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Objective: Terminal liver disease due to viral hepatitis infections is an important health problem. This study aimed to compare the expression of members of the signal transducer and activator of transcription (STAT) family (STAT-1, -2, -3, -5a, and -5b) and interleukin (IL)-6 and IL-10 in hepatectomy material from patients who received antiviral treatment and underwent a liver transplantation due to terminal liver failure. Methods: The study consisted of 45 patients who underwent a liver transplantation due to chronic liver failure associated with viral hepatitis (hepatitis C virus [HCV] or hepatitis B virus [HBV]). The patients were divided into three groups according to the drug treatments they received prior to the liver transplantation: Group A: lamivudine, Group B: adefovir, and Group C: interferon or interferon + ribavirin. Results: In the study population, 9 (20%) patients were females and 36 (80%) were males. The mean age was 45.7 (29–69) years. STAT-2, -3, and IL-6 expression were significantly higher in hepatocytes in Group A (p

Objectives: The aim of this study was to evaluate acute abdomen cases that developed as a result of spontaneous perforations of hydatid liver cysts in our regions, where hydatid cyst disease is endemic.Methods: The records of 218 hydatid cyst patients who underwent surgery at our clinic between 01.01.2012 and01.08.2016 were retrospectively reviewed.Twelve (5.5%) cases who required emergency surgerydue to the ruptureof hydatid cysts were included in this study. The cases were reviewed with respect to age, sex, current symptoms, radiological findings, laboratory results and post-operative results.Results: Ten (83.3%) of the 12 patients were females, and two (16.7%) were males, and their me an age was 40.4 y (23–69). All patients with spontaneous perforationshadhydatid liver cysts. Eleven of the patients had a single cyst, and one hadmultiple cysts. Nine patients were diagnosed withultrasonography (US), and three patients were diagnosed with computed tomography (CT).Conclusions:Hydatid cystic rupture should be considered in cases of an acute abdomen in regions where hydatid cystic disease is endemic. We believe that patients with a single cyst that is peripherally located in the liver ha ve ahigh risk of spontaneousperforation.Patients who are diagnosed with hydatid cystic rupture should undergo emergency surgery, followed bymedical treatment.

Giriş: Viral hepatit infeksiyonlarına bağlı terminal dönem karaciğer hastalığı önemli bir sağlık sorunudur. Bu çalışmada antiviral tedavi almış terminal dönem karaciğer yetmezliği sebebiyle karaciğer nakli yapılan hepatektomi materyallerinde STAT-1,2,3,5,5a,5b, IL-6 ve IL-10 ekspresyonlarının karşılaştırılması amaçlandı. Yöntemler: viral hepatitler (HCV ve HBV)’e bağlı kronik karaciğer yetmezliği nedeni ile karaciğer transplantasyonu yapılan 45 olgu çalışmaya dâhil edildi. Çalışmamızda hastalar karaciğer transplantasyonu öncesi almış oldukları ilaç tedavilerine göre 3 gruba ayrıldı. Grup A: Lamuvidine, Grup B: Adefovir, Grup C: İnterferon veya interferon + ribavidin. Sonuçlar: Çalışma popülasyonunda 9 (%20) hasta kadındı ve 36 (%80) erkek idi. Yaş ortalaması 45.7 (29-69) idi. STAT-2, -3 ve IL-6 ekspresyonu Grup A'da hepatositlerde anlamlı olarak daha yüksekti (p, Objective: Terminal liver disease due to viral hepatitis infections is an important health problem. This study aimed to compare the expression of members of the signal transducer and activator of transcription (STAT) family (STAT-1, -2, -3, -5a, and -5b) and interleukin (IL)-6 and IL-10 in hepatectomy material from patients who received antiviral treatment and underwent a liver transplantation due to terminal liver failure. Methods: The study consisted of 45 patients who underwent a liver transplantation due to chronic liver failure associated with viral hepatitis (hepatitis C virus [HCV] or hepatitis B virus [HBV]). The patients were divided into three groups according to the drug treatments they received prior to the liver transplantation: Group A: lamivudine, Group B: adefovir, and Group C: interferon or interferon + ribavirin. Results: In the study population, 9 (20%) patients were females and 36 (80%) were males. The mean age was 45.7 (29–69) years. STAT-2, -3, and IL-6 expression were significantly higher in hepatocytes in Group A (p

