Safra kesesi polipleri , safra kesesi mukozasından köken alan lezyonlardır. Bu çalışmada, kliniği... more Safra kesesi polipleri , safra kesesi mukozasından köken alan lezyonlardır. Bu çalışmada, kliniğimizde preoperatif safra kesesi polibi tanısı alarak cerrahi girişim uygulanan olgular patolojik tanıları ile tartışılmakta ve cerrahi endikasyon koyduracak kriterlerin tanımlanması amaçlanmaktadır. : Kliniğimizde Ocak 1995 ile Haziran 2003 tarihleri arasında preopeeratif safra kesesi polibi tanısı alan olgular demografik özellikleri, klinik ve abdominal ultrasonografi bulguları, yapılan cerrahi tedavi, histopatolojik tanıları, morbidite ve mortalite açısından retrospektif olarak değerlendirildi. Kolesistektomi yapılan 1420 olgunun otuzüçü de (%2,3) preoperatif safra kesesi polibi tanısı almıştır. Karın ağrısı en sık rastlanılan semptom idi.Tüm olgulara abdominal ultrasonografi ile tanı konulmuş olup görüntülemede, 3 olguda sesil, 30 olguda ise pediküllü polip bulunurken, 7 olguda ek olarak kolelithiasis saptandı. Tedavide 8 olguda laparoskopik, 25 olguda ise açık olarak kolesistektomi yapıldı. Histopatolojik incelemede ; 16 olguda sadece kolelithiasis ve kronik kolesistit, 14 olguda kolesterol polibi, 2 olguda adenomatöz polip, 1 olguda ise adenokarsinom saptandı. Safra kesesi poliplerinde cerrahi tedavi, tüm semptomatik, beraberinde kolelitiasis olan, polip boyutu 10 mm geçen ve ultrasonografik olarak malignite riski taşıyan olgularda yapılmalıdır. Safra kesesi, polip, cerrahi.
We present a 48-year-old caucasian woman presenting with anal pain, discharge and diffi culty in ... more We present a 48-year-old caucasian woman presenting with anal pain, discharge and diffi culty in defecation due to recurrent Buschke-Lowenstein tumor with rectal involvement discuss it in the light of literature. A 48-year old caucasian woman was referred to our institute with anal mass causing pain, discharge and diffi-culty in defecation. She initially had simple excision and electro-coterisation 3 and 15 years before at different centers. At physi-cal examination, multiple vegetative mass lesions presented as a caulifl ower-like tumor were seen at perianal region. Colonoscopy showed an infl amated, vegetative mass covering all mucosa annu-larly and starting from 2 cm away from anal verge and reaching un-til 20 cm was seen. Due to the large extent of tumor invasion in this case, curative surgery would have been achieved only by wide local surgical excision and abdominoperineal resection due to rectal in-volvement. This severe mutilation was refused by the patient. Thus, patient wa...
The treatment of staple line leaks after gastric conduit remains controversial. We present a case... more The treatment of staple line leaks after gastric conduit remains controversial. We present a case of 59-year-old man with distal esophagous cancer. The patient underwent IvorLewis procedure with gastric conduit. The dehiscence of the staple line occured on the postoperative course. We report our experience in the management of a patient,and of the various treatment proposals.
Journal of Clinical and Experimental Investigations, 2013
Amac: Bu calismada prospektif olarak laparoskopik total ekstraperitoneal (TEP) kasik fitigi onari... more Amac: Bu calismada prospektif olarak laparoskopik total ekstraperitoneal (TEP) kasik fitigi onarimi ile konvansiyonel Lichtenstein yontemi karsilastirmak amaclanmistir. Yontemler: Kasik fitikli 50 olgu (25 konvansiyonel, 25 laparoskopik) calismaya alindi. Prospektif olarak ameliyat oncesi olgulara ait yas, cinsiyet, vucut kitle indeksi (BMI), kasik fitigi turu (Nyhus siniflamasi), Amerikan Anesteziyoloji Dernegi risk skorlamasi (ASA), ilk cilt insizyonundan kapatilmaya kadar gecen ameliyat sureleri, peroperatif ve postoperatif komplikasyonlar, postoperatif donemde agri skoru, analjezik ihtiyaci, hastanede kalis suresi, normal fizik aktiviteye donus sureleri ve nuks acisindan incelenmistir. Hastalarin tumunun agri skorlamasi icin vizuel analog skala (VAS) kullanilmistir. Bulgular: Olgularin 46(%92)\'si erkek olup ortalama yas 50,9 (17-78) idi. Sirasi ile ortalama BMI degerleri 25,7 ve 25,8 olan gruplar arasi demografik ozellikler bakimindan fark veya istatiksel anlamlilik y...
