Turkish Journal of Surgery最新文献

{"title":"Continuous saline irrigation during video-assisted liver transection: The 'Waterfall' technique.","authors":"Vor Luvira, Chalisa Suwanprinya, Yodkhwan Laochuvong, Theerawee Tipwaratorn","doi":"10.47717/turkjsurg.2023.6143","DOIUrl":"10.47717/turkjsurg.2023.6143","url":null,"abstract":"<p><p>The use of a sealing device during video-assisted liver transection has gained a lot of popularity due to its advantages in operative and patient outcomes. However, it has some technical problems including tissue debris sticking to the instrument, excessive smoke production, and loss of pneumoperitoneum from suction. Herein, we describe a novel 'Waterfall' technique that uses continuous irrigation of saline directly on the transection plane. This technique washes away tissue particles and smoke, clears the operative view, and improves the effectiveness of tissue sealing.</p>","PeriodicalId":23374,"journal":{"name":"Turkish Journal of Surgery","volume":"39 3","pages":"281-282"},"PeriodicalIF":0.6,"publicationDate":"2023-09-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10696449/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138499533","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":"Hospital teaching status and patient outcomes in intestinal obstruction surgery: A comparative analysis.","authors":"Fidelis Uwumiro, Oluwatobi Olaomi, Victory Okpujie, Chimaobi Nwevo, Uwakmfonabasi Abel Umoudoh, Grace Ogunkoya, Olawale Abesin, Michael Bojeranu, Bolanle Aderehinwo, Olasunkanmi Oriloye","doi":"10.47717/turkjsurg.2023.6091","DOIUrl":"10.47717/turkjsurg.2023.6091","url":null,"abstract":"<p><strong>Objectives: </strong>Surgery at large teaching hospitals is reportedly associated with more favourable outcomes. However, these results are not uniformly consistent across all surgical patients. This study aimed to assess potential disparities in clinical outcomes by hospital type for patients with intestinal obstruction.</p><p><strong>Material and methods: </strong>2018 NIS was queried for all adult non-elective admissions for intestinal obstruction. Hospitals were classified as either smallmedium non-teaching hospitals or large teaching hospitals. Multivariate regression analyses were used to assess the association between hospital type and inpatient mortality, access to surgery, admission duration, non-home discharges, hospital costs, and postoperative complications.</p><p><strong>Results: </strong>After adjustments, admission to large teaching hospitals was not associated with a reduction in inpatient mortality (AOR= 0.73; 95% CI= 0.41- 1.31; p= 0.29), lower likelihood of surgery (AOR= 0.93; 95% CI= 0.58-1.48; p= 0.76) or increased chance of early surgery (p= 0.97). Patients admitted to large teaching hospitals had shorter hospital stays (p= 0.002) and were less likely to be discharged to other acute care hospitals (AOR= 0.94; 95% CI= 0.80-0.94; p= 0.04). Admission to large teaching hospitals was not associated with a reduction in perioperative complications (AOR= 1.04; 95% CI= 0.80- 1.28; p= 0.91) or significantly higher hospital costs (mean increase= 1518; 95% CI= 1891-4927; p= 0.38).</p><p><strong>Conclusion: </strong>Admission to large teaching hospitals does not necessarily result in better patient outcomes. Merely considering the teaching status of the hospital in isolation cannot explain the diverse outcomes observed for this condition.</p>","PeriodicalId":23374,"journal":{"name":"Turkish Journal of Surgery","volume":"39 3","pages":"204-212"},"PeriodicalIF":0.6,"publicationDate":"2023-09-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10696440/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138499537","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 breast cancer awareness in female patients diagnosed with schizophrenia.","authors":"Ayşe Gökçen Gündoğmuş, Yasemin Koçyiğit, Şerif Bora Nazlı","doi":"10.47717/turkjsurg.2023.6100","DOIUrl":"10.47717/turkjsurg.2023.6100","url":null,"abstract":"<p><strong>Objectives: </strong>In this study, it was aimed to investigate the awareness of female patients diagnosed with schizophrenia about breast cancer and to evaluate whether there was a difference in this awareness between the control group and individuals diagnosed with schizophrenia. Secondly, the frequency of breast cancer screenings of patients diagnosed with schizophrenia and the control group was compared.</p><p><strong>Material and methods: </strong>Individuals between 18 and 65 years of age who were literate and voluntarily gave informed consent to participate after being informed about the study were included. The research study group comprised of 82 individuals, 35 patients with schizophrenia and 47 healthy individuals. Patients with schizophrenia were required to have no clinically severe disease picture (CGI-S score of 3 or below). Individuals were given the Breast Cancer Awareness Scale (B-CAS) to fill in.