Nesimi Eren | Dicle University (original) (raw)
Papers by Nesimi Eren
Turkiye Klinikleri Journal of Medical Sciences, 2003
Minerva Chirurgica, Aug 1, 2011
Although incidence of subclavian and axillary artery injury account for less than 9% of all vascu... more Although incidence of subclavian and axillary artery injury account for less than 9% of all vascular injuries, trauma to these vessels presents a surgical challenge particularly with high mortality and morbidity rates. The aim of the study was to review our experience on subclavian and axillary vessels injury and to analyze factors that may influence results of reconstructive surgery. Data of 35 patients have been recorded between January 2000 and June 2010. Mean age was 24.86 ± 8.99 years and most were males (88.57%). Regression analysis was performed to find out factors affecting outcome. The mean follow-up time was 60 months. The artery was injured in 32 of the 35 cases (91.43%) and the vein was injured in nine cases (25.71%). Seven of 24 reconstructions with saphenous graft failed as a result of thrombosis, whereas all of seven prosthetic grafts were patent during the long-term follow-up period. Except one, all surgical interventions followed by warfarin administration were patent while seven repair failures occurred among the anticoagulation-free interventions. Autologous vein graft must be the first choice; however, in case of size discrepancy, prosthetic graft usage may be an alternative approach and postoperative administration of anticoagulants may be considered at least in the presence of certain risk factors such as native artery-graft diameter discrepancy, thrombus history and prosthetic graft.
European Journal of Cardio Thoracic Surgery Official Journal of the European Association For Cardio Thoracic Surgery, 2002
Tracheobronchial injuries have different clinical pictures and high mortality unless aggressive t... more Tracheobronchial injuries have different clinical pictures and high mortality unless aggressive treatment is used. We reviewed our surgical experience. The records of 32 patients from 1988 to 2002 were reviewed. Mean age was 22.3 years (range: 4-53). Three patients were female. Prominent symptoms were dyspnea, subcutaneous air and pneumothorax in chest X-rays. Associated injuries were seen in 22 patients (68.7%): most frequently in the lung parenchyma (11 patients) and esophagus (seven patients). Bronchoscopic detection of a rupture of the trachea or bronchus was the main indication for surgery. Nineteen injuries (59%) were penetrating and 13 blunt (41%). The most common presenting sign of airway disruption was subcutaneous emphysema (25%) and stridor (22%). Of the 32 patients, 22 underwent bronchoscopic examination. Bronchography was used in three patients admitted during the late period. Surgical morbidity was 19.3%. Seven patients died (21.8%), of whom six had been operated on. In operations performed during the first 2 h of trauma, no mortality occurred. There were associated injuries in 100% of patients that died and in 60% of those that survived. The proportion (100 vs. 24%) and duration (2.8 vs. 11.6 days) of ventilatory support were lower in patients that survived than in those that died. Mean injury severity score of patients that died was 34.7+/-8.8 while it was 24.3+/-8.6 in those that survived. Tracheal stenosis developed in three patients (9.3%). In civilian life, tracheobronchial injuries occur relatively rarely. Early diagnosis and operative intervention save lives. Associated injury is an important mortality factor.
Turkiye Klinikleri Journal of Cardiovascular Surgery, 2002
Turkiye Klinikleri Journal of Medical Sciences, 2004
Of 156 patients referred in 1977-1987 for pulmonary hydatid cyst, nine were found to have simulta... more Of 156 patients referred in 1977-1987 for pulmonary hydatid cyst, nine were found to have simultaneous affection of the right lung and the liver. The diagnosis of concomitant liver cyst was made from radiographic dumbbell elevation of the diaphragm (3 cases), by preoperative ultrasound scan and computed tomography in (5 cases), and by intraoperative palpation through the diaphragm (1 case). The hepatic cysts were removed via the thoracotomy performed for removal of the lung cyst in seven patients and via thoracolaparotomy in two. The postoperative course was satisfactory and no recurrence of cyst has been observed, although mebendazole was not given. In cases of hydatidosis of the right lung, preoperative search should be made for subdiaphragmatic concomitant liver cyst which can be removed through the same thoracotomy.
