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Öğe The Clinical Course of Acute Appendicitis During Pregnancy: Comparison of Reproductive Age Patients and Pregnant Patients(2022) Bozbıyık, Osman; Uc, Can; Yoldas, Tayfun; Çalışkan, Cemil; Akgün, Zekeriya Erhan; Korkut, Mustafa AliAim: The differential diagnosis of acute abdominal pain in women of reproductive age is challenging. Acute appendicitis is the most common cause of acute abdomen during pregnancy. This study aimed to compare pregnant women with nonpregnant women of reproductive age in terms of diagnostic approach, clinical management, and surgical outcomes in acute appendicitis and to identify any differences occurring in pregnant patients. Method: Female patients aged between 18-45 years, who underwent appendectomy between January 2015 and December 2018 were included in this retrospective study. Pregnant and non-pregnant patients were compared in terms of clinical presentation, management, and outcomes. Results: A total of 277 patients (28 pregnant and 249 non-pregnant) were included. In terms of diagnostic imaging, ultrasound was used in all pregnant patients, and 57.1% also underwent magnetic resonance imaging. In the non-pregnant group, computed tomography (CT) was used in 87.9%. There was a higher negative appendectomy rate in the pregnant group (21.4 vs 8.8%; p=0.038). Laparoscopic surgery was performed significantly more often in the non-pregnant group (21.4 vs 59.8%; p=0.001). Duration of diagnosis and length of stay was longer in the pregnant group. Both groups had similar rates of complicated appendicitis (7.1 vs 10.8%; p=0.416) and overall postoperative complications (14.2 vs 8.8%; p=0.316). Conclusion: The use of CT in the diagnosis of acute appendicitis was common in women of reproductive age. In pregnant women, negative appendectomy rates were higher. Clinical management and surgical outcomes were similar in pregnant women and non-pregnant women of reproductive age.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 Fall of another myth for colon cancer: Duration of symptoms does not differ between right- or left-sided colon cancers(Aves, 2019) Ozturk, Ersin; Kuzu, Mehmet Ayhan; Oztuna, Derya; Isik, Ozgen; Canda, Aras Emre; Balik, Emre; Erkasap, Serdar; Yoldas, Tayfun; Akyol, Cihangir; Demirbas, Sezai; Ozogul, Bunyamin; Topcu, Omer; Gedik, Ercan; Baca, Bilgi; Erguner, Ilknur; Asoglu, Oktar; Erkek, Bulent; Yilmazlar, Tuncay; Reis, Erhan; Gencosmanoglu, Rasim; Aslar, Ahmet Kessaf; Konan, AliBackground/Aims: Patients with colorectal cancer continue to present with relatively advanced tumors that are associated with poor oncological outcomes. The aim of the present study was to assess the association between localization, symptom duration, and tumor stage. Materials and Methods: A prospective, multicenter cohort study was conducted on patients newly diagnosed with a histologically proven colorectal adenocarcinoma. Standardized questionnaire-interviews were performed. Data were collected on principal presenting symptoms, duration of symptoms (time to first presentation to a doctor and time to diagnosis) and treatment, diagnostic procedures, tumor site, and stage of the tumor (tumor, node, and metastasis (TNM)). Results: A total of 1795 patients with colorectal cancer were interviewed (mean age: 60.76 +/- 13.50 years, male patients: 1057, patients aged >50 years: 1444, colon/rectal cancer: 899/850, right side/left side: 383/1250, stage 0-1-2/stage 3-4: 746/923). No statistically significant correlations were found between duration of symptoms and either tumor site or stage. Principal presenting symptoms were significantly associated with left colon cancer. Patients who had "anemia," "change in bowel habits," "anal pruritus or discharge," " weight loss," and "tumor in right colon" had a significantly longer symptom time. Conclusion: Symptom duration is not associated with localization, nor is the tumor stage. Diagnosis of colorectal cancer at an earlier stage may be best achieved by screening of the population.