1
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Okut G, Saglam K, Kocaaslan H, Kayaalp C. First two cases of literature: Caustic sclerosing cholangitis due to percutaneous treatment of hydatid liver disease causing liver transplantation. Hepatol Forum 2024; 5:90-92. [PMID: 38487740 PMCID: PMC10936115 DOI: 10.14744/hf.2023.2023.0031] [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] [Subscribe] [Scholar Register] [Received: 07/10/2023] [Revised: 08/28/2023] [Accepted: 09/28/2023] [Indexed: 03/17/2024]
Abstract
Echinococcus granulosus is predominantly found in the liver and can be effectively managed through antihelminthic therapy, surgical intervention, or interventional radiology. Percutaneous treatment (PT) has gained widespread popularity due to its minimally invasive nature. An integral step in surgical and PT procedures involves the utilization of protoscolicidal agents to eliminate the parasites. However, the administration of protoscolicidal agents carries the risk of inducing caustic sclerosing cholangitis (SC) if there is a communication between the cyst and the biliary tract. In this pioneering study, we present two cases of caustic SC that occurred subsequent to PT for hydatid liver, necessitating further progression of the disease and ultimately leading to liver transplantation.
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Affiliation(s)
- Gokalp Okut
- Department of Gastrointestinal Surgery, Inonu University School of Medicine, Malatya, Turkiye
| | - Kutay Saglam
- Department of Gastrointestinal Surgery, Inonu University School of Medicine, Malatya, Turkiye
| | - Huseyin Kocaaslan
- Department of Gastrointestinal Surgery, Inonu University School of Medicine, Malatya, Turkiye
| | - Cuneyt Kayaalp
- Department of Gastrointestinal Surgery, Inonu University School of Medicine, Malatya, Turkiye
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2
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Karagul S, Senol S, Karakose O, Uzunoglu K, Kayaalp C. One Anastomosis Gastric Bypass versus Roux-en-Y Gastric Bypass: A Randomized Prospective Trial. Medicina (Kaunas) 2024; 60:256. [PMID: 38399543 PMCID: PMC10890302 DOI: 10.3390/medicina60020256] [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] [Subscribe] [Scholar Register] [Received: 12/30/2023] [Revised: 01/21/2024] [Accepted: 01/31/2024] [Indexed: 02/25/2024]
Abstract
Background and Objectives: One anastomosis gastric bypass (OAGB) and Roux-en-Y gastric bypass (RYGB) surgeries are effective methods used in bariatric surgery. There are limited randomized studies comparing these procedures over more than 2 years. Here, we aimed to compare the 3-year results of two bariatric procedures. Materials and Methods: Patients included in this randomized prospective study were compared in OAGB and RYGB groups. A total of 55 patients, aged between 18 and 65, were eligible for the study. Thirteen patients who did not accept randomization were excluded. Patients were evaluated at 6, 12, 24, and 36 months postoperatively. Results: Three patients were excluded from the study due to loss of communication during the clinical follow-up and one due to death by amyotrophic lateral sclerosis, which started in the eighth month after surgery. The study was completed with a total of 38 patients (OAGB; n = 20, RYGB; n = 18). Patients in the two groups were similar in terms of age, gender, body mass index (BMI), and obesity-related comorbidities. At the end of 3-year follow-up, BMI in the OAGB and RYGB groups was 28.80 ± 4.53 kg/m2 and 29.17 ± 5.36 kg/m2, respectively (p = 0.822). Percentage total weight loss (TWL%) was similar. No significant differences were found between the groups regarding percentage excess weight loss (EWL%). Remission of comorbidities was similar. De novo refluxes developed in four OAGB patients; there were no occurrences of these in RYGB patients (p = 0.066). Conclusions: Both OAGB and RYGB are effective in the treatment of morbid obesity. The two procedures are similarly successful in terms of obesity-related comorbidities.
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Affiliation(s)
- Servet Karagul
- Department of General Surgery, Samsun Training and Research Hospital, 55090 Samsun, Turkey; (S.S.); (O.K.); (K.U.)
| | - Serdar Senol
- Department of General Surgery, Samsun Training and Research Hospital, 55090 Samsun, Turkey; (S.S.); (O.K.); (K.U.)
| | - Oktay Karakose
- Department of General Surgery, Samsun Training and Research Hospital, 55090 Samsun, Turkey; (S.S.); (O.K.); (K.U.)
| | - Kevser Uzunoglu
- Department of General Surgery, Samsun Training and Research Hospital, 55090 Samsun, Turkey; (S.S.); (O.K.); (K.U.)
| | - Cuneyt Kayaalp
- Private Clinic of Gastroenterological Surgery, 34363 Istanbul, Turkey;
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Karagul S, Kayaalp C. Letter to the Editor Regarding "Efficacy and Safety of One Anastomosis Gastric Bypass Versus Roux‑en‑Y Gastric Bypass for Obesity: a Meta‑analysis and Systematic Review". Obes Surg 2023; 33:4178. [PMID: 37930601 DOI: 10.1007/s11695-023-06915-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/18/2023] [Revised: 09/18/2023] [Accepted: 10/18/2023] [Indexed: 11/07/2023]
Affiliation(s)
- Servet Karagul
- Private Clinic of Gastroenterogical Surgery, Istanbul, Turkey.
| | - Cuneyt Kayaalp
- Private Clinic of Gastroenterogical Surgery, Istanbul, Turkey
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Uylas U, Gundogdu R, Sumer F, Samdanci E, Kayaalp C. Incidental cancer in colectomy specimens from patients with familial adenomatous polyposis: single centre experience and literature review. Int J Colorectal Dis 2023; 38:76. [PMID: 36949302 DOI: 10.1007/s00384-023-04370-4] [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] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 03/16/2023] [Indexed: 03/24/2023]
Abstract
BACKGROUND Since cancer development is inevitable in patients with familial adenomatous polyposis (FAP), we aimed to determine the incidence of incidental malignancy in prophylactic colectomy specimens. METHODS The files of patients who underwent prophylactic surgery for FAP between 2010 and 2020 were retrospectively reviewed. The incidence of incidental malignancy in histopathological specimens was examined and a comprehensive literature review was made. RESULTS Fifty-five patients were included in the study, of whom 30 patients had a diagnosis of primary malignancy. Prophylactic colectomy was performed on 25 patients. The pathology results indicated that the specimens were benign in 12 patients (48%) and revealed carcinoma in situ in 11 patients (44%). Incidental malignancy was detected in 2 patients (8%). In the literature review, there were 243 patients who underwent prophylactic colectomy and incidental cancer was detected in 25 patients (10.3%) with the stages of 1 (7.4%), 2 (2.1%), and 3 (0.8%), respectively. CONCLUSIONS Incidental cancer is not rare in patients who have undergone prophylactic colectomy for FAP. Hopefully. they are usually at early stages and unexpected advanced cancers are seen rarely.
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Affiliation(s)
- Ufuk Uylas
- General Surgery Department, Health Sciences University Izmir Tepecik Education and Research Hospital, Izmir, Turkey.
| | - Ramazan Gundogdu
- General Surgery Department, Baskent University Adana Dr. Turgut Noyan Training and Research Hospital, Adana, Turkey
| | - Fatih Sumer
- Gastroenterology Surgery Department, Inonu University Faculty of Medicine, Malatya, Turkey
| | - Emine Samdanci
- Pathology Department, Inonu University Faculty of Medicine, Malatya, Turkey
| | - Cuneyt Kayaalp
- Gastroenterology Surgery Department, Inonu University Faculty of Medicine, Malatya, Turkey
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Bai J, Yang M, Liu Z, Efetov S, Kayaalp C, Dulskas A, Shaw D, Wang X. Primary tumor resection in colorectal cancer patients with unresectable distant metastases: a minireview. Front Oncol 2023; 13:1138407. [PMID: 37182188 PMCID: PMC10172590 DOI: 10.3389/fonc.2023.1138407] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2023] [Accepted: 04/12/2023] [Indexed: 05/16/2023] Open
Abstract
Colorectal cancer (CRC) is the second most common cause of cancer-related death among both men and women worldwide and the third most common cancer overall. About 20% of patients diagnosed with CRC were discovered to have distant metastatic lesions, the majority of which were located in the liver. For the optimum treatment of CRC patients with hepatic metastases, interventional radiologists, medical oncologists, and surgeons must all collaborate. The surgical excision of the primary tumor is an important part of CRC treatment since it has been found to be curative in cases of CRC with minimal metastases. However, given the evidence to date was gathered from retrospective data, there is still controversy over the effectiveness of primary tumor resection (PTR) in improving the median overall survival (OS) and quality of life. Patients who have hepatic metastases make up a very tiny fraction of those who are candidates for resection. With a focus on the PTR, this minireview attempted to review the current advancements in the treatment options for hepatic colorectal metastatic illness. This evaluation also included information on PTR's risks when performed on individuals with stage IV CRC.
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Affiliation(s)
- Junge Bai
- Department of Colorectal Surgery, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Ming Yang
- Department of Colorectal Surgery, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Zheng Liu
- Department of Colorectal Surgery, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
- *Correspondence: Zheng Liu,
| | - Sergey Efetov
- Clinic of Coloproctology and Minimally Invasive Surgery, I.M. Sechenov First Moscow State Medical University (Sechenov University), Moscow, Russia
| | - Cuneyt Kayaalp
- Department of Gastrointestinal Surgery, Yeditepe University, Istanbul, Türkiye
| | - Audrius Dulskas
- Department of Abdominal and General Surgery and Oncology, National Cancer Institute, Vilnius, Lithuania
- Faculty of Medicine, Institute of Clinical Medicine, Vilnius University, Vilnius, Lithuania
| | - Darcy Shaw
- Colorectal Surgery Associates, Kansas City University, Kansas, MO, United States
| | - Xishan Wang
- Department of Colorectal Surgery, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
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Ertugrul I, Altuntas YE, Kayaalp C, Uzunoglu H, Kaya S, Altin O, Kucuk HF. Comparison of transanal and transvaginal specimen extraction in laparoscopic colorectal surgery. Ann Ital Chir 2023; 94:295-299. [PMID: 37530070] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/03/2023]
Abstract
AIM This study aimed to compare the outcomes of transanal and transvaginal NOSES in patients undergoing laparoscopic colorectal surgery. MATERIAL AND METHODS This study included 45 patients who were scheduled for NOSES after undergoing laparoscopic colorectal resection in our clinic between January 2019 and March 2020. To ensure homogeneity between the groups, the data of 22 female patients were analyzed in this study. Patients were divided into two groups according to the specimen extraction technique used. Demographic data, preoperative and postoperative findings, as well as the pathology and sizes of the specimens were examined in both the groups. RESULTS The demographic characteristics and preoperative and early postoperative outcomes were similar in both the groups. The size of the lesion was larger in the transvaginal group than that in the transanal group [4.58 ± 1.28 and 2.71 ± 1.55, respectively (P = 0.039)]. Two complications associated with extraction were observed (%9.09). A patient who underwent transanal extraction developed transient anal incontinence, which spontaneously resolved, and a patient who underwent transvaginal extraction developed anastomotic leakage and rectovaginal fistula associated with anastomotic leakage; a colonic stent was inserted for the management of this condition following which the patient recovered. CONCLUSION Only the lesion size was statistically significantly different between the transanal and transvaginal routes. Further, avoiding secondary organ injury is essential; therefore, the transanal route is primarily preferred. However, if the diameter of the lesion is large and the patient is female, the transvaginal route can be a useful alternative. KEY WORDS Natural orifice specimen extraction surgery, Laparoscopic colorectal surgery, Minimally invasive surgery.