The Journal of Cardiovascular Surgery, Feb 1, 2004
To assess the efficacy of pleural tenting in patients with complicated primary spontaneous pneumo... more To assess the efficacy of pleural tenting in patients with complicated primary spontaneous pneumothorax (PSP). From 1988 through 2001, 43 patients underwent operations. Mean age was 30.4 years; the male/female ratio was 9.7. Twenty-one (48.8%) underwent pleural tenting in addition to bulla excision (experimental group, EG). Twenty-two (51.2%) underwent bulla excision plus pleural abrasion (11 patients), apical partial pleurectomy (9 patients) and complete apical pleurectomy (2 patients) (control group, CG). The most frequent symptom was chest pain (37.2%). Surgical indications were recurrence in 21 (48.8%), prolonged air leak in 12 (27.9%), failure of expansion without air leak in 6 (13.9%), high risk occupancy in 2 (4.6%) and empyema due to air leak in 2 (4.6%). Air leak time was decreased by tenting (1.9 days vs 3.7 days) as well as time of drainage (4.8 vs 6.9) and hospital stay (5.8 vs 7.9). Morbidity was 9.5% in EG and 9.1% in CG. Causes of morbidity were postoperative hematoma, prolonged air leak, expansion failure and blunt posterior sinus one of each. Re-operation needed for postoperative hematoma in CG. Mean follow-up was 5.1 years and 1 (4.5%) recurrence observed in CG. Tenting of the dependent lung from the apical pleura after bullectomy via axillary thoracotomy lessens air leak time without recurrence and low morbidity.
Turkiye Klinikleri Journal of Cardiovascular Surgery, 2002
Turkiye Klinikleri Journal of Cardiovascular Surgery, 2004
African Journal of Pharmacy and Pharmacology, 2012
Diabetes is in close relation with peripheral artery disease (PAD) and there are conflicting resu... more Diabetes is in close relation with peripheral artery disease (PAD) and there are conflicting results regarding efficacy of iloprost in PAD. The aim of this study was to investigate the efficacy of iloprost in improving walking capacity and increasing oxygenation to diseased tissues in PAD patients with diabetes, compared to pentoxiphylline. Data of 80 patients were recorded contemporaneously. Patients were divided into two groups (Group 1: Users of iloprost and pentoxiphylline; Group 2: Users of only pentoxiphylline). O 2 saturations in diseased limbs were significantly improved at three-months followup in both groups (both p<0.001). The difference between groups was in favor of Group 1 (p = 0.012). Maximum walking capacity was also increased significantly in both groups (both p<0.001). However, the improvements in walking distance were at similar extent (p = 0.226). In comparison with pentoxiphylline, iloprost has no superior effect on walking capacity of diabetic patients with intermittent claudication. However, iloprost improves oxygenation of tissues better than pentoxiphylline, therefore iloprost may be preferred especially in diabetic patients with critical limb ischemia as an adjunctive therapy followed by pentoxiphylline or cilostazol. Usage of iloprost may contribute to the recovery of diabetic ulcers and also, it may postpone occurrence of diabetic ulcers.
Turkiye Klinikleri Journal of Medical Sciences, 2003
Pulmoner hamartomlar akciğerin en sık görülen benign tümörüdür. Tüm benign akciğer neoplazmların ... more Pulmoner hamartomlar akciğerin en sık görülen benign tümörüdür. Tüm benign akciğer neoplazmların %75'ini oluşturur (1,2). Hamartomlar bronşun fibröz bağ dokusundan gelişir ve çoğunlukla kıkırdak dokusu içerirler. Çoğunlukla asemptomatiktirler. Orta yaş erişkinlerde ve erkeklerde sıktır (3-5). Otopsilerde yaygınlığı %0.25 bulunmuştur (5).
Objective: Penetrating cardiac injuries are fatal thoracic traumas. Many patients arrive at the h... more Objective: Penetrating cardiac injuries are fatal thoracic traumas. Many patients arrive at the hospital dead or in severe shock. Rapid hemodynamic deterioration may develop in patients exposed to cardiac trauma. Early diagnosis and rapid surgical intervention can determine the prognosis. The aim of this study was to analyze retrospectively false cases recognized postoperatively.
