Fakülteler / Faculties
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Item Effectiveness of Simultaneous Umbilical Hernia Primary Repair with Laparoscopic Cholecystectomy(2023) Gundogdu, Ramazan; Erkan, Serkan; Kus, Murat; Aytac, Huseyin Ozgur; Yabanoglu, Hakan; 37829743OBJECTIVE: Umbilical hernia repair can be easily performed simultaneously with laparoscopic cholecystectomy. The use of mesh is recommended for hernias larger than 1 cm. In this study, patients with primary repair of umbilical hernia simultaneously with laparoscopic cholecystectomy were evaluated. It aimed to present the effectiveness of this method and the effect of body mass index (BMI) on treatment results.METHODS: The records of patients who underwent primary repair of umbilical hernia simultaneously with laparoscopic cholecystectomy between 2014 and 2021 were reviewed retrospectively. Patients' age, gender, BMI, length of hospital stay, recurrence and reoperation information, and follow-up times were analyzed. The patients were examined in three groups according to their BMI, and the effect of BMI on treatment was investigated.RESULTS: patients were included in the study. Median values of the patients for age, BMI, hospitalization, and follow-up were 63 (28-94), 31 (20-51) kg/m2, 1 (1-25) days, and 23 (0.6-76) months, respectively. Recurrence was detected in 8 patients. BMI was <25 in one patient with recurrence and >30 in 5 patients. There was no significant correlation between length of stay, number of relapse and reoperation, and BMI (p>0.05).CONCLUSION: In our study, the recurrence rate was found to be higher than the studies reported with the use of mesh, and most of the patients with recurrence are obese, although it is not statistically significant. If the recurrence rate is acceptable, we believe that repair with primary suture is feasible in umbilical hernia.Item Dexamethasone Effects on Vascular Flow and Organ Injury in Septic Mice(2014) Aytac, Huseyin Ozgur; Iskit, Alper B.; Sayek, Iskender; https://orcid.org/0000-0002-3583-9282; 24582065; AAJ-7913-2021Background: To demonstrate the effects of low-dose dexamethasone treatment on mesenteric artery blood flow, oxidative injury, vascular reactivity, and survival in Swiss albino mice with intra-abdominal polymicrobial sepsis accomplished by cecal ligation and puncture (CLP). Methods: Mice were allocated to CLP + saline, CLP + dexamethasone, sham + saline, and sham + dexamethasone subgroups to evaluate blood flow, organ injury, and vascular response to consecutive phenylephrine administrations at 24, 48, and 72 h. Survival rates were also evaluated in a different group of mice. Dexamethasone (1 mg/kg/d) and saline (4 mL/kg/d) were administered intraperitoneally to mice 2 h after CLP or sham procedure, whichever appropriate, and repeated once a day until evaluation time at 48 and 72 h. Relaparotomy was performed at the concerned time and mesenteric blood flow was measured, and liver, lung, and peritoneum samples were obtained. Alteration in mesenteric blood flow response to intravenous phenylephrine injections was recorded at the related time intervals in different mice groups. Survival group was followed up by 7-d administration of dexamethasone or saline for 18 d. Results: The significant fall in mesenteric blood flow after CLP ameliorated with dexamethasone treatment at 48 and 72 h. Dexamethasone also diminished the malonyl dialdehyde level, which is an indicator of organ injury raised after CLP, at 24 h in liver, lung, and peritoneum samples. Dexamethasone therapy has significantly enhanced the vascular response to phenylephrine injections at all doses; however, no change was observed in survival rates. Conclusions: Low-dose dexamethasone has beneficial effects on mesenteric blood flow and organ injury in experimental sepsis models. (C) 2014 Elsevier Inc. All rights reserved.Item A Comparative Study of Conservative versus Surgical Treatment Protocols for 77 Patients with Idiopathic Granulomatous Mastitis(2015) Yabanoglu, Hakan; Colakoglu, Tamer; Belli, Sedat; Aytac, Huseyin Ozgur; Bolat, Filiz Aka; Pourbagher, Aysin; Tezcaner, Tugan; Yildirim, Sedat; Haberal, Mehmet; 0000-0003-2031-7374; 0000-0002-3462-7632; 0000-0002-5735-4315; 0000-0002-3641-8674; 0000-0002-3583-9282; 0000-0002-1161-3369; 25858348; HJZ-1654-2023; AAJ-8097-2021; AAF-4610-2019; AAD-9865-2021; AAJ-7913-2021; AAJ-7865-2021The purpose