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Öğe 196 Genel Cerrahi Uzmanının Kasık Fıtığına Yaklaşımları ile İlgili Anket Çalışması(2008) Kartal, Adil; Tekin, Ahmet; Vatansev, Celalttin; Tekin, Şakir; Belviranlı, Metin; Yol, Serdar; Aksoy, FarukAmaç: Anket çalışması kasık fıtıklarının onarımında Türkiye’deki genel cerrahların tecrübelerini analiz etmek için planlandı. Durum De?erlendirilmesi: Anket çalışmaları geri bildirimdeki yetersizlik nedeniyle araştırmacılar için zor yürütülmektedir. Bu konuda hekimlerin daha duyarlı olması bilime önemli katkılar sağlayacaktır. Yöntem: 2002 yılında Türkiye’deki 250 genel cerraha posta yoluyla bir anket (örneğin Lichtenstein veya diğer tekniklerin uygulanması ve kullanılan anestezi türünü içeren) gönderildi. Bulgular: 250 katılımcının 196’sından (%78) geri bildirim elde edildi. Bunlardan 128 cerrah (%65.3) kasık fıtığı onarımı için ilk tercih olarak Lichtenstein tekniğini kullanmaktaydı. Rutkow tekniği ve Bassini onarımı bunu takip etmekteydi. Cerrahların çoğunluğu genel anestezi kullanmaktaydı. Seroma ve hematom en sık bildirilen komplikasyonlardı. Sonuç: Özellikle Lichtenstein olmak üzere gerilimsiz meş tekniği primer ve nüks fıtıkların her ikisinde de tercih edilen tedavi yöntemiydi. Kasık fıtıklarının onarımında cerrahların yarıdan fazlası genel anesteziyi tercih etmekteydi. Hastaların çoğu ameliyat sonrası birinci günde hastaneden çıkartıldı.Öğe Anjiyoimmünoblastik Lenfadenopati Benzeri Lenfoma (Olgu sunumu)(1998) Avunduk, Mustafa Cihat; Tavlı, Şakir; Yol, Serdar; Tavlı, Lema; Yılmaz, Osman; Güngör, Salim; Yavuz, Ayşe75 yaşındaki kadın olgu, koltuk altında şişlik yakınması ile Selçuk Üniversitesi Tıp Fakültesi Genel Cerrahi polikliniğine başvurduğunda 2-3 yıldır devam eden iştahsızlık ve kilo yitiminden yakınmaktaydı. Yapılan fizik bakısında koltuk altında çok sayıda lenfadenopatileri (LAP) ve hepatosplenomegalisi saptandı. Posteroanteriyor (PA) akciğer grafisinde hiler lenfadenopati gözlenirken, Coombs () hemolitik anemisi ve hiper-gammaglobulinemisi gözlendi. Eksizyonel biyopsi ile çıkarılan koltuk altı lenf düğümünün histopatolojik incelenmesinde anjiyoimmünoblastik lenfadenopati benzeri lenfoma tanısına ulaşıldı. Olgunun klinik ve patolojik özellikleri ilginç bulunarak sunuldu.Öğe A Comparison of the Hemodynamic and Metabolic Effects of Extraperitoneal Carbon Dioxide and Nitrous Oxide Insufflation(EXCERPTA MEDICA INC, 2001) Aksoy, Faruk; Belviranlı, Metin; Vatansev, Celalettin; Tuncer, Sema; Yol, Serdar; Özergin, Ufuk; Atabek, MustafaBackground: The aim of the present study was to compare the hemodynamic and metabolic effects of extraperitoneal carbon dioxide (CO2)and nitrous oxide. (N2O) insufflation. Material and methods: Fourteen dogs were used in the experiment. All the animals were intubated under general anesthesia. A catheter was placed into the right juguler vein for central venous pressure (CVP), pulmonary artery pressure (PAP), pulmonary wedge pressure (PWP), and heart rate (HR) monitorization. End-tidal CO2 pressure was measured by a capnometer connected to the endotracheal tube. Another catheter was inserted into the left femoral artery for arterial blood gas analysis and blood pressure monitorization. The preperitoneal dissection was made from a 1.5 cm subumbilical incision by using a preperitoneal dissection balloon. A laparoscope was placed in the preperitoneal space and the gas insufflation was kept at a constant pressure of 12 mm Hg throughout the experiment. All the study parameters were measured at the beginning of the insufflation and at every 15 minutes for 1 hour. Results: Mean artery pressure increased with time in both groups, but the increase was only significant in the CO2 group. PWP, CVP, PAP, and HR increased slightly in both groups, but there was no significant