Publications by authors named "Cengiz Aydin"

57 Publications

Faculty perceptions, awareness and use of open educational resources for teaching and learning in higher education: a cross-comparative analysis.

Res Pract Technol Enhanc Learn 2022 25;17(1):11. Epub 2022 Mar 25.

Beijing Normal University, Beijing, China.

This paper explores faculty's perspectives and use of open educational resources (OER) and their repositories across different countries by conducting a multiple case study to find similarities and differences between academics' awareness, perceptions and use of OER, as well as examining related aspects of institutional policy and quality that may influence individual views. Data were collected through nine expert reports on each country studied (Australia, Canada, China, Germany, Japan, South Africa, South Korea, Spain and Turkey) and were analyzed through qualitative content analysis using thematic coding. Findings show the impact on individual OER adoption with regard to the individual control of diverse factors by faculty members; of institutional policies and quality measures on the externally determined factors (by the institution); and of institutional professional development and provision of incentives in more internally determined factors (by the faculty members themselves). These findings carry implications for higher education institutions around the world in their attempt to boost OER adoption by faculty members.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1186/s41039-022-00185-zDOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8947858PMC
March 2022

Galectin-3 levels and inflammatory response in patients undergoing bariatric surgery.

Cytokine 2022 03 13;151:155793. Epub 2022 Jan 13.

Department of General Surgery, University of Health Sciences, Tepecik Training and Research Hospital, Izmir, Turkey.

Purpose: Obesity, a low-grade systemic inflammatory disease, causes inflammation in metabolic tissues. Galectin-3(Gal-3) is one of the lectin molecules involved in inflammatory processes. We evaluated the possible relationship between Gal-3 level and the metabolic inflammatory process before and after obesity surgery.

Methods: One hundred participants were included in the study and classified as normal weight, overweight, Class I, II, and III obese. Class III obese group underwent bariatric surgery and evaluated in the 3rd and 6th months after surgery. Glucose, insulin, glycated hemoglobin A1c (HbA1c), homeostatic model assessment of insulin resistance (HOMA-IR), high sensitivity C-reactive protein (hsCRP), Gal-3, interleukin (IL)-6, IL-10, adiponectin, and leptin levels were determined.

Results: Gal-3 levels were higher in Class III obese compared to the normal weight group. Postoperative leptin and hsCRP levels were decreased significantly, but the decrease in IL-6 and Gal-3 levels were not significant. Postoperative increased adiponectin and IL-10 levels were significant. Gal-3 was found significantly higher in insulin resistant group. The correlation between Gal-3 with BMI, adiponectin, leptin, hsCRP levels, and HOMA-IR was found weak.

Conclusion: These findings might support the fact that Gal-3 is one of the molecules involved in the linkage between insulin resistance and meta-inflammation in morbid obese.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1016/j.cyto.2022.155793DOI Listing
March 2022

30-Day Morbidity and Mortality of Bariatric Surgery During the COVID-19 Pandemic: a Multinational Cohort Study of 7704 Patients from 42 Countries.

Obes Surg 2021 10 30;31(10):4272-4288. Epub 2021 Jul 30.

Bariatric Unit, South Tyneside and Sunderland NHS Trust, Sunderland, UK.

Background: There are data on the safety of cancer surgery and the efficacy of preventive strategies on the prevention of postoperative symptomatic COVID-19 in these patients. But there is little such data for any elective surgery. The main objectives of this study were to examine the safety of bariatric surgery (BS) during the coronavirus disease 2019 (COVID-19) pandemic and to determine the efficacy of perioperative COVID-19 protective strategies on postoperative symptomatic COVID-19 rates.

Methods: We conducted an international cohort study to determine all-cause and COVID-19-specific 30-day morbidity and mortality of BS performed between 01/05/2020 and 31/10/2020.

Results: Four hundred ninety-nine surgeons from 185 centres in 42 countries provided data on 7704 patients. Elective primary BS (n = 7084) was associated with a 30-day morbidity of 6.76% (n = 479) and a 30-day mortality of 0.14% (n = 10). Emergency BS, revisional BS, insulin-treated type 2 diabetes, and untreated obstructive sleep apnoea were associated with increased complications on multivariable analysis. Forty-three patients developed symptomatic COVID-19 postoperatively, with a higher risk in non-whites. Preoperative self-isolation, preoperative testing for SARS-CoV-2, and surgery in institutions not concurrently treating COVID-19 patients did not reduce the incidence of postoperative COVID-19. Postoperative symptomatic COVID-19 was more likely if the surgery was performed during a COVID-19 peak in that country.

Conclusions: BS can be performed safely during the COVID-19 pandemic with appropriate perioperative protocols. There was no relationship between preoperative testing for COVID-19 and self-isolation with symptomatic postoperative COVID-19. The risk of postoperative COVID-19 risk was greater in non-whites or if BS was performed during a local peak.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1007/s11695-021-05493-9DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8323543PMC
October 2021

Isolated Metastasis of Left Seminal Vesicle due to Colon Adenocarcinoma: An Unusual Pattern of Metastasis.

