Search

Aim: The aim of this study was to compare the procedure duration and complications of standard percutaneous dilatational tracheostomy (PDT) with PDT via fiberoptic bronchoscopy. Methods: Patients over 18 years of age who were dependent on mechanical ventilation were included in this prospective study. The patients were divided into two groups as PDT (group F n=28) performed by using fiberoptic bronchoscopy and standard PDT (group S, n=30) performed without fiberoptic bronchoscopy. Age, gender, cause of hospitalization, hemogram, blood gas values, duration of tracheostomy and complications during and after the procedure were recorded in all patients. Results: A total of 58 patients were included in the study. Twenty-one (36.2%) patients were female. There was no difference between the two groups in terms of demographic characteristics except age, and laboratory values (p=0.006). The most common cause of hospitalization were respiratory diseases in both groups (28.6% in group F and 40% in group S). There was no difference in the duration of the procedure (6.07±4.72 and 7.50±1.79 minutes in group F and group S, respectively (p=0.12). The most common postoperative complications were minor bleeding (28.5% in group F and 43.3% in group S) and bleeding around the stoma (21.4% in group F and 20% in group S), respectively. None of the patients had pneumothorax, subcutaneous emphysema, major bleeding, or tracheal posterior wall damage. Conclusion: In our study, there was no difference in terms of procedure duration and early complications between patients undergoing PDT with and without bronchoscopy. In the tracheostomy procedure, the method to be used should be decided by considering the patient's condition and the materials available to the practitioner. [ABSTRACT FROM AUTHOR]

Aim: Valganciclovir is the preferred drug for chemoprophylaxis for the prevention of cytomegalovirus (CMV) infection in kidney recipients. Low-dose (450 mg/day) valganciclovir use is gaining popularity because standard dose (900 mg/day) has negative effect on renal function and side effects such as leukopenia. We present our results with low-dose valganciclovir prophylaxis in kidney recipients. Methods: One hundred thirteen kidney transplant recipients who were operated between 1 December 2017 and 1 September 2018 in İstanbul Aydın University Faculty of Medicine, Training and Research Hospital and İstinye University Training and Research Hospital were retrospectively evaluated. Demographic data, preoperative CMV status, incidence of CMV infection and leukopenia rates were recorded. Results: A total of 113 patients (46 women, 67 men) with a mean age of 42.85 years were evaluated. All the recipients and donors were preoperative CMV IgG-positive. The mean follow-up was seven (6-13) months. In this period, only two (1.76%) CMV infection occurred and treated with intravenous ganciclovir. There were no complications due to CMV infection. There was no leukopenia related with valganciclovir. Conclusion: This study showed that low-dose valganciclovir is an effective prophylaxis for CMV infection in kidney transplantation with CMV-positive donors and recipients. We recommend low-dose valganciclovir due to low incidence of CMV infection found in our study. [ABSTRACT FROM AUTHOR]

Aim: To analyze the effect of double-J stent placement on shockwave lithotripsy (SWL) success in the treatment of relatively large (15-25 mm) upper and middle calyceal stones. Methods: A total of 167 patients who had 15-25 mm opaque upper or middle calyceal stones and scheduled for SWL were included in the study. Patients with solitary kidney, urinary system anomalies, skeletal anomalies, previous urologic surgery, severe calyceal dilatation, untreated urinary tract infection, bleeding disorder, eGFR<60 and suspected pregnancy were excluded from the study. The remaining 148 patients were randomized into two groups as stented and non-stented. Thirty-one patients whose stones could not be fragmantated despite three sessions were also excluded. A total of 117 patients (30 stented and 87 non-stented) were further analyzed. The groups were compared in terms of patient- and stone-related factors. Results: Eighty-nine (76%) patients were male and 28 (24%) were female. There was no significant difference between the groups in terms of age, gender, body mass index, stone side, stone size, skin-to-stone distance, Hounsfield unit and renal parenchymal thickness. The success rate was 70% and 51.7% in the stented and non-stented groups, respectively (p=0.31). Conclusion: Prestenting does not affect the success of SWL in the treatment of 15-25 mm upper and middle calyceal stones. [ABSTRACT FROM AUTHOR]

Aim: The aim of this study was to assess the effects of preoperative aspirin use on postoperative complications, especially risk of bleeding, in patients undergoing bilateral total thyroidectomy. Methods: A total of 201 patients who underwent bilateral total thyroidectomy between 15 August 2016 and 1 February 2019 were included in the study. The patients were divided into two groups: preoperative aspirin group (n=42, 20%) and aspirinnaïve group (n=168, 80%). Parameters, including demographic characteristics, complications and length of hospital stay were compared between the groups. Results: Eight (4.4%) patients in aspirin-naïve group and three (7.1%) in preoperative aspirin group had minor hematoma and ecchymosis not requiring any intervention. There was only one patient in aspirin-naïve group (0.5%) who required surgical intervention due to bleeding in the postoperative period, whereas there were not any in the other study group. Conclusion: The results of this study showed that aspirin had no significant effect on the development of postoperative complications in patients undergoing bilateral total thyroidectomy. However, large-scale prospective and randomized series are warranted for more accurate and precise results. [ABSTRACT FROM AUTHOR]

Aim: Hyperthermic intraperitoneal chemotherapy with cytoreductive surgery has a positive effect on survival in advanced abdominal cancers. We aimed to present our experience with cytoreductive surgery and hyperthermic intraperitoneal chemotherapy in gastric cancer patients with peritoneal carcinomatosis and a review of the literature. Methods: Ten patients (seven male, three female) who were diagnosed with gastric cancer between June 2017 and November 2018 were included in the study. Data on demographic characteristics, short-term follow-up results, surgical findings, peritoneal carcinomatosis index score, completeness of cytoreduction score, and morbidity and mortality rates were retrospectively analyzed. Results: The mean age of the patients was 60.3 years. The mean follow-up period was six months (1-15 months). One patient developed an anastomotic leak. In the other nine cases, there was no morbidity leading to mortality. Conclusion: While gastric cancer with peritoneal carcinomatos has a poor survival, less than six months with non-operative approach, treatment with cytoreductive surgery and hyperthermic intraperitoneal chemotherapy offers better outcomes and overall survival. Our first results in our study with a limited number of patients are satisfactory and multicentric randomized studies are needed on this subject. [ABSTRACT FROM AUTHOR]

Aim:Our aim in this study was to evaluate the surgical treatment of hyperhidrosis versus oxybutynin medical treatment comparing the response and long-term complications. Methods: We evaluated medical and surgical treatment results of 56 palmar and axillary hyperhidrosis patients (29 female, 27 male). Patients mean age was 26.6±6.3 (minimum: 18 - maximum: 48) years old. Sympathetic ganglion ligation was performed in patients treated with surgery.In patients we used medical treatment, oxibutinin treatment was started at 2.5 mg/day and the doses of the drug were increased according to the treatment response. The quality of life index implemented by Amir was adapted into Turkish and used for evaluating life quality of the patients in the study. Results: Postoperative the quality of life scores of palmar hyperhidrosis patients were found to be higher in T3-T4 levels than in T2-T3-T4 levels (p=0.015). In patients with axillary hyperhidrosis, there was no difference between T2-T3-T4 and T4-T5 level surgical operations (p>0.05). The average the quality of life score of patients who received medical treatment was 28.54±5.74. There was no significant difference in the quality of life scores between patients treated with surgery and medical therapy with oxybutynin. Conclusion: We assume that the response rates to oxybutynin are as favorable as surgery in the treatment of hyperhidrosis. [ABSTRACT FROM AUTHOR]