Browsing by Author "Kivilcim, Taner"

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Citation Count: 9
An analysis of general surgery theses set up between years 1998-2018 in Turkey: Evidence levels and publication rates of 1996 theses
(Turkish Surgical Assoc, 2020) Ferhatoglu, Murat Ferhat; Kivilcim, Taner; Kartal, Abdulcabbar; Filiz, Ali Llker; Kebudi, Abut
Objective: Setting up and advocating a thesis is mandatory at the end of the residency training program to become a specialist in general surgery according to the regulations on medical specialization in Turkey. Writing a thesis helps the resident to learn to ask structured questions, assembling the most accurate study design, managing the study process, collecting the results and building a conclusion with medical implications. In this descriptive study, we aimed to investigate the publication rates of the theses written in the field of general surgery and to assess the properties of the published theses. Material and Methods: We performed an online search on September 1, 2018, about the theses of general surgery residents on the website of National Thesis data center of Academic Educational Board in Turkey including theses of medical residents in university-affiliated hospitals and analyzed theses accomplished between 1998-2018. The publication status of the theses was assessed by the entry of author name, the title of the theses and keywords of the theses by using the search engines of PubMed, Google Scholar and Turkish Academic Network and Information Center Turkish Database (ULAKBIM). Data were presented in a descriptive form as absolute numbers and percentages. Results: Between 1998-2018, 1996 theses were completed. 393 (20.5%) of these were published in a journal, and 288 (14.4%) were published in a journal indexed in SCI/SCIE. According to research methodologies, 79.2% of the experimental studies were published in SCI/SCIE indexed journals. Conclusion: Publication rates of the theses in the field of general surgery are low as they are in other specialties of medicine. This descriptive study might give an idea about the low scientific publication rates of general surgery theses. Further studies are needed to understand the underlying factors, which are responsible for this scant scientific performance.
Citation Count: 1
Clinicopathologic and Prognostic Features in Gallbladder Malignancies: Retrospective Analysis of 5206 Cases
(Galenos Yayincilik, 2019) Ferhatoglu, Murat Ferhat; Gürkan, Alp; Kivilcim, Taner; Kartal, Abdulcabbar; Gurkan, Alp; Genel Cerrahi / General Surgery
Aim: Gallbladder cancer is the sixth most common cancer of the gastrointestinal system. Clinical presentation may not be distinguished from cholelithiasis or cholecystitis and most patients are diagnosed intraoperatively or in the postoperative histologic examination. In this study, we aimed to investigate the association of incidentally detected gallbladder cancer with gallbladder premalignant lesions, age, gender, ultrasonography features and gallbladder stones. Methods: Demographic and clinical characteristics and pathology results of 5206 patients who underwent cholecystectomy between January 2012 and December 2015 were evaluated retrospectively. Results: Three thousand eight hundred and eighty four (74.6%) patients were female. Pathologic reports showed pre-malignant and malignant lesions in 102 (1.95%) cases. Metaplasia was significantly more common in females, while no significant difference was found in development of dysplasia and cancer between genders. Gallbladder stone was found to be a risk factor for the development of metaplasia. Gallbladder wall thickening and advanced age are the most important risk factors for gallbladder cancer. Conclusion: Female gender and gallstone are important risk factors for the development of metaplasia. Advanced age, gallstone and gallbladder wall thickening on ultrasonography are the most important factors in the development cancer. Cholecystectomy should be kept in mind as the most effective method to prevent cancer development in elderly patients with gallbladder stones.
Citation Count: 1
A Comparative Analysis of Once-daily and Twice-daily Formulation of Tacrolimus in De Novo Kidney Transplant Recipients
(Kare Publ, 2021) Gürkan, Alp; Kartal, Abdulcabbar; Kivilcim, Taner; Filiz, Ali Ilker; Yildiz, Gursel; Gurkan, Alp; Genel Cerrahi / General Surgery
Objectives: We aimed to compare the once-daily and twice-daily formulation of tacrolimus concerning the efficiency and effects on graft function in de novo kidney transplant patients. Methods: Twenty once-daily (TAC-OD) and twenty twice-daily (TAC-BID) tacrolimus administrated de novo kidney recipients who had received initial immunosuppressive therapy according to protocols at our institution (0.2 mg/kg of tacrolimus combined with 1000 milligrams of steroid taper plus 720 mg of mycophenolate and with 2.5mg/kg anti-thymocyte globulin) assessed concerning demographics, drug doses and blood concentration, and graft function. Results: The mean tacrolimus blood concentration measurements were higher in the TAC-OD group in the first sixty days after transplantation, and the TAC- OD group showed more blood concentration overshoots/fluctuations in the first 30 days of the treatment. The initial drug dose was significantly higher in the TAC-OD group than the TAC-BID group (p=0.04). There was no meaningful difference among groups according to graft function (creatinine measurements) (p>0.05). Conclusion: Between de novo kidney recipients, the new TAC-OD formulation presents a similar short-term efficacy profile as TACBID. However, a higher daily dosage of TAC-OD is needed to achieve similar blood concentrations in the early postoperative period.
