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Eren T, Tigrel LZ, Gapbarov A, Aydemir MA, Seneldir H, Ekinci O, Alimoglu O. Prognostic value of the lymph node ratio in surgically treated stage III colorectal cancer patients with high numbers of harvested lymph nodes. Acta Chir Belg 2023; 123:535-543. [PMID: 35849005 DOI: 10.1080/00015458.2022.2103247] [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: 11/11/2021] [Accepted: 07/14/2022] [Indexed: 11/01/2022]
Abstract
BACKGROUND The lymph node ratio (LNR), defined as the number of positive lymph nodes (LN) divided by the total number of harvested LN, has been demonstrated to be an independent factor in the prognosis of surgically treated colorectal cancer (CRC) patients. This study aims to establish the prognostic value of LNR in stage III CRC patients with high numbers of LN removed. METHODS Stage III CRC patients who underwent curative resections over an 8-year period were included to the study. Demographics, clinicopathological features, surgical as well as recurrence and survival outcomes were recorded and statistically analyzed. Calculations for LNR were carried out as a function of percentage rates and Cox proportional hazards regression analyses were performed to determine its effect on disease-free and overall survival. RESULTS Among a total of 493 surgically treated CRC cases, 104 patients were included to the study consisting of 68 (65.4%) men and 36 (34.6%) women with a median age of 64 (inter-quartile range: 55-74) years. The mean number of harvested LN was 31.6 ± 21.0 (range: 12-103). Multivariate Cox regression analyses proved LNR to be a significant factor in both disease-free and overall survival (p = 0.007 and p = 0.003, respectively). Forward elimination analyses showed that a 1% increase in LNR resulted with a 2% increase in both the risks of recurrence and mortality. CONCLUSIONS The LNR may be assessed as an adjunct to the current staging systems for the prediction of oncological outcomes and survival of surgically treated stage III CRC patients.
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Affiliation(s)
- Tunc Eren
- Department of General Surgery, Faculty of Medicine, Istanbul Medeniyet University, Goztepe Prof. Dr. Suleyman Yalcin City Hospital, Istanbul, Turkey
| | - Leyla Zeynep Tigrel
- Department of General Surgery, Faculty of Medicine, Istanbul Medeniyet University, Goztepe Prof. Dr. Suleyman Yalcin City Hospital, Istanbul, Turkey
| | - Aman Gapbarov
- Department of General Surgery, Faculty of Medicine, Istanbul Medeniyet University, Goztepe Prof. Dr. Suleyman Yalcin City Hospital, Istanbul, Turkey
| | - Muhammet Ali Aydemir
- Department of General Surgery, Faculty of Medicine, Istanbul Medeniyet University, Goztepe Prof. Dr. Suleyman Yalcin City Hospital, Istanbul, Turkey
| | - Hatice Seneldir
- Department of Pathology, Faculty of Medicine, Istanbul Medeniyet University, Goztepe Prof. Dr. Suleyman Yalcin City Hospital, Istanbul, Turkey
| | - Ozgur Ekinci
- Department of General Surgery, Faculty of Medicine, Istanbul Medeniyet University, Goztepe Prof. Dr. Suleyman Yalcin City Hospital, Istanbul, Turkey
| | - Orhan Alimoglu
- Department of General Surgery, Faculty of Medicine, Istanbul Medeniyet University, Goztepe Prof. Dr. Suleyman Yalcin City Hospital, Istanbul, Turkey
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Baysal H, Erol CI, Baysal B, Ozemir IA, Ozsoy MS, Buyuker F, Kir G, Alimoglu O. The effects of clinicopathological and imaging findings on recurrence and survival in mammary Paget's disease. North Clin Istanb 2023; 10:541-549. [PMID: 37829736 PMCID: PMC10565753 DOI: 10.14744/nci.2023.77010] [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] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2023] [Accepted: 08/30/2023] [Indexed: 10/14/2023] Open
Abstract
OBJECTIVE Mammary Paget's disease (MPD) is a rare presentation type of breast cancer. The aim of this study was to evaluate the clinicopathological and imaging features affecting the invasive component, loco-regional recurrence, prognosis, and survival of MPD. METHODS Patients who had undergone surgery due to MPD in a 10-year period were included. Parameters including mammography and magnetic resonance imaging (MRI) findings, tumor stage, molecular subtype, axillary involvement, presence of invasive carcinoma, loco-regional recurrence, overall survival (OS), and disease-free survival (DFS) were recorded and statistically analyzed. P<0.05 was determined as statistically significant. RESULTS The study group consisted of 49 women with a mean age of 67.05±14.43 (range: 23-90) years. There was a significant association between the presence of invasive carcinoma and a mass lesion in the MRI (p=0.002). The frequency of sentinel lymph node (SLN) metastasis was significantly higher in patients with multicentric tumors (p=0.029; p<0.05). Locoregional recurrence and distant metastasis were significantly more frequent in patients with axillary involvement (p=0.0336; p<0.05). The mean DFS was 115.02±7.28 months, while the mean OS was 119.29±6.57 months. CONCLUSION The presence of a mass lesion on MRI was determined to be significant in recognizing invasive carcinoma in MPD. The rate of SLN metastasis was higher in patients with multicentric tumors than in patients with unifocal tumors. Axillary involvement was associated with impaired DFS.
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Affiliation(s)
- Hakan Baysal
- Department of General Surgery, Istanbul Medeniyet University, Goztepe Prof. Dr. Suleyman Yalcin City Hospital, Istanbul, Turkiye
| | - Cem Ilgin Erol
- Department of General Surgery, Erzurum City Hospital, Erzurum, Turkiye
| | - Begumhan Baysal
- Department of Radiology, Istanbul Medeniyet University, Goztepe Prof. Dr. Suleyman Yalcin City Hospital, Istanbul, Turkiye
| | - Ibrahim Ali Ozemir
- Department of General Surgery, Istanbul Medeniyet University, Goztepe Prof. Dr. Suleyman Yalcin City Hospital, Istanbul, Turkiye
| | - Mehmet Sait Ozsoy
- Department of General Surgery, Istanbul Medeniyet University, Goztepe Prof. Dr. Suleyman Yalcin City Hospital, Istanbul, Turkiye
| | - Fatih Buyuker
- Department of General Surgery, Istanbul Medeniyet University, Goztepe Prof. Dr. Suleyman Yalcin City Hospital, Istanbul, Turkiye
| | - Gozde Kir
- Department of Pathology, Istanbul Medeniyet University, Goztepe Prof. Dr. Suleyman Yalcin City Hospital, Istanbul, Turkiye
| | - Orhan Alimoglu
- Department of General Surgery, Istanbul Medeniyet University, Goztepe Prof. Dr. Suleyman Yalcin City Hospital, Istanbul, Turkiye
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Trastulli S, Desiderio J, Lin JX, Reim D, Zheng CH, Borghi F, Cianchi F, Norero E, Nguyen NT, Qi F, Coratti A, Cesari M, Bazzocchi F, Alimoglu O, Brower ST, Pernazza G, D'Imporzano S, Azagra JS, Zhou YB, Cao SG, Guerra F, Liu T, Arcuri G, González P, Staderini F, Marano A, Di Nardo D, Parisi A, Huang CM, Tebala GD. Open vs robotic gastrectomy with D2 lymphadenectomy: a propensity score-matched analysis on 1469 patients from the IMIGASTRIC prospective database. Langenbecks Arch Surg 2023; 408:302. [PMID: 37555850 DOI: 10.1007/s00423-023-03032-x] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [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: 03/13/2023] [Accepted: 07/28/2023] [Indexed: 08/10/2023]
Abstract
BACKGROUND Comparative data on D2-robotic gastrectomy (RG) vs D2-open gastrectomy (OG) are lacking in the Literature. Aim of this paper is to compare RG to OG with a focus on D2-lymphadenectomy. STUDY DESIGN Data of patients undergoing D2-OG or RG for gastric cancer were retrieved from the international IMIGASTRIC prospective database and compared. RESULTS A total of 1469 patients were selected for inclusion in the study. After 1:1 propensity score matching, a total of 580 patients were matched and included in the final analysis, 290 in each group, RG vs OG. RG had longer operation time (210 vs 330 min, p < 0.0001), reduced intraoperative blood loss (155 vs 119.7 ml, p < 0.0001), time to liquid diet (4.4 vs 3 days, p < 0.0001) and to peristalsis (2.4 vs 2 days, p < 0.0001), and length of postoperative stay (11 vs 8 days, p < 0.0001). Morbidity rate was higher in OG (24.1% vs 16.2%, p = 0.017). CONCLUSION RG significantly expedites recovery and reduces the risk of complications compared to OG. However, long-term survival is similar.
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Affiliation(s)
- Stefano Trastulli
- Department of Digestive and Emergency Surgery, Azienda Ospedaliera Santa Maria, 05100, Terni, Italy
| | - Jacopo Desiderio
- Department of Digestive and Emergency Surgery, Azienda Ospedaliera Santa Maria, 05100, Terni, Italy
| | - Jian-Xian Lin
- Department of Gastric Surgery, Fujian Medical University Union Hospital, Fuzhou, 350001, China
| | - Daniel Reim
- Klinik Und Poliklinik Für Chirurgie, Klinikum Rechts Der Isar, Technische Universität München, 81675, Munich, Germany
| | - Chao-Hui Zheng
- Department of Gastric Surgery, Fujian Medical University Union Hospital, Fuzhou, 350001, China
| | - Felice Borghi
- General and Oncologic Surgery Unit, Department of Surgery, Santa Croce E Carle Hospital, 12100, Cuneo, Italy
| | - Fabio Cianchi
- Digestive Surgery Unit, Department of Experimental and Clinical Medicine, "Careggi" Hospital, University of Florence, 50134, Florence, Italy
| | - Enrique Norero
- Esophagogastric Surgery Unit, Digestive Surgery Department, Hospital Dr. Sotero del Rio, Pontificia Universidad Catolica de Chile, 8207257, Santiago, Chile
| | - Ninh T Nguyen
- Irvine Medical Center, Department of Surgery, Division of Gastrointestinal Surgery, University of California, Orange, CA, 92868, USA
| | - Feng Qi
- Gastrointestinal Surgery, Tianjin Medical University General Hospital, Tianjin, 300052, China
| | - Andrea Coratti
- Department of General and Emergency Surgery, Division of General and Emergency Surgery, School of Robotic Surgery, "Misericordia" Hospital, 58100, Grosseto, Italy
| | - Maurizio Cesari
- Department of General Surgery, Hospital of Città Di Castello, USL1 Umbria, 06012, Città Di Castello, Italy
| | - Francesca Bazzocchi
- Department of Surgery, Fondazione IRCCS Casa Sollievo Della Sofferenza, 71013, San Giovanni Rotondo, Italy
| | - Orhan Alimoglu
- Department of General Surgery, School of Medicine, Istanbul Medeniyet University, 34000, Istanbul, Turkey
| | - Steven T Brower
- Department of Surgical Oncology and HPB Surgery, Englewood Hospital and Medical Center, Englewood, NJ, 07631, USA
| | - Graziano Pernazza
- Robotic General Surgery Unit, Department of Surgery, San Giovanni-Addolorata Hospital, 00184, Rome, Italy
| | - Simone D'Imporzano
- Esophageal Surgery Unit, Tuscany Regional Referral Center for the Diagnosis and Treatment of Esophageal Disease, Medical University of Pisa, 56124, Pisa, Italy
| | - Juan-Santiago Azagra
- Unité Des Maladies de L'Appareil Digestif Et Endocrine, Centre Hospitalier de Luxembourg, 1210, Luxembourg, Luxembourg
| | - Yan-Bing Zhou
- Department of General Surgery, The Affiliated Hospital of Qingdao University, Qingdao, 266003, China
| | - Shou-Gen Cao
- Department of General Surgery, The Affiliated Hospital of Qingdao University, Qingdao, 266003, China
| | - Francesco Guerra
- Department of General and Emergency Surgery, Division of General and Emergency Surgery, School of Robotic Surgery, "Misericordia" Hospital, 58100, Grosseto, Italy
| | - Tong Liu
- Gastrointestinal Surgery, Tianjin Medical University General Hospital, Tianjin, 300052, China
| | - Giacomo Arcuri
- Division of Surgery, "S.Maria Della Misericordia" Hospital, 06129, Perugia, Italy
| | - Paulina González
- Esophagogastric Surgery Unit, Digestive Surgery Department, Hospital Dr. Sotero del Rio, Pontificia Universidad Catolica de Chile, 8207257, Santiago, Chile
| | - Fabio Staderini
- Digestive Surgery Unit, Department of Experimental and Clinical Medicine, "Careggi" Hospital, University of Florence, 50134, Florence, Italy
| | - Alessandra Marano
- General and Oncologic Surgery Unit, Department of Surgery, Santa Croce E Carle Hospital, 12100, Cuneo, Italy
| | - Domenico Di Nardo
- Department of Digestive and Emergency Surgery, Azienda Ospedaliera Santa Maria, 05100, Terni, Italy
| | - Amilcare Parisi
- Department of Digestive and Emergency Surgery, Azienda Ospedaliera Santa Maria, 05100, Terni, Italy
| | - Chang-Ming Huang
- Department of Gastric Surgery, Fujian Medical University Union Hospital, Fuzhou, 350001, China
| | - Giovanni Domenico Tebala
- Department of Digestive and Emergency Surgery, Azienda Ospedaliera Santa Maria, 05100, Terni, Italy.
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Colapkulu-Akgul N, Gunel H, Beyazadam D, Ozsoy MS, Alimoglu O. Gastrointestinal Stromal Tumors: Recurrence and Survival Analysis of 49 Patients. Middle East J Dig Dis 2023; 15:19-25. [PMID: 37547161 PMCID: PMC10404080 DOI: 10.34172/mejdd.2023.315] [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] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/27/2022] [Accepted: 09/20/2022] [Indexed: 08/08/2023] Open
Abstract
Background: Gastrointestinal stromal tumors (GISTs) are the most common mesenchymal tumor originating from the gastrointestinal tract and have a broad spectrum of clinicopathological features affecting disease management regarding the treatment modalities. Methods: A retrospective study of 49 patients who underwent surgery for gastrointestinal tumors between 2008 and 2016 was conducted. Clinical, pathological, and immunohistochemical features of patients with and without recurrence were statistically analyzed. Results: Twenty-nine (59.1%) patients had gastric; 16 (32.6%) had small intestinal; 3 (6.1%) had mesenteric; and 1 (2.2%) had rectal GISTs. Microscopic tumor necrosis and tumor ulceration were also significant for disease recurrence (P = 0.005, P = 0.049). High-risk patients according to Miettinen's risk classification were more likely to develop a recurrence (P < 0.001). Additionally, high-grade tumors were also a risk factor for recurrence (P < 0.001). Ki-67 levels were available in 40 patients and the mean Ki-67 level was 16.8 in patients with recurrence, which was a significant risk factor in regression analysis (HR: 1.24, 95%, CI: 1.08-1-43). Five-year disease-free survival rates of non-gastric and gastric GISTs were 62.3% and 90%, respectively (P = 0.044). Conclusion: Larger tumors and higher mitotic rates are more likely to develop recurrence. High Ki-67 levels were also associated with recurrence.
