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Öğe 3rd and 4th Degree Perineal Tears that Occurs During Vaginal Delivery(Marmara Univ, Inst Health Sciences, 2022) Senturk, Mustafa; Yavuz, YusufObjective: Perineal injuries are common in vaginal delivery. In this study, we aimed to investigate the factors affecting the degree of perineal injury and the effect of injury degree on incontinence. Methods: Fifteen patients, underwent sphincter repair by the general surgery unit, who had perineal tear during normal vaginal delivery between January 2018 and March 2019 in our hospital and were retrospectively evaluated. Those with grade 3a and 3b perineal tears were divided into 2 groups as group-1, and those with grade 3c and grade 4 perineal tears as group-2. Episiotomy type, fetal characteristics [head circumference and birth weight], early postoperative continence findings were compared in between groups. Results: The average age of the patients was 30 +/- 8.7 years. When the groups were compared, there was no significant superiority of episiotomy in terms of perinea! injury (p=0.07). 4 patients had 3a, 3 patients had 3b, 6 patients had 3c and 2 patients had fourth-degree perineal injuries. The average birth weight of the newborns was 3438 +/- 492 g, and the head circumference was 34.33 +/- 1.23 cm. There was no significant difference in incontinence between the groups (p=0.55). Conclusion: The treatment of anorectal injuries is surgery. The method of treatment varies according to the time elapsed between injury and intervention, fecal contamination, degree of injury, general condition of the patient, presence of accompanying injury, experience and preference of surgeon. We think that sphincter damage during delivery can be looked after successfully with early diagnosis and intervention before tissue edema develops.Öğe Acute appendicitis in pregnancy(Turkish Assoc Trauma Emergency Surgery, 2021) Yavuz, Yusuf; Senturk, Mustafa; Gumus, Tufan; Patmano, MehmetBACKGROUND: Acute appendicitis is the most common cause of non-obstetric acute abdomen in pregnant women. We examined the patients who were admitted to our emergency department with abdominal pain and diagnosed with acute appendicitis in the light of the literature. METHODS: Seventeen pregnant patients with acute appendicitis who were admitted to the emergency department of Sanliurfa Training and Research Hospital between the years of 2016-2019 were retrospectively analyzed using an electronic recording system. Our patients were evaluated concerning age, gestational week, clinical status, the operation performed, ultrasonography results, pathology results, presence of additional diseases, laboratory results and hospital stay length. RESULTS: The mean age of our patients was 25.5 (18-41) years. Three patients were in the first trimester (17.6%), 11 patients were in the second trimester (64.8%), and three patients were in the third trimester (17.6%) at the time of admission. All of our patients had abdominal pain. Acute appendicitis was detected in 11 patients, while it was not detected in six patients on the USG examination. Two patients having term delivery underwent caesarean section with concurrent appendectomy. The mean hospital stay length was 2.9 (2-5) days. Histopathologically, 13 (86.7%) of our operated patients were diagnosed with appendicitis. No additional problems were observed in the mothers and infants in the postoperative period. CONCLUSION: Acute appendicitis should be considered as a non-obstetric pathology in pregnant patients admitted to the emergency department with abdominal pain. We think that it is important for both maternal and infant health to examine this condition, which shows differences concerning clinical course and physical examination, with a meticulous and multidisciplinary approach.