Objective: The aim of this study was to investigate the effects of lycopene (Lyc) on methotrexate (Mtx)-induced intestinal damage in rats. Method: Twenty-eight male Sprague Dawley rats were divided into four equal groups: control, Mtx, Lyc, and Mtx-L. Control group: Rats were given only the vehicle. Lyc group: Rats were given Lyc (10 mg/kg) with corn oil by oral gavage for 10 days. Mtx group: Rats were injected intraperitoneally with a single dose of 20 mg/kg of Mtx and given corn oil by oral gavage. Mtx-L group: Rats were treated with Lyc (10 mg/kg) for 10 days after a single dose of Mtx (20 mg/kg). All of the rats were euthanized using terminal anesthesia, and the intestinal tissues were removed for histological examination and for pro-inflammatory cytokine measurement (tumor necrosis factor alpha (TNF-α), interleukin-1 beta (IL-1β)), total oxidative status (TOS), total antioxidant capacity (TAC), and oxidative stress index (OSI). Results: Mtx administration increased histopathological damage and increased TNF-α, IL-1β, TOS, TAC, and OSI levels in the small intestine tissues. Lyc therapy applied to the Mtx-L group provided significant improvement in all parameters of histopathological damage to the small intestine and significantly reduced the levels of IL-1β, TOS, and OSI in the intestinal tissues. Conclusions: The results of this study indicate that Lyc might be useful for protecting intestinal damage induced by Mtx in rats by reducing the increased oxidative stress and pro-inflammatory cytokine (IL-1β) levels.

Carbon monoxide (CO) poisoning is a serious emergency that may result with death in our country. When CO is inhaled, it connects with hemoglobin and forms carboxyhemoglobin, which impairs oxygen transport and metabolism. In acute cases of smoke inhalation, CO and cyanide intoxication are associated with. A 35-year-old male patient weighing 90 kg was evaluated with a diagnosis of acute smoke inhalation from burns caused by fire in the office. We applied the recommended treatment modalities of up to three sessions per day for the CO intoxication patient admitted to our clinic. He was an acute smoke inhalation case exposed to long-term CO poisoning due to the intervention of a delayed fire. Applying early and high doses of HBO treatment reduces the possibility of sequels.

Laparoscopic appendectomy is increasingly being performed because of its quick recovery time, low instance of wound infection, and early return of patients to home and work. Operating time should be short yet safe. Therefore, in this study, we compared the effects of various sealing systems on the length of surgery and examined whether these systems could be used to separate the appendix from its stump successfully. This prospective and randomized ex vivo study was conducted on 20 consecutive patients diagnosed with acute appendicitis. All patients underwent classical open appendectomy. The patients were classified into two groups according to the type of sealing system used. The LigaSure® system was used for coagulation in Group L and the Harmonic® system in Group H. After coagulation, a pressure system was used to evaluate the closure of the appendix. Results showed that the use of ultrasonic instruments alone to close the appendiceal stump caused an incomplete closure.Appendicular stump, Laparoscopic appendectomy.

