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Introduction: Gastric cancer is the fifth most common cancer today. It is the third most common cause of cancer-related death because it is usually at an advanced stage at the time of diagnosis. Several factors affect the prognosis of gastric cancer. In this study, we examined various factors affecting the prognosis in gastric cancer and evaluated their effects on the prognosis. Methods: Between 2011 and 2016, 146 patients who underwent resection with the diagnosis of curative gastric cancer in Haydarpaşa Numune Training and Research Hospital General Surgery Clinic were included in the study. A total of 146 gastric cancer patients who underwent curative surgery were retrospectively analyzed. Age, gender, type of operation, preoperative albumin and tumor markers, tumor stage, lymph node involvement, histological type, tumor localization, tumor differentiation, lymphovascular and perineural invasion, and Her-2 immunohistochemical features were examined, and survival analyses were performed. Results: Age, stage, lymph node involvement, and perineural-lymphovascular invasion were found to be statistically significant. Discussion and Conclusion: It was concluded that the determination of these prognostic factors will have an important place in the planning of the treatment. However, the subject should be supported by randomized clinical studies involving more patients. [ABSTRACT FROM AUTHOR]

Objective: Thermal ablation techniques including radio frequency ablation and microwave ablation are treatment modalities that have proven efficacy and reliability for the treatment of primary and metastatic hepatic tumors. One of the best measures of the technical success of thermal ablation is local recurrence. The purpose of this study was to determine the incidence of local recurrence after thermal ablation of hepatic malign tumors in our interventional radiology department. Materials and Methods: A retrospectively maintained database of 83 patients (208 lesions) who underwent thermal ablation from March 2010 to December 2019 for the treatment of malignant hepatic tumors was analyzed. All lesions were assessed regarding age, gender, prior treatment, tumor type, etiology, size, location, and approach of ablation. Imaging and demographic characteristics were compared between groups. Overall intrahepatic recurrence, local recurrence, and intrahepatic distant recurrence were evaluated. Results: The mean tumor size was 1.8 cm (range: 0.2-7 cm). The lesions were hepatocellular carcinoma in 21 (25%) and metastasis in 62 (75%) patients. These were colorectal liver metastasis (n=52, 63%), pancreatic liver metastasis (n=6, 7%), and other tumors (n=4, 4.8%). The mean follow-up was 32.5 months. The local and intrahepatic distant recurrence rates were 13.9% and 50.6%. The significant risk factors for local recurrence were tumor diameter >3 cm and the presence of intrahepatic distant recurrence. Other parameters had insignificant relationship to the local recurrence rate. Conclusion: After ablation, intrahepatic distant recurrence occurred more frequently than local recurrences, and those with intrahepatic distant recurrence had a higher local recurrence rate. [ABSTRACT FROM AUTHOR]

Background Intestinal ultrasound (IUS) is a valid cross-sectional imaging technique for the evaluation of Crohn's disease (CD). With advancements in technology, portable ultrasound systems are becoming widely available, and the inevitable change to their use by non-radiologist clinicians would be a valuable contribution to improving patient care. This study aimed to investigate the diagnostic yield of IUS examination performed by a gastroenterologist with a portable system as an adjunct imaging modality in the routine care of CD patients. Methods A total of 117 CD patients were assessed by IUS imaging. Pre- and post-IUS clinical-management decisions were recorded. The primary outcome was to evaluate the change in the patients' clinical-management decision following the IUS examination. The diagnostic accuracy was compared against the reference decision reached via a multidisiplinary meeting after the evaluation of all patient-related data. The endoscopic disease activity was determined using the simple endoscopic score for Crohn's disease (SES-CD). Results The initial clinical-management decision was changed in 47 patients (40.2%) after the IUS examination (P  = 0.001). The accuracy of patient-management decisions improved from 63.2% to 90.6% in comparison to reference decisions (P  < 0.001). After IUS examination, a further 13 cases (11.1%) were identified for urgent surgical/interventional procedures. The accuracy of colonoscopic (SES-CD ≥3) assessment was shown to be comparable to that of IUS (94% vs 91%). The sensitivity for disease presence was 95% with colonoscopy and 94% with the IUS assessment. Conclusion IUS examination with the use of a portable ultrasonography system significantly improves clinical-management decisions. With further supporting data, this practice would possibly become a requirement for CD management. [ABSTRACT FROM AUTHOR]

The aim of this study was to evaluate the clinical and radiological features of xanthogranulomatous cholecystitis (XGC) and the results of surgical treatment. This retrospective study concerns clinical, radiological, and surgical data as well as histopathological findings and postoperative results of 108 patients with XGC who were identified after evaluating 7916 cholecystectomy specimens between 2004 and 2014 in a single institute. One hundred eight patients with XGC were evaluated (56 males and 52 females, mean age 62.3 years). Clinical findings at referral included acute and chronic cholecystitis, Mirizzi's syndrome, choledocholithiasis, cholangitis, and acute pancreatitis. Ultrasound was performed in all patients, CT in 25, contrast-enhanced MRI in 29, and magnetic resonance cholangiopancreatography (MRCP) in 25 patients. None of the patients were diagnosed preoperatively, but mild-moderate degrees of wall thickening were present in most. Fifty-four patients received open cholecystectomy, while 54 received laparoscopic intervention, among whom 23 were converted to open. Partial cholecystectomy was performed in 11 patients. Two patients with gallbladder adenocarcinoma were treated with radical cholecystectomy. XGC has nonspecific clinical and radiological findings; thus, preoperative diagnosis is generally absent. Open cholecystectomy is the recommended treatment modality. Conversion to open is frequently necessary after laparoscopy. Complete cholecystectomy is the ultimate goal; however, partial cholecystectomy may be preferred to protect the structures of the hepatic hilum. [ABSTRACT FROM AUTHOR]

