Turkish Journal of Surgery最新文献

{"title":"Gastro-intestinal stromal tumor (GIST): Experience from a tertiary care center in a low resource country.","authors":"M Tayyab H Siddiqui,&nbsp;K M Inam Pal,&nbsp;Fatima Shaukat,&nbsp;Aliza Fatima,&nbsp;K M Babar Pal,&nbsp;Jibran Abbasy,&nbsp;Noman Shazad","doi":"10.47717/turkjsurg.2022.5746","DOIUrl":"https://doi.org/10.47717/turkjsurg.2022.5746","url":null,"abstract":"<p><strong>Objectives: </strong>The aim of this retrospective study was to review the overall survival (OS) and disease-free survival (DFS) of GISTs treated surgically at our center over the past decade.</p><p><strong>Material and methods: </strong>We undertook a 12-year retrospective review of our experience in treating this condition with a focus on long-term outcomes of treated patients in a resource-constrained environment. Incomplete follow-up information continues to be a major problem with studies conducted in low resource settings, and in order to overcome this, we undertook telephonic contact with patients or their relatives to get the necessary information about their clinical status.</p><p><strong>Results: </strong>Fifty-seven patients with GIST underwent surgical resection during this period of time. The stomach was the most common organ involved in the disease, with 74% of the patients. Surgical resection was the main treatment approach, with R0 resection possible in 88%. Nine percent of the patients were given Imatinib as neoadjuvant treatment and 61% were offered the same, as adjuvant therapy. The duration of adjuvant treatment changed from one year to three years over the study period. Pathological risk assessment categorized the patients as Stage I, 33%; Stage II, 19%; Stage III, 39%; and Stage IV, 9%. Of the 40 patients who were at least three years from surgery, 35 were traceable giving an 87.5%, overall three-year survival. Thirty-one patients (77.5%) were confirmed to be disease-free at three years.</p><p><strong>Conclusion: </strong>This is the first report of mid-long-term outcomes of the multimodality treatment of GIST from Pakistan. Upfront surgery continues to be the main modality. OS & DFS in resource-poor environments can be similar to those seen in a better-structured healthcare setting.</p>","PeriodicalId":23374,"journal":{"name":"Turkish Journal of Surgery","volume":"38 4","pages":"362-367"},"PeriodicalIF":0.6,"publicationDate":"2022-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9979561/pdf/TJS-38-362.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10849184","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":"What has changed in the last 20 years in the postoperative specimen findings of the papillary thyroid cancer cases? A retrospective analysis.","authors":"Burak Bakar,&nbsp;Pınar Taşar,&nbsp;Turkay Kırdak,&nbsp;Sadık Kılıçturgay","doi":"10.47717/turkjsurg.2022.5688","DOIUrl":"https://doi.org/10.47717/turkjsurg.2022.5688","url":null,"abstract":"<p><strong>Objectives: </strong>In this study, it was aimed to investigate the changes in surgical approaches and histopathological evaluation of the tumor according to years of patients who were operated on with the diagnosis of thyroid papillary cancer (PTC) in our center in the last 20 years.</p><p><strong>Material and methods: </strong>The records of the cases who underwent thyroidectomy in our department were divided into four groups of five years each and analyzed retrospectively. Demographic characteristics, surgical procedures, presence of chronic lymphocytic thyroiditis, histopathological features of tumour and hospital stay of the cases in the groups were evaluated. Based on tumor size, PTCs were classified into five subgroups. PTCs of 10 (mm) or less were accepted as papillary thyroid microcarcinoma (PTMC).</p><p><strong>Results: </strong>There was a significant increase in PTC and multifocal tumors in the groups over the years (p <0.001). There was a significant increase between the groups in the presence of chronic lymphocytic thyroiditis (p <0.001). In contrast, the total number of metastatic lymph nodes (p= 0.486) and the largest metastatic lymph node size were similar between the groups (p> 0.999). In our study, it was observed that there was a significant increase over the years in both the total/near-total thyroidectomy cases and the number of cases with a postoperative hospital stay of one day (p <0.001).</p><p><strong>Conclusion: </strong>In the present study, it was found that papillary cancer sizes decreased gradually and the frequency of papillary microcarcinoma increased gradually in last 20 years. Also, a significant increase was detected in the rates of total/near-total thyroidectomy and lateral neck dissection over the years.</p>","PeriodicalId":23374,"journal":{"name":"Turkish Journal of Surgery","volume":"38 4","pages":"345-352"},"PeriodicalIF":0.6,"publicationDate":"2022-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9979550/pdf/TJS-38-345.