Turkish Journal of Colorectal Disease

Turkish Journal of Colorectal Disease

Basic info

  • Publisher: Galenos Publishing House
  • Country of publisher: turkey
  • Date added to EuroPub: 2019/Aug/13

Subject and more

  • LCC Subject Category: Medicine, Surgery
  • Publisher's keywords: Colon, Rectum, Anus, Pelvic Floor, Disease, Surgery
  • Language of fulltext: english, turkish

Publication charges

  • Article Processing Charges (APCs): No
  • Submission charges: No
  • Waiver policy for charges? No

Editorial information

Open access & licensing

  • Type of License: CC BY
  • License terms
  • Open Access Statement: Yes
  • Year open access content began: 2007
  • Does the author retain unrestricted copyright? False
  • Does the author retain publishing rights? False

Best practice polices

  • Permanent article identifier: DOI
  • Content digitally archived in: Other
  • Deposit policy registered in: None

This journal has '29' articles

Trephine Stoma Creation Under Local Anesthesia with Sedoanalgesia

Trephine Stoma Creation Under Local Anesthesia with Sedoanalgesia

Authors: Ali Aksu, Mehmet Buğra Bozan, Nurullah Aksoy, Ayşe Azak Bozan, Nizamettin Kutluer, Burhan Hakan Kanat, Sevim Şenol Karataş, Asude Aksoy, Abdullah Böyü...
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Abstract

Aim: In this paper, we aimed to evaluate the patients who underwent trephine stoma with sedoanalgesia in addition to local anesthesia and to share the results. Method: The patients who underwent trephine stoma with sedoanalgesia in addition to local anesthesia for fecal diversion in our general surgery clinic between June 2012 and June 2017 were evaluated retrospectively. The patients were evaluated in terms of demographic characteristics, diagnosis of primary disease and complications. Results: A total of 11 patients (F/M: 4/7) were evaluated. The mean age was 54 (±4) years. The mean follow-up period was 18 months (range 2-30). Primary disease was rectal cancer in seven patients (63.6%), Fournier’s disease in two patients (18.2%), genital cancer in one patient (9.1%), and rectovaginal fistula in one patient (9.1%). Only one patient underwent transverse colostomy and 10 patients underwent sigmoid colostomy. There were no complications related to surgical procedures. One patient died on the 14th postoperative day because of complications secondary to metastasis. Conclusion: Trephine stoma technique, which does not require laparotomy, is a fast, reliable, and easy to use method especially in high-risk patients with poor general condition.

Keywords: Kolostomi, acil cerrahi, lokal anestezi, minimal invaziv cerrahi, trefin stoma
Comparison of V-Y Flap and Limberg Flap Methods in Pilonidal Sinus Surgery

Comparison of V-Y Flap and Limberg Flap Methods in Pilonidal Sinus Surgery

Authors: Ramazan Sarı, Soner Akbaba, Rıza Haldun Gündoğdu, Mustafa Ömer Yazıcıoğlu
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Abstract

Aim: The aim of this study was to compare the advantages of V-Y flap and Limberg flap techniques in the surgical management of complicated pilonidal sinus disease requiring extensive excision, and to review the superiorities of each other in the light of the literature. Method: The study included 100 patients who were hospitalized with the diagnosis of pilonidal sinus disease and who were planned to undergo flap reconstruction due to the diameter of the defect. Patients were randomly divided into two groups as A and B. Fifty patients in group A underwent V-Y flap and 50 patients in group B underwent Limberg flap. Both groups were prospectively followed-up in terms of complications, recovery times, workforce losses, patient satisfaction and 2-year recurrence rates, and the findings were compared statistically. Results: Demographic characteristics, complaints and clinical findings of both groups were similar. Although postoperative wound infection rates were similar (26% vs. 28%; p>0.05), wound dehiscence was more common in the Limberg group (36% vs. 26%; p<0.05). The wound healing process and workforce losses were longer in the Limberg flap group, but the differences were not statistically significant. There were no differences between the groups in terms of patient satisfaction and recurrence in the 2-year follow-up period. Conclusion: The long-term recurrence rates of V-Y flap and Limberg flap techniques are similar. Wound dehiscence is significantly less in V-Y flap technique. According to the results of this study, V-Y flap method following extensive tissue loss due to excision can be considered as a good alternative.

