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K Y Polat

Publications and source records attributed to K Y Polat.

8 recordsLinked to original sources

Spontaneous rupture of hepatocellular carcinoma: a case report and review of literature.

Hepatocellular carcinoma (HCC) has a tendency for fatal spontaneous rupture leading to massive haemorrhage. A 64-year-old man presented with sudden, severe epigastric pain for 6 h. Systolic blood pressure was 80/50 mmHg, and pulse rate was 100/min. The patient's history did not reveal any operation or disease up to date. Contrast enhancement-axial computed tomography (CT) scan showed a tumoral lesion with a necrotic centre measuring 6 x 5 cm within 6th segment of the liver and a fluid collection (haemoperitoneum) at the periphery of the liver. At exploratory laparotomy, the liver was found to be cirrhotic, and an actively bleeding tumour confirmed in 6th segment of the liver. The tumour was resected. Post-operative recovery was unremarkable, and the patient was discharged on the 14th post-operative day. Ruptured HCC should be included in the differential diagnosis of non-traumatic intra-abdominal haemorrhage.

Carcinoma, Hepatocellular↗

Late complications of incisional hernias following prosthetic mesh repair.

BACKGROUND: Incisional hernias still continue to be a serious problem for surgeons. In this study, we aimed to investigate the effects of polypropylene mesh and mersilene mesh, which are frequently employed in incisional hernias, as well as the effects of their application techniques on late complications. METHODS: Two-hundred-sixty-four open abdominal hernia repairs were performed between 1986--2000, using prosthetic materials: polypropylene mesh and mersilene mesh were used in hernia repair. Mesh was placed as onlay, underlay and sandwich techniques. Follow-up data were obtained from medical records. RESULTS: Comparisons were made with respect to surgical techniques and to late complications such as recurrence, enterocutaneous fistula, intestinal obstruction, and infections. Enterocutaneous fistulas developed in two patients. Recurrence occurred in 6.4 per cent. Chronic infection and wound sinus formation occurred in 5 per cent. The causes of recurrence included smoking, cellulitis, chronic infection/sinus tract, upper abdominal localization, and obstruction. Fistula formation occurred in patients with no peritoneal prevention, which was statistically significant (p=0.012). Chronic infection/sinus tract was high in patients for whom mersilene mesh was used, and enterocutaneous fistula occurred in 2 patients. CONCLUSION: To prevent late complications, it is necessary to avoid the contact of mesh with bowel.

Abdomen↗

[Hepatic injuries. Surgical treatment experience].

PURPOSE: To evaluate the results of the surgical treatment of hepatic injuries in our institution for liver injuries. PATIENTS AND METHODS: One hundred seventy four patients who underwent operations between January 1986-December 1999 in Atatürk University Medical School, Emergency Service were reviewed retrospectively. RESULTS: 135 patients were male (77.5%). The mean age was 25.4 (range 3-84). Sixty three patients (36.3%) had only hepatic injuries and the others had co-existing abdominal organ injury [62 patients (35.7%) had one organ, 29 (16.7%) had two, 17 (9.7%) had three, 2 (1.1%) had four, and 1 (0.5%) had 5 organ injuries]. Five patients (2.8%) had inferior vena cava and 1 (0.5%) had vena porta injuries. One hundred seven patients (61.4%) had blunt, 44 (25.3%) had stab wound and 23 (13.3%) had gunshot injuries. Management was simple suture in 104 patient (60%), primary suture + surgical cell patching in 52 (29.8%), hepatectomy (5 right hepatectomy, 5 non anatomic hepatectomy) in 10 (5.7%), perihepatic packing in 4 (2.3%), primary suture + omental patch in 2 (1.1%), primary suture + arterial ligation in 2 (1.1%). Eleven patients (16.4%) in penetrating trauma group "Penetrating Abdominal Trauma Index" (PATI) score were higher than 25. Fever was the most common complaint postoperatively (5%). Three patients (1.7%) underwent reoperation. Twenty-six patients (14.9%) which one of them ware died. Died in the postoperative periods, 23 (13.2%) had blunt and 3 (1.7%) had penetrating traumas. CONCLUSION: Liver trauma still has high mortality rate injuries are very momentous. Especially blunt trauma related hepatic.

Abdominal Injuries↗

[Perforated peptic ulcers].

Two hundred forty-eight patients were operated for perforated peptic ulcer between 1983 and 1998. Of the patients 112 (45.1%) had chronic, 34 (13.7%) had acute ulcer history and 102 (41.2%) had no ulcer history. Of the patients 228 (92.0%) had duodenal, 9 (3.6%) had juxtapyloric, 6 (2.4%) had marginal, and 5 (2.0%) had antral ulcer. Forty two patients (16.9%) admitted within 12 hours and 206 patients (83.1%) between 12 hours and six days after perforation. Simple closure and omental patch was performed in 32 patients (12.9%) who had severe concomitant illness and 126 (50.8%) intraabdominal sepsis, truncal vagotomy + pyloroplasty in 32 (12.9%), simple closure + omental patch + truncal vagotomy + gastroenterostomy in 34 (13.7%), simple closure + omental patch + parietal cell vagotomy in 21 (8.5%), truncal vagotomy + antrectomy in 3 (1.2%). Patients who didn't have definitive procedure received H2 receptor blockers or proton pomp inhibitors. One hundred ninety-three patients (77.8%) underwent endoscopic control. Two of 53 patients with definitive procedure (3.8%) and 34 of 140 patients (24.3%) with simple closure had recurrence. Two patients in simple closure group underwent parietal cell vagotomy, the others received medical treatment. The recurrence rate was significantly higher in simple closure group (p < 0.01).

Acute Disease↗

Surgical treatment of hydatid disease of the liver: review of 304 cases.

HYPOTHESIS: To review the results of different modalities of treatment of hydatid disease of the liver. DESIGN: Retrospective study of 304 patients. SETTING: A university hospital in Turkey. PATIENTS: Three hundred four patients with hepatic hydatid disease who underwent operation between 1981 and 1996. MAIN OUTCOME MEASURES: Mortality and morbidity. RESULTS: Two hundred thirty-eight patients had a cyst on the right lobe, 41 patients had a cyst on the left lobe, and 25 patients had a cyst on both lobes. Forty-five patients had multiple hepatic cysts and 18 patients had coexisting cysts in other intra-abdominal organs. Surgical procedures were tube drainage, capitonnage, omentoplasty, cystectomy, segmentectomy, and cystoenterostomy. Of the patients with tube drainage, 36 developed an infection of the remaining cavity, 10 developed long-lasting biliary fistula, 8 developed cholangitis, and 6 developed septicemia. Four patients died of unreleated complications. Of the patients with capitonnage, 7 developed cholangitis and 3 developed an infection of the remaining cavity. Of the patients with omentoplasty, 1 developed an infection of the remaining cavity and 1 developed cholangitis. One patient who underwent segmentectomy developed pulmonary complications. Of the patients with cystoenterostomy, 1 developed cholangitis, 1 developed septicemia, and 1 developed pulmonary complications. CONCLUSION: For management of hydatid disease of the liver, capitonnage, omentoplasty, cyst excision, segmentectomy, or cystoenterostomy are all superior to tube drainage.

Adolescent↗