Emin Lapsekili

An evaluation of combat application tourniquets on training military personnel: changes in application times and success rates in three successive phases

Introduction Haemorrhage from the injured extremity is a significant cause of preventable death in military settings. This study evaluated the effect of training on the efficacy of the combat application tourniquet (CAT) and to define standards for military personnel. Method Participants from a training tank battalion were randomised. Data collected included age, body mass index, mean arterial pressure, hand dominance, femoral artery diameter and skin thickness. The study involved tourniquet application times (AT) and application success rates in basic, after-training and eyes-closed phases. Doppler ultrasound was used to identify the presence or absence of popliteal, radial and ulnar artery pulses. Results A total of 102 trainees participated. In the after-training phase, the left and right upper extremity ATs were 35±13.1 s, and 34.8±13.5 s and the right and left lower extremity ATs were 20.6±6.0 s and 20.5±5.5 s, respectively. The overall tourniquet success rates in three successive study phases were 69.6%, 82.4% and 91.2%, respectively. A negative significant relationship was found between extremity circumference and tourniquet success. Discussion The results show that the efficacy of CAT application increases with training. Further studies are required to investigate the reasons underlying application failures. This single group prospective randomised study involves level of evidence 4.

Publication rates of abstracts presented at the annual congress of the Turkish Society of Colorectal Surgery (years 2003-2011)

OBJECTIVE The aim of our study is to examine the Publication Rate of Congress of Turkish Society of Colorectal Surgery meeting abstracts and determine the factors affecting publication rate. MATERIAL AND METHODS All presentations at Congress of Turkish Society of Colorectal Surgery congresses held in 2003, 2007, 2009, 2011 were retrospectively assessed. Manuscripts indexed in Google-Scholar database were included. The meeting year, study type, presentation type, title and time to publication of studies were assessed. Actual impact factor values were assessed to introduce the scientific power of the journals. RESULTS Among a total of 614 abstracts presented at these congresses, 139 (22.6%) presentations were published in various medical journals. The publication rate was higher in oral presentations as group compared to poster presentations (29.7% vs. 19.5%) (p<0.001). Mean time to publication period was 20.4 (±21.1) months. 78 (56.1%) of published articles were published in SCI-E journals while 61 (43.9%) were published in non-SCI-E journals. Experimental studies had a higher Publication Rate in analysis of publication rate according to study type (p<0.001). Prospective clinical studies had a higher publication rate than retrospective studies. The journals in which oral presentations had been published had greater impact factor than journals in which poster presentations had been published (p=0.02). If published; prospective clinical studies were published in journals with greater impact factor than retrospective studies (p=0.04). CONCLUSION The quality of a meeting is correlated with the publication of abstracts accepted as presentations. Congress of Turkish Society of Colorectal Surgery congress is an efficient meeting for researchers, and have a lower PR as compared to international congresses while having a similar publication rate to equivalent scientific meetings. Being more selective during abstract acceptance should increase the Publication Rate and quality of Congress of Turkish Society of Colorectal Surgery congresses.

Giant Epidermal Cyst Unusually Located in Perianal Region

Address for Correspondence/Yazışma Adresi: Şahin Kaymak MD Gülhane Training and Research Hospital, Clinic of General Surgery, Ankara, Turkey Phone: +90 532 333 41 14 E-mail: sahinkaymak@hotmail.com ORCID ID: orcid.org/0000-0003-4717-5791 Received/Geliş Tarihi: 23.08.2017 Accepted/Kabul Tarihi: 20.10.2017 ©Copyright 2018 by Turkish Society of Colon and Rectal Surgery Turkish Journal of Colorectal Disease published by Galenos Publishing House. DOI: 10.4274/tjcd.46362 Turk J Colorectal Dis 2018;28:40-43 CASE REPORT

Central hepatectomy: A valuable option to avoid posthepatectomy liver insufficiency in patients requiring extensive liver resection

Despite being uncommon, posthepatectomy liver failure (PLF) is a dreadful complication following extended hepatectomy or liver trisectionectomy. It has been reported that liver insufficiency may occur in as high as 12% of posthepatectomy patients, especially in those who have a concomitant chronic liver disease, hepatosteatosis or history of receiving long-course (>6 cycles) chemotherapy (1). Central hepatectomy or mesohepatectomy, defined as en-bloc anatomical resection of liver segments 4-5 and 8, is a valuable option in patients with central large or multiple liver lesions to minimize PLF caused by the loss of a considerable portion of functional liver parenchyma following extensive resections (2). The purpose of this video-based article is to share key procedural components to be adhered to when performing central hepatectomy.

Role of alkaline phosphatase intestine-isomerase in acute mesenteric ischemia diagnosis.

BACKGROUND The aim of the present study was to investigate the diagnostic value of alkaline phosphatase (ALP) intestine-isomerase, plasma lactate dehydrogenase (LDH), and D-dimer levels in acute mesenteric ischemia. METHODS Thirty Wistar rats were divided into 5 groups of 6 rats each. In Group 1, blood samples were obtained to determine normal parameter levels. In the sham group, Group 2, blood samples were obtained following laparotomy. In Group 3, blood samples were obtained 2 hours after ligation. In Groups 4 and 5, blood samples were obtained at 4 and 6 hours after ligation, respectively. Ischemic damage was assessed using a pathological scoring system. Blood samples were analyzed for hourly changes in parameters. RESULTS No statistically significant difference in D-dimer levels was found between ischemia groups (p=0.337). A statistically significant difference in LDH levels was found between the control group, Group 1, and Group 4 (p=0.018). ALP intestine-isomerase enzyme levels were not statistically significant in other groups (p=0.077). CONCLUSION Findings indicate that plasma LDH levels higher than 1900 IU/L may be a useful marker in the early diagnosis of acute mesenteric obstruction. However, ALP intestine-isomerase enzyme and D-dimer plasma levels were not found to contribute to the diagnosis.

The Role of the Ultrasonography of Abdomen Performed by a General Surgeon on Diagnosis of Acute Appendicitis

Aim: In this study, we aimed to investigate whether abdominal ultrasonography (USG) performed by a general surgeon provides significant contribution to himself in diagnosing acute appendicitis. Method: This study was performed at two different hospitals where referral of patients to another hospital is not possible due to geographical reasons. Two hundred fifteen patients with suspicious diagnosis of acute appendicitis were included into the study among 2140 patients with abdominal pain at three different periods during 12 months. Data of the patients were evaluated retrospectively and patients were divided into three groups. Group 1 and 2 include patients followed and treated in the same hospital. Group 1 patients were followed and treated by general surgeon using conventional methods without abdominal USG. Group 2 patients were followed and treated by same general surgeon using both conventional methods and abdominal USG. Group 3 patients were followed and treated by a different general surgeon in a different hospital using conventional methods and abdominal USG performed by a radiologist. Results: Of patients, 200 male and 15 were female, and mean age was 23. A total of 66 patients from all groups underwent appendectomy. When the groups were compared with according to the pathological results which were consistent with acute appendicitis; there was not statistically significant difference among groups (p=0.362). Conservative treatment were applied to the patients with sonographically negative for appendicitis and with negative findings for physical examination and laboratory tests in their follow-up. When the groups were compared in terms of correctly identification of nonacute appendicitis and avoidance of negative appendectomy (laparotomy); statistically significant difference in favor of group 2 (p=0.002) was found. Conclusion: According to the results of the study; when surgeons use USG as an adjunctive method, the rate of negative appendectomy decreases.