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Öğe An obstruction not to forget: Pseudo-obstruction (Ogilvie syndrome): Single center experience(Medknow Publications & Media Pvt Ltd, 2016) Yazar, Fatih Mehmet; Kanat, Burhan Hakan; Emir, Seyfi; Bozan, Mehmet Buğra; Bilgiç, Yılmaz; Şahin, Abdurrahman; Urfalıoğlu, AykutPurpose: Colonic pseudo obstruction disease commonly seen in the elderly, immobile patient group can cause serious mortality and morbidity. Our objective in this retrospective study is to share our clinical experience by evaluating patients with Ogilvie syndrome who were followed and treated in our clinic. Methods: Eleven cases with the diagnosis of Ogilvie syndrome followed up and treated between September 2010 and April 2013 were evaluated retrospectively. All the patients that had no symptoms of acute abdominal pain were initiated conservative treatment. Colonoscopic decompression was attempted for patients whose clinical pictures were not recovered. Patients underwent operation if they developed peritoneal irritation symptoms during these procedures and of their number of white blood cells seriously increased during the follow-up period. Results: A total of 11 patients were treated for Ogilvie syndrome. 6 of the patients underwent surgical treatment, and 5 were treated medically. Mortality developed in two patients. The main cause of mortality was a delay in diagnosis and additional severe underlying diseases. Seven patients were given Neostigmine. Of these, 2 patients required surgery and 3 patients responded to Neostigmine. Conclusion: Ogilvie syndrome is a rare cause of ileus of the colon. It is more common particularly in old patients with additional problems. If the disease is suspected and diagnosed early, unnecessary surgical interventions can be prevented with medical treatment choices.Öğe Basal Cell Carcinoma Appearing As a Suture Reaction Along The Incision Line(Namık Kemal Üniversitesi, Tıp Fakültesi, 2014) Aziret, Mehmet; Erdem, Hasan; Çetinkünar, Süleyman; Yaycıoğlu, İsmail Bülent; İrkörücü, Oktay; Emir, SeyfiThe most frequently occurring malignant neoplasm of the skin is basal cell carcinoma (BCC). It is seen most often around the head and neck area. Predisposing factors include exposure to ultraviolet radiation (UV) and inorganic arsenic, trauma, chronic wounds, immune dysfunction and plaques, such as sebaceous nevus.While squamous cell carcinoma is frequently encountered as a result of chronic wounds, silk fistulas and scar formation, cases of BCC are very rare. In incidences of BCC developing along the incision line, the treatment involves making a large surgical excision. Problems related to the incision site are most often observed in operations conducted at surgical clinics, with the most common cause being suture reactions. In cases of chronic ulceration and discharge, a diagnosis of BCC should be considered and a biopsy should be conducted.Öğe Comparison of colorectal neoplastic polyps and adenocarcinoma with regard to NLR and PLR(Verduci Publisher, 2015) Emir, Seyfi; Aydın, M.; Can, G.; Bali, İlhan; Yıldırım, Oğuzhan; Öznur, Meltem; Gürel, A.OBJECTIVE: Cancer-related inflammation affects many aspects of malignancy, including proliferation and survival of malignant cells, angiogenesis, and therapeutic response. Some biomarkers representing the degree of systemic inflammation, such as the Glasgow prognostic score, NLR and PLR, have been shown to have prognostic value in many kinds of cancer patients. Aim of this study to investigate to compare neutrophil/leukocyte (NLR) and platelet/lymphocyte (PLR) ratios of the patients with colorectal neoplastic polyps and colorectal cancer (CRC) and tried to determine whether this could be used as a biomarker in follow up of the patients with neoplastic polyps. PATIENTS AND METHODS: A total of 100 colorectal polyps, 113 colorectal cancers and 124 healthy controls were included in the study. Exculusion criteria were endocrinologic or metabolic diseases, acute or chronic diseases, hypertension and atherosclerotic heart diseases, renal diseases. Blood count parameters of the patients were measured. The NLR was calculated as a simple ratio between the absolute