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    Clinical and surgical profile and follow up of patients with liver hydatid cyst from an endemic region
    (2008) Tekin A.; Kücükkartallar T.; Kartal A.; Kaynak A.; Özer Ş.; Tavli Ş.; Belviranli M.
    Aim: The aim of this study is to present the changes in the treatment of liver hydatid cyst during the last 20 years in our clinic according to literature data. Material and methods: Clinical, laboratory and operational findings and pre- and postoperative complications of 650 from 700 patients with liver hydatid cysts, examined and treated at Selcuk University Meram Medicine Faculty, General Surgery Department, between 1985-2005, were evaluated in two groups: 1st period (1985-1995) and 2nd period (1995-2005). Results: 436 of the cases were females (67.1%) and 214 (32.9%) males. The mean age of the females was 35 years (ranges 10-73) and of the males 46 years (ranges 12-76). Surgical treatment comprised radical and obliterative conservative techniques in the first period, while non-obliterative conservative techniques and percutaneous puncture and aspiration of the cyst, injection of scolex eliminating substance and reaspiration (PAIR) were preferred in the second period. During the follow-up (498 cases were followed for a mean period of 32 [12-72] months), recurrence occurred in 12 in the first period and in 9 in the second period, a total of 21 patients (4.21%). Conclusion: We consider that regardless of the surgical treatment used in liver hydatid cyst cases, combination with chemotherapy is the safest and most effective approach.
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    The effect of extracoporeal schock waves on intestinal anastomosis
    (2011) Pekin C.; Tekin S.; Kucukkartallar T.; Cakir M.; Tekin A.; Kartal A.
    Background and Objectives: To investigate the effect of extracorporeal shock waves on the healing of intestinal anastomosis. Materials and Methods: Thirty Wistar rats were randomly divided into three groups of ten each comprising of Group I (only laparotomy), Group II (right colon segment resection and end to end anastomosis) and Group III (right colon segment resection and end to end anastomosis). Group III animals a total of 1200 impulse 0.12 mj/mm 2 shock waves on the post-operative 3 rd, 5 th and 7 th days in three session each of which included 400 impulse with 14KV. On the 10 th post operative day, the rats were sacrificed and postmortem examination was done. The explosion pressures were measured using a sphygmomanometer specially designed for this purpose. In the study groups 4 cm intestine segments which include anastomose line was taken out. The segments which include anastomosis of the study group and the control group pieces were histopathologically examined. The fibroblast, collagen, angiogenesis and inflammatory cells were studied. Results: The mean anastomoses explosion pressure for group III was 272±7.895 and the average anastomose explosion pressure was 220±6.831. The difference between the pressure means was significant (P < 0.05). Histological fibroblast/collagen ratio were 14.50±5.66, 274±66.21 and 416±52.44 for Group I, Group II and Group III, respectively. The vein amount was 5.80±3.19, 51.20±10.76 and 75.10±13.80, respectively. In Group III, fibroblast/collagen and vein ratio was significantly higher compared to Group I and II (3.19, 51.20±10.76 and 75.10±13.80, respectively. In Group III, fibroblast/collagen and vein ratio was significantly higher compared to Group I and II (P < 0.05). Conclusion: From the results of our study, extracorporeal shock waves treatment (ESWT) increase the intestinal tensile strength and may be useful to enhance the mechanical strength of anastomosis of the colon during healing.
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    Our experiences in RF - Assisted resections in liver tumors and hydatid cysts [Karaci?er tümörleri ve kist hidatiklerinde rezektif amaçli radyofrekans enerji uygulamalarimiz]
    (2005) Şahìn M.; Kartal A.; Tekin A.; Pekin C.
    Purpose: In this preliminary study, we applied Radiofrequency(RF) energy in six patients with liver diseases for parenchymal transection to minimize bleeding or to do bloodless hepatectomy. Materials and Methods: Of six patients, four had liver tumors (3 heamangyomas, one hepatocellular carcinoma) and two hepatic hydatic cysts. Surgical procedures were RF assisted hepatectomy, enucleation, cystectomy and pericystectomy. Results: There was no need for blood transfusion except one case. Liver enzymes was normal after one week postoperatively except in two cases. Conclusion: We think that RF will be technique of choice for bloodless hepatectomy in coming years.