Browsing by Author "Baca, Bilgi"

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Complete response after neoadjuvant treatment for rectal cancer
(ELSEVIER SCIENCE INC, 2019-01-01) Esen, Eren; Karahasanoglu, Tayfun; Ozben, Volkan; Aytac, Erman; Baca, Bilgi; Hamzaoglu, Ismail; Remzi, Feza H.
Dealing with the gray zones in the management of gastric cancer: The consensus statement of the Istanbul Group
(AVES, 2019-01-01) Aytac, Erman; Aslan, Fatih; Cicek, Bahattin; Erdamar, Sibel; Gurses, Bengi; Guven, Koray; Falay, Okan; Karahasanoglu, Tayfun; Selcukbiricik, Fatih; Selek, Ugur; Atalar, Banu; Balik, Emre; Tozun, Nurdan; Rozanes, Izzet; Arican, Ali; Hamzaoglu, Ismail; Baca, Bilgi; Mandell, Nil Molinas; Saruc, Murat; Goksel, Suha; Demir, Gokhan; Agaoglu, Fulya; Yakicier, Cengiz; Ozbek, Ugur; Ozben, Volkan; Ozyar, Enis; Guner, Ahmet Levent; Er, Ozlem; Kaban, Kerim; Bolukbasi, Yasemin; Bugra, Dursun; Ahishali, Emel; Asian, Fatih; Boz-bas, Aysun; Hamzaoglu, Hulya; Karaman, Ahmet; Kucukmetin, Nurten Turkel; Vardareli, Eser Kutsal; Onder, Fatih Oguz; Sisman, Gurhan; Tiftikci, Arzu; Unal, Hakan Umit; Yapali, Suna; Acar, Sami; Agcaoglu, Orhan; Aghayeva, Afag; Akyuz, Ali; Atasoy, Deniz; Batik, Emre; Bayraktar, Ilknur Erenler; Bayram, Onur; Bilgic, Cagri; Bilgin, Ismail Ahmet; Can, Ugur; Dulgeroglu, Onur; Durukan, Ugur; Gencosmanoglu, Rasim; Gonenc, Murat; Gurbuz, Bulent; Kaya, Mesut; Omarov, Nail; Ozben, Volkan; Ozgur, Ilker; Ozoran, Emre; Sobutay, Erman; Uras, Cihan; Uymaz, Derya; Zenger, Serkan; Ozbek, Ugur; Yakicier, M. Cengiz; Afsar, Cigdem Usul; Bozkurt, Mustafa; Demir, Atakan; Er, Ozlem; Kanitez, Metin; Korkmaz, Taner; Mandel, Nil Molina; Mert, Askhan Guven; Ozer, Leyla; Sonmez, Ozlem; Tunali, Didem; Uluc, Basak Oyan; Yazar, Aziz; Yildiz, Ibrahim; Demirkurek, Cengiz; Guner, Ahmet Levent; Vardareli, Erkan; Armutlu, Aye; Baba, Fisun; Ersozlu, Ilker; Kapran, Yersu; Sahin, Davut; Abacioglu, Mehmet Ufuk; Bese, Nuran; Durankus, Nilufer Kilic; Gural, Zeynep; Ozyar, Enis; Sengoz, Meric; Sezen, Duygu; Caliskan, Can; Guven, Koray; Karaaslan, Ercan; Kizilkaya, Esref; Suleyman, Erdogan; Grp, Istanbul
The geographical location and differences in tumor biology significantly change the management of gastric cancer. The prevalence of gastric cancer ranks fifth and sixth among men and women, respectively, in Turkey. The international guidelines from the Eastern and Western countries fail to manage a considerable amount of inconclusive issues in the management of gastric cancer. The uncertainties lead to significant heterogeneities in clinical practice, lack of homogeneous data collection, and subsequently, diverse outcomes. The physicians who are professionally involved in the management of gastric cancer at two institutions in Istanbul, Turkey, organized a consensus meeting to address current problems and plan feasible, logical, measurable, and collective solutions in their clinical practice for this challenging disease. The evidence-based data and current guidelines were reviewed. The gray zones in the management of gastric cancer were determined in the first session of this consensus meeting. The second session was constructed to discuss, vote, and ratify the ultimate decisions. The identification of the T stage, the esophagogastric area, imaging algorithm for proper staging and follow-up, timing and patient selection for neoadjuvant treatment, and management of advanced and metastatic disease have been accepted as the major issues in the management of gastric cancer. The recommendations are presented with the percentage of supporting votes in the results section with related data.
