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    Can Lymph Node Metastasis be Predicted in Gastroenteropancreatic Neuroendocrine Neoplasias?
    (Coll Physicians & Surgeons Pakistan, 2025) Ocakli, Serhat; Ceylan, Cengiz; Canlikarakaya, Firat; Goktas, Abidin; Kankoc, Rumeysa; Terzioglu, Serdar Gokay
    Objective: To investigate the predictive factors influencing lymphatic metastasis in gastroenteropancreatic neuroendocrine Place and Duration of the Study: Department of General Surgery, Ankara City Hospital, Ankara, Turkiye, between the years 2019 and 2022. Methodology: Patients who underwent surgery and were diagnosed with GEP-NEN based on final pathology between the study years were enrolled. Demographic information of the patients including age, gender, tumour location, and pathological characteristics (tumour size, grade, Ki-67 index, mitotic rate, total number of lymph nodes examined, pathological lymph nodes), inflammatory markers (White blood cell, lymphocyte, neutrophil, and monocyte counts, albumin levels, modified systemic inflammation score [mSIS], delta neutrophil index [DNI], neutrophil-lymphocyte ratio [NLR], and lymphocyte-monocyte ratio [LMR]) were retrieved from the patient database. Results: One hundred and thirty-two patients were included. The median age was 51 (34-64) years, with 56.8% being male. GEPNENs were most commonly found in the pancreas (43.2%) and appendix (22.7%). The median tumour size was 1.7 cm (0.7-3.5 cm), the mitotic rate was 1(1-2), and the Ki-67 Index was 2 (1-5). Grade I and II accounted for 91.6 % of cases. In multivariate analysis, independent predictive factors for pathological lymph node involvement were identified as small bowel tumour location (p = 0.002), tumour Grade III (p = 0.008), and tumour size >= 2 cm (p = 0.017). Conclusion: This study identified tumour size, grade, and site of origin as independent risk factors for LN metastasis.
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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.