Background: Early postoperative pain is a significant problem in bariatric and metabolic surgery. Our study aimed to investigate the potential role of intraperitoneal bupivacaine hydrochloride in pain management in the early postoperative period after bariatric and metabolic surgery. Methods: This double-blind, prospective, randomized, controlled study included 68 individuals who underwent bariatric and metabolic surgery at the Department of Surgery, Istanbul Aydin University Hospital. The study group received 20 mL of 0.5% bupivacaine hydrochloride intraperitoneally at the operative site, and the control group received 20 mL of normal saline. Visual analog scale (VAS) scores of each patient were recorded at 2nd, 4th, and 6th hours postoperatively. Results: Our study found significant differences in VAS scores of patients between study group and control group at 2nd, 4th, and 6th hours postoperatively. Significant differences were found between male and female patients in the control group at 2nd, 4^th, and 6th hours postoperatively. Interestingly, no significant difference was found between female patients in the study group and control group at 2nd, 4th, and 6th hours postoperatively. Conclusions: Our study suggests that intraperitoneal administration of bupivacaine hydrochloride is effective in reducing early postoperative pain in male patients. However, no significant difference was found between the study group and the control group in female patients. Our results indicate that there may be a gender-related difference in the response to bupivacaine administration. Further research is needed to confirm these findings and determine the optimal dosing and administration of local anesthetics for postoperative pain management.

Laparoscopic Sleeve Gastrectomy (LSG) is the most common bariatric procedure worldwide. However, the influence of preoperative factors on weight loss outcomes remains incompletely understood. We investigated the effects of preoperative weight, height, and age on total weight loss percentage (%TWL) following LSG using advanced statistical modeling. 2014 LSG patients were analyzed and stratified by preoperative weight (7 categories: 160 kg) and age (5 groups: 14–25 to ≥ 56 years). %TWL was calculated at 1 week, 1, 3, 6, and 12 months post-surgery. A Generalized Additive Model (GAM) was used to calculate Adjusted Total Weight Loss percentage (%ATWL), accounting for height and preoperative weight confounding effects. The population (mean age: 38.0 ± 11.4 years, BMI: 42.9 ± 8.2 kg/m²) showed weight-dependent %TWL at 12 months, from 32.2%±10.0% (< 90 kg) to 39.8%±7.5% (> 160 kg) (p < 0.001). GAM-adjusted %ATWL revealed superior outcomes in younger cohorts. The 14–25 and 26–35 year groups had comparable 12-month %ATWL (38.2% vs. 37.0%, p = 0.222), significantly exceeding older groups (p < 0.001). Early postoperative %ATWL (1-week) was similar across ages (4.6–5.7%), with progressive differentiation at 3, 6, and 12 months. Preoperative weight and age significantly influence LSG weight loss outcomes. Younger patients and those with higher pre-op weights achieved greater 12-month %TWL.

Purpose: Our study has three main aims: 1) to assess the distribution of Breast Imaging Reporting and Data System (BI-RADS) classifications in a cohort of Turkish women undergoing screening mammography, 2) to analyze the frequency and non-completion rates of recommended follow-up ultrasound (US) examinations, and 3) to examine the outcomes of completed follow-up US examinations. Our goal was to evaluate potential gaps in the current breast cancer screening process by analyzing BI-RADS classifications, follow-up completion rates, and outcomes of completed ultrasound examinations. Patients and Methods: This retrospective study analyzed 1761 Turkish women who underwent screening mammography from 2020– 2022 at the Istanbul Aydin University General Surgery Clinic, Istanbul, Turkey. We assessed the distribution of BI-RADS classifications, analyzed the frequency and non-completion rates of recommended follow-up US, and examined the outcomes of completed follow-up US examinations. Chi-square tests of independence and Spearman’s rank correlation test were used to analyze the data. Results: Our study revealed three key findings: 1) Over half of mammograms (55.9%) were classified as BI-RADS 0, requiring further imaging. 2) Nearly one-third of patients who recommended US examinations (31.91%) did not complete recommended follow-up ultrasound appointments. 3) Among those who completed follow-up ultrasonography, almost one-third (29.7%) were reclassified as BI-RADS 3 or higher. Notably, 2.3% (n=18) were classified as BI-RADS 4 or 5, suggesting findings suspicious for malignancy. Conclusion: Our findings highlight the crucial role of follow-up US in breast cancer screening. The high rate of initial BI-RADS 0 classifications using mammography, coupled with the significant non-completion rate for follow-up US examinations, particularly among older age groups, highlights potential gaps in the current screening process.

