Turkish Journal of Surgery最新文献

{"title":"Effects of GLP-1 receptor agonists on aesthetic surgery practice: A contemporary review.","authors":"Mert Ersan, Orhan Özturhan","doi":"10.47717/turkjsurg.2026.2026-4-35","DOIUrl":"https://doi.org/10.47717/turkjsurg.2026.2026-4-35","url":null,"abstract":"<p><p>Glucagon-like peptide-1 receptor agonists (GLP-1 RAs) have become increasingly relevant to aesthetic surgery because of the significant weight loss they provide in the treatment of type 2 diabetes mellitus and obesity. While these agents expand the pool of surgical candidates, they also raise new clinical questions related to rapid or substantial weight loss, including soft tissue volume loss, skin laxity, nutritional deficiencies, perioperative safety concerns, and the durability of aesthetic surgical outcomes. This contemporary narrative review evaluated the current implications of GLP-1 RAs in aesthetic plastic surgery practice. A targeted PubMed/MEDLINE search covering January 2015 through August 2026 was supplemented by manual reference screening. Retrospective cohorts, database analyses, prospective observational studies, systematic reviews, survey studies, case reports, and selected guidance or opinion articles were evaluated. Current literature indicates increasing demand for facial aesthetic, breast aesthetic, and body contouring procedures among patients using GLP-1 RAs. The facial volume loss and skin laxity popularly described as \"Ozempic face\" more plausibly reflect rapid or substantial weight loss than a proven drug-specific facial effect. Although the breast surgery literature remains limited, upper-pole volume loss, ptosis, reduced soft tissue support, and healing problems along high-tension closure lines are noteworthy. Outcomes in body contouring surgery are heterogeneous: While some studies report comparable complication rates, others emphasize delayed wound healing, wound dehiscence, altered scar behavior, or nutrition-related risks. Surgical timing, weight stabilization, nutritional balance, and individualized perioperative aspiration-risk assessment are key areas of evaluation. GLP-1 RA use should be considered neither an absolute advantage nor an automatic contraindication in aesthetic surgery. Direct pharmacologic effects often cannot be separated from the consequences of weight loss or baseline metabolic risk. Surgical decision-making should be individualized based on weight stability, metabolic optimization, nutritional status, history of bariatric surgery, psychological adaptation, and procedure-specific risks. Current evidence is promising but heterogeneous, and prospective studies are needed to clarify long-term aesthetic outcomes and procedure-specific risks.</p>","PeriodicalId":23374,"journal":{"name":"Turkish Journal of Surgery","volume":" ","pages":""},"PeriodicalIF":0.7,"publicationDate":"2026-10-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149115209","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":"Toward the intelligent operating room: Artificial intelligence and computer vision applications in surgery.","authors":"Berke Şengün, Yalın İşcan","doi":"10.47717/turkjsurg.2026.2026-4-45","DOIUrl":"https://doi.org/10.47717/turkjsurg.2026.2026-4-45","url":null,"abstract":"<p><p>The operating room is evolving into an information-rich environment where surgical care is increasingly shaped by integrated digital architectures. The proliferation of minimally invasive and robotic platforms has generated a massive influx of high-resolution video, shifting the field toward real-time computational analysis. Artificial intelligence, particularly computer vision, is moving beyond retrospective analysis to extract structured intelligence from the operative field, redefining how procedures are analyzed and supported. This review focuses on the clinical applications of computer vision with the greatest translational relevance: Computer-aided detection, instrument tracking, procedural phase recognition, and video-based skill assessment. However, clinical translation remains constrained by practice variability, a lack of standardized open datasets, ethical and regulatory considerations, and the difficulty of ensuring model generalizability across diverse institutions. This review examines the current evidence for computer-aided detection, instrument tracking, phase recognition, and video-based skill assessment in surgery, and discusses their clinical readiness and key limitations.</p>","PeriodicalId":23374,"journal":{"name":"Turkish Journal of Surgery","volume":" ","pages":""},"PeriodicalIF":0.7,"publicationDate":"2026-09-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149031448","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":"Determinants of subspecialty training intention among general surgeons in Türkiye: A national survey.","authors":"Bahattin Bayar, M Salih Süer, Serkan Demir, Uğurcan Bulut, Faruk Yazıcı, Şener Balas","doi":"10.47717/turkjsurg.2026.2026-3-39","DOIUrl":"https://doi.org/10.47717/turkjsurg.2026.2026-3-39","url":null,"abstract":"<p><strong>Objective: </strong>This study aimed to evaluate, at a national level, the individual, professional, and institutional factors associated with the intention to pursue subspecialty training among general surgery residents and surgeons across a range of career stages in Türkiye.