Publications by authors named "Umit Turan"

10 Publications

  • Page 1 of 1

The effect of Farnesoid X receptor agonist tropifexor on liver damage in rats with experimental obstructive jaundice.

Acta Cir Bras 2021 25;36(9):e360902. Epub 2021 Oct 25.

MD. University of Sharjah - College of Medicine - Clinical Sciences Department - Sharjah, UAE.

Purpose: To investigate experimentally the effects of Tropifexor, a farnesoid X receptor agonist, on liver injury in rats with obstructive jaundice.

Methods: Forty healthy Wistar albino female rats were divided randomly in selected groups. These groups were the sham group, control group, vehicle solution group, Ursodeoxycholic acid group and Tropifexor group. Experimental obstructive jaundice was created in all groups, except the sham one. In the blood samples obtained, aspartate transaminase (AST), alanine transaminase (ALT), alkaline phosphatase (ALP), gamma-glutamyl transferase (GGT), total bilirubin and direct bilirubin levels were established and recorded. Additionally, liver malondialdehyde, myeloperoxidase and catalase enzyme activity in the tissue samples were studied. Histopathological analysis was also performed.

Results: No statistical difference was found between the control group and the Tropifexor group when AST, ALT and ALP values were compared. However, it was found that the Tropifexor group had statistically significant decreases in the values of GGT, total bilirubin and direct bilirubin (p < 0.05). Additionally, Tropifexor decreased the median values of malondialdehyde and myeloperoxidase, but this difference was not statistically significant compared to the control group. Finally, the Tropifexor group was statistically significant in recurring histopathological liver damage indicators (p < 0.05).

Conclusions: Tropifexor reduced liver damage due to obstructive jaundice.
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November 2021

The effects of COVID-19 pandemic on emergency anterior abdominal wall hernia surgery: is it safe to postpone elective hernia surgery in the pandemic?

Eur J Trauma Emerg Surg 2021 Oct 4. Epub 2021 Oct 4.

Department of General Surgery, Adana City Research and Training Center, Saglik Bilimleri University, Adana, Turkey.

Background: The aim of this study was to investigate the effects of the COVID-19 pandemic on emergency anterior abdominal wall hernia surgeries (EAAWHS) by comparing the pandemic period with the control period a year ago and to share our experiences in the pandemic period.

Methods: This single-center retrospective cohort study included all patients who underwent EAAWHS during the pandemic (from 11 March 2020 to 25 January 2021) and control period (1 year before the same period, from 11 March 2019 to 25 January 2020). Demographic data, preoperative clinical and pathological parameters, intraoperative findings and postoperative complications secondary to operation and COVID-19 infection, length of intensive care and hospital stay of patients were recorded, and the pandemic and control groups were compared.

Results: Of the 87 patients who underwent anterior abdominal wall hernia surgery during the COVID-19 pandemic, 41 (47.1%) were operated emergently and 46 (52.9%) were operated electively. Of the 485 patients who underwent anterior abdominal wall hernia surgery during the control period, 24 (4.95%) were operated emergently and 461 (95.05%) were operated electively. The decrease in the number of elective operations and the increase in the number of emergency operations were significant during the pandemic (p < 0.001).There was a decrease in the number of emergency inguinal hernia operations and an increase in the number of emergency ventral (incisional, umbilical) hernia operations during the pandemic period compared to the control period (p < 0.05).The mortality rates were similar (8.3 vs. 9.8%, p > 0.05) in both periods.

Conclusion: Despite the increase in the number of EAAWHS during the COVID-19 pandemic, there was no significant difference in mortality and morbidity rates. EAAWHS can be performed safely during the pandemic by taken necessary and adequate precautions.
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October 2021

The reliability of breast cancer surgery in a regional pandemic hospital during the COVID-19 pandemic: Delay or Do?

J BUON 2021 Jul-Aug;26(4):1379-1385

Department of General Surgery, Adana City Training and Research Hospital, Adana, Turkey.

Purpose: The purpose of this study was to examine the effect of COVID-19 infection on the morbidity and mortality rates of breast cancer patients performed in the East Mediterranean region of Turkey during the COVID-19 pandemic and to share the results of those investigations.

