May 2018

Original Article

Rhomboid excision and limberg flap reconstruction for pilonidal disease

Volkan Oter1 , SerdarOter2 , Mehmet Tolga Kafadar3 1

Department of Gastroenterological Surgery, School of Medicine, Sakarya Unıversity, Sakarya, 2 Department of General Surgery, Cihanbeyli State Hospital, Konya, 3 Department of General Surgery, Health of Science University, Mehmet Akif İnan Training and Research Hospital Şanlıurfa, Turkey

DOI: 10.4328/AEMED.129

Abstract

Aim: Pilonidal sinus is a common disease that affects generally younger patients and occurs mostly in the sacro-coccygeal region. The main treatment of pilonidal sinus is still controversial. This study aimed to evaluate the usefulness and surgical results of Limberg flap reconstruction in pilonidal sinus disease. Material and Method: Between January 2012 and January 2017, 78 patients were operated on electively and rhomboid excision with Limberg flap reconstruction was performed for pilonidal sinus disease in our clinic. Demographic features, clinical data, operative findings, postoperative complications, and patient follow-up were retrospectively analyzed. Results: The mean age of the patients was 27.91± 6.49 years. Out of the 78 patients, 59 (75.6%) were male and 19 (24.4%) were female. The mean duration of symptoms was 5.38 months (2-13 months) and the mean operative time was 68.4 ± 18.7 min. The median amount of blood loss during surgery was 75 ml (range from 30 to 200 ml). The mean hospital stay was 7.79 ± 1.85 days. In the postoperative period, recurrences were noted in only 2 (2.56%) patients in the follow-up period, which ranged from 1 to 6 years. Discussion: Limberg flap is an efficient and easy technique with less complication. It is especially useful in patients with large diseased pilonidal sinus tissue and multiple sinuses with lateral openings. This technique results in a reduced hospital stay and recurrence rate which means that the patients can go back to their daily lives sooner.

Keywords

Pilonidal Sinus Disease; Limberg Flap; Low Recurence Rate; Surgical Treatment Option

Corresponding Author: Volkan Öter, Department of Gastroenterological Surgery, School of Medicine, Sakarya Unıversity, Kemalpasa Neighborhood, Serdivan, 54050, Sakarya, Türkiye. GSM: +905053366333 F.: +90 2642955032 E-Mail: otervolkan@gmail.com

How to Cite: Volkan Oter, Serdar Oter, Mehmet Tolga Kafadar. Rhomboid excision and limberg flap reconstruction for pilonidal disease. J Ann Eu Med 2018;6(2): 28-31

Simultaneous combined spinal epidural anesthesia technique without catheter

Varlik K. Erel
Department of Anesthesiology and Reanimation, Medical Faculty, Adnan Menderes University, Aydin, Turkey
 
DOI: 10.4328/AEMED.128
 
Abstract
Aims: The extension of spinal anesthesia by extradural injection has been identified as a modification of the combined spinal-epidural anesthesia. Epidural volume extension (EVE) is a rescue strategy that can raise the level of insufficient post-spinal sensory block. Material and Method: After approval of Adnan Menderes University Ethics Committee (Decision 2016/834/37), the data of 455 patients who had undergone insufficient simultaneous combined spinal epidural without catheter between 2010 and 2016 were retrospectively analyzed in terms of ASA scores; demographic and hemodynamic data; surgery type; preoperative and postoperative sensory and motor block levels; operation onset times after anesthesia; need for peroperative additional anesthesia, vasopressor (ephedrine) and atropine; and postoperative pain onset times. Results: Of the 455 patients, there were two groups. In the first group, there were 238 patients who had undergone cesarean section and in the second group there were 217 patients who had undergone surgery for inguinal hernia. There was no mortality and morbidity in any group. There was a statistically significant decrease in heart rate, systolic, diastolic, and mean arterial pressures during the peroperative period in both groups (p<0.05). Discussion: The simultaneous combined spinal-epidural technique (sCSEA) without catheter may be considered as an alternative to conventional methods for appropriate surgeries. It can be safely used with local anesthetic combinations instead of saline for EVE. The advantages and disadvantages of EVE compared to the conventional method should be demonstrated with clinical randomized studies.
Keywords
Combined Spinal Epidural Anesthesia; Epidural Volume Extension; without Catheter; Bupivacaine; Lidocaine; Morphine
 
Corresponding Author: Varlik K. Erel, Department of Anesthesiology and Reanimation, Adnan Menderes University, School of Medicine, Aydin, Turkey. E-Mail: varlik.erel@gmail.com
ORCID ID: 0000-0002-0539-661X
 
How to cite this article: Erel VK. Simultaneous combined spinal epidural anesthesia technique without catheter. J Ann Eu Med 2018;6(2): 24-7.
 
