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Öğe Abdominal cocoon syndrome as a rare cause of mechanical bowel obstruction: report of two cases(Turkish Assoc Trauma Emergency Surgery, 2011) Yeniay, Levent; Karaca, Can Avni; Caliskan, Cemil; Firat, Ozgur; Ersin, Sinan Muhtar; Akgun, ErhanAn abdominal cocoon is an extremely rare condition, and has been reported mainly in young adolescent women as a cause of small bowel obstruction. In these patients, the small bowel is encased in a fibrous sac called an abdominal cocoon. We hereby present two cases who were diagnosed only by laparotomy and their correlation with the literature. They both received early intervention, thus preventing the need for bowel resection. The pathology of both membranes showed inflammation.Öğe Can hyperbaric oxygenation decrease doxorubicin hepatotoxicity and improve regeneration in the injured liver?(Springer Japan Kk, 2009) Firat, Ozgur; Kirdok, Ozgur; Makay, Ozer; Caliskan, Cemil; Yilmaz, Funda; Ilgezdi, Savas; Karabulut, Bulent; Coker, Ahmet; Zeytunlu, MuratPortal vein embolization is used in the treatment of hepatocellular cancer, with the purpose of enhancing resectability. However, regeneration is restricted due to hepatocellular injury following chemotherapeutics (e.g. doxorubicin). The aim of this study was to investigate whether hyperbaric oxygenation (HBO) can alleviate the hepatotoxicity of chemotherapy and improve regeneration in the injured liver. Rats were allocated to four experimental groups. Group I rats were subjected to right portal vein ligation (RPVL); rats in groups II and III were administered doxorubicin prior to RPVL, with group III rats being additionally exposed to HBO sessions postoperatively; group IV rats was sham-operated. All rats were sacrificed on postoperative day 7, and liver injury was assessed by measuring alanine aminotransferase (ALT) and aspartate aminotransferase (AST) levels. Protein synthetic ability was determined based albumin levels and liver regeneration by the mitotic index (MI). The AST and ALT values of group II rats were significantly higher than those of group I, but not those of group III. Rats treated with doxorubicin and HBO (groups II and III) showed slightly but not significant differences in albumin levels than those subjected to only RPVL or sham-operated. The MI was significantly increased in groups I, II, and III, with the MI of group III rats significantly higher than those of group I rats. Based on our results, we conclude that HBO treatment has the potential to diminish doxorubicin-related hepatotoxicity and improve regeneration in the injured liver.Öğe Coexistence of gastric cancer and gastrointestinal stromal tumor: Report of two cases(Turkish Soc Gastroenterology, 2010) Firat, Ozgur; Caliskan, Cemil; Karaca, Can; Sezak, Murat; Ozutemiz, Omer; Ersin, Sinan; Guler, AdemGastrointestinal stromal tumors and adenocancers are distinct neoplasms originating from different cell layers. Though adenocancers constitute the most common type of gastric tumors, synchronous development of a gastrointestinal stromal tumor is extremely rare. Case 1: A 63-year-old male patient underwent a radical total gastrectomy with D2 lymphadenectomy and Rouxen-Y reconstruction. Histopathologic and immunohistochemical examination of the specimen disclosed an advanced stage, intestinal type adenocancer intermixing with a distinct lesion of gastrointestinal stromal tumor. The early postoperative course was uneventful; however, recurrence was seen and he survived only 13 months. Case 2: A 60-year-old male patient underwent a distal subtotal gastrectomy with D2 lymphadenectomy, and reconstruction was provided with Billroth 2 procedure. Intra-operatively, a 0.5 cm vegetating lesion was detected on the gastric body and resected. Histopathologic and immunohistochemical examination disclosed an intestinal type adenocancer, and the incidental lesion was reported as gastrointestinal stromal tumor. His postoperative course was uneventful, and the patient is free of disease after one year. The conditions under which the synchronous tumors develop away from each other or collide are vague. Currently, the stage of the adenocancer and the size and mitotic manner of the gastrointestinal stromal tumors are the leading prognostic factors.