Browsing by Author "Kalayci, Tolga"

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Direct X-Ray and Ct Findings of Gallstone Ileus
(Springer india, 2020) Turkoglu, Saim; Goya, Cemil; Kalayci, Tolga
Gallstone ileus is a complication of biliary tree stones and was first described by Bartholin in 1654. In any localization, one or more gallstones may occlude as a result of access to the gastrointestinal tract via the bilioenteric fistula. In this article, we aimed to present a rare and operate with gallstone ileus cases of radiological and surgical imaging findings. A 74-year-old male patient presented with complaints of right upper quadrant pain, nausea, vomiting, and constipation in the last few days of the emergency department. Radiographical and computed tomography examination was done. The patient was urgently operated with gallstones. The ileal stone was removed in addition to cholecystectomy in the operation, and the cholecystododenal fistula detected during the operation was repaired. Gallstone ileus is an uncommon cause of a mechanical small bowel obstruction. Gallstone ileus should also be kept in mind in the elderly patients who have recurrent abdominal operation history with abdominal obesity findings of the omentum. In our case, we wanted to emphasize the importance of the radiological approach in diagnosing gallstone ileus disease in elderly patients with diabetes mellitus.
Evaluation of Preoperative and Postoperative Total Serum Sialic Acid Levels in Patients With Colon Cancer
(Edizioni Luigi Pozzi, 2020) Iliklerden, Umit Haluk; Peksen, Caghan; Kalayci, Tolga; Kemik, Ozgur
AIM: The aim of this study was to compare the preoperative and postoperative (48th hour) total serum sialic acid levels of the patients with colon cancer and to investigate if the total serum sialic acid levels can be used as a tumor marker in colon cancer. METHODS: Preoperative and postoperative (48th hour) total serum sialic acid levels of 100 patients that were diagnosed with colon cancer and 70 healthy individuals were examined. All total serum sialic acid levels were determined by the methods of Warren. RESULTS: Total sialic acid levels of both patient groups were significantly higher when compared to the control group (p<0.0001). Also, highly significant difference was found between preoperative and postoperative total serum sialic acid levels (p<0.001). CONCLUSION: Evaluation of total serum sialic acid levels may play a critical role in colon cancers. Total serum sialic acid levels may serve as a non-invasive tool for early diagnosis of colon cancer.
Factors Affecting Morbidity, Mortality, and Recurrence in Incarcerated Femoral Hernia
(Coll Physicians & Surgeons Pakistan, 2022) Kalayci, Tolga; Iliklerden, Umit Haluk; Kotan, Mehmet Cetin
Objective: To ascertain the factors that govern morbidity, mortality, and recurrence in incarcerated femoral hernia. Study Design: Observational study. Place and Duration of Study: Department of General Surgery, Faculty of Medicine, Van Yuzuncu Yil University, Van, Turkey, between January 2010 and January 2020. Methodology: This observational study included patients operated on due to incarcerated femoral hernias under emergency conditions. The preoperative, intraoperative, and postoperative parameters of the patients were gathered. The study excluded pregnant patients and patients in the pediatric age group (0-18 years). Mann-Whitney U-test was used to compare quantitative variables. In addition, a Chi-square test and Likelihood-ratio test were used to compare the qualitative variables. A p-value <0.05 was deemed statistically significant. Results: The mean age of the 50 patients was 54.56 +/- 19.34 (19-91) years and the female/male ratio was 33:17. The morbidity, mortality, and recurrence rates of the study were 14%, 4%, and 6% respectively. Higher morbidity was observed in patients who had preoperative nausea (p = 0.003), vomiting (p <0.001), tachycardia (p <0.001), recurrent hernia (p <0.001), surgery under general anesthesia (p <0.001) or who underwent both laparotomy (p = 0.007) and visceral resection during surgery (p <0.001). Higher rates of mortality were observed in patients who had preoperative tachycardia (p = 0.054) or visceral resection during surgery (p = 0.029). However, the study identified no factors affecting recurrence. Conclusion: In cases of incarcerated femoral hernia, symptoms of intestinal obstruction or signs of strangulation are more important in the development of postoperative morbidity. In addition, the probability of mortality is higher in patients who had preoperative tachycardia and in patients who underwent visceral resection. To the extent possible, regional anesthesia should be preferred in suitable cases.
