serhat doğan - Academia.edu (original) (raw)

Papers by serhat doğan

Archives of Medical Science - Civilization Diseases

Introduction: We aimed to evaluate the effect of stump ligation techniques on operative time in l... more Introduction: We aimed to evaluate the effect of stump ligation techniques on operative time in laparoscopic appendectomy. Material and methods: The patients who underwent laparoscopic appendectomy in our General Surgery Clinic between January 2016 and August 2018 were retrospectively reviewed. The effects of stump ligation techniques used in the operations on operative times were evaluated. Results: Sixty consecutive patients were screened and 3 groups, 20 patients in each group, were formed based on stump ligation techniques. Extracorporeal knotting-loop ligation was used in Group 1; intracorporeal knotting was used in the Group 2; hem-o-lok clip was used in Group 3.There was no statistically significant difference between the groups in terms of gender distribution and mean age. However, there was a significant difference between the hem-o-lok clip group (Group III) and the intracorporeal knot group (Group II) in terms of operative time. Group III had a shorter operative time. The Group III patients had the shortest operative time, while the Group II patients had the longest operative time (p < 0.05). Conclusions: We can speculate that hem-o-lok clip among the stump ligation techniques reduces the cost, is a safe method and shortens the operative time. However, prospective randomized studies with a large sample size comparing different techniques are needed to determine the ideal treatment procedure. At the same time, stapler use may be considered in cases where the base of the appendix is too inflamed or necrosed. It is known that the use of a stapler and endoloop is more expensive than all other techniques. However, the most important issue for the surgeon is patient safety; therefore the most appropriate technique should be preferred.

Archives of Medical Science - Civilization Diseases

Meckel's diverticulum (MD) is the most common congenital anomaly of the gastrointestinal system. ... more Meckel's diverticulum (MD) is the most common congenital anomaly of the gastrointestinal system. It is located approximately 60-80 cm proximal to the cecum, on the antimesenteric face of the small bowels. The average length is 4-6 cm and it is a real diverticulum. It occurs if the omphalomesenteric tract does not close between the 5 th and 7 th weeks of intrauterine life [1]. Meckel's diverticulum was first described in the 16 th century by Fabricus Hildanus. It was embryologically described and named by the German Johann Friedrich Meckel in 1809 [2, 3]. The rule of 2s is a useful memory aid. MD occurs in 2% of the population, is 2 inches (5 cm) long, 2 feet (60 cm) from the ileocecal valve, two thirds have ectopic mucosa, 2 types of ectopic tissue are commonly present (mostly gastric and pancreatic) and 2% become symptomatic [4-6]. Patients usually have nonspecific complaints such as nausea, vomiting, abdominal pain, and loss of appetite [7]. These findings were exacerbated after perforation and abdominal symptoms may progress. Many complications occur such as massive gastrointestinal hemorrhage [8], cecal volvulus [9], ileus [10], subphrenic abscess [11], small bowel torsion due to MD [12], and perforation, as in our case and in the literature. The mortality rate is reported to be between 1.6% and 7.7% [13]. Mortality usually occurs in delayed cases and with intestinal gangrene [7]. Here we present our case, which was diagnosed as spontaneous MD perforation due to acute abdomen, in light of the literature. A 27-year-old male patient presented with abdominal pain, anorexia, nausea and fever to the emergency department. The patient was examined in emergency service. On physical examination, rebound tenderness and guarding was positive. The patient had an acute abdomen. There was nothing in his anamnesis. Digital rectal examination was performed. The rectum was empty and without hemorrhage. In the patient's blood tests, white blood count (WBC) was 26.52 10 3 /Ul, glucose 131 mg/dl, lactic dehydrogenase 350 U/l, creatine kinase 2742 U/l, C-reactive protein 4.89 mg/dl, sodium 135 mmol/l. The patient's complete urinalysis included 7 erythrocytes/HPF and 3 leukocytes/HPF. Nothing was detected in the direct abdominal X-ray (Figure 1). Abdominal ultrasonography report of the patient: "Mesenteric echo is heterogeneous

Selcuk Tip Dergisi

Kırk bir yaşında kadın ve 64 yaşında bir erkek hasta karın ağrısı nedeniyle kliniğimize başvurdu.... more Kırk bir yaşında kadın ve 64 yaşında bir erkek hasta karın ağrısı nedeniyle kliniğimize başvurdu. Yapılan tetkiklerinde her iki vakada da karaciğerde dev hemanjiom olduğu raporlandı. Her iki vakada semptomatik olması ve malignite şüphesi olması nedeniyle operasyon kararı alındı. Operasyon esnasında kitlenin karaciğer kaynaklı olmadığı, sağ sürrenal kaynaklı dev adenom olduğu görüldü, ikinci vakada da kitlenin sağ böbrek kaynaklı olduğu görüldü. Rezeksiyon yapıldı. Sürrenal bölgedeki kitlelerin hemanjiomlarla karıştırılabileceği unutulmamalıdır.

