Turkish Journal of Surgery最新文献

{"title":"Factors affecting the formation of lymphedema due to breast cancer (Is primary systemic treatment an independent factor in the formation of breast cancer related lymphedema?).","authors":"Melek Kumcuoğlu, Semra Günay, Berk Gökçek","doi":"10.47717/turkjsurg.2025.2025-5-13","DOIUrl":"10.47717/turkjsurg.2025.2025-5-13","url":null,"abstract":"<p><strong>Objective: </strong>This study aimed to evaluate the local and systemic risk factors associated with breast cancer-related lymphedema (BCRL), with a focus on whether primary systemic treatment (PST), particularly taxane-based chemotherapy, is an independent risk factor.</p><p><strong>Material and methods: </strong>A prospective clinical study was conducted on 80 breast cancer patients discussed at our institution's weekly breast cancer council. Patients were grouped based on PST status. Clinical examinations and measurements were performed preoperatively and postoperatively at 1, 6, 12, 18, and 24 months. Only the operated arm was assessed using tape measurements and the truncated cone formula. Arm volumes were calculated, and lymphedema (LE) was diagnosed based on a volume difference (≥200 mL or ≥2 cm circumference).</p><p><strong>Results: </strong>No statistically significant differences were found between PST and non-PST groups regarding age, body mass index, menopausal status, smoking, or tumor characteristics. LE was detected in 7 (8.8%) patients, all Stage 1. PST and taxane-based chemotherapy were not significantly associated with LE development. However, seroma presence (p=0.038) and axillary radiotherapy (p=0.043) were significantly associated with LE. Arm volume increase was most significant at 1 and 18 months postoperatively (p=0.055 and p=0.044, respectively).</p><p><strong>Conclusion: </strong>PST, including taxane-based chemotherapy, does not appear to be an independent risk factor for BCRL. In contrast, postoperative seroma and axillary radiotherapy are significantly associated with LE development. Early identification and management strategies should target these modifiable factors to reduce the risk of LE.</p>","PeriodicalId":23374,"journal":{"name":"Turkish Journal of Surgery","volume":" ","pages":"248-254"},"PeriodicalIF":0.6,"publicationDate":"2025-09-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12406632/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144817514","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":"Unveiling the secrets of the profunda femoris artery: A cadaveric journey with morphometric insights.","authors":"Athikayala Gopikrisshna Dhaminirithika, Hannahsugirthabai Rajilarajendran, Gowthaman Kavinnilavan, P Indra","doi":"10.47717/turkjsurg.2025.6571","DOIUrl":"10.47717/turkjsurg.2025.6571","url":null,"abstract":"<p><strong>Objective: </strong>Profunda femoris artery (PFA), a branch of femoral artery primarily supplies blood to skin, muscles of the inner thigh and proximal femur and plays a significant role in collateral blood supply. This study aimed to investigate the origin, branching pattern and morphometries of PFA in cadavers.</p><p><strong>Material and methods: </strong>Lower limbs of male and female cadavers (n=41) were analyzed for origin of PFA, lateral circumflex artery (LCFA) and medial circumflex artery (MCFA), distance from mid-inguinal point, course, branching pattern and their external calibers. Data were tabulated and analyzed using SPSS.</p><p><strong>Results: </strong>The PFA showed origins that are posterolateral, posteromedial, and posterior. The distance between PFA and the midpoint of the inguinal ligament was (L=3.7-6.2; mean =5.19±0.7 cm; R=3.2-6.2 cm, mean =4.74±0.9 cm). The origin of MCFA was medial (R=61%, L=52%) and posteromedial (R=39%, L=48%); LCFA was lateral (R=100%, L=78%) and posterolateral (R=0%, L=22%). The average diameter of PFA, MCFA, & LCFA was (L=5.04, 2.9, 2.8 cm and R=5.4, 3.09, 3.71 cm). The paired t-test with a significant p-value (95% confidence) demonstrated that differences in the diameters of the arteries at the specified levels between the left and right limbs could have clinical implications, such as differences in blood flow or susceptibility to vascular conditions.</p><p><strong>Conclusion: </strong>To reduce intra-operative and post-operative complications in the femoral region branches during diagnostic and surgical procedures, it is essential to comprehend the normal and variant positions and distances of the PFA's origin and its circumflex branches.