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Öğe Alteration of butyrylcholinesterase level in cholelithiasis patients after laparoscopic cholecystectomy: Do butyrylcholinesterase levels affect lipid metabolism?(Bayrakol Medical Publisher, 2021) Ayan, Durmus; Bolat, Haci; Ozmen, Esma; Sari, IsmailAim: Cholelithiasis (gallbladder stone) is a disease with a high incidence worldwide. The disease is multifactorial and various factors such as gender, age, obesity and use of oral contraceptives are held responsible for the development of the disease. In addition, lipid disorder is observed in more than 50% of patients with cholelithiasis. Laparoscopic cholecystectomy (LC) is one of the most frequently used surgical methods in the treatment of cholelithiasis, and there are data indicating that lipid profile changes and metabolic syndrome (MetS) develop after the operation. In this study, we aimed to investigate whether there is a change in lipid profile and Butyrylcholinesterase (BChE) activity, which affects lipid metabolism, in cholelithiasis patients after LC. Material and Methods: In our study, 31 patients (obese and non-obese) who applied to the general surgery clinic of Nigde Omer Halisdemir University Training and Research Hospital were included. Blood samples were taken from the patients before LC and 6 months after the operation, and the lipid levels and BChE enzyme activity were examined using spectrophotometric method. Results: According to the results, it was determined that the total cholesterol (p=0.015) and LDL (p=0.010) levels significantly decreased after LC, while no significant difference was found in the other parameters examined (p>0.05). In addition, it was observed that there was no significant correlation between the lipid profile examined both before and after LC and BChE activity level. Discussion: According to the data obtained, the significant decrease in LDL and total cholesterol after LC indicates that this operation causes a positive change at least within a period of 6 months in the lipid profile of patients.Öğe Benign nodules of the thyroid gland and 25-hydroxy-vitamin D levels in euthyroid patients(K Faisal Spec Hosp Res Centre, 2022) Bolat, Haci; Erdogan, AlirizaBACKGROUND: The presence of nodules in the thyroid gland is common in iodine-deficient areas of the world. Recently, vitamin D levels were found to be lower than normal and sometimes deficient in malignant nodules of the thyroid. OBJECTIVE: Evaluate the relationship between the serum vitamin D levels and benign thyroid nodules in euthyroid patients. DESIGN: Cross-sectional. SETTING: Tertiary care center in Turkey. PATIENTS AND METHODS: Patients referred to the general surgery outpatient clinic and diagnosed with thyroid nodules were the study group. The control group consisted of healthy individuals without thyroid nodules. Age, BMI, thyroid ultrasonography, serum 25-hydroxyvitamin D, free T3, free T4, thyroid stimulating hormone, calcium, magnesium, phosphorous, total protein, albumin, glucose, creatinine levels and glomerular filtration rate (GFR) were compared between groups. MAIN OUTCOME MEASURE: Serum 25-hydroxy-vitamin D levels and size of the thyroid nodules. SAMPLE SIZE AND CHARACTERISTICS: Of 849 individuals, 453 were patients with thyroid nodules and 396 were healthy individuals. RESULTS: The mean serum vitamin D levels of patients with thyroid nodules were significantly lower than controls (P<.001). Serum vitamin D levels along with serum total protein levels and eGFR were independent variables associated with the presence of a thyroid nodule (P<.001, p=.005 and P=.017, respectively). CONCLUSION: These findings suggest vitamin D deficiency might be one of the pathophysiologic factors in development of thyroid nodules.Öğe Case controlled study for determination of risk factors in abdominal wall endometriosis following a cesarean section(Sage Publications Ltd, 2022) Erdogan, Pinar; Erdogan, Aliriza; Bolat, Haci; Ozbey, CanerIntroduction: Abdominal wall endometriosis (AWE) is the presence of ectopic endometrial tissue in abdominal wall and is most frequently encountered in women with previous cesarean section (CS). The aim of this study is to evaluate the possible risk factors of AWE development. Methods: Women with previous CS and pathologically confirmed AWE were included into the study (n=33). Controls (n= 127) were randomly selected among women who had previous CS and absence of AWE were confirmed by physical examination. Clinical characteristics of the patient and the CS operation preceding AWE were recorded. Results: CS was performed before onset of labor in 87.9% in AWE and in 59.1 % of control group (p= 0.002). The antenatal BMI and weight gain during pregnancy were significantly higher in AWE patients (p < 0.0001; p = 0.002, respectively). In logistic regression model procedure duration (p= 0.039; OR= 1083), antenatal BMI (p =0.003; OR= 1254), weight gain (p=0.002; OR= 1171), and CS before spontaneous labor (p= 0.021; OR = 5169) were significant parameters for predicting AWE. Discussion: High antenatal BMI, weight gain during pregnancy, and longer duration of operation are all factors effecting subsequent AWE development. However, CS before spontaneous labor is by far the most powerful risk factor for AWE development.