Cerrahi Tıp Bilimleri Bölümü / Department of Surgical Sciences

Permanent URI for this collectionhttps://gcris3.etu.edu.tr/handle/20.500.11851/707

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Aktif Hastalarda Diz Medial Kondil Sınırlı Kıkırdak Defektlerinde Yüzey Kaplama Artroplastisi Tedavi Sonuçlarımız
(Kanuni Sultan Süleyman Training and Research Hospital, 2020) Karahan, Nazım; Yılmaz, Barış; Kaya, Murat; Kömür, Baran; Aktaş, Erdem; Heybeli, Nurettin
INTRODUCTION: In this study, we aimed to present the clinical results of articular resurfacing prosthesis cases applied to cartilage problems of active patients who cannot be treated conservative and biological surgical methods. METHODS: From April 2007 to March 2014, 32 patients were treated with femoral resurfacing using the HemiCAP implant. Indication for treatment with HemiCAP implant was symptomatic cartilage lesion at the medial femoral condyle demonstrated by MRI or arthroscopy, which was ICRS grade 3–4 and size less than 4 cm2. Patients were evaluated according to VAS score, American Knee Society Score, clinical improvement. RESULTS: 32 patients ( 8 males, 24 females) evaluated in this study. Mean age was 53.1 ± 3.2 years. 18 ( %56.3 ) patients were operated from right knee while 14 ( %43.7) of patients from left. Follow-up time was between 24 and 30 months ( 26.6 ±1.9 ). The decrease in postoperative VAS compared to preoperative VAS was statistically significant ( p<0.01 ). A statistically significant increase was observed in postoperative American Knee Society Score compared to preoperative knee scores ( p<0.01 ). Preoperative function score was 46.5 ± 9.1, postoperative function score was 77.3 ± 7.7. A statistically significant increase was observed in postoperative knee function scores compared to preoperative knee function scores ( p<0.01 ). DISCUSSION AND CONCLUSION: The femoral resurfacing treatment in active patients with local cartilage damage clinically reduces symptoms and improves knee function in the early period.
Citation - WoS: 16
Citation - Scopus: 18
Anestezistin Uyanik Kraniyotomi Uygulamalarındaki Yaklaşımı
(Turkish Society of Anaesthesiology and Reanimation, 2018) Özlü, Onur
Awake craniotomy, which was initially used for the surgical treatment of epilepsy, is performed for the resection of tumours in the vicinity of some eloquent areas of the cerebral cortex which is essential for language and motor functions. It is also performed for stereotactic brain biopsy, ventriculostomy, and supratentorial tumour resections. In some institutions, avoiding risks of general anaesthesia, shortened hospitalization and reduced use of hospital resources may be the other indications for awake craniotomy. Anaesthesiologists aim to provide safe and effective surgical status, maintaining a comfortable and pain-free condition for the patient during surgical procedure and prolonged stationary position and maintaining patient cooperation during intradural interventions. Providing anaesthesia for awake craniotomy require scalp blockage, specific sedation protocols and airway management. Long-acting local anaesthetic agents like bupivacaine or levobupivacaine are preferred. More commonly, propofol, dexmedetomidine and remifentanyl are used as sedative agents. A successful anaesthesia for awake craniotomy depends on the personal experience and detailed planning of the anaesthetic procedure. The aim of this review was to present an anaesthetic technique for awake craniotomy under the light of the literature.
Citation - WoS: 33
Citation - Scopus: 33
Associations Between Risk Factors and Developmental Dysplasia of the Hip and Ultrasonographic Hip Type: a Retrospective Case Control Study
(2019) Ömeroğlu, H.; Akceylan, A.; Köse, N.
