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Öğe Can Lymph Node Metastasis be Predicted in Gastroenteropancreatic Neuroendocrine Neoplasias?(Coll Physicians & Surgeons Pakistan, 2025) Ocakli, Serhat; Ceylan, Cengiz; Canlikarakaya, Firat; Goktas, Abidin; Kankoc, Rumeysa; Terzioglu, Serdar GokayObjective: To investigate the predictive factors influencing lymphatic metastasis in gastroenteropancreatic neuroendocrine Place and Duration of the Study: Department of General Surgery, Ankara City Hospital, Ankara, Turkiye, between the years 2019 and 2022. Methodology: Patients who underwent surgery and were diagnosed with GEP-NEN based on final pathology between the study years were enrolled. Demographic information of the patients including age, gender, tumour location, and pathological characteristics (tumour size, grade, Ki-67 index, mitotic rate, total number of lymph nodes examined, pathological lymph nodes), inflammatory markers (White blood cell, lymphocyte, neutrophil, and monocyte counts, albumin levels, modified systemic inflammation score [mSIS], delta neutrophil index [DNI], neutrophil-lymphocyte ratio [NLR], and lymphocyte-monocyte ratio [LMR]) were retrieved from the patient database. Results: One hundred and thirty-two patients were included. The median age was 51 (34-64) years, with 56.8% being male. GEPNENs were most commonly found in the pancreas (43.2%) and appendix (22.7%). The median tumour size was 1.7 cm (0.7-3.5 cm), the mitotic rate was 1(1-2), and the Ki-67 Index was 2 (1-5). Grade I and II accounted for 91.6 % of cases. In multivariate analysis, independent predictive factors for pathological lymph node involvement were identified as small bowel tumour location (p = 0.002), tumour Grade III (p = 0.008), and tumour size >= 2 cm (p = 0.017). Conclusion: This study identified tumour size, grade, and site of origin as independent risk factors for LN metastasis.Öğe Coagulopathy in multiple traumas(Ulusal Travma ve Acil Cerrahi Dergisi, 2010) Turtay, Muhammet Gökhan; Kırımlıoğlu, Vedat; Ceylan, CengizÖz: AMAÇ Erken dönemde genel vücut travmalı (GVT) hastalarda, kafa travmasının ve diğer bölge travmalarının koagülasyon üzerine etkisi ve bu hastalarda koagülasyon parametreleri ile Glaskow Koma Skoru (GCS) ve travma şiddet skoru (ISS) ilişkilerinin araştırılması amaçlandı. GEREÇ VE YÖNTEM Acil servise GVT ile başvuran, 50 hasta (9 kadın, 41 erkek) çalışmaya alındı. Hastaların GCS, ISS, koagülasyon parametreleri düzeyleri belirlendi. GCS, ISS ile koagülasyon parametreleri arasında korelasyon değerlendirildi. Hastalar; önemli bir travma tespit edilmeyen (A), sadece kafa travması olanlar (B), kafa travması ve diğer bölge travması olanlar (C), kafa travması olmayan ancak diğer bölge travmaları olanlar (D) olarak ayrıldı. BULGULAR ISS ile uluslararası normalize oranı (INR), aktif parsiyel tromboplastin zamanı (aPTT), D-dimer ve fibrin yıkım ürünleri (FDP) düzeyleri arasında pozitif, ISS ile antitrombin (AT) ve fibrinojen düzeyleri arasında negatif bir ilişki saptandı (p<0,05). C grubuyla diğer gruplardaki INR, D-dimer, fibrinojen, aPTT, AT parametreleri karşılaştırıldığında istatistiksel anlamlılık saptandı (p<0,05). Kafa travması olan ve olmayan gruplar arasındaki INR, D-dimer ve fibrinojen parametrelerinde istatistiksel anlamlılık saptandı (p<0,05). SONUÇ Kafa travması olan hastalarda koagülasyon parametrelerinin bozulduğu, ancak kafa travmasına diğer bölge travmaları eşlik ettiğinde koagülasyon parametrelerinin daha fazla anormalleştiği belirlendi. Başlık (İngilizce): Çoklu travmalarda koagülopati Öz (İngilizce): BACKGROUND This study aimed at analyzing the effect on coagulation of head trauma and other local traumas in patients exposed to multiple traumas in the early stage, and also the relations of Glasgow Coma Scale (GCS) and Injury Severity Score (ISS) with coagulation parameters in these patients. METHODS Fifty consecutive patients (9 women, 41 men) with multiple traumas were included in this study. The GCS, ISS and coagulation parameter levels were measured. Presence of a correlation between GCS and ISS with coagulation parameters was analyzed. Patients exposed to multiple traumas were assessed in four categories as the patients with no significant