Introduction: Hyperbaric oxygen (HBO2) treatment results in elevated production of reactive oxygen species (ROS) that leads to cellular damage. Thymoquinone (TQ) is reported to have anti-inflammatory and anti-microbial activity and may suppress the generation of free radicals. The goal of this study is reduction of side effects of hyperbaric oxygen therapy with thymoquinone treatment. Methods: 30 female Sprague-Dawley rats were randomly assigned to one of three groups (n = 10 per group). Group 1 represented the control group (no treatment). Group 2 was exposed to 100% oxygen at 2.5 ATA for two sessions of two hours’ duration each day for five days. Group 3 was treated identically to Group 2 and was also given thymoquinone once daily at 50 mg/kg/day by oral gavage for five days, after first session of HBO2. Lipid hydro-peroxidation (LOOH) and free sulfhydryl groups (SH) and Fetuin A were measured from the left lung. The right lung was saved for pathological evaluation. Results: LOOH and SH levels were significantly elevated in the group receiving HBO2 treatment relative to the control group rats. Fetuin A is increased during TQ treatment. LOOH and SH levels were significantly decreased in animals treated with TQ. Conclusions: Long-term and repeated HBO2 treatment leads to damage to the lung tissue. In urgent situations or cases of severe hypoxia, repeated HBO2 sessions may be necessary, and TQ antioxidant agents may be useful for prevention of HBO2-associated injury. TQ may represent a useful therapeutic option during HBO2 treatment.

Acute appendicitis is the most frequent abdominal condition that requires non-obstetric surgical intervention during pregnancy. This study aims to scan pregnant patients operated on for acute appendicitis to evaluate the efficiency of using the Alvarado Score (AS) for diagnosis. Our study included 48 pregnant patients who were pre-diagnosed with acute appendicitis and operated on at our department of general surgery from January 2010 to July 2016 and whose files were accessed. Fifty-three non-pregnant female patients of reproductive age who were operated on for appendicitis during the same period were included in the study as the control group. The patients in both groups were divided into two groups based on their AS total score being 7 and ≥ 7. The mean age of the 48 pregnant patients was 28 (19–42) years, while the mean age of the 53 control patients was 31 (18–45) years. Among pregnant and non-pregnant women, about a third of patients had an AS

Background The aim of this study was to investigate the effects of lycopene (Lyc) on methotrexate (Mtx) induced liver toxicity in rats. Methods Twenty-eight male Sprague-Dawley rats were divided into four equal groups: control, Lyc, Mtx and Mtx-L: Control group: Rats were given only the vehicle. Lyc group: Rats were given Lyc (10 mg/kg) with corn oil by oral gavage for ten days. Mtx group: Rats were injected intraperitoneally with a single dose of 20 mg/kg of Mtx and given corn oil by oral gavage. Mtx-L group: Rats were post-treated with Lyc (10 mg/kg) for ten days after a single dose of Mtx (20 mg/kg). Results Mtx administration increased histopathological damage, TNF-α, IL-1β, TOS, TAS and OSI levels in tissues; AST, ALT levels in the blood. Sinusoidal dilatation, inflammatory cell infiltration and congestion were significantly improved in the Mtx-L aon histopathologic examination of the rats.In Mtx-L group that were treated at the Lyc, TNF-α and IL-1β levels of liver tissue were decreased significantly compared to Mtx group whereas the decrease in OSI was not significant. Lyc treatment improved the AST and ALT values in Mtx-L group. But only AST improvement was significant. Conclusions The results of this study revealed that Lyc might be useful in protecting the liver from injury due to Mtx in rats by reducing the increased proinflammatory cytokine levels (Tab. 4, Fig. 1, Ref. 44).

