Publications by authors named "Mahmut Said-Degerli"

3 Publications

  • Page 1 of 1

Which Is More Effective: Laparoscopic or Open Partial Cholecystectomy?

J Laparoendosc Adv Surg Tech A 2021 Jul 27. Epub 2021 Jul 27.

Department of General Surgery, Haseki Training and Research Hospital, University of Health Sciences, Istanbul, Turkey.

In laparoscopic cholecystectomy, partial cholecystectomy is usually preferred when the anatomic exploration is not enough to prevent bile duct injury and other complications. Some surgeons choose laparoscopically to perform partial cholecystectomy, whereas others convert to open surgery. In this study, we aim to discuss and compare the effectiveness of laparoscopic partial cholecystectomy (LPC) and open partial cholecystectomy (OPC). The data of 4712 patients who underwent laparoscopic cholecystectomy between 2012 and 2020 were reviewed. A total of 98 patients who had partial cholecystectomy were included in the study. Patients were examined in two groups according to whether the procedure was open or laparoscopic. The first group of patients was named the OPC group ( = 52), and the second group of patients was the LPC group ( = 46). The data of the two groups were comparatively analyzed. The mean operative time and the postoperative hospital stay, respectively, were 118.2 minutes and 4.8 days in the OPC group, and 87.3 minutes and 2.55 days in the LPC group ( < .005 and  = .005). It was found that wound infection decreased by 83.1% ( = .026; odds ratio [OR] = 0.169) in the LPC group compared with the OPC group, and the probability of developing incisional hernia decreased by 81.1% ( = .014; OR = 0.189). At least one complication was observed in 17 patients in the OPC group and in 7 patients in the LPC group ( = .045). The probability of developing complications in any patient was 63% lower in the LPC group ( = .049; OR = 0.370). The indications that cause the surgeon to perform partial cholecystectomy are inherently open to complications, regardless of the surgical technique used. However, the laparoscopic operation has advantages such as shorter operation time, shorter postoperative hospital stay, lower risk of wound infection and incisional hernia rate, and lower complication rate than the open procedure. However, if the team performing the surgery does not have enough experience, they should never hesitate to switch to open cholecystectomy.
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http://dx.doi.org/10.1089/lap.2021.0300DOI Listing
July 2021

How correct is the postponed cholecystectomy during the coronavirus disease-19 pandemic process? Gallstone ileus is not a myth anymore.

Cir Cir 2021 ;89(3):390-393

Department of General Surgery, University of Health Sciences, Haseki Training and Research Hospital, Istanbul, Turkey.

Posponer cirugías electivas durante el proceso pandémico de Covid-19 aumentó el riesgo de complicaciones graves de enfermedades benignas. El íleo biliar es una de las raras complicaciones de la colelitiasis (0,3-0,5%). Los episodios recurrentes de colecistitis aguda están involucrados en la fisiopatología. La demostración de la tríada de Rigler en tomografía computarizada es diagnóstica. Para reducir la morbilidad se recomienda la cirugía dos etapas: extirpar el cálculo por enterotomía en la primera operación, cirugía biliar en la segunda operación. El íleo biliar debe estar en el diagnóstico diferencial de las obstrucciones intestinales mecánicas, especialmente en pacientes con antecedentes de ataques de colecistitis durante el proceso pandémico de Covid-19 porque las cirugías electivas se detuvieron.

Postponing elective surgeries during the coronavirus disease-19 (COVID-19) pandemic process increased the risk of severe complications of benign diseases. Gallstone ileus is one of the rare complications of cholelithiasis (0.3-0.5%). Recurrent episodes of acute cholecystitis are involved in pathophysiology. Demonstration of Rigler’s triad on computed tomography is diagnostic. To reduce morbidity stepped surgery is recommended: remove the stone by enterotomy at the first operation and biliary surgery at the second operation. Gallstone ileus should be in the differential diagnosis of mechanical intestinal obstructions, especially in patients with a history of cholecystitis attacks during the COVID-19 pandemic process because elective surgeries stopped.
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http://dx.doi.org/10.24875/CIRU.21000043DOI Listing
June 2021

The Effect of Prognostic Factors on Long-Term Protection in Breast Cancer.

Cureus 2020 Jun 28;12(6):e8878. Epub 2020 Jun 28.

Medical Service and Techniques, Nisantasi University Vocational High School, Istanbul, TUR.

Objectıves Axillary lymph node involvement is considered to be one of the most important factors in the staging and survival of breast cancer. Recurrences in women with a negative axillary condition detected as a result of long patient follow-up have revealed the importance of other prognostic factors and many studies have begun. The aim of this study is to evaluate breast cancer patients and to investigate other factors affecting breast cancer. Materials and methods Patients with breast cancer who were operated in our clinic between January 2005 and June 2007 were included in the study. Demographic characteristics, tumor size, lymph node involvement, grade, histological type, the status of estrogen and progesterone receptors (ER and PR), type of surgery performed, and cerb-B2 receptor status were recorded retrospectively. Results The mortality rate of the ER (+) PR (+) group was significantly lower than that of the ER (-) PR (-) group (p<0.05). There was no statistically significant difference between the ER (+) PR (+) cases and the mortality rates of any positive cases (p>0.05). There was a statistically significant difference between survival rates according to cerb-B2 status (p<0.01); cerb-B2 was positive in all patients who died. In cerb-B2 positive cases, there was a statistically significant difference between survival rates according to the tumor stages (p <0.05). Conclusion As a result; preoperative and postoperative staging of all breast cancer patients who applied to surgery clinics should be performed. Prognostic factors should be determined and patients should be directed to post-surgical treatment according to this information. Axillary lymph involvement, number, tumor size, estrogen receptor, progesterone receptor, and cerb-B2 status are safe markers that can be used to determine prognosis in our series.
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http://dx.doi.org/10.7759/cureus.8878DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7387074PMC
June 2020
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