of this study was to analyze the clinical features and demographic data of patients with idiopathic granulomatous mastitis (IGM) and to compare the results of conservative versus surgical treatment protocols. The demographic data, clinical findings, microbiological and pathologic features, scanning and treatment methods, recurrence, and recovery rates of 77 patients were analyzed retrospectively. The patients were divided into two groups based on the type of treatment received. Core biopsies were used to diagnose 37 patients: 26 using incisional biopsies and 14 using excisional biopsies. Of the patient population with IGM, 31 were treated with surgical excision, one with a simple mastectomy, and one with a subcutaneous mastectomy combined with a breast implant, whereas 44 were treated with steroids. The recovery rates of the 44 patients who were treated conservatively were 6 (1-15) months while for the 33 patients who were treated surgically, it was 1 (1-5) month (p=0.001). Nine patients from the conservative treatment group experienced a recurrence while there were no recurrences in the surgically treated group (p=0.009). Among all patients, the recurrence rate was 11.7% (9/77) while the average follow-up period was 16.57 +/- 18.57months. As a comparative study between conservative treatment protocols and surgical ones for patients with idiopathic granulomatous mastitis (IGM), this study is the largest to date. A wide surgical excision is the preferred approach for treating patients with IGM because of the low recurrence rate.Item Reverse Cover-Up: Easy Way to Remove the Appendix(2015) Aytac, Huseyin Ozgur; Torer, Nurkan; Yabanoglu, Hakan; Nursal, Tarik Zafer; 0000-0003-0268-8999; 0000-0002-1161-3369; 0000-0002-3583-9282; AAK-2011-2021; IQV-1169-2023; AAJ-7865-2021; AAJ-7913-2021Item Predictors Determining the Status of Axilla in Breast Cancer: Where is PET/CT on That?(2015) Aytac, Huseyin Ozgur; Colacoglu, Tamer; Nursal, Gul Nihal; Nursal, Tarik Zafer; Bolat, Filiz Aka; Yabanoglu, Hakan; Yildirim, Sedat; Moray, Gokhan; 0000-0002-3583-9282; 0000-0003-0268-8999; 0000-0003-2498-7287; 0000-0002-5735-4315; 0000-0002-5302-4386; 0000-0002-3462-7632; 0000-0002-1161-3369; 0000-0003-2031-7374; 26537078; AAJ-7913-2021; AAK-2011-2021; AAE-1041-2021; AAF-4610-2019; R-3735-2016; IQV-1169-2023; AAJ-8097-2021; AAJ-7865-2021; HJZ-1654-2023Purpose: 18 F-FDG PET/CT has an acceptable specificity but a low sensitivity on the prediction of axillary lymph node (ALN) metastasis in breast cancer. We analyzed the factors that could possibly affect this prediction. Methods: The records of 270 patients with T1-2 invasive breast cancer who underwent surgery, 116 of whom had been evaluated by preoperative 18 F-FDG PET/CT were reviewed. Prediction of ALN status by PET/CT according to tumor stage, estrogen receptor (ER), progesterone receptor (PgR) and HER2 status, histology, age and sentinel node properties was assessed. Results: ALN metastasis was present in 62 of 131 T1 (43.7%) and 106 of 142 T2 tumors (74.6%), 20 of 46 (43.5%) ER(-) and 146 of 222 (65.8%) ER(+) tumors, 38 of 71 (53.5%) PgR(-) and 127 of 200 (63.5%) PgR(+) tumors. On multivariate analysis only the tumor size (>2 cm) independently correlated with ALN metastasis (Odds ratio/OR=3.1). None of the other parameters had statistical significance in terms of ALN prediction on FDG-PET/CT. Conclusion: Though T2 tumors showed increased tendency to metastasize to the axilla, prediction of ALN metastasis in preoperative FDG-PET/CT was not associated with any of the predictive factors.Item Is PET/CT Necessary in the Management of Early Breast Cancer?(2016) Nursal, Gul Nihal; Nursal, Tarik Zafer; Aytac, Huseyin Ozgur; Hasbay, Bermal; Torun, Nese; Reyhan, Mehmet; Yapar, Ali Fuat; https://orcid.org/0000-0002-5302-4386; https://orcid.org/0000-0002-3583-9282; https://orcid.org/0000-0002-5597-676X; https://orcid.org/0000-0001-8550-3368; https://orcid.org/0000-0003-1715-4180; 26914560; R-3735-2016; IQV-1169-2023; AAJ-7913-2021; AAE-2718-2021; AAJ-5242-2021; AAI-8973-2021Purpose Advanced imaging methods in early breast cancers are not recommended before surgery. In contrast to the accepted guidelines, some recent studies have shown some benefits with the use of PET/CT in early-stage breast cancer. In this study, we aimed to document the efficacy of PET/CT in detection of distant metastasis as well as other primary