Person: GÜNAL, ÖMER
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GÜNAL
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ÖMER
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Publication Open Access Prognostic Impact of the Metastatic Lymph Node Ratio on Survival in Gastric Cancer(SPRINGER INDIA, 2016-03) GÜNAL, ÖMER; Attaallah, Wafi; Uprak, Kivilcim; Gunal, Omer; Yegen, CumhurResearch on the prognostic value of lymph node ratio (LNR) in gastric cancer (GC) remains limited and controversial results were obtained. In this study, we aimed to evaluate whether LNR was an independent prognostic factor for gastric carcinoma. A retrospective review of a database of gastric cancer patients was performed to determine the effect of the LNR on the overall survival (OS) and the disease-free survival (DFS). Of the total 135 patients with gastric cancer who underwent resection between March 2012 and December 2013, 44 patients with non metastatic gastric cancer were eligible for analysis. Survival curves were estimated using the Kaplan-Meier method. Cox regression analyses, after adjustments for potential confounders, were used to evaluate the relationship between the LNR and survival. According to the cutoff point 0.37 (37 %), the one-year OS rate for LNR <= 37 % was significantly better than that for LNR > 37 % (91.3 % and 61.9 %, respectively, P = 0.02). The one-year DFS for LNR <= 37 % was significantly better than that for LNR > 37 % (91.3 % and 66.7 %, respectively, P = 0.027). In stratified and multivariate analyses adjusted for age, gender, histology and tumor status, a higher LNR was associated with high pN stage and so associated with worse OS and DFS. Thus, the LNR 37% as a cutoff point was found not to be an independent factor for predicting the one-year OS or DFS in patients with non-metastatic GC. The LNR is a prognostic factor in GC. However, no single cut-off value was determined as an independent prognostic factor.Publication Metadata only Captopril prevents the oxidative damage to proteins after renal ischemia reperfusion injury: role of endothelin-1(1997) KURTEL, HIZIR; Günal, O.; Aktan, A. O.; Yegen, C.; Kurtel, H.; Yalin, R.Ischemia reperfusion (I/R) injury is one of the leading cause of the transplanted organ loss. In this experimental study, we investigated the effect of captopril on endothelin and eicosanoid release in I/R injury of the kidney. Rats were subjected to 60 min ischemia and 60 min of reperfusion of the left kidney in control and captopril groups. Tissue protein oxidation products, PGE2 and LTB4 levels and plasma endothelin-1 (ET-1) like activity were determined in sham operated, control and captopril groups. There were no differences in the LTB4 levels among the groups. ET-1 and PGE2 levels and protein oxidation products increased in the control group when compared with the sham. Captopril further increased both PGE2 and ET-1 concentrations and prevented protein oxidation. The increased ET-1 concentrations in the captopril treated group may imply the protective role of endothelin as the significant increase in protein oxidation products was reversed by captopril infusion. This has led us to believe that captopril might be useful in preventing I/R injury of the kidney. Also the release of endothelin from the vascular endothelium is increased by captopril and may be mediated by PGE2.Publication Metadata only Simultaneous resection for colorectal cancer with synchronous liver metastases is a safe procedure: Outcomes at a single center in Turkey(IRCA-BSSA, 2017) ERDİM, AYLİN; Dulundu, Ender; Attaallah, Wafi; Tilki, Metin; Yegen, Cumhur; Coskun, Safak; Coskun, Mumin; Erdim, Aylin; Tanrikulu, Eda; Yardimci, Samet; Gunal, OmerThe optimal surgical strategy for treating colorectal cancer with synchronous liver metastases is subject to debate. The current study sought to evaluate the outcomes of simultaneous colorectal cancer and liver metastases resection in a single center. Prospectively collected data on all patients with synchronous colorectal liver metastases who underwent simultaneous resection with curative intent were analyzed retrospectively. Patient outcomes were compared depending on the primary tumor location and type of liver resection (major or minor). Between January 2005 and August 2016, 108 patients underwent simultaneous resection of primary colorectal cancer and liver metastases. The tumor was localized to the right side of the colon in 24 patients (22%), to the left side in 40 (37%), and to the rectum in 44 (41%). Perioperative mortality occurred in 3 patients (3%). Postoperative