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Gastic cancer is a life-threatening malignancy in the world. The aim of this study was to investigate the clinical significance of the prognostic nutritional index (PNI) as a guiding marker for gastric cancer patients with laparoscopic gastrectomy. We retrospectively examined the medical records of 138 gastric cancer patients who had adenocarcinoma pathological diagnosis and operated laparoscopically. Patients were divided into two groups (survived and death) and these groups were compared with clinical and laboratory parameters results. The PNI was calculated as 10 × serum albumin (g/dL) + 0.005 × total lymphocyte count (per mm

Objective: Remnant Gastric Cancer (RGC) describes cancers occurring in the remaining stomach and/or anastomosis in the follow-up after gastric cancer or benign gastric surgery. RGC is diagnosed in esophago-gastroscopy follow-ups of patients who underwent this surgery in the past. Again, the increase in the success of gastric cancer surgery and following medical treatments has increased the incidence of RGC in long-term follow-up after gastric cancer surgery. Laparoscopic surgery has been also reported in few cases. In the present study, the purpose was to present the results of the first five patients that underwent laparoscopic total gastrectomy due to RGC in our clinic. Material and Methods: The patients who underwent laparoscopic gastric cancer surgery between November 2014 and December 2018 were evaluated retrospectively. Results: Mean age of the patients was 62.4 years (ranging between 49 and 74 years). Two of these patients had a surgical history due to gastric cancer and 3 due to peptic ulcer. Surgery was completed laparoscopically in all patients. In the early period, one patient had to undergo re-surgery due to stenosis in Jejuno-Jejunostomy, and the patient died. One patient underwent laparotomy due to colonic stenosis in the second month after the surgery. Recurrence was detected on the 140th and 180th days of follow-up in the other two patients. Conclusion: Laparoscopic surgery is a technically applicable method in RGC; however, it is also a risk factor for past surgical postoperative complications. Early recurrence in this group of patients requires a comparison of open and laparoscopic surgery.

Background Data regarding the outcomes of pure minimally invasive techniques of radical gastrectomy are scarce. We aimed to compare short-term post-operative outcomes in patients undergoing totally minimally invasive radical gastrectomy with the da Vinci Xi® robotic system versus straight laparoscopy for gastric adenocarcinoma. Methods Between December 2013 and March 2018, robotic and laparoscopic radical gastrectomy performed in two centres were included. Both groups were compared with respect to perioperative short-term outcomes. Results Ninety-four patients were included in the study. Anticoagulant and neoadjuvant chemotherapy use were higher in the robotic group (p = 0.02, p = 0.02). There were conversions in the laparoscopy group whereas no conversions occurred in the robotic group (p = 0.052). Operating time in the robotic group was longer (p = 0.001). The number of harvested lymph nodes in the laparoscopic group was higher (p = 0.047). Conclusion Totally robotic technique with the da Vinci Xi® robotic system provides similar short-term results compared to laparoscopic surgery in radical gastrectomy.

Data regarding the outcomes of pure minimally invasive techniques of radical gastrectomy are scarce. We aimed to compare short-term post-operative outcomes in patients undergoing totally minimally invasive radical gastrectomy with the da Vinci XiBetween December 2013 and March 2018, robotic and laparoscopic radical gastrectomy performed in two centres were included. Both groups were compared with respect to perioperative short-term outcomes.Ninety-four patients were included in the study. Anticoagulant and neoadjuvant chemotherapy use were higher in the robotic group (p = 0.02, p = 0.02). There were conversions in the laparoscopy group whereas no conversions occurred in the robotic group (p = 0.052). Operating time in the robotic group was longer (p = 0.001). The number of harvested lymph nodes in the laparoscopic group was higher (p = 0.047).Totally robotic technique with the da Vinci Xi

As advanced gastric cancer often leads to obstruction or cancer-related cachexia, gastric cancer seems to have a closer association with sarcopenia than other types of cancer. Our study aim was to investigate the relationship between the psoas muscle area (PSMA) and morbidity and mortality in patients undergoing gastric cancer surgery. The data of patients who underwent laparoscopic gastric resection between November 2014 and April 2020 were analyzed retrospectively. The intervertebral disc space was verified at L3-4 in the sagittal plane. The PSMA on the right and left sides were measured separately and then added to obtain the total PSMA. This value was then divided by the patient's height (m2) to calculate the psoas muscle area index (PSMAI) (mm2/m2). The mean PSMAI of men (741.1 mm2/m2) was significantly higher than that of women (502.1 mm2/m2) (p

