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    Open Surgery for Hepatic Hydatid Disease
    (Int College Of Surgeons, 2014) Sozuer, Erdogan; Akyuz, Muhammet; Akbulut, Sami
    Hydatid disease is a zoonosis caused by the larvae of Echinococcus granulosus. Humans are an intermediate host and are usually infected by direct contact with dogs or indirectly by contaminated foods. Hydatid disease mainly involves the liver and lungs. The disease can be asymptomatic. Imaging techniques such as ultrasonography and computed tomography are used for diagnosis. The growth of hydatid cysts can lead to complications. Communication between bile duct and cysts is a common complication. The goal of treatment for hydatid disease is to eliminate the parasite with minimum morbidity and mortality. There are 3 treatment options: surgery, chemotherapy, and interventional procedures. Medical treatment has low cure and high recurrence rates. Percutaneous treatment can be performed in select cases. There are many surgical approaches for managing hydatid cysts, although there is no best surgical technique, and conservative and radical procedures are used. Conservative procedures are usually preferred in endemic areas and are easy to perform but are associated with high morbidity and recurrence rates. In these procedures, the parasite is sterilized using a scolicidal agent, and the cyst is evacuated. Radical procedures include hepatic resections and pericystectomy, which have high intraoperative risk and low recurrence rates. Radical procedures should be performed in hepatobiliary centers. The most common postoperative complications are biliary fistulas and cavity-related complications. Endoscopic retrograde cholangiopancreatography can be used to diagnose and treat biliary system complications. Endoscopic sphincterotomy, biliary stenting, and nasobiliary tube drainage are effective for treating postoperative biliary fistulas.
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    Persistent left superior vena cava frequency in congenital heart surgery and its effect on surgical strategy
    (2022) Mercan, Ilker; Isik, Onur; Akyuz, Muhammet; Cakmak, Meltem; Guven, Baris
    Aim: Persistent left superior vena cava encompasses a wide range of systemic venous anomalies. Persistent left superior vena cava is relatively infrequent and, under normal circumstances, asymptomatic but may be of clinical importance in cardiac surgery. This study aims to investigate the effect of persistent left superior vena cava on surgical planning. Material and Methods: We included a total of 525 consecutive patients (310 males, 215 females) who underwent open-heart surgery for congenital heart disease. The association of persistent left superior vena cava with congenital anomalies and surgical approaches were recorded. Demographic data and outcome data were retrospectively analyzed. Results: Persistent left superior vena cava was observed in 28 (5.3%) patients. The drainage point of PLSVC was coronary sinus in 23 (82.1%) patients, left atrium in 5 (17.9%) patients. The mean age and weight of the patients were 11.5 months (range, one day to 18 years), 9.3 kg (range, 0.5-65 kg), respectively. Persistent left superior vena cava was obtained in 11 (39.4%) patients with echocardiography, 12 (%42.8) patients with cardiac catheterization and tomography imaging, and 5 (17.8%) patients during surgery. Surgical management of the PLSVC included of temporary occlusion in 17 (60.7%) patients, direct cannulation in 6 (21.5%) patients, Glenn shunt in 2 (7.1%) patients, intracardiac rerouting in 2 (7.1%) patients and ligation in 1 (3.6%) patient. No operative morbidity and complication associated with persistent left superior vena cava were seen. Conclusions: Consequently, persistent left superior vena cava is relatively infrequent, but the surgical team should be aware of this anomaly, its draining points, and possible complications, and it must be kept in mind simple and effective solutions about persistent left superior vena cava.