Objectives: The aim of this study is to investigate the relationship between the lactate/albumin ratio (LAR) and 28-day mortality in gastric cancer patients undergoing monitoring in a postoperative intensive care unit due to reasons such as haemodynamic instability, need for vasopressor support, or intraoperative bleeding. Methods: This retrospective study included patients followed up at the tertiary surgical intensive care unit of Kastamonu University Faculty of Medicine between January 2020 and October 2025 who were diagnosed with histologically confirmed gastric adenocarcinoma and underwent total open surgery or subtotal gastrectomy + D2 lymphadenectomy. The patients were categorized into two groups: non-survivors within 28 days (n: 45) and survivors within 28 days (n: 139). Results: A total of 184 critically ill patients (110 males, 74 females) who underwent gastric adenocarcinoma surgery and were followed up in the surgical intensive care unit were included in this study. The mean age of the patients was 72.2 ± 11.3 years. Of these patients, 139 (75.5%) were survivors, and 45 (24.5%) were non-survivors. Albumin, the C-reactive protein (CRP)/albumin ratio, lactate, and the lactate/albumin ratio were associated with 28-day mortality. Receiver operating characteristic (ROC) analysis showed that the LAR (area under the curve (AUC): 0.839) was superior to the serum albumin (AUC: 0.736) and lactate levels (AUC: 0.796) for predicting 28-day mortality. The optimal cut-off value of the LAR was 0.82, and an LAR of ≥ 0.82 was shown to be a significant and independent prognostic factor for 28-day mortality in patients with stomach cancer in a critical postoperative condition (odds ratio (OR): 4.78, confidence interval (CI): 1.09–21.08, p = 0.0386). Conclusions: The lactate/albumin ratio is a prognostic parameter for 28-day mortality in critically ill postoperative gastric cancer patients. The optimal cut-off value for the lactate/albumin ratio is 0.82.

Objective: The aim of this study was to examine the early surgical and long-term survival outcomes of cytoreductive surgery (CRS) alone and CRS plus perioperative intraperitoneal chemotherapy (IPC) in patients with peritoneal metastases (PM). Material and Methods: CRS alone or CRS plus IPC was performed on 122 patients for various intraabdominal PMs. Patients were divided into two groups as PCI ≤19 and PCI >19 to compare early surgical outcomes. Results: Among PM patients 70 (57.4%) were of non-ovarian and 52 (42.6%) were of ovarian origin. Of the patients 74 (60.7%) were in the peritoneal cancer index (PCI) ≤19 group and 48 (39.3%) were in the PCI >19 group. The complication ratio of PCI >19 group was higher than that of the PCI ≤19 group and median overall survival (OS) of PCI >19 group was lower than that of the PCI ≤19 group. Complete or nearly complete (CCR-0/CCR-1) resections rates were similar in both groups (95.9% in the PCI ≤19 group and 93.8% in the PCI >19 group). However, CCR-0 resection rate was found to be lower in the PCI >19 group compared to the PCI ≤19 group (60.8% vs. 39.6%) (p 19 score. It would be appropriate to consider CRS or CRS plus perioperative IPC for palliative purposes in selected patients with PCI >19 score.