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Okut G, Turgut E, Kaplan K, Bag YM, Akbas S, Sumer F, Kayaalp C. Does laparoscopic-guided transversus abdominis plane block have an effect on postoperative pain and recovery after sleeve gastrectomy? Eur Rev Med Pharmacol Sci 2022; 26:5406-5412. [PMID: 35993635 DOI: 10.26355/eurrev_202208_29408] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/15/2023]
Abstract
OBJECTIVE Postoperative pain management is thought to have an effect on patient comfort, morbidity, and mortality after bariatric surgery. Local anesthetic agents are frequently used for this purpose. Local anesthetics can be used in many different ways. In this study, we aimed to investigate the effect of transversus abdominis plane (TAP) block on postoperative pain by laparoscopic method. PATIENTS AND METHODS A prospective randomized clinical trial was performed. While TAP block was applied to one group with bupivacaine, no action was taken for the other group. Postoperative analgesia was given to both patient groups with the "patient-controlled analgesia (PCA)" device. Demographic, operational, and postoperative clinical and pain data of the patients were recorded. RESULTS TAP block and non-TAP block groups consisted of 30 patients each. Visual analog scale (VAS) scores of the patients at 6, 12, and 24 hours were lower in the TAP group compared to the non-TAP group (p=0.015, 0.018, 0.04, respectively). According to the PCA device data, the analgesic requirement was lower in the TAP group at 6, 12, and 24 hours (p <0.001). Rescue analgesia was required more in the non-TAP group (p=0.04). There was no statistically significant difference between the two groups in terms of gas discharge time (p=0.102), stool discharge occurred earlier in the TAP group (p=0.02). Oral intake times (p=0.554) and length of stay hospital (p=0.551) were similar. CONCLUSIONS Laparoscopic TAP block using bupivacaine can be safely administered in morbidly obese patients and reduces postoperative analgesic requirements. Thus, side effects that may develop secondary to the use of analgesics are avoided.
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Affiliation(s)
- G Okut
- Gastroenterology Surgery Department, Bozyaka Research and Training Hospital, Izmir, Turkey.
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Okut G, Turgut E, Kaplan K, Karahan M, Bag YM, Sumer F, Kayaalp C. Manejo del sangrado de la línea de grapas en la gastrectomía en manga laparoscópica: cauterio monopolar versus sobrecostura. CIR CIR 2022; 90:115-120. [DOI: 10.24875/ciru.21000835] [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: 11/17/2022]
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Okut G, Turgut E, Kaplan K, Sumer F, Kayaalp C. Puede la revisión de RYGB para gastrectomia vertical ser una solución para el tratamento inadecuado de pérdida de peso? CIR CIR 2022; 90:25-30. [DOI: 10.24875/ciru.21000458] [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: 11/17/2022]
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10
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Toman D, Sengul I, Pelikán A, Sengul D, Vavra P, Ihnat P, Roman J, Kayaalp C. A narrative review on nonalcoholic fatty liver disease and nonalcoholic steatohepatitis versus hepatocellular carcinoma: do you mind? Rev Assoc Med Bras (1992) 2022; 68:871-874. [PMID: 35766704 PMCID: PMC9575893 DOI: 10.1590/1806-9282.20220268] [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] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2022] [Accepted: 02/22/2022] [Indexed: 11/22/2022] Open
Affiliation(s)
- Daniel Toman
- Ostrava University, Faculty of Medicine, Department of Surgery - Ostrava, Czechia.,University Hospital Ostrava, Department of Surgery - Ostrava, Czechia
| | - Ilker Sengul
- Giresun University, Faculty of Medicine, Division of Endocrine Surgery - Giresun, Turkey.,Giresun University, Faculty of Medicine, Department of General Surgery - Giresun, Turkey
| | - Anton Pelikán
- Ostrava University, Faculty of Medicine, Department of Surgery - Ostrava, Czechia.,University Hospital Ostrava, Department of Surgery - Ostrava, Czechia.,Tomas Bata University in Zlin, Department of Surgery - Zlin, Czechia
| | - Demet Sengul
- Giresun University, Faculty of Medicine, Department of Pathology - Giresun, Turkey
| | - Petr Vavra
- Ostrava University, Faculty of Medicine, Department of Surgery - Ostrava, Czechia.,University Hospital Ostrava, Department of Surgery - Ostrava, Czechia
| | - Petr Ihnat
- Ostrava University, Faculty of Medicine, Department of Surgery - Ostrava, Czechia.,University Hospital Ostrava, Department of Surgery - Ostrava, Czechia
| | - Jan Roman
- Ostrava University, Faculty of Medicine, Department of Surgery - Ostrava, Czechia.,University Hospital Ostrava, Department of Surgery - Ostrava, Czechia
| | - Cuneyt Kayaalp
- nonu University, Faculty of Medicine, Department of Surgery, Liver Transplantation Institute - Malatya, Turkey
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Okut G, Turgut E, Kaplan K, Bag YM, Sumer F, Kayaalp C. Is It Possible to Estimate the Liver Left Lobe Volume Using Preoperative Data Before Bariatric Surgery? Obes Surg 2022; 32:2696-2705. [PMID: 35689141 DOI: 10.1007/s11695-022-06143-4] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2021] [Revised: 06/03/2022] [Accepted: 06/03/2022] [Indexed: 11/24/2022]
Abstract
PURPOSE Retraction of the left lobe of the liver (LLL) is an important step in bariatric surgical procedures. A good liver retraction will both facilitate the operation and reduce complications. The aim of the study is to identify patients with large LLL with preoperative anthropometric and laboratory data, and to reveal complications due to large LLL. MATERIALS AND METHODS The data of 245 patients who underwent bariatric surgery in our department between April 2019 and March 2021 were retrospectively analyzed. The patients were divided into two groups according to the visibility of the caudate lobe of the liver, the left diaphragmatic artery-vein, and the fat pad on the esophagus after liver retraction. RESULTS Univariate analyses revealed significant differences in BMI, waist and hip circumferences, TG, DM, and HbA1c values, but only BMI (p = 0.001) and the presence of DM (p = 0.017) were found to be independent predictors of LLL size. BMI ≥ 42.1 kg/m2 indicates the size of LLL with 83% sensitivity and 49% specificity. Retractor-related complications were significantly higher in the large LLL group (p = 0.036). There was no difference between the two groups in terms of complications related to trocar insertion (p = 0.014) and postoperative liver enzyme levels (p = 0.714). The operation time (laparoscopic sleeve gastrectomy [LSG]; p = 0.021) (laparoscopic Roux-N-Y gastric bypass [LRYGB]; p = 0.020) and the amount of bleeding (LSG; p < 0.001) (LRYGB; p = 0.011) are higher in patients with large LLL. CONCLUSION Large LLL can be predicted and complications may be reduced with the help of preoperative data.
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Affiliation(s)
- Gokalp Okut
- Gastroenterology Surgery Department, Inonu University Turgut Ozal Medical Center, Bulgurlu Mahallesi, Elazığ Yolu 15. Km, 44280, Merkez/Battalgazi/Malatya, Turkey.
| | - Emre Turgut
- Gastroenterology Surgery Department, Inonu University Turgut Ozal Medical Center, Bulgurlu Mahallesi, Elazığ Yolu 15. Km, 44280, Merkez/Battalgazi/Malatya, Turkey
| | - Kuntay Kaplan
- Gastroenterology Surgery Department, Inonu University Turgut Ozal Medical Center, Bulgurlu Mahallesi, Elazığ Yolu 15. Km, 44280, Merkez/Battalgazi/Malatya, Turkey
| | - Yusuf Murat Bag
- Gastroenterology Surgery Department, Inonu University Turgut Ozal Medical Center, Bulgurlu Mahallesi, Elazığ Yolu 15. Km, 44280, Merkez/Battalgazi/Malatya, Turkey
| | - Fatih Sumer
- Gastroenterology Surgery Department, Inonu University Turgut Ozal Medical Center, Bulgurlu Mahallesi, Elazığ Yolu 15. Km, 44280, Merkez/Battalgazi/Malatya, Turkey
| | - Cuneyt Kayaalp
- Gastroenterology Surgery Department, Inonu University Turgut Ozal Medical Center, Bulgurlu Mahallesi, Elazığ Yolu 15. Km, 44280, Merkez/Battalgazi/Malatya, Turkey
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Toman D, Sengul I, Pelikán A, Sengul D, Vavra P, Ihnát P, Roman J, Kayaalp C. Hepatocellular carcinoma versus nonalcoholic fatty liver disease: metabolic, environmental, and genetic association? De facto? Rev Assoc Med Bras 2022; 68:708-711. [DOI: 10.1590/1806-9282.20220147] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/09/2022] [Accepted: 02/09/2022] [Indexed: 12/15/2022]
Affiliation(s)
- Daniel Toman
- University of Ostrava, Czechia; University Hospital in Ostrava, Czechia
| | - Ilker Sengul
- Giresun University, Turkey; Giresun University, Turkey
| | - Anton Pelikán
- University of Ostrava, Czechia; University Hospital in Ostrava, Czechia; Tomas Bata University in Zlín, Czechia
| | | | - Petr Vavra
- University of Ostrava, Czechia; University Hospital in Ostrava, Czechia
| | - Peter Ihnát
- University of Ostrava, Czechia; University Hospital in Ostrava, Czechia
| | - Jan Roman
- University of Ostrava, Czechia; University Hospital in Ostrava, Czechia
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Saglam K, Sahin TT, Usta S, Koc C, Otan E, Kayaalp C, Aydin C, Yilmaz S. Portal vein reconstruction with cryopreserved vascular grafts: A two-edged sword. Pediatr Transplant 2022; 26:e14206. [PMID: 34889009 DOI: 10.1111/petr.14206] [Citation(s) in RCA: 2] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/18/2021] [Revised: 11/09/2021] [Accepted: 11/29/2021] [Indexed: 02/05/2023]
Abstract
BACKGROUND Portal vein anastomotic complications related to size discrepancy are important causes of morbidity and mortality in pediatric liver transplantation. Interposed vascular grafts in portal vein anastomosis can solve this problem. The aim of this study is to evaluate the results of pediatric liver transplantations performed using cryopreserved interposed vascular grafts between graft portal vein and superior mesenteric vein (SMV)-splenic vein (SpV) confluence. METHODS Twenty-nine pediatric patients received liver transplantation using cryopreserved venous grafts in our Liver Transplant Institute between 2013 and 2020 were included in this study. Demographic, clinical, and operative characteristics and postoperative follow-up were analyzed. RESULTS Sixteen patients (55.2%) had portal hypoplasia and five patients (17.2%) had portal vein thrombosis. In total, six patients (20.6%) suffered portal vein thrombosis in the early postoperative period. Three patients (10.3%) experienced portal vein thrombosis in the late postoperative period. Late portal vein thrombosis rate was significantly higher in patients with early portal vein thrombosis (3/6 patients [50%] versus 0/23 patients [0%]; p = .034). Lack of portal flow was significantly higher in patients with both early (50% versus 0%; p = .002) and late portal vein thrombosis (66.7% versus 6.7%; p = .03). CONCLUSION Preoperative portal vein thrombosis and insufficient flow are important factors affecting success of liver transplant in children. The use of interposed vein grafts in problematic portal anastomoses can overcome portal flow problems.
