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  1. Article ; Online: Effect of Early Versus Delayed Laparoscopic Cholecystectomy on Postoperative Morbidity and Difficult Cholecystectomy in Patients With Grade II Cholecystitis According to Tokyo 2018 Guidelines: A Prospective Study.

    Kilinc Tuncer, Gizem / Tuncer, Korhan / Sert, Ismail / Emiroglu, Mustafa

    The American surgeon

    2023  Volume 89, Issue 12, Page(s) 5775–5781

    Abstract: Background: The timing of the cholecystectomy in patients with acute cholecystitis is still controversial. In our study, we aimed to investigate the effect of early and delayed cholecystectomy on difficult cholecystectomy, morbidity and mortality in ... ...

    Abstract Background: The timing of the cholecystectomy in patients with acute cholecystitis is still controversial. In our study, we aimed to investigate the effect of early and delayed cholecystectomy on difficult cholecystectomy, morbidity and mortality in patients diagnosed with Grade II acute cholecystitis according to Tokyo 2018 guidelines.
    Methods: Patients who presented to the emergency department and diagnosed with Grade II acute cholecystitis between December 2019 and June 2021 were included in this study. Cholecystectomy was performed within 7 days and 6 weeks after symptom onset. The effect of early and delayed cholecystectomy was observed.
    Results: A total of 92 patients were included in the study. The timing of cholecystectomy was not a risk factor for mortality, morbidity and difficult cholecystectomy. The conversion rate was higher in delayed group (
    Conclusions: Delayed cholecystectomy does not facilitate cholecystectomy in patients with Grade II acute cholecystitis. Early cholecystectomy can be performed safely and high CRP levels can be used to determine difficult cholecystectomy in early period.
    MeSH term(s) Humans ; Cholecystectomy, Laparoscopic ; Prospective Studies ; Tokyo ; Cholecystectomy ; Cholecystitis/surgery ; Cholecystitis, Acute/surgery ; Cholecystitis, Acute/diagnosis
    Language English
    Publishing date 2023-05-09
    Publishing country United States
    Document type Journal Article
    ZDB-ID 202465-2
    ISSN 1555-9823 ; 0003-1348
    ISSN (online) 1555-9823
    ISSN 0003-1348
    DOI 10.1177/00031348231175113
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  2. Article ; Online: Effectiveness of laser hemorrhoidoplasty in the treatment of hemorrhoidal disease.

    Dursun, Ayberk / Tuncer, Gizem Kilinc / Tuncer, Korhan / Karaali, Cem / Erdoğan, Gürsoy / Emiroglu, Mustafa

    Cirugia y cirujanos

    2023  Volume 91, Issue 2, Page(s) 179–185

    Abstract: Introduction: Minimally invasive techniques still continue to maintain their popularity in hemorrhoidal disease. In this study, we aimed to present the symptomatic recovery and recurrence rates, post-operative pain levels, and complication rates of ... ...

    Title translation Eficacia de la hemorroidoplastia láser en el tratamıento de la enfermedad hemorroidal.
    Abstract Introduction: Minimally invasive techniques still continue to maintain their popularity in hemorrhoidal disease. In this study, we aimed to present the symptomatic recovery and recurrence rates, post-operative pain levels, and complication rates of patients treated with the laser hemorrhoidoplasty (LHP) method in our clinic.
    Methods: The data of patients who underwent LHP due to Grades 2, 3, and 4 internal hemorrhoidal disease in our clinic were reviewed retrospectively. The patients enrolled in the study were followed for at least 6 months (6 months, 1 year, and 2 years) and their results were analyzed.
    Results: A total of 103 patients were included in the study. Seventy-five (72.8%) of them were male and the mean age was 41.6 ± 13.6 years. The mean operation time was 17.9 ± 5.2 min and minor complications developed in 3 (2.9%) patients postoperatively. Mean time to return to normal daily life was 2.17 (1-11) days. Recurrence developed in 16 (17.6%) patients with Grades 2 and 3 disease and in 6 (50%) of 12 patients with Grade 4 disease (p = 0.019).
    Conclusion: LHP is a popular procedure which is effective in selected patient groups with acceptable recurrence rates.
    MeSH term(s) Humans ; Male ; Adult ; Middle Aged ; Female ; Hemorrhoids/surgery ; Hemorrhoids/complications ; Hemorrhoidectomy/adverse effects ; Hemorrhoidectomy/methods ; Retrospective Studies ; Lasers ; Pain, Postoperative/epidemiology ; Pain, Postoperative/etiology ; Treatment Outcome ; Ligation
    Language English
    Publishing date 2023-04-21
    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.22000287
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  3. Article: Effect of preoperative skeletal muscle area and prognostic nutritional index values on postoperative morbidity and mortality in patients with gastric cancer: a single-center retrospective analysis.