Öğe Comparison of follow-up results of patients undergoing Laparoscopic Total Extraperitoneal Herniorrhaphy or undergoing Lichtenstein Herniorrhaphy(Cukurova Univ, Fac Medicine, 2020) Bolat, Haci; Kocaoz, ServetPurpose: The aim of this study is to compare the treatment outcomes of patients that were operated for an inguinal hernia surgery with lap aro scopic total extraperitoneal (TEP) hernia repair and Lichtenstein herniorrhaphy (LH). Materials and Methods: This comparative descriptive study, includes a total of 318 inguinal hernia patients treated with TEP herniorrhaphy and 159 patients treated with Lichtenstein herniorrhaphy. The data of the study, Patient identification data form and Herniorrhaphy Assessment Form were used to collect data regarding the following items: postoperative complications, resting and post-exercise pain levels, length of hospital stay, time of the return to normal activity and work, recurrence rates, wound healing, the amount of scar, satisfaction with surgery and general health status. ResultsThe mean follow-up period was 6.67 +/- 2.95 and 4.23 +/- 3.06 years for TEP and LH patients, respectively Post-operative TEP patients were able to return to work sooner and postoperative scar development was less in patients with TEP. Despite having more seroma formation in the TEP group, paresthesia was less common than in the LH group. Patients in the TEP group were found to feel healthier than those in the LH group. Conclusion: Despite having more seroma and hematoma formation, TEP group had less paresthesia and permanent nerve damage outcomes compared to the LH group. TEP inguinal hernia repair recurrence rates can be close to those of the LH herniorrhaphy method if the operation is performed by a proficient surgeon.Öğe Comparison of spinal anaesthesia and erector spinae plane block in unilateral inguinal hernia: Randomised clinical trial(Wolters Kluwer Medknow Publications, 2024) Kacmaz, Mustafa; Bolat, Haci; Erdogan, AlirizaIntroduction:The objective of our study was to compare erector spinae plane block (ESP) with spinal anaesthesia (SA) for inguinal hernia repair with respect to anaesthetic efficacy, post-operative analgesia, mobilisation, discharge, complication and side effects. Patients and Methods:The study included 52 patients over 50 years of age, with the American Society of Anaesthesia physical status Class I-III. Group ESP (n = 26) was applied 30 ml of mixed local anaesthetic mixture applied at the L1 level to the plane of the erector spinae and 10 ml of tumescent when necessary, while Group SA (n = 26) was applied 3 ml of 0.5% bupivacaine at the L3-L4/L2-L3 level. Results:Intraoperative Visual Analogue Scale (VAS) value was lower in Group S, whereas the 6th-h VAS value was lower in Group ESP (P < 0.05). There was no significant difference between the VAS values at hour 12 and 24 (P > 0.05). Reaching post-anaesthesia discharge criteria 9 and time to mobilisation and oral feeding was shorter in Group ESP, whereas post-procedure waiting time was shorter in Group S (P < 0.05). While the need for post-operative analgesics was higher in Group S (P < 0.05), there was a high level of patient satisfaction in Group ESP (P = 0.05). Intraoperative midazolam requirement was lower in Group S, post-operative diclofenac requirement was lower in Group ESP (P < 0.05), post-operative urinary retention and tremor were higher in Group S (P = 0.05). Conclusion:ESP block provides adequate surgical anaesthesia compared to SA (non-inferiority) for inguinal hernia repair. It is associated with less analgesic requirement, low post-operative pain, less complication rate and high patient satisfaction in the post-operative period.Öğe Comparison of spinal anaesthesia versus ilioinguinal-iliohypogastric nerve block applied with tumescent anaesthesia for single-sided inguinal hernia(Springer, 2020) Kacmaz, Mustafa; Bolat, HaciBackground & aims Primary aim of this study is to determine whether the use of local anaesthesia performed with IINB and IHNB against spinal anaesthesia in inguinal hernia repair is accepted as an alternative medicine. Methods 75 cases in the class of American Society of Anesthesia physical status (ASA) I-III between the ages of 18 and 75 diagnosed with single-sided inguinal hernia and hospitalized for surgery in general surgery clinic were prospectively and randomly included in this study. Results There was statistically significant