Laminin: a New Biomarker for Gastric Cancer
(Kuwait Medical Assoc, 2024) Kalayci, Tolga; Yilmaz, Ozkan; Iliklerden, Umit Haluk; Kemik, Ozgur; Kotan, Mehmet Cetin
Objective: To evaluate the diagnostic and prognostic utility of serum laminin levels in gastric cancer Design: A prospective and observational study Setting: Department of General Surgery, Van Yuzuncu Yil University Medical Faculty, Van, Turkey Subjects: Between June 2018 and September 2018, eighty patients who were diagnosed with gastric cancer as the patient group, and forty volunteers as the control group were included in the study. Intervention: From each patient, 3 ml of peripheral blood sample was collected. Main outcome measures: Enzyme-linked immunosorbent assay kit for human laminin were used for the detection of laminin in samples of serum. Data on patient demographics (age, gender) and serum laminin levels were recorded in both control and gastric cancer groups. In gastric cancer patients, serum laminin levels were further analyzed with respect to tumor stages and tumor size. Results: Serum laminin levels were significantly higher in gastric cancer patients [median (min-max): 205 (165-483) vs. 12 (9-18) ng/mL, P <0.001]. Laminin levels were higher in patients with advanced invasion depth, distant organ metastasis and lymph node metastasis ( P <0.001). The sensitivity and specificity determined from the receiver operating characteristic curves at cut-off level of 70 were 95% and 97% for serum laminin, respectively. Conclusion: The serum concentration of laminin can be used as a biomarker at the time of diagnosis for gastric cancer with high sensitivity and specificity. In addition, laminin can be used to discriminate between earlier, advanced or metastatic stages of gastric cancer.
Morbidity, Mortality and Recurrence Factors of Incarcerated Femoral Hernia
(Oxford Univ Press, 2021) Kalayci, Tolga; Iliklerden, Umit Haluk; Kotan, Mehmet Cetin
New Diagnostic Biomarker-Soluble Erythropoietin-Producing Hepatocellular Receptor A2 (Epha2) for Colon Cancer
(Springer india, 2023) Iliklerden, Umit Haluk; Kalayci, Tolga
To evaluate the association between soluble erythropoietin-producing hepatocellular receptor A(2) (EphA(2)) levels and the patients' tumor stage, tumor size, and lymph node metastasis. This study was planned at a tertiary health institute from May 2020 to October 2020 as prospective observational study after ethical committee approval. Samples were taken from 90 colon cancer patients and 40 healthy volunteers matched for age and sex. All samples were centrifuged to eliminate components and stored at -80 degrees C until testing. Serum levels of the EphA(2) were measured with sandwich ELISA. The mean age of the control group was 63.48 years (55-0 years; 19 men and 21 women), while the mean age of patient's group was 64.09 (range from 57 to 70 years; 46 men and 44 women). There was no difference between patient and control group according to age and gender (p>0.05). The mean value of serum EphA(2) was 194.75 ng/mL in the control group and 2622.39 ng/mL in the colon cancer patients (p<0.001). EPHA(2) level was significantly higher in the patients with tumor diameter over 30 mm (p<0.001). In addition, EPHA(2) levels were higher in patients with advanced TNM stage, deeply invasive tumors, multiple lymph node metastases, and distant metastasis (p<0.001). From the result of this study, EPHA(2) levels can be a diagnostic marker and can be used to differentiate cancer stages (to distinguish stages I-III from stage IV). It is also the first study investigating the relationship between EPHA(2) levels and colon cancer.
The Role of Latent Transforming Growth Factor Β Binding Protein 2 (Ltbp2) in the Diagnosis and Stage Discrimination of Gastric Cancer
(Springer india, 2022) Kalayci, Tolga; Iliklerden, Umit Haluk
Gastric cancer is a major health problem all over the world. In this study, it is aimed to investigate the effect of Latent Transforming Growth Factor beta Binding Protein 2 (LTBP2) on the diagnosis and stage discrimination of gastric cancer. Between May 2019 and October 2019, ninety patients, who were diagnosed with gastric cancer as the patient group, and forty-five healthy volunteer (samples were also taken from health volunteers to test LTBP2 usability) as the control group were included in the study. From each patient, 3 ml of peripheral blood sample was collected. Enzyme-linked immunosorbent assay kit for human LTBP2 were used for the detection of serum samples. Data on patient demographics (age, gender) and serum LTBP2 levels were recorded in both control and gastric cancer groups. In gastric cancer patients, serum LTBP2 levels were further analyzed with respect to tumor stages and tumor size. The mean LTBP2 levels were 14.78 SD4.54 and 2.79 SD0.93 in the gastric cancer patients and control group, respectively. The LTBP2 levels were significantly correlated with advanced lymph node status, depth of invasion, and TNM stage (p < 0.001). In addition, when the tumor diameter was over 30 mm, LTBP2 levels increased significantly. Increased level of LTBP2 in gastric tumor tissue is consistently associated with advanced gastric cancer. From the result of this study, LTBP2 can be a diagnostic marker and can be used to differentiate cancer stages (to distinguish stage I-III from stage IV). Further emphasis should be put on the integration of these markers and validation in larger cohorts for the prediction of gastric cancer.
