Tıp Fakültesi / Faculty of Medicine

Permanent URI for this collectionhttps://hdl.handle.net/11727/1403

Browse

Filters

2020 - 20222

Settings

Author: search.filters.author.Karaca, Ahmet SerdarSubject: search.filters.subject.Laparoscopy

Search Results

Now showing 1 - 2 of 2
  • No Thumbnail Available
    Item
    Current status of laparoscopic surgery usage in Turkiye: A middle-income country
    (2022) Esmer, Ahmet Cem; Colak, Tahsin; Edizsoy, Akay; Tazeoglu, Deniz; Karaca, Ahmet Serdar; 36875273
    Objective: This study aimed to determine the usage status of laparoscopic procedures in general surgical practice in Turkiye, which is a sample of middle-income countries. Material and Methods: The questionnaire was sent to general surgeons, gastrointestinal surgeons, and surgical oncologists who have completed their residency training and are actively working in university, public or private hospitals. Demographic data, laparoscopy training and the period of education, the rate of laparoscopy use, the type and volume of laparoscopic surgical procedures, their views on the advantages and disadvantages of laparoscopic surgery, and the reasons for preferring laparoscopy were determined with a 30-item questionnaire. Results: Two hundred and forty-four questionnaires from 55 different cities of Turkiye were evaluated. The responders were mainly males, younger surgeons (F/M=11.1/88.9 % and 30-39 y/o), and graduated from the university hospital residence program (56.6%). Laparoscopic training was frequently taken during residency (77.5%) in the younger age group, while the elderly participants mostly received additional training after specialization (91.7%). Laparoscopic surgery was mostly not available in public hospitals for advanced procedures (p< 0.0001) but was available for cholecystectomy and appendectomy operations (p=NS). However, participants working in university hospitals mostly stated that the laparoscopic approach was the first choice for advanced procedures. Conclusion: The results of this study showed that the surgeons working in MICs spent strong effort to use laparoscopy in daily practice, especially in university and high-volume hospitals. However, inappropriate education, cost of laparoscopic equipment, healthcare policies, and some cultural and social barriers might have negatively impacted the widespread use of laparoscopic surgery and its usage in daily practice in MICs such as Turkiye.
  • No Thumbnail Available
    Item
    Incidental Gallbladder Cancer Diagnosed During Or After Laparoscopic Cholecystectomy, What Did We Do?
    (2020) Sapmaz, Ali; Guldogan, Can Emir; Yagiz, Betül Keskinkilic; Karaca, Ahmet Serdar
    Objective: Gallbladder cancer is a rare neoplasm. We report our experience with gallbladder cancer that was incidentally diagnosed during or after laparoscopic cholecystectomy performed for gallstone disease. Methods: This study included all laparoscopic cholecystectomies due to gallstone disease undertaken from January 2010 to April 2015. Exclusion criteria were suspicion of malignancy and/or existence of gallbladder polyps detected with ultrasonography preoperatively. Patients with incidentally diagnosed gallbladder cancer were recorded, and the clinical and demographic characteristics of these patients were reviewed. Results: Of 6,114 patients in whom laparoscopic cholecystectomy was attempted, 5.948 were included in this study. Incidental gallbladder cancer was found in thirty-six patients, with a mean age of 64.08 years. The histological tumor stages were adenocarcinoma in situ in seven patient, pT1b in nine patient, pT2 in eleven patient, and pT3 in nine patients. Sixteen patients who underwent laparoscopic cholecystectomy alone underwent no additional surgery because of the low stage of the tumors. The twenty remaining patients, whose laparoscopic cholecystectomies were converted to open surgeries, underwent cholecystectomy, excision of the liver bed and lymph node dissection. The overall median survival time was 28 months. Conclusions: The incidence of incidental gallbladder cancer has been reported to vary, up to 2.85%. In this single-center study, the rate of incidental gallbladder cancer was found to be 0.60%. Female gender and advanced age are demographic risk factors for gallbladder carcinoma. Although gallbladder cancer is well known for its poor prognosis, tumors that are incidentally diagnosed are often found at an early stage and have a better prognosis.