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Affiliation(s)
- Kutay Saglam
- Department of Surgery and Liver Transplant Institute, Inonu University Faculty of Medicine, Malatya, Turkey
| | - Tevfik Tolga Sahin
- Department of Surgery and Liver Transplant Institute, Inonu University Faculty of Medicine, Malatya, Turkey
| | - Sertac Usta
- Department of Surgery and Liver Transplant Institute, Inonu University Faculty of Medicine, Malatya, Turkey
| | - Cemalettin Koc
- Department of Surgery and Liver Transplant Institute, Inonu University Faculty of Medicine, Malatya, Turkey
| | - Emrah Otan
- Department of Surgery and Liver Transplant Institute, Inonu University Faculty of Medicine, Malatya, Turkey
| | - Cuneyt Kayaalp
- Department of Surgery and Liver Transplant Institute, Inonu University Faculty of Medicine, Malatya, Turkey
| | - Cemalettin Aydin
- Department of Surgery and Liver Transplant Institute, Inonu University Faculty of Medicine, Malatya, Turkey
| | - Sezai Yilmaz
- Department of Surgery and Liver Transplant Institute, Inonu University Faculty of Medicine, Malatya, Turkey
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14
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Karagul S, Kayaalp C, Demircan F. Portal vein arterialization following portal vein thrombosis in liver transplantation: A salvage method. Int J Surg 2022. [DOI: 10.1016/j.ijsu.2022.106456] [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: 10/18/2022]
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15
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Kayaalp C, Turgut E, Aydin C, Yilmaz S. Liver transplantation in Wilson’s disease: A systematic review. Int J Surg 2022. [DOI: 10.1016/j.ijsu.2022.106457] [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: 10/18/2022]
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16
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Sumer F, Okut G, Kaplan K, Gunes O, Kayaalp C. Laparoscopic Splenopexy Due to Wandering Spleen: Feasible Technique. Cureus 2022; 14:e22597. [PMID: 35355540 PMCID: PMC8957781 DOI: 10.7759/cureus.22597] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/25/2022] [Indexed: 11/25/2022] Open
Abstract
Wandering spleen (WS) is a rare disease caused by the looseness of the splenic ligaments. A 29-year-old female patient presented to the emergency department with complaints of abdominal pain and a palpable mass in the abdomen. A diagnosis of WS was made as a result of preoperative imaging. We performed urgent laparoscopic splenopexy with non-absorbable mesh in a patient with torsioned WS. WS is a disease that must be operated on urgently because it causes ischemia and necrosis in cases where it causes torsion in the splenic pedicle. Many researchers also recommend surgery in asymptomatic patients. While splenectomy was previously recommended for WS, current recommendations advocate for splenopexy. As a result, the only and definite treatment option in the case of WS is surgery. Splenopexy with minimally invasive techniques should be the first choice if possible. Splenopexy with non-absorbable mesh is an inexpensive and feasible method to prevent re-torsion. The use of non-absorbable mesh in laparoscopic splenopexy has not been shared before in the literature.
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Zengin A, Bag Y, Aydin M, Sumer F, Kayaalp C. Previous open gastric surgery is not a contraindication for laparoscopic gastric cancer surgery. Med-Science 2022. [DOI: 10.5455/medscience.2021.08.268] [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: 11/03/2022] Open
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Turgut E, Zengin A, Bag Y, Kaplan K, Gunes O, Karatoprak S, Sumer F, Aydin C, Kayaalp C. The association between psoas muscle area index and morbidity/mortality in laparoscopic gastric cancer surgery. Med-Science 2022. [DOI: 10.5455/medscience.2022.03.051] [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: 11/03/2022] Open
Abstract
As advanced gastric cancer often leads to obstruction or cancer-related cachexia, gastric cancer seems to have a closer association with sarcopenia than other types of cancer. Our study aim was to investigate the relationship between the psoas muscle area (PSMA) and morbidity and mortality in patients undergoing gastric cancer surgery. The data of patients who underwent laparoscopic gastric resection between November 2014 and April 2020 were analyzed retrospectively. The intervertebral disc space was verified at L3-4 in the sagittal plane. The PSMA on the right and left sides were measured separately and then added to obtain the total PSMA. This value was then divided by the patient's height (m2) to calculate the psoas muscle area index (PSMAI) (mm2/m2). The mean PSMAI of men (741.1 mm2/m2) was significantly higher than that of women (502.1 mm2/m2) (p<0.001). While there was a positive correlation between the PSMAI and BMI (r:0.352, p:0.019 in women; r:0.447, p<0.001 in men), the correlation between PSMAI and age was negative (r: -0.369, p:0.014 in women; r:-0.349, p<0.001 in men). PSMAI was statistically lower in patients with attendant morbidity (p:0.035). There was no significant relationship between PSMAI and the first 30-day mortality rate (p:0.096); however, the association between PSMAI and both the 90-day mortality rate (p:0.023) and the total mortality rate (p:0.046) were significant. In our opinion, assessing gastric cancer patients for sarcopenia and supporting them with the necessary nutrition and exercise program prior to surgery can help predict and lower postoperative morbidity and mortality rates.
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Gunes O, Bag YM, Turgut E, Gunes A, Sumer F, Kayaalp C. Splenic surgery: a ten years experience of a tertiary center in Turkey. Ann Ital Chir 2022; 92:59-64. [PMID: 35342100] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/14/2023]
Abstract
AIM Splenectomy has been performed for various indications. In this study, we aimed to present the experience of a tertiary center on splenic surgery and analyze what has changed in the last 10 years. MATERIAL AND METHODS Three hundred and sixteen patients who underwent splenic surgery were enrolled in the study. Demographic data, comorbidities, American Society of Anesthesiologists score, indications, operation type, postoperative complications, and mortality were analyzed retrospectively. RESULTS The most common indication was traumatic splenic injury. Immune thrombocytopenic purpura (ITP) and gastric cancer were the second and third. Splenectomy was performed on 300 (94.9%) patients. Splenorrhaphy, partial splenectomy, and splenopexy were the other procedures performed. Postoperative complications occurred in almost onethird of the patients (n=118, 37.3%). Most of them were grade 5 according to the Clavien-Dindo classification. CONCLUSIONS Splenectomy has become a less preferred treatment option with the development of non-operative management in splenic trauma, medical treatments for hematological diseases, and a better understanding of the immune, hematological and metabolic functions of the spleen. In the future, minimally invasive and spleen-sparing surgeries will be performed more frequently for patients who need splenectomy even for those with trauma. KEY WORDS Cyst, Hematology, Laparoscopy, Sepsis, Splenectomy, Trauma.
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Ozdemir E, Gokler C, Gunes O, Kaplan K, Aydin MC, Sumer F, Kayaalp C. Isolated Roux loop versus conventional pancreaticojejunostomy following pancreaticoduodenectomy. Ann Ital Chir 2022; 93:248-253. [PMID: 35476642] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/14/2023]
Abstract
AIM This study aimed to examine the effects of isolated Roux loop (IP) versus conventional pancreaticojejunostomy (CP) techniques on the rate of postoperative pancreatic fistula and its severity. MATERIAL AND METHODS This study included retrospectively collected data from 132 patients who underwent pancreaticoduodenectomy in a single institute. Collected data were compared between IP and CP groups. Postoperative pancreatic fistula and its grades were defined according to International Study Group on Pancreatic Fistula (ISGPF) definition. RESULTS A total of 58 patients had IP and 74 patients had CP. Biochemical leak (IP 20.6% versus CP 14.9%, p=0.38) and grade B/C pancreatic fistula (IP 20.6% versus CP 32.4%, p=0.13) rates of both groups were similar. Durations of hospital stay and intensive care unit stay and 30-day mortality rates of the two groups were similar. CONCLUSION Isolated Roux loop reconstruction following pancreaticoduodenectomy is not associated with a lower rate of pancreatic fistula but may contribute to reducing the severity of pancreatic fistula. KEY WORDS Anastomotic leak, Pancreatic fistula, Pancreaticoduodenectomy, Roux en y anastomosis.
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Sumer F, Gundogan E, Kaplan K, Okut G, Kayaalp C. Transvaginal Specimen Extraction After Laparoscopic Gastrectomy for Tumors. Surg Laparosc Endosc Percutan Tech 2021; 32:247-251. [PMID: 34966150 DOI: 10.1097/sle.0000000000001031] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2021] [Accepted: 09/09/2021] [Indexed: 11/26/2022]
Abstract
AIM The aim was to evaluate the feasibility of transvaginal specimen extraction after laparoscopic gastrectomy for tumors. METHOD Inclusion criteria were females not planning to deliver a child and an accessible vaginal entry. Exclusion criteria were benign gastric pathologies and emergency cases. RESULTS There were 24 females with a mean age of 54.5±12.0. Subtotal, total, central, and vertical gastrectomies were implemented in 17, 4, 2, and 1 patients, respectively. There was no conversion to open or conventional laparoscopic surgery. Specimens were removed from the vagina in all cases successfully. Histopathologies were adenocarcinoma in 20, gastrointestinal stromal in 3, neuroendocrine tumors in 2 and high-grade dysplasia in the rest. Mean blood loss and duration of surgery were 122.5±163.4 (range: 10 to 800) ml. and 287.7±95.9 (range: 120 to 440) minutes, respectively. No patient required intraoperative blood transfusions. The median length of hospital stay was 7 days (range: 3 to 22). The mean tumor size was 7.8±6.5 (range: 0.5 to 24) cm. Fourteen of 24 cases were advanced gastric cancers. Mean dissected lymph node numbers in the patients with radical gastrectomy was 35.3±12.9 (range: 18 to 62). There were no early or late complications related to the specimen extraction and no wound-related problems were observed. CONCLUSIONS In the selected cases, transvaginal specimen extraction was feasible after laparoscopic gastric resections in patients with stomach tumors. As far as we know, this was the largest study on the transvaginal extraction of gastric tumors.
