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Approach to Traumatic Diaphragm Injuries: Single Center Experience
(Taiwan Soc Emergency Medicine, 2021) Senturk, Mustafa; Cakir, Murat; Akbulut, Muhammed Ali; Yesildag, Kerim
Background: Traumatic diaphragm injuries are rare. After blunt trauma, injuries occur with a 1-7% rate. This rate increases up to 15% in penetrating injuries. Diagnosis may be difficult and imaging tests may be misleading. The misdiagnosis may lead to herniated abdominal organs towards the intrathoracic cavity, with a mortality rate between 30% and 60%. This study was designed to investigate the data of patients operated for diaphragmatic injury in our clinic. Methods: The files of trauma patients admitted to our hospital between 2014-2019 were reviewed retrospectively. The files of cases with diaphragmatic injury were examined. Patients were evaluated in terms of age, sex, type of injury, localization, additional organ injuries, grade, surgical method, and mortality. Values were statistically analyzed. Results: A total of 20 patients were included in the study. Of the patients, 7 were female and 13 were male. The mean age was 32.7 (17-52) years. Of the cases, 10 were with stab wounds while 4 were incar traffic accidents and 6 were gunshot wounds. Although all patients had thoracoabdominal injuries, 4 patients had additional pelvic injuries. Of the cases, 14 were accompanied with lung injury while 5 with intestinal, 4 with the spleen, 3 with liver, and 2 with cardiovascular injury. Patients with intestinal resection performed had a longer hospitalization period than others. When the severity of the injury was evaluated, grade 3 injuries were detected most commonly, whereas 3 patients had grade 1, 2, and 4 injuries. Grade 5 injury was detected in 1 patient. Primary repair was performed in 18 patients and mesh repair was performed in 2 patients. In three cases, the repair was performed with a thoracic way. One patient died on the postoperative first day. Conclusions: Diaphragmatic injuries that may be missed during imaging may be damaged with many organs. Diaphragmatic injuries should be kept in mind in the upper abdominal and thoracic injuries.
A case of pathologic complete response after neoadjuvant triplet chemotherapy for locally advanced colon cancer with mismatch repair enzyme proficiency
(Via Medica, 2023) Kocak, Mehmet Zahid; Cakir, Murat; Kerimoglu, Ulku; Araz, Murat; Eryilmaz, Melek Karakurt; Yumuk, Perran Fulden; Artac, Mehmet
Patients with potentially resectable colon cancer and expected to have negative margins should undergo resection rather than neoadjuvant chemotherapy. Recent studies have suggested that neoadjuvant immunotherapy may be an option for tumors with mismatch repair enzyme deficiency (dMMR), but standard treatment for locally advanced colon cancer with mismatch repair enzyme proficiency (pMMR) is still unclear. A 37-year-old male patient was diagnosed with clinical stage IIIC (T4b N1a M0) transverse colon cancer. Mismatch repair proteins were proficient. After 3 cycles of oxaliplatin (85 mg/m(2), day 1), irinotecan (150 mg/m2, IV, day 1), leucovorin (200 mg/m(2), IV, day 1), and 5-fluorouracil (3000 mg/m(2), 46 hours of continuous infusion initiating from day 1), there was a remarkable reduction in the tumoral mass on the abdominal computed tomography. A right hemicolectomy was performed. A pathologic complete response was obtained. Although there is no consensus on which patients are suitable for neoadjuvant therapy in pMMR locally advanced colon cancer, triplet chemotherapy may be a reasonable option in selected patients.
A Case Of Sporadic Mesenteric Fibromatosis Mimicking Pancreatic Mass
(Cukurova Univ, Fac Medicine, 2015) Tasci, Halil Ibrahim; Cakir, Murat; Esen, Haci Hasan
The term abdominal fibromatosis refers to sporadic, pelvic, and mesenteric lesions and to all the fibromatosis lesions seen in Gardner's syndrome. Sporadic fibromatosis, however, is very rarer and literature offers a limited number of cases. The 14-year-old female patient presented to our clinic with complaints of indefinite abdominal pain in the epigastric area for the last 2 months, dyspeptic problems, and vomiting after eating. Upon the patient's gastroscopy revealed a mass lesion pressuring the stomach, endoscopic ultrasonography was performed. A hyperechoic mass lesion of 9x5 cm thought to have originated from the pancreatic tail was detected. The mass was surgically excised. Although mesenteric fibromatosis shows the characteristics of a benign tumor pathologically, it is extremely aggressive clinically and has a very high rate of recurrence. These patients should be treated like they have malign tumors and surgeons should perform surgical resection as wide as possible.