J Coll Physicians Surg Pak 2021 Jun;30(6):752-753

Department of General Surgery, University of Health Sciences, Tepecik Training and Research Hospital, Izmir, Turkey.

View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.29271/jcpsp.2021.06.752DOI Listing
June 2021

The relationship between thyroidectomy complications and body mass index.

Rev Assoc Med Bras (1992) 2020 Nov;66(11):1573-1576

University of Health Sciences Tepecik Training and Research Hospital, Department of General Surgery, Izmir, Turkey.

Introduction: Obesity is a growing public health problem associated with many comorbid diseases. The aim of this study was to evaluate the relationship between body mass index and complications of thyroidectomy.

Methods: Patients who underwent total thyroidectomy between January 2015 and December 2018 were enrolled. Patients were divided into two groups, i.e., BMI <25 (group A) and BMI≥ 25 (group B). Demographics, operative time, and complications were retrospectively reviewed.

Results: The study included 145 patients (66 in Group A and 79 in Group B). There was no significant difference between the two groups in terms of age (p=0.330) and gender (p=0.055). No surgical site infection and bleeding complications were observed in any patients. The mean operative time was 148.4 minutes (90-235) in Group A and 153.4 minutes (85-285) in Group B (p=0.399). Transient hypocalcemia was observed in 25 (37.9%) patients in group A, and 23 (29.1%) patients in Group B (p = 0.291). Permanent hypocalcemia was not observed in any patient in group A, and in 2 patients in Group B (2.5%) (p = 0.501). Transient recurrent nerve palsy was observed in 1 (1.5%) patient in Group A and in 3 (3.8%) patients in Group B (p=0.626). None of the patients had permanent recurrent nerve palsy. Parathyroid autotransplantation was performed on 1 patient (1.5%) in group A and on 7 (8.9%) patients in Group B (p=0.055).

Conclusion: We think there is no relationship between a high BMI and thyroidectomy complications, and surgery can also be performed safely in this patient group.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1590/1806-9282.66.11.1573DOI Listing
November 2020

Assessment of prophylactic antibiotic usage habits of the general surgeons in Turkey.

J Infect Dev Ctries 2020 07 31;14(7):758-764. Epub 2020 Jul 31.

Department of General Surgery, Adnan Menderes University, Aydin, Turkey.

Introduction: One of the most important aspects of inappropriate antibiotic use among general surgeons in Turkey is the use of surgical antibiotic prophylaxis (SP). In order to shed light on the current situation, we conducted a survey of general surgeons in our country. Our aim was to evaluate the approach taken by our general surgeons in prescribing SP, while providing data pertinent to the effectiveness of the 'Rational Drug Use' (AIK) national action plan.

Methodology: A questionnaire on the subject of personal SP usage and compliance with guidelines was distributed amongst general surgeons between 2018-2019. The questions related to individual approaches taken by surgeons when treating patients with either clean or clean-contaminated wounds. Results of the questionnaires were collated and compliance with ASHP guidelines was evaluated.

Results: A total of 317 completed questionnaires were evaluated. According to the questionnaire results, the rate of total compliance with ASHP guidelines was 26.8%. The compliance rate for preoperative SP was 69.7% in the clean wound group and 54.6% in the clean-contaminated wound group. Although 96.5% of the participants reported correct timing for the first dose of SP, this number dropped to 79.5% apropos the adminstration of further doses of prophylaxis. The percentage of surgeons prescribing continued antibiotics at discharge for clean and clean-contaminated cases was 22.7% and 38.5%, respectively.

Conclusions: The results of this study indicate that inappropriate use of SP is widespread in our country, and that antibiotics continue to be prescribed at discharge.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.3855/jidc.12296DOI Listing
July 2020

A new antibiotic stewardship program approach is effective on inappropriate surgical prophylaxis and discharge prescription.

J Infect Dev Ctries 2019 11 30;13(11):961-967. Epub 2019 Nov 30.

Department of General Surgery, Tepecik Education and Research Hospital, Yenisehir, Izmir, Turkey.

Introduction: This study aims to evaluate the efficacy of a new antimicrobial stewardship program (ASP) on surgical antibiotic prophylaxis (SP) and antibiotics in discharge prescriptions used as a continuation of SP.

Methodology: The study included elective patients with clean and clean-contaminated wounds. The accuracy of the assigned SP was evaluated according to international guidelines. Primary outcome measures comprised appropriateness of prophylactic antibiotic indication, correct timing of initial dose, discontinuation of SP within 24 hours, and antibiotic prescription at discharge. A secondary outcome measure was to determine whether the effect of ASP was sustained long-term.

Results: The total compliance rate for all stages of SP increased from 8% to 52.1% after the intervention (p < 0.05). When analyzed according to individual SP components, it was found that although ASP did not change first dose timing rates, it did affect the rates of prophylactic antibiotic indication, discontinuation of SP within 24 hours and antibiotic prescription at discharge, with statistical significance (p < 0.05). In addition, ASP continued to increase its effectiveness throughout the 3rd year.

