Pub Date : 2016-06-16DOI: 10.5835/JECM.OMU.33.02.001
S. Bilge, A. Ağrı, Bahar Akyüz
Blood brain barrier (BBB) is a special cellular system that enables the nervous system to maintain in brains homeostasis by allowing the essential materials to pass while denying harmful substances. All of the drugs with high molecular weight and 98% of the drugs with low molecular weight cannot pass through the BBB. Only a few high liposoluble molecules, which have smaller than 500 Da molecular weight, can pass through the BBB. Thus, a great number of central nervous system diseases do not respond to this kind of drugs. However, in order to effectively treat a great quantity of neurological diseases there is increasing necessity for drugs which can pass through the central nervous system. In conclusion, in recent years, studies aimed new strategies for the passage of the drugs with high molecular weight through the brain have been carried out.
{"title":"Drug transport to the brain","authors":"S. Bilge, A. Ağrı, Bahar Akyüz","doi":"10.5835/JECM.OMU.33.02.001","DOIUrl":"https://doi.org/10.5835/JECM.OMU.33.02.001","url":null,"abstract":"Blood brain barrier (BBB) is a special cellular system that enables the nervous system to maintain in brains homeostasis by allowing the essential materials to pass while denying harmful substances. All of the drugs with high molecular weight and 98% of the drugs with low molecular weight cannot pass through the BBB. Only a few high liposoluble molecules, which have smaller than 500 Da molecular weight, can pass through the BBB. Thus, a great number of central nervous system diseases do not respond to this kind of drugs. However, in order to effectively treat a great quantity of neurological diseases there is increasing necessity for drugs which can pass through the central nervous system. In conclusion, in recent years, studies aimed new strategies for the passage of the drugs with high molecular weight through the brain have been carried out.","PeriodicalId":15770,"journal":{"name":"Journal of Experimental & Clinical Medicine","volume":"33 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2016-06-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"85626743","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2016-06-16DOI: 10.5835/JECM.OMU.33.02.002
E. Kurtoğlu, A. Kokcu, H. Çelik, F. D. Bıldırcın, M. Tosun, T. Alper, E. Malatyalıoğlu
The aim of this study was to evaluate the validity of platelet count (PC) and indices, including mean platelet volume (MPV), platelet distribution width (PDW) and platelet crit (PCT), in identifying the pregnancies at risk for preeclampsia. Demographic data and laboratory tests for PC, MPV, PDW and PCT of 250 pregnant women (100 normotensive pregnants, 121 pregnants with severe preeclampsia and 29 pregnants with mild preeclampsia) were retrospectively analyzed. Platelet counts and indices were compared between the study groups. MPV and PDW were significantly higher in preeclamptic pregnant women when compared to the normal group (p=0.006, p=0.046) and area under ROC curve for MPV was found statistically significant. PC, MPV and PCT were found significantly increased in late-onset preeclampsia (p<0.05) whereas there was no significant difference in these three indices in terms of severity of the disease. ROC analysis for MPV levels to differentiate earlyonset and late-onset preeclamptic cases was also found statistically significant. Measurement of MPV may contribute to identify the pregnants at risk for preeclampsia and assess the onset-time. PDW may be also useful in detection of the pregnant at risk for preeclampsia.