    Tuncer, Korhan / Sert, Ismail / Kilinc, Gizem / Tugmen, Cem / Emiroglu, Mustafa

    Acta chirurgica Belgica

    2021  Volume 123, Issue 3, Page(s) 251–256

    Abstract: Introduction: The aim of this study was to determine the impact of preoperative prognostic nutritional index (PNI) value and skeletal muscle area (SMA) on short-term outcomes of patients with gastric cancer.: Patients and methods: A total of 107 ... ...

    Abstract Introduction: The aim of this study was to determine the impact of preoperative prognostic nutritional index (PNI) value and skeletal muscle area (SMA) on short-term outcomes of patients with gastric cancer.
    Patients and methods: A total of 107 patients underwent gastrectomy due to gastric cancer between January 2016 and December 2019 were retrospectively analyzed. The patients were divided into groups according to the determined PNI and SMA cutoff values. Clinicopathological features and short-term results were compared.
    Results: Overall morbidity was 29% (
    Conclusions: As a result, preoperative SMA and PNI values were found closely related to the postoperative hospital stay, morbidity and mortality results of patients with gastric cancer. Preoperative nutritional support may help to overcome longer hospital stay, higher mortality and morbidity rates in patients with gastric cancer.
    MeSH term(s) Male ; Humans ; Female ; Nutrition Assessment ; Retrospective Studies ; Prognosis ; Sarcopenia/complications ; Sarcopenia/pathology ; Stomach Neoplasms/pathology ; Muscle, Skeletal/pathology ; Morbidity ; Gastrectomy/adverse effects ; Nutritional Status
    Language English
    Publishing date 2021-09-15
    Publishing country England
    Document type Journal Article
    ZDB-ID 210274-2
    ISSN 0001-5458
    ISSN 0001-5458
    DOI 10.1080/00015458.2021.1977462
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  4. Article ; Online: Effect of skeletal muscle area and prognostic nutritional index in periampullary tumors.

    Kilinc-Tuncer, Gizem / Sert, Ismail / Tuncer, Korhan / Sarioglu, Orkun / Yesilyurt, Degercan / Karaali, Cem / Emiroglu, Mustafa

    Cirugia y cirujanos

    2023  Volume 91, Issue 1, Page(s) 73–78

    Abstract: Introduction: The skeletal muscle area (SMA) and prognostic nutritional index (PNI) are both considered as predictive parameters for mortality and morbidity for various type of cancer. In this study, we aimed to identify the effects of pre-operative SMA ...

    Title translation Efecto del área del músculo esquelético y del índice nutricional pronóstico en los tumores periampulares.
    Abstract Introduction: The skeletal muscle area (SMA) and prognostic nutritional index (PNI) are both considered as predictive parameters for mortality and morbidity for various type of cancer. In this study, we aimed to identify the effects of pre-operative SMA and PNI values on post-operative mortality and morbidity in patients with periampullary region tumors (PRT).
    Methods: Patients between 2010 and 2020 were retrospectively analyzed and divided into two groups according to SMA and PNI cutoff values. Univariate and multivariate analysis was performed to find potential risk factors.
    Results: The mean age was 65.94 ± 11.242 and 54 (60.6%) of the patients were male. Hypertension was found a reducing factor for morbidity in both univariate and multivariate analysis (p = 0.039; p = 0.045). Chronic obstructive pulmonary disease and low PNI were found as factors affecting mortality in univariate analysis (p = 0.046; p = 0.014). However, only low PNI was found as an enhancing factor for mortality in multivariate analysis.
    Conclusion: Although SMA is not a risk factor for post-operative morbidity and mortality, PNI can be considered as a risk factor for mortality in patients with PRT.
    MeSH term(s) Humans ; Male ; Middle Aged ; Aged ; Female ; Nutrition Assessment ; Prognosis ; Nutritional Status ; Retrospective Studies ; Stomach Neoplasms/pathology
    Language English
    Publishing date 2023-02-08
    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.21000563
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  5. Article: National Consensus on Oncoplastic Breast Conserving Surgery in Turkey: Position Paper for the Standardization of Surgical Practice.