</p><p><strong>Material and methods: </strong>This descriptive cross-sectional survey was conducted online between December 10 and 25, 2025. The questionnaire, developed via Google forms, was distributed through professional email lists and national/regional WhatsApp groups. A total of 195 responses were received; after excluding five incomplete questionnaires, 190 participants were analyzed. Data were summarized using descriptive statistics. Group comparisons were performed using chi-square and Fisher's exact tests. Multivariable logistic regression analysis was used to identify independent predictors of subspecialty training intention. Statistical significance was set at p<0.05.</p><p><strong>Results: </strong>Among participants, 20.5% intended to pursue subspecialty training, 24.2% were undecided, and 55.3% did not. In bivariable comparisons (yes vs. no, undecided excluded), intention was associated with shorter professional experience (≤5 years; p<0.001), workplace violence exposure (p<0.001), higher monthly on-call burden (p=0.003), absence of children (p=0.016), and single marital status (p=0.035). In multivariable analysis (Firth penalized logistic regression), professional experience ≤5 years (odds ratio 7.51) and workplace violence exposure (odds ratio 3.44) were the only independent predictors. Many participants reported negative perceptions regarding workload, on-call burden, and insufficient institutional support.</p><p><strong>Conclusion: </strong>The intention to pursue subspecialty training among general surgeons in Türkiye is relatively low and is independently associated with shorter professional experience and exposure to workplace violence. Decision-making is shaped by both individual factors and working conditions, indicating a multidimensional process that should be considered in workforce planning and training policy.</p>","PeriodicalId":23374,"journal":{"name":"Turkish Journal of Surgery","volume":" ","pages":""},"PeriodicalIF":0.7,"publicationDate":"2026-09-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149017607","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":"Comparison of Clavien-Dindo classification (CDC) and comprehensive complication index (CCI) systems for grading of surgical complications in patients with gastroduodenal perforations-a prospective study.","authors":"Mohammad Faiz, Priyanka Rai, Amarjot Singh, Rohit Srivastava, Sunil Kumar Singh","doi":"10.47717/turkjsurg.2026.2026-4-9","DOIUrl":"https://doi.org/10.47717/turkjsurg.2026.2026-4-9","url":null,"abstract":"<p><strong>Objective: </strong>Gastro-duodenal perforation is a life-threatening surgical emergency associated with high morbidity and mortality, particularly in low- and middle-income countries due to delayed presentation and sepsis. Accurate assessment of postoperative complications is essential for predicting outcomes. While the Clavien-Dindo classification (CDC) is widely used, it records only the highest-grade complication, potentially underestimating overall morbidity. The comprehensive complication index (CCI), a continuous scale incorporating all complications, may provide better prognostic value.</p><p><strong>Material and methods: </strong>This prospective observational study was conducted over 18 months in a tertiary care centre in northern India and included 50 adult patients with gastro-duodenal perforation. Postoperative complications were graded using CDC and quantified using CCI. Associations with length of hospital stay (LOS) were analysed using ANOVA, Pearson's correlation, and multivariate linear regression.</p><p><strong>Results: </strong>The mean age was 42.26±12.92 years, with a predominance of male and rural patients. Most participants had CDC Grade 3A complications (72%), with a mean CCI of 32.94±14.82. LOS increased significantly with higher CDC grades and CCI categories (p<0.01). CCI showed a significant moderate correlation with LOS (r=0.444, p=0.001), whereas CDC demonstrated a weak, non-significant correlation (r=0.149, p=0.303). On multivariate analysis, CCI independently predicted LOS (β=0.17, p<0.001), while CDC was not significant. The CCI-based model showed better predictive performance (R²=0.35) compared to the CDC model (R²=0.21).</p><p><strong>Conclusion: </strong>The CCI is a superior predictor of postoperative morbidity and hospital stay compared to CDC, particularly in patients with lower-grade CDC complications, as it more comprehensively reflects the cumulative burden of complications.