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Atar C, Dalcı K, Aktar Y, Totik N, Topal U, Eray İC, Akçam AT, Sakman G. Correlation of TIRADS scoring in thyroid nodules with preoperative fine needle aspiration biopsy and postoperative specimen pathology. Head Neck 2024; 46:849-856. [PMID: 38197158 DOI: 10.1002/hed.27622] [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: 08/10/2023] [Revised: 10/29/2023] [Accepted: 12/19/2023] [Indexed: 01/11/2024] Open
Abstract
INTRODUCTION The aim of our study is to determine the value of Thyroid Imaging Reporting and Data Systems (TIRADS) scoring in predicting malignancy in thyroid nodules by examining its relationship with fine needle aspiration biopsy and postoperative histopathological results. MATERIALS AND METHODS In this study, patients who underwent surgery after ultrasonographic examination and fine needle aspiration biopsy for thyroid nodules at the General Surgery Clinic of Çukurova University Faculty of Medicine between January 2014 and November 2021 were retrospectively analyzed. The thyroid ultrasonography and fine needle aspiration biopsy of the included patients were performed by a clinician with 15 years of experience. The ultrasonographic features of the nodules were re-evaluated by the same clinician, and the American College of Radiology (ACR) TIRADS score was determined. Fine needle aspiration biopsy results were grouped according to Bethesda criteria. Postoperative histopathological examination results were divided into two groups: benign and malignant. The ACR TIRADS score was compared with fine needle aspiration biopsy and histopathological results. The performance of the ACR TIRADS score in predicting malignancy was determined. RESULTS 79.8% of the 397 patients were female, and the mean age was 50.9 ± 12.8 years. The mean diameter of the nodules was 27.4 ± 15.8 mm. There was a significant, positive, but weak correlation between ACR TIRADS and Bethesda (p < 0.001) (r = 0.33). When the ACR TIRADS score was compared with histopathological results, it was found that the rate of malignancy increased as the TIRADS score increased (p < 0.001). The rates of malignancy diagnosis were 0% for TR1, 13.2% for TR2, 21.7% for TR3, 50.3% for TR4, and 72.4% for TR5. The area under the receiver operating characteristic curve for TIRADS in predicting malignancy was 0.747 (95% CI: 0.699-0.796, p < 0.001). TIRADS can distinguish malignancy with 75% accuracy. The optimal cutoff point was determined as TR4 with 80.3% sensitivity and 60.8% specificity. CONCLUSION The ACR TIRADS scoring system is an effective risk classification system for thyroid nodules, providing 75% accuracy in predicting malignancy, with 80.3% sensitivity and 60.8% specificity values.
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Affiliation(s)
- Cihan Atar
- Department of General Surgery, Ministry of Health Osmaniye State Hospital, Osmaniye, Turkey
| | - Kubilay Dalcı
- Department of General Surgery, Çukurova University Faculty of Medicine, Adana, Turkey
| | - Yasemin Aktar
- Department of Nuclear Medicine, Çukurova University Faculty of Medicine, Adana, Turkey
| | - Nazlı Totik
- Department of Biostatistics, Çukurova University Faculty of Medicine, Adana, Turkey
| | - Uğur Topal
- Department of General Surgery, Çukurova University Faculty of Medicine, Adana, Turkey
| | - İsmail Cem Eray
- Department of General Surgery, Çukurova University Faculty of Medicine, Adana, Turkey
| | - Atılgan Tolga Akçam
- Department of General Surgery, Çukurova University Faculty of Medicine, Adana, Turkey
| | - Gürhan Sakman
- Department of General Surgery, Çukurova University Faculty of Medicine, Adana, Turkey
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Aytac E, Sökmen S, Öztürk E, Rencüzoğulları A, Sungurtekin U, Akyol C, Demirbaş S, Leventoğlu S, Karakayalı F, Korkut MA, Öncel M, Gülcü B, Canda AE, Eray İC, Özgen U, Ersöz Ş, Özer T, Özerhan İH, Bozbıyık O, Haksal M, Oral BM. Management and Morbidity of Major Pelvic Hemorrhage in Complex Abdominopelvic Surgery. Eur Surg Res 2023; 64:390-397. [PMID: 37816336 DOI: 10.1159/000534477] [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: 05/19/2021] [Accepted: 09/04/2023] [Indexed: 10/12/2023]
Abstract
