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Article: Splenic infarct in a COVID-19 patient under anticoagulant therapy with normal D-dimer levels.

Atıcı, Semra Demirli / Akpınar, Göksever

International journal of surgery case reports

2022 Volume 92, Page(s) 106847

Abstract: Background: Many studies have shown that COVID-19 can progress with coagulopathy and multisystemic thrombotic events. We report a patient who presented with abdominal pain after COVID-19 and was found to have splenic infarction (SI) concomitant with ... ...

Abstract	Background: Many studies have shown that COVID-19 can progress with coagulopathy and multisystemic thrombotic events. We report a patient who presented with abdominal pain after COVID-19 and was found to have splenic infarction (SI) concomitant with acute myocardial infarctus (MI) under anticoagulant treatment. Case presentation: A 45-year-old man was admitted to the emergency department with left-sided abdominal pain radiating through to his back persisting for one day. He had COVID-19 PCR positivity nine days ago. After seven days of hospitalization due to COVID-19 pneumonia, he had been discharged with low-molecular-weight heparin (LMWH). Abdominal computerized tomography (CT) showed SI. His ECG and laboratory parameters were normal except for 17.2 × 10∧3/μL leukocytosis. The anticoagulant drug dose that he was taking was increased to 2 × 0.6 mL during hospitalization. He described new-onset chest pain during follow-up. Acute anterior MI was detected on ECG. Successful percutaneous coronary angiography was performed by cardiologists. No problems were observed in the follow-up. The patient was discharged on the fifth day of conservative treatment due to splenic infarction. Conclusion: Thrombosis prophylaxis with prophylactic doses of LMWH in hospitalized COVID-19 patients may not be sufficient to prevent the development of coagulopathy in patients. Abdominal-visceral thromboembolism should be suspected in a COVID-19-positive patient presenting with abdominal pain despite receiving anticoagulant therapy and normal d-dimer levels.
Language	English
Publishing date	2022-02-18
Publishing country	Netherlands
Document type	Case Reports
ISSN	2210-2612
ISSN	2210-2612
DOI	10.1016/j.ijscr.2022.106847
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Article ; Online: The effect of body mass ındex on parathyroidectomy complications in primary hyperparathyroidism.

Akpinar, Göksever / Ustun, Mehmet

Cirugia y cirujanos

2022 Volume 90, Issue 5, Page(s) 623–626

Abstract: Objective: There are few studies evaluating the effect of high body mass index (BMI) on parathyroid surgery. The aim of this study was to examine the relationship between the BMI and post-operative outcome of the patients who were operated for primary ... ...

Title translation	El efecto del índice de masa corporalsobrelas complicaciones de la paratiroidectomía en el hiper sparatiroidismoprimario.
Abstract	Objective: There are few studies evaluating the effect of high body mass index (BMI) on parathyroid surgery. The aim of this study was to examine the relationship between the BMI and post-operative outcome of the patients who were operated for primary hyperparathyroidism (PHP). Material and methods: Hospital files of patients who were operated for PHP between January 2013 and January 2020 were reviewed retrospectively. Patients operated by surgeons experienced in endocrine surgery (more than 25 cases/year) were included in the study. Patients were divided into two groups according to BMI (Group 1 < and Group 2 ≥ 25). Data were analyzed. Results: Groups were similar in terms of age (p = 0.715) and sex (p = 0.253). There was no significant difference between groups regarding postoperative hospital stay (p = 0.561), rate of transient hypocalcemia (p = 0.748), or permanent hypocalcemia (p = 0.530). The mean operative time was shorter in Group 1 (84 min in Group 1 and 70 min in Group 2, p = 0.045). Conclusion: Parathyroid surgery can safely be performed in patients with high BMI by surgeons experienced in endocrine surgery.
MeSH term(s)	Humans ; Parathyroidectomy ; Hyperparathyroidism, Primary/surgery ; Hyperparathyroidism, Primary/complications ; Body Mass Index ; Hypocalcemia/etiology ; Retrospective Studies ; Postoperative Complications/epidemiology ; Postoperative Complications/etiology ; Postoperative Complications/surgery
Language	English
Publishing date	2022-11-03
Publishing country	Mexico
Document type	Journal Article
ZDB-ID	730699-4
ISSN	2444-054X ; 0009-7411
ISSN (online)	2444-054X
ISSN	0009-7411
DOI	10.24875/CIRU.22000137
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Article ; Online: Isolated Metastasis of Pancreas due to Endometrial Carcinoma.

