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Alver S, Ciftci B, Güngör H, Gölboyu BE, Ozdenkaya Y, Alici HA, Tulgar S. Efficacy of modified thoracoabdominal nerve block through perichondrial approach following laparoscopic inguinal hernia repair surgery: a randomized controlled trial. Braz J Anesthesiol 2023; 73:595-602. [PMID: 37201747 PMCID: PMC10533976 DOI: 10.1016/j.bjane.2023.05.001] [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: 11/18/2022] [Revised: 05/03/2023] [Accepted: 05/04/2023] [Indexed: 05/20/2023]
Abstract
BACKGROUND Modified thoracoabdominal nerve block through perichondrial approach is a novel fascial plane block and provides abdominal analgesia by blocking thoracoabdominal nerves. Our primary aim was to evaluate the efficacy of M-TAPA on quality of recovery and pain scores in patients who underwent laparoscopic inguinal hernia repair surgery (Trans Abdominal Pre-Peritoneal approach ‒ TAPP). METHODS Patients with American Society of Anesthesiologists (ASA) physical status I-II aged between 18 and 65 years scheduled for elective TAPP under general anesthesia were enrolled in the study. After intubation, the patients were randomized into two groups: M: M-TAPA group (n = 30) and the control group (n = 30). M-TAPA was performed with total 40 ml 0.25% bupivacaine in the M group. Surgical infiltration was performed in the control group. The primary outcome of the study was the global quality of recovery score, the secondary outcomes were pain scores, rescue analgesic demands, and adverse effects during the 24-h postoperative period. RESULTS The global quality of recovery scores at 24 h were significantly higher in the M group (p < 0.001). There was a reduction in the median static and dynamic NRS for the first postoperative 8 h in the M group compared to the control group (p < 0.001). The need for rescue analgesia was significantly lower in the M group compared to the control group (13 patients vs. 24 respectively, p < 0.001). The incidence of side effects was significantly higher in the control group (p < 0.001). CONCLUSION In our study, M-TAPA increased patient recovery scores, and provided pain relief in patients who underwent TAPP. REGISTER NUMBER NCT05199922.
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Affiliation(s)
- Selcuk Alver
- Istanbul Medipol University, Department of Anesthesiology and Reanimation, Istanbul, Turkey
| | - Bahadir Ciftci
- Istanbul Medipol University, School of Medicine, Department of Anesthesiology and Reanimation, Istanbul, Turkey.
| | - Hande Güngör
- Istanbul Medipol University, Department of Anesthesiology and Reanimation, Istanbul, Turkey
| | | | - Yasar Ozdenkaya
- Istanbul Medipol University, Department of General Surgery, Istanbul, Turkey
| | - Haci Ahmet Alici
- Istanbul Medipol University, Department of Algology, Istanbul, Turkey
| | - Serkan Tulgar
- Samsun University, Faculty of Medicine, Samsun Training and Research Hospital, Department of Anesthesiology and Reanimation, Samsun, Turkey
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Tazeoglu A, Ozdenkaya Y, Kamali GH, Tazeoglu D. Anti-inflammatory activity of curcumin in a model of L-arginine-induced acute pancreatitis in rats. Ann Ital Chir 2023; 12:S2239253X2303880X. [PMID: 37199116] [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: 05/19/2023]
Abstract
BACKGROUND Acute pancreatitis (AP) is a pathology characterized by activated digestive enzymes to digest pancreatic tissue and inflammation. This study aimed to investigate the effect of curcumin, which has antioxidant and anti-inflammatory properties, on AP and its effectiveness at different doses. METHODS Forty Sprague Dawley albino male rats, 12 weeks old, weighing 285-320 g, were used in the study. The rats were divided into control, curcumin, AP, low (100 mg/kg), and high (200mg/kg) dose curcumin groups. An experimental pancreatitis model was created with 5 g/kg L-arginine and samples (amylase, lipase, IL-1β, IL-6, TNF-alpha, CRP, histopathological) were taken after 72 hours. RESULTS There was no difference between the groups in terms of the weight of the rats (p=0.76). In the AP group, it was observed that the experimental pancreatitis model was successfully created after examination. Laboratory and histopathological examination results in the curcumin-administered groups were regressed compared to the AP group. The decrease in laboratory values was higher in the high-dose curcumin group than in the low-dose (p<0.001). CONCLUSION Laboratory and histopathological changes occur in AP according to clinical severity. The antioxidant and anti-inflammatory effects of curcumin are known. In the light of this information and according to the results of our study, it has been shown that curcumin is effective in the treatment of AP, and the effect of curcumin increases with the dose increase. Curcumin is effective in treating AP. However, while high-dose curcumin was more effective in inflammatory response than low-dose, it showed similar histopathological results. KEY WORDS Acute, Curcumin, Cytokines, Inflammation, Pancreatitis.