traumas (A), only head traumas (B), head trauma and other local traumas (C), and no head traumas but other local traumas (D). RESULTS A marked relationship was found between ISS and international normalized ratio (INR), activated partial thromboplastin time (aPTT), D-dimer, fibrin degradation product (FDP), antithrombin (AT), and fibrinogen (p<0.05). There was a statistically significant difference between Group C and the other groups in INR, D-dimer, fibrinogen, aPTT, and AT parameters (p<0.05). There was also a statistically significant difference between the groups with and without head trauma in INR, D-dimer and fibrinogen (p<0.05). CONCLUSION The coagulation parameters were observed to diverge in patients with head trauma, but in cases with head injuries accompanying other local traumas, more coagulation parameters became abnormal.Öğe Comparison of laparoscopic and open appendectomy for complicated appendicitis: Retrospective analysis of single centre experiences(2024) Ceylan, Cengiz; Barut, BoraDespite all the advances in laparoscopic surgery, it is still controversial whether complicated appendicitis should be treated by laparoscopic or open surgery. In this study, we aimed to compare intraoperative and postoperative outcomes of patients with complicated appendicitis who underwent laparoscopic or open appendectomy. Between March 2018 and March 2022, 151 patients underwent laparoscopic or open appendectomy for complicated appendicitis were analysed retrospectively. Demographic, laboratory data, and postoperative outcomes were examined. The median age of the patients was 46 years (interquartile range: 31- 63) and 55% of the patients were male. Laparoscopic appendectomy was performed in 54.3% of the patients. While there was no significant difference observed in hospitalization durations between groups, laparoscopic appendectomy exhibited longer operation times compared to open appendectomy. Furthermore, postoperative follow-ups revealed a higher incidence of severe complications (Clavien-Dindo 3-4) in laparoscopic appendectomy (p=0.037). Subgroup analysis of complications indicated a greater frequency of intra-abdominal abscesses in laparoscopic procedures (p=0.033). Although the benefits of minimally invasive surgeries have been well-established, in cases of complicated appendicitis, we recommend open surgery over laparoscopic surgery to clinicians.Öğe Does total omentectomy increase survival in laparoscopic gastric cancer surgery? A retrospective study(Bmc, 2026) Kocaaslan, Huseyin; Ceylan, Cengiz; Sumer, Fatih; Kocaaslan, Zeynep; Aydin, CemalettinPurpose In non-metastatic advanced gastric cancer, gastrectomy with D2 lymph node dissection is the main curative treatment. The clinical benefit of omentectomy in gastric cancer surgery is still controversial. We planned to investigate the effect of omentectomy in addition to curative laparoscopic surgery on patient survival in patients with gastric cancer in our clinic. Materials and methods We retrospectively reviewed the records of 265 patients who underwent laparoscopic gastrectomy for gastric adenocarcinoma between 2010 and 2023 in our clinic. The demographic and clinicopathologic data of the patients were obtained from the patient database. The patient population was divided into two different groups as partial and total omentectomy patients. Overall survival and disease free survival were performed by Kaplan-Meier analysis. P < 0.05 was considered statistically significant. Results Of the 265 patients whose data were obtained, 188 were included in the study. The median age of the patients was 64(53-71) and 122(35.1%) were male. In addition to gastrectomy and D2 dissection, 127(67.6%) patients underwent partial omentectomy and 61(32.4%) patients underwent total omentectomy. Complications requiring surgical procedure (Clavien Dindo 3a, 3b) developed in 44(23.4%) patients (Table 2). There was no statistical difference between the groups except for histologic aggressive type and complications requiring surgical procedure (p = 0.044, p = 0.004, respectively). There was no statistically significant difference between the groups according to the results of survey analysis and disease free survival. Conclusions Our study demonstrated that partial omentectomy in laparoscopic curative gastric cancer surgery is similar to total omentectomy in patient survival, but the major complication rates after total omentectomy are higher. We have presented to the literature that partial omentectomy in laparoscopic gastric cancer surgery is sufficient in curative surgery except for aggressive tumor subtypes and does not have a negative result on patient survival. Randomized controlled and multicenter studies are needed to provide clearer messages.