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Öğe Bezoars: A comprehensive review of the literature with analysis of 30 collected cases(2019) Turgut, Hamdi Taner; Tiryaki, ÇağrıAim: The aim of the present study was to discuss the operated cases for bezoar and the treatment results in comparison to the literature. Material and Methods: We retrospectively reviewed 30 cases operated due to bezoar in our hospital from 2008 to 2017. Demographic characteristics, comorbidities, obstruction locations, dietary habits, clinical findings, diagnostic and therapeutic methods, and the outcomes of the patients were recorded from the patient files. Results: Thirty cases of bezoar were found. One patient was treated two times due to recurrence. The distribution of cases according to the monthly prevalence was observed as 4 patients in November, 10 patients in January, 9 patients in December, 3 patients in February (86.6% in autumn and winter). Twenty-one patients (70 %) had a history of abdominal surgery. Eighteen (% 60) patients also had gastric surgery. Surgery revealed 18 (%60) bezoar cases in the jejunum and ileum. Five (%16.6) patients had bezoars found concurrently in the stomach and ileum and in 7 patients (%23.3) had bezoars in the stomach. Fragmentation and milking were done to three patients, resection-anastomosis was performed to one patient, enterotomy was performed to 16 patients, gastroenterostomy was performed to 3 patients, enterotomy and gastrotomy were performed to 2 patients, gastrectomy was performed to one patient and gastrotomy was performed to 4 patients. The average days of patients stayed at the hospital were 12.83 ± 14.2 (6-84) days. Conclusion: IBO caused by bezoar is still a rare diagnosis. This case must be considered for intestinal bowel obstruction encountered in patients with previously undergone gastric surgery and fibrous food consumption, especially in autumn and winter months.Öğe Comparison of open and laparoscopic gastrectomy for gastric cancer: a low volume center experience(Turkish Surgical Assoc, 2021) Yuksel, Adem; Coskun, Murat; Turgut, Hamdi Taner; Sumer, FatihObjective: In gastric cancer, laparoscopic gastrectomy is commonly performed in Asian countries. In other regions where tumor incidence is relatively low and patient characteristics are different, developments in this issue have been limited. In this study, we aimed to compare the early results for patients who underwent open or laparoscopic gastrectomy for gastric cancer in a low volume center. Material and Methods: We retrospectively analyzed the data of patients who underwent curative gastric resection (open gastrectomy n: 30; laparoscopic gastrectomy n: 30) by the same surgical team between 2014 and 2019. Results: The tumor was localized in 60% (36/60) of the patients in the proximal and middle 1/3 stomach. In laparoscopic gastrectomy group, the operation time was significantly longer (median, 297.5 vs 180 minutes; p<0.05). In open gastrectomy group, intraoperative blood loss (median 50 vs 150 ml; p<0.05) was significantly higher. Tumor negative surgical margin was achieved in all cases. Although the mean number of lymph nodes harvested in laparoscopic gastrectomy group was higher than the open surgery group, the difference was not statistically significant (28.2 +/- 11.48 vs 25.8 +/- 9.78, respectively; p=0.394). The rate of major complications (Clavien-Dindo >= grade 3) was less common in the laparoscopic group (6.7% vs 16.7%; p=0.642). Mortality was observed in four patients (2 patients open, 2 patients laparoscopic). Conclusion: In low-volume centers with advanced laparoscopic surgery experience, laparoscopic gastrectomy for gastric cancer can be performed with the risk of morbidity-mortality similar to open gastrectomy.Öğe Comparison of Results of Minimal Invasive Surgery for Pilonidal Sinus with Karydakis Procedure: Less is More(2017) Ozyildiz, Mehmet; Yazicioglu, Murat Burc; Coskun, Murat; Turgut, Hamdi Taner; Tiryaki, Çağrı; Civil, Osman; Yuksel, Adem; Yildiz, Selim YigitAim: Controversy still remains regarding the best surgical technique to use for the treatment of pilonidal disease to minimize disease recurrence and patient discomfort. Minimal surgical procedures can be performed on an outpatient basis. In this study, the early results of our minimally invasive operative approach cases are compared with Karydakis flap reconstruction results.Öğe Comparison of the methods of intracorporeal knot and hem-o-lok clip to cover the stumps in laparoscopic appendectomy(2018) Subasi, Ozkan; Coskun, Murat; Yuksel, Adem; Yildiz, Selim Yigit; Turgut, Hamdi Taner; Gunes, AbdullahAim: Laparoscopic appendectomy (LA) is used in acute appendicitis treatment in many centers today. Various methods such as intracorporeal knot, endoloop, stapler and hem-o-lok clip are used to close of the appendix stump during LA. All of these methods has several advantages and disadvantages. In this study, we aimed to compare the effect of the intracorporal knot method with hemo-lok clip method to close of the appendix stump in LA. Material and Methods: Operative data, complications and follow-up results of 143 patients which treated with LA between January 2012 and December 2017 were evaluated retrospectively. Results: Sixty-four patients (44.7%) were males and 79 (55.2%) were females. Seventy-five patients (52.4%) were treated with 2/0 polyglactin (coated vicyrl, ethicon) sutures and 68 patients (47%) were treated with hem-o-lok clip XL (weck hem-o-lok polymer ligation system) for intracorporeal knot to close of the appendix stump. Patients were compared according to the duration of operation, the duration of hospitalization and postoperative complications and there were no statistically significant difference between the data of the cases according to the groups (p = 0.197, p = 0.902, p = 0.503, respectively). Conclusion: We identified that both techniques for appendix stump closure are effective and safe methods in LA.Öğe Lower gastrointestinal endoscopy results of surgical endoscopy unit(2019) Coskun, Murat; Turgut, Hamdi Taner; Yuksel, Adem; Yildiz, Selim Yigit; Firtina, GizemAim: Endoscopic examinations are gold standard methods with great potential for early diagnosis of colorectal adenomas and carcinomas and reduction of colorectal cancer incidence, and mortality. Our aim in this retrospective study was to evaluate our results regarding the patients who underwent lower gastrointestinal system endoscopy in the general surgical endoscopy unitin Derince Resear hand Training Hospital. Material and Methods: We retrospectively evaluated the data of patients undergoing colonoscopy or rectosigmoidoscopy after admission to the general surgery clinic between January 2015 and December 2017 due to complaints of the lower gastrointestinal system or for bowel preparation for control purposes. Results: Colonoscopies were performed to 57% (n = 2784) of the patients and rectosigmoidoscopy procedure was performed in43% (n = 2100) of 4884 patients. 49.5% (n = 2417) of the patients were males and 50.5% (n = 2467) were females. In 81.5% of the patients the procedure was completed adequately and successfully. The number of patients evaluated as inadequate procedure was 903 (18.5%). Reasons for inadequate procedure were insufficient bowel cleansing in 12.7% (625/4884) of patients and intolerance due to pain in 5.5% (270/4884) of patients. Endoscopic procedures revealed no pathology in 28.7% of the patients (n=1170), hemorrhoids in 30.1 % (n=1198), polyps in 15.7% (n=625), anal fissure in 6.3% (n=250), and malignant diseases in 4.6% (n=183). Conclusion: In this study we evaluated the endoscopy results of the lower gastrointestinal system in our unit, we found that the inadequacy rate of operation was high and the most important cause of this was insufficient bowel cleansing. Being more careful about patient preparation before the procedure, and informing the patient in detail will increase the success of the procedure and prevent unnecessary repetition of the procedure.