difference between the groups. The end-tidal CO2 increased in the CO2 group but decreased from the baseline in the N2O group. A significant acidosis was observed in only the CO2 group. PaCO2 significantly increased in the CO2 group; hence, PaCO2 slightly decreased in N2O group. The difference between the groups was significant. Conclusions: N2O insufflation of the extraperitoneal space in dogs avoided the unwanted metabolic and hemodynamic side effects of CO2 insufflation. Thus, N2O insufflation in the extraperitoneal space is a safer alternative to CO2 insufflation experimentally, and can be preferred especially in patients with cardiac and pulmonary diseases.Öğe Dalak Karaciğere Metastaz Oluşumunda Rol Oynuyor Mu?(1996) Yol, Serdar; Kartal, Adil; Gunjı, Yoshio; Isono, Kaichi[Abstract not Available]Öğe Does Large Bowel Enema Reduce Septic Complications in Acute Pancreatitis?(CAHNERS PUBL CO, 1998) Şahin, Mustafa; Yol, Serdar; Çiftçi, Ersin; Baykan, Mahmut; Özer, Şükrü; Aköz, Mehmet; Yılmaz, Osman; Kuru, CüneytBACKGROUND: The source of septic complications in acute pancreatitis was unknown until recent years. The pathogenesis of bacterial translocation from the gut has been accepted as the main source of pancreatic or peripancreatic infection. This study was designed to investigate the role of large bowel enema during acute pancreatitis in preventing bacterial translocation. MATERIALS AND METHODS: Twenty-four Spraque-Dawley rats were used in this study. The rats were divided into two groups. Group I animals received biliopancreatic duct ligation plus colon cleansing by rectal enemas; group II animals received only biliopancreatic duct ligation. Rectal enemas were applied to the first group of animals three times, at 6, 24, and 48 hours after the operation using 10 cc sodium hydrogen phosphate solutions. All animals were sacrificed 72 hours later, and tissue samples were taken from mesenteric lymph nodes, pancreas, spleen, and liver for bacteriologic cultures via a midline laparatomy. Blood and cecum cultures were also prepared. RESULTS: positive mesenteric lymph node cultures were found in all 12 animals in group II but in only 3 of 11 animals of group I (P <0.05). Distant organ cultures were positive in 9 of group II, but the only infected distant organ culture found in group I was the positive liver culture (P <0.05). CONCLUSION: AS a result of this study, we. believe that large bowel enema can reduce the frequency of septic complications in acute pancreatitis by reducing bacterial translocation.Öğe Effect of Laparoscopic Cholecystectomy on Platelet Aggregation(Springer Verlag, 2000) Yol, Serdar; Kartal, Adil; Çalışkan, Ümran; Tavlı, Şakir; Şahin, Mustafa; Bozer, MikdatThe purpose of this study was to investigate the effect of laparoscopic cholecystectomy on platelet function. We operated on 40 women with symptomatic gallbladder stone, 20 of whom (study group) underwent laparoscopic cholecystectomy and 20 of whom (control group) open cholecystectomy. Patients with a history of bleeding, abnormal platelet count, or systemic disorders and those who were on salicylates, heparin, or oral anticoagulants were excluded. Blood parameters were checked at the beginning and the end of the operation, including platelet aggregation using adenosine 5'-diphosphate (ADP), collagen, and ristocetin in a whole-blood aggregometer. Platelet aggregation,vas evaluated by percent aggregation. Platelet aggregation due to collagen and ristocetin increased significantly at the end of the operation in the study group (p < 0.001). Aggregation due to ADP did not differ significantly from the start to the end of the operation. Control group results did not show any differences. Although the clinical findings of aggregated platelet are not frequently observed in practice, we suggest that laparoscopy increases platelet aggregation.