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    Comparison of postoperative analgesic efficacy of bupivacaine and levobupivacaine for dorsal penile block
    (Bayrakol Medical Publisher, 2024) Esen, Hayruenisa Kahraman; Esen, Osman; Yildiz, Turan; Ilce, Zekeriya
    Aim: In this study, we aimed to evaluate the postoperative analgesic efficacy and side effects of bupivacaine and levobupivacaine for dorsal penile blockage in circumcised patients. Material and Methods: A total of 84 circumcised patients (age range: 7-11 years) were enrolled in this study. The patients were divided into two groups according to the dorsal penile block method: bupivacaine utilized Group B, levobupivacaine utilized Group L. Blocks were administered preoperatively with 1mL kg -1 of 0.25% bupivacaine and levobupivacaine. Postoperative pain scores and sedation were evaluated. Pain assessment was performed using the WongBaker faces Pain Scale (WBPS). The number of patients without pain within the first 6 hours, analgesia duration, time of first analgesia, and total paracetamol consumption were recorded. Results: Mean scores of WBPS were found statistically higher at the first, second and third hours in group B than in group L (p<0,05). The results showed no statistically significant differences between groups according to the WBAS assessment at 4, 5 and 6 hours, rates of rescue analgesic requirement and also rescue paracetamol dose between the groups. Discussion: Administration of levobupivacaine for dorsal penile blockage was found to be more efficient to provide postoperative analgesia and also to reduce postoperative analgesia utilization than bupivacaine in circumcised children under general anesthesia.
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    External hemorrhoidal disease in child and teenage: Clinical presentations and risk factors
    (Professional Medical Publications, 2019) Yildiz, Turan; Aydin, Dilek Bingol; Ilce, Zekeriya; Yucak, Aysel; Karaaslan, Erol
    Objective: Hemorrhoidal disease (HD), though mostly seen in adults, has recently emerged as a common problem among children. However, the diagnosis and treatment of HD in children is mostly based on the data obtained in adult studies. In this study, we aimed to evaluate risk factors, diagnostic and treatment modalities in the children diagnosed with external HD. Methods: The study was conducted at Sakarya University Medical School Pediatric Surgery Department between January 2012 and July 2018. We reviewed children who were diagnosed as having HD at Pediatric Surgery clinic. Age, gender, presenting symptoms, physical examination findings, risk factors, and treatment outcomes were evaluated for each patient. Results: The study included 56 patients with a mean age of 140.8 +/- 45.2 months. The patients comprised 48 (85.7%) boys and 8 (14.3%) girls. Constipation and a positive family history were the most common risk factor (n=33; 58.9%, n=29; 51.8%, respectively). Conservative treatment was performed in 53 (94.6%) patients. Recurrence was observed in 5 (8.9%) and skin tag was detected in 6 (10.7%) patients. Conclusions: External HD mostly occurs in boys in their second decade of life. Positive family history and constipation were the most common risk factors in our patients. Conservative treatment is sufficient for the management of external HD in children because of its low recurrence rates.
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    Place of Cholecystectomy in Children with Uncomplicated Gallstones
    (Kowsar Corp, 2019) Yildiz, Turan; Ilce, Zekeriya; Turan, Gupse; Yucak, Aysel; Elmas, Bahri; Alan, Cumali
    Background: The incidence of gallstones in children has increased in recent years. Risk factors that increase the formation of bile duct stones have been described in children, and discussions are ongoing about surgical indications of uncomplicated gallstones. Objectives: This study aimed to investigate the impact of risk factors on gallstone-induced complications and identify surgical indications for uncomplicated gallstones in children. Methods: Patients who had a cholecystectomy in the pediatric surgery clinic between October 2011 and January 2018 were evaluated. Data including age and sex, body mass index (BMI), associated risk factors, gallstone-induced complications, postoperative complications, postoperative complaints, and pathological results were recorded. Results: Seventy-two patients were included in the study. The mean age was 13.2 years with a female-to-male ratio of 2.27:1. Obesity was the most common risk factor (25%). A total of 44% of the patients experienced a complication on admission. The risk factors had no effect on the development of complications. The patients underwent cholecystectomy, but some symptoms persisted in thirteen patients postoperatively (18.1%). Ten of these patients did not have any risk factors; however, chronic cholecystitis findings were not identified in six specimens of those with uncomplicated gallstones. Conclusions: The risk factors have no influence on the development of gallstone-induced complications in children. Gallstones were cured with cholecystectomy; however, some complaints persisted in risk-free and uncomplicated gallstones. We think that if there are no risk factors in patients with uncomplicated gallstones, the patients should not receive surgerybut be closely monitored.
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    Simple patch closure for perforated peptic ulcer in children followed by Helicobacter pylori eradication
    (Professional Medical Publications, 2014) Yildiz, Turan; Iice, Huri Tilla; Ceran, Canan; Ilce, Zekeriya
    Objective: Peptic ulcer disease in children is rare. Therefore, the diagnosis can be missed until complications such as perforation or hemorrhage occur. Few reports have investigated the procedures and outcomes of children who have undergone operations for perforated duodenal ulcers. We report our experience with the modified Graham technique for perforated duodenal ulcers in nine children and review the literature. Methods: The records of patients operated on for a perforated duodenal ulcer in the last 8 years in two pediatric surgery centers were evaluated retrospectively. Patient demographics, symptoms, time to admission to hospital, operative findings, and postoperative clinical course were evaluated. Results: Nine children (mean age 13.2 years, range 6-170 years) were included. All patients were admitted in the first six hours after their abdominal pain started. In three patients, there was free air on plain x-rays, while the x-rays were normal in six. All perforations were located on the anterior surface of the first part of the duodenum and repaired with primary suturing and Graham patch omentoplasty. The recovery was uneventful in all patients. In five patients, urea breath tests were performed postoperatively for Helicobacter Pylon, and the results were positive. All patients underwent triple therapy with lansoprazole, amoxicillin, and clarithromycin. The mean follow-up time was 58 (range 3-94) months. Conclusions: Peptic ulcer perforation should be suspected in children who have acute abdominal pain and peritoneal signs, especially when their suffering is intense. The simple patch repair and postoperative triple therapy for Helicobacter Pylori are safe and satisfactory for treating peptic ulcer perforation in children.