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 Impact of pandemic and socioeconomic influences on decision-making for emergency ostomy procedures: Key factors affecting hospital visit decisions(Lippincott Williams & Wilkins, 2024) Umman, Veysel; Girgin, Tolga; Baki, Bahadir Emre; Bozbiyik, Osman; Akbulut, Sami; Yoldas, TayfunEmergency surgeries are linked with increased morbidity and reduced life expectancy, often associated with low socioeconomic status, limited access to healthcare, and delayed hospital admissions. While the influence of socioeconomic status on elective surgery outcomes is well-established, its impact on emergency surgeries, including ostomy creation and closure, is less clear. This study aimed to explore how the pandemic and socioeconomic status affect emergency ostomy procedures, seeking to determine which has a greater effect. It emphasizes the importance of considering socioeconomic factors in patient care pathways for ostomy procedures. A total of 542 patients who underwent emergency ostomy formation between 2016 and 2022 were retrospectively analyzed and divided into pre-pandemic and pandemic periods. The pre-pandemic and pandemic periods were compared between themselves and against each other. Demographic data (age and sex), comorbidities, socioeconomic status, etiology of the primary disease, type of surgery, stoma type, length of hospital stay, ostomy closure time, and postoperative complications were retrospectively analyzed for all patients. In total, 290 (53%) patients underwent surgery during the pandemic period, whereas 252 (47%) underwent surgery during the pre-pandemic period. Emergency surgery was performed for malignancy in 366 (67%) patients. The number of days patients underwent ostomy closure was significantly higher in the low-income group (P = .038, 95% CI: 293,2, 386-945). The risk of failure of stoma closure was 3-fold (95% CI: 1.8-5.2) in patients with metastasis. The risk of mortality was 12.4-fold (95% CI: 6.5-23.7) when there was failure of stoma closure. When compared to pandemic period, the mortality risk was 6.3-fold (95% CI: 3.9-10.2) in pre-pandemic period. Pandemic patients had a shorter hospital stay than before the pandemic (P = .044). A high socioeconomic status was significantly associated with early hospital admission for ostomy closure, and lower probability of mortality. More metastases and perforations were observed during the pandemic period and mortality was increased during pandemic and in patients without ostomy closure. The socioeconomic status lost its effect in cases of emergency ostomy creation and had no impact on length of hospital stay in either the pre-pandemic or pandemic period.Öğe An interview with specialist physicians: what are the interests of thoracic surgery?(Baycinar Medical Publ-Baycinar Tibbi Yayincilik, 2012) Aktin, Banu; Apiliogullan, Burhan; Esme, Hidir; Yoldas, TayfunBackground: The aim of this study was to determine the current level of knowledge or misunderstanding regarding thoracic surgery for specialist physicians who work in various fields in our hospital and to could help them have a more productive work atmosphere. Methods: Ninety-seven specialists from 31 different departments in our hospital gave their consent to answer our questionnaire concerning thoracic surgery. They were asked to answer the choices, and the data obtained was then analyzed using the SPSS version 10.0 software program. Results: The knowledge if the thoracic surgeons treat spontaneous pneumothorax, lung hydatid cysts, and lung cancer was correct (89-96%). However, they exhibited only moderate knowledge (50%) regarding bronchiectasis, lung metastasis, regional hyperhidrosis, and surgical diagnosis of interstitial lung diseases. Furthermore, one-third of the physicians believed that videothoracoscopy is a kind of bronchoscopy performed using video under local anesthesia. Also, some misunderstood that thoracic vertebra surgery is related to thoracic surgery. Conclusion: Our study results suggested that even specialists may have missing or wrong knowledge regarding thoracic surgery. Considering that almost all patients who are admitted to a thoracic surgery outpatient clinic are referred from other specialities, physicians from other fields should endeavor to learn as much as possible about thoracic surgery so medical facilities can provide a more effective working atmosphere.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 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 Our 'Ligation of Intersphincteric Fistula Tract' Experience for Complex Anorectal Fistulas: Is It a Preferable Method?