Turkish Journal of Surgery最新文献

{"title":"Associating liver partition and portal vein ligation for staged hepatectomy (ALPPS) for pediatric mesenchymal hamartoma: A case report.","authors":"Alvin Caballes, Kristian Alexis De Lara","doi":"10.47717/turkjsurg.2025.6696","DOIUrl":"10.47717/turkjsurg.2025.6696","url":null,"abstract":"<p><p>The case involves a one-year-old male with a mesenchymal hamartoma involving the right hepatic lobe. The tumor-free segments comprised 17% of the liver volume, which placed the patient at risk for post-resection liver failure. A staged approach, the associating liver partition with portal vein ligation for staged hepatectomy, was employed. This allowed the interval growth of the liver remnant and thereafter enabled right lobectomy with adequate liver function.</p>","PeriodicalId":23374,"journal":{"name":"Turkish Journal of Surgery","volume":"41 1","pages":"108-111"},"PeriodicalIF":0.5,"publicationDate":"2025-02-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11878189/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143516797","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Diagnostic value of vascular endothelial growth factor (VEGF) levels in gastrointestinal cancers with ascites - A cross sectional study.","authors":"Evangeline Mary Kiruba Samuel, Sudharsanan Sundaramurthi, Nandeesha Hanumanthappa, Vishnu Prasad Nelamangalaramakrishnaiah","doi":"10.47717/turkjsurg.2025.6592","DOIUrl":"10.47717/turkjsurg.2025.6592","url":null,"abstract":"<p><strong>Objective: </strong>Malignant ascites is suggestive of peritoneal carcinomatosis. The distinction between malignant and non-malignant ascites in a patient with malignancy is important, as it alters the management and prognosis. Current diagnostic methods are imaging, cytology, and diagnostic laparoscopy, all of which have low sensitivities. The vascular endothelial growth factor (VEGF) is essential for tumour growth and, hence, ascitic VEGF levels can be a diagnostic method for malignant ascites.</p><p><strong>Material and methods: </strong>This cross-sectional study was conducted in patients with gastrointestinal malignancies and ascites. The calculated sample size was 68 patients, who were divided into those who were truly positive or negative for malignant ascites based on a composite gold standard, comprising cytology, contrast enhanced computed tomography, and laparoscopy. The ascitic VEGF levels in these patients were compared.</p><p><strong>Results: </strong>A total of 84 patients were enrolled, of whom 60.71% were found to have malignant ascites. It was found that the greater the volume of ascites, the greater the statistical likelihood of finding truly malignant ascites. The ascitic VEGF levels had a non-normal distribution, with median values of 783.64 and 41.12 pg/mL for malignant and non-malignant ascites (p<0.001). Using a receiver operating characteristics curve, a cut-off of 83.68 pg/mL was obtained, with a sensitivity of 100% and a specificity of 93.94%.</p><p><strong>Conclusion: </strong>This study demonstrates that ascitic VEGF levels are significantly elevated in patients with gastrointestinal malignancies and malignant ascites and hence can reliably be used for diagnosing malignant ascites. This study also shows that massive ascites and well-differentiated tumours have a higher rate of peritoneal carcinomatosis.</p>","PeriodicalId":23374,"journal":{"name":"Turkish Journal of Surgery","volume":"41 1","pages":"78-84"},"PeriodicalIF":0.5,"publicationDate":"2025-02-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11878185/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143516841","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":"The identification and ligation of the parotid duct during parotidectomy.","authors":"Amr Abouzid, Mosab Shetiwy, Mohamed Hamdy, Mohamed Ezzat, Mohamed Abd Elghaffar","doi":"10.47717/turkjsurg.2025.6339","DOIUrl":"10.47717/turkjsurg.2025.6339","url":null,"abstract":"<p><strong>Objective: </strong>The complication rates after parotidectomy were reported to be 13-29% and many techniques were implemented to decrease these post-parotidectomy complications.</p><p><strong>Material and methods: </strong>Between August 2016 and June 2022, one hundred and twenty-five patients with parotid tumors had parotidectomy and ligation of the main parotid duct in the Department of Surgical Oncology, Oncology Center, Mansoura University with the observation of its effect on the postoperative outcomes.