Objective: The treatment of gastroesophageal junction tumors remains controversial due to confusion on whether they should be considered as primary esophageal or as gastric tumors. The incidence of these tumors with poor prognosis has increased, thus creating scientific interest on gastroesophageal cancers. Esophagogastric cancers are classified according to their location by Siewert, and the treatment of each type varies. We evaluated the prognostic factors and differences in clinicopathologic factors of patients with gastroesophageal junction tumor, who have been treated and followed-up in our clinics. Material and Methods: We retrospectively analyzed 187 patients with gastroesophageal junction tumors who have been operated and treated in the Oncology Department between 2005 and 2014. The chi-square test was used to evaluate differences in clinicopathologic factors among Siewert groups I, II and III. Prognostic factors were analyzed by univariate and multivariate analysis. Results: The median age of our patients was 62 years, and approximately 70% was male. Nineteen patients (10.2%) had Siewert I tumors, 40 (21.4%) II, and the remaining 128 (64.4%) had Siewert III tumors. Siewert III tumors were at more advanced pathologic and T stages. Preoperative chemoradiotherapy was mostly applied to Siewert group I patients. There was no difference between the 3 groups in terms of recurrence. While the median overall survival and 2-year overall survival rate were 26.6 months and 39.6%, the median disease free survival and disease free survival rates were 16.5 months and 30.1%, respectively. The N stage, pathologic stage, vascular invasion, lymphatic invasion, perineural invasion, surgical margin, and grade were associated with both overall survival and disease free survival, while pathologic stage and presence of recurrence were significant factors for overall survival. The median disease free survival for Siewert III tumors was 20 months, 11.3 month for Siewert I tumors, and 14 months for Siewert II tumors, but the finding was not statistically significant (p=0.08). Conclusion: Although gastroesophageal junction tumors were grouped according to their location and they exerted different clinicopathologic properties, their prognosis was similar. [ABSTRACT FROM AUTHOR]

Ganglioneuromas arise from sympathetic ganglion cells and, like paragangliomas and pheochromocytomas, have the capacity to synthesize and secrete catecholamines (%30). They can be seen anywhere throughout the sympathetic nervous system but most commonly located in the posterior mediastinum and retroperitoneum. They usually hormonally inactive and detected incidentally. We report a case of a female patient with incidentally detected adrenal ganglioneuroma. Case: Eighteen-year old female patient was admitted to hospital with abdominal pain. Physical examination was insignificant except right lower quadrant pain. Laboratory tests were normal with no significant past medical history. She was prediagnosed as appendicitis and abdominal ultrasonography was performed which revealed 95x52 mm well-defined right adrenal mass lesion. Patient was referred to endocrinology department for futher evaluation. Abdominal MRI showed a solid mass measuring 65x72x91 mm arising from right adrenal gland. Tumor was hypointense on T1A and T2A-weighted images, with no significant washout. Endocrinologic evaluation of urinary catecholamines, cortisol, calsitonin were normal. One mg overnight dexamethasone suppression test was suppressed. Although catecholamine levels were normal, we could not exclude pheochromocytoma so alpha blocker treatment was initiated preoperatively. Right adrenalectomy was performed without any complications. Pathology result was compatible with ganglioneuroma. As no sign and symptoms are pathognomonic for adrenal ganglioneuromas differential diagnosis is often challenging. Adrenalectomy is the gold standard for the diagnosis and treatment. Overall prognosis is generally good. [ABSTRACT FROM AUTHOR]

Gastric duplication cyst which is a rare anomaly can also be observed in adulthood. Abdominal pain is the most common complaint in adults and most cases are discovered incidentally by radiological examination or gastric endoscopy. Preoperative diagnosis of gastric duplication is difficult and definitive diagnosis requires findings on laparatomy together with histopathological examination of the lesion. Gastric duplication cyst is primarily managed by complete excision. Gastric duplication cyst was suspected on gastric endoscopy and magnetic resonance imaging (MRI) of the abdomen in a 52-year-old woman presented with abdominal pain. She was treated by complete excision of the cyst and the diagnosis was confirmed with the operative findings and histopathological examination of the removed specimen.

Background: Microbial infections and translocation of intestinal bacteria are thought to contribute to multiple system organ failure, but bacterial cultures are often negative in patients with this complication. The purpose of this study was to determine the sensitivity of PCR for detecting microbial DNA in the blood of animals after conducting an experimental model of anastomotic leakage., Methods: Fourty rats were divided into three groups as follows: Control Group; simple laparotomy group, Anastomosis Group; colon resection and anastomosis group, and Leakage Group; group with colon resection and an anastomosis leaving a 5 mm opening. Blood was drawn form rats before the procedure, and postoperative 3rd and 6th days. DNAs were extracted from these samples and PCR techniques were used to amplify genes of Escherichia coli. Statistical analysis for the percentage of rats with microbial DNA in the blood for all groups was done by Fisher's exact chi- square test. The difference among groups was considered significant if the P value was less than 0.05., Results: Most of the detected Escherichia coli genes were from the Leakage Group, and the detection rate was significant compared to other groups., Conclusion: We suggest that PCR could be a useful adjunct tool for immediate diagnosis of anastomotic leakages.