Öğe Dieulafoy's lesion of the anal canal: Report of a case(Turkish Soc Gastroenterology, 2007) Firat, Oezguer; Karakoese, Yueksel; Caliskan, Cemil; Makay, Oezer; Oezuetemiz, Oemer; Korkut, Mustafa AliBackground/aims: Dieulafoy's lesion of the anal canal is a very rare clinical case. Although it was first described in the stomach, there has been an increasing frequency, especially in the last decade, of reports of the lesion in the colorectal region. Methods: Herein, we report one case presenting with massive hematochezia requiring multiple blood transfusions due to a Dieulafoy's lesion in the anal canal. To our knowledge, this is the fourth case in Medline. Surgical oversewing was attempted twice but rebleeding occurred, and local excision through the anal canal was performed. Results: The patient was treated successfully with mucosectomy including the lesion. Conclusions: Sclerotherapy, alcohol and epinephrine injection, thermocoagulation and selective arterial embolization are the options of therapeutic endoscopy and interventional radiology. As for surgical management, oversewing is an alternative technique. However, in our opinion, because of the recurrent and life-threatening manner of this arterial bleeding pattern, local excision, if possible, is the most reliable management of the disease.Öğe Ectopic fascioliasis mimicking a colon tumor(Baishideng Publishing Group Inc, 2007) Makay, Ozer; Gurcu, Baris; Caliskan, Cemil; Nart, Deniz; Tuncyurek, Muge; Korkut, MustafaFasciola hepatica, a leaf shaped trematode that is common in cattle, sheep and goats, is acquired by eating raw water plants like watercress or drinking water infected with the encysted form of the parasite. The varied clinical presentations of fascioliasis still make a high index of suspicion mandatory. Besides having a wide spectrum of hepatobiliary symptoms like obstructive jaundice, cholangitis and liver cirrhosis, the parasitic infection also has extrabiliary manifestations. Until recently, extrahepatic fascioliasis has been reported in the subcutaneous tissue, brain, lungs, epididymis, inguinal lymph nodes, stomach and the cecum. In this report, a strange manifestation of the fasciola infection in a site other than the liver, a colonic fascioliasis, is presented. (C) 2007 The WJG Press. All rights reserved.Öğe Effect of interval between neoadjuvant chemoradiotherapy and surgery on disease recurrence and survival in rectal cancer: long-term results of a randomized clinical trial(Oxford Univ Press, 2022) Akgun, Erhan; Caliskan, Cemil; Bozbiyik, Osman; Yoldas, Tayfun; Doganavsargil, Basak; Ozkok, Serdar; Kose, TimurBackground: The optimal timing of surgery following chemoradiotherapy (CRT) is controversial. This trial aimed to assess disease recurrence and survival rates between patients with locally advanced rectal adenocarcinoma (LARC) who underwent total mesorectal excision (TME) after a waiting interval of 8 weeks or less (classic interval; CI) versus more than 8 weeks (long interval; LI) following preoperative CRT. Methods: This was a phase III, single-centre, randomized clinical trial. Patients with LARC situated within 12 cm of the anal verge (T3-T4 or N+ disease) were randomized to undergo TME within or after 8 weeks after CRT. Results: Between January 2006 and January 2017, 350 patients were randomized, 175 to each group. As of February 2022, the median follow-up time was 80 (6-174) months. Among the 322 included patients (CI, 159; LI, 163) the cumulative incidence of locoregional recurrence at 5 years was 10.1 per cent in the CI group and 6.9 per cent in the LI group (P = 0.143). The cumulative incidence of distant metastasis at 5 years was 30.8 per cent in the CI group and 18.6 per cent in the LI group (sub-HR = 1.78; 95 per cent c.i. 1.14 to 2.78, P = 0.010). The disease-free survival (DFS) in each group was 59.7 and 69.9 per cent respectively (P = 0.157), and overall survival (OS) rates at 5 years were 73.6 versus 77.9 per cent (P = 0.476). Conclusion: Incidence of distant metastasis decreased with an interval between CRT and surgery exceeding 8 weeks, but this did not impact on DFS or OS.