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Article: Can invasive diagnostic methods be reduced by magnetic resonance imaging in the diagnosis of diaphragmatic injuries in left thoracoabdominal penetrating injuries?

Alizade, Elchin / İlhan, Mehmet / Durak, Görkem / Kaan Gok, Ali Fuat / Ertekin, Cemalettin

2022 Volume 18, Issue 3, Page(s) 431–437

Abstract: Aim: In this study, we aimed to investigate the effect of magnetic resonance imaging (MRI) in detecting diaphragmatic injury by comparing preoperative computed tomography (CT) and MRI imaging results with diagnostic laparoscopy/thoracoscopy results in ... ...

Abstract	Aim: In this study, we aimed to investigate the effect of magnetic resonance imaging (MRI) in detecting diaphragmatic injury by comparing preoperative computed tomography (CT) and MRI imaging results with diagnostic laparoscopy/thoracoscopy results in patients with left thoracoabdominal penetrating injury. We investigated whether MRI reduces the rate of unnecessary surgery by examining its sensitivity and specificity. Materials and methods: Patients with left thoracoabdominal penetrating injuries who applied to the Emergency Surgery Unit of Istanbul University Istanbul Faculty of Medicine between November 2017 and December 2020 were evaluated. Patients who underwent emergency surgery, who could not undergo MRI or CT for any reason or who could not be operated on were excluded from the study. Preoperative MRI and CT images of patients who underwent diagnostic laparoscopy/thoracoscopy due to left thoracoabdominal injury in our clinic were evaluated retrospectively by a radiologist who did not know the surgical results. MRI results of the cases were compared with surgical findings and CT images. Results: A total of 43 (41 males, mean age: 31, range: 15-57) patients were included in the study. The most common physical examination finding was lateral injury. The diaphragmatic injury was detected in 13 (30%) cases during surgical interventions. Laparoscopic repair was performed in 11 (84%) cases and thoracoscopic repair was performed in 2 (15%) cases with diaphragmatic injuries. MRI images of 14 (32%) cases were found to be compatible with diaphragmatic injury, in 1 of them no injury was observed during surgical intervention. According to these data, the sensitivity of MRI was calculated as 100%, specificity 94%, positive predictive value 86%, and negative predictive value 100%. The mean hospital stay was 6 days (1-30) in all cases. Conclusion: In our study, MRI was found to have high specificity and sensitivity in detecting diaphragmatic injuries. The number of negative laparoscopy/thoracoscopy can be reduced by performing surgical intervention only in cases with positive or suspected diaphragmatic injury on MRI. Results should be supported by conducting new studies with larger case series with normal MRI findings and long follow-ups.
Language	English
Publishing date	2022-05-30
Publishing country	India
Document type	Journal Article
ZDB-ID	2186884-0
ISSN	1998-3921 ; 0972-9941
ISSN (online)	1998-3921
ISSN	0972-9941
DOI	10.4103/jmas.jmas_259_21
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Article ; Online: Can ionized calcium levels and platelet counts used for estimating the prognosis of pediatric trauma patients admitted to the emergency surgery intensive care?

Koltka, Kemalettin / Ilhan, Mehmet / Gök, Ali Fuat Kaan / Günay, Kayıhan / Ertekin, Cemalettin

Ulusal travma ve acil cerrahi dergisi = Turkish journal of trauma & emergency surgery : TJTES

2022 Volume 28, Issue 5, Page(s) 579–584

Abstract: Background: Injury is the leading cause of death for pediatric population older than 1 year of age and 95% of those deaths are from the low- and middle-income countries. Most of those injured pediatric patients are treated in general hospitals. In ... ...