    Emiroglu, Mustafa / Karaali, Cem / Oztop, Mehmet B / Gulluoglu, Bahadır M

    Turkish journal of surgery

    2020  Volume 36, Issue 3, Page(s) 271–277

    Abstract: Objectives: The algorithms that define most of the application of oncoplastic breast conserving surgery (OBCS) in breast cancer patients are not clearly defined. Therefore, a consensus survey was conducted between the leading and experienced breast ... ...

    Abstract Objectives: The algorithms that define most of the application of oncoplastic breast conserving surgery (OBCS) in breast cancer patients are not clearly defined. Therefore, a consensus survey was conducted between the leading and experienced breast surgeons and oncoplastic breast surgeons in Turkey on the controversial areas of oncoplastic breast surgery.
    Material and methods: This consensus survey was carried out on-line through the Consensus software program (www.consensuss.com) under the roof of Turkish Federation of National Societies for Breast Diseases (TFNSBD). After finalizing each proposition, web-based remote access consensus process was performed on the Likert scale using Delphi method with the Consensus (www.consensuss.com) software program. Through the related software, an invitation was sent to 111 people who had at least 5 years of general surgery expertise in Turkey, and who devoted more than 50% of their daily clinical practice to the treatment and surgery of breast diseases.
    Results: Sixty-two out of 111 people accepted to participate in the panel and made an on-line evaluation. According to the consensus results; Lumpectomy area should be done by placing the clips on at least four walls of the cavity, if the margin of the tumor is clear in central tumors, the distance between the tumor and the nipple is not significantly important, oncoplastic techniques may be used in patients with locally advanced breast cancer after neoadjuvant chemotherapy, in patients who have macromastia with ductal carcinoma in situ or breast cancer, OBCS techniques can be performed, and OBCS should be evaluated in terms of breast aesthetics. After OBCS, re-excision can be performed at a re-do setting in cases with involved surgical margins.
    Conclusion: Our consensus results may provide a basis for the development of some standards in OBCS.
    Language English
    Publishing date 2020-09-28
    Publishing country Turkey
    Document type Journal Article
    ISSN 2564-6850
    ISSN 2564-6850
    DOI 10.47717/turkjsurg.2020.4639
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  6. Article ; Online: Duct-to-Mucosa Pancreaticojejunostomy with Less Serosal Stitches: A Different Approach to Well-known Problem.

    Sert, Ismail / Yesilyurt, Degercan / Ertekin, Suleyman Caglar / Karaali, Cem / Emiroglu, Mustafa

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

    2021  Volume 32, Issue 1, Page(s) 75–80

    Abstract: Objective: To describe a new approach (duct-to-mucosa pancreaticojejunostomy with less serosal stiches) for postoperative pancreatic fistula (POPF) in pancreaticoduodenectomy.: Study design: An observational study.: Place and duration of study: ... ...

    Abstract Objective: To describe a new approach (duct-to-mucosa pancreaticojejunostomy with less serosal stiches) for postoperative pancreatic fistula (POPF) in pancreaticoduodenectomy.
    Study design: An observational study.
    Place and duration of study: Tepecik Training and Research Hospital, Izmir, Turkey, between January 2019 and May 2020.
    Methodology: Medical records of 45 patients, who underwent pancreaticoduodenectomy by the same general surgeon between January 2019 and May 2020, were reviewed retrospectively. Pylorus-preserved pancreaticoduodenectomy was performed for all patients. Duct-to-mucosa PJ with less serosal suture technique was used for all patients in reconstruction after pancreaticoduodenectomy. Definition of the ISGPS was used for the POPF and only grade B and C fistulas were accepted as clinically relevant POPF. Here, the descriptive measures were reported.
    Results: Seventeen (17) of the forty-five (45) patients were females and median age was sixty- six (66) years. The majority of the underlying disease was pancreatic adoneocarcinoma. Hyperbilirunemia was seen in 15 patients. Median operation time was 360 minutes. Number of patients with pancreatic duct size <3 mm was five. Rate of soft pancreas texture was 33.3%. Lastly, the number of patients that underwent vascular resection or additional organ resection were 6 (13.3%) and 8 (17.8%), respectively. Clinically relevant POPF according to ISGPS was seen in 6 patients (grade B:4 and grade C:2). The most prevalent postoperative complication was surgical site infection at a rate of 40%. There was no POPF related mortality.
    Conclusion: Two-layer duct-to-mucosa pancreaticojejunostomy with less serosal stitches technique has acceptable pancreatic fistula rates. This technique could be used by surgeons who are faced with challenges with the duct-to-mucosa anastomosis due to aforementioned causes. Large multi-centre randomised future studies are required to confirm these findings. Key Words: Postoperative pancreatic fistula, Surgical technique, Duct-to-mucosa pancreaticojejunostomy, Less serosal stiches.
    MeSH term(s) Female ; Humans ; Mucous Membrane ; Pancreatic Fistula/etiology ; Pancreaticoduodenectomy/adverse effects ; Pancreaticojejunostomy/adverse effects ; Postoperative Complications/epidemiology ; Postoperative Complications/surgery ; Retrospective Studies
    Language English
    Publishing date 2021-12-20
    Publishing country Pakistan
    Document type Journal Article ; Observational Study
    ZDB-ID 2276646-7
    ISSN 1681-7168 ; 1022-386X
    ISSN (online) 1681-7168
    ISSN 1022-386X
    DOI 10.29271/jcpsp.2022.01.75
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  7. Article: National study on use of artificial intelligence in breast disease and cancer.

