Turkish Journal of Surgery最新文献

{"title":"How we do it: Songket suture technique for lying half cone dog ear.","authors":"Nur Qodir, Afifah Zulfa Salsabila, Muhammad Baharul Iman","doi":"10.47717/turkjsurg.2024.6549","DOIUrl":"10.47717/turkjsurg.2024.6549","url":null,"abstract":"<p><p>Dog ear deformities in wound closure can lead to cosmetic concerns and discomfort for patients, particularly when there is unequal wound length, resulting in lying half cone-type dog ears. Managing these deformities involves aligning the longer side with the shorter side without extending the wound. The Songket suture technique, implemented in a two-stage process, has shown effectiveness in addressing this issue, especially in patients undergoing modified radical mastectomy with a crescent incision that we have presented.</p>","PeriodicalId":23374,"journal":{"name":"Turkish Journal of Surgery","volume":"40 4","pages":"349-352"},"PeriodicalIF":0.5,"publicationDate":"2024-12-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11831999/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143469106","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 cholecystectomy for symptomatic gall stone disease on hepatic steatosis using transabdominal ultrasonography: An observational prospective study.","authors":"Umang Dhakaria, Rajesh Kumar Bansiwal, Agrawal Kavita Khemchand, Rajeev Sharma, Mandeep Singh, Narinder Kaur, Seema Gupta","doi":"10.47717/turkjsurg.2024.6593","DOIUrl":"10.47717/turkjsurg.2024.6593","url":null,"abstract":"<p><strong>Objectives: </strong>Hepatic steatosis and gallstones are common in the general population, with risk factors being multifactorial. Experimental studies have shown that cholecystectomy increases hepatic steatosis and leads to non-alcoholic fatty liver disease (NAFLD). In order to evaluate this, the current study was carried out in the department of general surgery at a medical school, in the north of India.</p><p><strong>Material and methods: </strong>One hundred and three patients awaiting cholecystectomy were selected after written informed consent. Their baseline characteristics were captured preoperatively and thereafter followed at 3^rd month with liver function test (LFT), lipid profile and ultrasound (USG) abdomen.</p><p><strong>Results: </strong>Average age of the patients enrolled was 41.62 ± 13.62 years and mean body mass index (BMI) was 25.96 ± 1.73 kg/m² . Total bilirubin (0.56 vs 0.76, p <0.0001) and direct bilirubin (0.15 vs 0.27, p <0.0001) decreased significantly post cholecystectomy as compared to preoperative values. Levels of serum glutamic-oxaloacetic transaminase (SGOT) (49.14 vs 34.98 IU/dL), serum glutamic-pyruvic transaminase (SGPT) (50.85 vs 35.46 IU/dL) and alkaline phosphatase (ALP) (101.16 vs 85.97 IU/dL) increased significantly post-surgery. Cholesterol values (146.28 vs 168.77 mg/dL), triglycerides (TGs) (119 vs 133.56 mg/dL), low density lipoprotein (LDL) (93.32 vs 113.05 mg/dL) and very low density lipoprotein (VLDL) (18.68 vs 27.45 mg/dL) decreased significantly while high density lipoprotein (HDL) (48.96 vs 42.42 mg/dL) increased significantly at three month follow-up. Prevalence of fatty liver increased post operatively with a rise in Grade 1 steatosis (75%). Severity of fatty liver increased with (8.73%) Grade 3 steatosis on USG post-surgery. Hence, new patients with formerly normal USG reports developed fatty liver and those with preexisting liver steatosis seemed to worsen.</p><p><strong>Conclusion: </strong>The study concluded that the prevalence of fatty liver increased post-cholecystectomy. Lipid profile parameters improved favorably with a decline in total cholesterol, TG, LDL and VLDL versus increase in HDL. LFT parameters also changed significantly.</p>","PeriodicalId":23374,"journal":{"name":"Turkish Journal of Surgery","volume":"40 4","pages":"320-327"},"PeriodicalIF":0.5,"publicationDate":"2024-12-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11831990/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143469112","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":"Tumor in the liver: Six inflammatory pseudotumor patient.","authors":"Akile Zengin, Ahmet Murat Şendil, Yavuz Selim Angın, Barış Türker, Mehmet Kılıç, Murat Ulaş, Elif Gündoğdu, Deniz Arık","doi":"10.47717/turkjsurg.2024.6479","DOIUrl":"10.47717/turkjsurg.2024.6479","url":null,"abstract":"<p><p>Inflammatory pseudotumor (IPT) is a rare liver disease confused with liver tumors. It is a disease that should be known in the differential diagnosis for clinicians as the correct diagnosis of IPT will prevent unnecessary surgery. Demographic datas, diagnoses and imaging modalities of six patients with radiologically and/or histopathologically diagnosed hepatic IPT between 2016 and 2023 were retrospectively analyzed. Four out of six patients were female and median