Conclusions: Based on the findings of our study, it seems clear that the modified ASP introduced in our general surgery clinic can be used effectively and simply; in addition, this ASP increases its efficacy with time.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.3855/jidc.11734DOI Listing
November 2019

Correction: Evaluation of Antibiotic Prophylaxis and Discharge Prescriptions in the General Surgery Department.

Cureus 2019 Aug 5;11(8):c23. Epub 2019 Aug 5.

General Surgery, University of Health Sciences Tepecik Training and Research Hospital, Izmir, TUR.

[This corrects the article DOI: 10.7759/cureus.4793.].
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.7759/cureus.c23DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6682413PMC
August 2019

Evaluation of Antibiotic Prophylaxis and Discharge Prescriptions in the General Surgery Department.

Cureus 2019 Jun 1;11(6):e4793. Epub 2019 Jun 1.

General Surgery, University of Health Sciences Tepecik Training and Research Hospital, Izmir, TUR.

Introduction Although there are international guidelines for surgical antibiotic prophylaxis (SP), the use of inappropriate SP is still a common problem. Most studies investigated SP applications in clean and clean-contaminated cases. However, antibiotics in the discharge prescriptions of these cases have not been adequately investigated. In this study, we aimed to examine the antibiotics in SP applications and discharged prescriptions together and to find out the causes of inappropriate use. Materials and methods We retrospectively evaluated the data of patients admitted to our general surgery wards between 2014 and 2015. Patients with clean or clean-contaminated wound category operations were included. The patients were evaluated in terms of convenience of SP (choice of antibiotics, compliance with an indication for SP, timing of the first dose, SP>24 hours, and discharge prescription). In addition, to interpret the results, a questionnaire has been performed for the surgeons in the same clinics. Results A total of 1205 patients with clean and clean-contaminated wound class operation were enrolled in this study. The total accuracy rate of SP was 7.1%. SP application with the correct indication and timing of the first dose was compatible with guidelines: 55.6% and 81.9%, respectively. SP was applied >24 hours at 60.2% and antibiotic prescribing carried out after discharge at 80.6% of patients. According to questionnaire results, the use of SP over 24 hours and the prescription of antibiotics during discharge were: drain usage, hyperthermia, leukocytosis, surgeons feeling of comfort, avoidance of patients, and their relatives' reactions. Conclusion The total accuracy rate of SP rate was low in the present study and in surgeons prescribing the SP after discharge. In light of the present study, we suggest that discharge prescriptions should also be reviewed in clinics who have a high inappropriate surgical antibiotic prophylaxis rate.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.7759/cureus.4793DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6726339PMC
June 2019

Reliability of fine needle aspiration biopsy in large thyroid nodules.

Turk J Surg 2017 1;33(1):10-13. Epub 2017 Mar 1.

Clinic of General Surgery, İzmir Tepecik Training and Research Hospital, İzmir, Turkey.

Objective: Fine needle aspiration biopsy provides one of the most important data that determines the treatment algorithm of thyroid nodules. Nevertheless, the reliability of fine needle aspiration biopsy is controversial in large nodules. The aim of this study was to evaluate the adequacy of fine needle aspiration biopsy in thyroid nodules that are four cm or greater.

Material And Methods: We retrospectively examined 219 patients files who underwent thyroidectomy for thyroid nodules that were greater than four centimeter between May 2007 and December 2012. Seventy-four patients with hyperthyroidism, and 18 patients without preoperative fine needle aspiration cytology were excluded from the study. Histopathologic results after thyroidectomy were compared with preoperative cytology results, and sensitivity and specificity rates were calculated.

Results: False-negativity, sensitivity and specificity rates of fine needle aspiration biopsy of thyroid nodules were found to be 9.7%, 55.5%, and 85%, respectively. Within any nodule of the 127 patients, 28 (22.0%) had thyroid cancer. However, when only nodules of at least 4 cm were evaluated, thyroid cancer was detected in 22 (17.3%) patients.

Conclusion: In this study, fine needle aspiration biopsy of large thyroid nodules was found to have a high false-negativity rate. The limitations of fine-needle aspiration biopsy should be taken into consideration in treatment planning of thyroid nodules larger than four centimeters.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.5152/UCD.2017.3329DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5448564PMC
March 2017

Treatment of pilonidal disease by phenol application.

Turk J Surg 2017 1;33(1):5-9. Epub 2017 Mar 1.

Department of General Surgery, İzmir Tepecik Training and Research Hospital, İzmir, Turkey.

The literature indicates various approaches regarding the properties of phenol, the target patient group, and the complication and recurrence rates. Although phenol is most frequently used to treat the fistulated form of the disease, it can also be applied for other types. The overall success and complication rates of the application is reported as 62-95% and 0%-2%, respectively. Phenol treatment in pilonidal disease can be used more frequently as an alternative method with acceptable success, complication, and recurrence rates.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.5152/UCD.2016.3532DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5448572PMC
March 2017

Predictive Value of Preoperative Neutrophil Lymphocyte Ratio in Determining the Stage of Gastric Tumor.

Med Sci Monit 2017 Apr 24;23:1973-1979. Epub 2017 Apr 24.

