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    Breast Conserving Surgery and Sentinel Lymph Node Biopsy in Locally Advanced Breast Cancer: Single Center Experience
    (Galenos Publ House, 2011) Sezer, Atakan; Alas, Rusen Cosar; Cicin, Irfan; Hoscoskun, Zeki; Tuncbilek, Nermin
    Objective: Patients with locally advanced breast cancer may undergo breast conserving surgery after neoadjuvant chemotherapy. The aim of the study is to evaluate the results of locally advanced breast cancer patients who underwent breast conserving surgery, axillary dissection and sentinel lymph node biopsy in a single center. Material and Methods: 12 patients with locally advanced breast cancer stage IIIA/IIIB were included in the study between 2002-2009. The patients were given anthracycline-based regimen before surgery. Patients underwent breast conserving surgery, axillary dissection, and sentinel lymph node biopsy followed by radiotherapy. Results: There were five patients in stage IIIA, six in stage IIIB, and one in stage IIIC. Patients had received 3-6 regimen of FAC/FEC. Eight had partial and four had complete response. Five positive axilla were detected. The median value of the lymph nodes was 12 (n:8-19). Five patients underwent sentinel lymph node biopsy. The biopsy has failed in one patient and the median value of dissected sentinel node was 3.5 (n:3-4). Locoregional recurrence was not observed in any patients. The mean follow-up of the patients was 29.8 months and median time was 16 (n:2-80) months. Of the 12 patients 10 are alive and 2 were deceased. Conclusion: In selected locally advanced patients, breast conserving surgery and sentinel lymph node biopsy may be applied by a multidisciplinary approach, and excellent success may be achieved in those patients as in early breast cancer patients.
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    Cystic artery anatomies in laparoscopic cholecystectomy and literature review
    (Bayrakol Medical Publisher, 2022) Turkyilmaz, Zeliha; Hoscoskun, Zeki; Taskinalp, Oguz
    Aim: In laparoscopic surgery, knowing the anatomic variations helps to be ready for any possibilities. In this study, it was aimed to evaluate the cystic artery (CA) variations and frequency in patients who underwent laparoscopic cholecystectomy (LC). Material and Methods: The study was carried out by reviewing retrospectively the reports and movies of 100 LC. The positions of the cystic artery and cystic duct relative to Calot's triangle (CT) were determined and the frequency of variation was reviewed. Results: In 82% of our cases, the cystic artery was monitored as a single branch in the CT, whereas two CA were clipped in 12% of cases. In 3 cases in this study, CA went through the caudal of and parallel with the cystic duct, and entered the gall bladder. In one case, the cystic duct passed through the curve formed by the CA. This pattern was named spiral cystic artery. Discussion: The anatomy of the components, which make up a CT has so many diversifications that understanding these variations acts as a key role during LC.
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    Effect of Dual Mesh Wrap on The Stability of Colonic Anastomosis
    (Aves, 2021) Albayrak, Dogan; Turkes, Bayram; Can, Nuray; Cakcak, Ibrahim Ethem; Kahya, Eyup; Oguz, Serhat; Hoscoskun, Zeki
    BACKGROUND/AIMS Colon anastomotic leakage is the cause of significant morbidity and mortality in surgery. Therefore, we aimed to demonstrate experimentally the effect of the conventional method of wrapping them through colo-colonic anastomosis performed by dual patch on anastomotic healing and security. MATERIAL and METHODS The study was conducted at the Experimental Animal Research Unit of the Medical Faculty of Trakya University, Edirne, Turkey. A total of 20 Wistar Albino adult rats were used. The rats were divided into 2 groups: 10 rats in the control group and 10 rats in the dual patch group. All rats underwent partial segmental colon resection, and colo-colonic anastomosis was performed in a single layer with 5/0 polypropylene. For rats in the dual patch group, the anastomosis was wrapped up with a 1-cm-wide dual patch. In the control group, there was no operation on the anastomosis. At 7 days after the procedure, the degree of peritoneal adhesion model previously prepared according to Evans devices laparotomy was used to observe all the rats and colon burst pressure. Both histopathological examination and the examination of the perianastomotic area were performed. RESULTS In the rats that were treated with dual mesh, there was a statistically significant increase in anastomotic line burst pressure (P<.05), a statistically significant increase in collagen amount (P<.05), and a statistically significant decrease in abdominal adhesions (P<.05). CONCLUSION As a result, the colo-colonic anastomosis of winding dual patch, without causing intra-abdominal adhesions, improves security by increasing the anastomosis bursting pressure.