neutrophil and the absolute lymphocyte counts. The PLR was defined as the platelet counts to lymphocyte ratio. RESULTS: A statistically significant difference was not detected between Group A and C with regard to NLR and PLR. NLR and PLR were found statistically significantly high in Group B (CRC), Group A (colorectal polyp) and Group C (healthy individuals) (p < 0.001 and p < 0.001). Our study showed that the optimum NLR cutoff point for neoplastic polyps was 2.28 (sensitivity: 68.7%, specificity: 42.3%). When the sensitivity and specificity levels of the PLR were assessed, they were 68.7% and 46.5% for neoplastic polyps, 80% and 68.9% for colorectal cancer. CONCLUSIONS: NLR and PLR may be used for follow up conversion of colonic and rectal neoplastic polyps to invasive tumor.Öğe Comparison of early surgery (unroofing-curettage) and elective surgery (Karydakis flap technique) in pilonidal sinus abscess cases(Turkish Assoc Trauma Emergency Surgery, 2014) Kanat, Burhan Hakan; Bozan, Mehmet Bugra; Yazar, Fatih Mehmet; Yur, Mesut; Erol, Fatih; Özkan, Zeynep; Urfalioglu, Aykut; Emir, SeyfiBACKGROUND: The aim of this study is to compare the effectiveness and success of early (acute) period local surgical intervention (unroofing-curettage) followed by dressing and secondary healing with the surgery performed in elective conditions (pilonidal sinus excision and Karydakis flap) following conventional abscess treatment (drainage-antibiotic therapy) in pilonidal sinus abscess cases. METHODS: The data of the patients treated for pilonidal sinus abscesses in our clinic between January 2012 and March 2013 were analyzed, retrospectively. Those who had early surgery were determined as Group S, and those who had elective surgery following drainage-antibiotic therapy were determined as Group K. Patients in both groups were compared in terms of age, gender, complications, recurrence rate and healing time. Patients were followed for an average of 14 months. RESULTS: Of the 53 patients included in the study, 28 were in Group S and 25 in Group K. The mean age and gender distribution of both groups were similar and a significant difference was not found between the groups in terms of complication development and recurrence. However, there was a statistically significant difference between the groups in terms of treatment duration (p=0.02). CONCLUSION: In treating acute pilonidal abscesses, the Karydakis method, following drainage-antibiotic therapy, is a preferable method due to its shorter treatment duration and higher patient comfort.Öğe Comparison of intracorporeal knotting and endoloop for stump closure in laparoscopic appendectomy(Turkish Assoc Trauma Emergency Surgery, 2015) Bali, İlhan; Karateke, Faruk; Özyazıcı, Sefa; Kuvvetli, Adnan; Oruc, Cem; Menekse, Ebru; Özdoğan, Mehmet; Emir, SeyfiBACKGROUND: Several appendiceal stump closure tecniques such as intracorporoeal-knotting, endoloop, stapler and clips are used during laparoscopic appendectomy. This study aimed to compare intracorporoeal-knotting and endoloop tecniques used to close appendiceal stump in laparoscopic appendectomy. METHODS: This study included patients who underwent laparoscopic appendectomy with preliminary diagnosis of acute appendicitis in General Surgery Department of Adana Numune Training and Research Hospital between June 2009 and July 2013. The demographics, appendiceal stump closure tecniques, operation time, complications, and length of hospital stays of the patients were compared. RESULTS: A total of one hundred and twenty-six patients underwent laparoscopic appendectomy (Female: 81, Male: 45). Intracorporeal-knotting (Group 1) was performed in sixty-five patients; whereas, endoloop (Group 2) was performed in sixty-one patients in order to close appendiceal stump. The operation time was longer in Group 1 compared to Group 2 (62.0 +/- 10.67 min., 56.80 +/- 11.94 min., p=0.01). The length of hospital stays were nonsignificant between the groups. Four patients were complicated by superficial surgical site infection in both groups. CONCLUSION: In the present study, the operation time was found to be longer for intracorporeal knotting tecnique compared to endoloop tecnique; however, there was no significant difference regarding the length of hospital stay and complications. Performing intracorporeal-knotting technique is suggested since it is cheaper than endoloops and it may also improve hand manipulations of the surgeons who intend to advanced laparoscopy.