Department of General Surgery, Erzincan Universitesi, Erzincan, Turkey.

BACKGROUND Neutrophil-lymphocyte ratio (NLR) is an indicator of the inflammatory state, and its increase has been shown to be a negative prognostic factor for many malignancies. The aim of this study was to determine whether there was a relationship between NLR and tumor aggressiveness in gastric cancer patients and to investigate the prognostic significance of NLR. MATERIAL AND METHODS The medical records of 189 patients with gastric cancer between January 2009 and January 2014 were examined for the presence of metastasis, tumor staging, tumor differentiation grade, and preoperative NLR value. RESULTS Of the 189 patients, 61 were female (32.2%) and 128 were male (67.7%). Eight-eight patients had NLR values of four or higher. A comparison of the high NLR value group and the low NLR value group found no statistically significant difference for clinicopathological features of age, gender, type of operation, of degree of differentiation; differences ranged from 20.7% to 46.2%, p<0.001. CONCLUSIONS Increase in NLR has been associated with poor prognosis in univariate analysis and variations of this parameter have also been shown to be correlated with tumor progression. NLR values should be considered as a useful follow-up parameter.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5413293PMC
http://dx.doi.org/10.12659/msm.900681DOI Listing
April 2017

Oncoplastic reduction mammoplasty for breast cancer in women with macromastia: long term aesthetic, functional and satisfaction outcomes.

Contemp Oncol (Pozn) 2016 4;20(3):256-60. Epub 2016 Mar 4.

Department of General Surgery, Tepecik Training and Research Hospital, Izmir, Turkey.

Aim Of The Study: Despite the increase in studies concerning oncoplastic reduction mammoplasty (ORM), data showing long-term aesthetic and patient satisfaction for ORM in patients with macromastia remain limited. Therefore, this study evaluated the long-term results of tumorectomy and concomitant bilateral ORM for early-stage breast cancer patients with macromastia in terms of cosmesis, patient satisfaction, and functional outcomes.

Material And Methods: Retrospective data of patients with macromastia undergoing ORM for breast cancer between 1996 and 2011 were examined and evaluated regarding the aesthetic results, patient satisfaction, and functional outcomes.

Results: The median age of the 82 patients was 50 years. The median follow-up was 120 months (range: 28-212 months). The median breast volume was 1402 cm(3), and the median weight of the excised breast material was 679 g. A good or excellent evaluation of the cosmetic outcome was as follows: self-evaluation: 84.1% at the early-stage, 80.3% at the later stage; panel evaluation: 75.4% at the late-stage. Median patient satisfaction rates were 9.1% for early-stage disease and 8.8% for late-stage disease. Reduced mobility and intertrigo improved by three-fold during the post-operative period.

Conclusions: ORM for early-stage breast cancer in women with macromastia results in good cosmesis in both the early-stage and long-term, and is quite acceptable for use in patients. Patients reacted favorably to the prospect of having their breast cancer and macromastia treated in a single session, and positive results continued over the long-term.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.5114/wo.2015.55272DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5013678PMC
September 2016

The effect of sleeve gastrectomy on serum irisin levels in patients with morbid obesity.

Endokrynol Pol 2016 17;67(5):481-486. Epub 2016 Feb 17.

Department of Endocrinology and Metabolism, Tepecik Education and Research Hospital, Izmir,.

Introduction: Irisin, a recently identified myokine, is associated with increased energy expenditure and has a potential role in obesity. Therefore, we investigated circulating irisin levels in morbidly obese patients undergoing sleeve gastrectomy (SG).

Material And Methods: Thirty morbidly obese patients undergoing SG and 30 healthy subjects were included. All participants were evaluated at baseline and again at three months post-SG. Body weight and height, the lipid profile, and plasma glucose, HbA1c, insulin, and irisin levels were measured at each visit.

Results: The two groups had similar mean age and sex distribution. Serum irisin was significantly lower in the morbidly obese subjects compared with the controls (p = 0.003) and negatively correlated with BMI, body weight, insulin levels, and HOMA-IR (p = 0.006, p = 0.011, p = 0.046, p = 0.048, respectively). When the morbidly obese patients were re-evaluated three months post-SG, their weight and BMI had significantly decreased (both p = 0.001). Similarly, the insulin, HbA1c, HDL-cholesterol, and HOMA-IR values significantly decreased (p = 0.001, p = 0.028, p = 0.006, and p = 0.001, respectively). However, irisin levels remained unchanged (p = 0,267).

Conclusion: Although the irisin levels were significantly lower in the morbidly obese subjects, they did not change after SG-induced weight loss. (Endokrynol Pol 2016; 67 (5): 481-486).
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.5603/EP.a2016.0029DOI Listing
April 2017

Metaplastic Breast Carcinoma: Analysis of Clinical and Pathologic Characteristics - A Case Series.

J Breast Health 2016 Apr 1;12(2):63-66. Epub 2016 Apr 1.

Clinic of General Surgery, Tepecik Training and Research Hospital, İzmir, Turkey.

