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  • Küçük Resim
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    Amyand’s hernia in children: A 20-year experience at a tertiary referral hospital
    (2022) Tartar, Tugay; Sarac, Mehmet; Bakal, Unal; Akdeniz, Ibrahim; Kazez, Ahmet
    Aim: 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.
  • Küçük Resim Yok
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    IS TIGECYCLINE EFFECTIVE IN CONTINUOUS AMBULATORY PERITONEAL DIALYSIS RELATED PERITONITIS
    (Carbone Editore, 2017) Tartar, Ayse Sagmak; Ozden, Mehmet; Dogukan, Ayhan; Akbulut, Ayhan; Demirdag, Kutbeddin; Tartar, Tugay
    Introduction: To compare conventional intraperitoneal vancomycin-amikacin and intravenous tigecycline treatments for continuous ambulatory peritoneal dialysis (CAPD) related peritonitis. Materials and methods: Patients diagnosed with CAPD-related peritonitis were randomized into two groups as intravenous tigecycline group (n = 10) and intraperitoneal vancomycin-amikacin group (n = 20). Patients accompanied by peritonitis exit site infection, peritonitis based on Pseudomonas or fungi were excluded from the study. Results: As for 24th and 48th hours peritoneal fluid leukocyte count of patients, significant difference was not observed in tigecycline group at 24th hours, while significant reduction was observed in vancomycin-amikacin group (p < 0.05). A significant reduction was observed at 48th hours in both groups. As for the treatment response, abdominal pain decreased in 18 (90%) patients in vancomycin-amikacin group, decreased in 8 (80%) patients in tigecycline group at 48th hours. It was detected that dialysate leukocyte count decreased significantly (p > 0.05). Relapse was observed in 4 (40%) patients in tigecycline group, while not observed in vancomycin-amikacin group (p < 0.05). Conclusion: Tigecycline proved its effectiveness in the clinical use for complicated intra-abdominal infections. However, it was considered that tigecycline cannot be alternative to vancomycin-amikacin treatment for continuous ambulatory peritoneal dialysis related peritonitis.