Browsing by Author "Zarbaliyev, Elbrus"

Now showing 1 - 7 of 7

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.
Epigastric Port Site Complications and Affecting Factors\rused for Gallbladder Specimen Extraction in Laparoscopic\rcholecystectomy
(2022) Çağlıkülekçi, Mehmet; Çelik, Sebahattin; Zarbaliyev, Elbrus; Özdemir, Abdulselam; Sevmiş, Doc. Dr. Murat
Introduction: Complications occur at the port site where the specimen is excised after laparoscopic cholecystectomy\r(LC). In this study, it was aimed to investigate port-site complications.\rMaterials and Methods: The results of patients who underwent LC surgery in our center between January\r01, 2018, and December 31, 2020, were retrospectively analyzed. Patients who were decided to have open\rsurgery and reside abroad were excluded from the study. Pre-operative, intraoperative, and post-operative\rfactors of all patients, which were considered to impact the development of complications, were noted down.\rResults: A total of 357 patients were included in the study. A total of 24 (6.7%) patients had epigastric trocar\rsite infection (EPSI). It was found out that trocar site hematoma was a risk factor causing a 39.37-fold\rincrease in the development of EPSI (<0.001) (95% confidence interval =10.69–144.97), while dilatation at\rthe trocar site was a risk factor causing a 3.1-fold increase (p=0.027) (95% confidence interval =1.14–8.48).\rTen patients had epigastric trocar insertion site hernia (EPSH). As a result of the multivariant analysis, it was\rdetermined that the development of EPSI caused the development of EPSH 27.59 times more (95% confidence\rinterval =5.92–128.7) (p<0.001), while the accompanying additional laparoscopic procedure caused\rthe development of EPSH 6.2 times more (95% confidence interval =6.2–1.17) (p=0.032).\rConclusion: Preventing the occurrence of hematoma in the epigastric trocar insertion site, where the specimen\ris excised after LC surgery, reduces the risk of EPSI, and indirectly reduces the incidence of EPSH.\rMoreover, we recommend careful follow-up for EPSH in patients who underwent additional laparoscopic\rsurgery during LC.
Lavaboda Akıllı Telefon Kullanımı ile Hemoroidal Hastalık Arasındaki İlişki
(2021) Çağlıkülekçi, Mehmet; Zarbaliyev, Elbrus; Özdemir, Abdulselam; Sohail, Ayesha; Çelik, Sebahattin
Amaç: Hemoroidal hastalık, nüfusun önemli bir bölümünün bir noktada karşılaştığı proktolojik bir sorundur. Günümüzde, cep telefonlarının aşırı sosyal medya alışkanlıkları ile birlikte aşırı kullanımı, birincisinin tuvalette kullanılmasına yol açmıştır. Bu çalışmanın amacı, lavaboda cep telefonu kullanımının hemoroidal hastalık ile ilişkili olup olmadığını araştırmaktır. Yöntem: Genel cerrahi polikliniğine hemoroid şikayeti ile başvuran hastalar çalışma grubuna dahil edilirken, bu tür şikayeti olmayan sağlıklı gönüllüler kontrol grubunu oluşturdu. Tüm katılımcılara cep telefonu kullanım alışkanlıkları hakkında sorular içeren bir anket verildi. Hemoroid hastalığının derecesi, varsa, fizik muayeneleri bizzat yapan deneyimli bir genel cerrah tarafından belirlendi. Bulgular: Çalışma grubu 882 katılımcı ve 802 kontrol grubundan oluşmaktaydı. Birincisinin %64,7’si (571 hasta) yanlarında cep telefonlarını lavaboya götürürken, bu oran kontrol grubu için sadece %38,4 (308 hasta) idi (p<0,001). Çalışma grubunun %49,9’u tuvaletteyken cep telefonlarında zaman geçirirken, kontrol grubunun sadece %27,3’ü bunu yapmıştı (p<0,001). Lavaboda bir cep telefonu kullanılarak geçirilen her ilave dakika için, hemoroit grubunda olma olasılığının 1,26 kat arttığı belirlendi (%95 güven aralığı =1,162-1,364). Sonuç: Cep telefonları artık lavaboda bile yaygın olarak kullanılmaktadır, bu alışkanlık hemoroit için risk faktörü olabilir. Bu nedenle, hemoroid tedavisi için, hastaların bu alışkanlığı bırakmaları tavsiye edilebilir.
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.
