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Article Citation - WoS: 8Citation - Scopus: 8Laparoscopic Sleeve Gastrectomy With Transit Loop Bipartition and Transit Bipartition in Type 2 Diabetic Patients With Obesity: a Retrospective Analysis(Lippincott Williams & Wilkins, 2023) Demir, Canan; Arslan, Ergin; Sariyildiz, Guelcin; Anil, Cueneyd; Banli, OktayAim:We aimed to compare 1-year postoperative results of patients with obesity and type 2 diabetes mellitus (T2DM) who underwent laparoscopic sleeve gastrectomy with transit bipartition (LSG-TB) and transit loop bipartition (LSG-TLB) and mini gastric bypass (MGB). Patients and Methods:This is a retrospective comparison of 2 novel bariatric surgery techniques with MGB. Primary outcome measure of the study was a rate of T2DM remission. Secondary outcomes included excess body mass index (BMI) loss, improvement in hepatosteatosis, and duration of operation. Revision surgery needs were also assessed. Results:Overall, 32 patients underwent the LSG-TLB, 15 underwent LSG-TB, and 50 underwent MGB. Mean age and sex distribution were comparable for all groups. Presurgical BMI was similar in MGB and LSG + TB groups, whereas LSG + TLB group had significantly lower BMI values compared with the MGB group. In both groups, BMI values reduced significantly compared with respective baseline values. Excess BMI loss was significantly higher in patients who underwent LSG-TLB compared with patients treated with LSG-TB and MGB. Bariatric surgery procedures lasted shorter in LSG-TLB than in LSG-TB. However, the shortest of all was MGB. The remission of T2DM rates were 71% and 73.3% in LSG-TLB and LSG-TB groups, respectively (P > 9.999). The rate of revision surgeries was comparable in both groups. Conclusion:In conclusion, LSG-TLB took less time and provided significantly higher excess BMI loss compared with LSG-TB. T2DM remission and improvement rates were similar in both groups. LSG-TLB seemed like a promising bariatric surgery technique in patients with obesity and T2DM.Article Citation - WoS: 5Citation - Scopus: 7Comparison of the Stability of Sandblasted, Large-Grit, and Acid-Etched Treated Mini-Screws with Two Different Surface Roughness Values: A Histomorphometric Study(Lippincott Williams & Wilkins, 2022) Seker, Elif Dilara; Yavuz, Ibrahim; Yucesoy, Turker; Cenkci, Ebru; Yay, ArzuPurpose: To evaluate the effects of 2 different surface roughness values produced by sandblasted, large-grit, and acid-etched treatments at different loading conditions on the stability of mini-screws. Material and Methods: A total of 56 mini-screws (Group 1; 28 with Ra value of 1 mm, Group 2; 28 with Ra value of 1.5 mu m) were inserted into the tibia of fourteen New Zealand rabbits. Surface analysis was performed before the placement of the miniscrews using multi-technique characterization. The mini-screws were loaded with 500 grf after different healing times: unloaded, immediate, 4 and 8 weeks. Resonance frequency analyses were performed immediately after mini-screw placement and at the end of loading. Biomechanical and histomorphometric analyses were also performed at the end of the loading period. Results: All mini-screws preserved their stability at the end of the loading period. However, the resonance frequency analyses showed higher implant stability quotient scores for 8-week group, unlike the immediate loading and unloaded groups (P < 0.05). According to the infinite focus microscopy results, prolongation of healing time resulted in a greater bone area on the loaded mini-screws in Group 2 (P < 0.05). Similarly, the histomorphometric analysis revealed higher bone-to-implant contact values in the 8-week group. There was no significant difference in the stability between the miniscrews with the Ra values of 1 and 1.5 mu m. Conclusions: Sandblasted, large-grit, and acid-etched treated miniscrews showed significantly higher stability with healing time under heavy forces. Sandblasted, large-grit, and acid-etched treated miniscrews can be removed without fracture of the screw or the bone surfaces.Article Effects of Cold Therapy on Pain and Anxiety During Needle Removal From Implanted Ports(Lippincott Williams & Wilkins, 2023) Bahar, Arzu; Aktas, Demet; Sonmez, MunevverThis study was conducted as a quasiexperimental, single-blind study to examine the effect of cold therapy on pain and anxiety during port needle removal. Patients in the experimental group received cold therapy 10 minutes