Background and Objectives: Seroma formation is the most common postoperative complication following mastectomy and axillary dissection, negatively affecting wound healing and delaying adjuvant therapy. Despite numerous surgical and pharmacological approaches, no universally effective strategies have been established. This study aimed to comparatively evaluate the effects of porcine dermal collagen (PDC), tranexamic acid (TXA), and thymoquinone (TQ) on seroma formation and tissue repair. Materials and Methods: A randomized controlled experimental study was conducted using 40 female Wistar albino rats that underwent modified radical mastectomy and axillary dissection. All surgical and postoperative procedures were performed in accordance with the institutional animal welfare and ethical guidelines, including postoperative analgesic administration. The animals were divided into four groups: control, PDC, TXA, and TQ (n = 10 each). Seroma volume was measured on postoperative day 14. Histopathological evaluation, immunohistochemical analysis (FGF2, VEGF, TGF-β1, p53), and quantitative real-time PCR were performed to assess tissue remodeling and molecular responses. Results: All treatment groups demonstrated a significant reduction in seroma volume compared to the control group, with the most pronounced decrease observed in the TQ and TXA groups (p < 0.0001), while PDC showed a moderate effect (p < 0.01). Histopathological analysis revealed increased collagen deposition and fibrin formation in the PDC and TQ groups, whereas TXA exhibited a more limited remodeling profile than the others. Immunohistochemical and molecular analyses showed significant upregulation of VEGF across all groups, with broader and more consistent increases in the PDC and TQ groups. TGF-β1 and FGF2 expression demonstrated region-specific increases, particularly in the thoracic tissue. p53 expression remained relatively stable in the TXA group but was elevated in specific regions in the PDC and TQ groups. Importantly, the increased inflammatory infiltration, edema, vascular proliferation, and fibrin deposition observed in the TQ group may reflect not only active tissue remodeling processes but also prolonged inflammatory activation and enhanced fibrotic responses and should therefore be interpreted cautiously. Conclusions: PDC, TXA, and TQ differentially modulate postoperative seroma formation via distinct biological mechanisms. While TXA primarily exerts a targeted anti-seroma effect and PDC enhances extracellular matrix stabilization, TQ is associated with broader angiogenic, inflammatory, and tissue remodeling responses within this preclinical rat model. These findings should be considered exploratory and hypothesis-generating, and additional mechanistic studies and clinical investigations are necessary before definitive therapeutic conclusions can be established regarding the use of TQ in human breast surgery settings.

AbstractIntroductionHydatid disease is a serious parasitic infection caused by Echinococcus granulosus. The mosteffective treatment method is surgery. The recurrence of disease is an important long-termpostoperative complication. The present study investigates the factors affecting recurrence inoperated cases of liver hydatid cysts.Material and MethodsThe study examines the data who underwent surgical therapy for hydatid cysts with liverlocalization between 2008-2014. Age, gender, serological test results, radiologicalexamination results, ASA score, operational technique, postoperative complications werereviewed retrospectively, making use of the hospital information system and the patientrecords.ResultsTotal 166 patients with liver hydatid cysts were analyzed. Of the study group, recurrencedeveloped in 26 (%15.6) patients and 15 (%9) patients were female. The indirecthemagglutination test (IHAT) was positive in 96 (%65.8) patients. Recurrence developed in15.6% of the IHAT (+), 20.0% (n=8) of patients with a cystic lesion of >10cm. There wasfurther no statistically significant difference between the diameter of cystic lesion,serological test results (IHAT), gender, age, Gharbi classification and recurrencedevelopment regardless of the type of surgical intervention (p>0.05). Multiple cystic lesionswere identified in 44 (%26.5) patients and recurrence rate was 29.5% (n=13). The rate ofrecurrence in this group is significantly higher than patients with a single cystic lesion(p<0.05). Recurrence was observed to develop at a lower rate among patients undergoingradical surgery groups than conservative ones (5.9% v.s 22.2%, p<0.05).Discussion and ConclusionRecurrence is a very important issue in hydatid cyst surgery. Patients with multiple cystshaving a significantly higher rate of recurrence. Likewise, radical surgical procedures reducethe development of recurrence rather than conservative ones, significantly. That said, radicalsurgical interventions are performed less frequently, as more experience is required, and thismay be associated with the high recurrence rates.Keywords: Hydatid cyst, surgery, recurrence, cyst characteristics.

AimThis study investigates the link between proliferation markers (PCNA, p16, Ki-67) and histopathological factors, exploring their prognostic value in breast cancer patients.Materials and methodsWe analyzed female breast cancer patients who underwent surgery. Data collected included demographics, clinical parameters (hemogram, Ca 15.3, menopause status, etc.), family cancer history, pathology, treatments (neoadjuvant, surgical, oncological), tumor staging, lymph node status, receptor status (ER, PR, cerb-b2), and survival. Paraffin blocks were retrospectively analyzed for PCNA, p16, and Ki-67 expression via immunohistochemical staining.ResultsPCNA scores showed no association with demographic or clinical features, though a statistically significant inter-marker correlation with p16 was found (both markers increased together). P16 scores were not linked to other parameters aside from Ki-67 (also demonstrating positive correlation). Higher Ki-67 index was associated with decreased ER and PR expression and, importantly, decreased survival. Although a significant correlation was observed between PCNA and p16 expression levels, neither marker demonstrated independent prognostic significance with respect to overall survival.ConclusionsAlthough PCNA and p16 expression levels were inter-correlated, neither marker showed an independent association with clinicopathological variables or overall survival in our cohort. In contrast, the Ki-67 index was significantly associated with hormone receptor status, pathological stage, and shorter overall survival, and remains the most informative proliferation marker for prognostic stratification in breast cancer. Further prospective studies with standardized scoring and multivariate analysis are warranted to clarify the prognostic value of PCNA and p16.

