Person: AKMERCAN, AHMET
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AKMERCAN
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AHMET
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Publication Metadata only Neoadjuvan kemoterapi uygulanan meme kanserli olgularda güvenli tümör-meme ucu mesafesini meme MR öngörebilir mi?(2022-02-24) UĞURLU, MUSTAFA ÜMİT; AKMERCAN, AHMET; BUĞDAYCI, ONUR; KAYA, HANDAN; AKOĞLU, HALDUN; GÜLLÜOĞLU, MAHMUT BAHADIR; UĞURLU M. Ü., AKMERCAN A., BUĞDAYCI O., KAYA H., AKIN TELLİ T., AKOĞLU H., GÜLLÜOĞLU M. B.Publication Metadata only Meme kanserinde neoadjuvan kemoterapi sonrası es-zamani: Rekonstrüksiyon güvenli midir? 5 yıllık tek merkez onkolojik sonuçlar(2022-09-18) UĞURLU, MUSTAFA ÜMİT; AKMERCAN, AHMET; SAÇAK, BÜLENT; AKDENİZ DOĞAN, ZEYNEP DENİZ; KAYA, HANDAN; BUĞDAYCI, ONUR; GÜLLÜOĞLU, MAHMUT BAHADIR; UĞURLU M. Ü., AKMERCAN A., SAÇAK B., AKDENİZ DOĞAN Z. D., HAYTAOĞLU A. A., KAYA H., BUĞDAYCI O., AKIN TELLİ T., ÖZGEN Z., GÜLLÜOĞLU M. B.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 Gastric medullary carcinoma: Clinicopathological features and prognosis-a single-center study(WILEY, 2021) AKMERCAN, AHMET; Uprak, Tevfik Kivilcim; Akmercan, Ahmet; Coskun, Mumin; Attaallah, WafiBackground Gastric medullary carcinoma (GMC) is a distinct histologic subtype of gastric adenocarcinoma, which prominently associated with Epstein-Barr virus infection. This study aimed to evaluate the clinicopathological features and prognosis of patients with medullary carcinoma in one center. Methods Data regarding patients with gastric cancer were retrospectively analyzed at Marmara University between 2014 and 2019. Demographics, pathological features, and overall survival of patients with GMC were evaluated. The primary outcome of this study was to compare the pathological features of GMC to non-GMC (NGMC). The secondary outcome was comparing overall survival between the two groups. Results A total of 412 patients were enrolled in the study. Of 412 patients, 19 (5%) were diagnosed with medullary cancer. Compared to NGMC, no significant differences were observed in patient age, gender, tumor macroscopic pattern, size, lymphovascular invasion, pathological stage, location and size of the tumors, and the number of metastatic lymph nodes in GMC. However, perineural invasion and Borrmann ulcerated type rates were significantly higher among NGMC. Whereas the microsatellite instability (MSI) rate was significantly higher in the GMC (64% and 11%, respectively, p < 0.001). Multivariate analysis showed that the MSI status was the solely significantly different feature between the two groups. Conclusion This study showed that GMC was associated with MSI, which could explain the better prognosis of medullary carcinomas.Publication Metadata only İleokolik Anastomoz Hattına Uygulanan Güçlendirici Süturlerin Anastomotik Komplikasyonlara Olan Etkisi(2021-12-04) COŞKUN, MÜMİN; FERATOĞLU, HALE; UPRAK, TEVFİK KIVILCIM; AKMERCAN, AHMET; COŞKUN M., EKDAL D. C., FERATOĞLU H., UPRAK T. K., AKMERCAN A.Giriş: Kolorektal cerrahiler sonrası meydana gelen anastomoz kaçağı morbidite ve mortaliteyi artıran en yıkıcı komplikasyonlardan biridir. Literatürde anastomoz kaçaklarını azaltmaya yönelik çeşitli girişimler tanımlanmıştır. Bu çalışmada ileokolik anastomoz hattına güçlendirici sütur uygulamasının postoperatif anastomoz kaçağı üzerine etkisi değerlendirildi. Metod: Marmara Üniversitesi Genel Cerrahi Kliniğinde Ekim 2010 - Şubat 2020 tarihleri arasında kolon kanseri nedeniyle sağ hemikolektomi ve ileokolik anastomoz yapılan hastaların demografik