Background and Objectives: One anastomosis gastric bypass (OAGB) and Roux-en-Y gastric bypass (RYGB) surgeries are effective methods used in bariatric surgery. There are limited randomized studies comparing these procedures over more than 2 years. Here, we aimed to compare the 3-year results of two bariatric procedures. Materials and Methods: Patients included in this randomized prospective study were compared in OAGB and RYGB groups. A total of 55 patients, aged between 18 and 65, were eligible for the study. Thirteen patients who did not accept randomization were excluded. Patients were evaluated at 6, 12, 24, and 36 months postoperatively. Results: Three patients were excluded from the study due to loss of communication during the clinical follow-up and one due to death by amyotrophic lateral sclerosis, which started in the eighth month after surgery. The study was completed with a total of 38 patients (OAGB; n = 20, RYGB; n = 18). Patients in the two groups were similar in terms of age, gender, body mass index (BMI), and obesity-related comorbidities. At the end of 3-year follow-up, BMI in the OAGB and RYGB groups was 28.80 ± 4.53 kg/m² and 29.17 ± 5.36 kg/m², respectively (p = 0.822). Percentage total weight loss (TWL%) was similar. No significant differences were found between the groups regarding percentage excess weight loss (EWL%). Remission of comorbidities was similar. De novo refluxes developed in four OAGB patients; there were no occurrences of these in RYGB patients (p = 0.066). Conclusions: Both OAGB and RYGB are effective in the treatment of morbid obesity. The two procedures are similarly successful in terms of obesity-related comorbidities.

Background and Objectives: The best way to distinguish complicated acute appendicitis (CAA) from uncomplicated acute appendicitis (UCAA) is still under debate. The aim of this study was to investigate the potential use of the serum sodium (Na⁺) level and the neutrophil-to-lymphocyte ratio (NLR) to distinguish CAA from UCAA and to evaluate whether CAA is more reliably diagnosed using these two variables together. Materials and Methods: This was a retrospective, cross-sectional, two-center study of patients diagnosed with AA between 1 January 2016 and 31 December 2023. The demographic and analytical variables were analyzed. The NLR was defined as the quotient between the absolute values of neutrophils and lymphocytes. Hyponatremia was defined as a serum Na⁺ level of ≤135 mmol/L. The sensitivity and specificity of the NLR and the serum Na⁺ level in the diagnosis of CAA were determined by assessing the receiver operating characteristic curves. Results: Among the patients who underwent an appendectomy, 3066 histologically confirmed AA cases were identified and included in this study. The registered data revealed that 348 (11.3%) patients had CAA, and the remaining 2718 (88.7%) patients had UCAA. The mean ages were 49.47 ± 18.97 and 38.16 ± 14.50, respectively (p < 0.001). The analysis revealed an exponential correlation between the NLR and the serum Na⁺ level with a moderate degree of agreement with CAA (Cohen’s Kappa: 0.461, p < 0.001). For CAA, using the NLR and the serum Na⁺ level, the areas under the curve and the cutoffs were 0.664, 4.2 with a confidence interval (CI) of 0.647–0.681 and 0.727, 135 mmol/L with a CI of 0.711–0.742, respectively; all these values were significant with a p-value of <0.001. Conclusions: Although the serum Na⁺ level is a more effective marker than the NLR, using these two variables together can help detect high-risk patients who may benefit from early management by limiting delays in surgery.

Introduction In patients with acute biliary pancreatitis (ABP), cholecystectomy is mandatory to prevent further biliary events, but the precise timing of laparoscopic cholecystectomy (LC) for non-severe disease remain a subject of ongoing debate. Aim To prove which method – early or delayed...

