Hipertiroidizm tiroid bezi tarafýndan fazla tiroid hormonu üretimi ve sekresyonu ile dokularda fazla tiroid hormonu konsantrasyonuna baðlý geliþen klinik durumdur. Hipertiroidizm düþük TSH ve yüksek T3 ve/veya T4 ile karakterizedir ve en sýk sebepleri Graves hastalýðý, toksik multinodüler guatr ve soliter toksik adenomdur. T3 tiroid hormonunun periferik etkili aktif formu olup hemen her doku ve sistemi etkilemektedir. Hipertiroidizmle ilgili en belirgin özellikler kardiyovasküler sistemle ilgili olanlardýr. Hipertiroidizmin tedavisinin 3 tedavi opsiyonu antitiroid ilaçlar (ATDs), radyoaktif iyot tedavisi (RAI) ve cerrahi olup, bunlar arasýnda en etkili tedavi cerrahidir. Cerrahi endikasyon koyulan hastalarda tiroidektominin optimal þartlarda uygulanabilmesi için hastalarýn preoperatif hazýrlýk tedavisinin yapýlmasý gerekmektedir. Preoperatif hazýrlýk tedavisi, tiroid bezinden tiroid hormonlarýnýn sentezini, salgýlanmasýný ve periferik etkilerini önlemeyi hedefleyen bir kombinasyon tedavisi olmalýdýr. Bu tedavide kullanýlabilen ilaçlar tiyonamidler, beta blokerler, iyod, kortikosteroidler, kolestiramin, perklorat, lityum, terapötik plazma deðiþimi olarak sayýlabilir. Hastanýn durumuna göre bu tedavi seçenekleri kombine edilebilir. Hipertiroidide cerrahi tercih edilecekse, hipertiroidinin korkulan komplikasyonu olan tiroid fýrtýnasýný önlemek için hastalarýn preoperatif antitiroid tedavi ile ötiroid hale getirilmesi önerilmekle birlikte kanýt düzeyi düþüktür. Ameliyat öncesi tedavi, ameliyat sýrasýndan hastanýn ötiroidi veya hipertiroidi olmasý tiroid fýrtýnasýndan korumaz. Hipertiroidik hastalarda biyokimyasal ötiroidi saðlanana kadar cerrahinin ertelenmesinin gerekip gerekmediði halen tartýþma konusudur. Son yýllarda yayýnlanan çalýþmalarda deneyimli anestezist ve cerrahlar tarafýndan hipertiroidik safhada tiroidektomi uygulanmasýnýn tiroid fýrtýnasýný presipite etmeden, intraoperatif ve postoperatif komplikasyon geliþimini arttýrmadan güvenli bir þekilde uygulanabileceði bildirilmektedir. Hipertiroidik hastalarda cerrahi öncesi ötiroid durumuna ulaþmak ideal olsa da, her zaman mümkün deðildir. Ötiroid ilaçlara karþý alerji, ilaç yan etkileri, tedaviye dirençli hastalýk, hastanýn tedaviye uyumsuzluðu ve kesin tedavinin ne kadar acil olmasý gerektiði gibi faktörler, hipertiroidizmin ameliyat öncesi kontrol edilip edilemeyeceðini belirlemede kritik öneme sahiptir. Hipertiroidik hastalarda ötiroid hale gelmeden cerrahi gerektiðinde hastanýn genel durumu, komorbiditeleri anestezist, cerrah ve endokrinolog tarafýndan birlikte deðerlendirilmeli, özellikle kardiyovasküler sistem stabilize edilmelidir. Hipertiroidik safhada ve kardiyovasküler açýdan stabil olan hastalarda tiroid cerrahisinin ertelenmeyebileceði ve güvenli bir þekilde uygulanabileceði düþüncesindeyiz. (SETB-2024-09-148)

Hyperthyroidism is a clinical condition that develops due to the excessive production and secretion of thyroid hormones by the thyroid gland, leading to an elevated concentration of thyroid hormones in tissues. Hyperthyroidism is characterized by low TSH and elevated T3 and/or T4, with the most common causes being Graves' disease, toxic multinodular goiter, and solitary toxic adenoma. T3 is the peripherally active form of thyroid hormone, affecting nearly each tissue and system. The most prominent aspects of hyperthyroidism are related to the cardiovascular system. The treatment of hyperthyroidism includes three options: antithyroid drugs (ATDs), radioactive iodine therapy (RAI), and surgery. Among these treatment modalities, surgery is considered as the most effective one. For patients who are candidates for surgery, preoperative preparation is required to ensure that the thyroidectomy can be performed under optimal conditions. Preoperative preparation should be a combination therapy aimed at preventing the synthesis, secretion, and peripheral effects of thyroid hormones from the thyroid gland. Medications that can be used in this treatment include thionamides, beta-blockers, iodine, corticosteroids, cholestyramine, perchlorate, lithium, and therapeutic plasma exchange. These treatment options can be combined based on the patient's condition. While it is recommended that patients be made euthyroid through preoperative antithyroid treatment to prevent the feared complication, which is the thyroid storm, the supporting evidence is limited. Preoperative treatment does not prevent against thyroid storm whether the patient is euthyroid or hyperthyroid during surgery. Whether surgery should be delayed until biochemical euthyroidism is achieved in hyperthyroid patients remains a topic of debate. Recent studies suggest that thyroidectomy can be safely performed during the hyperthyroid phase by experienced anesthesiologists and surgeons without precipitating thyroid storm or increasing intraoperative and postoperative complications. Although achieving the euthyroid state before surgery is ideal in hyperthyroid patients, it is not always possible. Factors such as allergies to medications, drug side effects, treatment-resistant disease, patient noncompliance, and the urgency of definitive treatment are critical in determining whether hyperthyroidism can be controlled preoperatively. When surgery is necessary in hyperthyroid patients without achieving euthyroidism, the patient's overall condition and comorbidities should be evaluated together by the anesthesiologist, surgeon and endocrinologist, with particular attention to stabilizing the cardiovascular system. We believe that in hyperthyroid patients who are cardiovascularly stable during the hyperthyroid phase, thyroid surgery may not need to be delayed and can be performed safely.

Amaç: Bu çalýþmada total ekstraperitoneal (TEP) tekniðiyle ve kýsmi emilebilir mesh kullanýlarak yapýlan laparoskopik inguinal herni onarýmlarýnýn 5 yýllýk bir dönemde postoperatif sonuçlar ve rekürrens oraný açýsýndan incelenmesi amaçlandý.
Yöntem: Toplamda 100 hastada (ort. (SS) yaþ: 51.0(14.6, 16-83) yýl, popülasyonun %91,0’i erkek hastalar) gerçekleþtirilen 150 kýsmi emilebilir mesh kullanýmlý laparoskopik TEP inguinal herni onarýmý (50 hastada bilateral) retrospektif olarak deðerlendirildi. Hastalarýn demografik özellikleri, herni özellikleri (taraf, alt tip), operasyon tarihi ve süresi, erken ve geç-dönem postoperatif komplikasyonlar ve rekürrens oraný 5-yýllýk dönemde kaydedildi.
Bulgular: Hastalarýn yaklaþýk yarýsýndaÝ inguinal herni 50 hastada (%50.0) bilateral (50.0%) ve 53(%53.0) hastada ya indirekt (53.0%) olup, 17(%17,0) olguda lipoma tespit edildi. Medyan operasyon süresi 45.0 dk (23.0 ila 40.0 dk aralýðýnda) oldu. Toplamda, 6(%6,0) hastada konservatif olarak tedavi edilen eroma oluþumu gözlenirken, hiçbir hastada preperitoneal hematom, enfeksiyon veya persistan kronik inguinal aðrý gözlenmedi. Postoperatif takipte 30 ay içinde (2 ila 60 ay aralýðýnda) rekürrens geliþim oraný %0,67 (1/150 operasyonda) idi. Bilateral hernide operasyon süresi, sol veya sað unilateral herni ile kýyaslandýðýnda, anlamlý olarak daha uzundu (median(minimum-maksimum) 50.0(34.0-140.0) dk’ya karþýn sýrasýyla 40.0(23-80) ve 40.0(25.0-130.0) dk, p<0.01 ve p<0.001). Operasyon süresi, hasta yaþý (r=0.240, p=0.017) ve VKÝ (r=0.205, p=0.044) ile pozitif korelasyon gösterdi.
Sonuç: Sonuç olarak, bu retrospektif tek-cerrah çalýþmasýbulgularýmýz, kýsmi emilebilir mesh kullanýlan laparoskopik TEP inguinal herni onarýmlarýnýn erken ve geç dönem komplikasyonlar bazýnda olumlu postoperatif sonuçlar ve 5 yýllýk süre zarfýnda %0,67 rekürrens oraný ile iliþkili olduðunu göstermektedir. (SETB-2024-06-110)

Objective: This study aimed to evaluate the postoperative outcomes and recurrence rate in laparoscopic inguinal hernia repairs performed over a 5-year period with totally extraperitoneal (TEP) technique and use of partially absorbable meshes.
Methods: A total of 100 patients (mean(SD, min-max) age: 51.0(14.6, 16-83) years, 91.0% were males) who underwent 150 laparoscopic TEP inguinal hernia repairs (bilateral in 50 patients) with use of the partially absorbable mesh were retrospectively reviewed. Data on patient demographics, hernia characteristics (side, subtype), date of operation, operating time, early and late postoperative complications as well as the recurrence rate were recorded over a 5-year period.
Results: The inguinal hernia was bilateral in 50(50.0%) patients and indirect hernia was noted in 53(53.0%) patients, while lipoma was evident in 17(17.0%) cases. Median operating time was 45.0 min (range, 23.0 to 140.0 min). Overall, seroma occurred in 6(6.0%) patients and treated conservatively, while none of patients developed preperitoneal hematoma, infection or persistent chronic inguinal pain. Recurrence rate was 0.67% (1/150 operations) within a median 30.0 months (range, 2 to 60 months) of postoperative follow up. Bilateral hernia was associated with significantly longer operating time compared to left or right unilateral hernia (median(min-max) 50.0(34.0-140.0) vs. 40.0(23-80) and 40.0(25.0-130.0) min, p<0.01 and p<0.001, respectively). Operating time was positively correlated both with patient age (r=0.240, p=0.017) and BMI (r=0.205, p=0.044).
Conclusion: In conclusion, our findings indicate that laparoscopic TEP inguinal hernia repair with use of the partially absorbable meshes enables a favorable postoperative outcome with minimal early and late postoperative complications and 0.67% recurrence rate over a 5-year period.

