BACKGROUND:Cholelithiasis is the most prevalent inflammatory condition of the gallbladder. The regulation of biological processes, including energy homeostasis, and control of body weight are key mechanisms that the leptin and melanocortin pathways play a role in Cholelithiasis is the most prevalent inflammatory condition of the gallbladder. There are various risk factors for the development of gallstone disease, especially weight gain, and obesity is just one of them. This risk factor can be minimized by maintaining appetite and energy balance. Here, leptin and melanocortin pathways are the key mechanisms in maintaining appetite and energy homeostasis. OBJECTIVES:The aim of this study was to investigate the relationship between the levels of LEP, LEPR, TrkB, BDNF, POMC, and MC4R proteins in patients with Cholelithiasis. This study aims to determine the relationship between LEP, LEPR, TrkB, BDNF, POMC, and MC4R protein levels, which play a role in maintaining appetite and energy homeostasis, and cholelithiasis. METHODS:This study examined 44 patients diagnosed with Cholelithiasis and 44 healthy control subjects who had not previously been diagnosed with any form of Cholelithiasis. The levels of leptin (LEP), Leptin Binds To Leptin Receptors (LEPR), Tropomyosin Receptor Kinase B (TrkB), Brain-Derived Neurotrophic Factor (BDNF), Pro-OpioMelanoCortin (POMC), and Melanocortin- 4 Receptors (MC4R) molecules were analyzed using the Enzyme-Linked Immunosorbent Assay (ELISA) method. The results were analyzed using the SPSS Software (Version 22.0) program and GraphPad Prism 8.0.1 software. RESULTS:The study found a statistically significant decrease (p < 0.05) in MC4R, TrkB, BDNF, and POMC protein levels in Cholelithiasis patients compared to the control group. There was no statistically significant difference in LEP and LEPR concentration values between the two groups (p = 0.247, p = 0.674). CONCLUSION:The proteins MC4R, TrkB, BDNF, and POMC, which are involved in the leptin and melanocortin pathways may play a significant role in Cholelithiasis disease. However, more detailed research on the relevant proteins is needed. Nevertheless, this research will guide new studies.

mir146a, a member of the microRNA family, plays an important role in the regulation of many biological pathways such as the regulation and differentiation of hematopoietic cells. The relationship between mir146a polymorphism and gastric, colon, rectum cancers have been investigated in Turkish population. Polymorphism in mir146a gene rs2961920 and rs2910164 have been determined in 212 patients (gastric: 73, colon:76 and rectum:63) and in 77 healthy controls by Real-Time PCR. Findings were evaluated by logistic regression and Khi (χ2) tests. The comparison of gastric, colon and rectum cancer patients and controls determined a statistically significant relationship for alcoholic drink consumption (p0.05). However, there was statistically significant relationship between this polymorphism and gastric cancer in GG+CG and CC genotypes when the gastric cancer patients and control group were evaluated for mir146a rs2910164 polymorphism (χ2: 5,49 p: 0,019). Similarly, there was statistically significant relationship between this polymorphism and gastric cancer in GG+CC and CG genotypes (χ2:5,39, p: 0,020). In this study, it is thought that by investigating the functions of microRNAs and their role in cancer, it may be promising in understanding the molecular pathology of cancer and in developing molecular targeted therapies.

Objectives: Cholelithiasis is a common gallbladder disease that refers to the formation of gallstones.In this study, we investigated the relationship between Cholelithiasis and Chitinase 3-like-1 protein (Chi3L1) and Chemerin levels. Materials and Methods:Our study was conducted in 88 individuals, 44 of whom were healthy and 44 of whom had cholelithiasis.Chemerin and Chi3L1 serum levels were measured by enzyme-linked immunsorbent assay-ELISA method.The results were then analyzed using SPSS.Results: When cholelithiasis patient groups were compared with healthy groups, a significant increase was found in Chemerin levels in cholelithiasis patients (6.28-4.68,p<0.001).Chi3L1 concentration values were not statistically different between groups (p=0.460).After receiver operating characteristic analysis, the Chemerin result was statistically significant in predicting disease [p<0.001,area under the curve: 0.795 (0.697-0.893)],Chi3L1 was statistically insignificant in predicting disease.While the difference between the patient and control groups in terms of creatinine, albumin, amylase, alanine aminotransferase, aspartate aminotransferase, gamma glutamyltransferase, direct bilirubin, sodium, and calcium was statistically significant (p<0.05), the difference between Chi3L1 concentration and creatinine and total protein was statistically significant (p<0.05). Conclusion:Our study suggests that chemerin may be a new biomarker in the diagnosis of cholelithiasis.In addition, since our study has not been done before, it can bring a new perspective to the literature.

