Yazar "Eray, Ismail Cem" seçeneğine göre listele

Listeleniyor 1 - 5 / 5
  • Küçük Resim
    Öğe
    Analysis of feasibility and safety of laparoscopic complete mesocolic excision with central vascular ligation for right-sided colon cancer: A single centre experience
    (2020) Erdogan, Osman; Teke, Zafer; Unal, Ayse Gizem; Yalav, Orcun; Eray, Ismail Cem
    Aim: Colectomies performed according to complete mesocolic excision (CME) principles have demonstrated an improvement in the quality of surgical specimen and a potential improvement of long-term results. The procedure is technically challenging and has a risk of serious complications, especially when performed laparoscopically. We here aimed to analyze our short-term results in relation to laparoscopic CME right hemicolectomy carried out for right-sided colon cancers. Material and Methods: Demographic data and preoperative, perioperative and postoperative parameters of twenty-three patients who underwent laparoscopic CME between January 2017 and January 2019 in our clinic for right-sided colon adenocarcinoma were retrospectively analysed.Results: There were 23 patients in our study and the mean (SD) age was 61.9±14.8. In the present series, 30% of patients were ≥70 years old, and three were ≥80 years old. Four patients were ASA class 3. Fifty-two percent of patients had comorbidities, and two had different system malignancies in their medical history. While the mean (SD) body mass index (BMI) was 25±4.3, BMI of 4 patients were over 30. Six of patients had a history of previous abdominal surgery. No perioperative mortality was observed. Thirteen percent of the patients developed wound site infection. Anastomotic leakage occurred in 2 cases, and one of them underwent reoperation. The mean (SD) operation time was 168±33 min. Good quality specimens were obtained with a mean (SD) length of 34.2±9.7 cm, a proximal margin of 14±8.2 cm and a distal margin of 16.6±8.9 cm. The mean (SD) number of harvested lymph nodes was 31.9±7.7. The radial surgical margin of all specimens was negative. The mean (SD) postoperative hospital stay was 7.2±2.8 days.Conclusion: We believe that our CME technique performed by laparoscopic method for right-sided colon cancers is safe and applicable, and allows obtaining good quality specimens when evaluating the short-term results. However, there is still a need for randomized controlled trials to evaluate the contribution to survival.
  • Küçük Resim
    Öğe
    Comparison of results of laparoscopic and open surgical techniques in adrenal masses larger than 6 cm
    (2019) Topal, Ugur; Dalci, Kubilay; Yalav, Orcun; Unal, Ayse Gizem; Eray, Ismail Cem; Sakman, Gurhan
    Aim: In this study, we aimed to compare the results of conventional and laparoscopic adrenalectomy in patients with adrenal masses greater than 6 cm.Material and Methods: Thirty-six patients with tumor size greater than 6 cm who underwent adrenalectomy between January 2011 and January 2018 were included in the study. Patients were divided into two groups as Group 1 conventional and Group 2 Laparoscopic surgery. The two groups were retrospectively compared in terms of age, sex, mass localization, mass size, duration of operation, amount of bleeding, duration of hospitalization, duration of onset of food intake, perioperative mortality, early period complications and re-admission to the hospital within 90 days. P0.05 was considered statistically significant.Results: There were 13 patients in Group 1 and 23 patients in Group 2. There was no statistically significant difference between the groups in terms of age, sex, tumor localization, tumor size, indications for operation, postoperative complications, perioperative mortality and readmission within 90 days. Duration of operation (min), amount of bleeding (ml), duration of oral intake (day) and duration of hospitalization (day) were higher in Group 1 and statistically significant.Conclusion: Laparoscopic adrenalectomy has demonstrated advantages in patients with a mass greater than 6 cm compared to conventional surgery, such as short operation duration, less blood loss, early onset of oral food intake and shorter hospital stay. It can be safely used in patients with a mass larger than 6 cm.
