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Yasar NF, Gundogdu E, Yilmaz AS, Badak B, Bayav FD, Ozen A, Oner S. Can 3D radiological calculations predict operational difficulties for rectal cancer?: A single center retrospective analysis. Medicine (Baltimore) 2024; 103:e36961. [PMID: 38241536 PMCID: PMC10798752 DOI: 10.1097/md.0000000000036961] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/09/2023] [Accepted: 12/21/2023] [Indexed: 01/21/2024] Open
Abstract
Low anterior resection, performing total mesorectal excision with appropriate pelvic dissection to prevent local recurrence, is probably the most challenging type of surgery in colorectal surgery, especially in a narrow pelvis. In this study, we aimed to predict the operation difficulty of rectal cancer by comparing the operation time with 2D and 3D pelvimetry. Sixty-six patients who underwent total mesorectal excision after neoadjuvant chemoradiotherapy due to primary rectal cancer located in the middle and lower rectum (10 cm from the anus) were included in the study. Surgery notes were reviewed and data on demographic factors, tumor stage, duration of surgery, and types of surgery were collected, as well as pelvimetric parameters. All protocols had 2D T2-weighted sequences in 3 planes (axial, sagittal, and coronal). Pelvimetric measurements were made by measuring 8 pelvic lengths and 2 angles. Pelvis and tumor volume were measured by manual margin monitoring. In each slice, both pelvis and tumor boundaries were manually drawn individually in the sagittal plane. Pelvis and tumor volumes were calculated from the set of adjacent images by summing slice thickness and products of area measurements within the pelvis and tumor boundaries. In our results, no correlation was observed with operation time, including pelvic volume. Exception for this were interacetabular distance and tumor volume. In the regression test, the only parameter that correlated with the operation time was tumor volume. In conclusion, we believe that tumor volumetric calculations may be useful in predicting difficult distal rectal carcinoma surgeries.
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Affiliation(s)
- Necdet Fatih Yasar
- Department of General Surgery, Faculty of Medicine, Osmangazi University, Eskişehir, Turkey
| | - Elif Gundogdu
- Department of Radiology, Faculty of Medicine, Osmangazi University, Eskişehir, Turkey
| | - Arda Sakir Yilmaz
- Department of General Surgery, Yunus Emre State Hospital, Eskişehir, Turkey
| | - Bartu Badak
- Department of General Surgery, Faculty of Medicine, Osmangazi University, Eskişehir, Turkey
| | - Fatma Didem Bayav
- Department of Radiology, Faculty of Medicine, Osmangazi University, Eskişehir, Turkey
| | - Alaattin Ozen
- Department of Radiation Oncology, Faculty of Medicine, Osmangazi University, Eskişehir, Turkey
| | - Setenay Oner
- Department of Biostatistics, Faculty of Medicine, Eskisehir Osmangazi University, Eskişehir, Turkey
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Yilmaz AS, Yasar NF, Badak B, Sendil AM, Salis M, Oner S. Are the conventional scoring systems efficient in predicting mortality of acute mesenteric ischemia?: Mortality estimation in patients with AMI. Medicine (Baltimore) 2022; 101:e32619. [PMID: 36596082 PMCID: PMC9803498 DOI: 10.1097/md.0000000000032619] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/31/2022] Open
Abstract
Acute mesenteric ischemia is a surgical emergency with high morbidity and mortality rates. Therefore, it is important to determine the prognosis for this disease. In the present study, we aimed to compare the prediction accuracy of 3 scoring systems: Acute physiology and chronic health evaluation II, sequential organ failure assessment score and simplified acute physiology score II (SAPS II). The retrospective cohort study was conducted in a university hospital. Eighty-two acute mesenteric ischemia patients were evaluated retrospectively. The mortality prediction abilities of the scoring systems were evaluated by comparing the prediction rates of > 10%, 30% and 50% and the actual mortality among survivors and non-survivors in pairs. Predicted mortality rates among survivors and non-survivors differed among the 3 classification systems. The mortality estimates of the SAPS II were closer to the actual mortality rates. Analysis of the estimated mortality rates as mortality risk limits showed that acute physiology and chronic health evaluation II was superior to sequential organ failure assessment score and SAPS II in estimating mortality rates, whereas SAPS II was more successful in detecting survivors. The estimated mortality rates of the 3 rating systems, the estimated mortality rates were higher in the non-survivor group than in the survivor group. The accuracy of the SAPS II in determining prognosis was relatively better.
