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  • Öğe
    Hyperbilirubinemia is a predictor of appendiceal perforation in children: A meta-analysis
    (Academic Journal of Health Sciences, 2023) Azizoğlu, Mustafa; Okur, Mehmet Hanifi; Aydoğdu, Bahattin; Orbay, Tuğçe Merve; Bakir, Ayten Ceren; Klyuev, Sergey Alexandrovich; Bilici, Salim; Bayram, Salih
    Objective: In this meta-analysis, our goal was to examine the diagnostic utility of bilirubin in identifying complicated from uncomplicated pediatric appendicitis. Materials and methods: Using the databases Embase, PubMed, Scopus, and Cochrane, we carried out a thorough literature search up to 2022. Studies comparing complicated appendicitis (CA) and simple appendicitis (SA) in terms of hyperbilirubinemia in the pediatric population were included. Results: A total of 5 studies with 2740 acute appendicitis patients (1097 complicated appendicitis and 1643 simple appendicitis) were included in this meta-analysis. Five studies have discussed the diagnostic value of total bilirubin (TB). When compared to simple appendicitis, complicated appendicitis had a significantly higher TB count (I2 =94%), (WMD=0.18, 95% CI -0.00 to 0.37; P=0.05), DB count (I2 =0%), (WMD=0.11, 95% CI 0.04 to 0.18; P=0.002), and IB count (I2 = not applicable), (WMD=0.04, 95% CI 0.01 to 0.07; P=0.02). Conclusions: In conclusion, in this meta-analysis, total bilirubin, direct bilirubin, and indirect bilirubin values were higher in complicated appendicitis compared to simple appendicitis. Both total bilirubin and direct bilirubin can be used as diagnostic parameters in childhood appendicitis to differentiate complicated appendicitis from simple appendicitis.
  • Öğe
    Laparoscopic versus open portoenterostomy for treatment of biliary atresia: a meta-analysis
    (SpringerLink, 2023) Bilici, Salim; Mehmet Hanif Okur, Bahattin Aydoğdu, Mustafa Azizoğlu, Salim Bilici, Salih Bayram, Fikret Salik
    Abstract Objective Our goal was to compare laparoscopic portoenterostomy versus open portoenterostomy for the treatment of biliary atresia. Materials and methods Using the databases EMBASE, PubMed, and Cochrane, we carried out a thorough literature search up to 2022. Studies comparing laparoscopic and open surgery for the treatment of biliary atresia were included. Results Twenty-three studies comparing laparoscopic portoenterostomy (LPE) (n=689) and open portoenterostomy (OPE) (n=818) were considered appropriate for meta-analysis. Age at surgery time was lower in the LPE group than OPE group (I 2=84%), (WMD − 4.70, 95% CI − 9.14 to − 0.26; P=0.04). Signifcantly decreased blood loss (I 2=94%), (WMD − 17.85, 95% CI − 23.67 to − 12.02; P<0.00001) and time to feed were found in the laparoscopic group (I 2=97%), (WMD − 2.88, 95% CI − 4.71 to − 1.04; P=0.002). Signifcantly decreased operative time was found in the open group (I 2=85%), (WMD 32.52, 95% CI 15.65–49.39; P=0.0002). Weight, transfusion rate, overall complication rate, cholangitis, time to drain removal, length of stay, jaundice clearance, and two-year transplant-free survival were not signifcantly diferent across the groups. Conclusions Laparoscopic portoenterostomy provides advantages regarding operative bleeding and the time to begin feeding. No diferences in remain characteristics. Based on the data presented to us by this meta-analysis, LPE is not superior to OPE in terms of overall results.
  • Öğe
    Oxidative Stress Enzyme NOX1 Is a New and Important Biomarker for Childhood Appendicitis?
    (SpringerLink, 2023) Avcı, Veli; Ayengin, Kemal; Huyut, Zubeyir; Huyut, Mehmet Tahir; Soysal, Lokman; Bilici, Salim
    Delayed appendicitis diagnosis may result in perforation and an increased risk of mortality. This study aimed to assess the diagnostic value of ischemia-modifed albumin, nicotinamide adenine dinucleotide phosphate oxidase 1, 2, and 4 levels in the diagnosis of non-complicated and complicated appendicitis. The study included 60 pediatric patients who presented to our clinic with a complaint of abdominal pain and underwent surgery with a diagnosis of appendicitis between November 2020 and December 2021 and also included 30 controls. Cases were divided into three groups: (i) non-complicated appendicitis (n = 30), (ii) complicated appendicitis (n = 30), and (iii) control (n = 30). The nicotinamide adenine dinucleotide phosphate oxidase 1 and 4 and ischemia-modifed albumin levels were higher in non-complicated and complicated appendicitis compared to the control (p < 0.001). In addition, considering the odds ratio values, the most efective biomarkers in the diagnosis were nicotinamide adenine dinucleotide phosphate oxidase 1 and 2, and procalcitonin, while the most efective biomarkers in the prognosis were nicotinamide adenine dinucleotide phosphate oxidase 1 and 2, and neotrophil/lymphocyte ratios. The data suggested that since the most successful biomarker nicotinamide adenine dinucleotide phosphate oxidase 1, with a value of 0.98- area under the curve, is the most successful biomarker in both diagnosis and prognosis of the disease, it can be used as an important biomarker in childhood appendicitis.