serhan yılmaz - Academia.edu (original) (raw)

Papers by serhan yılmaz

Lietuvos chirurgija

Objective. This study was designed to compare the diagnosis, treatment, and results of acute appe... more Objective. This study was designed to compare the diagnosis, treatment, and results of acute appendicitis in pregnant and non-pregnant women. Material and Methods. Women between the ages of 18 and 40 who were operated for acute appendicitis between 2015 and 2020 were included in the study. Results. There were 27 (3.8%) patients in Group Pregnant, and 679 (96.2%) patients in Group non-Pregnant. The mean WBC values in Group P and Group non-P was 16.53±2.91 and 13.99±4.31 (x103), and there was a significant difference between the groups.Mean pain symptom duration time was 3.40±1.90 in Group P and 1.91±1.34 day in Group non-P, while it was significantly longer in Group P . When the preoperative USG reports were evaluated, no significant difference was found between the groups.The diagnosis was made by MRI in 2 (7.4%) pregnant patients who non-visualized according to the USG report. In Group P, 10 patients were laparoscopic, 17 patients open; In group non-P, 153 patients laparoscopic and...

The American Journal of Surgery

Background: Patients with obesity are at a high risk of severe disease and death from Coronavirus... more Background: Patients with obesity are at a high risk of severe disease and death from Coronavirus Disease 2019 (COVID-19). Vaccination offers a safe and effective means of reducing this risk. The rate of COVID-19 vaccine refusal in patients with obesity is unknown. Methods: Patients with obesity were administered validated questionnaires assessing COVID-19 fear, general vaccine hesitancy, and COVID-19-specific vaccine hesitancy. Results: 507 participants completed the study. COVID-19 vaccine hesitancy was high: Fifteen percent of patients refused COVID-19 vaccine. Hesitancy related to other vaccines was also high: Eight percent of patients refused a vaccine in the past, and 15% delayed a vaccine. Fear of side effects and doubts regarding effectiveness were the most common reasons for vaccine refusal. Conclusions: Despite high risk for complications, vaccine hesitancy is high among patients with obesity. Targeted public health interventions are critical to reduce vaccine hesitancy and improve vaccination rates.

Annali italiani di chirurgia, 2021

AIM The aim of this study is to evaluate the factors that has an effect on Cecal Intubation time ... more AIM The aim of this study is to evaluate the factors that has an effect on Cecal Intubation time (CIT), and to define the relationship between quality of bowel preparation and body mass index (BMI). PATIENTS METHODS The Boston Bowel Preparation Scale (BBPS) was used for the evaluation of bowel cleansing. A total of 346 patients were included. The time from anus to caecum was recorded as the time of the cecal intubation time. Patients were defined under 3 subgroup BMI-1; ≤ 24.9, BMI-2; 25-29.9, BMI-3; ≥30. RESULTS The mean BMI of women was 29.30 4.25 and men were 26.19 6.14 (p<0,001). Mean Cecal Intubation time was 9.11 6.00 and 10.21 3.45 minutes for women and men (p=0.012). Women with High BMI (≥30) have shorter Cecal Intubation time compared to women with BMI less than 30 (p=0001). When BBPS evaluated, there was a significant difference in BMI-3 due to high scores compared to both BMI-1 and BMI-2 (p<0.001). In BMI-3 group, also women had significantly higher scores in terms ...