Öğe Acute appendicitis in pregnancy(Turkish Assoc Trauma Emergency Surgery, 2021) Yavuz, Yusuf; Senturk, Mustafa; Gumus, Tufan; Patmano, MehmetBACKGROUND: Acute appendicitis is the most common cause of non-obstetric acute abdomen in pregnant women. We examined the patients who were admitted to our emergency department with abdominal pain and diagnosed with acute appendicitis in the light of the literature. METHODS: Seventeen pregnant patients with acute appendicitis who were admitted to the emergency department of Sanliurfa Training and Research Hospital between the years of 2016-2019 were retrospectively analyzed using an electronic recording system. Our patients were evaluated concerning age, gestational week, clinical status, the operation performed, ultrasonography results, pathology results, presence of additional diseases, laboratory results and hospital stay length. RESULTS: The mean age of our patients was 25.5 (18-41) years. Three patients were in the first trimester (17.6%), 11 patients were in the second trimester (64.8%), and three patients were in the third trimester (17.6%) at the time of admission. All of our patients had abdominal pain. Acute appendicitis was detected in 11 patients, while it was not detected in six patients on the USG examination. Two patients having term delivery underwent caesarean section with concurrent appendectomy. The mean hospital stay length was 2.9 (2-5) days. Histopathologically, 13 (86.7%) of our operated patients were diagnosed with appendicitis. No additional problems were observed in the mothers and infants in the postoperative period. CONCLUSION: Acute appendicitis should be considered as a non-obstetric pathology in pregnant patients admitted to the emergency department with abdominal pain. We think that it is important for both maternal and infant health to examine this condition, which shows differences concerning clinical course and physical examination, with a meticulous and multidisciplinary approach.Öğe Gastrointestinal stromal tümörlerde prognozun belirlenmesinde preoperatif nötrofil lenfosit oranının etkisi(2015) Kargın, Süleyman; Çakır, Murat; Gündeş, Ebubekir; Yavuz, Yusuf; Esen, Hacı Hasan; İyisoy, Mehmet SinanAmaç: Gastrointestinal stromal tümörlerin lokal etkileriyle immünsupresyonda rol oynadığı düşünülmektedir. İnflamasyonla ilişkili bazı kanserlerde tedavi öncesi nötrofil lenfosit oranındaki artış kötü prognozun göstergesi olarak kabul edilmektedir. Çalışmamızın amacı gastrointestinal stromal tümör hastalarında kan nötrofil lenfosit oranı ile hastalığın prognozunu değerlendirmektir. Gereç ve Yöntemler: Kliniğimizde primer gastrointestinal stromal tümör nedeniyle cerrahi uygulanan 78 hastanın verileri retrospektif olarak değerlendirildi. Hastaların operasyon öncesi periferik kandan bakılan nötrofil lenfosit oranları belirlendi. Nötrofil lenfosit oranı ile tümör riski ve prognoz arasındaki ilişki karşılaştırıldı. Verilerin değerlendirilmesinde Pearson korelasyon analizi ve ANOVA Welch testi kullanıldı. Bulgular: Preoperatif nötrofil lenfosit oranındaki artış patolojik olarak yüksek riskli gastrointestinal stromal tümör gruplarında anlamlıydı (p0,05). Preoperatif nötrofil lenfosit oranı yüksek olan hastaların sağkalımları düşüktü (r- 0,32, p0,009). Ayrıca nötrofil lenfosit oranı artışı ile tümör mitotik aktivitesi artışı benzerdi (r-0,364, p0,025). Sonuç: Gastrointestinal stromal tümörlerde preoperatif nötrofil lenfosit oranı yüksek riskli tümörlerin belirlenmesinde ve kötü prognozun göstergesi olarak kullanılabilecek bir parametredir.Öğe The Investigation of 14 Appendiceal Mucocele Cases Encountered in 4850 Appendectomy Patients(Springer, 2021) Senturk, Mustafa; Yavuz, Yusuf; Alkan, Selman; Kafadar, Mehmet TolgaBackground Appendiceal mucocele is a rarely seen disease which occurs when the appendix lumen is filled and obstructed by mucous. In our study, we aimed to reveal the surgical approach of our clinic, features of tumors, and clinical presentations in line with literature in cases of appendix mucocele. Methods Fourteen appendix mucocele patients who were admitted in our hospital between 2012 and 2019 were examined retrospectively in the electronic recording medium. Our patients were evaluated in terms of age, gender, clinical status, operation, imaging results, and pathology results. Results Of the fourteen patients, 12 applied to the emergency department