INTRODUCTION Hemorrhage is a challenging complication of pelvic surgery. This study aimed to analyze the causes, management, and factors associated with morbidity in patients experiencing major pelvic hemorrhage during complex abdominopelvic surgery. METHODS Patients who had major intraoperative pelvic hemorrhage during complex abdominopelvic surgery at 11 tertiary referral centers between 1997 and 2017 were included. Patient characteristics, management strategies to control bleeding, short- and long-term postoperative outcomes were evaluated retrospectively. RESULTS There were 120 patients with a mean age of 56.6 ± 2.4 years and a mean BMI of 28.3 ± 1 kg/m2. While 104 (95%) of the patients were operated for malignancy, 16 (5%) of the patients had surgery for a benign disease. The most common bleeding site was the presacral venous plexus 90 (75%). Major pelvic hemorrhage was managed simultaneously in 114 (95%) patients. Electrocauterization 27 (23%), pelvic packing 26 (22%), suturing 7 (6%), thumbtacks application 7 (6%), muscle welding 4 (4%), use of energy devices 2 (2%), and topical hemostatic agents 2 (2%) were the management tools. Combined techniques were used in 43 (36%) patients. Short-term morbidity and mortality rates were 48 (40%) and 2 (2%), respectively. High preoperative CRP levels (p = 0.04), history of preoperative radiotherapy (p = 0.04), longer bleeding time (p = 0.006), and increased blood transfusion (p = 0.005) were the factors associated with postoperative morbidity. CONCLUSION Postoperative morbidity related to major pelvic hemorrhage can be reduced by optimizing the risk factors. Prehabilitation prior to surgery to moderate inflammatory status and prompt action with proper technique to control major pelvic hemorrhage can prevent excessive blood loss in complex abdominopelvic surgery.
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Affiliation(s)
- Erman Aytac
- Acibadem Mehmet ali Aydinlar University, Istanbul, Turkey
| | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | - Tahir Özer
- SBU Gulhane Education and Training Hospital, Ankara, Turkey
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Rencuzogullari A, Atar C, Topal U, Coğal İ, Saritas AG, Yalav O, Dalci K, Eray İC. Analysis of appendiceal neoplasms in 1,423 appendectomy specimens: a 10-year retrospective cohort study from a single institution. Rev Assoc Med Bras (1992) 2023; 69:e20220714. [PMID: 37222313 DOI: 10.1590/1806-9282.20220714] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/05/2023] [Accepted: 02/24/2023] [Indexed: 05/25/2023]
Abstract
OBJECTIVE This study aimed to reveal the incidence, clinicopathological, and oncological outcomes of appendiceal neoplasms. METHODS This is a retrospective cohort study from a single institution. Patients with a pathological diagnosis of malignancy who underwent appendectomy between January 2011 and 2021 were included in the study, and groups were formed according to pathological type. Clinical, pathological, and oncological results were compared in these groups. RESULTS The incidence of neoplasia was 2.38% (n=34) in a cohort of 1,423 appendectomy cases. Of the cases, 56% (n=19) were female. The median age in the entire cohort was 55.5 (range: 13-106) years. In the cohort, the rate of neuroendocrine tumor mucinous cystadenoma adenocarcinoma, and low-grade appendiceal mucinous neoplasm, according to the American Joint Committee on Cancer classification of appendiceal neoplasms, was 32.3% (n=11), 26.4% (n=9), 26.4% (n=9), and 14.7% (n=5), respectively. Neuroendocrine tumor patients (median age: 35 years) were younger than the other groups (p=0.021). Secondary complementary surgery was performed in 66.7% (n=6) of adenocarcinoma patients and 27.3% (n=3) of neuroendocrine tumor patients. Right hemicolectomy was performed in all neuroendocrine tumor patients requiring secondary surgery, while right hemicolectomy was performed in three adenocarcinoma patients and cytoreductive surgery and hyperthermic intraperitoneal chemotherapy in three adenocarcinoma patients. After a median follow-up of 44.4 months (95% confidence interval: 18.6-70.1), the mean survival rate was 55% in appendiceal adenocarcinoma patients compared to 100% in neuroendocrine tumor patients. CONCLUSION Appendiceal neoplasms are rare but remain an important cause of mortality. Appendiceal adenocarcinomas are associated with poorer oncological outcomes compared to other neoplasms.
