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1. A Rare Cause of Acute Abdomen: Torsion of the Gallbladder

Author

Emir Eroler, Uğur Duman, Deniz Necdet Tihan, Emrah Mehmet Bayam, Evren Dilektaşlı, Kazım Şenol, and Özgür Dandin

Subjects
Acute abdomen, gallbladder, torsion, necrosis, emergency surgery, cholecystectomy, Medicine, Medical emergencies. Critical care. Intensive care. First aid, RC86-88.9
Abstract

Gallbladder (GB) torsion is defined as a rotation of the GB on its mesentery along the axis of the cystic duct and cystic artery. It is a rare case that might be the cause of GB necrosis and consequent acute abdomen. To date, approximately 500 patients with GB torsion have been reported. In this case, the patient is a 42-year-old woman who was admitted to our hospital with abdominal pain. The patient was subjected to laparotomy; during the operation, a GB torsion resulting in necrosis was observed, and cholecystectomy was performed.

Published
2015
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2. An unusual approach for the treatment of oesophageal perforation: Laparoscopic-endoscopic cooperative surgery

Author

Haci Murat Cayci, Umut Eren Erdoğdu, Evren Dilektasli, Mehmet Akif Turkoglu, Deniz Firat, and Hasan Cantay

Subjects
Boerhaave, laparoscopy, oesophageal perforation, stent, Surgery, RD1-811, Diseases of the digestive system. Gastroenterology, RC799-869
Abstract

Boerhaave syndrome describes a transmural oesophageal rupture that develops following a spontaneous, sudden intraluminal pressure increase (i.e. vomiting, cough). It has a high rate of mortality and morbidity because of its proximity to the mediastinum and pleura. Perforation localisation and treatment initiation time affect the morbidity and mortality. In this article, we aim to present our successful laparoscopic-endoscopic cooperative surgery in a 59-year-old female who was referred to our clinic with a diagnosis of spontaneous lower oesophageal perforation. Laparoscopy and a simultaneous oesophageal stent application may be assumed as an effective alternative to conventional surgical approaches in cases of spontaneous lower oesophageal perforation.

Published
2017
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3. The effects of obstructive jaundice on the brain: An experimental study

Author

Evren Dilektasli, M.M. Ozmen, Emre Gundogdu, Hayrettin Dizen, H.T. Besler, and Candan Ozogul

Subjects
astrocyte swelling, electron microscopy, malondialdehyde, obstructive jaundice, oxidative stress, Surgery, RD1-811
Abstract

Background/Objective: The study aims to evaluate the alterations in the brain due to oxidative stress and lipid peroxidation resulting from obstructive jaundice. Methods: Forty-one Wistar albino rats were used in this study. Simple laparotomy was performed in the sham group (n = 5). In the remaining 36 rats, the common bile duct (CBD) was found and ligated. They were divided into six groups. Group I, Group II, and Group III were sacrificed at the 3rd, 7th, and 14th day of ligation, respectively. In Group Id, Group IId, and Group IIId ligated bile ducts were decompressed at the 3rd, 7th, and 14th day, respectively. One week after decompression these rats were also sacrificed and samples were taken. Results: After the CBD ligation, serum levels of bilirubin and malondialdehyde were found to be increased progressively in parallel to the ligation time of the CBD. After decompression these values decreased. In electron microscopy evaluation, the damage was found to be irreversible depending on the length of the obstruction period. In Group II, the damage was mostly reversible after the internal drainage period of 7 days. However in Group III, the tissue damage was found to be irreversible despite the decreased values of oxidative stress and bilirubin. Conclusion: Ultrastructural changes in brain tissue including damage in the glial cells and neurons, were found to be irreversible if the CBD ligation period was >7 days and did not regress even after decompression. It is unreliable to trace these changes using blood levels of bilirubin and free radicals. Therefore, timing is extremely critical for medical therapies and drainage.

Published
2016
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5. Effect of BMI on safety of bariatric surgery during the COVID-19 pandemic, procedure choice, and safety protocols - An analysis from the GENEVA Study

