Tülay Diken Allahverdi

The Comparison of the Effects of Ellagic Acid and Diclofenac Sodium on Intra-Abdominal Adhesion: An In Vivo Study in the Rat Model

Peritoneal adhesions are seen frequently after abdominal surgery and can cause serious complications. We aimed to evaluate the effects of the oral use of diclofenac sodium and ellagic acid on formation of postoperative adhesions in rats Studies have shown that agents with anti-inflammatory properties and antioxidant substances can prevent adhesion by decreasing oxidative stress. We compared and evaluated the effects of ellagic acid that has strong antioxidant and anti-inflammatory properties and the nonsteroidal anti-inflammatory diclofenac sodium on peritoneal adhesion development in our experimental study. Laparotomy was performed with a midline incision under general anesthesia and an adhesion model was created on the antimesenteric side of the cecum in Groups I, II, and III. Group I received 85 mg/kg ellagic acid and Group II, 50 mg/kg diclofenac sodium through the nasogastric catheter while Group III received no medication. Only laparotomy was performed in Group IV. The rats were sacrificed at the end of the 14th day. Following macroscopic scoring, tissue samples were removed and subjected to biochemical and histopathologic evaluation. The degree of adhesion and the malondialdehyde level were decreased (P < 0.05), and glutathione level increased (P < 0.05) in Group I compared to Group II and Group III. The effects of ellagic acid on the prevention of peritoneal adhesion were found to be stronger than diclofenac sodium. This can be explained by the fact that ellagic acid is a strong antioxidant and decreases oxidative stress with anti-inflammatory and anti-angiogenic effects.

Retrospective Evaluation of Patients Diagnosed with Cystic Echinococcosis at Kafkas University Faculty of Medicine’s Surgical Outpatients Unit

OBJECTIVE The aim of this study was to retrospectively evaluate the serological and radiological analysis and medical and surgical treatment results of patients diagnosed with cystic echinococcosis (CE). METHODS Records belonging to a total of 67 patients diagnosed with CE who presented to the Kars Kafkas University Faculty of Medicine Research Hospitals Surgical Outpatient unit between January 2012 and December 2015 were retrospectively evaluated. RESULTS Of 67 CE cases, 53 (79.1%) were females and 14 (20.9%) were males. The age ranged between 12 and 77 years, and the mean age was 47.37±17.81 years. The most common cyst location was the liver, in 60 patients (89.5%). Other localizations were found in 7 (10.5%) of the 67 cases. Open surgery was used to treat 32, and drainage accompanied by ultrasonography (USG) was used to treat 13 cystic cases. The remaining 22 patients were followed-up. Among the followed-up patients, the radiologic imaging findings of six patients were consistent with a hydatid cyst, but the indirect hemagglutination assay (IHA) results were negative. CONCLUSION We concluded that CE is an important public health problem for the Kars region due to a low socioeconomic and educational level, where livestock breeding is also common. More comprehensive epidemiological studies should be undertaken and national control programs are required to keep the disease under control.

Evaluation of patients who have undergone unintentional parathyroidectomy following thyroidectomy: a retrospective cohort study

Aim: We investigated the postoperative parathormone levels and the incidence of hypocalcemia in patients who had inadvertently underwent parathyroidectomy during thyroid surgery . Material and Methods: We retrospectively evaluated a total of 142 patients who had undergone thyroidectomy between January 2011 and March 2017 from their charts. The demographic feature sand pathology diagnoses of the thyroidectomy patients were evaluated. The number of excised parathyroid glands in the pathology specimens and their location were determined. The PTH level was checked after surgery. Calcium was measured on the 2nd day. Calcium replacement was provided for patients with low PTH and calcium. The level of calcium replacement was determined by referring to biochemical values. Following discharge, the calcium and PTH levels were checked during outpatient visits to determine whether the hypocalcemia was transient or permanent. Results: The 142 patients consisted of 23 males (16.2%) and 119 females (83.8%). The mean age was 49.5 years. The surgery performed was bilateral total thyroidectomy in 131, bilateral subtotal thyroidectomy in 3, left total right subtotal thyroidectomy in 3, right total leftsubtotalthyroidectomy in 2, left thyroid lobectomy in 2, and complementary thyroidectomy in 1. Unilateral neck dissection (level II, III, IV, V) was performed in 2 patients and central lymphnode dissection in 82 patients. Parathyroid tissue was found to have been excised during surgery in 35 patients, consisting of 33 females (94.2%) and 2 males (5.8%). The parathyroid tissue had been removed incidentally in 31 and not incidentally in 4. We found transient hypocalcemia in 42 patients and permanent hypocalcemia in 2 patients. Discussion: We found that some parathyroid glands had been inadvertently removed despite careful thyroid surgery. We believe that checking the PTH level postoperatively is important in determining hypocalcemia. Conclusion:

