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    Barolith a rare cause of acute appendicitis a case report
    (Turkish Journal of Trauma and Emergency Surgery, 2013) İnce, Volkan; Işık, Burak; Koç, Cemalettin; Başkıran, Adil; Asım, Onur
    A barolith consists of inspissated barium associated with feces and is seen, rarely, after barium studies for imaging the gastrointestinal system. The barium used in such studies can enter the appendiceal lumen and, rarely, cause appendicitis by obliterating or narrowing the lumen of the appendix. The appendix fills with barium and the entire appendix is visualized in 80-90% of barium swallow or enema studies, and this is accepted as a reliable sign of a non-diseased appendix Post-examination retention of barium in the appendix is very common (90~95%), and 10% of the patients retain barium in the appendix beyond 72 hours. If the barium is retained for more than two months, complicated appendicitis can result. We present a 46-year-old male who was diagnosed with acute appendicitis due to a barolith and required an appendectomy three months after a double-contrast barium enema study. After barium studies, patients should be informed regarding retention of barium in the appendix and the possibility that it can cause acute appendicitis. Thus, if abdominal pain develops, the patient can be referred quickly to a medical center for the appropriate treatment and the complications of acute appendicitis can be prevented with early intervention.
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    Barolith a rare cause of acute appendicitis a case report
    (Turkish Journal of Trauma and Emergency Surgery, 2013) İnce, Volkan; Işık, Burak; Koç, Cemalettin; Başkıran, Adil; Onur, Asım
    A barolith consists of inspissated barium associated with feces and is seen, rarely, after barium studies for imaging the gastrointestinal system. The barium used in such studies can enter the appendiceal lumen and, rarely, cause appendicitis by obliterating or narrowing the lumen of the appendix. The appendix fills with barium and the entire appendix is visualized in 80-90% of barium swallow or enema studies, and this is accepted as a reliable sign of a non-diseased appendix Post-examination retention of barium in the appendix is very common (90~95%), and 10% of the patients retain barium in the appendix beyond 72 hours. If the barium is retained for more than two months, complicated appendicitis can result. We present a 46-year-old male who was diagnosed with acute appendicitis due to a barolith and required an appendectomy three months after a double-contrast barium enema study. After barium studies, patients should be informed regarding retention of barium in the appendix and the possibility that it can cause acute appendicitis. Thus, if abdominal pain develops, the patient can be referred quickly to a medical center for the appropriate treatment and the complications of acute appendicitis can be prevented with early intervention.
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    Biliary complications in 106 consecutive duct to duct biliary reconstruction in right lobe living donor liver transplantation performed in 1 year in a single center a new surgical technique
    (Transplant Proc., 2011) Kırımlıoğlu, Vedat; Tatlı, Faik; İnce, Volkan; Aydın, Cemalettin; Ersan, Veysel; Ara, Cengiz; Aladağ, Murat; Kutlu, Ramazan; Kırımlıoğlu, Saime Hale; Yılmaz, Sezai
    Objective. Biliary complications remain a major source of morbidity after living donor liver transplantation (LDLT). Of 109 consecutive right lobe (RL)-LDLTs performed in 1 year in our institution, we present the biliary complications among 106 patients who underwent a new duct-to-duct anastomosis technique known as University of Inonu. Methods. Of 153 liver transplantations performed in 1 year from January to December of 2008, 128 were LDLTs including 109 RL-LDLTs. The others were left or left lateral grafts. All RL-LDLT patients were adults, all of whom except three included a duct-toduct anastomosis. Results. All, but three, biliary reconstructions were completed with a surgical technique, so called UI, in which 6-0 prolene sutures were used. Nine bile leaks were seen in 106 recipients (8.49%) performed in a duct-to-duct fashion in a time period of 1 to 4 weeks. Seventeen patients (16.03%) posed bile duct stricture (BDS). Five patients had both. Although endoscopic stent placement and percutaneous balloon dilatation, 4 patients continued to suffer from BDS on whom a permanent access hepatico-jejunostomy (PAHJ) procedures were performed. Conclusion. We recommend a duct-to-duct biliary reconstruction because of its de facto advantages over other types of anastomosis provided the native duct is not diseased. After almost 2 years, the bile tract complication rate was 22.64%.
