Yazar "Kutlutürk, Koray" seçeneğine göre listele
Listeleniyor 1 - 20 / 20
Sayfa Başına Sonuç
Sıralama seçenekleri
Öğe Analysis of risk factors of mortality in abdominal trauma(2020) Gönültaş, Fatih; Kutlutürk, Koray; Gök, Ali Fuat Kaan; Barut, Bora; Şahin, Tevfik Tolga; Yılmaz, SezaiAbstract: BACKGROUND: The present study aims to analyze blunt and penetrating abdominal traumas that were evaluated in our emergency department, the treatment approaches and risk factors of mortality. METHODS: Six hundred and sixty-four patients were admitted to our emergency department for surgical evaluation for trauma between January 2009 and April 2019. After the exclusion of dead on arrival, patients with missing data and patients without abdominal trauma were excluded from this study. Hundred and thirteen patients with abdominal trauma admitted to our department were evaluated in this study. Demographic, clinical, prognostic and mortality related factors were retrospectively analyzed. RESULTS: The mean age of the patients was 36.08±16.1 years. There were 90 male patients. Eighty patients (70.8%) had blunt abdominal trauma (BAT). Twenty-eight patients (24.7%) had isolated liver and two patients (1.7%) had isolated spleen injury. Combined liver and spleen injury was found in two patients (1.7%). Twenty-two (19.4%) patients had mortality. Causes of mortality were an irreversible hemorrhagic shock (40.9%) and central nervous system (13.6%) injuries. BAT was the main mechanism of injury in patients with mortality (86.4% versus 67%; p<0.001). The frequency of retroperitoneal injury was significantly higher in patients with mortality (50% versus 16.5%, p<0.001). The frequency of extra-abdominal injury in patients with mortality was higher (68.1% versus 49.4%; p=0.047). Mean arterial pressure at admission was found to be significantly lower in patients with mortality (67±26.8 mmHg versus 84.3±17 mmHg; p=0.02). The number of packed erythrocytes transfused in patients with mortality was higher (8.8±8.6 versus 3.3±5.9 units; p=0.047). Mean international normalized ratio (INR) was significantly higher in patients with mortality (4.3±7.1 versus 2.7±4; p=0.016). Mean lactate dehydrogenase level was higher in patients with mortality (1685.7±333.8 versus 675.8±565.3 IU/mL; p<0.001). Mean alanine aminotransferase (ALT) was significantly higher in patients with mortality (430±619 versus 244±448 IU/mL; p<0.001). Mean alkaline phosphatase (ALP) level in patients with mortality was higher (76.9±72.8 versus 67.3±27.8 IU/mL; p=0.003). The presence of retroperitoneal injury and ALT >516 IU/mL were independent risk factors o mortality. CONCLUSION: We have found certain laboratory variables to increase in patients with mortality. These are related to the severity of trauma. Retroperitoneal injury and increased ALT levels being risk factors of mortality is the most important finding of this study. Our results can guide other centers in the evaluation of trauma patients, and high-risk groups can be identified.Öğe Coexistence of hashimoto's thyroiditis with papillary thyroid carcinoma: a single center experience(Turgut Özal Tıp Merkezi Dergisi, 2017) Kutlutürk, Koray; Ünal, Bülent; Çetin, SedatAbstract Aim: A positive correlation between Hashimoto's thyroiditis (HT) and papillary thyroid cancer (PTC) is determinated in studies based on histopathological examination of the thyroidectomy materials, but this correlation is not determinated in studies based on Fine Niddle Aspiration Biopsy (FNAB). In this study, the histopathologic results of bilateral total thyroidectomy (TT) specimens were studied for outcomes of PTC association with HT and its relationship with clinical and pathological prognostic factors. Material and Methods: Demographic data, thyroidectomy indications and pathology results of 568 patients with performed TT between April 2009 March 2016 were collected. PTC identified patients, were evaluated in terms of HT association. In these patients, the prognostic factors were evaluated according to coexistence of HT. Results: The average age of the patients was 48.9 years and M / F ratio was 1: 3.5. HT was detected in 36 patients and PTCin 121 patients by histopathological examinations. PTC incidence in HT group was higher than non-HT group. (p = 0.025). HT incidence in PTC group was higher than non-PTC group (p = 0.025).When compared in terms of demographic and prognostic data of PTC patiens,no statistically significant difference was detected between PTC with and without HT groups. Conclusion: PTC detection rate in patients with HT, who has indication for thyroidectomy is higher than non-HT patients. HT patients (especially female sex), should be followed closely, in terms of the development of malignant nodules. Keywords: Hashimoto's Thyroiditis; Papillary Thyroid Cancer; Thyroidectomy.