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Öğe An evaluation of the reliability of the neutrophil-tolymphocyte ratio in patients with acute cholecystitis undergoing laparoscopic surgery(Turkish Association for Endoscopic Laparoscopic Surgery, 2019) Özdenkaya, Yaşar; Bademci, RefikIntroduction: Acute cholecystitis is observed quite commonly in emergency surgery clinics and parameters are needed for diagnosis and treatment. The aim of this study was to determine whether the neutrophil-tolymphocyte ratio (NLR) is of benefi in the diagnosis of acute cholecystitis. Materials and Methods: A retrospective evaluation of patients who were hospitalized between January 2014 and February 2018 for the treatment of acute cholecystitis was conducted. The blood tests and radiological tests of the patients were evaluated. The NLR was calculated and compared with the clinical and laboratory values of the patients. Results: A total of 185 patients were identifid, comprising 102 (55.1%) females and 83 (44.9%) males with a mean age of 51.5±15.9 years. The mean leukocyte count was 11.6±3.6 109/L and the mean C-reactive protein (CRP) value was 37±76.4 mg/L. Overall, 90 (48.6%) patients had normal leukocyte values and 59 (31.8%) patients had normal CRP values. In 20 (10.8%) patients with an NLR of approximately 1, only 1 (5%) was aged >60 years and all of the remaining patients were <45 years of age. In 53 (28.6%) patients, the NLR was determined to be approximately 2, and the NLR value was ?3 in 112 (60.5%) patients. Conclusion: Awareness of an increased NLR may be benefiial in the diagnosis of patients with acute cholecystitis.Öğe Comparison of breast cancer patients over the age of 70 and under the age of 35(Turkish Geriatrics Society, 2023) Akan, Arzu; Günay, Semra; Bademci, Refik; Gürdal, Necla; Güven, Merve Nur; Yalçın, Orhanİntroduction: Although breast cancer is a type of cancer that is mainly seen in advanced ages, its incidence is increasing in early ages in developing countries. While advanced age may create limitations in treatment due to the person's functional capacity and low life expectancy, treatments may be exaggerated at a young age due to the long-life expectancy and expectations from life. In this study, we aimed to examine possible differences in approach in two different age groups diagnosed with breast cancer. Materials and Methods: The retrospective study included 123 patients over the age of 70 or under 35 who applied to our hospital's breast surgery outpatient clinic between 2016 and 2021 and were diagnosed with breast cancer. The patients' complaints at the outpatient clinic, the histopathological features of the tumor, and the treatments applied were compared. Results: 64 (52%) of the patients included in the study were over 70 years old, and 59 (47%) were under 35 years old. Patients in both groups were applied to the outpatient clinic with a palpable mass. Histopathologically, invasive ductal cancer constituted the majority in both groups. While the elderly patients were lower grade and Estrogen receptor-positive, the younger patients were high grade, Estrogen receptor negative, and mostly triple negative. Conclusions: Regardless of age, breast cancer is a cancer type that can have better results with early diagnosis. While making the treatment decision the decision should be made according to the characteristics of the tumor, comorbidity, and life expectancy, regardless of the patient's age.Öğe Conversion of aspireassist system® to sleeve gastrectomy. Technical video description revisional surgery(Springer, 2019) Sanchez-Cordero, Sergi; Vilallonga, Ramon; Bademci, Refik; Roriz-Silva, Renato; Curbelo, Yuhamy; Almanza, Ariel; Perez, Manolo; Riudaura, N.; Pares, Berta; Petrolas, C.