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  • Küçük Resim
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    The effect of surgeon’s fatigue on early term patency and complications of arteriovenous fistulas: A prospective cohort study
    (2018) Yabanoglu, Hakan; Bali, Cagla; Avci, Tevfik; Arer, İlker Murat; Yildirim, Sedat
    Aim: Examining the effect of surgeon’s fatigue on early term patency and complications of arteriovenous fistula (AVF). Material and Methods: AVFs created for hemodialysis in patients with end-stage renal failure were included in the study. The patients were divided into 2 groups as those operated in the first operation of that day (Group 1) and those operated after the first or second operations (Group 2). The patients were compared with respect to clinical, demographics, postoperative, surgical variables, and operation duration. Results: A total of 100 patients underwent AVF operation. No statistically significant differences were found between the groups with respect to clinical, demographic, surgical, and postoperative variables. Efficiency of dialysis was found to be higher and complication rate lower in Group 1. But no statistical significance was obtained in terms of early dialysis efficiency and complication rates in between the groups (p>0.05). Complication rate was higher in Group 2 when compared according to operation time as 120, 120-240, and 240< minutes. But no statistical significance was obtained in this manner (p>0.05). Conclusions: Although not statistically significant, surgical fatigue factor and long operation time increase the rate of early complications and reduce early dialysis efficiency. We think that early term patency of AVF can also be affected by the complication rate. The effect of this variable can be statistically significant with studies having larger sample size.
  • Küçük Resim
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    Surgical and endovascular treatment for mesenteric ischemia
    (2019) Aydin, Huseyin Onur; Ayvazoglu Soy, Ebru Hatice; Avci, Tevfik; Tezcaner, Tugan; Boyvat, Fatih; Yildirim, Sedat
    Aim: Mesenteric ischemia is a rare, highly fatal, surgical emergency. In addition to open surgical (OS) intervention, endovascular treatment (ET) was also recommended for treatment in last years. Surgical resection becomes inevitable in the cases of intestinal ischemia. We aimed to assess patient-related factors and compare treatment outcomes in mesenteric ischemia treated by OS and ET. Material and Methods: Patients treated for mesenteric vascular occlusion at our hospital between 2013 and 2018 were retrospectively evaluated. Duration of symptoms, time from symptom onset to treatment, treatment used and surgery used, re-laparotomy need, duration of intensive care unit stay, duration of hospital stay, and 30-day and 1-year mortality rates were evaluated. Results: Twenty patients with mesenteric ischemia were evaluated. The OS group had a significantly higher CCI score than the ET group (p<0.05). The most common comorbidities in the OS and ET groups were coronary artery disease and hypertension, respectively. The duration of symptoms and time from symptom onset to treatment were significantly shorter in the OS group than the ET group (p<0.05). The OS group most commonly had SMA emboli while the ET group most common had chronic SMA occlusion (p<0.05). Thirty-day and 1-year mortality rates were significantly greater in the OS group than the ET group (p<0.05). Conclusion: Mesenteric ischemia is a highly morbid and fatal condition. ET significantly reduces morbidity and mortality in the face of signs of intestinal ischemia. On the other hand, OS would be inevitable for patients with signs of diffuse peritoneal irritation or those with suspected intestinal necrosis.