18 research outputs found
Performance and Safety Evaluation of Polypropylene Mesh Used in Inguinal Hernia Repairs
No full textAim: This study aimed to compare the data of patients who underwent open tension-free hernia repair using polypropylene mesh with the data obtained from the literature, and to evaluate the efficacy and safety of this mesh in the early postoperative period. The results of this study will provide additional data to the literature in terms of comparing different mesh materials.
Material and Methods: In this cross-sectional, and observational study, the early postoperative-period data of 96 patients who had undergone standard Lichtenstein tension-free hernia repair using polypropylene mesh in a tertiary-level hospital, using polypropylene mesh were evaluated and compared with the data obtained from the literature.
Results: The mean age of patients was 58.59±13.82 (range, 20-83) years. The median length of hospital stay was 1 (range, 1-4) day. The median of visual analogue scale (VAS) scores was 2 (range, 0-4) for the day of surgery, 0 (range, 0-4) for postoperative day-1, and 0 (range, 0-2) for postoperative day-2. A total of 6 complications developed in 5 of the patients, 3 (3.13%) were hematoma, 2 (2.08%) were wound site infections, and 1 (1.04%) was seroma. In one patient, both hematoma and wound infection were determined. No mortality was encountered.
Conclusion: Polypropylene mesh could be used effectively and safely in groin hernia operations. Although some complications with the use of synthetic mesh materials have been reported since the introduction of these materials into clinical use, none of these have yet been considered as conditions that will adversely affect the use of polypropylene mesh
The role of preoperative ultrasound in predicting conversion from laparoscopic cholecystectomy to open surgery in acute cholecystitis
No full textBACKGROUND: The aim of this study is to evaluate the role of pre-operative ultrasound findings for conversion from laparoscopic cholecystectomy to open surgery in patients with acute cholecystitis and to evaluate the effects of pre-operative ultrasound findings on operation time and length of stay.METHODS: The study included 80 patients who underwent laparoscopic cholecystectomy for acute cholecystitis between January 1 and June 30, 2023. The relationship between gallbladder wall thickness and the presence of pericholecystic fluid on pre-operative ultrasonography and the duration of surgery, conversion to open surgery, and hospitalization was evaluated.RESULTS: The patient group undergoing open surgery exhibited a statistically significant increase in both the median gallbladder wall thickness (P= 5.75 millimeters showed a sensitivity of 85.7% and specificity of 84.9% in predicting the requirement for open surgery.CONCLUSION: Our study highlights the significance of two factors in predicting the conversion from laparoscopic cholecystectomy to open surgery in patients with acute cholecystitis. The presence of pericholecystic fluid and a gallbladder wall thickness of 5.75 mm or greater are indicators that the laparoscopic procedure may be more challenging in such cases. These results can aid surgeons in making informed decisions and planning the surgical approach accordingly for better patient outcomes
Predicting complicated acute diverticulitis with the HALP score: A retrospective study
No full textObjective: HALP score is a scoring system consisting of hemoglobin, albumin, lymphocyte and platelet. It is different from other prognostic markers because it provides information about both inflammation and immunonutrition status. This study aims to evaluate the severity of the disease and the level of prognosis in patients diagnosed with acute diverticulitis. Material methods: 190 patients diagnosed with acute diverticulitis between January 2017 and June 2023 were included in the study. The patients were divided into two separate groups according to the Hinchey classification. The prognostic effect of inflammatory markers and HALP score was examined. Result: The median values of C-reactive protein, white blood cell count, neutrophil count, HALP score, and hospitalization duration were significantly higher in patients diagnosed with complicated diverticulitis than in those diagnosed with uncomplicated diverticulitis. (p < 0.001, p = 0.045, p = 0.004, p < 0.001 and p < 0.001, respectively). The distinguishing feature of the HALP score in predicting the complexity of the diagnosis of diverticulitis was evaluated using ROC analysis. Area Under Curve (AUC) value was found to be 0.723 (p < 0.001). According to the ROC curve, the sensitivity and specificity for the cut-off value of HALP score ≤44.1 were 66.7 % and 75.0 %, respectively. Conclusion: HALP score is an inexpensive parameter that can be used safely to determine the severity and prognosis of acute diverticulitis
Penetrating Cardiac Injuries
