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Objective: Gastrointestinal stromal tumor (GIST) is one of the most common mesenchymal tumors in the gastrointestinal system, occurring frequently after epithelial tumors. Although rare, secondary epithelial malignancies can be associated with GISTs. It was planned to conduct a retrospective cohort study evaluating the coexistence of GISTs with malignancies and their long-term outcomes through clinical and pathological findings. Material and Methods: Demographic and clinicopathological data of 69 patients who underwent surgery for GIST between January 2011 and November 2021 were retrieved from the patient database. Variables between the groups with only GIST and those with a secondary malignancy alongside GIST were analyzed using the Chi-square test and Mann-Whitney U test. Long-term survival analyses were conducted using the Kaplan-Meier test. A p-value of <0.05 was considered statistically significant. Results: Out of the 69 patients in our population, 40 (58%) were male, and the median age was 65 years (interquartile range= 56-75). GIST was the most commonly located in the stomach (59.4%), and nine (13%) patients had a secondary malignancy. Tumor size, smooth muscle antibody (SMA), and S100 antibody expression showed significant differences between the groups (p< 0.001, p= 0.015, p= 0.006). Shorter survival was observed in patients with GIST plus secondary malignancy (p= 0.005). Conclusion: The incidence of other intraabdominal malignancies occurring alongside GISTs is more common than have been previously thought. While the presence of a secondary malignancy does not impact the overall survival (OS) in GISTs, it was observed that survival is dependent on the primary malignancy. Patients diagnosed with GISTs require thorough investigation and close monitoring for secondary malignancies. [ABSTRACT FROM AUTHOR]

Background/aim: Despite advancements in surgical methodologies and the extensive perioperative and postoperative care administered to recipients, the prevalence of complications requiring early relaparotomy following living donor liver transplantation (LDLT) remains persistent. This study sought to analyze the determinants influencing relaparotomy occurrences in the initial 30 days following LDLT. Additionally, it was aimed to evaluate the impact of early laparotomy on both graft and patient survival within this distinct patient cohort. Materials and methods: The study encompassed recipients (n = 535) aged 18 years and older who underwent primary LDLT at our institution from January 2019 to December 2021. Exclusion criteria involved patients necessitating early retransplantation. Early relaparotomy was specified as surgical intervention within the initial 30 days following LDLT. Results: The study enrolled a total of 535 patients, among whom 85 (15.9%) underwent early relaparotomy. The median age of the patients was 54 (range: 41-60) years, with a predominant male representation (66.2%). Univariate analysis comparing the laparotomy and nonrelaparotomy groups revealed statistically significant differences in the creatinine (p = 0.043) and sodium (p = 0.025) levels, graft side (p < 0.001), etiology (p = 0.005), and blood loss (p = 0.012). In the multivariate analysis, creatinine (p = 0.039; OR = 1.668; 95% CI = 1.027-2.709) and left lobe graft (p < 0.0001; OR = 3.611; 95% CI = 1.960-6.652) emerged as independent risk factors for relaparotomy. Conclusion: The primary causes of early relaparotomy following LDLT include postoperative bleeding, biliary leakage, and vascular complications. Preoperative elevation in creatinine and sodium levels, the presence of Budd-Chiari syndrome, utilization of a left lobe graft, and intraoperative blood loss are identified as risk factors associated with early relaparotomy after LDLT. Patients undergoing early relaparotomy exhibit inferior survival rates compared to those who do not. [ABSTRACT FROM AUTHOR]

Introduction: The incidence of bariatric procedures is on the rise, primarily driven by the escalating prevalence of obesity. Among these procedures, laparoscopic sleeve gastrectomy (LSG) has gained significant popularity. However, ongoing debates persist regarding the necessity of microscopic examination of postoperative pathology specimens for certain benign conditions, including those related to bariatric surgery, due to financial concerns. In our retrospective study, we aimed to investigate the adequacy of macroscopic evaluation of pathology specimens obtained from patients who underwent bariatric surgery and to identify any unforeseen pathologies that may be detected through microscopic evaluation. Materials and Methods: Demographic and pathological data of patients who underwent surgical intervention for morbid obesity at our clinic from May 2017 to December 2021 were retrieved from the patient database. Following the macroscopic assessment of LSG specimens, the surgeon identified suspicious lesions, prompting further microscopic evaluation by pathologists. A p-value of less than 0.05 was considered statistically significant. Results: A total of 225 patients and corresponding specimens were included in the study. The majority of patients were female (82.2%). The median age of the patients was 36 (range: 19-61) years, and the mean preoperative body mass index (BMI) was 42.6±4.21 kg/m². Macroscopic examinations revealed pathological suspicions in 21 cases (9.3%), and subsequent microscopic evaluations confirmed pathology in 20 of these cases (p<0.001). Notably, microscopic evaluation of all specimens identified pathology in 175 patients (77.8%). Conclusion: Based on our findings, we conclude that relying solely on macroscopic examination of LSG specimens is inadequate for detecting lesions. Therefore, we strongly advocate for the inclusion of microscopic evaluation, particularly due to its importance in detecting premalignant lesions. We recommend that microscopic assessment be routinely performed to ensure comprehensive pathological evaluation in LSG specimens. [ABSTRACT FROM AUTHOR]

