Cerrahi Olarak Çıkarılan Özofagusta Dev Kemik Parçası

Gastrointestinal yabancı cisimlerin çoğu gastrointestinal sisteme zarar vermeden spontan geçmektedir. Ancak olguların %10-20’sinde gastrointestinal trakta takılabilmektedir. Bunların çoğu da özofagusta görülmektedir. Çocuklarda daha çok metal para, pil gibi mad- deler sık görülürken erişkinlerde et, kemik gibi gıdalar daha sık görülmektedir. Erişkinlerde morbidite ve mortalite daha yüksektir. Kemik, protez gibi sivri kenarlı yabancı cisimler perforasyon riski nedeni ile özellik arz etmektedir. Keskin sivri yabancı cisimlerde tedavi planlaması önemlidir. Bu yazıda özofagus girişinde sıkışmış ve ancak cerrahi tedavi ile çıkarılabilmiş dev kemik parçası olgusu sunulmuştu

Konya il merkezinde hizmet veren iki hastanenin tiroidektomi endikasyonlarının değerlendirilmesi

Amaç: Konya İl Merkezindeki iki farklı hastanenin Tiroidektomi uygulamalarını, endikasyonları bakımından karşılaştırmayı amaçladık. Yöntem: Ocak 2007 ile Aralık 2008 tarihleri arasında Konya’da farklı iki A ve B hastaneleri hastanede tiroidektomi ameliyatı geçiren hastaların dosyaları retrospektif olarak incelendi. Hastaların yaş, cins, tiroit fonksiyon testleri TFT , tiroit ultrasonografi USG bulguları, yapıldıysa tiroit ince iğne aspirasyon biyopsileri İİAB raporları ve tiroit ameliyat raporları bulunanlar çalışmaya alındı. İki hastanenin tiroidektomi ameliyatı yapılan hastaları ameliyat endikasyonları ve malignite tespiti bakımından birbiriyle karşılaştırıldı. Bulgular: İki yıllık süre içinde A hastanesinde 60, B hastanesinde 223 hastaya tiroidektomi ameliyatı yapılmıştı. Hastaların yaş ortalaması sırasıyla 53 , 49 idi. İki guruptaki vakalar cins, yaş ve dominant nodül çapları bakımından benzerdi. A hastanesinde tiroidektomi kararında klinik, USG ve İİAB ile belirlenen malignite riski öne çıkarken, B hastanesinde ise palpable nodül varlığı, USG’ de nodülün 1 cm den büyük olması ve USG ile malignite şüphesi tespit edilmiş olması yeterli idi. A hastanesinde basit nodüler guatrlı 53 hastanın 19 unda % 35.8 İİAB yapılmıştı. B hastanesinde hiç bir hastaya İİAB yapılmamıştı. A hastanesinde genel malignite oranı % 25, B hastanesinde ise % 13 idi p=0.028 . Sonuç: Nodüler guatrlarda, klinik, US ve İİAB’ nin birlikte kullanımı ile malignite riski daha iyi belirlenebilir. Ameliyat veya takip kararı buna göre verilmelidi

Effect of an Information Video before Thyroid Biopsy on Patients' Anxiety

Aim To investigate the effects of video-based information on the anxiety of patients who underwent ultrasound-guided thyroid fine-needle aspiration biopsy. Methods Fifty consecutive patients who underwent thyroid fine needle aspiration biopsy were included in the study prospectively. Patients were divided into two groups before the biopsy. 25 patients in Group 1 received only written information about thyroid biopsy. In Group 2, 25 patients received video-based information along with written information. Baseline anxiety of all the patients was evaluated prior to procedure using STAI-S and STAI-T questionnaires. After the written information was provided to the patients in group 1, the STAI-S questionnaire was repeated. In the same way, group 2 patients were asked to repeat the STAI-S questionnaire after written and video-based information were provided. All patients were asked to evaluate pain during biopsy using visual analog scale (VAS). Results There was no significant difference between the groups in terms of age and gender. Although the VAS score was lower in group 2, there was no statistically significant difference between the two groups. When the groups were compared in terms of basal anxiety scores, STAI-T was similar in both groups (p = 0.708). Although STAI-S values were similar in pre and post-information patients in Group 1, the STAI-S values in group 2 were statistically significantly decreased. Conclusion The video based information provided prior to thyroid biopsy draws the attention as an effective and easy to apply method to decrease the anxiety of the patients

