Turkish Journal of Surgery最新文献

{"title":"Computed tomography defined body composition may predict postoperative outcomes and prognosis following gastric cancer surgery.","authors":"Ahmet Akmercan, Tevfik Kıvılcım Uprak, Onur Buğdaycı, Meltem Kurşun, Ali Emre Atıcı","doi":"10.47717/turkjsurg.2025.6744","DOIUrl":"10.47717/turkjsurg.2025.6744","url":null,"abstract":"<p><strong>Objective: </strong>Loss of muscle mass (sarcopenia) and impaired muscle quality (myosteatosis) associated with poor surgical outcomes. This study aimed to evaluate the impact of sarcopenia and myosteatosis on postoperative short-term outcomes and prognosis in patients with gastric cancer.</p><p><strong>Material and methods: </strong>Patients who underwent gastric cancer surgery and had abdominal computed tomography (CT) imaging were included in the study. Skeletal muscle index (SMI) and skeletal muscle density (SMD) were calculated using CT images. Patients were divided into groups based on previously established threshold values: Those with low SMI (indicating sarcopenia) versus those with normal SMI, and those with low SMD (indicating myosteatosis) versus those with normal SMD. Demographics, clinicopathologic characteristics, postoperative outcomes, and survival data were extracted from prospective database.</p><p><strong>Results: </strong>Among the 237 patients, 87 patients (36.7%) had sarcopenia and 139 patients (58.6%) had myosteatosis. Patients with myosteatosis were characterized by older age, poorer preoperative nutritional status, inferior performance status, and extended hospital stays. Higher severe complication incidence was observed among patients with myosteatosis (18% vs. 10.2%, p=0.09). Overall survival of patients with sarcopenia or myosteatosis was significantly lower than that of patients with a normal SMI or SMD (p=0.03, p<0.001 respectively). Myosteatosis was identified as an independent risk factor for overall survival in multivariate analysis (hazard ratio: 2.20, 95% confidence interval: 1.26-3.86, p=0.006).</p><p><strong>Conclusion: </strong>This study indicated sarcopenia or myosteatosis is associated with reduced overall survival. Although there were no significant difference severe complication rates are higher in patients with low SMD than in patients with normal SMD, and reporting of SMD from preoperative CT should be considered in preoperative evaluation.</p>","PeriodicalId":23374,"journal":{"name":"Turkish Journal of Surgery","volume":" ","pages":"227-234"},"PeriodicalIF":0.6,"publicationDate":"2025-09-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12406638/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143983362","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":"Bariatric surgery outcomes in obese adults with cognitive impairments: A systematic review.","authors":"Moneer E Almadani","doi":"10.47717/turkjsurg.2025.2025-6-21","DOIUrl":"10.47717/turkjsurg.2025.2025-6-21","url":null,"abstract":"<p><p>Obesity is highly prevalent among individuals with cognitive impairments, yet bariatric surgery is often underutilized in this population due to concerns regarding adherence and safety. The aim of this review is to evaluate the outcomes of bariatric surgery in obese adults with cognitive impairments, focusing on weight loss, cognitive function, general health, and postoperative risks. A systematic review of 11 studies was conducted, including case reports, cohort studies, and pilot trials that investigated bariatric surgery outcomes in adults with intellectual disabilities, neurodevelopmental disorders, or acquired cognitive dysfunction. Outcomes included excess weight loss (EWL), cognitive changes, comorbidity resolution, and postoperative complications. Most studies reported significant weight loss, although slightly lower than in neurotypical populations (EWL ranging from 31.1% to 90%). Cognitive improvements were observed in domains such as memory and executive function within weeks after surgery. Bariatric surgery also led to notable improvements in comorbidities such as diabetes and hypertension. However, risks included nutritional deficiencies and poor adherence, particularly in patients with low preoperative cognitive function. Strong caregiver support and structured follow-up programs were key predictors of long-term success. Bariatric surgery can be a safe and effective intervention for adults with cognitive impairments when tailored support systems are implemented. Cognitive screening and personalized postoperative care are essential to optimize outcomes.