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Öğe Comparison of clinical findings in adult and paediatric burn victims(Wolters Kluwer Medknow Publications, 2019) Tiryaki, Çağrı; Haksal, Mustafa CelalettinAim: We aimed to compare the epidemiological data, general characteristics, laboratory findings, and outcomes of burn patients with %18 and 18 years of age. By this way, we also aimed to determine the effective preventive measures appropriate for different age groups. Subjects and Methods: The data of 630 consecutive patients admitted to our hospital with 2(nd) or 3(rd) degree burn injuries were retrospectively investigated. The patients were grouped into two regarding their ages as %18 (group 1) and 18 (group 2) years. Data of age, gender, cause of injury, location of injury, total burn area, length of hospital stay, laboratory data, and outcome of treatment were recorded. Results: We determined that although burn injury is more common in males compared with the females, male predominance is more commonly determined in older age group than children. Extremities are most commonly affected areas in both groups. In children, the most common etiological agent was hot beverages while in older age group electrical burns, and work accidents were more common (P <0.001). Among children, patients younger than 3 years of age were compromising 62.4% of all cases. In adult group, total burned body surface area %, operation or intensive care unit requirement, hospitalization period, blood transfusion, or fresh frozen plasma requirement and the number of patients expired were all significantly higher compared with the children. Regarding the admission laboratory data, renal and liver function tests were significantly worse in older age group. However, neutrophile percentage was significantly higher in older group which may be a sign of augmented inflammatory response. Conclusion: Especially clinicians and public health providers should be aware of the clinical findings and outcomes of burn victims in order to drive more effective preventive measures.Öğe Comparison of intratumoural and peritumoural budding in colorectal carcinoma(Springer, 2016) Ramadan, Saime; Çetinaslan Türkmen, İlknur; Saka, Burcu; Oran, Gülbin; Haksal, Mustafa Celalettin; Öncel, Mehmet[Abstract Not Available]Öğe Comparison of the reliability and efficacy of LigaSure hemorrhoidectomy and a conventional Milligan-Morgan hemorrhoidectomy in the surgical treatment of grade 3 and 4 hemorrhoids(AVES, 2017) Haksal, Mustafa Celalettin; Çiftçi, Ali; Tiryaki, Çagrı; Yazıcıoğlu, Murat Burç; Özyıldız, Mehmet; Yıldız, Selim YiğitObjective: The aim of this study was to compare the clinical results of LigaSure-assisted hemorrhoidectomy and Milligan-Morgan hemorrhoidectomy as a conventional method in our clinic. Materials and Methods: Patients who underwent LigaSure-assisted hemorrhoidectomy or conventional hemorrhoidectomy for grade 3 and 4 hemorrhoids in our clinic between 2009 and 2014 were included in this study. The patient data were reviewed by screening records. Gender, age, preoperative hemoglobin and hematocrit levels, operation time, presence of thrombosis, number of packages, hospitalization time, early and late postoperative complications, prolonged pain presence, and follow-up period were recorded. Results: In this period, surgical interventions were performed on 365 patients diagnosed with hemorrhoids. Among these, 159 underwent LigaSure-assisted operations, while 206 were operated on by conventional methods. One hundred forty-four (39.5%) cases were female, while 221 (60.5%) cases were male. The median age of the patients was 40 (19-82) years in the LigaSure group and 41 (16-78) years in the conventional method group. The operation time was 15 (4-60) min in the LigaSure group and 20 (6-40) min in the conventional method group. Postoperative analgesics were given to the 182 (88.3%) cases in the conventional group and 107 (67.3%) cases in the LigaSure group. The time required for returning to normal daily activity was 6 (1-15) days in the LigaSure group and 7 (1-30) days in the conventional method group. Conclusion: In this study, LigaSure was determined to be superior to a conventional method in terms of operation time, hospitalization period, postoperative analgesic requirements, time required for returning to normal daily activity, and postoperative bleeding.