2012-11-13, SARI, S, Aysan, E, MUSLUMANOGLU, M, ERSOY, YELİZ EMİNE, BEKTASOGLU, HÜSEYİN KAZIM, YARDıMCı, ERKAN, AYŞAN, MUSTAFA ERHAN, ERSOY, YELIZ EMINE, BEKTAŞOĞLU, HÜSEYİN KAZIM, YARDIMCI, ERKAN

Background: We aimed to minimalize operative complications by spraying of methylene blue stain on thyroid glands and the perithyroidal area. Material and methods: The intra-operative methylene blue spraying technique was used prospectively on a total of 56 patients who had undergone primary (not recurrent) thyroid surgery for a variety of thyroid diseases. Bilateral total thyroidectomy was performed in all cases. After superior but before inferior pole ligation, 0.5ml of methylene blue was sprayed over the thyroid lobe and perilober area. Tissues, especially parathyroides, the recurrent laryngeal nerve, and the inferior thyroid artery, were identified and evaluated. Results: Recurrent laryngeal nerve and arteries were not stained and thus they remained white in all cases while all other tissues were stained blue. Within three minutes parathyroid glands washed out the blue stain and the original yellow color was regained. Thyroid tissue wash-out time was not less than 15 minutes; perithyroideal muscles, tendinous and lipoid structures took no less than 25 minutes. Conclusion: The safety of intravascular methylene blue guidance on thyroid surgery is known. This research demonstrates the effectiveness of the spraying technique, a new technique which ensures not only identification of parathyroid glands within three minutes, but also identification of recurrent laryngeal nerves and inferior thyroid arteries.

2015-03-01, Bektasoglu, HÜSEYİN KAZIM, CIPE, Gokhan, YARDIMCI, ERKAN, Arici, DİLEK SEMA, HASBAHCECI, Mustafa, KARATEPE, Oguzhan, MUSLUMANOGLU, Mahmut, BEKTAŞOĞLU, HÜSEYİN KAZIM, YARDIMCI, ERKAN, ARICI, DILEK SEMA

Pheochromocytomas and paragangliomas are neuroendocrine tumors that arise from chromaffin cells of adrenal medulla and extra-adrenal paraganglia, respectively. The recurrence of these neuroendocrine tumors as a jejunal mass causing obstruction in the small intestine is an exceptional entity. The present study reports the case of a 70-year-old male who presented to the Emergency Department of Bezmialem Vakif University Hospital with abdominal pain and vomiting. The patient possessed a history of left nephrectomy due to malignant pheochromocytoma that had invaded into the left kidney eight months prior to presentation. Bowel obstruction was diagnosed and the patient underwent a laparoscopic procedure. Partial resection of the jejunum was performed and immunohistochemical studies revealed the lesion to be malignant paraganglioma. The majority of paragangliomas are chemo- and radioresistant. Surgical excision remains the primary treatment. Metachronous paraganglioma arising from the small intestine is an extremely rare entity and may be a relevant consideration in patients presenting with bowel obstruction.

2018-01-01, Kunduz, ENVER, Bektasoglu, HÜSEYİN KAZIM, Yigman, SAMET, Akbulut, HÜSEYİN, KUNDUZ, ENVER, BEKTAŞOĞLU, HÜSEYİN KAZIM, YIĞMAN, SAMET, AKBULUT, HÜSEYİN

Abdominoperineal resection (APR) is one of the surgical techniques performed for the distal rectal cancer. The perineal herniation is one of the complications of APR surgery. In this report, we aim to demonstrate a rare case of small bowel evisceration and strangulation secondary to the transvaginal herniation evolved in the late stage after perineal hernia repair following laparoscopic APR.

2018-06-27, Destek, Sebahattin, Bektasoglu, HÜSEYİN KAZIM, Unver, NURCAN, Aydogan, CEYHUN, Timocin, GİZEM, KUNDUZ, ENVER, BEKTAŞOĞLU, HÜSEYİN KAZIM, ÜNVER, NURCAN, AYDOĞAN, CEYHUN, TİMOÇİN, GİZEM, DESTEK, SABAHATTİN