Amaç: Struma ovarii (SO) tüm yumurtalýk tümörlerinin yaklaþýk %1'ini oluþturur. Çalýþmamýzýn amacý, aðýrlýklý olarak monodermal teratom içinde tiroid dokusu ile karakterize SO tanýsý alan hastalardan oluþan kapsamlý bir vaka serisindeki klinik deneyimimizi sunarak tedavi algoritmasýna katkýda bulunmaktýr.
Yöntem: Ocak 2012 ile Ocak 2022 tarihleri arasýnda yumurtalýk kitlesi nedeniyle ameliyat edilen ve histopatolojik olarak SO tanýsý alan 17 yaþ ve üzeri hastalar çalýþmaya dahil edildi. Hastalarýn dosyalarý geriye dönük olarak incelendi. Demografik veriler, baþvuru þikayetleri, radyolojik bulgular, tümör boyutlarý, laboratuvar verileri, uygulanan cerrahi iþlemler, patoloji raporlarý, ek tedaviler ve takip bilgileri kaydedildi.
Bulgular: Toplam 19 hastanýn yaþ ortalamasý 41,7 ± 17,59 yýldý. Bunlardan 3 hastada malign struma ovarii (MSO) mevcuttu. Histopatolojik olarak benign struma ovarii (BSO) tanýsý doðrulanan hastalara kistektomi sonrasý ek tedavi uygulanmadý. Malign vakalarda tek taraflý salpingo-ooferektominin yaný sýra total tiroidektomi, radyoaktif iyot (RAI) ablasyonu ve L-Tiroksin baskýlamasý (TSH serum düzeyinin 0,1 mU/L'nin altýnda olmasý) uygulandý. Takip süresi boyunca mortalite meydana gelmedi.
Sonuç: Benign struma ovarii vakalarýnda konservatif tedaviler kabul edilebilir bir tedavi olarak görülse de malign vakalarýnýn yönetimi tartýþmalýdýr. Genç kadýnlar için doðurganlýðý koruyucu cerrahiyi takiben postoperatif adjuvan tiroidektomi ve radyoaktif iyot ablasyonu tercih edilebilir. (SETB-2024-05-079)

Objective: Struma ovarii (SO) accounts for approximately 1% of all ovarian tumors The objective of our study is to contribute to the treatment algorithm by presenting our clinical experience in a comprehensive case series of patients diagnosed with SO, predominantly characterized by thyroid tissue within a monodermal teratoma.
Materials and Methods: Patients aged 17 years and older who underwent surgery due to ovarian masses and were histopathologically diagnosed with SO between January 2012 and January 2022 were included in the study. The patients' files were retrospectively reviewed. Demographic data, presenting complaints, radiological findings, tumor sizes, laboratory data, surgical procedures performed, pathology reports, additional treatments, and follow-up information were recorded.
Results: The median age of total 19 patients was 41.7 (17-74) years. Among them, malignant struma ovarii was present in 3 patients. In patients with histopathologically confirmed benign struma ovarii, no additional treatment was administered after tumor enucleation. In malignant cases, in addition to unilateral salpingo-oophorectomy, total thyroidectomy, radioactive iodine (RAI) ablation, and L-Thyroxine suppression were performed. No mortality occurred during the follow-up period.
Conclusion: Although conservative treatments are considered as acceptable treatment in cases of benign struma ovarii, the management of cases with malignant struma ovarii is controversial. Fertility sparing surgery followed by postoperative adjuvant thyroidectomy and radioactive iodine ablation may be preferred for young women.

Giriþ: Tiroglossal kist (TGC)’ler genellikle çocukluk çaðýnda ve 30 yaþýndan önce presente olmasýna raðmen, yetiþkinlerde hatta ileri yaþlarda da görülebilmektedir. Yetiþkinlerde nodüler tiroid hastalýðý da sýk görülmektedir. Literatürde çocuk ve yetiþkinlerde TDC kliniðinin, cinsiyetin, cerrahi sonrasý rekürensin farklý olduðu ile ilgili tartýþmalar devam etmektedir. Biz de bu çalýþmada kliniðimizde TDC nedeni ile cerrahi uygulanan yetiþkin hastalarýn TDC ile ilgili verileri, eþ zamalý tiroid hastalýðý ve tiroid cerrahisi ile ilgili verilerini deðerlendirmeyi amaçladýk
Materyal Metod: Þiþli Hamidiye Etfal Eðitim ve Araþtýrma Hastanesi Genel Cerrahi Kliniðinde 2018-2024 tarihleri arasýnda TGC tanýsý opere edilen 18 yaþ üstü hastalarýn verileri retrospektif olarak deðerlendirildi.
Bulgular: Kriterlere uygun yaþ ortalamasý 43.94+12.98 (21-67) yýl olan 16 hasta (11 kadýn/5 erkek) çalýþmaya alýndý. TGC tanýsý 12 hastada 8%75) ultrasonografi (USG), 1 hastada (%6.25), 1 hastada magnetik rezonans görüntüleme, 2 hastada insidental olarak (12.5) intraoperatif saptandý. TGC için 13 hastaya (%81.25) Sistrunk ameliyatý, 3 hastaya (%18.75) kist eksizyonu uygulandý. 16 TGC’li hastanýn birinde (%6.25) preoperatif TGC içinde papiller tiroid kanseri saptandý. Preoperatif deðerlendirmede 12 hastada (%75) nodüler tiroid hastalýðý saptandý. Bunlarýn 3 (%18.75)’ünde preoperatif papiller tiroid kanseri saptandý. TGC’li hastalardan 3’üne (%18.75) tiroid malignitesi, 5 (%31.25)’ine nodüler tiroid hastalýðý nedeniyle (%50)’ine ek tiroid cerrahisi uygulandý. Hastalar 22.63+18.32 ay (3-67 ay) takip edildi. Takip süresinde TGC rekürensi geliþmedi.
Sonuç: TGC’li hastalarda tiroid hastalýðý, malign veya benign tiroid hastalýðý için ek tiroidektomi gerekliliði nadir deðildir. TGC’li hastalar cerrahi tedavi öncesi tiroid hastalýðý açýsýndan da deðerlendirilmelidir. TGC’li hastalarýn cerrahi tedavisinde Sistrunk ameliyatý standart cerrahi teknik olmasýna raðmen, yetiþkinlerde eðer kist hyoid kemiðin inferiorunda sonlanýyorsa hyoid kemik ortasý çýkarýlmadan total kist eksizyonu yeterli olabilir. (SETB-2024-09-149)

Introduction: Thyroglossal cysts (TGCs) usually present during childhood and before the age of 30, however they can also be seen in adults, even in advanced age. Nodular thyroid disease is also common in adults. In the literature, there is an ongoing debate regarding the differences in clinical presentation, gender, and postoperative recurrence of TGC between children and adults. In this study, we aimed to process the data of adult patients who underwent surgery for TGC in our clinic, along with the data on concurrent thyroid disease and thyroid surgery.
Materials and Methods: The data of patients over 18 years old who were operated on for TGC at the General Surgery Clinic of Sisli Hamidiye Etfal Training and Research Hospital between 2018 and 2024 were retrospectively evaluated.
Results: A total of 16 patients with a mean age of 43.94 ± 12.98 (21-67) years, were included in the study (11 F/5 M). The diagnosis of TGC was made in 12 patients (75%) by ultrasonography (USG), in 1 patient (6.25%) by computed tomography, in 1 patient (6.25%) by magnetic resonance imaging (MRI), and in 2 patients (12.5%) incidentally intraoperatively. 13 patients (81.25%) underwent the Sistrunk procedure, and 3 patients (18.75%) underwent cyst excision. Among the 16 TGC patients, papillary thyroid cancer in the cyst was detected in one patient (6.25%) preoperatively. During preoperative evaluation, nodular thyroid disease was found in 12 patients (75%). Of these, papillary thyroid cancer was detected in 3 patients (18.75%) preoperatively. Of the TGC group, 3 (18.75%) underwent thyroidectomy for thyroid malignancy, and five (31.25%) underwent additional thyroid surgery for nodular thyroid disease. The patients were followed for a mean of 22.63 ± 18.32 months (3-67 months), and no recurrence of TGC was observed during the follow-up period.
Conclusion: In patients with TGC, thyroid diseases and the requirement for thyroidectomy due to benign or malignant thyroid disease is not uncommon. Patients with TGC should be evaluated for thyroid disease before surgical treatment. While the Sistrunk procedure is the standard surgical technique in the treatment of TGC, in adults, if the cyst terminates below the hyoid bone, total cyst excision without removing the central portion of the hyoid bone may be sufficient.