[Abstract Not Available]Öğe Conversion of aspireAssist system® to sleeve gastrectomy: Technical video description(Springer, 2019) Vilallonga, Ramon; Bademci, Refik; Roriz-Silva, Renato; Sanchez-Cordero, Sergi; Curbelo, Yuhamy; Almanza, ArielPurpose: The AspireAssist System® (Aspire Bariatrics, Inc. King of Prussia, PA) is a new endoscopic procedure used to treat obese patients. The aim of this dedicated video is to present a case that required revision surgery due to failure of the AspireAssist System®, and to show how the cannula was removed from the abdomen, and why sleeve gastrectomy (SG) was a good option for revisional surgery in that patient. We aim to discuss technical aspects. Patient and Methods: A 43-year-old female patient who underwent a placement in 2016. Her initial BMI (body mass index) was 38 kg/m2, with a follow-up period of 26 months. A revisional surgery was performed including dissection of the previous gastric fistula and adhesiolysis from the previous AspireAssist System® placement. A complete dissection of the gastrostomy, including removal of all the system, was done. A decision was made, once the incisura angularis and the placement of a 40 Fch bougie showed that the transection could be performed. SG was done. Patients showed an uneventful postoperative course and 4 months follow-up with 45% EWL. Conclusion: In case of having the device in place, the surgeon must be aware to remove intraoperatively or endoscopically, the device. Surgeons should consider endoscopic removal of the AspireAssist System® before conversion to another procedure (SG or GBP) at least 6 months of the removal. Removal of the AspireAssist System® should be performed endoscopically but direct conversion to another bariatric procedure can be considered, either to SG or GBP depending on the technical intraoperative aspects.Öğe Demonstration of the protective effect of ghrelin in the livers of rats with cisplatin toxicity(SAGE Publications Inc., 2021) Bademci, Refik; Erdoğan, Mümin Alper; Eroğlu, Ersan; Meral, Ayfer; Erdoğan, Arife; Atasoy, Özüm; Erbaş, OytunDespite the various and newly developed chemotherapeutic agents in recent years, cisplatin is still used very frequently as a chemotherapeutic agent, even though cisplatin has toxic effects on many organs. The aim of our study is to show whether ghrelin reduces the liver toxicity of cisplatin in the rat model. Twenty-eight male Sprague Dawley albino mature rats were chosen to be utilized in the study. Group 1 rats (n = 7) were taken as the control group, and no medication was given to them. Group 2 rats (n = 7) received 5 mg/kg/day cisplatin and 1 ml/kg/day of 0.9% NaCl, Group 3 rats (n = 7) received 5 mg/kg/day cisplatin and 10 ng/kg/day ghrelin, Group 4 rats (n = 7) received 5 mg/kg/day cisplatin and 20 ng/kg/day ghrelin for 3 days. Glutathione, malondialdehyde (MDA), superoxide dismutase (SOD), plasma alanine aminotransferase (ALT) levels, and liver biopsy results were measured in rats. It was determined that, especially in the high-dose group, the MDA, plasma ALT, and SOD levels increased less in the ghrelin group as compared to the cisplatin group, and the glutathione level decreased slightly with a low dose of ghrelin, while it increased with a higher dose. In histopathological examination, it was determined that the toxic effect of cisplatin on the liver was reduced with a low dose of ghrelin, and its histopathological appearance was similar to normal liver tissue when given a high dose of ghrelin. These findings show that ghrelin, especially in high doses, can be used to reduce the toxic effect of cisplatin.Öğe Gall bladder polyps: Our experience in a tertiary referral centre(2019) Bademci, Refik; Özdenkaya, YaşarAim: An increasing number of patients are undergoing surgical treatment for gallbladder polyps (GPs). As there is still controversy on the subject, it remains unclear whether GPs are the precursors of gallbladder tumors. The aim of this study was to examine the clinicopathological features of patients who had undergone cholecystectomy in our clinic for the treatment of gallbladder polyps. Material and Methods: A retrospective review was made of the clinicopathological data of patients who underwent cholecystectomy, selected from a group of 2048 patients, who received treatment between 2014-2018. Results: A total of 79 (3.8%) patients were identified, comprising 50 (63.2%) females and 29 (36.8%) males with a mean age of 43 years (range, 22-81 years). During pre-operative ultrasonography, 60 (75.9%) patients were detected with a single polyp and 19 (23.1%) patients had multiple polyps. When postoperative histology was evaluated, 70 (88.6%) patients had cholesterol polyps, 2 (2.5%) patients had gallbladder stones, 5 (6.3%) patients had papillary adenomas without dysplasia and 1 (1.2%) patient had papillary adenoma with dysplasia, while 1 (1.2%) of patient had gallbladder adenocarcinoma. Conclusion: According to the results of this study, as gallbladder polyps may be pre-cancerous or cancerous lesions, patients diagnosed with GP should be followed up closely with surgical treatment applied when necessary.