Publications by authors named "Bulent Calik"

14 Publications

  • Page 1 of 1

Histopathological examination of the impact of sodium hypochlorite on the hepatobiliary system. An experimental study.

Ann Ital Chir 2021 ;92:412-418

Background: The liver is the most common organ for settlement of hydatic cyst disease. All acknowledged protoscolicidals that are used for echinococcus degeneration have a risk of caustic secondary sclerosing cholangitis. The sodium hypochlorite is an effective protoscolicidal agent for treatment of hydatid liver cysts in vitro.

Objective: This study aimed to investigate the safe usability of sodium hypochlorite for the treatment of hydatid cyst in the hepatobiliary system in an experimental rat model.

Methods: This experimental study designed as one side blinded animal study. Study was carried out between October 2017 and August 2018. Rats were randomly allocated to the study (n=7), control (n=7), and sham (n=7) groups. A duodenotomy was performed, and a catheter was inserted through the ampulla. The tip of the catheter was placed to instill 0.15 ml sodium hypochlorite (0,25%) solution, and 0.15 ml isotonic saline solution were into the common bile duct in the study and control groups, respectively. After three months, all rats were sacrificed. Livers, biliary tracts, pancreas, and duodenum were investigated for histopathological changes by blinded two pathologists.

Results: No significant difference was found between groups for periductal portal inflammation (p=0.077), parenchymal inflammation, and focal necrosis (p=0.119). There was not any histopathological change in 71.4 % of the subjects in control and experimental groups.

Conclusion: Sodium hypochlorite (0,25%) did not cause any unfavorable changes in the hepatobiliary system, and this reminds that sodium hypochlorite can be a safe alternative in percutaneous drainage, laparoscopic, and open surgery in the treatment of hydatid cyst.

Key Words: Hepatobiliary system, Hydatid disease, Sodium hypochlorite, Treatment.
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September 2021

An invited commentary on "impact of choledochotomy techniques during laparoscopic CBD exploration on short- and long-term clinical outcomes".

Int J Surg 2020 12 17;84:18-19. Epub 2020 Oct 17.

The University of Health Sciences, Izmir Tepecik Education and Research Hospital, General Surgery Department, Yenisehir, Gaziler Street, No:468, 35020, Konak, Izmir, Turkey. Electronic address:

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http://dx.doi.org/10.1016/j.ijsu.2020.10.008DOI Listing
December 2020

An invited commentary on "Robotic pancreaticoduodenectomy in elderly and younger patients: A retrospective cohort study" [Int. J. Surg. (2020) Epub ahead of print].

Int J Surg 2020 11 11;83:24. Epub 2020 Sep 11.

The University of Health Sciences, Izmir Tepecik Education and Research Hospital, General Surgery Department, Yenisehir, Gaziler Street, No:468, 35020, Konak, Izmir, Turkey. Electronic address:

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http://dx.doi.org/10.1016/j.ijsu.2020.08.062DOI Listing
November 2020

Correction: Evaluation of Antibiotic Prophylaxis and Discharge Prescriptions in the General Surgery Department.

Cureus 2019 Aug 5;11(8):c23. Epub 2019 Aug 5.

General Surgery, University of Health Sciences Tepecik Training and Research Hospital, Izmir, TUR.

[This corrects the article DOI: 10.7759/cureus.4793.].
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http://dx.doi.org/10.7759/cureus.c23DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6682413PMC
August 2019

Evaluation of Antibiotic Prophylaxis and Discharge Prescriptions in the General Surgery Department.

Cureus 2019 Jun 1;11(6):e4793. Epub 2019 Jun 1.

General Surgery, University of Health Sciences Tepecik Training and Research Hospital, Izmir, TUR.

