Kenan Büyükaşık

Background/Objectives: Acute mesenteric ischemia (AMI) resembles non-vascular intestinal ischemia (NSII) and non-specific abdominal pain (NSAP) at presentation yet carries 50–80% mortality. We tested how well admission data separate these conditions and predict in-hospital mortality, the primary endpoint. Methods: We studied 197 consecutive adults (2015–2021): AMI (n = 61), NSII (n = 62), and NSAP controls (n = 74). Admission demographics, comorbidities, laboratory markers, the Mannheim Peritonitis Index (MPI), and APACHE-II were compared by ROC/DeLong analysis and multivariable logistic regression (STROBE). Results: AMI had more atrial fibrillation, thromboembolism, chronic kidney disease (CKD), and dyslipidemia (p ≤ 0.028) and higher in-hospital mortality than NSII (47.5% vs. 16.1%; p < 0.001). Inflammatory ratios, lactate, and albumin separated AMI from NSAP well (AUC up to 0.93) but from NSII modestly (lactate, 0.672). APACHE-II (AUC 0.861) and MPI (0.810) predicted in-hospital death and improved combined (0.897; DeLong p = 0.014). Independent predictors were MPI (adjusted odds ratio 1.14, 95% CI 1.06–1.23), CKD (3.72, 1.25–12.10), and arterial lactate (1.20, 1.03–1.45). Conclusions: A composite admission panel was internally consistent but hypothesis-generating, not a triage tool ready for clinical use. CT angiography remains essential, since these markers cannot separate vascular from non-vascular ischemia; prospective external validation is required.

AIM: This study aimed to evaluate the relationship between colonic diverticular disease (CD) and colonic polyps (CP) in Turkiye, considering age and gender distribution. METHODS: This retrospective cross-sectional study analyzed patients who underwent total colonoscopy between 1 January 2021, and 1 January 2022. Patients with a history of colon resection, inflammatory bowel disease, or prior polypectomy were excluded. The presence of CD and CP was assessed according to age, gender, and colonic localization [right (R), left (L), bilateral (B)]. RESULTS: A total of 452 patients were included, with 248 (54.9%) males and 204 (45.1%) females. The mean age was 57.7 ± 13.0 years. Among them, 235 were in the patient group [CD (+) and/or CP (+)], and 217 were in the control group. The study found a significant association between CD and CP, particularly among older patients, with rates of CD (+) and CP (+) increasing with age (p = 0.001). Interestingly, CD (+) patients had a lower risk of CP compared to CD (–) patients (p = 0.003). Additionally, male patients exhibited significantly higher CP rates than females. CONCLUSIONS: Our findings indicate that CD (+) patients have a significantly lower risk of CP (+) compared to CD (–) patients. These results provide valuable insights into the relationship between CD and CP, which may help guide future research.

AIM: The aim of this study was to investigate the effect of metastatic lymph node ratio (mLNR) on overall survival after curative resection in patients with right-sided colon cancer. METHODS: Patients diagnosed with right-sided colon cancer and treated at Istanbul Teaching and Research Hospital between 2012 and 2017 were retrospectively analyzed. Variables including age, sex, total number of lymph nodes removed, metastatic lymph node ratio, disease stage, tumor location, and patient morbidity were compared with overall survival. Kaplan-Meier survival analysis and Cox regression analysis were used to evaluate the impact of these variables on overall survival. RESULTS: A total of 129 patients were included in this study. By the end of the follow-up period, 51 patients (39.5%) had died. Receiver operating characteristic (ROC) analysis identified a cut-off value for mLNR at 0.0801 (p < 0.001), with 39 patients (30.2%) having an mLNR greater than this threshold. Patients with a high mLNR exhibited significantly shorter overall survival (20.3 months, 95% confidence interval (CI): 12.0–28.6) compared to those with a lower mLNR (106.6 months, 95% CI: 98.4–114.8) (p < 0.001). Furthermore, overall survival was significantly lower in patients with advanced-stage tumors, highlighting the prognostic importance of tumor, node, and metastasis (TNM) staging system. In multivariate Cox regression analysis, TNM stage (hazard ratio (HR) = 50.229, 95% CI: 6.678–372.242, p < 0.001) and mLNR (HR = 3.136, 95% CI: 1.843–5.337, p < 0.001) were identified as independent prognostic factors for overall survival. CONCLUSIONS: This study underscores that in right-sided colon cancer, the mLNR and TNM stage provide critical prognostic insights, independent of the total number of lymph nodes removed. These findings support the use of mLNR as a practical and reliable tool for refining prognostic assessments and guiding personalized treatment strategies, emphasizing its potential role in clinical decision-making.