No full textObjective:Penetrating cardiac injuries have high mortality rates due to serious clinical outcomes. This study was planned to evaluate patients with penetrating cardiac injury.Material and methods:We reviewed the records of patients who were operated because of penetrating cardiac injuries in Department of Thoracic Surgery, Ministry of Health Ankara Training and Research Hospital between January 2005- December 2009.Result:Among those patients, 11 cases (64.8%) were stab (perforating device) injury, 6 cases were gunshot (35.2%). In 8 cases right atrium, in 4 cases left ventricle, in 3 cases right atrium and in 2 cases left atrium injuries were present. Emergent surgery was performed in all patients and cardiac injuries were repaired.Conlusion:The rapid transport, properly resuscitation and emergent surgery was improved sur-vival in patients sustained penetrating cardiac injuries
Effect of sılymarın on oxıdatıve stress and lıver hıstopathology ın experımental obstructıve jaundıce model
No full textABSTRACT PURPOSE: To investigate the effect of silymarin on oxidative stress and hepatic injury induced by obstructive jaundice in an experimental model. METHODS: Thirty Wistar-Albino type female rats were divided into 3 groups each including 10 rats. Only laparotomy was performed in group 1. Bile duct ligation was performed in group 2. In group 3, bile duct ligation was performed and orogastic silymarin 300 mg/kg/day dose was given for seven days. At the end of seven days, rats were sacrificed. The blood and liver tissue samples were taken to be examined biochemically and histopathologically. RESULTS: The plasma and liver levels of malondialdehyde were significantly lower in silymarin group than in the bile duct ligated group. Although liver levels of GSH were significantly higher in silymarin group than in the bile duct ligated group, there was no significant difference between the plasma GSH levels of these groups. In silymarin group; the enlargement of hepatocytes, dilatation of canaliculi and the edema were regressed. CONCLUSION: Silymarin diminished the harmful effects of obstructive jaundice on liver
Fibrin Glue's Intraabdominal Adhesion Creation Potential:Experimental Study
No full textAMAÇ: Çalışmamızda abdominal operasyon yapılan sıçanlarda, hemostatik ajan olarak kullanılan Fibrin Glue(Tisseel)'nin operasyon sonrası intraabdominal adezyon oluşturma potansiyelini değerlendirdik.GEREÇ VE YÖNTEMLER: SB Ankara Eğitim ve Araştırma Hastanesi Genel Cerrahi Kliniği'nde planlanan çalışmada, 30 (otuz) adet Wistar Albino cinsi dişi rat kullanıldı. Ratlar randomize olarak, 10'ar ratdan oluşan 3 gruba ayrıldı. Sham grubuna; laparotomi çekumun dışarı alınması ve yeniden batına gönderilmesi işlemi uygulandı.Kontrol grubuna; çekal abrazyon karşı peritondan 1x1 cm eksizyon işlemi, Fibrin Glue grubuna ise; çekal abrazyon karşı peritondan 1x1 cm eksizyon ve çekum üzerine Figrin Glue uygulaması yapıldı. Postoperatif 21. Günde ratlar yüksek doz anestezik verilerek sakrifiye edildi. Laparotomi esnasında adezyon skorlaması; yaygınlık, görünüm ve uygulanan kuvvete karşı direncin temel alındığı adezyon skorlaması; gruplar hakkında bilgisi olmayan bir cerrahi ekip tarafından; yaygınlığın, görünümün ve uygulanan kuvvete karşı direncin temel olarak alındığı bir yöntemle yapıldı. Periton ve çekumdan alınan doku örnekleri histopatolojik incelemeye gönderildi.BULGULAR: Adezyon skoru değerlendirmesinde, tüm gruplar Kruskal -Wallis Testi ile genel karşılaştırıldığında; Sham, Kontrol ve Fibrin Glue grupları arasında istatistiksel anlamlı fark bulundu (p 0.003). Mann-Whitney Testi ile yapılan ikili karşılaştırmalarda; Sham ve Kontrol grupları arasında istatistiksel anlamlı fark olduğu (p 0.013), Sham ve Fibrin Glue grupları arasında da anlamlı fark olduğu görüldü (p 0.001). Ancak Kontrol ve Fibrin Glue grupları arasında anlamlı istatistiksel fark bulunmadı (p0.05). Fibrin Glue grubunun adezyon skor ortalaması, Kontrol grubundan daha yüksek idi. Histopatolojik değerlendirme sonuçları için tüm gruplar Kruskal-Wallis Testi ile genel karşılaştırıldığında; Sham, Kontrol ve Fibrin Glue grupları arasında inflamasyon ve fibrozis açısından anlamlı fark olduğu (Fibrozis için p0.001, inflamasyon için p0.014) tespit edildi. Mann-Whitney Testi ile ikili grup karşılaştırılmalarında; Sham ve Kontrol grubu arasında anlamlı fark görüldü (inflamasyon için p0.022, fibrozis için p0.001), Sham ve Fibrin Glue grupları arasında da anlamlı fark görüldü( inflamasyon için p0.006, fibrozis için p0.002). Kontrol ve Fibrin Glue grupları arasında anlamlı fark yoktu (p0.05). Ancak, Fibrin Glue grubundaki inflamasyon ve fibrozis skor ortalamaları Kontrol grubundaki değerlerden daha yüksek idi. SONUÇ: Fibrin Glue (Tisseel)'nun intraabdominal yapışıklık oluşturma potansiyeli deneysel olarak değerlendirilmiş, makroskobik ve mikroskobik olarak yapılan karşılaştırmalarda; Sham, Kontrol grubu ve Fibrin Glue (Tisseel) grupları arasında istatistiksel olarak anlamlı fark bulunmuştur. Ancak, insanlardaki abdominal cerrahilerde olası adezyon potansiyelinin değerlendirilebilmesi için denek sayısının fazla olduğu daha kapsamlı çalışmalara ihtiyaç olduğu kanaatindeyiz.OBJECTIVE: In our study, we evaluated the potential of intraabdominal adhesion of fibrin glue (Tisseel), which is used as a hemostatic agent in rats undergoing abdominal surgery.MATERIAL AND METHODS: Thirty (30) female Wistar Albino rats were used in the study which was planned at the General Surgery Clinic of the Ankara Training and Research Hospital. The rats were randomly divided into 3 groups, each consisting