Öğe Current approaches to esophageal variceal bleeding(J Turgut Ozal Med Cent, 2015) Ünal, Bülent; Kutlutürk, Koray; Pişkin, Turgut; Otan, Emrah; Aydın, Cemalettin; Yılmaz, SezaiEsophageal varices are collateral veins at the distal esophagus between gastric and azygos veins arising following increased portal pressure. Vein pressure above 10 mmHg is regarded as portal hypertension, in which portal vein-hepatic vein pressure gradient is increased. This status is seen as "clinically important portal hypertension" and it is most common in liver cirrhosis. Acid and esophageal variceal bleeding is the result of portal hypertension, which are the signs of advanced disease with poorer survival rates. Esophageal varices develop in 30% of the patients with compensated cirrhosis and 60-70% of the patients with decompensated cirrhosis. Varice development incidence is around 4-12% in cirrhotic patients without varices. Esophageal variceal hemorrhage has high recurrence, mortality, and morbidity rates requiring immediate medical treatment and these constitute approximately 10% of upper gastrointestinal bleeding, which is one of the major causes of mortality in patients with cirrhosis. Bleeding develops in 30% of the cirrhotic patients with esophageal varices diagnosed during endoscopy. The mortality of the first bleeding episode ranges from 25 to 70% and after the first bleeding episode rebleeding occurs at a rate of 75-80% in six to twelve months. Variceal diameter, grade, degree of red dots, and cirrhosis are among the factors that increase the risk of variceal bleeding. The risk of bleeding in Grade 1 varices is 8% and a higher grade increases the risk of bleeding four to five folds. Pharmacological endoscopic and antibiotic treatment constitutes the basis for esophageal variceal bleeding treatment. In this study, we aimed to evaluate the current approaches to esophageal variceal bleeding.Öğe Devam edilemeyen donör hepatektomi olgularımız(İnönü Üniversitesi, 2013) Kutlutürk, KorayCVKN organ havuzunu genişletmek için uygulanabilecek güvenli bir yöntemdir. Uygun donor hazırlığı postoperatif morbidite ve mortaliteyi önlemek açısından multidisipliner olarak detaylı bir şekilde yapılmalıdır. Ancak önceden kestirilemeyen donöre ya da alıcıya ait bazı nedenlerle donor ve/veya alıcı operasyonlarına devam edilemediği durumlar ile karşılaşılabilmektedir. Bu çalışmada devam edilemeyen ve farklı aşamalarda sonlandırılan donor hepatektomi olgularımız retrospektif olarak incelenmiştir. Materyal ve Metod: MerkezimizdeMart 2002 tarihinden, 2013 Eylül ayı sonuna kadar toplam 1151 karaciğer nakli yapıldı. Bunların 900?ü (% 78,2) canlı vericili karaciğer nakli olup, 251?i (% 21,8) kadaverik karaciğer naklidir. Bu süre aralığında toplam 935 donör adayı donör hepatektomi için operasyona alınmış ve bunlardan 35?inin (% 3.7) donör hepatektomi operasyonları operasyonun çeşitli aşamalarında beklenmeyen çeşitli nedenlerle sonlandırılmıştır. Bu 35 olgu retrospektif olarak değerlendirilmiş, operasyonlara devam edilememe ve sonlandırılma nedenleri incelenmiştir. Donör ve recipient adaylarına ait nedenlerdetaylı olarak tartışılmıştır. Bulgular: Olguların yaş ortalaması 40,6 ± 10,7 idi. Ortalama VKİ?i 26,8 ± 4,1, ortalama hastanede kalış süresi 4,6 ± 1,7 gündü. Bu donör adayları ortalama 19,1 ± 17,7 ay takip edildi. Yedi olguda tek, bir olguda ise üç olmak üzere toplam 10 komplikasyon gelişti. En sık yara yeri enfeksiyonugörüldü. Erken postoperatif dönemde yalnızca bir olguda kanama nedeni ile tekrar operasyon gerekti.Bir olguda ise postopertif sağ plexus brakialis zedelenmesi tespit edildi. Devam edilemeyen donör hepatektomi olgularımızın 26?sı (% 74,3) donöre bağlı nedenlerle, 8?i (% 22,9) alıcıya bağlı nedenlerle, bir tanesi (% 2,9) diğer nedenlerle sonlandırılmıştır. Donöre bağlı nedenlerle devam edilemeyen donör hepatektomi olgularında en sık neden % 40 ile greftte histopatolojik olarak yağlanmanın tespit edilmesiydi. Sonuç: Donör güvenliği açısından intraoperatif beklenmedik bulgular nedeni ile donör hepatektomi operasyonlarının sonlandırılabileceği her zaman akılda tutulmalıdır. Devam edilemeyen donör hepatektomi olgularının sayısını azaltmak için, özellikle operasyon öncesi alıcı ve verici adaylarının, radyoloji ekibi ve organ nakli ekibi tarafınca ciddi bir işbirliği ile değerlendirilmesi gerekmektedir. Ayrıca cerrahi tecrübenin artmasıyla, devam edilemeyen donör hepatektomi olgularının azalacağını düşünmekteyiz.