Person: UPRAK, TEVFİK KIVILCIM
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UPRAK
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TEVFİK KIVILCIM
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Publication Metadata only Pankreati̇koduodenektomi̇ sonrasi yapilan uç yan pankreti̇kojejenostomi̇lerde stent uygulamasi pankreati̇k fi̇stül oranina etki̇li̇ mi̇?(2021-09-12) ATICI, ALİ EMRE; ÖZOCAK, AYŞEGÜL BAHAR; UPRAK, TEVFİK KIVILCIM; COŞKUN, MÜMİN; YEGEN, ŞEVKET CUMHUR; ATICI A. E., ÖZOCAK A. B., UPRAK T. K., COŞKUN M., YEGEN Ş. C.Publication Metadata only A new technique of completely diverted tube ileostomy for the protection of colorectal anastomosis: a pilot study(WILEY, 2020) YEGEN, ŞEVKET CUMHUR; Attaallah, W.; Bulut, A.; Uprak, T. K.; Yegen, C.Aim This study was designed to evaluate a new technique for a completely diverting tube ileostomy achieved through temporary occlusion of the distal ileum using a flexible rubber strip. Methods This prospective interventional study was conducted in one centre. Patients who underwent colorectal resections with a primary anastomosis and who were deemed as requiring a defunctioning stoma were included in the study. After completion of resection and anastomosis, the tube ileostomy was fashioned by inserting a reinforced (spiral) endotracheal tube with an inner diameter of 7.5 mm into the ileum. To provide complete faecal diversion, temporary occlusion of the distal ileum was performed using a flexible rubber strip. The primary outcome of this study was the incidence of complete diversion achieved using this method. Results Fifty consecutive patients underwent a diverted tube ileostomy using the technique described above. Defaecation before removal of the strip did not occur in any of the patients inferring that complete diversion was observed in all patients (100%). The tube was removed at postoperative week 3. After tube removal, the resulting enterocutaneous fistulas closed spontaneously in a median of 6 (2-30) days. Conclusion The diverting tube ileostomy technique using an easily removable rubber strip to defunction the colorectal anastomosis is a safe and effective method that precludes the need to fashion a stoma.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 Chemical Ablation for Treating Anal Fistulas without Surgical Intervention: Long-Term Results(SAGE PUBLICATIONS INC, 2021) KARA, BURAK; Attaallah, Wafi; Uprak, Tevfik K.; Kara, Burak; Sen, Aliosman; Tuney, Davut; Yegen, CumhurPurposes. This study aimed to evaluate long-term outcomes after the application of a corrosive chemical agent for ablation of epithelial tissue as a non-surgical treatment of anal fistulas. Methods. Adult patients with symptomatic perianal fistula were prospectively included in the study. The fistula tract was irrigated with a 5% silver nitrate solution. The primary outcome measured in this study was the rate of clinical healing after long-term follow-up. Factors that may affect healing were also analysed. Results. A total of 186 patients with anal fistula were analysed. After irrigation with silver nitrate, 82 (44%) patients had complete clinical healing during a median follow-up time of 50 (7-64) months. Patients with intermittent discharge had a significantly higher rate of complete clinical healing than those with continuous discharge (P < .04). Fistulas without abscesses or secondary tracts had a significantly higher rate of complete clinical healing than the other types (P = .007). Conclusion. Chemical ablation of the epithelium of the anal fistula yields promising long-term outcomes in the management of anal fistulas without surgical intervention.Publication Open Access Percutaneous endoscopic gastrostomy: a secondary care hospital experience(2021-01-01) UPRAK, TEVFİK KIVILCIM; ERGENÇ M., Derici S. T. , UPRAK T. K.INTRODUCTION: Percutaneous endoscopic gastrostomy (PEG) is the most common enteral feeding method in patients with swallowing disorders. PEG is a minimally invasive procedure, but acute and chronic complications may develop after the procedure. Therefore, in this article, we evaluated PEG interventions that were performed in a secondary care hospital. METHODS: We performed a retrospective observational study of patients who underwent PEG intervention from January 2019 to June 2021 at the Istanbul Sultanbeyli State Hospital Endoscopy Unit. This study was approved by the local Ethics Committee and registered with ClinicalTrials.gov (NCT05012527). A total of 45 patients’ comorbidities, indications, complications, and 30-day mortality rates were analyzed. RESULTS: The majority of our population was elderly patients, and the mean age of the patients