Browsing by Author "Gülen, Merter"

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    Effects of carbon dioxide pneumoperitoneum on renal function in obstructive jaundice: an experimental study in a rat model
    (Asoc Regional Dialisis Trasplantes Renales, 2023) Gulen, Merter; Sare, Mustafa; Kozan, Ramazan; Yuksel, Seher; Deger, Serpil Muge; Senes, Mehmet; Cayci, Ayse Banu; Surgical Sciences
    Introduction: Both pneumoperitoneum (PNP) and obstructive jaundice (OJ) are known to lead to acute kidney injury (AKI) potentially, but the combined effect has not been investigated. Aim: This study aimed to investigate the effects of PNP on renal functions in a rat model of OJ. Methods: We divided forty-eight rats into eight groups of six rats. Group 1 was the control (sham-operated) group; Groups 2, 3, and 4 were induced 5, 10, and 15 mmHg of CO2 PNP, respectively (Groups 1-4: "non-OJ Groups"); Group 5 was the OJ group; and Groups 6, 7 and 8 were OJ groups that were induced with 5, 10, and 15 mmHg CO2 PNP was respectively (Groups 5-8: "OJ Groups"). The common bile duct was ligated and divided into OJ Groups. After 48 hours, a 5-10-15 mmHg PNP was induced by mini-laparotomy with a Veress needle in Groups 6, 7, and 8, maintained for 60 minutes. Results: There were no statistically significant differences between groups regarding blood urea Nitrogen and Creatinin levels (p> 0.05). Neutrophil gelatinase-associated lipocalin (NGAL) values were significantly higher in OJ Groups than in non-OJ Groups (p< 0.05). Serum Cystatin-C values were significantly higher in OJ Groups with 10 and 15 mmHg PNP than in nonOJ Groups (p< 0.05). Conclusion: In the early stage of AKI, NGAL and Cystatin-C levels might be higher, while standard renal function tests were normal. Our findings highlight the apparent unfavorable effect of OJ with PNP on renal functions and early recognition of AKI with the measurement of NGAL and Cystatin-C in these conditions.
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    Effects of carbon dioxide pneumoperitoneum on renal function in obstructive jaundice: an experimental study in a rat model;
    (Asociacion Regional de Dialisi y Transplantes Renales de Capital Federal y Provincia de Buenos Aires, 2023) Gulen,M.; Sare,M.; Kozan,R.; Yuksel,S.; Deger,S.M.; Senes,M.; Cayci,A.B.; Surgical Sciences
    Introduction: Both pneumoperitoneum (PNP) and obstructive jaundice (OJ) are known to lead to acute kidney injury (AKI) potentially, but the combined effect has not been investigated. Aim: This study aimed to investigate the effects of PNP on renal functions in a rat model of OJ. Methods: We divided forty-eight rats into eight groups of six rats. Group 1 was the control (sham-operated) group; Groups 2, 3, and 4 were induced 5, 10, and 15 mmHg of CO2 PNP, respectively (Groups 1-4: “non-OJ Groups”); Group 5 was the OJ group; and Groups 6, 7 and 8 were OJ groups that were induced with 5, 10, and 15 mmHg CO2 PNP was respectively (Groups 5-8: “OJ Groups”). The common bile duct was ligated and divided into OJ Groups. After 48 hours, a 5-10-15 mmHg PNP was induced by mini-laparotomy with a Veress needle in Groups 6, 7, and 8, maintained for 60 minutes. Results: There were no statistically significant differences between groups regard-ing blood urea Nitrogen and Creatinin levels (p> 0.05). Neutrophil gelatinase-associated lipocalin (NGAL) values were significantly higher in OJ Groups than in non-OJ Groups (p< 0.05). Serum Cystatin-C values were significantly higher in OJ Groups with 10 and 15 mmHg PNP than in non-OJ Groups (p< 0.05). Conclusion: In the early stage of AKI, NGAL and Cystatin-C levels might be higher, while standard renal function tests were normal. Our findings highlight the apparent unfa-vorable effect of OJ with PNP on renal functions and early recognition of AKI with the measurement of NGAL and Cystatin-C in these conditions. © 2023, Asociacion Regional de Dialisi y Transplantes Renales de Capital Federal y Provincia de Buenos Aires. All rights reserved.
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    Hemoroid Lastik Band Ligasyonu Komplikasyonlarının Yönetimi: Masif Rektal Kanama
    (Galenos Publ House, 2024) Gülen, Merter; Emral, Ahmet Cihangir; Ege, Bahadır; Surgical Sciences
    Amaç: Çalışmanın amacı, hemoroidal hastalıkta cerrahi dışı tedavi seçeneklerinden biri olan lastik band ligasyonunu (RBL) ve buna bağlı gelişen komplikasyonları irdelemektir. Morbiditesi nedeniyle önem arz eden masif rektal kanama komplikasyonunun yönetimini sunmaktır. Gereç ve Yöntem: Evre 1-2 ve 3 internal hemoroidal hastalık nedeniyle 2018-2022 yılları arasında kliniğimizde RBL yapılan 564 hasta retrospektif olarak irdelenmiştir. Gebelik durumu, geçirilmiş anorektal cerrahi, kronik karaciğer hastalığı ve antikoagülan kullanımı nedeniyle 72 hasta çalışma dışında bırakılmıştır. Hastaların 492’si çalışmaya dahil edilmiştir. Tüm hastalara proktoloji ünitesinde detaylı anorektal muayene, 50 yaş üstündekilere ise kolonoskopik değerlendirme yapılmıştır. Hastaların demografik özellikleri, gelişen komplikasyonlar (minör/majör) ve uygulanan band ligasyon sayısı standardize edilmiş formlara kayıt edildi. Bulgular: Hastaların ortalama yaşı 33,4±11 (18-65) yıl olup, 385’i (%78,3) erkek, 107’si (%21,7) kadındı. Hastaların 39’una (%8) tek kadran, 448 hastaya (%91) iki kadran ve 5 hastaya üç kadran RBL uygulandı. RBL sonrası minör komplikasyonlar (anal ağrı, vazovagal semptomlar, minör rektal kanama, üriner retansiyon) yirmi hastada (%4) gelişirken, hastaların 4’ünde (%0,8) masif rektal kanama meydana gelmiştir. Masif rektal kanama gelişen hastaların hepsi acil şartlarda hospitalize edildi ve operasyona alındı. Bu hastaların birine 3 ünite, üç hastaya ise 4 ünite eritrosit transfüzyonu yapıldı. Sonuç: Hemoroidal band ligasyonu, hemoroidal hastalık tedavisinde güvenli ve etkili bir yöntemdir. Ancak hayatı tehdit edecek ciddi kanamalara yol açabileceği göz önünde bulundurulmalıdır.