Tiroid Bezinin Yapısal Özellikleri ve Fonksiyonları Tansu ALTINTAŞ Tiroid Hastalıklarının Cerrahi Tedavisi Nihat GÜLAYDIN Tiroid Cerrahisine Bağlı Komplikasyonların Yönetimi Yusuf Emre AYTİN Oğuzhan Alp ÖZTÜRK Paratiroid Bezinin Yapısal Özellikleri ve Fonksiyonları Serkan ADEMOĞLU Paratiroid Hastalıkları ve Cerrahi Tedavi Kıvılcım ORHUN ERDOĞAN Paratiroidektominin Postoperatif Komplikasyonları Mehmet Fatih EKİCİ Sürrenal Bez Yapısal Özellikleri ve Fonksiyonları Adnan Mesut DEDE Sürrenal Bez Cerrahi Hastalıkları ve Tedavileri İsa KARACA Sürrenal Bez Cerrahisine Bağlı Komplikasyonların Yönetimi Mümtaz ERAKIN Metabolik Cerrahi Fatih TÜRKOĞLU Murat ÇİLEKAR Obezitenin Tarihi Yüksel DOĞAN Obezitenin Tanımı ve Tanı Yöntemleri Mahmut APAYDIN Obezitenin Medikal Tedavisi Serdar GÖK Selvihan BEYSEL Obezite Cerrahisi ve Psikiyatri İlişkisi Mustafa Melih BİLGİ Obezite Cerrahisine Hazırlık; Anestezi Preoperatif Hazırlıklar Bilge Banu Taşdemir MECIT Obezite Cerrahisine Hazırlık – Obez Hastalarda Görülen Kardiyolojik Problemler, Preoperatif ve Postoperatif Takip Prensipleri Mehmet Hakan UZUN Serkan GÖKASLAN Obezite Cerrahisinde Ameliyat Öncesi ve Sonrasında Pulmoner Değerlendirme Şule ÇİLEKAR Obezite Cerrahisi ve Beslenme Reyhan ÇETİN Perioperatif Obezite Cerrahisinde Anestezi Prensipleri Tuba Berra Sarıtaş Obeziteye Yönelik Endoskopik İntragastrik Balon Uygulamaları Metehan AYDIN Khalig YAGUBLU Sezgin YILMAZ Obezite Cerrahi Tedavi Prensipleri Kübra ERTEKİN Mehlika BİLGİ KIRMACI Sleeve Gastrektomi Metehan AYDIN Sezgin Yılmaz Roux-N-Y Gastrik Bypass Murat ÇİLEKAR Minigastrik By-Pass (Tek Anastomozlu Gastrik By-Pass) Kenan BÜYÜKAŞIK Biliyopankreatik Diversiyon ve Duodenal Switch Murat KEĞİN Obezitenin Cerrahi/Endoskopik Tedavisi Sonrası Metabolik ve Nutrisyonel Destek Tedavisi Emre BALLI Abdullah KARAKAYA Obezite ve Metabolik Sendrom Cerrahi Tedavi Sonrası Komplikasyonların Radyodiagnostik Değerlendirilmesi- Perkütan İşlemler Medine BÖGE Çiğdem ÖZER GÖKASLAN Obezite ve Metabolik Sendrom Cerrahi Tedavi Sonrası Komplikasyonların Yönetimi Mehmet Nuri KOŞAR Obezite Cerrahisinde Revizyon Cerrahisinin Yeri Murat AKICI Çocuk ve Ergen Obezite Tedavisinde Endoskopik ve Cerrahi Yaklaşımlar Çiğdem ARSLAN ALICI Ahmet Ali TUNCER Pankreas’ın Yapısal Özellikleri ve Fonksiyonları Burak Öztop Pankreasın Endokrin Tümörleri Mehlika BİLGİ KIRMACI Esat Taylan UĞURLU Bariyatrik Cerrahi Sonrası Vücut Şekillendirme Ameliyatları Salih Kavuncu