Author

Rishi Singhal, Islam Omar, Brijesh Madhok, Christian Ludwig, Abd A. Tahrani, Kamal Mahawar, Michał Pędziwiatr, Piotr Major, Piotr Zarzycki, Athanasios Pantelis, Dimitris P. Lapatsanis, Georgios Stravodimos, Chris Matthys, Marc Focquet, Wouter Vleeschouwers, Antonio G. Spaventa, Carlos Zerrweck, Antonio Vitiello, Giovanna Berardi, Mario Musella, Alberto Sanchez-Meza, Felipe J. Cantu, Fernando Mora, Marco A. Cantu, Abhishek Katakwar, D. Nageshwar Reddy, Haitham Elmaleh, Mohammad Hassan, Abdelrahman Elghandour, Mohey Elbanna, Ahmed Osman, Athar Khan, Laurent Layani, Nalini Kiran, Andrey Velikorechin, Maria Solovyeva, Hamid Melali, Shahab Shahabi, Ashish Agrawal, Apoorv Shrivastava, Ankur Sharma, Bhavya Narwaria, Mahendra Narwaria, Asnat Raziel, Nasser Sakran, Sergio Susmallian, Levent Karagöz, Murat Akbaba, Salih Zeki Pişkin, Ahmet Ziya Balta, Zafer Senol, Emilio Manno, Michele Giuseppe Iovino, Mohamed Qassem, Sebastián Arana-Garza, Heitor P. Povoas, Marcos Leão Vilas-Boas, Alan Li, Basil J. Ammori, Hany Balamoun, Mohammed Salman, Amrit Manik Nasta, Ramen Goel, Hugo Sánchez-Aguilar, Miguel F. Herrera, Adel Abou-Mrad, Lucie Cloix, Guilherme Silva Mazzini, Leonardo Kristem, Andre Lazaro, Jose Campos, Joaquín Bernardo, Jesús González, Carlos Trindade, Octávio Viveiros, Rui Ribeiro, David Goitein, David Hazzan, Lior Segev, Tamar Beck, Hernán Reyes, Jerónimo Monterrubio, Paulina García, Marine Benois, Radwan Kassir, Alessandro Contine, Moustafa Elshafei, Sueleyman Aktas, Sylvia Weiner, Till Heidsieck, Luis Level, Silvia Pinango, Patricia Martinez Ortega, Rafael Moncada, Victor Valenti, Ivan Vlahović, Zdenko Boras, Arnaud Liagre, Francesco Martini, Gildas Juglard, Manish Motwani, Sukhvinder Singh Saggu, Hazem Al Momani, Luis Adolfo Aceves López, María Angelina Contreras Cortez, Rodrigo Aceves Zavala, Christine D'Haese, Ivo Kempeneers, Jacques Himpens, Andrea Lazzati, Luca Paolino, Sarah Bathaei, Abdulkadir Bedirli, Aydın Yavuz, Çağrı Büyükkasap, Safa Özaydın, Andrzej Kwiatkowski, Katarzyna Bartosiak, Maciej Walędziak, Antonella Santonicola, Luigi Angrisani, Paola Iovino, Rossella Palma, Angelo Iossa, Cristian Eugeniu Boru, Francesco De Angelis, Gianfranco Silecchia, Abdulzahra Hussain, Srivinasan Balchandra, Izaskun Balciscueta Coltell, Javier Lorenzo Pérez, Ashok Bohra, Altaf K. Awan, Paul C. Leeder, Sherif Awad, Waleed Al-Khyatt, Ashraf Shoma, Hosam Elghadban, Sameh Ghareeb, Bryan Mathews, Marina Kurian, Andreas Larentzakis, Gavriella Zoi Vrakopoulou, Konstantinos Albanopoulos, Ahemt Bozdag, Azmi Lale, Cuneyt Kirkil, Mursid Dincer, Ahmad Bashir, Ashraf Haddad, Leen Abu Hijleh, Bruno Zilberstein, Danilo Dallago de Marchi, Willy Petrini Souza, Carl Magnus Brodén, Hjörtur Gislason, Kamran Shah, Antonio Ambrosi, Giovanna Pavone, Nicola Tartaglia, S. Lakshmi Kumari Kona, K. Kalyan, Cesar Ernesto Guevara Perez, Miguel Alberto Forero Botero, Adrian Covic, Daniel Timofte, Madalina Maxim, Dashti Faraj, Larissa Tseng, Ronald Liem, Gürdal Ören, Evren Dilektasli, Ilker Yalcin, Hudhaifa AlMukhtar, Mohammed Al Hadad, Rasmi Mohan, Naresh Arora, Digvijaysingh Bedi, Claire Rives-Lange, Jean-Marc Chevallier, Tigran Poghosyan, Hugues Sebbag, Lamia Zinaï, Saadi Khaldi, Charles Mauchien, Davide Mazza, Georgiana Dinescu, Bernardo Rea, Fernando Pérez-Galaz, Luis Zavala, Anais Besa, Anna Curell, Jose M. Balibrea, Carlos Vaz, Luis Galindo, Nelson Silva, José Luis Estrada Caballero, Sergio Ortiz Sebastian, João Caetano Dallegrave Marchesini, Ricardo Arcanjo da Fonseca Pereira, Wagner Herbert Sobottka, Felipe Eduardo Fiolo, Matias Turchi, Antonio Claudio Jamel Coelho, Andre Luis Zacaron, André Barbosa, Reynaldo Quinino, Gabriel Menaldi, Nicolás Paleari, Pedro Martinez-Duartez, Gabriel Martínez de Aragon Ramírez de Esparza, Valentin Sierra Esteban, Antonio Torres, Jose Luis Garcia-Galocha, Miguel Josa, Jose Manuel Pacheco-Garcia, Maria Angeles Mayo-Ossorio, Pradeep Chowbey, Vandana Soni, Hercio Azevedo de Vasconcelos Cunha, Michel Victor Castilho, Rafael Meneguzzi Alves Ferreira, Thiago Alvim Barreiro, Alexandros Charalabopoulos, Elias Sdralis, Spyridon Davakis, Benoit Bomans, Giovanni Dapri, Koenraad Van Belle, Mazen Takieddine, Pol Vaneukem, Esma Seda Akalın Karaca, Fatih Can Karaca, Aziz Sumer, Caghan Peksen, Osman Anil Savas, Elias Chousleb, Fahad Elmokayed, Islam Fakhereldin, Hany Mohamed Aboshanab, Talal Swelium, Ahmad Gudal, Lamees Gamloo, Ayushka Ugale, Surendra Ugale, Clara Boeker, Christian Reetz, Ibrahim Ali Hakami, Julian Mall, Andreas Alexandrou, Efstratia Baili, Zsolt Bodnar, Almantas Maleckas, Rita Gudaityte, Cem Emir Guldogan, Emre Gundogdu, Mehmet Mahir Ozmen, Deepti Thakkar, Nandakishore Dukkipati, Poonam Shashank Shah, Shashank Subhashchandra Shah, Simran Shashank Shah, Md Tanveer Adil, Periyathambi Jambulingam, Ravikrishna Mamidanna, Douglas Whitelaw, Vigyan Jain, Deepa Kizhakke Veetil, Randeep Wadhawan, Max Torres, Tabata Tinoco, Wouter Leclercq, Marleen Romeijn, Kelly van de Pas, Ali K. Alkhazraji, Safwan A. Taha, Murat Ustun, Taner Yigit, Aatif Inam, Muhammad Burhanulhaq, Abdolreza Pazouki, Foolad Eghbali, Mohammad Kermansaravi, Amir Hosein Davarpanah Jazi, Mohsen Mahmoudieh, Neda Mogharehabed, Gregory Tsiotos, Konstantinos Stamou, Francisco J Barrera Rodriguez, Marco A. Rojas Navarro, Omar MOhamed Torres, Sergio Lopez Martinez, Elda Rocio Maltos Tamez, Gustavo A. Millan Cornejo, Jose Eduardo Garcia Flores, Diya Aldeen Mohammed, Mohamad Hayssam Elfawal, Asim Shabbir, Kim Guowei, Jimmy By So, Elif Tuğçe Kaplan, Mehmet Kaplan, Tuğba Kaplan, DangTuan Pham, Gurteshwar Rana, Mojdeh Kappus, Riddish Gadani, Manish Kahitan, Koshish Pokharel, Alan Osborne, Dimitri Pournaras, James Hewes, Errichetta Napolitano, Sonja Chiappetta, Vincenzo Bottino, Evelyn Dorado, Axel Schoettler, Daniel Gaertner, Katharina Fedtke, Francisco Aguilar-Espinosa, Saul Aceves-Lozano, Alessandro Balani, Carlo Nagliati, Damiano Pennisi, Andrea Rizzi, Francesco Frattini, Diego Foschi, Laura Benuzzi, Chirag Parikh, Harshil Shah, Enrico Pinotti, Mauro Montuori, Vincenzo Borrelli, Jerome Dargent, Catalin A Copaescu, Ionut Hutopila, Bogdan Smeu, Bart Witteman, Eric Hazebroek, Laura Deden, Laura Heusschen, Sietske Okkema, Theo Aufenacker, Willem den Hengst, Wouter Vening, Yonta van der Burgh, Ahmad Ghazal, Hamza Ibrahim, Mourad Niazi, Bilal Alkhaffaf, Mohammad Altarawni, Giovanni Carlo Cesana, Marco Anselmino, Matteo Uccelli, Stefano Olmi, Christine Stier, Tahsin Akmanlar, Thomas Sonnenberg, Uwe Schieferbein, Alejandro Marcolini, Diego Awruch, Marco Vicentin, Eduardo Lemos de Souza Bastos, Samuel Azenha Gregorio, Anmol Ahuja, Tarun Mittal, Roel Bolckmans, Tom Wiggins, Clément Baratte, Judith Aron Wisnewsky, Laurent Genser, Lynn Chong, Lillian Taylor, Salena Ward, Michael W. Hi, Helen Heneghan, Naomi Fearon, Andreas Plamper, Karl Rheinwalt, Justin Geoghegan, Kin Cheung Ng, Krzysztof Kaseja, Maciej Kotowski, Tarig A. Samarkandy, Adolfo Leyva-Alvizo, Lourdes Corzo-Culebro, Cunchuan Wang, Wah Yang, Zhiyong Dong, Manel Riera, Rajesh Jain, Hosam Hamed, Mohammed Said, Katia Zarzar, Manuel Garcia, Ahmet Gökhan Türkçapar, Ozan Şen, Edoardo Baldini, Luigi Conti, Cacio Wietzycoski, Eduardo Lopes, Tadeja Pintar, Jure Salobir, Cengiz Aydin, Semra Demirli Atici, Anıl Ergin, Huseyin Ciyiltepe, Mehmet Abdussamet Bozkurt, Mehmet Celal Kizilkaya, Nezihe Berrin Dodur Onalan, Mariana Nabila Binti Ahmad Zuber, Wei Jin Wong, Amador Garcia, Laura Vidal, Marc Beisani, Jorge Pasquier, Ramon Vilallonga, Sharad Sharma, Chetan Parmar, Lyndcie Lee, Pratik Sufi, Hüseyin Sinan, and Mehmet Saydam

