Browsing by Author "Celik, Sebahattin"

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Analysis of Factors Affecting Outcomes of Pregnancy Complicated by Echinococcus: an Algorithm for Approach and Management
(Springer Heidelberg, 2018) Celik, Sebahattin; Okyay, Ozan; Karaman, Erbil; Sert, Ozlem Z.; Cim, Numan; Okyay, Tuba Y.
The management of hydatid disease (HD) co-occurring with pregnancy remains a challenge for physicians. We aimed to determine factors that were related to fetal and maternal outcomes in HD complicated pregnancies and then develop an approach/treatment algorithm. All patients at the participating hospitals were first analyzed to determine whether they had HD. Only patients diagnosed with HD during the course of their pregnancy were included. Certain cyst-related factors (diameter, localization, increase in size, and viability) and certain pregnancy-related factors (treatments, gestational week, maternal co-morbidities, and delivery type) were investigated. Nonlinear principal component analysis (NPCA) was performed to determine the relationships between the categories of variables. Out of 12,926 pregnancies, 27 cases were diagnosed with HD. In 13 cases, each developed at least one fetal problem. Using Albendazol in first trimester, presence of an active cyst, increased diameter by more than 1 cm during pregnancy and a cyst diagnosed in the second trimester were associated with at least one fetal problem. According to the NPCA results, cyst diameter when first diagnosed was related to fetal outcomes; a cyst greater than 10 cm was associated with "at least one fetal problem". Cysts 5-10 cm in diameter were in a neutral position, while 2-5 cm in diameter were in the "no problems" group. HD mostly affects fetus. If cyst-related and pregnancy-related variables are optimal, close follow-up on a monthly is the best course of action. However, in high-risk conditions, percutaneous interventions or surgery should be considered.
Application of Machine Learning Techniques To Analyze Anastomosis Integrity After Total Gastrectomy for Prediction of Clinical Leakage
(Springer Heidelberg, 2019) Celik, Sebahattin; Sohail, Ayesha; Ashraf, Shaina; Arshad, Arooba
Intraoperative testing (IT) is used to confirm the integrity of gastrointestinal anastomosis. Clinical trials are available in the literature to support the fact that methylene blue can identify the leaks, and can thus help in minimizing the postoperative ratio of clinical leaks after total gastrectomy. In the recent literature, machine learning tools have been used very successfully to investigate the hypothesis of such complex clinical trials, where incomplete data is available. In this article, data obtained from a clinical study, is analyzed using machine learning, to verify whether or not the methylene blue test can accurately identify the leaks and to predict future outcomes. Furthermore, a comparative study based on most robust machine learning solvers is presented in this article to identify the most appropriate machine learning technique(s) for future applications. We have considered the data (over a period starting from Jan 2007 till Dec 2014) based on the total gastrostomies (TG), where methylene blue test was applied. Data was obtained from 198 patients having gastric cancer. Out of 198, 108 cases went through methylene blue test done by a nasojejunal tube while no test was carried out for rest of 90 cases. Intraoperative leakage rate, mortality rate, length of hospitalization and postoperative clinical leakage rate were the measured outcomes. To analyze the data and to predict whether there will be a leak or not, machine learning techniques were applied and the accuracy was compared. The main objective of this research is to predict the clinical leakage after applying methylene blue test on gastric cancer patients. This objective is successfully achieved by implementing six machine learning approaches. Case specific machine learning approaches are discussed to evaluate post clinical leakage rate and radio leakage rate. From our analysis, we have concluded that the prediction of intraoperative leak, post clinical leak and radio leak is possible with the aid of different machine learning techniques. An important conclusion drawn from this study is that a single machine learning technique can not accurately predict different stages of leak, since the accuracy of the technique depends on the specification of clinical data that varies from stage to stage.