Title translation	Acil cerrahi yoğun bakıma kabul edilen pediyatrik travma hastalarının prognozunun tahmininde iyonize kalsiyum düzeyleri ve trombosit sayıları kullanılabilir mi?
Abstract	Background: Injury is the leading cause of death for pediatric population older than 1 year of age and 95% of those deaths are from the low- and middle-income countries. Most of those injured pediatric patients are treated in general hospitals. In designated trauma centers, the outcomes of severely injured patients are better. Scoring systems used frequently in intensive care units (ICUs) to make triage easier and to estimate prognosis. However, some of the scores may require additional expensive and sometimes time consuming tests. The purpose of the present study was to compare the usefulness of several scoring systems with initial ionized calcium levels and platelet counts to predict prognosis of pediatric trauma patients admitted to the emergency surgery department. Methods: This retrospective study was performed at a tertiary university hospital. The patients' ages, genders, trauma etiologies, types of trauma, time of trauma, transport place (primary or secondary), duration of stay in the ICU and in the hospital, mortality rates, initial ionized calcium levels (Ca+2), initial platelet counts, and data of several trauma scores (GCS, RTS, ISS, TRISS, and PTS) were analyzed. Results: One hundred and fourteen pediatric trauma patients were admitted to the ICU. The mean age was 77.8±54 months. Most of them were male, falls were the primary mechanism of injury, and head trauma was the most common pattern of injury. The mortality rate was 15.8%, and the admission values for Ca+2, platelet counts, GCS, RTS, TRISS, and PTS had been found higher for patients who survived, while ISS scores were higher for those who had died. Conclusion: It was found that pediatric patients admitted to the ICU were younger than 10 years, of whom most of them were male. Falls were the most common mechanism of injury, and head trauma was present in most of the pediatric patients admitted to the ICU. Initial Ca+2 levels and platelet counts can be used along with the trauma scoring systems in predicting mortality and overall survey regarding pediatric trauma patients.
MeSH term(s)	Calcium ; Child ; Child, Preschool ; Craniocerebral Trauma ; Critical Care ; Female ; Humans ; Infant ; Male ; Platelet Count ; Prognosis ; Retrospective Studies
Chemical Substances	Calcium (SY7Q814VUP)
Language	English
Publishing date	2022-04-27
Publishing country	Turkey
Document type	Journal Article
ZDB-ID	2253739-9
ISSN	1307-7945 ; 1306-696X
ISSN (online)	1307-7945
ISSN	1306-696X
DOI	10.14744/tjtes.2022.17329
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Article ; Online: Clinical outcomes of obstructive colorectal cancer patients during the coronavirus disease 2019 pandemic.

Kulle, Cemil Burak / Sengun, Berke / Gok, Ali Fuat Kaan / Ozgur, Ilker / Bayraktar, Adem / Ertekin, Cemalettin / Deniz, Alisan Berk / Keskin, Metin

Ulusal travma ve acil cerrahi dergisi = Turkish journal of trauma & emergency surgery : TJTES

2023 Volume 29, Issue 6, Page(s) 663–668

Abstract: Background: The coronavirus disease 2019 (COVID-19) pandemic has affected all aspects of clinical care including diagnosis and treatment of colorectal cancers (CRCs) globally, including in Türkiye. During the initial peak of the pandemic, elective ... ...