Öğe Donor postoperative biliary complications after living donor liver transplant(Experimental and Clinical Transplantation, 2015) Dirican, Abuzer; Ara, Cengiz; Kutlutürk, Koray; Özsoy, Mustafa; Ateş, Mustafa; Başkıran, Adil; Işık, Burak; Yılmaz, SezaiAlthough the main factors responsible for donor deaths after living-donor liver transplant are liver failure and sepsis, the most common donor complications are associated with the biliary tract.Between April 2006 and May 2012, five hundred ninety-three donors underwent living-donor hepatectomy procedures for living-donor liver transplants. The mean age of donors was 31.0 ± 9.9 years and the ratio of men to women was 341:252. Of all donors, 533 (89.9%) underwent a right lobe hepatectomy, 45 (7.6%) underwent a left lateral segmentectomy, and 15 (2.5%) underwent a left hepatectomy.Biliary complications were observed in 51 liver donors (8.6%). Based on the Clavien-Dindo classification, grade I and grade II complications were 3.2% and 0%, while grade IIIa and grade IIIb complications were observed in 3.5% and 1.85% of cases. Right lobe donor biliary complications occurred at the rate of 8.2% in 44 donors. Grade IV and grade V complications were not observed. Grade IIIa complications necessitating radiologic and endoscopic procedures were observed in 21 liver donors (3.5%). Bile leakage unresponsive to medical therapy was detected in 19 donors (3.2%). Nasobiliary catheters were placed in 3 of 19 donors and internal stents were placed in 1. Two sessions of balloon dilatation were performed in the 2 grade IIIb donors (0.33%). Biliary strictures observed in 2 right lobe donors and 1 left lobe donor was treated by hepaticojejunostomy an average of 14 months after surgery.Avoidance of intraoperative issues and early recognition of bile leakage are fundamental in preventing complications in living-donor liver transplant donors.Öğe Donor postoperative biliary complications after living donor liver transplant(Experimental and Clinical Transplantation, 13(6), 0–0., 2015) Dirican, Abuzer; Ara, Cengiz; Kutlutürk, Koray; Özsoy, Mustafa; Ateş, Mustafa; Başkıran, Adil; Işık, Burak; Yılmaz, SezaiObjectives: Although the main factors responsible for donor deaths after living-donor liver transplant are liver failure and sepsis, the most common donor complications are associated with the biliary tract. Materials and Methods: Between April 2006 and May 2012, five hundred ninety-three donors underwent living-donor hepatectomy procedures for living-donor liver transplants. The mean age of donors was 31.0 ± 9.9 years and the ratio of men to women was 341:252. Of all donors, 533 (89.9%) underwent a right lobe hepatectomy, 45 (7.6%) underwent a left lateral segmentectomy, and 15 (2.5%) underwent a left hepatectomy. Results: Biliary complications were observed in 51 liver donors (8.6%). Based on the Clavien-Dindo classification, grade I and grade II complications were 3.2% and 0%, while grade IIIa and grade IIIb complications were observed in 3.5% and 1.85% of cases. Right lobe donor biliary complications occurred at the rate of 8.2% in 44 donors. Grade IV and grade V complications were not observed. Grade IIIa complications necessitating radiologic and endoscopic procedures were observed in 21 liver donors (3.5%). Bile leakage unresponsive to medical therapy was detected in 19 donors (3.2%). Nasobiliary catheters were placed in 3 of 19 donors and internal stents were placed in 1. Two sessions of balloon dilatation were performed in the 2 grade IIIb donors (0.33%). Biliary strictures observed in 2 right lobe donors and 1 left lobe donor was treated by hepaticojejunostomy an average of 14 months after surgery. Conclusions: Avoidance of intraoperative issues and early recognition of bile leakage are fundamental in preventing complications in living-donor liver transplant donors. Key words: Liver failure, Sepsis, Bile leakage, Hepatectomy, Postoperative follow-upÖğe Donor postoperative biliary complications after living donor liver transplant(Experimental and Clinical Transplantation, 2015) Dirican, Abuzer; Ara, Cengiz; Kutlutürk, Koray; Özsoy, Mustafa; Ateş, Mustafa; Başkıran, Adil; Işık, Burak; Yılmaz, SezaiObjectives: Although the main factors responsible for donor deaths after living-donor liver transplant are liver failure and sepsis, the most common donor complications are associated with the biliary tract. Materials and Methods: Between April 2006 and May 2012, five hundred ninety-three donors underwent living-donor hepatectomy procedures for living-donor liver transplants. The mean age of donors was 31.0 ± 9.9 years and the ratio of men to women was 341:252. Of all donors, 533 (89.9%) underwent a right lobe hepatectomy, 45 (7.6%) underwent a left lateral segmentectomy, and 15 (2.5%) underwent a left hepatectomy. Results: Biliary complications were observed in 51 liver