Objective: We aimed to evaluate our diagnosis and treatment approach to pregnant patients with acute cholecystitis in our high birth rate region. Methods: Twenty-one patients who suffering from acute cholecystitis during their pregnancy were analyzed retrospectively between January 2010 August 2014 at Harran University Medical School, Department of General Surgery. Treatment methods, complications, demographic and laboratory data were recorded for each patient. Results: Twenty one patients with abdominal pain and diagnosed as acute cholecystitis were included in this study. The mean age and gestational weeks of patients were 28 ± 7.4 years, 23.4 ± 8.5 respectively. Upper abdominal pain and nausea-vomiting were the most frequent complaints of the patients to hospital admissions. For the surgical treatment one patient underwent open cholecystectomy due to bladder perforation during the second trimester of her pregnancy, laparoscopic cholecystectomy was performed in one patient due to recurrent cholecystitis and in two patients due to decline cholecystitis findings. All other patients were treated medically. Maternal or fetal complication after treatment was not observed. Conclusion: Although, during pregnancy acute cholecystitis episodes are seen rare successful results can be obtained with medical therapy. When medical therapy has failed, especially in the second trimester, laparoscopic surgery can be considered as reliable surgical intervention for mother and fetus., Amaç: Bu çalışmada amacımız, yüksek doğum oranı olan bölgemizde akut kolesistitli gebe hastalarda tanı ve tedavi yaklaşımlarımızı değerlendirmektir. Yöntemler: Harran Üniversitesi Tıp Fakültesi Genel Cerrahi Anabilim Dalında Ocak 2010- Ağustos 2014 tarihleri arasında gebeliği sırasında akut kolesistit hastalığı geçiren 21 hastanın verileri retrospektif olarak analiz edildi. Hastaların demografik ve laboratuar verileri ile uygulanan tedavi yöntemleri ve komplikasyonları not edildi. Bulgular: Çalışmamıza gebeliği sırasında üst karın ağrısı şikayeti ile başvuran ve akut kolesistit tanısı konan toplam 21 hasta dâhil edildi. Hastaların yaş ortalaması 28±7,4, ortalama gebelik haftası 23,4±8,5 olarak tespit edildi. En sık hastaneye başvuru şikâyetlerinin üst karın ağrısı ve bulantı-kusma olduğu görüldü. Tedavi olarak; bir hastada ikinci trimester sırasında gelişen kese perforasyonu nedeniyle açık kolesistektomi, bir hastada tekrarlayan kolesistite bağlı, iki hastada ise kolesistit bulgularının medikal tedavi rağmen gerilememesi nedeniyle laparoskopik kolesistektomi yapıldı. Diğer bütün hastalara ise medikal tedavi uygulandı. Uygulanan tedaviler sonrasında maternal ya da fetal herhangi bir komplikasyon tespit edilmedi. Sonuç: Gebelik sırasında akut kolesistit atağı nadir görülmekle beraber, medikal tedavi ile başarılı sonuçlar alınmaktadır. Medikal tedavinin başarısız olduğu durumlarda özellikle ikinci trimesterde laparoskopik cerrahi hem anne hem de fetüs açısından güvenilir bir cerrahi girişim olarak kabul edilebilir.

Hydatid cyst disease continues to be a problem in developing countries. They are divided into different types according to the Gharbi classification. Percutaneous or surgical treatment can be applied according to their anatomic location and types. Furthermore, laparoscopy is a technique of minimally invasive surgery. PAIR (Percutaneus aspiration, Irrigation, Reaspiration) should perform to some cysts if there has been an experienced radiologist. If stones in gallbladder and hydatid cysts in the liver are detected and there is no experienced radiologist, laparoscopic cholecystectomy and percutaneous drainage should be performed in the same session. In this method, an external used veress needle was used for aspirating the cyst content, and povidone-iodine was administered as a proto-scholastic agent. No problem was observed at the patient’s follow-ups, and the patient was discharged.

Introduction Timely diagnosis of the gastroduodenal perforation usually allows primary repair or resection. Treatment of a large gastric perforation is more difficult than the common duodenal ulcer perforation by plugging and usually requires agastric resection. On the other hand, gastric resection fora hemodynamically compromised patient in sepsis hasa high rate of anastomotic failure and mortality. Here, we described a practical surgical technique that can avoid emergency gastric resection in such situations. Presentation of case A 83 year-old female admitted with peritonitis, severe sepsis and hemodynamic instability. After the diagnosis of hollow organ perforation and supportive therapy, laparotomy revealed a delayed and large (7 cm) gastric perforation. Instead of gastrectomy, we downsized the large defect by means of a purse-string suture around the perforation and made it suitable for the application of omental plugging. Discussion The patients with poor performance status who are not suitable for the gastric resection, a free omental plug fixation to the narrowed perforation area by a purse-string suture can overcome the problem. Conclusion This method can be keep in mind as a damage control surgery technique in the non-traumatic abdominal emergencies due to large gastric perforations., Highlights • A new technique for damage control surgery. • Omental patching for gastric perforation. • Narrowing perforation area.

