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Öğe Comparison of intracorporeal knotting and endoloop for stump closure in laparoscopic appendectomy(2015) Bali, İlhan; Karateke, Faruk; Özyazıcı, Sefa; Kuvvetli, Adnan; Oruç, Cem; Menekşe, Ebru; Emir, Seyfi; Özdoğan, MehmetBACKGROUND: 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 laparoscopyÖğe Contrubition of white blood cell count and C-reactive protein in the diagnosis of acute apendicitis: Exprience of a town hospital(Anatolian Journal of Clinical Investigation, 2015) Işik, Özgen; Üreyen, Orhan; Oruç, CemTo determine if white blood cell count and C-reactive protein contribute the diagnosis of acute appendicitis in a town hospital that is far away high-volume centers.Patients who underwent appendectomy between January 2011 and June 2012 reviewed retrospectively. Patients who were performed appendectomy as a secondary of another operation excluded from the study. Patients distributed into two groups: appendicitis and negative appendectomy.65 patients were performed open appendectomy while other 5 patients underwent laparoscopic appendectomy. Negative appendectomy rate was 14.3%. Both mean white blood cell counts (p<0.01) and C-reactive protein levels (p=0.02) were significantly different for two groups. However, the highest specificity (90%) was obtained when both of them raised. 6 patients had morbidities in the postoperative course, and the mean length of hospital stay was 2.3 days.White blood cell count and C-reactive protein level are simple tests that can be worked in many centers; however, they can only facilitate acute appendicitis diagnosis when they interpreted with clinical findings. Possibility of acute appendicitis is very low, in a patient who admits emergency department with low right abdominal pain, when both tests are in normal ranges. We believe that observation with re-evaluation in certain intervals would contribute on reducing negative appendectomy rate even in centers with limited facilities. © 2015, Anatolian Journal of Clinical Investigation. All rights reserved.Öğe Deneysel kolit modelinde centella asiatika ekstresinin etkinliği(2017) Özgür, Tümay; Özcan, Oğuzhan; Akküçük, Seçkin; Kılıç, Erol; Koyuncu, Onur; Oruç, Cem; Aydoğan, Akın; Öztürk, Ozan Utku; Motor, Sedat; Yetim, İbrahim; Temiz, MuhittinAmaç: İnflamatuvar barsak hastalıkları (İBH) çevresel, genetik ve immün faktörlerin sebep olduğu düşünülen bir grup kronik ve inflamatuvar durum olarak tanımlanmaktadır. Tedavisinde başlıca antiinflamatuvar, immünsupresif ve sitotoksik ilaç kombinasyonları kullanılmaktadır. Fakat bu ajanların ciddi yan etkilerinden dolayı yeni tedavi yöntemleri bulmak için araştırmalar yapılmaktadır. Bu çalışmanın amacı dekstran sülfat sodium (DSS) ile indüklenmiş deneysel kolit modelinde Centella Asiatica (CA) ekstresinin etkinliğini araştırmaktır. Gereç ve Yöntem: Çalışmada 24 adet Wistar Albino rat üç eşit gruba ayrıldı. Grup 1' e (kontrol) sadece su verildi. Grup 2' ye (kolit) DSS' li içme suyu ve Grup 3'e (medikasyon grubu) 200mg/kg/gün CA ekstresi ve DSS' li içme suyu verildi. Deney sonunda kolonun histopatolojik incelemesi ve myeloperoksidaz (MPO), malonildialdehit (MDO), tümör nekroz factör alfa (TNF-?) ve interlökin-10 (IL-10) düzeyleri belirlendi. Bulgular: CA ekstratı veilen grupta kolit grubu ile kıyaslandığında TNF- ? düzeyi daha düşüktü ve İL 10 düzeyi daha yüksekti. MPO ve MDA düzeyleri kolit grubunda diğer gruplarla karşılaştırıldığında anlamlı düzeyde daha yüksek bulundu. (p<0.05). Histopatolojik incelemede medikasyon grubunda daha az doku hasarı saptandı. Sonuç: CA ekstresi proinflamatuvar ve antiinflamatuvar sitokin düzeyini değiştirerek immünregulatuvar bir etki göstermektedir. Ayrıca serbest oksijen radikalleri oluşumunu önleyerek doku hasarını önlemektedir. Bu etkilerinden dolayı CA ekstresinin İBH tedavisinde faydalı bir ajan olarak kullanılabileceğini düşünmekteyiz.Öğe Where should the damage control surgery be performed, at the nearest health center or at a fully equipped hospital ?(2016) Uğur, Mustafa; Akküçük, Seçkin; Koca, Yavuz Savaş; Oruç, Cem; Aydoğan, Akın; Kılıç, Erol; Yetim, İbrahim; Temiz, MuhyittinBACKGROUND: 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