Purpose: Breast cancer is a major global health concern. In some societies, male family members influence women’s healthcare decisions, yet their awareness and attitudes toward breast cancer screening remain poorly understood. Our research aimed to analyze awareness, knowledge, and willingness to recommend breast cancer screening among men from two distinct populations, and to examine how age and educational level influence willingness to recommend breast examinations for female family members. Patients and Methods: This prospective cross-sectional survey study included male academic staff at a university (University Personnel Group, n=105) and male patients visiting a hospital policlinic with non-breast-related complaints along with their male companions (Clinical Attendee Group, n=100). A 10-item structured questionnaire assessed demographics, knowledge about breast cancer, and attitudes toward mammography screening using statistical analysis. Results: Both groups demonstrated similar knowledge levels regarding breast cancer frequency in women (~55%), male breast cancer occurrence (~45%), and annual mammography necessity (~52%). The clinical attendee group showed significantly greater willingness to recommend breast examinations compared to the university personnel group (94.0% vs 74.3%, p< 0.001). In the clinical attendee group, willingness increased with age (88.9% in ages 15– 25 to 100% in ages 40+), showing a significant positive trend (p< 0.05). The university personnel group exhibited peak willingness (87.1%) in the 25– 40 age group, with lower rates in other age categories. Educational status strongly influenced willingness in the university personnel group, increasing from 33.3% at high school level to 87.8% at Master’s/Ph.D. level, while the clinical attendee group maintained high willingness (91.7– 100%) across all education levels. Conclusion: Our findings show patterns of breast cancer awareness and screening recommendation willingness between clinical attendees and university personnel. While basic knowledge about breast cancer was similar, willingness to recommend screening differed significantly, with age and education having differential impacts between groups.

Background/Objectives: Total weight loss after laparoscopic sleeve gastrectomy (LSG) does not fully capture changes in body composition, particularly the loss of lean mass. We examined sex-specific changes in regional and whole-body composition before and one year after LSG. Methods: This retrospective single-center study included 121 adult patients (84 female, 37 male) who underwent LSG at Istanbul Aydin University Faculty of Medicine between May 2017 and February 2025. Multi-frequency segmental bioelectrical impedance analysis was performed pre-operatively and at one year post-operatively. Three ALM normalization indices (ALM/weight × 100, ALM/BMI, ALM/height²) were compared before and after surgery. Associations between pre-operative fat mass (FM) and ALM were examined using sex-stratified linear regression with and without adjustment for height, age, and sex via ordinary least squares residualization. Results: Pre- and post-operative values were compared. We found that BMI, fat-free mass (FFM), and FM decreased significantly in both sexes (all p < 0.001), with comparable total weight loss between females and males (p > 0.05). Males lost more absolute FFM and showed greater proportional lean mass loss in the limbs, while females showed greater proportional loss in the trunk. After adjusting for height, age, and sex, pre-operative FM was positively associated with ALM both pre-post-operatively (both p < 0.001). Patients with greater pre-operative FM lost more ALM over the surgical year. Conclusions: Body composition changes following laparoscopic sleeve gastrectomy in this cohort of 121 patients were metric-dependent. Patients with lower pre-operative adiposity may present with lower post-operative ALM one year after LSG.

This study aimed to evaluate differences in tumor characteristics, molecular subtypes, and surgical approaches between elderly (≥70 years) and younger (<70 years) breast cancer patients. This retrospective, single-center study analyzed 120 breast cancer patients (99 younger, 21 elderly) treated surgically between 2020 and 2025 at Istanbul Aydın University, Turkey. Tumor characteristics and surgical management related data were analyzed to compare two age groups. Statistical analyses included t-tests, chi-square tests, and Fisher’s exact tests. Elderly patients presented with significantly larger tumors (3.91±0.56 vs 2.81±0.35 cm, p<0.05), higher T4 disease prevalence (19.05% vs 3.37%, p<0.05), and greater metastatic burden (7.90±6.06 vs 3.54±4.49 metastases, p<0.05). SLNB was performed significantly more frequently in younger patients (90.9%) compared to elderly patients (71.4%, p < 0.05). Elderly patients underwent axillary dissection in 57.1% of cases compared to 33.3% in younger patients. Advanced tumors (T3+T4) were more prevalent in elderly patients with Luminal B HER2-positive (33.3% vs 0%, p<0.0001) and Luminal B HER2-negative (37.5% vs 8.3%, p<0.05) subtypes. Surgical management differed significantly between groups: mastectomy was performed more frequently in elderly patients (57.14% vs 31.31%, p<0.05), whereas breast-conserving surgery was less common (42.9% vs 67.7%, p<0.05). These findings demonstrate important differences in disease presentation and surgical management between age groups in Turkey, where breast cancer screening ends at age 69. The absence of screening detection in elderly patients, combined with their advanced disease presentation, highlights the need for further investigation with larger, multicenter cohorts to evaluate optimal screening strategies for women beyond age 69.