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    Assessment of demographic, clinical and histopathological features of patients who underwent appendectomy due to a presumed diagnosis of acute appendicitis
    (Turkish Assoc Trauma Emergency Surgery, 2021) Akbulut, Sami; Bahce, Zeynep Sener; Oztas, Tulin; Gumus, Serdar; Sogutcu, Nilgun; Sakarya, Hamdi; Gok, Ali Fuat Kaan
    BACKGROUND: To compare the clinical, biochemical, and histopathological features of patients who underwent appendectomy due to a presumed diagnosis of acute appendicitis (AAp). METHODS: The demographic, biochemical and histopathological data of 8206 patients who underwent appendectomy for AAp between January 2006 and March 2014 were retrospectively analyzed in this study. Patients were compared regarding the following characteristics: disruption by season (autumn vs. winter vs. spring vs. summer), working days (weekdays vs. weekends), histopathological findings (AAp vs. normal appendix [NAp]) and histopathological subgroup (non-perforated AAp vs. perforated AAp vs. NAp). RESULTS: Of the 8206 patients aged between 16 and 89 years, 4763 (58.0%) were male. Appendectomy distribution by season was as follows: autumn (n=1959; 23.9%), winter (n=2062; 25.1%), spring (n=2061; 25.1%) and summer (n=2124, 25.9%). NAp rates were higher in summer than those in other seasons. White blood cell (WBC) and neutrophil levels were significantly higher in autumn and winter compared with those in other seasons. In total, 6120 (74.6%) appendectomies occurred on weekdays and 2086 (25.4%) on weekends. WBC and neutrophil levels were significantly higher on weekends than those on weekdays. Appendectomy distribution by histopathological groups as follows: AAp (n=7414; 90.3%) and NAp (n=792; 9.7%). Appendectomy distribution by histopathological subgroups was as follows: non-perforated AAp (n=6966; 84.9%), perforated AAp (n=448; 5.5%), and NAp (n=792; 9.7%). WBC, neutrophil, and TBil levels in the non-perforated and perforated AAp groups were significantly higher than in the NAp group. While most of the patients with perforated AAp (62.1%) and non-perforated AAp (59.6%) were males, most of the patients with NAp (58.1%) were females. CONCLUSION: This study suggests that a relationship exists between demographic features, histopathological findings of appendectomy specimens, seasons, days of the week, and working days in patients undergoing appendectomy.
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    Management of acute cholecystitis during pregnancy: A single-center experience
    (Turkish Assoc Trauma Emergency Surgery, 2019) Barut, Bora; Gonultas, Fatih; Gok, Ali Fuat Kaan; Sahin, Tevfik Tolga
    BACKGROUND: This study aimed to present to evaluate the results of two different approaches in the management of acute cholecystitis during pregnancy: immediate surgery and delayed surgery following conservative management. METHODS: In this study, 20 pregnant women who were treated in our clinic for acute cholecystitis between 2010 and 2018 were included in the analysis. Demographic characteristics, parameters related with acute cholecystitis (gallbladder wall thickness, laboratory data), duration of hospitalization, readmission rates, and preterm labor rate were retrospectively evaluated. RESULTS: The median age was 29.5 years. The median gestational week was 20 (6-32) weeks. Laparoscopic cholecystectomy was performed in 6 (30%) patients on admittance. When compared with the conservative management group, patients who received immediate surgery had higher gallbladder wall thickness. WBC count, and CRP, ALT, AST, ALP, and GGT levels (p<0.05). Furthermore, readmission rate and duration of hospitalization were lower in the patients who underwent immediate surgery (p<0.05). The preterm labor rate in conservative management and immediate surgery groups were 28.5% and 0%, respectively (p>0.05). CONCLUSION: In this study, even though these patients had thicker gallbladder wall and higher inflammatory markers suggesting severe inflammation, the outcome of early surgery was better than conservative management. Although the characteristics of the conservative management group was more favorable, complication rate seemed to be high.
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    Review of the waiting list for cadaveric kidney transplant recipients: A single institution study
    (2019) Bayraktar, Adem; Gok, Ali Fuat Kaan
    Keywords: key, this ratio is below 25% due to insufficient cadaveric organ supply. In this study, we aimed to give a general assessment of cadaveric kidney transplant of patients on the waiting list of Istanbul University Medical Faculty General Surgery Organ Transplantation Unit.br /Material and Methods: Patients waiting for transplantation for a cadaveric kidney on National Organ Waiting List have been evaluated for demographic data, mean duration of dialysis, concomitant diseases, dialysis type, blood groups, end-stage renal failure etiologies, additional diseases that developed during kidney transplant waiting period, and their final status.br /Results: Two hundred and forty-four patients were included in the study. There were 122 female and 122 male. The median age was 52 (2-77) years. The most common etiology of renal failure was hypertensive nephrosclerosis. The median waiting time was 89 months (13-390). Though there was no difference between female and male patients according to median age, height and BMI, there was a significant difference according to waiting duration (F/M 113/75 months, p 0,017). In the last 1 year, 13 patients died while they were waiting for a kidney transplant and 17 patients lost their chance of kidney transplant due to developing diseases.br /Conclusion: To increase Turkey’s organ transplantation and cadaveric transplant donation on the waiting list we need to develop donation policy for a shorter period of dialysis and to ensure that patients receive transplantation earlier.br / Dialysis period, kidney transplantation, cadaveric waiting list.