Öğe Effect of octreotide (Sandostatin 201-995) on bile flow and bile components(KLUWER ACADEMIC/PLENUM PUBL, 1999) Şahin, Mustafa; Kartal, Adil; Belviranlı, Metin; Yol, Serdar; Aksoy, Faruk; Ak, MehmetOctreotide (Sandostatin 201-995) has an inhibitory effect on gastric, intestinal, and pancreatic secretions and hepatic and splachnic blood flow. We examined the effects of octreotide on bile flow and bile components in 10 patients with T-tube choledochostomy. A Fogarty balloon catheter was inserted distal to the T-tube of these patients for measurement of bile flow and bile components. Bile samples were obtained to analyze bile acid, phospholipid, lipoprotein, and cholesterol, and bile flow measurements were performed every 15 min for a period of 90 min before study and after normal saline and octreotide administrations. While octreotide had an inhibitory effect on bile flow, the concentrations of bile acid, phospholipid, and lipoprotein in bile were increased with octreotide.Öğe Effect of Pedunculated Seromuscular Flap on Bursting Strength of Intestinal Anastomosis After Corticosteroid Treatment(Lippincott Williams & Wilkins, 2000) Yol, Serdar; Yol, Sinan; Tavlı, Şakir; Şahin, Mustafa; Özer, ŞükrüPURPOSE: This study was designed to investigate the protective effect of a pedunculated seromuscular flap on intestinal anastomosis after corticosteroid treatment. METHODS: Forty male Sprague-Dawley rats were divided into four groups, and all animals underwent intestinal anastomosis. Two groups, with or without seromuscular flap wrapping, received 5 mg cortisone acetate, and two groups received placebo (saline) preoperatively for 16 days. Anastomotic strength was defined as bursting pressure (in millimeters of mercury). The pedunculated seromuscular flap was prepared from a segment of intestine next to the anastomosis. intestinal bursting strength at the anastomotic site was measured at Postoperative Day 8. RESULTS: The anastomotic bursting strength was significantly lower in the steroid groups at Postoperative Day 8 (P < 0.01). The pedunculated seromuscular flap increased the strength of the anastomosis both in the steroid and control groups (P < 0.05). CONCLUSION: The adverse effect of corticosteroids on intestinal anastomoses may be prevented by a pedunculated seromuscular flap.Öğe The Effect of Tissue Environments on Primary Tumor Growth and Liver Metastasis in Mice Colon Adenocarcinoma(1996) Yol, Serdar; Gunjı, Yoshio; Kartal, Adil; Isono, Kaichi[Abstract not Available]Öğe Effects of platelet rich plasma on colonic anastomosis(ACADEMIC PRESS INC ELSEVIER SCIENCE, 2008) Yol, Serdar; Tekin, Ahmet; Yilmaz, Hueseyin; Kuecuekkartallar, Tevfik; Esen, Hasan; Caglayan, Osman; Tatkan, YuekselPurpose. To investigate the effect of platelet-rich plasma (PRP) on tissue maturation and wound healing in experimental colonic anastomosis. Materials and methods. Thirty Sprague Dawley rats were divided into three groups of 10 rats each. Group I (control group) was subjected to colon anastomosis only. Group II (PRP group) was subjected to colon anastomosis and topical PRP was applied. Group III (Bioglue group) was subjected to colon anastomosis and topical tissue sealant was applied (Bioglue; Cryo-life, Kennesaw, GA). The rats were sacrificed on postoperative day 7, and the bursting pressure of the anastomosis and tissue hydroxyproline levels were measured; histopathological changes on the anastomosis line were also examined. Results. The bursting pressure was statistically higher in the PRP group than in the control and Bioglue groups (P < 0.05). The hydroxyproline levels were also statistically higher in the PRP group than in the control and Bioglue groups (P < 0.05). Histopathologically, there was less inflammatory cell infiltration, intensive fibroblast development, and rich collagen production in the PRP group. Conclusion. PRP may be used in colon anastomosis, especially in patients with impaired wound healing, to obtain a better anastomotic strength. (c) 2008 Elsevier Inc. All rights reserved.