Introduction Anastomotic strictures are a prevalent complication in colorectal surgery. This study aimed to investigate the antifibrotic effects of pirfenidone on colorectal anastomotic stenosis, abdominal wall wound healing, and adhesion formation in a rat model by comparing various routes of administration (intraperitoneal, oral, and rectal). Methods Forty female Wistar Albino rats were randomly allocated to four groups: control, intraperitoneal pirfenidone administration (IAP), oral pirfenidone administration, and rectal pirfenidone administration. Colonic anastomosis was performed followed by pirfenidone administration for 14 d. This study evaluated burst pressure, histopathological parameters, immunohistochemical analyses, and molecular analyses of transforming growth factor-β, vascular endothelial growth factor-A, and fibroblast growth factor-2 expression. Results Burst pressure increased significantly across all treatment groups, with IAP and rectal pirfenidone administration demonstrating a three-fold increase compared with the control. Histopathological analysis revealed enhanced inflammatory cell infiltration, fibroblastic activity, collagen deposition, and neoangiogenesis in the treatment groups. Transforming growth factor-βexpression increased in all treatment groups, whereas vascular endothelial growth factor-A and fibroblast growth factor-2 expressions decreased. Intra-abdominal adhesions decreased across all treatment groups, with IAP exhibiting the most substantial reduction. Anastomosis width increased in all treatment groups, with oral pirfenidone administration demonstrating the widest anastomosis. Conclusions Pirfenidone exhibited a significant antifibrotic effect by preventing colorectal anastomotic stenosis, reducing intra-abdominal adhesions, and promoting optimal wound healing. Oral administration resulted in the widest anastomotic lumen, suggesting its potential as the preferred route for clinical applications. Further research is necessary to elucidate the long-term impact of pirfenidone on anastomotic healing and optimize its therapeutic potential.

Aim: Endoscopic retrograde cholangio-pancreatography (ERCP) should be performed as the first-line treatment after appropriate imaging and drainage in noncomplete biliary tract injuries. Our aim is to present our treatment strategy in such injuries in a tertiary center with the aim of contributing to the literature. Material and Methods: Between January 2016 and January 2022, 39 patients who underwent ERCP for iatrogenic simple biliary tract injury were included in our study. Magnetic resonance cholangiopancreatography was performed in all patients before the procedure. Sphincterotomy, balloon, basket catheter or balloon dilatation and plastic stent were performed under sedo-analgesia. Complication rates of the procedures were recorded. Results: 39 patients were included in the study. The mean age was 61.94 +/- 15.60 years. When the procedure characteristics of the patients who underwent ERCP were evaluated, 33 patients underwent selective cannulation and 6 patients underwent pre-cut. Primary cannulation was performed in 27 patients and secondary cannulation was performed in 12 patients. When we looked at the complications after ERCP, bleeding was not seen in any patient, while pancreatitis developed in 6 (15.40%) patients. After sphincterotomy and stenting, the procedure was successful in 35 (89.70%) patients and bile leakage disappeared in the follow-up. Discussion: Endoscopic interventional procedures should be considered as the first choice for idiopathic simple biliary tract leaks after laparoscopic cholecystectomy because they are minimally invasive, have a high success rate and eliminate the need for reoperation. Our early results are similar to the literature.

BACKGROUND:The aim of the study was to investigate the use of prophylactic nitroglycerin patch in patients who applied to our clinic with occlusion icter and underwent endoscopic retrograde cholangiopancreatography (ERCP) for complications such as pancreatitis, bleeding, perforation that may occur during and after the procedure, duration of the procedure, length of hospitalization, precut and selective cannulation rates, and mortality. METHODS:Patients were searched retrospectively using the hospital database.Patients under the age of 18, patients with poor general condition and patients treated under emergency conditions were excluded from the study.The effects of the drug on morbidity, mortality, duration of procedure, length of hospital stay, and cannulation techniques were investigated in patient groups with and without nitroglycerin patch. RESULTS:It was observed that using nitroglycerin decreased the precut probability by 2.28 times (p<0.001),and decreased perioperative bleeding by 3.4 times (p<0.001).75.1% selective cannulation was observed in the group not administered nitroglycerin, this rate was determined as 87.3% in the group administered nitroderm(p<0.001).In the regression model, it was observed that the presence of nitroderm increased the probability of selective cannulation 2.21 times (p<0.001).The effects of nitroglycerin use on mortality, patient's history of malignancy, presence of stones and mud, gender, age, post-operative pancreatitis, and perioperative bleeding variables were evaluated by regression analysis, and age increased mortality by 1.09 (p=0.023). CONCLUSION:It has been shown that the use of prophylactic nitroglycerin patch in ERCP procedure increases the prophylactic selective cannulation rate, shortens the precut rate, pre-operative bleeding, hospital stay, and procedure time.