Does laparoscopy decrease incisional hernia and bowel obstruction rates after rectal cancer surgery?-results of 5 years follow-up in a randomized trial (COLOR II)
(AME PUBL CO, 2020-01-01) Benlice, Cigdem; Baca, Bilgi
Effects of prior abdominal surgery on laparoscopic cholecystectomy
(TURKISH SURGICAL ASSOC, 2018-01-01) Atasoy, Deniz; Aghayeva, Afag; Sapci, Ipek; Bayraktar, Onur; Cengiz, Turgut Bora; Baca, Bilgi
Objectives: With increased experience and technological advancement, laparoscopic cholecystectomy is reported to be safe and feasible even in the presence of most of the previously recognized contraindications. The purpose of this study was to explore the effects of prior upper and lower abdominal surgery on laparoscopic cholecystectomy. Material and Methods: A retrospective evaluation of all sequential patients who underwent laparoscopic cholecystectomy from January 2014 to June 2016 was conducted. Patients were divided into three groups (Group A: patients without any prior abdominal surgical procedures
Is Early Surgical Treatment of Crohn’s Disease Harmful or Beneficial in Children?
(Acıbadem Mehmet Ali Aydınlar Üniversitesi, 2016-01-01) Çevik, Muazez; Baca, Bilgi
ABSTRACT Objectives: Crohn’s disease is an increasingly common health problem in children. If untreated or treated inappropriately, it eventually results in complications. This report presents a case of suspected Crohn’s disease with inflammation of the pelvic region with a review of the literature. Case: An 11-year-old female was suspected of having Crohn’s disease, but laboratory tests and biopsy by endoscopy failed to confirm the diagnosis. She had intra-abdominal inflammation, an enteroenteric fistula, and an abscess that did not resolve despite antibiotic treatment for 1.5 months. She was referred to us for diagnosis. We performed surgery with a provisional diagnosis of Crohn’s disease; the pathology was consistent with Crohn’s disease. Conclusion: Surgery is indicated for the therapy and diagnosis of Crohn’s disease under certain conditions. The treatment of Crohn’s disease requires a multidisciplinary team
Laparoscopic surgery for complex and recurrent Crohn's disease
(BAISHIDENG PUBLISHING GROUP INC, 2017-01-01) Sevim, Yusuf; Akyol, Cihangir; Aytac, Erman; Baca, Bilgi; Bulut, Orhan; Remzi, Feza H.
Crohn's disease (CD) is a chronic inflammatory disease of digestive tract. Approximately 70\% of patients with CD require surgical intervention within 10 years of their initial diagnosis, despite advanced medical treatment alternatives including biologics, immune suppressive drugs and steroids. Refractory to medical treatment in CD patients is the common indication for surgery. Unfortunately, surgery cannot cure the disease. Minimally invasive treatment modalities can be suitable for CD patients due to the benign nature of the disease especially at the time of index surgery. However, laparoscopic management in fistulizing or recurrent disease is controversial. Intractable fibrotic strictures with obstruction, fistulas with abscess formation and hemorrhage are the surgical indications of recurrent CD, which are also complicating laparoscopic treatments. Nevertheless, laparoscopy can be performed in selected CD patients with safety, and may provide better outcomes compared to open surgery. The common complication after laparoscopic intervention is postoperative ileus seems and this may strongly relate excessive manipulation of the bowel during dissection. But additionally, unsuccessful laparoscopic attempts requiring conversion to open surgery have been a major concern due to presumed risk of worse outcomes. However, recent data show that conversions do not to worsen the outcomes of colorectal surgery in experienced hands. In conclusion, laparoscopic treatment modalities in recurrent CD patients have promising outcomes when it is used selectively.