Öğe Factors affecting mortality among victims of electrical burns(Turkish Association of Trauma and Emergency Surgery, 2017) Tiryaki, Çağrı; Haksal, Mustafa Celalettin; Yazıcıoğlu, Murat Burç; Çiftçi, Ali; Esen, Osman; Turgut, Hamdi Taner; Yıldırım, Abdullah; Güven, MuratBACKGROUND: The aim of this study was to determine the factors affecting mortality rate among patients with an electrical burn. METHODS: A total of 115 patients admitted to the emergency department and hospitalized in the Burn Treatment Center or Intensive Care Unit (ICU) due to the electrical burn, were included in the study. RESULTS: A total of 115 patients (4 female and 111 male) with a mean age of 32.88 +/- 12.87 years were included in the study. The mean hospitalization period was 25.03 coproduct 20.50 days, and the mean total body surface area burned (% TBSA) was 22.83 +/- 15.54%. Among those patients, 9 (8.5%) expired, and the remaining 106 were discharged after treatment. In a logistic regression analysis, TBSA > 20% (p= 0.02, OR: 11.7, CI: 1.38-99.16); ICU requirement (p= 0.005, OR: 1.28, CI: 1.08-1.58); erythrocyte transfusion requirement (p= 0.02, OR: 12.48, CI: 1.44-107.83); fresh frozen plasma (FFP) requirement (p= 0.03, OR: 10.23, CI: 1.18-88.17); albumin requirement (p= 0.02, OR: 12.60, CI: 1.44-109.85); admission serum albumin level < 3.5 mg/dl (p= 0.04, OR: 7.25, CI: 0.82-63.64); and admission hemoglobin level < 12 mg/dl (p= 0.01, OR: 8.29, CI: 1.57-43.61) were determined as risk factors for mortality in patients with electrical burns. CONCLUSION: In clinical practice, defining a mortality risk analyzer using these factors may be helpful in the management of patients with electrical burns. Additional, more comprehensive studies are required to define the risk factors for mortality and long-term morbidities in patients with electrical burns.Öğe General characteristics of paint thinner burns: Single center experience(Turkish Assoc Trauma Emergency Surgery, 2017) Haksal, Mustafa Celalettin; Tiryaki, Çagri; Yazıcıoğlu, Murat Burç; Güven, Murat; Çiftçi, Ali; Esen, Osman; Turgut, Hamdi Taner; Yıldırım, AbdullahBACKGROUND: The aim of the present study was to present characteristic features and risk factors of paint thinner burns in order to raise awareness and help prevent these injuries. METHODS: Records of patients admitted to the burn unit due to paint thinner burns were retrospectively reviewed, and patients with comprehensive data available were included in the study. Total of 48 patients (3 female and 45 male) with mean age of 27.79 +/- 11.49 years (range: 4-58 years) were included in the study. RESULTS: Mean total hospitalization period was 30.25 +/- 27.11 days (range: 3-110 days), and mean total burn surface area was 32.53 +/- 24.06% (range: 3.0-90.0%). In 31 cases (64.6%), intensive care unit admission was required. Among all 48 patients, 9 (18.8%) died in hospital and remaining 38 were discharged after treatment. Primary cause of death was septicemia (n = 7) or respiratory failure (n = 6). Inhalation injury was present in 12 of the patients, 6 of whom died (50%). Statistically significant differences were found between expired and discharged patients when compared for presence of inhalation injury (p = 0.01) and septicemia (p = 0.031). CONCLUSION: Ignition of paint thinner is an important cause of burn injuries that may result in very severe clinical picture. Patients require prompt and careful treatment. Clinicians should be aware that inhalation injury and sepsis are the 2 main factors affecting mortality rate in this group of patients. With increased awareness, preventive measures may be defined. Further studies are warranted to decrease mortality rate in this subgroup of burn patients.Öğe Laparoscopic and conventional incisional hernia repair: A retrospective analysis(Kocaeli Derince Training and Research Hospital, 2018) Haksal, Mustafa Celalettin; Gezen, Cem; Okkabaz, Nuri; Yılmaz, Merih; Öncel, MustafaINTRODUCTION: To analyze the outcomes oflaparoscopic and open techniques in incisional herniarepair.METHODS: Patients’ charts with incisional herniawere retrospectively reviewed. Demographics, diseaseand operation related variables and short term outcomeswere compared between groups.RESULTS: Nineteen [12 female (63.2%), mean±SD ageof 53.5±15.1] of 33 patients were operated on with opentechnique, whereas 14 [11 female (78.5%), mean±SDage of 59.1±14.2] patients with laparoscopic technique.Body mass index was bigger in laparoscopic group(30.3±4.6 vs. 34.4±6.3, p=0.041). Hernia size andoperation time was not different between groups(7.6±4.8 cm vs. 8.9±3.1 cm, p=0.404) and [100(40-300)vs. 77.5(35-150) minutes, p=0.071), respectively. Lengthof stay was 2 days after both techniques.DISCUSSION and CONCLUSION: Laparoscopicincisional hernia repair has similar short term outcomeswith open technique.