Öğe Early relaparotomy in recipients after living donor liver transplantation: causes, risk factors, and consequences(Tubitak Scientific & Technological Research Council Turkey, 2024) Barut, Bora; Ceylan, Cengiz; Zengin, Akile; Guzel, Mehmet; Dalda, Yasin; Yilmaz, SezaiBackground/aim: Despite advancements in surgical methodologies and the extensive perioperative and postoperative care administered to recipients, the prevalence of complications requiring early relaparotomy following living donor liver transplantation (LDLT) remains persistent. This study sought to analyze the determinants influencing relaparotomy occurrences in the initial 30 days following LDLT. Additionally, it was aimed to evaluate the impact of early laparotomy on both graft and patient survival within this distinct patient cohort. Materials and methods: The study encompassed recipients (n = 535) aged 18 years and older who underwent primary LDLT at our institution from January 2019 to December 2021. Exclusion criteria involved patients necessitating early retransplantation. Early relaparotomy was specified as surgical intervention within the initial 30 days following LDLT. Results: The study enrolled a total of 535 patients, among whom 85 (15.9%) underwent early relaparotomy. The median age of the patients was 54 (range: 41-60) years, with a predominant male representation (66.2%). Univariate analysis comparing the laparotomy and nonrelaparotomy groups revealed statistically significant differences in the creatinine (p = 0.043) and sodium (p = 0.025) levels, graft side (p < 0.001), etiology (p = 0.005), and blood loss (p = 0.012). In the multivariate analysis, creatinine (p = 0.039; OR = 1.668; 95% CI = 1.027-2.709) and left lobe graft (p < 0.0001; OR = 3.611; 95% CI = 1.960-6.652) emerged as independent risk factors for relaparotomy. Conclusion: The primary causes of early relaparotomy following LDLT include postoperative bleeding, biliary leakage, and vascular complications. Preoperative elevation in creatinine and sodium levels, the presence of Budd-Chiari syndrome, utilization of a left lobe graft, and intraoperative blood loss are identified as risk factors associated with early relaparotomy after LDLT. Patients undergoing early relaparotomy exhibit inferior survival rates compared to those who do not.Öğe Effectiveness of X-ray film in diagnosing peptic ulcer perforation(2024) Ceylan, Cengiz; Bilen, Zafer; Aydın, CemalettinPurpose: A retrospective case-control study was undertaken to assess the diagnostic efficacy of X-ray film in detecting peptic ulcer perforation (PUP). Materials and Methods: The study retrieved demographic data, perioperative observations, and postoperative results of 353 patients from the hospital repository. These individuals were categorized into two cohorts depending on the detection of intraperitoneal free air on X-ray imaging. Results: The study cohort exhibited a median age of 57 years (interquartile range: IQR 38-71), comprising predominantly males (82.4%). Intraperitoneal free air was evident in 73.1% of patients on X-ray imaging. In the multivariate analyses of the respective groups, time interval and diabetes mellitus (DM) emerged as independent risk factors. Notably, the sensitivity of X-ray film heightened with prolonged duration between symptom onset and emergency department admission, while specificity increased in the presence of DM. Conclusion: The imperative for supplementary imaging modalities in conjunction with clinical assessment is apparent in the diagnostic approach to PUP. Nonetheless, the fluctuation in sensitivity and specificity of X-ray film concerning DM and the duration from symptom onset to emergency department admission warrants careful consideration. Especially in cases where clinical suspicion of PUP exists despite the absence of intraperitoneal free air on X-ray, the utilization of advanced diagnostic techniques is advocated.