Turkish Journal of Surgery最新文献

{"title":"Long-term outcomes of extended versus segmental resection for transverse colon cancer: A population-based analysis based on the SEER database.","authors":"Çiğdem Benlice, Metincan Erkaya, Afag Aghayeva, Volkan Özben, Emre Görgün, Deniz Atasoy, Bilgi Baca","doi":"10.47717/turkjsurg.2025.2025-7-6","DOIUrl":"https://doi.org/10.47717/turkjsurg.2025.2025-7-6","url":null,"abstract":"<p><strong>Objective: </strong>To investigate long-term cancer-specific outcomes associated with extended versus segmental colectomy (SC) in patients with stage I-III transverse colon adenocarcinoma using a large, population-based cohort.</p><p><strong>Material and methods: </strong>Patients who diagnosed with transverse colon cancer undergoing curative-intent colectomy were identified from the surveillance, epidemiology, and end results database (2013-2019). Surgical procedures were categorized as extended colectomy (EC) or SC based on standardized procedural coding. 1:1 propensity score matching was performed to reduce selection bias and balance baseline characteristics. Cancer-specific survival (CSS) was analyzed using multivariable Cox proportional hazards regression.</p><p><strong>Results: </strong>Among 18,799 eligible patients, 58% underwent EC. EC was more frequently performed in individuals with higher tumor stage (p<0.01) and those receiving adjuvant chemotherapy (26% vs. 23%, p<0.01). After matching (n=7.904 in each group), EC was associated with a higher rate of adequate lymphadenectomy (>12 lymph nodes retrieved: 94% vs. 89%, p<0.01). Five-year overall survival did not differ significantly between groups (65.6% for EC vs. 66.9% for SC, p=0.074). However, SC was associated with a modest but statistically significant improvement in CSS (84.3% vs. 81.7%, p<0.01). In adjusted analysis, surgical extent (HR=0.8376, p<0.001), along with age, sex, tumor grade, stage, and lymph node yield, were independently associated with CSS.</p><p><strong>Conclusion: </strong>While EC is more commonly utilized in advanced-stage disease and facilitates higher lymph node retrieval, SC offers comparable-and potentially superior-CSS in selected patients. These findings support the consideration of a tailored surgical strategy based on tumor biology and individual patient characteristics.</p>","PeriodicalId":23374,"journal":{"name":"Turkish Journal of Surgery","volume":" ","pages":""},"PeriodicalIF":0.6,"publicationDate":"2025-10-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145252808","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Robot-assisted total vs. unicompartmental knee arthroplasty: A systematic review and meta-analysis.","authors":"Syeda Bushra Rizvi, Naseer Ullah, Mursala Tahir, Yousaf Ali, Shahnawaz Tahir, Nemer Alotaibi, Hasan Nawaz Tahir","doi":"10.47717/turkjsurg.2025.2025-5-14","DOIUrl":"https://doi.org/10.47717/turkjsurg.2025.2025-5-14","url":null,"abstract":"<p><strong>Objective: </strong>Robot-assisted (RA) surgeries are a major advancement in the medical field, allowing surgeons to operate remotely with minimal direct involvement. Over the past decade, robotic systems have been increasingly used in many areas, including orthopedic procedures. This systematic review and meta-analysis aimed to evaluate the effectiveness of RA-total knee arthroplasty (TKA) and unicompartmental knee arthroplasty (RA-UKA).</p><p><strong>Material and methods: </strong>A systematic review and meta-analysis of 12 randomized controlled trials was conducted to compare total and unicompartmental RA-TKA with each other and with the conventional method. A total of 1.538 participants were included in the studies, which were published between January 2014 and November 2024. The main outcomes of interest were range of motion (ROM) and pain measured by the visual analogue scale (VAS). The Cochrane RoB2 tool was used to assess the risk of bias. Subgroup analyses were carried out for RA-TKA and RA-UKA outcomes. Prospero Registration: CRD42024627463.</p><p><strong>Results: </strong>RA knee arthroplasty and conventional knee arthroplasty showed no significant differences in either outcome ROM or VAS score for pain with results of [MD =2.30, 95% CI: -1.56 to 6.16] and (MD =0.05, 95% CI: -0.14 to 0.23), respectively. Similarly, the comparison between RA-TKA and RA-UKA in the subgroup analysis also showed no significant difference, with combined results of (MD =2.30, 95% CI: -1.56 to 6.16) and (MD =0.05, 95% CI: -0.14 to 0.23), respectively.