Öğe Laparoscopic appendectomy for acute and perforated appendicitis: A comparative analysis(2019) Haksal, Mustafa Celalettin; Okkabaz, NuriObjective: The purpose of this study was to compare the short-term outcomes of laparoscopically operated uncomplicated acute appendicitis and perforated appendicitis. Methods: Laparoscopically operated uncomplicated acute and perforated appendicitis were screened, retrospectively. Demographics, operative variables, and postoperative complication rates were compared between the groups. Results: Among 155 patients, acute appendicitis was found in 130 patients (77 [59.2%] male; median age, 32 [16–72]), while 25 patients (15 [60.0%] male; median age, 39 [17–84]) had perforated appendicitis. The duration of the operation and hospitalization period were 45 (20–105) minutes and 1 (1–6) day, respectively, in the acute appendicitis group, and 60 (20–155) minutes and 2 (1–16) days, respectively, in the perforated group. Total complication rates were statistically significantly higher in the perforated group. Conclusion: Laparoscopic approach can be applied in selected cases of perforated appendicitis.Öğe Laparoscopic resection of primary tumor with synchronous conventional resection of liver metastases in patients with stage 4 colorectal cancer: A retrospective analysis(2019) Okkabaz, Nuri; Haksal, Mustafa Celalettin; Öncel, MustafaAim: Aim of this study is to analyze the short and long term results of laparoscopic colorectal cancer resection with synchronous conventional resection of liver metastasis. Method: All cases operated on synchronous colorectal cancer and liver metastasis between 2009 and 2017 were retrospectively retrieved from a prospective database. Three and more liver segment resection was considered as major resection. Demographics, patient characteristics, operative and postoperative findings and survival were analyzed. Results: A total of 35 patients [23 (65.7%) male, median age: 56 (34-79)] was included to the study. The most common primary tumor localization was rectum (n=20, 57.1%). Neoadjuvant chemoradiotherapy and chemotherapy was applied in 15 (75%) and 14 (40%) cases, respectively. Major, minor resection or only ablative therapy performance was 12 (34.3%), 19 (54.3%) and 4 (11.4%), respectively, but 13 (37.1%) cases received both resection and ablative therapy. Mean operation time was 307.8±103.6 minutes and estimated blood loss was 300 (10-2200) cc. Blood transfusion was needed in 15 (42.9%) cases. Length of stay was 7 (4-17) days. Eleven complications developed in 10 (28.6%) cases, but none required re-operation. A patient (2.9%) underwent laparoscopic low anterior resection with major hepatectomy and radiofrequency ablation was deceased in postoperative 11th day due to liver failure and subsequent multiorgan failure. Three, 5, 7 and 9-year survival rates was 63%, 35%, 35%, and 35%. Conclusion: Laparoscopic colorectal resection with synchronous conventional liver resection in patients with metastatic colorectal cancer is safe and feasible. Long term survival rates are acceptable.Öğe Preoperative imaging guided no-laparotomy vs conventional diverting colostomy: A multi-institutional case-control study(Kocaeli Derince Training and Research Hospital, 2019) Haksal, Mustafa Celalettin; Okkabaz, Nuri; Şeker, Mehmet; Göret, Nuri Emrah; Altuntaş, Yunus Emre; Erol, Cengiz; Öncel, MustafaINTRODUCTION: We aimed to compare the outcomes of no-laparotomy and conventional diverting colostomy techniques and to describe the process and benefits of using preoperative imaging tools in no-laparotomy procedure. METHODS: Patients intended to receive no-laparotomy diverting colostomy, have preoperative imaging tools of 3D computerized tomography and X-ray examinations in order to predict the best location for the stoma construction. The perioperative outcomes in these cases were compared with those obtained from the patients operated with conventional diverting colostomy with laparotomy at another institution. RESULTS: Eighteen and 16 patients had a diverting colostomy with no-laparotomy technique after preoperative assessment, and conventional procedure. Demographics and most of the patient- and procedure-related factors were similar. Length of incision, (4.8±0.8 vs. 13.3±1.9cms, p<0.001) operation time (31.4±13.0 vs 46.7±7.9mins, p<0.001) and the rate of surgical site infection (0 vs 4 [25%], p=0.039) and hospitalization period (4 [3-30] vs 5 [4-34]days, p=0.01) were significantly less in no-laparotomy group. DISCUSSION and CONCLUSION: No-laparotomy technique may be safe and beneficial while performing a diverting colostomy. Length of incision, operation time and hospitalization period are shortened if a laparotomy is avoided, and the rate of surgical site infection decreases. Current study recommends preoperative imaging tools when a no-laparotomy technique is intended.