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Affiliation(s)
- Arda Sakir Yilmaz
- Departament of General Surgery, Sivrihisar State Hospital, Eskisehir, Turkey
- * Correspondence: Arda Sakir Yilmaz, Department of General Surgery, Sivrihisar State Hospital, Yunus Emre Mahallesi 20 Eylül Caddesi No:1, Sivrihisar, Eskişehir 26600, Turkey (e-mail: )
| | - Necdet Fatih Yasar
- Department of General Surgery, Faculty of Medicine, Osmangazi University, Eskişehir, Turkey
| | - Bartu Badak
- Department of General Surgery, Faculty of Medicine, Osmangazi University, Eskişehir, Turkey
| | - Ahmet Murat Sendil
- Department of General Surgery, Faculty of Medicine, Osmangazi University, Eskişehir, Turkey
| | | | - Setenay Oner
- Department of Biostatistics, Faculty of Medicine, Eskisehir Osmangazi University, Eskisehir, Turkey
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Badak B, Pasaoglu E, Caga HT, Ihtiyar E, Sahin A, Erkasap S, Ates E, Yasar NF. Fistulized Crohn’ Disease Mimicking Sigmoid Cancer: A Case Report. Galician med j 2020. [DOI: 10.21802/gmj.2020.4.2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
Abstract
Crohn’s disease is an inflammatory bowel disease of unknown etiology, progressing with frequent exacerbation periods that can involve any part of the gastrointestinal tract. Although, it can manifest itself with complaints from the entire gastrointestinal tract; abdominal pain, diarrhea, nausea, weight loss and fever are the most important clinical symptoms. In this presentation, a 41-year-old male patient with known Crohn’s disease was presented to our hospital with the help of operation images.
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Akyuz C, Yasar NF, Uzun O, Peker KD, Sunamak O, Duman M, Sehirli AO, Yol S. Effects of melatonin on colonic anastomosis healing following chemotherapy in rats. Singapore Med J 2018; 59:545-549. [PMID: 29552688 DOI: 10.11622/smedj.2018035] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [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: 01/01/2023]
Abstract
INTRODUCTION This study aimed to investigate the effects of melatonin on the healing of colon anastomosis following chemotherapy. METHODS 32 rats were randomised into four groups: (a) control group, which underwent sigmoid colon transection and primary anastomosis; (b) melatonin group, which received melatonin daily following anastomosis; (c) 5-fluorouracil (5-FU) group, which received 5-FU for five days prior to anastomosis; and (d) 5-FU+melatonin group, which received 5-FU for five days prior to anastomosis and melatonin daily following anastomosis. The rats were sacrificed on Postoperative Day 7 and anastomotic bursting pressures were measured. The anastomotic segment was extracted for hydroxyproline, luminol and lucigenin measurement and histopathological examination. Blood samples were obtained from the vena cava for measurement of tumour necrosis factor-alpha (TNF-α) and interleukin-1 beta (IL-1β) plasma levels. RESULTS Compared to the 5-FU group, bursting pressures of anastomosis and hydroxyproline levels were significantly higher, while luminol and lucigenin levels were significantly lower, in the control and 5-FU+melatonin groups. In addition, TNF-α and IL-1β plasma levels were significantly lower in the control and 5-FU+melatonin groups than in the 5-FU group. Histopathological examination showed a significant decrease in inflammation and necrosis formation in the melatonin group when compared to the control group. The positive effect of melatonin was also seen in the rats that received 5-FU. CONCLUSION Our study results showed that the adverse effects of chemotherapy on the mechanical, biochemical and histopathological parameters of anastomosis healing were attenuated through melatonin treatment.