Purpose We aimed to revisit the correlation between the previously defined risk factors and the occurrence of developmental dysplasia of the hip (DDH) and to assess the influence of these factors on the ultrasonographic type of hip dysplasia according to the Graf’s classification in patients with DDH. Methods Data of healthy infants (mean age 33 days) who had bilateral mature (normal) hips (Graf type I) were compared with the data of infants (mean age 105 days) who were treated by abduction brace due to unilateral or bilateral DDH (Graf type IIa- and worse hips). Results Infants with at least one risk factor had a significantly higher rate of DDH than those with no risk factors (p < 0.001). Likewise, infants with more than one risk factor had a significantly higher rate of DDH than those with only one risk factor (p = 0.008). Family history, breech presentation and swaddling were found to be the three significant risk factors related to the development of DDH. Family history, swaddling and oligohydramnios were found to be the three significant risk factors correlated with a higher rate of unstable/decentred hip(s) (Graf types D/III/IV) in patients with DDH. Conclusion The risk of DDH significantly increases in infants who have more than one risk factor for DDH. Positive family history and postnatal traditional swaddling are the two main factors both in the aetiology of DDH and in development of a more severe hip dysplasia in patients with DDH. Besides, breech presentation increases the risk of development of DDH and oligohydramnios leads to development of a more severe hip dysplasia in patients with DDH. By introducing these four variables as ‘absolute risk factors for DDH’ to the selective newborn hip screening programmes, the sensitivity and specificity of these programmes may be optimized and the risk of delayed diagnosis may be lessened.
“az Görü-yorum” : Az Görenlere Medikososyal Yaklaşım
(TOBB ETÜ Yayınları, 2024) Özen Tunay, Zühal
Baş-boyun Patolojisinde Tuzaklar
(Kongre Tıp Kitabevi, 2022) Kahraman, Devrim; Günhan, Ömer; Sarıoğlu, Sülen; Olgaç, Vakur
[No Abstract Available]
Citation - WoS: 27
Citation - Scopus: 32
Basic Principles of Fracture Treatment in Children
(2018) Ömeroğlu, Hakan
This review aims to summarize the basic treatment principles of fractures according to their types and general management principles of special conditions including physeal fractures, multiple fractures, open fractures, and pathologic fractures in children. Definition of the fracture is needed for better understanding the injury mechanism, planning a proper treatment strategy, and estimating the prognosis. As the healing process is less complicated, remodeling capacity is higher and non-union is rare, the fractures in children are commonly treated by non-surgical methods. Surgical treatment is preferred in children with multiple injuries, in open fractures, in some pathologic fractures, in fractures with coexisting vascular injuries, in fractures which have a history of failed initial conservative treatment and in fractures in which the conservative treatment has no/little value such as femur neck fractures, some physeal fractures, displaced extension and flexion type humerus supracondylar fractures, displaced humerus lateral condyle fractures, femur, tibia and forearm shaft fractures in older children and adolescents and unstable pelvis and acetabulum fractures. Most of the fractures in children can successfully be treated by non-surgical methods.
Benzer Kırma Kusuru İçin Uygulanan Farklı Keratorefraktif Cerrahi Yöntemlerinin Keratometrik Değerler Üzerine Etkileri
(2021) Özülken, Kemal; İlhan, Çağrı; Tekin, Kemal; Mumcuoğlu, Tarkan; Kaya, Mahmut
Amaç: Fotorefraktif keratektomi (PRK) ve laser in-situ keratomileusis (LASIK) gibi farklıkeratorefraktif yöntemlerle düzeltilen benzer büyüklükteki miyopik ve birleşik miyop astigmatik kırmakusurunun, korneal keratometrik güç üzerindeki etkilerinin benzer olup olmadığının araştırılmasıdır.Gereç ve Yöntemler: Bu geriye dönük, randomize olmayan, karşılaştırmalı klinik araştırmaOcak 2018 ve Haziran 2019 tarihleri arasında gerçekleştirilmiştir. Uygulanan cerrahiye göre olgularPRK (n=100) ve LASIK (n=76) olarak 2 gruba ayrılmıştır ve her bir hastanın sağ gözü çalışmayadahil edilmiştir. Olguların cerrahi öncesi ve cerrahi sonrası 6. aydaki klinik verileri göz önündebulundurularak sferik eşdeğerindeki (SE) azalma ile SEfark ve ortalama keratometrideki (Km) değişim ileKfark değerleri hesaplanmıştır. Kfark/SEfark hesaplaması ile birim SE değişiminin Km üzerindeki etkileriaraştırılmış ve gruplar arasında karşılaştırma yapılmıştır.Bulgular: PRK ve LASIK grupları arasında cinsiyet (p=0,348) ve yaş (p=0,768) bakımından anlamlıfark yoktu. SEfark değeri PRK grubunda -3,36 ± 1,46 D (-0,88 ile -6,50 D) iken LASIK grubunda -3,26± 1,41 D (-1 ile -6,13 D) idi ve gruplar arasında anlamlı fark yoktu (p=0,206). Kfark/SEfark parametresiPRK grubunda -0,87 ± 0,23 (-0,23 ile -1,53) iken LASIK grubunda -0,94 ± 0,46 (-0,32 ile -1,29) idive gruplar arasında anlamlı fark yoktu (p=0,169).Sonuç: Benzer büyüklükteki miyopik veya birleşik miyop astigmatik kırma kusuru düzeltmesindeuygulanan PRK ve LASIK cerrahilerinin Km değerindeki cerrahi ile elde edilen değişim üzerine olanetkileri benzerdir.