Öğe Ekstralüminal Yerleşimli Atipik Ameboma Olgusu: Ultrason Eşliğinde Perkutan Drenaj ve Matronidazol ile Tedavisi(2003) Toprak, Şükrü; Yazgan, Alparslan; Yol, SerdarAmaç: Nadir olarak karın içi kitle yapan ameboma olgusunun sunumu amaçlanmıştır. Olgu sunumu: Amebiasis ülkemizde sık görülen ve Entamoeba histolitica adlı amipin yol açtığı paraziter enfeksiyondur. Ekstraintestinal ve intestinal olmak üzere birçok klinik tabloyla karşımıza çıkabilmekle beraber ender olarak ameboma adı verilen kitle lezyonuyla da kendini göstermektedir. Ameboma sıklıkla çekum ve çıkan kolonda yerleşim gösteren lümeniçi tümöral kitleler şeklinde ortaya çıkmaktadır. Sunduğumuz vakada barsak lümeni dışında yerleşim göstermiş ve kolonoskopiyle tanısı konamamıştır. Batın tomografisinde de bu sebeple ameboma akla gelmemiştir. Sitopatolojik ve serolojik yöntemlerle tanısı konan vakada böylece gereksiz laparotomi yapılmamıştır. Sonuç: İntraabdominal ameboma olgusu metronidazol ve drenaj tedavisi ile başarılı bir şekilde tedavi edilebilmektedir.Öğe Internal herniation as a major cause of intestinal obstruction(KARGER, 2008) Tekin, Ahmet; Kuecuekkartallar, Tevfik; Aksoy, Faruk; Vatansev, Celalettin; Belviranli, Metin; Tekin, Sakir; Yol, SerdarObjectives: To evaluate internal herniation as a rare cause of intestinal obstruction. Materials and Methods: Files of 18 cases, operated due to internal herniation between 2000 and 2006 at Selcuk University, Meram School of Medicine, General Surgery Department, were reviewed retrospectively. Sixteen patients (88.8%) were male (mean age: 58.2 years; range: 42-67) and 2 were female (mean age: 56.5 years; range: 52-61). Cases were grouped according to the location of internal herniation, and the clinical findings and applied treatment strategies were evaluated. Results: All patients were taken into surgical operation after preoperative preparations were completed. Findings were as follows: 6 cases of paraduodenal internal herniation, 4 of internal herniation through a defect in the terminal mesoileum, 2 of herniation through a defect in the falciform ligament, 2 of herniation through a defect in the omentum majus, 1 of herniation to the recessus over the bladder, 2 of herniation through a defect in the transverse mesocolon and 1 iatrogenically caused internal herniation through a defect in the mesojejunum. Conclusion: In an adult patient with findings of intestinal obstruction, diagnosis is difficult. Most cases presented to date are incidental findings during laparotomy, and surgical treatment is necessary. Copyright (c) c 2008 S. Karger AG, Basel.Öğe Kemoterapi ile Tedavi Edilmiş Bir Primer Meme Lenfoması Olgusu(2005) Çakır, Murat; Yol, Serdar; Ecirli, ŞamilAmaç: Memenin primer non-hodgkin lenfoması nadir görülen bir hastalıktır. Bilateral tutulumun daha da nadir görülmesi nedeniyle tartışılması amaçlandı. Olgu: Bilateral primer meme lenfoması teşhis edilen 44 yaşında bir kadın hastayı sunduk. Hastada dört aydır sağ kolda güç kaybı ve bir aydır sağ memede sertlik şikayeti vardı. Yapılan muayenesinde; sağ memede 6x5 cm’lik, sol memede 3x2 cm’lik iki kitle, sağ aksiller bölgede bir adet mobil lenfadenopati ile sağ kolda hareket kısıtlılığı tespit edildi. Meme İİAB’sinde (ince iğne aspirasyon biopsisi) diffüz eritrositler içerisinde hiperkromatinli düzensiz şüpheli hücreler izlendi. Bunun üzerine yapılan eksizyonel biopside Non-hodgkin (intermediate grade diffüz miks tip) lenfoma olduğu görüldü. Hastaya kemoterapi başlandı. Her iki kitlenin de kaybolduğu izlendi. Sonuç: Memenin lenforetiküler malignitelerinin tanısında radyoloji yetersiz kalabilir. İİAB tanı koydurmaz ancak maligniteden şüphelenmeyi sağlar. Sonrasında uygulanan tru-cut veya eksizyonel biopsi ile sonuca ulaşılır. Hastalar kemoterapi ile tedavi edilir.