Objective: We aimed to analyzed the association between gastric cancer and polymorphism of XPO5 gene. Method: The polymorphism in the XPO5 gene (rs11544382) was determined in 120 individuals (60 gastric cancer patients; 60 healthy controls) using Real-Time PCR method. Results: The comparison of gastric cancer patients and controls revealed a statistically significant relationship for alcoholic drink consumption (p<0.05).The relationship between XPO5 gene (rs11544382) polymorphism and gastric cancer was statistically not significant. There was no a statistically significant relationship between mutant (GG) genotype with both wild type (AA) and heterozygous (AG) polymorphic genotypes when evaluated in XPO5 polymorphism gastric cancer patients and control groups (χ2:0.12, p=0.729). The heterozygous (AG) was dominant in gastric cancers patients and control subjects, 93.3 and 91.7% respectively. Conclusions: This study provides information about allele and genotype frequency distribution of XPO5 gene polymorphism (rs11544382) in Turkish At the same time, AG genotype was found to be dominant in gastric cancer patients and their controls.

Heterotopia is mass of tissue normal to the site in abnormal location. Heterotopic gastric mucosa has been described in almost every part of the gastrointestinal tract including the tongue, oesophagus, epiglottis, small bowel, appendix vermiformis, rectum and gallbladder. The diagnosis of heterotopic gastric mucosa in gallbladder can be difficult clinically . Heterotopic gastric mucosa in gallbladder can be symptomatic or detected incidentally. It is relevant to distinguish heterotopic gastric mucosa from benign polyps, gallbladder carcinoma or metastasis. We present a case of a 51 year old female patient who represented suspicious lesion on computed tomography (CT). After cholecystectomy, in the microscopical examination gastric mucosa consisting of fundic glands and pyloric glands and typical features of chronic cholecystitis are seen.

Objective: Symptomatic anastomotic leakage observed after colorectal surgery is one of the major complications. One of the factors affecting the anastomosis healing is the type of suture material used. This study aims to investigate the effects of the suture material polydioxanone (PDS, Ethicon), which is late absorbable and has a monofilament structure, and the suture material polyglactin 910 (Vicryl, Ethicon), which is absorbable and has a multifilament structure, on the healing of colonic anastomosis, and to compare the traditional forms of these sutures with their antibacterial effective triclosan-impregnated forms (PDS Plus, Ethicon and Vicryl Plus, Ethicon). Materials and Methods: The rats were divided into four equal groups consisting of 10 subjects each: Group I: Vicryl; Group II: Vicryl Plus; Group III: PDS; and Group IV: PDS Plus. The presence of wound infection, whether the integrity of the abdominal wall was maintained, intra-abdominal adhesion scoring, the presence of intra-abdominal abscess, and whether the macroscopic integrity of anastomosis was maintained were evaluated. Results: According to the results of this experimental study, while the highest ABP and hydroxyproline levels were observed in the PDS Plus group, the lowest values were observed in the Vicryl group. However, the difference was not statistically significant. Conclusion: Slowly absorbable and monofilament PDS suture material causes less tissue reaction and inflammatory response compared to the Vicryl suture material that is absorbable in the colonic anastomosis line and multifilament.