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Affiliation(s)
- Fatih Sumer
- Department of Gastrointestinal Surgery, Inonu University, Malatya
| | - Ersin Gundogan
- Department of Gastrointestinal Surgery, Kayseri City Training and Research Hospital, Health Sciences University, Kayseri, Turkey
| | - Kuntay Kaplan
- Department of Gastrointestinal Surgery, Inonu University, Malatya
| | - Gökalp Okut
- Department of Gastrointestinal Surgery, Inonu University, Malatya
| | - Cuneyt Kayaalp
- Department of Gastrointestinal Surgery, Inonu University, Malatya
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Kirmizi S, Kayaalp C, Karagul S, Tardu A, Ertugrul I, Sumer F. Comparison of stapled versus stapleless sleeve gastrectomy with natural orifice specimen extraction (NOSE). Niger J Clin Pract 2021; 24:1689-1693. [PMID: 34782510 DOI: 10.4103/njcp.njcp_388_20] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
Background Sleeve gastrectomy is a stapler dependent bariatric procedure. A stapleless sleeve gastrectomy can be necessary for certain circumstances. Aims Here, we aimed to show whether laparoscopic stapleless sleeve gastrectomy with natural orifice specimen extraction (NOSE) can be an alternative procedure to stapled sleeve gastrectomy. Patients and Methods In the stapleless group (n = 6), no staplers were used and after vertical resection of the stomach by energy devices, the stomach remnant was closed by two rows of intracorporeal sutures. The resected specimen was removed through the mouth using an endoscopic snare. In the stapler group (n = 7), sleeve gastrectomy was carried out with linear stapler under the guidance of 36 Fr bougie. The specimens were extracted from the left upper quadrant trocar site. Results A total of 13 patients were compared (stapleless = 6 and stapled group = 7). All the sleeve gastrectomies were completed laparoscopically. The operative time was longer at 200 minutes (range 120-300) versus 120 minutes, (range 90-200) p = 0.07) and the amount of bleeding was higher at 100 ml (range 50-200) versus 30 ml (range 10-50) (p = 0.004) in the stapleless group. Leakage and gastrointestinal bleeding were seen in the stapleless group but no complications were found in the stapler group. No statistically significant difference was found between the metabolic outcomes of the two groups after the operation (p > 0.05). Decrease in BMI at similar rates was observed in 5 postoperative year (stapleless group: 35 kg/m2 (range 31-39) versus stapled group: 36.5 kg/m2 (range 31-39), p > 0.05). Conclusion Laparoscopic stapleless sleeve gastrectomy with natural orifice specimen extraction has longer procedure time, more blood loss and complications.
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Affiliation(s)
- Serdar Kirmizi
- Department of Surgery, Yozgat City Hospital, Yozgat, Turkey
| | - Cuneyt Kayaalp
- Department of Gastrointestinal Surgery, Inonu University, Malatya, Turkey
| | - Servet Karagul
- Department of Surgery, Samsun Training and Research Hospital, Samsun, Turkey
| | - Ali Tardu
- Department of Gastrointestinal Surgery, Inonu University, Malatya, Turkey
| | - Ismail Ertugrul
- Department of Surgery, Istanbul Kartal Dr. Lutfi Kirdar Education andResearch Hospital, Istanbul, Turkey
| | - Fatih Sumer
- Department of Gastrointestinal Surgery, Inonu University, Malatya, Turkey
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Sumer F, Kutlu R, Yağcı MA, Kayaalp C. Ureteral injury during laparoscopic rectal resection and concurrent laparoscopic repair by uretero-ureterostomy. J Clin Invest Surg 2021. [DOI: 10.25083/2559.5555/6.2.16] [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
Iatrogenic ureteral injury is an uncommon but severe complication of laparoscopic colorectal surgery. If it is detected intraoperatively, conversion to open surgery is usually inevitable. Here, we described a complete ureteral transection during laparoscopic low anterior resection, which was simultaneously repaired by laparoscopic uretero-ureterostomy. The most important points during the anastomosis of two tiny tubular tissues are dissecting the tubular organs without trauma, obtaining meticulous hemostasis without causing any necrosis, and achieving accurate approximation of tissues with the sutures. To the best of our knowledge, this is the first report that focused on laparoscopic repair of ureteral injury during laparoscopic colorectal surgery. As there are still few data on laparoscopic repair of ureteral lesions, no firm conclusions can be drawn. But, in appropriate cases, if intracorporeal suture expertise is available, laparoscopic repair can be done during colorectal surgery.
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Zengin A, Bag YM, Aydin MC, Kocaaslan H, Kaplan K, Sumer F, Kayaalp C. Is Prognostic Nutritional Index an Indicator for Postoperative 90-Day Mortality in Laparoscopic Gastric Cancer Surgery? Nutr Cancer 2021; 74:2088-2094. [PMID: 34779330 DOI: 10.1080/01635581.2021.2002920] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Abstract
Gastic cancer is a life-threatening malignancy in the world. The aim of this study was to investigate the clinical significance of the prognostic nutritional index (PNI) as a guiding marker for gastric cancer patients with laparoscopic gastrectomy. We retrospectively examined the medical records of 138 gastric cancer patients who had adenocarcinoma pathological diagnosis and operated laparoscopically. Patients were divided into two groups (survived and death) and these groups were compared with clinical and laboratory parameters results. The PNI was calculated as 10 × serum albumin (g/dL) + 0.005 × total lymphocyte count (per mm3). Logistic regression analyses were performed to identify the risk factors of 90-day mortality. The median age of the study cohort was 62.5 (19-91) years, 98 (71%) were males, and 9 (6.5%) patients died during the 90-day after laparoscopic gastrectomy. The PNI levels were significantly lower in death group compared with survived group 37.5 (25-47.1) to 46.9 (22.8-64.9). The PNI (Odds Ratio = 0.81, 95% Confidence Interval 0.70-0.92, p = 0.003) was found as an independent factor for 90-day mortality in multivariate analysis. Receiver operating characteristic (ROC) curve analysis showed that 45.15 is the best-cutoff value for 90-day mortality after laparoscopic gastrectomy. 90-day mortality rate of PNI > 45.15 was 2.2% and PNI ≤ 45.15 was 13.6% found. Lower PNI is associated with increased 90-day mortality in laparoscopic gastrectomy for gastric cancer. The PNI may be a useful marker for predicting the 90-day mortality of gastric cancer patients after laparoscopic gastrectomy.
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Affiliation(s)
- Akile Zengin
- Department of Gastrointestinal Surgery, Malatya Training and Research Hospital, Malatya, Turkey
| | - Yusuf Murat Bag
- Department of Gastrointestinal Surgery, Van Training and Research Hospital, Van, Turkey
| | - Mehmet Can Aydin
- Department of Gastrointestinal Surgery, Ondokuz Mayıs University, Samsun, Turkey
| | - Huseyin Kocaaslan
- Department of Gastrointestinal Surgery, Inonu University, Malatya, Turkey
| | - Kuntay Kaplan
- Department of Gastrointestinal Surgery, Inonu University, Malatya, Turkey
| | - Fatih Sumer
- Department of Gastrointestinal Surgery, Inonu University, Malatya, Turkey
| | - Cuneyt Kayaalp
- Department of Gastrointestinal Surgery, Yeditepe University, Istanbul, Turkey
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Bag YM, Kayaalp C, Cavus D, Sumer F. Laparoscopic transvaginal ventral hernia repair: a case and review of the literature. CIR CIR 2021; 89:57-61. [PMID: 34762624 DOI: 10.24875/ciru.20001123] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
A 52-year-old female underwent laparoscopic repair for recurrent epigastric hernia by hybrid natural orifice transluminal endoscopic surgery. Three 5-mm abdominal trocars and a 15-mm transvaginal trocar were used. The defect was closed by intracorporeal suturing before mesh fixation. She was discharged uneventfully on the 2nd post-operative day. Intracorporeal closing the defect may reduce the bulging of the mesh in laparoscopic ventral hernia repair. This case is the first hybrid transvaginal ventral hernia repair using defect closure technique.
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Affiliation(s)
- Yusuf Murat Bag
- Department of Gastrointestinal Surgery, Inonu University, Malatya, Turkey
| | - Cuneyt Kayaalp
- Department of Gastrointestinal Surgery, Inonu University, Malatya, Turkey
| | - Dilek Cavus
- Department of Gastrointestinal Surgery, Inonu University, Malatya, Turkey
| | - Fatih Sumer
- Department of Gastrointestinal Surgery, Inonu University, Malatya, Turkey
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Karagul S, Kayaalp C. Is Laparoscopy Assistance Always Necessary During Minimally Invasive Living Donor Liver Transplantation Using Upper Midline Incision? Liver Transpl 2021; 27:1677. [PMID: 34396674 DOI: 10.1002/lt.26265] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/22/2021] [Accepted: 08/09/2021] [Indexed: 01/13/2023]
Affiliation(s)
- Servet Karagul
- Liver Transplantation Unit, Yeditepe Üniversitesi, Istanbul, Turkey
| | - Cuneyt Kayaalp
- Liver Transplantation Unit, Yeditepe Üniversitesi, Istanbul, Turkey
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Turgut E, Okut G, Kaplan K, Bağ YM, Sumer F, Kayaalp C. Is Sleeve Gastrectomy or Roux-en-Y Gastric Bypass Better in Terms of Quality of Life? Bariatr Surg Pract Patient Care 2021. [DOI: 10.1089/bari.2020.0138] [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: 11/12/2022] Open
Affiliation(s)
- Emre Turgut
- Department of Gastrointestinal Surgery, Faculty of Medicine, University of Inonu, Malatya, Turkey
| | - Gokalp Okut
- Department of Gastrointestinal Surgery, Faculty of Medicine, University of Inonu, Malatya, Turkey
| | - Kuntay Kaplan
- Department of Gastrointestinal Surgery, Faculty of Medicine, University of Inonu, Malatya, Turkey
| | - Yusuf Murat Bağ
- Department of Gastrointestinal Surgery, Faculty of Medicine, University of Inonu, Malatya, Turkey
| | - Fatih Sumer
- Department of Gastrointestinal Surgery, Faculty of Medicine, University of Inonu, Malatya, Turkey
| | - Cuneyt Kayaalp
- Department of Gastrointestinal Surgery, Faculty of Medicine, University of Inonu, Malatya, Turkey
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Aktas A, Kayaalp C, Gunes O, Kirkil C, Tardu A, Aydin MC, Bag YM, Cayci HM, Arslan U, Sumer F, Aygen E. Surgical Site Infections after Laparoscopic Bariatric Surgery: Is Routine Antibiotic Prophylaxis Required? Surg Infect (Larchmt) 2021; 22:705-712. [DOI: 10.1089/sur.2020.426] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022] Open
Affiliation(s)
- Aydin Aktas
- Department of Gastrointestinal Surgery, Inonu University, Malatya, Turkey
- Department of Gastrointestinal Surgery, Kanuni Training and Research Hospital, Trabzon, Turkey
| | - Cuneyt Kayaalp
- Department of Gastrointestinal Surgery, Inonu University, Malatya, Turkey
| | - Orgun Gunes
- Department of Gastrointestinal Surgery, Inonu University, Malatya, Turkey
| | - Cuneyt Kirkil
- Department of General Surgery, Fırat University, Elazig, Turkey
| | - Ali Tardu
- Department of Gastrointestinal Surgery, Yuksek Ihtisas Teaching and Research Hospital, Bursa, Turkey
| | - Mehmet Can Aydin
- Department of Gastrointestinal Surgery, Inonu University, Malatya, Turkey
| | - Yusuf Murat Bag
- Department of Gastrointestinal Surgery, Inonu University, Malatya, Turkey
| | - Haci Murat Cayci
- Department of Gastrointestinal Surgery, Yuksek Ihtisas Teaching and Research Hospital, Bursa, Turkey
| | - Ufuk Arslan
- Department of Gastrointestinal Surgery, Yuksek Ihtisas Teaching and Research Hospital, Bursa, Turkey
| | - Fatih Sumer
- Department of Gastrointestinal Surgery, Inonu University, Malatya, Turkey
| | - Erhan Aygen
- Department of General Surgery, Fırat University, Elazig, Turkey
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Abstract
PURPOSE There are two main goals in hepatocellular carcinoma management, the first is long term survival and the second is the low recurrence rate after the treatment. Therefore, a lot of selection criteria defined for each treatment method and tumor size is one of the most important parameter in almost all of them. METHODS In this review, importance of diamater in hepatocellular carcinoma is reviewed. RESULTS Many reports showed a significant association between increase in maximum tumor diameter and microvascular invasion. Patients with larger tumors are more likely to have poorly differentiated tumors. Increased regional and distant metastasis of tumors were observed in the larger size hepatocellular carcinoma. Liver transplantation represents the best treatment option for patients with decompensated liver cirrhosis and hepatocellular carcinoma. CONCLUSIONS Combined with biological, inflammatory, radiological, pathological and genetic markers that predict the biological behavior of the tumor, today, tumor size is one of the best aggressiveness markers until new markers are found. So, tumor size is matter.
