Papers by Akif Enes ARIKAN
Abstract INTRODUCTION: Sentinel lymph node biopsy became the gold standard for early stage breast... more Abstract INTRODUCTION: Sentinel lymph node biopsy became the gold standard for early stage breast cancer by taking the place of axillary dissection in many centers. Different materials and injection sites can be used for sentinel lymph node biopsy. OBJECTIVES: The purpose of this study is comparing different injection sites for sentinel lymph node biopsy with methylene blue dye and determining ideal injection site for finding the sentinel lymph node. MATERIAL AND METHODS: Three hundred seventeen patients who were underwent to surgery for breast cancer with clinically negative axilla and sentinel lymph node biopsy with methylene blue dye was performed in Istanbul University Cerrahpasa Medical Faculty Department of General Surgery between 2003 and 2011 were included in the study. Patients were grouped according to site of injection (subareolar, peritumoral, upper outer quadrant and peritumoral plus subareolar). Statistical difference between groups was assessed for ratio of finding se...
Turkiye Klinikleri Journal of General Surgery Special Topics, 2014
Girifl: Tiroidektomi sonras› hipokalsemi s›k görülmektedir ve birçok faktör ile iliflkilidir. Vit... more Girifl: Tiroidektomi sonras› hipokalsemi s›k görülmektedir ve birçok faktör ile iliflkilidir. Vitamin D kalsiyum dengesinde önemli role sahiptir. Bu çal›flman›n esas amac› geriatrik hastalarda D vitamini eksikli¤inin tiroidektomi sonras› hipokalsemiye etkisini saptamakt›r.
Hepato-gastroenterology, 2015
Due to being a severe complication, iatrogenic bile duct injury is still a challenging issue for ... more Due to being a severe complication, iatrogenic bile duct injury is still a challenging issue for surgeons in gallbladder surgery. However, a commonly accepted classification describing the type of injury has not been available yet. This study aims to evaluate ability of six current classification systems to discriminate bile duct injury patterns. Twelve patients, who were referred to our clinic because of iatrogenic bile duct injury after laparoscopic cholecystectomy were reviewed retrospectively. We described type of injury for each patient according to current six different classifications. 9 patients underwent definitive biliary reconstruction. Bismuth, Strasberg-Bismuth, Stewart-Way and Neuhaus classifications do not consider vascular involvement, Siewert system does, but only for the tangential lesions without structural loss of duct and lesion with a structural defect of hepatic or common bile duct. Siewert, Neuhaus and Stewart-Way systems do not discriminate between lesions a...
Girifl: Bu çal›flman›n amac› geriatrik yafl grubundaki hastalarda total tiroidektominin güvenir-l... more Girifl: Bu çal›flman›n amac› geriatrik yafl grubundaki hastalarda total tiroidektominin güvenir-li¤ini do¤rulamak ve yafl›n olas› morbidite ve mortalite üzerine etkisini araflt›rmakt›r.
Turkish Journal of Surgery, 2015
Turkish Journal of Surgery, 2015
Turkish Journal of Surgery, 2015
Sentinel lymph node biopsy can be applied by using either blue dye or radionuclide method or both... more Sentinel lymph node biopsy can be applied by using either blue dye or radionuclide method or both in breast cancer. Fluorescent imaging with indocyanine green is a new defined method. This study evaluates the applicability of sentinel lymph node biopsy via fluorescent indocyanine green. IC-VIEW (Pulsion Medical Systems AG, Munich, Germany) infrared visualization system was used for imaging. Two mL of indocyanine green was injected to visualize sentinel lymph nodes. After injection, subcutaneous lymphatics were traced and sentinel lymph nodes were found with simultaneous imaging. Sentinel lymph nodes were excised under fluorescent light guidance, and excised lymph nodes were examined histopathologically. Patients with sentinel lymph node metastases underwent axillary dissection. Four patients with sentinel lymph node biopsy due to breast cancer were included in the study. Sentinel lymph nodes were visualized with indocyanine green in all patients. The median number of excised sentinel lymph node was 2 (2-3). Two patients with lymph node metastasis underwent axillary dissection. No metastasis was detected in lymph nodes other than the sentinel nodes in patients with axillary dissection. There was no complication during and after the operation related to the method. According to our limited experience, sentinel lymph node biopsy under fluorescent indocyanine green guidance, which has an advantage of simultaneous visualization, is technically feasible.
