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1.
Transplant Proc ; 47(2): 348-53, 2015 Mar.
Article in English | MEDLINE | ID: mdl-25769571

ABSTRACT

OBJECTIVE: Data on transplantation survival is widely available for developed countries where cadaveric transplantation is the dominant transplantation type. We aimed to assess patient and graft survival and to determine the possible factors affecting graft survival in a developing country where kidney transplantations were mainly performed from living donors. METHODS: We retrospectively analyzed data from 427 adult kidney transplantations performed at our center from January 1990 to November 2010. We collected data from patient files, including characteristics of the recipients and donors, transplantation-related factors, post-transplantation features, causes of graft loss, and patient death. The Kaplan-Meier method was used to analyze survival, and Cox regression analysis was used to evaluate the effects of multiple factors on graft survival. RESULTS: Most of the recipients (82.6%) received their organs from living donors. One-year and 5-year graft survival rates were 87.5% and 78.3%, respectively, where the 5-year graft survival rates were 87.1% for living donors and 74.8% for cadaveric donors. The 1-year and 5-year patient survival rates were 90.9% and 88.9%, respectively. Univariate analysis showed that predictors for better graft survival were serum creatinine levels <1.5 mg/dL at 1 month after transplantation, proteinuria <500 mg/d at 1 year after transplantation, use of tacrolimus and mycophenolic acid derivative-based immunosuppression at baseline, living-donor transplantation, and transplantations performed in the years 2000-2010. CONCLUSIONS: We report data on kidney transplantation in an emerging country where living-donor transplantation constitutes a large proportion of kidney transplant activities. Modern immunosuppressive medications help to achieve a better survival. Our 5-year results are similar to those of developed countries.


Subject(s)
Developing Countries , Graft Survival , Kidney Failure, Chronic/mortality , Kidney Failure, Chronic/surgery , Kidney Transplantation/mortality , Tertiary Care Centers , Adult , Aged , Creatinine/blood , Female , Humans , Immunosuppression Therapy , Immunosuppressive Agents/therapeutic use , Kidney Transplantation/adverse effects , Living Donors , Male , Middle Aged , Mycophenolic Acid/therapeutic use , Retrospective Studies , Survival Analysis , Survival Rate , Tacrolimus/therapeutic use , Turkey
2.
Transplant Proc ; 43(3): 833-6, 2011 Apr.
Article in English | MEDLINE | ID: mdl-21486609

ABSTRACT

We compared the tolerability and efficacy of mycophenolate mofetil (MMF) versus mycophenolate sodium (MPS) among renal transplant recipients on tacrolimus-based immunosuppression. The 105 patients who underwent kidney transplantation between January 2002 and March 2008 and were treated with steroid, tacrolimus, and a mycophenolic acid compound were enrolled in the study. From patient files we collected on demographics data, donors, immunosuppressive drug doses, biochemical and hematologic parameters, gastrointestinal and hematologic side effects, and kidney function. Fifty-six patients were prescribed MMF and 49 of them were taking MPS. Demographic parameters and pretransplantation dialysis duration were similar between the 2 groups. After the third month, the MPS dose was higher than that of MMF. There were no clinically important differences between the 2 groups, regarding other immunosuppressive drug doses. Gastrointestinal side effects were similar: 42.4% in the MMF versus 44.8% in the MPS group (P = .846). Six patients in the MMF group and 1 patient in the MPS group underwent a switch of the mycophenolic acid therapy due to severe gastrointestinal side effects (P = .183). Biopsy-proven acute rejection was reported in 6 patients on MMF and 7 patients on MPS therapy (P = .768). The log-rank test evaluating a 50% reduction in glomerular filtration rate (GFR) showed no significant difference between the 2 groups (P = .719). No deaths were recorded during the study period; there was only 1 graft loss, which occurred in the MMF group. We did not observe a significant difference in tolerability and efficacy between the 2 widely used mycophenolic acid derivatives. Economic considerations can be an important factor when choosing the drug.


Subject(s)
Immunosuppressive Agents/therapeutic use , Kidney Transplantation , Mycophenolic Acid/therapeutic use , Tacrolimus/therapeutic use , Female , Humans , Male
3.
Tech Coloproctol ; 6(1): 27-32, 2002 Apr.
Article in English | MEDLINE | ID: mdl-12077638

ABSTRACT

Sacrococcygeal pilonidal sinus disease affects younger persons, resulting in long-term loss of productive power. It also has a high rate of morbidity because there is no standard treatment approved by all surgeons. In this study, early and late results of 85 cases treated with excision and Limberg flap in our clinic were investigated. The patients were followed for 9-120 months. The complication rate was 4.7% and the long-term relapse rate was 3.5: Insufficient personal hygiene and inadequate excision were the main causes for recurrence. On the basis of the literature and our previous experiences, we conclude that the Limberg flap is the ideal treatment for sacrococcygeal pilonidal sinus disease with low morbidity, mortality and recurrence rates.


Subject(s)
Pilonidal Sinus/surgery , Surgical Flaps , Adolescent , Adult , Female , Follow-Up Studies , Humans , Male , Middle Aged , Postoperative Complications , Recurrence , Suture Techniques , Treatment Outcome
4.
Swiss Surg ; 8(1): 7-10, 2002.
Article in English | MEDLINE | ID: mdl-11883346

ABSTRACT

Castleman's disease is a benign lymphoid neoplasm first reported as hyperplasia of mediastinal lymph nodes. Some authors referred to the lesions as isolated tumors, described as a variant of Hodgkin's disease with a possibility of a malignant potential and others proposed that the lymphoid masses were of a hamartomatous nature. Three histologic variants and two clinical types of the disease have been described. The disease may occur in almost any area in which lymph nodes are normally found. The most common locations are thorax (63%), abdomen (11%) and axilla (4%). We report two separate histologic types of Castleman's disease which were rare in the literature, mimicking sigmoid colon tumor and Hodgkin lymphoma. The diagnostic and therapeutic aspects of this rare entity is discussed.