PURPOSE:The Murine double minute 2 (MDM2) gene plays a crucial role in regulating and suppressing the function of apoptotic pathway. We investigated the relationship between MDM2 gene SNP309 (T309G) (rs2279744) polymorphism and colorectal cancer (CRC) in a Turkish population.METHODS:The polymorphism T309G (rs2279744) in the MDM2 gene was studied in patients with colorectal cancer (n=135) and healthy control subjects (n=145) using the polymerase chain reaction restriction fragment length polymorphism (PCR-RFLP) method. The findings were evaluated using logistic regression and x2 tests.RESULTS:When CRC cases and controls were evaluated based on different habits and family cancer histories, a statistically significant relationship was found between CRC and alcohol consumption (x2=4.07, p=0.044). Cancer cases and controls had statistically significant different family histories of cancer (x2=6.82, p=0.009). There was also significant difference in TG genotype distribution in the MDM2 T309G polymorphism between those with and without cancer (OR=1.98, 95% CI=1.98-3.91, x2=4.00, p=0.045).CONCLUSIONS:The SNP309 polymorphism of the MDM2 gene is associated with increased CRC risk in the Turkish population.

BACKGROUND/AIMS:Patients with colorectal cancer continue to present with relatively advanced tumors that are associated with poor oncological outcomes. The aim of the present study was to assess the association between localization, symptom duration, and tumor stage. MATERIALS AND METHODS:A prospective, multicenter cohort study was conducted on patients newly diagnosed with a histologically proven colorectal adenocarcinoma. Standardized questionnaire-interviews were performed. Data were collected on principal presenting symptoms, duration of symptoms (time to first presentation to a doctor and time to diagnosis) and treatment, diagnostic procedures, tumor site, and stage of the tumor (tumor, node, and metastasis (TNM)). RESULTS:A total of 1795 patients with colorectal cancer were interviewed (mean age: 60.76±13.50 years, male patients: 1057, patients aged >50 years: 1444, colon/rectal cancer: 899/850, right side/left side: 383/1250, stage 0-1-2/stage 3-4: 746/923). No statistically significant correlations were found between duration of symptoms and either tumor site or stage. Principal presenting symptoms were significantly associated with left colon cancer. Patients who had "anemia," "change in bowel habits," "anal pruritus or discharge," "weight loss," and "tumor in right colon" had a significantly longer symptom time. CONCLUSION:Symptom duration is not associated with localization, nor is the tumor stage. Diagnosis of colorectal cancer at an earlier stage may be best achieved by screening of the population.

Amac: Mide kanseri multi-fonksiyonel bir hastaliktir. Kanser hastalarinda duygusal stres, fizyolojik ve noroendokrin degisiklikler, hipotalamik-pituiter-adrenal eksenin aktivasyonuna ve katekolamin gibi strese bagli hormonlarin serbest birakilmasina neden olabilmektedir. Ozellikle katekolaminin uyarilmasi ile β 2 -Adrenerjik reseptor (β 2 -AR) aracili sinyal ileti yoluyla tumor hucrelerinin biyolojik davranislarini dogrudan etkiledigi bildirilmistir. Bu calismada, mide kanserli hastalarda β 2 -AR gen (rs1042717) polimorfizminin arastirilmasi amaclanmistir. Yontem: β 2 -AR genindeki polimorfizim (rs1042717) 60 mide kanseri hastasi ve 50 saglikli kontrol de Real-Time PCR metoduyla belirlendi. Elde edilen sonuclar, lojistik regresyon ve Khi-kare (χ2) testi kullanilarak degerlendirildi. Tartisma: Mide kanseri hastalari ve kontroller alkol kullanma acisindan degerlendirildiginde, istatistiksel olarak anlamli bir iliski belirlendi (p<0,05). β2-AR (rs1042717) polimorfizmi ile mide kanseri arasinda istatistiksel olarak anlamli bir iliski bulundu (p<0,05). β2-AR (rs1042717) polimorfizmi mide kanse ri hastalari ve kontrol grubunda degerlendirildiginde, mutant (AA ) genotipi ile yabanil tip (GG ) ve heterozigot (AG) polimorfik genotipleri arasinda istatistiksel olarak anlamli bir iliski oldugu goruldu (χ 2 : 19,38, p : 0,001). Benzer sekilde heterozigot (AG) ile yabanil tip (GG) ve mutant (AA) polimorfik genotipleri kiyaslandiginda ise mide kanserinde istatistiksel olarak anlamli bir iliski oldugu saptandi ( χ 2 : 14,27, p :0,001). Sonuc: Bu calismada, mide kanseri hastalari ve kontrollerde en cok AG genotipinin hakim oldugu ve ayrica , AA genotipinin mide kanserine karsi koruyucu bir etkiye sahip oldugu gorulmustur.