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Affiliation(s)
- Ahmet Rencuzogullari
- Cukurova University, Faculty of Medicine, Department of General Surgery - Adana, Turkey
| | - Cihan Atar
- Cukurova University, Faculty of Medicine, Department of General Surgery - Adana, Turkey
| | - Ugur Topal
- Cukurova University, Faculty of Medicine, Department of General Surgery - Adana, Turkey
| | - İbrahim Coğal
- Cukurova University, Faculty of Medicine, Department of General Surgery - Adana, Turkey
| | - Ahmet Gokhan Saritas
- Cukurova University, Faculty of Medicine, Department of General Surgery - Adana, Turkey
| | - Orcun Yalav
- Cukurova University, Faculty of Medicine, Department of General Surgery - Adana, Turkey
| | - Kubilay Dalci
- Cukurova University, Faculty of Medicine, Department of General Surgery - Adana, Turkey
| | - İsmail Cem Eray
- Cukurova University, Faculty of Medicine, Department of General Surgery - Adana, Turkey
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Eray İC, Topal U, Balal M, Paydas S. Management of pericatheter dialysate leaks using hemostatic agents. Semin Dial 2022; 35:363-365. [PMID: 35178784 DOI: 10.1111/sdi.13064] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2021] [Accepted: 02/07/2022] [Indexed: 11/28/2022]
Abstract
Continuous ambulatory peritoneal dialysis (CAPD) is one of the treatment modalities used in end-stage renal disease. The most common cause of failure is catheter-related complications. Dialysate leak represents a major noninfectious complication of PD. Here, we aimed to present the results of patients who had pericatheter dialysate leak following PD catheterization and who were administered a hemostatic agent (HaemoCer Plus, BioCer, Germany) around the catheter and the tunneled segment under the subcutaneous tissue under local anesthesia. We performed a local procedure on six patients in total. No major complications developed in any of the patients at postoperative follow-up. Five patients started to receive PD uneventfully within postoperative 3 days with no dialysate leak. We believe that this practice is effective in the management of peritoneal dialysate leak. The hemostatic agents administered in the present study can manage dialysate leak and ensure safe use of the catheter.
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Affiliation(s)
- İsmail Cem Eray
- Department of General Surgery, Cukurova University Faculty of Medicine, Adana, Turkey
| | - Ugur Topal
- Department of General Surgery, Cukurova University Faculty of Medicine, Adana, Turkey
| | - Mustafa Balal
- Department of Nephrology, Cukurova University Faculty of Medicine, Adana, Turkey
| | - Saime Paydas
- Department of Nephrology, Cukurova University Faculty of Medicine, Adana, Turkey
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Yavuz B, Aba M, Aydın İ, Eray İC, Erdoğan KE. Ileal rhabdomyosarcoma in a patient with a history of squamous cell lung cancer. Ann R Coll Surg Engl 2021; 103:e327-e329. [PMID: 34414778 PMCID: PMC9773922 DOI: 10.1308/rcsann.2021.0047] [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] [Indexed: 11/22/2022] Open
Abstract
Rhabdomyosarcoma is an infrequent muscular cancer seen in adults. We present a case of ileal intussusception due to pleomorphic rhabdomyosarcoma in a patient diagnosed previously with squamous cell carcinoma of the lung (SCCL). The patient was a 68-year-old man with a history of SCCL. He was admitted to the emergency department for nausea, emesis and obstipation. Surgical investigation of the abdomen revealed an intussusception caused by a tumour located 160cm distal of the ligament of Treitz. Pathological examination showed that tumour was a primary rhabdomyosarcoma of the ileum. This case contributes to the literature by defining an infrequent presentation of rhabdomyosarcoma causing ileal intussusception in an adult patient.
