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  1. Article ; Online: A new technique of doppler dearterialization for hemorrhoidal disease: arterial detection ligation (ADL).

    Zenger, Serkan / Gurbuz, Bulent / Can, Ugur / Yalti, Tunc

    Surgery today

    2020  Volume 51, Issue 4, Page(s) 612–618

    Abstract: Purpose: We describe the arterial detection ligation (ADL) technique, designed to find arteries at time-appropriate depth for ligating, and report our preliminary results of using this technique to treat patients with the hemorrhoidal disease (HD).: ... ...

    Abstract Purpose: We describe the arterial detection ligation (ADL) technique, designed to find arteries at time-appropriate depth for ligating, and report our preliminary results of using this technique to treat patients with the hemorrhoidal disease (HD).
    Methods: The subjects of this retrospective analysis were patients with symptomatic grades 2 or 3 HD. We analyzed the clinical characteristics, postoperative complications, recurrence, and patient satisfaction of the patients treated with ADL.
    Results: A total of 75 patients were included in the study (male/female ratio 1.88; mean age 48 ± 19 years; mean BMI 24 ± 3 kg/m
    Conclusion: Based on our preliminary findings, ADL is an effective technique for treating HD, generally as an outpatient procedure, without serious morbidity. We anticipate that the incidence of tenesmus, which is encountered frequently after other dearterialization methods, will be lower after the ADL technique, which avoids both mass ligation of hemorrhoidal arteries deeper than 12 mm and running a long mucopexy suture line.
    MeSH term(s) Adult ; Aged ; Arteries/diagnostic imaging ; Arteries/surgery ; Female ; Hemorrhoidectomy/adverse effects ; Hemorrhoidectomy/methods ; Hemorrhoids/diagnostic imaging ; Hemorrhoids/surgery ; Humans ; Ligation/adverse effects ; Ligation/methods ; Male ; Middle Aged ; Patient Satisfaction ; Postoperative Complications/epidemiology ; Postoperative Complications/etiology ; Rectum/blood supply ; Retrospective Studies ; Surgery, Computer-Assisted/adverse effects ; Surgery, Computer-Assisted/methods ; Treatment Outcome ; Ultrasonography, Doppler/methods ; Vascular Surgical Procedures/adverse effects ; Vascular Surgical Procedures/methods ; Young Adult
    Language English
    Publishing date 2020-10-24
    Publishing country Japan
    Document type Journal Article
    ZDB-ID 1115435-4
    ISSN 1436-2813 ; 0941-1291
    ISSN (online) 1436-2813
    ISSN 0941-1291
    DOI 10.1007/s00595-020-02164-7
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  2. Article ; Online: Reply.

    Zenger, Serkan / Gurbuz, Bulent / Can, Ugur / Erginoz, Ergin / Ozata, Ibrahim Halil / Kulle, Cemil Burak / Balik, Emre / Bugra, Dursun

    Diseases of the colon and rectum

    2023  Volume 66, Issue 6, Page(s) e315

    Language English
    Publishing date 2023-03-10
    Publishing country United States
    Document type Journal Article
    ZDB-ID 212581-x
    ISSN 1530-0358 ; 0012-3706
    ISSN (online) 1530-0358
    ISSN 0012-3706
    DOI 10.1097/DCR.0000000000002867
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  3. Article ; Online: Clinicopathologic features and prognosis of histologic subtypes in the right-sided colon cancer.

    Zenger, Serkan / Gurbuz, Bulent / Can, Ugur / Balik, Emre / Bugra, Dursun

    Journal of B.U.ON. : official journal of the Balkan Union of Oncology

    2020  Volume 25, Issue 5, Page(s) 2154–2159

    Abstract: Purpose: Differentiation of the histopathologic subtypes can be clinically important as it can affect the course of treatment and the prognosis. The aim of this study was to investigate both the clinicopathological features and prognosis of histologic ... ...

