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[LANGUAGE= \"English\"] INTRODUCTION: Minimal invasive gastrectomy procedures offer better postoperative recovery and lower complication rates. Furthermore, oncological outcomes are not inferior to conventional open gastrectomy (OG) procedures. The aim of this study was to evaluate the short-term postoperative clinical outcomes and histopathological results after laparoscopic gastrectomy (LG) versus OG in our clinic.METHODS: A total of 50 eligible patients were included in the study. All the patients were divided into two main groups as LG (n=18) and OG (n=32). Demographic parameters, intraoperative findings, early postoperative outcomes, and histopathological findings were compared between the groups.RESULTS: Age, gender, BMI, comorbid diseases, ASA scores, neoadjuvant treatment history were similar in both LG and OG groups. The mean first flatus time (LG: 2.01 vs. OG: 2.62 days, p=0.002) and hospital stay (LG: 10.2 vs. OG: 14.4 days, p=0.004) were shorter and estimated blood loss was lesser (LG: 147.5 vs. OG: 194.5ml, p= 0.041) in LG patients. The duration of operation significantly higher in LG patients (285.7 vs. 239.7 min, p<0.001). Postoperative 30-day minor and major complications and mortality rates were lesser in LG patients but the differences were not significant. The mean number of retrieved total lymph nodes in total gastrectomy patients (LTG: 39.2 vs. OTG: 38.7, p=0.982) and in distal gastrectomy patients (LDG: 32.4 vs. ODG: 37.1, p=0.649) were similar to open procedures.DISCUSSION AND CONCLUSION: LG procedures are superior to OG with advantageous postoperative clinical outcomes and similar oncologic results in both distal or total gastrectomy patients and can be safely performed for early or locally advanced gastric carcinomas.[LANGUAGE= \"Turkish\"] GİRİŞ ve AMAÇ: Minimal invaziv gastrektomi prosedürleri geleneksel açık gastrektomi (AG) prosedürlerine kıyasla ameliyat sonrası daha az komplikasyon oranlarına sahiptir ve daha erken iyileşme imkanı sunar. Ayrıca onkolojik sonuçları AG prosedürleri kadar başarılıdır. Bu çalışmada, merkezimizde yaptığımız laparoskopik gastrektomi (LG) ile AG sonrası kısa dönem postoperatif klinik sonuçları ve histopatolojik sonuçlarını karşılaştırmak amaçlanmıştır.YÖNTEM ve GEREÇLER: Çalışmaya toplam 50 hasta dahil edildi. Tüm hastalar LDG (n = 18) ve AG (n = 32) olarak iki ana gruba ayrıldı. Demografik parametreler, intraoperatif bulgular, erken postoperatif sonuçlar ve histopatolojik bulgular gruplar arasında karşılaştırıldı.BULGULAR: Gruplardaki yaş, cinsiyet, VKİ, komorbid hastalıklar, ASA skorları, neoadjuvan tedavi öyküsü benzerdi. Ortalama ilk gaz çıkarma zamanı (LG: 2.01'e karşı AG: 2.62 gün, p = 0.002) ve hastanede kalış süresi (LG: 10.2'ye karşı AG: 14.4 gün, p = 0.004) daha kısaydı. İntraoperatif tahmini kan kaybı LG'de daha azdı (LG: 147.5'e karşı AG: 194,5 ml, p = 0,041). Operasyon süresi LG hastalarında anlamlı olarak daha yüksek (285,7'ye karşı 239,7 dk, p <0,001) bulundu. Postoperatif 30 günlük minör ve majör komplikasyonlar ve mortalite oranları LG hastalarında daha düşüktü ancak farklar anlamlı değildi. Çıkarılan toplam lenf düğümü ortalama sayısı total gastrektomi hastalarında (LTG: 39,2'ye karşı ATG: 38,7, p = 0,982) ve distal gastrektomi hastalarında (LDG: 32,4'e karşı ADG: 37,1, p = 0,649) açık prosedürlerle benzerdi.TARTIŞMA ve SONUÇ: Laparoskopik gastrektomi prosedürleri hem distal hem de total gastrektomi hastalarında avantajlı postoperatif klinik sonuçlar ve benzer onkolojik sonuçlarla AG'den üstündür. Erken evre veya lokal ileri mide karsinomlarında güvenle uygulanabilir.

Purpose In this study, it was aimed to determine the predictors of clinically relevant postoperative pancreatic fistula (CR-POPF) following pancreaticoduodenectomy (PD) and clinical significance of mean platelet volume (MPV)/total platelet count ratio (MPR) as a new predictor for CR-POPF. Methods A total of 105 patients who underwent PD consecutively due to periampullary located diseases were included in the study. Patients were divided into two groups as CR-POPF and no postoperative pancreatic fistula (No-POPF). Demographic parameters, preoperative serum-based inflammatory indicators, surgical procedures, intraoperative findings, and histopathological parameters were recorded retrospectively from prospectively recorded patient files and compared between the groups. Results CR-POPF occurred in 16 (15.2%) patients: 8 (7.6%) were grade B and 8 (7.6%) were grade C according to the ISGPF classification. In univariate analysis, intraoperative blood loss > 580 mL (OR: 5.25, p  = 0.001), intraoperative blood transfusion (OR: 5.96, p  = 0.002), intraoperative vasoconstrictor medication (OR: 4.17, p  = 0.014), benign histopathology (OR: 3.51, p  = 0.036), and poor differentiation in malignant tumors (OR: 4.07, p  = 0.044) were significantly higher in the CR-POPF group, but not significant in multivariate analysis. Soft pancreatic consistency (OR: 6.08, p  = 0.013), pancreatic duct diameter < 2.5 mm (OR: 17.15, p  < 0.001), and MPR < 28.9 (OR: 13.91, p  < 0.001) were the independent predictors of CR-POPF according to multivariate analysis. Neoadjuvant treatment history and simultaneous vascular resection were less likely to cause CR-POPF development; however, they were insignificant. Conclusion Soft pancreatic consistency, pancreatic duct diameter, and preoperative MPR were the independent predictors of CR-POPF following PD. Decreased MPR is a strong predictor for CR-POPF and should be considered when deciding treatment strategies.