complications were noted in 32 patients (30%), and most of these complications (75%) were grade 1 to 3 according to the Clavien-Dindo classification. Neither perioperative mortality nor the rate of postoperative complications after simultaneous resection differed among patients with cancer of the right side of the colon, those with cancer of the left side of the colon, and those with rectal cancer (4%, 2.5%, and 2%, respectively, p = 0.89) and (17%, 33%, and 34%, respectively; p = 0.29)]. The 5-year overall survival of the entire sample was 54% and the 3-year overall survival was 67 %. In conclusion, simultaneous resection for primary colorectal cancer and liver metastases is a safe procedure and can be performed without excess morbidity in carefully selected patients regardless of the location of the primary tumor and type of hepatectomy.Publication Open Access Melatonin in preservation solutions prevents ischemic injury in rat kidneys(2022-08-01) YEGEN, ŞEVKET CUMHUR; GÜNAL, ÖMER; COSKUN A., YEGEN Ş. C. , ARBAK S., Attaallah W., GÜNAL Ö., Elmas M. A. , UÇAL Y., CAN Ö., Baş B., Yildirim Z., et al.© 2022 Coskun et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.Transplantation is lifesaving and the most effective treatment for end-stage organ failure. The transplantation success depends on the functional preservation of organs prior to transplantation. Currently, the University of Wisconsin (UW) and histidine-tryptophan-ketoglutarate (HTK) are the most commonly used preservation solutions. Despite intensive efforts, the functional preservation of solid organs prior to transplantation is limited to hours. In this study, we modified the UW solution containing components from both the UW and HTK solutions and analyzed their tissue-protective effect against ischemic injury. The composition of the UW solution was changed by reducing hydroxyethyl starch concentration and adding Histidine/Histidine-HCl which is the main component of HTK solution. Additionally, the preservation solutions were supplemented with melatonin and glucosamine. The protective effects of the preservation solutions were assessed by biochemical and microscopical analysis at 2, 10, 24, and 72 h after preserving the rat kidneys with static cold storage. Lactate dehydrogenase (LDH) activity in preservation solutions was measured at 2, 10, 24, and 72. It was not detectable at 2 h of preservation in all groups and 10 h of preservation in modified UW+melatonin (mUW-m) and modified UW+glucosamine (mUW-g) groups. At the 72nd hour, the lowest LDH activity (0.91 IU/g (0.63-1.17)) was measured in the mUW-m group. In comparison to the UW group, histopathological damage score was low in modified UW (mUW), mUW-m, and mUW-g groups at 10, 24, and 72 hours. The mUW-m solution at low temperature was an effective and suitable solution to protect renal tissue for up to 72 h.Publication Open Access Prognostic Impact of the Metastatic Lymph Node Ratio on Survival in Rectal Cancer(2013) GÜNAL, ÖMER; Attaallah, Wafi; Gunal, Omer; Manukyan, Manuk; Ozden, Gulden; Yegen, CumhurPublication Open Access Management of staple line leaks after laparoscopic sleeve gastrectomy: Single-center experience(2024-05-31) UPRAK, TEVFİK KIVILCIM; COŞKUN, MÜMİN; UĞURLU, MUSTAFA ÜMİT; GÜNAL, ÖMER; CİNGİ, ASIM; YEGEN, ŞEVKET CUMHUR; UPRAK T. K., COŞKUN M., UĞURLU M. Ü., GÜNAL Ö., CİNGİ A., YEGEN Ş. C.Objective: In obesity surgery, laparoscopic sleeve gastrectomy (LSG) is a frequently applied method. However, there are certain complications. Leakage is one of the most serious complications after surgery, causing postoperative morbidity and sometimes mortality. There is no consensus about management of leaks after LSG. In our study, we aimed to present our experience on the management of LSG leaks. Patients and Methods: Patients who underwent LSG between 2010-2017 in a tertiary university hospital were analyzed retrospectively. Demographic characteristics, endoscopic and surgical interventions, morbidity, and mortality rates of patients diagnosed with LSG leak were analyzed from prospectively recorded data. Results: Leak was observed in 11 (2.15%) of a total of 510 LSG patients. Six (54%) patients were diagnosed as acute and 5 were early leaks. Stent was applied to most of the patients (72%) with or without surgical exploration. The average length of stay in hospital was 21 days. Mortality was observed in 2 patients. Conclusions: Consequently, leakage after LSG is a complication that requires multimodal therapy. Surgical treatment combined with endoscopic intervention may increase success.