{"title":"Validity of platelet indices in predicting the risk of developing preeclampsia","authors":"E. Kurtoğlu, A. Kokcu, H. Çelik, F. D. Bıldırcın, M. Tosun, T. Alper, E. Malatyalıoğlu","doi":"10.5835/JECM.OMU.33.02.002","DOIUrl":"https://doi.org/10.5835/JECM.OMU.33.02.002","url":null,"abstract":"The aim of this study was to evaluate the validity of platelet count (PC) and indices, including mean platelet volume (MPV), platelet distribution width (PDW) and platelet crit (PCT), in identifying the pregnancies at risk for preeclampsia. Demographic data and laboratory tests for PC, MPV, PDW and PCT of 250 pregnant women (100 normotensive pregnants, 121 pregnants with severe preeclampsia and 29 pregnants with mild preeclampsia) were retrospectively analyzed. Platelet counts and indices were compared between the study groups. MPV and PDW were significantly higher in preeclamptic pregnant women when compared to the normal group (p=0.006, p=0.046) and area under ROC curve for MPV was found statistically significant. PC, MPV and PCT were found significantly increased in late-onset preeclampsia (p<0.05) whereas there was no significant difference in these three indices in terms of severity of the disease. ROC analysis for MPV levels to differentiate earlyonset and late-onset preeclamptic cases was also found statistically significant. Measurement of MPV may contribute to identify the pregnants at risk for preeclampsia and assess the onset-time. PDW may be also useful in detection of the pregnant at risk for preeclampsia.","PeriodicalId":15770,"journal":{"name":"Journal of Experimental & Clinical Medicine","volume":"155 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2016-06-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"77982635","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2016-02-21DOI: 10.5835/JECM.OMU.33.01.010
B. Yağız, Unal Biçakçi, E. Ariturk, Y. Issi, F. Bernay
Congenital prepubic sinus is a rare disorder with fewer than 30 cases reported in the literature. The origin of the sinus and its tract is unclear but urethral duplication, cloacal remnant or midline closure defect are amongst the postulated mechanisms for the development of the sinus. Chronic discharge and infection are the main indications for surgery. Although surgery is the definite way of correction, timing and extend of surgery are not well documented due to the limited number of cases. Here we present two cases with congenital prepubic sinus, a four month old girl and a five years old boy, who were admitted with discharge through the external opening of the prepubic sinus which are shown not to have a connection with urinary system and are managed by limited surgical excision. Postoperative courses were uneventful and no relapse or complications were encountered. Histological examination revealed that the sinus tract is lined with squamous stratified epithelium without any other significant finding. Although the classification and definition of congenital prepubic sinus is not clear, extensive imaging modalities and surgical procedures are not necessary in most conditions as these can create additional burden for the patient and the healthcare system and may cause complications at the cost of nothing.
{"title":"Congenital prepubic sinus: Report of two cases","authors":"B. Yağız, Unal Biçakçi, E. Ariturk, Y. Issi, F. Bernay","doi":"10.5835/JECM.OMU.33.01.010","DOIUrl":"https://doi.org/10.5835/JECM.OMU.33.01.010","url":null,"abstract":"Congenital prepubic sinus is a rare disorder with fewer than 30 cases reported in the literature. The origin of the sinus and its tract is unclear but urethral duplication, cloacal remnant or midline closure defect are amongst the postulated mechanisms for the development of the sinus. Chronic discharge and infection are the main indications for surgery. Although surgery is the definite way of correction, timing and extend of surgery are not well documented due to the limited number of cases. Here we present two cases with congenital prepubic sinus, a four month old girl and a five years old boy, who were admitted with discharge through the external opening of the prepubic sinus which are shown not to have a connection with urinary system and are managed by limited surgical excision. Postoperative courses were uneventful and no relapse or complications were encountered. Histological examination revealed that the sinus tract is lined with squamous stratified epithelium without any other significant finding. Although the classification and definition of congenital prepubic sinus is not clear, extensive imaging modalities and surgical procedures are not necessary in most conditions as these can create additional burden for the patient and the healthcare system and may cause complications at the cost of nothing.","PeriodicalId":15770,"journal":{"name":"Journal of Experimental & Clinical Medicine","volume":"6 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2016-02-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"88771064","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2016-02-21DOI: 10.5835/JECM.OMU.33.01.011
A. Tuncer, Didem Baskın Embleton, S. Yılmaz, N. Okur, E. Kacar, Altınay Bayraktaroğlu
In this report, we present a patient with intrabiliary rupture of a hydatid cyst, which caused choledochal obstruction and treated with endoscopic retrograde cholangiopancreatography (ERCP). It is an emergency and treated with mini - mally invasive surgery. A twelve-year-old female patient with acute upper ab - dominal pain, nausea, and vomiting was admitted to pediatric surgery clinic with the preliminary diagnosis of cholestasis. There were localized right upper abdominal rebound and tenderness. Contrast-enhanced axial computed tomog - raphy images through the liver showed that there was a cystic lesion in segment 4 communicating with the biliary system. The main hepatic duct was obliterat - ed and dilated by curvilinear densities consistent with germinative membranes expelled from the cyst into the biliary system. ERCP and sphincterotomy were performed. Germinative membrane and daughter cysts were cleaned with the use of balloon and basket. The patient is doing well without any other complica - tion 20 months after ERCP. There have been few case reports documenting the successful use of ERCP treatment of hydatid cyst. ERCP may be a useful pro - cedure in selected children with suspected intrabiliary rupture or common bile duct obstruction, which occurs due to daughter cyst and germinative membrane.