Changes in cerebral oxygen saturation with the Trendelenburg position and increased intraabdominal pressure in laparocopic rectal surgery
(Turkish Surgical Assoc, 2022) Alkan, Selman; Cakir, Murat; Senturk, Mustafa; Varman, Alper; Buyukbezirci, Gulcin; Yildirim, Mehmet Aykut; Bicer, Mehmet
Objective: Position changes and increased intra-abdominal pressure in laparoscopic interventions lead to some physiopathological changes. There is no definite information in the literature regarding cerebral oxygen saturation in patients undergoing colorectal surgery. Our aim was to investigate whether there is oxygen saturation change in the brain tissue in pneumoperitoneum and the Trendelenburg position during laparoscopic rectal surgery. Material and Methods: Cerebral oxygen saturation was measured in 35 patients who underwent laparoscopic rectal surgery in the Trendelenburg position. Measurements were made under general anesthesia in the pneumoperitoneum and the Trendelenburg position. Results: The values that are statistically affected by the position are systolic blood pressure, mean arterial blood pressure and cerebral oxygen saturation. The Trendelenburg position does not disturb the cerebral oxygen saturation and it causes an increase in saturation. After pneumoperitoneum occurred, changes in systolic blood pressure, mean arterial blood pressure and brain oxygen saturation were detected. Cerebral oxygen saturation increases with the formation of pneumoperitoneum. Conclusion: The Trendelenburg position and increased intraabdominal pressure during laparoscopic rectal surgery do not impair brain oxygen saturation.
Clinicopathologic and Surgical Characteristics Study of 151 Cases of GIST
(Springer, 2021) Senturk, Mustafa; Yildirim, Mehmet Aykut; Cakir, Murat; Kisi, Omer
Background Gastrointestinal stromal tumor (GIST) is the most appearing mesenchymal tumor of the gastrointestinal system. In this study, we are aiming to share the most up to date knowledge about diagnosis and treatment of these tumors by transferring our clinical experience about GISTs. Methods The 151 patients who were operated between 2006-2020 and whose pathological examination was reported as GIST were analyzed retrospectively. Demographic, clinical, and pathological features and treatment methods of patients were evaluated. Results Seeventy-six of the patients were women and 75 of them were men whose age averages were 66.1 (31-86). The most common location was the stomach (55.6%), followed by the small intestine, retroperitoneal, large intestine, rectum, esophagus, and another organ. With surgical intervention, 139 of them had been cured. Twelve of cases were accepted as inoperable. The diameter of tumors in our cases were between 0.4 cm and 35 cm. Determined mitotic activity was <= 5 in 71 patients and 5 < in 80 patients. In 8 of 12 unresectable cases, it has been seen that partial remission after the treatment of 12-month tyrosine kinase inhibitors, C-KIT, was positive in 96.7% of our cases. CD34 and Ki-67 was analyzed in patients. CD34 was found positive in 98 (64.9%) of them, Ki-67 was positive in 82 (54.3%) patients. Patients had been observed for 40 months. Conclusion Despite GISTs are not appearing frequently, nowadays they have started to be seen more frequently than before with the growing present-day diagnostic methods. The ideal treatment is performing radical resection without leaving any tumor cells behind. Tyrosine kinase inhibitors have an important place in unresectable cases.
