Person: ATALAY, VAFİ
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ATALAY
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VAFİ
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Publication Open Access Tumor Response after Preoperative Chemoradiation Therapy with Simultaneous Integrated Boost Using Volumetric Modulated Arc Therapy in Locally Advanced Rectal Cancer(ELSEVIER SCIENCE INC, 2019-09) DEVRAN, BENNUR ZEYNAN; Adli, M.; Alkis, H.; Gulegen, B. Z.; Halil, S.; Degerli, A. Dagli; Ozturk, F.; Atalay, V.; Yegen, C.Publication Metadata only Kolorektal cerrahi pratiğimizde eras (cerrahi sonrası hızlandırılmış iyileşme) uygulanması: Tek merkez sonuçları(2019-04-10) ATALAY, VAFİ; DALKILIÇ, MUHAMMED SAİD; ÖZOCAK, AYŞEGÜL BAHAR; YEGEN, ŞEVKET CUMHUR; Atalay V., Dalkılıç M. S., Özocak A. B., Yegen Ş. C.Cerrahi sonrası hızlandırılmış iyileşme (ERAS) perioperatif cerrahi stresi azaltmak ve iyileşmeyi hızlandırmak için önerilen bir tedavi protokolüdür. Bu çalışmada ERAS protokolünde tanımlanan maddelerin pratiğimizde ne kadarının uygulandığı araştırılmıştır. Gereç-Yöntem: Kolorektal cerrahi uygulanmış hastaların bilgileri retrospektif olarak incelendi. Hastaların preoperatif bilgilendirilmesi, tromboemboli profilaksisi, antibiyotik profilaksisi, erken mobilizasyon, erken oral beslenme, normotermi, epidural analjezi, nazogastrik (NG) sondanın ve idrar sondasının tutulma süreleri, drenlerin tutulma süresi ve postoperatif komplikasyonlar ile ilgili data incelendi. Bulgular : Aralık 2017 ile Ocak 2019 tarihleri arasında Marmara Üniversitesi Hastanesinde kolorektal cerrahi uygulanmış 168 hastanın bilgileri incelendi. Ortanca yaş 60 (18- 88) ve 90’ı (%53) erkek hastaydı. Hastaların tamamına preoperatif bilgilendirme, tromboemboli profilaksisi, antibiyotik profilaksisi, erken mobilizasyon ve normotermi uygulanmıştır. 148 (%88) açık,21 (%12) laparoskopik cerrahi uygulanmıştır. Ortanca dren tutulma süresi 5 (2- 13) gündür. NG tüpün ortanca tutulma süresi 0 (0-7) olarak saptanmıştır. İdrar sondasının tutulma süresi 3 (1-12) gündür. 144 (%86) hastaya epidural analjezi uygulanmıştır. 159 (%94) hastaya postoperatif 1.gün sıvı gıda ve %85 hastaya postoperatif 4.güne kadar katı gıda verilmiştir. 50 (%30) hastada postoperatif ilk 2 günde, 141(%84) hastada ise ilk 4 günde gaz çıkışı izlendi. Ortanca yatış süresi 5(2-33) gündür. 26 (%15) hastada postoperatif komplikasyon izlenmiştir. En sık komplikasyonlar ileus ve yara yeri infeksiyonudur. İdrar sondası tutulma süreleri karşılaştırıldığında postoperatif komplikasyon gelişen ve gelişmeyenler arasında anlamlı fark saptanmamıştır (p=0.06). Epidural uygulanan hasta grubunda komplikasyon oranı daha fazla izlenmiştir [26 (%18) vs 0 (%0), p<0.001]. İleus görülen hastaların (n=12) tamamının epidural grubunda izlenmesi dikkat çekmektedir (p<0.001). Ayrıca postoperatif gaz çıkışı epidural olmayan grupta daha erken saptanmıştır (2,5 ± 0.7 vs 3,5 ± 1,75, p=<0.001). Açık cerrahi uygulanan hasta grubunda komplikasyon oranı daha fazla izlenmiştir [26 (%18) vs 0 (%0), p<0.001]. Sonuç: ERAS protokolünde tanımlanan maddelerin kendi pratiğimizde sıkça uygulandığı görülmüştür. Bu çalışmada ERAS protokolünün çoğunlukla iyileşmeyi hızlandırdığı görülürken epidural analjezinin postoperatif genel komplikasyonlar açısından olumsuz etkisinin olduğu gösterilmiştir.Publication Open Access Transanal Minimally Invasive Surgery (TAMIS) Using Single Incision Laparoscopic Surgery (SILS) Port for the Management of Benign Rectal Neoplasms: A Single Center Study(2021-01-01) UPRAK, TEVFİK KIVILCIM; ATALAY, VAFİ; UPRAK T. K. , ATALAY V.; Marmara Üniversitesi, Tıp Fakültesi, Cerrahi Tıp Bilimleri BölümüAim: Conventional transanal excision was described decades ago for treatment of benign rectal neoplasms. However, the chalanges of this technique leads to use