Person: GÜNAL, ÖMER
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GÜNAL
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ÖMER
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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 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 Metadata only Laparoskopik sleeve gastrektomi sonuçlarımız(2015-04-26) KARPUZ, ŞAKİR; ERGENÇ, MUHAMMER; GÜNAL, ÖMER; BAT O., ATTAALLAH W., KARPUZ Ş., ERGENÇ M., ERTEKİN S. Ç., GÜNAL Ö.Amaç: Bu çalışmada 2,5 yılda tek cerrah tarafından yapılan sleeve gastrektomi sonuçlarını sunmayı amaçladık. Gereç ve Yöntem: Mayıs 2012 ile Aralık 2014 tarihleri arasında ardışık sleeve gastrektomi yapılan hastaların dosyaları geriye dönük incelendi. Hastaların demografik özellikleri, ameliyat süreleri, taburculuk süreleri, komplikasyon gelişimi, takip kiloları, ek hastalıklarının durumu kaydedildi. Bulgular: Çalışmaya 320 hasta alındı. Hastaların 92›si (%28,8) erkek, 228›i (%71,2) kadındı. Yaş ortalaması 36,6 yıldı. Ameliyat öncesi vücut kitle indeksi (vki) ortalamaları 45,7 kg/m2 idi. Ortalama ameliyat süresi 56,5 dakikaydı. Ortalama taburculuk süresi 3,9 (3-87) gündü. Postoperatif 30 günlük dönemde 5 (%1,6) hastada kaçak, 3 (%0,9) hastada stapler hattından kanama, 2’şer (%0,6) hastada trokar yerinden kanama, karın içi abse, cerrahi alan enfeksiyonu ve 1’er (%0,3) hastada pulmoner emboli, safra kaçağı ve pnömoni gelişti. Pulmoner emboli olan hasta postoperatif 1. gün exitus oldu. 1-3-6- 9-12-18 ve 24. aylarda fazla kilo kayıpları sırasıyla %23,7, %44,6, %58,9, %65,6, %69,2, %67,9, %62,2 olarak bulundu. Hastaların 79’unda(%24,8) hipertansiyon vardı. Bunların 63’ünde(%79,7) antihipertansif tedavi kesildi, 2’sinde(%2,5) ise ilaç dozu azaltıldı. 52(%16,4) hastada tip 2 diyabet vardı. 37’sinde(%71,1) insülin ve/veya oral antidiyabetik ilaçlar (OAD) kesildi, 6’sında(%11,5) insülinden OAD’ye geçildi, 5’inde(%9,6) ise ilaç dozu azaltıldı. 59(%18,6) hastada hiperlipidemi vardı ve bunların 26’sında(%44,1) hiperlipidemi düzeldi. 13(%4,1) hastada astım vardı ve 9’unda(%69,2) tedavi gerektiren semptomlar geriledi. Uyku apne sendromu olan 12(%3,8) hastanın 11’inde(%91,7) tamamen düzelme oldu. Sonuç: Laparoskopik sleeve gastrektomi, diğer bariatrik cerrahi yöntemlerine göre uygulanması daha kolay ve sonuçları da en az onlar kadar yüz güldürücüdür. Ancak uzun stapler hattından dolayı komplikasyon gelişimi riski de göz önünde bulundurulmalıdır.Publication Metadata only The Effects of Perioperative Factors on Early Postoperative Morbidity in Bariatric Surgery(2022) ORHON ERGÜN, MELİHA; Zengin, Seniyye Ulgen; Orhon Ergun, Meliha; Gunal, OmerPublication Open 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, HavvaObjective: 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.Publication Metadata only How do we treat to incidental proximal jejunal tumors during laparoscopic bypass surgery?(2019-10-31) UPRAK, TEVFİK KIVILCIM; AKMERCAN, TAYFUN; GÜNAL, ÖMER; KARATAŞ S. A. , UPRAK T. K. , AKMERCAN T., GÜNAL Ö.Publication Open 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.Publication Metadata only Compari̇ng the anastomoti̇c techni̇que of the mi̇ni̇mally invasi̇ve and open ivor-lewi̇s esophagectomy for esophageal cancer(2021-10-30) GÜNAL, ÖMER; UPRAK, TEVFİK KIVILCIM; ŞİMŞEK, OĞUZHAN; GÜNAL Ö., UPRAK T. K., KARATAŞ S. A., CİCİBOĞA K., ŞİMŞEK O., ŞİMŞEK O.Publication Open Access Can Gastric Specimen Measurements Defines the Laparoscopic Sleeve Gastrectomy Outcome?(2018) ERDİM, AYLİN; Günal, Ömer; Uprak, Kıvılcım; Ergenc;, Muhammer; Erdim, AylinPublication Metadata only Captopril prevents the oxidative damage to proteins after renal ischemia reperfusion injury: role of endothelin-1(1997) KURTEL, HIZIR; Günal, O.; Aktan, A. O.; Yegen, C.; Kurtel, H.; Yalin, R.Ischemia reperfusion (I/R) injury is one of the leading cause of the transplanted organ loss. In this experimental study, we investigated the effect of captopril on endothelin and eicosanoid release in I/R injury of the kidney. Rats were subjected to 60 min ischemia and 60 min of reperfusion of the left kidney in control and captopril groups. Tissue protein oxidation products, PGE2 and LTB4 levels and plasma endothelin-1 (ET-1) like activity were determined in sham operated, control and captopril groups. There were no differences in the LTB4 levels among the groups. ET-1 and PGE2 levels and protein oxidation products increased in the control group when compared with the sham. Captopril further increased both PGE2 and ET-1 concentrations and prevented protein oxidation. The increased ET-1 concentrations in the captopril treated group may imply the protective role of endothelin as the significant increase in protein oxidation products was reversed by captopril infusion. This has led us to believe that captopril might be useful in preventing I/R injury of the kidney. Also the release of endothelin from the vascular endothelium is increased by captopril and may be mediated by PGE2.