Renal cell carcinoma is an urologic malignancy with poor prognosis. Local invasion and distant me... more Renal cell carcinoma is an urologic malignancy with poor prognosis. Local invasion and distant metastasis determine the prognosis of the disease. Dissemination to inferior vena cava via renal vein is seen in 4-10% of the patients. The role of radiotherapy and chemotherapy is limited, surgery is the only curative treatment option and patients with liver metastasis also benefit from surgery. In patients with vena cava trombosis, cavotomy and trombectomy should be done to prolong survival, if nodal or visseral metastasis is not present. Surgical procedure differs according to location of trombus in inferior vena cava. In our case report, a patient treated with right nephrectomy due to renal cell carcinoma 3 years ago who was re-operated for vena caval trombus is mentioned. Operation was done without using Pringle technique (clamping of hepatic pedicle) by mobilization of the liver with piggy back technique, and after cavotomy and trombus excision, defect in vena cava was reconstructed ...
Received: August 21, 2017; Accepted: September 18, 2017; Published: September 21, 2017 We would l... more Received: August 21, 2017; Accepted: September 18, 2017; Published: September 21, 2017 We would like to draw readers attention to colocutanous fistulas,notable rare in this letter. In this report, we present a patient with colonic diverticular disease Type III according to Hinchey classification mimicking subcutaneous abscess and despite effective antiinflammatory therapy and drainage resulting colocutanous fistula. However, internal fistulas of diverticular diseases are well-defined in literature, colocutaneous fistulas well not documanted after percutane drainage of a cutanous abscess [1-3].
Background: Incisional hernia that may occur following abdominal surgeries affect the quality of ... more Background: Incisional hernia that may occur following abdominal surgeries affect the quality of life and lead to loss of labor by causing morbidity. It is a continuing problem of surgery due to high rates of prevalence and morbidity. This study aimed to compare laparoscopic versus conventional method of incisional hernia repair. Methods: Forty patients with incisional hernia who underwent hernia repair by laparoscopic (n = 20) or conventional (n = 20) technique between January 2010 and January 2011 in our clinic were included in the study . Preoperative, peroperative and postoperative data were collected prospectively, and the patients were followed up for a period of 1 year. Results: No statistical difference was found between two hernia repair groups in terms of age, sex, number of previous abdominal surgery, distribution of incisional hernia and size of the defect. Mean body mass index (BMI) was significantly (P = 0.001) greater in laparoscopic group. No statistical difference w...
This study evaluated the shrinkage of surgical margins in colorectal specimens prior to resection... more This study evaluated the shrinkage of surgical margins in colorectal specimens prior to resection and at final examination and established a correction factor to ensure a sufficient resection margin. The proximal and distal surgical margins in normal anatomic positions were measured in patients with colorectal cancer prior to resection during surgery. Fresh specimens were sent to the pathology laboratory, and the distance of the tumor to the proximal and distal margins were measured before formalin fixation and after 24 h formalin fixation. The mean proximal surgical margins prior to resection, after resection, at 24 h after fixation, and after a histopathological examination were 19.8 (SD7.1) cm, 17 (SD7.5) cm, 14 (SD5.6) cm, and 13. 6 (SD5.3) cm, respectively. The values for the distal surgical margin were 12 (SD10.9) cm, 10.3 (SD9) cm, 7. 9 (SD7.7) cm and 7.7 (SD6.4) cm in respective order. The correction factor calculated for the proximal and distal resection margins prior to resection and after the final pathological examination were 1.45 and 1.55, respectively. It would be beneficial to establish and make use of correction factors when predicting shrinkages in surgical margins in curative colorectal cancer surgery.
Wandering spleen is a rare clinical entity characterised by splenic hypermobility resulting from ... more Wandering spleen is a rare clinical entity characterised by splenic hypermobility resulting from laxity or maldevelopment of the suspensary gastrosplenic, splenorenal, and phrenicocolic ligaments. Diagnosis is quite difficult because of the lack of symptoms and signs until splenic torsion have occured. In this article, we present and discuss a 23-year-old caucasian woman presenting with acute abdomen, diagnosed as splenic torsion by ultrasound and magnetic resonance imaging and managed surgically.
