Turkiye Klinikleri Journal of Ophthalmology

.: ORIGINAL RESEARCH
Assessment of Patients Whose Pars Plana Vitrectomy Operations Were Postponed in the Operating Room: Retrospective Study
Pars Plana Vitrektomi Cerrahisi Ameliyathanede Ertelenen Hastaların Değerlendirmesi: Retrospektif Çalışma
Suzan DOĞRUYAa, Özcan Rasim KAYIKÇIOĞLUb , İsmail DİRİc , Muhammed ALTINIŞIKb , Ömer Can KAYIKÇIOĞLUd
aDepartment of Ophthalmology, Uşak University Training and Research Hospital, Uşak, Türkiye
bDepartment of Ophthalmology, Manisa Celal Bayar University Faculty of Medicine, Manisa, Türkiye
cClinic of Ophthalmology, Tunceli State Hospital, Tunceli, Türkiye
dDepartment of Ophthalmology, Balıkesir University Faculty of Medicine, Balıkesir, Türkiye
Turkiye Klinikleri J Ophthalmol. 2023;32(3):169-75
doi: 10.5336/ophthal.2023-96073
Article Language: EN
Full Text
ABSTRACT
 Objective: To determine the reasons related to the cancellation of the surgeries of the patients who were taken to the operating table for pars plana vitrectomy and the precautions needed to be taken to prevent them. Material and Methods: Twenty-five patients who were planned to be operated on for different retinal diseases between January 2018 and June 2019, but whose surgeries were canceled due to medical reasons, were included in this study. Demographic data of the patients and indications of surgery and causes of operation cancellation were analyzed. Results: 11 (44%) of the patients were female and 14 (56%) were male, and 15 (60.2%) of them needed to have a vitreoretinal surgery in the right eye while the other 10 (39.8%) in the left eye. Surgical indications were diabetic intravitreal hemorrhage in 8 (32%) cases, retinal detachment in 7 (28%) cases, cataract, and epiretinal membrane in 5 (20%) cases, intraocular lens dislocation in 4 (16%) eyes and 1 (4%) case with retinal detachment and prephytisis. 16 (64%) of the patients had hypertension (HT), 11 (44%) of the patients had diabetes mellitus, 7 (28%) of the patients had coronary heart disease (CHD), 2 (8%) of the patients had obesity, 2 (8%) of the patients had a chronic renal failure and 1 (4%) of the patients had epilepsy. The most common medical reason for cancellation of the surgery was HT and CHD (64%). Conclusion: Careful assessment of the reasons for cancellation will lessen time loss and financial losses for both the patient and the healthcare system.

Keywords: Pars plana vitrectomy; systemic disease; operating room
ÖZET
 Amaç: Pars plana vitrektomi (PPV) için ameliyathaneye alınan ancak ameliyatı ertelenen hastaların ameliyatlarının ertelenme sebepleri ve bunlara yönelik alınabilecek önlemleri tespit etmek. Gereç ve Yöntemler: Ocak 2018-Haziran 2019 tarihleri arasında farklı retina hastalıkları nedeniyle ameliyat edilmesi planlanan ancak tıbbi nedenlerle ameliyatları iptal edilen 25 hasta bu çalışmaya dahil edildi. Hastaların demografik bilgileri ve ameliyat olma endikasyonları ve ameliyatlarının ertelenme sebepleri analiz edildi. Bulgular: Hasta grubunda 11'i (%44) kadın ve 14'ü (%56) erkek ve 15'inin (%60,2) sağ gözünde, 10'unun (%39,8) sol gözünde vitreoretinal cerrahi ihtiyacı vardı. Ameliyat endikasyonu 8 (%32) hastada diyabetik intravitreal hemoroji, 7 (%28) hastada retina dekolmanı, 5 (%20) hastada katarakt ve epiretinal membran, 4 (%16) hastada göz içi lens dislokasyonu ve 1 (%4) hastada retina dekolmanlı prefitizik göz idi. Öz geçmişlerinde 16 (%64) hastada hipertansiyon (HT), 11 (%44) hastada diabetes mellitus, 7 (%28) hastada koroner kalp hastalığı (KKH), 2 (%8) hastada obezite, 2 (%8) hastada kronik böbrek yetersizliği ve 1 (%4) hastada epilepsi vardı. En çok karşılaşılan ameliyat erteleme sebebi HT ve KKH (%64) idi. Sonuç: Ameliyat erteleme sebeplerini dikkatli şekilde değerlendirmek ve daha fazla önlem almak hem hasta hem de sağlık sisteminin zaman ve diğer kayıplarını azaltacaktır.

