Browsing by Author "Yabanoglu, Hakan"

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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.
Acute appendicitis during pregnancy: case series of 20 pregnant women
(2016) Arer, Ilker Murat; Alemdaroglu, Songul; Yesilagac, Hasan; Yabanoglu, Hakan; 0000-0002-1161-3369; 0000-0003-4335-6659; 0000-0002-1365-9256; 28074461; AAJ-7865-2021; AAY-2668-2021; AAI-8400-2021; AAJ-6068-2021
BACKGROUND: Acute appendicitis (AA) is the most common cause of acute abdomen during pregnancy. Most of the signs of appendicitis are also found during normal pregnancy period, however, and diagnosis of appendicitis during pregnancy remains challenging. The aim of the current study was to report our clinical experience of AA during pregnancy and investigate optimal management of this difficult situation. METHODS: Records of 20 pregnant women with diagnosis of AA who underwent appendectomy between 2005 and 2015 were included in this study. Data were collected retrospectively. Patients were evaluated according to age, signs and symptoms, gestational age, physical findings, serum white blood cell count, ultrasound (US) findings, pathology reports, surgical technique, operation time, and complications. RESULTS: Of 20 patients, 16 (80%) underwent open appendectomy and 4 (20%) underwent laparoscopic appendectomy. Mean age of patients was 29.6 +/- 5.6 years. Most common symptom was abdominal pain (95%). Six (30%) patients were in first trimester, 9 (45%) patients were in second trimester and 5 (25%) patients in were in third trimester. US findings consistent with AA were found in 12 (60%) patients. Negative appendectomy rate was 30%. Maternal complication was seen in only 1 (5%) patient. No fetal complication was observed. CONCLUSION: Accurate diagnosis and prompt surgical treatment of AA in pregnant women should be performed due to high rates of maternal and fetal complications.
Anastomotic Leakage in a Patient with Acute Intestinal Obstruction Secondary to Appendiceal and Ileal Endometriosis: A Case Report
(2016) Arer, Ilker Murat; Yabanoglu, Hakan; Hasbay, Bermal; 27190890
Endometriosis is a commonly encountered problem in women of reproductive age. It usually causes chronic abdominal pain. However, it rarely causes complications such as intestinal obstruction. The most commonly performed procedure for these patients is bowel resection and anastomosis. Unless it is complicated with anastomotic leakage. We present a 39-year-old woman presented with intestinal obstruction due to appendiceal and ileal endometriosis complicated with anastomotic leakage after surgery.
Assessment of Atrial Fibrillation and Ventricular Arrhythmia Risk after Transplantation in Patients with End Stage Renal Disease by P Wave/QT Interval Dispersion, Tp-e Interval, Tp-e/QT Interval Ratio
(2018) Yilmaz, Mustafa; Altin, Cihan; Tekin, Abdullah; Arer, Ilker; Yabanoglu, Hakan; Caliskan, Kenan; Moray, Gokhan; Ozin, Bulent; Muderrisoglu, Haldun; Haberal, Mehmet; https://orcid.org/0000-0002-2557-9579; https://orcid.org/0000-0002-5658-870X; https://orcid.org/0000-0002-1161-3369; https://orcid.org/0000-0002-8767-5021; https://orcid.org/0000-0003-2498-7287; https://orcid.org/0000-0003-3821-412X; https://orcid.org/0000-0002-9635-6313; https://orcid.org/0000-0002-3462-7632; S-6973-2016; ABD-7304-2021; AAJ-7865-2021; AAJ-7201-2021; AAE-1041-2021; AAD-9938-2021; AAG-8233-2020; AAJ-8097-2021