Objective We reported the demographic, clinical, radiologic, preoperative and postoperative chara... more Objective We reported the demographic, clinical, radiologic, preoperative and postoperative characteristics and outcomes on patients of appendix mucocele that presented with or operated for acute appendicitis or acute abdomen. Methods A retrospective study. Patients who were presented or operated for acute appendicitis or acute abdomen and had an operative histopathological diagnosis as appendix mucocele (simple mucocele, mucinous cystadenoma, mucinous cystadenocarcinoma) were included. Demographic, clinical, radiologic, preoperative and postoperative data of eligible cases were evaluated. Results From January 2003 to February 2010, a total of 2120 patients with the pre-operative diagnosis of acute appendicitis were treated in our center, and nine (0.42%) patients were diagnosed to have mucocele of the appendix. Seven patients (78%) were female. Average age of the patients was 59.5 (range=25-74). Major complaint was right lower quadrant pain in eight (89%) patients. In preoperative ...
We present a 48-year-old caucasian woman presenting with anal pain, discharge and difficulty in d... more We present a 48-year-old caucasian woman presenting with anal pain, discharge and difficulty in defecation due to recurrent Buschke-Lowenstein tumor with rectal involvement discuss it in the light of literature. A 48-year old caucasian woman was referred to our institute with anal mass causing pain, discharge and difficulty in defecation. She initially had simple excision and electrocoterisation 3 and 15 years before at different centers. At physical examination, multiple vegetative mass lesions presented as a cauliflower-like tumor were seen at perianal region. Colonoscopy showed an inflamated, vegetative mass covering all mucosa annularly and starting from 2 cm away from anal verge and reaching until 20 cm was seen. Due to the large extent of tumor invasion in this case, curative surgery would have been achieved only by wide local surgical excision and abdominoperineal resection due to rectal involvement. This severe mutilation was refused by the patient. Thus, patient was referre...
Anaplastic carcinoma of the pancreas (ACP) is a very rare histologic subtype of pancreatic cancer... more Anaplastic carcinoma of the pancreas (ACP) is a very rare histologic subtype of pancreatic cancer and associated with more aggressive and poor prognosis than pancreatic ductal adenocarcinoma. We aimed to review this rare entity and discuss its clinical features, diagnosis and therapy. We presented a case of a 63-year-old male patient that diagnosed as ACP with cyst formation at a tertiary medical center with a detailed review of the current medical literature. We performed pancreaticoduodenectomy operation with lymph node dissection after diagnosis. Any complication after surgery was not observed. Anaplastic pancreas carcinomas are associated with poor survival when compared to invasive ductal adenocarcinomas. Clinical, radiological, laboratory and histological features may be helpful in making differential diagnosis and should be kept in mind in the diagnosis of this rare pancreatic malignancy.
Jaundice that develops following laparoscopic cholecystectomy is a troublesome experience for the... more Jaundice that develops following laparoscopic cholecystectomy is a troublesome experience for the surgeon which requires invasive management after a challenging diagnosis period. Jaundice is. We aimed to present our experience with a rare complication of jaundice in a patient that occurred due to the compression of an isolated drain without choledoc canal injury. A 63-year-old female patient underwent laparoscopic cholecystectomy due to symptomatic gallstone. The patient developed post-operative jaundice which was detected by upper abdominal magnetic resonance (MR) and magnetic resonance cholangiopancreatography (MRCP) to result from compression by the silicon drain on main hepatic canal. The patient was discharged upon removal of the silicon drain with recovery in biochemical and radiological parameters. To the best of our knowledge, our study is the first to report jaundice developing due to extrahepatic bile duct obstruction caused by isolated drain compression. Although this rar...
Stromal tumor of the duodenum is rarely seen among the gastrointestinal stromal tumors. In this p... more Stromal tumor of the duodenum is rarely seen among the gastrointestinal stromal tumors. In this paper, a patient presented with obscure gastrointestinal bleeding and the small bowel endoscopy revealed a bleeding ulcer at the second part of duodenum. The patient underwent segmental duodenectomy. The histopathology of the mass confirmed the diagnosis of duodenal stromal tumor.