Subjects
obesity, Endocrinology, Diabetes and Metabolism, bariatric surgery, resuming elective surgery, laparoscopy, body mass index, BMI, covid-19, metabolic surgery, obesity surgery, pandemic, Sars-Cov-2, female, gastrectomy, humans, male, pandemics, retrospective studies, treatment outcome, weight loss, gastric bypass, Resuming Elective surgery, Obesity, Morbid, Bariatric surgery, Nutrition and Dietetics, Pandemic, Manchester Cancer Research Centre, SARS-CoV-2, ResearchInstitutes_Networks_Beacons/mcrc, COVID-19, Obesity, Morbid, Obesity surgery, Metabolic surgery, Body Mass Index, Female, Gastrectomy, Humans, Male, Pandemics, Retrospective Studies, Treatment Outcome, Weight Loss, Bariatric Surgery, Gastric Bypass, Laparoscopy
Abstract

Background: It has been suggested that patients with a Body Mass Index (BMI) of > 60 kg/m2 should be offered expedited Bariatric Surgery (BS) during the Coronavirus Disease-2019 (COVID-19) pandemic. The main objective of this study was to assess the safety of this approach. Methods: We conducted a global study of patients who underwent BS between 1/05/2020 and 31/10/2020. Patients were divided into three groups according to their preoperative BMI - Group I (BMI60 kg/m2). The effect of preoperative BMI on 30-day morbidity and mortality, procedure choice, COVID-19 specific safety protocols, and comorbidities was assessed. Results: This study included 7084 patients (5197;73.4 % females). The mean preoperative weight and BMI were 119.49 ± 24.4 Kgs and 43.03 ± 6.9 Kg/m2, respectively. Group I included 6024 (85 %) patients, whereas Groups II and III included 905 (13 %) and 155 (2 %) patients, respectively. The 30-day mortality rate was higher in Group III (p = 0.001). The complication rate and COVID-19 infection were not different. Comorbidities were significantly more likely in Group III (p = 70 kg/m2 had a 30-day mortality of 7.7 % (2/26). None of these patients underwent a Roux-en-Y Gastric Bypass. Conclusion: The 30-day mortality rate was significantly higher in patients with BMI > 60 kg/m2. There was, however, no significant difference in complications rates in different BMI groups, probably due to differences in procedure selection.

Published
2022
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6. Safety of Bariatric Surgery in ≥ 65-Year-Old Patients During the COVID-19 Pandemic