Assessment of Carotid Artery Distensibility and Elasticity After Laparoscopic Sleeve Gastrectomy: a Prospective Study
(2020) Gunesli, Aylin; Yilmaz, Mustafa; Altin, Cihan; Gezmis, Esin; Yabanoglu, Hakan; Erol, Varlik; 0000-0002-2557-9579; 0000-0002-8337-6905; 0000-0002-1161-3369; 0000-0002-1001-6028; 0000-0003-0268-8999; 32813160; S-6973-2016; AAK-3065-2021; AAJ-7865-2021; AAE-8301-2021; AAK-2011-2021
Purpose Although it is well known that obesity increases the risk of atherosclerosis in carotid arteries, it is not clear whether this risk changes after obesity surgery. The aim of this study was to investigate whether weight reduction with a laparoscopic sleeve gastrectomy (LSG) has any effect on distensibility and elasticity which show subclinical atherosclerosis in the carotid arteries of obese individuals. Materials and Methods This prospective study included 130 patients (body mass index (BMI) 48.21 +/- 6.97 kg/m(2)) who underwent LSG. The patients were followed up for 1 year. Comparisons were made of the distensibiliy and elasticity values calculated preoperatively and at 1, 3, 6, and 12 months, postoperatively. Results There was a statistically significant increase in distensibility and elasticity values from baseline to 1, 3, 6, and 12 months postoperatively (p < 0.001 for both comparisons). The multiple linear regression analysis was used to find the variables affecting both distensibility and elasticity. According to the results, the presence of BMI decreases distensibility percentage change level by 0.38 units (beta= - 0.38, 95% CI - 0.51;- 0.25,p < 0.001). The presence of fasting plasma glucose decreases elasticity percentage change level by 0.20 units. (beta= - 0.20, 95% CI - 0.39; - 0.01,p = 0.037). Conclusion Carotid artery distensibility and elasticity values increase after LSG, and this change could be caused by the change in metabolic parameters and heart geometry. These results may indirectly suggest that subclinical atherosclerosis in carotid arteries has decreased after obesity surgery.
Can red cell distribution width be used as a predictor of acute cholecystitis?
(2017) Arer, Ilker Murat; Yabanoglu, Hakan; Caliskan, Kenan; 0000-0003-0268-8999; 0000-0002-1161-3369; 0000-0002-8767-5021; 28740954; AAJ-7865-2021; AAJ-7201-2021; AAK-2011-2021
Objective: Acute cholecystitis is a common disease requiring accurate markers for diagnosis and proper treatment. The aim of this study was to investigate the role of red cell distribution width (RDW) in acute cholecystitis. Material and Methods: 299 were included in the study. The subjects were divided into 2 groups; group 1 (n: 46) acute cholecystitis group and group 2 (n:253) chronic cholecystitis group. The patients were compared with respect to demographic characteristics, white blood cell count, C-reactive protein, and red cell distribution width. Results: A statistically significant difference was observed between groups with respect to gender, white blood cell count, C-reactive protein, and red cell distribution width level (p<0.05). The mean red cell distribution width level of group 1 and 2 was 14.19 +/- 2.02% and 15.03 +/- 2.51%, respectively. Conclusion: Red cell distribution width level can be used as a predictor of acute cholecystitis. Multicenter prospective studies should be performed to elucidate the exact role of RDW level in acute cholecystitis.