Atici, Semra Demirli / Akpinar, Goksever / Sert, Ismail / Tugmen, Cem

Journal of the College of Physicians and Surgeons--Pakistan : JCPSP

2021 Volume 30, Issue 12, Page(s) 1362–1363

MeSH term(s)	Endometrial Neoplasms ; Female ; Humans ; Pancreas
Language	English
Publishing date	2021-01-04
Publishing country	Pakistan
Document type	Journal Article
ZDB-ID	2276646-7
ISSN	1681-7168 ; 1022-386X
ISSN (online)	1681-7168
ISSN	1022-386X
DOI	10.29271/jcpsp.2020.12.1362
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Article ; Online: Ectopic ureter associated with Zinner's syndrome in a kidney recipient: case report and literature review.

Tuncer, Korhan / Kilinc, Gizem / Sert, Ismail / Akpinar, Goksever / Tugmen, Cem

Revista da Associacao Medica Brasileira (1992)

2020 Volume 66, Issue 5, Page(s) 692–695

Abstract: INTRODUCTION Zinner's Syndrome is a triad of mesonephric duct anomalies comprising unilateral renal agenesis, seminal vesicle cyst, and ejaculatory duct obstruction. In this study, we present a kidney recipient with ectopic ureter associated with Zinner' ... ...

Abstract	INTRODUCTION Zinner's Syndrome is a triad of mesonephric duct anomalies comprising unilateral renal agenesis, seminal vesicle cyst, and ejaculatory duct obstruction. In this study, we present a kidney recipient with ectopic ureter associated with Zinner's syndrome and a literature review. CASE PRESENTATION A 59-year-old male with a history of chronic kidney disease and left renal agenesis underwent deceased donor kidney transplantation. After securing optimal renal functions, the patient underwent abdominal computed tomography (CT) scan for the seroma that occurred under the incision. The final diagnosis was an ectopic distal ureter ending in the seminal vesicle cyst's wall and ipsilateral renal agenesis. The patient was discharged without any complications and the clinical follow up was uneventful. DISCUSSION AND CONCLUSION Congenital seminal vesicle disorders are usually associated with ipsilateral urinary duct anomalies stemming from the same embryonic structure. To our knowledge, this is the first case report that describes kidney transplantation in a patient with ipsilateral renal agenesis and ectopic ureter ending in the seminal vesicle cyst. In patients with renal agenesis, during the ipsilateral urinary tract anastomosis, the possibility of ectopic ureter should be kept in mind otherwise graft loss can occur with a high morbidity rate.
MeSH term(s)	Cysts ; Genital Diseases, Male ; Humans ; Kidney ; Kidney Transplantation ; Male ; Middle Aged ; Seminal Vesicles ; Ureter
Language	English
Publishing date	2020-07-03
Publishing country	Brazil
Document type	Case Reports ; Journal Article ; Review
ZDB-ID	731969-1
ISSN	1806-9282 ; 0104-4230 ; 0004-5241 ; 0102-843X
ISSN (online)	1806-9282
ISSN	0104-4230 ; 0004-5241 ; 0102-843X
DOI	10.1590/1806-9282.66.5.692
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Article ; Online: Corticosteroid associated lupus pancreatitis.

Atıcı, Semra Demirli / Engin, Ömer / Akpınar, Göksever / Tuğmen, Cem

Revista da Associacao Medica Brasileira (1992)

2020 Volume 66, Issue 10, Page(s) 1414–1416

Abstract: The relationship between acute pancreatitis and the administration of glucocorticoids is unclear because most reported cases have been diagnosed with systemic vascular diseases, such as systemic lupus erythematosus, which may be responsible for ... ...