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    Biliary complications in 106 consecutive duct to duct biliary reconstruction in right lobe living donor liver transplantation performed in 1 year in a single center a new surgical technique
    (Transplant Proc, pp. 0–0, Apr. 2011., 2011) Kırımlıoğlu, Vedat; Tatlı, Faik; İnce, Volkan; Aydın, Cemalettin; Ersan, Veysel; Ara, Cengiz; Aladağ, Murat; Kutlu, Ramazan; Kırımlıoğlu, Hale; Yılmaz, Sezai
    ABSTRACT Objective. Biliary complications remain a major source of morbidity after living donor liver transplantation (LDLT). Of 109 consecutive right lobe (RL)-LDLTs performed in 1 year in our institution, we present the biliary complications among 106 patients who underwent a new duct-to-duct anastomosis technique known as University of Inonu. Methods. Of 153 liver transplantations performed in 1 year from January to December of 2008, 128 were LDLTs including 109 RL-LDLTs. The others were left or left lateral grafts. All RL-LDLT patients were adults, all of whom except three included a duct-toduct anastomosis. Results. All, but three, biliary reconstructions were completed with a surgical technique, so called UI, in which 6-0 prolene sutures were used. Nine bile leaks were seen in 106 recipients (8.49%) performed in a duct-to-duct fashion in a time period of 1 to 4 weeks. Seventeen patients (16.03%) posed bile duct stricture (BDS). Five patients had both. Although endoscopic stent placement and percutaneous balloon dilatation, 4 patients continued to suffer from BDS on whom a permanent access hepatico-jejunostomy (PAHJ) procedures were performed. Conclusion. We recommend a duct-to-duct biliary reconstruction because of its de facto advantages over other types of anastomosis provided the native duct is not diseased. After almost 2 years, the bile tract complication rate was 22.64%.
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    Circumferential Fence With the Use of Polyethylene Terephthalate Dacron Vascular Graft for All in One Hepatic Venous Reconstruction in Right Lobe Living Donor Liver Transplantation
    (Transplantation Proceedings, 47(5), 1458–1461., 2015) Ara, Cengiz; Akbulut, Ahmet Sami; İnce, Volkan; Aydın, Cemalettin; Kayaalp, Cüneyt; Ünal, Bülent; Yılmaz, Sezai
    Integration of hepatic vein tributaries with a diameter 5 mm into the drainage system in rightlobe living-donor liver transplantation (LDLT) is of vital importance for graft function. Recently, the most commonly emphasized hepatic venous reconstruction model is the all-in-one reconstruction model. In the final stage of this model that aims to form a common large opening, allogeneic vascular grafts are almost always used to construct a circumferential fence. To date, no other study has reported the use of polyethylene terephthalate (Dacron) vascular graft as a circumferential fence in LDLT. We aimed to present the 1st 4 cases of circumferential fences created with Dacron vascular graft. Four right-lobe grafts weighing 522e1,040 g were used. A polytetrafluoroethylene vascular graft was used for the integration of segment 5 vein and segment 8 vein into the drainage model, whereas a Dacron graft was used to creating a circumferential fence. The patency of hepatic outflow evaluated with the use of multidetector computerized tomography at postoperative day 7. Venous outflow obstruction was not detected in any cases. This study suggested that owing to its flexible structure the polyethylene terephthalate vascular graft can be an alternative to allogeneic vascular grafts in forming circumferential fence.
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    Circumferential fence with the use of polyethylene terephthalate dacron vascular graft for all in one hepatic venous reconstruction in right lobe living donor liver transplantation
    (Transplantation Proceedings, 2015) Ara, Cengiz; Akbulut, Ahmet Sami; İnce, Volkan; Aydın, Cemalettin; Gönültaş, Fatih; Kayaalp, Cüneyt; Ünal, Bülent; Yılmaz, Sezai
    Integration of hepatic vein tributaries with a diameter 5 mm into the drainage system in rightlobe living-donor liver transplantation (LDLT) is of vital importance for graft function. Recently, the most commonly emphasized hepatic venous reconstruction model is the all-in-one reconstruction model. In the final stage of this model that aims to form a common large opening, allogeneic vascular grafts are almost always used to construct a circumferential fence. To date, no other study has reported the use of polyethylene terephthalate (Dacron) vascular graft as a circumferential fence in LDLT. We aimed to present the 1st 4 cases of circumferential fences created with Dacron vascular graft. Four right-lobe grafts weighing 522e1,040 g were used. A polytetrafluoroethylene vascular graft was used for the integration of segment 5 vein and segment 8 vein into the drainage model, whereas a Dacron graft was used to creating a circumferential fence. The patency of hepatic outflow evaluated with the use of multidetector computerized tomography at postoperative day 7. Venous outflow obstruction was not detected in any cases. This study suggested that owing to its flexible structure the polyethylene terephthalate vascular graft can be an alternative to allogeneic vascular grafts in forming circumferential fence.