cancers. Patients and Methods In this retrospective study, we reviewed the records of all women patients diagnosed with early breast cancer between March 2012 and December 2014. Besides demographics, we recorded the clinical TNM stage, histology of the tumor, and hormone receptor status. As PET/CT imaging is a routine procedure in our center for early breast cancer, tumor size, lymph node status, distant metastasis, and possible other primary malignancies detected by PET/CT were also recorded. Results Of the 419 women included in the study, 24.8% were clinically staged as stage I while the rest were stage II. Distant metastases were detected in 42 patients (10%). The yield of PET/CT in detecting metastasis was significant in stage II patients compared with stage I patients (12.4% vs 2.9%). In subgroup analysis of stage II patients, the performance of PET/CT in detecting metastasis was still evident in stage IIA patients (9.5%). In logistic regression analysis of the significant and near-significant factors (as detected by univariate analysis) effecting PET/CT detected distant metastasis, only nodal status (P = 0.053) was found to be significant. Conclusions We suggest the use of PET/CT in investigating metastasis in axilla positive and clinically stage II early breast cancer patients.Item The Effect of Subcutaneous Suction Drains on Surgical Site Infection in Open Abdominal Surgery. A Prospective Randomized Study(2016) Arer, Ilker Murat; Yabanoglu, Hakan; Aytac, Huseyin Ozgur; Ezer, Ali; https://orcid.org/0000-0002-1161-3369; https://orcid.org/0000-0002-3583-9282; https://orcid.org/0000-0002-3834-9924; 27025777; AAJ-7865-2021; AAJ-7913-2021; AAJ-8558-2021AIM: Surgical site infection (SSI) is a major problem associated with open abdominal surgery and related to increased morbidity and mortality rates, healthcare costs and also incisional hernia. A negative pressure subcutaneous drain reduces dead space in subcutaneous tissue by preventing accumulation of fluid. The aim of current study was to establish the efficacy of a subcutaneous drainage system for preventing SSI after open abdominal clean-contaminated surgery. MATERIAL AND METHODS: A total of 62 patients underwent abdominal surgery, between November 2014 and March 2015, were enrolled. 48 eligible patients, were randomized into subcutaneous drainage (DG) and no drainage group (NDG). Antibiotic prophylaxis was appiled to each patient. The diagnosis of superficial SSI was made according to the Centers for Disease Control and Prevention's (CDC) definition. RESULTS: The mean age of patients was 48.77 +/- 12.62 years with a male-female ratio of 21:27. No statistical difference between groups was observed for age, sex, comorbidity, incision type, hemoglobin level, blood loss, hospital stay and operation time (P>0.05). 2 (8.7%) patients in DG and 8 (32%) patients in NDG had incisional SSI but no statistical difference was observed (P>0.05). CONCLUSION: SSI appear to be reduced with subcutaneous suction drains in open abdominal surgery however prospective randomized larger scaled studies should be performed on this topic.Item Prophylactic Oral Calcium Supplementation Therapy to Prevent Early Post Thyroidectomy Hypocalcemia and Evaluation of Postoperative Parathyroid Hormone Levels to Detect Hypocalcemia: A Prospective Randomized Study(2017) Arer, Ilker Murat; Kus, Murat; Akkapulu, Nezih; Aytac, Huseyin Ozgur; Yabanoglu, Hakan; Caliskan, Kenan; Tarim, Mehmet Akin; 0000-0001-7392-961X; 0000-0003-0268-8999; 0000-0002-3583-9282; 0000-0001-6529-7579; 0000-0002-1161-3369; 0000-0002-8767-5021; 28039060; AAM-8548-2021; AAK-2011-2021; AAJ-7913-2021; AAJ-7870-2021; AAJ-7865-2021; AAJ-7201-2021Background: Postoperative hypocalcemia is the most common complication after total thyroidectomy. Postoperative parathyroid hormone (PTH) measurement is one of the methods to detect or prevent postoperative hypocalcemia. Prophylactic oral calcium supplementation is another method to prevent early postoperative hypocalcemia. The aim of this study is to detect the accurate timing of PTH and evaluate efficacy of routine oral calcium supplementation for postoperative hypocalcemia. Methods: A total of 106 patients were performed total thyroidectomy. Rotuine oral calcium supplementation was given to group 1 and no treatment to group 2 according to randomization. Serum calcium and PTH level of patients in group 2 at