</p><p><strong>Results: </strong>Superficial parotidectomy was performed in 87 (69.6%) patients, total parotidectomy in 31 (24.8%) patients, and quadrantectomy in 7 (5.6%) patients. The operative time was 130.76±51.5 min, and the blood loss was 81.32±45.02 mL. A suction drain was placed in 106 patients and a non-suction drain was used in 19 patients. Postoperative complications included facial nerve morbidity in 12% of the patients, bleeding in 1 patient, seroma in 5 patients, edema in 1 patient, wound gap in 1 patient, wound infection in 1 patient, and keloid in 1 patient.</p><p><strong>Conclusion: </strong>The identification and ligation of the main parotid duct during parotidectomy has favorable impacts on the incidence of post-parotidectomy complications such as salivary fistula, seroma, sialocele, and wound infections.</p>","PeriodicalId":23374,"journal":{"name":"Turkish Journal of Surgery","volume":"41 1","pages":"92-97"},"PeriodicalIF":0.5,"publicationDate":"2025-02-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11878191/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143516849","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":"Pathologic results of laparoscopic cholecystectomy specimens with 8148 patients in a single center.","authors":"Hikmet Pehlevan Özel, Tolga Dinç","doi":"10.47717/turkjsurg.2025.6529","DOIUrl":"10.47717/turkjsurg.2025.6529","url":null,"abstract":"<p><strong>Objective: </strong>The aim of this study was to investigate the frequency of incidental pathologies detected in the surgical specimens of patients who underwent laparoscopic cholecystectomy in high-volume referral center, which accepts patients from different regions of our country, and to contribute to epidemiological studies.</p><p><strong>Material and methods: </strong>Male and female patients over 18 years of age who underwent laparoscopic cholecystectomy between July 2010 and May 2019 were included in the study. All surgical specimens were taken for pathologic examination. The pathology results were classified into three categories: Benign pathologies (including cholecystitis, non-neoplastic lesions and benign tumors), premalignant pathologies and malignant pathologies.</p><p><strong>Results: </strong>The study included a total of 8148 patients. The mean age was 49.74±14.51 years (minimum 18, maximum 94) and 72.2% of the patients were female. Benign pathologies included cholecystitis in 1742 (21.4%), non-neoplastic lesions in 6203 (76.1%) and benign tumors in 12 (0.1%), premalignant pathologies in 173 (2.1%) and malignant pathologies in 18 (0.2%). Although no statistically significant gender difference was observed between benign, premalignant and malignant pathologies, the incidence of premalignant and malignant pathologies increased with age (p=0.273, p<0.001, respectively).</p><p><strong>Conclusion: </strong>In this study of 8148 patients, incidental premalignant and malignant pathologies were identified in 2.1% and 0.2% of cases, respectively, which is consistent with the findings of literature. These results may be instructive for epidemiologic studies.</p>","PeriodicalId":23374,"journal":{"name":"Turkish Journal of Surgery","volume":"41 1","pages":"42-46"},"PeriodicalIF":0.5,"publicationDate":"2025-02-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11878175/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143516786","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":"Double jeopardy: The aortic-diaphragmatic injury complex.","authors":"Vitor Favali Kruger, Murilo Luciano Langoni, Cristhian Jaillita Meneses, Thiago A R Calderan, Elcio S Hirano, Gustavo Pereira Fraga","doi":"10.47717/turkjsurg.2025.6720","DOIUrl":"10.47717/turkjsurg.2025.6720","url":null,"abstract":"<p><strong>Objective: </strong>Concurrent traumatic diaphragmatic hernia (TDH) and blunt thoracic aortic injury (BTAI) are rare but critical injury complexes that result from high-energy trauma mechanisms. This study analyzed the epidemiology, diagnostic approaches, risk factors, and outcomes of concurrent TDH and BTAI and proposed a structured treatment algorithm.</p><p><strong>Material and methods: </strong>A retrospective analysis was performed using trauma records from a level 1 trauma center (2004-2024). Four male patients with confirmed concurrent TDH and BTAI were included in the study. Data on demographics, injury characteristics, diagnostic methods, treatment, and outcomes were collected. Statistical analyses were conducted using appropriate tests.</p><p><strong>Results: </strong>All injuries were caused by high-energy traumas. Mean injury severity score was 38 and the revised trauma score was 6.58. A massive transfusion protocol was activated in 75.0% of cases. Diagnostic imaging showed varying accuracies, with computed tomography demonstrating superior sensitivity for both injuries. All TDH were left-sided posterolateral and BTAI predominantly involved the isthmus. Management followed a sequential approach, with 75.0% of diaphragmatic repairs preceding the aortic intervention. Mean hospital stay was 33 days, with complications including infections, deep vein thrombosis, and atelectasis. Despite the high severity of the injury, all patients survived.