Turkish Journal of Surgery最新文献

{"title":"Anticipating critical view of safety challenges in laparoscopic cholecystectomy for symptomatic cholelithiasis patients: Can we predict them earlier?","authors":"Arnetta Naomi Louise Lalisang, Davin Nathan Wijaya, Indah Jamtani, Vania Myralda Giamour Marbun, Lam Sihardo, Febiansyah Ibrahim, Agi Satria Putranto, Wifanto Saditya Jeo, Yarman Mazni, Toar Jean Maurice Lalisang","doi":"10.47717/turkjsurg.2025.6505","DOIUrl":"https://doi.org/10.47717/turkjsurg.2025.6505","url":null,"abstract":"<p><strong>Objective: </strong>Laparoscopic cholecystectomy (LC) is the gold standard treatment for symptomatic cholelithiasis. Identifying the critical view of safety (CVS) is crucial in this procedure to prevent complications, but achieving CVS can be challenging, necessitating bailout procedures. This study analyzes factors influencing CVS identification and describes bailout procedures used when CVS identification fails.</p><p><strong>Material and methods: </strong>We collected data from symptomatic cholelithiasis patients undergoing LC at Cipto Mangunkusumo Hospital from January to October 2023. Factors contributing to CVS identification failure were analyzed, and bailout procedures were described.</p><p><strong>Results: </strong>Among 107 symptomatic cholelithiasis patients, the mean age was 50.38 years, with the majority being female (55.14% of whom were female). CVS was identified in 88 patients (82.24%). Univariate analysis showed that history of endoscopic retrograde cholangiopancreatography (ERCP) [odds ratio (OR) 5.46], Bile duct (BD) stent (OR 16.53), and diagnosis of cholecystitis (acute, OR 6.17; chronic; OR 4.00) significantly increased CVS identification failure risk. Multivariate analysis identified BD stent as the only significant risk factor (OR 7.41). Higher failure rates were associated with Parkland scores of 4-5, Nassar scores of 4, and G10 scores of 4-5. Among those with CVS identification failure, 5 completed cholecystectomy via top-down approach, 6 underwent subtotal fenestrating cholecystectomy, 6 underwent subtotal reconstituting cholecystectomy, and 2 converted to open cholecystectomy.</p><p><strong>Conclusion: </strong>Predicting CVS identification failure using preoperative parameters and intraoperative scoring systems is crucial for anticipating surgical complexity and ensuring timely intervention. History of ERCP, BD stent presence, and cholecystitis diagnosis were significant predictors of CVS identification failure. Intraoperative scoring systems reliably predicted CVS identification failure.</p>","PeriodicalId":23374,"journal":{"name":"Turkish Journal of Surgery","volume":" ","pages":""},"PeriodicalIF":0.5,"publicationDate":"2025-07-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144699606","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":"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":"https://doi.org/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":""},"PeriodicalIF":0.5,"publicationDate":"2025-07-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144691661","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":"Pilonidal sinus disease and intergluteal fold depth.","authors":"Cüneyt Kayaalp","doi":"10.47717/turkjsurg.2025.2025-6-2","DOIUrl":"https://doi.org/10.47717/turkjsurg.2025.2025-6-2","url":null,"abstract":"","PeriodicalId":23374,"journal":{"name":"Turkish Journal of Surgery","volume":" ","pages":""},"PeriodicalIF":0.5,"publicationDate":"2025-07-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144643624","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":"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":"https://doi.org/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":""},"PeriodicalIF":0.5,"publicationDate":"2025-07-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144609707","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":"Has the COVID-19 pandemic affected the incidence of <i>Helicobacter pylori</i> infection? Evaluation of endoscopic results in patients with dyspeptic complaints.","authors":"Evren Peker, Ahmet Cem Esmer, Çiğdem Ataizi Çelikel, Asım Cingi, Şevket Cumhur Yeğen","doi":"10.47717/turkjsurg.2025.2025-5-8","DOIUrl":"https://doi.org/10.47717/turkjsurg.2025.2025-5-8","url":null,"abstract":"<p><strong>Objective: </strong>The coronavirus disease-2019 (COVID-19) pandemic led to widespread public health measures that reduced human-to-human contact. This study investigates the pandemic's effect on the clinical and pathological outcomes of <i>Helicobacter pylori</i> (<i>HP</i>) infection in patients with dyspeptic complaints.</p><p><strong>Material and methods: </strong>We retrospectively analyzed data from patients presenting with dyspepsia before the pandemic (January-December 2019) and during the pandemic (April-December 2020). Gastric biopsies were evaluated for <i>HP</i> infection and inflammation severity according to the Sydney classification. Statistical analyses compared the incidence and clinical characteristics of <i>HP</i> infection between the two periods.</p><p><strong>Results: </strong>Among 788 patients, there was no significant difference in <i>HP</i> infection incidence or severity between the pre-pandemic and pandemic periods (p=0.51). However, more symptomatic patients presented during the pandemic, including increased cases of epigastric pain (p<0.01) and gastroesophageal reflux (p<0.001).