verileri, operatif parametreleri ve postoperatif komplikasyonları retrospektif olarak incelendi. Hastalar güçlendirici sütür uygulanan ve uygulanmayan olarak 2 gruba ayrıldı. Güçlendirici sütur grubunda operasyonu gerçekleştiren primer cerrahın kararına göre stapler ile yapılan ileokolik anastomoz hattına 3/0 vicrylle separe seromüsküler güçlendirici süturler konuldu. Çalışmanın primer hedefi anastomoz hattına uygulanan güçlendirici süturlerin anastomoz kaçağı üzerine etkisi olarak belirlendi. Bulgular: Çalışmaya anastomoz hattına güçlendirici süturlerin uygulandığı 75 (%36.2) ve uygulanmadığı 129 (%62.3) olmak üzere toplamda 204 hasta dahil edildi. İki grup arasında demografik veriler, komorbiditeler ve operasyon süresi açısından istatistiksel olarak anlamlı fark saptanmadı. Anastomoz hattına güçlendirici süturlerin uygulandığı grupta 5 hastada (%7.3), uygulanmayan grupta 12 hastada (%11.3) anastomoz kaçağı meydana geldi. Kaçak oranı karşılaştırıldığında istatistiksel olarak anlamlı fark saptanmadı (p: 0.3). Sonuç: Bu çalışma, ileokolik anastomoz hattına güçlendirici sütur uygulamasının istatiksel olarak anlamlı olmasa da anastomoz kaçağını %4 oranında azalttığını göstermiştir.Publication Open Access Pancreatic neuroendocrine tumor mimicking intraductal papillary mucinous neoplasm: Case report(2021-01-01) AKMERCAN, AHMET; BAĞCI ÇULÇİ, PELİN; ATICI, ALİ EMRE; YEGEN, ŞEVKET CUMHUR; UPRAK, TEVFİK KIVILCIM; AKMERCAN A., UPRAK T. K., BAĞCI ÇULÇİ P., ATICI A. E., YEGEN Ş. C.ABSTRACTPancreatic neuroendocrine tumors (PanNETs) are rare pancreatic tumors. They usually exhibit parenchymal growing, however some cases can exhibit intraductal growing. PanNET with intraductal growth may cause intraductal papillary mucinous neoplasm (IPMN)- like clinic scenario by presenting as cystic formations secondary to duct obstruction. In our case, a 69-year- old man with a history of abdominal pain and nausea underwent a computed tomography scan that showed dilated pancreatic duct and cystic lesion which was 8 cm originating from the pancreas. Imaging and laboratory findings were considered to be consistent with an IPMN so the patient underwent distal pancreatectomy and splenectomy. However, the pathological examination of the surgical specimen showed a millimeter-sized PanNET located in pancreatic tail mimicking the IPMN by obstructing the pancreatic duct.Keywords: Gastroenteropancreatic neuroendocrine tumor; pancreatic intraductal neoplasmsPublication Metadata only Neoadjuvan kemoterapi sonrası meme koruyucu cerrahide marjin pozitifligi ve reeksizyon oranları(2022-03-23) UĞURLU, MUSTAFA ÜMİT; AKMERCAN, AHMET; KAYA, HANDAN; BUĞDAYCI, ONUR; GÜLLÜOĞLU, MAHMUT BAHADIR; UĞURLU M. Ü., AKMERCAN A., KAYA H., BUĞDAYCI O., YUMUK P. F., GÜLLÜOĞLU M. B.Publication Open Access Outcomes of proximal versus total gastrectomy for proximal gastric cancer: A propensity score-matched analysis of a western center experience(2023-01-01) UPRAK, TEVFİK KIVILCIM; ERGENÇ, MUHAMMER; AKMERCAN, AHMET; YEGEN, ŞEVKET CUMHUR; UPRAK T. K., ERGENÇ M., AKMERCAN A., YEGEN Ş. C.Purpose: In this western study, we aimed to compare perioperative outcomes, postoperative complications, and overall survival in patients who underwent total gastrectomy (TG) or proximal gastrectomy (PG) for proximal gastric cancer (GC). Methods: Patients who underwent GC surgery at Marmara University Hospital between January 2014 and December 2021 were evaluated retrospectively. Propensity score matching (PSM) was performed to balance the baseline characteristics of patients undergoing PG and TG. Data on patients’ demographics, clinicopathological