Methods: This retrospective study included all breast cancer patients that underwent surgery during the COVID-19 pandemic in the General Surgery Clinic of Adana City Training and Research Hospital, a regional pandemic hospital, between March 11, 2020 and December 25, 2020. The patients were evaluated preoperatively and postoperatively (the first 30 days) in terms of COVID-19 infection. Moreover, these patients were also evaluated in terms of admission to the hospital, length of hospital stay, and mortality due to COVID-19 infection during the follow-up period of the study.

Results: Included in the study were 139 patients that underwent surgery for breast cancer during the pandemic period, with no observed mortality or morbidity associated with COVID-19 in any patient postoperatively within the first 30 days. In addition, within 121.22±70.05 days, the mean and standard deviation of the study's follow-up period, 19 patients (15.7%) were admitted to the hospital with a suspected COVID-19 infection (after the first 30 days postoperatively) and 6 of them (4.3%) returned a positive PCR test. All of the COVID-19 positive patients (6 patients, 4.3%) were hospitalised and 3 of them (2.2%) died due to the COVID-19 infection.

Conclusion: Breast cancer surgery can be performed safely during the COVID-19 pandemic period after taking the necessary precautions.
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September 2021

Surgical Management of Penetrating Duodenal Injury: Role of Primary Repair.

J Coll Physicians Surg Pak 2020 Oct;30(10):1078-1081

Department of General Surgery, Adana City Training and Research Hospital Adana, Turkey.

Objective: To evaluate the outcome of primary repair in penetrating duodenal injuries.

Study Design: Descriptive study.

Place And Duration Of Study: Adana City Training and Research Hospital, Adana, Turkey, between March 2011 and September 2018 Methodology: Patients with penetrating duodenal injury, who underwent primary repai, were reviewed retrospectively. The patients who had early death, grade 1 duodenum injuries and operative procedures except primary repair, were excluded from the study. Age, gender, mechanism of penetrating injury, grade of the duodenal injury, associated intra-abdominal injuries, length of intensive care unit and hospital stay, duodenum-related mortality and morbidity were analysed. Fisher's exact test was used to compare the outcomes between survivor and non-survivor groups.

Results: Data of 26 patients with primary repair (5 females, 21 males) were reviewed. The mean age was 33.11 ±12.07 years; and gunshot (n=19, 73.1%) was the most common cause of the duodenal injury. Twenty-five had a total of 103 (3.9 injuries per patient) associated intra-abdominal organ injuries. 20 (76.9%) patients had grade 2 duodenal injuries; and the most injured portion of the duodenum was segment IV (n: 9, 34.6%). Three (11.5%) patients had duodenal leakage and postoperative complication rate was 53.8%. Duodenum-related mortality (DRM) was 3.8% (n:1) and overall mortality was 19.2% (n:5). The anatomic localisation of duodenal injury and associated vascular trauma were significantly different between survivor and non-survivor groups (p: 0.038, and p: 0.034, respectively).

Conclusion: Associated intra-abdominal organ and vascular injuries were predictive factors of overall mortality in duodenal injuries. Duodenum-related mortality was low, for this reason minimally invasive procedures such as primary repair will be more accurate in surgical management of penetrating duodenal injuries. Key Words: Duodenal injury, Primary repair, Surgical management.
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October 2020

A Novel Oxidative Stress Mediator in Acute Appendicitis: Thiol/Disulphide Homeostasis.

Mediators Inflamm 2016 23;2016:6761050. Epub 2016 Aug 23.

Department of Biochemistry, Faculty of Medicine, Yildirim Beyazit University, 01170 Ankara, Turkey.

Aim. To investigate the role of a novel oxidative stress marker, thiol/disulphide homeostasis, in patients diagnosed with acute appendicitis (AA). Methods. In this study, seventy-one (43 male and 28 female) patients diagnosed with AA and 71 (30 male and 41 female) healthy volunteers were included. Age, gender, body mass index (BMI), haemoglobin (Hb), white blood cell (WBC), c-reactive protein (CRP), and thiol/disulphide homeostasis parameters (native thiol, total thiol, disulphide, disulphide/native thiol, native thiol/total thiol, and disulphide/total thiol ratios) were compared between the groups. Thiol/disulphide homeostasis was determined by a newly developed method by Erel and Neselioglu. Results. The native thiol, total thiol, and the native thiol/total thiol ratio levels were statistically significantly decreased in the AA compared with the control group (p < 0.001). Disulphide level and the ratios of disulphide/native thiol and disulphide/total thiol were higher in the AA group than in the control group (p < 0.001). There was a negative correlation of CRP with native thiol, total thiol, and native thiol/total thiol ratio while there was a positive correlation of CRP with disulphide/native thiol and disulphide/total thiol in the AA group. In the stepwise regression model, risk factors as disulphide/native thiol (OR = 1.368; p = 0.018) and CRP (OR = 1.635; p = 0.003) were determined as predictors of perforated appendicitis compared to the nonperforated group. Conclusion. This is the first study examining the thiol/disulphide homeostasis as a diagnostic aid in AA and establishing thiol/disulphide homeostatis balance shifted towards the disulphide formation due to thiol oxidation. Further studies are needed to optimize the use of this novel oxidative stress marker in AA.
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May 2017

