Turkish Journal of Surgery最新文献

{"title":"Neuroblastoma treatment in children: Single-center case series and review of the literature.","authors":"Asmir Jonuzi, Ilhana Tinjak, Benjamin Kulovac, Predrag Ilic, Zlatan Zvizdic","doi":"10.47717/turkjsurg.2026.2025-9-34","DOIUrl":"10.47717/turkjsurg.2026.2025-9-34","url":null,"abstract":"<p><strong>Objective: </strong>Description of the clinical presentation and tumor behavior, its general and pathological characteristics, diagnostic and therapeutic approaches, as well as treatment outcomes in children with neuroblastoma (NB) at a single-center. Special focus was placed on the duration of the diagnostic process and the correlation between disease stage, presence of metastases, and treatment outcomes. Given the small cohort, this report is presented as a descriptive case series complemented by a focused review of the literature NB.</p><p><strong>Material and methods: </strong>A retrospective study was conducted for the time period from January 1^st, 2010, to December 31^st, 2024. The study included 13 patients (7 males, 6 females; median age: 44 months; range, 0-114) diagnosed with NB who underwent surgery and were hospitalized at the Department of Pediatric Surgery, Clinical Center of the University of Sarajevo. Demographic, clinical, biochemical, radiological, and treatment data were extracted from medical records. A narrative review of major published NB cohorts was conducted to compare our observations with existing evidence.</p><p><strong>Results: </strong>The median age at diagnosis was 44 months. The largest number of patients were in the age group of 2-4 years, and most presented with stage four disease (according to International Neuroblastoma Staging System classification). The tumor was located in the adrenal gland in 92.3% of cases. The median survival time was 36 months. Patients had elevated serum neuron-specific enolase, urinary vanillylmandelic acid, as well as blood ferritin and lactate dehydrogenase levels. The most common symptoms were loss of appetite, presence of a palpable mass, and abdominal pain. Metastases were present in 76.9% of patients, and stage four was associated with aggressive metastatic dissemination. A multimodal approach was used in treatment. The median time from symptom onset to primary care physician consultation was 12 days, and the median time from physician consultation to diagnosis was 14 days. Relapse occurred in 46.2% of cases, most frequently in patients with stage four disease. A total of 7 patients (46.2%) survived.</p><p><strong>Conclusion: </strong>Advanced-stage disease at diagnosis, metastatic burden, and unfavorable outcomes, are dominating factors in our single-center experience. When compared with larger published cohorts, our findings align with global patterns. Due to inherent sample size limitations, these observations are hypothesis-generating and the need for larger, multicenter studies remains.</p>","PeriodicalId":23374,"journal":{"name":"Turkish Journal of Surgery","volume":" ","pages":"239-250"},"PeriodicalIF":0.7,"publicationDate":"2026-06-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13237509/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147821281","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":"Predictive value of the albumin-to-creatinine and bicarbonate-to-lactate ratios for 28-day mortality in acute mesenteric ischemia.","authors":"İbrahim Doğan, Serhat Ocaklı, Fırat Canlıkarakaya, Cengiz Ceylan","doi":"10.47717/turkjsurg.2026.2025-12-10","DOIUrl":"10.47717/turkjsurg.2026.2025-12-10","url":null,"abstract":"<p><strong>Objective: </strong>Acute mesenteric ischemia (AMI) is a life-threatening condition characterized by rapid deterioration, yet it is often identified late owing to vague and non-specific clinical findings. Identifying laboratory markers that can assist in early mortality prediction remains essential for improving outcomes. This study aimed to determine whether the bicarbonate-to-lactate ratio (HCO₃/lactate) and the albumin-to-creatinine ratio could serve as reliable predictors of early mortality in patients with AMI.</p><p><strong>Material and methods: </strong>This retrospective case-control study included 87 patients who underwent surgical treatment for acute arterial mesenteric ischemia caused by superior mesenteric artery embolism between 2015 and 2025. Demographic characteristics, comorbidities, laboratory findings, and mortality outcomes were evaluated. The predictive performance of the bicarbonate-to-lactate and albumin-to-creatinine ratios was assessed using receiver operating characteristic (ROC) analysis; independent predictors of mortality were identified through multivariate logistic regression.