Wos Açık Erişimli Yayınlar
Permanent URI for this collectionhttps://hdl.handle.net/11727/10754
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Item Factors Affecting Recurrence of Idiopathic Granulomatous Mastitis(2022) Tasci, Halil Ibrahim; Turk, Emin; Erinanc, Ozgur Hilal; Erkan, Serkan; Gundogdu, Ramazan; Karagulle, Erdal; https://orcid.org/0000-0003-2269-4798; 35108784; AAJ-2989-2021Objective: To investigate factors that may have an effect on recurrence by retrospectively analysing the data of patients who were followed up and treated for idiopathic granulomatous mastitis in this clinic. Study Design: Analytic study. Place and Duration of Study: Department of General Surgery, Faculty of Medicine, Baskent University, Konya and Adana Practice and Research Hospitals between January 2010 and January 2021. Methodology: The data of patients who were histopathologically diagnosed with granulomatous mastitis were retrospectively analysed. The patients included in the study were divided into two groups: Recurrence (Group 1) and non-recurrence (Group 2). Patients with underlying etiological factors that may cause granulomatous inflammation such as infection, trauma, tuberculosis, sarcoidosis, and autoimmune disease were excluded from the study. The effects of other parameters (involvement area, followup duration, the time from the onset of complaints to diagnosis, side of involvement, breastfeeding, oral contraceptive use, redness, ulceration and/or discharge, preoperative histopathological diagnosis, diagnosis by any of the preoperative imaging techniques, preferred treatment method) on recurrence, were statistically analysed. Results: Furthermore, the analysis results showed no significant difference between the groups with and without recurrence with regard to any of the other variables such as follow-up period, size of the involvement area, presenting complaints, breast-feeding,preferred treatment alternative (steroid, steroid + surgery, surgery), and preferred surgical technique (p>0.05). The time from the onset of complaints to diagnosis was significantly longer in the recurrence group (p=0.001). In addition, the frequency of oral contraceptive use was statistically significantly higher in the recurrence group (Odds ratio=7.6, p=0.044). Conclusion: The results of this study suggest that early diagnosis could prevent recurrence in patients with idiopathic granulomatous mastitis. Prospective randomised controlled studies are needed to support this thought.Item A Rare Case: Primary Mucinous Cystic Neoplasm Of The Gallbladder(2021) Tasci, Halil Ibrahim; Erinanc, Ozgur Hilal; Turk, Emin; Karagulle, ErdalCystic lesions originating from the gallbladder are very rare. Mucinous cystic neoplasms of the liver and biliary system principally occur in the liver, followed by the extrahepatic biliary system. Only a few case reports were reported primarily in the gallbladder. A 63-year-old woman was admitted to our hospital with complaints of pain in the right upper abdomen, increasing after meals, and abdominal discomfort. A laparoscopic cholecystectomy was performed. Macroscopically, the cyst was localized in the serosa of the fundus. Based on immunohistochemical examination, the cyst was diagnosed as primary mucinous cystic neoplasia of the gallbladder. Although it is very rare, mucinous cystic neoplasia should be kept in mind when dealing with cystic lesions of the gallbladder. Due to serious associated problems such as the risk of malignant transformation or bile duct obstruction, particularly in larger cysts, a cholecystectomy is mandatory.Item Unusual Findings in Appendectomy Specimens of Adults: Retrospective Analyses of 1466 Patients and a Review of Literature(2014) Yabanoglu, Hakan; Caliskan, Kenan; Aytac, Huseyin Ozgur; Turk, Emin; Karagulle, Erdal; Kayaselcuk, Fazilet; Tarim, Mehmet AkinBackground: Diseases and tumors of the appendix vermiformis are very rare, except acute appendicitis. Objectives: This retrospective study was conducted to document the unusual findings in appendectomy specimens. Patients and Methods: Data of 1466 adult patients were gathered retrospectively. Appendectomy was performed in 1169 and in 297 patients following a diagnosis of acute appendicitis and during other abdominal operations, respectively. The data of 57 (3.88 %) patients who were pathologically reported to have unusual appendix findings were retrospectively collected. The records were analyzed according to patients' age, gender, clinical presentations, operative reports, pathological