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Öğe A comparison of crystal phenol treatment, midline primary closure and Limberg flap reconstruction methods in female patients with primary pilonidal sinus disease(Edizioni Luigi Pozzi, 2021) Kanlioz, Murat; Uyanikoglu, Hacer; Ekici, Ugur; Karatas, Turgay; Tatli, FaikPilonidal sinus disease (PSD) is a chronic problem often occurs in healthy hirsute men, however, women may also be affected. A range of conservative techniques to surgical flaps have been used to treat this condition. Currently, midline primary closure (MPC) is considered the standard of therapy; however, no statistically significant difference has been noted between primary versus secondary (Karydakis flap or Limberg flap) closure. Recently, flap reconstruction methods have been applied and superiority of these methods have been shown. Treatment methods should be employed to the individual, taking into account recurrence and complication rates of the method, recovery time, patients' preference and surgeon's skill.Öğe Comparison of primary repair and placing a drain without repair methods in duodenum perforations(Turkish Assoc Trauma Emergency Surgery, 2023) Karatas, Turgay; Kanlioz, Murat; Karatas, Mehmet; Gokturk, Nurcan; Selcuk, Engin Burak; Cevirgen, Furkan; Turkoz, YusufBACKGROUND: Duodenal ulcer perforation is a serious condition. A number of methods have been defined and used in surgical treatment. In this study, it was aimed to compare the effectiveness of primary repair and drain placement without repair methods in duodenal perforations using an animal model.METHODS: Three equivalent groups of ten rats each were formed. Perforation was created in the duodenum in the first (primary repair/sutured group) and the second group (drain placement without repair/sutureless drainage group). In the first group, the per-foration was repaired with sutures. In the second group, only a drain was placed in the abdomen without sutures. In the third group (control group), only laparotomy was performed. Neutrophil count, sedimentation, serum C-reactive protein (CRP), serum total an-tioxidant capacity (TAC), serum total thiol, serum native thiol, and serum myeloperoxidase (MPO) analyses were performed on animal subjects in the pre-operative period and on the post-operative 1st and 7th days. Histological and immunohistochemical (transforming growth factor-beta 1 [TGF-131]) analyzes were performed. Blood analysis, histological, and immunohistochemical findings obtained from the groups were compared statistically.RESULTS: There was no significant difference between the first and second groups, except for the TAC on the post-operative 7th day and MPO values on the post-operative 1st day (P>0.05). Although tissue healing was more pronounced in the second group than in the first group, there was no significant difference between the groups (P>0.05). TGF-131 immunoreactivity observed in the second group was found to be significantly higher than in the first group (P<0.05). CONCLUSION: We think that the sutureless drainage method is as effective as the primary repair method in the treatment of duo-denal ulcer perforation and can be safely applied as an alternative to the primary repair method. However, further studies are needed to fully determine the efficacy of the sutureless drainage method.Öğe The Correlation Between Delayed Surgical Therapy After the Diagnosis of Pilonidal Sinus Disease and Relapse, Labor Loss, and Costs(Springernature, 2019) Karatas, Turgay; Kanlioz, MuratIntroduction There has been no detailed study of the relationship between recurrence and symptom duration in pilonidal sinus disease. The aim of this study was to explore the correlation between delayed surgical therapy after symptoms appear in sacrococcygeal pilonidal sinus disease (SPSD) and relapse, labor loss and costs. Methods Patients diagnosed with SPSD were split into two groups according to symptom duration before surgery: 30 days or less (G1) and more than 30 days (G2). Patients included those who underwent Limberg flap reconstruction (LFR) for primary SPSD. The length of hospitalization during surgery, postoperative follow-up period, and, if any, relapse periods were obtained from patients' files. Of the patients with incomplete information, only those whose information was confirmed by phone were also covered by the study. Results G1 included 153 patients, including 37 (24.18%) females and 116 (75.82%) males. The median age in G1 was 22 years and the mean age was 23.08 +/- 8.72 years. G2 included 214 patients, including 51 (23.83%) females and 163 (76.17%) males. The median age in G2 was 22 years and the mean age was 22.64 +/- 9.06 years. The mean lengths of hospitalization in G1 and G2 were 2.14 +/- 0.86 and 2.98 +/- 1.04 days, respectively, and the difference between them was significant (p<0.03). The follow-up periods in G1 and G2 were 61.52 +/- 29.84 (12-108) and 64.0 +/- 31.24 ( 12-113) months, respectively. Relapse occurred in nine patients (5.8%) in G1 and 19 patients (8.8%) in G2, and the difference between them was significant (p<0.02). The mean relapse period was 3.44 +/- 6.01 and 11.23 +/- 7.62 months in G1 and G2, respectively, and the difference between them was significant (p<0.04). Conclusion Delayed surgery should be avoided to minimize the costs and the probability of relapse in SPSD.Öğe Correlation between perforated appendicitis and total bilirubin(2019) Ekici, Ugur; Kanlioz, MuratAim: In this study, we aimed to examine to what extent total bilirubin (TB) measurements can help us in diagnosing perforated appendicitis. Material and Methods: The TB levels of the patients for whom a surgery was planned with a preliminary diagnosis of appendicitis, were measured and then recorded. The patients with a TB level of 1.20 mg/dL and below were considered “normal”, and those with a TB value of 1.21 mg/dL and above were considered “high”. The appendectomy materials were divided into three groups, namely nonappendicitis, perforated appendicitis and non-perforated appendicitis, according to postoperative pathology report. The statistical correlation between the postoperative pathological findings of appendectomy materials and the groups formed according to TB results was analyzed. Results: Of the patients included in our study, 80 (46%) were female and 96 (54%) were male. The average age was 27.48±12.08 years, and the median age was 25 years. As per the pathology report, 15 patients had no appendicitis (negative laparotomy), 2 (13%) of whom had a high TB level whereas 24 patients had perforated appendicitis, 8 (33%) of whom had a high TB level and 135 patients had non-perforated appendicitis, 28 (21%) of whom had a high TB level. Conclusion: Our study found that the TB level in perforated appendicitis was 1.6 times higher than that in non-perforated appendicitis and 2.5 times higher than that in negative laparatomies. The bilirubin value differences between the groups were statistically significant (p< 0.05).Öğe D-Dimer in inguinal hernias(2019) Kanlioz, MuratAim: This study aimed to find out whether there was a correlation between D-Dimer (DD) and inguinal hernia. Material and Methods: Demographic data, direction of hernia, type of hernia, presence of local coexisting pathology, family history of hernia, presence of chronic disease, chronic obstructive pulmonary disease (COPD), hard labour / sports history, body mass index (BMI) of the patients operated for inguinal hernia are recorded: some labarotory parameters (DD) in blood, CRP, ESR, WBC, neutrophil ratio ( NR ), erythrocyte distribution range ( RDW ), AST, ALT, ALP, GGT ) and their correlation with the patient features were analyzed. The results were analysed using the SPSS statistical program. The correlation between the groups was evaluated by Chi-square test. p<0.05 was considered significant. Results: Total 109 patients operated for inguinal hernia. 34 of 109 patients had DD high (31%). A statistical significance was found between DD and those with chronic diseases, WBC, RDW, NR, type of hernia, family hernia history, heavy labour/ sports history and COPD (p<0.05). Conclusion: DD may constitute an important auxiliary marker in suspected femoral hernia and strangulated hernia. DD in primary hernia was significantly higher than the recurrent hernias and DD rate in those with no family history of hernia was higher in patieents without family history.Öğe DOUBLE MECKEL'S DIVERTICULUM PRESENTING AS ACUTE APPENDICITIS: A CASE REPORT AND LITERATURE REVIEW(Elsevier Science Inc, 2013) Emre, Arif; Akbulut, Sami; Yilmaz, Mehmet; Kanlioz, Murat; Aydin, Burcu ElifBackground: Meckel's diverticulum is the most common developmental anomaly of the gastrointestinal tract, affecting 1-3% of the general population. This anomaly is caused by incomplete obliteration of the omphalomesenteric duct during the 7th week of gestation and is located in the last meter of the ileum in 90% of patients. Meckel's diverticulumis often an incidental finding during a laparotomy for other causes, such as acute appendicitis, and occasional complications are bleeding, obstruction, diverticulitis, and perforation. Objective: Primary aim of this study