{"title":"ERCP treatment for intrabiliary rupture of hepatic hydatid cyst in a child","authors":"A. Tuncer, Didem Baskın Embleton, S. Yılmaz, N. Okur, E. Kacar, Altınay Bayraktaroğlu","doi":"10.5835/JECM.OMU.33.01.011","DOIUrl":"https://doi.org/10.5835/JECM.OMU.33.01.011","url":null,"abstract":"In this report, we present a patient with intrabiliary rupture of a hydatid cyst, which caused choledochal obstruction and treated with endoscopic retrograde cholangiopancreatography (ERCP). It is an emergency and treated with mini - mally invasive surgery. A twelve-year-old female patient with acute upper ab - dominal pain, nausea, and vomiting was admitted to pediatric surgery clinic with the preliminary diagnosis of cholestasis. There were localized right upper abdominal rebound and tenderness. Contrast-enhanced axial computed tomog - raphy images through the liver showed that there was a cystic lesion in segment 4 communicating with the biliary system. The main hepatic duct was obliterat - ed and dilated by curvilinear densities consistent with germinative membranes expelled from the cyst into the biliary system. ERCP and sphincterotomy were performed. Germinative membrane and daughter cysts were cleaned with the use of balloon and basket. The patient is doing well without any other complica - tion 20 months after ERCP. There have been few case reports documenting the successful use of ERCP treatment of hydatid cyst. ERCP may be a useful pro - cedure in selected children with suspected intrabiliary rupture or common bile duct obstruction, which occurs due to daughter cyst and germinative membrane.","PeriodicalId":15770,"journal":{"name":"Journal of Experimental & Clinical Medicine","volume":"93 4 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2016-02-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"82743324","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2016-02-21DOI: 10.5835/JECM.OMU.33.01.008
A. Sencan, Chad M. Gridley, Hiep T Nguyen, A. Şencan
Up to date, many surgical techniques have been described for biliary reconstruction. The aim of this study is to try a new surgical technique for biliary reconstruction and also to show whether intraoperative fluorescent molecular imaging (IFMI) is effective to evaluate the perfusion of the new biliary conduit. Two adult pigs were operated. Cholecystectomy and removal of the extrahepatic biliary tract were performed by robotic surgery. A duodenal conduit was created from the duodenum by open surgery. The distal end of the conduit was sutured to portohepatis by end-to-end anastomosis. The perfusion of the conduit was evaluated by photo-dynamic eye. Although the viability of both of the duodenal conduits were macroscopically evaluated as normal, it was screened by IFMI that the middle and distal parts of the conduit were not well-vascularized and that only the base portion of the conduit had sufficient blood supply. As a result, IFMI is a good intraoperative diagnostic tool for showing tissue viability. This new technique may not be used for biliary reconstruction as described here. However, the development of alternative techniques to increase the viability of the conduit may enable the use of this technique successfully.
{"title":"A new surgical technique and intraoperative flourescent molecular imaging for biliary reconstruction","authors":"A. Sencan, Chad M. Gridley, Hiep T Nguyen, A. Şencan","doi":"10.5835/JECM.OMU.33.01.008","DOIUrl":"https://doi.org/10.5835/JECM.OMU.33.01.008","url":null,"abstract":"Up to date, many surgical techniques have been described for biliary reconstruction. The aim of this study is to try a new surgical technique for biliary reconstruction and also to show whether intraoperative fluorescent molecular imaging (IFMI) is effective to evaluate the perfusion of the new biliary conduit. Two adult pigs were operated. Cholecystectomy and removal of the extrahepatic biliary tract were performed by robotic surgery. A duodenal conduit was created from the duodenum by open surgery. The distal end of the conduit was sutured to portohepatis by end-to-end anastomosis. The perfusion of the conduit was evaluated by photo-dynamic eye. Although the viability of both of the duodenal conduits were macroscopically evaluated as normal, it was screened by IFMI that the middle and distal parts of the conduit were not well-vascularized and that only the base portion of the conduit had sufficient blood supply. As a result, IFMI is a good intraoperative diagnostic tool for showing tissue viability. This new technique may not be used for biliary reconstruction as described here. However, the development of alternative techniques to increase the viability of the conduit may enable the use of this technique successfully.","PeriodicalId":15770,"journal":{"name":"Journal of Experimental & Clinical Medicine","volume":"50 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2016-02-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"87025698","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2016-02-21DOI: 10.5835/JECM.OMU.33.01.006
Unal Biçakçi, D. Demirel, N. Bicakci, Y. Issi, B. Yağız, Mithat Günaydın, B. Tander, E. Ariturk, F. Bernay
Surgery for sacrococcygeal teratoma (SCT) in neonatal period may result in functional problems of micturation and defecation caused by pelvic nerve dam - age. We aimed to evaluate long term outcome of patients with SCT in terms of bladder dynamics. To evaluate the postoperative urological outcome related with SCT excision, urodynamic study, ultrasonographic and scintigraphic ex - aminations were performed. The families are asked about the micturition and defecation paterns. Twenty-one patients (eight male, thirteen female) underwent SCT excision between 2006 and 2013 and seventeen (six male, eleven female) are regarded eligible for long term evaluation. Incidence of constipation was 9.4%, encopresis 9.4% and urinary incontinence 4.7%. Two patients had a his - tory of urinary tract infection without reflux on voiding cystourethrography or renal scarring on renal cortical scintigraphy. Three patients had increased post - voiding residual urine of 25 to 35 mL while four had increased bladder capacity. Meticulous surgical technique for excision of SCT in newborns may avoid sig - nificant urinary and defecation problems subsequently.