</p>","PeriodicalId":23374,"journal":{"name":"Turkish Journal of Surgery","volume":" ","pages":"219-226"},"PeriodicalIF":0.6,"publicationDate":"2025-09-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12406621/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144817512","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 pediatric prostatic and retroperitoneal embryonal rhabdomyosarcoma with high Ki-67-case series study.","authors":"Melih Akın, Koray Yalçın, Emel Berfe Bük, Esma Sehoviç, Salih Güler","doi":"10.47717/turkjsurg.2025.6723","DOIUrl":"10.47717/turkjsurg.2025.6723","url":null,"abstract":"<p><p>Embryonal rhabdomyosarcoma (ERMS) is a highly aggressive pediatric malignancy that can develop in various anatomical locations. This case series presents four pediatric patients diagnosed with ERMS, including one with the uncommon presentation of prostatic rhabdomyosarcoma. By analyzing clinical features, treatment strategies, and outcomes, this study aims to provide insights into the challenges of managing this malignancy in different anatomical sites.</p>","PeriodicalId":23374,"journal":{"name":"Turkish Journal of Surgery","volume":" ","pages":"333-337"},"PeriodicalIF":0.6,"publicationDate":"2025-09-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12406629/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144000772","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":"Gastrointestinal schwannomas: A case series of 9 patients and literature review.","authors":"Server Sezgin Uludağ, Ergin Erginöz, Nazım Güreş, Zeynep Özdemir, Nuray Kepil, Şebnem Batur","doi":"10.47717/turkjsurg.2025.2025-5-28","DOIUrl":"10.47717/turkjsurg.2025.2025-5-28","url":null,"abstract":"<p><p>Gastrointestinal schwannomas are benign, slow-growing, rare tumors comprising 2-6% of all mesenchymal tumors of the gastrointestinal tract and 0.2% of all gastric neoplasms. In the gastrointestinal system, schwannomas are mostly observed in the stomach, followed by the colon and rectum. In this case series, we present the clinicopathological results of 9 cases, along with a literature review. A retrospective analysis was conducted on nine patients diagnosed with gastrointestinal schwannoma in a single institution. Tumors were located in the small intestine and stomach, with an average tumor size of 4.6 cm (range: 1.8-8.5 cm). Diagnoses were incidental in most cases, with only four patients presenting symptoms such as epigastric pain and changes in bowel habits. Histopathological characteristics of tumors were studied. Surgical resection with negative margins was performed in 8 cases. Histopathological analysis confirmed schwannomas characterized by solid, homogeneous, spindle-cell structures without cystic changes or necrosis. Immunohistochemically, all tumors were S-100 positive, with variable expression of other markers. Desmin was negative in seven samples. One gastric schwannoma showed focal smooth muscle actin positivity, while others were negative. The Ki-67 index ranged from 0% to 6%, and c-Kit was negative in all cases. DOG-1 expression was examined in four cases, showing focal positivity in small bowel schwannoma and negativity in three gastric schwannomas. Gastrointestinal schwannomas are predominantly benign tumors, more common in women, and typically occur in the sixth decade of life. While imaging and endoscopic techniques help in diagnosis, definitive diagnosis relies on histopathological analysis. Surgical resection remains the gold standard for treatment.</p>","PeriodicalId":23374,"journal":{"name":"Turkish Journal of Surgery","volume":"41 3","pages":"327-332"},"PeriodicalIF":0.6,"publicationDate":"2025-09-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12406649/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144970351","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":"One-stage tunneled de-epithelialized deltopectoral flap for huge head and neck cancer defects in the era of free flaps.","authors":"Shadi Awny, Mohammad Zuhdy, Ibrahim Nazif, Ahmed M Abdellatif, Khalid Atallah, Ahmed Fareed, Ahmed Abdallah","doi":"10.47717/turkjsurg.2025.2025-3-32","DOIUrl":"https://doi.org/10.47717/turkjsurg.2025.2025-3-32","url":null,"abstract":"<p><strong>Objective: </strong>The deltopectoral (DP) flap was and still is a workhorse flap in the reconstruction of head and neck defects following tumor resection, even in the current era of free microvascular flaps.