Cardiovascular journal of Africa, 2012
Postoperative pneumonia is a devastating complication after cardiac surgery that increases morbid... more Postoperative pneumonia is a devastating complication after cardiac surgery that increases morbidity and mortality. The objective of this study was to identify potential risk factors for the development of nosocomial pneumonia post cardiac surgery by the way of logistic regression analysis. Data of the last 162 patients undergoing cardiac surgery before November 2009 were retrospectively collected and analysed. The mean age of the patients was 65.57 ± 10.48 years and 83 (51%) were male. Postoperative pneumonia was diagnosed in 21 (13%) patients. The mean remaining time in the intensive care unit and mean length of hospitalisation were longer for patients with postoperative pneumonia. Pre-operative heart rate, previous diabetes mellitus, previous chronic obstructive pulmonary disease, postoperative urea, creatinine and potassium levels, extubation time, postoperative atrial fibrillation, and number of units of transfused packed red blood cells (pRBC) and fresh frozen plasma were asso...
Minerva chirurgica, 2011
Although incidence of subclavian and axillary artery injury account for less than 9% of all vascu... more Although incidence of subclavian and axillary artery injury account for less than 9% of all vascular injuries, trauma to these vessels presents a surgical challenge particularly with high mortality and morbidity rates. The aim of the study was to review our experience on subclavian and axillary vessels injury and to analyze factors that may influence results of reconstructive surgery. Data of 35 patients have been recorded between January 2000 and June 2010. Mean age was 24.86 ± 8.99 years and most were males (88.57%). Regression analysis was performed to find out factors affecting outcome. The mean follow-up time was 60 months. The artery was injured in 32 of the 35 cases (91.43%) and the vein was injured in nine cases (25.71%). Seven of 24 reconstructions with saphenous graft failed as a result of thrombosis, whereas all of seven prosthetic grafts were patent during the long-term follow-up period. Except one, all surgical interventions followed by warfarin administration were pate...
International surgery
Phrenic nerve injury resulting from blunt trauma is unusual and may closely mimic diaphragmatic r... more Phrenic nerve injury resulting from blunt trauma is unusual and may closely mimic diaphragmatic rupture. Diagnosis remains difficult and is often delayed. A prompt diagnosis requires a high index of suspicion. We describe one patient with phrenic nerve injury in whom the diagnosis was made late at the time of injury. Radiograph, ultrasonography, and computed tomography were helpful in the diagnosis. Video-assisted thoracic surgery was performed on our patient for diagnostic purposes. Left phrenic nerve injury and pericardial injury were found. Diaphragmatic plication was performed through a miniature left posterolateral thoracotomy. This case was presented to show the unusual nature of phrenic nerve injury.
The Journal of cardiovascular surgery, 2004
To assess the efficacy of pleural tenting in patients with complicated primary spontaneous pneumo... more To assess the efficacy of pleural tenting in patients with complicated primary spontaneous pneumothorax (PSP). From 1988 through 2001, 43 patients underwent operations. Mean age was 30.4 years; the male/female ratio was 9.7. Twenty-one (48.8%) underwent pleural tenting in addition to bulla excision (experimental group, EG). Twenty-two (51.2%) underwent bulla excision plus pleural abrasion (11 patients), apical partial pleurectomy (9 patients) and complete apical pleurectomy (2 patients) (control group, CG). The most frequent symptom was chest pain (37.2%). Surgical indications were recurrence in 21 (48.8%), prolonged air leak in 12 (27.9%), failure of expansion without air leak in 6 (13.9%), high risk occupancy in 2 (4.6%) and empyema due to air leak in 2 (4.6%). Air leak time was decreased by tenting (1.9 days vs 3.7 days) as well as time of drainage (4.8 vs 6.9) and hospital stay (5.8 vs 7.9). Morbidity was 9.5% in EG and 9.1% in CG. Causes of morbidity were postoperative hematoma...