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Affiliation(s)
| | - Humeyra Gunel
- Department of Pathology, Istanbul Medeniyet University, Goztepe Prof. Dr. Suleyman Yalcin City Hospital, Istanbul, Turkey
| | - Damla Beyazadam
- Department of General Surgery, Istanbul Medeniyet University, Goztepe Prof. Dr. Suleyman Yalcin City Hospital, Istanbul, Turkey
| | - Mehmet S Ozsoy
- Department of General Surgery, Istanbul Medeniyet University, Goztepe Prof. Dr. Suleyman Yalcin City Hospital, Istanbul, Turkey
| | - Orhan Alimoglu
- Department of General Surgery, Istanbul Medeniyet University, Goztepe Prof. Dr. Suleyman Yalcin City Hospital, Istanbul, Turkey
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Ozemir IA, Aydemir MA, Gapbarov A, Ekinci O, Alimoglu O. The Effect of the Mucinous Component Presence on the Clinical Outcomes of Colorectal Cancer. Galician med j 2022. [DOI: 10.21802/gmj.2022.4.6] [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: 12/05/2022] Open
Abstract
Background. The effect of colorectal cancer (CRC) histological subtypes on the prognosis is still a controversial issue. We aimed to compare clinical findings, histopathologic data, and survival outcomes in CRC patients with classical and mucinous subtypes.
Methods. Patients who were operated on for CRC between 2010 and 2017 were included in the study. Patients were classified into two groups according to the presence of a mucinous component: mucinous adenocarcinoma (MAC) - mucinous component > 50% and classical adenocarcinoma (CAC). Clinical and histopathologic findings, recurrence, metastasis, and survival rates were compared.
Results. Data of the 484 CRC patients were documented. Sixty-nine patients (14.3%) were in the MAC group and 415 (85.7%) patients were in the CAC group. The mean age of patients with MAC and CAC was 63.4 ± 13.5 and 68.5 ± 12.7 years, respectively (p = 0.002). Proximal colon localization was found in 30 (43.5%) MAC patients and 123 (29.6%) CAC patients (p = 0.029). The number of patients with metastatic lymph nodes was higher in the MAC group (58% vs. 41.2%, p = 0.03). Nevertheless, there was no significant difference between the CAC and MAC groups in terms of disease-free survival (63.1% vs. 69.6%, p = 0.37) and disease-related mortality (23.6% vs. 23.2%, p = 0.94) over the follow-up period. Multivariate analysis showed that the presence of perineural invasion, patient’s age, and disease stage were associated with mortality in CRC patients.
Conclusions. MACs occurred at a younger age than CACs and were more likely localized in the proximal colon as compared to CACs. Despite increased lymph node metastasis in MAC patients, no statistical significance was detected in overall survival or disease-free survival. Multivariate analysis revealed that age, perineural invasion, and disease stage were relevant to mortality in CRC patients.
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Baysal H, Serdaroglu AY, Ozemir IA, Baysal B, Gungor S, Erol CI, Ozsoy MS, Ekinci O, Alimoglu O. Comparison of Magnetic Resonance Imaging With Positron Emission Tomography/Computed Tomography in the Evaluation of Response to Neoadjuvant Therapy of Breast Cancer. J Surg Res 2022; 278:223-232. [DOI: 10.1016/j.jss.2022.04.063] [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] [Received: 08/17/2021] [Revised: 04/12/2022] [Accepted: 04/23/2022] [Indexed: 10/18/2022]
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Alimoglu O, Colapkulu-Akgul N, Erol CI. Upward trend of proximal gastric cancers in Istanbul. Int J Surg 2022; 104:106732. [PMID: 35809847 DOI: 10.1016/j.ijsu.2022.106732] [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] [Received: 06/01/2022] [Accepted: 06/22/2022] [Indexed: 11/29/2022]
Affiliation(s)
- Orhan Alimoglu
- Department of General Surgery, Prof Dr Suleyman Yalcin City Hospital, Istanbul Medeniyet University, Istanbul, Turkey.
| | - Nuray Colapkulu-Akgul
- Department of General Surgery, Prof Dr Suleyman Yalcin City Hospital, Istanbul Medeniyet University, Istanbul, Turkey
| | - Cem Ilgin Erol
- Department of General Surgery, Prof Dr Suleyman Yalcin City Hospital, Istanbul Medeniyet University, Istanbul, Turkey
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Alimoglu O, Colapkulu N. Surgical Residency Training Program in Somalia: Outcomes of 8 Years. Surgical Practice 2022. [DOI: 10.1111/1744-1633.12574] [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: 11/29/2022]
Affiliation(s)
- Orhan Alimoglu
- Department of General Surgery Istanbul Medeniyet University, Medical Faculty, Goztepe Dr. Suleyman Yalcin Sehir Hastanesi Istanbul Turkey
- Istanbul Medeniyet University Africa Health Training and Research Center (MASAM) Istanbul Turkey
| | - Nuray Colapkulu
- Department of General Surgery Istanbul Medeniyet University, Medical Faculty, Goztepe Dr. Suleyman Yalcin Sehir Hastanesi Istanbul Turkey
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Beyazadam D, Kaya F, Taşdemir İM, Alimoglu O. Analysis of physical violence incidents against physicians in Turkey between 2008 and 2018. ULUS TRAVMA ACIL CER 2022; 28:641-647. [PMID: 35485472 PMCID: PMC10442990 DOI: 10.14744/tjtes.2021.66745] [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: 11/10/2020] [Accepted: 01/24/2021] [Indexed: 11/20/2022]
Abstract
BACKGROUND Violence against physicians is a global issue that causes impaired physical and mental health, declined work quality, resignations, and even suicides. Studies regarding violence against physicians are very limited. Therefore, our aim is to investigate the physical violence incidents against physicians presented in print media between 2008 and 2018. METHODS A total of 8612 news reports acquired in national news database via 45 keywords were assessed. Five hundred and sixty-four of the reports met the inclusion criteria and were retrospectively analyzed. RESULTS Of 5964 news reports, 3754 (62.9%) were reprimands and protests against violence incidents. In 11 years, 560 individual incidents occurred where 647 physicians were physically assaulted, with 2267 news reports written on those incidents. The number of incidents increased over the years, and in 2012 both the number of incidents (n=91) and news reports count per incident were found highest. About 77.7% of assaulted physicians were male, and incident rate was higher in Western Turkey (42.15%). In 11 years, ten dedicated physicians have lost their lives in the line of duty. Emergency medicine (20.4%), primary care (9.89%) were the departments most exposed to physical violence. The claim of receiving inadequate medical attention was noted to be the primary allegation of the assailants. CONCLUSION The frequency of physical violence incidents against physicians is increasing. Throughout the study period, news reports containing condemnations, critiques, and protests are also more frequently, yet not adequately, placed in print media. Thus, social and public awareness ought to be enhanced through national and global media outlets. Furthermore, extensive measures must be taken by governments in order to prevent and eliminate violence.
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Affiliation(s)
- Damla Beyazadam
- Department of General Surgery, İstanbul Medeniyet University Faculty of Medicine Göztepe Prof. Dr. Süleyman Yalçın City Hospital, İstanbul-Turkey
| | - Feyza Kaya
- İstanbul Medeniyet University Faculty of Medicine, İstanbul-Turkey
| | | | - Orhan Alimoglu
- Department of General Surgery, İstanbul Medeniyet University Faculty of Medicine Göztepe Prof. Dr. Süleyman Yalçın City Hospital, İstanbul-Turkey
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Wehliye LH, Sonmez RE, Moalin Fiqi A, Alimoglu O. Histological patterns of thyroid lesions among different age groups in Mogadishu, Somalia. Bangladesh J Med Sci 2022. [DOI: 10.3329/bjms.v21i1.56328] [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: 11/05/2022] Open
Abstract
Background: Thyroid nodules are seen in 4-7% of the population which are more common in women. Excising all of these lesions is impractical and associated with certain risk factors as well. Fine needle aspiration (FNA) biopsy is the most relevant diagnostic procedure to decide those that need to be surgically excised or not.
Methodology: The present study was conducted in Liban clinic, Mogadishu, Somalia. 220 patients whom were diagnosed with various types of tyroid lesions within 2 years of period were included in the study. Main objectives were to put forward the distribution of histological findings according to fine needle aspiration (FNA) biopsy results among different age groups, and to define the prevelance of certain subtypes of thyroid nodules in the region.
Results: 207 patients had ‘benign’ nodules and 13 patients had ‘malignant’ nodules according histological evaluationof fine needle aspiration (FNA) biopsy results. ‘31-40’ years of age interval was found to have the highest percentage of histologically ‘benign findings’, while patients within ‘41-50’ years of age had the highest rate of ‘malignant lesions’ in count among the study population. ‘Papillary’ (n=8)(61.5%) and ‘medullary’ (n=5)(38.5%) carcinomas were most common malignant features.Mostly recorded benign lesions were ‘colloidal goiter, multinodular goiter (MNG), nodular hyperplasia and adenomatoid goiter’ (n=94)(45.4%).
Conclusion: Characteristics of thyroidlesions in region of Mogadishu, Somalia show similar patterns based upon correlation of age with histological differences compared to recent literature. With the aid of FNA, majority of the population can be managed conservatively safely without need of surgical interventions.
Bangladesh Journal of Medical Science Vol. 21(1) 2022 Page : 67-71
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Colapkulu-Akgul N, Ozemir IA, Beyazadam D, Alimoglu O. Perioperative Short Term Prophylaxis against Deep Vein Thrombosis after Major Abdominal Cancer Surgery: Retrospective Cohort Study. Vasc Specialist Int 2021; 37:45. [PMID: 35008064 PMCID: PMC8752334 DOI: 10.5758/vsi.210065] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [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: 09/03/2021] [Revised: 12/03/2021] [Accepted: 12/19/2021] [Indexed: 11/20/2022] Open
Abstract
Purpose The aim of this study is to evaluate the outcomes of pharmacological thromboprophylaxis given for short-term duration to the patients who underwent major abdominal surgery for colorectal and gastric cancer. Methods Materials and This retrospective cohort study was performed in consecutive patients who underwent major abdominal surgery for colorectal and gastric cancer and received short-term pharmacological thromboprophylaxis during hospital stay were enrolled. Complete duplex ultrasonography of the lower limbs was performed for all patients to investigate both symptomatic and asymptomatic deep vein thrombosis (DVT). Results Overall, 278 patients were evaluated for inclusion and 62 colorectal and 27 gastric cancer patients were enrolled. Of 89 patients, the incidence of total and symptomatic DVT was 4.5% and 2.2%, respectively. The patients with symptomatic DVT were diagnosed within the first four months. The incidence of coronary artery disease, mucinous adenocarcinoma and vascular tumor invasion were significantly higher in patients with DVT (P-values<0.001, 0.009, and 0.02, respectively). Conclusion Short-term pharmacological thromboprophylaxis after major abdominal surgery for colorectal and gastric cancer does not increase symptomatic DVT rates of patients with low Caprini score. Postoperative DVT surveillance may benefit patients with coronary artery disease, mucinous adenocarcinoma or vascular invasion of the tumor.
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Affiliation(s)
| | - Ibrahim Ali Ozemir
- Department of General Surgery, Istanbul Medeniyet University, Goztepe Prof Dr Suleyman Yalcin City Hospital, Istanbul, Turkey
| | - Damla Beyazadam
- Department of General Surgery, Istanbul Medeniyet University, Goztepe Prof Dr Suleyman Yalcin City Hospital, Istanbul, Turkey
| | - Orhan Alimoglu
- Department of General Surgery, Istanbul Medeniyet University, Goztepe Prof Dr Suleyman Yalcin City Hospital, Istanbul, Turkey
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Gündüz N, Buyuker F, Seneldir H, Durukan G, Alimoglu O, Kabaalioglu A. Computed Tomography-based Morphological Differences between Histologic Subtypes of Periampullary Ductal Adenocarcinoma. J Coll Physicians Surg Pak 2021; 31:959-964. [PMID: 34320715 DOI: 10.29271/jcpsp.2021.08.959] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/06/2020] [Accepted: 01/06/2021] [Indexed: 11/11/2022]
Abstract
OBJECTIVE To evaluate the computed tomography (CT)-based differences between pancreaticobiliary (PBST) and intestinal (IST) subtypes of periampullary pancreatic ductal adenocarcinomas (PDAC). STUDY DESIGN Analytical study. PLACE AND DURATION OF STUDY Faculty of Medicine, Istanbul Medeniyet University, Göztepe Training and Research Hospital, Turkey between 2015 and 2018. METHODOLOGY Overall 24 periampullary PDAC cases, in whom histomorphologic evaluation and CDx2 expression were used to discriminate between PBST and IST, were included. The lesion morphology (infiltrative versus nodular), common bile and main pancreatic ducts' dilation, tumor grade, enhancement pattern, pancreaticoduodenal groove, pancreaticoduodenal artery and lymphatic involvement were evaluated by CT. RESULTS Overall 24 PDAC cases [median age 67.5 (60.5-76.5) years] were enrolled. Histopathology revealed 9 (25%) IST and 18 (75%) PBST. The age [72.5 (69-81) versus 63 (57.75-75.5) years, respectively, p=0.204] and gender [3 (50%) versus 12 (66.7%) males, respectively, p=0.635] and the prevalence of all CT characteristics were similar between groups (p>0.05 for all) except for lesion morphology. Infiltrative morphology was more frequent in PBST than IST [14 (77.8%) versus 1 (16.7%), respectively, p=0.015]. Multiple variable logistic regression analysis revealed infiltrative morphology as the only independent CT predictor of PBST [OR: 14.9, 95% CI: 1.2-186), p=0.036]. The interrater reproducibility for lesion morphology was moderate (Cohen's Kappa: 0.55, p<0.007). CONCLUSION Infiltrative appearance is associated with PBST; whereas, nodular appearance more likely predicts IST. The potential role of CT lesion morphology on guiding appropriate chemotherapy in cases with no chance for surgery or biopsy requires addressing. Key Words: Intestinal differentiation, Pancreatobiliary differentiation, Periampullary adenocarcinoma.