Öğe Laparoscopic conversion from single anastomosis duodeno-jejunal bypass with sleeve gastrectomy (SADJ-S) to roux-en-Y gastric bypass (GBP): Improving unsatisfactory outcomes(Springer New York LLC, 2020) Vilallonga, Ramon; Curbel, Yuhamy; Sanchez-Cordero, Sergi; Roriz-Silva, Renato; Bademci, Refik; Torres, Antonio JoseSingle anastomosis duodeno-ileal bypass with sleeve gastrectomy (SADI-S) can be considered as either a primary procedure or second stage procedure. Malnutrition is rare but could lead to a reversal of the SADI-S. The aim of this manuscript is to present the management and technique of weight regain after proximalization of a SADI-S by converting it to a gastric bypass.Öğe Rectum cancer: The effects of perioperative outcomes of patients as long-term prognostic factor(2019) Bademci, Refik; Öndeş Bayar, Özlem; Tabak Dinçer, Selvi; Akan, Arzu; Camcı, Cemalettin; Eryavuz, M. YavuzAim: After cancer treatment, patients and clinicians expect accurate prediction of long-term prognosis. The aim of this study was to determine which perioperative factors that may also be useful in determining long-term prognosis. Material and Methods: The data of rectum cancer patients operated on between 1998 and 2006 were retrospectively compared in respect of clinicopathological and operative results, and long-term survival. Survival was calculated using a Kaplan-Meier method. Data thought to be associated with survival were subjected to univariate analysis followed by Cox proportion regression. Results: A total of 348 patients were included in the study. The mean age was 56 (±12) years in patients and 195 (56%) were male patients. After retrospective evaluation of the database, the mean duration of disease-free survival was 54 (±50) months and the mean duration of life was 60 (±48) months. There was no statistically significant correlation between gender, surgical procedure, histopathologic type of tumor, T level of the tumor, stage of the patient, ca 19-9 and mean life span. Grade, lymph node status and CEA were statistically correlated with survival time. Conclusion: We have demonstrated that grade, lymph node status and CEA are associated with long-term survival. These clinical factors are suitable to provide a good clinical guide to prognosis.Öğe Robotic Roux-En-Y gastric bypass: Comparison of Da Vinci S and Xi Robotic platforms outcomes robotic bariatric surgery(Springer, 2019) Roriz Silva, Renato; Vilallonga, Ramon; Manuel Fort, Jose; Caubet, Enric; Gonzalez, Oscar; Ruiz De Gordejuela, A. Garcia; Guerrero Gual, Mireia; Fidillo, E.; Blanco, Raymond; Bademci, Refik; Kraft Carre, M.Robotic surgery is an emerging and promising technology in bariatric surgery. Current studies have confirmed its feasibility and safety with a relatively short learning curve. The advantages for the surgeon are already well established with better ergonomics. The potential benefits to the patient are still being studied. Robotic surgery seems to offer more advantages for complex cases, such as super obesity and revisional surgery.Öğe Therapeutic effects of vitamin D on acetic acid-induced colitis in rats(Acta Cirurgica Brasileira, 2020) Bademci, Refik; Erdoğan, Mümin Alper; Kara, Ali Yücel; Yiğittürk, Gürkan; Erbaş, OytunPurpose: To analyze the effect of calcitriol treatment on acute colitis in an experimental rat model. Methods: A total of 24 adult Sprague Dawley albino rats were randomly separated into 3 equal groups: control group (n:8), colitis group (n:8), calcitriol administered group (n:8). A single dose of acetic acid (1 ml of 4% solution) was administered intrarectally to induce colitis. Group 1 was given 1 ml/kg 0.9% NaCl intraperitoneally; rats belonging to Group 2 were administered calcitriol 1 mu g/kg for 5 days. Results: Plasma tumor necrosis factor alpha, Pentraxin 3, and malondialdehyde levels were significantly lower in the calcitriol administered colitis group than in the standard colitis group (p<0.01). In the Calcitriol group, there was a significant histological improvement in hyperemia, hemorrhage and necrotic areas in the epithelium compared to the placebo group (p<0.000). Conclusion: The findings suggest that calcitriol may be an agent that could be used in acute colitis treatment.