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Affiliation(s)
- Sertac Usta
- Department of Surgery, Liver Transplantation Institute, Inonu University, 44315, Malatya, Turkey.
| | - Cuneyt Kayaalp
- Department of Surgery, Liver Transplantation Institute, Inonu University, 44315, Malatya, Turkey
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Gundogan E, Kayaalp C, Gokler C, Gunes O, Bag M, Sumer F. Natural orifice specimen extraction versus transabdominal extraction in laparoscopic right hemicolectomy. CIR CIR 2021; 89:326-333. [PMID: 34037617 DOI: 10.24875/ciru.20000321] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
INTRODUCCIÓN La extracción de muestras de orificio natural (NOSE) para resecciones colorrectales, que mejoran aún más las ventajas de la cirugía mínimamente invasiva, se utilizan cada vez con mayor frecuencia. En este estudio, nuestro objetivo fue comparar los métodos de extracción de muestras de nariz y transabdominales en casos de resecciones de colon derecho totalmente laparoscópicas. MÉTODOS Se incluyeron datos de 52 pacientes que se sometieron a cirugía laparoscópica de colon derecho entre 2013 y 2019. La extracción de muestras transabdominales se realizó en 35 pacientes, mientras que 17 pacientes fueron sometidos a NOSE. Se compararon datos demográficos, hallazgos operativos, resultados patológicos y datos de seguimiento. RESULTADOS Las mujeres (94% frente a 28%, p = 0,0001), comórbidas (76% frente a 40%, p = 0,01) y antecedentes de cirugía abdominal previa (75% frente a 23%, p = 0,001) fueron más altas en el grupo NOSE . Todas las otras características preoperatorias de los grupos fueron comparables. La pérdida de sangre intraoperatoria, el tiempo de operación y las tasas de complicaciones fueron similares en ambos grupos. La escala VAS postoperatoria (2.8 ± 1.2 vs. 4.5 ± 2.4, p = 0.001) y los puntajes cosméticos fueron mejores en el grupo NOSE (10 vs. 7, p = 0.0001). Los resultados oncológicos fueron similares después de un seguimiento medio de 27.4 ± 20.5 (1-77) meses. CONCLUSIÓN El método NOSE después de la resección laparoscópica del colon derecho fue un método más ventajoso en términos de cosméticos y dolor postoperatorio que la extracción de muestras transabdominales. INTRODUCTION Natural orifice specimen extraction (NOSE) for colorectal resections, which further enhance the advantages of minimally invasive surgery, are being used increasingly more often. In this study, we aimed to compare NOSE and transabdominal specimen extraction methods in cases of totally laparoscopic right colon resections. METHODs Data of 52 patients who underwent laparoscopic right colon surgery between 2013 and 2019 were included in the study. Transabdominal specimen removal was done in 35 patients, while 17 patients underwent NOSE. Demographic data, operative findings, pathological results, and follow-up data were compared. RESULTS Female (94% vs. 28%, p = 0.0001), co-morbid (76% vs. 40%, p = 0.01), and previous abdominal surgery history (75% vs. 23%, p = 0.001) were higher in the NOSE group. All the other pre-operative features of the groups were comparable. Intraoperative blood loss, operation time, and complication rates were similar in both groups. Post-operative visual analog scale (2.8 ± 1.2 vs. 4.5 ± 2.4, p = 0.001) and cosmetic scores were better in the NOSE group (10 vs. 7, p = 0.0001). Oncologic results were similar after a mean follow-up of 27.4 ± 20.5 (1-77) months. CONCLUSION The NOSE method following laparoscopic right colon resection was a more advantageous method in terms of cosmetics and post-operative pain than transabdominal specimen extraction.
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Affiliation(s)
- Ersin Gundogan
- Department of Gastrointestinal, Surgery Inonu University, Malatya, Turkey
| | - Cuneyt Kayaalp
- Department of Gastrointestinal, Surgery Inonu University, Malatya, Turkey
| | - Cihan Gokler
- Department of Gastrointestinal, Surgery Inonu University, Malatya, Turkey
| | - Orgun Gunes
- Department of Gastrointestinal, Surgery Inonu University, Malatya, Turkey
| | - Murat Bag
- Department of Gastrointestinal, Surgery Inonu University, Malatya, Turkey
| | - Fatih Sumer
- Department of Gastrointestinal, Surgery Inonu University, Malatya, Turkey
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Yilmaz S, Akbulut S, Kutluturk K, Dogan SM, Baskiran A, Ersan V, Koc C, Aydin C, Kayaalp C. Splenic Artery Transposition for Hepatic Artery Reconstruction During Liver Transplantation: Is It the Best Choice for Adequate Arterial Inflow in Extraordinary Conditions? Liver Transpl 2021; 27:595-599. [PMID: 37160046 DOI: 10.1002/lt.25884] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/01/2020] [Revised: 07/03/2020] [Accepted: 07/30/2020] [Indexed: 02/05/2023]
Affiliation(s)
- Sezai Yilmaz
- Department of Surgery and Liver Transplant Institute, Inonu University Faculty of Medicine, Malatya, Turkey
| | - Sami Akbulut
- Department of Surgery and Liver Transplant Institute, Inonu University Faculty of Medicine, Malatya, Turkey
| | - Koray Kutluturk
- Department of Surgery and Liver Transplant Institute, Inonu University Faculty of Medicine, Malatya, Turkey
| | - Sait Murat Dogan
- Department of Surgery and Liver Transplant Institute, Inonu University Faculty of Medicine, Malatya, Turkey
| | - Adil Baskiran
- Department of Surgery and Liver Transplant Institute, Inonu University Faculty of Medicine, Malatya, Turkey
| | - Veysel Ersan
- Department of Surgery and Liver Transplant Institute, Inonu University Faculty of Medicine, Malatya, Turkey
| | - Cemalettin Koc
- Department of Surgery and Liver Transplant Institute, Inonu University Faculty of Medicine, Malatya, Turkey
| | - Cemalattin Aydin
- Department of Surgery and Liver Transplant Institute, Inonu University Faculty of Medicine, Malatya, Turkey
| | - Cuneyt Kayaalp
- Department of Surgery and Liver Transplant Institute, Inonu University Faculty of Medicine, Malatya, Turkey
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Aktas A, Gokler C, Sansal M, Karadag N, Kayaalp C. Acute Liver Failure following Sleeve Gastrectomy with Jejuno-Ileal Bypass. Obes Res Clin Pract 2021; 15:297-299. [PMID: 33766490 DOI: 10.1016/j.orcp.2021.03.009] [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] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/01/2020] [Revised: 03/10/2021] [Accepted: 03/13/2021] [Indexed: 11/15/2022]
Abstract
INTRODUCTION Laparoscopic sleeve gastrectomy (LSG) is one of the most commonly performed bariatric surgery in recent years, and some modifications have emerged to improve its efficacy. Melissas has described SG plus jejuno-ileal bypass (JIB), which has reported good results in a few studies. We performed this procedure in 21 cases and in one case, we observed acute liver failure (ALF) that has not been reported before. CASE PRESENTATION A 38-year-old female (BMI: 56.1 kg/m2) underwent laparoscopic SG plus JIB. There was no sign of diarrhea, malnutrition or liver failure for eight months and her BMI was 43.0 kg/m2. At the 9th month, she was hospitalized for abdominal pain, jaundice and ALF. The patient was treated by plasmapheresis and molecular absorptive recirculation system. She was planned to undergo liver transplantation but died of multiorgan failure on the 40th day of hospitalization. CONCLUSION ALF can be observed following SG plus JIB. JIB reversal before compromising liver functions should be taken into consideration.
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Affiliation(s)
- Aydin Aktas
- Department of Gastrointestinal Surgery, Inonu University, Malatya, Turkey.
| | - Cihan Gokler
- Department of Gastrointestinal Surgery, Inonu University, Malatya, Turkey.
| | - Mufit Sansal
- Department of Gastrointestinal Surgery, Inonu University, Malatya, Turkey.
| | - Nese Karadag
- Department of Pathology, Inonu University, Malatya, Turkey.
| | - Cuneyt Kayaalp
- Department of Gastrointestinal Surgery, Inonu University, Malatya, Turkey.
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Gundogan E, Gokler C, Sumer F, Kayaalp C. Effect of Abdominal Drain on Patient Comfort in Laparoscopic Sleeve Gastrectomy: A Randomized Controlled Study. Bariatr Surg Pract Patient Care 2021. [DOI: 10.1089/bari.2020.0043] [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: 11/13/2022] Open
Affiliation(s)
- Ersin Gundogan
- Department of Surgery, Inonu University, Malatya, Turkey
| | - Cihan Gokler
- Department of Surgery, Inonu University, Malatya, Turkey
| | - Fatih Sumer
- Department of Surgery, Inonu University, Malatya, Turkey
| | - Cuneyt Kayaalp
- Department of Surgery, Inonu University, Malatya, Turkey
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Tatli F, Bardakci O, Ozgonul A, Erkmen F, Karaca E, Erol MK, Yilmaz M, Uzunkoy A, Kayaalp C. A new seton tightening method for anal fistula treatment: sailor's knot. Ann Ital Chir 2021; 92:201-205. [PMID: 34031291] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/12/2023]
Abstract
AIM There are certain problems experienced while retightening the seton material during the patient follow-ups, such as pain and anaesthesia requirements in perianal fistula. The aim of the present study was to compare a sailor's knot with other seton tightening methods for the surgical treatment of perianal fistulas. MATERIAL AND METHODS The records of 105 patients who underwent surgeries for perianal fistulas using the seton method between 2016 and 2019 were analysed retrospectively. The demographic characteristics, complaints, fistula localizations, surgery types, hospital stay lengths, postoperative complications and imaging modalities of the patients included in the study were recorded. The patients were divided into two groups according to the surgical treatment method. Those patients who underwent seton procedures with a sailor's knot were included in Group 1. Group 2 included those patients who underwent other seton procedures, including silk and penrose drain procedures. Groups were compared with regard to success rates and postoperative recurrence. RESULTS There was no statistically significant difference between the groups in terms of the age, gender, fistula type and follow-up duration. Success rate in all patient was 88.6%, 91.2% in group 1 and 87.1% in group 2 (p=0.36). The number of patients with a kind of incontinence was 7 (7.1%), 3 (5.8%) in Group 1 and 4 (7.4%) in Group 2 (p = 0.297). CONCLUSION There were no statistically significant differences with regard to complications and recurrences between the sailor's knot and the other seton tightening methods used for the treatment of anal fistulas. The sailor's knot is recommended with regard to its easy application and seton retightening with satisfactory outcomes. KEY WORDS Perianal fistula, Sailor's knot, Seton.