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Ciftci B, Güngör H, Alver S, Gölboyu BE, Ozdenkaya Y, Tulgar S. In response to 'postoperative analgesic efficacy of M-TAPA'. J Anesth 2023; 37:497-498. [PMID: 37093278 DOI: 10.1007/s00540-023-03196-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2023] [Accepted: 04/12/2023] [Indexed: 04/25/2023]
Affiliation(s)
- Bahadir Ciftci
- Department of Anesthesiology and Reanimation, Istanbul Medipol University School of Medicine, Bagcilar, 34040, Istanbul, Turkey.
| | - Hande Güngör
- Department of Anesthesiology and Reanimation, Istanbul Medipol University School of Medicine, Bagcilar, 34040, Istanbul, Turkey
| | - Selcuk Alver
- Department of Anesthesiology and Reanimation, Istanbul Medipol University School of Medicine, Bagcilar, 34040, Istanbul, Turkey
| | | | - Yasar Ozdenkaya
- Department of General Surgery, Istanbul Medipol University, Istanbul, Turkey
| | - Serkan Tulgar
- Faculty of Medicine, Department of Anesthesiology and Reanimation, Samsun University, Samsun Training and Research Hospital, Samsun, Turkey
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Güngör H, Ciftci B, Alver S, Gölboyu BE, Ozdenkaya Y, Tulgar S. Modified thoracoabdominal nerve block through perichondrial approach (M-TAPA) vs local infiltration for pain management after laparoscopic cholecystectomy surgery: a randomized study. J Anesth 2022; 37:254-260. [PMID: 36575362 DOI: 10.1007/s00540-022-03158-0] [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: 09/28/2022] [Accepted: 12/18/2022] [Indexed: 12/29/2022]
Abstract
PURPOSE Modified thoracoabdominal nerves block through perichondrial approach (M-TAPA) targets thoracoabdominal nerves. Our primary aim was to compare M-TAPA vs local infiltration on pain management in patients underwent laparoscopic cholecystectomy (LC) surgery. METHODS Patients with ASA class I-II patients aged between 18 and 65 years scheduled for elective LC under general anesthesia were enrolled in the study. There were two randomized groups: Group M: M-TAPA group (n = 30) and the local infiltration (LI) group (n = 30). M-TAPA was performed with totally 40 ml 0.25% bupivacaine in the M group. LI was performed in infiltration group. The primary outcome of the study was pain score in the PACU, the secondary outcomes were the patient satisfaction scores, rescue analgesic need, and adverse effects during the 24-h postoperative period. RESULTS The static NRS scores were significantly lower in Group M at the postoperative first 4 h (p = 0.001). There was a significant decrease in the dynamic NRS scores in Group M at the postoperative first 16 h (p = 0.001). The incidence of nausea was significantly higher in the LI group (12 vs. 5 patients, p = 0.047). The need for rescue analgesia was significantly lower in Group M (p = 0.009). The patient satisfaction scores were significantly higher in Group M (p = 0.001). CONCLUSION M-TAPA provides superior analgesia compared to LI in patients undergoing LC.
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Affiliation(s)
- Hande Güngör
- Department of Anesthesiology and Reanimation, Istanbul Medipol University, Bagcilar, 34040, Istanbul, Turkey
| | - Bahadir Ciftci
- Department of Anesthesiology and Reanimation, Istanbul Medipol University, Bagcilar, 34040, Istanbul, Turkey.