Öğe The effects of chemoradiotherapy on recurrence and survival in locally advanced rectal cancers with curative total mesorectal excision: a prospective, nonrandomized study(Bmc, 2017) Akgun, Erhan; Ozkok, Serdar; Tekin, Mevlut; Yoldas, Tayfun; Caliskan, Cemil; Kose, Timur; Karabulut, Bulent; Sezak, Murat; Elmas, Nevra; Ozutemiz, OmerBackground: There are only two prospective, randomized studies comparing preoperative long-term chemoradiotherapy and postoperative chemoradiotherapy in locally advanced rectal cancer (LARC); however, conflicting results in terms of locoregional recurrence (LR) and survival rates have been reported. This prospective study aims to compare the effects of preoperative versus postoperative chemoradiotherapy on recurrence and survival rates in LARC patients. Methods: From January 2003 to January 2016, a total of 336 eligible patients who were clinically diagnosed with LARC (T3-T4 tm or node-positive disease) were prospectively assigned into preoperative chemoradiotherapy (n = 177) and postoperative chemoradiotherapy (n = 159) groups. The preoperative treatment consisted of 50.4 Gy total dose of radiotherapy (delivered in fractions of 1.8 Gy) and concomitant two cycles chemotherapy of 5-fluorouracil and leucovorin. The patients in the preoperative group underwent curative total mesorectal excision (TME) following long-term chemoradiotherapy. Surgery was performed 8 (range 4-12) median weeks after the completion of the chemoradiotherapy. Similar protocol was administered to the postoperative group 4 weeks after the operation. Four cycles of adjuvant chemotherapy were added to the groups. The primary end points were locoregional recurrences and 5-year cancerspecific, overall, and disease-free survivals. Results: The mean follow-up period was 60.4 (range 12 to 168) months. Five-year cumulative incidence of locoregional recurrence (LR) was 7.4% in the preoperative group and 13.4% in the postoperative group (p = 0.021). Five-year cancerspecific survival (CSS) was 87.5% in the preoperative group and 80% in the postoperative group (p = 0.022). Overall survival (OS) was 79.8 versus 74.7% (p = 0.064), disease-free survival (DFS) was 75.2 versus 64.8% (p = 0.062), and severe late toxicity was 7.4 versus 13.2% (p = 0.002), respectively. The rate of patient compliance was higher in the preoperative group (p < 0.001). Conclusions: Preoperative chemoradiotherapy, as compared with postoperative chemoradiotherapy, significantly improved local control, patient compliance, CSS, and late toxicity and suggested a trend toward improved overall and disease-free survival.Öğe Effects of hyaluronic acid and chondroitin sulfate on acute radiation proctitis in rats(Turkish Assoc Trauma Emergency Surgery, 2023) Yoldas, Mehmet; Yoldas, Tayfun; Solak, Ilhami; Caliskan, Cemil; Cin, Samed; Doganavsargil, Basak; Sezak, MuratBACKGROUND: This study was designed to investigate the prophylactic and therapeutic effects of hyaluronic acid and chondroitin sulfate combination (HA/CS) on a model of acute radiation proctitis.METHODS: Rats were divided into five groups: SHAM; irradiation (IR) + saline (1 mL for 5th and 10th day); IR + HA/CS (1 mL for 5th and 10th day). A single fraction of 17.5 Gy was delivered to each rat. HA/CS was administered rectally each day after irradiation. Each rat was observed daily for signs of proctitis. Irradiated rats were euthanized on days 5 and 10. The mucosal changes were evaluated macroscopically and pathologically.RESULTS: According to the clinical findings, five rats in the irradiation + saline group showed grade 3-4 symptoms on the 10th day. No significant difference in the macroscopic finding scores on the 5th day was observed between the irradiation + saline and irradiation + HA/CS groups. In the pathological examination, radiation-induced mucosal damage was the most prominent finding 10 days after irradiation in saline-treated rats. On the 10th day, the irradiation + HA/CS group showed mild inflammation and slight crypt changes, which corresponded to grade 1-2 pathological findings.CONCLUSION: We think that HA/CS used in radiation cystitis can be beneficial for radiation proctitis.Öğe Foreign bodies in the rectum: An analysis of 30 patients(Springer, 2011) Caliskan, Cemil; Makay, Ozer; Firat, Ozgur; Karaca, A. Can; Akgun, Erhan; Korkut, Mustafa A.A foreign body in the rectum is a rare clinical entity. These foreign bodies can be classified under two major groups: the ones that are inserted from the anus and the ones that are swallowed and thereafter become stuck in the rectum. Data of patients admitted with a foreign body in the rectum between 1988 and 2008 were retrospectively analyzed. A total of 30 patients were reviewed. The most common reason for a foreign body in the rectum was insertion for erotic purposes, which was seen in 19 of the 30 patients. All these patients were male. The remaining 11 patients reported nonerotic causes. The most efficient and implemented therapeutic method was simple extraction during the first examination. The most common reason for a foreign body in the rectum is insertion for erotic purposes. The first target of therapy should be extraction of the foreign body using the simplest method possible. Meanwhile, protecting the integrity of the intestine is of the utmost importance. The care for maintaining the integrity of the rectum should include an evaluation of the patient's psychological status.