SSRN Electronic Journal, 2022

İstanbul Kanuni Sultan Süleyman Tıp Dergisi, 2021

Objective: The aim of this study was to analyze the clinical, imaging, pathological and postopera... more Objective: The aim of this study was to analyze the clinical, imaging, pathological and postoperative surveillance data of patients with medullary thyroid carcinoma (MTC). Method: We included 11 patients who underwent surgery. The surgical type was documented. Clinical characteristics and imaging findings as well as preoperative and postoperative calcitonin and carcinoembryonic antigen (CEA) levels and preoperative thyroid stimulating hormone (TSH) levels were retrospectively reviewed. The demographic characteristics of the patients were also noted. Results: The mean age of the patients was 53.7 ± 12.8 years, and the mean nodule size was 27 ± 18 (range, 9-70) mm. The mean preoperative TSH level was 1.1 ± 1.0 mIU/L, and the median calcitonin and CEA levels were 898 (range, 10.9-1747) pg/mL and 98.1 (range, 44-196) ng/mL, respectively. Total thyroidectomy and central/lateral lymph node dissection were performed in all patients. According to preoperative fine-needle aspiration biopsy results, two (18.2%) patients were classified as Bethesda 2 and one (9.1%) as Bethesda 4 and eight (72.7%) patients had MTC. Of the patients, seven (63.6%) were in the early stage and four (36.4%) were in the localized advance stage. One patient had ret proto-oncogene-positive hereditary MTC and 10 had sporadic MTC. During the follow-up, one (9.1%) patient died because of lung metastasis. Conclusion: For the preoperative diagnosis of MTC, clinical characteristics, imaging findings, cytology test results, and genetic test results as well as serum calcitonin and CEA levels should be comprehensively evaluated. As a clinical approach, obtaining preoperative calcitonin and CEA levels for patients with thyroid nodules scheduled for thyroidectomy is advisable.

Medical Journal of Bakırkoy, 2021

PURPOSE: The aim of this study is to determine risk factors for malignancy in gallbladder polyps.... more PURPOSE: The aim of this study is to determine risk factors for malignancy in gallbladder polyps. METHODS: 92 patients who underwent laparoscopic cholecystectomy due to gallbladder polyp were retrospectively analyzed. Demographic data of the patients, size and number of polyp, the presence of gallstones and histopathological features of the polyps were recorded. RESULTS: 92 patients were included. Mean age was 45.78±11.21 years (21-72). 59 of the patients (64.1%) were female and 33 (35.9%) were male. Mean polyp size was 8.17±2.19 mm and 35 patients (38.0%) had a single polyp, while 57 (62.0%) had multiple polyps (≥2). 47 of the patients (51.1%) had gallstone disease, while 45 (48.9%) had no stone disease. Benign polyps (Group 1) were found in 79 patients (85.9%) and adenocarcinomas (Group 2) were found in 13 (14.1%). Of the benign polyps, 71 (77.1%) were non-neoplastic polyps and 8 (8.8%) were neoplastic polyps (adenomas). Of the 13 patients with adenocarcinomas, 11 (11.9%) were T1a...

Annali italiani di chirurgia, 2021

INTRODUCTION Anastomotic leakage (AL) is one of the most disastrous complications after rectosigm... more INTRODUCTION Anastomotic leakage (AL) is one of the most disastrous complications after rectosigmoid cancer operations. The aim of this study is to investigate the effect of the insertion time of circular stapler anvil on assessing the blood supply of the proximal colon segment, and thus to evaluate the prevention of early anastomotic leaks. MATERIAL METHODS A total of 57 patients were included in the study, 25 patients in group A and 32 patients in group B, respectively. From the beginning of the operation to the time of anvil placement in group A, it was 32.08 (± 7.34) minutes, and in group B it was 92.19 (± 16.63) minutes. None of the patients in group A had AL, and 4 patients in group B had AL. DISCUSSION Our study shows that the anvil must be placed at the beginning of the dissection to evaluate the anomalies that cause anastomotic leaks. We think that this method increases the reliability of the anastomosis line. Thus, the hospitalization period of the patients was shortened a...

