Tıp Fakültesi / Faculty of Medicine
Permanent URI for this collectionhttps://hdl.handle.net/11727/1403
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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 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 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 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 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 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 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 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.