Wos İndeksli Yayınlar Koleksiyonu
Permanent URI for this collectionhttps://hdl.handle.net/11727/4807
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Item Importance of Laparoscopy in Predicting Complete Cytoreduction at Advanced Stage Ovarian Cancer(2022) Durdag, Gulsen Dogan; Alemdaroglu, Songul; Baran, Safak Yilmaz; Serbetcioglu, Gonca Coban; Ozmete, Ozlem; Ezer, Ali; Celik, Husnu; https://orcid.org/0000-0003-4335-6659Purpose Laparoscopy has been used in evaluation of ovarian cancer to assess the extent and surgical resectability of the disease, and to avoid futile laparotomy, where primary cytoreduction is not suitable. Aim of this study is to investigate the contribution of laparoscopy in predicting 'no gross residue' in advanced stage ovarian cancer. Methods Data of advanced stage ovarian cancer patients, who underwent diagnostic laparoscopy for prediction of complete cytoreduction due to an alternative model, are analyzed retrospectively. Accordingly, in the absence of obvious mesenteric retraction or extensive tumoral implants on small intestine in laparoscopic assessment, cases were deemed surgically resectable, and the operation was continued with laparotomy to achieve complete cytoreduction. Clinical features of the patients, surgical details, complete and optimal cytoreduction rates, and perioperative complications were evaluated. Results Out of 243 patients with advanced stage ovarian/tubal/peritoneal cancer, laparoscopy was performed at 93 patients, 77 of whom underwent primary cytoreduction subsequently. Complete cytoreduction (no gross residue) and optimal cytoreduction (< 1 cm residual tumor) rates were 75.3 and 100%, respectively. None of the patients had suboptimal surgery. Morbidity and mortality rates were acceptable. Conclusion Laparoscopic evaluation prior to cytoreductive surgery can highly contribute to prediction of complete or optimal cytoreduction in suitable patients. However, experience and skills of the surgeon, as well as technical equipment of the center, may affect surgery; therefore, the model to predict residual tumor should be individualized according to the set up and the surgical team of each center.Item Laparoscopic para-aortic lymphadenectomy: Technique and surgical outcomes(2021) Durda, Gulsen Dogan; Alemdaroglu, Songul; Baran, Safak Yilmaz; Yaginc, Didem Alkas; Simsek, Seda Yuksel; Celik, Husnu; 0000-0003-4335-6659; 0000-0001-5874-7324; 0000-0001-8309-3537; 0000-0003-1185-9227; 32961327; AAI-8400-2021; AAK-2461-2021; AAL-1923-2021Objective: Pelvic and para-aortic lymph node dissection is an important part of staging surgery. Aim of this study is to evaluate perioperative outcomes of patients, who underwent laparoscopic para-aortic lymphadenectomy for gynecological cancer in a single center over a period of 7 years, based on body mass index (BMI), and to present the surgical technique in steps. Methods: Data of patients who underwent para-aortic lymphadenectomy at gynecological oncology department of a tertiary center in between March 2013 and July 2020 were analyzed retrospectively. Patients were evaluated in two groups according to their BMI (< 30 kg/m(2) as non-obese and >= 30 kg/m(2) as obese groups). Surgical technique is described in steps. Perioperative outcomes of the two groups were evaluated. Results: A total of 230 patients were included in the study. BMI was >= 30 at 58.46 % of the patients. Perioperative features were not significantly affected by the patient's BMI with the presented surgical technique, however, collected para-aortic lymph node numbers were higher in the group with BMI <30, though sufficient number of lymph nodes were achieved in both groups. Conclusion: Although some technical difficulties may be encountered, laparoscopic para-aortic lymphadenectomy is feasable in gynecologic oncological surgery independent of BMI. However, surgical experience is important. (C) 2020 Elsevier Masson SAS. All rights reserved.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 SerdarObjective: 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.Item Surgical and interventional management of complications caused by acute pancreatitis(2014) Karakayali, Feza Y.; 25309073Acute pancreatitis is one of the most common gastrointestinal disorders worldwide. It requires acute hospitalization, with a reported annual incidence of 13 to 45 cases per 100000 persons. In severe cases there is persistent organ failure and a mortality rate of 15% to 30%, whereas mortality of mild pancreatitis is only 0% to 1%. Treatment principles of necrotizing pancreatitis and the role of surgery are still controversial. Despite surgery being effective for infected pancreatic necrosis, it carries the risk of long-term endocrine and exocrine deficiency and a morbidity and mortality rate of between 10% to 40%. Considering high morbidity and mortality rates of operative necrosectomy, minimally invasive strategies are being explored by gastrointestinal surgeons, radiologists, and gastroenterologists. Since 1999, several other minimally invasive surgical, endoscopic, and radiologic approaches to drain and debride pancreatic necrosis have been described. In patients who do not improve after technically adequate drainage, necrosectomy should be performed. When minimal invasive management is unsuccessful or necrosis has spread to locations not accessible by endoscopy, open abdominal surgery is recommended. Additionally, surgery is recognized as a major determinant of outcomes for acute pancreatitis, and there is general agreement that patients should undergo surgery in the late phase of the disease. It is important to consider multidisciplinary management, considering the clinical situation and the comorbidity of the patient, as well as the surgeons experience. (C) 2014 Baishideng Publishing Group Inc. All rights reserved.Item Tips and Tricks in Laparoscopic Surgery in Light of 172 Patients, From A Gynecological Point of View in Turkey(2016) Bakay, Kadir; Aytekin, Fatih; Tunkiran, AhmetAim: In this prospective study we aim to discuss and share our experience of what we have learned in laparoscopic surgery in