</p><p><strong>Material and methods: </strong>We retrospectively recruited, from a prospectively maintained database, all patients with a history of defect reconstruction using one-stage tunneled de-epithelialized fasciocutaneous DP flap following resection of head and neck cancer between June 2020 and June 2023. Patient and disease characteristics, surgery parameters, flap specifics, oncological outcomes, and follow-up data were analyzed and reported.</p><p><strong>Results: </strong>Eleven patients were recruited; 6 of them were females (54.54%). Head and neck squamous cell carcinoma is the most common pathology (54.5%), followed by papillary carcinoma of the thyroid gland (27.3%). Six patients were operated upon for recurrences, and tumor fungation and/or ulceration was reported in 81.8%. The median age at the time of flap reconstruction was 71 years (range: 46.5-77). Wound complications were reported in 36.4% of patients, with the overall rate of flap necrosis being 27.3%, including 3 patients who suffered from major necrosis at the distal 1/3 of the flap. No delay in receiving adjuvant therapies, according to treatment protocols, was reported for any of the surviving patients.</p><p><strong>Conclusion: </strong>The one-stage tunneled de-epithelialized fasciocutaneous DP flap is an effective choice with acceptable outcomes for defect reconstruction following resection of locally advanced head and neck cancer, whether on a curative or palliative basis, in relatively old patients with different comorbidities who require rapid treatment sequencing.</p>","PeriodicalId":23374,"journal":{"name":"Turkish Journal of Surgery","volume":" ","pages":""},"PeriodicalIF":0.6,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144970408","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":"How I do it: Submucosal hemorrhoidectomy with advanced bipolar technology-modified Parks' method.","authors":"Sergey K Efetov, Akmalbek A Otabekov, Aleksandra Y Koziy","doi":"10.47717/turkjsurg.2025.2025-4-19","DOIUrl":"https://doi.org/10.47717/turkjsurg.2025.2025-4-19","url":null,"abstract":"<p><p>Park's method of submucosal hemorrhoidectomy has not gained widespread clinical use despite its minimally invasive nature. However, combining this technique with modern bipolar technology LigaSure™ offers a promising approach to surgical treatment of hemorrhoidal disease. A patient with stage III hemorrhoidal disease underwent surgery under subarachnoid anesthesia in the Lloyd Davis position. The procedure involved lifting external hemorrhoids with an Allis clamp to expose internal hemorrhoids. Using monopolar coagulation, a linear incision was made in the distal skin covering left lateral external hemorrhoids. The surgeon carefully separated varicose veins from sphincter fibers. The LigaSure™ device was then used to dissect hemorrhoidal tissue in the submucosal layer toward the hemorrhoidal artery origin. The artery was ligated 1 cm above the dentate line using bipolar technology while preserving the mucosa. Similar techniques were applied to remove right posterior and anterior hemorrhoidal tissue. The result showed three small incisions on the anoderm with complete preservation of the anal canal mucosa. The modified technique allows excision of hemorrhoidal tissue and ligation of arteries without sutures, preserving the lining of the anal canal. This approach potentially results in shorter hospital stays, less postoperative pain, and promotes rapid recovery.</p>","PeriodicalId":23374,"journal":{"name":"Turkish Journal of Surgery","volume":" ","pages":""},"PeriodicalIF":0.6,"publicationDate":"2025-08-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144970819","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":"Nipple adenoma; a literature review and our experience with a rare feature.","authors":"Betül Güzelyüz, Berrin Papila, Cemal Gündoğdu, Hüseyin Büyükbayram","doi":"10.47717/turkjsurg.2025.2025-3-31","DOIUrl":"https://doi.org/10.47717/turkjsurg.2025.2025-3-31","url":null,"abstract":"<p><p>With this review, we aimed to contribute to the literature by reviewing the studies on nipple adenoma and presenting a novel study regarding its occurrence in a male case, for which we have not found any publications worldwide. We have reviewed studies on nipple