</p>","PeriodicalId":23374,"journal":{"name":"Turkish Journal of Surgery","volume":" ","pages":"294-299"},"PeriodicalIF":0.6,"publicationDate":"2025-09-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12406633/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143731899","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":"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":"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":"307-312"},"PeriodicalIF":0.6,"publicationDate":"2025-09-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12406637/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144609708","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":"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":"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":"313-320"},"PeriodicalIF":0.6,"publicationDate":"2025-09-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12406630/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144609709","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":"Evaluation of quality of life in primary hyperparathyroidism patients: Pre- and post-parathyroidectomy outcomes in an Indian cohort.","authors":"Manish Rohilla, Cherring Tandup, Divya Dahiya, Arunanshu Behera, Sanjay Kumar Bhadada, Manish Thakur, Sree Vani Paladugu","doi":"10.47717/turkjsurg.2025.6811","DOIUrl":"10.47717/turkjsurg.2025.6811","url":null,"abstract":"<p><strong>Objective: </strong>Primary hyperparathyroidism (PHPT) is a common endocrine condition that causes hypercalcemia and other symptoms due to improper parathyroid hormone (PTH) secretion. With fatigue, bone pain, and neuropsychiatric difficulties, the disorder drastically lowers quality of life (QoL). This study uses Pasieka's parathyroid symptoms score to evaluate parathyroidectomy's impact on Indian PHPT patients' QoL.</p><p><strong>Material and methods: </strong>This 18-month prospective observational study was conducted at an Indian academic tertiary care facility. Parathyroidectomy was performed on 42 PHPT patients. Pasieka's parathyroid symptoms questionnaire and baseline clinical and biochemical parameters were completed preoperatively and three months postoperatively. The questionnaire uses a linear analog scale to assess 13 symptoms, including weariness, bone pain, mood issues, and cognitive issues.</p><p><strong>Results: </strong>Preoperatively, patients demonstrated markedly increased calcium and PTH levels. Post-parathyroidectomy, notable enhancements were noted across various QoL dimensions. Significant reductions in bone pain, joint pain, weariness, and muscle weakness were seen (p<0.001). Neuropsychiatric symptoms, such as irritability and mood fluctuations, shown considerable improvement (p<0.001). Cognitive symptoms, including amnesia, exhibited some improvement, although dermatological symptoms such as itching and polydipsia were mitigated.</p><p><strong>Conclusion: </strong>PHPT patients benefit greatly after parathyroidectomy in both physical and mental ways. In order to reduce the systemic effects of PHPT, surgery must be performed quickly. Parathyroidectomy improves patient well-being.</p>","PeriodicalId":23374,"journal":{"name":"Turkish Journal of Surgery","volume":" ","pages":"235-240"},"PeriodicalIF":0.6,"publicationDate":"2025-09-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12406604/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144576354","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":"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":"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":"270-276"},"PeriodicalIF":0.6,"publicationDate":"2025-09-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12406622/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144699606","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":"Insight into the early postoperative improvement of the functionality of the reconstructed urethra after distal hypospadias repair treated by the Snodgrass technique.","authors":"Asmir Jonuzi, Benjamin Kulovac, Amira Mešić, Una Glamoclija, Semir Vranić, Zlatan Zvizdic","doi":"10.47717/turkjsurg.2025.6756","DOIUrl":"10.47717/turkjsurg.2025.6756","url":null,"abstract":"<p><strong>Objective: </strong>This study aimed to evaluate the functional status of the urethra using uroflowmetry before surgery, as well as three and six months postoperatively in cases of distal hypospadias.</p><p><strong>Material and methods: </strong>Thirty-nine consecutive patients who underwent surgery for distal hypospadias (hypospadias group) between 2016 and 2019 were prospectively included as part of this study. The control group consisted of 40 patients with a normal urethra who underwent surgery due to conditions other than hypospadias (phimosis, undescended testis, hernia). Uroflowmetry was performed preoperatively in these patients. Postoperative uroflowmetry was performed at three and six months following hypospadias surgery. Uroflowmetric results [maximum flow rate (Q_max), average flow rate (Q_ave), voided volume, void duration, flow start time, time to maximum urine flow rate, post-void residual urine, flow curve] were compared between the groups.