Tıp Fakültesi / Faculty of Medicine

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Author: search.filters.author.Avci, TevfikHas files: No

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    Management of Symptomatic Arterial and Venous Aneurysms in Hemodialysis Patients Related To Arteriovenous Fistulas
    (2018) Avci, Tevfik; Yabanoglu, Hakan; Moray, Gokhan; Haberal, Mehmet; https://orcid.org/0000-0001-5225-959X; https://orcid.org/0000-0002-1161-3369; https://orcid.org/0000-0003-2498-7287; https://orcid.org/0000-0002-3462-7632; AAF-1698-2021; AAJ-7865-2021; AAE-1041-2021; AAJ-8097-2021
    AIM: Our aim in this study is to present the management of the symptomatic aneurysms that are related to AVF. MATERIAL AND METHODS: Between January 2011 and January 2017, 50 patients who were operated due to symptomatic AVF aneurysms were evaluated. Forty-four (88%) patients' fistulas were closed for symptomatic venous aneurysm. In 6 (12%) patients true brachial artery aneurysm were present and a segmental artery resection with its repair was performed. RESULTS: The most common symptomatic aneurysm was seen on the brachiocephalic fistula (n=32, 64%). The symptoms of the patients were; aneurysm thrombosis (n=15, 30%), steal syndrome (n=9, 18%), rupture/massive bleeding (n=7, 14%), infection (n=7, 14%), skin necrosis (n=5, 10%), venous hypertension (n=4, 8%) and high output cardiac failure (n=1, 2%). Nine (18%) patients had two or more symptoms. While the mean duration of dialysis of patients who underwent venous aneurysmectomy was 69 +/- 4.2 years, patients who underwent arterial aneurysmectomy and brachial artery repair was 11.7 +/- 3.6 years (p = 0.012). DISCUSSION: Arterial aneurysm is a rare complication of vascular access. Although it causes serious symptoms including those of related such as thrombosis, ischemia, nerve compression, the most important complication is aneurysm rupture. Therefore, preoperative evaluation and appropriate surgical interventions will prevent morbidities that may arise. CONCLUSION: The choice of a treatment modality in patients with a symptomatic arteriovenous fistula aneurysms is to maintain the continuity of the arteriovenous fistula but when acute bleeding occurs in an unstable patient, ligation of fistula should be considered.
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    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.
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    Comparison of Mortality Rates in Patients Waiting for Liver Transplant and Patients With Colorectal Metastatic Tumors
    (2022) Erkent, Murathan; Aydin, H. Onur; Tezcaner, Tugan; Avci, Tevfik; Kavasoglu, Lara; Soy, Ebru H. Ayvazoglu; Yildirim, Sedat; Haberal, Mehmet; 0000-0002-3592-5092; 0000-0002-0664-5147; 0000-0002-0993-9917; 0000-0002-3462-7632; 35352633; CAA-2756-2022; AAJ-8219-2021; AAC-5566-2019; AAJ-8097-2021
    Objectives: We aimed to identify outcomes of liver surgery in patients with hepatocellular carcinoma and colorectal cancer, which result in primary and secondary liver tumors. Materials and Methods: Our study included 51 patients with colorectal cancer and liver metastases and 63 patients with hepatocellular carcinoma who were prepared for liver transplant due to cirrhosis who underwent hepatic resection or local ablation treatments; patients were seen between January 2011 and December 2021. Results: Most patients with colorectal cancer were men (58.8%). Mean age was 65.76 +/- 13.818 years (range, 27-88 y). Most patients had planned, elective surgery (86.3%). Neoadjuvant chemotherapy was administered to 58.8% of patients. The most common location of metastasis in the liver was in the right lobe (43.1%), and the most common surgery was low anterior resection (17 patients). During simultaneous liver surgery, 31 patients required metastasectomy and 7 patients required radiofrequency ablation plus metastasectomy. No deaths occurred in the early posttransplant period, and cumulative survival was 82.624 +/- 7.962 months. Disease-free survival was 45.2 +/- 7.495 months. Most patients with hepatocellular carcinoma were men (82.5%). Mean age was 58.73 +/- 17.428 years. Hepatocellular carcinoma lesions were mostly located in both the right and left lobes (23.8%). In the hepatocellular cancer group, 60.3% had transarterial chemoembolization and 42.9% had radiofrequency ablation. The primary surgical resection was metastasectomy (17.9%) because of multiple localized lesions. Median follow-up was 22 months (range, 1-126 mo). Overall survival was 101.898 +/- 7.169 months, with 10-year overall survival of 38%. Disease-free survival was 74.081 +/- 8.732 months, with 1-year and 5-year disease-free survival of 90.5% and 54%. Conclusions: Better survival was shown in patients with hepatocellular carcinoma than in patients with colorectal cancer. Therefore, more aggressive treatment options, as used in hepatocellular carcinoma, including liver transplant, may be options for patients with colorectal cancer.