| | - Selcuk Alver
- Department of Anesthesiology and Reanimation, Istanbul Medipol University, Bagcilar, 34040, Istanbul, Turkey
| | | | - Yasar Ozdenkaya
- Department of General Surgery, Istanbul Medipol University, Istanbul, Turkey
| | - Serkan Tulgar
- Faculty of Medicine, Department of Anesthesiology and Reanimation, Samsun University, Samsun Training and Research Hospital, Samsun, Turkey
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Kurtulus I, Basim S, Ozdenkaya Y. Can serum tumor necrosis factor-alpha predict peritoneal adhesions prior to secondary laparoscopic procedures? J Visc Surg 2022:S1878-7886(22)00181-3. [PMID: 36577610 DOI: 10.1016/j.jviscsurg.2022.12.007] [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: 12/27/2022]
Abstract
AIM OF THE STUDY This study aimed to investigate the incidence and degree of postoperative intra-abdominal adhesions(POAs) in secondary laparoscopic procedures and assess the power of the preoperative levels of tumor necrosis factor-alpha(TNF-α) and interleukin-1 beta(IL-1β) and selected peripheral inflammatory biomarkers(PIBs) in the prediction of the development and extent of POA. PATIENTS AND METHODS This prospective study enrolled 103 patients who had previously undergone at least one or more laparoscopic abdominal or gynecological operations. We examined TNF-α, IL-1β, and PIBs, namely C-reactive protein, white blood cell count, neutrophil-to-lymphocyte ratio(NLR), platelet-to-lymphocyte ratio, and systemic immune-inflammation index(SII) according to the presence, location, and score of adhesions determined during secondary laparoscopic procedures. RESULTS Only age, postoperative adhesion index(PAI) score, NLR, SII, TNF-α, and IL-1β resulted in a significant difference in the existence of adhesion(P<0.05). The correlation analysis of TNF-α with variables showed that the PAI score and IL 1β levels had a significantly positive correlation. CONCLUSION The presence and extent of POA could be predicted by examining the preoperative TNF-α level in patients who had laparoscopic abdominal surgery previously. We could overcome adverse events during secondary laparoscopic procedures by assessing high-risk patients and integrating a personalized surgical approach to managing selected patients.
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Affiliation(s)
- I Kurtulus
- Department of General Surgery, Basaksehir Cam and Sakura City Hospital, Istanbul, Turkey.
| | - S Basim
- Department of General Surgery, Basaksehir State Hospital, Istanbul, Turkey
| | - Y Ozdenkaya
- Department of General Surgery, Istanbul Medipol University, Bagcilar, Istanbul, Turkey
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Ciftci B, Ekinci M, Celik EC, Kaciroglu A, Karakaya MA, Demiraran Y, Ozdenkaya Y. Comparison of Intravenous Ibuprofen and Paracetamol for Postoperative Pain Management after Laparoscopic Sleeve Gastrectomy. A Randomized Controlled Study. Obes Surg 2020; 29:765-770. [PMID: 30474791 DOI: 10.1007/s11695-018-3613-1] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [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: 12/18/2022]
Abstract
BACKGROUND Laparoscopic sleeve gastrectomy (LSG) is defined as the first-step bariatric surgery for the treatment of obesity. Opioid analgesics are often preferred for pain management because of their strong analgesic potentials. However, opioids have undesirable adverse effects. OBJECTIVES The objective of this study is to evaluate and compare the influence of IV forms of ibuprofen and paracetamol on pain management and opioid consumption on patients undergoing LSG surgery. SETTING This study was conducted at Istanbul Medipol University Hospital. METHODS Patients were stratified into three groups. Group I (group ibuprofen, n = 30) was administered 800 mg of IV ibuprofen, group P (group paracetamol, n = 30) was administered 1000 mg of IV paracetamol, and group C (control group, n = 30) was given 100 ml of saline solution. We evaluated opioid consumption and VAS scores postoperatively. RESULTS This study included 90 patients who underwent LSG. The use of rescue medication in group I was statistically lower than the other groups. VAS scores in group I and group P at recovery and at 2, 4, 8, 12, and 24 h were lower than those in group C. In particular, the VAS scores in group I at the first 2 h postoperatively were significantly lower than those in group P (p < 0.05). Opioid consumption in group C was significantly higher than the other groups (p < 0.05). CONCLUSION Our study suggested that IV ibuprofen resulted in lower pain scores compared to paracetamol by reducing postoperative opioid use in the first 24 h in patients undergoing LSG surgery.
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Affiliation(s)
- Bahadır Ciftci
- Department of Anesthesiology and Reanimation, Istanbul Medipol University, Bagcilar, 34000, Istanbul, Turkey.
