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Öğe Comparison of limberg flap and primary suture technique in surgical treatment of sacrococcygeal pilonidal sinus(Turgut Özal Tıp Merkezi Dergisi, 2016) Kafadar, Mehmet TolgaAbstract Objective: In this study, we aim to present the results of two different surgical techniques in sacrococcygeal pilonidal sinus that we operated on. Materials and Methods: 123 patients who underwent Limberg flap or primary suture for pilonidal sinus by a single surgeon were evaluated prospectively at Bitlis State Hospital between October 2011 and September 2014. Patients were divided into two groups: in group 1 (n=65), rhomboid excision of tissue was applied and wound was closed with Limberg flap. In group 2 (n=58), after excision, wound was primarily closed. All patients were evaluated for postoperative complication and recurrence. Results: 109 (88.6%) of patients were male and 14 (11.4%) were female, the proportion of male to female patients was 7.8/1. The most common postoperative complications were seroma (n=10) and infection (n=9) in the both groups. Significant difference was detected in both groups for complications (p=0.012). Patients were followed up 14.7±4.4 months in group 1 and 14.6±4.3 months in group 2. Recurrence rate was more common in group 2 (n=8) when compared to group 1 (n=1). A statistically significant difference was determined in both groups for recurrence (p=0.009). There was no differences between groups as far as postoperative pain and time to return work is concerned. Conclusion: Recurrence was noticed more commonly in the patients with primary repair compared to Limberg flap repair in this study. No significant difference in terms of postoperative pain and time to return to work being found. We arrived to the conclusion that Limberg flap is a good technique for the repair of pilonidal sinus disease due to less recurrence rate and infection rate. Keywords: Pilonidal Sinus; Limberg Flap; Complication.Öğe Imipenem-associated seizure in a patient operated for left-sided colon tumor(Turgut Özal Tıp Merkezi Dergisi, 2016) Kafadar, Mehmet Tolga; Miryaguboğlu, Abdullayev Mirsaleh; Gençler, Serdar; Kılıç, Hatice; Şen, MeralAbstract Although the pathophysiology of drug-associated seizures involves many factors, it mainly depends on the culprit drug and case-specific factors. There is usually no previous history of epilepsy in these patients, and epileptic seizures are due to lowering in epileptic threshold by the culprit drug. Epileptic seizures usually do not recur when the culprit agent is discontinued. Convulsion is a rare side effect of beta-lactam antibiotics. The neurotoxic side effects of carbapenem group antibiotics are thought to occur through an interaction with amino butyric acid receptors. Meropenem and imipenem are also a carbapenem group antibiotic. A 61-year-old man who developed a postoperative wound infection after being operated for left colon tumor had Klebsiella Pneumoniae proliferation in culture antibiogram and was put on imipenem/cilastatin treatment. He developed seizures with tonic-clonic convulsions on the fourth day of treatment, and the seizures were attributed to the imipenem/cilastatin treatment. No other pathology suggestive of seizure etiology could be found in his examinations. His antibiotic regimen was changed to a different one and he was discharged in good health on the 11th day of his hospital admission. Keywords: Antibiotheraphy; Imipenem; Seizure.Öğe Incidence of thyroid carcinoma in patients undergoing thyroidectomy for nodular goiter in bitlis province(Turgut Özal Tıp Merkezi Dergisi, 2016) Kafadar, Mehmet TolgaAbstract Objective: The most frequently observed endocrine cancer is thyroid malignity. It constitutes only one percent of all malignities. The aim of this study is to investigate the incidence of thyroid cancer in cases with nodular goiter who undrewent thyroidectomy performed by a single surgeon in Bitlis province (Turkey), an endemic goiter region. Materials and Methods: Pathology reports with surgery indication of 940 patients, who underwent thyroidectomy administered by the same surgeon for nodular goiter at Bitlis State Hospital between September 2008 and March 2015, were studied retrospectively. Postoperative histopathologic examinations were evaluated. Results: Female and male counts of our 940 patients were 827 (88%) and 113 (12%), respectively. The proportion of female to male patients was 7,3/1. 