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10849183","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":"Validation of the adapted clavien dindo in trauma (ACDiT) scale to grade management related complications at a level I trauma center.","authors":"Niladri Banerjee,&nbsp;Dinesh Bagaria,&nbsp;Harshit Agarwal,&nbsp;Anand Kumar Katiyar,&nbsp;Subodh Kumar,&nbsp;Sushma Sagar,&nbsp;Biplab Mishra,&nbsp;Amit Gupta","doi":"10.47717/turkjsurg.2022.5793","DOIUrl":"https://doi.org/10.47717/turkjsurg.2022.5793","url":null,"abstract":"<p><strong>Objectives: </strong>Complications during trauma management are the main factor responsible for the overall increase in treatment cost. There are very few grading systems to measure the burden of complications in trauma patients. A prospective study was conducted using the Adapted Clavien Dindo in Trauma (ACDiT) scale, with the primary aim of validating it at our center. As a secondary aim, it was also wanted to measure the mortality burden among our admitted patients.</p><p><strong>Material and methods: </strong>The study was conducted at a dedicated trauma center. All patients with acute injuries, who were admitted, were included. An initial treatment plan was made within 24 hours of admission. Any deviation from this was recorded and graded according to the ACDiT. The grading was correlated with hospital-free days and ICU-free days within 30 days.</p><p><strong>Results: </strong>A total of 505 patients were included in this study, with a mean age of 31 years. The most common mechanism of injury was road traffic injury, with a median ISS and NISS of 13 and 14, respectively. Two hundred and forty-eight out of 505 patients had some grade of complication as determined by the ACDiT scale. Hospital-free days (13.5 vs. 25; p <0.001) were significantly lower in patients with complications than those without complications, and so were ICU-free days (29 vs. 30; p <0.001). Significant differences were also observed when comparing mean hospital free and ICU free days across various ACDiT grades. Overall mortality of the population was 8.3 %, the majority of whom were hypotensive on arrival and required ICU care.</p><p><strong>Conclusion: </strong>We successfully validated the ACDiT scale at our center. We recommend using this scale to objectively measure in-hospital complications and improve trauma management quality. ACDiT scale should be one of the data points in any trauma database/registry.</p>","PeriodicalId":23374,"journal":{"name":"Turkish Journal of Surgery","volume":"38 4","pages":"391-400"},"PeriodicalIF":0.6,"publicationDate":"2022-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9979560/pdf/TJS-38-391.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10854736","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Preoperative scoring system validation and analysis of associated risk factors in predicting difficult laparoscopic cholecystectomy in patients with acute calculous cholecystitis: A prospective observational study.","authors":"Sam Paul,&nbsp;Himsikhar Khataniar,&nbsp;Akshai Ck,&nbsp;Himagirish K Rao","doi":"10.47717/turkjsurg.2022.5816","DOIUrl":"https://doi.org/10.47717/turkjsurg.2022.5816","url":null,"abstract":"<p><strong>Objectives: </strong>Today laparoscopic cholecystectomy (LC) is the treatment of choice for acute cholecystitis. However, the presence of severe inflammation makes it challenging for the surgeons to accurately recognize the Calot's triangle which increases the risk of intraoperative complications. The aim of this study was to explore the validity of a scoring system used to predict difficult LC and to analyse the risk factors associated with difficult cholecystectomy in the setting of acute calculous cholecystitis.</p><p><strong>Material and methods: </strong>An observational study was conducted between December 2018 and December 2020 among 132 patients diagnosed with acute cholecystitis, who underwent laparoscopic cholecystectomy. A scoring system by Randhawa et al. was used preoperatively for all of these patients to predict difficult LC, which was correlated to intraoperative difficulties in actual surgery. Data were analysed using the SPSS version 26.0.</p><p><strong>Results: </strong>Mean age was 43.63 ± 13.37, with almost equal representation from both sexes. History of previous attacks of cholecystitis, impacted stone, thickness of GB wall were statistically significant in calculating preoperative difficulty of laparoscopic cholecystectomy. The scoring system had a sensitivity and specificity of 82.6% and 63.5%, respectively. The conversion rate to open cholecystectomy was 6.9%.