The Effects of Direct Oxygen Supply During Static Cold Preservation of Rat Livers: An Experimental Study.

Exp Clin Transplant 2016 Dec 31;14(6):650-655. Epub 2015 Aug 31.

From the Departments of General Surgery, Adana Numune Training and Research Hospital, Adana, Turkey.

Objectives: We aimed to determine the biochemical and histopathologic effects of direct oxygen supply to the preservation fluid of static cold storage system with a simple method on rat livers.

Materials And Methods: Sixteen rats were randomly divided into 2 groups: the control group, which contained Ringer's lactate as preservation fluid; and the oxygen group, which contained oxygen and Ringer's lactate for preservation. Each liver was placed in a bag containing 50 mL Ringer's lactate and placed in ice-filled storage containers. One hundred percent oxygen supplies were given via a simple, inexpensive system created in our laboratory, to the livers in oxygen group. We obtained samples for histopathologic evaluation in the 12th hour. In addition, 3 mL of preservation fluid was subjected to biochemical analysis at 0, sixth, and twelfth hours. Aspartate aminotransferase, alanine aminotransferase, lactate dehydrogenase, and pH levels were measured from the preservation fluid.

Results: In oxygen-supplemented group, the acceleration speed of increase in alanine aminotransferase and lactate dehydrogenase levels at sixth hour and lactate dehydrogenase, alanine aminotransferase, and lactate dehydrogenase levels at 12th hour were statistically significantly reduced. In histopathologic examination, all parameters except ballooning were statistically significantly better in the oxygen-supplemented group.

Conclusions: This simple system for oxygenation of liver tissues during static cold storage was shown to be effective with good results in biochemical and histopathologic assessments. Because this is a simple, inexpensive, and easily available method, larger studies are warranted to evaluate its effects (especially in humans).
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December 2016

Rhomboid Flap Technique in Breast-conserving Surgery: An Alternative Method for the Reconstruction of Lumpectomy Defects.

J Breast Health 2015 Oct 1;11(4):186-191. Epub 2015 Oct 1.

Department of General Surgery, Adana Numune Training and Research Hospital, Adana, Turkey.

Objective: We aimed to present our experience with rhomboid flap reconstruction, which is a simple technique, in breast cancer patients who underwent breast-conserving surgery.

Methods: We reviewed the medical records of 13 patients with breast cancer who underwent rhomboid flap reconstruction. The patients were evaluated for tumor size, safe surgical margin, and other clinical and pathological features.

Results: The mean age of the patients was 43.1 years (range: 28-69 years). The mean tumor diameter was 30.8 mm (range: 15-60 mm). The mean of the safe margin of resection was evaluated to be 17.8 mm (range: 5-30 mm). Re-excision was required for one patient in the same session.

Conclusion: Rhomboid flap reconstruction can facilitate the applicability of breast-conserving surgery in early breast cancer patients with large tumor-to-breast-size ratio or tumors close to the skin.
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October 2015

The comparison of pulmonary functions in open versus laparoscopic cholecystectomy.

J Pak Med Assoc 2009 Apr;59(4):201-4

Ankara Numune Education and Research Hospital, Ankara, Turkey.

Objective: To examine respiratory functions of patients after open and laparoscopic cholecystectomy and to compare the advantages.

Methods: Fifty five cases with cholelithiasis subjected to elective cholescystectomy were studied. The patients were divided into two groups. Open Cholecystectomy (OC) was performed on 27 cases (Group I), and Laparoscopic Cholecystectomy (LC) in 28 cases (Group II). Respiratory function tests were performed 24 hours before the operation and on the 1st and 6th day after surgery. Blood gas values and anaesthesia periods were recorded. Forced expiratuary volume in the 1st second (FEV1), forced vital capacity (FVC) and FEV1/FVC values were also noted.