Giriþ: Papiller tiroid kanseri (PTK) insidansý giderek artmakta olup ameliyat sonrasý iyi seyreden saðkalým süreleri nedeniyle yapýlacak ameliyatýn geniþliði iyi belirlenmeli ve operasyon sýrasýnda geliþebilecek komplikasyonlardan kaçýnýlmalýdýr. Rekürren laringeal sinirin (RLS) sað ve sol boyun taraflarýndaki anatomik seyrinden dolayý sað paratrakeal lenf bezleri anteromedial ve posterolateral olarak ikiye ayrýlmakta ve posterolateral lenf bezleri RLS ile yakýn bir komþuluk halinde bulunmaktadýr. Bu komplikasyon riski nedeniyle bu çalýþmada PTK’da oluþabilen sað paratrakeal posterolateral lenf bezi (SPTPLLB) metastazý için risk faktörlerini belirlemeyi amaçladýk.
Gereç ve Yöntem: 2013-2022 yýllarý arasýnda tiroid bezi sað lobda PTK mevcudiyeti nedeniyle santral boyun diseksiyonu veya santral ve lateral boyun diseksiyonu yapýlmýþ olan hastalar çalýþmaya dahil edildi. Tanýmlayýcý verilerle beraber preoperatif görüntüleme bulgularý ve postoperatif patoloji bulgularý retrospektif olarak deðerlendirildi.
Bulgular: Kriterlere uyan 55 hastanýn verileri istatistiksel olarak deðerlendirildi. Hastalarýn 24’ü (%43.6) erkek, 31’i (%56.4) kadýndý. Yaþ ortalamalarý 47.9±17.5(16-81)’du. Ortalama tümör çapý 2.17±1.43(0.4-7.0) cm’di. Hastalarýn 13’ünde (%23.6) SPTPLB metastazý izlendi. Tek deðiþkenli analizde ekstratiroideal yayýlým (p=0.008), lenfovasküler invazyon (p=0.044), sað paratrakeal anteromedial lenf bezi (SPTAMLB) metastaz varlýðý (p=0.001) ve sol paratrakeal metastaz (p=0.049) varlýðý istatistiksel olarak anlamlý faktörler olarak belirlendi. Yapýlan çok deðiþkenli analizde yalnýzca sað paratrakeal anteromedial bölgede lenf bezi metastazý olmasý anlamlý deðiþken olarak belirlendi(p=0.035).
Sonuç: PTK nedeniyle opere olan hastalarda intraoperatif deðerlendirme sýrasýnda, SPTPLLB’inde metastaz olma riskinin SPTAMLB’inde metastaz olmasýyla beraber arttýðý göz önünde bulundurulmalýdýr. Santral diseksiyon planlanan sað lobda tümörü olan hastalarda sað paratrakeal diseksiyonun formal yapýlmasýnýn optimal deðerlendirme açýsýndan uygun olacaðý kanaatindeyiz. SPTAMLB varlýðýnda posterolateral diseksiyon rutin uygulanmalýdýr. Karar verilemediðinde anteromedial doku frozen patoloji ile incelenerek negatif sonuçlanmasý durumunda posterolateral diseksiyon uygulanmayabilir. (SETB-2024-09-153)

Introduction: The incidence of papillary thyroid cancer (PTC) is increasing, and due to the favorable postoperative survival rates, the extent of surgery should be carefully determined, and complications during the operation should be avoided. The recurrent laryngeal nerve (RLN) divides the right paratracheal lymph node (RPTLN) into anteromedial and posterolateral compartments due to its anatomical course on the right and left sides of the neck, and the posterolateral lymph nodes are in close proximity to the RLN. Due to the risk of this complication, in this study, we aimed to determine the risk factors for the development of right paratracheal posterolateral lymph node (RPTPLLN) metastasis in PTC.
Materials and Methods: Between 2013 and 2022, patients who underwent central neck dissection (CLND) or central and lateral neck dissection due to the presence of PTC in the right lobe of the thyroid gland were included in the study. Descriptive data, along with preoperative imaging findings and postoperative pathology findings, were retrospectively evaluated.
Findings: The data of 55 patients who met the criteria were statistically analyzed. Of these patients, 24 (43.6%) were male and 31 (56.4%) were female. The mean age was 47.9±17.5 years (range: 16-81). The mean tumor size was 2.17±1.43 cm (range: 0.4-7.0). RPTPLLN was observed in 13 patients (23.6%). Univariate analysis revealed that extrathyroidal extension (p=0.008), lymphovascular invasion (p=0.044), presence of right paratracheal anteromedial (RPTAMLN) metastasis (p=0.001), and presence of left paratracheal metastasis (p=0.049) were statistically significant factors. However, in the multivariate analysis, only the presence of RPTAMLN was determined to be a significant variable (p=0.035).
Conclusion: In patients undergoing surgery for PTC, the risk of metastasis in the RPTPLLN should be considered higher when there is metastasis in the RPTAMLN. We believe that formal dissection of the RPTLN should be considered for optimal evaluation in patients with tumors in the right lobe where central dissection is planned. Posterolateral dissection(PLD) should be routinely performed in the presence of clinical lymph nodes in the RPTAMLN. When a decision cannot be made, PLD may not be performed if the anteromedial tissue is examined with frozen pathology and the result is negative.

Amaç: Bu retrospektif çalýþmada tümör hacmi, derecesi ve invazyon derinliðinin servikal lenf nodu metastazýný öngörmedeki etkinliðini deðerlendirdik. Servikal lenf nodu tutulumunu güvenilir bir þekilde öngören tanýsal parametrelerin tanýmlanmasý, laringeal kanserin yönetiminin iyileþtirilmesinde yararlý olabilir.
Gereç ve Yöntemler: Larenks yassý hücreli karsinomu nedeniyle ameliyat edilen 17 hasta retrospektif olarak deðerlendirildi. Tümörlerin yaþý, cinsiyeti, tümör-lenf nodu-metastaz (TNM) evresi, derecesi, invazyon derinliði ve tomografi (BT) hacmi analiz edildi. Bu parametreler ile servikal lenf nodu metastazý arasýndaki iliþki belirlendi.
Bulgular: Otuz iki hastada (%29.91) servikal lenf nodu pozitifliði vardý. Az diferansiye tümörlerin 13'ünde (%46.43), orta-iyi diferansiye tümörlerin 19'unda (%24.05) lenf nodu metastazý saptandý. Lenf nodu negatif hastalarda ortalama hacim 2.15±0.14 cc, lenf nodu pozitif hastalarda ise 2.97±1.05 cc idi. Lenf nodu negatif hastalarda ortalama invazyon derinliði 10.1±0.87 mm, lenf nodu pozitif hastalarda ise 11.3±1.05 mm idi. Larinks skuamöz hücreli karsinomlu hastalarda tümör derecesi ve hacmi lenf nodu metastazýný baþarýlý bir þekilde öngördü ancak invazyon derinliði nodal metastaz ile iliþkili deðildi (sýrasýyla p=0.047, p=0.0022, p=0.916)
Sonuç: Larenks skuamöz hücreli karsinomlu hastalarda tümör derecesi ve hacmi servikal lenf nodu metastazýný öngörebilirken, invazyon derinliði öngörmemektedir. Tümör hacminin radyolojik olarak hesaplanmasý, patologlarýn yaptýðý invazyon derinliði gibi ölçümlerdeki deðiþkenliði en aza indirerek lenf nodu metastazýný öngörmeye yardýmcý olabilir. (SETB-2024-05-085)

Objectives: In this retrospective study, we evaluated the effectiveness of the tumor volume, grade and invasion depth in the prediction of cervical lymph node metastasis.
Background: Identification of diagnostic parameters reliably predicting cervical lymph node involvement can be useful in improving the management of laryngeal cancer.
Material and Methods: One hundred and seven patients with squamous cell carcinoma of larynx and who underwent surgery were assessed retrospectively. Age, sex, Tumor-Node-Metastasis (TNM) stage, grade, invasion depth and tomography(CT) volume of the tumors were analysed. The association between these parameters and cervical lymph node metastasis was determined.
Results: Thirty two patients (%29.91) had positive cervical lymph nodes. Lymph node metastasis is detected in 13 (46.43%) poorly differentiated tumors, and in 19 (24.05%) moderate-well differentiated tumors. Mean volume was 2.15±0.14 cc in lymph node negative patients and 2.97±1.05 cc in lymph node positive patients. Mean invasion depth was 10.1±0.87 mm in lymph node negative patients and in 11.3±1.05 mm lymph node positive patients. The tumor grade and volume predicted successfully lymph node metastasis in patients with squamous cell carcinoma of the larynx, however invasion depth were not associated with nodal metastasis (p=0.047, p=0.0022, p=0.916, respectively)
Conclusion: The tumor grade and volume can predicted cervical lymph node metastasis in patients with squamous cell carcinoma of the larynx, whereas the depth of invasion did not. Calculation of the tumor volume radiologically can help predict lymph node metastasis by minimizing the variability in measurements such as the depth of invasion performed by pathologists.

