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Biomedical subjects

F Sirin

Publications and source records attributed to F Sirin.

10 recordsLinked to original sources

Laparoscopic repair of an internal supravesical hernia: a rare hernia causing small bowel obstruction.

The application of diagnostic laparoscopy in emergency surgery has facilitated a wide range of endoscopic operative procedures. We report an extremely rare case of a patient who had a bowel obstruction caused by an internal supravesical hernia that was repaired via a minimally invasive technique. Abdominal computed tomography (CT) showed signs of small bowel obstruction: the cause was thought to be an invagination due to a small bowel tumor. Laparoscopic exploration of the dilated small bowel segments allowed the diagnosis of supravesical hernia. Reduction was performed with slight traction, and the hernial orifice was closed with intracorporeal sutures. To our knowledge, this is the first repair of an internal supravesical hernia ever to receive herniorraphy based on laparoscopic techniques. The mean starting time for bowel-function and mean hospital stay following the laparoscopic release of the intestinal obstruction were significantly shorter than is typically seen with standard techniques.

Diagnosis, Differential↗

Bowel cleansing for diagnostic colonoscopy: which method is preferable? Istanbul experience.

BACKGROUND: A prospective randomized trial to assess the cleansing ability and tolerance of bowel preparations for colonoscopy was conducted in a group of 953 patients. METHODS: The bowel cleansing methods were: sennoside calcium, polyethylene glycol (PEG) lavage, oral sodium phosphate (NaP) in one 90-ml dose, oral NaP in 2 doses (90 ml + 45 ml), oral NaP in 2 doses (45 ml + 90 ml), oral NaP in 2 doses (45 ml + 90 ml) plus cisapride, and oral NaP in 2 doses (45 ml + 90 ml) plus domperidone. RESULTS: The cisapride-containing procedure was abandoned partially through the study because of its adverse effects. The colon cleansing ability in groups with NaP plus cisapride and NaP plus domperidone was significantly better than the other groups ( p<0.05). Tolerance to sennoside calcium and PEG lavage in comparison to the other groups was significantly worse ( p<0.05). CONCLUSION: Two doses of NaP solution (45 ml + 90 ml) plus domperidone for colon cleansing is safe, effective, rapid, inexpensive and well tolerated.

Antiemetics↗

Protective covering of surgical wounds with honey impedes tumor implantation.

HYPOTHESIS: Tumor implantation (TI) development at the surgical wound following cancer surgery is still an unresolved concern. Trocar site recurrence, which is likely a form of TI, has become one of the most controversial topics and, with the widespread acceptance of laparoscopic surgery, has caused renewed interest in questions about TI. Honey has positive effects on wound healing. Physiological and chemical properties of honey might prevent TI when applied locally. DESIGN, INTERVENTIONS, AND MAIN OUTCOME MEASURES: Sixty BALB/c strain mice, divided into 2 groups, were wounded in the posterior neck area. Group 1 mice formed the control group, and group 2 mice had wounds coated with honey before and after tumor inoculation. All wounds were inoculated with transplantable Ehrlich ascites tumor. The presence of TI was confirmed in the wounded area by histopathological examination on the 10th day. RESULTS: Tumor implantation was achieved in all group 1 animals and verified by palpable mass and histopathological examination. In group 2 mice, although TI could not be detected macroscopically, it was revealed by pathological examination in 8 cases. Tumor implantation was less likely in group 2 mice (8 of 30 vs 30 of 30; P<.001). CONCLUSIONS: Tumor implantation was markedly decreased by the application of honey pre- and postoperatively. It is possible that the physiological and chemical properties of honey protected wounds against TI. Honey could be used as a wound barrier against TI during pneumoperitoneum in laparoscopic oncological surgery and in other fields of oncological surgery.

Animals↗

Can laparoscopy be performed safely early after laparotomy?

Early subsequent laparotomy has high morbidity and mortality rates. The majority of these procedures, such as control of intraabdominal bleeding, management of intraabdominal sepsis, assessment of bowel viability, or anastomotic suture line, which are performed during early subsequent laparotomy, can be managed safely by laparoscopy, with resultant decreased mortality and morbidity rates. However, fear of dehiscence and ventral hernia prevents widespread use of laparoscopy. The aim of this experimental study was to compare the deleterious effects of subsequent laparotomy with laparoscopy in abdominal wounds during the early postceliotomy period. A 4-cm median laparotomy was performed in 120 Wistar-Albino rats that were classified into three groups. The control group (1) did not receive additional treatment. On the third postoperative day, early subsequent laparotomy and pneumoperitoneum were performed in group 2 and group 3 rats, respectively. Ten rats from each group were selected randomly and killed after 5 days, 1 week, 2 weeks, and 4 weeks. Bursting pressure and tensile strength of the abdominal wound were assessed. Results of the study showed impaired abdominal wound healing in subsequent laparotomy group rats (group 2) (P < 0.05). Pneumoperitoneum did not cause statistical differences in wound healing parameters when compared with control group rats (P > 0.05). In conclusion, pneumoperitoneum does not affect abdominal wound healing adversely, but early subsequent laparotomy impairs wound healing severely. Laparoscopy would be an alternative to high-risk early subsequent relaparotomy.