</p><p><strong>Results: </strong>The mean age for the patients with distal hypospadias was 35.9±29.6 months and 40.8±26.1 months for the control group. Pre- and postoperative Q_max values (three and six months after surgery) were 6.9 mL/s (0.1-15), 6.4 (0.2-14), and 7.5 (2.5-15). Qave values were preoperatively 4.0 (0.1-12.1), 3.8 (0.3-8.1), and 4.7 (1.0-11.1) mL/s three and six months after surgery, respectively. Bell-type flow was the most frequent uroflow flow curve in the preoperative hypospadias and control groups (95% and 66.6%, respectively). Postoperatively, bell-type flow remained the most common pattern, while a significant reduction in plateau-type flow was observed. Four boys (10.3%) had symptoms of obstruction.</p><p><strong>Conclusion: </strong>Surgery improved urination dynamics and partial urethral obstruction of hypospadias cases that were present from the baseline. The urinary flow rates improve over time as the reconstructed neourethra regains functionality six months after the tubularized incised plate procedure.</p>","PeriodicalId":23374,"journal":{"name":"Turkish Journal of Surgery","volume":"41 3","pages":"255-260"},"PeriodicalIF":0.6,"publicationDate":"2025-09-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12406640/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144970363","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":"Are respiratory risks after cardiac surgery universal? A case study from Tuzla, Bosnia and Herzegovina.","authors":"Alisa Krdžalić, Amar Skakić, Omar Krdžalić, Ivana Iveljić","doi":"10.47717/turkjsurg.2025.6722","DOIUrl":"10.47717/turkjsurg.2025.6722","url":null,"abstract":"<p><strong>Objective: </strong>Postoperative respiratory complications (PRCs) are a significant concern after cardiac surgery, contributing to increased morbidity and mortality. This study aimed to analyze the incidence and risk factors for PRCs in a tertiary center in Bosnia and Herzegovina and compare findings with data from developed countries.</p><p><strong>Material and methods: </strong>This prospective cohort study included 300 adult patients who underwent open-heart surgery with cardiopulmonary bypass at the Clinic for Cardiovascular Surgery, University Clinical Center Tuzla, between January 2020 and October 2023. Preoperative, intraoperative, and postoperative variables were analyzed, including comorbidities, surgical procedures, mechanical ventilation duration, and intensive care unit stay. PRCs were defined based on standardized clinical and radiological criteria. Multivariate logistic regression identified independent risk factors.</p><p><strong>Results: </strong>The most common PRCs were pneumonia (37.3%), atelectasis (29.3%), pleural effusion (22.0%), and respiratory failure (10.7%). Key independent risk factors included oxygen saturation <94%, ejection fraction <45%, diabetes mellitus, anemia, and red blood cell transfusion >500 mL. In contrast to studies from developed countries, intraoperative variables were not significant predictors.</p><p><strong>Conclusion: </strong>Our findings suggest that preoperative comorbidities play a more dominant role in PRC development in our setting compared to developed nations. The high incidence of pneumonia may reflect delayed postoperative mobilization and limited access to respiratory therapy. These results underscore the need for optimized preoperative patient management and improved postoperative respiratory care protocols in resource-limited healthcare settings.</p>","PeriodicalId":23374,"journal":{"name":"Turkish Journal of Surgery","volume":"41 3","pages":"300-306"},"PeriodicalIF":0.6,"publicationDate":"2025-09-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12406650/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144970414","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":"Preoperative CONUT score predicts postoperative complications in stage I-III gastric cancer patients undergoing curative gastric resections.","authors":"İsmail Tırnova, Ahmet Serdar Karaca","doi":"10.47717/turkjsurg.2025.2025-7-36","DOIUrl":"10.47717/turkjsurg.2025.2025-7-36","url":null,"abstract":"<p><strong>Objective: </strong>The controlling nutritional status (CONUT) score, calculated using serum albumin, total cholesterol, and lymphocyte count, is an effective predictor of post-operative complications (PC) following oncologic resections in gastrointestinal system cancers. This retrospective study aimed to investigate the impact of pre-operative CONUT scores on overall post-operative complications (OPC) in patients with stage I-III gastric cancer (GC) who underwent gastrectomy.