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Öğe Comparison of diagnostic scoring systems with imaging methods for the diagnosis of acute appendicitis(2020) Birben, Birkan; Sonmez, Bedriye Muge; Er, Sadettin; Ozden, Sabri; Kosa, Murat; Tez, MesutAim: Acute appendicitis scores have been developed to better analyze the symptoms and signs of acute appendicitis. In this study, we compared the success rates of different scoring systems with imaging methods in the diagnostic confirmation of acute appendicitis.Materials and Methods: Patients aged above 18 years, who presented to the emergency department with right lower quadrant pain and were suspected to have acute appendicitis, were prospectively and observationally evaluated. The demographic characteristics, imaging modalities, Alvarado score, acute inflammatory response score, and adult appendicitis score were assessed.Results: 237 patients, 46.8% female and 53.2% male, mean age of 34±13 (18-95) years. Appendectomy was performed in 144 (61%) patients with a prediagnosis of acute appendicitis. The pathological results were appendiceal cancer in two patients, lymphoid hyperplasia in 12, and acute appendicitis in 130. Imaging methods were found to be more specific than scores, and positive predictive values in scoring systems were more sensitive than imaging methods in the diagnosis of acute appendicitis.Conclusion: There is still no effective and guiding scoring system for the diagnosis of acute appendicitis. Due to the low negative predictive values of the available scoring systems, patients should be evaluated with detailed anamnesis, examination and laboratory findings, and computed tomography should be performed if there is clinical suspicion of acute appendicitis.Öğe Effect of cyst volume and other risk factors on biliary leak following liver hydatid cyst surgery(2019) Ucar, Nilay Sefa; Er, Sadettin; Berkem, Huseyin; Yuksel, Bulent CavitAim: This study aimed to determine the effect of prognostic factors indicating the presence of cystobiliary communication in the preoperative period and volume values obtained using the magnetic resonance imaging technique on the rate of biliary leak. Material and Methods: Twenty-six patients surgically treated for hydatid disease were included in the study. Age, sex, number, localization, volume and size of cysts, and liver function test results were statistically compared between the patients with and without biliary leak. Results: There were no significant differences between the groups with respect to age, gender, and number, volume and localization of cysts (p>0.05). However, a significant difference was found concerning the increase in liver function test results and cystobiliary relationship (p<0.05). Conclusion: In conclusion, we found no significant relation between the presence of preoperative cystobiliary communication and localization, volume and size of HD cysts. In the detection of preoperative cystobiliary communication, radiological and clinical findings should be evaluated together.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 predictive value of preoperative neutrophil-lymphocyte and platelet-lymphocyte ratio on overall survival in patients with operable gastric cancer(2020) Ozden, Sabri; Gundogdu, Salih Burak; Er, Sadettin; Birben, Birkan; Yildiz, Baris Dogu; Tez, MesutAim: Elevated preoperative neutrophil–lymphocyte ratio (NLR) and platelet–lymphocyte ratio (PLR) predict overall survival rates among patients with several types of cancer. The current study was conducted to clarify whether NLR and PLR are clinically useful in predicting overall survival among patients undergoing curative resections for gastric cancer. Material and Methods: 202 gastric cancer patients were reviewed retrospectively who had been appealed to our clinic between 2006 and 2013. 192 patients who had local disease, and underwent curative surgery for gastric cancer were included to the study. Data regarding potential prognostic factors including age, sex, preoperative neutrophil, lymphocyte, and platelet counts, postoperative tumor characteristic such as tumor location, tumor size, lymph node metastasis, tumor–nodes–metastasis staging, Lauren's classification of subtypes and survival times were obtained from medical records.Results: No significant correlations were noted between NLR, PLR and tumor location, size, Lauren's classification of subtypes, histology, stage, and type of gastrectomy. Univariate analysis revealed that metastasis at the follow up, sex, T, N stage, and lymph node ratio (LNR) were predictors of worse overall survival. In multivariate analysis, metastasis at follow up (p=0.014; HR:1.81; CI:1,126-2,911) and LNR (p=0.001; HR:3,564; CI:2,175-5,842) were found to be independent variables with worse overall survival. Conclusion: Preoperative NLR and PLR cannot be used as independent variables for prediction of overall survival in patients with operable gastric cancer.Öğe Umbilical endometriosis: A case report(2017) Er, Sadettin; Akin, Merve; Berkem, Hüseyin; Akin, TezcanÖğe Umbilical endometriosis: a case report(2017) Er, Sadettin; Akın, Merve; Berkem, Hüseyin; Akın, Tezcan
