Person: MALYA, FATMA ÜMİT
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Publication Open Access The Role of C-Reactive Protein in the Early Prediction of Serious Pancreatic Fistula Development after Pancreaticoduodenectomy(2018-01-01T00:00:00Z) MALYA, Fatma Ümit; Hasbahceci, Mustafa; Tasci, Yunus; KADIOĞLU, HÜSEYİN; GÜZEL, Mehmet; Karatepe, Oguzhan; DOLAY, Kemal; MALYA, FATMA ÜMİT; KADIOĞLU, HÜSEYİN; GÜZEL, MEHMET; DOLAY, KEMALIntroduction. Despite recent advances in surgical techniques, pancreatic fistulas are common. We aimed to determine the role of C-reactive protein in the prediction of clinically relevant fistula development. Materials and Methods. Data from patients who underwent pancreaticoduodenectomy between 2012 and 2015 is collected. Postoperative 1st, 3rd, and 5th day (POD1, POD3, and POD5) C-reactive protein (CRP) levels, postoperative pancreatic fistula (POPF) development, other complications, length of hospital stay, and mortality were recorded. Results. Of 117 patients, 43 patients (36.8%) developed complications (including fistulas). Of the patients developing fistulas, 21 (17.9%) had POPF A, 2 (1.7%) had POPF B, and 7 (6.0%) had POPF C. POD5 CRP and POD3 CRP were shown to be significantly correlated with mortality and development of clinically relevant POPF (p = 0 001 and p = 0 0001, resp.) and with mortality (p = 0 017), respectively. The development of clinically relevant POPFs (B and C) could be predicted with 90% sensitivity and 82.2% specificity by POD5 CRP cut-off level of 19 mg/dL and with 100% sensitivity and 63.6% specificity by the difference between POD5 and POD1 CRP cut-off level of > 2.5 mg/dL. Conclusion. CRP levels can effectively predict the development of clinically relevant pancreatic fistulas.Publication Open Access The role of PET and MRI in evaluating the feasibility of skin-sparing mastectomy following neoadjuvant therapy.(2018-02-01) MALYA, FATMA ÜMİT; KADIOGLU, HÜSEYİN; BEKTASOGLU, HÜSEYİN KAZIM; Gucin, ZÜHAL; YILDIZ, S; GUZEL, MEHMET; ERDOGAN, EZGİ BAŞAK; YUCEL, S; ERSOY, YELİZ EMİNE; MALYA, FATMA ÜMİT; KADIOĞLU, HÜSEYİN; BEKTAŞOĞLU, HÜSEYİN KAZIM; GÜCİN, ZÜHAL; YILDIZ, ŞEYMA; GÜZEL, MEHMET; ERDOĞAN, EZGİ BAŞAK; ERSOY, YELIZ EMINEAbstract Objective: To investigate the role of positron emission tomography (PET) and magnetic resonance imaging (MRI) in evaluating the feasibility of skin-sparing mastectomy in patients with locally-advanced breast cancer (LABC) who will undergo neoadjuvant chemotherapy (NAC) by evaluating the sensitivity and specificity of PET and MRI compared with skin biopsy results before and after NAC treatment. Methods: Patients with LABC who were treated with NAC between November 2013 and November 2015 were included in this study. Demographic, clinical, radiological and histopathological features of the patients were recorded. Results: A total of 30 patients were included in the study with a mean age of 52.6 years (range, 35– 70 years). Sensitivity and specificity for detecting skin involvement in LABC was 100%/10% (62%/ 85%) with MRI and 60%/80% (12%/92%) with PET before (after) NAC, respectively. When radiological skin involvement was assessed in relation to the final histopathological results, the preNAC PET results and histopathological skin involvement were not significantly different; and there was no difference between postNAC MRI and histopathological skin involvement. Conclusions: As preNAC PET and postNAC MRI more accurately determined skin involvement, it might be possible to use these two radiological evaluation methods together to assess patient suitability for skin-sparing mastectomy in selected patients.Publication Open Access The correlation between breast cancer and urinary iodine excretion levels(2018-02-01) Malya, FATMA ÜMİT; Kadioglu, HÜSEYİN; Hasbahçeci, Mustafa; Dolay, KEMAL; Guzel, MEHMET; Ersoy, YELİZ EMİNE; MALYA, FATMA ÜMİT; KADIOĞLU, HÜSEYİN; DOLAY, KEMAL; GÜZEL, MEHMET; ERSOY, YELIZ EMINEObjective To compare urinary iodine excretion levels in patients with breast cancer and control subjects. Methods In this prospective pilot study, patients with breast cancer and normal controls were recruited. Age and menopausal status were recorded. Levels of serum thyroid-stimulating hormone, blood urea nitrogen and creatinine and urine iodine concentration (UIC) were measured. UIC levels were divided into three categories: low (<100 µg/l), normal (100-200 µg/l) or high (>200 µg/l). Results A total of 24 patients with breast cancer and 48 controls were included in the study. There were no statistically significant differences between the two groups with regard to thyroid-stimulating hormone, blood urea nitrogen or