Author

Singhal, Rishi, Omar, Islam, Madhok, Brijesh, Rajeev, Yashasvi, Graham, Yitka, Tahrani, Abd A, Ludwig, Christian, Wiggins, Tom, Mahawar, Kamal, Michał, Pędziwiatr, Piotr, Major, Piotr, Zarzycki, Athanasios, Pantelis, Dimitris, P Lapatsanis, Georgios, Stravodimos, Chris, Matthys, Marc, Focquet, Wouter, Vleeschouwers, Antonio, G Spaventa, Carlos, Zerrweck, Antonio, Vitiello, Giovanna, Berardi, Mario, Musella, Alberto, Sanchez-Meza, Felipe, J Cantu Jr, Fernando, Mora, Marco, A Cantu, Abhishek, Katakwar, D Nageshwar Reddy, Haitham, Elmaleh, Mohammad, Hassan, Abdelrahman, Elghandour, Mohey, Elbanna, Ahmed, Osman, Athar, Khan, Laurent, Layani, Nalini, Kiran, Andrey, Velikorechin, Maria, Solovyeva, Hamid, Melali, Shahab, Shahabi, Ashish, Agrawal, Apoorv, Shrivastava, Ankur, Sharma, Bhavya, Narwaria, Mahendra, Narwaria, Asnat, Raziel, Nasser, Sakran, Sergio, Susmallian, Levent, Karagöz, Murat, Akbaba, Salih Zeki Pişkin, Ahmet Ziya Balta, Zafer, Senol, Emilio, Manno, Michele Giuseppe Iovino, Mohamed, Qassem, Sebastián, Arana-Garza, Heitor, P Povoas, Marcos Leão Vilas-Boas, Alan, Li, Basil, J Ammori, Hany, Balamoun, Mohammed, Salman, Amrit Manik Nasta, Ramen, Goel, Hugo, Sánchez-Aguilar, Miguel, F Herrera, Adel, Abou-Mrad, Lucie, Cloix, Guilherme Silva Mazzini, Leonardo, Kristem, Andre, Lazaro, Jose, Campos, Joaquín, Bernardo, Jesús, González, Carlos, Trindade, Octávio, Viveiros, Rui, Ribeiro, David, Goitein, David, Hazzan, Lior, Segev, Tamar, Beck, Hernán, Reyes, Jerónimo, Monterrubio, Paulina, García, Marine, Benois, Radwan, Kassir, Alessandro, Contine, Moustafa, Elshafei, Sueleyman, Aktas, Sylvia, Weiner, Till, Heidsieck, Luis, Level, Silvia, Pinango, Patricia Martinez Ortega, Rafael, Moncada, Victor, Valenti, Ivan, Vlahović, Zdenko, Boras, Arnaud, Liagre, Francesco, Martini, Gildas, Juglard, Manish, Motwani, Sukhvinder Singh Saggu, Hazem Al Momani, Luis Adolfo Aceves López, María Angelina Contreras Cortez, Rodrigo Aceves Zavala, Christine, D'Haese, Ivo, Kempeneers, Jacques, Himpens, Andrea, Lazzati, Luca, Paolino, Sarah, Bathaei, Abdulkadir, Bedirli, Aydın, Yavuz, Çağrı, Büyükkasap, Safa, Özaydın, Andrzej, Kwiatkowski, Katarzyna, Bartosiak, Maciej, Walędziak, Santonicola, Antonella, Luigi, Angrisani, Iovino, Paola, Rossella, Palma, Angelo, Iossa, Cristian Eugeniu Boru, Francesco De Angelis, Gianfranco, Silecchia, Abdulzahra, Hussain, Srivinasan, Balchandra, Izaskun Balciscueta Coltell, Javier Lorenzo Pérez, Ashok, Bohra, Altaf, K Awan, Brijesh, Madhok, Paul, C Leeder, Sherif, Awad, Waleed, Al-Khyatt, Ashraf, Shoma, Hosam, Elghadban, Sameh, Ghareeb, Bryan, Mathews, Marina, Kurian, Andreas, Larentzakis, Gavriella Zoi Vrakopoulou, Konstantinos, Albanopoulos, Ahemt, Bozdag, Azmi, Lale, Cuneyt, Kirkil, Mursid, Dincer, Ahmad, Bashir, Ashraf, Haddad, Leen Abu Hijleh, Bruno, Zilberstein, Danilo Dallago de Marchi, Willy Petrini Souza, Carl Magnus Brodén, Hjörtur, Gislason, Kamran, Shah, Antonio, Ambrosi, Giovanna, Pavone, Nicola, Tartaglia, S Lakshmi Kumari Kona, Kalyan, K, Cesar Ernesto Guevara Perez, Miguel Alberto Forero Botero, Adrian, Covic, Daniel, Timofte, Madalina, Maxim, Dashti, Faraj, Larissa, Tseng, Ronald, Liem, Gürdal, Ören, Evren, Dilektasli, Ilker, Yalcin, Hudhaifa, Almukhtar, Mohammed Al Hadad, Rasmi, Mohan, Naresh, Arora, Digvijaysingh, Bedi, Claire, Rives-Lange, Jean-Marc, Chevallier, Tigran, Poghosyan, Hugues, Sebbag, Lamia, Zinaï, Saadi, Khaldi, Charles, Mauchien, Davide, Mazza, Georgiana, Dinescu, Bernardo, Rea, Fernando, Pérez-Galaz, Luis, Zavala, Anais, Besa, Anna, Curell, Jose, M Balibrea, Carlos, Vaz, Luis, Galindo, Nelson, Silva, José Luis Estrada Caballero, Sergio Ortiz Sebastian, João Caetano Dallegrave Marchesini, Ricardo Arcanjo da Fonseca Pereira, Wagner Herbert Sobottka, Felipe Eduardo Fiolo, Matias, Turchi, Antonio Claudio Jamel Coelho, Andre Luis Zacaron, André, Barbosa, Reynaldo, Quinino, Gabriel, Menaldi, Nicolás, Paleari, Pedro, Martinez-Duartez, Gabriel Martínez de Aragon Ramírez de Esparza, Valentin Sierra Esteban, Antonio, Torres, Jose Luis Garcia-Galocha, Miguel, Josa, Jose Manuel Pacheco-Garcia, Maria Angeles Mayo-Ossorio, Pradeep, Chowbey, Vandana, Soni, Hercio Azevedo de Vasconcelos Cunha, Michel Victor Castilho, Rafael Meneguzzi Alves Ferreira, Thiago Alvim Barreiro, Alexandros, Charalabopoulos, Elias, Sdralis, Spyridon, Davakis, Benoit, Bomans, Giovanni, Dapri, Koenraad Van Belle, Mazentakieddine, Pol, Vaneukem, Esma Seda Akalın Karaca, Fatih Can Karaca, Aziz, Sumer, Caghan, Peksen, Osman Anil Savas, Elias, Chousleb, Fahad, Elmokayed, Islam, Fakhereldin, Hany Mohamed Aboshanab, Talal, Swelium, Ahmad, Gudal, Lamees, Gamloo, Ayushka, Ugale, Surendra, Ugale, Clara, Boeker, Christian, Reetz, Ibrahim Ali Hakami, Julian, Mall, Andreas, Alexandrou, Efstratia, Baili, Zsolt, Bodnar, Almantas, Maleckas, Rita, Gudaityte, Cem Emir Guldogan, Emre, Gundogdu, Mehmet Mahir Ozmen, Deepti, Thakkar, Nandakishore, Dukkipati, Poonam Shashank Shah, Shashank Subhashchandra Shah, Simran Shashank Shah, Md Tanveer Adil, Periyathambi, Jambulingam, Ravikrishna, Mamidanna, Douglas, Whitelaw, Vigyan, Jain, Deepa Kizhakke Veetil, Randeep, Wadhawan, Max, Torres, Tabata, Tinoco, Wouter, Leclercq, Marleen, Romeijn, Kelly van de Pas, Ali, K Alkhazraji, Safwan, A Taha, Murat, Ustun, Taner, Yigit, Aatif, Inam, Muhammad, Burhanulhaq, Abdolreza, Pazouki, Foolad, Eghbali, Mohammad, Kermansaravi, Amir Hosein Davarpanah Jazi, Mohsen, Mahmoudieh, Neda, Mogharehabed, Gregory, Tsiotos, Konstantinos, Stamou, Francisco, J Barrera Rodriguez, Marco, A Rojas Navarro, Omar MOhamed Torres, Sergio Lopez Martinez, Elda Rocio Maltos Tamez, Gustavo, A Millan Cornejo, Jose Eduardo Garcia Flores, Diya Aldeen Mohammed, Mohamad Hayssam Elfawal, Asim, Shabbir, Kim, Guowei, Jimmy By So, Elif Tuğçe Kaplan, Mehmet, Kaplan, Tuğba, Kaplan, Dangtuan, Pham, Gurteshwar, Rana, Mojdeh, Kappus, Riddish, Gadani, Manish, Kahitan, Koshish, Pokharel, Alan, Osborne, Dimitri, Pournaras, James, Hewes, Errichetta, Napolitano, Sonja, Chiappetta, Vincenzo, Bottino, Evelyn, Dorado, Axel, Schoettler, Daniel, Gaertner, Katharina, Fedtke, Francisco, Aguilar-Espinosa, Saul, Aceves-Lozano, Alessandro, Balani, Carlo, Nagliati, Damiano, Pennisi, Andrea, Rizzi, Francesco, Frattini, Diego, Foschi, Laura, Benuzzi, Chirag, Parikh, Harshil, Shah, Enrico, Pinotti, Mauro, Montuori, Vincenzo, Borrelli, Jerome, Dargent, Catalin, A Copaescu, Ionut, Hutopila, Bogdan, Smeu, Bart, Witteman, Eric, Hazebroek, Laura, Deden, Laura, Heusschen, Sietske, Okkema, Theo, Aufenacker, Willem den Hengst, Wouter, Vening, Yonta van der Burgh, Ahmad, Ghazal, Hamza, Ibrahim, Mourad, Niazi, Bilal, Alkhaffaf, Mohammad, Altarawni, Giovanni Carlo Cesana, Marco, Anselmino, Matteo, Uccelli, Stefano, Olmi, Christine, Stier, Tahsin, Akmanlar, Thomas, Sonnenberg, Uwe, Schieferbein, Alejandro, Marcolini, Diego, Awruch, Marco, Vicentin, Eduardo Lemos de Souza Bastos, Samuel Azenha Gregorio, Anmol, Ahuja, Tarun, Mittal, Roel, Bolckmans, Tom, Wiggins, Clément, Baratte, Judith Aron Wisnewsky, Laurent, Genser, Lynn, Chong, Lillian, Taylor, Salena, Ward, Michael, W Hi, Helen, Heneghan, Naomi, Fearon, Andreas, Plamper, Karl, Rheinwalt, Justin, Geoghegan, Kin Cheung Ng, Krzysztof, Kaseja, Maciej, Kotowski, Tarig, A Samarkandy, Adolfo, Leyva-Alvizo, Lourdes, Corzo-Culebro, Cunchuan, Wang, Wah, Yang, Zhiyong, Dong, Manel, Riera, Rajesh, Jain, Hosam, Hamed, Mohammed, Said, Katia, Zarzar, Manuel, Garcia, Ahmet Gökhan Türkçapar, Ozan, Şen, Edoardo, Baldini, Luigi, Conti, Cacio, Wietzycoski, Eduardo, Lopes, Tadeja, Pintar, Jure, Salobir, Cengiz, Aydin, Semra Demirli Atici, Anıl, Ergin, Huseyin, Ciyiltepe, Mehmet Abdussamet Bozkurt, Mehmet Celal Kizilkaya, Nezihe Berrin Dodur Onalan, Mariana Nabila Binti Ahmad Zuber, Wei Jin Wong, Amador, Garcia, Laura, Vidal, Marc, Beisani, Jorge, Pasquier, Ramon, Vilallonga, Sharad, Sharma, Chetan, Parmar, Lyndcie, Lee, Pratik, Sufi, Hüseyin, Sinan, and Mehmet, Saydam

