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Öğe COVID-19 pandemisi döneminde onkolojik ve acil cerrahi vakalarının yönetimi(2022) Dal, Mehmet Burak; Uğur, Mustafa; Duymuş, Mehmet Esat; Temiz, MuhyittinAmaç: Acil cerrahi vakalara Genel Cerrahide önemli bir yer tutmaktadır. COVID-19 salgını döneminde, hastaların salgından etkilenme korkusu ve davranış şekillerinin karmaşıklığı bu hastalıkların teşhis ve tedavisini zorlaştırmaktadır. Yöntem: Üçüncü basamak olan merkezimizde, COVID pandemisi sırasında akut apandisit, kolesistit ve kolorektal kanser tanısı ile cerrahi geçiren hastaların bilgisayarlı veri tabanı retrospektif olarak pandemi öncesi ve pandemi dönemi şeklinde gözden geçirildi. Bulgular: Çalışma süresi boyunca 1100 hasta apandisit, 500 hasta kolesistit, 120 hasta onkolojik hastalıklar nedeni ile ameliyat edildi. Ortalama yaş her iki dönem için benzerdi, pandemi öncesi dönemde 34.06 ± 16.7 pandemi döneminde 36,72 ± 15,31 yaş ortalaması mevcuttu. Semptom başlaması ile hastaların hastaneye başvuru süreleri her iki döneme benzerdir (34,55 ± 31,51 ile 34,35 ± 37,94 sa, P = 0,968). Laboratuvar testler arasında anlamlı bir farklılık göstermemiştir. WBC değerleri pandemi öncesi dönemde 12.73 ± 4.3 × 103 idi pandemi sonrası dönemde 13.62 ± 4.62×103 (P = 0.1308) idi. Pandemi öncesi ve pandemi döneminde tüm hastalar en az 1 görüntüleme yöntemi kullanılmıştır. Sonuç: COVID-19 pandemisinin ilk aşamasında, komplike acil cerrahi gereksinimi oranında önemli bir artış vardı. Hastalar bundan kaçınmaları için semptomların başlaması ile acil polikliniklere başvurmaları şiddetle teşvik edilmelidir.Öğe Evaluation of preoperative anxiety in cancer patients: Experience of a single center(2022) Duymuş, Mehmet Esat; Urfalı, Senem; Uğur, Mustafa; Dal, Mehmet Burak; Dönmez, Yasemin; Bağ, Yusuf Murat; Temiz, MuhyittinAnxiety disorder is observed in half of the patients in the preoperative period. Psychological disorders are also frequently observed in cancer patients and need to be supported. The aim of the present study is to determine the level of preoperative anxiety in patients with malignant and benign diagnoses who were planned for elective surgery and to reveal its relationship with socio-demographic data. A tertiary hospital-based cross-sectional study was conducted in the general surgery clinic between June 1, 2021- March 31, 2022, on 158 patients who underwent elective surgery. Participants were evaluated in two groups depending on their diagnosis; the cancer group and the benign group. The socio-demographic data were recorded and the level of anxiety was determined by the Beck Anxiety Inventory (BAI). The median age of par- ticipants was 55 (19-78) years. There were 72 (45.6%) patients in the cancer group and 86 (54.4%) patients in the benign group. There was no significant difference in age, gender, marital status, job, level of income, and family cancer history between the two groups. There were significant differences between the groups in level of education, and previous surgical history (p=0.035, and p=0.037, respectively). BAI scores of the cancer group and control group were 10.5 (0-35) and 5 (0-49), respectively (p<0.001). The level of anxiety in the cancer group was also significantly higher than in the benign group (p<0.001). Cancer patients have more anxiety during the preoperative period than patients who were with benign diseases. We believe that previous surgical history and education level are other factors that affect anxiety.Öğe Prognostic value of Prognostic Nutritional Index (PNI) for 5-year recurrence-free survival in surgically resected gastrointestinal stromal tumors(Edizioni Luigi Pozzi, 2023) Duymus, Mehmet Esat; Ugur, Mustafa; Dal, Mehmet Burak; Aslan, Ersin Rasim; Donmez, Yasemin; Ozgur, Tumay; Secinti, Ilke EvrimBACKGROUND: Recent studies have investigated the role of neutrophil-to-lymphocyte ratio (NLR), platelet-to-lymphocyte ratio (PLR), systemic inflammation index (SII), and prognostic nutritional index (PNI) on prognosis for various malig-nancies. However, the value of these markers in determining the prognosis for gastrointestinal stromal tumors (GIST) remains controversial. We investigated the effect of NLR, PLR, SII, and PNI on 5-year recurrence-free survival (RFS) in patients with surgically resected GIST. MATERIALS AND METHODS: We retrospectively analyzed patients (n=47) who had undergone surgical resection for pri-mary, localized GIST at a single institution between 2010 and 2021. The patients were divided into two groups accord-ing to the recurrence status in the 5-year period as 5-year RFS(+) (patients with no recurrence (n=25) and 5-year RFS(-) (patients with recurrence (n=22) groups. RESULTS: In univariate analyses, Eastern Cooperative Oncology Group Performance Status (ECOG-PS), tumor localiza-tion, tumor size, PNI, and risk category were significantly different between the RFS(+) and RFS(-) groups while NLR, PLR, SII were not. Multivariate analyses revealed that only the tumor size (HR =5.485, 95% CI: 0.210-143.266, p=0.016), and PNI (HR= 112.020, 95% CI: 8.755-1433.278, p<0.001) were independent prognostic factors for RFS. The patients with a high PNI (>= 46.25) had a higher 5-year RFS rate than the patients with low PNI (<46.25) (95.2% to 19.2%, p<0.001). CONCLUSION: A higher preoperative PNI is an independent positive predictor for 5-year RFS for patients with surgi-cally resected GIST. However, NLR, PLR, and SII have no significant effect.