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Öğe Acute acalculous cholecystitis induced by aortic dissection: report of a case(Turkish Assoc Trauma Emergency Surgery, 2010) Sogutlu, Gokhan; Isik, Burak; Yilmaz, Mehmet; Karadag, Nese; Hoca, Onur; Olmez, Aydemir; Cinpolat, OezguerAcute acalculous cholecystitis (AAC), inflammation of the gallbladder without evidence of calculi, comprises approximately 10% of all cases of acute cholecystitis. Although the mechanism of AAC has not yet been sufficiently clarified, the most commonly postulated theories regarding its pathogenesis are bile stasis, sepsis and ischemia. We present a case of AAC associated with ischemia of the gallbladder caused by aortic dissection Bakey type III.Öğe CARCINOMA ERYSIPELOIDES FROM BREAST CANCER MIMICKING AS RADIODERMATITIS: REPORT OF A CASE(Aves, 2009) Sogutlu, Gokhan; Aydin, Cemalettin; Karadag, Nese; Olmez, Aydemir; Ozgor, Dincer; Deniz, SumerCarcinoma erysipeloides (CE) is an uncommon metastatic pattern arising from visceral carcinoma. As a consequence of lymphatic blockage by the tumor cells, erysipel like appearance can occur. It may be confused with erysipelas and other infl ammatory lymphedemas. We report a case of CE in a woman previously treated by mastectomy for locally advanced breast carcinoma. The lesion was clinically mimicked a radiation dermatitis.Öğe Complications of Bursectomy after Radical Gastrectomy for Gastric Cancer(Springer, 2012) Kayaalp, Cuneyt; Piskin, Turgut; Olmez, Aydemir[Abstract Not Available]Öğe Investigation of a One-Time Phenol Application for Pilonidal Disease(Karger, 2010) Kayaalp, Cuneyt; Olmez, Aydemir; Aydin, Cemalettin; Piskin, Turgut; Kahraman, LatifObjective: To investigate wound healing rates and postoperative recovery of patients after a one-time phenol application for pilonidal disease. Subjects and Methods: A total 30 consecutive patients with chronic pilonidal disease ranging from midline to complex sinuses were enrolled in the study. No preoperative laboratory examinations or bowel preparation were required. No antibiotic prophylaxis or sedation was used. A small incision was made on the midline and hair/debris in the sinuses was removed. A cotton swab with saturated phenol was moved into the cavity and the phenol was left for 2 min. No special dressing was necessary and patients left the hospital immediately afterwards. Patients filled out a daily questionnaire for 7 days. We did not intervene in the wounds with a second phenol application or curettage during the observation period. Wounds were inspected at weekly intervals for 2 months. Results: At the end of the third day, 97% of the patients were pain-free and 100% of the patients were free from analgesics. Time off work was 2 days for most patients (93.3%). Twenty-eight ( 93.3%) patients were satisfied with the procedure, they found it easy and painless and suggested the procedure to other patients. Twenty-five (83%) patients were asymptomatic at the end of 2 months' observation and the remaining 5 patients had un-healed sinuses. Mean time for wound healing was 25 days ( range 10-63 days). There were 4 recurrences after a mean of 14 months' follow-up and the overall success rate was 70%. Conclusions: A one-time phenol application was an effective treatment for pilonidal disease with acceptable wound healing rates, less postoperative pain and less time off work. Hence it can be an alternative treatment modality. Copyright (C) 2010 S. Karger AG, BaselÖğe Is vena cava resection justified for hydatid liver cyst?(Springer, 2008) Kayaalp, Cuneyt; Aydin, Cemalettin; Olmez, Aydemir[Abstract Not Available]Öğe Jejunal diverticulum perforation resulting from distal mechanic obstruction: A case report(Aves, 2011) Olmez, Aydemir; Sumer, Aziz; Piskin, Turgut; Aydin, CemalettinExcluding Meckel's diverticulum, jejunum and ileum diverticula are acquired diverticula which are rarely observed and have an asymptomatic course. They are mostly observed in elderly patients. Men are twice as likely as women to have diverticula. The complications like inflammation, bleeding, obstruction and perforation may develop in less than 10% of patients with jejunal diverticula. Perforation, as an uncommon complication, may occur following diverticulitis in 82%, blunt trauma in 12%, and impact of foreign body in 6% of cases. Herein we present a 62 year old man operated emergently due to development of acute abdomen that resulted from perforation caused by an increased jejunal and diverticular pressure secondary to rectal obstruction without any common factors mentioned for diverticular perforation. We performed resection and anastomosis at operation.