Abstract INTRODUCTION: Sentinel lymph node biopsy became the gold standard for early stage breast... more Abstract INTRODUCTION: Sentinel lymph node biopsy became the gold standard for early stage breast cancer by taking the place of axillary dissection in many centers. Different materials and injection sites can be used for sentinel lymph node biopsy. OBJECTIVES: The purpose of this study is comparing different injection sites for sentinel lymph node biopsy with methylene blue dye and determining ideal injection site for finding the sentinel lymph node. MATERIAL AND METHODS: Three hundred seventeen patients who were underwent to surgery for breast cancer with clinically negative axilla and sentinel lymph node biopsy with methylene blue dye was performed in Istanbul University Cerrahpasa Medical Faculty Department of General Surgery between 2003 and 2011 were included in the study. Patients were grouped according to site of injection (subareolar, peritumoral, upper outer quadrant and peritumoral plus subareolar). Statistical difference between groups was assessed for ratio of finding se...
Archives of the Balkan Medical Union
Background: Papillary thyroid cancer (PTC) is the most common thyroid malignancy and it constitut... more Background: Papillary thyroid cancer (PTC) is the most common thyroid malignancy and it constitutes about 50 – 90% of differentiated thyroid cancers all over the world. Obesity is also a wellknown risk factor for multiple endocrine pathologies and certain types of cancer. Rapidly incremented incidence rates of PTC and MNG were the major drivers motivated us to study on the possible relationship in between being obese or over weighted and these two prominent thyroid diseases. This study aims to evaluate the relationship of body mass index (BMI), PTC and MNG. Method: Patients with PTC or adenomatous hyperplasia pathology results, who underwent thyroidectomy in the endocrine surgery subdivision, were screened retrospectively by the use of pathology database from 2005 to 2010. Gender, age, BMI, histopathological diagnosis and subtypes of PTC of the cases were recorded from patient files. Results: According to database enquiry, 878 patients of whom 771 were MNG and 107 were PTC had total...
Minerva chirurgica, 2013
Some operative techniques in fundoplication seem to increase the incidence of obstructive symptom... more Some operative techniques in fundoplication seem to increase the incidence of obstructive symptoms. Some authors believe that using intraesophageal bougie and preparing a short and floppy valve in laparoscopic Nissen fundoplication will help to decrease any possible tight crus repair and wrap and so it is effective to decrease the prevalence of postoperative dysphagia. The aim of this study is to show that there is no absolute benefit of routine insertion of a bougie during laparoscopic Nissen fundoplication in relation to post-operative dysphagia. All patients who underwent laparoscopic Nissen fundoplication by a single surgeon between January 2001 and August 2011 were reviewed retrospectively. Esophageal bougie intubation was performed in none of the 154 patients. The operation technique, the duration of the operation, hospital stay and the improvement of the symptoms were assessed. The patients who had esophagitis with Barrett's esophagus and who had hiatal hernia that could ...
Journal of Investigative Surgery, 2014
Background: Ankaferd (Ankaferd blood stopper R , ABS) is a recently developed topical hemostatic ... more Background: Ankaferd (Ankaferd blood stopper R , ABS) is a recently developed topical hemostatic agent. ABS is a standardized mixture of the plants Thymus vulgaris, Glycyrrhiza glabra, Vitis vinifera, Alpinia officinarum, and Urtica dioica. Through its effects on the endothelium, blood cells, angiogenesis, cellular proliferation, vascular dynamics, and cell mediators; Ankaferd plays a part in inflammation and hemostasis processes. The aim of this experimental study is to assess the effects of ABS on the left colonic anastomoses under normal, septic, and ischemic conditions. Methods: Forty-eight Wistar Albino male rats were divided into six weight-matched equal groups: A, anastomosis in normal condition (n = 8); AA, anastomosis with ABS in normal condition (n = 8); AS, anastomosis in septic condition (n = 8); AAS, anastomosis with ABS in septic condition (n = 8); AI, anastomosis in ischemic condition (n = 8); and AAI, anastomosis with ABS in ischemic condition (n = 8). Blood and tissue samples were taken for the histopathological and biochemical studies after the anastomotic bursting pressures were measured. Results: Higher hydroxyproline levels (p = .048) and angiogenesis (p = .038) were observed in the sepsis-induced rats compared to the control group. The inflammatory activity, fibrosis, and granulation were comparable in all experimental groups. Ankaferd improved the angiogenesis under septic conditions (AAS) when compared to the control group (AI; p = .038). Conclusions: ABS may support anastomotic healing in septic conditions. Topical ABS application controlling the mucosal bleeding at the cut ends of the colon may also improve the anastomotic wound healing by means of increasing mechanical strength and positively affecting angiogenesis. Further studies shall focus on the clinical importance of those findings.
