Araştırma Çıktıları
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Item Management of endocrine surgical disorders during COVID-19 pandemic: expert opinion for non-surgical options(SPRINGER-VERLAG ITALIA SRL, 2022-01-01) Agcaoglu, Orhan; Sezer, Atakan; Makay, Ozer; Erdogan, Murat Faik; Bayram, Fahri; Guldiken, Sibel; Raffaelli, Marco; Sonmez, Yusuf Alper; Lee, Yong-Sang; Vamvakidis, Kyriakos; Mihai, Radu; Duh, Quan-Yang; Akinci, Baris; Alagol, Faruk; Almquist, Martin; Barczynski, Marcin; Bayraktaroglu, Taner; Berber, Eren; Bukey, Yusuf; Cakmak, Guldeniz Karadeniz; Canturk, Nuh Zafer; Canturk, Zeynep; Celik, Mehmet; Celik, Ozlem; Ceyhan, Banu Ozturk; Cherenko, Sergii; Clerici, Thomas; Coombes, David Scott; Demircan, Orhan; Deyneli, Oguzhan; Dionigi, Gianlorenzo; Emre, Ali Ugur; Erbil, Yesim; Filiz, Ali Ilker; Gozu, Hulya Iliksu; Gurdal, Sibel Ozkan; Gurleyik, Gunay; Haciyanli, Mehmet; Kebudi, Abut; Kim, Seokmo; Koutelidakis, Giannis; Kuru, Bekir; Mert, Meral; Oruk, Guzide Gonca; Ozbas, Serdar; Palazzo, Fausto; Pandev, Rumen; Riss, Phillip; Sabuncu, Tevfik; Sahin, Ibrahim; Sakman, Gurhan; Saygili, Fusun; Senyurek, Yasemin Giles; Sleptsov, Ilya; Van Slycke, Sam; Teksoz, Serkan; Terzioglu, Tarik; Tezelman, Serdar; Tunca, Fatih; Ugurlu, Mustafa Umit; Uludag, Mehmet; Villar-del-Moral, Jesus; Vriens, Menno; Yazici, DilekPurpose The COVID-19 pandemic brought unprecedented conditions for overall health care systems by restricting resources for non-COVID-19 patients. As the burden of the disease escalates, routine elective surgeries are being cancelled. The aim of this paper was to provide a guideline for management of endocrine surgical disorders during a pandemic. Methods We used Delphi method with a nine-scale Likert scale on two rounds of voting involving 64 experienced eminent surgeons and endocrinologists who had the necessary experience to provide insight on endocrine disorder management. All voting was done by email using a standard questionnaire. Results Overall, 37 recommendations were voted on. In two rounds, all recommendations reached an agreement and were either endorsed or rejected. Endorsed statements include dietary change in primary hyperparathyroidism, Cinacalcet treatment in secondary hyperparathyroidism, alpha-blocker administration for pheochromocytoma, methimazole +/- beta-blocker combination for Graves' disease, and follow-up for fine-needle aspiration results of thyroid nodules indicated as Bethesda 3-4 cytological results and papillary microcarcinoma. Conclusion This survey summarizes expert opinion for the management of endocrine surgical conditions during unprecedented times when access to surgical treatment is severely disrupted. The statements are not applicable in circumstances in which surgical treatment is possible.Item 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, DursunObjective: 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.Item 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, DursunIn 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.Item 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, IstanbulThe 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.