Clinicopathological Characteristics of Gastroenteropancreatic Neuroendocrine Tumors 10 Years of Experience From a Single Center
(Lippincott Williams & Wilkins, 2022) Senturk, Mustafa; Acar, Berkan; Yildirim, Mehmet Aykut; Cakir, Murat; Kucukkartallar, Tevfik; Vatansev, Celalettin
Objectives Gastorenteropancreatic neuroendocrine (GEP-NET) tumors are the second most common tumors of the gastrointestinal tract. We aimed to investigate the clinicopathological features and factors affecting the prognosis of patients with GEP-NET. Methods Clinicopathological features of 158 patients were evaluated, including tumor location, TNM stage and grade, pathological features, presence of lymph nodes and distant metastases at the time of diagnosis, maximum tumor diameter and treatment details. Also, follow-up information was analyzed to discover possible prognostic factors. Results The most common primary site is pancreas (45.6%, n = 72). Most of the GEP-NETs were nonfunctional (93.6%, n = 148). Of the 158 patients, 94 (59.5%) were grade 1, 46 (29.1%) grade 2, and 18 (11.4%) grade 3. The 1-year, 3-year, and 5-year survival rates were 82.3% (130/158), 61.4% (70/114), and 47.2% (35/74), respectively. In multivariate analysis, histological grade (P = 0.04) and TNM stage (P < 0.001) were independent prognostic factors for survival in patients with GEP-NET. Conclusions They are increasing in frequency and are the most common tumors in the pancreas. Nonfunctional tumors made up the majority of cases. The main treatment was surgical resection. Histological grade and TNM stage are independent prognostic factors.
Comparison of primary repair and repair with polyglycolic acid coated tube in recurrent laryngeal nerve cuts (an experimental study)
(Excerpta Medica Inc-Elsevier Science Inc, 2020) Senturk, Mustafa; Cakir, Murat; Tekin, Ahmet; Kucukkartallar, Tevfik; Yildirim, Mehmet Aykut; Alkan, Selman; Findik, Siddika
Background: Recurrent laryngeal nerve (RLN) injury is an important complication of thyroid surgery. In our study, we aimed to compare the effects of primary repair and polyglycolic acid (PGA) coated tube repair on nerve function and regeneration in RLN cuts in rats. Methods: Twenty seven rats were used for the study. Group-1 with only nerve cuts, group-2 with primary repair, and group-3 with conduit repair. The study was planned over two-stage surgery. In the first step, nerve defect formation and nerve repair were performed in the same session. In the second step, samples were taken from the subjects for histopathological. Results: Vocal cord mobility was proportionally higher in group-3 than other groups. However, there was no statistically significant difference between the groups (p < 0.239). The mean number of highest axons were detected the group-3. Conclusions: We think that PGA coated conduit can provide a more accurate orientation of nerve fibers by creating an isolated environment when compared to the primary repair. And this may be the cause of functional improvement in the nerve. (C) 2019 Elsevier Inc. All rights reserved.
Comparison of standard and standard plus vitamin E therapy for Helicobacter pylori eradications in children
(Aves, 2014) Tumgor, Gokhan; Baran, Masallah; Cakir, Murat; Yuksekkaya, Hasan Ali; Aydogdu, Sema
Background/Aims: Although various drugs can be used in adults for Helicobacter pylori eradication in adults, treatment options are limited in children. The aim of this study was to compare the effects of the standard lansoprazole, amoxicillin, and clarithromycin (LAC) protocol to those of LAC + vitamin E (LACE) combination for H. pylori eradication. Materials and Methods: The study included 90 children (age range: 10-17 years) who were admitted to four pediatric gastroenterology centers between March 2011 and November 2012 with dyspeptic symptoms and who had tested positive for H. pylori by 14C-urea breath tests. The patients were randomized into two groups. The LAC group [45 patients (pts)] was treated with a standard regimen consisting of lansoprazole (1 mg/kg/day), amoxicillin (50 mg/kg/day), and clarithromycin (14 mg/kg/day), each of which was given in two equally divided doses every 12 h for 14 days; the LACE group (45 pts) was given the standard regimen and vitamin E at 200 IU/day for 14 days. H. pylori eradication was assessed using the 14C-UBT in the 6th week after the cessation of treatment. Results: H. pylori was eradicated in 21 (46.6%) pts in the LAC group, while it was eradicated in 29 (64.4%) pts in the LACE group. There was no statistical difference between the two groups (p=0.13). Conclusion: The eradication rate of H. pylori in children while using the LAC regimen has decreased in the last years. The LACE regimen has been associated with an increased eradication rate but can reach to statistically significance. Further studies with larger cohorts are needed to examine the success of the LACE regimen for H. pylori eradication.