Subjects
Nutrition and Dietetics, Manchester Cancer Research Centre, SARS-CoV-2, ResearchInstitutes_Networks_Beacons/mcrc, Endocrinology, Diabetes and Metabolism, obesity, older patients, resuming elective surgery, metabolic surgery, Resuming elective surgery, Bariatric Surgery, COVID-19, Metabolic surgery, Obesity, Older patients, Aged, Humans, Pandemics, Postoperative Complications, Prospective Studies, Obesity, Morbid, Surgery, Morbid
Abstract

Background Age ≥ 65 years is regarded as a relative contraindication for bariatric surgery. Advanced age is also a recognised risk factor for adverse outcomes with Coronavirus Disease-2019 (COVID-19) which continues to wreak havoc on global populations. This study aimed to assess the safety of bariatric surgery (BS) in this particular age group during the COVID-19 pandemic in comparison with the younger cohort. Methods We conducted a prospective international study of patients who underwent BS between 1/05/2020 and 31/10/2020. Patients were divided into two groups — patients ≥ 65-years-old (Group I) and patients < 65-years-old (Group II). The two groups were compared for 30-day morbidity and mortality. Results There were 149 patients in Group 1 and 6923 patients in Group II. The mean age, preoperative weight, and BMI were 67.6 ± 2.5 years, 119.5 ± 24.5 kg, and 43 ± 7 in Group I and 39.8 ± 11.3 years, 117.7±20.4 kg, and 43.7 ± 7 in Group II, respectively. Approximately, 95% of patients in Group 1 had at least one co-morbidity compared to 68% of patients in Group 2 (p = < 0.001). The 30-day morbidity was significantly higher in Group I (11.4%) compared to Group II (6.6%) (p = 0.022). However, the 30-day mortality and COVID-19 infection rates were not significantly different between the two groups. Conclusions Bariatric surgery during the COVID-19 pandemic is associated with a higher complication rate in those ≥ 65 years of age compared to those < 65 years old. However, the mortality and postoperative COVID-19 infection rates are not significantly different between the two groups. Graphical abstract

Published
2022
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8. High-Density Free Fluid on Computed Tomography: a Predictor of Surgical Intervention in Patients with Adhesive Small Bowel Obstruction

Author

Kenji Inaba, Aaron Strumwasser, Keith D. Herr, Ryan Dollbaum, Evren Dilektasli, Sabrina Asturias, Demetrios Demetriades, Kazuhide Matsushima, Vincent Cheng, and Moazzam Khan

Subjects
Adult, Male, medicine.medical_specialty, Radiodensity, High density, Tissue Adhesions, Computed tomography, 03 medical and health sciences, 0302 clinical medicine, Red Blood Cell Count, Hounsfield scale, Intestine, Small, Ascitic Fluid, Humans, Medicine, In patient, Prospective Studies, Digestive System Surgical Procedures, Laparotomy, medicine.diagnostic_test, business.industry, Gastroenterology, 030208 emergency & critical care medicine, Middle Aged, medicine.disease, Surgery, Bowel obstruction, Treatment Outcome, 030220 oncology & carcinogenesis, Female, Radiology, Tomography, X-Ray Computed, business, Intestinal Obstruction, Free fluid
Abstract

Patients with adhesive small bowel obstruction (ASBO) often develop intraabdominal free fluid (IFF). While IFF is a finding on abdominopelvic computed tomography (CT) associated with the need for surgical intervention, many patients with IFF can be still managed non-operatively. A previous study suggested that a higher red blood cell count of IFF is highly predictive of strangulated ASBO. We hypothesized that radiodensity in IFF (Hounsfield unit (HU)) on CT would predict the need for surgical intervention.Patients with clinicoradiological evidence of ASBO between January 2009 and December 2013 were identified. In patients with IFF 3 cmA total of 318 patients with ASBO (median age 52 years, 56.0 % male) were identified. Of 111 patients who had IFF on CT, 55.9 % underwent therapeutic laparotomy and 15.3 % required bowel resection. Radiodensity of IFF in the operative group was significantly higher than that in the non-operative group (18.2 vs. 7.0 HU, p 0.01). Sensitivity, specificity, positive predictive value, negative predictive value, and accuracy of high-density IFF (10 HU) to predict the need for surgical intervention were 83.9, 65.3, 75.4, 76.2, and 75.6 %, respectively.High-density IFF on CT was significantly associated with the need for surgical intervention in patients with ASBO. Prospective study to validate the predictive value of high-density IFF on CT will be warranted.

Published
2016
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9. Prehospital intubation for isolated severe blunt traumatic brain injury: worse outcomes and higher mortality

Author

Demetrios Demetriades, Evren Dilektasli, Tobias Haltmeier, Kenji Inaba, Stefano Siboni, and Elizabeth Benjamin

Subjects
Adult, Male, Emergency Medical Services, Traumatic brain injury, medicine.medical_treatment, Sedation, Length of hospitalization, Poison control, Wounds, Nonpenetrating, Critical Care and Intensive Care Medicine, Cohort Studies, 03 medical and health sciences, Blunt, Injury Severity Score, 0302 clinical medicine, 030202 anesthesiology, Brain Injuries, Traumatic, Intubation, Intratracheal, medicine, Humans, Intubation, Glasgow Coma Scale, Orthopedics and Sports Medicine, Hospital Mortality, Retrospective Studies, Multivariable regression analysis, business.industry, 030208 emergency & critical care medicine, Retrospective cohort study, Emergency department, medicine.disease, Survival Analysis, United States, medicine.anatomical_structure, Case-Control Studies, Anesthesia, Emergency Medicine, Abdomen, Female, Surgery, medicine.symptom, business
Abstract

Prehospital endotracheal intubation (ETI) for traumatic brain injury (TBI) is a controversial issue. The aim of this study was to investigate the effect of prehospital ETI in patients with TBI. Cohort-matched study using the US National Trauma Data Bank (NTDB) 2008–2012. Patients with isolated severe blunt TBI (AIS head ≥3, AIS chest/abdomen

Published
2016
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10. Negative computed tomography can safely rule out clinically significant intra-abdominal injury in the asymptomatic patient after blunt trauma: Prospective evaluation of 1193 patients

Author

Evren Dilektasli, Jayun Cho, John Brunner, Gustavo Recinos, Demetrios Demetriades, Kenji Inaba, Lydia Lam, and Elizabeth Benjamin

Subjects
Adult, Male, Abdominal pain, medicine.medical_specialty, Abdominal Injuries, Critical Care and Intensive Care Medicine, Wounds, Nonpenetrating, Asymptomatic, 03 medical and health sciences, 0302 clinical medicine, Trauma Centers, Predictive Value of Tests, Medicine, Humans, Prospective Studies, Prospective cohort study, False Negative Reactions, business.industry, Incidence, Trauma center, Glasgow Coma Scale, Reproducibility of Results, 030208 emergency & critical care medicine, Middle Aged, Surgery, Hospitalization, medicine.anatomical_structure, Blunt trauma, 030220 oncology & carcinogenesis, Predictive value of tests, Abdomen, Female, Radiology, medicine.symptom, business, Tomography, X-Ray Computed
Abstract