</p><p><strong>Conclusion: </strong>RA knee arthroplasties (RA-TKA and RA-UKA) show similar outcomes to each other and to conventional methods in terms of ROM and pain reduction (VAS), with both robotic techniques showing comparable alternatives to traditional methods. These techniques also offer advantages such as greater precision and less direct involvement from the surgeon, which may help reduce human error. RA-TKA and RA-UKA produce similar results, and either can be used depending on the patient's knee condition and availability of experienced surgeons in robotics. Future studies with standardized protocols, larger sample sizes, and longer follow-up periods are needed to better understand and confirm the long-term benefits and differences between RA-TKA and RA-UKA techniques.</p>","PeriodicalId":23374,"journal":{"name":"Turkish Journal of Surgery","volume":" ","pages":""},"PeriodicalIF":0.6,"publicationDate":"2025-10-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145252805","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Children are not just small adults: Comment on \"Associating liver partition and portal vein ligation for staged hepatectomy (ALPPS) for pediatric mesenchymal hamartoma: A case report\" by Caballes et De Lara.","authors":"Juri Fuchs","doi":"10.47717/turkjsurg.2025.2025-3-17","DOIUrl":"10.47717/turkjsurg.2025.2025-3-17","url":null,"abstract":"","PeriodicalId":23374,"journal":{"name":"Turkish Journal of Surgery","volume":" ","pages":"345-346"},"PeriodicalIF":0.6,"publicationDate":"2025-09-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12406605/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144576353","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Microbiome, mechanics, and morphology: Rethinking the etiopathogenesis of pilonidal sinus disease.","authors":"Semra Demirli Atıcı","doi":"10.47717/turkjsurg.2025.2025-5-2","DOIUrl":"10.47717/turkjsurg.2025.2025-5-2","url":null,"abstract":"","PeriodicalId":23374,"journal":{"name":"Turkish Journal of Surgery","volume":" ","pages":"343-344"},"PeriodicalIF":0.6,"publicationDate":"2025-09-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12406620/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144576356","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Pilonidal disease: Gaps in the guidelines and future perspectives.","authors":"Çiğdem Arslan","doi":"10.47717/turkjsurg.2025.2025-5-19","DOIUrl":"10.47717/turkjsurg.2025.2025-5-19","url":null,"abstract":"","PeriodicalId":23374,"journal":{"name":"Turkish Journal of Surgery","volume":" ","pages":"216-218"},"PeriodicalIF":0.6,"publicationDate":"2025-09-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12406603/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144576358","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Long-term outcomes of surgery for chronic pancreatitis: A single-center experience.","authors":"Abdullah Altaf, Syed Tatheer Abbas, Nusrat Yar Khan, Abu Bakar Hafeez Bhatti","doi":"10.47717/turkjsurg.2025.6656","DOIUrl":"10.47717/turkjsurg.2025.6656","url":null,"abstract":"<p><strong>Objective: </strong>There are limited data on the long-term outcomes after surgery for chronic pancreatitis. The aim of the current study was to assess the long-term pain relief and survival outcomes following surgical intervention for chronic pancreatitis.</p><p><strong>Material and methods: </strong>This was a single-center retrospective cohort study that included 36 patients who underwent surgery for chronic pancreatitis. The study analyzed 30-day morbidity and mortality rates, long-term pain relief, and endocrine and exocrine insufficiency. Additionally, 10-year overall survival rates were assessed.</p><p><strong>Results: </strong>The 30-day morbidity rate was 12/36 (33.4%), with no reported mortality. The median preoperative and postoperative visual analog scale scores were 9 (8-9) and 1 (1-2), respectively (p<0.001). Among 34 patients with severe pain, 33 (97%) reported substantial improvement. Long-term mortality was 6/36 (16.7%), and the 1-year, 5-year, and 10-year overall survival rates were 97%, 90%, and 85%, respectively. Factors associated with inferior survival included preoperative diabetes mellitus (p<0.001), hospital admissions after surgery (p=0.002), failure to gain weight after surgery (p=0.001), post-operative body mass index <18.5 kg/m² (p=0.029), and poor pain control after surgery (p=0.004). Conversely, preoperative endoscopic stent placement (p=0.031) was linked to improved 10-year overall survival.