Öğe Effects of intraoperative different fluid therapy protocols on postoperative renal functions(Bmc, 2024) Ozcan, Ayca Tuba Dumanli; Tas, Nisan; Ersoy, Umut Cahit; Yamen, Kevser; Yilmaz, Yusuf; Ozcan, Erdal; Ceylan, CengizPurpose Planning intraoperative fluid therapy in patients undergoing major abdominal surgery is important. It was aimed to define the difference between fluid therapy protocols for renal function, bleeding and postoperative service follow-ups. Materials and methods This is an observational case-controlled prospective study. Sixty patients aged 18-65 years who had undergone pancreatic surgery between December 2023- February 2023 were included in the study. Liberal (Group 1; n = 30) and targeted fluid therapies (Group 2; n = 30) were administered to the patients. Liberal fluid therapy was planned with 8-10 ml/kg/h crystalloid infusion. The targeted fluid therapy (TFT) group (Group 2; n = 30) began with a 2 ml/kg/h crystalloid infusion at the baseline. Additional fluid boluses were given in 250 ml of colloid infused over 10 min if PVI was > 13% for at least five minutes. The patients were staged using the KDIGO (Kidney Disease: Improving Global Outcomes) criteria. The amount of bleeding during surgery was recorded for both groups. Results No significant difference was observed in postoperative renal function. A significant difference was observed in the amount of intraoperative bleeding. The amount of bleeding was greater in patients managed with liberal fluid therapy. No significant difference was observed between the groups in the oral intake (hour), drain withdrawal (hour) mobilization (hour) and discharge (day) times and there isn't any statistically significant differance between groups in cost effectivity (p>0.05). Conclusion Kidney function was preserved during individualized targeted fluid therapy using non-invasive haemodynamic monitoring parameters.Öğe Evaluation of surgical margins of laparoscopic gastric cancer surgery: Single-center results(2023) Sağlam, Kutay; Kocaaslan, Huseyin; Aydın, Cemalettin; Angın, Yavuz Selım; Ceylan, Cengiz; Karayol, Fatih; Güngörür, ÖmerIntroduction: Surgical margin positivity incidence is reported between 5 snd 20% in gastric cancer surgery. Although some studies showed that presence of positive surgical margins affects overall survival negatively, others reported no effect. The aim of this study is to investigate the relationship between surgical margin and the survival of patients who underwent laparoscopic gastrectomy in our clinic. Materials and Methods: Between 2015 and 2022 years, patients who underwent laparoscopic gastrectomy because of gastric cancer were included in this study. Surgical resection margin (diameter) width, micro- scopic evaluation of the surgical margin, pathological tumor stage, resected lymph nodes numbers and involvement, and overall survival were analyzed. Results: After patients with benign disorders and inadequate lymph nodes resection were excluded from the study, 136 patients were included the study. Median surgical margin length width? was 2.3 (0.1–10) cm, and 13 (9.6%) patients had positive surgical margin after pathological evaluation. Median survival was 51.00±18.56 months in patients with positive surgical margins and 46.00±2.99 months in patients with neg- ative surgical margins (p=0.977). The 1, 3, and 5-year survival rates of patients with negative versus positive surgical margins (78.9% vs. 69.2%, p=0.426), (46.3% vs. 46.2%, p=0.990), and (17.1% vs. 30.8%, p=0.225), respectively. Surgical margin was positive in 3 (7.7%) patients with proximal tumors, and in 10 (10.3%) pa- tients with distal located tumors. Conclusion: While most studies emphasized surgical margin positivity in proximal tumors, the rate of distal surgical margin positivity was found to be higher in this study. In conclusion, no correlation was found be- tween surgical margin positivity and overall survival.