Öğe The impact of plasma-rich platelet injection to perianal sphincters on incontinence and quality of life in patients with rectal cancer after low anterior or intersphincteric resection: a prospective cohort study(2024) Haksal, Mustafa Celalettin; Akın, Mustafa Salih; Karagöz, Emre; Koçak, Mehmet; Korkut, Emin; Hosseini, Reza Shah; Göğenur, İsmail; Öncel, MustafaBackground: Incontinence is not rare after rectal cancer surgery. Platelet-rich plasma may promote tissue repair and generation but has never been tested for the treatment of anal incontinence. This study evaluated the impact of platelet-rich plasma injection on the severity of incontinence and quality of life after low rectal cancer surgery. Methods: This is a prospective cohort proof of concept study in a colorectal cancer institution. Patients had undergone low anterior or intersphincteric resection for low rectal cancer and had a Wexner score > 4. Ten milliliters of platelet-rich plasma were injected into the internal and external sphincters under endoanal ultrasound (EAUS) guidance. Primary outcome measure was > 2 point improvement in Wexner score (improved group). The patients were assessed with endo-anal ultrasound examination, manometry, the Wexner Questionnaire and SF-36 Health Surveys, and patients were asked whether they used pads and antidiarrheal medications before and 6 months after PRP injection. Results: Of 20 patients included in the study, 14 (70%) were men, and the average age was 56.8 (SD = 9.5) years. No statistically significant difference was found in Wexner scores before and after PRP injection (p = 0.66). Seven (35%) patients experienced a > 2 point improvement in Wexner score. Rectal manometry demonstrated improved squeezing pressure (p = 0.0096). Furthermore, physical functioning scoring (p = 0.023), role limitation (p = 0.016), emotional well-being (p = 0.0057) and social functioning (p = 0.043) domains on the SF-36 questionnaire improved. One (5%) and three (15%) patients stopped using pads and antidiarrheal medications. Conclusion: Platelet-rich plasma injection does not restore Wexner scores, but more than one-third of patients may benefit from this application with an improvement of > 2 points in their scores. Platelet-rich plasma injection may improve squeezing pressure and certain life quality measures for incontinent patients after rectal cancer surgery.Öğe Transabdominal preperitoneal repair for bilateral inguinal hernias: A single center experience(2018) Haksal, Mustafa Celalettin; Okkabaz, Nuri; Civil, Osman; Kement, Metin; Öncel, MustafaAim: To evaluate outcomes of transabdominal preperitoneal repair in patients with bilateral inguinal hernias. Methods: Sociodemographic data, and data about disease and operation with postoperative data of all patients with bilateral inguinal hernias, who were treated by transabdominal preperitoneal repair were prospectively collected. Patients were followed-up for recurrence and chronic pain in the long-term. Results: A total of 70 (67 [95.7%] males, mean age was 53.4±13.6 years) cases were included. Total 138 hernias (mostly Nyhus type 3 [n=116; 84.1%]) were repaired in 70 cases. Unilateral inguinal hernia was diagnosed in two cases during the operation. Mean operation time was 80.6±26.5 minutes. Inferior epigastric vein was injured in 2 (1.4%) cases. Parenteral analgesics were required in only 10 (14.3%) patients. Patients were discharged 1.21±0.67 days after the operation, and only 9 (12.8%) cases were hospitalized more than one day. Patients returned work or normal activity 10.5±4.7 days after the surgery. The mean follow-up period was 25.9±19.4 months. Symptomatic recurrence was observed in 2 (1.4%) patients. Six (8.7%) cases had chronic pain. Conclusion: Transabdominal preperitoneal repair may be an alternative approach in treatment of bilateral inguinal hernias.Öğe Travmatik abdominal duvar herniasyonu: Olgu sunumu(2013) Altuntaş, Yunus Emre; Kement, Metin; Eser, Mehmet; Gezen, Fazlı Cem; Haksal, Mustafa Celalettin; Aksakal, Nihat; Öncel, MustafaTravma sonrası abdominal duvarın herniasyonu nadir görülen bir durumdur. Bu tip hernilerin tanımı ve tanısı zordur. Tanı ve tedavide gecikmenin morbidite ve mortalite oranlarını artıracağı aşikardır. Bu yazıda traktör devrilmesi sonrası çoklu travma tanısıyla acil servise yatırılan 53 yaşında erkek olgu sunuldu. Hasta ameliyata alındı, posterior üretra laserasyonu sorunsuz bir şekilde tamir edildi. Fakat ameliyat sonrası dördüncü günde sistemik enflamatuvar cevap sendromu bulguları gelişti. Yapılan bilgisayarlı batın tomografisinde (BBT) sigmoid kolon segmentinin batın duvarına fıtıklaştığı görüldü. Laparotomide sigmoid kolonun fıtık sahasına perfore olduğu ve alanı kontamine ettiği görüldü. Etkilenen sigmoid kolon segmenti rezeke edilerek Hartman tipi uç kolostomi uygulandı. Çevre nekrotik dokular debride edildi. Travmatik karın duvarı hernileri özellikle geç kalınması durumlarında içi boş organların inkarserasyon ve perforasyonuna yol açarak ciddi morbidite ve mortaliteye sebep olabilirler. Bu nedenle travmatik herni olasılığı ciddi künt batın travmalı olgularda mutlaka akılda tutulmalı ve şüpheli olgularda yüksek tanı değerine sahip BBT uygulanmalıdır.
