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Biomedical subjects

Sinan Yol

Publications and source records attributed to Sinan Yol.

7 recordsLinked to original sources

A rare complication of D3 dissection for gastric carcinoma: chyloperitoneum.

BACKGROUND: Chyloperitoneum is the accumulation of lymphatic fluid in the peritoneal cavity. Although uncommon, it has been reported after retroperitoneal lymph node dissection. But the incidence of this complication after radical gastrectomy is unknown. In the present study, we analyzed our patients who underwent D3 dissection for gastric carcinoma and developed chyloperitoneum. METHODS: Between June 1999 and June 2002, a total of 134 patients with gastric cancer underwent radical lymph node dissection, performed according to the Japanese Research Society for Gastric Cancer guidelines, as the standard procedure for gastric cancer treatment. Of these patients, 34 underwent D3 lymphadenectomy, and chyloperitoneum was detected in 4 of them. RESULTS: There were three male patients and one female patient. All patients were in stage III according to the International Union Against Cancer (UICC)-TNM classification. In three patient, chyle leakage was noticed during the surgery, and surgical ligation of the duct was performed. Abdominal distension developed in one patient 7 days after the surgery, and chylous ascites was diagnosed. This patient was success-fully treated with fasting and total parenteral nutrition, within 2 weeks. CONCLUSION: The incidence of chyloperitoneum is not low, and may increase with more aggressive surgery. Surgeons should be aware of this complication after retroperitoneal lymph node dissection, and injured lymphatics must be controlled and ligated intraoperatively.

Aged↗

Epiphrenic diverticulum with abnormal manometry: a case report.

A 50-year-old man was admitted to our hospital with the chief complaints of vomiting and nocturnal cough for one year. His complaints were progressive and had worsened within the last two months. Chest X-ray revealed a right-sided paracardiac opacity. Computed tomography of the thorax showed a supradiaphragmatic mass lesion containing air and solid components. Barium esophagogram revealed a giant distal esophageal diverticulum and hiatal hernia. Stationary manometric examination of the esophagus showed non-specific esophageal motility disorder. The patient underwent a successful abdominal approach diverticulectomy operation and the postoperative course was uncomplicated. There is a high prevalence of esophageal motility abnormalities in patients with epiphrenic diverticula, though they are very rare, and, as in this case, may be difficult to classify.

Digestive System Surgical Procedures↗

Extensive adult colo-colonic intussusception from ascending colon to sigmoid colon: report of a case.

Intussusception in adults is relatively rare. Here we report a 52-year-old man with an extensive colo-colonic intussusception caused by a polypoid mass in the ascending colon. The mass, which was 10 x 8 x 5 cm in size, had been palpated preoperatively and was suspected to be a sigmoid tumor. The patient was treated successfully by reduction of the invagination and subsequent right hemicolectomy.

Colectomy↗

Distribution of hydatid cysts into the liver with reference to cystobiliary communications and cavity-related complications.

BACKGROUND: This study was designed to test a hypothesis that intrahepatic hydatid cyst location can effect the incidence of cystobiliary communications and the cavity-related complications. METHODS: A total of 121 cysts treated by conservative surgical methods in 113 patients were evaluated prospectively. Cysts were grouped as near to the liver hilum (segment I, III, IVb, V, and VI) and far from the hilum (segment II, IVa, VII, and VIII). RESULTS: There were 58 (48%) hilar and 63 (52%) peripheral cysts. We found more cystobiliary communications (48% versus 27%, P = 0.015), more biliary leakage (36% versus 10%, P <0.001), and more biliary fistula (12% versus 3%, P = 0.080) in the cysts near to the hilum than far from the hilum. Postoperative hospital stay was longer in the cysts near to the hilum (12.3 +/- 3.1 days) than the cysts far from the hilum (7.7 +/- 2.7 days, P = 0.022). CONCLUSIONS: The location of the hydatid cyst near to the liver hilum is a risk factor for the cystobiliary communications and the cavity related complications.

Adolescent↗

Laparoscopic treatment of small bowel phytobezoar obstruction.

An intestinal bezoar causing obstruction is usually treated by an open approach, either with manual mechanical fragmentation or with enterotomy and removal of the bezoar. In this article, we report the minimally invasive surgical management of a 59-year-old man in whom a bezoar obstructing the small intestine developed at the site of an adhesion from a previous gastric surgery. The bezoar was laparoscopically broken down and milked through the ileocecal valve. In the future, the laparoscopic approach may be the treatment of choice for patients with a bezoar when surgery is indicated.

Bezoars↗

Drainage of liver abscess via laparoscopic trocar with local anesthesia.

There are several methods for treatment of liver abscess. These include drainage by open surgery, laparoscopic surgery, or percutaneous catheterization. In this report a new therapeutic approach is presented. A 47-year-old man admitted to the hospital had an abscess 12 cm in diameter, originating from the left liver lobe. After the patient's permission was obtained, a laparoscopic trocar was inserted into the abscess with the patient under local anesthesia in the operating room. A 28-French chest tube catheter was introduced through the trocar cannula, and approximately 1,000 mL of pus was drained. There were no complications, and the patient was discharged on the same day. After computed tomography showed an obliterated abscess cavity, the drain was removed on postoperative day 7. The pus culture, performed on the day of surgery, was found to be positive for Escherichia coli, which was responsive to cefaclor. Oral antibiotic therapy was given for 1 month. At follow-up 2 months after surgery, the patient was asymptomatic. This report describes the first case of a liver abscess drained by a laparoscopic trocar with local anesthesia. This method can be the treatment of choice for some easily accessible liver abscesses.

Anesthesia, Local↗