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GİRİŞ ve AMAÇ: Bu çalışma ile apendiks güdüğünün kapatılmasında modifiye bir teknik olarak el yapımı loop kullanımının ameliyat sonuçları üzerinde etkisini araştırmayı hedefledik. YÖNTEM ve GEREÇLER: Ocak 2012 ile Ocak 2015 tarihleri arasında kliniğimizde akut apandisit tanısıyla laparoskopik apendektomi yapılan hastalardan güdük kapatılmasında el yapımı loop kullanılan hastalar belirlendi. Hastaların demografik verileri, ameliyat ve hastanede kalış süreleri ile komplikasyonları incelendi. Sonuçlar literatür verileri eşliğinde tartışıldı.BULGULAR: Toplam 197 hasta çalışmaya alındı. Bunlardan 111'i erkek (% 56,3), 86'sı kadın (%43,6) idi. Yaş ortalaması 30,9 ± 12,9 idi. Ortalama ameliyat süresi 52,5 ± 20,4 dakika idi. Hastaların 14 tanesinde (% 7,1) komplike apandisit (perforasyon/apse) mevcuttu. Ortalama hastanede kalış süresi 2,49 ± 1,25 gündü. 18 hastada (%9,1) postoperatif komplikasyon gelişti. Bunlardan 12'si trokar yeri enfeksiyonu, 4'ü postoperatif erken dönemde ileus ve 1 tanesinde postoperatif pelvik apse (perkütan drenaj ile tedavi edildi) idi. Tekrar ameliyata alınan hastamız olmadı.TARTIŞMA ve SONUÇ: Laparoskopik apendektomide apendiks güdüğünü el yapımı loop ile kapatmak güvenlidir. Bu yöntemin kullanılması laparoskopik apendektomi maliyetini azaltabilir., INTRODUCTION: Our aim in this study is to describe the handmade loop as a modified technique for closing the appendiceal stump and discuss its effects on outcome. METHODS: Patients who underwent laparoscopic appendectomy due to acute appendicitis between January 2012 and January 2015 and in whom the handmade loop technique was used were included in the study.The demographic and clinical findings, surgical complications and length of stay in hospital were all retrieved from patients files. Results were discussed with relevant literature. RESULTS: A total of 197 patients were enrolled in the study. 111 male (56.3%) and 86 female (43.6%) patients were operated. Median age of the patients was 30.9 ± 12.9. The mean operative time was 52.5 ± 20.4 minutes. In 14 patients (7.1%) a complicated appendicitis (perforation/ abscess) was observed. Mean duration of hospital stay was 2.49 ± 1.25 days. !8 patients (9.1%) experienced post op complications. These were trocar site infection in 12 patients, postoperative ileus in the early postoperative period in 4 patients, and one pelvic abscess (treated with percutaneous drainage). None required re operation.DISCUSSION AND CONCLUSION: The handmade loop is a safe method to close the appendix stump in laparoscopic appendectomy. Using this method can reduce the cost of laparoscopic appendectomy.

Amaç: Dünya çapında, meme kanseri kadınlarda en sık görülen kanserdir. Türkiye'de de meme kanseri tüm kadın kanserlerinin %25'i gibi bir sıklıkta kadınlarda en sık görülen kanserdir. Tümör baskılayıcı genlerdeki (BRCA1 ve BRCA2) germline mutasyonlar kanser için genetik yatkınlığa neden olur ve tüm meme ve yumurtalık kanserlerinin %510'undan sorumludur. BRCA1 veya BRCA2 genlerinde mutasyon taşıyan kadınlar, özellikle 45 yaşından önce meme kanserine yakalanmak için yüksek riske sahiptir. Bu çalışmanın amacı, en yaygın olan BRCA1 ve BRCA2 gen mutasyonlarının, Türk populasyonunda erken yaş meme kanserli hastalardaki sıklığını belirlemektir. Yöntem: Bu çalışmaya, erken yaş (

Pneumobilia is the detection of gas within the biliary system. It usually develops after bilioenteric anastomosis, percutaneous or endoscopic biliary interventions, infections and abscesses. The treatment is surgical, especially in cases with no prior interventions to the biliary system. The development of pneumobilia is quite rare after blunt trauma. Therefore, both the diagnosis and management are challenging for surgeons. Herein, we present the diagnosis and conservative management of a patient with pneumobilia after blunt trauma.