(Southeastern Surgical Congress, 2014) Yoldas, Tayfun; Karaca, Can; Unalp, Omer; Ekmekcigil, Ela; Uguz, Alper; Sezer, Taylan; Caliskan, Cemil; Akgun, Erhan; Korkut, MustafaÖğe Prognostic Factors for Isolated Locoregional Recurrences in Colon Cancer and Survival After Salvage Surgery: a Cohort Study(Springer India, 2018) Akgun, Erhan; Yoldas, Tayfun; Caliskan, Cemil; Karabulut, Bulent; Doganavsargil, Basak; Akarca, Ulus SalihThe purpose of this study was to establish the factors affecting development of locoregional recurrence (LR) and survival following salvage surgery in patients operated on for stage I-III colon adenocancer with curative purposes and using a standard technique by an experienced surgeon in elective circumstances. This was a cohort study of patients diagnosed with colon cancer, operated on (n=312) between January 2003 and 2015. Isolated LR was detected in 15 patients (4.8%) among 312 consecutive patients (99.7% R-0 resection) in a mean follow-up period of 60.5months. The most important prognostic factors affecting LR development were found to be R-1 resection, pT(4) tumor (tm), postoperative development of morbidity, T-4 tm, N-2 tm, and mucinous tm. All patients who were detected to have isolated LR were re-operated with curative intent (80% R-0). Prognostic factors for cancer-specific survival (CSS) in those cases were development of distant metastasis, localization of the recurrent tumor (pelvis), and symptomatic patient. Mean survival in the whole series was 125.2months and 5-year CSS was 89%, while respective values in cases with development of LR were 47.4months and 54.4%, respectively. Although development of isolated LR worsens the prognosis considerably, a long survival and even cure can be provided in some patients. Survival is closely related with resectability and localization of the recurrent tumor and development of distant metastasis. Close follow-up of high-risk patients, early diagnosis and treatment in patients with development of recurrence, experienced team and standardized curative surgery, and a multidisciplinary approach improve the prognosis.Öğe Prognostic Factors for Isolated Locoregional Recurrences in Colon Cancer and Survival After Salvage Surgery: a Cohort Study(Springer India, 2018) Akgun, Erhan; Yoldas, Tayfun; Caliskan, Cemil; Karabulut, Bulent; Doganavsargil, Basak; Akarca, Ulus SalihThe purpose of this study was to establish the factors affecting development of locoregional recurrence (LR) and survival following salvage surgery in patients operated on for stage I-III colon adenocancer with curative purposes and using a standard technique by an experienced surgeon in elective circumstances. This was a cohort study of patients diagnosed with colon cancer, operated on (n=312) between January 2003 and 2015. Isolated LR was detected in 15 patients (4.8%) among 312 consecutive patients (99.7% R-0 resection) in a mean follow-up period of 60.5months. The most important prognostic factors affecting LR development were found to be R-1 resection, pT(4) tumor (tm), postoperative development of morbidity, T-4 tm, N-2 tm, and mucinous tm. All patients who were detected to have isolated LR were re-operated with curative intent (80% R-0). Prognostic factors for cancer-specific survival (CSS) in those cases were development of distant metastasis, localization of the recurrent tumor (pelvis), and symptomatic patient. Mean survival in the whole series was 125.2months and 5-year CSS was 89%, while respective values in cases with development of LR were 47.4months and 54.4%, respectively. Although development of isolated LR worsens the prognosis considerably, a long survival and even cure can be provided in some patients. Survival is closely related with resectability and localization of the recurrent tumor and development of distant metastasis. Close follow-up of high-risk patients, early diagnosis and treatment in patients with development of recurrence, experienced team and standardized curative surgery, and a multidisciplinary approach improve the prognosis.Öğe Prognostic Factors in Peptic Ulcer Perforations: A Retrospective 14-Year Study(Int College Of Surgeons, 2015) Unver, Mutlu; Firat, Ozgur; Unalp, Omer Vedat; Uguz, Alper; Gumus, Tufan; Sezer, Taylan Ozgur; Ozturk, Safak; Yoldas, Tayfun; Ersin, Sinan; Guler, AdemRegarding the complications of peptic ulcer, a perforation remains the most important fatal complication. The aim of our retrospective study was to determine relations between postoperative morbidity and comorbid disease or perioperative risk factors in perforated peptic ulcer. In total, 239 patients who underwent emergency surgery for perforated peptic ulcer in Ege University General Surgery Department, between June 1999 and May 2013 were included in this study. The clinical data concerning the patient characteristics, operative methods, and complications were collected retrospectively. One hundred seventy-five of the 239 patients were male (73.2%) and 64 were female (26.8%). Mean American Society of Anesthesiologists (ASA) score was 1 in the patients without morbidity, but mean ASA score was 3 in the morbidity and mortality groups. Primary