PubMed Açık Erişimli Yayınlar
Permanent URI for this collectionhttps://hdl.handle.net/11727/10763
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Item A multi-institutional analysis of sequential versus 'sandwich' adjuvant chemotherapy and radiotherapy for stage IIIC endometrial carcinoma(2019) Onal, Cem; Sari, Sezin Yuce; Yildirim, Berna Akkus; Yavas, Guler; Gultekin, Melis; Guler, Ozan Cem; Akyurek, Serap; Yildiz, Ferah; 0000-0002-2742-9021; 30887753; D-5195-2014Objective: To analyze the outcomes of sequential or sandwich chemotherapy (ChT) and radiotherapy (RT) in patients with node-positive endometrial cancer (EC). Methods: Data from 4 centers were collected retrospectively for 179 patients with stage IIIC EC treated with postoperative RT and ChT (paclitaxel and carboplatin). Patients were either treated with 6 cycles of ChT followed by RT (sequential arm; 96 patients) or with 3 cycles of ChT, RT, and an additional 3 cycles of ChT (sandwich arm; 83 patients). Prognostic factors affecting overall survival (OS) and progression-free survival (PFS) were analyzed. Results: The 5-year OS and PFS rates were 64% and 59%, respectively, with a median followup of 41 months (range, 5-167 months). The 5-year OS rates were significantly higher in the sandwich than sequential arms (74% vs. 56%; p=0.03) and the difference for 5-year PFS rates was nearly significant (65% vs. 54%; p=0.05). In univariate analysis, treatment strategy, age, International Federation of Gynecology and Obstetrics (FIGO) stage, pathology, rate of myometrial invasion, and grade were prognostic factors for OS and PFS. In multivariate analysis, non-endometrioid histology, advanced FIGO stage, and adjuvant sequential ChT and RT were negative predictors for OS, whereas only non-endometrioid histology was a prognostic factor for PFS. Conclusion: Postoperative adjuvant ChT and RT for stage IIIC EC patients, either given sequentially or sandwiched, offers excellent clinical efficacy and acceptably low toxicity. Our data support the superiority of the sandwich regimen compared to the sequential strategy in stage IIIC EC patients for OS.Item Biphasic Pulmonary Blastoma Associated with Cerebral Metastasis(2016) Kilic, Dalokay; Yilmaz, Cem; Tepeoglu, Merih; Vural, Cigdem; Caner, Hakan; 26768884Pulmonary blastoma is a very rare malignant tumor of the lungs. A biphasic pulmonary blastoma was histologically diagnosed by a characteristic finding as it was mainly constituted of immature tumor tissue that had both epithelial and mesenchymal components. We present a case of a 68-year-old man with biphasic pulmonary blastoma. The patient underwent cranial metastatectomy and left lung upper lobectomy. Although the tumor was resected, there was rapid metastasis to the cranial, liver, kidney and multiple bones. Although radiotherapy and chemotherapy were administrated, the patient died about 6 months postoperatively. Close follow-up and aggressive chemotherapy should be considered for such tumours. In the light of this case, the authors review the pathologic, clinical, radiological and therapeutic features of this very rare malignant lung tumor.Item Recurrent Pleomorphic Adenoma of the Submandibular Gland(2016) Inan, Serhat; Aydin, Erdinc; Babakurban, Seda Turkoglu; Akcay, Eda Yilmaz; 0000-0001-6864-7378; 0000-0001-6831-9585; 0000-0001-5067-4044; 29392015; AAJ-1407-2021; AAJ-2379-2021; AAK-1960-2021; AAI-8856-2021Pleomorphic adenoma (PA) is the most common benign tumor of salivary glands. Most PAs occur in the parotid (80%), followed by the submandibular gland (10%) and minor salivary and sublingual glands (10%). Submandibular gland PAs usually manifest in the submandibular area as a painless hard mass. Although several recurrent parotid gland PA cases have been reported in the literature, recurrent submandibular gland PA is quite rare. Complete surgical removal of tumor of the submandibular gland and keeping the capsule intact are important to prevent recurrence. Here we present a rare case of submandibular gland PA recurrence that occurred 5 years after the first surgery and methods to prevent recurrence.Item Submandibular Gland Surgery: Our Clinical