Yazar "Unver, M." seçeneğine göre listele

Listeleniyor 1 - 2 / 2
  • Küçük Resim Yok
    Öğe
    Can polyglactin mesh be used for prevention of seroma after mastectomy: an experimental study
    (Springer Wien, 2014) Yeniay, L.; Unalp, O. V.; Uguz, A.; Unver, M.; Karaca, A. C.; Sezer, T. O.; Yoldas, T.; Demir, H. B.; Zekioglu, O.; Kapkac, M.; Yilmaz, R.
    Background Seroma formation is still a common problem in breast surgery. Seroma formation is associated with morbidity and financial loss. Fibrin glue was used in several studies for solution, but the results were controversial. On the other hand surgical meshes are promising to prevent the seroma formation. Methods A total of 48 female Sprague-Dawley rats were randomly assigned to four groups. Each underwent radical mastectomy, axillary lymph node dissection, and disruption of the dermal lymphatic vessels. Group 1 is the control group (n = 12). In group 2 (n = 12), 1 x 1 cm polyglactin 910 mesh (Vicryl, Ethicon Johnson&Johson USA) is placed over the chest wall under the skin flaps prior to closure. The animals in group 3 received 0.5 mL fibrin glue (Baxter Healthcare Ltd. United Kingdom) topically throughout the wound before the closure (n = 12). The animals in group 4 (n = 12) received 0.5 mL fibrin glue topically throughout the wound, and 1 x 1 cm polyglactin 910 mesh is placed under the skin flaps prior to the closure. Full thickness tissue samples from both the chest wall and the skin were harvested. The harvested tissue samples were evaluated by a single pathologist in a blind fashion. Results The mean seroma volume of the control group was 1.536 mL whereas the mean seroma volume of the groups 2, 3, and 4 were 1.189, 0.438, and 0.556 respectively. Mean seroma volume was significantly lower, adhesion index and foreign body reaction were higher in group 4. Conclusion Although various studies show controversial results to prevent the seroma formation. This experimental study is an evidence that fibrin glue and polyglican mesh reduce seroma with increasing inflammatory reaction.
  • Küçük Resim Yok
    Öğe
    RECEIVER OPERATING CHARACTERISTIC ANALYSIS AND DISCRIMINATIVE EFFECT OF NEUTROPHIL-TO-LYMPHOCYTE RATIO IN PATIENTS WITH SUSPECTED APPENDICITIS
    (Carbone Editore, 2016) Ozturk, S.; Unver, M.; Yoldas, O.; Dizen, H.; Erol, V; Bozbiyik, O.; Guner, M.; Pehlivanoglu, K.; Kebapci, B.; Aydin, C.; Akbulut, G.
    Introduction: Acute appendicitis (AA) is one of the most common causes of abdominal pain and emergent abdominal surgery. The incidence is approximately 10% during the lifetime. Although appendectomy is a most common surgical procedure worldwide, it's complication rate is 5-28% A delay in diagnosis of AA is associated with prolonged hospitalization, an increased rate of perforation (34%-75%), wound infection (0%-11%), pelvic abscess (1%-5%) and late intro-abdominal adhesions. Appendectomy is first described by McBurney in 1894 and still remains the standart procedure for AA. Although patients with AA often present with a characteristic symptom complex and physical findings, atypical presentations are common. The aim of this study was to assess the diagnostic value of neutrophil-to-lymphocyte ratio (NLR) in patients who were operated for suspected acute appendicitis and to assess the discriminative effect of this ratio between wzinflamed, uncomplicated and complicated appendicitis. Materials and methods: The medical records of 3212 patients who underwent appendectomy for suspected acute appendicitis during a 10-year period were reviewed retrospectively. Patients were divided into 3 groups; group 1, 208 consecutive patients who had uninflamed appendix at appendectomy; group 2, 2111 consecutive patients who had uncomplicated acute appendicitis at appendectomy; group 3, 893 patients who had complicated appendicitis (perforated appendix or peri-appendicular abscess) at appendectomy. Data for three groups of patients were analyzed to calculate the sensitivity and specificity of the NLR in the diagnosis of acute appendicitis. Receivers operating characteristic (ROC) curves were used to evaluate this ratio in a relation with true diagnosis and severity of acute appendicitis. Results: 1792 (55.8%) of the patients were male and 1420 (44.2%) of them were female. The mean age of the groups were 30.28 +/- 14.18, 29.98 +/- 12.63 and 33.81 +/- 16.27 respectively. The discriminative effect of NLR was higher between uninflamed and complicated appendicitis groups with a cut-off value of 3,94. The recommended cut-off value of the preoperative NLR was decided using ROC curve analyses. The recommended cut-off value of the NLR was based on the most prominent point on the ROC curve for sensitivity (82.2%) and specificity (56.5%). The area under the ROC curve was 0.74. Conclusion: AA is one of the most common surgical emergencies and the most common source of infection in community acquired intra-abdominal infections. However the diagnosis is often challenging and the decision to operate, observe or further work-up on a patient is often unclear. Initial management of patients with suspected AA is based on the history of the patient, physical examination, basic laboratory tests reflecting the inflammatory response and radiologic imaging. NLR is a helpful biochemical parameter for the diagnosis of acute appendicitis but it has limited value on differentiating patients with complicated appendicitis from patients with uninflamed and uncomplicated appendicitis.