was to present and share an extremely rare case of double Meckel's diverticulum. Methods: A 20-year-old woman who was admitted due to symptoms of right lower quadrant pain, nausea, and vomiting. A laparotomy with a McBurney's incision was performed because of a presumed diagnosis of acute appendicitis. The surgical exploration revealed a double Meckel's diverticulum localized 50 cm proximal to the ileocecal valve, but no acute appendicitis. The operation was finished after a diverticulectomy and appendectomy. No complications occurred during the postoperative follow-up. Conclusions: We conducted a literature review of studies published in the English language on double Meckel's diverticulum, accessed via PubMed, Medline, and the Google Scholar databases. We found only five case reports of such a Meckel's diverticulum variant. (C) 2013 Elsevier Inc.Öğe Efficacy of Intragastric Balloon Placement and Botulinum Toxin Injection in Bariatric Endoscopy(Lippincott Williams & Wilkins, 2020) Kanlioz, Murat; Ekici, Ugur; Tatli, Faik; Karatas, TurgayBackground: To evaluate the results obtained from the combination of intragastric botulinum toxin A (IGBTA), intragastric balloon (IGB), and IGBTA(+)IGB in the treatment of obesity. Materials and Methods: Three separate treatment groups were set up. IGBTA, IGB, and IGBTA(+)IGB were administered to Group 1, 2, and 3, respectively. The body mass indexes (BMI) of patients were measured before and 6 months after the treatment. The intragroup and intergroup treatment results have been evaluated. PResults: The mean BMI decreased by 1.6 kg/m(2) in 40 patients who received IGBTA in group 1 (P<0.001), 3.95 kg/m(2) in 42 patients who received IGB in group 2 (P<0.001), and 4.9 kg/m(2) in 39 patients who received IGBTA and IGB in group 3 (P<0.001) after 6 months of treatment. The intolerance because of the application was the highest in group 3, followed by group 2. Conclusion: The treatment was most successful in group 3 followed by group 2 and group 1, respectively. The authors recommend the group 3 treatment, provided that nausea, vomiting, and flatulence have a high index of probability in such a treatment. However, when deciding between group 1 and group 2 treatments, the authors recommend opting for group 2 treatment that shows to be more efficient.Öğe Is the appendix length/diameter ratio an early-indicator for the perforation in acute appendicitis?(2018) Ekici, Uğur; Tatli, Faik; Kanlioz, MuratAim: Acute appendicitis is the most frequent reason for the stomachaches resulting in the surgery. The acute appendicitis perforation might create complications that are of vital importance. In this study, it is aimed to examine the relationship of appendix length/ diameter ratio with acute appendicitis perforation. Material and Methods: Using the pathology results of appendectomy materials of 144 patients that applied to emergency service between March 2013 and May 2014 and were operated due to the suspicion of acute appendicitis, the length/diameter ratios were calculated. The patients were divided into 2 groups as perforated appendicitis and non-perforated appendicitis. The number of patients and the length/diameter ratios were calculated and recorded for both groups. Pearson’s Chi-Square test was used for statistical analysis. Results: In pathological examination of 144 patients involved in this study, non-complicated acute appendicitis was diagnosed in 123 (85.4%) patients, while 21(14.6%) patients were found to have perforation. In present study, the results indicating that the length/ diameter ratio might be used as early indicator for the perforation were achieved. When the appendix length/diameter ratio declined below 10, then the perforation frequency significantly increased (p<0.01). Conclusion: Knowing these rate can help the surgeon in early surgical intervention, so the possible complications of perforated appendicitis might be decreased via early surgical intervention.Öğe Is there any relationship between complicated appendicitis and leucocyte counts?