suture and omentoplasty was the selected procedure in 228 of the patients. Eleven patients underwent resection. In total, 105 patients (43.9%) had comorbidities. Thirty-seven patients (67.3%) in the morbidity group had comorbid diseases. Thirteen (92.9%) patients in the mortality group had comorbid diseases. Perforation as a complication of peptic ulcer disease still remains among the frequent indications of urgent abdominal surgery. Among the analyzed parameters, age, ASA score, and having comorbid disease were found to have an effect on both mortality and morbidity. The controversial subject in the present study is regarding the duration of symptoms. The duration of symptoms had no effect on mortality nor morbidity in our study.Öğe Prognostic Factors in Peptic Ulcer Perforations: A Retrospective 14-Year Study(Int College Of Surgeons, 2015) Unver, Mutlu; Firat, Ozgur; Unalp, Omer Vedat; Uguz, Alper; Gumus, Tufan; Sezer, Taylan Ozgur; Ozturk, Safak; Yoldas, Tayfun; Ersin, Sinan; Guler, AdemRegarding the complications of peptic ulcer, a perforation remains the most important fatal complication. The aim of our retrospective study was to determine relations between postoperative morbidity and comorbid disease or perioperative risk factors in perforated peptic ulcer. In total, 239 patients who underwent emergency surgery for perforated peptic ulcer in Ege University General Surgery Department, between June 1999 and May 2013 were included in this study. The clinical data concerning the patient characteristics, operative methods, and complications were collected retrospectively. One hundred seventy-five of the 239 patients were male (73.2%) and 64 were female (26.8%). Mean American Society of Anesthesiologists (ASA) score was 1 in the patients without morbidity, but mean ASA score was 3 in the morbidity and mortality groups. Primary suture and omentoplasty was the selected procedure in 228 of the patients. Eleven patients underwent resection. In total, 105 patients (43.9%) had comorbidities. Thirty-seven patients (67.3%) in the morbidity group had comorbid diseases. Thirteen (92.9%) patients in the mortality group had comorbid diseases. Perforation as a complication of peptic ulcer disease still remains among the frequent indications of urgent abdominal surgery. Among the analyzed parameters, age, ASA score, and having comorbid disease were found to have an effect on both mortality and morbidity. The controversial subject in the present study is regarding the duration of symptoms. The duration of symptoms had no effect on mortality nor morbidity in our study.Öğe Prognostic Factors in Peptic Ulcer Perforations: A Retrospective 14-Year Study(Int College Of Surgeons, 2015) Unver, Mutlu; Firat, Ozgur; Unalp, Omer Vedat; Uguz, Alper; Gumus, Tufan; Sezer, Taylan Ozgur; Ozturk, Safak; Yoldas, Tayfun; Ersin, Sinan; Guler, AdemRegarding the complications of peptic ulcer, a perforation remains the most important fatal complication. The aim of our retrospective study was to determine relations between postoperative morbidity and comorbid disease or perioperative risk factors in perforated peptic ulcer. In total, 239 patients who underwent emergency surgery for perforated peptic ulcer in Ege University General Surgery Department, between June 1999 and May 2013 were included in this study. The clinical data concerning the patient characteristics, operative methods, and complications were collected retrospectively. One hundred seventy-five of the 239 patients were male (73.2%) and 64 were female (26.8%). Mean American Society of Anesthesiologists (ASA) score was 1 in the patients without morbidity, but mean ASA score was 3 in the morbidity and mortality groups. Primary suture and omentoplasty was the selected procedure in 228 of the patients. Eleven patients underwent resection. In total, 105 patients (43.9%) had comorbidities. Thirty-seven patients (67.3%) in the morbidity group had comorbid diseases. Thirteen (92.9%) patients in the mortality group had comorbid diseases. Perforation as a complication of peptic ulcer disease still remains among the frequent indications of urgent abdominal surgery. Among the analyzed parameters, age, ASA score, and having comorbid disease were found to have an effect on both mortality and morbidity. The controversial subject in the present study is regarding the duration of symptoms. The duration of symptoms had no effect on mortality nor morbidity in our study.