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Zengin A, Bag Y, Aydin M, Kaplan K, Sumer F, Kayaalp C. Does body mass index affect the intraoperative and early postoperative outcomes in patients with laparoscopic distal gastrectomy for gastric cancer? Med-Science 2021. [DOI: 10.5455/medscience.2021.04.116] [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: 11/03/2022] Open
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Bag YM, Topel C, Ozdemir E, Saglam K, Sumer F, Kayaalp C. A Novel Radiological Predictor for Postoperative Pancreatic Fistula After Stapled Distal Pancreatectomy. Am Surg 2020; 87:725-731. [PMID: 33170027 DOI: 10.1177/0003134820952429] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
Abstract
BACKGROUND Distal pancreatectomy (DP) is the main surgical treatment of benign and malignant lesions located in pancreatic body and tail. Postoperative pancreatic fistula (POPF) following DP is still a considerable cause of morbidity. Identification of risk factors for POPF after DP might provide some preventive applications. We aimed to evaluate the factors affecting POPF after DP and to present a new and easy radiological predictive factor. MATERIALS AND METHODS Thirty-four patients underwent DP with stapler closure were included. Several risk factors for clinically relevant POPF (CR-POPF) were analyzed. Additionally, computed tomography findings of pancreatic thickness (PT), main pancreatic duct diameter (MPDD), and PT/MPDD ratio were evaluated for POPF. RESULTS CR-POPF was observed in 10 patients (29.4%). Univariate and multivariate analyses showed that previous abdominal surgery and PT/MPDD ratio were predictive factors for CR-POPF after DP (P = 0.040, P = 0.034, respectively). The cutoff value for the PT/MPDD ratio was 8. CONCLUSION A PT/MPDD ratio greater than 8 (a wide pancreas with a narrow duct) is a significant predictive factor for CR-POPF following DP.
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Affiliation(s)
- Yusuf Murat Bag
- Department of Gastrointestinal Surgery, Inonu University, Malatya, Turkey
| | - Cagdas Topel
- Department of Radiology, University of Health Sciences, Mehmet Akif Ersoy Thoracic and Cardiovascular Surgery Training and Research Hospital, Istanbul, Turkey
| | - Egemen Ozdemir
- Department of Gastrointestinal Surgery, Inonu University, Malatya, Turkey
| | - Kutay Saglam
- Department of Gastrointestinal Surgery, Inonu University, Malatya, Turkey
| | - Fatih Sumer
- Department of Gastrointestinal Surgery, Inonu University, Malatya, Turkey
| | - Cuneyt Kayaalp
- Department of Gastrointestinal Surgery, Inonu University, Malatya, Turkey
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Sumer F, Bag YM, Aydin MC, Evren B, Aydin ES, Sahin I, Kayaalp C. Mini-laparoscopic adrenalectomy with transgastric specimen extraction. Updates Surg 2020; 73:1487-1491. [PMID: 33119843 DOI: 10.1007/s13304-020-00904-5] [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: 07/23/2020] [Accepted: 10/16/2020] [Indexed: 11/25/2022]
Abstract
We aimed to describe the initial experience of mini-laparoscopic adrenalectomy combined with transgastric specimen extraction and to assess its safety and feasibility. We used only 5-mm trocars, three ports for left adrenalectomy and four for right. Intraoperative gastroscopy was performed for specimen extraction through the mouth via an endoscopic snare. The gastrotomy was closed intracorporeally. Demographic, perioperative and pathological data were analyzed. There were 16 patients (12 females) with the mean age of 46.5 ± 11.3 years and half of them had previous abdominal surgeries. The median operative time was 150 (45-432) min with a median blood loss of 88 (0-350) ml. The median oral intake time was 2 (1-4) days and the median length of hospital stay was 2 (2-5) days. There was no mortality and extraction-related complication. Histopathological median tumor length, width and depth were 3 cm, 2.15 cm, and 1.9 cm, respectively. The median specimen length, width and depth were 6.25 cm, 4 cm, and 2.2 cm, respectively. Mini-laparoscopic adrenalectomy combined with transgastric specimen extraction is a safe and feasible surgical technique. It provides a less invasive surgery and may also have some benefits on wound-related complications and cosmesis.
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Affiliation(s)
- Fatih Sumer
- Department of Gastrointestinal Surgery, Inonu University, Malatya, Turkey
| | - Yusuf Murat Bag
- Department of Gastrointestinal Surgery, Inonu University, Malatya, Turkey.
| | - Mehmet Can Aydin
- Department of Gastrointestinal Surgery, Inonu University, Malatya, Turkey
| | - Bahri Evren
- Department of Endocrinology and Metabolism, Inonu University, Malatya, Turkey
| | - Emine Sener Aydin
- Department of Endocrinology and Metabolism, Inonu University, Malatya, Turkey
| | - Ibrahim Sahin
- Department of Endocrinology and Metabolism, Inonu University, Malatya, Turkey
| | - Cuneyt Kayaalp
- Department of Gastrointestinal Surgery, Inonu University, Malatya, Turkey
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Abstract
PURPOSE Sigmoid volvulus is frequently seen in male patients over 60 years old. Here, we aimed to investigate the causes of sigmoid volvulus developing in patients under 60 years of age. METHODS Patients diagnosed with sigmoid volvulus between 2009 and 2018 were retrospectively analyzed. The patients were divided into two as under 60 years old and above. The co-morbidity, mortality, morbidity, complications, age, and gender data were analyzed. RESULTS A total of 134 patients were included. The median age was 70 (19-92), ≤ 59 age patients constituted 24% of all patients. Eighty-one percent (109/134) of the patients were male, and male/female ratio was lower in ≤ 59 age patients (2.0 vs 6.2, p = 0.01). Diseases that caused and underlying colon dilatation (mental retardation with hypomotility, pregnancy-puerperium, Hirschsprung's disease, etc.) were more common in ≤ 59 age patients, but no observed at 60≤ age patients (15.2% vs 0%, p = 0.0007). While there was no difference between the two groups in terms of mortality, it was proportionally higher in the 60≤ age group (3.0% vs. 13.9%, p = 0.12). CONCLUSION By decreasing age, male dominance disappears progressively, and it is likely to have an underlying colonic hypomotility in young sigmoid volvulus patients.
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Affiliation(s)
- Ufuk Uylas
- Faculty of Medicine, Gastroenterology Surgery, Inonu University, Malatya, Turkey.
| | - Cuneyt Kayaalp
- Faculty of Medicine, Gastroenterology Surgery, Inonu University, Malatya, Turkey
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Gundogan E, Karabulut E, Ersan V, Kayaalp C. Dieulafoy lesion in a Hartmann stump. Asian J Endosc Surg 2020; 13:560-563. [PMID: 31943868 DOI: 10.1111/ases.12781] [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] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/30/2018] [Revised: 08/07/2019] [Accepted: 12/01/2019] [Indexed: 11/30/2022]
Abstract
A 70-year-old man underwent laparoscopic anterior resection for sigmoid carcinoma, and on postoperative day 4, he required an emergency Hartmann procedure for bowel ischemia and anastomotic leakage. Five days after the emergency procedure, there was a massive hemorrhage through the anus that appeared in the abdominal drain. During exploration, the origin of the bleeding could not be found, and the rectal stump was closed over a urinary Foley catheter (with an inflated balloon) with the help of a purse-string suture. In the intensive care unit, massive hematochezia continued. Emergency transanal colonoscopy to the Hartmann stump found the rectum full of clotted blood. Active pulsatile arterial bleeding of a rectal Dieulafoy lesion was detected. After endoscopic hemostasis efforts failed, bleeding was stopped successfully by transanal suturing. The patient was discharged without any other problems, and no recurrent bleeding occurred during the 18-month follow-up. Here, we report a rectal Dieulafoy lesion in a Hartmann stump for the first time.
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Affiliation(s)
- Ersin Gundogan
- Department of Gastrointestinal Surgery, Inonu University, Malatya, Turkey
| | - Ertugrul Karabulut
- Department of Gastrointestinal Surgery, Inonu University, Malatya, Turkey
| | - Veysel Ersan
- Department of Gastrointestinal Surgery, Inonu University, Malatya, Turkey
| | - Cuneyt Kayaalp
- Department of Gastrointestinal Surgery, Inonu University, Malatya, Turkey
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Uylas U, Kayaalp C. Correction to: Different clinicopathological features of non-elderly sigmoid volvulus patients. Int J Colorectal Dis 2020; 35:1943. [PMID: 32780224 DOI: 10.1007/s00384-020-03713-9] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Abstract
The presentation of "≤ 60 age group" throughout the article were incorrect. The data should have been presented as "60≤ age group".
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Affiliation(s)
- Ufuk Uylas
- Faculty of Medicine, Gastroenterology Surgery, Inonu University, Malatya, Turkey.
| | - Cuneyt Kayaalp
- Faculty of Medicine, Gastroenterology Surgery, Inonu University, Malatya, Turkey
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Ince V, Akbulut S, Otan E, Ersan V, Karakas S, Sahin TT, Carr BI, Baskiran A, Samdanci E, Bag HG, Koc C, Usta S, Ozdemir F, Barut B, Gonultas F, Sarici B, Kutluturk K, Dogan MS, Ozgor D, Dikilitas M, Harputluoglu M, Aladag M, Kutlu R, Varol I, Dirican A, Aydin C, Isik B, Ara C, Kayaalp C, Emre S, Yilmaz S. Author Correction: Liver Transplantation for Hepatocellular Carcinoma: Malatya Experience and Proposals for Expanded Criteria. J Gastrointest Cancer 2020; 51:1006. [PMID: 32643114 DOI: 10.1007/s12029-020-00451-7] [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] [Indexed: 02/07/2023]
Abstract
The original version of this article unfortunately contained a mistake in the author group section.
