Eyüp Murat Yılmaz

Potential diagnostic and prognostic significance of plasma prolidase activity in gastric cancer

AIM Plasma prolidase activities (PPAs) in cases of gastric cancer. METHODOLOGY/RESULTS This study was based on a prospective design. 60 patients with gastric cancer (operable cases: 48; inoperable: 12) and 60 healthy controls were included in the study. Prolidase activity was analyzed. The mean PPA levels in the operable, inoperable and control groups were 45.60 ± 4.20, 54.35 ± 4. 9 and 10.92 ± 0.79 U/l, respectively (p < 0.001). PPA decreased significantly after tumor resection. PPA level was significant in differentiating operable cases from inoperable (sensitivity: 91.7%; specificity: 85.2%). DISCUSSION/CONCLUSION PPA was significantly higher in patients with inoperable gastric cancer than in operable cases and the control group. A strong correlation was found between tumor volume and PPA.

Tiroid bezinde primer kist hidatik olgusu

Hydatid disease is a significant infestation caused by the tapeworm Echinococcus granulosus. Primary hydatid disease of the head and neck without systemic involvement is quite rare in endemic regions.

Significance of Red Blood Cell Distribution Width and CRP/Albumin Levels in Predicting Prognosis of Acute Pancreatitis

BACKGROUND Acute pancreatitis (AP) is one of the major pathologies among gastrointestinal system diseases. The aim of this study was to determine the relationship between the red cell distribution width (RDW) value and the C-reactive protein (CRP)/ albumin ratio in patients with AP. METHODS In this retrospective study, AP cases were enrolled and divided into 2 groups according to the Ranson criteria as moderate or severe pancreatitis. The RDW and CRP/albumin values, length of hospitalization and stay in the intensive care unit (ICU), and the complications experienced were compared between these 2 groups. RESULTS A total of 264 patients were included in the study. Moderate pancreatitis was detected in 204 patients (77.2%) while severe pancreatitis was seen in 60 patients (22.8%) (p=0.081). There was no statistically significant difference in the RDW value between the groups (p=0.193). The CRP/albumin values were significantly higher in the severe pancreatitis group compared with the moderate group (p<0.001). The severe AP group also had a longer period of hospital care, both overall and in the ICU (p=0.001, p=0.047). CONCLUSION RDW was not a specific marker for predicting prognosis in AP, but the CRP/albumin ratio is an easy-to-apply, inexpensive, and reliable marker.

Prognostic Factors and Evaluation through Mannheim Peritonitis Index and Platelet-to-Lymphocyte Ratio in Acute Mesenteric Ischemia

BACKGROUND Acute mesenteric ischemia (AMI) is a disease that has a very high mortality rate and for which the diagnosis is frequently delayed. The aim of the present study was to assess the predictive value of the Mannheim Peritonitis Index (MPI) and platelet-to-lymphocyte (P/L) ratio in the prognosis of AMI. METHODS The files of 34 patients diagnosed with AMI between September 2014 and April 2016 were retrospectively examined. The patients were divided into 2 groups based on survival. The parameters of MPI and P/L ratio, demographic data, and duration of hospitalization were recorded and compared. RESULTS In all, 19 (55.9%) patients were male, and 15 (44.1%) were female. Total of 19 patients (55.9%) were discharged with a complete recovery, while 15 (44.1%) died. MPI mean value was 21.13±7.55 and 16.00±5.24 in those who died and survived, respectively (p=0.026). P/L ratio was 288.48±233.01 and 373.82±389.62 in those who survived and died, respectively (p=0.045). CONCLUSION MPI and P/L ratio are simple and reliable methods to predict the prognosis of AMI.

Contribution of an educational video to surgical education in laparoscopic appendectomy

Objective With recent widespread advances in laparoscopy, providing education on this subject has become a significant challenge. The aim of this study was to determine the degree of contribution made by surgeons to laparoscopic education through an educational video. Material and Methods A total of 40 volunteer general surgery residents and specialists participated in our study. Before watching the approximately six-minute educational video prepared for laparoscopic appendectomy, the participants were asked to fill out participant information forms and information measurement questionnaire forms. After the video, the participants were asked to fill out the information measurement questionnaire forms a second time; additionally, attitude evaluation forms and education evaluation questionnaire forms were presented to the participants for completion, and statistical analysis was performed. Furthermore, the total watching duration and the number of times the video was paused were recorded. Results A total of 40 surgeons participated in the study (75% residents and 25% specialists). When the results of the information determination questionnaire forms filled out by the resident and specialist groups before and after the video were compared, it was observed that the scores of both groups significantly increased after watching the video (p=0.001). A statistical significance was identified between the length of time the video was watched and the education evaluation form scores of the participants (p<0.01). It was observed that the longer the video was watched, the greater the increase in the education evaluation scores. The results of the attitude evaluation forms implied that the video could be produced more professionally. Conclusion Although education is an inevitable requirement of laparoscopic surgery, many teaching methods are available. Awareness-enhancing videos prepared on this topic can be efficient in providing laparoscopic education.

A rare cause of duodenal obstruction: Bouveret syndrome

Gallstone ileus is a relatively rare pathology, most commonly obstructing the terminal ileum. Bouveret syndrome is a syndrome found particularly in elderly patients, which develops as the result of a cholecystoenteric fistula. It leads to the gastric outlet obstruction and has an incidence of less than 1%. In this report, we presented a 95-year-old patient diagnosed with Bouveret syndrome.

