Factors affecting organ donation

2006-10-01

Purpose: Family consent is a legal requirement in our country when harvesting organs from a cadaveric donor, a fundamental organ source for transplantation. In our study we investigated the correlation bet-ween the rate of consent received and demographic data concerning the patients with brain death in our institution in 2004 and 2005 and those relatives whose consent was requested. Patients and Methods: In the years 2004 and 2005, our transplant coordinators asked for consent from the relatives of patients who developed brain death in our hospital's intensive care units and were medically fit to be organ donors. The two groups of patients and their relatives, one consented for organ donation and the other denied were compared with respect to the patient's age, this person's degree of relation to the patient, his level of education, patient's age and the cause of death of the patient. Results: 54 brain deaths were confirmed in our hospital's intensive care units in the years 2004 and 2005. The transplant coordinators asked the relatives of 53 of these brain death patients for their consent for organ donation. One patient's relatives could not be reached. For 30 of the 53 patients (56.6 %) consent for multiple organ harvesting was taken. 15 of the 53 patients (28.3 %) were below the age of 20, with a rate of consent of 37.5 %. For patients older than 20 years, the rate of consent was found to be 52.6 % while it was 66.7 % in the younger patients (p=0.539). The rate of consent increased as the level of education of the relatives increased, although without statistical significance. The patient's cause of death, the age, degree of relation to the patient, degree of education and job of the closest relative contacted did not have any effect on the giving of consent. Declaration of the brain death by the intensive care unit nurse or patient's attending doctor resulted with a higher rate of consent when compared to cases found out during the coordinators' visit to the intensive care unit (p= 0.011). It was also seen that when the first contact about organ donation with the patient's relatives was made by the coordinators, the chance of concenting was higher. Conclusion: Finding out and declaration of the brain death by the attending health personnel but first contact and discretion to the family by the coordinators resulted with a higher rate of consent. Our transplant coordinators' work has resulted in a rate of organ donation remarkably higher than our country's standards.

Spigelian hernia: Diagnosis and treatment

Aytekin Co�kun, Ramazan Ery�lmaz, Deniz G�zey, Fatih Da��ran, Mustafa �ahin — 2006-10-01

Purpose: Spigelian hernia is a rare type of ventral hernia that may develop anywhere in the area between the lateral border of the rectus abdominis muscle and medial border of the transversus abdominis muscle from the 9. costal cartilage to the pubis. Materials and Methods: This retrospective study reviews 6 patients operated on for a Spigelian hernia, evaluating the age, sex, body-mass index, co-morbidity, clinical presentation, localization, size of the defect, duration of hospitalization and surgical techniques. Results:

Minimally invasive surgery in esophageal cancer

2006-10-01

Purpose: The aim of this study is to evaluate the results of minimally invasive surgical approach in the treatment of the patients who have esophageal cancer. Materials and Methods: Between May 2003 and February 2007, nine consecutive patients underwent minimally invasive surgery for esophageal cancer by a single surgical team. Surgical technique, operative data and short term results were asssessed. Results: There were five male and four female patients with a mean age of 55 (29-74) years. Esophageal tumor localization sites were upper third in three, middle third in four, lower third in two patients. Three staged operation was performed in all patients, except one (right thoracoscopy or thoracotomy, laparoscopy or laparotomy, cervical anastomosis). Laparoscopic transhiatal esophagectomy was done in one patient. Gastric conduit was used in eight patients whereas left colon interposition in one patient for reconstruction. One patient who underwent a left colonic interposition died on the postoperative day 11 because of aspiration pneumonia. Hoarseness developed in one patient caused by recurrent nerve injury. Mean operation time was 270 (210-360) minutes. All patients, except two were followed in the surgery service. Mean postoperative hospital stay was 11 (7-18) days. Mean follow-up time was 11 (1-35) months. There was no recurrence during follow-up. Conclusion: Minimally invasive esophagectomy is a reliable procedure with advantages of minimally invasive surgery. Effective oncological resection can be done. We think that it will be a good alternative procedure over conventional esophagectomy with an increased experience.

Lipoma causing a colo-colic intussusception and mimicking carcinoma

Neriman �eng�l, Kahraman Dinler, �etin Boran, Melike E. Kalfao�lu, Hayri Erkol — 2006-10-01

Colonic lipomas are relatively uncommon, although they are among the most common nonepithelial benign tumors of the colon. They are usually asymptomatic and often discovered incidentally on imaging studies, during colonoscopy, or in patients operated for other reasons. Rarely, appearing symptoms as if constipation, diarrhea, abdominal pain, bleeding, obstruction. We are presenting a case of colonic lipoma causing colo-colonic intussusception, in which clinical presentation mimicking carcinoma but diagnosed with computed tomography examination and verified with histopathology as lipoma in the left colon.

Intra-abdominal lymphangiomyomatosis

Vildan T�rkeli, Neriman �eng�l, Efsun �enocak, Hayri Erkol — 2006-10-01

Lymphangiomyomatosis (LAM) is a rare idiopathic disease characterized by hamartomatous smooth muscle proliferation of the lymph nodes, lymphatics, blood vessels as well as airways within the lung, mediastinum and abdomen. Extrapulmonary LAM is quite rare.

Scientific criterias for surgical suture and needle selection

Faik �elik, Mehmet Altan Kaya — 2006-10-01

Suture materials are used in surgery widely to keep the wound together and give needed support until the healing is achieved. They are a member of the main supports for wound healing. Despite their importance in surgery their properties and usage areas are not known well by doctors, even by surgeons. To make the correct decision in choosing the appropriate suture, the type and strength of the tissue, healing time of the tissue, properties of the suture material, iinteraction between the suture and tissue must be well known. In this paper the main purpose is to inform about these properties and needle selection criteria.

Ele�tirilen Makalenin Ad�: “Meme kanserinde interpektoral lenf nodu tutulumu”

Safa �nel — 2006-10-01