Fatih Gürsoy

Aim: This study compares two different fixation methods used in laparoscopic transabdominal preperitoneal (TAPP) inguinal hernia repair: self-gripping micro-hooked meshes and prolene meshes fixed with absorbable staples.Material and Methods: The research was performed retrospectively on 179 patients who received TAPP procedures at the General Surgery Unit of Afyonkarahisar Health Sciences University from January 2022 to March 2025.Results: Participants in the study were split into two groups: those who used self-gripping mesh (Group 1, n = 74) and those who used staple-fixed mesh (Group 2, n = 105). Analysis revealed no statistically significant difference in operating time between the groups (Group 1: 60.85 min, Group 2: 62.86 min). Both groups exhibited comparable outcomes regarding the necessity for postoperative narcotic analgesics. No significant difference was found in seroma formation and hernia recurrence rates (1.35% in Group 1, 2.86% in Group 2). All recurrence cases were noted within the initial three months post-surgery.Conclusion: This study demonstrates that the two mesh fixation methods employed in the TAPP approach for hernia repair exhibit comparable efficacy and reliability for clinical outcomes. Self-gripping meshes did not show any medical superiority over the traditional staple method in terms of reducing pain or shortening surgery time. Consequently, it is advisable to prioritize cost and economic considerations over clinical outcomes when selecting a procedure.

OBJECTIVE: In recent years, cancer has continued to rise globally. Breast cancer has become a significant health problem, raising concerns among young, healthy women due to both its prevalence and mortality. Therefore, this study aimed to assess the breast cancer knowledge levels of female university students and to evaluate their attitudes toward breast self-examination (BSE) following a short-term structured educational intervention.MATERIAL AND METHODS: This cross-sectional study was conducted with 250 female university students studying health sciences. Participants completed a structured questionnaire measuring their knowledge of breast health and BSE. Following this, an educational program consisting of didactic presentations and animation-supported activities was conducted, and the same survey was administered again to assess pre- and post-intervention changes in knowledge and attitudes.RESULTS: Before the training, participants' knowledge of breast cancer and BSE was found to be limited (78.4%), and their BSE practice rates were low (36.1%). Their information sources were largely based on the internet (42.7%) and social circle (8.5%). Following the training, a significant increase was observed in participants' knowledge, awareness, and intention and frequency of BSE practice.CONCLUSIONS: It was determined that not only the level of knowledge but also factors such as motivation, confidence, and awareness are effective in young individuals' adoption of protective health behaviors. Furthermore, it was concluded that short-term, structured training strengthens students' awareness of health responsibility and increases the potential for healthy habits acquired at an early age to become sustainable health behaviors in the long term.

OBJECTIVE: Infrared thermography is a noninvasive imaging technique that measures skin surface temperature and may reflect underlying inflammatory activity. However, its diagnostic role in thyroiditis remains unclear. This study evaluated the diagnostic performance of infrared thermography in thyroiditis and its relationship with thyroid function tests (TFTs) and inflammatory markers.MATERIAL AND METHODS: This retrospective study included 144 patients (72 with thyroiditis and 72 controls). Thermal images obtained using a portable infrared thermal camera (FLIR One Edge Pro®) were analyzed. Thyroid surface temperature parameters were compared between groups and their relationship with thyroid function tests and inflammatory markers was evaluated.RESULTS: Mean thyroid surface temperature and temperature asymmetry were significantly higher in the thyroiditis group (36.8 ± 0.5 °C vs. 36.1 ± 0.4 °C; 0.54 ± 0.27 °C vs. 0.18 ± 0.09 °C; both p < 0.001). Surface temperature correlated positively with C-reactive protein (CRP) (r = 0.61) and anti–thyroid peroxidase (anti-TPO) (r = 0.57), and negatively with free thyroxine (fT4) (r = −0.52) (all p < 0.001). A temperature cut-off > 36.4 °C predicted thyroiditis with an AUC of 0.88. Multivariate analysis identified mean thyroid surface temperature (OR = 5.21), anti-TPO (OR = 3.76), and CRP (OR = 1.38) as independent predictors.CONCLUSIONS: Infrared thermography may serve as a useful noninvasive adjunct in the evaluation of thyroiditis. Elevated thyroid surface temperature and asymmetry correlate with inflammatory and biochemical markers of thyroid dysfunction. These findings suggest that thermographic assessment may contribute to clinical decision-making as a complementary tool. Prospective multicenter studies are needed to confirm these findings.