</p><p><strong>Results: </strong>The patient group had less awareness of breast cancer than the control group; conversely, they faced more barriers in breast cancer screening. The number of those who stated that they did not know about breast cancer early diagnosis methods was higher in the patient group than in the control group. In the evaluation of health attitudes toward breast cancer, it was found that the healthy control group was better than the patient group in performing regular breast self-exam.</p><p><strong>Conclusion: </strong>Educating individuals with schizophrenia about the signs and symptoms of cancer and adapting healthcare systems to facilitate rapid and early cancer diagnosis may result in cost-effective and applicable cancer control strategies for curable cancers.</p>","PeriodicalId":23374,"journal":{"name":"Turkish Journal of Surgery","volume":"39 3","pages":"213-221"},"PeriodicalIF":0.6,"publicationDate":"2023-09-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10696450/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138499535","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":"Feasibility of totally extraperitoneal inguinal hernia repair in patients with previous prostatectomy.","authors":"İbrahim H Özata, Serkan Sucu, Salih N Karahan, Bilge Kaan Kılıçoğlu, Mekselina Kalender, Furkan Camcı, Emre Özoran, Emre Bozkurt, Derya S Uymaz, Orhan Ağcaoğlu, Emre Balık","doi":"10.47717/turkjsurg.2023.6198","DOIUrl":"10.47717/turkjsurg.2023.6198","url":null,"abstract":"<p><strong>Objectives: </strong>Laparoscopic totally extraperitoneal inguinal hernia repair (TEP) surgery technique includes three key steps: reaching the preperitoneal space, reducing hernias, and placement of mesh. However, reaching the preperitoneal space can be complicated in patients with previous lower abdominal surgeries. This study aimed to assess the feasibility of laparoscopic inguinal TEP in patients with previous prostatectomies.</p><p><strong>Material and methods: </strong>Inguinal hernia patients who underwent laparoscopic TEP between January 2015 and February 2021 at Koç University Faculty of Medicine, Department of General Surgery, were included in this retrospective study. The operations were performed by five senior surgeons experienced in laparoscopy. Patients were divided into two study groups, as the radical prostatectomy (RP) group which included patients with previous prostatectomy non-RP which included patients without previous radical prostatectomy. Operative time (OT), length of hospital stay (LOS), and postoperative complications were compared within two groups.</p><p><strong>Results: </strong>Three hundred and forty-nine patients underwent laparoscopic TEP, and 27 had previous prostatectomies. Among them, 190 patients had unilateral inguinal hernias, and 159 had bilateral inguinal hernias. Mean age of the patients in the non-RP and RP groups was 58.1 ± 14.7 and 73.9 ± 9.6 years, respectively. Only one (3.7%) case was complicated with urinary tract infection in the RP group, and 10 (3.1%) were complicated in the non-RP group. Complications for the non-RP group include hematomas in six cases, urinary tract infection in three cases, and urinary retention in one case. No significant difference in mean operative time was seen between non-RP and RP groups (p= 0.43). There was no significant difference in the means of the length of hospital stay between the two groups (p= 0.7).</p><p><strong>Conclusion: </strong>Laparoscopic TEP in patients with a previous prostatectomy can be performed safely without prolonging the operative time and increasing the length of hospital stay.</p>","PeriodicalId":23374,"journal":{"name":"Turkish Journal of Surgery","volume":"39 3","pages":"258-263"},"PeriodicalIF":0.6,"publicationDate":"2023-09-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10696445/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138499536","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 affecting oncological outcomes of surgical resections for middle and lower rectal cancer.","authors":"İsmail Tırnova, Özgen Işık, Ahmet Tuncay Yılmazlar","doi":"10.47717/turkjsurg.2023.5946","DOIUrl":"10.47717/turkjsurg.2023.5946","url":null,"abstract":"<p><strong>Objectives: </strong>In our study, it was aimed to evaluate the factors affecting oncological outcomes in resections for rectal cancer.</p><p><strong>Material and methods: </strong>Between January 2010 and December 2014, patients with rectal tumors were analyzed retrospectively. Demographic and pathological data and oncological outcomes were analyzed as disease-free survival, overall survival, and local recurrence.