Keywords: Pilonidal sinus, Limberg flap, V-Y flap
Evaluation of Etiological Risk Factors in the Development of Adult Chronic Pilonidal Disease

Evaluation of Etiological Risk Factors in the Development of Adult Chronic Pilonidal Disease

Authors: Adnan Kuvvetli, Süleyman Çetinkunar, Alper Parlakgümüş
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Abstract

Aim: Pilonidal disease has a high rate of recurrence after surgical interventions and measures that can be taken to prevent the recurrence are gaining importance. This study was planned to review the possible risk factors and to provide guidance for the reduction of pilonidal disease. Method: Patients diagnosed with pilonidal disease between January 2014 and January 2017 were evaluated. Age, gender, weight, height, body mass index (BMI), occupation and sitting or standing position during working, family history of pilonidal sinus, skin color and hair color were analyzed retrospectively. The BMI of the patients was categorized as ≤20.0 kg/m2, 20.1-25.0 kg/m2, 25.1-30.0 kg/m2, 30.1-35.0 kg/m2 and 35.1-40.0 akg/m2. Results: The total number of patients with pilonidal disease was 217 with a mean age 26.0. The disease had two age peaks at 19 and 24-27 years. Pilonidal disease was statistically significantly more commonly observed in patients with BMI of 25.1-30.0 kg/m2 (p<0.001). The disease was significantly higher in brunette patients compared to auburn and blonde patients (p<0.001). The disease was observed in 49.8% patients with seated positional occupations (p<0.001). Conclusion: Age, skin color and hair color are unmodifiable risk factors, but prevention of obesity, reducing sitting time and changing routines while fulfilling occupations seem preventive methods.

Keywords: Etiology, pilonidal sinus, prevention
Birth Trauma: Sphincter Injuries

Birth Trauma: Sphincter Injuries

Authors: Murat Çakır, Mehmet Aykut Yıldırım
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Abstract

Aim: Fecal incontinence is a condition that has social and economic effects and that disrupts the quality of life. A complete definition of fecal incontinence is difficult. However, it can be defined as the failure to control the anal discharge of intestinal content at an appropriate time and place. The diagnosis of fecal incontinence is challenging and complex. One of the most important causes of fecal incontinence is trauma in the perianal region. The most important cause of such trauma is birth trauma. We examined our cases who had sphincter repair due to acute injury in the perianal region during delivery. Method: The data of 10 female patients who were admitted to Necmettin Erbakan University, Meram Faculty of Medicine, Department of General Surgery with perianal injuries between 2010 and 2015 were analyzed retrospectively. Data regarding age, severity of injury, first intervention time, repair type, wound problems and post-operative complications were investigated. Long-term results were analyzed. Results: It was observed that 10 female patients underwent emergency surgery due to acute perianal injury. Tenpatients were included in the study and their files were analyzed retrospectively. The mean age of the patients was 24 (range: 19-36) years. Four patients had type 4 injury, two had type 3a injury, one had type 3b injury, and three had type 3c injury. Conclusion: We believe that it is important to perform surgical treatment before tissue edema develops.

Keywords: Childbirth, incontinence, trauma
An Acute Abdomen Dilemma: Epiploic Appendagitis

An Acute Abdomen Dilemma: Epiploic Appendagitis

Authors: Hakan Özdemir, Oğuzhan Sunamak, Zehra Ünal Özdemir, Ferdi Cambaztepe
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Abstract

Aim: Appendagitis is a clinical condition caused by ischemia, torsion or inflammation of epiploic appendices located on serosal surface of the colon. Antibiotics and analgesics are generally sufficient in treatment. Rarely, excision might be needed. It might be confused with acute appendicitis and diverticulitis, depending on its localization. Method: The data of 12 patients with acute abdomen, who were diagnosed to have epiploic appendagitis and responded to medical treatment completely, were analyzed retrospectively. Results: There were seven female and five male patients with a mean age of 33 (range: 21-48) years. The mean body mass index was 25.5 (range: 19-34). There was no abdominal surgery. The mean length of hospital stay, leukocyte count and C-reactive protein (CRP) were 2.08 days, 10.41x103/μL and 2.3 mg/dL, respectively. Sixty-six point six percent (n=8) of the epiploic appendagitis was localized in the right colon and 33.3% (n=4) in the left colon. A positive correlation was found between the diameter of appendagitis and leukocyte count and CRP level (p>0.05). There was no correlation between appendagitis diameter and vomiting (p>0.05). Conclusion: Appendagitis should be kept in mind in patients presenting with sudden onset, sharp and constant pain. Informing radiologist about this possibility may help to confirm the diagnosis.