Comparison of the efficacy of growth factor collagen and antibiotic collagen on colon anastomosis in experimental animals with peritonitis
(Springer India, 2021) Yildirim, Mehmet Aykut; Cakir, Murat; Findik, Siddika; Kisi, Omer; Senturk, Mustafa
Introduction In spite of advances in surgical techniques, the significance of anastomosis leak continues in colorectal surgery. There is no ideal method in spite of all studies and technical advances in this field. Our aim of this study was to use fibroblast growth factor collagen (FGF-C) and antibiotic collagen (AB-C) to increase the rate of anastomosis healing in experimental animals with peritonitis. Methods This animal experimental study received ethics committee approval. The animals were divided into three groups of seven animals each; the first group was control, the second group was the fibroblast growth factor collagen group, and the third group was the antibiotic collagen group. Under anesthesia, more than 50% of the colonic lumen was opened 4-5 cm distal to the ileocecal junction to create a defect. Twenty-four hours later, primary anastomosis was performed. The second group had the anastomosis line covered with a cover containing FGF-C. The third group had the anastomosis line covered by material containing AB-C. The experiment was concluded on the postoperative 7th day, and the anastomosis burst pressure, tissue hydroxyproline level, and histopathological assessment were performed. Results Though the burst pressure was higher in the experimental groups, it was not statistically significant. In the second and third groups, vascular proliferation and fibroblastic activity appeared to be better than in the control group. Hydroxyproline values were statistically significant in the experimental groups compared to the control group. Conclusion FGF-C and AB-C may have potential utility in anastomosis healing, especially in those susceptible to infection due to anastomosis leak.
Complications and recurrence after Karydakis Flap surgery
(Index Copernicus Int, 2021) Cakir, Murat; Bicer, Mehmet
Introduction: Pilonidal sinus is a disease affecting individuals at young age. Numerous surgical methods have been described in the treatment of pilonidal sinus disease. Currently, there is no treatment method providing a rapid recovery with low recurrence risk. Aim: In this study, we aimed to evaluate the results of our patients who underwent Karydakis surgery. Material and methods: Results of 112 patients operated on between 2012 and 2019 were retrospectively evaluated. Only the patients who underwent Karydakis surgery were included in the study. Results: Of all patients, 20 were female and 92 were male. The mean age was 21 years in the female and 20.8 years in the male patients. The mean BMI was 29.6 kg/m(2). The patients were followed up for a mean of 28 months. Postoperative length of stay in hospital was 2.1 days. The complications included wound dehiscence in 10.2%, infection in 3.6%, and bleeding (hematome) in 7.1%. Four patients developed recurrence during follow-up. Conclusions: Karydakis surgery is a preferable surgical technique with low rates of complications and recurrence.
An easy way to put the spleen into the bag
(Termedia Publishing House Ltd, 2013) Cakir, Murat; Tekin, Ahmet; Kartal, Adil; Tuncer, Fatma Betul
Introduction: Splenectomy is a therapeutic and diagnostic procedure used in a wide range of situations. Laparoscopic splenectomy has become the gold standard in some hematological diseases. The laparoscopically removed spleen is placed into a surgical bag, a step which is sometimes the most time-consuming part of the operation. Aim: To present the method that we employed in laparoscopic splenectomy to place the specimen into the bag and extract it in an easier and simpler way Material and methods: The proximal part of the splenorenal ligament is left undivided in the size of one LigaSure cut length to use as a stalk while placing the spleen into the surgical bag. The bag is advanced from the inferior pole of the spleen toward the superior pole. Only keeping the bag open is sufficient to place the spleen into the bag. Results: Recently, me started to put the spleen into the bag easily before cutting upper attachment of the spleen laparoscopically. So far we applied this procedure in more than eleven cases without complication. Conclusions: Splenectomy is now the gold standard in the treatment of hematologic diseases that are resistant to medical treatment or that are not amenable to medical treatment because of its complications. Through our experience, the method that we describe here easily overcomes one of the most unpleasant parts of laparoscopic splenectomy.
