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ERGENÇ, MUHAMMER

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ERGENÇ

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MUHAMMER

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  • PublicationOpen Access
    A comparative study of abdominal wall hernia surgery before and after the COVID-19 pandemic: Results from a 2-year observational period
    (2023-08-01) ERGENÇ, MUHAMMER; UPRAK, TEVFİK KIVILCIM; Ergenç M., Uprak T. K.
    BACKGROUND: Abdominal wall hernia surgery is among the most common procedures in general surgery. It is thought that postponing elective hernia surgeries due to the pandemic will increase emergency presentations of hernias, but different data have been published in the literature. OBJECTIVE: This study aimed to evaluate the effect of the coronavirus disease 2019 (COVID-19) pandemic on emergency and elective hernia operations. MATERIALS AND METHODS: Patients who underwent hernia surgery in the Istanbul Sultanbeyli State Hospital between March 2018 and March 2022 were retrospectively analyzed. March 11, 2018–March 11, 2020, and March 12, 2020–March 12, 2022, were categorized as prepandemic and pandemic periods, respectively, and were evaluated as 1-year periods. All abdominal wall hernia operations performed in the hospital were examined. RESULTS: A total of 1,644 patients underwent hernia operations. Patients’ ages ranged from 18 to 87 years; the mean age was 47.5±13.6. A total of 1,319 (80%) of patients were men. There was a 50% decrease in the number of surgeries during the pandemic, but there was no significant increase in emergency surgeries (P = 0.49). Incisional and ventral hernia procedures declined dramatically over the COVID-19 pandemic compared with the prepandemic period, whereas inguinal hernia surgeries increased proportionally (P = 0.002). CONCLUSIONS: While a decrease was observed in total abdominal hernia surgeries performed during the COVID-19 pandemic compared with the prepandemic period, no significant increase was found in emergency abdominal hernia surgeries. Patients with ventral and incisional hernias can be followed up to be operated on under optimal conditions.
  • PublicationOpen Access
    Prognostic significance of metastatic lymph node ratio in gastric cancer: a Western-center analysis
    (2023-08-01) UPRAK, TEVFİK KIVILCIM; AKIN, MUHAMMED İKBAL; ÇELİKEL, ÇİĞDEM; YEGEN, ŞEVKET CUMHUR; ERGENÇ, MUHAMMER; Ergenç M., Uprak T. K., Akın M. İ., Hekimoğlu E. E., Çelikel Ç., Yegen Ş. C.
    BackgroundTumor-node-metastasis (TNM) staging is the central gastric cancer (GC) staging system, but it has some disadvantages. However, the lymph node ratio (LNR) can be used regardless of the type of lymphadenectomy and is considered an important prognostic factor. This study aimed to evaluate the relationship between LNR and survival in patients who underwent curative GC surgery.MethodsAll patients who underwent radical gastric surgery between January 2014 and June 2022 were retrospectively evaluated. Clinicopathological features of tumors, TNM stage, and survival rates were analyzed. LNR was defined as the ratio between metastatic lymph nodes and total lymph nodes removed. The LNR groups were classified as follows: LNR0 = 0, 0.01 < LNR1 ≤ 0.1, 0.1 < LNR2 ≤ 0.25 and LNR3 > 0.25. Tumor characteristics and overall survival (OS) of the patients were compared between LNR groups.ResultsAfter exclusion, 333 patients were analyzed. The mean age was 62 ± 14years. According to the LNR classification, no difference was found between groups regarding age and sex. However, TNM stage III disease was significantly more common in LNR3 patients. Most patients (43.2%,n = 144) were in the LNR3 group. In terms of tumor characteristics (lymphatic, vascular, and perineural invasion), the LNR3 group had significantly poorer prognostic factors. The Cox regression model defined LNR3, TNM stage II—III disease, and advanced age as independent risk factors for survival. Patients with LNR3 demonstrated the lowest 5-year OS rate (35.7%) (estimated mean survival was 30 ± 1.9months) compared to LNR 0–1–2.ConclusionOur study showed that a high LNR was significantly associated with poor OS in patients who underwent curative gastrectomy. LNR can be used as an independent prognostic predictor in GC patients.
  • PublicationOpen Access
    Can Gastric Specimen Measurements Defines the Laparoscopic Sleeve Gastrectomy Outcome?
    (2018) ERDİM, AYLİN; Günal, Ömer; Uprak, Kıvılcım; Ergenc;, Muhammer; Erdim, Aylin
  • PublicationOpen Access
    Outcomes of proximal versus total gastrectomy for proximal gastric cancer: A propensity score-matched analysis of a western center experience
    (2023-01-01) UPRAK, TEVFİK KIVILCIM; ERGENÇ, MUHAMMER; AKMERCAN, AHMET; YEGEN, ŞEVKET CUMHUR; UPRAK T. K., ERGENÇ M., AKMERCAN A., YEGEN Ş. C.
    Purpose: In this western study, we aimed to compare perioperative outcomes, postoperative complications, and overall survival in patients who underwent total gastrectomy (TG) or proximal gastrectomy (PG) for proximal gastric cancer (GC). Methods: Patients who underwent GC surgery at Marmara University Hospital between January 2014 and December 2021 were evaluated retrospectively. Propensity score matching (PSM) was performed to balance the baseline characteristics of patients undergoing PG and TG. Data on patients’ demographics, clinicopathological features of tumors, complications, and survival rates were analyzed. Perioperative outcomes and overall survival of the patients were compared between PG and TG groups. Results: A total of 212 patients were included in this study, with 53 patients in the PG and 159 in the TG group. After 1:1 matching according to PSM, 46 patients in the PG group were matched to 46 in the