Change of respiratory functions, the STOP-Bang questionnaire, and Epworth sleepiness scale after bariatric surgery
(2020) Kara, Sibel; Habesoglu, Mehmet Ali; Yabanoglu, Hakan; 33055387
INTRODUCTION AND OBJECTIVE: Obesity is a highly morbid and fatal syndrome that reduces respiratory function. Obstructive sleep apnea syndrome (OSAS) is a common sleep disorder in morbid obesity. Herein, we aimed to determine how respiratory function tests changed over time after bariatric surgery and to assess non-PSG (polysomnography) tests, namely STOP-Bang questionnaire and Epworth sleepiness tests, for predicting OSAS risk. METHOD: This retrospectively conducted study enrolled 35 patients who underwent bariatric surgery. Patients were divided into three groups formed on the basis of time passed after surgery (1, 2, or 3 years). Preoperative and postoperative respiratory function test parameters assessed by spirometry, body mass index (BMI), STOP-Bang questionnaire, and Epworth sleepiness test scores were recorded. RESULTS: Twenty-four (68.6%) patients were female, 11 (31.4%) male. The mean age was 36.5 +/- 10.5 years. Postoperative weight loss of the study groups was 26% p=0.001, 23.6% p=0.002 and 25.9% p=0.005. Reductions in BMI were 32 kg/m(2) p=0.001, 34.5 kg/m(2) p=0.002, 35.8 kg/m(2) p=0.005 respectively. Postoperative FVC (440 ml, 390 ml, 430 ml p = 0.005) and FEV1 (220 ml p = 0.005, 250 ml p = 0.004, 214 ml p = 0.005) increased in all three groups. STOP-Bang questionnaire and Epworth sleepiness scale scores significantly decreased after weight loss compared to preoperative period in all the study groups. CONCLUSION: We showed that FVC and FEV1 increased in the short and long term after weight loss by bariatric surgery; we also found that STOP-Bang questionnaire and Epworth sleepiness scale scores decreased postoperatively. These tests may be helpful to assess OSAS risk before and after surgery.
A Comparative Study of Conservative versus Surgical Treatment Protocols for 77 Patients with Idiopathic Granulomatous Mastitis
(2015) Yabanoglu, Hakan; Colakoglu, Tamer; Belli, Sedat; Aytac, Huseyin Ozgur; Bolat, Filiz Aka; Pourbagher, Aysin; Tezcaner, Tugan; Yildirim, Sedat; Haberal, Mehmet; 0000-0003-2031-7374; 0000-0002-3462-7632; 0000-0002-5735-4315; 0000-0002-3641-8674; 0000-0002-3583-9282; 0000-0002-1161-3369; 25858348; HJZ-1654-2023; AAJ-8097-2021; AAF-4610-2019; AAD-9865-2021; AAJ-7913-2021; AAJ-7865-2021
The purpose of this study was to analyze the clinical features and demographic data of patients with idiopathic granulomatous mastitis (IGM) and to compare the results of conservative versus surgical treatment protocols. The demographic data, clinical findings, microbiological and pathologic features, scanning and treatment methods, recurrence, and recovery rates of 77 patients were analyzed retrospectively. The patients were divided into two groups based on the type of treatment received. Core biopsies were used to diagnose 37 patients: 26 using incisional biopsies and 14 using excisional biopsies. Of the patient population with IGM, 31 were treated with surgical excision, one with a simple mastectomy, and one with a subcutaneous mastectomy combined with a breast implant, whereas 44 were treated with steroids. The recovery rates of the 44 patients who were treated conservatively were 6 (1-15) months while for the 33 patients who were treated surgically, it was 1 (1-5) month (p=0.001). Nine patients from the conservative treatment group experienced a recurrence while there were no recurrences in the surgically treated group (p=0.009). Among all patients, the recurrence rate was 11.7% (9/77) while the average follow-up period was 16.57 +/- 18.57months. As a comparative study between conservative treatment protocols and surgical ones for patients with idiopathic granulomatous mastitis (IGM), this study is the largest to date. A wide surgical excision is the preferred approach for treating patients with IGM because of the low recurrence rate.
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.