 
 

Laparoscopic colorectal surgery outcomes in our first 65 case comparing with literature

Eyüp Murat Yılmaz1 , Varlik K. Erel2

1 Department of General Surgery, 2 Department of Anesthesiology and Reanimation, Medical Faculty Adnan Menderes University, Aydin Turkey

DOI: 10.4328/AEMED.126

Abstract

Aim: Laparoscopic colorectal surgery has become widely performed in many centers today. We planned to present the first 65 cases in our clinic. Material and Method: Sixty-five patients who underwent laparoscopic colorectal surgery between September 2014 and March 2018 were retrospectively reviewed. Cases returning open surgery despite laparoscopic onset were excluded from the study. Demographic data, operative types, duration, tumor stages were recorded. Results: 65 cases were included, 39 were male (60%), 26 were female (40%), mean age was 63.2 (40-81). Low anterior resection (LAR) in 20 cases (%30.7), anterior resection (AR) in 19 cases (29,2%), right colectomy in 18 cases (27,6%), abdomino-perineal resection (APR) in 5 cases (7,7%), colloanal anastomosis in 2 cases, total colectomy in 1 case (1.6%) were performed. It have been showed anastomotic leakage in 3 cases (4,6%), wound infection in 10 cases (15.3%), 3 patient incisional hernia (4,6%), ureter injury in a patient (1.5%) and urethra injury in a patient (1.5%). There was no mortality. Discussion: Although our experience with laparoscopic colorectal surgery is compatible with the literature and is not yet gold standard, we think that it gives better results than open surgery due to its advantages.

Keywords

Laparoscopic Colorectal Surgery; Surgery; Open Surgery; Anastomotic Leakage; Incisional Hernia

Corresponding Author: Eyüp Murat Yılmaz. Department of General Surgery, Adnan Menderes University, School of Medicine, Aydın, Turkey. E-Mail: drmyilmaz80@gmail.com

How to cite this article: Yılmaz EM, Erel VK. Laparoscopic colorectal surgery outcomes in our first 65 case comparing with literature. J Ann Eu Med 2018;6(2): 16-9

Endobronchial foreign body aspirations causing chronic cough and dyspnea

Suat Konuk1 , Hikmet Çoban2

1 Pulmonology Department, Abant Izzet Baysal University, Faculty of Medicine, Bolu, 2 Sakarya Training and Research Hospital Pulmonology Clinic, Sakarya, Turkey

DOI: 10.4328/AEMED.125

Abstract

Aim: In this retrospective report, the foreign body findings in adult patients with chronic cough were aimed to explore. Material and Method: Between October 2011 and May 2017, patients with bronchial foreign body aspirations mistakenly diagnosed as COPD or asthma in outside centers were collected. The bronchoscopic and clinical findings of four patients with chronic cough were found from the archieve of the hospital. Results: The age of the patients who applied to our clinic ranged from 27 to 64 years. Endobronchial foreign bodies were successfully removed with FOB in all patients. The extracted foreign bodies were stone, headscarf needle, a needle-like object and a foil paper. Discussion: In adults with chronic cough foreign body aspiration should be immediately taken into account.

Keywords

Chronic Cough; Bronchoscopy; Foreign Body Aspiration

Corresponding Author: Suat Konuk, Kültür Mah. Akçam Sok. Daire: 1/2, Düzce, Turkey. GSM: +905073410126 E-Mail: suatkonukk@windowslive.com

How to cite this article: Konuk S, Çoban H. Endobronchial Foreign Body Aspirations Causing Chronic Cough and Dyspnea. J Ann Eu Med 2018;6(2): 11-5.

 

Protective effect of B.clasuii on sepsis

Varlik K. Erel1 , Eyüp Murat Yılmaz2

1 Department of Anesthesiology and Reanimation, 2 Department of General Surgery, Medical Faculty, Adnan Menderes University, Aydin, Turkey

DOI: 10.4328/AEMED.127 

Abstract

Aim: Sepsis is a clinical problem that still has high mortality and morbidity despite advances in supportive care in intensive care. The study’s aim was to investigate the protective effect of Bacillus clausii, an important probiotic with a strengthening effect on the gastrointestinal barrier, on septicemia. Material and Method: Twenty-four rats were divided into three randomized and double-blind groups, as Group 1 (control group, n=8), Group 2 (sepsis group, n=8), and Group 3 (sepsis+probiotic group, n=8). Lipopolysaccharide extracted from serotypes (0111:B4) of Escherichia coli (E.coli ) was injected intraperitoneally to all group for sepsis model at a dose of 15 mg/kg and rats were sacrificed at 48 hours. Serum oxidant and antioxidant parameters were measured. Results: The C-Reactive Protein (CRP) value of Group 1 was significantly lower than Group 2 [CI:(-44.16)-(-28.52), p=0.000], whereas the CRP values of Group 3 were significantly lower than Group 2 [CI:(7.4)-(34.7), p=0.005]. MDA values were found to be significant between Groups 1 and 2, CI:(-0.3)-(-0.7), p=0.045. The thiol values of Group 2 were significantly lower than Group 1 [CI:(9)-(366), p=0.041], whereas the thiol (SH) values of Group 3 were significantly higher than those of Group 2 [CI:(-659)-(-98), p=0.016]. Discussion: B. clausii is one of a group of probiotics that is inexpensive and effective. Sepsis is still a high-risk clinical problem. Our study showed that B. clausii has a protective effect against sepsis.

Keywords

Sepsis; B. Clausii; Probiotic; Rat; Experimental Sepsis Model; Protective Effect

Corresponding Author: Varlik K. Erel, Department of Anesthesiology and Reanimation, Adnan Menderes University, School of Medicine, Aydın, Turkey. E-Mail: varlik.erel@gmail.com

ORCID ID: 0000-0002-0539-661X

How to cite this article: Erel VK, Yılmaz EM. Protective effect of B.clasuii on sepsis. J Ann Eu Med 2018;6(2): 20-3.