| | - Mursel Ekinci
- Department of Anesthesiology and Reanimation, Istanbul Medipol University, Bagcilar, 34000, Istanbul, Turkey
| | - Erkan Cem Celik
- Department of Anesthesiology and Reanimation, Erzurum Regional Training and Research Hospital, Yakutiye, 25070, Erzurum, Turkey
| | - Ahmet Kaciroglu
- Department of Anesthesiology and Reanimation, Fatih Sultan Mehmet Training and Research Hospital, Merkez, 34000, Istanbul, Turkey
| | - Muhammet Ahmet Karakaya
- Department of Anesthesiology and Reanimation, Istanbul Medipol University, Bagcilar, 34000, Istanbul, Turkey
| | - Yavuz Demiraran
- Department of Anesthesiology and Reanimation, Istanbul Medipol University, Bagcilar, 34000, Istanbul, Turkey
| | - Yasar Ozdenkaya
- Department of General Surgery, Istanbul Medipol University, Bagcilar, 34000, Istanbul, Turkey
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Ozdenkaya Y, Olmuscelik O, Basim P, Saka B, Arslan NC. The effect of fibrin glue in preventing staple-line leak after sleeve gastrectomy. An experimental study in rats. Acta Cir Bras 2019; 34:e201900801. [PMID: 31618401 PMCID: PMC6802941 DOI: 10.1590/s0102-865020190080000001] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/07/2019] [Accepted: 07/08/2019] [Indexed: 01/18/2023] Open
Abstract
Purpose To evaluate the effect of fibrin glue on staple-line leak after sleeve
gastrectomy. Methods Fourteen adult wistar rats 300 gr were randomized into two groups: Control
group (n=7) and study group (n=7). All the rats underwent sleeve gastrectomy
using lineer stapler. In the study group, fibrin glue was used to reinforce
the staple-line. The rats were sacrificed 7 days after surgery. The stomach
was resected, submerged in saline and exposed to excess pressure to obtain a
burst pressure value. The gastric staple line was evaluated
histopathologically according to the Ehrlich Hunt scale. The results of the
two groups were compared. Results The mean Ehrlich-Hunt scores for inflammation, fibroblastic activity and
neo-angiogenesis were similar between the groups (p>0.05). Collagen
deposition was significantly higher in study group (3.42±0.53) when compared
with control group (2.57±0.78) (p=0.035). The mean burst pressure was
137.8±8.5 mmHg for control group and 135.0±8.1 mmHg for study group
(p=0.536). Conclusion Reinforcement of the staple-line with fibrin glue has no effect on the burst
pressure after sleeve gastrectomy. More studies are needed to evaluate the
precautions against leak after sleeve gastrectomy.
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Affiliation(s)
- Yasar Ozdenkaya
- MD, Assistant Professor, Department of General Surgery , Medipol University Medical Faculty , Istanbul , Turkey . Conception and design of the study, acquisition of data, manuscript writing
| | - Oktay Olmuscelik
- MD, Assistant Professor, Department of Internal Medicine , Medipol University Medical Faculty, Istanbul , Turkey . Conception of the study, acquisition of data, critical revision
| | - Pelin Basim
- MD, Assistant Professor, Department of General Surgery , Medipol University Medical Faculty , Istanbul , Turkey . Conception and design of the study, acquisition of data, critical revision
| | - Burcu Saka
- MD, Assistant Professor, Department of Pathology , Medipol University Medical Faculty , Istanbul , Turkey . Histopathological examinations
| | - Naciye Cigdem Arslan
- MD, Associate Professor, Department of General Surgery , Medipol University Medical Faculty , Istanbul , Turkey . Statistics analysis, manuscript writing, final approval
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Ozdenkaya Y, Ersavas C, Olmuscelik O, Basim P, Ozover I, Seker M, Arslan NC. Comparison of the Bethesda system classification and postoperative cytology of thyroid nodules: A single center experience. Dicle Tıp Dergisi 2019. [DOI: 10.5798/dicletip.620391] [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: 11/14/2022] Open
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Arslan NC, Degirmenci AK, Ozdenkaya Y, Terzi C. Wound Irrigation with Chlorhexidine Gluconate Reduces Surgical Site Infection in Pilonidal Disease: Single-Blind Prospective Study. Surg Infect (Larchmt) 2019; 21:143-149. [PMID: 31460835 DOI: 10.1089/sur.2019.053] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [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: 12/28/2022] Open
Abstract
Background: The aim of this study was to determine whether incision irrigation with chlorhexidine gluconate (CHG) reduces surgical site infections (SSIs) in pilonidal disease surgery. Methods: Between 2013 and 2018, patients who underwent wide excision with primary closure for pilonidal disease were enrolled in this prospective observational multi-institutional cohort. The incision was irrigated with either saline or 0.05% CHG before skin closure. The infection risk of each patient was determined by the National Nosocomial Infection Surveillance System. Post-operative site care and follow-up were carried out according to the U.S. Centers for Disease Control and Prevention guideline by two surgeons blinded to the irrigation solution used. Surgical site infection rates in the saline and 0.05% CHG groups were compared. The secondary outcomes were seroma formation, incision dehiscence, and time to healing. Results: There were 129 patients in the control group and 138 patients in the CHG group. The mean age was 25.1 ± 5.4, and 225 patients (84.3%) were male. Surgical site infection was seen in 35 patients (13.1%): 26 (20.2%) in the control group and 9 (6.5%) in the CHG group (p = 0.001). There were no differences in seroma formation (n = 12; 9.3% in the control vs n = 12; 8.7% in the CHG group; p = 0.515) or incision dehiscence (n = 9; 7% in the control vs n = 9; 6.5% in the CHG group; p = 0.537). The primary healing rate was higher in the CHG group (n = 130; 94.2%) than in the control group (n = 104; 80.6%). Time to healing was 20.5 ± 7.8 days in the control group and 16 ± 4.3 days in the CHG group (p < 0.001). Conclusion: Intra-operative incision irrigation with CHG decreased the SSI rate and time to healing in pilonidal disease surgery. Further randomized trials should focus on specific irrigation methods and procedures to build a consensus on the effect of incision irrigation on SSIs.