Giriş ve Amaç:Endoskopi ünitemizde alt gastrointestinal sistem endoskopisi uygulanan hastaların makroskopik tanılarını ve kolorektal kanser sıklığını retrospektif olarak belirleyip sunmak. Gereç ve Yöntem:Karabük Üniversitesi Eğitim ve Araştırma Hastanesi Endoskopi Ünitesinde 2006-2012 yılları arasında alt gastrointestinal sistem endoskopi yapılarak video arşivleme sistemine kaydedilen 1800 olgunun yaşı, cinsiyeti ve endoskopi raporlarındaki kolorektal hastalıkları belirlendi. Bulgular:Alt gastrointestinal sistem şikâyeti nedeniyle altı yıllık süreçte 1800 hastaya endoskopik işlem yapıldı. Hastaların 920 (%51.11)’si erkek ve 880 (%48.88)’i kadın idi. Hastaların yaş aralığı 24-91 (ort: 58,68) idi. Hastaların 601’inin (%33,38) endoskopisi normal olarak rapor edildi. Alt gastrointestinal sistem endoskopisi uygulanan olgularda kolorektal kanser oranı %6.11 idi. Yapılan endoskopik işlemler sırasında komplikasyon oranı %0.16 idi ve mortalite olmadı. Sonuç:Alt gastrointestinal sistem endoskopisi, alt gastrointestinal sistem hastalıklarının teşhisinde hala altın standarttır, bu yöntem ile kanser saptama sıklığı yakla-şık %6’dır. Alt gastrointestinal sistem endoskopisi morbidite ve mortalitesi çok düşük tanısal bir işlemdir.

Acute appendicitis is the most common surgical abdominal emergency. In the early diagnosis of acute appendicitis, the fact that there is no a sign which could be a reliable indicator in most of the patients increases the complications. In this study we aimed to search the relation between Ultrasonography(US) findings in patients with diagnosis of acute appendicitis and postoperative histopathologic investigation on remoced appendix..The files of 174 patients who came in our emergency department with lower right abdominal pain were studied retrospectively from January 2013 to May 2014. Of them, 26 patients were excluded, because these patients were not studied with US. US findings and histopathology reports of 148 patients with suspected acute appendicitis and studies preoperatively with abdominal US were enrolled. Greater than 6-mm diameter of the appendix under compression was accepted as positive sign of appandicitis in US. The demographic characteristics of the patients, US findings (acut appendicitis or not) and the pathology results were recorded on the standard proform.Of these 148 patients, 100 were acute appendicitis in preoperative US, and of these 100 patients, 93 histopathologic reports were acute appendicitis, 7 were normal appendices. The sensitivity of US was 75.6 % and specificity was 72 %. Positive predictive value (PPV) was 93 %, negative predictive value (NPV) was 14.6 % and the accuracy of US value was 81.7%. As a result, although US in diagnosis of acute appendicitis is a reliable technique, negative result doesn't mean no acute appendicitis. In order to determine an accurate diagnosis of acute appendicitis clinical and laboratoary findings should be assessed together.Abdominal pain, Acute appendicitis, Ultrasonography.L’appendicite acuta rappresenta la più comune causa di urgenza chirurgica. Il fatto che per la diagnosi precoce non c’è un segno indicativo caratteristico accresce le complicazioni. Con questo studio si è cercato di riconoscere un rapporto tra i casi di appendicite acuta posta con gli US ed i riscontri istopatologici sull’appendice asportata. Sono state esaminate retrospettivamente le cartelle cliniche di 174 pazienti del dipartimento di emergenza che via vevano fatto ricorso per dolori in fossa iliaca destra da gennaio 2013 a maggio 2014. 26 di questi paziente sono stati esclusi perchè non studiati preoperatoriamente con l’ecografia, includendo nello studio i referti istopatogici di 148 pazienti che erano stati sospettati di appendicite acuta. Era stata accettata la diagnosi ecografica di appendicite acuta nel caso di un diametro appendicolare superiore ai 6 mm sotto compressione. Sono state registrate in un modulo standard le caratteristiche demografiche dei pazienti ed i reperti ecografici, positivi o meno per appendicite acuta. In 100 di questi 148 pazienti la diagnosi ecografica preoperatoria era stata di appebdicite acuta, ed il referto istopatologico aveva confermato la diagnosi in 93 casi, mentre in 7 casi si trattave di appendici normali. La sensibilità degli US è risultata del 75,6% e la specificità del 72%. Il valore predittivo positivo (PPV) è stato del 93% e quello negativo (NPV) 14,6% con accuratezza del valore ecografico 81,7% Risulta che l’ecografia è una tecnica affidabile per la diagnosi di appendicite acuta, ma la negatività non significa negazione della diagnosi. Per una diagnosi più accurata i dati ecografici devono essere associati ai rilievi clinici ed ai dati di laboratorio.