</p><p><strong>Results: </strong>The 28-day mortality rate was 62.1%. In univariate analysis, lower bicarbonate and albumin levels, reduced HCO₃/lactate and albumin/creatinine ratios, and higher lactate, creatinine, and C-reactive protein values were significantly associated with mortality (p<0.05). ROC analysis identified values of <6 for the HCO₃/lactate ratio and <2.6 for the albumin/creatinine ratio as the best cut-off values. In the multivariate model, a HCO₃/lactate ratio <6 increased the risk of death by more than 13-fold, while an albumin/creatinine ratio <2.6 increased mortality risk by approximately 4.5-fold.</p><p><strong>Conclusion: </strong>Both the HCO₃/lactate and albumin/creatinine ratios are simple, inexpensive, and easily obtainable biochemical markers that may assist clinicians in predicting early mortality in AMI. Their incorporation into early evaluation algorithms could enhance risk stratification, although validation through prospective studies is warranted.</p>","PeriodicalId":23374,"journal":{"name":"Turkish Journal of Surgery","volume":"42 2","pages":"167-172"},"PeriodicalIF":0.7,"publicationDate":"2026-06-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13237503/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148164746","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":"Immunoglobulin G4-related disease mimicking acute appendicitis: The first case report from Türkiye.","authors":"Serra Bayrakçeken, Nilsu Güvencer, İsmail Ahmet Bilgin, Süha Göksel, Volkan Özben","doi":"10.47717/turkjsurg.2026.2026-3-18","DOIUrl":"https://doi.org/10.47717/turkjsurg.2026.2026-3-18","url":null,"abstract":"<p><p>Immunoglobulin G4-related disease (IgG4-RD) is a fibroinflammatory condition that can present as mass-like lesions mimicking tumors, infections or immune-mediated diseases. Although multiple organs may be involved, appendiceal involvement is extremely rare with only eight cases reported in the literature. Here, we report a case of a 38-year-old male patient who presented with clinical features of acute appendicitis and underwent laparoscopic appendectomy with cecal wedge resection. Intraoperatively, a mass-like lesion was observed. Histopathological examination revealed IgG4-positive plasma cells, non-necrotizing granulomas, submucosal and subserosal fibrosis consistent with IgG4-RD of the appendix. The patient was discharged on postoperative day one without complications and no clinical abnormalities were noted during a postoperative one-year follow-up period. This report describes the first case of appendiceal IgG4-RD reported from Türkiye. Despite its uniqueness, IgG4-RD should be considered in the differential diagnosis of appendiceal pathologies to ensure accurate diagnosis and patient management.</p>","PeriodicalId":23374,"journal":{"name":"Turkish Journal of Surgery","volume":" ","pages":""},"PeriodicalIF":0.6,"publicationDate":"2026-05-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147933915","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":"Beyond mammography: Superior performance of ultrasound in early-onset breast cancer implications for age-specific, density-tailored screening.","authors":"Salman Saad Bin Shaber, Fahad Mohammed Alsahli, Maher Mohammed Alotaibi, Yasser Ahmad Alahmad, Bandar Mohammad Alajmy, Saud Fohaid Alqahtani, Nourah Bader Hadhoud, Khaled Mohammed A Al Moadi, Mousa Essa Dahhas","doi":"10.47717/turkjsurg.2025.2025-7-34","DOIUrl":"10.47717/turkjsurg.2025.2025-7-34","url":null,"abstract":"<p><strong>Objective: </strong>Breast cancer accounts for 31.8% of female cancers in Saudi Arabia, with 56% of cases diagnosed before age 50, 14 years younger than in Western countries. Aggressive subtypes (TNBC: 18-24%; HER2+: 25-28%) are common, and dense breast tissue reduces the effectiveness of mammography. Currently, no age-specific screening protocols exist for this unique epidemiological profile. This study aimed to assess the age-specific diagnostic accuracy of mammography, ultrasound, and magnetic resonance imaging (MRI), and to characterize molecular subtype distribution in Saudi breast cancer patients to guide personalized screening guidelines.</p><p><strong>Material and methods: </strong>A retrospective cohort study was conducted at a tertiary care center in Riyadh, Saudi Arabia (January 2021-December 2023). Medical records of 148 women aged 30-70 with histopathologically confirmed breast cancer (BI-RADS 4/5) were analyzed. The sensitivity and specificity of imaging modalities were assessed across age groups (30-39, 40-49, 50-59, ≥60 years). Subtype distribution and breast density (BI-RADS A-D) were correlated with imaging performance using chi-square tests and logistic regression (SPSS v28, STARD 2015 guidelines).