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    Comparison of carcinoid tumors with the other tumors of appendix
    (2019) Cakar, Ekrem; Gurbulak, Bunyamin; Duzkoylu, Yigit; Colak, Sukru; Bektas, Hasan
    Aim: Carcinoid tumor is the most frequent primary tumor of the appendix which may reach up to 60% of all appendiceal neoplasms. We aimed to evaluate the incidental appendiceal carcinoid tumors following acute appendicitis analyzing the demographics, clinical, laboratory, pathological features and follow-up results of the patients. Material and Methods: We evaluated the patients retrospectively who had been operated for acute appendicitis between January 2006 and May 2018 . Results: We found 29 patients with carcinoid tumor among 7122 cases (0.4%) between 2006-2018. Median size of tumors was found to be 7.5 mm (Min: 0.8, max: 20 mm). While appendectomy was sufficient for 27 of the patients, right hemicolectomy was performed for 2 cases. When labaratory values were analysed the neutrophil / WBC ratio was significantly higher and lymphocyte count in the study group was significantly lower than control group (p < 0.05). The neutrophil / lymphocyte ratio was significantly higher than control group (p < 0.05). Conclusion: Evaluation of laboratory values at admission, histopathological examination of appendiceal specimens, early diagnosis of cancer and performing the appropriate treatment are required for the survival of patients.
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    Comparison of diagnostic efficacy of mrcp and ercp in the management of choledocholithiasis
    (2019) Gurbulak, Bunyamin; Ucuncu, Muhammed Zubeyr
    Aim: We compared the accuracy of MRCP and ERCP findings in the management of suspected common bile duct stones. Material and Methods: Between September and December 2017, 104 patients underwent MRCP and then ERCP to explain the etiology of cholestasis and elevated liver enzymes and / or the bilirubin levels. Laboratory values and MRCP were compared with ERCP findings for the accuracy and reliability of laboratory and radiological findings. Results: The one-hundred four patients underwent MRCP and then ERCP. Of these, 49 (47.1%) were males. The mean age of the patients was 60.7 ± 16.4 years. When compared MRCP and ERCP findings, the sensitivity of MRCP was 71%, specificity was 35%, negative predictive value (NPV) was 31% and positive predictive value(PPV) was 75%. The accuracy rate was calculated as 61% Conclusion: The diagnosis of choledocholithiasis, should have been done with primarily MRCP and EUS should be used in cases when MRCP is inadequate. ERCP should be used for only in therapeutic procedures.
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    Comparison of mesh plug and laparoscopic TEPP techniques in the repair of inguinal hernia
    (2018) Colak, Sukru; Gurbulak, Bunyamin
    Aim: We aimed to compare the Mesh-Plug technique, which we used for tension-free inguinal hernia, with the anterior approach and Laparoscopic TEPP(Total Extraperitoneal Preperitoneal) technique, which we used routinely, in terms of operation time, postoperative pain, return time to work, post-operative complication and recurrence. Material and Methods: Between February 1999 and December 2002, 60 patients who underwent Mesh-Plug and 62 patients with inguinal hernia who underwent laparoscopic TEPP between January 2012 and December 2014 were reviewed retrospectively in our clinic. The age, gender, hernia localization and type, duration of operation, type of anesthesia, duration of return to work and postoperative complications of the patients were recorded. Results: The median age was 40.1 (17-69) in the Mesh-Plug group and 29.2 (20-44) in the TEPP group. The median duration of operation was 29 (20-55) minutes in the Mesh-Plug group and 66.3 (44-88) minutes in the TEPP group (p: 0.04). The duration of hospital stay was 1.2 (1-3) days in the Mesh-Plug group and 1.12(1.1- 1.3) days in the TEPP group (p>0.05). The TEPP group had a shorter duration of postoperative pain and shorter duration in returning to work and daily activities. Conclusion: The Mesh-Plug method, which is quite cost effective, can be applied with anterior approach and spinal anesthesia. When the Mesh-Plug technique was compared with the laparoscopic TEPP, which is applied under general anesthesia, the duration of hospital stay, the return time to daily activities, and the complications rates were very close.
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    Surgery of Zenker’s diverticulum; Single center experience
    (2018) Colak, Sukru; Gurbulak, Bunyamin; Cakar, Ekrem; Bektas, Hasan
    Aim: Zenker’s diverticulum is the most frequently seen esophageal diverticula. Zenker’s diverticulum should be considered that the patients have symptoms such as dysphagia, regurgitation of undigested food, turbulence sound, chronic cough, weight loss, and halytosis. We aimed to evaluate the patients whom underwent diverticulectomy and cricomyotomy due to Zenker’s diverticulum located in the proximal esophagus in terms of demographic features, operative type, postoperative complications and recurrence. Material and Methods: Between January 2013 and 2018, 10 patients (9 female and 1 male) who underwent surgery due to dysphagia because of the Zenker’s diverticulum were evaluated retrospectively. The median age of the patients was 67.5 (47-77). Because of the dysphagia was the most frequently symptom, initial evaluation was performed with upper gastrointestinal system endoscopy (UGSE). All patients were examined barium esophagography and some patients with tomography.Dysphagia levels of the patients were evaluated before and after the operation. Patients were followed-by endoscopy 1 and 6th. months after surgery. Results: Complications, mortality and morbidity were not seen in postoperative early and late periods. Only 1 patient had recurrence. When compared the dysphasia scores of the patients before and after surgery were significantly improved after operation. Conclusion: Diverticulectomy and cricomyotomy operations in Zenker’s diverticulum are effective and safe procedures.