features of tumors, complications, and survival rates were analyzed. Perioperative outcomes and overall survival of the patients were compared between PG and TG groups. Results: A total of 212 patients were included in this study, with 53 patients in the PG and 159 in the TG group. After 1:1 matching according to PSM, 46 patients in the PG group were matched to 46 in the TG group. After PSM, there were no differences in clinicopathological outcomes except retrieved lymph nodes. In terms of short-term outcomes, overall perioperative morbidity (Clavien Dindo ≥ 3a) was significantly higher in the PG group (p = 0.01). However, there was no significant difference when the complications were considered separately. In the long-term follow-up, reflux esophagitis was associated with the PG group (p=0.04). In multivariate analysis, positive surgical margin and lymphovascular invasion were significant factors related to overall survival. Overall, 5-year survival was 55% in matched patients. The difference in survival was not statistically significant (57 vs. 69 months, p = 0.3) between the two groups. Conclusions: Proximal gastrectomy is applicable to patients up to stage 3 disease, with no difference in overall survival, with caution in early complications and reflux esophagitis. Among all demographic and oncological factors, lymphovascular invasion and resection margin were significantly associated with worse survival.Publication Open Access The role of rectal redundancy in the pathophysiology of rectal prolapse: a pilot study(2022-05-01) AKMERCAN, AHMET; FERATOĞLU, HALE; Attaallah W., AKMERCAN A., FERATOĞLU H.Purpose: Rectal prolapse is hypothesized to be caused due to weakness of the pelvic floor which is related to childbearing. However, half of the female patients with rectal prolapse were reported to be nulliparous and this hypothesis doesn???t explain the prolapse in males. The aim of this study is to evaluate the role of rectal redundancy in rectal prolapse pathophysiology. Methods: This study was conducted prospectively. Fourteen patients who underwent rectopexy were included in the study group. A total of 17 patients who underwent laparotomy for another reason and who have no symptoms regarding rectal prolapse were included in the control group. In order to measure the redundancy of the rectum, we have calculated the ratio of length of intraperitoneal rectum (R) to length of distance between promontorium and peritoneal reflection (PRx). The primary outcome of this study was to evaluate whether the R/PRx ratio is higher in patients with rectal prolapse compared to the control group. Results: Comparing the anatomic features showed that the length of sigmoid colon and length of PRx were not significantly different between the two groups. However, the length of intraperitoneal rectum was significantly higher in the prolapse group. Furthermore, the median R/PRx ratio in the prolapse group was significantly higher than in the control group. Conclusion: This study showed that intraperitoneal rectum in patients with rectal prolapse is significantly more redundant than in the normal population. This could be considered reasonable evidence for the role of rectal redundancy on rectal prolapse pathophysiology. [Ann Surg Treat Res 2022;102(5):289-293]Publication Metadata only ÖZOFAGUS REZEKSİYONU SONRASI ANOSTOMOZ KAÇAĞINDAENDOSKOPİK VAKUM TEDAVİSİ DENEYİMİMİZ: 3 HASTALIK VAKA SERİSİ(2021-10-30) AKMERCAN, TAYFUN; AKMERCAN, AHMET; UPRAK, TEVFİK KIVILCIM; ATICI, ALİ EMRE; COŞKUN, MÜMİN; AKMERCAN T., AKMERCAN A., UPRAK T. K. , ATICI A. E. , COŞKUN M.