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    Comparison of intracorporeal knot tying suture polyglactin and titanium endoclips in laparoscopic appendiceal stump closure
    (Surgical Laparoscopy, Endoscopy & Percutaneous Techniques, 2012) Ateş, Mustafa; Dirican, Abuzer; İnce, Volkan; Ara, Cengiz; Işık, Burak; Yılmaz, Sezai
    Background: Laparoscopic appendectomy is a well-described surgical technique. However, concerns still exist regarding whether the closure of the appendiceal stump should be done with a clip, an endoloop, staples, or other techniques. Therefore, several modifications to the original technique with new materials have been introduced for appendiceal stump closure. The aim of this study was to compare intracorporeal (polyglactin) knot-tying suture with titanium endoclips in appendiceal stump closure during laparoscopic appendectomy. Methods: The study was carried out as a prospective randomized clinical trial between April 2010 and February 2011. Patients with a presentation of appendicitis were included into the study. Two groups were defined—patients with the titanium endoclip and patients with the knot-tying (polyglactin) suture. The results in terms of operating time, complication rates, and hospital stay were analyzed. Results: Sixty-one patients who underwent laparoscopic appendectomy were enrolled in the titanium endoclip group (n= 30) or the knot-tying (polyglactin) suture group (n= 31). No statistically significant differences were detected between the groups in terms of the distribution of age, sex percentage, appendix localization, and histopathologic diagnosis (P> 0.05). One patient required a second operation on postoperative day 10 because of intraperitoneal abscess. The mean operative time for the endoclip group (41.27± 12.2 min) was shorter than that for the knot-tying group (62.81± 15.4 min) (P= 0.001). No statistically significant differences were detected between the groups in terms of hospital stay, follow-up time, and preoperative and postoperative complications (P> 0.05). Conclusions: In laparoscopic appendectomy, using a titanium endoclip for optimizing and controlling the appendiceal stump closure is safe and is associated with shorter operation time. This also simplifies the procedure, so it can be a useful alternative to intracorporeal knot-tying for appendiceal stump closure.
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    Comparison of intracorporeal knot tying suture polyglactin and titanium endoclips in laparoscopic appendiceal stump closure a prospective randomized study
    (Surg Laparosc Endosc Percutan Tech Volume 22, Number 3, June 2012., 2012) Ateş, Mustafa; Dirican, Abuzer; İnce, Volkan; Ara, Cengiz; Işık, Burak; Yılmaz, Sezai
    Background: Laparoscopic appendectomy is a well-described surgical technique. However, concerns still exist regarding whether the closure of the appendiceal stump should be done with a clip, an endoloop, staples, or other techniques. Therefore, several modifications to the original technique with new materials have been introduced for appendiceal stump closure. The aim of this study was to compare intracorporeal (polyglactin) knot-tying suture with titanium endoclips in appendiceal stump closure during laparoscopic appendectomy. Methods: The study was carried out as a prospective randomized clinical trial between April 2010 and February 2011. Patients with a presentation of appendicitis were included into the study. Two groups were defined—patients with the titanium endoclip and patients with the knot-tying (polyglactin) suture. The results in terms of operating time, complication rates, and hospital stay were analyzed. Results: Sixty-one patients who underwent laparoscopic appendectomy were enrolled in the titanium endoclip group (n= 30) or the knot-tying (polyglactin) suture group (n= 31). No statistically significant differences were detected between the groups in terms of the distribution of age, sex percentage, appendix localization, and histopathologic diagnosis (P> 0.05). One patient required a second operation on postoperative day 10 because of intraperitoneal abscess. The mean operative time for the endoclip group (41.27± 12.2 min) was shorter than that for the knot-tying group (62.81± 15.4 min) (P= 0.001). No statistically significant differences were detected between the groups in terms of hospital stay, follow-up time, and preoperative and postoperative complications (P> 0.05). Conclusions: In laparoscopic appendectomy, using a titanium endoclip for optimizing and controlling the appendiceal stump closure is safe and is associated with shorter operation time. This also simplifies the procedure, so it can be a useful alternative to intracorporeal knot-tying for appendiceal stump closure. Key Words: laparoscopy, appendectomy, knot-tying, endoclip
