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Öğe Amyand’s hernia in children: A 20-year experience at a tertiary referral hospital(2022) Tartar, Tugay; Sarac, Mehmet; Bakal, Unal; Akdeniz, Ibrahim; Kazez, AhmetAim: Amyand’s hernia is detected in 0.42%–1% of children with inguinal hernia (IH) and is quite difficult to diagnose prior to surgery. There is no consensus on its treatment. Materials and Methods: The records of patients who underwent IH repair and were diagnosed with Amyand’s hernia between 2001 and 2019 were retrospectively analysed in terms of age, gender, complaints at presentation, side of IH, treatment methods (with appendectomy or reduction of appendix), complications, duration of hospital stay and follow-up. Results: In total, 3,577 patients (male/female: 3,045/532) who underwent surgery for IH and 1,898 patients who underwent appendectomy were analysed. Cases with Amyand’s hernia (n=47, male/female: 41/6) accounted for 1.31%, 1.4% and 0.31% of all IH, incarcerated/strangulated hernia and appendectomy cases, respectively. The median age was 3 months. In one case, the appendix was located within the left hernial sac. One patient presented with a complaint of recurrent abscess in the right inguinal region. In all cases, the diagnosis was made intra-operatively based on identification. In 23.4% of the cases with Amyand’s hernia, appendectomy was performed. In 46 of the 47 cases diagnosed with Amyand’s hernia, inguinal transverse incision and high ligation procedures were performed. Acute appendicitis did not develop during follow-up in cases without appendectomy. Conclusion: Because the appendix plays an active role in the immune system, especially during childhood, and is used in some pathologic cases as luminal supportive tissue, we believe that appendectomy should not be performed if there are no signs of inflammation and the appendix can be reducted into the abdomen.Öğe A case with pyoderma gangrenosum, after an abdominal surgery(2019) Saraç, Gülbahar; Mantar, Irem; Cenk, Hülya; Sarac, MehmetAbstract: Pyoderma gangrenosum (PG) is a pathergy positive, ulcerative neutrophilic dermatosis. Pathergy phenomenon is described as a sterile pustule and an ulcer development after minor skin traumas like a bump or bruise, or needlestick injury. In the literature, there are PG cases associated with the pathergy phenomenon on the post-surgical scar tissue. It presents as a necrotic and an ulcerative lesion clinically and, debridement is performed mostly with wrong pre-diagnoses. Debridement makes the lesion get wider and the morbidity increase. There are some PG case reports in the literature which were ended up with amputation due to debridement of a lesion which was an overlooked PG. Herein, we present a case with a giant abdominal pyoderma gangrenosum developed after a surgery in the abdominal drainage site and has reached to 30 cm size after debridement.Öğe Dermatological signs in liver transplant recipients(Wiley, 2021) Sarac, Gulbahar; Ozcan, Kubra Nur; Baskiran, Adil; Cenk, Hulya; Sarac, Mehmet; Sener, Serpil; Yilmaz, SezaiBackground In recent years, the number of liver transplantations for advanced-stage liver diseases has considerably increased and the patients have a wide range of dermatologic manifestations. Aim This study aims to reveal cutaneous, mucosal, and nail lesions in liver transplant recipients in quite large patient series. Patients/Methods The study included 520 patients in the Inonu University Liver Transplantation Institute. New and followed-up patients attended to the study between May and October 2019. The patients were examined by a dermatologist, and their data were recorded. Results The study included 163 female and 357 male patients with the main age of 44.20 +/- 18.18 (range: 1-83 years), and 465 livers (89.4%) were taken from live donors, while 54 livers (10.4%) were taken from cadavers. A total of 314 (60.4%) patients had dermatophyte infections, 174 (33.4%) patients had pathological nail changes, and 427 (82.1%) patients had oral mucosal lesions. Graft-versus-host disease (GVHD) developed in 9 (1.73%) patients after the transplantation, and 5 patients died of GVHD. Four patients had cutaneous malignancies. Conclusions Tumoral and nontumoral dermatological diseases may be encountered following the transplantation depending on underlying liver disease, immunosuppressive treatment, the graft itself, or any primary cutaneous disease. Liver transplantation recipients require a multidisciplinary clinical approach, and dermatological care must be an integral part of this approach.Öğe The effect of trimethazidine on mortality in an experimental acute pancreatitis model(Aves, 2020) Ergucuk, Hakan; Isik, Sevil; Iflazoglu, Nidal; Kayaalp, Cuneyt; Sarac, Mehmet; Gursul, SerdarBackground/Aims: Acute pancreatitis has a high morbidty and mortality. Its physiopathogenesis has not been enlightened up to the present. This study aims to investigate trimethazidine (antiischemic, antioxidant and cardioprotective agent) 's effects on the acute pancreatitis. Materials-Methods: In this study, four aqual groups are formed with 43 female Spraque-dawley type rats weighed between 230-300 gr (mean 265 gr). 0.9% NaCl is injected intraperitoneally after laparotomy to the Group 1 (n=6). Group 2 (n=6) is control group that without any intervention. Acute pancreatitis is formed in Group 3 (n=16) via injection of Na-taurocholate in the common bile duct. Group 4 (n=15) is being formed pancreatitis and treated with Trimetazidine. In group 4 Trimetazidine 10 mg/kg/day drugs were given, 30 minutes, 24 and 72 hours after formation of acute pancreatitis, in three equal doses by orogastric way. In all groups, the rats have been laparatomised 72 hours later under general anesthesia and pancreas tissues has been extracted and studied histopathologically. Amylase, lipase, lactate dehydrogenase, aspartate transaminase, alanine tranaminase levels in the rats serum and superoxide dismutase, catalase, glutathione, malondialdehyde, nitricoxide, protein carbonyl, glutathione peroxidase levels in the rats tissue also have been looked up. Results: Serum and tissue findings and histopathologically examination of the pancreas tissues show significant decrease in the treatment group compare to study group. Conclusion: Trimethazidine protects pancreas tissue and decreases the mortality by significantly lowering the biochemical and histopathological changes in the early stages of acute pancreatitis.