Tiroid kanseri (TK) olgularında Bethesda sistemi ile ACR-TIRADS skorlarının birlikte kullanımının... more Tiroid kanseri (TK) olgularında Bethesda sistemi ile ACR-TIRADS skorlarının birlikte kullanımının önemini vurgulamayı amaçladık. Gereç ve Yöntem: Multinodüler guatr ve TK ön tanılarıyla total tiroidektomi yapılan hastalar retrospektif olarak incelendi. Hasta yaşı, cinsiyeti gibi demografik veriler ve nodül büyüklüğü kayıt altına alındı. Hastaların preoperatif Bethesda kategorilerine göre ACR-TIRADS skorları değerlendirildi. Bulgular: Çalışmaya toplam 241 hasta dahil edildi. Ortalama yaş 46,68±12,62 yıl ve kadın/erkek oranı 205/36 idi. Nodül boyutu ortalama 24,33±15,7 mm olarak tespit edildi. Bethesda 1 kategorisinde olan 6 hastanın 2'si (%33,3) TR4, 1 hasta (%16,7) TR5 olarak raporlandı. Bethesda 2 kategorisindeki 46 hastanın 13'ü (%28,3) TR4, 2 hasta (%4,3) TR5 olarak raporlandı. Bethesda 3-4 kategorisindeki 49 hastanın 17'si (%34,6) TR4, 1'i (%2,0) TR5 olarak raporlandı. Bethesda 5 kategorisinde olan 16 hastanın 11'i (%68,8) TR4, 1'i (%6,3) TR5 olarak raporlandı. Bethesda 6 kategorisindeki 124 hastanın 61'i (%49,2) TR4, 13'ü (%10,5) TR5 olarak raporlandı. Sonuç: ACR-TIRADS raporlama sistemini kullanmanın temel amacı tiroid nodüllerinin malign potansiyelini belirlemek ve benign biyopsi sonuçları gelen olgularda tedavi stratejisini belirlemeye yardımcı olmaktır. Bu çalışmanın sonuçları, tiroid nodüllerinin tanı ve tedavisinde yardımcı olacak iki yöntemin birlikte kullanımını desteklemektedir. Anahtar Kelimeler: Tiroid kanseri, Bethesda, ACR-TIRADS Objectives: We aimed to emphasize the importance of using the Bethesda system and ACR-TIRADS scores together in thyroid cancer (TC) cases. Materials and Methods: Patients who underwent total thyroidectomy with a pre-diagnosis of multinodular goiter and TC were retrospectively analyzed. Demographic data such as patient age and gender and nodule size were recorded. The ACR-TIRADS scores of the patients were evaluated according to the preoperative Bethesda categories. Results: A total of 241 patients were included. The mean age was 46.68±12.62 years and the female/male ratio was 205/36. The mean nodule size was 24.33±15.7 mm. Of the 6 patients in the Bethesda 1 category, 2 (33.3%) were reported as TR4 and 1 (16.7%) as TR5. Of the 46 patients in the Bethesda 2 category, 13 (28.3%) were reported as TR4, and 2 (4.3%) as TR5. Of the 49 patients in the Bethesda 3-4 category, 17 (34.6%) were reported as TR4, and 1 (2.0%) as TR5. Of the 16 patients in the Bethesda 5 category, 11 (68.8%) were reported as TR4 and 1 (6.3%) as TR5. Sixty-one (49.2%) of 124 patients in Bethesda 6 category were reported as TR4 and 13 (10.5%) as TR5. Conclusion: The main purpose of using the ACR-TIRADS reporting system is to determine the malignant potential of thyroid nodules and to help determine the treatment strategy in cases with benign biopsy results. The results of this study support the use of two methods to help in the diagnosis and treatment of thyroid nodules.

Videosurgery and Other Miniinvasive Techniques, 2021

Introduction: The method of stump closure is controversial in complicated patients, especially wi... more Introduction: The method of stump closure is controversial in complicated patients, especially with appendix base necrosis or perforation. Aim: To evaluate the efficacy and safety of partial cecum resection technique with an endostapler in patients with appendix base necrosis or perforation. Material and methods: Thirty-six patients who underwent laparoscopic partial cecum resection due to appendix base necrosis or perforation between 2015 and 2020 were retrospectively analyzed. In acute complicated appendicitis with appendiceal base necrosis or perforation, it was performed by laparoscopic partial cecum resection using an endostapler within a safe surgical margin. Demographic characteristics, duration of operation, days of hospital stay, and intra-and post-operative complications were evaluated. Results: The mean age of the patients is 42.72 ±16.69, female/male ratio was 19/17 (52.8%/47.2%). No intraoperative complications developed. Mean operative time and hospital stay were 104.75 ±34.96, 4.58 ±2.82 days, respectively. Post-operative complications developed in 5 (13.7%) patients. One of them was wound infection (2.7%), 2 of them were ileus (5.5%) and 2 patients had an intraabdominal abscess (5.5%). Stapler line leak was not observed in any of the patients. Conclusions: The use of an endostapler in laparoscopic appendectomy is a safe and effective technique in cases where appendix base necrosis, appendix perforation or severe inflammation affects the base of the cecum.