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Affiliation(s)
- Cebrail Akyuz
- Department of Surgery, Haydarpasa Numune Training and Research Hospital, İstanbul, Turkey
| | - Necdet Fatih Yasar
- Department of Surgery, Koşuyolu High Specialized Training and Research Hospital, İstanbul, Turkey
| | - Orhan Uzun
- Department of Surgery, Koşuyolu High Specialized Training and Research Hospital, İstanbul, Turkey
| | - Kıvanc Derya Peker
- Department of Surgery, Koşuyolu High Specialized Training and Research Hospital, İstanbul, Turkey
| | - Oguzhan Sunamak
- Department of Surgery, Haydarpasa Numune Training and Research Hospital, İstanbul, Turkey
| | - Mustafa Duman
- Department of Surgery, Koşuyolu High Specialized Training and Research Hospital, İstanbul, Turkey
| | - Ahmet Ozer Sehirli
- Department of Pharmacology, Faculty of Dentistry, Near East University, İstanbul, Turkey
| | - Sinan Yol
- Department of General and Gastroenterological Surgery, Faculty of Health Sciences, Istanbul Medeniyet University, İstanbul, Turkey
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Baspinar M, Ozyurt R, Kus G, Kutlay O, Ozkurt M, Erkasap N, Kabadere S, Yasar NF, Erkasap S. Effects of ceranib-2 on cell survival and TNF-alpha in colon cancer cell line. ACTA ACUST UNITED AC 2017; 118:391-393. [PMID: 28766347 DOI: 10.4149/bll_2017_076] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
OBJECTIVE The aim of this study was to investigate the effects of a novel anti-cancer drug, ceranib-2, which targets the acid ceramidase, in human colon cancer cell line. MATERIALS AND METHODS The cell lines were treated with 50 µM of ceranib-2. Relative mRNA expression of TNF-alpha, TNF-R1 and ASAH were assessed by quantitative RT-PCR. RESULTS Ceranib-2 reduced cell viability in a dose-dependent manner and the apoptotic values of cells following treatment with the dose of 50 µM were reduced significantly both at 24 h and 48 h compared to the control cells (p < 0.001). TNF-alpha receptor 1 (TNF-R1) mRNA levels were reduced significantly in the cell lines treated with both 25 µM and 50 µM of ceranib-2 for 24 h compared to the control cells (p < 0.05), whereas the difference between the treatment and the control cell lines diminished at 48 h. The human acid ceramidase gene (ASAH) mRNA levels were significantly higher in the cell lines treated with 50 µM of ceranib-2 for 48 h than in the other cell lines (p < 0.001). CONCLUSION The study shows that ceranib-2 increased apoptosis by inducing ASAH expression and reduced TNF-R1 expression in human colon cancer cell lines in a dose and time-dependent manner (Fig. 3, Ref. 17).
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Peker KD, Ozkanli SS, Akyuz C, Uzun O, Yasar NF, Duman M, Yol S. Preoperative immunonutrition regulates tumor infiltrative lymphocytes and increases tumor angiogenesis in gastric cancer patients. Arch Med Sci 2017; 13:1365-1372. [PMID: 29181067 PMCID: PMC5701679 DOI: 10.5114/aoms.2016.60054] [Citation(s) in RCA: 7] [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] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/28/2015] [Accepted: 08/06/2015] [Indexed: 12/19/2022] Open
Abstract
INTRODUCTION An increased number of tumor infiltrative lymphocytes (TILs) is considered a favorable prognostic factor in various cancers because it is a marker of antitumoral activity of the immune system. In this prospective, non-randomized clinical trial, we evaluated the impact of preoperative immunonutrition on tumor infiltrative lymphocytes and neoangiogenesis in cancerous tissue in patients with locoregional and resectable gastric adenocarcinoma. MATERIAL AND METHODS Patients with locoregional and resectable gastric adenocarcinoma were divided non-randomly into two study groups. The first (control) group included patients who had standard nutrition, and the second group included those who had immunonutrition for 7 days before surgery. The biopsy samples taken endoscopically in the preoperative period, as well as the gastrectomy samples, were subjected to immunohistochemical staining for quantitative analysis of CD4, CD8, CD16, CD56, CD31 and CD105 antibodies. Main outcome measures were CD4-to-CD8 ratio and CD105 levels. RESULTS Fifty patients were included in the study between January 2013 and December 2014. Twenty-five patients were assigned to each of the first and second group. The CD4-to-CD8 ratio and CD105 levels determined in endoscopic biopsy samples were similar in both groups. The CD4-to-CD8 ratio in gastrectomy samples was significantly higher in the first group (p = 0.0001). The CD105 levels in gastrectomy samples were significantly lower in the first group (p = 0.01). CONCLUSIONS Seven-day preoperative immunonutrition use regulates TILs in gastric cancer patients, but prolonged use increases tumor angiogenesis.