Introduction Although there are international guidelines for surgical antibiotic prophylaxis (SP), the use of inappropriate SP is still a common problem. Most studies investigated SP applications in clean and clean-contaminated cases. However, antibiotics in the discharge prescriptions of these cases have not been adequately investigated. In this study, we aimed to examine the antibiotics in SP applications and discharged prescriptions together and to find out the causes of inappropriate use. Materials and methods We retrospectively evaluated the data of patients admitted to our general surgery wards between 2014 and 2015. Patients with clean or clean-contaminated wound category operations were included. The patients were evaluated in terms of convenience of SP (choice of antibiotics, compliance with an indication for SP, timing of the first dose, SP>24 hours, and discharge prescription). In addition, to interpret the results, a questionnaire has been performed for the surgeons in the same clinics. Results A total of 1205 patients with clean and clean-contaminated wound class operation were enrolled in this study. The total accuracy rate of SP was 7.1%. SP application with the correct indication and timing of the first dose was compatible with guidelines: 55.6% and 81.9%, respectively. SP was applied >24 hours at 60.2% and antibiotic prescribing carried out after discharge at 80.6% of patients. According to questionnaire results, the use of SP over 24 hours and the prescription of antibiotics during discharge were: drain usage, hyperthermia, leukocytosis, surgeons feeling of comfort, avoidance of patients, and their relatives' reactions. Conclusion The total accuracy rate of SP rate was low in the present study and in surgeons prescribing the SP after discharge. In light of the present study, we suggest that discharge prescriptions should also be reviewed in clinics who have a high inappropriate surgical antibiotic prophylaxis rate.
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http://dx.doi.org/10.7759/cureus.4793DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6726339PMC
June 2019

Intussusception Can Be the First Sign of Post-transplant Lymphoproliferative Disease.

Transplant Proc 2019 May 10;51(4):1184-1186. Epub 2019 Feb 10.

Department of General Surgery, University of Health Sciences Tepecik Training and Research Hospital, Yenişehir/Konak/İzmir, Turkey.

Intussusception is usually seen in the pediatric age group and rarely seen in adults. It results in the progression of the proximal segment of the intestine into the distal intestine. A 50-year-old immunosuppressive male patient presented with the complaints of abdominal pain, nausea, vomiting, and no gas or stool discharge for 2 days. He was hospitalized with the presumptive diagnosis of acute abdomen. He has a history of renal transplantation due to chronic renal insufficiency. An explorative laparotomy was performed. The operative findings were compatible with jejunojejunal intussusception, and a segmental small bowel resection and end-to-end anastomosis were performed. The patient was uncomplicated postoperatively and discharged on the fifth postoperative day. The pathology was reported as Epstein-Barr virus negative with diffuse large-cell B lymphoma. In this case report, we aim to report on a jejunojejunal intussusception that was presented as the first sign of post-transplant lymphoproliferative disease.
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http://dx.doi.org/10.1016/j.transproceed.2019.01.085DOI Listing
May 2019

Robotic-Assisted Transthoracic Esophageal Diverticulectomy.

JSLS 2018 Apr-Jun;22(2)

Department of General Surgery, Tepecik Education and Research Hospital, Izmir, Turkey.

Introduction: Esophageal diverticulum is a rare entity with symptoms that include dysphagia, halitosis, chest pain, and regurgitation. Indications for surgery include the presence of any of these symptoms and a diverticulum larger than 3 cm because of the increased risk of malignancy and aspiration. Treatment is open or minimally invasive surgery performed from the transhiatal or transthoracic approach.

Case Description: Three patients were investigated by esophagogastroduodenoscopy, esophageal manometry, and computed tomography and were given the diagnosis of epiphrenic diverticulum of the esophagus.

Management And Outcome: The patients underwent robot-assisted surgery by a transthoracic approach for esophageal diverticulectomy. The mean operative time was 211 min, with no significant blood loss or intraoperative complications.

Discussion: This report of robot-assisted surgery for esophageal diverticulectomy from a transthoracic approach adds to the literature regarding surgical treatment of epiphrenic esophageal diverticulum. It is a feasible method that can be used in selected patients with esophageal diverticulum.
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http://dx.doi.org/10.4293/JSLS.2018.00002DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5988400PMC
October 2018

Visceral organ resection during femoral hernia surgery is a predictor of morbidity.

