2012-11-13, SARI, S, Aysan, E, MUSLUMANOGLU, M, ERSOY, YELİZ EMİNE, BEKTASOGLU, HÜSEYİN KAZIM, YARDıMCı, ERKAN, AYŞAN, MUSTAFA ERHAN, ERSOY, YELIZ EMINE, BEKTAŞOĞLU, HÜSEYİN KAZIM, YARDIMCI, ERKAN

Background: We aimed to minimalize operative complications by spraying of methylene blue stain on thyroid glands and the perithyroidal area. Material and methods: The intra-operative methylene blue spraying technique was used prospectively on a total of 56 patients who had undergone primary (not recurrent) thyroid surgery for a variety of thyroid diseases. Bilateral total thyroidectomy was performed in all cases. After superior but before inferior pole ligation, 0.5ml of methylene blue was sprayed over the thyroid lobe and perilober area. Tissues, especially parathyroides, the recurrent laryngeal nerve, and the inferior thyroid artery, were identified and evaluated. Results: Recurrent laryngeal nerve and arteries were not stained and thus they remained white in all cases while all other tissues were stained blue. Within three minutes parathyroid glands washed out the blue stain and the original yellow color was regained. Thyroid tissue wash-out time was not less than 15 minutes; perithyroideal muscles, tendinous and lipoid structures took no less than 25 minutes. Conclusion: The safety of intravascular methylene blue guidance on thyroid surgery is known. This research demonstrates the effectiveness of the spraying technique, a new technique which ensures not only identification of parathyroid glands within three minutes, but also identification of recurrent laryngeal nerves and inferior thyroid arteries.

2019-01-01, BEKTAŞOĞLU, HÜSEYİN KAZIM, Hasbahceci, Mustafa, YIĞMAN, SAMET, YARDIMCI, ERKAN, KUNDUZ, ENVER, MALYA, FATMA ÜMİT, BEKTAŞOĞLU, HÜSEYİN KAZIM, YIĞMAN, SAMET, YARDIMCI, ERKAN, KUNDUZ, ENVER, MALYA, FATMA ÜMİT

Objective: We aim to evaluate the effect of peritoneal closure on postoperative pain and life quality associated with open appendectomy operations. Methods: This is a single-center, prospective, randomized, and double-blinded study. Here, 18-65-year-old patients who underwent open appendectomy for acute appendicitis were included. Demographic data of the patients, operation time, length of hospital stay, pain scores using a 10 cm visual analogue scale (VAS) on the first postoperative day, quality of life assessment using the EuroQol-5D-5L questionnaire on postoperative 10th day, deep wound dehiscence, bowel obstruction, and mortality data were recorded. Results: In total, 112 patients were included in the study. The demographic data showed no significant difference between the groups. The median VAS score was lower in the group with open peritoneum, but this difference was not statistically significant (3 vs. 4, p=0.134). The duration of surgery was significantly shorter in the peritoneal nonclosure group (31.0 ± 15.1 vs. 38.5 ± 17.5 minutes, p=0.016). Overall complication rates and life quality test (EuroQol-5D-5L) results were similar between groups. Conclusion: Nonclosure of the peritoneum seems to shorten the duration of surgery without increasing complications during open appendectomy. Postoperative pain and life quality measures were not affected by nonclosure of the peritoneum. This trial is registered with NCT02803463.

2014-01-01T00:00:00Z, Bektasoglu, HÜSEYİN KAZIM, Idiz, UO, Hasbahceci, M, Yardimci, ERKAN, Firat, YD, Karatepe, O, Muslumanoglu, M, BEKTAŞOĞLU, HÜSEYİN KAZIM, YARDIMCI, ERKAN

2018-06-01T00:00:00Z, Gürbulak, B, Üçüncü, MZ, Yardımcı, ERKAN, Kırlı, E, Tüzüner, F, YARDIMCI, ERKAN

2017-03-24, YARDIMCI, ERKAN, BOZKURT, SÜLEYMAN, CENGIZ, MB, Malya, FATMA ÜMİT, YARDIMCI, ERKAN, BOZKURT, SÜLEYMAN, MALYA, FATMA ÜMİT

