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Biomedical subjects

Fatih M Avsar

Publications and source records attributed to Fatih M Avsar.

11 recordsLinked to original sources
PubMed2006

Reinforcement of the suture line with an ePTFE graft attached with histoacryl glue in duodenal trauma.

BACKGROUND: Most duodenal injuries are managed with primary repair, but the degree of duodenal-wall injury may threaten the integrity of the primary repair. Therefore, we evaluated whether the primary repair site could be reinforced with histoacryl glue (HAG) or HAG with an expanded polytetrafluoroethylene (ePTFE) mesh. METHODS: Grade 3 duodenal injury in the second portion of the rat duodenum was chosen as a standard trauma model. Thirty-three male rats were divided into sham (n = 3), 2-layer primary repair (n = 10), 1-layer primary repair plus HAG application (n = 10) and ePTFE attached with HAG over the 1-layer primary repair site (n = 10) groups. Ten-day survival, adhesion grades and histological assessment were taken as outcome measures. RESULTS: A significant survival advantage was identified in the group that had an ePTFE graft attached with HAG over a 1-layer repair when compared with the group that had a 2-layer primary repair. Adhesion grades were found to be particularly increased in the group that had an ePTFE graft attached with HAG over the primary repair site, moderately increased in the primary repair plus HAG application group and lower in the 2-layer primary repair group. ePTFE graft application was found to be beneficial to coverage of the HAG-dependent empty spaces in the serosal layer. CONCLUSIONS: A primary repair site after duodenal trauma or a difficult duodenal stump can be reinforced with the application of HAG or ePTFE graft implantation with HAG.

Animals↗
PubMed2005

V-Y advancement flap closures for complicated pilonidal sinus disease.

BACKGROUND AND AIMS: Hair entry into the midline is the generally accepted theory in pilonidal sinus formation. This theory is also involved in the pathogenesis of the recurrence after different types of operations for pilonidal sinus disease. The relationship of the suture lines and the midline was evaluated in this study. PATIENT AND METHODS: Thirty-four patients with stage 4 or recurrent pilonidal sinus disease who underwent V--Y advancement flap closure were randomized into two groups: vertical suture line unrelated to midline (VLUM, n=18) and vertical suture line related to midline (VLRM, n=16). RESULTS: None of the patients with or without a suction drain developed flap necrosis, local haematomas or seromas. The median length of the postoperative hospital stay was 3 days for theVLRM group and the VLUM group (p>0.05). The median follow-up period was 32 months. During the follow-up period, two recurrences were determined 22 and 15 months after operation in the VLRM group. Recurrences were situated in the scar tissue over the midline. INTERPRETATION AND CONCLUSION: Routine application of suction drains is not recommended after V--Y advancement flap closure. Avoidance of the relationship of the postoperative suture line and the midline, if possible, offers a safe method of definitive reconstruction.

Adolescent↗
PubMed2005

Effects of TVE application during 70% hepatectomy on regeneration capacity of rats.

BACKGROUND: For adequate control of excess bleeding during liver resection, total vascular exclusion (TVE) is preferred by surgeons, especially when the tumor is located in the posterior liver lobes or near the cava. To the authors' knowledge, the effects of TVE technique on the postoperative liver regeneration process have not thus far been evaluated yet in the literature. This study was planned to compare the effects of liver resections performed either with portal pedicle clamping or with TVE on the regeneration process. MATERIALS AND METHODS: Seventy percent hepatectomy was performed with portal pedicle clamping (n=10, Group A) or with TVE (n=10, Group B) in rats. At 48 h after resection, sampling was performed for the measurement of serum transaminase, alkaline phosphatase (ALP), tissue malondialdehyde (MDA), and glutathione (GSH) levels. Liver regeneration rate, proliferating cell nuclear antigen (PCNA) labeling, and mitotic indices were also evaluated. RESULTS: Liver injury determinants (serum transaminases, ALP, and tissue MDA levels) were found significantly higher in group B than in group A. Liver regeneration rate, liver GSH levels, PCNA labeling index, and mitotic index were significantly lower in group B than in group A. CONCLUSIONS: The injury during TVE seems to be greater than during resection with portal pedicle clamping. The negative effect of this oxidative damage may influence the regenerative capacity of the remnant liver tissue.

Animals↗
PubMed2005

Comparison of bariatric and non-bariatric elective operations in morbidly obese patients on the basis of wound infection.

BACKGROUND: Wound infection rates after various types of bariatric operations have been well described. The question of whether bariatric surgery increases wound infection rate compared with similar elective surgical procedures in obese patients has not been clearly answered. The purpose of this study was to investigate wound status of morbidly obese patients after elective general surgery. METHODS: A prospective evaluation was conducted of 141 morbidly obese patients undergoing bariatric (n=60) and non-bariatric elective general surgery operation of similar invasiveness (n=81) with the ASEPSIS wound surveillance method. RESULTS: Median age of patients undergoing non-bariatric elective surgery (51, 32-68) was significantly higher than patients exposed to bariatric surgery (39, 24-57). Patients undergoing bariatric surgery had higher BMIs (44.0, 35-52.5) compared to the others (38.4, 35-43). All patients enrolled in the study were followed for a 21-day period. At the 7th postoperative day, 9 patients in the bariatric surgery group developed infection (15%), whereas 13 patients (16%) in the non-bariatric surgery group suffered wound infection. Wound infection was still present in 2 patients (3.4%) in the bariatric surgery group and 3 patients (3.7%) in the non-bariatric surgery group at the 21st day. Risk factors for wound infection included history of coronary artery diseases, diabetes, chronic respiratory illness and malignant disease. CONCLUSION: Bariatric surgery does not cause an additional risk of postoperative wound infection in morbidly obese patients, compared to elective general surgical operations of the same invasiveness.