AIM: This study aimed to evaluate the surgical outcomes of liver and lung hydatid cysts treated either simultaneously or in separate stages. The main focus was to determine the impact of surgical timing on postoperative complications and overall patient recovery, with an emphasis on minimally invasive techniques. METHODS: A retrospective analysis was conducted on 42 patients diagnosed with concomitant liver and lung hydatid cysts between March 2009 and July 2020. Surgical procedures included video-assisted thoracoscopic surgery (VATS), thoracotomy, laparoscopy, and laparotomy. Patient demographics, cyst characteristics, concomitant diseases, surgical procedures, postoperative complications, and recovery times were analyzed. The statistical significance of surgical outcomes between one-stage and two-stage procedures was assessed using appropriate statistical tests. RESULTS: Demographic analysis revealed that 57.1% of the participants were female and 42.9% male, with an average age of 36 years. Comorbidities were present in 23.8% of patients, with chronic obstructive pulmonary disease (COPD) being the most common at 11.9% and asthma at 7.1%. The complication rate was 35.3% in patients who underwent lung hydatid cyst surgery and 30.8% in those who underwent liver and lung hydatid cyst surgery. Although there was no statistically significant difference among the three groups (p = 0.840), liver surgery was associated with a longer hospital stay (p = 0.013). Minimally invasive surgical techniques (VATS, laparoscopy) had a lower complication rate (20% versus 40.9%, p = 0.143). These results suggest that minimally invasive techniques can reduce the risk of complications. CONCLUSIONS: The timing of the surgical procedure, whether performed in one or two stages, had no significant effect on the complication rate. Minimally invasive techniques are recommended due to their lower complication rate and shorter recovery time.

Background: Our aim in this study is to determine the relationship among Helicobacter pylori (HP) with colon cancer and colorectal polyps. Thus, colorectal cancers (CRC) can be diagnosed at an early stage, the progression of the disease can be prevented and a contribution can be made to prolonging the life span of the patients. Methods: The 75 patients as the case group and 150 patients as the control group were included in the study. Patients with family history of CRC and clinical symptoms who had total colonoscopy in a tertiary hospital between 31/09/2021 and 31/03/2022 and underwent gastroscopic gastric biopsy and evaluated for HP were included. The patients were divided into three groups as patients with colorectal polyps, CRC and normal patients. Results: HP positivity was more common in patients with cancer history than those without cancer history (p<0.001). In the analyzes performed, HP positivity was more common in patients with cancer than in patients without cancer (p<0.001). Concordantly, more polyps were detected in HP positive patients than in non-HP patients (p=0.001). In the analyzes performed, HP infection was significantly higher in patients with CRC and colorectal polyps compared to normal controls. Conclusions: HP positive patients can be evaluated in terms of CRC and colorectal polyp.

Objective: Death due to thoracic trauma accounts for 20% of all trauma deaths. The aim of this study was to discuss the approach applied by general surgeons to thoracic trauma in our center. Material and Methods: A total of 89 patients (82 male, 7 female; mean age: 26.8 years; range: 7 to 77 years) with thoracic trauma who were admitted to the emergency department and underwent thoracostomy performed by general surgeons between January 2008 and December 2013 were retrospectively analyzed. Results: Penetrating trauma was found in 61 patients (68%); this was the most common cause of thoracic trauma. Pneumothorax, the most common clinical sign, was found in 57 patients (64%). Abdominal pathologies, the most common concomitant extra-thoracic pathologies, were found in 17 patients (19%). Fifteen patients (17%) underwent laparotomy due to intra-abdominal organ injuries. Splenic trauma and diaphragmatic injury were detected in five patients. Complications were seen in two patients (2.2%): one had an air leak and one had persistent pneumothorax. Three patients with multi-trauma died in the early period due to additional pathologies. No mortality was seen in any patient due to thoracic trauma. Conclusion: All general surgeons should be highly familiar with approaches to thoracic trauma, and necessary interventions should be performed in emergency situations. It is also essential to correctly identify patients who require timely and appropriate referral to a tertiary center to reduce the rates of mortality and morbidity.