</p><p><strong>Results: </strong>The mean age was 48 years, with 56.4% of cases occurring in women under 50 (peak incidence: 40-49 years, 34.1%). Ultrasound sensitivity exceeded mammography in women under 50 (85.3% vs. 74.5%, p<0.01), while MRI demonstrated the highest overall accuracy (91.7%, 95% confidence interval 89.2-93.5). TNBC prevalence decreased with age (24.7% in 30-39 years to 12.0% in ≥60 years, p<0.01), while invasive lobular carcinoma incidence doubled (8.2% to 18.0%, p<0.001). Delayed diagnosis (>60 days) lowered 2-year survival by 21% (p=0.003).</p><p><strong>Conclusion: </strong>Ultrasound is more effective than mammography for early detection in Saudi women under 50 years old, while MRI remains highly accurate across all age groups. National screening guidelines should adopt biennial ultrasound-first screening starting at age 40, with MRI reserved for high-risk cases and BI-RADS 3-4 lesions.</p>","PeriodicalId":23374,"journal":{"name":"Turkish Journal of Surgery","volume":" ","pages":"57-66"},"PeriodicalIF":0.7,"publicationDate":"2026-03-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12964097/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146012323","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":"Preliminary single-operator experience with ultrasound-guided liver core needle biopsy performed by a supervised general surgery resident.","authors":"Wojciech Ciesielski, Konrad Kosztowny, Tomasz Klimczak, Anna Sawina, Paulina Lange, Antoni Knera, Adam Placek, Karol Sadowski, Adam Durczyński, Janusz Strzelczyk, Piotr Hogendorf","doi":"10.47717/turkjsurg.2026.2025-9-15","DOIUrl":"10.47717/turkjsurg.2026.2025-9-15","url":null,"abstract":"<p><strong>Objective: </strong>Ultrasound-guided core needle biopsy (CNB) is essential for diagnosing liver tumors not amenable to resection, but the outcomes of resident-performed CNB are poorly defined. We evaluated the diagnostic performance and safety of liver CNB performed by a single ultrasound-certified general surgery resident under specialist supervision.</p><p><strong>Material and methods: </strong>In this retrospective single-center case series, 65 consecutive patients underwent ultrasound-guided liver CNB between July 2022 and January 2025. All procedures constituted the resident's entire initial experience with liver CNB. Diagnostic success was defined as obtaining sufficient tissue for definitive histopathological diagnosis. Predictors of diagnostic success were assessed using univariate analyses and logistic regression. Learning-curve effects were evaluated by comparing early and late tertiles of chronologically ordered cases and by modelling case number as a continuous predictor. The impact of lesion size was examined by subgroup analysis comparing <4 cm and ≥4 cm lesions and by treating the maximal lesion diameter as a continuous variable.</p><p><strong>Results: </strong>Adequate tissue was obtained in 58/65 biopsies (89.2%), with malignancy confirmed in 49 patients (75.4%) and benign lesions in 9 patients (13.8%). Diagnostic success was 85.7% in the early tertile and 95.5% in the late tertile (p=0.345). Logistic regression showed a non-significant trend toward a higher diagnostic yield over time. Neither lesion size (categorized as <4 cm versus ≥4 cm) nor maximal diameter (analyzed as a continuous variable) was significantly associated with diagnostic success. No immediate or clinically overt delayed complications were observed during 24 hours of in-hospital monitoring.</p><p><strong>Conclusion: </strong>This preliminary single-operator experience suggests that, under close supervision, an appropriately trained general surgery resident can perform ultrasound-guided liver CNB with a high diagnostic yield and a low observed complication rate. These hypothesis-generating findings support further multi-operator and comparative studies of resident-performed liver CNB.</p>","PeriodicalId":23374,"journal":{"name":"Turkish Journal of Surgery","volume":" ","pages":"93-99"},"PeriodicalIF":0.7,"publicationDate":"2026-03-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12964085/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146107382","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":"Blood product transfusion in major burned pediatric patients: A case-control study.","authors":"Ayten Saraçoğlu, Ezgi Hatip Ünlü, Sezer Yakupoğlu, Fathima R Mahmood, Tahsin Şimşek, Amna Zar, Gaye Filinte, Murat Dereli, Kemal Tolga Saraçoğlu","doi":"10.47717/turkjsurg.2025.2025-8-38","DOIUrl":"10.47717/turkjsurg.2025.2025-8-38","url":null,"abstract":"<p><strong>Objective: </strong>To evaluate the impact of blood product transfusions on clinical outcomes, including mortality, dialysis requirement, and infection, in pediatric patients with extensive burns.