AMAÇ: Karmaþýk kraniyofasiyal deformitelerin onarýmý birçok teknik zorluk içermektedir. Son yýllarda, operasyon kalitesini artýrmaya ve zorluklarý azaltmaya yönelik yeni cerrahi teknikler geliþtirilmiþtir. Ancak, etkilenen bölgenin þeklini tasarlamak ve hassas kontur elde etmek hala zorlayýcýdýr. Üç boyutlu (3D) katý modellerin kullanýmý, operasyonlarýn tüm aþamalarýnda önemli bir yardým saðlayabilir. Bu çalýþmanýn amacý, karmaþýk kraniyofasiyal operasyonlar için prototip 3D katý modellerin geçerliliðini araþtýrmaktýr.
MATERYAL VE YÖNTEM: Hastalarýn simüle edilmiþ 3D modelleri kullanýlmýþtýr. Operasyonlarýn planlanmasýnda klasik cerrahi aletler kullanýlmýþtýr. Hastalarýn takip süreleri 6 ila 18 ay arasýnda deðiþmektedir.
SONUÇLAR: Üç boyutlu katý modeller kullanýlarak operasyonlar planlanmýþ ve gerçekleþtirilmiþtir. Ameliyat sýrasýnda adýmlar, planlama sýrasýnda simüle edildiði þekilde uygulanmýþtýr. Büyük bir komplikasyon geliþmemiþtir. Tüm kemik ve yumuþak doku rekonstrüksiyonlarý büyük bir enfeksiyon olmadan iyileþmiþtir.
SONUÇ: Stereolitografik modeller þunlarý saðlar: 1) anatomiyi daha iyi anlama, 2) ameliyat öncesi simülasyon, 3) lezyon lokalizasyonunda ameliyat sýrasýnda doðruluk, 4) implantlarýn hassas üretimi ve 5) öðrencilerin eðitiminde geliþme. Ameliyat sýrasýnda navigasyon ve ameliyat öncesi planlama için doðru bir yöntem açýkça faydalýdýr. Bu teknoloji, hastanýn anatomisinin bilgisayar ile yeniden yapýlandýrýlmasý yoluyla doðrudan bir temsilini sunar, karmaþýk yüz rekonstrüksiyon prosedürlerinde bilgilerin verimli ve doðru bir þekilde aktarýlmasýný saðlar. (SETB-2024-07-125)

OBJECTIVE: Restoring complex craniofacial deformities presents numerous challenges. Recent years have seen the development of new surgical techniques aimed at improving operation quality and reducing difficulty. However, designing the reduction volume for the affected region and achieving precise contouring remain difficult tasks. The use of three-dimensional (3D) solid models can provide significant assistance at all stages of the operations. This study aimed to investigate the validity of prototype 3D solid models for complex craniofacial operations.
MATERIALS AND METHODS: Simulated 3D models of the patients were used. Conventional surgical instruments were employed for the planning of the operations. Patients had follow-up periods ranged from 6 to 18 months.
RESULTS: Operations have been planned and performed using three-dimensional solid models. Intraoperative steps were executed as simulated during planning. No major complications were developed. All bone and soft-tissue reconstructions healed without major infection.
CONCLUSION: Stereolithographic models provide: 1) a better understanding of anatomy, 2) presurgical simulation, 3) intraoperative accuracy in lesion localization, 4) accurate fabrication of implants, and 5) improved education for trainees. An accurate method for intraoperative navigation and preoperative planning is clearly useful. This technology offers a direct representation of the patient's anatomy through computer reconstruction, allowing for the efficient and precise transfer of information in complex facial restorative procedures.

Giriþ: Nadir de olsa elektif karýn veya pelvik ameliyatlarda damar yaralanmalarýyla karþýlaþýlmaktadýr. Ýlgili arter/vende herhangi bir yaralanma olduðunda, bu durum hem kýsa hem de uzun vadede mortalite ve morbidite ile iliþkilidir. Elektif olgularda damar yaralanmalarýnda tedavi yaklaþýmýmýzý ve kýsa dönem sonuçlarýmýzý paylaþmayý amaçladýk.
Method: Bu çalýþmada Ocak 2018 ile Temmuz 2023 tarihleri arasýnda elektif karýn ve pelvik cerrahi esnasýnda olan iyatrojenik damar yaralanmasý nedeniyle damar cerrahý tarafýndan müdahale edilen hastalar retrospektif olarak incelendi.
Bulgular: Çalýþmada ürolojik cerrahi giriþim uygulanan 21 (%29,2) olguda, jinekolojik cerrahi tedavi uygulanan 35 (%48,6) olguda ve batýn cerrahisi uygulanan 16 (%22,2) olguda iyatrojenik damar yaralanmasý meydana geldi. 29 hastada izole arteriyel yaralanma, 37 hastada izole venöz yaralanma ve 6 hastada hem arter hem de ven yaralanmasý vardý. 24 hastaya embolektomi uygulandý. Hastalarýn 22'sine primer sütür, 13'üne ven grefti ile uç uca anastomoz, 11'ine dacron/PTFE ile uç uca anastomoz yapýldý. 10 hastaya nativ ven uç uca anastomozu yapýldý. 30 günlük takiplere bakýldýðýnda 3 hastada arter týkanýklýðý, 2 hastada venöz tromboz olduðu görüldü. Hastanede ve 30 günlük takipte mortalite olmadý.
Sonuç: Elektif karýn ve pelvik ameliyatlarda damar yaralanmalarý nadiren de olsa görülür. Ancak gerçekleþtiðinde mortal seyredebilir. Bu nedenle özellikle kitle eksizyonlarý ve damar yakýnlýðý olan lenf nodu diseksiyonlarýnda ameliyat öncesi multidisipliner deðerlendirme vasküler komplikasyonlarý en aza indirecektir. (SETB-2024-03-048)

INTRODUCTION: Although rare, vascular injuries are common in elective abdominal or pelvic surgeries. When encountered, any problem in the relevant artery/vein (occlusion, stenosis, dissection, pseudoaneurysm or arteriovenous fistula) is associated with mortality and morbidity in both the short and long term. We aimed to share our treatment approach and short-term results for vascular injuries in elective surgery.
METHODS: In this study, the clinical data of patients who underwent elective abdominal and pelvic surgery performed by a vascular surgeon and who sustained iatrogenic vascular injury between January 2018 and July 2023 were retrospectively examined. All patients with no iatrogenic vascular injuries were excluded from the study.
RESULTS: In the present study, a total of 72 patients had iatrogenic vascular injuries and underwent vascular surgery. The average age of the patients was 50.8 ± 14.6 years. Twenty-eight (38.8%) of the patients were male, and 44 (61.1%) were female. Iatrogenic vascular injury occurred in 21 (29.2%) patients who underwent urologic surgical interventions, 35 (48.6%) who underwent gynecologic surgical treatments, and 16 (22.2%) who underwent abdominal surgeries. Twenty-nine patients had isolated arterial injuries, 37 patients had isolated venous injuries, and 6 patients had both arterial and vein injuries. Embolectomy was performed in 24 patients. Primary sutures were applied in 22 patients, end-to-end anastomosis with a vein graft was performed in 13 patients, and end-to-end anastomosis with Dacron/PTFE was performed in 11 patients. In 10 patients, native vein end-to-end anastomosis was performed. During the 30-day follow-up period, 3 patients experienced arterial occlusion, and 2 patients experienced venous thrombosis. There was no mortality in the hospital or during the 30-day follow-up period.
CONCLUSION: Vascular injuries rarely occur in elective abdominal and pelvic surgeries. However, when they happen, they are fatal. For this reason, preoperative, multidisciplinary evaluation will minimize the risk of vascular complications, especially in patients requiring mass excision and lymph node dissection with close vascular proximity.

Amaç: Proliferatif diyabetik retinopati (PDR) tedavisi için panretinal fotokoagülasyon (PRP) uygulanan hastalarda Navilas lazer ile konvansiyonel lazeri karþýlaþtýrarak aðrý algýsýný ve tedavi süresini deðerlendirmektir.
Yöntem: Bilateral yüksek riskli PDR hastalarýný içeren 40 hastadan oluþan bir çalýþma yapýldý. Her hastanýn bir gözüne konvansiyonel lazer, diðer gözüne ise Navilas lazer ile PRP tedavisi uygulandý. Tüm hastalarda lazer parametreleri, spot boyutu ve pulse süresi dahil olmak üzere standartlaþtýrýldý. Aðrý algýsý, ‘Verbal Rating Scale’ (VRS) ve ‘Visual Analogue Scale’ (VAS) kullanýlarak deðerlendirildi.
Bulgular: Navilas ve konvansiyonel lazer gruplarý arasýnda iþlem öncesi görme keskinliði, lens durumu, göz içi basýnç, cup-disk oraný ve kistik maküler ödem açýsýndan anlamlý farklýlýk bulunmadý. Lazer tedavi süresi Navilas lazer grubunda anlamlý derecede daha kýsa bulundu (517.3±48.78 saniye, p<0.001). Aðrý skorlarý (VAS ve VRS) Navilas lazer grubunda (sýrasýyla p<0.001, p=0.002) konvansiyonel lazer grubuna göre anlamlý derecede düþüktü. Hem Navilas hem de konvansiyonel lazer gruplarýnda VAS ve VRS skorlarý ile lazer süresi arasýnda korelasyon yoktu (p>0.05).
Sonuç: PDR hastalarýnda PRP için Navilas lazerin kullanýmý, konvansiyonel lazerlere kýyasla azalan aðrý ve hýzlý prosedürler gibi avantajlar sunmaktadýr. Bu bulgular, klinik kararlarýn optimize edilmesi için deðerli bir öngörü saðlamakta olup, diyabetik retinopati tedavisinde hastanýn uyumunu artýrabilir ve görme kaybý riskini en aza indirebilir. (SETB-2024-04-066)

Objective: To compare the pain perception and treatment duration in patients undergoing panretinal photocoagulation (PRP) for high-risk proliferative diabetic retinopathy (PDR) using Navilas laser versus conventional laser.
Methods: A study was conducted involving 40 patients with bilateral high-risk PDR. Each patient underwent PRP with conventional laser in one eye and Navilas laser in the other. Laser parameters, including spot size and pulse duration were standardized. Pain perception was evaluated using Verbal Rating Scale (VRS) and Visual Analogue Scale (VAS).
Results: The Navilas and conventional laser groups showed no significant differences in baseline visual acuity, lens status, intraocular pressure, cup-to-disc ratio, and cystoid macular edema. The duration of laser treatment was significantly shorter with Navilas laser group (517.3±48.78 second, p<0.001). Pain scores (VAS and VRS) were significantly lower in the Navilas laser group (p<0.001, p=0.002 respectively) than conventional laser group. There was no correlation between VAS and VRS scores and laser time in both the Navilas and conventional laser groups (p>0.05).
Conclusion: Utilizing the Navilas laser for PRP in PDR patients offers advantages over conventional lasers, including reduced pain and expedited procedures. These findings contribute valuable insights for optimizing clinical decisions, potentially enhancing patient compliance and minimizing the risk of visual deterioration in diabetic retinopathy treatment.

