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Öğe Baseline characteristics associated with survival in patients with hepatocellular carcinoma(Kare Publ, 2022) Aslanov, Seymur; Unal, Nalan Gulsen; Senkaya, Ali; Celik, Ferit; Buyruk, Abdullah Murat; Uysal, Alper; Akyildiz, MuratBackground and Aim: Hepatocellular carcinoma (HCC) is one of the most common and most lethal cancers worldwide. The objective of this study was to investigate the relationship between basal parameters and survival characteristics in patients with HCC. Materials and Methods: The records of 1447 HCC patients of a tertiary center during the period 2000-2017 were screened retrospectively. The demographic details; basal clinical, laboratory, and radiological characteristics; treatments; and survival time were recorded and prognostic scores were calculated. Results: A total of 788 patients with HCC (male/female: 623/165; mean age: 60.5 +/- 10.9 years) were included in the study. The median length of survival was 26.3 months (95% confidence interval [CI], 22.3-30.4 months). The 5-year survival rate was 28.1%. The number and diameter of the tumors; platelet count; platelet-to-lymphocyte ratio; level of aspartate aminotransferase, alanine aminotransferase, and gamma-glutamyl transferase; portal and hepatic vein involvement; and an alpha-fetoprotein level of <9.6 ng/mL were found to be independently related to survival. Conclusion: The positive predictive value of the prognostic index derived from independent survival-related parameters for 5- and 10-year survival or overall survival was approximately 86%. Integration of this prognostic index to the criteria used in making treatment decisions for patients with HCC should be considered.Öğe A Case of Taenia saginata Infestation Presenting with Chronic Constipation(Bilimsel Tip Yayinevi, 2023) Kurtulmus, Ilkce Akgun; Buyruk, Abdullah Murat; Ozutemiz, Ahmet OmerTaenia saginata is a parasitic infectious agent of the cestode class, which is transmitted to humans by the raw consumption of beef containing the larvae of Cysticercus bovis. Although the infection is usually asymptomatic in humans, it can cause symptoms such as nausea, vomiting, diarrhea, weight loss, and swelling in the abdomen. Chronic constipation, according to the Rome IV classification criteria, is a gastroenterological condition characterized by straining during defecation, infrequent defecation, and a sense of incomplete rectal emptying persisting for at least six months. This case report aims to highlight the concurrent infestation of Taenia saginata and the improvement in constipation symptoms after treatment in a patient who had been presenting to our outpatient clinic with chronic constipation for four years.Öğe Cerrahi prosedürler öncesi anti-HCV taraması: Hastalar yeterince bilgi sahibi mi?(2021) Türkeş, Ayşın Zeytinoğlu; , Fulya; Buyruk, Abdullah Murat; Akarca, Ulus Salih; Danış, Nilay; Altuğlu, İmre; Arslan, AyşeGiriş ve Amaç: Direkt etkili anti viral ilaçların kullanılmasıyla, hepatit C virüsü enfeksiyonunun tedavisinde başarı oranı %100’e yaklaşmıştır. Bununla birlikte, birçok hasta teşhis konulmayı beklemektedir. Biz mevcut çalışmada cerrahi öncesi hepatit C virüsü taraması yapılan hastalarda anti-hepatit C virüsü ve hepatit C virüs-RNA pozitifliğinin prevalansını belirlemeyi ve hastalığından habersiz olan hastaların oranını araştırmayı amaçladık. Gereç ve Yöntem: 2012-2015 yılları arasında cerrahi kliniklerinde anti-hepatit C virüsü pozitif saptanan hastalar, hepatit C virüs-RNA pozitifliği ve tedavi geçmişi açısından araştırıldı. Hepatit C virüs-RNA pozitifliği açısından hastane kayıtları tarandı. Tedavi bilgilerine Medula Sisteminden (Sosyal Güvenlik Sisteminden entegre bir veri tabanı) ulaşıldı. Tedavisiz anti-hepatit C virüsü pozitif hastalara telefonla pozitiflikten haberdar olup olmadıkları soruldu. Bulgular: 4 yıl boyunca 19627 hasta anti-hepatit C virüsü pozitifliği açısından tarandı. 