Öğe Long-term results utilizing the unroofing technique in treating hydatid cysts of the liver(2008) Tekin, Ahmet; Kartal, Adil; Aksoy, Faruk; Vatansev, Celalettin; Küçükkartallar, Tevfik; Belviranlı, Metin; Şahin, Mustafa; Yol, SerdarPurpose. The aim of this study was to present the long-term follow-up results of liver hydatid cysts treated with unroofing, together with a review of the related literature data. Methods. Of 700 liver hydatid cyst patients examined and treated at Selcuk University Meram Medical Faculty, General Surgery Department, between 1985 and 2007, 650 had accessible data and the unroofing method had been applied in 189 of them. The clinical and laboratory findings, stages, operations, and complications of patients treated with unroofing were reviewed. In particular, the resolution of residual cyst cavities over time after the application of this method was evaluated using computed tomography. Results. Four hundred and thirty-six (67.07%) of the cases were female [mean age: 35 (range: 10-73) years] and 214 (32.9%) were male [mean age: 46 (range: 12-76) years]. Of the 189 cases treated with unroofing and followed by tomography, the data of 144 were documented. Cavities were classified into five groups (A-E) according to their postoperative appearance. Conclusions. Unroofing is an easy approach and it does not require extensive experience. This technique is recommended for peripherally localized cysts but may also be applied to those more deeply situated. Unroofing should be applied as deeply as possible and the residual cavity should also be as shallow as possible. © 2008 Springer.Öğe Mide Karsinomlarında Hücre Proliferasyon Belirleyicisi Olarak PCNA, Ki-67 ve Agnor Kullanımı(2000) Avunduk, Mustafa Cihat; Tavlı, Şakir; Yol, Serdar; Tavlı, Lema; Yavuz, Ayşe; Güngör, Salim; Yılmaz, OsmanSelçuk Üniversitesi Tıp Fakültesi Patoloji Anabilim Dalı'nda Mide adenokarsinomu tanısı alan 30 olgu tespit edildi. Bu olguların tümörlü ve normal mukoza alanlarını aynı preparat üzerinde içeren blokları seçildi. Bu bloklardan hazırlanan kesitlere immünhistokimyasal olarak PCNA ve Ki-67 boyaması ile NOR cisimlerini boyamak için gümüş iınpregnasyonu uyguIandı. Mitoz sayısı ve mitotik indeksi belirlemek için ise Hematoksilen Eozin ile boyalı tanı koyduran preparatları kııllanıldı.. Tüm değerlendirmeler müm k ün olduğunca aynı alanlar taranarak yapıldı. Olguların elde edilen sonuçları birbirleri ile karşılaştırıldığında rnide adenokarsiomlarında, hücresel proliferasyon belirleyicisi olan AgNOR, PCNA ve Ki-67 nin birbirleri ile istatistik.sel olarak uyumluluk iç erisinde oldukları belirlendi.Öğe Ratlarda Kronik Perioperatif Steroid ve İmuran Kullanımının Kolon Anastamoz İyileşmesi ve Patlama Basıncına Etkileri(1999) Yol, Sinan; Yol, Serdar; Beck, David E.The alm of present study was to compare the effects of long term chronic preoperative steroids and azathioprine on colonic anastomotic healing and tissue strength. One hundred male Sprague-Dawley rats weighing 260-330 grams were divided into four groups, each of which had 25 animals. Group I received two placebo tablets. Group II received a time release drug pellet(200 mg cortisone acetate in a 60 day release form) and a placebo pellet placed in the subcutaneous tissue of the posterior neck for an average daily dose of 3.3 mg cortisone. Group III received a time release drug pellet (50 mg azathioprine in a 60 day release form) and a placebo pellet for an average daily dose of 0.83 mg azathioprine. Group IV