TR Dizin İndeksli Yayınlar Koleksiyonu / TR Dizin Indexed Publications Collection
Permanent URI for this collectionhttps://hdl.handle.net/20.500.14365/4
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Article Factors Affecting Bilirubin Levels Following Drainage Proceduresin Obstructive Jaundice(2019) Aydın, Cengiz; Çapar, Ahmet Ergin; Günay, Süleyman; Karaca, Avni Can; Ustun, Mehmet; Karaca, CanIntroduction: Measuring serum bilirubin levels is easy and readily available invirtually every healthcare facility. It is practically used by physicians for thefollow up of the patients with obstructive jaundice.Despite its common use as amarker for follow up, the literature lacks clear data about its interpretation as aclinical marker.We don’t have clearly set prognostic rules and cutoff pointsespecially about the rate of bilirubin decrease following biliary drainageprocedures.We conducted a retrospective study to determine the likely factorsthat affect bilirubin levels following the interventional relief of obstructivejaundice.Material-Method: We retrospectively analyzed data from 73 patients withobstructive jaundice who underwent interventional drainage procedures over atime period of 4 years in a tertiary healthcare center.Results: Decrease in the bilirubin levels was most rapid in the first 48hour following the drainage. From the analyzed variables, only age andselected type of the drainage procedure significantly affected the rateof bilirubin decrease in our patient group. We failed to establish cutoffpoints that can accurately predict the patients with slower bilirubindecrease.Conclusion: Serum bilirubin level is an important and commonly usedmarker predicting the success of treatment and the prognosis of thepatients with obstructive jaudince. Type of drainage and the ageproven to significantly affect the rate of bilirubin decrease regardless ofunderlying pathologyArticle Hepatoselüler Kanser için Karaciğer Nakli: Altı Yıllık Deneyimin Öğrettikleri(2020) Yılmaz, Cahit Hüseyin; Karaca, Avni Can; Karaca, CanAmaç: 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 sunumArticle Management of Gallbladder Polyps: a Tertiary Center Experience(2019) Aydın, Cengiz; Üstün, Mehmet; Karaca, Avni Can; Karaca, CanObjective: 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.Article 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, CanAim: 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.