Gastric duplication cysts (GDCs) are uncommon developmental anomalies found primarily in children... more Gastric duplication cysts (GDCs) are uncommon developmental anomalies found primarily in children, being rarely seen in adults. Duplications can occur anywhere in the intestinal tract from the mouth to the anus. Accurate diagnosis of cysts before resection is difficult even using the most advanced imaging techniques. In this report, we present and discuss a case of GDC in a 25-year-old man treated laparoscopically. Patient admitted to our department with complaints of epigastric pain and swelling. Magnetic resonance imaging performed for accurate characterisation showed a 4 cm × 4.5 cm cystic lesion, with heterogeneous signal intensity on T2-weighted images, located in the posterior wall of the stomach. Pre-operative differential diagnosis including gastrointestinal stromal tumour (GIST) was made according to radiological findings. Patient underwent surgery and cyst resected laparoscopically. Histopathological examination suggesting duplication cyst. GDC can easily be mistaken for a...
Background Groove pancreatitis is a form of focal chronic pancreatitis in the pancreatic tissue b... more Background Groove pancreatitis is a form of focal chronic pancreatitis in the pancreatic tissue between the duodenal wall and the intrapancreatic portion of the common bile duct. Groove pancreatitis, paraduodenal pancreatitis, and duodenal dystrophy are regarded as synonyms by some authors whereas others
Mastitis is inflammation of the breast tissue that may or may not originate from an infection. Tw... more Mastitis is inflammation of the breast tissue that may or may not originate from an infection. Two different forms of mastitis have been described, lactational and non-lactational. Lactational mastitis is the most common infection of the breast, usually associated with fever, pain, redness, and swelling in a breast-feeding mother. It is generally seen in the first six weeks of the postpartum period. Conservative therapy including milk removal and physical therapy generally provides symptomatic relief but antibiotic therapy is also needed (1, 2). Mastitis does not always occur during lactation. Common types of non-lactational mastitis are periductal mastitis and idiopathic granulomatous mastitis. Periductal mastitis is the inflammation of subareolar ducts, which is especially seen in young women; smoking increases risk. Periductal mastitis treatment includes antibiotics combined with needle aspiration or incision and abscess drainage but it is usually a chronic process and needs surgical treatment with excision of the diseased duct (3, 4). Idiopathic granulomatous mastitis (IGM) is benign inflammation of breast with unknown etiology. IGM may be associated a mass, pain, abscess, nipple retraction, sinus or fistula formation, and mimics malignancy. Treatment includes antibiotics, drainage, surgery, and steroids (5). The therapeutic management algorithm of chronic breast inflammation is unclear and has no consensus. The use of negative-pressure wound therapy (NPWT) was first reported in traumatology. NPWT systems have become a common treatment choice for acute, sub-acute, and chronic wounds (6). Use of NPWT in breast wounds is not common and there are insufficient publications in the literature to support its use. In this report, we present and discuss two patients with chronic breast inflammation due to idiopathic granulomatous mastitis and periductal mastitis who underwent surgery and were successfully treated with NPWT to minimize wide tissue defects and cosmetic problems after surgery. Case Presentations Case 1 A woman aged 31 years was admitted to our department with symptoms of right breast pain, swelling and redness. Her past medical history did not include any diseases. The patient's physical examination revealed erythema, hyperemia and a fluctuating mass in the right upper
There is still an ongoing debate, especially regarding early diagnosis of acute appendicitis. Ear... more There is still an ongoing debate, especially regarding early diagnosis of acute appendicitis. Early surgery leads to inadequate evaluation of acute abdominal pain and negative appendectomy, whereas delayed surgery leads to appendicitis perforation complications. The diagnosis of this condition is considerably difficult, especially due to subtle early symptoms and clinical condition. The aim of the present study was to identify whether the Alvarado scoring system could reduce the incidence of negative appendectomy in patients who will undergo surgery for acute appendicitis. Patients who underwent surgery with acute appendicitis prediagnosis were retrospectively classified as negative appendectomies (group A) and positive appendectomies (group B) according to histological diagnosis. All groups were evaluated for age, gender, Alvarado scores, and parameters. Two hundred eighty-one patients were included in the study. Group A contained 71 (25.3 %) patients, and group B contained 210 (74.7 %) patients. There was a significant difference in WBC, left shift, rebound, and change of pain localization between the groups (p = 0.002, p < 0.001, p < 0.001, and p = 0.023, respectively). Alvarado scores were significantly different between the groups (p < 0.001). In logistic model examination, the major factor was the Alvarado score (7 or above) and the minor factor was spreading pain. The Alvarado scoring system can be used to reduce negative appendectomy in patients who will undergo surgery with acute appendicitis.