Effect of sex steroids on soleus muscle response in hypocalcemic medium (in vitro)
(Academic Press Inc Elsevier Science, 2013) Kokcam, S. Said; Tekin, Sakir; Kartal, Adil; Ayaz, Murat; Sahin, Mustafa; Acar, Fahreddin; Cakir, Murat
Purpose: Postoperative hypocalcemia is a frequently encountered complication of thyroid surgery. Since hypocalcemic symptoms are closely associated with sex, the aim of this study is to investigate the effects of sex steroids on muscle tissue under hypocalcemic conditions. Methods: Six groups consisting of control male (M), control female (F), gonadectomized male (M -), gonadectomized female (F-), estradiol- applied gonadectomized male (MX), and testosterone- applied gonadectomized female (FX) rats were used. Contraction recordings were obtained from soleus muscle flaps. Maximal tension (PT), frequency required for 50% of PT (F50), contraction velocity at F50 (V50), and changes in contraction values (d[PT], d[F50], d[V50]) between normocalcemic and hypocalcemic conditions were calculated. Results: d[PT], d[F50], and d[V50] were significantly higher in M - and MX groups compared with control M group. Whereas d[PT], d[F50], and d[V50] parameters of the F- group were significantly higher than control F group, d[F50] and d[PT] of the FX group showed no significant change and d[V50] for the FX group was significantly lower. A comparison of control groups showed that d[PT], d[F50], and d[V50] of the F group were significantly higher than those of the M group. Conclusion: Whereas absence of both testosterone and estradiol caused an increase in hypocalcemia- induced changes in contraction parameters of rat skeletal muscle, presence or application of testosterone clearly stabilized contraction parameters. (C) 2013 Elsevier Inc. All rights reserved.
Effectiveness of collagenase in preventing postoperative intra-abdominal adhesions
(Elsevier Science Bv, 2013) Cakir, Murat; Tekin, Ahmet; Kucukkartallar, Tevfik; Yilmaz, Huseyin; Belviranli, Metin; Kartal, Adil
Introduction: The purpose of this study is to investigate the effectiveness of Collagenase clastridiopeptidase an enzyme preparation used in enzymatic debridement in preventing adhesions brought about by peritoneal damage. Methods: The study covers a total of 40 rats in 4 groups each having 10 rats. Group 1: The control group. Group 2: Normal saline group. Group 3: Sterile Novuxol (R) group. Group 4: The group where the intraperitoneal and systemic effects of sterile Novuxol (R) were investigated. Adhesion frequency and grades were scored on the post-op 11th day according to Granat. Blood work including hemoglobin, aspartate aminotransferase, alanine aminotransferase, urea, creatinine, and albumin level measurements were performed. Toxicity was investigated histopathologically through samples taken from the liver and the peritoneum from Group 4. Results: Adhesion frequency was found to be 80% on the right and 90% on the left for Group 1, while it was 50% on both left and right for Group 2, and 30% on the right and 10% on the left for Group 3. Adhesion stages were found to be 1: 2.35 +/- 1.42 for Group 1, 0.31 +/- 1.15 for Group 2, and 0.20 +/- 0.41 for Group 3. Adhesion stage of the Sterile Novuxol (R) Group was lower than all the other groups (p < 0.05). Biochemical and hematological parameters were similar in all groups (p > 0.05). Histopathological analysis revealed no hepatotoxicity. Conclusions: According to the results of our study, we believe that Sterile Novuxol (R) can be a good anti-adhesive agent considering its ease of use, non-toxicity, and effectiveness. (C) 2013 Surgical Associates Ltd. Published by Elsevier Ltd. All rights reserved.