Minimally invasive versus open surgery for gastric cancer in Turkish population
(TURKISH SURGICAL ASSOC, 2021-01-01) Agcaoglu, Orhan; Sengun, Berke; Tarcan, Serim; Aytac, Erman; Bayram, Onur; Zenger, Serkan; Benlice, Cigdem; Ozben, Volkan; Balik, Emre; Baca, Bilgi; Hamzaoglu, Ismail; Karahasanoglu, Tayfun; Bugra, Dursun
Objective: In this study, it was aimed to compare short-term outcomes of minimally invasive and open surgery for gastric cancer in the Turkish population carrying both European and Asian characteristics. Material and Methods: Short-term (30-day) outcomes of the patients undergoing minimally invasive and open gastrectomy with D2 lymphadenectomy for gastric adenocarcinoma between January 2013 and December 2017 were compared. Patient demographics, history of previous abdominal surgery, comorbidities, short-term perioperative outcomes and histopathological results were evaluated between the study groups. Results: There were a total of 179 patients. Fifty (28\%) patients underwent minimally invasive {[}laparoscopic (n= 19) and robotic (n= 31)] and 129 (72\%) patients underwent open surgery. There were no differences between the two groups in terms of age, sex, body mass index and ASA scores. While operative time was significantly longer in the minimally invasive surgery group (p< 0.0001), length of hospital stay and operative morbidity were comparable between the groups. Conclusion: While both laparoscopic and robotic surgery is safe and feasible in terms of short-term outcomes in selected patients, long operating time and increased cost are the major drawbacks of the robotic technique preventing its widespread use.
Nüks Rektum Kanserinde İntraoperatif Radyoterapi
(Acıbadem Mehmet Ali Aydınlar Üniversitesi, 2019-10-01) Bilgin, İsmail Ahmet; Aytaç, Erman; Erenler Bayraktar, İlknur; Şahin, Bilgehan; Atalar, Banu; Beşe, Nuran; Özyar, Enis; Baca, Bilgi; Hamzaoğlu, İsmail; Karahasanoğlu, Tayfun
ÖZET Giriş: Lokal ileri ve nüks rektum kanserinde multimodal tedavi seçeneklerden biri olan intraoperatif radyoterapi (İORT), lokal kontrolü sağlamak için tercih edilebilir. Bu çalışmada nüks rektum kanseri nedeniyle radikal cerrahi ve intraoperatif radyoterapi uyguladığımız hastalar üzerindeki deneyimimizi sunmayı amaçladık. Metod: Acıbadem Mehmet Ali Aydınlar Üniversitesi Tıp Fakültesi, Maslak Hastanesi’nde Kasım 2012 ve Aralık 2016 tarihleri ara sında nüks rektum kanseri nedeniyle radikal cerrahi ve İORT uygulanan hastaların klinik özellikleri ve ameliyat sonrası takipleri değerlendirildi. Bulgular: Çalışmamıza nüks rektum kanseri olan 8 hasta (4 kadın) dahil edildi. Tüm hastalarda nüks adenokarsinom mevcuttu. Hastaların ortanca yaş değeri 54.5 (33-67) ve vücut kitle indeksi 24.3 (19.6-32.5) kg/m2 idi. Rektum kanseri için yapılan ilk ameliyatların tümü sfinkter koruyucu rezeksiyondu. Nüks tümör nedeniyle 4 hastaya aşağı anterior rezeksiyon, 2 hastaya abdo minoperineal rezeksiyon, 2 hastaya da pelvisten kitle çıkarılması işlemi uygulandı. 5 hastaya R0, 2 hastaya R1 ve 1 hastaya R2 rezeksiyon yapıldı. Ameliyat sonrası erken dönem takiplerinde 2 hastada cerrahi yara enfeksiyonu gelişti. Ortanca hastanede kalış süresi 8 (4-10) gündü. Ortanca 35.5 (7-52) aylık takip süresince 4 hasta hastalıksız takip edilmektedir. İki hastada pelvik nüks gelişti. İki hasta eksitus oldu. Sonuç: Nüks rektum kanserinde intraoperatif radyoterapi, toksisite riskini azaltarak yüksek doz radyoterapi uygulayabilmemize olanak sağlayan ve bu yolla cerrahinin lokal kontrol üzerindeki etkinliğini artıran bir yöntemdir.