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Affiliation(s)
- Nesrin Gündüz
- Department of Radiology, Faculty of Medicine, Istanbul Medeniyet University, Göztepe Training and Research Hospital, Turkey
| | - Fatih Buyuker
- Department of General Surgery, Faculty of Medicine, Istanbul Medeniyet University, Göztepe Training and Research Hospital, Turkey
| | - Hatice Seneldir
- Department of Pathology, Faculty of Medicine, Istanbul Medeniyet University, Göztepe Training and Research Hospital, Turkey
| | - Gulcin Durukan
- Department of Radiology, Faculty of Medicine, Istanbul Medeniyet University, Göztepe Training and Research Hospital, Turkey
| | - Orhan Alimoglu
- Department of General Surgery, Faculty of Medicine, Istanbul Medeniyet University, Göztepe Training and Research Hospital, Turkey
| | - Adnan Kabaalioglu
- Department of Radiology, Faculty of Medicine, Istanbul Medeniyet University, Göztepe Training and Research Hospital, Turkey
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13
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Sagiroglu J, Ozemir IA, Eren T, Akkin F, Gapbarov A, Okur O, Baysal H, Ekinci O, Ceyran AB, Tozan Bayrak E, Ozturk T, Bas G, Alimoglu O. Comparison of Oncoplastic Breast Surgery, Non-oncoplastic Breast Conserving Surgery and Mastectomy in Early Breast Cancer: A Single Center Retrospective Study. Arch Iran Med 2021; 24:390-396. [PMID: 34196204 DOI: 10.34172/aim.2021.56] [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] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/28/2020] [Accepted: 02/27/2021] [Indexed: 11/09/2022]
Abstract
BACKGROUND Surgical procedures applied in the treatment of early breast cancer (EBC) to achieve satisfactory oncological results lie in a wide spectrum. There has been a major shift toward less-invasive treatments during the past decades. We compared the outcomes of oncoplastic breast surgery (OBS), non-oncoplastic breast conserving surgery (NBCS) and mastectomy in the treatment of EBC. METHODS The records of 412 patients with EBC who underwent OBS, NBCS or mastectomy at our institution between January 2012 and June 2019 were retrospectively analyzed. Postoperative complications, local recurrences (LR) and disease-free survival (DFS) were compared between the groups. EBC patients with unilateral stage-I, IIa and IIb tumors were studied. All patients received adjuvant, targeted and/or endocrine therapy according to the tumor characteristics, followed by radiotherapy (all OBS and NBCS cases, and selected mastectomy patients). RESULTS Postoperative complications were similar in all groups except for six fat necrosis and partial nipple-areola necrosis in two diabetic patients treated with OBS. Re-excision rate was lower in OBS (6.5%) than NBCS (8%). There was no statistical difference between the groups regarding recurrence (P=1.000) or DFS (P=0.937). CONCLUSION OBS, NBCS and mastectomy are equally acceptable procedures in EBC in terms of both oncological and surgical aspects.
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Affiliation(s)
- Julide Sagiroglu
- Istanbul Medeniyet University Medical Faculty, Department of General Surgery, Istanbul, Turkey
| | - Ibrahim A Ozemir
- Istanbul Medeniyet University Medical Faculty, Department of General Surgery, Istanbul, Turkey
| | - Tunc Eren
- Istanbul Medeniyet University Medical Faculty, Department of General Surgery, Istanbul, Turkey
| | - Fatih Akkin
- Istanbul Medeniyet University Medical Faculty, Department of General Surgery, Istanbul, Turkey
| | - Aman Gapbarov
- Istanbul Medeniyet University Medical Faculty, Department of General Surgery, Istanbul, Turkey
| | - Ozlem Okur
- Istanbul Medeniyet University Medical Faculty, Department of General Surgery, Istanbul, Turkey
| | - Hakan Baysal
- Istanbul Medeniyet University Medical Faculty, Department of General Surgery, Istanbul, Turkey
| | - Ozgur Ekinci
- Istanbul Medeniyet University Medical Faculty, Department of General Surgery, Istanbul, Turkey
| | - Ayse B Ceyran
- Istanbul Kadikoy Florence Nightingale Hospital, Department of Pathology, Istanbul, Turkey
| | - Esra Tozan Bayrak
- Istanbul Medeniyet University Medical Faculty, Department of Radiology, Istanbul, Turkey
| | - Turkan Ozturk
- Istanbul GOP Hospital, Department of Medical Oncology, Istanbul, Turkey
| | - Gurhan Bas
- Istanbul Medeniyet University Medical Faculty, Department of General Surgery, Istanbul, Turkey
| | - Orhan Alimoglu
- Istanbul Medeniyet University Medical Faculty, Department of General Surgery, Istanbul, Turkey
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14
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Leblebici M, Erol CI, Ekinci O, Eren T, Alimoglu O. Gastric Glomus Tumor: Report of a Case. BANGLADESH JOURNAL OF MEDICAL SCIENCE 2021. [DOI: 10.3329/bjms.v20i3.52813] [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: 11/05/2022] Open
Abstract
Abstract not available
Bangladesh Journal of Medical Science Vol.20(3) 2021 p.662-664
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15
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Alimoglu O, Colapkulu N. Global surgery: Improving health in low-income countries. Bangladesh J Med Sci 2021. [DOI: 10.3329/bjms.v20i3.52789] [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: 11/05/2022] Open
Abstract
The aim of this report is to examine the definition of global surgery, discuss the problems and propose some suggestions. Global surgery aims to improve the surgical conditions to maintain a standard and equal surgical care, especially in low- and middle-income countries where burden of surgical diseases are increasing over the years. According to Lancet Commission on Global Surgery, 1.27 million more surgical healthcare workers will be required to provide minimal surgical workforce, by 2030. In resource-limited settings of the world-wide where medical education and post-graduation training programs are disrupted due to brain drain, instable conditions and economic reasons, sustaining a standard and accessible surgical care are possible by training surgeons.
Bangladesh Journal of Medical Science Vol.20(3) 2021 p.483-486
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16
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Uranues S, Fingerhut A, Belyaev O, Zerbi A, Boggi U, Hoffmann MW, Reim D, Esposito A, Primavesi F, Kornprat P, Coppola R, Fragulidis GP, Serradilla-Martin M, Alimoglu O, Peri A, Diaconescu B. Clinical Impact of Stump Closure Reinforced With Hemopatch on the Prevention of Clinically Relevant Pancreatic Fistula After Distal Pancreatectomy: A Multicenter Randomized Trial. Ann Surg Open 2021; 2:e033. [PMID: 37638240 PMCID: PMC10455066 DOI: 10.1097/as9.0000000000000033] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/24/2020] [Accepted: 12/24/2020] [Indexed: 01/02/2023] Open
Abstract
Introduction Postoperative pancreatic fistula (POPF) is the most dreaded complication after distal pancreatectomy (DP). This multicenter randomized trial evaluated the efficacy, safety, and tolerance of Hemopatch in preventing clinically relevant (grades B/C according to the ISGPS classification) POPF after DP. Material and methods After stump closure, patients were randomized to affix Hemopatch to the stump or not. Statistical significance was set at 0.025. Clinical significance was defined as the number of patients needed to treat (NNT) to avoid 1 B/C POPF. Results Of 631 eligible patients, 360 were randomized and 315 analyzed per protocol (155 in the standard closure group; 160 in the Hemopatch group). The rates of B/C POPF (the primary endpoint) were 23.2% and 16.3% (P = 0.120), while the number of patients with 1 or more complications (including patients with B/C POPF) was 34.8% and 24.4% (P = 0.049) in the standard and Hemopatch groups, respectively. In patients with hand-sewn stump and main duct closure, the rates were 26.2% versus 10.0% (P = 0.014) and 23.3% versus 7.7% (P = 0.015) in the standard and Hemopatch groups, respectively. The NNT in these 2 subgroups was 6 and 6.4, respectively. Conclusion The results of the first randomized trial evaluating Hemopatch-reinforced pancreatic stump after DP to prevent type B/C POPF do not allow us to conclude that the risk of B/C POPF was lower. Based on the NNT, however, routine use of Hemopatch after DP may result in fewer complications (including POPF) overall, especially in cases with hand-sewn closure of the pancreatic stump or main pancreatic duct.
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Affiliation(s)
- Selman Uranues
- From the Section for Surgical Research, Department of Surgery, Medical University of Graz, Graz, Austria
| | - Abraham Fingerhut
- From the Section for Surgical Research, Department of Surgery, Medical University of Graz, Graz, Austria
- Department of General Surgery, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai Minimally Invasive Surgery Center, Shanghai, P. R. China
| | - Orlin Belyaev
- Klinik für Allgemein- und Viszeralchirurgie St. Josef-Hospital, Bochum, Germany
| | - Alessandro Zerbi
- Pancreatic Surgery Unit, Humanitas Clinical and Research Center-IRCCS, Rozzano (MI), Italy Humanitas University, Pieve Emanuele (MI), Italy
| | - Ugo Boggi
- Division of General and Transplant Surgery, University of Pisa, Pisa, Italy
| | - Matthias W. Hoffmann
- Department of General and Visceral Surgery, Raphaelsklinik Münster, Münster, Germany
| | - Daniel Reim
- Klinik und Poliklinik für Chirurgie, Klinikum Rechts der Isar, Technische Universität München, München, Germany
| | - Alessandro Esposito
- Department of General and Pancreatic Surgery—Pancreas Institute, University of Verona, Verona Hospital Trust, Verona, Italy
| | - Florian Primavesi
- Department of Visceral, Transplant and Thoracic Surgery, Medical University of Innsbruck, Innsbruck, Austria
- Department of Surgery, Salzkammergut-Klinikum, Vöcklabruck, Austria
| | - Peter Kornprat
- Clinical Division of General, Visceral and Transplantation Surgery, Medical University of Graz, Austria
| | - Roberto Coppola
- Department of Surgery, Campus Bio-Medico University of Rome, Rome, Italy
| | - Georgio P. Fragulidis
- 2nd Department of Surgery “Aretaieio” Hospital, National and Kapodistrian University of Athens School of Medicine, Athens, Greece
| | - Mario Serradilla-Martin
- Department of Surgery, Instituto de Investigación Sanitaria Aragón, Miguel Servet University Hospital, Zaragoza, Spain
| | - Orhan Alimoglu
- Department of General Surgery, Faculty of Medicine, Istanbul Medeniyet University Goztepe Training & Research Hospital, Istanbul, Turkey
| | - Andrea Peri
- General Surgery, Fondazione IRCCS Policlinico San Matteo, Pavia, Italy
| | - Bogdan Diaconescu
- Anatomy Department, Carol Davila University of Medicine and Pharmacy, Bucharest, Romania
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Yuksekdag S, Bas G, Okan I, Karakelleoglu A, Alimoglu O, Akcakaya A, Sahin M. Timing of laparoscopic cholecystectomy in acute cholecystitis. Niger J Clin Pract 2021; 24:156-160. [PMID: 33605903 DOI: 10.4103/njcp.njcp_138_20] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
Background Timing of laparoscopic cholecystectomy (LC) in acute cholecystitis (AC) is still debated. Aims The aim of this study was to investigate the effect of timing on operative results; from the first appearance of symptoms to the operation. Methods The study included 57 sequential patients operated laparoscopically for AC. Patients operated within the first 3 days of admission (Group 1), those operated between 4th and 7th days (Group 2) and those operated after 7th day (Group 3) were evaluated and compared with respect to demographics, time from admission to operation, duration of operation, adhesion score, complications, conversion rates, duration of hospital stay, morbidity and mortality rates, bile culture results, and histopathological evaluation. Results A total of 63% of the patients were female and 21 (37%) were male. The mean age was 48 years (range, 21-74). There was no significant difference among the groups with respect to demographics (P > 0.05, for each). The duration of operation was significantly shorter in Group 1 than both Groups 2 and 3 (P < 0.05 and P < 0.001, respectively). Duration of operation was also significantly shorter in Group 2 than Group 3 (P < 0.001). Group 1 had significantly fewer adhesions compared to Group 2 and Group 3 (P < 0.05 and P < 0.001, respectively), and no significant difference was found between Group 2 and Group 3 (P > 0.05). Duration of hospital stay was significantly shorter in Group 1 compared to Group 2 and Group 3 (P < 0.001) and also was significantly shorter in Group 2 than Group 3 (P < 0.05). Group 1 had significantly lower rate of culture proliferation than Group 3 (P < 0.001), whereas no significant differences were evident in other inter-group analyses (P > 0.05, for each). Conclusion LC can safely be performed within 7 days of admission in cases of AC.
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Affiliation(s)
- S Yuksekdag
- Department of General Surgery, Bezmialem Vakıf University, Medical Faculty, Istanbul, Turkey
| | - G Bas
- Department of General Surgery, Bezmialem Vakıf University, Medical Faculty, Istanbul, Turkey
| | - I Okan
- Department of General Surgery, Bezmialem Vakıf University, Medical Faculty, Istanbul, Turkey
| | - A Karakelleoglu
- Department of General Surgery, Bezmialem Vakıf University, Medical Faculty, Istanbul, Turkey
| | - O Alimoglu
- Department of General Surgery, Bezmialem Vakıf University, Medical Faculty, Istanbul, Turkey
| | - A Akcakaya
- Department of General Surgery, Bezmialem Vakıf University, Medical Faculty, Istanbul, Turkey
| | - M Sahin
- Department of General Surgery, Bezmialem Vakıf University, Medical Faculty, Istanbul, Turkey
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18
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Okur O, Sagiroglu J, Kir G, Bulut N, Alimoglu O. Diagnostic accuracy of sentinel lymph node biopsy in determining the axillary lymph node metastasis. J Cancer Res Ther 2021; 16:1265-1268. [PMID: 33342782 DOI: 10.4103/jcrt.jcrt_1122_19] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
Background Sentinel lymph node biopsy (SLNB) is accepted as the standard procedure to determine the axillary lymph node metastasis in breast cancer at early stage. However, in many cases with sentinel lymph node positivity, the axilla does not contain any tumor cells. As a result, the accuracy of SLNB to predict axillary lymph node metastasis must be evaluated. Patients and Methods Thousand hundred and fourteen women operated for breast cancer were retrospectively examined. Breast cancer patients without axillary metastasis on clinical examination who had undergone SLNB were included in the study. Sentinel lymph node positivity and axillary lymph node positivity were compared. Results Among 1114 women operated for breast cancer, 230 were clinically node negative preoperatively and undergone SLNB. Eighty-three (36%) of the patients were SLNB positive and undergone axillary dissection. Forty-three (51.8%) of them had tumor positive axillary lymph nodes and 40 (48.2%) of them had tumor negative axillary lymph nodes. Interpretation In 48.2% of the patients, positive sentinel lymph node does not demonstrate a positive axilla. This finding supports sparing axillary dissection in patients with favorable prognostic factors even if the sentinel lymph node is found to be positive. Conclusion Axillary lymph node dissection(ALND) may be spared even if there are macrometastatic sentinel lymph nodes in patients with favorable tumor types who will undergo breast-conserving surgery.
