TECHNICAL NOTE | |
1. | National Scientific Board Pages 49 - 51 Abstract | |
2. | Contents Pages 52 - 53 Abstract | |
EDITORIAL | |
3. | Editorial Page 54 Abstract | |
RESEARCH ARTICLE | |
4. | Complications related to the lost stones during laparoscopic cholecystectomy: review of the literature and meta-analyses M. Tahir Oruç, Ömer Özozan, M. Mahir Özmen, Faruk Coşkun Pages 55 - 69 INTRODUCTION: the aim of this study is to review published literature on the complications due to spillage of gallstone during laparoscopic cholecystectomy and to identify possible risk factors in the light of literature. METHODS: Papers derived from Medline search between 1987 and 2004 years and papers from reference lists within these papers were evaluated. One hundred and twenty one cases from Medline search and additionally fifty six cases from Memon et al's (Surg Endosc 1999; 13: 848-57), a review including papers until 1999, were considered for evaluation. RESULTS: The most common complication of the lost stones during laparoscopic cholecystectomy was abdominal wall abscess and its related events such as fistulas and sinus formation. The mean age was 64.1 (ranged from 31- to 86). The female/male ratio was 1.44(36/25). The average time from laparoscopic cholecystectomy to complications was 385 days (ranged from 1 day to 10 years). The most commonly used diagnostic method was tomography. Öulltiple milimetric stones, large stones, infected stones were found to be risk factors for developing complications. Most commonly detected microorganisms were E. coli, klebsiella, Ebterecoccus feacalis etc. respectively. Pain was the most common symptom followed by tender mass, fever, malasia, anorexia, weight loss and vomiting respectively. Laparotomy was the most frequently performed intervention to treat the complications. DISCUSSION AND CONCLUSION: Gallbladder perforation and stone spillage might be a life threating complication despite common belief of its innocence. Therefore, every effort must attempt to retrieve the dropped stones and if necessary one should not refrain to do open surgery. |
5. | Comparison of the early results of laparoscopic and laparoscopic assisted appendectomy Sezai Demirbaş, Cengiz Erenoğlu, Vedat Atay, Yavuz Kurt, Arman Api, Mehmet Yıldız, Tuncay Çelenk Pages 70 - 75 INTRODUCTION: Laparoscopic approaches to the patients with acute appendicitis have several biases to delineate as a treatment of choice. Despite decreased pain and earlier return to work or school, laparoscopic procedures with long operation time and complications are the major disadvantages. The aim of this study is to compare two different laparoscopic procedures, laparoscopic and laparoscopic assisted appendectomy in operated patients with a clinicak diagnosis of acute appendicitis. METHODS: Hundred and fifty seven patients undergoing two different laparoscopic surgery were compared regarding lenght of operation,pain control, time to return to daily life, complications and lenght of hospitalization. RESULTS: Duration of the hospitalization, time to return to work or school was shorter and pain management was achived by pain killers in a short time in both groups of patients. Considering tge patient satisfaction in the both groups 80% of patients declared good or perfect health condition at the end of one month. DISCUSSION AND CONCLUSION: Laparoscopic procedures for acute appendicitis are safe methods and gave some benefits like short hospitalization and returm to work or school in a shor period of time.Regarding two laparoscopic procedures no superiority was found in this study for one over the other. |
6. | Trocar site herniation following laparoscopic cholecystectomy Orhan Alimoğlu, Bülent Kaya, Mustafa Şahin, Ramazan Eryılmaz, Adem Akçakaya Pages 76 - 79 INTRODUCTION: Laparoscopic surgery have been more commonly used in general surgery practice. Although it has some advantages such as short hospitalization, less work off time, good cosmesis, and less postoperative pain, it has some complications. One of them is trocar site herniation. Our aim was to examine this uncommon complication in our cases. METHODS: We have collected data from 9 patients who were operated due tı trocar site hernias from February 2000 to January 2004. Age, gender, patients' complaints, hernia localization and size of hernias, repair type and inpatient stay were recorded. RESULTS: There were 1 man and 8 women patients in our serial. Ten trocar hernias were detected. The average age was 58.66 (range, 45-76). The hernia defects were repaired with polypropylene mesh in 6 cases, primary in 2 cases, and plication darn in 1 case. The avarage inpatient stay was 4 (range,2-8) days. There were no mortality and 1 wound infection in our serial. DISCUSSION AND CONCLUSION: We suggest that all fascial defects due to trocar site 10 mm and above in diameter should be repair carefully at the end of operation so that the incidence of trocar site hernias could be decreased. |
CASE REPORT | |
7. | A bronchogenic cyst treatment by cervical mediastinoscopy: a case report Ali Kılıçgün, Muzaffer Metin, Necmi Küçükyağcı, Songül Çuhadaroğlu, Atilla Gürses Pages 80 - 82 Bronchogenic cysts are benign custic lesions which arise from the defect of growing tracheobronchial tree in embriyonal term. Generally these cysts are located in subcarinal, paratracheal area or hilum. The treatment of choice is surgical excision. Mediastinoscopy is a minimal invasive surgical intervention used in staging of lung cancer, the diagnosis or the treatment of mediastinal mass. We treated the patient who had paratracheal bronchogenic cyst using mediastinoscopy. The patient was discharged at the same day without any morbidity. |
REVIEW | |
8. | Sterilization / disinfection of endoscopic and laparoscopic equipments Nuray Akyüz Pages 83 - 88 Endoscopy in medicine is defined as examining a body cavity. Rigid endoscopes like laparoscope, arthroscope, rectoscope and flexible endoscopes like gastroscope, colonoscope, duodenoscope, broncoscope are used in endoscopic procedures. Sterilization/disinfection of endoscopic and laparoscopic equipment has a lot of pitfalls it's very important to have an effective disinfection to reduce risk of transmission of bacterial infection. For the sterilization/disinfection of endoscopic and laparoscopic equipment, steam sterilization and chemical sterilization (ethylene oxide gas, glutaraldehyde, alcohol and peracetic acid) can be used. Endoscopy nurse must be well-trained in disinfection and must know the hazards in endoscopy unit. The nurse must take the preventive measures for herself and the other health workers during the procedure of cleaning, disinfection and endoscopy. |
TECHNICAL NOTE | |
9. | Instructions to the Authors Pages 89 - 96 Abstract | |