AMAÇ: Tiroid ve paratiroid cerrahileri endokrin cerrahide sıklıkla uygulanmaktadır. Bu girişimlerde Rekürren Laringeal Sinir (RLS) hasarına bağlı vokal kord paralizisi (VKP) önemli bir komplikasyondur. Bu çalışmada malignite nedeniyle total tiroidektomi ve lobektomi-paratiroidektomi sonrası RLS hasarı gelişen hastalarda ses terapisinin sonuçlarını ve ses parametrelerindeki değişimleri incelemeyi amaçlamaktadırGEREÇ VE YÖNTEM: Bu çalışma 2021–2025 yılları arasında tiroidektomi veya paratiroidektomi yapılan hastalarda postoperatif dönemde RLS hasarı ve vokal kord paralizisi gelişen 39 hasta üzerinde gerçekleştirilmiştir. Bu hastalara haftada bir kez, 45 dakika süreyle ses terapisi uygulanmıştır. Ses fonksiyonlarının değerlendirilmesinde maksimum fonasyon süresi, S/Z oranı, temel frekans, jitter, shimmer ve gürültü-harmonik oranı (NHR) ve Voice Handicap Index (VHI) ölçeği kullanılmıştır. BULGULAR: Hastalarda postoperatif erken dönemde ses parametrelerinde bozulma saptanmıştır. Ses terapisi verilerek takip edilen hastalarda tüm akustik ve aerodinamik parametrelerde kademeli iyileşme gözlenmiş olup MFS değerlerinde anlamlı artış, S/Z oranında azalma ve jitter, shimmer ile NHR değerlerinde düşüş izlenmiştir. VHI skorlarında zamanla azalma görülmüş olup, bu durum hastaların ses algısında da iyileşme olduğunu göstermiştir. Takip edilen diğer seanslarda vokal kord paralizi çeşidinde erken dönemde bazı parametrelerde anlamlı farklılıklar saptanırken, ileri seanslarda bu farkların azaldığı gözlenmiştir. SONUÇ: Rekürren laringeal sinir (RLS) hasarına bağlı vokal kord paralizisi (VKP) sonrası gelişen ses değişikliklerinin iyileşme eğiliminde olduğu söylenebilir. Postoperatif dönemde uygulanan ses terapisinin ve rehabilitasyon yaklaşımlarının ses fonksiyonlarının düzelmesine katkı sağlayabileceğini düşündürmektedir. Gözlenen iyileşmenin doğal iyileşme süreci ile değerlendirilmesi gerektiği göz önünde bulundurulmalıdır.

Background: Nuclear atypia is associated with an increased risk of malignancy in Bethesda III thyroid nodules; however, reactive nuclear changes related to Hashimoto thyroiditis (HT) may complicate its interpretation. We investigated whether HT modifies the association between nuclear atypia and malignancy in Bethesda III nodules. Methods: This retrospective single-center study included 426 surgically selected patients with Bethesda III nodules who underwent thyroidectomy between January 2015 and August 2026. HT was defined by postoperative histopathology. The association between nuclear atypia and malignancy was evaluated according to HT status. Effect modification was assessed using an HT × nuclear atypia interaction term in unadjusted and multivariable logistic regression models. Results: HT was present in 199 (46.7%) patients. Malignancy was less frequent in patients with HT than in those without HT (26.1% vs. 38.8%, p = 0.006), whereas nuclear atypia was more frequent (91.0% vs. 45.8%, p < 0.001). In patients without HT, nuclear atypia was strongly associated with malignancy and remained an independent predictor after multivariable adjustment (adjusted OR 13.24, 95% CI 5.46–32.10; p < 0.001). In patients with HT, nuclear atypia was not associated with malignancy (OR 0.68, 95% CI 0.24–1.94; p = 0.466). The HT × nuclear atypia interaction was significant in both unadjusted (OR 0.040, p < 0.001) and adjusted models (OR 0.031, p < 0.001). Conclusions: HT significantly modified the association between nuclear atypia and malignancy in Bethesda III nodules. Nuclear atypia strongly predicted malignancy in the absence of HT but not in its presence. Given the postoperative definition of HT, prospective validation using preoperative HT indicators is required before clinical application.

