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  1. Article ; Online: Laparoscopic Surgery for Adult Intussusception: Case Series.

    Yüksel, Adem / Coşkun, Murat

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

    2021  Volume 32, Issue 8, Page(s) 611–615

    Abstract: Background/aims: Intussusception is a rare condition in adults which accounts for 1% of all intestinal obstructions. It usually requires surgical treatment and the classic approach is laparotomy. This article presented six adult patients who underwent ... ...

    Abstract Background/aims: Intussusception is a rare condition in adults which accounts for 1% of all intestinal obstructions. It usually requires surgical treatment and the classic approach is laparotomy. This article presented six adult patients who underwent laparoscopic surgery for intestinal obstruction due to intussusception.
    Materials and methods: Between January 2017 and July 2019, six adult patients underwent laparoscopic surgery for intestinal obstruction due to intussusception. The patients were evaluated in terms of presenting symptoms, diagnosis, treatment modality, morbidity, mortality and histopathological results.
    Results: All patients presented with acute (50%) or subacute (50%) symptoms. All patients had intestinal obstruction (partial, complete) findings. Intussusception was diagnosed by abdominal computed tomography (CT). The patients with ileocolic and colo-colonic intussusception underwent colonoscopy. In the preoperative period, the etiology of intussusception (neoplasm, idiopathic, etc.) was diagnosed only in one patient (16.6%). Two patients underwent laparoscopic segmental small bowel resection, two patients underwent laparoscopic right hemicolectomy, one patient underwent laparoscopic left hemicolectomy, and one patient underwent laparoscopic anterior resection. None of the patients developed intraoperative or postoperative complication. The histopathological examination revealed malignancy in two patients (33.3%).
    Conclusion: CT is helpful in diagnosing of adult intussusception. However, it is usually difficult to define the underlying pathology with CT. Laparoscopic approach seems to be safe and effective as open surgery, both in diagnosis and treatment of intussusception.
    MeSH term(s) Adult ; Humans ; Intussusception/diagnostic imaging ; Intussusception/surgery ; Laparoscopy/adverse effects ; Tomography, X-Ray Computed ; Treatment Outcome
    Language English
    Publishing date 2021-09-16
    Publishing country Turkey
    Document type Case Reports
    ZDB-ID 1340275-4
    ISSN 2148-5607 ; 1300-4948
    ISSN (online) 2148-5607
    ISSN 1300-4948
    DOI 10.5152/tjg.2020.19835
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  2. Article ; Online: Safety and efficacy of laparoscopic colectomy in low volume centre following effective laparoscopic training. Retrospective cohort study.

    Muhammedoglu, Bahtiyar / Yuksel, Adem / Kupeli, Aydin Hakan / Pircanoglu, Eyup Mehmet / Uylas, Ufuk / Karadag, Mehmet

    Annali italiani di chirurgia

    2023  Volume 94, Page(s) 56–62

    Abstract: The use of minimally invasive surgery in colon cancers is becoming widespread and developing day by day Laparoscopic right hemicolectomy (LRHC) with complete mesocolic excision is gradually becoming the standard oncological surgical principle for right ... ...

    Abstract The use of minimally invasive surgery in colon cancers is becoming widespread and developing day by day Laparoscopic right hemicolectomy (LRHC) with complete mesocolic excision is gradually becoming the standard oncological surgical principle for right hemicolectomy. The aim of our study was to evaluate the safety and efficacy of laparoscopic right hemicolectomy in a small-volume center.
    Methods: Clinical outcomes were analyzed in a study comparing laparoscopic right hemicolectomy with conventional right hemicolectomy. By standardizing laparoscopic right hemicolectomy in our center, data on patient characteristics, surgical details, tumor, lymph node, and metastasis stage (TNM), postoperative recovery, and survival were retrieved and analyzed from retrospective databases.
    Results: Patients underwent open (n. 63) and laparoscopic (n. 51) right hemicolectomies in our units. In the laparoscopic group, the rate of conversion to open was 5.8%, and there was no mortality for 30 days. In the open group, the first-month mortality was 6.3%, and the rate of complications was 15.9%. The mean age of the patients in the laparoscopic group (65.7±13.46) was statistically significantly higher than that of the open group 60.49±12.67) (p=0.042). Operation time was 147.53±57 minutes in the laparoscopic group and 132.84±34 minutes in the open batch, and there was no statistically significant difference between them. Significant correlations were found between stage and cancer subgroup information (p=0.001). Adenocarcinoma (42%) and mucinous (43.8%) type cancers were found more frequently in patients with stage III, while signet ring cancers were more common (100%) in stage IV patients.
    Conclusions: LRHC and laparoscopic conventional right hemicolectomy offered similar oncologic outcomes for right colon cancers in small volume centers. LRHC can be performed safely, and sufficient laparoscopic experience is essential for it to be considered the gold standard procedure. With an improved standard technique and systematic learning method, patient safety and surgical results can be achieved as successfully as in the open surgical approach.
    Key words: Colorectal cancer, Intracorporeal anastomosis, Right laparoscopic hemicolectomy, Side-to-side anastomosis.
    MeSH term(s) Humans ; Retrospective Studies ; Laparoscopy/methods ; Lymph Nodes/pathology ; Colonic Neoplasms/surgery ; Colectomy/methods ; Treatment Outcome
    Language English
    Publishing date 2023-01-30
    Publishing country Italy
    Document type Journal Article
    ZDB-ID 418927-9
    ISSN 2239-253X ; 0003-469X
    ISSN (online) 2239-253X
    ISSN 0003-469X
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  3. Article ; Online: Oversewing the Staple Line: Does It Safe to Prevent Leakage?