received two time release drug pellets(200 mg cortisone acetate and 50 mg azathioprine each in a 60 a day release form). After 6 weeks all animals underwent division and anastomosis of their midtransverse colon. One and two weeks after anastomosis, colonic bursting pressures were determined at the anastomotic site and in the normal left colon by measuring intraluminal pressures at which leakage/rupture occurred. Blood cortisol levels and histopathologic changes were also compared. There was no significant difference in bursting pressures(anastomosis and normal left colon) between treated and control animals at 7 and 14 days. Bursting pressure at the anastomotic site was significantly lower then left colonic site at 7 and 14 days (p<0.05). The increase in pressure at the anastomotic site by 14 days was statistically significant for each group (p<0.05). There was no significant difference at left colon for first and second week. In conclusion, bursting pressure of the colonic anastomosis was not affected by long term administration of cortisone acetate and azathioprine at seventh and 14(th) days of anastomosis in this rat model.Öğe Retroperitoneal and Scrotal Giant Liposarcoma: Report of a Case(SPRINGER VERLAG, 1998) Yol, Serdar; Tavlı, Şakir; Tavlı, Lema; Belviranlı, Metin; Yosunkaya, AlperThe case of a 63 year-old man with a giant scrotal and retroperitoneal tumor is herein reported, The initial symptoms began in the scrotum and subsequent abdominal distention resulted in discomfort 2 years later. The intraabdominal organs were under pressure because of the bulky mass, and the patient had dyspnea. Ultrasonograpy, computed tomography, and fine needle aspiration biopsy investigations all revealed a retroperitoneal tumor suspected to be liposarcoma. At operation, a tumor weighing 42kg was excised. Respiratory support was provided in the early postoperative period. The histopathological diagnosis was myxoid liposarcoma. The patient was discharged from the hospital 14 days after the operation and was scheduled to undergo radiotherapy.Öğe Sex as a factor in conversion from laparoscopic cholecystectomy to open surgery.(2006) Yol, Serdar; Kartal, Adil; Vatansev, Celalettin; Aksoy, Faruk; Toy, HaticeOBJECTIVES: Although laparoscopic cholecystectomy has become the standard treatment for symptomatic gallbladder diseases, conversion to open surgery is required in a substantial proportion of patients. In this study, we attempted to clarify whether male sex carries an increased risk for conversion to open surgery during laparoscopic cholecystectomy. METHODS: This study comprised 80 patients (41 females, 39 males) with symptomatic gallbladder stones. Average age was 39.2 years, and all female patients were of reproductive age. Patients were excluded from the study if they had acute cholecystitis, previous abdominal surgery, systemic or connective tissue diseases, or were using tobacco, alcohol, or medications that affect wound healing or inflammation. Tissue samples were obtained from the same sites in each gallbladder wall and pericholecystic tissue for the measurement of tissue hydroxyproline (HP) and collagen. Samples were examined under light microscopy for histopathology. Findings in male and female patients were compared by using the Student t test. RESULTS: All patients except 3 males received laparoscopic cholecystectomy. Conversion to open cholecystectomy was necessary in those 3 because of intense pericholecystic fibrosis. In male patient samples, macrophages were twice as numerous as in female samples, whereas mast cells in the men were 4 times more numerous, and eosinophils were 6 times more numerous (P<0.01). In men, HP levels in the gallbladder wall and pericholecystic tissue were 23.4+/-14.9 microg/mg dry tissue and 25.2+/-13.1 microg/mg dry