30 of 940 patients (3,2%) underwent one part total and the other part near total thyroidectomy and 910 patients (96,8%) underwent total thyroidectomy. Histopathological examination showed that 825 (87,7%) cases had nodular hyperplasia, 46 (4,9%) cases had lymphocytic thyroiditis, and 69 (7,3%) cases had thyroid tumors. 69 tumors in 18 (26%) cases were benign; 51 (74%) cases were malign. In terms of cancer type, 45 (4,7%) cases had papillary carcinoma, 5 (0,5%) cases had follicular carcinoma, and 1 (0,1%) case had medullary carcinoma. Conclusion: In some cases in endemic goiter regions, received exogenous iodine can affect cytological results and cause changes in thyroid tissue morphology. The observed incidence of thyroid cancer was 5,4% in the cases who underwent thyroidectomy due to nodular goiter in Bitlis province; and papillary thyroid carcinoma was the most observed cancer type. Keywords: Endemic Nodular Goiter; Thyroidectomy; Thyroid Carcinoma.Öğe Inguinal hernia repair via laparoscopic transabdominal preperitoneal (TAPP) method: Our 2 years clinical results(2021) Gok, Mehmet Ali; Kafadar, Mehmet TolgaAim: Inguinal hernia repair is one of the most common surgeries in General Surgery practice. Although different surgical procedures have been used for the treatment of hernias, minimally invasive approaches are increasingly preferred to manage hernia repair. The aim of this study is to evaluate our 2-year laparoscopic transabdominal preperitoneal (TAPP) hernia repair outcomes. Materials and Methods: The data of patients who were diagnosed with inguinal hernia and who underwent the TAPP procedure between the dates of December 2017 and December 2019 were evaluated retrospectively.Results: Ninety-six patients were included in this study. Of these patients, 89 were male and 7 were female. The mean age was 46 (range between 22 and 76). Fifty six (58.3%) cases had right inguinal hernia, 22 (22.9%) cases had left inguinal hernia and 18 (18.7%) cases had bilateral inguinal hernia. The mean hospital stay was 1.06 (1-3) days. In the early postoperative period we observed for minor complications such as seroma, hydrocele, epididymitis, and hematoma. Three patients experienced chronic pain. Recurrence was observed in 3 patients during follow-up. No major complications were seen.Conclusion: Laparoscopic hernia repair is an efficient and attractive method because it offers better cosmetic results, earlier recovery, less pain, shortened hospital stay and early return to daily activities. However, the learning process for performing this procedure is more difficult than for the open method. Therefore, the learning curve of laparoscopic hernia surgery is longer. It has been reported that there is a difference in the rate of recurrence in surgeons trained in the laparoscopic method after specialization. We believe that this method can be applied safely by people who have received laparoscopic hernia surgery training.Öğe The results of perforated peptic ulcer surgery; A single center experience of 86 patients(2018) Oter, Volkan; Yalcin, Metin; Kafadar, Mehmet Tolga; Oter, SerdarAim: At the present time, eradication of the Helicobacter pylori infection is dramatically reduced the risk of the peptic ulcer disease. Whereas, complication rate of the peptic ulcer, such as perforations or bleedings have not been reduced significantly yet. The aim of the current study is to analyze the surgical treatment outcomes of our experiences in 86 patients with peptic ulcer perforation. Material and Methods: Between January 2012 and December 2017, 86 patients who were operated emergently for perforated peptic ulcer disease with Graham’s omental patch procedure in our hospital were included in this study. Demographic, clinical data, diagnostic studies, surgical procedures, operative findings, postoperative complications and patient follow-up were analyzed. Results: The mean age was 41.57±16.09 years. Out of 86 cases there were 65 (75.6%) male patients and 21 (24.4%) female patients. The mean operation time was 66.98±18.61 minutes. The mean hospital stay period was 7.95±2.02. In three months of follow-up period, endoscopy was done to all of these patients and peptic ulcer disease was not seen in any of them. Conclusion: Our findings revealed that Graham’s omental patch repair is still a useful method for perforated peptic ulcer disease. Low complication rates, low duration of hospital stay and also low postoperative morbidity can be achieved with good preoperative and postoperative supportive care in open surgery for peptic ulcer perforation. Laparoscopic surgery should be performed only in the presence of experienced surgeon and also in the presence of sufficient laparoscopic materials.