The purpose of this study was to determine the risk factors that caused non-sentinel lymph nodes (nonSLNs) metastasis by considering the clinicopathological characteristics of patients who have 1-2 sentinel lymph node (SLN) metastasis in the clinical early stage (T1-2, N0) breast cancer. The demographic and clinicopathological characteristics of the patients were recorded retrospectively. Among these, age, size of the primary breast tumor, tumor localization and multifocality/multicentricity status, preoperative serum Neutrophil/Lymphocyte rate (NLR), c-erbB2/HER2-neu status, Estrogen Receptor (ER) and Progesterone Receptor (PR) status, primary tumor proliferation index (Ki-67), histopathological grade, molecular subtypes, histopathological subtypes, nipple/areola infiltration, Lymphatic Invasion (LI), Vascular Invasion (VI), Perineural Invasion (PNI), number of metastatic SLN m(SLN), mSLN diameter, SLN Extranodal Extension (ENE) status, and number of metastatic nonSLNs were recorded. According to the univariate analysis, the HER2 positivity, Ki-67≥%20, mSLN diameter, LI, VI, PNI, ENE and molecular subtypes were found to be significant. However, the age, tumor localization, multifocality/multicentricity, T stage, ER and PR status, tumor size, histopathological grade and subtypes, nipple/areola infiltration and NLR were not found to be significant. In the multivariate analysis, significant independent predictors in nonSLN metastasis development were found to be HER2 positivity, PNI, mSLN diameter ≥10,5 mm and ENE. The HER2 positivity, ENE, PNI and mSLN diameter ≥10,5 mm were found to be very strong predictors in nonSLN metastasis development. The findings of this study have the potential to be a guideline for surgeons and oncologists when determining their patients' treatment plan. These components are candidates for inclusion among the clinicopathological factors that may be used in the new nomograms due to their higher sensitivity and specificity.

The systemic immune-inflammation index (SII) is used to assess survival in many cancers. SII has been examined separately in pancreatic head, ampulla, and distal choledochus cancers, and different cut-off values were found. Detecting the location of periampullary cancer before surgery may be difficult or misleading. This study aimed to investigate the use of SII in predicting overall survival (OS) with periampullary cancers regardless of tumor location. Between January 2010 and January 2020, 163 patients who underwent pancreaticoduodenectomy for periampullary tumors were assessed. After applying the exclusion criteria, data from 116 patients with cancer who underwent pancreaticoduodenectomy were included in the study. OS was compared using Kaplan-Meier curves. The prognostic significance of baseline SII and other factors were assessed in univariate and multivariate analyses using the Cox proportional hazard regression model. Univariate analysis demonstrated that age ≥60.5 years (hazard ratio [HR]: 2.042, 95% CI: [1.355-3.078]; p = 0.001), male sex (HR: 1.863, 95% CI: [1.231-2.821]; p = 0.003), tumor in the pancreatic head vs. ampulla (HR: 2.150, 95% CI: [1.364-3.389]; p = 0.001), tumor in the pancreatic head vs. distal choledochus (HR: 1.945, 95% CI: [1.091-3.472]; p = 0.024), N (+) stage (HR: 1.868, 95% CI: [1.223-2.854]; p = 0.004), total bilirubin level >0.35 (HR: 2.131, 95% CI: [1.245-3.649]; p = 0.006), NLR >2.13 (HR: 1.911, 95% CI: [1.248-2.925]; p = 0.003), and SII >704 (HR: 1.966, 95% CI: [1.310-2.950]; p = 0.001) were significantly associated with OS. Multivariate analysis revealed that SII >704 (HR: 2.375; p < 0.001), age ≥ 60.5 years (HR: 2.728; p < 0.001), N-stage positivity (HR: 3.431; p < 0.001), and tumor in the pancreatic head vs. ampulla (HR: 2.801; p < 0.001) were independently associated with poor survival. There was no difference between tumor locations in terms of SII (p = 0.206). SII is an independent prognostic risk factor and may be a marker for predicting OS in patients with periampullary cancer. There was no statistical difference between the tumor locations in terms of SII. A single cut-off value of SII may be used for periampullary cancer survival without the need for a pathology specimen.

