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Öğe Comparison of Unilateral Fasciocutaneous V-Y Flap Technique with Cleft Lift Procedure in the Treatment of Recurrent Pilonidal Sinus Disease: A Retrospective Clinical Study(Int Scientific Literature, Inc, 2018) Koca, Yavuz Savas; Yildiz, Ihsan; Okur, Selahittin Koray; Saricik, Bekir; Ugur, Mustafa; Bulbul, Mustafa Tevfik; Uslusoy, FuatBackground: This study aimed to assess treatment outcomes of the cleft lift procedure and V-Y flap technique in the treatment of recurrent pilonidal sinus disease (PSD). Material/Methods: A total of 51 patients who underwent cleft lift procedure and 43 patients who underwent fasciocutaneous V-Y flap technique were evaluated. The demographic characteristics, previous operations, duration of symptoms, perioperative complications, duration of operation and hospital stay, duration of draining of all patients, and recurrence of PSD were recorded. Results: The mean operation time was 35.61 +/- 5.254 min in the cleft lift group (CLG) and 57.42 +/- 7.327 min in the V-Y flap group (VYFG) (p=0.001). No wound dehiscence was found in the VYFG and 5 patients (9.8%) had wound dehiscence in the CLG (p=0.035). Draining time was 1.39 +/- 0.603 days in the CLG and 2.79 +/- 0.638 days in VYFG (p=0.001). The mean hospital stay was 1.75 +/- 0.523 days in the CLG and 3.77 +/- 1.02 days in the VYFG (p=0.001). Two patients (3.9%) in the CLG had recurrence and no recurrence was reported in the VYFG (p=0.189) in the given time interval. Conclusions: Both methods in treatment of recurrent PSD can be preferred because of low complication and recurrence rates. Because no recurrence was found after the V-Y flap technique, it appears to be a preferable method despite some disadvantages.Öğe Giant Retroperitoneal Liposarcoma with Multi-Organ Involvement(Derman Medical Publ, 2014) Ugur, Mustafa; Orlic, Cem; Akkucuk, Seckin; Koca, Yavuz Savas; Atci, NesrinRetroperitoneal liposarcomas are very rare tumors with poor prognosis. The diagnosis can be delayed since there are no specific symptoms and findings. Surgical resection is the primary treatment choice. Obtaining negative surgical margins should be the primary aim., Multiple organ resections may be essential in cases with huge liposarcoma and incomplete resection leads to local recurrences. There is still an ongoing controversy in the medical treatment of liposarcoma. In this study we presented a patient with liposarcoma who was advised for surgery due to retroperitoneal mass 2 years ago but refused so the mass grew to a huge size invading left kidney, left adrenal gland and left mesocolon. We aimed to point out organ invasion and huge masses of liposarcoma are not contraindications for resection, and resections of these huge tumors improve quality of life. All retroperitoneal masses should be aggressively excised and patients should be closely followed up.Öğe The role of co-administration of damage control surgery and vacuum-assisted closure in the treatment of perineal wounds(Turkish Surgical Assoc, 2018) Ugur, Mustafa; Oruc, Cem; Yildiz, Ihsan; Koca, Yavuz Savas; Daban, UgrasPerineal wounds caused by high-kinetic-energy shotgun blasts have a high mortality risk because they are often accompanied by injuries of the anus, rectum, genitourinary system, and extremities. Mortality often results from hemorrhage in the early stage and from multiple organ failure caused by sepsis in the late stage. The primary step in the treatment of patients presenting with perineal wound and hemodynamic instability caused by severe hemorrhage is to control hemorrhage and contamination using damage control surgery. After achieving hemodynamic stability, vacuum-assisted closure can be used to reduce the risks of infection and sepsis. In this report, we present a case who had a perineal wound caused by a mine blast and was successfully treated by damage control surgery and vacuum-assisted closure.Öğe Splenosis Causing ITP Relapse: Case Report(Derman Medical Publ, 2014) Koca, Yavuz Savas; Yildiz, Ihsan; Gozel, Sedat; Ugur, Mustafa; Sabtincuoglu, Mehmet ZaferITP (idiopathic trombocitopenic purpura) is defined as isolated thrombocytopenia which occurs even in normal bone marrow structure without any reason. Splenectomy is an efficient and permanent treatment in treatment-resistant ITP cases. Accesory spleen and splenosis, also known as auto-implantation of spleen, are rare clinical cases that need to be considered in ITP relapses. In this study, a 49 year old woman patient who had splenectomy because of ITP and had ITP relapse stemming from splenosis in postoperative 5th year is presented with literature.