{"title":"Urological and intestinal functional outcomes of sacrococcygeal teratoma following surgery","authors":"Unal Biçakçi, D. Demirel, N. Bicakci, Y. Issi, B. Yağız, Mithat Günaydın, B. Tander, E. Ariturk, F. Bernay","doi":"10.5835/JECM.OMU.33.01.006","DOIUrl":"https://doi.org/10.5835/JECM.OMU.33.01.006","url":null,"abstract":"Surgery for sacrococcygeal teratoma (SCT) in neonatal period may result in functional problems of micturation and defecation caused by pelvic nerve dam - age. We aimed to evaluate long term outcome of patients with SCT in terms of bladder dynamics. To evaluate the postoperative urological outcome related with SCT excision, urodynamic study, ultrasonographic and scintigraphic ex - aminations were performed. The families are asked about the micturition and defecation paterns. Twenty-one patients (eight male, thirteen female) underwent SCT excision between 2006 and 2013 and seventeen (six male, eleven female) are regarded eligible for long term evaluation. Incidence of constipation was 9.4%, encopresis 9.4% and urinary incontinence 4.7%. Two patients had a his - tory of urinary tract infection without reflux on voiding cystourethrography or renal scarring on renal cortical scintigraphy. Three patients had increased post - voiding residual urine of 25 to 35 mL while four had increased bladder capacity. Meticulous surgical technique for excision of SCT in newborns may avoid sig - nificant urinary and defecation problems subsequently.","PeriodicalId":15770,"journal":{"name":"Journal of Experimental & Clinical Medicine","volume":"39 2 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2016-02-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"79631049","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2016-02-21DOI: 10.5835/JECM.OMU.33.01.012
Erdal Türk, I. Karaca, R. Ortaç
Pilomatrixoma is a benign tumor originating from the matrix of hair follicles. It is commonly found in children and young adolescents as a slowly-growing nodule, mostly in the head and neck regions. It is relatively less common in the upper extremities. Pilomatrixomas are usually asymptomatic, solitary, hard, and mobile dermal and subcutaneous nodules and are mostly misdiagnosed despite being commonly seen in the practise. Most are smaller than 3 cm and usually around 1 cm in size while those larger than 5 cm are called pilomatrixoma and are less common. We present a seven-year-old girl with a giant pilomatrixoma on the upper arm in this study.
{"title":"Giant pilomatrixoma of the arm: An unusual presentation in a child","authors":"Erdal Türk, I. Karaca, R. Ortaç","doi":"10.5835/JECM.OMU.33.01.012","DOIUrl":"https://doi.org/10.5835/JECM.OMU.33.01.012","url":null,"abstract":"Pilomatrixoma is a benign tumor originating from the matrix of hair follicles. It is commonly found in children and young adolescents as a slowly-growing nodule, mostly in the head and neck regions. It is relatively less common in the upper extremities. Pilomatrixomas are usually asymptomatic, solitary, hard, and mobile dermal and subcutaneous nodules and are mostly misdiagnosed despite being commonly seen in the practise. Most are smaller than 3 cm and usually around 1 cm in size while those larger than 5 cm are called pilomatrixoma and are less common. We present a seven-year-old girl with a giant pilomatrixoma on the upper arm in this study.","PeriodicalId":15770,"journal":{"name":"Journal of Experimental & Clinical Medicine","volume":"33 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2016-02-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"80852357","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2016-02-21DOI: 10.5835/JECM.OMU.33.01.007
Unal Biçakçi, D. Demirel, B. Yağız, Y. Issi, Mithat Günaydın, B. Tander, F. Bernay
Our aim is to evaluate the efficiency and outcomes of endoscopic surgery (ES) and open surgery (OS) in children with urinary tract dilatation (UTD). Between February 2009 and June 2014, 77 patients (41 male, 36 female) with UTD underwent either an OS or ES. The age, gender, final diagnosis, type of surgery, postoperative problems (hematuria, fever, urinary tract infection and length of hospital stay (LOS) are retrospectively evaluated. The ES for UTD causes less pain, less hematuria, decreased LOS after surgery. ES is superior in terms of postoperative pain management, morbidity and LOS in selected conditions.
