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    Clinicopathologic features of operated gastric cancer patients, single center nine years experience
    (2020) Yol, Sinan; Uzun, Orhan; Senger, Aziz Serkan; Dincer, Mursit; Polat, Erdal; Duman, Mustafa; Deger, Kamuran Cumhur; Cigiltepe, Huseyin; Gundes, Ebubekir; Cetin, Durmus Ali; Aday, Ulas
    Aim: Gastric cancer is one of most common malignancies in the world. In developed countries including Europe and United States, despite the advanced technology, advanced stages of gastric cancer are still common with a poor survival. In this study, we aimed to describe clinicopathological characteristics and outcomes of gastric cancer in patients who were operated in our clinic.Material and Methods: We respectively evaluated a total of 200 patients who underwent gastrectomy, D2 lymph node dissection due to gastric cancer between November 2006 and December 2015. Data including clinicopathologic features, postoperative complications, overall survival and prognostic factors affecting prognosis were analyzed and statistical analysis was performed. Data including clinicopathologic features, postoperative complications, overal survival and prognostic factors affecting prognosis were analyzed and statistical analysis was performed.Results: Of the patients, 134 (67%) were males and 66 (33%) were females. The mean age was 61.36±11.92 (28-91) years. Tumor localization was frequently low (57%). The most common postoperative complication, regardless of the type of gastrectomy, was the surgical site infection. The major of the patients had Stage 3 disease. The median overall survival was 24.9 (0.07-116.3) months and overall survival was 43.7%.Conclusion: Except for early stage, the chance of curative treatment is low in gastric cancer. Early diagnosis and treatment can yield improved outcomes for this patient population. Therefore, it is important to develop national programs for early diagnosis and to develop experienced endoscopists
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    Comparison of first-line eradication therapy protocols for Helicobacter pylori in regions with high clarithromycin resistance
    (2019) Bozkurt, Hilmi; Sert, Ozlem Zeliha; Kaplan, Esin; Aray, Emre; Olmez, Tolga; Uzun, Orhan; Koksal, Rabia; Polat, Erdal; Duman, Mustafa
    Aim: First-line eradication therapy protocols for Helicobacter pylori infection and their success rates still prove to be matter of interest for researchers. The aim of this study was to examine retrospectively eradication therapy protocols used in patients infected with H. pylori in our region with high resistance to clarithromycin, compare success rates and determine the factors affecting success rates. Material and Methods: Eradication therapies for dyspeptic patients who were found to be Helicobacter pylori positive as revealed by upper gastrointestinal endoscopy and biopsy results and success rates attained in the microscopic examination of stool in the 4th week after the therapy were analyzed. Group 1 (legacy triple therapy): clarithromycin 500 mg film-coated tablet 2x1, lansoprazole 30 mg capsule 2x1, amoxicillin 1000 mg tablet 2x1, 14-day therapy period; Group 2 (bismuth-free quadruple therapy): clarithromycin 500 mg film tablet 2x1, rabeprazole 20 mg tablet 2*1, amoxicillin 1000 mg tablet 2x1, metronidazole 500mg 2x1 tablet, 14-day therapy period; Group 3 (bismuthal quadruple therapy): bismuth subsalicylate 262 mg tablet 2x2, metronidazole 500 mg tablet 3x1, tetracycline 500 mg capsule 3x1, pantoprazole 40mg tablet 2x1, 10-day therapy period.Results: Data of 168 patients were analyzed. The patients were divided into Group 1 (classical therapy) with 80 patients, Group 2 (bismuth-free quadruple therapy) with 46 patients and Group 3 (bismuthal quadruple therapy) with 42 patients. Eradication success rates were as follows: Group 1 (80%), Group 2 (80.4%) and Group 3 (83.3%).Conclusion: Antibiotic resistance is the sole reason for the low success rate in eradication therapy for Helicobacter pylori. In regions with high clarithromycin resistance bismuth-free quadruple therapy can be employed as an alternative. In regions with metronidazole resistance in addition to clarithromycin resistance bismuthal therapy protocols can be employed. Keywords: Helicobacter pylori; eradication therapy; clarithromycin resistance.
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    Incidental ectopic pancreas during upper gastrointestinal endoscopy
    (2018) Cetin, Durmus Ali; Ciyiltepe, Huseyin; Aday, Ulaş; Gundes, Ebubekir; Deger, Kamuran Cumhur; Duman, Mustafa
    Aim: Ectopic pancreas is a rare developmental anomaly which is detected incidentally in general. Frequently, it is an incidental finding and can be detected in various regions of gastrointestinal system. It can be readily recognized by its crater-like appearance at gastric antrum adjacent to pylori during upper gastrointestinal endoscopy. Here, we presented characteristics of cases with ectopic pancreas which was detected incidentally during upper gastrointestinal endoscopy performed for other reasons. Material and Methods: We retrospectively reviewed upper gastrointestinal endoscopy evaluations performed in our endoscopy unit between January 2012 and December 2015. Age, gender, endoscopy indication, endoscopic findings, and histopathological findings, if available, were recorded in all patients with ectopic pancreas. Results: Overall, 9850 patients underwent upper gastrointestinal endoscopy between January 2012 and December 2015; of these, findings compatible to ectopic pancreas were observed in 14 patients (0.14%). Those were 4 males (28.5%) and 10 females (71.5%). Mean age was 49 years (29-69 years) in these patients. Ectopic pancreas tissue was detected at gastric antrum of all patients. Mean size was 8.5 mm (5-15 mm) in lesions detected. Histopathological examination was performed in 9 patients (64.2%) and chronic gastritis was observed in all of these patients. Conclusion: Ectopic pancreas should be kept in mind in the differential diagnosis of several gastrointestinal submucosal lesions although it is rarely seen.