Search

Objectives: The renal transplant program of Istanbul Okan University Hospital started in August 2017. Five cadaveric and 95 living donor kidney transplants have been performed for over 16 months. In this study, we aimed to share our experiences regarding kidney transplantation. Methods: In this study, a retrospective analysis of 100 patients who underwent kidney transplantation at the Istanbul Okan University over 16 months, the Health Application and Research Center was carried out. Patients’ demographics, creatinine levels of donors and recipients, co-morbid conditions, postoperative complications, features of arterial anastomosis and arterial variations observed on computed tomography angiography of donor-patient were assessed. Results: Mean age of donor patients was 44.05±13.76 (18-71) years. All living donors had computed tomography angiography for assessment of the vascular structure of both kidneys. Accessory right kidney artery was the most dominant vascular variation (16.5%). The primary cause of chronic renal disease was diabetes mellitus (36.4%) and hypertension (15.6%). Mean warm and cold ischemia time was 1.82±0.44 (1-3) and 40.25±6.12 (31-57) minutes, respectively. The most observed postoperative complication was stenosis of ureter anastomosis (4.1%). End-to-end arterial anastomosis between renal and internal iliac arteries was the most preferred anastomosis (57.2%). Conclusion: Increasing kidney transplantation, which is the most appropriate treatment in terms of cost-effectiveness, will be beneficial for patient health and economy of the country.

GİRİŞve AMAÇ: Üst sindirim sistemine ait birçok hastalığınetyopatogenezinde rol oynayan helicobacter pylori insanlarda en sık görülenkronik bakteriyel enfeksiyondur. Prevalansı sosyokültürel ve coğrafi bölgeleregöre değişkenlik gösteren bu patojen dünya nüfusunun %30-%50'sinietkilemektedir. Yıllar içerisine artan antibiyotik kullanımı ve sanitasyonkoşullarındaki değişiklikler nedeniyle bu yaygın enfeksiyonun davranış şekli dedeğişiklik göstermiştir. Bu çalışmamızda birçok merkezde kolaylıkla yapılabilenbir tetkik olan tam kan sayımında bulunan ve enfeksiyon belirteci olabilecekparametreler ile helicobacter pylori enfeksiyonu arasındaki ilişkiyi inceledik.YÖNTEMve GEREÇLER: Bu çalışmamızda Ocak2016- Aralık 2016 üst gastrointestinal sistem endoskopisi yapılan 2939hastanın tam kan sayımı ve patoloji verileri retrospektif olarak inceledik. BULGULAR: Helicobacterpylori varlığına göre nötrofil/lenfosit oranı arasında istatistiksel olarak anlamlıfarklılık saptanmış ve helicobacter pylori (+) olguların NLR değerleri helicobacterpylori (-) olgulara göre yüksek bulunmuştur.TARTIŞMA ve SONUÇ: Nötrofil/lenfositoranının helicobacter pylori eradikasyonu tedavi sürecini takip etmek içinyararlı olabileceğini düşünmekteyiz.

NSAIDs have dual roles of providing analgesia and promoting healing. This study investigated the effects of 3 different NSAIDs on healing of colonic anastomosis in rats. The aim is to provide an evidence-based rationale for choice of postoperative analgesic agent in surgical patients who undergo this procedure. Forty-eight Sprague-Dawley conventional rats were separated into 4 groups of 12 rats, with one group as control, and the other groups receiving tenoxicam, metamizole, or diclofenac, respectively. Each group was subdivided into 2 subgroups according to sacrifice on postoperative day 3 or 7. Anastomotic healing was assessed by 3 parameters: (1) physical evaluation (bursting pressure), (2) histological evaluation (fibrotic index), and (3) biochemical evaluation (tissue hydroxyproline levels). Diclofenac had a negative effect on bursting pressures. Tenoxicam significantly increased the fibrotic index at day 7. Metamizole increased tissue hydroxyproline levels at day 3, but there was no significant difference between control and NSAID groups at day 7. Each drug showed benefits and drawbacks. Because tenoxicam promoted fibrosis, and metamizole increased collagen synthesis, with both agents showing few disadvantages, these 2 agents are recommended above diclofenac for promoting healing.Key words: NSAID, Colonic anastomoses, rats