Are Serum Mac 2-Binding Protein Levels Elevated in Esophageal Cancer? a Control Study of Esophageal Squamous Cell Carcinoma Patients
(Hindawi Ltd, 2018) Cobanoglu, Ufuk; Mergan, Duygu; Dulger, Ahmet Cumhur; Celik, Sebahattin; Kemik, Ozgur; Sayir, Fuat
Objective. Elevated serum Mac 2-binding protein (M2BP) levels have been observed in some cancers. As far as we know, its importance has not been investigated in esophageal squamous cell carcinoma (ESCC). The investigated problem of this study was to evaluate whether there was a difference between ESCC patients and the control group in terms of M2BP. Also, we evaluated the diagnostic performance of serum M2BP alone or in combination with the CEA for patients with ESCC. Material and Methods. Blood serum samples were collected from 50 healthy donors and 150 patients with ESCC. M2BP levels of all 200 samples were quantified by ELISA (enzyme-linked immunosorbent assay). Patients who had been diagnosed with ESCC and did not have any other malignancies were enrolled to study. Results. The two groups did not significantly differ in terms of age (p > 0 05). In the control group, the mean serum M2BP level was 14.97 coproduct 3.46 ng/mL. The mean serum M2BP level of the ESCC patients was 176.65 +/- 22.14 ng/mL. The serum M2BP level was significantly higher in patients with ESCC than in the control group (p < 0 001). Gender was also comparable in both groups (p = 0 695). Conclusions. Our analysis demonstrated that this marker may be associated with the mechanism of the disease. Despite that serum M2BP is not a specific marker for ESCC, it can be used as an adjuvant biomarker for the diagnosis of ESCC.
Benchmarking Coefficients for Forecasting Weight Loss After Sleeve Gastrectomy Biomedical Engineering
(World Scientific Publ Co Pte Ltd, 2020) Celik, Sebahattin; Sohail, Ayesha; Arif, Fatima; Ozdemir, Abdulselam
Background/Aim: In treatment practice of obesity, losing excess weight and then maintaining an ideal body weight are very important. By the sleeve gastrectomy initial weight loss is easier, but the progress of patients have diverse variability in terms of maintaining weight loss. Predicting models for weight changes may provide doctors and patients a good tool to modify their approach to obesity treatment.The main objective of this research is to verify the dependence of weight loss on sleeve coefficients and to forecast the weight loss. The weight loss and its dependence on remnant gastric volume compartmants (antral and body parts), after laparoscopic sleeve gastrectomy (LSG) is discussed in this paper. Data was obtained from a previous study which included 63 patients. Deep analysis of weight loss after LSG and its relation with remnant gastric volume is still a challenge due to weight loss dependence on multiple factors. During this research, with the aid of machine learning regression classifier, the relationship(s) between the sleeve coefficients' formulae and weight loss formulae (%EWL and %TWL), are developed in a novel way. Other factors such as age and gender are also taken into account. A robust approach of artificial intelligence, i.e. the "Neural Network Bayesian Regularization" is adopted to utilize the third month, sixth month and first year weight loss data, to forecast the second year weight loss. Models are proposed to demonstrate the dependance of total weight loss on crucial parameters of components of remanat gastric volumes. A comparative study is conducted for the appropriate selection of artificial intelligence training algorithm.
Breast Hematoma: a Rare Complication of Anticoagulant and Antiplatelet Use and Review of the Literature
(Galenos Publ House, 2023) Dagtekin, Emrah; Celik, Sebahattin
Oral anticoagulants and anti-platelet therapies are used for treatment and especially prophylaxis in clinical situations where there is a risk of thromboembolism or when thromboembolic events occur. The presented case was a patient who was hospitalized due to cellulitis in the leg, and was diagnosed with heart failure, obesity and chronic obstructive pulmonary disease. She was started on prophylactic oral anticoagulants for deep vein thrombosis and pulmonary emboli and subsequently developed spontaneous breast hematoma. The usual sites of such bleeding are the skin, gastrointestinal tract, genitourinary tract, central nervous system, retroperitoneum, muscle, and the site of recent surgical procedures or trauma while breast hematomas are usually of traumatic origin. Spontaneous bleeding into the breast after anticoagulant use is rare. While using anticoagulants, it should be kept in mind that, rarely, bleeding may occur in the breast. We advise that intervention in such cases is unnecessary, no matter how large the breast hematoma is, and that new anti-coagulant drugs may be safer.
