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Öğe Comparison of Harmonic Scalpel Versus Conventional Knot Tying for Transection of Short Hepatic Veins at Liver Transplantation: Prospective Randomized Study(Elsevier Science Inc, 2012) Olmez, A.; Karabulut, K.; Aydin, C.; Kayaalp, C.; Yilmaz, S.The objective of this study was to compare harmonic scalpel for short hepatic vein transection with conventional ligation during recipient hepatectomy with caval preservation. Sixteen patients undergoing elective living donor liver transplantation were randomized into 2 groups. We recorded number, diameter, and location of each short hepatic vein, procedure time, central venous pressure, and degree of liver failure (Child-Pugh and Model for End stage Liver Disease scores). As an end point, we observed the intraoperalive and postoperative bleeding rates of the transected veins. We transected 144 veins of mean diameter of 2.6 +/- 1.8 mm (range, 1-12 mm). Mean number of short hepatic veins in each person was 9 (range, 5-16). Harmonic scalpel was safe for veins with a diameter <= 2 mm; these veins were more prone to bleeding with conventional ligation. Bleeding rate was higher after ligation of veins in the upper half than the lower half of the cava (37% vs 21%; P = .04). Both total and per vessel procedure time did not differ between the groups. No postoperative bleeding complications occurred. Transection of veins with a diameter <= 2 mm by harmonic scalpel was as safe as conventional ligation. Harmonic scalpel transection of small hepatic veins (<= 2 mm) can be even safer than conventional control by knot tying, particularly in narrow areas.Öğe Incidental Appendectomy in Donors Undergoing Hepatectomy for Living-Donor Liver Transplantation(Elsevier Science Inc, 2012) Yilmaz, M.; Olmez, A.; Piskin, T.; Unal, B.; Ersan, V.; Sarici, K. B.; Dirican, A.Background. The aim of this study was to investigate the morbidity associated with appendectomy in living liver donors undergoing hepatectomy. Methods. The medical records of 338 donors who underwent hepatectomies for living-donor liver transplantation between 2008 and 2010 were reviewed retrospectively. The patients were divided into 2 groups on the basis of appendectomy: patients in group A (n = 126) received incidental appendectomies in conjunction with donor hepatectomy, and those in group B (n = 212) underwent hepatectomy alone. Results. No significant difference in age, gender, or body mass index was found between groups. The wound infection rate (P = .037) and length of hospital stay (P = .0038) were higher in group A than in group B. Intraoperative findings in 126 donors in group A were subserosal (n = 4), retrocecal (n = 6), or hard nodular (n = 11) appendix; hyperemic appendix with edema (n = 9); appendix length >= 8 cm (n = 18); and palpable fecalith (n = 78). Histopathologic examination of appendix specimens revealed lymphoid hyperplasia with a fecalith (n = 32), fecalith only (n = 32), acute appendicitis (n = 20), normal anatomy (n = 18), fibrous obliteration (n = 9), lymphoid hyperplasia (n = 9), Enterobius vermicularis (n = 3),appendiceal neuroma (n 1), carcinoid tumor (n = 1), and mucoceles (n = 1). Conclusion. Although incidental appendectomy increased the wound infection rate and length of hospital stay, this procedure is necessary for the prevention of potential complications due to appendicitis when the exploration of the ileocecal region in patients undergoing donor hepatectomy reveals one or more of the following: appendix length >= 8 cm; dropsical, hyperemic, subserosal, nodular, and/or retrocecal appendix; and/or palpable fecaloma.Öğe Living Donor Liver Transplantation in the Absence of Inferior Vena Cava: A Case Report(Elsevier Science Inc, 2012) Hatipoglu, S.; Olmez, A.; Ozgor, D.; Kayaalp, C.; Yilmaz, S.Because of difficulties in the supply of cadaveric organs, of living donor liver transplantations are performed in increasing numbers. Congenital hepatic fibrosis associated with fibrosis and atrophy of the inferior vena cava were present in a potential recipient of living donor liver transplantation. This case report documented living donor liver transplantation as a treatment modality for a patient with absence of the inferior vena cava due to chronic liver failure.Öğe Treatment of pilonidal disease by combination of pit excision and phenol application(Springer-Verlag Italia Srl, 2013) Olmez, A.; Kayaalp, C.; Aydin, C.To examine the results of our minimal invasive treatment for pilonidal disease. Total 83 patients treated by pit excision and consecutive phenol applications on an outpatient setting. All procedures were performed under local anesthesia, without any preoperative testing, colon cleansing, prophylactic antibiotics or sedation. A pit excision (mean length 1.3 +/- A 0.5 cm) including several close midline orifices was done. Separated pit excisions were done to the remaining midline and lateral orifices. Sinus cavity was cleared of hair and debris, and the walls of the cavity were sclerosed using a cotton bud dipped in 80 % liquid phenol. Phenolization was repeated twice on day one and seven. Mean procedure time was 22.2 +/- A 7.4 min. Rates of patients who did not required analgesics at first, second, third and fourth days after surgery were 58, 85, 91 and 100 %, respectively. All the patients returned to work/school after 3 days. Mean wound closure time was 28.5 +/- A 14.9 days. Total 86.7 % of the patients were asymptomatic after a mean 25.7 +/- A 8.5 months follow-up. Simple pit excision and sclerosing the pilonidal sinus cavity consecutively was an effective and minimal invasive method for relief of pilonidal symptoms.