BACKGROUND Ligation of the left gastric artery (LLGA), which supplies the fundus of the stomach, may reduce the appetite hormone ghrelin, resulting in weight control. The aim of this study was to compare LLGA and sleeve gastrectomy (SG) in terms of postoperative outcomes in a rat model. MATERIAL AND METHODS Fifteen male Wistar albino rats, weighing >350 grams (range 350-525 grams), were enrolled in LLGA (N=5), SG (N=5), and control (N=5) groups. Blood samples were drawn preoperatively and also during the first and fourth week postoperatively to assay ghrelin and leptin hormone levels. Body weight was measured in each group. RESULTS The maximum reduction in ghrelin level (41.5%) was found in the LLGA group. Considerable% total weight loss (TWL) (mean 24.1%) was observed in the SG group, and slight%TWL was noted in the control and LLGA groups (means of 0.1% and 2.1%, respectively). There was no significant difference in mean percent weight change between the LLGA and the SG groups (p=0.08). Blood sample analysis revealed no statistically significant changes in ghrelin or leptin levels between the groups (p=0.9 and p=0.3, respectively). CONCLUSIONS We present evidence that LLGA causes the same reduction in ghrelin hormone levels as SG at 4 weeks after surgery in a rat model. However, LLGA did not cause the same%TWL as SG. The mechanism of weight loss in SG is most likely due to restriction and to the effects of the procedure, rather than due to neurohormonal changes.

2021-12-01T00:00:00Z, Yıldız, Nida, Baş, Murat, Coşkun, Halil, Batar, Nazlı, Yardımcı, Erkan, COŞKUN, HALIL, YARDIMCI, ERKAN

Aim: In this study, we aimed to investigate the early effect of probiotic supplementation after Laparoscopic Sleeve Gastrectomy (LSG) on constipation and gastrointestinal quality of life compared to control group. Methods: This study was a prospective, randomized clinical trial. Participants were recruited to Bariatriklab Obesity and Metabolic Surgery Center for LSG. All patients were divided into 2 groups as probiotic and control by using simple randomization. The probiotic group consumed Bifidobacterium animalis lactis BB-12 strain as a probiotic supplement during 6 weeks after LSG. Gastrointestinal Symptom Rating Scale (GSRS), Constipation Severity Instrument (CSI), Patient Assessment of Constipation Quality of Life Scale (PAC-QOL), Bristol Stool Form Scale (BSFS), Gastrointestinal Quality of Life Index (GIQLI) of the patients were recorded before LSG and at the 2nd, 4th, 6th weeks after LSG. Results: The probiotic group had an average age of 37.00±8.92 years (18 female, 12 male), the control group had an average age of 41.03±11.29 years (23 female, 7 male). CSI (16.50 ± 14.76 vs. 31.37 ± 15.34), PAC-QOL (58.53 ± 12.59 vs 72.30 ± 19.70), GSRS (26.83 ± 9.14 vs. 37.93 ± 16.59) and total score mean were lower compared to the control group, GIQLI total score average (147.50 ± 11.79 vs 136.87 ± 18.98) was found higher (p <0.05) in probiotic group. Conclusions: Probiotic supplementationimproved the constipation and gastrointestinal quality of life in the early post LSG-period in the brobiotic group compared to the control group.

2012-01-01, CIPE, G, MUSLUMANOGLU, M, YARDıMCı, ERKAN, MEMMI, NAİM, Aysan, E, YARDIMCI, ERKAN, MEMMİ, NAİM, AYŞAN, MUSTAFA ERHAN

In the treatment of distal rectal cancer, abdominoperineal resection is traditionally performed. However, the recognition of shorter safe distal resection line, intersphincteric resection technique has given a chance of sphincter-saving surgery for patients with distal rectal cancer during last two decades and still is being performed as an alternative choice of abdominoperineal resection. The first aim of this study is to assess the morbidity, mortality, oncological, and functional outcomes of intersphincteric resection. The second aim is to compare outcomes of patients who underwent intersphincteric resection with the outcomes of patients who underwent abdominoperineal resection.

2015-03-01, Bektasoglu, HÜSEYİN KAZIM, CIPE, Gokhan, YARDIMCI, ERKAN, Arici, DİLEK SEMA, HASBAHCECI, Mustafa, KARATEPE, Oguzhan, MUSLUMANOGLU, Mahmut, BEKTAŞOĞLU, HÜSEYİN KAZIM, YARDIMCI, ERKAN, ARICI, DILEK SEMA

Pheochromocytomas and paragangliomas are neuroendocrine tumors that arise from chromaffin cells of adrenal medulla and extra-adrenal paraganglia, respectively. The recurrence of these neuroendocrine tumors as a jejunal mass causing obstruction in the small intestine is an exceptional entity. The present study reports the case of a 70-year-old male who presented to the Emergency Department of Bezmialem Vakif University Hospital with abdominal pain and vomiting. The patient possessed a history of left nephrectomy due to malignant pheochromocytoma that had invaded into the left kidney eight months prior to presentation. Bowel obstruction was diagnosed and the patient underwent a laparoscopic procedure. Partial resection of the jejunum was performed and immunohistochemical studies revealed the lesion to be malignant paraganglioma. The majority of paragangliomas are chemo- and radioresistant. Surgical excision remains the primary treatment. Metachronous paraganglioma arising from the small intestine is an extremely rare entity and may be a relevant consideration in patients presenting with bowel obstruction.