A Case of Pancreatic Cancer With Concomitant Median Arcuate Ligament Syndrome Treated Successfully Using an Allograft Arterial Transposition
(Oxford Univ Press, 2015) Celik, Sebahattin; Ringe, Kristina I.; Boru, Cristian E.; Constantinica, Victor; Bektas, Hueseyin
An association of pancreatic cancer and median arcuate ligament syndrome (MALS) is a rare and challenging situation in terms of treatment. A 60-year-old man diagnosed with pancreatic cancer underwent laparotomy. A pancreaticoduodenectomy was planned, but during the resection part of the operation, a celiac artery stenosis was noticed. The patient was diagnosed with MALS causing almost total celiac artery occlusion, with no radiological solution. The patient was re-operated the next day, and an iliac artery allograft was used for aorta-proper hepatic artery reconstruction, concomitant with the total pancreaticoduodenectomy. Preoperative meticulous evaluation of vascular structures of the celiac trunk and its branches is important, especially in pancreatic surgery. A vascular allograft may be a lifesaving alternative when vascular reconstruction is necessary.
Colon Cancer Presented With Sigmoid Volvulus: a Case Report
(Elsevier Sci Ltd, 2015) Aras, Abbas; Kiziltan, Remzi; Batur, Abdussamet; Celik, Sebahattin; Yilmaz, Ozkan; Kotan, Cetin
Introduction: Sigmoid volvulus is the most prevalent type of colonic volvulus. Colon cancer is seen less where sigmoid volvulus is common, so it is rare to see that colon cancer is synchronous with sigmoid volvulus. PRESENTATION OF CASE: We would like to present a case of sigmoid volvulus caused by colon cancer in a male patient aged 80 who was referred to the hospital with toxaemic shock presentation. DISCUSSION: Sigmoid cancer can be presented as sigmoid volvulus to the emergency department. In intestinal obstruction early diagnosis is of crucial importance. Computarized tomography is a diagnosis tool that should be preferred both in the diagnosis of obstruction and in detecting its cause, localisation, degree and complications. CONCLUSION: When surgery is performed due to the urgent colonic obstruction in colonic volvulus diagnosed patients, a colon tumour should be considered in the same column loops or in the distal colon. We believe that CT is the method that should be preferred in large-bowel obstruction suspected patients. (C) 2015 The Authors. Published by Elsevier Ltd.
Comparison of Magenstrasse and Mill Gastroplasty and Sleeve Gastrectomy Techniques as an Experimental Study on Rabbits
(Edizioni Luigi Pozzi, 2020) Sumer, Aziz; Celik, Sebahattin; Aktokmakyan, Talar Vartanoglu; Peksen, Caghan; Sancak, Tunahan; Kuscu, Yagmur; Eren, Eryigit
AIM: Bariatric surgery is an important option when lift-style modification, diet, and medical treatment are inadequate in lose weight. Bariatric surgical methods have gained popularity in recent years. In this paper, we compared the Magenstrasse and Mill(M&M) technique, with performing a simpler and more physiological type of gastroplasty without implanted foreign material such as band and reservoir, to the Sleeve Gastrectomy (SG) technique. This study aimed to determine the effects of the M&M for obesity on the rabbits in comparison with the SG, which is accepted as a standard bariatric technique with creating a gastric tube. MATERIAL AND METHODS: The study was approved by the University of Van Yuzuncu Yil Regional Committee of Ethics (Institutional Animal Care and Use Committee). 20New Zealand Rabbits underwent operations. After prestudy with 2 rabbits, the remaining 18 rabbits were divided into 2 groups; Group 1 (SG) and Group 2 (M&M). RESULTS: Group 1 rabbits were observed to lose weight in all, while Group 2 rabbits; 2 of them died 5 of them lost weight, 2 of them gained weight. When the pre and post-operative weight of the rabbits were compared; preoperative median weight values of 9 rabbits in Group 1 were significantly higher than postoperative values. On the other hand, there was no significant change in the mean weight of Group 2 of 7 rabbits (living up to 8weeks). The mean weight of rabbits undergoing standard SG was significantly lower than the MeM technique. CONCLUSION: We believe that this animal experimental study, which we conducted intending to compare MeM and SG techniques, will contribute to the literature as a pilot study and determine the survey of M&M technique as a pioneer in other studies.