Background: Imaging techniques for breast cancer identify distant organ metastasis, but can be time-consuming and costly. This study compares clinicopathological and laboratory data between metastatic and nonmetastatic breast cancer patients at initial diagnosis and evaluates CA 15 − 3’s predictive value for distinguishing distant metastases. Methods: This retrospective study examined 232 untreated breast cancer patients diagnosed between January 2021 and January 2022. They were divided into distant organ metastatic (Group I) and nonmetastatic (Group II) at the initial diagnosis. We analyzed laboratory data, including CA 15 − 3 and CEA levels, and used Receiver Operating Characteristic (ROC) curves to find optimal cut-off values for predicting distant organ metastasis. Results: Forty-nine patients (21.1%) had distant organ metastases at initial diagnosis. Significant differences were found between groups in tumor diameter, neutrophil and lymphocyte counts, T-stage, N-stage, CA 15 − 3, CEA, albumin, alkaline phosphatase, neutrophil-to-lymphocyte ratio, and the systemic immune inflammation index (SII) (all p < 0.05). CA 15 − 3 demonstrated excellent discriminatory ability (AUC = 0.950; 95% CI: 0.924–0.975; p < 0.001). A CA 15 − 3 cutoff value of 25.8 U/mL had 100% sensitivity, 82.5% specificity, 60.5% positive predictive value, and 100% negative predictive value. No patient with a CA 15 − 3 level below 25.8 U/mL presented with distant organ metastasis. Conclusions: CA 15 − 3 demonstrated promising performance in ruling out distant metastases in newly diagnosed breast cancer patients. Further prospective studies are needed to confirm whether using CA 15 − 3 may reduce the time loss and costs associated with routine imaging for distant organ metastasis.

Background: In some patients who achieved complete remission (CR) of type 2 diabetes mellitus (T2DM) after sleeve gastrectomy with transit bipartition (TB), T2DM relapses after a while. ABCD scoring predicts the likelihood of remission following TB. However, the factors affecting T2DM relapse are unknown. Methods: The data of patients with CR after TB who were followed for more than 5 years was analyzed retrospectively. Results: The median follow-up of 56 patients, 29 of whom were female (51.8%), was 71 months (range: 61 to 101). Eleven of 56 patients (19.6%) had relapse in T2DM. Patients with an ABCD score less than 4 had a significantly higher rate of relapse. Its sensitivity and specificity rates were 90.9% and 93.3%, respectively. Preoperative C-peptide level (OR 0.032 [CI 0.003–0.295], p = 0.002), LDL-cholesterol level (OR 1.025 [CI 1.005–1.045], p = 0.013), duration of T2DM (OR 1.553 [1.216–1.983], p < 0.001), ABCD score (OR 0.047 [0.006–0.361], p = 0.003), and FIB-4 index (OR 6.073 [1.496–24.656], p = 0.012) were risk factors. Conclusions: Patients with longer durations of T2DM, higher LDL-cholesterol levels, lower C-peptide levels and ABCD scores, and worse liver fibrosis are at a higher risk of relapse after achieving initial CR of T2DM with TB.