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Affiliation(s)
- Kivanc Derya Peker
- Department of Gastroenterologic Surgery, Kartal Kosuyolu Training and Research Hospital, Istanbul, Turkey
| | - Sidika Seyma Ozkanli
- Department of Pathology, Medical Faculty, Istanbul Medeniyet University, Istanbul, Turkey
| | - Cebrail Akyuz
- Department of Gastroenterologic Surgery, Kartal Kosuyolu Training and Research Hospital, Istanbul, Turkey
| | - Orhan Uzun
- Department of Gastroenterologic Surgery, Kartal Kosuyolu Training and Research Hospital, Istanbul, Turkey
| | - Necdet Fatih Yasar
- Department of Gastroenterologic Surgery, Kartal Kosuyolu Training and Research Hospital, Istanbul, Turkey
| | - Mustafa Duman
- Department of Gastroenterologic Surgery, Kartal Kosuyolu Training and Research Hospital, Istanbul, Turkey
| | - Sinan Yol
- Department of General Surgery and Subspecialty (Gastrointestinal) Surgery, Faculty of Health Sciences, Istanbul Medeniyet University, Istanbul, Turkey
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Polat E, Duman U, Duman M, Derya Peker K, Akyuz C, Fatih Yasar N, Uzun O, Akbulut S, Birol Bostanci E, Yol S. Preoperative serum tumor marker levels in gastric cancer. Pak J Med Sci 2014; 30:145-9. [PMID: 24639849 PMCID: PMC3955560 DOI: 10.12669/pjms.301.3968] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2013] [Accepted: 10/23/2012] [Indexed: 12/12/2022] Open
Abstract
OBJECTIVE Tumor markers have shown little benefit as a method for screening. However, they can be used clinically for the monitoring of tumor recurrence and used as prognostic factors because higher levels have been observed in advanced disease. This study aimed to investigate the relationship between the preoperative tumor marker levels and different clinical aspects of gastric cancer. METHODS One hundred and six consecutive patients with confirmed diagnosis of gastric cancer and 106 subjects (age and sex matched) with no malignancy as control group were included prospectively in this study in 3 years. The relationships between tumor markers CEA, CA 19-9 and stage of disease, tumor differentiation, presence of ringlet cell type, presence of peritoneal carcinomatozis were investigated. RESULTS The serum CEA and CA 125 levels were found to be significantly elevated in gastric cancer patients than in controls. The serum level of CEA had showed a significant elevation with the presence of distant metastasis. The CA 19-9 and CA 125 levels had showed significant elevations with the presence of peritoneal carcinomatozis. Conclusions : This study showed that there is a limited clinical benefit of preoperative tumor marker measurements in gastric cancer such as estimation of peritoneal dissemination.