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Affiliation(s)
- Ozlem Okur
- Department of General Surgery, Goztepe Education and Research Hospital, Istanbul Medeniyet University, Istanbul, Turkey
| | - Julide Sagiroglu
- Department of General Surgery, Goztepe Education and Research Hospital, Istanbul Medeniyet University, Istanbul, Turkey
| | - Gozde Kir
- Department of Pathology, Goztepe Education and Research Hospital, Istanbul Medeniyet University, Istanbul, Turkey
| | - Nurgul Bulut
- Department of Biostatistics and Medical Informatics, Istanbul Medeniyet University, Istanbul, Turkey
| | - Orhan Alimoglu
- Department of General Surgery, Goztepe Education and Research Hospital, Istanbul Medeniyet University, Istanbul, Turkey
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19
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Halbony H, Salman K, Alqassieh A, Albrezat M, Hamdan A, Abualhaija’a A, Alsaeidi O, Masad Melhem J, Sagiroglu J, Alimoglu O. Breast cancer epidemiology among surgically treated patients in Jordan: A retrospective study. Med J Islam Repub Iran 2020. [DOI: 10.47176/mjiri.34.73] [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: 11/09/2022] Open
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20
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Alimoglu O, Erol CI, Kayali A, Acar M, Colapkulu N, Leblebici M, Ekinci O. Emergency Surgery During COVID-19 Pandemic; What Has Changed in Practice? Br J Surg 2020; 107:e581-e582. [PMID: 32924150 PMCID: PMC7929338 DOI: 10.1002/bjs.11979] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/22/2020] [Accepted: 07/14/2020] [Indexed: 12/03/2022]
Affiliation(s)
- Orhan Alimoglu
- Department of General Surgery, Istanbul Medeniyet University, Faculty of Medicine, Goztepe Training and Research Hospital, Istanbul, Turkey
| | - Cem Ilgin Erol
- Department of General Surgery, Istanbul Medeniyet University, Faculty of Medicine, Goztepe Training and Research Hospital, Istanbul, Turkey
| | - Abdullah Kayali
- Department of General Surgery, Istanbul Medeniyet University, Faculty of Medicine, Goztepe Training and Research Hospital, Istanbul, Turkey
| | - Mehmet Acar
- Department of General Surgery, Istanbul Medeniyet University, Faculty of Medicine, Goztepe Training and Research Hospital, Istanbul, Turkey
| | - Nuray Colapkulu
- Department of General Surgery, Istanbul Medeniyet University, Faculty of Medicine, Goztepe Training and Research Hospital, Istanbul, Turkey
| | - Metin Leblebici
- Department of General Surgery, Istanbul Medeniyet University, Faculty of Medicine, Goztepe Training and Research Hospital, Istanbul, Turkey
| | - Ozgur Ekinci
- Department of General Surgery, Istanbul Medeniyet University, Faculty of Medicine, Goztepe Training and Research Hospital, Istanbul, Turkey
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21
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Halbony H, Salman K, Alqassieh A, Albrezat M, Hamdan A, Abualhaija'a A, Alsaeidi O, Masad Melhem J, Sagiroglu J, Alimoglu O. Breast cancer epidemiology among surgically treated patients in Jordan: A retrospective study. Med J Islam Repub Iran 2020; 34:73. [PMID: 33306068 PMCID: PMC7711030 DOI: 10.34171/mjiri.34.73] [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] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2019] [Indexed: 11/09/2022] Open
Abstract
Background: Multiple risk factors contribute to the development of breast cancer, including age, positive family history, early menarche, late menopause and the strongest factor being female gender. In this study, we aimed to investigate the proportion of breast cancer patients with certain risk factors, the prevalence of each cancer type, in addition to the surgical procedures performed.
Methods: The medical records of patients diagnosed with breast cancer from January 2010 to November 2015 were evaluated retrospectively regarding demographics, breast cancer risk factors, comorbidities, diagnostic methods, tumor location, cancer type and stage, pathological findings, tumor markers, harvested lymph nodes and the types of surgical procedures. The collected data were statistically analyzed as number, mean, and frequency as percentages. Cases with deficient medical records were excluded from the analysis of certain parameters.
Results: The sample consisted of 120 patients, 118 (98.3%) of whom were women. The mean age was 56.5±12.0 years. The most common diagnostic method at presentation was self-exam in 93.3% of patients. Invasive ductal carcinoma was the most common type of tumor (80.0%). The pathological stages could be determined for only 106 patients, and 26 patients (24.5%) were at stage 1 disease, 45 patients (42.5%) were at stage 2 whereas 34 patients (32.1%) were at stage 3. According to the results of pathological examinations, 72.6% (85 patients) of the cases were estrogen receptor positive, 61.2% (71 patients) were progesterone receptor positive while 24.8% (27 patients) were HER positive. Modified radical mastectomy (MRM) was performed in 52 (43.3%) patients and wide local excision (WLE) was preferred in 46 (38.3%) cases.
Conclusion: Advanced age, positive family history, and prolonged estrogen exposure were remarkable in the majority of patients. Moreover, the most common type of breast cancer was invasive ductal carcinoma, and around half of the patients presented at stage 2 disease. Modified radical mastectomy and WLE were the most commonly performed surgical procedures.
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Affiliation(s)
- Hala Halbony
- University of Jordan, Faculty of Medicine, Amman, Jordan
| | - Khadija Salman
- University of Jordan, General Surgery Department, Amman, Jordan
| | - Ahmad Alqassieh
- University of Jordan, General Surgery Department, Amman, Jordan
| | - Mutaz Albrezat
- University of Jordan, General Surgery Department, Amman, Jordan
| | - Ahmad Hamdan
- Istanbul Medeniyet University, Goztepe Research and Training Hospital, General Surgery Department, Istanbul, Turkey
| | - Ali Abualhaija'a
- Istanbul Medeniyet University, Goztepe Research and Training Hospital, General Surgery Department, Istanbul, Turkey
| | - Omar Alsaeidi
- Istanbul Medeniyet University, Goztepe Research and Training Hospital, General Surgery Department, Istanbul, Turkey
| | | | - Julide Sagiroglu
- Istanbul Medeniyet University, Goztepe Research and Training Hospital, General Surgery Department, Istanbul, Turkey
| | - Orhan Alimoglu
- University of Jordan, General Surgery Department, Amman, Jordan
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Alimoglu O. An invited commentary on "use of vital signs in predicting surgical intervention in a South African population: A cross-sectional study". Int J Surg 2020; 79:305-306. [PMID: 32534146 DOI: 10.1016/j.ijsu.2020.05.096] [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] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2020] [Accepted: 05/28/2020] [Indexed: 11/19/2022]
Affiliation(s)
- Orhan Alimoglu
- Department of General Surgery, Faculty of Medicine, Istanbul Medeniyet University, Goztepe Training & Research Hospital, Kadikoy, 34722, Istanbul, Turkey.
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Alimoglu O, Dilek HF, Tonyali M, Eren T. Do all detected thyroid cancers correspond to 'real cancer'? Br J Surg 2020; 107:e276. [PMID: 32449153 DOI: 10.1002/bjs.11658] [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] [Received: 04/03/2020] [Accepted: 04/06/2020] [Indexed: 12/24/2022]
Affiliation(s)
- O Alimoglu
- Department of General Surgery, Faculty of Medicine, Istanbul, Turkey
| | - H F Dilek
- Faculty of Medicine, Istanbul Medeniyet University, Istanbul, Turkey
| | - M Tonyali
- Faculty of Medicine, Istanbul Medeniyet University, Istanbul, Turkey
| | - T Eren
- Department of General Surgery, Faculty of Medicine, Istanbul, Turkey
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Abstract
The coronavirus disease (Covid-19), which has spread rapidly all over the world after its appearance in December 2019, soon became a pandemic. In many places struck by the epidemic, clinical branches have prepared new guidelines for approaching the management of the disease in their area during the pandemic. Surgeons have also delayed elective surgeries. The first case of Covid-19 in Turkey was detected on March 10, 2020. After this date, 39 patients with a diagnosis of cancer were operated on in our clinic. In this study, we wanted to reveal the results of the cancer surgeries that we have performed during this period.
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Affiliation(s)
- Orhan Alimoglu
- Department of General Surgery, Istanbul Medeniyet University, Faculty of Medicine, Goztepe Training & Research Hospital, Istanbul, Turkey.
| | - Cem Ilgin Erol
- Department of General Surgery, Istanbul Medeniyet University, Faculty of Medicine, Goztepe Training & Research Hospital, Istanbul, Turkey
| | - Furkan Kilic
- Department of General Surgery, Istanbul Medeniyet University, Faculty of Medicine, Goztepe Training & Research Hospital, Istanbul, Turkey
| | - Hakan Baysal
- Department of General Surgery, Istanbul Medeniyet University, Faculty of Medicine, Goztepe Training & Research Hospital, Istanbul, Turkey
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25
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Ekinci O, Eren T, Kurtoglu Yakici M, Gapbarov A, Aydemir MA, Saglam ZA, Alimoglu O. Relationship Between Metabolic Syndrome and Postmenopausal Breast Cancer. Cir Esp 2020; 98:540-546. [PMID: 32197778 DOI: 10.1016/j.ciresp.2019.12.015] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/03/2019] [Revised: 12/24/2019] [Accepted: 12/30/2019] [Indexed: 11/28/2022]
Abstract
INTRODUCTION Metabolic syndrome is associated with an increased risk of diabetes mellitus (DM) and coronary heart disease. It may also be associated with a higher risk of some common cancers. The objective of this study was to determine the relationship between metabolic syndrome and breast cancer in postmenopausal women. METHODS We present a prospective cohort study of postmenopausal women. This cohort was divided into two groups: the «benign diagnosis group», including women who were studied after breast cancer screening; and the «malignant tumor group», including patients with breast cancer that had been diagnosed by biopsy. Age, weight, height, body mass index (BMI), abdominal perimeter, serum glucose, LDL, HDL and insulin levels were analyzed as variables under study. The HOMA-IR homeostatic model formula was used to assess insulin resistance. The differences were considered statistically significant when P<.05. RESULTS Two hundred women with a mean age of 61.5±9.6 (range: 37-93) were enrolled in the study, consisting of 150 (75%) patients with a benign diagnosis and 50 (25%) patients with a malignant tumor. BMI and abdominal perimeter were higher in the group with a malignant tumor (P<.05). The incidence of DM and metabolic syndrome was higher in the malignant tumor group (P<.005). In the malignant tumor group, much higher incidences correlated with fasting glycemic levels >100mg/dL, insulin levels >10mIU/L and HOMA-IR scores >2.7 (P<.05). CONCLUSIONS There is a relationship between metabolic syndrome and postmenopausal breast cancer. More studies are needed to establish methods for the prevention of breast cancer in women with metabolic syndrome.
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Affiliation(s)
- Ozgur Ekinci
- Departamento de Cirugía General, Facultad de Medicina, Istanbul Medeniyet Üniversitesi, Estambul, Turquía
| | - Tunc Eren
- Departamento de Cirugía General, Facultad de Medicina, Istanbul Medeniyet Üniversitesi, Estambul, Turquía.
| | - Melike Kurtoglu Yakici
- Departamento de Medicina Familiar, Facultad de Medicina, Istanbul Medeniyet Üniversitesi, Estambul, Turquía
| | - Aman Gapbarov
- Departamento de Cirugía General, Facultad de Medicina, Istanbul Medeniyet Üniversitesi, Estambul, Turquía
| | - Muhammet Ali Aydemir
- Departamento de Cirugía General, Facultad de Medicina, Istanbul Medeniyet Üniversitesi, Estambul, Turquía
| | - Zuhal Aydan Saglam
- Departamento de Medicina Familiar, Facultad de Medicina, Istanbul Medeniyet Üniversitesi, Estambul, Turquía
| | - Orhan Alimoglu
- Departamento de Cirugía General, Facultad de Medicina, Istanbul Medeniyet Üniversitesi, Estambul, Turquía
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Seneldir H, Kir G, Soylemez T, Girgin RB, Ozbay N, Ozen F, Ankarali H, Bas G, Alimoglu O. Diagnostic accuracy of molecular testing with three molecular markers on thyroid fine-needle aspiration cytology with abnormal category. Diagn Cytopathol 2020; 48:507-515. [PMID: 32031330 DOI: 10.1002/dc.24394] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2019] [Revised: 01/12/2020] [Accepted: 01/30/2020] [Indexed: 12/29/2022]
Abstract
BACKGROUND Cases with abnormal category, determined by thyroid fine-needle aspiration (FNA), frequently undergo surgical resection, despite the majority of cases being identified as benign after resection. Additional diagnostic markers are needed to guide the management of patients with abnormal thyroid nodules. MATERIALS AND METHODS The retrospective study enrolled 150 cases diagnosed abnormal by FNA cytology that had undergone molecular testing with three markers (BRAF V600E, NRAS, and KRAS) on the cell block. Seventy-one cases had a surgical follow-up. RESULTS When NIFTP is not considered as malignant, positive predictive values (PPVs) of cytology and combined cytology and molecular testing (CC-MT) were 67.6% (95% CI: 0.555-0.782) and 89.2% (95% CI: 0.746-0.970) (P = .004), respectively. The sensitivity of the CC-MT was 68.8%, specificity was 82.5%, and the false-positive rate was 17.4%. When NIFTP is considered as malignant, PPVs of cytology and CC-MT were 83.1% (95% CI: 0.743-0.918) and 94.6% (95% CI: 0.873-1.018) (P = .047), respectively. The sensitivity of the CC-MT was 59.3%, specificity was 83.3%, and the false-positive rate was 16.7%. CONCLUSION The addition of molecular testing with a small panel to FNA cytology may increase the PPV of cytology in abnormal categories. Small panel (BRAF V600E, KRAS, and NRAS) with high specificity and high PPVs may be used particularly for the detection of thyroid malignancy. Cell blocks can be an especially useful and straightforward method for molecular diagnostic studies.