Öğe Comparison of Topical Treatment with Silver Sulfadiazine and Sweetgum Oil (Liquidambar orientalis) on Burn Wound Healing in an Experimental Rat Model(Sci Printers & Publ Inc, 2016) Yanık, Mehmet Emin; Uygur, Ramazan; Aktaş, Cevat; Emir, Seyfi; Kumral, Bahadır; Şener, Ümit; Kulaç, Mustafa; Erboğa, Mustafa; Uygur, Emine; Aydın, Murat; Yılmaz, Ahsen; Orhan, Abdullah ErkanOBJECTIVE: To investigate effects of Sweetgum oil (SO) on wound healing in comparison with silver sulfadiazine (SS) in a burn wound model, which was experimentally created on rats. It was observed in the literature that no study had investigated the effects of SO on burn wounds. STUDY DESIGN: Seventy-two Sprague Dawley rats were divided into 3 main groups: Burn, Burn+SS, and Burn+SO (subgroups: 4, 8, and 12 days). RESULTS: In the histopathological examinations it was observed that parameters indicating wound-healing stages had increased in the Burn+SS and Burn+SO groups more than in the Burn group, whereas they were similar in the Burn+SS and Burn+SO groups. In the PCNA immunostaining, more rapid epidermal growth, more increased thickening in the cuticular layer, and more prominent wound healing were observed in the Burn+SS and Burn+SO groups than in the Burn group. While hydroxyproline levels in the Burn+SS and Burn+SO subgroups were similar on Days 8 and 12, it was observed that levels were increased in the burn subgroups. CONCLUSION: Topical use of SO on burn wound areas had favorable effects on healing, indicating that this agent could be used as an alternative treatment for burn wounds.Öğe Does hyperbaric oxygen therapy reduce the effects of ischemia on colonic anastomosis in laparoscopic colon resection?(Edizioni Luigi Pozzi, 2016) Emir, Seyfi; Gürdal, Sibel Özkan; Sözen, Selim; Bali, İlhan; Yeşildağ, Ebru; Çelik, Atilla; Topçu, Birol; Güzel, SavaşBACKGROUND: An increase in intra-abdominal pressure causes a decrease in the splanchnic blood flow and the intramucosal pH of the bowel, as well as increasing the risk of ischemia in the colon. The aim of the present study is to evaluate the effect of hyperbaric oxygen therapy (HBOT) on the ischemia caused by laparoscopy in colonic anastomosis in an experimental model of laparoscopic colonic surgery. MATERIALS AND METHODS: We divided 30 male Wistar albino rats into three groups: Group A was the control (open colon anastomosis); Group B received LCA (laparoscopic colon anastomosis); while Group C received both LCA. and HBOT. Each group contained ten animals. We placed Group C (LCA and HBOT) in an experimental hyperbaric chamber into which we administered pure oxygen at 2.1 atmospheres absolute 100% oxygen for 60 min for ten consecutive days. RESULTS: The anastomotic bursting pressure value was found to be higher in the open surgery group (226 +/- 8.8) (Group A). The result for Group C (213 +/- 27), which received HBOT, was better than that for Group B (197 +/- 27). However, there was no statistically significant difference between Group B and Group C. Group A showed better healing than the other groups, while significant differences in the fibroblast proliferation scores were found between Groups A and B. In terms of tissue hydroxyproline levels, a significant difference was found between Groups A and B and between Groups A and C, but not between Groups B and C. CONCLUSIONS: HBOT increases the oxygen level in the injured tissue. Although HBOT might offer several advantages, it had only a limited effect on the healing of colonic anastomosis in rats with increased intra-abdominal pressure in our study.