Beta-Catenin or Pax 2. Which One Is More Useful in Endometrial Cancer?
(Bayrakol Medical Publisher, 2021) Kahraman, Devrim
Aim : Pax 2 is a nuclear transcription factor. It is essential for the embryonic development of Mullerian organs and is suppressed through at later stages of embryonic development, but is reactivated during carcinogenesis. Beta-catenin is a protein that is translocated from membrane to cytoplasm and nucleus in WNT activation as a signaling pathway. Endometrioid carcinoma is associated with beta-catenin mutations. This study aimed to evaluate PAX2 and Beta-catenin expressions in benign and precancerous endometrial hyperplasias. Material and Methods: The study was performed on 40 endometrial curettage materials, including benign endometrial hyperplasia (n: 20), precancerous endometrial hyperplasia (n: 10), and endometrioid carcinoma (n: 20) as study groups. For immunohistochemical evaluation, one representative paraffin block for each case was selected. Results: Pax 2 nuclear staining was detected in all endometrial tissues. The mean percentage was % 70 in benign hyperplasia and % 90 in precancerous endometrial hyperplasia and endometrioid carcinoma. Beta-catenin membranous-cytoplasmic staining was detected in only precancerous endometrial hyperplasia with a percentage of % 80 and endometrioid carcinoma with a percentage of % 90. Discussion: Pax 2 is expressed in benign endometrial hyperplastic, precancerous endometrial hyperplasia and carcinoma, but beta catenin is expressed in only precancerous endometrial hyperplasia and carcinoma. These findings suggest that both the WNT signaling pathway and PAX 2 transcription factor may contribute to the development of endometrial cancer.
Citation - WoS: 1
Citation - Scopus: 2
Black Aorta in a Patient With Alkaptonuric Ochronosis
(Turkish Soc Cardiology, 2012) Tosya, Alper; Coşkun, Pınar Köksal; Uymaz, Barış; Tarcan, Onurcan; Aybek, Tayfun
[No abstract available]
Citation - WoS: 6
Citation - Scopus: 9
Botulinum Toxin Type a Injection Increases Range of Motion in Hip, Knee and Ankle Joint Contractures of Children With Cerebral Palsy
(TURKISH JOINT DISEASES FOUNDATION, 2019) Aktaş, Erdem; Ömeroğlu, Hakan
Objectives: This study aims to evaluate the clinical outcomes of children with spastic type cerebral palsy (CP) treated with botulinum toxin type A (BoNT-A) injection for lower limb contracture and the influence of age, gender, functional level and degree of initial contracture on treatment outcomes. Patients and methods: Clinical records at pre-BoNT-A injection and post-BoNT-A injections of 153 sessions of a total of 118 consecutive children (67 boys, 51 girls; mean age 5.9 +/- 2.6 years; range, 2.5-16 years) were retrospectively evaluated. Degrees of pre- and post-injection contracture were evaluated. Post-injection supplemental casting for 10 days was recorded in all cases. Less than 20 degrees of hip flexion contracture, more than 30 degrees of hip abduction, a negative prone Ely test, less than 50 degrees of popliteal angle and at least 5 degrees of ankle dorsiflexion values at post-injection were accepted as sufficient clinical improvement. Results: Sufficient post-injection range of motion (ROM) was observed in 80% of cases with hip flexion contracture, in 45% of cases with hip adduction contracture, in 84% of cases with knee flexion contracture and in 77% of cases with ankle equinus contracture. Prone Ely test that was positive in 60% of cases with knee extension contracture was negative at post-injection. Improvement in contractures were prominent in children with lesser degree initial contractures. Conclusion: Botulinum toxin type A injection increases ROM in hip, knee and ankle joint contractures in CP. Although age, gender and functional level may influence the clinical outcomes, pre-treatment level of contracture is the main determinant in improvement in ROM at post-injection.
