Publications by authors named "U Sekmen"

12 Publications

  • Page 1 of 1

Myxoma complicated acute intestinal obstruction: A rare case with diagnostic challenges.

Niger J Clin Pract 2021 Feb;24(2):292-294

School of Medicine-Medical School Student, Acibadem Mehmet Ali Aydınlar University, Istanbul, Turkey.

Myxomas are slowly growing mesenchymal tumors and are considered as extremely rare benign tumors of small intestine. This is the case of a young woman presenting with acute bowel obstruction due to ileo-ileal intussusception caused by an intraluminal 4- cm solitary nodule, found to be a myxoma upon pathologic examination, after resection by surgery.
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February 2021

The Efficacy of Botulinum Toxin Injection Site in Chronic Anal Fissure Healing.

U Sekmen M Paksoy

Niger J Clin Pract 2020 Dec;23(12):1639-1642

Department of General Surgery, Acibadem Health Group, Fulya Hospital, Istanbul, Turkey.

Background: Chronic anal fissure is a common disease of the anoderm. Botulinum toxin injection has recently been recommended. However, the injection sites are still debatable.

Aims: This study aimed to assess the site-dependent efficacy of Botulinum toxin injection for chronic anal fissure healing.

Methods: Randomized clinical trial was performed, 80 patients were enrolled in two semi groups according to the site of botulinum toxin injection. Lateral sites of internal sphincter muscle were used in group 1, anterior and posterior regions were used in group 2 in lithotomy position. In this prospective study, the effect of injection site preference on the early complications (pain, infection, hematoma, incontinence) and late results (clinical fissure healing) of chronic anal fissure treatment were assessed.

Results: There was no statistical significant difference between the number of patients who achieved complete healing at the end of the 12 week. Postoperative pain scores were significantly lower in group 2 at the end of 1 week and they stayed lower at the end of the 2 week. Thrombosed haemorrhoids were encountered significantly lower in group 2.

Conclusions: Even though there was no statistical difference in the long term healing rate between groups 1 and 2, choosing 6 and 12 o'clock alignments of internal sphincter muscle for botox injection is more advantageous than 3 and 9 o'clock alignments in terms of better postoperative pain and lower complication rate in the early period.
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December 2020

Does Fixation of Gastric Sleeve Prevent Functional Stenosis in Sleeve Gastrectomy Patients?

Surg Laparosc Endosc Percutan Tech 2020 Oct 29;31(2):220-222. Epub 2020 Oct 29.

İstanbul Bariatrics, Obesity and Advanced Laparoscopy Center.

Aim: The aim of this study is to determine whether gastric sleeve fixation prevents functional stenosis (twist or kink) and to investigate its effects on symptoms such as nausea and vomiting after laparoscopic sleeve gastrectomy (LSG).

Methods: A total of 717 patients who underwent primary LSG for morbid obesity and completed at least 1 year of follow-up between 2012 and 2019 were included in the study. All operations were performed by the same surgical team using the same technique. The patients were divided into 2 groups, that is, group 1: standard LSG and group 2: gastric sleeve fixation with LSG. These 2 groups were compared in terms of demographic characteristics, baseline body mass index, follow-up duration, bleeding, leaks, gastric stenosis, postoperative nausea, vomiting, and the need for antiemetics. In the follow-up period, patients with suspected gastric stenosis underwent endoscopy and upper gastrointestinal series.

Results: LSG was performed in 717 patients (55.2% female) with a mean age of 37.8±11.5 years and a median body mass index of 42.2 (30.2 to 74.2) kg/m2. The 241 patients in the first group underwent LSG without fixation, and the 476 patients in the second group with fixation. Functional stenosis was detected in 8 patients, all of whom were in group 1. One patient in group 1 had a leak on the background of functional stenosis. There was bleeding that required transfusion in 2 patients (group 1) and reoperation in 2 patients (group 2). None of the study patients died. During the in-hospital period, 122 (50.6%) patients in group 1 and 159 (33.4%) patients in group 2 had nausea and vomiting that required antiemetic treatment (P<0.001).

Conclusion: Gastric sleeve fixation in LSG prevents complications that may arise because of improper gastric mobilization. This method is effective in reducing nausea and vomiting in LSG patients.
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October 2020

Sportsman hernia; the review of current diagnosis and treatment modalities.

Ulus Cerrahi Derg 2016 18;32(2):122-9. Epub 2015 Aug 18.

Clinic of General Surgery, Acıbadem Fulya Hospital, İstanbul, Turkey.

Groin pain is an important clinical entity that may affect a sportsman's active sports life. Sportsman's hernia is a chronic low abdominal and groin pain syndrome. Open and laparoscopic surgical treatment may be chosen in case of conservative treatment failure. Studies on sportsman's hernia, which is a challenging situation in both diagnosis and treatment, are ongoing in many centers. We reviewed the treatment results of 37 patients diagnosed and treated as sportsman's hernia at our hospital between 2011-2014, in light of current literature.
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July 2016

Alternative anaesthetic management in ankylosing spondylitis.

Agri 2014 ;26(4):196-7

Department of General Surgery, Başkent University Faculty of Medicine, İstanbul, Turkey.

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October 2016

The comparison of heavyweight mesh and lightweight mesh in an incisional animal model.

Hernia 2010 Aug 13;14(4):397-400. Epub 2010 Mar 13.

Fourth Department of General Surgery, Haydarpaşa Numune Research and Training Hospital, Usküdar, Istanbul, Turkey.

Purpose: An incisional hernia may occur through the incision area following a surgical operation, through the trocar opening and even through drainage exit points. Various synthetic surgical meshes have recently been used for the surgical repair of incisional hernias. In this study, we analysed the burst strength forces of heavyweight mesh and lightweight mesh in an incisional animal model.