    Abstract Purpose: Differentiation of the histopathologic subtypes can be clinically important as it can affect the course of treatment and the prognosis. The aim of this study was to investigate both the clinicopathological features and prognosis of histologic subtypes in right-sided colon cancer.
    Methods: This study included 138 patients who underwent surgery for right-sided colon cancer. The patients were divided into three groups according to histopathological subtypes as follows: medullary carcinoma (MC, n=11), mucinous adenocarcinoma (MAC, n=29), and classic adenocarcinoma (AC, n=98). The groups were compared in terms of demographic characteristics, type of surgery, pathological outcomes and survival.
    Results: The rate of laparoscopic surgery was significantly lower in the MC group compared with MAC and AC groups (45.4% vs 54.5% vs 35.7%, respectively, p=0.001). In MC group, T4 stage was significantly higher than in other groups (90.0% vs 34.5% vs 35.7%, respectively, p=0.001). While patients with MAC had no distant metastasis, 18.2% and 15.3% of patients with MC and AC respectively, had distant metastasis (p=0.07). MAC vs MC, p=0.01, MAC vs AC, p=0.03). Tumor size, tumor volume, and the rate of microsatellite instability were found significantly higher in the MC group (p<0.05). The 5-year overall (OS) and disease-free survival (DFS) were better in the MAC group compared with MC and AC groups, but these differences did not reach statistical significance (OS: 92.8% vs 72.7% and 68.7%, p=0.16 and DFS 87.3% vs 58.2% and 64%, p=0.10, respectively).
    Conclusion: MC is associated with more advanced tumor size and T stages, and therefore entails reduced rate of minimally invasive procedures. In our series, the absence of distant metastasis in the patients of MAC also had a positive effect on survival.
    MeSH term(s) Aged ; Colonic Neoplasms/physiopathology ; Female ; Humans ; Male ; Middle Aged ; Prognosis
    Language English
    Publishing date 2020-12-10
    Publishing country Greece
    Document type Journal Article
    ZDB-ID 2040386-0
    ISSN 2241-6293 ; 1107-0625
    ISSN (online) 2241-6293
    ISSN 1107-0625
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  4. Article ; Online: Comparative study between ghost ileostomy and defunctioning ileostomy in terms of morbidity and cost-effectiveness in low anterior resection for rectal cancer.

    Zenger, Serkan / Gurbuz, Bulent / Can, Ugur / Balik, Emre / Yalti, Tunc / Bugra, Dursun

    Langenbeck's archives of surgery

    2021  Volume 406, Issue 2, Page(s) 339–347

    Abstract: Purpose: The aim of this study was to compare ghost ileostomy (GI) and defunctioning ileostomy (DI) in patients who underwent low anterior resection (LAR) for rectal cancer in terms of postoperative morbidity, rehospitalization rates, and total costs.!## ...

    Abstract Purpose: The aim of this study was to compare ghost ileostomy (GI) and defunctioning ileostomy (DI) in patients who underwent low anterior resection (LAR) for rectal cancer in terms of postoperative morbidity, rehospitalization rates, and total costs.
    Methods: Patients with an anastomosis level between 5 and 10 cm from the anal verge after LAR were analyzed retrospectively. Clinical characteristics, operative outcomes, postoperative morbidity, rehospitalization rates, and total costs were compared.
    Results: A total of 123 patients were enrolled as follows: 42 patients in the GI group and 81 patients in the DI group. Anastomotic leakage (AL) was identified in three patients who underwent GI, and in all of them, GI was easily converted to DI. There were 96.3% of the patients with DI rehospitalized at least one time because of surgery-related and/or stoma-related complications or stoma closure. When we did not take into account the patients who were rehospitalized for stoma closure, the rates of rehospitalization were 4.7% and 22.2% in the GI and DI groups, respectively (P= 0.01). The mean total costs calculated by removing additional surgical procedures and adding all of the rehospitalization costs were 25,767 USD and 41,875 USD in the GI and DI groups, respectively (P= 0.0001).
    Conclusion: GI may be a safe and cost-effective method in patients who underwent LAR with low or medium risk factors for AL. It is possible to avoid unnecessary ileostomy and reduce unwanted outcomes due to it, such as postoperative complications, rehospitalizations, and increased total costs by performing GI.
    MeSH term(s) Anastomosis, Surgical/adverse effects ; Anastomotic Leak/epidemiology ; Cost-Benefit Analysis ; Humans ; Ileostomy/adverse effects ; Morbidity ; Postoperative Complications/epidemiology ; Rectal Neoplasms/surgery ; Retrospective Studies
    Language English
    Publishing date 2021-02-04
    Publishing country Germany
    Document type Journal Article
    ZDB-ID 1423681-3
    ISSN 1435-2451 ; 1435-2443
    ISSN (online) 1435-2451
    ISSN 1435-2443
    DOI 10.1007/s00423-021-02089-w
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  5. Article: Laparoscopic partial cecum resection in appendiceal intussusception.

