Mustafa Öncü

Kolorektal cerrahide ASEPSIS yöntemiyle yara takibi

GIRIŞ Kolorektal cerrahi geciren hastalar Yara yeri enfeksiyonlari (YYE) acisindan yuksek riske sahiptir (1,2). Yara yeri komplikasyonlarinin yakindan izlemi yara iyilesmesi ve hasta sag kalimi uzerinde olumlu etki yapmaktadir (3-8). Bu calismadaki amaclar kolorektal cerrahide YYE gelismesine neden olan faktorleri arastirmak, YYE siddetini ve iyilesme surecini yara skorlama yontemi olan ASEPSIS ile izlemek ve YYE riskini belirlemek amaciyla kullanilan NNIS (National Nosocomial Infections Surveillance System) ve SENIC (The Study on the Efficacy of Nosocomial Infection Control) yontemlerini karsilastirmaktir (4-12).

Spontaneous Choledochoduodenal Fistula due to Peptic Ulcer Disease

Spontaneous choledochoduodenal fistula is a rare complication of peptic ulcer disease, and surgical is generally directed towards the ulcer itself. We present 2 cases with spontaneous choledochoduodenal fistula due to peptic ulcer disease. One of our cases is a 27-year-old male who had a 3-year history of duodenal ulcer, while the other patient is a 56-year-old female who had a 5-year history of peptic ulcer and developed pyloric stenosis in the last month before hospitalization. Both these patients were successfully treated by truncal vagotomy with antecolic gastrojejunostomy. They were asymptomatic for follow-up periods of 8 months and 6 years, respectively.

Stellungnahme zum eingeladenen Kommentar vonK. Keminger (ACA 23: 1991; 30–31) zur PublikationM. Öcü, et al.: Zum Problem des Trachealkollapses nach großen Strumaoperationen

did not w a n t to p r e s e n t th i s s u r g i c a l a p p r o a c h as a n e w t e c h n i q u e . T h e t e c h n i q u e e x i s t s a l r e a d y in c l a s s i c a l b o o k s as Kemingere x p l a i n s . W e c o n g r a t u l a t e Keminger, w h o p r a c t i c e s a n d has d e s c r i b e d the m e t h o d in l i t e r a t u r e f o r the f i r s t t i m e . I w o u l d also l ike to t h a n k h i m

Zum Problem des Trachealkollapses nach großen Strumaoperationen

ZusammenfassungNach der Thyreoidektomie tritt nur sehr selten ein Trachealkollaps auf; wenn dies allerdings der Fall ist, verursachter eine plötzliche Luftröhrenobstruktion mit folgendem Tod des Patienten. Einen Trachealkollaps trifft man meistens nach großen Strumaoperationen an. Die bei der Operation an die Trachea angelegten Seidensuturen werden herausgezogen, wenn es durch Inspirationschwierigkeiten zum Trachealkollaps kommt. Dadurch wird die Luftröhre wieder geöffnet.SummaryTracheal collapse after thyroidectomy is uncommon; when it occurs, complete airway obstruction is often sudden, unexpected and fatal. It usually follows the removal of a large goiter. When the inspiration difficulty is seen because of the tracheal collapse after large goiter operations, silk tractions sutures which have been put on trachea during the operation, can be pulled to open the airway again.

Catheter related sepsis

In 100 patients plastic catheters were placed into the basilic vein for parenteral nutrition (n=40) and central venous pressure monitoring (n=60). Catheter related sepsis rates were compared between indication for parenteral nutrition (10%) and central venous pressure measurement (18%). Intraoperative complications were not seen.ZusammenfassungFür parenterale Ernährung wurden an 40 Patienten und für zentralvenöse Druckmessung an 60 weiteren Venenkatheter in die V. basilica gelegt. Katheterbedingte Sepsis trat bei der parenteral ernährten Gruppe in 10%, bei Patienten, bei denen zentralvenöse Druckmessung durchgeführt wurde, in 18% auf. Intraoperative Komplikationen wurden nicht beobachtet.

Tunneling and untunneling catheter sepsis during parenteral nutrition

In 100 patients plastic catheters were used for parenteral nutrition. The catheters were placed into the basilic vein with (n=26) and without (n=74) a subcutaneous tunnel, the incidence of catheter induced sepsis was 15% in the cases without in comparison to tunneled catheters with 3.5%. Intraoperative complications were not seen.ZusammenfassungAn 100 Patienten wurden zentrale Venekatheter mit einem Einzellumen in die V. basilica gelegt. 26 Katheter wurden mit einem subkutanen Tunnel, 74 ohne Tunnel plaziert. Die Kathetersepsis trat bei den nichttunnellierten Fällen in 15%, bei den tunnelierten in 3,5% (p<0,05) der Fälle auf. Intraoperative Komplikationen wurden nicht beobachtet.