(Turgut Özal Tıp Merkezi Dergisi, 2016) Kanlioz, Murat; Ekici, Uğur; Tatlı, Faik; Karataş, Turgay; İnan, TarıkAbstract Aim: We aim to show the increasing in leucocyte count according to severity of inflammation in complicated appendicitis. Materials and Methods: 174 patients who had appendectomy were included in this prospective study. Patient consents were taken. Types of appendicitis were categorized as negative appendicitis, non-complicated appendicitis, and complicated appendicitis. Groups were formed according to leucocyte count as 6000/uL and below (L1), 6001- 12000/ uL (L2), 12001-16000 /uL (L3), and 16001/ uL and higher (L4). Types of appendicitis were compared with leucocyte counts. P <0,05 value was considered positive. Results: All 174 patients were evaluated prospectively. Number of negative appendicitis was 15 (8,62%), non-complicated appendicitis was 135 (77,58%), and complicated appendicitis was 24 (13,79%). There were 4 patients (2,29%) in L1 group, 78 patients (44,82%) in L2, 43 patients (24,71%) in L3, and 49 patients (28,16%) in L4. The sensitivity and specificity of leucocyte counts were 69,7% and 80% in diagnosis of acute appendicitis. Complicated appendicitis cases were compared with leucocyte groups. Complicated appendicitis count was 0 (0%) in L1 group, 6 (7,69%) in L2, 8 (18,60%) in L3, and 10 (20,40%) in L4. There was a positive relationship between complicated appendicitis and increasing in leucocyte count (P<0,03). Conclusion: We have concluded that leucocyte count can be helpful in detecting severity of appendix inflammation in adults. Keywords: Acute Appendicitis; Complicated Appendicitis; Leucocyte Count.Öğe Pilonidal Sinus Disease: An Analysis of the Factors Affecting Recurrence(Lippincott Williams & Wilkins, 2021) Kanlioz, Murat; Ekici, Ugur; Tatli, Faik; Karatas, TurgayOBJECTIVE: o assess the success of treatment methods at reducing recurrence, the most important problem in pilonidal sinus disease (PSD), along with factors affecting the occurrence of PSD and posttreatment recurrence. METHODS; The researchers retrospectively analyzed files of patients treated for PSD between 2003 and 2018. Three study groups were created: G1, G2, and G3. G1 included all PSDs with recurrence, and a comparable number of cases without recurrence were selected randomly for the G2 group. The control group, G3, included healthy individuals without PSD. In all groups, the following were recorded: body mass index, skin color and oiliness, family history of PSD, hair overgrowth, smoking habit time spent sitting per day, and number of baths per week. The following were additionally recorded for G1 and G2 treatment methods, follow-up periods, pretreatment abscess(es), and time of onset of complaints before treatment The number of recurrences and the period between last treatment and recurrence were also recorded for G1. RESULTS: G1 comprised 234 patients: G2, 247 patients; and G3, 128 healthy individuals. The significant factors causing recurrence included body mass index, family history, bathing habits, hair overgrowth, skin color and oiliness, time spent sitting per day, smoking habit, abscessles), and duration of symptom(s)(P < .05). Limberg flap repair was the most successful treatment method. Sixty-three (27%), 135 (58%), and 185 (79%) recurrences occurred in the first 6 months, in the first year, and in the first 2 years, respectively. CONCLUSIONS: The researchers recommend Limberg flap repair for treatment. It is possible to reduce recurrence by taking preventable factors into consideration.Öğe The place of total testosterone in the etiology of pilonidal sinus disease(2020) Kanlioz, Murat; Karatas, Turgay; Ekici, Ugur; Tatli, FaikAim: There are lots of factors accused in the etiology of SPSD. One of those factors is hypertrichosis. Hypertrichosis is increased by high levels of testosterone. In our clinical practices, we observe the secondary effects of high testosterone levels in those with SPSD. Hence, we intended to analyze the correlation between testosterone and SPSD.Material and Methods: The first 200 patients who applied to General Surgery Clinic at Malatya State Hospital and were diagnosed with SPDS, were included in the study after being informed of our research and signing the informed consent form. The total testosterone (TT) levels of the patients were measured and recorded along with their demographic data. Also, a control group was formed of male and female patients without SPSD having the same demographic characteristics, whose TT levels were also subsequently recorded. The data from control and study groups were then compared and analyzed.Results: Of the 200 patients included in the study, 43 (21.5%) were female and 157 (78.5%) were male. Their overall mean age was 24.13±7.04 years and the median age was 22 years (min:14- max:50). The male-to-female ratio was 3.65. The rate of females and males who had high levels of TT was significantly higher than that of the control group (p0.001). Conclusion: We recommend measuring serum TT levels of patients who apply to hospital for SPSD. SPSD might be the first visible ring of the chain of diseases characterized by high levels of TT.