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    Comparison of ıntracorporeal knot tying suture polyglactin and titanium endoclips in laparoscopic appendiceal stump closure
    (Surgical Laparoscopy, Endoscopy & Percutaneous Techniques, 2012) Ateş, Mustafa; Dirican, Abuzer; İnce, Volkan; Ara, Cengiz; Işık, Burak; Yılmaz, Sezai
    Background: Laparoscopic appendectomy is a well-described surgical technique. However, concerns still exist regarding whether the closure of the appendiceal stump should be done with a clip, an endoloop, staples, or other techniques. Therefore, several modifications to the original technique with new materials have been introduced for appendiceal stump closure. The aim of this study was to compare intracorporeal (polyglactin) knot-tying suture with titanium endoclips in appendiceal stump closure during laparoscopic appendectomy. Methods: The study was carried out as a prospective randomized clinical trial between April 2010 and February 2011. Patients with a presentation of appendicitis were included into the study. Two groups were defined—patients with the titanium endoclip and patients with the knot-tying (polyglactin) suture. The results in terms of operating time, complication rates, and hospital stay were analyzed. Results: Sixty-one patients who underwent laparoscopic appendectomy were enrolled in the titanium endoclip group (n= 30) or the knot-tying (polyglactin) suture group (n= 31). No statistically significant differences were detected between the groups in terms of the distribution of age, sex percentage, appendix localization, and histopathologic diagnosis (P> 0.05). One patient required a second operation on postoperative day 10 because of intraperitoneal abscess. The mean operative time for the endoclip group (41.27± 12.2 min) was shorter than that for the knot-tying group (62.81± 15.4 min) (P= 0.001). No statistically significant differences were detected between the groups in terms of hospital stay, follow-up time, and preoperative and postoperative complications (P> 0.05).
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    Comprehensive analysis of the efficacy of liver transplantation in pediatric patients with Wilson’s disease
    (2023) Sarıcı, Barış; Şahin, Tevfik Tolga; Ara, Cengiz; Aydın, Cemalettin; Karakas, Serdar; İnce, Volkan; Varol, Fatma
    Aim: The aim of the present study is to evaluate the results of liver transplantation (LT) in pediatric Wilson disease (WD) with a specific sub-analysis in patients with neuropsychiatric symptoms. Materials and Methods: Demographic, operative, laboratory and neurologic findings of 23 pediatric patients with WD that underwent LT were analyzed by examining the patient charts. Results: Median age of the patients was 13 ( 7 to 17) years. Median Wilson’s Index scores of the patients were 7 (5-13). Median Child-Pugh Score, MELD-Na and PELD scores of the patients were 10 (5-12), 19 (8-34) and 25.4 (8.4-30.7); respectively. Eight patients (34.8%) had Kayser-Fleischer rings on examination. Five patients (21.7%%) presented with acute decompensated Wilson’s disease. Fifteen patients (65.2%) received living donor liver transplantation. Totally, 10 patients (43,4%) had nervous system involvement in the preoperative period. Two patients fully recovered; 2 patients showed partial recovery. On the other hand, 4 patients showed no improvement and 2 patients had progression of their disease in the postoperative period. Conclusions: The results of the present study show that LT is an effective and safe alternative in end-stage liver failure in WD. However, in these patients, nervous system involvement may not improve despite successful LT.
