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Affiliation(s)
- Bülent Cavit Yüksel
- University of Health Sciences, Ankara City Hospital, Department of Surgery, Cankaya, Ankara/Turkey
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Canlıkarakaya F, Cavit Yüksel B, Er S, Keçelioğlu Y, Neselioglu S. Research of Importance of Thiol, CRP and Lactate in Diagnosing Mesenteric Ischemia At An Early Stage: Animal Model. ULUS TRAVMA ACIL CER 2023; 29:949-955. [PMID: 37681723 PMCID: PMC10560810 DOI: 10.14744/tjtes.2023.45234] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2023] [Revised: 05/14/2023] [Accepted: 05/24/2023] [Indexed: 09/09/2023]
Abstract
INTRODUCTION AND PURPOSE Acute mesenteric ischemia is especially seen in the elderly population. It has an increasing incidence in today's world where the average life expectancy is increasing. Early diagnosis is the most important factor reducing morbidity and mortality, and there is still no marker with high sensitivity and specificity for early diagnosis.In this study, we aimed to find a more sensitive and specific serum marker in the early diagnosis of mesenteric ischemia by comparing thiol with the currently used markers C-reactive protein and lactate. MATERIALS AND METHODS In our study, 32 Wistar Albino male rats, 10-12 weeks old, weighing 250-300 g, were used. 32 rats were divided into 4 groups, one of which was the control group. The superior mesenteric artery of the other 3 groups was ligated. Blood samples were taken after 2 hours from the first group, 4 hours from the second group, and 6 hours from the third group. Then the rats were sacrificed. Mesenteric ischemia and its level were observed in sacrificed subjects. The samples were separated under appropriate conditions and analyzed biochemically. RESULTS As the ischemia time increased, CRP increased and this increase was found to be statistically insignificant (p>0.05). The changes in lactate were found to be statistically significant (p<0.05). The difference between the changes of total and native thiol values was found to be statistically significant (p<0.05). CONCLUSION Although CRP is a non-specific parameter in the early diagnosis of acute mesenteric ischemia, lactate maintains its importance as seen in our study. Differences in total thiol and native thiol changes were statistically significant. The fact that this significant difference is observed at the 4th hour values, reveals the importance of these parameters in early diagnosis. Thanks to the economic and fast results of thiol parameters, it is thought that new studies to be added to the literature can lead to the diagnosis of mesenteric ischemia.
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Affiliation(s)
| | - Bülent Cavit Yüksel
- Department of General Surgery, University of Healt Sciences Ankara City Hospital, Ankara -Türkiye
| | - Sadettin Er
- Department of General Surgery, University of Healt Sciences Ankara City Hospital, Ankara -Türkiye
| | - Yasir Keçelioğlu
- Department of General Surgery, University of Healt Sciences Ankara City Hospital, Ankara -Türkiye
| | - Salim Neselioglu
- Department of Medical Biochemistry, Ankara Yildirim Beyazit University, Faculty of Medicine, Ankara-Türkiye
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Çetinkaya E, Bayazıtlı ŞM, Göktaş A, Akın T, Akgül Ö, Er S, Hamamcı EO, Berkem H, Yüksel BC, Tez M. A new, simple marker for predicting complicated appendicitis in patients with normal white blood cell count indicator; LUC. ULUS TRAVMA ACIL CER 2023; 29:872-876. [PMID: 37563899 PMCID: PMC10560799 DOI: 10.14744/tjtes.2023.60196] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/04/2023] [Revised: 02/06/2023] [Accepted: 04/10/2023] [Indexed: 08/12/2023]
Abstract
