Publisher: Mustafa Hasbahceci (Total: 1 journals)   [Sort alphabetically]

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Archives of Clinical and Experimental Medicine     Open Access  
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Archives of Clinical and Experimental Medicine
Number of Followers: 0  

  This is an Open Access Journal Open Access journal
ISSN (Online) 2564-6567
Published by Mustafa Hasbahceci Homepage  [1 journal]
  • Choledochoduodenostomy for failed endoscopic treatment of common bile duct
           stones. Both traditional and current method

    • Authors: Mehmet Can AYDIN; Oğuzhan ÖZŞAY, Kağan KARABULUT
      Abstract: Background: The gold standard current treatment for common bile duct (CBD) stones is stone extraction via endoscopic retrograde cholangiopancreatography (ERCP). In ERCP failed cases, alternative surgical treatment methods come to the fore. Choledochoduodenostomy (CDD), which is a traditional method, is one of them. We aimed to present our conventional CDD results in ERCP failed patients.Methods: Between March 2015 and February 2022, clinicodemographics, perioperative findings, and postoperative results of 23 ERCP failed patients with underwent CDD for CBD stones were analyzed retrospecificleyResults: The median age was 71 (41-85), and 13 (56%) were female. Of the patients, 5 (21%) had cholecystectomy and 7 (30%) had gastrectomy + gastroenterostomy, previously. The most common presenting symptom was abdominal pain (39%). The median number of failed ERCPs was 1 (1-6), and the reasons for failure were gastroenterostomy in 7 patients, impacted stones in 9, multiple and/or large stones in 6, and papillary opening anomaly in 1. The median CBD diameter was 15 (10-40) mm. The median operation time was 120 (60-240) minutes, and no perioperative complication developed. The median length of hospital stay was 7 (4-14) days. In the early postoperative period, wound infection was observed in 2 (8%) patients, and evisceration was observed in 1 (4%). There was no mortality. The mean follow-up period was 27 (2-77) months, and incisional hernia was encountered in 2 (8%) patients in the late postoperative period. There was no evidence of Sump syndrome within the follow-up period.Conclusion: In treatment of ERCP failed CBD stones, CDD is an effective and safe surgical treatment method in selected patients.
      PubDate: Mon, 01 Aug 2022 00:00:00 +030
       
  • Influence of weekly endoscopic debridement on success rate of endoscopic
           transcanalicular diode laser dacryocystorhinostomy

    • Authors: Cevat UÇAR; Selim GENÇ
      Abstract: Aim: To evaluate the outcomes of transcanalicular diode laser DCR (TL-DCR) in patients with chronic dacryostenosis.Methods: In this retrospective study we included 75 eyes of 67 patients with chronic dacryostenosis who underwent TL-DCR. In 65 patients transnasal endoscopic debridement the opening and nasalacrimal syringing was performed every week for 1 month (Group 1, 65 patients). The later patients who did not have postoperative visits were defined as Group 2 (10 patients). All patients were examined at postoperative 3 months.Results: In group 1, 65 of 63 patients had complete surgical success and two had restenosis. In group 2, six of 10 patients had success however four had restenosis. In group 1 the surgical success rate was 98% whereas it was 60% in group 2 (p< 0.001). None of the patients had any serious complications including infection and bleeding.Conclusions: The surgical success rate of TL-DCR may increase by endoscopic debridement after the surgery.
      PubDate: Mon, 01 Aug 2022 00:00:00 +030
       
  • Anesthesia management in patients with abnormally invasive placenta: A
           single-center experience

    • Authors: Güneş Özlem YILDIZ; Canberk ÇETİNEL, Elif MARANGOZ, Özlem Melike EKŞİ, Fidan AYGÜN, Sema KARAKAŞ, Gökhan SERTÇAKACILAR
      Abstract: Aim: Postpartum hemorrhage is a life-threatening obstetric emergent clinical situation accompanied by blood loss of more than 500 ml after vaginal delivery and more than 1000 ml after cesarean section. This situation, frequently encountered in placental adhesion anomalies, is essential in terms of follow-up, treatment, and multidisciplinary management. We aimed to retrospectively evaluate the perioperative anesthesia management, transfusion requirement, and postoperative intensive care unit requirement of patients diagnosed with placental invasion anomaly who had an intraoperative hemorrhageMethods: In our single-center study, a total of 58 female patients diagnosed with of placental invasion anomaly with a cesarean section between 2017-2020 were examined. Patients under 18 years of age and missing data were excluded from the study. Demographic data of patients (age, American Society of Anesthesiologists score (ASA)), diagnosis, duration of operation, perioperative laboratory findings, anesthesia type, perioperative hemodynamics (highest heart rate, lowest mean arterial pressure, shock index), amount of bleeding, blood products, and fluids used, surgical interventions (B-Lynch, Bacri balloon application, uterine artery ligation, hysterectomy), intraoperative vasopressor/inotrope use, ICU stay, laboratory results in the first 24 hours postoperatively, and total hospital stay were recorded.Results: In the preoperative evaluation, 27 (46.5%) patients were diagnosed with placenta accreta, and placenta previa was diagnosed in 19 (32.7%) patients. Perioperatively mean of 3.08 ± 1.7 units of Red blood cell was used. In patients with postoperative intensive care unit hospitalization, the highest intraoperative lactate value was 3.5±1.8 mmol/L, shock index was 1.3±0.3 (0.6-1.8). In patients given intraoperative fibrinogen concentrate, the intraoperative shock index was 1.5±0.2 (0.9-1.8), the amount of intraoperative bleeding was 2575±302.2 ml, and the fibrinogen levels measured in the first 24 hours after surgery were 294.7±79.7 mg/dl.Conclusions: Anesthesia management of patients diagnosed with abnormal placental invasion is important because of significant hemorrhage. Due to unstable hemodynamics, preoperative blood product preparation with a multidisciplinary approach and a postoperative intensive care unit plan should be made for these patients.
      PubDate: Mon, 01 Aug 2022 00:00:00 +030
       