</p><p><strong>Conclusion: </strong>Surgery offers long-term pain relief for chronic pancreatitis, and outcomes can be optimized through early identification and management of high-risk factors.</p>","PeriodicalId":23374,"journal":{"name":"Turkish Journal of Surgery","volume":" ","pages":"277-282"},"PeriodicalIF":0.6,"publicationDate":"2025-09-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12406626/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144601664","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Diagnostic utility of inflammatory ratios and nutritional scores in acute mesenteric ischemia: A retrospective single-center study.","authors":"Ferdi Bolat, Muhammet Fatih Keyif, Mustafa Şit, Bahri Özer, Oğuz Çatal, Songül Peltek Özer","doi":"10.47717/turkjsurg.2025.2025-4-7","DOIUrl":"10.47717/turkjsurg.2025.2025-4-7","url":null,"abstract":"<p><strong>Objective: </strong>Acute mesenteric ischemia (AMI) is a rare but highly fatal vascular emergency. Due to its non-specific clinical presentation, early diagnosis remains a major challenge. This study aimed to evaluate the diagnostic utility of selected inflammatory ratios and nutritional scores in differentiating AMI from other causes of acute abdominal pain.</p><p><strong>Material and methods: </strong>This retrospective, single-center study included 40 patients diagnosed with AMI and 40 control patients who presented with non-specific abdominal pain and had no definitive diagnosis. Preoperative laboratory parameters obtained upon emergency admission were analyzed. Calculated indices included neutrophil-to-lymphocyte ratio (NLR), platelet-to-lymphocyte ratio (PLR), systemic immune-inflammation index (SII), prognostic nutritional index (PNI), C-reactive protein (CRP)-to-albumin ratio (CAR), and CRP-to-LDH ratio (CLDR), among others. Group comparisons, Pearson correlation analyses, and receiver operating characteristic (ROC) curve analyses were performed.</p><p><strong>Results: </strong>Compared to controls, AMI patients showed significantly elevated levels of NLR, PLR, SII, CAR, and CLDR, and significantly lower levels of PNI (p<0.05). ROC analysis revealed that SII [area under the curve (AUC) =0.89], NLR (AUC =0.86), and PNI (AUC =0.81) demonstrated the strongest diagnostic performance. Several indices were found to be strongly correlated, Including NLR with SII and CAR with CLDR. The observed mortality rate in the AMI group was 52.5%.</p><p><strong>Conclusion: </strong>Inflammatory and nutritional markers, particularly SII, NLR, and PNI, appear to offer valuable diagnostic support in identifying AMI. These indices may help prioritize patients for advanced imaging and early intervention, especially in resource-limited emergency settings. Further prospective multicenter studies are needed to confirm their clinical utility.</p>","PeriodicalId":23374,"journal":{"name":"Turkish Journal of Surgery","volume":" ","pages":"283-288"},"PeriodicalIF":0.6,"publicationDate":"2025-09-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12406627/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144691661","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Retroperitoneal duodenal perforation following biliary stent migration: A case report and review of conservative management.","authors":"Recep Erçin Sönmez, Tuğrul Özdemir, Fatih Büyüker, Orhan Alimoğlu","doi":"10.47717/turkjsurg.2025.2025-3-6","DOIUrl":"10.47717/turkjsurg.2025.2025-3-6","url":null,"abstract":"<p><p>Endoscopic biliary stenting is a widely adopted technique for managing bile duct injuries post-cholecystectomy. However, its complications can have severe consequences. Although rare compared to other endoscopic retrograde cholangiopancreatography-related complications, duodenal perforation due to stent migration carries a significant risk of morbidity and mortality. While biliary stenting is often considered a less invasive alternative to surgery, timely recognition and management of potential complications remain crucial. We present a case of duodenal perforation due to biliary stent migration in a 49-year-old woman following laparoscopic cholecystectomy, emphasizing the effectiveness of conservative management, including the key role of interventional radiology, in selected patients.