Öğe Laparoscopic splenectomy with a vessel sealing device(Taylor & Francis As, 2008) Aydin, Cemalettin; Kayaalp, Cuneyt; Olmez, Aydemir; Tatli, Faik; Kirimlioglu, VedatWhen compared with open splenectomy, laparoscopic splenectomy was associated with fewer complications, however, with more hemorrhagic complications. Furthermore, the mean operative time for laparoscopy was significantly longer than for the open procedure. Vessel sealing systems are represented as decreasing operative time and blood loss in Several surgical procedures. The aim of this study is to evaluate the blood loss and operating time of laparoscopic splenectomy with a vessel sealing system. We evaluated 19 laparoscopic splenectomies with a vessel sealing device, particularly focusing on operative blood loss and operating time. Patients were operated in the right lateral decubitus position usually with three ports. In all cases, dissection of the spleen and sealing of hilar vessels and short gastric vessels were performed with a vessel sealing system. No clips, sutures, or monopolar bipolar diathermy were used. Mean operative blood loss was 88ml (range 20400 ml) and mean operative time was 107 minutes (range 45-230 minutes). Both results were better than those of most series of laparoscopic splenectomy performed with endostaplers or endoclips. Laparoscopic splenectomy with a vessel sealing system is safe for all vascular controls in laparoscopic splenectomy and can lead to less blood loss. This technique removes the disadvantage of longer operating times for laparoscopic as compared to open splenectomy.Öğe Leakage tests reduce the frequency of biliary fistulas following hydatid liver cyst surgery(Hospital Clinicas, Univ Sao Paulo, 2011) Kayaalp, Cuneyt; Aydin, Cemalettin; Olmez, Aydemir; Isik, Sevil; Yilmaz, SezaiBACKGROUND AND AIM: Biliary fistulas are the most common morbidity (8.2-26%) following hydatid liver surgery. The aim of our study was to reduce the incidence of postoperative biliary fistulas after the suturing of cystobiliary communications by applying a bile leakage test. PATIENTS AND METHODS: A total of 133 hydatid liver cysts from 93 patients were divided into two groups, according to whether the test was performed. Tests were performed on 56 cysts from 34 patients, and the remaining 77 cysts from 59 patients were treated without the test. In both groups, all visible biliary orifices in the cysts were suture ligated, and drains were placed in all cysts. The visibility of the biliary orifices and postoperative biliary drainage through the drains were recorded. Patients in both groups were also compared with respect to the number of days living with the drains, the length of the hospital stay, and secondary interventions related to biliary complications. RESULTS: Biliary orifices were more visible in the tested cysts (13% vs. 48%; P < 0.001). Fewer biliary complications occurred in the tested patients (8.8% vs. 27.7%, P = 0.033). The mean drain removal time (4.1 +/- 3.3 days vs. 6.8 +/- 8.9 days, P < 0.05) and the length of the hospital stay (6.7 +/- 2.7 days vs. 9.7 +/- 6.3 days, P < 0.01) were shorter for the tested patients. None of the patients in the test group required postoperative Endoscopic retrograde cholangiopancreaticography (ERCP) or nasobiliary drainage (0.0% vs. 8.4%, P = 0.09). There were no long-term biliary complications for either group after three years of follow-up. CONCLUSIONS: Identification of biliary orifices with a bile leakage test and the suturing of cystobiliary communications significantly reduced postoperative biliary complications following hydatid liver surgery.Öğe Measurement of Spleen Size at Laparoscopic Splenectomy(Springer, 2009) Kayaalp, Cuneyt; Aydin, Cemalettin; Olmez, Aydemir[Abstract Not Available]Öğe Omentopexy versus falciformopexy for peptic ulcer perforation(Turkish Assoc Trauma Emergency Surgery, 2019) Olmez, Aydemir; Cicek, Egemen; Aydin, Cemalettin; Kaplan, Kuntay; Kayaalp, CuneytBACKGROUND: Open or laparoscopic Graham's omentopexy is frequently used in the treatment of peptic ulcer perforation (PUP). The technical difficulty of applying the omental plug, especially in patients with previous omentum resection, has led to the use of falciform ligament for the PUP, and some studies have reported that PUP may even be a more advantageous technique than omentopexy. Here, in this study, we aimed to compare the