</p><p><strong>Material and methods: </strong>Patients who underwent curative gastric resection for GC between January 2013 and December 2024 were retrospectively analyzed. Patients with a preoperative CONUT score of 0-1 were classified as the normal CONUT group. In contrast, those with a score of 2 or higher were classified as the high CONUT group. Preoperative, intraoperative, and postoperative data were reviewed. Risk factors for the development of OPC were evaluated using univariate and multivariate analyses.</p><p><strong>Results: </strong>In the high CONUT group, American Society of Anesthesiologists scores, neutrophil/lymphocyte ratio, lymphatic invasion rates, TNM stages, duration of intensive care unit stay, OPC rates, and comprehensive complication index values were significantly higher (p<0.05). Multivariate analysis revealed that advanced TNM stage [odds ratio (OR): 5.8, 95% confidence interval (CI): 1.4-24.6, p=0.016] and a high CONUT score (OR: 4.1, 95% CI: 1.3-13.0, p=0.014) were independent risk factors for the development of PC.</p><p><strong>Conclusion: </strong>Pre-operative CONUT score may serve as a predictor of OPC following curative GC resections.</p>","PeriodicalId":23374,"journal":{"name":"Turkish Journal of Surgery","volume":"41 3","pages":"261-269"},"PeriodicalIF":0.6,"publicationDate":"2025-09-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12406628/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144970431","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":"Risk factors for visceral artery pseudoaneurysm in chronic pancreatitis: A retrospective analysis.","authors":"Utpal Anand, Sitaram Yadav, Rohith Kodali, Kunal Parasar, Ramesh Kumar, Rajeev Nayan Priyadarshi, Basant Narayan Singh, Kislay Kant","doi":"10.47717/turkjsurg.2025.2025-6-10","DOIUrl":"10.47717/turkjsurg.2025.2025-6-10","url":null,"abstract":"<p><strong>Objective: </strong>Chronic pancreatitis (CP) leads to enduring abdominal pain and functional insufficiency, alongside notable risks posed by vascular complications. Pseudoaneurysms (PSA) are common in CP, necessitate careful management due to potential life-threatening hemorrhage. Literature suggests a 5-10% incidence of gastrointestinal bleeding in CP, often related to PSA affecting nearby arteries. Our study aims to evaluate the prevalence and outcomes of vascular complications in CP, aiding in improved management strategies.</p><p><strong>Material and methods: </strong>This retrospective observational study was conducted on the patients diagnosed with CP at a tertiary care center in Northeast India from April 2018 to December 2023. Demographic data and risk factors such as smoking and alcohol use were collected from medical records. The diagnosis and etiological assessment followed the M-ANNHEIM criteria, employing contrast-enhanced computed tomography.</p><p><strong>Results: </strong>In our study of 86 patients with CP, predominantly male (68.6%), the median age at presentation was 37.4 years. Arterial PSAs were identified in 11 patients (12.79%), with a median onset of 18.2 months from symptom onset. Univariate analysis revealed that male sex (p=0.015), alcohol abuse (p=0.001), smoking (p=0.035), pseudocyst formation (p=0.008), and absence of parenchymal calcification (p=0.002) were significantly associated with PSA development. Interestingly, inflammatory head mass was more prevalent in patients without PSA (49.3% vs. 9.1%, p=0.02), suggesting a potential protective effect. On multivariate analysis, independent predictors of PSA formation included an alcohol abuse [odds ratio (OR): 10.75, 95% confidence interval (CI): 0.967-119.53, p=0.05], a pseudocyst presence (OR: 27.41, 95% CI: 1.591-472.39, p=0.02), and a bulky pancreatic head (OR: 12.72, 95% CI: 2.97-54.51, p=0.0006), while parenchymal calcification remained inversely associated (OR: 0.1279, 95% CI: 0.016-1.02, p=0.05).</p><p><strong>Conclusion: </strong>Arterial PSA formation in CP is independently associated with alcohol abuse, pseudocysts, and inflammatory head mass, while parenchymal calcification appears protective. Endovascular coiling has emerged as a promising intervention, demonstrating effective management of PSA and successful prevention of hemorrhagic complications.</p>","PeriodicalId":23374,"journal":{"name":"Turkish Journal of Surgery","volume":" ","pages":"321-326"},"PeriodicalIF":0.6,"publicationDate":"2025-09-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12406623/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144817515","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}