Öğe Effectiveness of Limberg and Karydakis flap in recurrent pilonidal sinus disease(Hospital Clinicas, Univ Sao Paulo, 2015) Bali, İlhan; Aziret, Mehmet; Sözen, Selim; Emir, Seyfi; Erdem, Hasan; Çetinkunar, Süleyman; Irkorucu, OktayOBJECTIVE: Sacrococcygeal pilonidal sinus is common in young men and may recur over time after surgery. We investigated whether a factor exists that can aid in the determination of the preferred technique between the early Limberg flap and Karydakis flap techniques for treating recurrent pilonidal sinus. MATERIALS AND METHODS: This prospective and randomized study enrolled 71 patients with recurrent pilonidal sinus in whom the Limberg flap or Karydakis flap techniques were applied for reconstruction after excision. Patients were divided into two groups as follows: 37 patients were treated with the Limberg flap technique and 34 patients were treated with the Karydakis flap technique. Fluid collection, wound infection, flap edema, hematoma, partial wound separation, return to daily activities, pain score, complete healing time, painless seating and patient satisfaction were compared between the groups. ClinicalTrial.gov: NCT02287935. RESULTS: The development rates of total fluid collection, wound infection, flap edema, hematoma, and partial wound separation were 9.8%, 16%, 7%, 15% and 4.2%, respectively; total flap necrosis was not observed in any patient (p<0.001). During the average follow-up of 28 months, no patients (0%) developed recurrent disease. The two groups differed with respect to early surgical complications (p<0.001). CONCLUSION: In this study, use of the Limberg flap was associated with lower complication rates, shorter length of hospital stay, early return to work, low pain score, high patient satisfaction and better complete healing duration. Therefore, we recommend the Limberg flap for treatment of recurrent pilonidal sinus.Öğe GASTRİK DİVERTİKÜL: İKİ OLGU SUNUMU(Namık Kemal Üniversitesi, Tıp Fakültesi, 2016) Can, Günhan; Emir, Seyfi; Güneş, Örgün; Sözen, SelimGastrik divertikül yaygın görülen bir hastalık değildir. Çoğu gastrik divertikül asemptomatiktir. Divertiküller semptomatik olduğu zaman çoğunlukla üst karın ağrısı, bulantı ve kusma görülürken dispeptik şikayetler ise daha az sıklıkla görülür. Nadir olarak da divertikülden masif kanama ve perforasyon gibi komplikasyonlarda görülebilmektedir. Hastalığın semptomları daha yaygın olarak görülen birçok gastrointestinal hastalıkta da görülebildiği için tanı koymak güçtür. Divertiküllere yaklaşım divertikülün büyüklüğüne ve semptomlarına göre değişir. Asemptomatik divertiküllerin herhangi bir spesifik tedavisi yoktur. Büyük divertiküller, semptomatik olanlar ile kanama, perforasyon ve malignite gibi komplikasyonlu divertiküllerde cerrahi tedavi uygulanır.Öğe IMPORTANCE OF TOGETHER USE OF ENDOSCOPIC AND INTRAOPERATIVE ULTRASONOGRAPHY IN THE DIAGNOSIS AND TREATMENT OF INSULINOMA(Namık Kemal Üniversitesi, Tıp Fakültesi, 2016) Arslan, Ersoy; Aziret, Mehmet; Akgündüz, Fatih; İrkörücü, Oktay; Reyhan, Enver; Adamhasan, Fulya; Bali, İlhan; Emir, SeyfiIntroduction: Insulinoma is a usually benign tumor of pancreas. It is seen rarely and incidence of insulinoma is 1 in 250,000 patient-years. We present a rare case with insulinoma which well diagnosed and treated with aid of endoscopic and intraoperative ultrasonography. Case Report: A patient involving a 39-year-old woman with complaints of cold sweats, weakness, syncope attacks, palpitations was evaluated in polyclinic. She was hospitalized with the diagnosis of pancreatic insulinoma after abdominal computer tomography(CT), magnetic resonance imaging(MRI) endoscopic ultrasonography(EUS), and biochemical parameters. The patient was well treated with enucleation and after imaging aid of endoscopic and intraoperative ultrasound(IOUS). Discussion: In patients with insulinoma, preoperative localization of tumor is most important for diagnosis and treatment. Therefore; CT scanning, MRI, EUS and SPECT / CT are used for diagnosis of insulinoma. Together use of endoscopic and intraoperatively ultrasonography are increasing recently. Enucleation is a curative treatment approach in insulinoma. Conclusion: Together using of preoperative endoscopic and intraoperative ultrasound is quite helpful in the diagnosis and treatment of insulinoma.