Laparoscopic cholecystectomy technique in a patient with situs inversus totalis

Situs inversus totalis is a rare congenital anomaly. It mayproduce difficulties in diagnosis and therapeutic managementof abdominal pathology, particularly in laparoscopicsurgery because of the mirror-image anatomy. Here wereport a case of situs inversus totalis and cholelithiasissuccessfully treated laparoscopically.Key words: Situs inversus totalis, cholelithiasis, laparoscopiccholecystectom

Sigmoid Diverticulitis: Our Experiences with 13 Patients

Objective: We aimed to present our treatment approach and results of the treatment in patients with the diagnosis of sigmoid diverticulitis. Material and Methods: In this study, we evaluated patients who presented to the emergency unit between March 2009 and February 2010 and have been diagnosed with sigmoid diverticulitis. The data were prospectively collected and retrospectively analyzed. Our patients were classified and staged according to Hinchey’s classification system. The results of the treatment, complication rates, and duration of hospitalization were presented in the light of the literature. Results: Thirteen patients (9 males, 4 females) with a mean age of 52 years and median age of 58 (35-58 years) were diagnosed with sigmoid diverticulitis. Five patients underwent laparotomy (Hinchey III-IV), while Hartmann’s procedure was carried out in 4 patients and resection and primer anastomosis was performed in 1 patient. Eight patients who were classified as Hinchey I-II (diverticulitis-abscess) were followed up with medical treatment. The mean duration of hospitalization was 8.6 (4-21 days) and 17.4 (10-27 days) days in Hinchey I-II and III-IV groups, respectively. All patients in the laparotomy group developed at least one complication. Conclusion: Hinchey stage III-IV sigmoid diverticulitis requires laparotomy. Complication rates are higher and duration of hospitalization is longer in patients with Hinchey stage III-IV when compared to those with Hinchey I-II. We conclude that Hinchey stage I-II diverticulitis can be successfully managed with medical treatment. (The Me di cal Bul le tin of Ha se ki 2012; 50: 21-4

Stapler hemoroidopeksi: 65 olguda klinik sonuçlar

Amaç: Hemoroidal hastalık sebebiyle stapler hemoroidopeksi uyguladığımız hastalarımızın sonuçlarını sunmak ve literatür eşliğinde tartışmak. Gereç ve yöntem: Ocak 2009- Nisan 2011 tarihleri arasında 3-4. derece hemoroidal hastalık tanısı konan ve Longo yöntemiyle hemoroidopeksi uygulanan hastalar çalışmaya dahil edildi. Tüm veriler prospektif toplanıp retrospektif olarak incelendi. Hastalar; demografik özellikler, başvuru sırasındaki şikayetler, ameliyat sonrası komplikasyonlar açısından değerlendirildi. Bulgular: Toplam 65 hastadan 43 (% 66)’ü erkek, 22 (% 34)’si kadındı. Ortalama yaş 38±11.9 (23-76) yıl idi. Olguların en sık başvuru şikayetleri sıklık sırasına göre kanama, şişlik, kaşıntı, ağrı, kabızlık şeklinde idi. Elli sekiz (% 89) hastada 3. derece, 7 (%11) hastada 4. derece hemoroid mevcuttu. Ortalama ameliyat süresi 37.6±8.1(24-55) dakika, ortalama yatış süresi 27±7.8 (20-76) saat idi. Toplam 17 (% 26) hastada bir ya da daha fazla komplikasyon gelişti. Komplikasyon olarak 13 (% 20) hastada kanama, 6 (%9)’sında ağrı, 2 (% 3)’sinde idrar retansiyonu, 3 (% 5)’ünde tenezm, 1 (% 2)‘inde eksternal hemoroidal tromboz, 4 (%6)’ünde ise nüks saptandı. Sonuç: Stapler hemoroidopekside ağrının az ve iyileşme sürecinin hızlı olması nedeniyle hastalar günlük aktivitelerine erken dönebilmektedirler. Bu yöntemin başarısında uygun hasta seçimi ve tekniğin doğru uygulanmasının önemli olduğunu düşünmekteyiz. Özellikle 3.derece hemoroidal hastalıkta Longo tekniği klasik yöntemlere alternatif olarak önerilebilir.Objectives: To present results of our patients underwent stapled hemorrhoidopexy due to hemorrhoidal disease and discuss in accompaniment with the literature. Material and methods: The patients, who diagnosed by 3rd-4th degree hemorrhoidal disease and underwent hemorrhoidopexy with Longo method between January, 2009 and April, 2011, were included. All data were prospectively collected and retrospectively examined. The patients were evaluated in terms of demographic properties, complaints on admission, and postoperative complications. Results: Forty-three (66%) of 65 patients were male, 22 (34%) were female. The mean age was 38±11.9 (range:23-76) years. The most frequent complaints were bleeding, swelling, itching, pain, constipation respectively. Third degree hemorrhoid was present in fifty-eight (89%) patients, 4th degree hemorrhoid was in 7 (11%) patients. The mean operation duration was 37.6±8.1(range:24-55) minutes, the mean hospitalization duration was 27±7.8 (range:20-76) hours. One or more complication developed in total 17 (26%) patients. As complication, bleeding was determined in 13 (20%) patients, pain was in 6 (9%), urinary retention was in 2 (3%), tenesmus was in 3 (5%), external hemorrhoidal thrombosis was in 1 (2%), and recurrence was in 4 (6%). Conclusions: The patients can return their daily activities early with stapled hemorrhoidopexy because of less pain and quick recovery period. We consider that appropriate patient selection and proper application of the technique are important in the success of this method. Particularly in 3rd degree hemorrhoidal disease, Longo’s technique can be suggested as an alternative to classical methods