Carotid Endarterctomy Surgery Results, a Yozgat Based Study
(2021) Er, Zafer Cengiz; Atılgan, Kıvanç; Zekey, Fethi Sada
Objectives: We aimed to present the examination of the results of patients who underwent carotid endarterctomy due to carotid artery stenosis and to compare our experience with the literature. Methods: Thirty five patients who underwent carotid endarterctomy at Bozok University hospital between January 2013 and March 2020 were included in the study. Etiology, concomitant diseases, anesthesia type, surgery and postoperative complications were evaluated retrospectively. Results: The mean age of the patients was 68±4.2. Of the patients, 27 were male and eight were female respectively. Right carotid endarterectomy was performed in 19 (54.28%) patients and left carotid endarterectomy in 16 (45.71%) patients. Thirty patients underwent surgery with general anesthesia and five patients underwent regional anesthesia. No mortality was observed. The records of complications were as follows; transient ischemic attacks in four patients (11.42%), difficulty in swallowing in two patients (5.71%), wound infection that improved with medical treatment in one patient (2.85%) and hematoma in three patients (8.57%) respectively in postoperative early period. Conclusion: Carotid endarterctomy is a surgery that can be performed with low mortality and morbidity when following the principles coming from the past and present.
The Clinical and Histological Analysis of 140 Cases of Ameloblastoma: an Emphasis To Histological Variants
(Türkiye Klinikleri (Ortadoğu Reklam Tanıtım Yayıncılık Turizm Eğitim İnşaat Sanayi ve Ticaret A.Ş.), 2020) Dereci, Ömür; Kahraman, Devrim; Koşar, Yasin Çağlar; Karagece, Ülker Yalçın; Günhan, Ömer
Objektive: The objective of this study is to evaluate the clinical and demographic features of ameloblastoma cases of a pathology center with a detailed examination of the histopathological properties of the subtypes and variants. Material and Methods: The clinical and radiological data and histologic slides of ameloblastoma cases diagnosed and treated between 2005 and 2017 were retrieved from the archives. Histopathological features of previously diagnosed cases were re-evaluated and re-classification of all cases was performed in accordance with the World Health Organization (WHO) classification of odontogenic tumors. The significance of the relationship between radiological appearance (multiocularity/unilocularity) and final histological diagnosis (solid/unicystic) was evaluated with statistical analysis. Results: There were a total of a hundred and forty cases of ameloblastoma. A hundred and twenty (85.7%) cases were diagnosed as solid type. Sixteen (11.4%) cases were diagnosed as unilocular ameloblastoma. Three cases showed admixed histopathological characteristics. There was a significant relationship between radiological appearance and histological diagnosis (p=0.005). All recurrent luminal unicystic ameloblastomas were re-diagnosed as mural subtype in the histopathological examination. Conclusion: The presence of rare variants should be diagnosed correctly with a thorough histopathological examination to contribute to the prognosis. The radiographic appearance of the tumor is correlated with the histological subtype. In the examination of recurrent unicystic cases, the surgical specimen should be entirely inspected to indicate mural ameloblastic invasions.
