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Öğe Clınıcal Analysıs of Traumatıc Isolated Rectal Injuries(2023) Doğan, Serhat; Öndeş, Bahadır; Aksu, Ali; kurt, feyziIn this study, we aimed to evaluate the approach to patients who applied to our clinic due to isolated rectal injury. Patients treated for isolated rectal injury in our clinic between January 2017 and December-2021 were retrospectively reviewed. Ten patients were examined and 7 patients were included in the scope of the evaluation. The patients were evaluated under the headings such as age, gender, injury site and whether or not diversion was performed. All patients were male and the mean age was 26.5±9.46 years. There were middle rectal injuries in two patients, upper rectal injuries in one patient, and lower rectal injuries in four patients. Except for one patient with lower rectal injury and no rectal contamination, the other six patients underwent diversion. One patient who underwent transanal repair was followed up with tomography in the postoperative period. Rectal injuries are high-risk injuries due to their neighborhood in the pelvic region. Intestinal diversion is a serious option to prevent pelvic sepsis. It should not be forgotten that transanal primary repair can also be performed after the location of the injury is determined and the perirectal area is cleaned.Öğe The effect of stump ligation techniques on operative time in laparoscopic appendectomy(20 haziran 2021) Kutluer, Nizamettin; Aksu, Ali; Kanat, Burhan Hakan; Aday, Ulaş; Böyük, Abdullah; Doğan, SerhatIntroduction: We aimed to evaluate the effect of stump ligation techniques on operative time in laparoscopic appendectomy. Material and methods: The patients who underwent laparoscopic appen dectomy in our General Surgery Clinic between January 2016 and August 2018 were retrospectively reviewed. The effects of stump ligation tech niques used in the operations on operative times were evaluated. Results: Sixty consecutive patients were screened and 3 groups, 20 patients in each group, were formed based on stump ligation techniques. Extracor poreal knotting – loop ligation was used in Group 1; intracorporeal knotting was used in the Group 2; hem-o-lok clip was used in Group 3.There was no statistically significant difference between the groups in terms of gender distribution and mean age. However, there was a significant difference be tween the hem-o-lok clip group (Group III) and the intracorporeal knot group (Group II) in terms of operative time. Group III had a shorter operative time. The Group III patients had the shortest operative time, while the Group II patients had the longest operative time (p < 0.05). Conclusions: We can speculate that hem-o-lok clip among the stump liga tion techniques reduces the cost, is a safe method and shortens the opera tive time. However, prospective randomized studies with a large sample size comparing different techniques are needed to determine the ideal treat ment procedure. At the same time, stapler use may be considered in cases where the base of the appendix is too inflamed or necrosed. It is known that the use of a stapler and endoloop is more expensive than all other tech niques. However, the most important issue for the surgeon is patient safety; therefore the most appropriate technique should be preferred.Öğe Evaluation of Skin Changes İn Patients Undergoing Obesity Surgery; A Retrospective Observational Study(2023) KANAT, ZEKİYE; Doğan, Serhat; Öndeş, Bahadır; Aksu, Ali; kurt, feyziNowadays, Obesity surgery performed with increasing frequency. Some problem s developed after these surgeries. Changes in the skin due to weight loss, vitamin, and element deficiencies are problems. In this study, we aimed to discuss how the skin changes that occur after the surgery affect the patients and their satisfaction. Questionnaire forms were prepared to evaluate the changes in the skin who underwent bariatric surgery in the General Surgery clinic, We were recorded by questioning one year before and one year after the surgery. Their satisfaction with the skin changes before and after the surgery was evaluated. A total of 51 patients, eight men (15.7%) and fourty three (84.3%) women, included in the study. The mean age of the patients was 32.8 years. The preoperative mean body weight of the patients was 119.7 kg. The mean fol low-up time was 15.4 months. During this follow-up period, the mean postoperative body weight of the patients was 82.8. While the rate of those who were satisfied with the changes in their skin during this period was 78.4 on average, the rate of those who were not satisfied was 21.6 on average. Most of the patients included in the study stated that they had skin problems related to obesity on their skin. Despite this, patients stated that the changes in their skin after bariatric surgery were better than be fore the surgery.Öğe Is body mass index and obesity surgery mortality score important in perioperative complications of laparoscopic sleeve gastrectomy before discharge?(Colegio Brasileiro de Cirurgia Digestiva, 2021) Bozan, Mehmet Buğra; Kutluer, Nizamettin; Aksu, Ali; Azak Bozan, Ayşe; Kanat, Burhan Hakan; Büyük, AbdullahBackground: Morbid obesity surgery and related complications have increased with time. Aim: To evaluate the relationship between perioperative complications before discharge and preoperative body mass index and obesity surgery mortality score in laparoscopic sleeve gastrectomy. Method: 1617 patients who met the inclusion criteria were evaluated retrospectively. The patients were examined in terms of demographic data, presence of comorbidities, whether there were complications or not, type of complications and obesity surgery mortality score. Results: Complications were seen in 40 patients (2.5%) and mortality wasn’t seen in the early postoperative period before discharge. The mean age of patients with complications was 36.3±10.02 years (19-57) and without complications 34.12±9.54 (15–64) years. The preoperative mean BMI values of patients with and without complications were 45.05±3.93 (40–57) kg/m2 and 44.8±3.49 (35–67) kg/m2 respectively. According to BMI groups 40–45 kg/m2, 45–50 kg/m2 and 50 and over, there was not any statistical significance seen in three groups in terms of complication positivity and major-minor complication rates. There was not any statistical significance seen between the patients with and without major-minor complications and obesity surgery mortality score. Conclusion: There was not any relation between perioperative laparoscopic sleeve gastrectomy complication rates before discharge and BMI and obesity surgery mortality scores.Öğe Reasons for Admission of Patients to the Emergency Department after Laparoscopic Sleeve Gastrectomy(2023) Kutluer, Nizamettin; Doğan, Serhat; Öndeş, Bahadır; kurt, feyzi; kanat, burhan hakan; Aksu, Ali; Pepele, Mustafa SafaObjective: Obesity is defined as abnormal or excessive fat accumulation in the body to the extent that it impairs health in humans. It is a common health problem that is increasing in severity. Laparoscopic sleeve gastrectomy (LSG) is a preferred method because of satisfactory weight loss, resolution of comorbidities and performance safety. The increase in surgery has brought along the postoperative problems. New conditions related to bariatric surgery can be observed in all areas of life. Methods: After obtaining the necessary permission from the local clinical research ethics committee, patients who had bariatric surgery in our hospital between January 2018 and December 2021 were asked to respond by sending a mini-questionnaire about their application to the emergency department after surgery. Eighty patients who agreed to answer the questions were included in the study. Questions were asked and the results were evaluated. In addition, none of the patients who applied to the hospital were admitted to the hospital. Results: 53.38% of the patients who applied to the hospital came with stomach spasm and vomiting. Among the 80 patients, 18.8% were admitted to the hospital again after surgery. After the operation, 53.3% of the patients applied to the hospital within the first three months, 26.6% within the 4th and 6th months, and 20.1% after the 10th month. Conclusion: General practitioners and emergency specialists should master the management algorithm of these patients. If there is the slightest doubt, obese patients should be consulted, if possible, from a surgeon experienced in bariatrics or a general surgeon.