Öğe The relationship between age and mortality and morbidity of patients diagnosed with breast cancer: a retrospective clinical study(2023) Dal, Mehmet Burak; Temiz, MuhyittinObjective: Breast cancer, the most common malignancy among women, is a universally challenging health problem. It is a known fact that the incidence of breast cancer increases with age. In addition, mortality and morbidity increase with age. For now, it does not seem possible to reduce the incidence of breast cancer but it is possible to limit deaths caused by it. Patients are encouraged to get early diag- nosis and age-appropriate screening tests. Because regular screening and early diagnosis are very important in improving breast cancer outcomes. Factors such as age, hormonal status and genetics are associated with the incidence of breast cancer. In this study, we aimed to contribute to the literature by examining age-related mortality and morbidity of breast cancer. Method: This study was carried out at a University Hospital. The sample consisted of 214 women between 01.09.2018/01.09.2022 diagno- sed with breast cancer, aged 30 to 80 years. Results: The mean age of women was 51.9 ± 7.6 years, with 52.8% being <50 years. Breast-conserving surgery was performed on 56.5% of the total participants (n=121). In our series, deaths due to breast cancer are less than 1% under the age of 50 and over 3% in those over the age of 50. Conclusion: Education campaigns should focus on increasing breast cancer awareness among young women, highlighting the importance of early detection and regular screenings. Each patient should receive a tailored treatment plan that considers their age, tumor characte- ristics, fertility preservation preferences, and long-term health goals.Öğe Relationship between platelet distribution width and hospital stay in incarcerated inguinal hernia treated by open surgery(Çukurova Üniversitesi, 2019) Ulutaş, Kemal Türker; Dal, Mehmet BurakPurpose: The study aimed to investigate the value of platelet distribution width (PDW) in incarcerated inguinal hernia which was treated with graft to illuminate its inflammatory role in surgery-related disorders. Materials and Methods: We perormed a case-control study by retrospective screening data of the 88 patients with inguinal hernia and 75 healthy. Patients data included demographics, hernia location, hospital stay, and hemogram parameters. Platelet-related parameters were anayzled with automated devices from EDTA samples. Results: The mean defect size was 25.3±17 mm for inguinal hernia, which ranged 6 to 75 mm. The PDW value was higher in group A as compared with that of group B. Also, the platelets were statistically higher in group A than group B. In the Pearson correlation analysis, PDW showed a strong and positive relationship with a hospital stay. Conclusion: We suggest that a strong positive correlation of platelet distribution width with hospital stay can be useful in incarcerated inguinal hernia which we treated with grafted by open surgery.Öğe Surgical Treatment Results in Obstetric and Iatrogenic Anal Sphincter Injuries(Archives Global Professionals, 2022) Dal, Mehmet BurakOne of the most important causes of perineal tears is vaginal delivery or episiotomy. It is also among the iatrogenic causes. Perineal tears have the advantage that they can be effectively corrected by surgical repair. However, if perineal tears occurring upon delivery are not recognized and repaired immediately, the possibility of developing fecal incontinence and other complications increases. Since the aim of our study was to examine the surgical treatment of obstetric perineal tears, the files of patients who underwent anal sphincter repair between January 1, 2017, and January 1, 2019, were reviewed retrospectively. The files of 26 patients were analyzed in the present study. Sixteen patients were due to obstetric injuries; fourteen (70%) patients in the first 24 hours, and 6 (30%) occurred later. The data of the group repaired in the first 24 hours (early group) and the group repaired later was analyzed; there was no significant difference in terms of mean age, the number of births, and episiotomy opening (p 0.05674). However, there was a significant difference in the hospital stay (p<0.05). Obstetric anal sphincter injuries affect about half of women who have a vaginal delivery, and incontinence develops in 25% of primiparous patients with these injuries. The opinion of an experienced second physician is required. Effective sphincter repairs applied in this way can prevent long-term complications such as anal incontinence.