The aim of this study is to evaluate the thyroid function tests in order to examine whether 10 % of Povidone-Iodine(PI), the medication we applied in 1/5 ratio diluted with 0.9 %NaCl, joins the systemic circulation during clean contaminated, contaminated and dirty operations for solid organ hydatid cysts in abdominal area to avoid abscess formation and spreading. 7 men and 6 women were included to the present study, prospectively. The mean age was 33.69(± 13.49). TSH, free T3 (fT3) and free T4 (fT4) hormone levels were measured before the operation and at the third day of postoperative period. Amount of used povidone-iodine for patients was recorded. As a result of statistical analysis applied, the preoperative and post operative values were not significantly different regarding with the measured hormone levels (preTSH vs postTSH: p= 0.984; prefT3 vs postfT3: p= 0.101; prefT4 vs postfT4: p=0.146). Thus, it has been shown that the dose we used is effective, and it does not enters at all or at quite low levels into the systemic circulation. Patients whom this application performed, abscess and intestinal adhesions have not been observed in our clinical experience. We recommend the use of suggested doses of Povidone-Iodine in the presence of intraabdominal perforation and abscess or in cases such as carrying a risk of cyst spreading to intraabdominal area in hydatid cysts.Povidone-iodine, Surgical adhesions, Surgical wound infections, Thyroid function tests.Scopo di questo studio è quello di valutare i test di funzione tiroidea per indagare se una soluzione di Povidone- Iodine (PI) al 10%, che usiamo nella diluizione 1/5 con 0,9% NaCl in area addominale durante interventi puliti- contaminati, contaminati e sporchi in caso di idatidosi in organi parenchimatosi, al fine di evitare la formazione di ascessi e la disseminazione, raggiunge la circolazione sistemica. In questo studio sono stati inclusi 7 uomini e 6 donne in maniera prospettica. L’età media era di 33,69 (± 13.49). Preoperatoriamente ed al terzo giorno postoperatorio sono stati dosati i livelli ormonali di TSH, T3 libero (FT3) e T4 libero (FT4). È stata presa nota della quantità di PI usata per ogni paziente. Dall’analisi statistica non sono risultati valori significativamente differenti tra il preoperatorio ed il postoperatorio relativamente al livello degli ormoni tiroidei (preTSH vs postTSH: p= 0.984; preFT3 vs postFT3: p= 0.101; preFT4 vs postFT4: p=0.146). Così si è dimostrato che la dose di PI usata è efficace e non entra, o quanto meno a livello piuttosto basso, nella circolazione sistemica. I pazienti in cui tale procedura è stata usata non sono andati incontro in questa nostra esperienza ad ascessi addominali o aderenze intestinali. Raccomnadiamo dunque l’uso di queste dosi suggerite di PI in caso di perforazioni intestinali o ascessi, o in caso di possibile rischio di disseminazione in area intraaddominale di cisti idatidee.