</p><p><strong>Results: </strong>A total of 158 patients' data were obtained. Median age was 60 (22-83). Fifty-three patients were older than 65 years of age (138). Ninety-five (60%) patients were males, and 63 (40%) were females. Eighty patients (50.4%) had middle rectal, and 78 (49.6) patients had lower rectal cancer. There was no effect of tumor localization on oncological outcomes. Univariate analyses revealed the effects of age (p= 0.003), operation type (p <0.001), nodal status (p <0.001), malignant lymph node ratio (p <0.001), stage of the disease (p <0.001), distal resection margin (p= 0.047), perineural invasion (p <0.001), lymphatic invasion (p <0.001), venous-vascular invasion (p= 0.025), local recurrence (p <0.001) and distant metastasis (p <0.001) on overall survival rates. Univariate analyses revealed the effects of nodal status (p= 0.007), malignant lymph node ratio (p= 0.005), stage of the disease (p= 0.008), perineural invasion (p= 0.004) and venous-vascular invasion (p <0.001) on disease-free survival rates. Univariate analyses revealed the effects of anastomotic leak (p= 0.015) and venous-vascular invasion (p= 0.001) on local recurrence rates.</p><p><strong>Conclusion: </strong>Older age, advanced nodal status, and distant metastasis were detected as independent risk factors for overall survival. Perineural and venous-vascular invasion were detected as independent risk factors for disease-free survival. Lastly, anastomotic leak and venous-vascular invasion were detected as independent risk factors for local recurrence.</p>","PeriodicalId":23374,"journal":{"name":"Turkish Journal of Surgery","volume":"39 3","pages":"197-203"},"PeriodicalIF":0.6,"publicationDate":"2023-09-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10696443/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138499543","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 effect of surgery and hormone therapy on quality of life in breast cancer patients receiving radiotherapy.","authors":"Yasemin Benderli Cihan, Orhun Öztürk","doi":"10.47717/turkjsurg.2023.6087","DOIUrl":"10.47717/turkjsurg.2023.6087","url":null,"abstract":"<p><strong>Objectives: </strong>The aim of this study was to examine the effect of surgery type and hormone therapy on the general quality of life in breast cancer patients receiving radiotherapy.</p><p><strong>Material and methods: </strong>A total of 109 patients were included in the study. As data collection tools in the research, a form stating the demographic and clinical features was used in the first part, and in the second part, \"EORTC QLQ-C30\" developed by the European Organization for Research and Treatment of Cancer and \"EORTC QLQ-BR23\" Turkish quality of life forms specific to breast cancer were used. The patients were asked to fill in the questionnaire forms on the first day, the last day of radiotherapy and three months after the end of the treatment.</p><p><strong>Results: </strong>Mean age of this study was 54.8 ± 12.1 years. In the questionnaires made on the first day, last day and three months after radiotherapy, the highest score according to the EORTC QLQ-C30 scale was in social and cognitive function, and in sexual life on the EORTC QLQ-BR23 scale. According to multiple comparison test and comparing the first day of radiotherapy and three months after radiotherapy, there was a significant difference in patients' physical function average (p= 0.049), future expectation (p= 0.033), sexual life (p= 0.029), sexual satisfaction (p <0.001), and hair loss (p= 0.011), and arm related problems (p <0.001). According to the analysis of variance in repeated measurements, physical function, sexual life, side effects, hair loss, dyspnea, and future expectation were statistically significant according to the type of surgery, and for hormone therapy, sexual life, hair loss, constipation and financial difficulty were found statistically significant.</p><p><strong>Conclusion: </strong>It was observed that other than radiotherapy, hormone therapy and surgical techniques were also effective on the quality of life in patients receiving radiotherapy for breast cancer.</p>","PeriodicalId":23374,"journal":{"name":"Turkish Journal of Surgery","volume":"39 3","pages":"237-248"},"PeriodicalIF":0.6,"publicationDate":"2023-09-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10696448/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138499544","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 Evolving Landscape of Surgical Education.","authors":"Kaya Sarıbeyoğlu","doi":"10.47717/turkjsurg.2023.20236801","DOIUrl":"10.47717/turkjsurg.2023.20236801","url":null,"abstract":"","PeriodicalId":23374,"journal":{"name":"Turkish Journal of Surgery","volume":"39 3","pages":"viii"},"PeriodicalIF":0.5,"publicationDate":"2023-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10696437/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138499545","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":"Single vs. double drain in modified radical mastectomy: A randomized controlled trial","authors":"Salma Khan, Momna Khan, Asma Wasim","doi":"10.47717/turkjsurg.2023.5666","DOIUrl":"https://doi.org/10.47717/turkjsurg.2023.5666","url":null,"abstract":"Objective: It was aimed to test the hypothesis that the use of a double drain results in less seroma formation, duration of the hospital stay, surgical site infection (SSI), postoperative pain, hematoma, flap necrosis compared to a single drain in patients undergoing modified radical mastectomy. Material and Methods: This parallel-group, single-institution randomized controlled trial was conducted at the department of surgery of our institute between April 2015 and July 2018. Women undergoing modified radical mastectomy were randomly allocated to either a single drain (n= 98) or double drain (n= 98). Results: Both groups were comparable for baseline variables such as age, co-morbidity, BMI, and tumor characteristics. The variables of single drain yielded no better outcomes compared to double drain with estimated blood loss (101.67 ± 25.14 vs.101.67 ± 24.40, p> 0.001), drain volume (898.81 ± 116.42 vs 803.97 ± 103.22 mL, p> 0.001), duration of surgery in minutes (103.19 ± 15.96, 103.19 ± 15.93) and seroma formation (13.4% vs 6.1%, p= 0.082). However, single drain yielded less postoperative pain (mean 2.5 ± 0.70 vs 5.22 ± 5.10, p< 0.000). On multivariable Cox regression analysis, single drain was associated with a lower risk of significant postoperative pain [adjusted relative risk 0.14 (95% confidence interval (CI) 0.070-0.25)] and overall complications [adjusted relative risk 0.47, (95% CI 0.26-0.86)]. On multiple linear regression, the duration of drains in the single drain group was 0.01 days less than double drain (r2= 0.00, b= 0.388, p> 0.001). Conclusion: The use of a single drain significantly reduces postoperative discomfort and pain while demonstrating similar morbidity to the patient with two drains. We thus recommend preferential use of a single drain in modified radical mastectomy (NCT02411617).","PeriodicalId":23374,"journal":{"name":"Turkish Journal of Surgery","volume":"125 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"136169894","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":"Video game experience affects performance, cognitive load, and brain activity in laparoscopic surgery training","authors":"Hasan Onur Keleş, Ahmet Omurtag","doi":"10.47717/turkjsurg.2023.5674","DOIUrl":"https://doi.org/10.47717/turkjsurg.2023.5674","url":null,"abstract":"Objective: Video games can be a valuable tool for surgery training. Individuals who interact or play video games tend to have a better visuospatial ability when compared to non-gamers. Numerous studies suggest that video game experience is associated with faster acquisition, greater sharpening, and longer retention of laparoscopic skills. Given the neurocognitive complexity of surgery skill, multimodal approaches are required to understand how video game playing enhances laparoscopy skill. Material and Methods: Twenty-seven students with no laparoscopy experience and varying levels of video game experience performed standard laparoscopic training tasks. Their performance, subjective cognitive loading, and prefrontal cortical activity were recorded and analyzed. As a reference point to use in comparing the two novice groups, we also included data from 13 surgeons with varying levels of laparoscopy experience and no video game experience. Results: Results indicated that video game experience was correlated with higher performance (R 2 = 0.22, p< 0.01) and lower cognitive load (R 2 = 0.21, p< 0.001), and the prefrontal cortical activation of students with gaming experience was relatively lower than those without gaming experience. In terms of these variables, gaming experience in novices tended to produce effects similar to those of laparoscopy experience in surgeons. Conclusion: Our results suggest that along the dimensions of performance, cognitive load, and brain activity, the effects of video gaming experience on novice laparoscopy trainees are similar to those of real-world laparoscopy experience on surgeons. We believe that the neural underpinnings of surgery skill and its links with gaming experience need to be investigated further using wearable functional brain imaging.","PeriodicalId":23374,"journal":{"name":"Turkish Journal of Surgery","volume":"50 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"136169889","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":"FROM THE EDITOR'S DESK","authors":"Kaya Sarıbeyoğlu","doi":"10.47717/turkjsurg.2023.230201","DOIUrl":"https://doi.org/10.47717/turkjsurg.2023.230201","url":null,"abstract":"","PeriodicalId":23374,"journal":{"name":"Turkish Journal of Surgery","volume":"50 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"136170331","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}