Experience(2016) Erbek, Selim Sermend; Koycu, Alper; Topal, Ozgul; Erbek, Hatice Seyra; Ozluoglu, Levent Naci; 0000-0002-2150-0237; 0000-0001-6305-5023; 29392010; AAI-8020-2021; ABI-6777-2020Objective: The aim of this study was to assess the demographic findings and surgical results of patients who underwent submandibular gland excision at a tertiary care center. Methods: The clinical characteristics and histopathological results of 45 patients who had undergone submandibular gland excision between 1997 and 2014 were evaluated in detail. Results: Twenty-eight (62.2%) and 17 (37.8%) patients presented with a complaint of a painful mass and painless mass, respectively. Histopathologic investigation of the surgical specimen revealed sialolithiasis in 14 patients (31.1%), chronic sialadenitis in 16 (35.6%), benign tumor in 12 (26.7%), malignant tumor in two (4.4%), and mucocele extravasation in one. As complications, permanent paralysis of the marginal mandibular branch of the facial nerve was seen in one patient (2.2%), temporary paralysis of the marginal mandibular branch of the facial nerve was seen in seven (15.6%), orocutaneous fistula was seen in one (2.2%), and temporary paralysis of the hypoglossal nerve was seen in one (2.2%). Conclusion: This study revealed that in patients presenting with complaints of a submandibular gland mass, sialolithiasis, sialadenitis, and benign masses were the mostly diagnosed pathologies. Transcervical submandibular gland excision is a satisfactory procedure with low complication and recurrence rates when it is performed on selected patients and obeyed to surgical techniques.Item Estimation of the capacity of emergency surgery in Konya: Nine-year multicenter study(2016) Türk, Emin; Kucukkartallar, Tevfik; Cakir, Murat; Tekin, Ahmet; Balasar, Mehmet; Kartal, Adil; Koksal, Hande; Erengul, Bulent; 0000-0003-4766-3373; 28149121; AAJ-5609-2021Objective: Although the number of surgical emergencies continues to increase, comprehensive data on emergency surgical admissions are scarce. The aim of this multicenter study was to evaluate the causes, management, and outcomes of the general surgical emergencies in the city of Konya, Turkey. Material and Methods: The relevant details of the cases admitted and considered to be general surgical emergencies in Konya over a nine-year period (January 2003-January 2012) were analyzed. All demographic data were analyzed statistically. Results: The study group comprised 21954 cases from 4 hospitals in Konya: 7154 from Konya Numune Hospital, 6,654 from Konya Education and Research Hospital, 6,400 from Necmettin Erbakan University Meram Medical Faculty, and 1,390 from Baskent University Konya Education and Research Hospital. Their mean age was 59.6 years, and the average hospitalization time was 3.3 days. The diagnoses of the admitted patients were as follows: acute appendicitis (59.57%), bowel obstruction (11.12%), trauma (7.97%), strangulated inguinal hernia (5.46%), acute cholecystitis (4.87%), peptic ulcer perforation (4.09%), mesenteric ischemia (2.73%), necrotizing fasciitis (2.73%), gastrointestinal system bleeding (1.79%), and others (1.1%). Conclusion: The findings of the study indicate a steady increase in surgical admissions to emergency units. Nontraumatic acute abdomen was the most common reason for general surgical emergencies. Although the number of elderly patients increased, the hospital stay and mortality rates decreased over the study period.Item Prospective Observational Study on acute Appendicitis Worldwide (POSAW)(2018) Akkapulu, Nezih; 0000-0001-7392-961X; 29686725; AAM-8548-2021Background: Acute appendicitis (AA) is the most common surgical disease, and appendectomy is the treatment of choice in the majority of cases. A correct diagnosis is key for decreasing the negative appendectomy rate. The management can become difficult in case of complicated appendicitis. The aim of this study is to describe the worldwide clinical and diagnostic work-up and management of AA in surgical departments. Methods: This prospective multicenter observational study was performed in 116 worldwide surgical departments from 44 