Ulusal travma ve acil cerrahi dergisi = Turkish journal of trauma & emergency surgery : TJTES, 2010
Although vascular trauma of the upper extremity is increasingly more common, mortality and morbid... more Although vascular trauma of the upper extremity is increasingly more common, mortality and morbidity rates remain low, at between 0-8%. Self-mutilation has become evident in recent years. We planned this study to compare the results of self-mutilation with other penetrating trauma in upper extremity vascular injuries and also to emphasize the dangers of self-mutilation for society. Data of 249 patients with penetrating vascular injury of the upper extremity were retrospectively analyzed. There were 214 male (86%) and 35 female (14%) patients, with a mean age of 24.76 ± 11.28 years (range: 2-69 years). Of these, 129 (52%) were self-mutilators. The ulnar artery was the most frequently affected (n=140, 56%). There was no mortality or limb loss. However, eight (3.21%) patients, who had penetrating trauma, had restriction in finger motions. Male predominance, substance abuse and associated nerve injury were significantly more common among self-mutilators (p values <0.001, <0.001 an...
General thoracic and cardiovascular surgery, 2011
Postoperative atrial fibrillation (AF) is the most common complication after coronary artery bypa... more Postoperative atrial fibrillation (AF) is the most common complication after coronary artery bypass graft (CABG) surgery, with an incidence of 20%-50%. The objective of this study was to investigate perioperative risk factors of postoperative sustained AF by the way of logistic regression analysis. Data for the last 98 patients who had undergone CABG surgery before January 2010 were retrospectively collected and analyzed. Postoperative sustained AF was detected in 34 (34.7%) patients. Mean arterial blood pressure, previous hypertension (HT), previous AF, previous chronic obstructive pulmonary disease, aortic cross-clamp time, cardiopulmonary bypass time, postoperative urea, postoperative creatinine, postoperative potassium, extubation time, chest tube drainage, units of transfused packed red blood cells (pRBC), and postoperative pneumonia were associated with higher occurrence of postoperative sustained AF according to the univariate analysis. Upon logistic regression analysis, pRBC...
Malign olmayan nedenlerden kaynaklanan tek tarafll diafragma paralizisi eri §kinlerde nadir bir d... more Malign olmayan nedenlerden kaynaklanan tek tarafll diafragma paralizisi eri §kinlerde nadir bir durumdur. En slk nedenleri travma, noromuskuler hastallklar, iatrojenik, servikal spondilosis ve infeksiyondur. Ocak 1996 ve MaYls 2003 tarihleri arasmda diafragmatik paralizi nedeniyle diafragmatik plikasyon gefiren 5 eri §kin hasta retrospektif olarak degerlendirildi. Ya §, cins, etyolojikfaktor, hastanede kall § siiresi, tedavi ve sonuflan incelendi. Olgulann 4'ii erkek 1'i bayandl ve ya §lan 40-55 arasmdaydl (ortalama:49.6). diafragma paralizisi 4 hastada post-travmatik, 1 hastada da cerrahi sonraSl idi. Biitiin hastalar dispne ile kendilerini belli ettiler. Biitiin hastalarda gogiis grafisinde sol hemidiafragmmn yiiksekliifi ile birlikte skopide paradoksal hareketi izlendi. . Biitiin hastalar posterolateral torakotomi ile sol diafragmatik plikasyon gefirdiler. Postoperatif komplikasyon veya oliim goriilmedi. Sonuf olarak; diafragmatik plikasyon, tek tarafll diafragmatik paralizi nedeniyle dispnesi olan eri §kin hastalarda giivenli ve etkili bir yontemdir. Anahtar kelimeler: Diafragmatik paralizi, Plikasyon, Eri §'kin UNILATERAL DIAPHRAGMATIC PARALYSIS AND DIAPHRACMATIC PLICATION IN ADULTS SUMMARY Unilaral diaphragmatic paralysis resulting from nonmalignant causes, an uncommon condition in adult. Common causes include trauma, neuromuscular disorders, iatrogenic, cervical spondylosis and infection. Between January 1996 and May 2003 Five adult patients who had undergone diaphragmatic plication due to diaphragmatic paralysis were retrospectively analyzed. Age, gender, etiologic factors, hospital stay, management and outcomes were revieved.