The effects of flavanoid on the treatment of hepatopulmonary syndrome
(Korean Surgical Society, 2013) Atalay, Talha; Cakir, Murat; Tekin, Ahmet; Kucukkartallar, Tevfik; Kargin, Suleyman; Kartal, Adil; Kaynak, Adnan
Purpose: Hepatopulmonary syndrome is an arterial oxygenation disorder brought about by advanced liver failure and pulmonary vascular dilatations. The reason why hypoxia develops in hepatopulmonary syndrome depends on the broadening of perialveolar capillary veins. Our study aims to investigate the effects of Flavanoid on hepatopulmonary syndrome through its inhibition of nitric oxide. Methods: Three groups, each having 8 rats, were formed within the scope of our study. Group I (the control group) only received laparatomy, group II received choledoch ligation, and group III was administered Flavanoid (90% flavonoid diosmin, 10% flavonoid hesperidin) following choledoch ligation. The rats were administered Flavanoid at week two following choledoch ligation. The rats' livers and lungs were examined histopathologically following a five-week follow-up and the perialveolar vein diameters were measured. Arterial blood gases and biochemical parameters were evaluated. Results: It was seen that fibrosis and oxidative damage in the liver with obstructive jaundice as well as hypoxia with pulmonary perialveolar vein sizes were significantly lower than the other group with cirrhosis formed through the administration of Flavanoid. Conclusion: We have concluded that Flavanoid administration might be useful in the treatment of hypoxia in hepatopulmonary syndrome and the delay of cirrhosis contraction.
The Effects of Topical Insulin Application on Wound Healing
(Modestum Ltd, 2015) Kargin, Suleyman; Tastekin, Didem; Kilic, Kemal; Cezik, Azamet; Cakir, Murat; Kucukkartallar, Tevfik; Kokbudak, Naile
The process of wound healing is a dynamic event during which the stages of fibroplasia, angiogenesis, and re-epithelization perfectly take place. The aim of this study is to compare the effects of wound irrigation by normal saline and topical insulin application, which we frequently use in clinical practice, on wound healing. The study covers a total of 20 male rats - 10 for the insulin group and 10 for the control group. The first group received topical insulin application while the second group had irrigation by normal saline. The macroscopic outlook, collagen production, and wound contraction rates in the animals wounds were checked at the end of day 20. The rate of wound closing was found to be higher in the topical insulin group than the NS group at all times. Further, the period of complete wound closing was shorter than the insulin group. Histopathological analysis revealed that the ulceration and inflammation were localized in the subepithelial field in the skin cross-sections of the insulin group and that there was a significant increase in collagen bundles. Thus, we think that insulin can be an alternative to normal saline application specifically in chronic wounds related to diabetes and post-op wound care.
The Effects of Topical Insulin Application on Wound Healing
(Modestum Ltd, 2015) Kargin, Suleyman; Tastekin, Didem; Kilic, Kemal; Cezik, Azamet; Cakir, Murat; Kucukkartallar, Tevfik; Kokbudak, Naile
The process of wound healing is a dynamic event during which the stages of fibroplasia, angiogenesis, and re-epithelization perfectly take place. The aim of this study is to compare the effects of wound irrigation by normal saline and topical insulin application, which we frequently use in clinical practice, on wound healing. The study covers a total of 20 male rats - 10 for the insulin group and 10 for the control group. The first group received topical insulin application while the second group had irrigation by normal saline. The macroscopic outlook, collagen production, and wound contraction rates in the animals wounds were checked at the end of day 20. The rate of wound closing was found to be higher in the topical insulin group than the NS group at all times. Further, the period of complete wound closing was shorter than the insulin group. Histopathological analysis revealed that the ulceration and inflammation were localized in the subepithelial field in the skin cross-sections of the insulin group and that there was a significant increase in collagen bundles. Thus, we think that insulin can be an alternative to normal saline application specifically in chronic wounds related to diabetes and post-op wound care.
