İstanbul Üniversitesi Açık Erişim Sistemi
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Single-incision laparoscopic clockwise continuous total abdominal colectomy with end ileostomy in ulcerative colitis; surgical technique and results of a 7-year experience
No full textBackground: Total abdominal colectomy with end ileostomy is the first stage of the three-stage surgical treatment of medically refractory ulcerative colitis. Laparoscopic surgery is a safe approach offering several benefits. Single-incision laparoscopic surgery is an alternative minimally invasive approach providing excellent cosmetic results. Literature on single-incision laparoscopic clockwise continuous total abdominal colectomy in the treatment of ulcerative colitis is limited. Aim of the study is to describe our surgical technique and report the outcomes. Methods: Medically refractory ulcerative colitis patients who underwent single-incision laparoscopic clockwise continuous total abdominal colectomy with end ileostomy by a single surgeon between January 2013 and December 2020 at our tertiary care center are included. Patient charts were reviewed retrospectively. Results: 52 patients were included in the final analysis. 51.9% patients were male with the median age of 31.5 years and body mass index of 22.2 kg/m2. Median duration of operation was 100 min with estimated blood loss of 50 ml. There were no intraoperative complications, conversions to conventional laparoscopy or open surgery. Postoperative complications were reported in 13 (25%) patients with most common being ileus (17.3%). 3 patients had surgical site infections. 2 patients had postoperative bleeding requiring blood transfusion. 2 patients had reoperation within postoperative 30 days. Median length of hospital stay was 2 days. No mortalities were reported. Conclusion: Single-incision laparoscopic clockwise continuous approach is safe and effective in ulcerative colitis patients undergoing total abdominal colectomy with end ileostomy. Further prospective randomized studies are warranted. Graphical abstract: [Figure not available: see fulltext.
Okullarda Sağlık Risklerinin Yönetimi Programı; Operasyonel Epidemiyoloji İle Eyüpsultan Modeli
No full textResidents' perception of tourism impacts and their support for tourism development: a study of a Bektashi faith destination in Türkiye (Ahead-of-Print)
No full textIntegrating shared autonomous vehicles in Last-Mile public transportation
No full textWhile public transportation (PT) plays a critical role in urban mobility, the discomfort and the disutility of the last-mile trips make PT unattractive. We study the feasibility of shared autonomous vehicles (AV) as an on-demand alternative to fixed-route buses for last-mile travel. To this end, the bus routes that operate along the edges of the PT network in Bursa, Turkey are selected. The origin and destination (OD) pairs of the trips made on these bus routes are inferred at an individual level. The vehicle routing problem is then formulated by considering the proposed transportation service. Several solution methods are developed for both solution construction and solution improvement phases of the problem. To assess solution methods with real-world data, an agent-based simulation framework is built. It is found that the solution methods successfully solved a dynamic problem. The results show that the integration of PT using AVs is well-suited to improve the service quality and energy efficiency in the last-mile mobility