retrospective results of patients who underwent falciformopexy or omentopexy for PUP. METHODS: Between 1999 and 2018, 303 patients who were followed-up and treated for PUP were included in this study. Patients who had malignancy, gastric resection, definitive ulcer surgery, laparoscopic surgery and nonoperative treatment were excluded from this study. In the remaining patients, either open ometopexy or falciformopexy were applied based on the surgeon's choice. These two techniques were compared for intraoperative and postoperative outcomes. RESULTS: Falciformopexy (n=46) and omentopexy (n=243) groups had similar demographics, but ASA scores were lower in the falciformopexy group. For ulcer size and localization, duration of operation, no difference was found between the groups. There was no significant difference between the groups concerning general postoperative morbidity and mortality. However, atelectasis was more frequently observed in the omentopexy group, whereas the pexia failure was more frequent in the falciformopexy group (2.6% and 8.7%, p=0.04). CONCLUSION: Falciformopexy is an alternative technique that can be used in situations where it is not possible to use the omentum. Falciformopexy is not superior to omentopexy for the repair of the PUP.Öğe Orifice Location Guided Excision and Flap Procedures for Treatment of Sacrococcygeal Pilonidal Disease(Wroclaw Medical Univ, 2011) Piskin, Turgut; Olmez, Aydemir; Mecit, Eren A.; Unal, Bulent; Aydin, Cemalettin; Kayaalp, CuneytBackground. Although various surgical techniques have been described, there is no consensus on the optimal treatment for sacrococcygeal pilonidal disease (SPD). Objectives. The aim of this study is to report the medium-term results of three different surgical methods used to treat SPD that were chosen according to the localization of the sinus orifices. Material and Methods. Between November 2005 and April 2007, 43 patients with symptomatic SPD were treated by three different surgical methods. A classic approach, a modified flap technique and a new excision and flap technique were evaluated for treating SPD cases with different localizations of the sinus orifices. The study was carried out on the basis of retrospective reviews of patient charts and telephone interviews for prospective evaluation. Outcome measures included wound complications, time off work, complete healing time, paresthesia, recurrence rates and satisfaction with the procedures and outcomes. Results. There were no early postoperative complication among the 43 patients. The median hospitalization time was 6.76 days (2-12 days). The authors reached 31 patients (72.09%) by phone for the interview; the median follow-up time was 48.41 months (range 42-59 months). No recurrences were reported. The median time off work and complete healing time were 20.54 and 18.61 days, respectively. All but three of the patients reported satisfaction with the esthetic outcome. All the patients reported satisfaction with the effectiveness of the surgical approaches used. One patient reported dissatisfaction with the anesthesia technique. There were complaints of paresthesia from eight patients (one severe, seven moderate). All the patients said that they would recommend these operations and anesthesia techniques to relatives or other patients with sacrococcygeal pilonidal disease. Conclusions. Different excision and flap methods should be used to treat cases of sacrococcygeal pilonidal disease with different localizations of the sinus orifices (Adv Clin Exp Med 2011, 2011, 4, 481-488).Öğe Polycystic liver transplant: a case report(Innovision Communications, 2013) Sakcak, Ibrahim; Olmez, Aydemir; Ozgor, Dincer; Eris, Cengiz; Kayaalp, Cuneyt; Yilmaz, SezaiA liver from a donor with brain death due to a ruptured cerebral aneurysm was transplanted. The liver had multiple bilobar simple cysts; the largest was less than 3 cm in diameter. The noncystic liver volume was greater than 50%, and the liver had neither fibrosis nor venous congestion. The donor surgery was performed in accordance with the standard protocol without rupture of the cysts. The recipient was a 40-year-old man with cirrhosis associated with hepatitis B. The recipient operation was done by using the piggyback method with no complications. Excessive drainage of chylous ascites (10 000 mL/d) started in the first days after surgery and continued, gradually decreasing until the end of the second month. The patient was discharged with no complications at the end of the third month. No