Objective: Metaplastic breast cancer (MBC) is a rare type of breast cancer that is considered to be clinically aggressive. The clinical significance and prognostic risk factors of MBC are limited. This study comprises a retrospective analysis of the clinical and pathologic findings of a series of patients treated for MBC.

Materials And Methods: The files of 657 patients who underwent surgery because of breast cancer at our clinic were examined and the data found on 11 patients who were diagnosed as having MBC were analyzed.

Results: With a median age of 56 years, all patients were postmenopausal and presented with a palpable mass on physical examination. Symptoms of ulceration and skin involvement were seen in only one patient. Eight patients were diagnosed as having squamous cell carcinoma (SCC), and 3 had both SCC and osseous differentiation. The median diameter was 3.8 cm (max. 14 cm; min. 1.5 cm). Lymph node metastasis was detected in 5 (45%) patients. Progesterone (PR) and estrogen (ER) were both negative in 11 (100%) patients and 10 (90.9%) patients, respectively, and CerbB2 was negative in 7 (63.6%) patients. Patients were followed up for a median period of 15 months (range, 6-40 months); at the end of which, 10 patients survived and one died of cardiac arrest at 7 months post-operatively. No instances of local recurrence or distant organ metastasis were found in any patients. The overall patient survival rate was 90%.

Conclusion: There is no consensus on the clinical significance or best treatment approach for metaplastic carcinoma. In our study, patients with MBC were of advanced age, had tumors with large margins, high negativity for hormone receptors, and moderate- to well-differentiated histology.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.5152/tjbh.2016.2837DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5351502PMC
April 2016

Oncoplastic reduction mammoplasty for breast cancer in women with macromastia: Oncological long-term outcomes.

Asian J Surg 2017 Jan 8;40(1):41-47. Epub 2015 Sep 8.

Tepecik Training and Research Hospital, Department of General Surgery, Izmir, Turkey.

Objective: To evaluate the long-term results of tumorectomy and concomitant bilateral oncoplastic reduction mammoplasty (ORM) for early stage breast cancer patients with macromastia in terms of local disease control and long-term oncological results.

Patients And Method: Data of 82 patients with macromastia undergoing ORM for breast cancer between 1996 and 2011 were retrospectively examined and evaluated with regard to oncological results.

Results: The median age was 50 years. The median follow-up was 121 months (range 28-212 months). The median breast volume was 1402 cm and the median weight of excised breast material was 679 g. The median surgical margin was 16 mm. Ten-year local recurrence rate was 8.7%. The 10-year overall survival rate was 82.2% and the disease-free survival rate was 73.2%. Early and late complication rates were 12.2% and 14.6%, respectively.

Conclusions: From the standpoint of local disease control and long-term observation, ORM can be considered a very safe and acceptable treatment for early stage breast cancer in women with macromastia.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1016/j.asjsur.2015.07.007DOI Listing
January 2017

How do surgeons approach breast cancer surgery in Turkey? A national survey.

Breast Cancer 2015 07;22(4):421-6

Department of Surgery, Tepecik Training and Research Hospital, Izmir, Turkey

Background: The aim of this study was to investigate the experience, practice and approaches of general surgeons in relation to the treatment of breast cancer in Turkey.

Methods: A survey was conducted between November 2012 and February 2013 with 453 general surgeons who claimed to perform breast surgery. Initial and most preferred approaches for breast cancer surgery and demographic features of participants were questioned. Initial approaches of surgeons for a suspected breast mass were assessed with a clinical scenario.

Results: A total of 12.6 % of practicing general surgeons in Turkey responded to the survey. A multidisciplinary assessment was employed by 57.2 % of participants. The most frequently used diagnostic tool was needle biopsies (64.9 %) and the most frequently performed surgery for early stage cancers was breast-conserving surgery (72.2 %). The initial approach for locally advanced breast cancer was neoadjuvant chemotherapy (59.8 %) and mastectomy for metastatic cancer (22.7 %). Sentinel lymph node biopsies were utilized by 59.2 % of participants by different methods in appropriate cases. Oncoplastic breast surgery was performed by 9.0 % of participants, frequently or constantly. The surgeons' initial approaches for the clinical scenario were imaging (56.7 %) and biopsy (40.6 %).

Conclusions: Although there are efforts to improve up-to-date approaches towards breast cancer surgery by surgeons, currently there are significant inadequacies for evidence-based medicine practices.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1007/s12282-013-0500-4DOI Listing
July 2015

The suppurative panniculitis of the breast.

Breast J 2015 May-Jun;21(3):314-5. Epub 2015 Mar 19.

Department of General Surgery, Tepecik Training and Research Hospital, Izmir, Turkey.

View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1111/tbj.12406DOI Listing
May 2016

Visceral organ resection during femoral hernia surgery is a predictor of morbidity.