Anahtar Kelimeler: Pars plana vitrektomi; sistemik hastalık; ameliyathane
REFERENCES:
  1. Znaor L, Medic A, Binder S, Vucinovic A, Marin Lovric J, Puljak L. Pars plana vitrectomy versus scleral buckling for repairing simple rhegmatogenous retinal detachments. Cochrane Database Syst Rev. 2019;3(3):CD009562. [Crossref]  [PubMed]  [PMC] 
  2. Ghoraba HH, Leila M, Zaky AG, Wasfy T, Maamoun Abdelfattah H, Elgemai EM, et al. Results of pars plana vitrectomy for different types of macular holes. Clin Ophthalmol. 2021;15:551-7. [Crossref]  [PubMed]  [PMC] 
  3. Kumar V, Kumawat D, Bhari A, Chandra P. Twenty-five-gauge pars plana vitrectomy in complex retinal detachments associated with giant retinal tear. Retina. 2018;38(4):670-7. [Crossref]  [PubMed] 
  4. Mahmoudzadeh R, Israilevich R, Salabati M, Hsu J, Garg SJ, Regillo CD, et al. Pars plana vitrectomy for idiopathic epiretinal membrane: OCT biomarkers of visual outcomes in 322 eyes. Ophthalmol Retina. 2022;6(4):308-17. [Crossref]  [PubMed] 
  5. Jackson TL, Donachie PH, Sparrow JM, Johnston RL. United Kingdom National Ophthalmology Database Study of Vitreoretinal Surgery: report 1; case mix, complications, and cataract. Eye (Lond). 2013;27(5):644-51. [Crossref]  [PubMed]  [PMC] 
  6. Smilowitz NR, Berger JS. Perioperative cardiovascular risk assessment and management for noncardiac surgery: a review. JAMA. 2020;324(3):279-90. [Crossref]  [PubMed] 
  7. Bierle DM, Raslau D, Regan DW, Sundsted KK, Mauck KF. Preoperative evaluation before noncardiac surgery. Mayo Clin Proc. 2020;95(4):807-22. [Crossref]  [PubMed] 
  8. Alabi RO, Turnbull ZA, Coombs PG, Wu Y, Orlin A, Chan RP, et al. Assessing the value of preoperative medical clearance in patients with primary rhegmatogenous retinal detachment. Clin Ophthalmol. 2019;13:1711-8. [Crossref]  [PubMed]  [PMC] 
  9. Yau GL, Silva PS, Arrigg PG, Sun JK. Postoperative complications of pars plana vitrectomy for diabetic retinal disease. Semin Ophthalmol. 2018;33(1):126-33. [Crossref]  [PubMed] 
  10. Haseeb U, Aziz-Ur-Rehman, Haseeb M. Visual outcomes of pars plana vitrectomy alone or with intravitreal bevacizumab in patients of diabetic vitreous haemorrhage. J Coll Physicians Surg Pak. 2019;29(8):728-31. [Crossref]  [PubMed] 
  11. Brown GC, Brown MM, Chaudhry I, Stein JD. Opportunities to reduce potential bias in ophthalmic cost-utility analysis. JAMA Ophthalmol. 2021;139(4):389-97. [Crossref]  [PubMed]  [PMC] 
  12. Brown MM, Brown GC, Lieske HB, Lieske PA. Preference-based comparative effectiveness and cost-effectiveness: a review and relevance of value-based medicine for vitreoretinal interventions. Curr Opin Ophthalmol. 2012;23(3):163-74. [Crossref]  [PubMed] 
  13. Chang JS, Smiddy WE. Cost evaluation of surgical and pharmaceutical options in treatment for vitreomacular adhesions and macular holes. Ophthalmology. 2014;121(9):1720-6. [Crossref]  [PubMed]  [PMC] 
  14. Waseem T, Reinhart C, Wagner AL, Kapoor KG. Updated cost-effectiveness of intravitreal ocriplasmin for vitreomacular adhesion and macular hole. Ophthalmic Surg Lasers Imaging Retina. 2018;49(12):e240-e8. [Crossref]  [PubMed] 
  15. Elhusseiny AM, Yannuzzi NA, Smiddy WE. Cost analysis of pneumatic retinopexy versus pars plana vitrectomy for rhegmatogenous retinal detachment. Ophthalmol Retina. 2019;3(11):956-61. [Crossref]  [PubMed] 
  16. Belin PJ, Yannuzzi NA, Wagley S, Smiddy WE, Ryan EH. Cost analysis of scleral buckle, pars plana vitrectomy, and pars plana vitrectomy with scleral buckle for retinal detachment repair. Retina. 2022;42(1):33-7. [Crossref]  [PubMed] 