Amaç: Böbrek taþlarý birçok yöntemle tedavi edilmektedir, ancak 1-2 cm alt böbrek taþlarýnda hangi yöntemin tercih edilmesi gerektiði konusunda fikir birliði yoktur. Çalýþmamýzda alt renal pol 1-2 cm taþlarýnda mini (Perkütan Nefrolitotomi) PCNL ve (Retrogarad Ýntrarenal Cerrahi) RIRS sonuçlarýný araþtýrmayý amaçladýk.
Materyal-Metod: Yirmi dört Mini PCNL ve 55 RIRS hastasý çalýþmaya dahil edildi. Hastalarýn demografik verileri ve Non-Kontrast Bilgisayarlý Tomografi (NCCT)'deki taþ bilgileri kaydedildi. Her iki yöntemin taþsýzlýk durumu (SFR), ek tedavi ihtiyacý ve komplikasyonlarý karþýlaþtýrýldý.
Bulgular: Ameliyat süresi Mini PCNL'de 55.2±20.8 dk iken RIRS'de 70.7±36.5 dk idi ve istatistiksel olarak anlamlý derecede daha düþüktü (p=0.002). Hastanede kalýþ süresi Mini PCNL'de 2.4 ± 1.5 gün ve RIRS'de 1.3 ± 0.7 gün olup istatistiksel olarak anlamlý derecede uzundu (p=0.011). Ameliyat sonrasý 1. ay ve 3. ay taþsýzlýk oranlarýnda SFR mini PCNL grubunda daha yüksekti. Birinci ay SFR sýrasýyla %91,6 ve %54,5 iken, üçüncü ay taþsýzlýk oranlarý %95,8 ve %69,1 idi (p<0,001). Yeniden tedavi ihtiyacý mini PCNL grubunda istatistiksel olarak daha düþüktü (p<0.001). Komplikasyonlar açýsýndan, komplikasyon insidansý mini PCNL grubunda %16,6 (2 hastada aðrý, 1 hastada ateþ, 1 hastada kan transfüzyonu ihtiyacý) ve RIRS grubunda %21,8 (2 hastada aðrý, 8 hastada ateþ, 2 hastada sepsis) idi. Ýki grup arasýnda anlamlý bir fark vardý (p=0.008).
Sonuç: Mini PCNL daha yüksek SFR'ye, daha az yeniden tedavi ihtiyacýna ve daha az komplikasyona sahiptir. (SETB-2024-04-070)

Objective: Kidney stones are treated with many methods, but there is no consensus on which method should be preferred for 1-2 cm lower renal stones. In our study, we aimed to investigate the results of mini (Percutaneous Nephrolitotomy) PCNL and (Retrograde Intrarenal Surgery) RIRS in lower renal pole 1-2 cm stones.
Material-Methods: Twenty-four Mini PCNL and 55 RIRS patients were included in the study. Demographic data of the patients and information about stones on Non-Computed Tomography (NCCT) were recorded. Stone free status (SFR), need for additional treatment and complications of both methods were compared.
Results: Operative time was 55.2±20.8 min in Mini PCNL and 70.7±36.5 min in RIRS, which was statistically significantly lower (p=0.002). Length of hospital stay was 2.4 ± 1.5 days in the Mini PCNL and 1.3 ± 0.7 days in the RIRS, which was statistically significantly longer (p=0.011). In the postoperative 1st month and 3rd month stone-free rates (SFR) was higher in the mini PCNL group. While the 1st month SFR was 91.6% and 54.5%, the 3rd month stone-free rates were 95.8% vs 69.1%, respectively (p<0.001). The need for re-treatment was statistically lower in the mini PCNL group (p<0.001). In terms of complications, the incidence of complications was 16.6% (pain in 2 patients, fever in 1 patients, need for blood transfusion in 1 patient) in the mini PCNL group and 21.8% (pain in 2 patients, fever in 8 patients, sepsis in 2 patients) in the RIRS group. There was a significant difference between the two groups (p=0.008).
Conclusion: Mini PCNL have a higher SFR, less need for re-treatment and fewer complications.

Amaç: Çalýþmamýzda trakeal rekonstrüksiyon ameliyatlarýnda laringeal maske (LMA) ve orotrakeal entübasyon (OTI) kullanýmýnýn perioperatif mortalite ve morbidite açýsýndan karþýlaþtýrmayý amaçladýk.
Yöntemler: Haziran 2020 ile Haziran 2022 tarihleri arasýnda trakeal rekonstrüksiyon ameliyatý geçiren eriþkin hastalar retrospektif olarak çalýþmaya dahil edildi. Veri kaybý olan ve primer trakeal malignitesi olan hastalar çalýþma dýþý býrakýldý. Trakeal rekonstrüksiyon yapýlan hastalar iki gruba ayrýldý: grup LMA ve grup OTI.
Bulgular: Çalýþmaya dahil edilen toplam 57 hastadan OTI ve LMA gruplarýnda sýrasýyla 30 (%52,63) ve 27 (%47,37) hasta vardý. Entübe olarak yoðun bakým ünitesine transfer oraný ve yoðun bakým ünitesinde kalýþ süresi OTI grubunda LMA grubuna göre anlamlý olarak daha yüksekti (p=0. 014, p=0. 031); ayrýca, trakeal kültürlerde üreme OTI grubunda anlamlý olarak daha yüksekti (%23.33) (p=0. 007). Ameliyat sonrasý mortalite oranlarý her iki grupta da benzer gözlendi.
Sonuçlar: Trakeanýn uç uca anastomozunda gerilim olmamasý ve trakeal kontaminasyonun olmamasý baþarýlý bir cerrahi için hayati önem taþýdýðýndan, LMA uygulamasý OTI'ye göre daha üstün kabul edilebilir. Bu çalýþmada LMA tüm hastalarda baþarýyla uygulanmýþtýr. Anestezi yönetiminin amacý minimal invaziv giriþimle yeterli oksijenasyon ve normokarbiyi saðlamaktýr. Bu nedenle çalýþmamýzýn sonucuna göre trakeal rekonstrüksiyon cerrahisinde ilk seçenek olarak LMA kullanýmýný öneriyoruz. (SETB-2024-03-057)

Objective: To compare the usage of laryngeal mask airway (LMA) and orotracheal intubation (OTI), which are separate airway management methods in tracheal reconstruction surgeries, in terms of perioperative management, mortality, and morbidity.
Methods: Adult patients who underwent tracheal reconstruction surgery between June 2020 and June 2022 were included in the study, retrospectively. Patients with lost data or primary tracheal malignancy were excluded. Patients who underwent tracheal reconstruction were divided into two groups: LMA and OTI.
Results: Of a total of 57 included patients, the OTI and LMA groups had 30 (52.63%) and 27 patients (47.37%), respectively. The rate of intubated transfer to the intensive care unit and the length of stay in the intensive care unit were significantly higher in the OTI group (p=0. 014, p=0. 031) than those of the LMA group; further, in tracheal cultures, reproduction was also significantly higher in the OTI group (23.33%) (p=0. 007). The postoperative mortality rates were similar in both groups.
Conclusion: Since the absence of tension in end-to-end anastomosis of the trachea is vital for successful surgery, the LMA application (which has no tracheal contact) can be considered superior to OTI. In this study, LMA was successfully applied in all patients. Considering that the aim of anesthesia management should be to provide adequate oxygenation and normocarbia with minimally invasive intervention, we suggest airway management using LMA as the first option for tracheal reconstruction surgery because of the advantages described in this study.

Amaç: Kronik ekstremite tehdit edici iskemi (CTLI), iskemik istirahat aðrýsý, iyileþmeyen alt ekstremite veya ayak ülserasyonu veya gangren ile karakterize edilen periferik arter hastalýðýnýn karmaþýk bir formudur. Yüksek amputasyon riski, düþük yaþam kalitesi, morbidite ve mortalite ile iliþkilidir. Prognostik Beslenme Ýndeksi (PNI), albumin ve lenfosit düzeylerini kullanarak hesaplanan, immunolojik ve beslenme durumunu yansýtan bir gösterge olarak kabul edilir. Bu çalýþmanýn amacý, endovasküler tedavi gören CLTI'li hastalarda PNI düzeyleri ile mortalite arasýndaki iliþkiyi belirlemektir.
Yöntemler: Retrospektif incelenen bu çalýþmaya, üçüncü basamak bakým merkezimizde alt ekstremiteye endovasküler tedavi uygulanan CLTI'li hastalar dahil edilmiþtir. Hastalar, sað kalanlar ve hayatta kalmayanlar olmak üzere iki gruba ayrýldý. Mortalitenin baðýmsýz öngörücülerini belirlemek için lojistik regresyon analizleri yapýldý ve PNI ile mortalite arasýndaki iliþkiyi deðerlendirmek için Cox regresyon modeli kullanýldý. Sað kalým eðrileri, Kaplan-Meier yöntemi kullanýlarak tahmin edildi.
Bulgular: Çalýþmaya periferik arter hastalýðý olan ve endovasküler tedavi uygulanan toplam 113 hasta dahil edildi. Hayatta kalamayan grup (42 hasta), sað kalan gruptan (71 hasta) daha yaþlýydý (67,7±9,9’e karþý 62,9±10,9 p: 0,045) ve kronik böbrek yetersizliði (%42,9’e karþý %22,5 p: 0,023) ile kalp yetersizliði (%21,4’e karþý %8,5 p: 0,049) daha yaygýndý. PNI deðeri, hayatta kalamayan grupta, sað kalan gruptan daha düþüktü (35,9±5’e karþý 38,2±4,4 p: 0,012). Cox regresyon analizleri, düþük PNI'nin artmýþ mortalite ile iliþkili olduðunu gösterdi (HR=0.931, CI= 0.872-0.995, P=0.035). Tüm nedenlere baðlý mortaliteyi tahmin etmek için 37.009 kesme deðeri PNI için %64.3 duyarlýlýk, %64.8 özgüllük ve 0.642 AUC deðeri gösterdi. Kaplan-Meier analizi, daha yüksek PNI'nin daha iyi bir saðkalým ile iliþkili olduðunu destekledi.
Sonuç: Prognostik Beslenme Ýndeksi, Kronik Ekstremite Tehdit edici Ýskemi hastalarýnda mortalite ile baðýmsýz olarak iliþkilidir. (SETB-2024-02-029)

