Person: BATIREL, HASAN FEVZİ
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BATIREL
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HASAN FEVZİ
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Publication Metadata only Minimally invasive techniques in thymic surgery: a worldwide perspective(2018) BATIREL, HASAN FEVZİ; Batirel, Hasan FevziMinimally invasive surgical techniques are important in surgical management of thymic pathologies. Traditional access techniques are being replaced with minimally invasive techniques using multiportal or uniportal approach. Adoption of minimally invasive techniques for thymic malignancies has been slow due to long term recurrence concerns. Recent studies show that minimally invasive video-assisted thoracoscopic surgery (VATS) or robotic approach to early stage thymic malignancies are associated with less intraoperative bleeding, lower rate of respiratory complications, shorter chest tube duration and shorter hospital stay. Oncologic outcomes are at least equivalent to open approach. Minimally invasive approach for benign pathologies is widely applied. There are significant variations in VATS approaches for thymus, showing a multinational interest in the issue of minimizing trauma during thymectomy. Use of robotic technology is also popular, as the retrosternal area is a narrow anatomic space to manipulate conventional instruments. The evolution of minimally invasive surgery for thymus has been possible with contribution from centers all around the world. In the current practice, various approaches are being adopted and every surgeon should prefer a technique depending on surgical preference and experience.Publication Open Access Radiation field size and dose determine oncologic outcome in esophageal cancer(BIOMED CENTRAL LTD, 2016-12) BATIREL, HASAN FEVZİ; Gemici, Cengiz; Yaprak, Gokhan; Batirel, Hasan Fevzi; Ilhan, Mahmut; Mayadagli, AlpaslanBackground: Locoregional recurrence is a major problem in esophageal cancer patients treated with definitive concomitant chemoradiotherapy. Approximately half of the patients fail locoregionally. We analyzed the impact of enlarged radiation field size and higher radiation dose incorporated to chemoradiotherapy on oncologic outcome. Methods: Seventy-four consecutive patients with histologically proven nonmetastatic squamous or adenocarcinoma of the esophagus were included in this retrospective analysis. All patients were locally advanced cT3-T4 and/or cN0-1. Treatment consisted of either definitive concomitant chemoradiotherapy (Def-CRT) (n = 49, 66 %) or preoperative concomitant chemoradiotherapy (Pre-CRT) followed by surgical resection (n = 25, 34 %). Patients were treated with longer radiation fields. Clinical target volume (CTV) was obtained by giving 8-10 cm margins to the craniocaudal borders of gross tumor volume (GTV) instead of 4-5 cm globally accepted margins, and some patients in Def-CRT group received radiation doses higher than 50 Gy. Results: Isolated locoregional recurrences were observed in 9 out of 49 patients (18 %) in the Def-CRT group and in 1 out of 25 patients (3.8 %) in the Pre-CRT group (p = 0.15). The 5-year survival rate was 59 % in the Def-CRT group and 50 % in the Pre-CRT group (p = 0.72). Radiation dose was important in the Def-CRT group. Patients treated with > 50 Gy (11 out of 49 patients) had better survival with respect to patients treated with 50 Gy (38 out of 49 patients). Five-year survivals were 91 and 50 %, respectively (p = 0.013). Conclusions: Radiation treatment planning by enlarged radiation fields in esophageal cancer decreases locoregional recurrences considerably with respect to the results reported in the literature by standard radiation fields (18 vs > 50 %). Radiation dose is as important as radiation field size; patients in the Def-CRT group treated with = 50 Gy had better survival in comparison to patients treated with 50 Gy.Publication Open Access Adoption of pleurectomy and decortication for malignant mesothelioma leads to similar survival as extrapleural pneumonectomy(MOSBY-ELSEVIER, 2016-02) YILDIZELİ, BEDRETTİN; Batirel, Hasan Fevzi; Metintas, Muzaffer; Caglar, Hale Basak; Ak, Guntulu; Yumuk, Perran Fulden; Yildizeli, Bedrettin; Yuksel, MustafaObjective: We changed our surgical approach to malignant pleural mesothelioma (MPM) in August 2011 and adopted pleurectomy and decortication (PD) instead of extrapleural pneumonectomy (EPP). In this study, we analyzed our perioperative and survival results during the 2 