Diaphragmatic injury is a rare condition, but late diagnosis may be associated with increased mortality and morbidity. The aim of this study was to present our experience with the management of this injury. Between 2004 to 2007, 13 patients with traumatic diaphragmatic rupture or diaphragmatic hernia were treated. We described the findings in patients, who had operated urgent or had complaints due to intestinal obstruction months to years after an injury. All patients were male and mean age was 23.1 years. Diaphragmatic rupture was left-sided in all patients. Six of these patients had blunt and the remaining 7 had penetrating trauma. Diagnosis of diaphragmatic rupture was established in less than 24 hours in 4 patients. In the remaining 9 patients, who developed intra- throracic herniation of abdominal organs, diagnostic delay ranged from 12 to 48 months. The most frequent herniated organ was transverse colon. Non-absorbable sutures were used for closure of the defect. Complication rate was 30% and no death was observed. After blunt or penetrating trauma in upper abdomen and distal chest, a high index of suspicion is important to diagnose diaphragmatic rupture. Late presentations are associated with increased morbidity.Key words: Blunt/penetrating trauma, diaphragmatic rupture, diaphragmatic hernia, complication

Objective: We aimed to investigate the effects of enteral immunonutrition and Total Parenteral Nutrition (TPN) on the immune system and acute inflammatory response of patients who underwent major abdominal surgery. Material and Methods: Sixty gastric or colorectal cancer patients were randomized into two groups. Enteral immunonutrition was given to the first group and TPN was given to the second group. Albumin, prealbumin, retinol binding globulin (RBP), transferrin, IL-2, IL-6, CRP and T-Lymphocyte levels were determined for nutritional state and immunologic evaluation. Also, postoperative complications, postoperative intensive care unit (ICU) and hospital stays were compared between the two groups. Results: All nutritional parameters were significantly decreased on the postoperative first day in both groups. RBP and prealbumin levels significantly increased in Group I on postoperative day 5. IL-6 and CRP levels increased significantly in both groups. IL-2 levels increased significantly in Group I, T-lymphocyte percentage decreased significantly in Group II on postoperative day 1 and 5. The length of ICU and hospital stays were longer and postoperative infection rate was less in Group II. Conclusion: Decrease in severity of acute inflammatory response and postoperative infection rate, augmentation in cellular immunity, decrease in the length of ICU and hospital stay were observed in the enteral immunonutrition group after major abdominal surgery. Turkish Başlık: Majör Abdominal Kanser Cerrahisi Uygulanan Hastalarda Total Parenteral Nutrisyon ve Enteral İmmunonutrisyon Karşılaştırılması Anahtar Kelimeler: Total parenteral nütrisyon; enteral immünonütrisyon; major cerrahi; kanser Amaç: Majör abdominal cerrahi uygulanan olgularda preoperatif başlanan ve erken postoperatif dönemde devam edilen enteral immünonütrisyon ürünü ile total parenteral nütrisyonun, immün sistem ve akut inflamatuar yanıt üzerine etkilerinin araştırılması amaçlandı. Gereç ve Yöntem: Mide ve kolorektal kanser tanılı 60 hasta iki gruba randomize edildi. Birinci gruba enteral immünonütrisyon, ikinci gruba Total Parenteral Nütrisyon uygulandı. Nütrisyonel değerlendirme için albümin, prealbümin, retinol bağlayıcı protein (RBP) ve transferin düzeylerine, immünolojik değerlendirme için IL-2, IL-6, CRP ve T-Lenfosit değerlerine bakıldı. Ayrıca, postoperatif komplikasyon oranları ile yoğun bakım ünitesinde (YBÜ) ve hastanede yatış süreleri karşılaştırıldı. Bulgular: Her iki grupta postoperatif 1. günde nütrisyonel değerlerde anlamlı azalma görüldü (p, Amaç: Majör abdominal cerrahi uygulanan olgularda preoperatif başlanan ve erken postoperatif dönemde devam edilen enteral immünonütrisyon ürünü ile total parenteral nütrisyonun, immün sistem ve akut inflamatuar yanıt üzerine etkilerinin araştırılması amaçlandı. Gereç ve Yöntem: Mide ve kolorektal kanser tanılı 60 hasta iki gruba randomize edildi. Birinci gruba enteral immünonütrisyon, ikinci gruba Total Parenteral Nütrisyon uygulandı. Nütrisyonel değerlendirme için albümin, prealbümin, retinol bağlayıcı protein (RBP) ve transferin düzeylerine, immünolojik değerlendirme için IL-2, IL-6, CRP ve T-Lenfosit değerlerine bakıldı. Ayrıca, postoperatif komplikasyon oranları ile yoğun bakım ünitesinde (YBÜ) ve hastanede yatış süreleri karşılaştırıldı. Bulgular: Her iki grupta postoperatif 1. günde nütrisyonel değerlerde anlamlı azalma görüldü (p