    Emiroglu, Mustafa / Esin, Huseyin / Erdogan, Mihriban / Ugurlu, Levent / Dursun, Ayberk / Mertoglu, Suleyman / Kiziloglu, Ilker / Karaali, Cem

    Bratislavske lekarske listy

    2022  Volume 123, Issue 3, Page(s) 191–196

    Abstract: Background: The aim of this study was to examine the thoughts, reservations, approaches and perspectives on the future of artificial intelligence (AI) held by physicians specializing in breast healthcare in our country.: Methods: Our survey was sent ... ...

    Abstract Background: The aim of this study was to examine the thoughts, reservations, approaches and perspectives on the future of artificial intelligence (AI) held by physicians specializing in breast healthcare in our country.
    Methods: Our survey was sent to the members of the Federation of Turkish Breast Disease Associations (MHDF) by e-mail. The survey investigates the attitudes towards the use of AI in breast disease and cancer, including demographic characteristics of the participants, their daily practice and approaches, and their stance on the future.
    Results: The questionnaire was sent to a total of 1,890 people via e-mail. 108 (40.1 %) participants believed that the use of AI in breast disease would improve their field of expertise moderately, 103 (38.3 %) expected this improvement to be considerable. 169 (70.3 %) respondents identified 'rapid diagnosis' as the most important advantage of AI. 123 (45.7 %) participants considered concerns about potential medical errors and liability issues to be the most worrying aspects of AI.
    Conclusion: According to our study, the use of AI technology in the diagnosis and treatment of breast disease and cancer seems to be beneficial for both physicians and patients. However, physicians have some concerns about possible medical errors and liability issues that AI might cause (Tab. 1, Ref. 25).
    MeSH term(s) Artificial Intelligence ; Breast Diseases ; Humans ; Neoplasms ; Surveys and Questionnaires
    Language English
    Publishing date 2022-03-28
    Publishing country Slovakia
    Document type Journal Article
    ZDB-ID 127421-1
    ISSN 0006-9248
    ISSN 0006-9248
    DOI 10.4149/BLL_2022_032
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  8. Article ; Online: Granulomatous Mastitis: A Clinical and Diagnostic Dilemma.

    Pala, Emel Ebru / Ekmekci, Sumeyye / Kilic, Melis / Dursun, Ayberk / Colakoglu, Gul / Karaali, Cem / Emiroglu, Mumin / Emiroglu, Mustafa

    Turk patoloji dergisi

    2021  Volume 38, Issue 1, Page(s) 40–45

    Abstract: Objective: Granulomatous mastitis (GM) is a challenging inflammatory disorder of the breast. In this study we aimed to present the detailed clinical and morphological features of GM cases, diagnostic clues for specific and idiopathic etiologies, the ... ...