Cerrahi’nin Tarihçesi Adem ASLAN Cerrahi Hastalarda Sıvı ve Elektrolit Yönetimi Tuba MERT Şok Burak UÇANER Cerrahi Enfeksiyon Oğuz HANÇERLİOĞULLARI Travma Cerrahisi Çağdaş KARAMAN Cerrahi Yara İyileşmesi Mehmet Sabri ÇİFTÇİ Cerrahi Kanama ve Transfüzyon Serdar ACAR Baş Boyun Cerrahisinde Yenilikler Seda SEZEN GÖKTAŞ Tiroid Hastalıklarına Yaklaşım Zeynep ANADOLULU Paratiroid Hastalıklarına Yaklaşım Murat ÖZKARA Benign Meme Hastalıklarına Yaklaşım Nimet SÜSLÜ Malign Meme Hastalıkları Cerrahisi Murat KARTAL Meme Kanserinde Sentinel Lenf Nodu Biyopsisi Furkan SAVAŞ Onkoplastik Meme Cerrahisi Hasan Turgut AYDIN Diyafragma Cerrahisi İsa KARACA Özofagus Kanseri Cerrahisi Mevlüt YORDANAGİL Akalazya: Tanı ve Tedavi Sacit Altuğ KESİKLİ Güncel Mide Cerrahisi Ali DURAN Midenin Selim Hastalıklarına Yaklaşım Mehmet ARSLAN Güncel Bariatrik Cerrahi Yunus YAPALAK Obezitenin Cerrahi Dışı Tedavi Yöntemleri Elnur HÜSEYNOV Safra Kesesi Cerrahisi Özkan SUBAŞI Safra Yolları Girişimleri Mirkhalig JAVADOV Emrah KARATAY Pankreas Hastalıkları ve Tedavisi Gökhan GARİP Açık ve Laparoskopik Splenektomi Erhan ERÖZ Sürrenal Hastalıkları ve Cerrahisi Baran MOLLAVELİOĞLU Güncel Apandisit Cerrahisi Sibel ÖZKARA Kasık Fıtığının Açık ve Laparoskopik Cerrahisi Murat DEMİR Ventral Herni Cerrahisi Abdullah AS Malign ve Benign Hastalıklarda Karaciğer Cerrahisi Seda BAŞTÜRK Karaciğer Kistlerinin Tedavisi Mevlüt Harun AĞCA Karaciğer Kistlerinde PAIR Uygulaması Mehmet Emin UNUTMAZ Endoskopik Retrograd Kolanjiyopankreatografi ERCP Mikail UYAN HIPEC, Sıcak Kemoterapi Gözde ERTUNÇ AÇIKGÖZ Transanal Endoskopik Mikrocerrahi (TEM) Serdar ACAR İnce Bağırsak Cerrahisi Serkan YILMAZ Gastrointestinal Sistem Kanamaları Mesud FAKİRULLAHOĞLU Hasar Kontrol Cerrahisi Sümeyra GÜLER Laparoskopik Diagnostik Girişimler Bilal TURAN Endsokopik Submukozal Diseksiyon Mehmet BİÇER Laparoskopik İnce Barsak Cerrahisi Mesut YUR Güncel Kolorektal Cerrahi Barış CANDAN Benign Kolorektal Hastalıklara Yaklaşım Osman AKDOĞAN Mehmet KARAHAN Rektal Prolapsus Cerrahisi Yasin Orhan ERKUŞ Karın Duvarı Tümörlerine Yaklaşım Göktürk GÜRSOY Proktolojide Güncel Tedavi Yöntemleri Muhammet Fikri KÜNDEŞ Transplantasyon Emil HÜSEYİNOĞLU Bahtiyar MUHAMMEDOĞLU Genel Cerrahide Lazer Teknolojisinin Kullanımı Şükran ÇAVDAR Murat Bulut ÖZKAN Cerrahi Komplikasyon Yönetimi Gizem FIRTINA Perkütan Abdominal Apse, Sıvı Drenajı Tuğberk BAŞTÜRK Cerrahide Stapler Teknolojisi ve Enerji Aletleri Oğuzhan ÇÖĞÜRLÜ Jinekolojide Minimal İnvaziv Cerrahi Burcu AYDIN BOYAMA İleri Endoskopik Girişimler Girayhan ÇELİK Anormal Uterin Kanama ve Cerrahisi Cansu ÖNAL KANBAŞ Endoscopik Ultrasonografi Mahmut Baran YERLİKAYA Batın Kapama Yöntemlerinde Yenilikler İbrahim KILINÇ Pelvik Taban Kusurlarında Cerrahi Uygulamalar Tamer TOPALOĞLU Omurga Cerrahisi Furkan SOY Halil GÖK Pediatrik Yaş Grubunda Pilonidal Sinüs Tedavisine Güncel Yaklaşımlar Gonca GERÇEL Ali İhsan ANADOLULU Pediatrik Minimal İnvaziv Uygulamalar Ali İhsan ANADOLULU Gonca GERÇEL Jinekolojik Onkolojik Aciller Nur Cansu YILMAZ BALDAN Cerrahide Anestezi Yönetimi Fatma OKUCU Robotik Cerrahi Teknolojisinin Gelişimi Berke MANOĞLU

BACKGROUND:The most challenging and mortal complication of gastric sleeve surgery (SG) is staple line leakage. Although many agents have been used for increasing tissue healing on the stapler line, there is still no consensus on its effectiveness and efficacy. The aim of study is to determine the effect of phenytoin on the healing process of gastric sleeve surgery in rats.METHODS:On the 10th post-operative day, the effects of phenytoin on bursting pressure in the stapler line were evaluated along-side pathohistological examinations. To investigate the molecular impact of phenytoin on the expression of TGF-β, VEGF, FGF2, and p53 genes, quantitative real-time polymerase chain reaction was utilized. In addition, gene expressions at the protein level were deter-mined by immunohistochemical analysis.RESULTS:No signs of intra-abdominal leakage were observed in the resected samples. A statistically essential extend in stable line bursting pressure measure was observed between the control group and the group treated with phenytoin application. Pathohisto-logical results indicate that the mean score of collagens of the study group (3.2±0.42) was significantly higher than the control group (2.3±0.48) (P=0.003). In addition, the mean epithelization score of the study group (3.4±0.52) was significantly higher than the control group (2.1±0.57) (P=0.001). mRNA of TGFβ, FGF2, VEGF, and p53 genes drastically increased phenytoin treated group. High FGF2 protein expression levels were determined from phenytoin use compared to the control group.CONCLUSION:Molecular studies suggest that phenytoin may increase the healing process of Gastric sleeve following SG in rats and may become a new agent for the prevention of human gastric leaks.