Traumatic Diaphragmatic Ruptures: a Multidisciplinary Study in a Tertiary Health Center
(Baycinar Medical Publ-baycinar Tibbi Yayincilik, 2022) Iliklerden, Duygu Mergan; Iliklerden, Omit Haluk; Kalayci, Tolga
Background: In this study, we present diagnostic and therapeutic approaches in diaphragmatic rupture cases secondary to trauma and treated using surgical intervention.Methods: Between March 2010 and December 2020, a total of 24 patients (23 males, 1 female; mean age: 35.0 +/- 13.7 years; range, 18 to 61 years) who were operated for traumatic diaphragm rupture were retrospectively reviewed. Preoperative, intraoperative, and postoperative data of the patients were evaluated. Differences between the groups with and without morbidity were analyzed.Results: The mean total length of stay in the hospital was 16.2 +/- 10.9 (range, 6 to 56) days. The morbidity rate was 50% (n=12), and the mortality rate was 4.2% (n=1). In the comparison of groups with and without morbidity, three factors were found to be statistically significant: instability at the time of admission (p=0.009), gastrointestinal system perforation regardless of its location (p=0.014), and rib fracture (p=0.027). There was a significant difference in the total length of hospital stay (p=0.045).Conclusion: Patients whose condition is unstable at the time of admission to the emergency room and who have gastrointestinal system perforations and rib fractures are more prone to developing morbidity, which prolongs the duration of hospital stay.
Treatment of Rectus Sheath Hematomas: Eight Years of Single-Center Experience With a Review of Literature
(Turkish Assoc Trauma Emergency Surgery, 2021) Iliklerden, Umit Haluk; Kalayci, Tolga
BACKGROUND: Rectus sheath hematoma is a rare and frequently misdiagnosed cause of acute abdominal pain. In the management of the patients with rectus sheath hematoma, which are mostly with advanced age and comorbid diseases, positive results can be obtained by avoiding unnecessary surgical procedures with correct diagnosis and treatment approaches. The presented study aims to contribute to the lack of algorithms and optimal treatment strategies in the management of rectus sheath hematoma patients with the description of our experience in their management. METHODS: Patients who underwent treatment with the diagnosis of rectus sheath hematoma between May 2010 and July 2018 were retrospectively analyzed. Demographic characteristics, medical histories, physical and laboratory findings and imaging methods, treatment processes, complications, morbidity, mortality, length of hospitalization and long-term follow-up results were searched. Data were analyzed from patient files, hospital computer registry system and radiology archives. Data analysis was performed using Microsoft Excel and IBM-SPSS-Statistics-24. RESULTS: The mean age of the 31 patients was 63.03 years (24-85 years). The female/male ratio (21/10) was 2.1. The most common presenting sign or symptom was abdominal pain (100%), followed by abdominal wall mass in 25 patients (80.6%). Twenty-five patients (80.6%) were receiving some form of anticoagulation and antiplatelet therapy. Diagnosis was confirmed by Computed Tomography in 11 (45.4%), Ultrasonography in five (16.1%) and Computed Tomography with Ultrasonography in 15 (33.3%). Eight patients (25.8%) were evaluated as Type-1, 10 (32.2%) as Type-2 and 13 (41.9%) as Type-3. Mean International Normalized Ratio (INR) value of patients was 2.59. Bleeding was controlled by surgery in three cases (9.6%). The conservative approach was preferred in 28 cases (90.3%). 29 (93.5%) patients were discharged after an average hospital stay of 7.48 days (4-21). One patient died on the postoperative 5th day and other on the 14th day of conservative treatment (6.45% mortality). The mortality rate of conservatively and surgically treated patients was 3.5% and 33.3%, respectively. CONCLUSION: Rectus sheath hematoma should be suspected in elderly patients using anticoagulants with acute abdominal pain, severe cough attacks and an umbilical palpable or radiologically supported mass. Computed Tomography and Ultrasonography should be performed in case of clinical suspicion. Early and correct diagnosis ensures successful conservative treatment and prevents unnecessary surgical procedures. In the management of cases where clinician experience is at the forefront, we are hopeful that a new effective algorithm system and guidelines for the diagnosis will be identified after increasing the presentations of case series and experiences.