Öğe Predisposing factors and demographic analysis in inguinal hernia(2019) Kanlioz, Murat; Ekici, UgurAim: This study aims to identify the distribution of inguinal hernia by types, age and gender, and to find the correlation between inguinal hernia and chronic diseases, lifestyle and familial tendency. Material and Methods: Of the patients admitted to our clinic, the following were recorded: age, gender, height, weight, body mass index (kg/m²), whether they do heavy labour or sports, chronic disease, direction of hernia, whether there is incarceration and strangulation and immediate family history of inguinal hernia. The data were analysed using the SPSS statistics software. p<0.05 was considered significant. Results: The study included 116 patients, of whom 12 (10.34%) were female and 104 (89.66%) were male. The mean age was 52.89 years, and the median age was 53.5 years. When the whole study group was evaluated, it was found that 5 (4.31%) of the patients had incarceration where 31 (26.72%) had family history, 36 (31.03%) had a history of chronic disease and 85 (73.27%) had a history of heavy labour/sports. Conclusion: Whereas the rate of hernia history in the families of patients with inguinal hernia was 28.8% in males and 8.3% in females, the difference in-between was statistically significant (p<0.001). Of the patients with inguinal hernia, the chronic disease rate was 31.7% in males and 25% in females, and the difference in-between was statistically significant (p<0.01). Of the patients with inguinal hernia, the rate of doing heavy labour/sports was 78.6% in males and 41.6% in females, and the difference in-between was statistically significant (p<0.01).Öğe The Relationship of Perforated Appendicitis with Total and Direct Bilirubin(Springernature, 2019) Kanlioz, Murat; Karatas, TurgayIntroduction Very different results have been reported regarding the relationship between bilirubin and perforated appendicitis. We observed this relationship with our own studies. Methods The patients, who underwent appendectomy, were retrospectively categorized as perforated and non-perforated based on their files. Those with a total bilirubin (TB) 1.20 mg/dL or less were considered normal whereas those with a 1.21 mg/dL or higher were considered having a high. Those with a direct bilirubin (DB) 0.50 mg/dL or less were considered normal whereas those with a 0.51 mg/dL or higher were considered having a high. The patients were assessed under two groups. Perforated appendicitis (PA) and non-perforated appendicitis (NPA) were analyzed according to the TB in Group 1 and the DB in Group 2. Results Group 1 included 269 patients whose TB were measured. Of those, 218 had NPA and 51 had PA. The rate of patients with high TB among the patients with PA was 1.37 times higher than those with NPA (p (<) 0.01). Group 2 included 258 patients whose DB values were measured. Of those, 208 had NPA and 50 had PA. The rate of patients with high TB among the patients with PA was 1.71 times higher than those with NPA (p (<) 0.001). Conclusion In the diagnosis of PA, both TB and DB show low diagnostic values. In the diagnosis, they can only be considered as a supportive factor to other parameters. However, in the case of a differential diagnosis, we recommend using DB since it has a higher sensitivity and specificity.Öğe Retrospective analysis of inguinofemoral hernias(2020) Karatas, Turgay; Ozbag, Davut; Kanlioz, MuratAbstract: We aim to present the operative findings of inguinal and femoral hernias that were operated.The records of 732 patients who underwent surgery for inguinal and femoral hernia between March 2000 and January 2013 were evaluated retrospectively. The number, sex, and age of patients, type and side of hernias, the existence of strangula-tion, structure, and content of hernia sac were recorded.684 (93.4 %) of patient is male, 48 (6.5 %) of patient is female. The average age was 46.2. The rate of inguinal hernia was 96.7 %. However, the rate of femoral hernia was 3.2 %. Inguinal hernia 97.9 % and femoral hernia 2 % was found among males. Inguinal hernia 79.1 % and femoral hernia 20 % was found among females. Indirect hernia rates were 70.4 % among males and 75 % among females. Direct hernia rates were 20.7 % among males and 4.1 % among females. Hernias were located in 59 % on right-side, in 37 % on left-side, in 3.1 % on bilateral. The strangulated hernia was seen at 3.1 % in all cases. Strangulation rate was higher among women (6.2 % - 2.9 %). The strangulation rate was 16.6 % in femoral hernia, but this ratio was 2.6 % in inguinal hernia. Hernia sac consisted of peritoneum frequently (99.4 %). The structure that was found mostly in hernia sac was omentum majus (40.4 %).Inguinal hernias are encountered more than femoral hernias. The strangulation rate in femoral hernias is higher than in inguinal hernias. Since the strangulation rate is higher in femoral hernias, the surgical urgency of this type of hernias is higher than inguinal hernias. At the same time, because the internal organs can form the hernia sac or the organ inside the sac, the surgeon should pay maximum attention during the operation.