BACKGROUND Appendiceal neoplasms are rare and generally determined in appendectomy specimens for acute appendicitis. Depending on a tumor's histopathology and size, appendectomy or right hemicolectomy are the surgical treatment options. Adenocarcinomas, mucinous neoplasms, goblet cell carcinoids and neuroendocrine tumors are the types of the primary appendiceal neoplasm histopathology. In this study, we aimed to determine the incidence of appendiceal neoplasms in an acute appendicitis cohort. Also, histopathological distributions, demographic data, preoperative radiological diagnosis, and intraoperative findings were revealed for analysis, retrospectively. MATERIAL AND METHODS Between October 2011 and September 2017, 3554 appendectomies were performed for acute appendicitis in Bezmialem University Hospital, Istanbul Turkey. The medical records of these consecutive 3554 patients were evaluated retrospectively. After the histopathological analysis of the appendectomy specimens, a total of 28 patients were detected as having appendiceal neoplasm including appendiceal adenocarcinoma, low grade mucinous neoplasia, and appendiceal neuroendocrine tumors. RESULTS Appendiceal neoplasms were determined in 28 out of 3554 acute appendicitis patients with an incidence of 0.78%. According to the histopathological types, 3 of the cases (10.7%) were appendiceal adenocarcinoma, 8 of the cases (28.5%) were low grade mucinous neoplasia, and 17 of the cases (60.8%) were neuroendocrine tumors. The overall incidence of the appendiceal neuroendocrine tumors was 0.48%. CONCLUSIONS The information obtained from our study suggests that pathological examination of the specimen may not be necessary if there is no doubt according to preoperative radiological diagnosis and/or intraoperative findings of the surgeon.

2019-01-01, Bektasoglu, HÜSEYİN KAZIM, HASBAHCECI, Mustafa, Taşçı, Yunus, Aydogdu, Ibrahim, MALYA, FATMA ÜMİT, Kunduz, ENVER, Dolay, KEMAL, BEKTAŞOĞLU, HÜSEYİN KAZIM, AYDOĞDU, İBRAHİM, MALYA, FATMA ÜMİT, KUNDUZ, ENVER, DOLAY, KEMAL

Introduction. Hydatidosis is a zoonotic infection and treatment is mandatory to avoid complications. Surgery remains the frst choice in the treatment especially for CE2-CE3b cysts. Open or laparoscopic approaches are available. However, comparative studies are limited. Materials and Methods. Data of patients who underwent cystotomy/partial cystectomy for liver hydatidosis between January 2012 and September 2016 (n=77) were evaluated retrospectively. Recurrent cases and the patients with previous hepatobiliary surgery were excluded. 23 patients were operated upon laparoscopically and named as Group 1. 48 patients operated conventionally named as Group 2. Demographics, cyst characteristics, operative time, length of hospital stay, recurrences, and surgery related complications were evaluated. Results. Groups were similar in terms of demographics, cyst characteristics, and operative time. Te length of hospital stay was 3.4 days in Group 1 and 4.7 days in Group 2 (p=0,007). Te mean follow-up period was 17.8 months and 21.7 months, respectively (p=0.170). Overall complication rates were similar in two groups (p=0.764). Tree conversion cases occurred (13%). One mortality was seen in Group 2. Four recurrences occurred in each group (17% versus 8.3%, respectively) (p=0.258). Conclusions. Laparoscopy is a safe and feasible approach for surgical treatment of liver hydatidosis. Recurrence may be prevented by selection of appropriate cases in which exposure of cysts does not pose an intraoperative difculty

2019-01-01, BEKTAŞOĞLU, HÜSEYİN KAZIM, Hasbahceci, Mustafa, YIĞMAN, SAMET, YARDIMCI, ERKAN, KUNDUZ, ENVER, MALYA, FATMA ÜMİT, BEKTAŞOĞLU, HÜSEYİN KAZIM, YIĞMAN, SAMET, YARDIMCI, ERKAN, KUNDUZ, ENVER, MALYA, FATMA ÜMİT

Objective: We aim to evaluate the effect of peritoneal closure on postoperative pain and life quality associated with open appendectomy operations. Methods: This is a single-center, prospective, randomized, and double-blinded study. Here, 18-65-year-old patients who underwent open appendectomy for acute appendicitis were included. Demographic data of the patients, operation time, length of hospital stay, pain scores using a 10 cm visual analogue scale (VAS) on the first postoperative day, quality of life assessment using the EuroQol-5D-5L questionnaire on postoperative 10th day, deep wound dehiscence, bowel obstruction, and mortality data were recorded. Results: In total, 112 patients were included in the study. The demographic data showed no significant difference between the groups. The median VAS score was lower in the group with open peritoneum, but this difference was not statistically significant (3 vs. 4, p=0.134). The duration of surgery was significantly shorter in the peritoneal nonclosure group (31.0 ± 15.1 vs. 38.5 ± 17.5 minutes, p=0.016). Overall complication rates and life quality test (EuroQol-5D-5L) results were similar between groups. Conclusion: Nonclosure of the peritoneum seems to shorten the duration of surgery without increasing complications during open appendectomy. Postoperative pain and life quality measures were not affected by nonclosure of the peritoneum. This trial is registered with NCT02803463.

