Türk kolon ve rektum cerrahisi derneği (TKRCD) terminoloji komisyonu çalışma raporu

This study aimed to explain the working order of the Terminology Commission, which was established at the workshop of the Turkish Society of Colon and Rectal Surgery (TKRCD) on February 22, 2020, the criteria and results in the preparation of the terminology report. The commission prepared a work plan to complete in three main steps. The working process continued in a way that the members expressed their opinions with equal rights and the decisions were taken by consensus or by majority vote. The main purpose of the commission study was determined as “determining the terms that need to be explained and agreed in colorectal surgery, and to define them in a way that is compatible with the literature and contributes to daily practice”. The first meeting of the commission was held on February 22, 2020, and the report was accepted by the TKRCD Board of Directors on May 25, 2021. A total of 20 meetings were held during this period. In the first step, five headings were determined for writing the terms: Anatomy, symptoms and diagnostic tools, diseases, treatments and complications. There was a consensus that the terms met the following three conditions: 1) the need for explanation and consensus in colorectal surgery, 2) literature support, and 3) use in daily practice. The terms were written in the following format: Terms and synonyms, English equivalents, definition, explanation and bibliography. In the second step, each commissioner wrote an average of 10.8±4.3 terms. The distribution of 89 terms in the final report was as follows: Anatomy (n=26, 29.2%), symptoms and diagnostic tools (n=8, 8.9%), diseases (n=20, 22.4%), treatments (n=28, 31.4%), and complications (n=7, 7.8%). Figures (n=7), all from the archives of the commission members, and figures drawn by a new commission member (n=53) were also added to the report. In the third step, the report was submitted to the TKRCD Management with the approval of the TKRCD President. The preparation process of the Terminology Commission report of TKRCD was presented. The final report is open to changes and expansions with future studies.Bu çalışma Türk Kolon ve Rektum Cerrahisi Derneği’nin (TKRCD) 22 Şubat 2020 tarihinde yaptığı çalıştayda kurulan Terminoloji Komisyonu’nun çalışma düzenini, terminoloji raporunun hazırlanmasındaki kriterleri ve sonuçlarını açıklamayı amaçlamaktadır. Komisyon üç ana basamakta tamamlayacak iş planı hazırlamıştır. Çalışma süreci üyelerin eşit haklarla görüş belirttiği ve kararların uzlaşı veya oy çokluğuyla alındığı bir şekilde sürdürülmüştür. Komisyon çalışmasının temel amacı “kolorektal cerrahide açıklanması ve uzlaşı sağlanması gerekli terimlerin belirlenmesi, literatüre uygun ve günlük pratiğe katkı sağlayacak bir şekilde tanımlanması” olarak saptanmıştır. Komisyon ilk toplantısı 22 Şubat 2020’de yapılmış, rapor ise TKRCD Yönetim Kurulu’nda 25 Mayıs 2021’de kabul edilmiştir. Bu dönemde toplam 20 toplantı yapılmıştır. İlk basamakta terimlerin yazılması için beş adet üst başlık belirlenmiştir: anatomi, semptomlar ve tanı gereçleri, hastalıklar, tedaviler ve komplikasyonlar. Terimlerin şu üç şartı sağlaması konusunda karar birliği oluşmuştur: 1) kolorektal cerrahide açıklanması ve uzlaşı sağlanması gerekliliği, 2) literatür desteği ve 3) günlük pratikte kullanılması. Terimler şu formatta yazılmıştır: terim ve eş anlamlıları, İngilizce karşılıkları, tanım, açıklama ve kaynakça. İkinci basamakta her bir komisyon üyesi ortalama 10,8±4,3 terim yazmıştır. Sonuç raporunda yer alan 89 terimin üst başlıklara dağılımı şu şekildedir: anatomi (n=26, %29,2), semptomlar ve tanı gereçleri (n=8, %8,9), hastalıklar (n=20, %22,4), tedaviler (n=28, %31,4) ve komplikasyonlar (n=7, %7,8). Tamamı komisyon üyelerinin arşivlerinden gelen resimler (n=7) ve yeni bir komisyon üyesi tarafından çizilen şekiller de (n=53) rapora eklenmiştir. Üçüncü basamakta rapor TKRCD Başkanının onayıyla TKRCD Yönetimi’ne sunulmuştur. TKRCD’nin Terminoloji Komisyonu raporunun hazırlık süreci sunulmuştur. Sonuç raporu ileride yapılacak çalışmalarla değişiklik ve genişletmelere açıktır

Age- and region-specific hepatitis B prevalence in Turkey estimated using generalized linear mixed models: a systematic review