Laparoscopic cholecystectomy during abdominoplasty: A case report

Giriş: Abdominal gevşeklik, rektus diastazı ve kolelitiyazis tanısı koyup aynı seansta trokar giriş yeri izi olmadan yapmış olduğumuz laparoskopik kolesistektomi ve abdominoplasti olgusunu sunmayı amaçladık. Olgu: 58 yaşında kadın hasta karında sarkma nedeniyle plastik cerrahi polikliniğine müracaat etti. Hastaya diastazis rekti tanısı kondu. Patolojinin düzeltilmesi amacı ile hastaya diastazis rekti tamiri ile birlikte abdominoplasti önerildi. Aynı zamanda mide bulantısı, yemeklerden sonra şişkinlik, sırt ağrısı şikayetlerinin de olması üzerine genel cerrahi konsültasyonu istendi. Yapılan batın ultrasonografisinde safra kesesinde en büyüğü 15 mm olan multipl kalküller saptandı. Aynı seansta kolesistektomi ve abdominoplasti planlandı. Ameliyat sonrası takiplerde komplikasyon gelişmeyen hasta postoperatif 4. Günde şifa ile taburcu edildi. Tartışma: Abdominoplasti gibi operasyonlar sonrasında batında oluşabilecek cerrahi gerektiren patolojiler hasta kozmetiğini çok ciddi derecede etkileyebilecektir. Bu açıdan abdominoplasti planlanan hastalarda ek şikayetler varsa ilave konsultasyon ve tetkikler istenmelidir.Introduction: We aimed to present the phenomenon of laparoscopic cholecystectomy and abdominoplasty which we diagnosed at the same period the abdominal laxation, diastase of rectum and cholelithiasis without leaving any trocar entrance mark. Case: A 58 year old female patient has consulted to the polyclinic of plastic surgery due to prolapsus on the abdominal region. Gall bladder multiplestones were ascertained through abdominal ultrasonograpy. On request and to provide minimal cosmetic failure to the patient, cholecystectomy and abdominoplasty is performed at the same session. Discussion: Patients with abdominal pathologies that may occur after operations requiring surgery such as abdominoplasty very serious impact on cosmetics. Concordantly, we strongly suggest to take abdominal USG, even if there is no additional complaints especially before the plastic surgery operations and abdominoplasty, for ascertain the existent patologies

Lipid peroxidation and transforming growth factor-beta 1 levels in gastric cancer at pathologic stages

WOS: 000315506200009PubMed: 25207013Objective: High levels of TGF-beta 1 and enhanced TGF-beta 1 receptor signaling are related to the pathology of gastric cancer. This effect is caused by oxidative stress and lipid peroxidation products. the aim of this study was to investigate the levels of TGF-beta 1 and lipid peroxidation products in gastric cancer patients and their correlation with pathologic stage. Material and Methods: Lipid peroxidation products and TGF-beta 1 levels were studied in the serum samples of 50 gastric cancer patients and 18 control subjects. Results: HNE-protein adducts and TGF-beta 1 levels were significantly higher in T2, T3 and T4 gastric cancers than in either the T1 stage or controls (p<0.001). Pathologic stage was correlated with TGF-beta 1 levels (r=0.702, p<0.05). Conclusion: These markers production may contribute to tumor angiogenesis and aid in the prognosis of the gastric cancer

