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Öğe Congenital Transmesenteric Hernia Without Bowel Strangulation in a Young Adult(Galenos Yayincilik, 2018) Kaya, Feridun; Kafadar, Mehmet Tolga; Gök, Mehmet Ali; Kısmet, Kemal; Ertaş, ErtuğrulCongenital internal hernia is a rare cause of bowel obstruction in adults and often presents with complications. A high index of suspicion, occasionally aided by appropriate radiological imaging, should lead to early surgical intervention and thus reduce morbidity and mortality. In this article, we describe a case of a 27-year-old man who presented with periumbilical and right lower quadrant pain. The patient who had undergone surgery for appendicitis was found to have an incidental mesenteric defect with herniating 30 cm-long small bowel segment on exploration. The mesenteric defect was repaired and the herniated bowel segment was reduced to prevent volvulus. The patient made an uneventful recovery.Öğe THE EFFECT OF CALCIUM DOBESILATE ON THE PREVENTION OF INTRAABDOMINAL ADHESIONS: AN EXPERIMENTAL STUDY(2020) Kılıçoğlu, Bülent; Kısmet, Kemal; Hücümenoğlu, Sema; Küçük, Berkay; Ertaş, Ertuğrul; Aydın, Osman; Ünal, YılmazAIM: It was aimed to demonstrate the efficacy of Calcium Dobesilate (Ca-Dob) in preventing postoperative intra-abdominal adhesion formation in an experimental cecal abrasion model. MATERIALS AND METHODS: Thirty female Wistar Albino rats used in the study were randomized into 3 groups. Laparotomy was performed in the sham group, the cecum was removed from the abdomen and replaced without any further processing. In the control group, after cecal abrasion and peritoneal resection no processing was applied. In the Ca-Dob group, abdomen was closed after cecal abrasion and peritoneal resection, then 100 mg/kg/day Ca-Dob was administered orogastrically for 21 days only this group. All rats were sacrificed on 21st day. The adhesions were evaluated. Tissue samples taken from the peritoneum and intestines were sent for histopathological examination to determine the degree of inflammation and fibrosis. Tissue and blood samples were taken for biochemical analysis. RESULTS: Statistically, inflammation, microscopic adhesions and fibrosis scores were found to be significantly lower in the Ca-Dob administered rats compared to the control group (p < 0.05). Tissue Malondialdehyde (MDA), Fluorescent Oxidation Products (FOP) and Total Oxidation Status (TOS) values were found to be significantly lower statistically compared to the control group (p = 0.001). Tissue Total Sulfhydryl (Total SH) values were found to be statistically significantly higher (p < 0.05) in the sham group compared with the control group. Finally; serum MDA and serum TOS values in the CaDob group, was statistically significantly lower (p < 0.05) compared to control group. CONCLUSION: Ca-Dob was found to be efficacious in preventing the formation of adhesions. In addition to the demonstrated antiinflammatory effect histopathologically, the effect of antioxidant effect demonstrated biochemically was concluded to participate to the adhesion preventive efficacy of Ca-Dob. Nevertheless, there is a need for further studies to assess the precise mechanism of the preventing of abdominal adhesions of Ca-Dob.Öğe Fibrin Glue'in İntraabdominal Adezyon Oluşturma Potansiyeli: Deneysel Çalışma(2017) Soylu, Veysel Garani; Kaptanoğlu, Buğra; Akgün, Yusuf Akif; Tuncal, Salih; Barlas, Aziz Mutlu; Celepli, Pınar; Ertaş, ErtuğrulAMAÇ: Çalışmamızda abdominal operasyon yapılan sıçanlarda, hemostatik ajan olarak kullanılan Fibrin Glue(Tisseel)'nin operasyon sonrası intraabdominal adezyon oluşturma potansiyelini değerlendirdik.GEREÇ VE YÖNTEMLER: SB Ankara Eğitim ve Araştırma Hastanesi Genel Cerrahi Kliniği'nde planlanan çalışmada, 30 (otuz) adet Wistar Albino cinsi dişi rat kullanıldı. Ratlar randomize olarak, 10'ar ratdan oluşan 3 gruba ayrıldı. Sham grubuna; laparotomi çekumun dışarı alınması ve yeniden batına gönderilmesi işlemi uygulandı.Kontrol grubuna; çekal abrazyon karşı peritondan 1x1 cm eksizyon işlemi, Fibrin Glue grubuna ise; çekal abrazyon karşı peritondan 1x1 cm eksizyon ve çekum üzerine Figrin Glue uygulaması yapıldı. Postoperatif 21. Günde ratlar yüksek doz anestezik verilerek sakrifiye edildi. Laparotomi esnasında adezyon skorlaması; yaygınlık, görünüm ve uygulanan kuvvete karşı direncin temel alındığı adezyon skorlaması; gruplar hakkında bilgisi olmayan bir cerrahi ekip