donors (8.6%). Based on the Clavien-Dindo classification, grade I and grade II complications were 3.2% and 0%, while grade IIIa and grade IIIb complications were observed in 3.5% and 1.85% of cases. Right lobe donor biliary complications occurred at the rate of 8.2% in 44 donors. Grade IV and grade V complications were not observed. Grade IIIa complications necessitating radiologic and endoscopic procedures were observed in 21 liver donors (3.5%). Bile leakage unresponsive to medical therapy was detected in 19 donors (3.2%). Nasobiliary catheters were placed in 3 of 19 donors and internal stents were placed in 1. Two sessions of balloon dilatation were performed in the 2 grade IIIb donors (0.33%). Biliary strictures observed in 2 right lobe donors and 1 left lobe donor was treated by hepaticojejunostomy an average of 14 months after surgery. Conclusions: Avoidance of intraoperative issues and early recognition of bile leakage are fundamental in preventing complications in living-donor liver transplant donors. Key words: Liver failure, Sepsis, Bile leakage, Hepatectomy, Postoperative follow-upÖğe Early portal vein thrombosis after pediatric liver transplantation: Assesment of risk factors(2023) Karakas, Serdar; Şahin, Tevfik Tolga; Sarıcı, Barış; Usta, Sertaç; Kutlutürk, Koray; Varol, Fatma İlknur; Sağlam, KutayAim: Despite advancements in surgical techniques, early portal vein thrombosis (ePVT) continues to be one of the major complications of liver transplantation (LT) in pediatric age group. Possible risk factors are portal vein diameter < 5 mm, infancy, patient body weight < 10 kg and high graft recipient weight ratios (GRWR > 4.0). We retrospectively evaluated our records of pediatric LTs’ in terms of ePVT and possible risk factors determining development of this dreaded complication. Materials and Methods: Between January 2018 and January 2022, 228 LTs were performed for pediatric age (under the age of 18) group at Inonu University, Liver Trans- plantation Institute. Among these patients, 212 were eligible for the study. Patients with ePVT were defined as Portal Vein Thrombüs Group (PVTG) and patients with no Portal Vein thrombosis were defined in control group (CG). ePVT was described as detection of impeded portal venous outflow with imaging studies either perioperatively or within postoperative 3 days . Demographic, clinical and operative variables were retrospectively evaluated. Results: Among 212 LTs, 24 cases were complicated with ePVTs (11.3 %). Preoperative platelet counts, etiology of Budd-Chiari, postoperative hepatic artery thrombosis (HAT) and lower age were significantly higher for early PVT. In multivariate analysis, preop- erative platelet levels, etiology of Budd-Chiari and postoperative HAT were significantly higher for PVT. One and 5 years overall survivals (OS) for PVTG and CG were 50.0 % - 50.0 % and 69 % - 63 % respectively. No significant OS difference was observed despite much more patients were died in PVTG. Conclusion: High preoperative platelet counts, Budd-Chiari syndrome and postoperative HAT are predictive factors for ePVT. Anti-thrombotic prophylaxes can be considered in high-risk patients. Venous jump grafts seem to have no effect on ePVT. Despite PVT increases the mortality rates, it can be resolved easily with immediate reoperation.Öğe Immunohistochemical profile in malignant ovarian tumors operated in our center and its discriminative importance(2020) Baloğlu, Demet; Çoşkun, Ebru İnci; Alan, Saadet; Yılmaz, Ercan; Yılmaz, Ercan; Kutlutürk, KorayAbstract: The aim of this study is to determine the correlation of histopathological subtype with frozen section examination and the importance of immunohistochemical analysis of ovarian malignancies which also include metastatic ones. This study is a retrospective study that have included 55 patients who have been operated for adnexial tumor and have the diagnosis of malignancy during surgery by frozen section or after surgery by final pathologic examination done by immunohistochemistry (IHC). The mean age of the patients with malignant ovarian tumor is 52.33 ± 15.5 years. When the pathologic diagnosis reports examined it has been found that 34 of 55 patients (61.8 %) have had epithelial type, 9 have had sex cord stromal tumor, 3 have had germ cell type and 9 of the patients have had metastatic ovarian cancer. Survival rates have been found as 70.6 % for epithelial ovarian cancer, 100 % for sex cord stromal tumors, 100 % for germ cell tumor and 44.4 % for metastatic tumors. Despite the rapid development in examination and imaging methods, histopathology is the pivotal issue in the diagnosis and also in sub-type diagnosis of pelvic mass lesions. The improvement is better in patients evaluated and operated in gynecologic oncology centers. The two important factor in this subject is the experience of the surgeon for maximum salvage from the tumoral burden and the well examination by frozen section the immunohistochemical methods for the discrimination of gastrointestinal tumors which can mimic ovarian primary tumors. Immunohistochemical methods have very important progression in diagnosis of cancer, its origin and subtypes and however IHC also could have a key role in treatment of cancer by targeted therapy.