158 hastada (%0.8) anti-hepatit C virüsü pozitif bulundu (76 erkek, 82 kadın; yaş: 58.2 ± 17.6). Hepatit C virüs-RNA 83 hastada bakılmıştı, 75 hastada hepatit C virüs-RNA testi yoktu. Ulaşılabilen 58 hastanın sadece 14’ü anti-hepatit C virüsü pozitif olduğunu biliyordu. Diğer 44 hasta gastroenteroloji veya enfeksiyon hastalıkları polikliniklerine başvurmaları konusunda uyarıldı. Sonuç: Cerrahi girişim uygulanan 19627 hastanın %0.8’inde anti-hepatit C virüsü genel Türkiye nüfusuna benzer oranda pozitif bulunmuştur. Hastaların neredeyse yarısında hepatit C virüs-RNA test edilmemiş ve çoğu hasta hepatit C virüsü-RNA’nın test edilmesi ve izlenmesi gerektiği bilgisine sahip değildir. Anti- hepatit C virüsünün cerrahi öncesi taranması yeni hastaların tespiti açısından yetersiz bulunmuştur.Öğe Dieulafoy’s lesion as a rare cause of gastrointestinal bleeding: a single-center experience(2021) Ünal, Nalan Gülşen; Çelik, Ferit; Şenkaya, Ali; Aslanov, Seymur; Özütemiz, Ahmet Ömer; Buyruk, Abdullah Murat; Tekin, FatihTo define the clinical characteristics of Dieulafoy’s lesion (DL),determine the localization features, and investigate endoscopic treatments and their results. This retrospectivestudy included 20 patients who presented to the Department of Gastroenterology due to gastrointestinal (GI) bleeding between January 2015 and December 2019 andwere diagnosed with DL. Age, gender, comorbidities, medications used, presentation findings, hemoglobin and hematocrit values at the time of presentation, number andtype of transfusions if applied, length of hospitalization in days, mortality/survival, and endoscopic procedure parameters, including the number of procedures, localizationof DL, type of bleeding stigmata, and the applied technique were recorded for all patients. Ten (50%) of the patients were women, and the mean age of all patients were66.8±17.8 years. One or more comorbidities were present in 90% of the patients. The use of acetyl salicylic acid (ASA) was present in five (25%) patients, ASA+ clopidogrelin five (25%), warfarin in two (10%), and non-steroidal anti-inflammatory drugs in two (10%). The most common complaint was observed to be hematemesis and/ormelena in 16 patients (80%). DL was most frequently seen in the stomach (n=10; 50%) where it was most commonly located in the proximal corpus (n=6; 60%). The mostprevalent bleeding stigma was active bleeding, which was seen in nine (45%) patients during endoscopy. Eight (40%) patients received endoscopic treatment combinedwith a mechanical method, and nine (45%) patients only received a mechanical treatment (endoscopic band ligation or hemoclip). The median number of hospitalizationswas five days (2-22). Transfusion was required by 13 patients (65%). The mortality rate was determined as 5%. DL should be considered especially in older patients withchronic diseases who present with recurrent GI bleeding. An endoscopic examination is the first method to be applied in the diagnosis and treatment of DL. Mechanicalmethods should be prioritized in endoscopic treatment.Öğe Efficacy and Safety of Peroral Endoscopic Myotomy in the Treatment of Zenker's Diverticulum: A Single-Center Experience(Aves, 2024) Buyruk, Abdullah Murat; Erdogan, CagdasBackground/Aims: The efficacy and safety of Zenker's peroral endoscopic myotomy (Z -POEM), a current method in the treatment of Zenker's diverticulum (ZD), have been demonstrated in a limited number of studies and case reports. This study aimed to report our experience with the Z -POEM method. Materials and Methods: Patients with ZD who were treated with Z -POEM between January 2019 and March 2023 and had a followup period of at least 3 months were included in the study. Our primary endpoint was clinical success. A Kothari-Haber score (KHS) of 2 or less at 1 month postoperatively was defined as clinical success. Our secondary endpoints were adverse events and recurrence rates. Results: In total, 20 patients (males, 65%; mean age, 63 +/- 14.4 years) were treated with Z -POEM. The mean ZD septum length was 33.7 (+/- 11.04) mm. The