Optimizing the Personalized Care for the Management of Rectal Cancer: A Consensus Statement
(AVES, 2022-01-01) Aytac, Erman; Ozer, Leyla; Baca, Bilgi; Balik, Emre; Kapran, Yersu; Taskin, Orhun Cig; Uluc, Basak Oyan; Abacioglu, Mehmet Ufuk; Gonenc, Murat; Bolukbasi, Yasemin; Cil, Barbaros E.; Baran, Bulent; Aygun, Cem; Yildiz, Mehmet Erdem; Unal, Kemal; Erkol, Burcak; Yalti, Tunc; Ozbek, Ugur; Attila, Tan; Tozun, Nurdan; Gurses, Bengi; Erdamar, Sibel; Er, Ozlem; Bese, Nuran; Bilge, Orhan; Ceyhan, Guralp Onur; Mandel, Nil Molinas; Selek, Ugur; Yakicier, Cengiz; Karabey, Hulya Kayserili; Saruc, Murat; Ozben, Volkan; Esen, Eren; Ozoran, Emre; Vardareli, Erkan; Guner, Levent; Hamzaoglu, Ismail; Bugra, Dursun; Karahasanoglu, Tayfun; Grp, Istanbul
Colorectal cancer is the third most common cancer in Turkey. The current guidelines do not provide sufficient information to cover all aspects of the management of rectal cancer. Although treatment has been standardized in terms of the basic principles of neoadjuvant, surgical, and adjuvant therapy, uncertainties in the management of rectal cancer may lead to significant differences in clinical practice. In order to clarify these uncertainties, a consensus program was constructed with the participation of the physicians from the Acibadem Mehmet Ali Aydinlar and Koc Universities. This program included the physicians from the departments of general surgery, gastroenterology, pathology, radiology, nuclear medicine, medical oncology, radiation oncology, and medical genetics. The gray zones in the management of rectal cancer were determined by reviewing the evidence-based data and current guidelines before the meeting. Topics to be discussed consisted of diagnosis, staging, surgical treatment for the primary disease, use of neoadjuvant and adjuvant treatment, management of recurrent disease, screening, follow-up, and genetic counseling. All those topics were discussed under supervision of a presenter and a chair with active participation of related physicians. The consensus text was structured by centralizing the decisions based on the existing data.
Portal vein ligation and in situ liver splitting in metastatic liver cancer
(TURKISH SURGICAL ASSOC, 2018-01-01) Aghayeva, Afag; Baca, Bilgi; Atasoy, Deniz; Ferahman, Sina; Uludag, Sezgin; Bilgin, Ismail Ahmet; Beyatli, Sonay; Mihmanli, Ismail; Hamzaoglu, Ismail
The most serious complication after major liver resection is liver failure. Depending on preoperative liver function, a future liver remnant of 25\%-40\% is considered sufficient to avoid postoperative liver failure. A new technique known as portal vein ligation combined with in situ splitting has been developed to obtain rapid liver hypertrophy. Herein, we present a case where we performed portal vein ligation combined with in situ splitting, A 37-year-old male patient with a diagnosis of sigmoid adenocarcinoma and liver metastasis underwent anterior resection because of an obstructing sigmoid tumor and received palliative chemotherapy. After chemotherapy, abdominal computed tomography revealed a lesion, 50 mm in diameter, localized between segments 5-8 of the liver on the bifurcation of the anteroposterior segmental branch of the right portal vein. Computed tomography volumetric assessments of the liver were performed in the preoperative period, and it was found that the remnant left liver volume was less than 25\% In the first stage, portal vein ligation and in situ splitting of the liver parenchyma were performed, On the second and sixth postoperative clays, computed tomography revealed hypertrophy of the left liver lobe. On the sixth clay, a right hepatectomy was performed, Portal vein ligation combined with in situ splitting has been used by surgeons worldwide to obtain rapid and adequate liver hypertrophy. This new approach yields hope for patients with locally advanced liver tumors and may increase the number of curative resections for primary or metastatic liver tumors.
