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    Factors Affecting Mortality in Patients who Underwent Primary Suture Repair for Peptic Ulcer Perforation
    (2018) Işık, Özgen; Dündar, Halit Ziya; Bakar, Burak; Özkan, Ömer Faruk; Öztürk, Ersin; Kaya, Ekrem; Yılmazlar, Tuncay
    Introduction: Primary suture is the most commonly used emergency surgery procedure for peptic ulcer perforation (PUP).The aim of this study was to evaluate factors affecting mortality in patients who underwent primary suture for PUP.Methods: In total, 103 patients underwent primary suture for PUP between September 2009 and December 2016. Patientdemographics, comorbidities, the time interval between symptom onset and hospital admission, the length of hospital stay,and morbidity and mortality data were retrospectively collected.Results: The median age of the patients was 63 years (min: 22, max: 99 years) and 74.8% were male. In all, 45 patients hadat least 1 comorbidity. The median time interval between symptom onset and hospital admission was 1 day (min: 1, max:10 days). The mortality rate was 10.7%. Non-surviving patients were older, more frequently presented with shock, and moreoften had postoperative pneumonia, compared with survivors. Older age (Odds ratio [OR]: 1.22; p=0.0015) and postoperativepneumonia (OR: 84.2; p=0.0031) were independent risk factors associated with increased mortality.Discussion and Conclusion: Advanced age and postoperative pneumonia were the factors associated with an increased riskof mortality in patients who underwent primary suture for PUP.
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    Upper Gastrointestinal Stent Placement: 8 Years’ Experience of a Single Institution
    (2018) Dündar, Halit Ziya; Işık, Özgen; Bakar, Burak; Özkan, Ömer Faruk; Öztürk, Ersin; Yılmazlar, Tuncay
    Introduction: Coated and uncoated self-expandable metal stents (SEMS) are increasingly used in the palliation of malignantand benign strictures in the upper gastrointestinal (GI) tract and in the treatment of postoperative anastomotic leakage andfistulas. The objective of this study was to share the experience of one clinic with upper gastrointestinal tract stent placement.Methods: Patients who underwent upper GI tract SEMS placement between 2009 and 2017 were identified, and patientcharts were retrospectively reviewed. The details of patient demographic data, stent type, indication for stent placement,success of stenting, need for stent replacement, morbidity, and mortality were documented.Results: In total, there were 29 patients with a median age of 57.5 years (min-max: 32-80 years), and 58.62% were male. Therewere benign problems in 9 patients. Nine (45%) of the patients with malignancy had esophageal carcinoma, while the remainder(55%) had gastric or esophagogastric junction carcinoma. Indications for stent placement were anastomotic leak(41.37%), esophageal stricture (37.94%), leak after obesity surgery (10.35%), esophageal perforation (6.89%), and tracheoesophagealfistula (3.45%).Discussion and Conclusion: SEMS placement is an effective, safe, and minimally invasive method for the palliation of upperGI tract strictures and the treatment of surgical complications. In this series, the mortality rate in patients who underwentSEMS placement for the treatment of anastomotic leak was high.