2020-03-07T00:00:00Z, Yardımcı, Erkan, YARDIMCI, ERKAN

Amaç : Çalışmamızda intersfinterik fistül trakt ligasyonu (LIFT) ile fistülotomi yöntemlerininperianal fistül tedavisindeki postoperatif sonuçlarının karşılaştırılması amaçlandı.Yöntem : Aralık 2012 ile Nisan 2016 yılları arasında Bezmialem Vakıf Üniversitesi TıpFakültesi Hastanesi Genel Cerrahi bölümüne başvuran, intersfinkterik veya alçaktranssfinkterik perianal fistül tanısıyla operasyon planlanan 42 hasta,https://www.randomizer.org internet adresinde başvuru sıralarına göre LIFT (grup-1) vefistülotomi (grup-2) uygulanacak gruplar olarak rastgele ikiye ayrıldı. Fistül tipininbelirlenmesinde preoperatif rektal endosonografi (R-EUS) ve/veya manyetik rezonans (MR)görüntüleme yöntemleri ile fizik muayene bulguları kullanıldı. Hastalara preoperatif dönemdeve postoperatif üçüncü aylarında anorektal manometri yapılarak sfinkterlerin maksimumsıkma basıncı (MSP) ve maksimum istirahat basınçları (MİP) bakıldı. Preoperatif vepostoperatif üçüncü aylarında Wexner klinik skorlaması yapılarak anal inkontinans durumlarıdeğerlendirildi ve gruplar arasında karşılaştırıldı. Hastaların postoperatif ikinci aylarına kadarhaftalık ve sonrasında üç ayda bir perianal muayeneleri yapılarak postoperatif iyileşmezamanı, yara yeri enfeksiyonu ve rekürrensler değerlendirildi ve gruplar arasındakarşılaştırıldı.Bulgular : İntersfinkterik (n=32) veya alçak transsfinkterik (n=10) perianal fistülü olanhastalar randomize edilerek 2 gruba ayrıldı. 42 hastanın 25’i (%57.1) erkek ve ortalama yaş43.8±9.9 yıl idi. İntraoperatif herhangi bir komplikasyon tespit edilmedi. Yara yeri enfeksiyonugrup-1’de %14.2 (n=3) iken, grup-2’de %9.5 (n=2) idi. İyileşme zamanı grup-1’de daha kısaidi (26.5±3.35 vs. 15.0 ±1.24 gün, p <0.001). Grup-1’de herhangi bir inkontinans tespitedilmedi ancak fistülotomi uygulanan 3 hastada anal inkontinans (%4.7) ve geçici gazinkontinans (%9.5) tespit edildi. Preoperatif ve postoperatif dönemki Wexner skorlarındakiartış grup-2’de anlamlı olarak yüksek bulundu (0.81±1.07 vs. 0.20±0.50, p=0.035).Fistülotomi ve LIFT gruplarında sırasıyla; preoperatif ortalama MİP 65 mmHg (aralık, 41-85mmHg) ve 71 mmHg (aralık, 43-112 mmHg), postoperatif ortalama MİP 81 mmHg (aralık, 13-178 mmHg) ve 80 mmHg (aralık, 6-174 mmHg), preoperatif ortalama MSP 58 mmHg (aralık,25-86 mmHg) ve 66 mmHg (aralık, 35-99 mmHg), postoperatif ortalama MSP 63 mmHg(aralık, 9-174 mmHg) ve 63 mmHg (aralık, 8-179 mmHg) idi. Preoperatif ve postoperatif analmanometri sonuçlarında ortalama MİP ve MSP arasında istatistiksel olarak anlamlı fark tespitedilmedi (p>0.05). Grup-1 ve grup-2’deki rekürrens oranları sırasıyla %14.2 (n=3) ve %4.7(n=1) idi.Sonuç : LIFT, standart fistülotomiye benzer nüks ve komplikasyon oranları ile intersfinkterikve alçak transsfinkterik perianal fistül tedavisinde etkili ve güvenilir bir tedavi seçeneği olarakuygulanabilir.Anahtar Kelimeler: Anal fistül, Anal inkontinans, Fistülotomi, LIFT

2017-10-01T00:00:00Z, Yardimci, ERKAN, Aysan, E, Idiz, UO, Akbulut, H, Yigman, S, YARDIMCI, ERKAN