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    Management of surgical oncology patients during the COVID-19 pandemic: Short-term results
    (2022) Bakir, Huseyin; Yordanagil, Mevlut; Okan, Ismail
    Aim: In our study, the effect of the pandemic on the treatment of surgical oncology patients and its short-term results were investigated. The Coronavirus Disease 2019 pandemic has put a heavy burden on healthcare institutions. During this period, treatment of many diseases, including cancer patients, have been disrupted. Methods: Our study was designed as a retrospective, observational study. It was investigated to what extent the treatment of patients receiving cancer treatment was affected and what changes were made in the management of patients diagnosed with cancer during the pandemic period. Results: The 148 cancer cases were discussed at Multidisciplinary Meetings (MDM) held in our clinic between December 2019 and May 2020. Of the patients, 76 (51.4%) had gastrointestinal system malignancies, 39 (26.3%) had breast malignancies, and the rest had other malignancies. There was no statistically significant difference between the mean number of cancer cases discussed in MDMs held in pre-pandemic and pandemic periods. However, it was observed that there was a statistically significant decrease in the number of operations performed during the pandemic period (p < 0.001). The treatment protocol of 14 malignancy patients was changed due to the pandemic. Of these patients, 10 were diagnosed with colorectal, 2 with gastric, 1 with breast cancer and 1 with gastrointestinal stromal tumor. Conclusion: According to the short-term results in our study, delaying surgical treatment for a while in some oncological patients and administration of systemic chemotherapy during this period when considered necessary did not have a significant negative effect on the course of the disease.
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    Minimally invasive surgery for the management of iatrogenic colon perforation in the elderly
    (2020) Dagmura, Hasan; Daldal, Emin; Bakir, Huseyin; Akbas, Ahmet; Dasiran, Fatih; Okan, Ismail
    Aim: Colonoscopy is the most commonly used diagnostic tool for screening for colorectal cancer in asymptomatic individuals and for surveillance in patients with a history of colonic disease. The procedure has several drawbacks, including acute colon perforation. As elderly individuals with aging immune systems frequently respond inadequately to physiologic stress, this life-threatening complication requires meticulous management in this patient cohort. We aimed to evaluate a minimally invasive surgical approach to iatrogenic colon perforation (ICP) in this vulnerable age group.Material and Methods: This is a retrospective study. We reviewed data from all patients ≥ 65 years of age diagnosed with iatrogenic colon perforation (ICP) between January 2012 and June 2019 at Gaziosmanpaşa University Hospital. Results: Seventeen cases of ICP were identified (mean age was 76.5 years); 16 patients were treated surgically and one was managed conservatively. The most frequent site of perforation was the sigmoid colon (58.8%) and surgical management was primarily laparoscopic (93.7%). Twelve of the 16 patients who were managed with surgical intervention underwent laparoscopic primary repair and three patients underwent laparoscopic colectomy due to a primary diagnosis of colorectal malignancy. One patient with delayed diagnosis underwent laparotomy and proctosigmoidectomy (Hartmann procedure); this patient did not survive beyond the immediate post-operative period.Conclusion: Our findings suggest that early recognition is critical for the successful treatment of ICP in the elderly. Most patients respond well to a minimally invasive laparoscopic approach. This approach can be considered for large perforations and is safe and effective when carried out by an experienced surgeon.