Results: FEV1, FVC and FEV1/FVC values on first post-operative day in all cases were statistically lower than the preoperative values (p = 0.0001). Percentage changes of respiratory function test was calculated preoperatively and 1st postoperative day. The changes in both groups showed a significant decrease in FEV1, FVC and FEVI/FVC in Group I compared to Group II (p = 0.0001 in FEV1, p = 0.007 in FVC and p = 0.004 in FEV1/FVC). There was no significant difference in respiratory function tests evaluated on the 6th postoperative day and they had returned to normal values. There was no difference among preoperative and postoperative PaCO2, pH values in arteriel blood gas values in all cases (p = 0.355 p = 0,215). These parameters did not differ in both groups (p = 0.527, p = 0.591), There was a significant decrease in PaO2 and O2 saturation in all cases (p = 0.0001), but there was no significant difference when both groups were compared (p = 0.166, p = 0.678).

Conclusion: The better results of pulmonary function tests in patients subjected to LC proves the advantage of the procedure over OC.
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April 2009

Laparoscopic cholecystectomy in elderly patients.

Bratisl Lek Listy 2008 ;109(7):313-6

Ankara Numune Training and Research Hospital, Ankara, Turkey.

Aim: In this study, we hypothesize that LC is a safe procedure in a non-laparoscopic specialized general surgery unit in a teaching hospital.

Patients And Methods: We evaluated retrospectively the data of 286 patients that had symptomatic cholelithiasis and were operated on with LC.

Results And Conclusion: Fifty-four (18.9%) male and 232 (81.1%) female patients underwent LC. Morbidity in patients over 75 years was higher than in patients under 75 years. Mean hospitalization time was 1.5 days. LC is as safe in young patients as in patients at age ranging from 65 to 75 at a general surgery setting at a teaching facility. Although postoperative morbidity risk is higher in patients over the age of 75 years and diagnosed with symptomatic cholelithiasis, the main reason for increased morbidity is having an ASA score greater or equal to 3, and it is independent from age. In conclusion, LC can be performed in patients older than 75 years of age after giving them proper treatment for comorbidities (Tab. 1, Ref. 12).
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October 2008

Ultrasonic harmonic scalpel in total thyroidectomies.

Adv Ther 2008 Mar;25(3):260-5

Ankara Numune Education and Research Hospital, Fatih Cad. Fatih sitesi 174/34, Kecioren, Ankara, Turkey.

Introduction: Haemostasis is very important in thyroid surgery. In conventional surgery, electrocoagulation and suture ligation are used for haemostasis; newer techniques include vessel clips, ultrasonic instruments and lasers. The aim of this prospective study was to compare the usage of the ultrasonic harmonic scalpel (UHS) with conventional procedures, in total thyroidectomies, for operation time, blood loss, usage of drain, cost, length of hospitalisation and complications.

Methods: We examined 104 patients who underwent bilateral total thyroidectomy. They were divided randomly into two groups. Patients in Group I (n=54) underwent operations using conventional techniques (electrocautery and suture ligation) while patients in Group II (n=50) underwent operations using the UHS. Operation time, number of ligatures used, blood loss, intra-operative complications, weight of the specimen, necessity of drain, postoperative seroma, bleeding, infection, transient or permanent hypocalcaemia, permanent recurrent laryngeal nerve palsy and length of hospitalisation were recorded.

Results: The operation time was significantly longer in Group I (conventional) (105+/-16 minutes; mean+/-standard deviation) than Group II (UHS) (77.9+/-12.5 minutes; P<0.001). The mean blood loss was less in patients who were operated on with the UHS (25.3+/-10.2 g) than in patients operated on with conventional methods (59.5+/-33.9 g; P<0.001). The mean number of ligatures used in the UHS group was 5.3, which was significantly fewer than the mean of 51.6 ligatures used in the conventional methods group (P<0.001). Drains were also used less in the UHS operations (12%-59%; P<0.001).

Conclusion: Use of the UHS in thyroid surgery results in decreased operation time, drain usage and amount of bleeding and does not increase postoperative complications. The UHS is an effective, reliable and less expensive technique for thyroid surgery.
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March 2008