Int Surg 2015 Mar;100(3):455-60

1 Izmir Tepecik Education and Research Hospital, Department of General Surgery, Izmir, Turkey.

Reports on the outcomes of emergency and elective femoral hernia surgery are scarce. Most studies do not distinguish femoral hernia from other types of groin hernia; studies of femoral hernia alone are few in number. The main objective of the present study was to identify factors affecting morbidity of femoral hernia patients. We retrospectively analyzed data on 80 patients who underwent femoral hernia surgery between June 2009 and June 2013. Patients who did and did not experience morbidity were compared in terms of age, sex, hernia location, the presence of any comorbid disease, the type of anesthesia employed, the operative technique used, the type of surgical intervention, and performance of small bowel resection. Forty-three patients (53.8%) underwent emergency surgery because of incarceration. Of these, 18 (41.9%) experienced strangulation and underwent resection. Postoperative complications developed in 11 patients (13.8%). Upon multiple logistic regression analysis, visceral organ resection (of the small bowel and/or omentum) was the only independent predictor of significant morbidity (P < 0.05; odds ratio [OR]: 14.010, 95% confidence interval [CI]: 1.001-196.143). When diagnosed, femoral hernias should be electively repaired as soon as possible. The cumulative probability of strangulation rises over time. A requirement for bowel resection seems to significantly increase morbidity.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.9738/INTSURG-D-14-00036.1DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4370535PMC
March 2015

The approach of general surgeons to oncoplastic and reconstructive breast surgery in Turkey: a survey of practice patterns.

Balkan Med J 2014 Dec 22;31(4):307-12. Epub 2014 Oct 22.

Department of General Surgery, Tepecik Training and Research Hospital, İzmir, Turkey.

Background: Oncoplastic Breast Surgery (OBS), which is a combination of oncological procedures and plastic surgery techniques, has recently gained widespread use.

Aims: To assess the experiences, practice patterns and preferred approaches to Oncoplastic and Reconstructive Breast Surgery (ORBS) undertaken by general surgeons specializing in breast surgery in Turkey.

Study Design: Cross-sectional study.

Methods: Between December 2013 and February 2014, an eleven-question survey was distributed among 208 general surgeons specializing in breast surgery. The questions focused on the attitudes of general surgeons toward performing oncoplastic breast surgery (OBS), the role of the general surgeon in OBS and their training for it as well as their approaches to evaluating cosmetic outcomes in Breast Conserving Surgery (BCS) and informing patients about ORBS preoperatively.

Results: Responses from all 208 surgeons indicated that 79.8% evaluated the cosmetic outcomes of BCS, while 94.2% informed their patients preoperatively about ORBS. 52.5% performed BCS (31.3% themselves, 21.1% together with a plastic surgeon). 53.8% emphasized that general surgeons should carry out OBS themselves. 36.1% of respondents suggested that OBS training should be included within mainstream surgical training, whereas 27.4% believed this training should be conducted by specialised centres.

Conclusion: Although OBS procedure rates are low in Turkey, it is encouraging to see general surgeons practicing ORBS themselves. The survey demonstrates that our general surgeons aspire to learn and utilize OBS techniques.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.5152/balkanmedj.2014.13230DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4318401PMC
December 2014

The effectiveness of simultaneous oncoplastic breast surgery in patients with locally advanced breast cancer.

Breast Cancer 2016 May 14;23(3):463-70. Epub 2015 Jan 14.

Department of General Surgery, Tepecik Training and Research Hospital, Gaziler Caddesi, No: 468, Yenisehir, Izmir, Turkey.

Background: Oncological outcomes of the oncoplastic breast surgery in patients with locally advanced breast cancer (LABC) are not well defined. This study examined the effects of oncoplastic techniques for LABC in terms of localized control and survival. We also evaluated the esthetic results of patients who had undergone oncoplastic breast conservation surgery (OBCS) and their satisfaction with the outcome.

Methods: The files and Medula (Probel Co.) database records of the patients were studied retrospectively. The esthetic evaluation was conducted by a panel. A validated satisfaction study was also performed.

Results: In total, 42 LABC cases (median age 48 years; range 33-69 years) were included. The median observation period was 61 months (range 26-151 months). Neoadjuvant chemotherapy (NACT) was administered in 32 (76%) cases, and a pathologic complete response was observed in 7 (16.7%) cases. The median T size during the post-NACT pathological study was 27 mm (range 0-44 mm). Oncoplastic reduction surgery was performed in 13 cases, a glandular flap in 7, Grisotti flap in 5, and latissimus dorsi flap in 3 cases. The median specimen weight was 198 g (range 103-812 g), and the mean surgical margin length was 8.7 mm (range 5-17 mm). The margin was positive in 7.1% of cases, and the local repetition rate was 14.6%. The total survival rate was 86.6%, and disease-free survival was 59.6%. The rate of excellent and good ratings by the esthetic assessment panel was 79.4%. The satisfaction rate was 88.2%. The early and delayed complication rate was 16.7%.

Conclusions: Oncoplastic techniques are suitable and safe for patients undergoing OBCS. These techniques do not pose a risk to oncological local control. No survival or follow-up problems were detected during the 5-year follow-up period, the esthetic results were acceptable, and the satisfaction rate was high.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1007/s12282-015-0585-zDOI Listing
May 2016

Comparison of Clinical and Pathological Differences of Breast Cancer Patients under 35 and above 55 Years of Age.

J Breast Health 2015 Jul 1;11(3):123-127. Epub 2015 Jul 1.