adenoma, which we rarely encounter in the literature. We also present a 41-year-old male patient, whom we operated on with a diagnosis of nipple adenoma. His postoperative histopathological examination revealed invasive breast carcinoma, a unique case in the literature, together with this review study. Nipple adenoma, which is extremely rare in male patients, is rare in the literature and clinical practice. In light of the data, this case is the second instance of a male patient with nipple adenoma presented in the literature after many years. The fact that it is the only male patient associated with invasive carcinoma makes the case unique. Nipple adenomas require careful examination because they are rare and can be confused with malignancy. Moreover, although its association with malignancy is exceptionally rare, it should still be included in the differential diagnosis for male breast lesions. Safe surgery and postoperative follow-up are recommended.</p>","PeriodicalId":23374,"journal":{"name":"Turkish Journal of Surgery","volume":" ","pages":""},"PeriodicalIF":0.6,"publicationDate":"2025-08-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144856461","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":"Critical appraisal of \"predictive score for conversion in laparoscopic cholecystectomy - a prospective study\" by V et al.","authors":"Karthik N, Swathi M","doi":"10.47717/turkjsurg.2025.2025-6-9","DOIUrl":"https://doi.org/10.47717/turkjsurg.2025.2025-6-9","url":null,"abstract":"","PeriodicalId":23374,"journal":{"name":"Turkish Journal of Surgery","volume":" ","pages":""},"PeriodicalIF":0.6,"publicationDate":"2025-08-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144817513","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":"Genetic profiling and pathway analysis in bladder carcinoma: Implications for therapeutic targeting.","authors":"Sampara Vasishta, Usha Sachidananda Adiga, Alfred J Augustine","doi":"10.47717/turkjsurg.2025.2025-3-33","DOIUrl":"https://doi.org/10.47717/turkjsurg.2025.2025-3-33","url":null,"abstract":"<p><strong>Objective: </strong>Bladder carcinoma represents a significant challenge in oncology due to its heterogeneous molecular nature. This study aimed to identify key genetic factors and molecular pathways involved in bladder carcinoma pathogenesis to facilitate the development of targeted therapies.</p><p><strong>Material and methods: </strong>The top 30 genes associated with bladder carcinoma were retrieved from the disease gene network database. Comprehensive bioinformatic analysis was performed using various enrichment tools, including gene ontology biological process, cellular component, molecular function analyses, and pathway mapping through WikiPathways and metabolite associations through human metabolome database. Drug interactions were evaluated using DrugMatrix data.</p><p><strong>Results: </strong>Gene ontology analysis revealed significant enrichment of cancer-related biological processes, cellular components, and molecular functions. Pathway analysis identified strong associations with head and neck squamous cell carcinoma, cancer pathways, pleural mesothelioma, endometrial cancer, and bladder cancer pathways. Key genes including <i>CDKN2A, PTEN, EGFR, PIK3CA, HRAS, FGFR3</i>, and <i>TP53</i> were implicated across multiple pathways. Metabolite analysis showed significant associations with phosphatidylinositol derivatives, highlighting the importance of the PI3K pathway. Drug interaction analysis revealed potential modulatory effects of several compounds including sertraline, valproic acid, and hydroxyurea on gene expression patterns in bladder carcinoma.</p><p><strong>Conclusion: </strong>This study provides comprehensive insights into the molecular underpinnings of bladder carcinoma, highlighting interconnected pathways and potential therapeutic targets. The significant overlap with other cancer types suggests common oncogenic mechanisms that could be exploited for therapeutic intervention. Further validation of these findings in clinical samples may facilitate the development of personalized treatment approaches for bladder carcinoma patients.</p>","PeriodicalId":23374,"journal":{"name":"Turkish Journal of Surgery","volume":" ","pages":""},"PeriodicalIF":0.6,"publicationDate":"2025-07-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144733476","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}