Akut karinla basvu?ran geri?atri?k hastalarda cerrahi? tedavi? ve sonuçlari

The aim of this study was to evaluate the factors affecting the outcome of geriatric patients presenting with acute abdomen. Eighty patients who underwent surgery with the diagnosis of acute abdomen were analysed retrospectively. The effects of age, sex, American Society of Anaesthesiology (ASA) class, preexisting disease, admission time after the onset of the symptoms, followup interval before the operation on morbidity, mortality and length of hospital stay were evaluated. Male/female ratio was 1.3, mean age was 72.4. Main causes were biliary system disease (38.8%), intestinal obstruction (31.3%), peptic ulcer perforation (12.5%) and acute appendicitis (8.7%). Median ASA class was 3 and 76.3% of the patients had at least one preexisting disease. ASA class was significantly effective on mortality and complication rate. Shock at the admission, malignity, male sex, mechanical ventilation and transfusion were the factors that have statistically significant effect on mortality. 58.8% of the patients had complications. Complications were significantly related to mortality, prolonged intensive care unit (ICU) stay and hospital stay. Male sex, ASA class, malign diseases, peptic ulcer perforation, colonic obstruction, shock, mechanical ventilation and blood transfusion were the factors affecting mortality in the elderly. Preexisting diseases other than malignity, period between the onset of symptoms and admission, follow-up time and operation time did not influence mortality. Complications and ASA classification were associated with a prolonged ICU and hospital stay

The Effects of Thymoquinone (Kalonji) on Abdominal Adhesion in Experimental Abdominal Adhesive Model

The aim of this study was to investigate the effects of thymoquinone on abdominal adhesion development in an experimental abdominal adhesion model. Forty-five female Wistar albino rats weighing 260–280 g were used in the study. The rats were randomized into 3 even groups. Control, serum physiological (SP), and thymoquinone (TQ) groups were formed. In the experimental abdominal adhesion model, caecum serosa was brushed until the petechial hemorrhages were seen. No additional procedures were performed in the control group except surgery protocol. SP was injected over the caecum in the SP group. In the thymoquinone group, the abdomen was closed after the application of prepared thymoquinone solution on the caecum surface. On the 21st day, tissue samples from sacrificed rats were examined macroscopically and microscopically, and statistically evaluated. There was a statistically significant difference between the control group and the thymoquinone group in the microscopic evaluation (p = 0.006). However, there was no statistically significant difference between SP group and control group, and between thymoquinone group and SP group. Macroscopic evaluation revealed a statistically significant difference between the thymoquinone group and the control group, and between the thymoquinone group and the SP group (p = 0.009, p = 0.027, respectively). In the microscopic and macroscopic evaluation, it was observed that thymoquinone had a decreasing effect on postoperative adhesions. We think that this effect of thymoquinone is due to its anti-inflammatory and antioxidant properties. However, the available data are not sufficient for this effect to be used in medical treatment. Further studies are needed in the future. © 2019, Association of Surgeons of India