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Öğe Early Hospital Readmission After Laparoscopic Cholecystectomy(Lippincott Williams & Wilkins, 2015) Simsek, Gurcan; Kartal, Adil; Sevinc, Baris; Tasci, Halil I.; Dogan, SerhatIntroduction:Laparoscopic cholecystectomy (LC) now has become the golden standard in the treatment of symptomatic gallstone cholecystitis.Aim:This retrospective analysis was conducted to clarify the reasons of early return to the hospital after discharge following a procedure like LC that has been frequently performed in daily surgical practice.Materials and Methods:This study covers 586 patients, who were called to follow-ups and thus evaluated, of 676 patients who had had LCs at Meram Medical School's General Surgery Clinic between January 2010 and May 2011.Findings:The rate of representation to the hospital during the early phase following LC was found to be 2.4% in our study. It was observed that 71% of returning patients had presented to the hospital with complaints of abdominal pain.Discussion:We believe that the rate of 2.4% early return to the hospital in our series is a bit high when all the complications are taken into consideration. This retrospective analysis, however, has shown that this rate can further be decreased by taking simple measures.Öğe Öğe Review of our ileal pouch experience in the light of literature(Turkish Surgical Assoc, 2015) Cakir, Murat; Dogan, Serhat; Kucukkartallar, Tevfik; Tekin, Ahmet; Tekin, SakirObjective: Retrospective proctocolectomy is a distinguished, sphincter saving treatment used for the treatment of ulcerative colitis and FAP disease. We aimed to evaluate ileal pouch interventions performed at our clinic and their results in the light of literature. Material and Methods: Medical records of 35 restorative proctocolectomy and J pouch ileo-anal anastomosis surgeries performed at Necmettin Erbakan University, Meram School of Medicine between the years 2006-2013 were retrospectively examined. The patients were assessed according to their age, gender, length of hospital stay, diagnosis, follow-up duration and pouch-related complications. All patients were contacted by phone and they were scheduled for controls at the outpatient clinic. Results: Nineteen patients were male (54%) and 16 were female (46%). Their mean age was 45 years (21-74). The mean length of hospital stay was 11 (5-20) days. Twenty two (63%) patients were operated on due to FAP, 12 (34%) due to synchronous rectum cancer and colon tumor or polyp, and one (3%) due to ulcerative colitis. All patients received J pouch and protective ileostomy. After the closure of ileostomy, two cases were identified to have J pouch fistulas. The patients were followed up for 6 months to 7 years. They were contacted by phone and they were questioned about their active complaints, number of defecations, urinary and sexual dysfunctions. It was identified that they had 5 (3-8) defecations per day on average and that 4 (11%) cases had one nocturnal defecation. No pouchitis were identified in the follow-up endoscopic examinations. Conclusion: Restorative proctocolectomy and ileo-anal anastomosis technique is a surgical procedure that can be performed with low rates of morbidity and mortality, including the elderly.Öğe SURGICAL TREATMENT OF PHYLLODES TUMORS OF THE BREAST: A SINGLE CENTER EXPERIENCE(Aves, 2013) Aksoy, Faruk; Gundes, Ebubekir; Vatansev, Celalettin; Emlik, Ganime Dilek; Dogan, SerhatObjective: Phyllodes tumor of the breast is a rare fibroepithelial tumor. In this study, our aim is to present the clinicopathological characteristics of our patients diagnosed with phyllodes tumor of the breast and our treatment approach to the cases. Materials and Methods: The medical records of a total of 9 patients who had been treated at our clinic between 2003 and 2011 for phyllodes tumor were analyzed retrospectively. Results: The median age of the patients was 38 (20-70) years. The presenting complaint of all patients was a palpable mass in the breast. Six of the patients were diagnosed by tru-cut biopsy, two were diagnosed through excisional biopsy, and one was diagnosed through fine-needle aspiration biopsy (FNAB). Median tumor size was 9.3 (4-20) cm. Local excision was performed on all but two patients so as to have the surgical border negative and no adjuvant additional treatment was initiated. Mastectomy was performed for one of the two patients and modified radical mastectomy was performed for the other. The follow-up period of the patients was an average of 43 (5-95) months. No breast recurrences were seen during the follow-up period. Conclusion: Pre-operative diagnosis is important for these cases in order to determine the surgical approach. It is difficult to differentiate these tumors from fibroadenoma by ultrasonography and mammography. It is possible to diagnose patients through tissue biopsy. In conclusion, a surgical approach with negative margins for all patients should be taken into consideration since phyllodes tumors are generally benign both clinically and pathologically.
