seymen bora | Dokuz Eylül University (original) (raw)

Papers by seymen bora

Hernia : the journal of hernias and abdominal wall surgery, 2002

To avoid the adverse consequences of abdominal compartment syndrome and to reduce the high mortal... more To avoid the adverse consequences of abdominal compartment syndrome and to reduce the high mortality the celiotomy wound in patients with abdominal sepsis was closed without tension using prosthetic mesh. This produces a semiopen situation that permits staged reinterventions together with the functional reconstitution of the continuity of the abdominal wall. Twenty-five patients with intra-abdominal sepsis of various causes were evaluated retrospectively to assess the results of semiopen management of the septic abdomen and reoperations on demand in severe peritonitis. All of the patients were in a state of neglected peritonitis, and had at least one failing organ system. The Mannheim Peritonitis Index (MPI) scoring system was used for stratification of abdominal sepsis. The mean MPI score of 25 patients was 24, ranging 10 to 33. Eight (32%) patients were reexplored (MPI=21). There were overall 9 (36%) complications in patients with mean MPI score of 23. Six (24%) mesh-related compl...

The American Surgeon

Morbid obesity surgery has increased by 450 per cent in the past decade. Preferred surgical techn... more Morbid obesity surgery has increased by 450 per cent in the past decade. Preferred surgical techniques have also changed, and since 2014, the most common surgical procedure worldwide has been laparoscopic sleeve gastrectomy (LSG). The most serious complication of this surgery is staple-line leaks, which leads to significant increases in cost and a considerable rate of mortality. This study aimed to investigate the effects of staples used in LSG on the development of staple-line leaks. The sample of the study comprised 70 patients that consecutively underwent surgery at Dokuz Eylül University Hospital between March 2014 and June 2015. The patients were divided into two equal groups. For the first group, resection was performed using blue-green EndoGIA™ cartridges (BGC) (Medtronic, Norwalk, CT). In the other group, purple Tri-Staple™ cartridges (TSC) (Medtronic) were used. To examine the effect of the cartridge type, the point and pressure of leak was determined from fresh specimens f...

Primary hyperoxaluria type 1 (PH1) is a rare inherited metabolic disorder in which deficiency of ... more Primary hyperoxaluria type 1 (PH1) is a rare inherited metabolic disorder in which deficiency of the liver enzyme AGT leads to renal failure and systemic oxalosis. Timely, combined cadaveric liver‐kidney transplantation (LKT) is recommended for end‐stage renal failure (ESRF) caused by PH1; however, the shortage of cadaveric organs has generated enthusiasm for living‐related transplantation in years. Recently, successful sequential LKT from the same living donor has been reported in a child with PH1. We present a sister‐to‐brother simultaneous LKT in a pediatric patient who suffered from PH1 with ESRF. Twelve months after transplantation, his daily urine oxalate excretion was decreased from 160 mg to 19.5 mg with normal liver and renal allograft functions. In addition to the well‐known advantages of living organ transplantation, simultaneous LKT may facilitate early postoperative hemodynamic stability and may induce immunotolerance and allow for low‐dose immunosuppression.

The number of new transplantations has not kept pace with the ever-growing number of patients wai... more The number of new transplantations has not kept pace with the ever-growing number of patients waiting for a kidney transplant, and there has been a growing shortage of deceased donor kidneys. Previously transplanted organs have been used to increase the donor pool. There is very little data about the reuse of a transplanted kidney. We report a case of successful reuse of a kidney graft after the death of the first recipient with a 3-year follow-up.

Ingestion of foreign bodies can be a common problem especially among children, alcoholics, psychi... more Ingestion of foreign bodies can be a common problem especially among children, alcoholics, psychiatric patients, and senile patients, but ingestion of a metallic dinner fork is uncommon. Foreign bodies with smooth edges usually do not pose significant problems, but a sharp foreign object that is not retrieved at the earliest may penetrate the wall and cause complications. Ingested foreign bodies usually pass the intestinal tract without problems, and perforation occurs in less than 1%. In this paper, a case of rare gastric outlet obstruction due to a dinner fork, which was ingested 25 days before, is reported.

