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    Öğe
    Efficacy of blood parameters as indicators of the need for overdue urgent cholecystectomy in elderly patients with acute cholecystitis
    (2023) Kubat, Mehmet; Şengül, Serkan; Şahin, Serdar
    BACKGROUND: Although early cholecystectomy is recommended for patients with acute cholecystitis, conservative treatment followed by delayed cholecystectomy (DC) is a highly preferred modality, especially in older adult patients. However, some severe cases require overdue urgent cholecystectomy (OC). This study aimed to evaluate the ability of laboratory findings and Tokyo severity classification (TokyoSC) to differentiate those with the need for OC among elderly patients. METHODS: Laboratory/radiological/clinical findings of geriatric patients with acute cholecystitis on admission and TokyoSC were retrospectively analyzed. The DC and OC groups were compared. RESULTS: The mean age of the 164 patients was 72.3±6.4 years. White blood cell, neutrophil (NEU), immature granulocyte (IG), C-reactive protein, neutrophil-to-lymphocyte ratio (NLR), and TokyoSC parameters were all significant at P<0.001 in differentiation. NLR had a specificity of 98%, and TokyoSC had a sensitivity of 98%. CONCLUSION: NLR, NEU, IG, and TokyoSC were effective in differentiating patients who needed OC while planning conservative treatment + DC for older adult patients who were followed up due to acute cholecystitis. If the NLR is >9.9 and TokyoSC is moderate/ high, early cholecystectomy should be preferred instead of conservative treatment + DC in aged patients.
  • [ X ]
    Öğe
    TİROİD İNCE İĞNE ASPİRASYON BİYOPSİSİ SONUCU ÖNEMİ BELİRSİZ ATİPİ TANISI KONULAN HASTALARIN DEĞERLENDİRİLMESİ
    (2020) Şahin, Serdar; Kubat, Mehmet; Çavuşoğlu, Nadir Turgut; Üstün, Hüseyin
    Amaç: Tiroid bezi hastalıkları en önemli endokrinsorunlardan biridir. Tiroid ince iğne aspirasyon biyopsisi(TİİAB)’nin ana rolü; hastaları cerrahi ve konservatif tedaviseçenekleri açısından ayırt etmektir. Bu çalışma ile AnkaraEğitim ve Araştırma Hastanesi’nde tiroidektomi operasyonuuygulanmış hastalara ilişkin tiroid ince iğne aspirasyonbiyopsisi (TİİAB) sonuçları ile histopatoloji raporsonuçlarının karşılaştırılarak, tiroid nodüllerindeki İİABetkinliğinin değerlendirilmesi amaçlanmıştır.Gereç ve Yöntemler: Ankara Eğitim ve AraştırmaHastanesi’nde 2007-2012 yılları arasında TİİAB sonucuönemi belirsiz atipi tanısı konulan ve tiroidektomioperasyonu yapılan hastaların histopatolojik verilerikarşılaştırıldı.Bulgular: Çalışmamıza toplam 87 hasta dahil edildi.Hastaların 77’si (%88.5) kadın, 10 (%11.5)’u ise erkekti.Yetmiş yedi kadın hastanın 55’ine (%71.4) benign, 22’sine(%28.6) malign nodül teşhisi konuldu. On erkek hastanın8’ine (%80) benign, 2’sine (%20) malign nodül teşhisikonuldu.Sonuç: Önemi belirsiz atipi teşhisi konan hastalar, yaş vecinsiyet gibi demografik özellikleri, radyolojik inceleme,ayrıntılı öykü ve fizik muayene dahil olmak üzere klinikolarak bir bütün olarak değerlendirilmeli ve cerrahi kararlarıbu özelliklere göre verilmelidir.
  • Küçük Resim
    Öğe
    Validation and Efficiency of a Scoring System Used in the Differentiation of Uncomplicated Appendicitis
    (2022) Kubat, Mehmet; Şahin, Serdar
    Objective: Various parameters are used to differentiate between complicated and uncomplicated appendicitis cases, and scoring systems are even created where these parameters are used together. The aim of this study was to evaluate the effectiveness of one of these scoring systems by external validation. Methodology: Retrospective evaluation was performed on the clinical, radiological and laboratory findings of patients who underwent an appendectomy between January 2018 and January 2021. Scoring was performed using the previously described scoring systems for each patient considered to have acute appendicitis as a result of imaging. They were divided into complicated appendicitis and uncomplicated appendicitis groups, according to clinical and pathological evaluation results. Results: While evaluating 425 patients, ultrasonography was used in 48% and tomography in 52% of the patients. Significant effectiveness of the score of ?6 was observed in the group using tomography (p<0.001, AUC: 0.838, Sensitivity 83.3%, positive predictive value 50.8%, specificity 84.3%, negative predictive value 96.3%). Significant effectiveness of the score of ?5 was observed in the ultrasonography group (p<0.001, AUC: 0.790, Sensitivity 85.7%, positive predictive value 39.0%, specificity 72.2%, negative predictive value 96.1%). Conclusion: The scoring system created for the selection of uncomplicated appendicitis cases has been shown to be effective and has been externally validated. Since each of the parameters used in the scoring system has higher efficiency than its independent effectiveness, scoring systems that evaluate clinical, radiological and laboratory variables together, give better results in clinical practice.