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    COMPARISON OF PREOPERATIVE BOWEL PREPARATION MODELS OF PATIENTS WHO UNDERWENT SURGERY FOR COLORECTAL CANCER
    (2023) Kartal, Bahadır; Bozkurt, Mehmet Abdussamet; Seyhun, Cemal
    Background The most prevalent cancer in society is colorectal cancer (CRC). Studies aiming to lower surgical morbidity and mortality have found a significant contribution from preoperative bowel preparation. Models for bowel preparation included mechanical cleaning, the use of antibiotics, and control groups. We compared preoperative bowel preparation for elective colorectal cancer and evaluated its effects in this study. Material and Methods Preoperative bowel preparation model was used to prospectively split 144 patients (n=144) with colorectal cancer into four groups. Patients in the first group (Group I) underwent mechanical bowel preparation (MBP), followed by oral antibiotic therapy (OAB) and MBP in the second group (Group II), intravenous antibiotic therapy (IVAB), MBP, and OAB in the third group (Group III), and no bowel preparation in the fourth group (Group IV). Demographic information, anastomotic leakage, surgical site infection, intraabdominal abscess, postoperative ileus, and death were compared between patients. Results Groups I, II, III, and IV of the study each had 35 patients, 38 patients, 35 patients, and 36 patients, respectively. There was no statistically significant difference between the four groups when the groups were evaluated by age, gender, and ASA (American Society of Anesthesiologists) score (p> 0.05). There were significant differences between surgical site infection (SSI), intraabdominal abscess, and anastomosis leaking (p0.05). Mortality and postoperative ileus did not differ significantly (p > 0.05). Conclusion We consider that the bowel preparation approach of mechanical colon cleansing and antibiotic administration is appropriate for patients who have had surgery owing to elective CRC.
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    What is the effect of percutaneous cholesistostomy in patients with acute cholecystitis? when is the right time for the procedure?
    (Turkish Assoc Trauma Emergency Surgery, 2023) Yirgin, Hakan; Topal, Uemmihan; Tatlidil, Yunusemre; Sibic, Osman; Yirgin, Inci Kizildag; Bozkurt, Mehmet Abdussamet
    BACKGROUND: Acute cholecystitis (AC) is one of the most common emergency diseases in surgical practice. Although the gold standard treatment is laparoscopic cholecystectomy, percutaneous cholecystostomy (PC) is performed in some patients due to age, comorbidity, and delays in admission. We aimed to investigate the effect of timing on the clinical process of patients undergoing PC.METHODS: Patients who underwent PC between February 2017 and December 2021 were included in the study. Those who underwent PC in the first 72 h were determined as the early PC group, and those who underwent PC after 72 h were determined as the late PC group. Demographic information of the patients, clinical information before drainage, biochemical values of the first 3 days, length of hospital stay, morbidity and mortality in the early and late period after drainage, and elective cholecystectomy information were recorded. These data were compared between the two groups.RESULTS: One hundred and twenty-two patients were included in the study. Early PC was performed in 98 patients (80.3%) and late PC was performed in 24 patients (19.7%). The median follow-up period was 26.6 months (min:0.25-max:67) in the early PC group and 26.4 months (min:0.6-max:66) in the late PC group (P=0.408). There was no statistically significant difference in mean age, distribution of males and women, concomitant disease, Charlson Comorbidity Index, hepatopancreatobiliary pathology (HPBP), endoscopic retrograde cholangiopancreatography in history and grade (TG18) compared to Tokyo classification (P>0.05). There was no difference between the biochemical parameters (P>0.05). In our study, the median length of hospital stay was 6 (min:2-max:36) days in the early PC group, and the median was 9 days (min:5-max:20) in the late PC group (P<0.001). A total of 25 patients developed HPBP after PC, 16 of which were AC. There was no statistically significant difference between the early and late PC groups in terms of HPBP development after PC (P=0.576). There was no statistically significant difference between the early and late PC group in terms of the rate of surgery and type of operation (emergency/elective, open/laparoscopic/conversion, total/subtotal, duration) (P>0.05).CONCLUSION: Discussions about the right timing are ongoing. In our study, we found that patients who underwent early PC had shorter hospital stays. There was no difference between the early and late groups in terms of patient characteristics and severity of AC. PC procedure in AC should be based on algorithms determined by objective data instead of patient-based indications with randomized controlled trials.