</p><p><strong>Material and methods: </strong>This case-control study included pediatric patients with ≥20% total body surface area burns who were treated at a university hospital burn center between 2012 and 2022. Deceased patients were classified as cases, and discharged patients as controls. The primary outcome was mortality, and the secondary outcomes were dialysis. Multivariable logistic regression was used to assess associations between blood product usage and clinical outcomes, adjusting for burn severity, surgical duration, and infection.</p><p><strong>Results: </strong>One hundred-thirteen patients were analyzed, with 93 discharged and 20 deceased. Platelet transfusion in the intensive care unit (ICU) was associated with lower mortality (odds ratio: 0.663, 95% confidence interval: 0.484-0.909, p=0.011) but with increased dialysis requirements. Moreover, albumin, red blood cell, and fresh frozen plasma transfusions in the ICU were correlated with an increased risk of infection. Albumin administration in the ICU was associated with decreased mortality (hazard ratio =0.848, 95% confidence interval: 0.735-0.977, p=0.023).</p><p><strong>Conclusion: </strong>The findings suggest that burn injury severity, the amount of blood products transfused, and the timing of transfusions are critical factors in determining patient outcomes. Future research should focus on establishing evidence-based transfusion thresholds.</p>","PeriodicalId":23374,"journal":{"name":"Turkish Journal of Surgery","volume":" ","pages":"124-130"},"PeriodicalIF":0.7,"publicationDate":"2026-03-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12993029/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145918508","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":"Rare anatomical localizations of hydatid cysts (2020-2025): Narrative review of presentation, imaging, and management.","authors":"Barış Zülfikaroğlu, Özgür Akgül, Tolga Dinç","doi":"10.47717/turkjsurg.2026.2025-9-22","DOIUrl":"10.47717/turkjsurg.2026.2025-9-22","url":null,"abstract":"<p><p>Hydatid disease, caused by <i>Echinococcus granulosus</i>, typically affects the liver and lungs. However, cyst development in rare anatomical sites presents unique diagnostic and therapeutic challenges. We conducted a narrative review using a structured search of PubMed, Scopus, and Google Scholar (first 200 records), with predefined eligibility criteria and dual-reviewer screening where applicable. Findings were synthesized narratively; numeric summaries reflect reporting frequency among included case-level reports rather than prevalence or comparative effectiveness. Seventeen studies (case reports/small series) were included. Among the included reports, the most commonly reported rare sites were the brain, bone, and heart. Imaging narratives most frequently supported magnetic resonance imaging triage for central nervous system/spine/cardiac disease and computed tomography for osseous/retroperitoneal involvement, while surgery was most often reported as the index treatment with context-dependent use of albendazole. Percentages in this review reflect the share of reports among included studies (i.e., reporting frequency), not population prevalence, incidence, or comparative effectiveness. Rare-site hydatid cysts require a high index of suspicion in endemic areas. Optimal outcomes are achieved through multidisciplinary evaluation, site-specific surgical planning, and tailored pharmacotherapy. Further research into minimally invasive techniques, molecular diagnostics, and vaccine development is warranted to improve diagnosis and long-term disease control.</p>","PeriodicalId":23374,"journal":{"name":"Turkish Journal of Surgery","volume":" ","pages":"13-25"},"PeriodicalIF":0.7,"publicationDate":"2026-03-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12964094/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146228738","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":"Integration of medical visual documentation into medical education, benefits for medicine, education and treatment.","authors":"Sertaç Ata Güler, Salih Efe Gül, Zeynep İrem Yarımbaş, Osman Demir","doi":"10.47717/turkjsurg.2025.2025-7-7","DOIUrl":"10.47717/turkjsurg.2025.2025-7-7","url":null,"abstract":"<p><strong>Objective: </strong>Medical visual documentation is an important part of medical education. It provides numerous benefits to both. This article argues for the integration of medical photography into medical education.</p><p><strong>Material and methods: </strong>A medical visualization and documentation elective course was offered to second-year students at the Kocaeli University Faculty of Medicine. At the end of the 14-week program, a questionnaire was administered to students who participated in the course. The survey results were analyzed using data analysis programs.</p><p><strong>Results: </strong>According to the survey results, the students stated that the elective course positively impacted their education and experience as future doctors.