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Affiliation(s)
| | | | - Yasar Ozdenkaya
- Department of General Surgery, Medipol University, Istanbul, Turkey
| | - Cem Terzi
- Department of General Surgery, Dokuz Eylul University, Izmir, Turkey
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Ozdenkaya Y, Ersavas C, Arslan NC. Robotic transoral vestibular parathyroidectomy: Two case reports and review of literature. World J Clin Cases 2018; 6:542-547. [PMID: 30397611 PMCID: PMC6212607 DOI: 10.12998/wjcc.v6.i12.542] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/31/2018] [Revised: 08/27/2018] [Accepted: 08/30/2018] [Indexed: 02/05/2023] Open
Abstract
Advances in preoperative localization studies and demands for scarless surgery have promoted the investigation for remote techniques in parathyroid surgery. Transoral vestibular approach seems to provide the most comfortable and safest access to the neck. In this paper, we report our initial experience with robotic transoral vestibular parathyroidectomy (RTVP) in four patients with primary hyperparathyroidism. The surgery was performed with the Da Vinci system through three trocars introduced from the lower lip vestibule. The procedure was converted to open in two patients due to inappropriate preoperative localization. The mean operative time was 169 min. No postoperative complications were seen. Patients were discharged on postoperative day 1. RTVP is a feasible and safe technique, which allows better surgical exposure and manipulation of the instruments. The advantages of transoral vestibular approach can be enhanced by robotics. Further studies are needed to analyze complications and costs.
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Affiliation(s)
- Yasar Ozdenkaya
- Department of General Surgery, Medipol University, Istanbul 34214, Turkey
| | - Cenk Ersavas
- Department of General Surgery, Medipol University, Istanbul 34214, Turkey
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Bener A, Ozdenkaya Y, Al-Hamaq AO, Barisik CC, Ozturk M. Low Vitamin D Deficiency Associated With Thyroid Disease Among Type 2 Diabetic Mellitus Patients. J Clin Med Res 2018; 10:707-714. [PMID: 30116441 PMCID: PMC6089577 DOI: 10.14740/jocmr3507w] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2018] [Accepted: 06/18/2018] [Indexed: 12/16/2022] Open
Abstract
BACKGROUND The aim of this study was to investigate the relationship between vitamin D deficiency and thyroid diseases among type 2 diabetes mellitus (T2DM) patients. METHODS This was a cohort case and control study, 546 T2DM patients and 546 control study participants were enrolled, aged between 25 and 65 years. The subjects were also investigated for fasting blood glucose levels (FBG), post prandial glucose (PPG,) glycosylated hemoglobin (HbA1c), thyroid stimulating hormone (TSH), T3, T4, and presence of other comorbid conditions. Thyroid fine needle aspiration biopsy was suggested to patients whose thyroid nodules were greater than 1.00 cm. RESULTS There were significant differences between T2DM patients and control subjects regarding BMI (kg/m2), physical activity, cigarette smoking, sheesha smoking, family history of diabetes, hypertension and family history of thyroid nodules. The clinical biochemistry values among T2DM for vitamin D, calcium, magnesium, potassium, phosphorous, fasting blood glucose, cholesterol, HbA1c, HLDL, LDL, triglyceride, systolic blood pressure (SBP) and diastolic blood pressure (DBP) were lower than control subjects, but higher in creatinine, albumin, TSH, T3, and T4 which appeared statistically significant differences (P < 0.001). Also, the study revealed statistically significant differences between subjects vitamin D deficiency and with thyroid nodules for calcium, magnesium, phosphorous, HbA1c, high density lipoprotein (HDL), SBP and DBP, TSH, T3, and T4 among T2DM patients and control subjects (P < 0.001). Multivariable stepwise logistic regression analysis showed that TSH, HbA1c, vitamin D deficiency, SBP (mm Hg), BMI, family history of DM, serum calcium level and family history of thyroid were considered at higher risk as predictors of thyroid among T2DM patients. CONCLUSIONS This study suggests that obesity, HbA1c, the environment, and genetic susceptibility among T2DM, may increase the risk of thyroid disease and cancer. Although evidence has shown that thyroid cancer incidence has been rising more rapidly over time than the occurrence of cancers of other sites, due to an increase of obesity, diabetes and lack of physical activity, this study lacks of direct evidence supporting this conclusion.