Abstract	The relationship between acute pancreatitis and the administration of glucocorticoids is unclear because most reported cases have been diagnosed with systemic vascular diseases, such as systemic lupus erythematosus, which may be responsible for pancreatitis. A 22-year-old woman with eye involvement of a newly diagnosed systemic lupus erythematosus was admitted to our hospital. Pulse intravenous methylprednisolone therapy was given at 1mg/kg day for 3 days, and oral prednisolone at 40 mg/day thereafter. During pulse steroid therapy, she had abdominal pain, back pain, distention, nausea, and vomiting. Her physical examination was compatible with acute abdomen and peritonitis. Abdomen Computerized Tomography scan revealed diffuse liquid perihepatic and perisplenic area with heterogeneity around the mesentery. Due to the symptoms of acute abdomen, explorative laparotomy was performed. There was diffuse free fluid in the abdomen and edematous changes were observed around the pancreas. Amylase and lipase from intraabdominal fluid were studied and found to be high. The postoperative prednol dose was reduced carefully. On the sixth postoperative day, the drain was removed, and the patient was discharged without any problem. Physicians should keep in mind that acute pancreatitis may also be a cause of differential diagnosis of newly developed abdominal pain in patients receiving pulse steroid therapy with a normal level of serum amylase and lipase.
MeSH term(s)	Acute Disease ; Adrenal Cortex Hormones ; Female ; Humans ; Lupus Erythematosus, Systemic/chemically induced ; Lupus Erythematosus, Systemic/complications ; Methylprednisolone/adverse effects ; Pancreatitis/chemically induced ; Young Adult
Chemical Substances	Adrenal Cortex Hormones ; Methylprednisolone (X4W7ZR7023)
Language	English
Publishing date	2020-11-10
Publishing country	Brazil
Document type	Case Reports ; Journal Article
ZDB-ID	731969-1
ISSN	1806-9282 ; 0104-4230 ; 0004-5241 ; 0102-843X
ISSN (online)	1806-9282
ISSN	0104-4230 ; 0004-5241 ; 0102-843X
DOI	10.1590/1806-9282.66.10.1414
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Article ; Online: Solid pseudopapillary neoplasms of the pancreas: Case series with a review of the literature.

Uğuz, Alper / Ünalp, Ömer Vedat / Akpınar, Göksever / Karaca, Can Avni / Oruç, Nevin / Nart, Deniz / Yılmaz, Funda / Aydın, Ahmet / Çoker, Ahmet

The Turkish journal of gastroenterology : the official journal of Turkish Society of Gastroenterology

2021 Volume 31, Issue 12, Page(s) 930–935

Abstract: Background/aims: The solid pseudopapillary neoplasms are quite rare tumors of the pancreas, comprising roughly 1-2% of all pancreatic neoplasms. It has a low malignant potential and usually affects young females. Despite increasing number of articles in ...

Abstract	Background/aims: The solid pseudopapillary neoplasms are quite rare tumors of the pancreas, comprising roughly 1-2% of all pancreatic neoplasms. It has a low malignant potential and usually affects young females. Despite increasing number of articles in the last decade, there is still debate on the pathogenesis, malignant potential and optimal surgical strategy for the solid pseudopapillary neoplasms. Materials and methods: Medical recordings of 326 patients who were operated due to pancreatic mass were retrospectively analyzed. Patient demographics, presenting symptoms, surgical and pathologic characteristics of the tumor, postsurgical course, long-term survival, and other relevant data were extracted from patients' charts. Results: Majority of the patients were female in consistency with the classic data in the literature. All the patients underwent curative intent resections. Tumors were commonly localized in the tail of the pancreas making distal pancreatectomy the most commonly performed surgical procedure. Mean tumor diameter was 5.8 centimeters with tumor sizes ranging from 1 to 19 cm. Conclusion: The solid pseudopapillary neoplasms of the pancreas is a rare tumor with low malignant potential, which is more common in females of reproductive age, with abdominal pain being their most common presentation. The short-term outcomes in patients following surgical R0 resection are excellent. However, proximal placement of the tumor and female gender may have slightly worse prognosis. We hope that our findings from a series of patients represent a contribution to the existing literature on SPN, and authors declare their willingness to provide further details for future meta-analyses.
MeSH term(s)	Adult ; Female ; Humans ; Male ; Middle Aged ; Neoplasms, Cystic, Mucinous, and Serous/mortality ; Neoplasms, Cystic, Mucinous, and Serous/pathology ; Neoplasms, Cystic, Mucinous, and Serous/surgery ; Pancreas/pathology ; Pancreatectomy ; Pancreatic Neoplasms/mortality ; Pancreatic Neoplasms/pathology ; Pancreatic Neoplasms/surgery ; Prognosis ; Retrospective Studies ; Sex Factors
Language	English
Publishing date	2021-02-24
Publishing country	Turkey
Document type	Journal Article ; Review
ZDB-ID	1340275-4
ISSN	2148-5607 ; 1300-4948
ISSN (online)	2148-5607
ISSN	1300-4948
DOI	10.5152/tjg.2020.19227
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Article ; Online: Serum markers for the early diagnosis of intestinal anastomotic leak after gyne-oncological operations.