</p><p><strong>Conclusion: </strong>Despite social distancing measures, the incidence of <i>HP</i> infection remained unchanged. Our findings suggest that COVID-19 restrictions did not significantly impact <i>HP</i> transmission but may have influenced symptom presentation and patient healthcare-seeking behavior.</p>","PeriodicalId":23374,"journal":{"name":"Turkish Journal of Surgery","volume":" ","pages":""},"PeriodicalIF":0.5,"publicationDate":"2025-07-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144609708","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":"Incidental identification of elastofibroma dorsi in oncologic PET/CT imaging: a retrospective single-center analysis.","authors":"Nilüfer Bıçakcı, Fatih Batı, Güler Silov, Banu Kırtıloğlu","doi":"10.47717/turkjsurg.2025.2025-5-18","DOIUrl":"https://doi.org/10.47717/turkjsurg.2025.2025-5-18","url":null,"abstract":"<p><strong>Objective: </strong>To evaluate the morphological and metabolic characteristics of incidentally detected elastofibroma dorsi (EFD) on F-18 florodeoksiglukoz (FDG) positron emission tomography/computed tomography (PET/CT) and their longitudinal changes in oncologic patients.</p><p><strong>Material and methods: </strong>We retrospectively reviewed 42 197 PET/CT scans performed at our institution between January 2019 and September 2023. EFD was incidentally identified in 20 patients (0.05%). Patient demographics, primary malignancy, lesion localization, dimensions, and maximum standardized uptake values (SUV_max) were recorded. Measurements were obtained before treatment and at the next 3‑month follow‑up. Statistical analyses included Mann‑Whitney U, Shapiro-Wilk and Spearman correlation tests; significance was set at p<0.05.</p><p><strong>Results: </strong>The cohort comprised 17 females (85%) and 3 males (15%) with a median age of 67 years (range, 47-83). Primary diagnoses were breast cancer (n=8, 40%) and various other malignancies (n=12, 60%). Lesions were bilateral in 75% of cases. Pre‑treatment lesion size ranged from 10 to 55 mm; median SUV_max was 2.4 (right) and 2.5 (left). No significant differences in baseline size or SUV_max were observed between breast and other cancers. A moderate correlation existed between right and left SUV_max (r=0.641; p=0.010). After 3 months, only the left longest diameter showed a statistically significant decrease (median, 45.0 mm vs. 43.0 mm; p=0.034), which may reflect measurement variability or positional factors rather than true biological change. SUV_max values remained stable.</p><p><strong>Conclusion: </strong>Incidentally detected EFD on PET/CT exhibits low to moderate and stable FDG uptake and predominantly bilateral localization. Recognition of its characteristic features can prevent unnecessary interventions.</p>","PeriodicalId":23374,"journal":{"name":"Turkish Journal of Surgery","volume":" ","pages":""},"PeriodicalIF":0.5,"publicationDate":"2025-07-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144609709","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":"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":"https://doi.org/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":""},"PeriodicalIF":0.5,"publicationDate":"2025-07-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144601664","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":"Gastric volvulus and a myriad of anomalies: Asplenia, jejunal diverticulosis and absent colonic attachments: A rare case report.","authors":"Maria Niaz Khan, Momina Waqar, Sufyan Yousaf, Ayesha Imran","doi":"10.47717/turkjsurg.2025.2025-3-8","DOIUrl":"https://doi.org/10.47717/turkjsurg.2025.2025-3-8","url":null,"abstract":"<p><p>Gastric volvulus is a rare cause of acute abdomen, and its complexity increases when associated with congenital anomalies. We report an exceptional case of gastric volvulus with perforation in a female patient, which was accompanied by asplenia, jejunal diverticulosis, and absent colonic attachments. To our knowledge, this combination has not been previously documented. This case highlights the need for further research into the mechanisms behind such rare anatomical associations.</p>","PeriodicalId":23374,"journal":{"name":"Turkish Journal of Surgery","volume":" ","pages":""},"PeriodicalIF":0.5,"publicationDate":"2025-07-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144576355","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":"Pilonidal disease: Gaps in the guidelines and future perspectives.","authors":"Çiğdem Arslan","doi":"10.47717/turkjsurg.2025.2025-5-19","DOIUrl":"https://doi.org/10.47717/turkjsurg.2025.2025-5-19","url":null,"abstract":"","PeriodicalId":23374,"journal":{"name":"Turkish Journal of Surgery","volume":" ","pages":""},"PeriodicalIF":0.5,"publicationDate":"2025-07-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144576358","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":"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":"https://doi.org/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":""},"PeriodicalIF":0.5,"publicationDate":"2025-07-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144576359","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}