Biomedical subjects

U Kucuktulu

Publications and source records attributed to U Kucuktulu.

7 recordsLinked to original sources

PubMed1999

Laparoscopic abdominal observation method without anesthesia for preventing unnecessary second-look procedures: short report.

Second-look operations after massive intestinal resections secondary to mesenterovascular occlusion are a frequent practice. In about one half of patients who undergo second-look procedures, no intraabdominal intervention is necessary. We present a laparoscopic abdominal observation method to prevent unnecessary laparotomies. In the first operation, two laparoscopic trocars, 5 and 10 mm in diameter, were left in the abdominal wall. After an appropriate time interval, the abdomen was explored laparoscopically through these trocars without anesthesia. If obvious intestinal gangrene and anastomotic leaks were observed laparoscopically, the patients were reoperated on while under general anesthesia; otherwise, the procedure was terminated with removal of the trocars. This method was performed on six patients. Unnecessary relaparotomies were prevented in four patients; intestinal gangrene and anastomotic leaks were not missed in the remaining two patients. A larger patient sample is needed to assess the advantages of this method in preventing unnecessary laparotomies.

Anesthesia↗

PubMed1996

Intestinal obstruction caused by splenic volvulus: report of a case.

Torsion of a wandering spleen is rare, usually presenting as acute abdomen, and is commonly misdiagnosed. In special cases, ultrasonography, arteriography, and additional scintigraphy are extremely valuable in the preoperative diagnostic management. We herein present an unusual case of torsion of a wandering spleen in a 19-year-old female. The presenting symptom was acute gastrointestinal obstruction due to pressure of the enlarged and ptotic spleen in the pelvis. The intestinal obstruction with signs of peritonitis made a laparatomy with removal of the infarcted spleen imperative. After the operation, the patient made a complete recovery.

Adult↗

PubMed1995

Solitary extramedullary plasmocytoma of the breast with kappa monoclonal gammopathy.

We report a case of solitary extramedullary plasmocytoma of the breast in a 85 year old woman. This is the third case of solitary breast plasmocytoma in the world's literature. This disorder is very rare and it was associated with a serum monoclonal protein. A similar case is presented and its clinical presentation and pathology discussed.

Aged↗

PubMed1994

A modified technique for performing anterior gastropexy in Stamm gastrostomies.

We describe herein a new modified technique for performing the anterior gastropexy step of the Stamm gastrostomy procedure. In this method, anterior gastropexy was carried out with four 2-0 silk or propylene sutures. These sutures were secured through the whole layer of the abdominal wall from out to within. Then, after passing the seromuscular layer of stomach, they return to skin through the abdominal wall from within to out and tied over the skin surface. This modified technique which provided better exposure and an excellent seal of the stomach and parietal peritoneum, was successfully performed on 23 patients, none of whom developed any peritoneal leakage and peritonitis. The only complications that arose were wound infection in one case and skin excoriation in two others, and these were easily managed.

Adult↗

PubMed1993

The management of enterocutaneous fistulas with parenteral hyperalimentation.

During a period of nine years, all patients with enterocutaneous fistula who received parenteral nutrition as part of therapy were evaluated retrospectively. Twenty-three patients were studied. Peptic ulcer was the most common primary disease, with the fistula arising in 78 percent of the cases from the breakdown of an anastomosis and in the remainder from a direct trauma to the bowel. The most common site of the fistulas was the ileum followed by the duodenum. All the patients were treated conservatively with total bowel rest and parenteral nutrition, and in 56.5 percent of the cases spontaneous closure occurred within an average of 29.6 days. In five patients, the fistula failed to close, and surgery was performed. The mean surgical closure time overall 36.4 days, but this varied from 20.8 days for the duodenum to 39 days for the jejunum and ileum, and 19.7 days for the large intestine. Five patients (22.7%) died, four from sepsis, the fifth from systemic malignancy. Mortality was related to the location and output of the fistula, with jejuno-ileal high-output fistulas in particular figuring prominently in the mortality.

Adolescent↗

PubMedDate not supplied

Complicated marginal ulcers after surgery for duodenal ulcer.

During a period of 10 years, 10 cases of marginal ulcer (MU) after surgery for duodenal ulcer were evaluated retrospectively. The most common cause of MU was inadequate gastric resection plus incomplete vagotomy; the second common cause was incomplete vagotomy. In one case, the MU could be ascribed to malignant gastrinoma. In eight of the ten cases epigastric pain was a major symptom. MU was complicated with perforation, massive bleeding, gastrojejunocolic fistula and afferent loop obstruction in 2, 2, 2, and 1 cases, respectively. Gastroscopy was very useful for the diagnosis except in emergency cases. Hollander test was used in six of the 10 patients to evaluate if the vagotomy had been complete. The mean acid output by insulin induction was found 32 meq/h. As a surgical therapy, total gastrectomy (2 cases), truncal vagotomy (2 cases), truncal vagotomy plus 60% gastric resection or reresection and Roux Y gastrojejunostomy were performed. Postoperative complications (enterocutaneous fistula, intraabdominal abscess and delayed gastric emptying) occurred in 33 patients. One patient was lost after total gastrectomy in the malignant gastrinoma and gastrojejunocolic fistula case, due to sepsis. The patients were followed up for 4.4 years on the average. No recurrence was seen.

Adult↗

PubMedDate not supplied

Complications of 867 thyroidectomies performed in a region of endemic goiter in Turkey.

This article aims to define the incidence of complications in 867 thyroidectomies performed by residents with attending surgeons' supervision as part of a training programme, in a region of endemic goiter. Seven hundred and nine patients were female and 158 were male. The age of the patients ranged between 6 and 76 and mean age was 32.5. Cases were divided into two groups according to their disease nature. Group 1 included 805 patients with nodular colloidal goiter (NCG) and adenomas. The remaining 62 cases, 25 with recurrence of goiter (RG), 21 with thyroid malignancy (TM) and 16 with thyroiditis formed group 2. While the overall complication rate was 11.3% (93 cases) in group 1, it was 20.9% (13 cases) in group 2. The mortality rate was zero in both groups. The incidence of complications of 867 thyroidectomies performed by residents with the attending surgeons' supervision was within acceptable limits especially as far as group 1 was concerned. However we suggested that attending surgeons themselves, disregarding residents training, should perform the operation in special cases such as recurrent goiters, thyroid carcinomas with positive regional lymph nodes and thyroiditis with regional adhesions.

Adolescent↗