tarafından; yaygınlığın, görünümün ve uygulanan kuvvete karşı direncin temel olarak alındığı bir yöntemle yapıldı. Periton ve çekumdan alınan doku örnekleri histopatolojik incelemeye gönderildi.BULGULAR: Adezyon skoru değerlendirmesinde, tüm gruplar Kruskal -Wallis Testi ile genel karşılaştırıldığında; Sham, Kontrol ve Fibrin Glue grupları arasında istatistiksel anlamlı fark bulundu (p 0.003). Mann-Whitney Testi ile yapılan ikili karşılaştırmalarda; Sham ve Kontrol grupları arasında istatistiksel anlamlı fark olduğu (p 0.013), Sham ve Fibrin Glue grupları arasında da anlamlı fark olduğu görüldü (p 0.001). Ancak Kontrol ve Fibrin Glue grupları arasında anlamlı istatistiksel fark bulunmadı (p0.05). Fibrin Glue grubunun adezyon skor ortalaması, Kontrol grubundan daha yüksek idi. Histopatolojik değerlendirme sonuçları için tüm gruplar Kruskal-Wallis Testi ile genel karşılaştırıldığında; Sham, Kontrol ve Fibrin Glue grupları arasında inflamasyon ve fibrozis açısından anlamlı fark olduğu (Fibrozis için p0.001, inflamasyon için p0.014) tespit edildi. Mann-Whitney Testi ile ikili grup karşılaştırılmalarında; Sham ve Kontrol grubu arasında anlamlı fark görüldü (inflamasyon için p0.022, fibrozis için p0.001), Sham ve Fibrin Glue grupları arasında da anlamlı fark görüldü( inflamasyon için p0.006, fibrozis için p0.002). Kontrol ve Fibrin Glue grupları arasında anlamlı fark yoktu (p0.05). Ancak, Fibrin Glue grubundaki inflamasyon ve fibrozis skor ortalamaları Kontrol grubundaki değerlerden daha yüksek idi. SONUÇ: Fibrin Glue (Tisseel)'nun intraabdominal yapışıklık oluşturma potansiyeli deneysel olarak değerlendirilmiş, makroskobik ve mikroskobik olarak yapılan karşılaştırmalarda; Sham, Kontrol grubu ve Fibrin Glue (Tisseel) grupları arasında istatistiksel olarak anlamlı fark bulunmuştur. Ancak, insanlardaki abdominal cerrahilerde olası adezyon potansiyelinin değerlendirilebilmesi için denek sayısının fazla olduğu daha kapsamlı çalışmalara ihtiyaç olduğu kanaatindeyiz.Öğe Increased sister chromatid exchanges in patients with gastrointestinal cancers and in their first-degree relatives(TIP ARASTIRMALARI DERNEGI, 2014) Turgut, Taner; Yaşar, Mehmet; Yaykaşlı, Kürşat Oğuz; Ertaş, Ertuğrul; Sılan, FatmaGastrointestinal Cancers (GICs) are the most important causes of mortality and morbidity in industrialized world. Sister chromatid exchange (SCE), as an index of chromosomal instability, involves cancer. The aim of this study is to determine whether SCE frequency is a heritable factor for GIC or not. The study groups consisted of 15 gastrointestinal carcinoma patients, 13 patient relatives and 15 healthy subjects as the control group. After collection of 2 ml peripheral blood, lymphocytes were cultured for 3 days and sister chromatid exchange (SCE), mitotic index, and replication index were analyzed. SCE was significantly increased (p<0.01) in patients (16.06±22.37) and in their relatives (5.23±2.64) compared with controls (3.51±1.58). There was no significant difference between patients' relatives and control group in terms of the incidence of SCE frequency. Mitotic index was significantly decreased (p<0.05, p<0.01) in patients (5.4±3.13) compared with healthy relatives (7.15±2.15) and controls (9.00±2.26). Replication index was also significantly lower (p<0.01) in patients (1.39±0.35) and in their relatives (1.7±0.21) compared with controls (2.04±1.13). The results of this study indicate that SCE is a heritable factor for GICs. Increased SCE reflects genomic instability, which is an important factor in carcinogenesis. Although the most putative factors causing genomic instability are epigenetics marks, further studies in combination with epigenetic modifications are needed using more subjects.Öğe Volvulated paraoesophageal gastric herniation with perforation into bursa omentalis: Report of a case(Acta Medical Belgica, 2006) Aydın, Mesut; Yaşar, Mehmet; Aslaner, Arif; Yazıcı, Burhan; Ertaş, ErtuğrulAlthough paraoesophageal hernias remain 30% asymptomatic, when diagnosed they have to be operated because of their fatal complications such as ischaemia, bleeding and perforation. The mortality rate increases to twenty times in emergency cases when it is compared with elective ones. Site of gastric perforation may be directed towards bursa omentalis as well as to peritoneal cavity. A case of a volvulated paraoesophageal gastric herniation ruptured to bursa omentalis is discussed with the review of the literature.
