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    A Rare Complication of Simple Hepatic Cyst: Spontaneous Rupture, Case Report and Literature Review
    (2020) Güler, Yılmaz; Sengul, Serkan; Çalış, Hasan; Ozen, Ozkan; Karabulut, Zülfikar
    Simple hepatic cysts are usually asymptomatic; most of them are found incidentally, and complications, such as rupture, bleeding, infection and obstructive jaundice, are rare. Intracystic hemorrhage is seen in 2-5% cases, but cyst rupture is an uncommon complication of hepatic cysts. A 70-year-old man without trauma history was admitted to our hospital’s emergency department with severe abdominal pain. Urgent laparotomy and surgical excision of the cyst were performed, revealing a ruptured cyst approximately 10x15 cm in size over the leftliver lobe and a rupture hole approximately 1.5 cm in size over the cystic wall. The postoperative period was uneventful, and the patient was discharged six days after the operation. Spontaneous rupture is an extremely rare complication of simple hepatic cysts. Treatment for symptomatic hepatic cysts includes percutaneous aspiration and surgery. Surgical intervention, especially laparotomy, was preferred in most cases.
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    Colonoscopic polypectomy: Analysis of 429 cases
    (2022) Sengul, Serkan; Kubat, Mehmet
    Aim: It is well known that most colorectal cancers develop from colon polyps. Therefore, removing polyps found during colonoscopy, regardless of their size and characteristics, is critical because of the risk of developing colorectal cancer. This study aimed to evaluate the outcomes of colonoscopic polypectomy performed in our clinic. Materials and Methods: The data of patients who underwent colonoscopy for various reasons between January 2018 and December 2020 and who had polypectomy performed during the procedure were evaluated retrospectively. These patients were divided into two groups, single polypectomy, and multiple polypectomy cases. Results: Single polyp was detected in 72% (n=309) of the 429 patients included in the study, whereas multiple polyps were detected in 28% (n=120). Of these patients, 62.9% (n=270) were male and 37.1% (n= 159) were female. The median age of patients with a single polyp (61.0) was lower than that of patients with multiple polyps (65.0) (p= 0.014). In patients with a single polyp, the most common localization was rectum (32.4%), and the most common histopathological subtype was tubular adenoma (50.8%). In patients who underwent multiple polypectomies, the most common localization was a sigmoid colon (25.5%), while the most common histopathological subtype was again tubular adenoma (48.1%). There was no statistically significant difference between the two groups in the severity of dysplasia (p = 0.838). A significant difference was found between polyp diameter and dysplasia severity in adenomatous polyps in both groups (p<0.001). Conclusion: Colonoscopic polypectomy effectively reduces the risk of colorectal cancer by removing precancerous polyps. Colon polyps are often prominent in the rectosigmoid region and more common in the male gender. An increase in the number of colon polyps is observed with age. In our country, a multicenter prospective study with many participants is required to characterize polyps.
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    Effect of propolis on wound healing in sacrococcygeal pilonidal disease: A randomized controlled clinical trial
    (Univ Karachi, 2021) Kubat, Mehmet; Karabulut, Zulfikar; Sengul, Serkan
    Wound healing and recurrence are the leading problems encountered in sacrococcygeal pilonidal sinus disease. Propolis has a place in both traditional and complementary medicine, and in vitro and in vivo studies have reported its anti-inflammatory, anti-oxidant, anti-bacterial, anti-fungal and immunostimulant properties. In the present study, we discuss the effect of propolis on wound healing in sacrococcygeal pilonidal diseases treated with marsupialization. Patients who were admitted to our clinic with sacrococcygeal pilonidal disease were analyzed prospectively, with a total of 33 patients divided into study and control groups. All patients underwent marsupialization surgery, and the wound areas were analyzed post-operatively, on the 0, 7th, 14th, 28th days and on the day of complete recovery. An acceleration of wound healing was observed from the first week that was found to be even faster between days 14 and 28. The complete recovery score in the study group was significantly lower. Propolis can be used to accelerate wound healing when the marsupialization method is preferred in patients diagnosed with uncomplicated sacrococcygeal pilonidal cyst due to its low cost, good patient compliance, low side effect profile, lack of toxicity and high efficacy.