BACKGROUND: The fate of suboptimal anastomosis is unknown and early detection of anastomotic leakage after colon resection is crucial for the proper management of patients.METHODS: Twenty-six rats were assigned to “Control”, “Leakage” and “Suboptimal anastomosis” groups where they underwent either sham laparotomy, cecal ligation, and puncture or anastomosis with four sutures following colon resection, respectively. At the fifth hour and on the third and ninth days; peripheral blood and peritoneal washing samples through relaparotomy were obtained. The abdomen was inspected macroscopically for anastomotic healing. Polymerase chain reaction (PCR) with 16s rRNA and E.coli-specific primers were run on all samples along with aerobic and anaerobic cultures.RESULTS: The sensitivity and specificity of PCR on different bodily fluids with 16s rRNA and E.coli-specific primers were 100% and 78%, respectively. All samples of peritoneal washing fluids on the third and ninth days showed presence of bacteria in both PCR and culture. The inspection of the abdomen revealed signs of anastomotic leakage in eight rats (80%), whereas mortality related with anastomosis was detected in two (20%).CONCLUSION: Anastomotic leakage with suboptimal anastomosis after colon resection is high and the early detection is possible by running PCR on peritoneal samples as early as 72 hours

Aim: The aim of this study was to validate the Pain Catastrophizing Scale (PCS) in the Turkish population and to investigate its correlation with the demographic and clinical characteristics of patients. Materials and methods: Volunteer patients, who were scheduled for elective surgery and who applied to the Outpatient Clinic of Anesthesiology for preoperative evaluation, were asked to complete a PCS form. The patient’s age, sex, educational level, marital status, presence of chronic pain, and American Society of Anesthesiologists score were recorded, and PCS scores and demographic variables were compared statistically. Results: Of the 257 patients enrolled in the study, 136 were male, 121 female, and the median age was 40. The 3 subscales in the Turkish version of the PCS consisted of rumination, magnification, and helplessness. Internal consistency of PCS was found to be congruent with Cronbach’s α = 0.90. Significantly higher PCS scores were found in women with chronic pain. In addition, patients who graduated from primary school had statistically higher scores compared to those who graduated from high school. Conclusion: In accordance with the original scale, demographic specifications of the Turkish version of the PCS were found congruent. PCS scores in our population were found compatible with the literature review.

Certain malignancies may occur concomitantly or consecutively. . We present a female patient with breast carcinoma who had chronic leukemia concurrently with breast cancer.. She underwent a modified radical mastectomy. The histopathologic examination of both mastectomy and axillary specimen revealed diffuse, atypical lymphoid proliferation and microscopic foci of lymphocytic infiltrations beside the typical breast carcinoma findings. Lymphocytes taken from peripheral blood and bone marrow aspirates were stained with CD5 and CD20. The diagnosis of chronic lymphocytic leukemia (CLL) was confirmed. CLL was diagnosed as a synchronous malignancy together with breast carcinoma. It should be kept in mind that breast carcinoma may occur concomitantly with other malignancies especially CLL. Second malignancies occur with an increased frequency in patients with CLL, mainly because of the immune defects associated with this disease., Maligniteler aynı anda veya birbirini takiben aynı hastada görülebilir. Biz bu çalışmada kronik lösemi ile aynı anda olan meme kanseri nedeniyle modifiye radikal mastektomi yapılan bayan hastayı sunduk. Histopatolojik incelemede tipik meme kanseri bulguları yanında hem memede hem de aksiller spesmende atipik lenfoid proliferasyon ve mikroskopik lenfositik infiltrasyon odakları saptandı. Periferik kandan alınan lenfositler ve kemik iliği CD5 ve CD20 ile boyandı. Kronik lenfositik lösemi (KLL) tanısı doğrulandı. KLL, meme kanseri ile senkron malignite olarak teşhis edildi. Meme kanserinin özellikle KLL gibi diğer maligniteler ile birlikte olabileceği akılda tutulmalıdır. İkinci maligniteler, KLL hastalarında immün defekt sebebiyle daha fazla görülebilir.