Öğe Is peritoneal dialysis prior to kidney transplantation a risk factor for ureteral stenosis after adult to adult live kidney transplantation(2020) Kutlutürk, Koray; Şahin, Tevfik Tolga; Çimen, Serhan; Dalda, Yasin; Gönültaş, Fatih; Doğan, Sait Murat; Toplu, Sibel; Ünal, Bülent; Pişkin, TurgutAbstract: Objective: Major urinary complications such as urinary leaks, stenosis or urinary tract infections after kidney transplantation can lead to graft or patient loss. The effect of peritoneal dialysis on post-kidney transplantation complications have been discussed but its effect on ureteral stenosis is unknown. In this study, it was aimed to analyze factors effecting major ureteral complications after living donor kidney transplantation and impact of peritoneal dialysis and double J-stents (JJ stents). Material and Methods: This study included 116 adult to adult living donor kidney transplant patients. Factors effecting major urologic complications after living donor kidney transplantation were analyzed. The donors were primary relatives of the recipients. Results: Major urologic complications after living donor kidney transplantation was 8/116 (6.9%). Urinary leak was present in 2 (1.7%) patients. Ureteral stenosis was encountered in 6 (5.2%) patients. Double J stents were used in 84 (72.4%) of the cases. The effect of JJ ureteral stent was not statistically significant for urinary leak, ureteral stenosis (p= 0.074, p= 0.470, respectively). A total of 29 (25%) patients had peritoneal dialysis before kidney transplantation. Preoperative peritoneal dialyses and bacteriuria after kidney transplantation were independent risk factors for ureteral stenosis in multivariate analysis (p= 0.013, and p= 0.010 respectively). Conclusion: In the guidance of the results of the present study, peritoneal dialysis prior to kidney transplantation and bacteriuria are independent risk factors for ureteral stenosis after living donor kidney transplantation. JJ stents have no effect on urologic complications after living donor kidney transplantation.Öğe The management of acute appendicitis in liver transplant patients: How effective is the Alvarado score?(2017) İnce, Volkan; Barut, Bora; Özdemir, Fatih; Kutlutürk, Koray; Gönültaş, Fatih; Onur, Asım; Kutlu, Ramazan; Yılmaz, SezaiAbstract: OBJECTIVE: The incidence of acute appendicitis after liver transplantation (LT) is extremely low, reported to be 0.09% to 0.49%, but the efficacy of the Alvarado score in this patient group has not been studied. This study was an investigation of the clinical management of patients who developed acute appendicitis after LT and the usefulness of the Alvarado score in the diagnosis.METHODS: The study was performed using the data of 7 patients treated for acute appendicitis who were among 1990 patients who underwent LT between March 2002 and July 2017. The Alvarado score of the patients was calculated and reliability was analyzed.RESULTS: In this study, the incidence of acute appendicitis in LT patients was 0.35%. All of the patients were in the adult age group; 86% were male. The mean age was 46.4±10.7 years and the timeframe for the development of appendicitis after transplantation was a median of 12 months (range: 4-101 months). The median Alvarado score was 7 . All of the patients had an Alvarado score above 5 and 71% had a score of 7 or more.CONCLUSION: Acute appendicitis is very rare in LT patients. As with non-transplant patients, Alvarado scoring can be safely performed in LT patients.