Aim: In spite of the demonstrated advantages, laparoscopic colorectal surgery is not adequately utilised in regional service hospitals. Purpose of the research was to document the findings of patients managed by a gastroenterological surgeon for colorectal neoplasms using laparoscopic surgery at a service hospital of the Central Black Sea Region, Turkey. Material and Method: Every sequential patient having laparoscopic colorectal surgery was registered prospectively and analysed retrospectively. Recorded parameters consisted of demographic characteristics, diagnostic work-up, surgical events, post-surgical morbidity, mortality and outcomes. Results: Seventy-five patients each underwent laparoscopic colorectal surgery for colorectal neoplasm within a period of forty months. Average age was 66.4 years and ratio of males to females was 11:4. Rectal cancer rate was 65.3%. Colon cancer rate was 34.6%. One patient had synchronous colorectal cancer. Mean time of surgery was 276 min and mean volume of haemorrhage was 75 ml. Conversion to open resection rate was 6.6%. Median day of hospitalization was six days. Postoperative complication rate (Clavien–Dindo grade ≥ III) was 8.5%. Two systemic recurrences were observed during the surveillance. Conclusion: Based on our results and those of other studies presented here, a trained surgeon with a high caseload can perform safe and adequate oncological laparoscopic colorectal resections in a regional service hospital of a developing country. The longer operative time is the drawback of the procedure, especially in crowded service hospitals. The results are also valuable in terms of showing the effect of health policies and regional conditions on surgical practices in our city and country. Under the current conditions, surgeons’ dedication and all relevant supports are required.

Background and Objectives: Magnetic resonance imaging (MRI) is the gold standard for rectal cancer staging; however, its reliability after neoadjuvant therapy (NAT) remains controversial due to treatment-induced tissue changes. This study aimed to compare preoperative MRI findings with postoperative pathologic results in rectal cancer patients following NAT and to assess MRI reliability across clinical subgroups. Materials and Methods: This single-center retrospective study included 47 adult patients with locally advanced rectal adenocarcinoma who received NAT followed by elective rectal resection, with preoperative pelvic MRI and postoperative pathology results. Clinical features, MRI (T stage, N stage, and circumferential resection margin [CRM]), and pathologic staging were recorded. The endpoints were defined as concordance (via kappa coefficients) and predictive performance (via ROC analysis). Results: Among 47 patients (mean age 63.5 ± 9.4 years; 80.9% male), MRI demonstrated slight concordance with pathology for the T stage (kappa = 0.178, p = 0.028) and moderate concordance with the N stage (kappa = 0.489, p < 0.001), but not for CRM (p = 0.154). Subgroup analyses revealed significant concordance for N stage across most subgroups, with lower rectal tumors showing significant agreement for all three parameters. ROC analysis demonstrated significant predictive value for the N stage (AUC = 0.776, p = 0.002) with 88.6% specificity, while the T stage and CRM showed non-significant discriminatory performance. Conclusions: Post-NAT MRI demonstrates moderate reliability relative to pathology, particularly for N staging, and may have even better utility in specific subgroups stratified for sex, NAT type, and tumor site.

Aim: Gastrointestinal cancers rarely metastasize to the brain and constitute 4-8% of all brain metastases (BM). Survival is generally poor for BM from gastrointestinal cancers and stereotactic radiosurgery (SRS) is frequently used in its management. Since the data are still insufficient due to their rare presentation, we aim to analyze the clinical results of patients who underwent SRS for BM due to gastrointestinal cancers. Material and Method: We retrospectively reviewed patients with BM from gastrointestinal cancers who received robotic SRS with CyberKnife at our institute from October 2013 to December 2022. Clinical characteristics and treatment outcomes were recorded. Study endpoints were local control rates, distant brain control rates, and overall survival (OS). Results: A total of 61 BM were detected in 42 patients. The median clinical follow-up time was 7 (0.5-36) months. Nine lesions progressed in the irradiated area, 14 new lesions were observed outside the irradiated area. The local control rate was 85.1% and the distant brain control rate was 77%. The median OS was 8 months; 12-month and 24-month OS were 31.6% and 10.5%, respectively. Patients with high performance status had better OS (p=0.016). The prognostic scoring scales RPA and GI-GPA were both associated with OS (p=0.049, p=0.002). Multivariate analysis found a significant association between GI-GPA classes and OS (p=0.011). Conclusion: We obtained comparable results in terms of local control, distant brain control and OS in this challenging patient population. The use of GI-GPA prognostic scoring scales in routine practice will guide the selection of the most appropriate patient for SRS.