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Affiliation(s)
- Erdal Polat
- Erdal Polat, MD, Department of Gastrointestinal Surgery, Kosuyolu High Specialty Training and Research Hospital, Istanbul, Turkey
| | - Ugur Duman
- Ugur Duman, MD, Bursa Sevket Yilmaz Training and Research Hospital, Department of General Surgery, Bursa, Turkey
| | - Mustafa Duman
- Mustafa Duman, MD, Associate Professor, Department of Gastrointestinal Surgery, Kosuyolu High Specialty Training and Research Hospital, Istanbul, Turkey
| | - Kivanc Derya Peker
- Kivanc Derya Peker, MD, Department of Gastrointestinal Surgery, Kosuyolu High Specialty Training and Research Hospital, Istanbul, Turkey
| | - Cebrail Akyuz
- Cebrail Akyuz, MD, Department of Gastrointestinal Surgery, Kosuyolu High Specialty Training and Research Hospital, Istanbul, Turkey
| | - Necdet Fatih Yasar
- Necdet Fatih Yasar, MD, Department of Gastrointestinal Surgery, Kosuyolu High Specialty Training and Research Hospital, Istanbul, Turkey
| | - Orhan Uzun
- Orhan Uzun, MD, Department of Gastrointestinal Surgery, Kosuyolu High Specialty Training and Research Hospital, Istanbul, Turkey
| | - Sabiye Akbulut
- Sabiye Akbulut, MD, Department of Gastroenterology, Kosuyolu High Specialty Training and Research Hospital, Istanbul, Turkey
| | - Erdal Birol Bostanci
- Erdal Birol Bostanci, MD, Professor, Department of Gastrointestinal Surgery, Turkiye High Specialty Training and Research Hospital, Ankara, Turkey
| | - Sinan Yol
- Sinan Yol, MD, Professor, Department of Gastrointestinal Surgery, Kosuyolu High Specialty Training and Research Hospital, Istanbul, Turkey
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Duman M, Polat E, Ozer M, Demirci Y, Yasar NF, Akyuz C, Uzun O, Peker KD, Genc E, Yol S. The effect of rabeprazole on LES tone in experimental rat model. J INVEST SURG 2013; 26:186-90. [PMID: 23514061 DOI: 10.3109/08941939.2012.733487] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/10/2023]
Abstract
INTRODUCTION Despite adequate treatment with proton pump inhibitors (PPIs), symptoms of gastroesophageal reflux disease (GERD) may remain persistent as well as Barrett's esophagus may emerge. It may be proposed that the relaxant effect of PPIs on the smooth muscles may lead to resistance of symptoms. The aim of this study is to investigate effects of rabeprazole on the lower esophageal sphincter (LES) pressure with a rat model. MATERIALS AND METHODS Sixteen rats were grouped as control and treatment groups. After obtaining LES tissues followed by a 60 min equilibration period for stabilization, contractile response to carbachol was obtained by application of single dose of carbachol to have a final concentration of 10(-6) M in the organ bath. After the contractions reached a plateau, concentration-response relationships for rabeprazole were obtained in a cumulative manner in the treatment group. RESULTS In the carbachol contracted LES preparations; 1.5 × 10(-6) and 1.5×10(-5) M of rabeprazole caused 6.08% and 11.34% relaxations respectively which were not statistically significant. However, mean integral relaxation value for 4.5 × 10(-5) M of rabeprazole was 17.34% and this relaxation was significant compared with controls. CONCLUSIONS In the present study, rabeprazole caused no direct significant change in LES tone in the therapeutic dose range applied to the organ bath. However, rabeprazole at the high dose caused a significant decrease in the LES tone.
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Affiliation(s)
- Mustafa Duman
- Department of Gastrointestinal Surgery, Kartal Kosuyolu Training and Research Hospital, Istanbul, Turkey.
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Bilge U, Yasar NF, Ihtiyar E. A retrospective evaluation of 75 patients operated for hyperparathyroidism between 2000–2010. Turk J Surg 2012. [DOI: 10.5152/ucd.2012.13] [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: 11/22/2022]
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Bilge U, Yasar NF, Ihtiyar E. A retrospective evaluation of 75 patients operated for hyperparathyroidism between 2000–2010. Turk J Surg 2012. [DOI: 10.5097/1300-0705.ucd.1586-12.00] [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: 11/08/2022]
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