difference between the groups (30.14 +/- 8.2 and 35.51 +/- 9.39) in terms of the duration of the surgery. The duration was shorter in Group 1 (p < 0.001). There was statistically significant difference between the groups in terms of the duration of the first mobilization. It was significantly shorter in Group 2 than in Group 1 (5.71 +/- 1.7 and 2.70 +/- 1.53 min) (p < 0.001). Mean duration of length of hospital stay criteria was significantly shorter in Group 2 than in Group 1 (26.00 +/- 6.43 and 14.23 +/- 5.40 h) (p < 0.001). Throughout the follow-up period in postoperative 24 h, the number of patients who needed analgesia was significantly higher in Group 1 than in Group 2 (91.4% and 45.7%) There was statistically significant difference between the groups in terms of patient satisfaction and urinary retention development (p < 0.005). Hematoma development or postoperative bleeding was not observed in either group. The time of sensory block onset was significantly higher in Group 2 than in Group 1 (9.66 +/- 1.41 and 9.03 +/- 0.98 min) (p < 0.005) Conclusion The results of our study show that IINB and IHNB applied with local anaesthesia are superior to spinal anaesthesia in unilateral inguinal hernia repairs.Öğe Does choroidal thickness change in advanced hemorrhoids patients?(Edizioni Luigi Pozzi, 2022) Bolat, Haci; Kucuk, Erkut; Zor, Kursad RamazanBACKGROUND: This study was conducted to examine the choroidal thickness of patients with grade 4 hemorrhoids to see if vascular abnormalities in hemorrhoid patients may affect other 'parts of the body. METHODS: 51 patients diagnosed with grade 4 hemorrhoids in the last two years and 49 healthy volunteers were included. Choroidal evaluation was done by measurements from various points of the choroid using a spectral domain Cirrus HD-OCT (Carl Zeiss Meditec Inc.) in enhanced-depth imaging mode. Choroidal thicknesses were compared between the two groups. RESULTS: Nasal choroidal thickness, temporal choroidal thickness and mean choroidal thickness measurements were significantly higher in the hemoroid group (p<0.05), while subfoveal choroidal thickness did not differ significantly between the groups. Macular thickness was also significantly higher in the hemoroid group compared to the control group (p<0.05). CONCLUSION: There was an increase in choroidal thickness in patients with grade 4 hemorrhoids.Öğe Free perforation of primary small bowel lymphoma in a patient with celiac sprue and dermatitis herpetiformis(Turkish Assoc Trauma Emergency Surgery, 2020) Bolat, Haci; Teke, ZaferSmall bowel lymphomas are rare and constitute approximately 1% of the malignant gastrointestinal tumors. However, the risk of malignant disease in adult celiac disease is about 8-10%, and non-Hodgkin lymphoma is the most common. In the literature, cases with celiac disease and small bowel lymphoma have been reported, but the emphasis on emergency surgery is extremely rare. We herein present a case of primary small intestinal lymphoma diagnosed after surgery in a 55-year-old male patient who presented to our emergency department with findings of gastrointestinal perforation and had a history of celiac disease and dermatitis herpetiformis. The purpose of this report is to review this situation briefly and discuss it in the light of literature.Öğe Noncyclical and cyclical mastalgia in turkish women: Prevalans, risk factors, health-care seeking and quality of life(Taylor & Francis Inc, 2022) Bolat, Haci; Asci, Ozlem; Kocaoz, Servet; Kocaoz, SemraOur aim in this study was to determine the prevalence of cyclical and noncyclical mastalgia, its underlying risk factors, and to examine its effect on women's quality of life. This study was conducted on 415 women, among whom the prevalence of mastalgia was found as 20.7%. It was found that experiencing intense stress, daily coffee and chocolate consumption, breast surgery history and the menstruation pattern were risk factors associated with mastalgia. Some domains of quality of life were found to be negatively affected in women who had mastalgia. Awareness among women about the risk factors of mastodynia and lifestyle changes is needed to improve mastalgia management.