Öğe Ingested bone fragment in the bowel: Two cases and a review of the literature(Baishideng Publishing Group Inc, 2013) Emir, Seyfi; Özkan, Zeynep; Altinsoy, Hasan Baki; Yazar, Fatih Mehmet; Sözen, Selim; Bali, İlhanGenerally, ingested foreign bodies are excreted from the digestive tract without any complications or morbidity. In adults, ingestion of foreign bodies frequently occurs in alcoholics and elderly individuals with dentures. The most commonly ingested foreign bodies are food stuffs or their parts, such as fish bones or fragments of bone and phytobezoars. Sharp foreign bodies like fish and chicken bones can lead to intestinal perforation and peritonitis. We report herein two cases, one of bowel perforation and another of anal impaction, both caused by ingested bone fragments. Complications due to ingested bone fragments are not common and pre-operative diagnosis remains a challenge and therefore it must be considered in susceptible cases. (C) 2013 Baishideng. All rights reserved.Öğe Laparoskopik kolesistektomi sırasında safra kesesi yatağından meydana gelen kanamalarda fibrin yapıştırıcı uygulamasının etkinliği(2013) Emir, Seyfi; Bali, İlhan; Sözen, Selim; Yazar, Fatih Mehmet; Kanat, Burhan Hakan; Gürdal, Sibel Özkan; Özkan, ZeynepAmaç: Laparoskopik kolesistektomi sırasında safra kesesi yatağından gelişen ve klasik yöntemlerle durdurulamayan kanamalarda fibrin yapıştırıcı uygulama deneyimimizi sunmak.Gereç ve Yöntemler: Laparoskopik kolesistektomi uygulanan 382 hastadan, safra kesesi yatağında kanama meydana gelen ve konservatif yöntemlerle durdurulamayan ve bu nedenle de fibrin glue kullanılan 14 hasta retrospektif olarak incelendi.Bulgular: Fibrin yapıştırıcı kullanılan hastaların 10'u (%71) kadın, 4'ü (%29) erkekti. Hastaların ortalama yaşı 55,7 idi. 14 hasta da semptomatik safra kesesi taşı nedeniyle ameliyat edildi. On üç hastada (%92) yandaş bir hastalık mevcuttu. Kanamanın kontrol altına alınarak hemostazın sağlanması için harcanan zaman ortalama olarak 23,9 dakika olarak saptandı. Hemoglobin değeri 8 mg/dL altına düşen 2 hastaya kan transfüzyonu yapıldı. Bir hastada fibrin yapıştırıcı kullanılmasına rağmen kanama kontrolü sağlanamadı ve açık cerrahiye geçildi.Sonuç: Laparoskopik kolesistektomi yapılan hastalarda, karaciğerde safra kesesi yatağından meydana gelen kanamalarda fibrin yapıştırıcı uygulanmasının açığa geçme oranlarını düşürdüğü saptanmış olup bu konu ile ilgili daha geniş çalışmalara da ihtiyaç duyulmaktadırÖğe Laparoskopik Kolesistektomiden Açık Ameliyata Geçme Nedenleri(Namık Kemal Üniversitesi, Tıp Fakültesi, 2014) Sözen, Selim; Emir, Seyfi; Bali, İlhanAmaç Hastanemiz genel cerrahi kliniğinde yapılan laparoskopik kolesistektomi girişimlerinin demografik özelliklerinin saptanması, açık ameliyata geçiş oranının belirlenmesi, açığa geçiş nedenlerinin ortaya konması hedeflenmiştir. Materyal ve Metod Hastanemizde Eylül 2008- Agustos 2013 yılları arasında yapılan 568 laparoskopik kolesistektomi girişiminin kayıtları incelendi. Yaş ve cinsiyetleri, açığa geçiş nedenleri, akut kolesistit ve kronik kolesistit olguları, yaş gruplarına göre açığa geçiş oranları belirlendi. Bulgular Olgularımızın 525’ i kadın (% 92,4),43’ü erkektir (% 7,6), kadın/erkek oranı 12,1 idi. Ortalama yaş 45,5 ± 12,7 (18- 82), ortalama ameliyat süresi 60,2 (17-200 ) dakika idi. Ameliyat endikasyonları; 525 hasta kolelitiyazis (% 92,4), 33 hasta akut kolesistit (% 4,4) ve 6 hasta safra kesesi polibi (% 1), 2 hasta akalkülöz kolesistit (% 0,35) nedeni ile opere olmuştu. Olgularımızın 20’sinde(% 3,5) açığa geçilmiş, 10 olguda (% 1,2) intraoperatif komplikasyonlar gelişmişti. Mortalite yoktur. Hastanede ortalama yatış süresi 1,6 gündür (8 saat-26 gün). Açığa geçiş nedenleri; Calot üçgeninde yapışıklık (3 hasta), akut kolesistit (33 hasta), koledok taşı (2 hasta), geçirilmiş ameliyata bağlı yapışıklıklar (1 hasta), diseksiyon güçlüğü (2 hasta), organ yaralanması (2 hasta), anatomik varyasyon (1 hasta), taş dökülmesi (1hasta) olarak belirlendi. Sonuç Laparakopik kolesistektomide açığa geçişi arttıran en önemli faktör akut kolesistit gibi görünmektedir. Erkek cinsiyet, ileri yaş ve akut kolesistit halinin açık ameliyata geçiş riskini arttıran faktörler olduğu saptandı. Buna rağmen ilk tercih edilecek girişim şekli laparakopik kolesistektomi olmalıdır.