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Affiliation(s)
- Hatice Seneldir
- Department of Pathology, Goztepe Research and Training Hospital, Istanbul Medeniyet University, Istanbul, Turkey
| | - Gozde Kir
- Department of Pathology, Goztepe Research and Training Hospital, Istanbul Medeniyet University, Istanbul, Turkey
| | - Tuce Soylemez
- Department of Pathology, Goztepe Research and Training Hospital, Istanbul Medeniyet University, Istanbul, Turkey
| | - Rabia B Girgin
- Department of Pathology, Goztepe Research and Training Hospital, Istanbul Medeniyet University, Istanbul, Turkey
| | - Nurver Ozbay
- Department of Pathology, Goztepe Research and Training Hospital, Istanbul Medeniyet University, Istanbul, Turkey
| | - Filiz Ozen
- Department of Medical Genetics, Istanbul Medeniyet University, Istanbul, Turkey
| | - Handan Ankarali
- Department of Biostatistics and Medical Informatics, Istanbul Medeniyet University, Istanbul, Turkey
| | - Gurhan Bas
- Department of General Surgery, Goztepe Research and Training Hospital, Istanbul Medeniyet University, Istanbul, Turkey
| | - Orhan Alimoglu
- Department of General Surgery, Goztepe Research and Training Hospital, Istanbul Medeniyet University, Istanbul, Turkey
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Sagiroglu J, Ozdemir T, Gapbarov A, Duman E, Kir G, Sermet M, Ekinci O, Alimoglu O. Subtotal cholecystectomy for "difficult gallbladder": pearls and pitfalls. Chirurgia (Bucur) 2020. [DOI: 10.23736/s0394-9508.18.04902-1] [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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Tosun S, Yener O, Ekinci O, Gapbarov A, Asik M, Eren T, Alimoglu O. Percutaneous Cholecystostomy as an Alternative to Cholecystectomy in High-Risk Patients with Acute Cholecystitis. AJTES 2019. [DOI: 10.32391/ajtes.v3i2.39] [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: 11/24/2022] Open
Abstract
Background: Cholecystectomy is the standard treatment for patients with acute cholecystitis. On the other hand, percutaneous cholecystostomy (PC) is an alternative for patients at high-risk for surgery. The aim of this study was to evaluate the clinical outcomes of PC.
Methods: Surgically high-risk patients with acute cholecystits having undergone PC at our institution between January 2014 – January 2017 were evaluated. Data including the indications for PC, route of insertion, technical success, clinical improvement, length of hospital stay, mortality rates, procedure related complications, subsequent admissions and performance of interval cholecystectomy were recorded and analyzed.
Results: The study group consisted of 30 patients with a mean age of 75.3 ( range: 49–99) years. The indications for PC were acute calculous cholecystitis in 28 (93.3%) and acalculous cholecystitis in 2 (6.7%) patients. All procedures were performed via the transhepatic route. Twenty-five PCs (84.4%) resulted in clinical improvement within five days. A repeated PC was performed in two (6.7%) patients. Seven (23.3%) patients underwent a subsequent cholecystectomy after 6 weeks. An emergent cholecystectomy was performed in one (3.3%) patient. Five (16.7%) patients died from underlying comorbid diseases, unrelated to the biliary system, during the follow-up.
Conclusions: Patients with acute cholecystitis were promptly relieved from their symptoms following PC. There were only minor complications following the procedure and an interval cholecystectomy was necessary in only 23.3% of the patients. PC is a safe alternative to choecystectomy in high-risk patients with acute cholecystitis with satisfactory results.
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Ekinci O, Boluk SE, Eren T, Ozemir IA, Boluk S, Salmaslioglu A, Leblebici M, Alimoglu O. Diffusion-weighted magnetic resonance imaging for the detection of thyroid cancer. Cir Esp 2018; 96:620-626. [PMID: 30224220 DOI: 10.1016/j.ciresp.2018.04.016] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [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: 03/07/2018] [Revised: 04/26/2018] [Accepted: 04/26/2018] [Indexed: 11/19/2022]
Abstract
BACKGROUND Nodular thyroid disease possesses the potential to harbor malignancy. Our aim was to evaluate the significance of cervical diffusion-weighted magnetic resonance imaging (DW-MRI) for the detection of malignant thyroid nodules. METHODS Sixty-five thyroid nodules from 58 patients who had undergone surgery were evaluated. Preoperative parameters, demographic data, ultrasound findings, fine-needle aspiration biopsy results and apparent diffusion coefficient (ADC) values of the nodules at DW-MRI were compared with the results from postoperative pathology examinations. RESULTS The "benign group" included 50 (76.9%) nodules, while 15 (23.1%) nodules constituted the "malignancy group". Minimum, maximum and mean ADC values of the nodules were significantly lower in the malignancy group (p < 0.05). The best cutoff value for the mean ADC value was 1.33 × 10-3 mm2/s, with a sensitivity of 66.67%, a specifity of 89.13%, a positive predictive value of 53.63% and a negative predictive value of 89.13%. A mean ADC value equal to or lower than 1.33 × 10-3 mm2/s was associated with 9 times higher risk of malignancy (odds ratio: 9.111, 95% confidence interval: 2.49-33.21). CONCLUSIONS The ADC value detected by cervical DW-MRI can be considered a predictive parameter for the detection of thyroid cancer.
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Affiliation(s)
- Ozgur Ekinci
- Universidad de Estambul Medeniyet, Facultad de Medicina, Departamento de Cirugía General, Estambul, Turquía
| | - Sumeyra Emine Boluk
- Universidad de Estambul Medeniyet, Facultad de Medicina, Departamento de Cirugía General, Estambul, Turquía
| | - Tunc Eren
- Universidad de Estambul Medeniyet, Facultad de Medicina, Departamento de Cirugía General, Estambul, Turquía.
| | - Ibrahim Ali Ozemir
- Universidad de Estambul Medeniyet, Facultad de Medicina, Departamento de Cirugía General, Estambul, Turquía
| | - Salih Boluk
- Universidad de Estambul Medeniyet, Facultad de Medicina, Departamento de Cirugía General, Estambul, Turquía
| | - Artur Salmaslioglu
- Universidad de Estambul, Facultad de Medicina de Estambul, Departamento de Radiología, Estambul, Turquía
| | - Metin Leblebici
- Universidad de Estambul Medeniyet, Facultad de Medicina, Departamento de Cirugía General, Estambul, Turquía
| | - Orhan Alimoglu
- Universidad de Estambul Medeniyet, Facultad de Medicina, Departamento de Cirugía General, Estambul, Turquía
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Ekinci O, Burcu B, Eren T, Ozemir IA, Leblebici M, Yildiz G, Isbilen B, Alimoglu O. Protective effects of thymoquinone on the healing process of experimental left colonic anastomosis. J Surg Res 2018; 231:210-216. [PMID: 30278931 DOI: 10.1016/j.jss.2018.05.044] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/31/2017] [Revised: 05/12/2018] [Accepted: 05/23/2018] [Indexed: 02/07/2023]
Abstract
PURPOSE Colorectal cancer is globally the third most common cancer. Anastomotic complications remain to be an important issue for colorectal surgery. The aim of this study was to investigate the protective effects of thymoquinone (TQ) on the healing process of left colonic anastomosis in an experimental model. METHODS Thirty-two male rats were divided into two groups, as the TQ group and the control group. TQ was administered to the TQ group, whereas the control group was given a standard feed and water for 2 wk. Following the creation of a left colonic anastomosis, subjects in both groups were sacrificed on the postoperative (PO) third and seventh days. Anastomotic burst pressures were measured mechanically. Immunohistochemical stainings for proliferating cell nuclear antigen, cluster of differentiation (CD) 31, CD45 were performed, and the matrix metalloproteinase-2 levels were measured. Histologic total scores were calculated according to Ehrlich-Hunt model. A value of P < 0.05 was considered as statistically significant. RESULTS One rat in the control group that died on the PO fourth day was excluded. Anastomotic burst pressures on the PO seventh day were higher in the TQ group than the control group (P < 0.01). Histopathological total scores on the PO third and seventh days were higher in the TQ group (P < 0.01). In addition, the TQ group revealed lower matrix metalloproteinase-2 scores on the PO third day and higher hydroxyproline levels on the PO seventh day (P < 0.05 and P < 0.01, respectively). CONCLUSIONS The use of TQ in colorectal surgery cases with left-sided colonic anastomosis resulted with increased anastomotic burst pressures and increased tissue hydroxyproline levels.
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Affiliation(s)
- Ozgur Ekinci
- Department of General Surgery, Istanbul Medeniyet University, School of Medicine, Istanbul, Turkey
| | - Busra Burcu
- Department of General Surgery, Istanbul Medeniyet University, School of Medicine, Istanbul, Turkey
| | - Tunc Eren
- Department of General Surgery, Istanbul Medeniyet University, School of Medicine, Istanbul, Turkey.
| | - Ibrahim Ali Ozemir
- Department of General Surgery, Istanbul Medeniyet University, School of Medicine, Istanbul, Turkey
| | - Metin Leblebici
- Department of General Surgery, Istanbul Medeniyet University, School of Medicine, Istanbul, Turkey
| | - Gorkem Yildiz
- Department of General Surgery, Istanbul Medeniyet University, School of Medicine, Istanbul, Turkey
| | - Banu Isbilen
- Department of Biochemistry, Istanbul Medeniyet University, School of Medicine, Istanbul, Turkey
| | - Orhan Alimoglu
- Department of General Surgery, Istanbul Medeniyet University, School of Medicine, Istanbul, Turkey
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Kaya M, Basak F, Sisik A, Hasbahceci M, Bas G, Alimoglu O, Topal CS, Kir G. Validation of microsatellite instability histology scores with Bethesda guidelines in hereditary nonpolyposis colorectal cancer. J Cancer Res Ther 2018. [PMID: 28643760 DOI: 10.4103/0973-1482.174558] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
AIMS Hereditary nonpolyposis colorectal cancer (HNPCC) is a subgroup of colorectal cancer (CRC) which should be differentiated because of the high risk for additional cancers and risk evaluation for other family members, especially for CRC. It is not practical to perform genetic testing for all CRC patients; therefore, various prediction modalities, for example, Bethesda guideline (BG) were studied in the literature. We aimed to assess the association of microsatellite instability (MSI), histology scores, and BG for predicting HNPCC risk. SUBJECTS AND METHODS Data were collected from CRC patients between 2009 and 2012. A total of 127 patients were retrospectively reviewed for BG status and the MSI scores, MsPath, and PathScore. STATISTICAL ANALYSIS USED Definitive statistical methods (mean, standard deviation, median, frequency, and percentage) were used to evaluate the study data. Comparison used Student's t-test, Continuity (Yates) correction, Fisher-Freeman-Halton test, Pearson correlation, and receiver operating characteristics curve analysis. RESULTS Patients who were detected as Bethesda-positive had significantly higher MsPath and PathScore scores (P = 0.001 and P = 0.007, respectively). According to the cut-off value of 2.8 and 2.9 for MsPath and PathScore, respectively, sensitivity, specificity, positive predictive value, negative predictive value, and accuracy were 90%, 43%, 22.8%, 95.8%, and 50.4% for MsPath, and 55%, 83.2%, 37.9%, 90.8%, and 78.7% for PathScore, respectively. CONCLUSIONS The MSI scoring systems, MsPath, and PathScore, are reliable systems and effectively correlated with BG for predicting patients who need advanced analysis techniques because of the risk of HNPCC.
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Affiliation(s)
- Mustafa Kaya
- Department of General Surgery, Umraniye Education and Research Hospital, Istanbul, Turkey
| | - Fatih Basak
- Department of General Surgery, Umraniye Education and Research Hospital, Istanbul, Turkey
| | - Abdullah Sisik
- Department of General Surgery, Umraniye Education and Research Hospital, Istanbul, Turkey
| | - Mustafa Hasbahceci
- Department of General Surgery, Faculty of Medicine, Bezmialem Vakif University, Istanbul, Turkey
| | - Gurhan Bas
- Department of General Surgery, Umraniye Education and Research Hospital, Istanbul, Turkey
| | - Orhan Alimoglu
- Department of General Surgery, Goztepe Education and Research Hospital, Medeniyet University, Istanbul, Turkey
| | - Cumhur Selçuk Topal
- Department of Pathology, Umraniye Education and Research Hospital, Istanbul, Turkey
| | - Gozde Kir
- Department of Pathology, Umraniye Education and Research Hospital, Istanbul, Turkey
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Kalcan S, Sisik A, Basak F, Hasbahceci M, Kilic A, Kosmaz K, Kivanc AE, Kudas I, Bas G, Alimoglu O. Evaluating factors affecting survival in colon and rectum cancer: A prospective cohort study with 161 patients. J Cancer Res Ther 2018. [PMID: 29516930 DOI: 10.4103/0973-1482.199390] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
Context Colorectal cancers are frequent among cancers of gastrointestinal system. Whether there are any differences between survival in rectum and colon cancer patients is controversial. Aims In this study, we aimed to compare survival in surgically treated rectum and colon cancers and determine the factors affecting survival. Subjects and Methods The patients with colon and rectum cancer operated between 2009 and 2013 were examined retrospectively using prospective database. Patients were categorized as colon and rectum according to the tumor's location. Survival was identified as the primary outcome. Kaplan-Meier survival analysis and log-rank tests in survival assessment were used. Results One hundred and sixty-one patients with a mean age of 62.8 ± 12.7 years were included in the study. Male/female ratio was 1.6. Colon and rectum patients were counted as 92 (%57.1) and 69 (%42.9), respectively. Both groups were similar in demographic data (P > 0.05). It was observed that in 46 months (mean) of follow-up, 39.7% (n: 64) died, and 60.3% (n: 97) survived. Median survival time was 79 months, and 5-year cumulative survival rate was 60.8%. Five-year cumulative survival rates in stages for 1, 2, 3 and 4 were 88.2%, 64.7%, 48.5%, and 37.0%, respectively. It was noted that median survival time for colon cancer was 78 months and for rectum cancer was 79 months. Five-year cumulative survival rates for colon and rectum cancers were calculated as 56.7% and 63.4%, respectively. There were no significant differences in colon and rectum cancers in the means of survival rate (P: 0.459). Conclusions While location of colorectal cancers shows no significant effect on survival, treatment in the early stages increases survival rate.