Aim: This study aimed to evaluate the distribution of endoscopic bile reflux and accompanying gastric mucosal findings in a large patient cohort and to investigate their association with demographic and clinical variables.Material and Methods: This retrospective, single-center study included 446 adult patients who underwent upper gastrointestinal endoscopy between January 2020 and December 2025. Endoscopic findings, including erythema, mucosal edema, bile reflux, hyperemia, and erosive changes, were recorded. Demographic and clinical variables, including age, sex, smoking status, and alcohol use, were analyzed. Associations were evaluated using univariate analyses and multivariable logistic regression.Results: Erythema was the most frequently observed finding (70.0%), followed by mucosal edema (55.6%), hyperemia (49.6%), bile reflux (43.9%), and erosive changes (23.3%). Bile reflux and erosive changes were more frequently observed in older patients and in those with smoking. In multivariable analysis, age ≥50 years (OR: 1.62, 95% CI: 1.08–2.42, p=0.021) and smoking (OR: 1.58, 95% CI: 1.05–2.37, p=0.028) were associated with bile reflux. Multiple concurrent endoscopic findings were present in a substantial proportion of patients.Conclusion: Endoscopic bile reflux and associated gastric mucosal abnormalities are common and exhibit variable associations with demographic and clinical factors. Given the non-specific nature of many endoscopic findings, their clinical interpretation should be made cautiously. Further prospective studies incorporating histopathological evaluation are needed to clarify their diagnostic and clinical relevance.

Aims: The aim of this study was to investigate the association between preoperative neutrophil-to-lymphocyte ratio (NLR) and the development of transient hypocalcemia in patients undergoing total thyroidectomy.Methods: In this retrospective cohort study, 84 adult patients who underwent total thyroidectomy between January 2015 and December 2025 were evaluated. Patients were grouped according to the presence of transient hypocalcemia, defined as serum calcium

Purpose: This study aimed to assess how well preoperative systemic inflammation markers, the prognostic nutritional index (PNI), and blood vitamin D [25(OH)D] levels predict short-term postsurgical issues following laparoscopic sleeve gastrectomy (LSG).Materials and Methods: The analysis of the data of 383 LSG patients was performed. Preoperative data consisted of neutrophil-to-lymphocyte ratio (NLR), platelet-to-lymphocyte ratio (PLR), PNI, and 25(OH)D measurements. To find independent complication predictors, we ran univariate and multivariate logistic regressions. Because of multicollinearity among inflammatory indices, the final model retained only NLR. Evaluation of the predictive accuracy and clinical usefulness was carried out with the receiver operating characteristic (ROC) and decision curve analyses.Results: Twenty-three patients (6.0%) developed early complications. On univariate analysis, elevated NLR, PLR, and SII, as well as reduced PNI and 25(OH)D levels, correlated with complication occurrence. Multivariate analysis identified NLR (OR = 1.85, 95% CI: 1.22–2.81, p=0.004) and male sex (OR = 2.45, 95% CI: 1.10–5.46, p=0.028) as independent predictors; vitamin D showed no such association (p=0.19). ROC analysis revealed NLR as the strongest predictor (AUC = 0.84), followed by PLR (AUC = 0.78); PNI and vitamin D displayed only modest discriminative ability. The multivariable model showed good performance (AUC = 0.86).Conclusion: Preoperative NLR and male sex independently predict early postoperative complications after LSG. NLR is a simple biomarker that may enhance preoperative risk assessment. Although PNI and 25(OH)D were not independent predictors, they remain clinically relevant for patient optimization.

Introduction: This study aimed to evaluate the association between treatment modality, intervention timing, and clinical outcomes in patients aged 65 years or older with acute mesenteric ischemia (AMI). Methods: This multicenter retrospective cohort study included 126 patients aged 65 years or older who were diagnosed with AMI between January 2015 and December 2025. Patients were classified according to treatment modality as endovascular treatment, open surgery, or conservative management. The primary outcome was 30-day mortality. Secondary outcomes included in-hospital mortality, intensive care unit admission, length of hospital stay, complications, and reoperation. Propensity score–based inverse probability of treatment weighting (IPTW) and multivariable logistic regression analyses were performed to reduce potential confounding. Results: The 30-day mortality rate was lower in the endovascular treatment group (26.2%) than in the open surgery (45.5%) and conservative management (45.0%) groups (p=0.041). Delayed intervention (>12 hours) was associated with an increased risk of mortality (OR: 2.68; 95% CI: 1.18–6.09; p=0.018). Serum lactate level, age, and Charlson Comorbidity Index were identified as independent predictors of 30-day mortality. In the IPTW-adjusted analysis, open surgery was associated with higher mortality compared with endovascular treatment (OR: 1.94; 95% CI: 1.05–3.58; p=0.034). Conclusion: Treatment modality and timing of intervention appear to be associated with clinical outcomes in elderly patients with AMI. Endovascular treatment was associated with lower 30-day mortality, whereas delayed intervention was linked to poorer outcomes. However, these findings should be interpreted cautiously because of the retrospective study design and the possibility of residual confounding.