Öğe Mekanik Bağırsak Tıkanıklığına Neden Olan Kolorektal Kanserlerde Morbidite ve Mortaliteye Etki Eden Faktörler(Namık Kemal Üniversitesi, Tıp Fakültesi, 2014) Emir, Seyfi; Sözen, Selim; Kanat, Burhan Hakan; Özkan, Zeynep; Yazar, Fatih Mehmet; Kavlakoğlu, Burak; Bozan, Mehmet Buğra; Erol, FatihBu çalışmanın amacı obstrüksiyon yapmış kolorektal kanserler nedeniyle kliniğimizde acil şartlarda ameliyat edilen hastalardaki morbidite ve mortalite oranlarını ve bunlara etki eden faktörleri sunmaktır. Materyal ve Metod Ocak 2008 - Temmuz 2012 yılları arasında mekanik bağırsak tıkanıklığına neden olmuş kolorektal kanser nedeniyle ameliyat edilen 10 erkek ve 8 kadın olmak üzere 18 hasta retrospektif olarak değerlendirildi. Hastalar yaş, cinsiyet, komplikasyon, yapılan ameliyat, morbidite, mortalite açısından incelendi. Yaşın, cinsiyetin ve tümör yerleşiminin morbidite üzerine olan etkileri incelendi. Bulgular Hastaların yaş ortalaması 66 ± 8,6 idi. 70 yaş üzerinde 10 (% 56,6) vardı. Hastaların 16’sında komplet bir obstrüksiyon izlendi (% 88,8). Bir hastada obstrüksiyonla beraber perforasyon mevcuttu (% 5,6). On iki hastaya Hartmann prosedürü (% 66,7) uygulanırken, 2 hastaya loop kolostomi (% 11,2), 2 hastaya sağ hemikolektomi (% 11,2), 1 hastaya total kolektomi ileorektal anastomoz (% 5,6), 1 hastaya sağ hemikolektomi uç ileostomi (% 5,6) uygulandı. Beş hastada morbidite izlendi (% 27,8). İki hastada mortalite izlendi (% 11,2). Morbidite görülen tüm hastalar 70 yaş üzerindeydi (p=0.21). Cinsiyete göre ve tümörün yerleşim yerine göre ise morbidite oranları açısından anlamlı fark yoktu. Sonuç Obstrüktif kolorektal kanser nedeniyle acil operasyona alınan hastalarda mortalite ve morbidite izlenme olasılığı artmaktadır. Bunun nedenlerinden birisi hastaların daha çok ileri yaşlarda olmalarıdır. Ayrıca hastalarda perforasyon gibi eşlik eden bir komplikasyon varlığı mortalite ve morbiditeyi ciddi ölçüde arttırmaktadır.Öğe Outcome analysis of laporoscopic D1 and D2 dissection in patients 70 years and older with gastric cancer(E-Century Publishing Corp, 2014) Emir, Seyfi; Sözen, Selim; Bali, İlhan; Gürdal, Sibel Özkan; Turan, Bünyamin Cüneyt; Yıldırım, Oguzhan; Yetişyiğit, TarkanObjective: Gastric cancer is a worldwide aggressive tumor with a bad prognosis. The purpose of this study was to retrospectively investigate operative findings of 53 patients aged over 70 with gastric cancer who underwent laporoscopic operations in our clinic. Material and methods: A retrospective review of all patients who underwent laporoscopic surgery for pathologically confirmed gastric cancer at our clinic between March 2008 and October 2010 was conducted. D1 resection (Level1 lymphadenectomy) was compared with D2 resection (Levels 1 and 2 lymphadenectomy). The two groups in which D1 and D2 Lymph node Dissection (LND) were applied were compared with respect to number of patients, sex, age, stage of disease, and score of American Society of Anesthesiologists (ASA). We analyzed surgical methods, the use of staplers, operative time, additional organ resections, hospital stay, postoperative complications and the need for re-operation, operative mortality, and the effects of prognostic factors on survival. Results: The patient group consisted of 31 (58%) males and 22 (42%) females. Of the patients, 28 (52%) underwent D1 and 25 (48%) D2 LND. There was a significant difference between the two groups with regard to length of surgery (p < 0.01). The length of operation, blood loss, and transfusion requirement in the D2 group were significantly more than those in the D1 group. There was no mortality in cases that underwent additional organ resection. The survival times of cases with a <= 0.25 ratio of dissected number of lymph nodes to metastatic lymph nodes were significantly longer than those of other cases. The survival time of cases with perineural and vascular invasion was significantly shorter. The survival rates of Stage I patients was significantly higher than those of Stage III (p: 0.002) and Stage IV (p: 0.003) patients. Conclusions: Although extensive dissection had an increased morbidity, there was no significant statistical difference between the two procedures. Early complications should not be attributed only to the extent of LND. The important prognostic factors related to long-time survival are the stage of the tumor, perineural and perivascular invasion, and metastatic lymph nodes.