Wos İndeksli Yayınlar Koleksiyonu
Permanent URI for this collectionhttps://hdl.handle.net/11727/4807
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Item Intraoperative neuromonitoring of the RLNs during TOETVA procedures(2020) Erol, Varlik; Dionigi, Gianlorenzo; Barczynski, Marcin; Zhang, Daqi; Makay, Ozer; 32175253Transoral endoscopic thyroidectomy by vestibular approach (TOETVA) is now being performed in increasing frequency and getting more and more attention. TOETVA is carried out through three incisions in the oral vestibular area. Thyroidectomy is performed endoscopically using conventional laparoscopic instruments, an energy based device and neuromonitoring instruments. Intraoperative neuromonitoring is one of the tools of utmost importance, used for navigation and confirmation of the functional integrity of the recurrent nerve during TOETVA. The aim of this study is to give information about the standards and technique of intraoperative neuromonitoring of the recurrent laryngeal nerves during TOETVA procedures. TOETVA is a safe technique with no visible scarring and hence resulting in an excellent cosmetic effect. We believe that neuromonitoring of the recurrent laryngeal nerves also minimizes the risk of nerve damage and is an essential safety component in this technique.Item CAN CHOLECYSTECTOMY BE PERFORMED AS SAFELY IN ELDERLY PATIENTS AS IT IS IN YOUNG PATIENTS?(2020) Arslan, Baha; Yilmaz, Tugbahan; Erol, Varlik; Tuncali, Bahattin; Gulay, Huseyin; 0000-0002-9590-0276; 0000-0002-7898-2943; 0000-0002-0442-6178; 0000-0003-4461-4904; AAJ-6354-2021; AAJ-7840-2021; AAJ-6407-2021; AAD-6127-2021Introduction: In this study, we aimed to compare the surgical outcomes between elderly and young patients undergoing surgery for gallstone disease and determine variations in patient characteristics, if any. Materials and Method: Data of patients who underwent surgery for gallstone disease at a single center between 2010 and 2018 were analyzed retrospectively. Two patient groups were evaluated: patients <65 years and >= 65 years. Patient characteristics, preoperative outpatient clinic data, surgical data, and postoperative data were collected. Results: In total, 1,198 patients with a mean age of 54.77 +/- 15.03 (15-91) years were assessed. Comorbid conditions, including cardiovascular disease, pulmonary disease, renal disease, and diabetes mellitus were significantly more common in elderly patients (p<0.001). Acute cholecystitis in the preoperative period was noted in 15.36% of young patients and in 30.4% of elderly patients (p<0.001). Need for emergency surgery was higher in elderly patients than in young patients [13.86% (47) and 9.31% (80), respectively] (p=0.021). Laparoscopic cholecystectomy and open cholecystectomy were performed in 98.37% and 1.04% of young patients, respectively, and in 92.62% and 3.53% of elderly patients, respectively (p<0.001). Among factors affecting the length of hospital stay in elderly patients, the duration of hospitalization was significantly longer in elderly patients who underwent emergency surgery, open surgery, needed additional surgery, and who had high American Society of Anesthesiologists scores (p<0.001, p<0.001, p=0.013, p<0.001, respectively). Conclusion: Complications rates associated with cholecystectomy are similar between young and elderly patients when appropriate surgical preparations are performed. Surgery for gallstone disease can be performed safely in elderly patients with low morbidity and mortality rates.Item Assessment of Carotid Artery Distensibility and Elasticity After Laparoscopic Sleeve Gastrectomy: a Prospective Study(2020) Gunesli, Aylin; Yilmaz, Mustafa; Altin, Cihan; Gezmis, Esin; Yabanoglu, Hakan; Erol, Varlik; 0000-0002-2557-9579; 0000-0002-8337-6905; 0000-0002-1161-3369; 0000-0002-1001-6028; 0000-0003-0268-8999; 32813160; S-6973-2016; AAK-3065-2021; AAJ-7865-2021; AAE-8301-2021; AAK-2011-2021Purpose Although it is well known that obesity increases the risk of atherosclerosis in carotid arteries, it is not clear whether this risk changes after obesity surgery. The aim of this study was to investigate whether weight reduction with a laparoscopic sleeve gastrectomy (LSG) has any effect on distensibility and elasticity which show subclinical atherosclerosis in the carotid arteries of obese individuals. Materials and Methods This prospective study included 130 patients (body mass index (BMI) 48.21 +/- 6.97 kg/m(2)) who underwent LSG. The patients were followed up for 1 year. Comparisons were made of the distensibiliy and elasticity values calculated preoperatively and at 1, 3, 6, and 12 months, postoperatively. Results There was a statistically significant increase in distensibility and elasticity values from baseline to 1, 3, 6, and 12 months postoperatively (p < 0.001 for both comparisons). The multiple linear regression analysis was used to find the variables affecting both distensibility and elasticity. According to the results, the presence of BMI decreases distensibility percentage change level by 0.38 units (beta= - 0.38, 95% CI - 0.51;- 0.25,p < 0.001). The presence of fasting plasma glucose decreases elasticity percentage change level by 0.20 units. (beta= - 0.20, 95% CI - 0.39; - 0.01,p = 0.037). Conclusion Carotid