Missed Gallstones in the Bile Duct and Abdominal Cavity: A Case Report

WOS: 000258504600027PubMed: 1871977

Turkish national consensus on breast cancer management during temporary state of emergency due to COVID-19 outbreak

Objective: Cancer care is excessively influenced by the COVID-19 outbreak for various reasons. One of the major concerns is the tendency for delayed surgical treatment of breast cancer patients. The outbreak has urged clinicians to find alternative treatments until surgery is deemed to be feasible and safe. Here in this paper, we report the results of a consensus procedure which aimed to provide an expert opinion-led guideline for breast cancer management during the COVID-19 outbreak in Turkey. Material and Methods: We used the Delphi method with a 9-scale Likert scale on two rounds of voting from 51 experienced surgeons and medical oncologists who had the necessary skills and experience in breast cancer management. Voting was done electronically in which a questionnaire-formatted form was used. Results: Overall, 46 statements on 28 different case scenarios were voted. In the first round, 37 statements reached a consensus as either endorsement or rejection, nine were put into voting in the second round since they did not reach the necessary decision threshold. At the end of two rounds, for 14 cases scenarios, a statement was endorsed as a recommendation for each.Thirty-two statements for the remaining 14 were rejected. Conclusion:There was a general consensus for administering neoadjuvant systemic therapy in patients with node-negative, small-size triple negative, HER2-positive and luminal A-like tumors until conditions are improved for due surgical treatment. Panelists also reached a consensus to extend the systemic treatment for patients with HER2-positive and luminal B-like tumors who had clinical complete response after neoadjuvant systemic therapy

Surgeon performed intraoperative ultrasound guidance with real - time specimen scanning may allow selective cavity shavings to reduce positive margin rates

WOS: 00039793040030

Intraoperative ultrasound-guided breast conserving surgery for palpable and nonpalpable breast cancer

37th Annual CTRC-AACR San Antonio Breast Cancer Symposium -- DEC 09-13, 2014 -- San Antonio, TXWOS: 000356730201059Canc Therapy Res Ctr, Amer Assoc Canc Re

A Rare cause of acute abdomen: Idiopathic necrosis of the fourth part of the duodenum

Duodenum nekrozu peritonit nedenlerinden biridir. İyi bilinen ve mutlak girişim gerektiren cerrahi acillerdendir. Çoğunlukla cerrahi sonrası duodenum güdüğünün kanlanmasının iyatrojenik nedenlere bağlı bozulması veya nekrotizan pankreatit sonucu gelişmektedir. Bu yazıda akut karın bulguları acil servise başvuran herhangi bir etiyolojik neden saptanmaksızın duodenumun 4. kısmında nekroz tespit edilen 69 yaşında kadın hasta sunulmuştur. Çekilen abdominal bilgisayarlı tomografisinde anormal değişiklikler saptanmış ve laparatomi yapılan hasta tüp duodenostomi uygulanarak başarılı bir şekilde tedavi edilmiştir. (Gazi Med J 2012; 23: 29-32)Duodenal necrosis is one of the causes of peritonitis. It remains a well-known surgical emergency requiring prompt surgical intervention. Duodenal necrosis mostly occurs following iatrogenic devascularisation of a duodenal stump or in the course of necrotising pancreatitis. We present a case of idiopathic necrosis of the fourth part of the duodenum without a certain aetiologic cause in a 69-year-old woman who was admitted to our hospital with acute abdomen findings. Abdominal computed tomography scan revealed abnormal results. Laparotomy was performed and the case was successfully treated with tube duodenostomy. (Gazi Med J 2012; 23: 29-32

Surgeon performed continuous intraoperative ultrasound guidance decreases re-excisions and mastectomy rates in breast cancer

Background Intraoperative ultrasound guided (IUG) breast conserving surgery (BCS) is being increasingly embraced by breast surgeons worldwide. We aimed to compare the efficacy of IUG-BCS for palpable and nonpalpable breast cancer with respect to margin status, re-excision rate, tissue sacrifice and cost-time analysis. Methods Intraoperative localization protocol includes intraoperative ultrasound prior to excision to localize the lesion and guide the initial resection. The excised specimen was then examined visually and by palpation and the specimen and cavity was examined with ultrasound. Frozen sections were obtained routinely from a portion of all six faces of the resected specimen, and shaved cavity margins were sent for permanent histology. Results Of the 208 patients, 57.2% had nonpalpable tumors. The sensitivity of ultrasound localization was 100%. Negative margins were achieved in 92.43% of nonpalpable and 91.01% of palpable lesions at initial procedure. The involved margins were correctly identified by the surgeon via specimen sonography in 95.4% of cases. Final positive margin rate was 2.4%. Calculated resection ratio and time analysis revealed nothing significant. Conclusion IUG-BCS is an invaluable and effective modality for obtaining clear surgical margins with optimum resection volumes and reducing re-operations. Furthermore, by means of this algorithm, in case of shaving cavity margins of the tumor bed for permanent analysis, frozen section evaluation might be omitted. © 201

Surgeon performed intraoperative ultrasound accurately predicts margin status after neaoadjuvant chemotheraphy

San Antonio Breast Cancer Symposium -- DEC 05-09, 2017 -- San Antonio, TXWOS: 00042548940031

Intraoperative continuous ultrasonography-guided oncoplastic surgery: Margin assessment and selective cavity shaving

20th Annual Meeting of the American-Society-of-Breast-Surgeons -- APR 30-MAY 05, 2019 -- Dallas, TXWOS: 000467382700095Amer Soc Breast Sur

Does intraabdominal use of Ankaferd Blood Stopper cause increased intraperitoneal adhesions?

Ankarali, Handan Camdeviren/0000-0002-3613-0523; Gultekin, Fatma Ayca/0000-0002-4148-5871; Cakmak, Guldeniz Karadeniz/0000-0001-5802-4441; Emre, Ali Ugur/0000-0002-1136-0517; Karakaya, Kemal/0000-0002-6742-9923WOS: 000281963300001PubMed: 21038113BACKGROUND The aim of this study was to investigate whether intraabdominal Ankaferd Blood Stopper (ABS) causes increased intraabdominal adhesion formation and to determine any side effects of ABS in vivo. METHODS The present experimental study was designed to examine the effects of Ankaferd solution on peritoneal adhesion formation in a rat model of cecal abrasion. Intraperitoneal adhesions were assessed macroscopically and histopathologically on the 10th postoperative day. The possible adverse affects of ABS on liver and lung tissues were analyzed histopathologically, and blood chemistry was also evaluated. RESULTS Our study revealed that ABS reduced intraperitoneal adhesion formation in an experimental rat model. The blood chemistry was not disturbed due to ABS administration. Intraperitoneal administration of ABS led to some minor changes in the lungs and serosal surfaces of the intestines, with minor architectural changes in the liver that were not considered as toxic. Further studies with various application doses and routes with more detailed cellular analysis are thus warranted to clarify the possible pleiotropic and adverse effects of this new agent away from hemostasis. CONCLUSION There was less intraperitoneal adhesion formation in the ABS group than in the control group and saline group. Intraperitoneal administration of ABS has no toxic effects on blood chemistry or the lungs, kidneys and the liver, but it has some minor adverse effects