Background Computed tomography of the abdomen and pelvis (CTAP) is highly specific for injury identification and commonly used in the evaluation of blunt trauma patients. Despite this, there is no consensus on the required clinical observation period after negative imaging, often impacting patient flow and hospital cost. The purpose of this study was to evaluate the use of CTAP after blunt trauma and the need for observation after negative imaging. Methods A prospective analysis at a large Level I trauma center was conducted from November 2014 to May 2015. All blunt trauma patients, older than 14 years with CTAP on admission were included. Symptomatic patients were defined as having abdominal pain or external signs of trauma on admission. The main outcome was missed injury. Results Over the study period, there were 1,468 blunt trauma admissions, of which 1,193 patients underwent CTAP. Eight hundred six (67.6%) patients were evaluable on admission (Glasgow Coma Scale score, 15), and of these, 327 (40.6%) were symptomatic, 479 (59.4%) asymptomatic. Among the evaluable asymptomatic patients, there were 65 (13.6%) positive computed tomography scans including 11 patients with grade III, IV, or V solid organ injury and three that required operation. In the 414 evaluable asymptomatic patients with negative imaging, median length of stay was 3 days, and there were zero missed injuries. All images were reviewed by an attending radiologist. Conclusion Abdominal imaging after trauma is justified in the appropriate clinical setting to evaluate for significant abdominal injury regardless of symptomatology. In asymptomatic, evaluable patients with a negative CTAP, clinically significant abdominal injury is unlikely, and these patients may be considered for early discharge or disposition to another treatment service. Level of evidence Diagnostic, level III; Therapy, level IV.

Published
2017

12. The prognostic value of neutrophil-to-lymphocyte ratio on mortality in critically ill trauma patients

Author

Evren Dilektasli, Elizabeth Benjamin, Demetrios Demetriades, Monica D. Wong, Kenji Inaba, Damon Clark, Tobias Haltmeier, and Lydia Lam

Subjects
Adult, Male, medicine.medical_specialty, Adolescent, Neutrophils, Critical Illness, Critical Care and Intensive Care Medicine, law.invention, 03 medical and health sciences, Leukocyte Count, Young Adult, 0302 clinical medicine, Interquartile range, law, Internal medicine, Medicine, Humans, Lymphocytes, Neutrophil to lymphocyte ratio, Aged, Retrospective Studies, Analysis of Variance, business.industry, Proportional hazards model, Hazard ratio, Trauma center, 030208 emergency & critical care medicine, Middle Aged, Prognosis, Intensive care unit, ROC Curve, Blunt trauma, 030220 oncology & carcinogenesis, Injury Severity Score, Wounds and Injuries, Surgery, Female, business
Abstract

BACKGROUND Recent studies suggest that the neutrophil-lymphocyte ratio (NLR) as a marker of inflammation is associated with mortality in surgical patients. The aim of this study was to determine the prognostic impact of NLR in critically ill trauma patients. METHODS This is a retrospective cohort study involving all trauma patients 16 years or older admitted to the surgical intensive care unit of a Level 1 trauma center (January 2013 to January 2014). The predictive capacity of NLR on mortality was assessed using a receiver operating characteristic curve analysis. To identify the effect of the NLR on survival, a separate log-rank test was used. Multivariable Cox proportional hazard modeling was used to identify independent predictors of mortality. RESULTS During the study period, 1,356 patients met inclusion criteria. Of these, 74% were male, 86% sustained blunt trauma, and the median age was 49 years (interquartile range [IQR], 35). The median Glasgow Coma Scale (GCS) score and Injury Severity Score (ISS) were 15 (IQR, 3) and 13 (IQR, 14), respectively. With the use of the receiver operating characteristic curve analyses at intensive care unit Days 2 and 5, optimal NLR cutoff values of 8.19 and 7.92 were calculated by maximizing the Youden index. Kaplan-Meier curves revealed an NLR greater than or equal to these cutoff values as a marker for increased in-hospital mortality (p < 0.001, log-rank test). The Cox regression model demonstrated that an NLR greater than 8.19 and 7.92 are independently associated with in-hospital mortality at Days 2 and 5, respectively (hazard ratio, 1.602 [p = 0.019] and 3.758 [p < 0.001]). CONCLUSION NLR is associated with mortality in critically ill trauma patients. Prospective validation of its role as a predictive marker for outcomes is warranted. LEVEL OF EVIDENCE Prognostic study, level III.

Published
2016

14. Airway management following repair of cervical tracheal injuries: A retrospective, multicenter study

Author

John A. Harvin, Bryan A. Cotton, Elliott R. Haut, Ethan A. Taub, Deborah M. Stein, Jason Brocker, Cory Evans, Kenji Inaba, John B. Holcomb, Jordan A. Weinberg, Oscar D. Guillamondegui, Michael D. Goodman, Evren Dilektasli, Bryce R.H. Robinson, Lisa M. Kodadek, and Michael A. Vella

Subjects
Adult, Male, medicine.medical_specialty, Adolescent, medicine.medical_treatment, Critical Care and Intensive Care Medicine, Neck Injuries, 03 medical and health sciences, Young Adult, 0302 clinical medicine, Tracheostomy, Intensive care, medicine, Intubation, Intratracheal, Intubation, Humans, Airway Management, Survival rate, Retrospective Studies, Univariate analysis, Trauma Severity Indices, business.industry, 030208 emergency & critical care medicine, Retrospective cohort study, respiratory system, Middle Aged, Respiration, Artificial, United States, Surgery, Survival Rate, Trachea, Treatment Outcome, 030220 oncology & carcinogenesis, Anesthesia, Injury Severity Score, Airway management, Female, Airway, business, Follow-Up Studies
Abstract

BACKGROUND Optimal airway management following repair of cervical tracheal injuries is unknown. This study aimed to determine the optimal airway strategy following cervical tracheal injury repair. METHODS Patients with cervical tracheal injuries admitted from January 2000 to January 2014 at seven US Level I trauma centers were identified. Patients were grouped depending on postoperative airway management: immediate or early extubation (≤24 hours, EXT), prolonged intubation (>24 hours, INT), and immediate tracheostomy (TRACH). Following univariate analysis, a multivariate model was then developed to evaluate for surgical site infection (SSI) and intensive care unit-free and ventilator-free days, comparing INT and TRACH with EXT as the reference. RESULTS A total of 120 cervical tracheal injuries were treated at seven Level I trauma centers. Ten patients were excluded for incomplete data, and seven died within 24 hours of admission, leaving 103 patients included in the study. Patients were grouped based on airway management: 40 (39%) in the EXT, 30 (29%) in the INT, and 33 (32%) in the TRACH group. There were no differences in demographics or injury mechanism. The INT and TRACH groups were more severely injured than the EXT group (median Injury Severity Score [ISS]: INT, 25; TRACH, 17 vs. EXT, 16; p < 0.01). Despite a higher SSI rate (TRACH, 21% vs. INT, 13% vs. EXT, 2%; p = 0.11), the TRACH group had a lower mortality rate (TRACH, 0% vs. INT, 13% vs. EXT, 0%, p < 0.01) and more ventilator-free days compared with the INT cohort. On multivariate analysis, tracheostomy was associated with an increased risk in the odds of SSI (odds ratio, 9.56; 95% confidence interval, 1.35-67.95) compared with both EXT and INT, while INT was associated with fewer ventilator-free days (correlation coefficient, -9.24; 95% confidence interval, -12.30 to -6.18) compared with both EXT and TRACH. CONCLUSION In patients with a cervical tracheal injury, immediate or early extubation was common and safe. However, among those with more severe injuries, immediate tracheostomy versus prolonged intubation presents a risk-benefit decision. Immediate tracheostomy is associated with increased risk of SSI, while prolonged intubation is associated with higher risk of mortality and fewer ventilator-free days. LEVEL OF EVIDENCE Therapeutic study, level IV.