technical success rate was 100% (20/20), and the clinical success rate was 95% (19/20). In 1 case with a large ZD (septum length of 60 mm), the mucosal septum, which was thought to cause partial persistence of symptoms, was treated by endoscopic septotomy. The mean KHS decreased significantly after Z -POEM (preoperative KHS: 7.3 and postoperative KHS: 0.15, P < .0001). The median follow-up period was 10 months (interquartile range, 3-39). No recurrence was observed in any case. Intraprocedural mild subcutaneous emphysema was observed in 4 (20%) cases. Emphysema regressed spontaneously in the postoperative period without any treatment. Conclusion: Zenker's peroral endoscopic myotomy is a successful and reliable method in the treatment of ZD, with low recurrence rates.Öğe Ileal Dieulafoy Lesion in a Patient with Glanzmann Thrombasthenia Presented with Hematochezia(2019) Buyruk, Abdullah Murat; Danış, Nilay; Özütemiz, ÖmerDieulafoy lesion (DL) is an important cause of acute gastrointestinal hemorrhage (GIH) because endoscopic diagnosis is very difficult. We report an ileal DL in a patient with Glanzmann Thrombasthenia (GT). A forty-year old female presented with bloody stool. Records showed that she was diagnosed with GT at 3 years of age. Physical examination on admission, she was clinically stable, except for tachycardia (110 bpm). Rectal examination revealed bright red blood. Her haemoglobin level was 8.7 g/dl. Colonoscopy revealed a DL at the terminal ileum. It was treated with combined endoscopic therapy of epinephrine injection followed by two clips application. Haemoglobin values were stable in the post-procedural period. DL in the terminal ileum is very rare. There have been fewer than 20 cases reported in the literature to date. Also GT is a rare congenital bleeding disorder. This case report revealed the coincidence of two rare disorders.Öğe The Impact of Early Nutrition Following Peroral Endoscopic Myotomy in Achalasia: A Tertiary Center Experience(Aves, 2024) Buyruk, Abdullah Murat; Erdogan, Cagdas; Tekin, FatihBackground/Aims: This retrospective single-center study aimed to assess the safety of early feeding in patients who met certain criteria following peroral endoscopic myotomy (POEM). Materials and Methods: Data from 100 patients who underwent POEM at our center between January and December 2022 were collected. Early feeding was defined as the introduction of clear liquid foods at 4 hours post procedure. At 4 and 24 hours, the pain was rated using the visual analog scale (VAS) in all patients. Patients without intraoperative complications (pneumoperitoneum requiring needle drainage, severe arterial bleeding requiring the use of hemostatic forceps, severe mucosal injury) and severe pain (VAS score > 6) and nausea-vomiting at the fourth postoperative hour were given the early feeding approach. In patients who did not meet these requirements, enteral feeding was initiated after 24 hours (late feeding). Results: Among the 100 patients, 50 patients were categorized early feeding. No patients had a control esophagogram. In the early and late enteral feeding groups, VAS scores were 4 (0-6) and 6 (1-8) (P < .001) at 4 hours and 1 (0-3) and 1 (0-6) (P = .043) at 24 hours, respectively. No severe complications were developed after early feeding. The median hospital stay in the early feeding group was 1 (1-3) day. There was no emergency readmission in any of early feeding patients. Conclusion: Our study showed early feeding following POEM can be begun in achalasia patients who do not have intraoperative complications, severe pain, or nausea/vomitingÖğe Localization and size of 1058 polyps detected in the lower gastrointestinal system and the approach used for their treatment(2021) Çelik, Ferit; Şenkaya, Ali; Aslanov, Seymur; Özütemiz, Ahmet Ömer; Sezak, Murat; Buyruk, Abdullah MuratThe occurrence of colon cancer typically depends on the presence or absence of adenomatous polyps. Hence, performing colonoscopy and polypectomy can aid in