1 Departments of General Surgery, Cumhuriyet University, Faculty of Medicine, Sivas, Turkey 2 Department of Nutrition and Diet, Cumhuriyet University, Faculty of Health Sciences, Sivas, Turkey 3 Department of Biochemistry, Cumhuriyet University, Faculty of Medicine, Sivas, Turkey 4 Clinic of General Surgery, Sivas Sample Hospital, Sivas, Turkey Corresponding author: Ayça Taş, MD., Department of Nutrition and Diet, Cumhuriyet University, Faculty of Health Sciences, Sivas, Turkey E-mail: aycatas@cumhuriyet.edu.tr Received/Accepted: June 06, 2018 / September 17, 2018 Conflict of interest: There is not a conflict of interest.

Murine double minute clone 2 oncoprotein (MDM2) is a key component in the regulation of the tumour suppressor p53. The association between the MDM2 polymorphism and gastric cancer (GC) has been investigated in Turkish population. In the present case-control study, the aim was to investigate the association between genetic polymorphisms of the MDM2 gene (a major regulator of p53 function) and primary GC risk in a Turkish population. The polymorphism, T309G (rs2279744) in the MDM2 gene was determined in patients with GC (n=65) and in healthy control subjects (n=67) using the polymerase chain reaction-restriction fragment length polymorphism method. The findings were evaluated using logistic regression and χ2 tests. No statistically significant differences were observed between the control subjects and patients with GC regarding smoking status. A comparison between GC cases and control subjects indicated a statistically significant difference for family history of cancer [odds ratio (OR)=0.17; 95% confidence interval (CI), 0.05-0.56; χ2=0.19; P=0.01]. A significant difference was identified in the GG genotype distribution between GC patients and control subjects (OR=4.58; 95% CI, 1.18-17.79; P=0.022). Thus, the results of the present study indicate that the MDM2 gene T309G intron (GG) genotype may be an important risk factor for GC development in the Turkish population.

PURPOSE:Thyroid tumors of uncertain malignant potential (TT-UMP) constitute a relatively new diagnosis. The purpose of this study was to analyze the relationship between immunohistochemical panels, prognostic parameters and TT-UMP.METHODS:Group I was composed of patients diagnosed as differentiated thyroid carcinoma (DTC) and Group II of patients diagnosed as TT-UMP. The prognostic scores of patients were calculated using data according to the well-known prognostic scoring systems MACIS, AMES, AGES. Evaluations of antibodies were based on the presence of nuclear staining for p16 and p53, membranous and cytoplasmic staining for epidermal growth factor receptor (EGFR) and cytoplasmic staining for fragile histidine triad (FHIT).RESULTS:Statistically significant difference was noted (p< 0.05) between Group I and Group II according to MACIS and AMES. No statistical difference was found in terms of immunostaining between groups when stained with p16, p53 and FHIT. On the other hand, in Group II a moderate positive correlation was detected between MACIS and EGFR.CONCLUSION:According to our findings p53 was not important in tumor genesis at early stages in well-differentiated thyroid carcinomas and p16 loss of expression could be used as a finding to help in difficult microscopic diagnosis. TT-UMP is a gray zone of lesions requiring specific therapeutic procedures and postoperative follow-up. A positive correlation was detected between EGFR and TT-UMP, leading to assume that this situation could be used as a new tool in the follow-up of these patients in the future.

