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Öğe 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.Öğe 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.Öğe Horseshoe kidney for transplant: Report of 3 cases(2007) Dinckan A.; Tekin A.; Turkyilmaz S.; Kocak H.; Gurkan A.; Erdogan O.; Tuncer M.Owing to the limited donor pool at transplant centers, grafts may be taken from marginal donors with congenital abnormalities, one of the most common of which is a fusion abnormality. Horseshoe kidneys may be transplanted to a single recipient en bloc or to 2 recipients after division. In our clinic, 3 grafts (1 obtained from a living donor and 2 from a deceased donor) were successfully transplanted to 3 patients. In select patients, horseshoe kidneys may be used for transplant. Copyright © Başkent University 2007 Printed in Turkey. All Rights Reserved.Öğe 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.Öğe Pre-operative pneumoperitoneum application in giant inguinal hernia repair [Dev ingunal fitik onariminda ameliyat öncesi pnömoperitoneum uygulamasi](Gulhane Medical School, University of Health Sciences, 2013) Çakir M.; Tekin A.; Kaynak A.Hernia repair is one of the most frequent operation surgeons apply. One of the undesired problems in hernia surgery is compartment syndrome which can occur when giant hernia content is pushed into the abdomen. In order to prevent this problem, we used pneumoperitoneum method in giant inguinal hernias and we found it to be worth of discussing. wia catheter placed under direct ultrasonographic vision We applied pneumoperitoneum to repair giant inguinal hernia in our 70 year-old patient with pain and tubercle in the inguinal and dysuria complaints. We applied pneumoperitoneum for 12 days at 15mmHg with catheter placed under direct ultrasonographic vision. The patient on whom tension-free mesh hernioplasty operation was performed was discharged on the postoperative 5th day. Pneumoperitoneum can be used as an effective method in the prevention of abdominal compartment syndrome in the repair of giant inguinal hernias. © Gülhane Askeri Ti{dotless}p Akademisi 2013.Öğe The relation between mesh thickness and mesh reaction m abdominal wall(2011) Küçükkartallar T.; Sahin M.; Çakir M.; Kafali E.; Saygun O.; Tekin A.; Ünlü Y.Aim. The aim of this study is to compare the severity of tissue reaction in anterior abdominal wall caused by synthetic meshes in different fiber thickness. Methods. In all rats, abdominal wall along the midline, skin and subcutaneous tissue was incised 2 cm along and a 3x3 cm2 area was dissected. Group I: Only dissection was applied. Group II: A 2x2 cm2 diameter mesh with 320 micron mesh thickness was placed on the dissected area. Group III: A 2x2 cm2 diameter mesh with 600 micron mesh thickness was placed on the dissected area. Results. Infection and seroma frequency in incision line was defined as, In Group I (15 %) in three rats, in Group II (25 %) in 5 rats and in Group III (35 %) in 7 rats. Measured plasma IgE levels in rats were found meaningfully high compared to that of control group (p<0.05). The value of thin mesh group was found meaningfully low compared to that of thick mesh group (p<0.05). A meaningful difference was not observed among the leucocytes values of the groups (p<0.05). The fibrosis measurements in group III was higher than that of the other group (p<0.05). Conclusion. Reaction has occurred for both meshes. It has been observed that the reaction occurred in thin mesh group was meaningfully lower compared to the thick mesh group as a result of serological tests, electron and light microscopic examinations. Referencing this, it has been understood that the reaction occurred has shown parallelism with the mass of mesh.
