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Author: search.filters.author.Attila, Tan

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    Endoscopic papillectomy of benign ampullary lesions: Outcomes from a multicenter study
    (AVES, 2018-01-01) Attila, Tan; Parlak, Erkan; Alper, Emrah; Disibeyaz, Selcuk; Cicek, Bahattin; Odemis, Bulent
    Background/Aims: Endoscopic papillectomy (EP) has emerged as an alternative to surgery in the management of ampullary lesions. The aim of this study is to evaluate feasibility, efficacy, safety, outcome, and impact of EP in the management of benign ampullary lesions. Materials and Methods: This is a multicenter, retrospective study of 44 patients who had EP of benign ampullary lesions. Results: Over the 11-year period, 44 (55.7\%) of 79 patients underwent EP for benign ampullary lesions. Complete resection was achieved in 40 patients (91\%). An underlying adenocarcinoma was the only risk factor for incomplete resection. Twenty-eight lesions (63.6\%) were resected en-bloc and 16 lesions (36.4\%) were resected in piecemeal fashion. Post-papillectomy histopathologic diagnoses were tubular adenoma in 14 patients (32\%), invasive adenocarcinoma in 9 patients (20.5\%), tubullovillous adenoma in 7 patients (16\%), tubullovillous adenoma with carcinoma limited to the mucosal layer in 5 patients (11.3\%), adenoma with high-grade dysplasia in 4 patients (9\%), neuroendocrine tumor in 1 patient (2.3\%), ganglioneuroma in 1 patient (2.3\%), hamartomatous polyp in 1 patient (2.3\%), adenofibroma in 1 patients (2.3\%), and Brunner gland hyperplasia in 1 patient (2.3\%). Seven (15.9\%) procedure-related complications occurred: 3 (6.8\%) bleeding, 2 (4.5\%) pancreatitis, 1(2.3\%) abdominal pain, and 1 (2.3\%) stent migration to the pancreatic duct. Seven patients (17\%) had recurrence. Conclusion: Endoscopic papillectomy is a safe and effective method and can be considered as a first-line approach in patients with benign ampullary lesions with intent for cure. It also allows for correct histological diagnosis and staging.
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    Lesion size determines diagnostic yield of EUS-FNA with onsite cytopathologic evaluation for upper gastrointestinal subepithelial lesions
    (AVES, 2018-01-01) Attila, Tan; Aydin, Ozlem
    Background/Aims: The aim of this study was to determine the diagnostic yield and factors influencing the diagnostic yield of endoscopic ultrasound-guided fine-needle aspiration (EUS-FNA) for upper gastrointestinal (GI) subepithelial lesions (SELs) with rapid onsite cytopathologic evaluation. Materials and Methods: This is a single-center, retrospective study. Results: Among 22 patients who underwent EUS-FNA, a cytopathological diagnosis was reached in 16 (72.7\%) patients. The EUS-FNA results were as follows: seven GISTS (31.8\%), six leiomyomas (27.2\%), four non-diagnostics (18\%), two duplication cysts (9\%), two spindle cell tumor (9\%), and one ectopic pancreas (4.5\%). The long-axis size was >20 mm in 12 patients (average size: 31.3 +/- 9.3 mm) and <20 mm (average size: 16.6 +/- 2.5 mm) in 10 patients. Diagnostic accuracy of EUS-FNA from lesions <20 mm was 50\% (5/10 lesions), and of lesions >20 mm was 91.6\% (11/12 lesions) (Fisher's exact test
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    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.