    Gönüllü, Emre / Yüksel, Adem / Coşkun, Murat / Harmantepe, Tarık / Fırtına, Gizem / Karaman, Kerem

    Journal of laparoendoscopic & advanced surgical techniques. Part A

    2023  Volume 34, Issue 2, Page(s) 120–126

    Abstract: Introduction: ...

    Abstract Introduction:
    MeSH term(s) Humans ; Obesity, Morbid/surgery ; Surgical Stapling ; Laparoscopy ; Gastrectomy/adverse effects ; Sutures
    Language English
    Publishing date 2023-11-07
    Publishing country United States
    Document type Journal Article
    ZDB-ID 1381909-4
    ISSN 1557-9034 ; 1092-6429
    ISSN (online) 1557-9034
    ISSN 1092-6429
    DOI 10.1089/lap.2023.0284
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  4. Article: The role of extended antral resection on weight loss and metabolic response after sleeve gastrectomy: A retrospective cohort study.

    Yuksel, Adem / Coskun, Murat / Karaman, Kerem

    Pakistan journal of medical sciences

    2020  Volume 36, Issue 6, Page(s) 1228–1233

    Abstract: Objective: The impact of extended antral resection (AR) after laparoscopic sleeve gastrectomy (LSG) on clinical results is still not clearly elucidated with conflicting results. Our study aimed to determine whether AR is superior to antral preservation ( ...

    Abstract Objective: The impact of extended antral resection (AR) after laparoscopic sleeve gastrectomy (LSG) on clinical results is still not clearly elucidated with conflicting results. Our study aimed to determine whether AR is superior to antral preservation (AP) regarding clinical results.
    Methods: Patients were divided into two groups according to the distance of gastric division as AR group (2cm from pylorus) and AP group (6cm from pylorus). Postoperative excess weight loss percentile (%EWL) and total body weight loss percentiles (%TBWL) at the end of first, 6
    Results: The first 68 patients underwent AP, and the following 43 patients underwent AR. Although statistically not significant, AR achieve more %EWL and %TBWL at the end of the first year, (P>0.05). On the other hand, metabolic parameters were similar at the end of the first year, (P>0.05). Resolution of comorbidities were statistically not different, (P>0.05). Staple line leak occurred in two patients of the AR group (4.7%) and two patients of the AP group (2.9%), (P>0.05).
    Conclusion: Both AR and AP seem to be equally effective in resolution of metabolic response. Although statistically not significant- AR provided more %EWL and %TBWL at the end of 12 months.
    Language English
    Publishing date 2020-08-28
    Publishing country Pakistan
    Document type Journal Article
    ZDB-ID 2032827-8
    ISSN 1681-715X ; 1682-024X ; 1017-4699
    ISSN (online) 1681-715X
    ISSN 1682-024X ; 1017-4699
    DOI 10.12669/pjms.36.6.2321
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  5. Article: Comparison of open and laparoscopic gastrectomy for gastric cancer: a low volume center experience.

    Yüksel, Adem / Coşkun, Murat / Turgut, Hamdi Taner / Sümer, Fatih

    Turkish journal of surgery

    2021  Volume 37, Issue 1, Page(s) 33–40

    Abstract: Objectives: In gastric cancer, laparoscopic gastrectomy is commonly performed in Asian countries. In other regions where tumor incidence is relatively low and patient characteristics are different, developments in this issue have been limited. In this ... ...