Background: Oxidative stress is a complicated process, which was defined as an increase in prooxidants and decrease in antioxidants caused by various mechanisms, including inflammation and surgical trauma. The association between acute appendicitis and oxidative stress has been showed in previous studies. However, comparison of oxidative stress in laparoscopic or open appendectomy (OA) has not been established. Patients and Methods: Patients who were diagnosed as acute appendicitis between October 2012 and January 2013 were randomized to open (OA, n = 50) and laparoscopic appendectomy (LA, n = 50). Blood samples for oxidative stress markers (total oxidant status [TOS] and total antioxidant status [TAS]), C-reactive protein (CRP) and white blood cells (WBC's) were collected just before the surgery and 24 h after surgery. Results: There were no differences in preoperative values of WBC and CRP between LA and OA groups (P = 0.523 and 0.424), however, in postoperative 24th h, CRP was reduced in LA group (P = 0.031). There were no differences in preoperative levels of TOS, TAS, and oxidative stress index (OSI) between LA and OA groups. In the postoperative 24th h, TOS and OSI were found to be significantly higher in OA group when compared to LA group (P = 0.017 and 0.002) whereas no difference was detected in TAS level in the postoperative 24th h (P = 0.172). Conclusions: This double-blind, randomized clinical trial provides evidence that LA for uncomplicated appendicitis is associated with significantly lower oxidative stress compared with OA. Some of the advantages of LA may be attributed to the significant reduction of oxidative stress in these patients.

BACKGROUND:The aim of this study is to compare the motility of Roux limb with that of normal segment.MATERIALS AND METHODS:Rats were divided into 3 equal groups as control, Roux-en-Y (Group A) and Roux-en-Y with vagotomy (Group B). Only midline incision and manipulations were applied in control group. Following distal gastrectomy, Roux-en-Y reconstruction was applied in Group A, while vagotomy Roux-en-Y gastrojejunostomy was applied in Group B. Rats were sacrificed 1 month later by cervical dislocations under anesthesia. The obtained jejunal segments were cut into four equal parts. The bath was 37 °C warm while 95 % O2 and 5 % CO2 gases were supplied in 10 ml bicarbonate Krebs' solution.RESULTS:KCl responses were similar in all three groups. Acetylcholine contraction responses in the vagotomy and non-vagotomy Roux-en-Y groups was higher than in those in control group significantly (p < 0.05). This response in vagotomy Roux-en-Y group was also higher than that in non-vagotomy group (p < 0.05). The induced electrical field stimulation contraction response in the vagotomy + Roux-en-Y group was lower than those in control group and non-vagotomy group (p < 0.05).CONCLUSIONS:These results show that muscarinic receptor density and/or function may increase after vagotomy and non-vagotomy group operation, and vagotomy may contribute to this increase. The decrease in electrical signal response in vagotomy Roux-en-Y group may depend on the decrease in acetylcholine oscillation from the cholinergic nerve ending (Tab. 1, Fig. 5, Ref. 25).

Background: Peptic ulcer perforation (PUP) constitutes a unique situation characterized by severe pain, leading almost every patient with this complication to seek help in the hospital. However, clinical features of PUP in elderly patients are different from those of young or in adult patients; indeed, symptoms of PUP may be atypical in old age.Materials and methods: This was a retrospective study of patients who underwent emergency surgery for PUP between 2002 and 2012. The patients were divided into two age groups. Medical conditions of the patients that may have had an effect on the perforation, such as age, gender, concomitant disease, use of drugs, presence of Helicobacter pylori infection, characteristic of pain (vague abdominal pain or severe epigastric pain), smoking status, and duration symptoms at the time of admission, were evaluated.Results: A total of 261 patients were included in this retrospective study. Group I (n = 202) was composed of adults (age < 65 years), Group II (n = 59) was composed of geriatric patients (age >= 65 years). Male dominancy was observed in both groups. Primary closure of the perforation was the most common procedure performed. Hypertension (18.3 % and 52.5%, respectively), and diabetes mellitus (11.9% and 15.3%, respectively) were the most frequent comorbidities in both groups, whereas mortality and morbidity rates were higher in elderly group.Conclusions: PUP is a serious condition, particularly in geriatric age requiring emergency surgical management. Primary closure of the perforation was the most common procedure performed in our series. Copyright (C) 2013, Taiwan Society of Geriatric Emergency & Critical Care Medicine. Published by Elsevier Taiwan LLC.

