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    A detailed analysis of surgical site infections and risk factors: A multicentric cohort study in Türkiye
    (Ondokuz Mayis Universitesi, 2024) Aktaş A.; Güner A.; Güneş O.; Karagül S.; Karaköse O.; Mangan Çolak E.; Tardu A.
    There is limited data on surgical site infection (SSI) in developing countries. The aim of this study was to investigate the incidence and risk factors of SSI following general surgical operations in Türkiye. This multicenter cohort study was conducted at 10 centers. Patients who underwent thyroid/parathyroid, breast, hernia and abdominal surgery between September 2017 and March 2018 were included in the study. Center for Disease Control and Prevention 2016 (CDC-2016) criteria was used for the diagnosis of SSI. Patients were followed for 30 days (90 days for mesh patients). Out of 1871 patients included, SSI occurred in 181 (9.7%) patients. Of these SSI, 101 (55.8%) were superficial, 41 (22.7%) deep, and 39 (21.5%) organ/space SSI. SSI incidence was seen to be high (>15.0%) following some surgeries (40.0% in pancreas, 39.1% in biliary duct, 30.3% in small bowel, 27.9% in colorectal, 27.3% in esophagus, 24.1% in liver, 15.7% in gastric). SSI incidences were generally <5.0% after some surgeries (4.4% in hernia, 4.2% in gallbladder, 3.3% in morbid obesity, 1.4% in breast, 0.8% in thyroid/parathyroid, and zero in spleen and surrenal). In univariate analysis, age ?60 years, female sex, preoperative weight loss, presence of comorbidities, preoperative albumin <3.5 g/dL and hemoglobin <12 g/dL, wound classification, ASA score, general anesthesia, emergency surgery, open surgery, operation time ?4 hours, intraoperative blood loss ?400 ml, perioperative blood transfusion, drain placement, distant infection and malignant disease were associated with SSI. In multivariate analysis preoperative weight loss, clean-contaminated wound, general anesthesia, emergency surgery, open surgical technique, prolonged operation duration (?4 hours), drain placement, and distant infection were found to be independent variable for SSI risk. In order to reduce the incidence of SSI, patients with a weight loss of 10% or more in six months preoperatively should be identified, and nutritional status of the patients should be corrected preoperatively, laparoscopic technique should be preferred in abdominal surgeries, and drain placement should be avoided, especially in clean-contaminated wounds. © 2024 Ondokuz Mayis Universitesi. All rights reserved.
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    Identification of ureter during colorectal surgery cannot always avoid ureteral injury: Duplicated collecting system
    (Southeastern Surgical Congress, 2015) Tardu A.; Kayaalp C.; Ertugrul I.; Yagci M.A.
    [No abstract available]
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    Portosystemic shunt surgery in patients with idiopathic noncirrhotic portal hypertension
    (Medical Science International, 2016) Karagul S.; Yagci M.A.; Tardu A.; Ertugrul I.; Kirmizi S.; Sumer F.; Isik B.
    Background: Idiopathic noncirrhotic portal hypertension (INCPH) is a rare disease characterized by increased portal venous pressure in the absence of cirrhosis and other causes of liver diseases. The aim of the present study was to present our results in using portosystemic shunt surgery in patients with INCPH. Material/Methods: Patients who had been referred to our Liver Transplantation Institute for liver transplantation and who had undergone surgery from January 2010 to December 2015 were retrospectively analyzed. Patients with INCPH who had undergone portosystemic shunt procedure were included in the study. Age, sex, symptoms and findings, type of portosystemic shunt, and postoperative complications were assessed. Results: A total of 1307 patients underwent liver transplantation from January 2010 to December 2015. Eleven patients with INCPH who did not require liver transplantation were successfully operated on with a portosystemic shunt procedure. The mean follow-up was 30.1±19 months (range 7–69 months). There was no mortality in the perioperative period or during the follow-up. Two patients underwent surgery again due to intra-abdominal hemorrhage; one had bleeding from the surgical site except the portacaval anastomosis and the other had bleeding from the h-graft anastomosis. No patient developed encephalopathy and no patient presented with esophageal variceal bleeding after portosystemic shunt surgery. Shunt thrombosis occurred in 1 patient (9.9%). Only 1 patient developed ascites, which was controlled medically. Conclusions: Portosystemic shunt surgery is a safe and effective procedure for the treatment of patients with INCPH. © Ann Transplant, 2016.