Biomedical subjects

Bülent Güleç

Publications and source records attributed to Bülent Güleç.

3 recordsLinked to original sources

PubMed2006

Lower extremity venous changes in pneumoperitoneum during laparoscopic surgery.

BACKGROUND: The effect of pneumoperitoneum on veins of the lower limbs related to the intra-abdominal working pressures during laparoscopic cholecystectomy has not been thoroughly investigated. We tested the hypothesis that working pressures do not affect the venous haemodynamics in the lower limbs. METHODS: The cross-sectional area and peak flow rates of femoral and saphenous veins in the right groin were measured in 60 patients divided into two groups according to the intra-abdominal working pressures (11 vs 14 mmHg). All measurements were carried out preoperatively and at predetermined periods during and after laparoscopic cholecystectomy by colour Doppler ultrasonography. One-way anova and chi(2) test were used for the analysis of demographic data. For the repeated measures, anova and Student's t-test were used for statistical analysis. The probabilities less than 0.05 were accepted as statistically significant. RESULTS: The cross-sectional area of the veins increased, whereas the peak flow rate in veins decreased during pneumoperitoneum. Comparing the peak flow rate in the saphenous vein at the third intraoperative measurement, there is statistically significant difference between the two groups (P < 0.05). CONCLUSION: The degree of intra-abdominal pressure affects the haemodynamics of the peripheral veins. Pneumoperitoneum during laparoscopy causes stasis in the peripheral veins. It is reasonable to use routine prophylaxis for deep vein thrombosis, in the light of these findings.

Cholecystectomy, Laparoscopic↗

PubMed2006

Abdominal heterotopic tissues: review of 24 cases diagnosed on postoperative histological evaluation.

BACKGROUND/AIMS: Heterotopy is defined as abnormal localization of well-differentiated tissue. Heterotopic tissues usually tend to be asymptomatic and noncomplicated but sometimes may cause serious clinical problems. Malignancy potential is the most important issue in this clinical entity. In this study we reviewed medical records of 24 patients with heterotopic tissues. METHODS: Between 1995-2004, 24 patients with heterotopic tissues who were diagnosed during gastrointestinal system or abdominal wall surgery or upper gastrointestinal endoscopy were included in this study. Patients' medical data were retrospectively reviewed. RESULTS: Sixteen patients with heterotopy were younger than 30 years and eight patients were older than 30 years. Nineteen (0.21%) heterotopic tissues were diagnosed in 8,945 patients who underwent gastrointestinal system surgery or upper gastrointestinal endoscopy, whereas five (0.21%) heterotopic tissues were diagnosed in 2,320 patients who underwent abdominal wall surgery. Overall, 24 (0.21%) heterotopic tissues were found in a total of 11,265 patients. The majority were pancreatic heterotopy, followed in decreasing order by gastric, adrenal and osseous heterotopy. In patients who underwent gastrointestinal surgery-endoscopy, pain was the main symptom (n=13)(68.4%), followed by dyspepsia (n=3)(15.7%) and vomiting- nausea (n=2)(10.5%). The main symptom in patients who underwent abdominal wall surgery was palpable mass. heterotopic tissues presented as wall thickening in 13, polypoid mass in five and whole solitary mass or intraparenchymal lesion in six patients. CONCLUSION: Although incidence of heterotopic tissues is low, in case of its suspicion or diagnosis, early treatment should be performed by surgical or endoscopic resection or patients must be followed up carefully due to risk of malignancy.

Abdomen↗

PubMed2005

The addition of O2 to the CO2 does not prevent the systemic effects of the CO2 pneumoperitoneum in a rabbit model.

CO2 pneumoperitoneum used in endoscopic surgery induces systemic effects by CO2 absorption. It was claimed that a reduction in CO2 pneumoperitoneum-induced metabolic hypoxemia was achieved by the addition of small amounts of O2 to the CO2 in a rabbit ventilated model. We reevaluated the effects of the addition of O2 to the CO2 pneumoperitoneum upon CO2 absorption in a rabbit model. The effects of a pneumoperitoneum using 100% CO2, 90% CO2 + 10% O2, 95% CO2 + 5% O2, or 100% O2 on arterial blood gases, acid base and O2 homeostasis were evaluated in nonintubated rabbits. A pneumoperitoneum pressure of 10 cm H2O (approximately 7.35 mm Hg) was used. CO2 pneumoperitoneum of 120 minutes affected blood gases and acid base homeostasis. Whereas partial pressure of CO2 and HCO3 increased (P < 0.001) during pneumoperitoneum, pH and partial pressure of O2 decreased (P < 0.001). Similar results were obtained in O2-CO2 pneumoperitoneum (P > 0.05). CO2 pneumoperitoneum profoundly affected blood gases and acid base homeostasis, resulting in metabolic hypoxemia. The addition of O2 to the CO2 did not prevent the systemic effects of CO2 pneumoperitoneum in nonintubated animals.

Animals↗