and 2 to the general surgery clinic. All of our patients had abdominal pain at the time of admission. In the physical examination, 5 (35%) patients had defenses, 10 (71%) patients had rebound tenderness, and 12 (85%) patients had tenderness. In preoperative imaging studies, 11 patients were interpreted as having acute appendicitis and 3 patients were evaluated as having appendix mucocele. The pathological results were reported as 6 patients had appendiceal mucocele and 8 patients had appendiceal mucocele together with acute appendicitis. Conclusion Appendiceal mucocele is a disease which generally causes similar clinical findings of acute appendicitis. Ultrasound and CT may be useful in preoperative diagnosis. Surgical treatment options of mucocele are open or laparoscopic appendectomy, cecum resection, and right hemicolectomy. Although its incidence is low, due to pseudomyxoma peritonei, it is a pathology that requires careful surgery.Öğe Mesenteric Cyst in 22 Cases(Springer, 2021) Yavuz, Yusuf; Varman, Alper; Senturk, Uyesi Mustafa; Kafadar, Mehmet TolgaBackground The aim of this study is to retrospectively and multi-centerly examine the clinicopathological features of patients who were operated with the diagnosis of mesenteric cyst, which is a rare cause of intra-abdominal mass in the last 9 years, in the light of the literature. Methods The patients were operated due to mesenteric cysts in the general surgery clinics of two Training and Research Hospital between 2010 and 2019; age, gender, preoperative clinical findings, computed tomography (CT) findings, localization of the mass, surgical procedure, morbidity, histopathological results, and follow-up period status were analyzed and reported electronically. Results The patients generally applied with the complaints of abdominal pain, palpable abdominal mass, and abdominal distention. Fourteen (63.7%) of the cases were male and 8 (36.3%) were female. The mesenteric cysts were located in the small intestine in 18 cases and colon in 4 cases. In the histopathological examination of the surgical materials, simple cyst was detected in 17 cases, lymphangioma in 4 cases, colon adenocarcinoma, and simple cyst in 1 case. In the postoperative period, superficial surgical site infection developed in 3 patients and morbidity developed in 1 patient due to anastomotic leakage. Conclusion Although mesenteric cysts are rarely seen, although most of them are not histopathologically malignant, they can reach large sizes and require extensive surgical operation, and related morbidities can be seen. Therefore, mesenteric cysts should be followed carefully in the postoperative period as well as during the diagnosis and surgical treatment process.Öğe Pilonidal sinüs hastalığının fizik muayene, ultrasonografı (USG) ve magnetık rezonans (MR) görüntüleme bulgularına göre sınıflaması(Necmettin Erbakan Üniversitesi Meram Tıp Fakültesi, 2017) Yavuz, Yusuf; Çakır, MuratPilonidal sinüs, sakro-koksigeal bölgede yer alan kıl foliküllerinden kaynaklanan, genç yaşlarda ortaya çıkan, sık görülen ve hastanın yaşantısını olumsuz etkileyen bir hastalıktır. Basit bir hastalıkmış gibi görünmesine rağmen tedavi protokolü çok farklılık gösteren ve hayat kalitesini ileri derece bozabilecek bir hastalıktır. Bu hastalıkta tedavinin amacı en kısa ve en uygun şekilde yapılmasıdır. Amaç Yaptığımız literatür taramasında pilonidal sinüsün sınıflamasında fizik muayene bulguları, ultrasonografik ve magnetik rezonans görüntülemeyi esas alan bir çalışmaya rastlamadık. Sınıflamaya yönelik daha önce yapılan bir çalışmada hastaların fizik muayene bulgularına göre sınıflaması yapılmış olmasına rağmen görüntüleme tetkiklerinden yararlanılmamış. Bu çalışma ile pilonidal sinüsün tanı, tedavi ve nüks yönünden takibinde objektif kriterler oluşturmayı sağlayacak klinik, ultrasonografik ve magnetik rezonans görüntülemesine dayalı bir sınıflama yapılmasını amaçlandık. Gereç ve Yöntem Bu çalışmada 2015 ile 2016 yılları arasında Necmettin Erbakan Üniversitesi Meram Tıp Fakültesi Genel Cerrahi Kliniğine başvuran ve pilonidal sinüs hastalığı tanısı konan hastaları