Title translation	Koronavirüs hastalığı 2019 pandemisi sırasında tıkayıcı kolorektal kanser hastalarının klinik sonuçları.
Abstract	Background: The coronavirus disease 2019 (COVID-19) pandemic has affected all aspects of clinical care including diagnosis and treatment of colorectal cancers (CRCs) globally, including in Türkiye. During the initial peak of the pandemic, elective surgeries and outpatient clinics were restricted in addition to the government-imposed lockdown, resulting in a decrease in the number of colonoscopies being performed and patients admitted to inpatient wards for treatment of CRCs. In this study, we aimed to investigate whether the pandemic has affected presentation characteristics and outcomes of obstructive colorectal cancer in this period. Methods: This is a single-center, retrospective cohort study based on all CRC adenocarcinoma patients that underwent surgical resection in a high-volume tertiary referral center in Istanbul, Türkiye. Patients were divided into two groups before and after 15 months of identification of 'patient-zero' in Türkiye (March 18, 2020). Patient demographics, initial presentation characteristics, clin-ical outcomes, and pathological cancer stages were compared. Results: Overall, 215 patients underwent resection for CRC adenocarcinoma during 30 months (COVID era: 107, pre-COVID era: 108). Patient characteristics, tumor location, and clinical staging were comparable between two groups. During the COVID period, the number of obstructive CRCs (P<0.01) and emergency presentations (P<0.01) increased significantly compared to the respective pre-COVID period. However, there were no differences between 30-day morbidity, mortality, and pathological outcomes (P>0.05). Conclusion: Although the results of our study indicate a significant increase in emergency presentation and a decrease in elective admissions of CRCs during the pandemic, patients treated during the COVID period were not at a significant disadvantage in terms of post-operative outcomes. Further efforts should be made to decrease risks related to an emergency presentation of CRCs for future adverse events.
MeSH term(s)	Humans ; COVID-19/epidemiology ; Retrospective Studies ; Pandemics ; Communicable Disease Control ; Colorectal Neoplasms/epidemiology ; Colorectal Neoplasms/surgery ; Adenocarcinoma/epidemiology ; Adenocarcinoma/surgery
Language	English
Publishing date	2023-06-05
Publishing country	Turkey
Document type	Journal Article
ZDB-ID	2253739-9
ISSN	1307-7945 ; 1306-696X
ISSN (online)	1307-7945
ISSN	1306-696X
DOI	10.14744/tjtes.2023.44524
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Article ; Online: Post-Transplant Immune Tolerance in Rats Following Lymphocyte Injection Into the Anterior Chamber of the Eye.

Sönmez, Recep Erçin / Ilhan, Mehmet / Ertekin, Cemalettin

Transplantation proceedings

2019 Volume 51, Issue 6, Page(s) 2132–2135

Abstract: Objective: We aimed to compare the clinical and histopathological results of skin graft transplants between rats that had been injected with lymphocytes into the anterior chamber of the eye with those that had not.: Methods: A total of 16 Wistar ... ...

Abstract	Objective: We aimed to compare the clinical and histopathological results of skin graft transplants between rats that had been injected with lymphocytes into the anterior chamber of the eye with those that had not. Methods: A total of 16 Wistar albino, male rats were included in the study. Subjects were divided into 2 groups, namely a test group and a control group. Lymphocyte suspensions derived from the subjects of the control group were injected into the anterior chamber of the eye of each opposing subject of the test group. Also, an identical volume of physiological saline was injected into the anterior chamber of each subject in the control group to prevent bias. One week after this procedure, circular skin grafts of 1 cm in diameter were transplanted within the opposing groups. After a period of 1 week, transplanted graft tissues were excised to compare tissue healing. Results: The occurence of granulation and reepithelialization was more evident in the test group (96% and 33%, respectively, vs 80% and 17% for the control group, respectively). On the other hand, it was determined that acute inflammation was more intense in the control group (77% vs 50% for the test group). Conclusion: We had created immune tolerance in rats through anterior chamber lymphocyte injection, which slowed down the rejection process. If this can be successfully implemented in practice, survival for transplant patients without long-term rejection will move closer to becoming a reality.
MeSH term(s)	Animals ; Anterior Chamber/immunology ; Graft Survival/immunology ; Lymphocytes/immunology ; Male ; Rats ; Rats, Wistar ; Skin Transplantation/methods ; Transplantation Tolerance/immunology
Language	English
Publishing date	2019-07-30
Publishing country	United States
Document type	Journal Article
ZDB-ID	82046-5
ISSN	1873-2623 ; 0041-1345
ISSN (online)	1873-2623
ISSN	0041-1345
DOI	10.1016/j.transproceed.2019.04.064
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Article ; Online: Is emergency gastrointestinal system tumor surgery safe under treatment of antitrombotics?