We aimed to retrospectively analyze patients who underwent surgical treatment in our clinic for hydatid cysts in terms of the surgical methods implemented and their results.Archival records of the patients who underwent surgery for the treatment of hydatid cysts between 2007 and 2014 were analyzed retrospectively.The records of 425 patients who underwent surgery with varying ages of 16 to 88 years (mean: 44.5) were obtained. Among the patients, 33.9% (n=144) were male and 66.1% (n=281) were female. The most frequent symptoms were abdominal pain (46.4%) and dyspepsia (30.9%). About 79.5% of the patients had hydatid cysts in their livers, and 66.8% of these cysts were on the right lobe of the liver. Surgical intervention was performed on 513 cysts. The average diameter of these cysts was 8.3 cm. About 85.5% (n= 438) of the interventions implemented were partial cystectomy. Laparotomy was performed through the right subcostal incision on 81% (n=345) of the patients who underwent conventional surgery. The most frequently encountered complication was biliary fistula. The mortality rate was 0%.The results showed that most of the cases were uncomplicated isolated hepatic hydatid cysts frequently found on the right lobe of the liver. The most frequently implemented surgical procedure was partial cystectomy. This procedure was simple, fast and applicable for uncomplicated hepatic hydatid cysts.Hepatic hydatid cyst, Mortality, Partial cystectomy.

Aim: Perianal Fistula is the chronic stage of anorectal infection and is characterized by intermittent pain associated with purulent drainage or abscess formation followed by spontaneous abscess drainage. In this study, we aimed to investigate the recurrence rates according to the type of surgery performed for patients who underwent surgery for perianal fistula. Material and Methods: The records of 201 patients who underwent surgery in our hospital between the dates of January 2015 and May 2018 were analyzed retrospectively. In addition to the demographic information of the patients included in the study, their complaints, localization of the fistula, type of surgery performed, length of stay in the hospital, postoperative complications, and imaging methods were recorded. Loose or incisional seton stitch, fistulotomy and fistulectomy were performed according to the localization and the type of fistula. The seton stitch method was applied to complex fistulas, and the fistulotomy and fistulectomy methods were applied to simple fistulas. Results: Of the patients included in the study, 178 (88.5%) were males and 23 (11.5%) were females. Their mean age was 41.65 (27-77) years. Of the patients, 136 (67.7%) had complex and 65 (32.3%) had simple fistulas. The fistulas were intersphincteric in 90 (44,8%) patients, transsphincteric in 51 (25.4%) patients, suprasphincteric in 33 (16.4%) patients, and extrasphincteric in 27 (13.4%) patients. Conclusion: The complications and recurrence rates were found to be low postoperatively in all types of surgical procedures performed in our clinic. No statistically significant difference was found between the type of surgery and the recurrence rate.

Aim: Laparoscopic cholecystectomy is a widely performed technique worldwide. The use of laparoscopic threaded holders for this is routine but takes a lot of time and may tear the gallbladder. There are no wide-mouthed and short endoscopic instruments that can be used for removing the gallbladder without perforation. We look at gallbladder removal methods that are quick and do not involve damage at the end of laparoscopic cholecystectomy.Materials and Methods: This prospective study was conducted on 30 laparoscopic cholecystectomy patients divided into two equal groups, one employing conventional laparoscopic cholecystectomy (CLC) and the other using a sponge holding forceps (SHF) (n=15, both groups) to demonstrate the effectiveness of our management. In the CLC group, the number of male patients was two (13.3 %) and female patients 13 (86.7%); in the SHF group, number of male patients was six (40%) and female patients nine (60%). When we compared the results statistically for bladder removal time, total operation time, gallbladder perforation, and wound infection, the p values were found to be 0.016, 0.182, 0.169, and 1, respectively.Results: Thirty patients were analyzed. The SHF group showed significantly better results than the CLC group for gallbladder removal time and better although not significantly better results for perforation of bladder, while there was no difference between the groups for wound infection.Conclusion: Removing the gallbladder with an SHF significantly shortens the duration of removal and also reduces perforations as compared to CLC.Keywords: Laparoscopic Cholecystectomy; Forceps; Techniques.

