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Öğe Comparision of Hem-o-lok polymeric clip and tri-staple in laparoscopic splenectomy(Edizioni Luigi Pozzi, 2021) Derebey, Murat; Ozbalci, Gokhan Selcuk; Yuruker, Savas; Tarim, Ismail Alper; Karabacak, Ufuk; Akgun, Can; Mutlu, VahitAIM: This study aimed to compare the hem-o-lok polymeric clip (HC) and tri-staple (TS) methods used in dividing the splenic hilum in terms of results, and to reveal their superiority to each other. MATERIAL AND METHODS: Medical records of patients undergoing elective laparoscopic splenectomy at the Ondokuz Mayis University Faculty of Medicine General Surgery Clinic between March 2011 and March 2020 were retrospectively analyzed. Forty-two laparoscopic splenectomy cases performed using hem-o-lok polymeric clip (HC) or tri-staple (TS) were included in this study. Demographic features, primary diagnoses, splenic size, intraoperative data and postoperative complications, as well as the clip and stapler prices used in the surgery were analyzed. RESULTS: The mean operative time was significantly longer for HC group than TS group (1167 min vs. 87.6 min, p<0.05). The mean cost of surgical instruments used to divide the splenic hilum was significantly lower for HC group than TS group (34.1 usd vs. 165.4 usd, p<0.05). There was no postoperative mortality, with a morbidity rate 6 (261%) for TS group and 4 (21.1%) for HC group (p>0.05). No significant difference existed in the complication rates. CONCLUSIONS: In the HC group, the operation time was longer, but the surgical cost was significantly lower. There was no significant difference when comparing other perioperative results. Although both techniques can be applied safely, we would like to emphasize that hemostasis is the most important factor for good results.Öğe Effects of COVID-19 pandemic on management of acute cholecystitis: A single tertiary center's experience(Ondokuz Mayis Universitesi, 2022) Derebey, Murat; Yüksek, Mahmut Arif; Karabacak, Ufuk; Mutlu, Vahit; Mizan, Salih Raşit; Tarim, Ismail Alper; Özbalci, Aysu BaşakFollowing the spread of novel coronavirus (COVID-19) pandemic, surgical associations have issued their different recommendations for managing the acute cholecystitis (AC) clinic during the pandemic. We aimed to examine the effects of the COVID-19 pandemic period on our clinical approach in patients who presented to the emergency department with abdominal pain and were diagnosed with AC. Medical records of patients diagnosed with AC in the emergency room between 11 March 2020 and 10 March 2021 and in the same period of one year before the pandemic were retrospectively reviewed. Patients were divided into 2 groups as COVID-19 period (Group 1) and non-COVID period (Group 2). Demographics and clinical characteristics, treatment modalities, and outcomes of these two groups were compared. The number of patients diagnosed with AC in the emergency department decreased during the ongoing COVID-19 pandemic. When the time between the onset of the complaints and the admission to the emergency service was evaluated, no statistically significant difference was found between the groups (p>0.05). The distribution of cholecystitis type and TG18 severity grading for AC were similar in both groups (p>0.05). While percutaneous cholecystostomy (PC) is more preferred in the treatment of AC during the pandemic period and the number of delayed interval laparoscopic cholecystectomy decreased, AC management was similar in both periods with no significant statistical difference (P>0.05). In conclusion, our clinical approach and management in the treatment of AC did not differ when compared to the pre-pandemic period. © 2022 Ondokuz Mayis Universitesi. All rights reserved.Öğe Effects of COVID-19 pandemic on management of acute cholecystitis: A single tertiary center's experience(Ondokuz Mayıs Üniversitesi, 2022) Derebey, Murat; Yüksek, Mahmut Arif; Karabacak, Ufuk; Mutlu, Vahit; Mızan, Salih Rasit; Tarım, Ismail Alper; Ozbalcı, Aysu BasakFollowing the spread of novel coronavirus (COVID-19) pandemic, surgical associations have issued their different recommendations for managing the acute cholecystitis (AC) clinic during the pandemic. We aimed to examine the effects of the COVID-19 pandemic period on our clinical approach in patients who presented to the emergency department with abdominal pain and were diagnosed with AC. Medical records of patients diagnosed with AC in the emergency room between 11 March 2020 and 10 March 2021 and in the same period of one year before the pandemic were retrospectively reviewed. Patients were divided into 2 groups as COVID-19 period (Group 1) and non-COVID period (Group 2). Demographics and clinical characteristics, treatment modalities, and outcomes of these two groups were compared. The number of patients diagnosed with AC in the emergency department decreased during the ongoing COVID-19 pandemic. When the time between the onset of the complaints and the admission to the emergency service was evaluated, no statistically significant difference was found between the groups (p>0.05). The distribution of cholecystitis type and TG18 severity grading for AC were similar in both groups (p>0.05). While percutaneous cholecystostomy (PC) is more preferred in the treatment of AC during the pandemic period and the number of delayed interval laparoscopic cholecystectomy decreased, AC management was similar in both periods with no significant statistical difference (P>0.05). In conclusion, our clinical approach and management in the treatment of AC did not differ when compared to the pre-pandemic period.Öğe Fournier's gangrene: etiology, treatment outcomes and factors affecting mortality in 38patients(2021) Derebey, Murat; Tarım, İsmail Alper; Karabacak, Ufuk; Şeker, Kadir; Özbalcı, Gökhan SelçukAim: Fournier's gangrene (FG) is a rare, rapidly progressing and life-threatening disease of the genital, perianal and perineal regions. We aimed to evaluate etiological parameters, accompanying diseases, current treatment methods and factors affecting mortality in patients with FG. Method: The medical records of 38 patients who were operated by the same team with a diagnosis of FG from December 2015 to January 2021 were retrospectively reviewed. Those patients were divided into two groups: survivors (Group 1), and non-survivors (Group 2). Comparisons were made regarding clinical and demographic features; comorbid diseases; leukocyte count at first presentation; etiological factors; treatment outcomes; and mortality rates. Results: Thirty-eight patients (24 males, 14 females) were evaluated; mean age was 60.2 ± 13.2 years. While 76.3% (n = 29) of these patients recovered with treatment, the total mortality rate was 23.7% (n = 9). The most common cause of the FG and comorbidity were anorectal diseases (n = 22; 57.9%) and type 2 diabetes mellitus (n = 21; 55.3%), respectively. Female gender, septic shock, necrosis, abdominal wall and lumbar region involvement, chronic renal failure, FG development secondary to postoperative complications and ostomy rates were higher in non-survivors. There were no significant differences between the two groups regarding leukocyte count at first presentation, number of debridement, dressing methods, reconstruction methods, and length of hospital stay. Conclusions: Female gender, presence of septic shock and necrosis on physical examination, involvement of the abdominal wall and lumbar region in addition to the perianal region, chronic renal failure, disease secondary to postoperative complications and the necessity of ostomy play an important role in mortality.