GEREC VE YONTEM Mart 2000 ile A¤ustos 2003 tarihleri aras›nda opere mide karsinomu tan›s› ile adj... more GEREC VE YONTEM Mart 2000 ile A¤ustos 2003 tarihleri aras›nda opere mide karsinomu tan›s› ile adjuvan tedavi icin klini¤imize refere edilen 31 olgu (7 kad›n, 24 erkek; medyan (ort.) yafl 56; da¤›l›m 24-77) de¤erlendirildi. Olgularda en s›k baflvuru yak›nmas› dispepsi (%42); en s›k tumor yerleflim yerleri eflit oranla kardiya, antrum ve kucuk kurvaturdu (%29). Dokuz hastaya total gastrektomi+lenf nodu diseksiyonu (LND)+splenektomi (%29), 11 hastaya distal subtotal gastrektomi+LND (%36), 9 hastaya ise total gastrektomi+LND uyguland› (%29). En s›k histopatolojik tur adenokarsinom (%58) idi. Olgulardan ort. 21 adet (0-71) lenf nodu diseke edildi; ort. metastatik LN say›s› 5 (0-49) idi. Evrelemede AJCC 1997 evreleme sistemi kullan›ld›. Evrelere gore da¤›l›m; 9 hasta evre II (%29), 10 hasta evre IIIA (%33), 5 hasta evre IIIB (%16), 7 hasta evre IV (%22) idi. Tum hastalarda tumor yata¤›na 1.8 Gy fraksiyon dozunda, 25 fraksiyonda, toplam 45 Gy radyoterapi (RT) uyguland›. Tum hastalar on-ark...

Turkish Journal of Surgery

Diagnostic and Interventional Radiology, 2016

We aimed to evaluate the relationship between gastrectomy and the volume of liver segments II and... more We aimed to evaluate the relationship between gastrectomy and the volume of liver segments II and III in patients with gastric cancer. Computed tomography images of 54 patients who underwent curative gastrectomy for gastric adenocarcinoma were retrospectively evaluated by two blinded observers. Volumes of the total liver and segments II and III were measured. The difference between preoperative and postoperative volume measurements was compared. Total liver volumes measured by both observers in the preoperative and postoperative scans were similar (P &amp;amp;amp;amp;amp;gt; 0.05). High correlation was found between both observers (preoperative r=0.99; postoperative r=0.98). Total liver volumes showed a mean reduction of 13.4% after gastrectomy (P = 0.977). The mean volume of segments II and III showed similar decrease in measurements of both observers (38.4% vs. 36.4%, P = 0.363); the correlation between the observers were high (preoperative r=0.97, P &amp;amp;amp;amp;amp;lt; 0.001; postoperative r=0.99, P &amp;amp;amp;amp;amp;lt; 0.001). Volume decrease in the rest of the liver was not different between the observers (8.2% vs. 9.1%, P = 0.388). Time had poor correlation with volume change of segments II and III and the total liver for each observer (observer 1, rseg2/3=0.32, rtotal=0.13; observer 2, rseg2/3=0.37, rtotal=0.16). Segments II and III of the liver showed significant atrophy compared with the rest of the liver and the total liver after gastrectomy. Volume reduction had poor correlation with time.

Transplant Immunology, Nov 30, 2004

Gastroenterology research and practice, 2016

Background. Laparoscopic sleeve gastrectomy (LSG) has become a popular operation during the recen... more Background. Laparoscopic sleeve gastrectomy (LSG) has become a popular operation during the recent years. This procedure requires resection of 80-90% of the stomach. Extraction of gastric specimen is known to be a challenging and costly stage of the operation. In this paper, we report results of a simple and cost-effective specimen extraction technique which was applied to 137 consecutive LSG patients. Methods. Between October 2013 and October 2015, 137 laparoscopic sleeve gastrectomy surgeries were performed at Dokuz Eylul University General Surgery Department, Upper Gastrointestinal Surgery Unit. All specimens were extracted through a 15 mm trocar site without using any special device. Results. We noticed one superficial incisional surgical site infection and treated this patient with oral antibiotics. No cases of trocar site hernia were observed. Conclusion. Different techniques have been described for specimen extraction. This simple technique allows extraction of specimen safel...

Turk Onkoloji Dergisi, 2006

... İlknur B. GÖRKEN, 1 Evrim BAYMAN, 1 Seymen BORA, 2 İlhan ÖZTOP, 3 Uğur YILMAZ, 3 Hilmi ALANYA... more ... İlknur B. GÖRKEN, 1 Evrim BAYMAN, 1 Seymen BORA, 2 İlhan ÖZTOP, 3 Uğur YILMAZ, 3 Hilmi ALANYALI, 1 Münir KINAY 1. ... 9] Üst gastrik yerleşimli tümörlerde de alan üst sınırı, ameliyat öncesi tümör uzanımı göz önüne alınmak üzere, T10 vertebra üzerinden, alt sınır L3 ...

Turkiye Klinikleri Journal of Gastroenterohepatology Special Topics, 2009

Surgery Gynecology Obstetrics, Sep 1, 1987

A technique for wedge biopsy of the liver is presented. By applying pressure on the liver, biopsy... more A technique for wedge biopsy of the liver is presented. By applying pressure on the liver, biopsy is performed. Cauterization of the bleeding surfaces in small areas provides hemostasis without need for sutures and hemostatic agents.