Predictive parameters of early postoperative complications in Crohn's disease: Single team experience
(AVES, 2018-01-01) Atasoy, Deniz; Aghayeva, Afag; Bilgin, Ismail Ahmet; Erzin, Yusuf; Bayraktar, Ilknur Erenler; Baca, Bilgi; Karahasanoglu, Tayfun; Hamzaoglu, Ismail
Background/Aims: Most of the patients with Crohn's disease (CD) may require at least one surgical procedure over their lifetime. However, these patients tend to have a high incidence of postoperative complications. The aim of this retrospective study was to investigate the predictive parameters of postoperative complications in CD. Materials and Methods: All consecutive patients with CD between March 2001 and March 2016 who underwent bowel resection were included to this study. Postoperative complications were divided as
Robotic Rectal Cancer Surgery with the da Vinci Xi System: First 100 Cases
(ISTANBUL TRAINING \& RESEARCH HOSPITAL, 2019-01-01) Ozben, Volkan; Dogruoz, Alper; Boga, Salih Anil; Aytac, Erman; Baca, Bilgi; Hamzaoglu, Ismail; Karahasanoglu, Tayfun
Introduction: The da Vinci Xi system, the latest model of the robotic technology, is proposed to enable multiquadrant abdominal surgery to be performed in a fully robotic approach without the need for a laparoscopic assistance, robot re-docking or re-positioning of the trocars. However, the literature has limited data on this topic. In this study, we aimed to evaluate the feasibility of the Xi robot use in rectal cancer surgery, a multiquadrant surgical procedure. Methods: Patients undergoing robotic mezorectal excision for rectal adenocarcinoma using the da Vinci Xi system between December 2014 and June 2017 were included in this study. Data were collected prospectively and analyzed retrospectively. Demographic data, perioperative clinical findings, histopathologic data and postoperative 30-day outcomes were analyzed. Results: One hundred patients were included in this study. There were 57 male and 43 female patients with a mean age of 61.4 +/- 12.3 years. Low anterior resection and abdominoperineal recetion were performed in 90 and 10 patients, respectively. In all the operations, the abdominal and pelvic stages of the procedure were completed robotically without a need for dual docking or trocar re-positioning. The mean operative time was 328.4 +/- 105.8 min and blood loss was 131.7 +/- 170.3 mL. Intraoperative complication occurred in 2 patients (2\%). Two procedures were converted to open surgery (2\%). The mean number of harvested lymph nodes was 25.3 +/- 12.0. All the surgical margins were clear except for four patients (4\%). The rate of incomplete mesorectal fascia was 3.2\%. The mean length of hospital stay was 6.6 +/- 3.6 days and the overall postoperative morbidity rate was 25\%. Conclusion: The da Vinci Xi model enables rectal cancer operations to be performed in a fully robotic fashion. This feature of the robot helps surgeon to benefit optimally from the advantages robotic surgery in all stages of the procedure.