creatinine levels. When considered overall, there was no statistical difference in UIC between patients and controls. However, comparisons within each category (low, normal or high UIC) showed a significantly higher percentage of patients with breast cancer had a high UIC compared with controls. Conclusions A high UIC was seen in a significantly higher percentage of patients with breast cancer than controls. UIC may have a role as a marker for breast cancer screening. Further studies evaluating UIC and iodine utilization in patients with breast cancer are warranted.Publication Open Access Endoscopic diagnosis and treatment of biliary obstruction due to acute cholangitis and acute pancreatitis secondary to Fasciola hepatica infection.(2018-01-01) DOLAY, KEMAL; HASBAHCECI, MUSTAFA; HATIPOĞLU, ENGİN; Ümit, Malya; Akçakaya, ADEM; DOLAY, KEMAL; MALYA, FATMA ÜMİT; AKÇAKAYA, ADEMIn the differential diagnosis of biliary obstruction with unknown etiology, biliary fascioliasis should be considered in endemic and nonendemic regions. After diagnostic evaluation, endoscopic retrograde cholangiopancreatography (ERCP) was performed for etiological evaluation and/or treatment of biliary obstruction in five patients with a mean age of 55.8 years. Endoscopic sphincterotomy and cholangiogram revealed linear filling defects in the biliary system. Fasciola hepatica parasites were extracted using balloon and basket catheters in two and three patients, respectively. No morbidity or mortality was observed. F. hepatica infection should be considered as a differential diagnosis of biliary obstruction with unknown etiology in endemic and non-endemic regions. ERCP can be the standard diagnostic and/or therapeutic procedure in cases of biliary obstruction due to fascioliasis. Due to slippery and gel-like characteristics of the parasite, use of a basket catheter in semi-opened position may be required in case of unsuccessful extraction using a balloon catheter.Publication Metadata only THE IMPORTANCE OF BIOMARKERS IN EARLY DIAGNOSIS OF PANCREATIC CANCER: GLYPICAN 1(2018-10-24T00:00:00Z) MALYA, FATMA ÜMİT; BİBERCİ KESKİN, ELMAS; KÖKER, İBRAHİM HAKKI; İNCE, ALİ TÜZÜN; ŞENTÜRK, HAKAN; MALYA, FATMA ÜMİT; BİBERCİ KESKİN, ELMAS; KÖKER, İBRAHİM HAKKI; İNCE, ALİ TÜZÜN; ŞENTÜRK, HAKANPublication Open Access The impact of a percutaneous cholecystostomy catheter in situ until the time of cholecystectomy on the development of recurrent acute cholecystitis: a historical cohort study(2018-01-01) HASBAHCECI, Mustafa; CENGİZ, Merve Busra; Malya, FATMA ÜMİT; Kunduz, Enver; Memmi, Naim; MALYA, FATMA ÜMİT; KUNDUZ, ENVERBackground: the optimal duration of percutaneous cholecystostomy in patients with acute cholecystitis is unknown. Methods: this study was a retrospective analysis of patients (age ≥ 18 years) who underwent percutaneous cholecystostomy due to acute calculous cholecystitis. Patients were grouped according to treatment modality: percutaneous cholecystostomy as a definitive treatment (group 1), subsequent surgical treatment after the removal of the catheter (group 2) and those remaining in situ (group 3). The development of gallstone-related complications was the main outcome. Results: there were 24 females (43.6%) and 31 males (56.4%) included in the study with a mean age of 64.8 ± 15.9 years. There were 16 (29.1%), 19 (34.5%) and 20 (36.4%) patients in groups 1, 2, and 3, respectively. The catheter withdrawal time for group 1 and group 2 was 18.2 ± 6.9 and 20.7 ± 13.4 days, respectively. Surgical treatment was performed after a mean of 85.4 ± 93.5 days following catheter removal in group 2 and a mean of 64 ± 32.5 days while the PC tube was in place in group 3. There were one (6.3%) and two cases of a recurrence (10.5%) in groups 1 and 2, respectively. Two patients developed choledocholithiasis (10%) in group 3. Conclusion: maintaining percutaneous cholecystostomy tubes in place until the time of surgery in surgically fit patients may help to prevent a recurrence after acute calculous cholecystitis.Publication Open Access A rare cause of obstructive defecation in a 29-year-old woman: Ileo-colo-colonic intussusception treated by subtotal colectomy with posterior rectopexy(2018-12-01) Kunduz, ENVER; Malya, FATMA ÜMİT; Mehdi, Elnur; HASBAHCECI, Mustafa; KUNDUZ, ENVER; MALYA, FATMA ÜMİTAdult intussusception is a rare clinical condition. In majority of adult cases, there is an underlying cause such as polyps or colon cancers. In the present study, a 29-year-old woman with intermittent and colicky abdominal pain, constipation, and painful defecation, accompanied with distention and sense of rectal fullness, was evaluated with computed