periods. Methods: All patients who underwent surgical intervention for MPM during 2003-2014 were included. Data were retrospectively analyzed from a prospective database. Before August 2011, patients underwent evaluation for EPP and adjuvant chemoradiation (group 1). After August 2011, patients were evaluated for PD and adjuvant chemotherapy and/or radiation (group 2). Demographic characteristics, surgical technique, histology, side, completeness of resection, and types of treatments were recorded. Statistics was performed using Student t test, chi(2) tests, uni- and multivariate regression, and Kaplan-Meier survival analysis. Results: The same surgical team operated on 130 patients. Median age was 55.7 years (range, 26-80 years) and 76 were men. EPP and extended PD was performed in 72 patients. Ninety-day mortality was 10%. Median survival was 17.8 months with a 5-year survival rate of 14%. Uni- and multivariate analyses showed that epithelioid histology, stage N0, and trimodality treatment were associated with better survival (P=.039, P=.012, and P<.001, respectively). Demographic variables and overall survival (15.6 vs 19.6 months, respectively) were similar between the groups, whereas nonepithelioid histology, use of preoperative chemotherapy, and incomplete resections were more frequent in group 2 (P<.001, P<.001, and P=.006, respectively). Follow-up was shorter in group 2 (22.5 +/- 20.6 vs 16.4 +/- 10.9 months; P<.001). Conclusions: Adoption of PD as the main surgical approach is not associated with survival disadvantage in the surgical treatment of MPM.Publication Metadata only Resveratrol induces cell cycle arrest and apoptosis in epithelioid malignant pleural mesothelioma cells(WALTER DE GRUYTER GMBH, 2018) BATIREL, HASAN FEVZİ; Batirel, Saime; Altundag, Ergul Mutlu; Toplayici, Selina; Corek, Ceyda; Batirel, Hasan FevziBackground: Resveratrol is a natural anti-carcinogenic polyphenol. Malignant pleural mesothelioma (MPM) is an aggressive tumor with poor prognosis. In this study, we investigated the effects of resveratrol on epithelioid MPM. Material and methods: Human epithelioid MPM cell line (NCI-H2452) was exposed to resveratrol (5-200 mu M) for 24 or 48 h. Cell viability was assessed by WST-1 assay. Flow cytometry analyses were performed to evaluate the effects of resveratrol on cell cycle distribution and apoptosis. Western blot analysis was used to determine protein expression levels of antioxidant enzymes, cyclin D1 and p53. Reactive oxygen species (ROS) were measured using H2 DCFDA. Results: Resveratrol reduced cell viability of the cells in a concentration and time dependent manner. After treatment, the cells accumulated in G0/G1 phase and the percentage of cells in G2/M phase was reduced. Resveratrol decreased cyclin D1 and increased p53 expression in cell lysates. Treated cells exhibited increased apoptotic activity. ROS were elevated with resveratrol treatment, but there was no change in the expression of superoxide dismutase (SOD)-1, SOD-2 and glutathione peroxidase. Conclusion: Our results revealed that resveratrol exhibits anti-cell viability effect on epithelioid MPM cells by inducing cell cycle arrest and apoptosis. Resveratrol may become a potential therapeutic agent for epithelioid MPM.Publication Open Access No Adverse Outcomes of Video-Assisted Thoracoscopic Surgery Resection of cT2 Non-Small Cell Lung Cancer during the Learning Curve Period(2017-08-05) YILDIZELİ, BEDRETTİN; Bilgi, Zeynep; Batırel, Hasan Fevzi; Yıldızeli, Bedrettin; Bostancı, Korkut; Laçin, Tunç; Yüksel, MustafaPublication Metadata only Preoperative Chemoradiation Therapy Decreases the Number of Lymph Nodes Resected During Esophagectomy(SPRINGER, 2015) ÇELİKEL, ÇİĞDEM; Issaka, Adamu; Ermerak, Nezih Onur; Bilgi, Zeynep; Kara, Volkan Hasan; Celikel, Cigdem Ataizi; Batirel, Hasan FevziBackground This study aimed to analyze the effect of preoperative chemoradiation on the adequacy of lymph node dissection. Methods Patients with esophageal cancer treated with esophagectomy by the same surgeon between 2004 and 2011 were reviewed. Specimens were examined by the same pathologist. Patients were grouped into two depending on the type of treatment received. Results Forty-seven patients with curative esophagectomy were included in the study. Twenty patients had preoperative chemoradiation followed by surgery and 27 had surgery alone. Open and hybrid esophagectomy approaches were used. The average number of lymph nodes dissected was 16 +/- 10 (1-39). There was a significant