Öğe A Rare Cause of Colonic Obstruction ''Colonic Intussusception'': Report of Two Cases(Hindawi Ltd, 2015) Yoldas, Tayfun; Karaca, Avni Can; Ozturk, Safak; Unver, Mutlu; Caliskan, Cemil; Korkut, Mustafa AliColocolic intussusceptions are rare clinical entities in adults and almost always caused by a leading lesion which often warrants resection. Mostly being malignant, the leading lesions are rarely benign lesions where intraluminal lipomas are the most frequent among them. Most adult intussusceptions require surgical resection owing to two major reasons: common presence of a leading lesion and significantly high risk of malignancy-reaching as high as 65% regardless of the anatomic site-of the leading lesion. Resection of the affected segment is usually the treatment of choice, since preoperative diagnosis of the lesion is usually ineffective and most leading lesions are malignant. This paper represents two cases of adult colocolic intussusception caused by intraluminal lipomas with a brief review of the literature.Öğe Recurrent Pilonidal Sinus: Lay Open or Flap Closure, Does It Differ?(Int College Of Surgeons, 2013) Yoldas, Tayfun; Karaca, Can; Unalp, Omer; Uguz, Alper; Caliskan, Cemil; Akgun, Erhan; Korkut, MustafaTreatment options of pilonidal sinus, which has high recurrence rates, is still controversial. In this study, we aimed to analyze for possible factors affecting recurrence. Forty-one patients with recurrent pilonidal sinus were included in this study. Of them, 33 were male and 9 were female (mean age, 24.9 years; age range, 16-42). Factors (i.e., risk factors) were detected in 32 patients. Excision-secondary healing and lay open was performed on 30 of the patients admitted with recurrence. Excision and flap closure was applied on 11 patients. Our recurrence rate was 9.7%. The recurrence rate of our study is compatible with the literature. Comparative studies are needed to determine the appropriate method to decrease recurrence rate.Öğe Should Subtotal Thyroidectomy Be Abandoned in Multinodular Goiter Patients From Endemic Regions Requiring Surgery?(Int College Of Surgeons, 2015) Yoldas, Tayfun; Makay, Ozer; Icoz, Gokhan; Kose, Timur; Gezer, Gulten; Kismali, Erkan; Tamsel, Sadik; Ozbek, Sureyya; Yilmaz, Mustafa; Akyildiz, MahirThe most convenient surgical procedure for benign thyroid diseases is still controversial. The aim of this study is to determine the recurrence rate and risk factors for recurrence after different thyroidectomy procedures in multinodular goiter patients. Patients were separated into two groups according to the detection of a recurrent nodule or not after thyroidectomy. Of the 748 patients, 216 (29%) had recurrence, while 532 had no recurrent nodule. The difference between surgical procedures described as subtotal (ST), near total (NT) and total thyroidectomy (TT) was statistically significant. Transient hypoparathyroidism was significantly higher in NT and TT, when compared to ST patients (P < 0.05). Young age, bilateral multinodular goiter and insufficient surgery are risk factors affecting recurrence for benign nodular thyroid disease. Currently, subtotal procedures should be discontinued and total or near total procedures should be preferred. Meanwhile, the probability of a higher risk of hypoparathyroidism should be kept in mind.Öğe Totally Curative Surgical Resection of Retrorectal Tumors(H G E Update Medical Publishing S A, 2015) Ucar, Ahmet Deniz; Yoldas, Tayfun; Oymaci, Erkan; Erkan, Nazif; Caliskan, Cemil; Yildirim, Mehmet; Akgun, Zekeriya ErhanBackground/Aims: Retrorectal (also known as presacral) tumor (RT) is a rare disease of retrorectal space. There is no large numbered case series in the literature. Well documented small numbered case series will help to establish meta-analysis and surgical decision making. Methodology: Between 2000 and 2014 medical records of patients with diagnosis of RT at two institutions were reviewed. Clinical features, diagnostic studies, type of surgery, surgical findings, surgical technique, and histopathology of the tumor, morbidity and survival are examined based on data registry. Results: During 14 years period of time, total of 12 patients operated with diagnosis of RT were retrieved to this study. There were five men and seven women. The median age at the time of diagnosis was 43 (27-56) years. The most frequent findings were pain and palpable mass. There were five anterior, four posterior and three anteroposterior approaches for surgery. There is no recurrence or disease related mortality observed after median of 7 years (1-14). Conclusion: The primary and only satisfactory treatment is surgery for RTs. Prognosis is directly related primary local control with complete excision, which is often difficult to achieve for malignant lesions.