alternative approachs. We evaluated the results of transanal minimally invasive surgery (TAMIS) with single incision laparoscopic surgery (SILS) port in treatment of benign rectal neoplasms. Method: Data of the patients who underwent TAMIS with SILS port in one center were retrospectively analyzed. SILS port was placed through in the anal canal and ultrasonic sealing device was used for excision the tumors. Complications during or after surgery were reported. Patients were followed-up by rectal examination with rectoscopy and recurrences were evaluated. Results: Between July 2015 and March 2020, 20 patients underwent TAMIS at one center. The median age of the patients was 67 (37-79). The procedure was performed in all of the patients with a lithotomy position. Full-thickness defect after complete resection of the lesion was observed in 5 (25%) patients. However, abdominal cavity was not exposed through the TAMIS procedure in any of the patients. The rectal wall defect was not repaired in any of the patients. No major complication occured in the patients. The hospital stay was 1 (1-4) days. The surgical margin was negative in 19 patients (95%). After the follow-up period of 9 (1-43) months, 3 (17%) patients had a recurrence and further surgery was performed. Conclusion: TAMIS using SILS port for the management of rectal neoplasms is a safe and effective for treatment benign rectal lesions.Publication Metadata only SİLS port kullanılarak yapılan Transanal Minimal İnvaziv Verrahi (TAMİS) tek merkez uzun dönem sonuçları(2022-04-27) UPRAK, TEVFİK KIVILCIM; ATALAY, VAFİ; DALKILIÇ, MUHAMMED SAİD; Verdiyev O., UPRAK T. K., ATALAY V., DALKILIÇ M. S.Publication Open Access Depression, Anxiety, Sexual Dysfunction and Quality of Life in Patients with Ileostomy or Colostomy(2018-06-14) ATALAY, VAFİ; Kader BAHAYİ;Wafi ATTAALLAH;Samet YARDIMCI;Hüseyin BULUT;EYLEM ÖZTENAim: Despite improved cure rates with oncological treatment, stomas (colostomy, ileostomy) are still a commonly used surgical procedure for thetreatment of colorectal cancer patients. The aim of this study was to evaluate depression, anxiety, sexual dysfunction, and quality of life in patientswith ileostomy and colostomy.Method: The study was planned as a case-control, retrospective study. Survivors of colorectal cancer who underwent surgery with ostomy (ileostomyor colostomy) at one center were included in the study. The control group consisted of healthy volunteers. Depression, anxiety, and quality oflife after treatment were assessed using validated questionnaires: the Beck Depression inventory, Beck Anxiety inventory, and Short-Form 36,respectively. Sexual function was measured using the validated questionnaires Arizona Sexual Experiences scale and Golombok-Rust inventory ofSexual satisfaction.Results: A total of 50 patients (patient group) completed the questionnaires. The control group comprised 50 healthy volunteers. The mean anxietyscore Beck Anxiety inventory was significantly higher in the patient group than in the control group (p=0.04). The mean Arizona Sexual Experiencesscale score was significantly higher in the patient group than in control group (23.0±4.2 vs. 14.1±6.5, respectively; p=0.01). According to Golombok-Rust inventory of Sexual satisfaction, infrequent sexual intercourse was significantly more common among the patient group than in the control group(p=0.01). The patient group had significantly lower self-reported mental health and physical well-being than the control group (p=0.01 and 0.03).Conclusion: It was found that patients who had ileostomy or colostomy had higher rates of anxiety symptoms, less sexual pleasure, more abstinencefrom sexual intercourse, and lower quality of life compared to healthy individuals.Publication Open 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.