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Affiliation(s)
- Suleyman Kalcan
- Department of General Surgery, Health Science University, Umraniye Education and Research Hospital, Istanbul, Turkey
| | - Abdullah Sisik
- Department of General Surgery, Health Science University, Umraniye Education and Research Hospital, Istanbul, Turkey
| | - Fatih Basak
- Department of General Surgery, Health Science University, Umraniye Education and Research Hospital, Istanbul, Turkey
| | - Mustafa Hasbahceci
- Department of General Surgery, Faculty of Medicine, Bezmialem Vakif University, Istanbul, Turkey
| | - Ali Kilic
- Department of General Surgery, Health Science University, Umraniye Education and Research Hospital, Istanbul, Turkey
| | - Koray Kosmaz
- Department of General Surgery, Health Science University, Umraniye Education and Research Hospital, Istanbul, Turkey
| | - Ali Ediz Kivanc
- Department of General Surgery, Health Science University, Umraniye Education and Research Hospital, Istanbul, Turkey
| | - Ilyas Kudas
- Department of General Surgery, Health Science University, Umraniye Education and Research Hospital, Istanbul, Turkey
| | - Gurhan Bas
- Department of General Surgery, Medeniyet University, Goztepe Education and Research Hospital, Istanbul, Turkey
| | - Orhan Alimoglu
- Department of General Surgery, Medeniyet University, Goztepe Education and Research Hospital, Istanbul, Turkey
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Mustafa Abualhayja'a A, Ankarali H, Alyacoub, R, Abudayeh A, Alsaoud, S, Majed Alsaeidi O, Alsmady M, Massad I, Alimoglu O. Sixth Class Students' Performance and Confidence Levels Before and After Training in Clinical Skills Laboratories. Int J Med Students 2017. [DOI: 10.5195/ijms.2017.170] [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: 11/20/2022] Open
Abstract
Background: Acquisition of basic clinical skills by undergraduate medical students is becoming of greater concern. Clinical skills laboratories may provide a comfortable environment for training and may allow students to gain adequate performance level. The aim of this study is to evaluate students' performance and confidence levels before and after training of selected procedural skills; also to explore students' expectation towards skills laboratory training. Methods: Two questionnaires were conducted before and after training sessions in the clinical skills laboratory, school of medicine, University of Jordan, Amman, Jordan. The skills selected for this study: suture practice, venous access, arterial access, intradermal and intramuscular injection, central venous cannulation, male and female urinary catheterization, nasogastric tube placement and rectal examination. Although fifty-seven 6th year medical students filled the first questionnaire at the beginning before training, only 29 students could attend all training sessions, and fill the second questionnaire. Results: For all trained clinical skills, the mean students' performance scores and confidence levels were significantly increased after training (P <0.001). Expectations of students for skills laboratory were high. Conclusions: The students' performance and confidence levels were significantly improved after training in the clinical skills laboratory.
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Parisi A, Reim D, Borghi F, Nguyen NT, Qi F, Coratti A, Cianchi F, Cesari M, Bazzocchi F, Alimoglu O, Gagnière J, Pernazza G, D’Imporzano S, Zhou YB, Azagra JS, Facy O, Brower ST, Jiang ZW, Zang L, Isik A, Gemini A, Trastulli S, Novotny A, Marano A, Liu T, Annecchiarico M, Badii B, Arcuri G, Avanzolini A, Leblebici M, Pezet D, Cao SG, Goergen M, Zhang S, Palazzini G, D’Andrea V, Desiderio J. Minimally invasive surgery for gastric cancer: A comparison between robotic, laparoscopic and open surgery. World J Gastroenterol 2017; 23:2376-2384. [PMID: 28428717 PMCID: PMC5385404 DOI: 10.3748/wjg.v23.i13.2376] [Citation(s) in RCA: 56] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/11/2016] [Revised: 01/23/2017] [Accepted: 03/15/2017] [Indexed: 02/06/2023] Open
Abstract
AIM To investigate the role of minimally invasive surgery for gastric cancer and determine surgical, clinical, and oncological outcomes.
METHODS This is a propensity score-matched case-control study, comparing three treatment arms: robotic gastrectomy (RG), laparoscopic gastrectomy (LG), open gastrectomy (OG). Data collection started after sharing a specific study protocol. Data were recorded through a tailored and protected web-based system. Primary outcomes: harvested lymph nodes, estimated blood loss, hospital stay, complications rate. Among the secondary outcomes, there are: operative time, R0 resections, POD of mobilization, POD of starting liquid diet and soft solid diet. The analysis includes the evaluation of type and grade of postoperative complications. Detailed information of anastomotic leakages is also provided.
RESULTS The present analysis was carried out of 1026 gastrectomies. To guarantee homogenous distribution of cases, patients in the RG, LG and OG groups were 1:1:2 matched using a propensity score analysis with a caliper = 0.2. The successful matching resulted in a total sample of 604 patients (RG = 151; LG = 151; OG = 302). The three groups showed no differences in all baseline patients characteristics, type of surgery (P = 0.42) and stage of the disease (P = 0.16). Intraoperative blood loss was significantly lower in the LG (95.93 ± 119.22) and RG (117.91 ± 68.11) groups compared to the OG (127.26 ± 79.50, P = 0.002). The mean number of retrieved lymph nodes was similar between the RG (27.78 ± 11.45), LG (24.58 ± 13.56) and OG (25.82 ± 12.07) approach. A benefit in favor of the minimally invasive approaches was found in the length of hospital stay (P < 0.0001). A similar complications rate was found (P = 0.13). The leakage rate was not different (P = 0.78) between groups.
CONCLUSION Laparoscopic and robotic surgery can be safely performed and proposed as possible alternative to open surgery. The main highlighted benefit is a faster postoperative functional recovery.
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Anilir E, Ozen F, Yildirim IH, Ozemir IA, Ozlu C, Alimoglu O. IL-8 gene polymorphism in acute biliary and non biliary pancreatitis: probable cause of high level parameters? Ann Hepatobiliary Pancreat Surg 2017; 21:30-38. [PMID: 28317043 PMCID: PMC5353913 DOI: 10.14701/ahbps.2017.21.1.30] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [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: 08/31/2016] [Revised: 01/19/2017] [Accepted: 01/20/2017] [Indexed: 02/06/2023] Open
Abstract
Backgrounds/Aims Inflammatory mediators of the innate immune response play fundamental roles in the pathogenesis of acute pancreatitis. The correlation between interleukin-8 (IL-8) gene polymorphism with types of acute pancreatitis and severity of pancreatitis, was evaluated in this study. Methods According to the diagnostic criteria, 176 patients with acute pancreatitis were grouped into biliary (n=83) and nonbiliary pancreatitis (n=93). Healthy blood donors (n=100) served as controls. Serum alanine transaminase, aspartate transaminase, total and direct bilirubin, amylase, lypase, white blood cell count and c-reactive protein levels were evaluated to correlate with IL-8 rs4073 (-251T/A) polymorphism, which was analyzed using a real-time polymerase chain reaction method with melting point analysis. Results The IL-8 AA genotype was detected with a significantly higher frequency among the patients with acute biliary pancreatitis having higher alanine transaminase levels than the median range. Homozygote alleles were significantly higher among patients with acute biliary pancreatitis having amylase levels higher than the median range. Conclusions Determination of the frequency of IL-8 polymorphism in acute pancreatitis is informative and provides further evidence concerning the role of IL-8 in laboratory tests.
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Affiliation(s)
- Ender Anilir
- Department of General Surgery, American Hospital of İstanbul, Turkey
| | - Filiz Ozen
- Medical Genetic Department, İstanbul Medeniyet University, Turkey
| | | | | | - Can Ozlu
- Hematology Depratment, İzmir Bozyaka Education and Research Hospital, İzmir, Turkey
| | - Orhan Alimoglu
- Department of General Surgery, İstanbul Medeniyet University, Turkey
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Ozemir IA, Aslan S, Eren T, Bayraktar B, Bilgic C, Isbilen B, Yalman H, Yigitbasi R, Alimoglu O. The Diagnostic and Prognostic Significance of Serum Neutrophil Gelatinase-Associated Lipocalin Levels in Patients with Colorectal Cancer. Chirurgia (Bucur) 2017; 111:414-421. [PMID: 27819647 DOI: 10.21614/chirurgia.111.5.414] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/01/2016] [Indexed: 11/23/2022]
Abstract
AIM OF THE STUDY Neutrophil gelatinase-associated lipocalin (NGAL) is an inflammatory biomarker that is stored in neutrophil granules. Recent studies revealed that NGAL expression increases in tissue samples of patients with inflammatory gastrointestinal system diseases and cancers. The aim of this study was to evaluate the diagnostic and predictive significance of plasma NGAL levels in various stages of adenoma-carcinoma sequence of colorectal cancer. Materials and Methods: Eighty cases were included in the study and separated into 3 groups. "Cancer Group" consisted of 27 colorectal cancer patients who underwent curative resection, whereas 24 patients with colorectal adenomatous polyps detected by colonoscopy were classified as the "Polyp Group", and 29 patients with normal colonoscopy findings were classified as the "Control Group". The serum NGAL, CEA and CA19-9 levels and histopathology findings were determined. Results: The mean plasma NGAL levels for control group, polyp group and cancer group were found to be 91.5 ng/ml, 139.6ng/ml and 184.3ng/ml, respectively. Plasma NGAL levels were found to be significantly higher in cancer group compared to the control group (p:0.006). Plasma NGAL levels were detected statistically significant and positive correlated with tumor diameter and number of metastatic lymph nodes (p:0.047, r:%38.6 and p:0.026, r:%42.8, respectively) in cancer group. Conclusions: We are of the opinion that pre-operative plasma NGAL level is a potential diagnostic biomarker for colorectal cancer patients. Although more comprehensive studies are needed for definitive judgments, serum NGAL levels may be used as a diagnostic and/or predictive biomarker for lymph node metastasis in patients with colorectal cancer.
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Ozemir IA, Orhun K, Eren T, Baysal H, Sagiroglu J, Leblebici M, Ceyran AB, Alimoglu O. Factors affecting sentinel lymph node metastasis in Turkish breast cancer patients: Predictive value of Ki-67 and the size of lymph node. ACTA ACUST UNITED AC 2017; 117:436-41. [PMID: 27546694 DOI: 10.4149/bll_2016_085] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [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
OBJECTIVES We aimed to analyze the factors that affect the axillary lymph node involvement in Turkish breast cancer patients with clinically non-palpable axillary lymph node. BACKGROUND Sentinel lymph node biopsy is the gold standard technique to evaluate the axillary lymph node status that directly influences the prognosis and the treatment options in breast cancer. METHODS Breast cancer patients without axillary lymph node involvement in clinic examination were enrolled the study. Patients were categorized into the two groups according to existence of axillary lymph node metastasis or not. Demographic, histopathological and clinical data of patients were revealed retrospectively. RESULTS One-hundred and eighty-seven patients were analyzed and 101 of patients fulfilled the criteria and were included the study. Metastatic lymph node was detected in 38 (37.6 %) patients (Group 1), and was negative in 63 (62.4 %) patients (Group 2). Sentinel lymph node metastasis were statistically significant higher in patients with Ki-67 ≥ 14 % than patients with Ki-67 < 14 % (51.9 % vs 22.4 %; p < 0.01). Likewise, the mean size of the sentinel lymph node was statistically significant higher in Group 1 compared to Group 2 (p < 0.01). CONCLUSION Ki-67 proliferation index and sentinel lymph node size may provide a higher prediction about the sentinel lymph node involvement in patients with clinically negative axillary lymph nodes (Tab. 3, Fig. 1, Ref. 31).
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Subaşı İE, Yucel M, Hasbahçeci M, Başak F, Alimoglu O. İnguinal herninin günübirlik cerrahisi: Cerrahi asistanları tarafından lokal anestezi altında gerçekleştirilen Lichtenstein inguinal herni onarımı. ARCHIVES OF CLINICAL AND EXPERIMENTAL MEDICINE 2016. [DOI: 10.25000/acem.289465] [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: 11/23/2022] Open
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Alsmady MM, Aladaileh MA, Al-Zaben K, Saleem MM, Alimoglu O. Chylopericardium presenting as cardiac tamponade secondary to mediastinal lymphangioma. Ann R Coll Surg Engl 2016; 98:e154-e156. [PMID: 27388545 DOI: 10.1308/rcsann.2016.0203] [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] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
Mediastinal lymphangioma is a rare entity and chylopericardium is a rare form of pericardial effusion. We report a case of acute chylous cardiac tamponade due to a cervicomediastinal lymphangioma in a one-year-old boy. A chest x-ray revealed marked cardiac enlargement and echocardiography showed massive pericardial effusion. Emergency surgery was performed whereby a pericardial window was created, followed by excision of the lymphangioma.
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Basak F, Hasbahceci M, Canbak T, Sisik A, Acar A, Yucel M, Bas G, Alimoglu O. Incidental findings during routine pathological evaluation of gallbladder specimens: review of 1,747 elective laparoscopic cholecystectomy cases. Ann R Coll Surg Engl 2016; 98:280-3. [PMID: 26924485 PMCID: PMC5226033 DOI: 10.1308/rcsann.2016.0099] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [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] [Accepted: 06/18/2015] [Indexed: 12/18/2022] Open
Abstract
Introduction Cholecystectomy for benign gallbladder diseases can lead to previously undiagnosed gallbladder cancer during histopathological evaluation. Despite some controversy over its usefulness, histopathological evaluation of all gallbladder specimens is common in most hospitals. We evaluated the results of routine pathology of the gallbladder after cholecystectomy for benign gallbladder diseases with regard to unexpected primary gallbladder cancer (UPGC). Methods Patients undergoing cholecystectomy because of benign gallbladder diseases between 2009 and 2013 were enrolled in this study. All gallbladder specimens were sent to the pathology department, and histopathological reports were examined in detail. The impact of demographic features on pathological diagnoses and prevalence of UPGC assessed. Data on additional interventions and postoperative survival for patients with UPGC were collected. Results We enrolled 1,747 patients (mean age, 48.7±13.6 years). Chronic cholecystitis was the most common diagnosis (96.3%) and was associated significantly with being female (p=0.001). Four patients had UPGC (0.23%); one was stage T3 at the time of surgery, and the remaining three cases were stage T2. Conclusions Routine histopathological examination of the gallbladder is valuable for identification of cancer that requires further postoperative management.
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Affiliation(s)
- F Basak
- Umraniye Education and Research Hospital , Turkey
| | | | - T Canbak
- Umraniye Education and Research Hospital , Turkey
| | - A Sisik
- Umraniye Education and Research Hospital , Turkey
| | - A Acar
- Umraniye Education and Research Hospital , Turkey
| | - M Yucel
- Umraniye Education and Research Hospital , Turkey
| | - G Bas
- Umraniye Education and Research Hospital , Turkey
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Abstract
BACKGROUND Breast pain is one of the leading complaints that ends up with referral to breast surgery clinics. The purpose of the present study was to investigate the factors that cause mastalgia, and its relation with benign or malignant breast disease. METHODS The study was performed in 700 patients. Data obtained from surveys, and imaging findings were prospectively recorded, and analyzed. RESULTS The mean age was 45.20 ± 10.78 years. The mastalgia group included 500 cases; the asymptomatic group comprised 200 individuals. Stressful lifestyle, caffeine consumption, and smoking were associated with mastalgia (p < 0.05). Rates of women who had breast fed 3 times or more were higher in the mastalgia group (p < 0.05). Increased breast density, and breast imaging-reporting and data system (BI-RADS) 2 mammography findings were related with mastalgia (p < 0.05). Cysts and fibroadenomas were more common in the mastalgia group (p < 0.05). The incidence of a past history of malignant breast disease was significantly higher in the mastalgia group (p < 0.05). CONCLUSIONS Stress, caffeine, smoking, lactation frequency, and benign disorders were factors detected to be related with mastalgia. Although a significant relation between mastalgia and malignant breast disease was detected in our study, more controlled studies are still required to investigate this issue further.