PURPOSE:There is a common doubt regarding the application of polypropylene mesh to treat incarcerated and strangulated hernias due to the possibility of surgical site infection. We aimed to investigate the results of mesh repair of incarcerated and strangulated hernias, and to evaluate the incidence of wound infection and recurrence.METHODS:One hundred and fifty-three consecutive patients with incarcerated and strangulated hernias underwent surgery with mesh repair. The patients were divided into two groups: a resection group and a nonresection group. Fisher's exact test, the Chi-square test and independent samples t test were used to determine the statistical significance level (p < 0.05).RESULTS:While 53 patients required organ resection, the remaining 100 patients did not. The most frequently incarcerated organs were the omentum (86), small bowel (74) and colon (15). Most of the resections were performed in the omentum (36), small bowel (23) and colon (2). While five of the 53 patients (9.4%) in the resection group developed wound infections, no infections were observed in the nonresection group (p = 0.004). The infection rate in all patients was 3.3% (five of 153 patients). None of the infected patients required mesh removal. There were no mortalities or recurrence in either group.CONCLUSIONS:The findings revealed effective and safe usage of mesh along with antibiotic therapy in patients undergoing incarcerated and strangulated hernia repair.

Aim. The aim of this retrospective study is to assess the mortality and morbidity after different types operations for sigmoid volvulus. Method. The results of surgical treatment of our patients with sigmoid volvulus were analyzed retrospectively. The patients were divided into two groups: Group-1: Single Stage Surgery (SSS) and Group-2: Hartmann’s Procedure (HP). Results. Total 51 patients aged 65.9 years in average (between 22-88 years) were included. In comparing the morbidity rates of SSS group to the HP group, it revealed no statistically significant differences. All died patients (12/51, 25.5%) were above 70 years old and had comorbidities. Overall, there were 12 patients (12/51, 23.52%) with sigmoid colon necrosis at exploratory laparotomy. While 4 of them were in SSS group, 8 of them were in HP group. Three of four (75%) sigmoid colon necrosis patients in SSS group, and 4 of 8 sigmoid colon necrosis patients in (50%) HP group were died. Conclusion. We want to notice that, there would be a high risk of complication, if the situation accompanies a sigmoid colon necrosis at laparotomy. Late admisson and patient’s negative general condition also play an important role in anastomosis safety.

Severe burn induces biochemical mediators such as reactive oxygen species that leads to lipid peroxidation which may have a key role in formation of acute lung injury (ALI). Sildenafil is a selective and potent inhibitor of cyclic guanosine monophosphate specific phosphodiesterase-5. Sildenafil preserves alveolar growth, angiogenesis, reduces inflammation and airway reactivity. The purpose of the present study was to evaluate the effects of different dosages of sildenafil in ALI due to severe scald burn in rats. Twenty-four rats were subjected to 30% total body surface area severe scald injury and were randomly divided into three equal groups as follow: control, 10 and 20mg/kg sildenafil groups. Levels of malondialdehyde (MDA), activities of glutathione peroxidase (Gpx), catalase (Cat), total oxidative stress (TOS), and total antioxidative capacity (TAC) were measured in both tissues and serums. Oxidative stress index (OSI) was calculated. A semi-quantitative scoring system was used for the evaluation of histopatological findings. Sildenafil increased Gpx, Cat, TAC and decreased MDA, TOS and OSI. Sildenafil decreased inflammation scores in lungs. Our results reveal that sildenafil is protective against scald burn related ALI by decreasing oxidative stress and inflammation and the dosage of 10mg/kg could be apparently better than 20mg/kg.