Clinical Behavior of Appendiceal Mucinous Neoplasia: 9 Years of Experience
(2022) Demirbaş, Sezai; Ozer, M. Tahir; Dogan, Semra; Tulunay, Gökhan; Kaymak, Sahin
Appendiceal mucocele is known a mucinous neoplasia of the appendix. It’s etiology is not clear. For last 30 years it’s incidence has increased to 2,8 cases/million person from 0,6 cases per million. Even if different classification has been made over the years, WHO and AJCC classifications are frequently used. Objective: The aim of this study was to find the pathologically performing the discrimination between LAMN and HAMN in the extracted specimen and how much the scattering mucin influenced the surgery and patients’ follow-up. Material and Methods: Patients and Centers: In two different hospitals between 2012-2020, the patients admitted to the emergency department and diagnosed as acute abdomen were evaluated retrospectively. All patients were accepted in the emergency clinic and operated then followed in the general surgical clinic. The appendiceal mucocele diagnosis was based on perioperative observation of mucinous distention or mucin dissemination. After obtaining specimens, the type of the mucinous neoplasm of appendix diagnosis and assessment was made by histopathological investigation. Results: Appendix mucocele was detected in 19 of 2974 patients included in the study. Two additional patients had advanced pseudomyxoma peritonei (PMP) after previous appendectomy. 11 of the patients (52.4%) were female. The mean age was 63.8 years. The appendix was evaluated preoperatively as enlarged in fourteen patients. In 1 patient, this condition was belonging to the ovary. Adeno cancer in one patient and PMP in 2 patients were clinically detected. Histopathologically, the appendix size was 37.1x71.9 mm. Sixteen of the patients were reported as LAMN, 2 as HAMN, 1 as adenocarcinoma and 2 as PMP. The leukocyte, carcinoembryonic antigen (CEA) and CA 19-9 levels of the patients were found to be significantly higher than normal. The patients were followed up for an average of 30.2 months. Early postoperative complications were seen in 5 patients. Complications evaluated late were seen in 8 patients. Recurrence was detected in one of the patients during the follow-up. The average survival rate was 36.7 months, although it was slightly higher in women. While the effect of leukocytosis, CEA, CA 19-9 on mortality was not significant, but tumor size was (p<0.05). This study has a few limitations. These are the small number of patients, the retrospective evaluation of the patients, and the relatively short follow-up time. Conclusion: In this study, we found mucocele more frequently than seen in the literature. Histopathologically, low grade mucinous neoplasia (LAMN) was often encountered. Mucocele with acellular mucin scattering were also seen in approximately 20% of the patients. After simple appendectomy, no recurrence was observed during the follow-up. The leukocyte count, tumor markers, and tumor size were evaluated in terms of their effects on postoperative morbidity and mortality. The tumor size had a negative effect on survival only. Finally, the simple appendectomy operation was considered suitable for the treatment.
Çocuk Kırıklarında Tedavi Planlaması
(Türkiye Klinikleri, 2020) Aktaş, Erdem; Ömeroğlu, Hakan
There is a significant increase in children's fractures. Socio-economic reasons, change in life-style, advanced technology and imaging techniques, training of orthopedic surgeons, parents excellent result expectations and increased participation in individual and team sports has recently influenced the treatment of pediatric fractures towards surgical procedures. Although the above mentioned factors affect the type of treatment and its outcomes, in order to achieve good functional results, orthopedic surgeons should make their treatment plans in the light of recent knowledge, knowing the properties of pediatric fractures and related treatment principles, issues in complex injuries and individual factors that may affect the overall result.
The Comparison of Bacterial Contamination and Antibacterial Effi Cacy of the Anti-Glaucomatous Eyedrops With and Without Preservatives
(Gazi Eye Foundation, 2020) Özülken, Kemal; Çubuk, Mehmet Özgür; İnan, Neşe; Acar, Uğur; Göçmen, Jülide Sedef; Akman, Ahmet
Purpose: To investigate the bacterial contamination risks and antimicrobial activities of the preservative-free and preservative-containing anti-glaucomatous ophthalmic solutions. Materials and Methods: Ophthalmic solution bottles of preservative-free brimonidine 0.15% (D1), benzalkonium chloride-containing (BAK) brimonidine 0.15% (D2), purite-containing brimonidine 0.15% (D3) and BAK-containing timolol maleate dorzolamide fi xed combination (D4) were included in this study in terms of microbial contamination risk. Moreover, microbial contamination of the two bottles [preservative-free brimonidine 0.15% (D7) and BAK-containing brimonidine 0.15% (D8)] was investigated after contacting their tips with the lower eyelid edge of a researcher. Every day twice a day for 60 days; the caps of the bottles were opened and they were closed after waiting for 20 sec. One drop was added from these six bottles 11 times during the study period (60 days) to the six separate and renewed blood-agar mediums. Microbial contamination was evaluated every visit by examining the blood agar mediums by the same microbiologist. In terms of antimicrobial effi cacy; D1, D2, D3 and D4 were compared with the antibiotic containing ophthalmic solutions; moxifl oxacin (D5) and tobramycin (D6) by using agar well diffusion method. Results: No bacterial growth was observed in the mediums of D1, D2, D3, D4 and D8 bottles. The bacterial growth of methicillin-susceptible and resistant coagulase-negative staphylococci was observed in the medium of D7 bottle on some days. A large inhibition zone was seen around D5 and D6, whereas a smaller inhibition zone was detected around D2 and D4. No inhibition zone was detected around the D1 and D3 bottles. Conclusions: Multi-dose preservative-free antiglaucomatous ophthalmic solutions have not any risk of bacterial contamination unless the tip of the bottle is contaminated.