countries over a 6-month period (April 1, 2016-September 30, 2016). All consecutive patients admitted to surgical departments with a clinical diagnosis of AA were included in the study. Results: A total of 4282 patients were enrolled in the POSAW study, 1928 (45%) women and 2354 (55%) men, with a median age of 29 years. Nine hundred and seven (21.2%) patients underwent an abdominal CT scan, 1856 (43.3%) patients an US, and 285 (6.7%) patients both CT scan and US. A total of 4097 (95.7%) patients underwent surgery; 1809 (42.2%) underwent open appendectomy and 2215 (51.7%) had laparoscopic appendectomy. One hundred eighty-five (4.3%) patients were managed conservatively. Major complications occurred in 199 patients (4.6%). The overall mortality rate was 0.28%. Conclusions: The results of the present study confirm the clinical value of imaging techniques and prognostic scores. Appendectomy remains the most effective treatment of acute appendicitis. Mortality rate is low.Item Chronic Subdural Hematoma Associated with Arachnoid Cyst of the Middle Fossa: Surgical Treatment and Mid-Term Results in Fifteen Patients(2018) Kircelli, Atilla; Musluman, Ahmet Murat; Ozsoner, Baris; Can, Songul Meltem; Yilmaz, Adem; Kaldirimoglu, Ayca; Sahin, Balkan; 0000-0003-2109-1274; 29131236AIM: To report neurological and radiological features, surgical management, and mid-term outcomes of patients with chronic subdural hematoma (CSDH) associated with ipsilateral arachnoid cyst (AC) of the middle fossa. MATERIAL and METHODS: A total of 453 patients with CSDH were treated at our clinic between August 2004 and August 2012. Of these patients, 15 had ipsilateral AC in the middle fossa. A single burr hole craniostomy was performed to drain the hematoma. The AC was left intact in 14 patients, and one patient had no surgical intervention. The follow-up period ranged from 13 to 88 months (mean 43.07 +/- 23.23 months). RESULTS: The patients with AC associated CSDH were found to be younger than the patients with CSDH alone, and the mean age of 58 patients was 13.15 +/- 13.17 years, while it was 11 +/- 14.22 years in the other patients. Eleven patients had experienced head trauma at 21-50 days before admission. Hematoma evacuation through a single burr hole with closed-system subdural drainage performed at 2-4 days after surgery improved the symptoms in all patients. Two patients developed subdural fluid collection, which was treated by subduroperitoneal shunt placement. CONCLUSION: Greater prevalence of ACs in patients with CSDHs has been reported in the literature. We recommend the drainage of the hematoma via a single craniostomy and to leave the AC intact as the first choice of treatment if the associated AC is a Galassi type I or II. Additional subduroperitoneal shunting may be performed in patients with Galassi type III cyst.Item Perivascular epithelioid cell tumor outgrowth from the liver(2018) Haberal, Mehmet; Kirnap, Mahir; Ozgun, Gonca; Moray, Gokhan; 30453241INTRODUCTION: Perivascular epithelioid celltumor (PEComa) is a rare mesenchymal neoplasia and can be found in various body sites. On the other hand, hepatic PEComa is very rare, with only a few studies having reported hepatic malignant PEComa. There is no gold standard regarding the use of diagnostic imaging studies. The diagnosis of hepatic PEComa is made by a positive immunohistochemical staining for HMB45 and Melan A. Herein, we discussed the therapeutic and follow-up process of a symptomatic hepatic PEComa case. PRESENTATION OF CASE: A 22-year-old woman presented with a palpable mass in abdomen. A computerized tomographic examination showed a giant hepatic mass of left lobe origin, which was excised surgically. The pathology result was reported as a PEComa. DISCUSSION: The diagnostic approach, treatment modalities, and follow-up procedures are not standard. The main treatment modality for PEComa is surgical excision with adequate surgical margin. CONCLUSION: A longer follow-up is required for patients with hepatic PEComa because the nature of the disease is not entirely clear. (C) 2018 The Author(s). Published by Elsevier Ltd on behalf of IJS Publishing Group Ltd.