Comparison of Thyroid Surgery Experiences of "east" and "west" Regions in Turkiye
(Kare Publ, 2022) Zarbaliyev, Elbrus; Sarsenov, Dauren; Hacisalihoglu, Payam; Celik, Sebahattin
OBJECTIVE: This study aimed to evaluate the differences between the types of thyroidectomy surgeries and surgical treatment approaches according to thyroid pathology results, in Turkiye's two non-endemic regions. METHODS: Two different centers of the country, which differ in many respects and are non-endemic for thyroidal diseases were included in the study. Data on patients from both sexes, who underwent thyroidectomy in the western (1st center) and the eastern (2nd center) regions between 2011 and 2017 have been reviewed. RESULTS: Two hundred and forty patients from Istanbul (1st center) and 992 patients from Van (2nd center); a total of 1232 patients were included in the study. According to the pre-operative ultrasonography and laboratory results, toxic nodular goiter and multinodular goiter were the most common diseases in the first and second centers, respectively. There was a significant statistical difference between the radiological diagnostic findings between the two centers (p<0.001). The rate of bilateral total thyroidectomy in the first center was 82.5% (198 patients), whereas this rate was 58.5% (555 patients) in the second center. The type of surgery may change from center to center, (p<0.001). The most common early post-thyroidectomy complication was hypocalcemia in both centers. CONCLUSION: The results from only two centers from the western and eastern Turkiye show that there is a difference between the thyroidectomy preferences. Future similar national studies will contribute to the provision of a consensus in surgical treatment of thyroid diseases.
Contribution of Diffusion Weighted Mri To Diagnosis and Staging in Gastric Tumors and Comparison With Multi-Detector Computed Tomography
(Assoc Radiology & oncology, 2017) Arslan, Harun; Ozbay, Mehmet Fatih; Calli, Iskan; Dogan, Erkan; Celik, Sebahattin; Batur, Abdussamet; Kotan, Mehmet Cetin
Background. Diagnostic performance of Diffusion-Weighted magnetic resonance Imaging (DWI) and Multi-Detector Computed Tomography (MDCT) for TNM (Tumor, Lymph node, Metastasis) staging of gastric cancer was compared. Patients and methods. We used axial T2-weighted images and DWI (b-0,400 and b-800 s/mm(2)) protocol on 51 pre-operative patients who had been diagnosed with gastric cancer. We also conducted MDCT examinations on them. We looked for a signal increase in the series of DWI images. The depth of tumor invasion in the stomach wall (tumor (T) staging), the involvement of lymph nodes (nodal (N) staging), and the presence or absence of metastases (metastatic staging) in DWI and CT images according to the TNM staging system were evaluated. In each diagnosis of the tumors, sensitivity, specificity, positive and negative accuracy rates of DWI and MDCT examinations were found through a comparison with the results of the surgical pathology, which is the gold standard method. In addition to the compatibilities of each examination with surgical pathology, kappa statistics were used. Results. Sensitivity and specificity of DWI and MDCT in lymph node staging were as follows: N1: DWI: 75.0%, 84.6%; MDCT: 66.7%, 82%;N2: DWI: 79.3%, 77.3%; MDCT: 69.0%, 68.2%; N3: DWI: 60.0%, 97.6%; MDCT: 50.0%, 90.2%. The diagnostic tool DWI seemed more compatible with the gold standard method (surgical pathology), especially in the staging of lymph node, when compared to MDCT. On the other hand, in T staging, the results of DWI and MDCT were better than the gold standard when the T stage increased. However, DWI did not demonstrate superiority to MDCT. The sensitivity and specificity of both imaging techniques for detecting distant metastasis were 100%. Conclusions. The diagnostic accuracy of DWI for TNM staging in gastric cancer before surgery is at a comparable level with MDCT and adding DWI to routine protocol of evaluating lymph nodes metastasis might increase diagnostic accuracy.