age was 57.5 (47-66). C-reactive protein was higher in four patients, and carbohydrate antigen 19.9 level was higher in one patient. We used magnetic resonance imaging (MRI) for diagnosis in five patients. Only in one patient computed tomography was enough for diagnosis. Tumor locations were segment 5 for two patients, segment 7-8 in two patients, segment 7 in one patient, and 8 in one patient. Liver biopsy was performed in five patients because it could not be distinguished from malignancy by imaging methods. Histopathological results of all these biopsies defined as IPT. Initial tumor median size was 31 (17-55) mm. Two patients were operated on. The first one underwent right hepatectomy due to a 2-fold increase in size within 11 months. The second one had a mass indistinguishable from hepatic adenoma by MRI and underwent nonanatomic resection. In one patient, IPT disappeared completely in the 18^th month of follow-up period while it regressed in size in two patients. Two of our patients had a history of recurrent endoscopic retrograde cholangiopancreatography, which we noticed incidentally before IPT was diagnosed. IPTs are liver masses with low malignant potential and may shrink spontaneously during follow-up. We suspected that biliary tract interventions may be the cause of IPT.</p>","PeriodicalId":23374,"journal":{"name":"Turkish Journal of Surgery","volume":"40 3","pages":"256-260"},"PeriodicalIF":0.5,"publicationDate":"2024-09-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11792901/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143365103","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 education: Ensuring knowledge transfer to future generations.","authors":"Kaya Sarıbeyoğlu","doi":"10.47717/turkjsurg.2024.20240301","DOIUrl":"10.47717/turkjsurg.2024.20240301","url":null,"abstract":"","PeriodicalId":23374,"journal":{"name":"Turkish Journal of Surgery","volume":"40 3","pages":"viii"},"PeriodicalIF":0.5,"publicationDate":"2024-09-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11792895/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143366193","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":"Comparison of surgical outcomes between shunt surgery and devascularization in non-cirrhotic portal hypertension.","authors":"Saad Anwar, Kunal Parasar, Utpal Anand, Basant Singh, Kislay Kant, Rohith Kodali","doi":"10.47717/turkjsurg.2024.6525","DOIUrl":"10.47717/turkjsurg.2024.6525","url":null,"abstract":"<p><strong>Objectives: </strong>Non-cirrhotic portal hypertension (NCPH) is the most common cause of portal hypertension and upper gastro-intestinal bleeding in children and adolescents in developing nations. It is characterized by features of portal hypertension with preserved liver function. Proximal splenorenal shunt (PSRS) and esophagogastric devascularization are the two most commonly performed surgeries for its management. The present study is aimed at comparison of surgical outcomes between these two procedures.</p><p><strong>Material and methods: </strong>Between April 2018 and March 2022, prospectively maintained data of consecutive NCPH cases who underwent surgical intervention was reviewed retrospectively. Cases were categorized into two groups- shunt surgery and devascularization. The pre-operative characteristics, peri-operative morbidity and long-term outcomes were compared between the groups.</p><p><strong>Results: </strong>Of 112 cases who were treated during the study period, 54 cases which underwent surgery were included in the study. Of these, 20 cases underwent PSRS, and splenectomy and devascularization was performed in 34 cases. There was no difference in pre-operative variables between the two groups. Patients undergoing PSRS experienced longer duration of surgery (260 vs. 200 minutes, p <0.001), and those in the devascularization group had significantly greater operative blood loss (350 vs. 455 ml, p <0.001). Post-operative morbidity was comparable between the two groups. Hypersplenism was corrected in all cases and no cases reported rebleeding after median follow-up of 30 months. Three cases in each group developed features of portal biliopathy in follow up period.</p><p><strong>Conclusion: </strong>Both PSRS and devascularization procedures have comparable efficacy and safety in the management of NCPH.</p>","PeriodicalId":23374,"journal":{"name":"Turkish Journal of Surgery","volume":"40 3","pages":"229-239"},"PeriodicalIF":0.5,"publicationDate":"2024-09-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11792894/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143366175","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 and survival outcomes of cytoreductive surgery alone or with perioperative intraperitoneal chemotherapy in high peritoneal cancer index.","authors":"Metin Ercan, Mehmet Aziret, Kerem Karaman, Osman Köse, Volkan Öter, Hakan Yırgın, Ahmet Kaya, Yavuz Selim Kahraman, Elif Köse, Erdal Birol Bostancı, Orhan Ünal","doi":"10.47717/turkjsurg.2024.6457","DOIUrl":"10.47717/turkjsurg.2024.6457","url":null,"abstract":"<p><strong>Objectives: </strong>The aim of this study was to examine the early surgical and long-term survival outcomes of cytoreductive surgery (CRS) alone and CRS plus perioperative intraperitoneal chemotherapy (IPC) in patients with peritoneal metastases (PM).