tomography. Ileo-colo-colic intussusception was determined. Subtotal colectomy with posterior rectopexy was performed. After the surgery, she was doing well at 13-month follow-up.Publication Open Access Glomus tumor of the stomach(2018-03-01) YILDIZ, PELİN; GÜCİN, ZÜHAL; ARICI, DİLEK SEMA; MALYA, FATMA ÜMİT; Baysal, Birol; YILDIZ, PELİN; GÜCİN, ZÜHAL; ARICI, DILEK SEMA; MALYA, FATMA ÜMİTGlomus tumor is a rare benign mesenchymal neoplasm derived from the glomus body, an arteriovenous shunt mainly located in dermis and subcutis. The most common localization of this tumor is extremities, especially nailbed. Glomus tumor in the gastrointestinal system is a rare condition. Here we report a gastric glomus tumor to raise awareness of this tumor and show the difficulties in the diagnosis.Publication Open Access Use of serum and peritoneal CEA and CA19-9 in prediction of peritoneal dissemination and survival of gastric adenocarcinoma patients: are they prognostic factors?(2018-04-01) HASBAHCECI, MUSTAFA; Malya, FATMA ÜMİT; Kunduz, ENVER; Guzel, MEHMET; Unver, NURCAN; Akcakaya, ADEM; MALYA, FATMA ÜMİT; KUNDUZ, ENVER; GÜZEL, MEHMET; ÜNVER, NURCAN; AKÇAKAYA, ADEMINTRODUCTION To evaluate the impact of serum and peritoneal levels of tumour markers on peritoneal carcinomatosis and survival in gastric adenocarcinoma. MATERIALS AND METHODS Patients with gastric adenocarcinoma were evaluated with regard to serum and peritoneal carcinoembryonic antigen (CEA) and CA19-9. Numeric values and groupings based on serum and peritoneal cutoff values were used. Development of peritoneal carcinomatosis, including positive washing cytology, was regarded as main outcome. Gastric cancer outcomes as disease free and overall survival were analysed. RESULTS There were 67 patients with a mean age of 60 ± 11 years. Positive peritoneal washing cytology was significantly associated with serum CA19-9 and high serum CA 19–9 group (P = 0.033 and P = 0.011, respectively). High peritoneal CEA was shown to be significantly associated with peritoneal carcinomatosis (P = 0.032). After a median follow up of 17 months, 48 patients (71.7%) were alive. Patients with peritoneal carcinomatosis showed significant poorer prognosis as shown by overall survival rate of 28.6%. Only serum CEA was significantly associated with lower disease free and overall survival (P = 0.002 and P = 0.001, respectively). DISCUSSION AND CONCLUSION Serum CEA is shown to be significantly associated with poor prognosis for gastric cancer patients. Serum level of CA19-9 and high peritoneal CEA levels are significant predictors for positive peritoneal washing cytology and the development of peritoneal carcinomatosis, respectively. Therefore, the possible impact of serum and peritoneal tumor markers especially on the staging and prognosis of gastric cancer remains to be clarified by future studies.Publication Open Access Use of peritoneal washing cytology for the detection of free peritoneal cancer cells before and after surgical treatment of gastric adenocarcinoma(2018-10-01) HASBAHCECI, Mustafa; Akcakaya, ADEM; Guler, BERİL; Kunduz, ENVER; Malya, FATMA ÜMİT; Muslumanoglu, Mahmut; AKÇAKAYA, ADEM; GÜLER, BERIL; KUNDUZ, ENVER; MALYA, FATMA ÜMİTAim: Cytological detection of peritoneal-free gastric cancer cells is considered as the gold standard with variable sensitivity. Seeding of cancer cells after radical surgery for gastric cancer is a controversial issue. In this study, it was aimed to detect the rate of positive peritoneal washing cytology and the incidence of spreading of tumor cells after radical surgery. Materials and methods: Patients with pathologically proven and surgically treated gastric adenocarcinoma were enrolled. Three peritoneal washing samples were examined cytologically: at the beginning, after completion of resection, and before closure of the abdomen. Identification of peritoneal-free gastric cancer cells was regarded as the main outcome. Results: Thirty-four patients with a mean age of 60.7 ± 12 years were enrolled. T3 and N0 were the most common stages seen in 16 (47%) and 12 patients (35.3%), respectively. There were two positive results (5.9%) as the first peritoneal sample. Considering T3- or N-positive patients, the incidence increased to 9.1%. There was no conversion of negative to positive cytology. Cytological positivity remained only in one case (2.9%) after the second and the third peritoneal samples. Conclusion: Rate of positive peritoneal washing cytology in patients with gastric cancer is influenced by clinicopathological findings and the technique used. Use of cytology alone is thought to be failed to detect free cancers cells within the peritoneal cavity.