Giris ve Amac: Endoskopi unitemizde ust gastrointestinal endoskopi uygulanan hastalarda ozofagus, mide, proksimal duodenum hastaliklari sikliginin retrospektif olarak arastirilmasi amaclanmistir. Gerec ve Yontem: Karabuk Universitesi Egitim ve Arastirma Hastanesi endoskopi unitesinde 2006-2012 yillari arasinda ust gastrointestinal sistem endoskopi yapilarak video arsivleme sistemine kaydedilen hastalarin yasi, cinsiyeti ve endoskopi raporlarindaki ozofagus, mide ve proksimal duodenum hastaliklari belirlendi. Bulgular: Ust gastrointestinal sistem sikayetleri nedeniyle 7703 hastaya endoskopik islem yapildi. Hastalarin 4578’i (%59,4) kadin, 3125’i (%40,6) erkekti. Kadinlarin yas araligi 18-83 (ortalama: 57.8), erkeklerin 20-93 (ortalama: 54.3) yas idi. Hastalarin 565’inin endoskopisinde patoloji tespit edilmedi. Olgularin %99.2’sinde ust gastrointestinal sistem endoskopisi topikal farenks aneztezisi ile yapildi. Ust gastrointestinal sistem endoskopisi uygulanan olgularda mide kanseri orani %1.4 bulundu. Yapilan endoskopik islemler sirasinda komplikasyon ve mortalite orani %0 idi. Sonuc: Ozofagogastroduodenoskopi, ust gastrointestinal sistem hastaliklarin teshisinde hala altin standarttir, topikal farenks aneztezisi ile kolaylikla uygulanabilir, mortalite ve komplikasyon orani oldukca dusuk, tanisal bir islemdir.

Aim: Acute appendicitis is the most common cause of abdominal pain resulting in surgery. This study aims to investigate the efficiency of Alvarado Score (AS) in diagnosis of acute appendicitis. Materials and Method: The files of 185 patients operated due to acute appendicitis between January 2013 and February 2015 were retrospectively examined. The Alvarado Scores of the patients were calculated. The patients were divided into 2 groups as

IntroductionForeign body ingestion has been a fundamental subject in the area of emergency surgery. The problem is encountered across all age groups; however, it is more common in the pediatric age group. Foreign body ingestion is rare in adults and usually occurs accidentally or in those with psychiatric problems, behavioral disorders, emotional disturbance, mental retardation, or impaired judgment caused by alcohol use.Presentation of caseA 33-year-old Caucasian man with chronic schizophrenia was admitted to the emergency department with signs of upper gastrointestinal discomfort as a result of ingestion of a lower dental prosthesis. An abdominal X-ray showed the swallowed dental prosthesis in front of the vertebral column. A technique comprising gastrotomy and duodenal kocherization was used to remove the dental prosthesis; the prosthesis could not be removed endoscopically due to its fixed position on the duodenal wall.DiscussionSurgery of the duodenum is difficult and carries high mortality and morbidity. Therefore, endoscopy should be the first choice for patients in whom a foreign object is demonstrated to be fixed in the duodenum. In cases where endoscopic extraction fails, surgery should be considered. During surgery, foreign bodies should be removed, paying meticulous attention not to harm the integrity of the duodenum.ConclusionThe technique presented in this study was performed successfully without any injury to the duodenum.