Parasitic Appendicitis: a Novel Laparoscopic Approach for the Prevention of Peritoneal Contamination
(Hindawi Ltd, 2018) Zarbaliyev, Elbrus; Celik, Sebahattin
Background/Aim. Although rare, parasitic infection can cause acute appendicitis and result in contamination of the peritonea during appendectomy. The goal of this study was to summarize our experiences with parasitic appendicitis and describe a novel laparoscopic technique to prevent contamination. Method. All patients diagnosed with acute appendicitis who underwent appendectomy between January 2016 and January 2017 were included in the study. All appendectomies were performed using the standard three-port laparoscopic method, and a video recording was made of each procedure. Following separation of the mesoappendix, a single endoloop was placed in the base of the appendix, and the appendix was then transected 3-4 mm above the clamp with the aid of a thermal cauterizing/sealing device. The appendix was extracted from the 10 mm trocar hole below the umbilicus and placed inside a bag prepared from a glove. After pathological confirmation of parasitic appendicitis, medical records were retrospectively analyzed in each case for whether peritoneal contamination had occurred or not. Results. Out of 97 appendectomies, parasitic infection was observed in 4 cases, as confirmed by pathological examination. In two of these patients, E. vermicularis was detected, while the other two were infected with Balantidium coli. Intraoperative contamination did not occur in any of the cases, and retrospective review of the video recordings indicated no peritoneal contamination. Conclusion. As a result of the coagulation and sealing effects of thermal devices, airtight seals were created on the residual appendiceal stumps, and consequently, no contamination was observed in any of the cases.
Proposal for an Index for Predicting the Success of Sleeve Gastrectomy: a Pilot Study
(Mary Ann Liebert, inc, 2019) Celik, Sebahattin; Sumer, Aziz; Yavuz, Alpaslan; Zarbaliyev, Elbrus; Dundar, Ilyas
Background: Determining the relationship between remnant gastric volume (RGV) following laparoscopic sleeve gastrectomy (LSG) and the percentage of excess weight loss (%EWL) remains a challenge. The components of RGV appear to play a much more important role than total RGV. We aimed to determine whether there is an optimal ratio between the components of RGV with respect to %EWL and to develop a statistical model to predict %EWL. Materials and Methods: This was a multicentric prospective observational cross-sectional study conducted between 2014 and 2016 with a minimum of 2 years of follow-up. Two university-affiliated hospitals participated in this study. Patients who underwent LSG as treatment for obesity were enrolled in the study. Those who did not consent to postoperative computed tomography (CT) or whose postoperative CT images were not technically suitable for calculating volumes were excluded. Patients whose follow-up was incomplete were also excluded. Out of a total of 82 patients, 63 completed follow-ups and met the inclusion criteria. By dividing RGV into its components (the antrum and body parts), volumetric measurements were made using a novel CT-based software program. RGV was divided by the antrum volume to yield a ratio that we termed the "Sleeve Coefficient" (SC). Taking SC as an independent variable, nonlinear regression analysis was performed to determine the best model for curve estimation of %EWL. The radiologists who measured the RGV components were blinded to the outcomes. Results: The participants were primarily female (56F/7M), with a mean age of 35.9 (+/- 11.9) and a mean preoperative body mass index of 44.8 (+/- 7.4). The best fitted model for predicting %EWL in the second year was the cubic model. In the second year following LSG, the mean %EWL was 76.1% (+/- 18.2%). There was no significant correlation between total remnant volume and %EWL. Optimal %EWL was obtained when the mean SC was 3.3 +/- 1.5 (95% CI: 2.94-3.72). Conclusions: The ratio between RGV and antral (rather than total remaining stomach) volume appears to be of greater importance and utility in predicting %EWL and in managing LSG candidates. The proposed SC should be validated by further studies.
The Relationship Between Small Peritoneal Flap Defects and Postoperative Seroma in Tapp Repair of Inguinal Hernias
(Lippincott Williams & Wilkins, 2023) Zarbaliyev, Elbrus; Turhan, Nihan; Dundar, Faruk; Sevmis, Murat; Celik, Sebahattain; Caglikulekci, Mehmet
Objective: Total abdominal preperitoneal (TAPP) is one of the most frequently used surgical treatment methods in the treatment of inguinal hernia (IH). One of the most common early postoperative complications after hernia repair is seroma/hematoma. In this study, we aimed to study the role of unclosed peritoneal flap defects on the development of postoperative seroma. Material and Methods: The study was performed retrospectively in 2 university hospitals. All patients over the age of 18 years who underwent laparoscopic TAPP surgery in Istanbul Yeni Yuzyil University Gaziosmanpasa Hospital General Surgery Clinic and Van Yuzuncu Yil University Faculty of Medicine General Surgery Clinic between January 1, 2018, and December 31, 2021, were included. Patients were divided into those with peritoneal defects (group 1) and those without (group 2). Whether there was a peritoneal defect or not was compiled from video recordings. In addition, risk factors affecting the development of seroma were determined. Results: A total of 250 patients, 16 (6.4%) women and 234 (93.6%) men, were included in the study. There were bilateral hernias in 35 (14%) patients, and a total of 320 hernias were analyzed in the study. It was determined that an American Society of Anaesthesiologists (ASA) III score increased the risk of seroma 15.97 fold (P<0.001, 95% CI, 4.94 to 51.56), direct hernia type increased risk 7.1 fold (P<0.03, 95% CI, 1.204 to 42.422), hernia descending into scrotum increased risk 22.48 fold (P<0.001, 95% CI, 6.66 to 75.84) and closure of the peritoneal flap completely without leaving any defect increased the risk of seroma 8.67 fold (P<0.001, 95% CI, 3.254 to 23.115). Conclusions: The presence or leaving of small-diameter defects on the peritoneal flap may reduce seroma development without increasing the risk of complications. Prospective randomized studies are required to reach definitive conclusions.