Yazar "Koç, Süleyman" seçeneğine göre listele
Listeleniyor 1 - 10 / 10
Sayfa Başına Sonuç
Sıralama seçenekleri
Öğe AKUT BATIN SENDROMUNUN NADİR BİR SEBEBİ: İLEOÇEKAL TÜBERKÜLOZ(2017) Çakır, Tuğrul; Polat, Cemal; Baştürk, Ahmet; Koç, SüleymanÖz: Gastrointestinal tüberküloz en sık görülen eks-trapulmoner tüberküloz tiplerindendir. Klinikte karın ağrısı, kilo kaybı, ateş, halsizlik, bulantı, iştahsızlık, kusma, distansiyon, gece terlemesi, diare, kabızlık gibi nonspesifik semptom ve bul-gular gösterir. İleoçekal bölgede kitleye bağlı akut karın sendromuna yol açması nadirdir. Hasta akut perfore apandisit ön tanısıyla ope-re edildi, fakat apandisitin ileoçekal tüberküloz kitlesine bağlı geliştiği görüldü ve sağ hemiko-lektomi ve ileotransversostomi uygulandı. Pos-toperatif dönemde bir sorun gelişmedi.Öğe Amyand hernia(2018) Dirican, Abuzer; Ateş, Mustafa; Koç, Süleyman; Özgör, Dinçer; Kocaaslan, Hüseyin[Abstract Not Acailable]Öğe Canlı Vericili Karaciğer Naklinden Sonra Gelişen Hepatik Venöz Çıkım Darlığı(İnönü Üniversitesi, 2014) Koç, SüleymanAMAÇ: Canlı vericili karaciğer nakli (CVKN) sonrası görülen önemli komplikasyonlardan biri hepatik venöz çıkım darlığı (HVÇD)'dır. HVÇD gelişme riskini minimize etmek için çeşitli venöz rekonstruksiyon modelleri geliştirilmiştir. Teknik gelişmelere rağmen HVÇD gelişen olgulara ne zaman ve nasıl yaklaşılması gerektiği konusundaki karmaşa hala devam etmektedir. Bu çalışmada CVKN sonrası HVÇD gelişen olgulara yaklaşımımızı paylaşmayı amaçladık. GEREÇ ve YÖNTEM: Kasım 2007 ile Nisan 2014 tarihleri arasında İnönü Üniversitesi tıp Fakültesi Genel Cerrahi Anabilim Dalında CVKN yapılan 1011 hastanın dosyaları retrospektif olarak incelendi. Nakil sonrası HVÇD gelişen 35 hastanın demografik, klinik ve radyolojik verileri retrospektif olarak değerlendirildi. Altta yatan sebepler gözönünde bulundurularak nakil sonrası ilk 30 gün içinde gelişen venöz darlıklar erken dönem HVÇD, 30. günden sonra ortaya çıkan darlıklar ise geç dönem HVÇD'ı olarak tanımlandı. HVÇD'nın tanısında karaciğer fonksiyon testleri, Doppler ultrasonografi ve dinamik bilgisayarlı tomografiden yararlanıldı. Ayrıca konvansiyonel venografi ile hem HVÇD tanısı doğrulandı hemde gerekli girişimsel tedavi yapıldı. BULGULAR: Yaşları 1 ile 61 yıl arasında değişen (32.5±20.3 yıl) 22'si erkek ve 13'ü kadın olmak üzere toplam 35 (%3.46) hasta çalışmaya dahil edildi. Hastaların 24'ü erişkin [yaş: 18-61 (44.1) yıl, MELD Skoru: 8-50 (19.3) GWRW: %1.1 (% 0.8-1.9)] ve 11'i pediatrik [yaş: 1-17 (8.0) yıl, PELD Skoru: 2-41 (22.4) GWRW: %1.6 (% 0.78-3)] yaş grubundandı. Hastalarda karaciğer naklinden ortalama 205.7±264 gün (aralık: 14 – 1440 gün) sonra HVÇD ile uyumlu bulgular gelişti. Hastaların 8'inde post-transplant erken dönemde (≤30 gün) HVÇD gelişirken 27 hastada ise geç dönemde (>30 gün) HVÇD gelişti. Hastalara ortalama 1.5 ± 1.1 (aralık:1-6) kez balon anjioplasti yapıldı. Balon anjioplasti yapılan 4 hastaya (2 erişkin, 2 pediatrik) aynı seansta genişleyebilir stent yerleştirildi. Anjioplasti sonrası 51 ile 2310 günlük takip sürecinde 24 (%68.6) hastada HVÇD ile ilgili belirtiler tamamen gerilerken 11 (%31.4) hastada HVÇD ile klinik tabloda düzelme olmadı. Klinik t ablosu düzelmeyen hastaların 9'u greft yetmezliğinden, 2'si retransplantasyondan sonra kaybedildi. Özetle post-transplant erken dönemde HVÇD gelişen olguların % 62,5'inde mortalite gelişirken post-transplant geç dönemde HVÇD gelişen olguların ise % 22,2'sinde mortalite gelişti. SONUÇ: CVKN sonrası HVÇD oranlarımız (%3.46) literatürde yayınlanan oranlardan daha düşüktür. Bu durum hepatik venöz drenaj için kullandığımız geniş ağızlı venöz anastomoz modeli ile yakından ilişkilidir. HVÇD gelişen olgulara yaklaşımda öncelik anjiografik tanı araçlarına verilmelidir. Anahtar Kelimeler: Karaciğer nakli, Venöz rekonstrüksiyon, Hepatik venöz çıkım darlığı, Balon anjioplastiÖğe Futility versus acceptability of the use of grafts taken from end of line in the national organ sharing network(Transplantation Proceedings, 2015) Soyer, Vural; Koç, Süleyman; Onur, Asım; Sarıcı, Kemal Barış; Kayaalp, Cüneyt; Işık, Burak; Ünal, Bülent; Yoloğlu, Saim; Yılmaz, SezaiBackground. The number of suitable donors for organ transplantation is limited in many countries. This limitation can be overcome with the use of organs removed from marginal donors (expanded-criteria donors [ECDs]). We examined the long-term results of 187 patients who underwent marginal cadaveric liver transplantation in our institution. Methods. The data of patients who underwent cadaveric liver transplantation from January 2007 to April 2014 were retrospectively reviewed. ECDs were evaluated by considering 19 internationally accepted criteria. The clinical data of recipients including age, clinical status, and Model for End-Stage Liver Disease (MELD) score were also assessed. Results. A total of 287 patients underwent cadaveric liver transplantation. A graft from an ECD was used in 181 (63.06%) patients. The mean MELD score was 18.8. In all, 45 patients (24.86%) underwent transplantations for fulminant liver failure and 136 patients (75.14%) underwent transplantations for other chronic conditions. The majority of donors died of cerebrovascular disease and trauma. Only hypotension requiring inotropic drugs and obesity significantly affected survival. The 90-day and 12-month survival rates of the recipients who received a graft from an ECD were 51.93% and 46.2%, respectively. Conclusions. The use of ECD allografts immediately and significantly expands the existing donor pool. Because of persistent organ scarcity, pressure to use a greater proportion of the existing donor pool will continue to increase.Öğe Futility versus acceptability of the use of grafts taken from end of line in the national organ sharing Network(Transplantation Proceedings, 2015) Soyer, Vural; Koç, Süleyman; Onur, Asım; Sarıcı, Kemal Barış; Kayaalp, Cüneyt; Işık, Burak; Ünal, Bülent; Yoloğlu, Saim; Yılmaz, SezaiBackground. The number of suitable donors for organ transplantation is limited in many countries. This limitation can be overcome with the use of organs removed from marginal donors (expanded-criteria donors [ECDs]). We examined the long-term results of 187 patients who underwent marginal cadaveric liver transplantation in our institution. Methods. The data of patients who underwent cadaveric liver transplantation from January 2007 to April 2014 were retrospectively reviewed. ECDs were evaluated by considering 19 internationally accepted criteria. The clinical data of recipients including age, clinical status, and Model for End-Stage Liver Disease (MELD) score were also assessed. Results. A total of 287 patients underwent cadaveric liver transplantation. A graft from an ECD was used in 181 (63.06%) patients. The mean MELD score was 18.8. In all, 45 patients (24.86%) underwent transplantations for fulminant liver failure and 136 patients (75.14%) underwent transplantations for other chronic conditions. The majority of donors died of cerebrovascular disease and trauma. Only hypotension requiring inotropic drugs and obesity significantly affected survival. The 90-day and 12-month survival rates of the recipients who received a graft from an ECD were 51.93% and 46.2%, respectively. Conclusions. The use of ECD allografts immediately and significantly expands the existing donor pool. Because of persistent organ scarcity, pressure to use a greater proportion of the existing donor pool will continue to increase.