Published
2015

15. Re

Author

Evren Dilektasli

Subjects
Neutrophils, business.industry, Immunology, Humans, Medicine, Surgery, Lymphocyte Count, Lymphocytes, Neutrophil to lymphocyte ratio, Critical Care and Intensive Care Medicine, business
Published
2017
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16. Impact of Short-Term Weight Loss on Hemostasis and Thrombosis after Bariatric Surgery

Author

Ahmed Taha, Hasan Eroğlu, İskender Eren Demirbaş, Berkay Demir, and Evren Dilektaşli

Subjects
Surgery, RD1-811
Abstract

Introduction. Obesity causes thrombophilia and many coagulation problems related to slowing the capillary flow. We aimed to evaluate rapid weight loss outcomes in the early period after bariatric surgery on the coagulation system. Materials and Method. A prospective study enrolled 28 patients with a BMI > 40 kg/m2 who underwent bariatric surgery. Preoperative and postoperative (first and third months) demographic criteria—such as age, gender, weight, height, and alcohol and tobacco use, and biochemical parameters such as PLT, PT, aPTT, INR, bleeding time, coagulation time, fibrinogen, D-dimer, albumin, calcium, ionized calcium, vitamin D, and PTH—were analyzed. Results. We found that both bleeding and thrombotic parameters increase in early-slowing surgery. The first-month platelet levels were significantly different from the preoperative values (p

Published
2023
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17. High Density Free Fluid on Computed Tomography: A Predictor of Surgical Intervention in Patients with Adhesive Small Bowel Obstruction

Author

Kenji Inaba, Vincent Cheng, Ryan Dollbaum, Evren Dilektasli, Sabrina Asturias, Gregory A. Magee, Kazuhide Matsushima, Aaron Strumwasser, Moazzam Khan, and Demetrios Demetriades

Subjects
medicine.medical_specialty, medicine.diagnostic_test, business.industry, High density, Computed tomography, medicine.disease, Surgery, Bowel obstruction, Intervention (counseling), medicine, In patient, Radiology, business, Free fluid
Published
2015
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18. Skateboard head injuries: are we making progress?

Author

Kenji Inaba, Elizabeth Benjamin, Evren Dilektasli, Tobias Haltmeier, Demetrios Demetriades, and Jayun Cho

Subjects
medicine.medical_specialty, Physical medicine and rehabilitation, business.industry, medicine, Head (vessel), Surgery, business
Published
2015
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19. Development of the European Organisation for Research and Treatment of Cancer quality of life questionnaire module for older people with cancer: The EORTC QLQ-ELD15

Author

Steve O'Connor, Evren Dilektasli, Anne Coolbrandt, Deborah Fitzsimmons, Steve George, Teresa Young, Colin A Johnson, Jacqueline Gilbert, Ramachandran Venkitaraman, Anne Brédart, Cindy Kenis, Edward Chow, M. Mahir Ozmen, Eva Hammerlid, Ghasem Yadegarfar, Juan-Ignacio Arrarras, Frances Howse, Verpleging & Verzorging, and RS: CAPHRI School for Public Health and Primary Care

Subjects
Gerontology, Male, Cancer Research, medicine.medical_specialty, Health Status, Health-related quality of life, Population, Disease, Elderly, Quality of life, Neoplasms, Surveys and Questionnaires, Medicine, Humans, education, Aged, Aged, 80 and over, education.field_of_study, business.industry, Age Factors, Questionnaire, Cancer, EORTC QLQ-C30, Middle Aged, medicine.disease, humanities, Clinical trial, Systematic review, Oncology, Otorhinolaryngology, Quality of Life, Neoplasm, Female, business
Abstract

Background and aim There is a lack of instruments that focus on the specific health-related quality of life (HRQOL) issues that affect older people with cancer. The aim of this study was to develop a HRQOL questionnaire module to supplement the European Organisation for Research and Treatment of Cancer (EORTC) core questionnaire, the EORTC QLQ-C30 for older (>70 years) patients with cancer. Methods Phases 1–3 were conducted in seven countries following modified EORTC Quality of Life Group guidelines for module development. Phase 1: potentially relevant issues were identified by a systematic literature review, a questionnaire survey of 17 multi-disciplinary health professionals and two rounds of qualitative interviews. The first round included 9 patients aged >70. The second round was a comparative series of interviews with 49 patients >70 years with a range of cancer diagnoses and 40 patients aged 50–69 years matched for gender and disease site. In Phase 2 the issues were formulated into a long provisional item list. This was administered in Phase 3 together with the QLQ-C30 to two further groups of cancer patients aged >70 (n = 97) or 50–69 years (n = 85) to determine the importance, relevance and acceptability of each item. Redundant and duplicate items were removed; issues specific to the older group were selected for the final questionnaire. Results In Phase 1, 75 issues were identified. These were reduced in Phase 2 to create a 45 item provisional list. Phase 3 testing of the provisional list led to the selection of 15 items with good range of response, high scores of importance and relevance in the older patients. This resulted in the EORTC QLQ-ELD15, containing five conceptually coherent scales (functional independence, relationships with family and friends, worries about the future, autonomy and burden of illness). Conclusion The EORTC QLQ-ELD15 in combination with the EORTC QLQ-C30 is ready for large-scale validation studies, and will assess HRQOL issues of most relevance and concern for older people with cancer across a wide range of cancer sites and treatment stages.

Published
2010

20. The Impact of Neutrophil-to-Lymphocyte Ratio on Mortality in Critically Ill Trauma Patients

Author

Damon Clark, Kenji Inaba, Tobias Haltmeier, Evren Dilektasli, Lydia Lam, Demetrios Demetriades, Monica D. Wong, and Elizabeth Benjamin

Subjects
Drug, medicine.medical_specialty, business.industry, media_common.quotation_subject, Trauma center, Analgesic, Dipstick, Internal medicine, mental disorders, medicine, Injury Severity Score, Surgery, Neutrophil to lymphocyte ratio, business, Amphetamine, Total body surface area, media_common, medicine.drug
Abstract

METHODS: This was a retrospective analysis of patients (aged 12 or older) drug tested by urine dipstick on admission to the University of North Carolina (UNC) level 1 trauma center from January 2012 to September 2013. Illicit substances included cocaine, amphetamine, marijuana, and phencyclidine. Patients testing positive only for analgesic substances (ie, opiates) were excluded. Basic demographics were collected. Outcomes variables analyzed included hospital and ICU lengths of stay (LOS), number of operations, Injury Severity Score, mortality, inhalation injury, and total body surface area (TBSA). Bivariate analysis of illicit drug users (IDUs) vs controls was performed. Agecontrolled regression then measured the effect of drug use on outcomes.