Adult↗
PubMed2005

Primary hydatid cyst of the breast with elevated CA 19-9 level.

Breast masses secondary to hydatid cyst disease are placed on the differential diagnosis of breast tumors under guidance of the literature. In addition to their characteristic appearance on mammography, many specific parameters for diagnosis are required. In this report, the relation of serum CA 19-9 levels to the primary breast cyst hydatid was evaluated in both preoperative and postoperative periods.

Aged↗
PubMed2004

Improvement of vertical banded gastroplasty by strict dietary management.

BACKGROUND: Vertical banded gastroplasty (VBG) has been found to reduce BMI significantly during the first postoperative year. However, the same trend in weight loss has not been established thereafter. The purpose of this study was to evaluate the effects of our dietary program on morbidly obese patients treated with VBG. METHODS: A prospective evaluation of 40 obese patients (25 female, 15 male) undergoing VBG over a 3-year period was undertaken. RESULTS: The age range was 24-57 (median 38) years, mean weight 133+/-2 SD kg, and mean BMI 45+/-6.4 SD kg/m2. After VBG, a special follow-up program was applied to patients. All patients (100%) were available for follow-up. Operative mortality was zero. 4 patients developed an early postoperative complication, and 1 patient was re-operated because of staple-line disruption 8 months after VBG. BMI decreased to 34+/-3.2 after 12 months, 27+/-1.3 after 24 months, and 28+/-1.4 after 36 months. All patients showed weight loss after VBG, and the weight loss continued with the strict follow-up program during a 3-year period, except in 1 patient who regained the weight lost despite an intact staple-line and stoma. CONCLUSION: Our policy for patients after VBG appears to be effective.

Adult↗
PubMed2003

The effects of nitric oxide synthase blockers on mesenteric blood flow with bile duct ligation.

BACKGROUND/AIMS: The aim of this study was to investigate the effects of nitric oxide synthesis inhibition by L-NNA (N-nitro-L-arginine) on mesenteric blood flow in bile duct ligated rats. METHODOLOGY: Forty female Wistar rats were allocated into four groups. Only common bile duct (CBD) was dissected with midline laparotomy (sham operated), CBD is ligated for obstructive jaundice (OJ group), with CBD dissection, 20 mg/kg L-NNA was given i.p. during 14 days (sham + L-NNA group), after CBD ligation, 20 mg/kg L-NNA was given i.p. during 14 days (OJ + L-NNA group). At the end of the 14th day, the rats were re-anaesthesized, phenylephrine was administered within the left jugular vein and, arterial blood pressure monitorization was done via left carotid artery. Blood flow of the mesenteric artery (SMA) was also recorded. Resistance of the SMA was calculated and in addition, pressure responses to phenylephrine were detected. Histopathological examination of the liver and blood analyses were done. RESULTS: The mean blood pressure levels of the rats with OJ were lower than the control group (P>0.05). Blood flow of the SMA and vascular resistance of the rats with OJ have no significant difference with other groups. In CBD ligated animals, mean blood pressure and mesenteric vascular resistance increased by L-NNA but there was no difference in mesenteric blood flow rate and vasoconstrictive response to phenylephrine. On microscopic examination of the liver with OJ, bile duct proliferation and minimal mononuclear reaction were observed which was not affected by L-NNA administration. CONCLUSIONS: Hypotension, low systemic vascular resistance, and a reduced sensitivity to vasoconstrictors are features of cirrhosis. In obstructive jaundice impaired vascular responsiveness to vasoconstrictor stimuli like as cirrhosis was not observed and also there was no improvement by L-NNA on histopathologic findings and liver function tests.

Animals↗
PubMed2003

Retrorectal benign cystic teratoma misdiagnosed with high lying pararectal abscess.

A case of presacral teratoma with abscess formation is presented in this report. Teratomas, like the chordomas and dermoids, constitute the largest group of retrorectal tumors. Their presentation has varied. Dependent to unique localization, cystic teratoma complicated with abscess formation are misdiagnosed as high lying pararectal abscesses. Both diagnostic and therapeutic difficulties were evaluated with literature review.

Abscess↗
PubMed2003

Jejunal intussusception caused by an inflammatory fibroid polyp.

The case of a 56-year old male with a jejunal intussusception due to the inflammatory fibroid polyp is presented. In the literature, eleven cases with jejunojejunal intussusception due to IFP were reported. This rare entitiy was reviewed with different perspectives in this report.

Humans↗
PubMedDate not supplied

Induction and assessment methods used in experimental adhesion studies.

Infertility and intestinal obstruction are well-known complications, arising from adhesion formation after intra-abdominal operations. Basic principles of adhesion formation have been found through animal studies. In addition, examination of agents for the prevention of adhesions can be easily made using experimental studies. However, lack of uniformity in study design makes assessment of the efficacy of any prophylactic regimen difficult. In this review, the material and methods used in experimental studies designed for adhesion formation or prevention were evaluated in detail, with experimental studies published in the literature from 1960 to 2003 being evaluated. Several methods for adhesion induction have been described in the literature. Severity of the adhesion varies from method to method, with the main problem being the lack of uniform expression of study results. Extensive use of complex adhesion classification systems should be used to resolve this discordance between experimental studies.

Animals↗