Analysis of Variance↗

Effect of fibrin glue on irradiated colonic anastomoses.

INTRODUCTION: The present study was planned to research the effects of fibrin glue on irradiated colonic anastomoses. METHOD: The effect of fibrin glue on irradiated colonic anastomoses was investigated in four identical groups of rats. In Group I (control group) colonic anastomoses were performed without radiotherapy; in Group II, colonic anastomoses were performed five days after radiotherapy; in Group III, fibrin glue was applied to anastomotic line without radiotherapy; in Group IV, fibrin glue was applied to anastomotic line with radiotherapy. The healing of left colonic anastomoses was evaluated through the bursting pressure of the anastomotic segment and the hydroxyproline contents of the anastomosis. RESULTS: Measurements done on the fourth postoperative day revealed that anastomotic healing was impaired in rats that underwent radiotherapy (P < 0.001); fibrin glue had no effect on anastomotic healing in groups with or without radiotherapy. CONCLUSION: In the early phases of anastomotic healing, fibrin glue cannot help remove unwanted effects of preoperative radiotherapy.

Anastomosis, Surgical↗

The combined scapular/parascapular flap for the treatment of extensive electrical burns of the upper extremity.

The combined scapular parascapular flap was used for coverage of six high voltage electrical burn defects of upper extremity. The flaps resurfaced the exposed tendon, nerve, bone or blood vessels on the volar and dorsal side of the distal forearm and the hand. In all cases successful soft tissue coverage and wound healing was achieved. After the stabilisation of the wounds, secondary reconstructive procedures, such as nerve grafting, tendon grafting, tendon transfers were performed. Nerve healing and tendon gliding was found to be successful under the flap.

Adult↗

Unilateral cleft foot deformity.

A 17-year-old girl with unilateral atypical cleft foot deformity is reported. In this case the deformity was associated with deafness, mandibular retrognathia and congenital bilateral temporomandibular joint luxation. Family history of cleft foot deformity was not found. A syndactylization procedure with shortening of the big toe was done. The temporomandibular joint luxation was also corrected.

Abnormalities, Multiple↗

Effects of cyclosporin and somatostatin on liver regeneration after partial hepatectomy in rats.

The major hepatic reaction which occurs in response to degeneration or partial loss of the liver is compensatory hyperplasia. After finding out that hemodynamic factors have no influence in hepatic regeneration, the investigations have been focused on some trophic factors which have been found in the blood and which have been believed to provide the basic control of regeneration. In our controlled experimental study we have tried to evaluate the effects on hepatic regeneration of cyclosporin and somatostatin which are known to act on the hepatic regeneration ability or which are thought to have effects on regeneration because of their mechanism of action. For the purpose of evaluating the regenerative response findings like the weight of the regenerated liver, mean Ag nuclear organizer region (AgNOR) number, the mitosis index, cells with double nuclei and hyperchromatic nucleus were taken into consideration. The results of the cyclosporin group were higher than of the controls, but there was no statistically significant difference between them. In the somatostatin group, an inhibition of regeneration related to the dose and to the duration at the beginning and a delayed augmentation of the regeneration rate due to the withdrawal of the drug were observed. Values of AgNOR were significantly higher compared to the control group on the 5th day postoperatively, while the liver weight was lower on the 1st day (p < or = 0.05).

Animals↗

Traumatic rupture of the diaphragm.

Diaphragmatic rupture following trauma is often an associated and missed injury. The diagnosis is difficult, so is usually made intraoperatively. Twenty-one patients with traumatic rupture of the diaphragm (TRD) who presented between 1995 and 1998 were retrospectively analysed: 12 had penetrating injuries and nine had blunt injuries. Right-sided defects exceeded left (12 vs 9). Only seven patients had signs and symptoms directly referrable to rupture of the diaphragm. All patients were operated on through a midline laparotomy. Diaphragmatic hernia was seen in six patients (28.5%); 20 (95%) patients had concomitant injuries. The liver was the most commonly injured organ (10 patients). The aim of this study was to report our experiences with TRD and review the literature. We conclude that correct preoperative diagnosis of TRD needs a high index of suspicion. It can be diagnosed intraoperatively by explorative laparotomy. Most ruptures can be repaired by the abdominal approach.

Adolescent↗