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    Idiopathic Granulomatous Mastitis: Overcoming this Important Clinical Challenge
    (Int College Of Surgeons, 2018) Emre, Arif; Akbulut, Sami; Sertkaya, Mehmet; Bitiren, Muharrem; Kale, Ilhami Taner; Bulbuloglu, Ertan; Yurttutan, Nursel
    The aim of this study was to determine possible risk factors for recurrence development in patients with idiopathic granulomatous mastitis (IGM). Demographic, clinical, radiologic, and histopathologic characteristics of 34 consecutive patients with IGM were retrospectively reviewed. Also, 32 patients who were informed about recurrence status were divided into non-recurrent (n = 27) and recurrent (n = 5) groups. Both groups were compared for demographic and clinical parameters. This study included 34 female patients with IGM aged between 26 and 70 years (median: 38 years). During the follow-up period, no recurrence occurred in 27 patients whereas recurrence developed in 5 patients. No significant difference was found between the groups with respect to age, lesion size, breast-feeding, number of child, marital status, use of oral contraceptive, familial or personal tuberculosis history, PPD test, smoking, lesion side, lesion location on the breast, and treatment choice. The diagnostic tools of the IGM as follows: tru-cut (n = 18); incisional (n = 6); tru-cut + incisional (n = 5); tru-cut + excisional (n = 2); tru-cut + FNAB (n = 1); FNAB + excisional (n = 1) and FNAB (n = 1). Treatment options were as follow: antibiotics + drainage (n = 10); antibiotics + drainage + corticosteroid (n = 9); wait and watch (n = 6); corticosteroid (n = 3); antibiotics + antituberculous (n = 1); antituberculous (n = 1); antibiotics + breast conserving surgery + chemotherapy (n = 1); modified radical mastectomy+ chemotherapy+ radiotherapy (n=1); and no available (n = 2). This study shows that no demographic and clinical data contributes to the development of recurrence disease. To give a strong message, this study should be supported by other high volume and prospective studies.
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    An objective evaluation of the laryngeal roof
    (2018) Sarica, Selman; Yurttutan, Nursel; Bilal, Nagihan; Sagiroglu, Saime; Yazar, Fatih Mehmet
    Aim: The anatomic measurements of the thyroid cartilage, which is an important part of the laryngeal roof, were calculated using computed tomography (CT) and the data obtained were compared in two groups of male and female. Material and Methods: A total of 148 adult patients were examined in this retrospective, cross-sectional study. All the patients were aged over18 year and presented to emergency ward between 2015 and 2016 due to trauma. Cervical vertebra CT was taken and the reformatted two-dimensional images were examined. Measurements were taken on the images at two separate levels of the interlaminar angle (ILA), thyroid prominence angle and the distance of the vocal cords from the lower edge of the thyroid. Results: The ILA in the glottis region was measured as 74.02°±17.23° for males and as 98.00°±12.78° for females. The difference between the genders was statistically significant (p<0.001). The distance of the vocal cords from the lower edge of the thyroid cartilage was measured as 7.12 ±2.29mm for males and 5.15±2.06mm for females. Conclusion: The results of the ILA measurements in this study were observed to be narrower in both genders than the measurements given in classic reference books. The ILA in both the regionsof glottis and supraglottiswas measured as a narrower angle in males than in females. These results show the presence of sexual dimorphism in the Kahramanmaraş region where the study was conducted
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    Self-expandable metallic stent application for the management of upper gastrointestinal tract disease
    (Aves, 2018) Emre, Arif; Sertkaya, Mehmet; Akbulut, Sami; Erbil, Ozan; Yurttutan, Nursel; Kale, Ilhami Taner; Bulbuloglu, Ertan