Cerrahi’nin Tarihçesi Adem ASLAN Cerrahi Hastalarda Sıvı ve Elektrolit Yönetimi Tuba MERT Şok Burak UÇANER Cerrahi Enfeksiyon Oğuz HANÇERLİOĞULLARI Travma Cerrahisi Çağdaş KARAMAN Cerrahi Yara İyileşmesi Mehmet Sabri ÇİFTÇİ Cerrahi Kanama ve Transfüzyon Serdar ACAR Baş Boyun Cerrahisinde Yenilikler Seda SEZEN GÖKTAŞ Tiroid Hastalıklarına Yaklaşım Zeynep ANADOLULU Paratiroid Hastalıklarına Yaklaşım Murat ÖZKARA Benign Meme Hastalıklarına Yaklaşım Nimet SÜSLÜ Malign Meme Hastalıkları Cerrahisi Murat KARTAL Meme Kanserinde Sentinel Lenf Nodu Biyopsisi Furkan SAVAŞ Onkoplastik Meme Cerrahisi Hasan Turgut AYDIN Diyafragma Cerrahisi İsa KARACA Özofagus Kanseri Cerrahisi Mevlüt YORDANAGİL Akalazya: Tanı ve Tedavi Sacit Altuğ KESİKLİ Güncel Mide Cerrahisi Ali DURAN Midenin Selim Hastalıklarına Yaklaşım Mehmet ARSLAN Güncel Bariatrik Cerrahi Yunus YAPALAK Obezitenin Cerrahi Dışı Tedavi Yöntemleri Elnur HÜSEYNOV Safra Kesesi Cerrahisi Özkan SUBAŞI Safra Yolları Girişimleri Mirkhalig JAVADOV Emrah KARATAY Pankreas Hastalıkları ve Tedavisi Gökhan GARİP Açık ve Laparoskopik Splenektomi Erhan ERÖZ Sürrenal Hastalıkları ve Cerrahisi Baran MOLLAVELİOĞLU Güncel Apandisit Cerrahisi Sibel ÖZKARA Kasık Fıtığının Açık ve Laparoskopik Cerrahisi Murat DEMİR Ventral Herni Cerrahisi Abdullah AS Malign ve Benign Hastalıklarda Karaciğer Cerrahisi Seda BAŞTÜRK Karaciğer Kistlerinin Tedavisi Mevlüt Harun AĞCA Karaciğer Kistlerinde PAIR Uygulaması Mehmet Emin UNUTMAZ Endoskopik Retrograd Kolanjiyopankreatografi ERCP Mikail UYAN HIPEC, Sıcak Kemoterapi Gözde ERTUNÇ AÇIKGÖZ Transanal Endoskopik Mikrocerrahi (TEM) Serdar ACAR İnce Bağırsak Cerrahisi Serkan YILMAZ Gastrointestinal Sistem Kanamaları Mesud FAKİRULLAHOĞLU Hasar Kontrol Cerrahisi Sümeyra GÜLER Laparoskopik Diagnostik Girişimler Bilal TURAN Endsokopik Submukozal Diseksiyon Mehmet BİÇER Laparoskopik İnce Barsak Cerrahisi Mesut YUR Güncel Kolorektal Cerrahi Barış CANDAN Benign Kolorektal Hastalıklara Yaklaşım Osman AKDOĞAN Mehmet KARAHAN Rektal Prolapsus Cerrahisi Yasin Orhan ERKUŞ Karın Duvarı Tümörlerine Yaklaşım Göktürk GÜRSOY Proktolojide Güncel Tedavi Yöntemleri Muhammet Fikri KÜNDEŞ Transplantasyon Emil HÜSEYİNOĞLU Bahtiyar MUHAMMEDOĞLU Genel Cerrahide Lazer Teknolojisinin Kullanımı Şükran ÇAVDAR Murat Bulut ÖZKAN Cerrahi Komplikasyon Yönetimi Gizem FIRTINA Perkütan Abdominal Apse, Sıvı Drenajı Tuğberk BAŞTÜRK Cerrahide Stapler Teknolojisi ve Enerji Aletleri Oğuzhan ÇÖĞÜRLÜ Jinekolojide Minimal İnvaziv Cerrahi Burcu AYDIN BOYAMA İleri Endoskopik Girişimler Girayhan ÇELİK Anormal Uterin Kanama ve Cerrahisi Cansu ÖNAL KANBAŞ Endoscopik Ultrasonografi Mahmut Baran YERLİKAYA Batın Kapama Yöntemlerinde Yenilikler İbrahim KILINÇ Pelvik Taban Kusurlarında Cerrahi Uygulamalar Tamer TOPALOĞLU Omurga Cerrahisi Furkan SOY Halil GÖK Pediatrik Yaş Grubunda Pilonidal Sinüs Tedavisine Güncel Yaklaşımlar Gonca GERÇEL Ali İhsan ANADOLULU Pediatrik Minimal İnvaziv Uygulamalar Ali İhsan ANADOLULU Gonca GERÇEL Jinekolojik Onkolojik Aciller Nur Cansu YILMAZ BALDAN Cerrahide Anestezi Yönetimi Fatma OKUCU Robotik Cerrahi Teknolojisinin Gelişimi Berke MANOĞLU