Kuru, Oguzhan / Cakır, Ilker / Akgor, Utku / Sen, Serhat / Gorgulu, Goksen / Ozdemir, Hasan Emre / Basok, Banu Isbilen / Akpınar, Goksever / Gokcu, Mehmet

International journal of clinical practice

2021 Volume 75, Issue 11, Page(s) e14609

Abstract: Objective: To analyse the serum markers for the early diagnosis of intestinal anastomotic leak (AL) after the gyne-oncological operations.: Methods: Between September 2017 and March 2021, patients with an intestinal anastomosis performed during the ... ...

Abstract	Objective: To analyse the serum markers for the early diagnosis of intestinal anastomotic leak (AL) after the gyne-oncological operations. Methods: Between September 2017 and March 2021, patients with an intestinal anastomosis performed during the gyne-oncological surgeries were identified from a tertiary centre in Turkey. As the local guideline of the clinic, all these patients were followed by measuring serum samples including procalcitonin (PCT) and C-reactive protein (CRP) on postoperative day (POD) 1 through the day of discharge or the day of re-operation for AL. Results: 12.5% (5/40) of the patients suffered an AL and 4 of them were re-operated. The mean albumin values on POD 3-4 and the mean platelet values on POD 1 were lower in the AL group (P < .05). Although it was not statistically significant (P > .05), median PCT values (ng/mL) on POD 8-10 were higher in the AL group compared with no leak group. The best cut-off point for PCT on POD 9 was determined to be 0.11 ng/mL (AUC: 0.917, Sensitivity = 100.0%, specificity = 66.7%, positive predictive value = 66.7%, negative predictive value = 100.0%). Conclusion: Serum PCT and CRP concentrations were not found to be helpful for the early diagnosis of AL in patients operated for gyne-oncological malignancies. Low levels of albumin and platelets in the first days after the operation may be clue for a possible AL.
MeSH term(s)	Anastomotic Leak/diagnosis ; Anastomotic Leak/etiology ; Biomarkers ; C-Reactive Protein ; Early Diagnosis ; Humans ; Predictive Value of Tests
Chemical Substances	Biomarkers ; C-Reactive Protein (9007-41-4)
Language	English
Publishing date	2021-07-14
Publishing country	England
Document type	Journal Article
ZDB-ID	1386246-7
ISSN	1742-1241 ; 1368-5031
ISSN (online)	1742-1241
ISSN	1368-5031
DOI	10.1111/ijcp.14609
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Article: Treatment of pilonidal disease by phenol application.

Emiroğlu, Mustafa / Karaali, Cem / Esin, Hüseyin / Akpınar, Göksever / Aydın, Cengiz

Turkish journal of surgery

2017 Volume 33, Issue 1, Page(s) 5–9

Abstract: The literature indicates various approaches regarding the properties of phenol, the target patient group, and the complication and recurrence rates. Although phenol is most frequently used to treat the fistulated form of the disease, it can also be ... ...

Abstract	The literature indicates various approaches regarding the properties of phenol, the target patient group, and the complication and recurrence rates. Although phenol is most frequently used to treat the fistulated form of the disease, it can also be applied for other types. The overall success and complication rates of the application is reported as 62-95% and 0%-2%, respectively. Phenol treatment in pilonidal disease can be used more frequently as an alternative method with acceptable success, complication, and recurrence rates.
Language	English
Publishing date	2017-03-01
Publishing country	Turkey
Document type	Journal Article ; Review
ISSN	2564-6850
ISSN	2564-6850
DOI	10.5152/UCD.2016.3532
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Article: Adjuvant versus neoadjuvant chemoradiotherapy in distal rectal cancer: Comparison of two decades in a single center.

Zengel, Baha / Uslu, Adam / Adıbelli, Zehra / Yetiş, Halit / Cengiz, Fevzi / Aykas, Ahmet / Şimşek, Cenk / Akpınar, Göksever / Eliyatkın, Nuket / Duran, Ali

Ulusal cerrahi dergisi

2015 Volume 31, Issue 4, Page(s) 218–223

Abstract: Objective: Standard surgery alone was not able to decrease local recurrence (LR) rate below 20% in rectal cancer treatment. Thus, many centers administered neoadjuvant radiotherapy (preopRTx) with or without concomitant chemotherapy for the prevention ... ...