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Affiliation(s)
- Volkan Ince
- Department of Surgery, Liver Transplantation Institute, Inonu University, 44315, Malatya, Turkey.
| | - Sami Akbulut
- Department of Surgery, Liver Transplantation Institute, Inonu University, 44315, Malatya, Turkey
| | - Emrah Otan
- Department of Surgery, Liver Transplantation Institute, Inonu University, 44315, Malatya, Turkey
| | - Veysel Ersan
- Department of Surgery, Liver Transplantation Institute, Inonu University, 44315, Malatya, Turkey
| | - Serdar Karakas
- Department of Surgery, Liver Transplantation Institute, Inonu University, 44315, Malatya, Turkey
| | - Tolga Tevfik Sahin
- Department of Surgery, Liver Transplantation Institute, Inonu University, 44315, Malatya, Turkey
| | - Brian I Carr
- Department of Surgery, Liver Transplantation Institute, Inonu University, 44315, Malatya, Turkey
| | - Adil Baskiran
- Department of Surgery, Liver Transplantation Institute, Inonu University, 44315, Malatya, Turkey
| | - Emine Samdanci
- Department of Pathology, Medical School, Inonu University, Malatya, Turkey
| | - Harika Gozukara Bag
- Department of Biostatistics, Medical School, Inonu University, Malatya, Turkey
| | - Cemalettin Koc
- Department of Surgery, Liver Transplantation Institute, Inonu University, 44315, Malatya, Turkey
| | - Sertac Usta
- Department of Surgery, Liver Transplantation Institute, Inonu University, 44315, Malatya, Turkey
| | - Fatih Ozdemir
- Department of Surgery, Liver Transplantation Institute, Inonu University, 44315, Malatya, Turkey
| | - Bora Barut
- Department of Surgery, Liver Transplantation Institute, Inonu University, 44315, Malatya, Turkey
| | - Fatih Gonultas
- Department of Surgery, Liver Transplantation Institute, Inonu University, 44315, Malatya, Turkey
| | - Baris Sarici
- Department of Surgery, Liver Transplantation Institute, Inonu University, 44315, Malatya, Turkey
| | - Koray Kutluturk
- Department of Surgery, Liver Transplantation Institute, Inonu University, 44315, Malatya, Turkey
| | - Murat Sait Dogan
- Department of Surgery, Liver Transplantation Institute, Inonu University, 44315, Malatya, Turkey
| | - Dincer Ozgor
- Department of Surgery, Liver Transplantation Institute, Inonu University, 44315, Malatya, Turkey
| | - Mustafa Dikilitas
- Department of Medical Oncology, Medical School, Inonu University, Malatya, Turkey
| | - Murat Harputluoglu
- Department of Gastroenterology, Medical School, Inonu University, Malatya, Turkey
| | - Murat Aladag
- Department of Gastroenterology, Medical School, Inonu University, Malatya, Turkey
| | - Ramazan Kutlu
- Department of Radiology, Medical School, Inonu University, Malatya, Turkey
| | - Ilknur Varol
- Department of Pediatric Gastroenterolgy, Medical School, Inonu University, Malatya, Turkey
| | - Abuzer Dirican
- Department of Surgery, Liver Transplantation Institute, Inonu University, 44315, Malatya, Turkey
| | - Cemalettin Aydin
- Department of Surgery, Liver Transplantation Institute, Inonu University, 44315, Malatya, Turkey
| | - Burak Isik
- Department of Surgery, Liver Transplantation Institute, Inonu University, 44315, Malatya, Turkey
| | - Cengiz Ara
- Department of Surgery, Liver Transplantation Institute, Inonu University, 44315, Malatya, Turkey
| | - Cuneyt Kayaalp
- Department of Surgery, Liver Transplantation Institute, Inonu University, 44315, Malatya, Turkey
| | - Sukru Emre
- Department of Surgery, Liver Transplantation Institute, Inonu University, 44315, Malatya, Turkey
| | - Sezai Yilmaz
- Department of Surgery, Liver Transplantation Institute, Inonu University, 44315, Malatya, Turkey
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Ince V, Akbulut S, Otan E, Ersan V, Karakas S, Sahin TT, Carr BI, Baskiran A, Samdanci E, Bag HG, Koc C, Usta S, Ozdemir F, Barut B, Gonultas F, Sarici B, Kutluturk K, Dogan MS, Ozgor D, Dikilitas M, Harputluoglu M, Aladag M, Kutlu R, Varol I, Dirican A, Aydin C, Isik B, Ara C, Kayaalp C, Emre S, Yilmaz S. Liver Transplantation for Hepatocellular Carcinoma: Malatya Experience and Proposals for Expanded Criteria. J Gastrointest Cancer 2020; 51:998-1005. [PMID: 32519232 DOI: 10.1007/s12029-020-00424-w] [Citation(s) in RCA: 32] [Impact Index Per Article: 8.0] [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] [Indexed: 02/07/2023]
Abstract
Survival was examined from a Turkish liver transplant center of patients with HCC, to identify prognostic factors. Data from 215 patients who underwent predominantly live donor liver transplant for HCC at our institute over 12 years were included in the study and prospectively recorded. They were 152 patients within and 63 patients beyond Milan criteria. Patients beyond Milan criteria were divided into two groups according to presence or absence of tumor recurrence. Recurrence-associated factors were analyzed. These factors were then applied to the total cohort for survival analysis. We identified four factors, using multivariate analysis, that were significantly associated with tumor recurrence. These were maximum tumor diameter, degree of tumor differentiation, and serum AFP and GGT levels. A model that included all four of these factors was constructed, the 'Malatya criteria.' Using these Malatya criteria, we estimated DFS and cumulative survival, for patients within and beyond these criteria, and found statistically significant differences with improved survival in patients within Malatya criteria of 1, 5, and 10-year overall survival rates of 90.1%, 79.7%, and 72.8% respectively, which compared favorably with other extra-Milan extended criteria. Survival of our patients within the newly defined Malatya criteria compared favorably with other extra-Milan extended criteria and highlight the usefulness of serum AFP and GGT levels in decision-making.
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Affiliation(s)
- Volkan Ince
- Department of Surgery, Liver Transplantation Institute, Inonu University, 44315, Malatya, Turkey.
| | - Sami Akbulut
- Department of Surgery, Liver Transplantation Institute, Inonu University, 44315, Malatya, Turkey
| | - Emrah Otan
- Department of Surgery, Liver Transplantation Institute, Inonu University, 44315, Malatya, Turkey
| | - Veysel Ersan
- Department of Surgery, Liver Transplantation Institute, Inonu University, 44315, Malatya, Turkey
| | - Serdar Karakas
- Department of Surgery, Liver Transplantation Institute, Inonu University, 44315, Malatya, Turkey
| | - Tolga Tevfik Sahin
- Department of Surgery, Liver Transplantation Institute, Inonu University, 44315, Malatya, Turkey
| | - Brian I Carr
- Department of Surgery, Liver Transplantation Institute, Inonu University, 44315, Malatya, Turkey
| | - Adil Baskiran
- Department of Surgery, Liver Transplantation Institute, Inonu University, 44315, Malatya, Turkey
| | - Emine Samdanci
- Department of Pathology, Medical School, Inonu University, Malatya, Turkey
| | - Harika Gozukara Bag
- Department of Bioistatistics, Medical School, Inonu University, Malatya, Turkey
| | - Cemalettin Koc
- Department of Surgery, Liver Transplantation Institute, Inonu University, 44315, Malatya, Turkey
| | - Sertac Usta
- Department of Surgery, Liver Transplantation Institute, Inonu University, 44315, Malatya, Turkey
| | - Fatih Ozdemir
- Department of Surgery, Liver Transplantation Institute, Inonu University, 44315, Malatya, Turkey
| | - Bora Barut
- Department of Surgery, Liver Transplantation Institute, Inonu University, 44315, Malatya, Turkey
| | - Fatih Gonultas
- Department of Surgery, Liver Transplantation Institute, Inonu University, 44315, Malatya, Turkey
| | - Baris Sarici
- Department of Surgery, Liver Transplantation Institute, Inonu University, 44315, Malatya, Turkey
| | - Koray Kutluturk
- Department of Surgery, Liver Transplantation Institute, Inonu University, 44315, Malatya, Turkey
| | - Murat Sait Dogan
- Department of Surgery, Liver Transplantation Institute, Inonu University, 44315, Malatya, Turkey
| | - Dincer Ozgor
- Department of Surgery, Liver Transplantation Institute, Inonu University, 44315, Malatya, Turkey
| | - Mustafa Dikilitas
- Department of Medical Oncology, Medical School, Inonu University, Malatya, Turkey
| | - Murat Harputluoglu
- Department of Gastroenterology, Medical School, Inonu University, Malatya, Turkey
| | - Murat Aladag
- Department of Gastroenterology, Medical School, Inonu University, Malatya, Turkey
| | - Ramazan Kutlu
- Department of Radiology, Medical School, Inonu University, Malatya, Turkey
| | - Ilknur Varol
- Department of Pediatric Gastroenterolgy, Medical School, Inonu University, Malatya, Turkey
| | - Abuzer Dirican
- Department of Surgery, Liver Transplantation Institute, Inonu University, 44315, Malatya, Turkey
| | - Cemalettin Aydin
- Department of Surgery, Liver Transplantation Institute, Inonu University, 44315, Malatya, Turkey
| | - Burak Isik
- Department of Surgery, Liver Transplantation Institute, Inonu University, 44315, Malatya, Turkey
| | - Cengiz Ara
- Department of Surgery, Liver Transplantation Institute, Inonu University, 44315, Malatya, Turkey
| | - Cuneyt Kayaalp
- Department of Surgery, Liver Transplantation Institute, Inonu University, 44315, Malatya, Turkey
| | - Sukru Emre
- Department of Surgery, Liver Transplantation Institute, Inonu University, 44315, Malatya, Turkey
| | - Sezai Yilmaz
- Department of Surgery, Liver Transplantation Institute, Inonu University, 44315, Malatya, Turkey
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Uylas U, Gunes O, Kayaalp C. Hirschsprung's Disease Complicated by Sigmoid Volvulus: A Systematic Review. Balkan Med J 2020; 38:1-6. [PMID: 32856883 DOI: 10.4274/balkanmedj.galenos.2020.2020.4.131] [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] [Indexed: 12/01/2022] Open
Abstract
BACKGROUND Hirschsprung's disease and sigmoid volvulus can sometimes be seen in the same patient. AIMS To investigate the presence of Hirschsprung's disease in patients with sigmoid volvulus and to discuss the diagnosis and treatment methods. STUDY DESIGN Systematic review. METHODS This systematic review has been reported in line with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses and the methodological quality of systematic reviews guidelines. The PubMed and Scopus databases were scanned using the keywords "Hirschsprung* volvulus*" and "congenital aganglionic megacolon volvulus*". The reference list of the selected studies was reviewed for cross-checking. Two reviewers independently screened the available literature. Only the Hirschsprung's disease cases involving sigmoid volvulus were included, and cases of patients with volvulus in other sites was excluded. There was no restriction with respect to the publication language and type of writing. The primary outcome was morbidity and mortality. RESULTS A total of 31 cases were analyzed in 22 articles; 97% of the patients were under the age of 40, 90% were male. There was a statistically significant difference in the necessity for relaparotomy between patients who were scheduled for sigmoid volvulus therapy with the suspicion of Hirschsprung's disease and patients who were treated without suspicion of Hirschsprung's disease (0% vs 37.5%, p=0.02). While there was no postoperative death in cases with suspected Hirschsprung disease, this mortality rate was 25% in cases without suspicion (p = 0.08). CONCLUSION Hirschsprung's disease should be excluded with rectal biopsy if a patient with sigmoid volvulus is under 40 years of age and has complaints of constipation from childhood.