Öğe FACTORS IMPACTING MORTALITY IN TURKISH OCTOGENARIAN AND NONAGENARIAN PATIENTS WHO UNDERWENT COLORECTAL SURGERY(Medical & Surgical Research Journals Group, 2022) Ceylan, Cengiz; Ocakli, Serhat; Akinci, Felat; Cetinkaya, Erdinc; Agackiran, Ibrahim; Akin, Tezcan; Er, SadettinBackground & objective: Due to their physiological conditions, the postoperative mortality rates of elderly patients are higher compared to other age groups, albeit the postoperative care and intensive care conditions are better than in the past. In this retrospective study, it was aimed to present a model to predict mortality and factors affecting mortality in this patient group who underwent colorectal surgery. Material & Methods: The population of octogenarian and nonagenarian patients who were operated for colorectal surgery in our clinic between 2020 and 2021 were included in the study. Patients' age, gender, albumin, lymphocyte, monocytes, lymphocyte-monocyte ratio (LMR), prognostic nutritional index (PNI), delta neutrophil index (DNI), Charlson comorbidity index (CCI), length of hospital stay, modified systemic inflammatory score (mSIS)) values, operation type (emergency/ elective), operation classification (minor/ moderate/ major/ complex major), anesthesia type (general/ epidural), and contamination status (clean/ clean-contaminated/ contaminated/ dirty or infected) were obtained from the hospital system. Results: Case status, operation type, contamination status, DNI, duration of hospitalization, mSIS variables were statistically significant in univariate regression analyses. However, in multivariate regression analyses, DNI of >= 0.05 (p< 0.015; OR 3.984, 95%CI 1.302-12.195) and contamination status (p< 0.038; OR 13,047, 95%Cl 1,150-148,087) were found to be independent risk factors affecting postoperative mortality. Conclusion: In the geriatric patient population undergoing colorectal surgery, DNI and contamination of the surgical field are two important factors affecting mortality. We think that the mortality estimation model created for this patient population will also help physicians for the postoperative period of the patients.Öğe The feasibility of falciformopexy in the repair of peptic ulcer perforation(Turkish Assoc Trauma Emergency Surgery, 2023) Terzioglu, Serdar Gokay; Canlikarakaya, Firat; Ocakli, Serhat; Ceylan, Cengiz; Agackiran, Ibrahim; Akinci, Felat; Kilic, Murat OzguerBACKGROUND: Modified Graham omentopexy is the most commonly used operative technique in the repair of peptic ulcer perforation (PUP); however, there is little data on falciformopexy in the literature. The aim is to investigate the feasibility of falciformopexy in the repair of PUP, comparing with modified Graham omentopexy.METHODS: Data of 471 patients who were operated for PUP were retrospectively analyzed. Patients' demographics, pre-operative basic laboratory findings, American Society of Anesthesiologists (ASA) status, operative findings, and post-operative complications were recorded. The patients were classified into two groups modified Graham omentopexy and falciformopexy, and then compared with each other in terms of clinical characteristics, operative findings, and post-operative complications.RESULTS: Modified Graham omentopexy and falciformopexy were performed in 425 (90.2%) and 46 (9.8%) patients, respectively. The two groups were similar in terms of basic patient characteristics and pre-operative laboratory findings (P>0.05). ASA physical status was significantly different between the groups (P=0.001). No statistically significant difference was found between the groups in terms of complications, except for an anastomotic leak. Anastomotic leak was observed more frequently in patients who underwent falciformopexy than in patients with modified Graham omentopexy (P=0.017). CONCLUSION: Although falciformopexy technique has a higher rate of leak compared to the modified Graham omentopexy method, it should be kept in mind as an alternative method for repair of PUP, especially in cases where omentopexy cannot be applied for various reasons such as the presence of unavailable or unsuitable omentum.