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    Öğe
    Efficacy of blood parameters as indicators of the need for overdue urgent cholecystectomy in elderly patients with acute cholecystitis
    (Turkish Assoc Trauma Emergency Surgery, 2023) Kubat, Mehmet; Sengul, Serkan; Sahin, Serdar
    BACKGROUND: Although early cholecystectomy is recommended for patients with acute cholecystitis, conservative treatment followed by delayed cholecystectomy (DC) is a highly preferred modality, especially in older adult patients. However, some severe cases require overdue urgent cholecystectomy (OC). This study aimed to evaluate the ability of laboratory findings and Tokyo severity classification (TokyoSC) to differentiate those with the need for OC among elderly patients.METHODS: Laboratory/radiological/clinical findings of geriatric patients with acute cholecystitis on admission and TokyoSC were retrospectively analyzed. The DC and OC groups were compared. RESULTS: The mean age of the 164 patients was 72.3 +/- 6.4 years. White blood cell, neutrophil (NEU), immature granulocyte (IG), C-reactive protein, neutrophil-to-lymphocyte ratio (NLR), and TokyoSC parameters were all significant at P<0.001 in differentiation. NLR had a specificity of 98%, and TokyoSC had a sensitivity of 98%. CONCLUSION: NLR, NEU, IG, and TokyoSC were effective in differentiating patients who needed OC while planning conservative treatment + DC for older adult patients who were followed up due to acute cholecystitis. If the NLR is >9.9 and TokyoSC is moderate/ high, early cholecystectomy should be preferred instead of conservative treatment + DC in aged patients.
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    Küçük Umbilikal Hernilerin Onarımında Sütür Onarım ile Meş Onarımının Karşılaştırılması: Retrospektif Kohort Çalışması
    (2023) Kubat, Mehmet; Sengul, Serkan
    Amaç: Küçük çaplı umbilikal hernilerin onarımında meş kullanımı gerekliliği klinik pratikte halen tartışmalı bir konudur. Çalışmamızda onarımında sık kullanılan meş ve sütür onarımı tekniklerinin ?3 cm çaplı umbilikal hernilerin; nüks, postoperatif ağrı ve hasta memnuniyeti açısından karşılaştırılması amaçlandı. Yöntem: Merkezimizde 3 yıllık süre içerisinde ameliyat edilen ?3 cm çaplı umbilikal hernilerin kayıtları retrospektif olarak değerlendirildi. Çalışmaya dahil edilen 218 hasta; meş onarımı ve sütür onarımı grupları ayrıldı. Nüks gelişmesi, dinlenirken ve fiziksel aktiviteyle ağrı, tedaviden memnuniyet açısından değerlendirildi. Bulgular: Meş onarımı ve sütür onarımı grupları arasında; nüks açsından anlamlı fark görülmedi (p=0,662). Meş onarımı grubunda, dinlenirken ağrı (p=0,002) ve fiziksel aktiviteyle ağrı (p=0,003) anlamlı daha fazla görülürken bu sonuçlar hasta memnuniyetinde anlamlı farklılık ile sonuçlanmadı (p=0,928). Sonuç: Küçük çaplı umbilikal hernilerin (?3 cm çap) onarımında sütür onarımı, daha az postoperatif ağrıya neden olması, nüks ve hasta memnuniyeti açısından meş onarımına göre fark görülmesi nedeniyle güvenle tercih edilebilir bulunmuştur.
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    Öğe
    When Should Definitive Surgery Be Performed After Sacrococcygeal Pilonidal Sinus Abscess Drainage
    (2023) Güler, Yılmaz; Sengul, Serkan; Çalış, Hasan; Karabulut, Zulfikar; Ozen, Ozkan
    Objective: The abscess development is one of the common clinical presentations of pilonidal sinus. Treatment in pilonidal sinus abscesses involves allowing secondary recovery following wide local excision with drainage, and excision procedures are performed after a few weeks and after the infection is completely cured. We aimed to investigate the effect of the time interval between the abscess drainage and definitive surgical treatment on the development of postoperative complications in patients who had pilonidal sinus abscess. Methods: The patients were divided into 2 groups according to the time interval from abscess drainage to sinus excision surgery: patients who under- went sinus excision 1 month after abscess drainage comprised group 1 and patients who underwent sinus excision 3 months after abscess drainage comprised group 2. Sinus excision and primary closure surgery were performed in patients in both groups. Results: In total, 44 patients (53.0%) underwent sinus excision group 1 and 39 patients (47.0%) underwent sinus excision group 2 after abscess drainage. Postoperative wound infection and wound dehiscence rates were significantly higher in group 1 patients than in group 2 patients (P < .05). Conclusion: We suggest that for reducing postoperative complications, it would be a better approach performing sinus excision after waiting for at least 3 months following drainage instead of performing excision right after recovery of infection or within a few weeks after the abscess drainage.