative complications. Presence of CPD, bleeding, endocarditis, and mortality were statistically significant for emergency surgeries when compared with the results obtained from elective surgeries. There were 5 (8.2%) deaths observed during follow-up. It was found that advanced age, prolonged duration of operations, and presence of CPD had a statistically significant effect on mortality (P < 0.05). The patients receiving oral anticoagulant had high postoperative complication and mortality rates. This case was more evident in emergency surgeries. It is recommendable that as mortality is more apparent in the patients who undergo emergency surgeries-being older, having long duration of operations as well as CPD. Therefore during the postoperative follow-up process, the patients should be closely monitored.
Solitary Cecal Diverticulitis Mimicking Cecal Carcinoma
(2018) Ezer, Ali; Parlakgumus, Alper; https://orcid.org/0000-0002-3834-9924; 29866226; AAJ-8558-2021
Cecal 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.