A Dilemma in Staging of Esophageal Cancer: How Should We Stage Ypt0 N2 M0 Esophageal Cancer After Neoadjuvant Therapy
(Hindawi Ltd, 2015) Celik, Sebahattin; Erten, Remzi; Batur, Abdulsamed; Suvak, Burak
Background. Since neoadjuvant treatment in esophageal cancer began to become popular, a complete pathological response at the primary tumour site has been commonly reported. An issue of conflict is whether complete response in the esophageal lumen means that the esophagus is completely tumour-free. Another important issue is whether lymph nodes that are retrieved from pathologically complete response cases are also tumour-free or not. There is a gap in the esophageal cancer staging system for ypT0 N2 M0 tumours that have received neoadjuvant therapy. Here, we will discuss the problem about staging of esophageal cancer associated with neoadjuvant therapy. Case. A female aged 40 years complaining of dysphagia was diagnosed as having locally advanced thoracic esophageal cancer. Neoadjuvant therapy decision was taken by oncology committee. Six weeks after neoadjuvant therapy, with a curative intention, minimal invasive surgery was performed. The pathology report was as follows. "There were no neoplastic cells in the suspected area of the esophageal mucosa upon examination with all staining. There was no cancer at resection margins. Four metastatic lymph nodes were infiltrated with squamous cell cancer." Conclusion. Despite the growing use of neoadjuvant treatment in locally advanced esophageal cancer in world, we do not have a protocol for the evaluation of these patients' pathology reports. We believe that new studies and new ideas are needed to resolve this dilemma associated with neoadjuvant therapy.
Effect of Thymoquinone on the Healing of Left Colon Anastomosis: an Experimental Study
(Springer international Publishing Ag, 2016) Kiziltan, Remzi; Yilmaz, Ozkan; Celik, Sebahattin; Yildirm, Serkan; Alp, Hamit Hakan; Aras, Abbas; Kotan, Cetin
Aim: To evaluate the effect of thymoquinone on the healing of experimental left colon anastomosis in rats. Methods: Forty Wistar albino rats weighing 250-300 g were randomly divided into four groups (10 rats/group). Group 1 (control group) rats were not administered Thymoquinone (TQ) for 3 days after the operation. Group 2 was administered daily TQ for 3 days starting from the first day after the operation. Group 3 was not administered TQ for 7 days after the operation. Group 4 was administered daily TQ for 7 days starting from the first day after the operation. Thymoquinone was administered as a single dose oral gavage through a 4F feeding catheter per each day. The bursting strength of the anastomosis was measured on 3rd and 7th postoperative days (POD) and resection was performed. Subsequently, the hydroxyproline level in the resected tissue was measured and a histological evaluation was performed. Results: The bursting pressures of the anastomoses were measured to be statistically significantly greater on 7th POD in TQ administered groups compared to those without TQ administration. Tissues were stained with Masson's trichrome dye in order to evaluate the amount of fibrous tissue reaction for histopathological examination; there was no significant difference in the amount of fibrous tissue between groups 1 and 2, while a very marked increase in the fibrous tissue was detected in groups 3 and 4. Mean tissue hydroxyproline levels of the groups 3 and 4 on 7th POD were 1.30 and 2.72 mu g/g-protein, respectively. The difference between the groups was statistically significant (p = 0.001). Conclusions: TQ significantly increased the bursting pressure of the anastomosis, tissue hydroxyproline level, and fibrous tissue production.
Effects of Laparoscopic and Conventional Methods on Lung Functon in Colorectal Surgery
(int Scientific information, inc, 2018) Celik, Sebahattin; Yilmaz, Eyup M.