</p>","PeriodicalId":23374,"journal":{"name":"Turkish Journal of Surgery","volume":" ","pages":""},"PeriodicalIF":0.7,"publicationDate":"2026-09-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149017577","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 rare case of abdominal actinomycosis mimicking ovarian cancer with presumed hepatic involvement and abdominal wall involvement.","authors":"Giuseppe Carbotta, Oscar Potì, Ivan Botrugno, Giuseppe Pietro Mingolla, Giuseppina Mottillo, Claudio Marra, Mirna Tondo, Samuela Cannazza, Giovanna Artioli, Federico Cucci, Elsa Vitale, Luana Conte, Roberto Lupo","doi":"10.47717/turkjsurg.2026.2026-5-3","DOIUrl":"10.47717/turkjsurg.2026.2026-5-3","url":null,"abstract":"<p><p>Abdominal actinomycosis is a chronic infection caused by anaerobic Gram-positive <i>Actinomyces</i> species. Because of its infiltrative growth, abscess formation, and fibrotic reaction, it may closely mimic malignant disease. We report the case of a 53-year-old woman presenting with abdominal pain and a palpable epigastric mass. Imaging showed a pelvic mass with abdominal wall involvement and a hepatic lesion, initially suggestive of advanced pelvic malignancy. Tumor markers were within normal limits. Because of persistent diagnostic uncertainty, the patient underwent elective exploratory laparoscopy with biopsy. Intraoperative findings showed a firm pelvic mass involving the right adnexa and uterus, without a clear tissue plane. Frozen-section examination initially suggested a small-cell neoplasm, whereas definitive histological examination confirmed abdominal actinomycosis. The hepatic lesion was not biopsied; therefore, hepatic involvement was considered presumptive, based on the radiological findings and complete regression after prolonged antibiotic therapy. Long-term intrauterine device use represented a relevant predisposing factor. Abdominal actinomycosis should be considered in the differential diagnosis of infiltrative pelvic masses. A conservative diagnostic surgical approach combined with prolonged antibiotic therapy may avoid unnecessary radical surgery.</p>","PeriodicalId":23374,"journal":{"name":"Turkish Journal of Surgery","volume":" ","pages":""},"PeriodicalIF":0.7,"publicationDate":"2026-09-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148991457","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":"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":"374-377"},"PeriodicalIF":0.7,"publicationDate":"2026-09-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13549094/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144576355","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":"Comments and suggestions on the article \"the effects of preoperative anaemia on postoperative complications in patients undergoing thoracic surgery\".","authors":"Yang Chen, Jiafu Wu","doi":"10.47717/turkjsurg.2026.2025-12-14","DOIUrl":"10.47717/turkjsurg.2026.2025-12-14","url":null,"abstract":"","PeriodicalId":23374,"journal":{"name":"Turkish Journal of Surgery","volume":" ","pages":"388-389"},"PeriodicalIF":0.7,"publicationDate":"2026-09-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13549096/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148875513","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":"Role of artificial intelligence in head and neck surgery - A narrative review.","authors":"Sarkheel Sarshar, Noor-Ul-Huda Bhatti, Momina Amir, Nida Jaffar, Muhammad Hasnain, Syed Ghazi Ali Kirmani, Raza Hussain, Shayan Khalid Ghaloo","doi":"10.47717/turkjsurg.2026.2025-3-27","DOIUrl":"10.47717/turkjsurg.2026.2025-3-27","url":null,"abstract":"<p><p>The advent of artificial intelligence (AI) in the field of head and neck surgery has remarkably impacted in various domains, including investigation, diagnosis, pre-operative decision making, surgical planning, rehabilitation, and so on. Head and neck surgery is a field that is practiced worldwide by otolaryngologists, maxillofacial surgeons, plastic surgeons and general surgeons. It has a number of challenging aspects. This review highlights the current advancements and future prospects in the field and its different applications in cancer detection, peri-operative care, and surgical planning. Deep learning and machine learning (ML) are the pillars of AI, by which huge datasets can be analyzed with precision. This can help to enhance the accuracy and meanwhile minimizing the chances of errors in making clinical decisions. On the other hand, there have been numerous ethical concerns regarding AI. Patient privacy, data security, element of empathy in complex decision making are a few concerns at the top. Like any other advancement, the decision is always taken after weighing risks and benefits. Therefore, instead of abandoning AI as a whole, we must come up with certain regulatory authorities that can keep these issues in check. And this can only happen with worldwide collaborative approach. We conducted this narrative review to summarize recent advancements in head and neck cancer surgery by searching PubMed, Scopus, and Google Scholar from January 2000 to July 2025 using predefined terms related to AI, ML, and head and neck surgery.