reports and follow up. Results: Unusual pathologic examination findings were detected in the appendectomy specimens of 57 patients with a mean age of 48.34 +/- 19. Twenty-nine patients (50.8%) were male and 28 (49.2%) were female. Normal appendix tissues were observed in specimens of 26 (45.6%) patients and inflamed appendix in 31 (54.3%). The most common unusual finding was parasitic diseases of the intestine. Pathological diagnosis of malignancy and benign features were reported in specimens of 14 and 43 patients, respectively. Macroscopic evaluation of appendectomy specimens during surgery might result in negligence of the presence of unusual pathology. Conclusions: Even if the macroscopic appearance of the specimen is normal or acute appendicitis, we suggest routine histopathological examination.Item Effect of Topical Tetracycline on Seroma Formation in the Lichtenstein Technique: A Prospective Randomized Study(2014) Turk, Emin; Karagulle, Erdal; Coban, Gokcen; Yildirim, Erkan; Moray, GokhanWe sought to investigate whether application of topical tetracycline has a limiting effect on seroma formation in patients undergoing hernia repair using a polypropylene mesh. This study was conducted in 96 patients undergoing an elective groin hernia repair. Patients were randomized and divided into 2 groups. After the graft was placed, and before external oblique muscle aponeurosis was closed, 5 mL tetracycline was administered on the graft in the tetracycline group (tetra group, n = 50), and 5 mL isotonic saline was administered in the control group (n = 46) without putting in a drain. Seroma checks via surface ultrasonography were done. Seroma amounts measured on the first day were significantly higher in the tetra group (P = 0.04). There were no significant differences regarding seroma measurements on the seventh day or in the first and second months. Topical tetracycline application has no limiting effect on seroma formation after a groin hernia operation.Item Outcomes of Surgical Treatment of Primary Signet Ring Cell Carcinoma of the Colon and Rectum: 22 Cases Reviewed With Literature(2014) Belli, Sedat; Aytac, Huseyin Ozgur; Karagulle, Erdal; Yabanoglu, Hakan; Kayaselcuk, Fazilet; Yildirim, Sedat; 25437572Colorectal primary signet ring cell carcinoma (PSRCCR) is a rare entity with a dismal prognosis, mainly because of delayed diagnosis. The objective of this study was to investigate the clinicopathologic features and prognostic factors for PSRCCR. This is a retrospective study including the data of 22 patients with PSRCCR who underwent surgery. Patients were categorized by age, sex, tumor site, and stage. Fifteen patients were male. Median age was 40 years. Sites for metastases were lymph nodes (86.4%), peritoneum (40.9%), and liver (9.1%). Most of the patients (91%) had stage III or IV tumors. The rates of curative and palliative resections performed were equal. Mean overall survival and mean progression-free survival times were found to be 33.3 +/- 7.1 months (95% confidence interval, 19.4-47.2 months) and 11.8 +/- 3.5 months (95% confidence interval, 4.9-18.7 months), respectively. It was concluded that site of the tumor, presence of bowel obstruction, peritoneum and lung metastases, adjacent organ infiltration, TNM stage, and efficiency of surgery have significant effects on survival. All in all, these aggressive tumors are generally diagnosed at advanced stages. Depending on the situation, survival is shorter. A high degree of vigilance is required for these patients to avoid the negative impact of late diagnosis on survival.Item Giant Fibroadenoma Growing Rapidly During Pregnancy(2014) Karagulle, Erdal; Turk, Emin; Erinanc, Ozgur Hilal; Moray, Gokhan; 25389498Introduction: Giant fibroadenoma is a rare disease with unknown etiology During pregnancy fibroadenomas increase in size and may show lactational histologic changes. High concentrations of estrogen, progesterone, and prolactin promote the ductal growth and formation of tubuloalveolar structures.This may be a reason for the significant enlargement in this period. Case Presentation: We presented a case of giant fibroadenoma, first detected at the onset of pregnancy, which grew rapidly and was excised surgically two months after the birth. There was no marked deformity in the breast nor a need to reconstruct it, despite the giant mass was excised and the mother was lactating. Discussion: We presented a rare case of giant fibroadenoma in a lactating woman. A progressively growing mass in breast can lead to structural