Background: We aimed to compare the lung functions, complication rates, and durations of the hospital and intensive care unit stays of patients who had undergone laparoscopic colorectal resection and open colorectal resection. Material/Methods: In this study, data were collected prospectively and then evaluated retrospectively. The study was carried out between January 2015 and November 2016 in 2 university hospitals. Pulmonary function tests (PFT) and chest radiography were performed in all patients preoperatively. In the postoperative period, PFT was performed in all patients but chest radiography was obtained only in patients for whom it was clinically indicated. Results: There were no significant differences between the 2 groups regarding their preoperative PFT parameters (p>0.05 for all variables). When compared to their preoperative PFT results, FEV1 and FVC values were determined to be significantly reduced on the 5th postoperative day (p <= 0.05) in both groups. When the postoperative 5th day PFT results of the Laparoscopy (LG) and Open group (OG) were compared, there were no significant differences (for all variables p>0.05). Consolidation developed in 11 patients, all of whom were in the OG, but this result was not associated with surgical procedure (p=0.080). The median duration of the postoperative intensive care stay was 1 day in the LG, whereas it was 2 days in the OG (p<0.001). Conclusions: In terms of pulmonary functions, both laparoscopic surgery and open surgery procedure have the same results. However, in terms of hospital stay and pulmonary infections, laparoscopy is more reliable.
Evaluation of Covid-19 Cases Who Received Immunosuppressive Therapy at a Tertiary Care Hospital
(Doc design informatics Co Ltd, 2022) Sayar, Merve Sefa; Acar, Ali; Bulut, Dilek; Celik, Sebahattin; Oguz, Emin
Objective: Immunosuppressive drugs are included in the treatment protocols of severe COVID-19 cases that may present with cytokine storm. In this study, we aimed to examine the characteristics of COVID-19 patients who received immunosuppressive therapy Methods: Patients diagnosed with COVID-19 and followed in the quarantine wards of our hospital between 01.03.2020-24.05.2020 were included in the study. Patient information was obtained retrospectively from patient files and discharge reports, and 263 COVID-19 patients-aged 18 and over-were included in the study. Results: The median age of the patients who received immunosuppressive therapy was 60.74 +/- 1.96, and 39.6% of them were women. The average symptom duration of the patients examined in the study at the time of admission to the hospital was 4.59 +/- 0.29 days. There was a significant difference in age, lymphocyte count, neutrophil/lymphocyte ratio, C-reactive protein, ferritin, D-Dimer, blood oxygen saturation, fever after antiviral therapy, qSOFA score, and total hospital stay between the two groups that received and did not receive immunosuppressive therapy (p<0.05). The need for immunosuppressive therapy increased 15.9 times over the age of 40, 15.6 times in the presence of diffuse involvement on thoracic CT, 6.6 times in the presence of chronic disease, 2.7 times in the presence of thrombocytopenia, and 1.7 times in the presence of lymphopenia (p <0.05).Conclusions: We observed that patients whose immunosuppressive therapy was added to their treatment protocols were admitted to the hospital later than others, had more prevalent involvement in thorax CT, high acute phase reactants, low SPO2, and more than one underlying disease.
Evaluation of Hemorrhoidal Disease and Lower Extremity Venous Insufficiency in Primary Adult Varicocele: a Prospective Controlled Study
(Sage Publications inc, 2019) Aslan, Rahmi; Erbin, Akif; Celik, Sebahattin; Ucpinar, Burak; Sahinalp, Sahin; Yildizhan, Murat; Taken, Kerem
Background The study investigated the association between varicocele, lower extremity venous insufficiency and hemorrhoidal disease. Methods The study included 62 patients with varicocele and 60 voluntary subjects with no varicocele. Patients who were diagnosed as having varicocele on physical examination and Doppler ultrasonography were included in the study group. Examination of lower extremity venous insufficiency was performed by physical examination and Doppler ultrasonography. Examination of hemorrhoidal disease was performed by a general surgery specialist. Results The patients with varicocele had a statistically significant (p < 0.05) higher rates of venous insufficiency of the lower extremities and had a borderline significant difference of higher hemorrhoidal disease rates (p = 0.05). Therewithal incidences of hemorrhoidal disease and lower extremity venous insufficiency were significantly higher in body mass index > 25 and age > 30 years of varicocele patients. Conclusion There is a statistically significant relation between varicocele, lower extremity venous insufficiency, and hemorrhoidal disease. In particular, varicocele patients who are aged over 30 years and overweight are at higher risk.