</p>","PeriodicalId":23374,"journal":{"name":"Turkish Journal of Surgery","volume":" ","pages":"338-342"},"PeriodicalIF":0.6,"publicationDate":"2025-09-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12406606/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144576359","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Non-standardized surgery lateral internal sphincterotomy: Is there a consensus?","authors":"Neriman Şengül, Buse Balcı, Hatice Maras, Cihangir Akyol","doi":"10.47717/turkjsurg.2025.2025-4-18","DOIUrl":"10.47717/turkjsurg.2025.2025-4-18","url":null,"abstract":"<p><strong>Objective: </strong>Lateral internal sphincterotomy (LIS) is considered the gold standard surgical treatment for chronic anal fissures. However, substantial variation exists in the surgical techniques applied. This study aims to evaluate practice differences among surgeons performing LIS and to assess whether a consensus has been established.</p><p><strong>Material and methods: </strong>An anonymous online survey was conducted to assess surgeons' technical approaches to LIS. Data were collected using a 24-question survey targeting surgeons from various countries.</p><p><strong>Results: </strong>A total of 207 surgeons (131 from Türkiye, 76 from other countries) responded. The majority were male (73.3%) and between 40 and 64 years of age (64.7%). Most participants (70%) had more than 10 years of surgical experience, and 55% were affiliated with academic centers. The open technique was preferred by 73.6% of respondents, while 21.4% opted for the closed method. Partial sphincterotomy was favored by 66%, followed by complete (21%) and tailored (12%) approaches. Substantial heterogeneity was noted in bowel preparation, patient positioning, incision type, and management of skin tags or hypertrophied papillae. Only 6% reported routine use of anorectal manometry. Variations were more prominent across countries than between demographic groups. The principal finding of the study is the lack of a standardized approach to LIS across international surgical communities.</p><p><strong>Conclusion: </strong>There is no standardized approach to LIS among surgeons. Surgical technique preferences vary significantly and appear to be influenced more by geographic practice location than by individual surgeon characteristics such as age, gender, or experience.</p>","PeriodicalId":23374,"journal":{"name":"Turkish Journal of Surgery","volume":" ","pages":"289-293"},"PeriodicalIF":0.6,"publicationDate":"2025-09-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12406635/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144576357","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A predictive tool for postoperative ileus after ileostomy closure: Model development and validation.","authors":"Atul Khare, Reena Kothari, Dinesh Kateha, Amrendra Verma, Pawan Agarwal, Dhananjaya Sharma","doi":"10.47717/turkjsurg.2025.2025-3-5","DOIUrl":"10.47717/turkjsurg.2025.2025-3-5","url":null,"abstract":"<p><strong>Objecitve: </strong>Postoperative ileus (POI) is a significant complication after ileostomy closure, which results in recurrent vomiting, dehydration, delay in starting enteral feeding, and even anastomotic breakdown. We aimed to develop a prediction model for POI occurrence after ileostomy closure.</p><p><strong>Material and methods: </strong>One hundred consecutive patients undergoing ileostomy closure were studied prospectively and data of various demographic and clinical variables were recorded in a predesigned proforma. The final prediction model was developed using logistic regression and internally validated in the next 50 patients.</p><p><strong>Results: </strong>Factors associated with POI were age, body mass index, tobacco or alcohol addiction, comorbidity, anemia, thrombocytopenia, renal dysfunction, as shown by creatinine level, hypoproteinemia, hypernatremia, and hypokalemia. The mean score of those who developed POI was higher (p=0.002) than those who did not. A cut-off at score 8 had a sensitivity of 85.71%, specificity of 73.12%, and area under the curve was 0.8241 (SE 0.1123). The predictive model was validated in the next 50 consecutive patients and showed good sensitivity (80%) and specificity (93.3%).</p><p><strong>Conclusion: </strong>Our predictive model can determine the occurrence of POI with accuracy.</p>","PeriodicalId":23374,"journal":{"name":"Turkish Journal of Surgery","volume":" ","pages":"241-247"},"PeriodicalIF":0.6,"publicationDate":"2025-09-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12406631/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144609707","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}