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Affiliation(s)
- B Yavuz
- Çukurova University, Adana, Turkey
| | - M Aba
- Çukurova University, Adana, Turkey
| | - İ Aydın
- Çukurova University, Adana, Turkey
| | - İC Eray
- Çukurova University, Adana, Turkey
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Yalav O, Topal U, Eray İC, Deveci MA, Gencel E, Rencuzogullari A. Retrorectal tumor: a single-center 10-years' experience. Ann Surg Treat Res 2020; 99:110-117. [PMID: 32802816 PMCID: PMC7406398 DOI: 10.4174/astr.2020.99.2.110] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [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: 02/18/2020] [Revised: 05/09/2020] [Accepted: 05/30/2020] [Indexed: 12/27/2022] Open
Abstract
Purpose Retrorectal tumors (RTs) are a rare incidence and recommendations on the ideal surgical approaches are lacking. This study aimed to evaluate outcomes and follow-up results of patients undergoing excision of RTs at our institution. Methods A retrospective review was conducted for undergoing surgery for RT between January 2009 and January 2019. Demographic characteristics, presenting symptoms, preoperative diagnostic tests, surgical procedures, histopathological results, intraoperative and postoperative complications, postoperative hospital stay, postoperative 30-day mortality, 90-day unplanned readmission rate, and long-term outcomes were evaluated. Results Twenty patients with a mean age of 48.3 ± 14.2 were analyzed. The most common presenting complaint was perineal pain (35.0%). Magnetic resonance imaging and computed tomography was preferred in 18 and 2 patients, respectively. Tumor localization was below the level of the third sacral vertebrae in 14 patients for whom the posterior surgical approach was used. No postoperative mortality was recorded at the end of follow-up of 53.8 ± 40 months. Mean length of postoperative hospital stay was 8.6 ± 9.4 days. Ten percent of the patients had unplanned hospital readmission within 90 days after discharge. Recurrence developed in 1 patient, for whom pathology were reported as chordoma. Conclusion RT should be managed by a multidisciplinary team given the complexity and heterogeneity of these tumors despite the fact that the majority are benign. A good understanding of pelvic anatomy and characterization of lesions through detailed radiological imaging is crucial to optimize surgical planning. Complete surgical resection is key for prolonged disease-free and overall survival of patients diagnosed with RTs.
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Affiliation(s)
- Orçun Yalav
- Department of General Surgery, Çukurova University Faculty of Medicine, Adana, Turkey
| | - Uğur Topal
- Department of General Surgery, Çukurova University Faculty of Medicine, Adana, Turkey
| | - İsmail Cem Eray
- Department of General Surgery, Çukurova University Faculty of Medicine, Adana, Turkey
| | - Mehmet Ali Deveci
- Department of Orthopedics and Traumatology, Çukurova University Faculty of Medicine, Adana, Turkey.,Department of Orthopedics and Traumatology, Koç University Faculty of Medicine, Istanbul, Turkey
| | - Eyüphan Gencel
- Department of Plastic and Reconstructive Surgery, Çukurova University Faculty of Medicine, Adana, Turkey
| | - Ahmet Rencuzogullari
- Department of General Surgery, Çukurova University Faculty of Medicine, Adana, Turkey
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Dalcı K, Topal U, Ünal AG, Eray İC, Yalav O, Sakman G. Adrenal kitlelerde laparaskopik ve açık cerrahi tekniklerin sonuç açısından karşılaştırılması. Cukurova Medical Journal 2019. [DOI: 10.17826/cumj.570824] [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: 11/07/2022] Open
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Eray İC, Rencüzoğulları A, Yalav O, Topal U, Sarıtaş AG, Dalcı K. Rektum kanser cerrahisi sonrası kalıcı ileostomi insidansı ve risk faktörleri. Cukurova Medical Journal 2019. [DOI: 10.17826/cumj.529941] [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: 11/07/2022] Open
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Sarıtaş AG, Topal U, Eray İC, Dalcı K, Akçamı AT, Erdoğan K. Jejunal diverticulosis complicated with perforation: A rare acute abdomen etiology. Int J Surg Case Rep 2019; 63:101-103. [PMID: 31574453 PMCID: PMC6796598 DOI: 10.1016/j.ijscr.2019.09.013] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/09/2019] [Revised: 09/03/2019] [Accepted: 09/08/2019] [Indexed: 11/24/2022] Open
Abstract
INTRODUCTION Jejunal diverticulosis is a rare intestinal pathology with an incidence of 0.5-1%. While most cases are asymptomatic, 30-40% of the cases may become symptomatic with chronic abdominal pain, malabsorption, hemorrhage, diverticulitis, obstruction, abscess formation and, rarely, diverticula perforation. It is generally localized on the mesenteric side and it develops from the entry points of the vessels into the jejunum. CASE PRESENTATION Case 1 - A 36-year Case 2 a 75 old female patient patient was admitted to the emergency department with the complaint of widespread abdominal pain, Case 1 8 diverticules, one with diverticule perforation, was observed in the jejunum segment between the 50th and 90th centimeters after the Treitz Ligament. Case 2 - In the diverticulum 100 cm distal from the Treitz ligament, mesenteric perforation area of 4-5 mm were observed. RESULTS Segmentary small bowel resection and side-by-side anastomosis were performed in these cases. In the histopathological examination, the Diverticula were seen to be pseudodiverticullar lesions including herniation of the mucosa and submucosa. CONCLUSION Jejunoileal diverticulosis is a rare disease with life-threatening complications such as perforation, obstruction and bleeding, it is usually asymptomatic or presents with nonspecific symptoms. It should be considered in the differential diagnosis of acute abdomen.