Erken Evre Küçük Hücreli Dışı Akciğer Kanserinde Minimal İnvaziv Cerrahi Seçenekleri Güntuğ BATIHAN Funda CANSUN Küçük Hücreli Akciğer Kanserinde Cerrahi Tedavi Ezin Cem YENİ Malign Plevral Mezotelyomada Cerrahi Tedavi Seçenekleri Arkın ACAR Akciğer Nöroendokrin Tümörlerinin Cerrahi Tedavisi Mehmet ÇETİN Timoma ve Timik Karsinomlarda Cerrahi Tedavi Mesut Melih ÖZERCAN Trakeal Tümörlerde Cerrahi Yaklaşım Barış GÜLMEZ Oral Kavite ve Orofarinks Tümörlerinin Cerrahi Tedavisi İsmail AYTAÇ Yusuf ARSLANHAN Nazofarenks Tümörlerinde Cerrahi Tedavi Ozan TÜYSÜZ Larenks Kanserlerinde Cerrahi Tedavi İsmail AYTAÇ Berkay GÜZEL Baş Boyun Kanserlerinde Rekonstrüktif Cerrahi Yaklaşımlar Ceyhun CENGİZ Tükrük Bezi Tümörlerinde Cerrahi Yaklaşımlar Sercan ÇIKRIKCI Secaattin GÜLŞEN Nazal Kavite ve Paranazal Sinüs Tümörlerinde Cerrahi Yaklaşımlar Fatih Mehmet HANEGE Tiroid Kanserlerinde Cerrahi Tedavi Serdal ÇELİK Paratiroid Karsinomlarında Cerrahi Tedavi Elvan ONAN Malign Göz Kapağı Tümörlerine Yaklaşım Neşe ARSLAN Şule BARMAN KAKİL Retina ve Koroidin Vasküler Tümörleri Özlem BURSALI Orbita Tümörlerine Yaklaşım Emin Serbülent GÜÇLÜ Primeri Bilinmeyen Boyun Tümör Metastazlarında Cerrahi Tedavi Elvan ONAN Erken Evre Meme Kanserinde Cerrahi Yaklaşım Recayi ÇAPOĞLU Meme Koruyucu Cerrahi Endikasyonları ve Teknikleri Mesut YUR Onkoplastik Meme Koruyucu Cerrahi Teknikleri Cüneyt AKYÜZ Aksiller Sentinel Lenf Nodu Biyopsisi Ertuğrul Gazi ALKURT Lokal İleri Evre Meme Kanserinde Aksilla Yönetimi Nurhan Haluk BELEN Aksiller Tersine Haritalama (ARM: Axillary Reverse Mapping) Hasan UZER Meme Kanserinde Neoadjuvan Tedavi Sonrası Cerrahi Yaklaşım Ali DURAN Uğur MENGENECİ Meme Kanserinde Lokal Nüks Durumunda Cerrahi Tedavi Zülfü BAYHAN Metastatik Meme Kanserinde Primer Tümör Cerrahisi Emin TÜRK Onkolojik Meme Cerrahisi Sonrası Meme Rekonstrüksiyon Yöntemleri Mehmet RENÇBER Mehmet Tolga KAFADAR Meme Kanserlerinde Robotik Cerrahi Uygulamaları Yaşar ÇÖPELCİ Umut Rıza GÜNDÜZ Meme Kanserinde Profilaktik Mastektomi Mehmet PATMANO Erken Evre Özofagus Kanserinde Cerrahi Tedavi Seçenekleri İsa Caner AYDIN Yasin TOSUN Erken Evre Özofagus Kanserlerinde Minimal İnvazif Cerrahi Tedaviler Sacit Altuğ KESİKLİ Lokal İleri Evre Özefagus Kanserinde Cerrahi Yaklaşımlar Azmi LALE Erken Evre Mide Kanserinde Cerrahi Tedavi Seçenekleri Elif TUNCAY Erken Evre Mide Kanserinde Minimal İnvaziv Cerrahi Tedavi Mehmet ÖZER Mide Kanserinde Lenf Nodu Diseksiyonunun Önemi ve Teknikleri Onur KILIÇ Lokal İleri Mide Kanserinde Cerrahi Tedavi Seçenekleri Aziz BULUT Mehmet UÇAR İzole Peritoneal Metastazlı Mide Kanserinde Sitoredüktif Cerrahi ve Hipertermik İntraperitoneal Kemoterapinin Yeri Mehmet ASLAN Metastatik Mide Kanserinde Palyatif Cerrahi Tedavi Osman BARDAKÇI Mide Kanseri Cerrahisi Komplikasyonları Üsküdar Berkay ÇARALAN İnce Barsak Malign Tümörlerinde Cerrahi Tedavi Serkan CEYLAN Laparoskopik İnce Barsak Cerrahisi Murat SEVMİŞ Erken Evre Kolon Kanserinde Cerrahi Tedavi Salih DEMİRELLİ Oligometastatik Kolon Kanserinde Primere Cerrahi Yaklaşım Mete YAZI Gökçe ACUN Oligometastatik Kolon Kanserlerinde Karaciğer Metastazlarına Genel Yaklaşım Ö. Bilgehan POYRAZOĞLU Kolon Kanserinde Stoma Yönetimi Emin TÜRK Rektal Kanserlerde Cerrahi Tedavi Seçenekleri Ali Erkan UÇAR Rektal Kanserlerde Minimal İnvaziv Cerrahi Tedaviler Erkan KARACAN Anal Kanserlerde Cerrahi Tedavi Seçenekleri