Int Surg 2015 Mar;100(3):455-60

1 Izmir Tepecik Education and Research Hospital, Department of General Surgery, Izmir, Turkey.

Reports on the outcomes of emergency and elective femoral hernia surgery are scarce. Most studies do not distinguish femoral hernia from other types of groin hernia; studies of femoral hernia alone are few in number. The main objective of the present study was to identify factors affecting morbidity of femoral hernia patients. We retrospectively analyzed data on 80 patients who underwent femoral hernia surgery between June 2009 and June 2013. Patients who did and did not experience morbidity were compared in terms of age, sex, hernia location, the presence of any comorbid disease, the type of anesthesia employed, the operative technique used, the type of surgical intervention, and performance of small bowel resection. Forty-three patients (53.8%) underwent emergency surgery because of incarceration. Of these, 18 (41.9%) experienced strangulation and underwent resection. Postoperative complications developed in 11 patients (13.8%). Upon multiple logistic regression analysis, visceral organ resection (of the small bowel and/or omentum) was the only independent predictor of significant morbidity (P < 0.05; odds ratio [OR]: 14.010, 95% confidence interval [CI]: 1.001-196.143). When diagnosed, femoral hernias should be electively repaired as soon as possible. The cumulative probability of strangulation rises over time. A requirement for bowel resection seems to significantly increase morbidity.
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http://dx.doi.org/10.9738/INTSURG-D-14-00036.1DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4370535PMC
March 2015

Gynecologic pathologies in our appendectomy series and literature review.

J Korean Surg Soc 2011 Apr 12;80(4):267-71. Epub 2011 Apr 12.

Department of Surgery, Izmir Bozyaka Training and Research Hospital, Izmir, Turkey.

Purpose: Appendectomy applied from the diagnosis of acute appendicitis is one the most common operations in surgery. The rates of negative appendectomy are still high. The rates of negative appendectomy in males and females differ and are higher in females. In our study, these differences, particularly in females, were studied and possible solutions were discussed.

Methods: Between October 2002 and October 2009, among women receiving urgent appendectomies, those whose primary cause was gynecological pathology were studied retrospectively. All our women subjects were examined by preoperative gynecologists. After gynecological consultation, the patients were evaluated by a general surgeon due to lack of urgent ultrasonography, computed tomography (CT) and diagnostic laparoscopy and the patient received appendectomy due to acute appendicitis.

Results: In our series of 1,969 appendectomies, the rate of female/male is 811/1,158. It was determined that the primary cause in 47 (47/811; 5.8%) women with applied appendectomy was gynecological pathology. As a gynecological pathology, it was observed that the most common cause was ovarian cyst ruptures at a rate of 72.3%. The negative appendectomy rate in males was found to be 14.94% (173/1,158), and in females it was 22.56% (183/811). The difference between them is significant (P < 0.01). Of these women, 5.8% were gynecologically-induced and 16.76% were unrelated to gynecological causes.

Conclusion: We believe that gynecological consultation before appendectomy in women is necessary, but not sufficient. It is also important that at least one of the facilities, such as us, CT, magnetic resonance imaging, and diagnostic laparoscopy should be available in surgical use for the diagnosis of negative appendicitis.
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http://dx.doi.org/10.4174/jkss.2011.80.4.267DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3204677PMC
April 2011

Phrenic-recurrent nerve anastomosis in animal models with unilateral cutting of the recurrent nerve.

Indian J Surg 2010 Oct 18;72(5):362-6. Epub 2010 Nov 18.

In our experimental study, the aim was to recover vocal cord physiology in cutting of recurrent laryngeal nerve, thus phrenic-recurrent nerve transposition was planned in rabbits. Experiments were performed on 10 experimental and 10 control rabbits. The right recurrent nerve was cut in the control group, while in the experiment group, the right recurrent nerve was cut. Then, a right phrenic-recurrent nerve end-to-end anastomosis was performed and the results were evaluated. After the 3rd postoperative week, videolaryngoscopy (VLS) and intramuscular electromyography (EMG) could not be evaluated in 1 rabbit from the experimental group which had died during anesthesia. In eight of the nine rabbits in the experiment which underwent VLS and EMG, activity was recorded in the right vocal cords. On light microscopic examination, atrophy was not detected in the vocal cord muscles of 9 rabbits among the 10 in the experiment group, while all rabbits in the control group and 1 rabbit in the experiment group were diagnosed with vocal cord atrophy. A success rate of approximately 90% was obtained based on the pathologic examination. We believe that the method can be used in patients without any contraindications, considering the complications of tracheostomy and the quality of life.
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http://dx.doi.org/10.1007/s12262-010-0196-zDOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3077144PMC
October 2010

Gallstone ileus as an unexpected complication of cholelithiasis: diagnostic difficulties and treatment.

Ulus Travma Acil Cerrahi Derg 2010 Jul;16(4):344-8

Izmir Bozyaka Training and Research Hospital, Izmir, Turkey.

Background: Gallstone ileus is a rare complication of cholelithiasis, mostly in the elderly. The aim of this study was to evaluate our experience with 12 gallstone ileus cases and discuss current opinion as reported in the literature.