Amac. Genc ve yasli hastalarda elektif cerrahi islemlerin sonuclari benzer gorulse de, yaslilarda acil cerrahiler onemli morbidite ve mortaliteye yol acabilir. Bu calisma yasli hasta grubunda akut apandisit yonetimindeki tecrubemizi sunmak amaciyla yapildi. Corresponding author: Dr. Ali Kagan Gokakin, Genel Cerrahi Anabilim Dali, Cumhuriyet Universitesi Tip Fakultesi, 58140 Sivas. Email: dralihan20@hotmail.comYontem. 2007-2012 yillari arasinda akut apandisit nedeniyle apandektomi yapilan hastalar calismaya alindi. Diger akut batin nedenleri saptanan olgular calisma disi tutuldu. Bu kosullara gore 1382 olgu calisma kapsaminda degerlendirildi. Calismaya alinan olgular uc yas grubuna bolundu: grup I, yas<29; grup II, yas 29-65; ve grup III, 65 yas ve uzeri. Yas, cinsiyet, belirtilerin suresi, hastanede yatis suresi (toplam ve preoperatif), ameliyat tipi, bulgulari ve ameliyat suresi, morbitite ve mortalite oranlari ve patolojik bulgularin uyumlulugu verileri degerlendirildi. Bulgular. Belirtilerin suresi ve hastanede yatis suresi (toplam ve preoperatif) grup III’de daha fazla bulundu. Postoperatif sonuclar grup III olgularda diger gruplara gore daha kotu bulundu; ama yanlis tani orani diger gruplara gore daha dusuktu. Sonuclar. Yaslilarda akut apandisit cerrahi pratiginin zor kisimlarindan biridir ve daha yuksek morbidite ile birliktedir. Yasam suresinin artmasi ile birlikte gelecekte bu olgularla daha fazla karsilasilacagi beklenilmelidir.

Aim. The aim of this retrospective study is to assess the mortality and morbidity after different types operations for sigmoid volvulus. Method. The results of surgical treatment of our patients with sigmoid volvulus were analyzed retrospectively. The patients were divided into two groups: Group-1: Single Stage Surgery (SSS) and Group-2: Hartmann’s Procedure (HP). Results. Total 51 patients aged 65.9 years in average (between 22-88 years) were included. In comparing the morbidity rates of SSS group to the HP group, it revealed no statistically significant differences. All died patients (12/51, 25.5%) were above 70 years old and had comorbidities. Overall, there were 12 patients (12/51, 23.52%) with sigmoid colon necrosis at exploratory laparotomy. While 4 of them were in SSS group, 8 of them were in HP group. Three of four (75%) sigmoid colon necrosis patients in SSS group, and 4 of 8 sigmoid colon necrosis patients in (50%) HP group were died. Conclusion. We want to notice that, there would be a high risk of complication, if the situation accompanies a sigmoid colon necrosis at laparotomy. Late admisson and patient’s negative general condition also play an important role in anastomosis safety. Keywords: Sigmoid volvulus, Hartmann’s procedure, single stage surgery. Ozet Amac. Bu retrospektif calismanin amaci sigmoid volvulus tedavisinde gerceklestirilen iki farkli yaklasimin mortalite ve morbide uzerine farkliliklarini degerlendirmektir. Yontemler. Sigmoid volvulus tedavisi uygulanan hastalarin sonuclari retrospektif olarak irdelendi. Hastalar Grup-1: Tek asamali cerrahi ve Grup-2: Hartmann Yontemi (HY) olmak uzere iki gruba ayrildi. Bulgular. Yas ortalamasi 65.9 yil (22-88 yil) olan toplam 51 hasta calismaya dahil edilmistir. Grup-1 ile Grup-2’nin morbidite ve mortalite sonuclarinin karsilastirilmasi sonucunda istatistiksel olarak anlamli bir sonuc cikmamistir. Kaybedilen tum hastalarin (n=12, %25,5) yandas problemleri vardir ve yaslari 70 ve uzeridir. Hastalarin 12’sinde (%23,52) laparotomide sigmoid kolon nekrozu ile karsilasilmis ve bu hastalarin 7’si (%58) kaybedilmistir. Sonuc. Bu calismada vurgulamak istedigimiz en onemli sey laparotomide sigmoid kolon nekrozu ile karsilasilmis ise komplikasyon oraninin yuksek olacagi seklindedir. Hastanin hastaneye basvuruda gecikmesi ve eslik eden sorunlar anastomoz guvenliginde onemli faktorlerdir. Anahtar sozcukler: Sigmoid volvulus, Hartmann Yontemi, tek asamali cerrahi