Makale Arama

 Meckel’s diverticulum is the most frequently seen congenital anomaly of the gastrointestinal tract. Most of the cases are asymptomatic. Generally they are found randomly during surgical procedures and autopsies. They can be seen following fulminant abdominal pain and subsequently life-threatening complications. A Meckel’s diverticulum with complications is generally diagnosed following diagnostic laparotomy procedures. In our study, we present the case of a gangrened Meckel’s diverticulum case twisted and attached to the fibrotic band, which is reported to be a rare complication in literature. The patient was taken into surgery with the pre-diagnosis of acute appendicitis and the procedure was completed laparoscopically.

Aim: Gallbladder cancer is an uncommon, but aggressive tumor. Its prognosis is poor and the most cases are incidentally detected in histopathological examinations of cholecystectomies due to benign diseases. With the era of laparoscopic cholecystectomy, the number of cases detected in early stage is increasing. In this study, we aimed to evaluate the rate of cancer encountered and the distribution of non-cancer diagnoses in cholecystectomy materials sent to our department, together with the literature findings.

Materials and Methods: The results of the cholecystectomy materials sent to the pathology laboratory and examined routinely in 2016-2017 were retrospectively evaluated by forming diagnostic groups. Clinical preliminary diagnoses, demographic informations (age, sex), and pathology reports of the patients were reviewed.

Results: We included a total of 1000 cholecystectomy materials into the study. Two of the 7 patients who presented with malignancy were incidentally diagnosed and underwent laparoscopic cholecystectomy with the preliminary diagnosis of cholelithiasis, with the primary focus was gallbladder in one patient, and the other was compatible with colonic adenocarcinoma infiltration. Preoperative and / or perioperative malignancy was detected in the remaining 5 patients. A large proportion (> 90%) of the other cases had chronic or chronic active cholecystitis and low rate of acute cholecystitis included gastric heterotopia found in 2 (0.2%), tubular adenoma in 1 (0.1%), tubulovillous adenoma in 1 (0.1%), adenomyoma / adenomyomatosis in 4 (0.4%), polyp in 6 (0,6%) and dysplasia (Biliary intraepithelial neoplasia, BilIN) in 5 (0.5%) patients.

Abstract:

Objective: Our objective in this study was to present our four years of experience in laparoscopic surgery for urinary system accompanied by literature.

Material and Methods: Between January 2014 and October 2018, laparoscopic surgical intervention was made on urinary system for 97 patients in our clinic. 54 patients had right and 42 patients had left laparoscopic surgical intervention and 1 patient had radical prostatectomy. Patients were retrospectively examined for operation duration, average blood loss, intraoperative and postoperative complications, hospitalization duration and drain installation time after separating into two groups as right and left.

Results.

Average age of the patients was 44(16-67). Male/Female rate was 54/43. Apart from radical prostatectomy, 54 patients had right and 42 patients had left kidney laparoscopic surgical intervention. Average operation duration was 145 (40-210) minutes, average drain removal time was 3.1 (1-10) days, hospitalization duration was 3.4 (1-14) days and bleeding amount was 150(20-500) cc in all interventions. Lengthened urinary drainage was observed from the drain in one patient who had pyelolithotomy and one patient who had radical prostatectomy. When all interventions were considered, the average complication ratio was found 5.1%. No differences were observed in the parameters compared among right and left laparoscopic surgery interventions.

Conclusion: For a surgeon in the first learning phase of laparoscopy, choosing relatively simpler procedures in the beginning but passing to more complex operations without much delay may quickly shorten the learning phase. Through the selection of suitable patients and adequate equipment, laparoscopic surgery can also be applied safely in peripheral centers.

 Many of the colorectal cancers originales from polips.We wanted to discuss a case accompanied with literature who has a complicated giant rectal polip which presented with an unusual clinic and confusion in diagnosis. 36 years old male patient.He has cramp like stomache and changing in volonic habits for about a year.During colonoscopy a malign mass in caecum and a giant villous adenoma in rectum is identified.The mass in caecum is excised via laparoscopic surgery.The mass in rectum received polipectomy via local excision.Altough a cancer has seen in the polip the surgery is considered opprepriote because of the surgical frontier and acceptable histologic properties. Colorectal polips are lesions which has the risk to turn into cancers thus, detoiled histopatologic examination and gently decission of surgery is needed.

Aim: Venous thromboembolism (VTE) events covering deep vein thrombosis (DVT) and pulmonary
embolism (PE) constitute the most important morbidity-mortality cause in obesity surgery. The objective
of this study was to assessment of thromboembolism results in patients who underwent bariatric surgery
with standard dose prophylaxis.
Patients and Methods: The patients who were operated for morbid obesity in our clinic between 2015 and
2019 were retrospectively examined. Cases that had laparoscopic sleeve gastrectomy and were applied
standard dose Enoxaparin prophylaxis were included in the study. Demographic data, preoperative
preparation and postoperative antiembolic treatment conditions of the patients were registered.
Results: Eighty-seven patients who had laparoscopic sleeve gastrectomy were included in the study. 66
(%75,8) of the patients were female and 21 (%24,1) were male. The mean age was 38.7 (18-55). Mean
hospitalization duration was 6.6 (3-69) days. Four patients (% 4,5) had postoperative complication. PE
developed in two patients while leak-related mediastinitis and incisional hernia (%1,1) developed in one
case each.
Conclusion: Despite available prophylaxis methods, VTE constitutes an important morbidity and mortality
cause in patients who had bariatric surgery. While high-dose low-molecular weight heparin (LMWH) use
may cause bleeding, the possibility of VTE increases with using low-dose LMWH. This situation appears
as a limitation of LMWHs. New studies are needed for increased dose at early period and standard dose
application after discharge.

 Heterotopic pregnancy is a condition in which intra- and extrauterine pregnancies occur at the same time. However in the last decades there has been a significant increase of heterotopic pregnancy as high as %1-3 , this raised frequency has been attributed to the extended use of assisted reproductive technologies. Because it is a rare condition,there is no standart management or treatment method for heterotopic pregnancy. Usually methotrexate, RU 486 (Mifepristone) and prostaglandins aren’t used if intrauterine pregnancy wanted to persist, because of their potantial teratogenic effects on embryo. Here we present a case with heterotopic pregnancy who were treated by surgery for ectopic pregnancy and intrauterine pregnancy ended with labour of a healthy infant in term.