    Zenger, Serkan / Bilgiç, Çağrı / Buğra, Dursun

    Turkish journal of surgery

    2018  Volume 35, Issue 1, Page(s) 74–77

    Abstract: Appendiceal intussusception (AI) is a difficult disease to diagnose. Various features of the disease were analyzed in a 35-year-old female patient admitted with abdominal pain and diagnosed with AI. The diagnosis was made with colonoscopy and abdominal ... ...

    Abstract Appendiceal intussusception (AI) is a difficult disease to diagnose. Various features of the disease were analyzed in a 35-year-old female patient admitted with abdominal pain and diagnosed with AI. The diagnosis was made with colonoscopy and abdominal computed tomography. Laparoscopic partial cecum resection was performed. Pathology examination revealed foci of endometriosis externa, which infiltrated the muscular layer of the appendix. AI should be kept in mind in the differential diagnosis of recurrent abdominal pain. Colonoscopy is an indispensable examination for differential diagnosis. Laparoscopic partial cecum resection, preserving the ileocecal valve, is an appropriate treatment approach in irreducible cases that are not suspected to be malignant.
    Language English
    Publishing date 2018-08-28
    Publishing country Turkey
    Document type Case Reports
    ISSN 2564-6850
    ISSN 2564-6850
    DOI 10.5578/turkjsurg.3633
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  6. Article: Laparoscopic partial cecum resection in appendix intussusception.

    Zenger, Serkan / Bilgiç, Çağrı / Buğra, Dursun

    Turkish journal of surgery

    2018  , Page(s) 1–3

    Abstract: Appendix intussusception (AI) is a difficult disease to diagnose. Various features of the disease have been analyzed in a 35-year-old female patient who was admitted with abdominal pain and diagnosed with AI. The diagnosis was made with colonoscopy and ... ...

    Abstract Appendix intussusception (AI) is a difficult disease to diagnose. Various features of the disease have been analyzed in a 35-year-old female patient who was admitted with abdominal pain and diagnosed with AI. The diagnosis was made with colonoscopy and abdominal computed tomography. Laparoscopic partial cecum resection was performed. The pathology examination revealed foci of endometriosis externa, which infiltrated the muscular layer of the appendix. AI should be kept in mind in the differential diagnosis of recurrent abdominal pain. Colonoscopy is an indispensable examination for the differential diagnosis. Laparoscopic partial cecum resection, preserving ileocecal valve, is an appropriate treatment approach in irreducible cases that are not suspected to be malignant.
    Language English
    Publishing date 2018-08-28
    Publishing country Turkey
    Document type Journal Article
    ISSN 2564-6850
    ISSN 2564-6850
    DOI 10.5152/turkjsurg.2018.3633
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  7. Article ; Online: Mid-transverse Location in Primary Colon Tumor: A Poor Prognostic Factor?

    Zenger, Serkan / Gurbuz, Bulent / Can, Uğur / Erginoz, Ergin / Ozata, Ibrahim H / Kulle, Cemil B / Balik, Emre / Bugra, Dursun

    Diseases of the colon and rectum

    2022  Volume 65, Issue 6, Page(s) 817–826

    Abstract: Background: The location of colonic tumors has been linked to different clinical and oncologic outcomes. Transverse colon cancers are generally included as right colon cancers. Furthermore, hepatic and splenic flexure tumors are usually included as ... ...