Methods: Following experimental formation of incisional hernias in 32 Wistar albino rats, they were divided into four groups. Polypropylene suture was used for closure of the abdominal incision in Group 1. In Groups 2, 3 and 4, polyester, polypropylene + polyglactin and polypropylene meshes, respectively, were fixed on the surface of the fascia after closing the defects in the rats. Polypropylene and polyester meshes are classified as heavy mesh. Light mesh is composed of a non-absorbable part (polypropylene) and an absorbable part (polyglactin), which will disappear 80 days after implantation. The rats were sacrificed at the end of the experiment. The pullout force of the fascia and meshes were recorded by use of a digital tension meter.

Results: The mean pullout forces for Groups 1, 2, 3 and 4 were found to be 123.4 +/- 13.3, 292.33 +/- 17.4, 281.66 +/- 16.3 and 310.60 +/- 26.1 N, respectively.

Conclusion: At the end of the experiment, the polypropylene (25 g/cm(2)) present in the lightweight mesh was found to lose only a small percentage of the burst strength compared to the polypropylene (85 g/cm(2)) present in the heavyweight mesh.
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August 2010

The role of suture fixation on mesh contraction after abdominal hernia repair.

J Invest Surg 2009 Mar-Apr;22(2):117-21

Department of Surgery, Haydarpasa Numune Teaching and Research Hospital, Hastanesi, Genel Cerrahi Klinigi, Uskudar 34668, Istanbul, Turkey.

Mesh contraction is a threat for hernia repair. Our aim is to analyze the effects of fixation techniques on mesh contraction. Forty-eight rats with abdominal wall defects were equally divided into four groups (G): G1 (control) with no repair, G2 defects were repaired with free polypropylene mesh, and G3 and G4 defects were reinforced with prolene mesh fixed by running and interrupted sutures, respectively. The corners of the defect and prolene mesh were marked with silver clips. The contraction rate was calculated by radiological measurement of distances between corner clips and by measuring the mesh areas after harvesting abdominal wall containing the patch. Host reaction was histhopathologically and biochemically examined by inflammation score, fibroblast count, thickness of the granulation tissue, and tissue hydroxyproline level. Distances between corner clips and mesh area have decreased by 31.5% and 26.4% respectively in G2, while in G3 the decrease was 24.4% (p = .008) and 22% (p = .01), respectively. Granulation tissue thickness was highest in the group with mesh fixed by running suture. The tissue hydroxyproline levels were similar in mesh repair groups. Our study suggests that mesh contraction, which reduces mesh surface, occurs during the wound healing process. In order to decrease the contraction rate, it is important to keep the mesh in place until its incorporation into the surrounding tissue. Our results suggest that mesh contraction is minimized by suture fixation, and running fixation suture, which provides more balanced tension around the mesh, seems more beneficial for decreasing contraction rate.
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May 2009

Multiple perforations along the entire colon as a complication of intestinal Behcet's disease: a rare case.

Saudi J Gastroenterol 2008 Apr;14(2):85-7

Department of General Surgery, Haydarpasa Numune Education and Training Hospital, Istanbul, Turkey.

Colonic complications of Behcet's disease due to intestinal involvement are rarely reported in the literature. Ulcers are the most frequently seen intestinal complications that cause bleeding and perforation predominantly in the ileocecal region. In this article, we report a patient with Behcet's disease who presented with multiple perforations along the entire colon. Postoperative histopathological examination revealed multiple ulcers containing lymphocytic infiltrations in the small peripheral and submucosal venules. Intimal thickening and fresh intraluminal fibrin thrombosis were also seen in these venules.
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April 2008

Accuracy of sentinel lymph node biopsy for the assessment of axillary status in patients with early (T1) breast carcinoma.

J Coll Physicians Surg Pak 2005 Nov;15(11):697-700

Department of Surgery, Haydarpasa Numune Teaching and Research Hospital, Istanbul, Turkey.

Objective: To determine the accuracy of SLN biopsy for the assessment of axillary status, and prognostic markers leading to lymphatic metastasis in patients with early (T1) breast cancer.

Design: Cross-sectional study.

Place And Duration Of Study: Department of Surgery, Teaching and Research Hospital. Between January 2000 and August 2004.

Patients And Methods: SLN mapping by blue dye method was performed on 39 patients with T1 breast carcinoma. SLNs, level 1 and 2 axillary nodes were dissected and excised. The size, pathologic features of the primary tumor, SLNs and other axillary nodes, and hormone receptors were evaluated by histopathologic examination. The rate of SLNs and non-SLNs involvement, and demographic, clinical and pathologic risk factors leading to nodal metastasis were established. The diagnostic accuracy of SLN for axillary status was calculated.

Results: SLNs were identified in 37 (95%) patients. The axilla had metastasis in 11 (28%) patients. Malignant cells involved SLNs in 8 patients. Non-SLNs had metastasis in 3 patients without SLN involvement. The sensitivity, specificity and accuracy of SLN biopsy for predicting axillary status was calculated as 73%, 100% and 92% respectively. Four of 5 patients with non-SLN metastasis were pre-menopausal (p=0.03), and hormone receptor negative (p=0.04). All 5 patients had T1c tumors (p=0.14) and lymphovascular invasion (p=0.0004).

Conclusion: SLN biopsy with high diagnostic accuracy may prevent unnecessary dissection of the axilla in the majority of patients with early (T1) breast carcinoma. Some risk factors as pre-menopausal status, absence of hormone receptors, and presence of lymphovascular invasion must be taken into account as important determinant of non-SLNs metastasis.
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November 2005