postoperative 6, 12 and 24 h and patients in both groups at postoperative day 7 were evaluated. Patients were compared according to age, sex, operation findings, serum calcium and PTH levels and symptomatic hypocalcemia. Results: Half of the patients (50%) were in group 1. Most of the patients were female (83%). The most common etiology of thyroid disease was multinodular goiter (64.1%). Oral calcium supplementation was given to 18 (33.9%) patients in group 2. Symptomatic hypocalcemia for group 1 and 2 was found to be 1.9 and 33.9% respectively (p < 0.05). No statistical difference can be observed regarding the timing of serum biomarkers. Conclusion: Serum PTH levels at postoperative 12 and 24 h can predict early post-thyroidectomy hypocalcemia. Prophylactic oral calcium supplementation therapy can prevent early post-thyroidectomy hypocalcemia with advantages of being cost effective and safe. (C) 2016 IJS Publishing Group Ltd.Item The Type of Specimen Retrieval in Laparoscopic Appendectomy Affects Wound Infection(2016) Aytac, Huseyin Ozgur; Torer, Nurkan; Arer, Ilker Murat; 0000-0002-3583-9282; 28070028; AAJ-7913-2021AIM: To evaluate the role of laparoscopy in appendicitis and importance of wound protection in this sense. MATERIALS AND METHODS: Data of 506 patients operated on by either open or laparoscopic appendectomy within the last four years were evaluated retrospectively for wound infection rates. Those had laparoscopic surgery were also sub grouped and analyzed in terms of retrieval type of the specimen. RESULTS: Wound infection rate was 5.7% for open appendectomy and zero for laparoscopic appendectomy in minimal or non-inflamed cases. For suppurative appendicitis and gangrenous or perforated cases wound infection rates were 9.1% versus 17.6% for open appendectomy versus laparoscopy. Laparoscopy without wound protection increased these rates to 17.9% versus 50%, where as wound protection reduced both to zero. DISCUSSION: Laparoscopy itself was protective for wound infection in non-inflamed or minimally inflamed appendectomy cases with respect to open surgery. However, for suppurative, gangrenous or perforated appendicitis, laparoscopy protects from wound infection only when contact of the specimen with incisions was avoided. CONCLUSION: Laparoscopy reduces wound infection rates in appendectomy. This advantage is prominent especially wound contamination with the specimen is prevented anywise. Using a glove finger, as a tissue bag for the retrieval of the specimen has been our favorite method that we defined as "reverse cover-up technique".Item Seroma Cytology in Breast Cancer: An Underappreciated Issue(2016) Aytac, Huseyin Ozgur; Nursal, Tarik Zafer; Colakoglu, Tamer; Bolat, Filiz Aka; Moray, Gokhan; 0000-0002-3583-9282; 0000-0003-2031-7374; 0000-0003-2498-7287; 27387392; AAJ-7913-2021; IQV-1169-2023; HJZ-1654-2023; AAE-1041-2021The presence of cancer cells in postoperative drain fluid has been ignored when achieving local disease control in breast cancer. We designed a prospective study to examine the drain cytology and demonstrated malignant cells in the drainage fluid from 4 of 68 cases, mostly independent of the axillary status. These findings highlight the danger regarding the overall objective of "disease-free local control" in breast cancer surgery. Background: The presence of malignant cells in postoperative seroma has been ignored in current breast cancer treatment. We aimed to assess the presence of malignant seroma cytology and to evaluate its relationship with the known prognostic factors for breast cancer. Patients and Methods: The solution from irrigation of the operation field and postoperative drainage fluid from 68 patients were prospectively collected and examined for malignant cytology. The results were evaluated according to the tumor characteristics and patient demographics. Results: Malignant cytology was found in none of the intraoperative samples but was found in the postoperative samples from 4 patients. Of these 4 patients, 3 were free of axillary metastasis. None of the common risk factors for breast cancer was associated with the finding of malignant cytology. Conclusion: Malignant cells can be seen in the drainage fluids from breast cancer patients independent of any contamination occurring during surgery, even in those without axillary metastasis.
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