Background: Chronic Limb-Threatening Ischemia (CLTI) represents a complex manifestation of peripheral artery disease distinguished by symptoms such as ischemic rest pain, non-healing ulcers on the lower limb or foot, and the development of gangrene. CLTI is associated with a high risk of limb amputation, decreased quality of life, and substantial morbidity and mortality. The Prognostic Nutritional Index (PNI), which is calculated using albumin and lymphocyte levels, reflects the immunological and nutritional status. The objective of this study was to investigate the correlation between PNI levels and mortality among patients diagnosed with CLTI who underwent endovascular therapy.
Methods: Individuals diagnosed with CLTI who received endovascular therapy below the knee in our tertiary care center were enrolled in this retrospective study. The patients were divided into two groups: survivors and non-survivors. Logistic regression analyses were performed to detect independent predictors of mortality and using Cox regression model, we assesed the relationship between PNI and mortality. Survival curves were estimated using the Kaplan-Meier method.
Results: The study comprised 113 patients diagnosed with PAD who underwent EVT. The non-survivor group (42 patients) was older (62.9±10.9 vs. 67.7±9.9, p: 0.045) and had a higher prevalence of chronic renal failure (22.5% vs. 42.9%, p: 0.023) and congestive heart failure (8.5% vs. 21.4%, p: 0.049) than the survivor group (71 patients). The median PNI value was lower in the non-survivor group than in the survivor group (35.9±5 vs 38.2±4.4, p: 0.012). Cox regression analyses showed that Low PNI associated with increased mortality (HR=0.931, CI= 0.872-0.995, P=0.035). PNI cut-off of 37.009 showed 64.3 % sensitivity, 64.8 % specificity, and AUC of 0.642 for predicting all-cause mortality. Kaplan-Meier analysis supported higher PNI correlating with better survival.
Conclusion: The Prognostic Nutritional Index was independently associated with mortality among individuals diagnosed with Chronic Limb-Threatening Ischemia.

Amaç: Graves hastalýðý (GH) varlýðý ile papiller tiroid kanseri (PTK) geliþimi arasýnda hala net bir iliþki saptanamamýþtýr. Bu çalýþmanýn amacý tiroid nodülü ve GH olup PTK tanýsý alan hastalar ile tiroid nodülü olan fakat otoimmün tiroid hastalýðý olmayan PTK tanýlý hastalarýn klinik ve patolojik özelliklerini karþýlaþtýrmaktýr.
Yöntem: Çalýþma retrospektif olarak tasarlanmýþtýr ve total tiroidektomi geçiren ve PTK olduðu tespit edilen 239 hastadan oluþan bir kohortu içermektedir. Taný yaþý, hastalýk evresi, PTK alt tipleri, tümör boyutu, radyoaktif iyot kullanýmý, nodül ultrasonografik özellikleri ve PTK nüks riski GH olan ve olmayan hastalar karþýlaþtýrýldý.
Bulgular: 239 hastanýn 99'unda (%41) GH mevcutken, 140 hastada (otoimmün tiroid hastalýðý olmayan) sadece papiller tiroid karsinomu vardý. Papiller tiroid karsinomu ve Graves hastalýðý olan grupta tümör çapý anlamlý olarak daha küçüktü (1,45 ± 1,28 cm vs 1,81 ± 1,34 cm, p <0,05). Graves hastalýðý ve papiller tiroid karsinomu tanýsý alan gruplarda, papiller tiroid karsinomu tanýsý alan gruba kýyasla anlamlý derecede daha düþük multifokal tutulum oranlarý gözlendi (p <0,05). Otoimmün tiroid hastalýðý olmayan hastalarda klasik papiller tiroid karsinomu alt tipi prevalansý daha yüksekti (%39'a karþý %25,7, p<0,05). GH ve PTK içeren nodüllerin ultrasonografik özellikleri, GH içermeyen PTK’lý nodüllerden farklý deðildi.
Sonuç: Taný anýnda yapýsal nüks riski, PTK'ya GH eþlik ettiðinde tek baþýna PTK varlýðý ile benzer görünmektedir. Ayrýca, GH-PTK birlikteliðinde daha küçük tümör boyutlarýnýn ve daha az multifokalitenin varlýðý olumlu bir prognozun habercisi olabilir. (SETB-2024-02-031)

Objective: There is still no clear relationship between the presence of Graves' disease (GD) and the development of papillary thyroid carcinoma. The aim of this study was to compare the clinicopathologic features of patients diagnosed with papillary thyroid carcinoma (PTC) with thyroid nodules and GD and patients with PTC with thyroid nodules but without autoimmune thyroid disease.
Methods: The study designed as retrospective manner and included a cohort of 239 patients with PTC who underwent total thyroidectomy. Age at diagnosis, disease stage, PTC subtypes, tumor size, radioactive iodine use, nodule ultrasonographic features, and risk of PTC recurrence were compared between patients with and without GD.
Results: Of 239 patients, 99 (41%) had GD, while 140 patients (without autoimmune thyroid disease) had only PTC. The tumor diameter was significantly smaller in the group with PTC + GD (1.45 ± 1.28 cm vs 1.81 ± 1.34 cm, p < 0.05). Significantly lower multifocal involvement rates were observed in the PTC + GD group compared to PTC only group (p < 0.05). The prevalence of the classic papillary thyroid carcinoma subtype was higher in patients without autoimmune thyroid disease (39% vs. 25.7%, p<0.05). Ultrasonographic features of nodules with GD and PTC do not have different characteristics from those of nodules with PTC without GD.
Conclusion: The risk of structural recurrence at the time of diagnosis appears to be similar when PTC is accompanied by GD as compared to PTC alone. Furthermore, the presence of smaller tumor sizes and less multifocality in GD-PTC coexistence may indicate a better prognosis.

AMAÇ: Ailevi Akdeniz Ateþi (AAA) Doðu Akdeniz bölgesinde daha sýk görülen otoinflamatuar bir hastalýktýr. Literatürde inflamatuar süreçlerin vitamin D, B12 ve folat düzeylerini azalttýðýný gösteren çalýþmalar olmakla birlikte atak sýklýðýnýn vitamin düzeylere etkisi ile ilgili kýsýtlý veri mevcuttur. Çalýþmamýzda AAA atak sýklýðýnýn vitamin düzeylerine etkisinin deðerlendirilmesi amaçlandý.
YÖNTEM: Çalýþma grubuna 4-18 yaþ arasýndaki FMF hastalarý dahil edilirken ayný dönemde baþvurusu olan ve vitamin düzeylerine bakýlmýþ olan saðlýklý çocuklar da kontrol grubu olarak çalýþmaya dahil edildi. Çalýþma grubu atak sayýsýna göre 2 subgrupa bölümdü. Yýllýk atak sayýsý 2 ve altýnda olan hastalar atak grubu, 6 veya daha fazla olanlar ise sýk atak grubuna dahil edildi.
BULGULAR: Toplam 494 çocuk çalýþmaya dahil edildi. Çalýþma grubu 108’i atak, 225’i sýk atak grubunda olmak üzere toplam 333 AAA hastasýndan oluþmaktaydý. Kontrol grubuna 161 saðlýklý çocuk dahil edildi. Vitamin düzeylerinin medyan ve çeyreklikleri sýk atak, atak ve kontrol grubunda sýrasýyla vitamin D için 14.3 (9.57-18.9), 14.85 (10.12-21.77), ve 14.95 (9.92-20.12) ng/ml, Vitamin B12 için 320 (238-415), 328 (250.25-439.25), and 373 (273.75-519.25) pg/ml, ve folik asit için 6 (5.13-8.12), 6.8 (5.36-8.9), and 7 (5.3-9.9) ng/ml olarak hesaplandý. Vitamin D ve folat düzeylerinde gruplar arasýnda anlamlý fark görülmedi (Sýrasýyla p=0.436 ve p=0.25). Vitamin B12 düzeyleri çalýþma grubunda anlamlý derecede daha düþük olarak saptanmakla birlikte atak sýklýðýna göre B12 düzeylerinde farklýlýk saptanmadý (Sýrasýyla p=0.001 ve p=0.92).
SONUÇ: Atak sýklýðýnýn Vitamin D, B12 ve folat düzeylerine etkisi olmadýðý görüldü. Vitamin B12 düzeyinin çalýþma grubunda anlamlý derecede düþük olsa da bütün gruplarda normal sýnýrlarda olmasý hastalarýn dengeli beslenme alýþkanlýklarý ile açýklanabilir. (SETB-2024-03-047)

