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    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, Sadettin
    Background & 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.
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    The feasibility of falciformopexy in the repair of peptic ulcer perforation
    (Turkish Assoc Trauma Emergency Surgery, 2023) Terzioglu, Serdar Gokay; Canlikarakaya, Firat; Ocakli, Serhat; Ceylan, Cengiz; Agackiran, Ibrahim; Akinci, Felat; Kilic, Murat Ozguer
    BACKGROUND: Modified Graham omentopexy is the most commonly used operative technique in the repair of peptic ulcer perforation (PUP); however, there is little data on falciformopexy in the literature. The aim is to investigate the feasibility of falciformopexy in the repair of PUP, comparing with modified Graham omentopexy.METHODS: Data of 471 patients who were operated for PUP were retrospectively analyzed. Patients' demographics, pre-operative basic laboratory findings, American Society of Anesthesiologists (ASA) status, operative findings, and post-operative complications were recorded. The patients were classified into two groups modified Graham omentopexy and falciformopexy, and then compared with each other in terms of clinical characteristics, operative findings, and post-operative complications.RESULTS: Modified Graham omentopexy and falciformopexy were performed in 425 (90.2%) and 46 (9.8%) patients, respectively. The two groups were similar in terms of basic patient characteristics and pre-operative laboratory findings (P>0.05). ASA physical status was significantly different between the groups (P=0.001). No statistically significant difference was found between the groups in terms of complications, except for an anastomotic leak. Anastomotic leak was observed more frequently in patients who underwent falciformopexy than in patients with modified Graham omentopexy (P=0.017). CONCLUSION: Although falciformopexy technique has a higher rate of leak compared to the modified Graham omentopexy method, it should be kept in mind as an alternative method for repair of PUP, especially in cases where omentopexy cannot be applied for various reasons such as the presence of unavailable or unsuitable omentum.