The Superiority of the Anterior Transposition Surgical Method to Decompression Procedures in a Case of Secondary Cubital Entrapment Neuropathy

Cubital Entrapment Neuropathy (cubital tunnel syndrome) is a peripheral entrapment neuropathy coming right after the carpal tunnel syndrome in terms of frequency. It is twice as common in adult males as in females. We report our surgical experience with the anterior transposition method. A 41-year-old male patient presented to our clinic with symptoms of functional weakness of the right hand hypothenar region and 3rd- 4th intrinsic lumbrical muscles together with atrophy and claw finger symptom in the 4th and 5th fingers (Grade III) that had been increasing for the last 19 months. The patient underwent ulnar nerve decompression. There was no improvement 5 months after the surgery and anterior transposition of the ulnar nerve was therefore performed as secondary surgery. No complication occurred afterwards.The anterior transposition method used in our case with secondary cubital tunnel syndrome has a high success rate when performed properly although it is a more invasive intervention.While the only accepted treatment for idiopathic cubital tunnel syndrome is decompression, the anterior transposition method can be used for posttraumatic secondary cubital tunnel syndrome. Surgical Methods of Anterior Transposition for Secondary Cubital Entrapment vs. Decompression Procedures.

Rectosigmoid Tumor Causing Rectal Prolapse: Case Report

Rectal prolapse is believed to develop secondary to anatomical defects. Rectosigmoid tumors are rare causes of this condition. This must be kept in mind in patients with prolapse; colonoscopic examination is recommended and biopsy should be performed when necessary. In this case report, we present an elderly patient with rectal prolapse. The mass that precipitated the prolapse was biopsied and identified as adenocarcinoma. The cancer was treated and patient was discharged.

The Comparison of Four-Port, Two-Port Without Suspension Suture and Single Port Laparoscopic Cholecystectomy Results

BACKGROUND Single-port surgery has recently become popular, however, many surgeons have to use additional ports during the surgery due to difficulties. OBJECTIVES We performed two-port MCAP (with an additional port using a multi-channel device through the umbilicus) without a suspension suture in a group of patients. We compared the results of this technique to the LC and SILC techniques. MATERIAL AND METHODS A total of 90 patients with gallbladder disease were included in the study. LC (n = 30) and SILC (n = 30) were performed in two groups. The other group underwent cholecystectomy (MCAP) by using an additional 5 mm port through the subxiphoid region with a multi-channel port through the transumblical. A transabdominal suspension suture was not used for the patients in this group. The surgery duration, estimated blood loss, length of hospitalization, visual analogue scale (VAS) score in the postoperative 1st and 7th day, need for analgesia in the postoperative period and complications, and the conversion rate were compared between the three methods. RESULTS A total of 62 females (68.9%) and 28 males (31.1%) participated in the study. MCAP duration was significantly shorter than LC and SILC (38.1 ± 16.6, 49.4 ± 15.8, 77.8 ± 26.7 min respectively) (p < 0.05). The conversion rate was similar in all three groups. Hernia developed in the port area in two patients after SILC (6.7%). No significant difference was found between the groups for the other data we compared. CONCLUSIONS MCAP seems to be an easier technique with a shorter operation time compared to the other two techniques. However, there is a need for other studies to evaluate the cosmetic results.

Effects of alpha lipoic acid on intra-abdominal adhesion: an experimental study in a rat model

BACKGROUND This study was performed to determine the effect of alpha lipoic acid, a powerful antioxidant, on intra-abdominal adhesion formation. METHODS Twenty-four female Wistar Albino rats weighing 250-300 g were used in this study conducted on three groups consisting of the alpha lipoic acid group (Group I, n=8), control group (Group II, n=8), and sham group (Group III, n=8). After performing laparotomy with a midline incision under general anesthesia, the adhesion model was created on the antimesenteric side of the caecum in Group I and Group II. 50 mg/kg alpha-lipoic acid was administered intraperitoneally (IP) in Group I while the surgical procedure was performed but no drugs administered in Group II. Only laparotomy was performed in Group III. Rats were sacrificed at the end of the tenth day. RESULTS Macroscopic scoring was performed, tissue samples were obtained and subjected to biochemical and histopathological evaluation. The degree of adhesion and malondialdehyde level decreased (p<0.01), and glutathione levels had increased (p<0.01) in Group I compared to Group II in macroscopic scoring. CONCLUSION Alpha lipoic acid was found to significantly decrease (p<0.01) intra-abdominal adhesion when administered IP compared to the control group.