Aim: This study was conducted to investigate the diagnostic importance of Urotensin II (UT-II) levels, which cause vasodilation as a compensation mechanism in the early phase of Acute Mesenteric Ischemia (AMI). For this purpose, human plasma urotensin was studied for the first time in the literature for the early diagnosis of mesenteric ischemia. Material and Method: The study consisted of 60 patients. The patients were divided into three groups: Group 1: group with mesenteric ischemia (n: 20); Group 2: group with abdominal pain and with no mesenteric ischemia (n: 20); Group 3: control group with no complaints (n: 20). The blood samples were taken from the patients through peripheral venous access, and Urotensin II (UT-II), Aspartate Aminotransferase (AST), Alkaline phosphatase (ALP), Lactate, and D-dimer levels were measured. Results: While a significant increase was found between Group1 and Group 2 and between Group1 and Group3 in terms of UT-II values (p0.05). A significant increase was found between Group1 and Group2 and between Group1 and Group3 regarding AST values (p0.05). There was a significant increase between Group1 and Group3 in terms of D-dimer values (p0.05). There was no significant difference between the groups concerning ALP and Lactate values (P>0.05). Conclusion: It was concluded that UT-II could be used in the diagnosis of AMI but that there was a need for comprehensive studies investigating the changes in ischemia time-related UT-II serum levels.

Aim: The aim of the study is to investigate whether the shock index (SI) and glomerular filtration rate (GFR) have significance in differentiating acute appendicitis from complicated perforated acute appendicitis. Materials-Methods: Patients were searched retrospectively on the hospital database. Age, gender, C-reactive protein (CRP), leukocyte (WBC), total bilirubin (T.BIL), urea, creatinine, pulse (NBZ), and arterial blood pressure (TA) values of the patients were searched retrospectively on the hospital database and a database was created by using these patient variables. GFR and SI were calculated by using these data. The surgical notes about patients were reviewed retrospectively, and they were divided into two groups, namely perforated appendicitis and non-perforated appendicitis. The data were analyzed to investigate whether GFR and SI were effective in predicting perforation. Results: It was observed that NB/TA value had more frequent pathological findings in patients with perforated appendicitis (p lt;0.001). It was found that age (p=0.001), CRP (p lt;0.001), WBC (p lt;0.001), T. BIL (p=0.002), NB (p=0.017), and NB/TA (p lt;0.001) values of the patients in the perforated appendicitis group were higher than those of the patients in the normal appendicitis group, while GFR (p lt;0.001) and TA (p lt;0.001) values were lower (p lt;0.05). Conclusion: It is thought that SI and GFR may be a prognostic parameter for showing both perforation and the associated increased mortality rate.

Autoantibodies are frequently detected in the presence of autoimmune liver diseases (ALD) [autoimmune hepatitis (AIH), primary biliary cirrhosis (PBC), primary sclerosing cholangitis (PSC)] and are widely used to classify the disease clinically. The aim of this study was to investigate the contribution of autoantibodies for the diagnosis of ALD and the identification of other accompanying systemic autoimmune rheumatic diseases (SARD). In addition, it was aimed to compare the results of indirect immunofluorescence (IIF) antinuclear antibody (ANA) patterns and extractable nuclear antigen (ENA) antibodies. A total of 593 patients, including 544 patients with high liver function tests from general surgery/gastroenterology clinics and 49 patients referred from internal medicine/rheumatology clinics to investigate ALD, were included in the study. HBsAg and anti-HCV test results of the patients were found to be negative. ANA, anti-mitochondrial antibody (AMA)/anti-liver-kidney microsomal antibody (LKM), anti-smooth muscle antibody (ASMA), antineutrophil cytoplasmic antibody (ANCA) assays were performed by indirect immunofluorescence method (IIF) (Euroimmune AG, Luebeck, Germany). Extractable nuclear antigen (ENA) (nRNP/Sm, Sm, SS-A, SS-B, Scl-70, Jo-1, dsDNA, nucleosome, histone, ribosomal P-protein, AMA-M2, Ro-52, PM-Scl, CENP-B, PCNA, DFS70) and liver profiles [soluble liver antigen\liver pancreas antigen (SLA/LP), liver cytosolic antigen1(LC-1), LKM-1, anti-mitochondrial antibody M2(AMA-M2)] (Euroimmune AG, Luebeck, Germany) were detected by immunoblot (IB) method. Demographic characteristics, clinical data, presence of systemic autoimmune rheumatic diseases (SARD), radiological and laboratory findings were determined from the medical records. Autoantibody tests were found to be negative in 461 (77.7%) of 593 patients (mean age= 53.3 ± 15.6, age range= 18-90), and were positive in 132 (22.3%) (86.4% female) of the patients. Of the patients with positive autoantibodies, 60.6% (80/132) were diagnosed as PBS and 1.5% (2/132) were diagnosed as AIH (positive anti-LC-1 and anti-LKM1 antibodies). Fourteen of the patients (10.6%) with centromere, nuclear membrane (NM), multiple nuclear dot (MND) staining patterns and elevated liver enzymes could not be diagnosed as a specific disease and were followed up. PBS (13/30) was detected in approximately half of the patients diagnosed with SARD. The most common accompanying SARD in PBC patients was Sjögren's syndrome (SS) (7.5%, 6/80), followed by rheumatoid arthritis (RA) (5.0%, 4/80), scleroderma (2.5%, 2/80), and systemic lupus erythematosus (SLE) (1.3%, 1/80) respectively. The most common pattern was the AMA staining pattern (34.8%, 46/132) among the autoantibody positive patients. AMA and ANA staining patterns were detected together in 31.1% (41/132) of the patients. In the ENA profile results of these patients, the most common profile detected was anti-Ro-52 (65.9%, 27/41), followed by anti-SSA (34.1%, 14/41), anti-SSB (22.0%, 9/41) and anti-CENP-B (12.2%, 5/41) autoantibodies , respectively. ANA patterns were detected in 32.6% (43/132) of the patients (NM 9.1%, centromere 9.1%, MND 6.8%, respectively). In our study, 87.5% (70/80) of the patients diagnosed as PBS were found to have AMA positivity and 12.5% (10/80) of them had ANA positivity (such as NM, CNN, centromere). The characteristics, laboratory and radiological findings of the patients with isolated AMA positivity alone (Group 1) and patients with multiple patterns/autoantibodies (Group 2) were compared. In patients with multiple patterns/autoantibodies (Group 2), the presence of cirrhosis and liver heterogeneity were found to be higher than Group 1 (p= 0.049). ALD associated autoantibodies can be detected before years from the clinical disease. ALD may be associated with various SARD. Detection of ALD-related autoantibodies in patients diagnosed with SARD can provide early diagnosis of these patients. These autoantibodies guide both diagnosis and prognosis as in PBC. Collaboration between the laboratory specialist and the clinician is critical in the diagnosis, management and early recognition of these patients before clinical disease.