  17. Nicod E, Jackson TL, Grimaccia F, Angelis A, Costen M, Haynes R, et al. Direct cost of pars plana vitrectomy for the treatment of macular hole, epiretinal membrane and vitreomacular traction: a bottom-up approach. Eur J Health Econ. 2016;17(8):991-9. [Crossref]  [PubMed]  [PMC] 
  18. Yannuzzi NA, Chang JS, Brown GC, Smiddy WE. Cost-utility of evaluation for posterior vitreous detachment and prophylaxis of retinal detachment. Ophthalmology. 2018;125(1):43-50. [Crossref]  [PubMed] 
  19. Simanjuntak GW, Djatikusumo A, Adisasmita A, Nadjib M, Mailangkay H, Hussain N. Cost analysis of vitrectomy under local versus general anesthesia in a developing country. Clin Ophthalmol. 2018;12:1987-91. [Crossref]  [PubMed]  [PMC] 
  20. Atik A, Barton K, Azuara-Blanco A, Kerr NM. Health economic evaluation in ophthalmology. Br J Ophthalmol. 2021;105(5):602-7. [Crossref]  [PubMed] 
  21. Framme C, Franz D, Mrosek S, Helbig H, Sachs HG. Kostenkalkulation für die Behandlung von offenen Augenverletzungen in der DRG C01Z an einer Universitäts-Augenklinik [Cost calculations for treating penetrating eye injuries within the DRG C01Z at a university eye hospital]. Ophthalmologe. 2008;105(10):936-42. German. [Crossref]  [PubMed] 
  22. Trujillo-Sanchez GP, Gonzalez-De La Rosa A, Navarro-Partida J, Haro-Morlett L, Altamirano-Vallejo JC, Santos A. Feasibility and safety of vitrectomy under topical anesthesia in an office-based setting. Indian J Ophthalmol. 2018;66(8):1136-40. [Crossref]  [PubMed]  [PMC] 
  23. Bricout M, Feldman, Rochepeau C, Hafidi M, Labeille E, Cornut PL. Chirurgie vitréo rétinienne en ambulatoire sans examen du lendemain: faisabilité et acceptabilité [Outpatient vitreoretinal surgery without next-day examination: Feasibility and acceptability]. J Fr Ophtalmol. 2018;41(9):852-6. [Crossref]  [PubMed] 
  24. Shalwala A, Hwang RY, Tabing A, Sternberg P Jr, Kim SJ. The value of preoperative medical testing for vitreoretinal surgery. Retina. 2015;35(2):319-25. [Crossref]  [PubMed] 
  25. Cornut PL, Soldermann Y, Robin C, Barranco R, Kerhoas A, Burillon C. Optimisation de l'impact financier du passage à la vitrectomie transconjonctivale et à la phakoémulsification par mini-incision [Optimizing the financial impact of transitioning to transconjunctival vitrectomy and microincisional phacoemulsification]. J Fr Ophtalmol. 2013;36(10):843-51. French. [Crossref]  [PubMed] 
  26. Cheong Y, Kim N, Kim M, Son HJ, Huh J, Kang SS, Lim SY, Hwang B. Postoperative pulmonary edema following vitrectomy in patients with ischemic heart disease and diastolic dysfunction in the post-anesthetic care unit: Two case reports. Medicine (Baltimore). 2020;99(38):e22296. [Crossref]  [PubMed]  [PMC] 
  27. Mahalingam P, Topiwalla TT, Ganesan G. Vitreous rebleed following sutureless vitrectomy: Incidence and risk factors. Indian J Ophthalmol. 2018;66(4):558-61. [Crossref]  [PubMed]  [PMC] 
  28. Cunningham AJ. Improving operating room productivity and efficiency-are there any simple strategies? Rom J Anaesth Intensive Care. 2017;24(2):87-8. [Crossref]  [PubMed]  [PMC] 
  29. Childers CP, Maggard-Gibbons M. Understanding costs of care in the operating room. JAMA Surg. 2018;153(4):e176233. [Crossref]  [PubMed]  [PMC] 
  30. Angermann R, Huber AL, Hofer M, Nowosielski Y, Egger S, Kralinger MT, et al. Efficiency benchmarks in the surgical management of primary rhegmatogenous retinal detachment: a monocentric register cohort study of operating room time metrics and influential factors. BMJ Open. 2021;11(12):e052513. [Crossref]  [PubMed]  [PMC] 
  31. Mimouni M, Abualhasan H, Mtanes K, Mazzawi F, Barak Y. Patients' experience of anxiety and pain during retrobulbar injections prior to vitrectomy. J Ophthalmol. 2019;2019:8098765. [Crossref]  [PubMed]  [PMC] 

