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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 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 Disease that should be remembered: Sacrococcygeal pilonidal sinus disease and short history(Baishideng Publishing Group Inc, 2015) Kanat, Burhan Hakan; Sözen, SelimPilonidal sinus disease has led to heated debates since it was first described in the medical literature. Although a consensus has been built on its etiology and pathogenesis, the same course has not progressed for treatment modality. This review is a short article about the process of pilonidal sinus disease from past to present. Some important points were mentioned between the years 1833, which is accepted as the milestone for the awareness of the disease, in which it was first reported until the year of 1880, in which it was given its name. Although its name has been the same for about two centuries, some other names such as Jeep Disease have also been used depending on the population affected by the disease. At present, it is indisputable that the disease is acquired. Large series were presented about the treatment in the last two decades. Some surgical methods were even named after the ones who first described them and they have many supporters. However, since the treatment modalities have some advantages and disadvantages and they do not have marked superiority over others, debates still continue. We hope that pilonidal sinus disease will not lose its significance and be underrated in parallel with the developments in technology and specialization in medicine.Öğe Effective conservative treatment of umbilical pilonidal sinus disease: Silver nitrate? Salt?(Edizioni Luigi Pozzi, 2015) Sözen, Selim; Kanat, Burhan Hakan; Kanat, Zekiye; Bali, İlhan; Polat, YılmazOBJECTIVE: The aim of this study was to compare the three different treatment methods and investigate The effectiveness of the therapeutic effect of common salt. METHODS: This retrospective study involved patients who were treated in our clinic for umbilical pilonidal sinus disease between January 2010 and December 2011. The patients were divided to three subgroups according to treatment methods. Group I: Cases treated with only local debridement and systemic antibiotic, group II: cases treated with local debridement, systemic antibiotic and silver nitrate, group 3: cases treated with debridement, systemic antibiotic and salt. RESULTS: In this study, 63 patients with the diagnosis of UPS were treated in our clinic. The patients were classified into three groups; group I included 20 patients, group II included 18 patients and group III included 18 patients. During 16-24 months of follow-up, 4 (20%) recurrences in group1 and 2 (11.1%) recurrences in group 2 were detected. Recurrence rate of group 3 was significantly different (5.55%) when compared to group 2. The mean period for returning to daily activities and work was 1 day for the patients. CONCLUSION: In conclusion, we suggest that pilonidal sinus cases which are not complicated by abcess and cellulitis can be treated by local removal of umbilical hairs, debridement and dressing without surgery. We conclude that application of common salt (table/cooking salt) to umbilical pilonidal sinus with granuloma is a simple and highly effective way of treatment without any relapse and complications.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 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 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 The efficacy of fibrin glue to control hemorrhage from the gallbladder bed during laparoscopic cholecystectomy(Aves, 2013) Emir, Seyfi; Bali, İlhan; Sözen, Selim; Yazar, Fatih Mehmet; Kanat, Burhan Hakan; Gürdal, Sibel Özkan; Özkan, ZeynepObjective: The aim of the study is to report our experience with fibrin glue application in the management of bleeding from the gallbladder bed during laparoscopic cholecystectomy, which could not be controlled by conventional methods. Material and Methods: Three hundred eighty-two patients underwent laparoscopic cholecystectomy. Fourteen patients with bleeding from the gallbladder bed, which could not be controlled by conventional methods, were analyzed retrospectively. Results: Fibrin glue was used in 10 patients. Six (71%) were female and 4 were (29%) male. The mean age was 55.7 years. Fourteen patients were operated for the presence of symptomatic gallstones. Thirteen patients (92%) had a concomitant pathology. The mean time spent to maintain hemostasis was 23.9 minutes (15-35). Blood products were used in two patients with hemoglobin values under 8 mg/dL. Hemostasis could not be achieved in a patient despite fibrin glue application, and the operation was converted to open surgery. Conclusion: The application of fibrin glue for bleeding from the gallbladder bed during laparoscopic cholecystectomy can reduce conversion rates, further studies including more patients are required.Öğe Yutulan Üç İğne ve Üç Farklı Yaklaşımla Sonuçlanan Tedavi: Bir Olgu Sunumu(Namık Kemal Üniversitesi, Tıp Fakültesi, 2014) Yur, Mesut; Kanat, Burhan Hakan; Can, ÇağdaşYabancı cisim yutulması pediatrik yaş grubunda erişkin yaş grubuna göre daha sık görülmektedir. Yutulan yabancı cisim tıbbi komplikasyonlara neden olabilmektedir. Tedavi yaklaşımları çeşitlilik gösterse de yabancı cismin çoğunlukla gastrointestinal sistem aracılığı kendiliğinden atılmaktadır. Yabancı cisim yutan hastaya uygulanan tedavi yaklaşımı hastada görülen klinik tabloya göre değişkenlik göstermektedir. Bu olgu sunumunda üç adet toplu iğne yutan hastaya uygulanan üç farklı tedavi yaklaşımı bildirildi.
