Person: KUNDUZ, ENVER
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Publication Open Access Comparison of Laparoscopic and Conventional Cystotomy/Partial Cystectomy in Treatment of Liver Hydatidosis(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, KEMALIntroduction. 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 difcultyPublication Open Access Co-existence of acute appendicitis and inflammatory myofibroblastic tumor of the small intestine: A case report(2015-09-01) Unver, NURCAN; Coban, GANİME; ONARAN, Oyku Izel; ARSLAN, ADNAN; Malya, FATMA ÜMİT; HASBAHCECI, Mustafa; ÜNVER, NURCAN; ÇOBAN, GANİME; KUNDUZ, ENVER; ARSLAN, ADNAN; MALYA, FATMA ÜMİTIntroduction: Inflammatory myofibroblastic tumor as a rare neoplastic lesion is seen most commonly in the pulmonary system. Beside the presence of limited number of inflammatory myofibroblastic tumors of the gastrointestinal tract in the literature, co-existence with acute appendicitis has not been reported before. Presentation of case: A 27-year-old woman admitted to emergency department with acute abdominal pain at the right lower quadrant. The initial diagnosis was as acute appendicitis. Intraoperatively, a mass with a diameter of almost 5 cm originated from the distal ileal segments neighboring the appendix was seen. The patient was managed by segmental resection of the small intestine including the mass with appendectomy. Histologically, there were bundles of spindle cells accompanied by lymphoplasmocytic infiltration. The immunohistochemical studies showed that tumor cells were positive for smooth muscle actin, vimentin, perinuclear activity for anaplastic lymphoma kinase and CD 68. The final pathologic diagnosis was inflammatory myofibroblastic tumor. Discussion: Concomitant resection of tumoral lesions detected in the neighbor intestinal segments during appendectomy should be considered to diagnose and treat. For the diagnosis of inflammatory myofibroblastic tumor, immunohistochemistry pattern including positivity for actin, vimentin, CD 68 and anaplastic lymphoma kinase plays a crucial role. Therefore, detailed immunohistochemistry analysis should be performed in suspicious cases. Conclusion: Coexistence of inflammatory myofibroblastic tumor located in the gastrointestinal system with acute appendicitis is a rare event. Complete surgical excision should be regarded as the mainstay of the treatment. Long-term follow up with serial imaging techniques is recommended.Publication Open Access Scalp recurrence of cholangiocarcinoma after curative hepatectomy: A report of two cases(2017-12-01) Kunduz, ENVER; Serin, Kursat Rahmi; Şeker, MESUT; KUNDUZ, ENVER; ŞEKER, MESUTCholangiocarcinomas are the second most common primary liver malignancies. The lymphatics are the common route of metastatic spread for cholangiocarcinomas. The most frequent sites of metastasis are the liver, abdominal lymph nodes, peritoneum and lungs. Cutaneous metastasis of cholangiocarcinoma is rare, and most commonly occurs following percutaneous biliary drainage. Brain or skull metastases from this tumor are uncommon. However, these rare metastatic lesions may occasionally be the first disease manifestation, although scalp recurrence following curative treatment is uncommon. We herein present the cases of two patients with cholangiocarcinoma, who were evaluated as resectable based on the criteria for cholangiocarcinoma resectability, and developed scalp recurrence following curative hepatectomy. Therefore, although scalp recurrence is a rare occurrence following curative treatment for cholangiocarcinoma, metastases should be included in the differential diagnosis.Publication Open Access Nonclosure of the Peritoneum during Appendectomy May Cause Less Postoperative Pain: A Randomized, Double-Blind Study(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 ÜMİTObjective: 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.Publication Open Access Laparoscopic surgery in distal pancreatic tumors(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, KEMALObjective: 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, oncologyPublication Open Access Transvaginal Small Bowel Evisceration following Abdominoperineal Resection(2018-01-01) Kunduz, ENVER; Bektasoglu, HÜSEYİN KAZIM; Yigman, SAMET; Akbulut, HÜSEYİN; KUNDUZ, ENVER; BEKTAŞOĞLU, HÜSEYİN KAZIM; YIĞMAN, SAMET; AKBULUT, HÜSEYİNAbdominoperineal 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.Publication Open Access The diagnostic ability of core needle biopsy in nodular thyroid disease.(2017-03-01) Aysan, E; KIRAN, TUĞÇE; IDIZ, UO; AKBULUT, H; GULER, B; KUNDUZ, ENVER; ARICI, S; KADAKAL, G; Ozgor, M; Coci, K; AYŞAN, MUSTAFA ERHAN; KIRAN, TUĞÇE; GÜLER, BERIL; KUNDUZ, ENVERINTRODUCTION Non-diagnostic results of fine needle aspiration biopsy (FNAB) remain an important limitation of this technqiue. The aim of our study was to evaluate the results of core needle biopsy (CNB) of thyroid nodules and its effectiveness in non-diagnostic FNAB cases. METHODS CNBs were performed in 1,000 patients (154 male, 846 female; mean age: 50.2 years, range: 18–86 years) with a spring loaded 20G needle. Of these, 143 had initially had FNABs that were insufficient for evaluation. The CNB reports were reviewed. Patients with suspicious or malignant CNB results underwent total thyroidectomy. RESULTS When considering all 1,000 CNBs, the non-diagnostic rate was 1.5% (15/1,000). However, when the first 100 cases were eliminated as a learning curve, this reduced to 0.9% (8/900). Of the 143 cases with initial FNABs that were non-diagnostic, 0.7% (1/143) were also non-diagnostic on CNB. Twelve patients underwent surgery because of malignant CNB reports and all of these cases were confirmed as malignant by the postoperative pathology specimen results (100% accuracy). There were no major complications although three self-limiting minor complications were observed. CONCLUSIONS CNB is a safe and accurate method. It is more diagnostic than FNAB for nodular thyroid disease.Publication 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 Comparison Of Surgical Technique And Results For Emergency Or Elective Femoral Hernia Repair(2019-01-01) KUNDUZ, ENVER; SORMAZ, ISMAIL; YAPALAK, YUNUS; Bektaşoğlu, HÜSEYİN KAZIM; GÖK, ALİ FUAT KAAN; KUNDUZ, ENVER; YAPALAK, YUNUS; BEKTAŞOĞLU, HÜSEYİN KAZIMBACKGROUND: 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.