Published
2015
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21. Pediatric resuscitative thoracotomy: a far from futile intervention

Author

Evren Dilektasli, Obi Okoye, Pedro G.R. Teixeira, Regan J. Berg, Kenji Inaba, Peter M. Hammer, Demetrios Demetriades, and Efstathios Karamanos

Subjects
Resuscitative thoracotomy, business.industry, Anesthesia, Intervention (counseling), Head injury, Cohort, medicine, Surgery, medicine.disease, business, hormones, hormone substitutes, and hormone antagonists
Abstract

RESULTS: We evaluated 484 children with head injury during the study period. From this cohort, 361 had SF, of which 122 were isolated. Of the isolated SF group, 101 (83%) were NDSFs of which 80 (79%) presented with GCS of 15. None of the patients with isolated NDSF and GCS 15 necessitated neurosurgical intervention or developed any neurologic deficit. 21 children had DSFs, of which 17 presented with GCS of 15 (80%). Likewise, none of those with DSF and GCS 15 developed a persistent neurologic deficit; however, 3 did undergo neurosurgical intervention (these were cranial elevations). 2,097 children identified in the NTDB with isolated SF and admission GCS of 15 had no TBI related mortality and no patients required neurosurgical intervention.

Published
2015
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22. The Effects of Body Mass Index on Complications and Mortality after Emergency Abdominal Operations: The Obesity Paradox

Author

Elizabeth Benjamin, Demetrios Demetriades, Kenji Inaba, Evren Dilektasli, Tobias Haltmeier, and Elizabeth Beale

Subjects
Male, Pediatrics, Matching (statistics), medicine.medical_specialty, Index (economics), Patient demographics, Overweight, Body Mass Index, 03 medical and health sciences, Postoperative Complications, 0302 clinical medicine, Thinness, Class I obesity, Bayesian multivariate linear regression, Abdomen, Humans, Medicine, Obesity, 030212 general & internal medicine, Emergency Treatment, Retrospective Studies, Class III obesity, business.industry, General Medicine, Middle Aged, medicine.disease, Surgery, 030220 oncology & carcinogenesis, Propensity score matching, Female, Abdominal operations, Underweight, medicine.symptom, business, Body mass index, Obesity paradox, Abdominal surgery
Abstract

Background Recent literature suggests that obesity is protective in critically illness. This study addresses the effect of BMI on outcomes after emergency abdominal surgery (EAS). Methods Retrospective, ACS-NSQIP analysis. All patients that underwent EAS were included. The study population was divided into five groups based on BMI; regression models were used to evaluate the role of obesity in morbidity and mortality. Results 101,078 patients underwent EAS; morbidity and mortality were 19.5% and 4.5%, respectively. Adjusted mortality was higher in underweight patients (AOR 1.92), but significantly lower in all obesity groups (AOR's 0.73, 0.66, 0.70, 0.70 respectively). Underweight and class III obesity was associated with increased complications (AOR 1.47 and 1.30), while mild obesity was protective (AOR 0.92). Conclusions Underweight patients undergoing EAS have increased morbidity and mortality. Although class III obesity is associated with increased morbidity, overweight and class I obesity were protective. All grades of obesity may be protective against mortality after EAS relative to normal weight patients.

Published
2015
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23. Laparoscopic Sleeve Gastrectomy Improves Excessive Daytime Sleepiness and Sleep Quality 6 Months Following Surgery: A Prospective Cohort Study

Author

Evren Dilektasli, Asli Gorek Dilektasli, Uludağ Üniversitesi/Tıp Fakültesi/Göğüs Hastalıkları Anabilim Dalı., and Dilektaşlı, Aslı Görek

Subjects
Male, Daytime somnolence, CPAP device, medicine.medical_treatment, High-risk, Pittsburgh sleep quality index, Excessive daytime sleepiness, Laparoscopic surgery, Procedures, Morbid obesity, 0302 clinical medicine, Apnea syndrome, Surveys and Questionnaires, Stop-bang score, Pharmacology (medical), Prospective Studies, 030212 general & internal medicine, Sleeve gastrectomy, Laparoscopy, Prospective cohort study, Original Research, Medicine(all), Sleep Apnea, Obstructive, Laparoscopic sleeve gastrectomy, medicine.diagnostic_test, Epworth Sleepiness Scale, Obstructive Sleep Apnea, Bariatric Surgery, Screening, General Medicine, Sleep quality, Metabolic syndrome, Obesity, Morbid, Pittsburg Sleep Quality Index, Impact, Treatment Outcome, Medical history, Female, Cohort analysis, medicine.symptom, Severely obese, Human, Adult, medicine.medical_specialty, Weight reduction, Research & experimental medicine, Obese-patients, 030209 endocrinology & metabolism, Apnea hypopnea index, Major clinical study, Disorders of Excessive Somnolence, Article, 03 medical and health sciences, Gastrectomy, Ghrelin levels, Postoperative period, medicine, Humans, Medicine, research & experimental, Prospective study, Bariatric surgery, Pharmacology & pharmacy, Sleep disordered breathing, Questionnaire, business.industry, medicine.disease, Obstructive sleep apnea, respiratory tract diseases, Surgery, Weight-loss, STOP-Bang, business, Complication
Abstract

Introduction Obstructive sleep apnea (OSA) is one of the most important co-morbid conditions related with morbid obesity. Bariatric procedures are associated with significant improvement in OSA. The aim of the current study was to evaluate the effect of bariatric surgery on daytime sleepiness and quality of sleep in patients that had undergone laparoscopic sleeve gastrectomy. Methods Fifty-nine patients were prospectively enrolled in the study. Pre-operative and post-operative (6 months) demographics, medical history, weight, and height of the patients were recorded, and patients were asked to complete Pittsburg Sleep Quality Index (PSQI) and Epworth Sleepiness Scale (ESS) questionnaires. OSA screenings were performed using the STOP-Bang questionnaire. Results The mean age of the patients was 37.1 ± 1.2 years and 76% were female. Pre-operative and post-operative median (range) BMIs were 47 kg/m2 (39–67 kg/m2) and 35 kg/m2 (25–44 kg/m2), respectively (P

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24. Spontaneous Gastrosplenic Fistula Resulting From Primary Gastric Lymphoma: Case Report and Review of the Literature

Author

Münevver Moran, İsmail Bilgiç, Hayrettin Dizen, Evren Dilektaşlı, Tankut Köseoğlu, and Mehmet Mahir Özmen

Subjects
Gastrosplenic fistula, Gastric lymphoma, Surgical Treatment, Medicine
Abstract

A fistulous tract between the stomach and the spleen is a rare manifestation. Spontaneous gastrosplenic fistula formation resulting from primary gastric lymphoma is extremely rare and should be managed as an emergency. To date, four gastrosplenic fistulas originating from gastric lymphoma have been reported, of which three were spontaneous and one occurred following chemotherapy. We report a case of spontaneous gastrosplenic fistula in a 35 years-old-man with gastric malignant B-cell non-Hodgkin’s lymphoma who was diagnosed by computed tomography and endoscopically, followed by successful treatment with total gastrectomy and splenectomy.

Published
2011

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