.: Up To Date

Login

 Forgot your password?

 New Registration  

Contact

Ortadoğu Reklam Tanıtım Yayıncılık Turizm Eğitim İnşaat Sanayi ve Ticaret A.Ş.

.: Address

Turkocagi Caddesi No:30 06520 Balgat / ANKARA
Phone: +90 312 286 56 56
Fax: +90 312 220 04 70
E-mail: info@turkiyeklinikleri.com

.: Manuscript Editing Department

Phone: +90 312 286 56 56/ 2
E-mail: yaziisleri@turkiyeklinikleri.com

.: English Language Redaction

Phone: +90 312 286 56 56/ 145
E-mail: tkyayindestek@turkiyeklinikleri.com

.: Marketing Sales-Project Department

Phone: +90 312 286 56 56/ 142
E-mail: reklam@turkiyeklinikleri.com

.: Subscription and Public Relations Department

Phone: +90 312 286 56 56/ 118
E-mail: abone@turkiyeklinikleri.com

.: Customer Services

Phone: +90 312 286 56 56/ 118
E-mail: satisdestek@turkiyeklinikleri.com

1. TERMS OF USE

1.1. To use the web pages with http://www.turkiyeklinikleri.com domain name or the websites reached through the sub domain names attached to the domain name (They will be collectively referred as "SITE"), please read the conditions below. If you do not accept these terms, please cease to use the "SITE." "SITE" owner reserves the right to change the information on the website, forms, contents, the "SITE," "SITE" terms of use anytime they want.