Turkiye Klinikleri Journal of Medical Sciences, 2003
Minerva Chirurgica, Aug 1, 2011
Although incidence of subclavian and axillary artery injury account for less than 9% of all vascu... more Although incidence of subclavian and axillary artery injury account for less than 9% of all vascular injuries, trauma to these vessels presents a surgical challenge particularly with high mortality and morbidity rates. The aim of the study was to review our experience on subclavian and axillary vessels injury and to analyze factors that may influence results of reconstructive surgery. Data of 35 patients have been recorded between January 2000 and June 2010. Mean age was 24.86 ± 8.99 years and most were males (88.57%). Regression analysis was performed to find out factors affecting outcome. The mean follow-up time was 60 months. The artery was injured in 32 of the 35 cases (91.43%) and the vein was injured in nine cases (25.71%). Seven of 24 reconstructions with saphenous graft failed as a result of thrombosis, whereas all of seven prosthetic grafts were patent during the long-term follow-up period. Except one, all surgical interventions followed by warfarin administration were patent while seven repair failures occurred among the anticoagulation-free interventions. Autologous vein graft must be the first choice; however, in case of size discrepancy, prosthetic graft usage may be an alternative approach and postoperative administration of anticoagulants may be considered at least in the presence of certain risk factors such as native artery-graft diameter discrepancy, thrombus history and prosthetic graft.
European Journal of Cardio Thoracic Surgery Official Journal of the European Association For Cardio Thoracic Surgery, 2002
Tracheobronchial injuries have different clinical pictures and high mortality unless aggressive t... more Tracheobronchial injuries have different clinical pictures and high mortality unless aggressive treatment is used. We reviewed our surgical experience. The records of 32 patients from 1988 to 2002 were reviewed. Mean age was 22.3 years (range: 4-53). Three patients were female. Prominent symptoms were dyspnea, subcutaneous air and pneumothorax in chest X-rays. Associated injuries were seen in 22 patients (68.7%): most frequently in the lung parenchyma (11 patients) and esophagus (seven patients). Bronchoscopic detection of a rupture of the trachea or bronchus was the main indication for surgery. Nineteen injuries (59%) were penetrating and 13 blunt (41%). The most common presenting sign of airway disruption was subcutaneous emphysema (25%) and stridor (22%). Of the 32 patients, 22 underwent bronchoscopic examination. Bronchography was used in three patients admitted during the late period. Surgical morbidity was 19.3%. Seven patients died (21.8%), of whom six had been operated on. In operations performed during the first 2 h of trauma, no mortality occurred. There were associated injuries in 100% of patients that died and in 60% of those that survived. The proportion (100 vs. 24%) and duration (2.8 vs. 11.6 days) of ventilatory support were lower in patients that survived than in those that died. Mean injury severity score of patients that died was 34.7+/-8.8 while it was 24.3+/-8.6 in those that survived. Tracheal stenosis developed in three patients (9.3%). In civilian life, tracheobronchial injuries occur relatively rarely. Early diagnosis and operative intervention save lives. Associated injury is an important mortality factor.
Turkiye Klinikleri Journal of Cardiovascular Surgery, 2002
Turkiye Klinikleri Journal of Medical Sciences, 2004
Of 156 patients referred in 1977-1987 for pulmonary hydatid cyst, nine were found to have simulta... more Of 156 patients referred in 1977-1987 for pulmonary hydatid cyst, nine were found to have simultaneous affection of the right lung and the liver. The diagnosis of concomitant liver cyst was made from radiographic dumbbell elevation of the diaphragm (3 cases), by preoperative ultrasound scan and computed tomography in (5 cases), and by intraoperative palpation through the diaphragm (1 case). The hepatic cysts were removed via the thoracotomy performed for removal of the lung cyst in seven patients and via thoracolaparotomy in two. The postoperative course was satisfactory and no recurrence of cyst has been observed, although mebendazole was not given. In cases of hydatidosis of the right lung, preoperative search should be made for subdiaphragmatic concomitant liver cyst which can be removed through the same thoracotomy.
