Mehmet Bektaş

Mallory-Weiss sendromunun argon plazma koagülasyonu ile tedavisi

The endoscopic hemostatic method has been introduced as a safe and effective mechanical approach to hemostasis for upper gastrointestinal bleeding related to Mallory-Weiss syndrome. A 62-year-old male patient with chronic cough and a 27-year-old 10-week pregnant female were admitted to our clinic with gross hematemesis. Upper gastrointestinal endoscopy was performed and Mallory-Weiss syndrome was diagnosed. Coagulum and visible vessels were observed during the procedure. Argon plasma coagulation was applied. After argon plasma coagulation, complete hemostasis was achieved and rebleeding did not occur. In conclusion, argon plasma coagulation can be performed easily and with minimum risk of complications such as perforation or delayed hemorrhage in patients with actively bleeding non-fibrotic Mallory-Weiss syndrome.

Ülseratif kolitli hastalarda displazi varlığı ve displastik mukozada p53 ve Ki-67 ekspresyonu

Giris ve Amac: Ulseratif kolitin baslangicindan 8-10 yil sonra kolorektal kanser gelisim riski artar. Ulseratif kolit hastalarinin kansere bagli mortalite ve morbiditesi kolonoskopik tarama yontemleriyle azaltilabilir. Bu calismanin amaci; ulseratif kolit hastalarinda histopatolojik olarak displazi varligini arastirmak ve immunohistokimyasal tekniklerle displastik mukozada p53 ve KI-67 ekspresyon oranlarini belirlemektir. Gerec ve Yontem: Calismaya klinik olarak remisyonda olan 52 ulseratif kolit hastasi alindi. Tum hastalara total kolonoskopi uygulandi ve cekuma kadar girildi. Kolondan rektuma kadar 10 cm’de bir dort kadran biyopsiler alindi. Displazi varligi biyopsi orneklerinde histopatolojik olarak tespit edildi ve displazi saptanan hastalarda immunohistokimyasal olarak p53 ve Ki-67 ekspresyonu varligi arastirildi. Bulgular: Hastalarin 32’sinde hastalik suresi 8 yildan az, 20’sinde ise 8 yil ve uzerindeydi. Hastalarin hepsi klinik olarak remisyonda olmasina ragmen endoskopik olarak sadece %59,6’i remisyondaydi. Hastalik %44,2 sol kolon ve %55,8 pankolit yerlesimliydi. Displazi 52 ulseratif kolit hastasinin 9’unda (%17,5) saptandi. Hastalik lokalizasyonu 6 hastada pankolit, 3 hastada ise sol kolon yerlesimliydi. Displazi, hastalik suresi 8 yildan fazla olan hastalarda yuksek saptandi. Immunohistokimyasal inceleme ile p53 icin pozitif boyanma 6 hastada, Ki-67 boyanmasi 3 hastada goruldu. Sonuc: Displazi hastalik suresi 8 yil ve uzeri olanlarda ve pankolitli olgularda daha fazla saptanmistir. Calismamizda hastalik suresi 8 yildan daha az olanlarda da displazi saptanmasi, tarama programina erken baslanmali mi sorusunu akla getirmektedir.

Son iki dekatta endoskopi merkezinde kolorektal kanser görülme sıklığı

Background and Aims: Colorectal cancer is seen more frequently in people and societies with higher socioeconomic status. In recent years, more evidence has emerged about the increasing involvement of the proximal colon. The purpose of this study was to evaluate the occurrence rate, localization and annual change in the rate of colorectal cancer. Materials and Methods: 18,484 lower gastrointestinal endoscopy procedures performed between 1993-2008 in the Endoscopy Units of Ankara University, Department of Gastroenterology were evaluated retrospectively. Among these, 8,249 (44.6%) were total colonoscopy and 10,235 (55.4%) rectosigmoidoscopy. Age, sex, occurrence of cancer, localization and annual changes in these parameters were determined. Results: Mean age of the patients was 47.8, and 52.2% were male. Colorectal cancer was detected in 659 (3.5%) of the cases. Cancer detection rate in males (4.5%) was significantly higher than in females (2.5%) (p

Gastrointestinal sistemde argon plazma koagulasyon (APC)uygulaması: Klinik deneyimlerimiz

Background and Aims: The aim of this study was to retrospectively analyze use of argon plasma coagulation in lesions of the gastrointestinal tract. Materials and Methods: Data of 92 patients treated with an argon plasma coagulation system in the upper and lower gastrointestinal tract between May 2005 and November 2006, using a VIO argon plasma coagulation device (VIO 300 D with argon plasma coagulation 2; Erbe Elektromedizin, Tubingen, Germany; pulsed argon plasma coagulation, 20?120 W), were reviewed and analyzed. Results: Ninety-two patients were treated with argon plasma coagulation, and the mean age was 61.84 (3-91) years. Fifty of these patients were male (54.3%) and 42 (45.7%) were female. Ninety-two patients were treated in 155 sessions. The mean number of treatment sessions required was 1.68 (1?12). Indications were vascular lesions (24 patients), bleeding peptic ulcers or prevention of bleeding recurrence (19 patients), adjunctive therapy after piecemeal resection of colonic polyps (17 patients), palliative treatment of gastrointestinal tract cancers, treatment of bleeding after polypectomy or biopsy (11 patients), ablation of inlet patch (11 patients), ablation of Barrett?s esophagus (5 patients), radiation proctopathy (4 patients), and metallic stent cut (1 patient). There were no major complications observed. Minor complications were seen in only five patients (bleeding in 2, chest pain in 1, anal pain in 2 patients). Conclusions: Argon plasma coagulation system was an effective and safe method in various gastrointestinal pathologies.