    Abstract Background: The location of colonic tumors has been linked to different clinical and oncologic outcomes. Transverse colon cancers are generally included as right colon cancers. Furthermore, hepatic and splenic flexure tumors are usually included as components of the transverse colon.
    Objective: This study was aimed at comparing the clinicopathologic characteristics and long-term outcomes between mid-transverse and right and left colon cancers and determining the prognostic impact of the primary tumor location in the mid-transverse colon.
    Design: This was a retrospective study.
    Settings: Two specialized colorectal centers were included.
    Patients: Patients who underwent curative surgery for colon cancer were analyzed. Tumors located in the transverse colon, excluding the flexures, were defined as mid-transverse colon cancers.
    Main outcome measures: Demographic characteristics, operative outcomes, pathologic results, and long-term outcomes were the primary outcome measures.
    Results: Of the 487 patients, 41 (8.4%) had mid-transverse, 191 (39.2%) had right, and 255 (52.4%) had left colon cancers. For mid-transverse colon cancers, the mean length of hospital stay, mean length of the resected specimen, and the mean number of harvested lymph nodes were significantly higher. For patients with stage I to III cancer, the 5-year overall and disease-free survival rates were significantly worse in the mid-transverse colon cancers than in the right and left colon cancers (overall survival: 55.5% vs 82.8% vs 85.9%, p = 0.004, and disease-free survival; 47.7% vs 72.4% vs 79.5%, p = 0.003). After adjustment for other clinicopathologic factors, mid-transverse colon cancers were significantly associated with a poor prognosis (HR = 2.19 [95% CI, 1.25-3.83]; p = 0.006).
    Limitations: Molecular and genetic information were unavailable in this retrospective study.
    Conclusions: In our case series, colon cancers located in the mid-transverse colon showed poorer prognosis than cancers in other locations. The impact of tumor location in the mid-transverse colon on prognosis, including molecular and genetic markers, should be investigated further in prospective studies. See Video Abstract at http://links.lww.com/DCR/B631.
    Localizacin transversa media en el tumor de colon primario un factor de mal pronstico: ANTECEDENTES:La ubicación de los tumores de colon se ha relacionado con diferentes resultados clínicos y oncológicos. Los cánceres de colon transverso se incluyen generalmente como cánceres de colon derecho. Además, los tumores del ángulo hepático y esplénico suelen incluirse como un componente del colon transverso.OBJETIVO:Este estudio tuvo como objetivo comparar las características clínico-patológicas y los resultados a largo plazo entre los cánceres de colon transverso medio y derecho e izquierdo y determinar el impacto pronóstico de la ubicación del tumor primario en el colon transverso medio.DISEÑO:Este fue un estudio retrospectivo.AJUSTE ENTORNO CLINICO:Se incluyeron dos centros colorrectales especializados.PACIENTES:Se analizaron los pacientes que fueron sometidos a cirugía curativa por cáncer de colon. Los tumores ubicados en el colon transverso, excluidos los ángulos, se definieron como "cánceres de colon transverso medio".PRINCIPALES MEDIDAS DE RESULTADO VOLARACION:Las características demográficas, los resultados quirúrgicos, los resultados patológicos y los resultados a largo plazo fueron las principales medidas de resultado valoracion.RESULTADOS:De los 487 pacientes, 41 (8,4%) tenían cáncer de colon transverso medio, 191 (39,2%) derecho y 255 (52,4%) cáncer de colon izquierdo. Para los cánceres de colon transverso medio, la duración media de la estancia hospitalaria, la duración de la muestra resecada y el número medio de ganglios linfáticos extraídos fueron significativamente mayores. Para los pacientes en estadio I-III, las tasas de supervivencia general y sin enfermedad a 5 años fueron significativamente peores en los cánceres de colon transverso medio que en los cánceres de colon derecho e izquierdo (supervivencia general: 55,5% frente versus a 82,8% frente versus a 85,9%, p = 0,004 y supervivencia libre de enfermedad; 47,7% frente a 72,4% frente a 79,5%, p = 0,003, respectivamente). Después del ajuste por otros factores clínico-patológicos, los cánceres de colon transverso medio se asociaron significativamente con un pronóstico desfavorable (Razón de riesgo: 2,19; intervalo de confianza del 95%: 1,25-3,83; p = 0,006).LIMITACIONES:La información molecular y genética no estuvo disponible en este estudio retrospectivo.CONCLUSIONES:En nuestra serie de casos, los cánceres de colon localizados en el colon transverso medio mostraron un peor pronóstico que los cánceres en otras localizaciones. El impacto de la ubicación del tumor en el colon transverso medio sobre el pronóstico, incluidos los marcadores moleculares y genéticos, debe investigarse más a fondo en estudios prospectivos. Consulte Video Resumen en http://links.lww.com/DCR/B631. (Traducción-Dr Adrián Ortega).
    MeSH term(s) Colon, Transverse/pathology ; Colon, Transverse/surgery ; Colonic Neoplasms/pathology ; Humans ; Neoplasm Staging ; Prognosis ; Prospective Studies ; Retrospective Studies
    Language English
    Publishing date 2022-05-03
    Publishing country United States
    Document type Journal Article ; Video-Audio Media
    ZDB-ID 212581-x
    ISSN 1530-0358 ; 0012-3706
    ISSN (online) 1530-0358
    ISSN 0012-3706
    DOI 10.1097/DCR.0000000000002083
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  8. Article ; Online: Is there no need to discuss adjuvant chemotherapy in stage II colon cancer patients with high tumor budding and lymphovascular invasion?