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Affiliation(s)
- Abdulbari Bener
- Department of Biostatistics and Medical Informatics, Cerrahpasa Faculty of Medicine, Istanbul University, Istanbul, Turkey
- Department of Evidence for Population Health Unit, School of Epidemiology and Health Sciences, The university of Manchester, Manchester, UK
- Department. of Endocrinology, Medipol International School of Medicine, Istanbul Medipol University, Istanbul, Turkey
| | - Yasar Ozdenkaya
- Qatar Diabetic Associations and Qatar National Research Foundation, Doha, Qatar
| | - Abdulla O.A.A. Al-Hamaq
- Department of Surgery, Medipol School of Medicine, Istanbul Medipol University, Istanbul, Turkey
| | - Cem Cahit Barisik
- Department of Radiology and Pathology, Medipol School of Medicine, Istanbul Medipol University, Istanbul, Turkey
| | - Mustafa Ozturk
- Department. of Endocrinology, Medipol International School of Medicine, Istanbul Medipol University, Istanbul, Turkey
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Haksal M, Okkabaz N, Atici AE, Civil O, Ozdenkaya Y, Erdemir A, Aksakal N, Oncel M. Fortune of temporary ileostomies in patients treated with laparoscopic low anterior resection for rectal cancer. Ann Surg Treat Res 2016; 92:35-41. [PMID: 28090504 PMCID: PMC5234425 DOI: 10.4174/astr.2017.92.1.35] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2016] [Revised: 08/23/2016] [Accepted: 09/12/2016] [Indexed: 12/22/2022] Open
Abstract
PURPOSE The current study aims to analyze the risk factors for the failure of ileostomy reversal after laparoscopic low anterior resection for rectal cancer. METHODS All patients who underwent a laparoscopic low anterior resection for rectal cancer with a diverting ileostomy between 2007 and 2014 were abstracted. The patients who underwent and did not undergo a diverting ileostomy procedure were compared regarding patient, tumor, treatment related parameters, and survival. RESULTS Among 160 (103 males [64.4%], mean [± standard deviation] age was 58.1 ± 11.9 years) patients, stoma reversal was achieved in 136 cases (85%). Anastomotic stricture (n = 13, 52.4%) was the most common reason for stoma reversal. These were the risk factors for the failure of stoma reversal: Male sex (P = 0.035), having complications (P = 0.01), particularly an anastomotic leak (P < 0.001), or surgical site infection (P = 0.019) especially evisceration (P = 0.011), requirement for reoperation (P = 0.003) and longer hospital stay (P = 0.004). Multivariate analysis revealed that male sex (odds ratio [OR], 7.82; P = 0.022) and additional organ resection (OR, 6.71; P = 0.027) were the risk factors. Five-year survival rates were similar (P = 0.143). CONCLUSION Fifteen percent of patients cannot receive a stoma reversal after laparoscopic low anterior resection for rectal cancer. Anastomotic stricture is the most common reason for the failure of stoma takedown. Having complications, particularly an anastomotic leak and the necessity of reoperation, limits the stoma closure rate. Male sex and additional organ resection are the risk factors for the failure in multivariate analyses. These patients require a longer hospitalization period, but have similar survival rates as those who receive stoma closure procedure.
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Affiliation(s)
- Mustafa Haksal
- Department of General Surgery, Kartal Education and Research Hospital, Istanbul, Turkey.; Department of General Surgery, Medipol University Medical School, Istanbul, Turkey
| | - Nuri Okkabaz
- Department of General Surgery, Kartal Education and Research Hospital, Istanbul, Turkey
| | - Ali Emre Atici
- Department of General Surgery, Kartal Education and Research Hospital, Istanbul, Turkey
| | - Osman Civil
- Department of General Surgery, Kartal Education and Research Hospital, Istanbul, Turkey
| | - Yasar Ozdenkaya
- Department of General Surgery, Medipol University Medical School, Istanbul, Turkey
| | - Ayhan Erdemir
- Department of General Surgery, Kartal Education and Research Hospital, Istanbul, Turkey
| | - Nihat Aksakal
- Department of General Surgery, Kartal Education and Research Hospital, Istanbul, Turkey
| | - Mustafa Oncel
- Department of General Surgery, Medipol University Medical School, Istanbul, Turkey
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Altun A, Saraydin SU, Soylu S, Inan DS, Yasti C, Ozdenkaya Y, Koksal B, Duger C, Isbir C, Turan M. Chemopreventive effects of hydatid disease on experimental breast cancer. Asian Pac J Cancer Prev 2015; 16:1391-5. [PMID: 25743804 DOI: 10.7314/apjcp.2015.16.4.1391] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Abstract
Breast cancer is one of the most common and letal cancers in all over the world. Since there have been significant improvements in treatment of breast cancer, there is still a big need for alternative approaches. In this study, we aimed to investigate protective role of hydatid disease against breast cancer. Twenty Wistar rats were divided into two groups of 10 rats each Group I (control) and Group II. In Group II intraperitoneal hydatidosis was performed. Then DMBA was applied to mammary tissues of all rats. Immunohistochemistry studies for Ki-67 and S-100 in the tumoral tissue sections of DMBA induced mammary tumor in rats were performed. TUNEL Assay was used to detect apoptotic cells of tumoral tissue. In vivo anticancer activity testing was carried out by preventing the tumorigenesis by DMBA in mammary tissue of rats. The expressions of the Ki-67 and S-100 protein decreased in rats who had Hydatid Disease (HD) (Group II), compared with the control rats (Group I). TUNEL positive cells were higher in rats with HD (Group II), compared with the control rats (Group I). In vivo studies showed that HD prevented the tumorigenesis by DMBA in mammary tissue of rats with 50 percent.In the light of the evidence the present study showed that HD may have chemopreventive effects on DMBA induced breast cancer.