The effects of trastuzumab, paclitaxel, and carboplatin on HER2-positive cancer stem cells that are isolated from primary breast cancer cultures: a preliminary report
(Amer Assoc Cancer Research, 2015) Artac, Mehmet; Kayadibi, Gozde; Ceylan, Ayca; Kars, Meltem Demirel; Artac, Hasibe; Cakir, Murat; Boruban, Cem
[Abstract Not Availabe]
Effects of Tumor Volume on Lymph Node Involvement and Prognosis at Stage pt3 Colon Cancers
(Springer India, 2022) Senturk, Mustafa; Ozer, Halil; Celik, Abdulkadir; Yildirim, Mehmet Aykut; Cakir, Murat; Vatansev, Celalettin
Some studies showed that the increase of tumor size has a negative effect on survival in colon cancers. Our study aims to assess the effects of tumor volume on lymph node positivity and prognosis in stage pT3 colon cancers. All patients who underwent surgery for colon cancer in our clinic were evaluated retrospectively. The study included 213 patients who were diagnosed with colon adenocarcinoma and reported as pathologic. Preoperative abdomen computed tomography scans were used for measurements of tumor volume. Tumor volumes were compared according to the pathological lymph node involvement. Cut-off values were determined with ROC analysis. The cases were divided into groups according to the determined cut-off value and data compared. Mean tumor volume was found to be higher in the lymph node-positive group (p=0.01). The higher number of removed lymph nodes and lymph node positivity was detected more in cases that were above the cut-off value (p=0.003 and p=0.004, respectively). The mean survival time was 37.3 +/- 1.3 months. There was no correlation between tumor volume and the overall survival time (p=0.21). According to data comparison of the lymph node positivity, Kaplan-Meier analysis showed that the increase of the N stage reduces the 5-year survival rate (for the N0, N1, N2 stages, 60%, 52%, 35%, respectively). Tumor volume is correlated with lymph node involvement. It has been shown that increasing the N stage has a negative effect on prognosis. Our study showed that tumor volume has no significant impact on survival but may have an indirect effect on prognosis.
Enzymatic Debridement in Necrotizing Pancreatitis
(Int College Of Surgeons, 2015) Cakir, Murat; Tekin, Ahmet; Kucukkartallar, Tevfik; Vatansev, Husamettin; Kartal, Adil
Multiple organ failure and pancreatic necrosis are the factors that determine prognosis in acute pancreatitis attacks. We investigated the effects of collagenase on the debridement of experimental pancreatic necrosis. The study covered 4 groups; each group had 10 rats. Group I was the necrotizing pancreatitis group. Group II was the collagenase group with pancreatic loge by isotonic irrigation following necrotizing pancreatitis. Group III was the collagenase group with pancreatic loge following necrotizing pancreatitis. Group IV was the intraperitoneal collagenase group following necrotizing pancreatitis. The progress of the groups was compared hematologically and histopathologically. There was no difference among the groups regarding the levels of leukocyte, hemogram, and urea. The differences in AST levels between Group I and II; and differences in glucose, calcium, LDH, AST, and amylase between Group II and III; between Group II and IV; between Group I and III; and between Group I and IV were statistically significant (P < 0.05). There were statistically significant differences between Group II and III, and Group II and IV regarding edema, acinar necrosis, inflammatory cell infiltration, hemorrhage, and fat necrosis (P < 0.05). In conclusion, the collagenase preparation used in this experimental pancreatitis model was found to be effective in the debridement of pancreatic necrosis.
Gastric necrosis and perforation caused by acute gastric dilatation
(Aves, 2014) Gundes, Ebubekir; Kucukkartallar, Tevfik; Tekin, Ahmet; Cakir, Murat
Acute gastric dilatation was first defined by Duplay in 1833. We herein present the case of a 55-year-old male patient diagnosed with gastric necrosis and perforation caused by acute gastric dilatation. Since the stomach has a rich blood circulation, necrosis and perforation are rarely seen. Clinically, more than 90% of cases have complaints of vomiting. The most useful method in revealing the diagnosis and aetiology is computerized tomography. Medical treatment is appropriate for cases where no necrosis and peritonitis findings are detected through endoscopy. Delays in surgical treatment increase the risk of mortality.

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