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Laparoscopic Endoscopic Surgical Science (LESS) - Laparosc Endosc Surg Sci : 12 (2)
Volume: 12  Issue: 2 - 2005
RESEARCH ARTICLE
1.Laparoscopic resection for colorectal cancer: perioperative results and long term outcomes of first 30 patients
Bilgi Baca, Süleyman Demiryas, Fadıl Ayan, Melih Paksoy, Metin Ertem
Pages 55 - 64
GİRİŞ ve AMAÇ: Laparoscopic resection has become an attractive and alternative technique for col­orectal cancer after the results of prospective studies were reported, regarding sufficient onco­logical safety. This present study was designed to evaluate the results of the patients who undergone laparoscopic colorectal resection for cancer.
YÖNTEM ve GEREÇLER: Thirty patients underwent laparoscopic resection for colorectal cancer between April 2001 and December 2005. The patients were operated on by the same surgical team. Operation time, length of hospital stay, postoperative complications, pathologic findings and long term outcomes were evaluated.
BULGULAR: The study included 12 women and 18 men. The average age of the patients was 62 (43-78) years. The mean follow-up period was 24 (3-56) months. Seventeen patients were oper­ated on for colon tumor. remaining were operated on for rectum tumor. The average operat­ing time was 138 ( 100-210) minutes and the length of hospital stay was 8.4 (5-29) days. The conversion rate was 0.6% (two patients), minor complication rate was 16% (surgical site infec­tion, mechanic intestinal obstruction) and minor complication rate was 16% (ureter injury, bleeding, anastomotic leakage). One port site recurrences was observed on the postoperative 17th month. Mean resected regional lymph node number was 14,3 (6-30). UICC staging of tumors were 10% (stage I), 43% (stage II), 43% (stage Ill) and 4% (stage IV).
TARTIŞMA ve SONUÇ: We conclude that laparoscopic surgery will provide a better oncological outcomes comparable with conventional colorectal resection, based on the increase of experience.
INTRODUCTION: Laparoscopic resection has become an attractive and alternative technique for col­orectal cancer after the results of prospective studies were reported, regarding sufficient onco­logical safety. This present study was designed to evaluate the results of the patients who undergone laparoscopic colorectal resection for cancer.
METHODS: Thirty patients underwent laparoscopic resection for colorectal cancer between April 2001 and December 2005. The patients were operated on by the same surgical team. Operation time, length of hospital stay, postoperative complications, pathologic findings and long term outcomes were evaluated.
RESULTS: The study included 12 women and 18 men. The average age of the patients was 62 (43-78) years. The mean follow-up period was 24 (3-56) months. Seventeen patients were oper­ated on for colon tumor. remaining were operated on for rectum tumor. The average operat­ing time was 138 ( 100-210) minutes and the length of hospital stay was 8.4 (5-29) days. The conversion rate was 0.6% (two patients), minor complication rate was 16% (surgical site infec­tion, mechanic intestinal obstruction) and minor complication rate was 16% (ureter injury, bleeding, anastomotic leakage). One port site recurrences was observed on the postoperative 17th month. Mean resected regional lymph node number was 14,3 (6-30). UICC staging of tumors were 10% (stage I), 43% (stage II), 43% (stage Ill) and 4% (stage IV).
DISCUSSION AND CONCLUSION: We conclude that laparoscopic surgery will provide a better oncological outcomes comparable with conventional colorectal resection, based on the increase of experience.

CASE REPORT
2.The role of diagnostic laparoscopy in intramural small bowel hemorrhage
Kağan Zengin, Ilknur Kılıç, Sinan Çarkman, Melih Paksoy, Metin Erdem
Pages 65 - 68
Intramural hematoma of the small intestine is a rare but serious complication of oral anticoag­ulant therapy. The treatment of choice is conservative but surgery should be prefered for cases in which the diagnosis is doubtful or for patients who have signs of bowel necrosis or peritoni­tis. We have performed diagnostic laparascopy and second look laparascopy on one patient who had been receiving chronic anticoagulant therapy and who presented to emergency room with symptoms of acute abdomen. When we want to make a decision about the viability of intestines and the viceral ischemi, second-look laparoscopy which is performed such as in this case prevents risks of laparatomy. This technique, which is simple and can. be done in a short time, is a minimally invasive procedure.
Intramural hematoma of the small intestine is a rare but serious complication of oral anticoag­ulant therapy. The treatment of choice is conservative but surgery should be prefered for cases in which the diagnosis is doubtful or for patients who have signs of bowel necrosis or peritoni­tis. We have performed diagnostic laparascopy and second look laparascopy on one patient who had been receiving chronic anticoagulant therapy and who presented to emergency room with symptoms of acute abdomen. When we want to make a decision about the viability of intestines and the viceral ischemi, second-look laparoscopy which is performed such as in this case prevents risks of laparatomy. This technique, which is simple and can. be done in a short time, is a minimally invasive procedure.