Clinic of General Surgery, Tepecik Training and Research Medicine, İzmir, Turkey.

Objective: In this study, we aimed to evaluate the clinical, pathologic and management differences between breast cancer patients under 35 years of age and postmenopausal patients above 55 years of age.

Materials And Methods: Patients who were operated on for breast cancer between November 2003 and March 2013 in our hospital were retrospectively analyzed. Patients were separated into two Groups according their age; Group 1 (<35 years) and Group 2 (>55 years).

Results: 94 patients with breast cancer, 45 patients in Group 1 and 49 patients in Group 2, were included in the study. The mean follow-up was 51 (19-121) months and 50 (19-120) months in Groups 1 and 2, respectively. Stages of breast cancer at the time of diagnosis were similar between the two groups. The groups were similar in terms of rates of re-excision (p=0.42), local recurrence (p=0.34) and solid organ metastases (p=0.182). The number of oncoplastic and reconstructive procedures were higher in Group 1 (p=0.04). Regarding pathological results, the rate of grade 3 tumors, those with Ki-67>12 and triple negative breast cancer were found to be higher in Group 1. In addition, the number of patients receiving chemotherapy was significantly higher in Group 1 (p=0.03).

Conclusion: Oncologic results were similar between young patients and postmenopausal patients. Nevertheless, tumor biology was found to be worse in young patients. In addition, oncoplastic and reconstructive approaches were significantly higher in young patients.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.5152/tjbh.2015.2539DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5351450PMC
July 2015

Surgeons' Approaches and Professional Perspectives on Breast Masses: A National Survey in Turkey.

J Breast Health 2015 Apr 1;11(2):76-80. Epub 2015 Apr 1.

Department of General Surgery, İzmir Tepecik Training and Research Hospital, İzmir, Turkey.

Objective: General surgeons' approaches to breast masses in their daily practices and their perspectives for issues on breast diseases and breast surgery are investigated through a survey.

Materials And Methods: Answers of 524 general surgeons for the survey "Approach to breast diseases and breast surgery" between November 2012 and February 2013 were assessed. Demographic features, approaches to the breast masses, and answers for the clinical scenerios of surgeons were questioned. Surgeons were asked about management of breast cancer and the future role of surgeons for oncoplastic breast surgery and breast diseases.

Results: Participants were representing 14.6% of all general surgeons in Turkey. The survey revealed that breast diseases are the most common cause for admission in general surgery outpatient clinics. Needle biopsies were employed by 241 (60%) respondents. Three hundred and seventy-one (71%) participants indicated that breast cancer management could be accurately conducted by the general surgeons. Two hundred and seventy-three (52%) respondents think that oncoplastic breast surgery should be performed by a general surgeon and 241 (41%) respondents predict that the role of general surgeons for breast diseases and breast surgery will decrease in the future.

Conclusion: Basic approaches towards breast masses need to be improved in our country despite the highest frequency of breast diseases in outpatient admissions. The views and opinions of surgeons on breast diseases and the course of breast surgery in different regions and different communities need to be defined and clarified.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.5152/tjbh.2015.2382DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5351491PMC
April 2015

S-shaped wide excision with primary closure for extensive chronic pilonidal sinus disease.

Case Rep Surg 2014 2;2014:451869. Epub 2014 Jun 2.

Department of General Surgery Clinic, Tepecik Teaching and Research Hospital, Izmir, Turkey.

Background. The management of complex pilonidal sinus disease (PSD) with multiple pits on and beside the natal cleft is variable, contentious, and problematic. Wide excision of the sinus and reconstruction of the defect using different flap techniques have become more popular in recent years. Case Report. We report a case with a complex chronic PSD to which we applied primary closure after S-shaped wide excision. The patient's postoperative course was uneventful, and at the end of one-year followup he is now disease-free and comes for routine checkups. Conclusion. The simplicity of the technique and the promising results support the applicability of the S-shaped wide excision in chronic bilaterally extended large PSDs. Further studies entailing large patient populations are needed to reach a definite conclusion.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1155/2014/451869DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4060288PMC
July 2014

The impact of Ramadan on peptic ulcer perforation.

Ulus Travma Acil Cerrahi Derg 2012 Jul;18(4):339-43

Department of General Surgery, Cumhuriyet University Faculty of Medicine, Sivas, Turkey.

Background: Medical treatment has played an important role in the reduction of peptic ulcer perforation (PUP). The goal of this study was to evaluate the effect of fasting on PUP.

Methods: A retrospective analysis of 229 patients who were operated due to PUP between 1999-2009 was made. Patients were divided into two groups. Group I (n=188) included the patients who were operated in other periods of the year, while Group II (n=41) included the patients who were operated during Ramadan, the Muslim period of fasting. Patients in Group II were analyzed in terms of duration of fasting.

Results: The increase in surgeries per group was higher in Group II than Group I (p<0.05). Predisposing factors, anti-ulcer drug usage and demographic variables were seen to have no role in this difference. Duration of fasting may have a minimal effect on the perforation.