{"title":"Comparison of treatment modalities for urinary tract dilatation in children: Open versus endoscopic surgery","authors":"Unal Biçakçi, D. Demirel, B. Yağız, Y. Issi, Mithat Günaydın, B. Tander, F. Bernay","doi":"10.5835/JECM.OMU.33.01.007","DOIUrl":"https://doi.org/10.5835/JECM.OMU.33.01.007","url":null,"abstract":"Our aim is to evaluate the efficiency and outcomes of endoscopic surgery (ES) and open surgery (OS) in children with urinary tract dilatation (UTD). Between February 2009 and June 2014, 77 patients (41 male, 36 female) with UTD underwent either an OS or ES. The age, gender, final diagnosis, type of surgery, postoperative problems (hematuria, fever, urinary tract infection and length of hospital stay (LOS) are retrospectively evaluated. The ES for UTD causes less pain, less hematuria, decreased LOS after surgery. ES is superior in terms of postoperative pain management, morbidity and LOS in selected conditions.","PeriodicalId":15770,"journal":{"name":"Journal of Experimental & Clinical Medicine","volume":"43 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2016-02-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"74166214","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2016-02-20DOI: 10.5835/JECM.OMU.33.01.005
Mithat Günaydın, B. Tander, D. Demirel, Unal Biçakçi, Ayşe Bahar Önaksoy, E. Ariturk, F. Bernay
We aimed to evaluate etiology and outcome of children with cholecystectomy. Between June 2006 and June 2015, sixty one patients with cholecystectomy were reviewed in order to age, sex, indication, procedures, length of stay and complications. There were 35 female, 26 male, total of 61 patients (2 days -18 years, median 8 years). The indications for surgery were idiopathic cholelithiasis in 38 (62.2%), hemolytic anemia in 14 (22.9%), bile duct cyst in 5 (8.1%), gallbladder polyps in 2 (3.2%) and pancreatitis and short bowel syndrome in one (1.6%). Although the patients with cholelithiasis received ursodeoxycholic acid preoperatively, all of them needed cholecystectomy. Fifty (81.9%) patients underwent laparoscopic surgery, 11 (18.1%) patients open surgery. In those with open surgery, four patients’ indications were common bile duct cysts, only one patient needed the open surgery because of a previous surgery. The patients’ length of stay was between two days to 110 days (median five days). Postoperatively, three (4.9%) patients developed bile leakage. We just put a drain in one of them. The other two patients required a Roux-en-Y choledocojejunostomy. The patient with short bowel syndrome died. Although the number of indications and variations for cholecystectomy are growing, many of them are still grouped under the name of “idiopathic or nonhemolytic cholelithiasis”. Most of the cholecystectomies’ outcome are excellent, however, it is not a complication-free operation.