Öğe Firearm injury and the Deloyers procedure: case report and literature review(Turkish Assoc Trauma Emergency Surgery, 2024) Ceylan, CengizFollowing extended colon resections, it may not always be possible to perform colorectal anastomosis. The Deloyers procedure, which involves the transposition of the right colon, has been identified as a viable solution. This report aims to discuss the circumstances under which the Deloyers procedure was performed, as well as to evaluate the early and late postoperative outcomes, by reviewing cases conducted between 2010 and 2023. In a 22 -year -old female patient who suffered major organ and tissue loss (with injuries to the sigmoid colon, descending colon, transverse colon, and mesentery) due to a firearm injury, the Deloyers procedure was applied during restorative surgery following initial damage control surgery. The procedure involved mobilizing the cecum and right colon, performing a cranio-caudal rotation over the ileocolic artery pedicle, followed by an appendectomy, and creating a colorectal anastomosis using circular staplers. There were no complications during the postoperative follow-ups. By the 14th postoperative day, the patient was discharged and experienced bowel movements four times a day, managed with 2.5 mg of diphenoxylate hydrochloride and 0.025 mg of atropine sulfate. At the 6 -month follow-up, the frequency of bowel movements had decreased to twice daily without the need for medical treatment. Given the functional outcomes in patients after extended left colectomies, the Deloyers procedure, with its low associated morbidity, stands out as a viable option.Öğe Impact of Prognostic Nutritional Index on Prognosis in Geriatric Patients Undergoing Surgical Intervention for Colorectal Cancer(Springer India, 2025) Kocaaslan, Huseyin; Ceylan, Cengiz; Baran, Necip T.; Sumer, Fatih; Aydin, CemalettinThe Prognostic Nutritional Index (PNI) is a valuable and informative indicator for clinicians. This study aims to investigate the impact of PNI on long-term survival in the geriatric population diagnosed with colorectal cancer. In this study, we collected demographic and clinicopathological data from 147 geriatric patients who underwent colorectal surgery at our institution between 2013 and 2022. PNI values were calculated for each patient. Based on ROC analysis for mortality, patients were categorized into two groups: low PNI and high PNI. With a median follow-up period of 34 months, the long-term outcomes of these groups were analyzed. The low PNI group (PNI <= 34.5) was associated with colon cancers rather than rectal cancer (p = 0.014), older age (p = 0.004), and higher mortality (p = 0.006). Additionally, in the survival analysis, the mean overall survival was 92.44 SD6.41 months in the high PNI group, compared to 76.66 SD8.77 months in the low PNI group (p = 0.006). For geriatric patients diagnosed with colorectal cancer who have a preoperative PNI <= 34.5, it is recommended that clinicians provide both preoperative and postoperative nutritional support, considering its significant impact on overall survival.Öğe The Importance of Minimal Cortex Thickness of the Lymph Node in Axillary Ultrasound for Early-stage Breast Cancer(Springer, 2023) Cangoz, Kayra; Menekse, Ebru; Elverici, Eda; Ozsoy, Arzu; Ceylan, Cengiz; Korukluoglu, Birol[Abstract Not Available]Öğe Is the appropriate timing for percutaneous cholecystostomy in acute cholecystitis a matter of concern?(Turkish Assoc Trauma Emergency Surgery, 2024) Ceylan, Cengiz[Abstract Not Available]Öğe Letter to the editor: Serum amylase on postoperative day one is a strong predictor of pancreatic fitlisua after pancreaticoduodenectomy: a retrospective cohort(Tubitak Scientific & Technological Research Council Turkey, 2024) Ceylan, Cengiz[No abstract available]Öğe Management of colonic volvulus: A retrospective analysis of short-term outcomes(2025) Ceylan, Cengiz; Barut, BoraColonic volvulus is the third most common cause of colonic obstruction globally. The management of colonic volvulus, comprising emergency surgery, endoscopic decompression, elective surgery following endoscopic decompression, and the specific surgical approach directly influences morbidity and mortality in these critically ill patients. This study aims to present the outcomes of patients with colonic volvulus treated at our institution. A retrospective analysis was conducted on 47 patients treated for sigmoid volvulus at our