damages. The current management approach for giant fibroadenomas is still surgical excision.Item 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; 25692434Our 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.Item 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; 25692422The 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.Item The effect of pneumoperitoneum on the cross-sectional areas of internal jugular vein and subclavian vein in laparoscopic cholecystectomy operation(2016) Pinar, Huseyin Ulas; Dogan, Rafi; Konuk, Ummu Mine; Cifci, Egemen; Duman, Enes; Karagulle, Erdal; Turk, Emin; Karaca, Omer; 27515323Background: Increased central venous pressure secondary to an increase in intraabdominal pressure has been reported during laparoscopic surgery. However, no study has yet determined the effect of pneumoperitoneum on cross-sectional area (CSA) of central veins by ultrasonography during laparoscopic cholecystectomy. Herein, we aimed to quantify changes in CSAs of internal jugular (IJV) and subclavian veins (SCV) by ultrasonography during this surgery. Methods: This study included 60 ASA I-II patients scheduled for laparoscopic cholecystectomy surgery under general anesthesia. Pneumoperitoneum was performed with CO2 at 12 mmHg. The CSAs of right IJV and right SCV were measured using a 6 Mhz ultrasonography transducer in supine and neutral positions before anesthesia induction (T1), 5 min after connecting to mechanical ventilator (T2), 5 min after creation of pneumoperitoneum (T3), at the end of pneumoperitoneum (T4), and 5 min after desufflation and before extubation (T5) both at end-expiration and end-inspiration. Results: The comparison of IJV CSA at inspiration showed significant increase in T3 value compared to T2 value (p < 0.001). Similarly the expiratory measurements of IJV CSA demonstrated significant increase in T3 value compared to T2 value (p < 0.001). The comparison of inspiratory CSA measurements of SCV showed significantly increased in T3 (p = 0.009) than T2 value. In expiratory measurements there was a significant increase in T3 (p = 0.032) value compared to T2. All measurements of IJV and SCV SCAs both end-inspiration and end-expiration T5 values significantly decreased compared to T4 values (p < 0.001). Conclusions: Pneumoperitoneum with an intraabdominal pressure of 12 mmHg produces significant increases in IJV and SCV CSAs during laparoscopic cholecystectomy procedure. We believe that this finding may enhance our understanding of pneumoperitoneum-induced hemodynamic changes and facilitate catheterization attempts.Item EFFECTS OF LOWER GASTROINTESTINAL TRACT SURGERY ON SURVIVAL IN ELDERLY AND OCTOGENARIAN PATIENTS(2018) Aydin, Huseyin Onur; Avci, Tevfik; Tezcaner, Tugan; Karagulle, Erdal; Yildirim, Sedat; 0000-0003-3795-5794; 0000-0002-8522-4956; 0000-0002-3641-8674; 0000-0001-5225-959X; 0000-0002-5735-4315; S-8185-2018; C-6247-2017; AAD-9865-2021; AAF-1698-2021; AAF-4610-2019Introduction: Life expectancy has significantly increased in the last decade. The decision to perform surgery has always been challenging in elderly patients. We aimed to evaluate outcomes in patients who underwent surgery for lower gastrointestinal tract diseases and investigate factors influencing morbidity and mortality, particularly in octogenarian patients, and the effects of age on prognosis and survival in the postoperative period. Materials and Method: This study included patients aged >= 70 years who underwent lower gastrointestinal tract surgery; patients were divided into three groups as 70-75 years, 75-79 years, and >= 80 years. Age, gender, type of surgery, ASA score, length of hospital stay, morbidity, 30-day mortality, and overall survival were evaluated. Results: The surgery was performed to 598 patients due to lower gastrointestinal tract diseases. There was a significant increase in the ASA score with increasing age (Chi-square=35.472; p<0.001). The survival rate was significantly higher in patients with malignancies than in those with benign diseases, and in patients who underwent elective surgery than in those who underwent emergency surgery (p<0.001). When patients were examined according to age groups, the overall survival was similar across groups (p=0.217). Conclusion: There was no significant difference between octogenarian and younger patients for complications and survival. Thus, planned surgical interventions in elderly patients will not negatively affect survival and surgical interventions and can be safely performed in these patients.