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    Efficacy of laboratory tests and ultrasonography in the diagnosis of acute appendicitis in gravid patients according to the stages of pregnancy
    (Ulusal Travma ve Acil Cerrahi Dergisi, 2018) Başkıran, Adil; İnce, Volkan; Çiçek, Egemen; Şahin, Tolga; Dirican, Abuzer; Balıkçı Çiçek, İpek; Işık, Burak; Yılmaz, Sezai
    Öz: BACKGROUND: Normal physiologic changes during pregnancy result in similar laboratory and symptomatology changes as those during acute appendicitis (AA), making the diagnosis extremely difficult. The aim of the present study was to analyze the efficacy of conventional laboratory and radiologic tests in the diagnosis of AA according to different stages of pregnancy. METHODS: Twenty-five pregnant patients with pathologically confirmed AA operated at our department between 2012 and 2017 were retrospectively analyzed in terms of changes in conventional laboratory parameters as well as neutrophil-to lymphocyte (NLR) and platelet-to-lymphocyte (PLR) ratios to aid the diagnosis of AA according to different stages of pregnancy. RESULTS: There were no significant changes in C-reactive protein levels, leukocyte and neutrophil counts, and accuracy of ultrasonography between patients in the first (group 1) and second + third trimesters (group 2) (p>0.05). Lymphocyte count was significantly lower (p>0.05), whereas NLR and PLR were significantly higher in group 2 (p<0.05). CONCLUSION: Laboratory values change significantly during pregnancy, and NLR and PLR seems to be valuable tools for evaluating AA in a stage-specific manner in pregnant patients.
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    Hepatosellüler kanserde canlı vericili karaciğer nakli
    (İnönü Üniversitesi, 2012) İnce, Volkan
    Karaciğer nakli, Hepatosellüler kanser (HSK) tedavisinde genel kabul görmüş bir tedavi modalitesidir. Ancak nakil yapılacak hastaları belirlemede, birbirinden farklı ve rakamlara dayanan çok sayıda kriter mevcuttur. Bunlardan en yaygın kullanılanı Milan kriterleridir. Biz kriter olarak hastalığın karaciğere sınırlı olmasını ve makrovasküler invazyon olmamasını canlı vericili nakil için yeterli görmekteyiz. Bu çalışmada bu kriterler göz önüne alınarak yapılan karaciğer nakli olgularımızın sonuçları değerlendirildi. Materyal-Metod: HSK tanısıyla 105 hastaya karaciğer nakli yapıldı. Ameliyat sonrası erken dönemde kaybedilen ve kadavradan nakil yapılan hastalar dışında kalan toplam 74 hasta değerlendirildi. Hastaların 65'i (% 88) erkek, 9'u (% 12) kadındı. Ortalama yaş 53'tü (19-69). Tek değişkenli Kaplan-Meier ve çok değişkenli Cox proportional hazards modeli ile genel ve hastalıksız sağkalım analizi yapıldı, p<0.05 anlamlı kabul edildi. Bulgular: Hastaların 32'si (% 43) Milan kriterlerinin içinde, 42'si (% 57) ise dışındaydı. 1 ve 2 yıllık genel sağkalım, Milan kriterleri içindeki hastalarda % 72 ve % 68, dışındakilerde sırasıyla % 61 ve % 58'di. Hastalıksız sağkalım oranları, 1 ve 2 yıl için Milan kriterleri içinde kalan hastalarda % 72 ve % 68 iken, dışındakilerde sırasıyla % 60 ve % 55 bulundu (p>0,05). Milan kriterleri içinde ve dışında olan hastalarda tümör nüksü sırasıyla % 0 ve % 36 idi (p=0.0002). Genel sağkalım açısından sadece AFP değeri, hastalıksız sağkalım açısından ise AFP değeri ve diferansiasyon derecesi istatistiksel olarak anlamlı bulundu. Sonuç: Milan kriterleri dışında kalan hastalarda beklenildiği üzere nüks açısından sonuçlar daha kötüdür ancak, kadavra organ bulunmasının zor olduğu ülkelerde, bu hastalar için canlı vericili karaciğer naklinin tek tedavi şansı olduğunu düşünüyoruz. Kadavra karaciğerlerin bu hastalarda kullanılmasının uygun olmadığına inanıyoruz.