Öğe Protective Effect of Nigella Sativa in an Animal Model of Colon Anastomosis With Ischemia/Reperfusion Injury(Int College Of Surgeons, 2018) Bali, İlhan; Polat, Fatin Rüştü; Aziret, Mehmet; Sözen, Selim; Oruc, Cem; Coskunkan, Ufuk; Koç, Ahmet; Bilir, Bülent; Emir, SeyfiObjective: Anastomotic leaks are one of the chief complications after gastrointestinal surgery. The aim of this study was to evaluate whether Nigella sativa administration protects against ischemia/reperfusion injury on healing of colonic anastomosis in rats. Method: Thirty male Wistar albino rats, weighing between 200 and 240 g, were used in the study. They were randomly divided into three groups (n = 10 for each group): Anastomosis (group 1), anastomosis and ischemia/reperfusion injury (group 2), and treatment group of anastomosis, ischemia/reperfusion injury, and Nigella sativa (group 3). After 7 days, serum, plasma, and colonic tissue were obtained and then all rats were sacrificed. Tissue and serum level of total oxidant status, total antioxidant status, total thiol levels, hydroxyproline, interleukin-6, and TNF-alpha were determined and specimens were histopathologically evaluated. Results: In the Nigella sativa treated rats, serum hydroxyproline levels were significantly higher, while tissue levels were significantly lower than those seen in group 1 and group 2 (P = 0.007, P = 0.01, respectively). In the Nigella sativa group, the serum levels of TNF-alpha were significantly lower than those seen in group 1 and 2 (P = 0.001). Also, in group 3, the tissue IL-6 level was significantly higher than that seen in group 1 and group 2 (P = 0.009). The histopathologic analysis showed less edema and inflammatory cell infiltration in the Nigella sativa treated group, as well as a statistically significant difference according to the Chiu classification (P < 0.05). Conclusion: The results of this study indicate that Nigella sativa has a protective and therapeutic effect against ischemia/reperfusion injury on the healing of colonic anastomosis in rats.Öğe Safra Kesesi Divertikülü: Olgu Sunumu(Namık Kemal Üniversitesi, Tıp Fakültesi, 2015) Polat, Fatin R.; Dinelek, Hasan; Bali, İlhan; Emir, Seyfi; Yıldız, Ergün; Alkhatib, MouiadSafra kesesi divertikülü nadir görülen bir hastalıktır. Hastalık ancak cerrahi sonrası piyesin incelenmesinden sonra tanı alır. Biz bu olgu sunumunda; kliniğimize karın ağrısı ve karında şişlik şikayetleri ile başvurmuş, yapılan ultrasonografi incelemesi neticesinde kolelitiazis ön tanısı ile laparoskopik kolesistektomi yapılmış, ancak ameliyat sonrası safra kesesi divertikül tanısı almış kolelitiazis olgusunun; operasyon bulguları, radyolojik bulgular ve tedavi yöntemleri açısından tartışmayı amaçladık.Öğe Sakrokoksigeal Pilonidal Sinüsün Cerrahi Tedavisinde Karydakis Flep Ameliyatının Kısa ve Uzun Dönem Sonuçları(Namık Kemal Üniversitesi, Tıp Fakültesi, 2013) Emir, Seyfi; Kanat, Burhan Hakan; Yazar, Fatih Mehmet; Gürdal, Sibel ÖzkanAmaç Bu çalışmanın amacı kliniğimizde Karydakis flep ile tedavi edilen sakrokoksigeal pilonidal sinüs hastalığının kısa ve uzun dönem sonuçlarını retrospektif olarak sunmaktır. Gereç ve Yöntem Kasım 2008 ile Aralık 2012 tarihleri arasında sakrokoksigeal pilonidal sinüs tanısıyla ameliyat edilen ve cerrahi yöntem olarak Karydakis flep prosedürü uygulanan 186 hasta incelendi. Hastalar yaş, cinsiyet, ameliyat süresi, postoperatif erken dönem komplikasyon ve nüksler açısından değerlendirildi. Bulgular Olguların 147’si (% 79) erkek, 39’u (% 21) kadındı. Hastaların yaş ortalaması 26±13 yıl idi. Ortalama ameliyat süresi 56 (38-76) dakika olarak bulundu. Hastaların takip süresi ortalama 24 (4-48) ay idi. Bu süre içerisinde 4 hastada (% 2,1) nüks saptandı. Ayrıca 6 hastada (% 3) seroma, 3 hastada (% 1,6) yara yeri enfeksiyonu ve 1 hastada (% 0,53) flep iskemisi gelişti. Sonuç Pilonidal sinüs hastalığı için ideal bir tedavi yöntemi henüz netlik kazanmamıştır. Bu konu güncel cerrahide hâla tartışmaya açıktır. Cerrahi ve cerrahi olmayan yöntemler mevcut olup bu çalışmaya göre Karydakis flep tekniği düşük nüks oranı ile sakrokoksigeal pilonidal sinüsün tedavisinde iyi bir cerrahi yöntemdir.