İlk olarak Kuzey Avrupa merkezli çalışmalar ile başlayan ERAS protokolünün geliştirilmesi ile postoperatif fizyolojik fonksiyonların düzenlenmesi amaçlanmıştır. Hastanın hastalık ve hastane döneminde geçirdiği tedavi deneyiminin standart, ölçülmüş, iyileştirilmiş bir süreç hâline getirilmesi için çalışılır. Operasyon öncesi, operasyon ve operasyon sonrası dönemde standart bakı ile hastalık sürecini yönetme disiplini gerektirir. Hastanın hekim, hemşire hastabakıcı da dâhil tüm sağlık uygulayıcısı ekip ile koordineli bilinçli, geliştirilmiş aktif bir şekilde uyumu şarttır. Bu sürecin yönetimi, tedaviye müdahil olan tüm sağlık personelini içerir. Genel cerrahi disiplininde de ilk olarak kolorektal cerrahi ile başlamış olmakla beraber, gastrik, hepatobiliyer, bariatrik vb gibi gastrointestinal tüm disiplinler için klavuzlar geliştirilmiştir. ERAS protokolü ile hastanede kalış süresinin, tedavi maliyetlerinin, komplikasyon oranlarının iyileşmesinin sağlandığı kanıtlanmıştır.
Rectal hemorrhage should be evaluated within a wide spectrum ranging from benign diseases to a malignant process. Especially, the melanomas of rectum are detected at an advanced stage when diagnosed since the present symptoms of rectal melanomas are similar. The question of what will be the surgical approach with MR, CT, and PET-CT imaging methods performed after histopathological diagnosis still conserves its topicality. PET-CT is a good imaging method for determination of distant metastasis and lymphatic involvement. In the present case, a patient with early-stage rectal melanoma was treated with APR. No relapse/metastasis was detected during the 18-month follow-up. The aggressive course of the disease and its low response rates to medical treatments may cause the surgical approaches to be more extensive.
Background Hydatid cyst is an endemic disease frequently localized to the liver. It is frequently observed in Southeast Europe, Middle East, and Turkey. Although the cyst rupture can occur spontaneously, it can also occur upon albendazole treatment. Its surgical treatment includes cystotomy, capitonnage, and wedge resection. Material-Method A 56-year-old male immigrant was admitted with fever, pain, and cough. Albendazole treatment was initiated and elective surgery was planned. Upon his admission to emergency service, he was diagnosed with pneumonia, and a spontaneous cyst rupture was detected. Result Thoracotomy and cystotomy were performed. Bile leakage aspiration and lung wedge resection were also performed. Conclusion Different surgical methods are used in the treatment of hydatid cysts depending on the localization and complications. Follow-up with antihelminthic drugs such as albendazole and mebendazole is recommended in medical treatment.
Splanchnic venous thrombosis is a rare type of venous thromboembolism, and its actual incidence is still unknown. Splenic infarction develops due to splenic vein (SV) thrombosis. Patients with COVID-19 had a risk of thrombotic events, and the system affected at the highest level by coagulopathy is the respiratory system. The case presented here is splenic infarction that developed because of SV thrombosis, which is a rare form of venous thromboembolism.
Only 5% of all cases of intussusceptions occur in adults. Although it is known to occur frequently due to inflammatory bowel disease, postoperative adhesions, or neoplastic masses, inflammatory fibroid polyps (IFP), which are rare lesions of the gastrointestinal tract, may present this clinical picture. In rare cases of intussusception due to IFP, clinical suspicion should be kept in the foreground and mind in the differential diagnosis. In this article, the purpose was to present the clinical, radiological, and pathological findings and the treatment of obstruction caused by this rare lesion.
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