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    İdiyopatik çekal ülser ve insidental apendiks karsinoid tümörü birlikteliği
    (Ulusal Cerrahi Dergisi, 2016) İnce, Volkan; Barut, Bora; Karakaş, Serdar
    Öz: İdiyopatik çekal ülser (İÇÜ) ya da soliter çekal ülser, oldukça nadir karşılaşılan ve kesin tanısı histopatolojik olarak konulan bir klinik durumdur. Çoğu zaman alt gastrointestinal sistem kanaması araştırılırken kolonoskopik biyopsi ile tanı konurken, nadir olarak da akut karın nedeniyle ya da çekumda kitle görüntüsüyle maligniteyi taklit etmesi nedeniyle cerrahi rezeksiyon sonrası tanı konur. Çekal karsinoid tümör, hastalığın nadir sebeplerinden biridir, ancak apendiks karsinoid tümör birlikteliği daha önce bildirilmemiştir. Bu çalışmada, akut apandisit kliniği ile başvuran ve çekumda duvar kalınlaşması saptanan 73 yaşındaki kadın hastaya sağ hemikolektomi yapılıp patoloji sonucu izole çekal ülser ve serozal apse ve eşlik eden apendiks karsinoid tümörü olan olgu sunulmaktadır. Başlık (İngilizce): Co-existence of idiopathic cecal ulcer and incidental appendix carcinoid tumor Öz (İngilizce): Idiopathic cecal ulcer or solitary cecal ulcer is a rare entity that can only be diagnosed by histopathological evaluation. Generally, it is diagnosed by histolopathological evaluation of biopsy specimens obtained by colonoscopy that is performed for lower gastrointestinal bleeding. It can also be diagnosed after surgical resection performed for acute abdomen or cecal mass mimicking malignancy. Cecal carcinoid tumor is a rare cause of this condition; however, coexistence of cecal ulcer and appendix carcinoid tumor has not been previously reported. In this case, we present a 73-year-old woman who clinically presented as acute appendicitis with cecal wall thickening, underwent right hemicolectomy and was subsequently diagnosed with cecal ulcer, serosal abscess and coexisting appendix carcinoid tumor.
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    İleri evreli kolanjiokarsinomda safen ven yaması ile retrohepatik vena kava inferior rekonstrüksiyonu
    (Ulusal Cerrahi Dergisi, 2014) Dirican, Abuzer; Özsoy, Mustafa; Barut, Bora; İnce, Volkan; Ateş, Mustafa; Yılmaz, Sezai
    Öz: Karaciğer rezeksiyonu, primer ve metastatik karaciğer tümörlerinin bilinen tek küratif tedavi seçeneğidir. Diğer malignite türlerinden farklı olarak karaciğer malignitelerinin en iyi kemoterapi rejimlerine yanıt oranları oldukça düşüktür. Tedavi edilmeyen veya geride tümör bırakılan karaciğer malignitelerinde yaşam süresi aylarla ifade edilmektedir. Optimal sağ kalım süresi ancak negatif cerrahi sınır ile karaciğer rezeksiyonları sonrasında elde edilebilmektedir. Bu nedenle karaciğer rezeksiyonu uygulanabilecek hasta sayısını arttırmak amacıyla portal ven embolizasyonu, neoadjuvan kemoterapi, iki basamaklı hepatektomi, re-do hepatektomi, karaciğerin hipotermik perfüzyonu gibi teknikler geliştirilmiş ve halen yeni arayışlar devam etmektedir. Hepatoselüler karsinoma, kolanjiokarsinoma gibi primer karaciğer maligniteleri ve metastatik karaciğer tümörleri anatomik yakınlığı nedeniyle retrohepatik vena kavayı invaze edebilmektedir. Hepatokaval konfluensı veya vena kavayı invaze eden maligniteler intraoperatif masif hava embolisi veya hemoraji nedeniyle karaciğer rezeksiyonları için çoğunlukla kontrendike olarak kabul edilmektedir. Bu makalede kolanjiokarsinoma nedeniyle sol hepatektomi ile birlikte vena kava rezeksiyonu ve safen ven ile rekonstrüksiyon yapılan bir olguyu sunmaktayız.