Annals of Medical Research

Archives of Medical Science - Civilization Diseases

Turkish Journal of Surgery, 2015

Objective: Retrospective proctocolectomy is a distinguished, sphincter saving treatment used for ... more Objective: Retrospective proctocolectomy is a distinguished, sphincter saving treatment used for the treatment of ulcerative colitis and FAP disease. We aimed to evaluate ileal pouch interventions performed at our clinic and their results in the light of literature. Material and Methods: Medical records of 35 restorative proctocolectomy and J pouch ileo-anal anastomosis surgeries performed at Necmettin Erbakan University, Meram School of Medicine between the years 2006-2013 were retrospectively examined. The patients were assessed according to their age, gender, length of hospital stay, diagnosis, follow-up duration and pouch-related complications. All patients were contacted by phone and they were scheduled for controls at the outpatient clinic. Results: Nineteen patients were male (54%) and 16 were female (46%). Their mean age was 45 years (21-74). The mean length of hospital stay was 11 (5-20) days. Twenty two (63%) patients were operated on due to FAP, 12 (34%) due to synchronous rectum cancer and colon tumor or polyp, and one (3%) due to ulcerative colitis. All patients received J pouch and protective ileostomy. After the closure of ileostomy, two cases were identified to have J pouch fistulas. The patients were followed up for 6 months to 7 years. They were contacted by phone and they were questioned about their active complaints, number of defecations, urinary and sexual dysfunctions. It was identified that they had 5 (3-8) defecations per day on average and that 4 (11%) cases had one nocturnal defecation. No pouchitis was identified in the follow-up endoscopic examinations. Conclusion: Restorative proctocolectomy and ileo-anal anastomosis technique is a surgical procedure that can be performed with low rates of morbidity and mortality, including the elderly.

Archives of Medical Science - Civilization Diseases

Introduction: We aimed to evaluate the effect of stump ligation techniques on operative time in l... more Introduction: We aimed to evaluate the effect of stump ligation techniques on operative time in laparoscopic appendectomy. Material and methods: The patients who underwent laparoscopic appendectomy in our General Surgery Clinic between January 2016 and August 2018 were retrospectively reviewed. The effects of stump ligation techniques used in the operations on operative times were evaluated. Results: Sixty consecutive patients were screened and 3 groups, 20 patients in each group, were formed based on stump ligation techniques. Extracorporeal knotting-loop ligation was used in Group 1; intracorporeal knotting was used in the Group 2; hem-o-lok clip was used in Group 3.There was no statistically significant difference between the groups in terms of gender distribution and mean age. However, there was a significant difference between the hem-o-lok clip group (Group III) and the intracorporeal knot group (Group II) in terms of operative time. Group III had a shorter operative time. The Group III patients had the shortest operative time, while the Group II patients had the longest operative time (p < 0.05). Conclusions: We can speculate that hem-o-lok clip among the stump ligation techniques reduces the cost, is a safe method and shortens the operative time. However, prospective randomized studies with a large sample size comparing different techniques are needed to determine the ideal treatment procedure. At the same time, stapler use may be considered in cases where the base of the appendix is too inflamed or necrosed. It is known that the use of a stapler and endoloop is more expensive than all other techniques. However, the most important issue for the surgeon is patient safety; therefore the most appropriate technique should be preferred.