Surgery for Intestinal Crohn's Disease: Results of a multidisciplinary approach
(TURKISH SURGICAL ASSOC, 2018-01-01) Atasoy, Deniz; Aghayeva, Afag; Aytac, Erman; Erenler, Ilknur; Celik, Aykut Ferhat; Baca, Bilgi; Karahasanoglu, Tayfun; Hamzaoglu, Ismail
Objectives: Crohn's disease is a chronic inflammatory bowel disease that requires lifelong multidisciplinary management. Seventy percent of patients affected by Crohn's disease will require at least one surgical procedure over their lifetime. The aim of this retrospective study was to present our series of patients suffering from Crohn's disease who were scheduled for surgery by a multidisciplinary team. Material and methods: The data were retrieved from a review of 950 patients with Crohn's disease treated at our institution between March 2000 and March 2016. Only patients with intestinal Crohn's disease were included into the study. A multidisciplinary team assessed the decision to perform surgery. Results: There were 203 patients who underwent surgery included in this study. One hundred and sixty-six were intestinal and 37 were perianal Crohn's disease. The mean age was 36 +/- 11.5 (range, 12-75) years. Ninety-two were stricturing, 45 were fistulizing, and 12 were inflammatory. The most commonly affected site was the ileocecal region (n=109, 65.7\%), and the most common surgical procedure was the ileocecal resection (n=109, 65.6\%). Laparoscopic approach was the procedure of choice in 56 (33.7\%) patients. Of the patients enrolled, the most common early (<30 days) complications observed were the wound infection as the first (n=11) and anastomotic leak as the second (n=10). The mortality rate was 2.4\% (n=4). Conclusion: Multidisciplinary approach to Crohn's disease may decrease the surgical complications and recurrence rates leading to a better treatment.
Totally Robotic Versus Totally Laparoscopic Surgery for Rectal Cancer
(LIPPINCOTT WILLIAMS \& WILKINS, 2018-01-01) Esen, Eren; Aytac, Erman; Agcaoglu, Orhan; Zenger, Serkan; Balik, Emre; Baca, Bilgi; Hamzaoglu, Ismail; Karahasanoglu, Tayfun; Bugra, Dursun
In this study, perioperative and short-term postoperative results of totally robotic versus totally laparoscopic rectal resections for cancer were investigated in a comparative manner by considering risk factors including obesity, male sex, and neoadjuvant treatment. In addition to overall comparison, the impact of sex, obesity (body mass index >= 30 kg/m(2)), and neoadjuvant treatment was assessed in patients who had a total mesorectal excision (TME). Operative time was longer in the robotic group (P<0.001). In obese patients who underwent TME, the mean length of hospital stay was shorter (7 +/- 2 vs. 9 +/- 4 d, P=0.01), and the mean number of retrieved lymph nodes was higher (30 +/- 19 vs. 23 +/- 10, P=0.02) in the robotic group. Totally robotic and totally laparoscopic surgery appears to be providing similar outcomes in patients undergoing rectal resections for cancer. Selective use of a robot may have a role for improving postoperative outcomes in some challenging cases including obese patients undergoing TME.
Transvaginal Specimen Extraction in Minimally Invasive Colorectal Resections: Initial Experience of a Tertiary Referral Hospital
(Acıbadem Mehmet Ali Aydınlar Üniversitesi, 2019-10-01) Bayraktar, Onur; Esen, Eren; Bengür, Fuat Barış; Erenler Bayraktar, İlknur; Aytaç, Erman; Bilgin, İsmail Ahmet; Baca, Bilgi; Güngör, Mete; Karahasanoğlu, Tayfun; Hamzaoğlu, İsmail
ABSTRACT Purpose: The aim of the present (this) study is to present the initial experience of a single team on specimen extraction from the vagina after laparoscopic or robotic colorectal resections. Patients and methods: Between January 2010 and April 2015, ten female patients whose resection specimens had been extracted transvaginally after robotic or laparosopic colorectal resections were evaluated in terms of short and mid term postoperative outcomes. Results: 10 cases were included. The operations were robotic rectal resections for cancer (n=6), laparoscopic total colectomy for transverse colon tumor (n=1), single port laparoscopic transumbilical right colectomy for Crohn’s disease (n=1), laparoscopic rectal resection for endometriosis (n=2). In one patient, a vaginal bleeding occurred on postoperative day 7 and a vaginal tampon was inserted and the bleeding was stopped. One patient had a urinary tract infection, it was treated with proper antibiotic therapy. The median postoperative hospital stay was 5 (4-9) days. No mortality occurred. Conclusion: Transvaginal specimen extraction is feasible after colorectal resection and could prevent additional skin incision and its potential complications.