Öğe Özofagus varis kanamalarına güncel yaklaşımlar(İnönü Üniversitesi Tıp Fakültesi Dergisi, 2015) Ünal, Bülent; Kutlutürk, Koray; Pişkin, Turgut; Otan, Emrah; Aydın, Cemalettin; Yılmaz, SezaiÖzofagus varisleri portal kan basıncının artmasına bağlı, özofagusun distalinde gastrik venler ile azigos ven arasında geşilen kolaterallerdir. Portal ven basıncının 10 mm Hg’nin üzerinde olmasına portal hipertansiyon denilir. Portal hipertansiyonda portal ven – hepatik ven basınç gradiyenti artmıştır. Bu durum “klinik olarak önem arz eden portal hipertansiyon” olarak adlandırılmaktadır ve en sık karaciğer sirozunda karşılaşılır. Karaciğer sirozu olan hastalarda asit oluşumu ve özofagus varis kanamalarının olması ilerlemiş hastalık belirtileridir ve bu hastaların beklenen yaşama süresi oldukça kısalmıştır. Kompanze sirozlu hastaların %30’unda dekompanze sirozlu hastaların %60-70’inde özofagus varisi gelişmektedir. Varisi olmayan sirotik hastalarda yıllık varis oluşum hızı %4-12 dolayındadır. Özofagus varis kanaması yüksek rekürrens, mortalite ve morbidite oranına sahip acil medikal tedavi gerektiren hastalıklardan biridir. Özofagus varis kanamaları üst gastrointestinal sistem kanamalarının yaklaşık %10’unu oluştururlar ve sirozlu hastalarda başlıca mortalite nedenlerindendir. Özofagus varis kanaması, endoskopik olarak özofagus varisi saptanan sirotik hastaların %30'unda gelişmektedir. İlk kanama epizodunun mortalitesi % 25-70 arasında değişmektedir ve ilk kanama sonrası varislerin % 75-80’inde altı ay ya da bir yıl içinde yeniden kanama meydana gelir. Varis çapı, grade, kırmızı noktalanmalar ve siroz derecesi varis kanaması riskini arttıran faktörlerdir. Grade 1 varislerde kanama riski %8 iken grade arttıkça kanama riski 4-5 kat artmaktadır. Özofagus varis kanamalarında tedavinin temelini farmakolojik, endoskopik ve antibiyotik tedavisi oluşturur. Bu çalışmada özofagus varis kanamalarına güncel yaklaşımlar ele alınmıştır.Öğe Partial cholecystectomy a technique that makes hilar dissection easier in recipient hepatectomy(Transplant Proc., 2014) Ara, Cengiz; Özdemir, Fatih; Ateş, Mustafa; Özgör, Dinçer; Kutlutürk, KorayBackground. Intraoperative blood loss and red blood cell transfusion requirements have a negative impact on outcome after orthotopic liver transplantation. In this study we compared blood transfusion requirements, bile duct injury, and dissection of hepatic artery rates in the patients with or without partial cholecystectomy during recipient hepatectomy. Methods. From December 2008 to August 2011, 100 recipient hepatectomies were performed by the same surgeon. Patients were divided into 2 groups. The first group included patients with partial cholecystectomy, and the other group patients without partial cholecystectomy. Each group consisted of 50 patients. Results. In recipient hepatectomy group without partial cholecystectomy, intraoperative blood transfusions were in the range of 3e11 units (mean, 6.3 units). In this group there were 4 hepatic artery dissections and 2 bile duct injuries. In the group with partial cholecystectomy, intraoperative blood transfusions were in the range of 0e7 units (mean, 3.1 units). In this group there was 1 hepatic artery dissection. There were no operative mortalities in either group. Conclusions. We recommend partial cholecystectomy during recipient hepatectomy of cirrhotic patients, particularly with hydropic gallbladders, because bleeding from the points of adherent gallbladder during mobilization of the liver is diminished and fewer artery dissections and bile duct injuries develop, because the procedure facilitates dissection of the hilar structures.Öğe Partial cholecystectomy a technique that makes hilar dissection easier in recipient hepatectomy(Transplant Proc., 2014) Ara, Cengiz; Özdemir, Fatih; Ateş, Mustafa; Özgör, Dinçer; Kutlutürk, KorayIntraoperative blood loss and red blood cell transfusion requirements have a negative impact on outcome after orthotopic liver transplantation. In this study we compared blood transfusion requirements, bile duct injury, and dissection of hepatic artery rates in the patients with or without partial cholecystectomy during recipient hepatectomy. Methods. From December 2008 to August 2011, 100 recipient hepatectomies were performed by the same surgeon. Patients were divided into 2 groups. The first group included patients with partial cholecystectomy, and the other group patients without partial cholecystectomy. Each group consisted of 50 patients. Results. In recipient hepatectomy group without partial cholecystectomy, intraoperative blood transfusions were in the range of 3e11 units (mean, 6.3 units). In this group there were 4 hepatic artery dissections and 2 bile duct injuries. In the group with partial cholecystectomy, intraoperative blood transfusions were in the range of 0e7 units (mean, 3.1 units). In this group there was 1 hepatic artery dissection. There were no operative mortalities in either group. Conclusions. We recommend partial cholecystectomy during recipient hepatectomy of cirrhotic patients, particularly with hydropic gallbladders, because bleeding from the points of adherent gallbladder during mobilization of the liver is diminished and fewer artery dissections and bile duct injuries develop, because the procedure facilitates dissection of the hilar structures.