Medical Journal of Bakırkoy, 2020

Objective: The choice of laparoscopic technique in the treatment of complicated acute appendiciti... more Objective: The choice of laparoscopic technique in the treatment of complicated acute appendicitis (CAA) harbours debatable evidence because of higher rates of surgical complications such as postoperative intraabdominal abscess (POIIA). The aim of this study is to compare postoperative results of appendiceal stump (AS) ligation and its burial into the cecum using laparoscopic or open surgical techniques in patients with CAA. Method: This is a single-center and retrospective analysis of patients with CAA operated between May 2018 and April 2020. AS was intracorporeally knotted with silk and buried in the cecum with a purse-string suture (PSS). The patients were divided into open appendectomy (OA) and laparoscopic appendectomy (LA) groups. Data concerning demographic characteristics, intraoperative variables, hospital stay, surgical complications, morbidities, and postoperative findings were compared. Results: A total of 66 patients including 36 patients (54.54%) underwent LA and 30 p...

Journal of Ankara University Faculty of Medicine, 2020

Objectives: In our study, we aimed to reveal prevalence of obesity, obesity knowledge and awarene... more Objectives: In our study, we aimed to reveal prevalence of obesity, obesity knowledge and awareness in normal weight and obese patients who applied to the general surgery outpatient clinic for different reasons. Materials and Methods: The questionnaire containing 23 yes-no questions, which was previously prepared by researchers, was filled in and answers were received regarding epidemiological risk factors associated with obesity and health problems that may accompany obesity. Patients with body mass index (BMI) <30 were classified as group 1 and those with BMI ≥30 were classified according to their BMIs. Results: A total of 956 patients were included. The mean height-weight were 167.57±8.93 cm and 71.88±14.34 kg, respectively. The incidence of obesity was determined as 13.2%. Gender (p=0.007), marital status (p<0.0001), age (p=0.02), number of children (p<0.0001), use of alcohol (p=0.028) and smoking (p=0.022) were found statistically significance between groups. 61% (n=51) of the patients thought that obesity is a disease that can be treated surgically (p=0.037). When groups compared there was a statistically significant relationship between patients with obesity in their families and patients with BMI ≥30. Conclusion: Our study is the first in our country to evaluate the knowledge and awareness level of our society about obesity. Although the awareness of obesity and the diseases it causes are known by the majority of the population (more than >50), it is still not sufficient. We believe that the prevalence can be reduced and the diseases that it can cause can be prevented by giving more information about obesity in the society.

Surgical Innovation, 2020

Background. Laparoscopic cholecystectomy (LC) often results in postoperative pain, especially in ... more Background. Laparoscopic cholecystectomy (LC) often results in postoperative pain, especially in the abdomen. Intraperitoneal local anesthesia (IPLA) reduces pain after LC. Acute cholecystitis–associated inflammation, increased gallbladder wall thickness, dissection difficulties, and a longer operative time are several reasons for assuming a benefit in pain scores in urgent LC with IPLA application. The aim was to determine the postoperative analgesic efficacy of high-volume, low-dose intraperitoneal bupivacaine in urgent LC. Materials and Methods. Fifty-seven patients who were American Society of Anesthesiologists physical status I or II were randomly assigned to receive either normal saline (control group) or intraperitoneal bupivacaine (test group) at the beginning or end of urgent LC. The primary outcome was the postoperative pain score of the Visual Analogue Scale (VAS). The secondary outcomes included Visual Rating Prince Henry Scale (VRS), patient satisfaction, and analgesic ...