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Affiliation(s)
- Ahmet Altun
- Department of Pharmacology, Faculty of Medicine, Cumhuriyet University, Sivas, Turkey E-mail :
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Ozturk G, Malya FU, Ersavas C, Ozdenkaya Y, Bektasoglu H, Cipe G, Citgez B, Karatepe O. A novel reconstruction method for giant incisional hernia: Hybrid laparoscopic technique. J Minim Access Surg 2015; 11:267-70. [PMID: 26622118 PMCID: PMC4640027 DOI: 10.4103/0972-9941.142403] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022] Open
Abstract
BACKGROUND AND OBJECTIVES: Laparoscopic reconstruction of ventral hernia is a popular technique today. Patients with large defects have various difficulties of laparoscopic approach. In this study, we aimed to present a new reconstruction technique that combines laparoscopic and open approach in giant incisional hernias. MATERIALS AND METHODS: Between January 2006 and August 2012, 28 patients who were operated consequently for incisional hernia with defect size over 10 cm included in this study and separated into two groups. Group 1 (n = 12) identifies patients operated with standard laparoscopic approach, whereas group 2 (n = 16) labels laparoscopic technique combined with open approach. Patients were evaluated in terms of age, gender, body mass index (BMI), mean operation time, length of hospital stay, surgical site infection (SSI) and recurrence rate. RESULTS: There are 12 patients in group 1 and 16 patients in group 2. Mean length of hospital stay and SSI rates are similar in both groups. Postoperative seroma formation was observed in six patients for group 1 and in only 1 patient for group 2. Group 1 had 1 patient who suffered from recurrence where group 2 had no recurrence. DISCUSSION: Laparoscopic technique combined with open approach may safely be used as an alternative method for reconstruction of giant incisional hernias.
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Affiliation(s)
- G Ozturk
- Department of Surgery, Medipol University, Istanbul, Turkey
| | - F U Malya
- Department of Hepatobiliary Surgery, Bezmialem Vakif University, Istanbul, Turkey
| | - C Ersavas
- Department of Surgery, Medipol University, Istanbul, Turkey
| | - Y Ozdenkaya
- Department of Surgery, Medipol University, Istanbul, Turkey
| | - H Bektasoglu
- Department of Hepatobiliary Surgery, Bezmialem Vakif University, Istanbul, Turkey
| | - G Cipe
- Department of Hepatobiliary Surgery, Bezmialem Vakif University, Istanbul, Turkey
| | - B Citgez
- Department of Hepatobiliary Surgery, Bezmialem Vakif University, Istanbul, Turkey
| | - O Karatepe
- Department of Hepatobiliary Surgery, Bezmialem Vakif University, Istanbul, Turkey
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Battal M, Çitgez B, Kartal A, Kemik A, Yildirim P, Ozdenkaya Y, Yilmaz A, Karatepe O. Impact of GLP-1 analogue on oxidative damage and hepatic regeneration in experimental 70% hepatectomy model. Hepatogastroenterology 2015; 62:257-260. [PMID: 25916043] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/04/2023]
Abstract
BACKGROUND/AIMS The purpose of our study is researching into impact of glucagon like peptide 1 (GLP 1) analogue on liver regeneration after major hepatectomy. METHODOLOGY 24 wistar albino rats were consecutively divided into 3 groups. Group 1: Control (sham) group day 14 (n = 8), Group 2: Liver resection group day 14 (n = 8); 70% Liver resection was performed, Group 3: Study group day 14 (n = 8); Subsequent to performing 70% liver resection, GLP-1 analogue was administered 2 times a day. (10 μgr/70 kg x 2 times). After 14 day, rats were sacrificed. Oxi- dative stress and antioxidant enzymes and mitochon- drial permeability transition, cytochrome-c, Bax, Bcl- 2, caspase-3, caspase-8 and caspase-3 activity were examined. RESULTS 70% Liver resection induced oxi- dative stress of liver tissue was ameliorated by GLP-1 induction. Administration of GLP increased Bcl-2 ex- pression. Decreased expression of cytochrome-c was accompanied by a decrease caspase-3, caspase-8, and Bax expression and caspase-3 activity. CONCLUSIONS Glp 1 induction plays a regenerative role in the major hepatectomy. This effect is dependent on modulation of the antiapoptotic and antioxidative pathways by GLP 1 expression.