</p>","PeriodicalId":23374,"journal":{"name":"Turkish Journal of Surgery","volume":" ","pages":"378-387"},"PeriodicalIF":0.7,"publicationDate":"2026-09-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13549099/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147692515","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":"Betamethasone to prevent hypocalcemia and other complications after total thyroidectomy: A retrospective case-control study.","authors":"Marcello Picchio, Raffaello Mancini, Alessandra Scotto Di Uccio, Annalisa Romina Di Filippo, Martina Spaziani, Alessandro De Cesare, Erasmo Spaziani","doi":"10.47717/turkjsurg.2026.2025-8-15","DOIUrl":"10.47717/turkjsurg.2026.2025-8-15","url":null,"abstract":"<p><strong>Objective: </strong>Hypocalcemia (HC) is a common complication after thyroid surgery. This retrospective case-control study aimed to evaluate the efficacy of postoperative betamethasone infusion in reducing the incidence of HC following thyroid surgery, with recurrent laryngeal nerve palsy and other complications as secondary outcomes.</p><p><strong>Material and methods: </strong>A total of 196 patients who underwent total or completion thyroidectomy were retrospectively analyzed. Patients were divided into groups receiving postoperative betamethasone infusion or no glucocorticoid treatment. Postoperative data on HC incidence (at least one serum calcium measurement below 8.0 mg/dL), symptomatic HC (HC associate with numbness of the extremities, facial paresthesia, muscular spasms, and Chvostek's or Trousseau's signs), pain, recurrent laryngeal nerve palsy, voice dysfunction, sore-throat and dysphagia were collected and analyzed. Additionally, demographic and clinical characteristics were assessed, including preoperative assessments, intraoperative techniques, and postoperative recovery parameters.</p><p><strong>Results: </strong>The study found a significantly lower incidence of HC and symptomatic HC in the betamethasone group compared to the control (32.0% vs. 49.5%, p=0.013; 11.3% vs. 25.3%, p=0.012, respectively). Betamethasone-treated patients also reported lower postoperative pain scores (p=0.002).</p><p><strong>Conclusion: </strong>Betamethasone infusion post-thyroidectomy demonstrated efficacy in reducing HC and symptomatic hypoparathyroidism, with minimal impact on other complications. The findings suggest the potential of glucocorticoids as a therapeutic option in thyroid surgery to enhance postoperative outcomes and patient recovery.</p>","PeriodicalId":23374,"journal":{"name":"Turkish Journal of Surgery","volume":" ","pages":"289-297"},"PeriodicalIF":0.7,"publicationDate":"2026-09-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13549095/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148353799","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":"General surgery residency training: Learning and teaching processes from the perspective of an educator?","authors":"Beyza Özçınar, Emine Vatansever, Ayşe Hilal Batı","doi":"10.47717/turkjsurg.2026.2026-1-44","DOIUrl":"10.47717/turkjsurg.2026.2026-1-44","url":null,"abstract":"<p><strong>Objective: </strong>Educator perspectives on general surgery residency training have been insufficiently investigated in Türkiye. Understanding educational processes and institutional challenges may contribute to the development of standardized competency-based surgical training models. This study aimed to evaluate educators' perspectives on general surgery residency training in Türkiye, identify learning and teaching processes, and evaluate current educational practices that may inform future standardization efforts.</p><p><strong>Material and methods: </strong>A nationwide cross-sectional survey study was conducted among general surgery educators between August and December 2019. The questionnaire included 21 closed-ended and 3 open-ended questions evaluating educational structure, faculty involvement, and perceived adequacy of residency training programs. Survey questions were prepared following a literature review and expert evaluation. A pilot study involving 10 educators was conducted prior to national distribution.</p><p><strong>Results: </strong>A total of 156 educators completed the survey. Although 97% of educators supported structured residency programs, only 44% considered the current curriculum content sufficient and fewer than one-fifth reported full curriculum implementation. Faculty members working simultaneously at private institutions reported lower institutional presence, despite perceiving their educational contribution as adequate. Participants also identified inconsistencies in curriculum implementation and faculty participation.</p><p><strong>Conclusion: </strong>Educators perceive significant limitations in the standardization and implementation of general surgery residency training programs in Türkiye. Strengthening competency-based curricula, improving faculty engagement, and developing validated educational assessment tools may improve the quality of residency training.</p>","PeriodicalId":23374,"journal":{"name":"Turkish Journal of Surgery","volume":" ","pages":"313-318"},"PeriodicalIF":0.7,"publicationDate":"2026-09-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13549087/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148405973","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}