  • The Significance of Novel Hematologic Inflammatory Parameters in
           Predicting Aortic Valve Sclerosis

    • Authors: Özge ÇAKMAK KARAASLAN; Funda BAŞYIĞIT
      Abstract: Aim: Inflammatory process plays a critical role in the progression of aortic valve sclerosis (AVS). This study aims to evaluate the haematological and biochemical inflammatory markers in AVS patients.Methods: A retrospective observational study was included consecutive 557 patients who underwent an echocardiogram between June 2021 and September 2021. The study population was divided into two groups according to the presence of AVS. The groups were compared in terms of C-reactive protein (CRP), Neutrophil-lymphocyte ratio (NLR), platelet-lymphocyte ratio (PLR), and monocyte-HDL cholesterol ratio (MHR).Results: The mean age was 63 ± 10 years. C-reactive protein (CRP), NLR, PLR and MHR were significantly higher in patients with AVS. The best cut-off values of the NLR were 1.4 (a sensitivity of 84%, a specificity of 74%), PLR was 116 (a sensitivity of 75%, a specificity of 54%), and MHR was 9.5 (a sensitivity of 78%, a specificity of 75%). CRP (OR: 1.246, 95% CI: 1.117 – 1.389; p < 0.001), NLR (OR: 2.10, 95% CI: 1.456 – 3.032; p < 0.001), and MHR (OR: 1.227, 95% CI: 1.125 – 1.339; p < 0.001) were independent predictors of the AVS when NLR and MHR analysed as a continuous variable. Using a cut off level of NLR > 1.4 (OR: 4.825, 95% CI: 2.430 – 9.583; p < 0.001) and MHR > 9.5 (OR: 13.937, 95% CI: 7.464 – 26.023; p < 0.001) were independent predictors of the AVS.Conclusion: Increased CRP levels, NLR and MHR were found to be independent predictors for AVS. Hematological inflammatory biomarkers are cost effective and helpful approach for prediction of AVS presence.
      PubDate: Mon, 01 Aug 2022 00:00:00 +030
       
  • Effect of COVID-19 pandemic on surgical treatment of inguinal hernia: A
           retrospective study

    • Authors: İbrahim Ethem CAKCAK; Mert KAPTAN
      Abstract: Aim: In this study, we aimed to examine the effect of the COVID 19 pandemic on the number, complication rates and epidemic characteristics of patients operated with the diagnosis of inguinal hernia in our institute.Methods: We analyzed all patients who underwent inguinal hernia operation in Trakya University Faculty of Medicine, Dept of General Surgery, between March 11, 2019, and March 11, 2020, and compared them with the cases between March 11, 2020, and March 11, 2021, retrospectively. Percentages, mean, standard deviation, median and interquartile range were used as the descriptive statistics. Mann-Whitney U test was used for the variations which are contrary to the normal distribution range in the comparison of two groups. The relations between qualitative variations were studied by the Pearson Chi-Square test and Fisher's Exact test. Significant value was determined as 0.05 for all statistical analyses.Results: Between March 11, 2019, and 2020, 65 patients were operated on (Group 1), and 26 patients between March 11, 2020, and 2021 (Group 2). The percentage of female patients was significantly higher in Group 2 (4.6% in Group 1, 23.1% in Group 2, p=0.008) and there was a statistically significant increase in the rate of incarceration and strangulation in Group 2 (44.6% in Group 1, 84.6% in Group 2, p=0.001).Conclusions: During the COVID-19 pandemic the incarceration and strangulation rate was higher. The increase in complication rates can be attributed to the relative decrease in elective surgeries or the increase in the number of female patients admitted during the COVID period.
      PubDate: Mon, 01 Aug 2022 00:00:00 +030
       
  • Does emergency surgery have impact on lymph node harvest in colorectal
           cancer surgery'

    • Authors: Andrej NİKOLOVSKİ; Kristijan DERVİSHOV, Cemal ULUSOY
      Abstract: Aim: Adequate oncologic surgery for colorectal cancer implies proper resection margin of the resected specimen and complete mesocolic excision in order to achieve objective postoperative pathologic staging. Current recommendations require a minimum of 12 lymph nodes retrieval. In emergency colon cancer surgery, questions are raised about its impact on the lymph node number harvest. Aim of this study is to determine the impact of emergency colorectal cancer surgery on the lymph node number retrieval.Methods: Retrospective analysis of 102 patients operated for colorectal cancer in the period of 1 year was conducted. Two groups (emergency and elective) were formed. Six surgeons performed all of the operations (three high-volume and three low-volume surgeons).Results: Twenty patients presented as surgical emergencies and the rest 66 were elective cases. Sixteen patients with stage IV were excluded. Mean number of lymph nodes retrieved in the emergency group was 11.1 [5 - 20], and 14.7 [4 – 34] in the elective one, respectively (p = 0.004). Sufficient number of lymph nodes (≥ 12) extraction was achieved in 7 patients in the emergency group and in 48 patients in the elective one (p = 0.003).Conclusions: Emergency colon cancer surgery did have impact on the lymph node number harvest. Adequate colorectal training is expected to improve the surgical technique in order to achieve reliable TNM staging.
      PubDate: Mon, 01 Aug 2022 00:00:00 +030
       
 
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