kapsamaktadır. Hastalara çalışma hakkında bilgi verilerek yazılı onamları alındı. Gerekli anamnez bilgileri alındıktan sonra fizik muayaneleri yapıldı. Sonrasında hastalara magnetik rezonans(MR) ve ultrasonografi(USG) görüntülemesi yapılarak pilonidal sinüsün cilt ciltaltı dokular ve çevre ile ilişkisi belirlenecek ve veriler tek tek dosya halinde hazırlandı. Sonuç Sonuç olarak yaptığımız çalışma ile MR ve USG bazında bir anlamlı bir sınıflama elde edildi. MR ve USG verilerine göre sınıflama yapılan hastaların tedavi prosedürü ve hastayı bilgilendirme açısından anlamlı olabileceği sonucuna ulaştık. Yaptığımız çalışma ileri dönemde daha fazla hasta sayısı ile yapılacak olan geniş çaplı çalışmalara öncelik oluşturacaktır.Öğe Rectal prolapse: our ten-years' experience(Edizioni Minerva Medica, 2016) Cakir, Murat; Yavuz, Yusuf; Tekin, Ahmet; Kucukkartallar, Tevfik; Belviranli, Mehmet M.; Karahan, OemerBACKGROUND: in this paper we discuss our ten-year experience about rectal prolapse according to literature. METHODS: The study consisted of 60 patients with the diagnosis of rectal prolapse which diagnosed and operated at Necmettin Erbakan university Meram Medical Faculty, Department of general surgery clinic. The study was performed retrospectively approved by the ethics committee. Our study covers patients' gender, age, clinical, preoperative evaluation, surgery and post-operative situations. RESULTS: Patients' 43.3% was male, 56.7% was female. The average age was 51.2. There were complaints in all patients prolapse through the anus. Twenty percent of patients were additional complaints such as bleeding, pain, constipation and incontinence. in the preoperative period proctologic examination, colonoscopy, abdominal ultrasound and defecography were performed. Notaras procedure was the most frequently used method of operation. Thiersch procedure was preferred in patients with emergent incarcerated cases. The average follow up time was 5.95 year. After surgery 86.7% of patients did not have any complaints. CONCLUSIONS: abdominal or perianal interventions can be applied with low risk of complications considering to the patient's condition and experience of the center. at emergent incarcerated cases can be treated step by step. Developing incontinence after surgery is improving at a greater rate with biofeedback therapy. We believe that application of mesh has fewer complications than specified in the literature.Öğe Relationship of preoperative neutrophil lymphocyte ratio with prognosis in gastrointestinal stromal tumors(Turkish Surgical Assoc, 2015) Kargin, Suleyman; Cakir, Murat; Gundes, Ebubekir; Yavuz, Yusuf; Esen, Haci Hasan; Iyisoy, M. Sinan; Kokbudak, NaileObjective: Gastrointestinal stromal tumors are believed to play a role in immunosuppression with their local effect. In some cancers with associated inflammation, an increased pretreatment neutrophil lymphocyte ratio is considered as an indicator of poor prognosis. The aim of our study was to assess the relationship of increased blood neutrophil lymphocyte ratio with disease prognosis in patients with gastrointestinal stromal tumors. Material and Methods: The data of 78 patients who underwent surgery with the diagnosis of primary gastrointestinal stromal tumor in our clinic were evaluated retrospectively. The preoperative neutrophil lymphocyte ratio in the peripheral blood was determined. The neutrophil lymphocyte ratio and its relationship with tumor risk and prognosis were compared. The data were evaluated by Pearson's correlation analysis and the Welch ANOVA test. Results: The preoperative neutrophil lymphocyte ratio was significantly increased in the high-risk groups (p<0.05). An increased preoperative neutrophil lymphocyte ratio was associated with shorter survival (r=-0.32, p=0.009). In addition, an increase in the neutrophil lymphocyte ratio was associated with an increase in the mitotic activity of the tumor (r=-0.364, p=0.025). Conclusion: The preoperative neutrophil lymphocyte ratio in gastrointestinal stromal tumors can be used as an indicator of high-risk tumors and poor prognosis.