Safra kesesi polipleri , safra kesesi mukozasından köken alan lezyonlardır. Bu çalışmada, kliniği... more Safra kesesi polipleri , safra kesesi mukozasından köken alan lezyonlardır. Bu çalışmada, kliniğimizde preoperatif safra kesesi polibi tanısı alarak cerrahi girişim uygulanan olgular patolojik tanıları ile tartışılmakta ve cerrahi endikasyon koyduracak kriterlerin tanımlanması amaçlanmaktadır. : Kliniğimizde Ocak 1995 ile Haziran 2003 tarihleri arasında preopeeratif safra kesesi polibi tanısı alan olgular demografik özellikleri, klinik ve abdominal ultrasonografi bulguları, yapılan cerrahi tedavi, histopatolojik tanıları, morbidite ve mortalite açısından retrospektif olarak değerlendirildi. Kolesistektomi yapılan 1420 olgunun otuzüçü de (%2,3) preoperatif safra kesesi polibi tanısı almıştır. Karın ağrısı en sık rastlanılan semptom idi.Tüm olgulara abdominal ultrasonografi ile tanı konulmuş olup görüntülemede, 3 olguda sesil, 30 olguda ise pediküllü polip bulunurken, 7 olguda ek olarak kolelithiasis saptandı. Tedavide 8 olguda laparoskopik, 25 olguda ise açık olarak kolesistektomi yapıldı. Histopatolojik incelemede ; 16 olguda sadece kolelithiasis ve kronik kolesistit, 14 olguda kolesterol polibi, 2 olguda adenomatöz polip, 1 olguda ise adenokarsinom saptandı. Safra kesesi poliplerinde cerrahi tedavi, tüm semptomatik, beraberinde kolelitiasis olan, polip boyutu 10 mm geçen ve ultrasonografik olarak malignite riski taşıyan olgularda yapılmalıdır. Safra kesesi, polip, cerrahi.
We present a 48-year-old caucasian woman presenting with anal pain, discharge and diffi culty in ... more We present a 48-year-old caucasian woman presenting with anal pain, discharge and diffi culty in defecation due to recurrent Buschke-Lowenstein tumor with rectal involvement discuss it in the light of literature. A 48-year old caucasian woman was referred to our institute with anal mass causing pain, discharge and diffi-culty in defecation. She initially had simple excision and electro-coterisation 3 and 15 years before at different centers. At physi-cal examination, multiple vegetative mass lesions presented as a caulifl ower-like tumor were seen at perianal region. Colonoscopy showed an infl amated, vegetative mass covering all mucosa annu-larly and starting from 2 cm away from anal verge and reaching un-til 20 cm was seen. Due to the large extent of tumor invasion in this case, curative surgery would have been achieved only by wide local surgical excision and abdominoperineal resection due to rectal in-volvement. This severe mutilation was refused by the patient. Thus, patient wa...
The treatment of staple line leaks after gastric conduit remains controversial. We present a case... more The treatment of staple line leaks after gastric conduit remains controversial. We present a case of 59-year-old man with distal esophagous cancer. The patient underwent IvorLewis procedure with gastric conduit. The dehiscence of the staple line occured on the postoperative course. We report our experience in the management of a patient,and of the various treatment proposals.
Journal of Clinical and Experimental Investigations, 2013
Amac: Bu calismada prospektif olarak laparoskopik total ekstraperitoneal (TEP) kasik fitigi onari... more Amac: Bu calismada prospektif olarak laparoskopik total ekstraperitoneal (TEP) kasik fitigi onarimi ile konvansiyonel Lichtenstein yontemi karsilastirmak amaclanmistir. Yontemler: Kasik fitikli 50 olgu (25 konvansiyonel, 25 laparoskopik) calismaya alindi. Prospektif olarak ameliyat oncesi olgulara ait yas, cinsiyet, vucut kitle indeksi (BMI), kasik fitigi turu (Nyhus siniflamasi), Amerikan Anesteziyoloji Dernegi risk skorlamasi (ASA), ilk cilt insizyonundan kapatilmaya kadar gecen ameliyat sureleri, peroperatif ve postoperatif komplikasyonlar, postoperatif donemde agri skoru, analjezik ihtiyaci, hastanede kalis suresi, normal fizik aktiviteye donus sureleri ve nuks acisindan incelenmistir. Hastalarin tumunun agri skorlamasi icin vizuel analog skala (VAS) kullanilmistir. Bulgular: Olgularin 46(%92)\'si erkek olup ortalama yas 50,9 (17-78) idi. Sirasi ile ortalama BMI degerleri 25,7 ve 25,8 olan gruplar arasi demografik ozellikler bakimindan fark veya istatiksel anlamlilik y...
