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    Diagnostic value of presepsin in predicting a complicated acute appendicitis
    (2020) Binboga, Sinan; Isiksacan, Nilgun; Kasapoglu Atar, Pinar; Binboga, Elif; Karabulut, Mehmet
    Aim: There is a growing body of evidence suggesting that the concentration of presepsin in serum was found to be increased in patients with sepsis compared to healthy individuals, but the clinical significance of presepsin in the diagnosis of complicated acute appendicitis remains unclear. The purpose of this study was investigation of the diagnostic value of presepsin in complicated acute appendicitis. Material and Methods: This clinical prospective single-center study was conducted between May and August 2018, and comprised 120 patients with definitive diagnosis of acute appendicitis and 30 individuals as control group. White blood cell count (WBC), C-reactive protein (CRP), neutrophil/lymphocyte ratio (NLR) and presepsin levels were measured from venous blood samples. A receiver operating characteristic (ROC) curve was constructed to assess sensitivity and specificity as well as optimal cut points for each presepsin to diagnose acute appendicitis.Results: Serum levels of CRP, WBC, NLR and presepsin were higher in complicated group compared with uncomplicated (p0.0001, p=0.01, p=0.034 and p0.0001, respectively). The time of hospitalization, the rate of postoperative infection, intraabdominal abscess and re-hospitalization were significantly higher in complicated group (p0.0001, p=0.0009, p=0.0073 and p=0.0073, respectively). Comparing the diagnostic test results with ROC analysis, variable WBC (AUC=0.646, p=0.0052), CRP (AUC=0.807, p0.001), NLR (AUC=0.620, p=0.0305) and presepsin (AUC=0.965, p0.001) were significant parameters in predicting the presence of complicated acute appendicitis. Cut-off points of CRP, WBC, NLR and presepsin were calculated as 13.5 mg/dL, 1.4 x103/uL, 4.79 and 272 pg/ml. AUC of presepsin was larger than AUCs of WBC, CRP and NLR, suggesting the highest predicting power of presepsin among other parameters.Conclusion: Plasma presepsin level with CRP, WBC and NLR are valuable diagnostic parameters to predict complicated acute appendicitis.
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    Early-stage outcomes of bursectomy in surgery of gastric cancer and radical gastric resection
    (2019) Cikot, Murat; Binboga, Sinan; Gemici, Eyup; Surek, Ahmet; Kones, Osman; Alis, Halil
    Aim: Bursectomy, mainly defined as a complete dissection of the peritoneal lining covering the anterior plane of the transverse mesocolon and the pancreas with an omentectomy during gastrectomy, has been performed for the serosa-positive gastric cancers. Recently, some researchers have interrogated whether bursectomy for gastric cancer is essential from a surgical point of view, thus, we aimed to investigate the short-term surgical and early-stage clinicopathological outcomes of bursectomy in the treatment of advanced gastric cancer patients by a single center study and retrospective controlled trial. Material and Methods: From January 2016 to December 2017, retrospective findings of selected 100 gastric cancer patients in advanced tumor stages and underwent D2 radical gastrectomy were grouped and analyzed in terms of bursectomy performed or not in Bakirkoy Dr. Sadi Konuk Training and Research Hospital. Results: In conclusion, 50 patients were in bursectomy (B) group and 50 patients in non-bursectomy (NB) group. Clinical features (age, gender, and gastrectomy pattern and tumor location) of both groups showed no statistically significant difference. Postoperative mortality rate were also similar of both groups (4%). All other post-operative complications were not significantly distinctive for two groups. Conclusions: Bursectomy may increase the surgical duration of D2 gastrectomy and but not early-stage outcomes and postoperative complications. Experienced surgeons can perform the procedure safely. However, long-term, large sample sized, and high-quality randomized controlled trials are needed for the survival benefits of bursectomy.
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    Laparoscopic approach for hospitalized women in reproductive period presenting with non-specific abdominal pain
    (İnönü Üniversitesi Turgut Özal Tıp Merkezi Dergisi, 2017) Cikot, Murat; Binboga, Sinan; Akarsu, Cevher; Surek, Ahmet; Gemici, Eyup; Sahbaz, Nuri Alper; Kartal, Bahadir; Alis, Halil
    Öz:Aim: The aim of this study is to evaluate nonspecific abdominal pain of hospitalized women in reproductive period and to make a contribution to the literature. Material and Method: Medical records from 201 women in reproductive period presenting with nonspecific abdominal pain admitted to emergency department between 2010 and 2014 are evaluated retrospectively. Results: Diagnostic laparoscopy was performed in 125 of 201 patients. The mean age of patients was 8.5 years, mean white blood cell (WBC) count:10.9 103/uL, mean C-reactive protein (CRP) levels: 2.6 mg/dl, mean preoperative follow-up time 7.8 hours, mean operation time 32 min., mean postoperative follow-up duration time was 15 hours. In ultrasonography, 38% of patients had minimal liquid in Douglas’s area. In Computerized Tomography (CT) with intravenous, oral-rectal contrast, 30% of patients had minimal liquid. In 89% of patients, who underwent laparoscopic exploration, cause of the abdominal pain was found. In 57 explorations, purulent fluid was detected and associated to pelvic inflammatory disease, in 42 patients sero-hemorrhagic fluid was detected and associated to hemorrhagic cyst rupture. 9 patients had acute appendicitis, 2 patients had Meckel’s diverticulitis and one patient had a left lower quadrant brid. Conclusion: Our results indicate that laparoscopy serves not only as diagnostic, but also as diagnostic tool for female patients in reproductive age with nonspecific abdominal pain.
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    Laparoscopic approach for hospitalized women in reproductive period presenting with non-specific abdominal pain
    (2017) Cikot, Murat; Binboga, Sinan; Akarsu, Cevher; Surek, Ahmet; Gemici, Eyup; Sahbaz, Nuri Alper; Kartal, Bahadir; Alis, Halil
    Aim: The aim of this study is to evaluate nonspecific abdominal pain of hospitalized women in reproductive period and to make a contribution to the literature. Material and Method: Medical records from 201 women in reproductive period presenting with nonspecific abdominal pain admitted to emergency department between 2010 and 2014 are evaluated retrospectively. Results: Diagnostic laparoscopy was performed in 125 of 201 patients. The mean age of patients was 8.5 years, mean white blood cell (WBC) count:10.9 103/uL, mean C-reactive protein (CRP) levels: 2.6 mg/dl, mean preoperative follow-up time 7.8 hours, mean operation time 32 min., mean postoperative follow-up duration time was 15 hours. In ultrasonography, 38% of patients had minimal liquid in Douglas’s area. In Computerized Tomography (CT) with intravenous, oral-rectal contrast, 30% of patients had minimal liquid. In 89% of patients, who underwent laparoscopic exploration, cause of the abdominal pain was found. In 57 explorations, purulent fluid was detected and associated to pelvic inflammatory disease, in 42 patients sero-hemorrhagic fluid was detected and associated to hemorrhagic cyst rupture. 9 patients had acute appendicitis, 2 patients had Meckel’s diverticulitis and one patient had a left lower quadrant brid. Conclusion: Our results indicate that laparoscopy serves not only as diagnostic, but also as diagnostic tool for female patients in reproductive age with nonspecific abdominal pain.