Amaç Çalışmanın amacı laparoskopik cerrahi tedavi uyguladığımız kist hidatik olgularını yaş, cinsiyet, kist yerleşimi, kist boyutu ve tipi, uygulanan tedavi, operasyon süresi, erken ve geç dönem komplikasyonları ve nüks açısından retrospektif olarak değerlendirmek ve bu bulguları literatürle karşılaştırmaktır. Gereç ve Yöntem Hastaların yaş, cinsiyet gibi demografik bilgileri, serolojik ve radyolojik tetkik sonuçları, kistlerin sayısı, Gharbi sınıflamasına göre tipi, boyutu, lokalizasyonu, operasyon şekli ve süresi, erken ve geç dönem komplikasyonları, hastanede kalış süreleri, mortalite ve morbidite verileri hastane kayıt sisteminden geriye dönük tarandı ve veri tabanı oluşturularak analiz edildi. Bulgular Hastaların yaş ortalaması 35.28 ±16.12 olup, %42.9’u kadın (6/14) ve %57.1’i erkek (8/14) hastalardan oluşmaktaydı. Hastaların en sık başvuru nedeni sırasıyla ağrı (%57.1) ve sarılık (%21.4) şikayetleriydi. Hastaların tamamına tanı aşamasında (Bilgisayarlı Tomografi) BT ve (Ultrasonografi) USG istendi. Medikal tedavi tüm hastalara uygulanmıştı. Tüm hastalara laparoskopik perikistektomi operasyonu yapıldı. Oral tedavi birinci gün başlandı. Hastaların üçünde (% 21.4) operasyon esnasında safra sızıntısı gelişti ve primer onarıldı. Postoperatif yedi hastada (%50.0, 7/14) safra sızıntısı gelişirken, bu hastalardan ikisinde (%14.3) ise Endoskopik Retrograd Kolanjiyo Pankreatografi (ERCP) gereksinimi oldu. Hastalar bir yıl süreyle takip edildi, bu sürede mortalite ve nüks gelişmedi. Sonuç Deneyimli merkezlerde ve tecrübeli cerrahlarca yapılan laparoskopik cerrahinin kist hidatik tedavisinde daha sık tercih edileceği düşünülmektedir.

Oosit Maturasyonunda Vitaminlerin Rolü Cemile Merve SEYMEN D Vitamin Düzeyi ve Analiz Yöntemleri Cemal POLAT Vitamin Eksikliklerinde Radyolojik Bulgular Emre MIRÇIK Biyotin (Vitamin B7) Muzaffer ŞENVELİ Vitamin Takviyelerinin Sporcu Sağlığı Üzerindeki Etkileri Alparslan ÜNVEREN Büşra YILMAZ Vitaminlerin, Sporcuların Ağız ve Diş Sağlığına Etkisi Alparslan ÜNVEREN Esra ÜNAL ÖZKAN Serkan ÖZKAN D Vitamini ve Kolorektal Kanser İlişkisi Alpaslan Fedayi ÇALTA Vitamin P (Rutin) Filiz ÖZYİĞİT Vitamin Eksikliklerinin Neden Olduğu Nörolojik Hastalıklara Genel Bir Bakış Yüksel ERDAL İstatistiksel Bakış ile Vitaminler Özlem ARIK İbrahim ARIK Kulak Burun ve Boğaz Hastalıkları Pratiğinde D Vitamini Mümtaz Taner TORUN Vitaminler ve Cilt Sağlığı Ayşe Nur DEĞER Hakkı DEĞER Palyatif Bakım Hastalarında Vitamin ve Mineral Desteği Adem DURMAZ Yoğun Bakım Hastalarında Vitamin Kullanımı Muzaffer ŞENVELİ Vitaminlerin Elektrospinning Yöntemi Kullanılarak Enkapsüllenmesi Merve DAĞCI TEKİN K Vitaminin Kemik ve Kardiyovasküler Sistem Üzerine Etkilerinin İncelenmesi Rukiye ÇİFTÇİ İskemi-Reperfüzyon Hasarında Vitaminlerin Koruyucu Rolü Saadet ÇELİKÖZLÜ Sporcularda D Vitamininin Etkileri Mihri Barış KARAVELİOĞLU C Vitamini ve Spektrofotometrik Yöntemle Tayini Merve DAĞCI TEKİN Genler ve Vitaminler: Karşılıklı Etkileşimde Bilinenler Emre TAŞKIN Depresyon ve Vitaminler İlkay BAŞAK Multipl Skleroz ve Vitaminler Ali DOĞAN Hemşirelik Bakımı ve Vitaminler Lütfiye PARLAK İlaçların Vitaminlerle Etkileşmesi Mahmut ÖZDEMİR Toplumsal Açıdan Vitaminlerin Kullanım Alanları Lütfiye PARLAK D Vitamininin Baş Ağrısındaki Rolü İlker Deniz CİNGÖZ D Vitamininin Bel Ağrısındaki Rolü İsmail KAYA Egzersiz Uygulamalarında D Vitamininin Etkileri İsmail BACAK Serkan BUDAK Epigenetik Mekanizmalar ve B Kompleks Vitaminleri Uğur GÜNŞEN Mide Kanseri ve A Vitamini Hakan EROĞLU Ali DURAN Vitamin E ve Nörolojik Hastalıklar Huri BULUT Otoimmün Hastalıklarda Çinko ve D Vitamini Nural PASTACI ÖZSOBACI B Vitaminleri ve Beyin Nuriye KURBETLİ Kadın ve Erkek İnfertilitesinde Vitaminlerin Rolü Pelin TOROS D Vitamini Eksikliği ve Palyatif Bakım Serkan BUDAK İsmail BACAK Nörolojik Hastalıklarda Vitamin ve Eser Elementlerin Etkisi Dilek DÜZGÜN ERGÜN D Vitamini ve Kemik Tuğrul ERGÜN Vitaminler, İmmün Sistem ve Mikroorganizmalar Merih ŞİMŞEK Ameliyat Sonrası Hemşirelik Bakımında Vitamin Desteğinin Önemi Nuriye DEĞİRMEN Sibel ERKAL İLHAN Nevin KANAN Covid-19 Hastalığı Tedavisinde Vitaminlerin Rolü Said ALTIKAT Antioksidan Vitaminler Said ALTIKAT Selenyum ve Tiroid Hastalıkları Hüseyin Evren ÖZTÜRKOĞLU Flavonoidlerin Kardiyovasküler Sistem ve İyon Kanalları Üzerine Etkileri Sinan DEĞİRMENCİ Merve Deniz DEĞİRMENCİ