Citation Count: 4
Comparison of the effects of two different marine-derived omega-3 fatty acid sources, krill oil, and fish oil, on the healing of primary colonic anastomoses after colectomy applied Wistar albino rat model
(Turkish Assoc Trauma Emergency Surgery, 2019) Ferhatoglu, Murat Ferhat; Kivilcim, Taner; Vural, Gurcan; Kartal, Abdulcabbar; Filiz, Ali Ilker; Kebudi, Abut
BACKGROUND: Oils from marine organisms have a different fatty acid composition. Fish oil (FO) has a high content of eicosapentaenoic and docosahexaenoic acids esterified to triacylglycerols; while in krill oil (KO), fatty acids are primarily esterified to phospholipids. This study aimed to compare the efficacy of two different, marine-derived omega-3 fatty acid sources in the wound healing of colon anastomoses rat model. METHODS: For the study, we used 42 male Wistar albino rats. The rats were divided into six groups with seven rats in each group-CO3: left colonic anastomosis (control group), sacrificed on the third day; KO3: left colonic anastomosis + oral KO, sacrificed on the third day; FO3: left colonic anastomosis + oral FO, sacrificed on the third day; CO7: left colonic anastomosis (control group), sacrificed on the seventh day; KO7: left colonic anastomosis + oral KO, sacrificed on the seventh day; FO7: left colonic anastomosis + oral FO, sacrificed on the seventh day. Peritoneal adhesions, anastomotic bursting pressures, hydroxyproline levels, and histological examination of the anastomotic tissue were evaluated. RESULTS: On day 7, bursting pressure and hydroxyproline measurements of the KO group was significantly higher than the FO group (p=0.012; p=0.002, respectively). Also, on day 7, a statistically significant difference was observed between the groups according to inflammatory cell infiltration, fibroblast activity, neoangiogenesis, and collagen deposition in favor of the KO group (p=0.023; p=0.028; p=0.016; p=0.012, respectively). CONCLUSION: Both KO and FO supplementation in patients before colorectal surgery may reduce some risk of anastomotic leakage; and KO might be a better alternative and excellent omega-3 source.
Citation Count: 1
Description and Outcomes of Three Different End-to-Side Microsurgical Techniques for the Anastomosis of Accessory Renal Artery With the Dominant Renal Artery in Kidney Transplantation
(Elsevier Science inc, 2021) Colak, Hulya; Gürkan, Alp; Unverdi, Omer Faruk; Yildiz, Gursel; Gurkan, Alp; Genel Cerrahi / General Surgery
Background. In this study, we compared the outcomes of three different surgical microscope-assisted end-to-side anastomosis techniques between the dominant and accessory renal arteries during living donor kidney transplant. Methods. The demographics, serum creatinine levels, warm and cold ischemia times, rate of complications, and incidence of delayed graft function of 135 kidney recipients were analyzed according to the type of arterial anastomosis. Group A (n = 98) had one dominant renal artery (DRA) with one end-to-side anastomosis to the external iliac artery (EIA) using a surgical microscope. Group B (n = 17) had one DRA plus one accessory renal artery (ARA) with two separate end-to-side anastomoses to the EIA using a surgical microscope. Group C (n = 20) had one DRA with end-to-side anastomosis to the EIA and one ARA with an ex vivo on-bench end-to-side anastomosis to the DRA using a surgical microscope. Results. Compared with groups A and B, the cold ischemia time and the rate of delayed graft function were significantly higher in group C (P <= .001). At 6 months after transplant, group B demonstrated a higher creatinine value (2.40 +/- 3.41 mg/dL) than group A and group B (P = .032). Also, the decrease in creatinine at postoperative month 6 was limited in group B as compared with groups A and C. Conclusions. An end-to-side anastomosis between ARA (group B) and DRA (group A) of the kidney graft using a surgical microscope on the bench ex vivo results in superior outcomes. Single arterial anastomosis techniques are associated with a better function in a 6-month follow-up than two separate arterial anastomoses.