Despite all the advances in laparoscopic surgery, it is still controversial whether complicated appendicitis should be treated by laparoscopic or open surgery. In this study, we aimed to compare intraoperative and postoperative outcomes of patients with complicated appendicitis who underwent laparoscopic or open appendectomy. Between March 2018 and March 2022, 151 patients underwent laparoscopic or open appendectomy for complicated appendicitis were analysed retrospectively. Demographic, laboratory data, and postoperative outcomes were examined. The median age of the patients was 46 years (interquartile range: 31-63) and 55% of the patients were male. Laparoscopic appendectomy was performed in 54.3% of the patients. While there was no significant difference observed in hospitalization durations between groups, laparoscopic appendectomy exhibited longer operation times compared to open appendectomy. Furthermore, postoperative follow-ups revealed a higher incidence of severe complications (Clavien-Dindo 3-4) in laparoscopic appendectomy (p=0.037). Subgroup analysis of complications indicated a greater frequency of intra-abdominal abscesses in laparoscopic procedures (p=0.033). Although the benefits of minimally invasive surgeries have been well-established, in cases of complicated appendicitis, we recommend open surgery over laparoscopic surgery to clinicians. [ABSTRACT FROM AUTHOR]

Purpose: A retrospective case-control study was undertaken to assess the diagnostic efficacy of X-ray film in detecting peptic ulcer perforation (PUP). Materials and Methods: The study retrieved demographic data, perioperative observations, and postoperative results of 353 patients from the hospital repository. These individuals were categorized into two cohorts depending on the detection of intraperitoneal free air on X-ray imaging. Results: The study cohort exhibited a median age of 57 years (interquartile range: IQR 38-71), comprising predominantly males (82.4%). Intraperitoneal free air was evident in 73.1% of patients on X-ray imaging. In the multivariate analyses of the respective groups, time interval and diabetes mellitus (DM) emerged as independent risk factors. Notably, the sensitivity of X-ray film heightened with prolonged duration between symptom onset and emergency department admission, while specificity increased in the presence of DM. Conclusion: The imperative for supplementary imaging modalities in conjunction with clinical assessment is apparent in the diagnostic approach to PUP. Nonetheless, the fluctuation in sensitivity and specificity of X-ray film concerning DM and the duration from symptom onset to emergency department admission warrants careful consideration. Especially in cases where clinical suspicion of PUP exists despite the absence of intraperitoneal free air on X-ray, the utilization of advanced diagnostic techniques is advocated. [ABSTRACT FROM AUTHOR]

Copyright of Turkish Journal of Trauma & Emergency Surgery / Ulusal Travma ve Acil Cerrahi Dergisi is the property of KARE Publishing and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Background/Aim: The impact of human epidermal growth factor receptor 2 (HER2) overexpression on the surveillance of gastric cancer remains uncertain. Typically, HER2 status is assessed in both locally advanced and metastatic diseases, and targeted therapies are applied to cases with HER2-positive status. Our objective was to investigate the correlation between HER2 receptor status, clinicopathological characteristics, and prognosis in gastric cancers across all stages. Based on the results from this investigation, we aim to provide clinicians with insights into the clinicopathological conditions that warrant HER2 investigation. Methods: In this retrospective study, we conducted a comprehensive analysis of clinicopathological data from a cohort of 169 patients who underwent surgical treatment for gastric cancer between 2014 and 2022. The HER2 status was determined based on results from immunohistochemistry (IHC) and fluorescent in situ hybridization (FISH) techniques applied to gastric cancer pathology samples. Based on the HER2 positivity, the patients were classified into two distinct groups: (1) HER2-positive and (2) HER2-negative. The relationship between the clinicopathological variables, HER2 status, and overall survival (OS) was evaluated using chi-squared and Kaplan-Meier analyses. A statistical significance level of P <0.05 was applied to determine significant associations. Results: According to the IHC analyses performed in our study population, 33 among 169 patients were HER2-positive (19.53%). Statistically significant factors related to HER2 positivity, such as male gender (P=0.009), pathological stage, N category, lymphovascular invasion status ([LVI] P=0.046), and proximal tumor location (P=0.015) were observed. In addition, OS was 40.49 (6.21) months in HER2-positive gastric cancer patients and 57.43 (3.48) months in HER2-negative gastric cancers (P=0.045). Conclusion: Irrespective of the pathological stage, gastric cancer exhibited HER2 positivity at a ratio of 5:1. Among the clinicopathological findings, a significant correlation was observed between HER2 expression and gastric cancers characterized by aggressive features. Moreover, HER2 positivity was associated with an unfavorable prognosis in gastric cancer patients. [ABSTRACT FROM AUTHOR]