Öğe Sinotomy technique versus surgical excision with primary closure technique in pilonidal sinus disease(Assoc Basic Medical Sci Federation Bosnia & Herzegovina Sarajevo, 2014) Emir, Seyfi; Topuz, Omer; Kanat, Burhan Hakan; Bali, İlhanPilonidal disease is a common chronic disorder mainly seen in the sacrococcygeal region, especially in young males. Many surgical treatment modalities have been suggested, but an ideal and widely accepted treatment has yet to be established. The aim of this study was to compare quality of life of patients treated with the sinotomy technique with quality of life of patients treated with surgical excision plus primary closure technique by means of quality of life questionnaire. The data of patients who had been treated for pilonidal sinus in our clinic from September 2010 to June 2012 were analyzed retrospectively. Forty patients were treated with sinotomy technique and 40 patients were treated with surgical excision plus primary closure technique. Time to return to work and to time to complete wound healing were evaluated. All patients were asked to fill the questionnaire after complete healing occurred. Postoperative complications were bleeding in 2.5%, infection in 3.75% and fever in 2.5% patients. There were no significant differences between the two groups in terms of complete healing (p=0.1) and sport times (p=0.1). There were significant diffetences between the groups in terms of length of hospital stay (p <= 0.001), time off work (p <= 0.001), times to sitting on toilet and walking without pain (p=0.002 and p <= 0.001, respectively). The mean postoperative VAS scores were 5.2 +/- 3.2 and 2.8 +/- 2.2, respectively (p=0.02). The technique of sinotomy with good wound and surrounding skin care seems to be an ideal approach with high chance of cure. The patients returned to their routine in a short period of time.Öğe Spectrum of histopathological lesions in laparoscopic cholecystectomy specimens and incidental carcinoma rate: Our surgical and clinical experience(Duzce University Medical School, 2015) Bali, İlhan; Emir, Seyfi; Gürdal, S.Ö.; Turan, Bünyamin Cüneyt; Yıldırım, Oğuzhan; Sakallı, Onur; Sözen, SelimAim: Laparoscopic cholecystectomy (LC) has become the standard treatment method of cholelithiasis. The chronic cholecystitis and cholelithiasis are the most common pathologies seen in gallbladder disease, accompanying hyperplastic and dysplastic lesions. Methods: 568 laparoscopic cholecystectomy procedures performed between 2008-2013 were analyzed. Clinical details and histopathological data were retrieved from the records. The variety of morphological changes in the diseased gall bladder were correlated with the clinical findings. Chronic cholecystitis and cholelithiasis were put into two groups. A single sample when taken from each neck-corpus and fundus of the gallbladder in the first group, two samples were taken from each site and gallbladder was mapped and examined as a whole in the second group. Results: The sex distribution of the cases was 525 (92.4%) and 43 (7.6%) male (F/M: 12.1). Median age was 45.5 ± 12.7 years (range: 18-82), median operative time was 60.2 minutes (range: 17-200). Indications for surgery, were chronic cholecystitis in 525 (92.4%), acute cholecystitis in33 (4.4%), and gallbladder polyps in 6 (1%). Acalculous cholecystitis was present in 2 patient(% 0.35) who were operated. Most common pathology noted in our study was chronic cholecystitis seen in 442 cases (%74). Other benign lesions were cholesterosis in 36 (%6) and acute cholecystitis in 28 (%.4). Various other associated lesions and variants of cholecystitis were also encountered. A total of six malignant lesions of gallbladder were observed, which included six cases of incidental adenocarcinomas. By increasing the sample size in gallbladder we saw an increase in the rate of metaplasia (p=0,009), dysplasia (p=0,009), epithelial hyperplasia (p=0.003), and carsinoma (p=0.008) statistically. Conclusion: By increasing the sample size in gallbladder we saw an increase in the rate of metaplasia, dysplasia and carcinoma statistically. © 2012 Düzce Medical Journal.