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Affiliation(s)
- Tunc Eren
- Department of General Surgery, Istanbul Medeniyet University Goztepe Training and Research Hospital, Istanbul, Turkey
| | - Adem Aslan
- Department of General Surgery, Istanbul Medeniyet University Goztepe Training and Research Hospital, Istanbul, Turkey
| | - Ibrahim A Ozemir
- Department of General Surgery, Istanbul Medeniyet University Goztepe Training and Research Hospital, Istanbul, Turkey
| | - Hakan Baysal
- Department of General Surgery, Istanbul Medeniyet University Goztepe Training and Research Hospital, Istanbul, Turkey
| | - Julide Sagiroglu
- Department of General Surgery, Istanbul Medeniyet University Goztepe Training and Research Hospital, Istanbul, Turkey
| | - Ozgur Ekinci
- Department of General Surgery, Istanbul Medeniyet University Goztepe Training and Research Hospital, Istanbul, Turkey
| | - Orhan Alimoglu
- Department of General Surgery, Istanbul Medeniyet University Goztepe Training and Research Hospital, Istanbul, Turkey
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Ozemir IA, Gurbuz B, Bayraktar B, Aslan S, Başkent A, Yalman H, Yigitbasi R, Alimoglu O. The Effect of Thyroid-Stimulating Hormone on Tumor Size in Differentiated Thyroid Carcinoma. Indian J Surg 2016; 77:967-70. [PMID: 27011492 DOI: 10.1007/s12262-014-1084-8] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2014] [Accepted: 04/23/2014] [Indexed: 11/28/2022] Open
Abstract
We evaluated the correlation between serum thyroid-stimulating hormone (TSH) levels and tumor size and other invasiveness parameters of tumor in patients with differentiated thyroid carcinoma (DTC). Several clinical studies have reported that TSH may also have a role as a regulator of the development and function of the thyroid gland. It is currently not clear whether TSH is involved in the existence of thyroid cancer or progression of thyroid cancer or both. Patients with DTC who underwent thyroid surgery between 2003 and 2008 were included this study. Preoperative serum T3, T4, and TSH levels were compared with the size and invasiveness of cancer, retrospectively. DTC was observed in 110 patients over the 5-year period. Seventy-seven (70 %) of them were euthyroid and classified as the "normal-TSH group" (NTG), and 33 (30 %) have an overt or subclinical hyperthyroidism, classified as the "low-TSH group" (LTG). The mean tumor diameter in the LTG was found to be 8.91 ± 8.03 mm; however, it was found to be 18.19 ± 16.24 mm in the NTG. There were significantly differences among the groups related to the diameter of tumor (p = 0.001). Microcarcinoma was determined in 36 patients (46.8 %) in the NTG and 23 patients (69.7 %) in the LTG (p = 0.027). Although there were no significant differences, tumor capsule invasion (33.8 vs. 18.2 %, p = 0.099) and lymphovascular invasion (16.9 vs. 6.1 %, p = 0.130) rates were higher in the NTG. These findings suggest that TSH has effects on growing and proliferation of not only normal thyroid cells but also cancer cells in DTC. This study revealed that serum TSH level can be explored as an important factor that affects the size and invasiveness of tumor in DTC.
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Affiliation(s)
- I A Ozemir
- Department of General Surgery, Medical Faculty, Göztepe Training and Research Hospital, İstanbul Medeniyet University, Istanbul, Turkey ; Küçüksu Mah., Asma Sok, Eston Kandilli Evleri Sitesi, A-12 Blok, Kandilli, Üsküdar, 34684 Istanbul Turkey
| | - B Gurbuz
- Department of General Surgery, Medical Faculty, Göztepe Training and Research Hospital, İstanbul Medeniyet University, Istanbul, Turkey
| | - B Bayraktar
- Department of General Surgery, Medical Faculty, Göztepe Training and Research Hospital, İstanbul Medeniyet University, Istanbul, Turkey
| | - S Aslan
- Department of General Surgery, Medical Faculty, Göztepe Training and Research Hospital, İstanbul Medeniyet University, Istanbul, Turkey
| | - A Başkent
- Department of General Surgery, Fatih Sultan Mehmet Training and Research Hospital, Istanbul, Turkey
| | - H Yalman
- Department of General Surgery, Medical Faculty, Göztepe Training and Research Hospital, İstanbul Medeniyet University, Istanbul, Turkey
| | - R Yigitbasi
- Department of General Surgery, Medical Faculty, Göztepe Training and Research Hospital, İstanbul Medeniyet University, Istanbul, Turkey
| | - O Alimoglu
- Department of General Surgery, Medical Faculty, Göztepe Training and Research Hospital, İstanbul Medeniyet University, Istanbul, Turkey
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Ozemir IA, Bayraktar B, Bayraktar O, Tosun S, Bilgic C, Demiral G, Ozturk E, Yigitbasi R, Alimoglu O. Single-site multiport combined splenectomy and cholecystectomy with conventional laparoscopic instruments: Case series and review of literature. Int J Surg Case Rep 2015; 19:41-6. [PMID: 26708949 PMCID: PMC4756215 DOI: 10.1016/j.ijscr.2015.12.018] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2015] [Accepted: 12/12/2015] [Indexed: 01/16/2023] Open
Abstract
INTRODUCTION Conventional laparoscopic procedures have been used for splenic diseases and concomitant gallbladder stones, frequently in patients with hereditary spherocytosis since 1990's. The aim of this study is to evaluate the feasibility of single-site surgery with conventional instruments in combined procedures. PRESENTATION OF CASE SERIES Six consecutive patients who scheduled for combined cholecystectomy and splenectomy because of hereditary spherocytosis or autoimmune hemolytic anemia were included this study. Both procedures were performed via trans-umbilical single-site multiport approach using conventional instruments. All procedures completed successfully without conversion to open surgery or conventional laparoscopic surgery. An additional trocar was required for only one patient. The mean operation time was 190min (150-275min). The mean blood loss was 185ml (70-300ml). Median postoperative hospital stay was two days. No perioperative mortality or major complications occurred in our series. Recurrent anemia, hernia formation or wound infection was not observed during the follow-up period. DISCUSSION Nowadays, publications are arising about laparoscopic or single site surgery for combined diseases. Surgery for combined diseases has some difficulties owing to the placement of organs and position of the patient during laparoscopic surgery. Single site laparoscopic surgery has been proposed to have better cosmetic outcome, less postoperative pain, greater patient satisfaction and faster recovery compared to standard laparoscopy. CONCLUSION We consider that single-site multiport laparoscopic approach for combined splenectomy and cholecystectomy is a safe and feasible technique, after gaining enough experience on single site surgery.
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Affiliation(s)
- Ibrahim Ali Ozemir
- Istanbul Medeniyet University, Faculty of Medicine, Goztepe Education and Research Hospital, Department of General Surgery, Istanbul, Turkey.
| | - Baris Bayraktar
- Istanbul Medeniyet University, Faculty of Medicine, Goztepe Education and Research Hospital, Department of General Surgery, Istanbul, Turkey
| | - Onur Bayraktar
- Acıbadem University, Faculty of Medicine, Department of General Surgery, Istanbul, Turkey
| | - Salih Tosun
- Istanbul Medeniyet University, Faculty of Medicine, Goztepe Education and Research Hospital, Department of General Surgery, Istanbul, Turkey
| | - Cagri Bilgic
- Istanbul Medeniyet University, Faculty of Medicine, Goztepe Education and Research Hospital, Department of General Surgery, Istanbul, Turkey
| | - Gokhan Demiral
- Istanbul Medeniyet University, Faculty of Medicine, Goztepe Education and Research Hospital, Department of General Surgery, Istanbul, Turkey
| | - Erman Ozturk
- İstanbul Medeniyet University, Göztepe Education and Research Hospital, Department of Hematology, Istanbul, Turkey
| | - Rafet Yigitbasi
- Istanbul Medeniyet University, Faculty of Medicine, Goztepe Education and Research Hospital, Department of General Surgery, Istanbul, Turkey
| | - Orhan Alimoglu
- Istanbul Medeniyet University, Faculty of Medicine, Goztepe Education and Research Hospital, Department of General Surgery, Istanbul, Turkey
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Alimoglu O, Sagiroglu J, Eren T, Kinik K. Rural surgery in Guinea Bissau: an experience of Doctors Worldwide Turkey. North Clin Istanb 2015; 2:196-202. [PMID: 28058367 PMCID: PMC5175106 DOI: 10.14744/nci.2015.10327] [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] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2015] [Accepted: 11/22/2015] [Indexed: 11/21/2022] Open
Abstract
OBJECTIVE In Africa, there is critical shortage of surgeons. Majority of the surgeons work in urban centers, and almost none of them is working in the rural areas. This study documents surgical interventions performed in Guinea-Bissau by Doctors Worldwide Turkey. METHODS A group of surgeons from the Doctors Worldwide Turkey performed various surgical interventions in the Simao Mendes, Gabu and Bafata community hospitals. Demographics, surgical methods, anesthesia techniques and complications were recorded. RESULTS Sixty- four procedures were undertaken between 5-16 February 2010 and 6-11 May 2011. The patient population consisted of 47 male (82.5%) and 10 female (17.5%) patients with a mean age of 44.5 (range: 6-81) years. Five emergency cases were observed. Hartmann's procedure for rectal carcinoma; modified radical mastectomy for breast carcinoma; 2 right total thyroidectomies, 1 bilateral subtotal thyroidectomy; 2 incisional hernia repairs with mesh, 1 breast lumpectomy, 3 mass excisions, 2 keloidectomies, and various techniques of hernia repair for 35 inguinal hernias (4 bilateral, 3 strangulated and 2 coexisting with hydrocele), Winkelmann's procedure for 5 hydroceles (1 bilateral), and unilateral orchiectomy for 1 bilateral hydrocele were recorded. Sixteen patients received general (23.5%), 23 spinal (33.8%), 7 epidural (10.3%), 15 local (22.1%), and 7 ketamine (10.3%) anesthesia. There was no mortality. CONCLUSION Surgical diseases, majority of which are hernias threaten public health in underdeveloped regions of Africa. Blitz surgery may be an efficient temporary solution.
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Affiliation(s)
- Orhan Alimoglu
- Department of General Surgery, Istanbul Medeniyet University School of Medicine, Istanbul, Turkey
| | - Julide Sagiroglu
- Department of General Surgery, Istanbul Medeniyet University School of Medicine, Istanbul, Turkey
| | - Tunc Eren
- Department of General Surgery, Istanbul Medeniyet University School of Medicine, Istanbul, Turkey
| | - Kerem Kinik
- Department of Disaster Medicine, Bezm-i Alem University School of Medicine, Vakif Gureba Hospital, Istanbul, Turkey
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Desiderio J, Jiang ZW, Nguyen NT, Zhang S, Reim D, Alimoglu O, Azagra JS, Yu PW, Coburn NG, Qi F, Jackson PG, Zang L, Brower ST, Kurokawa Y, Facy O, Tsujimoto H, Coratti A, Annecchiarico M, Bazzocchi F, Avanzolini A, Gagniere J, Pezet D, Cianchi F, Badii B, Novotny A, Eren T, Leblebici M, Goergen M, Zhang B, Zhao YL, Liu T, Al-Refaie W, Ma J, Takiguchi S, Lequeu JB, Trastulli S, Parisi A. Robotic, laparoscopic and open surgery for gastric cancer compared on surgical, clinical and oncological outcomes: a multi-institutional chart review. A study protocol of the International study group on Minimally Invasive surgery for GASTRIc Cancer-IMIGASTRIC. BMJ Open 2015; 5:e008198. [PMID: 26482769 PMCID: PMC4611863 DOI: 10.1136/bmjopen-2015-008198] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/14/2022] Open
Abstract
INTRODUCTION Gastric cancer represents a great challenge for healthcare providers and requires a multidisciplinary treatment approach in which surgery plays a major role. Minimally invasive surgery has been progressively developed, first with the advent of laparoscopy and recently with the spread of robotic surgery, but a number of issues are currently being debated, including the limitations in performing an effective extended lymph node dissection, the real advantages of robotic systems, the role of laparoscopy for Advanced Gastric Cancer, the reproducibility of a total intracorporeal technique and the oncological results achievable during long-term follow-up. METHODS AND ANALYSIS A multi-institutional international database will be established to evaluate the role of robotic, laparoscopic and open approaches in gastric cancer, comprising of information regarding surgical, clinical and oncological features. A chart review will be conducted to enter data of participants with gastric cancer, previously treated at the participating institutions. The database is the first of its kind, through an international electronic submission system and a HIPPA protected real time data repository from high volume gastric cancer centres. ETHICS AND DISSEMINATION This study is conducted in compliance with ethical principles originating from the Helsinki Declaration, within the guidelines of Good Clinical Practice and relevant laws/regulations. A multicentre study with a large number of patients will permit further investigation of the safety and efficacy as well as the long-term outcomes of robotic, laparoscopic and open approaches for the management of gastric cancer. TRIAL REGISTRATION NUMBER NCT02325453; Pre-results.