Early Infections in Renal Transplant Recipients: Incidence, Risk Factors, and Causative Microorganisms
(2015) Yabanoglu, Hakan; Aliskan, Hikmet Eda; Caliskan, Kenan; Arer, Ilker; Akdur, Aydincan; Yildirim, Sedat; Moray, Gokhan; Haberal, Mehmet; 0000-0002-1161-3369; 0000-0002-8726-3369; 0000-0002-5735-4315; 0000-0001-9060-3195; 0000-0002-8767-5021; 0000-0002-3462-7632; 0000-0003-0268-8999; 0000-0003-2498-7287; 26640902; AAJ-7865-2021; AAA-3068-2021; AAF-4610-2019; AAE-2282-2021; AAJ-7201-2021; AAJ-8097-2021; AAK-2011-2021; AAE-1041-2021
Objectives: This study aimed to compare renal transplant recipients with and without infection with respect to demographic and clinical characteristics as well as risk factors; to determine the incidence of posttransplant infections; and to study the antibiotic resistance patterns of bacterial species identified as the causative organisms in posttransplant infections. Materials and Methods: This study included a total of 136 patients undergoing renal transplant in a 4-year period. The patients were categorized into 2 groups. The 2 groups were compared with each other with respect to general clinical and demographic variables and the number and frequency of infectious attacks within a 1-year follow-up, infection type, and antibiotic resistance patterns. Results: Ninety-two (67.6%) of the subjects were male and 44 (32.4%) were female. A total of 57 (41.9%) patients developed 128 infectious attacks. Urinary tract infections were the most common infections (42.1%). There was a significant correlation between a clinically relevant urinary culture proliferation and postoperative infection rate (P =.002). There was a significant correlation between antimicrobial resistance and the number of infectious attacks (P =.023). There was a significant correlation between the proliferation of Extended Spectrum Beta Lactamase-positive Enterobactericeae species and the number of infectious attacks (P =.000). Conclusions: Presence of a clinically relevant proliferation in the preoperative urinary culture, which was identified as a risk factor for infection, increased the number of infectious attacks. Moreover, Extended Spectrum Beta Lactamase-positive Enterobactericeae species increased the number of infections. These 2 principle results should be taken into account in patient management.
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-8558-2021
AIM: 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.
The Effect of the Use of Synthetic Mesh Soaked in Antibiotic Solution on the Rate of Graft Infection in Ventral Hernias: A Prospective Randomized Study
(2015) Yabanoglu, Hakan; Arer, Ilker Murat; Caliskan, Kenan; 25590831
Wound infections and seroma formations are important problems in ventral hernia repair operations using synthetic mesh grafts. The aim of this study was to investigate the effect of the use of synthetic mesh soaked in vancomycin solution on the rate of graft infection. The total number of subjects was 52. The subjects were randomized into 2 groups using a software program. Group 1 (n = 26) was the control group. In group 2 (n = 26), synthetic mesh was soaked in a Vancomycin solution before it was implanted. The patients were compared with respect to demographic characteristics and preoperative, intraoperative, and postoperative variables. There were no significant differences between the groups with respect to the available variables. Seroma development was significantly more common in group 2 (P < 0.041). Three patients (5.7%) developed superficial wound infection, and 9 (17%) developed surgical site infection 2-type wound-site infection. No significant difference was found between the groups in terms of infection. The use of synthetic mesh soaked in vancomycin solution had no beneficial effects on the rate of wound-site infection. Future randomized, controlled, large-scale studies using the same mesh and suture types, and meshes soaked in larger spectrum antibiotics are needed.
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.
Evaluation of Demographic and Clinical Characteristics of Patients who Attempted Suicide by Self-Inflicted Burn Using Catalyzer
(2015) Yabanoglu, Hakan; Aytac, Huseyin Ozgur; Turk, Emin; Karagulle, Erdal; Belli, Sedat; Sakallioglu, Ayse Ebru; Tarim, Mehmet Akin; Moray, Gokhan; Haberal, Mehmet; 25692434
Our aim was to assess demographic and clinical characteristics of patients treated at our units who attempted suicide by self-incineration, and to compare the results of burns with or without catalyzer use. Twenty patients who attempted suicide by self-incineration were examined in terms of clinical and demographic characteristics. Average age of the study population was 35 years (range 13-85 years). Average percentage of total body surface area burn was 53% (9%-100%). Six (30%) patients used gasoline and 5 (25%) used paint thinner in order to catalyze burning. Of these 11 patients who used a catalyzer, 5 (45.4%) had inhalation injury and 7 (63.6%) died. Among 9 patients who did not use any catalyzer, 1 (11.1%) had inhalation injury and 4 (44.4%) died. In general, inhalation injury was diagnosed in 6 patients (30%) while 11 (55%) patients died. A high morbidity and mortality rate was found in patients who used a catalyzer.
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.