İlhan, Mehmet / Alizade, Elchin / Uzunyolcu, Görkem / Gök, Ali Fuat Kaan / Gunay, Kayihan / Ertekin, Cemalettin / Kurtoğlu, Mehmet

Ulusal travma ve acil cerrahi dergisi = Turkish journal of trauma & emergency surgery : TJTES

2022 Volume 28, Issue 6, Page(s) 776–780

Abstract: Background: The use of antitrombotic (antiaggregant and anticoagulant) drugs is increasing all over the world and in our coun-try. About 12.6% of patients who underwent gastrointestinal tumor surgery receive antitrombotic therapy for various reasons, ... ...

Title translation	Antitrombotik tedavi alan hastalarda, acil gastrointestinal sistem cerrahisi güvenli midir?
Abstract	Background: The use of antitrombotic (antiaggregant and anticoagulant) drugs is increasing all over the world and in our coun-try. About 12.6% of patients who underwent gastrointestinal tumor surgery receive antitrombotic therapy for various reasons, and in this study, we aimed to demonstrate the safe feasibility of elective or emergency gastrointestinal tumor surgery with the correct perioperative antitrombotic therapy management. Methods: The patients who were planned for gastrointestinal tumor surgery under antitrombotic treatment were analyzed in three groups as those whose pre-operative treatment management treatment was discontinued, those who underwent bridging treat-ment, and those whose treatment continued. Anti-embolic stockings or intermittent pneumatic compression devices were applied to all patients preoperatively and postoperatively as mechanical prophylaxis. Post-operative complications, especially post-operative bleeding and thrombosis, were evaluated using the Clavien-Dindo post-operative complication classification. Results: When patients who were under antithrombotic therapy, whose therapy was discontinued, and who underwent surgery under bridging therapy, no significant difference was found between the three groups in terms of bleeding complications. Conclusion: In tertiary centers with high clinical experience, elective and emergency gastrointestinal system tumour surgery can be safely performed under antitrombotic therapy without increasing the thromboembolic risk.
MeSH term(s)	Anticoagulants/adverse effects ; Digestive System Surgical Procedures ; Elective Surgical Procedures ; Gastrointestinal Neoplasms/drug therapy ; Gastrointestinal Neoplasms/surgery ; Humans ; Postoperative Complications/drug therapy ; Postoperative Complications/prevention & control
Chemical Substances	Anticoagulants
Language	English
Publishing date	2022-05-31
Publishing country	Turkey
Document type	Journal Article
ZDB-ID	2253739-9
ISSN	1307-7945 ; 1306-696X
ISSN (online)	1307-7945
ISSN	1306-696X
DOI	10.14744/tjtes.2022.92442
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Article ; Online: A rare cause of acute abdominal pain: Actinomyces infection of colon mimicking a malignant neoplasm due to intrauterine device.

Canbay Torun, Bahar / Gök, Ali Fuat Kaan / İlhan, Mehmet / Yeğen, Gulçin / Başaran, Seniha / Ertekin, Cemalettin / Güney, Mustafa Kayıhan / Yanar, Hakan

Ulusal travma ve acil cerrahi dergisi = Turkish journal of trauma & emergency surgery : TJTES

2022 Volume 28, Issue 4, Page(s) 537–540

Abstract: Actinomycosis is a rare, chronic granulomatous disease that is challenging to diagnose because the clinical symptoms and signs are nonspecific. Usage of intrauterine device (IUD) or being immunocompromised is facilitating factors. Clinical and ... ...