Keywords: Conservative treatment, epiploic appendagitis, radiology
The Effects of Glutamine and N-Acetylcysteine on Experimental Colitis Induced by 2,4,6-Trinitrobenzene Sulphonic Acid in Rats

The Effects of Glutamine and N-Acetylcysteine on Experimental Colitis Induced by 2,4,6-Trinitrobenzene Sulphonic Acid in Rats

Authors: İsmail Cem Eray, Orçun Yalav, Kubilay Dalcı, Ahmet Rencüzoğulları, Ahmet Gökhan Sarıtaş, Ömer Alabaz, Şule Menziletoğlu Yıldız, Gülşah Seydaoğlu, Fige...
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Abstract

Aim: Various factors including free oxygen radicals were have been described in the pathogenesis of inflammatory bowel disease. The aim of this study was to investigate the effects of antioxidant N-acetylcysteine (NAC) and combined glutamine (Gln) on experimental colitis. Method: In order to achieve this, rats were randomized and administered intraperitoneal NAC or oral Gln + intraperitoneal NAC one day after experimental colitis model induced with trinitrobenzen sulphonic acid. After the treatment, the rats were sacrificed and colon damage was evaluated macroscopically and microscopically. Malonyldialdehyde level and superoxide dismutase activity were analyzed biochemically. Results: NAC and Gln + NAC groups showed macroscopically better results than the colitis group. Histopathologically, all treated groups provided significantly lower scores than the colitis group. Similarly, all treated groups provided better biochemical results than the colitis group. Conclusion: According to the results of the experiment, it was concluded that NAC had positive effects on experimental colitis model.

Keywords: Experimental colitis, glutamine, N-acetylcysteine
Appendix Duplication Accompanied by Acute Appendicitis

Appendix Duplication Accompanied by Acute Appendicitis

Authors: Uğur Topal, Figen Doran, Ahmet Rencüzoğulları
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Abstract

Acute appendicitis is the most common non-traumatic emergency surgical pathology, and duplication of the appendix is a rare congenital anomaly usually detected incidentally during laparotomy. Since Picoli first described appendix duplex in a female patient who presented with associated anomalies, few other cases have been reported. In this study, we aimed to present a case of appendix duplication detected in a 56-year-old female renal transplant patient undergoing surgery for acute appendicitis. Surgical management of double appendix is of practical importance to avoid serious medical and legal consequences.

Keywords: Double appendix, acute appendicitis, appendectomy
Idiopathic Nonobstructive Colo-colonic Intussusception: A Rare Clinical Presentation

Idiopathic Nonobstructive Colo-colonic Intussusception: A Rare Clinical Presentation

Authors: Fatma Ayça Gültekin, Ramazan Kozan, Yücel Üstündağ
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Abstract

Adult intussusception is a rare clinical condition. There is generally an etiological factor, mainly malignancy. However, the number of idiopathic cases is very low. Patients may present with obstruction or acute abdomen, but the symptoms and signs may also be nonspecific. The diagnostic process is more difficult in patients with non-specific clinical presentation. In this article, the diagnosis and treatment options of an adult idiopathic colo-colonic intussusception are discussed.

Keywords: Intussusception, adult, idiopathic, colonic diseases, laparoscopy
Penetrating Sharp Object Injury in the Gluteal Region and Small Bowel Perforation Due to Pelvic Penetration: A Case Report

Penetrating Sharp Object Injury in the Gluteal Region and Small Bowel Perforation Due to Pelvic Penetration: A Case Report

Authors: Ergün Yüksel, Mehmet Akif Üstüner, Ahmet Karayiğit, Lütfi Doğan
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Abstract

Penetrating sharp object injuries in the gluteal region are common. However, it is very rare that these injuries lead to perforation of the small bowel by pelvic penetration, which is generally overlooked. As penetration depth increases, there may be life-threatening injuries such as vascular injury, bowel injury and genitourinary injury depending on the localization of injury site. The case report addressed in the present research focuses on a patient who was admitted to the hospital because of a penetrating sharp object injury in the gluteal region.