{"title":"Cholecystectomy in children: Why and how?","authors":"Mithat Günaydın, B. Tander, D. Demirel, Unal Biçakçi, Ayşe Bahar Önaksoy, E. Ariturk, F. Bernay","doi":"10.5835/JECM.OMU.33.01.005","DOIUrl":"https://doi.org/10.5835/JECM.OMU.33.01.005","url":null,"abstract":"We aimed to evaluate etiology and outcome of children with cholecystectomy. Between June 2006 and June 2015, sixty one patients with cholecystectomy were reviewed in order to age, sex, indication, procedures, length of stay and complications. There were 35 female, 26 male, total of 61 patients (2 days -18 years, median 8 years). The indications for surgery were idiopathic cholelithiasis in 38 (62.2%), hemolytic anemia in 14 (22.9%), bile duct cyst in 5 (8.1%), gallbladder polyps in 2 (3.2%) and pancreatitis and short bowel syndrome in one (1.6%). Although the patients with cholelithiasis received ursodeoxycholic acid preoperatively, all of them needed cholecystectomy. Fifty (81.9%) patients underwent laparoscopic surgery, 11 (18.1%) patients open surgery. In those with open surgery, four patients’ indications were common bile duct cysts, only one patient needed the open surgery because of a previous surgery. The patients’ length of stay was between two days to 110 days (median five days). Postoperatively, three (4.9%) patients developed bile leakage. We just put a drain in one of them. The other two patients required a Roux-en-Y choledocojejunostomy. The patient with short bowel syndrome died. Although the number of indications and variations for cholecystectomy are growing, many of them are still grouped under the name of “idiopathic or nonhemolytic cholelithiasis”. Most of the cholecystectomies’ outcome are excellent, however, it is not a complication-free operation.","PeriodicalId":15770,"journal":{"name":"Journal of Experimental & Clinical Medicine","volume":"6 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2016-02-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"81702112","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2016-02-20DOI: 10.5835/JECM.OMU.33.01.004
Ç. Karadağ, B. Erginel, N. Sever, M. Akın, A. Yıldız, A. Dokucu
This study aimed to evaluate the outcomes of laparoscopic inguinal hernia (LIH) repair in pediatric patients in our clinic. LIH repairs that are between January 2008 and April 2013 were evaluated retrospectively. LIH repair was performed between in 133 patients with a mean age of 5.57 years (range 1 month-17 years). For the repairs, either the Schier’s, Montupet’s, or percutaneous internal ring suturing (PIRS) techniques were used. Of the cases, 67 were on the right side (50.4%), 33 on the left (24.8%), and 33 were bilateral (24.8%). Of the patients who underwent laparoscopic surgery for inguinal hernia (133) 70 were male. Schier’s method was used in 23 patients, 8 with bilateral hernias. Montupet’s was used in 28 patients (4 with bilateral hernias). The PIRS method can be very well considered as the first choice because of it is relatively easy to apply, can be completed in less operative time, and is more cost effective than the other methods. In 7 cases, concomitant umbilical hernias were used as camera ports and repaired at the end of the operation. One femoral hernia was diagnosed and repaired. No complications or recurrences occurred during the mean 48-month (16-76 months) follow up. LIH repair is a safe method in children, it is affordable compared to other laparoscopic operations, and it is advantageous, especially in recurrent hernias, in cases concomitant with umbilical hernias, and in bilateral hernias. The PIRS method may be the first choice because of its lesser operative time, expense, and need for surgical experience.
{"title":"Laparoscopic hernia repair in children: Which method is the best?","authors":"Ç. Karadağ, B. Erginel, N. Sever, M. Akın, A. Yıldız, A. Dokucu","doi":"10.5835/JECM.OMU.33.01.004","DOIUrl":"https://doi.org/10.5835/JECM.OMU.33.01.004","url":null,"abstract":"This study aimed to evaluate the outcomes of laparoscopic inguinal hernia (LIH) repair in pediatric patients in our clinic. LIH repairs that are between January 2008 and April 2013 were evaluated retrospectively. LIH repair was performed between in 133 patients with a mean age of 5.57 years (range 1 month-17 years). For the repairs, either the Schier’s, Montupet’s, or percutaneous internal ring suturing (PIRS) techniques were used. Of the cases, 67 were on the right side (50.4%), 33 on the left (24.8%), and 33 were bilateral (24.8%). Of the patients who underwent laparoscopic surgery for inguinal hernia (133) 70 were male. Schier’s method was used in 23 patients, 8 with bilateral hernias. Montupet’s was used in 28 patients (4 with bilateral hernias). The PIRS method can be very well considered as the first choice because of it is relatively easy to apply, can be completed in less operative time, and is more cost effective than the other methods. In 7 cases, concomitant umbilical hernias were used as camera ports and repaired at the end of the operation. One femoral hernia was diagnosed and repaired. No complications or recurrences occurred during the mean 48-month (16-76 months) follow up. LIH repair is a safe method in children, it is affordable compared to other laparoscopic operations, and it is advantageous, especially in recurrent hernias, in cases concomitant with umbilical hernias, and in bilateral hernias. The PIRS method may be the first choice because of its lesser operative time, expense, and need for surgical experience.","PeriodicalId":15770,"journal":{"name":"Journal of Experimental & Clinical Medicine","volume":"12 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2016-02-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"75493354","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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