</p><p><strong>Conclusion: </strong>Concurrent TDH and BTAI are rare, but critical injury complexes. Early recognition through structured diagnostic protocols and sequential management guided by institutional capabilities can achieve favorable outcomes despite high injury severity.</p>","PeriodicalId":23374,"journal":{"name":"Turkish Journal of Surgery","volume":"41 1","pages":"31-41"},"PeriodicalIF":0.5,"publicationDate":"2025-02-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11878192/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143516843","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":"Surgical results of liver metastases of tumors other than colorectal-neuroendocrine: Is it really worth it or is it necessary?","authors":"Fuat Aksoy, Erhan Gökçe, Eyüp Anıl Balkan, Halit Ziya Dündar, Ekrem Kaya","doi":"10.47717/turkjsurg.2024.6474","DOIUrl":"10.47717/turkjsurg.2024.6474","url":null,"abstract":"<p><strong>Objectives: </strong>It is known that surgical treatment is advantageous in terms of efficacy and survival in colorectal cancer and neuroendocrine tumor liver metastases. Our aim in this study was to determine the results of surgical treatment of non-colorectal (NCR), non-neuroendocrine tumor (NNET) liver metastases (LM).</p><p><strong>Material and methods: </strong>A total of 125 patients having NCR and NNET were included in the study. Demographic characteristics of the patients, histological features of the tumor, time from resection of the primary tumor to the first diagnosis of liver metastases, synchronous and metachronous presentations of hepatic metastases with primary malignancy, type of resection, postoperative complications, length of hospital stay, and survival were analyzed retrosepctively.</p><p><strong>Results: </strong>Median follow-up time was 21 (1-132) months. Mean overall survival (OS) and mean proression free survival (PFS) were 29.86 ± 2.4 and 21.23 ± 2.1 months respectively. Most of the cases were LM of breast (n= 33, 26.4%), gastric (n= 25, 20.0%) and gastrointestinal stromal tumors (GIST) (n= 16, 12.8%). Interval from resection of primary tumor to the diagnosis of LM was 20.90 ± 28.9 (0-144) months. OS and DFS rates were found respectively as; 78% and 69% at one year, 45% and 38% at three years, 32% and 21% at five years and 3.2% and 1.6% at 10 years. Breast cancer liver metastases had the longest OS and PFS. Pancreatic cancer and gastric cancer group significantly have shorter OS than the other groups.</p><p><strong>Conclusion: </strong>According to our data, the results are better in breast and GIST liver metastases, and the place of surgical treatment in pancreatic and malignant melanoma liver metastases is controversial.</p>","PeriodicalId":23374,"journal":{"name":"Turkish Journal of Surgery","volume":"40 4","pages":"267-274"},"PeriodicalIF":0.5,"publicationDate":"2024-12-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11831993/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143469109","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A global journal with deep local roots: Turkish Journal of Surgery.","authors":"Kaya Saribeyoğlu","doi":"10.47717/turkjsurg.2024.20240401","DOIUrl":"https://doi.org/10.47717/turkjsurg.2024.20240401","url":null,"abstract":"","PeriodicalId":23374,"journal":{"name":"Turkish Journal of Surgery","volume":"40 4","pages":"viii"},"PeriodicalIF":0.5,"publicationDate":"2024-12-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11831995/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143469006","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":"Clinical significances of liver fibrotic markers in patients with cholangiocarcinoma after radical resections.","authors":"Atsushi Nanashima, Masahide Hiyoshi, Naoya Imamura, Takeomi Hamada, Yuki Tsuchimochi, Takashi Wada, Ikko Shimizu, Takahiro Ochiai","doi":"10.47717/turkjsurg.2024.6486","DOIUrl":"10.47717/turkjsurg.2024.6486","url":null,"abstract":"<p><strong>Objectives: </strong>We examined the relation between several fibrotic markers reflecting liver parenchymal injury and conventional liver function or surgical outcomes in 67 patients with cholangiocarcinoma who underwent biliary drainage for obstructive jaundice followed by surgical resection.</p><p><strong>Material and methods: </strong>We examined conventional clinicopathological factors, six hepatic fibrosis parameters, including platelet count, hyaluronic acid, Mac-2 binding protein glycosylation isomer (M2BPGi), type IV collagen 7S, aspartate aminotransferase-to-platelet ratio index (APRI), and FIB-4 index before hepatectomy, and surgical outcomes or long-term prognosis.