RESEARCH ARTICLE
3.Laparoscopic gastrostomy: when to do?
Kağan Zengin, Ilknur Kılıç, Melih Paksoy, Metin Erdem
Pages 69 - 73
GİRİŞ ve AMAÇ: Beslenme destegi gereken hastalara günümüzde gastrostomi işlemi endoskopik, laparotomi ve laparoskopik olmak üzere 3 yolla uygulanmaktadır.
YÖNTEM ve GEREÇLER: Anatomik yolları tıkayan ve endoskopun ge­çişini engelleyen bir tumor mevcutsa seçilen yontem laparatomi veya laparoskopi yolu ile gast­rostomi tatbikidir.
BULGULAR: Bu çalışmada İ.Ü. Cerrahpaşa Tip Fakültesi Genel Cerrahi Anabilim Dalı’nda endoskopun geçişini engelleyen ozofagus tümörlü 3 ve dil kokü tümörlü 1 hastaya yapılan lapa­roskopik gastrostomi işlemi literatür eşliginde sunuldu.
TARTIŞMA ve SONUÇ:
INTRODUCTION: Gastrostomy is performed on the patients who need nutritional support, using one of the three alternatives as endoscopy, laparotomy and laparoscopy.
METHODS: If there is a tumor which causes an obstruction of the anatomic ways and prevents the passage of the endoscopic instrument, the choice of the method is gastrostomy procedure either by laparotomy or laparoscopy
RESULTS: In this study we present four patients, 3 with eosophageal tumor which prevents the passage of endo­scopic instrument and 1 with a tumor at the base of tongue, that we performed laparascopic gastrostomy in I. U. Cerrahpasa Medical Faculty Department of the General Surgery.
DISCUSSION AND CONCLUSION:

CASE REPORT
4.7 years of follow up of our first laparoscopic hydatic cycst of liver: a case report
Turgay Erginel, Gülay Dalkılıç
Pages 75 - 77
Hydatic cyst in the left lobe of the liver of a 35 years old female patient was treated laparo­scopically, using the gassless 'laparolift' technic. She was not treated medically postoperatively. After 7 years she is still living without any complaint or symptom. This case is our first one using the laparoscopic technic. In time, when surgeons are more familiar with the laparoscopic tech­nic, selected cases of hydatic cyst in the liver may be treated laparoscopically.
Hydatic cyst in the left lobe of the liver of a 35 years old female patient was treated laparo­scopically, using the gassless 'laparolift' technic. She was not treated medically postoperatively. After 7 years she is still living without any complaint or symptom. This case is our first one using the laparoscopic technic. In time, when surgeons are more familiar with the laparoscopic tech­nic, selected cases of hydatic cyst in the liver may be treated laparoscopically.

RESEARCH ARTICLE
5.Laparoscopic treatment of lymphoceles in patients after renal transplantation
Burhan Mayir, Okan Erdoğan, Alper Demirbaş, Ayhan Dinçkan, Alihan Gürkan
Pages 79 - 82
GİRİŞ ve AMAÇ: Lymphocele is a recognized complication of renal transplantation. The reported frequency ranges from 0.6-18%. Most lymphoceles are asymptomatic and requiring no therapy. When symptomatic it should be treat.
YÖNTEM ve GEREÇLER: Laparoscopic internal peritoneal drainage by open or laparo­scopic surgery is gold standart at the treatment of symptomatic lymphocele.
BULGULAR: Laparoscopic drainage provides short hospitalization, low morbidite and low recurrens rate.
TARTIŞMA ve SONUÇ: In this study we report our experience using laparoscopic internal peritoneal drainage in the treatment of lym­phocele.
INTRODUCTION: Lymphocele is a recognized complication of renal transplantation. The reported frequency ranges from 0.6-18%. Most lymphoceles are asymptomatic and requiring no therapy. When symptomatic it should be treat.
METHODS: Laparoscopic internal peritoneal drainage by open or laparo­scopic surgery is gold standart at the treatment of symptomatic lymphocele.
RESULTS: Laparoscopic drainage provides short hospitalization, low morbidite and low recurrens rate.
DISCUSSION AND CONCLUSION: In this study we report our experience using laparoscopic internal peritoneal drainage in the treatment of lym­phocele.

REVIEW
6.Radiation safety in endoscopy settings
Deniz Öztekin
Pages 83 - 88
A large number of investigations in gastroenterology involve exposing the patient to radiation by radiological screening or by administering a radioactive isotope and on some occasions both. Radiation can harm patients, staff and endoscopes. Radiation is a hazard; it can modify mole­cules within body cells, causing cell dysfunction, alteration or halt in cell replication, or cell destruction. Radiation safety in the practice setting is a responsibility shared by the department of radiology, the department of radiation safety/ health physics, and endoscopy personnel. In this web page translation, it is focused on rules and procedures for assisting the endoscopy staff in reducing radiation exposure for the patient and the staff in the endoscopy practice set­ting. Radiation policies and procedures should be written, reviewed annually, and accessible to all endoscopy personnel. It should be planned to provide direction for staff in endoscopy set­tings in the development of radiation safety policies and procedures. Educational requirements of health professionals should be met by in-sservice programmes periodically.

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