Conclusion: The results of this study demonstrate that PUP is detected as relatively higher during Ramadan among those who are fasting for more than 12 hours daily. We suggest that people with predisposing factors should be informed before making a decision to fast.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.5505/tjtes.2012.61257DOI Listing
July 2012

Effective weight control and normalization of metabolic parameters after laparoscopic sleeve gastrectomy: a single center experience.

Hepatogastroenterology 2013 Mar-Apr;60(122):368-71

Third General Surgery Clinic, Tepecik Teaching and Research Hospital, Izmir, Turkey.

Background/aims: Obesity is one of the most serious public health problems. Laparoscopic sleeve gastrectomy (LSG), a type of bariatric surgery, is emerging as the new promising therapy for the treatment of morbid obesity.

Methodology: In the present study we aimed to assess the effects of LSG on body weight and other obesity related pathological conditions.

Results: A total of 19 obese subjects underwent LSG surgery. All patients underwent complete evaluation including anthropometric/clinical parameters and laboratory tests. Hypertension (HT), diabetes mellitus (DM), body mass index (BMI), and hyperlipidemia were significantly reduced after LSG.

Conclusions: Results of this study demonstrate that LSG induces stable weight loss and resolution of obesity-associated comorbidities.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.5754/hge12566DOI Listing
August 2013

Management of neuroendocrine carcinomas of the breast: A rare entity.

Oncol Lett 2011 Sep 23;2(5):887-890. Epub 2011 May 23.

Department of Medical Oncology, Acibadem University, Soyak Yenisehir Selale Evleri, 34770 Umraniye, Istanbul, Turkey.

Neuroendocrine (NE) carcinoma of the breast is extremely rare and constitutes less than 0.1% of all breast tumors. Only a few studies are currently available in the literature and a standard approach to treating this tumor has yet to be established. The aim of this study was to apply pathological treatment modalities in clinical practice and to select the most appropriate treatment accordingly. Six female patients were diagnosed with primary NE carcinoma of the breast. The patients underwent modified radical mastectomy with axillary dissection. Pathological specimens were stained with hematoxylin and eosin and an immunohistochemical panel of antibodies [neuron-specific enolase (NSE), chromogranin, synoptophysin, estrogen and progesterone receptor, c-erbB2 and Ki-67]. The results showed that tumor size ranged from 2 to 4.5 cm in diameter. Lymph node metastasis was detected in 4 (67%) patients. Estrogen and progesterone receptor expression was found in 5 (83%) patients. None of the patients expressed c-erbB2. Chromogranin was found to be positive in 5 (83%) patients. Synoptophysin expression was detected in 5 (83%) patients. NSE was stained in 4 (67%) patients. An intraductal component was found in 5 (83%) patients. Lymphovascular invasion was found in 5 (83%) patients. Adjuvant chemotherapy was administered to patients with a Ki-67 index of ≥10%. Radiotherapy was administered to 4 (67%) patients, and 4 (67%) patients received hormonal therapy. The mean follow-up time was 31.1 months (range 12-52). All 6 patients survived, although following chemotherapy and tamoxifen, the disease progressed in 1 patient who received second-line hormonal therapy. In conclusion, NE carcinoma of the breast is a distinct entity. Management of this rare tumor may include surgery and radiotherapy depending on the size of the tumor and lymph node status. However, the exact role of chemotherapy and hormonal therapy has yet to be established. Adjuvant chemotherapy is recommended for patients with a Ki-67 index of ≥10%, and hormonal treatment appears to be feasible in patients who are positive for estrogen and/or progesterone receptor.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.3892/ol.2011.320DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3408058PMC
September 2011

Effects of proton pump inhibitors and h(2) receptor antagonists on the ileum motility.

Gastroenterol Res Pract 2011 14;2011:218342. Epub 2011 Dec 14.

Department of General Surgery, Faculty of Medicine, Cumhuriyet University, 58140 Sivas, Turkey.

Objectives. To investigate the effects of proton pump inhibitors (PPIs) and H(2) receptor antagonists on ileum motility in rats with peritonitis and compare changes with control group rats. Methods. Peritonitis was induced by cecal ligation and puncture in 8 rats. Another of 8 rats underwent a sham operation and were accepted as controls. Twenty-four hours later after the operation, the rats were killed, and their ileum smooth muscle was excised and placed in circular muscle direction in a 10 mL organ bath. Changes in amplitude and frequency of contractions were analyzed before and after PPIs and H(2) receptor blockers. Results. PPI agents decreased the motility in a dose-dependent manner in ileum in both control and intraabdominal sepsis groups. While famotidine had no significant effect on ileum motility, ranitidine and nizatidine enhanced motility in ileum in both control and intraabdominal sepsis groups. This excitatory effect of H(2) receptor antagonists and inhibitor effects of PPIs were significantly high in control group when compared to the peritonitis group. The inhibitor effect of pantoprazole on ileum motility was significantly higher than the other two PPI agents. Conclusions. It was concluded that H(2) receptor antagonists may be more effective than PPIs for recovering the bowel motility in the intraabdominal sepsis situation.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1155/2011/218342DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3247876PMC
August 2012
-->