before port needle removal. Patients in the control group received no intervention before port needle removal. Data were collected using the visual analog scale (VAS) and State-Trait Anxiety Inventory (STAI). After cold therapy was applied to the patients in the experimental group, the second and third VAS scores were found to be statistically significant and lower than those in the control group (P < .05). There was no statistically significant difference between the anxiety levels of the experimental group and the control group before cold therapy (P> .005). However, the STAI scores of the experimental group were found to be statistically and significantly lower than those of the control group after cold therapy (P < .05). This study determined that cold therapy before port needle removal reduces pain and anxiety. Cold therapy may be recommended as an effective nonpharmacological pain control method with ease of application to prevent pain induced by port needle removal.Article Citation - WoS: 15Citation - Scopus: 19Efficacy and Safety of Gonioscopy-Assisted Transluminal Trabeculotomy for Primary Congenital Glaucoma(Lippincott Williams & Wilkins, 2023) Aktas, Zeynep; Ozmen, Mehmet C.; Ozdemir Zeydanli, Ece; Oral, Merve; Eskalen, OguzcanPrecis:Gonioscopy-assisted transluminal trabeculotomy (GATT) provided effective intraocular pressure (IOP) control in primary congenital glaucoma (PCG). Also, approximately two third of patients did not need antiglaucoma medication at an average follow-up of 1 year after surgery. Purpose:The purpose of this study was to assess the safety and efficacy of GATT surgery in eyes with PCG. Materials and Methods:This study is a retrospective review of patients who underwent GATT surgery for PCG. Outcome measures were changes in IOP and number of medications at all time points (1, 3, 6, 9, 12, 18, 24, and 36 mo after surgery), and success rates. Success was defined as IOP<21 mm Hg with at least a 30% reduction from the baseline, complete if without medications, or qualified if with or without medications. Cumulative success probabilities were analyzed using the Kaplan-Meier survival analyses. Results:Twenty-two eyes of 14 patients diagnosed with PCG were enrolled in this study. The mean IOP reduction was 13.1 mm Hg (57.7%) with a mean decrease of 2 glaucoma medications at the final follow-up. All mean IOP readings during postoperative follow-up were significantly lower than baseline (P<0.05 for all). Cumulative probability of qualified success was 95.5% and the cumulative probability of complete success was 66.7%. Conclusion:GATT was safe and successfully lowered IOP in patients with PCG with the advantage of avoiding conjunctival and scleral incisions.Article Citation - WoS: 34Citation - Scopus: 39Outcomes of Prolene Gonioscopy Assisted Transluminal Trabeculotomy in Primary Open Angle Glaucoma and Pseudoexfoliation Glaucoma: a Comparative Study(Lippincott Williams & Wilkins, 2022) Aktas, Zeynep; Zeydanli, Ece Ozdemir; Uysal, Betul Seher; Yigiter, AhmetPrecis: Gonioscopy-assisted transluminal trabeculotomy (GATT) provides greater intraocular pressure (TOP) reduction in pseudoexfoliative glaucoma (PXG) than in primary open angle glaucoma (POAG) in the first year of surgery; however, the difference between groups equalizes in the long term. Purpose: To compare outcomes of GATT in eyes with POAG and PXG. Methods: Single-center, retrospective, comparative case-series. A total of 202 eyes (91 eyes of POAG; 111 eyes of PXG) were included. GATT was performed as a standalone procedure or in combination with cataract extraction. Outcome measures were change in IOP and number of medications at all time points (1, 3, 6, 9, 12, 18, 24, and 36 mo after surgery), success rate (IOP reduction >= 20% from baseline or IOP between 6 and 21 mmHg, without further glaucoma surgery), and complication rate. Cumulative success probabilities were compared using Kaplan-Meier survival analyses. Results: The mean IOP decreased by 8.8 mmHg (34.4%) in the POAG group with a mean decrease of 2 glaucoma medications at final visit. In the PXG group, the mean IOP decreased by 12.8 mm Hg (44.6%) on 2.3 fewer medications. Mean IOP reduction was significantly higher in PXG than POAG at all time points up to 2-year visit (P < 0 .0 5 for all), after which the difference was not significant. Cumulative success probability during the first year was significantly higher in PXG (97.6%) than in POAG (86.8%) (P = 0.01); no