Fatih Dal; U?ur Topal; Erdogan Mutevelli Sozuer; Muhammet Akyuz; Tutkun Talih; Hizir Yakup Akyildiz
Volume 24, Issue 2 , 2022
Abstract
Objective: In this five-year study, we aimed at investigating the factors related to strangulation and mortality in patients who underwent urgent surgery to treat incarcerated abdominal wall hernias.Methods: Patients presenting to the emergency department with an incarcerated abdominal wall hernia (incisional, ...
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Objective: In this five-year study, we aimed at investigating the factors related to strangulation and mortality in patients who underwent urgent surgery to treat incarcerated abdominal wall hernias.Methods: Patients presenting to the emergency department with an incarcerated abdominal wall hernia (incisional, umbilical, femoral, or inguinal) between October 2015and October 2019 were included in the study. The presence of intraoperative ischemia and necrosis was defined as "strangulation." Depending on the presence or absence of strangulation in the incarcerated segment, patients were divided into two groups: Group 1 (nonstrangulated) and Group 2 (strangulated). Between the groups, length of time between incarceration and hospital admission, demographic and clinical data, and physical examination findings, Risk factors for strangulation and mortality were determined with univariate and multivariate analyses.Results: A total of 161 patients were enrolled in the study. Group 1 consisted of 119 patients and Group 2 consisted of 42 patients. In multivariate analysis, the prominent risk factors for strangulation were: high ASA score (p=0.008), acute abdomen findings with distension and elevated body temperature (p<0.001), delayed hospital admission (p<0.001), procalcitonin >0.5 ng/ml (p<0.001), D-Dimer > 500 µg/L (p<0.001), lactate > 2 mmol/L (p<0.001),and creatinine levels > 2 mg/dl (p<0.001). For mortality, the presence of strangulation (p<0.001), lactate levels > 2 mg/dl (p=0.004), and ASA scores > 3 (p =0.035) were the leading risk factors.Conclusion: The most significant risk factors for strangulation were delay of more than 48 hours, high procalcitonin, creatinine, lactate and D-Dimer levels while for mortality, strangulation, high lactate and ASA levels were significantly effective. Mortality rates may be lowered with an earlier diagnosis, more specifically, one made before the development of metabolic and radiologic impairment.
Muhammet Akyuz; Ugur Topal; Mahmut Kulturo?lu; Erdogan Sozuer; Fatih Dal; Tutkun Talih; Kemal Deniz; Hizir Akyildiz
Volume 23, Issue 11 , 2021
Abstract
Background: A majority of colorectal neoplasms are adenocarcinomas; however, there is a small percentage of tumors from other histological cell lines.
Methods: A total of 1100 patients were applied for surgical treatment due to colorectal cancer at a general surgical clinic between 2010 and 2020. The ...
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Background: A majority of colorectal neoplasms are adenocarcinomas; however, there is a small percentage of tumors from other histological cell lines.
Methods: A total of 1100 patients were applied for surgical treatment due to colorectal cancer at a general surgical clinic between 2010 and 2020. The selected patients were divided into four groups of Diffuse large B-cell lymphoma (DLBCL), Malignant melanoma (MM), Medullary carcinoma (MC), and Neuroendocrine tumor (NET). Following that, clinicopathological data of patients and their survival periods have been compared in this study.
Results: A total of 20 patients were included in this study and were divided into the DLBCL (n=5), MM (n=4), MC (n=3), and NET (n=8) groups. The emergency application rate (60%) was the highest in the DLBCL group (P=0.004). The mean age of the patients was above 50 years in all groups, and there was no difference among groups in this regard (P=0.966). The mean tumor diameter values were 8, 6.55, 5.4, and 3.75 cm, respectively (P=0.73) in the groups. Furthermore, the numbers of lymph nodes dissected were 13, 14.5, 19, and 19, respectively (P=0.373), and the numbers of metastatic lymph nodes were determined at 0 ,1.5, 0, and 0.5, respectively (P=0.188). The survival rate was significantly the shortest in the MM group, and the longest survival rate was noted in the NET group (15.625, 8.5, 20, 40.857, respectively; P=0.001).
Conclusion: Although clinicopathological features and postoperative follow-up results were similar, there were differences in the survival rates among patients. Malignant melanoma histopathological type had a worse prognosis than the other tumors.