Alirıza ERDOĞAN Hepatoselüler Karsinom Tedavisinde Cerrahi Yöntemler Hüseyin Fahri MARTLI Potansiyel Rezektable Hepatoselüler Karsinomlarda Cerrahi Yaklaşım Seda ARZUMAN BAŞTÜRK Hepatosellüler Kanser Tedavisinde Karaciğer Transplantasyonu Seyyit Muhsin SARIKAYA Karaciğer Tümörlerinde İntraarteriyel Tedaviler Sinan KARATOPRAK Karaciğer Tümörlerinde Lokal Ablatif Tedaviler Nurullah DAĞ İntrahepatık Kolanjıoseluler Karsınomda Cerrahi Tedavi Yöntemleri Ramazan TOPCU Kanser Cerrahisinde Tromboemboli ve Profilaksisi Ceyda ASLAN Malign Safra Yolu Obstruksiyonunda Palyatif Cerrahi Yaklaşımlar Doğukan DURAK Pankreas Başı Tümörlerinde Cerrahi Tedavi Yavuz Selim KAHRAMAN Pankreas Gövde ve Kuyruk Tümörlerinde Cerrahi Tedavi Halil İbrahim TAŞCI Pankreas Kanserlerinde Palyatif Cerrahi Yaklaşımlar Sümeyra GÜLER Harun KARABACAK Erken ve Lokal İleri Evre Böbrek Kanserlerinde Cerrahi Tedavi Ahmet GÜZEL Metastatik Böbrek Tümörlerinde Cerrahi Tedavi Sefa Alperen ÖZTÜRK Ürotelyal Kanserlerde Cerrahi Tedavi Seçenekleri Şeref COŞER Mesane Kanserinde Cerrahi Tedavi Ferec AFENDIYEV Erken ve Lokal İleri Evre Prostat Kanserinde Cerrahi Tedavi Murat KESKE Gökhan SÖNMEZ Testis Tümörlerinde Cerrahi Tedavi Ender Cem BULUT Penil Tümörlerde Cerrahi Tedavi İrfan Şafak BARLAS Erken ve Lokal İleri Evre Serviks Kanserinde Cerrahi Tedavi Pınar ERDOĞAN Erken ve Lokal İleri Evre Vajen Kanserinde Cerrahi Tedavi Filiz...

Percutaneous cholecystostomy (PC) has emerged as a valuable alternative to early cholecystectomy for managing acute cholecystitis (AC) in high-risk patients, particularly those classified as grade II or III according to the Tokyo Guidelines (TG). However, the criteria for optimal patient selection and predictors of definitive surgical needs remain inadequately defined. This single-center, retrospective study included 30 patients who underwent PC for AC between 2022 and 2025. Patients were classified as having TG18 grade II or III AC. Demographic characteristics, clinical scores (American Society for Anesthesiologists [ASA] and Charlson Comorbidity Index), laboratory parameters (neutrophil-to-lymphocyte ratio [NLR], platelet-to-lymphocyte ratio [PLR], and systemic immune-inflammation index [SII]), length of hospital stay, intensive care unit (ICU) and total parenteral nutrition (TPN) needs, and outcomes, including 30-day and 12-month mortality, and the need for interval cholecystectomy, were analyzed. Patients with grade III AC exhibited significantly higher NLR and lower lymphocyte counts ( P = .042 and P = .005, respectively). ICU admission, TPN requirements, and 12-month mortality rates were significantly higher in this group. Post-PC cholecystectomy was performed in 30% of patients, and those requiring surgery had higher ASA scores, experienced prolonged hospitalization, and an elevated mortality rate ( P < .05). No major PC-related complications were observed. PC was a safe and effective alternative for high-risk patients with AC. However, many patients with higher ASA scores and severe grades still require surgery and experience higher mortality. Accurate patient selection, therefore, is essential to achieve better outcomes and avoid unnecessary procedures. These findings support personalized guideline-based decisions and identify clinical and laboratory factors that may predict the need for surgery and prognosis.