    Title translation Granulomatous Mastitis: A Clinical and Diagnostic Dilemma.
    Abstract Objective: Granulomatous mastitis (GM) is a challenging inflammatory disorder of the breast. In this study we aimed to present the detailed clinical and morphological features of GM cases, diagnostic clues for specific and idiopathic etiologies, the difficulties in evaluating trucut biopsies, and the results of different therapeutic approaches.
    Material and method: We retrospectively analysed the clinical, radiological and morphological features of 114 GM cases diagnosed with fine needle aspiration, and trucut, incisional, and excisional biopsy.
    Results: The mean age was 35.8. Only eight cases were older than 45 years. Bilateral involvement was observed in 4 (3.5%) cases. The most common clinical symptoms were breast mass/abscesses, tenderness, and skin changes. Microbiological culture was positive in 4 cases for gram-positive bacteria. Only 3 cases showed a positive tuberculin/PCR test for tuberculosis. The major USG finding was a hypoechoic well-defined or ill-defined mass/abscess; MRI finding was heterogeneous non-mass contrast enhancement. Cases diagnosed with cytology (35 cases) did not have breast malignancy either in their history or clinical follow up period. Fine needle aspiration cytology materials revealed epitheloid granulomas mixed with neutrophils, lymphocytes accompanied by giant cells, and suppurative necrosis. Histopathological reevaluation of 65 trucut/incisional/ excisional biopsies revealed granuloma formation in 65 (100%), Langhans type giant cells in 59 (90.7%), microabscess formation in 41 (63%), caseous necrosis in 1 (1.5%), neutrophilic cysts in 30 (46.1%), eosinophilic infiltration in 48 (73.8%), interlobular inflammation in 14 (21.5%), fat necrosis in 5 (7.6%), ductal ectasia in 6 (9.2%), and lactational changes in 4 (6.1%) cases. Granulomas were lobulocentric in 58 cases, foreign body type/fat necrosis-related in 6 case, and periductular in 1 case. Cystic neutrophilic granulomatous mastitis was observed in one case. We also evaluated the histochemical stains of these 65 biopsies. Only one sample was positive for acido-resistant bacilli (ARB) by the EZN method and one sample was positive for gram-positive bacilli by gram stain.
    Conclusion: Small, superficial trucut biopsies may cause difficulties in determining the etiology and differential diagnosis of granulomatous mastitis. For optimal management and timing the appropriate therapy, the ideal biopsy procedure, special stains, and a multidisciplinary team consisting of the surgeon, pathologist, and radiologist are the most important issues.
    MeSH term(s) Adult ; Angiotensin Receptor Antagonists ; Angiotensin-Converting Enzyme Inhibitors ; Breast ; Female ; Granulomatous Mastitis/diagnosis ; Granulomatous Mastitis/surgery ; Humans ; Retrospective Studies
    Chemical Substances Angiotensin Receptor Antagonists ; Angiotensin-Converting Enzyme Inhibitors
    Language English
    Publishing date 2021-09-30
    Publishing country Turkey
    Document type Journal Article
    ZDB-ID 2515899-5
    ISSN 1309-5730 ; 1309-5730
    ISSN (online) 1309-5730
    ISSN 1309-5730
    DOI 10.5146/tjpath.2021.01554
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  9. 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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  10. Article: The Role of Oncoplastic Breast Surgery in Breast Cancer Treatment.

    Emiroğlu, Mustafa / Sert, İsmail / İnal, Abdullah

    The journal of breast health

    2015  Volume 11, Issue 1, Page(s) 1–9

    Abstract: The aim of this study is to discuss indications, advantages, disadvantages, oncologic and aesthetic results of Oncoplastic Surgery (OBS). Pubmed and Medline database were searched for articles published between 1998 and 2014 for keywords: oncoplastic ... ...

    Abstract The aim of this study is to discuss indications, advantages, disadvantages, oncologic and aesthetic results of Oncoplastic Surgery (OBS). Pubmed and Medline database were searched for articles published between 1998 and 2014 for keywords: oncoplastic breast surgery, therapeutic mammoplasty, oncoplastic breast reduction, synchrenous reconstructions. Role of OBS in breast cancer surgery, its aspects to be considered, its value and results have been interpreted. This technique has advantages by providing more extensive tumourectomy, yielding better aesthetic results compared with breast conserving surgery, allowing oncoplastic reduction in breast cancer patients with macromastia, with higher patient satisfaction and quality of life and by being inexpensive due to single session practice. As for its disadvantages are: re-excision is more difficult, risk for mastectomy is higher, it is depent on the Surgeron's experience, it has a risk for delay in adjuvant therapies and its requirement for additional imaging studies during management. Main indications are patients with small tumour/breast volume, macromastia, multifocality, procedures which can disrupt breast cosmesis such as surgeries for upper inner breas tquadrient tumours. Contraindications are positive margin problems after wide excision, diffuse malign microcalsifications, inflammatory breast cancer, history of radiotherapy and patients' preferences. Despite low evidence level, Oncoplastic Breast Surgery seems to be both reliable and acceptable in terms of oncologic and aesthetic aspects. Oncoplastic Breast Surgery increase the application rate of breast conserving surgery by obviating practical limitations and improve the results of breast conserving surgery. Correct patient and technique choice in OBS is vital for optimization of post surgical.
    Language English
    Publishing date 2015-01-01
    Publishing country Turkey
    Document type Journal Article ; Review
    ISSN 1306-0945
    ISSN 1306-0945
    DOI 10.5152/tjbh.2014.2215
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