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    The impact of tumor localization on prognosis of the patients following liver transplantation for hepatocellular carcinoma
    (2020) Başkıran, Adil; Sarıgöz, Talha; Şahin, Tevfik Tolga; İnce, Volkan; Usta, Sertaç
    Aim: Hepatocellular carcinoma usually occurs in the setting of liver cirrhosis and therefore, resection is not possible in majority ofthe cases. Orthotopic liver transplantation (OLS) is a gold standard treatment option in hepatocellular carcinoma. The aim of thepresent retrospective study was to evaluate the prognosis of hepatocellular carcinoma localized in left or right side of the liver inpatients who underwent OLS.Materials and Methods: 120 patients received OLS for hepatocellular carcinoma between 2007 and 2018 in the institute of livertransplantation. Tumors that were centrally located were excluded from the analysis. The remaining 104 patients were divided intotwo groups; Group 1 (right lobe, n=85 [81.7%]), Group 2 (left lobe, n=19 [18.3%]). The clinical and demographic data of the patientsalong with preoperative laboratory values such as alpha fetoprotein (AFP), gamma-glutamyl transpeptidase (GGT) and thrombocytecount were retrospectively evaluated.Results: The Median age in Group 1 and 2 were 54 (4-72) and 50.5 (37-68) years, respectively. Preoperative AFP levels in Group 1and 2 were 9.25 (1-10800) ng/ml and 13 (1.5-317) ng/ml, respectively. The Model for end stage liver disease (MELD) scores in Group1 and 2 were 12 (6-52) and 9 (6-21), respectively. None of the clinical, demographic and laboratory values along with disease-freesurvival, early mortality and recurrence were significantly different among the study groups (p>0.05).Conclusions: Although there is a big discrepancy in terms of patient’s numbers in right and left-sided tumors, our data failed toshow any survival difference among the groups. Further studies, especially in hepatocellular carcinoma beyond the Milan criteria,are needed to validate our results.
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    Influence of Liver Transplantation on Neuropsychiatric Manifestations of Wilson Disease
    (Transplantation Proceedings, 2015) Tardu, Ali; Karagül, Servet; Ertuğrul, İsmail; İnce, Volkan; Kırmızı, Serdar; Ünal, Bülent; Işık, Burak; Kayaalp, Cüneyt; Yılmaz, Sezai
    Objectives. This study sought to evaluate the effect of liver transplantation on the neuropsychological manifestations of Wilson disease. Materials and Methods. Nine of 42 Wilson disease patients had neuropsychological symptoms before liver transplantation. They were 7 male and 2 female subjects with a median age of 19 years (range 10 to 25). They were analyzed for their preoperative and postoperative hepatic, neurological, and psychological scores described by the Unified Wilson Disease Rating Scale after a mean 36.6 months of follow-up. Results. Preoperative mean Model for End-Stage Liver Disease and Child-Pugh scores were 18.3 (range 15 to 26) and 8.9 (range 6 to 12), respectively. One patient had acute postoperative ischemic stroke unrelated to Wilson disease and was excluded from the statistical analysis. Preoperative and postoperative hepatic, neurological, and psychological scores of the remaining 8 patients were 7.4 2.3 vs 2.4 1.3 (P ¼ .0005), 17.7 11.7 vs 12.7 12.5 (P ¼ .055), and 9.0 1.7 vs 7.0 2.1 (P ¼ .033). Conclusions. Liver transplantation for Wilson disease can provide some improvement of the neuropsychological symptoms in addition to the hepatic recovery.
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    Influence of liver transplantation on neuropsychiatric manifestations of wilson disease
    (Transplantation Proceedings, 2015) Yağcı, Mehmet Ali; Tardu, Ali; Karagül, Servet; Ertuğrul, İsmail; İnce, Volkan; Kırmızı, Serdar; Ünal, Bülent; Işık, Burak; Kayaalp, Cüneyt; Yılmaz, Sezai
    Objectives. This study sought to evaluate the effect of liver transplantation on the neuropsychological manifestations of Wilson disease. Materials and Methods. Nine of 42 Wilson disease patients had neuropsychological symptoms before liver transplantation. They were 7 male and 2 female subjects with a median age of 19 years (range 10 to 25). They were analyzed for their preoperative and postoperative hepatic, neurological, and psychological scores described by the Unified Wilson Disease Rating Scale after a mean 36.6 months of follow-up. Results. Preoperative mean Model for End-Stage Liver Disease and Child-Pugh scores were 18.3 (range 15 to 26) and 8.9 (range 6 to 12), respectively. One patient had acute postoperative ischemic stroke unrelated to Wilson disease and was excluded from the statistical analysis. Preoperative and postoperative hepatic, neurological, and psychological scores of the remaining 8 patients were 7.4 2.3 vs 2.4 1.3 (P ¼ .0005), 17.7 11.7 vs 12.7 12.5 (P ¼ .055), and 9.0 1.7 vs 7.0 2.1 (P ¼ .033). Conclusions. Liver transplantation for Wilson disease can provide some improvement of the neuropsychological symptoms in addition to the hepatic recovery.