Keywords: Penetrating sharp object injuries, gluteal region, perforation of the small intestine
Midgut Nonrotation in an Adult Patient and Ladd’s Procedure

Midgut Nonrotation in an Adult Patient and Ladd’s Procedure

Authors: Huriye Hande Aydınlı, Özgen Işık, Tuncay Yılmazlar
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Abstract

Midgut malrotation is a congenital anomaly that usually occurs during infancy. The most common type is the “classic” form, which is defined as complete failure of rotation of both proximal (duodenojejunal limb) and distal (cecocolic) small bowel loops (nonrotation). Delayed diagnosis of midgut malrotation anomalies may lead to progression to catastrophic complications including volvulus and ischemic necrosis. Ladd’s procedure is the standard of care. We aimed to report a brief case of a midgut nonrotation in an adult male patient.

Keywords: Midgut, malrotation, anomaly
Should Support Group Intervention be Implemented for Individuals with Stoma?

Should Support Group Intervention be Implemented for Individuals with Stoma?

Authors: Serap Sayar, Fatma Vural
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Abstract

The presence of stoma in individuals causes physical, psychological and social problems. For this reason, individuals with stoma need effective psychosocial interventions in order to adapt to the stoma. One of these effective psychosocial interventions is support groups. Support groups are defined as groups of individuals with the same problem that provide common support through interpersonal relationships. Individuals generally need to join these groups when natural social support networks are inadequate or if their psychosocial needs are not met. Sharing experiences with other group members in the support group intervention creates positive effects, and solutions are developed for problems with participation in the group. In many studies carried out with other patient groups, support group intervention has positive effects and individuals improve their quality of life. In our country, there is no ongoing support group intervention for individuals with stoma, but in order to help develop psychosocial adaptation to stoma and its effects, nurses should raise awareness about the need for support group intervention and implement these interventions.

Keywords: Stoma, support groups, nursing
Robotic Ventral Mesh Rectopexy: Where do we Stand?

Robotic Ventral Mesh Rectopexy: Where do we Stand?

Authors: Bahadır Osman Bozkırlı, Erman Aytaç, Eren Esen, Volkan Özben, Bilgi Baca, İsmail Hamzaoğlu, Tayfun Karahasanoğlu
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Abstract

This paper aims to review the current status of robotic ventral mesh rectopexy (VMR). The articles reporting the outcomes of patients who underwent robotic VMR were reviewed and evaluated. Complications of robotic VMR ranged between 0% to 25%, the majority of them were minor complications. Longer operating time and higher hospital expenses are the major limitations of robotic surgery compared to laparoscopy. As an emerging technique, robotic VMR promises good outcomes. Robotic VMR seems to be a safe and effective surgical technique in the treatment of rectal prolapse.

Keywords: Robotic, rectopexy, ventral mesh repair
Four Determinative Factors in Fournier’s Gangrene Mortality

Four Determinative Factors in Fournier’s Gangrene Mortality

Authors: Seracettin Eğin, Sedat Kamalı, Berk Gökçek, Metin Yeşiltaş, Semih Hot, Dursun Özgür Karakaş
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Abstract

Aim: We aimed to more accurately predict mortality in Fournier’s gangrene (FG) by investigating factors affecting mortality such as age, extent of infection, presence of accompanying comorbidities, the intensive care unit (ICU) length of stay (LOS). Method: Routinely recorded data of 37 FG patients treated between February 2012-May 2018 were retrospectively evaluated. The patients were divided in two groups as the deceased group (DG) (n=10) and surviving group (SG) (n=27) and compared in terms of sex, age score (AS), dissemination score (DS), Uludağ Fournier’s gangrene severity index (UFGSI) score, Fournier gangrene severity index (FGSI) score, serum urea levels, presence of diabetes and obesity, presence of comorbidities other than diabetes and obesity (COTDO), presence of diversion colostomy, number of days of vacuum-assisted closure treatment, hospital LOS, ICU LOS, and species of isolated bacteria. Associations between mortality and factors such as age, DS, COTDO, and ICU LOS were investigated in all cases. Results: There was a significant difference between the two groups in terms of AS. DS was significantly higher in the DG than in SG. All of the patients in the DG had COTDO, while only 13 of the patients in the SG had these comorbidities, and the difference between the two groups was statistically significant. ICU LOS was significantly higher in the MG. In reciever operator characteristics curve analysis, UFGSI and FGSI had 93% specificity and 90% and 70% sensitivity, respectively. In logistic regression analysis, age, DS, COTDO, and ICU LOS were independent predictive factors associated with mortality. Conclusion: Age, DS, COTDO, and ICU LOS showed significant differences between deceased and surviving patients, and emerged as independent predictive factors associated with mortality. As a result, these factors have been shown to be determinative factors in FG mortality.