Abstract	Objective: Standard surgery alone was not able to decrease local recurrence (LR) rate below 20% in rectal cancer treatment. Thus, many centers administered neoadjuvant radiotherapy (preopRTx) with or without concomitant chemotherapy for the prevention of LR. In this study, the results of 164 consecutive patients with mid- and distal rectal cancer who received surgery and adjuvant chemoradiotherapy (Group A) or neoadjuvant chemoradiotherapy (Group NA) followed by surgery are presented. Material and methods: The staging system used in this study is that of the American Joint Committee on Cancer (AJCC), also known as the TNM system. Eligible patients were required to have radiologically assessed stage 1 (only T2N0M0) to stage 3C (T4bN1-2M0) tumor with pathologically confirmed R0 resection. The surgical method was total mesorectal excision (TME). Radiotherapy was applied with daily 180 cGy fractions for 28 consecutive days. Chemo-therapy comprised 5-fluorouracil (450 mg/m(2)/d) and leucovorin (20 mg/m(2)/d) bolus at days 1-5 and 29-33. Results: Nine patients (13%) in Group NA achieved pathologic complete response (pCR). In Group NA and Group A, locoregional recurrence (LRR) rates were 6.7% and 30.8%, (p<0.001), the mean LR-free survival was 190.0±7.3 months and 148.0±11.7 months (p=0.002) and the mean overall survival (OS) was 119.2±15.3 months and 103.0±9.4 months (p=0.23), respectively. A significant difference with regard to LR has been obtained with a statistical power of 0.92. Secondary outcome measures (DFS and OS) have not been met. Conclusion: Neoadjuvant chemoradiotherapy with TME is an efficient treatment protocol, particularly for the treatment of magnetic resonance imaging-staged 2A to 3C patients with two or three distal rectal adenocarcinomas. Given that a considerable proportion of patients with cT2N0M0 would develop pCR, this method of treatment can be considered for further studies.
Language	English
Publishing date	2015-12-01
Publishing country	Turkey
Document type	Journal Article
ZDB-ID	1394172-0
ISSN	1300-0705
ISSN	1300-0705
DOI	10.5152/UCD.2015.3015
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Article: Sentinel lymph node biopsy in breast cancer: predictors of axillary and non-sentinel lymph node involvement.

Postacı, Hakan / Zengel, Baha / Yararbaş, Ulkem / Uslu, Adam / Eliyatkın, Nuket / Akpınar, Göksever / Cengiz, Fevzi / Durusoy, Raika

Balkan medical journal

2013 Volume 30, Issue 4, Page(s) 415–421

Abstract: Background: Sentinel lymph node biopsy is a standard method for the evaluation of axillary status in patients with T1-2N0M0 breast cancers.: Aims: To determine the prognostic significance of primary tumour-related clinico-histopathological factors on ...

Abstract	Background: Sentinel lymph node biopsy is a standard method for the evaluation of axillary status in patients with T1-2N0M0 breast cancers. Aims: To determine the prognostic significance of primary tumour-related clinico-histopathological factors on axillary and non-sentinel lymph node involvement of patients who underwent sentinel lymph node biopsy. Study design: Retrospective clinical study. Methods: In the present study, 157 sentinel lymph node biopsies were performed in 151 consecutive patients with early stage breast cancer between June 2008 and December 2011. Results: Successful lymphatic mapping was obtained in 157 of 158 procedures (99.4%). The incidence of larger tumour size (2.543±1.21 vs. 1.974±1.04), lymphatic vessel invasion (70.6% vs. 29.4%), blood vessel invasion (84.2% vs. 15.8%), and invasive lobular carcinoma subtype (72.7% vs. 27.3%) were statistically significantly higher in patients with positive SLNs. Logistic stepwise regression analysis disclosed tumour size (odds ratio: 1.51, p=0.0021) and lymphatic vessel invasion (odds ratio: 4.68, p=0.001) as significant primary tumour-related prognostic determinants of SLN metastasis. Conclusion: A close relationship was identified between tumour size and lymphatic vessel invasion of the primary tumour and axillary lymph node involvement. However, the positive predictive value of these two independent variables is low and there is no compelling evidence to recommend their use in routine clinical practice.
Language	English
Publishing date	2013-12-01
Publishing country	Turkey
Document type	Journal Article
ZDB-ID	2612982-6
ISSN	2146-3131 ; 2146-3123
ISSN (online)	2146-3131
ISSN	2146-3123
DOI	10.5152/balkanmedj.2013.9591
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