Subject(s)
Castleman Disease/diagnostic imaging , Hodgkin Disease/diagnostic imaging , Peritoneal Neoplasms/diagnostic imaging , Sigmoid Neoplasms/diagnostic imaging , Adult , Biopsy , Castleman Disease/pathology , Colon, Sigmoid/diagnostic imaging , Colon, Sigmoid/pathology , Diagnosis, Differential , Hodgkin Disease/pathology , Humans , Lymph Nodes/pathology , Male , Mesentery/diagnostic imaging , Mesentery/pathology , Peritoneal Neoplasms/pathology , Sigmoid Neoplasms/pathology , Tomography, X-Ray Computed
5.
Tech Coloproctol ; 6(3): 187-90, 2002 Dec.
Article in English | MEDLINE | ID: mdl-12525914

ABSTRACT

Laparoscopy is being increasingly used in colorectal surgery interventions. Herein, we present a patient with giant parastomal hernia who underwent laparoscopic repair. A70-year-old man who had undergone abdominoperineal resection and end colostomy for carcinoma of rectum was admitted to our clinic with a giant parastomal hernia. The parastomal hernia was repaired by laparoscopic approach using prosthetic material. The patient was discharged uneventfully on postoperative day 4. Laparoscopic approach is a rational alternative to conventional repair techniques of parastomal hernia and may be a reliable and easily applicable method with the classic benefits of laparoscopic surgery.


Subject(s)
Carcinoma/surgery , Hernia/etiology , Herniorrhaphy , Laparoscopy , Postoperative Complications , Prostheses and Implants , Rectal Neoplasms/surgery , Surgical Mesh , Surgical Stomas/adverse effects , Aged , Carcinoma/pathology , Hernia/pathology , Humans , Male , Rectal Neoplasms/pathology , Severity of Illness Index , Surgical Stomas/pathology
6.
Surg Laparosc Endosc Percutan Tech ; 11(4): 289-90, 2001 Aug.
Article in English | MEDLINE | ID: mdl-11525379

ABSTRACT

The purpose of this study was to find an effective and reasonable solution to replace damaged balloon dissector used in laparoscopic extraperitoneal inguinal hernia repair. The thumb of a surgical glove was used to repair torn balloon dissector for laparoscopic total extraperitoneal hernia repair. The new balloon presented an adequate tightness to perform the dissection of the extraperitoneal area without complication. Although the best way to replace a damaged balloon dissector is to replace it with a new one, this method may be taken into consideration in such a situation in which a new balloon dissector is not available.


Subject(s)
Catheterization/instrumentation , Hernia, Inguinal/surgery , Laparoscopy , Equipment Failure , Humans
9.
Acta Chir Belg ; 96(1): 44-8, 1996 Feb.
Article in English | MEDLINE | ID: mdl-8629389

ABSTRACT

Surgical trauma (ST) is one of the causative factor of bacterial translocation. In this study we investigated the prevention of bacterial translocation with lactulose in a surgical trauma model. The study was designed in 3 experimental groups consisting of 15 rats in each. Group 1 was sham operated controls, group 2 was ST + physiologic saline treated and group 3 was ST + lactulose treated animals. Lactulose and physiologic saline were given by oro-gastric intubation in a dose of 2 ml of 33.5% solution/d and 2 ml/d respectively starting 3 days prior to surgery. Bacterial translocation was investigated 48 hours after the operations. In sham operated controls only 1 bacterial translocation to the mesenteric lymph nodes (MLN) was observed. In the ST + physiologic saline treated group bacterial translocation to the MLN and portal venous blood (PVB) were significantly increased compared with both sham operated controls and the ST + lactulose treated group (p < 0.001). In rats with lactulose treatment the results of caecal bacterial counts showed a significant decrease in the number of gram-negative aerobes and facultative anaerobe bacteria (p < 0.01) and a significant increase in the number of lactobacilli (p < 0.001) compared to the sham operated controls. Measurement of the mucosal height showed a significant increase at the terminal ileum and the caecum compared with the sham operated controls and the surgical trauma+physiologic saline treated group (p < 0.001). We conclude that oral lactulose treatment 3 days prior to the surgical trauma, reduced the incidence of bacterial translocation to the MLN and PVB.


Subject(s)
Bacterial Translocation/drug effects , Lactulose/pharmacology , Laparotomy , Animals , Bacteria, Aerobic/isolation & purification , Bacteria, Anaerobic/isolation & purification , Feces/microbiology , Intestinal Mucosa/microbiology , Lactulose/therapeutic use , Lymph Nodes/microbiology , Mesentery , Rats , Rats, Sprague-Dawley
10.
Acta Chir Belg ; 93(3): 92-3, 1993.
Article in English | MEDLINE | ID: mdl-8372591

ABSTRACT

Phytobezoars are rare causes of acute abdomen cases. Here we are reporting two cases which were presented with acute abdomen symptoms and later were found to be small intestinal perforation due to bezoar.


Subject(s)
Bezoars/complications , Diet/adverse effects , Fruit , Intestinal Perforation/etiology , Intestine, Small , Vegetables , Adult , Bezoars/diagnostic imaging , Bezoars/surgery , Humans , Male , Middle Aged , Radiography
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