    Zenger, Serkan / Gurbuz, Bulent / Can, Ugur / Erginoz, Ergin / Ozata, Ibrahim Halil / Yilmaz, Serpil Postgil / Taskin, Orhun Cıg / Peker, Onder / Adsay, Volkan / Balik, Emre / Bugra, Dursun

    Langenbeck's archives of surgery

    2023  Volume 408, Issue 1, Page(s) 127

    Abstract: Purpose: The aim of this study is to evaluate the clinicopathologic associations of tumor budding (Bd) as well as other potential prognosticators including lymphovascular invasion (LVI) in T3/4aN0 colon cancer patients and to investigate their impact on ...

    Abstract Purpose: The aim of this study is to evaluate the clinicopathologic associations of tumor budding (Bd) as well as other potential prognosticators including lymphovascular invasion (LVI) in T3/4aN0 colon cancer patients and to investigate their impact on the outcome.
    Methods: The patients were enrolled in three groups according to the number of budding as Bd1 (0-4 buds), Bd2 (5-9 buds), and Bd3 (> 10 buds). These groups were retrospectively compared in terms of demographic features, other tumor characteristics, operative outcomes, recurrences, and survival. The mean follow-up time was 58 ± 22 months.
    Results: A total of 194 patients were divided as follows: 97 in Bd1, 41 in Bd2, and 56 in Bd3 groups. The Bd3 group was associated with significantly higher LVI and larger tumor size. The rate of recurrence increased progressively from 5.2% in Bd1 to 9.8% in Bd2 and to 17.9% in Bd3 group (p = 0.03). More importantly, the 5-year overall survival (OS: Bd1 = 92.3% vs. Bd2 = 88% vs. Bd3 = 69.5%, p = 0.03) and disease-free survival (DFS: Bd1 = 87.9% vs. Bd2 = 75.3% vs. Bd3 = 66%, p = 0.02) were significantly worse in Bd3 group. In addition, in the subgroup of patients with the presence of Bd3 and LVI together, the 5-year OS (60% vs. 92%, p = 0.001) and DFS (56.1% vs. 85.4%, p = 0.001) were significantly worse. In multivariate analysis, Bd3+LVI was significantly associated with poor OS and DFS (p < 0.001).
    Conclusion: In patients with T3/4aN0 colon cancer, high tumor budding negatively affects long-term oncological outcomes. These findings strongly suggest that adjuvant chemotherapy be considered for the patients with Bd3 and LVI together.
    MeSH term(s) Humans ; Prognosis ; Retrospective Studies ; Colonic Neoplasms/drug therapy ; Colonic Neoplasms/surgery ; Colonic Neoplasms/pathology ; Disease-Free Survival ; Chemotherapy, Adjuvant ; Neoplasm Staging ; Neoplasm Invasiveness/pathology
    Language English
    Publishing date 2023-03-27
    Publishing country Germany
    Document type Journal Article
    ZDB-ID 1423681-3
    ISSN 1435-2451 ; 1435-2443
    ISSN (online) 1435-2451
    ISSN 1435-2443
    DOI 10.1007/s00423-023-02864-x
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  9. Article: Laparoscopic colon resection in patients with situs inversus totalis: Is it the same operation as in patients without situs inversus totalis?