Lietuvos chirurgija

Objective. This study was designed to compare the diagnosis, treatment, and results of acute appe... more Objective. This study was designed to compare the diagnosis, treatment, and results of acute appendicitis in pregnant and non-pregnant women. Material and Methods. Women between the ages of 18 and 40 who were operated for acute appendicitis between 2015 and 2020 were included in the study. Results. There were 27 (3.8%) patients in Group Pregnant, and 679 (96.2%) patients in Group non-Pregnant. The mean WBC values in Group P and Group non-P was 16.53±2.91 and 13.99±4.31 (x103), and there was a significant difference between the groups.Mean pain symptom duration time was 3.40±1.90 in Group P and 1.91±1.34 day in Group non-P, while it was significantly longer in Group P . When the preoperative USG reports were evaluated, no significant difference was found between the groups.The diagnosis was made by MRI in 2 (7.4%) pregnant patients who non-visualized according to the USG report. In Group P, 10 patients were laparoscopic, 17 patients open; In group non-P, 153 patients laparoscopic and...

The American Journal of Surgery

Background: Patients with obesity are at a high risk of severe disease and death from Coronavirus... more Background: Patients with obesity are at a high risk of severe disease and death from Coronavirus Disease 2019 (COVID-19). Vaccination offers a safe and effective means of reducing this risk. The rate of COVID-19 vaccine refusal in patients with obesity is unknown. Methods: Patients with obesity were administered validated questionnaires assessing COVID-19 fear, general vaccine hesitancy, and COVID-19-specific vaccine hesitancy. Results: 507 participants completed the study. COVID-19 vaccine hesitancy was high: Fifteen percent of patients refused COVID-19 vaccine. Hesitancy related to other vaccines was also high: Eight percent of patients refused a vaccine in the past, and 15% delayed a vaccine. Fear of side effects and doubts regarding effectiveness were the most common reasons for vaccine refusal. Conclusions: Despite high risk for complications, vaccine hesitancy is high among patients with obesity. Targeted public health interventions are critical to reduce vaccine hesitancy and improve vaccination rates.

Annali italiani di chirurgia, 2021

AIM The aim of this study is to evaluate the factors that has an effect on Cecal Intubation time ... more AIM The aim of this study is to evaluate the factors that has an effect on Cecal Intubation time (CIT), and to define the relationship between quality of bowel preparation and body mass index (BMI). PATIENTS METHODS The Boston Bowel Preparation Scale (BBPS) was used for the evaluation of bowel cleansing. A total of 346 patients were included. The time from anus to caecum was recorded as the time of the cecal intubation time. Patients were defined under 3 subgroup BMI-1; ≤ 24.9, BMI-2; 25-29.9, BMI-3; ≥30. RESULTS The mean BMI of women was 29.30 4.25 and men were 26.19 6.14 (p<0,001). Mean Cecal Intubation time was 9.11 6.00 and 10.21 3.45 minutes for women and men (p=0.012). Women with High BMI (≥30) have shorter Cecal Intubation time compared to women with BMI less than 30 (p=0001). When BBPS evaluated, there was a significant difference in BMI-3 due to high scores compared to both BMI-1 and BMI-2 (p<0.001). In BMI-3 group, also women had significantly higher scores in terms ...