Citation - WoS: 7
Citation - Scopus: 9
Comparison of Higher-Order Aberrations After Single-Step Transepithelial and Conventional Alcohol-Assisted Photorefractive Keratectomy
(Turkish Ophthalmological Association, 2020-06) Özülken, Kemal; Çağrı, İlhan
Objectives: To compare the asphericity and higher-order aberration (HOA) outcomes of single-step transepithelial photorefractive keratectomy (tPRK) and conventional alcohol-assisted PRK (aaPRK) in patients with myopia and myopic astigmatism. Materials and Methods: Of the 108 eyes of 54 patients enrolled in the study, tPRK was performed on 54 (50%) eyes and aaPRK was performed on 54 (50%) eyes. The following parameters were compared: corrected distance visual acuity (CDVA), spherical equivalent (SE), flat and steep keratometry, intraocular pressure, central corneal thickness, asphericity, and HOAs including horizontal and vertical coma, horizontal and vertical trefoil, spherical aberration, second-order vertical coma, and aberration coefficient. Results: The demographic and baseline characteristics were similar between the two groups (p>0.05, for all). The aberration coefficient value was significantly lower in patients treated with aaPRK compared to patients treated with tPRK at postoperative 3 months, 6 months, and 1 year (p=0.022, p=0.019, and p=0.017, respectively). Differences in the other variables were statistically insignificant (p>0.05 for all). Conclusion: Both tPRK and aaPRK procedures obtain similar postoperative CDVA, SE, asphericity, and HOA outcomes, except the aberration coefficient value.
Comparison of Optic Nerve Head Parameters Measured by Kowa Three Dimensional Non-Mydriatic Retinal Camera and Heidelberg Retinal Tomograph Iii in Healthy Subjects
(Gazi Eye Foundation, 2019) Köylü, Mehmet Talay; Akıncıoğlu, Dorukcan; Gökçe, Gökçen; Özge, Gökhan; Mumcuoğlu, Tarkan
Purpose: To compare the optic nerve head (ONH) parameters obtained by KOWA three dimensional (3D) non-mydriatic stereoscopic retinal camera (NMRC) and Heidelberg retinal tomograph III (HRT) in healthy subjects. Materials and methods: In this study, 72 eyes of 36 healthy subjects were enrolled. Kowa 3D NMRC and HRT III examinations were performed to each subject on the same day. Nine ONH parameters, including vertical cup disc ratio, cup area, disc area, rim area, height variation contour, cup volume, rim volume, maximum cup depth, and mean cup depth values of both devices were compared and correlated. Results: Kowa 3D NMRC and HRT revealed similar values for vertical cup disc ratio, cup volume, and rim volume (p>0.05). However Kowa 3D NMRC signifi cantly overestimated the HRT determined cup area, disc area, height variation contour, and rim area (p<0.001). Kowa 3D NMRC signifi cantly underestimated the HRT determined mean cup depth and maximum cup depth (p<0.001). A statistically signifi cant, high degree correlation was found between the two devices for the vertical cup disc ratio, cup area, disc area, cup volume, maximum cup depth, and mean cup depth (r=0.66-0.83, p<0.001). A statistically signifi cant but low degree correlation was found regarding height variation contour (r=0.29, p=0.01). There was no significant correlation in the measurement of rim volume and rim area (p>0.05). Conclusion: Most of ONH parameters including vertical cup disc ratio are similar when measured by Kowa 3D NMRC and HRT III. Kowa 3D NMRC is a potential tool for monitoring ONH parameters.
Comparison of Single-Incision and Conventional Laparoscopic Cholecystectomy in Terms of Quality of Life, Body Image, and Cosmesis
(Wolters-Kluwer, 2019-04-01) Sinan, H; Saydam, M; Demir, P; Ozer, MT; Demirbaş, Sezai
Background: Clinical studies indicate that single-incision laparoscopic cholecystectomy (SILC) has many advantages over conventional laparoscopic cholecystectomy (CLC), such as improved cosmesis, reduced postoperative pain, and shorter hospital stay. The aim of this study was to compare quality of life, body image, and cosmesis between single-incision laparoscopic and conventional laparoscopic approaches in patients undergoing cholecystectomies. Subjects and Methods: This retrospective study between SILC and CLC and was conducted among 58 patients undergoing SILC and CLC from January 2011 to March 2013 in Turkey. After the surgery, the EuroQol-5 Dimension Questionnaire (EQ-5D™), and body image questionnaire (BIQ) were administered to the patients. Results: Differences between the early and late postoperative scores in the EQ-5D were statistically significant (P < 0.001). Differences between most BIQ areas favored SILC, especially regarding cosmesis (P = 0.016); SILC patients had higher satisfaction with their scar's appearance. Conclusion: SILC is a promising alternative to traditional laparoscopic cholecystectomy in terms of quality of life, body image, and cosmesis in selected patients.
