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Öğe Abdominal compartment syndrome following open and endovascular repair of ruptured abdominal aortic aneurysm(2023) Kızıloğlu, İlker; Daylan, AhmetObjectives: This study aimed to reveal the incidence, treatment, and outcomes of abdominal compartment syndrome (ACS) following open or endovascular repair of ruptured abdominal aortic aneurysm (rAAA). Patients and methods: The retrospective study included 36 patients (27 males, 9 females; mean age: 68.9±7.2 years; range, 61 to 81 years) who presented with rAAA between May 2016 and July 2023. In all patients, data regarding demographic characteristics, type of repair (open repair or endovascular aneurysm repair [EVAR]), ACS onset, morbidity, and mortality were recorded. The diagnosis of ACS was made by clinical signs and abdominal pressure measurements. Results: The overall mortality was 41.7% (n=15). Abdominal compartment syndrome developed in five (13.9%) patients, including two (25%) of eight patients who underwent EVAR and three (10.7%) of 28 patients who underwent open repair. In the open repair group, three (60%) of five patients who developed ACS and 12 (38.7%) of 31 patients without ACS died while one (50%) of two patients who developed ACS died in the EVAR group. No death was noted among patients without ACS in the EVAR group. Conclusion: This study shows that ACS can develop following both EVAR and open rAAA repair. Decompression laparotomy and open abdominal treatment should not be delayed when indicated. Although intra-abdominal pressure remains high, appropriate therapy may significantly affect outcomes.Öğe Acute mesenteric ischemia in the surgical intensive care unit: Analysis of clinical characteristics and risk factors for mortality(2023) Kızıloğlu, İlker; Daylan, Ahmet; Şener, Aslı; Aygün, Hakan; Bozok, ŞahinObjectives: This study aimed to present the clinical characteristics of patients followed due to acute mesenteric ischemia (AMI) in the surgical intensive care unit and evaluate mortality-related prognostic factors. Patients and methods: This retrospective study reviewed clinical records of 28 patients (19 males, 9 females; mean age: 67.5±17 years; range, 29 to 86 years) who were followed due to AMI in the intensive care unit between May 2016 and April 2023. We analyzed the clinical characteristics, risk factors, and prognostic factors of the patients. The Acute Physiology and Chronic Health Evaluation II (APACHE II) score was calculated in each patient to assess its prognostic value in AMI patients. Results: Of the 28 patients, 19 had acute arterial occlusive mesenteric ischemia (AOMI), four patients had acute mesenteric venous thrombosis (MVT), and five patients had nonocclusive mesenteric ischemia (NOMI). Overall mortality was 60.7% (n=17). The mortality rate was 57.8% (n=11) in the AOMI group, 50.0% (n=2) in the MVT group, and 80.0% (n=4) in the NOMI group. Compared to survivors, the APACHE II score, shock incidence, arterial lactate concentration, specifically more prominent 24 h after diagnosis (p<0.001), acute renal failure, serum creatinine level, vasoactive agent consumption, and maximum vasopressor dose were significantly higher among nonsurvivors (p<0.05). Conclusion: The clinical outcomes remain poor in AMI, and even in-hospital mortality is rather high. The death following AMI was mostly related to multiorgan failure, renal failure, elevated lactate level, and colon involvement. It appears that monitoring arterial lactate is helpful in identifying patients with poor prognosis. Early diagnosis, timely treatment, correction of shock, and renal protection are important to improve clinical prognosis.Öğe Comparative analysis of the results of cyanoacrylate ablation and radiofrequency ablation in the treatment of venous insufficiency(Elsevier, 2022) Daylan, Ahmet; Islamoglu, FatihBackground: Varicose vein treatment has shifted to less invasive techniques owing to the complications associated with traditional treatment. The present study was designed to compare the effectiveness of cyanoacrylate ablation (CAA) with radiofrequency ablation (RFA). Methods: Patients who had undergone RFA vs CAA (634 vs 246 patients) to treat great saphenous vein (GSV) insufficiency during a 5-year period were included in the present study. The preoperative and postoperative CEAP (clinical, etiologic, anatomic, pathophysiologic) class, symptoms, recurrence, and Doppler ultrasound findings were compared. Results: All the veins in both groups were occluded at day 5. The 1-month closure rates were 97.3% and 98.7% for RFA and CAA, respectively. The overall postoperative closure rates at 5 years were 93.1% and 91.1% for RFA and CAA, respectively. The postoperative symptoms, CEAP class, and Doppler ultrasound findings were similar in both groups. The 5-year symptom-free survival rates were 73.5% and 72.0% in the RFA and CAA groups, respectively. The venous clinical severity scores had decreased from 5.9 +/- 1.2 to 0.9 +/- 0.8 and 5.8 +/- 0.9 to 0.8 +/- 0.6 in the RFA and CAA groups, respectively. The Aberdeen varicose vein questionnaire scores had decreased from 19.7 +/- 5.5 to 4.8 +/- 1.5 in the RFA group and from 18.9 +/- 5.8 to 4.9 +/- 1.4 in the CAA group. Conclusions: CAA seems to be the ideal treatment for GSV insufficiency because it is suitable for most patients and is nonthermal and nontumescent, with satisfactory results comparable to those with RFA. Long-term outcomes and cost analyses from larger series are required to confirm our findings.Öğe Short-term preoperative intravenous iron replacement: Impact on surgical outcomes in cardiovascular disease(2024) Koseoğlu, Fatoş Dilan; Daylan, Ahmet; Rahman, Ömer Faruk; Dağlar, Cansu; Metehan, Oğuzhan; Bozok, ŞahinObjectives: This study aimed to compare surgical outcomes between patients scheduled for cardiovascular surgery diagnosed with anemia according to the World Health Organization criteria who received intravenous iron replacement and those who were not anemic. Patients and methods: This retrospective study analyzed patients who underwent cardiovascular surgery between February 2021 and January 2024. Patients with preoperative anemia treated with intravenous iron replacement were compared with nonanemic patients. Data on demographics, preoperative conditions, surgical details, and postoperative outcomes were analyzed. Results: Of the 193 patients (142 males, 51 females; mean age: 62±10 years; range, 27 to 82 years) analyzed, 173 survived, and 20 did not. Surviving patients were younger and had a lower body mass index. Comorbidities such as congestive heart failure and a history of cerebrovascular events were associated with mortality. Laboratory results showed significant differences in hemoglobin levels and iron binding capacity between survivors and nonsurvivors. The study found no significant differences in surgical procedures or reoperation rates between the groups. However, nonsurvivors had more postoperative complications. Multivariate analysis identified cardiopulmonary bypass time and new-onset acute renal failure as independent risk factors for 30-day mortality. Anemic patients treated with intravenous iron replacement had comparable perioperative outcomes to nonanemic patients, including similar lengths of intensive care unit and hospital stays and mortality rates. Conclusion: Treatment of preoperative anemia with intravenous iron replacement in patients undergoing cardiovascular surgery resulted in outcomes comparable to those of nonanemic patients. This suggests that short-term intravenous iron replacement may be an effective strategy to improve surgical readiness and outcomes in anemic patients.