</p><p><strong>Conclusion: </strong>Analysing the significant risk factors before operating in the presence of an inflamed gallbladder can reduce the overall mortality and morbidity. An accurate preoperative scoring system will enable the operating surgeon to be well prepared with adequate resources and time. The patient attenders can also be counselled regarding the risk involved beforehand.</p>","PeriodicalId":23374,"journal":{"name":"Turkish Journal of Surgery","volume":"38 4","pages":"375-381"},"PeriodicalIF":0.6,"publicationDate":"2022-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9979552/pdf/TJS-38-375.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10854737","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":"Protective effect of intraluminal fecal diverting device against colonic wall erosion induced by wrapping bands: A post-hoc pathological analysis.","authors":"Sung Il Kang,&nbsp;Sohyun Kim,&nbsp;Mi Jin Gu,&nbsp;Jae Hwang Kim","doi":"10.47717/turkjsurg.2022.5768","DOIUrl":"https://doi.org/10.47717/turkjsurg.2022.5768","url":null,"abstract":"<p><strong>Objectives: </strong>Materials wrapping the bowel elicits tissue erosion gradually. We experienced several bowel wall erosions with no serious clinical consequences in our two previous animal experiments aimed at the safety and efficacy of the COLO-BT developed for intra-luminal fecal diversion. We tried to find out why the erosion is safe by investigating histologic changes of the tissue.</p><p><strong>Material and methods: </strong>Tissue slides at the COLO-BT fixing area from the subjects which had COLO-BT over three weeks acquired from our two previous animal experiments were reviewed. For the classification of the histologic change, microscopic findings were classified for six stages (from minimal change of stage 1 to severe change of stage 6).</p><p><strong>Results: </strong>A total of 26 slides of 45 subjects were reviewed in this study. Five subjects (19.2%) had stage 6 histological change; three of stage 1 (11.5%), four of stage 2 (15.4%), six of stage 3 (23.1%), three of stage 4 (11.5%), and five of stage 5 (19.2%). All subjects which had a stage 6 histologic change survived. The phenomenon from which the back of the band is passed through is replaced by a relatively stable tissue layer due to fibrosis of the necrotic cells in the stage 6 histologic change.</p><p><strong>Conclusion: </strong>We found that thanks to the sealing effect of the newly replaced layer, no leakage of the intestinal content occurs even if perforation by erosion develops according to this histologic tissue evaluation.</p>","PeriodicalId":23374,"journal":{"name":"Turkish Journal of Surgery","volume":"38 4","pages":"368-374"},"PeriodicalIF":0.6,"publicationDate":"2022-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9979562/pdf/TJS-38-368.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10849186","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":"Selective approach to arterial ligation in radical sigmoid colon cancer surgery with D3 lymph node dissection: A multicenter comparative study.","authors":"Sergey Efetov,&nbsp;Albina Zubayraeva,&nbsp;Cüneyt Kayaalp,&nbsp;Alisa Minenkova,&nbsp;Yusuf Bağ,&nbsp;Aftandil Alekberzade,&nbsp;Petr Tsarkov","doi":"10.47717/turkjsurg.2022.5867","DOIUrl":"https://doi.org/10.47717/turkjsurg.2022.5867","url":null,"abstract":"<p><strong>Objectives: </strong>Radical surgery for sigmoid colon cancer is commonly performed with complete mesocolic excision (CME) and apical lymph node dissection, reached by central vascular ligation (CVL) of the inferior mesenteric artery (IMA) and associated extended left colon resection. However, IMA branches can be ligated selectively according to tumor location with D3 lymph node dissection (LND), economic segmental colon resection and tumorspecific mesocolon excision (TSME) if IMA is skeletonized. This study aimed to compare left hemicolectomy with CME and CVL and segmental colon resection with selective vascular ligation (SVL) and D3 LND.</p><p><strong>Material and methods: </strong>Patients (n= 217) treated with D3 LND for adenocarcinoma of the sigmoid colon between January 2013 and January 2020 were included in the study. The approach to vessel ligation, colon resection and mesocolon excision was based on tumor location in the study group, while in the comparison group, left hemicolectomy with routine CVL was performed. Survival rates were estimated as the primary endpoints of the study. Long- and short-term surgery-related outcomes were evaluated as the secondary endpoints of the study.</p><p><strong>Results: </strong>The studied approach to the IMA branch ligation was associated with a statistically significant decrease in intraoperative complication rates (2 vs 4, p= 0.024), operative procedure length (225.56 ± 80.356 vs 330.69 ± 175.488, p <0.001), and severe postoperative morbidity (6.2% vs 19.1%, p= 0.017). Meanwhile, the number of examined lymph nodes significantly increased (35.67 vs 26.69 per specimen, p <0.001). There were no statistically significant differences in survival rates.