Wos İndeksli Yayınlar Koleksiyonu
Permanent URI for this collectionhttps://hdl.handle.net/11727/4807
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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 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 One of the Rare Causes of Acute Abdomen Leading to Subileus: Jejunal Diverticulitis(2016) Aydin, Elcin; Yerli, Hasan; Avci, Tevfik; Yilmaz, Tugbahan; Gulay, Huseyin; 27308082Background: Jejunal diverticulitis is one of the rare causes of acute abdomen generally seen in the elderly. Jejunal diverticulosis was defined as the herniation of the mucosa and the submucosa from the inside of the muscular layer of the bowel wall on the mesenteric side of the intestine. Case Report: We presented the intraoperative and pathological findings of a 69-year-old male patient who had presented with complaints about abdominal pain, nausea, and vomiting and been operated upon due to subileus and peritonitis induced by large-sized jejunal diverticulitis, along with his computed tomography (CT) findings. Conclusion: Jejunal diverticulitis is uncommon and may be a disease which might be difficult to diagnose when it develops on the basis of the large-sized diverticula resembling intestinal ansae. To the best of our knowledge, the computed tomography and intraoperative findings of a case in which partial resection is applied to the jejunum due to subileus have not been previously presented in the literature.Item Laparoscopic Approach to Giant Over Cysts and Case Report(2018) Arslan, Baba; Erl, Varlik; Yilmaz, Tugba Han; Gulay, HuseyinTumor behavior plays an important role when abdominal masses approach. Minimally invasive surgery in patients who are thought to be benign is a valuable approach to comfort patients and surgeons. In the light of the literature, we examined a laparoscopic surgical approach in a premenopausal patient who applied to our clinic for swelling in her abdomen and whose mesenteric and over cysts were not completely differentiated.