Generalist versus Abdominal Subspecialist Radiologist Interpretations of Abdominopelvic Computed Tomography Performed on Patients with Abdominal Pain and its Impact on the Therapeutic Approach
(2020) Yesilagac, Hasan; Arer, Ilker Murat; Gulalp, Betul; Yabanoglu, Hakan; Karagun, Ozlem; Karadeli, Elif; 0000-0003-0681-8375; 0000-0002-2045-2771; 0000-0002-0352-8818; 0000-0002-1365-9256; 0000-0002-1161-3369; 32322789; U-4084-2017; P-6931-2016; AAK-5399-2021; AAJ-6068-2021; AAJ-7865-2021
Introduction: Abdominal pain is one of the most common patient complaints in the emergency department (ED) and abdominopelvic computed tomography (ACT) scan plays an important role in evaluation of these patients. Objective: The aim of this study was to determine the differences between interpretations by generalist radiologists and abdominal subspecialist radiologists regarding the abdominopelvic computed tomography (ACT) of patients who were admitted to the Emergency Department (ED) and to investigate its effect on the patients' therapeutic approach. Methods: The records of 16452 patients who were admitted to the emergency department with complaint of abdominal pain between January 2015 and April 2017 were reviewed, retrospectively. Out of these patients, 245 (1.5%) underwent ACT for differential diagnosis and among them, 137 (0.8%) patients had their ACT reports evaluated by generalist radiologists in 45 minutes and by abdominal subspecialist radiologist 8-12 hours later and were included in the study. Patients were divided into three groups according to the effect of ACT reports on the performed treatment. Group 1: no effect on planned treatment, group 2: minor effect on planned treatment, which did not result in a change in the treatment process and group 3: major effect on planned treatment approach, which resulted in a change in the treatment process. These changes included at least one of the two criteria: changing the indication of surgery from emergency surgery to elective surgery and/or discharge of the patient from the ED, when actually hospitalization was required. Results: Out of the 137 patients, 87 (63.5%) were male, 50 (36.5%) were female and the patients' mean age was 56 (27-93) years. There were 117 (85.4%) patients in group 1, 15 (10.9%) patients in group 2, and 5 (3.7%) patients in group 3. We determined minor inconsistency between the reports in group 2 and major inconsistency in group 3. Patients in group 3 suffered from delayed surgical intervention due to inconsistency of the CT reports resulting in prolonged hospital stay and increased morbidity. In 17 patients (four patients in Group 1 and 13 patients in Group 2) treatment plan was changed due to CT results; and while surgical treatment was planned for them prior to CT scan, they were discharged with medical treatment after that and overtreatment was prevented. Conclusion: Contribution of abdominal radiologists to evaluation of ACT images in the ED would reduce the inconsistency in ACT reports and prevent the patients from receiving insufficient treatment or overtreatment.
Hand-made Extracorporeal Knotting versus Hem-o-Lok Clip for Stump Closure in Laparoscopic Appendectomy
(2019) Arer, Ilker Murat; Avci, Tevfik; Yabanoglu, Hakan; 31839096
Objective: To compare hand-made extracorporeal knotting and hem-o-lok clip for the closure of appendix stump regarding safety, complications and cost-effectiveness. Study Design: Descriptive study. Place and Duration of Study: Baskent University Adana Teaching and Research Center, between January 2010 and December 2016. Methodology: A total of 287 patients, who underwent laparoscopic appendectomy, were enrolled in this study. Patients were divided into hand-made extracorporeal knotting and hem-o-lok clip groups. Patients were compared according to age, gender, duration of symptoms, serum leukocyte count, American Society of Anesthesiologists (ASA) score, intraoperative findings, operation time, hospital stay, pathology report and complications. Results: Of 287 patients, 149 (51.9%) were female and 138 (48.1%) were male. The mean age was found 34.9 years. No statistical difference was observed between groups according to age, gender, duration of symptoms, serum leukocyte count, ASA score, operation time and hospital stay. Intraoperative findings were different between groups (p<0.05). Overall postoperative complication rate was 6.6%. No statistical difference was observed regarding complications Conclusion: Both hand-made extracorporeal knotting and hem-o-lok clips can be used for stump closure in laparoscopic appendectomy. Hand-made extracorporeal knotting is an effective, safe and costeffective method alternative to hem-o-lok clips.