</p><p><strong>Material and methods: </strong>CRS alone or CRS plus IPC was performed on 122 patients for various intraabdominal PMs. Patients were divided into two groups as PCI ≤19 and PCI >19 to compare early surgical outcomes.</p><p><strong>Results: </strong>Among PM patients 70 (57.4%) were of non-ovarian and 52 (42.6%) were of ovarian origin. Of the patients 74 (60.7%) were in the peritoneal cancer index (PCI) ≤19 group and 48 (39.3%) were in the PCI >19 group. The complication ratio of PCI >19 group was higher than that of the PCI ≤19 group and median overall survival (OS) of PCI >19 group was lower than that of the PCI ≤19 group. Complete or nearly complete (CCR-0/CCR-1) resections rates were similar in both groups (95.9% in the PCI ≤19 group and 93.8% in the PCI >19 group). However, CCR-0 resection rate was found to be lower in the PCI >19 group compared to the PCI ≤19 group (60.8% vs. 39.6%) (p <0.001).</p><p><strong>Conclusion: </strong>CCR-0/CCR-1 resections can be achieved with CRS in most patients with PCI >19 score. It would be appropriate to consider CRS or CRS plus perioperative IPC for palliative purposes in selected patients with PCI >19 score.</p>","PeriodicalId":23374,"journal":{"name":"Turkish Journal of Surgery","volume":"40 3","pages":"219-228"},"PeriodicalIF":0.5,"publicationDate":"2024-09-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11792903/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143366192","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":"Emphysematous liver abscess: Variable clinical presentations, management challenges and outcomes-a case series.","authors":"Sukesh Kudumallige Sudhakara, Shiva Shiva, Ranjith Kumaran, Sheefali Chandra, Akshay Anand, Abhinav Arun Sonkar","doi":"10.47717/turkjsurg.2024.6436","DOIUrl":"10.47717/turkjsurg.2024.6436","url":null,"abstract":"<p><p>Emphysematous liver abscesses (ELAs), characterized by the presence of gas within the hepatic parenchyma, are an uncommon and potentially lifethreatening entity. ELAs with clinical presentations mimicking hollow viscus perforation pose a diagnostic conundrum for clinicians. This series highlights the diagnostic challenges posed by such atypical presentations and emphasizes the importance of considering hepatic pathology in the differential diagnosis of pneumoperitoneum. Our objective is to provide a comprehensive analysis of the diverse clinical presentations, diagnostic challenges, and therapeutic strategies employed in managing this unique subset of liver abscesses.</p>","PeriodicalId":23374,"journal":{"name":"Turkish Journal of Surgery","volume":"40 3","pages":"247-255"},"PeriodicalIF":0.5,"publicationDate":"2024-09-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11792900/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143366179","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 role of ergonomics training and posture exercises in surgeons' musculoskeletal system disorders.","authors":"Sevinç Külekçioğlu, Evren Dilektaşlı","doi":"10.47717/turkjsurg.2024.6413","DOIUrl":"10.47717/turkjsurg.2024.6413","url":null,"abstract":"<p><strong>Objectives: </strong>The surgeon needs to understand the risks involved in performing surgery with ergonomic errors. Although there are many barriers to ergonomic effectiveness, success begins with the surgeon's awareness, recognition of existing obstacles, and education. The main purpose of the study is to evaluate the effect of ergonomic training and posture exercises on the surgeon's pain, physical workload, psychological state, and quality of life to prevent musculoskeletal system disorders and extend career life.</p><p><strong>Material and methods: </strong>Surgeons who had completed at least one year in their profession, worked an average of 40 hours a week, had musculoskeletal pain in at least one area, and volunteered to participate in the study, regardless of gender and age, were included in the study. Researchers carried out the ergonomics training and exercise program individually by giving face-to-face training. Surgeons were asked to complete the physical workload questionnaire (PWQ), Beck depression index (BDI), and short form health survey (SF-36) before and one month after the study. Changes in visual analogue scale (VAS) and activities of daily living were recorded.