BACKGROUND The aim of this study was to investigate the ability of a new marker that could be easily obtained to differentiate between complicated and uncomplicated appendicitis in a patients with a white blood cell (WBC) count within the normal range. METHODS The patients who underwent surgery with histopathologically proven acute appendicitis (AA) between January 2021 and October 2022 were evaluated retrospectively. Patients were classified into two groups as uncomplicated and complicated appendicitis, based on the surgical and histopathological findings. Groups were compared in terms of laboratory parameters at the time of hospital admission. RESULTS During the study period, 2589 patients underwent an appendectomy, among these 612 patients who had a WBC count within the normal range at the time of admission were analyzed. Uncomplicated appendicitis was detected in 79.6% of the patients and complicated appendicitis in 20.4%. Neutrophil%, neutrophil-to-lymphocyte ratio, C-reactive protein, and total bilirubin levels were significantly higher, whereas lymphocyte%, lymphocyte count, lymphocyte-to-monocyte ratio, sodium levels, and large unstained cells (LUC)% were significantly lower in patients with complicated appendicitis. Multiple logistic regression analysis revealed that lower LUC% (Odds Ratio [OR]: 0.45; 95% Confidence Intervals [CI]: 1.08-2.09; P=0.01) and higher total bilirubin levels (OR: 1.50; 95% CI: 1.08-2.09; P=0.01) were independent risk factors for complicated appendicitis. CONCLUSION In patients with a diagnosis of AA with a normal WBC value, LUC% obtained from the complete blood count can be used as a new parameter predicting the diagnosis of complicated appendicitis.
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Affiliation(s)
- Erdinç Çetinkaya
- Department of General Surgery, Ankara Bilkent City Hospital, University of Health Sciences, Ankara-Türkiye
| | - Şükrü Melih Bayazıtlı
- Department of General Surgery, Ankara Bilkent City Hospital, University of Health Sciences, Ankara-Türkiye
| | - Abidin Göktaş
- Department of General Surgery, Ankara Bilkent City Hospital, University of Health Sciences, Ankara-Türkiye
| | - Tezcan Akın
- Department of General Surgery, Ankara Bilkent City Hospital, University of Health Sciences, Ankara-Türkiye
| | - Özgür Akgül
- Department of General Surgery, Ankara Bilkent City Hospital, University of Health Sciences, Ankara-Türkiye
| | - Sadettin Er
- Department of General Surgery, Ankara Bilkent City Hospital, University of Health Sciences, Ankara-Türkiye
| | - Enver Okan Hamamcı
- Department of General Surgery, Ankara Bilkent City Hospital, University of Health Sciences, Ankara-Türkiye
| | - Hüseyin Berkem
- Department of General Surgery, Ankara Bilkent City Hospital, University of Health Sciences, Ankara-Türkiye
| | - Bülent Cavit Yüksel
- Department of General Surgery, Ankara Bilkent City Hospital, University of Health Sciences, Ankara-Türkiye
| | - Mesut Tez
- Department of General Surgery, Ankara Bilkent City Hospital, University of Health Sciences, Ankara-Türkiye
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Yüksel BC, Tez M. Yes, We Have Guidelines, but We Are Emotional Artists. Dis Colon Rectum 2023; 66:e316. [PMID: 36989385 DOI: 10.1097/dcr.0000000000002857] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 03/31/2023]
Affiliation(s)
- Bülent Cavit Yüksel
- Department of Colon and Rectum, General Surgery, University of Health Science, Ankara City Hospital
| | - Mesut Tez
- University of Health Science, Ankara City Hospital, General Surgery, Surgical Oncology
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Yüksel BC. New indication area in intersphincteric resection: transanal total mesorectal excision combined with intersphincteric resection. Gastroenterol Rep (Oxf) 2023; 11:goad007. [PMID: 36911143 PMCID: PMC9995089 DOI: 10.1093/gastro/goad007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/29/2022] [Revised: 01/11/2023] [Accepted: 02/08/2023] [Indexed: 03/10/2023] Open
Affiliation(s)
- Bülent Cavit Yüksel
