Araştırma Çıktıları

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Author: search.filters.author.Kara, HalilHas files: No

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    Robotic nipple sparing mastectomy through a single incision: Advantages of starting with posterior dissection
    (TURKISH SURGICAL ASSOC, 2020-01-01) Uras, Cihan; Arikan, Akif Enes; Kara, Halil; Dulgeroglu, Onur; Avsar, Yakup
    Objective: Loss of breast, which is an important body marking of women, causes a huge decrease in quality of life (QoL) after treatment. In order to overcome this morbidity and increase QoL, nipple sparing mastectomy (NSM) has been developed. Even though the demand for better cosmetic results has yielded endoscopic nipple sparing mastectomy, limitations like unsuitable optical window and limited manual control of rigid-tip instruments, and struggling to keep dissection space have led robotic nipple sparing mastectomy (rNSM) to be developed. Material and Methods: Records of three patients who underwent to rNSM for invasive breast carcinoma with DaVinci Xi (Intuitive Surgical, Sunnyvale, CA) in affiliated hospitals of Acibadem Mehmet Ali Aydinlar University, Research Institute of Senology in 2018 were investigated retrospectively. In all breasts (n= 4), dissection was started from the posterior side of breast. Results: In the unit, 738 breast cancer patients underwent surgery between 2018 and 2019 with an NSM ratio of 31.4\% (n= 232). Of these patients, three underwent rNSM with DaVinci Xi robotic system. The operation was performed on the left breast in one patient, right in one, and bilateral in one patient. Only in patient \#2, who was a neoadjuvant chemotherapy recipient, seroma was observed six weeks after surgery (3 weeks after removal of drains) and spontaneously resolved in 4 weeks. No other complication was seen in all patients. In the follow-up period of median 21 months, no loco-regional recurrence or distant metastasis was seen. Conclusion: A single incision robotic mastectomy can be performed easily and safely when the dissection starts from the pre-pectoral plane rather than the subcutaneous plane.
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    Effects of Duraseal (R) and Fibrin Glue on healing of normal and ischemic colon anastomosis
    (ISTANBUL UNIV, FAC PHARMACY, 2020-01-01) Kara, Halil; Ulualp, Kenan
    Background and Aims: Anastomotic leaks represent a major complication of colorectal surgery. This study, involving a rat model of normal and ischemic colon anastomosis, aims to compare the effects of Duraseal (R) with those of Fibrin Glue (FG). Methods: Fifty adult male Wistar Albino rats were divided into six groups
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    Three Cases of Breast Metastases from Lung Cancer and Systematic Review of the Literature
    (GALENOS YAYINCILIK, 2021-01-01) Guldogan, Nilgun; Icten, Gul Esen; Tokat, Fatma; Tutar, Burcin; Kara, Halil; Korkmaz, Taner; Uluc, Basak Oyan; Demir, Gokhan
    Despite the high prevalence of lung cancer among other primary tumors, metastasis of this particular malignancy in the breast is very rare. We report three new cases of lung cancer with breast metastases and discuss radiological and clinical findings. Radiologically, each case displayed different characteristics. First, one of them had bilateral superficially and deeply located irregular lesions. Second, the patient presented with findings similar to inflammatory breast cancer. The third case had a circumscribed mass, resembling a benign complicated cyst. To guide clinicians for proper patient management, radiologists should be aware of the scope of typical and atypical imaging findings of metastatic involvement of the breast.
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    Role of Sentinel Lymph Node Biopsy During Contralateral Prophylactic Mastectomy
    (ISTANBUL TRAINING \& RESEARCH HOSPITAL, 2020-01-01) Kara, Halil; Arikan, Akif Enes; Dulgeroglu, Onur; Uras, Cihan
    Introduction: Contralateral prophylactic mastectomy (CPM) is the removal of the opposite breast with the aim of risk reduction in cases of unilateral breast carcinoma. Routine use of sentinel lymph node biopsy (SLNB) at the time of CPM is controversial due to low occult breast cancer risk. This study aims to determine the rate of occult breast carcinoma and to evaluate whether SLNB should be performed during CPM. Methods: Ninety-four patients who underwent CPM between 2009 and 2018 were evaluated retrospectively. Occult breast carcinoma detection rate and approach to axilla were evaluated. Results: Occult invasive breast carcinoma was detected in three patients (3.2\%): two invasive ductal carcinoma and one multifocal invasive lobular carcinoma. Axillary staging was performed in second session. SLNB was performed in two patients and a micro-metastasis in one of four sentinel lymph nodes (SLN) was detected in one patient. Axillary lymph node dissection was performed in one patient in whom SLN was not detected. Conclusion: SLNB can be performed in patients with suspicious lesion in the absence of biopsy or in patients with high-risk of occult breast cancer (postmenopausal, high Gail score, lobular histology, multi-centric tumor, ipsilateral high-risk lesion)
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    Management of Mechanical Problems of Totally Implantable Venous Catheters
    (MARMARA UNIV, INST HEALTH SCIENCES, 2020-01-01) Kara, Halil; Arikan, Akif Enes; Dulgeroglu, Onur; Uras, Cihan
    Objective: Although the most common complications of totally implantable venous catheters(TIVC) are infection and thrombosis, mechanical complications can also affect the treatment and cause catheter removal. This study aimed to investigate mechanical complications of TIVC and prevention methods. Methods: Data of 983 procedures in 961patients who underwent TIVC implantation between 2010 and 2019 in AcibademMaslak, Bakirkoy, and Atakent Hospitals were retrospectively analyzed for mechanical complications. Results: Mechanical complications were encountered in 33(3.3\%) cases: 12(1.2\%) were detachment of TIVC, 8(0.8\%) occlusions, 5(0.5\%) pneumothorax, 1(0.1\%) hemothorax, 1(0.1\%) malposition, 1(0.1\%) extravasation, 2(0.2\%) TIVC rotation, 3(0.3\%) skin necrosis and extrusions. Conclusion: The catheter tip should be placed in distal superior vena cava, reservoir pocket must be sufficient in size, reservoir should be fixed to pectoral muscle or fascia at least two points with nonabsorbable sutures. Subcutaneous fatty tissue resection from reservoir pocket should be performed in obese patients. The nature of the withdrawn blood form Seldinger needle should be checked visually whether venous or not. Risk of pneumothorax and detachment can be reduced by inserting the catheter from 1/3 outer part of the clavicle during percutaneous technique. While complication rate can be reduced by peroperative fluoroscopy use, control X-ray should be taken in symptomatic patients, not routinely. Malposition can be seen in the peroperative period and can usually be corrected by good manipulation. Percutaneous transcatheter retrieval in addition to surgery is the gold standard treatment for detachment of TIVC. The most important factors in preventing complications are surgical experience and good care.