The Journal of Cardiovascular Surgery, Feb 1, 2004
To assess the efficacy of pleural tenting in patients with complicated primary spontaneous pneumo... more To assess the efficacy of pleural tenting in patients with complicated primary spontaneous pneumothorax (PSP). From 1988 through 2001, 43 patients underwent operations. Mean age was 30.4 years; the male/female ratio was 9.7. Twenty-one (48.8%) underwent pleural tenting in addition to bulla excision (experimental group, EG). Twenty-two (51.2%) underwent bulla excision plus pleural abrasion (11 patients), apical partial pleurectomy (9 patients) and complete apical pleurectomy (2 patients) (control group, CG). The most frequent symptom was chest pain (37.2%). Surgical indications were recurrence in 21 (48.8%), prolonged air leak in 12 (27.9%), failure of expansion without air leak in 6 (13.9%), high risk occupancy in 2 (4.6%) and empyema due to air leak in 2 (4.6%). Air leak time was decreased by tenting (1.9 days vs 3.7 days) as well as time of drainage (4.8 vs 6.9) and hospital stay (5.8 vs 7.9). Morbidity was 9.5% in EG and 9.1% in CG. Causes of morbidity were postoperative hematoma, prolonged air leak, expansion failure and blunt posterior sinus one of each. Re-operation needed for postoperative hematoma in CG. Mean follow-up was 5.1 years and 1 (4.5%) recurrence observed in CG. Tenting of the dependent lung from the apical pleura after bullectomy via axillary thoracotomy lessens air leak time without recurrence and low morbidity.
Turkiye Klinikleri Journal of Cardiovascular Surgery, 2002
Turkiye Klinikleri Journal of Cardiovascular Surgery, 2004
African Journal of Pharmacy and Pharmacology, 2012
Diabetes is in close relation with peripheral artery disease (PAD) and there are conflicting resu... more Diabetes is in close relation with peripheral artery disease (PAD) and there are conflicting results regarding efficacy of iloprost in PAD. The aim of this study was to investigate the efficacy of iloprost in improving walking capacity and increasing oxygenation to diseased tissues in PAD patients with diabetes, compared to pentoxiphylline. Data of 80 patients were recorded contemporaneously. Patients were divided into two groups (Group 1: Users of iloprost and pentoxiphylline; Group 2: Users of only pentoxiphylline). O 2 saturations in diseased limbs were significantly improved at three-months followup in both groups (both p<0.001). The difference between groups was in favor of Group 1 (p = 0.012). Maximum walking capacity was also increased significantly in both groups (both p<0.001). However, the improvements in walking distance were at similar extent (p = 0.226). In comparison with pentoxiphylline, iloprost has no superior effect on walking capacity of diabetic patients with intermittent claudication. However, iloprost improves oxygenation of tissues better than pentoxiphylline, therefore iloprost may be preferred especially in diabetic patients with critical limb ischemia as an adjunctive therapy followed by pentoxiphylline or cilostazol. Usage of iloprost may contribute to the recovery of diabetic ulcers and also, it may postpone occurrence of diabetic ulcers.
Turkiye Klinikleri Journal of Medical Sciences, 2003
Pulmoner hamartomlar akciğerin en sık görülen benign tümörüdür. Tüm benign akciğer neoplazmların ... more Pulmoner hamartomlar akciğerin en sık görülen benign tümörüdür. Tüm benign akciğer neoplazmların %75'ini oluşturur (1,2). Hamartomlar bronşun fibröz bağ dokusundan gelişir ve çoğunlukla kıkırdak dokusu içerirler. Çoğunlukla asemptomatiktirler. Orta yaş erişkinlerde ve erkeklerde sıktır (3-5). Otopsilerde yaygınlığı %0.25 bulunmuştur (5).
Objective: Penetrating cardiac injuries are fatal thoracic traumas. Many patients arrive at the h... more Objective: Penetrating cardiac injuries are fatal thoracic traumas. Many patients arrive at the hospital dead or in severe shock. Rapid hemodynamic deterioration may develop in patients exposed to cardiac trauma. Early diagnosis and rapid surgical intervention can determine the prognosis. The aim of this study was to analyze retrospectively false cases recognized postoperatively.