- Department of Colon & Rectum, General Surgery, Ankara Bilkent City Hospital, University of Health Science, Ankara, Turkey
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Yüksel BC. Chemoradiotherapy in Locally Advanced Rectal Cancer: Surgeon Perspective. J Clin Oncol 2022; 40:4029. [PMID: 35930762 DOI: 10.1200/jco.22.00934] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022] Open
Affiliation(s)
- Bülent Cavit Yüksel
- Bülent Cavit Yüksel, MD, University of Health Science, Ankara City Hospital, Department of Colon & Rectum Surgery, Ankara, Turkey
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Vila F, Yüksel BC. A Missed Chance for Organ Preservation after Watch and Wait. Dis Colon Rectum 2022; 65:e21. [PMID: 34636782 DOI: 10.1097/dcr.0000000000002306] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/08/2023]
Affiliation(s)
- Frenki Vila
- Turkey Albania Fier Friendship Hospital, Albania
| | - Bülent Cavit Yüksel
- University of Health Sciences of Turkey, Department of Colon&Rectum, General Surgery, Turkey
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Yüksel BC. Comment on 'Local recurrence in sigmoid cancer is a hidden problem, could CT prognostic factors be of value in their prevention? A multi-centre study of 414 patients'. Eur J Surg Oncol 2021; 47:2696. [PMID: 34393027 DOI: 10.1016/j.ejso.2021.06.019] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2021] [Accepted: 06/17/2021] [Indexed: 11/16/2022] Open
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Er S, Berkem H, Özden S, Birben B, Çetinkaya E, Tez M, Yüksel BC. Clinical course of percutaneous cholecystostomies: A cross-sectional study. World J Clin Cases 2020; 8:1033-1041. [PMID: 32258074 PMCID: PMC7103974 DOI: 10.12998/wjcc.v8.i6.1033] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/19/2019] [Revised: 03/11/2020] [Accepted: 03/19/2020] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND Although cholecystectomy is the standard treatment modality, it has been shown that perioperative mortality is approaching 19% in critical and elderly patients. Percutaneous cholecystostomy (PC) can be considered as a safer option with a significantly lower complication rate in these patients.
AIM To assess the clinical course of acute cholecystitis (AC) in patients we treated with PC.
METHODS The study included 82 patients with Grade I, II or III AC according to the Tokyo Guidelines 2018 (TG18) and treated with PC. The patients’ demographic and clinical features, laboratory parameters, and radiological findings were retrospectively obtained from their medical records.
RESULTS Eighty-two patients, 45 (54.9%) were male, and the median age was 76 (35-98) years. According to TG18, 25 patients (30.5%) had Grade I, 34 (41.5%) Grade II, and 23 (28%) Grade III AC. The American Society of Anesthesiologists (ASA) physical status score was III or more in 78 patients (95.1%). The patients, who had been treated with PC, were divided into two groups: discharged patients and those who died in hospital. The groups statistically significantly differed only concerning the ASA score (P = 0.0001) and WBCC (P = 0.025). Two months after discharge, two patients (3%) were readmitted with AC, and the intervention was repeated. Nine of the discharged patients (13.6%) underwent interval open cholecystectomy or laparoscopic cholecystectomy (8/1) within six to eight weeks after PC. The median follow-up time of these patients was 128 (12-365) wk, and their median lifetime was 36 (1-332) wk.
CONCLUSION For high clinical success in AC treatment, PC is recommended for high-risk patients with moderate-severe AC according to TG18, elderly patients, and especially those with ASA scores of ≥ III. According to our results, PC, a safe, effective and minimally invasive treatment, should be preferred in cases suffering from AC with high risk of mortality associated with cholecystectomy.