Zenker's Diverticulum: A Case Report

Zenker's diverticulum is a rare pulsion diverticulum, the juntion of esophageal -hypopharynx. All patients need to be treated with symptomatic and large diverticulum. In recent years, successful results have been reported with endoscopic treatment. However, myotomi and diverticulectomy seems to be the best method of treatment. In this study, a case of right-sided a Zenker diverticulum and treatment were examined with data from the literature. [Cukurova Med J 2013; 38(3.000): 475-478

Breast Cancer During Pregnancy: Case Report

During pregnancy breast cancer is rarely seen. In this case, when the patient was being operated for the right breast cancer which was diagnosed in the first exam, a left breast cancer was also detected in the operation. When the patient analysed retrospectively, lesion in the left breast could not detected because of the lactation period. Consequently,pregnancy patients must be re-examined after the lactation period to avoid any possible mistakes. [Cukurova Med J 2013; 38(3.000): 492-494

Randomized prospective comparison of long-term results of onlay and sublay mesh repair techniques for incisional hernia

Objective: Incisional hernia is a significant problem after laparotomy, and there is still no consensus on an idealtreatment method. The aim of this study was to compare the results of onlay and sublay mesh repair techniques.Material and Methods: In this randomized prospective trial, 100 patients were divided into two groups: onlay andsublay groups. Recurrences were evaluated by performing a physical examination.Results: The median follow-up was 37.1 (26.6 to 46.5) months. In the onlay group, the mean operation time wassignificantly shorter. However, in terms of postoperative pain and wound complications, the sublay group had significantlybetter results. The recurrence rates were found to be similar in both groups (6% in the onlay group and2% in the sublay group).Conclusion: In the treatment of incisional hernia, sublay mesh repair is superior to onlay mesh repair in terms ofpostoperative pain and wound complications. Both techniques have similar recurrence rates

Zinc oxide, lidocaine, hot water, and lateral internal sphincterotomy for fissure-in-ano: Randomized controlled study

Aim: Aim of this study is to compare the effect of zinc oxide pomade, lidocaine pomade, hot water sitting bath and lateral internal sphincterotomy for treatment of chronic anal fissure in terms of healing and complications.Material and Methods: One hundred and forty five patients who were diagnosed with chronic anal fissure between May 2011 and September 2012 at our clinic were enrolled for this prospective randomized trial. All cases were randomized into four groups. Group 1: The patients would apply 15% of zinc oxide pomade twice a day after the 10 minutes of hot water sitting bath. Group 2: The patients would apply 5% of lidocaine pomade twice a day after the 10 minutes of hot water sitting bath. Group 3: The patients would make only 10 minutes of hot water sitting bath twice a day.Group 4: Lateral internal sphincterotomy was performed to the patients.Healing rates, recurrences,changes in symptoms after the treatment and complications were recorded.Results: There were not any difference within the groups in terms of age and gender. The healing in the Sphincterotomy group significantly much more when compared to the other groups at both the third and the sixth weeks(p0,001).The other groups were similar with the each other(p0,05).Conclusion: LIS is superior to zinc oxide, lidocaine or hot water applications. There was no difference between the non-operative treatments

Robotic versus laparoscopic surgery for mid or low rectal cancer in male patients after neoadjuvant chemoradiation therapy: comparison of short-term outcomes

The aim of our study was to compare short-term outcomes of robotic and laparoscopic sphincter-saving total mesorectal excision (TME) in male patients with mid-low rectal cancer (RC) after neadjuvant chemoradio-therapy (NCRT). The study was conducted as a retrospective review of a prospectively maintained database, and we analyzed 14 robotic and 65 laparoscopic sphincter saving TME (R-TME and L-TME, respectively) performed by one surgeon between 2005 and 2013. Patient characteristics, perioperative recovery, postoperative complications and and pathology results were compared between the two groups. The patient characteristics did not differ significantly between the two groups. Median operating time was longer in the R-TME than in the L-TME group (182 min versus 140 min). Only two conversions occurred in the L-TME group. No difference was found between groups regarding perioperative recovery and postoperative complication rates. The median number of harvested lymph nodes was higher in the RTME than in the L-TME group (32 versus 23, p = 0.008). The median circumferential margin (CRM) was 10 mm in the R-TME group, 6.5 mm in the L-TME group (p = 0.047. The median distal resection margin (DRM) was 27.5 mm in the R-TME, 15 mm in the L-TME group (p = 0.014). Macroscopic grading of the specimen in the R-TME group was complete in all patients. In the L-TME group, grading was complete in 52 (80 %) and incomplete in 13 (20 %) cases (p = 0.109). R-TME is a safe and feasible procedure that facilitates performing of TME in male patients with midlow RC after NCRT