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Baskan O, Ozdenkaya Y, Erol C, Dolay K. Median Arcuate Ligament: Should Be Recognised before the Surgery; Importance in Pancreaticoduodenectomy. Balkan Med J 2014. [DOI: 10.5152/balkanmedj.2014.14082] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
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Yilmaz A, Malya F, Ozturk G, Citgez B, Ozdenkaya Y, Ersavas C, Agan A, Senturk H, Karatepe O. Effect of pre-operative red blood cell distribution on cancer stage and morbidity rate in patients with pancreatic cancer. Int J Clin Exp Med 2014; 7:3072-3075. [PMID: 25356183 PMCID: PMC4211833] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2014] [Accepted: 08/28/2014] [Indexed: 06/04/2023]
Abstract
BACKGROUND The red blood cell distribution (RDW) is a test measure of erythrocyte variation and the volume level which shows the heterogeneity and it is a proven test in literature for the determination of survival on cardiovascular diseases. The main purpose of this research is to investigate the relationship between the RDW level and postoperative morbidity as well as its stages in diagnosed pancreatic cancer patients. METHODS In this study we covered 104 diagnosed pancreatic cancer patients who have been operated in 2011-2014. The RDW levels were separated into two groups. Group 1 contains higher level RDW patients (> 14) whereas group 2 contains only lower level RDW patients. We compared both groups in terms of the patients' demographic data, duration of hospitalization, ratio of pancreatic fistula, disease period, and the mortality rates. RESULTS In group 1 contains 39 patients whereas group 2 contains only 65 patients. We determined the positive correlation between stages of disease with RDW levels as well as the correlation between low level of blood albumin and Ca 19.9 levels (p = 0001). However we did not observe statistically important difference in postoperative morbidity. CONCLUSIONS Based on this study we report that RDW levels can be use as a marker to show the stages of pancreatic cancer in diagnosed patients.
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Affiliation(s)
- A Yilmaz
- Department of Surgery, Medipol University Turkey
| | - Fu Malya
- Department of Surgery, Bezmialem University Turkey
| | - G Ozturk
- Department of Surgery, Medipol University Turkey
| | - B Citgez
- Department of Surgery, Bezmialem University Turkey
| | - Y Ozdenkaya
- Department of Surgery, Medipol University Turkey
| | - C Ersavas
- Department of Surgery, Medipol University Turkey
| | - Af Agan
- Department of Gastroenterology, Medipol University Turkey
| | - H Senturk
- Department of Gastroenterology, Bezmialem University Turkey
| | - O Karatepe
- Department of Surgery, Medipol University Turkey
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Karatepe O, Gulcicek OB, Adas G, Battal M, Ozdenkaya Y, Kurtulus I, Altiok M, Karahan S. Cecal diverticulitis mimicking acute Appendicitis: a report of 4 cases. World J Emerg Surg 2008; 3:16. [PMID: 18426572 PMCID: PMC2365938 DOI: 10.1186/1749-7922-3-16] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2007] [Accepted: 04/21/2008] [Indexed: 11/14/2022] Open
Abstract
Diverticulum of the cecum is a rare, benign, generally asymptomatic lesion that manifests itself only following inflammatory or hemorrhagic complications. Most patients with inflammation of a solitary diverticulum of the cecum present with abdominal pain that is indistinguishable from acute appendicitis. The optimal management of this condition is still controversial, ranging from conservative antibiotic treatment to aggressive resection. We describe four cases that presented with symptoms suggestive of appendicitis, but were found at operation to have an inflamed solitary diverticulum.
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Affiliation(s)
- Oguzhan Karatepe
- Department of General Surgery, Okmeydaný Training and Research Hospital, Istanbul, Turkey.
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