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Affiliation(s)
- Sadettin Er
- Department of Surgery, Ankara Numune Training and Research Hospital, Ankara 06100, Turkey
| | - Hüseyin Berkem
- Department of Surgery, Ankara Numune Training and Research Hospital, Ankara 06100, Turkey
| | - Sabri Özden
- Department of Surgery, Ankara Numune Training and Research Hospital, Ankara 06100, Turkey
| | - Birkan Birben
- Department of Surgery, Ankara Numune Training and Research Hospital, Ankara 06100, Turkey
| | - Erdinç Çetinkaya
- Department of Surgery, Ankara Numune Training and Research Hospital, Ankara 06100, Turkey
| | - Mesut Tez
- Department of Surgery, Ankara Numune Training and Research Hospital, Ankara 06100, Turkey
| | - Bülent Cavit Yüksel
- Department of Surgery, Ankara Numune Training and Research Hospital, Ankara 06100, Turkey
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Er S, Sevim Y, Özden S, Tikici D, Yıldız BD, Yüksel BC, Turan UF, Tez M. A novel simplified scoring system for predicting mortality in emergency colorectal surgery: prediction model development. SAO PAULO MED J 2019; 137:132-136. [PMID: 31314873 PMCID: PMC9721224 DOI: 10.1590/1516-3180.2018.0316240119] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/10/2019] [Accepted: 01/24/2019] [Indexed: 11/22/2022] Open
Abstract
BACKGROUND Despite advances in surgical approaches, emergency colorectal surgery has high mortality and morbidity. OBJECTIVE We aimed to create a simple and distinctive scoring system, for predicting mortality among patients undergoing emergency colorectal surgery. DESIGN AND SETTING Prediction model development study based on retrospective data-gathering. METHODS Patients who underwent emergency colorectal surgery between March 2014 and December 2016 at a single tertiary-level referral center were included in our study. Patient demographics, comorbidities, type of surgery, etiology and laboratory and radiological findings were collected retrospectively and analyzed. A new clinical score (named the Numune emergency colorectal resection score) was constructed from the last logistic regression model, in which one point was assigned for the presence of each predictive factor. RESULTS 138 patients underwent emergency colorectal surgery. These comprised 64 males (46.4%) and 74 females (53.6%), with a mean age of 64 years. Multivariate analysis revealed that blood urea nitrogen level > 65 mg/dl (odds ratio, OR: 8.03; 95% confidence interval, CI: 2.16-15.77), albumin level < 0.7 -mg/-dl (OR: 4.43; 95% CI: 1.96-14.39) and American Society of Anesthesiologists score ≥ 3 (OR: 3.47; 95% CI: 0.81-9.18) were associated with postoperative complications. The Numune score was graded from I to III. The risk of mortality was found to be 63.2% in the group with grade III, which accounted for 35.2% of the subjects. There were 37 postoperative deaths. CONCLUSIONS Surgeons need scoring systems, especially to predict postoperative mortality. We propose the Numune emergency colorectal resection score for emergency surgical procedures as a practical, usable and effective system for predicting postoperative morbidity.
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Affiliation(s)
- Sadettin Er
- MD. Attending Physician, Department of Surgery, Ankara Numune Eğitim ve Araştırma Hastanesi, Ankara, Turkey.
| | - Yusuf Sevim
- MD. Associate Professor, Department of Surgery, Ankara Numune Eğitim ve Araştırma Hastanesi, Ankara, Turkey.
| | - Sabri Özden
- MD. Attending Physician, Department of Surgery, Ankara Numune Eğitim ve Araştırma Hastanesi, Ankara, Turkey.
| | - Deniz Tikici
- MD. Attending Physician, Department of Surgery, Ankara Numune Eğitim ve Araştırma Hastanesi, Ankara, Turkey.
| | - Barış Doğu Yıldız
- MD. Associate Professor, Department of Surgery, Ankara Numune Eğitim ve Araştırma Hastanesi, Ankara, Turkey.
| | - Bülent Cavit Yüksel
- MD. Associate Professor, Department of Surgery, Ankara Numune Eğitim ve Araştırma Hastanesi, Ankara, Turkey.
| | - Umut Fırat Turan
- MD. Attending Physician, Department of Surgery, Ankara Numune Eğitim ve Araştırma Hastanesi, Ankara, Turkey.
| | - Mesut Tez
- MD. Associate Professor, Department of Surgery, Ankara Numune Eğitim ve Araştırma Hastanesi, Ankara, Turkey.