Liver transplantation is the lifesaving treatment option for rare acute liver failure that develops due to iatrogenic bile duct injuries or after major hepatectomy. The aim of the study is to analyze patients with acute liver failure due to iatrogenic bile duct injury or major hepatectomy on the waiting list for emergency liver transplantation. Between the years 2011-2020, 9 patients (5 female/4 male; median age: 30 years old, (range:4-63 years)) with acute liver failure related to bile duct injury or major hepatectomy for whom urgent liver transplantation was planned were included in this study. Eight patients were accepted for urgent liver transplantation. Acute liver failure developed in 6 patients due to hepatoduodenal ligament injury during cholecystectomy, and in 3 patients due to major hepatectomy. The patients were listed for urgent transplantation within the mean of 1.5 days (range:0-3 days) after acute liver failure. Two patients had living donor and 1 patient had cadaveric liver transplantation. Acute hepatic failure, especially after iatrogenic bile duct injuries associated with vascular injuries, seems to be more fatal than post hepatectomy liver failure. In these cases of acute liver failure, which is a difficult situation to decide, emergency liver transplantation should be kept in mind as the treatment option.

Background: To research the perioperative significance of the simple laboratory test values on differentiating complicated acute appendicitis. Methods: The medical records of 216 acute appendicitis patients were examined retrospectively. Patients were divided into two groups according to pathological results (non-complicated (n=157) and complicated (n=59)). The demographic and clinical data, laboratory findings, length of hospital stay, and pathological results were compared between the two groups. Receiver operating characteristics (ROC) curves were performed to analyze the optimal cutoff value of numerical variables which were significantly differed between the group comparisons. Results: The preoperative data were similar in two groups except for age. The length of hospital stay (LOHS) was longer and total/direct bilirubin levels higher in the complicated group (p=0.002, p=0.002, and p=0.002, respectively. The lymphocyte level and amylase level were lower in the complicated group (p=0.02 and p=0.004, respectively). ROC curve analysis showed a cutoff values as follows: total bilirubin ≥0.89 mg/dL, direct bilirubin ≥0.43 mg/dL, lymphocyte≤1.63%, and amylase ≤46.5 U/L. Conclusion: Preoperative higher total and direct bilirubin levels are able to predict complicated appendicitis. Preoperative higher serum amylase levels should not have a place in the differential diagnosis of complicated appendicitis. This means that if serum amylase is elevated in a patient with doubted acute appendicitis, it does not suggest acute complicated appendicitis.

Myxoglobulosis is a specific type of mucocele consisting of mucoid material. It is characterized by opaque, transparent globules that resemble "fish eggs" or "frogspawns". It is generally diagnosed incidentally during an appendectomy or an autopsy. In this paper, we aim to present the case of a 58-year-old male patient who was referred to our hospital because of abdominal pain and loss of appetite. The patient underwent an appendectomy. Opaque intraluminal globules were found in the appendectomy material. The globules resembled pearls and they were 2-3 mm in diameter. After histopathological examinations, the patient was diagnosed with myxoglobulosis accompanied with acute appendicitis. According to our research, this is the first case of myxoglobulosis in our country. Copyright © 2017 by Turkish Surgical Association.

Aim: The aim of this study was to compare the data of patients who underwent gastric cancer surgery as laparoscopically completedand converted to open surgery and draw attention to complications arising from trocar entry.Materials and Methods: This study included 211 patients who underwent laparoscopic gastric cancer surgery. Patients were dividedin to two groups as laparoscopically completed and converted to open surgery. Demographics parameters and perioperative datawere retrospectively analyzed.Results: The median age of the study group was 62 (19-91) years and 68.2% were males. Conversion occured in 16 patients (7.5%).The reasons for conversion were locally advanced tumor (n=6), complications due to trocar insertion (n=4), technical difficultyin performing esophagojejunostomy anastomosis (n=4), leakage in esophagojejunostomy anastomosis (n=1), and persistentbradycardia (n=1). Intraoperative blood loss was higher and time to oral intake was longer in the conversion group. No significantdifference was found in terms of demographic parameters, operative time, length of hospital stays, the rate of postoperativecomplications, reoperation, 30-day mortality.Conclusion: Complications due to trocar entry is an unpredictable and preventable conversion reason in laparoscopic gastric cancersurgery. Thin patients are riskier for complications during abdominal access. Abdominal access should be performed with an opentechnique in thin patients