Öğe The predictivity of thyroid fine-needle aspiration biopsy varies depending on the radiologist experience: A retrospective cohort study(2019) Gönültaş, Fatih; Kutlutürk, Koray; Dalda, Yasin; Barut, Bora; Alan, Saadet; Ünal, BülentAbstract: Aim: To compare thyroid fine-needle aspiration biopsy with histopathological examination results.Material and Methods: Postoperative histopathological examination results of 361 patients, who were thyroidectomized betweenDecember 2010 and October 2017 in Inonu University Turgut Ozal Medical Center Department of General Surgery and whosepreoperative FNAB registries we could reach were evaluated retrospectively. Biopsies made in external centers were included inpreoperative FNAB results. FNAB results were examined according to Bethesda 2007 in 6 categories: unsatisfactory, benign, atypiaof undetermined significance, follicular lesion-neoplasm or suspicious for a neoplasm, suspicious for malignancy and malignant.Histopathological results of patients with incidental malignancy were presumed benign.Results: Among the 361 patients that were included in the study, 274 were female (75.9%), 87 were male(24.1%). Mean age of thepatients in the benign group was 49.1±12.5 years, and 48.6±13.5 years in the malignant group. It was found that FNAB’s sensitivitywas 83.9 %, specificity was 92.4%, false positive rate was 16.1% and false negative rate was 7.6%.Conclusion: FNAB is reported as the gold standard for preoperative evaluation of thyroid nodules. In our study, however, it wasseen that FNAB was not adequate alone tÖğe The predictors of malignancy in thyroid nodules with atypia of undetermined significance or follicular lesions of undetermined significance(2020) Şimsek, Arife; Kutlutürk, KorayAim: This study aimed to evaluate clinical, radiological and laboratory (neutrophil-to-lymphocyte and platelet-to-lymphocyte ratios, and mean platelet value) features that may better define the rate of malignancy in order to contribute to the management of thyroid nodules with AUS/FLUS.Material and Methods: The data of patients with histologic findings of AUS/FLUS on FNA, who underwent surgery at General Surgery Department in a tertiary care hospital between January 2012 and December 2019, were reviewed retrospectively. The patients with any other malign and/or inflammatory diseases and continued on corticosteroid therapy and/or chemotherapy were excluded.Results: The current study included 60 patients (73.3% women), who underwent surgery for 62 thyroid nodules classified as AUS/ FLUS. The specimen pathology revealed a thyroid malignancy in 16 patients, including 10 patients with papillary cancer, 5 patients with micro-papillary thyroid cancer, 1 patient with minimally invasive follicular carcinoma. Ten patients had follicular adenoma. The remaining 35 patients (37 nodules) had nodular colloidal hyperplasia and/or chronic lymphocytic thyroiditis. The rates of malignancy (ROM) and neoplasia (RON) were 25.8% and 40.3%, respectively. Nearly half of the cases (41.9%) had chronic lymphocytic thyroiditis. The malignancy rate in cases with chronic lymphocytic thyroiditis was 26.9%, which was similar in cases without (25%). In multivariate analysis, only microcalcifications were found to be positively associated with malignancy (p: 0.1; [OR] 5.185; CI95% 1.4-19.18).Conclusion: Chronic lymphocytic thyroiditis may lead to overestimation of AUS/FLUS results. It was not associated with malignancy in thyroid nodules with AUS/FLUS. Inflammatory values, such as NLR, PLR and MPV, were not useful markers of malignancy. Among all variables only US findings (microcalcifications according to the current study) may be useful in risk-stratification of malignancyin thyroid nodules with AUS/FLUS.Öğe Primer hiperparatiroidiye eşlik eden tiroid patolojileri: yüksek tiroid papiller mikrokarsinom oranı(Ulusal Cerrahi Dergisi, 2014) Kutlutürk, Koray; Otan, Emrah; Yağcı, Mehmet Ali; Usta, Sertaç; Aydın, Cemalettin; Ünal, Bülent[Abstract Not Acailable]Öğe Pseudoangiomatous stromal hyperplasia of the breast presenting as a giant breast tumor a case report(J Breast Health, 2015) Kutlutürk, Koray; Usta, Sertaç; Ünal, Bülent; Karadağ, Neşe; Akatlı, Ayşe NurPseudoangiomatous stromal hyperplasia (PASH) of the breast is a benign proliferative lesion of mammary stroma. It is identified as stromal cleavage surrounded by spindle-shaped stromal cells histomorphologicaly. Generally, it is determined in premenopausal women incidentally during breast biopsy. Clinically, it is rarely emerges as a palpable mass. PASH may be confused with low-grade angiosarcoma, hamartomas and phyllodes tumors in histopathological examination. Here, we report a giant left breast lesion that caused breast asymmetry and pain, and treated by total excision of the mass. The patient was a 39 years old women. Histopathologic examination of the specimen was evaluated as PASH. No additional medical treatment and clinical follow-up was recommended to patient. Within four months of the patient fallow-up, no problem occured.