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Affiliation(s)
- Jacopo Desiderio
- Department of Digestive Surgery, St Mary's Hospital, University of Perugia, Terni, Italy
| | - Zhi-Wei Jiang
- Department of General Surgery, Jinling Hospital, Medical School, Nanjing University, Nanjing, China
| | - Ninh T Nguyen
- Department of Surgery, Division of Gastrointestinal Surgery, University of California, Irvine Medical Center, Orange, California, USA
| | - Shu Zhang
- Department of General Surgery, Jinling Hospital, Medical School, Nanjing University, Nanjing, China
| | - Daniel Reim
- Chirurgische Klinik und Poliklinik, Klinikum Rechts der Isar der Technischen Universität München, München, Germany
| | - Orhan Alimoglu
- Department of General Surgery, School of Medicine, Istanbul Medeniyet University, Istanbul, Turkey
| | - Juan-Santiago Azagra
- Unité des Maladies de l'Appareil Digestif et Endocrine (UMADE), Centre Hospitalier de Luxembourg, Luxembourg, Luxembourg
| | - Pei-Wu Yu
- Department of General Surgery, Third Military Medical University Southwest Hospital, Chongqing, China
| | - Natalie G Coburn
- Division of General Surgery, Sunnybrook Health Sciences Centre, Toronto, Canada
| | - Feng Qi
- Department of Gastrointestinal Surgery, Tianjin Medical University General Hospital, Tianjin, China
| | - Patrick G Jackson
- Division of General Surgery, Medstar Georgetown University Hospital, Washington DC, USA
| | - Lu Zang
- Department of Surgery, Ruijin Hospital, Shanghai Jiaotong University, School of Medicine, Shanghai, China
| | - Steven T Brower
- Department of Surgical Oncology and HPB Surgery, Englewood Hospital and Medical Center, Englewood, New Jersey, USA
| | - Yukinori Kurokawa
- Department of Gastroenterological Surgery, Osaka University Graduate School of Medicine, Osaka, Japan
| | - Olivier Facy
- Service de chirurgie digestive et cancérologique CHU Bocage. Dijon, France
| | - Hironori Tsujimoto
- Department of Surgery, National Defense Medical College, Tokorozawa, Japan
| | - Andrea Coratti
- Division of Oncological and Robotic Surgery, Department of Oncology, Careggi University Hospital, Florence, Italy
| | - Mario Annecchiarico
- Division of Oncological and Robotic Surgery, Department of Oncology, Careggi University Hospital, Florence, Italy
| | - Francesca Bazzocchi
- Department of General Surgery, Division of General, Gastroenterologic and Minimally Invasive Surgery, GB Morgagni Hospital, Forlì, Italy
| | - Andrea Avanzolini
- Department of General Surgery, Division of General, Gastroenterologic and Minimally Invasive Surgery, GB Morgagni Hospital, Forlì, Italy
| | - Johan Gagniere
- Digestive and Hepatobiliary Surgery Department, University of Auvergne, University Hospital Estaing, Clermont-Ferrand, France
| | - Denis Pezet
- Digestive and Hepatobiliary Surgery Department, University of Auvergne, University Hospital Estaing, Clermont-Ferrand, France
| | - Fabio Cianchi
- Department of Surgery and Translational Medicine, Center of Oncological Minimally Invasive Surgery (COMIS), University of Florence, Florence, Italy
| | - Benedetta Badii
- Department of Surgery and Translational Medicine, Center of Oncological Minimally Invasive Surgery (COMIS), University of Florence, Florence, Italy
| | - Alexander Novotny
- Chirurgische Klinik und Poliklinik, Klinikum Rechts der Isar der Technischen Universität München, München, Germany
| | - Tunc Eren
- Department of General Surgery, School of Medicine, Istanbul Medeniyet University, Istanbul, Turkey
| | - Metin Leblebici
- Department of General Surgery, School of Medicine, Istanbul Medeniyet University, Istanbul, Turkey
| | - Martine Goergen
- Unité des Maladies de l'Appareil Digestif et Endocrine (UMADE), Centre Hospitalier de Luxembourg, Luxembourg, Luxembourg
| | - Ben Zhang
- Department of General Surgery, Third Military Medical University Southwest Hospital, Chongqing, China
| | - Yong-Liang Zhao
- Department of General Surgery, Third Military Medical University Southwest Hospital, Chongqing, China
| | - Tong Liu
- Department of Gastrointestinal Surgery, Tianjin Medical University General Hospital, Tianjin, China
| | - Waddah Al-Refaie
- Division of General Surgery, Medstar Georgetown University Hospital, Washington DC, USA
| | - Junjun Ma
- Department of Surgery, Ruijin Hospital, Shanghai Jiaotong University, School of Medicine, Shanghai, China
| | - Shuji Takiguchi
- Department of Gastroenterological Surgery, Osaka University Graduate School of Medicine, Osaka, Japan
| | | | - Stefano Trastulli
- Department of Digestive Surgery, St Mary's Hospital, University of Perugia, Terni, Italy
| | - Amilcare Parisi
- Department of Digestive Surgery, St Mary's Hospital, University of Perugia, Terni, Italy
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Alimoglu O, Sagiroglu J, Atak I, Kilic A, Eren T, Caliskan M, Bas G. Robot-assisted laparoscopic (RAL) procedures in general surgery. Int J Med Robot 2015; 12:427-30. [DOI: 10.1002/rcs.1706] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/10/2015] [Revised: 07/24/2015] [Accepted: 08/21/2015] [Indexed: 01/06/2023]
Affiliation(s)
- Orhan Alimoglu
- Istanbul Medeniyet University, School of Medicine; Department of Surgery; Istanbul Turkey
| | - Julide Sagiroglu
- Istanbul Medeniyet University, School of Medicine; Department of Surgery; Istanbul Turkey
| | - Ibrahim Atak
- Umraniye Research and Training Hospital; Department of Surgery; Istanbul Turkey
| | - Ali Kilic
- Umraniye Research and Training Hospital; Department of Surgery; Istanbul Turkey
| | - Tunc Eren
- Istanbul Medeniyet University, School of Medicine; Department of Surgery; Istanbul Turkey
| | - Mujgan Caliskan
- Umraniye Research and Training Hospital; Department of Surgery; Istanbul Turkey
| | - Gurhan Bas
- Umraniye Research and Training Hospital; Department of Surgery; Istanbul Turkey
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Atak T, Sagiroglu J, Eren T, Ali Özemir I, Alimoglu O. Strategies to treat idiopathic granulomatous mastitis: retrospective analysis of 40 patients. Breast Dis 2015; 35:19-24. [PMID: 24989362 DOI: 10.3233/bd-140373] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.6] [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: 11/15/2022]
Abstract
BACKGROUND Idiopathic granulomatous mastitis (IGM) is a rare benign breast disease which often mimics breast carcinoma both clinically and radiologically. Confirmation of diagnosis is only made by histopathological analysis. This study aims to define clinical and demographic features of IGM patients and discuss the results of treatment modalities. METHODS Forty patients with IGM who were assigned in Istanbul Medeniyet University General Surgery Clinic between March 2008 and October 2013 were retrospectively analyzed. RESULTS Mean age was 39.07 ± 11.5. The most common complaint was breast mass (55%). Nipple retraction was present in 6 patients (15%) and 9 patients (22.5%) had fistulizing abscess. Two patients had erythema nodosum on the lower extremity. Breast ultrasonography (USG) (n:40), mammography (MG) (n:20), and magnetic resonance imaging (MRI) (n:20) were used for imaging. Selected treatment methods were antibiotics and anti-inflammatory agents (27.5%), steroids (15%), abscess drainage (40%), and surgical excision (17.5%). Fifteen patients had recurrence after their first line treatment protocol. Mean follow-up period was 24.85 ± 19.7 months. CONCLUSION Surgical excision still seems to be the best treatment method for IGM patients. Administration of steroids for large lesions prior to surgery may help minimize the lesion size and obtain better cosmesis.
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Affiliation(s)
- Tuba Atak
- Department of General Surgery, Faculty of Medicine, Goztepe Research and Training Hospital, Istanbul Medeniyet University, Istanbul, Turkey
| | - Jülide Sagiroglu
- Department of General Surgery, Faculty of Medicine, Goztepe Research and Training Hospital, Istanbul Medeniyet University, Istanbul, Turkey
| | - Tunc Eren
- Department of General Surgery, Faculty of Medicine, Goztepe Research and Training Hospital, Istanbul Medeniyet University, Istanbul, Turkey
| | - Ibrahim Ali Özemir
- Department of General Surgery, Faculty of Medicine, Goztepe Research and Training Hospital, Istanbul Medeniyet University, Istanbul, Turkey
| | - Orhan Alimoglu
- Department of General Surgery, Faculty of Medicine, Goztepe Research and Training Hospital, Istanbul Medeniyet University, Istanbul, Turkey
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Yucel M, Bas G, Ozpek A, Basak F, Sisik A, Acar A, Ozdemir BA, Yuksekdag S, Alimoglu O. The predictive value of physical examination in the decision of laparotomy in penetrating anterior abdominal stab injury. Int J Clin Exp Med 2015; 8:11085-11092. [PMID: 26379908 PMCID: PMC4565291] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2015] [Accepted: 07/02/2015] [Indexed: 06/05/2023]
Abstract
A selective conservative treatment for penetrating anterior abdominal stab injuries is an increasingly recognized approach. We analyzed patients who followed-up and treated for penetrating anterior abdominal stab injuries. The anterior region was defined as the area between the arcus costa at the top and the mid-axillary lines at the laterals and the inguinal ligaments and symphysis pubis at the bottom. An emergency laparotomy was performed on patients who were hemodynamically unstable or had symptoms of peritonitis or organ evisceration; the remaining patients were followed-up selectively and conservatively. A total of 175 patients with purely anterior abdominal injuries were included in the study. One hundred and sixty-five of the patients (94.29%) were males and 10 (5.71%) were females; the mean age of the cohort was 30.85 years (range: 14-69 years). While 16 patients (9%) were made an emergency laparotomy due to hemodynamic instability, peritonitis or evisceration, the remaining patients were hospitalized for observation. During the selective conservative follow-up, an early laparotomy was performed in 20 patients (12%), and a late laparotomy was performed in 13 patients (7%); the remaining 126 patients (72%) were discharged after non-operative follow-up. A laparotomy was performed on 49 patients (28%); the laparotomy was therapeutic for 42 patients (86%), non-therapeutic for 4 patients (8%), and negative for 3 patients (6%). A selective conservative approach based on physical examination and clinical follow-up in penetrating anterior abdominal stab injuries is an effective treatment approach.
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Affiliation(s)
- Metin Yucel
- Department of General Surgery, Umraniye Training and Research Hospital Istanbul, Turkey
| | - Gurhan Bas
- Department of General Surgery, Umraniye Training and Research Hospital Istanbul, Turkey
| | - Adnan Ozpek
- Department of General Surgery, Umraniye Training and Research Hospital Istanbul, Turkey
| | - Fatih Basak
- Department of General Surgery, Umraniye Training and Research Hospital Istanbul, Turkey
| | - Abdullah Sisik
- Department of General Surgery, Umraniye Training and Research Hospital Istanbul, Turkey
| | - Aylin Acar
- Department of General Surgery, Umraniye Training and Research Hospital Istanbul, Turkey
| | - Buket Altun Ozdemir
- Department of General Surgery, Umraniye Training and Research Hospital Istanbul, Turkey
| | - Sema Yuksekdag
- Department of General Surgery, Umraniye Training and Research Hospital Istanbul, Turkey
| | - Orhan Alimoglu
- Department of General Surgery, Umraniye Training and Research Hospital Istanbul, Turkey
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49
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Eren T, Boluk S, Bayraktar B, Ozemir IA, Yildirim Boluk S, Tombalak E, Alimoglu O. Surgical indicators for the operative treatment of acute mechanical intestinal obstruction due to adhesions. Ann Surg Treat Res 2015; 88:325-33. [PMID: 26029678 PMCID: PMC4443264 DOI: 10.4174/astr.2015.88.6.325] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2014] [Revised: 11/06/2014] [Accepted: 12/03/2014] [Indexed: 12/18/2022] Open
Abstract
Purpose Our aim was to investigate the predictive factors indicating strangulation, and the requirement for surgery in patients with acute mechanical intestinal obstruction due to adhesions. Methods This study retrospectively evaluated the records of patients with adhesive acute mechanical intestinal obstruction. The surgical treatment (group S), conservative treatment (group C), intraoperative bowel ischemia (group I), and intraoperative adhesion only (group A) groups were statistically evaluated according to the diagnostic and surgical parameters. Results The study group of 252 patients consisted of 113 women (44.8%), and 139 men (55.2%). The mean age was 62.79 ± 18.08 years (range, 20-98 years). Group S consisted of 50 patients (19.8%), and 202 (80.2%) were in group C. Group I consisted of 19 patients (38%), where as 31 (62%) were in group A. In group S, the prehospital symptomatic period was longer, incidence of fever was increased, and elevated CRP levels were significant (P < 0.05). Plain abdominal radiography, and abdominal computerized tomography were significantly sensitive for strangulation (P < 0.05). The elderly were more prone to strangulation (P < 0.05). Fever, rebound tendernes, and urea & creatinine levels were significantly higher in the presence of strangulation (P < 0.05, P < 0.05, and P < 0.05, consecutively). Conclusion Fever, rebound tenderness, urea & creatinine levels, plain abdominal radiography, and abdominal computerized tomography images were important indicators of bowel ischemia. Longer prehospital symptomatic period was related with a tendency for surgical treatment, and the elderly were more prone to strangulation. CRP detection was considered to be useful for the decision of surgery, but not significantly predictive for strangulation.
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Affiliation(s)
- Tunc Eren
- Department of General Surgery, Istanbul Medeniyet University School of Medicine, Istanbul, Turkey
| | - Salih Boluk
- Department of General Surgery, Istanbul Medeniyet University School of Medicine, Istanbul, Turkey
| | - Baris Bayraktar
- Department of General Surgery, Istanbul Medeniyet University School of Medicine, Istanbul, Turkey
| | - Ibrahim Ali Ozemir
- Department of General Surgery, Istanbul Medeniyet University School of Medicine, Istanbul, Turkey
| | - Sumeyra Yildirim Boluk
- Department of General Surgery, Istanbul Medeniyet University School of Medicine, Istanbul, Turkey
| | - Ercument Tombalak
- Department of General Surgery, Istanbul Medeniyet University School of Medicine, Istanbul, Turkey
| | - Orhan Alimoglu
- Department of General Surgery, Istanbul Medeniyet University School of Medicine, Istanbul, Turkey
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50
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Yener O, Buldanlı MZ, Eksioglu H, Leblebici M, Alimoglu O. Agenesis of the gallbladder diagnosed by magnetic resonance cholangiography: report of a case and review of the literature. Prague Med Rep 2015; 116:52-6. [PMID: 25923971 DOI: 10.14712/23362936.2015.46] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022] Open
Abstract
Gallbladder agenesis (GA) is a rare congenital anomaly of the biliary system often associated with other congenital abnormalities. Patients become symptomatic in 23% of cases (Richards et al., 1993). GA is often misinterpreted as other diseases, therefore, leading to unnecessary surgery. Many of these patients develop a typical symptomatology of cholelithiasis that leads them to operating theatre. If an operative procedure is done, it is better to remain at the level of laparoscopy because further surgical investigation may lead to detrimental biliary tract injuries (Waisberg et al., 2002). We present a case of GA, diagnosed by magnetic resonance with cholangiopancreatography.
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Affiliation(s)
- Oktay Yener
- Faculty of Medicine, Istanbul Medeniyet University, Göztepe Training and Research Hospital, Istanbul, Turkey.
| | - Mehmet Zeki Buldanlı
- Faculty of Medicine, Istanbul Medeniyet University, Göztepe Training and Research Hospital, Istanbul, Turkey
| | - Hayati Eksioglu
- Faculty of Medicine, Istanbul Medeniyet University, Göztepe Training and Research Hospital, Istanbul, Turkey
| | - Metin Leblebici
- Faculty of Medicine, Istanbul Medeniyet University, Göztepe Training and Research Hospital, Istanbul, Turkey
| | - Orhan Alimoglu
- Faculty of Medicine, Istanbul Medeniyet University, Göztepe Training and Research Hospital, Istanbul, Turkey
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