clinic between 2017-2024. The study examined demographic data, preoperative radiological assessments, management strategies for volvulus, and postoperative outcomes. The median age of the 47 patients diagnosed and treated for colonic volvulus was 73 years (25th and 75th percentiles: 55-79), with 83% of the patients being male. Endoscopic detorsion was performed in 66% of the patients, and the overall morbidity rate in the treated population was 34%, while the mortality rate was 12.8%. Univariate analyses revealed that factors such as pH, lactate, CRP, creatinine, BUN, bowel necrosis, perforation, and endoscopic detorsion were associated with morbidity. Multivariate analysis indicated that endoscopic detorsion was the only factor that significantly reduced morbidity (p=0.01). In sigmoid volvulus, endoscopic detorsion in patients without signs of perforation is the most important independent risk factor for reducing morbidity in the treatment algorithm. Therefore, it should be considered the first-line treatment option by clinicians.Öğe A new model for prediction of bowel gangrene in sigmoid volvulus(Turkish Assoc Trauma Emergency Surgery, 2023) Ceylan, Cengiz; Baran, Necip Tolga; Kocaaslan, Huseyin; Gungorur, Omer; Cengiz, Emrah; Guzel, Mehmet; Angin, Yavuz SelimBACKGROUND: Sigmoid volvulus is a pathology that can be mortal because it is frequently encountered in elderly patients. In case of bowel gangrene, mortality and morbidity increase further. We planned a retrospective study, in which the effectiveness of the model was evaluated by creating a model that aims to predict whether intestinal gangrene is present in patients with sigmoid volvulus only by blood tests and thus to quickly guide treatment methods.METHODS: In addition to demographic data such as age and gender, laboratory values such as white blood cell, C-reactive protein (CRP), lactate dehydrogenase (LDH), potassium, and colonoscopic findings and whether there was gangrene in the colon during the operation were evaluated retrospectively. In the analysis of the data, independent risk factors were determined by univariate and multivariate logistic regression analyzes as well as Mann-Whitney U and Chi-square tests. Receiver operating characteristic (ROC) analysis was performed for statistically significant continuous numerical data, and cutoff values were determined and Malatya Volvulus Gangrene Model (MVGM) was created. The effectiveness of the created model was again evaluated by ROC analysis.RESULTS: Of the 74 patients included in the study, 59 (79.7%) were male. The median age of the population was 74 (19-88), and gangrene was detected in 21 (28.37%) patients at surgery. In univariate analyzes, leukocytes <4000/mm3 and >12000/mm3 (OR: 10.737; CI 95%: 2.797-41.211, p=0.001), CRP >= 0.71 mg/dl (OR: 8.107 CI 95%: 2.520-26.082, p<0.0001), potassium >= 3.85 mmoL/L (OR: 3.889; 95% CI): 1.333-11.345, p=0.013), and LDH >= 288 U/L (OR: 3.889; CI 95%: 1.333-11.345, p=0.013), whereas, in multivariate analyzes, only CRP >= 0.71 mg/dL (OR: 3.965; CI 95%: 1.071-15.462, p=0.047) was found to be an independent risk factor for bowel gangrene. The strength of MVGM was AUC 0.836 (0.737-0.936). In addition, it was observed that the probability of bowel gangrene increased approximately 10 times if MVGM was >= 7 (OR: 9.846; 95% CI: 3.016-32.145, p<0.0001).CONCLUSION: Besides being non-invasive compared to the colonoscopic procedure, MVGM is a useful method for detecting bowel gangrene. In addition, it will guide the clinician in taking the patients with intestinal loop gangrene to emergency surgery without wasting time in the treatment steps, as well as avoiding complications that may occur during colonoscopy. In this way, we think that morbidity and mortality rates can be reduced.