Özefagus Kanseri Epidemiyoloji, Etiyopatogenez ve Klinik Prezentasyon Ferit ASLAN Özefagus Kanserinde Patolojik Sınıflandırma Bermal HASBAY Özofagus Kanserinde Evreleme Sinan KOCA Özofagus Subepitelyal Lezyonların Karakterizasyonunda Endoskopik Ultrason Kullanımı Berrin YALINBAŞ KAYA Erken Evre Özefagus Kanseri’nde Minimal İnvaziv Cerrahi Tedaviler Murat KUŞ Özefagus Kanserinde Erken Evre Hastalıkta Ablatif Tedaviler Nilay DANIŞ Erken Evre Hastalıkta Cerrahi Tedavi Mehmet Ali GÖK Özofagus Kanserinde Adjuvan Sistemik Tedavi Yaklaşımları Hayriye ŞAHİNLİ Opere Özefagus Kanserinde Adjuvan Radyoterapi Seçenekleri Savaş TOPUK Özefagus Kanserinde Neoadjuvan Sistemik Tedavi Yaklaşımları Serkan GÖKÇAY Lokal İleri Hastalıkta Kemoradyoterapinin Yeri Aynur AYTEKİN Lokal İleri Özefagus Kanserinde Kemoradyoterapi Sonrası Cerrahi Yaklaşımlar Ali DURAN Nidal İFLAZOĞLU Metastatik Hastalıkta Sistemik Kemoterapi Veli SUNAR Metastatik Özefagus Kanserinde Moleküler Hedefli Tedaviler Serkan YILDIRIM Metastatik Özefagus Kanserinde İmmünoterapinin Yeri Ali YILMAZ Özefagus Kanserinde Endoskopik Palyasyon Orhan BALIKCI Özefagus Kanserinde Nutrisyon Uğur Bayram KORKMAZ Disfaji Palyasyonunda Radyoterapinin Yeri Kerem POYRAZ Disfaji Palyasyonunda Cerrahinin Yeri Nuri OKKABAZ Küratif Radyoterapi Alan Hastalarda Akut ve Uzun Dönem Toksisite Ayşe KÖTEK Mide Kanseri Epidemiyoloji, Etiyopatogenez ve Klinik Prezentasyonu Umut ÇAKIROĞLU Mide Kanserinde Risk Faktörleri Ayşegül ERTINMAZ ÖZKAN Mide Kanseri ve Genetik Özlem ÖZDEMİR Helikobakter Pilori Enfeksiyonu İle Mide Kanseri Arasındaki İlişki Yusuf ÜZÜM Mide Kanseri Güncel Evreleme Sistemi İbrahim KARADAĞ Serdar KARAKAYA Erken Evre Mide Kanserinde Minimal İnvaziv Cerrahi Tedavi Ramazan SARI Erken Evre Mide Kanserinde Cerrahi Tedavi Mehmet GÜLMEZ Mide Kanserinde Adjuvan Sistemik Tedavi Yaklaşımları Özlem ÖZKUL Mide Kanseri Tedavisinde Adjuvan Radyoterapinin Yeri Uğur YILMAZ İzole Peritoneal Metastazlı Mide Kanserinde Sitoredüktif Cerrahi ve Hipertermik İntraperitoneal Kemoterapinin Yeri Veysel Haksöyler Lokal İleri Mide Kanserinde Neoadjuvan Sistemik Tedavi Yaklaşımları Yusuf KARAKAŞ Lokal İleri Hastalıkta Neoadjuvan Radyoterapinin Yeri Bengül SERARSLAN YAĞCIOĞLU Mide Kanserinde Definitif Radyoterapi Sümerya DURU BİRGİ Serap AKYÜREK Lokal İleri Mide Kanserinde Cerrahi Tedavi Şekli ve Zamanlaması Özgür Cem MÜSRİ Mide Kanseri Cerrahisinde Lenf Nodu Diseksiyonu Tuğrul KESİCİOĞLU Metastatik Mide Kanserinde Sistemik Kemoterapi Esin OKTAY Metastatik Mide Kanserinde Moleküler Hedefli Tedaviler Deniz IŞIK Mide Kanseri Tedavisinde İmmunoterapinin Yeri Mehmet Salim DEMİR Metastatik Mide Kanserlerinde Sitoredüktif Cerrahi ve İntraperitoneal Kemoterapi İsmail AYDIN Mert GÜNGÖR Metastatik Hastalıkta Palyatif Cerrahi Tedavi Yunus DÖNDER Hepatosellüler Kanser Epidemiyoloji ve Etyopatogenez Mukaddes TOZLU Hepatoselüler Karsinom Evreleme Ve Prognostik Faktörler Demet IŞIK BAYRAKTAR Potansiyel Rezektable Tümörlerde Cerrahi Yaklaşım Mustafa SARAÇOĞLU Hepatoselüler Kanser Tedavisinde Transplantasyon Ali AVANAZ Hepatosellüler Karsinomda Lokal Ablatif Tedaviler Hazal Selvi ÇUBUK Hepatosellüler Kanser Tedavisinde Nükleer Tıp Uygulamaları Göksel Alçın Hepatoselüler Karsinom Tedavisinde Radyoterapinin Yeri Taylan BÜKÜLMEZ İleri Evre Hepatosellüler Kanserde Sistemik Kemoterapi Şahin LAÇİN İleri Evre Hepatoselüler Kanserde Hedefe Yönelik Tedaviler Büşra NİĞDELİOĞLU Hepatoselüler Karsinomda İmmünoterapi’ Nin Yeri Tülay Kuş