SSRN Electronic Journal, 2022

İstanbul Kanuni Sultan Süleyman Tıp Dergisi, 2021

Objective: The aim of this study was to analyze the clinical, imaging, pathological and postopera... more Objective: The aim of this study was to analyze the clinical, imaging, pathological and postoperative surveillance data of patients with medullary thyroid carcinoma (MTC). Method: We included 11 patients who underwent surgery. The surgical type was documented. Clinical characteristics and imaging findings as well as preoperative and postoperative calcitonin and carcinoembryonic antigen (CEA) levels and preoperative thyroid stimulating hormone (TSH) levels were retrospectively reviewed. The demographic characteristics of the patients were also noted. Results: The mean age of the patients was 53.7 ± 12.8 years, and the mean nodule size was 27 ± 18 (range, 9-70) mm. The mean preoperative TSH level was 1.1 ± 1.0 mIU/L, and the median calcitonin and CEA levels were 898 (range, 10.9-1747) pg/mL and 98.1 (range, 44-196) ng/mL, respectively. Total thyroidectomy and central/lateral lymph node dissection were performed in all patients. According to preoperative fine-needle aspiration biopsy results, two (18.2%) patients were classified as Bethesda 2 and one (9.1%) as Bethesda 4 and eight (72.7%) patients had MTC. Of the patients, seven (63.6%) were in the early stage and four (36.4%) were in the localized advance stage. One patient had ret proto-oncogene-positive hereditary MTC and 10 had sporadic MTC. During the follow-up, one (9.1%) patient died because of lung metastasis. Conclusion: For the preoperative diagnosis of MTC, clinical characteristics, imaging findings, cytology test results, and genetic test results as well as serum calcitonin and CEA levels should be comprehensively evaluated. As a clinical approach, obtaining preoperative calcitonin and CEA levels for patients with thyroid nodules scheduled for thyroidectomy is advisable.

Medical Journal of Bakırkoy, 2021

PURPOSE: The aim of this study is to determine risk factors for malignancy in gallbladder polyps.... more PURPOSE: The aim of this study is to determine risk factors for malignancy in gallbladder polyps. METHODS: 92 patients who underwent laparoscopic cholecystectomy due to gallbladder polyp were retrospectively analyzed. Demographic data of the patients, size and number of polyp, the presence of gallstones and histopathological features of the polyps were recorded. RESULTS: 92 patients were included. Mean age was 45.78±11.21 years (21-72). 59 of the patients (64.1%) were female and 33 (35.9%) were male. Mean polyp size was 8.17±2.19 mm and 35 patients (38.0%) had a single polyp, while 57 (62.0%) had multiple polyps (≥2). 47 of the patients (51.1%) had gallstone disease, while 45 (48.9%) had no stone disease. Benign polyps (Group 1) were found in 79 patients (85.9%) and adenocarcinomas (Group 2) were found in 13 (14.1%). Of the benign polyps, 71 (77.1%) were non-neoplastic polyps and 8 (8.8%) were neoplastic polyps (adenomas). Of the 13 patients with adenocarcinomas, 11 (11.9%) were T1a...

Annali italiani di chirurgia, 2021

INTRODUCTION Anastomotic leakage (AL) is one of the most disastrous complications after rectosigm... more INTRODUCTION Anastomotic leakage (AL) is one of the most disastrous complications after rectosigmoid cancer operations. The aim of this study is to investigate the effect of the insertion time of circular stapler anvil on assessing the blood supply of the proximal colon segment, and thus to evaluate the prevention of early anastomotic leaks. MATERIAL METHODS A total of 57 patients were included in the study, 25 patients in group A and 32 patients in group B, respectively. From the beginning of the operation to the time of anvil placement in group A, it was 32.08 (± 7.34) minutes, and in group B it was 92.19 (± 16.63) minutes. None of the patients in group A had AL, and 4 patients in group B had AL. DISCUSSION Our study shows that the anvil must be placed at the beginning of the dissection to evaluate the anomalies that cause anastomotic leaks. We think that this method increases the reliability of the anastomosis line. Thus, the hospitalization period of the patients was shortened a...