BACKGROUND: Familial Mediterranean fever (FMF) is an autoinflammatory disease more commonly observed in the Eastern Mediterranean region. Studies have shown that inflammatory processes may decrease vitamin D, vitamin B12 and folate levels, but there is no clear data on the effect of attack frequency on these levels. Our study aimed to evaluate the effect of FMF attack frequency on vitamin levels.
MATERIALS AND METHODS: FMF patients aged between 4-18 years were considered as the study group, while healthy children who had vitamin levels during the same period were considered as the control group. The study group was further subgrouped according to the number of attacks. Those experiencing 2 or fewer attacks per year are classified as the attack group, while those experiencing 6 or more attacks per year are classified as the frequent attack group.
RESULTS: A total of 494 subjects were included. The study group was composed of 333 FMF patients,108 of them in the attack group and 225 in the frequent attack group. Control group included 161 children. The median and interquartile range (IQR: P25-75) in the frequent attack, attack, and control groups for 25(OH)D levels were 14.3 (9.57-18.9), 14.85 (10.12-21.77), and 14.95 (9.92-20.12) ng/ml, for B12 levels were 320 (238-415), 328 (250.25-439.25), and 373 (273.75-519.25) pg/ml, and for folate levels were 6 (5.13-8.12), 6.8 (5.36-8.9), and 7 (5.3-9.9) ng/ml, respectively. There is no significant difference between groups for 25(OH)D and folate (p=0.436 and p=0.25, respectively). Vitamin B12 levels are significantly lower in study group (p=0.001) but there is no difference according to attack frequency (p=0.92).
CONCLUSION: There is no effect of attack frequency on 25(OH)D, vitamin B12 and folate levels. The fact that vitamin B12 levels are within normal limits in patients with FMF may be explained by the adequate dietary habits of these patients.

Amaç: Koroner mikrovasküler disfonksiyon toplumun büyük bir kýsmýnda mevcut olup, birçok durumda patolojik ve prognostik bir role sahip olduðu gösterilmiþtir. Bu nedenle, bilhassa seçilmiþ popülasyonlarda mikrovasküler disfonksiyonun erken tespiti önem arz etmektedir. Bu çalýþmanýn amacý, prehipertansif bireylerde, galaninin koroner akým rezervi (KAR) ile iliþkisini araþtýrarak mikrovasküler disfonksiyon tespiti için bir belirteç olarak kullanýlýp kullanýlamayacaðýný belirlemektir.
Yöntem: Bu prospektif çalýþmaya 50 prehipertansif ve 50 normotansif olmak üzere toplam 100 katýlýmcý dahil edilmiþtir. Ayrýntýlý transtorasik ekokardiyografi yapýlarak koroner akým rezervleri ve serum galanin düzeyleri ölçülmüþtür.
Bulgular: Prehipertansif grupta KAR anlamlý olarak daha düþüktü (p<0.001). Galanin deðerlerininde prehipertansif grupta sayýsal olarak daha düþük olmasýna raðmen gruplar arasýndaki fark istatistiksel anlamlýlýða ulaþmadý (p=0.062). KAR ile galanin arasýnda anlamlý bir korelasyon saptanmadý (r=-0.161 p=0.11)
Sonuç: Prehipertansiflerde KAR deðerlerinin daha düþük olmasý, hipertansiyon geliþmese bile normotansif deðerlerin üzerinde mikrovasküler disfonksiyonun baþladýðýný göstermektedir. Galaninin gruplar arasýnda istatistiksel olarak farklý saptanmamasý ve KAR ile arasýnda korelasyon saptanmamasýnýn nedeni çalýþma popülasyonunun nispeten küçüklüðünden kaynaklanabilir. Galanin, prehipertansiyon ve mikrovasküler disfonksiyon arasýndaki iliþki, geniþ çaplý popülasyon çalýþmalarý yapýldýðýnda daha net hale gelecektir. (SETB-2024-01-023)

Objective: Coronary microvascular dysfunction is present in large percentage of the population, and it has been shown to have a pathological and prognostic role in many conditions. Therefore, early detection of microvascular dysfunction is important, especially in selected populations. The aim of this study was to investigate the association of galanin with coronary flow reserve (CFR) in prehypertensive individuals to determine whether it can be used as a marker to detect microvascular dysfunction.
Methods: A total of 100 participants, 50 prehypertensive and 50 normotensive were included in this prospective study. Serum galanin levels were measured and CFR were calculated by detailed transthoracic echocardiography.
Results: CFR was significantly lower in the prehypertensive group (p<0.001). Also galanin values were numerically lower in the prehypertensive group, but the difference between the groups did not reach statistical significance (p=0.062). There was no significant correlation between CFR and galanin (r=-0.161 p=0.11)
Conclusion: Lower CFR values in prehypertensives suggest that, microvascular dysfunction starts above normotensive values even if hypertension not develop. The reason why low galanin levels were not statistically significant in prehypertensives and no correlation was found between Galanin and CFR may be due to the small study population. Relationship between galanin, prehypertension and microvascular dysfunction will become clearer if large-scale population studies are carried out.

Amaç: Koronavirüs Hastalýðý 2019 (COVID-19) da hematolojik, inflamatuar ve biyokimyasal parametrelerin biyobelirteç olarak rolü, erken evrede riskli hastalarý belirlemede ve prognozdaki yeri araþtýrýlmýþtýr.
Metot: Çalýþmaya ülkemizdeki ilk dalgada COVID-19 ön tanýsý ile yatýrýlarak takip edilen hastalar dahil edildi. Demografik ve klinik özellikler ile beraber baþvuru, üçüncü, yedinci, 14. gündeki tam kan sayýmý, C reaktif protein (CRP), prokalsitonin (PCT), fibrinojen (FIB), ferritin, albümin (ALB), laktat dehidrogenaz (LDH) düzeyleri incelendi. Hastane takibinde ölüm gerçekleþmesine göre hastalar gruplandýrýlarak karþýlaþtýrýldý. Mortalite üzerine anlamlý düþünülen deðiþkenler tek ve çok deðiþkenli lojistik regresyon modelleri ile incelendi.
Bulgular: Çalýþma 273 (56,3%)’ü erkek, 212 (43,72%)’si kadýn olmak üzere toplam 485 hasta ile gerçekleþtirildi. Hastalarýn yaþ ortalamasý 58±16,2 idi ve 71%’i hafif-orta, 29%’u ciddi-kritik hastalýk grubunda idi. Hastalýk þiddeti, yoðun bakým ünitesi (YBÜ) takip ihtiyacý ve ölüm geliþimi; yaþ, eþlik eden hastalýk, nötrofil, lökosit, nötrofil lenfosit oraný (NLR), PCT, CRP, ferritin, LDH deðerleri ile pozitif korele iken, lenfosit (LE), ALB, hemoglobin (HGB) deðerleri ile negatif korele olarak saptandý. Çok deðiþkenli analizde hastane baþvurusunda PCT yüksekliði (OR: 6,96 [1,63;39,65]), LDH ≥ 352U/L (OR: 4,35 [1,23;16,61]), LE < 0,810 × 109/L (OR: 3,0 [1,16;7,85]) ve ileri yaþ (OR: 1,08 [1,03;1,14]) baðýmsýz olarak hastane içi ölüm ile iliþkili bulundu. Hemogram ve akut faz reaktaný takibinde PCT, CRP ve LDH ölüm öngörüsü için sýrasýyla en deðerli bulunan göstergelerdi (Üçüncü gün sýrasýyla EAA: 0,90;0,83;0,83 ve yedinci gün EAA: 0,95;0,90;0,89). Sonuç: Çalýþmamýzda hastaneye baþvuruda sýrasýyla lökosit, lenfosit, NLR, CRP, PCT, ferritin, albümin ve LDH’ nin kötü prognozu ön görmede deðerli olduðu saptandý. Ayrýca takipte PCT, LDH ve CRP artýþlarýnýn hastane içi ölümü öngörmede ve yakýn takip gereken hastalarý belirlemede kullanýlabileceði belirlendi. (SETB-2024-01-020)

Objectives: The role of hematologic, inflammatory and biochemical parameters as biomarkers, their role in identifying risky patients in the early stage and their role in prognosis in COVID-19 Coronavirus disease 2019 (COVID-19) were investigated.
Method: The study included patients who were hospitalized and followed up with a prediagnosis of COVID-19 in the first wave in our country at the XXXXXX. Demographic and clinical characteristics as well as complete blood count, C reactive protein (CRP), procalcitonin (PCT), fibrinogen (FIB), ferritin, albumin (ALB), lactate dehydrogenase (LDH) levels on admission, third, seventh and 14th days were analyzed. Patients were grouped and compared according to the occurrence of death during hospital follow-up. Variables considered significant on mortality were analyzed with univariate and multivariate logistic regression models.
Results: The study was conducted with 485 patients, 273 (56.3%) males and 212 (43.72%) females. The mean age of the patients was 58±16.2 years, and 71% were in the mild-moderate and 29% in the severe-critical disease group. Disease severity, the need for intensive care unit (ICU) follow-up, and the development of death were positively correlated with age, comorbidity, neutrophil (NE), leukocyte, neutrophil-lymphocyte ratio (NLR), PCT, CRP, ferritin, LDH values, and negatively correlated with lymphocyte (LE), ALB and hemoglobin (HGB) values. In multivariate analysis, elevated PCT at hospital admission (OR: 6.96 [1.63;39.65]), LDH ≥ 352U/L (OR: 4.35 [1.23;16.61]), LE < 0.810 × 109/L (OR: 3.0 [1.16;7.85]) and advanced age (OR: 1.08 [1.03;1.14]) were independently associated with in-hospital death. In hemogram and acute phase reactant monitoring, PCT, CRP and LDH were the most valuable markers for predicting death, respectively (third-day AUC: 0.90;0.83;0.83 and seventh-day AUC: 0.95;0.90;0.89, respectively).
Conclusion: In our study, leukocytes, lymphocytes, NLR, CRP, PCT, ferritin, albumin and LDH at admission were valuable in predicting poor prognosis. In addition, it was determined that increases in PCT, LDH and CRP during follow-up could be used to predict in-hospital death and to identify patients requiring close follow-up.