Aim: Hepatitis B(HBV), Hepatitis C(HCV) and HIV infections are important parenterally transmitted infections. The aim of this study is to determine the seroprevalence of HBsAg, anti-HBs, anti-HCV and anti-HIV in patients with preoperative preparation. Materials and MethodS: Anti-HBs, HBsAg, anti-HCV, anti-HIV tests with chemiluminescent enzyme immune-assay method in a total of 900 patients applied to the General Surgery Clinic and were evaluated preoperatively by Abbott Architect i1000 immunoassay analyzer (Abbott Diagnostics, Illinois, USA) operated according to the manufacturer's instructions. Anti-HBs titer above 10 IU/mL, serum optical density/”cut-off” control optical density (S/Co) ≥1 in HBsAg, anti HCV and anti-HIV tests were accepted as positive. HBV-DNA and HCV RNA tests were performed with real-time PCR method. Results: Anti-HBs test was found to be reactive in 34.11% and nonreactive in 65.89%. HBsAg positivity was 1.0% (9/900), and anti-HCV positivity was 0.33% (3/900). Anti-HIV positivity and HBsAg-anti-HCV association were not detected. Six patients with HBsAg positivity and one patient with anti-HCV positivity were found incidentally during preoperative examinations. Conclusion:As a result of these data, it can be concluded that cost-effective serological tests for HBV and HCV infections performed in the preoperative period are extremely important in the detection of asymptomatic patients. Preoperative screening is important in terms of early diagnosis of patients before complications such as cirrhosis and HCC develop, enabling treatment, as well as enabling healthcare professionals to increase infection control measures while intervening with infected patients, to be more careful in terms of percutaneous injuries, and to reduce the risk of transmission.

Aim: Combined pulmonary fibrosis and emphysema (CPFE) and idiopathic pulmonary fibrosis (IPF) have been discussed intensively in recent years as two different entities.We aimed to compare the clinical, functional and respiratory parameters, clinical course and mortality rates of patients with CPFE and IPF.Materials and Methods: 36 patients with a diagnosis of CPFE and 40 IPF who applied between September 2013 and February 2019 were retrospectively included in the study.Demographic data, comorbidities, pulmonary function parameters, mortality, systolic pulmonary artery pressures(sPAP) recorded.Results: In the CPFE patient group, the ratio of male patients (p=0.02),smoking history (p=0.00),frequency of acute exacerbation (p=0.001) were found to be significantly higher, SF-36 total score (p=0.000) were significantly lower than IPF group.While FVC% (p=0.00),FEV1% (p=0.049) and TLC% (p=0.002) were significantly higher in the CPFE group than IPF group, TLCO% (p=0.002) and FEV1/FVC (p=0.00) was lower.Pulmonary hypertension (PH) was 40% in CPFE and 37% in IPF and no significant difference was found between them (p=0.806).Those who received long-term oxygen therapy (LTOT) were more common in the CPFE group (p=0.04).In CPFE patients; the percentage of those who treated with bronchodilator, antifibrotic, systemic corticosteroid was respectively 52.7%, 36.1%,5.6%.Mortality from any cause was 9(25%) in CPFE and 8(20%) in IPF, and there was no significant difference between the two groups (p=0.601).Conclusion: It was observed that lung volumes were preserved and gas exchange of the lung was significantly decreased in patients with CPFE.Compared to IPF, the quality of life was lower and acute exacerbation was more common in CPFE.The frequency of PH and mortality were similar in both groups.Male gender and smoking history were important risk factors for CPFE patients.There is a need for multicenter studies reporting the clinical features, prognosis, and mortality of CPFE.