Comparison of T and N Staging on Preoperative Magnetic Resonance Imaging and Postoperative Histopathologic Specimens in Rectum Cancer

Amaç: Günümüzde rektum cerrahisinde preoperatif dönemde manyetik rezonans görüntüleme (MRG) en çok kullanılan tanı yöntemlerinden birisidir. Çalışmamızda rektum kanserli hastalarda, MRG’nin preoperatif evrelemesi ile histopatolojik evrelemenin uyumunu araştırmayı planladık. Yöntem: Adnan Menderes Üniversitesi Tıp Fakültesi, Genel Cerrahi Anabilim Dalı’nda Eylül 2014-Kasım 2016 tarihleri arasında rektum kanseri nedeniyle ameliyat edilmiş 56 hasta çalışmaya dahil edildi. T ve N değerleri preoperatif ve histopatolojik olarak karşılaştırıldı. Bulgular: Çalışmaya 56 hasta alındı. Ortalama yaşı 66,05 (38-88) idi. Tümörlerin yerleşim yerine bakıldığında %29,8’i alt rektum, %32,3’ü orta rektum, %37,9’u ise üst rektum olarak gözlendi. MRG’de N(+) 21 olgu saptanırken bunlardan sadece 15’i patolojik olarak da N(+) olarak saptandı. MR’de 35 olgu N(-) saptanırken bunlardan 19’u patolojik olarak N(-) saptandı. N(+)’de duyarlılığı %71,4 iken, N(-)’lerde bu oran %54,3 olarak gözlendi. T değerlerine bakıldığında ise MR ile histopatolojik evreleme arasında istatistiksel bir anlamlılık olduğu gözlendi (p=0,049). Sonuç: Günümüz rektum kanserlerinde preoperatif görüntüleme yöntemlerinden ilk başvurulacaklardan birisi yüksek çözünürlüklü MRG olmakla birlikte, tanıda kuşku duyulması halinde ek görüntüleme yöntemleri de mutlaka kullanılmalıdır. Anahtar Kelimeler: Rektum kanseri, manyetik rezonans görüntüleme, evreleme ÖZ ABSTRACT

Effects of Glutamine, Arginine and Beta Hydroxymethybutirate on Anastomotic Leakage in Experimental Colon Anastomosis

Amaç: Kolon anastomozu ile ilgili kaçak nedenleri konusunda devam etmekte olan araştırmalar vardır. Bu çalışmada anastomoz dayanıklılığının ameliyat öncesinde beta-hidroksi-metil bütirat (HMB) ile artıp artmayacağı denetlenmiştir. Gereç ve Yöntemler: Kırk rat 4 gruba randomize edildi. Grup A (n=10) ratları standart rat yemi ile birlikte arjinin+glutamin+HMB’den zengin diyetle 7 gün beslendikten Öz Objective: The studies on anastomotic leakage which is one of the leading serious complications of colonic anastomoses keep going as well as other surgical researches. This study was designed to investigate effects of hydroxy-ß-methyl butyrate (HMB) on anastomotic healing. Materials and Methods: Forty rats were randomized into four groups. Group A (n=10) rats received chow food plus arginine+glutamine+HMB rich diet for 7 days before right colonic transection followed by an end-to-end anastomosis. Group B (n=10) rats received chow food plus arginine and glutamine rich diet for 7 days before the same surgical procedure. Group C (n=10) rats underwent the same procedure after a 7-day chow plus glutamin rich diet. Group D (n=10) rats had the surgery after a chow food only diet for seven days. All the subjects were fed accordingly to their groups for 7 days postoperatively. On the 7th day, all rats were sacrificed under anesthesia to measure anastomotic bursting pressure and evaluate hydroxyproline levels as well as histopathological scoring of anastomotic line. Results: This study revealed significantly increased hydoxyproline level at the 7th day in group A (p<0.002) and group B (p<0.001) relative to group D. There were no significant differences among the groups for anastomotic bursting pressures and histopathological scores. Conclusion: Enteral HMB support may result statistically significant increased biochemical anastomotic strength with an insignificant difference in biomechanical force. Although more studies are needed to delineate better efficacy, preoperative enteral HMB support may decrease postoperative morbidity and mortality. Ad dress for Cor res pon den ce/Ya zış ma Ad re si: Hakan Erpek MD, Adnan Menderes University Faculty of Medicine, Department of General Surgery, Aydın, Turkey Phone : +90 548 822 71 04 E-mail : hakanerpek@yahoo.com Received/Geliş Ta rihi : 12.01.2017 Accepted/Ka bul Ta ri hi : 17.05.2017 Anah tar Ke li me ler Beta-hidroksi-beta-metil butirat, anastomoz, nütrisyon

Obturator Hernia in Elderly Female Patients

Obturator hernia (OH) constitutes 0.07% to 0.4% of all intraabdominal hernias and 0.2% to 5.8% of small intestinal hernias. OH is usually seen in elderly, multiparous females and patients with a lo...

Nadir bir olgu sunumu: Çift rekürren laringeal sinir

One of the most important and feared complications of thyroid and parathyroid surgery is injury to the recurrent laryngeal nerve. The main reason for this type of injury is anatomical variations. Currently, nerve monitoring is being widely used to reduce complications due to the high variation rate. However, it is not being used extensively in our country, due to cost related issues. In this case, we present a left sided double recurrent laryngeal nerve.