Browsing by Author "Aytaç, Erman"

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Martius Flap for Rectovaginal Fistula Repair: Operative Technique and Postoperative Outcomes
(Acıbadem Mehmet Ali Aydınlar Üniversitesi, 2020-03-03) Agheyeva, Afag; Atasoy, Deniz; Aytaç, Erman; Kırbıyık, Ebru; Bağhaki, Semih; Karahasanoğlu, Tayfun; Baca, bilgi; Hamzaoğlu, İsmail
ABSTRACT Purpose: The most common reason for rectovaginal fistula (RVF) is obstetric trauma and the other most common cause is Crohn’s disease (CD). Various surgical options, including sphincteroplasty, gracilis flaps, Martius flaps, fecal diversion and advancement flaps are discussed. The aim of this study is to present the techniques of Martius flap and present patients’ long-term surgical outcomes, quality of life and sexual activity. Methods: A total of six patients with RVF who underwent Martius flap procedure were included in this study. Patient demographics, perioperative outcomes, short and long-term results including quality of life (QOL), sexual function and complications were evaluated. Results: Between April 2014 and August 2014 six female patients with RVF underwent Martius flap procedure. Mean age and body mass index were 47±14.17 (range, 33-68) and 25 (range, 20-36), respectively. The indications for operation were Crohn’s disease (n=3), obstetrical trauma (n=1) and postsurgical complications including stapler misfire (n=1) and rectocele repair (n=1). The mean follow up was 32± 1.47 (range, 3-34) months. Cosmetic outcomes were good for all patients. As the result of the Female Sexual Function Index (FSFI), 66% (n=4) of patients have an active sexual life. QOL is well for all patients. The CGQL score was 0.8. Five patients are followed without recurrence but a patient with CD has recurrence at 18 mo. of operation. Conclusion: Considering the aforementioned advantages, the Martius flap is a feasible technique for RVF repair when performed selectively by experienced hands
Nüks Rektum Kanserinde İntraoperatif Radyoterapi
(Acıbadem Mehmet Ali Aydınlar Üniversitesi, 2019-10-01) Bilgin, İsmail Ahmet; Aytaç, Erman; Erenler Bayraktar, İlknur; Şahin, Bilgehan; Atalar, Banu; Beşe, Nuran; Özyar, Enis; Baca, Bilgi; Hamzaoğlu, İsmail; Karahasanoğlu, Tayfun
ÖZET Giriş: Lokal ileri ve nüks rektum kanserinde multimodal tedavi seçeneklerden biri olan intraoperatif radyoterapi (İORT), lokal kontrolü sağlamak için tercih edilebilir. Bu çalışmada nüks rektum kanseri nedeniyle radikal cerrahi ve intraoperatif radyoterapi uyguladığımız hastalar üzerindeki deneyimimizi sunmayı amaçladık. Metod: Acıbadem Mehmet Ali Aydınlar Üniversitesi Tıp Fakültesi, Maslak Hastanesi’nde Kasım 2012 ve Aralık 2016 tarihleri ara sında nüks rektum kanseri nedeniyle radikal cerrahi ve İORT uygulanan hastaların klinik özellikleri ve ameliyat sonrası takipleri değerlendirildi. Bulgular: Çalışmamıza nüks rektum kanseri olan 8 hasta (4 kadın) dahil edildi. Tüm hastalarda nüks adenokarsinom mevcuttu. Hastaların ortanca yaş değeri 54.5 (33-67) ve vücut kitle indeksi 24.3 (19.6-32.5) kg/m2 idi. Rektum kanseri için yapılan ilk ameliyatların tümü sfinkter koruyucu rezeksiyondu. Nüks tümör nedeniyle 4 hastaya aşağı anterior rezeksiyon, 2 hastaya abdo minoperineal rezeksiyon, 2 hastaya da pelvisten kitle çıkarılması işlemi uygulandı. 5 hastaya R0, 2 hastaya R1 ve 1 hastaya R2 rezeksiyon yapıldı. Ameliyat sonrası erken dönem takiplerinde 2 hastada cerrahi yara enfeksiyonu gelişti. Ortanca hastanede kalış süresi 8 (4-10) gündü. Ortanca 35.5 (7-52) aylık takip süresince 4 hasta hastalıksız takip edilmektedir. İki hastada pelvik nüks gelişti. İki hasta eksitus oldu. Sonuç: Nüks rektum kanserinde intraoperatif radyoterapi, toksisite riskini azaltarak yüksek doz radyoterapi uygulayabilmemize olanak sağlayan ve bu yolla cerrahinin lokal kontrol üzerindeki etkinliğini artıran bir yöntemdir.
Transvaginal Specimen Extraction in Minimally Invasive Colorectal Resections: Initial Experience of a Tertiary Referral Hospital
(Acıbadem Mehmet Ali Aydınlar Üniversitesi, 2019-10-01) Bayraktar, Onur; Esen, Eren; Bengür, Fuat Barış; Erenler Bayraktar, İlknur; Aytaç, Erman; Bilgin, İsmail Ahmet; Baca, Bilgi; Güngör, Mete; Karahasanoğlu, Tayfun; Hamzaoğlu, İsmail
ABSTRACT Purpose: The aim of the present (this) study is to present the initial experience of a single team on specimen extraction from the vagina after laparoscopic or robotic colorectal resections. Patients and methods: Between January 2010 and April 2015, ten female patients whose resection specimens had been extracted transvaginally after robotic or laparosopic colorectal resections were evaluated in terms of short and mid term postoperative outcomes. Results: 10 cases were included. The operations were robotic rectal resections for cancer (n=6), laparoscopic total colectomy for transverse colon tumor (n=1), single port laparoscopic transumbilical right colectomy for Crohn’s disease (n=1), laparoscopic rectal resection for endometriosis (n=2). In one patient, a vaginal bleeding occurred on postoperative day 7 and a vaginal tampon was inserted and the bleeding was stopped. One patient had a urinary tract infection, it was treated with proper antibiotic therapy. The median postoperative hospital stay was 5 (4-9) days. No mortality occurred. Conclusion: Transvaginal specimen extraction is feasible after colorectal resection and could prevent additional skin incision and its potential complications.