Person: AKMERCAN, AHMET
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AKMERCAN
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AHMET
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Publication Metadata only Mide kanseri cerrahisinde enhanced recovery after surgery (Eras)protokolünün etkinliği(2021-06-11) UPRAK, TEVFİK KIVILCIM; AKMERCAN, AHMET; UPRAK T. K., EKDAL D. C., AKMERCAN A.Publication Metadata only Gastric medullary carcinoma: Clinicopathological features and prognosis-a single-center study(WILEY, 2021) AKMERCAN, AHMET; Uprak, Tevfik Kivilcim; Akmercan, Ahmet; Coskun, Mumin; Attaallah, WafiBackground Gastric medullary carcinoma (GMC) is a distinct histologic subtype of gastric adenocarcinoma, which prominently associated with Epstein-Barr virus infection. This study aimed to evaluate the clinicopathological features and prognosis of patients with medullary carcinoma in one center. Methods Data regarding patients with gastric cancer were retrospectively analyzed at Marmara University between 2014 and 2019. Demographics, pathological features, and overall survival of patients with GMC were evaluated. The primary outcome of this study was to compare the pathological features of GMC to non-GMC (NGMC). The secondary outcome was comparing overall survival between the two groups. Results A total of 412 patients were enrolled in the study. Of 412 patients, 19 (5%) were diagnosed with medullary cancer. Compared to NGMC, no significant differences were observed in patient age, gender, tumor macroscopic pattern, size, lymphovascular invasion, pathological stage, location and size of the tumors, and the number of metastatic lymph nodes in GMC. However, perineural invasion and Borrmann ulcerated type rates were significantly higher among NGMC. Whereas the microsatellite instability (MSI) rate was significantly higher in the GMC (64% and 11%, respectively, p < 0.001). Multivariate analysis showed that the MSI status was the solely significantly different feature between the two groups. Conclusion This study showed that GMC was associated with MSI, which could explain the better prognosis of medullary carcinomas.Publication Metadata only İleokolik Anastomoz Hattına Uygulanan Güçlendirici Süturlerin Anastomotik Komplikasyonlara Olan Etkisi(2021-12-04) COŞKUN, MÜMİN; FERATOĞLU, HALE; UPRAK, TEVFİK KIVILCIM; AKMERCAN, AHMET; COŞKUN M., EKDAL D. C., FERATOĞLU H., UPRAK T. K., AKMERCAN A.Giriş: Kolorektal cerrahiler sonrası meydana gelen anastomoz kaçağı morbidite ve mortaliteyi artıran en yıkıcı komplikasyonlardan biridir. Literatürde anastomoz kaçaklarını azaltmaya yönelik çeşitli girişimler tanımlanmıştır. Bu çalışmada ileokolik anastomoz hattına güçlendirici sütur uygulamasının postoperatif anastomoz kaçağı üzerine etkisi değerlendirildi. Metod: Marmara Üniversitesi Genel Cerrahi Kliniğinde Ekim 2010 - Şubat 2020 tarihleri arasında kolon kanseri nedeniyle sağ hemikolektomi ve ileokolik anastomoz yapılan hastaların demografik verileri, operatif parametreleri ve postoperatif komplikasyonları retrospektif olarak incelendi. Hastalar güçlendirici sütür uygulanan ve uygulanmayan olarak 2 gruba ayrıldı. Güçlendirici sütur grubunda operasyonu gerçekleştiren primer cerrahın kararına göre stapler ile yapılan ileokolik anastomoz hattına 3/0 vicrylle separe seromüsküler güçlendirici süturler konuldu. Çalışmanın primer