Impact of surgeon factor on radiocephalic fistula patency rates
(2016) Arer, Ilker Murat; Yabanoglu, Hakan; 26900457
Introduction: Hemodialysis with arteriovenous fistula (AVF) has been widely accepted treatment modality for patients with chronic renal failure (CRF). Radiocephalic fistulas are considered to be the most desirable for the initial vascular access. The aim of this study is to investigate the surgeon factor on radiocephalic fistula patency rates. Methods: A total of 186 patients with diagnosis of CRF underwent Radiocephalic fistula for hemodialysis access were included. Patients were divided into 2 groups according to operating surgeon. Patients were evaluated according to demographic characteristics, secondary patency rates, second AVF creation and complications. Results: Mean age was 57.7 +/- 14.8 years. The most common etiology of CRF was idiopathic (66.6%). 40 (75.5%) patients in group 1 and 122 (91.7%) patients in group 2 were pre-dialysis patients (p < 0.05). Overall secondary patency rate was 77.4%. Patients in group 1 and group 2 have secondary patency rates of 83% and 75.2%, respectively (p = 0.458). Second AVF creation was done in 2 (3.8%) patients in group 1 and 23 (17.3%) patients in group 2 (p < 0.05). Postoperative complication rate was 9.6%. Conclusion: Operating surgeon is not a major factor of secondary patency in radiocephalic arteriovenous fistulas. (C) 2015 The Authors. Published by Elsevier Ltd on behalf of IJS Publishing Group Limited.
Laparoscopic Repair of Morgagni Hernia
(2015) Arer, Ilker Murat; Yabanoglu, Hakan; Aytac, Huseyin Ozgur; Caliskan, Kenan; Torer, Nurkan
Morgagni hernia is a congenital herniation of abdominal contents into the thoracic cavity through a retrosternal diaphragmatic defect and make up about 1 % - 5 % of all types of congenital diaphragmatic hernias. Surgical repair of Morgagni hernias is usually indicated when patients are symptomatic and have a high risk of strangulation or incarceration of the contained viscera. 71-year-old male patient admitted to emergency department with a 2-day history of abdominal pain, vomiting and obstipation. Laparoscopic repair for Morgagni hernia was performed. Laparoscopic repair for Morgagni hernia with mesh repair is secure, satisfactory and easily performed.
Long term results of total parathyroidectomy/autotransplantation without cryopreservation in secondary hyperparathyroidism
(2018) Avci, Tevfik; Karakayali, Feza; Yabanoglu, Hakan; Moray, Gokhan
Purpose: The aim of this study was to compare the efficacy and early-late results of subtotal parathyroidectomy and total parathyroidectomy/auto transplantation without cryopreservation conducted on cases with secondary hyperparathyroidism (HPT). Materials and Methods: 68 patients with secondary HPT who had parathyroidectomy were analysed retrospectively. In group1 (n=47) subtotal parathyroidectomy, in group2 (n=21) total parathyroidectomy/auto transplantation without cryopreservation were performed in our clinic. Patients' demographic characteristics and clinical features were evaluated. Results: In group1 8 patients (14.9%), in group2 17 patients (76.2%) had concurrent thymectomies. The rates of persistant HPT in group1 and group2 were 14.9% (n=7), 4.8% (n=1) respectively. In group2 no recurrent HPT was seen, in group2 10.6% (n=5) of the patients had recurrent HPT. The reasons of persistent and recurrent HPT were ectopic or supernumerary glands in 69.2% (n=9) of the patients. Conclusion:. In patients with end stage renal failure and secondary HPT, bilateral cervical thymectomy concurrent with total parathyroidectomy/auto transplantation without cryopreservation can be applied as a safe and efficient surgical procedure.