cancer prevention. This study aimed to retrospectively investigate demographic, endoscopic, and histopathological data of patients who presented with colorectal polyps and underwent endoscopic resection at our center. In this single-center retrospective study, we collected the data of 1058 colorectal polyps that were excised from 498 cases between September 2019 and September 2020. We reviewed patient’s information, including patient age and sex, indications for colonoscopy, polyp characteristics (localization, size, number, and histopathology), endoscopic resection techniques, and presence of related complications. Mean age of the 498 cases included in this study was 62.44 ± 11.77 years (21–90 years); among these patients, 296 (59.4%) were females. The age group of 60–69 years had the highest number of cases (150 cases) presenting with polyps (30.1%). The most common indication for colonoscopy was polyp surveillance in 100 cases (20.1%). The polyps were most commonly localized in the sigmoid colon (26%). Histopathologically, the most common type of polyp was tubular adenoma. Furthermore, 54.3% of the polyps were diminutive. Polyps with dysplasia were significantly different from those without dysplasia in terms of polyp size, polyp localization, and post-polypectomy complications (p < 0.001, p = 0.006, and p < 0.001, respectively). In people aged >50 years, colon polyps were more common in the left colon, especially in the rectosigmoid region. Endoscopic polypectomy is a safe method for resecting precancerous lesions. Polypectomy should be performed immediately after identifying polyps in colonoscopy screenings to determine their histology and prevent progression to malignancy. Additionally, these patients should be included in a polyp surveillance program.Öğe The role of endoscopic submucosal dissection in the treatment of large superficial duodenal epithelial neoplasia(2024) Buyruk, Abdullah Murat; Baki, Bahadır Emre; Kalkan, ÇağdaşBackground and Aims: Endoscopic submucosal dissection is one of the recommended treatment modality in terms of facilitating en-bloc resection in patients with superficial duodenal epithelial neoplasm larger than 2 cm. There is limited information in the literature about the applicability of endoscopic submucosal dissection in superficial duodenal epithelial neoplasm. In this single-center study, the results of eight patients with superficial duodenal epithelial neoplasm who underwent endoscopic submucosal dissection were retrospectively analyzed. Materials and Methods: Twelve patients who underwent duodenal endoscopic submucosal dissection between February 2019 and November 2023 were screened. Eight patients with superficial duodenal epithelial neoplasm larger than 2 cm were included in the study. Results: The median tumor diameter was 27.5 mm (20 - 80 mm). The most common localization was the duodenum second part (87.5%). En bloc and R0 resection rates were each 100%. The median procedure time was 37.5 min. Two patients (20%) with complications were treated with endoscopic clips. No recurrence was observed in all patients (mean 21 months). Conclusion: Endoscopic submucosal dissection is a technically challenging but successful method in the treatment of superficial duodenal epithelial neoplasm. Due to the high risk of complications, duodenal endoscopic submucosal dissection should be performed in experienced centers.Öğe Trauma Associated Ectopic Ileal Varices(2020) Çınar, Celal; Buyruk, Abdullah Murat; Ersöz, Galip; Özütemiz, ÖmerEctopic varices (EcV) are portosystemic collaterals that can be observed anywhere in the gastrointestinal tract (GIT) except stomach and esophagus. It was most frequently localised in duodenum while it was rarely observed in ileum. Its etiology is usually associated with portal hypertension. Herein, we present a case of patient with ectopic ileal varices succesfully treated with angiographic coil embolization. In this patient, portal hypertension was not observed in the etiology of EcV.