Öğe Routine Histopathologic Examination of Appendectomy Specimens: Retrospective Analysis of 1255 Patients(Int College Of Surgeons, 2013) Emre, Arif; Akbulut, Sami; Bozdag, Zehra; Yilmaz, Mehmet; Kanlioz, Murat; Emre, Rabia; Sahin, NurhanThe objective of this study was to analyze the clinical benefit of histopathologic analysis of appendectomy specimens from patients with an initial diagnosis of acute appendicitis. We retrospectively analyzed the demographic and histopathologic data of 1255 patients (712 males, 543 females; age range, 17-85 years) who underwent appendectomy to treat an initial diagnosis of acute appendicitis. Patients who underwent incidental appendectomy during other surgeries were excluded from the study. Histopathologic findings of the appendectomy specimens were used to confirm the initial diagnosis. Ninety-four percent of the appendectomy specimens were positive for appendicitis. Of those, 880 were phlegmonous appendicitis, 148 were gangrenous appendicitis with perforation, and the remaining 88 showed unusual histopathologic findings. In the 88 specimens with unusual pathology, fibrous obliteration was observed in 57 specimens, carcinoid tumor in 11, Encheliophis vermicularis parasite infection in 8, granulatomous inflammation in 6, appendiceal endometriosis in 2, and 1 specimen each showed mucocele, eosinophilic infiltration, Taenia saginata parasite infection, and appendicular diverticulitis. All carcinoid tumors were located in the distal appendix. Six of the 11 carcinoid tumors were defined by histopathology as involving tubular cells, and the other 5 as involving enterochromaffin cells. Six patients had muscularis propria invasion, 2 patients had submucosa invasion, 2 patients had mesoappendix invasion, and 1 patient had serosal invasion. All patients with tumors remained disease free during the follow-up (range, 127 months). We conclude that when the ratio of unusual pathologic findings for appendectomy specimens is considered, it is evident that all surgical specimens should be subjected to careful histologic examination.Öğe Ultrasonography in diagnosis of acute appendicitis(Edizioni Luigi Pozzi, 2016) Tatli, Faik; Ekici, Ugur; Kanlioz, Murat; Gozeneli, Orhan; Uzunkoy, Ali; Yucel, Yusuf; Dirican, AbuzerPURPOSE: Acute appendicitis is the most common surgical abdominal emergency. In the early diagnosis of acute appendicitis, the fact that there is no a sign which could be a reliable indicator in most of the patients increases the complications. In this study we aimed to search the relation between Ultrasonography(US) findings in patients with diagnosis of acute appendicitis and postoperative histopathologic investigation on remoced appendix.. MATERIALS AND METHODS: The files of 174 patients who came in our emergency department with lower right abdominal pain were studied retrospectively from January 2013 to May 2014. Of them, 26 patients were excluded, because these patients were not studied with US. US findings and histopathology reports of 148 patients with suspected acute appendicitis and studies preoperatively with abdominal US were enrolled. Greater than 6-mm diameter of the appendix under compression was accepted as positive sign of appendicitis in US. The demographic characteristics of the patients, US findings (acut appendicitis or not) and the pathology results were recorded on the standard proform. RESULTS: Of these 148 patients, 100 were acute appendicitis in preoperative US, and of these 100 patients, 93 histopathologic reports were acute appendicitis, 7 were normal appendices. The sensitivity of US was 75.6 % and specificity was 72 %. Positive predictive value (PPV) was 93 %, negative predictive value (NPTO was 14.6 % and the accuracy of US value was 81.7%. As a result, although US in diagnosis of acute appendicitis is a reliable technique, negative result doesn't mean no acute appendicitis. In order to determine an accurate diagnosis of acute appendicitis clinical and laboratoary findings should be assessed together.