Keywords: Fournier’s gangrene, mortality, vacuum-assisted closure
Evaluation of Constipation Risk among Inpatients in Surgery and Internal Medicine Wards

Evaluation of Constipation Risk among Inpatients in Surgery and Internal Medicine Wards

Authors: Şenay Karadağ Arlı
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Abstract

Aim: This study was conducted to evaluate the risk of constipation among inpatients in the surgery and internal medicine wards. Method: This descriptive study included 251 inpatients being treated in the Ağrı State Hospital between April 2018 and June 2018 who consented to participate. Data were collected using a personal information form and the constipation risk assessment scale (CRAS). Results: The mean age of the participants was 49.74±19.50 years. Analysis of the patients’ distributions according to mean CRAS score and sociodemographic characteristics showed that gender, marital status, education level, and occupation were statistically significant (p<0.05, p<0.01). In addition, when the distribution of the patients according to mean CRAS total score and health status/lifestyle characteristics was examined, statistically significant differences were observed in terms of hospital ward, presence of chronic disease, regular medication use, predominant food group, skipping meals, regular exercise, constipation problem, and constipation risk (p<0.05, p<0.01). There was a statistically significant positive correlation between total CRAS score and age (p<0.01). Conclusion: Older age was associated with more problems with constipation in our study group. Therefore, it is recommended to prevent or solve the problem through constipation risk assessment for inpatients, early diagnosis of constipation, appropriate nursing interventions, and team collaboration.

Keywords: Constipation, constipation risk assessment, constipation care
Compliance with Quality Standards and Causes of Incomplete Colonoscopy: A Prospective Observational Study

Compliance with Quality Standards and Causes of Incomplete Colonoscopy: A Prospective Observational Study

Authors: Ulaş Aday, Ebubekir Gündeş, Hüseyin Çiyiltepe, Durmuş Ali Çetin, Emre Bozdağ, Sabiye Akbulut, Rabia Köksal, Erdal Polat
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Abstract

Aim: To evaluate incomplete colonoscopy rate, factors affecting incomplete colonoscopy, and compliance with colonoscopy quality standards in our clinic. Method: This prospective study was conducted in a tertiary health center between January 2017 and December 2017. Demographic characteristics of individuals undergoing colonoscopy, their colon cleansing status, causes of incomplete colonoscopy, and factors affecting incomplete colonoscopy were investigated. Results: A total of 756 people were included in this study. The mean age was 54±12.74 years and 63% of the patients were female. Mean body mass index (BMI) was 28.32±4.84 and 309 (40.9%) had history of prior abdominal surgery. The duration of cecal intubation was 355±187 seconds and colonoscopy could not be completed in 89 patients (11.8%). Advanced age (p=0.036), female gender (p=0.036), high BMI values (p=0.042), presence of comorbidity (p=0.004), antiaggregant/anticoagulant use (p=0.001), and inadequate bowel cleansing (p<0.001) were found to be significant factors for incomplete colonoscopy. Excluding the patients who had inadequate colon cleansing and were recommended to repeat the procedure, colonoscopy was completed in 93.9% (667/710) of patients. Inadequate bowel preparation was the most common cause of incomplete colonoscopy (51.6%) and male gender (p=0.047), antiaggregant/anticoagulant use (p=0.021) were identified as factors affecting colon cleansing. Polyp detection rate was 24.7% (165/667), below the currently recommended rate of detection of adenoma. Conclusion: Inadequate bowel preparation, advanced age, female gender, high BMI, presence of comorbidity, use of antiaggregant/anticoagulant are risk factors for incomplete colonoscopy. We are below colonoscopy quality standards due to high incomplete colonoscopy rate and low adenoma detection rate due to inadequate bowel preparation.

Keywords: Incomplete colonoscopy, bowel preparation, quality in colonoscopy

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