Öğe Predictive Factors of Postoperative Pancreatic Fistula in Geriatric Patients Undergoing Pancreatoduodenectomy for Periampullary Malignancy(Coll Physicians & Surgeons Pakistan, 2023) Ceylan, Cengiz; Kocaaslan, Huseyin; Baran, Necip Tolga; Kulus, Mehmet; Saglam, Kutay; Aydin, CemalettinObjective: To identify predictive factors associated with the occurrence of postoperative pancreatic fistula (POPF) following pancreato-duodenectomy (PD) in an increasingly geriatric population.Study Design: Observational study.Place and Duration of the Study: Department of General Surgery, Inonu University, Malatya, Turkey, from January 2010 to April 2022.Methodology: Demographic and clinicopathological data of 74 geriatric patients who underwent PD for periampullary tumours in the clinic at Inonu University were retrieved from the patient database. POPF was defined and categorised based on the guidelines established by the International Study Group for Pancreatic Surgery (ISGPS). The patients were stratified into two cohorts of POPF and no POPF. Univariate and multivariate analyses were conducted to compare variables between the two groups.Results: The median age of the patient population was 72 (65-92) years, and 51 (68.9%) individuals were male. Among the 74 patients, 35 (47.3%) experienced POPF. In the multivariate analysis, hypertension (HT, p=0.012), Wirsung diameter <3.5 mm (p<0.01), and pancreaticojejunostomy (PJ, p=0.022) emerged as independent risk factors for POPF.Conclusion: In the context of geriatric patients undergoing PD, HT, intraoperative wirsung diameter <3.5 mm, and PJ were identified as independent risk factors for POPF. These findings can guide the adoption of safer techniques in preoperative and intraoperative evaluations, as well as in postoperative follow-ups of patients presenting with these risk factors.Öğe Preoperative predictive factors affecting sentinel lymph node positivity in breast cancer and comparison of their effectiveness with existing nomograms(Lippincott Williams & Wilkins, 2022) Ceylan, Cengiz; Ozel, Hikmet Pehlevan; Agackiran, Ibrahim; Ozdemir, Buket Altun; Atas, Hakan; Menekse, EbruThis study aimed to establish a strong regression model by revealing the preoperative predictive factors for sentinel lymph node (SLN) positivity in patients with early stage breast cancer (ESBC). In total, 445 patients who underwent SLN dissection for ESBC were included. All data that may be potential predictors of SLN positivity were retrospectively analyzed. Tumor size >2 cm, human epidermal growth factor receptor 2 (HER2) + status, lymphovascular invasion (LVI), palpable tumor, microcalcifications, multifocality or multicentricity, and axillary ultrasonographic findings were defined as independent predictors of SLN involvement. The area under the receiver operating characteristic (ROC) curve (AUC) values were 0.797, 0.808, and 0.870 for the Memorial Sloan-Kettering Cancer Center (MSKCC) nomogram, MD Anderson Cancer Center (MDACC) nomogram, and our regression model, respectively (P < .001). The recent model for predicting SLN status in ESBC was found to be stronger than existing nomograms. Parameters not included in current nomograms, such as palpable tumors, microcalcifications, and axillary ultrasonographic findings, are likely to make this model more meaningful.Öğe Preoperative predictor laboratory markers for complicated appendicitis: A retrospective analysis of single center experience(2023) Ceylan, Cengiz; Barut, BoraIn this study, we aimed to investigate the pre-operative predictive role of the serum white blood cell and platelet counts, C-reactive protein (CRP), bilirubin, amylase, lipase, and sodium levels for complicated appendicitis in patients aged≥18 years. We retrospectively evaluated 574 patients (aged≥18 years) who underwent appendectomy due to acute appendicitis (AA) between March 2018 and March 2022 at our clinic. The patient population was divided into two groups as perioperative complicated and uncomplicated appendicitis and the preoperative predictor role of serum white blood cell counts, platelet counts, CRP, bilirubin, amylase, lipase, and sodium levels were compared for complicated versus uncomplicated appendicitis. In multivariate analyses, age>38 years, the timing of Emergency Department (ED) arrival to admission ≥2 days, CRP ≥3.36 mg/dL, and total bilirubin ≥0.76 mg/dL are independent risk factors for detecting complicated AA. Moreover, in the designed scoring system, the AUC: 0.877 (CI: 0.847-0.907) for perforated AA at scores below or above. Estimation of the complications of AA can help clinicians practically with the scoring system designed because of the determined predictive factors.