</p><p><strong>Results: </strong>Obstructive jaundice was observed in 57% of the patients, a history of biliary diseases in 7.5%, and chronic hepatic injuries in 17.9%. M2BPGi was significantly higher in patients with obstructive jaundice as the primary sign (p <0.05), the FIB-4 index was significantly correlated with patient age (p <0.01), and serum hyaluronic acid and T4C7 levels were significantly increased in distal cholangiocarcinoma (CC). No markers were associated with the histological hepatic fibrotic index, tumor-related factors, or postoperative morbidities. Tumor relapse was observed in 37% of patients, and cancer-related death was observed in 25%. A higher FIB-4 index was significantly associated with shorter cancer-free survival (p <0.05). Cox multivariate analysis showed that bilirubin levels, poor histological cancer differentiation, and absence of fibrotic markers were associated with cancer-free, cancer-specific overall, and overall survival.</p><p><strong>Conclusion: </strong>Although a sufficient relation exists between these markers and elastographic or histological fibrotic indexes, the clinical significance of measuring conventional fibrotic markers might no longer be necessary in future studies.</p>","PeriodicalId":23374,"journal":{"name":"Turkish Journal of Surgery","volume":"40 4","pages":"283-295"},"PeriodicalIF":0.5,"publicationDate":"2024-12-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11832000/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143469143","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":"First case of laparoscopic donor hepatectomy in Türkiye.","authors":"Aydın Alper, Cihan Karataş, Şenol Çarıllı, Nesimi Mecit, Münci Kalayoğlu, Turan Kanmaz","doi":"10.47717/turkjsurg.2022.5062","DOIUrl":"10.47717/turkjsurg.2022.5062","url":null,"abstract":"<p><p>Living donor liver transplantation is an important treatment option in countries like ours where cadaver donors are insufficient. This surgery is a major operation for the donor as well as the recipient. We should minimize the damage to donors who come for organ donation in a healthy way and minimize the risks of such a major surgery. For this purpose, we have explained the details of the first laparoscopic donor hepatectomy surgery performed in our country.</p>","PeriodicalId":23374,"journal":{"name":"Turkish Journal of Surgery","volume":"40 4","pages":"357-360"},"PeriodicalIF":0.5,"publicationDate":"2024-12-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11831994/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143469104","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":"Anal fissures in COVID-19 survivors: Incidence, risk factors, and outcomes.","authors":"Ahmad Sakr, Yousef Hesham, Hossam Elfeki, Mostafa Shalaby, Ahmed Hossam Elfallal, Amr Sameer","doi":"10.47717/turkjsurg.2024.6494","DOIUrl":"10.47717/turkjsurg.2024.6494","url":null,"abstract":"<p><strong>Objectives: </strong>In spite of COVID-19's typical presentation in the form of fever, cough, myalgia, and pneumonia, other gastrointestinal manifestations have been reported. Among the COVID-19 survivors, anal fissure has been documented. The aim of this study was to report the incidence of anal fissure among those patients, its possible risk factors and outcome.</p><p><strong>Material and methods: </strong>This is a retrospective cross-sectional study which was conducted on COVID-19 patients' who were diagnosed with anal fissure. Those who survived and were discharged home safely were contacted to pick up whether they suffered from any symptoms suggesting anal fissure, to identify the risk factors of anal fissure and their outcomes.</p><p><strong>Results: </strong>A total of 176 COVID-19 patients were enrolled in this study. The incidence of anal fissure among all patients was 36.9%. Patients were categorized into two groups; fissure and non-fissure groups. No significant difference was noted in the demographic data apart from age, which was younger in the fissure group. The majority of anal fissures resolved spontaneously after patients recovered from the COVID-19 symptoms with no specific treatment (43.1%).</p><p><strong>Conclusion: </strong>Anal fissure is quite a common problem in COVID-19 patients. Young and middle-aged patients are more vulnerable to develop anal fissure after COVID-19 infection.</p>","PeriodicalId":23374,"journal":{"name":"Turkish Journal of Surgery","volume":"40 4","pages":"336-342"},"PeriodicalIF":0.5,"publicationDate":"2024-12-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11831989/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143469036","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}