growth in the cysts was observed on follow-up computed tomography scans. Excluding this particular case, a total of 7 other patients have received a polycystic liver transplant. In all 7 cases, the fact that the donor had polycystic liver disease was not known but was encountered by coincidence during procurement. The case reported here is the first case where the polycystic liver disease was diagnosed before procurement and the transplant was still carried out. It appears that, if the donor liver has enough healthy noncystic volume, polycystic livers can be transplanted. (C) 2013 NATCO, The Organization for Transplant ProfessionalsÖğe Postoperative Hypoparathyroidism in Total Thyroidectomy: Incidence and Predictive Factors(Galenos Yayincilik, 2007) Sogutlu, Gokhan; Cikim, Ayfle Sertkaya; Olmez, Aydemir; Sahin, Brahim; Cikim, Kerim; IsiK, Burak; Cinpolat, OzgurObjective: Total thyroidectomy is increasingly accepted as a choice of treatment not only for malignant but also for benign thyroid disorders. Nowadays, postoperative hypocalcaemia is the major concern in total thyroidectomy. The aim of this study is to quantify risk factors contributing to postoperative hypocalcaemia rates. Material and methods: Medical records of 88 patients who underwent total thyroidectomy from 2000 to 2004 were reviewed. In addition to demographic information, postoperative hypocalcaemia and related risk factors were identified. Results: The most common indication for total thyroidectomy was multinodular goiter (53.4%). One patient with anaplastic thyroid carcinoma died because of respiratory failure (1.1%). Temporary and permanent hypoparathyroidism rates were 26.1% and 3.4 %, respectively. Parathyroid reimplantation was performed to 7 patients (7.9%). Indication of surgery was statistically associated with an increased incidence of hypocalcemia (P=0.019 for thyroid carcinoma and P=0.005 for completion thyroidectomy), whereas, sex, age, neck dissection and parathyroid reimplantation were not. Conclusions: Postoperative hypocalcaemia is the major concern for thyroid surgeons. Completion and total thyroidectomy for thyroid malignancy increased postoperative hypoparathyroidism. With meticulous attention to operative technique and anatomical detail, surgeons can achieve low morbidity rates.Öğe A practical scoring system to predict mortality in patients with perforated peptic ulcer(Bmc, 2015) Menekse, Ebru; Kocer, Belma; Topcu, Ramazan; Olmez, Aydemir; Tez, Mesut; Kayaalp, CuneytIntroduction: The mortality rate of perforated peptic ulcer is still high particularly for aged patients and all the existing scoring systems to predict mortality are complicated or based on history taking which is not always reliable for elderly patients. This study's aim was to develop an easy and applicable scoring system to predict mortality based on hospital admission data. Methods: Total 227 patients operated for perforated peptic ulcer in two centers were included. All data that may be potential predictors with respect to hospital mortality were retrospectively analyzed. Results: The mortality and morbidity rates were 10.1% and 24.2%, respectively. Multivariated analysis pointed out three parameters corresponding 1 point for each which were age >65 years, albumin <= 1,5 g/dl and BUN >45 mg/dl. Its prediction rate was high with 0,931 (95% CI, 0,890 to 0,961) value of AUC. The hospital mortality rates for none, one, two and three positive results were zero, 7.1%, 34.4% and 88.9%, respectively. Conclusion: Because the new system consists only age and routinely measured two simple laboratory tests (albumin and BUN), its application is easy and prediction power is satisfactory. Verification of this new scoring system is required by large scale multicenter studies.Öğe Prophylactic bursectomy at radical gastrectomy for gastric cancer(Springer, 2011) Kayaalp, Cuneyt; Olmez, Aydemir; Piskin, Turgut[Abstract Not Available]Öğe Reversal of the Hartmann Procedure Through Only a Stomal Orifice(Southeastern Surgical Congress, 2011) Aydin, Cemalettin; Olmez, Aydemir; Isik, Sevil; Sumer, Fatih; Kayaalp, CuneytWe performed reversal of the Hartmann procedure only through the stoma site and we did not use either any other incision nor laparoscopic assistance. A total of 8 patients (7 males), ages between 23 and 80 years, were treated by means of a defined technique. The indications of the Hartmann procedure were sigmoid volvulus (4), sigmoid cancer obstruction (2), rectal trauma (1), and Fournier gangrene (one). The duration from the