Öğe The effects of mythomycin C, hylan Gf20 and honey combinations on adhesion formation in laparotomized rats(2019) Sarac, Mehmet; İflazoglu, Nidal; Ergucuk, Hakan; Gursul, Serdar; Camci, CemalettinAim: Postoperative adhesions are stil unsolved important problems. Some studies have been showed that Mitomycine, Hylan GF20 and honey can decrease adhesion formation. This study; was planned to aim to compare the adhesion formation effects of Mitomycin C with Hylan GF-20, Mitomycin C with honey and Hylan GF-20 with honey combinations in the laparotomized rats. Material and Methods: Wistar-Albino 70 malerats, weight range between 180-220 gr, divided into 7 groups. After abrasion formation in the rats’ caecum wall and in the peritoneal surface at the localization of right lower quadrant of anterior abdominal wall, Mitomycin C, Hylan GF-20 and honey combinations used and seven days after operation the abdomen was opened for examination. Results: There were statistically significant differences between control group and the study groups according to adhesion formation scala. In all groups that agents were used adhesion formation was decreased, but when the groups comparing the agents used, there was no statistically significant difference. Conclusion: Mitomycin C, Hylan GF-20 and Honey usage in the laparotomized rats decrease adhesion formation. But the combinations of these agents do not show any additional effect to decrease adhesion formation.Öğe Parameters associated with survival in patients undergoing surgical treatment due to rectal cancer(2019) Gursul, Serdar; Iflazoglu, Nidal; Karabulut, Koray; Sarac, MehmetAim: Colorectal cancer is the third most common type of cancer.Approximately 1/3 of colorectal cancers are rectum cancers. The percentage of local disease stage is 39%, and the 10-year survival rate in such patients is approximately 90%. The aim of our study was to evaluate the relationship between the clinicopathological characteristics and survival of patients with rectal cancer. Material and Methods: Patients who had undergone surgical treatment for rectal cancer in our clinic between January 2008 and December 2013 were evaluated retrospectively. The effects of clinicopathological parameters of these patients on survival were investigated. The preoperative and postoperative variables were evaluated together with survival data. Results: Of the 70 patients, 30 (43%) were females and 40 (57%) were males. The median age was 61 years (min-max = 29-87 years). Eight of the patients (6%) were operated under emergency conditions due to acute abdomen or ileus. 13 (19%) of the patients had undergone laparoscopic surgery and 57 (81%) had undergone open surgical resection. 15 patients (21%) had undergone anterior resection (AR), 51 (73%) had lower anterior resection (LAR) and 4 (6%) had abdomino-perineal resection (APR). According to pTNM staging, 6 patients (8%) were at stage-0, 7 (10%) were at stage-I, 22 (32%) were at stage-II, 26 (37%) were at stage-III, and 9 (13%) were at stage IV. Conclusion: We found that the ASA (American society of Anesthesiologists) score height, final stage of the tumor and vascular (venous) invasion associated with overall survivalÖğe Short and long-term results of the Karydakis flap versus the Limberg flap for treating pilonidal sinus disease: a prospective randomized study(Excerpta Medica Inc-Elsevier Science Inc, 2011) Ates, Mustafa; Dirican, Abuzer; Sarac, Mehmet; Aslan, Ahmet; Colak, CemilBACKGROUND: Pilonidal sinus is a common disease that mostly affects young people. Although various surgical techniques have been described for treating sacrococcygeal pilonidal disease (SPD), controversy still exists as to the best surgical technique. The purpose of this study was to compare the efficiency and short-term and long-term results of the Karydakis flap with that of the Limberg flap for treating SPD. METHODS: In this prospective randomized study, 269 patients with SPD were recruited to undergo either the Karydakis flap (n = 135) or the Limberg flap (n = 134) procedure between September 2004 and September 2008. RESULTS: The mean operative time for the Karydakis group (42.32 +/- 8.64 minutes) was shorter than that for the Limberg group (50.14 +/- 6.96 minutes) (P = .01). The complication rate for the Karydakis group (n = 15 [11.1%]) was lower than that for the Limberg group (n = 28 [20.8%]) (P = .029). The visual analogue scale score for postoperative pain at the operation site on the 30th day was lower in the Karydakis group than in the Limberg group (2.22 +/- 1.01 vs 3.23 +/- 1.14, P = .01). The visual analogue scale score for satisfaction with the cosmetic appearance of the scars in the Karydakis group was 7.08 +/- 1.75, whereas it was 3.16 +/- 1.40 in the Limberg group at the 3rd month (P = .01). Length of hospital stay was significantly shorter in the Karydakis group than in the Limberg group (3.40 +/- .94 vs 3.8 +/- 1.19 days, P = .03). Only 4 patients in the Karydakis group developed recurrence (3%), whereas 9 patients (6.9%) did so in the Limberg group (P = .151). CONCLUSIONS: The Karydakis flap procedure should be chosen instead of the Limberg flap for treating uncomplicated SPD because of its lower postoperative complication rate, lower pain scores, shorter operation time and length of hospital stay, and good cosmetic satisfaction. However, no differences existed between the 2 surgical procedures in terms of recurrence prevention. (C) 2011 Elsevier Inc. All rights reserved.Öğe Vocal cord paralysis after total thyroidectomy with ecchymosis secondary to thyroid biopsy(2019) Sarac, Mehmet; Dogan, Serhat; Gursul, Serdar