Öğe Unusual histopathological findings in appendectomy specimens from patients with suspected acute appendicitis(World Journal of Gastroenterology, 2013) Yılmaz, Mehmet; Akbulut, Ahmet Sami; Kutlutürk, Koray; Şahin, Nurhan; Arabacı, Ebru; Ara, Cengiz; Yılmaz, SezaiTo investigate the prevalence and implications of unusual histopathological findings in appendectomy specimens from patients with suspected acute appendicitis. METHODS: The demographic and histopathological data of 1621 patients (≥ 16 years-old) who underwent appendectomy to treat an initial diagnosis of acute appendicitis between January 1999 and November 2011 were retrospectively assessed. Microscopic findings were used to classify the patients under six categories: appendix vermiformis, phlegmonous appendicitis, gangrenous appendicitis, perforated appendicitis, supurative appendicitis, and unusual histopathologic findings. The demographic and clinicopathologic characteristics of patients with unusual histopathologic findings were evaluated in detail, and re-analysis of archived resected appendix specimens was carried out. RESULTS: A total of 912 males and 709 females, from16 to 94 years old, were included in the study and comprised 789 cases of suppurative appendicitis, 370 cases of appendix vermiformis, 243 cases of perforated gangrenous appendicitis, 53 cases of flegmaneous appendicitis, 32 cases of gangrenous appendicitis, and 134 (8.3%) cases of unusual histopathological findings. The unusual histopathological findings included fibrous obliteration (n = 62), enterobius vermicularis (n = 31), eosinophilic infiltration (n = 10), mucinous cystadenoma (n = 8), carcinoid tumor (n = 6), granulomatous inflammation (n = 5), adenocarcinoma (n = 4; one of them mucinous), and mucocele (n = 3), adenomatous polyp (n = 1), taenia sup (n = 1), ascaris lumbricoides (n = 1), appendiceal diverticula (n = 1), and B cell nonhodgkin lymphoma (n = 1). None of the 11 patients with subsequent diagnosis of tumor were suspected of cancer prior to the appendectomy. CONCLUSION: Even when the macroscopic appearance of appendectomy specimens is normal, histopathological assessment will allow early diagnosis of many unusual diseases.Öğe Unusual histopathological findings in appendectomy specimens from patients with suspected acute appendicitis(World Journal of Gastroenterology, 19(25), 4015–0., 2013) Yılmaz, Mehmet; Akbulut, Ahmet Sami; Kutlutürk, Koray; Şahin, Nurhan; Arabacı, Ebru; Ara, Cengiz; Yılmaz, SezaiAIM: To investigate the prevalence and implications of unusual histopathological findings in appendectomy specimens from patients with suspected acute appendicitis. METHODS: The demographic and histopathological data of 1621 patients (≥ 16 years-old) who underwent appendectomy to treat an initial diagnosis of acute appendicitis between January 1999 and November 2011 were retrospectively assessed. Microscopic findings were used to classify the patients under six categories: appendix vermiformis, phlegmonous appendicitis, gangrenous appendicitis, perforated appendicitis, supurative appendicitis, and unusual histopathologic findings. The demographic and clinicopathologic characteristics of patients with unusual histopathologic findings were evaluated in detail, and re-analysis of archived resected appendix specimens was carried out. RESULTS: A total of 912 males and 709 females, from 16 to 94 years old, were included in the study and comprised 789 cases of suppurative appendicitis, 370 cases of appendix vermiformis, 243 cases of perforated gangrenous appendicitis, 53 cases of flegmaneous appendicitis, 32 cases of gangrenous appendicitis, and 134 (8.3%) cases of unusual histopathological findings. The unusual histopathological findings included fibrous obliteration (n = 62), enterobius vermicularis (n = 31), eosinophilic infiltration (n = 10), mucinous cystadenoma (n = 8), carcinoid tumor (n = 6), granulomatous inflammation (n = 5), adenocarcinoma (n = 4; one of them mucinous), and mucocele (n = 3), adenomatous polyp (n = 1), taenia sup (n = 1), ascaris lumbricoides (n = 1), appendiceal diverticula (n = 1), and B cell non-hodgkin lymphoma (n = 1). None of the 11 patients with subsequent diagnosis of tumor were suspected of cancer prior to the appendectomy. CONCLUSION: Even when the macroscopic appearance of appendectomy specimens is normal, histopathological assessment will allow early diagnosis of many unusual diseases.