of 10 rats. Sham group: Laparotomy withdrawal of the graft and resuscitation was performed. Control group: 1x1 cm excision process from cecal abrasion counterperiton. Fibrin Glue group; cecal abrasion 1x1 cm excision from the peritoneum and Fibrin Glue were applied on the cecum. On postoperative day 21, the rats were sacrificed by high dose anesthetic. Adhesion scoring during laparotomy; the prevalence, appearance, and resistance to applied force are based on adhesion scoring; by a surgical team without information about the groups; the appearance, and the resistance against the applied perspiration were used as a basis. Tissue specimens taken from the peritoneum and cecum were sent to a histopathological examination.RESULTS: When all groups were compared with the Kruskal-Wallis test in evaluating the adhesion score. There was statistically significant difference between sham, control and fibrin glue groups (p 0.003). In the binary comparisons made with the Mann-Whitney Test; There was a statistically significant difference between sham and control groups (p 0.013), and there was also a significant difference between sham and fibrin glue groups (p 0.001). However, there was no statistically significant difference between Control and Fibrin Glue groups (p> 0.05). The adhesion score average of the fibrin glue group was higher than the control group. When all groups were compared with Kruskal-Wallis test for histopathological evaluation results; There was a significant difference between the sham, control and fibrin glue groups in terms of inflammation and fibrosis (p 0.001 for fibrosis, p 0.014 for inflammation). Mann-Whitney test was used to compare the two groups; There was a significant difference between sham and control group (p 0.022 for inflammation, p 0.001 for fibrosis) and a significant difference between sham and fibrin glue groups (p 0.006 for inflammation and p 0.002 for fibrosis). There was no significant difference between control and fibrin glue groups (p> 0.05). However, the mean scores of inflammation and fibrosis in the fibrin glue group were higher than those in the Control group.CONCLUSION: Fibrin glue (Tisseel) has been experimentally evaluated in terms of the potential for intraabdominal adhesion formation, macroscopically and microscopically, There was a statistically significant difference between sham, control group and fibrin glue (Tisseel) groups. However, we believe that there is a need for more extensive studies to assess the potential adhesion of abdominal surgeons in humans
Effects of diosmine-hesperidine on experimental colonic anastomosis
No full textAim: Our goal was to determine the effects of a diosmine-hesperidine combination on wound healing
in a rat model of colonic anastomosis.
Materials and methods: In this study, 20 Wistar Albino female rats were randomized into four experimental groups
containing fi ve rats in each group. A segment of 1 cm of colon was excised 4 cm proximally to the peritoneal
refl ection in all rats without carrying out any mechanical or antibacterial bowel preparation. Colonic anastomosis
was performed with interrupted, inverting sutures of 6/0 polypropylene. Beginning from the fi rst postoperative
day, the rats in Groups II and IV received 100 mg/kg per day of diosmine-hesperidine via orogastic route
by 4F fi ne feeding catheter.
Results: A signifi cant difference was detected between groups in terms of their hydroxyproline levels (p<0.05);
the hydroxyproline level of Group I was signifi cantly lower than that of the other groups while no signifi cant difference
was noted between Groups II and III.
Conclusion: The administration of diosmine-hesperidine increased the amount of collagen and bursting pressures
at the anastomotic site and thus had favorable infl uences on the healing of colonic anastomosis
The effects of enoxaparin on the liver in experimental pneumoperitoneum model
No full textABSTRACT PURPOSE: To investigate the potential protective effects of enoxaparin against the adverse events of carbon dioxide (CO2) pneumoperitoneum. METHODS: Thirty four rats were divided into three groups: Group 1 (sham) underwent insertion of Veress needle into the abdomen and 90 min of anesthesia with no gas insufflation. The animals in control and enoxaparin groups were subjected to 90 min of 14 mmHg CO2 pneumoperitoneum. Enoxaparin (100 u/kg) was administered subcutaneously to the rats in enoxaparin group one hour before the operation. After 90 min of pneumoperitoneum, the rats were allowed for reperfusion through 60 min. Blood and liver samples were obtained for biochemical and histopathological examination. RESULTS: Treatment with enoxaparin decreased the histopathological abnormalities when compared with the control group. The highest levels of oxidative stress parameters were found in control group. The use of enoxaparin decreased the levels of all oxidative stress parameters, but the difference between the control and enoxaparin groups was not statistically significant. CONCLUSION: Enoxaparin ameliorated the harmful effects of high pressure CO2 pneumoperitoneum on the liver
Akut Kolesistitin Şiddetini Derecelendirmede Güvenilir Bir Belirteç; İmmatür Granülosit Yüzdesi
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