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GÜNAL, ÖMER

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GÜNAL

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ÖMER

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2013 - 201932020 - 20246
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    PublicationOpen 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, Cumhur
    Research 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.
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    PublicationOpen Access
    Comparing the Effects of Antiadhesive Materials after Abdominal Surgery
    (DUZCE UNIV, 2020-03-02) GÜNAL, ÖMER; Dogan, Sami; Cetin, Mehmet Fuat; Gunal, Omer; Erdem, Havva
    Objective: We aimed to evaluate and compare the effects of anti-adhesion materials, Seprafilm, Suprofilm, olive oil, and olive oil containing Vitamin E by measuring tension forces. Methods: 60 male Wistar-Albino rats were divided into six groups. The front side of the cecum and right abdominal parietal peritoneal wall were abrased. The rats were euthanized on the 14th postoperative day. Adhesions between intestines, omentum, other abdominal organs, cecum, incisionsites, and abdominal anterior wall peritoneum were all evaluated. Adhesion strength was measured with dynamometer. Histopathological evaluations of the adhesion area was performed. Results: Stage-I (0.43Newton) in Group-I, stage-IV (1.0540N) in Group-II, stage-II (0.6370N) in Group-III, stage-II in Group-IV (0, 5230N), stage-III (0.7620N) in Group-V, stage-IV (1.3560N) in Group-VI, were detected. A significant difference was found between these findings. P = 0.001, (p<0.05). Histopathological examination: It was found that GroupV-VI reduced inflammation, increased collagen production, fibroblastic activity and vascular proliferation. Conclusions: More objective evaluation can be made by measuring the tension force of the adhesions. Suprafilm can also be effectively used as an antiadhesive, such as Seprafilm. Olive oil and vitamin E require more studies to be used as antiadhesives.
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    PublicationOpen Access
    The effects of perioperative factors on early postoperative morbidity in bariatric surgery
    (2022-04-01) ZENGİN, SENİYYE ÜLGEN; ORHON ERGÜN, MELİHA; GÜNAL, ÖMER; Zengin S. Ü., Orhon Ergün M., Günal Ö.
    Purpose This study aims to examine the predictive role of obesity-type-related indexes and perioperative intraabdominal pressure measurements for early postoperative complications following bariatric surgery. Materials and Methods Sixty-seven female patients with obesity who underwent bariatric surgery (laparoscopic sleeve gastrectomy or gastric bypass) were included in this study. Obesity-related indexes (BMI, waist/hip ratio, and waist/height ratio) were calculated using patient data. Intraoperative hemodynamic measurements and intraabdominal pressure measurements were done at the beginning and at the end of the operation. Intraabdominal pressure measurements were done using both bladder port and trocar port. Patients were followed for early postoperative complications. Results Among 67 patients included, 22 developed early postoperative complications (32.8%), mostly pulmonary (20.9%). Trans-trocar IAP measured at the beginning of the operation emerged as the single independent predictor of postoperative complications (OR, 40.3; p=0.002). Based on ROC analysis, AUC for predicting complications was 0.955 (p<0.01). Optimal cutof point (≥14.5 mmHg) was associated with 100% sensitivity and 82% specifcity. In addition, there were weak but signifcant positive correlations between trans-trocar IAP-beginning and BMI (r=0.443, p<0.001), waist/hip ratio (r=0.434, p<0.001), and waist/height ratio (r=0.539, p<0.001). Conclusion Findings of this study suggest that a high baseline intraabdominal pressure predicts a higher risk for early postoperative complications following bariatric surgery. This information would help improve patient care. Further large studies are warranted.
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    PublicationOpen Access
    Can Gastric Specimen Measurements Defines the Laparoscopic Sleeve Gastrectomy Outcome?
    (2018) ERDİM, AYLİN; Günal, Ömer; Uprak, Kıvılcım; Ergenc;, Muhammer; Erdim, Aylin
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    PublicationOpen 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.
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    PublicationOpen 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, Cumhur
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    PublicationOpen Access
    Does Gastric Expansibility Affect Weight Loss Success After Laparoscopic Sleeve Gastrectomy?
    (2022-08-01) UPRAK, TEVFİK KIVILCIM; ERDİM, AYLİN; KARATAŞ, SABRİ ALPER; GÜNAL, ÖMER; UPRAK T. K. , ERDİM A., Karatas S. A. , GÜNAL Ö.; Marmara Üniversitesi, Tıp Fakültesi, Cerrahi Tıp Bilimleri Bölümü
    Reduced excess weight loss (EWL) or regain is a worrying problem after metabolic surgery. Factors attainable from the resected specimen that can predict this outcome are investigated. We retrospectively analyzed 64 patients who had undergone laparoscopic sleeve gastrectomy. We collected demographic data, preoperative gastric emptying measurements, volume, expansion capacity, and 6-dimensional measurements of sleeve gastrectomy specimens. Correlations between EWL, body mass index levels, and gastric specimen measurements related to gastric remnant dimensions were also scrutinized. We found a significant correlation between the gastric specimen and remnant gastric volume, the resection line length in the gastric specimen, and 12th-month EWL%. Antrum expansibility was significantly increased in patients with weight regain. There was also a negative correlation between weight loss and age at postoperative first and third years. Sleeve resection line measurement and resected antrum diameter measurements can be used to predict weight loss, especially in the first year postoperatively.
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    PublicationOpen Access
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    PublicationOpen 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.