Öğe Functional outcomes of intersphincteric resection in low rectal tumors(Turkish Surgical Assoc, 2022) Bozbiyik, Osman; Caliskan, Cemil; Kose, Ozgun; Verendag, Ozan; Goktepe, Berk; Yoldas, Tayfun; Akgun, ErhanObjective: Currently, sphincter-saving procedures are increasingly performed in the treatment of low rectal cancers. This study aimed to evaluate the outcomes of patients who underwent intersphincteric resection. Material and Methods: This was a single-center, retrospective, cross-sectional study. We evaluated the electronic data files of 29 patients who had intersphincteric resections at our institute between 2008 and 2018. Bowel function outcomes were assessed prospectively using Wexner incontinence score. Histopathological, surgical and functional outcomes were analyzed. Results: Mean age of nine female and 20 male patients included in the study was 55.8 +/- 12.8 (30-76) years. A tumor-free surgical margin was achieved in all patients. Anastomotic leakage was detected in two patients. Mean Wexner incontinence score of 20 patients who still had functional anastomosis was 8.35, whereas 65% of the patients (n= 13) had a good continence status. There was no relationship between the continence status and sex, tumor distance from anal verge, T stage, distal surgical margin, and lymph node involvement. Twenty-one patients underwent primary coloanal anastomosis and eight patients underwent two-stage coloanal anastomosis. Conclusion: In the treatment of distal rectal cancer, adequate oncological surgery and relatively acceptable functional outcomes can be obtained with intersphincteric resection technique in suitable patients.Öğe Giant gastrointestinal stromal tumour of the oesophagus presenting with atypic symptom(Wiley-Blackwell Publishing, Inc, 2010) Yilmaz, Rasih; Caliskan, Cemil; Icoz, GokhanÖğe Intestinal Behcet's disease: A case report(Springer, 2007) Doganavsargil, Basak; Keser, Gokhan; Kandiloglu, Gulsen; Caliskan, Cemil; Tuncyurek, Muge; Doganavsargil, EkerÖğe Intussusception in adults: Clinical characteristics, diagnosis and operative strategies(Baishideng Publ Grp Co Ltd, 2009) Yakan, Savas; Caliskan, Cemil; Makay, Ozer; Denecli, Ali Galip; Korkut, Mustafa AliAIM: To evaluate 20 adults with intussusception and to clarify the cause, clinical features, diagnosis, and management of this uncommon entity. METHODS: A retrospective review of patients aged > 18 years with a diagnosis of intestinal intussusception between 2000 and 2008. Patients with rectal prolapse, prolapse of or around an ostomy and gastroenterostomy intussusception were excluded. RESULTS: There were 20 cases of adult intussusception. Mean age was 47.7 years. Abdominal pain, nausea, and vomiting were the most common symptoms. The majority of intussusceptions were in the small intestine (85%). There were three (15%) cases of colonic intussusception. Enteric intussusception consisted of five jejunojejunal cases, nine ileoileal, and four cases of ileocecal invagination. Among enteric intussusceptions, 14 were secondary to a benign process, and in one of these, the malignant cause was secondary to metastatic lung adenocarcinoma. All colonic lesions were malignant. All cases were treated surgically. CONCLUSION: Adult intussusception is an unusual and challenging condition and is a preoperative diagnostic problem. Treatment usually requires resection of the involved bowel segment. Reduction can be attempted in small-bowel intussusception if the segment involved is viable or malignancy is not suspected; however, a more careful approach is recommended in colonic intussusception because of a significantly higher coexistence of malignancy. (C) 2009 The WJG Press and Baishideng. All rights reserved.Öğe Is D-dimer a predictor of strangulated intestinal hernia?