Renal cell carcinoma is an urologic malignancy with poor prognosis. Local invasion and distant me... more Renal cell carcinoma is an urologic malignancy with poor prognosis. Local invasion and distant metastasis determine the prognosis of the disease. Dissemination to inferior vena cava via renal vein is seen in 4-10% of the patients. The role of radiotherapy and chemotherapy is limited, surgery is the only curative treatment option and patients with liver metastasis also benefit from surgery. In patients with vena cava trombosis, cavotomy and trombectomy should be done to prolong survival, if nodal or visseral metastasis is not present. Surgical procedure differs according to location of trombus in inferior vena cava. In our case report, a patient treated with right nephrectomy due to renal cell carcinoma 3 years ago who was re-operated for vena caval trombus is mentioned. Operation was done without using Pringle technique (clamping of hepatic pedicle) by mobilization of the liver with piggy back technique, and after cavotomy and trombus excision, defect in vena cava was reconstructed ...
Received: August 21, 2017; Accepted: September 18, 2017; Published: September 21, 2017 We would l... more Received: August 21, 2017; Accepted: September 18, 2017; Published: September 21, 2017 We would like to draw readers attention to colocutanous fistulas,notable rare in this letter. In this report, we present a patient with colonic diverticular disease Type III according to Hinchey classification mimicking subcutaneous abscess and despite effective antiinflammatory therapy and drainage resulting colocutanous fistula. However, internal fistulas of diverticular diseases are well-defined in literature, colocutaneous fistulas well not documanted after percutane drainage of a cutanous abscess [1-3].
Background: Incisional hernia that may occur following abdominal surgeries affect the quality of ... more Background: Incisional hernia that may occur following abdominal surgeries affect the quality of life and lead to loss of labor by causing morbidity. It is a continuing problem of surgery due to high rates of prevalence and morbidity. This study aimed to compare laparoscopic versus conventional method of incisional hernia repair. Methods: Forty patients with incisional hernia who underwent hernia repair by laparoscopic (n = 20) or conventional (n = 20) technique between January 2010 and January 2011 in our clinic were included in the study . Preoperative, peroperative and postoperative data were collected prospectively, and the patients were followed up for a period of 1 year. Results: No statistical difference was found between two hernia repair groups in terms of age, sex, number of previous abdominal surgery, distribution of incisional hernia and size of the defect. Mean body mass index (BMI) was significantly (P = 0.001) greater in laparoscopic group. No statistical difference w...
This study evaluated the shrinkage of surgical margins in colorectal specimens prior to resection... more This study evaluated the shrinkage of surgical margins in colorectal specimens prior to resection and at final examination and established a correction factor to ensure a sufficient resection margin. The proximal and distal surgical margins in normal anatomic positions were measured in patients with colorectal cancer prior to resection during surgery. Fresh specimens were sent to the pathology laboratory, and the distance of the tumor to the proximal and distal margins were measured before formalin fixation and after 24 h formalin fixation. The mean proximal surgical margins prior to resection, after resection, at 24 h after fixation, and after a histopathological examination were 19.8 (SD7.1) cm, 17 (SD7.5) cm, 14 (SD5.6) cm, and 13. 6 (SD5.3) cm, respectively. The values for the distal surgical margin were 12 (SD10.9) cm, 10.3 (SD9) cm, 7. 9 (SD7.7) cm and 7.7 (SD6.4) cm in respective order. The correction factor calculated for the proximal and distal resection margins prior to resection and after the final pathological examination were 1.45 and 1.55, respectively. It would be beneficial to establish and make use of correction factors when predicting shrinkages in surgical margins in curative colorectal cancer surgery.
Wandering spleen is a rare clinical entity characterised by splenic hypermobility resulting from ... more Wandering spleen is a rare clinical entity characterised by splenic hypermobility resulting from laxity or maldevelopment of the suspensary gastrosplenic, splenorenal, and phrenicocolic ligaments. Diagnosis is quite difficult because of the lack of symptoms and signs until splenic torsion have occured. In this article, we present and discuss a 23-year-old caucasian woman presenting with acute abdomen, diagnosed as splenic torsion by ultrasound and magnetic resonance imaging and managed surgically.
