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    Assessment of demographic, clinical and histopathological features of patients who underwent appendectomy due to a presumed diagnosis of acute appendicitis
    (Turkish Assoc Trauma Emergency Surgery, 2021) Akbulut, Sami; Bahce, Zeynep Sener; Oztas, Tulin; Gumus, Serdar; Sogutcu, Nilgun; Sakarya, Hamdi; Gok, Ali Fuat Kaan
    BACKGROUND: To compare the clinical, biochemical, and histopathological features of patients who underwent appendectomy due to a presumed diagnosis of acute appendicitis (AAp). METHODS: The demographic, biochemical and histopathological data of 8206 patients who underwent appendectomy for AAp between January 2006 and March 2014 were retrospectively analyzed in this study. Patients were compared regarding the following characteristics: disruption by season (autumn vs. winter vs. spring vs. summer), working days (weekdays vs. weekends), histopathological findings (AAp vs. normal appendix [NAp]) and histopathological subgroup (non-perforated AAp vs. perforated AAp vs. NAp). RESULTS: Of the 8206 patients aged between 16 and 89 years, 4763 (58.0%) were male. Appendectomy distribution by season was as follows: autumn (n=1959; 23.9%), winter (n=2062; 25.1%), spring (n=2061; 25.1%) and summer (n=2124, 25.9%). NAp rates were higher in summer than those in other seasons. White blood cell (WBC) and neutrophil levels were significantly higher in autumn and winter compared with those in other seasons. In total, 6120 (74.6%) appendectomies occurred on weekdays and 2086 (25.4%) on weekends. WBC and neutrophil levels were significantly higher on weekends than those on weekdays. Appendectomy distribution by histopathological groups as follows: AAp (n=7414; 90.3%) and NAp (n=792; 9.7%). Appendectomy distribution by histopathological subgroups was as follows: non-perforated AAp (n=6966; 84.9%), perforated AAp (n=448; 5.5%), and NAp (n=792; 9.7%). WBC, neutrophil, and TBil levels in the non-perforated and perforated AAp groups were significantly higher than in the NAp group. While most of the patients with perforated AAp (62.1%) and non-perforated AAp (59.6%) were males, most of the patients with NAp (58.1%) were females. CONCLUSION: This study suggests that a relationship exists between demographic features, histopathological findings of appendectomy specimens, seasons, days of the week, and working days in patients undergoing appendectomy.
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    Assessment of the relationship between clinical and histopathological features in cases of thyroidectomy
    (Edizioni Luigi Pozzi, 2018) Yagmur, Yusuf; Akbulut, Sami; Sakarya, Hamdi; Sogutcu, Nilgun; Gumus, Serdar
    Aim: The aim of this study is to evaluate the relationship between clinical parameters and ultimate histopathologic features of patients underwent thyroid surgery. METHOD: Demographic and clinicopathologic parameters of patients who underwent thyroid surgery for benign or malignant disease in our clinic between June 2006 and March 2014 were retrospectively reviewed. Pearson's Chi-Square, Independent Sample T test, ROC Curve and Youden J Index were used to investigate whether there was any relationship between the clinical parameters and permanent histopathologic features of patients. RESULTS: A total of 3059 patients (Benign: 2727; Malign: 332) aged between 15 and 90 years were reviewed. The patients age was higher in malign group (mean +/- SD: 468 +/- 4.2) than benign group (mean +/- SD: 43.7 +/- 12.9 yr) and this difference was statistically significant (p <0.001). The nodule diameter (mean +/- SD: 30.8 +/- 13.5 mm) was greater in malign group than the benign group (mean +/- SD: 28.3 +/- 13.4 mm) and this difference was statistically significant (p = 0.002). The sensitivity and specificity rates of the most appropriate cut-off point (> 26 mm) for the nodule size were 60% and 49.05%, respectively. Sensitivity, specificity, positive predictive value, negative predictive value and accuracy of FNAB were calculated as 4.17 %, 100 %, 100 %, 89.96% and 90 %, respectively. CONCLUSION: This study showed that higher age and greater nodule diameter (> 26 mm) are associated with malignancy.
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    Case Report of Four Different Primary Mesenteric Neoplasms and Review of Literature
    (Kowsar Publ, 2016) Yagmur, Yusuf; Akbulut, Sami; Gumus, Serdar; Babur, Mehmet; Can, Mehmet Ali
    Introduction: It is rare for primary tumors to arise from the mesentery. Lymphangiomas appear as congenital malformations of the lymphatic system or benign neoplasms as a large, thin-walled, often multilocular cyst. Mesenteric infiltration is common and during surgical treatment, adjustment of structures such as the bowel and resection of the spleen may be required. Cystic mesotheliomas are rare, benign tumors that originate from the peritoneal mesothelium and are more common in women. Mesenteric cysts are mostly benign and rare intra-abdominal tumors, and can be seen as occupying a large cyst. Malignant fibrous histiocytoma is a rare pleomorphic sarcoma that is more commonly encountered in men. After the extremities, the second most common areas to be affected are the retroperitoneum and peritoneal cavity. Case Presentation: We encountered four cases of different primary mesenteric neoplasms that were operated at the Gazi Yasargil teaching and research hospital, department of general surgery, Diyarbakir, Turkey, between 2013 and 2014. We reviewed these primary mesenteric neoplasms and compared them with previous literature. Conclusions: Primary mesenteric tumors are rare and mostly benign tumors. Complete surgical excision is necessary for all tumors and follow-up is necessary after surgery for malignant fibrous histiocytoma due to recurrence.