</p><p><strong>Discussion: </strong>In many medical schools, both in Turkey and around the world, medical photography training is not integrated into medical education. This presents challenges for medical education and physicians. However, these difficulties can be overcome by providing integrated training and courses for doctors.</p>","PeriodicalId":23374,"journal":{"name":"Turkish Journal of Surgery","volume":" ","pages":"100-107"},"PeriodicalIF":0.7,"publicationDate":"2026-03-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12964103/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145918496","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":"Barriers to bariatric surgery completion: A narrative review of preoperative attrition and its determinants.","authors":"Sedanur Caydı, Meltem Anafarta Şendağ","doi":"10.47717/turkjsurg.2026.2025-6-27","DOIUrl":"10.47717/turkjsurg.2026.2025-6-27","url":null,"abstract":"<p><p>Although bariatric surgery is an effective intervention for morbid obesity, a significant proportion of patients referred for surgery fail to proceed to the operation. This narrative review aims to examine the rates, characteristics, and underlying reasons for preoperative attrition among bariatric surgery candidates. The literature demonstrates variability in defining pre-op attrition, with some studies adopting binary classifications and others focusing on attrition at specific stages of the preparation process. Key factors associated with attrition include socio-demographic variables (e.g., gender, age, and income), clinical and logistical issues (e.g., waiting times, insurance barriers), and psychosocial characteristics (e.g., anxiety, substance use, and motivation). Some qualitative studies have reported that patients' thoughts and feelings about the meaning of surgery-particularly their emotional readiness and identity-related concerns-can substantially influence whether they follow through with the procedure. In Türkiye, where no standardized national guidelines are in place and structured interventions are limited, there is a clear need for broader changes in how the pre-op phase is managed. Addressing this issue will likely require support systems that are flexible, multidisciplinary, and responsive to individual circumstances. This review emphasizes that personal experiences and system-level factors jointly influence whether patients complete the surgical process. Recognizing how these layers interact may help create more effective strategies for supporting those at risk of dropping out before surgery.</p>","PeriodicalId":23374,"journal":{"name":"Turkish Journal of Surgery","volume":" ","pages":"26-34"},"PeriodicalIF":0.7,"publicationDate":"2026-03-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12964095/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146012235","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":"How I do it: Nerve-sparing laparoscopic low anterior resection: Step by step nerve identification and preservation.","authors":"Kerim Deniz Batun, Ali Emre Atıcı, Aykhan Valiyev, Şerif Furkan Doğancı, Asım Cingi, Şevket Cumhur Yeğen","doi":"10.47717/turkjsurg.2026.2025-8-33","DOIUrl":"10.47717/turkjsurg.2026.2025-8-33","url":null,"abstract":"<p><p>Advances in surgical techniques, together with the widespread use of neoadjuvant and adjuvant therapies, have markedly improved disease-free and overall survival in patients with rectal cancer. Nevertheless, urogenital dysfunction remains a significant source of postoperative morbidity, primarily due to the anatomical location of the rectum and its close relationship with the autonomic pelvic nerves. Although the incidence of urological complications has declined to below 10%, sexual dysfunction continues to affect approximately one-quarter of patients. Nerve-sparing total mesorectal excision, performed without compromising oncological principles, has therefore become a critical component of contemporary rectal cancer surgery. Minimally invasive video-assisted techniques, offering magnified visualization and enhanced precision during pelvic dissection, facilitate the accurate identification and preservation of autonomic nerve structures. However, current evidence indicates that awareness and consistent application of nerve-sparing principles remain suboptimal, even among experienced colorectal surgeons. This video systematically demonstrates the key anatomical landmarks and stepwise surgical maneuvers required for effective nerve preservation during total mesorectal excision, aiming to reduce urogenital functional morbidity.</p>","PeriodicalId":23374,"journal":{"name":"Turkish Journal of Surgery","volume":" ","pages":"142-143"},"PeriodicalIF":0.7,"publicationDate":"2026-03-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12964078/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146214332","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}