Investigation of Tandoor Ovens and Tandoor Smoke as a Public Health Problem: an Epidemiological Study in the Province of Van, Turkey
(Sage Publications inc, 2022) Celik, Sebahattin; Deniz, Serpil Sevimli; Koksal, Hakan; Abbasoglu, Osman
Lymphovascular Invasion in Colorectal Cancers: Can We Predict It Preoperatively
(Korean Soc Coloproctology, 2024) Zarbaliyev, Elbrus; Turhan, Nihan; Celik, Sebahattin; Caglikulekci, Mehmet
Purpose: This study aimed to investigate preoperative predictors of lymphovascular invasion (LVI), which is a poor prognostic factor usually detected postoperatively in patients with colorectal cancer. Methods: Results for all patients operated on for colorectal cancer between January 1, 2006, and December 31, 2021, were retrospectively analyzed. Potential preoperative factors and postoperative pathology results were recorded. The patients were categorized as those with LVI and those without LVI. Potential factors that may be associated with LVI were compared between the 2 groups. Results: The study included 335 patients. The incidence of LVI was 3.11 times higher in patients with ascending colon tumors (odds ratio [OR], 3.11; 95% confidence interval [CI], 1.34-7.23; P = 0.008) and 4.28 times higher in those with metastatic tumors (OR, 4.28; 95% CI, 2.18-8.39; P < 0.001). Diabetes mellitus was inversely related to LVI in colorectal cancer patients; specifically, LVI was 56% less common in colorectal cancer patients with diabetes mellitus, irrespective of its duration (OR, 0.44; 95% CI, 0.25-0.76; P < 0.001). Conclusion: The presence of preoperative LVI in colorectal cancer patients is difficult to predict. In particular, the effect of the effect of factors such as chronic disease accompanied by microvascular pathologies on LVI is still unclear. Advances in the neoadjuvant treatment of colorectal cancer patients, who are becoming more widespread every day, will encourage the investigation of different methods of preoperatively predicting LVI as a poor prognostic factor in these patients.
Maternal and Fetal Outcomes After Laparoscopic Vs. Open Appendectomy in Pregnant Women: Data From Two Tertiary Referral Centers
(Studio K, 2016) Karaman, Erbil; Aras, Abbas; Cim, Numan; Kolusari, Ali; Kiziltan, Remzi; Celik, Sebahattin; Anule, Turgut
Objectives: Appendectomy is the most common cause of non-obstetric surgery in pregnant women. Our aim was to compare the clinical characteristics, pert-and post-operative data of pregnant women undergoing either laparoscopic appendectomy (LA) or open appendectomy (OA). Material and methods: This was a retrospective study of medical records of all pregnant women diagnosed and treated surgically for acute appendicitis at two referral centers of Yuzuncu Yil University Medical Faculty and Kafkas University Medical Faculty, from January 2010 to January 2015. Results: The study included 48 patients, divided to two groups (12 - LA and 36 - OA). There were no significant differences in demographic characteristics of the studied population, including age, BMI, gestational age at operation, gravidity, parity, and history of cesarean sections. A far as obstetric and fetal outcomes are concerned, no significant differences were found in terms of preterm delivery, fetal loss, delivery mode, birth weight, APGAR score, and maternal death between the two investigated groups. One perioperative complication of intra-abdominal abscess was noted in the OA group. However, the LA group had shorter hospital stay (3.25 +/- 2.45 vs. 4.28 +/- 3.31, p=0.004), earlier mobilization time (8.1 +/- 2.2 vs. 10.1 +/- 1.6, p=0.025), and shorter time to first flatus (2.3 +/- 0.3 vs. 4.0 +/- 1.6, p=0.032) as compared to the OA group. The OA group had statistically shorter operation time than the LA group (38.61 +/- 11.5 vs. 49.42 +/- 11.38, p=0.007). Conclusion: LA is related to shorter hospital stay, faster return to daily activities, and shorter time to first flatus. LA appears to be as safe and effective as OA in pregnant patients without increasing adverse perinatal outcomes.