    Karabay, Onder / Gurbuz, Bulent / Zenger, Serkan / Balik, Emre / Bugra, Dursun

    Journal of minimal access surgery

    2018  Volume 15, Issue 1, Page(s) 68–70

    Abstract: Situs inversus totalis (SIT) is a rare condition. In this case, a patient who underwent laparoscopic anterior resection for repeated sigmoid colon diverticulitis with SIT was presented. Laparoscopy surgery in patients with this condition has some ... ...

    Abstract Situs inversus totalis (SIT) is a rare condition. In this case, a patient who underwent laparoscopic anterior resection for repeated sigmoid colon diverticulitis with SIT was presented. Laparoscopy surgery in patients with this condition has some important technical differences than standard laparoscopic procedures. Therefore, it may be more appropriate to request surgical experience to perform safe laparoscopic surgery in patients with SIT.
    Language English
    Publishing date 2018-05-04
    Publishing country India
    Document type Case Reports
    ZDB-ID 2186884-0
    ISSN 1998-3921 ; 0972-9941
    ISSN (online) 1998-3921
    ISSN 0972-9941
    DOI 10.4103/jmas.JMAS_13_18
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  10. Article: The importance of serum intestinal fatty acid-binding protein for the early diagnosis of acute mesenteric ischemia.

    Zenger, Serkan / Demir Piroğlu, Işılay / Çevik, Ayhan / Özcabı, Yetkin / Fakıoğlu, Doğan / Senol, Metin / Altıntaş, Mehmet Mustafa / Bildik, Nejdet / Yücel, Tayfun

    Ulusal travma ve acil cerrahi dergisi = Turkish journal of trauma & emergency surgery : TJTES

    2021  Volume 27, Issue 3, Page(s) 278–283

    Abstract: Background: Acute mesenteric ischemia (AMI), although relatively rare, is an emergency condition with high mortality rates (60-80%) attributed to lack of early diagnosis. The aim of this experimental study was to observe the changes in serum intestinal ... ...

    Title translation Akut mezenter iskeminin erken tanısında serum intestinal yağ asidi bağlayıcı proteininin önemi.
    Abstract Background: Acute mesenteric ischemia (AMI), although relatively rare, is an emergency condition with high mortality rates (60-80%) attributed to lack of early diagnosis. The aim of this experimental study was to observe the changes in serum intestinal fatty acid-binding protein (I-FABP) levels over time in the AMI model by ligating superior mesenteric artery (SMA) in rats and to compare with the serum I-FABP levels of the rats in the control group.
    Methods: Twenty rats were randomly allocated into two groups as control and ischemia group. The basal serum I-FABP levels were determined. SMA was isolated by laparotomy in all animals. In the ischemia group, SMA was ligated and intestinal ischemia was formed. Blood was taken from each rat in both groups at 30th, 60th, and 90th min to determine the serum I-FABP levels. The blood results were compared between two groups and were also compared by time in each group.
    Results: In the ischemia group, serum I-FABP levels were significantly higher than the control group at post-operative 30th, 60th, and 90th min (p<0.01). In comparison with pre-operative serum I-FABP levels, remarkable increases were observed statistically at post-operative 30th, 60th, and 90th min in the ischemia group (p<0.01). In contrast, there was no statistically significant difference within the serum I-FABP levels over time in the control group. The increases of serum I-FABP levels in the ischemia group were directly correlated with the time of ischemia.
    Conclusion: Serum I-FABP levels have increased significantly in the intestinal ischemia and these values have risen progressively over time. Serum I-FABP may be a useful and promising biomarker for the early diagnosis of AMI.
    MeSH term(s) Animals ; Disease Models, Animal ; Early Diagnosis ; Fatty Acid-Binding Proteins/blood ; Mesenteric Artery, Superior/physiopathology ; Mesenteric Ischemia/diagnosis ; Rats
    Chemical Substances Fatty Acid-Binding Proteins
    Language English
    Publishing date 2021-04-21
    Publishing country Turkey
    Document type Journal Article
    ZDB-ID 2253739-9
    ISSN 1306-696X
    ISSN 1306-696X
    DOI 10.14744/tjtes.2020.35823
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