Background and Objectives: Complicated left-sided colonic diverticulitis is one of the important causes of hospital admissions and emergency surgery in industrialized societies and requires serious clinical decision-making processes for patient management. This study aims to evaluate the predictive role of albumin-based nutritional indices in deciding on surgical strategy (primary anastomosis vs. Hartmann procedure) in patients treated operatively for complicated left-sided colonic diverticulitis. Materials and Methods: This retrospective single-center study included 57 patients who were operatively treated for Hinchey stage III–IV diverticulitis between 2021 and 2024. Patients were divided into two groups according to surgical method: Hartmann procedure (n = 40) and primary anastomosis (n = 17). Prognostic Nutritional Index (PNI), Hemoglobin–Albumin–Lymphocyte–Platelet Score (HALP), CRP–Albumin–Lymphocyte (CALLY) Index, and Modified Glasgow Prognostic Score (mGPS) were evaluated as albumin-based nutritional indices in the preoperative period. Predictive parameters were determined using ROC analysis and multivariate logistic regression. Results: Albumin level, PNI, HALP, and CALLY scores were found to be significantly lower in the Hartmann procedure group. Additionally, the proportion of patients with mGPS score 2 was significantly higher in the Hartmann procedure group (57.5% vs. 5.9%; p < 0.001). In the ROC analysis, the cut-off value for the CALLY index was determined as 0.45 (AUC: 0.826). In multivariate analysis, albumin < 38.5 g/L (OR: 16.53), CALLY index < 0.45 (OR: 6.40), and systemic inflammatory response syndrome (SIRS) detection (OR: 12.98) were determined as independent factors predicting the Hartmann procedure. Conclusions: A low CALLY index was found to be independent predictors for the Hartmann procedure. The CALLY index, which reflects the inflammatory response, immune capacity and nutritional status, can assist surgeons in making objective, and individualized decisions by holistically evaluating the patient’s physiological status. Multicenter prospective studies are required to confirm the clinical validity of the findings.

BACKGROUND Acute appendicitis is a common surgical emergency, and appendectomy is essential to prevent complications such as perforation and peritonitis. Although the procedure is routine, outcomes may be affected by surgery timing, staffing, and hospital resources. Evidence on whether off-hour operations increase complications is conflicting. This study aimed to assess whether laparoscopic appendectomy performed during weekday in-hours, after-hours, or holiday periods influences postoperative outcomes. AIM To investigate clinical outcomes of laparoscopic appendectomy performed during weekday daytime, weekday evening, and weekends or holidays. METHODS The data of 977 patients who underwent laparoscopic appendectomy in a high-volume tertiary hospital between January 1, 2024, and December 31, 2024, were recruited. Patients were divided into three groups including surgeries during regular weekday in-hours (group 1), during weekday after-hours (group 2) and during weekends or extended holiday periods (group 3). Demographic, peri-, and postoperative data were compared. RESULTS There were no significant differences in operative time, conversion to open surgery, or complication rates between all groups. However, patients in the weekend/holiday group had significantly shorter time to surgery (median: 584 minutes vs 589 minutes vs 535 minutes, P = 0.002), and patients in the weekday in-hours group had significantly longer hospital stays than the other groups (median: 2 days vs 1 day vs 1 day, P < 0.001). No mortality occurred in any group. CONCLUSION In a well-staffed center, laparoscopic appendectomy during weekends or holidays is safe and may offer faster surgical access. Delay to surgery, not the working hour, is the main factor affecting outcomes.

Background and Objectives: Laparoscopic cholecystectomy is one of the most performed surgical procedures worldwide. In low-risk patients, routine postoperative blood tests are frequently ordered despite limited evidence supporting their necessity. The aim of the study was to evaluate the predictability of complications that may occur with routine postoperative blood tests. Materials and Methods: This retrospective study examined 538 patients who underwent surgery in Cam and Sakura City Hospital between May 2020 and May 2021. Patients were divided into two groups: no postoperative complications (Group NC, n = 521) and postoperative complications (Group C, n = 17). Demographic characteristics, including age and gender, duration of surgery, cystic duct closure method, drain use, complications, preoperative and postoperative blood tests, and the mean time of hospital stay, were the collected data throughout the study. Results: The analysis of the post-operative blood test values revealed that the total bilirubin (p = 0.005), ALT (p = 0.002), AST (p = 0.002), GGT (p = 0.02) and amylase (p = 0.034) values were statistically significantly higher in Group C than in Group NC, but these values did not exceed the normal range except for ALT, AST and GGT, which were slightly higher than the normal parameters. Seventeen patients (3.15%) developed postoperative complications, including biliary leakage (n = 1); choledocholithiasis (n = 2); cardiac (n = 2), pulmonary (n = 9), and hemorrhagic (n = 2) complications; and a superficial wound infection (n = 1). Most complications were identified by symptoms and clinical observation. Conclusions: Routine postoperative blood tests in low-risk laparoscopic cholecystectomy patients do not significantly contribute to the early detection of complications. Clinical observation and targeted use of laboratory or imaging tests in selected high-risk cases might be more efficient. This approach can help reduce unnecessary workload, hospital costs, and healthcare expenditures without compromising patient safety.

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

BACKGROUND: This study aimed to evaluate the healing effects of adipose tissue-derived mesenchymal stem cells (AT-MSC) and sildenafil citrate alone or in combination of colon anastomosis experimental model.METHODS: A total of 40 female Wistar rats were randomly distributed to four groups: Control (without any intervention post-anas-tomosis), stem cell (AT-MSC injection on the anastomosis site), SIL (oral gavage of 10 mg/kg sildenafil citrate), and stem cell + SIL (AT-MSC injection and oral administration of sildenafil citrate) groups. Rats were euthanized 5 days post-anastomosis. Intra-abdominal adhesion status and anastomotic burst pressure were measured to assess anastomotic healing. Hydroxyproline and TNF-alpha level, neu-trophil leukocyte infiltration, epithelial regeneration, and necrosis in the anastomosis tissue were examined.RESULTS: Anastomosis leakage and anastomosis burst pressure were not different among the groups. Treatment with sildenafil, stem cell, and stem cell + SIL reduced the degree of perianastomotic adhesions compared to control (p<0.05). A significant increase was noted in hydroxyproline in the stem cell and stem cell + SIL groups (p=0.001). AT-MSC injection alone or in combination with sildenafil citrate reduced the TNF-alpha concentration at the anastomosis site (p=0.001). Histopathological examination revealed that all treatments enhanced the clearance of the necrotic debris, reduced leukocytes infiltration, and accelerated the retraction of anastomo-sed ends except control (p=0.001). Epithelial regeneration was more pronounced in the stem cell group than other groups (p=0.001). Macrophage density was lower in groups treated with the SIL or stem cell groups than the control and stem cell + SIL groups (p=0.001).CONCLUSION: Sildenafil citrate and/or AT-MSC in the anastomosed rats promoted the anastomosis healing that was more pro-nounced in groups receiving stem cell injections.