artery distensibility and elasticity values increase after LSG, and this change could be caused by the change in metabolic parameters and heart geometry. These results may indirectly suggest that subclinical atherosclerosis in carotid arteries has decreased after obesity surgery.Item Recommendations for bariatric and metabolic surgical operations during the COVID-19 pandemic in Turkey(2020) Erol, Varlik; Sumer, Aziz; Savas, Osman Anil; Peksen, Caghan; Gulay, Huseyin; Aktimur, Recep; Ozmen, Mehmet Mahir; 0000-0002-0442-6178; 33015558; AAJ-6407-2021The world has been struggling with the COVID-19 virus since December 2019. Turkey has also been battling with the virus since March 2019. While struggling with this unknown virus, we have postponed our new bariatric surgeries like most elective surgery. However, curfew and quarantine period (increase in food intake and decreased physical activity) increases risks for morbidity and mortality because of obesity and diabetes. When the pandemic decreases and disappears, many obesity patients will seek treatment for obesity and the workload of surgeons will increase. Before bariatric and metabolic surgery operations, which is the most effective treatment of obesity and related comorbidities, necessary precautions must be determined and implemented to protect patients and healthcare workers before and during surgery. In this review, it was aimed to determine the pre-peri and postoperative periods of bariatric surgical requirements. This review has been written on behalf of the Turkish Society for Metabolic and Bariatric Surgery as an initiative in order to answer some questions about bariatric and metabolic surgery during the COVID-19 pandemic.Item Diagnostic Accuracy of Axillary Ultrasound in Early-Stage Breast Cancer(2019) Yilmaz, Tugba Han; Yerli, Hasan; Arslan, Baha; Erol, Varlik; Gulay, HuseyinSentinel lymph node biopsy is the standard application for evaluating the axilla in patients with breast cancer. The Z0011 trial conducted by The American College of Surgeons Oncology Group (ACOSOG) revealed that axillary dissection may be redundant in selected patients with positive sentinel node. This raises questions regarding the application of this result to ultrasound-positive patients. This research therefore aimed to evaluate how accurate an ultrasound scan is for axillary node status in early-stage breast carcinoma. The study included 156 newly diagnosed clinical T1-T2, N0 breast cancer patients attending our breast clinic between January 2010 and February 2016. Sentinel lymph node biopsy and axillary lymph node clearance in the presence of sentinel lymph node metastasis was performed on all the breast cancer patients. Axillary ultrasound reports were reviewed retrospectively and the results compared with surgical pathology results. The sensitivity and specificity of axillary ultrasound for detecting axillary lymph node disease was 69.2% and 98%, respectively, with a negative predictive value of 86.4% and positive predictive value of 94.7%. Given the high sensitivity and specificity, and high positive predictive value and negative predictive value demonstrated in the present study, axillary ultrasound represents a potential alternative to sentinel lymph node biopsy for staging of the axilla in early breast cancer. Subsequent trials (SOUND) comparing axillary ultrasound alone with sentinel lymph node biopsy in early breast cancer patients will provide additional information about the subject.Item Retroperitoneal paraganglioma presenting with pancytopenia: A rare case with rare manifestation(2015) Unver, Mutlu; Ozturk, Safak; Erol, Varlik; Carti, Erdem Baris; Bozbiyik, Osman; Kebapci, Eyup; Olmez, Mustafa; Akbulut, Gokhan; 26241167INTRODUCTION: Paragangliomas are tumors that arise from extraadrenal chromaffin cells and most of them are asymptomatic presenting with painless mass. Retroperitoneal paragangliomas are mostly benign with good prognosis; however, they can present with abdominal pain, palpable mass, or hypertensive episodes. Surgical resection is still the main treatment and necessary for histological assessment. CASE REPORT: A 41 year old female patient presented with 6 months of loss of appetite, weight loss, weakness and breathlessness on exertion.. The patient's initial blood examination showed marked anemia, reduced leukocyte count with neutropenia and lymphopenia and a marked reduction in the platelet count. The patient was admitted for evaluation of her pancytopenia. Magnetic resonance imaging revealed a 8 x 7 x 8 cm sized mass closed to the pancreatic tail invading splenic hilum. A large mass was identified retroperitoneally, closed to the tail of pancreas with a splenic hilum invasion. Total mass resection and splenectomy was performed. DISCUSSION: Complete surgical excision is the treatment of choice for extra-adrenal paragangliomas as well as for recurrent or metastatic neoplasms. Reactive thrombocytosis is a common cause of thrombocytosis. Splenectomy was found to be one of the main causes of extreme reactive thrombocytosis. Reactive thrombocytosis is a predictable finding after splenectomy and management of the thrombocytosis and prevention of complications should be initiated. (C) 2015 The Authors. Published by Elsevier Ltd.