Cardiovascular journal of Africa, 2012
Postoperative pneumonia is a devastating complication after cardiac surgery that increases morbid... more Postoperative pneumonia is a devastating complication after cardiac surgery that increases morbidity and mortality. The objective of this study was to identify potential risk factors for the development of nosocomial pneumonia post cardiac surgery by the way of logistic regression analysis. Data of the last 162 patients undergoing cardiac surgery before November 2009 were retrospectively collected and analysed. The mean age of the patients was 65.57 ± 10.48 years and 83 (51%) were male. Postoperative pneumonia was diagnosed in 21 (13%) patients. The mean remaining time in the intensive care unit and mean length of hospitalisation were longer for patients with postoperative pneumonia. Pre-operative heart rate, previous diabetes mellitus, previous chronic obstructive pulmonary disease, postoperative urea, creatinine and potassium levels, extubation time, postoperative atrial fibrillation, and number of units of transfused packed red blood cells (pRBC) and fresh frozen plasma were asso...
Minerva chirurgica, 2011
Although incidence of subclavian and axillary artery injury account for less than 9% of all vascu... more Although incidence of subclavian and axillary artery injury account for less than 9% of all vascular injuries, trauma to these vessels presents a surgical challenge particularly with high mortality and morbidity rates. The aim of the study was to review our experience on subclavian and axillary vessels injury and to analyze factors that may influence results of reconstructive surgery. Data of 35 patients have been recorded between January 2000 and June 2010. Mean age was 24.86 ± 8.99 years and most were males (88.57%). Regression analysis was performed to find out factors affecting outcome. The mean follow-up time was 60 months. The artery was injured in 32 of the 35 cases (91.43%) and the vein was injured in nine cases (25.71%). Seven of 24 reconstructions with saphenous graft failed as a result of thrombosis, whereas all of seven prosthetic grafts were patent during the long-term follow-up period. Except one, all surgical interventions followed by warfarin administration were pate...
International surgery
Phrenic nerve injury resulting from blunt trauma is unusual and may closely mimic diaphragmatic r... more Phrenic nerve injury resulting from blunt trauma is unusual and may closely mimic diaphragmatic rupture. Diagnosis remains difficult and is often delayed. A prompt diagnosis requires a high index of suspicion. We describe one patient with phrenic nerve injury in whom the diagnosis was made late at the time of injury. Radiograph, ultrasonography, and computed tomography were helpful in the diagnosis. Video-assisted thoracic surgery was performed on our patient for diagnostic purposes. Left phrenic nerve injury and pericardial injury were found. Diaphragmatic plication was performed through a miniature left posterolateral thoracotomy. This case was presented to show the unusual nature of phrenic nerve injury.
The Journal of cardiovascular surgery, 2004
To assess the efficacy of pleural tenting in patients with complicated primary spontaneous pneumo... more To assess the efficacy of pleural tenting in patients with complicated primary spontaneous pneumothorax (PSP). From 1988 through 2001, 43 patients underwent operations. Mean age was 30.4 years; the male/female ratio was 9.7. Twenty-one (48.8%) underwent pleural tenting in addition to bulla excision (experimental group, EG). Twenty-two (51.2%) underwent bulla excision plus pleural abrasion (11 patients), apical partial pleurectomy (9 patients) and complete apical pleurectomy (2 patients) (control group, CG). The most frequent symptom was chest pain (37.2%). Surgical indications were recurrence in 21 (48.8%), prolonged air leak in 12 (27.9%), failure of expansion without air leak in 6 (13.9%), high risk occupancy in 2 (4.6%) and empyema due to air leak in 2 (4.6%). Air leak time was decreased by tenting (1.9 days vs 3.7 days) as well as time of drainage (4.8 vs 6.9) and hospital stay (5.8 vs 7.9). Morbidity was 9.5% in EG and 9.1% in CG. Causes of morbidity were postoperative hematoma...