significant difference was found at 2-year (P = 0.07) and 3-year visits (P = 0.24). Conclusion: GATT was safe and effectively reduced the IOP and medication burden in patients with POAG and PXG. In the first year after GATT, a significantly higher success rate was noted in PXG compared with POAG; however, in subsequent years, the success rate was similar at similar to 75%.Article Citation - WoS: 10Citation - Scopus: 8Biomechanical Evaluation of Different Fixation Methods for Mandibular Anterior Segmental Osteotomy Using Finite Element Analysis, Part One: Superior Repositioning Surgery(Lippincott Williams & Wilkins, 2016) Kilinc, Yeliz; Erkmen, Erkan; Kurt, AhmetThe aim of the current study was to comparatively evaluate the mechanical behavior of 3 different fixation methods following various amounts of superior repositioning of mandibular anterior segment. In this study, 3 different rigid fixation configurations comprising double right L, double left L, or double I miniplates with monocortical screws were compared under vertical, horizontal, and oblique load conditions by means of finite element analysis. A three-dimensional finite element model of a fully dentate mandible was generated. A 3 and 5mm superior repositioning of mandibular anterior segmental osteotomy were simulated. Three different finite element models corresponding to different fixation configurations were created for each superior repositioning. The von Mises stress values on fixation appliances and principal maximum stresses (P-max) on bony structures were predicted by finite element analysis. The results have demonstrated that double right L configuration provides better stability with less stress fields in comparison with other fixation configurations used in this study.Article Citation - WoS: 3Citation - Scopus: 3Risk Factors for Trabeculotomy Failure in Primary Congenital Glaucoma(Lippincott Williams & Wilkins, 2022) Aktas, Zeynep; Ucgul, Ahmet Y.; Boluk, Ceyda E.; Atalay, Hatice T.Precis:This study demonstrates that a baseline corneal diameter >12.25, initial age <4 months at diagnosis, higher baseline IOP than 24 mm Hg, bilaterality, or inability to perform circumferential trabeculotomy, increases the risk of surgical failure of trabeculotomy in patients with primary congenital glaucoma (PCG). Purpose:The aim of this study was to identify clinical predictive factors for surgical failure and to evaluate potential prognostic factors affecting surgical success in patients with PCG who underwent trabeculotomy. Patients and Methods:The medical charts of 123 eyes of 75 patients who underwent trabeculotomy surgery for the treatment of PCG were retrospectively reviewed. At baseline and each visit, intraocular pressure (IOP), corneal diameter, cup to disc ratio, axial length, number of medications, and need for further glaucoma surgery were noted. Surgical success was defined as an IOP <= 18 mm Hg and 20% IOP reduction from baseline with (qualified) or without (complete) medication and without any further IOP-lowering surgery. Results:The mean age at surgery was 4.2 +/- 6.6 months and the mean follow-up time was 60.0 +/- 37.6 months. The receiver operating characteristic curve showed 4 following best cutoff values to predict surgical failure: the first for age at surgery was 4.5 months; the second baseline IOP was 24.0 mm Hg; the third for baseline cup to disc ratio was 0.4; and the fourth for baseline corneal diameter was 12.25 mm. Multivariate logistic regression analysis revealed that baseline IOP more than 24 mm Hg increased the risk of surgical failure by 2 times, baseline mean corneal diameter >12.25 mm did by 4.2 times, younger age than 4 months did by 2.5 times, bilaterality did by 1.5 times. Conclusions:A higher baseline IOP, younger age, larger corneal diameter, and bilaterality were identified as risk factors for trabeculotomy failure in congenital glaucoma. The presence of one or more of these should be considered in the decision-making process when considering surgical options to manage glaucoma in these patients.Review Citation - WoS: 31Citation - Scopus: 37The Effectiveness of Simulation-Based Team Training in Obstetrics Emergencies for Improving Technical Skills a Systematic Review(Lippincott Williams & Wilkins, 2020) Yucel, Cigdem; Hawley, Glenda; Terzioglu, Fusun; Bogossian, FionaThis review explores the effectiveness of simulation-based team training in obstetric emergencies for improving technical skills. A literature