Browsing by Author "Üstün, Mehmet"

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Laparoskopik Adrenalektomi Sonrası Hastanede Kalış Süresine Etkili Faktörler
(2024) Üstün, Mehmet; Akpınar, Göksever; Tuncer, Korhan; Vatansever, Safa
Amaç: Bu çalışmanın amacı laparoskopik adrenalektomi uygulanan hastalarda, ameliyat sonrasında hastanede kalış süresine etki eden faktörleri değerlendirmektir. Yöntem: 2012-2022 yılları arası laparoskopik adrenalektomi uygulanan hastalar retrospektif olarak incelendi. Hastanede kalış süresi için çalışma popülasyonunun 75. yüzdelik dilimi sınır olarak belirlendi. Bu süreden daha uzun süre kalınması uzamış hastanede kalış olarak tanımlandı. Uzamış hastanede kalışa etkili faktörler tek değişkenli ve çoklu lojistik regresyon analizleriyle incelendi. Tek değişkenli lojistik regresyon analizinde p-değeri <0,10 olan değişkenler çoklu regresyon modeline dahil edildi. Bulgular: Çalışmaya toplam 86 hasta dahil edildi. Hastaların 71’i (%83) kadındı. Ortanca yaş 54 (çeyrekler arası aralık, 45-61) yıldı. Ortanca hastanede kalış süresi 2 (interkuartil aralık, 2-2) gündü. Popülasyonun 75. yüzdelik dilimine göre 2 günden uzun süren kalış süresi uzamış hastanede kalış olarak belirlendi. Buna göre 14 (%16) hastada uzamış hastanede kalış saptandı. Çoklu regresyon analizi sonucunda operasyon süresi (olasılık oranı: 1,03; p-değeri: 0,017), açık cerrahiye geçiş (odds oranı: 4,79; p-değeri: 0,045) ve erkek cinsiyet (olasılık oranı: 5,61; p-değeri: 0,022), uzamış hastanede kalış süresi ile ilişkili bulundu. Sonuç: Laparoskopik adrenalektomi, bir çok adrenal patolojinin tedavisinde güvenilir bir yöntemdir. Operasyon süresi ve açık cerrahiye geçiş, uzamış hastanede kalış süresi ile ilişkili bulunmuştur; ancak kanıt düzeyi yüksek çalışmalara ihtiyaç vardır.
Management of Gallbladder Polyps: a Tertiary Center Experience
(2019) Aydın, Cengiz; Üstün, Mehmet; Karaca, Avni Can
Objective: The main purpose of the management of gallbladder polyps is to establish an early diagnosis and toprevent the development of gallbladder cancer.Methods: Fifty-six patients who underwent cholecystectomy with the diagnosis of gallbladder polyp betweenJanuary 2012 and September 2018, were retrospectively evaluated.Results: Twenty-one patients (39.3%) were female and 34 (60.7%) were male. The indications for cholecystectomywere ? 10 mm polyps in (n=22, 39.3%), increase in polyp size during follow-up (n=8, 14.3%), symptomatic polypssmaller than 10 mm (n=24, 42.9%), polyps smaller than 10 mm with concomitant risk factors (n=2, 3.6%).Histopathological examination of gallbladders revealed the presence of cholesterol polyps in 51 (91.1%), inflammatory polyps in 1 (1.8%), and adenoma in 1 (1.8%) patient. Three patients (5.4%) had no polyps and only gallstoneswere detected. Malignancy was not detected in any patient.Conclusion: The management of gallbladder polyps is still a controversial issue. The recommendations publishedin guidelines, can be used as a guide in the management of gallbladder polyps. The characteristics of symptomsand their response to cholecystectomy should be evaluated in symptomatic cases.
Parathyroid Lesions: Our Single-Center Experience Forthe Last 5 Years
(2021) Ekmekçi, Sümeyye; Küçük, Ülkü; Pala, Emel Ebru; Üstün, Mehmet; Atıcı, Semra Demirli; Adalı, Yasemen
Objective: Parathyroid neoplasms are tumors seen in about 0.1% of the population. Although parathyroid adenomas are the most common, rarely carcinomas are also seen. Our aim in this study is to evaluate the clinical, laboratory and histopathological characteristics of patients who underwent parathyroidectomy in our hospital in the last 5 years.Method: A total of 156 patients who underwent parathyroidectomy in our hospital and examined in the pathology department were included in the study. Cases were grouped according to the types of operations performed as those who underwent only parathyroid excision or partial/total thyroid excision with parathyroid excision. Age, gender, pre- and post-operative parathyroid hormone values, size, weight, pathological diagnosis of the parathyroid gland, presence of complications, comorbidities and their clinical follow-ups were evaluated.Results: The 84% of 156 cases were female, and 16% were male. The mean age of the patients was 53.82±13.49 years. The mean pre-, and post-operative parathyroid hormone levels of the cases were 415.18±491.15 mg/dl, and 64.02±110.72 mg/dl, respectively. The mean volume of parathyroid tissues was calculated as 5.13±8.85 and the mean weight as 2.78±2.88 g. Pathological diagnoses were adenoma in 83.3%, hyperplasia in 10.9%, atypical adenoma in 2.6%, carcinoma in 1.9%, normal parathyroid gland in 0.6% and lymph node in 0.6%, of the cases. It was observed that as the postoperative PTH level increased, the weight of the parathyroid gland increased and the weight of the lesion was higher in males. The addition of thyroidectomy to the treatment, conventional parathyroidectomy instead of the minimally invasive method, and the high size and volume of the parathyroid gland were found to be associated with complications in the postoperative period.Conclusion: In terms of thyroid pathologies that may accompany, it will be more appropriate to evaluate preoperative cases in detail and to continue the treatment with minimally invasive methods for the comfort of the patient in postoperative processes. It is highly important to always take a multidisciplinary management in the approach to parathyroid masses and to evaluate the clinical, laboratory, intraoperative and pathological findings of the cases in combination.