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    The effectiveness of splenic autotransplantation
    (Turkish Assoc Trauma Emergency Surgery, 2007) Karaguelle, Erdal; Hoscoskun, Zeki; Kutlu, Ali Kemal; Kaya, Meryem; Baybar, Serkan
    BACKGROUND The purpose of this study was to establish the effects of spleen autotransplantation on immunity and to examine the viability of autotransplanted spleen tissue. METHODS Three groups were assigned and following operations were performed in twenty New Zealand rabbits. 1st group: sham laparotomy, 2nd group: splenectomy and 3rd group: splenectomy and splenic autotransplantation. Scintigraphic methods, hematological-immunological tests and histopathological examination were used to evaluate the effects of splenic autotransplantation. RESULTS Histopathological findings showed that eight rabbits had splenic regrowth and two had necrosis of autotransplanted splenic tissue. Preoperative hematological and immunological findings compared with those at sixth week postoperatively. In group 3, postoperative immunoglobulin G, immunoglobulin M and interleukin-1 levels were significantly increased when compared with preoperative levels. Between all groups, postoperative leukocyte counts were found to be significantly higher in group 2 comparing with group 1. In group 2, postoperative platelet counts were significantly higher in comparison to group 1 and 3. No statistically significant difference was detected between the groups for immunoglobulin G, immunoglobulin M and interleukin-1 levels. CONCLUSION Conservative treatment is important in patients with splenic injury. However when splenectomy is indicated, splenic autotransplantation into the omentum pouch could be a reliable method for reconstruction of splenic functions and the viability of the implanted spleen tissue can be monitored by scintigraphy and laboratory examination.
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    Perforated primary small bowel lymphoma: A case report
    (Ekin Tibbi Yayincilik Ltd Sti-Ekin Medical Publ, 2008) Albayrak, Dogan; Ibis, Abdil Cem; Hatipoglu, Ahmet Rahmi; Polat, Nihat; Hoscoskun, Zeki
    Malignant tumors of the small bowel are rarely seen and are usually diagnosed in advanced stages because of the difficulties in diagnosis. Lymphomas account for %1 of malignant gastrointestinal system tumors. Primary gastrointestinal lymphoma is very rare and its preoperative diagnosis is difficult. Its diagnosis is usually made through laparotomy. A 77-year-old male patient developed acute abdomen during observation for partial mechanic intestinal obstruction. Emergent explorative laparotomy revealed perforation of a small bowel tumor. A wide small bowel resection was performed with a double-layer end-to-end anastomosis. Histopathological examination of the surgical specimen was reported as indolent B-cell non-Hodgkin's lymphoma. It should be kept in mind that small bowel tumors can present as mechanic intestinal obstruction, resulting in delayed diagnosis.
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    A RARE BREAST TUMOR: SECRETORY BREAST CARCINOMA
    (Aves, 2011) Yagci, Mehmet Ali; Sezer, Atakan; Yeldan, Eyup; Hoscoskun, Zeki; Hatipoglu, Ahmet; Altaner, Semsi; Cicin, Irfan
    Secretory breast carcinoma is a rare type of invasive breast cancer. The tumor was first reported in pediatric patients, but actual incidence among pediatric and adult decades is similar. We present the case of a 50-year-old woman with a secretory breast carcinoma treated by breast conserving surgery and sentinel node dissection followed by chemotherapy and radiotherapy. The patient has meanwhile completed 3 years of follow-up with no evidence of recurrence. Secretory breast carcinoma usually has a low progression rate, and the prognosis is usually favorable. The choice of treatment should be patient based and minimal invasive procedures consist of breast conserving surgeries and sentinel node biopsies should be favoured. Systemic treatment and radiotherapy are points still awaiting for further investigation.