hedefi anastomoz hattına uygulanan güçlendirici süturlerin anastomoz kaçağı üzerine etkisi olarak belirlendi. Bulgular: Çalışmaya anastomoz hattına güçlendirici süturlerin uygulandığı 75 (%36.2) ve uygulanmadığı 129 (%62.3) olmak üzere toplamda 204 hasta dahil edildi. İki grup arasında demografik veriler, komorbiditeler ve operasyon süresi açısından istatistiksel olarak anlamlı fark saptanmadı. Anastomoz hattına güçlendirici süturlerin uygulandığı grupta 5 hastada (%7.3), uygulanmayan grupta 12 hastada (%11.3) anastomoz kaçağı meydana geldi. Kaçak oranı karşılaştırıldığında istatistiksel olarak anlamlı fark saptanmadı (p: 0.3). Sonuç: Bu çalışma, ileokolik anastomoz hattına güçlendirici sütur uygulamasının istatiksel olarak anlamlı olmasa da anastomoz kaçağını %4 oranında azalttığını göstermiştir.Publication Open Access Pancreatic neuroendocrine tumor mimicking intraductal papillary mucinous neoplasm: Case report(2021-01-01) AKMERCAN, AHMET; BAĞCI ÇULÇİ, PELİN; ATICI, ALİ EMRE; YEGEN, ŞEVKET CUMHUR; UPRAK, TEVFİK KIVILCIM; AKMERCAN A., UPRAK T. K., BAĞCI ÇULÇİ P., ATICI A. E., YEGEN Ş. C.ABSTRACTPancreatic neuroendocrine tumors (PanNETs) are rare pancreatic tumors. They usually exhibit parenchymal growing, however some cases can exhibit intraductal growing. PanNET with intraductal growth may cause intraductal papillary mucinous neoplasm (IPMN)- like clinic scenario by presenting as cystic formations secondary to duct obstruction. In our case, a 69-year- old man with a history of abdominal pain and nausea underwent a computed tomography scan that showed dilated pancreatic duct and cystic lesion which was 8 cm originating from the pancreas. Imaging and laboratory findings were considered to be consistent with an IPMN so the patient underwent distal pancreatectomy and splenectomy. However, the pathological examination of the surgical specimen showed a millimeter-sized PanNET located in pancreatic tail mimicking the IPMN by obstructing the pancreatic duct.Keywords: Gastroenteropancreatic neuroendocrine tumor; pancreatic intraductal neoplasmsPublication Open 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.Publication Metadata only ÖZOFAGUS REZEKSİYONU SONRASI ANOSTOMOZ KAÇAĞINDAENDOSKOPİK VAKUM TEDAVİSİ DENEYİMİMİZ: 3 HASTALIK VAKA SERİSİ(2021-10-30) AKMERCAN, TAYFUN; AKMERCAN, AHMET; UPRAK, TEVFİK KIVILCIM; ATICI, ALİ EMRE; COŞKUN, MÜMİN; AKMERCAN T., AKMERCAN A., UPRAK T. K. , ATICI A. E. , COŞKUN M.Publication Metadata only Mide Kanserinde Bilgisayarlı Tomografi ile Ölçülen Kas Kütlesi Postoperatif Komplikasyon ve Sağkalımı Öngerebilir mi?(2022-04-27) AKMERCAN, AHMET; UPRAK, TEVFİK KIVILCIM; BUĞDAYCI, ONUR; ATICI, ALİ EMRE; AKMERCAN A., UPRAK T. K., BUĞDAYCI O., ATICI A. E.Publication Metadata only Distal mide kanserinde proksimal cerrahi sınır mesafesinin prognostik değeri(2022-04-27) AKMERCAN, AHMET; UPRAK, TEVFİK KIVILCIM; AKMERCAN A., Kötan T., UPRAK T. K.Publication Metadata only Comparison of different anastomosis types in treatment of ileocecal crohn’sdisease(2022-10-01) UPRAK, TEVFİK KIVILCIM; AKMERCAN, AHMET; ATICI, ALİ EMRE; UPRAK T. K., AKMERCAN A., ERGENÇ M., SEVİNDİ H. İ., ATICI A. E.Publication Metadata only Özofagogastrik anastamoz kaçağı kontrolünde peg-j kataterle dekompresyon(2022-04-27) AKMERCAN, AHMET; UPRAK, TEVFİK KIVILCIM; YEGEN, ŞEVKET CUMHUR; EKDAL D. C., AKMERCAN A., UPRAK T. K., YEGEN Ş. C.