AimNeoadjuvant chemotherapy (NAC) has transitioned from a treatment modality used solely for inoperable and locally advanced breast cancer to a therapeutic approach for early-stage breast cancer. High-risk patients, such as those with HER2-positive and triple-negative breast cancer, particularly benefit from NAC. This study aimed to evaluate the factors affecting pathological complete response (pCR) in primary breast tumors and axillary lymph nodes in patients with breast cancer.MethodsThe study included female patients with breast cancer who received NAC at a training and research hospital between 2020 and 2024. Patients were categorized based on age, tumor stage, and tumor biology: luminal A, HER2-positive luminal B, HER2-negative luminal B, HER2-positive alone, or triple-negative. The presence or absence of E-cadherin in tumor cells and Ki-67 levels were also examined. Data were obtained from medical records to assess the impact of these factors on complete response in patients with breast cancer and axillary metastatic lymph nodes following NAC.Results: Univariate analysis revealed that histopathological subtypes, estrogen receptor and progesterone receptor (PR) status, HER2 status, perineural invasion, lymphovascular invasion (LVI), Ki-67 index, and carcinoma in situ (CIS) component significantly influenced pCR. Multivariate analysis confirmed that PR status [Odds ratio (OR): 3.33, 95% confidence interval (CI): 1.57-7.08, p=0.002], HER2 status (OR: 3.56, 95% CI: 1.71-7.44, p=0.001), LVI (OR: 3.91, 95% CI: 1.84-8.30, p<0.001), Ki-67 index (OR: 1.03, 95% CI: 1.01-1.05, p<0.001), and CIS component (OR: 7.01, 95% CI: 2.44-20.11, p<0.001) were independent predictors of complete response.ConclusionOur findings underscore the multifaceted nature of NAC response in breast cancer, which is influenced by histopathological and molecular characteristics.

INTRODUCTION: There are still controversies in the management of gallstones in patients who are candidate for bariatric surgery. The aim of this study was to evaluate the effect of the concomitant cholecystectomy (CC) during laparoscopic sleeve gastrectomy (LSG) on post-operative short-term complications in patients with symptomatic gallstone. METHODS: After exclusion and inclusion criteria, a total of 251 patients were included in the study. Patients were divided into two study groups as Group A (only LSG, n=214) and Group B (LSG + CC, n=37). RESULTS: Female-to-male ratio was 2/1 in Group A and 8/1 in Group B (p=0.01). The mean age, comorbid disease distributions, length of stay, and initial body mass index were similar in both groups. The differences in the rates of postoperative 30-day minor and major complications in Group A (7.5% and 2.8%, respectively) and Group B (18.9% and 2.7%, respectively) were not significant (p=0.64). CC prolonged the operation time at an average of 15 min (p<0.001). DISCUSSION AND CONCLUSION: CC during LSG is a safe procedure in patients with symptomatic gallstone, which has an acceptable increase in operation time and does not cause an increase in minor or major complications and prolongation on length of stay.

Aim: To evaluate postoperative histopathological findings and short-term clinical outcomes of laparoscopic complete mesocolic excision (L-CME) versus open-complete mesocolic excision (O-CME) for right-sided colon cancers. Method: A total of 36 eligible patients were included. Patients were divided into two main groups as L-CME (n=21) and O-CME (n=15). Demographic parameters, intraoperative findings, early postoperative outcomes and histopathological findings were compared between the groups. Results: Age, sex, body mass index, American Society of Anesthesiology scores, comorbid diseases, neoadjuvant treatment, carcinoembryonic antigen level, and tumor locations were similar in L-CME and O-CME groups. tumor, node, and metastasis stage, mean proximal and distal surgical margin distances, and mean total retrieved lymph nodes (L-CME: 27.9 vs O-CME: 28.4; p=0.368) were similar between the groups. Duration of operation (L-CME: 171.9 vs O-CME: 164.7 minutes; p=0.287), estimated blood loss (L-CME: 130 vs O-CME: 143.3 mL; p=0.508), length of hospital stay (L-CME: 8.6 vs O-CME: 11.5 days; p=0.936), intraoperative complication rates, postoperative non-surgical complication rates (L-CME: 4.8% vs O-CME: 20.0%; p=0.214), postoperative mortality rates (L-CME: 0.0% vs O-CME: 13.3%; p=0.085), and re-operation rates (L-CME: 4.8% vs O-CME: 6.7%; p=0.806) were also similar between the groups. First flatus time was shorter (L-CME: 2.5 vs O-CME: 2.9 days; p=0.038), postoperative surgical complication rate was less (L-CME: 14.3% vs O-CME: 53.7%; p=0.008), overall postoperative 30-day complication rates were less (L-CME: 14.3% vs O-CME: 60.0%; p=0.004), and the severity of complications were less (p=0.016) in L-CME group. Conclusion: L-CME is technically feasible and safe for right colon cancers. It appears to be non-inferior to O-CME in terms of harvested lymph nodes and it provides faster postoperative recovery.