Öğe Treatment of colorectal injuries in the civil war and the factors affecting mortality(Edizioni Luigi Pozzi, 2018) Ugur, Mustafa; Kilic, Erol; Koca, Yavuz Savas; Yetim, Ibrahim; Temiz, Muhyittin; Koyuncu, OnurAIM: Colorectal injuries are one of the most common causes of mortality in war. Mainstay treatment of these injuries include primary repair or stoma creation. METHODS: Clinical data of the patients were evaluated retrospectively. Time from injury to hospital admission, method of treatment, the colorectal area affected, injury severity score ISS, hemodynamic instability, and mortality rate were determined. RESULTS: Of the 61 patients included in the study. Mean time from injury to hospital admission was 160 19 minutes. The injury was in the right colon in 24 patients 39.3%, in the left colon in 18 29.5%, and in the rectum in 19 31.2% patients. Median ISS value of 61 patients was 16, IQR 5. Mortality and complication rates were higher in patients with hemodynamic instability and stoma requirement was also higher in this group p<0.05. Total mortality occurred in 15 24.5% patients. Of these, 10 66.6% patients had hemodynamic instability. DISCUSSION: Hemodynamic instability is the most important factor affecting the mortality and the treatment method in wartime colorectal injuries. CONCLUSION: We believe that in victims of war with colorectal injuries, surgical intervention before the development of hemodynamic instability may reduce the rate of mortality and stoma requirement.Öğe The V-Y flap technique in complicated and recurrent pilonidal sinus disease(Edizioni Luigi Pozzi, 2018) Koca, Yavuz Savas; Yildiz, Ihsan; Ugur, Mustafa; Barut, IbrahimOBJECTVES: This study presents early and long term (5 years) outcome of 61 complicated pilonidal sinus disease cases undergoing V-Y advancement flap method together with the literature data. METHOD: Data of 336 patients undergoing surgery for pilonidal sinus disease between 2008 and 2012 were retrospectively analyzed. Patients with defect size >= 10 cm, and more than one subcutaneous sinus tunnels were assumed to have complicated pilonidal sinus disease. A total of 61 patients were included in the study. Age, gender, type of surgery, duration of hospitalization, time of drain removal, pre-operative complications, and relapse rates at post-operative 5th year were analyzed. RESULTS: Of the 66 patients, 51 underwent unilateral V-Y advancement and 10 patients had bilateral V-Y plasty. Mean duration of operations was 6687 +/- 18.37 minutes for total, 61.02 +/- 12.30 minutes for unilateral V-Y plasty, and 9670 +/--15.04 minutes for bilateral V-Y plasty. Hemovac drains were removed at 5.59 +/- 1.91 days averagely, 5.16 +/- 1.37 in unilateral group, and 7.80 +/- 2.74 in bilateral V-Y plasty group. Of the 4 patients who developed wound site infection, 2 had unilateral and 2 had bilateral V-Y flap advancement. Postoperative hematomas developed in 2 patients with unilateral flap and one patient with bilateral flapss. Seroma occurred in 2 patients with unilateral flap and one patient with bilateral flaps. Dehiscence developed two patients, one patient from each group. The mean duration of hosptalization was 5.98 +/- 2.21 days; 5.49 +/- 1.52 in unilateral group, and 8.50 +/- 3.34 in bilateral group. Early or late relapse was not seen in any groups. CONCLUSON: V-Y advancement flap technique can be applied as an efficient method in the treatment of complicated pilonidal sinus disease due to low relapse and complication rates.Öğe Where should the damage control surgery be performed, at the nearest health center or at a fully equipped hospital?(Turkish Assoc Trauma Emergency Surgery, 2016) Ugur, Mustafa; Akkucuk, Seckin; Koca, Yavuz Savas; Oruc, Cem; Aydogan, Akin; Kilic, Erol; Yetim, IbrahimBACKGROUND: Transport of casualties from a combat area to a fully equipped hospital where all techniques of damage control surgery (DCS) can be performed requires a great deal of time. Therefore, prior to transport, prompt control of hemorrhage and contamination should be achieved, and resuscitative procedures should be performed at the nearest health center. The aim of the present study was to investigate the effect of the location at which DCS was performed on rates of mortality. METHODS: The present retrospective study included 51 combat casualties who underwent DCS at the present clinic or at hospitals nearest the combat area due to high kinetic energy gunshot injuries to the abdomen between 2010 and 2015. Patients were evaluated in terms of acidosis, hypothermia, coagulopathy, and mortality. RESULTS: Patients were divided into 2 groups depending on the location where the first step of DCS was performed: (1) at the present hospital or (2) at other hospitals. Group 1 comprised 26 patients (51%), and Group 2 comprised 25 (49%). Total mortality occurred in 23 (45.1%) patients, including 15 (57.7%) patients in Group 1 and 8 (32%) in Group 2. In Group 1, mean time from injury to hospital admission was longer, and deep acidosis, hypothermia, and coagulopathy were more marked. CONCLUSION: Initial surgical control of hemorrhage and contamination in patients injured by high kinetic gunshots should be promptly achieved at the nearest health center. In this way, acidosis, hypothermia, and coagulopathy can be prevented, and the risk of mortality can be reduced.