Lipid Peroxidation and Transforming Growth Factor 1 Levels In Gastric Cancer at Pathologic Stages

OBJECTIVE: High levels of TGF-β1 and enhanced TGF-β1 receptor signaling are related to the pathology of gastric cancer. This effect is caused by oxidative stress and lipid peroxidation products. The aim of this study was to investigate the levels of TGF-β1 and lipid peroxidation products in gastric cancer patients and their correlation with pathologic stage. MATERIAL AND METHODS: Lipid peroxidation products and TGF-β1 levels were studied in the serum samples of 50 gastric cancer patients and 18 control subjects. RESULTS: HNE-protein adducts and TGF-β1 levels were significantly higher in T2, T3 and T4 gastric cancers than in either the T1 stage or controls (p<0.001). Pathologic stage was correlated with TGF-β1 levels (r=0.702, p<0.05). CONCLUSION: These markers production may contribute to tumor angiogenesis and aid in the prognosis of the gastric cancer

Lipid Peroxidation and Transforming Growth Factor-β1 Levels in Gastric Cancer at Pathologic Stages

Objective: High levels of TGF-β1 and enhanced TGF-β1 receptor signaling are related to the pathology of gastric cancer. This effect is caused by oxidative stress and lipid peroxidation products. The aim of this study was to investigate the levels of TGF-β1 and lipid peroxidation products in gastric cancer patients and their correlation with pathologic stage. Material and Methods: Lipid peroxidation products and TGF-β1 levels were studied in the serum samples of 50 gastric cancer patients and 18 control subjects.Results: HNE-protein adducts and TGF-β1 levels were significantly higher in T2, T3 and T4 gastric cancers than in either the T1 stage or controls (p<0.001). Pathologic stage was correlated with TGF-β1 levels (r=0.702, p<0.05).Conclusion: These markers production may contribute to tumor angiogenesis and aid in the prognosis of the gastric cancer

Situs inversus totalis olgusunda laparoskopik kolesistektomi tekniği

Situs inversus totalis nadir bir kongenital anomalidir. Özellikle laparoskopik cerrahideki ayna görüntüsü nede- niyle bu durum abdominal patolojilerin tanı ve tedavisinde zorluğa neden olabilir. Biz bu yazıda situs inversus totalis ve kolelitiasis’i olan olgunun başarılı laparoskopik tedavi- sini sunmaktayız.Situs inversus totalis is a rare congenital anomaly. It may produce difficulties in diagnosis and therapeutic manage ment of abdominal pathology, particularly in laparoscopic surgery because of the mirror-image anatomy. Here we report a case of situs inversus totalis and cholelithiasis successfully treated laparoscopically

Heterotopic bone formation in colorectal carcinoma: A case report

Heterotopik kemik oluşumu (kemik metaplazisi) gastrointestinal sistemde nadir olarak görülür. Genellikle kolorektal benign veya malign epitelyal tümörler ve sıklıkla müsinöz adenokarsinom ile birliktelik gösterir. Gastrointestinal sistemde rektum en sık tutulan bölgedir. Kemik metaplazisinin patogenezi bilinmemekte fakat fibroblastların metaplazisi sonucu oluştuğu düşünülmektedir. Yetmiş üç yaşında erkek hastada gözlenen primer kolorektal adenokarsinomda heterotopik kemik oluşumu irdelenmiştir.Heterotopic bone formation (osseous metaplasia) is rarely seen in the gastrointestinal tract. It usually occurs in the colorectum in association with benign or malignant epithelial tumors, and most often with mucinous adenocarcinoma. The rectum is the most common location of ossification in the gastrointestinal tract. The pathogenesis of the heterotopic ossification is unknown, but it is probably the result of metaplasia of fibroblasts. We present a case of heterotopic bone formation in a primary rectal adenocarcinoma which was observed in a 73-year-old man

A rare cause of ileus: Gallstone ileus

Safra taşı ileusu nadir görülen bir hastalıktır. Mekanik obstruksiyonlu hastaların yaklaşık %1-4’ünü oluşturur. Teşhiste gecikmeden dolayı mortalite ve morbiditesi yüksektir. İnce barsakta tıkanmaya neden olan ve kesin tanısını ameliyat esnasında koyduğumuz safra taşı ileusu vakasını sunduk.Gallstone ileus is a rare disease, which is responsible for about 1-4% of all cases of mechanical obstruction. The morbidity and mortality rate remain very high, mainly because of delayed diagnosis. We report a case of gallstone ileus which caused intestinal obstruction which was definitively diagnosed on operation