1.2. The owner of the "SITE" is Ortadoğu Advertisement Presentation Publishing Tourism Education Architecture Industry and Trade Inc. (From now on it is going to be referred as "Turkiye Klinikleri", shortly) and it resides at Turkocagi cad. No:30, 06520 Balgat Ankara. The services in the "SITE" are provided by "Turkiye Klinikleri."

1.3. Anyone accessing the "SITE" with or without a fee whether they are a natural person or a legal identity is considered to agree these terms of use. In this contract hereby, "Turkiye Klinikleri" may change the stated terms anytime. These changes will be published in the "SITE" periodically and they will be valid when they are published. Any natural person or legal identity benefiting from and reaching to the "SITE" are considered to be agreed to any change on hereby contract terms done by "Turkiye Klinikleri."

1.4. The "Terms of Use" hereby is published in the website with the last change on March 30th 2014 and the "SITE" is activated by enabling the access to everyone. The "Terms of Use" hereby is also a part of the any "USER Contract" was and/or will be done with the users using "Turkiye Klinikleri" services with or without a fee an inseparable.

2. DEFINITIONS

2.1. "SITE": A website offering different kind of services and context with a certain frame determined by "Turkiye Klinikleri" and it is accessible on-line on http://www.turkiyeklinikleri.com domain name and/or subdomains connected to the domain name.

2.2. USER: A natural person or a legal identity accessing to the "SITE" through online settings.

2.3. LINK: A link enabling to access to another website through the "SITE", the files, the context or through another website to the "SITE", the files and the context.

2.4. CONTEXT: Any visual, literary and auditory images published in the "Turkiye Klinikleri", "SITE" and/or any website or any accessible information, file, picture, number/figures, price, etc.

2.5. "USER CONTRACT": An electronically signed contract between a natural or a legal identity benefiting from special services "Turkiye Klinikleri" will provide and "Turkiye Klinikleri".

3. SCOPE OF THE SERVICES

3.1. "Turkiye Klinikleri" is completely free to determine the scope and quality of the services via the "SITE".

3.2. To benefit the services of "Turkiye Klinikleri" "SITE", the "USER" must deliver the features that will be specified by "Turkiye Klinikleri". "Turkiye Klinikleri" may change this necessity any time single-sided.

3.3. Not for a limited number, the services "Turkiye Klinikleri" will provide through the "SITE" for a certain price or for free are;

- Providing scientific articles, books and informative publications for health industry.

- Providing structural, statistical and editorial support to article preparation stage for scientific journals.

4. GENERAL PROVISIONS

4.1. "Turkiye Klinikleri" is completely free to determine which of the services and contents provided in the "SITE" will be charged.

4.2. People benefiting from the services provided by "Turkiye Klinikleri" and using the website can use the "SITE" only according to the law and only for personal reasons. Users have the criminal and civil liability for every process and action they take in the "SITE". Every USER agrees, declares and undertakes that they will not proceed by any function or action infringement of rights of "Turkiye Klinikleri"s and/or other third parties', they are the exclusive right holder on usage, processing, storage, made public and revealing any written, visual or auditory information reported to Turkiye Klinikleri" and/or "SITE" to the third parties. "USER" agrees and undertakes that s/he will not duplicate, copy, distribute, process, the pictures, text, visual and auditory images, video clips, files, databases, catalogs and lists within the "SITE", s/he will not be using these actions or with other ways to compete with "Turkiye Klinikleri", directly or indirectly.

4.3. The services provided and the context published within the "SITE" by third parties is not under the responsibility of "Turkiye Klinikleri", institutions collaborated with "Turkiye Klinikleri", "Turkiye Klinikleri" employee and directors, "Turkiye Klinikleri" authorized salespeople. Commitment to accuracy and legality of the published information, context, visual and auditory images provided by any third party are under the full responsibility of the third party. "Turkiye Klinikleri" does not promise and guarantee the safety, accuracy and legality of the services and context provided by a third party.