Citation Count: 0
Effect of Dead Space Reduction in Pilonidal Sinus Surgery: Introduction of a Novel Technique
(H M P Communications, 2022) Kartal, Abdulcabbar; Yalcin, Metin; Kivilcim, Taner; Uzunkoy, Ali
Introduction. Pilonidal sinus (PNS) disease affects the skin and subcutaneous tissue of the natal cleft of the buttocks. The treatment is variable and depends on presentation and the extent of disease. The mainstay of surgical management for PNS disease is to excise all sinus tracts and pits. There are numerous surgical techniques and none of them are considered optimal. Residual dead space is responsible for the majority of complications in PNS surgery. Objective. In this study, the authors describe a modified technique of the Karydakis procedure and investigate the effects of this new method. Materials and Methods. In this trial, 80 patients were included between January 2014 and January 2015. A new technique in PNS surgery, which can be described as a modified Karydakis procedure, was performed. In this technique, following total sinus excision, the excised defect was closed with the standard Karydakis method, but in order to reduce the dead space under the standard Karydakis flap, an advancement tissue flap with additional skin excision was performed. During a mean follow-up period of 20 months, some complications occurred, including wound dehiscence, the formation of a seroma, the formation of a hematoma, and infection. These complications were monitored. Results. There were 19 female and 61 male patients with a mean age of 24 years (range, 18-49 years). The mean volume of the sinus was 26 cc (range, 8-80 cc). A total of 10 patients (12.5%) experienced complications. All complications were managed successfully with follow-up treatment and appropriate wound care. Conclusions. The results of this pilot study suggest this technique may be considered as an alternative surgical method in PNS surgery, provided the results are corroborated by further randomized controlled trials.
Citation Count: 13
Intestinal Obstruction due to Bezoar in Elderly Patients: Risk Factors and Treatment Results
(Hindawi Ltd, 2019) Altintoprak, Fatih; Gemici, Eyup; Yildiz, Yasin Alper; Uzunoglu, Mustafa Yener; Kivilcim, Taner
Purpose. Bezoars are foreign particles from the accumulation of indigestible materials in the gastrointestinal system and a rare cause of mechanical intestinal obstruction. We aimed at investigating differences in risk factors for the development of intestinal obstruction associated with bezoar in elderly patients. Methods. Hospital records of patients who underwent surgery associated with phytobezoar between January 2004 and May 2016 were retrospectively evaluated. Patients were divided into two groups [<65 years (Group 1) and 65 years (Group 2)]. Data were examined regarding presence of comorbidity, history of abdominal surgery, operation time, bezoar site, surgical technique, length of hospitalization, morbidity, and mortality. Results. Of 121 patients enrolled, 48 (39.7%) were male and 73 (60.3%) were female (range: 24-86 years). Group 1 consisted of 69 patients aged < 65, while Group 2 consisted of 52 patients aged 65. Comorbidity was reported in 52 (42.9%) patients (mostly diabetes mellitus, 20.7%), while 60 patients (49.6%) had history of abdominal surgery (mostly peptic ulcer, 27.3%). No statistical differences were found between the two groups in terms of sex, bezoar site, surgical technique preferred, history of abdominal surgical intervention, pre- and postoperative CT examination, morbidity rates, and length of hospitalization. But, ratio of peptic ulcer operations history, presence of total comorbidity, and time of surgery decision was higher in Group 2 patients. Conclusion. In bezoar-related intestinal obstruction, duration and outcome of treatment are not affected by age distribution. Possibility of bezoar should primarily be considered in elderly patients with history of peptic ulcer operation.
Citation Count: 0
Intestinal Obstruction due to Bezoar in Elderly Patients: Risk Factors and Treatment Results (vol 2019, 3647356, 2019)
(Hindawi Ltd, 2019) Altintoprak, Fatih; Gemici, Eyup; Yildiz, Yasin Alper; Uzunoglu, Mustafa Yener; Kivilcim, Taner
[No Abstract Available]
Citation Count: 0
Penetration of components of cervical fixation device into esophagus: An unexpected finding for the endoscopist
(Kare Publ, 2019) Ferhatoglu, Murat Ferhat; Kivilcim, Taner
[No Abstract Available]
Citation Count: 4
The Positive Effects of the Human Amniotic Membrane on the Healing of Staple Line After Sleeve Gastrectomy Applied Long-Evans Rat Model
(Springer, 2019) Ferhatoglu, Murat Ferhat; Kivilcim, Taner; Senol, Kazim; Vural, Gurcan; Kartal, Abdulcabbar; Incir, Said; Kebudi, Abut
Background The staple line leakage is a dangerous complication of sleeve gastrectomy. Various strategies have been tried to reduce the leakage risk. The amniotic membrane (AmM) is the inner layer of the placental membranes and has anti-inflammatory, anti-fibrosis, and anti-scarring effects, and it also has lower immune characteristics which are another essential characteristic of AmM concerning its utility for grafting. In this study, we aimed to investigate the impact of AmM on the staple line healing process of sleeve gastrectomy model in rats. Materials and Methods We used twenty-eight Long-Evans rats in this study. Sleeve gastrectomy was performed with tristapler. Fourteen rats served as controls, AmM was applied staple line of the other fourteen. Fourteen animals were sacrificed (seven from the AmM applied group and the other seven from the control group) on the third postoperative day. And, the other fourteen animals were sacrificed (seven from the AmM applied group and seven from the control group) on the seventh postoperative day. The tissue around the staple line was evaluated microscopically and macroscopically, bursting pressures and hydroxyproline levels were also measured. Results The bursting pressure and hydroxyproline measurements of the AmM applied group was significantly higher on the seventh postoperative day (p = 0.015, p = 0.012) Fibroblast activity and neoangiogenesis of the AmM applied group was also significantly higher on the seventh postoperative day (p = 0.004, p = 0.002). Conclusion This study showed that covering of staple line of sleeve gastrectomy model in rats significantly provided higher bursting pressures and increased hydroxyproline levels, fibroblast activity, and neoangiogenesis which may potentially lead a better staple line healing. We think further investigations are needed on this issue.