Ulusal travma ve acil cerrahi dergisi = Turkish journal of trauma & emergency surgery : TJTES, 2010
Although vascular trauma of the upper extremity is increasingly more common, mortality and morbid... more Although vascular trauma of the upper extremity is increasingly more common, mortality and morbidity rates remain low, at between 0-8%. Self-mutilation has become evident in recent years. We planned this study to compare the results of self-mutilation with other penetrating trauma in upper extremity vascular injuries and also to emphasize the dangers of self-mutilation for society. Data of 249 patients with penetrating vascular injury of the upper extremity were retrospectively analyzed. There were 214 male (86%) and 35 female (14%) patients, with a mean age of 24.76 ± 11.28 years (range: 2-69 years). Of these, 129 (52%) were self-mutilators. The ulnar artery was the most frequently affected (n=140, 56%). There was no mortality or limb loss. However, eight (3.21%) patients, who had penetrating trauma, had restriction in finger motions. Male predominance, substance abuse and associated nerve injury were significantly more common among self-mutilators (p values <0.001, <0.001 an...
General thoracic and cardiovascular surgery, 2011
Postoperative atrial fibrillation (AF) is the most common complication after coronary artery bypa... more Postoperative atrial fibrillation (AF) is the most common complication after coronary artery bypass graft (CABG) surgery, with an incidence of 20%-50%. The objective of this study was to investigate perioperative risk factors of postoperative sustained AF by the way of logistic regression analysis. Data for the last 98 patients who had undergone CABG surgery before January 2010 were retrospectively collected and analyzed. Postoperative sustained AF was detected in 34 (34.7%) patients. Mean arterial blood pressure, previous hypertension (HT), previous AF, previous chronic obstructive pulmonary disease, aortic cross-clamp time, cardiopulmonary bypass time, postoperative urea, postoperative creatinine, postoperative potassium, extubation time, chest tube drainage, units of transfused packed red blood cells (pRBC), and postoperative pneumonia were associated with higher occurrence of postoperative sustained AF according to the univariate analysis. Upon logistic regression analysis, pRBC...
Malign olmayan nedenlerden kaynaklanan tek tarafll diafragma paralizisi eri §kinlerde nadir bir d... more Malign olmayan nedenlerden kaynaklanan tek tarafll diafragma paralizisi eri §kinlerde nadir bir durumdur. En slk nedenleri travma, noromuskuler hastallklar, iatrojenik, servikal spondilosis ve infeksiyondur. Ocak 1996 ve MaYls 2003 tarihleri arasmda diafragmatik paralizi nedeniyle diafragmatik plikasyon gefiren 5 eri §kin hasta retrospektif olarak degerlendirildi. Ya §, cins, etyolojikfaktor, hastanede kall § siiresi, tedavi ve sonuflan incelendi. Olgulann 4'ii erkek 1'i bayandl ve ya §lan 40-55 arasmdaydl (ortalama:49.6). diafragma paralizisi 4 hastada post-travmatik, 1 hastada da cerrahi sonraSl idi. Biitiin hastalar dispne ile kendilerini belli ettiler. Biitiin hastalarda gogiis grafisinde sol hemidiafragmmn yiiksekliifi ile birlikte skopide paradoksal hareketi izlendi. . Biitiin hastalar posterolateral torakotomi ile sol diafragmatik plikasyon gefirdiler. Postoperatif komplikasyon veya oliim goriilmedi. Sonuf olarak; diafragmatik plikasyon, tek tarafll diafragmatik paralizi nedeniyle dispnesi olan eri §kin hastalarda giivenli ve etkili bir yontemdir. Anahtar kelimeler: Diafragmatik paralizi, Plikasyon, Eri §'kin UNILATERAL DIAPHRAGMATIC PARALYSIS AND DIAPHRACMATIC PLICATION IN ADULTS SUMMARY Unilaral diaphragmatic paralysis resulting from nonmalignant causes, an uncommon condition in adult. Common causes include trauma, neuromuscular disorders, iatrogenic, cervical spondylosis and infection. Between January 1996 and May 2003 Five adult patients who had undergone diaphragmatic plication due to diaphragmatic paralysis were retrospectively analyzed. Age, gender, etiologic factors, hospital stay, management and outcomes were revieved.