Methods: Data of 12 patients operated between January 1998 and January 2008 with gallstone ileus were retrospectively studied.

Results: There were 12 cases (9 F, 75%; 3 M, 25%) with a mean age of 63.6 (50-80) years. Median duration of symptoms before admission to the hospital was 4.1 (1-15) days. Preoperative diagnosis was made in only five cases (41.6%). Enterolithotomy was done in nine cases (75%). Enterolithotomy and resection of the small intestine--required for decubital necrosis from the gallstone--was performed in one case (8.3%). In one case (8.3%), enterolithotomy was completed in one stage with cholecystectomy and closure of the fistula during acute surgery, and in another case (8.3%), enterolithotomy + primary suturing of the jejunal perforation was performed. There were two (16.6%) perioperative mortalities.

Conclusion: Gallstone ileus remains a diagnostic challenge despite advances in imaging techniques, and pre-operative diagnosis is often delayed. Gallstone ileus should be suspected in all cases admitted to the emergency service with acute intestinal obstruction with a history of cholelithiasis, especially in the elderly and females.
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July 2010

Is repair of incisional hernias by polypropylene mesh a safe procedure?

Med Princ Pract 2010 4;19(2):129-32. Epub 2010 Feb 4.

Department of Surgery, Izmir Bozyaka Training Hospital, Izmir, Turkey.

Objective: The aim of our study was to evaluate the safety of the intraperitoneal mesh repair procedure and to assess the complications that develop after the procedure.

Subjects And Methods: We reviewed the records of 25 patients who underwent intraperitoneal mesh repair procedures. Data on age, sex, size and cause of the hernia, postoperative mortality, and morbidity with special attention to complications were obtained from the medical records.

Results: Of the 25 patients (7 males, 18 females), the original operation was cholecystectomy in 15 cases (60%), gynaecological surgery in 2, gastric surgery in 2, and umbilical hernia in 2. Incisions were midline in 20 cases (80%), transverse in 2 and laparoscopic port sites in 3 patients. The average size of the hernia was 150 cm(2). Local complications occurred in 4 (16%) patients. Postoperative complications included wound infection in 3 patients and haematoma in 1 patient. Postoperative hospital stay ranged from 3 to 25 days with a mean of 6 days. No recurrence developed during 28-month follow-up.

Conclusion: The tension-free repair of incisional hernia with polypropylene mesh in intraperitoneal position is a safe and easy procedure with acceptable morbidity and no recurrence.
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http://dx.doi.org/10.1159/000273074DOI Listing
May 2010

[Acute necrotizing pancreatitis: the results of the management of 38 patients].

Ulus Travma Acil Cerrahi Derg 2006 Jan;12(1):26-34

Department of General Surgery Medicine Faculty of Celal Bayar University, Manisa, Turkey.

Background: We evaluated the patients who underwent surgical or nonoperative treatment for acute necrotizing pancreatitis.

Methods: The study included 38 patients (22 males, 16 females; mean age 51.3 years; range 16 to 79 years) with acute necrotizing pancreatitis. Surgical treatment was performed in 23 patients, while 15 patients were treated conservatively.

Results: Gallstone (in 17 patients) was the most common cause of pancreatitis. Twenty-five patients had sterile necrotizing pancreatitis, while 13 patients had infected necrotizing pancreatitis. Fifteen of the 25 cases with sterile necrosis were treated conservatively. The other 10 patients were initially treated by conservative methods, and were later treated surgically (due to six incorrect diagnosis, three organ failures, and one symptomatic pseudocyst). We applied continuous lavage to six of those patients and conventional drainage to four of them. Mortality rate was 23.7% globally; 24.0% in the sterile necrosis group and 23.1% in the infected necrosis group. Mortality rate was 21.7% in the surgical treatment group, and 26.7% in the conservative treatment group. There were no statistically significant differences between those groups (p>0.05). Eleven of the 29 patients who survived had some complications.

Conclusion: The management of sterile pancreatic necrosis is still a matter of debate. Most patients with sterile necrosis can be treated with conservative methods. Indication for surgery in sterile necrosis should be based on persisting or advancing organ complications and sepsis signs despite intensive care therapy. The patients with infected necrosis should be treated surgically. Surgical intervention is best deferred until the demarcation of necrosis is complete.
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January 2006
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