(Springer, 2006) Icoz, Gokhan; Makay, Ozer; Sozbilen, Murat; Gurcu, Baris; Caliskan, Cemil; Firat, Ozgur; Kurt, Zahide; Ersin, SinanBackground: The goal of this study was to assess the relevance of serum D-dimer measurement as a possible reliable marker for the diagnosis of strangulated intestinal hernia. Methods: Consecutive patients admitted with nontraumatic acute abdominal gastrointestinal disorders were recruited prospectively in a tertiary referral hospital. The study was conducted in 159 patients between August 2002 and April 2004. D-dimer, lactate dehydrogenase, serum amylase, and international normalized ratio (INR) levels were tested in the emergency room prior to surgical intervention. For each patient, 15 variables, including D-dimer, were available for analysis. Results: Thirty-three (20.7%) of the 159 patients had intestinal ischemia, and 28 (85%) of these 33 patients had D-dimer level > 300 ng/ml. Plasma levels of D-dimer in patients with intestinal ischemia were significantly higher than in patients without ischemia (P < 0.05). There were 29 (18.2%) patients in the hernia group with incarceration (n = 22) or strangulation requiring resection (n = 7). D-dimer levels in patients requiring intestinal resection were insignificantly higher than in patients without resection (P > 0.05). Six (85%) of the 7 hernia patients requiring resection had D-dimer levels > 360 ng/ml. The D-dimer variable correlated best with the leukocyte count in patients with hernia requiring resection. Levels of lactate dehydrogenase, serum amylase, and INR did not show any correlation with D-dimer levels. Conclusions: To help predict ischemic events, the increasing use of the D-dimer assay in clinical practice could be extended to patients presenting with intestinal emergencies. An elevated D-dimer level on admission had a high sensitivity for identifying patients with intestinal ischemia, although it had a low specificity. Whether it is predictive or preventive for resection in strangulated intestinal hernia patients still remains a question.Öğe Is Neoadjuvant Radiotherapy Alone a Good Alternative to Neoadjuvant Chemoradiotherapy in Patients with Low Performance Status?(Southeastern Surgical Congress, 2017) Caliskan, Cemil; Yoldas, Tayfun; Mulailwa, Kilongo; Erozkan, Kamil; Yalman, Deniz; Ozkok, Serdar; Akgun, Erhan; Korkut, MustafaÖğe Massive gastrointestinal bleeding caused by stromal tumour of the jejunum(Cma-Canadian Medical Assoc, 2009) Caliskan, Cemil; Makay, Ozer; Akyildiz, MahirÖğe Massive gastrointestinal bleeding caused by stromal tumour of the jejunum(Cma-Canadian Medical Assoc, 2009) Caliskan, Cemil; Makay, Ozer; Akyildiz, MahirÖğe Mesenteric fibromatosis of the ileocolic area: a case report(Springer India, 2011) Caliskan, Cemil; Korkut, Mustafa A.Fibromatosis is a kind of spindle cell tumor which is characterized by the remarkable proliferation and invasive growth of fibrous tissue. It often arises from the abdominal wall or the extremities and rarely from the mesentery and abdominal organs. The patient was 35 year old female whose major complaints were an abdominal mass and pain. She underwent a right hemicolectomy after the tumor was confirmed by abdominal ultrasonography and computerized tomography. Hereby the pathophysiology, diagnosis and the treatment of the disease is discussed.Öğe Morgagni Hernia: Is It Just a Congenital Hernia or a Cause of Emergency Surgery?(Southeastern Surgical Congress, 2016) Yoldas, Tayfun; Ustun, Mehmet; Karaca, Can; Firat, Ozgur; Caliskan, Cemil; Akgun, Erhan; Korkut, MustafaÖğe Negative prognostic factors in colorectal carcinoma: An analysis of 448 patients(Springer India, 2010) Caliskan, Cemil; Guler, Necdet; Karaca, Can; Makay, Ozer; Firat, Ozgur; Korkut, Mustafa A.Colorectal carcinoma (CRC) is the most frequent malignancy of the gastrointestinal tract. Prognostic researches are carried out for choosing the optimum therapy, evaluating therapy results and comparing multicentre results for better qualification in the therapy of the disease. In this study, 448 patients, whose surgery and follow-up was performed by the same correspondent surgeon between the years 1995 and 2003, were retrospectively analyzed. Age, presence of comorbidity, weight loss, emergency admission, high serum CEA and CA 19-9 levels, neighboring organ invasion, operation type, major morbidity, tumor size and type, lymph node metastases, venous and perineural invasion, Dukes' classification and local recurrence and distant metastasis during follow-up are found to be significant negative factors affecting prognosis of the CRC patient. Therapy results of the CRC are evaluated by survival times regardless of the therapy method selected for each individual. In our study we tried to find out negative prognostic factors by researching possible factors affecting disease free survival time for CRC. Since our understanding of factors that have an impact on prognosis increases, we are hoping to improve survival.