  • Küçük Resim
    Öğe
    The impact of previous open abdominal surgery on the outcome of laparoscopic colorectal surgery
    (2021) Eray, Ismail Cem; Topal, Ugur; Yalav, Orcun; Dalci, Kubilay; Saritas, Ahmet Gokhan; Rencuzogullari, Ahmet
    Aim: Although the laparoscopic approach is increasingly being used in colorectal surgery, it is anticipated that the technical problems caused by previous abdominal open surgery (PAOS) will adversely affect the outcomes. The aim of this study was to evaluate the outcomes of previous abdominal surgery in patients with colorectal cancer who underwent laparoscopic surgery for treatment. Material and Methods: Among the patients who underwent laparoscopic surgery for colorectal cancer between January 2015 and December 2018, those who had a history of previous abdominal surgery and those who did not were compared. Those with a history of laparoscopic abdominal surgery are not included in the PAOS group and short-term postoperative complications, conversion to open surgery, reoperations, hospital readmissions, and mortality rates were analyzed between the groups. Results: 21 of 140 patients who underwent laparoscopic surgery for colorectal cancer had PAOS. The groups with and without PAOS were similar in terms of age, sex, body mass index, ASA score, and comorbid disease. No difference was observed regarding conversion to open surgery (p = 0.513), postoperative complications (p> 0.05), reoperations (p = 0.162), unplanned hospital readmissions (p = 0.154), and perioperative mortality (p = 0.136) between the two groups. Conclusion: We believe that laparoscopy can be safely performed in patients with colorectal cancer who had previous abdominal open surgery with similar clinical and postoperative complication rates as in patients without a history of PAOS.
  • Küçük Resim
    Öğe
    Management of rectovaginal fistulas secondary to use of stapling device for rectal cancer surgery
    (2019) Topal, Ugur; Rencuzogullari, Ahmet; Eray, Ismail Cem; Alabaz, Omer
    Aim: Scarce data are available for rectovaginal fistula (RVF) as a serious complication of low anterior resection with a double-stapled anastomosis for rectal cancer. In this study, we aimed to evaluate our surgical management of RVFs formed due to stapler use.Material and Methods: Between 2010 and 2018, patients who developed rectovaginal fistula after the use of circular stapler during rectal surgery were included. Clinic characteristics, type of surgical treatment performed and details of surgery in patients were retrospectively evaluated.Results: Ten patients for whom stapler device was used for rectal cancer surgery and diagnosed with RVF were included in our study. The mean age of the patients was 45.7±11.8 and mean BMI value was 27±2.4. For 9 patients who had primary repair for RVFs, 7 patients experienced recurrence after their first operation. For this subgroup, muscle flap was performed in 3, vaginal mucosa advancement flap 2, sartius flap one, and another primary repair plus fibrin glue application one patient. After the second interventions, two patients were managed with muscle flap creation and primary repair plus fibrin glue was required for one patient, for their recurrence. For patient who had primary repair plus fibrin glue application for her second operation, sigmoid colostomy followed by abdominoperineal resection was required for persisting complaints.Conclusion: The management of postoperative (RVF) after low anterior resection for rectal cancer is difficult and the results are often unsatisfactory. Endoanal mucosal flaps and muscle flaps are the treatment modalities we recommend, especially in patients with recurrence.Keywords: Circular stapler; rectovaginal fistula; rectal cancer.
  • Küçük Resim
    Öğe
    Prognostic value of neutrophil-to-lymphocyte ratio in patients undergoing curative surgical resection for hepatocellular carcinoma
    (2020) Saritas, Ahmet Gokhan; Ulku, Abdullah; Topal, Ugur; Dalci, Kubilay; Eray, Ismail Cem; Akcam, Tolga
    Aim: the purpose of this study is to determine the prognostic value of the preoperative Neutrophil-to-Lymphocyte ratio (NLR) in patients who underwent curative surgical treatment for hepatocellular carcinoma (HCC). Materials and Methods: Patients who underwent curative resection for HCC between 2004 and 2015 were included in the study. Patients were divided into two groups based on the cut-off value: Group 1 (NLR low) and Group 2 (NLR elevated). Demographics and clinical characteristics, tumor characteristics, and mean survival of patients were compared between the groups.Results: 41 patients were included in our study and Group 1 (NLR low) consisted of (n:11) patients; Group 2 (NLR elevated) consisted of (n:30) patients based on a cut-off value of 2.43. The number of males was higher in both groups (90.9% vs 90%, p:0.712). The Child-Plug class A was the most common one in both groups (81.8%vs76.7%, p:0.680). HBV infection was the most common etiological cause (81.8% vs 53.3%, p:0.344). Lesions were predominantly located in the right lobe (63.6% vs 66.7%, p:0.568). The total tumor diameter was similar (6.56 cm vs 8.69 cm, p:0.258). In the multivariate analysis for survival, tumor diameter greater than 5 cm (HR 1.412 95% - Cl0.345-5.780, p:0.018) and NLR higher than 2.43 (HR 0.100 95% -Cl 0.011-0.882, p:0.038) were independent risk factors. Overall survival time was found to be lower in Group 2 compared to Group 1 (171 vs 106 months p:0.033). Disease-free survival rates were similar in the groups (37 vs 43 months, p:0.485).Conclusion: Although the elevated NLR level was found to be a risk factor for decreased overall survival in our study, this was not related to clinicopathological variables.