Toy M, Önder FO, Wörmann T, et al. Age- and region-specific hepatitis B prevalence in Turkey estimated using generalized linear mixed models: a systematic review. BMC infectious diseases. 2011;11(1): 337.BACKGROUND: To provide a clear picture of the current hepatitis B situation, the authors performed a systematic review to estimate the age- and region-specific prevalence of chronic hepatitis B (CHB) in Turkey. METHODS: A total of 339 studies with original data on the prevalence of hepatitis B surface antigen (HBsAg) in Turkey and published between 1999 and 2009 were identified through a search of electronic databases, by reviewing citations, and by writing to authors. After a critical assessment, the authors included 129 studies, divided into categories: 'age-specific'; 'region-specific'; and 'specific population group'. To account for the differences among the studies, a generalized linear mixed model was used to estimate the overall prevalence across all age groups and regions. For specific population groups, the authors calculated the weighted mean prevalence. RESULTS: The estimated overall population prevalence was 4.57, 95% confidence interval (CI): 3.58, 5.76, and the estimated total number of CHB cases was about 3.3 million. The outcomes of the age-specific groups varied from 2.84, (95% CI: 2.60, 3.10) for the 0-14-year olds to 6.36 (95% CI: 5.83, 6.90) in the 25-34-year-old group. CONCLUSION: There are large age-group and regional differences in CHB prevalence in Turkey, where CHB remains a serious health problem

Biliary fistula after liver hydatid cyst surgery: Is it a predictable complication?

Aim: The biliary fistula development after liver hydatid cyst surgery is a common complication. The aim of this study is to examine the factors affecting the development of postoperative biliary fistula in patients operated for liver hydatid disease. Methods: The study was retrospectively performed in patients treated surgically for liver hydatid cyst between 1999 and 2010. The data of 53 patients operated for hydatid csyt were reviewed with hospital records. Patients were divided into two groups as biliary fistulas with (Group A) and without biliary fistula (Group B). The demographic data (age, sex), cyst diameter, cyst localization, laboratory tests and length of hospital stay were recorded. These parameters were compared with the groups.Results: The groups were similar in terms of age and sex (p = 0.790 and p=1.0, respectively). In group A, the mean cyst diameter was significantly higher than group B (p=0.001). The mean duration of hospitalization was longer in group A than group B (p=0.001). There was no difference between the groups considering cyst localization, AST, ALT, total bilirubin and direct bilirubin (p>0.05 for all). Conclusion: Preoperative cyst diameter may be a valuable parameter for predicting biliary fistula preoperatively. However, larger prospective studies are needed on this subject

Jejunal fecaloma as a rare cause of intestinal obstruction: A case report

Fecalomas are usually found in the colon or the rectum. In adult ages, jejunal giant fecaloma is a very rare condition. It has been thought that there should be any kind of chronic diseases leading to the occurrence of such fecalomas at the unexpected localizations. In this case, it was aimed to present a 50-year-old male patient with small bowel obstruction caused by jejunal giant fecalomas. There was previous gastrojejunostomy with vagotomy as the peptic ulcer surgery 25 years ago. Jejunal resection was performed due to the presence of small necrotic areas on the affected segment caused by impacted jejunal fecaloma. Fecalomas may be considered as a differential diagnosis of small intestinal obstruction in a patient with previous peptic ulcer surgery

Individualized treatment outcomes in colorectal cancer with liver metastasis

Aim: Liver metastasis (LM) is the most common cause of death in colorectal cancer (CRC). In cases of recurrent LM, individualized aggressive local treatments are recommended for better survival outcomes. In this study, we aimed to present the health outcomes obtained in a group of highly selected patients with metastatic CRC. Materials and Methods: We retrospectively reviewed the medical records of a total of 45 (28 males, 17 females) patients who were diagnosed with liver-metastatic CRC and underwent surgical treatment between March 2013 and November 2018. Results: The median patient age was 61 years. Thirty-two patients were diagnosed with synchronous metastases, and 21 of these patients underwent synchronous surgery. The median time for metachronous metastases was 18 months. Twenty-three patients developed bilobar metastases, with a median number of 4 (1–18) metastases. Eleven (10 synchronous and 1 metachronous metastasis) patients underwent liver resection without perioperative chemotherapy while the other 34 received perioperative treatment. Parenchymal-sparing liver surgery (metastasectomy/segmentectomy) as performed in 34 patients was the most preferred surgical approach and, again in accordance with the oncological principles, surgery was combined with ablation procedures to treat 31 metastases in 10 patients. The median tumor size and surgical margin width were 35 mm and 3 mm, respectively. Surgical margin positivity was present in 4 patients, of whom only 1 developed local recurrence. In a median time of 12 months, a total of 20 patients developed recurrent LM, and 12 of them underwent secondary surgery. The median survival time was 32 months for all 45 patients and 36 months for the 12 patients who underwent secondary surgery due to recurrences. Discussion and Conclusion: In CRC with LM, aggressive individualized multidisciplinary treatments can provide better survival outcomes in the long term. Synchronous or staged interventions are applicable with an acceptable morbidity and mortality. In patients with recurrent metastasis, parenchymal-sparing procedures should be preferred in order to increase the patient’s chance of repeated surgical treatment. Keywords: hepatectomy; liver resection; metastasectomy; microwave ablatio