    Abstract Objectives: In gastric cancer, laparoscopic gastrectomy is commonly performed in Asian countries. In other regions where tumor incidence is relatively low and patient characteristics are different, developments in this issue have been limited. In this study, we aimed to compare the early results for patients who underwent open or laparoscopic gastrectomy for gastric cancer in a low volume center.
    Material and methods: We retrospectively analyzed the data of patients who underwent curative gastric resection (open gastrectomy n: 30; laparoscopic gastrectomy n: 30) by the same surgical team between 2014 and 2019.
    Results: The tumor was localized in 60% (36/60) of the patients in the proximal and middle 1/3 stomach. In laparoscopic gastrectomy group, the operation time was significantly longer (median, 297.5 vs 180 minutes; p <0.05). In open gastrectomy group, intraoperative blood loss (median 50 vs 150 ml; p <0.05) was significantly higher. Tumor negative surgical margin was achieved in all cases. Although the mean number of lymph nodes harvested in laparoscopic gastrectomy group was higher than the open surgery group, the difference was not statistically significant (28.2 ± 11.48 vs 25.8 ± 9.78, respectively; p= 0.394). The rate of major complications (Clavien-Dindo ≥ grade 3) was less common in the laparoscopic group (6.7% vs 16.7%; p= 0.642). Mortality was observed in four patients (2 patients open, 2 patients laparoscopic).
    Conclusion: In low-volume centers with advanced laparoscopic surgery experience, laparoscopic gastrectomy for gastric cancer can be performed with the risk of morbidity-mortality similar to open gastrectomy.
    Language English
    Publishing date 2021-03-22
    Publishing country Turkey
    Document type Journal Article
    ISSN 2564-6850
    ISSN 2564-6850
    DOI 10.47717/turkjsurg.2021.5048
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  6. Article ; Online: Clip closure and division instead of stapling for the last small gastric bridge between gastric pouch and remnant stomach in laparoscopic Roux-en-Y gastric bypass.

    Yuksel, Adem / Sumer, Fatih / Kayaalp, Cuneyt

    International journal of surgery (London, England)

    2017  Volume 47, Page(s) 1–3

    Abstract: Introduction: Here, a modification during gastric pouch forming was implemented in laparoscopic Roux-en-Y gastric bypass (LRYGB). We aimed to examine the feasibility of metallic clip closure for the remaining small stomach bridges (<1 cm) between the ... ...

    Abstract Introduction: Here, a modification during gastric pouch forming was implemented in laparoscopic Roux-en-Y gastric bypass (LRYGB). We aimed to examine the feasibility of metallic clip closure for the remaining small stomach bridges (<1 cm) between the pouch and the remnant stomach.
    Methods: During pouch creation, after the last stapler firing, the remaining small bridge was closed with clips and divided instead of using a new stapler. Metallic clips for this aim were used in 41 of 520 LRYGP between September 2010 and January 2017. Preoperative mean body mass index (BMI) was 47.3 ± 5.3 kg/m
    Results: Gastric bridges in 41 patients were successfully closed with metallic clips and divided. In one patient, intraoperative methylene blue test was positive from the anastomosis (not from the clipped place) and repaired by intracorporeal sutures. Abdominal drain was used selectively (32%). No postoperative leakage or other complications were seen. Mean length of hospital stay was 3.8 ± 1.1 days. Mean BMI was 30.3 ± 6.1 kg/m
    Conclusion: In LRYGB metallic clip closure for a stomach bridge (<1 cm) between the pouch and the remnant stomach is an easy, safe and reliable method.
    Language English
    Publishing date 2017-11
    Publishing country England
    Document type Journal Article
    ZDB-ID 2212038-5
    ISSN 1743-9159 ; 1743-9191
    ISSN (online) 1743-9159
    ISSN 1743-9191
    DOI 10.1016/j.ijsu.2017.09.014
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  7. Article ; Online: Distal spread and tumor regression patterns following preoperative chemoradiotherapy in rectal cancer patients

    Özer, İlter / Zengin, Neslihan İnci / Çaycı, Hacı Murat / Yüksel, Adem / Dalgıç, Tahsin / Ulaş, Murat / Bostancı, Erdal Birol / Akoğlu, Musa

    Turkish journal of medical sciences

    2021  Volume 51, Issue 6, Page(s) 2978–2985

    Abstract: Background/aim/aim: This study aimed to evaluate the regression pattern with the distal intramural spread (DIS) of rectum cancer after preoperative chemoradiation.: Materials and methods: Specimens from 56 patients who underwent radical resection ... ...