Tiroid kanseri (TK) olgularında Bethesda sistemi ile ACR-TIRADS skorlarının birlikte kullanımının... more Tiroid kanseri (TK) olgularında Bethesda sistemi ile ACR-TIRADS skorlarının birlikte kullanımının önemini vurgulamayı amaçladık. Gereç ve Yöntem: Multinodüler guatr ve TK ön tanılarıyla total tiroidektomi yapılan hastalar retrospektif olarak incelendi. Hasta yaşı, cinsiyeti gibi demografik veriler ve nodül büyüklüğü kayıt altına alındı. Hastaların preoperatif Bethesda kategorilerine göre ACR-TIRADS skorları değerlendirildi. Bulgular: Çalışmaya toplam 241 hasta dahil edildi. Ortalama yaş 46,68±12,62 yıl ve kadın/erkek oranı 205/36 idi. Nodül boyutu ortalama 24,33±15,7 mm olarak tespit edildi. Bethesda 1 kategorisinde olan 6 hastanın 2'si (%33,3) TR4, 1 hasta (%16,7) TR5 olarak raporlandı. Bethesda 2 kategorisindeki 46 hastanın 13'ü (%28,3) TR4, 2 hasta (%4,3) TR5 olarak raporlandı. Bethesda 3-4 kategorisindeki 49 hastanın 17'si (%34,6) TR4, 1'i (%2,0) TR5 olarak raporlandı. Bethesda 5 kategorisinde olan 16 hastanın 11'i (%68,8) TR4, 1'i (%6,3) TR5 olarak raporlandı. Bethesda 6 kategorisindeki 124 hastanın 61'i (%49,2) TR4, 13'ü (%10,5) TR5 olarak raporlandı. Sonuç: ACR-TIRADS raporlama sistemini kullanmanın temel amacı tiroid nodüllerinin malign potansiyelini belirlemek ve benign biyopsi sonuçları gelen olgularda tedavi stratejisini belirlemeye yardımcı olmaktır. Bu çalışmanın sonuçları, tiroid nodüllerinin tanı ve tedavisinde yardımcı olacak iki yöntemin birlikte kullanımını desteklemektedir. Anahtar Kelimeler: Tiroid kanseri, Bethesda, ACR-TIRADS Objectives: We aimed to emphasize the importance of using the Bethesda system and ACR-TIRADS scores together in thyroid cancer (TC) cases. Materials and Methods: Patients who underwent total thyroidectomy with a pre-diagnosis of multinodular goiter and TC were retrospectively analyzed. Demographic data such as patient age and gender and nodule size were recorded. The ACR-TIRADS scores of the patients were evaluated according to the preoperative Bethesda categories. Results: A total of 241 patients were included. The mean age was 46.68±12.62 years and the female/male ratio was 205/36. The mean nodule size was 24.33±15.7 mm. Of the 6 patients in the Bethesda 1 category, 2 (33.3%) were reported as TR4 and 1 (16.7%) as TR5. Of the 46 patients in the Bethesda 2 category, 13 (28.3%) were reported as TR4, and 2 (4.3%) as TR5. Of the 49 patients in the Bethesda 3-4 category, 17 (34.6%) were reported as TR4, and 1 (2.0%) as TR5. Of the 16 patients in the Bethesda 5 category, 11 (68.8%) were reported as TR4 and 1 (6.3%) as TR5. Sixty-one (49.2%) of 124 patients in Bethesda 6 category were reported as TR4 and 13 (10.5%) as TR5. Conclusion: The main purpose of using the ACR-TIRADS reporting system is to determine the malignant potential of thyroid nodules and to help determine the treatment strategy in cases with benign biopsy results. The results of this study support the use of two methods to help in the diagnosis and treatment of thyroid nodules.

Videosurgery and Other Miniinvasive Techniques, 2021

Introduction: The method of stump closure is controversial in complicated patients, especially wi... more Introduction: The method of stump closure is controversial in complicated patients, especially with appendix base necrosis or perforation. Aim: To evaluate the efficacy and safety of partial cecum resection technique with an endostapler in patients with appendix base necrosis or perforation. Material and methods: Thirty-six patients who underwent laparoscopic partial cecum resection due to appendix base necrosis or perforation between 2015 and 2020 were retrospectively analyzed. In acute complicated appendicitis with appendiceal base necrosis or perforation, it was performed by laparoscopic partial cecum resection using an endostapler within a safe surgical margin. Demographic characteristics, duration of operation, days of hospital stay, and intra-and post-operative complications were evaluated. Results: The mean age of the patients is 42.72 ±16.69, female/male ratio was 19/17 (52.8%/47.2%). No intraoperative complications developed. Mean operative time and hospital stay were 104.75 ±34.96, 4.58 ±2.82 days, respectively. Post-operative complications developed in 5 (13.7%) patients. One of them was wound infection (2.7%), 2 of them were ileus (5.5%) and 2 patients had an intraabdominal abscess (5.5%). Stapler line leak was not observed in any of the patients. Conclusions: The use of an endostapler in laparoscopic appendectomy is a safe and effective technique in cases where appendix base necrosis, appendix perforation or severe inflammation affects the base of the cecum.