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Affiliation(s)
- Ahmet Gökhan Sarıtaş
- Department of General Surgery, Cukurova University Faculty of Medicine, 01330, Cukurova, Adana, Turkey
| | - Uğur Topal
- Department of General Surgery, Cukurova University Faculty of Medicine, 01330, Cukurova, Adana, Turkey.
| | - İsmail Cem Eray
- Department of General Surgery, Cukurova University Faculty of Medicine, 01330, Cukurova, Adana, Turkey
| | - Kubilay Dalcı
- Department of General Surgery, Cukurova University Faculty of Medicine, 01330, Cukurova, Adana, Turkey
| | - Atılgan Tolga Akçamı
- Department of General Surgery, Cukurova University Faculty of Medicine, 01330, Cukurova, Adana, Turkey
| | - Kıvılcım Erdoğan
- Department of Pathology, Cukurova University Faculty of Medicine, 01330, Cukurova, Adana, Turkey
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Ülkü A, Topal U, Sarıtaş AG, Rencüzoğulları A, Akçam T, Eray İC, Yalav O, Dalcı K, Aydın İ. Elektif olgularda açık ve laparaskopik splenektominin karşılaştırılması. Cukurova Medical Journal 2019. [DOI: 10.17826/cumj.467031] [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: 11/07/2022] Open
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Sarıtaş AG, Yalav O, Kekeç Y, Sakman G, Kılıç E, Zorludemir S, Ergin M, Eray İC, Kara O, Paydaş S. Lokal ileri evre meme kanserli hastalarda neoadjuvan kemoterapinin ER, PR, c-erb2, VEGF ve Ki-67 üzerine etkisi. Cukurova Medical Journal 2019. [DOI: 10.17826/cumj.412192] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023] Open
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Topal U, Eray İC. Tanısı sıklıkla operasyon sırasında konan nadir bir herni: Amyand hernisi. Cukurova Medical Journal 2019. [DOI: 10.17826/cumj.468056] [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: 11/07/2022] Open
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Rencüzoğulları A, Erdoğan KE, Sarıtaş AG, Topal U, Akçam AT, Ülkü A, Yalav O, Eray İC, Dalcı K, Doran F. İntraabdominal ekstragenital yerleşimli endometriozisler: tek merkez deneyimi. Cukurova Medical Journal 2018. [DOI: 10.17826/cumj.370849] [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: 11/07/2022] Open
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Erdoğan K, Sarıtaş AG, Doran F, Karabağ S, Ülkü A, Rencüzoğulları A, Eray İC. Retroperitoneal rekürren matür kistik teratom zemininde gelişen nöroendokrin tümör. Cukurova Medical Journal 2018. [DOI: 10.17826/cumj.330759] [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: 11/07/2022] Open
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Eray İC, Rencüzoğulları A, Yalav O, Dalcı K, Kakil E, Bağır E, Parsak CK. Primary gastric tuberculosis mimicking gastric cancer. Ulus Cerrahi Derg 2015; 31:177-9. [PMID: 26504425 DOI: 10.5152/ucd.2014.2667] [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] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/17/2014] [Accepted: 03/09/2014] [Indexed: 11/22/2022]
Abstract
A 42-year-old female patient with no previous known diseases who had complaints of postprandial epigastric pain and weight loss and who could not be diagnosed by endoscopic biopsy, although gastric cancer was suspected radiologically and endoscopically, was diagnosed with primary gastric tuberculosis by laparotomy and frozen section. Following anti-tuberculosis treatment, a complete clinical, radiological, and endoscopic response was achieved.
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Affiliation(s)
- İsmail Cem Eray
- Department of General Surgery, Çukurova University Faculty of Medicine, Adana, Turkey
| | - Ahmet Rencüzoğulları
- Department of General Surgery, Çukurova University Faculty of Medicine, Adana, Turkey
| | - Orçun Yalav
- Department of General Surgery, Çukurova University Faculty of Medicine, Adana, Turkey
| | - Kubilay Dalcı
- Department of General Surgery, Çukurova University Faculty of Medicine, Adana, Turkey
| | - Erdem Kakil
- Department of General Surgery, Çukurova University Faculty of Medicine, Adana, Turkey
| | - Emine Bağır
- Department of Pathology, Çukurova University Faculty of Medicine, Adana, Turkey
| | - Cem Kaan Parsak
- Department of General Surgery, Çukurova University Faculty of Medicine, Adana, Turkey
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