</p><p><strong>Conclusion: </strong>Selective IMA branch ligation and TSME resulted in better intraoperative and postoperative outcomes with no difference in survival rates.</p>","PeriodicalId":23374,"journal":{"name":"Turkish Journal of Surgery","volume":"38 4","pages":"382-390"},"PeriodicalIF":0.6,"publicationDate":"2022-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9979549/pdf/TJS-38-382.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10849187","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":"Treatment conundrums in osteosarcoma of the breast: Case report of two cases from a tertiary care cancer center in India.","authors":"Dinesh Chandra Doval,&nbsp;Juhi Tayal,&nbsp;Kumardeep Dutta Choudhary,&nbsp;Pankaj Goyal,&nbsp;Gurudutt Gupta,&nbsp;Sunil Pasricha","doi":"10.47717/turkjsurg.2022.4075","DOIUrl":"https://doi.org/10.47717/turkjsurg.2022.4075","url":null,"abstract":"<p><p>Extraosseous sarcoma of the breast is an infrequent entity and a harbinger of poor prognosis. Histogenesis of this tumor is uncertain, and it can arise both in denovo and metastatic settings. Morphologically, it is indistinguishable from its skeletal counterpart and clinically, it presents like any other subtype of breast cancer. Tumor recurrence with a propensity for hematogenous rather than lymphatic spread plagues with this malicious disease. Treatment guidelines are mainly extrapolations from those of treatment of other extra-skeletal sarcomas as literature is limited in this context. In this study, it was aimed to present two clinical cases with similar clinical profiles and different treatment outcomes. The intent of this case report is to contribute to the limited database available for management of this rare disease.</p>","PeriodicalId":23374,"journal":{"name":"Turkish Journal of Surgery","volume":"38 4","pages":"409-412"},"PeriodicalIF":0.6,"publicationDate":"2022-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9979553/pdf/TJS-38-409.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10849188","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":"Changes in vitamin D and calcium-phosphorus metabolism in patients with severe acute pancreatitis.","authors":"Ihor Kolosovych,&nbsp;Ihor Hanol,&nbsp;Maryna Bystrytska,&nbsp;Halil Uzun","doi":"10.47717/turkjsurg.2022.5669","DOIUrl":"https://doi.org/10.47717/turkjsurg.2022.5669","url":null,"abstract":"<p><strong>Objectives: </strong>The problem of predicting the course of acute pancreatitis and early diagnosis of its complications remains unresolved. This study aimed to determine changes in vitamin D and calcium-phosphorus metabolism in patients with severe acute pancreatitis.</p><p><strong>Material and methods: </strong>There were examined 72 people divided into two groups as healthy persons (comparison group) - males and females without pathology of the gastrointestinal tract and any other conditions or diseases that could affect the state of calcium-phosphorus metabolism (n= 36) and patients with acute pancreatitis (main group, n= 36). In addition, in order to determine the prognostic criteria for the severity of the disease, patients in the main group were divided into two subgroups. The first subgroup included patients with severe disease (n= 18), the second (n= 18) - with mild and moderate disease.</p><p><strong>Results: </strong>Serum calcium value was lower in patients with severe acute pancreatitis comparison to healthy persons: 2.18 (2.12; 2.34) vs 2.36 (2.31; 2.43) mmol/L (p <0.0001), and the decrease of calcium levels was associated with an increase in the severity of acute pancreatitis. Therefore, hypocalcemia can be considered a reliable predictor of the severity of the disease. In patients with acute pancreatitis, the level of vitamin D was significantly low than in the healthy persons and was 13.8 (9.03; 21.34) and 28.4 (21.8; 32.3) ng/mL, respectively (p <0.0001).</p><p><strong>Conclusion: </strong>For patients with acute pancreatitis, serum vitamin D levels≤ 13.28 ng/mL can be considered as a significant predictor of severe disease (sensitivity 83.3%, specificity 94.4%) regardless of calcium level.</p>","PeriodicalId":23374,"journal":{"name":"Turkish Journal of Surgery","volume":"38 4","pages":"327-333"},"PeriodicalIF":0.6,"publicationDate":"2022-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9979554/pdf/TJS-38-327.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10849185","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":"Current status of laparoscopic surgery usage in Türkiye: A middle-income country.","authors":"Ahmet Cem Esmer,&nbsp;Tahsin Çolak,&nbsp;Akay Edizsoy,&nbsp;Deniz Tazeoğlu,&nbsp;Ahmet Serdar Karaca","doi":"10.47717/turkjsurg.2022.5713","DOIUrl":"https://doi.org/10.47717/turkjsurg.2022.5713","url":null,"abstract":"<p><strong>Objectives: </strong>This study aimed to determine the usage status of laparoscopic procedures in general surgical practice in Türkiye, which is a sample of middle-income countries.