Medical Journal of Bakırkoy, 2020

Objective: The choice of laparoscopic technique in the treatment of complicated acute appendiciti... more Objective: The choice of laparoscopic technique in the treatment of complicated acute appendicitis (CAA) harbours debatable evidence because of higher rates of surgical complications such as postoperative intraabdominal abscess (POIIA). The aim of this study is to compare postoperative results of appendiceal stump (AS) ligation and its burial into the cecum using laparoscopic or open surgical techniques in patients with CAA. Method: This is a single-center and retrospective analysis of patients with CAA operated between May 2018 and April 2020. AS was intracorporeally knotted with silk and buried in the cecum with a purse-string suture (PSS). The patients were divided into open appendectomy (OA) and laparoscopic appendectomy (LA) groups. Data concerning demographic characteristics, intraoperative variables, hospital stay, surgical complications, morbidities, and postoperative findings were compared. Results: A total of 66 patients including 36 patients (54.54%) underwent LA and 30 p...

Journal of Ankara University Faculty of Medicine, 2020

Objectives: In our study, we aimed to reveal prevalence of obesity, obesity knowledge and awarene... more Objectives: In our study, we aimed to reveal prevalence of obesity, obesity knowledge and awareness in normal weight and obese patients who applied to the general surgery outpatient clinic for different reasons. Materials and Methods: The questionnaire containing 23 yes-no questions, which was previously prepared by researchers, was filled in and answers were received regarding epidemiological risk factors associated with obesity and health problems that may accompany obesity. Patients with body mass index (BMI) <30 were classified as group 1 and those with BMI ≥30 were classified according to their BMIs. Results: A total of 956 patients were included. The mean height-weight were 167.57±8.93 cm and 71.88±14.34 kg, respectively. The incidence of obesity was determined as 13.2%. Gender (p=0.007), marital status (p<0.0001), age (p=0.02), number of children (p<0.0001), use of alcohol (p=0.028) and smoking (p=0.022) were found statistically significance between groups. 61% (n=51) of the patients thought that obesity is a disease that can be treated surgically (p=0.037). When groups compared there was a statistically significant relationship between patients with obesity in their families and patients with BMI ≥30. Conclusion: Our study is the first in our country to evaluate the knowledge and awareness level of our society about obesity. Although the awareness of obesity and the diseases it causes are known by the majority of the population (more than >50), it is still not sufficient. We believe that the prevalence can be reduced and the diseases that it can cause can be prevented by giving more information about obesity in the society.

Surgical Innovation, 2020

Background. Laparoscopic cholecystectomy (LC) often results in postoperative pain, especially in ... more Background. Laparoscopic cholecystectomy (LC) often results in postoperative pain, especially in the abdomen. Intraperitoneal local anesthesia (IPLA) reduces pain after LC. Acute cholecystitis–associated inflammation, increased gallbladder wall thickness, dissection difficulties, and a longer operative time are several reasons for assuming a benefit in pain scores in urgent LC with IPLA application. The aim was to determine the postoperative analgesic efficacy of high-volume, low-dose intraperitoneal bupivacaine in urgent LC. Materials and Methods. Fifty-seven patients who were American Society of Anesthesiologists physical status I or II were randomly assigned to receive either normal saline (control group) or intraperitoneal bupivacaine (test group) at the beginning or end of urgent LC. The primary outcome was the postoperative pain score of the Visual Analogue Scale (VAS). The secondary outcomes included Visual Rating Prince Henry Scale (VRS), patient satisfaction, and analgesic ...