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Affiliation(s)
- Ufuk Uylas
- Department of Gastroenterology Surgery, İnönü University School of Medicine, Malatya, Turkey
| | - Orgun Gunes
- Department of Gastroenterology Surgery, İnönü University School of Medicine, Malatya, Turkey
| | - Cuneyt Kayaalp
- Department of Gastroenterology Surgery, İnönü University School of Medicine, Malatya, Turkey
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Ispir M, Cumhur B, Sahin T, Otan E, Kayaalp C, Yilmaz S. Psychosocial Outcomes of Donors Whose Recipients Died After Living Donor Liver Transplantation. J Gastrointest Cancer 2020; 51:1200-1208. [PMID: 32833220 DOI: 10.1007/s12029-020-00496-8] [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] [Indexed: 02/08/2023]
Abstract
PURPOSE Our aim was to investigate the psychosocial outcomes of the donors whose recipients died after living donor liver transplantation (LDLT). METHODS Forty-one donors whose recipients died and 87 donors whose recipients were alive after LDLT at Inonu University Liver Transplantation Institute between 2012 and 2017 were included into the study. Demographic data form, Beck anxiety scale, Beck depression scale, Beck Hopelessness Scale, Posttraumatic Growth Inventory, Decision Regret Scale, Multidimensional Scale of Perceived Social Support, and general evaluation questionnaire (24 questions) were used in all donors by face to face questioning. In addition to the descriptive statistical analysis, chi-square and student's t tests were used to evaluate the differences between the groups. RESULTS Recipient death after living donor liver transplantation is a factor that negatively increases the level of anxiety, depression, hopelessness levels, and repentance of donors, and adversely affects the psychological growth of the donors after donation experience. CONCLUSION Regular follow-up of the donors should be done psychosocially in the postoperative period, especially the donors whose recipients have died should be followed up more frequently, and their support and treatment should be provided when needed. The donors should also be informed about the psychosocial implications of operative management and postoperative period. More studies are needed regarding the psychosocial problems of the donors.
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Affiliation(s)
- Mukadder Ispir
- Liver Transplant Institute, Inonu University, Elazig Yolu 10. Km, 44280, Malatya, Turkey
| | - Birgul Cumhur
- Department of Psychiatry, Inonu University Faculty of Medicine, 244280, Malatya, Turkey
| | - Tolga Sahin
- Liver Transplant Institute, Inonu University, Elazig Yolu 10. Km, 44280, Malatya, Turkey
| | - Emrah Otan
- Liver Transplant Institute, Inonu University, Elazig Yolu 10. Km, 44280, Malatya, Turkey
| | - Cuneyt Kayaalp
- Liver Transplant Institute, Inonu University, Elazig Yolu 10. Km, 44280, Malatya, Turkey
| | - Sezai Yilmaz
- Liver Transplant Institute, Inonu University, Elazig Yolu 10. Km, 44280, Malatya, Turkey.
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Aktas A, Aytac E, Bas M, Gunes O, Tarcan SH, Esen E, Gokler C, Aghayeva A, Uylas U, Ozben V, Zengin A, Sumer F, Baca B, Hamzaoglu I, Kayaalp C, Karahasanoglu T. Totally minimally invasive radical gastrectomy with the da Vinci Xi ® robotic system versus straight laparoscopy for gastric adenocarcinoma. Int J Med Robot 2020; 16:1-9. [PMID: 32757483 DOI: 10.1002/rcs.2146] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/08/2020] [Revised: 07/24/2020] [Accepted: 07/28/2020] [Indexed: 11/05/2022]
Abstract
BACKGROUND Data regarding the outcomes of pure minimally invasive techniques of radical gastrectomy are scarce. We aimed to compare short-term post-operative outcomes in patients undergoing totally minimally invasive radical gastrectomy with the da Vinci Xi® robotic system versus straight laparoscopy for gastric adenocarcinoma. METHODS Between December 2013 and March 2018, robotic and laparoscopic radical gastrectomy performed in two centres were included. Both groups were compared with respect to perioperative short-term outcomes. RESULTS Ninety-four patients were included in the study. Anticoagulant and neoadjuvant chemotherapy use were higher in the robotic group (p = 0.02, p = 0.02). There were conversions in the laparoscopy group whereas no conversions occurred in the robotic group (p = 0.052). Operating time in the robotic group was longer (p = 0.001). The number of harvested lymph nodes in the laparoscopic group was higher (p = 0.047). CONCLUSION Totally robotic technique with the da Vinci Xi® robotic system provides similar short-term results compared to laparoscopic surgery in radical gastrectomy.
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Affiliation(s)
- Aydin Aktas
- Department of Gastrointestinal Surgery, Inonu University, Malatya, Turkey
| | - Erman Aytac
- Department of General Surgery, Acibadem Mehmet Ali Aydinlar University, Istanbul, Turkey
| | - Mustafa Bas
- Department of General Surgery, Acibadem Mehmet Ali Aydinlar University, Istanbul, Turkey
| | - Orgun Gunes
- Department of Gastrointestinal Surgery, Inonu University, Malatya, Turkey
| | - Serim Hande Tarcan
- Department of General Surgery, Acibadem Mehmet Ali Aydinlar University, Istanbul, Turkey
| | - Eren Esen
- Langone Medical Center, New York University, New York, New York, USA
| | - Cihan Gokler
- Department of Gastrointestinal Surgery, Inonu University, Malatya, Turkey
| | - Afag Aghayeva
- Department of General Surgery, Acibadem Mehmet Ali Aydinlar University, Istanbul, Turkey
| | - Ufuk Uylas
- Department of Gastrointestinal Surgery, Inonu University, Malatya, Turkey
| | - Volkan Ozben
- Department of General Surgery, Acibadem Mehmet Ali Aydinlar University, Istanbul, Turkey
| | - Akile Zengin
- Department of Gastrointestinal Surgery, Inonu University, Malatya, Turkey
| | - Fatih Sumer
- Department of Gastrointestinal Surgery, Inonu University, Malatya, Turkey
| | - Bilgi Baca
- Department of General Surgery, Acibadem Mehmet Ali Aydinlar University, Istanbul, Turkey
| | - Ismail Hamzaoglu
- Department of General Surgery, Acibadem Mehmet Ali Aydinlar University, Istanbul, Turkey
| | - Cuneyt Kayaalp
- Department of Gastrointestinal Surgery, Inonu University, Malatya, Turkey
| | - Tayfun Karahasanoglu
- Department of General Surgery, Acibadem Mehmet Ali Aydinlar University, Istanbul, Turkey
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Karakas S, Sahin TT, Kutluturk K, Otan E, Baskiran A, Sarici KB, Varol I, Aydin C, Kayaalp C, Yilmaz S. Diaphragmatic hernias after pediatric liver transplantation: Experience of a high-volume transplant center. Pediatr Transplant 2020; 24:e13684. [PMID: 32166863 DOI: 10.1111/petr.13684] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/20/2019] [Accepted: 02/05/2020] [Indexed: 02/05/2023]
Abstract
Diaphragmatic hernias (DHs) are rare complications after pediatric liver transplantation (PLT). It is now widely accepted that DHs after liver transplantation (LT) is a pediatric related condition. PLTs (under of age 18) performed between January 2013 and June 2019 at Malatya Inonu University Institute of Liver Transplantation were retrospectively scanned. Study group consisting DHs and a control group were compared. Among 280 PLTs, 8 of them were complicated with DHs (%2.9). Median age of the patients with DH was 3.0 (0.8-9.5) years. Median graft recipient weight ratio was 2.5 (0.9-4.4). Five patients were below 5th percentiles in terms of pediatric weight growth chart at the time of LT. Also, 6 patients were below 5th percentiles in terms of pediatric height growth chart. There was no statistical difference between study and control groups. There are many risk factors mentioned in literature that may be primarily responsible for DHs after PLT. These factors are left lobe and large-for-size grafts, malnutrition, trauma or diathermy of diaphragmatic nerve and vessels and immunosuppressants. In our study, we could not specify any reason that differs in DHs. In our aspect, narrow diaphragma and thorax are exposed to high intra-abdominal pressure from abdomen. Large-for-size grafts, which are specific to children, also may contribute to this affect. Excessive diathermy and trauma to diaphragmatic collaterals may aggravate the risk of DH. More patients are needed to make an exact conclusion, in order to evaluate with comparable study on this aspect.
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Affiliation(s)
- Serdar Karakas
- Institute of Liver Transplantation, Inonu University, Malatya, Turkey
| | | | - Koray Kutluturk
- Institute of Liver Transplantation, Inonu University, Malatya, Turkey
| | - Emrah Otan
- Institute of Liver Transplantation, Inonu University, Malatya, Turkey
| | - Adil Baskiran
- Institute of Liver Transplantation, Inonu University, Malatya, Turkey
| | | | - Ilknur Varol
- Department of Pediatric Gastroenterology, Medical Faculty, Inonu University, Malatya, Turkey
| | - Cemalettin Aydin
- Institute of Liver Transplantation, Inonu University, Malatya, Turkey
| | - Cuneyt Kayaalp
- Institute of Liver Transplantation, Inonu University, Malatya, Turkey
| | - Sezai Yilmaz
- Institute of Liver Transplantation, Inonu University, Malatya, Turkey
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Abstract
OBJECTIVE Bariatric surgery is not a risk-free procedure and requires lifelong patient compliance in the postoperative period. Although the risks involved in bariatric surgery and the importance of lifelong follow-ups in the postoperative period are explained to patients in detail through verbal and written informed consent, the strong desire for weight loss can sometimes cause patients and their families to be ignorant of the mentioned issues preoperatively. The objective of this study is to evaluate the effectiveness of preoperative informational videos at improving the comprehension of informed consent content in bariatric surgery candidates. MATERIALS AND METHODS A total of 74 bariatric surgery candidates were randomized into two groups. The first group was given a usual verbal-written informed consent. The second group got an additional informing video presentation informed consent, in addition to the usual verbal-written informed consent. Then, both groups got a questionnaire evaluating their knowledge of bariatric surgery informed consent. The correct response scores and their relationship with patient demographics were analyzed. RESULTS Both groups had similar demographic features. Video-presented group had higher scores in questionnaire (11.3 ± 2.3 versus 9.4 ± 1.7, p = 0.001). Subgroup analysis showed that health care workers (12.5 ± 1.9 versus 10.3 ± 2.2, p = 0.005) and university graduates (11.6 ± 2.4 versus 10.1 ± 2.1, p = 0.03) got better results in the questionnaire. In multivariate analysis, video-assisted informing was found to be the only independent variable for high questionnaire scores (p = 0.0001). CONCLUSIONS This study showed that video-assisted informed consent improves patients' comprehension prior to bariatric surgery. We recommend routine preoperative video-assisted informing for bariatric surgery candidates in addition to usual verbal-written informed consent.
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Affiliation(s)
- Kutay Saglam
- Department of Gastrointestinal Surgery, Inonu University, 44315, Malatya, Turkey.
| | - Cuneyt Kayaalp
- Department of Gastrointestinal Surgery, Inonu University, 44315, Malatya, Turkey
| | - Aydin Aktas
- Department of Gastrointestinal Surgery, Inonu University, 44315, Malatya, Turkey
| | - Fatih Sumer
- Department of Gastrointestinal Surgery, Inonu University, 44315, Malatya, Turkey
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Ince V, Barut B, Baskiran A, Ersan V, Gonultas F, Ozdemir F, Otan E, Koc C, Sahin TT, Kutlu R, Kayaalp C, Yilmaz S. Liver transplantation for combined hepatocellular-cholangiocarcinoma. Int J Surg 2020. [DOI: 10.1016/j.ijsu.2020.01.096] [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: 11/28/2022]
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