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    İnsidental Meckel divertiküllü hastada safra taşı ileusunun tek aşamalı cerrahi tedavisi: Olgu sunumu
    (Ulusal Cerrahi Dergisi, 2012) İnce, Volkan; Usta, Sertaç; Ünal, Bülent; Yılmaz, Mehmet
    Yıl: 2012Cilt: 28Sayı: 4ISSN: 1300-0705Sayfa Aralığı: 222 - 224 Metin Dili: Türkçe Öz: İntestinal obstrüksiyonun nadir sebeplerinden birisi de safra taşlarıdır. Tekrarlayan kolesistit atakları sonucu oluştuğu düşünülen bilio-enterik ya da koledoko-enterik fistüllerden gastrointestinal sisteme geçip sıkışan büyük safra taşları mekanik obstrüksiyona yol açmaktadır. Bu tür hastalarda cerrahlara düşen görev hastanın şikayetini gidermek ve altta yatan patolojiyi ortadan kaldırmaktır. Aralıklı obstrüksiyon ile takip edilen 54 yaşında erkek hastanın tek aşamalı cerrahi ile hem rastlantısal saptanan Meckel divertikülünün hem de safra taşı ileu- sunun başarılı tedavisi sunulmaktadır. Başlık (İngilizce): Treatment of gallstone ileus by single stage surgery of a patient with incidental Meckel diverticulum: a case report Öz (İngilizce): Gallstones are rare causes of intestinal obstruction. Mechanical ob- struction occurs by impaction of large gallstones in the gastrointest- inal tract following entry via a bilio-enteric or choledocho-enteric fis tula, thought to occur as a result of recurrent cholecystitis. The duty of surgeons in the treatment of these patients is to resolve the patient&#8217;s complaint and eliminate the underlying pathology. A 54 year old male patient admitted for intermittent obstruction was successfully treated by single stage surgery for incidental Meckel diverticulum and gall- stone ileus.
  • Küçük Resim
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    "İnsidental Meckel divertiküllü hastada safra taşı ileusunun tek aşamalı cerrahi tedavisi: Olgu sunumu "
    (2012) İnce, Volkan; Usta, Sertaç; Ünal, Bülent; Yılmaz, Mehmet Tuğrul
    Öz:İntestinal obstrüksiyonun nadir sebeplerinden birisi de safra taşlarıdır. Tekrarlayan kolesistit atakları sonucu oluştuğu düşünülen bilio-enterik ya da koledoko-enterik fistüllerden gastrointestinal sisteme geçip sıkışan büyük safra taşları mekanik obstrüksiyona yol açmaktadır. Bu tür hastalarda cerrahlara düşen görev hastanın şikayetini gidermek ve altta yatan patolojiyi ortadan kaldırmaktır. Aralıklı obstrüksiyon ile takip edilen 54 yaşında erkek hastanın tek aşamalı cerrahi ile hem rastlantısal saptanan Meckel divertikülünün hem de safra taşı ileu- sunun başarılı tedavisi sunulmaktadır.
  • Küçük Resim
    Öğe
    Karaciğer ve Kolon Malignitesini Taklit Eden Fasiyoliyaz: Üç Olgu Sunumu
    (İnönü Üniversitesi Tıp Fakültesi Dergisi, 2010) İnce, Volkan; Ara, Cengiz; Koç, Cemalettin; Ersan, Veysel; Barut, Bora
    Fasiyoliyaz tüm dünyada birçok memeli türü konakçılarını enfekte eden zoonotik bir hastalıktır. Türkiye’yi de içine alan Uzak ve Orta Doğu’nun bazı bölümlerinde endemik olarak bildirilen insan fasiyoliyazı, nadir karşılaşılan bir parazitik enfeksiyondur. Parazitin karaciğer dışı yerleşimi çok nadirdir. Günümüze kadar subkütan dokuda, beyinde, akciğerde, epididimde, inguinal lenf bezlerinde ve mide ve kolon gibi gastrointestinal sistemde, karaciğer dışı fasiyoliyazı bildirilmiştir. Bu makalede karaciğer ve kolon malignitesini taklit eden fasiyoliyazlı üç hasta sunulmaktadır.