Minimally Invasive Distal Pancreatectomy a Retrospective Review of 30 Cases
(Edizioni Luigi Pozzi, 2017) Sumer, Aziz; Barbaros, Umut; Conde, Salvador Morales; Celik, Sebahattin; Aksakal, Nihat; Alamo, Jose Maria; Budak, Demir
OBJECTIVES: Pancreatic surgery has been greatly influenced by the advent of laparoscopic surgery and increasing experience in its performance and by advances in techniques and surgical devices. This study aimed to represent two centers' initial experiences in laparoscopic distal pancreatic surgery. METHODS: This study was a bi-centric study including 30 patients undergoing distal pancreatectomy for pancreatic disorders. All the patients were operated on from November 2006 to November 2013 in Turkey and Spain. RESULTS: Laparoscopic spleen-preserving distal pancreatectomy was performed in 9 patients, laparoscopic distal pancreatectomy was performed in 14 patients, laparoscopic enucleation was performed in 4 patients, and single-incision laparoscopic distal pancreatosplenectomy with splenectomy was performed in 3 patients. CONCLUSIONS: Laparoscopic distal pancreatectomies for pancreatic disorders are feasible and safe procedures if performed by experienced laparoscopic surgeons.
Molecular Characterization of Human Lung and Liver Cystic Echinococcosis Isolates in Van Province, Turkey
(Elsevier, 2020) Beyhan, Yunus Emre; Cobanoglu, Ufuk; Celik, Sebahattin; Yilmaz, Hasan; Halidi, Ahmed Galip
Cystic echinococcosis (CE) is a zoonotic infection and could lead to significant public health problems. The genetic diversity of CE includes five species: E. granulosus sensu stricto (s.s.) (G1-G3), Echinococcus equinus (G4), Echinococcus ortleppi (G5), Echinococcus canadensis genotypic cluster (G6, G7, G8 and G10, with the doubtful G9) and the Echinococcus felidis (lion strain). The species are important in epidemiology, pathology, control, prevention measures and vaccine/drug designs. The aim of the present study was to determine the E. granulosus genotypes in humans in the Van province in east of Turkey. In total, 102 echinococcal cysts were collected from operated patients. Genomic analyses were conducted with PCR-RFLP of the rDNA internal transcribed spacer 1 (ITS1) fragment and partial PCR sequencing of the cytochrome c oxidase subunit 1 (coxl) mitochondrial DNA gene region. In total, DNAs of 96 isolates could be extracted, unfortunately six extractions failed. The PCR-RFLP analysis findings were identical in all isolates. Two bands were observed at approximately 300 bp and 600 bp. All profiles corresponded to the Gl-G3 strain. Also, 446 bp amplified gene regions were observed for coxl. Out of 20 samples, alignment of 16 sequences exhibited a total identification (100%) of granulosus sensu stricto (G1/G3). Of 16 samples, 8 were obtained in the lung and 12 were obtained in the liver; 8 belonged to male and 12 belonged to female patients. Other four samples exhibited one nucleotide substitution at different positions. Four samples had one nucleotide substitution at different positions. We detected single nucleotide variations in TRH1, TRH67, TRH85 and TRH89 isolates at the positions C240T; G330T; G211A and T157C, respectively. In conclusion, the present study was the first comprehensive molecular investigation on genetic characterization of human CE isolates in Van region. The findings demonstrated that E. granulosus s.s. was the dominant species, which indicated that the sheep-dog cycle was the source in human infections. And, probably, it would be possible to describe these mutations as "Turkey" or "lung" variants. In addition to contributing molecular epidemiological data, the present results should be considered when designing and implementing E. granulosus control programs.