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    J-pouch vs. side-to-end anastomosis after hand-assisted laparoscopic low anterior resection for rectal cancer: A prospective randomized trial on short and long term outcomes including life quality and functional results
    (Elsevier Science Bv, 2017) Okkabaz, Nuri; Haksal, Mustafa; Atici, Ali Emre; Altuntas, Yunus Emre; Gundogan, Ersin; Gezen, Fazli Cem; Oncel, Mustafa
    Purpose: To analyze the outcomes of j-pouch and side-to-end anastomosis in rectal cancer patients treated with laparoscopic hand-assisted low anterior resection. Methods: Prospective trial on cases randomized to have a colonic j-pouch or a side-to-end anastomosis after low anterior resection. Demographics, characteristics of disease and treatment, perioperative results, and functional outcomes and life quality were compared between the groups. Results: Seventy four patients were randomized. Reservoir creation was withdrawn in 17 (23%) patients, mostly related to reach problem (n = 11, 64.7%). Anastomotic leakage rate was significantly higher in j-pouch group (8 [27.6%] vs. 0, p = 0.004). Stoma closure could not be achieved in 16 (28.1%) patients. Life quality and functional outcomes, measured 4, 8 and 12 months after the stoma reversal, were similar. Conclusions: Colonic j-pouch and side-to-end anastomosis are similar regarding perioperative measures including operation time, rates of postoperative complications, reoperation and 30-day mortality, and hospitalization period except anastomotic leak rate, which is higher in j-pouch group. Postoperative aspects are not different in patients receiving either technique including functional outcomes and life quality for the first year after stoma closure. In our opinion, both techniques may be preferred during the daily practice while performing laparoscopic surgery; but surgeons may be aware of a possibly higher anastomotic leak rate in case of a j-pouch. (C) 2017 IJS Publishing Group Ltd. Published by Elsevier Ltd. All rights reserved.
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    Prognostic significance of systemic inflammatory markers in rectal cancer
    (2021) Sari, Ramazan; Kaya, Selcuk; Tuzun, Sabah; Altuntas, Yunus Emre; Kucuk, Hasan Fehmi
    Aim: The neutrophil-lymphocyte ratio (NLR) and the platelet-lymphocyte ratio (PLR), which is indicators of systemic inflammatory response, have been demonstrated to be prognostic factors in many types of cancer. The aim of this study was to investigate importance of NLR and PLR in rectal cancer.Materials and Methods: The data of 114 patients who underwent curative resection after neoadjuvant chemoradiotherapy (NACRT) for rectal cancer (RC) between January 2012 to June 2017 and 113 healthy subjects were retrospectively analyzed. Blood samples obtained prior to NACRT were examined. The NLR and PLR in RC patients were compared with the results of healthy individuals.Results: The distribution of NLR and PLR results was significantly different between the RC patients and the control group (p0.001 for both). According to the ROC curve, the cut-off value for NLR was 2.70 and for PLR it was 151.18 in estimating the survival of the patients. NLR and PLR only correlated significantly with tumor wall involvement (T stage). The Kaplan-Meier method of predicting survival revealed no significant difference between groups with increased or decreased NLR and PLR in terms of overall survival (OS) and disease-free survival (DFS).Conclusion: The NLR and PLR of the study group treated with NACRT and those of the control group were significantly different. However, elevated NLR and PLR before NACRT were not found to be significant prognostic biomarkers for OS and DFS in surgically treated RC patients.

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