Objectives: It is known that obesity is associated with increased complications and early recurrence after cancer surgery. This may also be the case in patients with hepatocellular carcinoma (HCC) who treated with liver transplantation (LT). Methods: This retrospective observational study aimed to investigate the potential impact of pre-transplant body mass index (BMI) on tumor recurrence and disease-free survival (DFS) in patients who underwent LT for HCC. The study analyzed data from 423 HCC patients who underwent LT at the Inonu University Liver Transplant Institute between 2006 and 2023. Results: The median age of the 423 patients included in the study was 56 years (range: 18-72), with 367 (86.8%) of them being male. The median BMI was 26 kg/m2 (range: 16.4-46.9). The recurrence rates were 24.3% in the non-obese group, 18.3% in the overweight group, and 16.7% in the obese group (p=0.239). The mean DFS durations were 8.4 years ± 0.6 in the non-obese group, 8.7 years ± 0.5 in the overweight group, and 9.7 years ± 0.9 in the obese group (p>0.05). Conclusion: This study suggests that obesity should not be considered a predictive factor for HCC recurrence when selecting candidates for liver transplantation. [ABSTRACT FROM AUTHOR]

Copyright of Anatolian Journal of General Medical Research is the property of Galenos Yayinevi Tic. LTD. STI and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Turkish Journal of Trauma & Emergency Surgery / Ulusal Travma ve Acil Cerrahi Dergisi is the property of KARE Publishing and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

In this study, we aimed to investigate the pre-operative predictive role of the serum white blood cell and platelet counts, C-reactive protein (CRP), bilirubin, amylase, lipase, and sodium levels for complicated appendicitis in patients aged≥18 years. We retrospectively evaluated 574 patients (aged≥18 years) who underwent appendectomy due to acute appendicitis (AA) between March 2018 and March 2022 at our clinic. The patient population was divided into two groups as perioperative complicated and uncomplicated appendicitis and the preoperative predictor role of serum white blood cell counts, platelet counts, CRP, bilirubin, amylase, lipase, and sodium levels were compared for complicated versus uncomplicated appendicitis. In multivariate analyses, age>38 years, the timing of Emergency Department (ED) arrival to admission ≥2 days, CRP ≥3.36 mg/dL, and total bilirubin ≥0.76 mg/dL are independent risk factors for detecting complicated AA. Moreover, in the designed scoring system, the AUC: 0.877 (CI: 0.847-0.907) for perforated AA at scores below or above. Estimation of the complications of AA can help clinicians practically with the scoring system designed because of the determined predictive factors. [ABSTRACT FROM AUTHOR]

Introduction: Surgical margin positivity incidence is reported between 5 snd 20% in gastric cancer surgery. Although some studies showed that presence of positive surgical margins affects overall survival negatively, others reported no effect. The aim of this study is to investigate the relationship between surgical margin and the survival of patients who underwent laparoscopic gastrectomy in our clinic. Materials and Methods: Between 2015 and 2022 years, patients who underwent laparoscopic gastrectomy because of gastric cancer were included in this study. Surgical resection margin (diameter) width, microscopic evaluation of the surgical margin, pathological tumor stage, resected lymph nodes numbers and involvement, and overall survival were analyzed. Results: After patients with benign disorders and inadequate lymph nodes resection were excluded from the study, 136 patients were included the study. Median surgical margin length width? was 2.3 (0.1-10) cm, and 13 (9.6%) patients had positive surgical margin after pathological evaluation. Median survival was 51.00±18.56 months in patients with positive surgical margins and 46.00±2.99 months in patients with negative surgical margins (p=0.977). The 1, 3, and 5-year survival rates of patients with negative versus positive surgical margins (78.9% vs. 69.2%, p=0.426), (46.3% vs. 46.2%, p=0.990), and (17.1% vs. 30.8%, p=0.225), respectively. Surgical margin was positive in 3 (7.7%) patients with proximal tumors, and in 10 (10.3%) patients with distal located tumors. Conclusion: While most studies emphasized surgical margin positivity in proximal tumors, the rate of distal surgical margin positivity was found to be higher in this study. In conclusion, no correlation was found between surgical margin positivity and overall survival. [ABSTRACT FROM AUTHOR]

Copyright of Journal of Tepecik Education & Research Hospital / İzmir Tepecik Eğitim ve Araştırma Hastanesi Dergisi is the property of Logos Medical Publishing and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Turkish Journal of Trauma & Emergency Surgery / Ulusal Travma ve Acil Cerrahi Dergisi is the property of KARE Publishing and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)