    Objective: The aim of the present study was to share our experiences of the use of self-expandable metallic stent for the upper gastrointestinal tract disease. Material and Methods: We retrospectively reviewed the medical records of 18 patients who underwent self-expandable metallic stent implantation procedure for anastomosis stricture, anastomosis leak, or spontaneous fistula of the upper gastrointestinal tract at two different surgery clinics. Self-expandable metallic stent implantation procedures were performed while keeping the patient under sedation and the correct stent localization was verified using fluoroscopy. The stent localization and possible stent migration were checked using X-ray films taken a few days after the stenting procedure. Results: Overall, 25 self-expandable metallic stents were implanted in 18 patients (malignant, 13; benign, 5) aged between 19 and 89 years. The indications for self-expandable metallic stent implantation were as follows: malignant gastric stricture (inoperable; n=6), malignant esophageal stricture (inoperable; n=4), staple line leak (laparoscopic sleeve gastrectomy; n=4), esophagojejunostomy anastomotic leak (total gastrectomy+Roux-en-Yesophagojejunostomy; n=2), and stricture (total gastrectomy+Roux-en-Yesophagojejunostomy; n=1), and esophagopleural fistula (pulmonary tuberculosis; n=1). A favorable outcome was achieved in a single session in 15 patients, whereas more than two sessions of stenting were necessary in the remaining three patients. Among the patients who underwent esophagojejunal anastomosis (n=3), self-expandable metallic stents were successfully deployed in a single session in two patients to relieve anastomosis leak (n=1) and anastomosis stricture (n=1); the remaining patients underwent four self-expandable metallic stent implantation procedures to relieve anastomosis leak and subsequent recurrent strictures. No complications developed during the stenting procedure. Three of the four patients who developed mortality had advanced stage esophageal cancer, whereas one patient had morbid obesity and developed staple line leakage. Conclusion: Endoscopic self-expandable metallic stent implantation under fluoroscopic guidance is a low-morbidity and effective procedure for the management of advanced stage tumors of the gastrointestinal tract and the elimination of postoperative complications.
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    Self-expandable metallic stent application for the management of upper gastrointestinal tractdisease
    (Aves, buyukdere cad 105-9, mecıdıyekoy, sıslı, ıstanbul 34394, turkey, 2018) Emre, Arif; Sertkaya, Mehmet; Akbulut, Sami; Erbil, Ozan; Yurttutan, Nursel; Kale, Ilhami Taner; Bulbuloglu, Ertan
    Objective: The aim of the present study was to share our experiences of the use of self-expandable metallic stent for the upper gastrointestinal tract disease. Material and Methods: We retrospectively reviewed the medical records of 18 patients who underwent self-expandable metallic stent implantation procedure for anastomosis stricture, anastomosis leak, or spontaneous fistula of the upper gastrointestinal tract at two different surgery clinics. Self-expandable metallic stent implantation procedures were performed while keeping the patient under sedation and the correct stent localization was verified using fluoroscopy. The stent localization and possible stent migration were checked using X-ray films taken a few days after the stenting procedure. Results: Overall, 25 self-expandable metallic stents were implanted in 18 patients (malignant, 13; benign, 5) aged between 19 and 89 years. The indications for self-expandable metallic stent implantation were as follows: malignant gastric stricture (inoperable; n=6), malignant esophageal stricture (inoperable; n=4), staple line leak (laparoscopic sleeve gastrectomy; n=4), esophagojejunostomy anastomotic leak (total gastrectomy+Roux-en-Yesophagojejunostomy; n=2), and stricture (total gastrectomy+Roux-en-Yesophagojejunostomy; n=1), and esophagopleural fistula (pulmonary tuberculosis; n=1). A favorable outcome was achieved in a single session in 15 patients, whereas more than two sessions of stenting were necessary in the remaining three patients. Among the patients who underwent esophagojejunal anastomosis (n=3), self-expandable metallic stents were successfully deployed in a single session in two patients to relieve anastomosis leak (n=1) and anastomosis stricture (n=1); the remaining patients underwent four self-expandable metallic stent implantation procedures to relieve anastomosis leak and subsequent recurrent strictures. No complications developed during the stenting procedure. Three of the four patients who developed mortality had advanced stage esophageal cancer, whereas one patient had morbid obesity and developed staple line leakage. Conclusion: Endoscopic self-expandable metallic stent implantation under fluoroscopic guidance is a low-morbidity and effective procedure for the management of advanced stage tumors of the gastrointestinal tract and the elimination of postoperative complications.