Comparison of the Accuracy of Isosulfan Blue and Technetium -99m Lymphoscintigraphy To Determine Axillary Node Metastasis in Breast Cancer.
(Islamic Academy of Sciences, 2017-07) Albuz, Özgür; Akkurt, Gökhan; Ayan, Aslı; Öztürk, Erkan; Balkan, Salih Müjdat
This study aimed to compare the efficiency of isosulfan blue (ISB) and colloid methods in determining metastatic conditions of axillary lymph node in sentinel lymph node biopsy (SLNB). This prospective study was performed between April 2005 and July 2009 at Gulhane Medical Faculty, Department of General Surgery. A total of 102 female patients diagnosed with breast cancer were enrolled in the clinic of Gulhane School of Medicine. According to the diagnostic protocols of SLN, the patients were divided into three groups as follows: ISB (group I), colloid (group II), and ISB and colloid (group III). SLN was identified in 49 of 52 patients (94.2%) in the ISB group; the sensitivity, specificity, negative predictive value (NPV), positive predictive value (PPV), and false negativity (FN) ratio were found to be 90.9%, 75.8%, 96.1%, 55.5%, and 9.1%, respectively. On the contrary, the sentinel lymph node was identified in 38 of 38 (100%) patients in the colloid group; the sensitivity, specificity, PPV, NPV, and FN were found to be 88.2%, 100%, 100%, 91.3%, and 11.8%, respectively. In ISB and colloid groups; SLN was identified in 12 of 12 (100%) patients in the ISB and colloid groups; the sensitivity, specificity, PPV, NPV, and FN were found to be 100%, 100%, 100%, and 0%, respectively. This study showed that the combined methods applied to heterogeneous groups of patients for SLNB in breast cancer cases were minimally invasive and effective and hence could be used for evaluating nodal metastases.
Citation - WoS: 2
Citation - Scopus: 2
Comparison of the Effect of Noise Levels on Stress Response in Two Different Operation Groups in an Orthopedic Surgery Room
(Derman Medical Publ, 2017) Yıldız, H. Gül Baytan; Özgencil, Enver; Çakar, Sanem; Ökten, Feyhan; Tüzüner, Filiz
The aim of this randomized, single-blinded study was to evaluate the effects of noise on hemodynamic and neuroendocrine stress response by measuring the level of noise in the surgery rooms of patients undergoing knee operations under neuroaxial anesthesia. Gerec ve Yontem: We compared patient responses from two groups of patients: those undergoing knee operations in a surgery room where the noise level (measured in decibels) is high, and those undergoing meniscus operations in a surgery room with lower noise levels. The STAI, the State-Trait Anxiety Inventory (STAI-1), and the anxiety test (STAI-2) wereperformed at preoperative and postoperative periods. 20 ml of blood sample was taken for basal, intraoperative 30th minute, and postoperative 1st hour measurements. Systolic, diastolic, and mean arterial blood pressures were found to be higher in the high noise level group. ACTH levels were increased during the early postoperative period and became normal during the late postoperative period in the high noise level group whereas ACTH levels were significantly decreased in the low-noise level group. Basal cortisol levels were significantly higher in the high noise level group. HCRP, an inflammatory response mediator was found to be decreased in both groups. Early and late blood glucose levels were significantly higher in the high noise group. There was a greater increase in early and late blood glucose levels in the high noise group. In the postoperative period, although the state-trait anxiety inventory (STAI-2) levels being higher in patients subject to noisier environment determines how people feel independent of the conditions and state they are in, this result made us consider that the noise the patients were subjected to in the intraoperative period may cause a stress response. Discussion: As a result we believe that standard noise levels should be achieved by reducing the factors causing high noise levels in the operating room. This will provide better sedation, less drug consumption, and better metabolic control.

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