first procedure was a mean of 5 months (range, 2 to 8 months). The length of the rectal stump was at least 5 cm over the pelvic peritoneum and the body mass indices of all patients were less than 30 kg/m(2). The diameter of the stoma opening was a mean of 50 mm (range, 40 to 55 mm). Incision extensions from the stomal orifice (accepted as conversion) were needed for two cases as a result of injury on the intestine and inability to identify the distal bowel stump (25%). The mean operative blood loss and duration of operation were 50 mL (range, 30 to 100 mL) and 65 minutes (range, 45 to 80 minutes), respectively. Fecal discharge of all patients was weighed before hospital discharge and the length of postoperative hospital stay was a mean of 5.5 days (range, 4 to 9 days). Neither anastomosis leakage nor surgical site infections were observed in any of the patients and all had an uneventful postoperative course. The described technique can be the least invasive one than the previously described techniques for the reversal of the Hartmann procedure by only using the stoma site, particularly for nonobese patients with a long distal rectal stump.Öğe Troid Bezi Hidatik Kisti: Vaka Sunumu(İnönü Üniversitesi Tıp Fakültesi Dergisi, 2007) Söğütlü, Gökhan; Çıkım, Ayşe Sertkaya; Pişkin, Turgut; Dirican, Abuzer; Mecit, Eren; Kahraman, Latif; Olmez, Aydemir; Kırımlıoğlu, VedatHidatik kist hastalığı, Echinococcus granulosus paraziti tarafından oluşturulan ve genelde karaciğer ve akciğeri tutan bir hastalıktır. Diğer lokalizasyonlar nadirdir. Biz burada, 18 yaşında, karaciğer, akciğer, abdominal duvar ve triode yerleşimli kistlerle karakterize bir kist hidatik vakasını sunmayı amaçladık. Vaka, iki yıldan beri mevcut olan boğazda ağrısız şişlik şikayetiyle başvurmuş olup, yapılan boyun tomografisi ve ultrasonografisi, sol lob ve istmusta, sırasıyla 35 ve 30 mm.lik kist hidatikle uyumlu kistleri ortaya koymuştur. Yapılan ek tetkilerle, karaciğer, abdominal duvar ve akciğer kistleri de ortaya konulmuş olup, hastaya troid sol lobektomi ve istmusektomi ve abdominal duvar kisti için de total eksizyon ameliyatları ayni seansda uygulanmıştır. Histopatoljik tanı kist hidatikle uyumlu gelmiştir.Öğe Tuberculosis of the Thyroid Gland: An Uncommon Cause of Thyroid Nodules(Galenos Yayincilik, 2006) Sogutlu, Gokhan; Isik, Burak; Yilmaz, Mehmet; Karadag, Nese; Olmez, Aydemir; Kebebew, Electron; Kirimlioglu, VedatWe present the case of a 33-year-old woman with tuberculosis of the thyroid. She presented with a thyroid mass, weakness and palpitation for two years. The diagnosis was established on histological examination after thyroid lobectomy. She had an uneventful recovery and received antituberculous medications.Öğe Tumescent Local Anesthesia for Excision and Flap Procedures in Treatment of Pilonidal Disease(Lippincott Williams & Wilkins, 2009) Kayaalp, Cuneyt; Olmez, Aydemir; Aydin, Cemalettin; Piskin, TurgutPURPOSE: We describe our experience with tumescent local anesthesia for excision and flap procedures in the treatment of pilonidal disease. METHODS: Forty consecutive patients with symptomatic pilonidal disease were treated. Tumescent solution was prepared by mixing one volume of a lidocaine (20 mg/ml) and adrenaline (0.0125 mg/ml) combination with 9 volumes of lactated Ringer's solution. The final solution was infiltrated gradually and liberally, first subcutaneously and then into the skin. The end point was swollen and firm skin. After excision, the area was filled with an advancement flap or a rotational flap. RESULTS: The study group consisted of 37 men (92.5%) and 3 women (7.5%); mean age, 27 (range, 18-61) years. The amount of injected solution ranged from 60 mL to 140 mL (mean, 100 mL; dose interval, 2-4 mg/kg). No additional anesthesia or sedation was needed, and no complications were observed during the procedure. Half of the patients were discharged on the day of the operation, half on the next day. Follow-up ranged from 13 to 37 months. Patients returned to daily activities after a mean of 10.5 (range, 2-30) days. Primary healing occurred uneventfully in 28 patients (70%); wound healing complications occurred in 12 (30%). No flap necrosis was observed. Thirty-seven (92.5%) patients reported satisfaction with the procedure. Recurrence was observed in 3 patients (7.5%). CONCLUSIONS: Excision and flap procedures for sacrococygeal pilonidal disease can be performed under tumescent local infiltration anesthesia with acceptable results, without requiring regional or general anesthesia.