Öğe Relationship of blood 25-hydroxy vitamin D level with fibrocystic breast disease and breast density(Cukurova Univ, Fac Medicine, 2022) Bolat, Haci; Erdogan, AlirizaPurpose: The aim of this study is to evaluate the association of blood 25-hydroxy vitamin D levels with fibrocystic breast masses and breast patterns. Materials and Methods: The study included 612 patients who presented with breast complaints or referred for routine screening between 2018-2021 and were requested to have breast ultrasonography (USG) and mammography (MG) examinations. Patients were divided into two groups; group 1 consisted of women with fibrocystic mass (BI-RADS 2-3) and group 2 consisted of women without breast mass (BI-RADS 1). These two groups were compared by age, breast USG, MG results, and blood 25-hydroxy vitamin D levels. Results: Of the 612 patients, 310 (51%) had fibrocystic mass in their breasts, while 302 (49%) had normal breasts. The mean age of both groups was similar. Those with fibrocystic mass in the breast had lower vitamin D levels and higher breast density than the control group. The group with higher breast density had lower vitamin D levels, and there was a negative correlation between vitamin D level and breast density Conclusion: Our study revealed that women with fibrocystic masses in their breasts (BI- RADS2 and BI-RADS3) had higher breast density and lower vitamin D levels than women without breast mass.Öğe Shall we use low-pressure CO2 pneumoperitoneum in laparoscopic cholecystectomy?(Edizioni Luigi Pozzi, 2022) Bolat, Haci; Kacmaz, MustafaBACKGROUND E AIMS: We aimed to determine whether intraabdominal pressure change caused by pneumoperitoneum created during laparoscopic cholecystectomy (LC) has effects on abdominal and shoulder pain, nausea, vomiting, bowel movements, time of first flatus and defecation, and biochemical parameters. METHODS: Seventy patients that were diagnosed with cholelithiasis and would undergo LC, between the ages of 18-75, with the Society of Anesthesia Physical Status (ASA) I-III classifications were included in the study. Patients were divided into two groups as whose intervention was defined as low pressure (8-10 mm/hg) and whose intervention was defined as high pressure (14-16 mm/hg). Differences in the prognoses of patients in both groups were observed for statistical significance. RESULTS: Shoulder pain-visual analogue scale (VAS) values in 6th and 24th hours were lower in Group 1(p<0.005). There was no significant difference in abdominal pain-VAS values(p >= 0.05). Mean intraoperative end-tidal carbon dioxide (ETCO2) values were higher in Group 2 (p<0.005). Differences in nausea and vomiting were not significant(p >= 0.05). There was no significant difference in the first flatus times(p >= 0.05). Bowel movements resumed earlier in Group 1(p<0.005). Changes were not significant for biochemical blood parameters in the preoperative and postoperative periods(p >= 0.05). CONCLUSION: The use of low-pressure and high pressure carbon-dioxide (CO2)-pneumoperitoneum created during LC does not cause a significant difference in terms of clinical and laboratory results. Therefore, the surgical team should prefer an easy-to-apply pressure level which they are used to and in which they have low complication rates.Öğe Spilled gallstones found incidentally in a direct inguinal hernia sac: Report of a case(Elsevier Sci Ltd, 2020) Bolat, Haci; Teke, ZaferINTRODUCTION: Laparoscopic cholecystectomy (LC) is the preferred surgical treatment for symptomatic gallstones. Iatrogenic gallbladder perforation and spillage of gallstones during LC is a frequent occurrence. There are many different clinical presentations of complications resulting from dropped gallstones. We herein present a case of scattered gallstones after LC encountered incidentally during a direct inguinal hernia repair. PRESENTATION OF CASE: A 62-year-old male presented with a 4-year history of swelling of both right and left groins. He had undergone LC for acute calculous cholecystitis at another hospital 5 months earlier. Physical examination revealed reducible both right and left direct inguinal hernias. Surgical exploration of the right side revealed foreign bodies at the fundus of the sac attached to the inner wall, with a fibrotic reaction around it. On closer inspection these foreign bodies were macroscopically consistent with gallstones. The gallstones were removed, and bilateral herniotomies and Lichtenstein's prolene mesh repair were performed. Pathologic evaluation confirmed 10 foreign bodies of 5-mm in size to be cholesterol gallstones. DISCUSSION: Gallstones have been very rarely reported previously within a hernia sac after LC. Most of the spilled gallstones are clinically silent and rarely become symptomatic. Complications may occur from the immediately postoperative period to a long time interval of 20 years. Treatment of complications is based on its type and location. CONCLUSION: This case presents a very rare entity resulting from leaving spilled gallstones behind. We recommend that every effort should be made to retrieve any scattered stones during LC in order to avoid complications. (C) 2019 The Authors. Published by Elsevier Ltd on behalf of IJS Publishing Group Ltd.