</p><p><strong>Material and methods: </strong>The questionnaire was sent to general surgeons, gastrointestinal surgeons, and surgical oncologists who have completed their residency training and are actively working in university, public or private hospitals. Demographic data, laparoscopy training and the period of education, the rate of laparoscopy use, the type and volume of laparoscopic surgical procedures, their views on the advantages and disadvantages of laparoscopic surgery, and the reasons for preferring laparoscopy were determined with a 30-item questionnaire.</p><p><strong>Results: </strong>Two hundred and forty-four questionnaires from 55 different cities of Türkiye were evaluated. The responders were mainly males, younger surgeons (F/M= 11.1/88.9 % and 30-39 y/o), and graduated from the university hospital residence program (56.6%). Laparoscopic training was frequently taken during residency (77.5%) in the younger age group, while the elderly participants mostly received additional training after specialization (91.7%). Laparoscopic surgery was mostly not available in public hospitals for advanced procedures (p <0.0001) but was available for cholecystectomy and appendectomy operations (p= NS). However, participants working in university hospitals mostly stated that the laparoscopic approach was the first choice for advanced procedures.</p><p><strong>Conclusion: </strong>The results of this study showed that the surgeons working in MICs spent strong effort to use laparoscopy in daily practice, especially in university and high-volume hospitals. However, inappropriate education, cost of laparoscopic equipment, healthcare policies, and some cultural and social barriers might have negatively impacted the widespread use of laparoscopic surgery and its usage in daily practice in MICs such as Türkiye.</p>","PeriodicalId":23374,"journal":{"name":"Turkish Journal of Surgery","volume":"38 4","pages":"353-361"},"PeriodicalIF":0.6,"publicationDate":"2022-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9979558/pdf/TJS-38-353.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10854733","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":"Long-term results and prognostic factors after surgical treatment for gallbladder cancer.","authors":"Mehmet Ali Uzun,&nbsp;Metin Tilki,&nbsp;Sevcan Alkan Kayaoğlu,&nbsp;Gülten Çiçek Okuyan,&nbsp;Zeynep Gamze Kılıçoğlu,&nbsp;Aylin Gönültaş","doi":"10.47717/turkjsurg.2022.5861","DOIUrl":"https://doi.org/10.47717/turkjsurg.2022.5861","url":null,"abstract":"<p><strong>Objectives: </strong>Gallbladder cancer is relatively rare and traditionally regarded as having poor prognosis. There is controversy about the effects of clinicopathological features and different surgical techniques on prognosis. The aim of this study was to investigate the effects of clinicopathological characteristics of the patients with surgically treated gallbladder cancer on long-term survival.</p><p><strong>Material and methods: </strong>We retrospectively analyzed the database of gallbladder cancer patients treated at our clinic between January 2003 and March 2021.</p><p><strong>Results: </strong>Of 101 evaluated cases, 37 were inoperable. Twelve patients were determined unresectable based on surgical findings. Resection with curative intent was performed in 52 patients. The one-, three-, five-, and 10-year survival rates were 68.9%, 51.9%, 43.6%, and 43.6%, respectively. Median survival was 36.6 months. On univariate analysis, poor prognostic factors were determined as advanced age; high carbohydrate antigen 19-9 and carcinoembryonic antigen levels; non-incidental diagnosis; intraoperative incidental diagnosis; jaundice; adjacent organ/structure resection; grade 3 tumors; lymphovascular invasion; and high T, N1 or N2, M1, and high AJCC stages. Sex, IVb/V segmentectomy instead of wedge resection, perineural invasion, tumor location, number of resected lymph nodes, and extended lymphadenectomy did not significantly affect overall survival. On multivariate analysis, only high AJCC stages, grade 3 tumors, high carcinoembryonic antigen levels, and advanced age were independent predictors of poor prognosis.</p><p><strong>Conclusion: </strong>Treatment planning and clinical decision-making for gallbladder cancer requires individualized prognostic assessment along with standard anatomical staging and other confirmed prognostic factors.</p>","PeriodicalId":23374,"journal":{"name":"Turkish Journal of Surgery","volume":"38 4","pages":"334-344"},"PeriodicalIF":0.6,"publicationDate":"2022-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9979551/pdf/TJS-38-334.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10849189","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}