4.4. "USER"s cannot act against "Turkiye Klinikleri", other "USER"s and third parties by using the "SITE". "Turkiye Klinikleri" has no direct and/or indirect responsibility for any damage a third party suffered or will suffer regarding "USER"s actions on the "SITE" against the rules of the hereby "Terms of Use" and the law.

4.5. "USER"s accept and undertake that the information and context they provided to the "SITE" are accurate and legal. "Turkiye Klinikleri" is not liable and responsible for promising and guaranteeing the verification of the information and context transmitted to "Turkiye Klinikleri" by the "USER"s, or uploaded, changed and provided through the "SITE" by them and whether these information are safe, accurate and legal.

4.6. "USER"s agree and undertake that they will not perform any action leading to unfair competition, weakening the personal and commercial credit of "Turkiye Klinikleri" and a third party,  encroaching and attacking on personal rights within the "SITE" in accordance with the Turkish Commercial Code Law.

4.7. "Turkiye Klinikleri" reserves the right to change the services and the context within the "SITE"  anytime. "Turkiye Klinikleri" may use this right without any notification and timelessly. "USER"s have to make the changes and/or corrections "Turkiye Klinikleri" required immediately. Any changes and/or corrections that are required by "Turkiye Klinikleri", may be made by "Turkiye Klinikleri" when needed. Any harm, criminal and civil liability resulted or will result from changes and/or corrections required by "Turkiye Klinikleri" and were not made on time by the "USER"s belongs completely to the users.

4.8. "Turkiye Klinikleri" may give links through the "SITE" to other websites and/or "CONTEXT"s and/or folders that are outside of their control and owned and run by third parties. These links are provided for ease of reference only and do not hold qualification for support the respective web SITE or the admin or declaration or guarantee for the information inside. "Turkiye Klinikleri" does not hold any responsibility over the web-sites connected through the links on the "SITE", folders and context, the services or products on the websites provided through these links or their context.

4.9. "Turkiye Klinikleri" may use the information provided to them by the "USERS" through the "SITE" in line with the terms of the "PRIVACY POLICY" and "USER CONTRACT". It may process the information or classify and save them on a database. "Turkiye Klinikleri" may also use the USER's or visitor's identity, address, e-mail address, phone number, IP number, which sections of the "SITE" they visited, domain type, browser type, date and time information to provide statistical evaluation and customized services.

5. PROPRIETARY RIGHTS

5.1. The information accessed through this "SITE" or provided by the users legally and all the elements (including but not limited to design, text, image, html code and other codes) of the "SITE" (all of them will be called as studies tied to "Turkiye Klinikleri"s copyrights) belongs to "Turkiye Klinikleri". Users do not have the right to resell, process, share, distribute, display or give someone permission to access or to use the "Turkiye Klinikleri" services, "Turkiye Klinikleri" information and the products under copyright protection by "Turkiye Klinikleri". Within hereby "Terms of Use" unless explicitly permitted by "Turkiye Klinikleri" nobody can reproduce, process, distribute or produce or prepare any study from those under "Turkiye Klinikleri" copyright protection.

5.2. Within hereby "Terms of Use", "Turkiye Klinikleri" reserves the rights for "Turkiye Klinikleri" services, "Turkiye Klinikleri" information, the products associated with "Turkiye Klinikleri" copyrights, "Turkiye Klinikleri" trademarks, "Turkiye Klinikleri" trade looks or its all rights for other entity and information it has through this website unless it is explicitly authorized by "Turkiye Klinikleri".

6. CHANGES IN THE TERMS OF USE

"Turkiye Klinikleri" in its sole discretion may change the hereby "Terms of Use" anytime announcing within the "SITE". The changed terms of the hereby "Terms of Use" will become valid when they are announced. Hereby "Terms of Use" cannot be changed by unilateral declarations of users.