tissue, respectively. The corresponding values in women were 13.1+/-9.4 microg/mg dry tissue and 14.5+/-8.1 microg/mg dry tissue. This higher level of tissue HP in men was statistically significant (P<0.015). Tissue collagen levels both in the submucosal area of the gallbladder wall and in pericholecystic tissue were significantly higher in men than in women (P<0.05). CONCLUSION: Our data suggest that in the context of symptomatic gallbladder stones, inflammation and fibrosis are more extensive in men than in women. These findings may help explain why the rate of conversion to open surgery is higher in men than in women.Öğe A survey of 196 general surgeons regarding their approach to groin hernia [196 genel cerrahi uzmaninin kasik fitigina yaklaçimlan ile ilgili anket çaliçmasi](2008) Kartal, Adil; Tekin, Ahmet; Vatansev, Celalettin; Tekin, Şakir; Belviranlı, Metin; Yol, Serdar; Aksoy, FarukPurpose: To analyze the experiences of general surgeons in Turkey In the field of groin hernia repair. Materials And Methods: A questionnaire (which includes mainly the technique used either Lichtenstein or other techniques and the type of anesthesia used) was mailed to 250 general surgeons in Turkey in 2002. They were asked to reply within a month. Results: 196[78 %] of the 250 questionnaires were completed and returned. 128[65,3 %] of the 196 surgeons indicated Lichtenstein technique as their first choice for groin hernia repair, followed in frequency by Mesh Plug |Rutkow)and Bassini, The ma|onty of surgeons preferred general anesthesia, Seroma and hematoma were reported as the most frequent complications. Conclusions: Tension-free techniques, especially Lichtenstein, were the preferred treatment of choice both in primary and recurrent hernias, As more than half of the surgeons preferred general anesthesia for the repair of groin hernia so it is advisable. As most of the patients are discharged from the hospital on the first postoperative day it can be done on day case basis.Öğe Tıkanma Sarılığında Serum C-RP Düzeyleri(1999) Şahin, Mustafa; Vatansev, Hüsamettin; Aksoy, Faruk; Yol, Serdar; Tavlı, Şakir; Kartal, Adil; Çiftçi, ErsinAmaç: Tıkanma sarılığında, CRP düzeylerinin tayini, bilirubin düzeyleri ve kanserin yaygınlığı ile ilişkisinin belirlenmesi. Yöntem: Çalışma, Haziran 1996-Ocak 1999 tarihleri arasında Selçuk Üniversitesi Genel Cerrahi Kliniğine Tıkanma Sarılığı tanısıyla yatan ve bilier drenaj sağlanmış olan 38 hasta alındı. Hastaların 21'inde malignite, 17'sinde benign patolojiler obstrüksiyon yapmaktaydı. Maligniteli hastalar I.grubu, benign hastalığı olanlar II.grubu oluşturdu. Kanserli hastalardan rezeksiyon yapılanlar Grup IA, rezeksiyon yapılamayanlar Grup IB'yi oluşturdu. Hastaların tamamında internal veya external bilier drenaj yapıldı. Hastalardan operasyon sabahı ve postoperatif 7-10. günlerde alınan kan örneklerinde total bilirubin ve CRP düzeyleri belirlendi. Bulgular: Grup I'deki hastaların preoperatif CRP değerleri 45.66 mg/lt iken postoperatif dönemde 19.84 mg/lt'ye düştü. Grup II'de preoperatif CRP değeri 22.31 mg/lt iken postoperatif dönemde 10.76 mg/lt'ye düştü. Bilier drenaj sonrası her iki grubun CRP değerlerindeki düşüş anlamlı bulundu. Ayrıca grup I'in postoperatif CRP değerleri Grup II'ye göre yüksek kalmaya devam etti. Rezeksiyon yapılan kanserli hastaların preoperatif CRP değerleri (29.6 mg/lt) yapılamayanlardan (70.7 mg/lt) daha düşüktü. Bilier drenaj sonrası CRP düzeyi her iki grupta da anlamlı düşüş gösterdi, ancak Grup IB'nin CRP düzeyleri Grup IA'dan yüksekti. Sonuç: Hiperbilirubinemi durumlarında CRP artış göstermekte, bu artış malign hastalarda malignitenin yaygınlığına göre daha da fazladır. Buna göre tıkanma sarılığının ayırıcı tanısında ve kanserli hastaların prognoz tayininde CRP düzeyinden yararlanabilir.