Objective We reported the demographic, clinical, radiologic, preoperative and postoperative chara... more Objective We reported the demographic, clinical, radiologic, preoperative and postoperative characteristics and outcomes on patients of appendix mucocele that presented with or operated for acute appendicitis or acute abdomen. Methods A retrospective study. Patients who were presented or operated for acute appendicitis or acute abdomen and had an operative histopathological diagnosis as appendix mucocele (simple mucocele, mucinous cystadenoma, mucinous cystadenocarcinoma) were included. Demographic, clinical, radiologic, preoperative and postoperative data of eligible cases were evaluated. Results From January 2003 to February 2010, a total of 2120 patients with the pre-operative diagnosis of acute appendicitis were treated in our center, and nine (0.42%) patients were diagnosed to have mucocele of the appendix. Seven patients (78%) were female. Average age of the patients was 59.5 (range=25-74). Major complaint was right lower quadrant pain in eight (89%) patients. In preoperative ...
We present a 48-year-old caucasian woman presenting with anal pain, discharge and difficulty in d... more We present a 48-year-old caucasian woman presenting with anal pain, discharge and difficulty in defecation due to recurrent Buschke-Lowenstein tumor with rectal involvement discuss it in the light of literature. A 48-year old caucasian woman was referred to our institute with anal mass causing pain, discharge and difficulty in defecation. She initially had simple excision and electrocoterisation 3 and 15 years before at different centers. At physical examination, multiple vegetative mass lesions presented as a cauliflower-like tumor were seen at perianal region. Colonoscopy showed an inflamated, vegetative mass covering all mucosa annularly and starting from 2 cm away from anal verge and reaching until 20 cm was seen. Due to the large extent of tumor invasion in this case, curative surgery would have been achieved only by wide local surgical excision and abdominoperineal resection due to rectal involvement. This severe mutilation was refused by the patient. Thus, patient was referre...
Anaplastic carcinoma of the pancreas (ACP) is a very rare histologic subtype of pancreatic cancer... more Anaplastic carcinoma of the pancreas (ACP) is a very rare histologic subtype of pancreatic cancer and associated with more aggressive and poor prognosis than pancreatic ductal adenocarcinoma. We aimed to review this rare entity and discuss its clinical features, diagnosis and therapy. We presented a case of a 63-year-old male patient that diagnosed as ACP with cyst formation at a tertiary medical center with a detailed review of the current medical literature. We performed pancreaticoduodenectomy operation with lymph node dissection after diagnosis. Any complication after surgery was not observed. Anaplastic pancreas carcinomas are associated with poor survival when compared to invasive ductal adenocarcinomas. Clinical, radiological, laboratory and histological features may be helpful in making differential diagnosis and should be kept in mind in the diagnosis of this rare pancreatic malignancy.
Jaundice that develops following laparoscopic cholecystectomy is a troublesome experience for the... more Jaundice that develops following laparoscopic cholecystectomy is a troublesome experience for the surgeon which requires invasive management after a challenging diagnosis period. Jaundice is. We aimed to present our experience with a rare complication of jaundice in a patient that occurred due to the compression of an isolated drain without choledoc canal injury. A 63-year-old female patient underwent laparoscopic cholecystectomy due to symptomatic gallstone. The patient developed post-operative jaundice which was detected by upper abdominal magnetic resonance (MR) and magnetic resonance cholangiopancreatography (MRCP) to result from compression by the silicon drain on main hepatic canal. The patient was discharged upon removal of the silicon drain with recovery in biochemical and radiological parameters. To the best of our knowledge, our study is the first to report jaundice developing due to extrahepatic bile duct obstruction caused by isolated drain compression. Although this rar...
Stromal tumor of the duodenum is rarely seen among the gastrointestinal stromal tumors. In this p... more Stromal tumor of the duodenum is rarely seen among the gastrointestinal stromal tumors. In this paper, a patient presented with obscure gastrointestinal bleeding and the small bowel endoscopy revealed a bleeding ulcer at the second part of duodenum. The patient underwent segmental duodenectomy. The histopathology of the mass confirmed the diagnosis of duodenal stromal tumor.