    Abstract Background/aim/aim: This study aimed to evaluate the regression pattern with the distal intramural spread (DIS) of rectum cancer after preoperative chemoradiation.
    Materials and methods: Specimens from 56 patients who underwent radical resection after preoperative chemoradiation for rectal cancer were examined. The regression pattern (total, fragmented) of the tumor was recorded. DIS status was evaluated by creating sections 0.2 to 0.3 cm thick.
    Results: A single macroscopic residual area was detected in all specimens. In 10 patients (17.8 %), pathologically complete responses were identified, and DIS was detected in 33 patients (58.9%). The average DIS distance was 0.56± 0.3 cm (range 0.2 – 1.8 cm); the spread was < 1 cm in 87.9% of the patients (29/33). The overall survival rates for 5 and 7 years were 76.8% and 73.2%, respectively. The survival rates between patients with and without DIS were not statistically different (94.6± 5.5 vs. 75.1 ± 10.2 months, respectively). In all of the patients, tumor regression pattern was total shrinkage of the tumor.
    Conclusion: A sufficient distal resection margin for rectal cancer after preoperative chemoradiation is 1 cm in the vast majority of cases. However, DIS may exceed 1 cm in a small proportion of patients.
    MeSH term(s) Adult ; Aged ; Chemoradiotherapy/methods ; Female ; Humans ; Male ; Margins of Excision ; Middle Aged ; Neoadjuvant Therapy ; Neoplasm Staging ; Rectal Neoplasms/pathology ; Rectal Neoplasms/therapy ; Survival Rate
    Language English
    Publishing date 2021-12-13
    Publishing country Turkey
    Document type Journal Article
    ZDB-ID 1183461-4
    ISSN 1303-6165 ; 1300-0144
    ISSN (online) 1303-6165
    ISSN 1300-0144
    DOI 10.3906/sag-2007-102
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  8. Article: The effect of immunonutrition on bacterial translocation after Pringle maneuverer in rats.

    Subasi, Ozkan / Yildiz, Selim Yigit / Yuksel, Adem / Coskun, Murat / Turgut, Hamdi Taner / Yildiz, Eda

    Przeglad gastroenterologiczny

    2019  Volume 14, Issue 3, Page(s) 178–182

    Abstract: Introduction: Temporary clamping of the hepatoduodenal ligament (the Pringle manoeuvre) is the most commonly used method to prevent intraoperative blood loss in liver surgery. Some side effects of the Pringle manoeuvre (PM) can occur.: Aim: To ... ...

    Abstract Introduction: Temporary clamping of the hepatoduodenal ligament (the Pringle manoeuvre) is the most commonly used method to prevent intraoperative blood loss in liver surgery. Some side effects of the Pringle manoeuvre (PM) can occur.
    Aim: To investigate the effectiveness of preoperative immunonutritional support to prevent bacterial translocation (BT) in rats due to PM.
    Material and methods: Forty Wistar albino rats were randomly divided into four groups. Groups 1 and 2 were fed with normal rat diet and water, and groups 3 and 4 were fed with enteral immunonutrition (Impact Glutamine) containing 1 g/kg/day amino acid in the preoperative period. Group 1 (
    Results: Proliferation in portal blood cultures was significantly higher in the samples from the normally fed group (group 2) in whom PM was applied, compared to the other groups (
    Conclusions: Preoperative immunonutritional support is effective in the prevention of BT due to PM in rats.
    Language English
    Publishing date 2019-09-27
    Publishing country Poland
    Document type Journal Article
    ZDB-ID 2596134-2
    ISSN 1897-4317 ; 1895-5770
    ISSN (online) 1897-4317
    ISSN 1895-5770
    DOI 10.5114/pg.2019.88166
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  9. Article ; Online: Solitary cecal diverticulitis, a rare cause of right lower quadrant pain: Four cases.

    Yuksel, Adem / Civil, Osman / Colakoglu, Muhammed Kadri / Sumer, Fatih / Eruyar, Ahmet Tugrul

    Northern clinics of Istanbul

    2018  Volume 5, Issue 2, Page(s) 148–152

    Abstract: Solitary cecal diverticulitis is a rare clinical condition. Like diverticulitis in other segments of the colon, it requires immediate surgical intervention if it is causing complications. Solitary cecal diverticulitis may be misdiagnosed as acute ... ...