Indian Journal of Surgery, 2013
Thyroidectomy is an elective operation performed in an anatomically complex region in which certa... more Thyroidectomy is an elective operation performed in an anatomically complex region in which certain structures are responsible for vital functions and special senses. This study aims to compare the effects of two different technical approaches-nerve dissection combined with intraoperative nerve monitoring (IONM) and no nerve identification-on recurrent laryngeal nerve (RLN) damage in total thyroidectomy. One hundred and sixty-one consecutive cases that underwent total thyroidectomy and 322 RLN under risk were evaluated. In group 1 (n=162), nerve dissection combined with IONM was performed, whereas no RLN identification was performed in group 2 (n=160). While the duration of operation in group 1 (34.23±12.21 min) was statistically shorter than that in group 2 (36.98±16.79 min, p=0.017), there was no significant difference between groups related to RLN palsy (group 1 n=10, group 2 n=7). Use of IONM was found only to shorten the duration of operation. According to our presented experience, there is no benefit of IONMcombined routine dissection of RLN during total thyroidectomy on the prevention of RLN palsy.
Surgical technology international, 2014
Hospitalizing patients up to 72 hours after thyroidectomy is a classical approach. However, the l... more Hospitalizing patients up to 72 hours after thyroidectomy is a classical approach. However, the length of hospitalization has decreased following surgical procedures with new technological devices. Seven hundred one consecutive patients who underwent sutureless total thyroidectomy (STT) between October 2011 and 2013 were included in this study. Six hundred seventy-two (95.9%) were discharged before 24 hours following surgery (short-stay = SS), and 29 were discharged later (delayed-discharge = DD). This study aims to assess short-stay STT with early postoperative complications and readmission to hospital. One hundred forty-three SS patients were male and 529 were female. Mean age was 48 ± 13 years, BMI was 28.7 ± 8.3 kg/m2. Mean hospital stay for SS was 18.13 ± 1.97 (17-23) hours. Histopathology was benign in 443 (65.92%) and malignant in 229 (34.08%) in the SS group. In three (0.4%) of the SS group drainage was required because of hematoma, and in seven (1%) wound infection was obse...
Hellenic Journal of Surgery, 2014
Turkish Journal of Endocrinology and Metabolism, 2013
Purpose: The purpose of this study was to evaluate the clinical and surgical differences between ... more Purpose: The purpose of this study was to evaluate the clinical and surgical differences between substernal goiter and non substernal goiter according to institutional experience.
Updates in Surgery, 2013
Imaging guided well-localized single gland excision via smaller incision without intraoperative p... more Imaging guided well-localized single gland excision via smaller incision without intraoperative parathormone (ioPTH) can be performed in ambulatory settings. Forty-six consecutive patients with solitary parathyroid adenoma causing primary hyperparathyroidism (PHPT), who underwent laterally approached minimal invasive parathyroidectomy (MIP) through 2-3 cm incision between January 2011 and April 2012, were included in the study. All data were collected prospectively; analyzed retrospectively. Intervention with local anesthesia was applied to 46 patients. Parathyroidectomy with local anesthesia and IV sedation was successfully completed in 42 of those. Forty-two patients had biochemically confirmed PHPT; single gland disease was supported by imaging methods. Localization was decided in 15 patients just with USG, in 11 patients just with scintigraphy, and in 16 patients with both. Preoperative mean serum total calcium value was 11.13 ± 1.02 mg/dl. Immediate postoperative and postoperative 2nd week's serum calcium levels were 10.62 ± 1.43 mg/dl (p = 0.006), 9.24 ± 0.79 mg/dl (p \ 0.001), respectively. Preoperative mean serum PTH value was 434.17 ± 550.22 pg/ml. Immediate postoperative and postoperative 2nd week's PTH values were 34.69 ± 28.50 pg/ml (p \ 0.001), 91.21 ± 81.86 pg/ml (p \ 0.001), respectively. In all interventions, no ioPTH assay or frozen section was performed. Forty-one patients (97.62 %) had reduction of serum PTH levels equal or more than 50 %. Cure rate for short-term follow-up was also 97.62 %. One patient had persistent hypercalcemia. Mean operation time was 15:09 ± 6:38 min (range 5:30-35:00). For all excised parathyroid adenomas, average weight was 2,278 ± 1,653.01 mg (range 100-8,000). For patients with well-localized single gland disease, MIP with local anesthesia and IV sedation have high cure rates and less morbidity at experienced centers without general anesthesia and hospital stay.
Uploads
Papers by Akif Enes ARIKAN