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Er S, Yüksel BC, Özden S, Tikici D, Yıldız BD, Tez M. Does Attenuated Mckittrick-Wheelock Syndrome Exists? Istanbul Med J 2019. [DOI: 10.4274/imj.04764] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022] Open
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Er S, Yüksel BC, Özden S, Tikici D, Yıldız BD, Tez M. Does Attenuated Mckittrick-Wheelock Syndrome Exists? Istanbul Med J 2019. [DOI: 10.4274/imj.galenos.2018.04764] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022] Open
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Er S, Çomçalı B, Soykurt A, Cavit Yüksel B, Tez M. Diagnosis of Appendicitis in Patients with a Normal White Blood Cell Count; A Cross-Sectional Study. Bull Emerg Trauma 2018; 6:128-132. [PMID: 29719843 DOI: 10.29252/beat-060207] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/31/2022] Open
Abstract
Objective To investigate the clinical, imaging and laboratory findings for diagnosis of acute appendicitis (AA) in patients with a normal white blood cell count (WBCC). Methods This retrospective cross-sectional study was conducted in Ankara Numune Training and Research Hospital, Ankara, Turkey, during a 1-year period. To determine diagnostic factors in AA in patients with normal WBCC, medical records of eligible patients were reviewed for demographic and clinical variables, as well as patient outcome. Results A total of 105 patients that had undergone appendectomy and were found to have a normal WBCC were included in the study. Of these patients, 53 (50.5%) were men and 52 (49.5%) were women. The mean age of the patients was 34.2±12.3 (min 14, max 78). The negative exploration rate was identified as 19%. In the multivariate analysis, only the diameter of appendix was statistically significant (p=0.002). ROC analysis revealed the cut off appendiceal diameter as 8 mm. Conclusion In patients suspected of AA due to ≥8 mm appendiceal diameter determined by imaging, we recommend surgical treatment even if WBCC and neutrophil count are normal.
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Affiliation(s)
- Sadettin Er
- Department of Surgery, Ankara Numune Training and Research Hospital, Department of Surgery, Ankara, Turkey
| | - Bülent Çomçalı
- Department of Surgery, Ankara Numune Training and Research Hospital, Department of Surgery, Ankara, Turkey
| | - Ahmet Soykurt
- Department of Surgery, Ankara Numune Training and Research Hospital, Department of Surgery, Ankara, Turkey
| | - Bülent Cavit Yüksel
- Department of Surgery, Ankara Numune Training and Research Hospital, Department of Surgery, Ankara, Turkey
| | - Mesut Tez
- Department of Surgery, Ankara Numune Training and Research Hospital, Department of Surgery, Ankara, Turkey
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Yüksel BC, Çetinkaya E. The transverse colon reconsider with respect to complete mesocolic excision and the greater omentum. Int J Colorectal Dis 2016; 31:1497. [PMID: 26838015 DOI: 10.1007/s00384-016-2518-5] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 01/25/2016] [Indexed: 02/04/2023]
Affiliation(s)
- Bülent Cavit Yüksel
- Department of Colorectal Surgery, General Surgery, Ankara Numune Education and Research Hospital, Sıhhiye, 06100, Ankara, Turkey
| | - Erdinç Çetinkaya
- Department of Colorectal Surgery, General Surgery, Ankara Numune Education and Research Hospital, Sıhhiye, 06100, Ankara, Turkey.
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Akin T, Çetinkaya E, Baba S, Yüksel BC. Perineal Approach in the Treatment of Rectal Prolapse (Altemeier's Procedure): Analysis of Long-Term Outcome. Am Surg 2016; 82:E71-E72. [PMID: 27099051] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/05/2023]
Affiliation(s)
- Tezcan Akin
- Ankara Numune Education and Research Hospital, Ankara, Turkey
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