Aim: The aim of the study was to investigate the effect of temporary plastic stenting and ursodeoxycholic acid (UDCA) treatment on difficult choledochal stones that cannot be removed by basic ERCP techniques in patients who applied to our clinic with occlusion and underwent endoscopic retrograde cholangiopancreatography (ERCP). Material and Method: Patients were scanned retrospectively using the hospital database. Patients who underwent ERCP due to malignancy, biliary tract injury and benign strictures were excluded from the study. 61 patients who were not successful with basic ERCP techniques such as endoscopic sphincterotomy (EST) and mechanical lithotripsy (ML) were included in the study. 750 mg/day UDCA was given to the patients for three months and plastic stent was applied. After the treatment, ERCP was tried again. Results: Among the patients who underwent stent+UDCA, three (4.9%) patients had perioperative bleeding, one (1.6%) patient had peroperative perforation, four (6.6%) patients had postoperative pancreatitis, and one (1.6%) patient had mortality. The mean hospital stay was 1.96±2.1 days. Post-procedure total bilirubin and direct bilirubin values were observed to be lower than before the procedure (respectively, p

BACKGROUND:Anastomotic leakage is the most feared complication after colonic anastomosis. The purpose of the study is to determine the effects of phenytoin applied by different application routes, on the healing process of colorectal anastomoses. METHODS:Wistar Albino rats were divided into Intraperitoneal Phenytoin Group, Oral Phenytoin Group (OAP), Rectal Phenytoin Group (RAP), and control groups. The molecular effect of phenytoin on the expression of vascular endothelial growth factor (VEGF), transforming growth factor-beta (TGF-β), fibroblast growth factor 2 (FGF2), and p53 genes was evaluated at mRNA and protein level. The effects of phenytoin on anastomotic bursting pressure analysis measured as well as pathohistological examinations. RESULTS:There are statistically significant increase in anastomotic bursting pressure values between control and application groups. Inflammatory cell infiltration of all groups increased in the intestinal anastomosis region compared to control. Collagen scores were found to be significantly higher in the OAP and RAP groups compared to the control group. mRNA of TGF-ß and FGF2 expression increased in all routes of phenytoin applications. CONCLUSION:Three different administration routes show considerably increase on the bursting pressure. Regarding the results of the expression of FGF2, TGF-β, p53, and VEGF genes, there is a significant increase FGF2 and TGF-β at mRNA and protein level in most administration routes.

OBJECTIVE To determine the diagnostic value of the haemoglobin, albumin, lymphocyte, and platelet (HALP) score in predicting axillary lymph node (ALN) involvement. STUDY DESIGN Observational study. PLACE AND DURATION OF STUDY Department of General Surgery, Balıkesir University and Mersin City Hospital, Turkey from January 2016-December 2021. METHODOLOGY Included in the study were 307 patients who underwent surgical treatment for breast cancer. HALP values were calculated by multiplying the haemoglobin, albumin, and lymphocyte values and dividing the resulting value by the platelet number. The patients were divided in two groups, being those with low HALP (Group 1) and high HALP (Group 2) scores. We examined the potential of the HALP score for the prediction of ALN involvement. RESULT Group 1 had 65 patients and the Group 2 had 242 patients. At the cut-off point, a HALP score of <29.01 predicted the presence of axillary involvement with a sensitivity of 84.33% and a specificity of 26.1%. The sentinel lymph node sampling rate was similar in both groups (12.3% vs. 16.9% p=0.365). The presence of positive lymph nodes in the axilla was higher in group 1 (67.7% vs. 53.3% p=0.038). There was no correlation between HALP score, and the metastatic lymph node and total lymph node count. CONCLUSION The use of HALP score alone for the prediction of axillary lymph node positivity in patients with breast cancer is not advised. In the present study, a low HALP score was associated with aggressive tumour activity, such as advanced tumour and axillary lymph node positivity. KEY WORDS Breast cancer, Axillary lymph node involvement, Immunity, Nutrition.

ÖZET: Amaç: Bu çalışmada malignite tanısı ile port kateter implante edilen hastaların retrospektif olarak incelenmesi ve takipleri sırasında meydana gelmiş olan komplikasyonların ortaya konulması amaçlanmıştır. Gereç-Yöntem: 2017 Eylül-2019 Eylül tarihleri arasında XXX Hastanesi Cerrahi Onkoloji Kliniğinde Subkutan Venöz Port Kateter (SVPK) takılan toplam 109 hasta (67 erkek, 42 kadın) (yaş ortalaması±standart sapma=59.68 ±11.84) retrospektif olarak incelenmiş demografik veri, venöz erişim yolu, teknik ve komplikasyonlar ortaya konulmuştur. Bulgular: En sık SVPK takılan malignitenin kolon kanseri olduğu görülmüştür. Erken dönem komplikasyonlardan Sağ İnternal Jugüler Ven (İJV)’den yapılan girişimlerde sekiz (%8.42) hastada giriş yerinde hematom, dört (%4.21) hastada tünel bölgesi hematomu, altı (%6.31) hastada tünel bölgesi ekimozu görülürken, Sağ Subklavien Ven (SCV)’den yapılan girişimlerde bir (%7.14) hastada giriş yerinde hematom ve bir (%7.14) hastada kateter malpozisyonu görülmüştür. Hastalarda pnömotorak/hemotoraks gelişmemiştir. Geç dönem komplikasyonlarında da İJV’den girişimlerinde altı (%6.31) hastada cilt enfeksiyonu, iki (%2.10) hastada rezervuar malrotasyonu, iki (%2.10) hastada fibrin tıkaç, iki (%2.10) hastada da kateter katlanması görülmüştür. SCV’den yapılan girişimlerde ise iki (%14.28) hastada cilt enfeksiyonu, bir (%7.14) hastada fibrin tıkaç görülmüştür. “Pinch off sendromu” ve venöz tromboz görülmemiştir. İki giriş yolunda komplikasyonlar açısından istatistiksel olarak anlamlı fark saptanmamıştır. İJV’den yapılan girişimlerde altı (%6.31), SCV’den girişim yapılan iki (%14.28) hastada çeşitli nedenlerle kateterler çıkarılırken, İJV’den girişim yapılan üç (%3.15) hastada kateter revizyonu yapılmıştır. Sonuç: Subkutan venöz port kateteri kanser hastalarında etkin ve güvenilir bir venöz erişim yoludur. Uygun teknik ve tecrübeli ellerde yapıldığı taktirde minimal komplikasyon ve uzun süreli bir venöz erişim yolu sağlamaktadır. Anahtar Kelimeler: Kemoterapi, Venöz port kateterizasyonu, Kanser, Komplikasyon