Citation Count: 3
A Rare Pathology Mimicking the Gallstone: Heterotopic Pancreas in the Gallbladder
(Springernature, 2018) Ferhatoglu, Murat F.; Kivilcim, Taner; Kartal, Abdulcabbar; Filiz, Ali I.
The placement of pancreatic tissue in an organ outside the pancreas is called pancreatic heterotopy. Heterotopic pancreatic (HP) tissue is frequently observed in the stomach and duodenum, while the gallbladder is an extremely rare localization. In this article, we present pancreatic heterotopy located in the gallbladder, a rarely observed embryologic anomaly, with the study of two cases and a review of the literature.
Citation Count: 2
Retrospective Analysis of the first 100 Kidney Transplants at the Istanbul Okan University, Health Application and Research Center
(Kare Publ, 2019) Gürkan, Alp; Kartal, Abdulcabbar; Kivilcim, Taner; Filiz, Ali Ilker; Kebudi, Abut; Gurkan, Alp; Genel Cerrahi / General Surgery
Objectives: The renal transplant program of Istanbul Okan University Hospital started in August 2017. Five cadaveric and 95 living donor kidney transplants have been performed for over 16 months. In this study, we aimed to share our experiences regarding kidney transplantation. Methods: In this study, a retrospective analysis of 100 patients who underwent kidney transplantation at the Istanbul Okan University over 16 months, the Health Application and Research Center was carried out. Patients' demographics, creatinine levels of donors and recipients, co-morbid conditions, postoperative complications, features of arterial anastomosis and arterial variations observed on computed tomography angiography of donor-patient were assessed. Results: Mean age of donor patients was 44.05 +/- 13.76 (18-71) years. All living donors had computed tomography angiography for assessment of the vascular structure of both kidneys. Accessory right kidney artery was the most dominant vascular variation (16.5%). The primary cause of chronic renal disease was diabetes mellitus (36.4%) and hypertension (15.6%). Mean warm and cold ischemia time was 1.82 +/- 0.44 (1-3) and 40.25 +/- 6.12 (31-57) minutes, respectively. The most observed postoperative complication was stenosis of ureter anastomosis (4.1%). End-to-end arterial anastomosis between renal and internal iliac arteries was the most preferred anastomosis (57.2%). Conclusion: Increasing kidney transplantation, which is the most appropriate treatment in terms of cost-effectiveness, will be beneficial for patient health and economy of the country.
Citation Count: 15
Role of Bacteriological Agents in Idiopathic Granulomatous Mastitis: Real or Not?
(Galenos Publ House, 2019) Kivilcim, Taner; Altintoprak, Fatih; Memis, Bahar; Ferhatoglu, Murat Ferhat; Kartal, Abdulcabbar; Dikicier, Enis; Dilek, Fatma Husniye
Objective: Granulomatous mastitis is a rare, benign, chronic inflammatory disease of the breast of unknown etiology. This study evaluated bacteriologic agents that might play a role in the etiology of granulomatous mastitis using a molecular method with a universal primer after isolating deoxyribonucleic acid (DNA) from pathology specimens from patients diagnosed with granulomatous mastitis. Materials and Methods: Breast biopsy material in the pathology department obtained between July 2008 and June 2013 was analyzed. The history of the granulomatous mastitis patients was examined in detail and paraffin block sections of the biopsy material were used to determine the presence of bacteria with a universal DNA primer. Results: This study examined 45 granulomatous mastitis patients who had been diagnosed using excisional, incisional, or core biopsies. We evaluated multiple bacterial taxa, but obtained no positive result using a nucleic-acid-based assay with a universal primer. Conclusion: The etiology of idiopathic granulomatous mastitis remains unclear. Further studies with a large number of patients should aim to identify the causative agent.
Citation Count: 0
What has changed with 2015 American Thyroid Association Management Guidelines
(Turkish Surgical Assoc, 2016) Kivilcim, Taner; Sezer, Sezgin; Makay, Ozer
[No Abstract Available]