    Abstract Solitary cecal diverticulitis is a rare clinical condition. Like diverticulitis in other segments of the colon, it requires immediate surgical intervention if it is causing complications. Solitary cecal diverticulitis may be misdiagnosed as acute appendicitis, since it causes right lower quadrant pain, or as a cecal tumor or inflammatory bowel disease, due to an intraoperative appearance resembling an inflammatory mass. Four patients with solitary cecum diverticulitis presenting with acute right lower quadrant pain are discussed in this report. Three patients underwent surgery with a preliminary diagnosis of acute appendicitis or cecal tumor, and 1 patient was diagnosed with cecal diverticulitis and treated medically. The treatment approach may change depending on a preoperative or intraoperative diagnosis of cecal diverticulitis. Therefore, in areas where this disease is uncommon, cecum diverticulitis should not be forgotten in the differential diagnosis of acute right lower quadrant pain or inflammatory bowel mass.
    Language English
    Publishing date 2018-03-15
    Publishing country Turkey
    Document type Case Reports
    ZDB-ID 3031921-3
    ISSN 2536-4553 ; 2148-4902
    ISSN (online) 2536-4553
    ISSN 2148-4902
    DOI 10.14744/nci.2017.60565
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  10. Article ; Online: Pancreatic stump closure using only stapler is associated with high postoperative fistula rate after minimal invasive surgery.

    Yüksel, Adem / Bostancı, Erdal Birol / Çolakoğlu, Muhammet Kadri / Ulaş, Murat / Özer, İlter / Karaman, Kerem / Akoğlu, Musa

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

    2018  Volume 29, Issue 2, Page(s) XXXX

    Abstract: Background/aims: Postoperative pancreatic fistula (POPF) is the most common cause of morbidity and mortality after distal pancreatectomy (DP). The aim of the present study is to determine the risk factors that can lead to POPF.: Materials and methods!# ...

    Abstract Background/aims: Postoperative pancreatic fistula (POPF) is the most common cause of morbidity and mortality after distal pancreatectomy (DP). The aim of the present study is to determine the risk factors that can lead to POPF.
    Materials and methods: The study was conducted between January 2008 and December 2012. A total of 96 patients who underwent DP were retrospectively analyzed.
    Results: Overall, 24 patients (25%) underwent laparoscopic distal pancreatectomy (LDP) and 72 patients (75%) open surgery. The overall morbidity rate was 51% (49/96). POPF (32/96, 33.3%) was the most common postoperative complication. Grade B fistula (18/32, 56.2%) was the most common fistula type according to the International Study Group on Pancreatic Fistula definition. POPF rate was significantly higher in the minimally invasive surgery group (50%, p=0.046). POPF rate was 58.6% (17/29) in patients whose pancreatic stump closure was performed with only stapler, whereas POPF rate was 3.6% (1/28) in the group where the stump was closed with stapler plus oversewing sutures. Both minimally invasive surgery (OR: 0.286, 95% CI: 0.106-0.776, p=0.014) and intraoperative blood transfusion (OR: 4.210, 95% CI: 1.155-15.354, p=0.029) were detected as independent risk factors for POPF in multi-variety analysis.
    Conclusion: LDP is associated with a higher risk of POPF when stump closure is performed with only staplers. Intraoperative blood transfusion is another risk factor for POPF. On the other hand, oversewing sutures to the stapler line reduces the risk of POPF.
    MeSH term(s) Adult ; Aged ; Blood Transfusion/methods ; Female ; Humans ; Intraoperative Care/adverse effects ; Intraoperative Care/methods ; Laparoscopy/adverse effects ; Laparoscopy/methods ; Male ; Middle Aged ; Pancreas/surgery ; Pancreatectomy/adverse effects ; Pancreatectomy/methods ; Pancreatic Fistula/etiology ; Pancreatic Fistula/mortality ; Postoperative Complications/etiology ; Postoperative Complications/mortality ; Retrospective Studies ; Risk Factors ; Surgical Stapling/adverse effects
    Language English
    Publishing date 2018-05-15
    Publishing country Turkey
    Document type Evaluation Studies ; Journal Article
    ZDB-ID 1340275-4
    ISSN 2148-5607 ; 1300-4948
    ISSN (online) 2148-5607
    ISSN 1300-4948
    DOI 10.5152/tjg.2018.17567
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