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    Giant Splenic Artery Pseudoaneurysm: A Case Report and Literature Review
    (Int College Of Surgeons, 2015) Yagmur, Yusuf; Akbulut, Sami; Gumus, Serdar; Demircan, Firat
    Splenic artery aneurysms (SAAs) are the third most frequent intra-abdominal aneurysm, following abdominal aorta and iliac artery aneurysms. SAAs are classified according to their involvement of arterial wall layers: true aneurysms involve all 3 layers (intima, media, and adventitia), and pseudoaneurysms involve only one or two. Herein we present a new case of giant pseudo SAA. A 65-year-old female patient with a pancreatic mass and iron deficiency was referred to our clinic for further investigation. Abdominal ultrasonography, contrast-enhanced CT and magnetic resonance imaging showed a lesion resembling a subcapsular hemangioma in the spleen, and aneurysmatic dilation of the splenic artery with a diameter of >5 cm. The large size of the aneurysm and the clinical findings were indications for surgical treatment. The patient underwent en bloc resection of the spleen, distal pancreas, and aneurysmatic segment of the splenic artery. The patient remains complication-free 2 months after the operation. Spontaneous rupture is the most important life-threatening complications of giant SAAs. Therefore, all symptomatic patients with SAA should be treated, as well as asymptomatic patients with lesions >= 2 cm, who are pregnant or fertile, have portal hypertension, or are candidates for liver transplantation. Despite advances in endovascular techniques, conventional abdominal surgery remains the gold standard for treatment.
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    Post Cholecystectomy Gossypiboma Mimicking a Liver Hydatid Cyst: Comprehensive Literature Review
    (Kowsar Publ, 2015) Yagmur, Yusuf; Akbulut, Sami; Gumus, Serdar
    Background: Gossypiboma is the term for forgotten textile products such as a surgical sponge and compress in the body cavity after a surgical procedure. Objectives: The aim of this study was to evaluate previously published articles related to post cholecystectomy gossypiboma. Materials and Methods: We conducted a systematic search using PubMed, Medline, Google and Google Scholar on post cholecystectomy gossypiboma. The keywords used were: gossypiboma and cholecystectomy, textiloma and cholecystectomy and post cholecystectomy gossypiboma. Furthermore, we also present a new case of post cholecystectomy gossypiboma. Results: A total of 32 articles concerning 38 patients with post cholecystectomy gossypiboma that met the aforementioned criteria were included. Detailed intraoperative findings and surgical management were provided. The patients were aged from 26 to 79 years (Mean +/- SD: 47 +/- 13.6 years); 32 were female and six were male. The time from the causative operation to presentation with a retained surgical sponge ranged from one to 480 months (Mean +/- SD: 56.5 +/- 93.5 months). Conclusions: Gossypiboma may not be symptomatic for many years or could be symptomatic for a short duration of time. Besides being a rare surgical complication, gossypiboma can lead to serious morbidity and mortality that may cause medico-legal problems. Diagnosis with imaging methods is difficult.
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    Relationship between clinical and histopathological features of patients undergoing cholecystectomy
    (Termedia Publishing House Ltd, 2020) Akbulut, Sami; Yagmur, Yusuf; Sakarya, Hamdi; Bahce, Zeynep Sener; Gumus, Serdar; Sogutcu, Nilgun
    Introduction: Cholelithiasis is most common disease of the gallbladder and cholecystectomy is the one of the most performed surgical procedure worldwide. Aim: To assess the relationship between the demographic, biochemical, and histopathological variables of patients who underwent cholecystectomy. Material and methods: Demographic, biochemical, and histopathological data of 5077 patients undergoing cholecystectomy were compared in terms of two different aspects: open cholecystectomy (OC group; n = 2090) versus laparoscopic cholecystectomy (LC group; n = 2987), and an elective group (n = 4814) versus an emergency group (n = 263). Results: A total of 5077 patients aged between 13 and 97 years were included in the study. Aspartate aminotransferase (AST) levels, alanine aminotransferase (ALT) levels, mean platelet volume, and prevalence of acute/chronic cholecystitis were significantly higher in the LC group than in the OC group. On the other hand, age, direct bilirubin level, thrombocyte count, and prevalence of gallbladder cancer/gangrenous cholecystitis were significantly higher in the OC group than in the LC group. Levels of AST, ALT, white blood cells, neutrophils, and some prevalence of acute/chronic active cholecystitis were higher in the emergency group than in the elective group. On the other hand, the lymphocyte count and prevalence of chronic cholecystitis/hyperplastic polyps were higher in the elective group than in the emergency group. Histopathological analysis identified 32 patients with malignant gallbladder cancer as follows: adenocarcinoma (n = 21), mucinous adenocarcinoma (n = 3), papillary adenocarcinoma (n = 3), adenosquamous carcinoma (n = 1), clear cell adenocarcinoma (n = 2), squamous carcinoma (n = 1), and hepatocellular carcinoma metastasis (n = 1). Conclusions: Even when the appearance of gallbladder specimens is normal, histopathological assessment allows for early diagnosis of many unusual findings such as gallbladder cancer.