Archives of Medical Science - Civilization Diseases

Meckel's diverticulum (MD) is the most common congenital anomaly of the gastrointestinal system. ... more Meckel's diverticulum (MD) is the most common congenital anomaly of the gastrointestinal system. It is located approximately 60-80 cm proximal to the cecum, on the antimesenteric face of the small bowels. The average length is 4-6 cm and it is a real diverticulum. It occurs if the omphalomesenteric tract does not close between the 5 th and 7 th weeks of intrauterine life [1]. Meckel's diverticulum was first described in the 16 th century by Fabricus Hildanus. It was embryologically described and named by the German Johann Friedrich Meckel in 1809 [2, 3]. The rule of 2s is a useful memory aid. MD occurs in 2% of the population, is 2 inches (5 cm) long, 2 feet (60 cm) from the ileocecal valve, two thirds have ectopic mucosa, 2 types of ectopic tissue are commonly present (mostly gastric and pancreatic) and 2% become symptomatic [4-6]. Patients usually have nonspecific complaints such as nausea, vomiting, abdominal pain, and loss of appetite [7]. These findings were exacerbated after perforation and abdominal symptoms may progress. Many complications occur such as massive gastrointestinal hemorrhage [8], cecal volvulus [9], ileus [10], subphrenic abscess [11], small bowel torsion due to MD [12], and perforation, as in our case and in the literature. The mortality rate is reported to be between 1.6% and 7.7% [13]. Mortality usually occurs in delayed cases and with intestinal gangrene [7]. Here we present our case, which was diagnosed as spontaneous MD perforation due to acute abdomen, in light of the literature. A 27-year-old male patient presented with abdominal pain, anorexia, nausea and fever to the emergency department. The patient was examined in emergency service. On physical examination, rebound tenderness and guarding was positive. The patient had an acute abdomen. There was nothing in his anamnesis. Digital rectal examination was performed. The rectum was empty and without hemorrhage. In the patient's blood tests, white blood count (WBC) was 26.52 10 3 /Ul, glucose 131 mg/dl, lactic dehydrogenase 350 U/l, creatine kinase 2742 U/l, C-reactive protein 4.89 mg/dl, sodium 135 mmol/l. The patient's complete urinalysis included 7 erythrocytes/HPF and 3 leukocytes/HPF. Nothing was detected in the direct abdominal X-ray (Figure 1). Abdominal ultrasonography report of the patient: "Mesenteric echo is heterogeneous

Selcuk Tip Dergisi

Kırk bir yaşında kadın ve 64 yaşında bir erkek hasta karın ağrısı nedeniyle kliniğimize başvurdu.... more Kırk bir yaşında kadın ve 64 yaşında bir erkek hasta karın ağrısı nedeniyle kliniğimize başvurdu. Yapılan tetkiklerinde her iki vakada da karaciğerde dev hemanjiom olduğu raporlandı. Her iki vakada semptomatik olması ve malignite şüphesi olması nedeniyle operasyon kararı alındı. Operasyon esnasında kitlenin karaciğer kaynaklı olmadığı, sağ sürrenal kaynaklı dev adenom olduğu görüldü, ikinci vakada da kitlenin sağ böbrek kaynaklı olduğu görüldü. Rezeksiyon yapıldı. Sürrenal bölgedeki kitlelerin hemanjiomlarla karıştırılabileceği unutulmamalıdır.

Annals of Medical Research

Archives of Medical Science - Civilization Diseases

Turkish Journal of Surgery, 2015

Objective: Retrospective proctocolectomy is a distinguished, sphincter saving treatment used for ... more Objective: Retrospective proctocolectomy is a distinguished, sphincter saving treatment used for the treatment of ulcerative colitis and FAP disease. We aimed to evaluate ileal pouch interventions performed at our clinic and their results in the light of literature. Material and Methods: Medical records of 35 restorative proctocolectomy and J pouch ileo-anal anastomosis surgeries performed at Necmettin Erbakan University, Meram School of Medicine between the years 2006-2013 were retrospectively examined. The patients were assessed according to their age, gender, length of hospital stay, diagnosis, follow-up duration and pouch-related complications. All patients were contacted by phone and they were scheduled for controls at the outpatient clinic. Results: Nineteen patients were male (54%) and 16 were female (46%). Their mean age was 45 years (21-74). The mean length of hospital stay was 11 (5-20) days. Twenty two (63%) patients were operated on due to FAP, 12 (34%) due to synchronous rectum cancer and colon tumor or polyp, and one (3%) due to ulcerative colitis. All patients received J pouch and protective ileostomy. After the closure of ileostomy, two cases were identified to have J pouch fistulas. The patients were followed up for 6 months to 7 years. They were contacted by phone and they were questioned about their active complaints, number of defecations, urinary and sexual dysfunctions. It was identified that they had 5 (3-8) defecations per day on average and that 4 (11%) cases had one nocturnal defecation. No pouchitis was identified in the follow-up endoscopic examinations. Conclusion: Restorative proctocolectomy and ileo-anal anastomosis technique is a surgical procedure that can be performed with low rates of morbidity and mortality, including the elderly.