Title translation	Akut karın ağrısının nadir görülen bir nedeni: Rahim içi araç kullanımına bağlı malign tümörü taklit eden kolonun aktinomiçes enfeksiyonu.
Abstract	Actinomycosis is a rare, chronic granulomatous disease that is challenging to diagnose because the clinical symptoms and signs are nonspecific. Usage of intrauterine device (IUD) or being immunocompromised is facilitating factors. Clinical and radiological findings can mimic malignant neoplasm, inflammatory bowel disorder, or acute diverticulitis. We report a case of actinomyces infection of the colon secondary to IUD, which is a rare cause of acute abdominal pain and can mimic a malignant neoplasm. We also provide a review of the literature. Unnecessary surgery can be avoided with the correct diagnosis of granulomatous infectious diseases that can be treated with antibiotics.
MeSH term(s)	Abdomen, Acute ; Abdominal Pain/etiology ; Actinomycosis/diagnosis ; Actinomycosis/drug therapy ; Actinomycosis/etiology ; Colon/pathology ; Female ; Humans ; Intrauterine Devices/adverse effects ; Neoplasms/complications
Language	English
Publishing date	2022-04-27
Publishing country	Turkey
Document type	Case Reports ; Review
ZDB-ID	2253739-9
ISSN	1307-7945 ; 1306-696X
ISSN (online)	1307-7945
ISSN	1306-696X
DOI	10.14744/tjtes.2020.45672
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Article: Recommendations for Trauma and Emergency General Surgery Practice During COVID-19 Pandemic.

Gok, Ali Fuat Kaan / Eryılmaz, Mehmet / Ozmen, Mehmet Mahir / Alimoglu, Orhan / Ertekin, Cemalettin / Kurtoglu, Mehmet Hamdi

Ulusal travma ve acil cerrahi dergisi = Turkish journal of trauma & emergency surgery : TJTES

2020 Volume 26, Issue 3, Page(s) 335–342

Abstract: COVID-19 is a new disease, based on currently available limited information, older adults and people of any age who have severe underlying medical conditions may be at higher risk for severe illness from COVID-19. People of all age groups are also at ... ...

Title translation	COVID-19 Pandemisi Sırasında Travma ve Acil Cerrahi Uygulamaları İçin Öneriler.
Abstract	COVID-19 is a new disease, based on currently available limited information, older adults and people of any age who have severe underlying medical conditions may be at higher risk for severe illness from COVID-19. People of all age groups are also at risk. Healthcare providers have always been the professionals most exposed to the risk of contracting to any kind of infection due to the nature of their profession. Elective interventions have been postponed to give care of patients with COVID-19. However, some interventions cannot be delayed, such as trauma surgery, acute abdomen, and emergency endoscopies. To maintain the sustainability of the healthcare system, the protection of healthcare providers should be the top priority. On the other hand, patients, who need emergency healthcare, should also be provided with appropriate treatment. Healthcare professionals should choose a treatment method appropriately in the circumstances to protect themselves and their patients as much as possible. This paper aims to summarize how a surgeon may act appropriately when an intervention is inevitable during the COVID-19 pandemic.
MeSH term(s)	Abdomen, Acute/surgery ; Aged ; Betacoronavirus ; COVID-19 ; Coronavirus Infections/complications ; Coronavirus Infections/epidemiology ; Emergency Service, Hospital/standards ; Female ; Humans ; Male ; Pandemics ; Pneumonia, Viral/complications ; Pneumonia, Viral/epidemiology ; Risk Factors ; SARS-CoV-2 ; Wounds and Injuries/surgery
Keywords	covid19
Language	English
Publishing date	2020-05-11
Publishing country	Turkey
Document type	Journal Article ; Review
ZDB-ID	2253739-9
ISSN	1306-696X
ISSN	1306-696X
DOI	10.14744/tjtes.2020.79954
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Article: Editörden.

Ertekin, Cemalettin

Ulusal travma ve acil cerrahi dergisi = Turkish journal of trauma & emergency surgery : TJTES

2005 Volume 11, Issue 1, Page(s) 1

Title translation	Editorial.
MeSH term(s)	Humans ; Periodicals as Topic ; Wounds and Injuries
Language	Turkish
Publishing date	2005-01
Publishing country	Turkey
Document type	Editorial
ZDB-ID	2253739-9
ISSN	1306-696X
ISSN	1306-696X
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Article: Spontaneous transvaginal small bowel evisceration following hysterectomy: a case report.