Gastric duplication cysts (GDCs) are uncommon developmental anomalies found primarily in children... more Gastric duplication cysts (GDCs) are uncommon developmental anomalies found primarily in children, being rarely seen in adults. Duplications can occur anywhere in the intestinal tract from the mouth to the anus. Accurate diagnosis of cysts before resection is difficult even using the most advanced imaging techniques. In this report, we present and discuss a case of GDC in a 25-year-old man treated laparoscopically. Patient admitted to our department with complaints of epigastric pain and swelling. Magnetic resonance imaging performed for accurate characterisation showed a 4 cm × 4.5 cm cystic lesion, with heterogeneous signal intensity on T2-weighted images, located in the posterior wall of the stomach. Pre-operative differential diagnosis including gastrointestinal stromal tumour (GIST) was made according to radiological findings. Patient underwent surgery and cyst resected laparoscopically. Histopathological examination suggesting duplication cyst. GDC can easily be mistaken for a...
Background Groove pancreatitis is a form of focal chronic pancreatitis in the pancreatic tissue b... more Background Groove pancreatitis is a form of focal chronic pancreatitis in the pancreatic tissue between the duodenal wall and the intrapancreatic portion of the common bile duct. Groove pancreatitis, paraduodenal pancreatitis, and duodenal dystrophy are regarded as synonyms by some authors whereas others
Mastitis is inflammation of the breast tissue that may or may not originate from an infection. Tw... more Mastitis is inflammation of the breast tissue that may or may not originate from an infection. Two different forms of mastitis have been described, lactational and non-lactational. Lactational mastitis is the most common infection of the breast, usually associated with fever, pain, redness, and swelling in a breast-feeding mother. It is generally seen in the first six weeks of the postpartum period. Conservative therapy including milk removal and physical therapy generally provides symptomatic relief but antibiotic therapy is also needed (1, 2). Mastitis does not always occur during lactation. Common types of non-lactational mastitis are periductal mastitis and idiopathic granulomatous mastitis. Periductal mastitis is the inflammation of subareolar ducts, which is especially seen in young women; smoking increases risk. Periductal mastitis treatment includes antibiotics combined with needle aspiration or incision and abscess drainage but it is usually a chronic process and needs surgical treatment with excision of the diseased duct (3, 4). Idiopathic granulomatous mastitis (IGM) is benign inflammation of breast with unknown etiology. IGM may be associated a mass, pain, abscess, nipple retraction, sinus or fistula formation, and mimics malignancy. Treatment includes antibiotics, drainage, surgery, and steroids (5). The therapeutic management algorithm of chronic breast inflammation is unclear and has no consensus. The use of negative-pressure wound therapy (NPWT) was first reported in traumatology. NPWT systems have become a common treatment choice for acute, sub-acute, and chronic wounds (6). Use of NPWT in breast wounds is not common and there are insufficient publications in the literature to support its use. In this report, we present and discuss two patients with chronic breast inflammation due to idiopathic granulomatous mastitis and periductal mastitis who underwent surgery and were successfully treated with NPWT to minimize wide tissue defects and cosmetic problems after surgery. Case Presentations Case 1 A woman aged 31 years was admitted to our department with symptoms of right breast pain, swelling and redness. Her past medical history did not include any diseases. The patient's physical examination revealed erythema, hyperemia and a fluctuating mass in the right upper
There is still an ongoing debate, especially regarding early diagnosis of acute appendicitis. Ear... more There is still an ongoing debate, especially regarding early diagnosis of acute appendicitis. Early surgery leads to inadequate evaluation of acute abdominal pain and negative appendectomy, whereas delayed surgery leads to appendicitis perforation complications. The diagnosis of this condition is considerably difficult, especially due to subtle early symptoms and clinical condition. The aim of the present study was to identify whether the Alvarado scoring system could reduce the incidence of negative appendectomy in patients who will undergo surgery for acute appendicitis. Patients who underwent surgery with acute appendicitis prediagnosis were retrospectively classified as negative appendectomies (group A) and positive appendectomies (group B) according to histological diagnosis. All groups were evaluated for age, gender, Alvarado scores, and parameters. Two hundred eighty-one patients were included in the study. Group A contained 71 (25.3 %) patients, and group B contained 210 (74.7 %) patients. There was a significant difference in WBC, left shift, rebound, and change of pain localization between the groups (p = 0.002, p < 0.001, p < 0.001, and p = 0.023, respectively). Alvarado scores were significantly different between the groups (p < 0.001). In logistic model examination, the major factor was the Alvarado score (7 or above) and the minor factor was spreading pain. The Alvarado scoring system can be used to reduce negative appendectomy in patients who will undergo surgery with acute appendicitis.
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Papers by Savas Yakan