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    Effects of CO2 insufflation on bacterial growth in rats with Escherichia coli-induced experimental peritonitis
    (Lippincott-Raven Publ, 1997) Sare, M; Yesilada, O; Gurel, M; Balkaya, M; Yologlu, S; Fiskin, K
    The effects of i.p. CO2 insufflation on bacterial proliferation in a setting of Escherichia coli-induced experimental peritonitis was studied in a rat model. Six male Wistar rats were given 0.25 ml of i.p. saline and formed the sham operation group. Twenty-four rats were divided into three groups, and all had i.p. E, coli injections. Microorganism counts were taken after 8 h in ail groups. Group I was used as the control group. Group 2 (laparoscopy) was insufflated with CO2, and group 3 (laparotomy) had a midline laparotomy. Microorganism counts were repeated 8 h after the procedures (16 h after i.p. E. coli inoculation). Postoperative microorganism counts were significantly higher in the CO2 insufflation group (p < 0.05) compared with the control and laparotomy groups and showed an increase, whereas they decreased in the other two groups.
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    The effects of indomethacin, NDGA, allopurinol and superoxide dismutase on prostaglandin E(2) and leukotriene C-4 levels after mesenteric ischemia-reperfusion injury
    (Churchill Livingstone, 1996) Sare, M; Bozkurt, S; Onuk, E; Oguz, M; Gurel, M; Ercan, S
    In this study, the changes of arachidonic acid metabolites after an ischemia-reperfusion (I/R) period are investigated. The cyclooxygenase and lipoxygenase metabolites were found to be significantly increased after a 45 min period of ischemia followed by 5 min of reperfusion. Prostaglandin E(2) (PGE(2))- and leukotriene C-4 (LTC(4))-like activities did not change in the ischemic period, but they both increased after reperfusion. A cyclooxygenase inhibitor indomethacin and lipoxygenase inhibitor nordehydroguaretic acid (NDGA) decreased PGE(2)- and LTC(4)-like activities, respectively, while allopurinol and superoxide dismutase (SOD) decreased both activities. According to our results, it can be assumed that free oxygen radicals are responsible for the elevation of PGE(2)- and LTC(4)-like activities and both of these arachidonic acid metabolites and free oxygen radicals are the main necrotizing agents in ischemia-reperfusion induced damage.
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    Intraoperative laparoscopy by a flexible scope: Is a a good alternative to routine bilateral exploration in childhood hernias?
    (Monduzzi Editore, 1997) Gursoy, MH; Gurel, M; Koltuksuz, U; Uguralp, S; Aydinc, M
    Negative contralateral explorations go on raising the question on whether the contralateral exploration is still necessary or not. To iind out whether the contralateral processus vaginalis was patent or not, we performed intraoperative non-puncture laparoscopy by a flexible scope. We inserted the flexible scope through the open hernia sac and tried to see the opening of the contralateral processus vaginalis. The study involved a total of 20 children, 16 boys and 4 girls. The symptomatic side was explored and laparoscopy was performed through the opened hernial sac. We found a contralateral processus vaginalis in 6 children, 4 boys and 2 girls, by flexible scopy. We confirmed the results by exploring the opposite groin. There was 1 false-positive result in a girl. Intraoperative non-puncture laparoscopy by a flexible scope through the hernial opening is an uncomplicated, reliable and precise method. it may represent a very satisfactory alternative to routine bilateral inguinal exploration and also by its enhanced mobility, it may be much more beneficial than the recently developed technique of scoping children with a rigid laparoscope.
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    Mirizzi syndrome: Choice of surgical procedure in the laparoscopic era
    (Lippincott Williams & Wilkins, 1998) Sare, M; Gurer, S; Taskin, V; Aladag, M; Hilmioglu, F; Gurel, M
    Impaction of a calculus in gallbladder neck or cystic duct or even in its remnant may produce common hepatic duct stricture by direct mechanical impression or associated inflammation. This clinical entity is referred to as Mirizzi syndrome. Four patients were operated on for Mirizzi syndrome. This represents 0.9% of the 444 patients who underwent laparoscopic cholecystectomy in our clinic. Two cases with Mirizzi syndrome type I, one of which had a stone in a gallbladder remnant, were successfully treated by laparoscopic cholecystectomy without any complications, One patient developed a bile leakage; fistulography via a sump drain revealed bile leakage from the laceration site of the stone, and: the patient was reoperated on to perform a Roux-en-Y hepaticojejunostomy. The patient was lost due to cardiopulmonary arrest originating from septic shock. In another case diagnosed as Mirizzi type Il, the operation was converted to an open procedure due to intense inflammation and fibrosis around the area of the Calot's triangle. Subtotal cholecystectomy was done and the defect on the common hepatic duct repaired by means of a gallbladder flap over the T tube.