Yanar, Fatih / Oner, Gizem / Ozcinar, Beyza / Gok, Ali Fuat Kaan / Ertekin, Cemalettin

Ulusal travma ve acil cerrahi dergisi = Turkish journal of trauma & emergency surgery : TJTES

2019 Volume 25, Issue 4, Page(s) 424–426

Abstract: Transvaginal small bowel evisceration is a rare, life-threatening condition, requiring urgent surgical intervention. In our case, ischemia developed in the intestinal segment with evisceration, with a laceration in the small intestine of the mesentery, ... ...

Title translation	Histerektomi sonrası geç dönem transvajinal ince bağırsak evisserasyonu: Olgu sunumu.
Abstract	Transvaginal small bowel evisceration is a rare, life-threatening condition, requiring urgent surgical intervention. In our case, ischemia developed in the intestinal segment with evisceration, with a laceration in the small intestine of the mesentery, and finally, a small bowel resection was required. An 89-year-old woman was brought to the hospital with a sudden onset of abdominal pain, which lasted for 4 hours. Upon the examination, it was found that approximately 50 cm of the small intestine was eviscerated from the vagina, with its mesentery. The intestines were edematous, and also there were signs of ischemia on the mesentery. The patient was urgently transferred to surgery. Functional end-to-end anastomosis was performed, following a 70 cm small bowel resection. The vaginal defect was repaired transvaginally. Transvaginal small bowel evisceration is rarely described in the literature. It is most commonly seen in postmenopausal, elderly women who underwent vaginal surgery before and who have enterocele. The treatment is an emergent surgical approach. Surgical treatment should be based on individual patient. Various surgical techniques have been described for the repair of transvaginal small bowel evisceration, such as vaginal, abdominal, laparoscopic, and combined approaches. Transvaginal small bowel evisceration should be considered in the differential diagnosis of patients with a sudden onset abdominal pain. Patients with an increased risk for transvaginal small bowel evisceration are postmenopausal women and patients who underwent vaginal surgery before. After the accurate diagnosis, patients should be operated as soon as possible, and necessary surgery should be done.
MeSH term(s)	Abdominal Pain ; Aged, 80 and over ; Anastomosis, Surgical ; Diagnosis, Differential ; Edema ; Emergencies ; Female ; Humans ; Hysterectomy ; Intestine, Small/pathology ; Intestine, Small/surgery ; Ischemia ; Laparoscopy/methods ; Mesentery/blood supply ; Mesentery/pathology ; Risk Factors ; Vagina/pathology ; Vagina/surgery
Language	English
Publishing date	2019-07-12
Publishing country	Turkey
Document type	Case Reports
ZDB-ID	2253739-9
ISSN	1306-696X
ISSN	1306-696X
DOI	10.14744/tjtes.2019.57318
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Article: COVID-19 Pandemisi Sirasinda Travma ve Acil Cerrahi Uygulamalari Için Öneriler./ Recommendations for Trauma and Emergency General Surgery Practice During COVID-19 Pandemic

Gok, Ali Fuat Kaan / Eryilmaz, Mehmet / Ozmen, Mehmet Mahir / Alimoglu, Orhan / Ertekin, Cemalettin / Kurtoglu, Mehmet Hamdi

Ulus Travma Acil Cerrahi Derg

Abstract	COVID-19 is a new disease, based on currently available limited information, older adults and people of any age who have severe underlying medical conditions may be at higher risk for severe illness from COVID-19. People of all age groups are also at risk. Healthcare providers have always been the professionals most exposed to the risk of contracting to any kind of infection due to the nature of their profession. Elective interventions have been postponed to give care of patients with COVID-19. However, some interventions cannot be delayed, such as trauma surgery, acute abdomen, and emergency endoscopies. To maintain the sustainability of the healthcare system, the protection of healthcare providers should be the top priority. On the other hand, patients, who need emergency healthcare, should also be provided with appropriate treatment. Healthcare professionals should choose a treatment method appropriately in the circumstances to protect themselves and their patients as much as possible. This paper aims to summarize how a surgeon may act appropriately when an intervention is inevitable during the COVID-19 pandemic.
Keywords	covid19
Publisher	WHO
Document type	Article
Note	WHO #Covidence: #185888
Database	COVID19

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