2019-01-01, KUNDUZ, ENVER, SORMAZ, ISMAIL, YAPALAK, YUNUS, Bektaşoğlu, HÜSEYİN KAZIM, GÖK, ALİ FUAT KAAN, KUNDUZ, ENVER, YAPALAK, YUNUS, BEKTAŞOĞLU, HÜSEYİN KAZIM

BACKGROUND: Inguinal hernia affects 3–8% of the population. Femoral hernias are only a small number of groin hernias; however, femoral hernias are very important because these operations are generally emergency procedures, and bowel resections are frequently necessary. This study aims to compare surgical outcomes of patients with femoral hernias using different techniques under emergency or elective conditions. METHODS: Between April 2013 and November 2017, 52 patients with femoral hernias were admitted to the emergency department of the General Surgery Clinics at two university hospitals in Istanbul. The medical files of all the patients who underwent surgery with a diagnosis of a femoral hernia were retrospectively evaluated. The demographic data, hernia side information, sac contents, surgical technique, length of hospital stay, recurrence according to the last outpatient clinic and complications were retrospectively analyzed. RESULTS: The sex distribution of the cases was as follows: 88.5% (n=46) of the patients were female, and 11.5% (n=6) were male. The mean age was 62.9±16.49 years (31–91 years). There were no significant differences between the two groups, according to the hernia side (p=0.282). Thirteen of the elective cases (52%) were operated using open techniques, and 12 cases (48%) were operated using laparoscopic techniques. CONCLUSION: For the comparison of surgical techniques and outcomes, prospective randomized studies should be designed to standardize broad-based surgical techniques.

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 EMINE

Abstract 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.

2017-12-01, Malya, FATMA ÜMİT, Bektaşoğlu, HÜSEYİN KAZIM, HASBAHCECI, Mustafa, Taşçı, Yunus, Kunduz, ENVER, Karatepe, Oguzhan, Dolay, KEMAL, MALYA, FATMA ÜMİT, BEKTAŞOĞLU, HÜSEYİN KAZIM, KUNDUZ, ENVER, DOLAY, KEMAL

Objective: Laparoscopic distal pancreatectomy is increasingly being used in the surgical treatment of corpus and distal pancreatic tumors. In this study, patients who underwent laparoscopic or open distal pancreatectomy for benign or malignant causes were evaluated in terms of tumor characteristics and perioperative outcomes. Material and Methods: We retrospectively reviewed data from a total of 27 distal pancreatectomy cases performed for benign or malignant causes in the General Surgery Department between January 2013 and December 2015. Groups were compared according to the demographic characteristics of patients, operation type (laparoscopic or open, with splenectomy or spleen preservation), operation time, surgical site infection (superficial, deep wound infection, or intra-abdominal abscess), pancreatic fistula development, and histopathological examination results. Results: Both groups were similar in terms of age, sex, and body mass index (p=0.42). Tumor diameter was similar (p=0.18). The total number of resected lymph nodes was similar in both groups (p=0.6). Pancreatic fistula developed in one patient in each group. Mean hospital stay duration and the amount of intraoperative bleeding were similar in both groups. The laparoscopy group had a markedly lower overall morbidity rate (p=0.08). There was no mortality observed in the study subjects. Conclusion: Laparoscopic distal pancreatectomy can be safely performed as a minimally invasive procedure in experienced centers and in selected cases without increasing perioperative complication rates, particularly in benign cases. Although oncological outcomes are acceptable for malignant cases, future prospective controlled studies are necessary for more reliable evaluation. Keywords: Laparoscopy, pancreas, oncology

2013-01-01, Aysan, E, SAHIN, F, TELCI, D, ERDEM, M, MUSLUMANOGLU, M, YARDıMCı, ERKAN, BEKTASOGLU, HÜSEYİN KAZIM, AYŞAN, MUSTAFA ERHAN, YARDIMCI, ERKAN, BEKTAŞOĞLU, HÜSEYİN KAZIM

Objective. The effect of oral boric acid intake on reducing body weight has been previously demonstrated although the mechanism has been unclear. This research study reveals the mechanism. Subjects. Twelve mice were used, in groups of six each in the control and study groups. For five days, control group mice drank standard tap water while during the same time period the study group mice drank tap water which contains 0.28 mg/250 mL boric acid. After a 5-day period, gene expression levels for uncoupling proteins (UCPs) in the white adipose tissue (WAT), brown adipose tissue (BAT), and skeletal muscle tissue (SMT) and total body weight changes were analyzed. Results. Real time PCR analysis revealed no significant change in UCP3 expressions, but UCP2 in WAT (𝑃: 0.0317), BAT (𝑃: 0.014), and SMT (𝑃: 0.0159) and UCP1 in BAT (𝑃: 0.026) were overexpressed in the boric acid group. In addition, mice in the boric acid group lost body weight (mean 28.1%) while mice in the control group experienced no weight loss but a slight weight gain (mean 0.09%, 𝑃 < 0.001). Conclusion. Oral boric acid intake causes overexpression of thermogenic proteins in the adipose and skeletal muscle tissues. Increasing thermogenesis through UCP protein pathway results in the accelerated lipolysis and body weight loss.