</p><p><strong>Results: </strong>Surgeons who received ergonomic training and exercise programs showed significant improvements in pain, physical workload, depression, and quality of life measurements.</p><p><strong>Conclusion: </strong>To prevent fatigue and pain resulting from the accumulation of ergonomic flaws, surgeons should be trained and guided on proper posture and endurance, and encouraged to maintain a comfortable and natural posture.</p>","PeriodicalId":23374,"journal":{"name":"Turkish Journal of Surgery","volume":"40 3","pages":"204-211"},"PeriodicalIF":0.5,"publicationDate":"2024-09-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11792904/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143365147","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":"Primary neuroendocrine tumor of the perihilar bile duct: A case report.","authors":"Mustafa Salış, Muhammed Kandemir, Elif Gündoğdu, İlter Özer, Bülent Ünal, Murat Ulaş","doi":"10.47717/turkjsurg.2022.4595","DOIUrl":"10.47717/turkjsurg.2022.4595","url":null,"abstract":"<p><p>Neuroendocrine tumors (NETs) arising from extrahepatic bile ducts are very rare. We present a patient with perihilar NET who was operated on with a preoperative diagnosis of Klatskin tumor. A 58-year-old female patient was admitted with abdominal pain and jaundice. Laboratory data showed elevated serum bilirubin levels and liver function tests. Computed tomography (CT) and magnetic resonance cholangiopancreatography (MRCP) findings were consistent with perihilar bile duct tumor. The patient was operated on with a diagnosis of Klatskin tumor. She underwent right hepatectomy, resection of the extrahepatic bile duct, portal lymphadenectomy and Roux-en-Y hepaticojejunostomy. The final pathologic examination of the resected specimen demonstrated a well differentiated neuroendocrine tumor (Grade 1). NETs originating from perihilar bile ducts are extremely rare, and preoperative definite diagnosis is very difficult. It should be kept in mind that NET may be one of the rare causes of perihilar bile duct obstruction.</p>","PeriodicalId":23374,"journal":{"name":"Turkish Journal of Surgery","volume":"40 3","pages":"261-263"},"PeriodicalIF":0.5,"publicationDate":"2024-09-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11792906/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143366191","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":"Unveiling molecular clues: Exploring IFNγ, IL-10, and MMP7 blood levels in gastric carcinoma patients.","authors":"Ajith Atul, Thirthar Palanivelu Elamurugan, Sundaramurthi Sudharsanan, Chellappa Vijayakumar, Gubbi Shamanna Sreenath, Vairappan Balasubramaniyan","doi":"10.47717/turkjsurg.2024.6421","DOIUrl":"10.47717/turkjsurg.2024.6421","url":null,"abstract":"<p><strong>Objectives: </strong>Gastric carcinoma is a leading cause of morbidity and mortality worldwide. Early detection can help reduce mortality rates. Biomarkers are being investigated globally for their potential in disease screening, monitoring, and follow-up in various cancers. However, currently, there is insufficient data on the role of biomarkers in gastric carcinoma.</p><p><strong>Material and methods: </strong>This single center case control study was conducted from June 2018 to March 2021 from South India. Blood samples were collected from 85 patients diagnosed with gastric carcinoma and 85 apparently healthy individuals serving as the control group. The samples were collected in a fasting state. The serum levels of biomarkers interferon gamma (IFNγ), interleukin 10 (IL-10), and matrix metalloproteinase 7 (MMP7) were measured using enzyme-linked immunosorbent assay (ELISA) and compared between the two groups. Additionally, the levels of biomarkers were compared within the gastric cancer group based on disease location, stage, and histotype.</p><p><strong>Results: </strong>The serum levels of IFNγ and IL-10 were found to be significantly elevated in gastric carcinoma patients compared to the healthy control group. Both biomarkers exhibited high sensitivity and specificity in detecting carcinoma of the stomach. However, there was no significant difference in the serum level of MMP7 between gastric cancer patients and control group.</p><p><strong>Conclusion: </strong>IFNγ and IL-10 show promise as potential molecular biomarkers for the detection of gastric carcinoma. Further, well designed studies, involving larger and more diverse populations matched for stage and histological types, are necessary to establish the screening and monitoring utility of these biomarkers in gastric carcinoma.</p>","PeriodicalId":23374,"journal":{"name":"Turkish Journal of Surgery","volume":"40 3","pages":"212-218"},"PeriodicalIF":0.5,"publicationDate":"2024-09-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11792898/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143365519","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}