Öğe Liver transplantation with livers from octogenarians and a nonagenarian(Transplantation Proceedings, 2015) Dirican, Abuzer; Soyer, Vural; Koç, Süleyman; Yağcı, Mehmet Ali; Sarıcı, Kemal Barış; Onur, Asım; Ünal, Bülent; Yılmaz, SezaiIntroduction. A shortage of deceased donors has compelled the use of extended-criteria donor organs in liver transplantation. The purpose of this study was to evaluate the impact of using deceased donors older than 80 years. Materials and Methods. We retrospectively evaluated 13 patients who received a liver graft from cadaveric donors older than 80 years between December 2007 and March 2014. We analyzed the donor and their recipient characteristics together with morbidity and mortality of recipients. Results. All 13 donors were older than 80 years (median age, 82.7; range, 80e93). There were 9 male and 4 female recipients with an average age of 50.7 (range, 2e65) years. All of the recipients did not have a living donor for liver transplantation. Recipients’ mean model for end-stage liver disease (MELD) score was 14.2 (range, 7e20). Graft with macroscopic steatosis was not accepted. Medium follow-up was 19.5 months. The most frequent cause for liver transplantation (LT) was hepatitis B virus (HBV) cirrhosis (8/13 patients). We had 1 case of primary nonfunction, and 4 patients died in 2 weeks after surgery. Of these patients, 2 of them received a split transplant from an 80-year-old cadaver liver. Overall the survival rate after 1 year was 61.5%. Conclusions. Deceased elderly donor usage in LT could expand the donor pool. Liver grafts from donors older than 80 years can be used in necessity or emergency situations. However, care should be taken to avoid early mortality and primary nonfunction. Procedures extending cold ischemia time such as split liver transplantation may increase the risk of primary nonfunction.Öğe Persistan hiperparatiroidiye neden olan intratimik paratiroid adenomu olgu sunumu(Causapedia, 2015) Sarıcı, Kemal Barış; Soyer, Vural; Ünal, Bülent; Koç, Süleyman; Onur, Asım; Dirican, AbuzerPrimer hiperparatiroidide (PHP) en sık etyolojik faktör, ektopik olarak yerleşimde gösterebilen soliter paratiroid adenomudur. Daha önce iki kere paratiroid adenomu nedeni ile opere edilmiş, kan kalsiyum ve parathormon düzeyi yüksekliği devam eden 63 yaşındaki kadın hasta sunuldu. Adenomun preoperatif tc99-MIBI sestamibi ile parajuguler yerleşimi tespit edildi ve intraoperatif gamma prob kullanıldı. Radyoaktivitenin en yüksek olduğu lokalizasyon intratimik bölge idi. Timus ile birlikte adenom eksizyonu yapıldı. Histolojik tanı, ektopik paratiroid adenomu olduğunu doğruladı. Özellikle rekürren paratiroid adenomlarının eksizyonu sırasında gamma prob kullanımı, hem operasyon süresini kısaltması hem de gereksiz boyun diseksiyonunu önlemesi açısından önemlidir. Nadiren görülse de, gamma prob ile aktivite tutulumu, timus dokusu içerisinde de araştırılmalıdır.Öğe Successful living donor liver transplantation of fulminant liver failure due to isoniazid prophylaxis(BMJ Case Rep 2015., 2015) Çakır, Tuğrul; Ara, Cengiz; Soyer, Hacı Vural; Koç, SüleymanProgressive liver failure is rarely seen in tuberculosis chemoprophylaxis with isoniazid. We present a case of a 32-year-old woman admitted to our clinic reporting abdominal pain, nausea and vomiting for 2 days. The initial diagnosis was fulminant toxic hepatitis due to isoniazid chemoprophylaxis, which was treated successfully with living donor transplantation. Tuberculosis continues to be a significant public health problem. Isoniazid-related hepatotoxicity is extremely rare in adults. The only treatment in cases of fulminant liver failure is orthotopic liver transplantation from a deceased or living donor. If a deceased donor is not available or the patient refuses this treatment, living donor transplantation is the only choice. Although rare, isoniazid used as protective therapy for pulmonary tuberculosis can lead to fulminant liver failure. When cadaveric liver transplantation is not available, living donor liver transplantation is vital.