Öğe The Effect of Conventional Open Thyroidectomy on Clinical Results and Respiratory Function Tests in Multinodular Goitre(Edizioni Luigi Pozzi, 2024) Bolat, Haci; Kacmaz, MustafaAIM: The primary aim of our study was to measure the effect of conventional open thyroidectomy performed for patients with multinodular goiter (MNG) on pulmonary volumes measured with respiratory function tests independent from surgical indications. A secondary aim was to determine whether there was a significant improvement in the complaints due to obstructive symptoms after MNG surgeries. METHODS: This study was conducted between October 2020 and June 2022. Patients who were hospitalized to undergo surgery for giant multinodular goiter were prospectively included in the study. Patients were questioned about complaints of pressure, hoarseness, dyspnea, sleep apnea, snoring, and dysphagia before the surgery and during the follow-up 6 months after surgery. In addition, pulmonary function tests were performed preoperatively, 48 hours after surgery and 6 months after surgery. Forced expiratory volume in 0.5 seconds forced expiratory volume in 1 second and forced vital capacity values in pulmonary function test (PFT) measurements were recorded. RESULTS: A total of 55 patients, 42 females and 13 males, mean age 49.54 +/- 13.6 years, were included in the study. Although there was a significant decrease in clinical symptoms caused by the thyroid volume within 6 months in patients who were operated for giant MNG there was no significant change in pulmonary function tests. There was a positive correlation between the thyroid volume and nodule weight in patients with MNG. CONCLUSIONS: Our results suggest that it is not necessary to follow up with patients without obstructive findings in preoperative pulmonary function tests with pulmonary function tests in the postoperative period.Öğe The Effects of Sex Hormones on Postoperative Pain in Patients with Laparoscopic Cholecystectomy(Lippincott Williams & Wilkins, 2024) Koras Sozen, Kezban; Bolat, Haci; Gunturk, InayetObjective: There are many factors that affect postoperative pain. This study determines the effect of preoperative sex hormone levels on postoperative pain levels in patients undergoing laparoscopic cholecystectomy. Patients and Methods: This study included a total of 89 patients who met the study inclusion criteria. The patients were divided into 3 groups based on their sex and pre and postmenopausal periods: male patients (n = 28), postmenopausal female patients (n = 31), and female patients with normal cycles (n = 30). Normal-cycle women were also regrouped based on their follicular and luteal phases. Data were collected using a descriptive characteristics form, a patient follow-up form, and the Visual Analog Scale. Results: Venous blood samples taken from the patients before surgery were used to measure their levels of estradiol (EST), testosterone (TES), and progesterone levels. Male patients had lower pain levels than female patients. The male patients' Visual Analog Scale scores were inversely related and correlated strongly with their TES levels (P < 0.05). However, subgroup analyses suggested that their EST level played a primary role in males and that the EST/TES ratio was determinant in the late postoperative period. In female patients, the EST/progesterone ratio was the most determining factor for the level of pain felt in the postmenopausal period, whereas there was no change in the premenopausal period at different stages of the menstrual cycle. Conclusions: Sex hormones were found to be effective in predicting postoperative pain severity.Öğe The use of ilioinguinal and iliohypogastric nerve block anesthesia in inguinal bladder hernia repair(Bayrakol Medical Publisher, 2023) Oztorun, Kenan; Kacmaz, Mustafa; Bolat, HaciAim: There are data showing that the use of minimally invasive anesthesia methods (local anesthesia, nerve blocks) as an alternative to traditional anesthesia methods used in inguinal hernia repair surgery is safe and effective. During the COVID-19 pandemic, which affected the whole world, we aimed to evaluate the use of minimally invasive anesthesia methods in patients with inguinal bladder hernia, as well as their perioperative and postoperative results in our pilot study.Material and Methods: We evaluated the perioperative and postoperative data of five patients with inguinal bladder hernia, who underwent surgery with local anesthesia and ilioinguinal/iliohypogastric nerve blockade, four of which were performed during the COVID-19 pandemic.Results: It is possible to perform inguinal bladder hernia surgery with local anesthesia and ilioinguinal/iliohypogastric nerve block, including in secondary cases. Better hemodynamic stabilization in the intraoperative period reduces the need for narcotic analgesics by providing effective analgesia in the postoperative period, as well as reducing the risk of contamination in airway control.Discussions: Performing inguinal bladder hernia surgery using local anesthesia and ilioinguinal/iliohypogastric nerve block provides reliable and effective analgesia during the perioperative and postoperative periods.