decrease in the number of lymph nodes examined in patients with preoperative chemoradiotherapy in comparison to surgery alone (p = 0.001). Median length of stay was 12 days. R0 resection rate was 96 %. The median survival was 36.3 months, with a 42 % 5-year survival. Seven patients (25 %) had complete pathologic response following chemoradiation. No significant difference was recorded in terms of disease recurrence (p = 0.3). While morbidity was higher in the preoperative therapy group with 30 day mortality of 10 %, type of surgical approach does not seem to influence the number of lymph nodes dissected (p = 0.7). Conclusions Preoperative chemoradiation decreases the number of harvested lymph nodes following esophagectomy regardless of the surgical technique used. The optimum number of lymph nodes currently recommended to be dissected for accurate nodal staging and survival needs revision in this group of patients.Publication Open Access EPIDURALS, INTRAOPERATIVE FLUID ADMINISTRATION, AND HYPOTENSION Reply(MOSBY-ELSEVIER, 2015-07) KARARMAZ, ALPER; Arslantas, Mustafa Kemal; Kararmaz, Alper; Batirel, Hasan FevziPublication Metadata only Early Islamic physicians and thorax(1999) BATIREL, HASAN FEVZİ; Batirel, H. F.Modern anatomic knowledge has developed throughout centuries with transfer of knowledge from generations to generations. Ibn-i Sina (980-1037), Razi (850-923), Davud El-Antaki (?-1008), Ali ibn Abbas (?-982), Ahmed bin Mansur (14th century), Semseddin-i Itaki (1570-1640), and Ibn-i Nafis (1210-1288) were Islamic physicians who all contributed to the understanding of anatomy. They benefited from Greek and Roman pioneers, as well as from each other. To show the situation of thoracic anatomy in early Islamic physicians, we analyzed two original manuscripts in the Süleymaniye Library and some contemporary texts. There were original drawings of the trachea, lung, and vascular system in Semseddin-i Itaki's and Ahmed bin Mansur's anatomy texts. Ibn-i Nafis's writings revealed that he was the first person to describe the pulmonary circulation. Also Ali ibn Abbas wrote that the pulmonary artery wall had two layers and these layers may have a role in constriction and relaxation of this vessel. He also stated that pulmonary veins branched together with the bronchial tree. Ahmed bin Mansur, Ali ibn Abbas, and Ibn-i Nafis each wrote that the heart has two cavities. They also added that the wall of the septum is very thick and there are no passages in between. These show that Islamic physicians had important contributions to thoracic anatomy and physiology. European physicians benefited from these contributions till the end of the 16th century.Publication Metadata only Higher risk of oesophageal squamous cell carcinoma in achalasia: another lifelong follow-up indication(OXFORD UNIV PRESS INC, 2019) BATIREL, HASAN FEVZİ; Batirel, Hasan FevziPublication Metadata only Local recurrence of tumor at sites of intervention in malignant pleural mesothelioma(ELSEVIER IRELAND LTD, 2008) BATIREL, HASAN FEVZİ; Metintas, Muzaffer; Ak, Guntulu; Parspour, Sebnem; Yildirim, Huseyin; Erginel, Sinan; Alatas, Fusun; Batirel, Hasan F.; Sivrikoz, Cumhur; Metintas, Selma; Dundar, EmineIn malignant pleural mesothelioma (MPM) patients, local. dissemination (LD) of the tumor is frequently observed at the sites of intervention where diagnosis/treatment are performed. We evaluate the factors affecting LD frequency and discuss the use of PR in MPM patients. Histopathotogically diagnosed 212 MPM patients who had not received PR were evaulated in terms of development of LD. Of the 212 patients, 29 received supportive therapy, 157 received chemotherapy and 26 received multi-modal therapy. The LD frequency was 13.2% for all patients. The median survival rate was 9 or 10 months in patients with or without LD, respectively. A higher LD frequency was observed in patients receiving thoracotomy. The LD appearance time in supportive care is short. The LD frequency in patients treated with chemotherapy that revealed progressive disease was higher than the patients who revealed stable disease or objective response. LD developed in 2 months in patients with sarcomatous and mixed cell type, and the survival rate was low. LD was not associated with the stage of the disease. The most suitable candidate groups for PR are patients receiving supportive therapy, thoracotomy without multi-modal therapy or patients with sarcomatous and mixed cell type tumors. (C) 2008 Elsevier Ireland Ltd. All rights reserved.