7. FORCE MAJEURE

"Turkiye Klinikleri" is not responsible for executing late or never of this hereby "Terms of Use", privacy policy and "USER Contract" in any situation legally taken into account as force majeure. Being late or failure of performance or non-defaulting of this and similar cases like this will not be the case from the viewpoint of "Turkiye Klinikleri", and "Turkiye Klinikleri" will not have any damage liability for these situations. "Force majeure" term will be regarded as outside of the concerned party's reasonable control and any situation that "Turkiye Klinikleri" cannot prevent even though it shows due diligence. Also, force majeure situations include but not limited to natural disasters, rebellion, war, strike, communication problems, infrastructure and internet failure, power cut and bad weather conditions.

8. LAW AND AUTHORISATION TO FOLLOW

Turkish Law will be applied in practicing, interpreting the hereby "Terms of Use" and managing the emerging legal relationships within this "Terms of Use" in case of finding element of foreignness, except for the rules of Turkish conflict of laws. Ankara Courts and Enforcement Offices are entitled in any controversy happened or may happen due to hereby contract.

9. CLOSING AND AGREEMENT

Hereby "Terms of Use" come into force when announced in the "SITE" by "Turkiye Klinikleri". The users are regarded to agree to hereby contract terms by using the "SITE". "Turkiye Klinikleri" may change the contract terms and the changes will be come into force by specifying the version number and the date of change on time it is published in the "SITE".

 

30.03.2014

Privacy Policy

We recommend you to read the terms of use below before you visit our website. In case you agree these terms, following our rules will be to your favor. Please read our Terms of Use thoroughly.

www.turkiyeklinikleri.com website belongs to Ortadoğu Advertisement Presentation Publishing Tourism Education Architecture Industry and Trade Inc. and is designed in order to inform physicians in the field of health

www.turkiyeklinikleri.com cannot reach to user’s identity, address, service providers or other information. The users may send this information to the website through forms if they would like to. However, www.turkiyeklinikleri.com may collect your hardware and software information. The information consists of your IP address, browser type, operating system, domain name, access time, and related websites. www.turkiyeklinikleri.com cannot sell the provided user information (your name, e-mail address, home and work address, phone number) to the third parties, publish it publicly, or keep it in the website. Gathered information has a directing feature to be a source for the website’s visitor profile, reporting and promotion of the services.

www.turkiyeklinikleri.com uses the taken information:

-To enhance, improve and maintain the quality of the website

-To generate visitor’s profile and statistical data

-To determine the tendency of the visitors on using our website

-To send print publications/correspondences

-To send press releases or notifications through e-mail

-To generate a list for an event or competition

By using www.turkiyeklinikleri.com you are considered to agree that;

-Ortadoğu Advertisement Presentation Publishing Tourism Education Architecture Industry and Trade Inc. cannot be hold responsible for any user’s illegal and immoral behavior,

-Terms of use may change from time to time,

-It is not responsible for other websites’ contents it cannot control or the harms they may cause although it uses the connection they provided.

Ortadoğu Advertisement Presentation Publishing Tourism Education Architecture Industry and Trade Inc. may block the website to users in the following events:

-Information with wrong, incomplete, deceiving or immoral expressions is recorded to the website,

-Proclamation, advertisement, announcement, libelous expressions are used against natural person or legal identity,

-During various attacks to the website,

-Disruption of the website because of a virus.

Written, visual and audible materials of the website, including the code and the software are under protection by legal legislation.

Without the written consent of Ortadoğu Advertisement Presentation Publishing Tourism Education Architecture Industry and Trade Inc. the information on the website cannot be downloaded, changed, reproduced, copied, republished, posted or distributed.

All rights of the software and the design of the website belong to Ortadoğu Advertisement Presentation Publishing Tourism Education Architecture Industry and Trade Inc.

Ortadoğu Advertisement Presentation Publishing Tourism Education Architecture Industry and Trade Inc. will be pleased to hear your comments about our terms of use. Please share the subjects you think may enrich our website or if there is any problem regarding our website.

info@turkiyeklinikleri.com