Browsing by Author "Karaca, Can"

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Congenital Absence of Portal Vein Presenting With Macroscopic Hematuria: a Case Report With a Brief Review of the Literature
(2021-08-17) Karaca, Avni Can; Yılmaz, Cahit Hüseyin; Karaca, Can
Congenital absence of the portal vein is a rare clinical entity in which portal blood flow is partially or totally diverted to the systemic circulation. This condition causes a myriad of clinical symptoms and is associated with other congenital abnormalities mostly of cardiac and vascular origin. A 14-year-old male patient with type IB Abernethy malformation who presented with macroscopic hematuria was treated with live donor liver transplantation. The medical recordings of the patient were retrospectively reviewed, and the case was presented with a brief review of the literature. The patient had associating nut-cracker syndrome and liver masses that were revealed to be focal nodular hyperplasia. The patient is doing well in the postoperative course. Liver transplantation offers a safe and radical treatment for this very rare anatomic malformation. It not only corrects aberrant portal flow but also prevents other life-threatening complications such as hepatopulmonary syndrome and possible liver malignancies.
Hepatoselüler Kanser için Karaciğer Nakli: Altı Yıllık Deneyimin Öğrettikleri
(2020) Yılmaz, Cahit Hüseyin; Karaca, Avni Can; Karaca, Can
Amaç: Karaciğer nakli (KN), hepatosellüler karsinom (HSK) için en iyi tedavi seçeneği olmaya devametmektedir. Milano kriterlerinin ortaya çıktığı 1996 yılından bu yana, hasta seçimi çok önem kazanmıştırancak bu kriterlerin kısıtlayıcılığı tartışılmaktadır. Canlı vericili KN dünya çapında artık daha rutin bir şekildeyapıldığından, daha fazla hastanın bu tedaviden faydalanabilmesi için orijinal kriterlere ek olarak birçok yenikriter ve / veya bu kriterlerin genişletilmiş versiyonları literatürde önerilmektedir.Bu çalışma, KN ile kabul edilebilir sonuçlar elde edilen hastaların sayısını artırmak için literatürdeki hergün daha da büyüyen dataya katkıda bulunmayı amaçlamaktadır.Gereç ve Yöntem: Altı yıllık bir sürede HSK için KN uygulanan 187 yetişkin hastanın tıbbi kayıtlarıretrospektif olarak toplandı. Hastalar Milan ve UCSF kriterlerine göre sınıflandırıldı. Her hasta için sağkalım süreleri, tümör, karaciğer hastalığı ve nüks ile ilgili veriler kaydedildi ve sonuçlar istatistikselolarak analiz edildi.Bulgular: Nüks ve sağ kalımı önemli ölçüde etkileyen faktörler histolojik farklılaşma, tümörün sayısı vebüyüklüğü ve vasküler invazyon varlığı olarak saptandı. Serum alfa-fetoprotein düzeylerinin sonuçlarıönemli ölçüde etkilemediği görüldü.Her iki kriteri de aşan hastalar arasında, toplam tümör boyutu 160 mm'den az olan hastaların sonuçlarıanlamlı derecede daha iyi olarak saptandı (p = 0,007).Sonuç: Sonuç olarak, vasküler invazyon, kötü diferansiasyon, 6’dan fazla odak ve 160 mm'yi aşantümörü olan HSK hastaları daha yüksek nüks oranları ve daha kötü sonuçlar göstermektedir.Anahtar Sözcükler: Hepatoselüler kanser, karaciğer nakli, sağ kalım, prognoz.Not: Bu makaleyi oluşturan verilerin farklı güncellikteki versiyonları aşağıda sıralanan etkinliklerderapor edilmiş / sunulmuştur:• 24–27 Mayıs 2017, Prag/Joint International Congress of ILTS, ELITA & Licage–Poster Sunumu• 23–26 Mayıs 2018, Lizbon/Joint International Congress of ILTS, ELITA & Licage–Poster Sunumu• 15–18 Mayıs 2019, Toronto/Joint International Congress of ILTS, ELITA & Licage–Poster Sunumu• 23–26 Ekim 2019, Antalya/14. HPB Cerrahi Kongresi – Sözlü sunum
Management of Gallbladder Polyps: a Tertiary Center Experience
(2019) Aydın, Cengiz; Üstün, Mehmet; Karaca, Avni Can; Karaca, 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.
Prospective Comparison of the Efficacy of Two Common Appendicitis Scoring Systems: Is Combination a Solution?
(2020-06-10) Karaca, Avni Can; Akpınar, Göksever; Karaali, Cem; Ustun, Mehmet; Atıcı, Semra Demirli; Karaca, Can
Aim: The diagnosis of acute appendicitis mostly relies on history taking and physical examination findings supported by laboratory and imaging studies. A number of different diagnostic scoring systems have been developed to facilitate diagnosis, and their accuracies vary among patient populations. This prospective study aims to evaluate the accuracy of the two most frequently used scoring systems in the Turkish patient population and to analyse the possible diagnostic advantage of using these two systems in combination. Method: Patients admitted to the emergency department of a tertiary healthcare centre with acute abdominal pain who eventually underwent appendectomy between July 2018 and January 2019 were enrolled in the study. Alvarado and Raja Isteri Pengiran Anak Saleha Appendicitis (RIPASA) scores, as well as other laboratory parameters, were recorded for each patient. Using histopathologic examination as the gold standard, the sensitivity, specificity and positive and negative predictive values of each scoring system were calculated and combined using McNemar’s x2 test. Results: Data from a total of 203 patients were analysed. The sensitivity of the RIPASA system (95%) was far superior to that of the Alvarado system (35.6%). However, the Alvarado scoring system had much higher diagnostic specificity than the RIPASA system (80% vs 33.3%). The combined sensitivity and specificity of the tests rose to 88% and 62.5%, respectively. Conclusion: The RIPASA system has high sensitivity; however, the Alvarado system has high specificity for the Turkish population. Both the Alvarado and RIPASA scoring systems are useful clinical tools with different strengths. Using these two systems in combination increases diagnostic power by combining the strongest aspects of both tests.