search was conducted that included all articles to January 2018. A total of 21 articles were included from a potential 1327 articles. Each included study was assessed for impact of the training program using Kirkpatrick's 4-level model. Only the performance of technical skills was evaluated. Five studies reported on acceptance of simulation as an education tool at a level 1. Level 2 outcomes were reported in 7 studies where staff demonstrated improved skills in an educational setting. Three studies reported improved performance in a clinical setting at a level 3. Ten studies were categorized as level 4 and found that simulation learning was translated into improved techniques or maneuvers in reduced time frames in emergency situations of shoulder dystocia and postpartum hemorrhage. There was evidence that neonatal outcomes were improved.Article Citation - WoS: 7Citation - Scopus: 7Biomechanical Evaluation of Different Fixation Methods for Mandibular Anterior Segmental Osteotomy Using Finite Element Analysis, Part Two: Superior Repositioning Surgery With Bone Allograft(Lippincott Williams & Wilkins, 2016) Kilinc, Yeliz; Erkmen, Erkan; Kurt, AhmetIn this study, the biomechanical behavior of different fixation methods used to fix the mandibular anterior segment following various amounts of superior repositioning was evaluated by using Finite Element Analysis (FEA). The three-dimensional finite element models representing 3 and 5mm superior repositioning were generated. The gap in between segments was assumed to be filled by block bone allograft and resignated to be in perfect contact with the mandible and segmented bone. Six different finite element models with 2 distinct mobilization rate including 3 different fixation configurations, double right L (DRL), double left L (DLL), or double I (DI) miniplates with monocortical screws, correspondingly were created. A comparative evaluation has been made under vertical, horizontal and oblique loads. The von Mises and principal maximum stress (P-max) values were calculated by finite element solver programme. The first part of our ongoing Finite Element Analysis research has been adressed to the mechanical behavior of the same fixation configurations in nongrafted models. In comparison with the findings of the first part of the study, it was concluded that bone graft offers superior mechanical stability without any limitation of mobilization and less stress on the fixative appliances as well as in the bone.Article Citation - WoS: 2Citation - Scopus: 2Endoscopic Retrograde Cholangiopancreatography-Oriented Surgery for Accomplished Treatment of Mirizzi Syndrome: a Single-Center Experience(Lippincott Williams & Wilkins, 2023) Karaahmet, Fatih; Kekilli, MuratBackgroundMirizzi syndrome is a gallstone disease characterized by compression of extrahepatic biliary duct with an impacted stone. Our aim is to identify and describe the incidence, clinical presentation, operative details and the association postoperative complication of Mirizzi syndrome in patients undergoing endoscopic retrograde cholangiopancreatography (ERCP). MethodsThe ERCP procedures were held in Gastroenterology Endoscopy Unit and retrospectively evaluated. The patients were divided into two groups, the cholelithiasis + common bile duct (CBD) stone group and the Mirizzi syndrome group. These groups were compared with the demographic characteristics, ERCP procedures, types of Mirizzi syndrome and surgical technique. ResultsA total of 1018 consecutive patients who underwent ERCP were scanned retrospectively. Of the 515 patients fulfilling the criteria for ERCP, 12 had Mirizzi syndrome and 503 had cholelithiasis and CBD stones. Half of the Mirizzi syndrome patients were diagnosed with pre-ERCP ultrasonography. The mean diameter of choledoc was found to be 10 mm in ERCP. ERCP-related complication rates (pancreatitis, bleeding and perforation) were the same in the two groups; 66.6% of the Mirizzi syndrome patients applied cholecystectomy and placement of T-tube surgical procedures, and there were no postoperative complications. ConclusionSurgery is the definitive treatment of Mirizzi syndrome. Thus patients should have a correct preoperative diagnosis for an appropriate and safe surgery. We think that ERCP could be the best guide for this. Also, we believe that intraoperative cholangiography with ERCP and hybrid procedures for guiding surgical treatment may become an advanced treatment option in the future.