Amaç: Biliþsel bozukluk, Parkinson Hastalýðýnýn (PH) yaygýn bir motor dýþý semptomudur ve hastanýn yaþam kalitesini önemli ölçüde etkiler. Saat Çizme Testi (SÇT) planlama, organizasyon ve dikkat, hafýza ve görsel-uzamsal beceriler gibi yürütücü iþlevler de dahil olmak üzere bir dizi biliþsel beceriyi deðerlendirir. Bu çalýþmanýn amacý, PH'da biliþsel bozukluðun teþhisinde CDT'nin duyarlýlýðýný belirlemektir.
Yöntem: 2018-2022 yýllarý arasýnda demans (30 hasta) veya hafif biliþsel bozukluk (14 hasta) tanýsý konan 44 PH hastasýnýn (16 kadýn, 28 erkek) kayýtlarý incelenmiþtir. Bu hastalar, 106 saðlýklý kontrol ile karþýlaþtýrýlmýþtýr. Ayrý bir araþtýrmacý, yaþ ve eðitim düzeyi hariç diðer tüm hasta verilerinin gizliliðini koruyarak hastalarýn SÇT puanlarýný deðerlendirmiþtir.
Bulgular: 44 PH hastasý arasýnda hafif biliþsel bozukluðu olan iki kiþi SÇT'de normal olarak deðerlendirilirken, tüm PH demans vakalarý yalnýzca SÇT aracýlýðýyla tespit edilmiþtir. Saðlýklý kontrol grubunda 106 kiþiden 72'si herhangi bir biliþsel þikayet bildirmezken, 34 kiþi (%32,1) kör bir araþtýrmacý tarafýndan deðerlendirilen biliþsel þikayetler bildirmiþtir. SÇT'nin pozitif öngörü deðeri %55,3 ve negatif öngörü deðeri %97,3 olarak hesaplanmýþtýr. Duyarlýlýk %95,5 ve özgüllük %67,9 olarak hesaplanmýþtýr.
Sonuçlar: Bulgular, SÇT'nin kognitif defisiti olan PH hastalarýnda kognitif bozukluðu saptamada hassas olduðunu göstermektedir. SÇT etkili bir hýzlý tarama aracý olarak hizmet ederken, yüksek skorlar biliþsel bozukluðun olmadýðýný gösterir, ancak düþük skorlar tek baþýna kesin demans tanýsý için yetersizdir. Kapsamlý nörolojik deðerlendirme ve ayrýntýlý kognitif deðerlendirme demans tanýsýný doðrulamak için gerekli olmaya devam etmektedir. (SETB-2024-05-097)

Objective: Cognitive impairment is a prevalent non-motor symptom of Parkinson's Disease (PD), significantly impacting patient quality of life. The Clock Drawing Test (CDT) evaluates cognitive abilities, including planning, organization, and executive functions such as attention, memory, and visuospatial skills. This study aimed to determine the sensitivity of the CDT in diagnosing cognitive impairment in PD.,
Method: We reviewed the records of 44 PD patients (16 female, 28 male) diagnosed with dementia (30 patients) or mild cognitive impairment (14 patients) between 2018 and 2022. These patients were compared to 106 visitors to the neurological outpatient clinic, serving as a control group. A separate researcher assessed the patients' CDT scores, maintaining confidentiality of all other patient data except age and education level.
Results: Among the 44 PD patients, two with mild cognitive impairment were rated as normal on usual, while all PD dementia cases were identified solely through the CDT. In the healthy control group, 72 out of 106 individuals reported no cognitive complaints, whereas 34 individuals (32.1%) reported cognitive complaints as assessed by a blind investigator. The CDT demonstrated a positive predictive value of 55.3% and a negative predictive value of 97.3%. Sensitivity was calculated at 95.5%, and specificity was 67.9%.
Conclusion: The findings suggest that the CDT is sensitive in detecting cognitive impairment in PD patients with cognitive deficits. While the CDT serves as an effective rapid screening tool, high scores indicate the absence of cognitive impairment, but low scores alone are insufficient for a definitive diagnosis of dementia. Comprehensive neurological evaluation and detailed cognitive assessment remain essential for confirming dementia diagnoses.

Amaç: Güncel kýlavuzlar, 10 yaþýn üzerindeki KF’li hastalarýn yýllýk olarak OGTT ile deðerlendirilmesi gerektiðini önermektedir. Bu çalýþmada merkezimizde kistik fibrozis (KF) tanýsýyla takip edilen 10 yaþ üstü hastalarda OGTT sonuçlarýnýn deðerlendirilmesi amaçlandý.
Gereç ve yöntemler: Çalýþmaya OGTT uygulanan 10 yaþ ve üzeri 46 KF hastasý dahil edildi. Cinsiyet, taný yaþý, antropometrik ölçümler, akciðer fonksiyonu (%FEV1) ve OGTT sonuçlarý gibi veriler elde edildi. Analizde normal glukoz toleransý(NGT) ve anormal glukoz toleransý(AGT) olan hasta gruplarý karþýlaþtýrýldý.
Bulgular: Olgularýn 37’sinde (%80,4) NGT, 9’unda (%19,5) AGT saptandý. Normal glukoz tolerans grubundaki olgularýn median açlýk glukoz ve OGTT sýrasýnda alýnan 120.dakikadaki ortalama glukoz düzeyleri AGT grubuna göre daha düþük saptandý (p<0,005). Anormal glukoz tolerans grubundaki olgularýn, ortalama vücut aðýrlýðý, boy, VKÝ SDS deðerleri, FEV1 yüzdesi NGT’li olgu grubuna göre daha düþük saptanmakla beraber aradaki fark istatistiksel olarak anlamlý bulunmadý (p>0,05).
Sonuç: 10 yaþ ve üzeri KF’li yaklaþýk 5 hastadan 1'inde AGT tespit ettik. AGT’li hastalarýn neredeyse yarýsýnýn (%44,4) açlýk kan þekerinin normal olduðu görüldü. Bu nedenle KF’li hastalarda açlýk kan þekeri yerine OGTT ile kistik fibrozis iliþkili diyabet taramasý yapýlmalýdýr. (SETB-2024-02-030)

Aim: Current guidelines suggest that patients with CF, who are over the age of 10, should be annually evaluated with OGTT. In this study, it was aimed to evaluate the OGTT results in patients above the age of 10, who were followed up in our center with the diagnosis of Cystic fibrosis (CF).
Materials and Methods: In the study, 46 patients with CF at the age of 10 and above, who underwent OGTT were included. Data such as gender, age at diagnosis, anthropometric measurements, lung function(FEV1 %) and the OGTT results were obtained. In the analysis, the patient groups with normal glucose tolerance(NGT) and abnormal glucose tolerance(AGT) were compared.
Results: NGT was found in 37(80.4%) of the patients, and AGT was found in 9(19.5%) of the patients. The median fasting glucose levels of the patients in the NGT group and the mean glucose levels measured at 120 minutes in the OGTT were found to be lower compared to the patients in the AGT group(p<0.005). Although the mean body weight, height, VKÝ-SDS, FEV1in the AGT group were found to be lower than the patients in the NGT group, the difference was not statistically significant (p>0.05).
Conclusion: We detected AGT in approximately in 1 out of 5 patients with CF who were at the age of 10 and above. Almost half (44.4%) of the patients with AGT were found to have normal fasting blood glucose levels. Therefore, Cystic fibrosis-related diabetes screening should be performed with OGTT instead of fasting blood glucose in patients with CF.

Kardiyak rabdomyom; sýklýkla fetal ekokardiyografi ile taný alabilen, infant döneminin en sýk primer kalp tümörüdür. Ýyi huylu olarak adlandýrýlan bu tümörün kalp tutulumu farklý lokalizasyonlarda görülebilmektedir. Kalbin sol ventrikülünde, sað ventrikülünde ya da septumda yerleþebilen rabdomyom, çoðunlukla multipledir. Tümörün seyrinde spontan gerileme olabilmekle birlikte, hemdinamik bozukluklar, aritmiler ve ani ölüm de bildirilmiþtir. Hayatý tehdit edici ventrikül çýkým yolu darlýklarýnda, kalp yetmezliðinde ve aritmilerde cerrahi tedavi ön plana çýkmaktadýr. Olgumuzda, ciddi sol ventrikül çýkým yolu darlýðýna neden olan rabdomyoma sahip yenidoðandaki baþarýlý cerrahi tedavi yaklaþýmýmýzý sunmayý amaçladýk. (SETB-2023-12-240)

Cardiac rhabdomyoma is the most common primary cardiac tumour in infants and can be diagnosed by fetal echocardiography. This benign tumour can be found in various locations within the heart, including the left ventricle, right ventricle, or septum, and is typically multiple. While spontaneous regression may occur, haemodynamic disorders, arrhythmias, and sudden death have also been reported. Surgical treatment is recommended for life-threatening ventricular outflow tract stenosis, heart failure, and arrhythmias. This case report presents a successful surgical treatment approach in a newborn with rhabdomyoma that caused severe left ventricular outflow tract stenosis.

(SETB-2024-02-036)