was 74. Most patients had multiple comorbidities such as hypertension, Alzheimer’s disease, stroke, and diabetes mellitus. The minor complication rate was 24.4%, and the major complication rate was 4.4%. Thirty-day mortality was observed in 18% of this cohort. DISCUSSION AND CONCLUSION: Before the PEG procedure, the patient’s general condition, the expected time of insufficient food intake, life expectancy, and comorbidities should be carefully examined. Our study has shown that PEG is a viable and safe procedure.Publication Metadata only PARKİNSON HASTALIĞININ TEDAVİSİNDE SÜREKLİ LEVODOPA- KARBİDOPA BAĞIRSAK JELİ (LCIG) İNFÜZYONU İÇİN PERKÜTAN ENDOSKOPİK TRANSGASTRİK JEJUNOSTOMİ (PEG-J) TÜPÜ TAKILMASI TEKNİĞİ VE TEK MERKEZ SONUÇLARIMIZ(2021-10-30) AKMERCAN, TAYFUN; UPRAK, TEVFİK KIVILCIM; COŞKUN, MÜMİN; GÜNAL, ÖMER; GÜNAL, DİLEK; AKMERCAN T., UPRAK T. K. , COŞKUN M., GÜNAL Ö., GÜNAL D.Publication Open Access Factors Predicting Surgical Treatment in Patients with Adhesive Small Bowel Obstruction: Retrospective Single-centre Study(2022-09-01) UPRAK, TEVFİK KIVILCIM; AKIN, MUHAMMED İKBAL; COŞKUN, MÜMİN; YEGEN, ŞEVKET CUMHUR; UPRAK T. K. , AKIN M. İ. , COŞKUN M., Yegen C.Objective: To investigate the factors which predict treatment strategy in patients with adhesive small bowel obstruction.Study Design: Descriptive study.Place and Duration of Study: General Surgery Clinic, Marmara University Medical Faculty, Istanbul, Turkey, between January 2016 and December 2020. Methodology: Data of the patients with adhesive small bowel obstruction (ASBO) was retrospectively collected. The demo-graphic characteristics and laboratory findings were evaluated. Patients, who underwent conservative treatment and surgical intervention, were compared. Differences between the two groups in terms of demographic characteristics, prognostic nutri-tional index (PNI) scores, and neutrophil (NEU)-to-lymphocyte (LYM) ratio (NLR), were evaluated.Results: One-hundred thirty-seven patients were included in the study. Seventy-four (54%) of the patients had conservative treatment. There was no statistically significant difference between the surgical and conservative treatment groups according to the age, gender, and ASA score (p=0.77, 0.21 and 0.95 respectively). The patients with congenital aetiology and low PNI scores were in significantly higher numbers among the surgical treatment group (p <0.001 and p=0.004, respectively). In patients, who underwent surgery, the resection rate was found significantly higher in older age (63 vs. 52, p=0.01).Conclusion: Patients with low PNI scores and congenital adhesive small bowel obstruction undergo operative treatment more frequently than conservative treatment. Future studies focusing on diagnostic scores to predict early surgery in ASBO patients may include these variables.Publication Open Access Video-Based Learning Habits of General Surgeons in Turkey: A Survey Study(2021-01-01) UPRAK, TEVFİK KIVILCIM; COŞKUN, MÜMİN; KARATAŞ, SABRİ ALPER; UPRAK T. K. , Karatas S. A. , COŞKUN M.GİRİŞ ve AMAÇ: Genel cerrahi eğitiminde, multimedya tabanlı eğitim kullanımı sınırlıdır. Çoğu cerrah, özellikle cerrahi asistanlığı sonrası devam eden eğitimleri için cerrahi videoları izlemek veya yayınlamak için farklı platformlar kullanır. Bu anket çalışması ile genel cerrahlar arasında video kaynakları kullanma alışkanlıklarını incelemesi planlanmaktadır. YÖNTEM ve GEREÇLER: Google anketiyle hazırlanan 28 soru Türk Cerrahi Derneği'nin posta duyuru sistemi aracılığıyla genel cerrahlara gönderildi. Demografik özellikler, cerrahi video ve eğitim perspektifleri, video görüntüleme platformları, ideal video özellikleri sorgulandı. BULGULAR: Soruları 212 cerrah yanıtladı. Güncel yayınlar ve ders kitapları öğrenme için iki temel güvenilir kaynaktır.Cerrahların büyük kısmı online video kaynaklardan faydalandığını ifade etti. Websurg, web tabanlı öğrenme için bir numaralı kaynak olarak tercih edilirken ve onu Youtube ve Türk Cerrahi Derneği web sitesi takip etmekteydi. TARTIŞMA ve SONUÇ: Sonuç olarak, cerrahların büyük çoğunluğu bir video platformunu takip etmektedir. Ancak yeni bilgi veya teknik öğrenmek için özellikle güncel yayınları izlemektedirler. Ancak ilerleyen teknoloji ile birlikte video bazlı öğrenme önem kazanmaktadır. Anlaşılır ve güvenilir video kaynakları oluşturmak, uzmanlık sonrası devam eden eğitiminde etkili bir yöntem olabilir.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 Mide MAlign tümörlerinde peritoneal tututlumu belirlemede Ca-125 seviyesinin kullanılması(2022-04-27) COŞKUN, MÜMİN; ÖZOCAK, AYŞEGÜL BAHAR; UPRAK, TEVFİK KIVILCIM; YEGEN, ŞEVKET CUMHUR; COŞKUN M., ÖZOCAK A. B., UPRAK T. K., YEGEN Ş. C.