Ulus Travma Acil Cer
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Ulus Travma Acil Cer · Oct 2022
Acute appendicitis over the age of 50: The evaluation of the impact of clinical variables on operative and post-operative outcomes.
Studies reported higher mortality and perforation rates, marked increase in delay from symptom onset to hospital admission, significant complication rates, as well as excessive malignancy outcomes on histopathological examinations in patients older than 50 years of age with acute appendicitis. Herein, it was aimed to reveal the clinical, laboratory, and imaging findings that might affect the operative and post-operative findings in a population of patients over the age of 50 who were diagnosed with and operated for acute appendicitis. ⋯ The management of acute appendicitis in late adulthood was suggested to be challenging both in terms of diagnosis and post-operative processes. Therefore, pre-operative clinical, laboratory, and imaging data obtained from these patients should be carefully and elaborately evaluated.
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Ulus Travma Acil Cer · Oct 2022
ReviewOpen versus laparoscopic technique in peptic ulcus perforation, how effective are score systems?Single-center experience and literature review.
One of the most common peptic ulcer complications is perforation (PUP) which also remains an important cause of morbidity and mortality. In this study, it was aimed to compare the results of patients who had similar pre-operative scoring index results (Boey, Charlson Comorbidity Index (CCI) and Mannheim Peritonitis Index (MPI), and type of surgery. ⋯ The laparoscopic method may be used safely in PUP due to the lower post-operative complication rates and known advantages of minimally invasive surgery.
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Ulus Travma Acil Cer · Oct 2022
The effect of emergency room consultations on emergency general surgery operations.
Hospitalizations in emergency general surgery (EGS) cases in the USA have increased by 28% since 2001. The costs of these cases are estimated to increase by 45% annually until 2060, reaching 41.20 billion dollars. According to the literature, the general surgery clinic team allocates an average of 5.5 hours a day for emergency room consultations. The aim of this study is to determine the effects of consultations from the emergency room in our country on the EGS approach and to create appropriate solution proposals with the data obtained from the regional hospitals. ⋯ The hospitalization/consultation rate was evaluated as the success of the doctors working at the emergency department in recognizing EGS cases; the average value was 20.15% across all hospitals. The surgery/emergency hospitalization rate, which shows rate of the hospitalized patients underwent surgery, is 59.17% when all centers are taken into account. The rate of surgery/admission in acute cholecystitis cases is 31.49% for all centers. It is seen that the hospitalization/consultation rate decreases with the increase in hospital workload. The rate of laparoscopic/total appendectomy is 22.78% across all centers. There is a correlation between acute appendicitis cases and EGS consultation numbers, but there is no correlation between laparoscopic appendectomy and consultation numbers. In addition, it is seen that medical follow-up is preferred in acute cholecystitis cases in centers where the consultation burden is increased; cholecystectomy is preferred at a higher rate in centers where the consultation burden is less. National EGS systems are needed and tried to be developed in order to improve the approach and outcomes of EGS patients worldwide. It is considered essential to establish a national EGS maintenance system that coordinates country resources and optimizes outcomes.
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Ulus Travma Acil Cer · Oct 2022
Effect of tunica albuginea incision on testicular tissue in testicular torsion.
Testicular torsion is the underlying cause in 15-20% of children presenting to the emergency department with scrotal pain. Testicular torsion, which is defined as the rotation of the testis around itself at the level of the spermatic cord, may cause organ loss due to impaired circulation. It is recommended to detortion the testis within the first 6 h to prevent organ loss. The aim of the study is to examine the effect of Tunica Albuginea incision (TAI) made in addition to detorsion (DT) on the viability of the torted testis. ⋯ The results showed that the testicles in the TAI group were better preserved than the testicles, in which only DT was applied. It can be argued that in testicular torsion, the DT procedure is not sufficient to protect the testis, and it would be bene-ficial to add TAI to the procedure.
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Ulus Travma Acil Cer · Oct 2022
Urgent re-laparotomies in cytoreductive surgery and hyperthermic intraperitoneal chemotherapy.
The objective of the study was to evaluate the morbidity-mortality results in terms of immunscore factors and to predict the outcomes of urgent re-laparotomized patients treated with cytoreductive surgery (CRS) and hyperthermic intraperitoneal chemotherapy (HIPEC). ⋯ The crucial decision-making factors at work were complex and complicated in 'unplanned' URL. The overall mor-bidity-mortality results seemingly depends on the severity and extent of peritoneal metastatic disease. Medically-unfit URL patients with high-risk factors should be selected to a vigilant monitoring and clinical care. Timely surgical intervention and intense management strategy are utmost important issues to lower morbi-mortality results in patients treated with URL.