general. Material and Method: Prospective case controlled study. Data obtained from 172 laparoscopic procedures performed in Baskent University Alanya hospital gynecology clinic were collected between April 2012 and March 2014. Results: Difference in abdominal wall elevation measurements with force applied during primary trocar entry ranged from 1cm to 3cm (mean: 2.13 +/- 1cm) when elevated manually and 0.5cm to 3cm (mean: 0.89 +/- 0.8cm) with the towel clips. The difference was statistically significant (p<0.05). Discussion: Laparoscopic surgery or minimally invasive surgery in general will undoubtedly dominate all fields of medicine in the near future, therefore it would be mandatory for almost every surgical branch to provide adequate training and skills for the operator in the both pre and post graduation period.Item Anesthesia management for laparoscopic bariatric surgery: retrospective analysis of 62 patients(2017) Ozmete, Ozlem; Bali, Cagla; Ergenoglu, Pinar; Akin, Sule; Aribogan, Anis; AAJ-2094-2021; AAI-7779-2021; AAI-8790-2021; J-5282-2013; S-8336-2019Purpose: The aim of this study was to present our experience in patients who underwent laparoscopic bariatric surgery and to discuss the current literature on the perioperative management Material and Methods: Sixty two patients with ASA risk classification II-III were evaluated retrospectively who underwent obesity surgery in our hospital. Demographic characteristics of the patients, surgical time, complications that seen in the perioperative period and the length of hospital stay were recorded Results: The age of the patients ranged from 19 to 59 years and 75.9% of them were female. Mean operation time was 167 minutes and the length of hospital stay was 5 days. Complications seen during intraoperative period were tachycardia, hypertension and arrhythmia. In the following days, 6 (9.7%) patients were re-operated and there was no mortality Conclusion: The prevention of complications that may occur in laparoscopic obesity surgery is required with a equipped team and teamwork, a good preoperative preparation, thromboembolism prophylaxis, tight hemodynamics and blood gas monitoring for safe anesthesiaItem Effects of volume-controlled equal ratio ventilation with recruitment maneuver and positive end-expiratory pressure in laparoscopic sleeve gastrectomy: a prospective, randomized, controlled trial(2018) Tuncali, Bahattin; Erol, Varhk; Zeyneoglu, Pinar; 30119152Background/aim: We compared the effects of volume-controlled equal ratio ventilation (VC-ERV) and volume-controlled conventional ratio ventilation (VC-CRV) on oxygenation, ventilation, respiratory mechanics, and hemodynamic status during mechanical ventilation with recruitment maneuver (RM) and positive end-expiratory pressure (PEEP) in patients undergoing laparoscopic sleeve gastrectomy. Materials and methods: A total of 111 patients scheduled for laparoscopic sleeve gastrectomy were randomized to ventilation with inspiratory to expiratory ratio of 1:1 (Group VC-ERV) or 1:2 (Group VC-CRV) following tracheal intubation. RM (40 cmH2O, 15 s) and PEEP (10 cmH2O) were administered to all patients. Arterial blood gas samples were taken and peak airway pressure (Ppeak), mean airway pressure (Pmean), dynamic compliance (Cdyn), mean arterial pressure, heart rate, SpO2, and EtCO2 were recorded at 4 time points. Postoperative respiratory complications were recorded. Results: Oxygenation, ventilation, Pmean levels, and hemodynamic variables were similar in both groups. VC-ERV significantly decreased Ppeak and increased Cdyn compared to VC-CRV at all time points of the operation (P < 0.05). No pulmonary complication was observed in any patients. Condusion: VC-ERV provides significantly lower Ppeak and higher Cdyn with similar oxygenation, ventilation, hemodynamic parameters, and Pmean levels when compared to VC-CRV during mechanical ventilation with RM and PEEP in laparoscopic sleeve gastrectomy.Item Retrospective Evaluation of Patients who Underwent Laparoscopic Bariatric Surgery(2018) Tuncali, Bahattin; Pekcan, Yonca Ozvardar; Ayhan, Asude; Erol, Varlik; Yilmaz, Tugba Han; Kayhan, Zeynep; 30140537Objective: In the present study, we aimed to retrospectively evaluate the preoperative characteristics, intraoperative and postoperative results of patients who underwent laparoscopic obesity surgeries. Methods: After obtaining the approval of the Ethics Committee, records of patients who underwent laparoscopic obesity surgery from January 2013 to December 2016 were reviewed. Demographic characteristics, medications used in anaesthesia and analgesia, the duration of recovery unit/hospital stay, intensive care unit/mechanical ventilation requirements and complications were recorded. Results: A total of 329 ASA II-III patients over a 3-year period were operated. Thiopental and propofol were administered at induction, sevoflurane, isoflurane and desflurane were administered for the maintenance, and vecuronium and rocuronium were administered to aid in neuromuscular blockage. The mean durations of recovery unit and hospital stays were 30.80 +/- 6.01 minutes and 4.27 +/- 1.68 days, respectively. The hypnotic agent, muscle relaxant or inhalation anaesthetics used did not have a significant effect on the duration of recovery unit and hospital stay. Mask ventilation and intubation were noted to be difficult in 5.5% and 8.5% of the cases, respectively. The presence of obstructive sleep apnoea syndrome and high body mass index and Mallampati scores significantly increased difficult mask ventilation and difficult intubation rates. Four patients were transferred to intensive care unit for close monitoring. Two patients were re-operated on, two patients had rhabdomyolysis, one patient had Wernicke's encephalopathy and two patients had peripheral neuropathy. Perioperative mortality did not occur in any patient. Conclusion: We believe that appropriate patient selection, the use of well-designed anaesthesia and surgical protocols play important roles in increasing the success rate of patient outcomes and early and late complications in laparoscopic obesity surgery.