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    Does hyperthermic intraperitoneal chemotherapy influence the rate of infective complications and change the pattern of infectious agents in patients undergoing cytoreductive surgery for peritoneal carcinomatosis?
    (2021) Mercan, Umit; Ersen, Ogun; Yuksel, Cemil; Unal, Ali
    Aim: When CRS, in which complex surgical procedures are applied combined with HIPEC in which high dose cytotoxic agents are applied, many serious postoperative complications, especially infection-related complications, may develop in the patient group with peritoneal carcinomatosis whose general condition is impaired. In this study, it was aimed to investigate the effect of HIPEC application after SRC on infection rates and microbial agent spectrum alone.Materials and Methods: Between January 2012 and January 2020, one thousand six hundreds forty eight patients diagnosed with peritoneal carcinomatosis were scanned from hospital database and two hundred thirty-five eligible patients were included in the study. Demographic and clinical data, perioperative results and culture results were analyzed by grouping the patients as HIPEC and non-HIPEC.Results : It has been found that the incidence of surgical site infections was significantly higher in HIPEC group. (23.6%vs11.5%p=0.011).When the culture results were analyzed. The number of patients with E.coli (13.7% vs 5.7% p = 0.001), Klebsiella pneumoniae (9.9% vs 2.8% p = 0.001) and Pseudomonas aeruginosa (2.2% vs 0.9% p = 0.034) growth was significantly higher in the HIPEC group.Conclusions: It has been found that HIPEC application not only increases the infection rates but also expands the potential pathogen spectrum. Prediction of possible pathogens responsible for postoperative infections may affect the choice of prophylactic and ultimate treatment and so the risk of developing morbidity and mortality which may result from a possible septic progression, can be minimized with an effective antimicrobial therapy.
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    Impact of body mass index on short-term outcomes following gastric and colorectral cancer surgery
    (2022) Yuksel, Cemil; Gojayev, Afig; Aydin, Ferit; Unal, Ali; Demirci, Salim
    Aim: The present study aims to investigate the effect of high body mass index (BMI) on short-term outcomes and survival in patients following intra-abdominal malignancy surgery. Materials and Methods: The study was carried out in Ankara University, Department of Surgical Oncology. We retrospectively analyzed the data of patients who underwent gastrectomy and colectomy for malignancy in our clinic between August 2019 and August 2020. BMI was calculated by dividing body weight (kg) by height (m) squared. The patients were classified into two groups as normal (< 25.0 kg/m2 ) and overweight (≥ 25 kg/m2 ) in terms of BMI. Results: 158 patients were included in our study. 78 (49.3%) had undergone surgery for gastric cancer and 80 (50.7%) for colorectal cancer. 73 (46.2%) patients were female and 85 (53.8%) male. The mean age was 61.50±13.37. Fifty four (34.2%) patients had BMI < 25 kg/m 2 and 104 (65.8%) of them were ≥25 kg/m 2 . 57.6% of the patients operated on for gastric cancer and 75.6% for colorectal cancer had high BMI, and the difference between the two groups was statistically significant (p = 0.01). An investigation of relationship between BMI and mortality revealed that 37 with BMI ≥25kg/m2 and 5 with BMI < 25kg/m2 died. The difference was statistically significant (p < 0.001). Conclusion: BMI is an important factor affecting postoperative morbidity and mortality in patients with gastric and colorectal malignant tumors. In the present study, we show that overweight may be associated with severe postoperative complications and poor prognosis in these patients. We suggest that surgeons be highly aware of BMI to make effective treatment plans in gastric and colorectal cancer cases