Turkish Journal of Medical Sciences, Aug 1, 1997

Hepato-gastroenterology, 2014

The association between systemic inflammatory response and tumor biology has been well documented... more The association between systemic inflammatory response and tumor biology has been well documented over the last decade. The aim of this study is to investigate the prognostic role of neutrophilto- lymphocyte ratio (NLR) in gastrointestinal stromal tumors (GISTs). A prospectively recorded database of 67 patients who underwent surgical resection for GIST was reviewed. High and low NLR were defined with respect to the sample median, which was 1.92. Demographical, clinicopathological, and surgical characteristics were analyzed as well as disease free survival (DFS) rates according to NLR classification. We observed better disease free survival rates in patients with low NLR compared to patients with high NLR (85.7% and 69%, respectively; p=0.037). Estimated five-year overall and disease free survival rates were 95.1% and 78.7%, respectively. In univariate analysis synchronous sarcomatosis, tumor size, mitotic rate, presence of necrosis, lymph node metastasis, surgical margin status, ris...

The Turkish journal of gastroenterology : the official journal of Turkish Society of Gastroenterology, 2012

ABSTRACT Breast cancer is the second most common primary tumor that metastasizes to the gastroint... more ABSTRACT Breast cancer is the second most common primary tumor that metastasizes to the gastrointestinal tract (1-2). The incidence of breast cancer metastasis to the stomach in long-term follow-up and postmortem studies has been estimated at 0.3-18% (3-5). In this letter, we present a case of gastric metastasis of breast cancer in a patient who underwent total gastrectomy for an initial diagnosis of primary gastric carcinoma. A 66-year-old female was admitted with epigastric pain, dyspeptic symptoms and anorexia. Eight years previously, she had undergone a right modified radical mastectomy, and pathologic examination revealed an invasive lobular carcinoma, mixed type, corresponding to T2 N1 M0. Estrogen receptors (ER), progesterone receptors (PR) and cerbB2 were positive. Adjuvant radiotherapy and chemotherapy with 3FEC were administered for six months, and she received tamoxifen daily for five years. The patient remained free of disease until the current presentation. At initial gastroscopy, diffuse hyperemia and edema indicating gastric lymphoma or linitis plastica were detected. Endoscopic biopsy revealed diffuse adenocarcinoma. Radiologic examinations showed celiac and paraaortic lymph node involvement, so neoadjuvant chemotherapy was planned before total gastrectomy. She was administered a five-month neoadjuvant chemotherapy regimen of modified docetaxel, cisplatin, and fluorouracil (mDCF). In December 2010, total gastrectomy with Roux-en-Y esophagojejunostomy and D1 lymph node dissection were performed. Macroscopic examination of the surgical specimen showed the gastric rugae were pale and flattened (Figure 1A). Postoperative pathologic examination revealed a diffuse malignant epithelial tumor with all involved 16 lymph nodes (Figure 1B). As some sites of the specimen showed obvious "Indian file" pattern evocative of lobular breast carcinoma, immunohistochemistry was performed (Figure 1C). Immunohistochemistry was positive for cytokeratin (CK)7, diffuse positive for ER and negative for CK20 and gross cystic disease fluid protein (GCDFP) (Figure 1D). Findings revealed breast cancer metastasis to the stomach. The patient was considered for further mDCF and additional hormonotherapy. It is very difficult to distinguish breast cancer metastasis and primary gastric cancer by clinical presentation. Second generation ER antibodies may be useful to identify metastatic breast cancer (6). Positivity of GCDFP-15 staining is reported as a sensitive (55-76%) and specific (95-100%) marker of metastatic breast cancer (6,7), but our patient had negative monoclonal staining with GCDFP-15. Symptoms and findings of a primary gastric carcinoma in patients with an initial diagnosis of breast cancer should always suggest the possibility of gastric metastasis of breast cancer.

Ulusal travma ve acil cerrahi dergisi = Turkish journal of trauma & emergency surgery : TJTES, 2010

The benign solitary cecal ulcer is a rare clinical entity that is not usually included in the dif... more The benign solitary cecal ulcer is a rare clinical entity that is not usually included in the differential diagnosis of the cecal diseases. The etiology is unknown, and there are no pathognomonic lesions or symptoms. Pre-operative and intra-operative diagnosis is difficult. Definitive diagnosis is generally obtained by histologic evaluation of the surgical specimen after a right hemicolectomy performed for a suspected neoplasm of the cecum. We herein describe a 70-year-old woman with solitary cecal ulcer presenting with abdominal pain, palpable mass on the right lower quadrant and leukocytosis, mimicking plastron appendicitis on initial evaluation.