Background and Objective Venous thromboembolism (VTE) remains a relevant complication after bariatric surgery despite routine extended thromboprophylaxis. This study evaluated 90-day thromboembolic and bleeding outcomes following laparoscopic sleeve gastrectomy under a standardized enoxaparin protocol and examined their association with baseline risk assessed by the Caprini Risk Assessment Model. Methods This retrospective cohort study included 348 patients who underwent primary laparoscopic sleeve gastrectomy between 2015 and 2025. All patients received extended enoxaparin prophylaxis for 21 days. Patients were stratified into low (≤ 4), moderate (5–6), and high (≥ 7) risk groups according to Caprini score. The primary outcome was 90-day VTE. Secondary outcomes included bleeding events and hospital readmission. Comparative analyses, univariable logistic regression, and receiver operating characteristic (ROC) analyses were performed. Results The incidence of VTE increased progressively across risk categories (0.9%, 3.2%, and 8.9% in the low-, moderate-, and high-risk groups, respectively; p = 0.006). Clinically relevant minor bleeding also increased across groups (4.9%, 8.3%, and 12.2%, respectively; p = 0.047), whereas major bleeding remained infrequent (2.0%, 2.6%, and 4.4%; p = 0.284). In univariable analysis, the Caprini score was significantly associated with 90-day VTE (OR: 1.48, 95% CI: 1.26–1.74; p < 0.001). ROC analysis demonstrated acceptable discriminative performance (AUC: 0.78, 95% CI: 0.70–0.86), with an optimal cut-off value of ≥ 7 (sensitivity: 78.6%, specificity: 71.2%, negative predictive value: 96.8%). Conclusion Within a homogeneous cohort undergoing laparoscopic sleeve gastrectomy and managed with standardized extended enoxaparin prophylaxis, thromboembolic and bleeding outcomes varied according to baseline VTE risk. Thromboembolic events increased progressively across Caprini risk categories despite uniform prophylaxis, whereas major bleeding remained uncommon. These findings support further evaluation of risk-adapted thromboprophylaxis strategies. Given the retrospective design and limited number of thromboembolic events, the results should be considered hypothesis-generating and require confirmation in prospective studies.

Aim: Evidence regarding the association of the visceral adiposity index (VAI) and dysfunctional adiposity index (DAI) with gallstone presence remains limited. This study evaluated their associations with gallstone presence and their discriminative performance.Material and Methods: This retrospective observational study included 721 adults who underwent abdominal ultrasonography between 2018 and 2024. Demographic, anthropometric, and laboratory data were retrieved from medical records. VAI and DAI were compared between patients with and without gallstones.Results: Gallstones were identified in 362 patients, while 359 patients served as gallstone-negative controls. Patients with gallstones were older (48.6±12.3 vs. 44.1±11.8 years, p<0.001), more frequently female (62.4% vs. 54.3%, p=0.028), and had higher BMI values (29.4±4.7 vs. 27.8±4.3 kg/m², p<0.001). Fasting glucose, triglyceride, and low-density lipoprotein cholesterol (LDL-C) levels were higher, whereas high-density lipoprotein cholesterol (HDL-C) levels were lower in the gallstone group. VAI (3.42±1.11 vs. 2.87±1.04) and DAI (1.74±0.52 vs. 1.49±0.47) were also significantly higher in patients with gallstones (both p<0.001). Receiver operating characteristic (ROC) curve analysis demonstrated moderate discrimination for VAI (area under the curve (AUC)=0.71, 95% confidence interval (CI): 0.66-0.75, p<0.001) and DAI (AUC=0.69, 95% CI: 0.65-0.74, p<0.001). Age (odds ratio (OR)=1.03, 95% CI: 1.01-1.05, p=0.001), female sex (OR=1.38, 95% CI: 1.02-1.89, p=0.037), VAI (OR=1.62, 95% CI: 1.25-2.10, p<0.001), and DAI (OR=1.47, 95% CI: 1.12-1.93, p=0.005) were found independently associated with gallstone presence.Conclusion: Higher VAI and DAI values were independently associated with gallstone presence. However, their moderate discriminative performance suggests that they should be considered complementary metabolic indicators rather than stand-alone diagnostic tools.