TG group. After PSM, there were no differences in clinicopathological outcomes except retrieved lymph nodes. In terms of short-term outcomes, overall perioperative morbidity (Clavien Dindo ≥ 3a) was significantly higher in the PG group (p = 0.01). However, there was no significant difference when the complications were considered separately. In the long-term follow-up, reflux esophagitis was associated with the PG group (p=0.04). In multivariate analysis, positive surgical margin and lymphovascular invasion were significant factors related to overall survival. Overall, 5-year survival was 55% in matched patients. The difference in survival was not statistically significant (57 vs. 69 months, p = 0.3) between the two groups. Conclusions: Proximal gastrectomy is applicable to patients up to stage 3 disease, with no difference in overall survival, with caution in early complications and reflux esophagitis. Among all demographic and oncological factors, lymphovascular invasion and resection margin were significantly associated with worse survival.
  • PublicationOpen Access
    Hand-sewn versus stapled anastomosis for billroth II gastrojejunostomy after distal gastrectomy: Comparison of short-term outcomes
    (2023-05-01) UPRAK, TEVFİK KIVILCIM; ERGENÇ, MUHAMMER; ATALAY, VAFİ; Uprak T. K., Ekdal D. C., Ergenç M., Atalay V.
    Introduction: Subtotal gastrectomy is usually performed in patients with distal gastric cancer. After distal gastrectomy, which reconstruction method can be used is still controversial. This study evaluated the effect of the stapler and hand-sewn techniques on postoperative results. Methods: Patients who underwent distal gastrectomy in a single center were evaluated retrospectively in this study. Patients who underwent the Billroth II reconstruction method were analyzed. Hand-sewn and stapled techniques were compared in terms of operative and short-term postoperative outcomes. Results: Two hundred fourteen patients were included. Most of the patients (66.8%) were male. The median age was 61 years. Billroth-II reconstruction with hand-sewn was performed in 161 (75%) patients, and the double stapler technique was performed in 53 (25%) patients. When the hand-sewn and stapled groups were compared, no difference was found in age, sex, or American Society of Anesthesiology scores. There was no difference in choosing antecolic or retrocolic as the surgical technique (p=0.19). A shorter length of hospital stay was detected in the stapled group (p=0.01). The overall complication rate was higher in the hand-sewn group (21.7% vs. 7.5%, p=0.02). Clavien-Dindo grade 3 and above complications were significantly higher in the hand-sewn group (13.7% vs. 3.8%, p=0.02). Conclusion: Our study showed that the stapler anastomosis technique for Billroth II gastrojejunostomy after distal gastrectomy led to fewer overall complications and shortened hospital stays.
  • PublicationOpen Access
    Laparoscopic treatment of a rare causes of acute abdomen; primary omental torsion
    (2021-01-01) ERGENÇ, MUHAMMER; UPRAK, TEVFİK KIVILCIM; Ergenç M., Uprak T. K.
    Primary omentum torsion is one of the diseases of the omentum that can lead to an acute abdomen. In thiscase report, primary omentum torsion was detected in a patient admitted to the emergency departmentwith abdominal pain and was operated on due to acute abdomen findings, and its laparoscopic treatmentwill be explained. The purpose of the case presentation is to emphasize the necessity that primary omentaltorsion should be considered in acute abdomen patients whose history and physical examination do notcomply with specific pathologies. Laparoscopic surgery can help with both the diagnosis and treatment ofthis unusual condition.
  • PublicationOpen Access
    Pancreaticoduodenectomy in patients < 75 years versus ≥ 75 years old: a comparative study
    (2024-12-01) ERGENÇ, MUHAMMER; UPRAK, TEVFİK KIVILCIM; KARPUZ, ŞAKİR; COŞKUN, MÜMİN; YEGEN, ŞEVKET CUMHUR; ATICI, ALİ EMRE; ERGENÇ M., UPRAK T. K., Özocak A. B., KARPUZ Ş., COŞKUN M., YEGEN Ş. C., ATICI A. E.
    Objective: This study aimed to compare the postoperative outcomes of < 75-year-old patients and ≥ 75-year-old patients who underwent pancreaticoduodenectomy (PD) for pancreatic head and periampullary region tumors. Methods: Patients who underwent PD in our hospital between February 2019 and December 2023 were evaluated. Demographics, Eastern Cooperative Oncology Group Performance Status (ECOG-PS) scores, American Society of Anesthesiologists (ASA) scores, comorbidities, hospital stays, complications, and clinicopathological features were analyzed. Patients were divided into < 75 years (Group A) and ≥ 75 years (Group B) groups and compared. Results: The median age of the entire cohort (n = 155) was 66 years (IQR = 16). There was a significant difference between Group A (n = 128) and Group B (n = 27) regarding the ECOG-PS and ASA scores. There was no significant difference between the groups regarding postoperative complications. The 30-day mortality rate was greater in Group B (p = 0.017). Group B had a cumulative median survival of 10 months, whereas Group A had a median survival of 28 months, with a statistically significant difference (p < 0.001). When age groups were stratified according to ECOG-PS, for ECOG-PS 2–3 Group A, survival was 15 months; for ECOG-PS 2–3 Group B, survival was eight months, and the difference was not statistically significant (p = 0.628). Conclusions: With the increasing aging population, patient selection for PD should not be based solely on age. This study demonstrated that PD is safe for patients older than 75 years. In older patients, performance status and the optimization of comorbidities should be considered when deciding on a candidate’s suitability for surgery.