Eken, Hüseyin; Isik, Arda; Özçiçek, Adalet; Yılmaz, İsmayil; Sekban, Nurdan; Çimen, Orhan; Peker, Kemal; Biçer, Şenol; Demiryılmaz, İsmail

Objective: While the patients who will not to be fed orally for less than a month are fed enterally with nasoenteral feeding tube, for the patients who are not able to take food orally more than a month gastrostomy application is recommended. Different gastrostomy techniques are used for this purpose. We aimed to discuss indications of percutaneous endoscopic gastrostomy (PEG) in the patients who underwent PEG operation, their early or late complications and the management of these complications. Material and Methods: This study was performed simultaneously in two different hospitals between 01.06.2010- 05.01.2014. The files of 66 patients whose oral feeding is not possible and PEG administered for enteral nutrition were reviewed retrospectively. Results: The most common indications for PEG placement in 47 patients (71.2 %) was malnutrition due to cerebrovascular diseases. A major complication related to procedure was not observed. The most common minor complications were feeding intolerance in 5 (7.6 %) patients and occlusion of tube in 5 (7.6 %) patients. Serious wound infection accompanied by necrosis that requires surgical debridement developed in 3 (4.6 %) patients. Conclusion: PEG offers great advantages because of ease of application especially in the critical patients who are not able to be fed orally due to a problem at proximal part while their gastrointestinal system are intact, and with its capability of being applied even at bedside, not requiring serious anesthesia and team. It is gaining widespread use with the improvement of intensive care units in terms of number of beds and facilities. Major and minor complications encountered require a surgical overview because application is an ostomy procedure. Therefore, we consider that in the PEG applications performed by the physicians other than surgeons, it would be appropriate to follow up these patients together with surgery clinics.

Polat, Muhammet Fevzi; Yılmaz, İsmayil; Akçay, Müfide Nuran; Biçer, Şenol; Demiryılmaz, İsmail

Aim: To determine the relationship between the serum levels of paraoxonase and colorectal cancer by measuring the levels of serum paraoxonase in patients with colorectal cancer and in control group. Material and method: The levels of triglyceride, high density lipoproteins, low density lipoproteins, very low density lipoproteins and paraoxonase were measured in blood samples that were obtained from 40 patients with colorectal cancer and from other 40 patients that who were healthy and had no complaints. The statistical difference was evaluated between these results. Results: The mean age of the patients with colorectal cancer was 54±12.45 and the mean age of the control group was 49.30±15.39. There was no statistically significant difference between the levels of triglyceride and very low density lipoproteins obtained from the patient and control group (p>0,5). The correlation analysis of the values in the patient group revealed significant (p<0.05) correlation of paraoxonase with triglyceride and low density lipoprotein;very significant correlation (p<0.01) between very low density lipoprotein and triglyceride. There was no correlation between the paraoxonase levels and triglyceride, high density lipoprotein, low density lipoprotein and very low density lipoprotein levels in control group (p>0.5). Conclusion: It is noteworthy that the levels of paraoxonase in patients with colorectal cancer are statistically very low as compared with the control group. So, the individuals with low paraoxonase levels are in the high risk group for developing colorectal cancer and must be followed for colorectal cancer.

Demirtaş, Levent; Akbas, Emin Murat; Özçiçek, Fatih; Kuyrukluyildiz, Ufuk; Özçiçek, Adalet; Timuroglu, Aysu; Turkmen, Kultigin; Kucuksu, Zafer

5-fluorourasil; kolon, meme ve üst gastrointestinal sistem tümörlerinde sık kullanılan bir kemoterapötik ajan olup, anjina, miyokard infarktüsü, supraventriküler ve ventriküler aritmiler, akut pulmoner ödem, kardiyojenik şok, kardiyak arrest ve ani ölüm gibi ciddi, mortal seyredebilen yan etkileri vardır. Hem bolus hem de intravenöz infüzyon şeklinde verilebilir. Kardiyotoksisite fluorourasilin ender görülen yan etkilerindendir. İskemik kalp hastalığı olanlarda 5-fluorourasil tedavisi sırasında dikkatli kardiyak monitorizasyon gerekli olup biz burada 5-fluorourasilin intravenöz infüzyonuna bağlı gelişen bir akut koroner sendrom olgusuna yer verdik