Öğe Successful living donor liver transplantation of fulminant liver failure due to isoniazid prophylaxis(Case Reports, 2015) Çakır, Tuğrul; Ara, Cengiz; Soyer, Hacı Vural; Koç, SüleymanProgressive liver failure is rarely seen in tuberculosis chemoprophylaxis with isoniazid. We present a case of a 32-year-old woman admitted to our clinic reporting abdominal pain, nausea and vomiting for 2 days. The initial diagnosis was fulminant toxic hepatitis due to isoniazid chemoprophylaxis, which was treated successfully with living donor transplantation. Tuberculosis continues to be a significant public health problem. Isoniazid-related hepatotoxicity is extremely rare in adults. The only treatment in cases of fulminant liver failure is orthotopic liver transplantation from a deceased or living donor. If a deceased donor is not available or the patient refuses this treatment, living donor transplantation is the only choice. Although rare, isoniazid used as protective therapy for pulmonary tuberculosis can lead to fulminant liver failure. When cadaveric liver transplantation is not available, living donor liver transplantation is vital.Öğe Use of the right lobe graft with double hepatic arteries in living donor liver transplant(Experimental and Clinical Transplantation, 2016) Çakır, Tuğrul; Sabuncuoğlu, Mehmet Zafer; Soyer, Vural; Sarıcı, Kemal Barış; Koç, Süleyman; Onur, Asım; Ünal, Bülent; Akbulut, Ahmet Sami; Yılmaz, SezaiObjectives: We aimed to examine management of double hepatic artery reconstruction in patients under going living-donor liver transplant. Materials and Methods: Between January 2002 and June 2014, one thousand thirty-six living-donor liver transplants were performed at the Liver Transplant Institute of Malatya Inonu University. Living liver grafts with a single hepatic artery were used in 983 living-donor liver transplants, while grafts with double hepatic artery branches were used in 53 livingdonor liver transplants. All of the liver grafts with double hepatic artery branches were right lobe grafts. Hepatic artery anastomosis technique and the other medical data of recipients who used grafts with double hepatic arteries were analyzed retrospectively. Results: A double hepatic artery anastomosis was created in 43 recipients, while a single anastomosis was created in the remaining 10 because of ligation of the nondominant hepatic artery branch. In 40 recipients, double hepatic artery branches in the graft were anastomosed with the recipient’s right and left hepatic artery. In the remaining 3 recipients, double hepatic artery branches in the graft were anastomosed with the recipient’s right hepatic artery and large segment 4 hepatic arteries. Postoperative complications related with hepatic artery anastomoses developed in 3 recipients: hepatic artery thrombosis (n = 1), hepatic artery aneurysm (n = 1), and hepatic artery stenosis (n = 1). A recipient with hepatic artery aneurysm immediately underwent a retransplant. A recipient with a hepatic artery thrombosis relapsed and required retransplant, which was treated with thrombectomy on postoperative day 10. A recipient with hepatic artery stenosis was followed conservatively. In our series, the incidence of complications related with double hepatic artery anastomosis was found to be 6.9%. Conclusions: According to our experiences, a double hepatic artery anastomosis does not increase the risk of hepatic artery thrombosis and can be performed safely by surgeons who are experienced with hepatic vascular reconstructions in a living-donor liver transplant recipient.
